bluuebunny/crossref_metadata_2025 huggingface dataset:
Complement-Mediated Thrombotic Microangiopathy Associated with Lupus Nephritis Treated with Eculizumab: A Case Report
Authors: Torres Everardo Arias , Chang Yongen , Desai Sheetal , Chang Ian , Zuckerman Jonathan E. , Burwick Richard , Kalantar-Zadeh Kamyar , Hanna Ramy M.
Published: March 2021

Thrombotic microangiopathies (TMAs) involve multiple organ systems due to the presence of microangiopathic hemolysis. One such condition, atypical hemolytic uremic syndrome (aHUS), is a complement-mediated process that is part of a spectrum of disorders that have underlying complement dysfunction of the alternative pathway due to overactivity or decreased self-nonself discrimination by innate immunity. Complement-amplifying conditions such as pregnancy may unmask a diagnosis of aHUS. We present an important case of a pregnant 23-year-old Hispanic female who presented in mid-gestation (21 weeks) with an initial diagnosis of systemic lupus erythematosus (SLE) complicated by aHUS. She met clinical criteria for aHUS on presentation and was found to have a pathogenic CFHR1–3 homozygous deletion. She has been treated with intravenous and oral steroids, cyclophosphamide, subsequently also with plasma exchange, and finally with eculizumab with partial improvement in renal function. This case adds to the emerging literature showing that SLE and aHUS (or complement-mediated TMA) can be successfully treated with C5 blockade.
Oral Pycnogenol® Intake Benefits the Skin in Urban Chinese Outdoor Workers: A Randomized, Placebo-Controlled, Double-Blind, and Crossover Intervention Study
Authors: Zhao Hua , Wu Jinhao , Wang Nan , Grether-Beck Susanne , Krutmann Jean , Wei Liu
Published: March 2021

Background: Oral supplementation with a standardized extract from the bark of the French pine (Pycnogenol®) has been reported to benefit the skin. It might thus represent an easy-to-use strategy to improve the skin health of individuals who are exposed to considerable environmental stress in large urban areas. Objective: We investigated if oral intake of Pycnogenol® can benefit the skin of Han Chinese working outdoors in Beijing, China. Methods: In a monocentre, double-blind, randomized, placebo-controlled, and crossover study, the effects of Pycnogenol® intake (2 × 50 mg/day for a total of 12 weeks) on a variety of skin physiological parameters was studied in Chinese subjects (n = 76), from spring to autumn, who were working outdoors in Beijing, China. Results: During the intervention period, study subjects were constantly exposed to increased levels of particulate matter (PM)2.5 as well as seasonal changes in humidity and temperature. Despite this environmental stress, Pycnogenol® intake prevented (i) a decrease in the skin hydration, (ii) transepidermal water loss (TEWL), and (iii) skin darkening during the dry autumn season. In addition, Pycnogenol® intake improved (iv) viscoelastic skin properties such as gross elasticity and elastic recovery irrespective of the season. These beneficial effects were not observed if the same subjects were supplemented with placebo. Conclusion: Oral intake of Pycnogenol® benefits the skin in Han Chinese, who are working outdoors under considerable environmental stress.
Frequency of Cytomegalovirus Viral Load in Iranian Human Immunodeficiency Virus-1-Infected Patients with CD4+ Counts <100 Cells/mm3
Authors: Jabbari Mohammad Reza , Soleimanjahi Hoorieh , Shatizadeh Malekshahi Somayeh , Gholami Mohammad , Sadeghi Leila , Mohraz Minoo
Published: March 2021

Objectives: The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count <100 cells/mm3 and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. Methods: This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count <100 cells/mm3, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). Results: Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (p value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (p < 0.02). Conclusions: We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count <100 mm3/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.
Impact of Comorbidity Burden on Cognitive Decline: A Prospective Cohort Study of Older Adults with Dementia
Authors: Kao Sheng-Lun , Wang Jen-Hung , Chen Shu-Cin , Li Yu-Ying , Yang Ya-Lin , Lo Raymond Y.
Published: March 2021

Introduction: The lack of longitudinal data of comorbidity burden makes the association between comorbidity and cognitive decline inconclusive. We aimed to measure comorbidity and assess its effects on cognitive decline in mild to moderate dementia. Methods: This was a prospective cohort study. The participants were enrolled from the Hualien Tzu Chi Hospital between January 2015 and December 2018. We enrolled 175 older adults with mild to moderate dementia and conducted in-person interviews to follow-up comorbidity and cognitive function annually. The comorbidity burden indices included Cumulative Illness Rating Scale for Geriatrics (CIRS-G), Charlson Comorbidity Index (CCI), and Medication Regimen Complexity Index (MRCI), and cognitive function was measured by Mini-Mental State Examination (MMSE) and clock drawing test. We employed the generalized estimating equations to assess the longitudinal effect of time-varying comorbidity burden on cognitive decline after adjusting for age, sex, and education. Results: Most patients were diagnosed with Alzheimer’s disease (88.6%) and in the early stage of dementia (Clinical Dementia Rating [CDR] = 0.5, 57.1%; CDR = 1, 36.6%). Multimorbidity was common (median: 3), and the top 3 most common comorbidities were osteoarthritis (67.4%), hypertension (65.7%), and hyperlipidemia (36.6%). The severity index of CIRS-G was significantly associated with cognitive decline in MMSE after adjusting for age, sex, and education. CCI and MRCI scores were, however, not associated with cognitive function. Conclusion: The severity index of CIRS-G outperforms CCI and MRCI in reflecting the longitudinal effect of comorbidity burden on cognitive decline in mild to moderate dementia.
Blood Donation-Related Adverse Reactions: Results of an Online Survey among Donors in Germany (2018)
Authors: Orru’ Stefano , Poetzsch Kay , Hoffelner Marcus , Heiden Margarethe , Funk Markus B. , Keller-Stanislawski Brigitte , Oberle Doris
Published: March 2021

Introduction: According to German legislation, reports of suspected serious adverse reactions (AR) associated with the donation of blood and its components are continuously being evaluated by the Paul-Ehrlich-Institut. This survey aimed at providing a more complete picture of the AR associated with the donation of blood and blood components. Materials and Methods: Eligible donors had the opportunity to anonymously report all AR occurring during or after their last donation by completing an online questionnaire. Reported AR were classified according to the Standard for Surveillance of Complications Related to Blood Donation. Donors’ self-assessment of AR seriousness was compared with the official severity classification as laid down by German legislation. Besides a descriptive statistical analysis, a multiple logistic analysis was performed to identify risk factors for AR. Results: A total of 8,138 data records were evaluated. Slightly more males (57.9%) participated in the survey and, except for donors aged ≥60 years, all age groups were equally represented. The majority of participants were whole blood donors (85.4%), repeat donors (97.2%), and stayed under observation in the blood establishment (BE) for more than 5 min (63.1%) after donation. Most participants did not report any reaction (72.5%), whereas 2,237 reported at least one AR (27.5%), 475 of whom underwent apheresis and 1,762 donated whole blood. Most AR occurred after leaving the BE (64.4%). Only a minority of participants required medical treatment (5.1%) or assessed the experienced AR as serious (3.9%). The most frequently reported donor AR were haematoma and other local reactions (57.6%). Vasovagal reactions without and with loss of consciousness were developed in 17 and 2% of the participants, respectively, whilst 7.6% experienced citrate reactions. New AR (i.e., allergic reactions and symptoms associated with iron deficiency) were reported as well. The occurrence of AR was linked to risk factors (i.e., female gender, young age, first-time donation, and thrombocytapheresis). Discussion: This survey yielded a more comprehensive AR spectrum, revealed a prolonged time to symptom onset, and identified risk factors for AR. This novel information could be implemented in an amended informed consent addressing common and rare AR.
Community mobility reports predict the national spread of COVID-19 in Indonesia in the new normal era
Authors: Ramadhan Muhammad Syahrul , Syakurah Rizma Adlia
Published: March 2021

Indonesia government encouraging to new normal life with obeys the health protocol. In Malaysia, the new normal had a significant impact on mobility trends. This study aimed to analyze the community mobility trend (including six categories) and coronavirus disease (COVID-19) daily cases in Indonesia in new normal era. An observational analytic using cross-sectional design. The community mobility data, include mobility trends for six different location categories, were obtained from Google COVID-19 Community Mobility Reports from May 15-July 14, 2020. The Indonesian’s COVID-19 daily cases data were taken from (http://covid19.go.id//) from May 15-July 17, 2020. Time-lag correlation to analyzed community mobility of each location category and COVID-19 daily cases in Indonesia using Pearson Correlation with significance ≤0.05. Recreation, parks, and transit stations have positively strong to very strong, while the residential has negatively strong, and the grocery and pharmacy and workplaces were positively weak to moderate correlations. The community mobility was significantly correlated with the COVID-19 transmission in Indonesia during new normal era, especially in transit stations, retail and recreation. Indonesia government is expected to improve their effort to manage the COVID-19 transmission and consider new policy to curb the COVID-19 transmission.
Effect of acute submaximal physical exercise before decompression dive on tumor necrosis factor alpha concentration among male trained divers
Authors: Chikih Chikih , Suryokusumo Guritno , Sulistomo Astrid
Published: March 2021

The increase of inflammatory biomarkers due to decompression dive is one of the factors that could cause decompression sickness (DCS), one of them is tumor necrosis alpha (TNFα). According to the preconditioning theory, exercise before dive can reduce amount of gas bubble to prevent DCS. This study aimed to prove that exercise before diving can prevent increase of TNFα. This study employed quasi-experimental design with trained male divers. The subject divided into two groups, treatment and control. The treatment group got submaximal exercise with 70% heart rate intensity, using cycle ergometer with young men's Christian association (YMCA) procedure modify by Guritno, 24 hours before decompression dive 280 kPa bottom time 80 minute with US-NAVY table, whereas the control group only do decompression dive. TNFα expression was checked three times, at beginning of study, before dive and after dive. In treatment group there was insignificant decrease TNFα, from 7.06±1.85pg./ml to 6.75±1.81pg./ml, whereas the control group showed a significant increased TNFα, from 8.22 (1.45 to 13.11)pg./ml to 8.39 (1.73 to 12.18)pg/ml, and significant difference was found between the mean difference for two groups p<0.05. It can be concluded that acute submaximal exercise prevents an increase of TNFα after single dive decompression to prevent possibility occurring DCS).
Intention on food safety among food handlers at the beach culinary tourism area
Authors: Rustiawan Asep , Suryani Dyah
Published: March 2021

Food safety remains a public health issue in developing countries. The theory of planned behavior (TPB) was applied to predict food handlers' intentions to perform safe food-handling practices in food processing. This was a quantitative research with observational analytic methods, using cross sectional approach. The sample consisted of 80 food handlers of locally-run seafood stalls along the coast of Bantul Regency, Special Region Yogyakarta, Indonesia. Data analysis employed Chi-square test. The results showed a very strong relationship between attitudes, subjective norms, and self-efficacy with the food handler's intention to perform hygienic food safety. This study suggested that food handlers must have a strong intention to perform safe food-handling practicing in processing food to protect consumers from potential foodborne diseases.
Fontan‐Associated Dyslipidemia
Authors: Lubert Adam M. , Alsaied Tarek , Palermo Joseph J. , Anwar Nadeem , Urbina Elaine M. , Brown Nicole M. , Alexander Craig , Almeneisi Hassan , Wu Fred , Leventhal Andrew R. , Aldweib Nael , Mendelson Michael , Opotowsky Alexander R.
Published: March 2021

Background

Hypocholesterolemia is a marker of liver disease, and patients with a Fontan circulation may have hypocholesterolemia secondary to Fontan‐associated liver disease or inflammation. We investigated circulating lipids in adults with a Fontan circulation and assessed the associations with clinical characteristics and adverse events.

Methods and Results

We enrolled 164 outpatients with a Fontan circulation, aged ≥18 years, in the Boston Adult Congenital Heart Disease Biobank and compared them with 81 healthy controls. The outcome was a combined outcome of nonelective cardiovascular hospitalization or death. Participants with a Fontan (median age, 30.3 [interquartile range, 22.8–34.3 years], 42% women) had lower total cholesterol (149.0±30.1 mg/dL versus 190.8±41.4 mg/dL,
P
<0.0001), low‐density lipoprotein cholesterol (82.5±25.4 mg/dL versus 102.0±34.7 mg/dL,
P
<0.0001), and high‐density lipoprotein cholesterol (42.8±12.2 mg/dL versus 64.1±16.9 mg/dL,
P
<0.0001) than controls. In those with a Fontan, high‐density lipoprotein cholesterol was inversely correlated with body mass index (
r
=−0.30,
P
<0.0001), high‐sensitivity C‐reactive protein (
r
=−0.27,
P
=0.0006), and alanine aminotransferase (
r
=−0.18,
P
=0.02) but not with other liver disease markers. Lower high‐density lipoprotein cholesterol was independently associated with greater hazard for the combined outcome adjusting for age, sex, body mass index, and functional class (hazard ratio [HR] per decrease of 10 mg/dL, 1.37; 95% CI, 1.04–1.81 [
P
=0.03]). This relationship was attenuated when log high‐sensitivity C‐reactive protein was added to the model (HR, 1.26; 95% CI, 0.95–1.67 [
P
=0.10]). Total cholesterol, low‐density lipoprotein cholesterol, and triglycerides were not associated with the combined outcome.

Conclusions

The Fontan circulation is associated with decreased cholesterol levels, and lower high‐density lipoprotein cholesterol is associated with adverse outcomes. This association may be driven by inflammation. Further studies are needed to understand the relationship between the severity of Fontan‐associated liver disease and lipid metabolism.
Prospective Validation and Comparative Analysis of Coronary Risk Stratification Strategies Among Emergency Department Patients With Chest Pain
Authors: Mark Dustin G. , Huang Jie , Kene Mamata V. , Sax Dana R. , Cotton Dale M. , Lin James S. , Bouvet Sean C. , Chettipally Uli K. , Anderson Megan L. , McLachlan Ian D. , Simon Laura E. , Shan Judy , Rauchwerger Adina S. , Vinson David R. , Ballard Dustin W. , Reed Mary E. ,   for the Kaiser Permanente CREST Network Investigators
Published: March 2021

Background

Coronary risk stratification is recommended for emergency department patients with chest pain. Many protocols are designed as “rule‐out” binary classification strategies, while others use graded‐risk stratification. The comparative performance of competing approaches at varying levels of risk tolerance has not been widely reported.

Methods and Results

This is a prospective cohort study of adult patients with chest pain presenting between January 2018 and December 2019 to 13 medical center emergency departments within an integrated healthcare delivery system. Using an electronic clinical decision support interface, we externally validated and assessed the net benefit (at varying risk thresholds) of several coronary risk scores (History, ECG, Age, Risk Factors, and Troponin [HEART] score, HEART pathway, Emergency Department Assessment of Chest Pain Score Accelerated Diagnostic Protocol), troponin‐only strategies (fourth‐generation assay), unstructured physician gestalt, and a novel risk algorithm (RISTRA‐ACS). The primary outcome was 60‐day major adverse cardiac event defined as myocardial infarction, cardiac arrest, cardiogenic shock, coronary revascularization, or all‐cause mortality. There were 13 192 patient encounters included with a 60‐day major adverse cardiac event incidence of 3.7%. RISTRA‐ACS and HEART pathway had the lowest negative likelihood ratios (0.06, 95% CI, 0.03–0.10 and 0.07, 95% CI, 0.04–0.11, respectively) and the greatest net benefit across a range of low‐risk thresholds. RISTRA‐ACS demonstrated the highest discrimination for 60‐day major adverse cardiac event (area under the receiver operating characteristic curve 0.92, 95% CI, 0.91–0.94,
P
<0.0001).

Conclusions

RISTRA‐ACS and HEART pathway were the optimal rule‐out approaches, while RISTRA‐ACS was the best‐performing graded‐risk approach. RISTRA‐ACS offers promise as a versatile single approach to emergency department coronary risk stratification.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03286179.
Acids and Rust: A New Perspective on the Chemical Revolution
Authors: Jacoby Franklin
Published: March 2021

This paper uses scientific perspectivism as a lens for understanding acid experiments from the Chemical Revolution. I argue that this account has several advantages over several recent interpretations of this period, interpretations that do not neatly capture some of the historical experiments on acids. The perspectival view is distinctive in that it avoids discontinuity, allows for the rational resolution of disagreement, and is sensitive to the historical epistemic context.
Lockdown Politics: A Response to Panagiotis Sotiris
Authors: Dale Gareth
Published: March 2021

In ‘Thinking Beyond the Lockdown’, Panagiotis Sotiris argues that lockdowns are repressive and should be opposed. In this response I take issue with his analysis. He posits the existence of a ‘lockdown strategy’ which has little relation to reality. He identifies lockdowns with neoliberalism, flirts with the Great Barrington project, and calls for anti-lockdown resistance – without so much as a glance at the right-wing libertarian camps that are also staked out on this terrain. On these points, and in respect of his interpretation of Foucault, I offer a rebuttal.
Internationalization of Higher Education under the Belt and Road Initiatives
Authors: Jiang Xiaoying
Published: March 2021

This is a systematic literature review of the internationalization of higher education in the context of the Belt and Road Initiative (bri). Following the systematic literature review methods, the author selected eight English and 29 Chinese studies in the academic databases. Through an inductive thematic analysis, the author synthesized five primary themes: (a) philosophical and theoretical foundations of bri education; (b) introduction of higher education development in bri countries; (c) higher education cooperation between China and bri countries; (d) international higher education and economic development; and (e) international student education management. The goal of this review is to underline new opportunities and challenges of bri education discussed within the literature and to present how the research can inform scholars, practitioners, and policymakers in the field of international higher education. It called for more joint research among Chinese scholars and overseas scholars in bri countries. In terms of the future research direction, the author suggested more research on the theoretical exploration and empirical investigation in international higher education within the context of bri.
Lectotypification of names in Duthiea (Poaceae)
Authors: YADAV REKHA , TRIPATHI SHAILJA , PRASAD DILESHWAR , JAISWAL SHUBHAM , MADHUKAR VIRENDRA K. , AGNIHOTRI PRIYANKA
Published: March 2021

The genus, Duthiea Hackel (1895: 200) consists of three species, viz. D. brachypodium (P.Candargy 1901: 65) Keng & Keng (1965: 182), D. bromoides Hackel (1895: 200) and D. oligostachya (Munro ex Aitchison 1880: 108) Stapf (1896: sub Pl. 2474), distributed mainly in mountainous zones of Afghanistan to western China (Kellogg 2015). Duthiea is characterized by having pedicelled spikelets arranged to congested one-sided racemes; rachilla disarticulating above the glumes and between the florets; glumes equal to sub-equal, elliptic or lanceolate, with 5–7 nerves, persistent; lemma hirsute or villous with bifid apex and geniculate single awn with twisted column arising from the sinus of lemma; lodicules absent; ovary obovoid; style single, tomentose, longer or shorter than the stigmas; stigmas 2, terminally exerted from the floret; caryopsis cylindrical, covered with forwardly directed bristles (Bor 1953, 1960).
The original description and date of publication of Cylindrophis lineatus and remarks on its type locality (Reptilia: Squamata: Cylindrophiidae)
Authors: FIGUEROA ALEX , LOW MARTYN E.Y.
Published: March 2021

The snake genus Cylindrophis Wagler, 1828 belongs to the  monogeneric family Cylindrophiidae comprising 15 species distributed predominately throughout SE Asia, with one extralimital species occurring in Sri Lanka (Bernstein et al. 2020: 535). Cylindrophis lineatus is a rare species known from only eight museum specimens (discussed herein), and a photograph of one live individual from Kuching, Sarawak, East Malaysia (Stuebing et al. 2014: 63). Despite being originally described with Singapore as the type-locality (Blanford 1881: 217, 218), it is currently understood that C. lineatus is endemic to western Sarawak, East Malaysia (Stuebing et al. 2014: 63). Wallach et al. (2014: 204) stated that C. lineatus is also found in Kalimantan, but did not provide any references. This appears to have been followed by Bernstein et al. (2020: 537), who provide a map indicating C. lineatus occurrences in Kalimantan. The original description of Cylindrophis lineatus is conventionally cited as Blanford (1881: 217, 218, pl. 20). Herein, we demonstrate that the authorship and date of publication of this taxon should correctly be Cylindrophis lineatus Dennys, 1880b, and discuss that the type locality should be changed to “Borneo”.
Middlemarch
Authors: Roberts Adam
Published: March 2021

In Middlemarch, George Eliot draws a character passionately absorbed by abstruse allusion and obscure epigraphs. Casaubon’s obsession is a cautionary tale, but Adam Roberts nonetheless sees in him an invitation to take Eliot’s use of epigraphy and allusion seriously, and this book is an attempt to do just that.

Roberts considers the epigraph as a mirror that refracts the meaning of a text, and that thus carries important resonances for the way Eliot’s novels generate their meanings. In this lively and provoking study, he tracks down those allusions and quotations that have hitherto gone unidentified by scholars, examining their relationship to the text in which they sit to unfurl a broader argument about the novel – both this novel, and the novel form itself.

Middlemarch: Epigraphs and Mirrors is both a study of George Eliot and a meditation on the textuality of fiction. It is essential reading for specialists and students of George Eliot, the nineteenth century novel, and intertextuality. It will also richly reward anyone who has ever taken pleasure in Middlemarch.
Protective Effect of Mitochondrially Targeted Peptide Against Oxidant Injury of Cone Photoreceptors Through Preventing Necroptosis Pathway
Authors: He Yuan , Xu Yun , Chen Zejun , He Beilei , Quan Zhuoya , Zhang Ruixue , Ren Yuan
Published: March 2021

Retinopathy is an eye disease caused by the death of retinal cells in the macular area and the surrounding choroid. As the retinal rod cell dysfunction and death lead to the loss of night vision, the disease will lead to visual dysfunction and blindness as the disease progresses. Because
of the irreversible nature of cell death, gene therapy has become a research hotspot in the field of retinopathy. But the technology is still in animal studies or clinical trials, and more research is needed to prove its feasibility. In this study, oxidative damage cell model was established
and divided into a control group, H2O2 group, SS31 +NEC1 group, SS31 +H2O2 group, and SS31 +NEC1 +H2O2 group, for different interventions. The cell survival rate of the H2O2 group was significantly increased
compared with those of the SS31 + H2O2 group, SS31 +NEC1 +H2O2 group, and NEC1 +H2O2 group. Nec1 combined treatment significantly reduced reactive oxygen species (ROS) production compared with that in the H2O2
group. The level of MDA in the SS31 group, Nec-1 group and combined treatment of SS31 +NEC1 group decreased significantly compared with the H2O2 group. The proportion of cells with decreased mitochondrial membrane potential in the H2O2 group significantly
increased, and the rate of positivity for propidium iodide (PI) of 661W cells in the H2O2 group and the control group significantly increased. Nine hours after H2O2 treatment of 661W cells, the RIP3 expression level began to increase, and peaked
at 24 h. The level of RIP3 in the H2O2 group was significantly increased, while this level was downregulated in the SS31 and NEC1 treatment groups. Therefore, this study suggests that SS31 has a partial protective effect on 661W cells by inhibiting necrosis, which has
certain guiding significance for the treatment of retinal diseases.
Innovative Mucoadhesive Precursor of Liquid Crystalline System Loading Anti-Gellatinolytic Peptide for Topical Treatment of Oral Cancer
Authors: Calixto Giovana Maria Fioramonti , Victorelli Francesca Damiani , Franz-Montan Michelle , Baltazar Fátima , Chorilli Marlus
Published: March 2021

Current researches report an actual benefit of a treatment for oral cancer via inhibition of proteolytic matrix metallopro-teinases (MPP) with a peptide drug, called CTT1. However, peptides present poor oral bioavailability. Topical administration on oral mucosa avoids its passage through
the gastrointestinal tract and the first-pass liver metabolism, but the barrier function of the oral mucosa can impair the permeation and retention of CTT1. The objective of this study is to incorporate CTT1 into a mucoadhesive precursor of liquid crystalline system (PLCS) as an interesting
strategy for the topical treatment of oral cancer. PLCS consisting of oleic acid, ethoxylated 20 and propoxylated cetyl alcohol 5, polyethyleneimine (P)-associated chitosan (C) dispersion and CTT1 (FPC-CTT1) was developed and characterized by polarized light microscopy (PLM) and small-angle
X-ray scattering (SAXS). In vitro permeation and retention across esophageal mucosa, In vitro cytotoxicity towards tongue squamous cell carcinoma cells, and in vivo evaluation of vascular changes using the chick embryo chorioallantoic membrane (CAM) model were performed.
PLM and SAXS showed that FPC-CTT1acted as PLCS, because it formed a lamellar liquid crystalline system after the addition of artificial saliva. FPC-CTT1increased approximately 2-fold the flux of permeation and 3-fold the retention of CTT1 on the porcine esophageal mucosa. CTT1 does not affect
cell viability. CAM tests showed that FPC preserved the blood vessels and it can be a safe formulation. These findings encourage the use of the FPC-CTT1 for topical treatment of oral cancer.
A Rare Clinical Report of Intramuscular Hemangioma of the Middle Scalene Muscle
Authors: Garefis Konstantinos , Nikolaidis Vasilios , Kipriotou Anastasia , Tigkiropoulos Konstantinos , Vlahodimos Apostolos , Markou Konstantinos
Published: March 2021

Intramuscular hemangioma (IMH) is an uncommon benign vascular lesion, which develops in skeletal muscles and it accounts for <1% of all hemangiomas. The accurate diagnosis is often difficult because the clinical and radiological findings are not specific. The gold standard treatment of IMH is surgical resection. We present a rare clinical report of IMH of the middle scalene muscle that was treated successfully with preoparative embolization and surgical excision.
Understanding the Relationship Between Sustainability and Ecofeminism in an Indian Context
Authors: Suresh Lavanya
Published: March 2021

This article looks closely at the relationship between gender and environment in the context of sustainability. It has been seen that without the inclusion of feminist concerns for gender equality, most environment public policy approaches will be incomplete and may even threaten to intensify women’s subordination. This is illustrated in this article through a case study from Nilgiris district of Tamil Nadu, India, wherein local organizations that operate successfully for environmental sustainability and women’s financial inclusion do not achieve gender equality due to the chokehold of patriarchy. The article is theoretically situated in Bina Agarwal’s idea that differences in attitudes to conservation between genders can stem primarily from the gendered division of economic resources, and the gendered division of labor. The article concludes that the relationship between women and nature in the Global South is a political issue that is fraught with power relations that operate at different scales and through different modalities.
Inequality in Contemporary India: Does Caste Still Matter?
Authors: Sengupta Susmita , Guchhait Sanat Kumar
Published: March 2021

Are the issues of socioeconomic inequalities related to specific caste biases in Contemporary India? Why are some social groups in the socioeconomic ladder lagging compared to others? How much have the poor people living in rural areas in India achieved their esteemed goals in the present economic arena of development? Is it the limited educational attainment or lack of physical and social capital of the poor households that begets inter-group economic inequality? Or is it a social identity that impedes the well-being of a certain social group? In search of answering these questions, this article explores the role of castes in explaining socioeconomic inequalities in the rural settings of contemporary India. The limited access to basic amenities and the poor educational attainment of the lower castes and the dominance of the upper castes in these regards show the persistence of social group inequalities. Four remote villages of Purulia district, one of the most backward tribal districts of West Bengal were systematically selected for scrutiny to explore socioeconomic inequality within the caste structure. Two are tribal villages with low inequality and the other two are multi-caste-oriented villages with high inequality.
Social Risks and Class in the Baltic States: Insights for Social Investment Strategy
Authors: Skuciene Daiva , Markeviciute Jurgita
Published: March 2021

The understanding of the distribution of social risks according to social classes can ensure more targeted social investment policies. This article aims to analyze the distribution of social risks according to the social classes in the three Baltic States of Estonia, Latvia, and Lithuania. The micro data used in this analysis are collected from the European Union Statistics on Income and Living Conditions (EU-SILC) data base of 2015 covering the three Baltic States: Lithuania, Latvia and Estonia. The findings of this analysis revealed that in many cases, the distribution of social risks is related to social class. However, the findings suggest there is a higher probability of certain social risks among members of the lower middle class than those who are employed in lower class elementary (basic skills) occupations.
Ìdàgbàsókѐ: An African Notion of Organic Development Ethics
Authors: Ipadeola Abosede Priscilla
Published: March 2021

Relevance and influence in the current world among nations and continents are largely measured in terms of development. Development is primarily viewed as economic and technological growth such that a country that is not advanced economically and technologically can hardly have “a voice” in the comity of nations. Development is so crucial to how a country is perceived internationally that it determines how a country is identified—whether “developed,” “developing,” or “underdeveloped.” All these descriptive terms are, however, suggestive of power play among nations—who has power, who lacks it, who is gaining it, or who is losing it. This essay argues against the popular idea of development, which sees development as predominantly technology- and economy-based. Arguing from the stance of Yorùbá conception of ìdàgbàsókè (development), this essay advocates a definition of sustainable development that is people-centered and, hence, focused on moral traits as found in ọmọlúàbí (a person of honor, good character, and integrity) rather than on just technology or the economy.
Functions of Imagined Interactions With AI Among Alexa-Users
Authors: Gaspard Timothy , Madison T. Phillip
Published: March 2021

Humans and agents of artificial intelligence (AI) participate in human-machine communication (HMC) more frequently now than ever before – especially in the U.S. Voice powered assistants (VPAs) are widely accessible software agents that enact various social roles, such as personal assistants, and are increasingly packaged with AI-devices to complete simple-tasks, such as sending texts, more efficiently. VPAs are designed to mimic human-human interactions (HHIs) to facilitate more natural human-VPA interactions (HVPAIs). The focus of this study is on the psychological effects of HVPAIs with Amazon’s VPA, Alexa, to identify predictors of frequent Alexa-use through six functions of imagined interactions (IIs) – rehearsal, self-understanding, relational maintenance, conflict linkage, compensation and catharsis. A modified survey of imagined interaction was distributed to 810 self-reported Alexa-users recruited through Amazon’s Mechanical Turk (MTurk). Results suggest that HVPAIs with Alexa impacts the imagination of participants similarly to HHIs, and that use of specific functions of IIs are significant negative predictors of Alexa-use. Moreover, the inclusion of machine-interlocutors as part of imagined interaction theory appears to be compelling as humans and machine interactions evolve in the 21st century.
Impact of gender in patients with continuous-flow left ventricular assist device therapy in end-stage heart failure
Authors: Zubarevich Alina , Szczechowicz Marcin , Osswald Anja , Arjomandi Rad Arian , Vardanyan Robert , Pompeu BO Sá Michel , Van den Eynde Jef , Schmack Bastian , Wendt Daniel , Koch Achim , Pizanis Nikolaus , Kamler Markus , Ruhparwar Arjang , Weymann Alexander , Zhigalov Konstantin
Published: March 2021

Background:

There is an ongoing debate about the influence of the female gender on postoperative outcomes after durable left ventricular assist device (LVAD) implantation. Despite the differences in pathophysiology of heart failure in females, therapy concepts are the same as in the male population. The aim of this study was to investigate the role of the female gender in surgical heart failure therapy.

Materials and methods:

Between August 2010 and January 2020, 207 patients were treated with durable LVAD at out institution. We matched 111 patients in two groups to compare the outcomes in male and female patients and to stratify the risk factors of mortality.

Results:

The groups were matched 2:1 and were comparable after matching. We found no difference in in-hospital and follow-up mortality between male and female patients. Postoperative adverse events and complications were found to be unvaried across male and female patients. Female patients had higher rates of postoperative LVAD-thrombosis compared to their male counterparts (13.5% vs 0, p = 0.001) and the rates of renal replacement therapy lasting over 90 days were also higher in the female group (33.8% vs 56.8%, p = 0.021). Furthermore, the female gender was not an independent predictor neither of in-hospital nor follow-up mortality.

Conclusions:

Durable continuous flow left ventricular assist devices as a bridge to transplantation or recovery in female patients are associated with a higher risk of acute kidney injury requiring RRT and are at a higher risk of LVAD-thrombosis. Nevertheless, survival rates between genders are similar.
Covid-19: The National Library of New Zealand experience
Authors: Macnaught Bill
Published: March 2021

This article summarises the experience of the National Library of New Zealand in coping with the first year of the global Covid-19 pandemic. It is written from the perspective of the National Librarian, Bill Macnaught CBE, in the months before he retired in December 2020. The new National Librarian, Rachel Esson, can be contacted at rachel.esson@dia.govt.nz for any enquiries about the current status.
The KB and Corona
Authors: Knibbeler Lily
Published: March 2021

This contribution describes the initial response of the KB, the National Library of the Netherlands, to the Corona / COVID-pandemic.
Evaluation of Velopharyngeal Closure Function With 4-Dimensional Computed Tomography and Assessment of Radiation Exposure in Pediatric Patients: A Cross-Sectional Study
Authors: Kobayashi Yoshikazu , Kobayashi Masanao , Kanamori Daisuke , Fujii Naoko , Kataoka Yumi , Satoh Koji , Sano Yoshimi , Yoshioka Satoshi , Tateya Ichiro , Toyama Hiroshi , Matsuo Koichiro
Published: March 2021

Objective:

Some patients with cleft palate (CP) need secondary surgery to improve functionality. Although 4-dimensional assessment of velopharyngeal closure function (VPF) in patients with CP using computed tomography (CT) has been existed, the knowledge about quantitative evaluation and radiation exposure dose is limited. We performed a qualitative and quantitative assessment of VPF using CT and estimated the exposure doses.

Design:

Cross-sectional.

Setting:

Computed tomography images from 5 preoperative patients with submucous CP (SMCP) and 10 postoperative patients with a history of CP (8 boys and 7 girls, aged 4-7 years) were evaluated.

Patients:

Five patients had undergone primary surgery for SMCP; 10 received secondary surgery for hypernasality.

Main Outcome Measures:

The presence of velopharyngeal insufficiency (VPI), patterns of velopharyngeal closure (VPC), and cross-sectional area (CSA) of VPI was evaluated via CT findings. Organ-absorbed radiation doses were estimated in 5 of 15 patients. The differences between cleft type and VPI, VPC patterns, and CSA of VPI were evaluated.

Results:

All patients had VPI. The VPC patterns (SMCP/CP) were evaluated as coronal (1/4), sagittal (0/1), circular (1/2), and circular with Passavant’s ridge (2/2); 2 patients (1/1) were unevaluable because of poor VPF. The CSA of VPI was statistically larger in the SMCP group ( P = .0027). The organ-absorbed radiation doses were relatively lower than those previously reported.

Conclusions:

Four-dimensional CT can provide the detailed findings of VPF that are not possible with conventional CT, and the exposure dose was considered medically acceptable.
Treacher Collins Syndrome in the United States: Examining Incidence and Inpatient Interventions
Authors: Reid Lauren , Carroll William
Published: March 2021

Objective:

Advancements have been made in the care of patients with Treacher Collins syndrome (TCS), but epidemiological data are lacking given its rarity. A national database provides a valuable opportunity for studying the incidence of rare craniofacial conditions. We sought to evaluate disease incidence of phenotypically severe cases and the frequency of the most common associated diagnoses and interventions.

Design:

The 2016 Kids’ Inpatient Database (KID), Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality was the first version to include updated International Classification of Diseases-Tenth Edition (ICD-10) coding encompassing a unique code for TCS. The 2016 KID was queried for the unique code. Incidence was calculated using national estimates. Diagnosis and procedure codes were pooled and analyzed.

Patients:

A total of 266 discharge cases with a diagnosis code for TCS (Q75.4).

Main Outcomes:

Disease incidence and the most frequent diagnosis and procedure codes.

Results:

The estimated incidence of children born with a diagnosis of TCS was approximately 1 in 80,000. Two of the three most common ICD-10 diagnosis codes were tracheostomy status and obstructive sleep apnea. The most common procedures performed were airway examination procedures.

Conclusions:

Treacher Collins syndrome is a rare craniofacial disorder requiring complex multidisciplinary management. Phenotypically severe cases requiring inpatient management may be rarer than previous estimates suggest. Inpatient airway interventions are very common, and multidisciplinary team members should anticipate the degree of potential airway risk these patients pose.
Antiphospholipid Antibodies in Sickle Cell Disease: A Systematic Review and Exploratory Meta-Analysis
Authors: Merashli Mira , Arcaro Alessia , Graf Maria , Caruso Matilde , Ames Paul R. J. , Gentile Fabrizio
Published: March 2021

The relationship between antiphospholipid antibodies (aPL) and sickle cell disease (SCD) has never been systematically addressed. Our aim was to evaluate potential links between SCD and aPL in all age groups. EMBASE/PubMed was screened from inception to May 2020 and Peto odds ratios for rare events were calculated. The pooled prevalence (PP) of IgG anticardiolipin antibodies (aCL) was higher in individuals with SCD than in controls (27.9% vs 8.7%, P < 0.0001), that of IgM aCL was similar in the two groups (2.9% vs 2.7%); only individuals with SCD were positive for lupus anticoagulant (LA) (7.7% vs 0%, P < 0.0001). The PP of leg ulcers was similar between aPL positive and negative individuals (44% vs 53%) and between patients in acute crisis and stable patients (5.6% vs 7.3%). Reporting of aPL as a binary outcome and not as a titer precluded further interpretation. The results indicate that a prospective case-control study with serial measurements of a panel of aPL in SCD patients might be warranted, in order to understand further the possible pathogenic role of aPL in SCD.
Role of Tissue Factor in the Pathogenesis of COVID-19 and the Possible Ways to Inhibit It
Authors: Cañas Carlos A. , Cañas Felipe , Bautista-Vargas Mario , Bonilla-Abadía Fabio
Published: March 2021

COVID-19 (Coronavirus Disease 2019) is a highly contagious infection and associated with high mortality rates, primarily in elderly; patients with heart failure; high blood pressure; diabetes mellitus; and those who are smokers. These conditions are associated to increase in the level of the pulmonary epithelium expression of angiotensin-converting enzyme 2 (ACE-2), which is a recognized receptor of the S protein of the causative agent SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). Severe cases are manifested by parenchymal lung involvement with a significant inflammatory response and the development of microvascular thrombosis. Several factors have been involved in developing this prothrombotic state, including the inflammatory reaction itself with the participation of proinflammatory cytokines, endothelial dysfunction/endotheliitis, the presence of antiphospholipid antibodies, and possibly the tissue factor (TF) overexpression. ARS-Cov-19 ACE-2 down-regulation has been associated with an increase in angiotensin 2 (AT2). The action of proinflammatory cytokines, the increase in AT2 and the presence of antiphospholipid antibodies are known factors for TF activation and overexpression. It is very likely that the overexpression of TF in COVID-19 may be related to the pathogenesis of the disease, hence the importance of knowing the aspects related to this protein and the therapeutic strategies that can be derived. Different therapeutic strategies are being built to curb the expression of TF as a therapeutic target for various prothrombotic events; therefore, analyzing this treatment strategy for COVID-19-associated coagulopathy is rational. Medications such as celecoxib, cyclosporine or colchicine can impact on COVID-19, in addition to its anti-inflammatory effect, through inhibition of TF.
Experiences With COVID-19 Stressors and Parents’ Use of Neglectful, Harsh, and Positive Parenting Practices in the Northeastern United States
Authors: Connell Christian M. , Strambler Michael J.
Published: March 2021

Objectives:

To estimate household exposure to COVID-19 related stress and the association with parent report of neglectful, harsh, and positive discipline practices.

Methods:

Cross sectional survey data was collected from 2,068 parents in the Northeastern US. Parents reported personal and household experiences of COVID-19 stressors, their level of distress, and use of neglectful parenting and discipline practices for a randomly selected child in their home. Analyses estimated rates of COVID-19 related stress and parenting practices. Logistic regression was used to assess the relation of COVID-19 stress to parenting behaviors.

Results:

Individual and household stressor level, as well as distress were each positively associated with likelihood of neglect. Personal exposure to stressors was minimally related to discipline, but household stressor level and parents’ distress were positively associated with harsh and positive discipline.

Discussion:

Indicators of COVID-19 stress (e.g., exposure to stressors and distress) each uniquely predicted parents’ use of neglect, particularly physical and family-based sub-types, and use of harsh and positive discipline practices. Results suggest that parents may require additional support to provide appropriate care for their children while coping with the increased rates of stress associated with the pandemic and the resulting public health response.