bluuebunny/crossref_metadata_2025 huggingface dataset:
The Costs of “Blue Sky”: Environmental Regulation and Employee Income in China
Authors: xiao Renrui , Tan Guangrong , Huang Baocong , Luo Yuanyue
Published: November 2021

Strict environmental regulations may change the behavioral decisions of firms. Based on the exogenous impact of the Chinese Central Government’s inclusion of environmental performance in the assessment targets of municipal officials in 2007, this study uses the difference-in-difference method to explore the impact of environmental regulations on employee income. We find that (1) environmental regulations will significantly reduce the average wage level of employees in polluting industries and have no significant impact on nonpolluting industries. (2) This effect is more pronounced in eastern China, where environmental regulations are more stringent, and in areas where political promotion incentives are stronger. (3) Mechanistic analysis finds that environmental regulations will affect employee income by increasing costs and constraining financing. (4) More importantly, we find that the decline in the average wage level of firms is mainly due to the decline in the average wage level of ordinary employees, and the average wage level of management has not decreased significantly, which means that environmental regulations have expanded social income inequality. Our findings contribute to a comprehensive understanding of the effectiveness of the implementation of environmental regulatory policies and economic cost issues.
Is Cell Regeneration and Infiltration a Double Edged Sword for Porcine Aortic Valve Deterioration: A Large Cohort of Histopathological Analysis
Authors: Li Li , Duan Xuejing , Wang Hongyue , Sun Yang , Zhao Wei , Lu Yang , Xu Hongyu , You Yiwei , Wang Qingzhi
Published: November 2021

Background Bioprostheses are the commonest prostheses used for valve replacement in the western world. The major ﬂaw of bioprostheses is the occurrence of structural valve deterioration (SVD). The objective of this study was to assess in a large cohort of patients the pathologic features of porcine aortic valve (PAV) SVD based on histomorphological and immunopathological features.Methods and materials 109 cases of resected PAV were observed grossly and histopathologically. The type and amount of infiltrated cells were evaluated in the different type of bioprosthetic SVD by immunohistochemical staining . Results The most common cause of SVD was calcification, leaflet dehiscence and tear (23.9%,19.3% and 18.3%, respectively). Immunohistochemical staining demonstrated that vimentin positive cells aggregated around the calcified area in calcified PAV. Macrophages infiltrated in the calcified, lacerated and dehiscence PAV. However, MMP-1 expression was mainly found in the lacerated PAV. The VIM(+)/SMA(-) and VIM(+)/CD31(-) cells were found in PAV. The endothelia rate of dehiscence leaflets were higher than that of calcified and lacerated leaflets. A large amount of CD31 positive cells aggregated in the spongy layer in the lacerated and dehiscence PAV. Conclusions Cell regeneration and infiltration is a double edged sword for the PAV deterioration. Valve interstitial cells (VIC) have essential role in PAV calcification. Macrophages infiltration maybe involve in the different type of SVD, but only MMP-1expression involves in leaflets laceration. VIM(+)/CD31(-) valve endothelial cells (VECs) protect the PAV against the formation of calcified and lacerated lesions. The existence of untransformed VECs maybe one of pathologic substrate of PAV tear and dehiscence, although they can prevent VICs activation and subsequent valve fibrosis and calcification.
Establishment of PIVKA-Ⅱ Reference Intervals From Hospital-stored Data: A Comparison Analysis
Authors: Zhou Lewei , Su Qiyuan , Yao Yan , Xiang Meixian , Zhen Jiesheng , Su Hanwen , Zhang Zhengjun
Published: November 2021

Objective The authors aimed to explore methods to establish indirect reference intervals for PIVKA-II from hospital-stored data.Method 7623 patient specimens of the Renmin Hospital of Wuhan University were collected. Indirect reference intervals were established based on the hospital-stored data with four different methods, including the Hoffmann method (HM), revised Hoffmann method (HMCDF), E-M algorithm-based method (EMBCT), and a recent estimator (KOSMIC). According to CLSI C28-A3 guidelines, 369 healthy specimens were collected. The authors tested the difference between reference intervals of gender-specific and age-specific subgroups using Harris and Boyd's test. Finally, the averaging result of estimates was calculated according to how likely each model was.Results The indirect reference intervals of PIVKA-II based on LIS data were 0 to 35.30 mAU/mL (HM), 0 to 31.48 mAU/mL (HMCDF), 0 to 30.78 mAU/mL (EMBCT), 0 to 36.17 mAU/mL (KOSMIC) and 0 to 31.48 mAU/mL (averaging) respectively, and the reference intervals based on healthy group were 0 to 32 mAU/mL. Compared with HM, EMBCT and KOSMIC, HMCDF and the averaging result was closer to those of the health group. Significant difference was detected between gender-partitioned subgroups, and the reference upper limit in the female group was smaller than the male group.Conclusions The authors established the indirect reference intervals of PIVKA-II for the Wuhan population, which could be used to the clinical reference intervals. The framework proposed could help clinical laboratory set their reference intervals of test items.
MiR-30c-1-3p Targets Matrix Metalloproteinase 9 Involved into the Rupture of Abdominal Aortic Aneurysms
Authors: Yang Lin , Sui Hong-gang , Wang Meng-meng , Li Jia-yin , He Xiao-feng , Li Jing-yuan , Wang Xiaozeng
Published: November 2021

Abdominal aortic aneurysm (AAA) can be fatal if ruptured, but there is no predictive biomarker. Our aim was to evaluate the prognostic potential of microRNAs (miRNAs/miRs) in an AAA mouse model and patients with unruptured AAA (URAAA) and ruptured AAA (RAAA). Among the 64 miRNAs differentially expressed in mice with AAA compared to control, miR-30c-1-3p, miR-432-3p, miR-3154, and miR-379-5p had high homology with human miRNAs. MiR-30c-1-3p plasma levels were significantly lower in patients with RAAA than in those with URAAA or control and tended to negatively correlate with the maximum aortic diameter (r = -0.3153, P = 0.06109). Mir-30c-1-3p targeted matrix metalloproteinase (MMP)-9 mRNA through the coding region and downregulated its expression in vitro. MMP-9 plasma concentrations were significantly higher in the RAAA group than in the URAAA group (P < 0.001) and were negatively associated with miR-30c-1-3p levels (r = -0.3671, P = 0.01981) and positively – with the maximal aortic diameter (r = 0.6251, P < 0.0001). The optimal cutoff values for MMP-9 expression and the maximal aortic diameter were 461.08 ng/ml and 55.95 mm, with areas under the curve of 0.816 and 0.844, respectively. Our results indicate that plasma levels of mir-30c-1-3p and MMP-9 may be candidate biomarkers of AAA progression.
Diverse Controlling Mechanisms and Teleconnections of Three Distinctive MJO Types
Authors: Liu Shihua , Fu Joshua Xiouhua , Wen Zhiping , Zhang Peng
Published: November 2021

In present study, three distinctive MJO types in boreal winter are documented and their controlling mechanisms and teleconnections are investigated with a synergetic glocal approach. For the first time, it is revealed that the diverse nature of the MJO primarily results from different Tropical-Extratropical Interactions and associated internal atmospheric processes. Both the type-I and type-II are initiated over the western Indian Ocean (IO) by a dry zone around the eastern IO, while only the type-I can move out the IO and circulate around the globe. The type-III initiates over the western Pacific (WP) and can circulate the globe and trigger another successive event. The strong upper-level equatorial westerly over the IO-WP, resulting from upstream and extratropical influences, suffocates the type-II MJO within the IO. On the other hand, the robust upper-level equatorial easterly over the IO-WP, also resulting from upstream and extratropical influences, along with regional convective instability over the WP and the arrival of east-Asian cold-surge foster the development and eastward propagation of the type-III MJO. The downstream and extratropical teleconnections are primarily controlled by the associated convection over the tropical IO-WP sector for the type-I, but also strongly influenced by the conditions over the extratropical WP for the type-II and type-III. Given that the MJO has been traditionally viewed as a tropical mode owing its existence to the coupling between organized convection and large-scale circulations, present findings advocate the MJO as a global mode and call for more research on the involved Tropical-Extratropical Interactions in order to better understand and simulate the diverse nature of the MJO.
Socioeconomic Status and Health Behavior in Children and Adolescents: A Systematic Literature Review
Authors: Gautam Nirmal , Dessie Getenet , Rahman Mohammad Mafizur , Khanam Rasheda
Published: November 2021

Background:Socioeconomic status (SES) is an important determinant of health behaviors in individuals and contributes to a complex relationship with health. Because of this complexity, the relationship between SES and health behavior is still unclear. Thus, this literature review aims to assess the association between socioeconomic inequalities and health behaviors in children and adolescents from both developed and developing countries.Methods:Preferred Reporting for Systematic Review and Meta-Analysis protocol (PRISMA-P) guideline was used to conduct a systematic literature review. The electronic online databases EBSCO Host, PubMed, Web of Science, and Science Direct were utilized to systematically search the published articles. Joanna Briggs Institute of critical appeal tool was deployed to assess the quality of included studies. Eligibilities criteria such as study population, study design, study type, study objective, language, and publication date were used to identify the relevant literature that measured the association between socioeconomic status and health behaviors.Results:Out of 1483 articles, only 31 met the final eligibility criteria and were assessed in this paper. Out of these studies: ten, nine, seven and five studies identified a positive association between socioeconomic status (SES) and (a) drinking alcohol; (b) physical activity; (c) fruits and vegetable consumption; (d) consumption of a healthy diet respectively. On the other hand, a negative association between SES and smoking and SES and consumption of cannabis were found by eleven and one study respectively among the children and adolescents. Conclusions:This review study found that the problem of health behaviors is continuing to be a major concern in children and adolescents, particularly those who are of low socioeconomic status. The findings of this study revealed that some specific intervention packages are needed for reducing these damaging health behaviors and enhancing the protective health behaviors in those children and adolescents from a low socioeconomic status.
Relationship between subjective socioeconomic status and sense of gain of health-care reform and the mediating role of self-rated health: A cross- sectional study in China
Authors: Su Yuan , LI Yueping
Published: November 2021

Background: The sense of gain has gradually become the main evaluation index for the effectiveness of China’s deepening reform and is affected by many factors. However, there is no relevant research on the sense of gain of health-care reform (SGHR) and its influencing factors. The purpose of this study was to explore the influence of subjective socioeconomic status (SSS) on SGHR and the mediating role of self-rated health (SRH) between them.Methods: Data (27,437 samples total) from China Family Panel Studies (CFPS) in 2018 were included in the analysis. A nonparametric test was used to explore the differences in demographic characteristics of SGHR, and a correlation analysis and mediating effect model were used to explore the influence of SSS on SGHR and the mediating effect of SRH.Results: Demographic characteristics such as age, urban and rural areas, educational background, marriage and choice of medical treatment had significant differences in the distribution of perceived acquisition of medical reform. SSS, SHR and SGHR are positively correlated with each other. SSS not only directly affects SGHR positively but also indirectly affects SGHR through SRH.Conclusions: SSS is an important predictor of SGHR, and SHR plays a partially mediating role in SGHR.
Evaporation in Hydrological Models Under Rising CO2: A Jump into The Unknown
Authors: Lemaitre-Basset Thibault , OUDIN Ludovic , THIREL Guillaume
Published: November 2021

Many hydrological models use the concept of potential evaporation (PE) to simulate actual evaporation. PE formulations often neglect the effect of carbon dioxide (CO2), which challenges their relevance in a context of climate change and rapid changes in CO2 atmospheric concentrations. In this work, we implement three options from the literature to take into account the effect of CO2 on stomatal resistance in the well-known Penman–Monteith PE formulation. We assess their impact on future runoff using the Budyko framework over France. On the basis of an ensemble of Euro-Cordex climate projections using the RCP 4.5 and RCP 8.5 scenarios, we show that taking into account CO2 in PE formulations largely reduces PE values but also limits projections of runoff decrease, especially under an emissive scenario, namely, the RCP 8.5. Whereas the classic Penman–Monteith formulation yields decreasing runoff projections over most of France, taking into account CO2 yields more contrasting results. Runoff increase becomes likely in the north of France, which is an energy-limited area, with different levels of runoff response produced by the three tested formulations. The results highlight the sensitivity of hydrological projections to the processes represented in the PE formulation.
Olaparib for Chinese Metastatic Castration-resistant Prostate Cancer: A Real-World Study of Efficacy and Gene Predictive Analysis
Authors: Dong Baijun , Yang Bin , Chen Wei , Du Xinxing , Fan Liancheng , Yao Xudong , Xue Wei
Published: November 2021

Objective: To evaluate the real-world effectiveness and gene predictive analysis of olaparib in Chinese patients with metastatic castration-resistant prostate cancer (mCRPC) .Methods: A multicenter, retrospective, real-world study was conducted by involving Chinese patients with mCRPC from December 2017 to June 2021. Homologous Recombination repair (HRR)gene mutation (HRRm) status was identified using targeted next-generation sequencing (NGS). The primary endpoint includes prostate-specific antigen (PSA) response rate (PSA50). Secondary end points include PSA progression-free survival (PSA-PFS), exploratory endpoints include PSA50, and PSA-PFS in HRRm-negative patients with variants of unknown significance (VUS). Survival rates were analyzed using Kaplan–Meier (KM) plot.Results: A total of 39 eligible patients with a median age of 65 (interquartile range [IQR]: 59.5-69.5) years were included in the study. Overall, 40% (12/30) of the patients with mCRPC achieved PSA50 and the median PSA-PFS was 3.1 months (95% Confidence interval [CI]: 2.4-7). Furthermore, higher PSA50 rate and longer PSA-PFS were observed in HRRm-positive patients (PSA50: 50% [7/14]; median PSA-PFS: 5.3 months, 95% CI: 3.73–10). Among the HRRm-positive patients, those harboring the BRCA2 aberrations experienced best clinical efficacy (PSA50: 55.5% [5/9] and median PSA-PFS [95% CI]: 9.5 months [4.3, NA]). Clinical benefit was also observed in HRRm-negative patients (PSA50: 31.3% [5/16]; median PSA-PFS [95% CI]:2.05 months [1.5,8]), wherein most patients with a PSA50 response were carrying VUS mutations (PSA50: 50% [4/8]; median PSA-PFS [95% CI]: 2.75 months [1.27, NA]). In one patients with mutation in the ATR gene, the PSA level decreased by 62%. Conclusion: Olaparib improved PSA response and prolonged PSA-PFS in Chinese mCRPC patients especially in those carrying HRR mutation. Among the HRR genes, patients with BRCA2 mutation showed the best clinical benefit. Besides, some patients carrying HRR VUS alternations and other DNA damage response (DDR) gene mutations also showed response to olaparib treatment, indicating that the clinical benefits observed in HRR negative group were driven by VUS and other DDR gene mutation. However, this should be further explored in the future, and more molecular functional studies are needed to reclassify VUS mutations for better clinical treatment decision-making and management of mCRPC.
Study on Wear Characteristics Evolution of Helical Gear With Linear Initial Defect
Authors: Zhu Yuqi , Yuan Wei , Guo Qianjian , Zhang Liguo , Wang Wenhua , Xue Peng
Published: November 2021

The initial defects have greatly affected the gear transmission under harsh working conditions in the fields of wind power and ships. The influence of linear initial defects on the evolution of wear characteristics of helical gears was studied. The laser marking device was used to process the linear initial defect along the tooth width direction, and the gear without initial defect was used for comparison. It can be concluded that the linear initial defect changed the meshing state of the gear tooth, and greatly shortened the normal wear life of the gear, the normal wear life of the gear is shortened by about 45%, and the wear rate in the stable wear stage is increased by about 56%, a great deal of pitting corrosion and plastic flow on the tooth surface occurred in the pitch circle position of the defective gear. In addition, the lubrication condition deteriorated in the later period caused by lubricating oil pollution and the hard particles falling off the gearbox bearings entered the meshing surface and the emerged crack, which further accelerated the wear process of gear.
The Potential Mechanisms of AMOC Multidecadal Periods in CMIP6/CMIP5 Preindustrial Simulations
Authors: Ma Xiaofan , Huang Gang , Li Xichen , Li Shouwei
Published: November 2021

Observations, theoretical analyses, and climate models show that the period of multidecadal variability of the Atlantic Meridional Overturning Circulation (AMOC) is related to westward temperature propagations in the subpolar North Atlantic, which is modulated by oceanic baroclinic Rossby waves. Here, we find major periods of AMOC variability of 12-28 years and associated westward temperature propagations in the preindustrial simulations of 9 CMIP6/CMIP5 models. Comparison with observations shows that the models reasonably simulate ocean stratifications in turn oceanic Rossby waves in the subpolar North Atlantic. The timescales of Rossby waves propagating on a static background flow across the subpolar North Atlantic basin overestimate the AMOC periods. The mean flow effects involving westward geostrophic self-advection and eastward mean advection largely shorten and greatly improve the estimate of AMOC periods through increasing Rossby wave speeds. Our results illustrate the importance of considering mean flow effects on Rossby wave propagations in the estimate of AMOC periods.
Controlling the Uncontrolled Variation in the Diet Induced Obese Mouse by Microbiomic Characterization
Authors: Bondarenko Valeriia , Løkke Cecillie , Dobrowolski Peter , Mentzel Caroline M. Junker , Castro-Meija Josué L. , Hansen Camilla Hartmann Friis , Sørensen Dorte Bratbo , Nielsen Dennis Sandris , Krych Lukasz , Hansen Axel Kornerup
Published: November 2021

C57BL/6NTac (B6NTac) and C57BL/6NRj (B6NRj) mice were fed a high calorie diet and treated with liraglutide. 42 mice would have been needed in an ordinary one-way ANOVA to show a reduction in glycosylated hemoglobin (HbA1c) in B6NTac mice, but incorporating the sequenced fecal microbiota in a two-way ANOVA reduced the group size needed to obtain a statistical significance to 12 mice. In B6NRj mice there was no impact of liraglutide on HbA1c neither with or without microbiota incorporation. In both sub-strains, the liraglutide effect on glucose tolerance and body weight was powered by incorporation of microbiota clusters. Although B6NTac mice were genetically far more conform than the B6NRj mice, incorporation of a genetic characterization by short tandem repeats had only little impact on the outcome of data evaluation. In conclusion, incorporation of microbiota characterisation powers data evaluation in diet induced obesity mouse strains, which are influenced by the microbiota.
Psychosocial Factors Associated With Malaria Care-seeking in Rural Ethiopia
Authors: Olapeju Bolanle , Tamene Habtamu , Ayele Minyahil , Heliso Simon , Berhanu Tsega , Alemayehu Guda , Kapadia-Kundu Nandita
Published: November 2021

BackgroundEthiopia’s National Malaria Control and Elimination Program aims to diagnose all suspected malaria cases within 24 hours of fever onset and provide prompt treatment for confirmed cases. This study explored psychosocial factors associated with no-, delayed- and prompt- care-seeking among female caregivers of children under five with fever in rural Ethiopia.MethodsHousehold surveys were conducted from 2016–2019 among female caregivers (N = 2453) of children under five years old in Oromia; Amhara; Southern Nations, Nationalities, and Peoples Region (SNNPR); and Tigray. Prompt and delayed care-seeking were defined as seeking treatment within ≤ 24 hours or > 24 hours of symptom onset respectively. Contextual factors explored included sociodemographic factors, household supply of bed nets, exposure to health messages, and household vulnerability (a measure of financial access to food, shelter, schooling, and medical treatment). Ideational factors included psychosocial factors related to care-seeking (knowledge, self-efficacy, response efficacy, beliefs, involvement in decision-making, and household social support).ResultsThe prevalence of fever among children under five was 18% (ranging from 9% in Tigray to 34% in SNNPR. Overall, 45% of caregivers of children with fever sought care promptly, while 23% delayed care-seeking and 32% sought no care. Prompt care-seeking rates were higher among caregivers with positive attitudes toward prompt care-seeking (48%), involved in decision-making (48%) or perceived equitable gender norms in the community (65%). Caregivers with a high care-seeking ideation had increased odds of prompt care-seeking (aOR: 2.65; 95% CI: 1.74–4.02). Significant contextual factors included residence in the Oromia region (aOR: 2.99; 95% CI:1.40–6.41), caregivers age 35–49 years (aOR: 0.49; 95% CI: 0.26–0.95), residence in vulnerable households (aOR: 2.01; 95% CI: 1.28–3.18).ConclusionsAmong this rural Ethiopian population, prompt care-seeking was low but positively influenced by both ideational and contextual psychosocial factors occurring at the caregiver level. Multi-sectoral interventions at the individual, community, and health facility levels are needed to improve prompt care-seeking. These include social behavior change interventions to improve ideation, complemented by health facility interventions to ensure provision of high-quality services and structural interventions to increase educational attainment in these rural settings.
Association of Maternal Mood Symptoms in Pregnancy with Exclusive Breastfeeding at Six Weeks Postpartum: A Cross-Sectional Study
Authors: Lai Xin , Peng Songxu , Yao Zhenzhen , Meng Liping
Published: November 2021

Background: Previous studies have shown that postpartum depression negatively affects breastfeeding practices. However, it is not clear whether maternal mood symptoms during pregnancy affect exclusive breastfeeding (EBF) behavior. Our study aimed to quantify the relationship between maternal mood symptoms (depression/anxiety) during pregnancy and EBF.Methods: A cross-sectional study was conducted at Baoan Maternal and Child Health Hospital, Shenzhen, China, from January 1, 2016, to December 31, 2016, among women who had delivered in the hospital and completed the 6-week postpartum visit. A structured questionnaire was designed to collect information on maternal mood symptoms during pregnancy and EBF status at 6 weeks postpartum. Logistic regression models were used to evaluate the associations between maternal mood symptoms (depression/anxiety) during pregnancy and EBF at 6 weeks postpartum.Results: In total, 6324 women were included in this study. In univariate analysis, we observed that depression during pregnancy was associated with a reduced risk for EBF (OR = 0.66; 95% CI: 0.54-0.81; P < 0.001). In the fully adjusted model, depression during pregnancy was still significantly associated with a reduced risk of EBF (OR=0.69; 95% CI: 0.56–0.86; P < 0.001). However, there was no significant difference in the rate of EBF between the anxiety and non-anxiety groups of women (OR=0.88; 95% CI: 0.77–1.01; P > 0.05). Conclusion: We believe that our findings confirm the adverse impact of maternal depression during pregnancy on EBF behavior. Therefore, to improve conditions for breastfeeding of infants, additional attention should be paid to women with depressive symptoms during pregnancy.
Assessment of Isokinetic Knee and Shoulder Strength in Elite Youth Boxers: Correlation with Punch Impact Force
Authors: Zhou Zixiang , Chen Xin , Chen Chao , Yi Wenjuan , Wang Dexin
Published: November 2021

This study aimed to assess the isokinetic strength performance of the knee and shoulder in amateur boxer, and further to explore the contribution of knee and shoulder peak torque to different punches. Boxers (6 females and 8 males) were measured the dynamic concentric torque of knee flexion(F) and extension(E), shoulder external rotation (ER) and internal rotation (IR) at 60°/S, 180°/S. We tested the punching force of three techniques by Kistler Instruments. At 60°/S, F/E ratios of the dominant (D) knee of female boxers were lower than those of non-dominant (ND) side (p=0.03). At two angular velocities, all boxers demonstrated higher ER/IR ratios in ND (p=0.011 for males, p=0.025 for females). Bilateral difference of knee flexor in females was greater (p=0.038) than that in males. The maximum correlation was found at 180°/S between punching forces and the joints strength. ANOVA analyses revealed that athletes with greater punching force tend to have higher knee strength. Although correlations between shoulders strength and punching forces were strong, they did not discriminate between athletes who punched with higher punching force. In order to effectively transfer muscle strength to punching force, rapid completion of action should be highlighted in strength training, especially lower-limb strength.
Convolutional Neural Network and Clustering-Based Codebook Design Method for Massive MIMO Systems
Authors: Xing Jing , Hu Die
Published: November 2021

In this paper, we propose a convolutional neural network(CNN) and clustering based codebook design method. Specifically, we train two different CNN networks, i.e., CNN1 and CNN2, to compress the channel state information(CSI) matrices into the channel vectors and recover the channel vectors back into the CSI matrices, respectively. After that, the clustering algorithm clusters the output of CNN1, i.e., the channel vectors into several clusters and outputs a centroid for each cluster. The sum-distance between each centroid and the channel vectors in the corresponding cluster is the smallest, which can lead to the maximum sum-rate of massive MIMO codebook design. Then, the centroids are recovered into matrices by CNN2. The output of CNN2 is our proposed codebook for massive multiple-input multiple-output(MIMO) systems. In the simulation, we compare the performance of different clustering algorithms. We also compare the proposed codebook with the traditional Discrete Fourier Transform(DFT) codebook. Simulation results show the superiority of the proposed algorithm.
Clinical Handover Communication at Maternity Shift Changes and Women's Safety in Banjul, The Gambia: A Mixed-Methods Study
Authors: Rickard Faith , Lu Fides , Gustafsson Lotta , MacArthur Christine , Cummins Carole , Coker Ivan , Wilson Amie , Mane Kebba , Manneh Kebba , Manaseki-Holland Semira
Published: November 2021

Background Clinical handover is a vital communication process for patient safety; transferring patient responsibility between healthcare professionals (HCPs). Exploring handover processes in maternity care is fundamental for service quality, addressing continuity of care and maternal mortality.MethodsThis mixed-methods study was conducted in all three maternity hospitals in Banjul, The Gambia. Shift-to-shift maternity handovers were observed and compared against a standard investigating content and environment. Semi-structured interviews and focus group discussions with doctors, midwives and nurses explored handover experience.Results110 nurse/midwife shift-to-shift handovers were observed across all shift times and maternity wards; only 666 of 845 women (79%) were handed over. Doctors had no scheduled handover. Shift-leads alone gave/received handover, delayed [median 35 minutes, IQR 24-45] 82% of the time; 96% of handovers were not confidential and 29% were disrupted. Standardised guidelines and training were lacking.A median 6 of 28 topics [IQR 5-9] were communicated per woman. Information varied significantly by time, high-risk classification and location. For women in labour, 10 [IQR 8-14] items were handed-over, 8 [IQR 5-11] for women classed ‘high-risk’, 5 [IQR 4-7] for ante/postnatal women (p<0.001); >50% had no care management plan communicated.21 interviews and two focus groups were conducted. Facilitators and barriers to effective handover surrounding three health service factors emerged; health systems, organisation culture and individual clinician factors.ConclusionMaternity handover was inconsistent, hindered by contextual barriers including lack of team communication and guidelines, delays, with some women omitted entirely. Findings alongside HCPs views demonstrate feasible opportunities for enhancing handover, thereby improving women's safety.
Influence of Clay Mineral Content on the Mechanical Properties and Microfabrics of Tailings
Authors: Zhang Chao , Pan Zhenkai , Ma Changkun , Ma Lei , Li Xueting
Published: November 2021

Clay mineral content has an important influence on the mechanical behavior of tailings, and the mechanical behavior of tailings directly affects the stability of tailings dams. XRF and XRD tests were carried out on tailings from three different regions. The chemical and mineral compositions of the tailings are analyzed. The strength and failure deformation of tailings were studied by carrying out laboratory triaxial compression tests. The effect of clay content on the stress path of tailings was investigated. The microfabric of tailings samples was examined with scanning electron microscopy (SEM) and nitrogen adsorption tests. The results show that the confining pressure corresponding to the samples exhibiting strain hardening increases with increasing clay mineral content in the tailings. The cohesion of tailings increases linearly, and the specific surface area decreases as the content of clay minerals increases. Nitrogen adsorption test results reveal from a microscopic point of view that changes in pore structure are associated with the content of clay minerals. The higher the content of clay minerals is, the higher the proportion of micropores (aggregated interior). Macroscopically, the overall porosity decreases and the fineness of the pores increases with clay content, which will directly affect the mechanical properties of tailings.
Research on the Association Between Perceived Neighborhood Environment and Life Satisfaction Among Older Adults in Shanghai, China: Do Social Capital And Gender Matter?
Authors: Lu Nan , Wu Bei
Published: November 2021

This study examined the mediator role of social capital on the association between perceived neighborhood environment and life satisfaction among older adults in urban China, and further tested the moderating effect of gender in the above paths (i.e., from neighborhood environment to life satisfaction; from neighborhood environment to social capital; from social capital to life satisfaction). We used quota sampling approach to recruit 472 respondents aged 60 years old or older in Shanghai in 2020. From the perspective of structural equation modeling, multiple group analysis was conducted to examine the proposed hypotheses. The measurement model of social capital was well established in urban Chinese community contexts. Based on the whole sample, the results of the mediation model showed that social capital played a mediation role in the association between neighborhood environment and life satisfaction. Furthermore, the results of multiple group analysis showed that the association between neighborhood environment and cognitive social capital was only significant among older women. The findings highlight the role of neighborhood environment and social capital in building age-friendly communities.
Association Between Early Initiation of Breastfeeding and Reduced Risk of Respiratory Infection: Implications for Non-separation of Infant and Mother in the COVID-19 Context
Authors: Borg Bindi , Gribble Karleen , Haag Karan Courtney , Parajuli Kedar Raj , Mihrshahi Seema
Published: November 2021

Early initiation of breastfeeding, within one hour of birth, is vital for the health of newborns, and reduces morbidity and mortality. Secondary analysis of the 2016 Nepal Demographic and Health Survey (DHS) showed that early initiation of breastfeeding significantly reduced the risk of acute respiratory infection (ARI) in children under two years. Early initiation of breastfeeding requires maternal proximity. However, during the COVID-19 pandemic, guidance varied, with some recommending that infants and mothers with SARS-CoV-2 be isolated from one another. Nepal’s Ministry of Health and Population recommended non-separation, but the adherence to this guidance was inconsistent. Separation of infant and mother inhibits early initiation of breastfeeding and increases the risk that infants will suffer from ARIs. Maternal proximity, non-separation and early initiation of breastfeeding should be promoted in all birthing facilities.
Aberrant MEK5 Signalling Promotes Renal Cancer Development via mTOR Activation
Authors: Li Fangzhou , Peng Xu Feng , Zhou Jiale , Chen Qi , Chen Yonghui
Published: November 2021

Purpose: Renal cell carcinoma is one of the most incident malignancies globally. Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma. However, comprehensive clinical treatment has some limitations. Therefore, exploring the pathogenesis and identifying novel therapeutic targets are required urgently. MEK5 has been reported to play an essential role in the development of various cancers. However, no study has evaluated its role and specific mechanisms in ccRCC. Methods: Using the ONCOMINE database, MEK5 expression in ccRCC and normal tissues was compared. ccRCC and adjacent normal tissues were collected from fourteen ccRCC patients, and ccRCC expression was assessed by qPCR and immunohistochemistry. MEK5 overexpression and knockdown plasmids were constructed and transfected into ccRCC cells. CCK8, wound-healing assay, and clone formation assay were performed to examine the cell proliferation, migration, and clone formation ability of ccRCC cells. Furthermore, a western blot was performed to verify the regulation and influence of MEK5 on the mTOR signaling pathway. The MEK5 small molecule inhibitor BIX was used to treat cells, followed by CCK8, wound-healing assay, clone formation, and flow cytometry assay to examine the cell proliferation, migration, clone formation ability, apoptosis, and cell cycle. Finally, a murine subcutaneous tumor model was constructed, and the effect and safety of BIX were evaluated in-vivo.Results: The ONCOMINE database indicated that the MEK5 expression in ccRCC was significantly higher than the normal tissues, further confirmed in clinical specimens. The knockdown of MEK5 markedly inhibited the ability of ccRCC cell proliferation, colony formation, and migration. In contrast, MEK5 overexpression promoted cell proliferation, colony formation, and migration. Western blotting showed that overexpression of MEK5 can further activate the mTOR signaling pathway. The MEK5 inhibitor, BIX treatment of ccRCC, significantly inhibited cell proliferation, arrested the cell cycle in the G0/G1 phase, induced apoptosis, and effectively inhibited cell migration and clone formation. BIX also showed an excellent anti-tumor effect and favorable safety profile in murine models.Conclusions: MEK5 regulated the mTOR signal pathway and regulated the cell proliferation, cycle, migration, clone formation of ccRCC. Targeted inhibition of MEK5 had a good anti-tumor effect and favorable safety profile, providing new directions for ccRCC therapy.
Awareness, Perceived Efficacy, and Utilization of Assisted Reproductive Technologies Among Women Attending Infertility Clinic in a Nigerian Tertiary Health Institution: A Cross-Sectional Study
Authors: Chikeme Paulina Chigwara , Arinze Bekuochi Lilian
Published: November 2021

BackgroundInfertility is a source of distress for couples considering the high accolade placed on having children in family settings in Nigeria. Assisted reproductive technologies (ARTs) offer a chance of parenthood to couples. However, studies on knowledge of ART abound in Nigeria but no previous studies exist on the extent of utilization of assisted reproductive technologies. This study thus explored the level of awareness, perceived efficacy and utilization of ARTs among women attending infertility Clinic in a Nigerian Tertiary Health Institution.Methods This cross-sectional study which utilized a self-administered questionnaire was adopted for this study. The questionnaire contains five sections with section A to E bordering on demographics, awareness, perceived efficacy, utilization, and factors influencing utilization respectivelyResultsOne hundred and seven women with infertility problems, aged between 26-35 years with a mean age of 31.46 ± 5.72 participated in the study. Sixty-two patients (57.9%) were aware of ARTs while 97 (90.7%) believed that ART cannot address male infertility. Only 27 (25.2%) admitted to have used ART procedures before while 82 patients (76.6%) stated that cost of the procedure was the major hindrance to use. Conclusions Awareness of ARTs is average while there is low utilization and perceived efficacy of ART. High cost of the procedure remains the major setback to its utilization
Structural Analysis of Traditional Chinese Complex Puzzle Locks
Authors: Shi Kan , Wang Ming-Jie , Zhang Yang , Hsiao Kuo-Hung , Yao Yan-An
Published: November 2021

The development of barbed-spring locks in ancient China has a history of more than two thousand years. With the development of the design and manufacturing techniques in ancient China, the safety of locks has gotten better and better. Since the 17th century, the puzzle lock, with a complicated structure and a high difficulty in opening, was gradually developed and used. The puzzle lock needs specific steps to be opened. Even if strangers have the correct key, it is still difficult for them to open the lock immediately. Based on the difficulty of the opening process, traditional Chinese puzzle locks can be partition into two sorts, namely, general puzzle locks and complex puzzle locks. As the structure of the puzzle lock will change during the opening process, the puzzle lock belongs to the reconfigurable mechanism. In this paper, a method of topology matrix is provided to analyze the structure of the complex puzzle lock during operation systematically. Firstly, the characteristics and types of general puzzle locks are explained, and then the topology matrix representation is introduced. Finally, four complex puzzle locks are taken as examples, to illustrate the opening process. There are various types of complex puzzle locks, and the mechanism designs are quite ingenious and interesting, which shows the extraordinary technique and ingenuity of the ancient craftsmen.
Genistein Mitigates High Glucose-Induced Podocyte Adhesion Injury by Modulating Autophagy via Mtor Signal
Authors: Lian Yuhang , Tian Zhixia , Cao Haiyan , Jia Zhonghui , Yan Tiekun , Li Dong
Published: November 2021

Purpose: The study aimed to investigate the characteristics of autophagy on podocyte under high glucose (HG) conditions and further explore the effect of Genistein on podocyte autophagy，adhesion and the potential mechanism.Materials and methods: CCK-8 was used to detect the viability of podocyte. The level of autophagy was mainly detected by western blot and immunofluorescence. The expression of autophagy related factors and podocyte adhesion markers, including LC3-II, p62, p-mTOR and integrin β1-MF, were detected by immunofluorescence at 0，6，12，24，36，48，72h. The expression levels of proteins in the LC3-II, p62, p-mTOR/mTOR, integrin β1-MF were further investigated by western blot. Wound healing test and cell migration assay were used to detect podocyte adhesion ability.Results: The present study showed that HG-induced podocyte viability was reduced significantly for 6 h. Decreased integrin β1-MF, LC3-II, increased p62 and abnormal activation of the mTOR signal was detected in podocyte under HG conditions. Genistein restored podocyte viability and up-regulated integrin β1-MF, LC3-II expression, down-regulated p62, p-mTOR expression. Moreover, the HG-induced podocyte adhesion injury was abrogated by treatment with Genistein.Conclusion：Our results demonstrated that podocyte adhesion injury in HG environment was related to the decrease of autophagy level. Genistein activated podocyte autophagy by inhibiting the mTOR signaling pathway, regulated the renewal expression of integrin β1-MF, and finally reduced HG-induced podocyte adhesion injury.
Improvement in Sintered Tungsten Carbide Tool Surface Integrity Using Femtosecond Pulse Laser
Authors: Konda Osamu , Liu Xiaoxu , Maegawa Satoru , Itoigawa Fumihiro
Published: November 2021

In this paper, we propose a surface integrity technique referred to as pulse laser grinding (PLG). This method is a combination of laser ablation and averaging processes, such as grinding, and has two characteristic features. The first feature is that the irradiation area consists of a long-focus lens and a pulse laser with a Gaussian profile, and this method has a laser irradiation area equivalent to that of the grinding wheel. However, owing to the difference in the removal process of PLG and that of conventional grinding, the surface roughness after processing is expected to be different. The second feature is that the workpiece is placed at an approximately parallel angle between the laser axis and the work surface to undergo laser ablation on the surface. The characteristic piece placement restrains laser-specific problems such as debris and redeposition. This study targets sintered tungsten carbide (WC-Co), for which it is particularly difficult to form low-roughness surfaces. Binder removal followed by WC grain detachment caused by conventional grinding contributes to the increase in roughness and deterioration of corner sharpness. The experimental results of PLG with a sufficiently averaged surface of a WC-Co tool confirmed that the parallel roughness reached an arithmetical mean roughness (Ra) of 0.025 μm, and the perpendicular roughness reached Ra below 0.006 μm, in agreement with the aforementioned considerations.
Optimal Positive End-Expiratory Pressure Obtained with Titration of Fraction of Inspiratory Oxygen: A Randomized Controlled Clinical Trial
Authors: Gao Lingling , Yang Li , Pan Lili , Cui Yun , Jiang Yandong , Zhang Jun
Published: November 2021

Background
Optimal intraoperative positive end expiratory pressure (PEEP) improves patient outcomes. The pulse-oximetry has been used to determine the lung opening and closing pressures. Therefore, we hypothesized that intraoperative optimal PEEP obtained by titrating inspiratory oxygen fraction (FiO2) guided with pulse-oximetry could improve perioperative oxygenation.
Methods
Forty-six males undergoing elective robotic assisted laparoscopic prostatectomy were randomly assigned to either optimal PEEP (Group O, n=23) or control with fixed PEEP of 5 cmH2O (Group C, n=23). Optimal PEEP, defined as the PEEP with lowest FiO2 or 0.21 to maintain SpO2≥ 95%, was obtained in both groups after placing the patients in Trendelenburg position and peritoneal insufflation. Patients in Group O maintained the optimal PEEP and in Group C maintained PEEP of 5cmH2O intraoperatively. Both groups were extubated in a sitting position once the extubation criteria met. The primary outcome was the partial arterial oxygen pressure (PaO2)/inspiratory oxygen fraction (FiO2) prior to extubation. Secondary outcome was the incidence of postoperative hypoxemia (SpO2༜92% on room-air after extubation) in post-operative care unit.
Results
The median optimal PEEP was 16 cm H2O [inter-quartile range, 12-18]. The PaO2/FiO2prior to extubation was significantly higher in Group O than that in Group C (77.0±4.9kPa vs.60.6±5.9kPa, p=0.04); PaO2/FiO2 was also significantly higher in Group O 30minutes after extubation (57.6±1.9 vs. 46.6±1.8kPa, p=0.01). The incidence of hypoxemia on room air in the post-operative care unit was significantly lower in the Group O than in the Group C (1/23, or 4.3% vs. 7/23 or 30.4%, p =0.02).
Conclusions
Intraoperative optimal PEEP can be achieved by titration of FiO2 guided with SpO2. Maintaining intraoperative optimal PEEP improves intraoperative oxygenation and reduces the incidence of post-operative hypoxemia.
Trial registration
: Chinese Clinical Trial Registry identifier: ChiCTR2100051010. Prospectively registered on 10 September, 2021
Association Between Thyroid Cancer and Cardiovascular Disease Risk: A Nationwide Observation Study
Authors: Tsai Ming-Chieh , Hsieh Cheng-Tzu , Hsu Hsin-Yin , Yeh Tzu-Lin , Lee Wen-Chung , Chiang Chun-Ju , Hsiao Bo-Yu , Jhuang Jing-Rong , Tsai Wen-Hsuan , Cheng Shih-Ping , Chou Chao-Liang , Lee Chun-Chuan , Liu Sung-Chen , Tseng Po-Jung , Chien Kuo-Liong
Published: November 2021

BackgroundResearch findings on the long-term cardiovascular risk associated with thyroid cancer and treatment are unclear. This study aimed to investigate the standardized incidence rate (SIR) of coronary heart disease (CHD), ischemic stroke (IS), and atrial fibrillation (AF) among thyroid cancer patients in comparison with the general population across different age groups. MethodsDesign, setting, and participantsThis observational cohort study enrolled patients between January 1, 2011 and December 31, 2016 with follow-up until December 31, 2018. This study analyzed the data of Taiwanese thyroid cancer patients registered on the National Taiwan Cancer Registry Database, with CHD and IS. Main outcomes and measuresSIR models were used to evaluate the association between thyroid cancer and CHD, IS, AF, and cardiovascular disease outcome, stratified by age and sex. SIR analyses were also conducted for both sexes, age groups (<60, ≥60 years), and different follow-up years.ResultsAfter excluding 128 individuals <20 years or >85 years and with missing index data, 4274 eligible thyroid cancer patients without CHD history, 4343 patients without IS history, and 4247 patients without AF history were included for analysis. During the median follow-up of 3.5 (1.2) years, CHD incidence was 70; IS, 30; and AF, 20. Compared with the general population, thyroid cancer patients had higher CHD risk throughout the age spectrum (SIR, 1.33; 95% confidence interval [CI], 1.02 to 1.65). The overall CHD risk gradually declined, but it was persistent for more than 5 years after thyroid cancer diagnosis. CHD risk was observed in both males and females, especially in young thyroid cancer patients <65 years. However, lower SIRs for IS (SIR, 0.74; 95% CI, 0.47 to 1), AF (SIR, 0.74; 95% CI, 0.42 to 1.06), and cardiovascular disease (SIR, 0.88; 95% CI, 0.7 to 1.05) were observed among thyroid cancer patients (not significant). ConclusionsThyroid cancer survivors have a substantial CHD risk even at long-term follow-up, especially in those patients <65 years. Further research on the association between thyroid cancer and CHD risk is warranted.