bluuebunny/crossref_metadata_2025 huggingface dataset:
Study protocol designed to investigate tumour response to calcium electroporation in cancers affecting the skin: a non-randomised phase II clinical trial
Authors: Vissing Mille , Ploen John , Pervan Mascha , Vestergaard Kitt , Schnefeldt Mazen , Frandsen Stine Krog , Rafaelsen Søren Rafael , Lindhardt Christina Louise , Jensen Lars Henrik , Rody Achim , Gehl Julie
Published: June 2021

Introduction

Skin malignancy is a distressing problem for many patients, and clinical management is challenging. This article describes the protocol for the Calcium Electroporation Response Study (CaEP-R) designed to investigate tumour response to calcium electroporation and is a descriptive guide to calcium electroporation treatment of malignant tumours in the skin. Calcium electroporation is a local treatment that induces supraphysiological intracellular calcium levels by intratumoural calcium administration and application of electrical pulses. The pulses create transient membrane pores allowing diffusion of non-permeant calcium ions into target cells. High calcium levels can kill cancer cells, while normal cells can restore homeostasis. Prior trials with smaller cohorts have found calcium electroporation to be safe and efficient. This trial aims to include a larger multiregional cohort of patients with different cancer diagnoses and also to investigate treatment areas using MRI as well as assess impact on quality of life.

Methods and analysis

This non-randomised phase II multicentre study will investigate response to calcium electroporation in 30 patients with cutaneous or subcutaneous malignancy. Enrolment of 10 patients is planned at three centres: Zealand University Hospital, University Hospital of Southern Denmark and University Hospital Schleswig-Holstein. Response after 2 months was chosen as the primary endpoint based on short-term response rates observed in a prior clinical study. Secondary endpoints include response to treatment using MRI and change in quality of life assessed by questionnaires and qualitative interviews.

Ethics and dissemination

The trial is approved by the Danish Medicines Agency and The Danish Regional Committee on Health Research Ethics. All included patients will receive active treatment (calcium electroporation). Patients can continue systemic treatment during the study, and side effects are expected to be limited. Data will be published in a peer-reviewed journal and made available to the public.

Trial registration numbers

NCT04225767and EudraCT no: 2019-004314-34.
Challenges of developing, conducting, analysing and reporting a COVID-19 study as the COVID-19 pandemic unfolds: an online co-autoethnographic study
Authors: das Nair Roshan , Hunter Rachael , Garjani Afagh , Middleton Rod M , Tuite-Dalton Katherine A , Nicholas Richard S , Evangelou Nikos
Published: June 2021

Objectives

To capture the complexities and unique experience of a newly formed multidisciplinary and multicentre research team developing and deploying a COVID-19 study and to identify lessons learnt.

Design

Co-autoethnographic study.

Setting

Staff at two UK academic institutions, a national charity and two major UK hospitals.

Participants

Researchers, clinicians, academics, statisticians and analysts, patient and public involvement representatives and national charity.

Methods

The sampling frame was any content discussed or shared between research team members (emails, meeting minutes, etc), standard observational dimensions and reflective interviews with team members. Data were thematically analysed.

Results

Data from 34 meetings and >50 emails between 17 March and 5 August 2020 were analysed. The analysis yielded seven themes with ‘Managing our stress’ as an overarching theme.

Conclusions

Mutual respect, flexibility and genuine belief that team members are doing the best they can under the circumstances are essential for completing a time-consuming study, requiring a rapid response during a pandemic. Acknowledging and managing stress and a shared purpose can moderate many barriers, such as the lack of face-to-face interactions, leading to effective team working.
Superiority trial comparing intraoperative wound irrigation with aqueous 10% povidone–iodine to saline for the purpose of reducing surgical site infection after elective gastrointestinal surgery: study protocol for a randomised controlled trial
Authors: Maemoto Ryo , Noda Hiroshi , Ichida Kosuke , Tamaki Sawako , Kanemitsu Rina , Machida Erika , Kikuchi Nozomi , Sakio Ryotaro , Aizawa Hidetoshi , Fukui Taro , Kakizawa Nao , Muto Yuta , Iseki Masahiro , Fukuda Rintaro , Watanabe Fumiaki , Kato Takaharu , Saito Masaaki , Tsujinaka Shingo , Miyakura Yasuyuki , Rikiyama Toshiki
Published: June 2021

Introduction

Surgical site infection (SSI) is one of the most common complications after gastrointestinal surgery, with a reported incidence of approximately 10%–25%, which is higher than the rates after other types of surgery. Intraoperative wound irrigation (IOWI) is a simple intervention for SSI prevention, and recent studies have reported that IOWI with aqueous povidone–iodine (PVP-I) is significantly more effective at reducing the incidence of SSI than saline. However, the evidence level of previous trials evaluating the efficacy of aqueous PVP-I solution for preventing SSI has been low.

Methods and analyses

We propose a single-institute, prospective, randomised, blinded-endpoint trial to assess the superiority of IOWI with aqueous 10% PVP-I solution compared with normal saline for reducing SSI in clean-contaminated wounds after elective gastrointestinal surgery. In the study group, IOWI with 40 mL of aqueous 10% PVP-I solution is performed for 1 min before skin suture, and in the control group, IOWI with 100 mL of saline is performed for 1 min before skin suture. We hypothesise that IOWI with aqueous 10% PVP-I solution will achieve a 50% reduction in the incidence of SSIs. The target number of cases is set at 950. The primary outcome is the incidence of incisional SSI up to postoperative day 30 and will be analysed in the modified intention-to-treat set.

Ethics and dissemination

This trial was designed and is being conducted by Saitama Medical Center, Jichi Medical University, with approval from the Bioethics Committee for Clinical Research, Saitama Medical Center, Jichi Medical University. Participant recruitment began in June 2019. The final results will be reported in international peer-reviewed journals immediately after trial completion.

Trial registration number

UMIN000036889.
High-fidelity simulation and virtual reality: an evaluation of medical students’ experiences
Authors: Macnamara Alexandra Frances , Bird Katie , Rigby Alan , Sathyapalan Thozhukat , Hepburn David
Published: June 2021

Background

Simulation technology is widely used in medical education, providing an environment in which students can develop and practise a multitude of skills that are relevant to clinical practice, without the risk of harm to patients.

Methods

We conducted a mixed methods cross-over study with quantitative and qualitative outcomes. This analysed students’ perceptions of two simulation technologies: a high-fidelity patient simulator and virtual reality. Twenty final year medical students completed a questionnaire after having experienced both simulation modalities.

Results

Students scored the patient simulator higher in domains such as developing team working and ‘ABCDE assessment skills’, whereas the virtual reality simulation was more immersive and fun. Participants found the patient simulator more useful in preparing them for clinical practice.

Conclusion

Medical students in this study expressed that a high-fidelity patient simulator, in a simulated clinical environment, was of greater value to their preparation for clinical practice than virtual reality simulation of a similar environment. However, the virtual reality simulation offered a near comparable experience, and was found to be was enjoyable, immersive and easily portable.
Effects of dietary patterns on driving behaviours among professional truck drivers: the mediating effect of fatigue
Authors: Ge Yan , He Shanshan , Xu Yan , Qu Weina
Published: June 2021

Objective

To explore the impact of the dietary patterns of truck drivers on their driving behaviours and the mediation effect of fatigue between these factors.

Methods

A sample of 389 male truck drivers from a transport company in Suzhou, China completed the Food Frequency Questionnaire (FFQ), the Multidimensional Fatigue Inventory (MFI), the Positive Driver Behaviours Scale (PDBS) and the Driver Behaviour Questionnaire (DBQ). The associations among dietary patterns, fatigue and driving behaviour were examined using pathway analysis.

Results

Four dietary patterns were identified based on principal component analysis: animal-derived foods, staple foods, snacks and vegetables. The pathway analysis showed that the vegetable-rich pattern had a direct positive impact on positive driving behaviour (β=0.211, p<0.001); the animal-derived pattern had a direct positive impact on errors (β=0.094, p<0.05) and ordinary violations (β=0.071, p<0.05); the snacks pattern had a direct negative impact on positive driving behaviour (β=−0.191, p<0.001); fatigue mediated the effect of dietary patterns on driving behaviours (p<0.001); and the staple foods had an indirect effect on driving behaviours.

Conclusions

Overall, the driving behaviours of truck drivers are correlated with their dietary patterns. Drivers who preferred vegetables and staple foods had more positive driving behaviour, while the animal-derived food and snack patterns were related to dangerous driving behaviour. The experience of fatigue could explained the underlying mechanism between these factors.
Effects of homo- and hetero-fermentative lactic acid bacteria on the quality and aerobic stability of corn silage
Authors: Zhang Fanfan , Miao Fang , Wang Xuzhe , Lu Weihua , Ma Chunhui
Published: June 2021

This study aimed to investigate the effects of homo/heterofermentative lactic acid bacteria (LAB) on the quality of corn silage and its rumen digestibility. Maize (Zea mays strain Xingsiyu No. 10), at the early dough stage, was harvested, chopped, ensiled in vacuum bags, and divided into four groups: (1) control (without added bacteria); (2) with the homofermentative LAB Lactobacillus plantarum and Pediococcus pentosaceus (1:1 mixture, 1 × 105 cfu·g−1); (3) with the heterofermentative LAB Lactobacillus buchneri (1 × 105 cfu·g−1); and (4) with the homo/heterofermentative LAB L. plantarum, P. pentosaceus, and L. buchneri (1:1:1 mixture). At 2, 8, 15, 45, and 60 d of ensiling, nutritional quality, fermentation characteristics, and microbial content were assessed. After 60 d, aerobic stability and rumen digestibility tests were performed. The addition of homo- and (or) hetero-fermentative LAB significantly improved the nutritional quality, fermentation characteristics, and microbial content. Addition of the heterofermenter L. buchneri, with or without the homofermenters L. plantarum and P. pentosaceus, improved aerobic stability. The different LAB inoculants increased the degradation rates of dry matter, acid detergent fiber, and neutral detergent fiber of the corn silage by sheep ruminants. Analysis indicated that L. buchneri yielded the best corn silage.
Erratum to: Echoes of 2HDM inflation at the collider experiments
Authors: Modak Tanmoy , Oda Kin-ya
Published: June 2021

A correction to this paper has been published: https://doi.org/10.1140/epjc/s10052-020-08450-5
Wiener Index of k-Connected Graphs
Authors: Qin Xiang , Zhao Yanhua , Wu Baoyindureng
Published: June 2021

The Wiener index [Formula: see text] of a connected graph [Formula: see text] is the sum of distances of all pairs of vertices in [Formula: see text]. In this paper, we show that for any even positive integer [Formula: see text], and [Formula: see text], if [Formula: see text] is a [Formula: see text]-connected graph of order [Formula: see text], then [Formula: see text], where [Formula: see text] is the [Formula: see text]th power of a graph [Formula: see text]. This partially answers an old problem of Gutman and Zhang.
Bovine Serum Albumin-Directed Fabrication of Nanohydroxyapatite with Improved Stability and Biocompatibility
Authors: Li Ting , Yu Jialu , Sui Hao , Zhang Tao , Zhou Ronghui
Published: June 2021

Nanohydroxyapatite (nHAp) has gained considerable concerns due to its vast potential in biomedical applications such as drug delivery, tissue engineering and bone repair. However, the preparation of HAp nanostructures in a controllable manner under environment-friendly reaction conditions remains a challenge. In recent years, the use of biological macromolecules or proteins as templates in the production of nanomaterials has gained more attention due to the relatively mild physical conditions needed for biomimetic synthesis. In this study, a novel nHAp was fabricated by employing bovine serum albumin (BSA) as template under mild condition. After that, the as-obtained nanostructured materials which have well-defined structures and morphologies were characterized by various methods. Furthermore, the rod-like shaped hydroxyapatite demonstrated improved stability properties, as well as cell viability and biocompatibility, compared to BSA free synthesized c-HAp. We expect that this pleasantly novel research will render new insights into the fabrication strategies of nanomaterials and be of practical importance for the expanding biological application.
State Income Tax Changes and the Demand for Municipal Bond Funds
Authors: Fulkerson Jon A. , Haskell Nancy L.
Published: June 2021

We consider how state income tax changes affect the demand for municipal bonds by in-state investors. A tax increase (decrease) makes investing in municipal bonds more (less) desirable, and theory predicts a change in demand by investors until the yields on municipal bonds reach a new equilibrium. Using a sample of state-specific municipal bond funds, we find states with tax decreases have net outflows in the following year of approximately 2% per percentage point drop in tax rates, while tax increases lead to inflows around 1.58%. We find that the response to tax changes is not the immediate reallocation predicted in perfect markets with no frictions.
SACNN: Self-attentive Convolutional Neural Network Model for Natural Language Inference
Authors: Quamer Waris , Jain Praphula Kumar , Rai Arpit , Saravanan Vijayalakshmi , Pamula Rajendra , Kumar Chiranjeev
Published: June 2021

Inference has been central problem for understanding and reasoning in artificial intelligence. Especially, Natural Language Inference is an interesting problem that has attracted the attention of many researchers. Natural language inference intends to predict whether a hypothesis sentence can be inferred from the premise sentence. Most prior works rely on a simplistic association between the premise and hypothesis sentence pairs, which is not sufficient for learning complex relationships between them. The strategy also fails to exploit local context information fully. Long Short Term Memory (LSTM) or gated recurrent units networks (GRU) are not effective in modeling long-term dependencies, and their schemes are far more complex as compared to Convolutional Neural Networks (CNN). To address this problem of long-term dependency, and to involve context for modeling better representation of a sentence, in this article, a general Self-Attentive Convolution Neural Network (SACNN) is presented for natural language inference and sentence pair modeling tasks. The proposed model uses CNNs to integrate mutual interactions between sentences, and each sentence with their counterparts is taken into consideration for the formulation of their representation. Moreover, the self-attention mechanism helps fully exploit the context semantics and long-term dependencies within a sentence. Experimental results proved that SACNN was able to outperform strong baselines and achieved an accuracy of 89.7% on the stanford natural language inference (SNLI) dataset.
Automatic Generation of the Draft Procuratorial Suggestions Based on an Extractive Summarization Method: BERTSLCA
Authors: Sun Yufeng , Yang Fengbao , Wang Xiaoxia , Dong Hongsong
Published: June 2021

The automatic generation of the draft procuratorial suggestions is to extract the description of illegal facts, administrative omission, description of laws and regulations, and other information from the case documents. Previously, the existing deep learning methods mainly focus on context-free word embeddings when addressing legal domain-speciﬁc extractive summarization tasks, which cannot get a better semantic understanding of the text and in turn leads to an adverse summarization performance. To this end, we propose a novel deep contextualized embeddings-based method BERTSLCA to conduct the extractive summarization task. The model is mainly based on the variant of BERT called BERTSUM. Firstly, the input document is fed into BERTSUM to get sentence-level embeddings. Then, we design an extracting architecture to catch the long dependency between sentences utilizing the Bi-Long Short-Term Memory (Bi-LSTM) unit, and at the end of the architecture, three cascaded convolution kernels with different sizes are designed to extract the relationships between adjacent sentences. Last, we introduce an attention mechanism to strengthen the ability to distinguish the importance of different sentences. To the best of our knowledge, this is the first work to use the pretrained language model for extractive summarization tasks in the field of Chinese judicial litigation. Experimental results on public interest litigation data and CAIL 2020 dataset all demonstrate that the proposed method achieves competitive performance.
Common Fixed Point Results for Generalized

g
−

α

s

p

,
ψ
,
φ

Contractive Mappings with Applications
Authors: Li Jianju , Guan Hongyan
Published: June 2021

In this paper, we introduce a new class of

g
−

α

s

p

−

admissible mappings and prove some common fixed point theorems involving this new class of mappings which satisfy generalized contractive conditions in the framework of

b
−

metric spaces. We also provide two examples to show the applicability and validity of our results. Meanwhile, we present an application to the existence of solutions to an integral equation by means of one of our results.
Protein Phosphatase 4 Promotes Hepatocyte Lipoapoptosis by Regulating RAC1/MLK3/JNK Pathway
Authors: Huang Xiuqing , Yang Guang , Zhao Li , Yuan Huiping , Chen Hao , Shen Tao , Tang Weiqing , Man Yong , Ma Jiarui , Ma Yanyan , Dou Lin , Li Jian
Published: June 2021

Lipotoxicity‐induced apoptosis, also referred to as lipoapoptosis, is one of the important initial factors promoting the progression from hepatosteatosis to nonalcoholic steatohepatitis (NASH). Saturated free fatty acids (SFAs), which are increased significantly in NASH, are directly hepatotoxic which induce hepatocyte lipoapoptosis. Previously, we reported that protein phosphatase 4 (PP4) was a novel regulator of hepatic insulin resistance and lipid metabolism, but its role in hepatic lipoapoptosis remains unexplored. In this study, we found out that PP4 was upregulated in the livers of western diet‐fed‐induced NASH mice and SFA‐treated murine primary hepatocytes and HepG2 cells. In addition, we found for the first time that suppression of PP4 decreased SFA‐induced JNK activation and expression of key modulators of hepatocyte lipoapoptosis including p53‐upregulated modulator of apoptosis (PUMA) and Bcl‐2‐interacting mediator (Bim) and reduced hepatocyte lipoapoptosis level as well both in vitro and in vivo. Further study revealed that PP4 induced JNK activation and lipoapoptosis‐related protein expression by regulating the RAC1/MLK3 pathway instead of the PERK/CHOP pathway. The effects of palmitate‐treated and PP4‐induced lipoapoptosis pathway activation were largely abolished by RAC1 inhibition. Moreover, we identified that PP4 interacted with RAC1 and regulated GTPase activity of RAC1. In conclusion, these results demonstrated that PP4 was a novel regulator of hepatocyte lipoapoptosis and mediated hepatocyte lipoapoptosis by regulating the RAC1/MLK3/JNK signaling pathway. Our finding provided new insights into the mechanisms of this process.
Prognostic Value of GDF-15 in Predicting Prolonged Intensive Care Stay following Cardiac Surgery: A Pilot Study
Authors: Barton Henry , Zechendorf Elisabeth , Ostareck Dirk , Ostareck-Lederer Antje , Stoppe Christian , Zayat Rashad , Simon-Philipp Tim , Marx Gernot , Bickenbach Johannes
Published: June 2021

Introduction. Predicting intensive care unit length of stay and outcome following cardiac surgery is currently based on clinical parameters. Novel biomarkers could be employed to improve the prediction models. Materials and Methods. We performed a qualitative cytokine screening array to identify highly expressed biomarkers in preoperative blood samples of cardiac surgery patients. After identification of one highly expressed biomarker, growth differentiation factor 15 (GDF-15), a quantitative ELISA was undertaken. Preoperative levels of GDF-15 were compared in regard to duration of intensive care stay, cardiopulmonary bypass time, and indicators of organ dysfunction. Results. Preoperatively, GDF-15 was highly expressed in addition to several less highly expressed other biomarkers. After qualitative analysis, we could show that preoperatively raised levels of GDF-15 were positively associated with prolonged ICU stay exceeding 48 h (median 713 versus 1041 pg/ml,p=0.003). It was also associated with prolonged mechanical ventilation and rates of severe sepsis but not with dialysis rates or cardiopulmonary bypass time. In univariate regression, raised GDF-15 levels were predictive of a prolonged ICU stay (OR 1.01, 95% confidence interval 1–1.02, andp=0.029). On ROC curves, GDF-15 was found to predict prolonged ICU stay (AUC=0.86, 95% confidence interval 0.71–0.99, andp=0.003). Conclusion. GDF-15 showed potential as predictor of prolonged intensive care stay following cardiac surgery, which might be valuable for risk stratification models.
Predicting Fracture Risk in Patients with Metastatic Bone Disease of the Femur: A Pictorial Review Using Three Different Techniques
Authors: Kaupp Shannon M. , Mann Kenneth A. , Miller Mark A. , Damron Timothy A.
Published: June 2021

One of the key roles of an orthopedic surgeon treating metastatic bone disease (MBD) is fracture risk prediction. Current widely used impending fracture risk tools such as Mirels scoring lack specificity. Two newer methods of fracture risk prediction, CT-based structural rigidity analysis (CTRA) and finite element analysis (FEA), have each been shown to be more accurate than Mirels. This case series illustrates comparative Mirels, CTRA, and FEA for 8 femurs in 7 subjects. These cases were selected from a much larger data set to portray examples of true positives, true negatives, false positives, and false negatives as defined by CTRA relative to the fracture outcome. Case illustrations demonstrate comparative Mirels and FEA. This series illustrates the use, efficacy, and limitations of these tools. As all current tools have limitations, further work is needed in refining and developing fracture risk prediction.
Frequency Interpolation of LOFAR Embedded Element Patterns Using Spherical Wave Expansion
Authors: Arts M. J. , Prinsloo D. S. , Bentum M. J. , Smolders A. B.
Published: June 2021

This paper describes the use of spherical wave expansion (SWE) to model the embedded element patterns of the LOFAR low-band array. The goal is to reduce the amount of data needed to store the embedded element patterns. The coefficients are calculated using the Moore–Penrose pseudoinverse. The Fast Fourier Transform (FFT) is used to interpolate the coefficients in the frequency domain. It turned out that the embedded element patterns can be described by only 41.8% of the data needed to describe them directly if sampled at the Nyquist rate. The presented results show that a frequency resolution of 1 MHz is needed for proper interpolation of the spherical wave coefficients over the 80 MHz operating frequency band of the LOFAR low-band array. It is also shown that the error due to interpolation using the FFT is less than the error due to linear interpolation or cubic spline interpolation.
Spatial Variability and Geostatistical Analysis of Soil Properties in the Diversified Cropping Regions of Bangladesh Using Geographic Information System Techniques
Authors: Khan Md. Zulfikar , Islam Md. Rafikul , Salam Ahmed Bin Abdus , Ray Tama
Published: June 2021

Mapping of soil properties is an important operation as it plays an important role in the knowledge about soil properties and how it can be used sustainably. The study was carried out in a local government area in Bangladesh in order to map out some soil properties and assess their variability within the area. From the study area, a total of 92 soil samples (0–20 cm) were collected from different cropping patterns at an interval of 2.2 × 2.2 km2 on a regular grid design. A portable global positioning system (GPS) was used to collect coordinates of each sampling site. Then, soil properties, that is, pH, electrical conductivity (EC), soil organic carbon (SOC), total nitrogen (Total N), and soil available nutrients (P, K, and S) were measured in the laboratory. After the normalization of data, classical statistics were used to describe the soil properties, and geostatistical analysis was used to illustrate the spatial variability of the soil properties by using kriging interpolation techniques in a GIS environment. Results show that the spatial distribution and spatial dependency level of soil properties can be different even within the small or large scale. According to cross-validation results, for most soil properties, the kriging interpolation method provided the least interpolation error. The generated maps of soil properties that indicate soil nutrient status over the study region could be helpful for farmers and decision-makers to enhance site-specific nutrient management. Also, these prototype maps would be helpful for future nutrient and fertilizer applications management, including a site-specific condition to not only reduce the cost of input management but also prevent any environmental hazard. It also demonstrates that the effectiveness of geostatistics and GIS techniques provided a powerful tool for this study in terms of regionalized nutrient management.
Association of HLA-B Gene Polymorphisms with Type 2 Diabetes in Pashtun Ethnic Population of Khyber Pakhtunkhwa, Pakistan
Authors: Jan Asif , Saeed Muhammad , Afridi Muhammad Hussain , Khuda Fazli , Shabbir Muhammad , Khan Hamayun , Ali Sajid , Hassan Muhammad , Samiullah  , Akbar Rani , Zakiullah
Published: June 2021

Human leukocyte antigen (HLA) system is the most polymorphic and gene dense region of human DNA that has shown many disease associations. It has been further divided into HLA classes I, II, and III. Polymorphism in HLA class II genes has been reported to play an important role in the pathogenesis of type 1 diabetes (T1D). It also showed association with T2D in different ethnic populations. However, a little is known about the relationship of HLA class I gene polymorphism and T2D. This study has evaluated the association of HLA-B (class I gene) variants with T2D in Pashtun ethnic population of Khyber Pakhtunkhwa. In the first phase of the study, whole exome sequencing (WES) of 2 pooled DNA samples was carried out, and DNA pools used were constructed from 100 diabetic cases and 100 control subjects. WES results identified a total of

n
=
17

SNPs in HLA-B gene. In the next phase, first 5 out of

n
=
17

reported SNPs were genotyped using MassARRAY® system in order to validate WES results and to confirm association of selected SNPs with T2D. Minor allele frequencies (MAFs) and selected SNPs×T2D association were determined using chi-square test and logistic regression analysis. The frequency of minor C allele was significantly higher in the T2D group as compared to control group (45.0% vs. 13.0%) (

p
=
0.006

) for rs2308655 in HLA-B gene. No significant difference in MAF distribution between cases and controls was observed for rs1051488, rs1131500, rs1050341, and rs1131285 (

p
>
0.05

). Binary logistic regression analyses showed significant results for SNP rs2308655 (

OR
=
2.233

,

CI
 

95
%

=
1.223
‐
4.077

, and

p
=
0.009

), while no considerable association was observed for the other 4 SNPs. However, when adjusted for these variants, the association of rs2308655 further strengthened significantly (

adjusted
 
OR
=
7.485

,

CI
 

95
%

=
2.353
‐
23.812

, and

p
=
0.001

), except for rs1131500, which has no additive effect. In conclusion, the finding of this study suggests rs2308655 variant in HLA-B gene as risk variant for T2D susceptibility in Pashtun population.
The Clinical Manifestations of Femoral-Facial Syndrome in an Orthopaedic Patient
Authors: Ghali Abdullah , Salazar Luis , Momtaz David , Prabhakar Gautham , Richier Preston , Dutta Anil
Published: June 2021

Femoral-facial syndrome (FFS) is an exceedingly rare congenital disorder of unknown etiology related to maternal diabetes during pregnancy. It is characterized by variations of bilateral femoral hypoplasia and facial anomalies. We discuss an interesting case of a 3-year-old girl with FFS with an extensive surgical history who presented to a pediatric orthopaedic clinic with ankle pains and absent femurs. As this disease process is not frequently encountered, it is imperative for the practicing clinician to be aware of the various presentations. In this study, we discuss the different orthopaedic presentations in the literature and discuss various management recommendations.
Exact Solutions to the Nonlinear Schrödinger Equation with Time-Dependent Coefficients
Authors: Mai Xin-Lei , Li Wei , Dong Shi-Hai
Published: June 2021

In this paper, a trial function method is employed to find exact solutions to the nonlinear Schrödinger equations with high-order time-dependent coefficients. This system might be used to describe the propagation of ultrashort optical pulses in nonlinear optical fibers, with self-steepening and self-frequency shift effects. The new general solutions are found for the general case

a

0

≠
0

including the Jacobi elliptic function solutions, solitary wave solutions, and rational function solutions which are presented in comparison with the previous ones obtained by Triki and Wazwaz, who only studied the special case

a

0

=
0

.
Geospatial Assessment of Floods in Western Nepal
Authors: Subedi Sugam , Kafle Gandhiv , Tripathi Shankar
Published: June 2021

Floods are major problems, and their coexistence poses a potent threat, which cannot be eradicated but has to be managed. Extreme affects untold numbers of people, taxing economies, disrupting food production, creating unrest, and prompting migrations. There is much more that can be done to understand the effects of floods, particularly to help protect the poorest and most vulnerable. This research was carried out in the affected area of Bhimdatta municipality and aimed to find out the flood event of 2013 and present the scenario done for flood disaster management. The primary data were collected by direct observation and key informant survey. Landsat images were downloaded from USGS websites, and secondary information was collected through previous research and articles. The data were analyzed by using ArcGIS. It was found that the flood had created a negligible impact on the forest, high impact on the river itself, and average impact on land. 0.13% of forests, 17.38% of land, and 82.48% of river bodies were affected by the flood of 2013. Different governmental and nongovernmental organizations played an effective role for flood disaster management.
Augmented Data Selector to Initiate Text-Based CAPTCHA Attack
Authors: Che Aolin , Liu Yalin , Xiao Hong , Wang Hao , Zhang Ke , Dai Hong-Ning
Published: June 2021

In the past decades, due to the low design cost and easy maintenance, text-based CAPTCHAs have been extensively used in constructing security mechanisms for user authentications. With the recent advances in machine/deep learning in recognizing CAPTCHA images, growing attack methods are presented to break text-based CAPTCHAs. These machine learning/deep learning-based attacks often rely on training models on massive volumes of training data. The poorly constructed CAPTCHA data also leads to low accuracy of attacks. To investigate this issue, we propose a simple, generic, and effective preprocessing approach to filter and enhance the original CAPTCHA data set so as to improve the accuracy of the previous attack methods. In particular, the proposed preprocessing approach consists of a data selector and a data augmentor. The data selector can automatically filter out a training data set with training significance. Meanwhile, the data augmentor uses four different image noises to generate different CAPTCHA images. The well-constructed CAPTCHA data set can better train deep learning models to further improve the accuracy rate. Extensive experiments demonstrate that the accuracy rates of five commonly used attack methods after combining our preprocessing approach are 2.62% to 8.31% higher than those without preprocessing approach. Moreover, we also discuss potential research directions for future work.
Exploring Green Hotel Competitive Strategies by Using the Hybrid Method for Complex Data Analysis
Authors: Wu Chia-Huei
Published: June 2021

Green hotels emphasize safety, health, and environmental friendliness and advocate for green operations, green consumption, environmental protection, and the reasonable consumption of resources in operations. In short, environmental protection and moderate resource consumption are underscored. The literature on green hotel criteria and competitive strategies has two shortcomings. Some studies assume the independence of each criterion; these criteria are not mutually influential or causally related. By contrast, other studies set equal weights for all criteria. The present study explored the criteria and competitive strategies of green hotels by combining the importance-performance analysis (IPA) and the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method into the IPA-DEMATEL model.
Volume of Crescents Affects Prognosis of IgA Nephropathy in Patients without Obvious Chronic Renal Pathology
Authors: Lin Zaoqiang , Liu Lichang , Zhang Rongling , Lin Xuefei , Lu Fuhua , Bao Kun , Wang Lixin , Lin Qizhan , Mai Jianling , Cao Yanfei , Yang Haifeng , Liu Xusheng , Zou Chuan
Published: June 2021

Introduction: A working group on the Oxford classification of IgA nephropathy (IgAN) recently reported that crescents detected in the kidney tissue predicted a worse renal outcome. However, the effect of C1 lesion (crescents in <1/4th of all glomeruli) and their volume on the prognosis of IgAN is still unclear. We explored the association of C1 lesion with the renal prognosis in IgAN patients without obvious chronic renal lesions (glomerulosclerosis <25%, T score <2). Methods: We investigated 305 biopsy-proven IgAN patients without obvious chronic renal lesions. Clinicopathologic features and treatment modalities were recorded. The patients were divided into several groups according to the presence or absence of a global crescent: no crescent (NC) group, only segmental crescent (SC) group, and global crescent (GC) group. The outcome was the survival from a combined event defined by a ≥15% decline in the estimated glomerular filtration rate (eGFR) after 1 year or ≥30% decline in the eGFR after 2 years. Results: Among all patients, 75.7% were in the NC group, 14.8% were in the SC group, and 9.5% were in the GC group. Compared with the NC group, patients in the SC group and the GC group had more urine protein, lower eGFR, and presented with more severe pathological change. During a median follow-up of 34.8 (26.16–57.95) months, the combined event occurred in 34 individuals (11.1%). In a multivariate model, the GC group (HR = 2.756, 95% CI = 1.068–7.109) was associated with an increased risk of the combined event. Conclusions: In IgAN patients without obvious chronic renal lesions, the GC group had more severe clinical and pathological manifestations than in the NC group. GC is an independent risk factor for the progression of IgAN renal function.
The Efficacy of Surgical Metastasectomy for Solitary Metastasis of Renal Cell Carcinoma
Authors: Suzuki Kotaro , Hara Takuto , Terakawa Tomoaki , Furukawa Junya , Harada Kenichi , Hinata Nobuyuki , Nakano Yuzo , Fujisawa Masato
Published: June 2021

Background: Patients with solitary metastasis of renal cell carcinoma (RCC) have shown to be ideal candidates for surgical metastasectomy (SM). However, whether SM will show more benefit than systemic therapy remains unclear. Methods: We included 73 patients treated for solitary metastasis after nephrectomy at our institute from April 2008 to December 2018. We compared the clinical outcomes between the SM (n = 29) and no-SM (n = 44) group which were treated with only systemic therapy. Results: Eleven of 29 patients in the SM group received presurgical targeted therapy (PTT). Although 13 of 29 patients in the SM group showed recurrence during the study period, a Cox proportional hazards model showed that SM was significantly associated with a favorable overall survival (hazard ratio: 0.18; p = 0.007). Patients receiving PTT prior to SM showed a longer recurrence-free survival after SM in comparison to those who underwent SM without PTT (median: not reached vs. 27.7 months; p = 0.009). Conclusions: If resection is feasible, SM may be beneficial for patients with solitary metastasis of RCC, and we showed the possibility that PTT prior to SM may be effective for avoiding recurrence after SM. Further large-scale prospective studies are needed to clarify the ideal treatment strategy for metastatic RCC.
The Continuing Need for Electron Microscopy in Examination of Medical Renal Biopsies: Examples in Practice
Authors: Yamashita Michifumi , Lin Mercury Y. , Hou Jean , Ren Kevin Y.M. , Haas Mark
Published: June 2021

Background: For the better part of the past 6 decades, transmission electron microscopy (EM), together with routine light microscopy and immunofluorescence and/or immunohistochemistry (IHC), has been an essential component of the diagnostic workup of medical renal biopsies, particularly native renal biopsies, with increasing frequency in renal allograft biopsies as well. Studies performed prior to the year 2000 have indeed shown that a substantial fraction of renal biopsies cannot be accurately diagnosed without EM. Still, EM remains costly and labor-intensive, and with increasing pressure to reduce healthcare costs, some centers are de-emphasizing diagnostic EM. This trend has been coupled with advances in IHC and other methods in renal biopsy diagnosis over the past 2–3 decades. Summary: Nonetheless, it has been our experience that the diagnostic value of EM in the comprehensive evaluation of renal biopsies remains similar to what it was 20–30 years ago. In this review, we provide several key examples from our practice where EM was essential in making the correct renal biopsy diagnosis, ranging from relatively common glomerular lesions to rare diseases. Key Messages: EM remains an important component of the diagnostic evaluation of medical renal biopsies. Failure to perform EM in certain cases will result in an incorrect diagnosis, with possible clinical consequences. We strongly recommend that tissue for EM be taken and stored in an appropriate fixative and ultrastructural studies be performed for all native renal biopsies, as well as appropriate renal allograft biopsies as recommended by the Banff consortium.
Adult Height in 299 Patients with Turner Syndrome with or without Growth Hormone Therapy: Results and Literature Review
Authors: Dantas Naiara C.B. , Braz Adriana F. , Malaquias Alexsandra , Lemos-Marini Sofia , Arnhold Ivo J.P. , Silveira Ester R. , Antonini Sonir R. , Guerra-Junior Gil , Mendonca Berenice , Jorge Alexander , Scalco Renata C.
Published: June 2021

Context: Treatment with growth hormone (GH) is considered effective in improving adult height (AH) in Turner syndrome (TS). However, there are few studies comparing AH between treated patients and a concurrent untreated group. Objective: To assess the efficacy of GH treatment in improving AH in TS and to review previous published studies with treated and untreated groups. Participants and Methods: We retrospectively analyzed clinical data and AH of a large cohort of GH-treated (n = 168) and untreated (n = 131) patients with TS. Data are shown as median and interquartile range (IQR). We assessed pretreatment variables related with AH and compared our results with 16 studies that also included an untreated group. Results: The GH-treated group was 6.2 cm taller than the untreated group (AH = 149 cm [IQR 144.5–152.5 cm] vs. 142.8 cm [IQR 139–148 cm], p < 0.001) after 4.9 years of GH treatment with a dose of 0.35 mg/kg/week. AH SDS corrected for target height (TH) was 7.2 cm higher in GH-treated patients. AH SDS ≥−2 was more frequent in GH-treated patients (43%) than in untreated patients (16%, p < 0.001). AH SDS was also more frequently within the TH range in the GH-treated group (52%) than in the untreated group (15%, p < 0.001). Height SDS at start of GH therapy and TH SDS were positively correlated with AH (p < 0.001; R2 = 0.375). Considering the current result together with previous similar publications, a mean AH gain of 5.7 cm was observed in GH-treated (n = 696) versus untreated (n = 633) patients. Conclusions: Our study strengthens the evidence for efficacy of GH therapy in patients with TS from different populations.
2021 European Thyroid Association Guidelines for the Management of Iodine-Based Contrast Media-Induced Thyroid Dysfunction
Authors: Bednarczuk Tomasz , Brix Thomas H. , Schima Wolfgang , Zettinig Georg , Kahaly George J.
Published: June 2021

Given the fact that a large number of radiological examinations using iodine-based contrast media (ICM) are performed in everyday practice, clinicians should be aware of potential ICM-induced thyroid dysfunction (TD). ICM can induce hyperthyroidism (Hyper) or hypothyroidism (Hypo) due to supraphysiological concentrations of iodine in the contrast solution. The prevalence of ICM-induced TD varies from 1 to 15%. ICM-induced Hyper is predominantly found in regions with iodine deficiency and in patients with underlying nodular goiter or latent Graves’ disease. Patients at risk for ICM-induced Hypo include those with autoimmune thyroiditis, living in areas with sufficient iodine supply. Most cases of ICM-induced TD are mild and transient. In the absence of prospective clinical trials on the management of ICM-induced TD, an individualized approach to prevention and treatment, based on patient’s age, clinical symptoms, pre-existing thyroid diseases, coexisting morbidities and iodine intake must be advised. Treatment of ICM-induced Hyper with antithyroid drugs (in selected cases in combination with sodium perchlorate) should be considered in patients with severe or prolonged hyperthyroid symptoms or in older patients with underlying heart disease. It is debated whether preventive therapy with methimazole and/or perchlorate prior to ICM administration is justified. In ICM-induced overt Hypo, temporary levothyroxine may be considered in younger patients with symptoms of Hypo, with an underlying autoimmune thyroiditis and in women planning pregnancy. Additional clinical trials with clinically relevant endpoints are warranted to further aid in clinical decision-making in patients with ICM-induced TD.
Determinants of Use of Traditional Birth Services in Communities Inclined to Use Them in Nigeria and Ghana
Authors: Olutegbe Nathaniel Siji , Bartimeus Harry Aryeh
Published: June 2021

Several programmes by government and non-governmental organisations aimed at improving maternal health in many sub-Saharan African nations have not achieved significant results. Use of traditional maternal care services has been identified as still prevalent and thus a possible factor. This study investigated determinants of use of traditional birth services (tbs s) among patrons in tbs-inclined communities of Nigeria and Ghana. A total of 180 and 160 patrons of tbs s were selected from the respective countries, using a multi-stage procedure. The most utilised tbs s include home delivery, concoctions/herbs and family planning. Educational level, constraints to using conventional services, income, and perceived social and economic advantages significantly influenced utilisation. Patrons in Nigeria had better perceived relative advantages of tbs than Ghana, while the accessibility of conventional maternal services, performance rating and overall utilisation of tbs s did not differ significantly between the two countries. Social bonds and economic status were the main reasons for continued patronage of tbs s.
To Medicalise or Not to Medicalise: Is that the Question?
Authors: Van Eekert Nina
Published: June 2021

Today, female genital cutting (fgc) is more often performed by health professionals. In this dissertation we aim to answer the question of why mothers opt to medicalise their daughters’ cut, and how this decision relates to their social position within their community. We focus on Egypt and Kenya.

The first important conclusion of our research is that increasing medicalisation and decreasing fgc prevalence can coexist. Moreover, we identify three major drivers behind mothers’ choice to medicalise their daughters’ cut. Firstly, mothers argue that they opt for a medicalised cut to reduce the health risks related to the cut. They seek a less harmful but still culturally acceptable alternative. Secondly, the medicalisation of fgc is socially stratified. Thirdly, medicalisation may act as a social norm in itself.

In conclusion, we state that the debate about medicalisation should be more nuanced and that the general discourse on medicalisation should be challenged and empirically grounded.
Two new species of Protonemura Kempny, 1898 (Plecoptera: Nemouridae) from the Italian Alps
Authors: VINÇON GILLES , REDING JEAN-PAUL G. , RAVIZZA CARLALBERTO
Published: June 2021

Two new species of Protonemura Kempny, 1898, P. bispina sp. n. and P. pennina sp. n., from the Eastern and Western Italian Alps, respectively, are described and illustrated. Further information on distribution and ecological preferences of these new species is provided. The species Protonemura auberti Illies, 1954 is re-described from topotypical material.
Taxonomic review of the genus Assamacris (Orthoptera: Acrididae: Catantopinae) with a new species and a newly discovered female
Authors: MAO BEN-YONG , NIU YAO , HUANG JIAN-HUA
Published: June 2021

Taxonomic review of the genus Assamacris Uvarov, 1942 is given. The genus Traulitonkinacris You & Bi, 1983 is synonymized with Assamacris. Traulitonkinacris bifurcatus You & Bi, 1983 is transferred to Assamacris as a new combination. Assamacris splendida sp. nov. is described as new species. A newly discovered female of A. curticerca (Huang, 1981) is introduced. A key to the species is updated.