bluuebunny/crossref_metadata_2025 huggingface dataset:
So-Called Serous Carcinoma of the Uterine Cervix with BRCA2 Mutation: Case Report and Review of the Literature
Authors: Herrera Gómez Ruth Gabriela , Hastir Delfyne , Liapi Aikaterini , Dolcan Ana , Herrera Fernanda G. , Mathevet Patrice , Sarivalasis Apostolos
Published: December 2021

Serous carcinoma of the uterine cervix (SCUC) is now believed to be a morphological variant of an HPV-associated endocervical adenocarcinoma or a metastasis from a serous carcinoma of the upper tract. In terms of mutational status as detected by next-generation sequencing (NGS), this controversial entity has not been characterized yet. We describe the case of a patient with a carcinoma categorized as stage IVB SCUC, initially treated with carboplatin, paclitaxel, and bevacizumab, followed by maintenance with bevacizumab. After locoregional progression, radiotherapy was administered. Unfortunately, further progression was observed, and carboplatin was resumed. Considering the presence of a BRCA2 mutation as detected by NGS, treatment with a PARP inhibitor (olaparib) was decided and allowed disease control for 6 months. We believe that BRCA mutation may be systematically searched in patients suffering from carcinomas formerly referred to as SCUC and that targeted treatments should be considered.
Impact of Parallel Topical Treatment with Nadifloxacin and Adapalene on Acne Vulgaris Severity and Quality of Life: A Prospective, Uncontrolled, Multicentric, Noninterventional Study
Authors: Neumeister Claudia , Bödeker Rolf-Hasso , Schwantes Ulrich , Borelli Claudia
Published: December 2021

Introduction: Daily parallel application of adapalene and nadifloxacin has been determined to be effective and well tolerated in patients with acne vulgaris in randomized, controlled clinical studies. Here, the authors report the results from a large, prospective, uncontrolled, multicentric, noninterventional study under real-life conditions in Germany. The effect of treatment on acne severity, safety, and, for the first time, health-related quality of life (HRQoL) was investigated. Methods: Of the 292 patients (safety collective: 231 adults, 61 adolescents) who had at least grade 4 acne vulgaris on the face as per the Leeds Revised Acne Grading (LRAG), 273 (efficacy collective: 213 adults, 60 adolescents) were treated with adapalene 0.1% cream or gel and nadifloxacin 1% cream for the defined minimum of 28 days. Patients were evaluated for acne severity, acne-related facial symptoms, HRQoL, overall assessment of therapy, and safety. Results: After the median treatment duration of 37 and 38 days (adults and adolescents, respectively), 93.4% and 85.0% of adults and adolescents, respectively, exhibited a sustained decrease in acne severity. The LRAG decreased by at least 3 scores in 29.1% and 24.6% of female and male adults, respectively. HRQoL improved in 67.9% and 63.5% of adults and adolescents, respectively (median improvement in the Dermatology Life Quality Index scores per patient of 3.0 [female adults], 1.0 [male adults], and 2.0 for all adolescents in the Children’s Dermatology Life Quality Index). Female adults were more impaired in terms of HRQoL compared to male adults. The 2 best overall efficacy ratings were provided by physicians in 79.3% and 69.5% and by patients in 68.5% and 58.3% of adult and adolescent cases, respectively. The treatment was well tolerated, as reflected in the low number of 9 mild adverse events (AEs), all of which resolved without treatment. However, 4 patients terminated the study prematurely due to AEs. Conclusion: In this study, the parallel use of adapalene and nadifloxacin for at least 5 weeks resulted in a rapid improvement in acne severity, an increase in HRQoL, and a good safety profile. Therefore, it represents a promising treatment option that offers the possibility of flexible therapy adjustment.
Exercise-Based Cardiac Rehabilitation Associates with Lower Major Adverse Cardiovascular Events in People with Stroke
Authors: Buckley Benjamin J.R. , Harrison Stephanie L. , Fazio-Eynullayeva Elnara , Underhill Paula , Lane Deirdre A. , Thijssen Dick H.J. , Lip Gregory Y.H.
Published: December 2021

Background: The risk of major adverse cardiovascular events is substantially increased following a stroke. Although exercise-based cardiac rehabilitation has been shown to improve prognosis following cardiac events, it is not part of routine care for people following a stroke. We therefore investigated the association between cardiac rehabilitation and major adverse cardiovascular events for people with stroke. Methods: This retrospective analysis was conducted on June 20, 2021, using anonymized data within TriNetX, a global federated health research network with access to electronic medical records from participating healthcare organizations, predominantly in the USA. All participants were aged ≥18 years with cerebrovascular disease and at least 2 years of follow-up. People with stroke and an electronic medical record of exercise-based cardiac rehabilitation were 1:1 propensity score matched to people with stroke but without cardiac rehabilitation using participant characteristics, comorbidities, cardiovascular procedures, and cardiovascular medications. Results: Of 836,923 people with stroke and 2-year follow-up, 2,909 met the inclusion for the exercise-based cardiac rehabilitation cohort. Following propensity score matching (n = 5,818), exercise-based cardiac rehabilitation associated with 53% lower odds of all-cause mortality (odds ratio 0.47, 95% confidence interval: 0.40–0.56), 12% lower odds of recurrent stroke (0.88, 0.79–0.98), and 36% lower odds of rehospitalization (0.64, 0.58–0.71), compared to controls. No significant association between cardiac rehabilitation and incident atrial fibrillation was observed. Conclusion: Exercise-based cardiac rehabilitation prescribed for people following a stroke associated with significantly lower odds of major adverse cardiovascular events at 2 years, compared to usual care.
Dental Caries in Children with Attention Deficit/Hyperactivity Disorder: A Meta-Analysis
Authors: Drumond Victor Zanetti , Souza Gabriela Luíza Nunes , Pereira Mateus José de Carvalho , Mesquita Ricardo Alves , Amin Maryam , Abreu Lucas Guimarães
Published: December 2021

Objectives: The aim of the study was to evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD by means of a systematic review and meta-analysis. Design: Electronic searches were performed in 4 databases (PubMed, Embase, Scopus, and Web of Science) in July 2021. Grey literature search in OpenGrey, a search in Google Scholar, and searches in the reference list of included articles were also conducted. The eligibility criteria were observational studies in which children with ADHD were compared with children without ADHD with respect to the dental caries. Study selection, data extraction, and risk of bias assessment, applying the Joanna Briggs tool were performed by 2 reviewers independently. Meta-analysis and assessment of heterogeneity among studies were conducted with the meta-package of RStudio using the R programming language (R Core Team, Vienna, Austria). Results of meta-analysis were provided in mean difference (MD), odds ratio (OR), and confidence intervals (CIs). For assessment of heterogeneity, Baujat plot and influence analysis plot were obtained. Results: Thirteen studies were included and 10 were incorporated into meta-analyses. The meta-analysis showed that children with ADHD had a higher decayed, missing, and filled teeth (DMFT) index than their peers without ADHD (I2 = 42%; MD = 0.75 [0.38–1.13]). For decayed, missing, and filled surfaces (I2 = 0; MD = 0.39 [−0.02 to 0.80]) and decayed surfaces (ds) (I2 = 0%; MD = 0.35 [−0.63 to 1.33]), no difference between groups was observed. In addition, children with ADHD had higher odds of having dental caries than their healthy peers (OR = 3.31 [1.25, 8.73]; I2 = 0%). After assessment of heterogeneity among studies, sensitivity analysis was conducted for DMFT. One study was removed and the significant difference between groups remained. Children with ADHD had a significantly higher DMFT index than their peers without ADHD (MD = 0.98 [CI = 0.75, 1.20]; I2 = 0%) Risk of bias ranged from low to high. Conclusion: The main shortcoming of the included studies is the high risk of bias regarding the strategies to deal with confounding factors. Within its limitations, this systematic review and meta-analysis demonstrated that children with ADHD were more likely to develop dental caries than their healthy counterparts. Funding: No funding. Registration: CRD42021238923.
IgA Nephropathy and Atypical Anti-GBM Disease: A Rare Dual Pathology in a Pediatric Rapidly Progressive Glomerulonephritis
Authors: Bajaj Varun , Thakur Shilpi , Barwad Adarsh , Sinha Aditi , Bagga Arvind , Singh Geetika
Published: December 2021

Introduction: Anti-GBM nephritis in the pediatric age group is exceedingly rare with concurrent additional pathologies being even rarer. Tissue diagnosis requires a combination of crescentic histomorphology, immunofluorescence showing “paint brush stroke” pattern of linear IgG or rarely IgA, and serum anti-GBM antibodies subject to the disease course and treatment. The authors describe one such case with a dual pathology involving IgA nephropathy and atypical anti-GBM disease. Case Presentation: A 13-year-old girl presenting with features of rapidly progressive glomerulonephritis underwent a renal biopsy showing a mesangioproliferative histology with crescents and an immunofluorescence pattern indicating a dual pathology of IgA nephropathy and anti-GBM nephritis. Additional ancillary testing including staining for IgG subclasses and galactose-deficient IgA (KM55) helped to confirm the diagnosis. She responded to steroid pulses and plasma exchange therapy, was off dialysis after 8 weeks with a serum creatinine level of 1.5 mg/dL, and however remains proteinuric at last follow-up. Conclusion: Concurrent anti-GBM nephritis and IgA nephropathy is a rare occurrence and possibly arises from a complex interaction between the anti-GBM antibodies and the basement membrane unmasking the antigens for IgA antibodies. Additional newer techniques like immunofluorescence for KM55 are helpful in establishing the dual pathology.
Epicardial and Endocardial Ablation Based on Channel Mapping in Patients With Ventricular Tachycardia and Chronic Chagasic Cardiomyopathy: Importance of Late Potential Mapping During Sinus Rhythm to Recognize the Critical Substrate
Authors: de Oliveira Dietrich Cristiano , de Oliveira Hollanda Lucas , Cirenza Claudio , de Paola Angelo Amato Vincenzo
Published: December 2021

Background

Ventricular tachycardia (VT) in patients with chronic chagasic cardiomyopathy (CCC) is associated with considerable morbidity and mortality. Catheter ablation of VT in patients with CCC is very complex and challenging. The main goal of this work was to assess the efficacy of VT catheter ablation guided by late potentials (LPs) in patients with CCC.

Methods and Results

Seventeen consecutive patients with refractory VT and CCC were prospectively included in the study. Combined endo‐epicardial voltage and late activation mapping were obtained during baseline rhythm to define scarred and LP areas, respectively. The end point of the ablation procedure was the elimination of all identified LPs. Epicardial and endocardial dense scars (<0.5 mV) were detected in 17/17 and 15/17 patients, respectively. LPs were detected in the epicardial scars of 16/17 patients and in the endocardial scars of 14/15 patients. A total of 63 VTs were induced in 17 patients; 22/63 (33%) were stable and entrained, presenting LPs recorded in the isthmus sites. The end point of ablation was achieved in 15 of 17 patients. Ablation was not completed in 2 patients because of cardiac tamponade or vicinity of the phrenic nerve and circumflex artery. Three patients (2 with unsuccessful ablation) had VT recurrence during follow‐up (39 months).

Conclusions

Endo‐epicardial LP mapping allows us to identify the putative isthmuses of different VTs and effectively perform catheter ablation in patients with CCC and drug‐refractory VTs.
Machine Learning Approach to Classify Cardiovascular Disease in Patients With Nonalcoholic Fatty Liver Disease in the UK Biobank Cohort
Authors: Sharma Divya , Gotlieb Neta , Farkouh Michael E. , Patel Keyur , Xu Wei , Bhat Mamatha
Published: December 2021

Background

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide. Cardiovascular disease (CVD) is the leading cause of mortality among patients with NAFLD. The aim of our study was to develop a machine learning algorithm integrating clinical, lifestyle, and genetic risk factors to identify CVD in patients with NAFLD.

Methods and Results

We created a cohort of patients with NAFLD from the UK Biobank, diagnosed according to proton density fat fraction from magnetic resonance imaging data sets. A total of 400 patients with NAFLD with subclinical atherosclerosis or clinical CVD, defined by disease codes, constituted cases and 446 NAFLD cases with no CVD constituted controls. We evaluated 7 different supervised machine learning approaches on clinical, lifestyle, and genetic variables for identifying CVD in patients with NAFLD. The most significant clinical and lifestyle variables observed by the predictive modeling were age (59 years [54.00–63.00 years]), hypertension (145 mm Hg [134.0–156.0 mm Hg] and 85 mm Hg [79.00–93.00 mm Hg]), waist circumference (98 cm [95.00–105.00 cm]), and sedentary lifestyle, defined as time spent watching TV >4 h/d. In the genetic data, single‐nucleotide polymorphisms in IL16 and ANKLE1 gene were most significant. Our proposed ensemble‐based integrative machine learning model achieved an area under the curve of 0.849 using the random forest modeling for CVD prediction.

Conclusions

We propose a machine learning algorithm that identifies CVD in patients with NAFLD through integration of significant clinical, lifestyle, and genetic risk factors. These patients with NAFLD at higher risk of CVD should be flagged for screening and aggressive treatment of their cardiometabolic risk factors to prevent cardiovascular morbidity and mortality.
Non‐Hispanic Black and Hispanic Patients Have Worse Outcomes Than White Patients Within Similar Stages of Peripheral Artery Disease
Authors: Kalbaugh Corey A. , Witrick Brian , Sivaraj Laksika Banu , McGinigle Katharine L. , Lesko Catherine R. , Cykert Samuel , Robinson William P.
Published: December 2021

Background

Racial and ethnic disparities in outcomes following lower limb revascularization for peripheral artery disease have been ascribed to disease severity at presentation for surgery.

Methods and Results

We calculated 1‐year risk of major adverse limb events (MALEs), major amputation, and death for patients undergoing elective revascularization for claudication or chronic limb‐threatening ischemia in the Vascular Quality Initiative data (2011–2018). We report hazard ratios according to race and ethnicity using Cox (death) or Fine and Gray subdistribution hazards models (MALE and major amputation, treating death as a competing event), adjusted for patient, treatment, and anatomic factors associated with disease severity. Among 88 599 patients (age, 69 years; 37% women), 1‐year risk of MALE (major amputation and death) was 12.8% (95% CI, 12.5–13.0) in 67 651 White patients, 16.5% (95% CI, 5.8–7.8) in 15 442 Black patients, and 17.2% (95% CI, 5.6–6.9) in 5506 Hispanic patients. Compared with White patients, we observed an increased hazard of poor limb outcomes among Black (MALE: 1.17; 95% CI, 1.12–1.22; amputation: 1.52; 95% CI, 1.39–1.65) and Hispanic (MALE: 1.22; 95% CI, 1.14–1.31; amputation: 1.45; 95% CI, 1.28–1.64) patients. However, Black and Hispanic patients had a hazard of death of 0.85 (95% CI, 0.79–0.91) and 0.71 (95% CI, 0.63–0.79) times the hazard among White patients, respectively. Worse limb outcomes were observed among Black and Hispanic patients across subcohorts of claudication and chronic limb‐threatening ischemia.

Conclusions

Black and Hispanic patients undergoing infrainguinal revascularization for chronic limb‐threatening ischemia and claudication had worse limb outcomes compared with White patients, even with similar disease severity at presentation. Additional investigation aimed at eliminating disparate limb outcomes is needed.
Concordance of apolipoprotein B concentration with the Friedewald, Martin-Hopkins, and Sampson formulas for calculating LDL cholesterol
Authors: Langlois Michel R. , Briers Pieter-Jan
Published: December 2021

Two new formulas, the Martin-Hopkins and the Sampson formula, were recently developed to overcome shortcomings of the Friedewald formula for calculating LDL-cholesterol. We aimed to compare the concordance of the two formulas with apolipoprotein B (apoB), a surrogate marker of the number of LDL particles.
In a study of serum lipid data of 1179 patients who consulted the AZ St-Jan Hospital Bruges for cardiovascular risk assessment, the correlation and concordance of the Friedewald, Martin-Hopkins and Sampson formulas with apoB concentration, measured by immunonephelometry, were determined and compared.
The Martin-Hopkins formula showed significantly higher correlation coefficient than the Friedewald formula with apoB in the entire dataset and in patients with low LDL-cholesterol < 1.8 mmol/L. Both Martin-Hopkins and Sampson formulas yielded > 70% concordance of LDL-cholesterol with regard to treatment group classification based on population-equivalent thresholds of apoB in hypertriglyceridemic patients (2-4.5 mmol/L), with the highest concordance (75.6%) obtained using Martin-Hopkins formula vs. 60.5% with Friedewald formula.
The Martin-Hopkins (and, to a lesser extent, Sampson) formula is more closely associated with the number of LDL particles than Friedewald formula. This, in combination with literature evidence of lesser accuracy of the Friedewald formula, is an argument to switch from Friedewald to a modified, improved formula.
Deviating glucose results in an international dual-center study. A root cause investigation
Authors: Bergsten Peter , Bergquist Jonas , Cadamuro Janne , Weghuber Daniel , Jabbour Jeanne , Brunner Susanne M. , Ciba Iris , Dahlbom Marie , Mörwald Katharina , Forslund Anders
Published: December 2021

During a dual-center study on obese and normal weight children and adolescents, focusing on glucose metabolism, we observed a marked difference in glucose results (N = 16,840) between the two sites, Salzburg, Austria and Uppsala, Sweden (P < 0.001). After excluding differences in patient characteristics between the two populations as cause of this finding, we investigated other preanalytic influences. Finally, only the tubes used for blood collection at the two sites were left to evaluate. While the Vacuette FC-Mix tube (Greiner Bio-One, Kremsmünster, Austria) was used in Uppsala, in Salzburg blood collections were performed with a lithium heparin tube (LH-Monovette, Sarstedt, Germany). To prove our hypothesis, we collected two blood samples in either of these tubes from 51 children (Salzburg N = 27, Uppsala N = 24) and compared the measured glucose results. Indeed, we found the suspected bias and calculated a correction formula, which significantly diminished the differences of glucose results between the two sites (P = 0.023). Our finding is in line with those of other studies and although this issue should be widely known, we feel that it is widely neglected, especially when comparing glucose concentrations across Europe, using large databases without any information on preanalytic sample handling.
On the Southern Hemisphere Stratospheric Response to ENSO and Its Impacts on Tropospheric Circulation
Authors: Stone Kane A. , Solomon Susan , Thompson David W. J. , Kinnison Douglas E. , Fyfe John C.
Published: December 2021

As the leading mode of Pacific variability, El Niño–Southern Oscillation (ENSO) causes vast and widespread climatic impacts, including in the stratosphere. Following discovery of a stratospheric pathway of ENSO to the Northern Hemisphere surface, here we aim to investigate if there is a substantial Southern Hemisphere (SH) stratospheric pathway in relation to austral winter ENSO events. Large stratospheric anomalies connected to ENSO occur on average at high SH latitudes as early as August, peaking at around 10 hPa. An overall colder austral spring Antarctic stratosphere is generally associated with the warm phase of the ENSO cycle, and vice versa. This behavior is robust among reanalysis and six separate model ensembles encompassing two different model frameworks. A stratospheric pathway is identified by separating ENSO events that exhibit a stratospheric anomaly from those that do not and comparing to stratospheric extremes that occur during neutral ENSO years. The tropospheric eddy-driven jet response to the stratospheric ENSO pathway is the most robust in the spring following a La Niña, but extends into summer, and is more zonally symmetric compared to the tropospheric ENSO teleconnection. The magnitude of the stratospheric pathway is weaker compared to the tropospheric pathway and therefore, when it is present, has a secondary role. For context, the magnitude is approximately half that of the eddy-driven jet modulation due to austral spring ozone depletion in the model simulations. This work establishes that the stratospheric circulation acts as an intermediary in coupling ENSO variability to variations in the austral spring and summer tropospheric circulation.
Parameterization of Submesoscale Mixed Layer Restratification under Sea Ice
Authors: Shrestha Kalyan , Manucharyan Georgy E.
Published: December 2021

Commonly used parameterization of mixed layer instabilities in general circulation models was developed for temperate oceans and does not take into account the presence of sea ice in any way. However, the ice–ocean drag provides a strong mechanical coupling between the sea ice and the surface ocean currents and hence may affect mixed layer restratification processes. Here we use idealized simulations of mixed layer instabilities to demonstrate that the sea ice dramatically suppresses the eddy-driven overturning in the mixed layer by dissipating the eddy kinetic energy generated during instabilities. Considering the commonly used viscous-plastic sea ice rheology, we developed an improvement to the existing mixed layer overturning parameterization, making it explicitly dependent on sea ice concentration. Below the critical sea ice concentration of about 0.68, the internal sea ice stresses are very weak and the conventional parameterization holds. At higher concentrations, the sea ice cover starts acting as a nearly immobile surface lid, inducing strong dissipation of submesoscale eddies and reducing the intensity of the restratification streamfunction up to a factor of 4 for a fully ice-covered ocean. Our findings suggest that climate projection models might be exaggerating the restratification processes under sea ice, which could contribute to biases in mixed layer depth, salinity, ice–ocean heat fluxes, and sea ice cover.
Environmental Justice: Segregation, Noise Pollution and Health Disparities near the Hartsfield-Jackson Airport Area in Atlanta
Authors: Ray Mona
Published: December 2021

The inquiry in this paper has two parts: (1) an examination of potential disparities in exposure to airport noise pollution between Blacks (non-Hispanic) and Whites (non-Hispanic) around the Atlanta Hartsfield-Jackson airport (AHJA) area, and (2) a binary logistic regression analysis studying factors contributing to these disparities. The proposed model is that the difference in noise exposure measured by Net Exposure Difference score is a function of the degree of Black-White residential segregation; differences in poverty rates between Blacks and Whites; some socio-economic-demographic variables and four health indicators - noise annoyance (NA); sleep disturbance (SD); hearing impairment (HI); and cardiovascular disorder (CVD).

A stratified random sampling method and telephonic survey using a 43-questions questionnaire among the adult households around the AHJA area produced 237 observations on Black and White households over a period of 2 years.

Parameter estimates reveals disparities in exposure to aircraft noise exposure between the Black and White households within the 10-mile radius of the airport area indicating environmental injustice. The odds-ratios from the binary logistic regression suggests residential segregation, difference in poverty rates, race, education, as well as health conditions like hearing impairment and sleep disturbances have a statistically significant association with this disparity in noise exposure.
Economic and political determinants of the South African labour share, 1971–2019
Authors: Gouzoulis Giorgos , Constantine Collin , Ajefu Joseph
Published: December 2021

This study examines the drivers of the steady decline in South Africa’s private sector labour share between 1971 and 2019. The focus on South Africa is instructive as its distributional contestation is bounded in a matrix of racial conflict. Crucial reforms on trade, finance and welfare were undertaken since 1994, but the study finds little evidence that the extension of the franchise promoted egalitarianism, since white economic elites invested in de facto political power. This study employs an Unrestricted Error Correction Model to estimate the drivers of the private sector labour share, and the findings suggest that globalisation, financialisation and public spending have decreased the labour share, while the effects of education have been positive but insufficient to halt the decline.
Resection of small acoustic neuroma using the transcanal transvestibular endoscopic approach
Authors: Chen Tao , Lu Zhenzhang , Zhou Yuxiang , Zhao Duanlong , Lu Yongtian , Meng Qingguo
Published: December 2021

We evaluated the outcomes of resection of small acoustic neuromas using the transcanal transvestibular endoscopic approach. Two patients with a small acoustic neuroma were treated using this approach. The sizes of the tumors were 11 × 6 mm and 12 × 10 mm. Both tumors were removed completely without residual tumor tissue, and damage to the facial nerve and cochlear nerve was avoided. No patients developed postoperative vertigo, aggravation of postoperative facial paralysis, severe pain, or permanent postoperative complications. The patients were followed up for 6 months, and none developed recurrence. Resection of small acoustic neuromas by the transcanal transvestibular endoscopic approach is a simple and safe technique that achieves excellent functional results.
Skill-relatedness and employment growth of firms in times of prosperity and crisis in an oil-dependent region
Authors: Rørheim John-Erik , Boschma Ron
Published: December 2021

Many studies have shed light on the positive side of relatedness, but little attention has yet been devoted to possible downsides of relatedness for firm performance in regions. We found in a case study of the oil-dependent Stavanger region in Norway that plants in industries that are skill-related to the dominant oil and gas industry showed lower employment growth than plants in other industries. This was the case both in the boom and the crisis periods, even when controlling for supply linkages to the oil and gas sector. However, we also found that plants skill-related to the oil and gas industry increased their relative performance during the crisis to some degree, but they did not outperform the non-skill-related plants during the crisis.
Kinematics of a 6-DOF parallel manipulator with two limbs actuated by spherical motion generators
Authors: Wang Kun , Wu Xiaoyong , Wang Yujin , Ding Jun , Bai Shaoping
Published: December 2021

Inspired by dual-arm-like manipulation, a novel 6-DOF parallel manipulator with two spherical-universal-revolute limbs is proposed. Compared with general 6-DOF parallel manipulators with six limbs, this new manipulator actuated by spherical motion generators has only two limbs, which brings advantages such as fewer active limbs for avoiding interference, larger reachable and orientational workspace for complex operating, more actuators integrated in active modules for decreasing installation errors and increasing compactness. In this paper, the kinematics of this novel parallel manipulator is solved and illustrated, covering its inverse and forward position analysis, workspace and singularities. The kinematic study reveals interesting features of this manipulator such as multiple working and assembly modes, small footprint and large workspace volume with high dexterity. Numerical examples of kinematic analysis are included. Practical application of the new manipulator is illustrated.
Nutritional Status of Married Tribal Women in Jharkhand, India
Authors: Majumder Navaneeta
Published: December 2021

The article explores the socio-economic and nutritional status of tribal married women in East Singhbum district, Jharkhand, by using mixed methods of enquiry. Dietary and anthropometric methods of nutritional assessment were supported by qualitative data. It was found that the most potent reason for undernourishment among tribal women is household food insecurity and low calorific intake. To enhance the nutritional status of tribal women, it is suggested that the issue of malnutrition be addressed with a life cycle approach, along with sustained behaviour change communication with the help of public–private partnerships and the efficient implementation of existing and new programmes to increase purchasing power and food security.
Is the assessment under Article 8 ECHR for migrants justifiable?
Authors: Edlund Jennie , Stehlík Václav
Published: December 2021

The paper analyses the protection granted under Article 8 of the European Convention of Human Rights for different immigration cases. The way the European Court of Human Rights determines compliance with Article 8 for settled migrants differs from the way the Court determines compliance for foreign nationals seeking entry or requesting to regularize their irregular migration status. The paper argues that the European Court of Human Rights application of different principles when determining a States’ positive and negative obligations is contradicting its own case law. It also argues that the absence of justification grounds for the refusal of foreign nationals who are seeking entry lacks legitimacy. By treating all immigration cases under Article 8(2) the paper suggests that the differentiation between cases should be based on how a refusal of entry or an expulsion would impact on the family life. The paper also suggests that more consideration should be given towards the insiders interests when balancing the individual rights against the state's interests. These changes would lead to a more consistent and fair case law and generate a more convergent practice by the states which will increase the precedent value of the Court's judgements.
Evaluation of Combined Cancer Markers With Lactate Dehydrogenase and Application of Machine Learning Algorithms for Differentiating Benign Disease From Malignant Ovarian Cancer
Authors: Jeong Seri , Son Dae-Soon , Cho Minseob , Lee Nuri , Song Wonkeun , Shin Saeam , Park Sung-Ho , Lee Dong Jin , Park Min-Jeong
Published: December 2021

Background

The differential diagnosis of ovarian cancer is important, and there has been ongoing research to identify biomarkers with higher performance. This study aimed to evaluate the diagnostic utility of combinations of cancer markers classified by machine learning algorithms in patients with early stage ovarian cancer, which has rarely been reported.

Methods

In total, 730 serum samples were assayed for lactate dehydrogenase (LD), neutrophil-to-lymphocyte ratio (NLR), human epididymis protein 4 (HE4), cancer antigen 125 (CA125), and risk of ovarian malignancy algorithm (ROMA). Among them, 53 were diagnosed with early stage ovarian cancer, and the remaining 677 were diagnosed with benign disease.

Results

The areas under the receiver operating characteristic curves (ROC-AUCs) of the ROMA, HE4, CA125, LD, and NLR for discriminating ovarian cancer from non-cancerous disease were .707, .680, .643, .657, and .624, respectively. ROC-AUC of the combination of ROMA and LD (.709) was similar to that of single ROMA in the total population. In the postmenopausal group, ROC-AUCs of HE4 and CA125 combined with LD presented the highest value (.718). When machine learning algorithms were applied to ROMA combined with LD, the ROC-AUC of random forest was higher than that of other applied algorithms in the total population (.757), showing acceptable performance.

Conclusion

Our data suggest that the combinations of ovarian cancer-specific markers with LD classified by random forest may be a useful tool for predicting ovarian cancer, particularly in clinical settings, due to easy accessibility and cost-effectiveness. Application of an optimal combination of cancer markers and algorithms would facilitate appropriate management of ovarian cancer patients.
When Cities Borrow State Power: New York State's Empire State Development Corporation in New York City
Authors: Marcello Elizabeth M.
Published: December 2021

Since the late 1960's New York State's Urban Development Corporation (UDC), now operating as the Empire State Development Corporation (ESDC), has been leveraged by New York City government to pursue large-scale projects. This paper examines two cases from New York City in which the city borrowed a state-controlled public authority's power to accomplish projects initiated at the local level: the case of Queens West, a development in western Queens, proposed in the early 1980s, and the case of Columbia - Manhattanville, an expansion of the Columbia University campus into Harlem, announced in 2003. These cases highlight how cities might, at times, embrace state involvement rather than lament its restrictions or rue its indifference. The study concludes by suggesting a theoretical path for incorporating such a city-state dynamic.
Telephone based smoking cessation intervention for adults with serious mental illness during the COVID-19 pandemic
Authors: Leutwyler Heather , Hubbard Erin
Published: December 2021

Background

The high rates of smoking in adults with serious mental illness (SMI) increases risk for COVID-19 infection. The purpose of this paper is to present the results of a smoking cessation intervention that was adapted to be offered by phone during a Shelter in Place (SIP) period in San Francisco, California, at the beginning of the COVID-19 pandemic.

Methods

During the SIP, we offered counseling sessions by phone to five participants. At the end of each session, we assessed readiness to quit, tobacco cessation or reduction, and inquired about the impact of the shelter in place on smoking habits and mental health. Grounded theory guided data collection and analysis.

Results

The categories that emerged around barriers and facilitators for smoking cessation were COVID-19–related stressors, having purpose, structure and feelings of connections, and the importance of quitting aides for smoking cessation.

Conclusion

Offering telephone based smoking cessation counseling to adults with SMI while they shelter in place may improve their readiness to quit.
COVID-19 Vaccination Uptake and Hesitancy Among Current Tobacco Users
Authors: Krebs Nicolle M , D’Souza Gail , Bordner Candace , Allen Sophia I , Hobkirk Andrea L , Foulds Jonathan , Yingst Jessica M
Published: December 2021

Novel mRNA vaccines have been developed and were first distributed to high-risk individuals (including smokers) in the United States starting in December 2020 to combat the coronavirus (COVID-19) pandemic. Over one-half of the U.S. adult population has received at least 1 dose of a COVID-19 vaccine, but many others have reported hesitation about becoming vaccinated. We examined COVID-19 vaccine uptake and hesitancy from a convenience sample of Pennsylvanian adult smokers in April 2021, approximately 3 months after tobacco users were eligible to receive vaccination in the state. Participants (n = 231) were 23.4% male, 90.5% white, and had a mean age of 48.1 (SD = 11.9) years. All participants were current tobacco users, with the majority reporting current cigarette smoking (90.9%) with an average of 16 (SD = 8.1) cigarettes smoked per day. Nearly 60% (n = 137) reported receiving at least 1 dose of the vaccine and of those who did not (n = 94), 84% (n = 79) said they were somewhat or very unlikely to get a vaccine. Those who were unvaccinated were more likely to not consume news about COVID-19 (chi-square P-value < .01) and less likely to believe government news sources as reliable information for COVID-19 (chi-square P-value < .01). Qualitative responses among those who were vaccine hesitant expressed concerns about the lack of research on the vaccine, distrust of the safety of the vaccine, and fears about side effects. Understanding vaccine hesitancy among tobacco users can help develop targeted communication strategies and directly address concerns to promote vaccination among this population who may be at an increased risk of severe complications from COVID-19.
Association Between Dermcidin, Salusin-α, Salusin-β Molecules and Diabetic Foot Infections
Authors: Sağmak Tartar Ayşe , Uğur Kader , Tuncer Kara Kevser , Akbulut Ayhan , Demirdağ Kutbettin , Aydin Süleyman
Published: December 2021

Dermcidin, salusin-α, and salusin-β are three recently discovered molecules that confer antimicrobial properties. The present study aims to investigate the association between dermcidin, salusin-α, and salusin-β in the etiopathology of patients with diabetic foot infection. The study included three groups: Group 1 - diabetic foot infection; Group 2 - diabetes without history of diabetic foot; and Group 3 – the control group. Plasma dermcidin, salusin-α, and salusin-β levels were compared across the groups. Median (Q1-Q3) values of plasma dermcidin levels in Groups 1, 2, and 3 were 3.45 (0.8-4.4), 5.2 (3.7-6.4), and 5.8 (3.1-10) ng/mL, respectively. Diabetic foot infection group had significantly lower plasma dermcidin levels compared to diabetes only group and control group ( P = .000, ANOVA), whereas there was no statistically significant difference between the Group 2 and Group 3 ( P = .163, ANOVA). Salusin-α and salusin-β levels were significantly higher in the Group 3 compared to the other groups. Based on our findings, diabetic foot infection group had significantly lower plasma dermcidin levels and salusin-α and salusin-β levels were significantly higher in the control group. These molecules (dermcidin specifically) can be researched as an adjuvant therapeutic agent in addition to conventional treatments in diabetic foot diabetic foot infections. Also, it can be searched this may prevent many complications including amputation.
Quality Assessment of Online Complementary and Alternative Medicine Information Resources Relevant to Cancer
Authors: Sansevere Megan E. , White Jeffrey D.
Published: December 2021

Background:

Complementary and alternative medicine (CAM) is often used by cancer patients and survivors in the US. Many people turn to the internet as their first source of information. Health information seeking through the internet can be useful for patients to gain a better understanding of specific CAM treatments to discuss with their healthcare team, but only if the information is comprehensive, high quality, and reliable. The aim of this article is to examine the content, writing/vetting processes, and visibility of cancer CAM online informational resources.

Methods:

Online CAM resources were identified by Google and PubMed searches, literature reviews, and through sources listed on various websites. The websites were analyzed through a modified online health information evaluation tool, DISCERN (score range = 1-5). The website’s features relevant to the quality assessment were described.

Results:

Eleven CAM websites were chosen for analysis. The DISCERN analysis showed a range of quality scores from 3.6 to 4.9. Lower DISCERN scores were generally due to deficiencies in describing the writing, editing, and updating processes. A lack of transparency with authorship and references was commonly present.

Conclusion:

Cancer patients interested in CAM need unbiased, evidence-based, reliable, high-quality, easily accessible educational materials. Individuals should use the guidelines followed in this analysis (including DISCERN and Medline Plus) to find reliable sources. Website developers can use CAM Cancer (NAFKAM), Beyond Conventional Cancer Therapies, Memorial Sloan Kettering Cancer Center, breastcancer.org , Office of Dietary Supplements, National Center for Complementary and Integrative Health, and Cancer.gov as models for trustworthy content.
Analysis of human glioma-associated co-inhibitory immune checkpoints in glioma microenvironment and peripheral blood
Authors: Shen Shaoping , Wu Qiyan , Liu Jialin , Wu Liangliang , Zhang Rong , Uemura Yasushi , Yu Xinguang , Chen Ling , Liu Tianyi
Published: December 2021

One biomarker for a better therapeutic effect of immune checkpoint inhibitors is high expression of checkpoint in tumor microenvironment The purpose of this study is to investigate the expression of immune checkpoints in human glioma microenvironment and peripheral blood mononuclear cells. First, single-cell suspension from 20 fresh high-grade glioma (HGG) specimens were obtained, and analyzed for lymphocyte composition, then six co-inhibitory immune checkpoints were analyzed at the same time. Second, 36 PBMC specimens isolated from HGG blood samples were analyzed for the same items. In GME, there were four distinct subtypes of cells, among them, immune cells accounted for an average of 51.3%. The myeloid cell population (CD11b+) was the most common immune cell identified, accounting for 36.14% on average; the remaining were most CD3+CD4+ and CD3+/CD8−/CD4− T lymphocytes. In these cells, we detected the expression of BTLA, LAG3, Tim-3, CTLA-4, and VISTA on varying degrees. While in PBMCs, the result showed that when compared with healthy volunteers, the proportion of NK cells decreased significantly in HGG samples ( p < 0.01). Moreover, the expression of BTLA, LAG3, and Tim-3 in CD45+ immune cells in PBMC was more remarkable in glioma samples. In conclusion, the CD11b+ myeloid cells were the predominant immune cells in GME. Moreover, some immune checkpoints displayed a more remarkable expression on the immune cells in GME. And the profile of checkpoint expression in PBMC was partially consistent with that in GME.
Repair of Anomalous Single Coronary Artery From the Pulmonary Artery (ASCAPA)
Authors: Ganta Srujan , Artrip John , Schuchardt Eleanor L. , Lai Wyman , Ryan Justin , Nigro John J
Published: December 2021

We describe the management of an infant presenting with severe heart failure at 6 weeks of age found to have an anomalous single coronary artery originating from the main pulmonary artery (MPA). This patient was transferred to our hospital and ultimately had their coronary artery translocated to the ascending aorta successfully. Preoperative severe left ventricular (LV) dysfunction and moderate/severe mitral regurgitation (MR) improved to normal function and mild-to-moderate MR 6 weeks postrepair. Three-dimensional CT reconstructions proved valuable and allowed for accurate preoperative planning leading to successful coronary transfer.
State-Anxiety in Geriatric Patients Undergoing Surgical Treatment for Femoral Neck or Intertrochanteric Fractures
Authors: Jung Kwang-Hwan , Park Jang-Ho , Song Joon-Yeon , Han Jung-Won , Park Ki-Bong
Published: December 2021

Introduction

Geriatric patients with hip fractures often experience unexpected falls and they may have unfamiliar and unpleasant experiences within a brief period. This study aimed to investigate the prevalence and levels of preoperative anxiety in patients undergoing surgical treatment for hip fractures, and to determine the anxiety-related characteristics experienced by patients during the period before and after surgery.

Materials and methods

We recruited a total of 75 geriatric patients who underwent surgical treatment for hip fractures and returned complete questionnaires. We used the State-Trait Anxiety Inventory (STAI)-X type to measure state-anxiety and defined a total score of 52 or higher as clinically meaningful state-anxiety. And, we investigated main cause of anxiety, moment of the highest level of anxiety, and the most helpful factor in overcoming anxiety before surgery and in reducing anxiety after surgery.

Results

The mean STAI score was 47.2 points and one-third of the patients experienced various levels of clinically meaningful state-anxiety. The most common cause of preoperative anxiety was the surgery itself and patients experienced the greatest level of anxiety from the night preceding the surgery to the day of the surgery. Further, patients’ trust in the medical staff prior to surgery and the surgeon’s explanation after the surgery were the most key factors in overcoming anxiety.

Conclusion

This study investigates the state-anxiety of geriatric patients undergoing surgery for hip fractures and presents important findings which can help in developing evidence-based interventions to improve the experience of patients undergoing hip surgeries.
Leisure Satisfaction Influences Learning Performance Among Community College Students
Authors: Kuo Yen-Ku , Wang Jiun-Hao , Kuo Tsung-Hsien , Ho Li-An
Published: December 2021

Many adults choose community college courses for continued learning to enrich themselves and satisfy their leisure needs, despite having completed formal education. We explored the relationship between learning motivation, learning satisfaction, leisure satisfaction, and learning performance among community college students attending classes in Taipei City. A total of 1,011 participants were recruited. Structural equation modeling was used to examine the validity of the questionnaires and test our hypotheses. Furthermore, we determined whether the two types of satisfaction acted as mediators by testing a dual mediation paths model. Learning motivation, learning satisfaction, leisure satisfaction, and learning performance were significantly and positively correlated. Additionally, learning and leisure satisfaction had complete mediating effects, with the indirect effect of learning satisfaction being relatively stronger than that of leisure satisfaction.
The Effect of Emotional Intelligence and Psychological Capital on Knowledge, Service and Leadership Excellence: Knowledge Sharing and Trust as Moderators
Authors: D’Souza George Sunil , Irudayasamy Francis Gnanasekar , Usman Syed Aktharsha , Andiappan Vignesh Sethu , Parayitam Satyanarayana
Published: December 2021

The purpose of this study is to examine the effect of emotional intelligence (EI) and psychological capital (PsyCap) on knowledge–service–leadership (KSL) excellence. A conceptual model is developed to explore knowledge sharing as the moderator in EI and PsyCap. Further, the study explores trust as a moderator in the relationship between PsyCap and KSL excellence. Using a structured survey instrument, this article gathered data from 963 faculty members working in various colleges and universities in three cosmopolitan cities (Chennai, Coimbatore and Tiruchirappalli) in the southern part of India. The hierarchical regression results reveal that (a) EI is positively and significantly related to PsyCap, (b) knowledge sharing moderates the relationship between EI and PsyCap, (c) PsyCap is positively related to KSL excellence, (d) trust moderates the relationship between PsyCap and KSL excellence and (e) PsyCap as a mediator in the relationship between EI and knowledge and leadership excellence. The findings underscore the importance of EI, PsyCap, knowledge sharing and trust in achieving excellence in educational institutions. The implications for theory and practice are discussed.