bluuebunny/crossref_metadata_2025 huggingface dataset:
Reasons for Diagnostic Delay of Foot Drop Caused by Parasagittal Meningioma: Two Case Reports
Authors: Nguyen Duc Thuan , Nguyen Quang An , Hoang Thi Dung , Dang Thanh Chung , Le Trung Duc
Published: June 2021

Foot drop is defined as an impaired ability or inability of dorsiflexion. Peripheral nervous system injuries are commonly considered as the cause of this condition. The central causes including parasagittal meningioma are also described in the literature but very rarely and commonly not recognized early. In this article, we report 2 patients with isolated unilateral foot drop as the first symptom of a parasagittal meningioma and discuss several reasons for delayed diagnosis. Two patients were treated with decompressive craniotomy. The histopathological findings demonstrated a fibroblastic meningioma and a meningothelial meningioma. During postoperative follow-up, the woman patient showed nearly complete recovery and the second case regained total muscle power over a period of 12 months. The rarity of the disease, the absence of upper motor neuron signs, the occurrence of peripheral pathologies and misinterpretation of F wave on nerve conduction study, and motor unit recruitment on electromyography lead to delay in diagnosis and treatment of the central foot drop due to parasagittal meningioma.
Cabozantinib in Advanced Hepatocellular Carcinoma: Efficacy and Safety Data from an International Multicenter Real-Life Cohort
Authors: Finkelmeier Fabian , Scheiner Bernhard , Leyh Catherine , Best Jan , Fründt Thorben Wilhelm , Czauderna Carolin , Beutel Alica , Bettinger Dominik , Weiß Johannes , Meischl Tobias , Kütting Fabian , Waldschmidt Dirk-Thomas , Radu Pompilia , Schultheiß Michael , Peiffer Kai-Henrik , Ettrich Thomas J. , Weinmann Arndt , Wege Henning , Venerito Marino , Dufour Jean-Francois , Lange Christian M. , Pinter Matthias , Waidmann Oliver
Published: June 2021

Background and Aims: The multikinase inhibitor cabozantinib has been approved for hepatocellular carcinoma (HCC) previously treated with sorafenib. We report safety and efficacy data of an international, multicenter, real-life cohort of patients with advanced HCC treated with cabozantinib. Methods: Patients with HCC who were treated with cabozantinib were retrospectively identified across 11 centers in Austria, Switzerland, and Germany. Patients’ characteristics, adverse events, duration of treatment and overall survival (OS) data were analyzed until April 1, 2020. Results: Eighty-eight patients from 11 centers were included. The predominant underlying liver diseases were NAFLD/NASH in 26 (30%) and hepatitis C infection in 21 (24%) patients. Seventy-eight patients (89%) were classified as Barcelona clinic liver cancer (BCLC) stage C. Sixty patients (68%) were Child-Pugh A, whereas 22 (25%) were Child-Pugh B, respectively. Cabozantinib was used as systemic second- and third-line or later treatment in 41 (47%) and 46 (52%) patients, respectively. The following best responses under cabozantinib were documented: partial response in 6 (7%), stable disease in 28 (32%), and progressive disease in 28 (32%) patients, respectively. Fifty-two patients (59%) died during follow-up. The median OS from start of cabozantinib treatment was 7.0 months in the entire cohort and 9.7 months in Child-Pugh A patients, while Child-Pugh B patients had a median OS of 3.4 months, respectively. Thirty-seven (42%) patients fulfilled the CELESTIAL inclusion and exclusion criteria, showing a median OS of 11.1 months. Most common adverse events were fatigue (15.6%) and diarrhea (15.6%). Conclusion: Cabozantinib treatment was effective, safe, and feasible in patients with advanced HCC in patients with compensated cirrhosis. Patients in the real-life setting had more advanced liver disease – in which 25% of patients were Child-Pugh B. However, OS in patients with Child-Pugh A cirrhosis was similar to that reported in the phase 3 trial (CELESTIAL).
Worldwide Practice in Gastric Cancer Surgery: A 6-Year Update
Authors: Gertsen Emma C. , Brenkman Hylke J.F. , Haverkamp Leonie , Read Matthew , Ruurda Jelle P. , van Hillegersberg Richard
Published: June 2021

Objectives: The aim of the study was to evaluate the current status of gastric cancer surgery worldwide and update the changes compared to a previous survey in 2014. Methods: A cross-sectional survey was sent to surgical members of the International Gastric Cancer Association, pilot centers of the World Organization for Specialized Studies on Diseases of the Esophagus, and the Australian and New Zealand Gastric and Oesophageal Surgeons Association in addition to participants of the 2019 International Gastric Cancer and European Society for Diseases of the Esophagus congresses. Topics addressed included hospital volume, staging, perioperative treatment, surgical approach, anastomotic techniques, lymphadenectomy, and palliative management. Results: Between June 2019 and January 2020, 165 respondents from 44 countries completed the survey. In total, 80% worked in a hospital performing >20 gastrectomies annually. Staging laparoscopy and 18F-fluorodeoxyglucose positron emission tomography with computed tomography were preferred by 68 and 26% for advanced cancer, and 90% offered perioperative chemo(radio)therapy to patients. For early cancer, a minimally invasive surgical approach was preferred by 65% for distal and by 50% for total gastrectomy. For advanced cancer, this was preferred by 39% for distal and by 33% for total gastrectomy. And 84% favored a stapled anastomosis, and 14% created a jejunal pouch as reconstruction during total gastrectomy. A D2 lymphadenectomy was preferred for distal as well as for total gastrectomy, in both early (62 and 71%) and advanced (84 and 89%) cancer. Conclusion: This international survey demonstrates that perioperative chemotherapy and a D2 lymphadenectomy have now become the preferred treatment for gastric cancer. A minimally invasive surgical approach has gained popularity.
Biomarkers for the Assessment of Exposure to Fluoride in Adults
Authors: Idowu Oladipo S. , Duckworth Ralph M. , Valentine Ruth A. , Zohoori Fatemeh V.
Published: June 2021

To monitor deficient or excessive intakes of biologically available fluoride (F), various biological samples have been tested for use as biomarkers of human exposure to F. Most such studies have concerned children and often have only involved measurement of F in 1 or 2 types of sample. The present study investigated the relationships of F concentrations in biomarkers of F exposure; including plasma, saliva, hair, finger- and toenails, and daily urinary F excretion (UFE) with the total daily F intake (TDFI) of adults. TDFI was assessed in 60 healthy adults, aged ≥20 years; 31 lived in a low-F water area (LFA, 0.04 mg F/L) and 29 in a high-F water area (HFA, 3.05 mg F/L) of Nigeria. All volunteers provided at least 1 biomarker sample from the above list and completed a questionnaire to evaluate F intake from the diet and toothpaste ingestion. TDFI, UFE and F concentrations of biomarkers were statistically significantly higher in the HFA than in the LFA. There were strong statistically significant positive correlations between TDFI and UFE (ρ = 0.730, p < 0.001); plasma F (ρ = 0.729, p < 0.001); fasting whole saliva F (ρ = 0.653, p < 0.001) and hair F (ρ = 0.603, p < 0.001). The statistically significant positive correlations between TDFI and fingernail F (ρ = 0.502, p < 0.001) and between TDFI and toenail F (ρ = 0.556, p < 0.001) were moderate. In conclusion, this study has indicated the usefulness of 24-h UFE as well as F concentration in plasma, fasting whole saliva and hair as biomarkers of contemporary or sub-chronic F exposure in groups of adults. However, they do not appear to have the necessary sensitivity to predict F exposure in individuals.
Impacts of Short-Term Fine Particulate Matter Exposure on Blood Pressure Were Modified by Control Status and Treatment in Hypertensive Patients
Authors: Lin Zhennan , Wang Xinyan , Liu Fangchao , Yang Xueli , Liu Qiong , Xing Xiaolong , Cao Jie , Li Jianxin , Huang Keyong , Yan Weili , Liu Tingting , Fan Meng , Li Wei , Chen Shufeng , Lu Xiangfeng , Gu Dongfeng , Huang Jianfeng
Published: June 2021

Previous studies revealed that fine particulate matter (PM
2.5
) exposure adversely affected blood pressure (BP), but factors that might attenuate this association were still unclear. Using a multicenter panel study among 277 hypertensive participants with intermediate-to-high risk of cardiovascular disease from 4 cities in China, we aimed to explore whether BP control status and antihypertensive medications were potential modifying factors. Each participant carried personal-portable monitors to record individual real-time PM
2.5
levels and 24-hour ambulatory BP up to 3× within 1 year. Generalized linear mixed model with individual-specific random intercept was used to assess effect sizes. We identified adverse impacts of short-term PM
2.5
exposure on BP. However, these impacts were attenuated among patients with controlled BP. For example, per interquartile range (43.78 µg/m
3
) increment in the prior 10-hour moving average of PM
2.5
, systolic BP increased −0.20 (95% CI, −0.57 to 0.18) mm Hg and 0.85 (95% CI, 0.36–1.35) mm Hg among those with controlled and uncontrolled BP, respectively (
P
interaction
, 0.0009). Furthermore, among those with uncontrolled BP, treatment with angiotensin receptor blocker would potentially lower BP in responses to PM
2.5
, with systolic BP associated with per interquartile range increment in 10-hour moving average PM
2.5
of 0.32 (95% CI, −0.37 to 1.00) mm Hg and 1.53 (95% CI, 0.74–2.33) mm Hg among those taking angiotensin receptor blocker or not, respectively (
P
interaction
, 0.0229). In conclusion, although PM
2.5
exposure would increase BP, keeping well-controlled BP status and using angiotensin receptor blockers might attenuate these adverse impacts, which might provide supporting evidence for guiding hypertensive patients who live in areas with high level of PM
2.5
.
The Effects of Frequency, Variability, and Co-occurrence on Category Formation in Neural Systems
Authors: Plebanek Daniel J. , James Karin H.
Published: June 2021

Objects are grouped into categories through a complex combination of statistical and structural regularities. We sought to better understand the neural responses to the structural features of object categories that result from implicit learning. Adult participants were exposed to 32 object categories that contained three structural properties: frequency, variability, and co-occurrences, during an implicit learning task. After this exposure, participants completed a recognition task and were then presented with blocks of learned object categories during fMRI sessions. Analyses were performed by extracting data from ROIs placed throughout the fusiform gyri and lateral occipital cortex and comparing the effects of the different structural properties throughout the ROIs. Behaviorally, we found that symbol category recognition was supported by frequency, but not variability. Neurally, we found that sensitivity to object categories was greater in the right hemisphere and increased as ROIs were moved posteriorly. Frequency and variability altered the brain activation while processing object categories, although the presence of learned co-occurrences did not. Moreover, variability and co-occurrence interacted as a function of ROI, with the posterior fusiform gyrus being most sensitive to this relationship. This result suggests that variability may guide the learner to relevant co-occurrences and this is supported by the posterior ventral temporal cortex. Broadly, our results suggest that the internal features of the categories themselves are key factors in the category learning system.
Examining Individual Differences in Language Learning: A Neurocognitive Model of Language Aptitude
Authors: Turker Sabrina , Seither-Preisler Annemarie , Reiterer Susanne Maria
Published: June 2021

A common practice in the cognitive neurosciences is to investigate population-typical phenomena, treating individuals as equal except for a few outliers that are usually discarded from analyses or that disappear on group-level patterns. Only a few studies to date have captured the heterogeneity of language processing across individuals as so-called “individual differences;” fewer have explicitly researched language aptitude, which designates an individual’s ability for acquiring foreign languages. Existing studies show that, relative to average learners, very gifted language learners display different task-related patterns of functional activation and connectivity during linguistic tasks, and structural differences in white and grey matter morphology, and in white matter connectivity. Despite growing interest in language aptitude, there is no recent comprehensive review, nor a theoretical model to date that includes the neural level. To fill this gap, we review neuroscientific research on individual differences in language learning and language aptitude and present a first, preliminary neurocognitive model of language aptitude. We suggest that language aptitude could arise from an advantageous neuro-cognitive profile, which leads to high intrinsic motivation and proactive engagement in language learning activities. On the neural level, interindividual differences in the morphology of the bilateral auditory cortex constrain individual neural plasticity, as is evident in the speed and efficiency of language learning. We suggest that language learning success is further dependent upon highly efficient auditory-motor connections (speech-motor networks) and the structural characteristics of dorsal and ventral fibre tracts during language learning.
Two new species of genus Spilolonchoptera Yang, 1998 from China (Diptera, Lonchopteridae)
Authors: GAO SHANG , ZHANG BING , YANG DING
Published: June 2021

Only five species of the genus Spilolonchoptera Yang, 1998 were previously known from China. Here two new species, Spilolonchoptera hainanensis sp. nov. and Spilolonchoptera zhejiangensis sp. nov. are reported from China. A key to species of the genus Spilolonchoptera from China is presented.
A Taxonomic study of two species of Thiotricha Meyrick (Lepidoptera: Gelechiidae), from southwestern Japan, with notes on the biology of their immature stages
Authors: KYAW KHINE MON MON , UEDA TATSUYA , YAGI SADAHISA , OKAMOTO TOMOKO , WANG MIN , HIROWATARI TOSHIYA
Published: June 2021

The taxonomy and biology of the immature stages of two gelechiid species of Thiotricha Meyrick, 1886, found in the southeastern part of the Sino-Japanese region is presented. Thiotricha lumnitzeriella Kyaw, Ueda & Hirowatari sp. nov., from islands in southwestern Japan is described. The larva of this species feeds as a portable case maker on Lumnitzera racemosa Willd. (Combretaceae). Thiotricha gemmulans Meyrick, 1931 originally described from India is newly recorded from Japan, mainland China, and Thailand. This species feeds as a portable case maker on Glochidion zeylanicum var. lanceolatum (Hayata) and G. zeylanicum var. zeylanicum (Gaertn.) A. Juss (Phyllanthaceae). Thiotricha acrophantis Meyrick, 1936 is newly synonymized with T. gemmulans.                Images of the adults of Thiotricha lumnitzeriella sp. nov. and T. gemmulans including genitalia, and images and illustrations of the larval chaetotaxy and pupa for both species are provided. Larval feeding habits are described in detail.
Study of the Porous Structure and High Adsorption Capacity of Biomass-Based Activated Carbon Prepared from Aspen Wood by Ferric Nitrate III Activation
Authors: Jin Chunjiang , Chen Huimin , Wang Luyuan , Cheng Xingxing , An Donghai , Zhang Jingru
Published: June 2021

In this study, aspen wood sawdust was used as the raw material, and Fe(NO3)3and CO2were used as activators. Activated carbon powder (ACP) was produced by the one-step physicochemical activation method in an open vacuum tube furnace. The effects of different mass ratios of Fe(NO3)3and aspen wood sawdust on the pore structure of ACP were examined under single-variable experimental conditions. The mass ratio was 0–0.4. The detailed characteristics of ACP were examined by nitrogen adsorption, scanning electron microscopy, X-ray diffraction, and Fourier transform infrared spectroscopy. The adsorption capacity of ACP was established by simulating volatile organic compounds (VOCs) using ethyl acetate. The results showed that ACP has a good nanostructure with a large pore volume, specific surface area, and surface functional groups. The pore volume and specific surface area of Fe-AC-0.3 were 0.26 cm3/g and 455.36 m2/g, respectively. The activator played an important role in the formation of the pore structure and morphology of ACP. When the mass ratio was 0–0.3, the porosity increased linearly, but when it was higher than 0.3, the porosity decreased. For example, the pore volume and specific surface area of Fe-AC-0.4 reached 0.24 cm3/g and 430.87 m2/g, respectively. ACP presented good VOC adsorption performance. The Fe-AC-0.3 sample, which contained the most micropore structures, presented the best adsorption capacity for ethyl acetate at 712.58 mg/g. Under the action of the specific reaction products nitrogen dioxide (NO2) and oxygen, the surface of modified ACP samples showed different rich C/O/N surface functional groups, including C-H, C=C, C=O, C-O-C, and C-N.
Milling Performance of Fluorinated Surfactants-Based Coating Tools in Processing Particleboard
Authors: Wang Jin-Xin , Zhu Zhao-Long , Gao Yu , Jiang Rong-Sheng , Cao Ping-Xiang
Published: June 2021

To investigate the cutting performance of tools with fluorinated surfactant-based coatings, the milling performance of melamine-coated particleboard was characterized by means of the cutting force, tool wear and surface quality. A scanning electron microscope (SEM) and a three-dimensional super field microscope were used to observe the morphologies of coated and uncoated tool wear and machined surfaces. The results showed that (1) the surface wettability of the coated tool is lower than that of the uncoated tool; (2) the main wear mechanisms for tools with a fluorinated surfactant-based coating are abrasive wear and microchipping. The fluorinated surfactant-based coating acts as a solid lubricant, which can obviously reduce adhesion wear; (3) the surface roughness obtained by machining using coated tools is much smaller than that found for uncoated tools.
Preparation of Nano Hydroxyapatite/Polyamide Composite and Its Application in Lumbar Disc Herniation Operation
Authors: Wang Yue , Harsh Priyadarshi M. S. , Wu Liyong , Chen Hengmei , Liu Chengzhao , Wang Chun
Published: June 2021

Carbon fiber (CFR) was used to strengthen the mechanical properties of hydroxyapatite/polyamide (ha/pa) to synthesize ternary composites with different mass fraction. At the same time, its mechanical and material characterization were compared with that of ha/pa without CFR. CFR-ha/pa was used as the substrate for the culture of mouse bone marrow mesenchymal stem cells (C3H10T1/2). The cell morphology and adhesion properties of materials were analyzed by immuno light staining of cytoskeleton and adhesion protein, and FESEM. The interbody fusion cage based on the material was used in the treatment of lumbar disc herniation. According to the X-ray film and the corresponding scoring standards (JOA, ODI and VAS), the therapeutic effect of the interbody fusion cage was evaluated. The results showed that there were cavities on the surface of CFR-ha/pa composites. With the increase of the mass fraction of CFR in CFR-ha/pa composites, the compressive strength (from 115 MPa to 218 Mpa), the bending strength (from 85 MPa to 140 MPa) and other mechanical indexes of the composite increased obviously. After 24 h of cell inoculation, the substrate of CFR-ha/pa group was covered by layered, well spread and fused cells, and there was dense cell adhesion around it, that was to say, the material and cells showed good adhesion performance. At the same time, the levels of Integrinα1and Integrinβ1significantly increased in CFR-ha/pa group (P< 0.05). The VAS and ODI scores of polyether ether ketone (Peek) interbody fusion cage group and CFR-ha/pa interbody fusion cage group were lower than those before operation (P< 0.05). The therapeutic effect of CFR-ha/pa interbody fusion cage is better than Peek interbody fusion cage.
Does Topographic Form Stress Impede Prograde Ocean Currents?
Authors: BAI YUE , WANG YAN , STEWART ANDREW L.
Published: June 2021

Topographic form stress (TFS) plays a central role in constraining the transport of the Antarctic Circumpolar Current (ACC), and thus the rate of exchange between the major ocean basins. Topographic form stress generation in the ACC has been linked to the formation of standing Rossby waves, which occur because the current is retrograde (opposing the direction of Rossby wave propagation). However, it is unclear whether TFS similarly retards current systems that are prograde (in the direction of Rossby wave propagation), which cannot arrest Rossby waves. An isopycnal model is used to investigate the momentum balance of wind-driven prograde and retrograde flows in a zonal channel, with bathymetry consisting of either a single ridge or a continental shelf and slope with a meridional excursion. Consistent with previous studies, retrograde flows are almost entirely impeded by TFS, except in the limit of flat bathymetry, whereas prograde flows are typically impeded by a combination of TFS and bottom friction. A barotropic theory for standing waves shows that bottom friction serves to shift the phase of the standing wave’s pressure field from that of the bathymetry, which is necessary to produce TFS. The mechanism is the same in prograde and retrograde flows, but is most efficient when the mean flow arrests a Rossby wave with a wavelength comparable to that of the bathymetry. The asymmetry between prograde and retrograde momentum balances implies that prograde current systems may be more sensitive to changes in wind forcing, for example associated with climate shifts.
Near-inertial dissipation due to stratified flow over abyssal topography
Authors: Zemskova Varvara E. , Grisouard Nicolas
Published: June 2021

Linear theory for steady stratified flow over topography sets the range for topographic wavenumbers over which freely propagating internal waves are generated, and the radiation and breaking of these waves contribute to energy dissipation away from the ocean bottom. However, previous numerical work demonstrated that dissipation rates can be enhanced by flow over large scale topographies with wavenumbers outside of the lee wave radiative range. We conduct idealized 3D numerical simulations of steady stratified flow over 1D topography in a rotating domain and quantify vertical distribution of kinetic energy dissipation. We vary two parameters: the first determines whether the topographic obstacle is within the lee wave radiative range and the second, proportional to the topographic height, measures the degree of flow non-linearity. For certain combinations of topographic width and height, breaking occurs in pulses every inertial period, such that kinetic energy dissipation develops inertial periodicity. In these simulations, kinetic energy dissipation rates are also enhanced in the interior of the domain. In the radiative regime the inertial motions arise due to resonant wave-wave interactions. In the small wavenumber non-radiative regime, instabilities downstream of the obstacle can facilitate the generation and propagation of non-linearly forced inertial motions, especially as topographic height increase. In our simulations, dissipation rates for tall and wide non-radiative topography are comparable to those of radiative topography, even away from the bottom, which is relevant to the ocean where the topographic spectrum is such that wider abyssal hills also tend to be taller.
Despite Efficiencies, Mergers and Acquisitions Reduce Firm Value by Hurting Customer Satisfaction
Authors: Umashankar Nita , Bahadir S. Cem , Bharadwaj Sundar
Published: June 2021

Most researchers focus on the effect of mergers and acquisitions (M&As) on investor returns and overlook customer reactions, despite the fact that customers are directly impacted by these corporate transformations. Others suggest that in M&A contexts, a dual emphasis of customer satisfaction and firm efficiency is both likely and beneficial. In contrast, the authors demonstrate that M&As not only do not yield a dual emphasis but also cause a decline in customer satisfaction to the extent that they eclipse any gain in firm value from an increase in firm efficiency. A quasiexperimental difference-in-differences analysis and an instrumental variable panel regression provide robust evidence for the dark side of M&As for customers. The authors use the attention-based view of the firm to demonstrate that post-M&A customer dissatisfaction occurs because of a shift in executive attention away from customers and toward financial issues. In line with the related upper echelons theory, they find that marketing representation on a firm’s board of directors helps maintain executive attention on customers, which mitigates the dysfunctional effect of M&As on customer satisfaction. This research identifies a negative M&A–customer satisfaction relationship and highlights executive attention to customer issues and marketing leadership as factors that mitigate this negative relationship.
Design and implementation of a wearable patch antenna that serves as a longitudinal strain sensor
Authors: Arango Toro Julian , Montes Granada Willer Ferney , Yepes Zuluaga Sara Maria
Published: June 2021

This paper describes the design and simulation of a rectangular wearable patch antenna. A parametric study of the antenna was conducted to determine the effect of subjecting it to longitudinal mechanical strain (along the x-axis) on its resonant frequency. The antenna-sensor was based on a cotton fabric dielectric and conductors made of flexible copper sheets that operated at a central frequency of 2.4 GHz, which is in one of the Industrial, Scientific, and Medical application bands. The Deming’s cycle, or Plan, Do, Check, and Act, was the adopted methodology in this study to address this research problem. The resonant cavity technique was implemented to find the relative permittivity and loss tangent of the textile substrate, and a universal testing machine was used to establish its mechanical properties (i.e., Young’s modulus and Poisson’s ratio). The mechanical properties of the dielectric materials, the elastic modulus in tensile loading (69.34 MPa), and the experimental value of the Poisson's ratio (0.342) were extracted from the literature. Based on the CST (Computer Simulation Technology) datasheet of flexible copper, its elastic modulus in tensile loading is 240 MPa and its Poisson's ratio is 0.39. A Computer Numerical Control machine was employed to cut the flexible copper, and the cotton fabric was cut by hand based on the dimensions of the ground plane. The patch was sewn with strong textile thread at the center of the ground plane and the cotton fabric. Such sewing ensured the physical resistance of the antenna to withstand the conditions of the multiple strains it was subjected to. The antenna implemented here resonated at a frequency of 2.3968 GHz (with a 0.13% error rate) and was well coupled with the transmission line with a Standing Wave Ratio of 1.04. CST Microwave Studio® software was used to simulate the antenna frequency response to mechanical strains based on the reaction of its return losses ([Formula: see text] in dB) to be compared with experimental rigs that bend at a different level of stresses. In line with the theory in the literature, the resonant frequency of the antenna was linearly and inversely proportional to the applied stress, which enabled us to calculate the transduction ratio of the sensor in terms of strain versus frequency. In the experimental setup, the range of variation of the resonant frequency of the sensor was 143.6 MHz, with a very good sensitivity of 2.38 [Formula: see text]. These results pave the way for future studies in which this sensor is used as part of a biomedical system to monitor the vital signs of patients (such as respiratory rate, lung capacity, and performance under different types of physical effort; for example, in high-performance athletes) and diagnose diseases or other kinds of disorders associated with respiratory problems.
Small joint polyarthritis – An unusual presentation of scrub typhus in a child
Authors: Mohandoss Vichithra , Srinath MV , Kumar Radha , Dev Kumar V , Chaudary Devanand Gulab
Published: June 2021

Scrub typhus is a common Rickettsial infection which is endemic in tropical regions. It is characterised by fever, eschar, thrombocytopenia, lymphadenopathy and organomegaly. Scrub typhus has significant morbidity and mortality owing to its multisystemic involvement. Non-inflammatory polyarthritis of small joints is an uncommon presentation in paediatric scrub typhus. We discuss a five-year-old boy who presented with fever, small joint polyarthritis, hepatosplenomegaly and pathognomonic eschar with positive scrub IgM ELISA. Arthritis resolved completely with doxycycline therapy without any deformity.
Stochastic distribution tracking control for stochastic non-linear systems via probability density function vectorisation
Authors: Liu Yefeng , Zhang Qichun , Yue Hong
Published: June 2021

This paper presents a new control strategy for stochastic distribution shape tracking regarding non-Gaussian stochastic non-linear systems. The objective can be summarised as adjusting the probability density function (PDF) of the system output to any given desired distribution. In order to achieve this objective, the system output PDF has first been formulated analytically, which is time-variant. Then, the PDF vectorisation has been implemented to simplify the model description. Using the vector-based representation, the system identification and control design have been performed to achieve the PDF tracking. In practice, the PDF evolution is difficult to implement in real-time, thus a data-driven extension has also been discussed in this paper, where the vector-based model can be obtained using kernel density estimation (KDE) with the real-time data. Furthermore, the stability of the presented control design has been analysed, which is validated by a numerical example. As an extension, the multi-output stochastic systems have also been discussed for joint PDF tracking using the proposed algorithm, and the perspectives of advanced controller have been discussed. The main contribution of this paper is to propose: (1) a new sampling-based PDF transformation to reduce the modelling complexity, (2) a data-driven approach for online implementation without model pre-training, and (3) a feasible framework to integrate the existing control methods.
Voltage controller with energy management unit for microgrid with hybrid sources
Authors: Babu Sheeba , Ashok Kumar L
Published: June 2021

An unprecedented year has past with Covid-19 lockdown. It has underscored the importance of reliable and uninterrupted power supply. Microgrid ensures reliability and continuity of power supply in a local region with its own local generation and load despatch system, thereby reducing or eliminating the need of a central generator. A microgrid is capable of autonomous operation or it can be connected to a central ac grid that it separates from during disturbances. In this paper results of a microgrid simulation model is presented. Here microgrid system uses two renewable sources namely, solar PV and wind generator along with a battery feeding an inverter supplying load. The system is modeled and implemented using Matlab/simulink environment. The simulation model consists of mono-crystalline solar PV panel of 2.5 kW and a wind turbine emulator having PMDC as wind generator of 1 kW rating as micro sources. For stabilisation of the system a battery bank of 48 V, 100 Ah is also provided. The system is designed to supply a maximum load of 2.5 kW. The system autonomy is approximately two hours for rated load of 2.5 kW. Stability of the system was tested during load variations. The voltage and frequency were found to be stable during load variations. The performance of the inverter to provide constant output voltage of 400 V is good and the output frequency of the inverter is also maintained at 50 Hz. The output voltage conforms to IEC 60038 Standards. An energy management scheme is also developed and simulation results show effectiveness of the scheme.
Beyond the political principle: Applying Martin Buber’s philosophy to societal polarization
Authors: Pauly Marc
Published: June 2021

Societal polarization has given rise to opposing groups that fight each other as enemies and that have very different ideas about what should be done and about what is the case. This article investigates what tools there are in the philosophy of Martin Buber to address this societal polarization. Buber’s notion of community, the relationship between means and ends, his opposition to the political principle, the notion of an I-Thou dialogue and his conception of truth are presented as relevant for overcoming societal polarization. The article also presents the case of Daryl Davis as manifesting some of these Buberian principles.
Severe Hydroxyapatite Deposition Disease in Binturongs (Arctictis binturong)
Authors: Takehana Kazuya , Moresco Anneke , Johnson James G. , Kasahara Masaaki , Kasahara Norio , Han Sushan
Published: June 2021

In a collection of 6 young binturongs ( Arctictis binturong), 3 presented with anorexia, lethargy, and footpad swelling diagnosed by surgical biopsy as calcinosis circumscripta. Despite supportive care over the next 4 years, affected binturongs had progressive weight loss, hyperphosphatemia, and hyperkalemia and developed large radiodense deposits in tissues adjacent to appendicular joints, thoracolumbar vertebrae, and the sternum. Two binturongs died and necropsies showed severe periarticular mineral deposition with fibrosis and granulomatous inflammation. Additionally, binturongs had mineralization of distal renal tubules, mineralization of the renal interstitium, and marked mineralization of the pulmonary interstitium and peribronchiolar smooth muscle. Foot biopsies from the surviving binturong were evaluated by spectroscopic microanalysis and were positive for hydroxyapatite, Ca10(PO4)6(OH)2. Periarticular and footpad mineralization in these binturongs is consistent with hydroxyapatite deposition disease, which is rarely described in humans and animals as a primary familial condition or a secondary condition often associated with renal injury.
Performance-Based Approach for Deciding the Age of New Concrete for Thin Epoxy Overlay Application
Authors: Attanayake Upul , Mazumder Abul Fazal
Published: June 2021

A thin epoxy overlay application is a capital preventive maintenance activity. Epoxy overlays reduce the rate of chloride ion ingress and extend bridge deck service life. Highway agency policies and manufacturer specifications require maintaining a 28-day curing period (7-day wet and 21-day dry curing) before the application of an epoxy overlay on bridge decks requiring new concrete for patches and repairs. Consequently, the contractors wait for 28 days to apply an epoxy overlay. Delaying application time increases project completion time and the cost of construction and mobility. The suitability of new concrete to receive epoxy overlays and the performance of overlays depend on several parameters including concrete strength, moisture, and tendency to crack. Such parameters depend on concrete mixture ingredients and wet and dry curing periods. This paper presents a performance-based procedure for evaluating the possibility of reducing the 28-day waiting period for a thin epoxy overlay application on new concrete. An experimental program was developed and executed to evaluate the impact of epoxy overlay application parameters and overlay performance using a tensile bond pull-off strength test. The results support developing a performance-based procedure for deciding on the suitable age of new concrete to receive a thin epoxy overlay. The pull-off bond strength of epoxy overlays applied at 7, 14, and 21 days, following a 7-day moist curing, shows the possibility of applying an epoxy overlay before the end of the 28-day curing period stipulated in the current specifications.
Dextrose solution for priming and rinsing the extracorporeal circuit in hemodialysis patients: A prospective pilot study
Authors: Rootjes Paul A , Penne Erik Lars , Ouellet Georges , Dou Yanna , Thijssen Stephan , Kotanko Peter , Raimann Jochen G
Published: June 2021

Introduction:

Excess sodium intake and consequent volume overload are major clinical problems in hemodialysis (HD) contributing to adverse outcomes. Saline used for priming and rinsing of the extracorporeal circuit is a potentially underappreciated source of intradialytic sodium gain. We aimed to examine the feasibility and clinical effects of replacing saline as the priming and rinsing fluid by a 5% dextrose solution.

Materials and methods:

We enrolled non-diabetic and anuric stable HD patients. First, the extracorporeal circuit was primed and rinsed with approximately 200–250 mL of isotonic saline during 4 weeks (Phase 1), subsequently a similar volume of a 5% dextrose solution replaced the saline for another 4 weeks (Phase 2), followed by another 4 weeks of saline (Phase 3). We collected data on interdialytic weight gain (IDWG), pre- and post-dialysis blood pressure, intradialytic symptoms, and thirst.

Results:

Seventeen chronic HD patients (11 males, age 54.1 ± 18.7 years) completed the study. The average priming and rinsing volumes were 236.7 ± 77.5 and 245.0 ± 91.8 mL respectively. The mean IDWG did not significantly change (2.52 ± 0.88 kg in Phase 1; 2.28 ± 0.70 kg in Phase 2; and 2.51 ± 1.2 kg in Phase 3). No differences in blood pressures, intradialytic symptoms or thirst were observed.

Conclusions:

Replacing saline by 5% dextrose for priming and rinsing is feasible in stable HD patients and may reduce intradialytic sodium loading. A non-significant trend toward a lower IDWG was observed when 5% dextrose was used. Prospective studies with a larger sample size and longer follow-up are needed to gain further insight into the possible effects of using alternate priming and rinsing solutions lowering intradialytic sodium loading.

Trial registration:

Identifier NCT01168947 (ClinicalTrials.gov).
Susceptibility to Undue Influence: The Role of the Medical Expert in Estate Litigation
Authors: Herrmann Nathan , Whaley Kimberly A. , Herbert Deidre J. , Shulman Kenneth I.
Published: June 2021

Objectives:

Medical experts are increasingly asked to assist the courts with Will challenges based on the determination of testamentary capacity and potential undue influence. Unlike testamentary capacity, the determination of undue influence has been relatively neglected in the medical literature. We aim to improve the understanding of the medical expert role in providing the courts with an opinion on susceptibility to undue influence in estate litigation.

Method:

Medical experts with experience in the assessment of testamentary capacity and susceptibility to undue influence collaborated with experienced estate litigators. The medical literature on undue influence was reviewed and integrated. The lawyers provided a historical background and a legal perspective on undue influence in estate litigation and the medical experts provided a clinical perspective on the determination of susceptibility to undue influence. Together, they provided recommendations for how the medical expert could best assist the court.

Results:

Susceptibility to undue influence is frequently used in estate litigation to challenge the validity of Wills and is defined as subversion of the testator’s free will by an influencer, resulting in changes to the distribution of the estate. While a determination of undue influence includes the documentation of indicia or suspicious circumstances under which the Will was drafted and executed, medical experts should focus primarily on the susceptibility of the testator to undue influence. This susceptibility should be based on a consideration of cognitive function, psychiatric symptoms, physical and behavioural function, with evidence derived from the medical documentation, the medical examination, and the history.

Conclusions:

The determination of undue influence is a legal one, but medical experts can help the court achieve the most informed legal decision by providing relevant information on clinical issues that may impact the testator’s susceptibility to undue influence.
Multi-objective design optimization of additively manufactured lattice structures for improved energy absorption performance
Authors: Gorguluarslan Recep M
Published: June 2021

This paper aims to improve the energy absorption performance of stiffness-optimized lattice structures by utilizing a multi-objective surrogate-based size optimization that considers the additive manufacturing (AM) constraints such as the minimum printable size. A truss optimization is first utilized at the unit cell level under static compressive loads for stiffness maximization and two optimized lattice configurations called the Face-Body Centered Cubic (FBCC) lattice and the Octet Cubic (OC) are obtained. A multi-objective size optimization process is then carried out to improve the energy absorption capabilities of those lattice designs using non-linear compression simulations with Nylon12 material to be fabricated by the Multi Jet Fusion (MJF) AM process. Thin plate spline (TPS) interpolation method is found to produce very high accuracy as the surrogate model to predict the highly nonlinear response surfaces of energy absorption objectives in the optimization. Compared to the lattice designs with uniform strut diameters, by using the optimization process, the maximum energy absorption efficiency ( EAEm) and the crush stress efficiency ( CSE) of the OC lattice design are further improved up to 33% and 37%, respectively. The FBCC lattice design is also found to have superior EAEm performance compared to the existing lattice types considered for fabricating by the MJF process in the literature.
Analytical study of thermal buckling and post-buckling behavior of composite beams reinforced with SMA by Reddy Bickford theory
Authors: Fani Mahshad , Taheri-Behrooz Fathollah
Published: June 2021

Shape memory alloys are used in composite structures due to their shape memory effect and phase transformation. The recovery force of the shape memory alloy improves the post-buckling behavior of the structure. In this study, the thermal buckling and post-buckling of Shape Memory Alloy (SMA) hybrid composite laminated beam subjected to uniform temperature distribution is investigated. To this purpose, considering Von-Karman non-linear strain terms for large deformation, the non-linear equations of SMA reinforced beam based on Reddy Bickford theory have been derived. Besides, the recovery stress of the restrained SMA wires during martensitic transformation was calculated based on the one-dimensional constitutive law of the Brinson’s model. A numerical solution using Galerkin’s method has been presented for solving the nonlinear partial differential equations to obtain the critical buckling temperature and transverse deformation of the beam in the post-buckling region in both symmetric and anti-symmetric layups. The effect of SMA volume fraction, pre-strain, the boundary condition of the beam, stacking sequence, and its geometric properties have been studied. The results show that even by adding a small amount of SMA to the composite, the critical buckling temperature increases significantly, and the beam deflection decreases. Besides, using this theory has an evident effect on the anti-symmetric layup, especially for the thick beams.
Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!
Authors: Anja Kerschen , Hélène Dano , Pascal Van Eeckhout , Liliane Marot , Mieke Van Bockstal
Published: June 2021

Mammary Paget’s disease accounts for 1% to 3% of all breast tumors and manifests as a chronic eczematous lesion of the areolar skin. It can occur without any underlying neoplasia or can be present in association with an underlying invasive and/or in situ carcinoma of the breast. The present report describes a challenging nipple punch biopsy showing an infiltration of the lower third to two-thirds of the epidermis by large, ovoid, neoplastic cells. The morphology was consistent with mammary Paget's disease, although immunohistochemistry for cytokeratin-7 (CK7) was repeatedly negative. This resulted in an initial misdiagnosis and, subsequently, a delay in the patient's follow-up. Additional immunohistochemistry for GATA binding protein 3 (GATA3) and human epidermal growth factor receptor 2 (HER2), as well as a second opinion of a breast pathologist, resulted in the diagnosis of mammary Paget's disease. The aim of this article is to raise awareness among pathologists and prevent them from misdiagnosing CK7-negative Paget disease of the breast.
Controlling Nutritional Status Score Evaluates Prognosis in Patients With Non-Muscle Invasive Bladder Cancer
Authors: Huang Jiaguo , Zhao Liwei , Wang Kai , Sun Ji , Tai Shengcheng , Hua Runmiao , Yu Yufu , Fan Yi
Published: June 2021

Objective:

We investigated the clinical value of the Controlling Nutritional Status score in evaluating the prognosis of patients with non-muscle invasive bladder cancer.

Methods:

We conducted a retrospective analysis of the clinical data of 88 patients with non-muscle invasive bladder cancer who underwent transurethral resection of bladder tumor or partial cystectomy between January 2011 and May 2015 in a single center. The patients were divided into groups base on high (>1) and low (≤1) Controlling Nutritional Status score.

Results:

Clinical and demographic data of the patient groups were analyzed using the Kaplan-Meier method and log-rank test to generate survival curves. Univariate and multivariate analyses were conducted using the Cox proportional hazard model. Among the participants, the male-to-female ratio was 70:18 and median age was 64.5 years (range, 25-84 years). The numbers of patients with Controlling Nutritional Status score of 0, 1, 2, 3, 4, 5, and 6 were 26 (29.55%), 21 (23.86%), 20 (22.73%), 12 (13.64%), 5 (5.68%), 1 (1.14%), and 3 (3.41%), respectively. The 5-year recurrence rate was 29 out of 88 patients (32.95%). The recurrence-free survival of the high-score group was significantly lower than that of the low-score group ( P < 0.001). On univariate analysis, age, smoking history, Controlling Nutritional Status score, depth of tumor invasion, pathological grade, and tumor diameter were related to the prognosis of patients with non-muscle invasive bladder cancer. On multivariate analysis, the Controlling Nutritional Status score (hazard ratio, 4.938; 95% confidence interval, 1.392-17.525; P = 0.013) was an independent factor affecting the recurrence-free survival of patients with non-muscle-invasive bladder cancer.

Conclusion:

Therefore, the Controlling Nutritional Status score could be a simple, cost-effective, and reliable predictor of prognoses among of patients with non-muscle-invasive bladder cancer.