bluuebunny/crossref_metadata_2025 huggingface dataset:
Intra-urban mobility: the place of para-transit operations in the ancient town of Ile-Ife, Nigeria
Authors: OLADEJI Peter B. , AGBABIAKA Hafeez Idowu
Published: July 2021

This study examined the effectiveness of para-transit transport activities by identifying the socioeconomic characteristics of both the passengers and drivers of public transport and the factors confronting their operation. It utilised primary and secondary data. A purposive sampling technique was employed which entailed the identification of all the motor parks, the selection of buses, minibuses and cars at the motor parks, major bus stops and conducting a survey using a structured questionnaire cum interview. Questionnaires were administered to 354 respondents to obtain information about their socioeconomic, trip characteristics and the unconventional public transport operations, of which a total of 312 questionnaires were duly completed and returned. Data collected were analysed using simple descriptive techniques and correlation analysis. The results showed that the majority of the passengers (61.4%) were within the 21 – 30 years age bracket while 43.7% of the drivers were within the 31-40 years age bracket, the patrons and the operators of the public transport are predominantly low-income earners as large proportion of the passengers (42.1%) earned below ₦10,000 per month while 46.9% of the drivers earned between ₦10,001 and ₦20,000 per month. The results of the correlation analysis indicated both the drivers’ and passengers’ perspectives, factors such as public transport conditions, road quality and drainage system are highly correlated between their paired variables. Hence, effort should be made by the government and public transport operators to improve the transport infrastructural facilities in the study area.
Time, Entropy, and Entanglement Contextually Defined
Authors: Crecraft Harrison
Published: July 2021

The prevailing interpretations of physics are based on deeply entrenched assumptions, rooted in classical mechanics. Logical implications include: the denial of entropy as a fundamental physical property, and the inability to explain irreversible change, random quantum measurements, or nonlocality without untestable and implausible metaphysical implications. We propose a conceptual model that is based on empirically justifiable assumptions and consistent with observations. The WYSIWYG Conceptual Model (WCM) assumes no hidden properties: “What You can See Is What You Get.” The WCM contextually defines a system’s state with respect to its actual ambient background, and it extends existing models of physical reality by defining entropy and exergy as objective contextual properties of state. The WCM establishes the irreversible dissipation of exergy and the Second law of thermodynamics as a fundamental law of physics, it recognizes physical randomness, and it provides a physical explanation for nonlocality, consistent with Special Relativity, without hidden variables, superdeterminism, or “spooky action.”
Computational Analysis of the Properties of Post-Keynesian Endogenous Money Systems
Authors: Kuypers Stef , Goorden Thomas , Delepierre Bruno
Published: July 2021

“Money has always been something of an embarrassment to economic theory. Everyone agrees that it is important; indeed, much of macroeconomic policy discussion makes no sense without reference to money. Yet, for the most part theory fails to provide a good account for it.” (Banerjee and Maskin, 1996, p. 955)The debate about whether or not a growth imperative exists in debt based, interest bearing mone- tary systems has not yet been settled. It is the goal of this paper to introduce a new perspective in this discussion.For that purpose an SFC computational model is constructed which simulates a post Keynesian Endogenous Money system without including economic parameters such as production, wages, consumption and savings. A case is made that isolating the monetary system allows for better analysis of the inherent properties of such a system.Loan demands, which are assumed to happen, are the driving force of the model. Simulations can be run in two modes, each based on a different assumption. Either the growth rate of the money stock is assumed to be constant or the loan rate, expressed as a percentage of the money stock, is assumed to be constant.Simulations with varying parameters are run in order to determine the conditions under which the model converges to stability, which is defined as converging to a bounded debt rate.The analysis shows that stability of the model is dependent on net bank profit ratios, expressed relative to their debt assets, remaining below the growth rate of the money stock. Based on these findings it is argued that the question about the existence of a growth imperative in debt based, interest bearing monetary systems needs to be reframed. The question becomes whether a steady state economy can realistically support such a system without destabilising it. In order to answer this question real world behavior of economic actors must be included in the model.It is concluded that there are indications that it might not be feasible for a steady state economy to support a stable debt based, interest bearing monetary system without strong interventions. However, more research is necessary for a definite answer. Real world observable data should be analysed through the lens of the presented model to bring more clarity.
Comparison Between Tailor-Made-ANN Techniques and Fuzzy c-Mean Clustering Technique in Industrial Laborers' Accident-Rates Prediction Modelling Based on Human Factors
Authors: M.A.S. Mahmoud Muhammad
Published: July 2021

This paper attempts to compare two different approaches to solve the problem of accident rates prediction based on human factors for industrial workers. One of the methods has already been done using Fuzzy c-Means Clustering and proved to be working with decent results. The second method which will be covered in this paper is using Artificial Neural Networks. The primary goal of this work is to insure that ANN will work efficiently in such prediction problem. The second goal is to reveal the fact that which one of the two selected methodologies is better at defining the estimation of accident rates among people who work in different industrial fields. The purpose has been achieved when the outcome of the ANN was obtained and compared accordingly with the output of the research previously carried out with Fuzzy c-means clustering method. Comparing the outcomes of these two different methods gave an immense insight on which features are more important than others when it comes to laborers properties with completely different background such as varying levels of health, knowledge, experience, training and physical properties. At the end of the research, it becomes clear that accident rates estimation for laborers with properly trained Artificial Neural Network gives better results when it is compared with Fuzzy c-Means Clustering method. Standard deviation method was used to calculate the validity of ANN technique. The result was compared with Fuzzy c-mean clustering technique. Impressive improvement of 8.8% in the accident rate prediction was achieved using Tailored-Made-ANN.
Molecular Biology and Pathological Process of an Infectious Bronchitis Virus With Enteric Tropism in Commercial Broilers
Authors: da Silva Ana Paula , Hauck Ruediger , Nociti Sabrina R.C. , Kern Colin , Shivaprasad H.L. , Zhou Huaijun , Gallardo Rodrigo A.
Published: July 2021

Abstract: Infectious bronchitis virus (IBV) induces respiratory and urogenital disease in chickens. Although IBV replicates in the gastrointestinal tract, enteric lesions are uncommon. We have reported a case of runting-stunting syndrome in commercial broilers from which an IBV variant was isolated from the intestines. The isolate, CalEnt, demonstrated an enteric tissue tropism in chicken embryos and SPF chickens experimentally. Here, we determined the full genome of CalEnt and compared it to other IBV strains, in addition to comparing the pathobiology of CalEnt and M41 in commercial broilers. Despite the high whole-genome identity to other IBV strains, CalEnt is rather unique in nucleotide composition. The S gene phylogenetic analyses showed great similarity between CalEnt and Cal 99. Clinically, vent staining was slightly more frequent in CalEnt-infected birds than those challenged with M41. Furthermore, IBV IHC detection was more evident and the viral shedding in feces was overall higher with the CalEnt challenge compared with M41. Despite underlying intestinal lesions caused by coccidiosis and salmonellosis vaccination, microscopic lesions in CalEnt-infected chickens were more severe than in M41-infected chickens or controls, supporting the enteric tropism of CalEnt. Further studies in SPF chickens are needed to determine the pathogenesis of the virus, its molecular mechanisms for the enteric tropism, and its influence in intestinal health.
Single Surgeon Experience of 500 Cases with the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery using the da-Vinci Xi System
Authors: Choi YunSuk , Shin Woo Young , Yi Jin Wook
Published: July 2021

Objectives: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. Methods: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (RTs) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. Results: The RT group was younger (43.41±11.41 versus 54.28±13.41 years, p<0.001) and had a higher proportion of females (84.3% versus 69.3%, p<0.001), a lower BMI (24.66±3.97 versus 25.83±4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p<0.001). The RT group had a lnger operation time (145.33±40.80 versus 93.39±43.55 minutes, p<0.001) and higher surgical cost. Although the OT group had a larger tumor size and higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the stimulated thyroglobulin level before radioactive iodine therapy (7.01±35.73 versus 8.39±58.77, p=0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. Conclusion: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels.
MMTV Prevalence in Breast Cancer Samples in Romania- Do Major Geographical Differences Exist in the World Population?
Authors: Fekete Zsolt , Tertan Bristena Octavia , Raduly Lajos , Eniu Dan Tudor , Buiga Rares , Galatar Mihaela , Berindean-Neagoe Ioana
Published: July 2021

Breast cancer, although the most frequently diagnosed malignant tumour in humans, has a less clear aetiology compared to other frequent cancer types. Mouse-mammary tumour virus (MMTV) is involved in breast cancer in mice and dogs and might play a role in the aetiology of some breast cancers in humans, since it has been identified in 20-40% of breast cancer samples in Western Europe, USA, Australia and some other parts of the world population. The purpose of our study was to identify MMTV DNA sequences in breast tissue samples from breast cancer patients operated in our regional centre from Romania. We have selected 75 patients with non-metastatic breast cancer treated with curative intent and searched with PCR the MMTV-like DNA sequence in the breast cancer tissue and normal breast tissue obtained from the same patients. Since none of the examined samples was positive for MMTV-like target sequences on PCR we could not prove that MMTV plays a role in the aetiology of breast cancer in our patient group. This finding is similar to publications of other geographically related research groups and might be due to the fact that only the Mus musculus domesticus mouse species was proven to carry infectious MMTV, but not the Mus musculus musculus species, which is specific to South-Eastern Europe (including Romania) and some parts of Asia.
Mitogenome Phylogeny Including Data from Additional Subspecies Provides New Insights into the Historical Biogeography of the Eurasian lynx Lynx lynx
Authors: Mengüllüoğlu Deniz , Ambarlı Hüseyin , Barlow Axel , Paijmans Johanna L. A. , Sayar Ali Onur , Emir Hasan , Kandemir Irfan , Hofer Heribert , Fickel Jörns , Förster Daniel
Published: July 2021

Phylogenetic and phylogeographic assessments of species should ideally include individuals of all known populations. However, this is difficult for species with large distribution areas. Previous molecular studies of the wide-ranging Eurasian lynx Lynx lynx focused mainly on its northern Palearctic populations, with the consequence that the reconstruction of this species’ evolutionary history did not include genetic variation present in its southern Palearctic distribution. We sampled a previously not considered Asian subspecies (L. l. dinniki), added published data from another Asian subspecies (L. l. isabellinus), and reassessed the Eurasian lynx mtDNA phylogeny along with previously published data from northern Palearctic populations. Our mitogenome-based analyses revealed that the subspecies L. l. isabellinus harbours the most basal matriline, consistent with the origin of Lynx lynx in this subspecies’ current range. L. l. dinniki harbours the second-most basal matriline, which is related to, and may be the source of, the mtDNA diversity of the critically endangered Balkan lynx L. l. balcanicus. Our results suggest that the Anatolian peninsula was a glacial refugium for Eurasian lynx, with previously unconsidered implications for the colonization of Europe by this species. Genetic variation present in southern Palearctic populations of Lynx lynx is clearly important for elucidating the evolutionary history of this species.
Small RNAs Asserting Big Roles in Mycobacteria
Authors: Coskun Fatma S. , Plocinski Przemyslaw , van Oers Nicolai S.C.
Published: July 2021

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb), with 10.4 million new cases per year reported in the human population. Recent studies on the Mtb transcriptome have revealed the abundance of noncoding RNAs expressed at various phases of mycobacteria growth; in culture, in infected mammalian cells and in patients. Among these noncoding RNAs are both small RNAs (sRNAs) between 50-350 nts in length and smaller RNAs (sncRNA) <50 nts. In this review, we provide an up-to-date synopsis of the identification, designation, and function of these Mtb-encoded sRNAs and sncRNAs. The methodological advances including RNA sequencing strategies, small RNA antagonists and locked nucleic acid sequence specific RNA probes advancing the studies on these small RNA are described. Initial insights into the regulation of their expression and putative processing enzymes required for their synthesis and function are discussed. There are many open questions remaining about the biological and pathogenic roles of these small non-coding RNAs, and potential research directions needed to define the role of these mycobacterial noncoding RNAs summarized
Insights Gained from Genomic Studies on the Role of Sex Steroids in the Aetiology of Endometriosis
Authors: Saunders Philippa TK
Published: July 2021

Endometriosis is a chronic neuro-inflammatory disorder the defining feature of which is the growth of tissue (lesions) that resembles the endometrium in sites outside the uterus. Estimates of prevalence typically quote rates of ~10% of women of reproductive age, equating to ~190 million women world-wide. Three subtypes of endometriosis are usually considered when discussing the aetiology of the disorder - superficial peritoneal, ovarian (endometrioma cysts), and deep (infiltrating). Genetic, hormonal and immunological factors have all been proposed as contributing to risk factors associated with the development of lesions. Twin studies report the heritable component of endometriosis as ~50%. Genome wide association studies (GWAS) have been conducted allowing unbiased scanning of the genome for single nucleotide polymorphisms (SNPs) in many thousands of individuals. These studies have identified SNPs that appear over-represented in patients with endometriosis, particularly those with more extensive disease (stage III/IV). Amongst the larger scale GWAS there has been replication of SNPs near genes involved in oestrogen and other signalling pathways including ESR1 (oestrogen receptor alpha), GREB1, HOXA10, WNT4 and MAPK kinase signalling. The results from patients with endometriosis have also provided an opportunity to make comparisons with GWAS conducted on other patient cohorts including those with reproductive traits (age at menarche) and disorders (fibroids, endometrial and ovarian cancer) and conditions that are reported by women with endometriosis (migraine, depression). These comparative studies have highlighted some shared genetically-controlled biological mechanisms, including hormone-regulated pathways which might explain the co-occurrence of endometriosis with these disorders. In summary, unbiased genetic analysis has provided new insights into the genetic factors that may contribute to increased risk of developing endometriosis. New studies are needed to broaden the range of patients contributing to these datasets and to improve integration with non-genomic and tissue expression data before their full potential for diagnosis and improvements in patient care can be fully realised.
Product Life Cycle Cost Model to Solve Supplier Selection Problems in the Supply Chain Management
Authors: Yu-Jwo Tao , Yi-Shyuan Lin , Hsuan-Shih Lee , Chang-Shu Tu
Published: July 2021

Today’s purchasing companies demand an advanced buyer equal of enactment from their supplier while the two parties maintain a respectful connection. Although the supplier selection (SC) product life cycle cost (SCPLCC) is an important consideration among corporations, SCPLCC problem has become associated with deciding how one supplier should be selected from possible alternatives. In this study, we applied two types of goal programming, multiobjective linear programming and revised multichoice goal programming to develop a PLCC-based concept to solve the SCPLCC problem and construct a decision-making tool for application to a case of supply chain management in a Taiwanese light-emitting diode company in the high-tech industry. Our study main contribution Company managers can easily use the two approaches of the SCPLCC model with different parameters to solve SCPLCC model problems. Finally, we comparing five models found RMCGP with weighted linear goal programming had an adequate effect for application to the PLCC concept for high-technology comapny; this cloud make company decision–makers focus on low PLCC and select better supplier.
The Impact of Overseas Warehouse on Cross-Border E-Commerce Exports from the Perspective of System Dynamics
Authors: Zhou Guanglan , Fan Zhiying , Fei Yulian
Published: July 2021

The novel coronavirus pneumonia epidemic is still raging around the world. Therefore, during the period of a global pandemic, maintaining the normal circulation of medicine and health fields is the key to fight against the epidemic. This paper based on relevant data such as the export volume of cross-border e-commerce in Hangzhou, China from 2015 to 2019, the article uses system dynamics modeling to explore the impact of overseas warehouse services on cross-border e-commerce export transactions. Studies have shown that the introduction of overseas warehouses has significantly improved customer satisfaction and improved the quality of cross-border logistics services, which has a positive impact on cross-border e-commerce export transactions. Through sensitivity analysis, it can be seen that under the same conditions, the efficiency of customs clearance has the greatest impact on overseas warehouse services. Therefore, when allocating various investments in overseas warehouses, you can favor the customs clearance process to enhance the competitiveness of the cross-border e-commerce market and provide a feasible experience for healthcare supplies export from cross-border e-commerce.
Topology Optimization of Large-Scale 3D Morphing Wingstructures
Authors: Jensen Peter Dørffler Ladegaard , Wang Fengwen , Dimino Ignazio , Sigmund Ole
Published: July 2021

This work proposes a systematic topology optimization approach to simultaneously design the morphing functionality and actuation in three-dimensional wing structures. The actuation is assumed to be a linear strain-based expansion in the actuation material and a three-phase material model is employed to represent structural and actuating materials, and void. To ensure both structural stiffness with respect to aerodynamic loading and morphing capabilities, the optimization problem is formulated to minimize structural compliance while morphing functionality is enforced by constraining a morphing error between actual and target wing shape. Moreover, a feature mapping approach is utilized to constrain and simplify actuator geometries. A trailing edge wing section is designed to validate the proposed optimization approach. Numerical results demonstrate that three-dimensional optimized wing sections utilize a more advanced structural layout to enhance structural performance while keeping morphing functionality than two-dimensional wing ribs. The work presents the first step towards systematic design of three-dimensional morphing wing sections.
Towards improved Water-Energy-Climate Change nexus assessment in South Africa: A Participatory Approach
Authors: Mathetsa Steven Matome , Simatele Mulala Danny , Rampedi Isaac T
Published: July 2021

This paper discusses the use of a participatory approach to assess the level of understanding of the Water-Energy-Climate Change nexus in South Africa. The aim is to facilitate the development of well-coordinated, systematic, and holistic strategies for efficient management of the nexus and its implications in the country. The assessment was guided by the broader Integrated Water Resource Management framework, which promotes a participatory approach in the administration of water resources. The paper argues that despite the reasonable level of understanding of WECC, there is still a lack of integrated policy development and planning among key stakeholders. This is exacerbated by limited coordination and consultation among these stakeholders, particularly policymakers. This necessitates the urgent adoption of holistic and systems thinking approaches, and the promotion of collaboration among different stakeholders mandated to manage WECC sectors. Until such approaches are adopted, the WECC nexus will continue to impede the country’s socio-economic development and environmental wellbeing.
Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial
Authors: Brandl Andreas , Egner Christoph , Schleip Robert
Published: July 2021

Background: Spine shape parameters, such as leg length, kyphotic or lordotic angle, are influenced by low back pain. There is also evidence that the thoracolumbar fascia plays a role in such pa-thologies. This study examined the immediate effects of a myofascial release technique (MFR) on the thoracolumbar fascia and of an osteopathic treatment (OMT) on postural parameters in pa-tients with acute low back pain (aLBP). Methods: This study was a single-blind randomized pla-cebo-controlled trial. Seventy-one subjects (43.8 ± 10.5 years) suffering from aLBP were randomly and blinded assigned to three groups to be treated with MFR, OMT or a placebo intervention. Spinal shape parameters (functional leg length discrepancy (fLLD), kyphotic angle, lordotic an-gle) were measured before and after the intervention using video raster stereography. Results: Within the MFR group, fLLD reduced by 5.2 mm, p < 0.001 and kyphotic angle by 8.2 degrees, p < 0.001. Within the OMT group, fLLD reduced by 4.5 mm, p < 0.001 and kyphotic angle by 8.4 °, p = 0.007. Conclusion: MFR and OMT have an influence on fLLD and the kyphotic angle in aLBP patients. The interventions could have a regulating effect on the impaired neuromotor control of the lumbar muscles.
Trends in the Prevalence of Overweight and Obesity and Associated Socioeconomic and Household Environmental Factors among Women in Nepal: Findings from the Nepal Demographic and Health Surveys
Authors: Rana Kritika , Ghimire Puspa , Chimoriya Romila , Chimoriya Ritesh
Published: July 2021

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011 and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, cooking fuel, refrigerator, and bicycle were significantly associated with having both overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, television, and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need of interventions addressing these critical socioeconomic and household environmental factors.
Life, Death, Transitions
Authors: Tandoc III Amado
Published: July 2021

I am sharing with you the first issue of the Philippine Journal of Pathology for 2021, our tenth issue since we breathed life into our society publication in 2016. We have two case reports of gynecologic tumors, and an autopsy case of a disseminated hematolymphoid malignancy. Four original articles include a molecular pathology study for lung cancer, a real-world observational study on pooled testing among asymptomatic individuals, a cost effectiveness study on diagnostics for leukemia in the Philippines, and a 5-year soft tissue tumor review. On top of these, we are featuring a new section – Opinion, and we have on board, Dr. Raymundo Lo, to regularly provide his take on issues relevant to our profession and practice. This issue also comes alive with the inclusion of the entries and winners of the PSP 69th Annual Convention Photomicroscopy Contest sponsored by Omnibus Biomedical Systems.
Mixed Small Cell and Large Cell Neuroendocrine Carcinoma of the Endometrium
Authors: Uyboco Joshua , Cruz Mary Anne , Cenizal Maria Concepcion , So Jeffrey , Bello Maximino , Moran Jose
Published: July 2021

Neuroendocrine carcinoma (NEC) of the endometrium is a rare, aggressive subtype of endometrial cancer.  We report a 61-year-old female with a history of breast cancer, s/p modified radical mastectomy, chemotherapy, radiotherapy and hormonal (tamoxifen) therapy, who  presented with post-menopausal bleeding. Patient underwent TAH-BSO with lymph node dissection, and was diagnosed with a mixed small cell neuroendocrine carcinoma (SCNEC) and large cell neuroendocrine carcinoma (LCNEC), confirmed by positive immunohistochemical staining for neuroendocrine markers.  No other lesions were identified on PET-CT, making a primary endometrial NEC the most likely diagnosis.  We review the clinical and pathologic characteristics of endometrial neuroendocrine carcinomas.
HPV-Independent Gastric Type Adenocarcinoma of the Uterine Cervix presenting as Ovarian Masses
Authors: Chatto Joseph Antoine , Salillas Annette
Published: July 2021

Adenocarcinoma, HPV-independent, gastric type of the uterine cervix comprises only 10-15% of all cervical adenocarcinomas. A rare case of which, with metastasis to the uterine corpus and bilateral ovaries, is described. A 43-year-old female (G0P0) presented with menorrhagia and right flank pain radiating to the hypogastrium. Physical examination revealed an immovable, tender mass at the right lower quadrant with a nodular, firm cervix. Transabdominal ultrasound revealed multiseptated ovarian masses. The right and left ovaries were sent for frozen section and was diagnosed as Mucinous Cystadenoma and Mature Cystic Teratoma, respectively. Hysterectomy revealed a detached and fragmented cervix with irregular, abnormally shaped glands lined by a single layer of columnar cells with bland, basally located nuclei and clear cytoplasm associated with desmoplasia, findings which were also seen in the endomyometrium and ovaries. These tumor cells were CK7 positive and negative for ER, PR, CK20 and CDX2. The patient died six months after surgery. The presence of benign appearing glands is a diagnostic challenge. Despite the appearance, they may be malignant and should be investigated rigorously.
A Five-Year Review of Soft Tissue Tumors with Intermediate Malignant Potential and Soft Tissue Sarcomas in a Tertiary Hospital: University of the Philippines – Philippine General Hospital
Authors: Salise Joeanne Marie , Atun Jenny Maureen
Published: July 2021

Objective. Describe the epidemiology of Soft Tissue Tumors with Intermediate Malignant Potential (STTI) and Soft Tissue Sarcomas (STS) diagnosed in Philippine General Hospital, Department of Laboratories, Section of Surgical Pathology, from years 2014 to 2018.
Methodology. We utilized a descriptive, retrospective, cross-sectional study design and involved all newly-diagnosed cases of STTI and STS that fit the specified set of inclusion and exclusion criteria.
Results. Out of 1896 cases of probable STTI and STS on initial screening, 680 cases (36%) were included in the study. Of the 1216 excluded cases, 815 (43%) needed ancillary diagnostic workup for definitive classification. Sarcoma, Not Otherwise Specified (n=149; 21.9%; 95% CI [18.80, 25.02]) was the most common diagnosis, followed by gastrointestinal stromal tumor (n=91; 13.4%; 95% CI [10.82, 15.94]) and leiomyosarcoma (n=62; 9.1%; 95% CI [6.95%, 11.28%]). Median age was 47 years, with a slight female predominance (n=371; 55%; 0.83 male to female ratio). The extremities (n=244, 36%) were the most frequent site.
Conclusion. The significant amount of cases excluded in the study may account for the differences of distribution. Despite the increased immunohistochemistry tests available, there is still an apparent inaccessibility to ancillary diagnostic methods that are necessary in the diagnosis of STTI and STS.
Development and performance of a population-based risk stratification model for COVID-19
Authors: Vela Emili , Carot-Sans Gerard , Clèries Montse , Monterde David , Acebes Xènia , Comella Adrià , Eroles Luís García , Coca Marc , Valero-Bover Damià , Piera Jordi , Sust Pol Pérez
Published: July 2021

The shortage of recently approved vaccines against the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has highlighted the need for evidence-based tools to prioritize healthcare resources for people at higher risk of severe coronavirus disease 2019 (COVID-19). Current evidence indicates that age is far from accurate in identifying the risk of severe illness; furthermore, the count of individual risk factors has limited applicability to population-based “stratify-and-shield” strategies. We developed a COVID-19 risk stratification system that allows allocating people into four mutually-exclusive risk categories based on multivariate models for hospital admissions, transfer to intensive care unit (ICU), and mortality among the general population. The model was developed using clinical, hospital, and epidemiological data from the entire population of Catalonia (North-East Spain; 7.5 million people) and validated using an independent dataset of 218,329 individuals with PCR-confirmed COVID-19, who were infected after developing the model. This showed high discrimination capacity, with an area under the curve of the receiving operating characteristics of 0.85 (95% CI 0.85–0.85) for hospital admissions, 0.86 (0.86–0.97) for ICU transfers, and 0.96 (0.96–0.96) for deaths. Our results provide clinicians and policymakers with an evidence-based tool for prioritizing COVID-19 healthcare resources other population groups aside from those with higher exposure to SARS-CoV-2 and frontline workers.
Comparison of the impact of allelic polymorphisms in PfAMA1 on the induction of T Cell responses in high and low malaria endemic communities in Ghana
Authors: Ofori Ebenezer Addo , Tetteh John Kweku A , Frimpong Augustina , Ganeshan Harini , Belmonte Maria , Peters Bjoern , Villasante Eileen , Sedegah Martha , Ofori Michael Fokuo , Kusi Kwadwo Asamoah
Published: July 2021

Background

Malaria eradication requires a combined effort involving all available control tools, and these efforts would be complemented by an effective vaccine. The antigen targets of immune responses may show polymorphisms that can undermine their recognition by immune effectors and hence render vaccines based on antigens from a single parasite variant ineffective against other variants. This study compared the influence of allelic polymorphisms in Plasmodium falciparum apical membrane antigen 1 (PfAMA1) peptide sequences from three strains of P. falciparum (3D7, 7G8 and FVO) on their function as immunodominant targets of T cell responses in high and low malaria transmission communities in Ghana.
Methods

Peripheral blood mononuclear cells (PBMCs) from 10 subjects from a high transmission area (Obom) and 10 subjects from a low transmission area (Legon) were tested against 15 predicted CD8 + T cell minimal epitopes within the PfAMA1 antigen of multiple parasite strains using IFN-γ ELISpot assay. The peptides were also tested in similar assays against CD8 + enriched PBMC fractions from the same subjects in an effort to characterize the responding T cell subsets.
Results

In assays using unfractionated PBMCs, two subjects from the high transmission area, Obom, responded positively to four (26.7%) of the 15 tested peptides. None of the Legon subject PBMCs yielded positive peptide responses using unfractionated PBMCs. In assays with CD8 + enriched PBMCs, three subjects from Obom made positive recall responses to six (40%) of the 15 tested peptides, while only one subject from Legon made a positive recall response to a single peptide. Overall, 5 of the 20 study subjects (83.3%) who had positive peptide-specific IFN-γ recall responses were from the high transmission area, Obom. Furthermore, while subjects from Obom responded to peptides in PfAMA1 from multiple parasite strains, one subject from Legon responded to a peptide from 3D7 strain only.
Conclusions

The current data demonstrate the possibility of a real effect of PfAMA1 polymorphisms on the induction of T cell responses in malaria exposed subjects, and this effect may be more pronounced in communities with higher parasite exposure.
Java-Sumatra Niño/Niña and associated regional rainfall variability
Authors: Lee Sang-Ki , Lopez Hosmay , Foltz Gregory , Kim Dongmin , Larson Sarah , Lim Eun-Pa , Pujiana Kandaga , Volkov Denis , Chakravorty Soumi , Gomez Fabian
Published: July 2021

A phenomenon referred to here as Java-Sumatra Niño/Niña (JSN or JS Niño/Niña) is characterized by the appearance of warm/cold sea surface temperature anomalies (SSTAs) in the coastal upwelling region off Java-Sumatra in the southeastern equatorial Indian Ocean. JSN develops in July-September and sometimes as a precursor to the Indian Ocean Dipole, but often without corresponding SSTAs in the western equatorial Indian Ocean. Although its spatiotemporal evolution varies considerably between individual events, JSN is essentially an intrinsic mode of variability driven by local atmosphere-ocean positive feedback, and thus does not rely on remote forcing from the Pacific for its emergence. JSN is an important driver of climate variability over the tropical Indian Ocean and the surrounding continents. Notably, JS Niña events developing in July-September project onto the South and Southeast Asian summer monsoons, increasing the probability of heavy rainfall and flooding across the most heavily populated regions of the world.
Gradually Modified Conductance in Self-Compliance Region of Atomic-Layer-Deposited Pt/TiO2/HfAlO x /TiN RRAM Device
Authors: Ryu Hojeong , Kim Sungjun
Published: July 2021

This study presents conductance modulation in a Pt/TiO2/HfAlOx/TiN resistive memory device in the compliance region for neuromorphic system applications. First, the chemical and material characteristics of the atomic-layer-deposited films were verified by X-ray photoelectron spectroscopy depth profiling. The low-resistance state was effectively controlled by the compliance current, and the high-resistance state was adjusted by the reset stop voltage. Stable endurance and retention in bipolar resistive switching were achieved. When a compliance current of 1 mA was imposed, only gradual switching was observed in the reset process. Self-compliance was used after an abrupt set transition to achieve a gradual set process. Finally, 10 cycles of long-term potentiation and depression were obtained in the compliance current region for neuromorphic system applications.
Effectiveness of Telehealth Acceptance and Commitment Therapy for Generalized Anxiety Disorder During the COVID-19 Pandemic: Protocol for a Systematic Review and Meta-Analysis
Authors: Jia Ruiying , Yu Jingfen , Liang Dandan , Wu Zhen , Chen Chaoran , Lu Guangli
Published: July 2021

Background: Generalized anxiety disorder (GAD) is a highly prevalent, chronic, costly and disabling mental disorder. However, due to various reasons, patients are not treated effectively. During the COVID-19 pandemic, when face-to-face intervention is limited to a certain extent, researchers have highlighted the need for evidence-based interventions that can be delivered remotely, such as telehealth mediated acceptance and commitment therapy (ACT).Methods/design: We will systematically search PubMed, Embase, Cochrane Library, EBSCO (MEDLINE, Psychology & Behavioral Sciences Collection), Web of Science, CNKI, and WanFang Database for randomized controlled trials examining telehealth acceptance and commitment therapy for generalized anxiety disorder. The Cochrane Collaboration's bias assessment tool will be used to evaluate the risk of bias for the included studies, RevMan 5.3 and Stata 14.0 will be utilized for the meta-analysis.Discussion: This study will provide evidence for evaluating the efficacy of telehealth acceptance and commitment therapy for generalized anxiety disorder treatment during the COVID-19 pandemic. All of these results may be used to improve clinical decision-making and future studies.Systematic review registration: PROSPERO CRD42021255909.
Pulsed Electromagnetic Fields for Post-appendectomy Pain Management: A Randomized, Placebo-controlled Trial
Authors: Perumal Muralitharan , Latib Aizatul Isla Abdul , Samy Malarvilee Paul , Abidin Mohd Rohisham Zainal , Nagandran Elanngovan , Tham Sim Wan , Francis Pamela , Foo Chee Yoong
Published: July 2021

BACKGROUND

Pulsed electromagnetic fields (PEMF) has been shown to improve post-caesarean section pain previously. This study evaluated the efficacy of PEMF in postoperative pain reduction among patients undergoing urgent appendicectomy.
METHODS

This is a double-blinded, randomized trial. Adults with a clinical diagnosis of acute appendicitis were enrolled. Patients were allocated randomly to receive an active-PEMF device or an inactive device after the surgery in addition to the standard post-operative pain management. The primary endpoint was 12-hour postoperative pain score measured using the Visual Analogue Scale. The primary analysis in this trial compared the two study groups for the median pain score using the Wilcoxon rank sum test.
FINDINGS:

118 subjects were randomized, 58 were allocated to the active-PEMF group and 60 to the inactive control group. Median pain score of both intervention groups reduced in a similar fashion over the course of 12 post-operative hours. Median pain score at rest and on movement did not differ significantly 12 hours after the procedure. (W = 1161, p-value 0.3542 for resting pain score; W = 1437.5, p-value 0.3183 for pain on movement).
DISCUSSION

PEMF was not superior to placebo as an adjunct pain management for up to 12 hours post-appendicectomy. Previously reported effect of PEMF on post-operative pain intensity and analgesia uses in similar surgical settings cannot be verified.
Clinical trial registration:

National Medical Research Register Malaysia (NMRR-15-670-25805) & Thai Clinical Trials Registry (retrospectively registered at November 01, 2019, Study ID - TCTR20191102002)
Investigation of sensitive element for pressure sensor based on bipolar piezotransistor
Authors: Basov Mikhail , Prigodskiy Denis
Published: July 2021

The article translated from Russian to English on pp. 691-693 (please, look down). The paper summarizes results of investigation of high-sensitivity MEMS pressure sensor based on a circuit containing both active and passive stress-sensitive elements: a differential amplifier utilizing two n-p-n piezotransistors and for p-type piezoresistors. A comparative analysis of a sensor utilizing this circuit with a pressure sensor based on traditional piezoresistive Wheatstone bridge and built on the same mechanical part is provided. MEMS pressure sensor with the differential amplifier (PSDA) has sensitivity of S = 0.66 mV/kPa/V, which exceeded the sensitivity of the element with piezoresistive Wheatstone bridge (PSWB) by 2.2 times. The sensitivity increase allows for the following sensor improvements: die size reduction, increase of diaphragm mechanical strength while keeping high pressure sensitivity, and simplifying requirements to external processing of the pressure sensor output signal. There are two main challenges related to the use of PSDA-based pressure sensors: strong dependence of output signal on temperature and higher than in PSWB noise reducing the dynamic range of the device to 10 3. The article describes methods of addressing these problems. The temperature dependence of sensor output signal can be minimized with help of an offset thermal compensation circuit and by eliminating metallization at the thin part of the diaphragm. The noise can be minimized by reducing the thickness of the active base region of the transistor. Circuit analysis with software NI Multisim shows that sensitivity of PSDA-based pressure sensor can be increased 2.3 times by circuit optimization.
Integrating The Boost: Development Of A Hybrid Volumetric Modulated Arc Based Simultaneous Integrated Boost Class Solution For Breast Cancer
Authors: Chatterjee Sanjoy , Mahata Anurupa , Mandal Samar , Chakraborty Santam
Published: July 2021

Purpose:

We describe the development of a simultaneous integrated boost (SIB) class solution employing a hybrid Volumetric Modulated Arc Therapy (VMAT) for adjuvant treatment of breast cancer where conformal avoidance of normal organs from low dose is prioritized.
Methods:

A field in field tangent pair was used to irradiate the whole breast while the VMAT SIB was used to deliver a boost to the tumor bed with a margin of 5 mm. Hybrid VMAT SIB was planned in 25 patients using two short arcs of 30 degrees each offset by 5–10 degrees from the medial and lateral tangent angles respectively. SIB dose of 8 Gy was prescribed in addition to the whole breast dose of 40 Gy in 15 fractions. Plans were compared against a standard sequential mini-tangent boost plan (SEQ) delivering a dose of 12 Gy in 4 fractions using the Wilcoxon Signed-Rank test. Mean probability of developing grade 2 or more fibrosis was estimated using the NTCP formula provided by Hammer et al.
Results:

VMAT SIB significantly improved conformity as compared to the SEQ plan (0.51 vs 0.35, p < 0.01). Target volume coverage was similar between the two techniques. The mean dose to the contralateral breast, contralateral lung, and heart was increased by 0.13 Gy, 0.02 Gy, and 0.03 Gy respectively which was clinically insignificant. The mean probability of developing Grade 2 fibrosis at 5 years was similar between the two techniques (2.5% vs 2.7% p = 0.19). The class solution achieved consistent plans across a wide range of sites and target volume ranges (35.38–247.10 cm3). The average total MU requirement was significantly reduced (593 vs 848.6, p < 0.01).
Conclusion:

A class solution for VMAT SIB was developed which satisfied the planning objectives. This solution will be used for a prospective randomized trial investigating a one-week hypofractionated schedule of radiotherapy.
Preemptive Analgesia for Hemorrhoidectomy: Study Protocol for a Prospective, Randomized, Double-Blind Trial
Authors: Kazachenko Ekaterina , Garmanova Tatiana , Derinov Alexander , Markaryan Daniil , Lee Hanjoo , Magbulova Sabrina , Tsarkov Petr
Published: July 2021

Background: Hemorrhoidectomy is associated with intense postoperative pain that requires the multimodal analgesia. It includes Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), acetaminophen and local anesthetics to reach the adequate pain control. There are data in literature preemptive analgesia could decrease postoperative pain after hemorrhoidectomy. The aim of this study is to assess the efficiency of preemptive analgesia with Ketoprofen 10 mg 2 hours before procedure per os with spinal anesthesia to decrease postoperative pain and the amount of used analgesics. Methods: Patients of our clinic who meet the following inclusion criteria are included: haemorrhoids grade III-IV and the planned Milligan-Morgan hemorrhoidectomy. After signing the consent all participants are randomly divided into 2 groups: the first one gets a tablet with 10 mg Ketoprofen, the second one gets a tablet containing starch per os 2 hours before surgery (72 participants per arm). Patients of both arms receive spinal anesthesia and undergo open hemorrhoidectomy. Following the procedure the primary and secondary outcomes are evaluated: opioid administration intake, the pain at rest and during defecation, duration and frequency of other analgesics intake, readmission rate, overall quality of life, time from the procedure to returning to work and the complications rate. Discussion: Multimodality pain management has been shown to improve pain control and decrease opioid intake in patients after hemorrhoidectomy in several studies. Gabapentin can be considered as an alternative approach to pain control as NSAIDs have limitative adverse effects. Systemic admission of ketorolac with local anesthetics also showed significant efficacy in patients undergoing anorectal surgery. We hope to prove the efficacy of multimodal analgesia including preemptive one for patients undergoing excisional hemorrhoidectomy that will help to hold postoperative pain level no more than 3-4 points on VAS with minimal consumption of opioid analgesics. Registered at clinicaltrial.gov number ID NCT04361695 , date of registration: April 24, 2020, version 1.0