bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of serum sex hormones in postmenopausal women with vestibular migraine: potential role of estradiol
Authors: Tang Bo , Yu Xiaojun , Jiang Wei , Zhang Chuang , Zhan Tao , He Yuqin
Published: May 2021

Objective

This study aimed to investigate the role of sex hormones in postmenopausal women with vestibular migraine.

Methods

This observational study included 242 female patients with vestibular migraine who were postmenopausal during April 2017 to December 2019. Serum levels of sex hormones, including estradiol, progesterone, testosterone, follicle-stimulating hormone, luteinizing hormone, and prolactin, were determined by radioimmunoassay. The duration and frequency (every month) of onset of vestibular migraine were recorded. The degree of vestibular migraine was measured by the visual analogue scale.

Results

Serum levels of estradiol, progesterone, and testosterone were significantly lower, while serum prolactin levels were significantly higher in postmenopausal patients with vestibular migraine compared with healthy controls. Serum estradiol levels were negatively correlated with the duration, frequency, and severity of onset of vestibular migraine. Patients with higher serum estradiol levels showed a longer disease-free survival time.

Conclusion

Sex hormones are correlated with vestibular migraine in postmenopausal women. Additionally, estradiol levels are correlated with the duration, frequency, and severity of onset of vestibular migraine, as well as the disease-free survival time.
Congenital renal arteriovenous malformation with cirsoid and cavernosal-type characteristics: a case report
Authors: Cai Jieru , Ding Li , Xie Yiwen , Wang Yuyong
Published: May 2021

Renal arteriovenous malformations (AVMs) are infrequent vascular morphological anomalies. About 20% of AVMs are congenital renal AVMs (CRAVMs). A 53-year-old female patient presented with a 5-day history of gross hematuria and right flank pain. The patient underwent the selective renal arteriography and embolization under local anesthesia. Renal computed tomography angiography (CTA) and digital subtraction angiography (DSA) results showed bleeding of the right renal arteriovenous malformation, both nidus and aneurysm, which indicated that the patient had both cirsoid and cavernosal types of CRAVM. Endovascular management was chosen to treat the patient. The patient was cured and discharged, then followed-up for 3 months. These results show that early identification using radiologic tests is important for diagnosis and treatment of CRAVM.
Endocrinological and metabolic characteristics in patients who are non-obese and have polycystic ovary syndrome and different types of a family history of type 2 diabetes mellitus
Authors: Wang Yuan , Gao Hua , Di Wen , Gu Zhuowei
Published: May 2021

Objective

We aimed to investigate whether patients with polycystic ovary syndrome (PCOS) and a family history (FH) of type 2 diabetes mellitus (T2DM) are at increased risk of endocrinological and metabolic abnormalities, and whether this risk differs between first-degree and second-degree relatives, and between maternal and paternal transmission.

Methods

A total of 680 patients with PCOS were enrolled in this retrospective, single-center study. Endocrine and glycolipid metabolism parameters were compared.

Results

The free androgen index (FAI), and levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol were significantly higher, whereas sex hormone binding globulin (SHBG) levels were significantly lower in patients with PCOS and a FH of T2DM. In patients with PCOS with a FH of T2DM in first-degree relatives, age and levels of FBG, FINS, and HOMA-IR were significantly higher than those who had a FH of T2DM in second-degree relatives. A maternal history of T2DM was associated with a higher body mass index, FAI, and TG levels, and lower SHBG levels.

Conclusions

Patients with PCOS and a FH of T2DM have more severe hyperandrogenism and metabolic disorders, especially in those with maternal transmission.
Comparison of learning direct laryngoscopy using a McGrath videolaryngoscope as a direct versus indirect laryngoscope: a randomized controlled trial
Authors: Yi In Kyong , Hwang Jihoon , Min Sang Kee , Lim Gang Mee , Chae Yun Jeong
Published: May 2021

Objective

Tracheal intubation using a direct laryngoscope is difficult to teach. The McGrath videolaryngoscope, a Macintosh-like device with a camera, can be used as a direct laryngoscope to educate novices under supervision using the screen. We compared the effect on Macintosh laryngoscopy skills following training with a McGrath videolaryngoscope as a direct versus indirect laryngoscope.

Methods

Thirty-seven participants were randomized into direct and indirect groups according to the training method using a McGrath videolaryngoscope. Participants attempted Macintosh direct laryngoscopy in normal and difficult airway scenarios. The primary endpoint was the intubation time, and the rate of successful intubation, dental trauma, and difficulty were secondary outcomes.

Results

The intubation time after education decreased significantly in both groups and was significantly shorter in the direct group than in the indirect group across time. The difficulty degree in the direct group was lower than that in the indirect group across time; however, the rate of dental trauma was not significantly different.

Conclusion

Both direct and indirect laryngoscopy using a McGrath videolaryngoscope improved the performance of Macintosh direct laryngoscopy in novices, while direct laryngoscopy using a McGrath videolaryngoscope demonstrated better educational effects than indirect laryngoscopy. Registered at ClinicalTrials.gov (NCT03471975).
The Impact of Life Domains on Developmental Trajectories of Peer Delinquency among Korean Adolescents: A Partial Test of Agnew’s General Theory of Crime and Delinquency with a Group-Based Trajectory Modeling Approach
Authors: Cho Sujung , Lacey Brett
Published: May 2021

Agnew introduced a new integrated theory; the General Theory of Crime and Delinquency, in which he attempted to corral the most influential predictors of criminal behavior into more parsimonious propositions of multiple life domains—self, family, peer, school, and work—as well as constraints against crime and motivations for it. This study presents a partial test of the theory using longitudinal data of 2,351 Korean adolescents. A group-based modeling approach (latent class growth analysis) was run to examine direct effects of life domains on peer delinquency as well as mediating effects of constraints and motivation on their relationships. The study identified three subgroups: early onset/decreasing (3.2%), moderate (12.4%), and low/none (84.4%). The findings revealed that the self and peer domains exhibited a positive impact on the early onset/decreasing trajectory group compared to the low/none group with the constraint exhibiting a negative impact. The moderate trajectory group demonstrated that the self-domain was significant but was not rendered insignificant after controlling for constraints and motivations. The study provided moderate support for life domains within Agnew’s new theory for peer delinquency in nonwestern countries.
Using Traffic Disturbance Metrics to Estimate and Predict Freeway Traffic Breakdown and Safety Events
Authors: Azizi Leila , Hadi Mohammed
Published: May 2021

The introduction of connected vehicles, connected and automated vehicles, and advanced infrastructure sensors will allow the collection of microscopic metrics that can be used for better estimation and prediction of traffic performance. This study examines the use of disturbance metrics in combination with the macroscopic metrics usually used for the estimation of traffic safety and mobility. The disturbance metrics used are the number of oscillations and a measure of disturbance durations in the time exposed time to collision. The study investigates using the disturbance metrics in data clustering for better off-line categorization of traffic states. In addition, the study uses machine-learning based classifiers for the recognition and prediction of the traffic state and safety in real-time operations. The study also demonstrates that the disturbance metrics investigated are significantly related to crashes. Thus, this study recommends the use of these metrics as part of decision tools that support the activation of transportation management strategies to reduce the probability of traffic breakdown, ease traffic disturbances, and reduce the probability of crashes.
Effects of Occupational Drivers’ Traffic Accident History on Risk Perception, Work Attitudes, and Unstable Driving
Authors: Chung Eun Kyoung , Park So Young , Sohn Young Woo
Published: May 2021

In previous studies the risk perception of future accidents was the main variable likely to affect safe driving. However, findings on the relationship between traffic accident history and risk perception of future accidents have been inconsistent. Moreover, in the case of occupational drivers, work attitudes could be the main factor affecting safe driving. However, no research has been conducted on the direct relationship between traffic accident history and work attitudes. Therefore, present study examined the effect of occupational drivers’ traffic accident history on their risk perception, work attitudes, and unstable driving. Data analysis was based on a self-reported survey of Korean occupational drivers (n = 388) and their official traffic accident records. Results show that traffic accident history was associated significantly with professional pride, job satisfaction, and aggressive driving but not with risk perception of future accidents or job stress. Moreover, all variables measuring unstable driving behavior were significantly related to professional pride, job satisfaction, and job stress. Furthermore, professional pride turned out to mediate the relationship between traffic accident history and current unstable driving. The major finding is that there is no significant relationship between traffic accident history and risk perception of future accidents. Furthermore, traffic accident history has a significant effect on positive variables such as professional pride and job satisfaction but not on negative variables such as job stress. In addition, the significant mediator in the relationship between traffic accident history and current unstable driving behavior was only professional pride.
Assessing Climate Change Impact on Asphalt Binder Grade Selection and its Implications
Authors: Swarna Surya T. , Hossain Kamal , Pandya Harshdutta , Mehta Yusuf A.
Published: May 2021

Anthropogenic climate change is having and will continue to have unpredictable effects on Canadian weather. Trends in average annual temperatures have been rapidly increasing over the last 50 years. The severe climatic variations in Canada are in line with global changes in climate occurring as a result of increased greenhouse gas concentrations in the atmosphere. Under the current CO2 emission scenarios, scientists predict the climate trends to further intensify in the near future. It is well known that asphalt binder is highly sensitive to climate factors. For this reason, reviewing asphalt binder grade is a vital step, and can help decelerate pavement deterioration. The objective of this study was to assess the change in asphalt binder grade for the future climate and to determine the influence of change in binder grade on the performance of pavements in Canada. To achieve this, the analysis was carried out in five phases. In the first phase, statistically downscaled climate change models were gathered from the Pacific Climate Impacts Consortium database. In the second phase, the temperature and precipitation data were extracted for the selected locations in southern Canada. In the third phase, the asphalt binder grade was determined for future climate data. In the fourth phase, the pavement materials, traffic, and structural data were collected from the Long-Term Pavement Performance database. Lastly, the pavement performance with the base binder and the upgraded binder were assessed using AASHTOware Mechanistic–Empirical Pavement Design. The results reemphasize the necessity of upgrading the asphalt binder grade in various provinces of Canada.
Evaluating the role of extracellular vesicles as a biomarker under transmission electron microscope in prostate cancer and benign prostate hyperplasia patients
Authors: Agarwal Vibhore , Yadav Sher Singh , Kumar Sanjay , Mehta Nishkarsh , Talwar Gagandeep , Qadri Javed , Sarwar Saba
Published: May 2021

Objectives:

To our knowledge, EVs (extracellular vesicles) are heterogenous encapsulated nanoparticles generated by the biological cells. EVs can be found in blood, urine and tissue of origin. They contain DNAs, RNAs, proteins specific to the cell of origin. It has been found that in PCa, increase in number of EVs can modulate phenotype and function of the recipient cells.

Methods:

This prospective randomized double-blind pilot study was conducted in the SMS Medical College, Jaipur in collaboration with All India Institute of Medical Sciences, New Delhi. For morphometric analysis, the number of extracellular vesicles per micrograph were counted under transmission electron microscope.

Results:

Out of 16 patients taken in our study, six were in group 1 (BPH group) and 10 were in group 2 (PCa group). The mean number of EVs was significantly higher in the cells of group 2 in comparison to the group 1. Among the PCa patients, mean number of EVs were 25, 30, 35, 43, 46 for the Gleason score 6, 7, 8, 9, 10 respectively. In our study the mean number of EVs in the newly diagnosed PCa group was less as compared to the CSPC and CRPC group.

Conclusions:

EVs are membrane bound particles shed regularly from the cells in the extracellular milieu under normal physiological and pathological conditions. In our study the number of EVs were more in the PCa cells in comparison with the BPH cells and among the PCa cells they bear a positive correlation with the Gleason score, thus EVs have the potential to become a biomarker.
Comprehensive study on mechanical properties of coated biaxial warp-knitted fabrics
Authors: Yang Bin , Shang Yingying , Yu Zeliang , Wu Minger , Tao Youji , Qin Jiaxiang
Published: May 2021

In recent years, coated fabrics have become the major material used in membrane structures. Due to the special structure of base layer and mechanical properties, coated biaxial warp-knitted fabrics are increasingly applied in pneumatic structures. In this article, the mechanical properties of coated biaxial warp-knitted fabrics are investigated comprehensively. First, off-axial tensile tests are carried out in seven in-plane directions: 0°, 15°, 30°, 45°, 60°, 75°, and 90°. Based on the stress–strain relationship, tensile strengths are obtained and failure modes are studied. The adaptability of Tsai–Hill criterion is analyzed. Then, the uniaxial tensile creep test is performed under 24-h sustained load and the creep elongation is calculated. Besides, tearing strengths in warp and weft directions are obtained by tearing tests. Finally, the biaxial tensile tests under five different load ratios of 1:1, 2:1, 1:2, 1:0, and 0:1 are carried out, and the elastic constants and Poisson’s ratio are calculated using the least squares method based on linear orthotropic assumption. Moreover, biaxial specimens under four load ratios of 3:1, 1:3, 5:1, and 1:5 are further tensile tested to verify the adaptability of linear orthotropic model. These experimental data offer a deeper and comprehensive understanding of mechanical properties of coated biaxial warp-knitted fabrics and could be conveniently adopted in structural design.
Precipitation-dependent corrosion analysis of heat treatable aluminum alloys via friction stir welding, a review
Authors: Majeed Tanveer , Mehta Yashwant , Siddiquee Arshad N
Published: May 2021

Although the various advantages of novel Friction stir welding (FSW) process; the weld surfaces are subjected to various serious problems such as lower corrosion resistance, high susceptibility to stress corrosion cracking and poor joint fatigue strength due to complex material flow and severe plastic deformation during the welding process. Corrosion behaviour of friction stir welded (FSWed) precipitate strengthening Al alloys have significant impact on metallurgical and electrochemical properties of structures. In FSW of precipitate strengthening Al alloys the localized heat input and severe plastic deformation creating appreciable changes in microstructure and modifies the microchemistry and metallurgical characteristics of precipitates. The heterogeneous distribution of precipitates and precipitate free zones (PFZs) along the grain boundaries leads to variation in electrochemical behaviour across the weld zones and hence increasing the susceptibility of weld surface to various corrosion attacks such as intergranular corrosion, pitting corrosion, exfoliation corrosion, stress corrosion cracking and galvanic corrosion. However, the corrosion resistance of FSWed joints can be improved either by reducing the size or redissolve the coarsened precipitates within the joint or modifying the microchemistry by controlling the size, location and distribution of precipitates which largely determine the corrosion rate of the weld surfaces. Consequently, it is imperative to address the influence of material modifications during FSW on corrosion behaviour of weld surface. This review paper addresses the precipitate dependent corrosion behaviour of FSWed joints of heat treatable/precipitate strengthening Al alloys and the various effective methods either to reduce or eliminate the effect of corrosion attack in FSWed joints of heat treatable Al alloys.
Design methodology of a highly loaded tandem rotor and its performance analysis under clean and distorted inflows
Authors: Kumar Amit , Pradeep AM
Published: May 2021

Compact and efficient compressor design is one of the key challenges in aero-engine development. The flow through a compressor is exposed to adverse pressure gradients, which limits the maximum allowable flow turning in a compressor blade. Tandem blading is an interesting concept to achieve a higher total pressure rise by augmenting the flow turning angle. Variation in axial overlap and percentage pitch of the forward and aft blade elements largely influences the behavior of the tandem configuration. In the present study, the genetic algorithm is used to optimize the axial overlap and the percentage pitch for the tandem rotor. Results indicate that a lower axial overlap and higher percentage pitch results in optimum performance. The paper presents the parametric study of four tandem configurations with different axial overlaps and percentage pitches. A detailed experimental analysis of the four different tandem configurations is included in this paper. The behavior of the tandem rotor is examined under the clean and radially distorted inflow. Further, a comparison is drawn with a conventional single rotor in terms of aerodynamic parameters such as total pressure rise, axial velocity, and stall margin. The experimental analysis is supplemented by some interesting computational results, which are included to provide some insight into the complex flow field of the tandem rotor. Tandem rotor design is observed to have a higher sensitivity to radial tip inflow distortion. The upstream shift of the aft rotor blade adversely affects the total pressure rise and stall margin of the tandem rotor.
Fuzzy neural network and coupled gene expression programming/multivariate non-linear regression approach on mechanical features of hydroxyapatite/graphene oxide/epoxy: Empirical and optimization study
Authors: Fooladpanjeh Sasan , Dadrasi Ali , Gharahbagh Abdorreza Alavi , Parvaneh Vali
Published: May 2021

One way to enhance the mechanical properties of nanocomposites has been to use different fillers. In this study, ternary hybrid composites of graphene oxide/hydroxyapatite/epoxy resin were investigated. An experimental design was performed based on the central composite design (CCD). Epoxy resin was modified by incorporating different graphene oxide and hydroxyapatite weight from 0 to 0.5 wt.% and 0 to 7 wt.%, respectively. Experimental results showed that Young’s modulus, yield strength and impact strength improved up to 25.64%, 5.95% and 100.05% compared to the neat epoxy resin, respectively. In addition, gene expression programming (GEP), multivariate non-linear regression (MNLR) and fuzzy neural network (FNN) methods were employed to determine the effects of nanoparticles on the mechanical properties. Based on the modelling results, optimization process was investigated by using particle swarm optimization (PSO). Finally, the fracture surface morphologies of the nanocomposites were analyzed by scanning electron microscopy.
Bilateral bidding strategy in joint day-ahead energy and reserve electricity markets considering techno-economic-environmental measures
Authors: Shivaie Mojtaba , Kiani-Moghaddam Mohammad , Weinsier Philip D
Published: May 2021

In this study, a new bilateral equilibrium model was developed for the optimal bidding strategy of both price-taker generation companies (GenCos) and distribution companies (DisCos) that participate in a joint day-ahead energy and reserve electricity market. This model, from a new perspective, simultaneously takes into account such techno-economic-environmental measures as market power, security constraints, and environmental and loss considerations. The mathematical formulation of this new model, therefore, falls into a nonlinear, two-level optimization problem. The upper-level problem maximizes the quadratic profit functions of the GenCos and DisCos under incomplete information and passes the obtained optimal bidding strategies to the lower-level problem that clears a joint day-ahead energy and reserve electricity market. A locational marginal pricing mechanism was also considered for settling the electricity market. To solve this newly developed model, a competent multi-computational-stage, multi-dimensional, multiple-homogeneous enhanced melody search algorithm (MMM-EMSA), referred to as a symphony orchestra search algorithm (SOSA), was employed. Case studies using the IEEE 118-bus test system—a part of the American electrical power grid in the Midwestern U.S.—are provided in this paper in order to illustrate the effectiveness and capability of the model on a large-scale power grid. According to the simulation results, several conclusions can be drawn when comparing the unilateral bidding strategy: the competition among GenCos and DisCos facilitates; the improved performance of the electricity market; mitigation of the polluting atmospheric emission levels; and, the increase in total profits of the GenCos and DisCos.
Total-factor air environmental efficiency and its influencing factors in the areas along the Belt and Road in China: A spatial spillover perspective
Authors: Yin Ni-Ni , Wang Ke-Liang , Yao Zhen , Ding Li-Li , Miao Zhuang
Published: May 2021

In order to promote sustainable economic development in the areas along the Belt and Road in China, it is of great necessity to reduce the negative impact of air pollutants resulting from industrialization and urbanization on the complex and fragile ecological environments of neighboring areas. First, this study estimated the total-factor air environmental efficiency (TFAEE) of 17 provinces along the Belt and Road in China from 2010 to 2017 using a slacks-based measure (SBM) model. Second, the global and local Moran indices were used to test the spatial correlations between TFAEEs. Finally, the spatial factors and spatial spillover effects influencing the TFAEEs were investigated using the spatial Durbin model with spatiotemporal double fixed effects. The results were shown as follows: (1) The total-factor TFAEEs of the areas along the Belt and Road were low and showed significant regional spatial differences during 2010–2017. (2) There was a positive spatial autocorrelation between the TFAEEs of the areas along the Belt and Road, and the spatial distribution generally clustered into High-High and Low-Low concentrations. (3) Economic development and technological innovation played significantly positive effects on TFAEEs of the areas in the Belt and Road, while energy consumption structure had negative effect on it. In addition, although industrial structure and environmental regulation were negatively correlated with TFAEEs, the coefficients were not significant. (4) The positive spatial spillover effect of the TFAEEs of the areas along the Belt and Road was mainly the result of significant environmental regulations and insignificant economic development factors, while the technological innovations, energy consumption structures and industrial structures showed insignificant negative spatial spillover effects.
A Systems-Based Approach to Analyze Environmental Issues: Problem-Oriented Innovation System for Water Scarcity Problem in Iran
Authors: Ghazinoory Sepehr , Khosravi Mohammad , Nasri Shohreh
Published: May 2021

Environmental issues such as water scarcity are typically multidimensional problems, and resolving them requires a systems-based approach and socio-technical innovations. This article applies the “Problem-oriented Innovation System (PIS)” as a new approach to resolve water scarcity problem. In Iran, this has not been the case as natural water scarcity along with decades of mismanagement has turned water scarcity into a national crisis and caused several interrelated socioeconomic problems. Using case study, in this article, Iran’s water scarcity is analyzed to see how the PIS is able to help resolve this problem. Results indicate that the inefficient management and monitoring the water scarcity and lack of appropriate standardization and tariffs are the most important system failures of the water scarcity PIS in Iran. Also, the most important policy implications are moving toward decentralization in water management based on a participatory approach and establishing a national drought monitoring system.
Accessory Talar Facet Impingement and Sinus Tarsi Pain Associated With Accessory Anterolateral Talar Facet
Authors: Park Jae Woo , Park JeongJin , Park Chul Hyun
Published: May 2021

Background:

Sinus tarsi pain caused by accessory talar facet impingement (ATFI) owing to accessory anterolateral talar facet (AALTF) is not well documented. We evaluated prevalence of AALTF and differences of magnetic resonance imaging (MRI) findings between persons with and without sinus tarsi pain, and investigated the relevant association between MRI findings and sinus tarsi pain in persons with AALTF.

Methods:

We performed a case-control study on 120 ankles with sinus tarsi pain and 120 age- and gender-matched ankles without sinus tarsi pain. As MRI findings, bone marrow edema (BME), sinus tarsi fat obliteration (STFO), calcaneal cyst, talocalcaneal coalition, Gissane angle, talar inferolateral surface (TILS) angle, and calcaneal cortical thickness (CCT) were evaluated. The MRI findings were compared between persons with and without sinus tarsi pain, and between persons with and without AALTF. Among persons with AALTF, MRI findings were compared between those with and without sinus tarsi pain. Relevant association was evaluated between MRI findings and sinus tarsi pain in persons with AALTF.

Results:

Presence of AALTF, BME, and STFO were significantly higher in the group with sinus tarsi pain. The Gissane angle was significantly smaller, and the TILS angle and CCT were significantly larger in the group with sinus tarsi pain. The BME (OR 7.571, CI 1.453-39.446) and small Gissane angle (OR 0.891, CI 0.804-0.986) were significantly associated with sinus tarsi pain in persons with the AALTF.

Conclusion:

The study provides evidence for ATFI related to impingement of an AALTF associated with talocalcaneal BME.

Level of Evidence:

Level III, case-control study.
Open vs Minimally Invasive Scarf Osteotomy for Hallux Valgus Correction: A Randomized Controlled Trial
Authors: Torrent Josep , Baduell Albert , Vega Jordi , Malagelada Francesc , Luna Rodrigo , Rabat Eduard
Published: May 2021

Background:

Minimally invasive (MI) surgery is becoming increasingly popular in the treatment of hallux valgus (HV). The scarf osteotomy is an effective procedure with a track record in open HV surgery. We adapted this effective osteotomy to MI surgery as a novel technique never reported before. The aim of this study was to compare the clinical and radiologic outcomes of patients who underwent open or MI scarf.

Methods:

Between 2017 and 2018, 58 patients were randomized to either open or MI scarf to treat HV deformity. Prospective patient-reported outcome measures and weightbearing radiographs were obtained. Data included the AOFAS score, radiologic angular correction, operative time, fluoroscopy radiation dose, and postoperative pain on visual analog scale (VAS).

Results:

The mean follow-up was of 21 (range, 12-38) months. Radiologic measurements (postoperative hallux valgus angle, first-to-second intermetatarsal angle, and distal metaphyseal articular angle) were similar in both groups and showed statistically significant improvement from preoperative measures. The mean operative time for the MI group was 16.7 vs 26.1 minutes in the open group, a statistically significant difference. Radiation exposure was 14 times higher in the MI group when compared to the open group (mean: 34 vs 2.4 mGy/cm2, P < .001). There were no major complications in either group.

Conclusions:

The MI scarf provides a clinically and radiologically equivalent outcome to open scarf for the treatment of HV with reduced operative time and immediate postoperative VAS for pain but is associated with a small increase in radiation exposure.

Level of Evidence:

Level I, randomized controlled trial.
Oncology boot camp: A preparatory curriculum for advanced pharmacy practice experience students
Authors: Horn Bethannee , Wells Lyn , Halford Zachery
Published: May 2021

Introduction

The primary objective of this study was to evaluate the effectiveness of an autonomous oncology boot camp on Advanced Pharmacy Practice Experience (APPE) student knowledge. Secondary objectives included assessing student perception of the virtual learning experience and overall comfort level with the material.

Methods

APPE students rotating through our institution between November 2019 and March 2020 were voluntarily enrolled in a 4-hour oncology-focused boot camp, which included five PlayPosit (Denver, CO, USA) interactive video lectures embedded with case-based application questions followed by one comprehensive web-based Quandary (Victoria, BC, Canada) action-maze case. Student learning was measured by a pre- and post-intervention exam. A web survey tool (Qualtrics, Provo, UT, USA) collected student perceptions evaluating their comfort with oncology-specific drug knowledge and APPE rotations tasks.

Results

Fifty students enrolled in the oncology boot camp, with 100% completing the pre- and post-intervention assessments. Overall, pre-intervention exam scores (mean: 55.4%, SD: 21.8%) improved by 23.2% following the boot camp (mean: 78.6%, SD: 19.2%; p < 0.001). Students performed better on all 10 exam questions, with 6 questions showing a statistically significant improvement (p < 0.05). Forty-five students (90%) completed the perception surveys. Of those, 93% agreed that it effectively reinforced important oncology knowledge, 91% supported the autonomous design, and 82% would recommend the oncology boot camp for future students.

Conclusion

The boot camp proved to be a beneficial educational tool that enhanced student knowledge and confidence in navigating common oncology concepts. Students valued the ability to independently complete the activities and supported its continuation.
Analysis of CYP1B1 gene mutations in primary congenital glaucoma patients
Authors: Haddad Amine , Ait Boujmia Oum Kaltoum , El Maaloum Loubna , Dehbi Hind
Published: May 2021

Primary congenital glaucoma (PCG) is a rare and severe form of glaucoma and is usually transmitted as an autosomal-recessive disease. However, PCG is more common in certain ethnic and geographic groups where consanguineous relationships are common. The importance of this review is to inspect the mutations in the cytochrome P450 1B1 gene ( CYP1B1) and to highlight the interest of the genetic study of CYP1B1 mutations by extending the work previously done by others. An in-depth study was carried out by the following search engines: PubMed, Scopus, ClinicKey and ScienceDirect for articles that have been published from 2011 until 2020. One hundred and sixty-one mutations were found in 1641 tested patients and three families, including 78 mutations, 18 of which are novel. We identified a no significant difference in the sex ratio and the bilaterality was reported in the majority of patients. We have shown through this study that inbreeding plays an important role in the pathogenesis of PCG transmission compared to the sporadic mutations that have been found in some cases. The majority of the included studies were from ASIA (64.3%), followed by Europe (17.85%), America (10.71%) and Africa (7.14%). The first and most common mutation in our study is 182 G>A (p.Gly61Glu). It was identified in Iran, Portugal and Saudi Arabia and for the first time in Brazil and Vietnam. The greatest number of mutations in common is p.Gly61Glu. Mainly within five countries: Iran, Portugal, Saudi Arabia, Brazil and Vietnam. The first step in PCG screening should be a genetic test looking for founder and common mutation coupled with a clinical examination.
The prognostic role of optical coherence tomography in diabetic macular edema patients undergoing early dexamethasone implant shift
Authors: Uzel Mehmet Murat , Karahan Eyyup , Koroglu Canli Melek , Guler Cenap
Published: May 2021

Purpose:

To determine the prognostic characteristics of optical coherence tomography (OCT) parameters by evaluating diabetic macular edema (DME) patients with early dexamethasone (DEX) shift after three doses of intravitreal ranibizumab (RNB) injection.

Methods:

Fifty-four eyes of 34 patients who had DEX implant after three doses of RNB were included in this retrospective study. Early DEX shift includes patients who received direct DEX implant replacement after three doses of RNB load. Baseline OCT values and factors affecting best corrected visual acuity (BCVA) and central macular thickness (CMT) response were analyzed with logistic regression analyses.

Results:

The presence of subretinal fluid and hyperreflective spot (HRS) >20 were found to be a negative predictive factor for anatomical response. ( p = 0.009, p = 0.001, respectively) Low initial BCVA creates a positive effect on visual gain.( p = 0.041) Giant outer nuclear layer cysts, completely disrupted inner segment-outer segment and HRS > 20 have a negative effect on visual gain. ( p = 0.025, p = 0.043, p = 0.023, respectively) According to the receiver operating characteristic analysis, the subretinal fluid volume threshold at which >20% reduction in CMT occurs was determined to be 0.85 mm3. (sensitivity 70%, specificity 84% area under the curve 0.817, p = 0.021).

Conclusion:

The presence of high number of HRS and high subretinal fluid volume at the baseline negatively affect prognosis even in patient groups with early DEX shift.
Is China exporting media censorship? China’s rise, media freedoms, and democracy
Authors: Gamso Jonas
Published: May 2021

This study explores the relationship between China’s rise and media censorship around the world, in light of recent suggestions in the Western press and among China experts that Beijing is advancing a global censorship agenda. I argue that the Chinese government occasionally promotes censorship in foreign countries, because it wishes to reduce negative media coverage of China or to silence certain groups abroad (e.g. Falun Gong). More often, China’s relative apathy about speech and press freedoms in foreign countries facilitates censorship in countries that can rely on trade with Beijing. Countries that cannot rely on China are less willing to risk alienating Western powers by violating press freedoms at home. Regime type is an important determinant as to whether censorship is facilitated through intensive economic integration with China, as democracies may respond to China’s rise differently than authoritarian countries. Analysis of country-level panel data shows higher rates of media censorship in democratic countries that trade intensively with China.
Complexity in balancing conservation and tourism in protected areas: Contemporary issues and beyond
Authors: KC Birendra
Published: May 2021

This study highlights ongoing issues in protected area (PA) tourism and presents management suggestions for PAs, given the growing popularity of PA tourism. This study takes a conceptual approach to discuss the ongoing issues within, and the sustainable future of, PAs. The expansion of PAs is a biodiversity conservation strategy. As PAs expand globally to promote conservation, new opportunities for ecotourism development will also evolve, further contributing to the challenge of balancing conservation and tourism. As many PAs operate without management plans, the development of regulations to foster sustainability is necessary, which is even more important now that the COVID-19 pandemic has disrupted PA tourism, challenging PAs across the globe. This study provides an overview of PA tourism, discusses ongoing issues, and offers strategies for managerial improvement. Given the substantial growth of PA tourism, the relationship between PAs and the Sustainable Development Goals (SDGs) should be explored further.
Attention Dysregulation in Breast Cancer Patients Following a Complementary Alternative Treatment Routine: A Double-Blind Randomized Trial
Authors: Dolev Talya , Ben-David Merav , Shahadi Ilanit , Freed Yaakov , Zubedat Salman , Aga-Mizrachi Shlomit , Brand Zev , Galper Shira , Jacobson Galia , Avital Avi
Published: May 2021

Introduction:

Breast cancer patients and survivors frequently report fatigue, emotional, and cognitive disturbances, which reduce performance at all levels of occupation and make life quality issues a considerable clinical concern. The aim of this study is to evaluate attention and emotion regulation across radiotherapy period and the possible effects of complementary alternative medicine (CAM).

Methods:

Fifty-seven patients with unilateral breast cancer underwent surgery and systemic chemotherapy before participating in this double-blind randomized study. Two thirds were given CAM (n = 38) while the rest received placebo (carrier only, n = 19). Patients’ attention and anxiety were physiologically tested at baseline, 2 and 4 weeks during the radiation period as well as 1-month after the end of radiation session.

Results:

Both groups showed similar levels of anxiety with no significant differences at baseline nor post-radiotherapy. Long-term significant recovery of attention performance was observed in the CAM patients, accompanied by a similar tendency in anxiety level, measured by the eye-blink probability.

Conclusions:

This study physiologically validates the attention impairment reported among breast cancer survivors; also, it depicted a beneficial late-effect of a routine CAM on attention dysregulation. The suggested non-invasive physiological measures can physiologically monitor patients’ psychological and cognitive well-being as well as evaluate the beneficial effect of CAM in breast cancer patients by assessing their coping ability to support the treatment plan. Thus, the results have potential clinical implications on patients’ and survivors’ quality of life.

Trial Registration:

NIH, NCT02890316. Registered July 2016, http://www.ClinicalTrials.gov
Inflammatory response and matrix metalloproteinases in chronic kidney failure: Modulation by adropin and spexin
Authors: Yazgan Burak , Avcı Filiz , Memi Gülsün , Tastekin Ebru
Published: May 2021

Chronic kidney disease is a major global public health problem. The peptide hormones adropin and spexin modulate many physiological functions such as energy balance and glucose, lipid and protein metabolism. However, it is unclear whether these peptides may exert effects on renal damage, tissue remodeling, and inflammatory conditions. In view of the limited information, we aimed to investigate the effect of adropin and spexin on matrix metalloproteinase and inflammatory response genes a rat model of adenine-induced chronic kidney failure. Chronic kidney failure was induced in rats by administering adenine hemisulfate. Renal function was determined in an autoanalyzer. Histopathological modifications were assessed by H&E staining. mRNA expression levels of ALOX 15, COX 1, COX 2, IL-1β, IL-10, IL-17A, IL-18 IL-21, IL-33, KIM-1, MMP-1, MMP-2, MMP-3, MMP-7, MMP-9, MMP-13, NGAL, TGFβ1, TIMP-1, and TNFα in kidney tissue were measured by qPCR. Our results showed an increase of 24-h urine volume, serum creatinine, BUN, and urine protein levels in group with adenine-induced CKF. Adropin and spexin treatments decreased urine protein and 24-h urine volume. Renal damage, TIMP-1, IL-33, and MMP-2 increased after CKF induction, while COX 1, MMP-9, and MMP-13 levels were significantly reduced. Furthermore, KIM-1, TIMP-1, IL-33, and MMP-2 were downregulated by spexin treatment. Renal damage, NGAL, TIMP-1 IL-17A, IL-33, MMP-2, and MMP-3 decreased after adropin treatment, while MMP-13 levels were upregulated. Treatment with adropin+spexin decreased KIM-1, NGAL, TIMP-1, IL-1β, IL-17A, IL-18, IL-33, ALOX 15, COX 1, COX 2, TGFβ1, TNFα, MMP-2, MMP-3, and MMP-7, but increased MMP-13 levels. Our findings revealed that inflammatory response and MMP genes were modulated by adropin and spexin. These peptides may have protective effects on inflammation and chronic kidney damage progression.
Nucleated red blood cells participate in myocardial regeneration in the toad Bufo Gargarizan Gargarizan
Authors: Liu Shu-Qin , Hou Xiao-Ye , Zhao Feng , Zhao Xiao-Ge
Published: May 2021

Heart regeneration is negligible in humans and mammals but remarkable in some ectotherms. Humans and mammals lack nucleated red blood cells (NRBCs), while ectotherms have sufficient NRBCs. This study used Bufo gargarizan gargarizan, a Chinese toad subspecies, as a model animal to verify our hypothesis that NRBCs participate in myocardial regeneration. NRBC infiltration into myocardium was seen in the healthy toad hearts. Heart needle-injury was used as an enlarged model of physiological cardiomyocyte loss. It recovered quickly and scarlessly. NRBC infiltration increased during the recovery. Transwell assay was done to in vitro explore effects of myocardial injury on NRBCs. In the transwell system, NRBCs could infiltrate into cardiac pieces and could transdifferentiate toward cardiomyocytes. Heart apex cautery caused approximately 5% of the ventricle to be injured to varying degrees. In the mildly to moderately injured regions, NRBC infiltration increased and myocardial regeneration started soon after the inflammatory response; the severely damaged region underwent inflammation, scarring, and vascularity before NRBC infiltration and myocardial regeneration, and recovered scarlessly in four months. NRBCs were seen in the newly formed myocardium. Enzyme-linked immunosorbent assay and Western blotting showed that the levels of tumor necrosis factor-α, interleukin- 1β, 6, and11, cardiotrophin-1, vascular endothelial growth factor, erythropoietin, matrix metalloproteinase- 2 and 9 in the serum and/or cardiac tissues fluctuated in different patterns during the cardiac injury-regeneration. Cardiotrophin-1 could induce toad NRBC transdifferentiation toward cardiomyocytes in vitro. Taken together, the results suggest that the NRBC is a cell source for cardiomyocyte renewal/regeneration in the toad; cardiomyocyte loss triggers a series of biological processes, facilitating NRBC infiltration and transition to cardiomyocytes. This finding may guide a new direction for improving human myocardial regeneration.
SARS-CoV-2 variants: A double-edged sword?
Authors: Jogalekar Manasi P , Veerabathini Anurag , Gangadaran Prakash
Published: May 2021

Since the worldwide emergence of the COVID-19 outbreak, there have been international concerns about the possible viral evolution into variants with underlying mutations that may contribute to their increased transmissibility, disease severity, risk of death, and their potential escape from the immune response or may even lead to its extinction. Rigorous surveillance has revealed the variants harboring mutations in the spike protein, the main target of neutralizing antibodies generated through vaccination or herd immunity. In this review, we have highlighted major SARS-CoV-2 variants as well as other local strains along with their specific mutations, suspected changes in their characteristics, and their impact on the current pandemic and vaccine efficacy. We have also emphasized the need to develop widely protective interventions to curb further transmission of variants.
Comparison Between Isometric and Concentric Motor Fatigability in Persons With Multiple Sclerosis and Healthy Controls – exploring central and peripheral contributions of motor fatigability
Authors: Gaemelke Tobias , Riemenschneider Morten , Dalgas Ulrik , Kjølhede Tue , Rasmussen Cuno , Stenager Egon , Overgaard Kristian , Hvid Lars G.
Published: May 2021

Background

Motor fatigability (i.e. contraction-induced reduction in muscle strength) from a concentric task associate stronger to walking and perception of fatigue in persons with multiple sclerosis (pwMS), compared with an isometric task. However, the central and peripheral contributions of motor fatigability between these tasks have not been investigated.

Objective

Compare the central and peripheral contributions of motor fatigability in the knee extensors in a sustained isometric fatigability protocol versus a concentric fatigability protocol and in pwMS versus healthy controls (HCs).

Methods

Participants (n=31 pwMS; n=15 HCs) underwent neuromuscular testing before and immediately after two knee extensor fatigability tasks (sustained isometric and concentric) in an isokinetic dynamometer. Neuromuscular testing of fatigability consisted of maximal voluntary contraction, voluntary activation (central/neural contributor), and resting twitch (peripheral/muscular contributor) determined by the interpolated twitch technique.

Results

Sustained isometric and concentric fatigability protocols resulted in motor fatigability for both pwMS and HCs, with no between-protocols differences for either group. Regression analysis showed that motor fatigability variance in pwMS was mainly attributed to central fatigability in the sustained isometric protocol and to both central and peripheral fatigability in the concentric protocol. In HCs, the variance in sustained isometric and concentric fatigability were attributed to both peripheral and central fatigability.

Conclusion

Central and peripheral contributions of motor fatigability differed between sustained isometric and concentric protocols as well as between pwMS and HCs. These between-protocol differences in pwMS provide a neuromuscular dimension to the reported difference in the strength of associations of concentric and isometric tasks to walking and perception of fatigue in pwMS.