bluuebunny/crossref_metadata_2025 huggingface dataset:
CAN COGNITIVE TRAINING USING A TABLET COMPUTER ENHANCE COGNITIVE FUNCTION OF HEALTHY OLDER ADULTS? AN ALTERNATING-TREATMENT DESIGN
Authors: PARK JIN-HYUCK
Published: July 2021

Even though a variety of cognitive interventions have been conducted to ameliorate age-related cognitive declines, the effects of cognitive intervention using activities in everyday life are still unknown. The purpose of this study was to compare the effects between tablet computer-based productive and receptive cognitive engagement using an alternating-treatment design. Three healthy older adults performed a total of 19 sessions consisting of three baseline periods and 16 alternating training sessions. The training sessions were divided into four blocks and each block involved four treatment sessions. Productive and receptive engagements were randomly allocated to four treatment sessions. All participants alternatively received productive engagement that requires learning new practical applications and receptive engagement requiring little new learning such as listening to music. Prefrontal cortex (PFC) activity using functional near-infrared spectroscopy and executive function through the Trail Making Test were assessed at the baseline and the end of each session. All data were visually analyzed. Visual analysis results showed that the productive engagement was associated with higher PFC activity and faster performance in the Trail Making Test, compared to those utilizing receptive engagement. These results suggest that productive engagement might be effective in facilitating PFC activity and improving the executive function of healthy older adults, indicating cognitively challenging activities are more beneficial relative to nonchallenging activities.
Local moves of the Stein factorization of the product map of two functions on a 3-manifold
Authors: Takao Kazuto
Published: July 2021

We give some local moves of the Stein factorization of the product map of two Morse functions on a closed orientable smooth 3-manifold which can be realized by isotopies of the functions.
Bridging Theory on Global Corporate Hierarchy and City Diplomacy: The Case of China
Authors: YU Hongyuan , Benjamin LEFFEL , LI Qianyuan , Craig SIMON
Published: July 2021

This study tests the relationship between the hierarchical position of cities in the global economy and a typology of cultural, economic, political, and social external relations, namely city diplomacy. We conduct this test on a sample of 46 Chinese cities, seeking to bridge otherwise separate existing theories on the structure of the world city hierarchy and varied dimensions of city diplomacy. Contrary to expectations, we find that the aggregate of the typology of city diplomacy, rather than only the economic dimension, is most closely associated with position in the world city hierarchy. This tentatively suggests that the collective effect of internationally-oriented cultural, economic, political and social activities in Chinese cities reflect the global structure of the highest levels of globalized urban wealth.
Changes in International Arms Control and China’s Role
Authors: Wu Chunsi
Published: July 2021

The international arms control regime has arrived at a crossroads as the United States pulls out of a number of international treaties and launches a new round of defense and military buildup in pursuit of absolute strategic and technological superiority. Under the Trump administration’s “America First” doctrine, Washington is leading the global arms control cause astray. The article traces the international arms control regime’s liberal institutionalist roots and situates the positions of the world’s largest nuclear powers in it. It analyzes the strengths and weaknesses of the regime and put forward a number of policy measures to improve it. It argues that the officially recognized nuclear powers, especially the United States and Russia, should assume the lion’s share of maintaining global strategic stability. The author highlights the most urgent challenges in the current arms control regime and outlines China’s role and responsibilities as a rising military power in the evolution of the arms control cause.
Getting Undergraduates Ready for China’s Belt and Road Initiative (BRI) Through an Overseas Experiential Learning Project
Authors: Chin Andrew Min Han , Menkhoff Thomas , Evers Hans-Dieter , Gn Hoong Hui Daniel , Koh Kevin , Lee Chester Wey , Loh Patrick H. M. , Low Linda , Tan Sebastian , Teo Teng Seng , Yap Natalie
Published: July 2021

In this paper, we explain how an experiential learning course and study tour to Gansu Province (People’s Republic of China) enabled undergraduates at the Singapore Management University (SMU) to acquire 21st-century competencies and higher-order thinking skills by analyzing and evaluating specific aspects of China’s Belt and Road Initiative (BRI) and China–Singapore (Chongqing) Connectivity Initiative — New International Land–Sea Trade Corridor (CCI-ILSTC) with emphasis on developing viable Go-To-Market (GTM) strategies aimed at selling Gansu produce in four Southeast Asian markets. We share how the course was designed to support the attainment of key learning goals and discuss how we turned pedagogical aspirations into concrete learning outcomes. We introduce key aspects of the so-called “SMU-XO” project that the students conducted in partnership with an industry partner, Pacific International Lines (PIL), and discuss how the project work helped learners to gain global competency by (i) examining critical issues related to BRI such as multi-modal infrastructure connectivity, (ii) appreciating the local perspectives of project stakeholders in Lanzhou and Shanghai and (iii) successfully interacting with people from different cultures, namely China, Indonesia, Vietnam, Malaysia and Thailand.
Central command-related increases in blood velocity of anterior cerebral artery and prefrontal oxygenation at the onset of voluntary tapping
Authors: Matsukawa Kanji , Asahara Ryota , Uzumaki Minami , Hashiguchi Yoshiki , Ishii Kei , Wang Jijia , Smith Scott A.
Published: July 2021

Anterior cerebral artery blood velocity and vascular conductance index along with prefrontal oxygenated-hemoglobin concentration all increased at the onset of finger tapping, peaking immediately after tapping onset, as long as tapping was arbitrarily started. Positive cross correlation and linear regression between the increases in ACABVand prefrontal Oxy-Hb were significant in 67%–75% of subjects. Active vasodilatation of the ACA vascular bed occurs with arbitrary tapping onset and contributes to increased ACABVand prefrontal oxygenation.
Study on the Application and Efficacy of Responsibility Nursing in Dialysis Care
Authors: Wu Ting , Gao Meiling , Shi Jun , Xu Linfang , Wang Jing , Zhang Kaili
Published: July 2021

Providing high-quality care to patients undergoing hemodialysis (HD) is a priority for nurses. The present study was conducted to explore the experiences of the quality of nursing care among patients, nurses, and caregivers in Yanghu Branch of Changzhou Second People’s Hospital, China. A total of 120 hemodialysis patients consecutively admitted to Yanghu Branch of Changzhou Second People’s Hospital were enrolled and divided into two groups according to the nursing method they received: control group (routine nursing) and experimental group (responsibility nursing). The two cohorts were observed and compared for alterations of adverse emotions and inflammatory factors, the incidence of complications, pre-and post-nursing sleep quality, life quality, and patients’ satisfaction with nursing. After nursing, the Self-Rating Anxiety/Depression Scale (SAS/DS) scores were lower in the experimental group (EG) than in the control group (CG) (both

P
<
0.05

). Serum IL-6, hs-CRP, and TNF-α were decreased in both groups after nursing and were even lower in EG (both

P
<
0.05

). EG had significantly improved sleep quality and life quality than CG, with a higher nursing satisfaction (all

P
<
0.05

). This validates that the responsibility nursing for dialysis patients can validly mitigate patients’ negative emotions, improve their quality of life, and ensure high-quality dialysis effect, which is feasible for wide popularization and application in clinics.
A Novel Raster Map Exchange Scheme Based on Visual Cryptography
Authors: Ren Lijing
Published: July 2021

Raster map is an image that has been discretized in space and brightness, and it is an important carrier of geospatial data. With the rapid development of Internet and big data technologies, preserving the privacy of raster map has become an urgent task. To solve these issues, we propose a novel extended visual cryptography scheme to securely store a raster map into other two meaningful halftone maps in the paper. The scheme avoids the random-looking shares of visual cryptography schemes which are vulnerable and hard to manage. We first apply the halftone and color decomposition methods to transform a color secret map into halftone images. After that, we encode the secret map block by block to avoid pixel expansion. At last, by optimizing the selection of encrypted blocks, we achieve a high-quality secret recovery from generated multiple equal-sized shares. The technique used is to employ a versatile and secure raster map exchange. Experimental results show that, compared with previous work, the proposed scheme significantly improves the performance of recovered raster maps.
Almost
α
-Cosymplectic Pseudo Metric Manifolds
Authors: Öztürk Sermin , Öztürk Hakan
Published: July 2021

The main purpose of this paper is to study almost

α

-cosymplectic pseudo metric manifold satisfying certain

η

-parallel tensor fields. We first focus on the concept of almost

α

-cosymplectic pseudo metric manifold and its curvature properties. Then, we obtain some results related to the

η

-parallelity of

h

,

φ
h

, and

τ

. Moreover, the deformation of almost

α

-Kenmotsu pseudo metric structure is given. We conclude the paper with an illustrative example of almost

α

-cosymplectic pseudo metric manifold.
Activity and Social Responsibility in the Discourse on Health Care, Long‐Term Care and Welfare Services for Older Immigrants
Authors: Goettler Andrea
Published: July 2021

Ageing well has been associated with the responsibility to age actively, successfully, or healthily in public and research discourses. This connection of individual responsibility with ageing has been criticised in Social Gerontology for neglecting the access to social, economic, and health resources. This paper investigates (individual) responsibility, informal support, and public initiatives in discourses on older immigrants in Germany. The research framework employs a sociology of knowledge approach to discourse, which guided the discourse analysis of German policy reports, guidelines and handbooks on ageing and migration from 2000 to 2019 (43 documents in total). The results reveal that besides public initiatives concerning long‐term care, health promotion, and social services, informal solutions through social networks are frequently emphasised in the data. The focus, thereby, is on long‐term care, which is presented as a responsibility of the extended family. Thus, resources are situated in the family, social networks, and ethnic group, which should be opened and connected with public services; however, the focus is shifting from older immigrants towards local municipalities. This study provides a discourse perspective on the construction of resources and challenges for older immigrants concerning health, care, and social services and offers an assessment of the cultural and integrating/excluding qualities in active ageing discourses.
Sovereign CDS Premiums’ Reaction to Macroeconomic News: An Empirical Investigation
Authors: Lu Min , Passariello Michele , Wang Xing
Published: July 2021

We assess the efficiency of the sovereign credit default swap (CDS) market by investigating how sovereign CDS spreads react to macroeconomic news announcements. Contrary to the vast majority of the existing literature, one of our main findings supports the hypothesis that news announcements reduce market uncertainty and, thus, that both better‐ and worse‐than‐expected news lower CDS prices during our sample period. In addition, we find that CDS spreads respond differently to the four macroindicators across the three different regions. Our findings might help investors in these areas to interpret the surprises of macronews announcements when making decisions in CDS markets.
Effect of Long-Term Proton Pump Inhibitor Use on Glycemic Control in Patients with Type Two Diabetes Mellitus
Authors: Trang Amy , Bushman Jordan , Halalau Alexandra
Published: July 2021

There have been conflicting results regarding the effect of proton pump inhibitors (PPIs) as an adjunctive therapy to oral antidiabetic medication (OAM) in those with type 2 diabetes (T2DM). PPIs increase gastrin levels, causing a rise in insulin. No studies have evaluated the duration of PPI therapy and its effect on glycemic control. Medical records across 8 hospitals between 2007 and 2016 were reviewed for 14,602 patients with T2DM (not on insulin therapy) taking PPIs. Values of HbA1c (baseline, follow-up, and the difference between the two) in those prescribed with PPIs and years of therapy were compared to HbA1c values of those who had no record of PPI use. Baseline and follow-up HbA1c for patients on PPIs were 6.8 and 7.0, respectively, compared to 7.1 and 7.2 in their untreated counterparts (

p
<
0.001

in both comparisons). For both groups, an increase in baseline HbA1c was seen with time. Those on PPI had an increase in HbA1c of 0.16 compared to 0.08 in those not prescribed PPI. Our results show no relationship between the length of PPI therapy and HbA1c reduction.
LSM‐SEC: Tongue Segmentation by the Level Set Model with Symmetry and Edge Constraints
Authors: Gao Shanshan , Guo Ningning , Mao Deqian
Published: July 2021

Accurate segmentation of the tongue body is an important prerequisite for computer‐aided tongue diagnosis. In general, the size and shape of the tongue are very different, the color of the tongue is similar to the surrounding tissue, the edge of the tongue is fuzzy, and some of the tongue is interfered by pathological details. The existing segmentation methods are often not ideal for tongue image processing. To solve these problems, this paper proposes a symmetry and edge‐constrained level set model combined with the geometric features of the tongue for tongue segmentation. Based on the symmetry geometry of the tongue, a novel level set initialization method is proposed to improve the accuracy of subsequent model evolution. In order to increase the evolution force of the energy function, symmetry detection constraints are added to the evolution model. Combined with the latest convolution neural network, the edge probability input of the tongue image is obtained to guide the evolution of the edge stop function, so as to achieve accurate and automatic tongue segmentation. The experimental results show that the input tongue image is not subject to the external capturing facility or environment, and it is suitable for tongue segmentation under most realistic conditions. Qualitative and quantitative comparisons show that the proposed method is superior to the other methods in terms of robustness and accuracy.
Dynamic Analysis of Retailers’ Paid Membership Strategy
Authors: Xu Lina , Meng Zhiqing
Published: July 2021

Paid membership system has attracted more and more attention from retailers because of its advantages in improving customer loyalty, increasing repeat purchases and corporate cash flow in the short term, and collecting consumption data conveniently. In the fierce competition environment, it is an interesting topic whether the paid membership card can be accepted by the customers as soon as possible. Based on the theory of evolutionary game, this paper discusses the strategies of retailers to implement the paid membership in the case of two different consumer groups. The results show that only when the relationship between the parameters meets certain conditions can the paid membership card be accepted smoothly. In order to satisfy the condition, retailers should take such measures: making the difference between service level and membership card price bigger and reducing consumers’ estimated default risk and retailers’ service adjustment factor. The results of this study provide a useful reference for retailers to successfully implement the paid membership system.
A Review of Plant-Based Therapies for the Treatment of Urinary Tract Infections in Traditional Southern African Medicine
Authors: Cock Ian , Mavuso Nothando , Van Vuuren Sandy
Published: July 2021

Urinary tract infections (UTIs) are amongst the most common bacterial infections globally, with ∼11% of the world’s population contracting at least one infection annually. Several South African plants are used in traditional healing systems to treat UTIs, yet the therapeutic potential of these plants against bacteria that cause UTI remains poorly explored. This study documents southern African plant species used traditionally to treat UTIs. An extensive literature review was undertaken to document the southern African plant species that are used in traditional South African medicine to treat UTIs, thereby highlighting gaps in the current research that require further study. One hundred and fifty-three southern African plant species that are used to treat UTIs were identified. Eighty-five southern African plants were identified as having noteworthy inhibitory activity against the major UTI-causing bacteria. Few of those studies screened against all of the bacterial causes of UTIs, and none of those studies examined the mechanism of action of the plant preparations. Furthermore, many of those studies did not test the toxicity of the plant extracts, so an evaluation of the safety for therapeutic usage was lacking. Substantial further research is to determine their potential for therapeutic use.
New Model of Food Supply Chain Finance Based on the Internet of Things and Blockchain
Authors: Hong Yan
Published: July 2021

The grain supply chain not only broadens the financing channels for small and medium-sized enterprises in the supply chain and strengthens the cohesion of the supply chain but also opens up new business models and sources of profit for commercial banks. This article aims to study the use of advanced information technologies such as mobile Internet, Internet of Things (IoT) transmission, BT, and other advanced information technologies to design intelligent grain depot integrated systems based on the IoT technology, in accordance with the principles of practicality and advancement, to realize the informatization of the daily management of the grain depot and provide construction experience for the informatization construction of the food industry. This article proposes a detailed summary of several models of agricultural supply chain finance from the perspective of supply chain management and analyzes the applicable conditions and basic processes of these models. It also analyzes the structure of the agricultural supply chain through typical cases, introduces the operation of supply chain finance, and evaluates and analyzes its effectiveness and problems. The experimental results in this paper show that, compared with other storage methods, this solution has obvious advantages in data query efficiency and data storage cost. Without a central server, the entire distributed system will have a certain degree of efficiency, reliability, and cost-effectiveness. When the amount of grain data reaches 100,000, 1 million, and 10 million, the system data integrity check time is 0.0263 seconds, 0.3251 seconds, and 1.5032 seconds, respectively. The program seems very useful.
Transcriptional Profiling of Exosomes Derived from Staphylococcus aureus‐Infected Bovine Mammary Epithelial Cell Line MAC‐T by RNA‐Seq Analysis
Authors: Chen Yu , Jing Hongyuan , Chen Miaoyu , Liang Wan , Yang Jing , Deng Ganzhen , Guo Mengyao
Published: July 2021

Mastitis is a common disease in the dairy industry that causes huge economic losses worldwide. Exosomes (carrying proteins, miRNA, lncRNA, etc.) play a vital role in the regulation of immune response. lncRNA can play a variety of regulatory roles by combining with protein, RNA, and DNA. The expression of mRNA and lncRNA in exosomes derived from bovine mammary epithelial cells infected by S. aureus is rarely understood. To explore this issue, RNA sequencing analysis was performed on exosomes derived from S. aureus‐infected and noninfected MAC‐T cells. Analysis of the sequencing results showed that there were 186 differentially expressed genes, 431 differentially expressed mRNAs and 19 differentially expressed lncRNAs in the exosomes derived from S. aureus‐infected and noninfected MAC‐T cells. By predicting lncRNA target genes, it was found that 19 differentially expressed lncRNAs all acted on multiple mRNAs in cis and trans. GO analysis revealed that differentially expressed genes and lncRNA target genes played significant roles in such metabolism (reactive oxygen species metabolic processes), transmembrane transport, cellular response to DNA damage stimulus, and response to cytokines. KEGG enrichment indicated that lncRNA target genes gathered in the TNF pathway, Notch pathway, MAPK pathway, NF‐kappa B pathway, Hippo pathway, p53 pathway, reactive oxygen species metabolic processes, and longevity regulating pathway. In summary, all data indicated that differentially expressed gene, mRNA, and lncRNA in transcriptional profiling of exosomes participated in bacterial invasion and adhesion, oxidative stress, inflammation, and apoptosis‐related signaling pathway. The data obtained in this study would provide valuable resource for understanding the lncRNA information in exosomes derived from dairy cow mammary epithelial cells and conduced to the study of S. aureus infection in dairy cow mammary glands.
Body Composition and Metabolic Improvement in Patients Followed Up by a Multidisciplinary Team for Obesity in China
Authors: Lu Difei , Yuan Zhenfang , Yang Lihua , Jiang Yong , Li Min , Wang Yuanzheng , Jing Lulu , Wang Rongli , Zhang Junqing , Guo Xiaohui
Published: July 2021

Background. This study evaluated the effectiveness of the multidisciplinary team (including a specialist, a dietitian, a physical exercise trainer, a surgeon for bariatric surgery, an acupuncturist, and several health educators) for obesity management and the body composition change and improvements in metabolic biomarkers during a 2-year follow-up. Materials and Methods. A total of 119 patients participated in the multidisciplinary team for obesity. Patients were followed up at 3 months, 6 months, 1 year, 18 months, and 2 years after their first visit. Individuals were divided into the high-protein diet (HPD) and standard-protein diet (SPD) group according to their results on a diet questionnaire that they filled out during follow-up. Results. After 1.2 years, the mean body weight of the participants dropped from 89.7 kg to 80.9 kg (

p
<
0.001

). The body adiposity index was reduced from 33.9 to 32.0 (

p
<
0.001

), while the fat-free mass index from 17.0 to 15.2 (

p
=
0.043

). Fasting glucose and HbA1c were also lower after treatment (

p
=
0.002

and 0.038 for FPG and HbA1c, respectively). Fasting insulin and HOMA-IR were reduced (

p
=
0.002

and <0.001 for fasting insulin and HOMA-IR, respectively). HDL-c increased along with weight loss (1.06 mmol/L vs. 1.19 mmol/L,

p
<
0.001

), and transaminase levels significantly dropped (

p
=
0.001

and 0.021 for ALT and AST, respectively). During treatment, mean protein intake was 29.9% in the HPD group and 19.5% in the SPD group (

p
<
0.001

). Weight loss, reduction of visceral fat area, maintenance of lean body mass, body adiposity index, and fat-free mass index showed no statistical significance between the HPD and SPD groups, as well as glucose metabolic variables. Conclusions. A multidisciplinary team for obesity management could significantly reduce body weight and improve metabolic indicators, including HDL-c, transaminase, and insulin resistance. A high-protein diet does not produce better weight control or body composition compared with a standard calorie-restricted diet.
Genes Encoding Teleost Orthologs of Human Haploinsufficient and Monoallelically Expressed Genes Remain in Duplicate More Frequently Than the Whole Genome
Authors: Picolo Floriane , Grandchamp Anna , Piégu Benoît , Rolland Antoine D. , Veitia Reiner A. , Monget Philippe
Published: July 2021

Gene dosage is an important issue both in cell and evolutionary biology. Most genes are present in two copies or alleles in diploid eukariotic cells. The most outstanding exception is monoallelic gene expression (MA) that concerns genes localized on the X chromosome or in regions undergoing parental imprinting in eutherians, and many other genes scattered throughout the genome. In diploids, haploinsufficiency (HI) implies that a single functional copy of a gene in a diploid organism is insufficient to ensure a normal biological function. One of the most important mechanisms ensuring functional innovation during evolution is whole genome duplication (WGD). In addition to the two WGDs that have occurred in vertebrate genomes, the teleost genomes underwent an additional WGD, after their divergence from tetrapods. In the present work, we have studied on 57 teleost species whether the orthologs of human MA or HI genes remain more frequently in duplicates or returned more frequently in singleton than the rest of the genome. Our results show that the teleost orthologs of HI human genes remained more frequently in duplicate than the rest of the genome in all of the teleost species studied. No signal was observed for the orthologs of genes mapping to the human X chromosome or subjected to parental imprinting. Surprisingly, the teleost orthologs of the other human MA genes remained in duplicate more frequently than the rest of the genome for most teleost species. These results suggest that the teleost orthologs of MA and HI human genes also undergo selective pressures either related to absolute protein amounts and/or of dosage balance issues. However, these constraints seem to be different for MA genes in teleost in comparison with human genomes.
A Rare Case of Cryptococcal Meningitis in a Child with a Congenital Heart Disease
Authors: Dhoubhadel Bhim Gopal , Laghu Ujjwal , Poudel Raju , Morimoto Konosuke , Ariyoshi Koya
Published: July 2021

Cryptococcal meningitis, which has a high mortality rate, is rare in immunocompetent children. Although many immunocompromised conditions are identified as predisposing factors, congenital heart disease in children is not well recognized as a predisposing factor for the disease. A 12-year-old female child presented with a progressively increasing headache for one month. There was history of vomiting and fever off and on. On examination, she had a pansystolic murmur and meningeal signs. Lumbar puncture was done; opening pressure was high (27 cm H2O) and white blood cell (WBC) count in cerebrospinal fluid (CSF) was slightly high. Gram staining, India ink preparation, and culture of CSF were negative. Cryptococcal antigen (CrAg) test was not available. Echocardiography showed a 12 mm ventricular septal defect (VSD). The patient was diagnosed as meningitis with VSD and treated with intravenous ceftriaxone and vancomycin; however, she did not improve after 7 days of antimicrobial treatment. She was then transferred to another hospital where India ink and culture of CSF showed cryptococcus; CrAg test was done, and it was positive. Despite the treatment with lyposomal amphotericin B and flucytosine, she died on 9th day of admission in pediatric intensive care unit. It is necessary for global advocacy for need of availability of CrAg test in resource-limited regions. Treating doctors should consider VSD, a congenital heart disease, as a predisposing factor for cryptococcal meningitis in children. As CrAg is more sensitive than India ink and culture, it should be the first line of investigation in suspected cases.
Late Nontraumatic Anterior Dislocation of Intraocular Lens with Complete Capsular Phimosis in Retinitis Pigmentosa
Authors: Ng In Sim , Leong Wa Cheong , Sun Li , Leong Chan
Published: July 2021

Intraocular lens (IOL) dislocation is an unusual but serious complication after cataract surgery. We are here to report a rare case which is nontraumatic IOL dislocated and prolapsed into the anterior chamber in a retinitis pigmentosa (RP) patient. Zonular weakness and capsular contraction are considered to be the main contributing factors of IOL dislocation in RP patients. Patients at risk should be recognized and managed accordingly intraoperatively or postoperatively.
Learning Curve of Upper Aerodigestive Tract Foreign Body Management for Otorhinolaryngology Residents
Authors: Chiu Ching-Ching , Huang Chien-Yu , Chang Keng-Ming , Lin Sheng-Chiao , Liu Yu-Hsi , Liao Pei-Hsun , Hung Chuan-Jen , Cho Chin-Fang , Liao Jyun-Yi , She Yun-Ying , Kang Bor-Hwang
Published: July 2021

Introduction: Foreign body ingestion is the most common reason for otolaryngology specialist consultations in emergency departments. Among the different types of foreign bodies, fish bones are the most common, particularly in Asian populations. In Taiwan, upper aerodigestive tract foreign bodies (UADT-FBs) are mostly managed by residents in the otorhinolaryngology (ORL) department. Considering the learning curve required for all procedures, different management types between residents, and possible resulting safety issues, this study explored the outcomes of UADT-FB management by residents in different years of ORL training. Materials and Methods: The medical records of 2,283 patients who visited Kaohsiung Veterans General Hospital’s Emergency Department for UADT-FB during June 2013–August 2019 were retrospectively reviewed. The reviewed data included the demographic data of enrolled patients, outcomes of foreign body management, and follow-up chart records of the patients. Results: Among the 2,283 patients, 1,324 (58%) were found to be negative for foreign bodies, and foreign bodies in 951 (41.7%) were removed immediately. In the negative finding (NF) group, 2 (4.9%) patients were later found to be positive for foreign bodies during follow-up in the outpatient department. One (2.4%) patient developed a deep neck infection and esophageal perforation. The percentage of NFs decreased from 62.58% in residents in the first half of their first year (R1a) to 54% for third-year residents (R3). Comparing R1a with R3, the number needed to harm for retained UADT-FBs after patients visited the emergency department was 12.2. Discussion/Conclusion: This study provides data from 1 referral center regarding the management of UADT-FBs. With increasing resident training, the percentage of NFs declined from 62.58 to 54%. Young residents, especially those in the first 6 months of their training, should have senior residents perform a second examination if UADT-FBs are not found in suspected cases.
Prospective Evaluation of Antibiotic Management in Ureteral Stent and Nephrostomy Interventions
Authors: Westhoff Niklas , Anokhin Alexey , Patroi Paul , Neuberger Manuel , Siegel Fabian , Pfalzgraf Daniel
Published: July 2021

Introduction: Screening for and treating asymptomatic bacteriuria (ABU) or administering antibiotic prophylaxis is recommended during ureteral stent and nephrostomy interventions. This study investigates the frequency of postinterventional infectious complications to gain insight into the need for antibiotics. Methods: Between September 2016 and June 2019, 168 insertions/exchanges of ureteral stents or nephrostomies were recorded in a prospective multicenter study. Patients without a symptomatic UTI did not receive antibiotic treatment/prophylaxis. Asymptomatic patients in whom their urologist already administered an antibiotic treatment served as a comparative group. Follow-up included postinterventional complications within 30 days. Symptoms were assessed by the Acute Cystitis Symptom Score (ACSS) before and after the intervention. Predictors of increasing postinterventional symptoms were analyzed by a multivariable logistic regression model. Results: One hundred forty-five interventions were eligible. One hundred twenty-two (84.1%) interventions were performed without antibiotic treatment. Preinterventional ABU was detected in 54.4% and sterile urine in 22.8% (22.8% without culture). Postinterventional infectious complications did not differ between patients with versus without antibiotics. Transurethral interventions aggravate symptoms (p = 0.034) but do not increase infectious complications compared to percutaneous interventions. Patients without diabetes mellitus are at higher risk for increasing symptoms. Conclusion: Results indicate that peri-interventional antibiotic treatment may be omitted in patients without symptomatic UTI. Symptoms must be differentiated between infectious and procedure-associated origins.
Prolapse Surgery: What Kind of Antibiotic Prophylaxis Is Necessary?
Authors: Illiano Ester , Trama Francesco , Crocetto Felice , Califano Gianluigi , Aveta Achille , Motta Gloria , Pastore Antonio Luigi , Brancorsini Stefano , Fabi Consuelo , Costantini Elisabetta
Published: July 2021

Introduction: The aim of this study was to assess whether antibiotic prophylaxis or therapy is sufficient for laparoscopic or vaginal prolapse surgery with mesh. Methods: This is a single-center prospective study. The study was divided into 3 groups. Protocol A: metronidazole (15 mg/kg) and piperacillin-tazobactam (2 g) 1 h before surgery and, for postoperative treatment, gentamycin (160 mg) 1 h before surgery in a single dose. Metronidazole and piperacillin-tazobactam were administered until hospital discharge. Protocol B: gentamycin and piperacillin-tazobactam in the same manner as group A. Protocol C: clindamycin (600 mg) and gentamicin (160 mg) 1 h before surgery in a single dose. Results: We included 87 consecutive patients who underwent prolapse surgery involving mesh prostheses: 57 by the laparoscopic approach and 30 by the vaginal route. Of these, 30 patients were included in protocol A, 30 in protocol B, and 27 in protocol C. There were no statistically significant differences among the 3 protocols regarding any postoperative complications, except for urinary tract infections that were more in the vaginal approach than in the laparoscopic route, in protocol A (p = 0.002). Conclusions: One-shot prophylaxis can be successfully used in prolapse surgery regardless of the surgical approach.
Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study
Authors: Göger Yunus Emre , Özkent Mehmet Serkan , Topçu Cemile , Atıcı Ahmet , Sönmez Mehmet Giray , Balasar Mehmet , Gürbilek Mehmet
Published: July 2021

Introduction: Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are the leading novel biomarkers used efficiently in acute kidney injury (AKI). The levels of these biomarkers increase especially in the early period of nephrotoxic and ischemic renal damage. In this study, we aimed to investigate the clinical importance of NGAL and KIM-1 biomarkers used in the effective evaluation of kidney functions in patients with acute unilateral obstructive stone disease (AUOSD) in the management of endoscopic surgery. Materials and Methods: We prospectively included patients who underwent endoscopic surgery due to AUOSD between January 2018 and December 2019. Urine KIM-1 and NGAL values of the patients were measured preoperative period, postoperative 4th h, and postoperative 7th day. The patients were evaluated according to the location and size of the stone, the degree of renal hydronephrosis, the duration of the operation, complications, and JJ stent placement. Results: The study enrolled 50 patients. Urinary KIM-1/Cr and urinary NGAL/Cr ratios were higher in postoperative 4th h than in others (p < 0.001). Also, we found that urinary KIM-1/Cr and urinary NGAL/Cr ratios with Grade 2 and higher hydronephrosis were statistically higher than Grade 0–1 hydronephrosis (p < 0.001 and p: 0.042, respectively). Additionally, a preoperative urinary KIM-1 value of 1.24 ng/mL had a sensitivity of 78% and a specificity of 63% to predict the presence of hydronephrosis. When urine KIM-1 and NGAL results were compared with surgery time, stone size and location, serum creatinine (sCr) value, and Post-Ureteroscopic Lesion Scale grade, the difference was not statistically significant. Postoperative 7th day NGAL/Cr and KIM-1/Cr ratios were statistically higher in those with JJ stents placed (p: 0.03 and p: 0.004, respectively). Conclusion: KIM-1 and NGAL can be used in our assessment of renal function in patients with AUOSD, even if sCr is normal. Also, these biomarkers can predict the presence of hydronephrosis. It can be helpful in determining the time of surgical treatment, as well as providing information in the follow-up of patients with JJ stents after treatment.
Workflow Times and Outcome of Endovascular Therapy in Stroke Patients with Initial MRI or CT
Authors: Stösser Sebastian , Bode Felix J. , Dorn Franziska , Petzold Gabor C. ,   on behalf of the GSR-ET Study Group
Published: July 2021

Introduction: Treatment of patients with acute large vessel occlusion (LVO) stroke is highly time dependent. MRI and CT are both used as primary neuroimaging modalities in these patients, which may be associated with differences in workflow times of endovascular therapy (ET), thus potentially affecting clinical outcome. We here aimed to compare workflow times and clinical outcome in a large cohort of patients initially examined by MRI or CT. Methods: We analyzed patients who underwent ET between 2015 and 2019 and were enrolled into the prospective multicenter German Stroke Registry-Endovascular Therapy (GSR-ET). Patients who had an MRI prior to ET were compared to patients with a pretreatment CT regarding baseline data, in-hospital workflow times, and clinical outcome. Results: Three hundred seventy out of 4,638 patients were examined with an initial MRI (8.0%). Compared to patients with an initial CT, MRI patients had a longer median time from hospital admission to imaging acquisition (23 vs. 14 min). All consecutive workflow times did not significantly differ between both groups after adjustment for confounders. Moreover, the clinical outcome did not differ between MRI and CT patients after adjustment for confounders. Conclusion: In LVO stroke patients undergoing ET, pretreatment imaging with MRI instead of CT leads to a delay of imaging acquisition after hospital admission without having a measurable impact on consecutive workflow steps and clinical outcome.
Plasma Renin Activity Predicts Prognosis and Liver Disease-Related Events in Liver Cirrhosis Patients with Ascites Treated by Tolvaptan
Authors: Osawa Leona , Nakanishi Hiroyuki , Kurosaki Masayuki , Kirino Sakura , Inada Kento , Yamashita Koji , Hayakawa Yuka , Sekiguchi Shuhei , Wang Wan , Okada Mao , Higuchi Mayu , Komiyama Yasuyuki , Takaura Kenta , Takada Hitomi , Kaneko Shun , Maeyashiki Chiaki , Tamaki Nobuharu , Yasui Yutaka , Tsuchiya Kaoru , Itakura Jun , Takahashi Yuka , Enomoto Nobuyuki , Izumi Namiki
Published: July 2021

Background and Aims: A retrospective study was to analyze the association of plasma renin activity (PRA) with overall survival and liver disease-related events in decompensated liver cirrhosis with ascites treated by tolvaptan. Methods: We included 196 patients with decompensated cirrhosis treated with tolvaptan and for whom hepatic ascites had remained uncontrolled by conventional diuretics. Factors associated with prognosis and appearance of liver disease-related events were investigated, including vasopressin, sympathetic nervous system hormones (adrenaline, noradrenaline, and dopamine), and the renin-angiotensin system (PRA and aldosterone) at the beginning of tolvaptan treatment. Results: Age, history of hepatocellular carcinoma (HCC), and PRA were identified as independent factors for prognosis after tolvaptan treatment. The median survival time in patients with PRA ≥9.5 ng/mL/h at the beginning of tolvaptan treatment was significantly shorter than in patients with PRA <9.5 ng/mL/h (193 vs. 893 days, p < 0.001). PRA and a history of HCC were independent factors for the occurrence of liver disease-related events. The median event-free period in patients with PRA ≥3.2 ng/mL/h was significantly shorter than that of patients with PRA <3.2 ng/mL/h (89 vs. 222 days, p < 0.001). Conclusions: PRA is an independent predictor of prognosis and appearance of liver disease-related events in patients with decompensated cirrhosis who have started tolvaptan treatment.
Predictive Risk Factors and Occupational Impact of Self-Perceived Voice Problems in Preschool-Kindergarten versus First- to Sixth-Grade Teachers
Authors: Kyriakou Kyriaki , Theodorou Elena , Petinou Kakia , Phinikettos Ioannis
Published: July 2021

Aim: The aim of this investigation was to complete a further analysis of existing data to compare risk factors of voice problems as well as create a hierarchical ranking of risk factors in preschool-kindergarten and 1st- to 6th-grade teachers in order to develop a voice hygiene program and prioritize its goals for each group of teachers. Methods: An online survey was completed by 148 preschool-kindergarten and 301 1st- to 6th-grade public school teachers. Participants were divided into four groups, preschool-kindergarten and 1st- to 6th-grade teachers with no self-perceived voice disorders and preschool-kindergarten and 1st- to 6th-grade teachers with self-perceived voice disorders. A χ2 test and a multivariate logistic regression model were used to examine the differences in answers between the preschool-kindergarten teachers with and without voice disorders and the 1st- to 6th-grade teachers with and without voice disorders and to identify the most important predictors. Results: The significant predictors for preschool-kindergarten teachers are frequently or sometimes continuing to talk after a breath cycle and being exposed to an excessive or a lot of noise generated in the classroom. The significant predictors for 1st- to 6th-grade teachers include having short breaks between classes and continuing to talk frequently after a breath cycle. Conclusions: Job-related risk factors in preschool-kindergarten and in 1st- to 6th-grade teachers may vary. Therefore, a preventative vocal hygiene education program specifically tailored for each population of teachers is suggested.
Blue Lagoon Algae Improve Uneven Skin Pigmentation: Results from in vitro Studies and from a Monocentric, Randomized, Double-Blind, Vehicle-Controlled, Split-Face Study
Authors: Grether-Beck Susanne , Marini Alessandra , Jaenicke Thomas , Brenden Heidi , Felsner Ingo , Aue Natalie , Brynjolfsdottir Asa , Krutmann Jean
Published: July 2021

Introduction: Bathing in the Blue Lagoon (BL) in Iceland benefits patients with psoriasis. Accordingly, the BL water contains algae with biological activities that improve skin barrier function and affect T-cell responses relevant for psoriasis. Bathing in the BL is also becoming increasingly popular among healthy individuals and anecdotal evidence suggests positive effects on uneven skin pigmentation. Objective: The aim of the study was to address the impact of BL algae on skin pigmentation. Methods: In this work, in vitro gene expression studies in melanocytes and a noninvasive in vivo study were conducted. Results: We here report that normal human epidermal melanocytes, which had been treated with nontoxic concentrations of BL algae, show a significantly reduced expression of α melanocyte-stimulating hormone-induced expression of genes important for melanin synthesis, such as tyrosinase, tyrosinase-related protein 1, dopachrome tautomerase, melan A protein, and pre-melanosome protein. This in vitro observation prompted us to conduct a randomized, double-blind, intra-individual, comparative split-face in vivo study, in which 60 volunteers with pre-existing facial pigment spots were treated twice daily with a BL algae containing serum or a vehicle control. We found that constitutive skin pigmentation as determined by colorimetry (individual typology angle and luminescence) did not differ significantly between vehicle- and serum-treated skin sites. In marked contrast, digital photography under cross-polarized lighting and RBX technology (VISIA CR) revealed that the number of pigment spots in the serum-treated face decreased significantly compared to the vehicle-treated side. Conclusion: Thus, BL algae can affect human melanocyte function in vitro and reduce uneven facial skin pigmentation in vivo.
Cantos da Tríplice Aliança traduzidos do náhuatl clássico para o português
Authors: Oliveira Sara Lelis de
Published: July 2021

Tradução inédita de dois cantos dos Cantares mexicanos [fls. 1f a 85f] para o português brasileiro referentes às folhas 17 frente, 17 verso e 18 frente. Atualmente o manuscrito encontra-se conservado no Fundo Reservado da Biblioteca Nacional do México (BNM) e é o primeiro dos treze opúsculos reunidos no volume MS 1628 bis. Os Cantares foram escritos em náhuatl clássico, língua indígena franca transcrita da forma oral para a escrita em alfabeto latino no âmbito da catequização de indígenas. Por conseguinte, os cantos tradicionais foram deturpados com, por exemplo, a introdução de elementos católicos tanto em náhuatl – a partir de neologismos – quanto em espanhol. Os dois cantos apresentados são o segundo e o terceiro de um conjunto de 24 cantos [fls. 16v a 26v] que aludem à tradição oral cultivada pela Tríplice Aliança, última elite indígena a ocupar o poder antes da Queda de Tenochtitlan (1521). Neles são exaltadas divindades eliminadas e/ou substituídas pelo Deus cristão e são comemoradas vitórias em guerras passadas.
Tradução do conto “Unguided Tour”, de Susan Sontag
Authors: Julles Dinaura
Published: July 2021

Uma das facetas menos conhecidas da caleidoscópica Susan Sontag, que já foi chamada de a “intelectual total”, é a de escritora de contos. Notabilizada no jornalismo literário norte-americano como ensaísta em obras seminais, Susan Sontag permanece inédita no Brasil como escritora de contos. O objetivo deste trabalho é apresentar o extremo oposto da racionalidade aplicada aos seus ensaios. Como em um giro no caleidoscópio, surge sua polêmica e conturbada vida pessoal, espelhada no conto agora intitulado “Turismo sem Guia”, originalmente Unguided Tour, encontrado por acaso em uma publicação da Revista Granta, de 1994. A tradução procura proporcionar ao leitor uma experiência estética semelhante àquela do leitor do original. Foi preciso desmontar Unguided Tour, conforme sugerido por Derrida na sua proposta de “Desconstrução”, fragmentá-lo para identificar suas especificidades, como o encobrimento do gênero dos personagens, descrições de cenas do passado, menções a profissões antigas, referências bíblicas e a outras obras, e recompô-lo, com toda sua polissemia. Que seja um passeio proveitoso a quem enveredar por esta experiência de “Turismo sem Guia”.
A morte de um Poeta. Tradução poética para o português da estreia literária de Mikhail Iúrevitch Lérmontov (1814-1841)
Authors: Pinto Pedro Augusto
Published: July 2021

O presente artigo busca introduzir e comentar a tradução inédita que aqui apresentamos do poema “A morte de um poeta”, de Mikhail Lérmontov, um dos mais importantes autores russos do século XIX. Para além de algumas escolhas feitas ao longo do processo tradutório, tentaremos apresentar os pressupostos teóricos de que nos valemos, assim como um breve panorama do contexto histórico e cultural em que se inserem a obra de Lérmontov como um todo, e sobretudo o poema em questão.