bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial Inclusion, Livelihood Activities, and Stock Market Participation
Authors: Amidu Mohammed , Abor Joshua Yindenaba , Coffie William , Akakpo Agnes Akpene
Published: December 2021

This article examines the livelihood activities of households who are financially included and participate in the stock market. We sample 1,966 households in Ghana and employ two stage least squares and robust probit regression analysis to test the relationship of interest. We find the following results: First, financial inclusion significantly improves sustainable livelihood activities when individuals who own accounts, use their accounts to save, have access to credit, and use their account frequently through making withdrawals. Second, improvement in the livelihood (income) of individuals encourages stock market participation (SMP, using agent visits). Third, financial inclusion, in the form of using account for savings purposes, negatively influences SMP (investment is stocks) as individuals prefer holding liquid funds in savings account than investing in risky assets. Finally, the sensitivity of SMP to financial inclusion and livelihood (employment and income), suggests that as the livelihood of financial included persons improves, they are less inclined to participate in the stock market. We conclude that financial inclusion and livelihood activities are relevant in explaining the participation of Ghanaians on the stock market.
Thrombotic microangiopathy and smoldering multiple myeloma after kidney transplant in a patient with MCP mutation
Authors: Almenara Tejederas Marina , De la Torre Corona Laura , García Fabiola Alonso , Pérez María Ángeles Rodríguez , Pérez Rocío Cabrera , Lazo Mercedes Salgueira
Published: December 2021

The most frequent cause of atypical hemolytic uremic syndrome (aHUS) is defective regulation of complement activation because of genetic anomalies. We present the case of 53-year-old man with a kidney transplant and stabilized kidney function (creatinine 2.5 mg/dL; proteinuria 0.4 g/24 h) with mycophenolate/tacrolimus/prednisone who was diagnosed of Thrombotic Microangiopathy (TMA). This diagnosis was associated with creatinine and proteinuria rise (3 mg/dL; 2.4 g/24 h) and a new monoclonal IgA/lambda component. Renal biopsy showed membranoproliferative glomerulonephritis; a pathogenic variant in the Membrane cofactor protein (MCP) gene with a polymorphism ggaac, typically associated to secondary aHUS, was identified. We suspected that immunoglobulin could be acting as a trigger for TMA in a genetically susceptible patient, so “clone-directed” therapy with bortezomib and dexamethasone was initiated.
Urbanizing Islands: A Critical History of Singapore's Offshore Islands
Authors: Connolly Creighton , Muzaini Hamzah
Published: December 2021

While Singapore is often considered an island city in the singular sense, the city-state actually consists of many islands, with the Singapore mainland being by far the largest. While most of these islands traditionally had thriving indigenous communities, all have since been displaced over time as the islands were developed to service Singapore's economic and metabolic needs as a rapidly urbanizing and developing nation. Some of the islands have also undergone considerable transformation (through reclamation) which has had significant impacts on the ecologies of the offshore islands. This simultaneously allowed for the ‘ruralization’ of mainland Singapore to provide more green space for nature conservation, recreation and leisure. This paper will provide a brief history of these transformations, drawing on specific examples which serve to illustrate how Singapore's offshore islands have been redeveloped over time to service the nation-state and in response to the changing needs of the urban core. In doing so, the paper examines how spaces on the urban periphery are deeply bound up with processes of ‘urbanization’, given their important role in processes of urban metabolism. In this way, the paper contributes to recent work in urban political ecology which has sought to trace processes of urbanization beyond the city and render visible the socio-environmental inequalities produced therein.
Association Between Fetal Thymus Size and Intrauterine Growth Restriction
Authors: Keshavarz Elham , Rustazade Sheikhyusefi Marjan , Khalili Pouya Ensi , Mirzamoradi Masoumeh , Khazaei Mehdi , Moharamzad Yashar , Sanei Taheri Morteza
Published: December 2021

Objective:

The objective of this study was to evaluate the association between reduced fetal thymus size and intrauterine growth restriction (IUGR). This study was devised to determine the association between thymus size and any abnormal Doppler indices within the fetal umbilical artery (UA), as well as the middle cerebral artery (MCA).

Materials and Methods:

Forty-six pregnancies between 20 and 38 weeks of gestation with IUGR and 46 normal pregnancies within similar gestational age (GA) range were included. The transverse diameter of fetal thymus was measured. In the IUGR group, the fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler flow velocities were recorded.

Results:

The mean GA of fetuses with IUGR (33.5 weeks) was higher than control group (30.3 weeks). To adjust for the effect of GA, analysis of covariance (ANCOVA) was performed. The adjusted mean thymus diameters were 19.02 mm in IUGR and 21.25 within the control group (mean difference = 2.23 mm; P = .02). The mean (±SD) thymus size in 16 fetuses, with abnormal Doppler findings, was significantly lower than in the group with normal Doppler findings, 17.45 (±2.50) vs 22.02 (±5.39) mm; P < .001.

Conclusion:

IUGR may be associated with reduced fetal thymus size, especially when coupled with abnormal Doppler findings. The thymus size in a group of IUGR fetuses, with abnormal Doppler findings, was smaller than IUGR fetuses, with normal Doppler findings.
Decidualized Endometrioma: Its Sonography and Optimal Clinical Management
Authors: Fernandez Carlos M. , Levine Elliot M. , Sodini Irma , Pena Maria , Shuber Heider , Elliott Stephanie
Published: December 2021

Endometriosis is a condition which affects many reproductive age women. During pregnancy, an ovarian endometrioma may undergo decidualization, which may take on the sonographic appearance suggestive of malignancy. In this instance, a surgical approach for treatment may be deemed necessary. Three cases are presented with different outcomes, worthy of viewing the contrasting management. In case 1, a patient was diagnosed with a left ovarian cyst at her routine 20-week gestation sonogram. This sonographic examination was suggestive of an ovarian malignancy. The patient underwent laparoscopy with left salpingo-oophorectomy at 23 weeks gestational age, without complications. The pathologic diagnosis of the removed mass was a decidualized endometrioma. In case 2, a female patient presented with bilateral ovarian decidualized endometriomas that were demonstrated sonographically and had the appearance of malignancy. This patient was treated conservatively with serial follow-up sonograms during her pregnancy. At the 2-month post-partum follow-up sonogram demonstrated persistent bilateral endometriomas, without decidualization. However, in case 3, possible decidualization of an endometrioma was seen, and a follow-up sonogram revealed the presence of ovarian carcinoma. There is previously published support for watchful waiting when similar sonographic findings, in pregnancy, are seen.
Retraction Note: Oxycodone versus morphine for analgesia after laparoscopic endometriosis resection
Authors: Niu Lijun , Chen Lihong , Luo Yanhua , Huang Wenkao , Li Yunsheng
Published: December 2021

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12871-021-01540-1.
TRAP1 suppresses oral squamous cell carcinoma progression by reducing oxidative phosphorylation metabolism of Cancer-associated fibroblasts
Authors: Xiao Li , Hu Qiannan , Peng Yanshuang , Zheng Kaiyue , Zhang Ting , Yang Lianjie , Wang Zhi , Tang Wanrong , Yu Jie , Xiao Qian , Zhang Dandan , Zhang Weifang , He Chanjuan , Wu Dengxun , Zheng Yanyan , Liu Ying
Published: December 2021

Background

Glucose metabolism in cancer associated fibroblasts (CAFs) within the tumor microenvironment is a material and energy source for tumorigenesis and tumor development. However, the characteristics and important regulatory mechanisms of glucose metabolism in fibroblasts associated with oral squamous cell carcinoma (OSCC) are still unknown.

Methods

We successfully isolated, cultured, purified and identified CAFs and normal fibroblasts (NFs). Cell culture, immunohistochemistry (IHC) and CCK8, flow cytometry, Seahorse XF Analyzer, MitoTracker assay, western blotting (WB), transmission electron microscope, Quantitative real-time PCR (qPCR), immunofluorescence (IF), and Label-free quantitative proteomics assay, animal xenograft model studies and statistical analysis were applied in this study.

Results

We demonstrated that the proliferation activity of CAFs was significantly enhanced as compared to NFs, while the apoptosis rate was significantly decreased. CAFs in OSCC preferentially use oxidative phosphorylation (OXPHOS) rather than glycolysis. Moreover, CAFs showed stronger maximal respiration, a larger substantial mitochondrial spare respiratory capacity (SRC) and higher adenosine triphosphate (ATP) production capacity than NFs. The results of mitotracker green fluorescence staining showed that compared with NFs, CAFs exhibited stronger green fluorescence. The results of WB showed the expression level of Peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) obviously increased in CAFs compared to NFs. These results confirmed that CAFs have greater mitochondrial activity and function than NFs. Furthermore, Label-free quantitative proteomics assays showed that both ATP synthase subunit O (ATP5O) and tumor necrosis factor receptor-associated protein 1 (TRAP1) are important differentially expressed proteins in the mitochondria of CAFs/NFs. Overexpression of TRAP1 in CAFs increased basal oxygen consumption rate (OCR), maximal respiration, ATP production and SRC. In vivo, overexpression TRAP1 expression in CAFs suppress tumor growth.

Conclusion

Taken together, the results indicated that TRAP1 is an important regulatory molecule of CAFs glucose metabolism and promotes OSCC progression by regulating the OXPHOS of CAFs.
Evaluation of a 55-gene classifier as a prognostic biomarker for adjuvant chemotherapy in stage III colon cancer patients
Authors: Oki Eiji , Shinto Eiji , Shimokawa Mototsugu , Yamaguchi Shigeki , Ishiguro Megumi , Hasegawa Seiji , Takii Yasumasa , Ishida Hideyuki , Kusumoto Tetsuya , Morita Masaru , Tomita Naohiro , Shiozawa Manabu , Tanaka Masafumi , Ozawa Heita , Hashiguchi Yojiro , Ohnuma Shinobu , Tada Sachiyo , Matsushima Tomoko , Hase Kazuo
Published: December 2021

Background

Adjuvant chemotherapy reduces the risk of recurrence of stage III colon cancer (CC). However, more effective prognostic and predictive biomarkers are needed for better treatment stratification of affected patients. Here, we constructed a 55-gene classifier (55GC) and investigated its utility for classifying patients with stage III CC.

Methods

We retrospectively identified patients aged 20–79 years, with stage III CC, who received adjuvant chemotherapy with or without oxaliplatin, between the years 2009 and 2012.

Results

Among 938 eligible patients, 203 and 201 patients who received adjuvant chemotherapy with and without oxaliplatin, respectively, were selected by propensity score matching. Of these, 95 patients from each group were analyzed, and their 5-year relapse-free survival (RFS) rates with and without oxaliplatin were 73.7 and 77.1%, respectively. The hazard ratios for 5-year RFS following adjuvant chemotherapy (fluoropyrimidine), with and without oxaliplatin, were 1.241 (95% CI, 0.465–3.308; P = 0.67) and 0.791 (95% CI, 0.329–1.901; P = 0.60), respectively. Stratification using the 55GC revealed that 52 (27.3%), 78 (41.1%), and 60 (31.6%) patients had microsatellite instability (MSI)-like, chromosomal instability (CIN)-like, and stromal subtypes, respectively. The 5-year RFS rates were 84.3 and 72.0% in patients treated with and without oxaliplatin, respectively, for the MSI-like subtype (HR, 0.495; 95% CI, 0.145–1.692; P = 0.25). No differences in RFS rates were noted in the CIN-like or stromal subtypes. Stratification by cancer sidedness for each subtype showed improved RFS only in patients with left-sided primary cancer treated with oxaliplatin for the MSI-like subtype (P = 0.007). The 5-year RFS rates of the MSI-like subtype in left-sided cancer patients were 100 and 53.9% with and without oxaliplatin, respectively.

Conclusions

Subclassification using 55GC and tumor sidedness revealed increased RFS in patients within the MSI-like subtype with stage III left-sided CC treated with fluoropyrimidine and oxaliplatin compared to those treated without oxaliplatin. However, the predictive power of 55GC subtyping alone did not reach statistical significance in this cohort, warranting larger prospective studies.

Trial registration

The study protocol was registered in the University Hospital Medical Education Network (UMIN) clinical trial registry (UMIN study ID: 000023879).
Exploratory study on classification of chronic obstructive pulmonary disease combining multi-stage feature fusion and machine learning
Authors: Peng Junfeng , Zhou Mi , Zou Kaiqiang , Zhu Xiongyong , Xu Jun , Teng Yi , Zhang Feifei , Chen Guoming
Published: December 2021

Background

Due to the complexity and high heterogeneity of the acute exacerbation of chronic obstructive pulmonary disease (AECOPD), the guidelines (global initiative for chronic obstructive, GOLD) is unable to fully guide the treatment of AECOPD.

Objectives

To provide a rapid treatment in line with the development of the AECOPD after admission. In this paper, we propose a multi-stage feature fusion (MSFF) framework combining machine learning to track the diseases deterioration risk of the AECOPD.

Methods

First, we identify 408 AECOPD patients as the study population. Then, feature segment and fusion methods are applied to generate the phased data set. Finally, human studies are designed to evaluate the performance of the MSFF framework.

Results

The experimental results show that the proposed framework is potential to obtain the full-process tracking of deterioration risk for the AECOPD patients. The proposed MSFF framework achieves a higher overall accuracy average and F1 scores than the four physician groups i.e., IM, Surgery, Emergency, and ICU.

Conclusions

The proposed MSFF model may serve as a useful disease tracking tool to estimate the deterioration risk at each stage, and finally achieve the disease monitoring and management for AECOPD patients.
A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program
Authors: Wang Haosheng , Fan Tingting , Li Wenle , Yang Bo , Lin Qiang , Yang Mingyu
Published: December 2021

Background

The aim of this study was to identify the risk factors associated with prolonged length of stay (LOS) in patients undergoing primary total hip arthroplasty (THA) managed with an enhanced recovery after surgery (ERAS) program and develop a prediction model for improving the perioperative management of THA.

Methods

In this single-center retrospective study, patients who underwent primary THA in accordance with ERAS from May 2018 to December 2019 were enrolled in this study. The primary outcome was prolonged LOS (> 48 h) beyond the first postoperative day. We collected the clinical patient’s clinical characteristics, surgery-related parameters, and laboratory tests. A logistic regression analysis explored the independent risk factors for prolonged LOS. According to published literature and clinical experience, a series of variables were selected to develop a nomogram prediction model to predict the risk of prolonged LOS following primary THA with an ERAS program. Evaluation indicators of the prediction model, including the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, were reported to assess the performance of the prediction model. The bootstrap method was conducted to validate the performance of the designed nomogram.

Results

A total of 392 patients were included in the study, of whom 189 (48.21%) had prolonged LOS. The logistics regression analysis demonstrated that age, sex, hip deformities, intraoperative blood loss, operation time, postoperative Day 1 (POD) hemoglobin (Hb), POD albumin (ALB), and POD interleukin-6 (IL-6) were independent risk factors for prolonged LOS. The C-index was 0.863 (95% CI 0.808 to 0.918) and 0.845 in the bootstrapping validation, respectively. According to the results of the calibration, ROC curve, and decision curve analyses, we found that the nomogram showed satisfactory performance for prolonged LOS in this study.

Conclusions

We explored the risk factors for prolonged LOS following primary THA with an ERAS program and developed a prediction model. The designed nomogram was expected to be a precise and personalized tool for predicting the risk and prognosis for prolonged LOS following primary THA with an ERAS program.
Effect of workshops for coaches on the motor ability of balance in children practicing sports in late childhood
Authors: Wilczyńska D. , Łysak-Radomska A. , Podczarska-Głowacka M. , Krasowska K. , Perzanowska E. , Walentukiewicz A. , Lipowski M. , Skrobot W.
Published: December 2021

Background

The coach attitude impacts the whole mind and body system of a child athlete from emotional and motivational aspects to motor skills like motor coordination. It translates into the ability to control and stabilize posture. The vestibular system plays an important role in this regulation. This system, next to the visual system and mechanoreceptors, is responsible for balance and control during posture transition. Moreover, the vestibular system is influenced by emotional factors. Therefore the authors of this study focused on the changes in the balance stability of children practicing sport after the implementation of the psychological workshops for coaches.

Methods

Fifty-nine children at the age of 9–12 practicing soccer, art gymnastic and sport gymnastic were divided into two groups. The experimental group consisted of 31 participants and 28 in the control group. Experimental group children were under the influence of the 3 coaches who attended three workshops over 12 weeks period. Control group children were coached by 5 coaches who attended no workshops. Postural stability tests were performed on children before and after the workshops.

Results

The statistically significant changes were observed in selected parameters of children’s balance stability after the experiment. The significant difference between the experimental and control group in Overall Stability Index (OSI) (p < 0.0002), Anterior–Posterior Stability Index (AP) (p < 0.01), Medial–Lateral Stability Index (ML) (p < 0.01) with eyes open were observed after the experiment. The results show a significant deterioration in control group contrary to the experimental group where the improvement trend was observed. Moreover, the difference between the groups was observed in OSI parameter (p < 0.005) with eyes closed after the experiment.

Conclusion

The results obtained by the authors of the current study may support the thesis that educating coaches allows for better results in postural stability of child’s athletes. Nevertheless, this thesis requires further research, with particular emphasis on the age and gender of young athletes.
GC–MS of essential oil, metal profile and physicochemical properties of fruits of Citrus macrophylla Wester from Sudan
Authors: Mohammed Abdelhafeez M. A. , Alrayeh Alrayeh S. , Mohamed Moawia E. , Abdel-Rahman Nawal A.
Published: December 2021

Background

The study investigated the essential oil composition, metal profile and physiochemical properties of Citrus macrophylla Wester fruits collected from Agricultural Research Corporation, Shambat area, Khartoum North, Sudan. The species was introduced by one of the authors Dr. Moawia E. Mohamed from the National Repository of Citrus and Dates of Riverside, California, USA. This species is known as universal rootstock.

Results

The graphite furnace–atomic absorption spectrometry determined the presence of sodium (6.38 ppm), potassium (701.93 ppm), calcium (371.28 ppm), magnesium (54.78 ppm), cadmium (0.013 ppm), zinc (0.256 ppm) and lead (0.200 ppm). The content of peel, moisture and ash of C. macrophylla was measured as 18.35%, 23.75% and 2.04%, respectively. Among thirty compounds identified using gas chromatography–mass spectrometry, limonene is the major compound (72.85%). The vitamin C (ascorbic acid) content of C. macrophylla juice was determined as 55.0 mg/100 g. The fruit diameter, fruit weight and percentages of juice, peel and seed were determined as 91.4 mm, 276.5 g, 47.92%, 26.37% and 19.20%, respectively. The pH value, total soluble solids (TSS), titratable acidity (TA) and ripening index (RI) of C. macrophylla are found to be 3.50, 8.00%, 7.44% and 10.81, respectively.

Conclusion

The results in this study suggested that C. macrophylla could be beneficial in food as healthy juice.
CFD investigation of flow through a centrifugal compressor diffuser with splitter blades
Authors: Khalafallah M. G. , Saleh H. S. , Ali S. M. , Abdelkhalek H. M.
Published: December 2021

The aerodynamic losses in centrifugal compressors are mainly associated with the separated flow on the suction sides of impeller and diffuser vanes. The overall performance of such compressors can be improved by adding splitter vanes. The present work examines the effect of varying the geometrical location of the splitter vanes in the diffuser on the overall performance of a high-speed centrifugal compressor stage of a small gas turbine. To increase the pressure recovery through the diffuser, two radial sets of vanes are used. The first set of vanes (diffuser-1) is equipped with splitter vanes, placed mid-distance between the main vanes, while the vanes of the second set (diffuser-2) are conventional vanes. Flow through the compressor was simulated using the ANSYS 19 workbench program. Flow characteristics and compressor performance were obtained and analyzed for different circumferential positions of the splitting vanes relative to the main vanes of diffuser-1. The study covered seven positions of the splitter vanes including the original design of the diffuser where the splitter vanes were located at mid-distance between the main vanes. The analysis shows that, at design conditions, selecting the position of the splitter vanes to be nearer to the pressure side of the main vanes improves the stage performance. In the present study, locating the splitters at 33% of the angular distance between the main vanes leads to the best performance, and a significant improvement in the overall stage performance is recorded. The pressure recovery coefficient is raised by about 17%, the pressure ratio is increased by about 1.13%, and the stage efficiency is increased by about 2.01%, compared to the original splitter position. Performance improvement is related to the suppression of the flow separation and the more uniformity of flow. On the contrary, further moving the splitter closer to the main blade, the pressure recovery coefficient is decreased by about 2% than the position of 33% of the angular distance, but still higher than the original position by about 15% and a limited improvement in the compressor performance is noticed. Moving the splitter far out the main blade annihilates the static pressure recovery of the diffuser by about 2:7% compared with the original position. So, for the investigated compressor, the best position of the splitter blade in the circumferential direction, which provides the best stage performance in our parametric analysis, is not necessary to be at the mid-angular distance between the diffuser’s main blades, but it is achieved by moving the splitter to about 33% of the angular distance where the diminished loss from the suppressed flow separation is more prevailing and the instigated friction losses from splitter surfaces are less critical.
Life-threatening complications of streptococcal sepsis: a PICU contemporary series
Authors: Piastra M. , Ferrari V. , Picconi E. , Morena T. C. , Pezza L. , De Rosa G. , Fedele M. C. , Genovese O. , Onesimo R. , Tempera A. , Valentini P. , Buonsenso D. , Visconti F. , Zito G. , Benassi C. , Conti G.
Published: December 2021

Background

Life-threatening streptococcal sepsis nowadays represents an uncommon event in previously healthy infants and children. Critically ill patients suffering from severe streptococcal sepsis complications may present with pre-antibiotic era clinical pictures and require a timely clinical approach to achieve restitutio ad integrum.

Results

We report a series of four patient groups affected by an uncommon life-threatening streptococcal sepsis, each of them exhibiting some distinct features. Streptococcus Agalactiae sepsis was associated with cerebral thrombotic/ischaemic lesions, whereas severe cardiogenic shock was prominent in the Streptococcus Viridans group; Streptococcus Faecalis and β-hemolytic group A Streptococcus patients mostly reported lung complications.

Conclusions

Previous antibiotic treatments should not delay aggressive treatment in the intensive care setting. Early diagnostic suspicion, as well as appropriate and aggressive treatment provided within an intensive care setting are crucial for the clinical outcome.
In Vitro Comparison of Recombinant and Plasma-Derived von Willebrand Factor Concentrate for Treatment of Acquired von Willebrand Syndrome in Adult Extracorporeal Membrane Oxygenation Patients
Authors: Mazzeffi Michael , Henderson Reney , Krause Eric , Rabin Joseph , Madathil Ronson , Chow Jonathan , Grazioli Alison , Meyer Michael , Wu Zhongjun , Tanaka Kenichi
Published: December 2021

BACKGROUND:

Coagulopathic bleeding is common during adult extracorporeal membrane oxygenation (ECMO), and acquired von Willebrand syndrome is a contributing factor. We compared ECMO patient blood samples that were treated in vitro with recombinant von Willebrand Factor concentrate and plasma-derived von Willebrand Factor concentrate. Our hypothesis was that recombinant von Willebrand Factor (vWF) would have greater efficacy in increasing vWF function. Secondarily, we hypothesized that recombinant vWF would have less impact on thrombin generation.

METHODS:

Thirty ECMO patients and 10 cardiac surgical controls were enrolled in the study. ECMO patient blood samples were treated in vitro with low- and high-dose recombinant vWFs and low- and high-dose plasma-derived vWFs. Whole blood ristocetin–induced platelet aggregation (RIPA), plasma ristocetin cofactor activity (RCo), and thrombin generation were compared between ECMO patient blood samples and control blood samples and between vWF-treated ECMO patient blood samples and nontreated samples.

RESULTS:

ECMO patient blood samples had severely reduced median RIPA compared to control samples 2 ohms (1–12 [25th–75th percentile]) vs 20 ohms (11–42) (P < .001). Treatment of ECMO patient blood samples with high-dose recombinant vWF significantly increased median RIPA to 10 ohms (2–15) (P < .001), while low-dose recombinant vWF and low- and high-dose plasma-derived vWFs did not significantly increase RIPA; 6 ohms (3–14), 4 ohms (1–13), and 6 ohms (2–10), respectively (P = .25, >.99, and >.99). Treatment with high-dose recombinant vWF and low- and high-dose plasma-derived vWFs significantly increased median plasma RCo to 4.7 international units (IU)/mL (3.7–5.9), 3.3 IU/mL (2.7–4.8), and 3.9 IU/mL (3.4–5.3), respectively, compared to controls 1.8 IU/mL (1.5–2.3) (all P < .001). Treatment with low- and high-dose plasma-derived vWFs significantly increased mean endogenous thrombin potential (6270.2 ± 2038.7 and 6313.1 ± 1913.3) compared to nontreated samples (5856.7 ± 1924.6) (P = .04 and .006), whereas treatment with low- and high-dose recombinant vWFs had no significant effect on mean endogenous thrombin potential (5776.1 ± 2087.3 and 5856.2 ± 1946.4) (P > .99 for both comparisons).

CONCLUSIONS:

In vitro treatment of ECMO patient blood samples with high-dose recombinant vWF was superior to low-dose recombinant vWF and plasma-derived vWF in terms of improving RIPA. In addition, recombinant vWF treatment did not increase endogenous thrombin potential, which may reduce overall thrombotic risk if it used to treat acquired von Willebrand syndrome in ECMO patients.
Development and performance estimation of an exhaust gas recirculation cooler with dimpled rectangular tubes
Authors: Seo Y-H , Heo S-C , Ku T-W , Kim J , Kang B-S
Published: December 2021

In this study, an exhaust gas recirculation (EGR) cooler with dimpled rectangular tubes, whose heat exchange effectiveness is higher than that of a conventional cooler, is developed. To maximize the heat transfer between the exhaust gas and coolant, the dimples are formed on the surface of the heat exchange tubes. A dimpled-tube manufacturing process is established that comprises: dimple shape forming, edge bending, centre v-notch bending, compression, and plasma welding. The high effectiveness of the dimple-type EGR cooler is confirmed by the effectiveness-NTU method and experimental approaches under normal operating conditions. It is also important to verify the structural integrity, in view of the practical uses of the dimple-type EGR cooler. In order to confirm the safety of the EGR cooler, finite element analyses are carried out for each component, such as the oval core tube with a dimpled shape. The structural integrity under thermal stress and pressure, which are caused by gas and coolant flows in the shell and tubes, is evaluated through thermal and structural analyses.
The importance of association between sexsteroids deficiency, reduction of bone mineral density and falling risk in men with implications in medical rehabilitation
Authors: POPA Florina Ligia , BOICEAN Loredana Camelia , ILIESCU Madalina Gabriela , STANCIU Mihaela
Published: December 2021

Introduction. Endocrino-metabolic rehabilitation represent one of the most complex sector in clinical medicine, regarding functional rehabilitation. Sex hormones deficiency plays an important role in the etiology of osteoporosis in men. At the same time, with age, the trophic role of androgens on muscle decreases and determines an increased frequency of falls. The objective of our study is to determine the association between sexsteroids deficiency, reduction of bone mineral density (BMD) and falling risk in men.
Methods. Our retrospective cross-sectional study included 146 men aged between 65–85 years with low BMD (study group) and 121 men with normal BMD (control group). The measurement of Total testosterone (Tt), free testosterone (Tf) and estradiol (E2) serum levels was performed using the immunoassay or the immunoenzymatic methods. Femoral neck and lumbar spine BMD was determined using Dual-energy X-ray absorptiometry (DEXA). The risk of falls was assessed by Tandem Standing, Up & Go, Chair – Rising and walking speed tests.
Results. We found a significantly association between Tf and E2 deficiency and low BMD (p=0.007). Also, in men with reduced BMD (study group) we observed significant lower levels of Tf (p<0.001) and E2 (p=0.003) compared to control group. E2 deficiency was associated significantly with low BMD and increased fall risk (p=0.001). At the same time the results highlighted significant lower levels of Tf in patients with BMD reduction and increased risk of falls (p=0.002). Tt deficiency was not associated with BMD reduction (p=0.088) or increased risk of falling (p=0.277).
Conclusions. This research revealed a significant association between male sexsteroids deficiency, low BMD and increase of falling risk, with implications in rehabilitation program. The risk of ostoporosis and for falling in man can be estimated by determining serum Tf and E2 levels.
Keywords: sexsteroids deficiency; bone mineral density; falling risk,
Cost-effectiveness of home non-invasive ventilation in COPD group GOLD D patients
Authors: BERES Enikő , BABES Katalin , BERES Zsolt-Levente , DAINA Lucia Georgeta , DAINA Cristian Marius , CHEREGI Cornel , CIUMARNEAN Lorena , DOGARU Gabriela
Published: December 2021

Introduction. Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, estimated to be the third most common cause of death by 2020. The natural evolution of the disease is characterized by frequent exacerbations, severe exacerbations evolving with respiratory acidosis. Introducing home non-invasive ventilation (NIV) in the management of COPD group GOLD (Global Initiative for Chronic Obstructive Lung Disease) D patients generates supplementary costs, but the decreasing of the number of severe exacerbations will decrease the costs of drug treatment and hospitalization. This balance can be verified through a careful study of cost-effectiveness through modern methods of assessing the costs and years of life gained in relation to quality of life.
Material and method. This prospective study took place in the Emergency Department of the Bihor County Clinical Emergency Hospital, Oradea, between 01 October 2017 – 31 October2018, with a follow-up period of 2 years. We included 36 Group risk D COPD patients, presented with severe exacerbation that required NIV; the patients were divided into two study groups according to the treatment scheme after discharge (standard medication according to GOLD guidelines and long-term oxygen therapy - LTOT vs. LTOT + NIV). We follow-up at 2 years with the study group, and analyze the following: number of exacerbations (moderate and severe), number of hospitalizations, mortality rate in two years, average costs for the treatment of exacerbations and for stable COPD periods, quality adjusted life year (QALY).
Results and discussions. From 36 enrolled, 10 patients benefited from home NIV. The number of exacerbations was significantly lower in the NIV group compared with the LTOT group (1.72±0.79 vs 3.54±1.18). The incremental cost-effectiveness ratio (ICER) showed a net gain of 31% from gross product (GDP) per capita (5,641.71 ± 1,737.0-euro vs 9,272.3 ± 3,681.9 euro) per quality adjusted life year (QALY) for each patient.
Conclusions. Introduction home-NIV demonstrated clinical improvement and higher cost-effectiveness over LTOT alone in Class Risk D, COPD patients after discharge following a severe exacerbation.
Keywords: chronic obstructive pulmonary disease, non-invasive ventilation, cost-effectiveness, quality adjusted life year,
Θεομητορικοί Κανόνες Γεωργίου Νικομηδείας
Authors: Παπαγεωργίου Μαργαρίτα
Published: December 2021

Το θέμα της παρούσας διατριβής είναι η κριτική έκδοση θεομητορικών κανόνων του Γεωργίου Νικομηδείας. Κάποιοι από αυτούς εκδίδονται για πρώτη φορά, ενώ άλλοι επανεκδίδονται, καθώς απουσίαζε μια σύγχρονη έκδοσή τους. Η εργασία διαρθρώνεται σε δύο μέρη. Στο πρώτο μέρος εμπεριέχονται βιογραφικές πληροφορίες για τον υμνογράφο. Ακολούθως παρουσιάζεται το έργο του, εκδεδομένο και ανέκδοτο, καθώς και διάφορα προβλήματα που εγείρονται σε συνάρτηση με αυτό. Στο δεύτερο μέρος εκδίδονται δεκαεπτά κανόνες. Αρχικά, παρουσιάζεται η χειρόγραφη παράδοση τους. Ακολουθεί η κριτική έκδοση των κανόνων, που συνοδεύεται από υπόμνημα πηγών και υπόμνημα παράλληλων χωρίων. Πριν από την έκδοση κάθε κανόνα υπάρχει ένα εισαγωγικό σημείωμα, στο οποίο εξετάζονται ζητήματα πατρότητας και αρτιότητας των κανόνων. Επιπλέον, πραγματοποιείται η σύγκριση με το εκδεδομένο ομιλητικό και υμνογραφικό έργο του Γεωργίου σε μια προσπάθεια εντοπισμού εκφράσεων που συνηθίζει να χρησιμοποιεί ο υμνογράφος, ώστε αυτές να χρησιμεύσουν ως τεκμήρια για την απόδοση κάποιων έργων σε αυτόν. Σε επίμετρο εκδίδεται ένας κανόνας του οποίου η πατρότητα αμφισβητείται. Ακολουθεί ένα κεφάλαιο με μετρικές παρατηρήσεις.
Barriers and enablers to sustaining self-management behaviours after completing a self-management support intervention for type 2 diabetes: a protocol for a systematic review and qualitative evidence synthesis
Authors: Carvalho Márcia , Dunne Pauline , Kwasnicka Dominika , Byrne Molly , McSharry Jenny
Published: December 2021

Background: Attendance at self-management support interventions is associated with improved outcomes for people with type 2 diabetes. However, initial improvements are often not sustained beyond one year, which may be a result of difficulties in sustaining positive changes made to self-management behaviours. The aim of this systematic review is to synthesise qualitative research on the barriers and enablers to sustaining self-management behaviours following completion of a self-management support intervention for type 2 diabetes.

Methods: The review will use the “best fit” framework synthesis method to develop a new conceptual model of sustained behaviour change in type 2 diabetes. MEDLINE (Ovid), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), SCOPUS, ProQuest Dissertations and Theses, WorldCat and Open Grey will be searched to identify primary qualitative studies. A parallel search will be conducted in Google Scholar to identify relevant theories for the development of an a priori framework to synthesise findings across studies. Methodological limitations of included studies will be assessed using an adapted version of the Critical Appraisal Skills Programme tool for Qualitative Studies. A sensitivity analysis will be conducted to examine the impact of studies with methodological limitations on synthesis findings. Confidence in the synthesis findings will be assessed using the GRADE-CERQual tool. Screening, data extraction, methodological limitation assessment, synthesis and GRADE-CERQual assessment will be conducted by one author with a second author independently verifying a randomly selected 20% sample.

Discussion: This review will develop a new model of sustained behaviour change in type 2 diabetes self-management. The findings can be used to inform the development of new interventions or revision of existing interventions to better support sustained engagement in type 2 diabetes self-management behaviours.
Evaluating researcher and stakeholder perspectives on socially responsible research and innovation practices in research performing organisations
Authors: Jensen Eric A. , Lorenz Lars
Published: December 2021

The European Commission-funded GRRIP (Grounding RRI Practices) project aims to embed sustainable Responsible Research and Innovation (RRI) practices in five research performing organisations (RPOs), focusing on the marine and maritime sector. The project’s goal is to achieve institutional and cultural change through a cycle of evaluation, evidence-based interventions and further evaluation. For this purpose, a set of three surveys were designed and implemented in the first part of the project (2020) to establish a baseline measurement of RRI-related practices within the project partner institutions and their stakeholders. Each survey was specifically designed to target a relevant category of people for each of the five RPOs implementing RRI actions. These five institutions are research departments and centres linked to the marine and maritime sector in Ireland, Spain, Portugal, France and the UK. This paper presents the design of these survey-based evaluation instruments and the linked datasets generated by their implementation.
Preemptive pyloroplasty for iatrogenic vagus nerve injury in intrahepatic cholangiocarcinoma patients undergoing extensive left-sided lymph node dissection: a retrospective observational study
Authors: Hwang Shin , Jung Dong-Hwan , Jwa Eun-Kyoung , Kim Yumi
Published: December 2021

Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients.Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed.Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month.Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.
Credit Stimulus, Executive Ownership, and Firm Leverage
Authors: Chakraborti Rajdeep , Dahiya Sandeep , Ge Lei , Gete Pedro
Published: December 2021

We show that executive ownership is a significant driver of the demand for credit following credit expansion policies. Our focus on credit demand is in contrast to most studies that have focused on credit supply factors such as bank capital. Our identification exploits the large and unexpected Chinese credit expansion in 2008. This setting offers a unique advantage as in 2008 the Chinese government had almost complete control over the banking sector and it directed the banks to increase credit supply. Thus, in this setting, demand, rather than supply, largely drives the observed changes in firms’ borrowing. We provide extensive robustness tests to validate our results.

This paper was accepted by Kay Giesecke, finance.
Tempo não é evidência: uma análise acerca do tempo processual como fundamento da tutela provisória baseada em evidência do artigo 311 do CPC
Authors: Rosalen Volnei
Published: December 2021

A tutela da evidência, incorporada de forma explícita ao quadro das técnicas de tutela provisória no CPC de 2015, toma como pressuposto a ideia de existência de um direito evidente do autor da ação, que condiciona uma maior efetividade da prestação jurisdicional nos casos previstos na lei processual. Direito “líquido e certo” e direito “evidente” devem estar associados invariavelmente às evidências que os suportam, ou seja, às provas. E, eventualmente, à incapacidade do réu de sustentar dúvida razoável quanto ao direito pleiteado.  A descrição e/ou fundamentação da tutela da evidência em uma eventual melhora do tempo do processo, ou redistribuição dos ônus desse tempo – que aparecem como fundamento implícito da tutela da evidência – embora política, econômica e sociologicamente defensáveis, não constituem elemento processual chave para a decisão da concessão da tutela. O artigo aborda esta questão, dialogando com visões doutrinárias a respeito.
A DISTRIBUIÇÃO DINÂMICA DO ÔNUS DA PROVA NO CÓDIGO DE PROCESSO CIVIL E SUA APLICAÇÃO NOS TRIBUNAIS ESTADUAIS À LUZ DA MAD (METODOLOGIA DE ANÁLISE DE DECISÕES)
Authors: Teixeira Pablo Mateus Matos da Silva , Pedron Flávio Quinaud
Published: December 2021

RESUMO: O presente trabalho traz uma análise acerca da Distribuição Dinâmica do ônus da prova implementada pelo Novo Código de Processo Civil. Como a novidade implementada pelo referido código se trata de um assunto de salutar importância no que tange a construção dos provimentos jurisdicionais em um cenário de processo democrático, nós propomos, por tal razão, a estudar tal teoria, e como é realizada sua aplicação nos Tribunais de Justiça da Bahia e Minas Gerais. O presente artigo foi redigido a partir de uma revisão bibliográfica sobre a teoria da distribuição dinâmica do ônus da prova tomando como base artigos científicos, livros e trabalhos acadêmicos de notáveis relevância para o tema, bem como com a análise jurisprudencial do Tribunal de Justiça da Bahia e Minas Gerais. PALAVRAS-CHAVE: Teoria da Carga Dinâmica. Inversão consumerista. Processo Democrático. Ônus da Prova
INTELIGÊNCIA ARTIFICIAL NA TOMADA DE DECISÕES JUDICIAIS: TRÊS PREMISSAS BÁSICAS
Authors: Roque Andre , Santos Lucas Braz Rodrigues dos
Published: December 2021

O Poder Judiciário brasileiro enfrenta enorme crise numérica, havendo um contingenciamento processual invencível, de modo que a comunidade jurídica não pode virar as costas para os benefícios da inteligência artificial, porém é preciso que sejam adotados alguns cuidados, garantindo-se a publicidade dos atos judiciais e transparência dos algoritmos, a informação prévia ao jurisdicionado sobre a adoção da inteligência artificial na tomada de decisões, o efetivo acesso à justiça amparado no direito subjetivo de acesso aos juízes e, sobretudo, o direito de revisão das decisões automatizadas sem a utilização dos mecanismos algorítmicos, a fim de que sejam mantidos incólumes os pilares democráticos da república brasileira, em especial o devido processo legal constitucional.
(IN)VALIDADE DAS CONVENÇÕES PROCESSUAIS ATÍPICAS E VULNERABILIDADE: UMA ANÁLISE À LUZ DO AUTORREGRAMENTO DA VONTADE
Authors: Oliveira Edson Freitas de , Brambilla Pedro Augusto De Souza , Junqueira Laura
Published: December 2021

O autorregramento da vontade incide não apenas no Direito Privado, mas também no Direito Público, como é o caso do Direito Processual Civil. O Código de Processo Civil de 2015 materializou tal princípio em diversos dispositivos, evidenciando o protagonismo assumido pelas partes no modelo processual contemporâneo. Nesse sentido, o artigo 190 possibilita que as partes realizem negócios processuais atípicos. Entretanto, seu parágrafo único impõe limitações à liberdade dos convenentes quando um deles for vulnerável. Relevante, portanto, analisar a liberdade, igualdade e vulnerabilidade aplicadas no processo civil, delimitando-se como se realizará o controle de validade das convenções processuais pelo magistrado.
A palavra do policial como meio de prova nos processos envolvendo a Lei de Drogas e o seu reflexo na seletividade do sistema penal
Authors: Secorun Inacio Mariana , Manzoni Bueno Marina
Published: December 2021

O presente artigo tem como objetivo a análise da palavra do policial e o seu impacto nos delitos envolvendo a Lei 11.343/06. Para tanto, analisa-se a prova testemunhal no processo penal brasileiro, com o intuito de possibilitar a compreensão da palavra do policial como meio de prova e seus reflexos no processo criminal. Além disso, são explanadas questões pertinentes a legislação sobre drogas no contexto internacional e no Brasil, para, por fim, entender de que maneira a palavra dos agentes públicos influencia na condenação pelos crimes previstos na Lei de Drogas, contribuindo para a seletividade do sistema penal nacional.
PRECEDENTES JUDICIAIS E PADRÕES DECISÓRIOS: DA INTEGRIDADE E COERÊNCIA AO “GAP” DA TAXATIVIDADE MITIGADA DO ROL DO ARTIGO 1.015 DO CÓDIGO DE PROCESSO CIVIL
Authors: Ferreira Débora Fernanda , Borges Fernanda Gomes e Souza
Published: December 2021

O presente ensaio propõe-se a analisar os conceitos de precedentes judiciais e padrões decisórios visando, principalmente, contribuir para o debate doutrinário sobre a suposta existência de um “sistema de precedentes”, inaugurado pelo CPC/2015, no ordenamento jurídico brasileiro. Oportunamente, faz-se também uma análise sobre o confronto entre os preceitos de integridade e coerência, preconizados pela teoria de Ronald Dworkin e presentes no CPC/2015, e a instabilidade jurídica causada por “gaps” decorrentes dos próprios padrões decisórios, como é o caso da taxatividade mitigada do rol do artigo 1.015 do CPC, analisando possíveis técnicas para superação dos problemas que possam advir dali.