bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Caesarean Expenditures of Households in Benin
Authors: Gnimassou Tchomi Oluwa Romuald Tchadrack , Filiz Emel
Published: June 2023

After years of effort, sub-Saharan Africa has seen little improvement in maternal and neonatal health indicators. Providing all women with access to emergency obstetric care is an accepted effective strategy to reduce maternal and neonatal mortality. In many African countries such as Benin, the cost of health care is a major obstacle to access obstetric care. The aim of this study was to evaluate the caesarean section expenditures of households in Benin and to determine the strategies for obtaining the necessary resources to meet the caesarean section expenditures of the households. Three hospitals and 505 households in the Littoral region were sampled, and data were collected by applying a questionnaire to the people accompanying the woman to the hospital. The socioeconomic status of the households was evaluated using a wealth index created by principal component analysis. Factors significantly associated with expenditure were determined using multivariate linear regression analysis. Despite the free caesarean section policy in effect, households spend a median of US$180.60 (IQR: 148.13–222.35) for a caesarean section, of which 76.0% are direct costs, 17.0% are indirect costs, and 7.0% are opportunity costs. Expenditures vary considerably depending on the residence area of the household, the presence of complications, the presence of health insurance, the socioeconomic class of the households, the education level, and working status of the woman. Finally, households use 11 strategies to obtain funds to pay for the caesarean costs. While poor households resort to foreign aid, asset sales, and/or current spending cuts, the rich use their income and/or savings to cover their caesarean section expenses. The results favour the adoption of a mechanism for direct exemption of the costs of caesarean sections payable by the poorest households, in addition to the current free caesarean policy.
Modeling and Performance Analysis of Flying Mesh Network
Authors: Shenghong Qin , Renhui Xu , Laixian Peng , Xingchen Wei , Xiaohui Wu
Published: June 2023

Maintaining good connectivity is a major concern when constructing a robust flying mesh network, known as FlyMesh. In a FlyMesh, multiple unmanned aerial vehicles (UAVs) collaborate to provide continuous network service for mobile devices on the ground. To determine the connectivity probability of the aerial link between two UAVs, the Poisson point process (PPP) is used to describe the spatial distribution of UAVs equipped with omnidirectional antennas. However, the PPP fails to reflect the fact that there is a minimum distance restriction between two neighboring UAVs. In this paper, the

β

-Ginibre point process (

β

-GPP) is adopted to model the spatial distribution of UAVs, with

β

representing the repulsion between nearby UAVs. Additionally, a large-scale fading method is used to model the route channel between UAVs equipped with directional antennas, allowing the monitoring of the impact of signal interference on network connectivity. Based on the

β

-GPP model, an analytical expression for the connectivity probability is derived. Numerical tests are conducted to demonstrate the effects of repulsion factor

β

, UAV intensity

ρ

, and beamwidth

θ

on network connectivity. The results indicate that an increase in UAV intensity decreases network connectivity when the repulsion factor

β

remains constant. These findings provide valuable insights for enhancing the service quality of the FlyMesh.
Supplementary Fig. 3 from A Phase 1/2 Multicenter Randomized Trial of Local Ablation plus Toripalimab versus Toripalimab Alone for Previously Treated Unresectable Hepatocellular Carcinoma
Authors: Zhou Chunhui , Li Yan , Li Jiaping , Song Botian , Li Hanfeng , Liang Bin , Gu Shanzhi , Li Haiping , Chen Changyong , Li Sai , Peng Changli , Liu Fei , Xiao Juxiong , Long Xueying , Li Ping , Xiong Zhengping , Yi Xiaoping , Liao Weihua , Shi Liangrong
Published: June 2023

Supplementary Fig. 3 A. Progression-free survival by CD8+ TIL density. B. Overall survival by CD8+ TIL density. Dot marks indicate censored data.
Supplementary Data 1 from A Phase 1/2 Multicenter Randomized Trial of Local Ablation plus Toripalimab versus Toripalimab Alone for Previously Treated Unresectable Hepatocellular Carcinoma
Authors: Zhou Chunhui , Li Yan , Li Jiaping , Song Botian , Li Hanfeng , Liang Bin , Gu Shanzhi , Li Haiping , Chen Changyong , Li Sai , Peng Changli , Liu Fei , Xiao Juxiong , Long Xueying , Li Ping , Xiong Zhengping , Yi Xiaoping , Liao Weihua , Shi Liangrong
Published: June 2023

Supplementary Method, Table 1-9
Vaccination and Microbiota Manipulation Approaches for Colon Cancer Prevention in Rodent Models
Authors: Tosti Elena , Srivastava Nityanand , Edelmann Winfried
Published: June 2023

Colorectal cancer represents the third most common cancer type worldwide and is a leading cause of cancer-related mortality in the United States and Western countries. Rodent models have been invaluable to study the etiology of colorectal cancer and to test novel chemoprevention avenues. In the past, the laboratory mouse has become one of the best preclinical models for these studies due to the availability of genetic information for commonly used mouse strains with well-established and precise gene targeting and transgenic techniques. Well-established chemical mutagenesis technologies are also being used to develop mouse and rat models of colorectal cancer for prevention and treatment studies. In addition, xenotransplantation of cancer cell lines and patient-derived xenografts has been useful for preclinical prevention studies and drug development. This review focuses on the recent use of rodent models to evaluate the utility of novel strategies in the prevention of colon cancers including immune prevention approaches and the manipulation of the intestinal microbiota.
Old Problem in a New Guise: Retinal Pigment Epithelium Tear after Intravitreal Faricimab (Vabysmo®) Injection
Authors: Clemens Christoph R , Alten Florian , Zimmermann Julian A , Eter Nicole
Published: June 2023

This case report describes a 78-year-old patient who developed a tear of the retinal pigment epithelium (RPE) during faricimab (Vabysmo®) therapy. After three consecutive intravitreal aflibercept (Eylea®) injections with persistent disease activity, therapy was switched to faricimab. The patient experienced a tear in the RPE 4 weeks postinjection. We report the first published case of RPE tear development after intravitreal faricimab injection in neovascular age-related macular degeneration. Faricimab has a new target structure in the angiopoietin-2 receptor in addition to VEGF. Patients at risk for RPE rupture were excluded from pivotal studies. Further investigation is needed to understand the effect of faricimab not only on visual acuity and intraretinal and subretinal fluid but also on mechanical stress on the RPE monolayer.
Expanded Spectrum Torpedo Retinopathy: A Case Series
Authors: Jiao George , Goldburg Samantha R. , Breazzano Mark P , Pandey Avi
Published: June 2023

Torpedo lesions in the retina are rare, and their clinical significance has not been well established. This case series highlights patients with atypical torpedo lesions with varying orientations and pigmentation patterns. We describe the first documented case of an inferiorly oriented lesion, to our knowledge, and add to the few previous descriptions of double-torpedo lesions.
Real-World Evaluation of Demographics, Treatment Pattern, and Economic Burden of Heart Failure and Kidney Disease in Type 2 Diabetes Mellitus Patient Population in Dubai, United Arab Emirates
Authors: Bashier Alaaeldin , Farghaly Mohamed , Alali Juwairia Yousif , AlHadari Amna Khalifa , Ajaz Yasmin , Warrier Vani Krishna , Abdelgadir Elamin , Farooqi Muhammad Hamed , Qamar Sana , Alsayed Mohamed , Fahmy Mohamed Samir , Tannouri Dali , Gowda Arun Jayarame , Awad Nancy Syed , Ramachandrachar Badarinath Chickballapur , Natarajan Ashok
Published: June 2023

Aims: The current study evaluated the demographics, clinical characteristics, treatment patterns, and economic burden of patients with type 2 diabetes mellitus (T2DM) with comorbidities (heart failure [HF], chronic kidney disease [CKD], and cardiovascular disease [CVD] without HF) in Dubai, United Arab Emirates (UAE). Methods: This observational, retrospective study collected data from January 01, 2014, to December 31, 2019, from the Dubai Real-World Claims Database (adults ≥18 years; at least 1 T2DM diagnosis claim). Patients were stratified into 5 cohorts: T2DM alone (cohort 1), T2DM and CKD (cohort 2), T2DM and CVD without CKD and HF (cohort 3), T2DM and HF (cohort 4), and T2DM with HF and CKD (cohort 5). An evaluation of demographics and clinical characteristics during pre-index period, as well as treatment patterns, healthcare resource utilization, and costs during the post-index period was conducted. Results: The sample had 374,271 patients with T2DM (age 43–56 years; male [72–84%]). Patients in cohorts 4 and 5 had Deyo-Charlson Comorbidity Index scores of 4.4 and 5.8, respectively. General practitioners (GPs) routinely prescribed biguanides for patients in cohorts 1–4 (24–38%), and insulin to patients in cohort 5 (27.7%). Prescription rates of novel antihyperglycemic drugs, such as glucagon-like peptide-1 (GLP-1 RA), were very low (∼2–8%) even in cohorts with cardiovascular and renal comorbidities (cohorts 2–5). A similar observation was noted with prescribing rates (0.6–4.4%) of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in cohorts 2–5. Endocrinologists preferred to prescribe GLP-1 RA and SGLT2i to T2DM patients with comorbidities. During the 5-year study period, median outpatient claims were the highest in cohort 5 (8.0 [range, 1.0–168.0]), followed by cohort 2 (5.5 [range, 1.0–52.0]). The median cost for inpatient claims was higher in cohort 5 (16,429 [range, 3,732–29,126] AED) compared to other cohorts. The median cost for drugs and procedures was highest in cohort 5 (4,525 [range, 38–31,546] AED and 2,297 [range, 56–105,074] AED, respectively). Conclusion: Continued and increased usage of drugs such as SGLT2i and GLP-1 RA with proven cardiorenal benefits could improve long-term outcomes and reduce associated healthcare costs in patients with T2DM and comorbidities in Dubai, UAE.
Nail Unit Arteriovenous Hemangioma Presenting as Longitudinal Erythronychia
Authors: Hwang Jonathan Kyle , Magro Cynthia M. , Lipner Shari R.
Published: June 2023

Introduction: Localized longitudinal erythronychia is defined as a single nail with a longitudinal red band extending the length of a nail plate. It has a broad differential of benign and malignant etiologies, and is rarely due to benign vascular proliferations. Case Presentation: We present a unique case of nail unit arteriovenous hemangioma presenting as longitudinal erythronychia of the left thumbnail in a 76-year-old male. The band was 6 mm and encompassed over 40% of the surface area of the nail plate. Dermoscopy showed red bands that were regular in terms of color, but not thickness or spacing. Due to concern for an amelanotic melanoma, a longitudinal excision was performed. Histopathology was consistent with a diagnosis of nail unit arteriovenous hemangioma. Conclusion: Arteriovenous hemangiomas were rarely present in the nail unit. They can be present as a blue or red nodule/macule, or as longitudinal erythronychia. Diagnosis often requires an excisional biopsy, with histopathology notable for a proliferation of multiple thick- and thin-walled vascular structures lined by a flattened endothelium. Our case emphasizes the need to consider vascular proliferations, such as arteriovenous hemangioma, in the differential diagnosis of longitudinal erythronychia.
Use of Some Relevant Parameters for Primary Prediction of Brain Activity in Idiopathic Tinnitus Based on a Machine Learning Application
Authors: Mohsen Samer , Sadeghijam Maryam , Talebian Saeed , Pourbakht Akram
Published: June 2023

Introduction: Tinnitus is one of the most common complaints, distressing about 15–24% of the adult population. Because of its pathophysiology heterogeneity, no curable treatment has been attained yet. Even though a neuromodulation management technique based on the tinnitus network model is currently being developed, it has not yet worked because the most involved brain areas still remain unpredictable from the patient’s individual clinical and functional profile. A remarkable correlation between tinnitus network activity and the subjective measures of tinnitus like perceived loudness and annoyance and functional handicap is well established. Therefore, this study aimed to develop software for predicting the involved brain areas in the tinnitus network based on the subjective characteristics and clinical profile of patients using a supervised machine-learning method. Methods: The involved brain areas of 30 tinnitus patients ranging from 6 to 80 months in duration were recognized by using QEEG and sLORETA software. There was a correlation between subjective information and those areas of activities in all rhythms by which we wrote our software. Results: For verification and validation of the software, we compared and analyzed the results with SPSS data and the receiver operating characteristic (ROC) curves. Conclusions: The findings of this study confirmed the effectiveness of the software in predicting the brain activity in tinnitus subjects; however, some other important parameters can be added to the model to strengthen its reliability and feasibility in clinical use.
Clinical Characteristics and Outcomes in Patients With Heart Failure: Are There Thresholds and Inflection Points in Left Ventricular Ejection Fraction and Thresholds Justifying a Clinical Classification?
Authors: Kondo Toru , Dewan Pooja , Anand Inder S. , Desai Akshay S. , Packer Milton , Zile Michael R. , Pfeffer Marc A. , Solomon Scott D. , Abraham William T. , Shah Sanjiv J. , Lam Carolyn S.P. , Jhund Pardeep S. , McMurray John J.V.
Published: June 2023

BACKGROUND:

Recent guidelines proposed a classification for heart failure (HF) on the basis of left ventricular ejection fraction (LVEF), although it remains unclear whether the divisions chosen were biologically rational. Using patients spanning the full range of LVEF, we examined whether there was evidence of LVEF thresholds in patient characteristics or inflection points in clinical outcomes.

METHODS:

Using patient-level information, we created a merged dataset of 33 699 participants who had been enrolled in 6 randomized controlled HF trials including patients with reduced and preserved ejection fraction. The relationship between the incidence of all-cause death (and specific causes of death) and HF hospitalization, and LVEF, was evaluated using Poisson regression models.

RESULTS:

As LVEF increased, age, the proportion of women, body mass index, systolic blood pressure, and prevalence of atrial fibrillation and diabetes increased, whereas ischemic pathogenesis, estimated glomerular filtration rate, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) decreased. As LVEF increased >50%, age and the proportion of women continued to increase, and ischemic pathogenesis and NT-proBNP decreased, but other characteristics did not change meaningfully. The incidence of most clinical outcomes (except noncardiovascular death) decreased as LVEF increased, with a LVEF inflection point of around 50% for all-cause death and cardiovascular death, around 40% for pump failure death, and around 35% for HF hospitalization. Higher than those thresholds, there was little further decline in the incidence rate. There was no evidence of a J-shaped relationship between LVEF and death; no evidence of worse outcomes in patients with high-normal (“supranormal”) LVEF. Similarly, in a subset of patients with echocardiographic data, there were no structural differences in patients with a high-normal LVEF suggestive of amyloidosis, and NT-proBNP levels were consistent with this conclusion.

CONCLUSIONS:

In patients with HF, there was a LVEF threshold of around 40% to 50% where the pattern of patient characteristics changed, and event rates began to increase compared with higher LVEF values. Our findings provide evidence to support current upper LVEF thresholds defining HF with mildly reduced ejection fraction on the basis of prognosis.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT00634309, NCT00634400, NCT00634712, NCT00095238, NCT01035255, NCT00094302, NCT00853658, and NCT01920711.
Designing a Multilateral Investment Court for Procedural Justice
Authors: Garcia Frank J. , Guven Brooke S.
Published: June 2023

Working Group III of the United Nations Commission on International Trade Law has embarked on a mandate to reform investor-State dispute settlement (ISDS), through identifying a set of concerns that merit multilateral procedural reform. In response, the EU has proposed creating a standing multilateral investment court. Despite the importance of procedural justice theory in domestic legal systems, its value as a resource in international dispute resolution is under-recognized. This article focuses on procedural justice through the literature on the social psychology of justice, as offering an empirically-based theoretical foundation that helps identify key elements and options in designing investment adjudication. Within ISDS reform, the authors focus on necessary innovations in independence and impartiality, transparency, participation, and correction of error, the key pillars of procedural justice research. The EU proposal suggests substituting a more traditional judicial model of dispute resolution for the current and problematic arbitral model, which aligns to a greater degree with the principles of procedural justice.
Preferences under uncertainty
Authors: Osborne Martin J. , Rubinstein Ariel
Published: June 2023

This chapter studies an instance of the model in which an alternative in the set involves randomness regarding the consequence it yields. We refer to these alternatives as lotteries.
Equilibrium with prices and expectations
Authors: Osborne Martin J. , Rubinstein Ariel
Published: June 2023

In the models of markets we have discussed so far, equilibrium prices make the individuals’ decisions compatible. Each individual takes the prices as given when deciding on her action, and at the equilibrium prices the demand and supply of every good are equal.

In this chapter, an individual’s behavior is affected not only by the prices but also by her expectations regarding other parameters. Each individual takes these expectations, like the prices, as given. In equilibrium, each individual behaves optimally, the supply and demand for each good are equal, and the expectations of individuals are correct.

We present three models. In the first model, each individual chooses one of two bank branches. Her decision is affected only by her belief about the expected service time in each branch. In the second model, potential buyers of a used car, who cannot observe the quality of the cars for sale, take into account their expectation of the average quality of these cars as well as the price. In the third model, the unit cost of catching fish depends on the total amount of fish caught. Each fisher makes her decision taking as given both the price of fish and her expectation about the unit cost she will incur.
Matching
Authors: Osborne Martin J. , Rubinstein Ariel
Published: June 2023

Consider the following problem. Some individuals in a society are X’s and others are Y ’s. Every individual of each type has to be matched with one and only one individual of the other type. For example, managers have to be matched with assistants, or pilots have to be matched with copilots. Each X has preferences over the Y ’s and each Y has preferences over the X’s. Every individual prefers to be matched than to remain unmatched. We look for matching methods that result in sensible outcomes given any preferences.
Producer behavior
Authors: Osborne Martin J. , Rubinstein Ariel
Published: June 2023

Producers, like consumers, play a central role in economic models. A consumer can trade goods, changing the distribution of goods among the agents in the economy. A producer can change the availability of goods, transforming inputs, which may be physical goods, like raw materials, or mental resources, like information and attention, into outputs. This chapter considers a producer who acts as if her behavior has no effect on the prices of the input or output. It is argued that this assumption may be appropriate if the producer’s quantities of inputs and output are small relative to the total volume of trade in the markets.
Analysis of differentially expressed genes in bile acid-treated liver cancer cells
Authors: Zha Yongzhong , Jiang Zheyu , Zhao Xuya , Zhou Shi , Jiang Tianpeng , Wang lizhou
Published: June 2023

Liver cancer is one of the tumors of digestive system. Bile acids are derivatives of choline acids and play a regulatory role in tumors. However, the gene expression profiles in liver cancer cells after bile acid treatment remain unclear. Human hepatoma cell line SMMC7721 was herein
cultured. mRNA expression profile was detected by mRNA suppression subtractive hybridization. SMMC7721 cells were divided into 3 groups: control group, DLC1 (deleted in hepatocellular carcinoma 1) group and DLC1 siRNA group. The expression of DLC1, cell proliferation, cell apoptosis and cell
invasion were detected by Transwell chamber method. The expressions of VEGF, MMP-2 and DLC1 were detected by Western blot. After bile acid treatment, DLC1, B-cell receptor-associated protein 31 (BCAP31), extension factor 1-α1 (eEF1a1), cell division cycle 20 (CDC20), WD repeat
containing protein 6 (WDR6), extension factor Tu and mitochondria (TUFM) were the most significantly increased genes. DLC1 gene was selected with most significant changes. Overexpression of DLC1 significantly decreased expression of VEGF, MMP-2, and ephrin type-A receptor 2 (EphA2) (P
<0.05). Transfection of DLC1 siRNA significantly down-regulated DLC1, promoting cell proliferation, decreasing Caspase3 activity, and increasing cell invasion, expression of VEGF, MMP-2 and EphA2 (P <0.05). Bile acid can cause differential gene expressions in liver cancer cells
with DLC1 changes being most significant. DLC1 can influence the invasion and of proliferation hepatoma cells by regulating the expression of VEGF, MMP-2 and EphA2.
Lidocaine-loaded polylactic acid-poly(ε-caprolactone) nano capsules to improve sustainable drug delivery system for nursing care of pain management
Authors: Li Wei , Guo Meiying , Zeng Jia , Yue Xionghua , Zhang Xiaohong
Published: June 2023

In recent years, drug-loaded polymeric nano capsules have demonstrated potential as drug delivery methods. In this work, lidocaine (LID) loaded polylactic acid-poly(ε-caprolactone) (PLA-PCL) nano capsules were prepared to achieve the controlled drug release. The mechanical characteristics of the PLA-PCL nano capsules were examined via rheological analysis. The composite structure of the PLA-PCL nano capsules, which had a size of less than 1μm, exhibited a smooth surface without cracks or pores. DLS studies were used to assess PLA-PCL nanoparticle solutionsin vitroin terms of particle size (87.5 nm), polydispersity (0.42), and zeta potential surface charge (−24.1 mV). The effective development of PLA-PCL nano capsules with desired physicochemical characteristics and a controlled release mechanism. The LID containing PLA-PCL nano capsules exhibited remarkable encapsulation efficiency and drug loading (78.8±1.92% and 7.53±0.75%). Cytotoxicity assays test on Balb-c 3T3 cells confirmed that the LID-loaded PLA-PCL nano capsules reduced its toxicity, relative to the free LID drug. Thein vivoresults demonstrated that the LID-loaded PLA-PCL nano capsules significantly endorsed healing in mice defects compared to PLA-PCL nano capsules alone. These findings indicate the potential of LID-loaded PLA-PCL nano capsules as sustainable drug delivery systems for pain management in emerging nursing care.
Ajugol attenuates renal injury in multiple myeloma by blocking LILRB4 signaling pathway to reduce PFKFB3 expression
Authors: Xu Rong , Tian Feng , Zhao Xiumin , Peng Qiang , Zhou Junfeng , Wang Weilong
Published: June 2023

Motherwort exhibits a curative effect on kidney damage and its component, ajugol, also might improve kidney damage. Therefore, this study assesses the mechanism whereby ajugol alleviates renal injury in multiple myeloma. After establishment of animal model of multiple myeloma (n
= 30), mice received treatment with low-dose and high-dose ajugol (n = 10, each group). And 10 healthy mice were taken as control group and 10 modeled mice were untreated (model group). Following treatment, the serum and spinal cord samples of the mice were collected, in which the levels
of Cys-C, RBP, Cr, UN, CD4+, CD8+, and CD25+ were examined and the expression of LILRB4 and PFKFB3 proteins in myeloma tissue were detected. Compared with model group, the levels of serum Cys-c, RBP, Cr and UN in low-dose and high-dose groups decreased, but
were still higher than those in control group (P <0.05). Of ajugol groups, the levels in high-dose group were lower (P <0.05). Importantly, the treatment of ajugol greatly alleviated lesions of myeloma tissue and reduced infiltration of inflammatory cells via lowering the
levels of serum CD4+, CD8+, and CD25+. Besides, ajugol dose-dependently decreased LILRB4 and PFKFB3 expression in myeloma tissue samples. Ajugol, a bioactive component of motherwort, blocked the LILRB4 signaling and reduced PFKFB3 expression to inhibit the
activity of immune cells and thereby alleviating renal injury in multiple myeloma. This is related to significant inhibition of multiple myeloma cell glycolysis and reduction of intracellular energy metabolism, indicating the anti-cancer potential of ajugol.
Multiweek Prediction and Attribution of the Black Saturday Heatwave Event in Southeast Australia
Authors: Abhik S. , Lim Eun-Pa , Hope Pandora , Jones David A.
Published: June 2023

Southeastern Australia experienced an extreme heatwave event from 27 January to 8 February 2009, which culminated in the devastating “Black Saturday” bushfires that led to hundreds of human casualties and major economic losses in the state of Victoria. This study investigates the causes of the heatwave event, its prediction, and the role of anthropogenic climate change using a dynamical subseasonal-to-seasonal (S2S) forecast system. We show that the intense positive temperature anomalies over southeastern Australia were associated with the persistent high pressure system over the Tasman Sea and a low pressure anomaly over southern Australia, which favored horizontal warm-air advection from the lower latitudes to the region. Enhanced convection over the tropical western Pacific and northern Australia due to weak La Niña conditions appear to have played a role in strengthening the high pressure anomalies over the Tasman Sea. The observed climate conditions are largely reproduced in the hindcast of the Australian Community Climate and Earth System Simulator–Seasonal prediction system version 1 (ACCESS-S1). The model skillfully predicts the spatial characteristics and relative intensity of the heatwave event at a 10-day lead time. A climate attribution forecast experiment with low atmospheric CO2 and counterfactual cold ocean–atmospheric initial conditions suggests that the enhanced greenhouse effect contributed about 3°C warming of the predicted event. This study provides an example of how a S2S prediction system can be used not only for multiweek prediction of an extreme event and its climate drivers, but also for the attribution to anthropogenic climate change.
High Grade Intestinal Obstruction From Internal Hernia Beneath an Intraperitoneal External Iliac Artery
Authors: Chaconas Christen E. , Moncada Isabella C. , Pepe Antonio P. , Matzinger Steven A.
Published: June 2023

Acute small bowel obstruction (SBO) is a common cause of emergency department visits in the United States, and it accounts for approximately 20% of emergency surgical operations.1 Its etiology is divided into intrinsic luminal obstruction or extrinsic compression of the bowel.2 Among the causes of SBO, by far the most common is intraperitoneal adhesions due to previous abdominal surgeries, which comprises about 60-70% of the cases.2 The abdominal cavity is subdivided into the peritoneal cavity and the retroperitoneal cavity; the division is marked by a thin covering of parietal peritoneum that encases all the intraperitoneal structures. Here, we present a rare case of an acute small bowel obstruction secondary to exposure of the retroperitoneal external iliac artery from a surgical procedure 20 years prior to presentation.
Prognostic Value of Tumor Size in Colon Cancer—Smaller is Better?
Authors: Meng Yan , Wang Bingyan , Lin Hsinyi , Li Fei , Lu Siyi , Wang Junwei , Wang Hao , Guo Limei , Zhou Xin , Fu Wei
Published: June 2023

Background

The prognostic value of tumor size in colon cancer remains controversial. This study aimed to reveal the correlation between tumor size and prognosis of colon cancer.

Methods

A total of 491 patients with colon cancer were included in this study. The correlation of tumor size with prognosis, mismatch repair status, and other clinicopathological characteristics as well as tumor microenvironment was analyzed.

Results

For stage IIA microsatellite stable (MSS) colon cancer, tumors sized <3.5 cm and ≥5 cm were associated with a poorer disease free survival (DFS) compared with tumors sized between 3.5 and 5 cm ( P = .002). Small tumor size (HR = 5.098, P = .001) and large tumor size (HR = 2.749, P = .029) were found to be independent prognostic factors for stage IIA MSS colon cancer. Moreover, high expression of transgelin (TAGLN), a marker of cancer-associated fibroblasts (CAFs), was found to be an independent prognostic factor for poorer DFS (HR = 9.651, P = .009), which was also associated with smaller tumor size ( P = .027).

Conclusion

Small (<3.5 cm) and large (≥5 cm) tumor sizes are associated with decreased DFS in stage IIA MSS colon cancer. Enrichment of TAGLN+ CAFs is associated with decreased DFS and small tumor size.
Wind farm control and power curve optimization using induction-based wake model
Authors: Jahantigh Reza , Esmailifar Sayyed Majid , Sina Seyyed Ali
Published: June 2023

This paper proposes a control strategy to achieve minimum wake-induced power losses in a wind farm. At first, the axial-induction-based wake model is developed to consider the aerodynamic wake interactions among wind turbines. To optimize the generated power of the whole wind farm, the axial induction factor of each wind turbine is calculated by the genetic algorithm. As a supervisory controller, each wind turbine’s optimal axial induction factor calculated by the genetic algorithm is implemented as a setpoint of each wind turbine’s internal controller. In the internal control loop, a comprehensive controller is designed to track the commanded axial induction factor. In the partial load region, the commanded axial induction factor was attained by tuning the generator torque. In the transient and full load regions, the blade pitch angle is tuned to keep the generator speed and torque at the rated values. The performance of the proposed control strategy is investigated through case studies, including three different wind speeds and a time-varying wind speed case in a 3 × 3 wind-farm layout. The simulation results show the satisfactory performance of the proposed approach.
Prediction of hunting instability index of high-speed railway vehicles based on a coupled 2DCNN-GRU model
Authors: Shuangxi Chen
Published: June 2023

A coupled Two-Dimension Convolutional Neural Network-Gated Recurrent Unit (2DCNN-GRU) model is proposed to evaluate and predict the hunting instability of high-speed railway vehicles in this paper. First, vibration accelerations of four measuring points on the surface of the bogie frame of a high-speed railway vehicle in good working condition and with hunting instability are obtained through a line test and model simulation. The vibration acceleration data under different conditions is cut into many pieces at equal intervals. Low-frequency band-pass filtering is applied to each piece to obtain filtered vibration data, which is then analyzed separately to get a sample set of spectrum images, including short-time Fourier spectrum, Hilbert time-frequency-amplitude spectrum, and marginal spectrum. Then, a 2DCNN model is proposed to extract features by deeply studying the spectrum images of each piece of the filtered vibration data. The root-mean-square (RMS) of the vibration responses of four measuring points on the surface of the bogie frame and the mean value of the filtered vibration response envelope are calculated and recorded for each piece. The Hunting Instability Index (HII) is proposed by considering the weighted mean of RMS and the envelope mean of the filtered vibration responses to quantitatively get the extent of hunting instability. Finally, the GRU method is applied to predicting the dynamic change of HII indicators, and the effectiveness and accuracy of the method are verified by typical examples. One contribution of this work is proposing a method to evaluate the hunting motion by image identification of the short-time Fourier spectrum, Hilbert time-frequency-amplitude spectrum, and marginal spectrum of vibration signals, and another is the definition of HII based on 2DCNN and statistics.
Time-dependent thermo-mechanical behavior of graphene epoxy nanocomposites: Creep, relaxation, compression
Authors: Birkan Besim Emre , Bakbak Okan , Colak Ozgen , Acar Alperen
Published: June 2023

The purpose of this work is twofold: the manufacturing of functionalized graphene (f-GNF) epoxy nanocomposite and time-dependent thermomechanical characterization of epoxy and nanocomposite. To accomplish these purposes, f-GNF-epoxy nanocomposites are produced for two different graphene fractions (0.1 and 0.5 wt%) using the non-covalent functionalization and three roll milling (3RM) dispersion techniques. Dynamic Mechanical Analysis (DMA) is performed to determine temperature-dependent viscoelastic properties. Quasi-static compression, creep and relaxation tests are conducted at two different temperature values: 65°C and 120°C. As expected, experimental results revealed that the elasticity modulus and yield stress decrease with increasing temperature. It is also determined that the reinforcing effect of graphene reduces with increasing temperature. An important conclusion revealed, through the compression, creep, and relaxation test results that graphene has no reinforcing effect at 120°C but has a weakening effect on total thermo-mechanical behavior.
Efficacy of a Technology-Based Early Language Comprehension Intervention: A Randomized Control Trial
Authors: McMaster Kristen L. , Kendeou Panayiota , Kim Jasmine , Butterfuss Reese
Published: June 2023

We examined the efficacy of a Technology-Based Early Language Comprehension Intervention (TeLCI) designed to teach inferencing in a non-reading context. A group of Grades 1 and 2 students from 2 elementary schools in the U.S. Midwest identified as at risk of comprehension difficulties were assigned randomly to a business-as-usual control group or to use TeLCI over an 8-week period. TeLCI comprised three learning modules per week that involved (a) learning new vocabulary, (b) watching fiction or nonfiction videos, and (c) answering inferential questions. Students also engaged in small-group read-alouds with their teachers once per week. Students who experienced TeLCI improved their inferencing and benefited from scaffolding and feedback provided during the intervention. Students’ pre- to posttest inferencing gains were comparable with those of control students. Female students and those receiving special education services appeared less likely to benefit from TeLCI, whereas multilingual students were more likely to respond. Further work is needed to determine the optimal conditions under which TeLCI will benefit young children.
The EASE Process: Increasing Educator Reflexivity to Foster Family-Educator Collaboration
Authors: Francis Grace L. , Strimel Morgan , Macedonia Anna
Published: June 2023

Family-educator collaboration results in enhanced outcomes among educators, families, and, most importantly, students with disabilities. Collaboration of this nature, however, does not always occur for many reasons, including tension that arises when family and educator microcultures differ and result in communication breakdowns. Reflexivity is one approach to improve family-educator collaboration by enhancing a shared sense of trust and understanding among families and educators. For this reason, the purpose of his paper is to present EASE, a four-step reflexivity process for educators to interrogate their complex microcultures and consider the influence of those microcultures on collaboration with students and their families.
An overheating criterion for bedrooms in temperate climates: Derivation and application
Authors: Lomas Kevin J , Li Matthew
Published: June 2023

Adequate sleep is crucial to human health and well-being and elevated night-time temperatures can degrade sleep quality. European countries with temperate climates use temperature thresholds between 25°C and 28°C to identify homes that are overheated. The current UK bedroom threshold of 26°C, is based on one small study, which is now over 45 years old. An extensive literature review indicated that with modern summertime bedding and bedwear, which enables body coverage to be easily adjusted, thermal comfort can be achieved for night-time bedroom temperatures up to approximately 29°C. Temperatures measured in 591 bedrooms during England’s hottest ever summer, 2018, are re-analysed. The prevalences of night-time overheating generated by alternative criteria are compared with the prevalences generated by the established adaptive overheating criterion. Comparisons are made for homes with different dwelling and household characteristics. Finally, a new overheating criterion is proposed based on the mean night-time bedroom temperature, with thresholds between 26°C and 29°C depending on the application of the criterion. The allowable exceedance of the chosen threshold is limited to seven nights between May and September. Adopting thresholds of 27°C for vulnerable households and 28°C for others, 23% (5.5 million) of the main bedrooms in English homes were deemed to be overheated in the hot summer of 2018, far fewer than the 69% obtained using the current UK bedroom criterion. Irrespective of the threshold chosen, there were clear, consistent and significant differences in overheating prevalence depending on dwelling and household characteristics. The proposed new overheating criterion is applicable to unconditioned bedrooms in temperate regions. It seeks to strike a balance between the risk that hot bedrooms will be air-conditioned and the risk of temperatures detrimental to a “good nights’ sleep”.

Practical Application

A new overheating criterion is proposed to identify overheated bedrooms. It adopts the familiar format of a temperature threshold and an allowable exceedance. It is applicable in temperate climates when people are asleep in unconditioned bedrooms. The criterion is intended to aid the interpretation of night-time temperatures predicted by dynamic thermal models and temperature measurements in existing bedrooms. It is applicable to individuals of different heat sensitivity, the design of new homes or the refurbishment of existing homes. With further testing and refinement, it offers a credible replacement to the existing UK bedroom criterion given in CIBSE Guide A, TM59 and in other guides. It can thus underpin the new overheating regulations, Part O, for the design of new dwellings in England.
Near-Field LED Illumination Strategies for Tonsillectomy and Adenoid Surgery
Authors: Cash Elizabeth , Albert Christina , Potts Kevin , Chandran Swapna , Horrell Robin
Published: June 2023

Objective: Perform a pilot feasibility study to demonstrate viability, quality, and safety advantages of light-emitting diode (LED) illumination when performing tonsillectomy. Study Design: Prospective cohort. Setting: Children’s Hospital and Community Multispecialty Hospital. Methods: We tested a commercially available LED light, held in position with a minimally modified mouth gag, for off-label use in a “cavernous wound.” We assessed surgeons’, residents’, and nurses’ perceptions of function, safety, as well as preferences compared to headlights. Results: The light was used in 30 cases. Noted advantages over traditional lighting methods included superior brightness, stability and consistency of illumination, and the ability for others to assist more quickly. The inability to adjust brightness and/or the angle of light was an observed disadvantage. A small oral cavity or large tonsillar pillars creating a shadow required the temporary addition of a headlight. However, LED light use was not discontinued. Surgeons and residents reported a preference for not wearing a headlight, and nurses expressed concerns about headlight cleanliness. Conclusion: LED lighting technology demonstrated utility for teaching surgeons, residents, and nurses, and was perceived as safe. Additional specifications may make the light applicable to a wider variety of cases and could potentially mitigate headlight use during procedures of the oral cavity and oropharynx.

Level of Evidence: 4
Shared family identity and communicatively managing the adaptation of family gatherings during the COVID-19 pandemic
Authors: Flora Jeanne , Paik Jihyun E. , Morales Gabriela I.
Published: June 2023

This study examined how shared family identity and COVID-19 worry were associated with choices to adapt family gatherings during the pandemic. Participants (N = 314) reflected on a conversation with a family member outside their household regarding whether/how to hold a gathering. Results showed that higher COVID-19 worry predicted higher likelihood of making adaptations to gatherings by either taking COVID-19 precautions while gathering in person or calling off the in-person gathering. However, higher shared family identity was associated with lower likelihood of calling off the gathering and higher probabilities of gathering in person with or without precautions. When people felt a high sense of shared family identity with a family member who disagreed with them, the decisions regarding adapting the family gathering did not necessarily reflect their own levels of COVID-19 worry. In qualitative analyses of open-ended responses regarding family discussions about whether to gather, participants wished for family members to express more openness, respect and understanding, and behavioral intentions that aligned with their own views on COVID-19. How shared family identity affects choices about health interventions and the way family members prefer to communicatively manage disagreements are discussed in the framework of social identity theory and communication accommodation theory.
Casual sexual relationships and their increase over time among Israeli emerging adults: Do these associate with the quality of future relationships?
Authors: Shulman Shmuel , Yonatan-Leus Refael , Seiffge-Krenke Inge
Published: June 2023

While casual sexual relationships (CSREs) have become common among emerging adults, it is unknown whether these affect future relationships. Guided by a developmental perspective, the current study questions whether engagement in CSREs might be associated with the quality of future relationships by serving as a model of instability. Data were collected from 110 Israeli emerging adults at ages 23, 25, and 28. Contrary to our expectations, the level of engagement in CSREs at age 23 was associated only with a lower capacity to resolve problems and a higher tendency to downplay disagreements at age 28. However, an increase in the level of engagement in CSREs over the 5 years was associated with future negative relationship outcomes, greater avoidant romantic attachment, a tendency to conceal from one’s partner, and a lower sense of certainty and capacity to manage disagreements. Conceptually, findings suggest that when engagement in casual sex is repeated and increases over time, it might become a more stable pattern of behavior and have an adverse effect on future competence in handling a romantic relationship.
Primary small cell carcinoma of the gallbladder diagnosed by PET/CT combined with tumour markers: A case report
Authors: Guo Ai’nan , Li Shichang , Fu Peng
Published: June 2023

Small cell cancer (SCC) of the gallbladder is a rare and highly aggressive malignancy. We report here a case diagnosed by positron emission tomography/computed tomography (PET-CT) combined with tumour markers. A 51-year-old man presented with pain in his neck, shoulder, back, lumbar and right thigh. Ultrasonography showed an isoechoic mass in the gallbladder, and a magnetic resonance image (MRI) scan showed multiple retroperitoneal occupations and multiple vertebral bone destruction with pathological fractures. Blood analysis showed elevated levels of tumour markers including neuron-specific enolase (NSE) and PET/CT images showed extensive distant metastases. A diagnosis of primary SCC of the gallbladder was made following exclusion of the possibility of metastasis from other organs. The use of biomarkers with immunohistochemical findings and PET/CT imaging, will assist clinicians in the identification and understanding of the pathology of this disease.
Secrets as Storytelling: Family Histories and Interpersonal Intimacy
Authors: Nico Magda , Silva Maria Gilvania , Caetano Ana
Published: June 2023

Keeping and telling secrets are acts of intimacy. This article explores secret-telling-friendly methodologies, capable of encouraging individuals to share their life stories in their own terms, with particular episodes, emotional connections, protagonists, and also secrets. The openness of our research design played an important part in the identification of the role of secret-storytelling in the understanding of life. This was enhanced by methodological tools mobilized during the biographical interviews with individuals of families (the life calendar and the socio-genealogical tree). It testifies the importance of the research design, and method lato sensu, in the sociological analysis of secrets. Each secret connects to the person’s biography, social positioning, historical context, and generational anchor, contributing to understand more about wider social, gender, family, interpersonal, and normative values of given time-space coordinates. Secrets are narrative and emotional devices to build biographical narratives and chronologize life stories, bridging biography and society, exemplarily.