bluuebunny/crossref_metadata_2025 huggingface dataset:
Design of Intelligent Environment Observation and Decision Support for Regional World Economy
Authors: Lifang Song
Published: November 2021

In order to avoid the risk of marginalization of low-level areas in the process of economic globalization, regional economies have also developed from this, which is important for the regional world economy in a smart environment. Observation and decision support have also attracted much attention from academia. Based on the important situation of regional world economic development, scholars have conducted a lot of research studies; this paper studies the development trend of the regionalized world economy in the intelligent environment under the network of interconnected objects and uses decision support technology and sensor networks to observe and design decision support for the regionalized world economy. Association rule mining technology is used to conduct data mining and data collection on the relevant data in the regionalized world economy, cluster analysis is used to sort and calculate the mined experimental data, and the experimental data model is extracted through the decision tree algorithm. This study collects various data on the number of trade agreements in 2015–2019, the expansion of free trade zones, the import and export trade rates of the EU, North America, and the Asia-Pacific region, and the currency circulation in each region of the world and also organize, observe, and analyze the regional world economy. The final results show that, from 2015 to 2019, free trade areas in various regions of the world are expanding every year. There are 12 free trade areas in Western Europe, the Middle East, the Mediterranean, Central and Eastern Europe, and Russia. At the same time, North America, Asia-Pacific, and the EU pay more attention to intraregional trade, especially the annual trade rate of the EU of more than 50%. The regional world economy still has a trend of development in modern society and even in the next few decades, and the regional world economy has a certain role in promoting the economic development of various countries and regions. The regional world economy still has a development trend in modern society and even in the next few decades. It has a certain promoting effect on the economic development of various countries and regions. It is an inevitable trend of world economic development and the only way to economic globalization.
Impact of the Field Winding Interturn Short-Circuit Position on Rotor Vibration Properties in Synchronous Generators
Authors: Yuan Xing-Hua , He Yu-Ling , Liu Man-Yu , Wang Hui , Wan Shu-Ting , Vakil Gaurang
Published: November 2021

This paper investigates the effect of the field winding interturn short-circuit (FWISC) position on the rotor vibration properties in turbo generators. Different from the previous studies which focused on the influence of the short-circuit degree, this work pays much attention to the impact of the short-circuit position on the rotor unbalanced magnetic pull (UMP) properties and vibration characteristics. The theoretical UMP model is firstly deduced based on the analysis of the magnetic flux density (MFD) variation. Then, the finite element analysis (FEA) is performed to calculate the UMP data. Finally, the rotor vibrations are tested on a CS-5 prototype generator which has two poles and a rated capacity of 5 kVA. It is shown that the occurrence of FWISC will greatly increase the UMP as well as the rotor vibration. In addition to the short-circuit degree, the short-circuit position will also affect the UMP and vibration. The nearer the short-circuit position is to the big rotor teeth, the larger the UMP and vibration will be. The proposed study in this paper will be beneficial for the monitoring and diagnosis of FWISC faults.
Understanding Customer Value in the Mobile Internet Era
Authors: Li Jing , Nigatu Ayenew Darge , Yu Baoquan , Gu Qiaolun , Yang Yong
Published: November 2021

The advent of mobile Internet era brings both opportunities and challenges to understanding customer value in the field of customer relationship management. Traditional customer relationship management theory and practice focus on the transaction value created by individual customers and do not take into consideration enough to the huge potential commercial value behind the interaction and connection among people by means of online social services in the mobile Internet era. Towards this end, this study first analyses the new characteristics of customer behaviour in the mobile Internet era. Second, the study proposes the integrated customer value model in three dimensions of purchase value, interactive value, and marketing diffusion value with 13 indicators based on the complex network theory and RFM model, considering the value created by connection and interaction among customers. Finally, the study discusses the eight types of customer clusters and the corresponding differentiate customer relationship management strategies in the era of mobile Internet based on the integrated customer value model. This study enriches the theory of customer value in the field of customer relationship management and also helps company better practice the innovation and change in the management of relationship with customer in the mobile Internet era.
Experimental Study on the Impact Resistance of Closed‐Cell Aluminum Foam Protective Materials to RC Piers under Lateral Impact
Authors: Zhou Xiwu , Zhang Wen , Wang Xiangyu , Zhang Wenchao , Zhan Meng
Published: November 2021

In this study, the lateral impact tests of six RC piers which were protected by closed‐cell aluminum foam (CCAF) were carried out by making use of an ultrahigh drop hammer horizontal impact test system. The protective effects of CCAF with different densities on the piers were then analyzed. The data regarding the piers’ impact force, displacement, reinforcement strain, and crack and damage development were mainly collected during the experimental testing processes. The results indicated that, when the impact energy was less than 7258 J and the density of the CCAF was 0.45 g/cm3, the cumulative impact force and displacements of the piers decreased by 67% and 35%, respectively. Therefore, it was considered that the CCAF with a density of 0.45 g/cm3 had displayed the best protective effects at that stage. It was also observed that when the impact energy was greater than 7258 J and the density of the CCAF was 0.55 g/cm3, the cumulative impact force and displacements of the piers decreased by 25% and 18%, respectively. Therefore, the CCAF with a density of 0.55 g/cm3 had displayed the best protective effects at that stage. Furthermore, under the conditions of constant accumulative impact energy, the protective effects of CCAF on the piers were observed to be weakened if it entered the densification stage too early and high‐yield platforms were formed due to the density levels becoming too high. However, it was found that reasonable density and thickness increases could effectively delay the entry of CCAF into the densification stage, which effectively reduced the shearing effects which occurred when the impact speeds were too high, thereby preventing the shear failure of the piers.
Qingjie Fuzheng Granule Inhibits EMT and Induces Autophagy in Colorectal Cancer via mTOR Signaling Pathways
Authors: Zhu Xiaoqin , Chen Yongan , Lin Minghe , Huang Bin , Lin Jiumao
Published: November 2021

Qingjie Fuzheng granule (QFG) is a traditional Chinese medicinal formula used extensively as an alternative medicine for cancer treatment, including colorectal cancer (CRC). But its pathological mechanism in CRC is unclear. To study antitumor treatment effects and mechanisms of QFG, we established a CRC HCT-116 xenograft mouse model and assessed QFG on EMT and autophagy progression in vivo. The mice were randomly divided into 2 groups (n = 10 each group) and treated with intragastric administration of 1 g/kg of QFG or saline 6 days a week for 28 days (4 weeks). Body weight was measured every other day with electronic balance. At the end of the treatment, the tumor weight was measured. Immunohistochemical (IHC) and western blot (WB) assay were used to detect the expression level of E-cadherin, N-cadherin, vimentin, and TWIST1 to evaluate the effect of QFG on tumor cell EMT progression. IHC and WB assay were also used to detect the expression level of beclin-1, LC3-II, and p62 to evaluate the effect of QFG on tumor cell autophagy progression. Furthermore, the expression level of relative proteins in mTOR pathway was detected by WB assay to investigate the mechanism of QFG effect on CRC. We discovered that QFG inhibited the rise of tumor weight while it had no effect on mice body weight, which proved that QFG could inhibit CRC growth progression without significant side effects in vivo. In addition, QFG treatment inhibited EMT and induced autophagy progression in CRC tumor cells, including that QFG upregulated the expression of E-cadherin, beclin-1, and LC3-II, but downregulated the expression of N-cadherin, vimentin, TWIST1, and p62. And, QFG decreased the ratio of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR, but increased the ratio of p-AMPK/AMPK. All findings from this research proved that QFG can induce autophagy and inhibit EMT progression in CRC via regulating the mTOR signaling pathway.
Using Circulating Tumor DNA for Colon Cancer Adjuvant Therapy: To Be or Not to Be?
Authors: Morris Van K. , George Thomas J.
Published: November 2021

Detection of circulating tumor DNA (ctDNA) postoperatively is prognostic for recurrence for patients with stage III colon cancer. Those with sustained undetectable ctDNA will likely be cured. Eradication of minimal residual disease (per ctDNA clearance) with chemotherapy did not occur in most ctDNA-positive patients and led to eventual disease relapse.

See related article by Henriksen et al., p. 507
Mutant IDH Inhibits IFNγ–TET2 Signaling to Promote Immunoevasion and Tumor Maintenance in Cholangiocarcinoma
Authors: Wu Meng-Ju , Shi Lei , Dubrot Juan , Merritt Joshua , Vijay Vindhya , Wei Ting-Yu , Kessler Emily , Olander Kira E. , Adil Ramzi , Pankaj Amaya , Tummala Krishna Seshu , Weeresekara Vajira , Zhen Yuanli , Wu Qibiao , Luo Meiqi , Shen William , García-Beccaria María , Fernández-Vaquero Mirian , Hudson Christine , Ronseaux Sebastien , Sun Yi , Saad-Berreta Rodrigo , Jenkins Russell W. , Wang Tong , Heikenwälder Mathias , Ferrone Cristina R. , Goyal Lipika , Nicolay Brandon , Deshpande Vikram , Kohli Rahul M. , Zheng Hongwu , Manguso Robert T. , Bardeesy Nabeel
Published: November 2021

Isocitrate dehydrogenase 1 mutations (mIDH1) are common in cholangiocarcinoma. (R)-2-hydroxyglutarate generated by the mIDH1 enzyme inhibits multiple α-ketoglutarate–dependent enzymes, altering epigenetics and metabolism. Here, by developing mIDH1-driven genetically engineered mouse models, we show that mIDH1 supports cholangiocarcinoma tumor maintenance through an immunoevasion program centered on dual (R)-2-hydroxyglutarate–mediated mechanisms: suppression of CD8+ T-cell activity and tumor cell–autonomous inactivation of TET2 DNA demethylase. Pharmacologic mIDH1 inhibition stimulates CD8+ T-cell recruitment and interferon γ (IFNγ) expression and promotes TET2-dependent induction of IFNγ response genes in tumor cells. CD8+ T-cell depletion or tumor cell–specific ablation of TET2 or IFNγ receptor 1 causes treatment resistance. Whereas immune-checkpoint activation limits mIDH1 inhibitor efficacy, CTLA4 blockade overcomes immunosuppression, providing therapeutic synergy. The findings in this mouse model of cholangiocarcinoma demonstrate that immune function and the IFNγ–TET2 axis are essential for response to mIDH1 inhibition and suggest a novel strategy for potentiating efficacy.

Significance:

Mutant IDH1 inhibition stimulates cytotoxic T-cell function and derepression of the DNA demethylating enzyme TET2, which is required for tumor cells to respond to IFNγ. The discovery of mechanisms of treatment efficacy and the identification of synergy by combined CTLA4 blockade provide the foundation for new therapeutic strategies.

See related commentary by Zhu and Kwong, p. 604.

This article is highlighted in the In This Issue feature, p. 587
Epigenetic Regulation during Primordial Germ Cell Development and Differentiation
Authors: Ramakrishna Navin B. , Murison Keir , Miska Eric A. , Leitch Harry G.
Published: November 2021

Germline development varies significantly across metazoans. However, mammalian primordial germ cell (PGC) development has key conserved landmarks, including a critical period of epigenetic reprogramming that precedes sex-specific differentiation and gametogenesis. Epigenetic alterations in the germline are of unique importance due to their potential to impact the next generation. Therefore, regulation of, and by, the non-coding genome is of utmost importance during these epigenomic events. Here, we detail the key chromatin changes that occur during mammalian PGC development and how these interact with the expression of non-coding RNAs alongside broader epitranscriptomic changes. We identify gaps in our current knowledge, in particular regarding epigenetic regulation in the human germline, and we highlight important areas of future research.
Squamous Cell Carcinoma as a Complication of Long-Term Hydroxyurea Treatment
Authors: Lewandowski Miłosz , Łukowicz Paweł , Jankau Jerzy , Romantowski Jan , Barańska-Rybak Wioletta
Published: November 2021

Hydroxyurea therapy is commonly used in the treatment of patients suffering from myeloproliferative diseases, such as polycythemia vera. It is supported by evidence that this type of therapy can generate mild skin lesions like leg ulcers, erythema, and hyperpigmentation. There are also some studies that show an increased risk of development of nonmelanoma skin cancers. We report a 56-year-old man with a 13-year history of polycythemia vera, treated chronically with hydroxyurea. In April 2020, the patient presented a skin lesion on the forehead, skin horn on the left forearm, and hyperkeratosis on the rims of both ears. In the patient’s history, in October 2019, complete excision of the skin lesion in the central area of the forehead was performed. After 4 months, a new skin lesion appeared at the same area of the forehead, which in May 2020 after resection in the histopathological examination was diagnosed as recurrence of squamous cell carcinoma. The aim of the case is to draw the clinicians’ attention to the increased risk of squamous cell carcinoma and basal cell carcinoma in patients treated with hydroxyurea. Increased vigilance would make it possible to recognize them earlier, and thus potentially reduce the undesirable effects associated with the delayed radical treatment of these skin cancers. Randomized clinical trials assessing the potential benefits of oral retinoids for chemoprevention of nonmelanoma skin cancers in the hydroxyurea-treated population should also be considered.
Necrobiosis Lipoidica: Atypical Presentation in a Diabetic Girl
Authors: Alhameedy Meshal M.
Published: November 2021

Necrobiosis lipoidica (NL) is a chronic granulomatous idiopathic disorder. It usually presents as yellow-brown, atrophic, telangiectatic plaques with an elevated violaceous rim, typically in the pretibial region of both extremities with and without ulceration [1, 2]. There are few reported cases of childhood-onset NL in atypical locations. We report a case of type 1 diabetic 13-year-old girl who developed yellow atrophic plaque with telangiectasia on the extensor aspect of her upper arm.
Burn Hemangioma: A New Variant of Hemangioma
Authors: Sharquie Khalifa E. , Al-Dhalimi Muhsin A. , Kawen Ahmed Abdulhussein , Dhaher Samer A.
Published: November 2021

Background: Burn hemangioma, also known as scalded pyogenic granuloma, is considered a variant of pyogenic granuloma, but unlike the classic type it presents with rapid progression. Most patients are infants and young children with a history of burns caused by liquids. Objective: The present study aims to present all patients with burn hemangiomas treated at our institutions with a full clinical and histopathological assessment. Patients and Methods: This case series includes 34 cases that were treated during the period from 2016 to 2021. Results: A total of 34 patients (16 female/18 male, mean age of 17.6 years) were included. Two age groups presented: infants and children (n = 22, age range 0.5–8 years, 10 female/12 male), and adults (n = 11, age range 25–44 years, 6 female/6 male). Lesions appeared 1–2 weeks following predominantly second-degree burns, and multiple lesions predominated in infants and children. The lesions evolved to large lesions within weeks, and these appeared to be either static or involute. The histopathology was compatible with hemangioma, rather than pyogenic granuloma. Conclusion: Burn hemangioma should be considered a new variant of hemangioma rather than a type of pyogenic granuloma that follows second-degree burns. They have many similarities with infantile hemangioma, both clinically and histopathologically.
A Gastric Metastatic Lesion That Resembled Early-Stage Gastric Cancer on Endoscopy during Treatment for Recurrent Breast Cancer: A Case Report
Authors: Watanabe Yukino , Horimoto Yoshiya , Takahashi Yuka , Murakami Fumi , Yamada Masaki , Yamazaki Sanae , Ishido Yasunori
Published: November 2021

Breast cancer metastasis to the gastrointestinal tract is relatively rare. Patients with such disease often develop gastrointestinal symptoms, but it is sometimes asymptomatic. Endoscopic findings of gastric metastasis from breast cancer markedly vary from benign to malignant, and even in suspected malignant cases, it is often difficult to differentiate between primary and metastatic disease. We experienced a case in which an endoscopic examination performed during the treatment for metastatic breast cancer resembled an early-stage gastric cancer. A 71-year-old woman underwent curative surgery for right breast cancer 16 years previously. She underwent endoscopic submucosal dissection for early-stage gastric cancer 5 years ago. Two years ago, she developed metastatic disease in the lungs and mediastinal lymph nodes, and endocrine therapy was administered. At the same time, a follow-up endoscopy revealed a new elevated lesion, suspected to be an early-stage gastric cancer. However, histological diagnosis of the biopsy was metastasis of breast cancer. One and a half years later, a follow-up endoscopy revealed a gastric lesion that had reduced in size. She is still alive, having received a variety of systemic treatments. Patients with metastatic breast cancer are experiencing prolonged survival. Thus, follow-up endoscopy should be considered after the diagnosis of gastrointestinal metastasis considering the risk of lethal conditions, such as gastrointestinal bleeding and perforation. Our case serves as a reminder to clinicians how difficult it is to determine whether a gastric lesion is primary or metastatic based on endoscopic findings and the importance of communication with endoscopists and pathologists.
Androgen Excess Increases Food Intake in a Rat Polycystic Ovary Syndrome Model by Downregulating Hypothalamus Insulin and Leptin Signaling Pathways Preceding Weight Gain
Authors: Liu Ying , Xu Yu-Chen , Cui Yu-Gui , Jiang Shi-Wen , Diao Fei-Yang , Liu Jia-Yin , Ma Xiang
Published: November 2021

Background: Polycystic ovary syndrome (PCOS) is a common reproductive and metabolic disorder characterized by high androgen levels. The aim of this study was to evaluate the effects of hyperandrogenism on the hypothalamus and subsequently on the food intake and obesity in females. Methods: A dihydroxy testosterone (DHT)-induced rat model was established to recapitulate the hyperandrogenism features of PCOS patients. Body weight and food intake of the rats were recorded. The food intake of DHT-induced rats was restricted by pair feeding to exclude possible effects of weight gain on the hypothalamus. The expression levels of relevant proteins and mRNAs in the hypothalamus and primary hypothalamic neurons exposed to DHT were analyzed by Western blotting and RT-PCR, respectively. The leptin levels in the serum and cerebrospinal fluid (CSF) were measured, and leptin was injected via the intracerebroventricular (ICV) route to test the leptin sensitivity of the hypothalamus. Results: The excessive prepuberty androgen levels in the DHT-induced rats markedly elevated food intake prior to weight gain. Consistent with this, the expression of neuropeptide Y and agouti-related peptide mRNAs was upregulated, which occurred prior to obesity and even with restricted food intake. In addition, the hypothalamic sensitivity to insulin and leptin was also impaired in the DHT-induced rats before obesity and with restricted food intake. DHT significantly reduced the leptin levels in the CSF, and ICV injection of leptin inhibited the DHT-induced increase in food intake. Conclusions: Androgen excess increased food intake in rats and promoted obesity by downregulating insulin and leptin signaling in the hypothalamus, most likely by suppressing leptin levels in the CSF.
Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States– and Foreign‐Born Adults in the National Health Interview Survey
Authors: Mannoh Ivy , Turkson‐Ocran Ruth‐Alma , Mensah Jasmine , Mensah Danielle , Yi Stella S. , Michos Erin D. , Commodore‐Mensah Yvonne
Published: November 2021

Background

Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality.

Methods and Results

We analyzed cross‐sectional data from the 2014 and 2017 National Health Interview Surveys on US‐ and foreign‐born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing “call 9‐1‐1” as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US‐born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign‐born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017.

Conclusions

These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.
Prediction of Lifetime Risk of Cardiovascular Disease Deaths Stratified by Sex in the Japanese Population
Authors: Imai Yukiko , Mizuno Tanaka Sachiko , Satoh Michihiro , Hirata Takumi , Murakami Yoshitaka , Miura Katsuyuki , Waki Takashi , Hirata Aya , Sairenchi Toshimi , Irie Fujiko , Sata Mizuki , Ninomiya Toshiharu , Ohkubo Takayoshi , Ishikawa Shizukiyo , Miyamoto Yoshihiro , Ohnishi Hirofumi , Saitoh Shigeyuki , Tamakoshi Akiko , Yamada Michiko , Kiyama Masahiko , Iso Hiroyasu , Sakata Kiyomi , Nakagawa Hideaki , Okayama Akira , Ueshima Hirotsugu , Okamura Tomonori , Imai Yutaka , Kitamura Akihiko , Kiyohara Yutaka , Harada Akiko , Sakurai Masaru , Nakayama Takeo , Tsuji Ichiro , Kokubo Yoshihiro , Yatsuya Hiroshi , Okamura Tomonori
Published: November 2021

Background

Lifetime risk is an informative estimate for driving lifestyle and behavioral changes especially for young adults. The impact of composite risk factors for cardiovascular disease on lifetime risk stratified by sex has not been investigated in the Japanese population, which has a much lower mortality of coronary heart disease compared with the Western population. We aimed to estimate lifetime risk of death from cardiovascular disease attributable to traditional risk factors.

Methods and Results

We analyzed pooled individual data from the Evidence for Cardiovascular Prevention from Observational Cohorts in a Japanese cohort study. A modified Kaplan–Meier approach was used to estimate the remaining lifetime risk of cardiovascular death. In total, 41 002 Japanese men and women with 537 126 person‐years of follow‐up were included. The lifetime risk at the index‐age of 45 years for those with optimal risk factors (total cholesterol <4.65 mmol/L, systolic blood pressure <120 mm Hg, diastolic blood pressure <80 mm Hg, absence of diabetes, and absence of smoking habit) was lower compared with the highest risk profile of ≥2 risk factors (6.8% [95% CI, 0%–11.9%] versus 19.4% [16.7%–21.4%] for men and 6.9% [1.2%–11.5%] versus 15.4% [12.6%–18.1%] for women).

Conclusions

The magnitude and the number of risk factors were progressively associated with increased lifetime risk even in individuals in early adulthood who tend to have low short‐term risk. The degree of established cardiovascular risk factors can be converted into lifetime risk. Our findings may be useful for risk communication in the early detection of future cardiovascular disease risk.
Sex‐, Race‐ and Ethnicity‐Based Differences in Thromboembolic Events Among Adults Hospitalized With COVID‐19
Authors: Ilyas Sadia , Henkin Stanislav , Martinez‐Camblor Pablo , Suckow Bjoern D. , Beach Jocelyn M. , Stone David H. , Goodney Philip P. , Ebinger Joseph E. , Creager Mark A. , Columbo Jesse A.
Published: November 2021

Background

Patients hospitalized with COVID‐19 have an increased risk of thromboembolic events. Whether sex, race or ethnicity impacts these events is unknown. We studied the association between sex, race, and ethnicity and venous and arterial thromboembolic events among adults hospitalized with COVID‐19.

Methods and Results

We used the American Heart Association Cardiovascular Disease COVID‐19 registry. Primary exposures were sex and race and ethnicity, as defined by the registry. Primary outcomes were venous thromboembolic events and arterial thromboembolic events. We used logistic regression for risk adjustment. We studied 21 528 adults hospitalized with COVID‐19 across 107 centers (54.1% men; 38.1% non‐Hispanic White, 25.4% Hispanic, 25.7% non‐Hispanic Black, 0.5% Native American, 4.0% Asian, 0.4% Pacific Islander, and 5.9% other race and ethnicity). The rate of venous thromboembolic events was 3.7% and was more common in men (4.2%) than women (3.2%;
P
<0.001), and in non‐Hispanic Black patients (4.9%) than other races and ethnicities (range, 1.3%–3.8%;
P
<0.001). The rate of arterial thromboembolic events was 3.9% and was more common in men (4.3%) than women (3.5%;
P
=0.002), and in non‐Hispanic Black patients (5.0%) than other races and ethnicities (range, 2.3%–4.7%;
P
<0.001). Compared with men, women were less likely to experience venous thromboembolic events (adjusted odds ratio [OR], 0.71; 95% CI, 0.61–0.83) and arterial thromboembolic events (adjusted OR, 0.76; 95% CI, 0.66–0.89). Compared with non‐Hispanic White patients, non‐Hispanic Black patients had the highest likelihood of venous thromboembolic events (adjusted OR, 1.27; 95% CI, 1.04–1.54) and arterial thromboembolic events (adjusted OR, 1.35; 95% CI, 1.11–1.65).

Conclusions

Men and non‐Hispanic Black adults hospitalized with COVID‐19 are more likely to have venous and arterial thromboembolic events. These subgroups may represent at‐risk patients more susceptible to thromboembolic COVID‐19 complications.
Effect of Moderate and Severe Persistent Hyperglycemia on Outcomes in Patients With Intracerebral Hemorrhage
Authors: Qureshi Adnan I. , Huang Wei , Lobanova Iryna , Chandrasekaran Premkumar N. , Hanley Daniel F. , Hsu Chung Y. , Martin Renee H. , Steiner Thorsten , Suarez Jose I. , Yamamoto Haruko , Toyoda Kazunori
Published: November 2021

Background:

We evaluated the effect of persistent hyperglycemia on outcomes in 1000 patients with intracerebral hemorrhage enrolled within 4.5 hours of symptom onset.

Methods:

We defined moderate and severe hyperglycemia based on serum glucose levels ≥140 mg/dL—<180 and ≥180 mg/dL, respectively, measured at baseline, 24, 48, and 72 hours. Persistent hyperglycemia was defined by 2 consecutive (24 hours apart) serum glucose levels. We evaluated the relationship between moderate and severe hyperglycemia and death or disability (defined by modified Rankin Scale score of 4–6) at 90 days in the overall cohort and in groups defined by preexisting diabetes.

Results:

In the multivariate analysis, both moderate (odds ratio, 1.8 [95% CI, 1.1–2.8]) and severe (odds ratio, 1.8 [95% CI, 1.2–2.7]) hyperglycemia were associated with higher 90-day death or disability after adjusting for Glasgow Coma Scale score, hematoma volume, presence or absence of intraventricular hemorrhage, hyperlipidemia, cigarette smoking, and hypertension (no interaction between hyperglycemia and preexisting diabetes,
P
=0.996). Among the patients without preexisting diabetes, both moderate (odds ratio, 1.8 [95% CI, 1.0–3.2]) and severe (odds ratio, 2.0 [95% CI, 1.1–3.7]) hyperglycemia were associated with 90-day death or disability after adjusting for above mentioned potential confounders. Among the patients with preexisting diabetes, moderate and severe hyperglycemia were not associated with 90-day death or disability.

Conclusions:

Persistent hyperglycemia, either moderate or severe, increased the risk of death or disability in nondiabetic patients with intracerebral hemorrhage.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01176565.
Gibellula flava sp. nov. (Cordycipitaceae, Hypocreales), a new pathogen of spider from China
Authors: CHEN MING-JUN , WANG TING , LIN YAN , HUANG BO
Published: November 2021

Gibellula is an exclusively spider-pathogen genus, with most species immediately recognized by their distinctive conidial state, but also including the teleomorphic states of these fungi that were previously included in the rejected genus Torrubiella. Two sexual specimens and an asexual morph specimen were collected from Anhui Province, China, and were recognized as the same species based on molecular evidence. Its asexual morph differs from Gibellula pulchra, to which it is morphologically similar, in having shorter verrucose conidiophores with slightly smaller metulae, phialides and conidia. Its sexual morph is characterized by producing superficial and elongate ellipsoid small perithecia with short asci on a cream-yellow mycelial mat covering the host. Multi-locus (SSU, LSU, TEF, and RPB1) phylogenetic analyses showed that the specimens belong to a strongly supported subclade, and formed a sister subclade with G. pulchra and Gibellula sp. A combination of morphological characteristics and its phylogenetic placement confirmed that these unique specimens are a new species, which is described as Gibellula flava.
Description of a new minute frog of the genus Pristimantis (Anura: Strabomantidae) from Cordillera del Condor, Ecuador
Authors: BRITO-ZAPATA DAVID , REYES-PUIG CAROLINA , CISNEROS-HEREDIA DIEGO , ZUMEL DANIEL , RON SANTIAGO R.
Published: November 2021

We describe a new species of Pristimantis from southern Ecuador, province of Zamora Chinchipe. The new species is closely related to an undescribed species of Pristimantis from Reserva Tapichalaca, Ecuador and with species of a clade historically assigned to the P. unistrigatus species group, such as P. parvillus, P. luteolateralis, P. walkeri, among others. The new species of Pristimantis is a miniaturized new frog (females 17.1±1.1 mm; males 13.2±0.9 mm), characterized by the presence of “› ‹”-shaped scapular folds, with two subconical tubercles on the medial and posterior regions of folds; tympanic membrane and tympanic annulus present but not externally visible; a prominent rostral papilla present; upper eyelid with one elongated conical tubercle; a conical tubercle on heels; groin with orange or yellow spots. The new species of Pristimantis is distributed in a restricted area in the Cordillera del Condor, a highly-diverse mountain range threatened by multiple anthropogenic activities. We recommend assigning the new species to the Endangered IUCN threatened category because it is only known from three nearby localities within mining concessions.
Three new species of the genus Boulenophrys (Anura, Megophryidae) from southern China
Authors: QI SHUO , LYU ZHI-TONG , WANG JIAN , MO YUN-MING , ZENG ZHAO-CHI , ZENG YANG-JIN , DAI KE-YUAN , LI YUAN-QIU , GRISMER L. LEE , WANG YING-YONG
Published: December 2021

The diversity of Asian horned toads is considered highly underestimated and to contain a large number of undescribed cryptic species. In this work, we describe three new species of Boulenophrys from south China, namely, Boulenophrys yaoshanensis sp. nov. from central Guangxi, Boulenophrys yingdeensis sp. nov. from northern Guangdong, and Boulenophrys yunkaiensis sp. nov. from western Guangdong. These three new species can be distinguished from all recognized congeners by a combination of morphological characteristics and significant genetic divergences. These descriptions increase the number of recognized species of Boulenophrys to 61. In addition, an updated checklist of the Asian horned toads of the subfamily Megophryinae is provided in this study.
The Resource Costs of Maintaining Learner Utilization of a Simulation Center During the COVID-19 Pandemic
Authors: Mitsakos Anastasios T. , Xanthoudakis Eftechios , Irish William , Robey Walter C. , Gilbird Rebecca M. , Cringan Jessica , Haisch Carl E.
Published: December 2021

Background

Despite advances in online education during the COVID-19 pandemic, its impact on surgical simulation remains unclear. The aim of this study was to compare the costs and resources required to maintain simulation training in the pandemic and to evaluate how it affected exposure of medical students to simulation during their surgical clerkship.

Methods

The number of learners, contact hours, staff hours, and costs were collected from a multi-departmental simulation center of a single academic institution in a retrospective fashion. Utilization and expenditure metrics were compared between the first quarter of academic years 2018-2020. Statistical analysis was performed to evaluate potential differences between overall resource utilization before and during the pandemic, and subgroup analysis was performed for the resources required for the training of the third-year medical students.

Results

The overall number of learners and contact hours decreased during the first quarter of the academic year 2020 in comparison with 2019 and 2018. However, the staff hours increased. In addition, the costs for PPE increased for the same periods of time. In the subgroup analysis of the third-year medical students, there was an increase in the number of learners, as well as in the staff hours and in the space required to perform the simulation training.

Discussion

Despite an increase in costs and resources spent on surgical simulation during the pandemic, the utilization by academic entities has remained unaffected. Further studies are required to identify potential solutions to lower simulation resources without a negative impact on the quality of surgical simulation.
Evangelistic belief and behavior among Canadian congregants
Authors: Thiessen Joel , Quantz Kennedy , Wong Arch Chee Keen , Walker Keith , McAlpine Bill
Published: December 2021

With the recent surge of “religious nones” in many Western nations, there is a growing interest among some church attenders to effectively “reach” this demographic. In this article, we build on theories of strictness and social embeddedness to tackle three questions regarding evangelistic belief and behavior in Canadian Catholic, mainline Protestant, and conservative Protestant congregations. First, in what ways are evangelistic beliefs and behaviors similar or dissimilar across theological traditions, notably when comparing stricter and less strict contexts? Second, how are evangelistic behaviors similar or dissimilar based on a person’s frequency of church attendance? Third, what challenges do people confront in their evangelistic efforts? Drawing on survey data with over 9100 Catholic, mainline, and conservative Protestant respondents in over 250 Canadian congregations, this study compares responses across theological sectors, reported levels of importance that church members attach to evangelism, as well as church attendance frequency. Data reveal that those in religious traditions with stricter “insider–outsider” boundaries and who were more socially embedded in their religious groups (i.e., conservative Protestant traditions) were the most likely to embrace evangelistic attitudes and behaviors, in contrast to those in religious groups with less strict boundaries or social embeddedness in their religious group (i.e., United Church of Canada). However, those with the strongest “us–them” boundaries also found those boundaries particularly prohibitive to their evangelistic efforts reflected, in part, in a widespread leaning toward passive versus assertive forms of evangelism.
Female rebels and United Nations peacekeeping deployments
Authors: Mehrl Marius , Dworschak Christoph
Published: December 2021

How does the presence of female rebel combatants during conflict influence the likelihood of United Nations post-conflict peacekeeping deployment? While past literature on peacekeeping emphasizes the role of conflict attributes and security council interests, only few studies investigate the importance of belligerent characteristics. We argue that, because dominant gender stereotypes paint women as peaceful, female rebel combatants lead domestic and international audiences to perceive conflicts in which they fight as more severe. Given that recent UN resolutions and mission mandates align with these stereotypes, this in turn, causes the UN to intervene and deploy peacekeepers. Multivariate regression models drawing on a global sample of UN post-conflict missions provide empirical support for our hypothesis. Our findings add to the growing body of literature emphasizing the role of women in combat roles, and contribute to the discussion on the UN’s Women, Peace, and Security agenda.
Structural development of a flexible textile-based thermocouple temperature sensor
Authors: Cheung Tin Wai , Liu Tao , Yao Mei Yu , Tao Yifei , Lin He , Li Li
Published: December 2021

Textiles are conventionally utilized as the raw materials for making clothing and complementary accessories. To keep abreast of the times, a new direction of integrating textiles into electronic technology has been given in order to develop a temperature-sensing device with outstanding built-in flexibility, versality and softness. In this study, a flexible construction of the textile-based thermocouple temperature sensor via an industrial-and-technological-based weaving process was designed. The feasible arrangement of the conductive textile materials in the warp and weft directions related to the temperature-sensing ability was studied in detail, and significant linearity was shown in the range of 5–50[Formula: see text] with different groups of combinations of the conductive yarns. More cross-intersections and ‘hot junctions’ resulted from the 3 × 3 warp–weft arrangement, offering higher stability and accuracy in thermal sensation. Besides, the resistance of the thermocouple remained almost constant under different degrees of bending. The relationship between the resistance and the bending flexibility was also investigated over a range of temperature.
Availability and Utilization of the WHO-Recommended Lifesaving Medicines for Under-Five Children at University of Gondar Comprehensive Specialized Hospital, Amhara Region, Ethiopia
Authors: Woldeyohanins Alem Endeshaw , Kasahun Asmamaw Emagn , Demeke Chilot Abiyu , Kifle Zemene Demelash
Published: November 2021

According to the World Health Organization report, 5.4 million under-five children died, which is similar to under-five mortality rate of 39 deaths per 1000 live births. This rate is higher in sub-Saharan Africa with 76 deaths per 1000 live births. More than 1 out of every 2 deaths is because of diseases that can be managed with drug of low-cost and high quality. Institutional-based cross-sectional survey was conducted from January to February 2021, at the University of Gondar Comprehensive Specialized Hospital. Statistical Package for the Social Sciences software version 24 was used for data analysis. The results were presented using Figures, tables, and texts according to the nature of the data. The overall average availability of priority medicines was 75% on the day of visit and the average stock-out duration in the last 6 months was 23.85 days. Availability and utilization of priority medicines for the management of antiretroviral infections, Vitamin A deficiency, malaria, and diarrheal cases were high, whereas availability and utilization of suggested medication for neonatal sepsis were very low. A significant proportion of priority diseases was managed by non-priority medications. Medicines supply sources of the country, ministry of health, policymakers as well as facility managers should work in collaboration toward ensuring sustainable and consistent availability of priority medicines through the country. Continues in-service training of healthcare professionals is also mandatory to update themselves with newly developed guidelines, standards, and recommendations.
A generalized additive model-based data-driven solution for lithium-ion battery capacity prediction and local effects analysis
Authors: Chen Tao , Gao Ciwei , Hui Hongxun , Cui Qiushi , Long Huan
Published: November 2021

Lithium-ion battery-based energy storage systems have been widely utilized in many applications such as transportation electrification and smart grids. As a key health status indicator, battery performance would highly rely on its capacity, which is easily influenced by various electrode formulation parameters within a battery. Due to the strongly coupled electrical, chemical, thermal dynamics, predicting battery capacity, and analysing the local effects of interested parameters within battery is significantly important but challenging. This article proposes an effective data-driven method to achieve effective battery capacity prediction, as well as local effects analysis. The solution is derived by using generalized additive models (GAM) with different interaction terms. Comparison study illustrate that the proposed GAM-based solution is capable of not only performing satisfactory battery capacity predictions but also quantifying the local effects of five important battery electrode formulation parameters as well as their interaction terms. Due to data-driven nature and explainability, the proposed method could benefit battery capacity prediction in an efficient manner and facilitate battery control for many other energy storage system applications.
Macbeth apropos to Rupert Goold's and Gregory Doran's stagecraft: Equivocation, violence, and vulnerability
Authors: Fischer Susan L.
Published: November 2021

If Macbeth is Shakespeare's play of equivocation and doubleness, Rupert Goold's and Gregory Doran's productions were informed by like concerns, even having double performance lives on stage and on film. Doran's production followed along the lines of Trevor Nunn's 1976 staging, which highlighted the interiority of the Macbeths in the intimate space of The Other Place. Besides creating a sense of intimacy on the Swan's stage, Doran underscored the play's political relevance. Goold's mise-en-scène, also performed in an intimate space, pushed further Doran's militaristic staging. Jan Kott's reading of Macbeth as a ‘nightmare’ also offers a yardstick for production choices.
Hazards and Management of Wire Bristle ingestions: A Systematic Review
Authors: Miller Nathaniel , Noller Michael , Leon Matthew , Moreh Yonatan , Watson Nora L. , Costello Justin , Hong Steven
Published: November 2021

Objective

Inadvertently ingested grill brush bristles can lodge in various locations and lead to a variety of injuries. They can also be difficult to identify and remove. Our primary objective was to perform a systematic review of cases reported in the literature, with analysis of trends in clinical presentation and success of diagnostic modalities and treatment approaches.

Data Sources

Cases of reported grill brush bristle ingestion reported in PubMed, PubMed Central, and Google Scholar databases through April 30, 2021.

Review Methods

Databases were searched for the following terms: (“ingestion” OR “injury” OR “barbeque” OR “BBQ” OR “grill” OR “foreign body” OR “brush” AND “wire” OR “bristle”). Data were collected on patient demographics, clinical presentation, and treatment course. Statistical analysis was performed on characteristics with low risk of confounding.

Results

An overall 57 studies involving 91 patients were included. Grill brush bristles presented most commonly in the upper aerodigestive tract (48/91), followed by the abdomen (26/91) and deep neck (17/91). Computed tomography was the most accurate imaging modality for initial diagnosis, identifying 92.8% of bristles. Less invasive or adjunctive techniques such as endoscopy, intraoperative imaging, or minimally invasive surgery may be useful particularly for bristles located in the head and neck given the low rate of success of transoral surgery (66.7%).

Conclusion

Although this review of retained bristle may be biased toward complex cases, retained grill brush bristles represent an underrecognized and difficult‐to‐manage hazard. When cases are suspected, clinicians should obtain computed tomography imaging based on presentation and tailor management appropriately.
Explanatory Models of Depression in a Rural Community of Coastal Karnataka, India: A Cross-Sectional Survey
Authors: Hegde Sameeksha , Karkal Ravichandra
Published: December 2021

Background:

Depression is a major public health problem but there is a huge treatment gap in India. Cultural beliefs influence conception of illness, personal meaning, help-seeking behaviors, and adherence to treatment. Research on explanatory models of depression attempt to explore these unique characteristics in an individual and the community. We set out to examine explanatory models of depression in a rural community of coastal Karnataka and explore the association between sociodemographic variables and explanatory models of depression.

Methods:

A cross-sectional household survey in the rural community of Harekala village, Mangaluru taluk, Dakshina Kannada district, Karnataka, was done using Kish tables. A total of 200 individuals were interviewed with an adaptation of the Short Explanatory Model Interview in a local language using a case vignette of depression.

Results:

Around 40% of the individuals perceived the problem as tension/stress/excessive worrying and did not perceive it as mental illness. A scant 10% of the participants recognized some mental illness. Around one-fifth of the individuals attributed the problem to evil spirits and black magic; female participants were more likely to endorse consulting a doctor (P = 0.003**) or a psychiatrist (P = 0.012*). In addition, participants belonging to Islam were less likely to consult a doctor (P = 0.028*) and psychiatrist (P = 0.021*). Also, participants belonging to lower social class were less likely to endorse psychiatric consultation (P = 0.018*)

Conclusions:

A vast majority of the study subjects failed to identify depression as an illness or acknowledge biomedical causation. Gender, religion, and socioeconomic class may influence help-seeking behavior.