bluuebunny/crossref_metadata_2025 huggingface dataset:
Mess up the empire: Deploying and disrupting homonationalism
Authors: Evangelista John Andrew G
Published: October 2020

Homonationalism refers to how the West folded LGBTQ rights into the nation through neoliberal economies, intervention, and surveillance of racialized communities. This shift relied on the exceptionalist narrative that reveres Western sexual liberation—liberal, bureaucratic, visible, and consumerist—while silencing queer narratives from Southern, racialized, and migrant communities. The literature found that some LGBTQ (lesbians, gays, bisexuals, transgenders, and queers) organizations deployed this imperial narrative, yet accounts on the social conditions facilitating such deployments remain scant. To expand the current discussions, my paper situates the Philippine LGBTQ movement’s affinity with homonationalism within the political, material, and ideological exigencies that confronted activists.
The Moorov doctrine and coercive control: Proving a ‘course of behaviour’ under s. 1 of the Domestic Abuse (Scotland) Act 2018
Authors: Cairns Ilona
Published: October 2020

In 2019, a distinct offence of ‘abusive behaviour towards partner or ex-partner’ (‘domestic abuse’) came into force in Scotland via s. 1 of the Domestic Abuse (Scotland) Act 2018. This new offence has been celebrated for its meaningful incorporation of the concept of coercive control (Evan Stark has described the 2018 Act as ‘gold standard’ legislation) and may serve as a model for other jurisdictions looking to criminalise coercive and controlling behaviours. The practical effectiveness of the offence in Scotland, however, will hinge on how Scotland’s corroboration rule, and the accompanying Moorov doctrine (‘ Moorov’), are applied in this context. Drawing both on recent doctrinal developments and on a conceptual understanding of the dynamics of coercive control, this article offers the first in-depth analysis of how Moorov is likely to apply in s. 1 cases. It identifies developments that are likely to assist the prosecution, as well as potential barriers to the doctrine’s successful application, and argues that in certain cases judges and jurors will have difficulty seeing the ‘course of conduct’ required by Moorov without proper understanding of the policy underpinning the Act and the gendered nature of domestic abuse. The article considers how this understanding may be brought about, both within the confines of the current law and in terms of possible reform.
Performance of airflow distance from personalized ventilation on personal exposure to airborne droplets from different orientations
Authors: Xu Jingcui , Fu Sauchung , Chao Christopher Y. H.
Published: October 2020

This study investigated the effect of airflow distance from a personalized ventilation (PV) system on the personal exposure of a PV user to exhaled droplets from different orientations. Constant and dynamic airflow from the PV system was studied. A PV system was designed to produce both constant and dynamic airflows with different periods. Thermal manikins were used to simulate a healthy person (HP), also the PV user, influenced by a respiratory activity from an infected person (IP) at different orientations. Results show that, with a short distance of 0.2 m between the PV and the HP, both constant and dynamic PV flow can effectively protect the HP at all orientations considered; with a longer distance of 0.5 m between the PV and the HP, at some orientations, neither constant PV flow nor dynamic PV flow could protect the HP from the IP under our testing conditions. PV is a potential method to prevent disease transmission. However, a proper design is essential, and the relative position of the PV terminal, the IP and the HP and the distance of the PV from the HP are important factors to be considered so as to achieve the best performance.
Important aspects of home care service: An interview study of persons with dementia
Authors: Olsen Marie , Udo Camilla , Boström Anne-Marie , Hammar Lena Marmstål
Published: October 2020

Background and Aim

Because of the policy of ‘ageing in place’ and a decreasing number of beds in residential settings, more persons with dementia live at home with support from home care services. However, previous studies have revealed more unmet needs and a lower quality of life in this group than in other groups. Because few qualitative studies are performed in which persons with dementia have the opportunity to tell their own stories and describe what they find important, this study aimed to interview persons with dementia and describe their views on the important aspects of receiving home care service.

Methods

The study used a qualitative approach, and 14 persons with dementia participated in the interviews. The interviews were analysed using qualitative content analysis.

Findings

The findings revealed one overarching theme. The importance of being supported as a unique and capable human, that is the persons with dementia stated that despite their dementia diagnoses, it was important to be seen as a person with capabilities, although in need of support. This theme was built on three subthemes: being seen as a person, being informed and involved, and being part of a relationship.

Conclusions

Our study showed that persons with dementia are able to express, formulate and reflect on their needs and preferences about their daily care as well as what is important to them when receiving home care service. Therefore, their point of view should be taken into consideration when planning, providing and evaluating care.
When Confucius meets Erikson: An innovative life review program on Chinese seniors with probable dementia
Authors: Lin Li-Jung , Yen Hsin-Yen
Published: October 2020

Before Erikson proposed the life stages, Confucius concluded an autobiographic review of his entire life in about 500 BC. Confucius’ life stages may be closer to the life experiences of Chinese older adults. Therefore, the purpose of this study was to examine the effect of the life review program on cognitive ability, life satisfaction, meaning of life, and ego integrity. The experiment was based on a single-group time-series design with a four-time test across 21 weeks. The evoking materials were horticultural activities held in seven weekly sessions. The innovative life review program was in accordance with a combination of Confucius’ and Erikson’s life stages. Nine participants completed all sessions. There was a significant positive effect of time on participants’ cognitive ability and meaning of life after the program. A combination of Confucius’ and Erikson’s life stages can be more advantageous for Chinese older adults than only Erikson’s life stage.
Human-centric lighting: Myth, magic or metaphor?
Authors: Houser KW , Boyce PR , Zeitzer JM , Herf M
Published: October 2020

This paper discusses the rise of human-centric lighting and its current status in lighting. We summarise the human benefits associated with light and lighting and show that human-centric lighting has sound motivations, despite being tainted by misleading marketing claims. The phrase integrative lighting avoids the hype and encapsulates what lighting aspires to be. Embodied in these concepts are some things old and some things new. The old is twofold. First, without diminishing the value of lighting products, the core ingredient for good human outcomes is good design, driven by a design team. Second, light is still for vision, and lighting for visibility, visual comfort and visual amenity is as important as ever. Complementing the old is new awareness and responsibility for how light and lighting influence non-visual responses in humans. Circadian, neuroendocrine and neurobehavioural responses are important for human health and should be considered on-par with visual responses. This awareness leads toward lighting design solutions with increased contrast between day and night. The parties responsible for addressing non-visual responses to light and lighting are evolving. Architects, lighting professionals, lighting equipment manufacturers, medical professionals, building owners and individuals all have a stake, but who should drive decisions and in what proportion?
Prevalence of class I–III BRAF mutations among 114,662 cancer patients in a large genomic database
Authors: Owsley Jeff , Stein Matthew K , Porter Jason , In Gino K , Salem Mohamed , O’Day Steven , Elliott Andrew , Poorman Kelsey , Gibney Geoffrey , VanderWalde Ari
Published: October 2020

BRAF mutations are relatively common in many cancers, particularly melanoma, colorectal cancer, and thyroid cancer and to a lesser extent in lung cancer. These mutations can be targeted by BRAF and MEK inhibitors, which exhibit good clinical activity. There are conflicting reports of the various relative rates of BRAF Class I mutations (V600 locus), defined as those that exhibit extremely strong kinase activity by stimulating monomeric activation of BRAF, Class II, define as non-V600 mutations that activate BRAF to signal as a RAS-independent dimer, and Class III mutations, defined as “kinase-dead” with low kinase activity as compared to wild type BRAF. Prospective studies have largely focused on patients with tumors harboring Class I BRAF mutations (limited to the V600 locus) where response rates up to 70% with BRAF plus MEK inhibition have been demonstrated. We report on the relative prevalence of various types of BRAF mutations across human cancers in a cohort of 114,662 patients that received comprehensive genomic profiling using next-generation sequencing. Of these patients, 4517 (3.9%) a pathogenic or presumed pathogenic BRAF mutation (3.9%). Of these, 1271 were seen in melanoma, representing 39.7% of all melanomas sequenced, representing the highest rate in all tumors. Class I (V600) mutations were seen overall in 2841 patients (62.1% of BRAF mutations, 2.4% of total cancers). Class II mutations were seen in 746 tumors (16.5% of BRAF mutant, 0.7% of total), and Class III mutations were seen in 801 tumors (17.7% of BRAF, 0.7% of total). Knowledge of the relative prevalence of these types of mutations can aid in the development of agents that might better address non-V600 mutations in cancer.

Impact statement

These data represent the largest aggregation of BRAF mutations within a single clinical database to our knowledge. The relative proportions of both BRAF V600 mutations and non-V600 mutations are informative in all cancers and by malignancy, and can serve as a definitive gold-standard for BRAF mutation cancer incidence by malignancy. The rate of BRAF mutation in human cancer in a real-world large database is lower than previously reported likely representing testing more broadly across tumor types. The relative percentages of Class II and Class III BRAF mutations are higher than previously reported, representing almost 35% of BRAF mutations in cancer. These findings provide support for the development of effective treatments for non-V600 BRAF mutations in cancer.
Preoperative serum circulating microRNAs as potential biomarkers for chronic postoperative pain after total knee replacement
Authors: Giordano Rocco , Petersen Kristian Kjær , Andersen Hjalte Holm , Lichota Jacek , Valeriani Massimiliano , Simonsen Ole , Arendt-Nielsen Lars
Published: October 2020

Background

Chronic postoperative pain affects approximately 20% of patients with knee osteoarthritis after total knee replacement. Circulating microRNAs can be found in serum and might act as biomarkers in a variety of diseases. The current study aimed to investigate the preoperative expression of circulating microRNAs as potential predictive biomarkers for the development of chronic postoperative pain in the year following total knee replacement.

Methods

Serum samples, collected preoperatively from 136 knee osteoarthritis patients, were analyzed for 21 circulatory microRNAs. Pain intensity was assessed using a visual analog scale before and one year after total knee replacement. Patients were divided into a low-pain relief group (pain relief percentage <30%) and a high-pain relief group (pain relief percentage >30%) based on their pain relief one year after total knee replacement, and differences in microRNAs expression were analyzed between the two groups.

Results

We found that three microRNAs were preoperatively dysregulated in serum in the low-pain relief group compared with the high-pain relief group. MicroRNAs hsa-miR-146a-5p, -145-5p, and -130 b-3p exhibited fold changes of 1.50, 1.55, and 1.61, respectively, between the groups (all P values < 0.05). Hsa-miR-146a-5p and preoperative pain intensity correlated positively with postoperative pain relief (respectively, R = 0.300, P = 0.006; R = 0.500, P < 0.001).

Discussion

This study showed that patients with a low postoperative pain relief present a dysregulation of circulating microRNAs. Altered circulatory microRNAs expression correlated with postoperative pain relief, indicating that microRNAs can serve as predictive biomarkers of pain outcome after surgery and hence may foster new strategies for preventing chronic postoperative pain after total knee replacement (TKR).
The role of aspirin in the prevention of ovarian, endometrial and cervical cancers
Authors: Joharatnam-Hogan Nalinie , Cafferty Fay H , Macnair Archie , Ring Alistair , Langley Ruth E
Published: October 2020

Drug repurposing is the application of an existing licenced drug for a new indication and potentially provides a faster and cheaper approach to developing new anti-cancer agents. Gynaecological cancers contribute significantly to the global cancer burden, highlighting the need for low cost, widely accessible therapies. A large body of evidence supports the role of aspirin as an anti-cancer agent, and a number of randomized trials are currently underway aiming to assess the potential benefit of aspirin in the treatment of cancer. This review summarizes the evidence underpinning aspirin use for the prevention of the development and recurrence of gynaecological cancers (ovarian, endometrial and cervical) and potential mechanisms of action.
Impact of COVID-19 on Management of Laryngeal/Oropharyngeal Neoplasms
Authors: Sabaa Mohamed Abd Elmottaleb , Algarf T. M.
Published: October 2020

Study Design:

A retrospective cohort study.

Objective:

The world was unprecedentedly struck by the new coronavirus in December 2019. Consequently, lockdown measures were imposed by many governments. Health-care services were reserved for emergencies and malignancies. Nevertheless, many patients who urgently needed these services did not present. This study estimates the impact of COVID-19 and lockdown measures on the patients’ flow in the outpatient clinic (OPC) and the operations for laryngeal and/or oropharyngeal neoplasms.

Methods:

This study is a retrospective cohort study performed in otolaryngology department of a tertiary care hospital which is a major referral center. All patients who attended the OPC and all operations performed for laryngeal and/or oropharyngeal neoplasms were counted from February 1, 2020 to May 31, 2020 and compared with the previous year as a reference.

Results:

In 2020, the number of patients attending the otolaryngology OPC and the laryngeal and/or oropharyngeal surgeries showed a major drop, especially after imposing the lockdown measures. The total number of these operations in April and May 2019 dropped by 79% for the same period in 2020.

Conclusion:

An estimate of 79% of patients, who had been presenting for laryngeal and/or oropharyngeal neoplasms, did not show up due to indirect COVID-19 effect.
In the Blink of an Eye: Reading Mental States From Briefly Presented Eye Regions
Authors: Schmidtmann Gunnar , Logan Andrew J. , Carbon Claus-Christian , Loong Joshua T. , Gold Ian
Published: October 2020

Faces provide not only cues to an individual’s identity, age, gender, and ethnicity but also insight into their mental states. The aim was to investigate the temporal aspects of processing of facial expressions of complex mental states for very short presentation times ranging from 12.5 to 100 ms in a four-alternative forced choice paradigm based on Reading the Mind in the Eyes test. Results show that participants are able to recognise very subtle differences between facial expressions; performance is better than chance, even for the shortest presentation time. Importantly, we show for the first time that observers can recognise these expressions based on information contained in the eye region only. These results support the hypothesis that the eye region plays a particularly important role in social interactions and that the expressions in the eyes are a rich source of information about other peoples’ mental states. When asked to what extent the observers guessed during the task, they significantly underestimated their ability to make correct decisions, yet perform better than chance, even for very brief presentation times. These results are particularly relevant in the light of the current COVID-19 pandemic and the associated wearing of face coverings.
Pursuing therapeutic success in Crohn’s disease: A matter of definition, tools and longterm outcomes
Authors: Goran Loredana , State Monica , Negreanu Ana Maria , Negreanu Lucian
Published: October 2020

Management of Crohn’s disease (CD) based on symptom control is a tale of the past as new treatment strategies aim toward a “treat to target” concept and to a patient-tailored approach. Defining treatment goals and assessing therapeutic success have been in the center of IBD research in the past years. Clinical remission and mucosal healing are well-established treatment goals by current recommendations, although prospective data is required to determine whether achieving these targets is enough to alter disease natural course. Furthermore, there is no standard in assessing therapeutic success. Low relapse and hospitalization rates, as well as a low need of surgery are indicators of a successful treatment. Close monitoring is part of the new therapeutic strategy. Monitoring tools are numerous, comprising clinical, biological, endoscopic and imaging scores or parameters but are far from being perfect. The traditional strategy of managing CD patients based on clinical symptoms and response to treatment did not improve the long-term outcomes. Clinical activity scores are frequently used in clinical trials and daily practice, but their use alone is not an accurate measure of inflammation. Endoscopic remission is associated with a lower risk of complications and a better long-term prognostic. Several guidelines include recommendations regarding surveillance endoscopy, but there is an open debate regarding the follow-up intervals. Cross-sectional imaging techniques play a complementary role in assessing transmural inflammation and in identifying extra-intestinal complications of CD and should be used in conjunction with endoscopy. Therapeutic drug monitoring is essential in assessing loss of response and making therapeutic decisions, although firm recommendations are not implemented into daily practice. Extraintestinal manifestations are often disregarded when discussing monitoring protocols. There is no current guideline indication for extraintestinal manifestations monitoring during remission periods.
Posterior Stabilization Without Neural Decompression in Osteoporotic Thoracolumbar Fractures With Dynamic Cord Compression Causing Incomplete Neurological Deficits
Authors: Mallepally Abhinandan Reddy , Marathe Nandan , Sangondimath Gururaj , Das Kalidutta , Chhabra Harvinder Singh
Published: October 2020

Study Design:

Prospective cohort study.

Objectives:

Management of osteoporotic vertebral compression fracture (OVCF) remains an unsolved problem for a spine surgeon. We hypothesize that instability at the fracture site rather than neural compression is the main factor leading to a neurological deficit in patients with OVCF.

Methods:

In this study, the prospective data of patients with osteoporotic fractures with incomplete neurological deficits from January 2015 to December 2017 was analyzed in those who underwent posterior instrumented fusion without neural decompression.

Results:

A total of 61 patients received posterior indirect decompression via ligamentotaxis and stabilization only. Of these 17 patients had polymethylmethacrylate (PMMA) augmented screws and in 44 patients no PMMA augmentation was done. The mean preoperative kyphosis was 27.12° ± 9.63°, there was an improvement of 13.5° ± 6.87° in the immediate postoperative period and at the final follow-up, kyphosis was 13.7° ± 7.29° with a loss of correction by 2.85° ± 3.7°. The height restoration at the final follow-up was 45.4% ± 18.29%. In all patients, back pain was relieved, and neurological improvement was obtained by at least 1 American Spinal Injury Association Impairment Scale in all except 3 patients.

Conclusion:

We propose that neural decompression of the spinal cord is not always necessary for the treatment of neurological impairment in patients with osteoporotic vertebral collapse with dynamic mobility. Dynamic magnetic resonance imaging is a valuable tool to make an accurate diagnosis and determine precise surgical plan and improving the surgical strategy of OVCF.
Predictors for readmission following primary total hip and total knee arthroplasty
Authors: Phruetthiphat Ong-art , Otero Jesse E , Zampogna Biagio , Vasta Sebastiano , Gao Yubo , Callaghan John J
Published: October 2020

Background:

Readmission following total joint arthroplasty has become a closely watched metric for many hospitals in the United States due to financial penalties imposed by Centers for Medicare and Medicaid Services. The purpose of this study was to identify both preoperative and postoperative reasons for readmission within 30 days following primary total hip and total knee arthroplasty (TKA).

Methods:

Retrospective data were collected for patients who underwent elective primary total hip arthroplasty (THA; CPT code 27130) and TKA (27447) from 2008 to 2013 at our institution. The sample was separated into readmitted and nonreadmitted cohorts. Demography, comorbidities, Charlson comorbidity index (CCI), operative parameters, readmission rates, and causes of readmission were compared between the groups using univariate and multivariate regression analysis.

Results:

There were 42 (3.4%) and 28 (2.2%) readmissions within 30 days for THA and TKA, respectively. The most common cause of readmission within 30 days following total joint arthroplasty was infection. Trauma was the second most common reason for readmission of a THA while wound dehiscence was the second most common cause for readmission following TKA. With univariate regression, there were multiple associated factors for readmission among THA and TKA patients, including body mass index, metabolic equivalent (MET), and CCI. Multivariate regression revealed that hospital length of stay was significantly associated with 30-day readmission after THA and TKA.

Conclusion:

Patient comorbidities and preoperative functional capacity significantly affect 30-day readmission rate following total joint arthroplasty. Adjustments for these parameters should be considered and we recommend the use of CCI and METs in risk adjustment models that use 30-day readmission as a marker for quality of patient care.

Level of Evidence:

Level III/Retrospective cohort study
A Rare Case of Partial Aortic Mechanical Valve Thrombosis With Intact Mitral Mechanical Valve Presenting With ST-Elevation Myocardial Infarction Patients
Authors: Khalid Mazin O. , Malyshev Yury , Hashmi Arsalan Talib , Siddiqui Sabah , Patel NeelKumar , Shani Jacob , Ayzenberg Sergey
Published: October 2020

The incidence of mechanical valve thrombosis (MVT) is around 0.4 per 100 patient-years. Mitral valve thrombosis has a higher incidence than aortic valve thrombosis with a nearly 5-fold increase. Various factors contribute to MVT. The most common cause of valve thrombosis is poor adherence/disruption of anticoagulation therapy. Low cardiac output is known to increase the risk of prosthetic valve thrombosis. Other factors such as diabetes, hypertension, and other patient comorbidities might also play a role. Decreased flow promotes hypercoagulability. Lower pressure in the left atrium (and higher velocities in the left ventricle) can partially contribute to the higher incidence of mitral MVT versus aortic MVT. The presenting symptoms usually depend on the severity of the valve thrombosis; nonobstructive valve thrombosis patients have progressive dyspnea, signs of heart failure, and systemic embolization with strokes being the most common complication. In this article, we present a case of a middle-aged woman with a history of mitral and aortic mechanical prosthesis who presented with an ST-segment elevation myocardial infarction and pulmonary edema due to mechanical aortic valve prosthesis thrombosis. She had an isolated mechanical aortic valve prosthesis thrombosis with intact mitral valve, which, to the best of our knowledge, has not yet been described. We performed a literature review by searching PubMed and Embase using the keywords “mechanical valve,” “thrombosis,” “aortic,” and “mitral,” our search did not show similar cases.
Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy
Authors: Malhotra Varun , Magoon Sandeep , Troyer Dean A. , McCune Thomas R.
Published: October 2020

As COVID-19 (coronavirus disease 2019) spreads across the world multiple therapeutic interventions have been tried to reduce morbidity and mortality. We describe a case of collapsing focal sclerosing glomerulosclerosis (FSGS) and acute oxalate nephropathy in a patient treated with high-dose intravenous vitamin C for severe COVID-19 infection. Collapsing FSGS has been described in patients with COVID-19 infection associated with APOL-1; however, this case had collapsing FSGS developing in low-risk heterozygous APOL-1 variant, and we postulate that the intensity of the COVID-19 cytokine storm overwhelmed the protective state of APOL-1 heterozygosity. This case illustrates the importance of assessing the risk and benefit of planned therapeutic interventions on a case-by-case basis especially when there are still so many unknowns in the management of COVID-19 infection. Strong consideration should be given for performing a renal biopsy in patients who develop multifactorial acute kidney injury.
Graft Tensioning in Superior Capsular Reconstruction Improves Glenohumeral Joint Kinematics in Massive Irreparable Rotator Cuff Tears: A Biomechanical Study of the Influence of Superior Capsular Reconstruction on Dynamic Shoulder Abduction
Authors: Dyrna Felix , Berthold Daniel P. , Muench Lukas N. , Beitzel Knut , Kia Cameron , Obopilwe Elifho , Pauzenberger Leo , Adams Christopher R. , Cote Mark P. , Scheiderer Bastian , Mazzocca Augustus D.
Published: October 2020

Background:

Superior capsular reconstruction (SCR) for massive, irreparable rotator cuff tears has become more widely used recently; however, ideal tensioning of the graft and the influence on joint kinematics remain unknown.

Purpose/Hypothesis:

The purpose of this study was to assess the effects of graft tensioning on glenohumeral joint kinematics after SCR using a dermal allograft. The hypothesis was that a graft fixed under tension would result in increased glenohumeral abduction motion and decreased cumulative deltoid forces compared with a nontensioned graft.

Study Design:

Controlled laboratory study.

Methods:

A total of 10 fresh-frozen cadaveric shoulders were tested using a dynamic shoulder simulator. Each shoulder underwent the following 4 conditions: (1) native, (2) simulated irreparable supraspinatus (SSP) tear, (3) SCR using a nontensioned acellular dermal allograft, and (4) SCR using a graft tensioned with 30 to 35 N. Mean values for maximum glenohumeral abduction and cumulative deltoid forces were recorded. The critical shoulder angle (CSA) was also assessed.

Results:

Native shoulders required a mean (±SE) deltoid force of 193.2 ± 45.1 N to achieve maximum glenohumeral abduction (79.8° ± 5.8°). Compared with native shoulders, abduction decreased after SSP tears by 32% (54.3° ± 13.7°; P = .04), whereas cumulative deltoid forces increased by 23% (252.1 ± 68.3 N; P = .04). The nontensioned SCR showed no significant difference in shoulder abduction (54.1° ± 16.1°) and required deltoid forces (277.8 ± 39.8 N) when compared with the SSP tear state. In contrast, a tensioned graft led to significantly improved shoulder abduction compared with the SSP tear state ( P = .04) although abduction and deltoid forces could not be restored to the native state ( P = .01). A positive correlation between CSA and maximum abduction was found for the tensioned-graft SCR state ( r = 0.685; P = .02).

Conclusion:

SCR using a graft fixed under tension demonstrated a significant increase in maximum shoulder abduction compared with a nontensioned graft; however, abduction remained significantly less than the intact state. The nontensioned SCR showed no significant improvement in glenohumeral kinematics compared with the SSP tear state.

Clinical Relevance:

Because significant improvement in shoulder function after SCR may be expected only when the graft is adequately tensioned, accurate graft measurement and adequate tension of at least 30 N should be considered during the surgical procedure. SCR with a tensioned graft may help maintain sufficient acromiohumeral distance, improve clinical outcomes, and reduce postoperative complications.
Bilateral Central Retinal Artery Occlusion in Infective Endocarditis
Authors: Mohamed Mohamed , Scholle Tahira
Published: October 2020

Purpose:

This report describes a patient with bilateral, sequential central retinal artery occlusions (CRAOs) due to infective endocarditis (IE).

Methods:

A case report is presented.

Results:

A 35-year-old man with IE who recently completed a course of intravenous antibiotic therapy presented with sudden right-eye vision loss. Examination revealed hand motion vision, a cherry-red spot in the macula in the right eye, and an embolus in the inferotemporal arcade of the left eye. The diagnosis of right-eye CRAO secondary to IE was made, with the presumed source being his dental caries. The patient was admitted with plans for aortic valve replacement and dental extraction. During his hospitalization, the patient suffered from a CRAO in his left eye, resulting in bilateral loss of vision.

Conclusions:

IE can have severe embolic complications; prompt diagnosis and treatment medically and surgically are necessary to reduce further morbidity and mortality.
Teams and Project Performance: An Ability, Motivation, and Opportunity Approach
Authors: Dasí Àngels , Pedersen Torben , Barakat Lívia Lopes , Alves Tiago Rangel
Published: October 2020

This article analyzes the relationships between project performance and the team’s ability, motivation, and opportunity (AMO). We contribute to the project management literature by exploring which combinations of AMO factors are best for project performance at different levels of complexity. We test our hypotheses on a sample of 285 projects. Our study shows that in simple projects, ability is the key factor both as a main effect and as a constraining factor that acts as a bottleneck for project performance. In the case of complex projects, the multiplicative model is superior given the significant interaction effects of motivation.
Eptinezumab for the prevention of chronic migraine: efficacy and safety through 24 weeks of treatment in the phase 3 PROMISE-2 (Prevention of migraine via intravenous ALD403 safety and efficacy–2) study
Authors: Silberstein Stephen , Diamond Merle , Hindiyeh Nada A. , Biondi David M. , Cady Roger , Hirman Joe , Allan Brent , Pederson Susan , Schaeffler Barbara , Smith Jeff
Published: October 2020

Background

PROMISE-2 was a phase 3, randomized, double-blind, placebo-controlled study that evaluated the efficacy and safety of repeat intravenous (IV) doses of the calcitonin gene-related peptide–targeted monoclonal antibody eptinezumab (ALD403) for migraine prevention in adults with chronic migraine. This report describes the results of PROMISE-2 through 24 weeks of treatment.

Methods

Patients received up to two 30-min IV administrations of eptinezumab 100 mg, 300 mg, or placebo separated by 12 weeks. Patients recorded migraine and headache endpoints in a daily eDiary. Additional assessments, including patient-reported outcomes, were performed at regularly scheduled clinic visits throughout the 32-week study period (screening, day 0, and weeks 2, 4, 8, 12, 16, 20, 24, and 32).

Results

A total of 1072 adults received treatment: eptinezumab 100 mg, n = 356; eptinezumab 300 mg, n = 350; placebo, n = 366. The reduction in mean monthly migraine days observed during the first dosing interval (100 mg, − 7.7 days; 300 mg, − 8.2 days; placebo, − 5.6 days) was further decreased after an additional dose (100 mg, − 8.2 days; 300 mg, − 8.8 days; placebo, − 6.2 days), with both doses of eptinezumab demonstrating consistently greater reductions from baseline compared to placebo. The ≥50% and ≥ 75% migraine responder rates (MRRs) increased after a second dose, with more eptinezumab-treated patients experiencing migraine response than placebo patients (≥50% MRRs weeks 13–24: 100 mg, 61.0%; 300 mg, 64.0%; placebo, 44.0%; and ≥ 75% MRRs weeks 13–24: 100 mg, 39.3%; 300 mg, 43.1%; placebo, 23.8%). The percentages of patients who improved on patient-reported outcomes, including the Headache Impact Test and Patient Global Impression of Change, increased following the second dose administration at week 12, and were greater with eptinezumab than with placebo at all time points. No new safety concerns were identified with the second dose regarding the incidence, nature, and severity of treatment-emergent adverse events.

Conclusion

Eptinezumab 100 mg or 300 mg administered IV at day 0 and repeated at week 12 provided sustained migraine preventive benefit over a full 24 weeks and demonstrated an acceptable safety profile in patients with chronic migraine.

Trial registration

ClinicalTrials.gov (Identifier: NCT02974153). Registered November 23, 2016.
Enhanced MRI-guided radiotherapy with gadolinium-based nanoparticles: preclinical evaluation with an MRI-linac
Authors: Byrne H. L. , Le Duc G. , Lux F. , Tillement O. , Holmes N. M. , James A. , Jelen U. , Dong B. , Liney G. , Roberts T. L. , Kuncic Z.
Published: October 2020

Background

The AGuIX® (NH TherAguix) nanoparticle has been developed to enhance radiotherapy treatment and provide strong MR contrast. These two properties have previously been investigated separately and progressed to clinical trial following a clinical workflow of separate MR imaging followed some time later by radiotherapy treatment. The recent development of MRI-linacs (combined Magnetic Resonance Imaging–linear accelerator systems enabling MRI-guided radiotherapy) opens up a new workflow where MR confirmation of nanoparticle uptake can be carried out at the time of treatment. A preclinical study was carried out to assess the suitability of a gadolinium-containing nanoparticle AGuIX® (NH TherAguix) for nano-enhanced image-guided radiotherapy on an MRI-linac.

Methods

Treatments were carried out on F344 Fischer rats bearing a 9L glioma brain tumour. Animals received either: (A) no treatment; (B) injection of nanoparticles followed by MRI; (C) radiotherapy with MRI; or (D) injection of nanoparticles followed by radiotherapy with MRI. Pre-clinical irradiations were carried out on the 1.0 T, 6 MV in-line Australian MRI-linac. Imaging used a custom head coil specially designed to minimise interference from the radiotherapy beam. Anaesthetised rats were not restrained during treatment but were monitored with a cine-MRI sequence. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis was used to quantify residual gadolinium in the brain in normal and tumour tissue.

Results

A preclinical evaluation of nano-enhanced radiation treatment has been carried out on a 1.0 T MRI-linac, establishing a workflow on these novel systems. Extension of life when combining radiotherapy with nanoparticles was not statistically different from that for rats receiving radiotherapy only. However, there was no detrimental effect for animals receiving nanoparticles and radiation treatment in the magnetic field compared with control branches. Cine-MR imaging was sufficient to carry out monitoring of anaesthetised animals during treatment. AGuIX nanoparticles demonstrated good positive contrast on the MRI-linac system allowing confirmation of tumour extent and nanoparticle uptake at the time of treatment.

Conclusions

Novel nano-enhanced radiotherapy with gadolinium-containing nanoparticles is ideally suited for implementation on an MRI-linac, allowing a workflow with time-of-treatment imaging. Live irradiations using this treatment workflow, carried out for the first time at the Australian MRI-linac, confirm the safety and feasibility of performing MRI-guided radiotherapy with AGuIX® nanoparticles. Follow-up studies are needed to demonstrate on an MRI-linac the radiation enhancement effects previously shown with conventional radiotherapy.
HbA1c variability and long-term glycemic control are linked to peripheral neuropathy in patients with type 1 diabetes
Authors: Pinto M. V. , Rosa L. C. G. F. , Pinto L. F. , Dantas J. R. , Salles G. F. , Zajdenverg L. , Rodacki M. , Lima M. A.
Published: October 2020

Background

HbA1c variability has been linked to retinopathy, renal disease and autonomic neuropathy in patients with type 1 diabetes mellitus (T1D) and type 2 diabetes mellitus (T2D). Although the same relationship has been demonstrated for diabetic peripheral neuropathy (DPN) in patients with T2D, data for T1D are still lacking.

Methods

Patients older than 17 years of age with ≥ 10 years of T1D duration and follow-up were included. All patients underwent nerve conduction studies and neurological examination. Laboratorial data was retrospectively extracted from chart review. Mean HbA1c (mHbA1c) over 10 years was calculated, as well as HbA1c variability estimated by standard deviation (HbA1c-SD) and coefficient of variation (HbA1c-CV).

Results

Fifty patients with T1D were included (30 females and 21 non-caucasians), with mean age and T1D duration of 25.6 ± 5.0 and 17.9 ± 6.1 years, respectively. The frequency of DPN was 24%. Higher mHbA1c (10.4 ± % vs 8.1 ± %; p < 0.001), HbA1c-SD (1.8 ± 0.8 vs 0.9 ± 0.4; p < 0.001), and HbA1c-CV (1.7 ± 0.8 vs 1.2 ± 1.1; p = 0.006) were observed in patients with DPN compared to others. SD-HbA1c and HbA1c-CV were associated with DPN, diagnosed by either clinical or NCS criteria, independent of mHbA1c, age and gender.

Conclusions

Not only long-term glycemic control, but also its variability is associated with DPN in patients with T1D. Larger studies are required to confirm this finding.
Human platelet lysate as a potential clinical-translatable supplement to support the neurotrophic properties of human adipose-derived stem cells
Authors: Palombella Silvia , Guiotto Martino , Higgins Gillian C. , Applegate Laurent L. , Raffoul Wassim , Cherubino Mario , Hart Andrew , Riehle Mathis O. , di Summa Pietro G.
Published: October 2020

Background

The autologous nerve graft, despite its donor site morbidity and unpredictable functional recovery, continues to be the gold standard in peripheral nerve repair. Rodent research studies have shown promising results with cell transplantation of human adipose-derived stem cells (hADSC) in a bioengineered conduit, as an alternative strategy for nerve regeneration. To achieve meaningful clinical translation, cell therapy must comply with biosafety. Cell extraction and expansion methods that use animal-derived products, including enzymatic adipose tissue dissociation and the use of fetal bovine serum (FBS) as a culture medium supplement, have the potential for transmission of zoonotic infectious and immunogenicity. Human-platelet-lysate (hPL) serum has been used in recent years in human cell expansion, showing reliability in clinical applications.

Methods

We investigated whether hADSC can be routinely isolated and cultured in a completely xenogeneic-free way (using hPL culture medium supplement and avoiding collagenase digestion) without altering their physiology and stem properties. Outcomes in terms of stem marker expression (CD105, CD90, CD73) and the osteocyte/adipocyte differentiation capacity were compared with classical collagenase digestion and FBS-supplemented hADSC expansion.

Results

We found no significant differences between the two examined extraction and culture protocols in terms of cluster differentiation (CD) marker expression and stem cell plasticity, while hADSC in hPL showed a significantly higher proliferation rate when compared with the usual FBS-added medium. Considering the important key growth factors (particularly brain-derived growth factor (BDNF)) present in hPL, we investigated a possible neurogenic commitment of hADSC when cultured with hPL. Interestingly, hADSC cultured in hPL showed a statistically higher secretion of neurotrophic factors BDNF, glial cell-derived growth factor (GDNF), and nerve-derived growth factor (NFG) than FBS-cultured cells. When cocultured in the presence of primary neurons, hADSC which had been grown under hPL supplementation, showed significantly enhanced neurotrophic properties.

Conclusions

The hPL-supplement medium could improve cell proliferation and neurotropism while maintaining stable cell properties, showing effectiveness in clinical translation and significant potential in peripheral nerve research.
Raising Well at Home: a pre-post feasibility study of a lifestyle intervention for caregivers and their child with obesity
Authors: Haire-Joshu Debra , Schwarz Cindy , Jacob Rebekah , Kristen Pat , Johnston Shelly , Quinn Karyn , Tabak Rachel
Published: October 2020

Background

Few efficacious pediatric obesity interventions have been successfully translated and sustained in real-world practice, often due to inadequate fit with the priorities of under-resourced populations. Lifestyle interventions, which incorporate tailoring of essential weight loss ingredients and adaptation of mode and intensity to the living circumstances of children with obesity, are needed. The purpose of this pilot study was to test the feasibility and efficacy of a tailored lifestyle intervention for caregivers and their children with obesity, conducted in partnership with Envolve, Inc., a family of comprehensive health solutions and wholly owned subsidiary of Centene Corporation.

Methods

This 6-month pilot study employed a pretest-posttest design to assess the impact of a tailored lifestyle intervention delivered by peer coaches on (a) caregiver and child weight impacted by changes in dietary intake, walking, and screen time; (b) changes in the home environment; and (c) caregiver engagement and satisfaction. The intervention was delivered via 3 core home visits every 4–6 weeks, with additional support via text.

Results

The majority of caregivers were female (95.2%) and Black (73.7%). Children had median age of 11.1 years and majority were female (57.6%), with a median BMI near the 99th percentile (Mdn 98.8, IQR 3.5) or 118.3% (IQR 35.8) of the 95th percentile for their sex and age. Participants expressed high satisfaction with the program (mean range 96.7–100.0% agreement on satisfaction items). From baseline to post, caregivers’ BMI decreased by 1.8% (p = 0.016, r = 0.22), while children’s BMI percentile z-score decreased significantly (p = 0.023, r = 0.18) and BMI percent of the 95th percentile remained constant (p = 0.05, r = 0.15). Caregivers and children decreased sugar-sweetened beverage intake (p = 0.026, r = 0.22; p = 0.006, r = 0.23, respectively), reduced presence of soda in the home (p = 0.002, g = 0.43), and decreased screen time (p = 0.046, g = 0.22). Other eating and walking behaviors remained stable for caregivers and child.

Conclusion

The Raising Well at Home pilot demonstrated that tailored lifestyle interventions, delivered by peer coaches in the home and via text, are feasible and can improve weight, eating, and environmental measures of caregivers and children with obesity. Future work should determine the effectiveness, sustainability, and scalability of this intervention in sites located across the country.

Trial registration

ClinicalTrials.gov (NCT04224623). Registered 9 January 2020—retrospectively registered.
An explorative approach to the cross-section of international migration and sexual preference: same-sex couples in Germany
Authors: Braack Mirko K. , Milewski Nadja
Published: October 2020

We study the intersection of international migration and sexual preference from a socio-demographic perspective by looking at same-sex couples among migrants in Germany. Despite increasing ethnic diversity and greater social and legal liberality toward non-normative living arrangements, there are hardly any available quantitative data on this vulnerable group, which crosses two social boundaries. Drawing on the scientific-use file of the German Microcensus (2013), we estimate the prevalence of same-sex couples among female and male migrants, and describe their socio-demographic characteristics. We use different approaches to imputing data to account for the possibility that the reported information on same-sex relationships may be missing or wrong, and consider different definitions of “migrant status”. Our results show that the share of couples who were same-sex was smaller among the immigrant (0.2 to 1.4%) than among the native population (0.6 to 2.0%). Moreover, migrants in a same-sex couple were more similar in terms of other socio-demographic variables (age, education) to natives in a same-sex union than to migrants in an opposite-sex union. This study contributes to the LGBT social science literature by providing the first quantitative description of this minority-in-a minority group in Germany.
Field evaluation of horticultural mineral oils and botanicals against bean thrips, Megalurothrips distalis (Karny) (Thysanoptera: Thripidae), in summer mung bean
Authors: Singh Harkamalpreet , Cheema Harpreet Kaur , Singh Ravinder
Published: October 2020

Background

Bean thrips, Megalurothrips distalis (Karny), are a serious insect pest of mung bean grown in summer season as a catch crop in wheat–rice cropping system in North West India. Severe incidence leads to flower shedding and fewer pods leading to loss in grain yield. Field studies were conducted to evaluate the efficacy of horticultural mineral oils, neem-based botanicals, and pongamia soap in the form of spray in comparison to the insecticide dimethoate in 2018 and 2019.

Main body

Randomized complete block design (RCBD) was used with 11 treatments including untreated control in 3 replications. Neem seed kernel extract (NSKE) at 5% gave the highest mean percent reduction in the number of thrips (90.44 and 79.59%), followed by 10 ml l−1 of Neem Kavach 1500 ppm (85.55 and 78.97%) and the insecticide dimethoate 30% EC at 250 ml ha−1 (84.92 and 78.22%) 1 and 3 days after treatment. Neem Baan 1500 ppm, Indo-Neem 1500 ppm, and Nimbecidine 300 ppm each at 10 ml l−1 also provided 75.29–82.42% and 61.18–75.82% reduction 1 and 3 days after treatment. Horticultural mineral oils also reduced the insect population by about 64%, while pongamia soap was least effective (31.58%) among botanicals. Dimethoate 30% EC at 250 ml ha−1 recorded the highest grain yield and net returns, followed by NSKE, Nimbecidine, and Neem Kavach that were on par with it. Homemade neem extracts evaluated in 2019 caused 62.7–77.3% reduction in thrips population up to 3 days after treatment with yields comparable to 10 ml l–1 of Indo-Neem spray.

Conclusion

The study indicated that neem extract was capable to manage the bean thrips in flowers of summer mung bean and obtained a high grain yield.