bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Traumatic Epidural Hematoma in Infants Younger than One Year: 50 Cases – Single Center Experience
Authors: Baş Nuri Serdar , Karacan Murat , Doruk Ebru , Karagoz Guzey Feyza
Published: April 2021

Aim and Background: Traumatic epidural hematoma (EDH) is a rare but possibly fatal complication of head trauma in infants. In this study, infants who were younger than 1 year and followed up and treated for TEDH in our clinic were evaluated. Our series is the largest series consisting only infantile cases in the literature. Material and Methods: There were 50 patients younger than 1 year followed up and treated in our hospital between January 2011 and December 2019. Their age, gender, hospital admission signs and symptoms, trauma type, localization and thickness of the hematoma, and accompanying skull fracture were noted from their hospital files. Decisions for conservative or surgical treatment were made according to neurological status, Children Coma Scale (CCS) score, and EDH thickness, degree of the midline shift on cranial computerized tomography (CT), and presence of additional intracranial pathology. Results: Patients’ age ranged from 0 day to 12 months (7 months as median), and their male/female ratio was 30/20. Falling from a height (<1 m) was the most frequent trauma mechanism, with a 96% rate. The most common finding was irritability and unusual crying (88%). The CCS score was 5–15 (median 13). The hematoma was located most frequently in the parietal region (48%) and least frequently in the posterior fossa (2%). Linear fracture was observed in 62% of the cases. Thirty-nine (78%) patients were treated conservatively (hematoma thickness ≤17 mm). Eleven (22%) cases were surgically treated (hematoma thickness was between 15 and 40 mm (26.3 ± 6.6 mm, mean ± standard deviation [SD]). The midline shift in the operated cases was between 1.8 and 11.8 mm (6.4 ± 3 mm, mean ± SD). One of them with a hematoma thickness of 15 mm was operated for associated open depression fracture above the hematoma. Other 10 patients were operated for primarily hematoma evacuation. None of the patients treated conservatively worsened neurologically or required operation during or after hospitalization. Two patients died (4%) during hospitalization, and both of them were anisocoric on admission. The hospital stay was between 1 and 10 (median 3) days, and the follow-up period of the living patients was between 1 month and 6 years (median 24 months). All of the living patients were neurologically normal on their last controls. Conclusions: Because the symptoms and signs in infants are nonspecific, it is difficult to diagnose EDH clinically. Cranial CT should be performed in cases with irritability, swelling of the scalp, pallor, deterioration of consciousness, and anisocoria after head trauma. Traumatic EDHs with normal neurological examination, high CCS score, hematoma thickness below 20 mm, no apparent shift, and without associated brain pathology can be treated conservatively. None of those patients treated conservatively required operation after that.
Design de materiais como uma demanda da ciência e tecnologia para a inovação
Authors: Barauna Debora , Razera Dalton Luiz , Zamoner Michele Tais D. C. , Silva Denise A. K.
Published: April 2021

O avanço do conhecimento na ciência e tecnologia dos materiais possibilitou a manipulação e a criação de novos materiais com melhores propriedades em atendimento a aplicações específicas. Dentro desse contexto, o presente artigo visa elucidar o termo design de materiais mediante a promoção da inovação. Foi realizada uma revisão narrativa da literatura e dissertado sobre o tema a partir de períodos históricos de desenvolvimento da sociedade. Os procedimentos de pesquisa utilizados foram pesquisa bibliográfica e análise de conteúdo. Os resultados obtidos mostram o design de materiais como uma abordagem demandada pela engenharia de materiais no final do século 20, quando o pensamento preditivo foi adotado para a pesquisa, o desenvolvimento e a aplicação de materiais avançados. Já no século 21 o conceito do design de materiais compreendeu os conhecimentos do design e da gestão com o propósito de aumentar a probabilidade de sucesso da difusão da inovação para a sociedade. A colaboração e a criatividade são as apostas emergentes nesse processo.
Fetal Programming by Methyl Donor Deficiency Produces Pathological Remodeling of the Ascending Aorta
Authors: Balint Brittany , Hergalant Sébastien , Camadro Jean-Michel , Blaise Sébastien , Vanalderwiert Laetitia , Lignières Laurent , Guéant-Rodriguez Rosa-Maria , Guéant Jean-Louis
Published: April 2021

Objective:

Deficiency in vitamin B12/folate (methyl donor deficiency [MDD]) produces cardiovascular outcomes during aging and fetal programming effects in newborns of MDD mothers. Whether fetal programming provokes long-term effects on aorta remains largely unknown.

Approach and Results:

We investigated the impact of fetal programming on ascending aorta of aged rats born from mothers subjected to MDD during gestation/lactation. We performed morphological and molecular examinations of ascending aortas in 21 days- and 400 days-aged rats with initial MDD fetal programming (iMDD) compared with control matched rats. iMDD induces remodeling of the ascending aorta in aged rats, with collagen deposition (
P
=0.0008), decreased thickness of elastin (
P
<0.0001), and 8.7-fold increase of elastin breaks (
P
=0.0002). Proteomic analyses, Western blotting, and immunohistochemical examination revealed decreased expression of α-smooth muscle actin, vinculin, SM22α (smooth muscle 22α), and N-cadherin and increased expression of TGF (transforming growth factor) β1. Elastin breaks were correlated to increased neutrophil elastase (
P
=0.0002), cathepsin-K (
P
=0.0002), cathepsin-S (
P
<0.0001), MMP (matrix metalloproteinase) 9, and MMP2 (
P
<0.0001 and
P
=0.02). Proximity Duolink ligation assay showed homocysteinylation of actin-associated and extracellular matrix proteins, including SM22α (
P
=0.01), N-cadherin (
P
=0.0008), and vinculin (
P
=0.001), which was associated with elastin breaks (
P
=0.002) and increased expression of MARS (methionyl-tRNA synthetase; involved in irreversible protein homocysteinylation). Furthermore, we observed an inverse relationship between elastin breaks and blood pressure (systolic,
P
=0.004 and diastolic,
P
=0.0007).

Conclusions:

MDD fetal programming produced altered integrity and remodeling of ascending aorta during aging and irreversible MARS-associated homocysteinylation of key proteins of extracellular matrix and elastin homeostasis. This contributes to understanding why homocysteine-lowering vitamin B supplementation fails to relieve vascular complications in adulthood.
H3K4 Methyltransferase Smyd3 Mediates Vascular Smooth Muscle Cell Proliferation, Migration, and Neointima Formation
Authors: Yang Di , Su Zhenghua , Wei Gang , Long Fen , Zhu Yi-Chun , Ni Ting , Liu Xinhua , Zhu Yi Zhun
Published: April 2021

Objective:

Smyd3 (SET and MYND domain-containing protein 3) is an H3K4 (histone H3 lysine 4) dimethyltransferase and trimethyltransferase that activates the transcription of oncogenes and cell cycle genes in human cancer cells. We discovered its overexpression in proliferative vascular smooth muscle cells (VSMCs). However, whether Smyd3 plays a role in vascular remodeling remains unanswered. The objective of this study is to investigate the role and underlying mechanism of Smyd3 in phenotypic transition of VSMCs (such as proliferation and migration) and vascular remodeling (such as neointima formation).

Approach and Results:

We discovered upregulation of Smyd3 in both PDGF (platelet-derived growth factor) BB–induced vascular cell proliferation model and balloon injury–induced neointima formation model. Knockdown of Smyd3 or blockade of its enzymatic activity suppressed VSMCs proliferation and migration ability, whereas Smyd3 overexpression promoted VSMC migration and proliferation. Mechanistically, RNA-seq and ChIP-seq analysis revealed Smyd3 promoted neointimal formation by directly binding and increasing H3K4me3 to the promoter regions of target genes that are associated with cell proliferation and migration, cell cycle control. Furthermore, Smyd3 knockout mice profoundly ameliorated carotid artery ligation–induced neointimal hyperplasia, consistently, local knocking down Smyd3 in rats relieved balloon injury–induced neointimal formation, while restored VSMC contractile protein expression, suggesting that Smyd3 plays a critical role in vivo.

Conclusions:

Our results demonstrate that Smyd3 promotes VSMC proliferation and migration during injury-induced vascular remodeling, which provide a potential therapeutic target for preventing neointimal hyperplasia in proliferative vascular diseases.
Gab2 (Grb2-Associated Binder2) Plays a Crucial Role in Inflammatory Signaling and Endothelial Dysfunction
Authors: Kondreddy Vijay , Magisetty Jhansi , Keshava Shiva , Rao L. Vijaya Mohan , Pendurthi Usha R.
Published: April 2021

Objective:

In response to inflammatory insult, endothelial cells express cell adhesion molecules and TF (tissue factor), leading to increased adhesion of leukocytes to the endothelium and activation of coagulation. Enhanced coagulation could further exacerbate inflammation. Identifying key signaling molecule(s) that drive both inflammation and coagulation may help devise effective therapeutic strategies to treat inflammatory and thrombotic disorders. The aim of the current study is to determine the role of Gab2 (Grb2-associated binder2), which is known to play a crucial role in the signaling evoked by growth factors and antigen receptors, in inflammatory signaling pathways and its contribution to vascular dysfunction.

Approach and Results:

WT (wild type) and Gab2-silenced endothelial cells were treated with TNFα (tumor necrosis factor alpha), IL (interleukin)-1β, or lipopolysaccharide (LPS). Activation of key signaling proteins in the inflammatory signaling pathways and expression of cell adhesion molecules, TF, and inflammatory cytokines were analyzed. Gab2
−/
−
and WT littermate mice were challenged with LPS or
S
pneumoniae (Streptococcus pneumoniae
), and parameters of inflammation and activation of coagulation were assessed. Gab2 silencing in endothelial cells markedly attenuated TNFα-induced, IL-1β–induced, and LPS-induced expression of TF, cell adhesion molecules, and inflammatory cytokines/chemokines. Gab2 silencing suppressed TNFα-induced, IL-1β–induced, and LPS-induced phosphorylation and ubiquitination of TAK1 (transforming growth factor beta-activated kinase 1) and activation of MAPKs (mitogen-activated protein kinases) and NF-κB (nuclear factor kappa B). Immunoprecipitation studies revealed that the Src kinase Fyn phosphorylates Gab2. Gab2
−/−
mice are protected from LPS or
S
pneumoniae
–induced vascular permeability, neutrophil infiltration, thrombin generation, NET formation, cytokine production, and lung injury.

Conclusions:

Our studies identify, for the first time, that Gab2 integrates signaling from multiple inflammatory receptors and regulates vascular inflammation and thrombosis.
Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association
Authors: Benesch Curtis , Glance Laurent G. , Derdeyn Colin P. , Fleisher Lee A. , Holloway Robert G. , Messé Steven R. , Mijalski Christina , Nelson M. Timothy , Power Martha , Welch Babu G. ,   On behalf of the American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Epidemiology and Prevention
Published: April 2021

Perioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including the role of preoperative carotid revascularization in patients with high-grade carotid stenosis and delaying surgery in patients with recent strokes. The second section reviews intraoperative strategies to reduce the risk of stroke, focusing on blood pressure control, perioperative goal-directed therapy, blood transfusion, and anesthetic technique. Finally, this statement presents strategies for the evaluation and treatment of patients with suspected postoperative strokes and, in particular, highlights the value of rapid recognition of strokes and the early use of intravenous thrombolysis and mechanical embolectomy in appropriate patients.
Intracerebral Injection of Heme Induces Lipid Peroxidation, Neuroinflammation, and Sensorimotor Deficits
Authors: Vasconcellos Luiz Ricardo C. , Martimiano Letícia , Dantas Danillo Pereira , Fonseca Filipe Mota , Mata-Santos Hilton , Travassos Leonardo , Mendez-Otero Rosalia , Bozza Marcelo Torres , Pimentel-Coelho Pedro Moreno
Published: April 2021

Background and Purpose:

Heme is a red blood cell component released in the brain parenchyma following intracerebral hemorrhage. However, the study of the pathophysiological mechanisms triggered by heme in the brain is hampered by the lack of well-established in vivo models of intracerebral heme injection. This study aims to optimize and characterize a protocol of intrastriatal heme injection in mice, with a focus on the induction of lipid peroxidation, neuroinflammation and, ultimately, sensorimotor deficits. We also evaluated the involvement of NLRP3 (NOD-, LRR-, and pyrin domain-containing protein 3), an inflammasome sensor, in the behavior deficits induced by heme in this model.

Methods:

Mice were injected with heme in the striatum for the evaluation of neuroinflammation and brain damage through histological and biochemical techniques. Immunoblot was used to evaluate the expression of proteins involved in heme/iron metabolism and antioxidant responses and the activation of the MAPK (mitogen-activated protein kinase) signaling pathway. For the assessment of neurological function, we followed-up heme-injected mice for 2 weeks using the rotarod, elevated body swing, and cylinder tests. Mice injected with the vehicle (sham), or autologous blood were used as controls.

Results:

Heme induced lipid peroxidation and inflammation in the brain. Moreover, heme increased the expression of HO-1 (heme oxygenase-1), ferritin, p62, and superoxide dismutase 2, and activated the MAPK signaling pathway promoting pro-IL (interleukin)-1β production and its cleavage to the active form. Heme-injected mice exhibited signs of brain damage and reactive astrogliosis around the injection site. Behavior deficits were observed after heme or autologous blood injection in comparison to sham-operated controls. In addition, behavior deficits and IL-1β production were reduced in
Nlrp3
knockout mice in comparison to wild-type mice.

Conclusions:

Our results show that intracerebral heme injection induces neuroinflammation, and neurological deficits, in an NLRP3-dependent manner, suggesting that this is a feasible model to evaluate the role of heme in neurological disorders.
Iatrogenic Diffusion-Weighted Imaging Lesions
Authors: Goyal Mayank , Ganesh Aravind , Tymianski Michael , Hill Michael D. , Ospel Johanna Maria
Published: April 2021

Infarct volume in acute ischemic stroke is closely linked with clinical outcome, with larger infarct volumes being associated with a worse prognosis. Small iatrogenic infarcts, which can occur as a result of surgical or endovascular procedures, are often only seen on diffusion-weighted MR imaging. They often do not lead to any overtly appreciable clinical deficits, hence the term covert or silent infarcts. There is relative paucity of data on the clinical impact of periprocedural hyperintense diffusion-weighted MR imaging lesions, partly because they commonly remain undiagnosed. Clearly, a better understanding of iatrogenic periprocedural diffusion-weighted MR imaging lesions and their clinical significance is needed. In this article, we describe the current limitations of our understanding of the significance of iatrogenic diffusion-weighted MR imaging lesions using exemplary data from the ENACT trial (Safety and Efficacy of NA-1 in Patients With Iatrogenic Stroke After Endovascular Aneurysm Repair) and outline a framework for how to investigate their clinical impact.
The Story of Intracerebral Hemorrhage
Authors: Broderick Joseph P. , Grotta James C. , Naidech Andrew M. , Steiner Thorsten , Sprigg Nikola , Toyoda Kazunori , Dowlatshahi Dar , Demchuk Andrew M. , Selim Magdy , Mocco J , Mayer Stephan
Published: April 2021

This invited special report is based on an award presentation at the World Stroke Organization/European Stroke Organization Conference in November of 2020 outlining progress in the acute management of intracerebral hemorrhage (ICH) over the past 35 years. ICH is the second most common and the deadliest type of stroke for which there is no scientifically proven medical or surgical treatment. Prospective studies from the 1990s onward have demonstrated that most growth of spontaneous ICH occurs within the first 2 to 3 hours and that growth of ICH and resulting volumes of ICH and intraventricular hemorrhage are modifiable factors that can improve outcome. Trials focusing on early treatment of elevated blood pressure have suggested a target systolic blood pressure of 140 mm Hg, but none of the trials were positive by their primary end point. Hemostatic agents to decrease bleeding in spontaneous ICH have included desmopressin, tranexamic acid, and rFVIIa (recombinant factor VIIa) without clear benefit, and platelet infusions which were associated with harm. Hemostatic agents delivered within the first several hours have the greatest impact on growth of ICH and potentially on outcome. No large Phase III surgical ICH trial has been positive by primary end point, but pooled analyses suggest that earlier ICH removal is more likely to be beneficial. Recent trials emphasize maximization of clot removal and minimizing brain injury from the surgical approach. The future of ICH therapy must focus on delivery of medical and surgical therapies as soon as possible if we are to improve outcomes.
Prionotropis xausi, a new species of Thrinchinae (Orthoptera: Pamphagidae) from Catalonia (northeast of the Iberian Peninsula)
Authors: OLMO-VIDAL JOSEP MARIA
Published: April 2021

A new species of the genus Prionotropis Fieber, 1853 is described from Catalonia (Northeast of the Iberian Peninsula). Prionotropis xausi n. sp. was collected in a steppic calcareous grassland with low shrubs and scattered rocks, dominated by Buxus, Arctostaphylos uva-ursi, Thymus and Poa species. P. xausi n. sp. is characterized by the pronotum in dorsal view narrow and in lateral view with the principal transverse sulcus between prozona and metazona clearly incised. Females squamipterous with the tegmina extending at most to the end of second abdominal segment. Males sub-brachypterous with the tegmina reaching the 5th abdominal tergite and the epiproct visible. Inside hind femora at the base to the middle part and inside hind tibia red. Phallic complex with the epiphallus more long than wide with short posterior edge and the penis valves long. This new species is compared to the similar species P. rhodanica Uvarov, 1923 , P. azami Uvarov, 1923 and P. hystrix (Germar, 1817) and to the species presents in Catalonia P. flexuosa (Serville, 1838) and P. ancosae Olmo-Vidal, 2017. P. xausi is the species of the genus Prionotropis with the smallest males.
An updated checklist of caridean shrimps of the Persian Gulf and Gulf of Oman
Authors: ASHRAFI HOSSEIN , DEHGHANI AMIR , SARI ALIREZA , NADERLOO REZA
Published: April 2021

The material of the present checklist has been collected from the Iranian intertidal and shallow subtidal shores of the Persian Gulf and Gulf of Oman from 2015 to 2019, in addition to re-examining all the materials deposited in the Zoological Museum of the University of Tehran. This checklist providing 16 new records for the Persian Gulf and 15 for the Gulf of Oman raised the number of recorded caridean shrimps to 109 and 49 for these gulfs, respectively. However, the actual number of these shrimps are higher than these numbers due to two facts. Firstly, most of the subtidal diverse ecosystems, e.g. coral reefs and seagrass bed have not been seriously investigated taxonomically. Secondly, there are some members of species complexes and probably some new species in the study which need to be carefully treated.
A new species and a new country record in the genus Protaetia Burmeister, 1842 (Coleoptera: Scarabaeidae: Cetoniinae) from Vietnam
Authors: MÜCKSTEIN PETR
Published: April 2021

Protaetia (Macroliocola) dianae Mückstein, a new species of fruit chafer (Coleoptera: Scarabaeidae: Cetoniinae) from northern Vietnam is described. Habitus and diagnostic features of the new species are illustrated. A new country record of Protaetia (Liocola) miharai (Alexis & Delpont, 1998) for Vietnam is presented.
Late Miocene eastwards transatlantic dispersal of flightless anchonine weevils (Coleoptera: Curculionidae: Molytinae)
Authors: GREBENNIKOV VASILY V. , ANDERSON ROBERT S.
Published: April 2021

The weevil genera Aethiopacorep Voisin and Titilayo Cristóvão & Lyal are the only native African members of the nearly pantropical and poorly known tribe Anchonini. All Anchonini are flightless, a trait likely limiting dispersal, yet these weevils are found on both sides of the Atlantic Ocean. A phylogenetic analysis of 79 terminals and 3248 aligned positions from one mitochondrial and two nuclear ribosomal fragments supports a clade of West African Anchonini nested within American Anchonini. As suggested by previous authors, the Asian genera Himalanchonus Zherikhin and Otibazo Morimoto do not form a clade with the tribe’s core, and along with Cycloterinus Kolbe, Euthycodes Pascoe, Leptanchonus Morimoto, Nepalanchonus Zherikhin, and Tanyomus Champion, are here removed from Anchonini and placed as Molytinae incertae sedis. So defined, the monophyletic tribe Anchonini contains 36 genus-group names, all but two denoting American taxa. Using molecular clock analysis, we estimate the separation of the West African Anchonini from its American sister at 9.5–5.2 million years ago (Ma). This date greatly postdates the Cretaceous opening of the Atlantic Ocean (about 100 Ma) and, therefore, evokes a single transatlantic dispersal to West Africa, likely by over-water rafting, leading to subsequent diversification. We postulate this to be the first documented eastwards crossing of the Atlantic Ocean by terrestrial non-volant arthropods based on morphological and molecular data.
A new species, genus and tribe of cicada (Hemiptera: Cicadoidea: Cicadidae: Tibicininae) from Chile with a list of Chilean cicada fauna
Authors: SANBORN ALLEN F.
Published: April 2021

Citroriginini n. tribe. is formed for the Chilean cicada Citroriginis elongata n. gen., n. sp.  Males differ from other South American Tibicininae Distant, 1905a because they lack timbal organs.  The new species has fore wings that are similar in general appearance to the Nearctic Platypediini Kato, 1932 and genitalia with a superficial resemblance to the Tettigadini Distant, 1905c and the Chilean Chilecicadini Sanborn, 2014 but the new species is divergent from the both tribes in the fore wing venation, fore wing cell shape, general body proportions and male genitalia. A female exuvia is described representing the first description of a Chilean cicada exuvia.  A list of Chilean cicada species is also provided with Calliopsida cinnabarina (Berg, 1879) removed from the Chilean cicada fauna.
Review of Uvarovistia (Orthoptera: Tettigoniidae; Tettigoniinae): genetic data indicate a new cryptic species, Uvarovistia munzurensis sp.n.
Authors: ULUAR ONUR , YAHYAOĞLU ÖZGÜL , ÇIPLAK BATTAL
Published: April 2021

Genus Uvarovistia ranged along the Zagros Mountain belt. We presented first genetic data from three species of the genus and a taxonomic rectification indicated by these data. Sequences of three mitochondrial and two nuclear gene segments were obtained from different populations. Phylogenetic and automatic species delimitation analyses consistently suggested three distinct phylogroups as U. zebra, U. satunini and the third a new species, U. munzurensis Uluar & Yahyaoğlu sp. n. Time estimation and population genetic analyses supported consistent results. The following conclusions were reached: (i) five species in the genus constitute two distinct species groups named as Zebra Group and Satunini Group, (ii) data suggest intra generic relationships as U. zebra + ((U. satunini + U. munzurensis) + (U. bakhtiara +U. iraka)), (iii) molecular clock estimations indicated a deep divergence time and no gene flow between U. satunini and U. munzurensis, (iv) although these two species cannot be clearly distinguished by morphology, range of U. munzurensis seems to be isolated from other by lowlands of Euphrates Valley, and (v) age of generic ancestor is around five million years a time corresponding to connection of Anatolian and Zagros plates, and genus radiated along Zagros belt after dispersal of ancestral stock here.
Morbidity and Mortality in the Obese Trauma Intensive Care Unit Patient
Authors: Conrad Hope L. , Hutchinson Robert A. , Pittman Jessica , Ewing Joseph A. , Cull John D.
Published: April 2021

Introduction

Obesity is an epidemic in the United States, known to be associated with comorbidities. However, some data show that obesity may be a protective factor in some instances. The purpose of this study is to determine if there are differences in morbidity and mortality when comparing the obese and non-obese critically ill trauma patient populations.

Materials and Methods

This was a retrospective study conducted at Prisma Health Upstate in Greenville, South Carolina, an Adult Level 1 Trauma Center. Patients over the age of 18 years admitted due to trauma from February 6, 2016 to February 28, 2019 were included in this study. Burn patients were excluded. An online trauma database was used to obtain age, sex, body mass index, Glasgow coma score (GCS), injury severity score (ISS), revised trauma score (RTS), days on mechanical ventilation, hospital length of stay (LOS), and intensive care unit (ICU) LOS.

Results

There were 2365 critically ill trauma patients who met inclusion criteria for this study. 1570 patients were men (66.38%) and mean age was 53.2 ± 20.9. Of the patients, 2166 patients had blunt trauma (91.59%). Median GCS was 15 (interquartilerange [IQR]: 12, 15), median RTS was 12 (IQR: 11, 12), and median ISS was 17 (IQR: 9, 22). Obese critically ill trauma patients had significantly lower odds of mortality than nonobese (OR .686, CI 0.473-.977). Penetrating traumas (OR: 4.206, CI: 2.478, 6.990), increased ISS (OR: 1.095, CI: .473, 1.112), and increased age (OR: 1.036, CI: 1.038, 1.045) were associated with significantly increased odds of mortality.

Discussion

The obesity paradox is observed in the obese critically ill trauma patient population.
Tissue Diagnosis Is Associated With Worse Survival in Hepatocellular Carcinoma: A National Cancer Database Analysis
Authors: Dahdaleh Fadi S. , Naffouje Samer A. , Sherman Scott K. , Kamarajah Sivesh K. , Salti George I.
Published: April 2021

Background

Biopsy to achieve tissue diagnosis (TD) of hepatocellular carcinoma (HCC) risks needle tract seeding. With chest wall and peritoneal recurrences reported, TD could worsen cancer outcomes. We investigated HCC outcomes after TD compared to clinical diagnosis (CD), hypothesizing that TD adversely affects overall survival (OS).

Methods

The National Cancer Database (NCDB) Participant User File for liver cancer was reviewed, including patients with nonmetastatic HCC treated with major hepatectomy or transplantation. Clinical diagnosis patients were matched 1:1 to TD patients per propensity score. Survival was examined in the unmatched and matched cohorts.

Results

Of 172 283 cases, 16 366 met inclusion criteria. Mean age was 60.8 years, 12 100 (73.9%) were male, and 48.4% of patients received hepatectomies. Clinical diagnosis occurred in 70.4% of cases, and 29.6% underwent TD. Cox regression confirmed the diagnostic method as an independent predictor of OS in addition to age, Charlson-Deyo score, grade, delay of surgery, lymphovascular invasion, nodal stage, and procedure type, favoring transplantation over hepatectomy. After propensity matching on these factors, 4251 patients were matched from each group. In the matched cohort, patients with TD had a significantly lower OS than patients with CD (median: 65.5 vs. 85.6 ± 2.7 months, P < .001). The corresponding 5-year survival was lower in the TD group (47.6% vs. 60.9% P < .001).

Conclusion

Hepatocellular carcinoma patients with preoperative TD had decreased OS compared to CD, which persisted after propensity matching. This study supports avoiding biopsy for HCC whenever possible.
They Lived Under That Rule as Do Those Who Have Succeeded Them: Simultaneity and Conflict in the Foundation Narratives of a French Women’s Convent (10th–18th Centuries)
Authors: Vanderputten Steven
Published: April 2021

While foundation accounts of medieval religious institutions have been the focus of intense scholarly interest for decades, so far there has been comparatively little interest in how successive versions related to each other in the perception of medieval and early modern observers. This essay considers that question via a case study of three such narratives about the 930s creation of Bouxières Abbey, a convent of women religious in France’s eastern region of Lorraine. At the heart of its argument stands the hypothesis that these conflicting narratives of origins were allowed to coexist in the memory culture of this small convent because they related to different arguments in its identity narrative. As such, it hopes to contribute to an ill-understood aspect of foundation narratives as a literary genre and a memorial practice in religious communities, with particular attention to long-term developments.
Reducing stigma associated with mental health problems among university students in the Asia-Pacific: A video content analysis of student-driven proposals
Authors: Withers Mellissa , Jahangir Tasfia , Kubasova Ksenia , Ran Mao-Sheng
Published: April 2021

Introduction:

Studies have demonstrated that mental health problems among university students may be increasing in both prevalence and severity. This study aimed to identify ways to reduce stigma and improve students’ utilization of mental health services.

Methods:

We performed a content analysis on video proposals to address stigma and mental health at universities, submitted by 15 teams from nine Asian-Pacific countries as part of a case competition. We examined five domains: (1) tone; (2) cultural context; (3) mental health issue of focus; (4) prevention versus secondary prevention; and (5) main intervention strategies.

Results:

Five main intervention strategies emerged: (1) educational campaigns; (2) peer interaction and support; (3) counseling; (4) screening; and (5) self-management. The results suggest that mental health literacy is low among students. Educational campaigns and events to increase awareness and reduce stigma were the most commonly incorporated strategy, through film screenings, mental health days, and social media. Building empathy through personal stories from celebrities and other students was also highly recommended. Second, counseling was incorporated in 80% of proposals, with a preference for peers and staff support, and web-based therapy over professional counselors, except in severe cases. Programs to increase social contact were the third most common strategy, suggesting students may feel isolated and disconnected. Creating common spaces for students to interact and pairing of students with and without mental health issues were widely suggested. The use of technology was recommended for self-management of mental health and for mandatory mental health screening, which was generally only recommended for incoming students.

Conclusions:

Our analysis provides insight into student-generated intervention approaches to prevent and address stigma associated with mental health issues among students. A greater university commitment is needed to provide a range of resources, including education and counseling, to leverage technology, and to foster stronger support networks among students.
Supervisory relationship in cyber supervision: Implications for social work supervision
Authors: Mo Kitty Yuen-han , Chan On-fat
Published: April 2021

There is a dearth of research in supervisory relationships in the emerging practice of cyber supervision. This study explores supervisees’ perception of supervision experience and the building of supervisory relationships on a cyber platform. Qualitative interviews were conducted with 24 participants in a nationwide supervision training programme. The findings revealed three themes concerning supervisees’ perception of satisfaction with the online supervisory relationship – the elements that hinder and facilitate relationships – and their impacts on future cyber supervision. The study helped to increase understanding of relationship building on cyber platforms and will have implications for future cyber supervision.
A Comparison of Security in City and Small-Town Gated Developments in the Western Cape province, South Africa
Authors: Spocter Manfred
Published: April 2021

Gated developments are a defining feature of the post-apartheid residential landscape. The fortification practices witnessed in gated developments are part of a wider securitisation of the South African urban- and ruralscapes. This research resides in the ambit of the theory of crime and violence as a precursor to the growth in gated developments. Research on gated developments has tended to focus on their proliferation in larger urban settlements, with scant attention being paid to gated developments in smaller settlements and in rural areas. However, non-metropolitan gated developments are a reality, and they display similar security features as those found in metropolitan areas. This paper compares the security levels of gated developments in a suburb of Cape Town with those in small towns in the Western Cape province. Security features are quantified to determine whether differences in securitisation levels exist between the locales. The gated developments in the city display higher levels of security than those in small towns. However, a closer analysis of small-town gated developments reveals high security levels in towns where tourism is the mainstay of the local economy. As the technology of security migrates from military applications to residential applications, a securified small-town future is a real possibility.
The role of repetitive transcranial magnetic stimulation in the treatment of cognitive impairment in stroke patients: A systematic review and meta-analysis
Authors: Liu Mengting , Bao Guanai , Bai Lu , Yu Enyan
Published: April 2021

Stroke is a global health problem, and survivors of a stroke often suffer from cognitive impairment, which has an essential impact on the rehabilitation of various functions. Repetitive Transcranial Magnetic Stimulation (rTMS) has been widely used in the rehabilitation treatment of stroke patients. There are many investigations into how rTMS impacts motor dysfunction, speech dysfunction and swallowing dysfunction after stroke, but the analysis of rehabilitation effect on stroke patients with cognitive dysfunction is lacking. The purpose of this study was to analyze the effect of different rTMS related therapies on cognitive impairment and to evaluate its clinical effect on cognitive rehabilitation after stroke. Four databases including PubMed, EMBASE, MEDLINE and the Cochrane Library, were searched and a total of 2754 papers were collected. Two reviewers independently completed a review of all papers’ titles and abstracts, screened out the documents that met the criteria, and carried out data extraction, quality assessment, and data analysis. A total of six studies with 197 patients were included. Three studies used the Mini-Mental Status Examination (MMSE) scale to evaluate the cognitive function with a mean effect size of 1.89 (95% CI = −3.08–6.86). Two studies used the Loewenstein Occupational Therapy of Cognitive Assessment (LOTCA) scale with the mean effect size of 1.64 (95% CI = −7.65–10.93). These studies were evaluated separately. Our article provides that rTMS has a positive effect on improving the cognitive ability of stroke patients, but the evidence is still limited, and further large-scale studies are needed to explore the optimal stimulus parameters.
Theological Reflection on Suffering: Overcoming Anxiety and Depression during the COVID-19 Pandemic
Authors: Cordero Dalmacito A.
Published: April 2021

The COVID-19 pandemic can cause mental health problems such as anxiety and depression which can be considered as forms of human suffering. This article explores the theological concept of suffering as reflected specifically in John Paul II’s apostolic letter Salvifici Doloris. Two significant themes emerged from the document which highlights suffering—part of humanity’s transcendence and that it is beneficial for the sufferer. Utilizing the personal experience of the author as the main source of data, overcoming suffering can be attained using the same themes. These themes are then translated and applied into a concrete plan of action which are actualized regularly, namely: acceptance, regular conversation with loved ones, and meditation. Habitual practice of such actions contributed greatly to the mental health recovery from such a crisis.
The Impact of Geopolitical Risks on Tourism Supply in Developing Economies: The Moderating Role of Social Globalization
Authors: Gozgor Giray , Lau Marco Chi Keung , Zeng Yan , Yan Cheng , Lin Zhibin
Published: April 2021

Capital investment is vital for sustainable tourism growth, particularly in times of geopolitical turmoil. This study examines how tourism investment was influenced by geopolitical risks considering social globalization as a moderating factor. Data were collected from 18 developing economies between 1995 and 2018. The results from the fixed effects and the least squares dummy variable–corrected methods show that the geopolitical risks negatively affect capital investment in tourism, with social globalization playing a moderating role in alleviating the adverse effect. The results were robust to different measures and analyses. The study advances our understanding of sustainable tourism growth amid geopolitical turmoil. Policymakers, especially those from developing economies, are suggested to be vigilant about the media atmosphere of geopolitics and enhancing social globalization as a countermeasure against politically turbulent times. The study also provides implications for alleviating the impact of the global pandemic on tourism investment.
Frequent Recurrence of Sinonasal Inverted Papilloma With Carcinoma In Situ in a Multifocal Attachment Pattern: A Case Report and Review of the Literature
Authors: Wang Yan , Cui Shunjiu , Li Cheng , Zhou Bing
Published: April 2021

Sinonasal inverted papilloma (SIP) is a benign tumor originating from the nasal cavity and paranasal sinuses. Sinonasal inverted papilloma is characterized by local infiltration, high recurrence, and malignant transformation, and its associated dysplasia ranges from mild, moderate, severe, carcinoma in situ (CIS) to invasive squamous cell carcinoma. Sinonasal inverted papilloma with carcinoma in situ (IPwCIS) is the highest degree of dysplasia, which is a stage of malignant transformation of IP. Surgical excision and proper adjuvant therapy can help reduce recurrence rates and suppress further deterioration. In this study, we present a patient with IPwCIS who developed 3 recurrences with a multifocal attachment pattern in less than 18 months. We report the clinical manifestations, development, and treatment process in detail. We also performed a literature review to analyze the characteristics of the disease. Despite comprehensive treatment methods, tumor recurrence and further deterioration of IPwCIS persist.
The Joke-Secret and an Ethics of Modern Individuality: From Freud to Simmel
Authors: Smith Daniel R.
Published: April 2021

Why has comedy become one of our most abiding ethical preoccupations as well as a dominant mode of political critique? It is suggested that comedy appeals to contemporary persons because it provides an apt social-aesthetic form through which to face up to living with others at a time when it is hard to bear others or otherness. The article outlines an ethics of modern individuality by developing a theory of comedy as more about building social bonds and finding out what could be shared knowledge and experience than the toppling of dominant modes of thought or repudiating our mutuality with others. Drawing on Georg Simmel’s ‘The Law of the Individual’, the article develops a Simmelian reading of Freud’s Jokes to argue that comedy is one solution to resolving our mutual un-alikeness by way of forging knotted paths toward recognising how we could be alike.
Understanding the palliative care needs and experiences of people with mesothelioma and their family carers: An integrative systematic review
Authors: Harrison Madeleine , Gardiner Clare , Taylor Bethany , Ejegi-Memeh Stephanie , Darlison Liz
Published: April 2021

Background:

People with mesothelioma and their families have palliative care needs throughout the relatively short trajectory of their illness.

Aim:

To describe the palliative care needs and experiences of people with mesothelioma and their family carers.

Design:

Integrative systematic review with narrative synthesis (PROSPERO: CRD42020190115).

Data sources:

MEDLINE, CINAHL, PsycINFO and the Cochrane Library were searched for articles published between 01 January 2000 and 10 May 2020. Articles were included if they presented empirical studies or comprehensive reviews including information about the palliative care needs and experiences of people with mesothelioma and their family carers.

Results:

The search yielded 508 articles, 14 were included in the analysis. A cross cutting theme of ‘uncertainty’ was identified encompassing five themes: (1) organisation and co-ordination of services, (2) communication and information needs, (3) management of care needs and high symptom burden, (4) consideration of the impact of seeking compensation and (5) family carer needs. Our findings demonstrate that people with mesothelioma want a co-ordinated, team-based approach to palliative care with a named point of contact. Whilst carers value and benefit from early referral to specialist palliative care, this does not necessarily reflect the outcomes and views of patients.

Conclusion:

The evidence base around the palliative care needs and experiences of people with mesothelioma and their carers needs to be strengthened. The results of this review support the need to develop a greater understanding about the role non-specialist palliative care clinicians’ play in providing generalist palliative care for people with mesothelioma and their carers.
Effect of “drip-and-ship” and “drip-and-drive” on endovascular treatment of acute ischemic stroke with large vessel occlusion: a single-center retrospective study
Authors: Hang Yu , Jia Zhen Yu , Zhao Lin Bo , Cao Yue Zhou , Huang Huang , Shi Hai-Bin , Liu Sheng
Published: April 2021

Background

Patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) were usually transferred from a primary stroke center (PSC) to a comprehensive stroke center (CSC) for endovascular treatment (drip-and-ship [DS]), while driving the doctor from a CSC to a PSC to perform a procedure is an alternative strategy (drip-and-drive [DD]).

Purpose

To compare the efficacy and prognosis of the two strategies.

Material and Methods

From February 2017 to June 2019, 62 patients with LVO received endovascular treatment via the DS and DD models and were retrospectively analyzed from the stroke alliance based on our CSC. Primary endpoint was door-to-reperfusion (DTR) time. Secondary endpoints included puncture-to-recanalization (PTR) time, modified Thrombolysis in Cerebral Infarction (mTICI) rates at the end of the procedure, and modified Rankin Scale (mRS) at 90 days.

Results

Forty-one patients received the DS strategy and 21 patients received the DD strategy. The DTR time was significantly longer in the DS group compared to the DD group (315.5 ± 83.8 min vs. 248.6 ± 80.0 min; P < 0.05), and PTR time was shorter (77.2 ± 35.9 min vs. 113.7 ± 69.7 min; P = 0.033) compared with the DD group. Successful recanalization (mTICI 2b/3) was achieved in 89% (36/41) of patients in the DS group and 86% (18/21) in the DD group ( P = 1.000). Favorable functional outcomes (mRS 0–2) were observed in 49% (20/41) of patients in the DS group and 71% (15/21) in the DD group at 90 days ( P = 0.089).

Conclusion

Compared with the DS strategy, the DD strategy showed more effective and a trend of better clinical outcomes for AIS patients with LVO.
Genetic mutations in patients with nonsyndromic hearing impairment of minority and Han Chinese ethnicities in Qinghai, China
Authors: Duan Shihong , Guo Yufen , Chen Xingjian , Li Yong
Published: April 2021

Objective

Mutations in GJB2, SLC26A4, and mitochondrial (mt)DNA 12S rRNA genes are the main cause of nonsyndromic hearing impairment. The present study analyzed these mutations in ethnic minority and Han Chinese patients with nonsyndromic hearing impairment from Qinghai, China.

Methods

The SNPscan assay was used to analyze mutation spectra and frequencies in the two patient groups.

Results

GJB2 mutations were detected in 9.5% (20/210) of minority patients and 20.88% (48/230) of Han Chinese patients. The most common Han Chinese GJB2 variants were c.235delC and c.299_300delAT, whereas c.235delC and c.109G > A were the most prevalent in minority patients. SLC26A4 mutations were detected in 5.71% (12/210) of minority patients and 14.35% (33/230) of Han Chinese patients, and mtDNA 12S rRNA mutations were detected in 4.28% (9/210) of minority patients and 9.13% (21/230) of Han Chinese patients.

Conclusions

These data indicate that the mutation frequencies of three deafness-associated genes were significantly higher in Han Chinese patients than in minority patients. Moreover, the GJB2 mutation spectrum was shown to differ between these two patient groups.
Are individual stock returns predictable?
Authors: Zeng Hui , Marshall Ben R , Nguyen Nhut H , Visaltanachoti Nuttawat
Published: April 2021

We show that the previously documented predictability of macroeconomic and technical variables for market returns is also evident in individual stock returns. Technical variables generate better predictability on firms with high limits to arbitrage (small, illiquid, volatile firms), while macroeconomic variables better predict firms with low limits to arbitrage. Technical predictors show a stronger predictive power for high limits to arbitrage firms across the business cycle, whereas macroeconomic variables capture more predictive information for firms with low limits to arbitrage during recessions.

JEL Classification: C58, E32, G11, G12, G17