bluuebunny/crossref_metadata_2025 huggingface dataset:
Phytochemicals as Potential Chemopreventive and Chemotherapeutic Agents for Emerging Human Papillomavirus–Driven Head and Neck Cancer: Current Evidence and Future Prospects
Authors: Aggarwal Nikita , Yadav Joni , Chhakara Suhail , Janjua Divya , Tripathi Tanya , Chaudhary Apoorva , Chhokar Arun , Thakur Kulbhushan , Singh Tejveer , Bharti Alok Chandra
Published: July 2021

Head and neck cancer (HNC) usually arises from squamous cells of the upper aerodigestive tract that line the mucosal surface in the head and neck region. In India, HNC is common in males, and it is the sixth most common cancer globally. Conventionally, HNC attributes to the use of alcohol or chewing tobacco. Over the past four decades, portions of human papillomavirus (HPV)-positive HNC are increasing at an alarming rate. Identification based on the etiological factors and molecular signatures demonstrates that these neoplastic lesions belong to a distinct category that differs in pathological characteristics and therapeutic response. Slow development in HNC therapeutics has resulted in a low 5-year survival rate in the last two decades. Interestingly, HPV-positive HNC has shown better outcomes following conservative treatments and immunotherapies. This raises demand to have a pre-therapy assessment of HPV status to decide the treatment strategy. Moreover, there is no HPV-specific treatment for HPV-positive HNC patients. Accumulating evidence suggests that phytochemicals are promising leads against HNC and show potential as adjuvants to chemoradiotherapy in HNC. However, only a few of these phytochemicals target HPV. The aim of the present article was to collate data on various leading phytochemicals that have shown promising results in the prevention and treatment of HNC in general and HPV-driven HNC. The review explores the possibility of using these leads against HPV-positive tumors as some of the signaling pathways are common. The review also addresses various challenges in the field that prevent their use in clinical settings.
The Role of Co-Signaling Molecules in Psoriasis and Their Implications for Targeted Treatment
Authors: Liu Suqing , Xu Jinhua , Wu Jinfeng
Published: July 2021

Psoriasis is a chronic, systemic immune-mediated inflammatory disease manifesting in the skin, joint or both. Co-signaling molecules are essential for determining the magnitude of the T cell response to the antigen. According to the function of co-signaling molecules, they can be divided into co-stimulatory molecules and co-inhibitory molecules. The role of co-signaling molecules in psoriasis is recognized, mainly including the co-stimulatory molecules CD28, CD40, OX40, CD27, DR3, LFA-1, and LFA-3 and the co-inhibitory molecules CTLA-4, PD-1, and TIM-3. They impact the pathological process of psoriasis by modulating the immune strength of T cells, regulating the production of cytokines or the differentiation of Tregs. In recent years, immunotherapies targeting co-signaling molecules have made significant progress and shown broad application prospects in psoriasis. This review aims to outline the possible role of co-signaling molecules in the pathogenesis of psoriasis and their potential application for the treatment of psoriasis.
Recent Advances and Challenges in the Development of Radiofrequency HTS Coil for MRI
Authors: Labbé Aimé , Authelet Gilles , Baudouy Bertrand , van der Beek Cornelis J. , Briatico Javier , Darrasse Luc , Poirier-Quinot Marie
Published: July 2021

Radiofrequency (RF) coils fashioned from high-temperature superconductor (HTS) have the potential to increase the sensitivity of the magnetic resonance imaging (MRI) experiment by more than a dozen times compared to conventional copper coils. Progress, however, has been slow due to a series of technological hurdles. In this article, we present the developments that recently led to new perspectives for HTS coil in MRI, and challenges that still need to be solved. First, we recall the motivations for the implementations of HTS coils in MRI by presenting the limits of cooled copper coil technology, such as the anomalous skin effect limiting the decrease of the electric resistance of normal conductors at low temperature. Then, we address the progress made in the development of MRI compatible cryostats. New commercially available low-noise pulsed-tube cryocoolers and new materials removed the need for liquid nitrogen-based systems, allowing the design of cryogen-free and more user-friendly cryostats. Another recent advance was the understanding of how to mitigate the imaging artifacts induced by HTS diamagnetism through field cooling or temperature control of the HTS coil. Furthermore, artifacts can also originate from the RF field coupling between the transmission coil and the HTS reception coil. Here, we present the results of an experiment implementing a decoupling strategy exploiting nonlinearities in the electric response of HTS materials. Finally, we discuss the potential applications of HTS coils in bio-imaging and its prospects for further improvements. These include making the technology more user-friendly, implementing the HTS coils as coil arrays, and proposing solutions for the ongoing issue of decoupling. HTS coil still faces several challenges ahead, but the significant increase in sensitivity it offers lends it the prospect of being ultimately disruptive.
Fast Hand Movements Unveil Multifractal Roots of Adaptation in the Visuomotor Cognitive System
Authors: Pratviel Yvan , Deschodt-Arsac Veronique , Larrue Florian , Arsac Laurent M.
Published: July 2021

Beyond apparent simplicity, visuomotor dexterity actually requires the coordination of multiple interactions across a complex system that links the brain, the body and the environment. Recent research suggests that a better understanding of how perceptive, cognitive and motor activities cohere to form executive control could be gained from multifractal formalisms applied to movement behavior. Rather than a central executive “talking” to encapsuled components, the multifractal intuition suggests that eye-hand coordination arises from multiplicative cascade dynamics across temporal scales of activity within the whole system, which is reflected in movement time series. Here we examined hand movements of sport students performing a visuomotor task in virtual reality (VR). The task involved hitting spatially arranged targets that lit up on a virtual board under critical time pressure. Three conditions were compared where the visual search field changed: whole board (Standard), half-board lower view field (LVF) and upper view field (UVF). Densely sampled (90 Hz) time series of hand motions captured by VR controllers were analyzed by a focus-based multifractal detrended fluctuation analysis (DFA). Multiplicative rather than additive interactions across temporal scales were evidenced by testing comparatively phase-randomized surrogates of experimental series, which confirmed nonlinear processes. As main results, it was demonstrated that: (i) the degree of multifractality in hand motion behavior was minimal in LVF, a familiar visual search field where subjects correlatively reached their best visuomotor response times (RTs); (ii) multifractality increased in the less familiar UVF, but interestingly only for the non-dominant hand; and (iii) multifractality increased further in Standard, for both hands indifferently; in Standard, the maximal expansion of the visual search field imposed the highest demand as evidenced by the worst visuomotor RTs. Our observations advocate for visuomotor dexterity best described by multiplicative cascades dynamics and a system-wide distributed control rather than a central executive. More importantly, multifractal metrics obtained from hand movements behavior, beyond the confines of the brain, offer a window on the fine organization of control architecture, with high sensitivity to hand-related control behavior under specific constraints. Appealing applications may be found in movement learning/rehabilitation, e.g., in hemineglect people, stroke patients, maturing children or athletes.
Hemodynamic Characteristics of Patients With Suspected Coronary Heart Disease at Their Initial Visit
Authors: Cao Haoyao , Li Yiming , Zhao Yiming , Xiong Tianyuan , Liu Zhan , Zheng Tinghui , Chen Mao
Published: July 2021

Purpose

It is difficult for doctors to decide whether patients with suspected coronary heart disease classified as Coronary Artery Disease Reporting and Data System (CAD-RADS) < 3 should be administered preventive treatment, or whether non-atherosclerotic chest pain should be considered. The aim of the current study was to investigate coronary hemodynamic characteristics in such patients, which may provide more information on their stenosis and be helpful for initial diagnoses.

Methods

Two patient-specific models were reconstructed based on the coronary computed tomographic angiography underwent in 2012. Patient 1 was classified as CAD-RADS 0, and was readmitted to hospital due to coronary artery disease within 5 years. Patient 2 was classified as CAD-RADS 2, and has experienced no adverse events to date. Computational fluid dynamics (CFD) analysis was used to obtain hemodynamic parameters including flow rate waveform, flow streamlines, time-average wall shear stress (TAWSS), and oscillatory shear index (OSI).

Results

Patient 1 exhibited no physiological characteristics of right coronary artery flow waveform, large areas of low TAWSS, and slow blood flow in the proximal and middle segments of the left anterior descending branch. Patient 2 exhibited reduced coronary supply, small and separate areas of abnormal TAWSS, and a higher left anterior descending branch OSI than patient 1.

Conclusion

Hemodynamic abnormalities may play an important role in the prognosis of patients with coronary stenosis, and patient-specific hemodynamic characteristics may facilitate more accurate initial diagnosis, and better management. Overall hemodynamics (along the whole vessel) warranted attention at the time of the initial visit in patients classified as CAD-RADS < 3.
Interaction Between Sulfur and Iron in Plants
Authors: Astolfi Stefania , Celletti Silvia , Vigani Gianpiero , Mimmo Tanja , Cesco Stefano
Published: July 2021

It is well known that S interacts with some macronutrients, such as N, P, and K, as well as with some micronutrients, such as Fe, Mo, Cu, Zn, and B. From our current understanding, such interactions could be related to the fact that: (i) S shares similar chemical properties with other elements (e.g., Mo and Se) determining competition for the acquisition/transport process (SULTRtransporter family proteins); (ii) S-requiring metabolic processes need the presence of other nutrients or regulate plant responses to other nutritional deficiencies (S-containing metabolites are the precursor for the synthesis of ethylene and phytosiderophores); (iii) S directly interacts with other elements (e.g., Fe) by forming complexes and chemical bonds, such as Fe-S clusters; and (iv) S is a constituent of organic molecules, which play crucial roles in plants (glutathione, transporters, etc.). This review summarizes the current state of knowledge of the interplay between Fe and S in plants. It has been demonstrated that plant capability to take up and accumulate Fe strongly depends on S availability in the growth medium in both monocots and dicot plants. Moreover, providing S above the average nutritional need enhances the Fe content in wheat grains, this beneficial effect being particularly pronounced under severe Fe limitation. On the other hand, Fe shortage induces a significant increase in the demand for S, resulting in enhanced S uptake and assimilation rate, similar to what happens under S deficiency. The critical evaluation of the recent studies on the modulation of Fe/S interaction by integrating old and new insights gained on this topic will help to identify the main knowledge gaps. Indeed, it remains a challenge to determine how the interplay between S and Fe is regulated and how plants are able to sense environmental nutrient fluctuations and then to adapt their uptake, translocation, assimilation, and signaling. A better knowledge of the mechanisms of Fe/S interaction might considerably help in improving crop performance within a context of limited nutrient resources and a more sustainable agriculture.
Comparing Exogenous Methods to Induce Plant-Resistance Against a Bark-Feeding Insect
Authors: Chen Yayuan , Puentes Adriana , Björkman Christer , Brosset Agnès , Bylund Helena
Published: July 2021

Exogenous application of the plant hormone methyl jasmonate (MeJA) can trigger induced plant defenses against herbivores, and has been shown to provide protection against insect herbivory in conifer seedlings. Other methods, such as mechanical damage to seedlings, can also induce plant defenses, yet few have been compared to MeJA and most studies lack subsequent herbivory feeding tests. We conducted two lab experiments to: (1) compare the efficacy of MeJA to mechanical damage treatments that could also induce seedling resistance, (2) examine if subsequent insect damage differs depending on the time since induction treatments occurred, and (3) assess if these induction methods affect plant growth. We compared Scots pine (Pinus sylvestris) seedlings sprayed with MeJA (10 or 15 mM) to seedlings subjected to four different mechanical bark damage treatments (two different bark wound sizes, needle-piercing damage, root damage) and previous pine weevil (Hylobius abietis) damage as a reference treatment. The seedlings were exposed to pine weevils 12 or 32 days after treatments (early and late exposure, hereafter), and resistance was measured as the amount of damage received by plants. At early exposure, seedlings treated with needle-piercing damage received significantly more subsequent pine weevil feeding damage than those treated with MeJA. Seedlings treated with MeJA and needle-piercing damage received 84% less and 250% more pine weevil feeding, respectively, relative to control seedlings. The other treatments did not differ statistically from control or MeJA in terms of subsequent pine weevil damage. For the late exposure group, plants in all induction treatments tended to receive less pine weevil feeding (yet this was not statistically significant) compared to control seedlings. On the other hand, MeJA significantly slowed down seedling growth relative to control and all other induction treatments. Overall, the mechanical damage treatments appeared to have no or variable effects on seedling resistance. One of the treatments, needle-piercing damage, actually increased pine weevil feeding at early exposure. These results therefore suggest that mechanical damage shows little potential as a plant protection measure to reduce feeding by a bark-chewing insect.
A Quantitative Arabidopsis IRE1a Ribonuclease-Dependent in vitro mRNA Cleavage Assay for Functional Studies of Substrate Splicing and Decay Activities
Authors: Diwan Danish , Liu Xiaoyu , Andrews Caroline F. , Pajerowska-Mukhtar Karolina M.
Published: July 2021

The unfolded protein response (UPR) is an adaptive eukaryotic reaction that controls the protein folding capacities of the endoplasmic reticulum (ER). The most ancient and well-conserved component of the UPR is Inositol-Requiring Enzyme 1 (IRE1). Arabidopsis IRE1a (AtIRE1) is a transmembrane sensor of ER stress equipped with dual protein kinase and ribonuclease (RNase) activities, encoded by its C-terminal domain. In response to both physiological stresses and pathological perturbations, AtIRE1a directly cleaves bZIP60 (basic leucine zipper 60) mRNA. Here, we developed a quantitative in vitro cleavage assay that combines recombinant AtIRE1a protein that is expressed in Nicotiana benthamiana and total RNA isolated from Arabidopsis leaves. Wild-type AtIRE1a as well as its variants containing point mutations in the kinase or RNase domains that modify its cleavage activity were employed to demonstrate their contributions to cleavage activity levels. We show that, when exposed to total RNA in vitro, the AtIRE1a protein cleaves bZIP60 mRNA. Depletion of the bZIP60 transcript in the reaction mixture can be precisely quantified by a qRT-PCR-mediated assay. This method facilitates the functional studies of novel plant IRE1 variants by allowing to quickly and precisely assess the effects of protein mutations on the substrate mRNA cleavage activity before advancing to more laborious, stable transgenic approaches in planta. Moreover, this method is readily adaptable to other plant IRE1 paralogs and orthologs, and can also be employed to test additional novel mRNA substrates of plant IRE1, such as transcripts undergoing degradation through the process of regulated IRE1-dependent decay (RIDD). Finally, this method can also be modified and expanded to functional testing of IRE1 interactors and inhibitors, as well as for studies on the molecular evolution of IRE1 and its substrates, providing additional insights into the mechanistic underpinnings of IRE1-mediated ER stress homeostasis in plant tissues.
Measuring Collaboration Load With Pupillary Responses - Implications for the Design of Instructions in Task-Oriented HRI
Authors: Kontogiorgos Dimosthenis , Gustafson Joakim
Published: July 2021

In face-to-face interaction, speakers establish common ground incrementally, the mutual belief of understanding. Instead of constructing “one-shot” complete utterances, speakers tend to package pieces of information in smaller fragments (what Clark calls “installments”). The aim of this paper was to investigate how speakers' fragmented construction of utterances affect the cognitive load of the conversational partners during utterance production and comprehension. In a collaborative furniture assembly, participants instructed each other how to build an IKEA stool. Pupil diameter was measured as an outcome of effort and cognitive processing in the collaborative task. Pupillometry data and eye-gaze behaviour indicated that more cognitive resources were required by speakers to construct fragmented rather than non-fragmented utterances. Such construction of utterances by audience design was associated with higher cognitive load for speakers. We also found that listeners' cognitive resources were decreased in each new speaker utterance, suggesting that speakers' efforts in the fragmented construction of utterances were successful to resolve ambiguities. The results indicated that speaking in fragments is beneficial for minimising collaboration load, however, adapting to listeners is a demanding task. We discuss implications for future empirical research on the design of task-oriented human-robot interactions, and how assistive social robots may benefit from the production of fragmented instructions.
What Am I Drinking? Vision Modulates the Perceived Flavor of Drinks, but No Evidence of Flavor Altering Color Perception in a Mixed Reality Paradigm
Authors: Stäger Lorena , Roel Lesur Marte , Lenggenhager Bigna
Published: July 2021

It is well established that vision, and in particular color, may modulate our experience of flavor. Such cross-modal correspondences have been argued to be bilateral, in the sense that one modality can modulate the other and vice versa. However, the amount of literature assessing how vision modulates flavor is remarkably larger than that directly assessing how flavor might modulate vision. This is more exaggerated in the context of cross-modal contrasts (when the expectancy in one modality contrasts the experience through another modality). Here, using an embodied mixed reality setup in which participants saw a liquid while ingesting a contrasting one, we assessed both how vision might modulate basic dimensions of flavor perception and how the flavor of the ingested liquid might alter the perceived color of the seen drink. We replicated findings showing the modulation of flavor perception by vision but found no evidence of flavor modulating color perception. These results are discussed in regard to recent accounts of multisensory integration in the context of visual modulations of flavor and bilateral cross-modulations. Our findings might be important as a step in understanding bilateral visual and flavor cross-modulations (or the lack of them) and might inform developments using embodied mixed reality technologies.
Positive Youth Development and Wellbeing: Gender Differences
Authors: Tomé Gina , Gaspar de Matos Margarida , Reis Marta , Gomez-Baya Diego , Coelhoso Filipa , Wiium Nora
Published: July 2021

The five C’s of positive youth development (PYD) (competence, confidence, character, caring, and connection) have been associated with adaptive development among young people. Gender differences in young people’s wellbeing and mental health have been studied and analyzed, but the investigation into their association with the five C’s is still in its infancy. In the present study, we analyzed the influence of the five C’s on the wellbeing, more specifically, anxiety, social alienation, general wellbeing, physical symptoms, and psychological symptoms, of Portuguese adolescents, by gender. Participants were 5th–12th grade students attending public schools in Lisbon, Portugal. The questionnaire was administered to 384 adolescents. The results indicated important gender differences in young people’s wellbeing. The results revealed some differences between genders that should be considered in interventions that aim to promote the wellbeing of adolescents. On the other hand, confidence was positively associated with mental health and wellbeing for both boys and girls, skill should be promoted among young people, because it was competence that revealed the greatest association with wellbeing, among the variables analyzed.
A Latent Class Analysis of Forensic Psychiatric Patients in Relation to Risk and Protective Factors
Authors: Janković Marija , Masthoff Erik , Spreen Marinus , de Looff Peter , Bogaerts Stefan
Published: July 2021

Forensic psychiatric patients form a very heterogeneous population regarding psychopathology, criminal history, and risk factors for reoffending. Therefore, the present study aimed to investigate whether there are more homogeneous classes of forensic patients based on DSM-IV-TR Axis I and II diagnoses and previously committed offenses, by means of explorative latent class analysis (LCA). It was also investigated which risk and protective factors are significantly more prevalent in one class compared to other classes. The study sample contained 722 male forensic psychiatric patients who were unconditionally released between 2004 and 2014 from high-security forensic clinics. Data were retrospectively derived from electronic patient files. Five distinctive patient classes emerged: class with only Axis II diagnosis, class with multiple problems, antisocial class, psychotic class, and intellectually disabled class. These classes differed significantly in risk and protective factors. This study contributes to the understanding of patient classes and provides directions for future, class-tailored interventions.
Examining the Role of Teachers’ Stroking Behaviors in EFL Learners’ Active/Passive Motivation and Teacher Success
Authors: Pishghadam Reza , Derakhshan Ali , Jajarmi Haniyeh , Tabatabaee Farani Sahar , Shayesteh Shaghayegh
Published: July 2021

Due to the important role that teachers’ professional success plays in the effectiveness of their students and the education system in which they are involved, the present study investigated whether teacher stroke can predict teacher success through the mediation of students’ active and passive motivation. For this aim, a group of 437 Iranian university English as a Foreign Language (EFL) students were targeted to respond to the teacher success, teacher stroke, and student motivation questionnaires. The main results of the study, obtained through running correlation and structural equation modeling (SEM), were first, while positive stroke showed a positive correlation with teacher success, it did not directly predict success; yet mediated by active motivation, it was a positive predictor of success; second, while teacher success had no significant relationship with total motivation, it was positively correlated with active and passive motivation, separately; third, in terms of gender differences, for the female participants, stroke, mediated by active motivation, was a better predictor of teacher success; fourth, high scores in positive, verbal, and conditional stroke were in association with high scores in active motivation, which significantly predicted teacher success. Based on the results, it can be concluded that teacher stroke, as an instance of positive teacher interpersonal communication behaviors, increases students’ active motivation for foreign language learning, which in turn results in their higher perceptions of English teachers’ professional success.
Aspects of Shared Decision Making in a Cognitive-Educational Intervention for Family Members of Persons Coping With Severe Mental Illness
Authors: Weiss Penina , Redlich-Amirav Dorit , Daass-Iraqi Sara , Hadas-Lidor Noami
Published: July 2021

Background: Partnerships and family inclusion are embedded in mental health policies. Shared Decision Making (SDM) is as an effective health communication model designed to facilitate service users and providers engagement in reaching jointly decisions concerning interventions. Keshet is a 15 bi-weekly academic course for family members of people with mental illnesses that enhances positive family cognitive communication skills.

Purpose: To exhibit how SDM is inherently expressed in Keshet.

Method: We conducted a secondary analysis of previous Keshet evaluation studies and course protocols that focused on revealing SDM use.

Results: SDM was found to be a prominent feature in Keshet interventions in both the structure of the course as well as the process and procedures. Following participation in the program, making decisions jointly was found to be a prominent feature.

Conclusions: Interventions such as Keshet that include an SDM approach can contribute to the integration of academic, professional and “lived experience” within a shared perspective, thus promoting an enhanced equality- based SDM model that benefits individuals as well as mental health systems.
Human Autonomy in Future Drone Traffic: Joint Human–AI Control in Temporal Cognitive Work
Authors: Lundberg Jonas , Arvola Mattias , Palmerius Karljohan Lundin
Published: July 2021

The roles of human operators are changing due to increased intelligence and autonomy of computer systems. Humans will interact with systems at a more overarching level or only in specific situations. This involves learning new practices and changing habitual ways of thinking and acting, including reconsidering human autonomy in relation to autonomous systems. This paper describes a design case of a future autonomous management system for drone traffic in cities in a key scenario we call The Computer in Brussels. Our approach to designing for human collaboration with autonomous systems builds on scenario-based design and cognitive work analysis facilitated by computer simulations. We use a temporal method, called the Joint Control Framework to describe human and automated work in an abstraction hierarchy labeled Levels of Autonomy in Cognitive Control. We use the Score notation to analyze patterns of temporal developments that span levels of the abstraction hierarchy and discuss implications for human-automation communication in traffic management. We discuss how autonomy at a lower level can prevent autonomy on higher levels, and vice versa. We also discuss the temporal nature of autonomy in minute-to-minute operative work. Our conclusion is that human autonomy in relation to autonomous systems is based on fundamental trade-offs between technological opportunities to automate and values of what human actors find meaningful.
Prognostic Value of Combined Preoperative Carcinoembryonic Antigen and Prognostic Nutritional Index in Patients With Stage II–III Colon Cancer
Authors: Xu Yan-song , Liu Gang , Zhao Chang , Lu Shao-long , Long Chen-yan , Zhong Hua-ge , Chen Yi , Huang Ling-xu , Liang Zheng
Published: July 2021

Background: Tumor status can affect patient prognosis. Prognostic nutritional index (PNI), as a nutritional indicator, is closely related to the prognosis of cancer. However, few studies have examined the combined prognostic value of CEA and PNI in patients. This study investigated the relationship between CEA/PNI and prognosis of colon cancer patients.

Methods: A total of 513 patients with stage II–III colon cancer who underwent curative resection at two medical centers from 2009 to 2019 were included. Clinicopathological factors were assessed and overall survival (OS) was assessed in a cohort of 413 patients. Multivariate analysis was used to identify independent prognostic variables to construct histograms predicting 1-year and 3-year OS. Data from 100 independent patients in the validation group was used to validate the prognostic model.

Results: The median OS time was 33.6 months, and mortality was observed in 54 patients. Multivariate analysis revealed that preoperative CEA/PNI, lymph node metastasis, peripheral nerve invasion, operation mode, and postoperative chemotherapy were independent factors for prognosis evaluation and thus were utilized to develop the nomogram. The C-index was 0.788 in the learning set and 0.836 in the validation set. The calibration curves reached favorable consensus among the 1-, 3-year OS prediction and actual observation.

Conclusion: The combined use of CEA and PNI is an independent prognostic factor and thus can serve as a basis for a model to predict the prognosis of patients with stage II–III colon cancer.
Eight Surgical Interventions for Lumbar Disc Herniation: A Network Meta-Analysis on Complications
Authors: Wei Fei-Long , Li Tian , Gao Quan-You , Yang Yi , Gao Hao-Ran , Qian Ji-Xian , Zhou Cheng-Pei
Published: July 2021

Objective: Therapeutic options for lumbar disc surgery (LDH) have been rapidly evolved worldwide. Conventional pair meta-analysis has shown inconsistent results of the safety of different surgical interventions for LDH. A network pooling evaluation of randomized controlled trials (RCT) was conducted to compare eight surgical interventions on complications for patients with LDH.

Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for RCT from inception to June 2020, with registration in PROSPERO (CRD42020176821). This study is conducted in accordance with Cochrane guidelines. Primary outcomes include intraoperative, post-operative, and overall complications, reoperation, operation time, and blood loss.

Results: A total of 27 RCT with 2,948 participants and eight interventions, including automated percutaneous lumbar discectomy (APLD), chemonucleolysis (CN), microdiscectomy (MD), micro-endoscopic discectomy (MED), open discectomy (OD), percutaneous endoscopic lumbar discectomy (PELD), percutaneous laser disc decompression (PLDD), and tubular discectomy (TD) were enrolled. The pooling results suggested that PELD and PLDD are with lower intraoperative and post-operative complication rates, respectively. TD, PELD, PLDD, and MED were the safest procedures for LDH according to complications, reoperation, operation time, and blood loss.

Conclusion: The results of this study provided evidence that PELD and PLDD were with lower intraoperative and post-operative complication rates, respectively. TD, PELD, PLDD, and MED were the safest procedures for LDH according to complications, reoperation, operation time, and blood loss.

Systematic Review Registration: PROSPERO, identifier CRD42020176821.
Continental Survey of Access to Diagnostic Tools and Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in Africa
Authors: Dokponou Yao Christian Hugues , Kotecha Jay , Bandyopadhyay Soham , Erhabor Joshua , Ooi Setthasorn Zhi Yang , Egiz Abdullah , Boutarbouch Mahjouba , Dalle David Ulrich , Higginbotham George , Thioub Mbaye , Sichimba Dawin , Bankole Nourou Dine Adeniran , Kanmounye Ulrick Sidney
Published: July 2021

Rationale: Interventional neurovascular procedures are effective in lowering the burden of mortality and complications resulting from aneurysmal subarachnoid hemorrhage (aSAH). Despite the wide uptake of interventional neurovascular procedures in high-income countries, access to care in low- and middle-income countries remains limited, and little is known about accessibility in Africa. In this survey, we decided to assess access to diagnostic tools and treatment of aSAH in Africa.

Methodology: A Google form e-survey was distributed to African neurosurgery centers accepting responses from January 4th to March 21st 2021. Data on accessibility to diagnostic tools, treatment methodologies, and interventional neuroradiology personnel in African centers were collected. Ninety five percent confidence intervals were computed for each variable.

Results: Data was received from 36 neurosurgical centers in 16 African countries (16/54, 30%). Most centers were public institutions. Ninety four percent of the centers had the necessary resources for a lumbar puncture (LP) and a laboratory for the diagnosis of aSAH. Most centers had at least one computed tomography (CT) scanner, 81% of the centers had access to CT angiography and some had access to conventional angiography. Forty seven percent of the centers could obtain a head CT within 2 h of presentation in an emergency. Sixty one percent of centers provided clipping of intracranial aneurysms whilst only 22% of centers could perform the endovascular treatment. Sixty four percent of centers did not have an endovascular specialist.

Conclusion: This survey highlights health inequity in access to endovascular treatment for aSAH. Lack of diagnostic tools to identify an aneurysm and a shortfall of qualified endovascular specialists are prime reasons for this. Our findings can inform health system strengthening policies including the acquisition of equipment and capacity building in Africa.
Robotic-Assisted vs. Open Simple Prostatectomy for Large Prostates: A Meta-Analysis
Authors: Xia Zhongyou , Li Jinze , Yang Xiaoying , Jing Hao , Niu Chao , Li Xianhui , Li Yunxiang , Zhang Zongping , Wu Ji
Published: July 2021

Purpose: To compare the efficacy and safety of robotic-assisted simple prostatectomy and open simple prostatectomy for large benign prostatic hyperplasia.

Methods: We systematically searched the Cochrane Library, PubMed, Embase, and Science databases for studies published through December 2020. Controlled trials on RASP and OSP for large prostates were included. The meta-analysis was conducted with the Review Manager 5.4 software.

Results: A total of seven studies with 3,777 patients were included in the analysis. There were no significant differences in IPSS (WMD, 0.72; 95%CI: −0.31, 1.76; P = 0.17), QoL (WMD, 0.00; 95%CI: −0.39, 0.39; P > 0.99), Qmax (WMD, 1.88; 95% CI: −1.15, 4.91; P = 0.22), or PVR (WMD, −10.48; 95%CI: −25.13, 4.17; P = 0.16) among patients undergoing RASP and OSP. However, compared with patients who underwent OSP, patients who underwent RASP had a shorter LOS (WMD, −2.83; 95%CI: −3.68, −1.98; P < 0.001), less EBL (WMD, −304.68; 95% CI: −432.91, −176.44; P < 0.001), a shorter CT (WMD, −2.61; 95%CI: −3.94, −1.29; P < 0.001), and fewer overall complications (OR, 0.30; 95% CI: 0.16, 0.57; P < 0.001). Nevertheless, RASP was associated with a longer OT (WMD, 59.69, 95% CI: 49.40, 69.98; P < 0.001).

Conclusion: The results of the current study demonstrated that RASP provided similar efficacy to those of OSP in the treatment of large prostate, while maintaining better security. Our findings indicate that RASP is a feasible and effective alternative to OSP.
Restricted Kinematic Alignment, the Fundamentals, and Clinical Applications
Authors: Vendittoli Pascal-André , Martinov Sagi , Blakeney William G.
Published: July 2021

Introduction:After a better understanding of normal knee anatomy and physiology, the Kinematic Alignment (KA) technique was introduced to improve clinical outcomes of total knee arthroplasty (TKA). The goal of the KA technique is to restore the pre-arthritic constitutional lower limb alignment of the patient. There is, however, a large range of normal knee anatomy. Unusual anatomies may be biomechanically inferior and affect TKA biomechanics and wear patterns. In 2011, the leading author proposed the restricted kinematic alignment (rKA) protocol, setting boundaries to KA for patients with an outlier or atypical knee anatomy.

Material and Equipment:rKA aims to reproduce the constitutional knee anatomy of the patient within a safe range. Its fundamentals are based on sound comprehension of lower limb anatomy variation. There are five principles describing rKA: (1) Combined lower limb coronal orientation should be ± 3° of neutral; (2) Joint line orientation coronal alignment should be within ± 5° of neutral; (3) Natural knee's soft tissues tension/ laxities should be preserved/restored; (4) Femoral anatomy preservation is prioritized; (5) The unloaded/most intact knee compartment should be resurfaced and used as the pivot point when anatomical adjustment is required. An algorithm was developed to facilitate the decision-making.

Methods:Since ~50% of patients will require anatomic modification to fit within rKA boundaries, rKA is ideally performed with patient-specific instrumentation (PSI), intra-operative computer navigation or robotic assistance. rKA surgical technique is presented in a stepwise manner, following the five principles in the algorithm.

Results:rKA produced excellent mid-term clinical results in cemented or cementless TKA. Gait analysis showed that rKA TKA patients had gait patterns that were very close to a non-operated control group, and these kinematics differences translated into significantly better postoperative patient-reported scores than mechanical alignment (MA) TKA cases.

Discussion:Aiming to improve the results of MA TKA, rKA protocol offers a satisfactory compromise that recreates patients' anatomy in most cases, omitting the need for extensive corrections and soft tissue releases that are often required with MA. Moreover, it precludes the reproduction of extreme anatomies seen with KA.
Accidental Dural Tears in Minimally Invasive Spinal Surgery for Degenerative Lumbar Spine Disease
Authors: Aspalter Stefan , Senker Wolfgang , Radl Christian , Aichholzer Martin , Aufschnaiter-Hießböck Kathrin , Leitner Clemens , Stroh Nico , Trutschnig Wolfgang , Gruber Andreas , Stefanits Harald
Published: July 2021

Background: One of the most frequent complications of spinal surgery is accidental dural tears (ADTs). Minimal access surgical techniques (MAST) have been described as a promising approach to minimizing such complications. ADTs have been studied extensively in connection with open spinal surgery, but there is less literature on minimally invasive spinal surgery (MISS).

Materials and Methods: We reviewed 187 patients who had undergone degenerative lumbar spinal surgery using minimally invasive spinal fusions techniques. We analyzed the influence of age, Body Mass Index (BMI), smoking, diabetes, and previous surgery on the rate of ADTs in MISS.

Results: Twenty-two patients (11.764%) suffered from an ADT. We recommended bed rest for two and a half to 5 days, depending on the type of repair required and the amount of cerebrospinal fluid (CSF) leakage. We could not find any statistically significant correlation between ADTs and age (p = 0.34,), BMI (p = 0.92), smoking (p = 0.46), and diabetes (p = 0.71). ADTs were significantly more frequent in cases of previous surgery (p < 0.001). None of the patients developed a transcutaneous CSF leak or post-operative infection.

Conclusions: The frequency of ADTs in MISS appears comparable to that encountered when using open surgical techniques. Additionally, MAST produces less dead space along the corridor to the spine. Such reduced dead space may not be enough for pseudomeningocele to occur, cerebrospinal fluid to accumulate, and fistula to form. MAST, therefore, provides a certain amount of protection.
Case Report: 1-Year Follow-Up of Vagus Nerve Stimulation in a Dog With Drug-Resistant Epilepsy
Authors: Hirashima Junya , Saito Miyoko , Igarashi Hirotaka , Takagi Satoshi , Hasegawa Daisuke
Published: July 2021

A vagus nerve stimulation (VNS) system was surgically implanted to treat drug-resistant epilepsy in a 5-year-old male Shetland Sheepdog. At regular visits during a 1-year follow-up, treatment efficacy and adverse effects were assessed, and programmable stimulation parameters were adjusted to optimize stimulation intensity while avoiding adverse effects. The frequency of generalized tonic–clonic seizures was reduced by 87% after the initiation of VNS. The owner reported that the dog regained his personality, and the quality of life of both the dog and owner improved. The only adverse effect of VNS was a cough that was controlled by adjusting stimulation parameters. There were no surgical complications or other issues with the VNS device. This is the first long-term evaluation of VNS therapy in a dog, and the results obtained suggest that gradual adjustments of VNS parameters facilitate optimum VNS dosing.
Ammonium Excess Leads to Ca Restrictions, Morphological Changes, and Nutritional Imbalances in Tomato Plants, Which Can Be Monitored by the N/Ca Ratio
Authors: Bonomelli Claudia , de Freitas Sergio Tonetto , Aguilera Camila , Palma Carola , Garay Rebeca , Dides Maximiliano , Brossard Natalia , O’Brien José Antonio
Published: July 2021

Both nitrogen and calcium fertilization management are vital for crops, where an imbalance of these elements can cause both physiological and yield problems. It has been proposed that nitrogen absorption, particularly ammonium, is in part dependent on calcium supply. Moreover, the balance between these two nutrients could be a key indicator of plant growth in some species. Tomato, one of the most cultivated crops worldwide, can also be widely affected by nutritional imbalance. Using large amounts of N fertilizers could lead to an imbalance with other nutrients and, thus, detrimental effects in terms of plant development and yield. Here we show that ammonium excess has a negative impact on plant development and results in calcium deficiency. Moreover, a deficit in calcium nutrition not only affects calcium concentration but also leads to a restriction in N uptake and reduced N concentration in the plant. These effects were evident at the seedling stage and also during flowering/fruit set. Using PCA analysis, we integrated both phenotypic and nutritional imbalances in seedlings and grown plants. Interestingly, the Ca/N ratio appears to be a key indicator to monitor appropriate N and calcium nutrition and more importantly the balance between both. Maintaining this balance could be an essential element for tomato crop production.
Topographic Position, Land Use and Soil Management Effects on Soil Organic Carbon (Vineyard Region of Niš, Serbia)
Authors: Jakšić Snežana , Ninkov Jordana , Milić Stanko , Vasin Jovica , Živanov Milorad , Perović Veljko , Banjac Borislav , Vučković Savo , Dozet Gordana , Komlen Vedrana
Published: July 2021

Spatial distribution of soil organic carbon (SOC) is the result of a combination of various factors related to both the natural environment and anthropogenic activities. The aim of this study was to examine (i) the state of SOC in topsoil and subsoil of vineyards compared to the nearest forest, (ii) the influence of soil management on SOC, (iii) the variation in SOC content with topographic position, (iv) the intensity of soil erosion in order to estimate the leaching of SOC from upper to lower topographic positions, and (v) the significance of SOC for the reduction of soil’s susceptibility to compaction. The study area was the vineyard region of Niš, which represents a medium-sized vineyard region in Serbia. About 32% of the total land area is affected, to some degree, by soil erosion. However, according to the mean annual soil loss rate, the total area is classified as having tolerable erosion risk. Land use was shown to be an important factor that controls SOC content. The vineyards contained less SOC than forest land. The SOC content was affected by topographic position. The interactive effect of topographic position and land use on SOC was significant. The SOC of forest land was significantly higher at the upper position than at the middle and lower positions. Spatial distribution of organic carbon in vineyards was not influenced by altitude, but occurred as a consequence of different soil management practices. The deep tillage at 60–80 cm, along with application of organic amendments, showed the potential to preserve SOC in the subsoil and prevent carbon loss from the surface layer. Penetrometric resistance values indicated optimum soil compaction in the surface layer of the soil, while low permeability was observed in deeper layers. Increases in SOC content reduce soil compaction and thus the risk of erosion and landslides. Knowledge of soil carbon distribution as a function of topographic position, land use and soil management is important for sustainable production and climate change mitigation.
Influence of Olive Maturity and Season on the Quality of Virgin Olive Oils from the Area Assigned to the Protected Designation of Origin of “Aceite de la Alcarria” (Spain)
Authors: Pardo José E. , Rabadán Adrián , Suárez Mariano , Tello Jacinto , Zied Diego C. , Álvarez-Ortí Manuel
Published: July 2021

This work aimed to assess the influence of olive maturity and oil season on the potential quality of monovarietal virgin olive oils from the area assigned to the Protected Designation of Origin of “Aceite de la Alcarria” (Spain), analysing the regulated physicochemical quality and sensory parameters, the stability parameters and composition of fatty acids, sterols and triterpenic dialcohols. To complete the study, we also characterised the coupage olive oils made in the oil mills located in the PDO area (real quality). The main variety grown in La Alcarria is Castellana, whose oils are characterised by a high content of palmitic acid (14.27% with olives in veraison, 13.81% with ripe olives), a low content of linoleic acid (5.03% with olives in veraison, 5.98% with ripe olives) and a total phenol content higher than the rest of varieties grown in the area (between 350 and 500 mg of caffeic acid/kg depending on the season considered), which is reflected in higher oxidative stability values (induction time of 50.65 h at 100 °C). In addition, they have a sterol content below that established by the regulations (<1000 mg/kg). The olive oils produced using olives in veraison presented a lower level of acidity and peroxide index, more intense fruitiness, an absence of defects in all the samples and higher oxidative stability, compared to those produced using ripe olives, and thus early harvest of the olives is recommended. It was also found that the season affects the physicochemical composition of the oils, although these changes tend to be of little significance, with the characteristics of the variety being maintained, regardless of the harvesting season analysed. The coupage virgin olive oils produced in the mills registered under the PDO of Aceite de la Alcarria, representative of their real quality, showed, as expected, similar values to those observed in the monovarietal virgin olive oils produced using the Castellana variety, which is clearly predominant in the study area. The characterization of oils from local varieties allows one to obtain a greater variability in terms of the sensory notes of extra virgin olive oil.