bluuebunny/crossref_metadata_2025 huggingface dataset:
Historical background and development trends of minerals’ processing – conclusions from KOMEKO–IMTech 2019 Conference
Authors: Malec M
Published: December 2019

The article describes historical background and a few development trends of minerals’ processing on the base of the conclusions drawn during the KOMEKO-IMTech 2019 Conference organized by the KOMAG Institute of Mining Technology last March. The scope of the Conference covered an exchange of information and professional experience among representatives of science and industry technology. Some information about processing techniques and technologies in Soverign Poland are also presented in the article. Special attention is paid to innovative solutions of minerals’ beneficiation machines and equipment, in particular developed at KOMAG for the hard coal mining industry.
Tests of BMS Battery Management System with active and passive system of balancing the battery capacity
Authors: Deja P
Published: December 2019

The tests of two BMS Battery management systems, equipped with active and passive systems of balancing the battery capacity, realized within the framework of the HYDKOM 75 project, are discussed in the article. These test were performed on the lithium-ferric-phosphate(LiFePO4) battery assembly for the mining mobile machine of BH 3000 B HYDKOM 75 type. The object of tests included two Battery Management Systems (BMS). The first one was a commercially available system most often used in the automobile industry, however the second one was the author’s BMS-Battery Management System developed at the KOMAG Institute of Mining Technology within a realization of the HYDKOM 75 project. The tests were conducted both during a battery charging process as well as during discharging the LiFePO4 battery for different values of the load current.
Investigations into the wear rate of conical picks with abrasion-resistant coatings in laboratory conditions
Authors: Krauze K , Bołoz Ł , Wydro T , Mucha K
Published: December 2019

As part of own works performed by the Department of Machine Engineering and Transport of AGH University of Science and Technology, investigations into the rate of conical picks’ wear were carried out. For this purpose, the previously developed methodology for running experiments at a specialist laboratory test stand was applied. Tests were carried out for a total of seven types of conical picks with the same geometric parameters, but made of various grades of steel and with the body working surface covered by abrasion-resistant materials. The conducted investigations and the analysis of results allowed recommending conical picks made of S235 steal and hardfaced with EP-TB-1-6 or EP-TB-2-46 electrodes. However, it seems advisable to continue attempts aimed at finding a protective coating for the body of the pick.
Safety of longwall mining with caving in the light of data from monitoring systems
Authors: Rajwa S , Lubosik Z , Płonka M
Published: December 2019

Shield supports are usually perceived as devices consisting mainly of mechanical and hydraulic parts, while other apparatus, mainly related to electronics, is often treated as a necessary supplement to the system which ensures its control. However, the development of features closely related to the latest electronic equipment in the mining complexes, mainly connected with measuring and registration possibilities, also allows for more and more frequent use of various types of monitoring. It enables observation of the operation of the mining complex in real time or with a slight time delay. What is more, it also enables signalling the operating states of the shield constituting specific threats or irregularities. The most advanced systems found abroad are equipped with functions analysing changes in specific monitored parameters to develop warnings about possible future threats to allow the operator to react with sufficient time in advance. Developing such a forecast system requires gathering and then analysing a sufficiently large and complete database of measurements and observations. These are primarily associated with various difficulties in operating a shield support, and especially with strictly emergency states, such as rock slides, shield clamping conditions, etc. The developed warning identifiers also depend on the mining and geological situation of the specific mining panel. The monitoring currently used, concerning a part of the mining complex related to the shield support, mainly concerns the pressures in the hydraulic props of the shield and the measure of the shifter advance. It allows determining the position of the section on the longwall panel length. The current instantaneous shield geometry and dimensions of the excavation itself, such as height, setting and inclination, are determined in-situ much less often. The information obtained is often also sent to the surface of the mine. The data from monitoring of shield support operation, through proper development of dependencies and analysis results, can optimize the safety of crew, reduce difficulties in maintaining the roof of longwall excavations and thus have a positive impact on the obtained economic results.
Optical and functional properties of hydrothermally synthesized tetragonal Ba0.4Cu0.6−xLaxTiO3 (x = 0.2–0.6) nanoparticles
Authors: Prakash M , Kumar R Jeevan , Chandra Babu Naidu K
Published: December 2019

Ba0.4Cu0.6−xLaxTiO3 (x = 0.2, 0.4 & 0.6) (BCLT) nanoparticles were prepared by hydrothermal method. The x-ray diffraction (XRD) pattern established the existence of tetragonal phases. The nanospheres were observed in the surface morphology of present materials using the transmission electron microscopy (TEM). The optical properties were investigated to confirm the presence of metal oxide bonds as well as the optical band-gap energy of BCLT nanoparticles. The dielectric and impedance parameters were studied as a function of frequency and composition. The Cole-Cole plots were drawn to understand the microstructure and electrical conduction mechanism. In addition, the ferroelectric nature was carried out with the help of polarization versus electric field (P-E) loop tracer.
The Historical Evolution of Allegiance During Occupation
Authors: Galvis Martinez Manuel
Published: December 2019

The article traces the historical evolution of an understudied area of International Humanitarian Law (IHL): the rules on allegiance during occupation. By mapping state practice and scholarly opinions, the article shows the abandonment of the automatic transfer of the population’s allegiance to the occupant in favour of other theories. Nonetheless, the discussions surrounding this topic show a general struggle to label the relation between inhabitants and occupiers, and a general rejection of any theory that directly or indirectly presumes sovereignty of the occupier over the inhabitants. The article presents an element that is rarely included in debates on allegiance and occupation, i.e. the efforts of states to reinforce their sovereignty over occupied population through criminal prosecution of those who collaborated with the occupant. Finally, contemporary practice aimed at bypassing the regulations is presented as incongruent with the rules regarding occupation in the Geneva Conventions. Despite the landmarks achieved in regulating the matter, the article shows that many aspects remain under discussion and formation. Furthermore, many current rules, practices and discussions only serve the interests of states and are oblivious of the hardships faced by individuals under occupation.
Distribution Pattern of Thrips (Thysanoptera: Thripidae) and Tomato Chlorotic Spot Virus in South Florida Tomato Fields
Authors: Khan Rafia A , Seal Dakshina R , Zhang Shouan , Liburd Oscar E , Srinivasan Rajagopalbabu , Evans Edward
Published: December 2019

Tomato chlorotic spot virus (TCSV) is an orthotospovirus that causes a devastating disease in tomato (Lycopersicon esculentum Miller). TCSV emerged recently in South Florida. Studies were conducted in three commercial tomato fields in Miami-Dade County, Florida during the vegetable-growing seasons from October to April in 2015 through 2017. Each year, data were collected at 3, 6, and 9 wk after transplanting at various distances from the edges of each fields. Based on 3 yr total samples, three species of thrips were commonly observed melon thrips, Thrips palmi Karny (62.16 ± 0.79%), being the most abundant species followed by common blossom thrips, Frankliniella schultzei Trybom (21.55 ± 0.66%), and western flower thrips, Frankliniella occidentalis (Pergande) (16.26 ± 0.61%). Abundance of all thrips and TCSV infected plants was high at the edge of a tomato field 3 wk after transplanting with significantly fewer infected plants toward the center of the field. The distribution patterns of thrips and TCSV in various fields were mostly regular and aggregated across the sampling dates during the study period. Abundance of TCSV symptomatic plants and thrips species was high at the edge of the field and increased over time. The number of samples required to accurately determine population density of thrips was calculated by using three precision levels (0.10, 0.20, 0.30) at three predetermined densities of thrips (0.10, 0.20, and 0.40 per sample). This information will provide guidelines to growers, crop protection personnel, agricultural scouts, and researchers to develop a sustainable thrips and tospovirus management program.
Systemic AAV9 gene therapy using the synapsin I promoter rescues a mouse model of neuronopathic Gaucher disease but with limited cross-correction potential to astrocytes
Authors: Massaro Giulia , Hughes Michael P , Whaler Sammie M , Wallom Kerri-Lee , Priestman David A , Platt Frances M , Waddington Simon N , Rahim Ahad A
Published: December 2019

Gaucher disease is caused by mutations in the GBA gene, which encodes for the lysosomal enzyme β-glucocerebrosidase (GCase), resulting in the accumulation of storage material in visceral organs and in some cases the brain of affected patients. While there is a commercially available treatment for the systemic manifestations, neuropathology still remains untreatable. We previously demonstrated that gene therapy represents a feasible therapeutic tool for the treatment of the neuronopathic forms of Gaucher disease (nGD). In order to further enhance the therapeutic affects to the central nervous system, we systemically delivered an adeno-associated virus (AAV) serotype 9 carrying the human GBA gene under control of a neuron-specific promoter to an nGD mouse model. Gene therapy increased the life span of treated animals, rescued the lethal neurodegeneration, normalized the locomotor behavioural defects and ameliorated the visceral pathology. Together, these results provided further indication of gene therapy as a possible effective treatment option for the neuropathic forms of Gaucher disease.
Is surgical resection of primary tumour superior to exploratory thoracotomy without resection in treating lung cancer patients with unexpected pleural metastasis detected during operation?
Authors: Deng Han-Yu , Zheng Xi , Zhu Da-Xing , Zhou Qinghua
Published: December 2019

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘In lung cancer patients with unexpected pleural metastasis detected during operation, is surgical resection of primary tumour superior to exploratory thoracotomy without resection in improving long-term survival?’. Altogether, 1443 papers were found using the reported search, of which 1 meta-analysis and 10 retrospective observational cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. One meta-analysis and 9 cohort studies found that surgical resection of the primary tumour, on the discovery of pleural metastases, yielded a better overall survival than exploratory thoracotomy alone, while 1 cohort study showed no difference. Six studies found that main tumour resection was an independent favourable prognostic factor for overall survival in lung cancer patients with unexpected pleural metastasis detected during operation, while 3 cohort studies also showed improved progression-free survival over exploratory thoracotomy. Therefore, we conclude that surgical resection of the primary tumour is superior to exploratory thoracotomy in treating lung cancer patients with unexpected pleural metastasis detected during operation.
Measuring Real-Time Response in Real-Life Settings
Authors: Waldvogel Thomas , Metz Thomas
Published: December 2019

Real-time response (RTR) measurement is an important technique to assess human processing of information. Ever since Maier et al. verified the reliability and validity of physical RTR devices in this journal a decade ago, there has been a growing trend toward virtual measurement platforms to overcome the limitations of conventional, laboratory-based methods. We introduce the Debat-O-Meter, a novel online RTR platform for mobile devices, which allows researchers to measure how viewers perceive political debates in the setting of their private homes. We draw on a large study (N = 5,660) conducted during the 2017 German general election campaign and show that virtualized measurement indeed facilitates diverse and large N field studies while simultaneously conforming to established standards of reliability and validity.
The updated outcomes of bladder-preserving trimodal therapy using a real-time tumor-tracking radiotherapy system for patients with muscle-invasive bladder cancer
Authors: Miyata Haruka , Osawa Takahiro , Abe Takashige , Kikuchi Hiroshi , Matsumoto Ryuji , Maruyama Satoru , Nishioka Kentaro , Shimizu Shinichi , Hashimoto Takayuki , Shirato Hiroki , Shinohara Nobuo
Published: December 2019

Objective

Bladder-preserving trimodal therapy is recognized as a promising alternative treatment for muscle-invasive bladder cancer. We report the updated outcomes of muscle-invasive bladder cancer patients that were treated using our treatment protocol, which involves radiotherapy delivered with a real-time tumor-tracking radiotherapy system.

Methods

Thirty-eight patients who were diagnosed with T2-T4N0M0 bladder cancer between 1998 and 2016 and had clinically inoperable disease or refused to undergo surgery were enrolled. The treatment protocol included maximal transurethral resection followed by whole-bladder radiotherapy (40 Gy). Concurrent nedaplatin-based chemotherapy was administered to patients with adequate renal function. At the time of the first evaluation (via transurethral resection of the tumor bed), fiducial markers were endoscopically inserted into the bladder wall around the tumor. A boost of 25 Gy was administered using the real-time tumor-tracking radiotherapy system. The second evaluation (via transurethral resection of the tumor bed) was performed 6 months after the start of treatment. The Kaplan–Meier method and Cox hazards analysis were used to analyze overall survival and cancer-specific survival.

Results

The median duration of the follow-up period was 28 months (range: 3–161 months). The 5- and 10-year overall survival rates were 54.9 and 41.2%, respectively. Twenty-five (65.8%) and twenty (74.1%) patients had achieved complete responses to chemoradiation at the first and second evaluations, respectively. In univariate and multivariate analyses, performance status was found to be significantly associated with overall survival [P = 0.03, hazard ratio: 3.48, 95% confidence interval: 1.15–10.6] and cancer-specific survival [P = 0.02, hazard ratio: 4.57, 95% confidence interval: 1.32–16.9], and sex was shown to be significantly associated with cancer-specific survival [P = 0.03, hazard ratio: 3.07, 95% confidence interval: 1.09–8.30].

Conclusions

Our bladder-preserving trimodal therapy protocol, which involves the use of a real-time tumor-tracking radiotherapy system, produced an acceptable overall survival rate. This therapy is a reasonable alternative for patients that are medically unfit for or do not want to undergo cystectomy.
Authoritarian Powers and Norm Contestation in the Liberal International Order: Theorizing the Power Politics of Ideas and Identity
Authors: Bettiza Gregorio , Lewis David
Published: December 2019

Are rising authoritarian powers such as China and Russia converging towards or challenging the normative structures of the liberal international order? This article argues that scholarship on norm contestation provides a fruitful theoretical avenue for addressing this question. It finds, however, that this literature has problematically tended to either overlook or externalize power dynamics from norm contestation. The article therefore proposes and develops a power political approach to norm contestation that, informed by a realpolitik sensibility, more explicitly and consistently makes power central to the analysis. A power political perspective conceptualizes norm contestation as the expression of battles for influence in world politics that take place at the ideational level and through symbolic instruments. It understands these struggles as occurring in the context of an international system profoundly marked by conflicting interests, cultural pluralism, hierarchical structures, and power asymmetries. This power political lens is then used to identify four modes of contestation that Russian and Chinese actors are engaged in: liberal performance, liberal mimicry, civilizational essentialization, and counter-norm entrepreneurship. It empirically explores how these contestatory practices express themselves at different intensity levels—applicatory, meaning, and validity—and display specific power political logics—fragmenting and integrative—with the goal of undermining the ideational hegemony of liberal Western-based actors and structures in world politics, and advancing alternative non-liberal visions of domestic and international order. Along with contributing to the literature on norms, this article also makes a broader intervention in current debates about rising powers and the future of the liberal international order.
Deep learning–based detection and segmentation-assisted management of brain metastases
Authors: Xue Jie , Wang Bao , Ming Yang , Liu Xuejun , Jiang Zekun , Wang Chengwei , Liu Xiyu , Chen Ligang , Qu Jianhua , Xu Shangchen , Tang Xuqun , Mao Ying , Liu Yingchao , Li Dengwang
Published: December 2019

Background

Three-dimensional T1 magnetization prepared rapid acquisition gradient echo (3D-T1-MPRAGE) is preferred in detecting brain metastases (BM) among MRI. We developed an automatic deep learning–based detection and segmentation method for BM (named BMDS net) on 3D-T1-MPRAGE images and evaluated its performance.

Methods

The BMDS net is a cascaded 3D fully convolution network (FCN) to automatically detect and segment BM. In total, 1652 patients with 3D-T1-MPRAGE images from 3 hospitals (n = 1201, 231, and 220, respectively) were retrospectively included. Manual segmentations were obtained by a neuroradiologist and a radiation oncologist in a consensus reading in 3D-T1-MPRAGE images. Sensitivity, specificity, and dice ratio of the segmentation were evaluated. Specificity and sensitivity measure the fractions of relevant segmented voxels. Dice ratio was used to quantitatively measure the overlap between automatic and manual segmentation results. Paired samples t-tests and analysis of variance were employed for statistical analysis.

Results

The BMDS net can detect all BM, providing a detection result with an accuracy of 100%. Automatic segmentations correlated strongly with manual segmentations through 4-fold cross-validation of the dataset with 1201 patients: the sensitivity was 0.96 ± 0.03 (range, 0.84–0.99), the specificity was 0.99 ± 0.0002 (range, 0.99–1.00), and the dice ratio was 0.85 ± 0.08 (range, 0.62–0.95) for total tumor volume. Similar performances on the other 2 datasets also demonstrate the robustness of BMDS net in correctly detecting and segmenting BM in various settings.

Conclusions

The BMDS net yields accurate detection and segmentation of BM automatically and could assist stereotactic radiotherapy management for diagnosis, therapy planning, and follow-up.
NF1-like optic pathway gliomas in children: clinical and molecular characterization of this specific presentation
Authors: Lobón-Iglesias María Jesús , Laurendeau Ingrid , Guerrini-Rousseau Léa , Tauziède-Espariat Arnault , Briand-Suleau Audrey , Varlet Pascale , Vidaud Dominique , Vidaud Michel , Brugieres Laurence , Grill Jacques , Pasmant Eric
Published: December 2019

Background

Pediatric neurofibromatosis type 1 (NF1)–associated optic pathway gliomas (OPGs) exhibit different clinico-radiological features, treatment, and outcome compared with sporadic OPGs. While NF1-associated OPGs are caused by complete loss-of-function of the NF1 gene, other genetic alterations of the RAS-MAPK pathway are frequently described in the sporadic cases. We identified a group of patients who presented OPGs with typical radiological features of NF1-associated OPGs but without the NF1 diagnostic criteria. We aim to investigate into the possible molecular mechanisms underlying this “NF1-like” pediatric OPGs presentation.

Methods

We analyzed clinico-radiological features of 16 children with NF1-like OPGs and without NF1 diagnostic criteria. We performed targeted sequencing of the NF1 gene in constitutional samples (n = 16). The RAS-MAPK pathway major genes were sequenced in OPG tumor samples (n = 11); BRAF FISH and IHC analyses were also performed.

Results

In one patient’s blood and tumor samples, we identified a NF1 nonsense mutation (exon 50: c.7285C>T, p.Arg2429*) with ~8% and ~70% VAFs, respectively, suggesting a mosaic NF1 mutation limited to the brain (segmental NF1). This patient presented signs of neurodevelopmental disorder. We identified a somatic alteration of the RAS-MAPK pathway in eight tumors: four BRAF activating p.Val600Glu mutations, three BRAF:KIAA oncogenic fusions, and one putative gain-of-function complex KRAS indel inframe mutation.

Conclusions

NF1-like OPGs can rarely be associated with mosaic NF1 that needs specific constitutional DNA analyses for diagnosis. Further studies are warranted to explore unknown predisposition condition leading to the NF1-like OPG presentation, particularly in patients with the association of a neurodevelopmental disorder.
The Attitudinal Opacity of Emotional Experience
Authors: Mitchell Jonathan
Published: December 2019

According to some philosophers, when introspectively attending to experience, we seem to see right through it to the (apparent) objects outside, including their properties. This is called the transparency of experience. This paper examines whether, and in what sense, emotions are transparent. It argues that emotional experiences are opaque in a distinctive way: introspective attention to them does not principally reveal non-intentional somatic qualia but rather felt valenced intentional attitudes. As such, emotional experience is attitudinally opaque.
Correcting tree-ring δ13C time series for tree-size effects in eight temperate tree species
Authors: Vadeboncoeur Matthew A , Jennings Katie A , Ouimette Andrew P , Asbjornsen Heidi
Published: December 2019

Stable carbon isotope ratios (δ13C) in tree rings have been widely used to study changes in intrinsic water-use efficiency (iWUE), sometimes with limited consideration of how C-isotope discrimination is affected by tree height and canopy position. Our goals were to quantify the relationships between tree size or tree microenvironment and wood δ13C for eight functionally diverse temperate tree species in northern New England and to better understand the physical and physiological mechanisms underlying these differences. We collected short increment cores in closed-canopy stands and analyzed δ13C in the most recent 5 years of growth. We also sampled saplings in both shaded and sun-exposed environments. In closed-canopy stands, we found strong tree-size effects on δ13C, with 3.7–7.2‰ of difference explained by linear regression vs height (0.11–0.28‰ m−1), which in some cases is substantially stronger than the effect reported in previous studies. However, open-grown saplings were often isotopically more similar to large codominant trees than to shade-grown saplings, indicating that light exposure contributes more to the physiological and isotopic differences between small and large trees than does height. We found that in closed-canopy forests, δ13C correlations with diameter at breast height were nonlinear but also strong, allowing a straightforward procedure to correct tree- or stand-scale δ13C-based iWUE chronologies for changing tree size. We demonstrate how to use such data to correct and interpret multi-decadal composite isotope chronologies in both shade-regenerated and open-grown tree cohorts, and we highlight the importance of understanding site history when interpreting δ13C time series.
Incidence and Distribution of Insect-Transmitted Cereal Viruses in Wheat in China from 2007 to 2019
Authors: Liu Yan , Khine May Oo , Zhang Peipei , Fu Yumei , Wang Xifeng
Published: December 2019

Diseases caused by insect-transmitted viruses are the predominant constraint to wheat production worldwide. However, detailed knowledge of virus incidence and dynamics in China in recent years is very limited. Here, major wheat-growing regions of China were surveyed over 10 years for insect-transmitted viruses, and 2,143 samples were collected (in 2007 to 2015) and analyzed by molecular hybridization or multiplex reverse-transcription PCR for barley yellow dwarf viruses (BYDVs: BYDV-GAV, -GPV, and -PAV) and wheat dwarf virus (WDV). In a 4-year survey (2016 to 2019), the incidence of eight insect-transmitted viruses (BYDVs, WDV, wheat yellow striate virus [WYSV], barley yellow striate mosaic virus [BYSMV], northern cereal mosaic virus [NCMV], and rice black-streaked dwarf virus [RBSDV]) was investigated, and BYDVs and WDV were widely distributed across China. BYDV-GAV (29.0% of the tested sample) was the most abundant, followed by BYDV-PAV (23.2%) from 2007 to 2015. From 2016 to 2019, however, BYDV-PAV had become the predominant species (39.5% positive of 952 samples tested), while the incidence of BYDV-GAV (13.4%) had declined. During the entire survey, the incidence of BYDV-GPV was very low in some locations in northwestern and northern China, and all eight viruses caused only local epidemics, not large-scale outbreaks throughout China. Two new cereal-infecting rhabdoviruses, leafhopper-transmitted WYSV and planthopper-transmitted BYSMV, were also found in China in recent years.
Educational Interventions to Improve Support for Family Presence During Resuscitation
Authors: Powers Kelly A.
Published: December 2019

Background:

Family presence during resuscitation (FPDR) remains controversial among nurses. Individual studies have shown educational interventions can improve support for FPDR; however, a systematic review of the literature has not been performed to appraise and synthesize the evidence.

Objectives:

The aim of this systematic review was to appraise and synthesize studies conducted to test the effect of education on nurses’ and providers’ support for FPDR.

Methods:

Electronic searches of CINAHL, MEDLINE, and PubMed were performed. The PRISMA flow diagram and predetermined inclusion and exclusion criteria were used to guide article selection. Articles selected for inclusion were evaluated for rigor in study design, sample, setting, and data collection and analysis.

Results:

Sixteen articles met eligibility criteria. Study findings demonstrated educational interventions can improve support for FPDR, as well as intent to offer it as an option. Methodological limitations of existing research and a lack of comparative studies render the optimal approach (classroom, simulation, or online) to FPDR education unknown.

Discussion:

Nurse educators should consider implementing educational interventions to improve nurses’ support for FPDR and prepare them to implement it in clinical practice. More research on FPDR educational interventions is needed to be able to provide specific guidance on optimal approaches to FPDR education.
Oxidative Stress Alters Angiogenic and Antimicrobial Content of Extracellular Vesicles and Improves Flap Survival
Authors: Mayo John S. , Kurata Wendy E. , O’Connor Kelsey M. , Pierce Lisa M.
Published: December 2019

Background:

Extracellular vesicles (EVs) secreted from adipose-derived mesenchymal stem cells (ADSCs) (ADSC-EVs) improve flap survival after ischemia–reperfusion injury. Exposure of parent ADSCs to oxidative stress has been shown to enhance this effect, but mechanisms are unclear. We aimed to determine whether angiogenesis-promoting protein and microRNA (miRNA) content is altered in EVs after preconditioning with hydrogen peroxide (H2O2 ADSC-EVs) and whether H2O2 ADSC-EVs can increase viability of random pattern skin flaps.

Methods:

EVs secreted by human ADSCs were isolated after culture in EV-depleted medium ± H2O2. Nanoparticle tracking analysis determined size and concentration of purified EVs. Mass spectrometry and small RNA next-generation sequencing were performed to compare proteomic and miRNA profiles. ADSC-EVs, H2O2 ADSC-EVs, or vehicle were injected into random pattern skin flaps of BALB/c mice (4–5 mice per group). Viable and necrotic areas were measured on day 7, and tissues underwent histologic analysis.

Results:

Angiogenic and antimicrobial protein content of EVs was altered with H2O2 preconditioning. Functional enrichment analysis identified constitutive photomorphogenesis 9 signalosome (known to direct vascular endothelial growth factor production) as the major enriched Gene Ontology term unique to H2O2 ADSC-EVs. Two miRNAs were increased, and 12 (including 10 antiangiogenic miRNAs) were reduced in H2O2 ADSC-EVs. Enhanced viability (P < 0.05) of flaps treated with H2O2 ADSC-EVs compared with vehicle corresponded to increased capillary density in the H2O2 group (P < 0.001).

Conclusion:

Altered protein and miRNA content in ADSC-EVs after H2O2 pretreatment likely contributes to enhanced therapeutic effects on flap survival observed in preclinical models.
FLUORESCENCE LIFETIME IMAGING OPHTHALMOSCOPY
Authors: Jaggi Damian , Solberg Yasmin , Dysli Chantal , Ebneter Andreas , Wolf Sebastian , Zinkernagel Martin S.
Published: December 2019

Purpose:

The purpose of this study was to investigate fluorescence lifetime imaging ophthalmoscopy lifetimes after macula-off rhegmatogenous retinal detachment (RRD) repair.

Methods:

Fifty-eight patients with successful macula-off RRD reattachment surgery were included. Retinal autofluorescence was excited with 470 nm, and amplitude-weighted mean fluorescence lifetimes (Tm) were measured in a short spectral channel (SSC, 498–560 nm) and a long spectral channel (LSC, 560–720 nm). Tm were obtained within a standardized Early Treatment Diabetic Retinopathy Study grid and correlated with Tm. The unaffected fellow eye served as control.

Results:

Fifty-eight patients (age: 65 ± 1.6 years, 11 women) were imaged at median 1.5 months postoperatively. Tm were significantly prolongxxxed within areas of previously detached retina in the long spectral channel and particularly in the central subfield in the short spectral channel. Short lifetimes in the center of the Early Treatment Diabetic Retinopathy Study grid correlated with better visual acuity (short spectral channel; r2 = 0.18, P = 0.001, long spectral channel; r2 = 0.08, P = 0.03). Areas of residual subretinal fluid pockets in four RRD eyes displayed short fluorescence lifetimes.

Conclusion:

Areas of previously detached retina exhibit significant fluorescence lifetime changes. We found a significant correlation of fluorescence lifetimes within the fovea with visual acuity after successful RRD repair. Our data suggests that the prolongation of fluorescence lifetimes in the fovea is mainly driven by loss of macular pigment. Therefore, fluorescence lifetime imaging ophthalmoscopy may be useful in the prediction of long-term functional outcomes after macula-off RRD surgery.
The International Society for the Study of Vulvovaginal Disease Surgical Oncological Procedure Definitions Committee “Surgical Terminology for Vulvar Cancer Treatment”
Authors: Micheletti Leonardo , Haefner Hope , Zalewski Kamil , MacLean Allan , Gomez Cherey Facundo , Pereira Claudia , Sluga Celeste , Solé-Sedeno Josep M. , Vargas-Hernandez Victor M. , Preti Mario
Published: December 2019

Objectives

The International Society for the Study of Vulvovaginal Disease (ISSVD) Surgical Oncological Procedure Definitions Committee propose a consistent terminology based on well-defined and reproducible anatomic landmarks that can be used by all who are involved in care of patients with vulvar conditions.

Materials and Methods

The fundamental principles behind the new terminology contained descriptions of the area extension and depth of the surgical procedure.

Results

Vulvar Surgical Topographic Anatomy Landmarks

Extension. The internal border of the vulva is the hymenal ring. The genitocrural folds are the external lateral borders.

The vertical line through the clitoris and the anus defines lateral portions of the vulva.

The horizontal line from the upper border of the hymenal ring defines anterior and posterior portion of the vulva.

Depth. The floor of the vulva is represented by the median perineal fascia or perineal membrane of the urogenital diaphragm.

A. Vulvectomy

1. Extension: partial/total vulvectomy. Removal of part/entire vulvar/perineal integument independent of the depth.

2. Depth: superficial/deep. Removal of the most superficial layer/removal of the vulvar tissue to the superficial aponeurosis of the urogenital diaphragm and/or pubic periosteum.

B. Inguinofemoral lymphadenectomy

1. Superficial inguinofemoral lymphadenectomy. Removal of the nodes located beside the inguinal ligament and along the great saphenous vein.

2. Deep femoral lymphadenectomy. Removal of the nodes below the cribriform lamina and medial to the femoral vein.

Conclusions

This terminology helps avoid confusion and promote better understanding and exchange of experiences among gynecologic oncologists involved in vulvar carcinoma care.
Vaginal Intraepithelial Neoplasia: A Retrospective Study of Treatment and Outcomes Among a Cohort of UK Women
Authors: Field Alexander , Bhagat Nanak , Clark Sharon , Speed Tracey , Razvi Khalil
Published: December 2019

Objectives

The aim of the study was to analyze the clinical features of women found to have vaginal intraepithelial neoplasia (VaIN), the treatment modalities that they were offered, and clinical outcomes after treatment and follow-up.

Materials and Methods

This is a retrospective review of all cases of biopsy-proven or treated VaIN occurring for a 15-year period at Southend University Hospital, United Kingdom.

Results

Eighty-eight cases of VaIN were identified. The age range was from 24 to 76 years, and 39% of cases were low grade (VaIN 1) and 60% high grade (VaIN 2 and 3). Sixty-five percent of patients had either already undergone or would go on to have treatment for cervical intraepithelial neoplasia. Of those with low-grade disease, 86% were managed conservatively with a 97% success rate. Similarly, with high-grade disease, 77% were managed with laser treatment with a success rate of 76% for primary treatment. Of the 6 cases of high-grade disease treated conservatively, 50% subsequently needed active treatment. There was 1 case of progression to vaginal cancer (1.3%).

Conclusions

Vaginal intraepithelial neoplasia remains an uncommon premalignant condition. It can affect women of all ages and is commoner in those who are immunosuppressed. Observation of low-grade disease is safe and the abnormality often resolves spontaneously. For persistent disease or higher-grade abnormalities, there are many treatment options but laser vaporization is the most commonly used. However, because of the nature of VaIN, recurrence is common even after treatment and further management can be challenging. The overall rate of malignant progression is small but protracted follow-up may be necessary.
Harmonizing Nutritional Therapies for Pediatric Inflammatory Bowel Disease
Authors: Picoraro Joseph A. , Akabas Sharon R. , LeLeiko Neal S.
Published: December 2019

Uses of nutritional therapies for inflammatory bowel disease (IBD) are of tremendous interest to the lay and professional communities. This interest currently outweighs the scientific basis for deciding on a particular therapy for any given patient. Some nutritional therapies have credible reports, in peer‐review journals, validating their use for some patients. The broad pediatric gastroenterology community in the United States has, however, been unable or unwilling to agree on the details necessary to disseminate the most effective therapies with adequate reliability and validity to implement these interventions successfully. The well‐established importance of the appropriate use of nutritional interventions for the treatment of undernutrition and maintenance of optimal nutrition is not an issue. A consensus and widely applicable solution for nutrition as therapy for IBD is, however, not imminent. In the interim, we aim to help the science‐based reader to evaluate manuscripts appearing in our journals and to use this information to make rational, informed therapeutic decisions. We outline the current limited evidence base and make recommendations to advance the field of nutritional therapy in IBD.
Should Obesity Be Considered a Contraindication for Prepectoral Breast Reconstruction?
Authors: Banuelos Joseph , Abu-Ghname Amjed , Vyas Krishna , Sharaf Basel , Nguyen Minh-Doan T. , Harless Christin , Manrique Oscar J. , Martinez-Jorge Jorys , Tran Nho V.
Published: December 2019

Background:

Prepectoral implant-based reconstruction reemerged as a viable approach following recent advances in reconstructive techniques and technology. To achieve successful outcomes, careful patient selection is critical. Obesity increases the risk of complications and has been suggested as a relative contraindication for prepectoral breast reconstruction.

Methods:

Retrospective chart review of patients who underwent immediate two-stage implant-based reconstruction at the authors’ institution was performed. Only women having a body mass index of 30 kg/m2 or greater were included. Patient demographics, operative details, and surgical outcomes of prepectoral and subpectoral reconstruction were compared.

Results:

One hundred ten patients (189 breasts) who underwent prepectoral and 83 (147 breasts) who underwent subpectoral reconstruction were included. Complications were comparable between the two groups. Twelve devices (6.4 percent), including implants and tissue expanders, required explantation in the prepectoral group, and 12 devices (8.2 percent) required explantation in the subpectoral group (p =0.522). Final implant-based reconstruction was achieved in 180 breasts (95.2 percent) in the prepectoral group and 141 breasts (95.9 percent) in the subpectoral group. Regardless of type of reconstruction (prepectoral or subpectoral), for each point increase in body mass index, the odds of complications and device explantation increased by 3.4 percent and 8.6 percent, respectively; and the optimal cutoff to predict higher complications and explantation rates was a body mass index of 34.8 kg/m2 and 34.1 kg/m2, respectively.

Conclusions:

Obesity increases complications and failure rates in a positive correlation; however, complications and final reconstruction rates are comparable between the prepectoral and subpectoral groups. The authors believe that obesity should not be a contraindication for prepectoral breast reconstruction but that care should be taken in patients with a body mass index above 35 kg/m2.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A Simple Standardized Three-Dimensional Anthropometry for the Periocular Region in a European Population
Authors: Guo Yongwei , Schaub Friederike , Mor Joel M. , Jia Renbing , Koch Konrad R. , Heindl Ludwig M.
Published: December 2019

Background:

The three-dimensional surface imaging system is becoming more common in plastic surgeries. However, few studies have assessed three-dimensional periocular structures and surgical outcomes. This study aimed to propose a standardized three-dimensional anthropometric protocol for the periocular region, investigate its precision and accuracy, and determine the three-dimensional periocular anthropometric norms for young Caucasians.

Methods:

Thirty-nine healthy young Caucasians (78 eyes) were enrolled. Three-dimensional facial images were obtained with a VECTRA M3 stereophotogrammetry device. Thirty-eight measurements in periocular regions were obtained from these images. Every subject underwent facial surface capture twice to evaluate its precision. A paper ruler was applied to assess its accuracy.

Results:

Sixty-three percent of measurements in linear distances, curvatures, angles, and indices were found to reach a statistically significant difference between sexes (p ≤ 0.05, respectively). Across all measurements, the average mean absolute difference was 0.29 mm in linear dimensions, 0.56 mm in curvatures, 1.67 degrees in angles, and 0.02 in indices. In relative error of magnitude, 18 percent of the measurements were determined excellent, 51 percent very good, 31 percent good, and none moderate. The mean value of the paper-ruler scale was 10.01 ± 0.05 mm, the mean absolute difference value 0.02 mm, and the relative error of magnitude 0.17 percent.

Conclusions:

This is the first study to propose a detailed and standardized three-dimensional anthropometric protocol for the periocular region and confirm its high precision and accuracy. The results provided novel metric data concerning young Caucasian periocular anthropometry and determined the variability between sexes.
Protective Effects of Micronized Fat against Ultraviolet B–Induced Photoaging
Authors: He Anqi , Wang Lu , Wang Qiang , Luan Wenjie , Qi Fazhi
Published: December 2019

Background:

Autologous fat grafting has long been an essential technique in cosmetic and reconstructive surgery. Here, the authors report the advantages of a new device for preparing micronized fat, and they also investigated the therapeutic potential of micronized fat against ultraviolet B–induced photoaging.

Methods:

Micronized fat aliquots were prepared through a connector device with trifoliate blades. The histologic structure and viability of the prepared fat samples were evaluated by calcein AM/propidium iodide staining. The levels of growth factor were measured by enzyme-linked immunosorbent assay, and flow cytometry was used to detect the ratio of adipose-derived mesenchymal stem cells to stromal vascular fraction. The authors also evaluated the effects of micronized fat transplantation through immunohistochemistry and Masson trichrome staining in an animal model of photoaging.

Results:

The micronized fat had a normal histologic structure and viable adipocytes. It had a higher level of hepatocyte growth factor compared with the control group, and its ratio of adipose-derived mesenchymal stem cells to stromal vascular fraction was also higher than in the control fat preparations. Transplantation of micronized fat preparations in the animal model of photoaging produced increased skin neovascularization, epidermal cell proliferation, and dermal collagen density.

Conclusions:

The authors’ results demonstrated that the novel device produced micronized fat easily, which can condense adipose tissue. This micronized fat was easy to use with smaller cannulas. It mitigated the signs of cutaneous photoaging and was superior to control fat. Contrary to previous reports, normal histologic structures and viable adipocytes were noted in the micronized fat.
Objective Measures of Sleep Apnea and Actigraphy-Based Sleep Characteristics as Correlates of Subjective Sleep Quality in an Epidemiologic Study: The Jackson Heart Sleep Study
Authors: Johnson Dayna A. , Javaheri Sogol , Guo Na , Champion Cora L. , Sims Jeraline F. , Brock Michelene P. , Sims Mario , Patel Sanjay R. , Williams David R. , Wilson James G. , Redline Susan
Published: December 2019

Objective

Self-reported “sleep quality” often is assessed in epidemiologic studies. However, the bases for variation in sleep quality is not fully understood. We quantified the extent to which subjective sleep quality was related to sleep disorders and sleep characteristics among 795 African American adults.

Method

Between 2012 and 2016, participants underwent home sleep apnea testing and 1-week actigraphy (estimating sleep duration, efficiency, fragmentation, latency). Sleep quality, insomnia and restless legs syndrome symptoms, sleepiness, and physician diagnosis of sleep disorders were self-reported. We fit linear regression models to determine the extent to which subjective and objective sleep measures as well as depressive symptoms and anxiety were related to subjective sleep quality.

Results

After adjustment for covariates, worse sleep quality scores were associated with insomnia and restless legs syndrome symptoms, sleep apnea, physician diagnosis of a sleep disorder, and actigraphy-based fragmented sleep, lower sleep efficiency, and shorter sleep duration. Insomnia symptoms explained the most variance in subjective sleep quality, 21%. Other sleep measures each explained 3% to 7% and psychosocial factors explained 8% to 9% of the variance in subjective sleep quality after adjustment for confounders.

Conclusions

The weak associations of sleep quality with sleep disorders and objectively measured sleep disturbances are consistent with concepts of “sleep health” as a multidimensional construct. Sleep quality is a patient-centered outcome that provides unique information over objective measurements of sleep disturbances.
Reliability and Diagnostic Accuracy of a New Vaginal Dynamometer to Measure Pelvic Floor Muscle Strength
Authors: Romero-Cullerés Georgia , Peña-Pitarch Esteban , Jané-Feixas Cecilia , Vilaseca-Grané Anna , Montesinos Jesus , Arnau Anna
Published: December 2019

Aims

Assess the intrarater and interrater reliabilities and diagnostic accuracy of a new vaginal dynamometer to measure pelvic floor muscle (PFM) strength in incontinent and continent women.

Methods

A test-retest reliability study including 152 female patients. Exclusion criteria: history of urge urinary incontinence, prolapse of pelvic organ, pregnancy, previous urogynecological surgery, severe vaginal atrophy, or neurological conditions. The examination comprised digital assessment using the modified Oxford scale (MOS) and dynamometry measurements with a new prototype hand-held dynamometer. The MOS score ranges from 0 to 5: 0, no contraction; 1, flicker; 2, weak; 3, moderate; 4, good; 5, strong. Examinations were performed by a physiatrist, a physiotherapist and a midwife. The rest period between each rater measurement was 5 minutes. Assessment of intrarater and interrater reliability was calculated with the intraclass correlation coefficient.

Results

One hundred twenty-two incontinent women and 30 continent women were included. Scores between 0 and 2 in MOS were recorded in 72% of incontinent women versus 20% in continent patients (P < 0.001). Intrarater reliability of the dynamometer was 0.942 (95% confidence interval [CI], 0.920–0.958) and the interrater reliability was 0.937 (95% CI, 0.913–0.954). The analysis of variance analysis showed significant differences in PFM strength across digital assessment categories. The post-hoc analysis showed statistical differences between adjacent categories of MOS 1–2 and 2–3. The diagnostic accuracy showed an area under the curve of 0.82 (95% C,: 0.75–0.89), 0.87 (95% CI, 0.81–0.92), and 0.83 (95% CI, 0.77–0.90) for the physiatrist, midwife, and physiotherapist, respectively.

Conclusions

The results obtained show a good reliability and validity of this new vaginal dynamometer to quantify PFM strength.