bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Stainless-Steel, Balloon-Expandable Chimney Grafts Is Durable Though Caution Is Required When Lining Angulated Renal Arteries
Authors: Taneva Gergana T. , Fazzini Stefano , Pipitone Marco Damiano , Karaolanis Georgios , Torsello Giovanni , Bremer Christoph , Austermann Martin , Donas Konstantinos P.
Published: August 2020

Purpose:

To analyze the overall performance of flexible nitinol stents used to line chimney grafts (CGs) during chimney endovascular aneurysm repair (chEVAR) of pararenal pathologies.

Materials and Methods:

A retrospective review was conducted of all 116 elective patients (mean age 74.3±7.2 years; 103 men) who underwent chEVAR with balloon-expandable Advanta V12/iCAST CGs in combination with the Endurant stent-graft between January 2009 and December 2017 at a single center. CG lining with a nitinol stent was electively performed in 43 target vessels of 32 patients. The Kaplan-Meier method was used to estimate the primary outcomes of CG patency and freedom from reintervention (FFR) at the patient level and according to the use of a stent to line the CG. Estimates are reported with the 95% confidence interval (CI). Adjusted odds ratios (ORs) were calculated to identify any confounding effect between the presence/absence of a stent lining or according to the number of CGs.

Results:

The mean radiological follow-up was 27.3 months (range 22.1–32.6). During this time, 8 CGs (4.7%) became occluded, 6 of them were lined with stents. Restoration of patency was possible in 3 of the 4 occluded stents that were associated with symptoms. First-year primary patency estimates were 96.9% (95% CI 92.5% to 100%) for the unlined group vs 77.1% (95% CI 58% to 95.3%; p=0.001) for the lined group, while FFR was 87.6% (95% CI 79.9% to 95.2%) vs 83.4% (95% CI 68.1% to 98.6%; p=0.82), respectively. Lining represented an independent risk factor for CG occlusion (OR 9.9, p=0.006).

Conclusion:

CG lining performed mainly in angulated renal arteries during chEVAR was significantly associated with CG occlusion. These findings highlight the importance of not having the distal part of the CG impinge on the angulated segment of the target vessel.
An open-label randomised pilot trial on safety of wheat variety C273 in patients with adult celiac disease
Authors: Grover Jasmine , Chhuneja Parveen , Midha Vandana , Singh Arshdeep , Mahajan Ramit , Mehta Varun , Verma Ramneek , Bansal Ekta , Deka Dipak , Bansal Namita , Sood Neena , Narang Vikram , Sood Ajit
Published: August 2020

Background:

The only effective treatment for celiac disease (CeD) is gluten free diet (GFD). However, GFD is restrictive and efforts are being made to explore alternative therapies including safer wheat varieties. Wheat variety C273 has been previously identified to have reduced load of intact T-cell stimulatory epitopes via in silico and in vitro analysis.

Methods:

Adult patients diagnosed with CeD and recovered on GFD were included in the study. Patients were randomised into two groups in a 2:1 ratio. Patients in group I had graded introduction of C273 wheat in diet, maintained for 24 weeks; in Group II, wheat was restricted with continuation of GFD. Clinical symptoms, serology [anti-tissue transglutaminase (anti-tTG), anti-endomysial antibody (anti-EMA)], circulating inflammatory biomarkers [intestinal fatty-acid binding protein (I-FABP), plasma citrulline, interferon-γ (IFN-γ)] and histology were evaluated periodically. Final evaluation was performed at week 28.

Results:

A total of 15 patients were enrolled (Group I: n = 10, Group II: n = 5). All patients except two in Group I remained compliant. None of the remaining eight patients in group I developed symptoms. No significant changes in serology (anti-tTG, anti-EMA) and histology were observed between the two groups at 28 weeks ( p > 0.05). Significant changes in plasma citrulline(29.87 ± 8.98 versus 36.58 ± 3.09, p = 0.049) and IFN-γ (44.56 ± 9.74 versus 33.50 ± 3.68; p = 0.031) were observed in Group I.

Conclusion:

Consumption of C273 wheat did not result in development of symptoms or evident changes in serology and histology at 28 weeks. However, variations in circulating inflammatory markers were noted. Larger randomised trials are needed to corroborate these findings.

Clinical Trials Registry-India:

CTRI/2018/06/014521.
The Challenge of Hebrew Bible Love Poetry: A Pleonastic Approach to the Translation of Metaphor—Part 2
Authors: de Hulster Izaak J.
Published: August 2020

Part 1 of this article made a case for “pleonastic” translation, i.e., adding pleonasms (synonymous adjectives) to metaphorical nouns to bridge the cultural distance between the ancient Israelite text and the present-day reader. Part 2 exemplifies this approach with a translation of some of the body-description verses from the Song of Songs (esp. 7.2-6 [English 7.1-5]). Introductory considerations concerning this biblical book are offered, addressing, e.g., life-setting, register, and hermeneutical key. Rooted in translation theory and metaphor theory, this article draws attention to the various aspects of the Song of Songs and proposes a “dynamic equivalent” way (following Nida and Taber’s call for clarity) to provide present-day readers with a comprehensible translation of its ancient metaphors. This results in a respectful translation with additional pleonasms and other types of elucidations.
Interpretative Polarization across Platforms: How Political Disagreement Develops Over Time on Facebook, Twitter, and WhatsApp
Authors: Kligler-Vilenchik Neta , Baden Christian , Yarchi Moran
Published: August 2020

Political polarization, seen as a key threat to contemporary democracy, has been tied to the rise of digital social media. However, how this process develops in the context of a social media environment characterized by multiple platforms—with differing norms, contents, and affordances—has not been sufficiently explored. In the present article, we propose a distinction between positional polarization, that is, people’s view on a political issue, and interpretative polarization, that is, how that political issue is contextualized and understood. We use this distinction to examine an issue of political controversy in Israel, examining how polarization develops over time, on three social media platforms—Facebook, Twitter, and WhatsApp. We find that contrasting positions are strongly connected to conflicting interpretations, both of which are clear from the start, with only minor overtime shifts. Moreover, while sharing broad similarities, the three platforms show a few distinctive polarization dynamics—both positional and interpretative—that can be connected to their varied socio-technical affordances. The study advances our theoretical understanding of polarization by examining how different social media platforms may shape distinct polarization dynamics over time, with different implications for democratic debate.
Longitudinal Assessment of Ellipsoid Zone Mapping Parameters in Retinal Venous Occlusive Disease With Associated Macular Edema
Authors: Abraham Joseph R. , Boss Joseph , Babiuch Amy S. , Singh Rishi P. , Srivastava Sunil , Reese Jamie , Ehlers Justis P.
Published: August 2020

Purpose:

This work evaluated the longitudinal dynamics of ellipsoid zone (EZ) integrity in retinal vein occlusion (RVO) with macular edema and their relation to outcomes.

Methods:

Clinical characteristics and optical coherence tomography data of patients with RVO and associated macular edema were collected at baseline and at 3 and 12 months. Macular cube scans were exported into EZ and retinal-layer analysis software. Longitudinal EZ parameters and visual acuity (VA) outcomes were regressed and correlated.

Results:

The study included 108 eyes of 108 patients; all eyes were treated with antivascular endothelial growth factor therapy at the baseline visit. VA improved from 20/97 at baseline to 20/52 at 3 months and 12 months ( P < .001), correlating with EZ integrity at each time point ( P < .001). At 12 months following initiation of antivascular endothelial growth factor therapy, EZ partial attenuation and EZ total attenuation improved over 12 months from 16.4% to 8.5% ( P < .001) and from 12.3% to 5.9% ( P < .001), respectively. VA improvement from baseline to 12 months correlated with improvement of EZ partial and total attenuation ( P < .001). Baseline EZ characteristics did not predict VA outcomes, but at 3 months, EZ parameters did predict improvement in visual outcomes by 12 months ( P < .01).

Conclusions:

EZ and outer retinal integrity are correlated with functional outcomes in RVO. Following treatment, EZ integrity improves and is associated with functional improvement. In RVO baseline, EZ features were not associated with 1-year VA outcomes, but evaluation of EZ integrity at 3 months was linked to 1-year outcomes.
Management of chronic respiratory complications in children and adolescents with sickle cell disease
Authors: Arigliani Michele , Gupta Atul
Published: August 2020

Sickle cell disease (SCD) is a life-threatening hereditary blood disorder that affects millions of people worldwide, especially in sub-Saharan Africa. This condition has a multi-organ involvement and highly vascularised organs, such as the lungs, are particularly affected. Chronic respiratory complications of SCD involve pulmonary vascular, parenchymal and airways alterations. A progressive decline of lung function often begins in childhood. Asthma, sleep-disordered breathing and chronic hypoxaemia are common and associated with increased morbidity. Pulmonary hypertension is a serious complication, more common in adults than in children. Although there is a growing attention towards respiratory care of patients with SCD, evidence regarding the prognostic meaning and optimal management of pulmonary issues in children with this condition is limited.

This narrative review presents state-of-the-art evidence regarding the epidemiology, pathophysiology and therapeutic options for chronic respiratory complications commonly seen in paediatric patients with SCD. Furthermore, it highlights the gaps in the current knowledge and indicates future directions for studies that aim to improve our understanding of chronic respiratory complications in children with SCD.
Magnitude of risk factors and in-hospital mortality of stroke in Ethiopia: a systematic review and meta-analysis
Authors: Alene Muluneh , Assemie Moges Agazhe , Yismaw Leltework , Ketema Daniel Bekele
Published: August 2020

Background

The morbidity and mortality of stroke is disproportionately high in developing countries owing to the poor health care system and poor neurologic interventions. Though a number of studies were conducted to estimate the in-hospital mortality rate of stroke in Ethiopia, the lack of a nationwide study that determines the overall magnitude of risk factors and in-hospital mortality rate of stroke is an important research gap. Meta-analysis is key to improve the accuracy of estimates through the use of more data sets. Thus, this study was aimed to determine the overall magnitude of risk factors and in-hospital mortality rate of stroke in Ethiopia.

Methods

This study was conducted following the PRISMA checklist. We searched from Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library databases for studies. Each of the original studies was assessed using a tool for the risk of bias adapted for cross-sectional studies. Data were pooled and a random effect meta-analysis model was fitted to provide the overall magnitude of risk factors and in-hospital mortality rate of stroke. Also, the subgroup analyses were performed to examine how the in-hospital mortality rate varies across different groups of studies.

Results

In this study, the overall magnitude of hypertension, diabetes mellitus, and atrial fibrillation among stroke patients were 47% (95%CI: 40–54), 8% (95CI%:6–12), and 10% (95%CI: 5–19), respectively. The overall in-hospital mortality of stroke in Ethiopia was 18% (95%:14–22). The highest magnitude of in-hospital mortality of stroke was observed in SNNPR and the lowest was noted in Tigray region. In addition, the magnitude of the in-hospital mortality rate of stroke was 15.1% (95%CI: 11.3–19.4), and 19.6%(95%CI: 14.1–25.7), among studies published before and after 2016, respectively.

Conclusions

Our pooled result showed that nearly one-fifth of stroke patients have died during hospitalization. The most common risk factor of stroke among the included studies was hypertension followed by atrial fibrillation and diabetes mellitus. There is a need for a better understanding of the factors associated with high blood pressure, especially in countries with a high risk of stroke.
Admission platelet count and indices as predictors of outcome in children with severe Sepsis: a prospective hospital-based study
Authors: Sayed Samira Z. , Mahmoud Mohamed M. , Moness Hend M. , Mousa Suzan O.
Published: August 2020

Background

Sepsis is still one of the main causes of infants and children mortality especially in developing, economically challenged countries with limited resources. Our objective in this study was to determine, the prognostic value of platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) in critically ill infants and children with severe sepsis, as they are readily available biomarkers, that can guide clinicians during managing of severe sepsis.

Methods

Sixty children were included; they were diagnosed with severe sepsis according to the international pediatric sepsis consensus conference criteria. At admission to Pediatric intensive care unit, complete blood count with platelet count and parameters (MPV, PDW and PCT) and C-reactive protein (CRP) level were determined for all children. Also, assessment of the Pediatric Risk of Mortality (PRISM III) score was done to all. These children were followed up till discharge from hospital or death. Accordingly, they were grouped into: (1)Survivor group:included 41 children. (2)Non-survivor group:included 19 children.

Results

Platelet count and PCT were significantly lower (p < 0.001) and MPV was significantly higher in non-survivor than survivors (p = 0.004). MPV/PLT, MPV/PCT, PDW/PLT, PDW/PCT ratios were found to be significantly higher in the non-survivors than survivor (p < 0.001 in all). PCT with sensitivity = 94.74%, was the most sensitive platelet parameter for prediction of death, while MPV/PCT was the most sensitive ratio (sensitivity = 94.7%).

Conclusion

Thrombocytopenia, platelet indices and their ratios, especially plateletcrit and MPV/PCT, are readily available, sensitive, prognostic markers, that can identify the severe sepsis patients with poorest outcome.
Epidemiological profile of pain and non-steroid anti-inflammatory drug use in collegiate athletes in the United States
Authors: Christopher S. , Tadlock B. A. , Veroneau B. J. , Harnish C. , Perera N. K. P. , Knab A. M. , Vallabhajosula S. , Bullock G. S.
Published: August 2020

Background

Although athletic endeavours are associated with a high amount of physical stress and injury, the prevalence of pain is underreported in the sports medicine literature with only a few studies reporting pain on collegiate athletes or exploring sex difference of pain. Impact of pain on athlete availability, training and performance can be mitigated when key epidemiological information is used to inform adequate pain management strategies. This study aims to 1) provide an epidemiological profile of self-reported pain experienced by the National Collegiate Athletic Association (NCAA) athletes by sex during the first half of the 2019 season, 2) describe their self-reported non-steroidal anti-inflammatory drug (NSAID) use.

Methods

Online survey was completed by athletes at three NCAA institutions from 1 August to 30 September 2019. Descriptive statistics were used to describe player demographic data, self-reported pain and self-reported NSAID use. Pain incidence proportion were calculated.

Results

Two hundred thirty female athletes and 83 male athletes completed the survey. Self-reported pain incidence proportion for female athletes was 45.0 (95% CI 41.5–48.5) vs 34.9 (95% CI 29.4–40.4) for male athletes. Majority of the athletes did not report pain (55% female vs 62% male) during the first half of the 2019 season. Female athletes reported pain in their back (35%), knee (26%), and ankle/foot (23%) whilst male athletes reported pain in their knee (35%), back (28%), and shoulder (24%). Of all athletes, 28% female vs 20% male athletes reported currently taking NSAIDs. Of athletes that reported pain, 46% female vs 38% male athletes currently took NSAIDs. 70% female vs 61% male athletes self-purchased NSAIDs, and 40% female vs 55% male athletes consumed alcohol.

Conclusions

Half of female athletes and one in three male athletes reported pain. Most commonly back, knee and foot/ankle pain and knee, back and shoulder pain was reported in female and male athletes respectively. One in four female athletes and one in five male athletes use NSAIDs for pain or prophylactic purpose. Majority self-purchase these medications indicating need for health literacy interventions to mitigate potential adverse effects.
Carcinogenic and neurotoxic risks of dietary acrylamide consumed through cereals among the Lebanese population
Authors: Merhi Areej , Naous Ghada El-Zakhem , Daher Ralph , Abboud Martine , Mroueh Mohamad , Taleb Robin I.
Published: August 2020

The present study aims to determine the carcinogenic and neurotoxic risks associated with acrylamide intake from cereal products. Analysis on a UPLC–MS/MS spectrometer revealed that oat-based and mixed cereals contain the highest amount of acrylamide among cereal products with levels as high as 271 and 348 μg/kg, respectively. Children were shown to exhibit both carcinogenic and neurotoxic risks regardless of the type of cereal product consumed. For adults above 50 years of age, only consumers of oat-based cereal products seem to exhibit carcinogenic and neurotoxic risks. To avoid a carcinogenic and neurotoxic risk among the Lebanese population, we propose that food processors set the maximum tolerable concentration for acrylamide in cereal products at 94.8 μg/kg product, a value which is threefolds lower than the average acrylamide levels found in this study. Alternatively, and unreasonably, the average Lebanese population and children among the Lebanese population may choose to cut down on cereal consumption by 1.7- and 7.2-folds respectively, should they want to avoid a health hazard as a result of acrylamide intake. The industry should also respond by optimizing the production process in a way to reduce acrylamide levels in cereals.
Two splice variants of the DsMEK1 mitogen-activated protein kinase kinase (MAPKK) are involved in salt stress regulation in Dunaliella salina in different ways
Authors: Tang Ziyi , Cao Xiyue , Zhang Yiping , Jiang Jia , Qiao Dairong , Xu Hui , Cao Yi
Published: August 2020

Background

Dunaliella salina can produce glycerol under salt stress, and this production can quickly adapt to changes in external salt concentration. Notably, glycerol is an ideal energy source. In recent years, it has been reported that the mitogen-activated protein kinase cascade pathway plays an important role in regulating salt stress, and in Dunaliella tertiolecta DtMAPK can regulate glycerol synthesis under salt stress. Therefore, it is highly important to study the relationship between the MAPK cascade pathway and salt stress in D. salina and modify it to increase the production of glycerol.

Results

In our study, we identified and analysed the alternative splicing of DsMEK1 (DsMEK1-X1, DsMEK1-X2) from the unicellular green alga D. salina. DsMEK1-X1 and DsMEK1-X2 were both localized in the cytoplasm. qRT-PCR assays showed that DsMEK1-X2 was induced by salt stress. Overexpression of DsMEK1-X2 revealed a higher increase rate of glycerol production compared to the control and DsMEK1-X1-oe under salt stress. Under salt stress, the expression of DsGPDH2/3/5/6 increased in DsMEK1-X2-oe strains compared to the control. This finding indicated that DsMEK1-X2 was involved in the regulation of DsGPDH expression and glycerol overexpression under salt stress. Overexpression of DsMEK1-X1 increased the proline content and reduced the MDA content under salt stress, and DsMEK1-X1 was able to regulate oxidative stress; thus, we hypothesized that DsMEK1-X1 could reduce oxidative damage under salt stress. Yeast two-hybrid analysis showed that DsMEK1-X2 could interact with DsMAPKKK1/2/3/9/10/17 and DsMAPK1; however, DsMEK1-X1 interacted with neither upstream MAPKKK nor downstream MAPK. DsMEK1-X2-oe transgenic lines increased the expression of DsMAPKKK1/3/10/17 and DsMAPK1, and DsMEK1-X2-RNAi lines decreased the expression of DsMAPKKK2/10/17. DsMEK1-X1-oe transgenic lines did not exhibit increased gene expression, except for DsMAPKKK9.

Conclusion

Our findings demonstrate that DsMEK1-X1 and DsMEK1-X2 can respond to salt stress by two different pathways. The DsMEK1-X1 response to salt stress reduces oxidative damage; however, the DsMAPKKK1/2/3/9/10/17-DsMEK1-X2-DsMAPK1 cascade is involved in the regulation of DsGPDH expression and thus glycerol synthesis under salt stress.
Using a combination therapy to combat scalp necrosis: a case report
Authors: Hajmohammadi Kazem , Esmaeili Zabihi Roghayeh , Akbarzadeh Kamran , Parizad Naser
Published: August 2020

Background

Chronic nonhealing wounds are very expensive to treat and debilitating, and they reduce health-related quality of life. Scalp necrosis is very rare due to its rich vascularity. However, any post-traumatic wounds with secondary infection can lead to scalp necrosis.

Case presentation

We report a case of a 77-year-old Azerbaijani man with a history of diabetes who had a car accident and sustained a scalp wound. He underwent reconstructive surgery for the scalp wound. The wound became infected, and scalp necrosis developed following the surgery. There was no progress in wound healing in spite of conventional wound therapy. We combined maggot debridement therapy with negative-pressure wound therapy and amniotic membrane grafting for 7 months. Necrotic tissues began to be eliminated after the second use of larva therapy, and the wound became free of necrotic tissues with clear increase of granulated tissues after four treatments with maggot debridement therapy. Then, we applied negative-pressure wound therapy and amniotic membrane grafting to accelerate wound healing and improve wound closure. The patient’s scalp wound recovered well, and he was discharged to home in good condition.

Conclusions

Medical and wound care teams can benefit from this combination therapy when dealing with nonhealing necrotic wounds.
Does wild-type Cu/Zn-superoxide dismutase have pathogenic roles in amyotrophic lateral sclerosis?
Authors: Furukawa Yoshiaki , Tokuda Eiichi
Published: August 2020

Amyotrophic lateral sclerosis (ALS) is characterized by adult-onset progressive degeneration of upper and lower motor neurons. Increasing numbers of genes are found to be associated with ALS; among those, the first identified gene,SOD1coding a Cu/Zn-superoxide dismutase protein (SOD1), has been regarded as the gold standard in the research on a pathomechanism of ALS. Abnormal accumulation of misfolded SOD1 in affected spinal motor neurons has been established as a pathological hallmark of ALS caused by mutations inSOD1(SOD1-ALS). Nonetheless, involvement of wild-type SOD1 remains quite controversial in the pathology of ALS with noSOD1mutations (non-SOD1ALS), which occupies more than 90% of total ALS cases. In vitro studies have revealed post-translationally controlled misfolding and aggregation of wild-type as well as of mutant SOD1 proteins; therefore, SOD1 proteins could be a therapeutic target not only inSOD1-ALS but also in more prevailing cases, non-SOD1ALS. In order to search for evidence on misfolding and aggregation of wild-type SOD1 in vivo, we reviewed pathological studies using mouse models and patients and then summarized arguments for and against possible involvement of wild-type SOD1 in non-SOD1ALS as well as inSOD1-ALS.
The superiority of multi-trait models with genotype-by-environment interactions in a limited number of environments for genomic prediction in pigs
Authors: Song Hailiang , Zhang Qin , Ding Xiangdong
Published: August 2020

Background

Different production systems and climates could lead to genotype-by-environment (G × E) interactions between populations, and the inclusion of G × E interactions is becoming essential in breeding decisions. The objective of this study was to investigate the performance of multi-trait models in genomic prediction in a limited number of environments with G × E interactions.

Results

In total, 2,688 and 1,384 individuals with growth and reproduction phenotypes, respectively, from two Yorkshire pig populations with similar genetic backgrounds were genotyped with the PorcineSNP80 panel. Single- and multi-trait models with genomic best linear unbiased prediction (GBLUP) and BayesC π were implemented to investigate their genomic prediction abilities with 20 replicates of five-fold cross-validation. Our results regarding between-environment genetic correlations of growth and reproductive traits (ranging from 0.618 to 0.723) indicated the existence of G × E interactions between these two Yorkshire pig populations. For single-trait models, genomic prediction with GBLUP was only 1.1% more accurate on average in the combined population than in single populations, and no significant improvements were obtained by BayesC π for most traits. In addition, single-trait models with either GBLUP or BayesC π produced greater bias for the combined population than for single populations. However, multi-trait models with GBLUP and BayesC π better accommodated G × E interactions, yielding 2.2% – 3.8% and 1.0% – 2.5% higher prediction accuracies for growth and reproductive traits, respectively, compared to those for single-trait models of single populations and the combined population. The multi-trait models also yielded lower bias and larger gains in the case of a small reference population. The smaller improvement in prediction accuracy and larger bias obtained by the single-trait models in the combined population was mainly due to the low consistency of linkage disequilibrium between the two populations, which also caused the BayesC π method to always produce the largest standard error in marker effect estimation for the combined population.

Conclusions

In conclusion, our findings confirmed that directly combining populations to enlarge the reference population is not efficient in improving the accuracy of genomic prediction in the presence of G × E interactions, while multi-trait models perform better in a limited number of environments with G × E interactions.
Participatory research for sustainable agriculture: the case of the Italian agroecological rice network
Authors: Pagliarino Elena , Orlando Francesca , Vaglia Valentina , Rolfo Secondo , Bocchi Stefano
Published: August 2020

Since the Green Revolution, worldwide agriculture has been characterized by a typical top–down approach. The degree of autonomy, creativity, and responsibility of farmers has been limited by the continuous external inputs of chemicals, machinery, advice, subsidies and knowledge.

The issue of sustainability has brought complexity and uncertainty to this mainly linear process of innovation, steering agriculture toward alternative models. Agroecology represents an innovative paradigm of agriculture in which external inputs are minimized, and the assets of the farm are greatly valued. Agroecological production relies on the farmers’ direct management of resources and on their active engagement in the agricultural knowledge and innovation system.

This paper focuses on the experience of a group of farmers, scientists, public officials, and managers of private companies who are experimenting with agroecology in rice production in one of the most intensively farmed, profitable and environmentally sensitive areas of Italy. The partnership regularly comes together to discuss agricultural techniques and results, needs, and paths of innovation; in addition, it stimulates and takes part in research projects, following a participatory process based on co-learning and mutual responsibility. By using ethnographic methods such as direct observations and in-depth interviews, our work may contribute to understanding the role of participatory research in sustainable agriculture and what makes for good participation.
Micromorphological analysis and bond strength comparison of two adhesives for different degrees of dental fluorosis
Authors: Liu Shuangfeng , Zhu Yanxia , Gegen Tana
Published: August 2020

The objective of this study was to analyze morphologically the all-etching bonding system and self-etching bonding system for enamel with different degrees of fluorosis and evaluate the bond strength of each system. Teeth that were indicated for extraction owing to orthodontic or periodontal problems were selected. According to Dean’s index and the Thylstrup-Fejerskov index, 180 extracted teeth were divided into three groups of mild, moderate, and severe dental fluorosis (DF), with 60 teeth in each group. The teeth in each group were randomly divided into two subgroups (n = 30), which were then subjected to the all-etching bonding system (Prime & Bond NT) and self-etching bonding system (SE-Bond). Each group of adhesives was used to bond Z350 universal resin (3 M) to the etched dental enamel. Tensile and shear tests were conducted to determine the bond strength. Subsequently, the fractured specimens were investigated using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). The Prime & Bond NT was statistically significant for the tensile and shear strength of enamel with mild fluorosis (P < 0.05) but did not exhibit a significant difference for moderate and severe DF (P > 0.05). The SE-Bond was not statistically significant for the tensile and shear strength of mild, moderate, or severe DF (P > 0.05). The SEM and CLSM results reveal that the mild fluorosis enamel crystals were relatively dense, and a small amount of resin remained. The moderate fluorosis enamel crystals were loosely arranged, and the gaps were widened. The severe fluorosis enamel crystals were irregularly arranged. The disorder was aggravated, and the dentinal orifice was exposed by partial enamel exfoliation. The bonding strength of mild fluorosis enamel with the Prime & Bond NT was better than that with the SE-Bond, and cohesive failure was the most common mode of failure. Because there was no difference in the bonding strength of the SE-Bond for different degrees of DF, we recommend the use of the all-etching adhesive system in the clinical treatment of teeth with mild fluorosis.
Characterization of bulk piezoelectric element-based ultrasonic motors
Authors: Izuhara Shunsuke , Mashimo Tomoaki
Published: August 2020

We propose miniature ultrasonic motors using stators made of a single bulk piezoelectric element. The bulk piezoelectric stator has the potential to increase output by reducing the dissipation that occurs in the adhesion layer between the PZTs and a metallic component in the stator. In this paper, we build two kinds of bulk piezoelectric stators: a cubic bulk stator with a side length of 4.2 mm and a hole of 3 mm in diameter, and a cylindrical bulk stator with an outer diameter of 4.2 mm and the same hole diameter. We evaluate their electrical and mechanical characteristics, such as impedance and vibration velocity. The experiments clarify the advantages of the bulk piezoelectric stators, such as low dissipation. The cubic bulk stator, which shows higher performance than the cylindrical one, is compared with a similar-shaped stator using a bronze cube and thin piezoelectric plates. The performance measures of the cubic bulk ultrasonic motor are optimized by the preload between the stator and rotor.
Development of novel mobile robot with semicircular wheels
Authors: Yamamoto Kanta , Aoki Takeshi
Published: August 2020

This paper describes development of a mobile robot using semicircular wheels on uneven terrain. It performs the crawl gait on flat ground without changing potential energy and the butterfly gait to climb over debris. We also used crawl gait to perform turning motion. The butterfly gait is used to climb over high steps. Turning motion is achieved not only by creating a difference in angular velocity between the wheels on both sides, but also by keeping the crawl gait. We achieved continuous movement from turning motion to pivot turning. We conducted an experiment on the movement and turning motion on flat ground using crawl gait.
Modelling infectious viral diseases in swine populations: a state of the art
Authors: Andraud M. , Rose N.
Published: August 2020

Mathematical modelling is nowadays a pivotal tool for infectious diseases studies, completing regular biological investigations. The rapid growth of computer technology allowed for development of computational tools to address biological issues that could not be unravelled in the past. The global understanding of viral disease dynamics requires to account for all interactions at all levels, from within-host to between-herd, to have all the keys for development of control measures. A literature review was performed to disentangle modelling frameworks according to their major objectives and methodologies. One hundred and seventeen articles published between 1994 and 2020 were found to meet our inclusion criteria, which were defined to target papers representative of studies dealing with models of viral infection dynamics in pigs. A first descriptive analysis, using bibliometric indexes, permitted to identify keywords strongly related to the study scopes. Modelling studies were focused on particular infectious agents, with a shared objective: to better understand the viral dynamics for appropriate control measure adaptation. In a second step, selected papers were analysed to disentangle the modelling structures according to the objectives of the studies. The system representation was highly dependent on the nature of the pathogens. Enzootic viruses, such as swine influenza or porcine reproductive and respiratory syndrome, were generally investigated at the herd scale to analyse the impact of husbandry practices and prophylactic measures on infection dynamics. Epizootic agents (classical swine fever, foot-and-mouth disease or African swine fever viruses) were mostly studied using spatio-temporal simulation tools, to investigate the efficiency of surveillance and control protocols, which are predetermined for regulated diseases. A huge effort was made on model parameterization through the development of specific studies and methodologies insuring the robustness of parameter values to feed simulation tools.

Integrative modelling frameworks, from within-host to spatio-temporal models, is clearly on the way. This would allow to capture the complexity of individual biological variabilities and to assess their consequences on the whole system at the population level. This would offer the opportunity to test and evaluate in silico the efficiency of possible control measures targeting specific epidemiological units, from hosts to herds, either individually or through their contact networks. Such decision support tools represent a strength for stakeholders to help mitigating infectious diseases dynamics and limiting economic consequences.
A web-based educational intervention to implement trauma-informed care in a paediatric healthcare setting: protocol for a feasibility study using pre-post mixed methods design
Authors: Simons Megan , De Young Alexandra , McPhail Steven M. , Harvey Gillian , Kenardy Justin , Kularatna Sanjeewa , Kimble Roy , Tyack Zephanie
Published: August 2020

Background

Adoption of responsive trauma-informed practices by staff in hospital-based paediatric care may help mitigate downstream costs associated with treatment delivery due to reduced pain and distress for children and care providers, improved health-related quality of life and increased satisfaction with care. A web-based education intervention (termed Responsive CARE) was developed to build self-efficacy of staff in a paediatric medical setting. This protocol paper describes a feasibility study (including preliminary effectiveness) of the implementation of Responsive CARE in a tertiary, outpatient burn clinical setting.

Methods

A pre-post, mixed methods design will be employed. Children and caregivers attending hospital for change of burn wound dressings or burn scar management during the 3-month control or 3-month intervention period will be eligible, with follow-up to 6-months post-baseline. All children and caregiver/s will receive “standard care” including burn interventions focused on wound healing, scar management, itch management (both pharmacological and non-pharmacological), counselling, age-appropriate procedural support and burn rehabilitation. Health professional participants will be those involved in the management of children with burns during the study period or their senior managers. Health professional participants who attend a weekly educational clinical meeting will be invited to complete the intervention during a 1-month timeframe between the control and intervention period (or upon their commencement in burn outpatients during the intervention period) using an individualised log-in process. A purposive sample of caregivers and health professionals will be sought for participation in semi-structured interviews. Qualitative data will be analysed using Framework analysis. Feasibility will be evaluated via interviews, digital records of intervention usage and technical assistance logs. The primary outcome measures of effectiveness (pain, itch and distress) will be measured using self-report or behavioural observation. Quantitative data will primarily be analysed descriptively and using generalised linear models.

Discussion

This study will provide insights into factors that impact upon the feasibility of a web-based trauma-informed care education intervention in a clinical practice setting. This knowledge may support other education approaches within healthcare settings related to improving and supporting patients to reduce the risk of healthcare interactions that result in paediatric medical traumatic stress.
Continuous erector spinae plane block for analgesia of sternum closure using a latissimus dorsi muscle flap for mediastinitis after coronary artery bypass grafting: a case report
Authors: Yamane Yu , Kosaka Masayuki , Akiizumi Haruki , Kuroda Mitsuo
Published: August 2020

Background

Erector spinae plane block (ESPB) is useful for providing analgesia after thoracic surgery. Previous reports show that ESPB is safely performed in patients receiving antithrombotic drugs. We effectively performed continuous ESPB in a patient receiving aspirin after coronary artery bypass grafting.

Case presentation

A 62-year-old man with mediastinitis was scheduled for sternum closure using a latissimus dorsi muscle flap. He had gone coronary artery bypass grafting and was taking aspirin. After induction of general anesthesia and tracheal intubation, a catheter was inserted for ESPB from the T6 level under ultrasound monitoring and infusion of ropivacaine was started. Tracheal tube was removed in the operating room, cold sense was absent between T2–8, and analgesia was between T3–T8 after uneventful surgery. There were no complications associated with ESPB postoperatively.

Conclusion

Continuous ESPB was a safe and useful analgesic method in a case undergoing sternum closure using a latissimus dorsi muscle flap.
Anesthetic management using a combination of anterior quadratus lumborum block and erector spinae plane block for robot-assisted partial nephrectomy: two case reports
Authors: Tanaka Nobuhiro , Kitazawa Takuzo , Mitani Saki , Suzuka Takanori , Kadoya Yuma , Kawaguchi Masahiko
Published: August 2020

Background

There has been increasing attention regarding quadratus lumborum block (QLB) and erector spinae plane block (ESPB) as effective truncal blocks. There have been reports of combined QLB and ESPB usage in hip surgery resulting in a symbiotic increase in effectiveness. However, there have been no reports regarding robot-assisted partial nephrectomy (RAPN), which requires multiple port holes ranging from near the xiphoid process to below the umbilicus. We hypothesized that the combined use of QLB and ESPB was an option for anesthesia and analgesia during RAPN.

Case presentation

Anterior QLB and ESPB were applied to two patients undergoing scheduled RAPN. With intravenous patient-controlled analgesia, the post-surgery numerical rating scale scores were < 3/10 at rest and < 5/10 upon movement, throughout the perioperative time.

Conclusions

The combination of QLB and ESPB could be an option for the postoperative analgesia in RAPN.
Neonatal and infantile appendicitis still confuses minds: report of two cases
Authors: Okumuş Mustafa , Zübarioğlu Adil Umut
Published: August 2020

Background

Acute appendicitis is extremely rare in the neonatal and infantile periods. The number of cases published in the last century is just over 100. Mortality and morbidity are still high due to diagnostic problems because there are no specific clinical features and reliable investigation for the diagnosis. Herein, we present two patients to remind physicians that the diagnosis of neonatal and infantile appendicitis should always be kept in mind.

Case presentations

A 30 3/7-week-old 740-g newborn girl was delivered by cesarean section because of preeclampsia. The newborn was followed in the neonatal intensive care unit and fed with an orogastric catheter. An abdominal distention developed on the 18th day of her life. While following up with a preliminary diagnosis of necrotizing enterocolitis, she was operated on the 4th day due to abdominal free air seen on X-ray. A perforated appendicitis was detected in the abdominal exploration and formal appendectomy was performed. Histology demonstrated marked transmural inflammation and necrosis at the perforated site and there was no evidence of Hirchsprung’s disease. The patient was started on breast milk on the third postoperative day and discharged home on day 98.

A 3.5-month-old boy was admitted to our clinic because of abdominal distention, discomfort, and constipation which had been ongoing for 4 days. He was followed up as an outpatient basis for 4 days in another center with the diagnosis of infantile colic. An increase in echogenicity due to intense inflammation was observed in mesenteric plans using USG in the right lower quadrant of the abdomen. Following preoperative preparations, the patient underwent abdominal exploration and appendectomy. He had an uneventful recovery and pathologic examination demonstrated a necrotizing appendicitis with perforation. He was discharged on the fourth postoperative day without any problems.

Conclusion

It is a fact that acute appendicitis in neonates and infants may not be diagnosed easily and quickly as in older children because there are no specific clinical features and reliable investigation for the diagnosis. Delay in diagnosis and treatment often results in appendicular perforation and peritonitis. The main safeguard against mortality and morbidity remains a high index of suspicion.
Mutation Rates in Cancer Susceptibility Genes in Patients With Breast Cancer With Multiple Primary Cancers
Authors: Maxwell Kara N. , Wenz Brandon M. , Kulkarni Abha , Wubbenhorst Bradley , D’Andrea Kurt , Weathers Benita , Goodman Noah , Vijai Joseph , Lilyquist Jenna , Hart Steven N. , Slavin Thomas P. , Schrader Kasmintan A. , Ravichandran Vignesh , Thomas Tinu , Hu Chunling , Robson Mark E. , Peterlongo Paolo , Bonanni Bernardo , Ford James M. , Garber Judy E. , Neuhausen Susan L. , Shah Payal D. , Bradbury Angela R. , DeMichele Angela M. , Offit Kenneth , Weitzel Jeffrey N. , Couch Fergus J. , Domchek Susan M. , Nathanson Katherine L.
Published: August 2020

PURPOSE

Women with breast cancer have a 4%-16% lifetime risk of a second primary cancer. Whether mutations in genes other than BRCA1/2 are enriched in patients with breast and another primary cancer over those with a single breast cancer (S-BC) is unknown.

PATIENTS AND METHODS

We identified pathogenic germline mutations in 17 cancer susceptibility genes in patients with BRCA1/2-negative breast cancer in 2 different cohorts: cohort 1, high-risk breast cancer program (multiple primary breast cancer [MP-BC], n = 551; S-BC, n = 449) and cohort 2, familial breast cancer research study (MP-BC, n = 340; S-BC, n = 1,464). Mutation rates in these 2 cohorts were compared with a control data set (Exome Aggregation Consortium [ExAC]).

RESULTS

Overall, pathogenic mutation rates for autosomal, dominantly inherited genes were higher in patients with MP-BC versus S-BC in both cohorts (8.5% v 4.9% [ P = .02] and 7.1% v 4.2% [ P = .03]). There were differences in individual gene mutation rates between cohorts. In both cohorts, younger age at first breast cancer was associated with higher mutation rates; the age of non–breast cancers was unrelated to mutation rate. TP53 and MSH6 mutations were significantly enriched in patients with MP-BC but not S-BC, whereas ATM and PALB2 mutations were significantly enriched in both groups compared with ExAC.

CONCLUSION

Mutation rates are at least 7% in all patients with BRCA1/2 mutation–negative MP-BC, regardless of age at diagnosis of breast cancer, with mutation rates up to 25% in patients with a first breast cancer diagnosed at age < 30 years. Our results suggest that all patients with breast cancer with a second primary cancer, regardless of age of onset, should undergo multigene panel testing.
Targeting DNA Methylation Depletes Uterine Leiomyoma Stem Cell–enriched Population by Stimulating Their Differentiation
Authors: Liu Shimeng , Yin Ping , Xu Jingting , Dotts Ariel J , Kujawa Stacy A , Coon V John S , Zhao Hong , Shilatifard Ali , Dai Yang , Bulun Serdar E
Published: August 2020

Uterine leiomyoma (LM) is the most common tumor in women and can cause severe morbidity. Leiomyoma growth requires the maintenance and proliferation of a stem cell population. Dysregulated deoxyribonucleic acid (DNA) methylation has been reported in LM, but its role in LM stem cell regulation remains unclear. Here, we fluorescence-activated cell sorting (FACS)-sorted cells from human LM tissues into 3 populations: LM stem cell–like cells (LSC, 5%), LM intermediate cells (LIC, 7%), and differentiated LM cells (LDC, 88%), and we analyzed the transcriptome and epigenetic landscape of LM cells at different differentiation stages. Leiomyoma stem cell–like cells harbored a unique methylome, with 8862 differentially methylated regions compared to LIC and 9444 compared to LDC, most of which were hypermethylated. Consistent with global hypermethylation, transcript levels of TET1 and TET3 methylcytosine dioxygenases were lower in LSC. Integrative analyses revealed an inverse relationship between methylation and gene expression changes during LSC differentiation. In LSC, hypermethylation suppressed the genes important for myometrium- and LM-associated functions, including muscle contraction and hormone action, to maintain stemness. The hypomethylating drug, 5′-Aza, stimulated LSC differentiation, depleting the stem cell population and inhibiting tumor initiation. Our data suggest that DNA methylation maintains the pool of LSC, which is critical for the regeneration of LM tumors.