bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Low Mandible Maneuver on Mutational Falsetto
Authors: Saltürk Ziya , Doğanay Timur , Üstün Onur , Tutar Belgin , Akgün Muhammed Fatih , Uyar Yavuz
Published: March 2020

Objectives: Mutational falsetto (MF) is a functional voice disorder involving failure to transition from the high-pitched voice of childhood to the lower-pitched voice of adolescence and adulthood. The low mandible maneuver (LMM) is used by professional singers to relax the larynx and expand the resonance space. It relaxes suprahyoid muscles and pushes the larynx backwards, so it can be used as a therapy for MF. Material and Methods: The data of 20 MF patients treated by the LMM were analyzed in this study. All of the patients were asked to complete the Voice Handicap Index-10 (VHI-10) before the first session, and again 2 weeks after the second visit. The Grade-Roughness-Breathiness-Asthenia-Strain (GRBAS) scale scores and fundamental frequency (F0) were analyzed for each patient. Results: All except 1 patient reported that they completed the exercises without difficulty; the patient who did not perform the exercises cited reasons other than their difficulty. Only 2 patients failed to transition from MF to a lower-pitched voice. The GRBAS scale scores (all parameters) differed significantly between the first and second sessions. The VHI-10 score also changed, i.e., self-perceived voice quality was improved significantly, as was the F0. Conclusions: Our results showed that the LMM is an efficient and rapid technique for treating MF patients and shows high patient compliance.
Evaluating a Clinical Pathway in Laparoscopic Cholecystectomy: Effective in Reducing Complications? A Propensity Score Matching Analysis
Authors: Arabacioglu Duygu , Lehn Annette , Herrmann Eva , Albers Benjamin , Hanisch Ernst , Buia Alexander
Published: March 2020

Background: Care pathways are primarily aimed at decreasing length of hospital stay (LOS) and preventing unnecessary costs while maintaining or improving the quality of care. In laparoscopic cholecystectomy, there is insufficient evidence for proving an impact upon postoperative complications. Methods: In this retrospective study, logistic regression was used to calculate a propensity score, and, after carrying out 1:1 nearest-neighbor matching, 296 patients were analyzed in both groups with regard to postoperative complications using the Clavien-Dindo classification system as a primary aim. In addition, secondary aims were LOS, compliance to care, and deviation from the care pathway with respect to patient discharge. Relative risk of the primary outcome was calculated and compared with the e-value as sensitivity testing approach. Results: Due to the mandatory part of the care pathway, patient record compliance was 100%. Deviation from the care pathway with respect to the planned patient discharge on postoperative day 2 was noted in 16% of the cases. After adjustment for potential factors, the relative risk when comparing Clavien-Dindo complication grades 0 versus 1–4 is 1.64 (95% CI 0.87–3.11), which did not reach significance (p = 0.127). After matching, LOS lasted 3.69 days without and 3.26 days with the care pathway, respectively. Conclusions: Against the background of already implemented structured standard operation procedures, a care pathway is not able to reduce postoperative complications. Nevertheless, we consider our clinical pathway a highly valuable tool for the interdisciplinary management of patient hospitalization under the supervision of experienced specialized surgeons.
Does Offline Beat Inline Treatment: Investigation into Extracorporeal Photopheresis
Authors: Helmberg Wolfgang , Sipurzynski Sabine , Groselje-Strehle Andrea , Greinix Hildegard , Schlenke Peter
Published: March 2020

Background: Extracorporeal photopheresis is a therapy based on the induction of apoptosis to cells harvested from peripheral blood, followed by direct retransfusion. Currently, there are two approaches: inline procedures, where cell harvesting, 8-methoxypsoralen (8-MOP) incubation, and UV irradiation is performed with a single device, and offline procedures, with collection in one device, followed by 8-MOP incubation/UV irradiation using a second device. Study Design and Methods: In a prospective crossover study, we compared an inline (Cellex, Therakos) with an established offline procedure (Optia, Terumo, and MacoGenic G2, Macopharma) in 6 patients, focusing on cell composition and apoptosis induction after 24 h. In total, 32 photopheresis treatments per device were performed. Results: We observed an overall 2-fold higher number of apoptotic “target” cells for each patient with offline treatment. All yields were stratified per patient. Yields were compared as ratio offline/inline for CD3+ (2.5-fold), CD4+ (2-fold), CD8+ (2.8-fold), CD56+ (2.8-fold), CD19+ (1.8-fold), CD15+ (0.5-fold), and CD14+ (2.2-fold) cells. Apoptosis induction was measured after 24 h with Annexin V/7-AAD for early and late apoptosis rates of CD3+ (CD4+, CD8+) and CD56+ cells. CD3+ cells of the inline treatment had an average of 88% (26% early, 62% late) of apoptotic cells compared to 75% (34% early, 41% late) in the offline treatment. Procedure duration ranged from 80 to 100 min inline, with a maximum of 1,500 mL processed blood, and 125–140 min offline, with at least 3,000 mL processed blood, depending on blood flow. Average hematocrit levels of the products were 2.7% inline versus 1.7% offline. Conclusions: The offline procedure, as established in our department, provides more apoptotic cells for treatment. The increased number of mononuclear cells collected outweighs a slightly reduced apoptosis rate after 24 h in comparison to the inline procedure. Besides this, the final decision for one or the other procedure has to take into account additional aspects, such as peripheral white blood cell count, hematocrit, and weight of the patient, required before apheresis, extracorporeal volume, and, last but not least, overall costs. The final criterion, however, has to be the reported clinical efficacy of the system applied.
miR-128-3p Is a Novel Regulator of Vascular Smooth Muscle Cell Phenotypic Switch and Vascular Diseases
Authors: Farina Floriana Maria , Hall Ignacio Fernando , Serio Simone , Zani Stefania , Climent Montserrat , Salvarani Nicolò , Carullo Pierluigi , Civilini Efrem , Condorelli Gianluigi , Elia Leonardo , Quintavalle Manuela
Published: March 2020

Rationale:

MicroRNAs (miRNAs, miRs) are small noncoding RNAs that modulate gene expression by negatively regulating translation of target genes. Although the role of several miRNAs in vascular smooth muscle cells (VSMCs) has been extensively characterized, the function of miRNA-128-3p (miR-128) is still unknown.

Objective:

To determine if miR-128 modulates VSMC phenotype and to define the underlying mechanisms.

Methods and Results:

We screened for miRNAs whose expression is modulated by an altered DNA methylation status in VSMCs, and among the hits, we selected miR-128. We found that miR-128 was expressed in various tissues, primary murine cells, and pathological murine and human vascular specimens. Through gain- and loss-of-function approaches, we determined that miR-128 affects VSMC proliferation, migration, differentiation, and contractility. The alterations of those properties were dependent upon epigenetic regulation of key VSMC differentiation genes; notably, Kruppel-like factor 4 was found to be a direct target of miR-128 and able to modulate the methylation status of the pivotal VSMC gene myosin heavy chain 11 (
Myh11
). Finally, in vivo lentiviral delivery of miR-128 prevented intimal hyperplasia in a mouse model of carotid restenosis without modifying vital cardiovascular parameters.

Conclusion:

miR-128 is a critical modulator of VSMCs and is regulated by epigenetic modifications upon stress. Its modulation in the context of disease could be exploited for therapeutic purposes.
Humanitarian Negotiation with Parties to Armed Conflict
Authors: Grace Rob
Published: March 2020

This article examines the role of international humanitarian law (ihl) and humanitarian principles in the discourse of humanitarian negotiation. The article is based on extensive, semi-structured interviews conducted with 53 humanitarian practitioners about their experiences engaging in negotiations in the field. The article proceeds in four parts. Part 1 discusses two key factors at play during humanitarian negotiation processes. The first factor is the counterpart’s familiarity with relevant legal and normative frameworks. The second factor is the interests that can drive counterparts’ behavior. Part 2 presents a framework for understanding how the interaction of these two factors – familiarity and interest-alignment – can shape the discourse of humanitarian negotiation. Part 3 addresses the impact of these same issues on the humanitarian side of the negotiation. In particular, there is the possibility that humanitarian actors themselves might also lack familiarity with ihl and/or humanitarian principles and might find that their interests exist in tension with humanitarian laws and principles. The final section offers concluding remarks.
Seven new species of Australian peacock spiders (Araneae: Salticidae: Euophryini: Maratus Karsch, 1878)
Authors: SCHUBERT JOSEPH
Published: March 2020

Seven new species of the Australian peacock spider genus Maratus Karsch, 1878 are described from Victoria, South Australia, and Western Australia: Maratus azureus sp. nov., Maratus constellatus sp. nov., Maratus inaquosus sp. nov., Maratus laurenae sp. nov., Maratus noggerup sp. nov., Maratus suae sp. nov., and Maratus volpei sp. nov.
A new genus, new species and taxonomic notes on American Cerambycinae (Coleoptera, Cerambycidae)
Authors: BOTERO JUAN PABLO , BEZARK LARRY G. , SANTOS-SILVA ANTONIO
Published: March 2020

Four new species and one new genus are described: Nesanoplium spinosum (Elaphidiini), from Honduras; Psyrassa zacki (Elaphidiini), from Mexico and Guatemala; Euderces ecuadorensis (Tillomorphini), from Ecuador; and Xela tysoni (Methiini), gen. nov., from Guatemala. Pteroplatus suturalis Buquet, 1840 is synonymized with Pteroplatus pulcher Buquet, 1840 (Pteroplatini). Acyphoderes baeri Gounelle, 1913 (= Odontocera baeri) is transferred to Acutiphoderes Clarke, 2015 (Rhinotragini). We question the validity of the lectotype designation for Cyrtomerus puberulus Fleutiaux & Sallé, 1889.
Overcome Multidrug Resistance in Colorectal Cancer by Natural Compounds
Authors: Li Yanxi , Liu Zhexian , Guo Xingqi , Ma Siping
Published: March 2020

Colorectal cancer, a commonly diagnosed cancer, is a leading cause of cancer-associated deaths in men and women globally. Amongst the current treatments for colorectal cancer including radiotherapy and chemotherapy, surgical resection provides the most benefit. However, the recurrence
rate after traditional treatment is high, and treatment failure is related to recurrence and metastasis. Although postoperative adjuvant chemotherapy can reduce these factors to prolong patient life, systemic toxicity and resistance to chemotherapeutic drugs reduces their effectiveness for
colorectal cancer treatment. Therefore, multidrug resistance is a major cause for concern in colorectal cancer treatment. This review focuses on recent studies of natural compounds derived from plants, animals or marine organisms related to colorectal cancer treatment including published clinical
trials. Studies have indicated that natural compounds might be of benefit as chemotherapeutic agents, chemopreventive agents, or chemosensitizers in combination chemotherapy strategies. We discuss the mechanisms involved in the reversal of multidrug resistance by natural products for cancer
chemotherapy. The evidence suggests natural compounds might have potential for the prevention and treatment of colorectal cancer.
Effects of Silanes on the Structure and Properties of Chromium-Free Passivation
Authors: Haiyang Fu , Bo Gao , Yingwei Zhou , Pengfei Xing
Published: March 2020

Steel is one of the most widely used metal materials, and corrosion of steel surfaces is a serious problem. Traditional chromate passivation produces hexavalent chromium with high toxicity and carcinogenicity. To solve toxicity and pollution problems, a chromium-free passivation method
was adopted to replace the traditional process. Based on the reaction mechanisms of some silane coupling agents, a new method of chromium-free passivation and anti-white rust production is presented in this paper. The chromium-free passivation process of an inorganic material-silane-resin
composite was used in the study. The microstructure and corrosion resistance of a hot-dip galvanized sheet and silane passivation film were compared by using a neutral salt spray test, scanning electron microscopy, infrared spectroscopy and X-ray photoelectron spectroscopy. The mechanism of
film formation was studied. The results show that the surface of the passivation film is dense and smooth without sharp protrusions and has a stable skeleton structure inside. The structure of the passive film is C=O, Si–O, C–Si, C–H, Si–O–Zn, Si–O–Si,
etc. A chromium-free passivation film prepared with a disilane can effectively prevent penetration between the corrosive medium and matrix. After a 96 h corrosion test, the corrosion area is less than 5%, which meets the requirements of some industrial production processes.
Catalytic Effect of Inherently-Water-Soluble Sodium on Zhundong Coal Gasification
Authors: Zhang Zhi-Yuan , Zhou Heng-Tao , Zhou Qian , Rao Pei-Jun , Zhu Huan-Guang
Published: March 2020

Coal loaded with inherently-water-soluble sodium was prepared with dicyclohexyl-18-crown-6 to investigate the effects of inherently-water-soluble sodium on temperature-programmed isothermal gasification. The results were compared with Na2CO3-loaded coal using thermo-gravimetric
analysis (TGA), and the results showed that sodium had a catalytic effect on gasification, and water-soluble sodium had a stronger catalytic ability than Na2CO3. The isothermal gasification reaction of inherently-water-soluble-sodium-loaded coal was complete in 4.68 min,
whereas that of Na2CO3-loaded coal was complete in 5.39 min. Chemisorption of CO2 to chars was investigated by TGA at 300 C, which showed that the order of CO2 chemisorption capacity was similar to that of the catalytic abilities during gasification.
Therefore, the CO2 chemisorption capacity accurately reflects differences in the gasification reactivity. Moreover, the distribution of sodium in coal and char structures were investigated by multiple techniques, including scanning electron microscopy (SEM), energy dispersive spectrometry
(EDS), and X-ray diffraction (XRD). EDS-mapping images of Na-loaded coal indicated that inherently-water-soluble sodium mainly adhered to coal particles. This finding shows that coal graphitization was strongly inhibited by inherently-water-soluble sodium, which further strengthened the chemisorption
of CO2 to char and the reactivity of char during gasification.
Biomechanics of Calcium Sulfate-Sodium Hyaluronate Composite Bone Graft Materials in Treating Radius Fractures
Authors: Yang Xuefeng , Qiang Shenglin , Liang Tian , Jia Yonglong , Xu Kewu
Published: March 2020

The composite bone graft materials were made of calcium sulfate (CaSO4) and sodium hyaluronate (SH). The SH was in the form of solution, with a concentration of 850 kDa 0.1% v/w. The two materials were mixed in a ratio of 2 g:1 mL to obtain the first composite bone graft
material Ca_Nw. Next, CaSO4 was mixed with SH-derivative (cross-linked SH) in a ratio of 2 g:1 mL to obtain the second composite bone graft material Ca_Cn. The experiment included 80 patients with ulna and radius nonunion, who were divided into 4 groups. The included patients were
treated with Ca_Nw bone graft material, Ca_Cn bone graft material, autograft, and allograft. The computed tomography (CT) data, MIMICS software, and PRO/E software were utilized to construct the finite element models of AO-typing C-type distal radius fractures treated by different bone graft
materials. The fixed constraints of radial and ulnar full degree of freedom (DOF) were set. The 120 N axial pressure was given on the forearm to compare the stress and fracture displacement. The results showed excellent stress simulation effects on two groups of patients treated by composite
bone graft materials than those treated by autograft and allograft (P < 0.05).
Application of Clustering Algorithms to TRMM Precipitation over the Tropical and South Pacific Ocean
Authors: Pike Maxwell , Lintner Benjamin R.
Published: March 2020

Understanding multiscale rainfall variability in the South Pacific convergence zone (SPCZ), a southeastward-oriented band of precipitating deep convection in the South Pacific, is critical for both the human and natural systems dependent on its rainfall, and for interpreting similar off-equatorial diagonal convection zones around the globe. A k-means clustering method is applied to daily austral summer (December–February) Tropical Rainfall Measuring Mission (TRMM) satellite rainfall to extract representative spatial patterns of rainfall over the SPCZ region for the period 1998–2013. For a k = 4 clustering, pairs of clusters differ predominantly via spatial translation of the SPCZ diagonal, reflecting either warm or cool phases of El Niño–Southern Oscillation (ENSO). Within each of these ENSO phase pairs, one cluster exhibits intense precipitation along the SPCZ while the other features weakened rainfall. Cluster temporal behavior is analyzed to investigate higher-frequency forcings (e.g., the Madden–Julian oscillation and synoptic-scale disturbances) that trigger deep convection where SSTs are sufficiently warm. Pressure-level winds and specific humidity from the Climate Forecast System Reanalysis are composited with respect to daily cluster assignment to investigate differences between active and quiescent SPCZ conditions to reveal the conditions supporting enhanced or suppressed SPCZ precipitation, such as low-level poleward moisture transport from the equator. Empirical orthogonal functions (EOFs) of TRMM precipitation are computed to relate the “modal view” of SPCZ variability associated with the EOFs to the “state view” associated with the clusters. Finally, the cluster number is increased to illustrate the change in TRMM rainfall patterns as additional degrees of freedom are permitted.
Decadal Change of Combination Mode Spatiotemporal Characteristics due to an ENSO Regime Shift
Authors: Jiang Feng , Zhang Wenjun , Stuecker Malte F. , Jin Fei-Fei
Published: March 2020

Previous studies have shown that nonlinear atmospheric interactions between ENSO and the warm pool annual cycle generates a combination mode (C-mode), which is responsible for the termination of strong El Niño events and the development of the anomalous anticyclone over the western North Pacific (WNP). However, the C-mode has experienced a remarkable decadal change in its characteristics around the early 2000s. The C-mode in both pre- and post-2000 exhibits its characteristic anomalous atmospheric circulation meridional asymmetry but with somewhat different spatial structures and time scales. During 1979–99, the C-mode pattern featured prominent westerly surface wind anomalies in the southeastern tropical Pacific and anticyclonic anomalies over the WNP. In contrast, the C-mode-associated westerly anomalies were shifted farther westward to the central Pacific and the WNP anticyclone was farther westward extended and weaker after 2000. These different C-mode patterns were accompanied by distinct climate impacts over the Indo-Pacific region. The decadal differences of the C-mode are tightly connected with the ENSO regime shift around 2000; that is, the occurrence of central Pacific (CP) El Niño events with quasi-biennial and decadal periodicities increased while the occurrence of eastern Pacific (EP) El Niño events with quasi-quadrennial periodicity decreased. The associated near-annual combination tone periodicities of the C-mode also changed in accordance with these changes in the dominant ENSO frequency between the two time periods. Numerical model experiments further confirm the impacts of the ENSO regime shift on the C-mode characteristics. These results have important implications for understanding the C-mode dynamics and improving predictions of its climate impacts.
Assessing the Skill and Reliability of Seasonal Climate Forecasts in Sahelian West Africa
Authors: Pirret Jennifer S. R. , Daron Joseph D. , Bett Philip E. , Fournier Nicolas , Foamouhoue Andre Kamga
Published: March 2020

Seasonal climate forecasts have the potential to support planning decisions and provide advanced warning to government, industry, and communities to help reduce the impacts of adverse climatic conditions. Assessing the reliability of seasonal forecasts, generated using different models and methods, is essential to ensure their appropriate interpretation and use. Here we assess the reliability of forecasts for seasonal total precipitation in Sahelian West Africa, a region of high year-to-year climate variability. Through digitizing forecasts issued from the regional climate outlook forum in West Africa known as Prévisions Climatiques Saisonnières en Afrique Soudano-Sahélienne (PRESASS), we assess their reliability by comparing them to the Climate Hazards Group Infrared Precipitation with Stations (CHIRPS) project observational data over the past 20 years. The PRESASS forecasts show positive skill and reliability, but a bias toward lower forecast probabilities in the below-normal precipitation category. In addition, we assess the reliability of seasonal precipitation forecasts for the same region using available global dynamical forecast models. We find all models have positive skill and reliability, but this varies geographically. On average, NCEP’s CFS and ECMWF’s SEAS5 systems show greater skill and reliability than the Met Office’s GloSea5, and in turn than Météo-France’s Sys5, but one key caveat is that model performance might depend on the meteorological situation. We discuss the potential for improving use of dynamical model forecasts in the regional climate outlook forums, to improve the reliability of seasonal forecasts in the region and the objectivity of the seasonal forecasting process used in the PRESASS regional climate outlook forum.
New laws ban commercial surrogacy in India
Authors: Saran JSRG , Padubidri Jagadish Rao
Published: March 2020

Surrogacy is a controversial issue and most particularly when well-known celebrities have used it. It is a boon for couples where normal pregnancy is not possible but can be used for commercial exploitation. The Government of India passed a law on surrogacy in December 2018, which introduced many changes to the pre-existing rules, in particular, it bans commercial surrogacy and curtails the freedom of foreigners to apply for surrogacy in India. This has dealt a major blow to the agencies who organised surrogacy for foreigners. A key reason for passing this law was the unjust treatment of the women who provided surrogacy services. They had poor living conditions and often failed to receive the money that was paid by the intended parents to the agency. 2 There are some countries where commercial surrogacy is legal, including some states in the United States of America, Poland, Russia and many others. 3 Some surrogate mothers suffer complications from the assisted reproductive technologies used; these mainly include ectopic pregnancy, psychological stress and ovarian hyper stimulation syndrome. 4 Same sex couples, single parents and even infertile women should be encouraged to adopt children.
Why spontaneity matters: Rosa Luxemburg and democracies of grief
Authors: Tambakaki Paulina
Published: March 2020

The article seeks to explain why spontaneity, a concept that political theorists have given scant attention to, matters. It argues that it matters because it delivers a capacity for producing democratic change that is urgent to reflect on amidst a prevailing mood of grief over a democracy lost. To stimulate this reflection, the article engages with Rosa Luxemburg’s work, showing how her understanding of spontaneity as an initiative that delivers something for democracy lays the groundwork for a theoretical orientation that allows us to notice the effects of spontaneity on democracy without overplaying its short-lived nature.
Quantification of contrast-uptake as imaging biomarker for disease progression of renal cell carcinoma after tumor ablation
Authors: Tegel Bruno R , Huber Steffen , Savic Lynn J , Lin MingDe , Gebauer Bernhard , Pollak Jeffrey , Chapiro Julius
Published: March 2020

Background

The prognosis of patients with renal cell carcinoma (RCC) depends greatly on the presence of extra-renal metastases.

Purpose

To investigate the value of total tumor volume (TTV) and enhancing tumor volume (ETV) as three-dimensional (3D) quantitative imaging biomarkers for disease aggressiveness in patients with RCC.

Material and Methods

Retrospective, HIPAA-compliant, IRB-approved study including 37 patients with RCC treated with image-guided thermal ablation during 2007–2015. TNM stage, RENAL Nephrometry Score, largest tumor diameter, TTV, and ETV were assessed on cross-sectional imaging at baseline and correlated with outcome measurements. The primary outcome was time-to-occurrence of extra-renal metastases and the secondary outcome was progression-free survival (PFS). Correlation was assessed using a Cox regression model and differences in outcomes were shown by Kaplan–Meier plots with significance and odds ratios (OR) calculated by Log-rank test/generalized Wilcoxon and continuity-corrected Woolf logit method.

Results

Patients with a TTV or ETV > 5 cm3 were more likely to develop distant metastases compared to patients with TTV (OR 6.69, 95% confidence interval [CI] 0.33–134.4, P=0.022) or ETV (OR 8.48, 95% CI 0.42–170.1, P=0.016) < 5 cm3. Additionally, PFS was significantly worse in patients with larger ETV ( P = 0.039; median PFS 51.87 months vs. 69.97 months). In contrast, stratification by median value of the established, caliper-based measurements showed no significant correlation with outcome parameters.

Conclusion

ETV, as surrogate of lesion vascularity, is a sensitive imaging biomarker for occurrence of extra-renal metastatic disease and PFS in patients with RCC.
Tattoo complications and magnetic resonance imaging: a comprehensive review of the literature
Authors: Alsing Kasper Køhler , Johannesen Helle Hjorth , Hansen Rasmus Hvass , Serup Jørgen
Published: March 2020

Tattooed patients undergoing magnetic resonance imaging (MRI) can develop cutaneous complications during the procedure. Our aim was to review all published case reports on MRI-induced tattoo complications to identify a possible pattern. So far, 17 cases have been reported. Five (29%) of the cases were in cosmetic tattoos.

 Symptoms are abrupt and painful with fast onset during MRI, sometimes requiring termination of the procedure. Clinical signs are absent or manifested as inflammation sensed as burning. No thermal skin burns have been recognized. Full recovery is fast, with no sequelae.

 MRI-induced tattoo complications are uncommon. Patients with cosmetic and traditional tattoos can undergo routine MRI.
Coexistence of gastric choriocarcinoma and adenocarcinoma with reproductive hormone secretion in a man: a case report
Authors: Chen Lei , Yi Xin , Zou Hong-Li , Chen Xu-An , Gao Shang , Zhang Pei-Hai
Published: March 2020

The present study reports a rare case of a 65-year-old male patient with an exophytic ulcerative lesion in the gastric antrum. After performing a radical subtotal gastrectomy with D2 lymph node dissection and Billroth I gastrojejunostomy, histological analysis revealed a poorly differentiated adenocarcinoma combined with a biphasic pattern consisting of cytotrophoblasts and syncytiotrophoblasts. Immunohistochemical analysis showed a positive reaction with an anti-β-human chorionic gonadotropin antibody, and an abnormal increase in reproductive hormones. Furthermore, the patient succumbed to upper gastrointestinal hemorrhage in less than 3 months after the initial diagnosis, although the rupture of his liver metastasis was successfully treated by transhepatic artery embolization during the second admission.
Exploration of barriers and enablers for evidence-based interventions for upper limb rehabilitation following a stroke: Use of Constraint Induced Movement Therapy and Robot Assisted Therapy in NHS Scotland
Authors: Sweeney Gillian , Barber Mark , Kerr Andrew
Published: March 2020

Introduction

The routine use of evidence-based upper limb rehabilitation interventions after stroke has the potential to improve function and increase independence. Two such interventions are Constraint Induced Movement Therapy and Robot Assisted Therapy. Despite evidence to support both interventions, their use within the National Health Service appears, anecdotally, to be low. We sought to understand user perceptions in order to explain low uptake in clinical practice.

Methods

A combination of a cross-sectional online survey with therapists and semi-structured interviews with stroke patients was used to explore uptake and user opinions on the benefits, enablers and barriers to each intervention.

Findings

The therapists surveyed reported low use of Constraint Induced Movement Therapy and Robot Assisted Therapy in clinical practice within the Scottish National Health Service. Barriers identified by therapists were inadequate staffing, and a lack of training and resources. Interviews with stroke patients identified themes that may help us to understand the acceptability of each intervention, such as the impact of motivation.

Conclusion

Barriers to the uptake of Constraint Induced Movement Therapy and Robot Assisted Therapy within the clinical setting were found to be similar. Further qualitative research should be completed in order to help us understand the role patient motivation plays in uptake.
Subcutaneous sumatriptan reduces cilostazol induced headache in migraine patients
Authors: Falkenberg Katrine , Bjerg Helene Rønde , Olesen Jes
Published: March 2020

Objectives

The authors have previously tried to develop a model for the testing of novel drug candidates for migraine, using the headache and migraine provoking agent cilostazol. Previous studies have used sumatriptan tablets as the validating drug, but they were not sufficiently effective. In this study we test the effect of subcutaneous sumatriptan on cilostazol induced headache in patients with migraine without aura.

Method

Thirty patients with migraine without aura received 200 mg cilostazol on two different study days. The induced headache was treated with subcutaneous sumatriptan in a randomized, double-blind cross-over design. The patients filled out a self-reported headache questionnaire until 12 h after cilostazol.

Results

All 30 patients experienced headache (range 3–10) on both study days and the headache fulfilled the criteria for a migraine-like attack in 73% on the sumatriptan day and in 77% on the placebo day. Sumatriptan injection reduced the headache score 2 h after treatment ( p = 0.003). The difference between headache intensity on the sumatriptan day and the placebo day was significant at both 2 h ( p = 0.01) and 4 h ( p = 0.0007) after treatment.

Conclusion

Subcutaneous sumatriptan reduces cilostazol induced headache in migraine patients. The cilostazol model may be useful as a tool to test the potential of new anti-migraine drugs. Trial registration: The study is registered on clinicaltrials.gov (NCT03422796).
The response of pin-clamped carbon fibre-reinforced plastics composite sandwich beams with polyvinylchloride foam core under bending impact
Authors: Caliskan Umut , Kemal Apalak M
Published: March 2020

The dynamic response of pin-clamped composite sandwich beam in terms of face-sheet effect with polyvinylchloride foam core subjected to bending impact loading was investigated in this paper. Composite sandwich beams with three different unidirectional skin layups of [0]4, [45]4 and [90]4 and two types of face-sheet thickness of 1 ([0]4) and 2 ([0]8) mm were fabricated. An explicit code, VUMAT, is written and implemented in ABAQUS/Explicit. The micro-computerised tomography scanning was used to detect adhesive layer failure. The ply angle orientation of face sheets plays an important role in the failure mechanism of the sandwich beam under bending loads. Although it is known that the fibre angle in the direction perpendicular to the bending direction is more stiff and strength, damage tolerances under bending impact loads of beams with other fibre angles were determined. In addition, as the number of layers increased, failure mechanism and load-carrying capacity of composite face sheets changed completely for increasing bending stiffness. This research provides fundamental information about the change of the failure mechanisms as the fibre angle and thickness of the face sheet were changed and in terms of interpretation with the help of finite elements using different failure criteria.
Promoting First Relationships®: Implementing a Home Visiting Research Program in Two American Indian Communities
Authors: Oxford Monica , Booth-LaForce Cathryn , Echo-Hawk Abigail , Madesclaire Odile , Parrish Lorilynn , Widner Mylene , Petras Anthippy , Abrahamson-Richards Tess , Nelson Katie , Buchwald Dedra ,   the CATCH Project Team
Published: March 2020

Background

Few, if any, home visiting programs for children under the age of three have been culturally adapted for American Indian reservation settings. We recently adapted one such program: Promoting First Relationships®.

Objectives

To culturally adapt Promoting First Relationships® while maintaining program fidelity, we used a community-based participatory approach to elicit input from two American Indian partners.

Methods

University-based researchers, reservation-based Native project staff, and Native tribal liaisons conducted collaborative meetings, conference calls, and focus groups to adapt Promoting First Relationships® to reflect local community needs and values.

Lessons Learned

Working closely with onsite Native project staff, being flexible and open to suggestions, and attending to the logistical needs of the community are imperative to developing and implementing adaptations.

Conclusions

Several adaptations were made based on the collaboration between researchers and Native project staff. Collaboration is critical for adapting programs so they can be tested in ways that respect both American Indian culture and research needs.
Do Female Directors Signal Indian SME IPOs Quality? Evidence From a Quantile Regression Approach
Authors: Arora Nischay , Singh Balwinder
Published: March 2020

The purpose of this article is to examine the influence of female directors on the underpricing of small and medium enterprise (SME) initial public offerings (IPOs) in an emerging country like India which is relatively a fruitful setting to investigate. The research in relatively underexplored area is undertaken using a sample of 403 SME IPOs issued between 2012 and 2018. Ordinary least square (OLS) regression (mean regression) and quantile regression (QR, median regression) has been used to examine the signaling role of female directors on listing day performance of Indian SME IPOs. The results unveil that presence of female directors on IPO board reduces the underpricing. However, the negative relationship lacks statistical association between the variables. Similar results have been obtained when proportion of female directors instead of female dummies is used to gauge the impact on underpricing. The study highlights the need to increase the proportion of women directors on board to break the ‘glass ceiling’ and capitalize their talent for improving IPO performance. The extant research investigating the impact of female directors has largely been concentrated on larger companies in developed countries. Thus, the present research contributes to the literature by examining its influence in context of IPOs of smaller firms which needs effective signals to communicate true quality to investors thereby gaining societal legitimacy.
Experiencing place identity and place belongingness at a children’s hospice: Parents’ perspectives
Authors: Dunbar Helena , Carter Bernie
Published: March 2020

Children’s hospices are key players in the provision of palliative care services for families with children with life-limiting conditions (LLCs). However, evidence suggests that some of the negative terminology/language which surrounds the notions of palliative and hospice care may contribute to the lack of uptake of hospice services by families. This article reports two elements of place bonding: parents’ experiences of place identity and place belongingness at a children’s hospice in a region in England. Underpinned by a constructivist grounded theory methodology, focus groups were undertaken with 24 parents of children with LLCs accessing a children’s hospice. Despite initial reservations associated with the identity of the hospice, parents described how and why their view changed and therefore consequently how they were able to experience the hospice differently. This article demonstrates how parents’ views of the identity of the hospice change and how the hospice becomes a place where parents experience a sense of belongingness.
Biophilic school architecture in cold climates
Authors: Watchman Mélanie , Demers Claude M. H. , Potvin André
Published: March 2020

Designing school settings that provide a satisfying experience of nature and enhance well-being could be advantageous for children and teachers, though in cold climates prolonged periods of precipitation, restricted sunshine and low temperatures represent non-ideal conditions for fostering a connection with nature. This paper reviews research into the relationships between principles of biophilic design and well-being, with specific consideration for learning environments in cold climates. Children spend more time in school than any other place, except the home, and most of their learning activities occur indoors. Given the large portion of the day children and teachers spend within the built environment, an architect's perspective investigates these relationships. The paper examines the concepts and research findings that appear to offer the greatest potential for future architectural applications in children's learning environments. It also identifies gaps in biophilic design strategies in relation to schools and the importance of considering climatic conditions to create satisfying experiences of nature within the built environment. If biophilic design research is to lead to healthier, more comfortable school settings that present a greater connection between learning spaces and the natural environment, then to identify and define beneficial guidelines that translate readily into architecture is essential.
Validation and identification of reference genes in Chinese hamster ovary cells for Fc-fusion protein production
Authors: Ma Xiaonan , Zhang Ling , Zhang Luming , Wang Chenglong , Guo Xiaorui , Yang Yu , Wang Lin , Li Xiangru , Ma Ningning
Published: March 2020

Chinese hamster ovary cells are the predominant cell lines used for bio-therapeutic production. Real-time quantitative PCR (RT-qPCR) and transcriptomics are powerful tools to understand and optimize the Chinese hamster ovary cells for higher productivity or better control of product qualities. Reliable reference genes, which were proved to be experiment-specific, are critical yardsticks. In this study, we compared expression stability of 20 candidate reference genes at mRNA level, including commonly used housekeeping genes, previous literature reported genes in Chinese hamster ovary cells producing an intact antibody, and new candidates suggested by our RNA-seq transcriptomic database, in RT-qPCR reactions in Fc-fusion protein-producing Chinese hamster ovary cells with various productivity during long-term cultivation and fed-batch cultures at 26 different conditions. geNorm, NormFinder, BestKeeper, and ΔCt programs and methods were utilized to analyze the gene expression stability and gave an overall ranking. Akr1a1, Gpx1, and Aprt in long-term cultivation and Akr1a1, Rps16 in fed-batch culture, which have not been reported previously, exhibited the highest stability of gene expression, while Pabpn1, Hirip3, and Actb in both sets of experiments together with Atp5f1 in long-term passage process showed the weakest stability. The results were then validated using GLP1-Fc (Glucagon-like peptide-1 Fc fusion protein) gene as the target with determined expression level which were doubly confirmed by both absolute RT-qPCR and confocal microscopy. These new references should be considered for the investigations on Chinese hamster ovary cells in related research.

Impact statement

In order to reveal potential genotype-phenotype relationship, RT-qPCR reactions are frequently applied which require validated and reliable reference genes. With the investigation on long-term passage and fed-batch cultivation of CHO cells producing an Fc-fusion protein, four new reference genes–Akr1a1, Gpx1, Aprt, and Rps16, were identified from 20 candidates with the aid of geNorm, NormFinder, BestKeeper, and ΔCt programs and methods. This article provided more verified options in reference gene selection in related research on CHO cells.
Heparin-Induced Thrombocytopenia in Patients Undergoing Valvular and Aortic Surgery: A Modern Assessment of Risk
Authors: Zapata David , Binongo Jose , Lasanajak Yi , Wei Jane , Leshnower Bradley G. , Chen Edward P. , Miller Jeffrey S. , Lattouf Omar M. , Guyton Robert A. , Halkos Michael E. , Keeling Brent
Published: March 2020

Objective

The incidence and outcomes of patients with heparin-induced thrombocytopenia (HIT) are well defined for general cardiac surgical populations. The purpose of this study was to define the outcomes of patients with HIT in a population excluding patients who underwent coronary artery bypass grafting (CABG).

Methods

The local Society of Thoracic Surgeons cardiac surgical database was queried between January 2008 and May 2017 for patients who underwent either open valvular surgery or aortic surgery. Patients who underwent either isolated or combined CABG procedures were excluded. Cohorts were formed based on the presence or absence of postoperative HIT. Logistic regression models were built to determine the association between postoperative HIT and outcomes, adjusted for both preoperative and intraoperative variables.

Results

Of the total cohort (8,107 patients), 176 patients (2.2%) developed HIT after surgery. HIT patients experienced an increased incidence of morbidities postoperatively, including reoperation for bleeding, reoperation for cardiac and noncardiac etiologies, postoperative stroke, perioperative myocardial infarction, postoperative sternal infection, postoperative arrhythmia, new-onset renal failure, and dialysis (all with P < 0.01). The unadjusted 30-day mortality was 14.8% in HIT patients vs 4.9% in those without HIT ( P < 0.01). After risk adjustment, reoperation for noncardiac events, renal failure, new dialysis, postoperative stroke, arrhythmia, and sternal wound infection remained significantly elevated in patients who developed postoperative HIT.

Conclusions

Patients who developed HIT after non-CABG cardiac surgery experienced increased postoperative rates of morbidity and mortality. Early diagnosis and treatment remained mainstays of therapy. Early identification of patients at highest risk should prompt careful risk stratification when possible.
Three-dimensional mechanical parts reconstruction technology based on two-dimensional image
Authors: Huo Jiaofei , Yu Xiaomo
Published: March 2020

With the development of computer technology and three-dimensional reconstruction technology, three-dimensional reconstruction based on visual images has become one of the research hotspots in computer graphics. Three-dimensional reconstruction based on visual image can be divided into three-dimensional reconstruction based on single photo and video. As an indirect three-dimensional modeling technology, this method is widely used in the fields of film and television production, cultural relics restoration, mechanical manufacturing, and medical health. This article studies and designs a stereo vision system based on two-dimensional image modeling technology. The system can be divided into image processing, camera calibration, stereo matching, three-dimensional point reconstruction, and model reconstruction. In the part of image processing, common image processing methods, feature point extraction algorithm, and edge extraction algorithm are studied. On this basis, interactive local corner extraction algorithm and interactive local edge detection algorithm are proposed. It is found that the Harris algorithm can effectively remove the features of less information and easy to generate clustering phenomenon. At the same time, the method of limit constraints is used to match the feature points extracted from the image. This method has high matching accuracy and short time. The experimental research has achieved good matching results. Using the platform of binocular stereo vision system, each step in the process of three-dimensional reconstruction has achieved high accuracy, thus achieving the three-dimensional reconstruction of the target object. Finally, based on the research of three-dimensional reconstruction of mechanical parts and the designed binocular stereo vision system platform, the experimental results of edge detection, camera calibration, stereo matching, and three-dimensional model reconstruction in the process of three-dimensional reconstruction are obtained, and the full text is summarized, analyzed, and prospected.
Dorsal intercarpal ligament capsulodesis: a retrospective study of 120 patients according to types of chronic scapholunate instability
Authors: Micicoi Grégoire , Micicoi Lolita , Dreant Nicolas
Published: March 2020

The purpose of this study was to assess the results of dorsal intercarpal ligament capsulodesis (Mayo technique) for cases of chronic scapholunate instability and to specify the indications according to the severity of instability. A retrospective analysis was conducted and examined dorsal intercarpal ligament capsulodesis procedures performed for chronic scapholunate instability without intercarpal or radiocarpal arthritis. One-hundred and twenty patients were examined by an independent observer (48 predynamic, 48 dynamic and 24 static scapholunate instabilities). The follow-up period averaged 54 months (range 24–127). Mean final Mayo wrist score was 70, mean final Patient-Rated Wrist Evaluation was 27 and mean final QuickDASH score was 26. Functional, clinical and radiological data were improved for the operated patients. We concluded that dorsal intercarpal ligament capsulodesis is a good option for treating early stages of scapholunate instability.

Level of evidence: IV
Dementia and its genes
Authors: Jain Vani , Duffin Donna , Angus Clarke Professor
Published: March 2020

Dementia is a collective term for a range of conditions that lead to a progressive deterioration in cognitive function. Together they are a major cause of disability, and it is estimated that 10 000 000 new cases are diagnosed every year, worldwide. Studies suggest that 1-in-20 individuals develop symptoms below the age of 65 years. Although non-genetic causes must be considered, a young age of onset or a strong family history could be due to the presence of a particularly strong genetic factor; a highly penetrant pathogenic variant. This article aims to provide GPs with an introduction to inherited forms of adult-onset dementia, their presenting features and clues to look out for in the family history.