bluuebunny/crossref_metadata_2025 huggingface dataset:
A dual U-Net algorithm for automating feature extraction from satellite imagery
Authors: Humphries Samuel , Parker Trevor , Jonas Bryan , Adams Bryan , Clark Nicholas J
Published: January 2021

Quick identification of building and roads is critical for execution of tactical US military operations in an urban environment. To this end, a gridded, referenced, satellite images of an objective, often referred to as a gridded reference graphic or GRG, has become a standard product developed during intelligence preparation of the environment. At present, operational units identify key infrastructure by hand through the work of individual intelligence officers. Recent advances in Convolutional Neural Networks, however, allows for this process to be streamlined through the use of object detection algorithms. In this paper, we describe an object detection algorithm designed to quickly identify and label both buildings and road intersections present in an image. Our work leverages both the U-Net architecture as well the SpaceNet data corpus to produce an algorithm that accurately identifies a large breadth of buildings and different types of roads. In addition to predicting buildings and roads, our model numerically labels each building by means of a contour finding algorithm. Most importantly, the dual U-Net model is capable of predicting buildings and roads on a diverse set of test images and using these predictions to produce clean GRGs.
Immediate Pneumothorax Diagnosis by Surgical Residents Using Portable Ultrasound
Authors: Bar Alon , Lin Guy , Lazar Li Or , Blanka-Deak Judit , Khalayleh Harbi , Pines Guy
Published: January 2021

Objective

Feasibility of diagnosis of pneumothorax using handheld ultrasound by non-radiologists shows inconsistent results. The aim of this study is to evaluate the feasibility and accuracy of portable ultrasound for immediate diagnosis of pneumothorax by general surgery residents who underwent short training.

Methods

Patients who presented to the emergency department of a university hospital with suspected pneumothorax between 10/2018 and 12/2019 were included in the study. Patients underwent ultrasound in 2 points of each hemithorax. Sensitivity and specificity for pneumothorax diagnosis by ultrasound and physical examination were calculated and compared with chest computed tomography (CT). Patients in whom a chest tube was placed prior to ultrasound examination and those who did not undergo a CT scan were excluded from the study.

Results

A total of 85 patients met the inclusion criteria. Mean age was 40.7 ± 20.2 years. Pneumothorax was found among 46 patients (54%) per chest CT, and of these, 21 (46%) underwent chest tube placement following imaging. Ultrasound showed the highest sensitivity and specificity (95.6% [95% confidence interval {CI} 85.16% to 99.47%] and 97.44% [95% CI 86.40% to 99.67%], respectively). Chest x-ray had the lowest sensitivity (47.8% [95% CI 32.89% to 63.05%]) for pneumothorax detection. Physical examination showed a moderate sensitivity and specificity (82.6% [95% CI 68.58% to 92.18%] and 77.89% [95% CI 60.67% to 88.87%], respectively) for the diagnosis of pneumothorax.

Conclusions

We found high accuracy rates of 2-point ultrasound in immediate pneumothorax diagnosis when performed by surgical residents who underwent a short ultrasound training. This is a fast and repeatable test, and has the potential for successful implementation in prehospital and military scenarios as well, minimizing unnecessary chest tube placements.
Domestic Violence Policy: A World of Change
Authors: Belknap Joanne , Grant Deanne
Published: January 2021

The second wave of the feminist movement brought unprecedented changes in awareness of criminal legal system (CLS) responses to domestic violence (DV). The seemingly feminist “success” in the harsher CLS responses, however, resulted in the disparate criminalization of BIPOC (Black, Indigenous, and People of Color) and poor individuals, among both DV defendants and victims. Therefore, feminist support for anti-carceral/abolitionist feminism, recognizing the cooptation of feminist ideals within a neoliberal CLS system, has grown. Colonial policing, however, has only tangentially been applied to DV (and other gender-based abuse offenses’) CLS responses. This article advocates for significant changes to policing DV.
Yarn on yarn abrasion performance of high modulus polyethylene fiber improved by graphene/polyurethane composites coating
Authors: Ning Fanggang , He Guifang , Sheng Chunfu , He Hongwei , Wang Jian , Zhou Rong , Ning Xin
Published: January 2021

As a high-performance fiber, high modulus polyethylene fiber (HMPE) has been widely used in the rope industry. However, due to its low melting point and poor thermal conductivity, it tends to break under the conditions of repeated yarn on yarn abrasion during tension-tension fatigue or tension-bending fatigue. This paper puts forward a method to improve the yarn on yarn abrasion performance of HMPE using a functional graphene/polyurethane composites coating (FG/PU) and discussed the influence of yarn tension, abrasion frequency on the yarn on yarn performance. Based on the yarn morphology and abrasion temperature observation, the failure mechanism was discussed. The experimental results show that the FG/PU coating obtained can improve the yarn on yarn abrasion performance obviously, especially in the case of high-frequency and large tension condition.
Methods for improving the accuracy of CIE tristimulus values of object color by calculation Part II: Improvement on measurement wavelength ranges
Authors: Hongying Yang , Jingjing Zhang , Zhihui Yang , Jinli Zhou , Wanzi Xie , Shizhong Cui
Published: January 2021

The previous paper (part I) analyzed test errors of the spectrophotometer and their reasons, then systematically investigated the algorithms to reduce measuring bandpass error and intervals error. This paper (part II) focuses on the influence of measurement wavelength ranges and their truncation errors, and some algorithms to overcome the truncation errors. CIE recommends that tristimulus values are calculated over a range of 360–830 nm. However, most spectrophotometers do not meet it. The reduction of measurement range will result in a measurement range error or a truncation error. In this study, five ranges commonly employed in practice are selected for investigating the truncation errors, and three extrapolation methods are used to extend the data to compensate for the measurement range loss. Results are obtained by employing 1301 Munsell color chips under illuminant D65 and CIE 1964 standard observer. For the standard 1-nm intervals, the narrower the range, the larger the truncation error. For the usual-measured 10-nm intervals, bandpass error and intervals error should be handled at the same time, 380–780 nm Table LWL gives the highest accurate outcomes, which even improve the accuracy of the range 360–750 nm to an acceptable level. Whereas, ranges of 360–700 nm and 400–700 nm still need extrapolation to reduce their truncation errors even with Table LWL. Three extrapolation methods of nearest, linear and second-order all reduce the truncation error, but for different ranges, algorithms and illuminants, the optimal method of extrapolation varies.
Endovascular electrothrombosis: A promising alternative for basilar artery perforator aneurysm treatment
Authors: Ma Hongyu , Zhao Rui , Fang Yibin , Li Qiang , Yang Pengfei , Huang Qinghai , Xu Yi , Hong Bo , Liu Jian-Min
Published: January 2021

Background

Basilar artery perforator aneurysms (BAPAs) are rare. Traditional surgical clipping and endovascular coiling have proven to be challenging. We present three patients treated with endovascular electrothrombosis and describe the characteristics of this new approach.

Methods

Three patients presented with subarachnoid hemorrhages (SAHs). Cerebral angiography identified BAPAs. Endovascular electrothrombosis was performed after obtaining informed consent. We placed the microwire into the sac of the aneurysms through the microcatheter and connected its proximal tip to the Solitaire stent detachment system. Electrothrombosis was conducted using 1.0 mA current.

Results

Two aneurysms were successfully occluded without treatment-related complication. The third one failed and converted to endovascular coiling using a 1.3-F microcatheter. The patient suffered brainstem infarction and finally died of severe SAH. At follow-up, the two patients were neurologically intact and angiography showed total occlusion of both aneurysms.

Conclusion

Endovascular electrothrombosis might be a potential alternative to traditional treatment for BAPAs. Close follow-up with caution should be mandatory. More research is needed to confirm its safety and efficacy.
Vessel wall MRI in ruptured cranial dural arteriovenous fistulas
Authors: Cord Branden J , Renedo Daniela , Santarosa Corrado , Sujijantarat Nanthiya , Antonios Joseph , Kim Jennifer A , Falcone Guido J , Sheth Kevin N , Malhotra Ajay , Matouk Charles C
Published: January 2021

Intracranial high-resolution vessel wall MRI (VW-MRI) is an imaging paradigm that is useful in site-of-rupture identification in patients presenting with spontaneous subarachnoid hemorrhage and multiple intracranial aneurysms. Only a handful of case reports describe its potential utility in the evaluation of more complex brain vascular malformations. We report for the first time three patients with ruptured cranial dural arteriovenous fistulas (dAVFs) that were evaluated with high-resolution VW-MRI. The presumed site-of-rupture was identified based on contiguity of a venous ectasia with adjacent blood products and thick, concentric wall enhancement. This preliminary experience suggests a role for high-resolution VW-MRI in the evaluation of ruptured cranial dAVFs, in particular, site-of-rupture identification. It also supports an emerging hypothesis that all spontaneously ruptured, macrovascular lesions demonstrate avid vessel wall enhancement.
Free vibration for a micro resonant pressure sensor with cross-type resonator
Authors: Han Guang , Fu Xiaorui , Xu Lizhong
Published: January 2021

In this paper, a cross resonator pressure sensor is proposed to improve the detection accuracy of capacitor-detecting sensor. Considering electrostatic force and molecular force, the multi-field coupled dynamic equation of the sensor is established. By solving the dynamic equation, the equations for the mode function and the natural frequencies of the resonator are obtained. Using these equations, the natural frequency and mode function of the sensor are given. Changes of natural frequency of sensor with main parameters are studied. Influence of molecular force on the natural frequency is analyzed. Results show that within a considerable range of pressure, the natural frequencies increase approximately linearly with pressure. Under small pressure, small initial distance between resonator and base, and lower order modes, effects of the Van der Waals force on the natural frequencies are quite obvious.
Testing of proposed design of stove-powered thermoelectric generator using natural and forced air cooling
Authors: Murčinková Zuzana , Kosturák Marek , Ferenc Jozef
Published: January 2021

This paper presents the prototype design, implementation and testing of a thermoelectric generator unusually applied to the fireplace stoves. The tested low-cost thermoelectric generator can be used as an alternative low source of electricity in areas with limited access to public electricity networks. Moreover, inclusion of a thermoelectric generator in the fireplace stove structure is novelty and interesting accessory in offer for customer. This study focuses on testing and determining the output values of voltage and current of the initial design using the natural and forces air cooling. The results are obtained by developed measuring device for that testing. The low-cost thermoelectric generator provided the power of 1.5 W at temperature difference 94°C using forced air cooling. Thus a thermoelectric generator prototype design is suitable for powering LED lighting and fans or recharging a mobile phone battery.
Analysis of hygrothermal performance of low-energy house in Nordic climate
Authors: Fedorik Filip , Alitalo Sanna , Savolainen Jukka-Pekka , Räinä Ilkka , Illikainen Kimmo
Published: January 2021

Analyses of hygrothermal conditions in low-energy houses is important because of their likely sensitivity for excessive moisture. The presented work deals with real-time measurement of temperature and relative humidity at multiple locations inside a low-energy house envelope. The measured data allows diagnosing approaches towards building design and understanding and evaluating the house performance. Suitability and accuracy of numerical computation was analysed. The Finnish mould growth model was used to monitor risk and extent of mould growth under measured and computed conditions. The measured conditions represent more favourable environment to avoid mould growth than the design values recommended by national and international guidelines. There was no mould growth indicated at any monitored points of the envelope. Monitoring the hygrothermal conditions provides valuable information about the performance of structural elements, building material and the house envelope and it helps to predict moisture related risks during the building’s service life.
Quo Vadis, Methodology? The Key Role of Manipulation Checks for Validity Control and Quality of Science
Authors: Fiedler Klaus , McCaughey Linda , Prager Johannes
Published: January 2021

The current debate about how to improve the quality of psychological science revolves, almost exclusively, around the subordinate level of statistical significance testing. In contrast, research design and strict theorizing, which are superordinate to statistics in the methods hierarchy, are sorely neglected. The present article is devoted to the key role assigned to manipulation checks (MCs) for scientific quality control. MCs not only afford a critical test of the premises of hypothesis testing but also (a) prompt clever research design and validity control, (b) carry over to refined theorizing, and (c) have important implications for other facets of methodology, such as replication science. On the basis of an analysis of the reality of MCs reported in current issues of the Journal of Personality and Social Psychology, we propose a future methodology for the post– p < .05 era that replaces scrutiny in significance testing with refined validity control and diagnostic research designs.
Previously reward-associated sounds interfere with goal-directed auditory processing
Authors: Kim Andy J , Lee David S , Anderson Brian A
Published: January 2021

Previously reward-associated stimuli have consistently been shown to involuntarily capture attention in the visual domain. Although previously reward-associated but currently task-irrelevant sounds have also been shown to interfere with visual processing, it remains unclear whether such stimuli can interfere with the processing of task-relevant auditory information. To address this question, we modified a dichotic listening task to measure interference from task-irrelevant but previously reward-associated sounds. In a training phase, participants were simultaneously presented with a spoken letter and number in different auditory streams and learned to associate the correct identification of each of three letters with high, low, and no monetary reward, respectively. In a subsequent test phase, participants were again presented with the same auditory stimuli but were instead instructed to report the number while ignoring spoken letters. In both the training and test phases, response time measures demonstrated that attention was biased in favour of the auditory stimulus associated with high value. Our findings demonstrate that attention can be biased towards learned reward cues in the auditory domain, interfering with goal-directed auditory processing.
Triglyceride-glucose index is associated with early neurological deterioration in single subcortical infarction: Early prognosis in single subcortical infarctions
Authors: Nam Ki-Woong , Kang Min K , Jeong Han-Yeong , Kim Tae J , Lee Eung-Joon , Bae Jeonghoon , Jeon Kipyoung , Jung Keun-Hwa , Ko Sang-Bae , Yoon Byung-Woo
Published: January 2021

Background

The research about the influence of triglyceride-glucose index on early prognosis in stroke is lacking.

Aims

In this study, we evaluated the association between triglyceride-glucose index and early neurological deterioration in patients with single subcortical infarctions.

Methods

Consecutive patients with single subcortical infarctions within 72 h of symptom onset between 2011 and 2015. Early neurological deterioration was defined as an increase of ≥2 in the total NIHSS score or ≥1 in the motor NIHSS score. The triglyceride-glucose index was calculated using the log scale of fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2.

Results

A total of 305 patients with single subcortical infarctions were evaluated. In multivariable analysis, the triglyceride-glucose index (adjusted odds ratio [aOR] = 2.94, 95% confidence interval [CI] = 1.58–5.45) and age (aOR = 1.05, 95% CI = 1.01–1.09) were associated with early neurological deterioration. In subgroup analysis according to the type of single subcortical infarctions, only patients with proximal single subcortical infarctions showed a significant association between the triglyceride-glucose index and early neurological deterioration (aOR = 2.92, 95% CI = 1.35–6.29). On the other hand, there was no statistical significance in patients with distal single subcortical infarctions. Patients with untreated diabetes also showed the close association between the triglyceride-glucose index and early neurological deterioration (aOR = 3.94, 95% CI = 1.47–10.52).

Conclusions

The triglyceride-glucose index was associated with early neurological deterioration in single subcortical infarctions. This association differed depending on the location of lesion and the presence of untreated diabetes.
Effects of implementing rotational thromboelastometry in cardiac surgery: A retrospective cohort study
Authors: Kallioinen Minna , Valtonen Mika , Peltoniemi Marko , Hynninen Ville-Veikko , Saarikoski Tuukka , Söderholm Oki , Kauko Tommi , Aittokallio Jenni
Published: January 2021

Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac surgery patients. Altogether 177 patients from 2012 and 177 patients from 2014 were included. In 2014, the thromboelastometry testing was performed on 56 patients. The mean blood drainage volume decreased and the number of patients receiving platelets decreased between 2012 and 2014. In addition, the use of fresh frozen plasma units decreased, and the use of prothrombin complex concentrate increased in 2014. When studied separately, the patients with a thromboelastometry testing received platelets, fresh frozen plasma, fibrinogen and prothrombin complex concentrate more often, but smaller amounts of red blood cells. In conclusion, after implementing the thromboelastometry testing to the practice, the blood products were given more cautiously overall. The use of thromboelastometry testing was associated with increased possibility to receive coagulation product transfusions. However, it appears that thromboelastometry testing was mostly used to assist in management of major bleeding.
Outcomes of 173 metacarpal and phalangeal fractures treated by intramedullary headless screw fixation with a 4-year follow-up
Authors: Poggetti Andrea , Fagetti Alessandro , Lauri Giulio , Cherubino Mario , Borelli Pier P. , Pfanner Sandra
Published: January 2021

Surgical treatment of extra-articular metacarpal and phalangeal fractures should be considered when there is instability or in patients with high demand. To overcome the issues related to the use of Kirschner wires, external fixators, and open reduction and internal fixation procedures, intramedullary headless screw fixation (IHSF) is an alternative technique to achieve primary fracture stability and early return to daily activities. We report the data of the Italian Multicentric Intra-Medullary Experience, which includes 173 cases of extra-articular unstable fractures (38 phalanges and 135 metacarpals) treated with the IHSF. After surgery, patients underwent early mobilization without splinting. The results confirm the reliability of IHSF in cases with non-articular involvement, showing a good recovery rate in terms of bone healing and range of motion.

Level of evidence: IV
Depression in adults
Authors: Norman Claire , Fotheringham Lachlan
Published: January 2021

Depression is a persistent state of low mood, low energy or anhedonia and is considered a common mental disorder. It is associated with a wide range of significant emotional, psychological and physical symptoms. It can have a significant impact on people’s functioning, and mental ill health is estimated to cost the UK economy £94 billion per year. An estimated 40% of GP consultations are about mental health, and it is important that depression is appropriately diagnosed and managed. This article reviews the most recent National Institute for Health and Care Excellence guidelines and also gives special consideration to managing depression alongside physical comorbidities and in patients from different cultures.
Real-world comparative safety and efficacy of tenecteplase versus alteplase in acute ischemic stroke patients with large vessel occlusion
Authors: Psychogios Klearchos , Palaiodimou Lina , Katsanos Aristeidis H. , Magoufis Georgios , Safouris Apostolos , Kargiotis Odysseas , Spiliopoulos Stavros , Papageorgiou Ermioni , Theodorou Aikaterini , Voumvourakis Konstantinos , Broutzos Elias , Stamboulis Elefterios , Tsivgoulis Georgios
Published: January 2021

Background and aims:

Tenecteplase has recently emerged as an alternative thrombolytic agent in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO), possibly superior in achieving early reperfusion compared with alteplase. We aimed to compare the safety and efficacy of intravenous tenecteplase with intravenous alteplase for AIS patients with LVO in everyday clinical practice settings.

Methods:

We prospectively evaluated patients with AIS due to LVO, treated with intravenous thrombolysis (IVT) with or without mechanical thrombectomy in two tertiary stroke centers. Patients were treated with standard-dose alteplase (0.9 mg/kg) or 0.25 mg/kg tenecteplase. Safety outcomes included prevalence of symptomatic intracranial hemorrhage (sICH) and mortality. Efficacy outcomes included averted thrombectomy, major neurological improvement at 24 h (defined as decrease in baseline NIHSS score of 8 points or greater) and functional status on discharge and on 3 months assessed by modified Rankin Scale (mRS).

Results:

Nineteen AIS patients with LVO received tenecteplase and 39 received alteplase. We observed a non-significant higher rate of averted thrombectomies (32% versus 18%, p = 0.243) and a non-significant higher rate of sICH (16% versus 5%, p = 0.201) in the tenecteplase group. The rate of 24 h major neurological improvement was higher in the tenecteplase group (64% versus 33%, p = 0.046) but this was marginally attenuated in multivariable analyses (adjusted OR 10.22, 95% CI: 0.73–142.98; p = 0.084). Discharge mRS, 3-months mRS, and 3-month functional independence (mRS scores of 0–2) did not differ ( p > 0.2) between the two groups. The rates of 3-month mortality (11% versus 18%, p = 0.703) were similar in the two groups. No independent association between thrombolytic agent and safety or efficacy outcomes emerged in multivariable regression analyses.

Conclusion:

The present pilot observational study highlights that AIS patients with LVO treated with 0.25 mg/kg bolus administration of tenecteplase had increased likelihood to achieve early neurological improvement compared with AIS patients treated with alteplase, but this association was attenuated after adjustment for potential confounders. There were no significant differences in 3-month functional or safety outcomes between the two groups. This preliminary real-world observation requires independent confirmation in larger, multicenter studies.
The role of ixekizumab in non-radiographic axial spondyloarthritis
Authors: San Koo Bon , Kim Tae-Hwan
Published: January 2021

Among patients with axial spondyloarthritis (axSpA), non-radiographic axial spondyloarthritis (nr-axSpA) is distinguished from ankylosing spondylitis (AS) by a lack of obvious radiographic changes in the sacroiliac joint. Tumor necrosis factor inhibitor (TNFi) has been used as a highly effective treatment in patients with AS and has shown good efficacy and safety in clinical trials in patients with nr-axSpA. As the pathophysiological mechanism for axSpA has started to become better recognized, various drugs other than TNFi, all of which are related to the interleukin-17 (IL-17) axis, are being evaluated in patients with axSpA. IL-17 inhibitors, such as secukinumab and ixekizumab, are effective drugs for patients with AS. A recent clinical trial reported that ixekizumab, a monoclonal antibody against IL-17A, was also effective in patients with nr-axSpA. In a COAST-X study, ixekizumab was superior to a placebo for improving signs and symptoms in patients with nr-axSpA at weeks 16 and 52. The adverse events were no different from those found in previous ixekizumab studies, and no new safety signals were identified. However, when considering several IL-17 inhibitors, it is necessary to obtain sufficient data to identify the exacerbation of extra-articular manifestation. In terms of effectiveness and safety, ixekizumab may be an appropriate alternative to TNFi in nr-axSpA patients.
An Interactive Web Application for the Statistical Analysis of Continuous Glucose Monitoring Data in Epidemiological Studies
Authors: De Livera Alysha M. , Shaw Jonathan E. , Cohen Neale , Reutens Anne , Salim Agus
Published: January 2021

Motivation:

Continuous glucose monitoring (CGM) systems are an essential part of novel technology in diabetes management and care. CGM studies have become increasingly popular among researchers, healthcare professionals, and people with diabetes due to the large amount of useful information that can be collected using CGM systems. The analysis of the data from these studies for research purposes, however, remains a challenge due to the characteristics and large volume of the data.

Results:

Currently, there are no publicly available interactive software applications that can perform statistical analyses and visualization of data from CGM studies. With the rapidly increasing popularity of CGM studies, such an application is becoming necessary for anyone who works with these large CGM datasets, in particular for those with little background in programming or statistics. CGMStatsAnalyser is a publicly available, user-friendly, web-based application, which can be used to interactively visualize, summarize, and statistically analyze voluminous and complex CGM datasets together with the subject characteristics with ease.
Polygokingiasides A and B: Two New Spirostane Glycosides From the Roots of Polygonatum kingianum With Nitric Oxide Inhibitory Activity
Authors: Ha Tran Thi Thu , Huy Trinh Quang , Chinh Pham The , Van Kiem Phan
Published: January 2021

Two new spirostane glycosides, named polygokingiaside A (1) and polygokingiaside B (2), and 6 known spirostane glycosides, (25 R)-26- O-( β-d-glucopyranosyl)-furost-5-en-3 β,22 α,26-triol 3- O-β-d-glucopyranosyl-(1→4)- β-d-galactopyranoside (3), (25 S)-26- O-( β-d-glucopyranosyl)-furost-5-en-3 β,22 α,26-triol 3- O-β-d-glucopyranosyl-(1→2)- β-d-glucopyranosyl-(1→4)- β-d-galactopyranoside (4), (25 R)-26- O-( β-d-glucopyranosyl)-furost-5-en-3 β,22 α,26-triol 3- O-β-d-glucopyranosyl-(1→2)- β-d-glucopyranosyl-(1→4)- β-d-galactopyranoside (5), (23 S,25 R)-spirostan-5-en-3 β,23-dihydroxy-12-one-3- O-β-d-glucopyranosyl-(1→2)- β-d-glucopyranosyl-(1→4)- β-d-galactopyranoside (6), (24 S,25 R)-spirostan-5-en-3 β,24-dihydroxy-12-one-3- O-β-d-glucopyranosyl-(1→2)- β-d-glucopyranosyl-(1→4)- β-d-galactopyranoside (7), and (25 R)-spirostan-5-en-3 β-hydroxy-12-one-3- O-β-d-glucopyranosyl-(1→4)- β-d-galactopyranoside (8), were isolated from the roots of Polygonatum kingianum Collett & Hemsl. (Asparagaceae). Their structures were determined by extensive analysis of high-resolution electron spray ionization mass spectrometry and nuclear magnetic resonance spectral data, as well as by comparison of the spectral data with those reported in the literature. Anti-inflammatory activity of compounds 1-8 was evaluated by their inhibition of nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. At a concentration of 20 µM, compounds 1-8 exhibited a modest inhibitory effect on NO production in LPS-stimulated RAW246.7 cells with inhibitory values ranging from 9.5 ± 0.8% to 33.8 ± 2.1%.
Chemical Composition, Antimicrobial, and Cytotoxic Activities of Leaf, Fruit, and Branch Essential Oils Obtained From Zanthoxylum nitidum Grown in Vietnam
Authors: Tuyen Tran Thi , Quan Pham Minh , Thu Le Vu Thi , Toan Tran Quoc , Nghi Do Huu , Bach Pham Cao , Inh Cam Thi , Hanh Nguyen Phuong , Vien Trinh Anh , Hong Minh Pham Thi , Long Pham Quoc , Khoi Nguyen Nguyen Hong , Thuy Dung Pham Nguyen , Hong Van Nguyen Thi
Published: January 2021

Zanthoxylum nitidum (Roxb.) DC is a traditional Vietnamese medicine to treat coughs, stomachache, toothache, blood stagnation, and sore throats. The essential oils (EOs) of the leaves, fruits, and stems of this plant were extracted by hydrodistillation and subjected to analysis by gas chromatography (GC)-flame ionization detector (FID) and GC-mass spectrometry (MS). The isolated EOs were then evaluated in terms of their antimicrobial activity by minimum inhibitory concentration (MIC) assay and in vitro cytotoxic effect against 5 human tumor cell lines. GC-MS-FID analysis showed 35, 32, and 25 compounds accounting for 97.6%, 91.7%, and 96.2% of the total EO contents from the leaves, fruits, and stems, respectively. The major compounds of the leaf EO were limonene (44.3%), β-caryophyllene (12.5%), linalool (11.0%), germacrene D (5.3%), and α-pinene (4.9%); the major compounds of the fruit EO were n-pentadecane (34.8%), sabinene (18.3%), and n-heptadecane (4.7%), and the major components of the stem EO were 2-undecanone (72.3%), β-caryophyllene (5.8%), and germacrene D (4.0%). The EOs of leaves, fruits, and stems of Z. nitidum exhibited antibacterial activity against Bacillus subtilis, Escherichia coli, and Fusarium oxysporum with MIC values of 100 µg/mL. The leaf and branch EOs exhibited cytotoxic activity against all tested cancer cell lines, especially A-549 and HepG-2. Findings from the present study provide important knowledge about the potential uses of Z. nitidum EOs as a natural antibacterial and antitumor agents.
Hallux Varus Correction With Extensor Hallucis Longus Tendon Transfer and Reverse Scarf Osteotomy
Authors: Koh Don Thong Siang , Chong Keen Wai , Yeo Nicholas Eng Meng
Published: January 2021

Introduction

Hallux varus is the medial deviation of the hallux. Although rare, it can cause discomfort, functional weakness, difficulty with shoe wear, and dissatisfactory cosmesis. This study reports 3 cases of hallux varus treated using extensor hallucis longus (EHL) tendon transfer with or without the use of reverse scarf osteotomy (RSO).

Methods

This cases series studies the technique of using EHL tendon transfer and the role for RSO in the surgical correction of hallux varus. Indication for RSO included osseous overcorrection in the index hallux valgus surgery or as an adjunct when EHL tendon transfer alone was unable to restore alignment. Patients were followed-up for 24 months and their postoperative outcomes were recorded.

Results

All patients were female between the ages 55 to 67 years. Radiological parameters after surgery improved in all patients. The mean hallux-valgus angle was corrected from −23.7 ± 3.5° to −3.2 ± 2.0° postoperatively ( P < .05). Intermetatarsal angle was increased from 5.0 ± 1.9° to 6.7 ± 1.0° ( P = .065). Distal metatarsal articular angle improved from −28.9 ± 7.6° to −7.8 ± 3.7° ( P < .05). Mean American Orthopaedic Foot and Ankle Society scores improved from 37 ± 24 to 75 ± 9 ( P = .064) at 24 months. In addition, visual analogue scale pain scores reduced from 5 ± 1.5 to 1 ± 1 ( P < .05). All patients reported being satisfied with the procedure, and no complications were reported at 24 months after surgery.

Conclusion

Hallux varus correction using EHL tendon transfer with or without RSO appears to provide satisfactory results at 24 months.

Levels of Evidence

Level V: Expert opinion, Techniques
Relationship Between the Lateral Plantar Artery and the Retrograde Intramedullary Nail During Tibiotalar and Subtalar Arthrodesis: A Fresh Cadaveric Study
Authors: Tonogai Ichiro , Tsuruo Yoshihiro , Sairyo Koichi
Published: January 2021

Background

Tibiotalocalcaneal (TTC) arthrodesis with retrograde intramedullary nailing has become established. Iatrogenic injury to the vasculature (eg, lateral plantar artery [LPA] pseudoaneurysm) during insertion of the nail has been reported. The aim of this study was to identify the safe zone that avoids injury to the LPA during TTC arthrodesis.

Methods

The retrograde lateral curved nail entry point should be in line with the midpoint of the tibial medullary canal and the lateral column of the calcaneus. Enhanced 3-dimensional computed tomography scans of 26 fresh cadaveric feet were assessed. The closest distance between the LPA and the edge of the nail entry point was measured in the plantar view.

Results

The closest mean distance between the LPA and the edge of the nail entry point was 6.7 mm for all 26 feet, 12.8 mm for 3 feet (11.5%) in which the LPA did not cross the medial wall of the calcaneus, 8.1 mm for 9 (34.1%) in which the point where the LPA crossed the medial wall of the calcaneus was anterior to the center of the nail entry point, and 4.2 mm for 14 (53.8%) feet in which this point was posterior to the center of the nail entry point.

Conclusions

Care should be taken to avoid the LPA during reaming at the nail entry point, especially when the point where the LPA crosses the medial wall of the calcaneus is posterior to the center of the nail entry point.

Levels of Evidence:

IV, cadaveric study
Early Hydromyelia as a Rare Complication of Tuberculous Meningitis
Authors: Ghavami Kimia , Chen Tychicus
Published: January 2021

Syringomyelia is an uncommon late complication of tuberculous meningitis with a latency period of up to 18 years. Acute hydromyelia is exceedingly rare with few case reports occuring within the first 6 weeks. We present a case and magnetic resonance imaging of a 38-year-old immunocompetent woman with this rare complication of early hydromyelia due to tuberculous meningitis which responded to ventriculoperitoneal shunting, highlighting that early detection and treatment may improve prognosis.
Infrapatellar Fat Pads–Derived Stem Cell Is a Favorable Cell Source for Articular Cartilage Tissue Engineering: An In Vitro and Ex Vivo Study Based on 3D Organized Self-Assembled Biomimetic Scaffold
Authors: Wang Chen-Chie , Chen Ing-Ho , Yang Ya-Ting , Chen Yi-Ru , Yang Kai-Chiang
Published: January 2021

Objective

Adipose tissue–derived stem cells (ASCs) are a promising source of cells for articular cartilage regeneration. However, ASCs isolated from different adipose tissue depots have heterogeneous cell characterizations and differentiation potential when cultured in 3-dimensional (3D) niches.

Design

We compared the chondrogenicity of ASCs isolated from infrapatellar fat pads (IPFPs) and subcutaneous fat pads (SCFPs) in 3D gelatin-based biomimetic matrix.

Results

The IPFP-ASC-differentiated chondrocytes had higher ACAN, COL2A1, COL10, SOX6, SOX9, ChM-1, and MIA-3 mRNA levels and lower COL1A1 and VEGF levels than the SCFP-ASCs in 3D matrix. The difference in mRNA profile may have contributed to activation of the Akt, p38, RhoA, and JNK signaling pathways in the IPFP-ASCs. The chondrocytes differentiated from IPFP-ASCs had pronounced glycosaminoglycan and collagen type II production and a high chondroitin-6-sulfate/chondroitin-4-sulfate ratio with less polymerization of β-actin filaments. In an ex vivo mice model, magnetic resonance imaging revealed a shorter T2 relaxation time, indicating that more abundant extracellular matrix was secreted in the IPFP-ASC–matrix group. Histological examinations revealed that the IPFP-ASC matrix had higher chondrogenic efficacy of new cartilaginous tissue generation as evident in collagen type II and S-100 staining. Conclusion. ASCs isolated from IPFPs may be better candidates for cartilage regeneration, highlighting the translational potential of cartilage tissue engineering using the IPFP-ASC matrix technique.
Joint Surface Lesions in the Knee Treated with an Acellular Aragonite-Based Scaffold: A 3-Year Follow-Up Case Series
Authors: Van Genechten Wouter , Vuylsteke Kristien , Struijk Caroline , Swinnen Linus , Verdonk Peter
Published: January 2021

Objective

The study aimed to evaluate the clinical outcome and repair capacity of a cell-free aragonite-based scaffold in patients with an isolated symptomatic joint surface lesion (JSL) of the knee.

Design

Thirteen patients (age 33.5 ± 8.9; female 23%; body mass index 25.3 ± 3.4, K/L [Kellgren-Lawrence] 1.8) with a JSL (2.6 ± 1.7 cm2 [1.0-7.5 cm2]) of the distal femur were enrolled in a single-center prospective case series. Safety and clinical outcome was assessed by the KOOS (Knee Injury and Osteoarthritis Outcome Score), IKDC (International Knee Documentation Committee), Lysholm, and Tegner activity scale at baseline and 6, 12, 18, 24, and 36 months follow-up. The MOCART 2.0 and scaffold integration were evaluated on magnetic resonance imaging at 12, 24, and 36 months postoperatively.

Results

Primary outcome (KOOS pain) improved with 36.5 ± 14.7 points at 12 months ( P = 0.002) and 41.2 ± 14.7 points at 36 months ( P = 0.002) follow-up. Similar increasing trends were observed for the other KOOS subscales, IKDC, and Lysholm score, which were significantly better at each follow-up time point relative to baseline ( P < 0.05). Activity level increased from 2.75 ± 1.6 to 4.6 ± 2.2 points at final follow-up ( P = 0.07). The MOCART was 61.7 ± 12.6 at 12 months and 72.9 ± 13.0 at 36 months postoperatively. Sixty-six to 100% implant integration and remodeling was observed in 73.3% cases at 36 months. No serious adverse events were reported.

Conclusion

The study demonstrated that the biphasic aragonite-based scaffold is a safe and clinically effective implant for treating small-medium sized JSLs of the distal femur in a young and active patient cohort. The implant showed satisfying osteointegration and restoration of the osteochondral unit up to 3 years postimplantation.
Is There Anything Good About Atheists? Exploring Positive and Negative Stereotypes of the Religious and Nonreligious
Authors: Moon Jordan W. , Krems Jaimie Arona , Cohen Adam B.
Published: January 2021

Negative stereotypes about atheists are widespread, robust, rooted in distrust, and linked to discrimination. Here, we examine whether social perceivers in the United States might additionally hold any positive stereotypes about atheists (and corresponding negative stereotypes of the religious). Experiments 1 ( N = 401) and 2 ( N = 398, preregistered) used methods of intuitive stereotypes (the conjunction fallacy). People tended to stereotype atheists as fun, open-minded, and scientific—even as they harbor extreme intuitive anti-atheist prejudice in Experiment 2. Experiment 3 ( N = 382) used a quasi-behavioral partner-choice paradigm, finding that most people choose atheist (vs. religious) partners in stereotype-relevant domains. Overall, results suggest that people simultaneously possess negative and also positive stereotypes about atheists, but that corresponding negative stereotypes of the religious may be even stronger. These effects are robust among the nonreligious and somewhat religious, but evidence is mixed about whether the highly religious harbor these positive stereotypes.
Knowledge and attitudes of Vietnamese high school students towards cardiopulmonary resuscitation: Results from a pilot student-led cross-country bystander training workshop
Authors: Yeow Marcus Wei Xuan , Ng Julia Yu Xin , Nguyen Van Hinh , Quan Anh Dung , Le Huyen Trang , Nguyen Thi Nga , Le Anh Tuan , Li Zisheng , Tang Jonathan Zhe Ying , Koh Dow Rhoon , Hwang Jeff Yi-Fu
Published: January 2021

Objectives:

This is a first-of-its-kind cross-country collaboration between medical students from Singapore and Vietnam in conducting a cardiopulmonary resuscitation (CPR) workshop for Vietnamese high school students. Our objective was to assess the effectiveness of CPR training in improving students’ knowledge and attitudes towards CPR.

Methods:

The CPR workshop was conducted using active learning methods, including interactive lecture session, games, small group demonstration and hands-on practice on the mannequin. Knowledge and attitudes towards CPR were studied using a standardised questionnaire administered at three time points: before the workshop (TP1), immediately after the workshop (TP2) and three months after the workshop (TP3).

Results:

There was an improvement in the median knowledge score from 6.5/14 at TP1 to 13/14 at TP2 ( p<0.001) which was sustained at TP3 (10/14). Willingness and confidence in performing CPR on strangers increased from TP1 to TP2. From TP2 to TP3, however, there was a decrease in willingness to perform CPR on all groups, though confidence in performing CPR remained high at TP3. The most-cited concern about performing CPR was a lack of skills and knowledge. Most participants picked formal training courses to increase confidence in performing CPR.

Conclusions:

The CPR training was effective in improving the knowledge and attitudes of high school students towards CPR. Our study supports expanding this workshop to train more students in basic cardiac life support in the community and further collaboration internationally between medical schools in order to increase the number of students in the community competent in performing CPR.
Treatment options for lower-risk myelodysplastic syndromes. Where are we now?
Authors: Volpe Virginia O. , Komrokji Rami S.
Published: January 2021

Myelodysplastic syndromes (MDS) are a spectrum of clonal stem-cell disorders characterized clinically by bone-marrow failure. Resultant cytopenias are responsible for significant mortality and decreased quality of life in patients with MDS. In patients with low-risk MDS (LR-MDS), anemia is the most common cytopenia and erythropoiesis-stimulating agents (ESA) are usually used as first-line therapy. Those patients who become refractory to ESA have a poor survival. Available treatment options such as lenalidomide, hypomethylating agents, and immunosuppressive therapy can provide some hematologic response among selected subsets of patients, however durable responses are limited, and these agents can carry significant adverse effects. Chronic transfusions help to alleviate symptoms of anemia but still carry risks associated with transfusion and iron overload. Luspatercept, recently approved for those LR-MDS with ring sideroblasts refractory to ESA, was found to have an improvement in transfusion independence with a well-tolerated safety profile. While anemia is the most common cytopenia, thrombocytopenia and neutropenia management is challenging and the co-occurrence of these cytopenias with anemia may dictate the choice of therapy. In this article, we review LR-MDS and discuss the optimal use of current treatment options and explore new therapeutic options on the horizon.
Double hiddenness: Governmentality and subjectivization in Gelug Buddhism
Authors: Forman Jed
Published: January 2021

Tibetan Buddhism, the Gelug school specifically, promotes a deep skepticism about the ability to know others’ minds. Its scripture is rife with cautionary tales allegorizing and extolling this skepticism in adherents, while claiming a buddha, by contrast, has eradicated this skepticism with their omniscience. I describe a buddha’s purported privileged epistemic access to others’ minds as “double-hiddenness.” On this skepticism, not just what a buddha knows, but if they know it is hidden, making their authority irreputable. I use critical theory to investigate the ramifications of this double hiddenness, demonstrating that the resultant subjectivization brought about by this extreme skepticism—although the product of power—is not merely a type of subjugation, as suggested by Foucault, but also constitutes a robust agency.
Risk assessment of preterm birth through identification and stratification of pregnancies using a real-time scoring algorithm
Authors: Shields Lisa BE , Weymouth Clayton , Bramer Kevin L , Robinson Scott , McGee Donna , Richards Lori , Ogle Corey , Shields Christopher B
Published: January 2021

Introduction:

Preterm birth poses a significant challenge. This study evaluated a real-time scoring algorithm to identify and stratify pregnancies to indicate preterm birth.

Methods:

All claims data of pregnant women were reviewed between 1 January 2014 and 31 October 2018 in Kentucky.

Results:

A total of 29,166 unique women who were matched to a live newborn were documented, with the pregnancy identified during the first trimester in 54.1% of women. Negative predictive values, sensitivity, and positive likelihood ratios increased from the first to third trimesters as pregnant women who were matched to a live newborn had more visits with their physicians. The area under the receiving-operating characteristics curve on test data classifying preterm birth was 0.59 for pregnancies identified during the first trimester, 0.62 for pregnancies identified in the second trimester, and 0.73 for pregnancies identified in the third trimester.

Conclusions:

This study presents a real-time scoring algorithm of indicating preterm birth in the first trimester of gestation which permits stratification of pregnancies to provide more efficient early care management.