bluuebunny/crossref_metadata_2025 huggingface dataset:
Lower- and higher-order aberrations after photorefractive keratectomy with and without compensation of pupil centroid shift: fellow eye comparison
Authors: Faramarzi Amir , Hassanpour Kiana , Yazdani Shahin , Moshirfar Majid
Published: January 2020

Purpose:

To study the effect of pupil centroid shift (PCS) compensation on lower- and higher-order aberrations (HOAs) after photorefractive keratectomy (PRK).

Setting:

Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Design:

Prospective intrasubject fellow eye study.

Methods:

One hundred twelve eyes of 56 patients with simple myopia or myopic astigmatism scheduled for PRK were enrolled. Preoperatively, the amount of PCS was measured in the horizontal and vertical directions. All eyes received wavefront-optimized treatment with static cyclotorsion compensation. PCS compensation was turned on for the right eye of each subject (PCS-on group), and turned off for the left eye (PCS-off group). Postoperatively, refraction and corneal HOAs were compared between the study groups at 6 months.

Results:

Mean preoperative myopia was −3.84 diopters (D) ± 2.41 (SD) vs −3.75 ± 2.27 D (P = .408), whereas mean preoperative cylinder was −1.18 D ± 1.15 (SD) vs −1.14 ± 1.16 D (P = .769) in the PCS-on and PCS-off groups, respectively. Mean absolute PCS values were 62.25 μm ± 41.82 (SD) vs 55.92 ± 37.47 μm (P = .45) in the horizontal direction and 65.04 ± 47.16 μm vs 58.40 ± 45.44 μm in the vertical direction (P = .29) in the PCS-on and PCS-off groups, respectively. The study groups were comparable in terms of postoperative refraction and root mean square of total corneal HOAs.

Conclusions:

Compensation of PCS did not affect lower- and higher-order aberrations after wavefront-optimized PRK with static cyclotorsion compensation in myopic or myopic astigmatic eyes.
Sex Differences in Prodromal Symptoms and Individual Responses to Acute Coronary Syndrome
Authors: Shi Hongling , Li Wentao , Zhou Xiaohua , Liu Xin , Liu Ju , Fan Shuqin , Wang Huina , An Libin
Published: January 2020

Background

Although researchers have shown that prodromal symptoms can predict acute coronary events, the ability of patients with acute coronary syndrome (ACS) to identify these symptoms in a timely manner is limited.

Objectives

We aimed to assess prodromal symptoms in Chinese patients with ACS and their responses to symptoms by sex.

Design

This cross-sectional, multicenter study involved 5 teaching hospitals in China and included 806 patients admitted for ACS between June 2013 and February 2014. The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (Chinese version) was used to gather data.

Results

Among 806 patients (including 483 women), 688 (85.4%) experienced at least 1 prodromal symptom before ACS onset. Using adjusted logistic regression models, we determined that women were significantly more likely than men to report back pain, between– or under–shoulder blade pain/discomfort, sleep disturbances, anxiousness, or heart racing. The prevalence of generalized chest pain and loss of appetite was higher among men than women. Only 41% of patients attributed their prodromal symptoms to the heart, and women were more likely than men to attribute prodromal symptoms to a heart attack.

Conclusions

More than two-thirds of patients with ACS reported at least 1 prodromal symptom, with some significant sex differences. Most patients do not attribute their symptoms to an impending ACS event.
A contemporary evidence basis for neoadjuvant chemotherapy in upfront resectable pancreatic adenocarcinoma: a systematic review of the literature
Authors: Stonko David P. , He Jin , Zheng Lei , Blair Alex B.
Published: January 2020

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with poor survival. Local control through surgical resection paired with radiotherapy and chemotherapy comprise the primary tenets of treatment. Debate exists regarding the timing of treatment and ordering of systemic therapy and resection in the management of early stage disease. The goal of this study was to review the literature and describe the contemporary evidence basis for the role of neoadjuvant therapy (NAT) in the setting of upfront resectable (UP-R) PDAC. Five databases were searched in parallel to identify relevant original articles investigating neoadjuvant therapy where at least 1 study arm contained UP-R PDAC; studies with only borderline resectable or locally advanced disease were excluded. Due to the diversity in NAT regimens and study design between trials, qualitative analyses were performed to investigate patient selection, impact on perioperative and survival outcomes, safety, and cost effectiveness. Thirty-five studies met inclusion criteria, of which 24 unique trials are discussed here in detail. These studies included those trials using single agents as well as more recent trials comparing modern multiagent therapies, and several large database analyses. Overall the data suggest that NAT is safe, may confer survival benefit for appropriately selected patients, is cost effective, and is an appropriate approach for UP-R PDAC. Nevertheless, the risk for disease progression during upfront medical therapy, requires appropriate patient identification and close monitoring, and emphasizes the need for further discovery of more effective chemotherapeutics, useful biomarkers or molecular profiles, and additional prospective comparative studies.
Cellular immune dysregulation in the pathogenesis of immune thrombocytopenia
Authors: Wen Ruiting , Wang Yufeng , Hong Yunguang , Yang Zhigang
Published: January 2020

Immune thrombocytopenia (ITP) is an acquired autoimmune hemorrhagic disease characterized by immune-mediated increased platelet destruction and decreased platelet production, resulting from immune intolerance to autoantigen. The pathogenesis of ITP remains unclear, although dysfunction of T and B lymphocytes has been shown to be involved in the pathogenesis of ITP. More recently, it is found that dendritic cells, natural killer, and myeloid-derived suppressor cells also play an important role in ITP. Elucidating its pathogenesis is expected to provide novel channels for the targeted therapy of ITP. This article will review the role of different immune cells in ITP.
Critical care considerations in the management of acute-on-chronic liver failure
Authors: MacDonald Andrew John , Olson Jody , Karvellas Constantine J.
Published: January 2020

Purpose of review

Patients with cirrhosis are frequently hospitalized with acute decompensation and organ system failure – a syndrome referred to as acute on chronic liver failure (ACLF). These patients often require critical care intervention and experience significant mortality; however, established diagnostic and prognostic criteria are lacking. Given this, it remains imperative for intensivists to develop an expertise in common ACLF complications and management.

Recent findings

Liver transplantation serves as the definitive management strategy in ACLF. Traditional organ allocation procedures are based on the Model for Endstage Liver Disease score, which may not correlate with ACLF severity and the associated need for urgent liver transplantation. Recent studies have suggested favorable postliver transplantation outcomes in ACLF patients with multiorgan failure, emphasizing the need for further studies to elucidate optimal timing and candidacy for liver transplantation.

Cirrhosis is a chronic and progressive condition leaving patients vulnerable to acute decompensation necessitating the need for critical care intervention. Prompt recognition and implementation of targeted supportive therapies, together with consideration of urgent liver transplantation, are essential to combat the high short-term mortality of ACLF patients.
Multiphase abdomen-pelvis CT in women of childbearing potential (WOCBP)
Authors: Al Naemi Huda , Aly Antar , Kharita Mohamad Hassan , Hilli Shatha Al , Al Obadli Amal , Singh Ramandeep , Rehani Madan M. , Kalra Mannudeep K.
Published: January 2020

To assess justification and radiation doses of abdomen-pelvis CT in women of childbearing potential (WOCBP) scanned in 2 tertiary hospitals in Qatar.

The local ethical committee approved retrospective study of 451 WOCBP (14–55 years) who underwent abdomen-pelvis CT examinations. Patients’ age, clinical indications for ordered CT, scanner types and vendors, number and type of scan phases (non-contrast, arterial, portal venous, and/or delayed phases), and radiation dose descriptors (CT dose index volume - CTDIvol and dose length product- DLP) were recorded. Patients undergoing simultaneous chest-abdomen-pelvis CT were excluded. We classified the clinical indications for all 451 CT into indicated and unindicated based on the ACR Appropriateness Criteria. Information regarding the date of last menstrual period, likelihood of pregnancy, and if available, results of the pregnancy test were recorded. Data were analyzed with descriptive statistics (median and inter-quartile range) and analysis of variance (ANOVA).

None of the patients were pregnant at the time of their scanning. Amongst the 673 phases acquired for multiphase abdomen-pelvis CT in 451 patients, the 47% unindicated phases (315/673) included non-contrast (122/673, 18%), arterial (33/673, 5%), portal venous (125/673, 19%) and delayed (35/673, 5%) phases. The respective median DLP for indicated and unindicated phases were 266 and 758 mGy.cm (P < .0001).

Multiphase abdomen-pelvis CT exams are frequent but seldom justified in WOCBP. They lead to a substantial increase in unindicated radiation dose compared to a single-phase CT.
Effectiveness of Tocilizumab in juvenile patients with refractory Takayasu arteritis
Authors: Asano Tomoyuki , Sato Shuzo , Temmoku Jumpei , Fujita Yuya , Furuya Makiko Yashiro , Matsuoka Naoki , Kobayashi Hiroko , Suzuki Eiji , Watanabe Hiroshi , Migita Kiyoshi
Published: January 2020

Rationale:

Takayasu arteritis (TA) is a systemic large-vessel vasculitis which can be accompanied by the symptoms associated with vascular stenosis.

Patient concerns:

We describe 2 female juveniles with TA who presented with progressive intermittent claudication.

Diagnosis:

Contrast-enhanced computed tomography (CT) revealed the stenosis of femoral arteries and increased levels of C-reactive protein (CRP), and serum amyloid A (SAA) were noted in both patients. According to European league against rheumatism consensus criteria for the diagnosis of TA was confirmed in both patients.

Interventions:

Both patients had shown resistance to glucocorticoids and treated with tocilizumab (TCZ) (subcutaneous injections, 162 mg/week).

Outcomes:

These treatments improved claudication symptoms. Follow-up imaging by enhanced CT revealed restoration of advanced stenosis of the femoral arteries in both patients. They achieved normalization of levels of the acute-phase reactants CRP and SAA. Serum levels of interleukin-6 were increased transiently after TCZ injection, but declined to within normal ranges at 12 weeks.

Lessons:

Juvenile patients with TA presenting with advanced stenosis of the femoral arteries are not rare. The clinical courses of our patients suggested the beneficial effects of TCZ against the progressive vascular stenosis observed in refractory TA.
Study protocol for a pilot randomized controlled trial on a smartphone application-based intervention for subthreshold depression
Authors: Kato Yudai , Kageyama Kaito , Mesaki Takanori , Uchida Hiroyuki , Sejima Yoshiyuki , Marume Risako , Takahashi Kana , Hirao Kazuki
Published: January 2020

Introduction:

Interventions aimed at addressing subthreshold depression (StD) are important to prevent the onset of major depressive disorder. Our video playback application (SPSRS) is designed to reduce depressive symptoms by presenting positive words in videos, shedding new light on the treatment of StD. However, no randomized controlled trial (RCT) has utilized this video playback application for the treatment of individuals with StD. Therefore, a pilot RCT was designed to determine the feasibility of a full-scale trial. We herein present a study protocol for investigating the utility of a video playback application intervention for individuals with StD.

Methods:

This 5-week, single-blind, 2-arm, parallel-group, pilot RCT will determine the effectiveness of the video playback application by comparing individuals who had and had not been exposed to the same. A total of 32 individuals with StD will be randomly assigned to the experimental or control group at a 1:1 ratio. The experimental group will receive a 10-minute intervention containing the video playback application per day, whereas the control group will receive no intervention. The primary outcome will include changes in the Center for Epidemiologic Studies Depression Scale score after the 5-week intervention, while secondary outcomes will include changes in the Kessler Screening Scale for psychological distress and the generalized anxiety disorder 7-item scale score after the 5-week intervention. Statistical analysis using linear mixed models with the restricted maximum likelihood estimation method will then be performed.

Discussion:

This pilot RCT will have been the first to explore the utility of SPSRS application interventions that display positive words in videos for individuals with StD. The results of this pilot trial are expected to help in the design and implementation of a full-scale RCT that investigates the effects of SPSRS applications among individuals with StD.

Trial registration:

ClinicalTrials.gov Identifier: NCT04136041
Cost‐effectiveness Analysis of Feeding Guidelines for Infants Following Intestinal Surgery
Authors: Shores Darla R. , Mogul Douglas , Allen Julia , Delarmente Benjo A. , Padula William
Published: January 2020

Objective:

The aim of the study was to determine the cost‐effectiveness of postoperative feeding guidelines to reduce complications in infants with intestinal surgery compared to standard feeding practices.

Methods:

Using outcomes from a cohort study, Markov models from health care and societal perspectives simulated costs per hospitalization among infants fed via guidelines versus standard practice. Short‐term outcomes included intestinal failure–associated liver disease, necrotizing enterocolitis after feeding, sepsis, and mortality. Effectiveness was measured as length of stay. The incremental cost‐effectiveness ratios (ICER) compared cost over length of stay. Univariate and multivariate probabilistic sensitivity analyses with 10,000 Monte Carlo Simulations were performed. A second decision tree model captured the cost per quality‐adjusted life years (QALYs) using utilities associated with long‐term outcomes (liver cirrhosis and transplantation).

Results:

In the hospital perspective, standard feeding had a cost of $31,258,902 and 8296 hospital days, and the feeding guidelines had a cost of $29,295,553 and 8096 hospital days. The ICER was $−9832 per hospital stay with guideline use. More than 90% of the ICERs were in the dominant quadrant. Results were similar for the societal perspective. Long‐term costs and utilities in the guideline group were $2830 and 0.91, respectively, versus $4030 and 0.90, resulting in an ICER of $−91,756/QALY.

Conclusion:

In our models, feeding guideline use resulted in cost savings and reduction in hospital stay in the short‐term and cost savings and an increase in QALYs in the long‐term. Using a systematic approach to feed surgical infants appears to reduce costly complications, but further data from a larger cohort are needed.
Do Histological Features of Eosinophilic Esophagitis in Children Correlate With Peripheral Eosinophils?
Authors: Choudhury Shelly , Kozielski Rafal , Hua Jia , Wilding Gregory E. , Baker Susan
Published: January 2020

Aim:

Eosinophilic esophagitis (EoE) is a chronic, relapsing inflammatory disease of the esophagus. We investigate whether peripheral eosinophils can be a good indicator of esophageal eosinophilia and whether they correlate with histological findings, such as basilar hyperplasia, spongiosis, microabscesses, number of lymphocytes, and number of neutrophils.

Methods:

A retrospective chart review was conducted with EoE patients ages <18 years after obtaining IRB approval. Biopsies obtained from 57 EoE patients were analyzed. Patient demographics, symptoms; complete blood count with differentials obtained at the time of endoscopies or within a month of the procedure, were documented.

Results:

A significant correlation was observed between peripheral absolute eosinophil count (AEC) and peak esophageal eosinophil count (P value: 0.0009). Subjects with biopsies suggestive of ongoing disease activity or active status had a higher mean of AEC at 577.41 ± 202.60 compared with subjects with inactivity with mean of 305.26 ± 526.67. However, when the subjects were broadly divided with 500 AEC as a cut off (<500 and >500 AEC), it was found that, out of 27 EoE inactive patients, 24 had AEC count less than or equal to 500 and out of 66 EoE active patients, 32 had AEC more than 500.

Conclusion:

Active EoE status meant a higher mean of AEC compared with inactive status; but AEC was not found to be a sensitive tool for detecting active EoE.
Assessing Undergraduate Nursing Students' Attitudes Toward the Dying in an End-of-Life Simulation Using an ACE.S Unfolding Case Study
Authors: Byrne Deborah , Overbaugh Kristen , Czekanski Kathleen , Wilby Mary , Blumenfeld Stephanie , Laske Rita Ann
Published: January 2020

Caring for the dying patient can be stressful for nursing students. The purpose of this study was to describe a multimodal educational intervention designed to improve nursing students' attitude toward care of the dying patient and the family. Sophomore nursing students participated in an interactive end-of-life (EOL) lecture and simulation. A quasi-experimental, pretest/posttest design with a convenience sample was used for this study. Frommelt Attitudes Toward Care of the Dying version A was used to measure attitudes toward care of the dying patient before and after educational intervention. In addition, students were given an open-ended questionnaire to reflect on their perceptions of the EOL experience and a demographic questionnaire. A paired t test revealed a statistically significant difference between the pretest and posttest (t
50 = 3.1, P = .003) on the Frommelt Attitudes Toward Care of the Dying, suggesting that students gained a more positive attitude toward caring for the dying patient. Three themes emerged from the content analysis and included knowing what to say and how to offer presence, becoming emotionally prepared, and learning skills to comfort. The use of lecture and simulation allowed students to assimilate the knowledge and affective skills needed to provide quality EOL care.
Pathological Narcissism and Symptoms of Major Depressive Disorder Among Psychiatric Outpatients
Authors: Kealy David , Laverdière Olivier , Pincus Aaron L.
Published: January 2020

Research is scarce regarding the mechanisms by which pathological narcissism––consisting of narcissistic grandiosity and vulnerability––is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.
Vaginal Bromocriptine Improves Pain, Menstrual Bleeding, and Quality of Life in Women With Adenomyosis: A Pilot Study
Authors: Andersson Johanna K. , Khan Zaraq , Weaver Amy L. , Vaughan Lisa E. , Gemzell-Danielsson Kristina , Stewart Elizabeth A.
Published: January 2020

(Abstracted from Acta Obstet Gynecol Scand 2019;98:1341–1350)

Animal models suggest that increased uterine prolactin concentration is a risk factor for adenomyosis. Prolactin is produced in the human endometrium, myometrium, and the pituitary gland and acts as a smooth muscle cell mitogen in vitro.
Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer
Authors: Greenberger Benjamin A. , Taylor James M. , Chen Victor E. , Den Robert B.
Published: January 2020

There is currently a lack of level 1 evidence regarding the relative efficacy of radical prostatectomy compared with radiotherapy combined with androgen deprivation therapy for high-risk prostate cancer. There has recently been an improved optimization of treatment, achieving superior biochemical outcomes and cancer-specific mortality through the use of combined modality therapy strategies. Combined modality therapies have also increasingly incorporated brachytherapy boost. Although available observational data must be interpreted with caution because of the effects of potential residual confounding, we present here a narrative review of recent advances in understanding the relative efficacy of the principal combined modality approaches for treating high-risk prostate cancer. As the trend has demonstrated approaching equivalence between well-selected combined modality therapies, an increasing emphasis should be placed on selecting therapy tailored toward a patient's goals regarding quality of life. We present here an outline of efforts to date to understand the implications of treatment on functional outcomes and quality-of-life endpoints.
Brief Report: Recurrence of Anal High-Grade Squamous Intraepithelial Lesions Among Women Living With HIV
Authors: Stier Elizabeth A. , Abbasi Wafaa , Agyemang Amma F. , Valle Álvarez Eduardo Amílkar , Chiao Elizabeth Y. , Deshmukh Ashish A.
Published: January 2020

Background:

Women living with HIV (WLHIV) have a high risk of developing invasive anal cancer. Anal cancer may be prevented with early detection and treatment of anal histologic high-grade squamous intraepithelial lesions (HSIL). However, there are limited data on the efficacy of anal HSIL treatment in WLHIV.

Study design:

We conducted a retrospective study of WLHIV treated for anal HSIL under high-resolution anoscopy (HRA) guidance from January 1, 2007 to December 31, 2017 with at least one post-treatment visit at an urban tertiary care hospital.

Results:

Forty-five WLHIV women with at least 1 follow-up evaluation after treatment for anal HSIL were identified. The median age was 46 years (range 35–66 years), 63% were African American, 27% were Hispanic/Latino, and 53% were current smokers. The mean absolute CD4+ T-cell count was 516 cells/mm3; 50% and 24% of the cohort had a history of cervical or vulvar HSIL respectively. The cumulative probability of anal HSIL recurrence was 29% at 12 months, 52% at 24 months, and 79% at 36 months post-treatment.

Conclusion:

Most WLHIV treated for anal HSIL recurred within 3 years, suggesting need for continued surveillance after treatment. Our data contribute to the information needed to develop effective anal cancer prevention guidelines in WLHIV.
Diffuse Hepatosplenic 99mTc-Pyrophosphate Activity Caused by Amyloidosis
Authors: Ren Jingyun , Ren Chao , Huo Li , Li Fang , Zhang Shuyang
Published: January 2020

A 46-year-old man underwent 99mTc-pyrophosphate scan to evaluate possible infiltrative myocardiopathy revealed by echocardiography. The images did not show abnormal cardiac activity. However, diffuse abnormal activity in the liver and spleen was noted. Pathological examination from the specimen acquired from hepatic biopsy demonstrated amyloidosis, light chain type.
Radioguided Surgery for Meckel Diverticulum
Authors: Medaer Eva , Miserez Marc , De Hertogh Gert , Van Laere Koen , Deroose Christophe M.
Published: January 2020

We present the case of a 13-year-old boy with bleeding complications from a Meckel diverticulum (MD), which was scintigraphically confirmed. A first exploratory laparoscopy was unsuccessful in identifying the diverticulum. A new 99mTc-pertechnetate scintigraphy (including SPECT/CT), 3 years later, suggested the anatomical location and was helpful during the surgical exploration for the MD by radioguided surgery. Radioguidance is helpful in pathologies characterized by small size or variable anatomical location. A MD with ectopic gastric mucosa can be distinguished from the rest of the small bowel based on selective 99mTc-pertechnetate uptake in the gastric mucosa, with limited background activity.
A Modified Procedure for Blepharoplasty: Physiological Structure Reconstruction of Upper Eyelids
Authors: Wang Yuting , Cao Yong , Xie Aiguo
Published: January 2020

Background:

Double eyelid operation has become the most popular cosmetic procedure in China, while how to make sure the acquired double eyelids the same as congenital ones is still a problem.

Objective:

This study aimed to explore a design and operation procedure to obtain natural and dynamic double eyelids, which are accordant with the congenital double eyelids both in appearance and movement.

Methods:

The authors conducted a retrospective review of 352 patients who underwent our operation from October 2012 to October 2018. The procedures were performed by one senior surgeon. First, design the incision line 7 to 8 mm distance parallel to the ciliary margin. Then, cut down the skin and orbicularis muscle, and dissect the orbicularis myocutaneous flap from the anterior surface of the tarsal plate. Next, expose the orbital septum transversely in the lowest site from lateral to medial direction, and dispose of the fat tissue herniated spontaneously. Subsequently, suture the upper margin of pretarsal orbicularis myocutaneous flap to the levator aponeurosis. Finally, the skin edge of incision was closed interruptedly. The patients were followed up from 6 to 30 months after surgery by 2 surgeons to evaluate the long-term results.

Results:

A total of 352 patients with 704 eyes were operated on and followed up in our study. There were 29 patients (8.2%) that showed slight asymmetry, and 7 eyes (2.0%) showed shallow creases. Besides that, all the creases were symmetry, parallel and natural. Just as congenital double eyelids, when opening eyes there was no sausagelike appearance, and when closing eyes there were no depressed scars.

Conclusions:

By reconstructing the physiological structure of upper eyelids, our double eyelid operation creates dynamic double eyelids, which are accordant with the congenital ones both in appearance and movement.
The Efficacy and Safety of Submandibular Transcatheter Perfusion Anesthesia in Submandibular Gland Surgery
Authors: Lu Ruohuang , Xiao Zhiqiang , Guo Xincheng , Gan Pingping
Published: January 2020

The present study aims to evaluate the feasibility, safety, and effects of the combined use of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration for anesthetic purposes during submandibular gland surgery. A total of 38 patients with benign tumors, who had undergone resection by submandibular gland surgery were randomly divided into 2 groups. Patients in group A were administered with submandibular anesthesia through catheter perfusion, lingual nerve block, and subcutaneous infiltration anesthesia. Patients in the group B were only treated with lingual nerve block and subcutaneous infiltration anesthesia. The submandibular gland surgery was performed within 5 minutes following anesthesia administration, after which the numerical rating scale (NRS) was evaluated before surgery, during skin incision (T
1), during the pulling process of the submandibular gland (T
2), during the removal of the submandibular gland (T
3), and at 2, 6, 12, and 24 hours post-surgery. The dosage of analgesic drugs was also measured after surgery. The findings revealed no significant difference in NRS before surgery, at T
1, 6, 12, and 24 hours after surgery (P > 0.01) while NRS was much lower in group A patients as observed at T
2, T
3, and 2 hours after surgery when compared with group B (P < 0.01). The combined application of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration can be used as an effective anesthetic method during submandibular gland surgery.
Perceptions of Family Physicians About Fall Risk Screening, Fall Risk Assessment, and Referral Practices for Fall Prevention in Malaysia
Authors: Jaafar Mohamad Hasif , Mat Sumaiyah , Mackenzie Lynette , Tan Maw Pin
Published: January 2020

Purpose:

This study aimed to identify factors that influence the implementation of fall prevention programs from the perspectives of the family physician (FP).

Methods:

A cross-sectional survey was conducted with all 1800 members of the Academy of Family Medicine, Malaysia.

Results:

Sixty (54%) and 75 (67%) FPs did not routinely ask older people about falls and fear of falling, respectively. Seventy-nine FPs (71%) reported being unfamiliar with any guidelines for screening for fall risk.

Conclusion:

Our study revealed major gaps in the delivery of evidence-based fall prevention in practice by Malaysian FPs.
Effect of Textured and Prefabricated Insole Use With Medical or Sports Shoes on Dynamic Postural Control in Elderly People
Authors: Kiaghadi Adele , Bahramizadeh Mahmood , Hadadi Mohammad
Published: January 2020

Background:

Evidence suggests that orthotic intervention can alter dynamic balance in elderly people. This study compared the effect of textured and prefabricated insoles on dynamic postural control in older adults.

Methods:

Thirty elderly people were tested with prefabricated and textured insoles in combination with medical and sports shoes. Reach distance of participants was measured in anteromedial, medial, and posteromedial directions of the Star Excursion Balance Test.

Results:

Significant footwear-dependent differences were seen in all reach directions. The reach distance was longer for barefoot than for other conditions in the 3 evaluated directions (P < .015).

Conclusions:

The use of prefabricated and textured insoles with 2 different shoes significantly reduced reach distance compared with when barefoot.
The Impact of Direct-acting Antivirals on Overall Mortality and Tumoral Recurrence in Patients With Hepatocellular Carcinoma Listed for Liver Transplantation: An International Multicenter Study
Authors: Gorgen Andre , Galvin Zita , Huang Annsa C. , Vinaixa Carmen , O’Rourke Joanne M. , Francoz Claire , Hansen Bettina E. , Durand François , Elsharkawy Ahmed M. , Shah Tahir , Berenguer Marina , Rubin Angel , Calatayud David , Mehta Neil , Terrault Norah A. , Lilly Les B. , Selzner Nazia , Sapisochin Gonzalo
Published: January 2020

Background.

There is a lack of data on the use of direct-acting antivirals (DAA) on the risk of death and tumoral recurrence in patients with hepatitis C virus (HCV) and hepatocellular carcinoma (HCC) listed for liver transplantation (LT). We aimed to assess the impact of antiviral treatment on mortality and HCC recurrence patients with HCC-HCV.

Methods.

This was a retrospective multicenter study of patients with HCC-HCV listed for LT from 2005 to 2015. Patients were divided according to the antiviral treatment received after HCC diagnosis: DAA, interferon (IFN), or no antiviral. Intention-to-treat overall survival and HCC recurrence incidence were compared by the Kaplan-Meier method. Multivariable regression analysis was performed to identify risk factors for outcomes.

Results.

A total of 1012 HCV-HCC patients were listed for LT during the study period. The median follow-up was 4.0 (interquartile range = 2.3–6.7) years. Mortality was 5.6 (95% confidence interval [CI], 4.3-7.2), 13.1 (95% CI, 11.0-15.7), and 6.2 (95% CI, 5.4-7.2) deaths per 100 person-year among patients treated with DAA, IFN, and antiviral naïve, respectively (P < 0.001). Of the 875 HCV-HCC transplant recipients, the 5-year recurrence-free survival was 93.4%, 84.8%, 73.9% for the pre-LT DAA, pre-LT IFN, and antiviral naïve groups, respectively (P < 0.001). After multivariable regression, the use of pre-LT DAA was not associated to risk of recurrence (hazard ratio = 0.44 [95% CI, 0.19-1.00]). Post-LT DAA was not related to increased risk of recurrence (hazard ratio = 0.62 [95% CI, 0.33-1.16]).

Conclusions.

In this multicenter intent-to-treat study, DAA therapy was not found to be a risk factor for mortality or HCC recurrence after adjusting for potential confounders.
Uninhibited chickens: ranging behaviour impacts motor self-regulation in free-range broiler chickens (
Gallus gallus domesticus
)
Authors: Ferreira Vitor Hugo Bessa , Reiter Lorène , Germain Karine , Calandreau Ludovic , Guesdon Vanessa
Published: January 2020

Inhibiting impulsive, less flexible behaviours is of utmost importance for individual adaptation in an ever-changing environment. However, problem-solving tasks may be greatly impacted by individual differences in behaviour, since animals with distinct behavioural types perceive and interact with their environment differently, resulting in variable responses to the same stimuli. Here, we tested whether and how differences in ranging behaviour of free-range chickens affect motor self-regulation performance during a cylinder task. For this task, subjects must refrain from trying to reach a food reward through the walls of a transparent cylinder and detour to its open sides, as a sign of inhibition. Free-range chickens exhibited an overall low performance in the motor self-regulation task (31.33 ± 13.55% of correct responses), however, high rangers showed significantly poorer performance than the low rangers (23.75 ± 9.16% versus 40 ± 12.90%, respectively). These results give further support to the impacts of individual behavioural differences on cognitive performances. This is the first demonstration to our knowledge of a relationship between exploratory tendencies and motor self-regulation for an avian species.
Environmental factors explain spawning day deviation from full moon in the scleractinian coral
Acropora
Authors: Sakai Yusuke , Hatta Masayuki , Furukawa Seishiro , Kawata Masakado , Ueno Naoto , Maruyama Shinichiro
Published: January 2020

Broadcast-spawning scleractinian corals annually release their gametes with high levels of synchrony, both within and among species. However, the timing of spawning can vary inter-annually. In particular, the night of spawning relative to the full moon phase can vary considerably among years at some locations. Although multiple environmental factors can affect the night of spawning, their effects have not been quantitatively assessed at the multi-regional level. In this study, we analysed environmental factors that are potentially correlated with spawning day deviation, in relation to the full moon phase, in
Acropora
corals inhabiting seven reefs in Australia and Japan. We accordingly found that sea surface temperature and wind speed within one to two months prior to the full moon of the spawning month were strongly correlated with spawning day deviations. In addition, solar flux had a weak effect on the night of spawning. These findings indicate that
Acropora
have the capacity to adjust their development and physiology in response to environmental factors for fine-tuning the timing of synchronous spawning, thereby maximizing reproductive success and post-fertilization survival.
The mechanics of nectar offloading in the bumblebeeBombus terrestrisand implications for optimal concentrations during nectar foraging
Authors: Pattrick Jonathan G. , Symington Hamish A. , Federle Walter , Glover Beverley J.
Published: January 2020

Nectar is a common reward provided by plants for pollinators. More concentrated nectar is more rewarding, but also more viscous, and hence more time-consuming to drink. Consequently, theory predicts an optimum concentration for maximizing energy uptake rate, dependent on the mechanics of feeding. For social pollinators such as bumblebees, another important but little-studied aspect of foraging is nectar offloading upon return to the nest. Studying the bumblebeeBombus terrestris, we found that the relationship between viscosity (µ) and volumetric transfer rates (Q) of sucrose solutions differed between drinking and offloading. For drinking,Q∝µ−0.180, in good agreement with previous work. Although offloading was quicker than drinking, offloading rate decreased faster with viscosity, withQ∝µ−0.502, consistent with constraints imposed by fluid flow through a tube. The difference in mechanics between drinking and offloading nectar leads to a conflict in the optimum concentration for maximizing energy transfer rates. Building a model of foraging energetics, we show that including offloading lowers the maximum rate of energy return to the nest and reduces the concentration which maximizes this rate by around 3%. Using our model, we show that published values of preferred nectar sugar concentrations suggest that bumblebees maximize the overall energy return rather than the instantaneous energy uptake during drinking.
Evaluation of burst release and sustained release of pioglitazone-loaded fibrous mats on diabetic wound healing: an
in vitro
and
in vivo
comparison study
Authors: Cam Muhammet Emin , Yildiz Sila , Alenezi Hussain , Cesur Sumeyye , Ozcan Gul Sinemcan , Erdemir Gokce , Edirisinghe Ursula , Akakin Dilek , Kuruca Durdane Serap , Kabasakal Levent , Gunduz Oguzhan , Edirisinghe Mohan
Published: January 2020

In order to provide more effective treatment strategies for the rapid healing of diabetic wounds, novel therapeutic approaches need to be developed. The therapeutic potential of peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist pioglitazone hydrochloride (PHR) in two different release kinetic scenarios, burst release and sustained release, was investigated and compared with
in vitro
and
in vivo
tests as potential wound healing dressings. PHR-loaded fibrous mats were successfully fabricated using polyvinyl-pyrrolidone and polycaprolactone by scalable pressurized gyration. The results indicated that PHR-loaded fibrous mats expedited diabetic wound healing in type-1 diabetic rats and did not show any cytotoxic effect on NIH/3T3 (mouse embryo fibroblast) cells, albeit with different release kinetics and efficacies. The wound healing effects of fibrous mats are presented with histological and biochemical evaluations. PHR-loaded fibrous mats improved neutrophil infiltration, oedema, and inflammation and increased epidermal regeneration and fibroblast proliferation, but the formation of hair follicles and completely improved oedema were observed only in the sustained release form. Thus, topical administration of PPAR-γ agonist in sustained release form has high potential for the treatment of diabetic wounds in inflammatory and proliferative phases of healing with high bioavailability and fewer systemic side effects.
Mitigating temozolomide resistance in glioblastoma via DNA damage-repair inhibition
Authors: Sorribes Inmaculada C. , Handelman Samuel K. , Jain Harsh V.
Published: January 2020

Glioblastomas are among the most lethal cancers, with a 5 year survival rate below 25%. Temozolomide is typically used in glioblastoma treatment; however, the enzymes alkylpurine-DNA-N-glycosylase (APNG) and methylguanine-DNA-methyltransferase (MGMT) efficiently mediate the repair of DNA damage caused by temozolomide, reducing treatment efficacy. Consequently, APNG and MGMT inhibition has been proposed as a way of overcoming chemotherapy resistance. Here, we develop a mechanistic mathematical model that explicitly incorporates the effects of chemotherapy on tumour cells, including the processes of DNA damage induction, cell arrest and DNA repair. Our model is carefully parametrized and validated, and then used to virtually recreate the response of heteroclonal glioblastomas to dual treatment with temozolomide and inhibitors of APNG/MGMT. Using our mechanistic model, we identify four combination treatment strategies optimized by tumour cell phenotype, and isolate the strategy most likely to succeed in a pre-clinical and clinical setting. If confirmed in clinical trials, these strategies have the potential to offset chemotherapy resistance in patients with glioblastoma and improve overall survival.
A unified rheological model for cells and cellularised materials
Authors: Bonfanti A. , Fouchard J. , Khalilgharibi N. , Charras G. , Kabla A.
Published: January 2020

The mechanical response of single cells and tissues exhibits a broad distribution of time-scales that often gives rise to a distinctive power-law rheology. Such complex behaviour cannot be easily captured by traditional rheological approaches, making material characterisation and predictive modelling very challenging. Here, we present a novel model combining conventional viscoelastic elements with fractional calculus that successfully captures the macroscopic relaxation response of epithelial monolayers. The parameters extracted from the fitting of the relaxation modulus allow prediction of the response of the same material to slow stretch and creep, indicating that the model captured intrinsic material properties. Two characteristic times, derived from the model parameters, delimit different regimes in the materials response. We compared the response of tissues with the behaviour of single cells as well as intra and extra-cellular components, and linked the power-law behaviour of the epithelium to the dynamics of the cell cortex. Such a unified model for the mechanical response of biological materials provides a novel and robust mathematical approach to consistently analyse experimental data and uncover similarities and differences in reported behaviour across experimental methods and research groups. It also sets the foundations for more accurate computational models of tissue mechanics.
Synthesis and characterization of cyclodextrin-based acrylamide polymer flocculant for adsorbing water-soluble dyes in dye wastewater
Authors: Su Qiong , Wang Yuxing , Sun Wanhong , Liang Junxi , Meng Shujuan , Wang Yanbin , Li Zhenhua
Published: January 2020

A novel hydrophobic and cationic cyclodextrin-based acrylamide flocculant (AM-β-CD-DMDAAC) was prepared by chemical oxidative polymerization to adsorb water-soluble dyes in dye wastewater. Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscope and thermogravimetric (TG) measurements results demonstrated that the AM-β-CD-DMDAAC was successfully synthesized. The effects of pH, contact time, initial dye concentration, temperature and adsorbent dose on dye removal efficiency for AM-β-CD-DMDAAC flocculants were investigated. The kinetic data were found to follow the pseudo-second-order kinetic model. The equilibrium adsorption data were fitted to the Langmuir isotherm model, with the maximum adsorption capacity of 147.1 mg g−1. The adsorbent retained about 60% of the adsorption efficiency after three adsorption/desorption cycles, which implied a promising application as the dye adsorbent.
Multiferroics beyond electric-field control of magnetism
Authors: Spaldin Nicola A.
Published: January 2020

Multiferroic materials, with their combined and coupled magnetism and ferroelectricity, provide a playground for studying new physics and chemistry as well as a platform for the development of novel devices and technologies. Based on my July 2017 Royal Society Inaugural Lecture, I review recent progress and propose future directions in the fundamentals and applications of multiferroics, with a focus on initially unanticipated developments outside of the core activity of electric-field control of magnetism.
Farming plant cooperation in crops
Authors: Montazeaud Germain , Rousset François , Fort Florian , Violle Cyrille , Fréville Hélène , Gandon Sylvain
Published: January 2020

Selection of the fittest can promote individual competitiveness but often results in the erosion of group performance. Recently, several authors revisited this idea in crop production and proposed new practices based on selection for cooperative phenotypes, i.e. phenotypes that increase crop yield through decreased competitiveness. These recommendations, however, remain difficult to evaluate without a formal description of crop evolutionary dynamics under different selection strategies. Here, we develop a theoretical framework to investigate the evolution of cooperation-related traits in crops, using plant height as a case study. Our model is tailored to realistic agricultural practices and shows that combining high plant density, high relatedness and selection among groups favours the evolution of shorter plants that maximize grain yield. Our model allows us to revisit past and current breeding practices in light of kin selection theory, and yields practical recommendations to increase cooperation among crops and promote sustainable agriculture.
Redirection of ambient light improves predator detection in a diurnal fish
Authors: Santon Matteo , Bitton Pierre-Paul , Dehm Jasha , Fritsch Roland , Harant Ulrike K. , Anthes Nils , Michiels Nico K.
Published: January 2020

Cases where animals use controlled illumination to improve vision are rare and thus far limited to chemiluminescence, which only functions in darkness. This constraint was recently relaxed by studies onTripterygion delaisi, a small triplefin that redirects sunlight instead. By reflecting light sideways with its iris, it has been suggested to induce and detect eyeshine in nearby micro-prey. Here, we test whether ‘diurnal active photolocation’ also improvesT. delaisi's ability to detect the cryptobenthic sit-and-wait predatorScorpaena porcus,a scorpionfish with strong daytime retroreflective eyeshine. Three independent experiments revealed that triplefins in which light redirection was artificially suppressed approached scorpionfish significantly closer than two control treatments before moving away to a safer distance. Visual modelling confirmed that ocular light redirection by a triplefin is sufficiently strong to generate a luminance increase in scorpionfish eyeshine that can be perceived by the triplefin over 6–8 cm under average conditions. These distances coincide well with the closest approaches observed. We conclude that light redirection by small, diurnal fish significantly contributes to their ability to visually detect cryptic predators, strongly widening the conditions under which active sensing with light is feasible. We discuss the consequences for fish eye evolution.
Habitat heterogeneity mediates effects of individual variation on spatial species coexistence
Authors: Chen Dongdong , Liao Jinbao , Bearup Daniel , Li Zhenqing
Published: January 2020

Numerous studies have documented the importance of individual variation (IV) in determining the outcome of competition between species. However, little is known about how the interplay between IV and habitat heterogeneity (i.e. variation and spatial autocorrelation in habitat quality) affects species coexistence at the landscape scale. Here, we incorporate habitat heterogeneity into a competition model with IV, in order to explore the mechanism of spatial species coexistence. We find that individual-level variation and habitat heterogeneity interact to promote species coexistence, more obviously at lower dispersal rates. This is in stark contrast to early non-spatial models, which predicted that IV reinforces competitive hierarchies and therefore speeds up species exclusion. In essence, increasing variation in patch quality and/or spatial habitat autocorrelation moderates differences in the competitive ability of species, thereby allowing species to coexist both locally and globally. Overall, our theoretical study offers a mechanistic explanation for emerging empirical evidence that both habitat heterogeneity and IV promote species coexistence and therefore biodiversity maintenance.