bluuebunny/crossref_metadata_2025 huggingface dataset:
Contrast of Mastoscopic and Conventional Axillary Lymph Node Dissection of Patients With Breast Cancer: Meta-Analysis
Authors: Xiong Hanchu , Chen Zihan , Xu Ling , Chen Cong , Fu Qingshuang , Teng Rongyue , Chen Jida , Xie Shuduo , Wang Linbo , Yu Xiao-Fang , Zhou Jichun
Published: June 2020

Mastoscopic axillary lymph node dissection (MALND) is a currently used and safe surgical treatment option for breast cancer. However, the extensive application of MALND is still debatable because of the use of conventional axillary lymph node dissection (CALND). Therefore, in the current study, we aimed to compare the efficacy and safety of MALND and CALND for obtaining evidence-based conclusions about the short-term and long-term outcomes of MALND for patients with breast cancer. PubMed, Web of Science, Cochrane Library, and CNKI were comprehensively searched for articles published between January 1998 and January 2019. Then Newcastle-Ottawa scale was used for quality assessment. The Review Manager software version 5.0 was utilized for generating forest maps and funnel plots. Twelve studies including 2157 patients were selected for the meta-analysis. There were no significant differences in the number of lymph node dissections, tumor recurrence rate, axillary drainage, postoperative hospitalization time, and tumor size between the MALND and CALND groups ( P > .05). In the MALND group, the surgery time was longer, while the incidence of intraoperative bleeding was lesser and the duration of drainage was shorter than those in the CALND group ( P < .01). The complications in the MALND group were also fewer than those in the CALND group ( P < .05). The results of the current study showed that MALND is reliable and feasible for breast cancer owing to the lesser incidence of intraoperative bleeding, shorter drainage duration, and lower incidence of complications compared to CALND.
Rotation-induced axial oscillation of a composite nanoconvertor at low temperature
Authors: Song Bo , Cai Kun , Shi Jiao , Qin Qing-Hua
Published: June 2020

We propose a model of a nanostructure which can transform an input rotation into an output oscillation. In the model, the rotor has two identical internally hydrogenated deformable parts. The mechanism is that the rotation-induced centrifugal force and van der Waals force drive the recoverable deformation of the hydrogenated deformable parts, which gives rise to the axial translation of the free end of the rotor. Once the two hydrogenated deformable parts deform periodically, the free end of the rotor oscillates periodically in the axial direction. Molecular dynamics simulations are conducted to reveal the dynamic response of the system at low temperature. Four main types of deformation and the first three orders of vibration responses of the hydrogenated deformable parts are analyzed. Synchronous breathing vibration of the two hydrogenated deformable parts produces ideal oscillation with large amplitude. Asynchronous axial vibration of the hydrogenated deformable parts reduces the oscillation amplitude or produces beat vibration. The way to control the amplitude of the axial oscillation/vibration is given.
Geometric description of time-dependent finite-dimensional mechanical systems
Authors: Eugster Simon R. , Capobianco Giuseppe , Winandy Tom
Published: June 2020

Using the non-standard geometric structure proposed by Loos, we present a coordinate-free formulation of the theory for time-dependent finite-dimensional mechanical systems with n degrees of freedom. The state space containing the system’s information on time, position and velocity is defined as a (2 n+1)-dimensional affine bundle over an ( n+1)-dimensional generalized space-time. The main goal is to present a geometric postulate that characterizes a second-order vector field whose integral curves describe the motions of a time-dependent finite-dimensional mechanical system. The core objects of the postulate are differential two-forms on the state space, called action forms, which are in a bijective relation with second-order vector fields. The requirements for a differential two-form to be an action form allow for a coordinate-free definition of non-potential forces, which may depend on time, position and velocity. Finally, we show that not only Lagrange’s equations but also Hamilton’s equations follow directly as mere coordinate representations of the same coordinate-free postulate.
Systematic Review of the Kynurenine Pathway and Psychoneurological Symptoms Among Adult Cancer Survivors
Authors: Li Hongjin , Liu Tingting , Heinsberg Lacey W. , Lockwood Mark B. , Wainwright Derek A. , Jang Min Kyeong , Doorenbos Ardith Z.
Published: June 2020

The co-occurrence of multiple psychoneurological symptoms, including pain, sleep disturbance, fatigue, depression, anxiety, and cognitive disturbance among adult cancer survivors led us to question which common biological mechanisms are shared among these conditions. Variances in tryptophan (Trp) levels and downstream metabolites of the kynurenine (Kyn) metabolic pathway are known to affect immune response and psychoneurological symptoms. The objective of this systematic review was to help us (a) better understand the role of the Kyn pathway in psychoneurological symptoms among adult cancer survivors and (b) identify common significant biomarkers across psychoneurological symptoms as a guide for future research. Some evidence has shown that decreased Trp levels and increased Kyn, Trp/Kyn ratio, and kynurenic acid/Trp ratio in parallel with immune activation are correlated with some psychoneurological symptoms among people undergoing cancer treatment, although discrepancies exist between studies. Kyn pathway activation could also be associated with psychoneurological symptoms among adult cancer survivors, but further research is needed to confirm its exact etiological role with respect to psychoneurological symptoms.
Effect of implementing an Epicutaneo-Caval Catheter team in Neonatal Intensive Care Unit
Authors: Bayoumi Mohammad A A , Van Rens Matheus F P , Chandra Prem , Francia Airene L V , D’Souza Sunitha , George Majee , Shahbal Saad , Elmalik Einas E , Cabanillas Irian J E
Published: June 2020

Background:

Until the 1980s, central vascular access in the Neonatal Intensive Care Unit was predominantly delivered by umbilical catheters and only and if needed by surgical cutdowns or subclavian vein catheterization through blind percutaneous venipuncture. In the early 1980s, epicutaneo-caval catheters were successfully introduced.

Methods:

In our Neonatal Intensive Care Unit, a dedicated team to insert epicutaneo-caval catheters was formally established in January 2017, including 12 neonatologists and 1 neonatal nurse practitioner. A before- versus after-intervention study was designed to determine whether the establishment of the epicutaneo-caval catheter insertion team is associated with increased success rates and a decreased risk of catheter-related complications. Success rates and other catheter-related parameters were traced from 2016 onward. Collected data were analyzed for three consecutive years: 2016, 2017, and 2018.

Results:

The epicutaneo-caval catheter team inserted 1336 catheters over 3 years. Both first prick (from 57.7% to 66.9%; p = 0.023) and overall success (from 81.7% to 97.6%; p < 0.0001) rates significantly improved. In 2018, the number of tunneled or surgically inserted central venous catheters came down to zero (p < 0.0001). Overall catheter-related complications were significantly lower following the epicutaneo-caval catheter team’s establishment (p < 0.0001) while there was no significant decrease noted (p = 0.978) in central line–associated bacterial stream infection rates.

Conclusion:

A dedicated epicutaneo-caval catheter team is a promising intervention to increase success rates and significantly decrease catheter-related complications in Neonatal Intensive Care Unit. Standardizing epicutaneo-caval catheter placement is important; however, standardizing catheter maintenance seems essential to the improvement of central line–associated bacterial stream infection rates.
‘Upon the gears and upon the wheels’: Terror convergence and total administration in the neoliberal university
Authors: McCann Leo , Granter Edward , Hyde Paula , Aroles Jeremy
Published: June 2020

University governance is becoming increasingly autocratic as marketization intensifies. Far from the classical ideal of a professional collegium run according to academic norms, today’s universities feature corporate cultures and senior leadership teams disconnected from both staff and students, and intolerant of dissenting views. This is not a completely new phenomenon. In 1960s America, senior leaders developed a technocratic and managerialist model of the university, in keeping with theories around the ‘convergence’ of socio-economic systems towards a pluralist ‘industrial society’. This administrative-managerial vision was opposed by radical students, triggering punitive responses that reflected how universities’ control measures were at the time mostly aimed at students. Today, their primary target is academics. Informed by Critical Theory and based on an autoethnographic account of a university restructuring programme, we argue that the direction of convergence in universities has not been towards liberal, pluralist, democracy but towards neo-Stalinist organizing principles. Performance measurements – ‘targets and terror’ – are powerful mechanisms for the expansion of managerial power or, in Marcuse’s words, ‘total administration’. Total administration in the contemporary university damages teaching, learning, workplace democracy and freedom of speech on campus, suggesting that the critique of university autocracy by 1960s students and scholars remains highly relevant.
Family entrepreneurial teams: The role of learning in business model evolution
Authors: Jones Oswald , Giordano Benito
Published: June 2020

There is limited research linking entrepreneurial learning and business models in start-up businesses. Business models are important cognitive devices that link entrepreneurial thinking and engagement with customers and suppliers during business start-up. This research examines business model evolution during the first 6 years of a family-based start-up, which was formed in 2008 by 2 young brothers. The business grew quickly and achieved a turnover of £4.5 million with 15 staff members by 2014. The case study contributes a better understanding of ways in which team-based learning in a family business links experiential and cognitive learning during business model evolution.
Working with families: A systematic scoping review of family-centred care in universal, community-based maternal, child, and family health services
Authors: Ridgway Lael , Hackworth Naomi , Nicholson Jan M , McKenna Lisa
Published: June 2020

Children’s long- and short-term health and developmental outcomes can be improved when families are engaged and supported, and inform care planning. Family-centred care (FCC) underpins policy directions for universal, community-based, child and family health services in the early years, although its implementation in this context is poorly understood. This systematic scoping review of the current literature aimed to improve understanding of FCC implementation in maternal, child, and family health universal services. Key databases and grey literature were searched using descriptors of maternal, child, and family health population and context, and FCC concept. Reference checking identified further literature for analysis. Thirteen included papers reported on nine studies from Australia, New Zealand, and the United Kingdom. Limited participant representation of fathers and diverse community members was evident. Deductive thematic analysis identified four areas of FCC demonstrated in this literature: respectful relationships, effective communication to foster shared understanding, flexible and contextualized care, and support for autonomy and agency. The literature demonstrated the interplay between organizational, professional, and recipient factors and their impact on the implementation of FCC. For successful FCC implementation, all these elements should be considered.
Phonological Characteristics of Korean-Speaking Children With Phonological Disorders: Preliminary Results
Authors: Kim Minjung , Kim Soo-Jin , Stoel-Gammon Carol
Published: June 2020

This study investigates phonological characteristics of Korean monolingual children with phonological disorders (PD), using data from 13 children aged 3.6 to 5.9, and compares the analyses of single-word productions (SW) to those of conversational speech (CS). Phonological analyses include overall percentage of consonants correct (PCC), individual phoneme accuracy, and phonological error patterns. Results indicate that children with PD have persistent difficulty with affricates, fricatives, and the liquid /l/. Overall consonant accuracy tends to be greater in CS than SW. Phonological errors that may be explained by language-specific phonological and phonetic properties of Korean are noted.
Machine-Learning Algorithms Based on Screening Tests for Mild Cognitive Impairment
Authors: Park Jin-Hyuck
Published: June 2020

Background:

The mobile screening test system for mild cognitive impairment (mSTS-MCI) was developed and validated to address the low sensitivity and specificity of the Montreal Cognitive Assessment (MoCA) widely used clinically.

Objective:

This study was to evaluate the efficacy machine learning algorithms based on the mSTS-MCI and Korean version of MoCA.

Method:

In total, 103 healthy individuals and 74 patients with MCI were randomly divided into training and test data sets, respectively. The algorithm using TensorFlow was trained based on the training data set, and then its accuracy was calculated based on the test data set. The cost was calculated via logistic regression in this case.

Result:

Predictive power of the algorithms was higher than those of the original tests. In particular, the algorithm based on the mSTS-MCI showed the highest positive-predictive value.

Conclusion:

The machine learning algorithms predicting MCI showed the comparable findings with the conventional screening tools.
Development of a computer-aided engineering–supported process for the manufacturing of customized orthopaedic devices by three-dimensional printing onto textile surfaces
Authors: Ahrendt Dustin , Romero Karam Arturo
Published: June 2020

Today, additive manufacturing, also called three-dimensional printing, is used for producing prototypes as well as other products for various industrial sectors. Although this technology is already well established in the automotive, aviation and space travel, building, dental and medical sectors, its integration in the textile and ready-made industry is still in progress. At present, there is a lack of specific application scenarios for the combination of three-dimensional printing and textile materials, apart from fashion and shoe design. Hence, this article presents a digital computer-aided engineering–supported process to manufacture customized orthopaedic devices by three-dimensional printing directly onto a textile fabric. State-of-the-art fabrication methods for orthoses are typically labour intensive. The combination of three-dimensional scanning, computer-aided design modelling and three-dimensional printing onto textile materials open up new possibilities for producing custom-made products. After three-dimensional scanning of a patient’s individual body shape, the surface is prepared for constructing the textile pattern cuts by reverse engineering. The transformation of the designed three-dimensional patterns into two-dimensional is software supported. Additional positioning lines in accordance with specific body measurements are transferred onto the two-dimensional pattern cuts, which are then used as the basis for the design of the three-dimensional printed functional elements. Subsequently, the design is saved in STL (Standard Triangulation/Tessellation Language) file format, prepared by slicing and directly printed onto textile pattern cuts by means of fused deposition modelling. The last manufacturing step involves the assembly of the textile fabric. The proposed process is demonstrated by an example application scenario, thus proving its potential for industrial use in the textile and ready-made industry.
School leadership for civic learning: The case of socio-political turbulence in Hong Kong
Authors: Wong Koon Lin , Lee John Chi-Kin , Kennedy Kerry J
Published: June 2020

Currently, the challenges deriving from the complex and dynamic socio-political context in Hong Kong influence principals’ and teachers’ relationships and interactions. Academic autonomy in Hong Kong secondary schools is not simply granted by the principals, it is influenced by the society, school conditions and key stakeholders. This study employed qualitative methods to examine how principals negotiate the political context surrounding citizenship education and how these practices influence the civic learning in schools. The results revealed that in school citizenship education, when principals lacked a clear vision of citizenship education, most teachers were compliant and avoided discussing controversial political topics with their students. Such teachers had less autonomy and consequently less self-efficacy. When principals mediated the diverse needs of students and balanced the different expectations of school stakeholders, there were both compliant and critical teachers. Teacher autonomy and self-efficacy were also affected by the current socio-political context in Hong Kong. When principals had a clear school civic mission, the results differed across schools. These findings suggest that principals have to reflect on their own understanding of the purposes and perspectives of citizenship education significantly to meet the multiple demands of a complicated and turbulent socio-political environment.
The Sisyphean Cycle of Technology Panics
Authors: Orben Amy
Published: June 2020

Widespread concerns about new technologies—whether they be novels, radios, or smartphones—are repeatedly found throughout history. Although tales of past panics are often met with amusement today, current concerns routinely engender large research investments and policy debate. What we learn from studying past technological panics, however, is that these investments are often inefficient and ineffective. What causes technological panics to repeatedly reincarnate? And why does research routinely fail to address them? To answer such questions, I examined the network of political, population, and academic factors driving the Sisyphean cycle of technology panics. In this cycle, psychologists are encouraged to spend time investigating new technologies, and how they affect children and young people, to calm a worried population. Their endeavor, however, is rendered ineffective because of the lack of a theoretical baseline; researchers cannot build on what has been learned researching past technologies of concern. Thus, academic study seemingly restarts for each new technology of interest, which slows down the policy interventions necessary to ensure technologies are benefiting society. In this article, I highlight how the Sisyphean cycle of technology panics stymies psychology’s positive role in steering technological change and the pervasive need for improved research and policy approaches to new technologies.
The influence of the video assistant referee on the Chinese Super League
Authors: Han Bo , Chen Qiu , Lago-Peñas Carlos , Wang Changquan , Liu Tianbiao
Published: June 2020

With the development and advancement of technology, various types of high-tech auxiliary equipment have been gradually introduced into football matches to assist referees to officiate the game. The Chinese football Super League (CSL) introduced the video assistant referee (VAR) in the 2018 season. The purpose of this study is to explore the impact of the introduction of VAR on football matches and on referees’ performance. This study compared the data of all 240 games without VAR in the season 2017 and all 240 games with VAR in the season 2018 using Generalized Linear Model (GLM) and means comparison. The following match variables were considered: goals, penalties, red cards, yellow cards, fouls, offsides, playing time in the first half, playing time in the second half and total playing time. The study found that: 1) After the introduction of VAR, the number of offsides and fouls in the Chinese Super League dropped significantly (p < .001); 2) the playing time in the first and second half and the total playing time increased significantly(p < .001); 3) after the introduction of VAR, the home team advantage decreased slightly. The research result can help to better understand the impact of VAR on professional football, especially on the Chinese football Super League, it can also help referees to optimize their refereeing strategy.
Postoperative opioid-free analgesia in elective bowel resection: Changes over time
Authors: Patel Ankoor , Rojas Aram , Samson David , Fakas Steliana , Gachabayov Mahir , L. Xu Jeff , Latifi Rifat , Bergamaschi Roberto
Published: June 2020

In the pain management evolution, opioid-free analgesia and multimodal analgesia strategies have emerged as feasible in many surgical settings including colorectal surgery. This was a retrospective cohort study including patients having undergone elective bowel resection between February 2012 and June 2018 aiming to evaluate whether there was reduction in opioid use after implementation of opioid-free analgesia in one medical centre. Trend analysis was conducted using Joinpoint regression employing nine-month intervals. The primary outcome for each interval was the proportion of patients receiving postoperative opioid-free analgesia, defined as forgoing all opioid analgesics after the day of surgery. This study showed a significant increasing trend in opioid-free analgesia in elective bowel resection from 0 to 42.5% over 4.5 years.
Glycyrrhizin, an HMGB1 inhibitor, Suppresses Interleukin-1β-Induced Inflammatory Responses in Chondrocytes from Patients with Osteoarthritis
Authors: Zhou Shifeng , Liu Guodan , Si Zhenxing , Yu Luanfei , Hou Limin
Published: June 2020

Background

High mobility group box 1 (HMGB1) is increased in osteoarthritis (OA) tissue and chondrocytes stimulated with interleukin-1β (IL-1β). Suppression of HMGB1 expression is correlated with reduced inflammatory responses induced by IL-1β. This study aimed to investigate how inhibition of HMGB1 by glycyrrhizin might affect inflammatory responses and viability of OA patient–derived chondrocytes treated with IL-1β.

Design

The amounts of HMGB1 in the cartilage tissue and synovial fluid in patients with OA were assessed by Western blot and enzyme-linked immunosorbent assay (ELISA). Chondrocytes were extracted from OA patients and maintained in culture. The impact of glycyrrhizin on IL-1β-induced cell toxicity and inflammatory mediators and cytokines, including prostaglandin E2 (PGE2), nitric oxide (NO), proinflammatory cytokines, and metalloproteases (MMPs), were assessed by ELISA, Western blot, quantitative real-time polymerase chain reaction, and the Griess reagent assay.

Results

We confirmed that HMGB1 was significantly upregulated in specimens acquired from patients with OA. HMGB1 inhibition by glycyrrhizin improved cell viability of chondrocytes treated with IL-1β. Glycyrrhizin suppressed IL-1β-induced upregulation of HMGB1 and inflammatory mediators and cytokines, including PGE2, NO, proinflammatory cytokines, and MMPs.

Conclusion

Our results indicate that glycyrrhizin may be a potential therapy for OA patients and these promising findings warrant further study for clinical application.
Chondral and Osteochondritis Dissecans Lesions Treated by Autologous Chondrocytes Implantation: A Mid- to Long-Term Nonrandomized Comparison
Authors: Paatela Teemu , Vasara Anna , Sormaala Markus , Nurmi Heikki , Kautiainen Hannu , Kiviranta Ilkka
Published: June 2020

Objective

The aim of this study was to compare the clinical outcome of cartilage repair with autologous chondrocyte implantation (ACI) in patients with osteochondritis dissecans (OCD) lesions and full-thickness cartilage lesions.

Design

This study included a cohort of 115 consecutive patients with a cartilage lesion of the knee treated with ACI. Of the patients, 35 had an OCD lesion and 80 a full-thickness cartilage lesion. During a follow-up period from 2 to 13 years all treatment failures were identified. The failure rate between OCD lesions and full-thickness cartilage lesions was compared with Kaplan-Meier analysis. Patient-reported outcome was evaluated 2 years postoperatively with the Lysholm score.

Results

During the follow-up 21 out of 115 patients encountered a treatment failure. The failure rate for full-thickness cartilage lesions was 19.1% and for OCD lesions 43.3% over the 10-year follow-up. Patient-reported outcome improved from baseline to 2 years postoperatively. The improvement from baseline was statistically significant, and the Lysholm score improved more than the minimal clinically important difference. The patient-reported outcome showed no difference between lesion types at 2 years.

Conclusions

In the presented retrospective study, the failure rate of first-generation ACI was higher in OCD lesions than in large full-thickness cartilage lesions, suggesting that OCD lesions may associate with properties that affect the durability of repair tissue. Future prospective studies are needed to tell us how to best repair OCD lesions with biological tissue engineering.
Experiences of allogeneic hematopoietic cell transplantation following non-myeloablative conditioning regimen in severely comorbid patients with myelofibrosis: case series with a patient presenting with extensive extramedullary hematopoiesis
Authors: Yoon Jae-Ho , Park Sung-Soo , Min Gi June , Park Silvia , Lee Sung-Eun , Cho Byung-Sik , Kim Yoo-Jin , Lee Seok , Kim Hee-Je , Min Chang-Ki , Cho Seok-Goo , Lee Jong Wook , Eom Ki-Seong
Published: June 2020

We have performed allogeneic hematopoietic cell transplantation (allo-HCT) using a reduced intensity conditioning regimen for curative management of advanced myelofibrosis (MF). However, allo-HCT is rarely considered for elderly or patients with severe comorbidities due to high transplantation-related mortality. In those patients, an alemtuzumab-based non-myeloablative (NMA) conditioning regimen followed by stem cell transplantation could be a possible treatment that has been tried in sickle cell anemia showing stable mixed chimerism and improvement of the disease. However, it is uncertain whether this regimen can provide durable donor-dominant chimerism also in patients with MF. We planned a two-stage allo-HCT in four patients – initially aimed at mixed chimerism with NMA conditioning and then reinforced with additional stem cell infusion if graft failure occurred. In one case with extensive extramedullary hematopoiesis, causing blindness and paraplegia, we achieved stable complete donor-chimerism and complete molecular response with disappearance of bone marrow fibrosis after allo-HCT. Although this NMA regimen failed to achieve durable donor-chimerism, additional stem cell infusion showed a possible role for stable long-term chimerism with good clinical outcomes. Although it leaves room for further improvement, allo-HCT using an NMA conditioning regimen may be worth consideration for advanced MF patients with severe comorbidity, otherwise no appropriate treatment option is available.
Low-dose macrolides for treating pediatric rhinosinusitis: A retrospective study and literature review
Authors: Seresirikachorn Kachorn , Chetthanon Thad , Suwansirisuk Teerapat , Aeumjaturapat Songklot , Chusakul Supinda , Kanjanaumporn Jesada , Snidvongs Kornkiat
Published: June 2020

The effects of low-dose macrolide (LDM) therapy on pediatric chronic rhinosinusitis (CRS) patients are unknown. This study aimed to assess the effectiveness of LDM for treating pediatric refractory CRS. A retrospective study was conducted by a medical chart review. Pediatric CRS patients (age <15 years) who received LDM after standard medical treatments failure between 2013 and 2019 were identified. The LDM treatments with any macrolide agents, doses, and regimens were included. Any co-interventions were allowed. Duration of the LDM therapy was ≥6 weeks. Outcomes were the total nasal symptoms by the visual analogue scale (TNS), presence of individual symptoms, physician-assessment nasal discharge and adverse events. Six patients (67% male, mean age 7±3.4 years) were assessed. All patients had failed to intranasal steroids and nasal saline irrigation but continued. The addition of LDM significantly improved TNS (mean difference ± standard deviation 5.83 ± 1.33; 95% confidence interval 4.44–7.23, p< 0.001). At the end of treatment, the numbers of patients with individual symptoms were decreased: nasal obstruction (100%–67%), rhinorrhea (83%–50%), hyposmia (50%–0%), cough (100%–33%), and physician-assessment thick mucoid discharge (33%–0%). No patients had facial pain. One patient reported mild tolerable nausea. Preliminary findings of this study showed some beneficial effects of LDM added to intranasal steroids and nasal saline irrigation in pediatric CRS after standard treatments failure. The beneficial effects included the improvements of the TNS and individual nasal symptoms and decrease in thick mucoid discharge.
Significance of prediction of the dorsal landmark using three-dimensional computed tomography during laparoscopic lymph node dissection along the proximal splenic artery in gastric cancer
Authors: Ikeda Taro , Kanaji Shingo , Takiguchi Gosuke , Urakawa Naoki , Hasegawa Hiroshi , Yamamoto Masashi , Matsuda Yoshiko , Yamashita Kimihiro , Matsuda Takeru , Oshikiri Taro , Nakamura Tetsu , Suzuki Satoshi , Kakeji Yoshihiro
Published: June 2020

Objectives:

Dissection of the No. 11p lymph nodes is technically challenging because of variations in anatomical landmarks. This study aimed to determine the accuracy and efficacy of predicting the dorsal landmark of No. 11p lymph node using three-dimensional computed tomography simulation.

Methods:

Laparoscopic gastrectomy with No. 11p lymph node dissection with preoperative simulation using three-dimensional computed tomography was performed in 24 patients at our institution from October 2016 to May 2018. Initially, preoperative three-dimensional computed tomography findings with operative videos in these 24 patients were compared. The dorsal landmark was defined as an anatomical structure behind the splenic artery on preoperative three-dimensional computed tomography and operative videos. The dorsal landmark of No. 11p lymph node was divided into four types: (1) splenic vein type, (2) splenic vein and pancreas type, (3) pancreas type, and (4) unclear type. Then, to investigate the efficacy of three-dimensional computed tomography, we compared the clinical and pathological features and surgical outcomes of nine patients who underwent preoperative three-dimensional computed tomography simulation (three-dimensional computed tomography group) and 23 patients who did not undergo three-dimensional computed tomography simulation from August 2014 to September 2016 (non-three-dimensional computed tomography group). All procedures were performed by one surgeon certified by the Endoscopic Surgical Skill Qualification System in Japan.

Results:

The concordance rate between three-dimensional computed tomography and operative videos of the dorsal landmark using three-dimensional computed tomography was 79% (19/24). The operative time of No. 11p lymph node dissection was significantly shorter in the three-dimensional computed tomography group than in the non-three-dimensional computed tomography group (7.7 versus 15.8 min, P = 0.044).

Conclusion:

The accuracy of predicting the dorsal landmark of No. 11p lymph node using three-dimensional computed tomography was extremely high. Preoperative simulation with three-dimensional computed tomography was useful in shortening the operative time of No. 11p lymph node dissection.
Aspirin use for cardiovascular disease prevention in the uninsured population
Authors: Liu Nina , Mathews Adithya , Swanson Justin , Mhaskar Rahul , Mathews Akshay , Ayoubi Noura , Mirza Abu-Sayeef
Published: June 2020

Introduction:

Aspirin is an effective anti-inflammatory and antiplatelet agent as an irreversible inhibitor of cyclooxygenase. In 2016, the U.S. Preventive Services Task Force recommended aspirin for primary prevention of cardiovascular disease in patients aged 50–69 years with a 10% or greater 10-year cardiovascular disease risk. Current guidelines for patients with prior myocardial infarction or coronary artery disease recommend aspirin use for the secondary prevention of cardiovascular disease. Due to the lack of literature describing adherence to these recommendations in the uninsured patient population, we studied aspirin use for cardiovascular disease prevention in free medical clinics.

Methods:

We conducted a cross sectional study of uninsured patients who visited nine free medical clinics in 2016–2017. Data from the records of 8857 patients were combined into a database for analysis. 10-year Framingham risk scores for coronary artery disease were calculated for the 50–69-year-old population to evaluate which patients qualified for aspirin usage. Aspirin use was assessed for patients with prior myocardial infarction or coronary artery disease.

Results:

In total, 1443 patients met the criteria to take aspirin for primary prevention of cardiovascular disease, but just 17% of these patients aged 50–59 years were on the medication. About 15% of the patients aged 60–69 years were taking aspirin. Of the 297 patients who had prior myocardial infarction or coronary artery disease, 50% were taking aspirin for secondary prevention.

Conclusion:

Among the uninsured population, there are low rates of aspirin use for risk reduction of cardiovascular disease. This study demonstrates that improvements are needed to increase adherence to current guidelines and address barriers uninsured patients may face in maintaining their cardiovascular health.
A rare case of Whipple’s disease with endocarditis in a patient with dextrocardia
Authors: Sullivan Abigayle , Shrestha Pragya , Basnet Sijan , Herb Ronald , Zagorski Emily
Published: June 2020

We report a case of an elderly Caucasian male with past medical history of dextrocardia with situs inversus totalis, polymyalgia rheumatica, history of cryptogenic stroke, and severe mitral regurgitation with mitral valve prolapse, who presented with acute heart failure symptoms, including severe dyspnea on exertion and worsening lower extremity edema in the setting of immunosuppression with steroids for a year-old diagnosis of polymyalgia rheumatica. One month prior to this presentation, the patient suffered a transient ischemic attack and during the workup, his transthoracic echocardiography showed myxomatous degeneration of posterior mitral leaflet, partially flail, with severe mitral regurgitation, which required mitral valve replacement. Genome sequencing of mitral valve anterior leaflet pathology detected Tropheryma whipplei as a causal agent of culture-negative endocarditis. The patient was treated with 6 weeks of ceftriaxone and ampicillin–sulbactam and further continued trimethoprim–sulfamethoxazole for 1 year. He continued antibiotic treatment with resolution of shortness of breath along with arthralgia.
Online time, experience of cyber bullying and practices to cope with it among high school students in Hanoi
Authors: Chi Pham Thi Lan , Lan Vu Thi Hoang , Ngan Nguyen Hanh , Linh Nguyen Thuy
Published: June 2020

This study is conducted to learn about experiences and practices to cope with cyberbullying among high school students in Hanoi and to explore the association between the average time of Internet used per day among high school students in Hanoi, Vietnam, and the risk of being cyberbullied. A total of 215 students aged 13–18 years completed an online survey using respondent-driven sampling method. The experience of being cyberbullied was examined using the modified Patchin and Hinduja’s scale. The prevalence of experiencing at least one type of cyberbullying was 45.1%. The most common type of cyberbullying was being called by names/made fun of. The average daily time spent on Internet showed dose-response association with the risk of being cyberbullied. The prevalence of having experienced cyberbullying was 54% among subjects who used Internet >3 hours/day compared to 39% among those who used 1–3 hours and 30% among those who used <1 hour. In terms of practices to cope with this, most students chose to ignore it and not share information with their family or teacher. The most frequent method to overcome this problem was talking with friends (60.8%). Research shows that the prevalence of cyberbullying victimization in Hanoi was high, and student’s practices to cope with this new form of bullying were not efficient. Online time had dose-response association with risk of cyberbullying. More attention is needed to increase level of society/school awareness to prevent cyberbullying in Hanoi.
Limited dorsal myeloschisis in three cats: a distinctive form of neural tube defect
Authors: Butterfield Sarah , Garcia-Gonzalez Beatriz , Driver Colin J , Rusbridge Clare
Published: June 2020

Case series summary

The aim of this case series was to describe the clinical presentation, imaging findings and histopathology of three cats with limited dorsal myeloschisis (LDM). The history, examination and MRI sequences were reviewed in three cases presented to a single referral hospital. The surgery report and histopathology were described in two cases. All cats were young (10 weeks old, 5 months old, 4 years old), presenting with varying degrees of progressive paraparesis. All had a midline skin defect overlying the spinal column that was either sunken or saccular, containing fluid thought to be cerebrospinal fluid. MRI sequences demonstrated tissue extending from the dura through an overlying bifid spinous process and attached to the dermis, with associated spinal cord tethering, atrophy and syringomyelia. Lesions were located at L2–L3, T8–T9 and L4. Histopathology described a fibroneural stalk with a glio-ependymal lining, surrounded by glial nests and nerve fibres. The youngest and most severely affected was euthanased, while the other two underwent surgery. Both regained independent ambulation with persistent paraparesis; however, one required ongoing management of urinary incontinence.

Relevance and novel information

LDM is a primary neural tube defect that may result in neurological deficits, including bladder dysfunction, and is characterised by a fibroneural stalk between the dermis and the spinal cord. Distinct MRI features, such as a visible intrathecal tract, dorsally tethered cord and syringomyelia, help distinguish this condition from the clinically similar dermoid sinus. The presence of progressive neurological signs, with a palpable midline defect overlying the affected spinal cord segment, may raise suspicion for this clinical entity in veterinary patients.
Upregulation of the miRNA-155, miRNA-210, and miRNA-20b in psoriasis patients and their relation to IL-17
Authors: El-Komy Mohamed , Amin Iman , El-Hawary Marwa Safwat , Saadi Dina , Shaker Olfat
Published: June 2020

Psoriasis is an immune-mediated disease, with genetic background and triggering environmental factors; however, several gaps are still present in understanding the intertwined relationship between these elements. Epigenetic mechanisms, including microRNAs (miRNAs), play an important role in the pathogenesis of psoriasis. The relationship between interleukin (IL)-17, a key cytokine in psoriasis, and these epigenetic mechanisms still needs to be elucidated. This study aimed at assessing the expression of miRNA-155, miRNA-210, and miRNA-20b in skin and sera of psoriasis patients in relation to IL-17 levels. For 20 psoriasis patients and 20 matching controls, the expression of miRNA-155, miRNA-210, and miRNA-20b was assessed using real-time polymerase chain reaction (RT-PCR), whereas IL-17/IL-17A levels were measured using quantitative enzyme-linked immunosorbent assay (ELISA) technique. MiRNA-155 expression was significantly higher in lesional skin compared to controls ( P = 0.001). MiRNA-210 expression was significantly higher in both, lesional skin ( P = 0.010) and sera of patients ( P = 0.001) in comparison with controls. A statistically significant positive correlation was found between serum miRNA-210 expression and serum levels of IL-17/IL-17A ( P = 0.010, rs = 0.562). MiRNA-20b lesional and non-lesional expression was significantly higher than controls ( P < 0.001; P = 0.018). In conclusion, the expression of miRNA-155, miRNA-210, and miRNA-20b is exaggerated in psoriasis and they may be involved in disease pathogenesis. A possible relationship between miRNA-210 and IL-17 may be suggested; however, further studies are still needed to verify this relation.
External validation of the sepsis severity score
Authors: Wełna Marek , Adamik Barbara , Goździk Waldemar , Kübler Andrzej
Published: June 2020

Introduction:

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Mortality rates are high, exceeding 50% in patients with septic shock. The sepsis severity score (SSS) was developed to determine the severity of sepsis and as a prognostic model. The aim of this study was to externally validate the SSS model.

Methods:

Calibration and discrimination of the SSS were retrospectively evaluated using data from a single-center sepsis registry.

Results:

Data from 156 septic patients were recorded; 56% of them had septic shock, 94% of patients required mechanical ventilation. The observed hospital mortality was 60.3%. The mean SSS value was 94.4 (95% CI 90.5–98.3). The SSS presented excellent discrimination with an area under the receiver operating characteristic curve (AUC) of 0.806 (95% CI 0.734–0.866). The pairwise comparison of APACHE II (AUC = 0.789; 95% CI 0.715–0.851) with SSS and 1st day SOFA (AUC = 0.75; 95% CI 0.673–0.817) with SSS revealed no significant differences in discrimination between the models. The calibration of the SSS was good with the Hosmer-Lemeshow goodness-of-fit H test 9.59, P > 0.05. Analyses of calibration curve show absence of accurate predictions in lower deciles of lower risk (2nd and 4th).

Conclusion:

The SSS demonstrated excellent discrimination. The calibration evaluation gave conflicting results; the H-L test result indicated a good calibration, while the visual analysis of the calibration curve suggested the opposite. The SSS requires further evaluation before it can be safely recommended as an outcome prediction model.
China’s New Laws and Policies on Nongovernmental Education: Background, Characteristics, and Impact Analysis
Authors: Dong Shengzu
Published: June 2020

Purpose:

China has a long history of private school education. Since the founding of the People’s Republic of China, nongovernmental education (private school education) once disappeared from Chinese society until its revival following the 3rd Plenary Session of the 11th Central Committee of the Communist Party of China. With its development of more than four decades, nongovernmental education has become an important part of China’s educational system and is vigorously promoting the modernization progress of Chinese education.

Design/Approach/Methods:

Being different from the overseas private school education, which is mostly funded by donations, China’s nongovernmental education sector has operated on the basis of private capital investments and contributions, with the organizers (contributors) typically expecting economic returns. Marked by the introduction of regulations and policies for nongovernmental education around the year of 2016, China’s nongovernmental education sector officially entered a new era of registration, support, and regulation by category.

Findings:

The macroscopic policies of China’s nongovernmental education in new era present the following new characters: (I) Emphasizing education provision as a public interest and comprehensively strengthening private school leadership; (II) managing negative lists and broadening the means by which social forces participate in operating schools; (III) implementing preferential policies for private schools through categories based on the principle of being fair but different; (IV) supporting the development of private schools with the goal of improving education quality; (V) standardizing private schools’ operating practices in order to promote healthy and orderly development.

Originality/Value:

The implementing of the new policies on nongovernmental education shall have significant impact on the development and reform of China’s nongovernmental education in the future: (1) The rapid development of nonprofit private schools due to government support; (2) for-profit private schools may face polarization in a fiercely competitive market environment; (3) heavy burden of categorizing and transferring existing stock of schools due to various historical and realistic constraints.
The Mathematics Learning Attributes Valued by Students in Eastern China
Authors: Tang (唐恒钧) Hengjun , Seah (佘伟忠) Wee Tiong , Zhang (张侨平) Qiaoping , Zhang (张维忠) Weizhong
Published: June 2020

Purpose:

Given that prior research has confirmed that students’ mathematics values significantly affect their mathematics learning, understanding how students’ values form and change, especially during different learning stages, is an important topic.

Design/Approach/Methods:

This study administered a questionnaire to investigate the values of primary, junior high, and senior high school students in Eastern China. A principal component analysis was conducted to investigate the factor structure of the students’ learning values. Then, paired sample t-tests were used to examine the differences in the two continuous categories ranking of each group, and a one-way analysis of variance with a Brown–Forsythe test was used to test the differences in the ranking of each dimension by the different grade-level groups.

Findings:

We found that students’ mathematics learning values consist of seven elements: culture, memorization, technology, objectism, practice, understanding, and control. Students placed different degrees of importance on these seven elements at different learning stages. Additionally, we found that junior high school is a critical period of change in students’ values.

Originality/Value:

These findings will be invaluable to teachers and educators as they reflect on their teaching approaches. Moreover, the findings that students’ values undergo changes in the course of their schooling are important information for educators seeking to foster students’ learning.