bluuebunny/crossref_metadata_2025 huggingface dataset:
A Proposal for Complex Gait Evaluation Using Dual-Task Gait Termination Time
Authors: Johnson Rachel S. , Scott Kendall H. , Lynall Robert C.
Published: September 2020

Context: Gait termination time (GTT) has been used to predict falls in older adults but has not been explored in the sport rehabilitation setting. The incorporation of a concurrent cognitive task as a complex measure of gait in this clinical population could lead to better health-related outcomes. Objective: To compare the effect of planned and unplanned gait termination with and without a concurrent cognitive task on reaction time (RT), gait velocity, and GTT. Design: Cross-sectional. Setting: Laboratory. Participants: Twenty young adults (females 60.0%, age 20.1 [0.9] y, height 169.5 [8.8] cm, mass 67.4 [10.8] kg). Intervention: Participants completed 6 planned and 6 unplanned gait termination trials on an instrumented gait mat with and without a cognitive task. Main Outcome Measures: The authors measured RT (s), gait velocity (m/s), GTT (s), and normalized GTT (s2/m). A 2 (motor) × 2 (cognitive) repeated-measures analysis of variance (α = .05) was used; significant interaction effects were explored using Bonferroni-corrected t tests (α < .008). Results: Participants walked more slowly during dual-task trials compared with single-task trials (F1,19 = 4.401, P = .050). Participants walked significantly more slowly with a cognitive task during planned (P < .001, mean difference = −0.184 m/s, 95% CI, −0.256 to −0.111) and unplanned (P = .001, mean difference = −0.111 m/s, 95% CI, −0.173 to −0.050) gait termination. Participants walked significantly more slowly (P < .001, mean difference = −0.142 m/s, 95% CI, −0.210 to −0.075) when performing the most difficult task, unplanned termination with a cognitive task, than when performing the least difficult task, planned termination with no cognitive task. We observed a cognitive task main effect such that adding a cognitive task increased RT (F1,19 = 16.375, P = .001, mean difference = −0.118 s, 95% CI, −0.178 to −0.057) and slowed normalized GTT (F1,19 = 5.655, P = .028, mean difference = −0.167 s2/m, 95% CI, −0.314 to −0.020). Conclusions: Overall, participants displayed more conservative gait strategies and slower RT, normalized GTT, and gait velocity as task difficulty increased. More investigation is needed to truly understand the clinical meaningfulness of these measures in athletic injuries.
Future climate response to Antarctic Ice Sheet melt caused by anthropogenic warming
Authors: Sadai Shaina , Condron Alan , DeConto Robert , Pollard David
Published: September 2020

Antarctic ice loss over the next 250 years will affect global climate, influencing warming rates and ice sheet stability.
Embedding two-dimensional graphene array in ceramic matrix
Authors: Sun Chuan , Huang Yujia , Qiang Shen  , Wang Wei , Pan Wei , Zong Peng’an , Yang Li , Xing Yan , Wan Chunlei
Published: September 2020

Ceramic matrix composites containing two-dimensional graphene array show outstanding mechanical and frictional properties.
First-order synchronization transition in a large population of strongly coupled relaxation oscillators
Authors: Călugăru Dumitru , Totz Jan Frederik , Martens Erik A. , Engel Harald
Published: September 2020

Strongly coupled relaxation oscillators synchronize abruptly beyond a tipping point.
The Hannes hand prosthesis replicates the key biological properties of the human hand
Authors: Laffranchi M. , Boccardo N. , Traverso S. , Lombardi L. , Canepa M. , Lince A. , Semprini M. , Saglia J. A. , Naceri A. , Sacchetti R. , Gruppioni E. , De Michieli L.
Published: September 2020

A prosthetic hand with human-like grasping behavior outperforms what is required in the execution of activities of daily living.
An adaptive deep reinforcement learning framework enables curling robots with human-like performance in real-world conditions
Authors: Won Dong-Ok , Müller Klaus-Robert , Lee Seong-Whan
Published: September 2020

An AI curling robot can compete and win against top-ranked human teams in the game of curling.
Nanopore Sequencing of the Fungal Intergenic Spacer Sequence as a Potential Rapid Diagnostic Assay
Authors: Morrison Gretchen A. , Fu Jianmin , Lee Grace C. , Wiederhold Nathan P. , Cañete-Gibas Connie F. , Bunnik Evelien M. , Wickes Brian L.
Published: September 2020

Fungal infections are being caused by a broadening spectrum of fungi, yet in many cases, identification to the species level is required for proper antifungal selection. We investigated the fungal intergenic spacer (IGS) sequence in combination with nanopore sequencing for fungal identification. We sequenced isolates from two
Cryptococcus
species complexes,
C. gattii
and
C. neoformans
, which are the main pathogenic members of this genus, using the Oxford Nanopore Technologies MinION device and Sanger sequencing.
Successful surgical resection of a rare case of a giant sacral chordoma: a multidisciplinary feat
Authors: Alomari Safwan Omar , Bsat Shadi , Khalife Mohammad , Skaf Ghassan
Published: September 2020

We, here, report the case of a 72-year-old man who presented with a giant sacral chordoma without aggressive clinical and neurological course and confirmed with a CT guided biopsy. The patient underwent multidisciplinary, two-stage successful complete en bloc sacrectomy along with total gross tumour resection, followed by lumboiliac fusion and instrumentation in the second stage without any neurological deficit nor bladder or bowel-related complications.
Sex dimorphism in the associations of gestational diabetes with cord blood adiponectin and retinol-binding protein 4
Authors: Yang Meng-Nan , Chiu Huei-Chen , Wang Wen-Juan , Fang Fang , Zhang Guang-Hui , Zhu Hong , Zhang Lin , Zhang Dan-Li , Du Qinwen , He Hua , Huang Rong , Liu Xin , Li Fei , Zhang Jun , Ouyang Fengxiu , Hua Xiaolin , Luo Zhong-Cheng
Published: September 2020

Introduction

Gestational diabetes (GD) is associated with impaired insulin sensitivity in newborns. Adiponectin and retinol-binding protein 4 (RBP-4) are involved in regulating insulin sensitivity. Females are more likely to develop diabetes at young ages than males. We tested the hypothesis that GD may affect RBP-4 and adiponectin levels in early life, and there may be sex-dimorphic associations.

Research design and methods

In a nested case–control study of 153 matched pairs of neonates of mothers with GD and euglycemic pregnancies in the Shanghai Birth Cohort, we evaluated cord plasma leptin, high molecular weight (HMW) and total adiponectin and RBP-4 concentrations.

Results

Comparing GD versus euglycemic pregnancies adjusted for maternal and neonatal characteristics in female newborns, cord plasma total adiponectin (mean±SD: 30.8±14.3 vs 37.1±16.1 µg/mL, p=0.048) and HMW adiponectin (14.6±7.7 vs 19.3±8.3 µg/mL, p=0.004) concentrations were lower, while RBP-4 concentrations were higher (21.7±5.4 vs 20.0±4.8 µg/mL, p=0.007). In contrast, there were no differences in male newborns (all p>0.2). RBP-4 concentrations were higher in female versus male newborns (21.7±5.4 vs 18.8±4.5 µg/mL, p<0.001) in GD pregnancies only. HMW adiponectin concentrations were significantly higher in female versus male newborns in euglycemic pregnancies only (19.3±8.3 vs 16.1±7.4 µg/mL, p=0.014).

Conclusions

GD was associated with lower cord plasma HMW adiponectin and higher RBP-4 concentrations in female newborns only. The study is the first to reveal a sex-dimorphic early life impact of GD on metabolic health biomarkers in the offspring. GD may alter the normal presence (HMW adiponectin) or absence (RBP-4) of sex dimorphism in some insulin sensitivity regulation-relevant adipokines in early life.
Decreased miR-150 in obesity-associated type 2 diabetic mice increases intraocular inflammation and exacerbates retinal dysfunction
Authors: Yu Fei , Chapman Samantha , Pham Dylan Luc , Ko Michael Lee , Zhou Beiyan , Ko Gladys Y-P
Published: September 2020

Introduction

Diabetic retinopathy (DR) is the leading cause of blindness among the working population in the USA. Current therapies, including anti-vascular endothelial growth factor treatments, cannot completely reverse the visual defects induced by DR. MicroRNA-150 (miR-150) is a regulator that suppresses inflammation and pathological angiogenesis. In patients with diabetes, miR-150 is downregulated. As chronic inflammation is a major contributor to the pathogenesis of DR, whether diabetes-associated decrease of miR-150 is merely associated with the disease progression or decreased miR-150 causes retinal inflammation and pathological angiogenesis is still unknown.

Research design and methods

We used high-fat diet (HFD)-induced type 2 diabetes (T2D) in wild type (WT) and miR-150 knockout (miR-150-/-) mice for this study and compared retinal function and microvasculature morphology.

Results

We found that WT mice fed with an HFD for only 1 month had a significant decrease of miR-150 in the blood and retina, and retinal light sensitivity also decreased. The miR-150-/-mice on the HFD developed diabetes similar to that of the WT. At 7–8 months old, miR-150-/-mice under normal diet had increased degeneration of retinal capillaries compared with WT mice, indicating that miR-150 is important in maintaining the structural integrity of retinal microvasculature. Deletion of miR-150 worsened HFD-induced retinal dysfunction as early as 1 month after the diet regimen, and it exacerbated HFD-induced T2DR by further increasing retinal inflammation and microvascular degeneration.

Conclusion

These data suggest that decreased miR-150 caused by obesity or diabetic insults is not merely correlated to the disease progression, but it contributes to the retinal dysfunction and inflammation, as well as the development of DR.
World Café approach: exploring the future vision of oral anticoagulants for patients with atrial fibrillation (AF) in Ireland
Authors: Murphy Aileen , Brosnan Stephen , McCarthy Stephen , O’Raghallaigh Paidi , Bradley Colin , Kirby Ann
Published: September 2020

Objectives

To explore and reflect on the current anticoagulation therapy offered to patients with atrial fibrillation (AF), potential challenges and the future vision for oral anticoagulants for patients with AF and healthcare professionals in Ireland.

Design

A multistakeholder focus group using a World Café approach.

Participants

Nine participants from academic, clinical and health backgrounds attended the focus group together with a facilitator.

Results

Enhanced patient empowerment; more effective use of technology and developing system-based medical care pathways would provide improved supports for AF management. The challenges in providing these include cost and access issues, the doctor–patient relationship and the provision of education. While consensus for developing evidence-based pathways to maximise efficiency and effectiveness of AF treatment was evident, it would require a shared vision between stakeholders of integrated care. The benefits of embracing technological advances for clinicians and patients were evident; however, clinicians indicate this can increase pressure on already stretched resources; coupled with institutional barriers (including scarce resources) arising from the complex nature of anticoagulation for patients with AF, which emerged strongly. Including the unpredictable nature of warfarin, hidden costs associated with monitoring, adverse clinical effects, different patient cohorts (including those prescribed anticoagulant for the first time vs those switching from warfarin to a new oral anticoagulant (NOAC)), non-adherence concerns and undesirable impacts on patients’ daily lives.

Conclusions

While anticoagulation therapy for patients with AF using NOACs has been widely adopted and is diffusing into routine practice, significant operationalisation issues and barriers to effective treatment/management persist. The reflections reported in this study are a catalyst for future discussion and research.
Qualitative study of antibiotic prescription patterns and associated drivers in Sudan, Guinea-Bissau, Central African Republic and Democratic Republic of Congo
Authors: Eibs Tonka , Koscalova Alena , Nair Mohit , Grohma Paul , Kohler Gisa , Bakhit Rawa Gafar , Thurashvili Mzia , Lasry Estrella , Bauer Sandra Wagner , Jimenez Carolina
Published: September 2020

Objectives

The objective of this study was to address the knowledge gap regarding antibiotic use in Medecins Sans Frontiéres (MSF) projects located in Africa by exploring antibiotic prescription and consumption habits and their drivers at different healthcare levels.

Design

This study used an exploratory study design through thematic analysis of semistructured, in-depth interviews, focus group discussions (FGDs) and field observations in order to understand the main drivers influencing current antibiotics prescription habits and consumption habits of patients in different geographical settings.

Setting

The study took place in MSF centres and towns across four countries: Guinea-Bissau, Central African Republic (CAR), Democratic Republic of Congo (DRC) and Sudan.

Participants

384 respondents participated in the study, which includes project staff, prescribers, community members, patients, among other groups.

Results

Treatment protocols were physically present in all countries except DRC, but compliance to protocols varied across contexts. A failing health system and barriers to accessing healthcare were perceived as major drivers of overuse and inconsistent prescription practices. Patient demands influenced prescription decisions, and self-medication was commonly reported in the context of failing health systems. Additionally, there was a strong demand for quick cures and communities preferred injections over pills. Patients tended to stop antibiotic treatment once symptoms abated and had major gaps in understanding antibiotic intake instructions and functions.

Conclusions

While there were specific findings in each context, the larger trend from these four MSF projects in Africa indicates widespread use of antibiotics based on unclear assumptions, which are often influenced by patient demands. There needs to be a broader focus on the balance between access and excess, especially in such fragile contexts where access to healthcare is a real challenge.
Effectiveness of three-dimensional printed and virtual reality models in learning the morphology of craniovertebral junction deformities: a multicentre, randomised controlled study
Authors: Cai Siyi , He Yu , Cui Haomin , Zhou Xi , Zhou Dongsheng , Wang Fu , Tian Ye
Published: September 2020

Objectives

To compare the effectiveness of three-dimensional printed (3DP), virtual reality (VR) and conventional normal physical (NP) models in clinical education regarding the morphology of craniovertebral junction (CVJ) deformities.

Design

Prospective, multicentre, randomised controlled study.

Setting

Three teaching hospitals in China.

Participants

One hundred and fifty-three participants in their first year of a 3-year medical residency programme.

Interventions

All participants were randomised to one of the three groups to learn the morphology of CVJ deformities using 3DP, VR or NP models.

Primary outcome measures

The objective outcomes were evaluated using three-level objective testing. In the first-level test, the participants were required to identify 15 anatomical landmarks on radiographs without CVJ deformities. In the second-level test, all participants were asked to identify the same 15 landmarks on radiographs showing classic CVJ deformities. In the third-level test, the participants were required to describe the key features of three classic cases of CVJ deformities depicted on radiographs. Each participant was also asked to answer four subjective questions to evaluate the importance and usefulness of the educational materials.

Results

In the first-level test, the 3DP, VR and NP groups achieved similar correct rates. In the second-level test, the correct rate was higher in the 3DP group (82.1%±13.6%) than the VR and NP groups (76.9%±16.9% and 69.9%±20.0%, p=0.002). In the third-level test, the 3DP group achieved better correct rates regarding the description of key CVJ deformities features (66.2%±20.0%, p=0.049) than the other groups. The subjective tests showed that the 3DP model method was considered the most valuable approach for learning CVJ deformities.

Conclusions

The objective and subjective results show that the 3DP model is more effective teaching instrument than the NP model for learning the pathomorphology of CVJ deformities. The VR model also showed great efficacy, second to 3DP model, in improving participants’ understanding of CVJ deformities.
Efficacy and safety of left bundle branch area pacing versus biventricular pacing in heart failure patients with left bundle branch block: study protocol for a randomised controlled trial
Authors: Cheng Liting , Zhang Junmeng , Wang Zefeng , Zhou Mengge , Liang Zhuo , Zhao Lin , Chen Jieruo , Wu Yongquan
Published: September 2020

Introduction

Left bundle branch area pacing (LBBaP) has been accepted as a physiological pacing method that can yield narrow paced QRS waves. For patients with failed biventricular pacing (Bi-V), LBBaP is another feasible option. However, no randomised controlled study has evaluated the efficacy and safety of LBBaP in heart failure patients with left bundle branch block (LBBB). Therefore, we aimed to conduct this type of randomised controlled trial.

Methods and analysis

This study is a single-centre, randomised controlled non-inferiority trial. This study will be conducted at the cardiac centre of Beijing Anzhen Hospital. From January 2020 to December 2022, 180 heart failure patients with reduced left ventricular ejection fraction (LVEF ≤35%) and LBBB undergoing Bi-V implantation will be consecutively enrolled in this study. Participants will be randomised at a 1:1 ratio into an experimental group (LBBaP) and a control group (Bi-V). The primary outcome is LVEF. The secondary outcomes are NT-proBNP, duration of the QRS complex, end systolic volume, end diastolic volume, the 6-minute walking test and quality of life (SF-36 scale), all causes of mortality, cardiovascular death, rehospitalisation rate of heart failure, other rehospitalisation rates, major complication rates, procedure costs and hospitalised dates.

Ethics and dissemination

This study has been approved by the Beijing Anzhen Hospital Medical Ethics Committee (No. ks201932). The results of this study will be presented at domestic and international conferences. We hypothesise that LBBaP is non-inferior compared with Bi-V for treating patients with heart failure and LBBB. This trial will provide evidence-based recommendations for electrophysiologists.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2000028726).
Incidence, morbidity and mortality of hip fractures over a period of 20 years in a health area of Southern Spain
Authors: Rey-Rodriguez Marta M , Vazquez-Gamez MA , Giner Mercè , Garrachón-Vallo Fernando , Fernández-López Luis , Colmenero Miguel Angel , Montoya-García María-José
Published: September 2020

Objective

To evaluate the incidence of osteoporotic hip fracture in the Macarena Health Area (Seville).

Setting and participants

This was a prospective observational study that collected all osteoporotic hip fractures that occurred between March 2013 and February 2014 at the Clinical Unit of Traumatology and Orthopaedics. All cases collected during the first 6 months of the study were followed for 1 year after the occurrence of the event.

Outcome measures

We evaluated the incidence of osteoporotic hip fractures in the Macarena Health Area (Seville) from 1 March 2013 to 28 February 2014, and we compared the incidence with that in 2 previous studies carried out with the same methodology in 1994 and 2006. Furthermore, we calculated the morbidity and degree of disability 1 year after the fracture occurred and determined mortality and the associated factors.

Results

The overall incidence was 228 per 100 000 individuals/year (95% CI 204.5 to 251.6), and the incidence was higher in women than in men. In women, the incidence rate decreased in all age groups over time, while in men, the incidence rate increased. The mortality rate 1 year after the episode was 27.2%. The factors associated with overall mortality were a body mass index below 25 kg/m2, renal failure and low plasma proteins.

Conclusions

Our results show a high incidence of osteoporotic hip fracture that is increasing in men, and in men it is associated with a higher mortality than in women. There is room to improve the modifiable factors associated with mortality and the available rehabilitation interventions to reduce the disability associated with these fractures.
Mixed methods study protocol to examine perceptions of family medicine among long-term patients of a family medicine clinic in Japan
Authors: Sato Kotaro , Michinobu Ryoko , Kusaba Tesshu
Published: September 2020

Introduction

Family physicians or general practitioners play central roles in many countries’ primary care systems, but family medicine (FM) remains relatively unestablished in Japan. Previous studies in Japan have examined the general population’s understanding of FM as a medical specialty, but none have explored this topic using actual FM clinic patients. Here, we describe a protocol to explore the perceptions of FM among long-term patients of one of Japan’s oldest FM clinics.

Methods and analysis

The study will be conducted at the Motowanishi Family Clinic in Hokkaido, Japan, using patients who have attended the clinic for over 10 years. The analysis will adopt a two-phase explanatory sequential mixed methods design. During phase I, quantitative data from participants’ medical records will be collected and reviewed, and patients’ perceptions of FM will be assessed through a questionnaire. The correlations between participants’ knowledge that the clinic specialises in FM and various characteristics will be examined. In phase II, qualitative data will be collected through semi-structured interviews of approximately 10 participants selected using maximum variation sampling based on phase I results. A thematic analysis will be conducted in phase II to identify patients’ perceptions and changes in perceptions. Finally, each theme identified in phase II will be transformed into a quantitative variable to analyse the relationships between the phases. A joint display will be used to integrate the phases’ findings and examine how phase II results explain phase I results.

Ethics and dissemination

The institutional review board of the Japan Primary Care Association has approved this research (2019-003). The results will be presented at the association’s annual academic meeting and submitted for publication in relevant journals. The findings will also be provided to the patients via the clinic’s internal newsletter.
Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months
Authors: Sui Yi , Luo Jianfeng , Dong Chunyao , Zheng Liqiang , Zhao Weijin , Zhang Yao , Xian Ying , Zheng Huaguang , Yan Bernard , Parsons Mark , Ren Li , Xiao Ying , Zhu Haoyue , Ren Lijie , Fang Qi , Yang Yi , Liu Weidong , Xu Bing
Published: September 2020

Background

The rate of intravenous thrombolysis for acute ischaemic stroke remains low in China. We investigated whether the implementation of a citywide Acute Stroke Care Map (ASCaM) is associated with an improvement of acute stroke care quality in a Chinese urban area.

Methods

The ASCaM comprises 10 improvement strategies and has been implemented through a network consisting of 20 tertiary hospitals. We identified 7827 patients with ischaemic stroke admitted from April to October 2017, and 506 patients underwent thrombolysis were finally included for analysis.

Results

Compared with ‘pre-ASCaM period’, we observed an increased rate of administration of tissue plasminogen activator within 4.5 hours (65.4% vs 54.5%; adjusted OR, 1.724; 95% CI 1.21 to 2.45; p=0.003) during ‘ASCaM period’. In multivariate analysis models, ‘ASCaM period’ was associated with a significant reduction in onset-to-door time (114.1±55.7 vs 135.7±58.4 min, p=0.0002) and onset-to-needle time (ONT) (169.2±58.1 vs 195.6±59.3 min, p<0.0001). Yet no change was found in door-to-needle time. Clinical outcomes such as symptomatic intracranial haemorrhage, favourable functional outcome (modified Rankin Scale ≤2) and in-hospital mortality remained unchanged.

Conclusion

The implementation of ASCaM was significantly associated with increased rates of intravenous thrombolysis and shorter ONT. The ASCaM may, in proof-of-principle, serve as a model to reduce treatment delay and increase thrombolysis rates in Chinese urban areas and possibly other highly populated Asian regions.
Why Do Corporations Decide to Do Good?
Authors: Siegel Donald S.
Published: September 2020

In his highly influential essay, Milton Friedman argued that companies should never engage in “social responsibility,” defined as going beyond regulatory compliance and normal business practices to advance a “social” goal. In contrast, I argue for a more nuanced approach when considering in engaging in these activities. Specifically, I assert that companies should not engage in such activities for “moral” or “ethical” reasons or in response to societal pressure alone, but rather in response to a legitimate demand for ‘social’ practices from groups (e.g. consumers) that can directly benefit the firm. This profit-maximizing approach to ‘social responsibility’ still allows for considerable scope in formulating and implementing strategic initiatives that simultaneously advance corporate and societal goals. Under certain conditions, managers can maximize profit, while also adopting practices that are perceived to be socially responsible.
Redundancy and multifunctionality among spinal locomotor networks
Authors: Pham Bau N. , Luo Jiangyuan , Anand Harnadar , Kola Olivia , Salcedo Pia , Nguyen Connie , Gaunt Sarah , Zhong Hui , Garfinkel Alan , Tillakaratne Niranjala , Edgerton V. Reggie
Published: September 2020

The results are consistent with there being an extensive amount of redundancy among spinal locomotor circuits. Using the newly developed FosTRAP mouse model, only ∼20% of neurons that were active (labeled by fos-linked tdTomato expression) during a first bout of 30-min stepping were also labeled for c-fos during a second bout of stepping. This finding suggests variability of neural networks that enables selection of many combinations of neurons (synapses) when generating each step cycle.
Matrix Metalloproteinase-2 Isoforms Differ within the Aortic Wall of Ascending Aortic Aneurysms Associated with Bicuspid Aortic Valve
Authors: Schmitt Ramona , Tscheuschler Anke , Laschinski Philipp , Discher Philipp , Fuchs Jana , Kari Fabian A.
Published: September 2020

The pathogenesis of ascending thoracic aortic aneurysm (aTAA) is thought to differ between patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV), and one of the causes is different hemodynamics. Influenced by hemodynamics, the tissue levels of proteins associated with aTAA might differ between aTAAs with BAV and TAV and between different localities within the aortic wall. We therefore analyzed aTAA tissue levels of MMP-2 (matrix metalloproteinase-2) isoforms (Pro-MMP-2, active MMP-2, and total MMP-2) and tissue levels of MMP-14, TIMP-2 (tissue inhibitor of metalloproteinase-2), MMP-9, and TIMP-1 in 19 patients with BAV and 23 patients with TAV via gelatin zymography and enzyme-linked immunosorbent assay (ELISA), respectively. TAV and BAV groups’ protein levels did not differ significantly. Whereas the TAV group exhibited no significant differences in protein levels between the aneurysm’s anterior and posterior parts, the BAV group revealed significantly higher levels of Pro-MMP-2, total MMP-2, and TIMP-2 in the aneurysm’s posterior parts (mean Pro-MMP-2 200.52 arbitrary units (AU) versus 161.12 AU, p=0.007; mean total MMP-2 235.22 AU versus 193.68 AU, p=0.002; mean TIMP-2 26.90 ng/ml versus 25.36 ng/ml, p=0.009), whereas the other proteins did not differ significantly within the aortic wall. Thus, MMPs are distributed more heterogeneously within the aortic wall of aTAAs associated with BAV than in those associated with TAV, which is a new aspect for understanding the underlying pathogenesis. This heterogeneous protein level distribution might be attributable to differences in the underlying pathogenesis, especially hemodynamics. This result is important for further studies as it will be essential to specify the location of samples to ensure data comparability regarding the main goals of understanding the pathogenesis of aTAA, optimizing treatments, and establishing a screening method for its potentially deadly complications.
A Randomized Controlled Trial: Comparison of 4% Articaine versus 0.5% Bupivacaine for Ambulatory Orthopedic Surgery under Supraclavicular Block
Authors: Armanious Simon H. , Abdelhameed Gamal A.
Published: September 2020

Background. Articaine has been used in many dental and ophthalmic outpatient procedures. In the era of ultrasound-guided regional techniques, we searched for short and potent local anesthetic for patients undergoing ambulatory upper limb procedures. However, studies about articaine efficacy in brachial plexus block are limited. In this study, we compared its safety and efficacy against bupivacaine as a commonly used anesthetic agent for ultrasound-guided supraclavicular brachial plexus block. Methods. This randomized prospective study was performed at Ain Shams University Hospital from January to March 2020. A total of 117 patients aged 20 to 60 years, with the American Society of Anesthesiologists physical status I and II, were enrolled in the study. Patients were randomly allocated into two groups: in group A, patients received 30 ml articaine 2%, and in group B, patients received 30 ml of bupivacaine 0.5%. We measured motor and sensory block duration as a primary outcome. Other secondary outcomes such as onset of block, duration of analgesia, patient satisfaction, and time to home discharge readiness were also measured. Results. We analyzed data collected from 97 patients. The motor block duration was significantly shorter in group A (165.73 ± 20.33 min) than in group B (220.27 ± 37.73 min). The onset of motor block was faster in group A (8.73 ± 4.33 min), and the postoperative VAS score was lower in group B. Patients in group A achieved an earlier home discharge of 289.67 ± 2.73 min. Conclusion. Earlier resolution of articaine block makes it more favorable than bupivacaine for ambulatory surgery. This trial is registered with (NCT04189198).
Convalescent Plasma: A Challenging Tool to Treat COVID‐19 Patients—A Lesson from the Past and New Perspectives
Authors: Selvi Valeria
Published: September 2020

On March 11th, 2020, the World Health Organization declared COVID‐19 infection as a pandemic. Since it is a novel virus, there are basically no proven drugs or therapies; although many laboratories in different countries are working to develop a vaccine, it will take time to make it available. Passive immunization is the therapy born from the intuition of Behring and Kisato in the late 19th century. It was widely used for the treatment of bacterial infections until the discovery of antibiotics, as well as during the viral pandemics of the 20th century and of the beginning of the 21st; it still has clinical applications (e.g., tetanus prevention). This paper summarizes the basic principles of passive immunization, with particular reference to convalescent plasma. The literature concerning its use during past epidemics and the results of the first clinical studies concerning its use during the current pandemic are discussed too. A large section is dedicated to the analysis of the possible, although rare, side effects. Recently, in 2017, the WHO Blood Regulators Network (BRN) published a position paper, recommending convalescent plasma as the first‐choice treatment to be tested in the absence of authorized drugs; however, this strategy has not been followed. In the current epidemic, the principle of passive immunization through convalescent plasma has been applied in several circumstances and particularly in patients with serious complications. The first reported results are encouraging and confirm the effectiveness of plasma therapy and its safety. Also, the FDA has proposed plasma treatment in order to face the increasingly complex situation and manage patients with serious or immediately life‐threatening COVID‐19 disease. Several studies and clinical programs are still ongoing.
Correlation of Serum Cardiac Markers with Acute Decompensating Events in Liver Cirrhosis
Authors: Li Miaomiao , Guo Zeqi , Zhang Dan , Xu Xiangbo , Romeiro Fernando Gomes , Mancuso Andrea , Zhang Jingqiao , Feng Ruirui , Zhou Xinmiao , Hong Cen , Qi Xingshun
Published: September 2020

Background and Aim. Liver cirrhosis is often accompanied by insidious cardiac dysfunction. This retrospective cross-sectional study is aimed at exploring the correlation between serum cardiac markers and decompensating events in liver cirrhosis.Methods. Cirrhotic patients who were consecutively hospitalized between January 2016 and March 2019 were screened. Serum cardiac biomarkers at admission, including N-Terminal pro-B-type natriuretic peptide (NT-pro BNP), high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), creatine kinase MB (CK-MB), and lactate dehydrogenase (LDH), were collected. Acute decompensating events at admission, primarily including ascites, acute gastrointestinal hemorrhage, and acute-on-chronic liver failure (ACLF), were recorded.Results. The NT-pro BNP level was significantly higher in cirrhotic patients with acute decompensating events than in those without any decompensating events (median: 140.75 pg/mL versus 41.86 pg/mL,P<0.001). The NT-pro BNP level significantly correlated with ascites, acute gastrointestinal hemorrhage, and ACLF. The hs-cTnT level was significantly higher in cirrhotic patients with acute decompensating events than in those without decompensating events (median: 0.008 ng/mL versus 0.006 ng/mL,P=0.007). The hs-cTnT level significantly correlated with acute gastrointestinal hemorrhage, but not ascites or ACLF. LDH (185.0 U/L versus 173.5 U/L,P=0.281), CK (71 U/L versus 84 U/L,P=0.157), and CK-MB (29.5 U/L versus 33.0 U/L,P=0.604) levels were not significantly different between cirrhotic patients with and without acute decompensating events.Conclusion. The elevated NT-pro BNP level seems to be closely related to the development of acute decompensating events in liver cirrhosis.
Polymorphic Ventricular Tachycardia Associated with High-Dose Methadone Use
Authors: Tam Weng-Chio , Lam U-Po , Mok Toi-Meng , Chang Tou , Ho Wa , De Brito Lima Evora Mario Alberto
Published: September 2020

Methadone is a well-tolerated drug that has been used for pain control and the treatment of opioid addiction. However, some fatal cardiac side effects have been reported previously, including ventricular arrhythmia, stress cardiomyopathy, and coronary artery disease. We reported a middle-aged woman receiving high-dose methadone whom was presented with QT prolongation and torsade de pointes. We replaced the methadone with benzodiazepine and gave lidocaine use simultaneously. Thus, QT interval was shortened within the normal limit. Methadone-induced torsade de pointes is a rare but serious event, and QT interval should be monitored periodically to prevent this fatal adverse event, especially some patients with high-dose methadone use.
Identification of the Key Genes Involved in the Effect of Folic Acid on Endothelial Progenitor Cell Transcriptome of Patients with Type 1 Diabetes
Authors: Lu Yi , Yang Qianhong , Hu Wei , Dong Jian
Published: September 2020

Type 1 diabetes (T1D) is one of the most common autoimmune diseases in children. Previous studies have suggested that endothelial progenitor cells (EPCs) might be engaged in the regulating of the biological processes in T1D and folic acid (FA) might be engaged in regulating EPC function. The present study has identified 716 downregulated genes and 617 upregulated genes in T1D EPC cases after treated with FA. Bioinformatics analysis has shown that these DEGs were engaged in regulating metabolic processes, cell proliferation-related processes, bone marrow development, cell adhesion, platelet degranulation, and cellular response to growth factor stimulus. Furthermore, we have conducted and identified hub PPI networks. Importantly, we have identified 6 upregulated genes (POLR2A, BDNF, CDC27, LTN1, RAB1A, and CUL2) and 8 downregulated genes (SHC1, GRIN2B, TTN, GNAL, GNB2, PTK2, TF, and TLR9) as key regulators involved in the effect of FA on endothelial progenitor cell transcriptome of patients with T1D. We think that this study could provide novel information to understand the roles of FA in regulating EPCs of T1D patients.
Thymic Stromal Lymphopoietin Is Implicated in the Pathogenesis of Bullous Pemphigoid by Dendritic Cells
Authors: Li Si-Zhe , Jin Xin-Xing , Ge Xiao-Lei , Zuo Ya-Gang , Jin Hong-Zhong
Published: September 2020

Objectives. Both thymic stromal lymphopoietin (TSLP) and dendritic cells (DCs) are involved in many autoimmune diseases, but the potential roles of TSLP and DCs in bullous pemphigoid (BP) have not been clarified. We sought to explore the contributions of TSLP and DCs in patients with BP.Methods. TSLP levels in sera and blister fluids were measured by enzyme-linked immunosorbent assay. The TSLP expression in the BP lesional skin was detected by immunohistochemical staining. Infiltration of DCs, marked by DC-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN), and its relationship with TSLP and TSLP receptors was evaluated by immunofluorescence staining.Results. We found that TSLP levels in sera and in blister fluids of patients with BP were higher compared to the control groups. In patients with BP, TSLP levels in sera correlated with TSLP levels in blisters. The expression of TSLP in the BP lesional skin was higher compared to the healthy controls’ skin. Greater numbers of TSLP-positive cells were observed in the epidermis of patients with BP compared to the healthy controls. Greater numbers of DC-SIGN-positive cells were present in the BP lesional skin compared to the skin of controls. The expression of TSLP was highly upregulated in DC-SIGN-positive cells, and most DC-SIGN-positive cells expressed TSLP receptors.Conclusions. We conclude that TSLP may activate DC-SIGN-positive DCs directly, which may be involved in the pathogenesis of BP.
Detection of Phosphorylated Alpha-Synuclein in the Muscularis Propria of the Gastrointestinal Tract Is a Sensitive Predictor for Parkinson’s Disease
Authors: Beck Goichi , Hori Yumiko , Hayashi Yoshito , Morii Eiichi , Takehara Tetsuo , Mochizuki Hideki
Published: September 2020

Background. Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor impairments, including constipation. Lewy bodies and neurites, the pathological hallmarks of PD, are found in the enteric nervous system (ENS) as well as the central nervous system. Constipation is a well-documented premotor symptom in PD, and recent reports have demonstrated Lewy pathology in gastrointestinal (GI) tissues of PD patients prior to the onset of motor symptoms. Objective. In the present study, we assessed Lewy pathology in the GI tracts of seven PD patients who had undergone a gastrectomy, gastric polypectomy, or colonic polypectomy prior to the onset of motor symptoms in order to assess whether the presence of pathological αSyn in the ENS could be a predictor for PD. Methods. GI tissue samples were collected from control patients and patients with premotor PD. Immunohistochemistry was performed using primary antibodies against α-synuclein (αSyn) and phosphorylated αSyn (pαSyn), after which Lewy pathology in each sample was assessed. Results. In all control and premotor PD patients, accumulation of αSyn was observed in the myenteric plexus in both the stomach and colon. In 82% (18/22) of control patients, mild-to-moderate accumulation of αSyn was observed in the submucosal plexus. However, there was no deposition of pαSyn in the ENS of control patients. In patients with premotor PD, abundant accumulation of αSyn was observed in the myenteric plexus, similar to control patients. On the other hand, pαSyn-positive aggregates were also observed in the nerve fibers in the muscularis propria in all examined patients with premotor PD (100%, 3/3), while the deposition of pαSyn in the submucosal plexus was only observed in one patient (14%, 1/7). Conclusion. Our results suggest that the detection of pαSyn, but not αSyn, especially in the muscularis propria of GI tracts, could be a sensitive prodromal biomarker for PD.
Evaluation of Wearable Sensor Devices in Parkinson’s Disease: A Review of Current Status and Future Prospects
Authors: Lu Ruirui , Xu Yan , Li Xiaohui , Fan Yongli , Zeng Weiqi , Tan Yang , Ren Kang , Chen Wenwu , Cao Xuebing
Published: September 2020

Parkinson’s disease (PD) decreases the quality of life of the affected individuals. The incidence of PD is expected to increase given the growing aging population. Motor symptoms associated with PD render the patients unable to self-care and function properly. Given that several drugs have been developed to control motor symptoms, highly sensitive scales for clinical evaluation of drug efficacy are needed. Among such scales, the objective and continuous evaluation of wearable devices is increasingly utilized by clinicians and patients. Several electronic technologies have revolutionized the clinical monitoring of PD development, especially its motor symptoms. Here, we review and discuss the recent advances in the development of wearable devices for bradykinesia, tremor, gait, and myotonia. Our aim is to capture the experiences of patients and clinicians, as well as expand our understanding on the application of wearable technology. In so-doing, we lay the foundation for further research into the use of wearable technology in the management of PD.
Effect of Selenium on Expression of Apoptosis‐Related Genes in Cryomedia of Mice Ovary after Vitrification
Authors: Nori-Garavand Reza , Hormozi Maryam , Narimani Leila , Beigi Boroujeni Nasim , Rajabzadeh Asghar , Zarei Leila , Beigi Boroujeni Masoud , Beigi Boroujeni Mandana
Published: September 2020

Introduction. Freezing of ovarian tissue is used for preservation of fertility. The freezing‐thawing process is accompanied by oxidative stress and induction of apoptosis. Apoptosis is a complex process that has been studied in animal models. The present study was aimed at investigating the effect of selenium on suppression of apoptosis during vitrification‐thawing process of mice ovary via studying expression of apoptosis‐related genes, and also, we aimed to design statistical models for the roles of single genes and gene‐gene interactions in suppression of apoptosis. Methods. A total of 10 right ovary samples from 10 mice were randomly divided into two groups of selenium treatment (at dose 5 μg/ml sodium selenite, through adding to the media) and control group. Vitrification‐thawing process was done according to the existed protocols. Real‐time PCR was used for gene expression study. The apoptosis gene profile included P53, Bax, Fas, and Bcl-2. General linear model was applied to study single gene associations and gene‐gene interactions. Results. From the studied genes, P53 showed a significant downregulation in the selenium group in comparison to the control group (∆∆CT = 1.96; P = 0.013; relative expression (RE) = 0.28). Bcl-2 showed a significant upregulation in the selenium group in comparison to the control group (∆∆CT = −2.49; P < 0.001; RE = 3.49). No significant result was found for other genes. According to the multiple models, Bcl-2 showed a protective single gene association (beta = −0.33; P = 0.032), and Fas ∗ Bcl-2 interaction was significantly positive (beta = 0.19; P = 0.036). Conclusion. Addition of selenium to cryomedia of vitrification‐thawing process could reduce the apoptosis induced by freezing‐thawing stress in mice ovary via downregulation of P53 and upregulation of Bcl-2 at transcription level. Multivariable statistical models should be performed in future researches to study biological systems.
New Results for Set-Valued Mappings on Ordered Metric Spaces
Authors: Sabetghadam F. , Masiha H. P. , Aydi H.
Published: September 2020

We establish some new fixed point results for order-closed multivalued mappings in complete metric spaces endowed with a partial order.
Z Boson Production via p-p and Pb-Pb Collisions at spp=5.02 TeV
Authors: Kisslinger Leonard S. , Das Debasish
Published: September 2020

We estimate the production of Za bosons, with a as the component of a Z vector boson, via p-p collisions using previous work on J/Ψ,Ψ2S production in p-p collisions, with the new aspect being the creation of Za bosons via quark interactions. We then estimate the production of Za bosons via Pb-Pb collisions using modification factors from previous publications.
Easy Identification of Optimal Coronal Slice on Brain Magnetic Resonance Imaging to Measure Hippocampal Area in Alzheimer’s Disease Patients
Authors: Zach P. , Bartoš A. , Lagutina A. , Wurst Z. , Gallina P. , Rai T. , Kieslich K. , Riedlová J. , Ibrahim I. , Tintěra J. , Mrzílková J.
Published: September 2020

Introduction. Measurement of an‐ hippocampal area or volume is useful in clinical practice as a supportive aid for diagnosis of Alzheimer’s disease. Since it is time‐consuming and not simple, it is not being used very often. We present a simplified protocol for hippocampal atrophy evaluation based on a single optimal slice in Alzheimer’s disease. Methods. We defined a single optimal slice for hippocampal measurement on brain magnetic resonance imaging (MRI) at the plane where the amygdala disappears and only the hippocampus is present. We compared an absolute area and volume of the hippocampus on this optimal slice between 40 patients with Alzheimer disease and 40 age‐, education‐ and gender‐mateched elderly controls. Furthermore, we compared these results with those relative to the size of the brain or the skull: the area of the optimal slice normalized to the area of the brain at anterior commissure and the volume of the hippocampus normalized to the total intracranial volume. Results. Hippocampal areas on the single optimal slice and hippocampal volumes on the left and right in the control group were significantly higher than those in the AD group. Normalized hippocampal areas and volumes on the left and right in the control group were significantly higher compared to the AD group. Absolute hippocampal areas and volumes did not significantly differ from corresponding normalized hippocampal areas as well as normalized hippocampal volumes using comparisons of areas under the receiver operating characteristic curves. Conclusion. The hippocampal area on the well‐defined optimal slice of brain MRI can reliably substitute a complicated measurement of the hippocampal volume. Surprisingly, brain or skull normalization of these variables does not add any incremental differentiation between Alzheimer disease patients and controls or give better results.