bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of baicalein on endoplasmic reticulum stress and autophagy on liver damage
Authors: Üstüner MC , Tanrikut C , Üstüner D , Kolaç UK , Köroğlu Z Özdemir , Burukoğlu D , Entok E
Published: March 2021

Carbon tetrachloride (CCl4) is a toxic chemical that causes liver injury. CCl4 triggers endoplasmic reticulum (ER) stress and unfolded protein response (UPR). UPR triggers autophagy to deal with the damage. The aim of this study was to investigate the effect of baicalein, derived from Scutellaria baicalensis, on CCl4-induced liver damage concerning ER stress and autophagy. Two groups of Wistar albino rats (n = 7/groups) were treated with 0.2 ml/kg CCl4 for 10 days with and without baicalein. Histological and transmission electron microscopy (TEM) analysis, autophagy, and ER stress markers measurements were carried out to evaluate the effect of baicalein. Histological examinations showed that baicalein reduced liver damage. TEM analysis indicated that baicalein inhibited ER stress and triggered autophagy. CCl4-induced elevation of C/EBP homologous protein (CHOP), glucose-regulating protein 78 (GRP78), activating transcription factor 4 (ATF4), activating transcription factor 6 (ATF6), inositol requiring enzyme 1 (IRE1), pancreatic ER kinase (PERK), and active/spliced form of X-box-binding protein 1 (XBP1s) ER stress markers were decreased by baicalein. Baicalein also increased the autophagy-related 5 (ATG5), Beclin1, and Microtubule-associated protein 1A/1B-light chain 3-phosphatidylethanolamine-conjugated form (LC3-II) autophagy marker levels. In conclusion, baicalein reduced the CCl4-induced liver damage by inhibiting ER stress and the trigger of autophagy.
The Fetal Origins of Human Psychological Development
Authors: Reid Vincent M. , Dunn Kirsty
Published: March 2021

The human fetus holds the key to unlocking the initial origins and predispositions of all aspects of human psychological development. Despite this, difficulties related to experimentally manipulating the behavior of the fetus to assess capacities have sidelined the fetus within the developmental sciences. Instead, the focus has been on the human infant. With new developments in the fields of obstetrics, medical physics, and psychology, the methodological constraints surrounding research on the human fetus are now reduced. We highlight new approaches and indicate possible new directions in the understanding of the cognitive and perceptual capacities of the human fetus.
Development of the Rubber Sector in North East India: A Case of Missing Innovation and Linkages
Authors: Bhowmik Indraneel , Viswanathan P. K.
Published: March 2021

The development of the rubber sector in North East (NE) India in recent decades is an outcome of the government’s import substitution initiatives in the post-independence period. The article attempts to trace the process of evolution and development of the rubber sector in the region and observes that the adopted policies for rubber expansion had been framed under the narrow innovation system model, whereby the localised knowledge and learning, as well as practices, remained completely ignored in the promotion of the sector. The lack of region-specific rubber development strategies with appropriate linkages supported by institutional systems are the critical gaps that undermine the sustainable growth of the rubber sector in the NE region. Eventualities of the sort call for reinventing policies and programmes under the broad innovation system framework, so as to reap the advantages emanating from the integration of the region with the global market and facilitate greater diversification and sustainable growth of the rubber sector.
Get up, stand up: art’s affordances for unseating and unsettling
Authors: Lysen Flora
Published: March 2021

In response to Erik Rietveld’s text “The affordances of art for making technologies,” this commentary probes art’s affordances for what Rietveld calls behavioral “changeability.” I ask, how can a view of art’s affordances help to better understand collective and relational affects and habitual behaviors? Can artworks help to “radically change the affordances available in our surroundings,” to generate collective social action and behavioral change?
Pharmacogenomics in Pain Management: A Review of Relevant Gene-Drug Associations and Clinical Considerations
Authors: Brandl Emily , Halford Zachery , Clark Matthew D. , Herndon Chris
Published: March 2021

Objective:

To provide an overview of clinical recommendations regarding genomic medicine relating to pain management and opioid use disorder.

Data Sources:

A literature review was conducted using the search terms pain management, pharmacogenomics, pharmacogenetics, pharmacokinetics, pharmacodynamics, and opioids on PubMed (inception to February 1, 2021), CINAHL (2016 through February 1, 2021), and EMBASE (inception through February 1, 2021).

Study Selection and Data Extraction:

All relevant clinical trials, review articles, package inserts, and guidelines evaluating applicable pharmacogenotypes were considered for inclusion.

Data Synthesis:

More than 300 Food and Drug Administration–approved medications contain pharmacogenomic information in their labeling. Genetic variability may alter the therapeutic effects of commonly prescribed pain medications. Pharmacogenomic-guided therapy continues to gain traction in clinical practice, but a multitude of barriers to widespread pharmacogenomic implementation exist.

Relevance to Patient Care and Clinical Practice:

Pain is notoriously difficult to treat given the need to balance safety and efficacy when selecting pharmacotherapy. Pharmacogenomic data can help optimize outcomes for patients with pain. With improved technological advances, more affordable testing, and a better understanding of genomic variants resulting in treatment disparities, pharmacogenomics continues to gain popularity. Unfortunately, despite these and other advancements, pharmacogenomic testing and implementation remain underutilized and misunderstood in clinical care, in part because of a lack of health care professionals trained in assessing and implementing test results.

Conclusions:

A one-size-fits-all approach to pain management is inadequate and outdated. With increasing genomic data and pharmacogenomic understanding, patient-specific genomic testing offers a comprehensive and personalized treatment alternative worthy of additional research and consideration.
Outcomes of Simultaneous Bilateral vs Unilateral Distal Chevron Metatarsal Osteotomy in Hallux Valgus Patients Aged ≥60 Years
Authors: Seo Jae Hyeon , Lee Ho Seong , Choi Young Rak , Park Seung Hwan , Lee Jae Hyung , Chun Hannah
Published: March 2021

Background:

The purpose of this study was to compare radiographic outcomes of simultaneous bilateral and unilateral distal chevron metatarsal osteotomy (DCMO) in hallux valgus patients aged ≥60 years.

Methods:

This retrospective study analyzed consecutive outcomes of simultaneous bilateral DCMO and unilateral DCMO performed between June 2010 and August 2018 in 90 feet of 60 patients. Thirty patients underwent simultaneous bilateral DCMO, and 30 underwent unilateral DCMO. Comparative analysis of radiographic and clinical parameters between a simultaneous bilateral DCMO group (SB) and a unilateral DCMO group (U) was performed.

Results:

Mean age at surgery (65.7±4.8 vs 65.2±5.2 years), mean length of follow-up period (20.0 vs 18.6 months), and preoperative radiographic parameters were similar between the 2 groups (SB vs U). Mean hallux valgus angle (HVA) improved from 34.2 to 5.4 degrees (correction angle SB 28.8 vs U 28.8 degrees). Mean first-to-second intermetatarsal angle improved from 15.8 to 6.8 degrees (correction angle SB 8.9 vs U 8.9 degrees). Hallux varus deformity was observed in 4 feet (SB 3 vs U 1), and mechanical instability with callus formation in 1 foot in the unilateral group.

Conclusion:

DCMOs in patients aged ≥60 years were radiographically effective and safe, even performed in one stage bilaterally. Radiographic parameters were similar in patients who underwent simultaneous bilateral and unilateral DCMO.

Level of Evidence:

Level III, retrospective cohort study.
Time-Dependent Effects of Individual and Combined Treatments With Nebivolol, Lisinopril, and Valsartan on Blood Pressure and Vascular Reactivity to Angiotensin II and Norepinephrine
Authors: Lezama-Martinez Diego , Elena Hernandez-Campos Maria , Flores-Monroy Jazmin , Valencia-Hernandez Ignacio , Martinez-Aguilar Luisa
Published: March 2021

Clinical guidelines suggest the combination of 2 drugs as a strategy to treat hypertension. However, some antihypertensive combinations have been shown to be ineffective. Therefore, it is necessary to determine whether differences exist between the results of monotherapy and combination therapy by temporal monitoring of the responses to angiotensin II and norepinephrine, which are vasoconstrictors involved in the development of hypertension. Thus, the purpose of this work was to determine the vascular reactivity to angiotensin II and norepinephrine in spontaneously hypertensive rat (SHR) aortic rings after treatment with valsartan, lisinopril, nebivolol, nebivolol-lisinopril, and nebivolol-valsartan for different periods of time. In this study, male SHR and Wistar Kyoto normotensive (WKY) rats were divided into 7 groups treated for 1, 2, and 4 weeks: (1) WKY + vehicle, (2) SHR + vehicle; (3) SHR + nebivolol; (4) SHR + lisinopril; (5) SHR + valsartan; (6) SHR + nebivolol-lisinopril; and (7) SHR + nebivolol-valsartan. Blood pressure was measured by the tail-cuff method, and vascular reactivity was determined from the concentration-response curve to angiotensin II and norepinephrine in aortic rings. The results showed that the combined and individual treatments reduced mean blood pressure at all times evaluated. All treatments decreased vascular reactivity to angiotensin II; however, in the case of lisinopril and nebivolol-lisinopril, the effect observed was significant up to 2 weeks. All treatments decreased the reactivity to norepinephrine up to week 4. These results show a time-dependent difference in vascular reactivity between the pharmacological treatments, with nebivolol-valsartan and nebivolol-lisinopril being both effective combinations. Additionally, the results suggest crosstalk between the renin-angiotensin and sympathetic nervous systems to reduce blood pressure and to improve treatment efficacy.
Reliability of nonlinear stochastic controlled systems considering the dynamics of sensors and actuators
Authors: Jiaojiao Sun , Lei Xia , Zuguang Ying , Ronghua Huan , Weiqiu Zhu
Published: March 2021

A closed-loop controlled system usually consists of the main structure, sensors, and actuators. The dynamics of sensors and actuators may influence the motion of the main structure. This article presents an analytical study on the first-passage reliability of a nonlinear stochastic controlled system under the consideration of the dynamics of sensors and actuators. The coupled dynamic equations of the controlled systems with sensors and actuators are first given, which are further integrated into a controlled, randomly excited, dissipated Hamiltonian system. By applying the stochastic averaging method for quasi-Hamiltonian systems, a one-dimensional averaged differential equation for the Hamiltonian function is obtained. The backward Kolmogorov equation associated with the averaged equation is then derived for the first-passage reliability analysis, from which the approximate reliability function and probability density of first-passage time are obtained. The accuracy of the proposed procedure is demonstrated by an example. A comparative analysis of the reliability of the system with/without sensors and actuators is carried out, which indicates that ignoring sensors and actuators will make underestimation of the reliability of the closed-loop system with small time. However, when time increases, there appears the opposite trend. Our findings provide a reference for control strategy design.
Chaos synchronization using an improved type-2 fuzzy wavelet neural network with application to secure communication
Authors: Moradi Zirkohi Majid , Shoja-Majidabad Sajjad
Published: March 2021

In this article, a simple yet efficient adaptive control method is proposed to investigate synchronizing two chaotic systems. This approach presents an improved type-2 fuzzy wavelet neural network for estimating the unknown terms and the external disturbance in the chaotic systems’ dynamics. Furthermore, an efficient robust control term is integrated into the suggested controller so that the robustness of the controller against system unknown disturbances and uncertainties is improved. This approach offers a very desirable characteristic as a model-free controller. With the help of the Lyapunov stability theory supported with the transient performance analysis, it is established that the proposed control scheme can guarantee the synchronization and the stability of the closed-loop control system. Comparative simulation results with radial basis function neural networks are given that prove the proposed method has superiority in secure communication applications.
Reper intraocular lens with artificial iris: implantation techniques and outcomes
Authors: Frisina Rino , De Biasi Chiara Sofia , Tozzi Luigi , Gius Irene , Londei Davide , Gambato Catia , Midena Edoardo
Published: March 2021

The authors describe the surgical techniques to implant a novel intraocular lens with artificial iris (Reper) in patients affected by traumatic aphakia and aniridia. Two surgical approaches are proposed: implantation by suture-loaded cartridge and “open sky” implantation combined with penetrating keratoplasty. The method of establishing the exact position of the scleral fixation points and the pre-assembly of the suture of Reper before its implantation are the main novel proposed surgical procedures. The rationale is to minimize surgical procedures in the anterior chamber and to prevent knot loosening and lens tilting. The simultaneous treatment of aphakia and aniridia with a single prosthesis, the stability of the Reper and the functional, anatomical and aesthetic outcomes obtained are the highlighted advantages in this study.
Moving with the Times: The Health Science Alliance (HSA) Biobank, Pathway to Sustainability
Authors: Quinn Carmel M , Porwal Mamta , Meagher Nicola S , Hettiaratchi Anusha , Power Carl , Jonnaggadala Jitendra , McCullough Sue , Macmillan Stephanie , Tang Katrina , Liauw Winston , Goldstein David , Zeps Nikolajs , Crowe Philip J
Published: March 2021

Human biobanks are recognised as vital components of translational research infrastructure. With the growth in personalised and precision medicine, and the associated expansion of biomarkers and novel therapeutics under development, it is critical that researchers can access a strong collection of patient biospecimens, annotated with clinical data. Biobanks globally are undertaking transformation of their operating models in response to changing research needs; transition from a ‘classic’ model representing a largely retrospective collection of pre-defined specimens to a more targeted, prospective collection model, although there remains a research need for both models to co-exist. Here we introduce the Health Science Alliance (HSA) Biobank, established in 2012 as a classic biobank, now transitioning to a hybrid operational model. Some of the past and current challenges encountered are discussed including clinical annotation, specimen utilisation and biobank sustainability, along with the measures the HSA Biobank is taking to address these challenges. We describe new directions being explored, going beyond traditional specimen collection into areas involving bioimages, microbiota and live cell culture. The HSA Biobank is working in collaboration with clinicians, pathologists and researchers, piloting a sustainable, robust platform with the potential to integrate future needs.
Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis and Malignancy: A Case of a Patient Diagnosed with Renal Failure and Pulmonary Carcinoma Concurrently
Authors: Asakura Maki , Akimoto Tetsu , Ohara Ken , Masuda Takahiro , Ono Yuko , Saito Osamu , Nagata Daisuke
Published: March 2021

A 70-year-old man presented with proteinuria, microscopic hematuria, and an increased level of serum creatinine. A systemic workup revealed that the patient had bronchogenic carcinoma and anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis concurrently. Despite the increase in the cumulative number of publications on paraneoplastic glomerulopathies, an awareness of the link between cancer and ANCA-associated glomerulonephritis is lacking. We strongly recommend the accumulation of more cases similar to our own, thereby allowing us to clarify the management strategies as well as the nature of this disease condition more precisely.
Analysis of the tribological interaction of a polytetrafluoroethylene-lined radial lip oil seal, shaft and lubricant sample
Authors: Shabbir Sarah , Garvey Seamus D , Dakka Sam M , Rothwell Benjamin C , Su Rong , Leach Richard , Weston Nicola
Published: March 2021

To investigate the tribological interaction and wear mechanisms of polytetrafluoroethylene-lined radial lip oil seals in service, a sleeve, seal and lubricant sample taken off a rotating rig are studied. The test was terminated at 72 h, after severe leakage in the final 15 h of the test. All three components are studied using a coherence scanning interferometer and environmental scanning electron microscopy to investigate wear after testing. Results show a wear band on the aerospace grade case-hardened sleeve, appearing as a ‘polished in’ area by the seal. A study of the filler content of the polytetrafluoroethylene coating uncover glass fibres, calcium carbonate, carbon and graphite layers present, assumed responsible for the wear to the sleeve. The polytetrafluoroethylene coating is a 300 μm coating, distinct from the bulk elastomer. This finding is confirmed after observing this layer on both, the tested and new seal lip. Wear of the seal lip is measured and facilitated by comparison to the identical new seal. Lastly, debris from the seal and sleeve wear are found in the lubricant sample.
Students’ experiences and learning of social inclusion in team activities in physical education
Authors: Hovdal Dag Ove G , Haugen Tommy , Larsen Inger Beate , Johansen Bjørn Tore
Published: March 2021

Physical education (PE) can be a context in which students are ‘educated through the physical’, which includes the possibility to learn social inclusion as an important life skill and contributor to the greater good of society. A key goal in the Norwegian educational system is that such positive life skills become internalised in students. The aims of this study were to understand students’ experiences of and behaviour towards social inclusion – such as passing the ball – in team activities and how the teacher facilitated the learning of social inclusion. We use Dewey’s pedagogical perspective on education, and Johnson and Johnson’s cooperative learning model to discuss possible consequences and implications of our findings. The participants consisted of two secondary classes from two state schools in Norway, where one class was investigated in depth. Methods comprised written narratives, interviews, observation and video recordings of PE lessons. Data creation was triangulated, and thematic analysis was conducted. The results highlighted a paradox between students’ experiences of and behaviour towards social inclusion in team activities. Students disliked socially exclusive behaviours, but they often provided positive feedback when the behaviour was seen as successful in the context of a game; furthermore, students could themselves behave in a socially exclusive manner. Although the teacher could ‘teach by telling’ the students to pass the ball or by having rules, passing the ball did not become internalised in students. We discuss a model of ‘learning through experiences and reflections’, according to which students may learn to become socially inclusive beings.
DSM-5 symptom expression in toddlers
Authors: Coulter Kirsty L , Barton Marianne L , Robins Diana L , Stone Wendy L , Fein Deborah A
Published: March 2021

Although the early behaviors associated with autism spectrum disorder have been well characterized, many behaviors are also commonly observed in young children with other developmental delays and even in those with typical development. Therefore, consideration must be given to whether a child demonstrates sufficient autism spectrum disorder symptoms to warrant this diagnosis. Using the Toddler Autism Symptom Inventory, we examined caregiver endorsement of specific behaviors in three groups of toddlers referred for autism spectrum disorder risk: those who received a best-estimate diagnosis of autism spectrum disorder, those with another developmental disorder, and those who showed slight or no developmental delays and did not meet criteria for any disorder. The results revealed significant differences in symptoms among the three diagnostic groups, as well as low frequency of some DSM-5, ASD criteria, especially insistence on sameness, for those with ASD. These findings have important implications for applying the DSM-5, diagnostic criteria to toddlers.

Lay abstract

Children with autism show more social-communication symptoms and repetitive behaviors than children with typical development or those diagnosed with other developmental disorders; however, non-autistic children often show some behaviors that are associated with autism. We compared the behavioral reports from caregivers of children in these three groups to identify the behaviors that were specific to autism. Children with autism were found to show more of these behaviors, and behaviors that are particularly indicative of autism were identified. These behaviors included social symptoms (approaching others to interact, showing things, looking back while showing, responding to an approaching child, spontaneous imitation) and repetitive behavior symptoms (specific, inflexible play, unusual body movements, strong specific interest, carrying around an unusual object, sensory seeking, and sensory hyper-reactivity). These findings may aid professionals in determining the most appropriate diagnosis for a child between the ages of 12 and 36 months.
Exploring the impacts of Internet access on poverty: A regional analysis of rural Mexico
Authors: García-Mora Fernando , Mora-Rivera Jorge
Published: March 2021

The purpose of this article is to estimate the impact of Internet access on poverty for a sample of people living in contrasting regions located across rural Mexico. Using a quasi-experimental technique, our results suggest that Internet access is an additional mechanism that contributes to decreasing poverty levels. Consequently, it could assist in increasing the proportion of people living out of poverty in rural areas; however, this is not uniform across regions (higher positive effects are estimated for less developed regions). These findings highlight the prevailing regional heterogeneity in Mexico’s rural sector and suggest that governments must design better-targeted public policies that address the uneven development in Internet diffusion typical of the rural sector. These policy improvements would allow governments to maximize the potential benefits of the Internet, as this technology alone is not sufficient to break the cycle of poverty in middle-income countries like Mexico.
LES investigation of cycle-to-cycle variation in a SI optical access engine using TFM-AMR combustion model
Authors: Zembi Jacopo , Battistoni Michele , Nambully Suresh Kumar , Pandal Adrian , Mehl Cédric , Colin Olivier
Published: March 2021

Multi-cycle large-eddy simulations (LES) are performed to investigate combustion cycle-to-cycle variability (CCV) in a gasoline spark ignited optical access engine operating under homogeneous stoichiometric conditions. Combustion is addressed with the Thickened Flame Model (TFM) and finite rate chemistry is accounted for through a reduced oxidation reaction mechanism. In view of the fact that computational costs of LES engine simulations are still very high today, this work investigates the use of adaptive mesh refinement (AMR) in the flame zone in conjunction with the artificial flame thickening applied by the TFM model. The paper discusses how the resulting coupled TFM-AMR combustion model allows good resolution of the flame, maintaining accuracy at acceptable costs. First, the details of the coupled model are presented and the effects of the parameters are explored, highlighting their impact on the combustion prediction. Then, computational fluid dynamics (CFD) simulation results are validated against experimental data collected in a low-speed low-load engine point, by comparing 20 LES cycles and 100 measured cycles, for mass fraction burned, combustion phasing, flame images and CCV indices. Lastly, a detailed investigation on the fastest and slowest numerical cycles is presented, analyzing instantaneous flame structures, ignition behaviors, propagation speeds, and probability density function (PDF) of the instantaneous velocity fluctuation around the spark region. The results show that combustion variability is highly correlated to the resolved velocity field and the resolved turbulence intensity, which is found to be the main cause of CCV and affects the early flame kernel growth. This work is an early attempt to use TFM-AMR combustion model for LES simulations of internal combustion engines.
Fabrication of biodegradable polyurethane electrospun webs of fibers modified with biocompatible graphene oxide nanofiller
Authors: Ivanoska-Dacikj Aleksandra , Makreski Petre , Bogoeva-Gaceva Gordana
Published: March 2021

A successful optimization of the electrospinning parameters for obtainment of biodegradable polyester urethane (DP) webs of fibers, neat and graphene oxide (GO) modified, was performed. The effect of the processing parameters (distance between the needle tip and the collector, applied voltage, and flowing rate), solution type and polymer concentration, on the fiber-forming process and the obtained fibers’ morphology was examined. The best homogeneity of the fibers was achieved for 12 wt% DP dissolved in 80:20 wt% mixture of chloroform and ethanol, applying similar processing parameters for the neat and modified samples (0.5 ml/h pumping rate, 15 kV applied voltage, and 150 mm distance to the collector, for the neat sample, and 0.4 ml/h, 18 kV, and 110 mm, for the GO modified samples). The main novelty of this work is the modification of DP with low quantities (0.5, 1.0 and 2.0 wt%) of GO – the “next generation” nanomaterial for stem cell control. The morphological characterization revealed a fibrous microstructure consisting of randomly oriented fibers with a diameters ranging from hundreds nanometers to couple micrometers, representing a feasible imitation of the structure of extracellular matrix (ECM). The XRD studies showed high dispersion of GO in DP matrix and even exfoliation for the sample that contains 2 wt% GO. Raman studies neatly complemented the highest filler/matrix interactions and the superior levels of dispersion for this sample. TGA was used to analyze the thermo-oxidative degradation and also to determine the actual content of GO present in the samples.
Can machine learning be used to forecast the future uncertainty of military teams?
Authors: Stevens Ronald H , Galloway Trysha L
Published: March 2021

Uncertainty is a fundamental property of neural computation that becomes amplified when sensory information does not match a person’s expectations of the world. Uncertainty and hesitation are often early indicators of potential disruption, and the ability to rapidly measure uncertainty would have implications for future educational and training efforts by targeting reflective discussions about past actions, supporting in-progress corrections, and generating forecasts about future disruptions.

An approach is described combining neurodynamics and machine learning to provide quantitative measures of uncertainty. Models of neurodynamic information derived from electroencephalogram (EEG) brainwaves have provided detailed neurodynamic histories of US Navy submarine navigation team members. Persistent periods (25–30 s) of neurodynamic information were seen as discrete peaks when establishing the submarine’s position and were identified as periods of uncertainty by an artificial intelligence (AI) system previously trained to recognize the frequency, magnitude, and duration of different patterns of uncertainty in healthcare and student teams. Transition matrices of neural network states closely predicted the future uncertainty of the navigation team during the three minutes prior to a grounding event.

These studies suggest that the dynamics of uncertainty may have common characteristics across teams and tasks and that forecasts of their short-term evolution can be estimated.
Development of a Low-Resource Operating Room and a Wide-Awake Orthopedic Surgery Program During the COVID-19 Pandemic
Authors: Turcotte Justin J. , Gelfand Jeffrey M. , Jones Christopher M. , Jackson Rubie S.
Published: March 2021

Introduction. The COVID-19 pandemic resulted in significant medication, supply and equipment, and provider shortages, limiting the resources available for provision of surgical care. In response to mandates restricting surgery to high-acuity procedures during this period, our institution developed a multidisciplinary Low-Resource Operating Room (LROR) Taskforce in April 2020. This study describes our institutional experience developing an LROR to maintain access to urgent surgical procedures during the peak of the COVID-19 pandemic. Methods. A delineation of available resources and resource replacement strategies was conducted, and a final institution-wide plan for operationalizing the LROR was formed. Specialty-specific subgroups then convened to determine best practices and opportunities for LROR utilization. Orthopedic surgery performed in the LROR using wide-awake local anesthesia no tourniquet (WALANT) is presented as a use case. Results. Overall, 19 limited resources were identified, spanning across the domains of physical space, drugs, devices and equipment, and personnel. Based on the assessment, the decision to proceed with creation of an LROR was made. Sixteen urgent orthopedic surgeries were successfully performed using WALANT without conversion to general anesthesia. Conclusion. In response to the COVID-19 pandemic, a LROR was successfully designed and operationalized. The process for development of a LROR and recommended strategies for operating in a resource-constrained environment may serve as a model for other institutions and facilitate rapid implementation of this care model should the need arise in future pandemic or disaster situations.
Synthesis, crystal structures, and magnetic properties of nitroxide radical-coordinated manganese(II) and cobalt(II) complexes
Authors: Gao Yan-Li , Tian Cuifang , Gao Pingqiang , Jiao Yurong , Gong Ying , Ma Xiangrong
Published: March 2021

Coordination complexes constructed from the nitronyl nitroxide radical NIT-Pyra-3-Isobu and MII(hfac)2(H2O)2 as building blocks (NIT-Pyra-3-Isobu = 2-(3-isobutyl-pyrazole)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide, hfac = hexafluoroacetylacetonato, and M = Mn or Co) are successfully synthesized. The crystal structures of the coordination compounds reveal the usefulness of the functionalized radical in providing discrete or extended architectures. Single-crystal X-ray diffraction analyses indicated that the ligand is coordinated through the oxygen atom of NO• and the N atom of the pyrazole linkage to the metal, and the metals adopt an octahedral geometry leading to one-dimensional zig-zag chain systems. The magnetic behavior of the manganese and cobalt shows overall antiferromagnetic interactions between the metal center and the organic radical.
Photothermal synergic catalytic degradation of the gaseous organic pollutant isopropanol in oxygen vacancies utilizing ZnFe2O4
Authors: Sun Hao , Cai He , Li Linli , Yang Yuan , He Pan , Zhou Kun , Han Yu , Guan Jie , Fan Xiaoxing
Published: March 2021

ZnFe2O4 is an environmentally friendly semiconductor material which has potential applications in catalytic organic pollutant degradation. Here, we demonstrate the synthesis of ZnFe2O4 and its photothermal catalytic application. The obtained ZnFe2O4 prepared by using the sol-gel method has a large specific surface area which reaches 56.4 m2/g. Electron paramagnetic resonance, X-ray photoelectron spectra, and photoabsorption results indicate that ZnFe2O4 has plentiful oxygen vacancies. When evaluated by the degradation of the gaseous organic pollutant isopropanol, oxygen-vacancy-rich ZnFe2O4 presents a high and stable thermal catalytic performance, while driven by high-intensity light. In addition, a distinct improvement is observed. Moreover, a synergic photothermal catalytic mechanism of isopropanol degradation on ZnFe2O4 is proposed.
A new approach in the mean residual lifetime evaluation of a multi-state system
Authors: Iscioglu Funda
Published: March 2021

Dynamic reliability measures are important characteristics for understanding the lifetime behaviour of multi-state systems. This study aims to analyze the mean residual lifetime (MRL) function for a one-unit three-state system.The system considered has just three states such as “0, 1, 2”. State “2” and “1” signify the perfect functioning and partially working states, respectively while state “0” is the failure state. We let [Formula: see text] and [Formula: see text] be the lifetimes of the system spent at state “1” and “2,” respectively. We assess a particular performance characteristic, MRL, of this three-state system via conditional survival functions, when [Formula: see text] and [Formula: see text] are both independent and dependent. In case of independency, MRL functions are obtained and the results are discussed with reference to a case study. The effect of different distributions on the MRLs are also investigated in this case study. In case of dependency, on the other hand, the effect of dependency on MRL functions is especially underlined given that the system is at state “ j” ([Formula: see text]) for [Formula: see text]. To understand the time dependent behaviour of the related MRL functions, certain graphical illustrations are also presented.
A Laplace transform finite difference scheme for the Fisher-KPP equation
Authors: Defreitas Colin L , Kane Steve J
Published: March 2021

This paper proposes a numerical approach to the solution of the Fisher-KPP reaction-diffusion equation in which the space variable is developed using a purely finite difference scheme and the time development is obtained using a hybrid Laplace Transform Finite Difference Method (LTFDM). The travelling wave solutions usually associated with the Fisher-KPP equation are, in general, not deemed suitable for treatment using Fourier or Laplace transform numerical methods. However, we were able to obtain accurate results when some degree of time discretisation is inbuilt into the process. While this means that the advantage of using the Laplace transform to obtain solutions for any time t is not fully exploited, the method does allow for considerably larger time steps than is otherwise possible for finite-difference methods.
An analysis of the management and incidence of postoperative nausea and vomiting
Authors: Szachnowicz Brooke , Pawasauskas Jayne , Brothers Todd
Published: March 2021

Background

Postoperative nausea and vomiting significantly increases recovery time, reduces patient satisfaction, and increases time to discharge. Consensus guidelines for the management of postoperative nausea and vomiting highlight effective methods for prophylaxis and treatment. Implications of adherence to these guidelines include both improved patient outcomes and reduced healthcare costs.

Objective

This study aimed to assess the incidence, contributing factors, and current prescribing practices for prophylaxis and treatment of postoperative nausea and vomiting.

Methods

Electronic medical records were assessed for adult patients who had an elective gastrointestinal or gynaecologic surgical procedure over a one-year period. Patient demographics and perioperative data were collected to assess risk factors and the incidence of postoperative nausea and vomiting. The appropriateness of prophylaxis and treatment was assessed according to current guidelines.

Results

The incidence of postoperative nausea and vomiting was consistent with previously noted findings. The average time spent under anaesthesia was significantly higher in patients who experienced postoperative nausea and vomiting. Appropriate evidence-based rescue therapy was administered in a minority of the cohort experiencing postoperative nausea and vomiting.

Conclusion

There is substantial opportunity for provider education and adherence to best prescribing practices. Enhanced adherence to evidence-based rescue therapy prescribing may improve patient outcomes and satisfaction.
Associations between glucocorticoids, antiphospholipid antibodies and femur head necrosis in patients with SLE: a directed acyclic graph-based multicentre study
Authors: Chen Shengbao , Cai Qianying , Xu Yanjun , Fu Qiong , Feng Yong , Chen Xiaoxiang , Dai Shengming , Zhao Dongbao , Zhan Ce , Xu Weidong , Wang Jiwei , Wang Yang , Yu Jinming , Bao Chunde , Zhang Changqing
Published: March 2021

Background:

Osteonecrosis of the femoral head (ONFH) remains a major cause of disability in patients with systemic lupus erythematosus (SLE) and seriously impairs quality of life. This study aimed to investigate associations between glucocorticoids (GCs), antiphospholipid antibodies (aPLs), and ONFH in patients with SLE.

Methods:

We conducted a multicentre cohort study on patients with SLE and used a directed acyclic graph-based analysis strategy. Details of GC therapy, aPLs status, other drug administration and other SLE-related characteristics were collected. ONFH occurrence during follow-up was determined by magnetic resonance imaging. Multivariable logistic regression and generalized estimating equation models were performed to assess their effects on ONFH, and a simplified scoring system comprising these factors for short- and medium-term SLE-ONFH prediction was developed by receiver operating characteristic curve analysis.

Results:

Of 449 SLE patients with a median follow-up duration of 5.3 years, 41 (9.1%) developed ONFH. Independently risk factors of SLE-ONFH including: average daily GC dose with an adjusted odds ratio (aOR) of 1.1 and 95% confidence interval (CI) of 1.0–1.1; GC therapy duration (3–5 years: aOR 3.3, 95% CI 1.4–7.8; >5 years: aOR 8.0, 95% CI 3.3–19.4); initial intravenous GC (aOR 4.4, 95% CI 1.9–10.1); positive aPLs (aOR 2.8, 95% CI 1.4–5.8); and Arterial hypertension secondary to GC usage (aOR 5.2, 95% CI 1.4–19.1). And we successfully developed the simplified scoring system (SCORE model) with an area under the curve of 0.88 (95% CI 0.82–0.94).

Conclusion:

Based on the risk factors involved in the development of SLE-ONFH, a novel SCORE model was developed, which might be helpful for risk stratification of SLE-ONFH in clinical practice.
Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study
Authors: van der Horst-Bruinsma Irene E. , van Bentum Rianne E. , Verbraak Frank D. , Deodhar Atul , Rath Thomas , Hoepken Bengt , Irvin-Sellers Oscar , Thomas Karen , Bauer Lars , Rudwaleit Martin
Published: March 2021

Introduction:

Acute anterior uveitis (AAU), affecting up to 40% of patients with axial spondyloarthritis (axSpA), risks permanent visual deficits if not adequately treated. We report 2-year results from C-VIEW, the first study to prospectively investigate certolizumab pegol (CZP) on AAU in patients with active axSpA at high risk of recurrent AAU.

Patients and methods:

C-VIEW (NCT03020992) was a 104-week (96 weeks plus 8-week safety follow-up), open-label, multicenter study. Eligible patients had active axSpA, human leukocyte antigen-B27 (HLA-B27) positivity and a history of recurrent AAU (⩾2 AAU flares in total; ⩾1 in the year prior to baseline). Patients received CZP 400 mg at weeks 0, 2 and 4, then 200 mg every 2 weeks to week 96. The primary efficacy endpoint was the AAU flare event rate during 96 weeks’ CZP versus 2 years pre-baseline.

Results:

Of 115 enrolled patients, 89 initiated CZP (male: 63%; radiographic/non-radiographic axSpA: 85%/15%; mean disease duration: 9.1 years); 83 completed week 96. There was a significant 82% reduction in AAU flare event rate during CZP versus pre-baseline [rate ratio (95% confidence interval): 0.18 (0.12–0.28), p < 0.001]. One hundred percent and 59.6% of patients experienced ⩾1 and ⩾2 AAU flares pre-baseline, respectively, compared to 20.2% and 11.2% during treatment. Age, sex and axSpA population subgroup analyses were consistent with the primary analysis. There were substantial improvements in axSpA disease activity with no new safety signal identified.

Conclusion:

CZP treatment significantly reduced AAU flare event rate in patients with axSpA and a history of AAU, indicating CZP is a suitable treatment option for patients at risk of recurrent AAU.

Trial Registration ClinicalTrials.gov:

NCT03020992, URL: https://clinicaltrials.gov/ct2/show/NCT03020992 [Media: see text]
A comparison of clinical examination and ultrasound enthesitis indices in patients with psoriatic arthritis, adjusted for concomitant fibromyalgia
Authors: Sapsford Mark , Evans Jobie , Clunie Gavin , Jadon Deepak
Published: March 2021

Objectives:

To: (a) determine the extent of ultrasound (US)-detected peripheral enthesitis in a cohort of patients with psoriatic arthritis (PsA); (b) compare this with three clinical examination (CE) enthesitis indices; and (c) determine the effect of concurrent fibromyalgia on the evaluation of enthesitis.

Methods:

A prospective single-centre cross-sectional study of consecutive outpatients with established PsA undergoing clinical examination for enthesitis and US examination for inflammatory and structural lesions of enthesitis. Multivariable analyses tested for association between US scores, CE enthesitis indices and influence of concurrent fibromyalgia.

Results:

A total of 106 patients were assessed. Of these, 91/106 (85.8%) had CE enthesitis and 105/106 (99.1%) had ⩾1 US feature of enthesitis. There was a moderate correlation between US entheseal inflammation and both the Leeds Enthesitis Index (LEI) (Spearman rank, r = 0.36) and Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC) ( r = 0.44). US entheseal damage did not correlate with CE enthesitis indices. Twenty-eight (26.4%) patients were classified as having concurrent fibromyalgia, in whom multivariable regression analyses demonstrated no correlation between US scores and CE enthesitis indices. PsA patients without fibromyalgia demonstrated a statistically significant association between both LEI ( r = 0.48, p < 0.0001) and SPARCC ( r = 0.62, p < 0.0001) and US entheseal inflammation.

Conclusion:

There is a moderate association between US entheseal inflammation, but not damage, and CE enthesitis indices in patients with PsA. The presence of concurrent fibromyalgia is linked with higher CE enthesitis scores, without an increase in US inflammation, suggesting that CE enthesitis indices should be used/interpreted with caution in these patients. Imaging, including US, should be the preferred modality to detect enthesitis in PsA patients with concurrent fibromyalgia.
Effective decellularisation of human saphenous veins for biocompatible arterial tissue engineering applications: Bench optimisation and feasibility in vivo testing
Authors: Sulaiman Nadiah S , Bond Andrew R , Bruno Vito D , Joseph John , Johnson Jason L , Suleiman M-Saadeh , George Sarah J , Ascione Raimondo
Published: March 2021

Human saphenous vein (hSV) and synthetic grafts are commonly used conduits in vascular grafting, despite high failure rates. Decellularising hSVs (D-hSVs) to produce vascular scaffolds might be an effective alternative. We assessed the effectiveness of a detergent-based method using 0% to 1% sodium dodecyl sulphate (SDS) to decellularise hSV. Decellularisation effectiveness was measured in vitro by nuclear counting, DNA content, residual cell viability, extracellular matrix integrity and mechanical strength. Cytotoxicity was assessed on human and porcine cells. The most effective SDS concentration was used to prepare D-hSV grafts that underwent preliminary in vivo testing using a porcine carotid artery replacement model. Effective decellularisation was achieved with 0.01% SDS, and D-hSVs were biocompatible after seeding. In vivo xeno-transplantation confirmed excellent mechanical strength and biocompatibility with recruitment of host cells without mechanical failure, and a 50% patency rate at 4-weeks. We have developed a simple biocompatible methodology to effectively decellularise hSVs. This could enhance vascular tissue engineering toward future clinical applications.
Effect of hypertonic saline in the management of elevated intracranial pressure in children with cerebral edema: A systematic review and meta-analysis
Authors: Afroze Farzana , Sarmin Monira , Kawser CA , Nuzhat Sharika , Shahrin Lubaba , Saha Haimanti , Jahan Shaly Nusrat , Parvin Irin , Bint-e Sharif Mohsena , Mamun M Al , Ahmed Tahmeed , Chisti Mohammod Jobayer
Published: March 2021

Objective:

To determine the hypertonic saline efficacy in children with cerebral edema and raised intracranial pressure.

Method:

Studies assessing the efficacy and safety of hypertonic saline in children with cerebral edema and elevated intracranial pressure were identified using Medline, Web of Science, Scopus, and Google Scholar databases. Two reviewers independently assessed papers for inclusion. The primary outcome was a reduction of elevated intracranial pressure by the administration of hypertonic saline.

Results:

We initially evaluated 1595 potentially relevant articles, and only 7 studies met the eligibility criteria for the final analysis. Out of the seven studies, three of them were randomized controlled trials. Three of the studies found that hypertonic saline significantly reduced elevated intracranial pressure compared to control. One study reported a resolution of the comatose state as a measure of reduced intracranial pressure. It also found a significantly higher resolution of coma in the hypertonic saline group rather than the control. Three studies reported that the reduction of intracranial pressure was comparable between the groups. The random-effects model using pooled estimates from four studies showed no difference in hypertonic saline and conventional therapy mortality outcomes. Hypertonic saline was administered as bolus-only therapy at a rate of 1–10 mL/kg/dose over 5 min to 2 h and or bolus followed by infusion therapy (0.5–2 mL/kg/h). One study reported a twofold faster resolution of high intracranial pressure following hypertonic saline administration compared to controls. The re-dosing schedule varied greatly in all included studies. However, three studies reported adverse events but not methodically, and there were no reports on neurological sequelae.

Conclusion:

Hypertonic saline appears to reduce intracranial pressure in children with cerebral edema. However, we cannot draw a firm conclusion regarding the safest dose regimens of hypertonic saline, including the safe and effective therapeutic hypernatremia threshold in the management of raised intracranial pressure with cerebral edema. Future clinical trials should focus on the appropriate concentration, dose, duration, mode of administration, and adverse effects of hypertonic saline to standardize the treatment.