bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise Adherence and Effect of Self-Regulatory Behavior Change Techniques in Patients Undergoing Curative Cancer Treatment: Secondary Analysis from the Phys-Can Randomized Controlled Trial
Authors: Mazzoni Anne-Sophie , Brooke Hannah L , Berntsen Sveinung , Nordin Karin , Demmelmaier Ingrid
Published: September 2020

Introduction:

Adherence to exercise interventions in patients with cancer is often poorly described. Further, it is unclear if self-regulatory behavior change techniques (BCTs) can improve exercise adherence in cancer populations. We aimed to (1) describe exercise adherence in terms of frequency, intensity, time, type (FITT-principles) and dropouts, and (2) determine the effect of specific self-regulatory BCTs on exercise adherence in patients participating in an exercise intervention during curative cancer treatment.

Methods:

This study was a secondary analysis using data from a Swedish multicentre RCT. In a 2×2 factorial design, 577 participants recently diagnosed with curable breast, colorectal or prostate cancer were randomized to 6 months of high (HI) or low-to-moderate intensity (LMI) exercise, with or without self-regulatory BCTs (e.g., goal-setting and self-monitoring). The exercise program included supervised group-based resistance training and home-based endurance training. Exercise adherence (performed training/prescribed training) was assessed using attendance records, training logs and heart rate monitors, and is presented descriptively. Linear regression and logistic regression were used to assess the effect of self-regulatory BCTs on each FITT-principle and dropout rates, according to intention-to-treat.

Results:

For resistance training (groups with vs without self-regulatory BCTs), participants attended on average 52% vs 53% of prescribed sessions, performed 79% vs 76% of prescribed intensity, and 80% vs 77% of prescribed time. They adhered to exercise type in 71% vs 68% of attended sessions. For endurance training (groups with vs without self-regulatory BCTs), participants performed on average 47% vs 51% of prescribed sessions, 57% vs 62% of prescribed intensity, and 71% vs 72% of prescribed time. They adhered to exercise type in 79% vs 78% of performed sessions. Dropout rates (groups with vs without self-regulatory BCTs) were 29% vs 28%. The regression analysis revealed no effect of the self-regulatory BCTs on exercise adherence.

Conclusion:

An exercise adherence rate ≥50% for each FITT-principle and dropout rates at ~30% can be expected among patients taking part in long-term exercise interventions, combining resistance and endurance training during curative cancer treatment. Our results indicate that self-regulatory BCTs do not improve exercise adherence in interventions that provide evidence-based support to all participants (e.g., supervised group sessions).

Trial registration:

NCT02473003
Effects of Resistance Exercise on Symptoms, Physical Function, and Quality of Life in Gastrointestinal Cancer Patients Undergoing Chemotherapy
Authors: Hong Yijin , Wu Chunmei , Wu Biyu
Published: September 2020

This research aimed to investigate the effects of resistance exercise on symptoms, physical function, and quality of life (QoL) in gastrointestinal cancer patients undergoing chemotherapy. Patients were quasi-randomly divided into the resistance exercise group and the relaxation control group, and machine-based resistance exercise was performed twice a week for 12 weeks under the guidance of experienced therapists. The QoL of patients was analyzed by EORTC-QLQ-C30. Resistance exercise training significantly reduced the incidences of lack of energy (inter-group P = .011), nausea (inter-group P = .007), acid reflux (inter-group P = .042), and back pain (inter-group P = .0009). Twelve weeks of resistance exercise training significantly elevated the muscular strength of leg press (inter-group P = .021) and leg extension (inter-group P = .041), and the muscular endurance of leg press (inter-group P = .005). The participants’ performance in 6-m fast walk (inter-group P = .008), 6-m backwards walk (inter-group P = .016), and chair rise (inter-group P = .031) were dramatically improved. Fatigue (inter-group P = .024) and appetite loss (inter-group P = .012) in the resistance exercise group were significantly lower than the relaxation control group. In conclusion, the beneficial effects of resistance exercise on symptoms, physical function and QoL in gastrointestinal cancer patients undergoing chemotherapy were demonstrated. Resistance exercise training reduced the incidences of nausea and acid reflux, improved physical function, and alleviated fatigue and appetite loss in gastrointestinal cancer patients undergoing chemotherapy.
Human Brain Organoid Models of Developmental Epilepsies
Authors: Nieto-Estévez Vanesa , Hsieh Jenny
Published: September 2020

Epilepsy is a common neurological disorder characterized by recurrent and unprovoked seizures due to neuronal hyperactivity. A large proportion of epilepsy cases begin during childhood. Causes of epilepsy include stroke, infections, brain injury, genetic factors, or other factors that alter brain structure and development, but in up to 50% of cases the cause is unknown. Approximately 35% of patients have refractory seizures that do not respond to medication. Animal models and in vitro cultures have contributed to our understanding of epilepsy, but there is a clear need for better models to explore the human brain in normal and pathological conditions. Human pluripotent stem cell (PSC) technologies opened the door for new models for analyzing brain development and disease, especially conditions with a genetic component. Initially, PSCs were differentiated into 2-dimensional cultures of a homogenous population of neural cells, such as glutamatergic excitatory or γ-aminobutyric acidergic inhibitory neurons, as well as glial cells. Nevertheless, these cultures lacked the structure and complexity of a human brain. In the last decade, PSC technology has advanced to the next level through the development of 3-dimensional culture, called organoids. These organoids recapitulate features of the human brain that are missing in animal models, enabling a deeper study of the human brain. In this review, we will summarize the current status of organoid research and its application to epilepsy.
Is On-Demand Dynorphin Destined to Be in Demand to Decrease Seizures?
Authors: Christian-Hinman Catherine A.
Published: September 2020

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TLR4 Signaling Contributes to Post-Traumatic Epileptogenesis Through Insertion of Inwardly Rectifying AMPA Receptors: Not a Happy CP-AMPAR
Authors: Lillis Kyle P.
Published: September 2020

[Box: see text]
Reasons for Course Selection and Academic Satisfaction among Master’s Degree Students
Authors: Figuera Gazo Pilar , Llanes Ordóñez Juan , Torrado Fonseca Mercedes , Valls Figuera Robert-Guerau , Buxarrais Estrada Maria Rosa
Published: September 2020

This study investigated the relationships between the motivations of master’s students and satisfaction with the programme. Participants included 978 students from two Spanish universities. The results showed that the characteristics of the master’s programme explained the differences in the reasons for choice and student satisfaction. We found a positive relationship between academic satisfaction and the reasons for self-realization and personal growth. The results allow us to reconsider the process of student guidance and counselling.
Blunt Traumatic Injury to the Superficial Femoral Artery in a Morbidly Obese Female: Case Report Using Endovascular Covered Stent Repair
Authors: Weeks Ahna H. , Grant April A. , Sciarretta Jason D. , Nguyen Jonathan , Todd S. Rob , Rajani Ravi
Published: September 2020

Lower extremity vascular injuries following trauma are rare events that require prompt identification and management in order to prevent ischemia and limb loss. Endovascular approaches, rather than traditional open procedures, are increasingly used to treat a wide range of vascular disease. The use of endovascular repair for revascularization in the trauma setting is not routine but may provide an appealing alternative in select trauma patients and injuries. We present a case of successful endovascular repair with stent grafting of a superficial femoral artery intimal injury following a femur fracture in a 35-year-old morbidly obese female and review the current literature regarding the use of endovascular therapy in the trauma setting.
The Experiences and Perceptions of College Peer Mentors Interacting with Students with Intellectual and Developmental Disabilities
Authors: Athamanah Lindsay S. , Fisher Marisa H. , Sung Connie , Han Jinny E.
Published: September 2020

Peer mentoring programs provide an opportunity for individuals with and without intellectual and developmental disabilities (IDD) to learn, socialize, and work together in supportive and inclusive environments. In this study, we used a phenomenological research design to explore the impact of a college campus-based peer mentoring program on the experiences and perceptions of participating college peer mentors ( n = 13) toward high school students with IDD who were enrolled in a school-to-work transition program housed on campus. Using thematic analysis across four different data sources, we identified three main themes that peer mentors discussed based on their experiences in the program: (a) mentors’ personal development: constructing meaning of self, (b) mentee growth: perceived work and social impact, and (c) campus community benefits: normalizing disability. Peer mentors reported their own attitudes toward individuals with IDD were changed based on participating in the peer mentoring program and they observed improvements in their mentees’ personal and work-related social relationships. We discuss how these outcomes have impacted the peer mentors’ attitudes, career choices, and lives in general. We also provide implications for future research and practice regarding development and implementation of peer mentoring programs in the community.
Comparative Enhancement of Motor Function and BDNF Expression Following Different Brain Stimulation Approaches in an Animal Model of Ischemic Stroke
Authors: Sims Serena-Kaye Kinley-Cooper , Rizzo Aitana , Howard Kern , Farrand Ariana , Boger Heather , Adkins DeAnna L.
Published: September 2020

Background

Combinatory intervention such as high-frequency (50-100 Hz) excitatory cortical stimulation (ECS) given concurrently with motor rehabilitative training (RT) improves forelimb function, except in severely impaired animals after stroke. Clinical studies suggest that low-frequency (≤1 Hz) inhibitory cortical stimulation (ICS) may provide an alternative approach to enhance recovery. Currently, the molecular mediators of CS-induced behavioral effects are unknown. Brain-derived neurotrophic factor (BDNF) has been associated with improved recovery and neural remodeling after stroke and thus may be involved in CS-induced behavioral recovery.

Objective

To investigate whether inhibitory stimulation during RT improves functional recovery of severely impaired rats, following focal cortical ischemia and if this recovery alters BDNF expression (study 1) and depends on BDNF binding to TrkB receptors (study 2).

Methods

Rats underwent ECS + RT, ICS + RT, or noCS + RT treatment daily for 3 weeks following a unilateral ischemic lesion to the motor cortex. Electrode placement for stimulation was either placed ipsilateral (ECS) or contralateral (ICS) to the lesion. After treatment, BDNF expression was measured in cortical tissue samples (study 1). In study 2, the TrkB inhibitor, ANA-12, was injected prior to treatment daily for 21 days.

Results

ICS + RT treatment significantly improved impaired forelimb recovery compared with ECS + RT and noCS + RT treatment.

Conclusion

ICS given concurrently with rehabilitation improves motor recovery in severely impaired animals, and alters cortical BDNF expression; nevertheless, ICS-mediated improvements are not dependent on BDNF binding to TrkB. Conversely, inhibition of TrkB receptors does disrupt motor recovery in ECS + RT treated animals.
A review of the use and utility of industrial network-based open source simulators: functionality, security, and policy viewpoints
Authors: Ani Uchenna Daniel , Watson Jeremy McKendrick , Carr Madeline , Cook Al , Nurse Jason RC
Published: September 2020

Simulation can provide a useful means to understand issues linked to industrial network operations. For transparent, collaborative, cost-effective solutions development, and to attract the broadest interest base, simulation is critical and open source suggested, because it costs less to access, install, and use. This study contributes new insights from security and functionality characteristics metrics to underscore the use and effectiveness of open source simulators. Several open source simulators span applications in communications and wireless sensor networks, industrial control systems, and the Industrial Internet of Things. Some drivers for their use span are as follows: supported license types; programming languages; operating systems platforms; user interface types; documentation and communication types; citations; code commits; and number of contributors. Research in these simulators is built around performance and optimization relative to flexibility, scalability, mobility, and active user support. No single simulator addresses all these conceivable characteristics. In addition to modeling contexts that match real-world scenarios and issues, an effective open source simulator needs to demonstrate credibility, which can be gained partly through actively engaging experts from interdisciplinary teams along with user contributions integrated under tight editorial controls. Government-led policies and regulations are also necessary to support their wider awareness and more productive use for real-world purposes.
Two-Point Fixation Technique in Retrosternal Midcolon Interposition for Corrosive Stricture of Esophagus-Our Experience With 25 Patients
Authors: Sharma Praveen , Pancholi Mukesh
Published: September 2020

Background. In 1911, Vuillet and Kelling independently described the anatomical and surgical bases of esophageal replacement with the colon. An important complication, in particular in later follow-up, is redundancy of the interposed colon, seen more after retrosternal interposition. The best treatment is prevention by a meticulous surgical technique and measurement of the length of the colon needed to replace the esophagus. Methods. This was a retrospective study of innovative surgical technique. A total of 25 patients with corrosive stricture of the esophagus undergoing two-point fixation in retrosternal colon interposition were included in the study. Preventive Operative Technique. After straightening of conduit by pulling very delicately over both sides, first fixation point we considered cervical anastomoses and second fixation point was made in subxiphoid space, taking two seromuscular stiches from the antimesenteric border of the colon to falciform ligament situated on the right side of the conduit. Results. There were 07 male and 18 female patients with M:F was 1:2.5; mean age was 29 years (range: 23-45 years) and mean hospital stay was 14 days (range: 10-23 days). In this study, we did not encounter any subjective or objective evidence of redundancy in any patients in follow-up barium swallow after 2.5 years of follow-up. Conclusion. Our Two-point fixation technique is refinement of already performed and tried fixation techniques to prevent redundancy of the colon conduit considering kinetics, anatomical alignment, and pathology.
Forced Back into the Closet: A (Queer) Principal’s Attempt to Maintain Queer Erasure
Authors: Duarte Bryan J.
Published: September 2020

This case adds to a lack of research that considers the intersection of queer identities and educational leadership. The case narrative demonstrates the complex nuances of two negotiated professional queer identities. In addition, the case considers the consequences of queer erasure on the existing heteronormative culture of schooling. The teaching notes review the literature on queer school professionals and provide a background for understanding the geographical and historical considerations of LGBTQ+ (lesbian, gay, bisexual, transgender, transsexual, queer) identities in schools. The author concludes with a plea to both heterosexual and queer school leaders and those who prepare them to reflect on their position and responsibilities within a heteronormative and heterosexist field. The activities and discussion questions are designed with these aims in mind.
At What Dose Can Total Body and Whole Abdominal Irradiation Cause Lethal Intestinal Injury Among C57BL/6J Mice?
Authors: Gu Jia , Chen Yu-Zhong , Zhang Zi-Xiang , Yang Zai-Xing , Duan Guang-Xin , Qin Li-Qiang , Zhao Lin , Xu Jia-Ying
Published: September 2020

Purpose and Methods:

To investigate the doses of total body (TBI) and whole abdominal irradiation (WAI) induced lethal intestinal injury, healthy C57BL/6 J mice were divided randomly into 7 groups: control group; 6, 7, and 8 Gy TBI groups; and 5, 10, and 15 Gy WAI groups. The survival length, general conditions, body weight, daily food and water intake of the mice and the histopathological changes of small intestine were observed.

Results:

Lethal injury among C57BL/6 J mice was caused by ≥6 Gy TBI and 15 Gy WAI. Their body weight and food intake decreased, the structure of their small intestinal villi was destroyed, and the number of surviving crypts per circumference of the jejunum decreased in ≥6 Gy TBI groups and 15 Gy WAI group. The mice in the 10 Gy WAI group significantly lost weight within 5 days but recovered slowly thereafter. They also had poor appetite and reversibly damaged intestinal mucosa.

Conclusions:

Nonlethal intestinal injury could be induced by 10 Gy WAI, whereas lethal intestinal injury could be triggered by ≥6 Gy TBI and >15 Gy WAI in mice. Our results provided a basis for establishing radiation-induced intestinal injury models with C57BL/6 J mice.
Significance of “de novo” appearance of thyroglobulin antibodies in patients with differentiated thyroid cancer
Authors: Scappaticcio Lorenzo , Trimboli Pierpaolo , Verburg Frederik A. , Giovanella Luca
Published: September 2020

Objective

Clinical and laboratory guidelines recommend thyroglobulin antibodies (TgAbs) measurement with every thyroglobulin (Tg) measurement for the follow-up of differentiated thyroid cancer (DTC) patients. However, no evidence exists on the need for perpetual TgAbs testing in patients who are TgAb-negative at baseline. Our study was carried out to evaluate the prevalence, the dynamic changes, and the clinical significance of TgAbs that appeared de novo during the follow-up of DTC patients who were TgAb-negative at baseline.

Methods

The data of DTC patients with negative pre-ablation TgAbs were reviewed retrospectively. The main characteristics of patients with both transient and sustained de novo TgAbs appearance were analyzed. DTC patients with persistently negative TgAbs served as controls.

Results

Among 119 patients with pre-ablation negative TgAbs, 14 cases (11.7%) with de novo TgAbs appearance (10 and 4 patients with a transient and sustained de novo TgAbs appearance, respectively) were detected. No differences in disease-free survival were observed in patients with de novo TgAbs appearance compared to controls. The TgAbs peak value was higher in patients with sustained de novo appearance compared to patients with transient de novo. Two of 14 patients with de novo TgAbs developed structural disease with concurrently detectable Tg in both cases.

Conclusions

Transient de novo TgAbs appearance is not infrequent during DTC patients’ follow-up, and it has no apparent clinical impact. Sustained de novo TgAbs appearance is rare and may predict structural recurrences; however, similar disease-free survival was observed in patients with sustained de novo TgAbs and TgAb-negative DTC patients.
Exosomes as a new pain biomarker opportunity
Authors: D’Agnelli Simona , Gerra Maria C , Bignami Elena , Arendt-Nielsen Lars
Published: September 2020

Exosomes are extracellular microvesicles implicated in intercellular communication with ability to transfer cargo molecules, including protein, lipids, and nucleic acids, at both close and distant target sites. It has been shown that exosomes are implicated in physiological and pathological processes. In recent years, the interest on exosomes’ role in many pain states has increased. Their involvements in pain processes have been demonstrated by studies on different chronic pain diseases, both inflammatory and neuropathic, such as osteoarthritis, rheumatoid arthritis, inflammatory bowel diseases, neurodegenerative pathologies, complex regional pain syndrome, and peripheral nerve injury. Animal and clinical studies investigated exosomes-based treatments, showing their ability to improve painful symptoms with fewer side effects, with potential immunoprotective and anti-inflammatory effect. Specific molecular patterns characterize exosomes’ cargo according to the cellular origin, epigenetic modifications, environmental state, and stressor factors. Therefore, the identification of specific cargo’s profile associated to pain states may lead to recognize specific pathological states and to consider the use of exosomes as biomarkers of diseases. Furthermore, exosomes’ ability to transfer information and their presence in many accessible biological fluids suggest a potential use as novel non-invasive therapeutic tools in pain field.
A Spectacle of Silencing: A Rural African-Canadian Woman’s Media Trial
Authors: Harling Stalker L. Lynda , Cormack Patricia
Published: September 2020

This thematic case study explores international, national, and local media coverage of a conflict between Barb Reddick, a rural, working-class, African-Nova Scotian woman, and her nephew over the ownership of a winning ‘Chase the Ace’ lottery ticket. Beginning from general media valuation of lottery winners, and Canadian coverage of the Nova Scotia CTA lottery ‘craze’, we find when Reddick goes off script as loving aunt she is pathologized and degraded in a dramatic reversal from soft to hard news story. Reddick’s habitus and trust in journalists to support her counternarrative became the dramatic content of media spectacle-making – what we call a ‘spectacle of silencing’ – as well as her deviance from Canadian white rurality, and class and gender norms. Rather than mere ‘misrepresentation’ of minorities, we conclude that the dynamics of counternarrative struggle are embedded in reportage itself as spectacle, reproducing the legitimacy and authority of journalistic institutions through a symbolic violence of consensus making.
Social prescribing
Authors: Barnes Dr Enrica
Published: September 2020

This article aims to describe what constitutes social prescribing, to highlight examples of services that exist, and to discuss the existing evidence base for social prescribing.
Anticancer Effect of the Iridoid Glycoside Fraction from Dipsacus fullonum L. Leaves
Authors: Kuhtinskaja Maria , Bragina Olga , Kulp Maria , Vaher Merike
Published: September 2020

Species of Dipsacus have been widely used in folk medicine for their neuroprotective, antiosteoporotic, antioxidative, anticomplementary, and antibacterial activities. However, there has been but a limited amount of research on the anticancer effect of one of the most popular representatives of this genus, D. fullonum. Also, the cytotoxic activity has not yet been investigated of the constituents of D. fullonum leaves. The purpose of this study was to evaluate the cytotoxic activity of the bis-iridoid glycosides isolated from D. fullonum leaves against murine fibroblast NIH/3T3, mouse melanoma B16F10, HeLa human cervical cancer, human breast cancer MCF7 and MDB-MB-231 cells. The bis-iridoids, obtained by chromatographic fractionation of the extract of D. fullonum leaves, were characterized by thin-layer chromatography and high-performance liquid chromatography-mass spectrometry (HPLC-MS)/MS analysis. The cytotoxicity of the iridoid fraction was evaluated by WST-1 assay, and the number of dead cells was determined by the propidium iodide test. HPLC-MS/MS analysis showed the isolated bis-iridoid fraction to consist mainly of sylvestroside III and/or sylvestroside IV. This fraction was applied to cell cultures and kept for 48 and 72 hours. The results demonstrated that the iridoid glycosides had a differential ability to induce cell death in normal and cancer cells. The study confirmed that the bis-iridoids extracted from D. fullonum leaves had a selective cytotoxic effect on human breast cancer cell lines MCF7 and MDB-MD-231, while their cytotoxic effect on noncancer cells was low.
A Review of the Secondary Metabolites From the Marine Sponges of the Genus Aaptos
Authors: He Qianqian , Miao Shuang , Ni Na , Man Yuqing , Gong Kaikai
Published: September 2020

Marine sponges, which belong to the phylum Porifera (Metazoa), are considered the single best source of marine natural products. Among them, members of the genus Aaptos are attractive targets for marine natural product research owing to their abundant biogenetic ability to produce aaptamine derivatives. Apart from aaptamine alkaloids, there are also reports of other compounds from Aaptos sponges. This work reviews the secondary metabolites isolated from Aaptos species from 1982 to 2020, with 46 citations referring to 62 compounds (47 for aaptamines and 15 for others). The emphasis is placed on the structure of the organic molecules, relevant biological activities, chemical ecology aspects, and biosynthesis studies, which are described in the classifications of aaptamines and other compounds in the order of the published year.
Dihydrotanshinone I Ameliorates Cardiac Hypertrophy in Diabetic Mice Induced by Chronic High-Fat Feeding
Authors: Li Songpei , Lei Xueping , Xiao Zekuan , Xia Wenyi , Lin Chaojin , Fu Xiaomei , Fu Jijun , Zhang Lingmin , Yu Xiyong
Published: September 2020

Salvia miltiorrhiza Bge. (Danshen) is widely used to improve blood circulation and the dredge meridian in traditional Chinese medicine. In the present study, we evaluated the effects of dihydrotanshinone I (DHTS), a natural product from Danshen, on chronic high-fat feeding-induced cardiac remodeling and dysfunction. DHTS (25 mg/kg, intraperitoneal) did not affect blood glucose, insulin levels, and glucose intolerance. However, it alleviated diastolic dysfunction induced by the high-fat diet, as indicated by the increase in the ratio of peak early filling velocity to peak late filling velocity of the mitral and suppression of the extension of the isovolumic relaxation phase of the left ventricle. Further investigations revealed that DHTS ameliorated high-fat induced cardiac hypertrophy in mice and suppressed insulin-induced enlargement of cardiomyocytes in vitro. In neonatal cardiomyocytes, DHTS restored insulin-induced suppression of CCAAT/enhancer-binding protein beta-2 isoform (CEBPβ) and the phosphorylation of glycogen synthase kinase-3β (GSK3β) and extracellular signal-regulated kinase (ERK). Taken together, our results indicated that DHTS ameliorated cardiac hypertrophy and diastolic dysfunction in high-fat-fed mice, probably through the inhibition of insulin-induced suppression of CEBPβ and phosphorylation of GSK3β and ERK in cardiomyocytes.
In Silico De Novo Curcuminoid Derivatives From the Compound Library of Natural Products Research Laboratories Inhibit COVID-19 3CLpro Activity
Authors: Yang Jai-Sing , Chiang Jo-Hua , Tsai Shih‑Chang , Hsu Yuan-Man , Bau Da-Tian , Lee Kuo-Hsiung , Tsai Fuu-Jen
Published: September 2020

The coronavirus disease 2019 (COVID‐19) outbreak caused by the 2019 novel coronavirus (2019-nCOV) is becoming increasingly serious. In March 2019, the Food and Drug Administration (FDA) designated remdesivir for compassionate use to treat COVID-19. Thus, the development of novel antiviral agents, antibodies, and vaccines against COVID-19 is an urgent research subject. Many laboratories and research organizations are actively investing in the development of new compounds for COVID-19. Through in silico high-throughput virtual screening, we have recently identified compounds from the compound library of Natural Products Research Laboratories (NPRL) that can bind to COVID-19 3Lpro polyprotein and block COVID-19 3Lpro activity through in silico high-throughput virtual screening. Curcuminoid derivatives (including NPRL334, NPRL339, NPRL342, NPRL346, NPRL407, NPRL415, NPRL420, NPRL472, and NPRL473) display strong binding affinity to COVID-19 3Lpro polyprotein. The binding site of curcuminoid derivatives to COVID-19 3Lpro polyprotein is the same as that of the FDA-approved human immunodeficiency virus protease inhibitor (lopinavir) to COVID-19 3Lpro polyprotein. The binding affinity of curcuminoid derivatives to COVID-19 3Lpro is stronger than that of lopinavir and curcumin. Among curcuminoid derivatives, NPRL-334 revealed the strongest binding affinity to COVID-19 3Lpro polyprotein and is speculated to have an anti-COVID-19 effect. In vitro and in vivo ongoing experiments are currently underway to confirm the present findings. This study sheds light on the drug design for COVID-19 3Lpro polyprotein. Basing on lead compound development, we provide new insights on inhibiting COVID-19 attachment to cells, reducing COVID-19 infection rate and drug side effects, and increasing therapeutic success rate.
Variations of the Anatomy and Bony Landmarks of Deep Circumflex Iliac Artery in a Select Kenyan Population
Authors: Sarna Krishan , Amuti Thomas , Butt Fawzia , Kamau Martin , Muriithi Anne
Published: September 2020

Background:

The deep circumflex iliac artery (DCIA) is a large caliber artery which branches laterally from the external iliac artery (EIA), directly opposite the origin of the inferior epigastric artery (IEA). Population variations have been reported in its origin, length, and branching patterns. These may alter its relationship to palpable surgical landmarks such as the anterior superior iliac spine (ASIS) and the pubic tubercle (PT) which are used to locate the artery preoperatively, thus predisposing it iatrogenic injury. Despite this, there is paucity of data from the Kenyan setting.

Study Design:

Cross-sectional study design.

Objective:

To determine the variations of the anatomy and bony landmarks of the Deep circumflex iliac artery in a select Kenyan population.

Methods:

A total of 104 DCIA from 52 formalin fixed adult cadavers were dissected to expose the DCIA, following which its vessel of origin and distance from the ASIS and PT, relation to the inguinal ligament (IL), length and branching patterns were noted. The average of the measurements were calculated. All data were collected and analyzed using Microsoft Excel 2007 (Microsoft Corporation, Redmond, WA). Representative photos of the vessel and its variations were taken.

Results:

The DCIA was found to be present and bilaterally symmetrical in all cadavers. In all cases observed, it originated as a lateral branch from the EIA (100%), opposite the IEA and directly behind the IL in 98% of the cases. Its average distance from the ASIS along the IL was 7.28 ± 0.99, while it was 5.91 ± 1.03 from the pubic tubercle to its origin. Its length ranged from 3.7 cm to 9.5 cm, with an average length of 3.86 cm in the right limb and 3.67 cm in the left limb. As regards its branching patterns, in 78% of the cases, it bifurcated into the horizontal and ascending branches, in 6%, it trifurcated and in 4%, it divided into more than 3, exhibiting a fine tree-like branching (arborization).

Conclusion:

The DCIA in our setting exhibited variations from other settings and an increase in awareness of these variations will probably reduce future iatrogenic lesions of the DCIA and its major branches in Kenya.
Treatment of Juvenile Knee Osteochondritis Dissecans with a Cell-Free Biomimetic Osteochondral Scaffold: Clinical and MRI Results at Mid-Term Follow-up
Authors: Sessa Andrea , Romandini Iacopo , Andriolo Luca , Di Martino Alessandro , Busacca Maurizio , Zaffagnini Stefano , Filardo Giuseppe
Published: September 2020

Objective

Osteochondral surgical procedures have been described for the treatment of unfixable osteochondritis dissecans (OCD), but only few of them have been studied for juvenile OCD (JOCD) lesions. A cell-free biomimetic osteochondral scaffold showed positive results in adult patients. The aim of this study was to evaluate the results of this scaffold for the treatment of knee JOCD at mid-term follow-up.

Design

Twenty patients (14 males, 6 females) were included in this study. Mean age was 16.2 ± 1.4 years, average defect size was 3.2 ± 1.8 cm2, and mean symptoms duration was 20.2 ± 17.9 months. After the implantation of the osteochondral collagen–hydroxyapatite scaffold (Maioregen, Fin-Ceramica, Faenza, Italy), patients were evaluated preoperatively and prospectively at 1, 2, and at final mean follow-up of 6 years (range 5-7 years) with International Knee Documentation Committee (IKDC) subjective and objective, Tegner, and EuroQol visual analogue scale (VAS) scores. MRI evaluation was performed with the MOCART 2.0 score.

Results

All scores showed a significant improvement. IKDC subjective score went from 50.3 ± 17.4 preoperative score to 75.3 ± 14.6 at 1 year ( P = 0.002), 80.8 ± 14.6 at 2 years and 85.0 ± 9.3 at 6 years. The Tegner score improved from the preoperative evaluation of 2.6 ± 1.4 to 5.5 ± 2.0 at 6 years ( P < 0.0005), although without reaching the level registered before the onset of symptoms. A longer symptoms duration influenced negatively IKDC subjective and Tegner scores up to 2 years ( P = 0.003 and P = 0.002, respectively) but did not affect the final outcome. Lesion size did not affect the final result. The MOCART 2.0 score showed a significant improvement between 1-year and final follow-up, but with persisting subchondral alterations.

Conclusions

This study demonstrated a clinical improvement stable over time with a high survival rate, although with persisting abnormal MRI findings, especially at subchondral bone level. This procedure can be considered a suitable option for the treatment of young patients affected by knee OCD. Level of evidence. Case series, level IV.
The Perfection Premium
Authors: Isaac Mathew S. , Spangenberg Katie
Published: September 2020

This research documents a perfection premium in evaluative judgments wherein individuals disproportionately reward perfection on an attribute compared to near-perfect values on the same attribute. For example, individuals consider a student who earns a perfect score of 36 on the American College Test to be more intelligent than a student who earns a near-perfect 35, and this difference in perceived intelligence is significantly greater than the difference between students whose scores are 35 versus 34. The authors also show that the perfection premium occurs because people spontaneously place perfect items into a separate mental category than other items. As a result of this categorization process, the perceived evaluative distance between perfect and near-perfect items is exaggerated. Four experiments provide evidence in favor of the perfection premium and support for the proposed underlying mechanism in both social cognition and decision-making contexts.
Torture-survivors’ experiences of healthcare services for pain: a qualitative study
Authors: Board Daniel , Childs Susan , Boulton Richard
Published: September 2020

Background:

Increasing numbers of torture-survivors are presenting to UK healthcare services with persistent pain. However, there is a paucity of evidence surrounding the management of persistent pain among torture-survivors and their experience of healthcare services for pain is currently unknown. This qualitative study explores their experiences of services for managing pain, to inform clinical practice and service provision.

Methods:

Thirteen participants were recruited from a specialist pain clinic for torture-survivors in the United Kingdom. Utilising an ethnographic approach, data were collected via clinic appointment observations, interviews and medical records and analysed using inductive thematic analysis.

Results:

Three themes emerged in relation to torture-survivors’ experiences of healthcare services for pain: the patient–clinician relationship; multiplicity of diagnoses and treatments; lack of service integration. Participants described limited engagement in decision-making processes regarding their care. Lack of recognition of torture experience when diagnosing and treating pain, alongside multiple unsuccessful treatments, led to confusion, frustration and hopelessness. These issues were exacerbated by the disconnect between physical and mental health services.

Conclusion:

This study provides new insight into the challenges faced by torture-survivors when accessing healthcare services for pain. Our findings suggest current service provision is not meeting their complex needs. Clinical implications include the need for integrated care systems and better recognition of the influence of torture experience on persistent pain. Strategies to engage and empower torture-survivors in the management of their pain are suggested.
Monostotic Fibrous Dysplasia Involving the Mandible: A Case Report
Authors: Assiri Khalil Ibrahim
Published: September 2020

Fibrous dysplasia (FD) is a skeletal developmental anomaly, which is non-hereditary and idiopathic in origin. It is characterized by the replacement of normal bone with the excess proliferation of fibrous tissue in irregular bony trabeculae. Patients might complain of swelling, pain, or numbness on the affected side. The incidence of monostotic FD (MFD) is four times more than that of polyostotic fibrous dysplasia. In MFD, the maxilla is more commonly affected than the mandible. The clinical behavior and rapid progression of FD renders the treatment challenging. The malignant potential is 0.5% for untreated cases. Here, we present a case of FD involving the mandible. The clinical diagnostic approach, different imaging modalities, and histological examination methods for definitive diagnosis have been elaborated.
Thrombotic microangiopathy following hump-nosed viper ‘Hypnale’ envenomation
Authors: Puthra Shiran , Pirasath Selladurai , Hemal Sugathapala Athwel Gamarallage , Gnanathasan Ariaranee
Published: September 2020

The hump-nosed vipers which compromise ‘ Hypnale hypnale’, ‘H. zara’ and ‘H. nepa’ have been highly venomous snakes and ‘H. zara’ and ‘H. nepa’ are indigenous to Sri Lanka and ‘H. hypnale’ is endemic to Sri Lanka and India. The clinical presentations range from local swelling, blistering and necrosis at the site of bite with distinct fang marks to systemic envenomations such as coagulopathy, thrombotic microangiopathy, acute kidney injury and death in severe cases. Here, we report a case of thrombotic microangiopathy following hump-nosed viper ‘ Hypnale’ bite.
Lithium toxicity following bariatric surgery
Authors: Jamison Suzanna Connick , Aheron Kelley
Published: September 2020

A patient with morbid obesity and several psychiatric comorbidities underwent laparoscopic sleeve gastrectomy and experienced success with weight loss. However, she experienced lightheadedness, nausea, and a fall and was admitted to the hospital for encephalopathy due to lithium toxicity. The pharmacokinetics of lithium is altered following bariatric surgery. Due to these factors, adjustments were made to the patient’s lithium therapy, her levels were subsequently reduced into the therapeutic range, and she continued with no further issues. Mechanisms of lithium toxicity following bariatric surgery and a monitoring protocol to prevent toxicity are discussed.
Stent placement for long-segment total occlusion of an aberrant right subclavian artery: A 7-year follow-up
Authors: Burket Grace J , Kakroo Mashhood , Burket Mark W
Published: September 2020

An aberrant origin of the right subclavian artery arising as the most distal vessel from the aortic arch is an uncommon but clinically important anomaly. Its abnormal course may result in esophageal compression with dysphagia, or tracheal compression resulting in asthma or stridor, and can greatly complicate radial artery access for coronary angiography. When an aberrant right subclavian artery is obstructed by atherosclerotic plaque, it may produce symptoms of arm ischemia such as pain and weakness. For the past 75 years, the standard treatment approach for symptomatic aberrant right subclavian artery has been surgical correction. There are only three case reports of percutaneous therapy, all for nonocclusive stenosis. There are no reported cases of percutaneous treatment of a completely occluded aberrant right subclavian artery. We report a patient with exertional right arm heaviness and weakness who was found to have a 60-mm long aberrant right subclavian artery occlusion. The blockage was successfully treated with angioplasty and placement of a single stent using percutaneous vascular access. Chest computerized tomography and duplex ultrasonography 5 years after treatment demonstrated a patent stent. At 7-year follow-up, she remained symptom-free and had a normal radial pulse. This case represents the first report of total occlusion of aberrant right subclavian artery treated percutaneously. Long-term durability supports this as a viable alternative to surgery in appropriately selected patients.
High-frequency oscillatory ventilation as a rescue for severe asthma crisis in a child
Authors: Sharma Kamal , Von Hack-Prestinary Ivan , Vidal Rosa
Published: September 2020

Mechanical ventilation in the asthmatic child may be complicated by dynamic air trapping leading to hemodynamic compromise and cardiac arrest. High-frequency oscillatory ventilation is relatively contraindicated because it may cause hyperinflation compared to conventional mechanical ventilation. A 2-year-old girl (weight, 11 kg) with a history of asthma was admitted because of status asthmaticus. Despite treatment with intravenous methylprednisolone, continuous albuterol, terbutaline, aminophylline, and magnesium sulfate, she had persistent respiratory distress. She required endotracheal intubation and mechanical ventilation because of worsening respiratory fatigue and hypercarbia ((PCO2), 96 mm Hg). Severe airflow obstruction persisted, and the hypercarbia worsened despite conventional mechanical ventilation (PCO2 > 134 mm Hg). It was judged that the patient was at risk for dynamic air trapping leading to hemodynamic compromise and cardiac arrest. High-frequency oscillatory ventilation was started to overcome airflow obstruction, and a decrease in arterial PCO2 to 87 mm Hg was observed within 2 h. High-frequency oscillatory ventilation was discontinued after 5 h, and conventional mechanical ventilation resumed. The patient was extubated after 5 days without further complications. In summary, this case shows that high-frequency oscillatory ventilation may be considered as a rescue treatment in children who have severe status asthmaticus with persistent airflow obstruction and hypercarbia unresponsive to pharmacological therapy and conventional mechanical ventilation.
A new cancer on the block: Tuberous sclerosis-associated renal cell carcinoma
Authors: Cui Helen , Verrill Clare , Sullivan Mark
Published: September 2020

Purpose:

The purpose of this article is to present the first reported case of a renal tumour classified as tuberous sclerosis complex-associated renal cell carcinoma in the UK and discuss its clinical implications.

Case report:

A female, aged 65 years, with tuberous sclerosis complex was found on surveillance imaging to have interval growth of multiple right renal tumours up to 19 mm. Right partial nephrectomy was performed. Histology showed multiple tiny angiomyolipomas and a 20 mm tumour classified as tuberous sclerosis complex-associated renal cell carcinoma. These tumour cells showed abundant clear cytoplasm with a branched elongated arrangement encircled in dense smooth muscle stroma.

Literature review:

Renal cell carcinoma in patients with tuberous sclerosis complex is rare, occurring in approximately 4% of cases. Tuberous sclerosis complex-associated renal cell carcinoma is a relatively new histological entity, having previously been described as clear cell or chromophobe-like, with only one published case series from the USA. These tumours have three histological entities which are distinct from all other renal cell carcinoma classifications. Based on case series, tuberous sclerosis complex-associated renal cell carcinoma tends to occur more often in females, present at a younger age, have multiple tumours, and tend to show an indolent course, although metastases have been reported.

Learning points:

Patients with tuberous sclerosis complex can develop renal cell carcinoma, though the risk is thought to be no higher than for sporadic renal cell carcinoma. Given the limited literature, more evidence is required to help predict the future behaviour of these tumours. Level of evidence: 5
Mass personalization: Predictive marketing algorithms and the reshaping of consumer knowledge
Authors: Kotras Baptiste
Published: September 2020

This paper focuses on the conception and use of machine-learning algorithms for marketing. In the last years, specialized service providers as well as in-house data scientists have been increasingly using machine learning to predict consumer behavior for large companies. Predictive marketing thus revives the old dream of one-to-one, perfectly adjusted selling techniques, now at an unprecedented scale. How do predictive marketing devices change the way corporations know and model their customers? Drawing from STS and the sociology of quantification, I propose to study the original ambivalence that characterizes the promise of a mass personalization, i.e. algorithmic processes in which the precise adjustment of prediction to unique individuals involves the computation of massive datasets. By studying algorithms in practice, I show how the active embedding of local preexisting consumer knowledge and punctual de-personalization mechanisms are keys to the epistemic and organizational success of predictive marketing. This paper argues for the study of algorithms in their contexts and suggests new perspectives on algorithmic objectivity.
The wound’s future
Authors: Rice Jenny
Published: September 2020

While we so commonly frame our public/civic wounds as past (or passed), we are used to talking about healing and mending existing wounds. This language also affects how we conduct deliberative discourse around current crises. However, I am more curious about the wound’s future. Specifically, I want to explore the wound’s future as it emerges in two different types of deliberation: prescriptive deliberation and descriptive deliberation. Rather than seeing the wound (only) as something that has already happened, or even as something that lingers on into the present, I want to address the wound’s future: a tactical future-oriented rhetoric that creates a broader deliberative practice.