bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive far lateral debridement combined with posterior instrumentation for thoracic and lumbar tuberculosis without severe kyphosis
Authors: Xiong Wei , Yu Bing , Zhang Yao , Wang Chunxiao , Tang Xiaojie , Cao Haifei , Zhang Xibing , Song Qinyong , Tan Fang , Tan Jiangwei
Published: June 2020

Background

Anti-tuberculous therapy (ATT) alone cannot easily cure spine tuberculosis (STB) though it is the most essential treatment. Many studies have confirmed the efficacy of the surgical treatment of STB through anterior, anterolateral, posterior debridement, and intervertebral fusion or combined with internal fixation. However, the conventional surgical approach requires extensive exposure of the affected areas with high rates of morbidity and mortality. Recently, minimally invasive surgery has come into use to reduce iatrogenic trauma and relevant complications. Here, we introduced a novel technique for the treatment of thoracic and lumbar spine tuberculosis: minimally invasive far lateral debridement and posterior instrumentation (MI-FLDPI). In this study, we evaluated the technical feasibility, the clinical outcomes, and the postoperative complications.

Methods

We did a prospective, non-randomized study on this new technique. Twenty three patients (13 males) with thoracic or lumbar spine tuberculosis who underwent minimally invasive far lateral debridement and posterior instrumentation were included in the study. The preoperative comorbidities, operation duration, intra-operative hemorrhage, Cobb’s angles, and postoperative complications were recorded and analyzed. Clinical outcomes were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI), neurological recovery, and eradication of tuberculosis. Radiological outcomes were evaluated by changes in Cobb’s angle and fusion status of the affected segments.

Results

The patients were followed for an average of 19 months (ranging from 12 to 36 months). At the final follow-up, CRP and ESR of all patients were normal. The VAS and ODI were significantly improved compared with preoperative values (P < 0.05). No evident progression of the kyphotic deformity was found after surgery. Twenty two patients showed spontaneous peripheral interbody fusion 1 year after surgery. There were no failure of the instrumentation even though a young female with drug-resistant tuberculosis showed no sign of interbody fusion at the third year follow-up. All the patients with preoperative neurological deficit showed complete recovery at the final follow-up.

Conclusions

MI-FLDPI using expandable tubular retractor could be recommended to treat thoracic and lumbar spine tuberculosis for the advantages of less trauma, earlier recovery, and less complications. Spontaneous peripheral interbody fusion was observed in nearly all the cases even without bone grafting.
Repeat-induced point mutation in Neurospora crassa causes the highest known mutation rate and mutational burden of any cellular life
Authors: Wang Long , Sun Yingying , Sun Xiaoguang , Yu Luyao , Xue Lan , He Zhen , Huang Ju , Tian Dacheng , Hurst Laurence D. , Yang Sihai
Published: June 2020

Background

Repeat-induced point (RIP) mutation in Neurospora crassa degrades transposable elements by targeting repeats with C→T mutations. Whether RIP affects core genomic sequence in important ways is unknown.

Results

By parent-offspring whole genome sequencing, we estimate a mutation rate (3.38 ×  10−6 per bp per generation) that is two orders of magnitude higher than reported for any non-viral organism, with 93–98% of mutations being RIP-associated. RIP mutations are, however, relatively rare in coding sequence, in part because RIP preferentially attacks GC-poor long duplicates that interact in three dimensional space, while coding sequence duplicates are rare, GC-rich, short, and tend not to interact. Despite this, with over 5 coding sequence mutations per genome per generation, the mutational burden is an order of magnitude higher than the previously highest observed. Unexpectedly, the majority of these coding sequence mutations appear not to be the direct product of RIP being mostly in non-duplicate sequence and predominantly not C→T mutations. Nonetheless, RIP-deficient strains have over an order of magnitude fewer coding sequence mutations outside of duplicated domains than RIP-proficient strains.

Conclusions

Neurospora crassa has the highest mutation rate and mutational burden of any non-viral life. While the high rate is largely due to the action of RIP, the mutational burden appears to be RIP-associated but not directly caused by RIP.
Study protocol for daiobotanpito combined with antibiotic therapy for treatment of acute diverticulitis: a study protocol for a randomized controlled trial
Authors: Ogawa-Ochiai Keiko , Yoshimura Kenichi , Shirai Akiko , Sakai Seisho , Moriyama Hideki , Nakamura Keishi , Murayama Toshinori , Ishikawa Hideki
Published: June 2020

Background

Colonic diverticular disease has been increasing in prevalence due to the rapidly aging global population, but standard treatment has not changed dramatically in recent years. Daiobotanpito (DBT; Da Huang Mu Dan Tang in Chinese) has been used in medical treatment of acute abdominal abscesses, such as appendicitis or diverticulitis in traditional Japanese (Kampo) medicine for many years, based on more than 3000 years of experience. Prior to this study, a retrospective open-label trial was conducted to compare patients with acute diverticulitis who received oral DBT combined with intravenous antibiotics with those who received intravenous antibiotic alone; it showed a positive effect of DBT on acute diverticulitis. We aim to investigate whether moderate to severe acute diverticulitis shows greater improvement with intravenous antibiotics plus orally administered DBT compared with intravenous antibiotics plus placebo.

Methods

This is a two-group, randomized, double-blind, placebo-controlled, multi-center trial, which is designed to evaluate the efficacy and safety of DBT in patients with moderate to severe diverticulitis treated with intravenous antibiotics. Eligible participants will be randomized to either a treatment group receiving a 10-day oral DBT regimen plus conventional therapy or a control group receiving a 10-day placebo regimen plus conventional therapy. The primary outcome will be success in treating diverticulitis: the success rate will be defined as elimination of abdominal pain within 4 days in all patients, and in patients with fever (body temperature ≧ 37.5 °C) on inclusion into this study, fever relief with reduction in body temperature to < 37.5 °C within 3 days. Secondary endpoints will include the number of hospitalization days, changes in inflammatory response (C-reactive protein (CRP), white blood cell (WBC) and neutrophil counts), fever type, number of days before beginning food intake, recurrence rate (observation for 1 year after registration), and adverse event expression rate. Assessments will be performed at baseline and on the day of discharge. The recurrence rate will be recorded at 1 year after registration.

Discussion

This study is expected to provide evidence to support the clinical benefits of DBT in the treatment of acute diverticulitis. It may also provide evidence on the efficacy and safety of DBT in the recurrence of acute diverticulitis.

Trial registration

UMIN-CTR: UMIN000027381. Registered on 27 April 2017.

https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000031377, and changed to jRCTs041180063, registered on 30 July 2019; as a result of the revision of the domestic law in 2018 in Japan.
First evidence of the mutations associated with pyrethroid resistance in head lice (Phthiraptera: Pediculidae) from Honduras
Authors: Larkin Kelsey , Rodriguez Carol A. , Jamani Shabana , Fronza Georgina , Roca-Acevedo Gonzalo , Sanchez Ana , Toloza Ariel C.
Published: June 2020

Background

The human head louse, Pediculus humanus capitis, is a cosmopolitan blood-sucking ectoparasite affecting mostly schoolchildren in both developed and developing countries. In Honduras, chemical pediculicides are the first line of treatment, with permethrin as their main active ingredient. Despite the extended use of these products, there is currently no research investigating insecticide resistance in Honduran head lice. In head lice, the most common mechanism is knockdown resistance (kdr), which is the result of two point mutations and the associated amino acid substitutions, T917I and L920F, within the voltage-sensitive sodium channel (VSSC).

Methods

Genomic DNA was extracted from 83 head lice collected in the localities of San Buenaventura and La Hicaca, Honduras. Polymerase chain reaction (PCR) was used to amplify a 332-bp fragment of the VSSC gene that contains a site affected by C/T mutation which results in a T917I amino acid substitution on each human head louse genomic DNA fragments.

Results

The C/T non-synonymous mutation which results in the T917I kdr amino acid substitution was detected in both head lice populations at frequencies ranging between 0.45–0.5. Globally, the frequency of this substitution was 0.47. Of these, 5 (6.1%) were homozygous susceptible and 78 (93.9%) were heterozygotes. The kdr-resistant homozygote (RR) was not detected in the studied populations. Thus, 93.9% of the head lice collected in Honduras harbored only one T917I allele. Exact test for the Hardy-Weinberg equilibrium for both localities showed that genotype frequencies differed significantly from expectation. In addition, San Buenaventura and La Hicaca populations had an inbreeding coefficient (Fis) < 0, suggesting an excess of heterozygotes.

Conclusions

To our knowledge, this is the first study showing the presence of the C/T mutation responsible of the T917I kdr allele associated with pyrethroid resistance in P. h. capitis from Honduras. The PCR-restriction fragment length polymorphism (RFLP) employed here has demonstrated to be a reliable, economic, and reproducible assay that can be used to accurately genotype individual head lice for the mutation encoding the resistance-conferring T917I amino acid substitution. This highlights the necessity of proactive resistance management programmes designed to detect pyrethroid mutations before they become established within populations of head lice.
Longitudinal immune cell monitoring identified CD14++ CD16+ intermediate monocyte as a marker of relapse in patients with ANCA-associated vasculitis
Authors: Matsumoto Kotaro , Suzuki Katsuya , Yoshimoto Keiko , Seki Noriyasu , Tsujimoto Hideto , Chiba Kenji , Takeuchi Tsutomu
Published: June 2020

Background

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune disease that affects small- to medium-sized blood vessels. Despite treatments having been improved, patients often experience disease relapses. It remains unclear how the immune cells involve in the development of vasculitis and how they fluctuate over the course of treatment. In this study, we aimed to identify the immune subsets and serum cytokines associated with disease relapse by comprehensive immuno-phenotyping in AAV patients.

Methods

We reviewed consecutive patients (n = 29) from Keio University Hospital who had been newly diagnosed with AAV from January 2015 to February 2019 and chronologically followed until 52 weeks. Numbers of circulating T cells, B cells, monocytes, and granulocytes were analyzed by flow cytometry (FACS). Serum levels of cytokines were measured by electrochemiluminescence enzyme immunoassay. Clinical information was obtained from patients’ records and association with time-course changes in immuno-phenotypes and serum levels of cytokines were assessed.

Results

Comprehensive immuno-phenotyping data from 161 samples from 29 AAV patients at diagnosis; at weeks 4, 12, 24, and 52 of treatment; and at time of major relapse were examined. FACS analysis from patients with relapse revealed that CD14++ CD16+ intermediate monocytes and plasma cells concomitantly changed associated with disease relapse, which were independent from treatment regimen, ANCA status, or disease phenotype. In particular, the number of CD14++ CD16+ intermediate monocytes at relapse was significantly higher than that in remission or in healthy controls. Serum cytokine measurement revealed that changes of monocyte-derived proinflammatory cytokines such as IL-1β, IL-6, IL-8, and TNF-α were associated with disease status.

Conclusions

Chronological changes in CD14++ CD16+ intermediate monocyte counts can be a marker of disease relapse in AAV patients.
MicroRNA-320d regulates tumor growth and invasion by promoting FoxM1 and predicts poor outcome in gastric cardiac adenocarcinoma
Authors: Chen Xiaojie , Gao Shegan , Zhao Zhiwei , Liang Gaofeng , Kong Jinyu , Feng Xiaoshan
Published: June 2020

Recent evidences demonstrate that dysregulated expression of microRNA-320d (miR-320d) has been associated with several cancer development and progression. However the effect of miR-320d on gastric cardiac adenocarcinoma (GCA) and the association of miR-320d with its potential gene target FoxM1 remain unclear. Here, we evaluated expression profile of miR-320d and FoxM1 in 60 human GCA tissues and GCA cell lines (OE-19 and SK-GT2). Immunohistochemistry, qualitative PCR and western-blotting were performed in GCA tissues to detect the expression level of miR-320d and FoxM1. CCK-8, transwell, wound-healing assays, and in vivo experiments were conducted using GCA cells that treated with miR-320d mimics or inhibitors to evaluate the biological functions of miR-320d. Luciferase reporter assay was conducted to confirm possible binding sites of FoxM1 for miR-320d. Compared with paired non-cancerous tissues, it showed that miR-320d expression was significantly decreased in GCA specimens (P < 0.0001), while FoxM1 was significantly upregulated in GCA tissues (P < 0.0001). Modulating miR-320d function by transfection of miR-320 mimics or inhibitor led to inhibition or promotion of GCA cell proliferation and invasion, thus regulating tumor progression in GCA-tumor bearing mice. The mechanism analysis of miR-320d/FoxM1 showed that FoxM1 has two miR-320d binding sites in its 3′-untranslated region (3′-UTR), that contributes to regulation of the cell biological behaviors. Taken together, our data suggested that miR-320d acts as a tumor suppressor in GCA by directly targeting FoxM1 and thus potentially serves as a biomarker for anti-GCA therapy in GCA patients.
Visible light communication-based traffic control of autonomous vehicles at multi-lane roundabouts
Authors: Fakirah Maged , Leng Supeng , Chen Xiaosha , Zhou Jihua
Published: June 2020

Roundabouts are a form of circular intersections adopted to secure road safety of the vehicles. However, collisions are not prevented entirely even when using roundabouts, since accidents may happen at specific intersection points leading to either traffic congestions or serious accidents. In this paper, a visible light communication (VLC)-based collision avoidance scheme is proposed to coordinate autonomous vehicles in traversing roundabouts, which has high effectiveness in vehicular environments. In particular, roadside units (RSUs) are deployed at the roundabout entrances to coordinate the vehicles in a vehicle-to-infrastructure (V2I) mode. By adopting the synchronization approach, vehicles can pass the roundabout simultaneously if their paths are concurrent with each other. Otherwise, vehicles are prioritized according to their arrival time and reasonable decelerations are applied to waive potential conflicts. Simulation results showed that our proposed approach satisfies the roundabout traffic demands in terms of concurrency, safety, and time utilization as vehicles are strongly recommended to decelerate in only 22% of the cases studied in different scenarios.
Quasilinear asymptotically periodic Schrödinger–Poisson system with subcritical growth
Authors: Zhang Jing , Guo Lifeng , Yang Miaomiao
Published: June 2020

The aim of this paper is establishing the existence of a nontrivial solution for the following quasilinear Schrödinger–Poisson system: $$ \left \{ \textstyle\begin{array}{l} -\Delta u+V(x)u-u\Delta(u^{2})+K(x)\phi(x)u=g(x, u),\quad x\in\mathbb {R}^{3}, \\ -\Delta\phi=K(x)u^{2}, \quad x\in\mathbb{R}^{3},\\ u\in H^{1}(\mathbb{R}^{3}),\qquad u>0, \end{array}\displaystyle \right . $$

{

−
Δ
u
+
V
(
x
)
u
−
u
Δ
(

u
2

)
+
K
(
x
)
ϕ
(
x
)
u
=
g
(
x
,
u
)
,

x
∈

R
3

,

−
Δ
ϕ
=
K
(
x
)

u
2

,

x
∈

R
3

,

u
∈

H
1

(

R
3

)
,

u
>
0
,

where V, K, g are continuous functions. To overcome the technical difficulties caused by the quasilinear term, we change the variable to guarantee the feasibility of applying the mountain pass theorem to solve the above problems. We use the mountain pass theorem and the concentration–compactness principle as basic tools to gain a nontrivial solution the system possesses under an asymptotic periodicity condition at infinity.
Improving bug report triage performance using artificial intelligence based document generation model
Authors: Lee Dong-Gun , Seo Yeong-Seok
Published: June 2020

Artificial intelligence is one of the key technologies for progression to the fourth industrial revolution. This technology also has a significant impact on software professionals who are continuously striving to achieve high-quality software development by fixing various types of software bugs. During the software development and maintenance stages, software bugs are the major factor that can affect the cost and time of software delivery. To efficiently fix a software bug, open bug repositories are used for identifying bug reports and for classifying and prioritizing the reports for assignment to the most appropriate software developers based on their level of interest and expertise. Owing to a lack of resources such as time and manpower, this bug report triage process is extremely important in software development. To improve the bug report triage performance, numerous studies have focused on a latent Dirichlet allocation (LDA) using the k-nearest neighbors or a support vector machine. Although the existing approaches have improved the accuracy of a bug triage, they often cause conflicts between the combined techniques and generate incorrect triage results. In this study, we propose a method for improving the bug report triage performance using multiple LDA-based topic sets by improving the LDA. The proposed method improves the existing topic sets of the LDA by building two adjunct topic sets. In our experiment, we collected bug reports from a popular bug tracking system, Bugzilla, as well as Android bug reports, to evaluate the proposed method and demonstrate the achievement of the following two goals: increase the bug report triage accuracy, and satisfy the compatibility with other state-of-the-art approaches.
How do mothers of adolescents with chronic pain experience their own quality of life?
Authors: Skarstein S. , Bergem A. K. , Helseth S.
Published: June 2020

Background

Chronic pain is a major health problem globally with severe personal and economic consequences. Maternal chronic pain is associated with their children’s pain. Family pain models and shared environmental aspects are important in the understanding of chronic pain among adolescents. Pain in itself impairs the quality of life (QoL). However, satisfaction in the aspects of health and functioning, social and economic, psychological, and family life will together constitute a person’s subjective experience of QoL. On this background, we considered it important to gain an understanding of the QoL of mothers who have children with chronic pain. We aimed to gain a broader understanding of the QoL in mothers of children with chronic pain and to investigate how they managed their children’s pain.

Methods

This study had a qualitative design with face-to-face, in-depth interviews. The concept of QoL was used as a framework for developing a thematic, semi-structured interview guide. Eight mothers of adolescents with chronic pain (two boys and six girls) participated with signed consent.

Results

Socio-economic difficulties and health complaints were common. Psychological stress, because of their children’s physical pain and other stressful experiences such as bullying, dominated everyday life. Lack of predictability and of responsible involvement from the fathers’ side increased the mothers’ burden considerably. Experiencing not being helped by others such as health professionals resulted in feelings of helplessness.

Conclusions

These mothers had reduced QoL caused by their own health problems, concern for the child’s well-being and lack of social support, which affected the child’s upbringing and pain management. By improving these mothers’ QoL, family-based shared pain management strategies could help in health promotion, leading to a more positive QoL circle. Elements of family and cognitive therapy could be applied when supporting the mothers and children and improving their QoL.
A randomised feasibility study of serial magnetic resonance imaging to reduce treatment times in Charcot neuroarthropathy in people with diabetes (CADOM): a protocol
Authors: Gooday Catherine , Game Frances , Woodburn Jim , Poland Fiona , Sims Erika , Dhatariya Ketan , Shepstone Lee , Hardeman Wendy
Published: June 2020

Background

Charcot neuroarthropathy is a complication of peripheral neuropathy associated with diabetes which most frequently affects the lower limb. It can cause fractures and dislocations within the foot, which may progress to deformity and ulceration. Recommended treatment is immobilisation and offloading, with a below knee non-removable cast or boot. Duration of treatment varies from six months to more than 1 year. Small observational studies suggest that repeated assessment with magnetic resonance imaging improves decision-making about when to stop treatment, but this has not been tested in clinical trials. This study aims to explore the feasibility of using serial magnetic resonance imaging without contrast in the monitoring of Charcot neuroarthropathy to reduce duration of immobilisation of the foot. A nested qualitative study aims to explore participants’ lived experience of Charcot neuroarthropathy and of taking part in the feasibility study.

Methods

We will undertake a two-arm, open study and randomise 60 people with a suspected or confirmed diagnosis of Charcot neuroarthropathy from five NHS, secondary care multidisciplinary Diabetic Foot Clinics across England. Participants will be randomised 1:1 to receive magnetic resonance imaging at baseline and remission up to 12 months, with repeated foot temperature measurements and X-rays (standard care plus), or standard care plus with additional three-monthly magnetic resonance imaging until remission up to 12 months (intervention). Time to confirmed remission of Charcot neuroarthropathy with off-loading treatment (days) and its variance will be used to inform sample size in a full-scale trial. We will look for opportunities to improve the protocols for monitoring techniques and the clinical, patient-centred and health economic measures used in a future study. For the nested qualitative study, we will invite a purposive sample of 10–14 people able to offer maximally varying experiences from the feasibility study to take part in semi-structured interviews to be analysed using thematic analysis.

Discussion

The study will inform the decision whether to proceed to a full-scale trial. It will also allow deeper understanding of the lived experience of Charcot neuroarthropathy, and factors that contribute to engagement in management and contribute to the development of more effective patient-centred strategies.

Trial registration

ISRCTN, ISRCTN74101606. Registered on 6 November 2017.
"Like a virgin". Correlates of virginity among Italian university students
Authors: Stranges Manuela , Vignoli Daniele
Published: June 2020

Virginity, as a status, carries with it enormous personal and social meaning and represents a sexual milestone with high cultural significance. In this paper, we describe the correlates of virginity in Italy by consulting a large-scale survey of university students conducted in 2000 and 2017 (N = 12,400). First, we note a reduction between 2000 and 2017 of both male and female students reporting themselves as virgins at the time of the interview. Second, we highlight the salience of several demographic-, family-, interpersonal-, bodily-, and health-related factors associated with their virginity status. Third, the findings of the present study draw special attention to two crucial characteristics of Italian society: regional divisions and the role of religiosity. We show that, although religiosity is still important to the sexual lives of Italian youths, its relevance is weakening over time. In all, our study extends research on sexuality among Italian youths and sheds light on factors related to their virginity, seeking to feed future research on the topic.
Performance of trust-based governance
Authors: Vanneste Bart S. , Yoo Onesun Steve
Published: June 2020

Trust is crucial for the success of interorganizational relationships, yet we lack a clear understanding of when trust-based governance is likely to succeed or fail. This paper explores that topic via a closed-form and a computational analysis of a formal model based on the well-known trust game. We say that trust-based governance performs better in situations where it results in a willingness to be vulnerable with trustworthy othersandan unwillingness to be vulnerable with untrustworthy others. We find that trust-based governance performs better in situations in which (a) trustworthy and untrustworthy partners exhibit markedly different behavior (high behavioral risk) or (b) the organization is willing to be vulnerable despite doubts concerning the partner’s trustworthiness (low trust threshold).
Design of high performance and low resistive loss graphene solar cells
Authors: Sabaeian Mohammad , Hajati Yaser
Published: June 2020

Despite metallic plasmonic excitations can enhance the performance of ultra-thin solar cells however these so-called plasmonic solar cells suffer from a large resistive (Ohmic) loss caused by metallic elements. In this work, we report on a new design that uses graphene nanoribbons (GNRs) in a two-dimensional (2D) grating form at the top of the semiconductor-on-insulator (SOI) solar cells aimed to reduce the resistive loss. The results showed that GNRs can remarkably reduce the resistive loss compared to the SOI cell with Ag nanograting, while keeping all other cell’s parameters, comparable with those of Ag SOI cell. Optical absorption and short-circuit current density of the graphene cells showed, respectively, enhancements of 18 and 1.7 times when optimizations were done with respect to width and the grating period. Our calculations showed that the graphene solar cells dissipate at most 5% of incident sunlight power as narrow and tiny peaks around 508 nm, which is noticeably lower than those of Ag solar cells with high and broad band peaks with the maximum values of 29% at 480 nm and 24% at 637 nm.
Spinal mepivacaine versus bupivacaine for ultrasound guided transvaginal oocyte retrieval. A comparative study
Authors: Menshawi Mohammed Abdelsalam , Fahim Hany Magdy
Published: June 2020

Study objective

The most important limitation for spinal anesthesia in the ambulatory setting is the prolonged motor blockade and delayed postoperative ambulation. The current study was conducted to compare spinal mepivacaine–fentanyl combination versus conventional combination of spinal bupivacaine with fentanyl for surgical anesthesia of ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization (IVF).

Patients and methods

Sixty female patients undergoing ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization on ambulatory basis were enrolled in the current study. Patients were randomly distributed in to one of two equal groups: mepivacaine group (group M) and bupivacaine group (group B). Patients in group M received intrathecal 37.5 mg of isobaric mepivacaine 1.5% plus 10 μg fentanyl while patients in group B received intrathecal 12.5 mg of hyperbaric bupivacaine 0.5% plus 10 μg fentanyl. Primary outcome measure was the time to complete motor block regression. Secondary outcome measures included the peak sensory blockade level achieved, the times for sensory block regression to S1 dermatome, post-anesthesia stable ambulation, 1st voiding, and hospital discharge. The incidence of perioperative adverse events was also recorded.

Results

Two patients (one in each group) were excluded from the study due to failed block and conversion to general anesthesia. The peak sensory blockade levels (T6–T10) were satisfactory for procedural anesthesia in the remaining patients of both groups. Patients in group M had significantly faster sensory block regression to S1 and motor block resolution when compared with group B (P< 0.05). Times to steady ambulation, voiding and hospital discharge were significantly shorter in group M when compared with group B (P< 0.05). There was no intergroup significant difference as regards the incidence of perioperative adverse events, and none of the patients reported transient neurological symptoms (TNS) or postdural puncture headache in both groups.

Conclusion

The mepivacaine–fentanyl combination was superior to bupivacaine–fentanyl combination for spinal anesthesia of ultrasound-guided transvaginal oocyte retrieval on ambulatory basis because of faster sensory and motor block resolution and the shorter time to ambulation and hospital discharge with reliability of surgical anesthesia and no difference in the incidence of perioperative adverse events between both groups.
Inclusion of fluted pumpkin (Telfaria occidentalis) fortified bread waste in broiler chickens’ diets
Authors: Adegbenro Muyiwa , Ayeni Oluwafemi A. , Agbede Johnson O. , Aletor Valentine A.
Published: June 2020

Background

The objective of this study was to produce a least-cost ration from the use of fluted pumpkin leaf meal and bread waste in broiler chickens’ diets. Fluted pumpkin leaves (FPL) were sourced in Akure and its environs. The leaves were air-dried and milled to produce fluted pumpkin leaf meal (FPLM), while bread wastes were collected from different bakeries in Ilara-mokin and Akure towns, Ondo State, Nigeria. The bread wastes were sun-dried and milled and tagged BWM. The fluted pumpkin meal and bread waste meal were mixed in ratio 1:9 (1 kg FPLM + 9 kg BWM) to produce the fortified bread waste meal (FBWM) and used as one of the feed ingredients in broiler chickens’ diets. The FBWM were included in the diets at 0, 5, 10 and 15% to serve as diets I, II, III and IV, respectively. Two hundred day-old Abor-acre broiler chicks were randomly allotted to the four (4) dietary treatments at fifty (50) chicks per treatment at five (5) replicates per treatment in a completely randomized design. The experimental diets (starter and finisher) and freshwater were offered to the chicks ad libitum for fifty-six (56) days.

Results

The results showed that the final weights and total weight gain were significantly (P < 0.05) influenced by dietary treatments. The highest final weight (2.12 ± 13.16 kg/bird) and the highest total weight gain (2.08 ± 13.14 kg/bird) were recorded in birds fed diet I, while the lowest final weight (1.73 ± 11.67 kg/bird) and the lowest total weight gain (1.69 ± 11.15 kg/bird) were recorded in birds fed diet IV. There was no significant (P > 0.05) difference in the feed conversion ratio for all birds fed diets I–IV. The highest dressed weight (92.64 ± 8.30%) and the highest eviscerated weight (79.52 ± 6.50%) were recorded in birds fed diet I. The lowest cholesterol (21.23 ± 3.15 mg/dl) was recorded in bird fed diet IV and the highest (32.78 ± 3.78 mg/dl) in birds fed diet I. Highest net profit (N 683.27) was recorded in bird fed diet IV.

Conclusion

Conceivably, within the limit of this study, the inclusion of FBWM in the diet of broiler chickens at 0% had better results than other test diets, but looking at the level of significant, up to 5% is practicable considering the final weight and weight gain. Bird fed 15% yielded the highest profit/bird produced.
Exploring the organic–inorganic interface in biosilica: atomistic modeling of polyamine and silica precursors aggregation behavior
Authors: Eckert Hagen , Montagna Maria , Dianat Arezoo , Gutierrez Rafael , Bobeth Manfred , Cuniberti Gianaurelio
Published: June 2020

Diatoms are a significant group of algae displaying a sizeable morphological diversity, whose underlying structure arises from nanopatterned silica. Extensive experimental evidence suggests that a delicate interplay between various organic components and polysilicic acid plays a crucial role in biosilica mineralization. Thus, gaining insight into the properties of this organic–inorganic interface is of great interest in understanding the mechanisms controlling biosilica formation over different length scales. In this work, we use all-atom Molecular Dynamics simulations to investigate the aggregation behavior of polysilicic acid and silica nanoparticles in solution in the presence of protonated long-chain polyamines with a focus on the nature of the driving forces mediating the organic–inorganic aggregation process. Our results show that electrostatic forces between organic and inorganic species are the dominant interaction responsible for largely preserving the structural integrity of the organic–inorganic aggregates in solution. Thus, aggregates involving electrically neutral polysilicic acid are fully dissolved in an aqueous environment, since hydrogen bonding and van der Waals interactions turn out to be not strong enough to keep the aggregates together. Our main simulation results are in qualitative agreement with in vitro experiments, so that we expect they can contribute to shedding light on the initial stages of biosilica mineralization in diatoms.
Primary cardiac tumors: a spectrum of pathologies and scenarios
Authors: Sanad Mohammed , Arafa Sherif , Hegazy Mohammed Adel , Abdel Hamid Wael Abdel Aziz
Published: June 2020

Background

Cardiac tumors are rare, and their diagnosis is challenging. The level of evidence for the management of cardiac tumors came from case reports or small case series. We aim to present our multicenter experience in the diagnosis and management of cardiac tumors.

Results

We performed a prospective study, including 82 cases of cardiac tumors encountered at three centers in 5 years. The mean age was 62 ± 5.8 years old (range 2 months–74 years), and 91.4% were females constituted. The median EuroSCORE II was 4.27%. All cases underwent radical excision of the tumor. Five cases underwent additional mitral valve replacement and one case underwent coronary bypass grafting. Pathological diagnoses were left atrial myxomas (n = 65, 79.3%), right atrial myxomas (n = 5, 6.1%), bi-atrial myxomas (n = 2, 2.4%), right ventricular outflow tract myxoma (n = 1, 1.2%), myxosarcoma (n = 1, 1.2%), thymoma (n = 1, 1.2%), recurrent hemangioendothelioma (n = 1, 1.2%), round cell tumor (n = 1, 1.2%), cardiac lymphoma (n = 1, 1.2%), rhabdomyomas (n = 2, 2.4%), and renal cell carcinomas (n = 2, 2.4%). Two patients (2.4%) had re-exploration for bleeding. One patient (1.2%) with right atrial thymoma experienced a severe vasoplegia with unstable hemodynamics. Two patients had operative mortality (2.4%), one with recurrent cardiac hemangioendothelioma. During 1-year follow-up, one patient (1.2%) died because of metastatic myosarcoma. Recurrence was reported in 2 patients (2.4%).

Conclusions

The clinical scenario of cardiac tumors depends mainly on tumor location and size rather than the histopathology. Surgical resection is feasible in benign tumors while very challenging in malignant tumors.
Vulvar Squamous Cell Carcinoma: Comprehensive Genomic Profiling of HPV+ Versus HPV– Forms Reveals Distinct Sets of Potentially Actionable Molecular Targets
Authors: Williams Erik A. , Werth Adrienne J. , Sharaf Radwa , Montesion Meagan , Sokol Ethan S. , Pavlick Dean C. , McLaughlin-Drubin Molly , Erlich Rachel , Toma Helen , Williams Kevin Jon , Venstrom Jeff M. , Alexander Brian M. , Shah Nikunj , Danziger Natalie , Hemmerich Amanda C. , Severson Eric A. , Killian Jonathan Keith , Lin Douglas I. , Ross Jeffrey S. , Tse Julie Y. , Ramkissoon Shakti H. , Mochel Mark C. , Elvin Julia A.
Published: June 2020

PURPOSE

Vulvar squamous cell carcinoma (vSCC) encompasses two predominant variants: one associated with detectable high-risk strains of human papillomavirus (hrHPV) and a second form often occurring in the context of chronic dermatitis in postmenopausal women. Genomic assessment of a large-scale cohort of patients with aggressive vSCC may identify distinct mutational signatures.

MATERIALS AND METHODS

Tumor samples from a total of 280 patients with vSCC underwent hybridization capture with analysis of up to 406 cancer-related genes. Human papillomavirus (HPV) sequences were detected by de novo assembly of nonhuman sequencing reads and aligned to the RefSeq database. Immunohistochemistry for programmed death-ligand 1 (PD-L1) was assessed.

RESULTS

One hundred two of 280 vSCCs (36%) contained hrHPV sequences, predominantly HPV 16 (88%). The HPV-positive (HPV+) group was significantly younger (median age, 59 v 64 years; P = .001). Compared with HPV-negative (HPV–) vSCCs, HPV+ tumors showed more frequent pathogenic alterations in PIK3CA (31% v 16%; P = .004), PTEN (14% v 2%; P < .0001), EP300 (14% v 1%; P < .0001), STK11 (14% v 1%; P < .0001), AR (5% v 0%; P = .006), and FBXW7 (10% v 3%; P = .03). In contrast, HPV– vSCCs showed more alterations in TP53 (83% v 6%; P < .0001), TERTp (71% v 9%; P < .0001), CDKN2A (55% v 2%; P < .0001), CCND1 amplification (22% v 2%; P < .0001), FAT1 (25% v 4%; P < .0001), NOTCH1 (19% v 6%; P = .002), and EGFR amplification (11% v 0%; P < .0001), as well as a higher rate of 9p24.1 ( PDL1/PDL2) amplification (5% v 1%) and PD-L1 immunohistochemistry high-positive tumor staining (33% v 9%; P = .04).

CONCLUSION

Comprehensive molecular profiles of vSCC vary considerably with hrHPV status and may inform patient selection into clinical trials. Sixty-one percent of HPV+ vSCCs had a pathogenic alteration in the PI3K/mTOR pathway, whereas HPV– vSCCs showed alterations in TP53, TERTp, CDKN2A, CCND1, and EGFR, and biomarkers associated with responsiveness to immunotherapy.
Health-related quality of life after vascular surgery and endovascular treatment in subjects with critical limb ischemia
Authors: Khalil Emced , Ozcan Sedat
Published: June 2020

Background & Objective: Revascularization of the target vessel and restoration of distal flow is critical not only to reduce mortality and morbidity but also improve health-related quality of life (HRQoL) in patients with critical limb ischemia. However, data concerning the impact of surgical bypass and percutaneous transluminal angioplasty (PTA) on HRQoL is limited. This study aimed to compare the impact of surgical bypass and PTA on HRQoL in subjects undergoing superficial femoral artery (SFA) or popliteal artery revascularization.

Methods: Seventy-one subjects who underwent successful revascularization of the SFA or popliteal artery either with surgical revascularization or PTA were enrolled in this study. Three months after revascularization, all subjects underwent ankle-brachial index (ABI) measurement, 6-minute walking test and completed the Nottingham Health Profile (NHP) questionnaire. The NHP score differences (measured at the post-procedural 3rd month) between subjects undergoing surgical or endovascular (PTA) revascularization subjects was the primary outcome measure of the study.

Results: Both groups experienced significant improvements in ABI and 6-minute walking distance at post-procedure three months. NHP total scores of Part I and Part II at post-procedural six months were similar in the two groups. However, social isolation [77.98 (0 - 85) vs. 22.53 (0 - 100), p=0.002] and physical abilities [78.7 (30.31 - 87.7) vs. 54.47 (0 - 100), P=0.014] domain scores of the surgical revascularization group were significantly higher than that of the endovascular treatment group.

Conclusion: This study shows that total scores obtained from the NHP questionnaire applied three months after revascularization of SFA stenosis are similar in subjects undergoing surgical revascularization or PTA. However, the social isolation and physical abilities domains of the NHP are significantly higher in subjects receiving surgical revascularization compared to those receiving PTA.

doi: https://doi.org/10.12669/pjms.36.5.2680

How to cite this:Khalil E, Ozcan S. Health-related quality of life after vascular surgery and endovascular treatment in subjects with critical limb ischemia. Pak J Med Sci. 2020;36(5):877-883. doi: https://doi.org/10.12669/pjms.36.5.2680

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Automatic migraine classification using artificial neural networks
Authors: Sanchez-Sanchez Paola A. , García-González José Rafael , Rúa Ascar Juan Manuel
Published: June 2020

Background: Previous studies of migraine classification have focused on the analysis of brain waves, leading to the development of complex tests that are not accessible to the majority of the population. In the early stages of this pathology, patients tend to go to the emergency services or outpatient department, where timely identification largely depends on the expertise of the physician and continuous monitoring of the patient. However, owing to the lack of time to make a proper diagnosis or the inexperience of the physician, migraines are often misdiagnosed either because they are wrongly classified or because the disease severity is underestimated or disparaged. Both cases can lead to inappropriate, unnecessary, or imprecise therapies, which can result in damage to patients’ health.

Methods: This study focuses on designing and testing an early classification system capable of distinguishing between seven types of migraines based on the patient’s symptoms. The methodology proposed comprises four steps: data collection based on symptoms and diagnosis by the treating physician, selection of the most relevant variables, use of artificial neural network models for automatic classification, and selection of the best model based on the accuracy and precision of the diagnosis. Results: The neural network models used provide an excellent classification performance, with accuracy and precision levels >97% and which exceed the classifications made using other model, such as logistic regression, support vector machines, nearest neighbor, and decision trees.

Conclusions: The implementation of migraine classification through neural networks is a powerful tool that reduces the time to obtain accurate, reliable, and timely clinical diagnoses.
A mouse model for functional dissection of TAB1 O-GlcNAcylation
Authors: Authier Florence , Muha Villő , van Aalten Daan M.F.
Published: June 2020

Background: O-GlcNAcylation is a posttranslational modification associated with various physiological and pathophysiological processes including diabetes, cancer, neurodegeneration and inflammation. However, the biological mechanisms underlying the role of specific O-GlcNAc sites and their link to phenotypes remain largely unexplored due to lack of suitable in vivo models. TGF-β activated kinase-1 binding protein-1 (TAB1) is a scaffolding protein required for TGF-β activated kinase-1 (TAK1) mediated signalling. A single O-GlcNAc site has been identified on human TAB1 that modulates TAK1-mediated cytokine release in cells.

Methods: Here, we report the generation of the Tab1S393A mouse model using a constitutive knock-in strategy. The Tab1S393A mice carry a Ser393Ala (S393A) mutation that leads to loss of O-GlcNAcylation site on TAB1.

Results: We did not observe any obvious phenotype in Tab1S393A mice. Loss of O-GlcNAcylation on TAB1 has no consequences on TAB1 protein level or on TAB1-TAK1 interaction.

Conclusions: The homozygous Tab1S393A mice are viable and develop with no obvious abnormalities, providing a powerful tool to further investigate the role of O-GlcNAc on TAB1 in the inflammatory response in the context of a whole organism.
Communicative Culture of Educational Space and Internet Identification technologies (Analysis of American Research Experience)
Authors: Popey-ool Saida
Published: June 2020

The article analyzes the experience of research of ethno-racial relations in social networks of the American educational system. The article defines the characteristics of the presentation culture of students on the Internet and in real relationships. The author characterizes the nature of the identification properties of ethnic-racial student groups in America.
Political hermeneutics
Authors: Karabuschenko Pavel
Published: June 2020

The monograph is devoted to the problem of formation and development of this branch of the division of hermeneutics as a political hermeneutics. Considered as the very origins of this hermeneutic stemming directly from the history of classical hermeneutics (Chapter 1) and its methodological principles (Chapter 2) and application characteristics (Chapter 3). It is from this triad (history — theory — practice) by the author and displayed the Foundation of political hermeneutics, which seems to them as the "deep method" study of the essence of the political elites and elitism and is characterized as a methodological division of lithologie to uncover the political "backstage" as the main sphere of professional activity of non-public elites.
In the formation of hermeneutical understanding, it is important to clarify the internal relationship of this triad as a "language — word — text". The author consistently reveals the idea that language is expressed in the word exactly the same as the word in the text, which in turn is designed for disclosure in another language and in another word
(in the "I — don't-Ya").
Designed for students and professionals; anyone interested in the problems of political consciousness and thinking of the elites.
OSCAR-4 CODE SYSTEM COMPARISON AND ANALYSIS WITH A FIRST-ORDER SEMI-EMPIRICAL METHOD FOR CORE-FOLLOW DEPLETION CALCULATION IN MNR
Authors: Alqahtani Mohammed , Day Simon , Buijs Adriaan
Published: June 2020

Knowledge of the isotopic composition of a nuclear reactor core is important for accurate core-follow and reload analysis. In the McMaster Nuclear Reactor, fuel depletion estimates are based upon a semi-empirical calculation using flux-wire measurements. These estimates are used to plan and guide fuelling operations. To further support operations, an OSCAR-4 model is being developed. To evaluate the performance of the OSCAR-4 code for this application, 2 points of comparison, considering the period between 2007 and 2010, are presented: (i) the multiplication factor keff and (ii) U-235 fuel inventory. The latter is compared with a simple first-order semi-empirical calculation. The calculation of keff for the last operational 3 months yields 0.997 ± 0.002 (vs. 1.000 for an operating reactor), and differences in both core-average inventory and the maximum standard fuel assembly inventories estimates are found to be 5.7% and 7.5%, respectively.