bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular Repair of Postdissection Thoracoabdominal Aortic Aneurysm in Patients With Vascular Ehlers-Danlos Syndrome
Authors: Eleshra Ahmed , Panuccio Giuseppe , Spanos Konstantinos , Rohlffs Fiona , Kodolitsch Yskertvon , Detter N. Christian , Tsilimparis Nikolaos , Kölbel Tilo
Published: June 2021

Purpose

To report endovascular repair of postdissection thoracoabdominal aortic aneurysm (TAAA) in 2 patients with vascular Ehlers-Danlos syndrome (vEDS).

Case Reports

Case 1. A 56-year-old vEDS male patient with a 50-mm type III TAAA [history of aortic root repair, hemiarch replacement, and thoracic endovascular aortic repair (TEVAR) for acute type A aortic dissection (TAAD) 7 years ago] was treated by a 2-stage procedure; first, cervical debranching of the left subclavian artery and second TEVAR and t-branch. The postoperative course was uneventful. Follow-up computed tomography angiography (CTA) 3.5 years postoperatively demonstrated aortic remodeling with patency of targeted visceral vessels and no endoleak. Case 2. A 47-year-old vEDS male patient presented with a TAAA (diameter of 67 mm). The patient had a history of aortic valve and arch replacement with elephant trunk for acute TAAD, and consequently a TEVAR and candy-plug procedure after a ruptured false lumen (FL) aneurysm of the descending thoracic aorta. He also had a surgical repair by an aorto-bi-iliac graft. Two years later, CTA demonstrated aneurysmal FL dilatation distally to the candy-plug and he was treated with fenestrated EVAR (F-EVAR).

Conclusion

Endovascular repair of postdissection TAAA was feasible and safe with good short-term outcome in 2 patients with vEDS.
The Deming management method and digital partnering in a construction procurement contract
Authors: Ganguly Joydeep , Handfield Robert , Harvey Delvin , Rasovsky Lily
Published: June 2021

In this case study of a research and development facility construction project at a large biopharmaceutical organization, we explored how digital investments must be accompanied by a partnership approach and a transformation of the cultural values of an organization tied to operational principles. The project faced considerable challenges, including a highly constrained market environment, time and cost constraints, and a multiyear organization transformation with a diverse mix of stakeholder objectives. Despite these challenges, the project was brought in under budget and on schedule, achieving other objectives that often seem at odds with each other (best-in-class sustainability ratings, quality scores from customers, and with a remarkably low number of change requests). We found that significant stakeholder engagement early in the architect and contractor selection process leads to the right contract management process and ultimately successful outcomes. A key insight from this case involves the need for differentiated supplier relationship management for procurement-project team integration.
Mechanical Effects of Lag Screw Retightening in a Simulated Hindfoot Arthrodesis Model
Authors: Rugg Amanda L. , Requist Melissa R. , Johnson Brooks W. , Son Michelle M. , Alvarez Alicia , Latt L. Daniel
Published: June 2021

Background:

Nonunion following hindfoot arthrodesis may be caused by failure to maintain compression at the arthrodesis site. The ability of lag screws, commonly used in arthrodesis, to maintain compression in hindfoot bones has not been well characterized. The aim of this work was to quantify the stress relaxation response of hindfoot bone with initial and repeated compression with a lag screw.

Methods:

Ten sets of 25-mm-diameter bone cylinders were cut from the talus and calcaneus in fresh-thawed cadaveric feet. A load cell was compressed between cylinders with an 8.0-mm partially threaded cannulated lag screw simulating arthrodesis. For 7 sets, screws were tightened by 3 quarter-turns, rested for 3 minutes, retightened 1 quarter-turn, and rested for 30 minutes. Three sets served as controls in which screws were not retightened.

Results:

Maximum compression after initial screw tightening and retightening averaged 275 and 337 N ( P = .07), respectively. Compression 3 minutes after initial screw tightening and retightening averaged 199 and 278 N ( P = .027), respectively. The compression recorded 3 minutes after screw retightening was an average of 40% higher than that recorded 3 minutes after initial tightening. The average compression 30 minutes after screw retightening was 255 N, a compression loss of 25% from the average maximum compression after retightening. Eighty percent of this compression loss happened in an average of 5.5 minutes.

Conclusion:

Hindfoot bones exhibit compression loss over time during simulated arthrodesis. Compression maintenance in bone is improved with screw retightening. Further work is needed to understand the mechanism of action and determine optimum time for recompression.

Clinical Relevance:

Retightening lag screws before wound closure may improve compression at the arthrodesis site and thereby decrease the chance of nonunion.

Level of Evidence:

N/A, laboratory experiment.
Intraspecific variation in the Cambrian: new observations on the morphology of the Chengjiang euarthropod Sinoburius lunaris
Authors: Schmidt Michel , Liu Yu , Hou Xianguang , Haug Joachim T. , Haug Carolin , Mai Huijan , Melzer Roland R.
Published: June 2021

Background

The Chengjiang biota from southwest China (518-million-years old, early Cambrian) has yielded nearly 300 species, of which more than 80 species represent early chelicerates, crustaceans and relatives. The application of µCT-techniques combined with 3D software (e.g., Drishti), has been shown to be a powerful tool in revealing and analyzing 3D features of the Chengjiang euarthropods. In order to address several open questions that remained from previous studies on the morphology of the xandarellid euarthropodSinoburius lunaris, we reinvestigated the µCT data with Amira to obtain a different approach of visualization and to generate new volume-rendered models. Furthermore, we used Blender to design 3D models showing aspects of intraspecific variation.

Results

New findings are: (1) antennulae consist of additional proximal articles that have not been detected before; (2) compared to other appendages, the second post-antennular appendage has a unique shape, and its endopod is comprised of only five articles (instead of seven); (3) the pygidium bears four pairs of appendages which are observed in all specimens. On the other hand, differences between specimens also have been detected. These include the presence/absence of diplotergites resulting in different numbers of post-antennular appendages and tergites and different distances between the tip of the hypostome and the anterior margin of the head shield.

Conclusions

Those new observations reveal intraspecific variation among Chengjiang euarthropods not observed before and encourage considerations about possible sexual dimorphic pairs or ontogenetic stages.Sinoburius lunarisis a variable species with respect to its morphological characters, cautioning that taxon-specific variabilities need to be considered when exploring new species.
Transcriptome analysis reveals Vernalization is independent of cold acclimation in Arabidopsis
Authors: Li Fei , Hu Qian , Chen Fadi , Jiang Jia Fu
Published: June 2021

Background

Through vernalization, plants achieve flowering competence by sensing prolonged cold exposure (constant exposure approximately 2-5 °C). During this process, plants initiate defense responses to endure cold conditions. Here, we conducted transcriptome analysis of Arabidopsis plants subjected to prolonged cold exposure (6 weeks) to explore the physiological dynamics of vernalization and uncover the relationship between vernalization and cold stress.

Results

Time-lag initiation of the two pathways and weighted gene co-expression network analysis (WGCNA) revealed that vernalization is independent of cold acclimation. Moreover, WGCNA revealed three major networks involving ethylene and jasmonic acid response, cold acclimation, and chromatin modification in response to prolonged cold exposure. Finally, throughout vernalization, the cold stress response is regulated via an alternative splicing-mediated mechanism.

Conclusion

These findings illustrate a comprehensive picture of cold stress- and vernalization-mediated global changes in Arabidopsis.
Therapeutic inertia in proteinuria management among type 2 diabetes (T2DM) patients in primary care settings: prevalence and associated risk factors
Authors: Chan FU Leung , Li Yim Chu , Chen Xiao Rui Catherine
Published: June 2021

Background

Therapeutic inertia (TI), defined as physicians’ failure to increase therapy when treatment goals are unmet, is an impediment to chronic disease management. This study aimed to identify the prevalence of TI in proteinuria management among T2DM patients managed in primary care settings and to explore possible associating factors.

Methods

This was a cross-sectional study. T2DM patients with proteinuria (either microalbuminuria or macroalbuminuria) and had been followed up in 7 public primary care clinics of the Hospital Authority of Hong Kong from 1 Jan, 2014 to 31 Dec, 2015 were included. The prevalence of TI in proteinuria management and its association with patients’ demographic and clinical parameters and the working profile of the attending doctors were explored. Student’s t test and analysis of variance were used for analyzing continuous variables and Chi square test was used for categorical data. Multivariate stepwise logistic regression was used to determine the association between TI and the significant variables from patients' and doctors' characteristics.

Results

Among the 22,644 T2DM patients identified in the case register, 5163 (26.4%) patients were found to have proteinuria. Among the sampled 385 T2DM patients with proteinuria, TI was identified in 155 cases, with a prevalence rate of 40.3%. Male doctor, doctor with longer duration of clinical practice and have never received any form of Family Medicine training were found to have a higher TI. Patients with microalbuminuria range and lower systolic and diastolic blood pressure (BP) were also found to have higher TI. Logistic regression study revealed that patients’ systolic BP level and microalbuminuria range of proteinuria were negatively associated with the presence of TI, whereas doctor’s year of clinical practice being over 20 years and patients being treated with submaximal dose of medication were positively associated with the presence of TI.

Conclusions

TI is commonly present in proteinuria management among T2DM patients, with a prevalence of 40.3% in primary care. Systolic BP and microalbuminuria range of urine ACR were negatively associated with the presence of TI, whereas submaximal ACEI/ARB dose and doctors practicing over 20 years were positively associated with the presence of TI. Further studies exploring the strategies to combat TI are needed to improve the clinical outcome of T2DM patients.
Exploring the impact of Patient Reported Outcome Measures (PROMs) among orthopaedic surgeons in mainland China: systematic review and survey-based study on hip and knee instruments
Authors: Ngwayi James Reeves Mbori , Tan Jie , Liang Ning , Obie Kenedy Uzoma , Porter Daniel Edward
Published: June 2021

Background

Patient Reported Outcome Measures (PROMs) are widely used in Europe and North America in a variety of areas including research, clinical governance, clinical registries and insurance ascertainment. The aim of this study was to assess commonly used knee and hip PROMs among Chinese surgeons and to gain an insight into their impact on evaluation of clinical outcomes.

Methods

1. A systematic literature search of databases Medline, EMBASE, CINAHL and CNKI was performed from the earliest records to 22/07/2020 for knee instruments and 22/08/2020 for hip instruments, to retrieve Chinese Mandarin cross culturally adapted and validated knee and hip PROMs. 2. An 11-item electronic questionnaire was then designed under four domain categories. The survey was distributed via a ubiquitous online social media platform to orthopaedic surgeons. Responses were collected and analyzed. Output from 1. was used to populate parts of the survey questionnaire.

Results

The systematic online search yielded a total of 41 evaluation instruments, (10 hip and 31 knee); all of which were incorporated as response options. 234 viable questionnaires were retrieved with the largest group representing attending surgeons. 59.0% were familiar with the concept of PROMs among which 78.4% reported to have used PROMs themselves. In order of frequency of use, PROMs were purposed for clinical assessment (55.6%), research (40.7%), health regulation policies (18.6%) and insurance service requirements (10.6%). Implementation was prompted by both departmental (43.4%) and institutional policy (34.5%). 89.4% of PROMs users reported difficulties in the use of PROMs, with major barriers including license fees, limited access, inadequate training and burden of fill-out time (all > 40%).

Conclusion

There is evidence of limited familiarity with knee and hip PROMs among orthopaedic surgeons. Barriers to their use are significant. Development of a Chinese language PROMs database would be helpful.
Identifying novel genetic variants for brain amyloid deposition: a genome-wide association study in the Korean population
Authors: Kim Hang-Rai , Jung Sang-Hyuk , Kim Jaeho , Jang Hyemin , Kang Sung Hoon , Hwangbo Song , Kim Jun Pyo , Kim So Yeon , Kim Beomsu , Kim Soyeon , Jeong Jee Hyang , Yoon Soo Jin , Park Kyung Won , Kim Eun-Joo , Yoon Bora , Jang Jae-Won , Hong Jin Yong , Choi Seong Hye , Noh Young , Kim Ko Woon , Kim Si Eun , Lee Jin San , Jung Na-Yeon , Lee Juyoun , Kim Byeong C. , Son Sang Joon , Hong Chang Hyung , Na Duk L. , Seo Sang Won , Won Hong-Hee , Kim Hee Jin
Published: June 2021

Background

Genome-wide association studies (GWAS) have identified a number of genetic variants for Alzheimer’s disease (AD). However, most GWAS were conducted in individuals of European ancestry, and non-European populations are still underrepresented in genetic discovery efforts. Here, we performed GWAS to identify single nucleotide polymorphisms (SNPs) associated with amyloid β (Aβ) positivity using a large sample of Korean population.

Methods

One thousand four hundred seventy-four participants of Korean ancestry were recruited from multicenters in South Korea. Discovery dataset consisted of 1190 participants (383 with cognitively unimpaired [CU], 330 with amnestic mild cognitive impairment [aMCI], and 477 with AD dementia [ADD]) and replication dataset consisted of 284 participants (46 with CU, 167 with aMCI, and 71 with ADD). GWAS was conducted to identify SNPs associated with Aβ positivity (measured by amyloid positron emission tomography). Aβ prediction models were developed using the identified SNPs. Furthermore, bioinformatics analysis was conducted for the identified SNPs.

Results

In addition to APOE, we identified nine SNPs on chromosome 7, which were associated with a decreased risk of Aβ positivity at a genome-wide suggestive level. Of these nine SNPs, four novel SNPs (rs73375428, rs2903923, rs3828947, and rs11983537) were associated with a decreased risk of Aβ positivity (p < 0.05) in the replication dataset. In a meta-analysis, two SNPs (rs7337542 and rs2903923) reached a genome-wide significant level (p < 5.0 × 10−8). Prediction performance for Aβ positivity increased when rs73375428 were incorporated (area under curve = 0.75; 95% CI = 0.74–0.76) in addition to clinical factors and APOE genotype. Cis-eQTL analysis demonstrated that the rs73375428 was associated with decreased expression levels of FGL2 in the brain.

Conclusion

The novel genetic variants associated with FGL2 decreased risk of Aβ positivity in the Korean population. This finding may provide a candidate therapeutic target for AD, highlighting the importance of genetic studies in diverse populations.
Specimen oriented intraoperative margin assessment in oral cavity and oropharyngeal squamous cell carcinoma
Authors: Horwich P. , MacKay C. , Bullock M. , Taylor S. M. , Hart R. , Trites J. , Geldenhuys L. , Williams B. , Rigby M. H.
Published: June 2021

Objective

Evaluate the oncologic outcomes and cost analysis of transitioning to a specimen oriented intraoperative margin assessment protocol from a tumour bed sampling protocol in oral cavity (OCSCC) and oropharyngeal squamous cell carcinoma (OPSCC).

Study design

Retrospective case series and subsequent prospective cohort study

Setting

Tertiary care academic teaching hospital

Subjects and methods

Retrospective case series of all institutional T1-T2 OCSCC or OPSCC treated with primary surgery between January 1st 2009 – December 31st 2014. Kaplan-Meier survival estimates with log rank tests were used to compare patients based on final margin status. Cost analysis was performed for escalation of therapy due to positive final margins. Following introduction of a specimen derived margin protocol, successive prospective cohort study of T1-T4 OCSCC or OPSCC treated with primary surgery from January 1st 2017 – December 31st 2018. Analysis and comparison of both protocols included review of intraoperative margins, final pathology and treatment cost.

Results

Analysis of our intra-operative tumour bed frozen section protocol revealed 15 of 116 (12.9%) patients had positive final pathology margins, resulting in post-operative escalation of therapy for 14/15 patients in the form of re-resection (7/14), radiation therapy (6/14) and chemoradiotherapy (1/14). One other patient with positive final margins received escalated therapy for additional negative prognostic factors. Recurrence free survival at 3 years was 88.4 and 50.7% for negative and positive final margins respectively ( p = 0.048). Implementation of a specimen oriented frozen section protocol resulted in 1 of 111 patients (0.9%) having positive final pathology margins, a statistically significant decrease ( p < 0.001). Utilizing our specimen oriented protocol, there was an absolute risk reduction for having a final positive margin of 12.0% and relative risk reduction of 93.0%. Estimated cost avoidance applying the specimen oriented protocol to our previous cohort was $412,052.812017 CAD.

Conclusion

Implementation of a specimen oriented intraoperative margin protocol provides a statistically significant decrease in final positive margins. This change in protocol leads to decreased patient morbidity by avoiding therapy escalation attributable only to positive margins, and avoids the economic costs of these treatments.

Graphical abstract
How does immigration affect anti-immigrant sentiment, and who is affected most? A longitudinal analysis of the UK and Japan cases
Authors: Igarashi Akira , Laurence James
Published: June 2021

Does increasing immigration affect natives’ attitudes towards immigrants? A significant volume of research has been conducted in Western contexts to explore this question. However, we know little about whether findings observed in Western societies translate to non-Western contexts. At the same time, there is a paucity of research into whether increasing immigration exerts differential-effects among different groups of individuals. Using Japanese and British longitudinal data, this study firstly compares and contrasts how immigrant-share in an environment affects anti-immigrant sentiment in Japan and Great Britain. Secondly, it explores two potential drivers of heterogeneity in the impact of immigration across individuals: (a) perceived financial situation, and (b) views towards the role government should play in issues of support for the vulnerable. Applying fixed-effects panel data modelling, the results show increasing immigration harms attitudes towards immigrants. Furthermore, these negative effects are stronger for those who perceive their financial situation is worse, and among those who lean further to the left on the role of government. Interestingly, these results are highly similar in Japan and the UK. Thus, these findings support similar mechanisms of the group-threat theory operating among natives in two distinct contexts.
A new classification of cardio-oncology syndromes
Authors: de Boer Rudolf A. , Aboumsallem Joseph Pierre , Bracun Valentina , Leedy Douglas , Cheng Richard , Patel Sahishnu , Rayan David , Zaharova Svetlana , Rymer Jennifer , Kwan Jennifer M. , Levenson Joshua , Ronco Claudio , Thavendiranathan Paaladinesh , Brown Sherry-Ann
Published: June 2021

Increasing evidence suggests a multifaceted relationship exists between cancer and cardiovascular disease (CVD). Here, we introduce a 5-tier classification system to categorize cardio-oncology syndromes (COS) that represent the aspects of the relationship between cancer and CVD. COS Type I is characterized by mechanisms whereby the abrupt onset or progression of cancer can lead to cardiovascular dysfunction. COS Type II includes the mechanisms by which cancer therapies can result in acute or chronic CVD. COS Type III is characterized by the pro-oncogenic environment created by the release of cardiokines and high oxidative stress in patients with cardiovascular dysfunction. COS Type IV is comprised of CVD therapies and diagnostic procedures which have been associated with promoting or unmasking cancer. COS Type V is characterized by factors causing systemic and genetic predisposition to both CVD and cancer. The development of this framework may allow for an increased facilitation of cancer care while optimizing cardiovascular health through focused treatment targeting the COS type.
Moving from North to North: how are the students’ university flows?
Authors: Rizzi Laura , Grassetti Luca , Attanasio Massimo
Published: June 2021

Student mobility has been much commented upon and much studied. Student mobility has social, economic, and political consequences. This form of mobility is relevant, in Italy, in terms of south-north flows, while the mobility of northern students toward the South and Centre of Italy is negligible. To the best of our knowledge, a proper focus on the dynamics among northern regions has not yet been carried out. This study focuses on the interregional mobility of northern first-year students. To this end, we use a longitudinal dataset with students’ individual histories from 2008 to 2017, obtained from the cohort-based datasets collected using the Italian Ministry of University’s administrative databases. Descriptive and model-based analyses are employed for assessing the association between the propensity to move and individual characteristics, as well as some territorial variables. A longitudinal study is also considered. Here, we see an increase in the population entering the university system and mobility flows across northern regions. The results show that students’ educational experiences influence the propensity to move. However, the most relevant driver of the phenomenon is the attractiveness of areas with a higher supply of university courses and a better economic context.
Inpatients with severe-enduring anorexia nervosa: Understanding the “enduringness” specifier
Authors: Marzola Enrica , Martini Matteo , Brustolin Annalisa , Abbate-Daga Giovanni
Published: June 2021

Background

Despite the need for a common definition of severe and enduring anorexia nervosa (SE-AN) with the overarching goal to optimize treatments, this definition still is being debated. Therefore, in this study we conducted an in-depth investigation of the history of AN and its clinical outcomes on inpatients with AN to ascertain the eventual “profiles” for individuals with varying durations of the illness (DOI).

Methods

We recruited 169 inpatients with AN, grouping them according to DOI: <3 years (short duration, SD-AN); 3–6.99 years (medium duration, MD-AN); and ≥7 years (long duration, LD-AN). We then performed a self-report and interview-based investigation of AN history, clinical data, eating, and general psychopathology, including personality, premorbid traits, stage of change, and quality of life. We measured the clinical outcomes for hospitalization as well.

Results

The majority of the measures did not differ across groups. Those with LD-AN were older and diagnosed mostly with the binge-purging AN subtype, failed more previous AN-related treatments, reported a lower lifetime body mass index, and trended toward a younger age at onset when compared to the other groups. All patients responded equally well to hospitalization, but patients with SD-AN improved less in drive for thinness and body-related concerns.

Conclusions

We did not find the “enduringness” of AN to be a specifier of severity. Hospitalization was effective for those with LD-AN and MD-AN, while interventions for the core cognitive aspects of over-evaluation of body shape should be offered to patients with SD-AN.
Associations Between Preoperative Biomarkers and Cardiac Surgery–Associated Acute Kidney Injury in Elderly Patients: A Cohort Study
Authors: Verwijmeren Lisa , Bosma Madeleen , Vernooij Lisette M. , Linde Esther M. , Dijkstra Ineke M. , Daeter Edgar J. , Van Dongen Eric P. A. , Van Klei Wilton A. , Noordzij Peter G.
Published: June 2021

BACKGROUND:

Acute kidney injury (AKI) is associated with mortality after cardiac surgery. Novel risk factors may improve identification of patients at risk for renal injury. The authors evaluated the association between preoperative biomarkers that reflect cardiac, inflammatory, renal, and metabolic disorders and cardiac surgery–associated AKI (CSA-AKI) in elderly patients.

METHODS:

This was a secondary analysis of the 2-center prospective cohort study “Anesthesia Geriatric Evaluation.” Twelve biomarkers were determined preoperatively in 539 patients. Primary outcome was CSA-AKI. The association between biomarkers and CSA-AKI was investigated with multivariable logistic regression analysis. Secondary outcomes were 1-year mortality and patient-reported disability and were assessed with relative risks (RR) between patients with and without CSA-AKI.

RESULTS:

CSA-AKI occurred in 88 (16.3%) patients and was associated with increased risk of mortality (RR, 6.70 [95% confidence interval {CI}, 3.38–13.30]) and disability (RR, 2.13 [95% CI, 1.53–2.95]). Preoperative concentrations of N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP), hemoglobin, and magnesium had the strongest association with CSA-AKI. Identification of patients with CSA-AKI improved when a biomarker panel was used (area under the curve [AUC] 0.75 [95% CI, 0.69–0.80]) compared to when only clinical risk factors were used (European System for Cardiac Operative Risk Evaluation [EuroSCORE II] AUC 0.67 [95% CI, 0.62–0.73]).

CONCLUSIONS:

Preoperative cardiac, inflammatory, renal, and metabolic biomarkers are associated with CSA-AKI and may improve identification of patients at risk.
Intrathecal 2-Chloroprocaine 3% Versus Hyperbaric Bupivacaine 0.75% for Cervical Cerclage: A Double-Blind Randomized Controlled Trial
Authors: Lee Allison , Shatil Ben , Landau Ruth , Menon Prahlad , Smiley Richard
Published: June 2021

BACKGROUND:

Cervical cerclage is a short ambulatory procedure. For spinal anesthesia, local anesthetic agents with rapid postoperative resolution are desired. We hypothesized that in combination with fentanyl, intrathecal 2-chloroprocaine would produce earlier resolution of motor block, resulting in shorter time to meet recovery room discharge criteria than hyperbaric bupivacaine.

METHODS:

Women undergoing cervical cerclage with spinal anesthesia were randomized to receive intrathecal 2-chloroprocaine 3% 50 mg or hyperbaric bupivacaine 0.75% 9 mg, both with fentanyl 15 µg. Doses were empirically selected. The onset and resolution of sensory and motor blockade and time to achieve recovery room discharge criteria were monitored. On postoperative day 1, patients rated their satisfaction with the anesthetic and reported on transient neurologic symptoms (TNS), back pain, or headache. The primary outcome was time from spinal injection to motor block resolution. The main secondary outcomes included times from spinal injection to (i) T12 dermatomal level, (ii) sensory block resolution, and (iii) ability to ambulate and void.

RESULTS:

Forty-three women were enrolled and randomized to either the chloroprocaine (N = 23) or bupivacaine group (N = 20). The mean (standard deviation [SD]) duration of surgery was 35.3 (11.4) minutes. There was no difference between groups for time to motor block resolution—the median [interquartile range] time for the bupivacaine group (N = 17) was 112 [97–143] minutes versus 109 [88–148] minutes in the chloroprocaine group (N = 22), P = .66, but there was a significant difference in median time to sensory block resolution: 143 [116–162] minutes in the chloroprocaine group versus 198 [152–263] minutes in the bupivacaine group, P = .002. The recovery room discharge criteria, which at our institution include the ability to ambulate unassisted and void urine, were met 76 (95% CI, 33–145) minutes earlier in the chloroprocaine group, P < .0005. One complete block failure occurred with hyperbaric bupivacaine and 2 subjects in each group received treatment for intraoperative discomfort. No patients reported TNS.

CONCLUSIONS:

Intrathecal 2-chloropocaine 3% provided similarly effective surgical anesthesia for cerclage placement. Although no difference in time to motor block resolution between groups was observed, the time to sensory block resolution and time to meet recovery room discharge criteria were both significantly shorter among patients who received chloroprocaine than patients who received bupivacaine. Future studies are needed to identify and compare equipotent doses of chloroprocaine and bupivacaine to confirm the superiority of chloroprocaine for this ambulatory obstetric procedure.
Intertestualità dantesche: Un’allusione a Ennio?
Authors: Aresu Francesco Marco
Published: June 2021

This article hypothesizes an intertextual relationship between the literary transfiguration of Occitan troubadour Bertran de Born in Inferno 28 and a fragment of Latin poetry preserved by late antique scholars (and disputedly attributed to Roman poet Ennius). The evidence presented in support of this hypothesis include lexical, prosodical, and rhetorical elements. The hypothesis is also examined with reference to the material and textual transmission of the fragment.
Mapping the Knowledge of Dante Commentaries in the Digital Context: A Web Ontology Approach
Authors: Meghini Carlo , Tavoni Mirko , Zaccarello Michelangelo
Published: June 2021

With digital repositories and databases available since the 1990s, Dante scholarship has always been at the forefront of the digital humanities and the digitization of medieval texts and manuscripts. However, the amount of information available about such aspects is imposing, and its location subject to the extreme dispersion of traditional scholarly publications: commentaries first but also academic journals, miscellanies, and so forth. Rather than being based on traditional word searches, a true advancement of knowledge needs to overcome the rigidity of text-based queries (and in-line markup embedded in text). Such paramount evolution is now made possible by the Semantic Web, an extension of the current web by description standards that help machines to understand and connect the information already available on the web. To achieve this, the latter is mapped using formal description and classification patterns, called ontologies. Ontologies are a key factor in managing meaningful search/data extraction, publishing relevant results on the web, search existing web resources, and offering answers to more sophisticated queries. Due to its vastness and complexity, Dante scholarship has calls for an ontology-based mapping, and specific tools have been designed to express the most difficult and articulate aspects of Dante’s literary production, such as its use of biblical, classical, and medieval sources. This paper aims to introduce the aims and scope of a new digital library of Dante commentaries, built according to the aforementioned standards and aiming to refine and extend the ontologies developed for Dante’s minor works to the more complex world of the Commedia.
Faturamento estagnado e baixa rentabilidade: e agora. E agora, como a Supera vai virar o jogo?
Authors: Canaparro Alexsander , Faccin Kadigia , Marconatto Diego
Published: June 2021

Este caso é uma narrativa com enredo fictício, baseado em fatos reais vivenciados pelo autor ao longo da sua trajetória profissional. Para tanto, apresenta-se a Supera, líder nacional no segmento de utilidades domésticas no Brasil. Uma empresa com 47 anos de existência, que viveu boa parte da sua história em um contexto de crescimento acelerado e domínio do mercado. Entretanto, nos últimos cinco anos, as coisas não andam muito bem – reflexo das escolhas estratégicas da empresa. A Supera mudou radicalmente a sua estratégia de go to market (GTM) e pagou um preço alto por isso. Agora, precisa encontrar novos caminhos estratégicos para reverter essa situação.
ИЗМЕНЕНИЕ ВНУТРЕННЕЙ УЧЕБНОЙ МОТИВАЦИИ ПЕРВОКЛАССНИКОВ ПРИ ПЕРЕХОДЕ НА ДИСТАНЦИОННОЕ ОБУЧЕНИЕ В ПЕРИОД САМОИЗОЛЯЦИИ
Authors: Pronina Anzhelika N.
Published: June 2021

Цель. Статья посвящена изучению внутренней мотивации первоклассников в период перехода на дистанционное обучение. Автор описывает основные научные подходы к актуальности проблемы учебной деятельности первоклассников и отмечает значимость учебной мотивации как одного из основных компонентов, раскрывает специфику и составляющие внутренней учебной мотивации. В исследовании представлены результаты опроса родителей, показывающие, что переход на дистанционное обучение в период самоизоляции вызывает изменение учебной мотивации школьников.
Целью экспериментальной работы являлось выявление различий и изменений внутренней учебной мотивации первоклассников до и после перехода на дистанционное обучение в период самоизоляции.
Метод или методология проведения работы. Эксперимент включал три этапа: на первом были определены характеристики и уровни внутренней учебной мотивации первоклассников в период традиционного обучения в школе (ноябрь – декабрь 2019 г.), на втором – измерялась внутренняя учебная мотивация в период дистанционного обучения (апрель – май 2020), на третьем этапе осуществлялось сравнение и определение различий внутренней учебной мотивации первоклассников при разных формах обучения. Методиками и методами диагностики внутренней учебной мотивации выступили: оценка школьной мотивации учащихся начальных классов (Н. Лусканова), «Изучение отношения к учебным предметам» (по Г.Н. Казанцева), «Направленность на приобретение знаний» (Е.П. Ильин, Н.А. Курдюкова), t-критерий Стьюдента.
Результаты. Результаты работы показали, что у испытуемых первоклассников выявлены различия внутренней мотивации по уровню и направленности, дистанционное обучение снижает уровень мотивации и направленность на получение знаний, у детей увеличивается направленность на получение оценки, мотивация и отсутствуют различия в мотивации изучения любимого учебного предмета. Автор делает предположение, что такие различия обусловлены возрастной несформированностью у первоклассников учебной мотивации, саморегуляции и целеудержания, отсутствием непосредственного контроля со стороны учителя, длительностью дистанционного обучения.
Область применения результатов. Результаты исследования могут быть применены в педагогической психологии, теории и технологии обучения.
The ratio of subjective resources and academic debt among students enrolled in individual educational trajectories in conditions of extreme social challenges
Authors: Vasil'eva Inna , Bulatova Ol'ga
Published: June 2021

Domestic higher education is going through a stage of active search for new forms of education focused on sustainability in an era of change. It is important to understand how factors of different levels of complexity (pandemic and innovative learning format) jointly affect the success of university education and resource parameters as markers of psychological well-being. Academic indebtedness is viewed as an external marker of the subjective resource of students. The aim of the work is to assess the ratio of academic debt and subject resource capacity among students studying according to individual educational trajectories (IET) and traditional educational technologies in universities of the Tyumen region. 280 students were polled anonymously via google-forms. Data collection methods: self-organization questionnaire E.Yu. Mandrikova; the scale of basic beliefs by R. Yanov-Bulman; questionnaire «Methods of coping behavior» by R. Lazarus; methodology for assessing «autonomy – dependence» G.S. Prygin; scale of psychological well-being K. Riff (adaptation of T.D.Shevelenkova, P.P. Fesenko); questionnaire «Losses and acquisitions of personal resources» N.Ye. Vodopyanova, M. Stein. Data analysis methods: Kruskell-Wallis H-test and Spearman's r-rank correlation test. The results of the study made it possible to formulate the following conclusions: 1) Students enrolled in IET have less pronounced subjective resources than students enrolled in traditional technology. Factors of different levels of complexity (pandemic and innovative teaching format) affect the success of university studies and resource parameters. IET advancement occurs in stages, is associated with the awareness of oneself as a subject of activity, requires the mobilization of resources for the development of the environment. A stressful factor was the transition to a distance learning format in the context of a pandemic, which led to a significant loss of resources among students enrolled in individual educational trajectories. 2) Protecting the parameters of subject resource capacity could be successful through the expansion of the functions of tutor support - specialists who are close in age to students and at the same time deeply integrated into the environment of a university that implements IET. The study was carried out with the financial support of the Russian Foundation for Basic Research within the framework of the scientific project No. 20-413-720004 "Resource subjectivity of students in universities that implement innovative educational technologies in the face of extreme social challenges in the Tyumen region."
Antioxidant, α-Glucosidases and α-Amylase Inhibitory Activities of Persicaria odorata
Authors: Thongra-ar Kanya , Rojsanga Piyanuch , Chewchinda Savita , Mangmool Supachoke , Sithisarn Pongtip
Published: June 2021

The objects of this study were to determine the effects to reactive oxygen species and antioxidant enzymes levels in HEK-293 cells and inhibition of α-glucosidases and α-amylase enzymes of extracts from Persicaria odorata or phak phaeo. The ethanol extracts from the leaves and the stems of phak phaeo were investigated for their 2,2-diphenyl-1-picryhydrazyl (DPPH) scavenging activities (IC50 were 7.74 ± 0.47 and 7.91 ± 0.43 µg/mL, respectively). Cellular antioxidant effects in human embryonic kidney-293 (HEK-293) cells with these extracts (0.1 mg/mL) also increased the mRNA expressions of manganese superoxide dismutase (Mn-SOD), glutathione peroxidase 1 (GPx-1), catalase and glutathione reductase (GRe). The leaf extract showed the higher efficacies in the induction of the mRNA expressions of Mn-SOD, GPx-1 and GRe while the stem extract exhibited a stronger effect to the induction of catalase. Phak phaeo in vitro inhibitory effects to α-glucosidase enzyme (IC50 values of 9.82 ± 1.64 and 13.99 ± 1.45 µg/mL, respectively and also strong inhibition to α-amylase with IC50 values of 90.66 ± 8.75 and 19.96 ± 5.37 µg/mL, respectively). Lineweaver-Burk plot demonstrated that phak phaeo extracts inhibited α-glucosidase and α- amylase in non-competitive manners. Total phenolic and total flavonoid contents were determined by Folin-Ciocalteu and aluminium chloride methods (the leaf and stem extracts were 22.89 ± 9.16 and 22.27 ± 8.77 g gallic acid equivalent in 100 g extract (g% GAE) and 7.20 ± 3.61 and 4.06 ± 1.73 g quercetin equivalent in 100 g extract (g% QE), respectively).

Keywords: Antioxidant enzymes, DPPH, HEK-293, MTT assay, Persicaria odorata, Reactive oxygen species, Total phenolic, Total flavonoid, α-glucosidases, α-amylase
Antiproliferative and Apoptosis-Inducing Activities of Benchalokawichian Remedy Against Doxorubicin-Sensitive and -Resistant Erythromyelogenous Leukemic Cells
Authors: Suttana Wipob , Singharachai Chatubhong , Charoensup Rawiwan , Rujanapun Narawadee , Suya Chutima
Published: June 2021

Chemotherapy can cause multidrug resistance in cancer cells and is cytotoxic to normal cells. Discovering natural bioactive compounds that are not cytotoxic to normal cells but inhibit proliferation and induce apoptosis in drug- sensitive and drug-resistant cancer cells could overcome these drawbacks of chemotherapy. This study investigated the antiproliferative effects of crude extracts of Benchalokawichian (BLW) remedy and its herbal components against drug-sensitive and drug-resistant cancer cells, cytotoxicity of the extracts toward normal cells, and their ability to induce apoptosis and cell cycle arrest in drug-sensitive and drug-resistant cancer cells. The extracts exhibited antiproliferative activity against doxorubicin-sensitive and doxorubicin-resistant erythromyelogenous leukemic cells (K562 and K562/adr). Tiliacora triandra root, BLW, and Harrisonia perforata root extracts displayed an IC50 of 77.00 ± 1.30, 79.33 ± 1.33, and 87.67 ± 0.67 µg/mL, respectively, against K562 cells. In contrast, Clerodendrum petasites, T. triandra, and H. perforata root extracts displayed the lowest IC50 against K562/adr cells (68.89 ± 0.75, 78.33 ± 0.69, and 86.78 ± 1.92 µg/mL, respectively). The resistance factor of the extracts was lower than that of doxorubicin, indicating that the extracts could overcome the multidrug resistance of cancer cells. Importantly, the extracts were negligibly cytotoxic to peripheral mononuclear cells, indicating minimal adverse effects in normal cells. In addition, these extracts induced apoptosis of K562 and K562/adr cells and caused cell cycle arrest at the G0/G1 phase in K562 cells.

Keywords: Antiproliferative, Apoptosis, Benchalokawichian, Cell cycle, Multidrug resistance
Tropical Wetland Earthworm Vermifluid Promotes Mitotic Activities and Root Growth in Allium cepa at low concentrations
Authors: Dada Ebenezer Olasunkanmi , Abdulganiy Tirmizhi , Owa Stephen Olugbemiga , Balogun Yusuf Olamilekan , Oludipe Emmanuel Olorunleke , Akinola Modupe Olatunde
Published: June 2021

It is well established that earthworms and their products promote plant growth and improve crop yield, but more information about their mechanisms of action, especially at cellular level, is required. This study assessed the enzyme and bacterial activities of vermifluid secreted by a tropical wetland earthworm, Alma millsoni. The effects of the vermifluid on the mitotic activities and root growth of Allium cepa (onions) were evaluated. Vermifluid enzyme and bacterial activities were assessed using standard procedures. Mitotic activities were evaluated using the Allium assay squash technique. Root lengths in onions grown in graduated dilutions of vermifluid were measured using a metre rule. Phosphatase had the highest activity (39.00 ± 3.70 units/ml/min) in the vermifluid, followed by urease (4.90 ± 0.18 units/ml/min), protease (3.20 ± 0.28 units/ml/min), amylase (1.40 ± 0.09 units/ml/min) and lipase (0.001 ± 0.00 units/ml/min). The total microbial count (TBC) and total fungi count (TFC) in the vermifluid were 6.0 × 104 CFU/ml and 2.4 × 105 CFU/ml, respectively. Results also indicated that the lower the vermifluid concentrations, the higher the number of dividing cells and mitotic index in onion roots. Onion roots grown in 10% vermifluid had the highest significant (P < 0.05) root growth of 2.65 ± 0.30 cm, 4.01 ± 0.61 cm, and 4.54 ± 0.62 cm, at 12-hour, 24-hour, and 72-hour exposure period, respectively. The inverse relationships between onion mitotic activities, root growth and vermifluid concentrations imply that the growth-promoting enzymes and other products in vermifluid stimulate cellular root growth better in small concentrations.

Keywords: Alma millsoni, earthworm fluid, enzymes, microbial activities, mitosis, phosphatase.
Reading Marguerite de Navarre: An Aged Professor's Meditation
Authors: Prescott Anne Lake
Published: June 2021

Abstract: Marguerite de Navarre's political importance as François I's sister and Henri IV's grandmother, together with her accomplishments as poet and writer of stories, drew attention in her own day and still does today. Much remains to discuss, not least her treatments of gender and the environment. Offering a close reading of the pigs in Story 34 of the Heptaméron, this essay considers how current ecological knowledge might give us a new perspective on this important early modern woman writer.
Hidden in Plain Sight: Editing and (Not) Canonizing Early Modern Women's Writing
Authors: Salzman Paul
Published: June 2021

Abstract: This essay explores some of the recent history of how early modern women's writing was edited. The process of recovering and analyzing that writing, in all its heterogeneity, has gone hand in hand with innovative approaches to editing. I explore a series of recent editorial developments that address three fundamental aspects of the positioning of early modern women's writing in relation to current debates about the nature of texts and textuality: the return of the authoritative complete edition, a revitalization of teaching editions, and new approaches to digital editing. What is at stake when we attempt to understand early modern women's writing, and how does editing contribute to that understanding? To illustrate this I look very briefly at the example of Katherine Austen's reflections on the Plague in her Book M .
The Presence of the Now
Authors: Demers Patricia
Published: June 2021

Abstract: By empathizing with and listening attentively to early modern women's voices, elite and plebeian, we can learn more about their inscriptive practice. The essay upholds collaborative initiatives among early modern scholars, the need for exemplary infrastructure and criteria in sustainable digital editions, and the value of cross-Channel comparisons.
Individual differences in ethics positions: The EPQ-5
Authors: O’Boyle Ernest H. , Forsyth Donelson R.
Published: June 2021

We revised the Ethics Position Questionnaire (EPQ), which measures variations in sensitivity to harm (idealism) and to moral standards (relativism). Study 1 identified the core components of the measured constructs theoretically and verified those features through confirmatory factor analysis (n = 2,778). Study 2 replicated these findings (n = 10,707), contrasted the theoretically defined two-factor model to alternative models, and tested for invariance of factor covariances and mean structures for men and women. Study 3 examined the relationship between the EPQ and related indicators of ethical thought (values and moral foundations) and the theory’s four-fold classification typology of exceptionists, subjectivists, absolutists, and situationists. The three studies substantially reduced the original EPQ’s length, clarified the conceptual interpretation of the idealism and relativism scales, affirmed the EPQ’s predictive and convergent validity, and supported the four-fold classification of individuals into ethics positions. Implications for previous findings and suggestions for future research are discussed.