bluuebunny/crossref_metadata_2025 huggingface dataset:
The preparation and characterization of a heterocyclic meta-aramid fiber with outstanding thermal stability
Authors: Cao Kaikai , Liu Yufeng , Yang You , Yuan Feng , Wang Jin , Liu Hanmao , Jiang Mengjin , Yang Jun
Published: December 2020

A heterocyclic meta-aramid fiber containing benzimidazole structure was prepared by the low-temperature polycondensation of m-phenylenediamine, 2-(4-aminophenyl)-5-benzimidazole, and isophthaloyl dichloride, followed by dry-jet wet spinning. The structure and properties of the heterocyclic modified meta-aramid (h-aramid for short) were explored and compared with poly(isophthaloylmetaphenylene diamine) (m-aramid for short). H-aramid exhibits excellent spinnability. The surface of the fiber is smooth and even, with a partially ordered structure. Mechanical properties, thermal resistance, and flame retardant of h-aramid are significantly enhanced as the introduction of benzimidazole can not only increase the rigidity of molecular chains but also strengthen hydrogen bonds and act as physical crosslinking points. The strength and modulus of h-aramid are up to 0.84 GPa and 16.66 GPa, respectively, with an elongation at break of 20%. The glass transition temperature and melting temperature of h-aramid reach 302°C and 356°C, respectively, about 30°C and 40°C higher than that of m-aramid. Temperature of 10 wt% weight loss under nitrogen and air atmosphere is 17°C and 39°C higher than those of m-aramid. Besides, the thermal degradation behavior of h-aramid was studied, and its degradation process and mechanism was proposed.
Influence of 25 MeV Si ions and 25 MeV O ions on the chemical and structural properties of PEEK films
Authors: Li Hongxia , Yang Jianqun , Dong Shangli , Li Xingji
Published: December 2020

Poly (ether ether ketone) (PEEK) material can be used in a wide variety of fields, such as the aerospace, automotive, electronics, and nuclear industries. In this research, the irradiation effect of 25 MeV Si ions and 25 MeV O ions on the PEEK films was studied, focusing on the changes in chemical and structural properties. By analyzing surface morphology and microstructure evolution of the PEEK films after 25 MeV Si ion and 25 MeV O ion irradiation, particles were generated on surface of the PEEK after 25 MeV Si ion irradiation and black dots were generated on surface of the PEEK after 25 MeV O ion irradiation. The irradiation reduced the surface roughness of the PEEK films from the atomic force microscopy (AFM) results. The Fourier transform infrared (FTIR) results indicated that the groups and structure of the material were not changed by irradiation. The X-ray photoelectron spectroscopy (XPS) results showed that the contents of the chemical bonds C–C, C=O increased first and then decreased with the increasing of the fluences. The generated free radicals were observed by the electron paramagnetic resonance spectroscopy (EPR) at room temperature and the irradiation degradation mechanisms were analyzed. Thermal properties of the PEEK irradiated by 25 MeV O ions, indicating that a new secondary crystallization peak was found during the cooling stage. Consequently, the low fluences irradiation improves in the viscoelasticity and mechanical properties of PEEK films, while the high fluences irradiation reduces its performance.
Profile of incidental exposures to e-cigarette liquids in Europe, 2018–2019
Authors: Vardavas Constantine I , Girvalaki Charis , Odani Satomi , Nikitara Katerina , de Vries Irma , van Riel Antoinette , van Sommeren-de Potter Iris , Grass Johanna Nordmark , Grassi Maria Caterina , Deim Szilvia , Balázs Andrea , Fosztó Szabolcs , Schiel Helmut , Arif Tara , Eronen Anna-Kaisa , Alonso Antonio Alonso , Menor José Luis Conejo , Arrieta Rosa Martinez , Babić Željka , Turk Rajka , Vardavas Alexander I , Tsatsakis Aristidis
Published: December 2020

Background:

Following the implementation of the European Union Tobacco Product Directive (EU TPD) regulations on e-cigarette products in 2016, we assessed the current profile of e-cigarette liquid exposure incidents and their associated health outcomes.

Methods:

De-identified data were received from poison centers in eight EU Member States (Sweden, the Netherlands, Italy, Hungary Austria, Finland, Spain and Croatia) reporting on e-cigarette liquid exposure incidents between August 2018 to December 2019. Descriptive analysis was conducted to present incident characteristics and health outcomes. Chi-square tests and multivariable logistic regression analysis were used to test associations.

Results:

Of the 223 e-liquid exposure incidents recorded by poison centers in multiple EU MS, 64.7% of the cases were unintentional exposures, ranging from 48.4% among adults aged ≥19 years to 100.0% among children aged 0–5 years (p < 0.05). The most frequent route of exposure was ingestion (73.5%) while55.2% experienced any clinical symptoms, including nausea (16.6%), vomiting (11.1%), and dizziness (9.0%). 57.8% of the cases were treated at the residence or on-site.

Conclusion:

Further monitoring is warranted, using uniform reporting requirements, to ensure the continued compliance to the EU TPD and assess its long-term impact on related incident characteristics.
Lasting Effects of a Community-Based Self-Management Intervention for Patients With Type 2 Diabetes in China: Outcomes at 2-Year Follow-up of a Randomized Trial
Authors: Jiang Yingying , Mao Fan , Dong Wenlan , Zhang Xingxing , Dong Jianqun
Published: December 2020

This research is to evaluate the lasting effects of a community-based self-management intervention for patients with type 2 diabetes at 2-year follow-up in China. Five hundred patients with diabetes were recruited and randomly divided into intervention group and control group. Eight times standardized self-management intervention group activities were conducted. The results of physical examination, biochemical laboratory examination, health behavior, and self-efficacy information were collected before intervention, 3 months after intervention, and 2 years after intervention. The total score for self-efficacy in the intervention group increased from 96.12 ± 17.48 to 112.90 ± 14.58 after intervention and decreased after 2 years (106.98 ± 18.03; F = 6.64, P = .0014). The number of days of self-blood glucose monitoring in the intervention group was increased from 1 day per week to 2 days per week after intervention, and 2 days per week at 2-year follow-up ( F = 8.02, P = .0003). The frequency of average number of aerobic exercises in the intervention group increased from 6 days per week to 7 days per week after intervention and was 7 days per week at 2-year follow-up ( F = 3.63, P = .0269). Community-based self-management group intervention for patients with diabetes has long-term effects.
Private law and public regulation for investor protection in the asset management industry: Aims and practices of transposing the UK model in China
Authors: Lee Joseph , Bao Yonghui
Published: December 2020

The paper discusses how asset managers are regulated in the UK in order to provide investor protection and market confidence. Fiduciary duties and the duty of care in the English common law, statutory laws, the rules of the FCA, and other industry codes are examined to provide an explanation of the UK regulatory approach to the asset management industry. The paper then discusses the extent to which a legal transplant of the UK model to China may be feasible as the asset management industry is currently being reformed in China. Recommendations are made for China to develop an independent asset management industry, to provide more investment outlets for investors, and to have effective enforcement mechanisms of laws and rules to deliver market confidence and investor protection.
Baselines and monitoring: More than a means to measure the end
Authors: Kelly Leanne M , Reid Carol
Published: December 2020

Monitoring is largely ignored in its capacity to provide a distinct contribution to evaluation. It is often thought of as a process of collecting data to feed into an evaluation, rather than for its own powerful transformative potential. Evaluation is considered a mechanism for producing findings that enable learning, improvement and decision-making; but what if monitoring could produce these same outcomes with, in some cases, greater alignment to quality characteristics of utility, timeliness, feasibility, propriety, accuracy, completeness and monitoring accountability? This article examines the utilisation and value of monitoring through a case study of a government funded 12-month rural health project in Victoria, Australia. The project initially commissioned a baseline to assess against post-project outcomes. However, adopting a utilisation-focused perspective to prepare for use and support stakeholder engagement enabled implementation of a multipurpose monitoring framework. The case study provides examples of monitoring in action with timely learning, decision-making and improvements resulting in incremental system and behaviour changes, rather than relying on periodic outcome recommendations at evaluation completion. This article adds to evaluation theory and practice through highlighting monitoring as a significant mechanism for enabling learning, decision-making, and improvement.
Footfall Deflection of Antifatigue Flooring During Simulated Human Stance
Authors: Zehr Jackie D. , Winberg Taylor B. , Laing Andrew C. , Callaghan Jack P.
Published: December 2020

This study quantified the effect of compression load and duration on the deflection of five separate antifatigue flooring surfaces. Following standardized measurement of A Shore hardness, each sample underwent simulated single-leg stance indentation procedures that differed by compression load (45.3 kg, 90.7 kg, 136.1 kg) and duration (initial = 2.5 s, intermediate = 6.25 s, final = 12.5 s). Vertical deflection was compared across conditions, and the relationship between A Shore hardness and deflection was characterized. When compressed with 45.3 kg, deflection was not influenced by duration, but at 136 kg, deflection differed between durations by up to 15%. The relationship between A Shore hardness and deflection was characterized by a third-order polynomial function ( R2 > 0.991).
Measurement of Family Management in Families of Individuals With Down Syndrome: A Cross-Cultural Investigation
Authors: Van Riper Marcia , Knafl George J. , Barbieri-Figueiredo Maria do Céu , Caples Maria , Choi Hyunkyung , de Graaf Gert , Duarte Elysângela Dittz , Honda Junko , Marta Elena , Phetrasuwan Supapak , Alfieri Sara , Angelo Margareth , Deoisres Wannee , Fleming Louise , dos Santos Aline Soares , Rocha da Silva Maria João , Skelton Beth , van der Veek Shelley , Knafl Kathleen A.
Published: December 2020

Down syndrome (DS) is the most common genetic cause of intellectual disability worldwide. The purpose of this analysis was to determine the internal consistency reliability of eight language versions of the Family Management Measure (FaMM) and compare family management of DS across cultures. A total of 2,740 parents of individuals with DS from 11 countries completed the FaMM. The analysis provided evidence of internal consistency reliability exceeding .70 for four of six FaMM scales for the entire sample. Across countries, there was a pattern of positive family management. Cross-cultural comparisons revealed parents from Brazil, Spain, and the United States had the most positive family management and respondents from Ireland, Italy, Japan, and Korea had the least positive. The rankings were mixed for the four remaining countries. These findings provide evidence of overall strong internal consistency reliability of the FaMM. More cross-cultural research is needed to understand how social determinants of health influence family management in families of individuals with DS.
Risk Markers for Women’s Physical Intimate Partner Violence Victimization in Iran: A Meta-Analysis
Authors: Nikparvar Fatemeh , Spencer Chelsea M. , Stith Sandra M.
Published: December 2020

In this study, evidence from 14 studies examines 16 unique risk markers for intimate partner violence (IPV) victimization for Iranian women. Large-to-medium effect sizes were found for emotional abuse victimization, depression, poor mental health, poor physical health, partner’s drug use, living in a patriarchal household, and partner having experienced child abuse as risk markers. Higher levels of education and higher levels of household income were significant protective markers against IPV victimization for Iranian women. Partner’s education, partner’s employment, being employed, being pregnant, age, partner’s age, and length of the relationship were not significant risk markers for IPV victimization among Iranian women.
Palliation or protection: How should the right to equality inform the government’s response to Covid-19?
Authors: Campbell Meghan , Fredman Sandra , Reeves Aaron
Published: December 2020

This article examines what role equality law can play in addressing the inequalities created and exacerbated by the British government’s response to the Covid-19 pandemic. We argue that while there is great potential in existing legislation, there is a need for both policy-makers and courts to apply a more searching and nuanced understanding of the right to equality if this potential is to be realised. We begin by examining how the burdens of confronting this pandemic as a society fall more heavily on those already at the bottom end of the scale of inequality. We then ask whether and to what extent the current legal structures protecting the right to equality can be mobilised to redress such inequalities, paying particular attention to the Public Sector Equality Duty under the Equality Act 2010 and on the Human Rights Act 1998. Finally, we argue that, to fulfil the requirements of both these legal duties, the courts should subject policies and practices to close scrutiny under the four-dimensional approach. When making and operationalising policies around Covid-19, substantive equality requires account to be taken simultaneously of the four dimensions of inequality to the greatest extent possible.
Thinking through silicon: Cables and servers as epistemic infrastructures
Authors: Munn Luke
Published: December 2020

Data centers and undersea cables allow information to be transmitted, stored, and processed. Yet, more than passively housing knowledge, information infrastructures actively shape knowledge. Infrastructures facilitate a certain use case, privileging some forms of knowledge while ignoring others. And infrastructures are material investments by states or corporations at a particular site, solidifying their knowledge-production, while marginalizing alternatives. These conditions are exemplified by two sites in Tseung Kwan O, Hong Kong. The TKO Express is a private undersea cable that offers its clients high-speed connectivity between financial centers, supporting the “fast knowledge” of finance and trading, while ignoring slower or more social forms of intelligence. The TKOIE industrial estate allocated land to a data center rather than a community center, prioritizing the production of corporate, proprietary knowledge over local and communal knowledge. The article reworks the concept of epistemic infrastructures to stress how such facilities influence what can be known and what remains unknown.
The quality of COPD care in German general practice—A cross-sectional study
Authors: Heinmüller Stefan , Schaubroeck Emmily , Frank Luca , Höfle Anina , Langer Michael , Saggau Korbinian , Schedlbauer Angela , Kühlein Thomas
Published: December 2020

Objectives:

Chronic Obstructive Pulmonary Disease (COPD) is a common health problem to be dealt with in primary care. Little is known about the quality of care provided for patients with COPD in Germany. Therefore, we wanted to assess the current quality of care delivered by a primary care network (PCN) for patients with COPD.

Methods:

A cross-sectional study was conducted in collaboration with a primary care network (PCN). All patients of the PCN aged 40 years and older with a diagnosis of COPD were identified through electronic health records (EHR). A set of quality indicators (QIs) developed in accordance with current COPD-guidelines were appraised through numerical data retrieved from the EHR.

Results:

In total, 2,568 patients with COPD were identified. Their mean age was 67 (SD±12) years, 49% were male. Thirty-five percent had a parallel diagnosis of asthma. There was no documentation of any spirometry for 54% of patients; 29% had a spirometry within the previous year. An influenza vaccination was documented for 37% within the preceding 12 months; 12% received a pneumococcal vaccination in the last 6 years. Smoking status was documented for 44% within the last year.

Conclusion:

The quality of care for patients with COPD in the PCN seemed suboptimal, despite the presence of a Disease Management Program (DMP). This finding is likely to apply widely to German general practice. Quality assessment through currently available EHR data was challenging due to non-standardized and insufficient documentation.
Computed tomography findings as determinants of pulmonary function tests in fibrotic interstitial lung diseases—Network-analyses and multivariate models
Authors: Lang David , Akbari Kaveh , Walcherberger Stefan , Hergan Benedikt , Horner Andreas , Hepp Magdalena , Kaiser Bernhard , Pieringer Herwig , Lamprecht Bernd
Published: December 2020

The aim was to evaluate the impact of multiple high-resolution computed tomography (HRCT) features on pulmonary function test (PFT) biomarkers in fibrotic interstitial lung disease (FILD) patients. HRCT of subsequently ILD-board-discussed FILD patients were semi-quantitatively evaluated in a standardized approach: 18 distinct lung regions were scored for noduli, reticulation, honeycombing, consolidations, ground glass opacities (GGO), traction bronchiectasis (BRK) and emphysema. Total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, diffusion capacity for carbon monoxide (DLCO) and transfer coefficient (KCO) were assessed. Interactions between each PFT biomarker and all HRCT scores were visualized by network analyses, modeled according to the Schwarz Bayesian Information Criterion and incorporated in uni- and multivariate stepwise regression analyses. Among 108 FILD patients (mean age 67 years, 77% male), BRK extent was a major significant uni- or multivariate determinant of all PFT analyzed. Besides that, diffusion-based variables DLCO and KCO showed a larger dependency on reticulation, emphysema and GGO, while forced expiratory volume-based measures FEV1, FVC and FEV1/FVC were more closely associated with consolidations. For TLC, the only significant multivariate determinant was reticulation. In conclusion, PFT biomarkers derived from spirometry, body plethysmography and diffusion capacity in FILD patients are differentially influenced by semi-quantified HRCT findings.
The Utility of a Pre-Transplant Psychosocial Evaluation in Predicting Post-Liver Transplant Outcomes
Authors: Becker Jacqueline H. , Shemesh Eyal , Shenoy Akhil , Posillico Ailie , Knight Christopher S. , Kim Se-Kang , Florman Sander S. , Schiano Thomas , Annunziato Rachel A.
Published: December 2020

Background:

There is insufficient evidence about the ability of pretransplant psychosocial evaluations to predict posttransplant outcomes. While standardized assessments were developed to increase predictive validity, it is unclear whether the risk scores they yield predict outcomes. We investigated if the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), a scaling approach to those assessments, would have been a superior predictor than the standard psychosocial evaluation.

Methods:

In this retrospective study, medical records of 182 adult liver transplant recipients who were at least 1 year posttransplant and prescribed tacrolimus for immunosuppression were analyzed. Regression analyses predicted outcomes of interest, including immunosuppressant nonadherence and biopsy-proven rejection, obtained 1-year posttransplant to time of data collection. Nonadherence was determined using the medication level variability index (MLVI).

Results:

Approximately 49% of patients had MLVI > 2.5, suggestive of nonadherence, and 15% experienced rejection. SIPAT total score did not predict adherence either using the continuous (P = .70), or dichotimized score, above or below > 2.5 (P = .14), or rejection (P = 0.87). Using a SIPAT threshold (total score > 69) did not predict adherence (p = .16) nor was a superior predictor of the continuous adherence score (P = .45), MLVI > 2.5 (P = .42), or rejection (P = 0.49), than the standard evaluation.

Conclusion:

Our findings suggest that the SIPAT is unable to predict 2 of the most important outcomes in this population, immunosuppressant adherence and rejection. Research efforts should attempt to evaluate the best manner to use psychosocial evaluations.
Pattern, predictors and clustering of handwashing practices in India
Authors: Pradhan Manas Ranjan , Mondal Sourav
Published: December 2020

Background:

Research on handwashing continues to draw researchers’ interest owing to its public health importance and significance in the reduction of infectious diseases. The aims of this study are to: (1) understand the pattern and predictors of handwashing using soap/detergent and water; and (2) assess the spatial clustering of handwashing through soap/detergent and water at the district level in India.

Methods:

Data of households where the place for handwashing was observed by the research investigators (n = 582,064), gathered through the National Family Health Survey-4 (2015–2016), were used for this analysis. The availability of soap/detergent and water at the usual place of handwashing was assumed to be used for handwashing. Binary logistic regression was carried out to examine the adjusted effect of socioeconomic characteristics on the use of soap/detergent and water for handwashing. The univariate local indicator of spatial association (LISA) cluster map and Moran’s I statistics were applied for assessing spatial autocorrelations at the district level. Analyses were carried out with IBM-SPSS Software.

Results:

Two-fifths of Indian households do not use both soap/detergent and water for handwashing. Households using both the cleansing elements vary considerably by socioeconomic characteristics— worse for the socioeconomically disadvantaged groups. There is spatial clustering in the use of soap/detergent and water for handwashing: lower in a cluster of districts in eastern India.

Conclusion:

Results suggest the need to generate awareness, particularly among the socioeconomically weaker populations, about advantages of hand hygiene, which will reduce the prevalence of infectious diseases like COVID-19 and be helpful to achieve many Sustainable Development Goals.
Synergistic Anticancer Effect of Gemcitabine Combined With Impressic Acid or Acankoreanogein in Panc-1 Cells by Inhibiting NF-κB and Stat 3 Activation
Authors: Jiang Sen , Li Dong-Li , Chen Jie , Zheng Xi , Wu Pan-Pan , Li Chen , Xu Xue-Tao , Zhang Kun
Published: December 2020

Natural products have presented potentiality to improve the outcomes of cancer therapies. Impressic acid (E12-1) and acankoreanogein (E13-1), important activity compounds in Acanthopanax trifoliatus (L.) Merr., show widely biological activities. In this study, we isolated E12-1 and E13-1 from Acanthopanax trifoliatus (L.) Merr., and investigated their improvement effect in gemcitabine (GEM) treatment in Panc-1 cells. The results showed that GEM in combination with E12-1 or E13-1 showed stronger inhibition on the growth and induction of apoptosis in Panc-1 cells compared to GEM, E12-1, or E13-1 alone. GEM in combination with E12-1or E13-1 also strongly inhibited cell migration. Mechanistic investigation showed that GEM in combination with E12-1or E13-1 effectively inhibited the activition of nuclear factor kappa-light-chain-enhancer of activated B cells and Stat 3. Overall, GEM in combination with E12-1 or E13-1 might be an effective strategy for the prevention of prostate cancer.
Systems Pharmacology Study of the Anticervical Cancer Mechanisms of FDY003
Authors: Lee Ho-Sung , Lee In-Hee , Kang Kyungrae , Park Sang-In , Kwon Tae-Wook , Moon Seung-Joon , Lee Chol Hee , Lee Dae-Yeon
Published: December 2020

Increasing data support that herbal medicines are beneficial in the treatment of cervical cancer; however, their mechanisms of action remain to be elucidated. In the current study, we used a systems pharmacology approach to explore the pharmacological mechanisms of FDY003, an anticancer herbal formula comprising Lonicera japonica Thunberg, Artemisia capillaris Thunberg, and Cordyceps militaris (Linn.) Link, in the treatment of cervical cancer. Through the pharmacokinetic assessment of absorption-distribution-metabolism-excretion characteristics, we found 18 active compounds that might interact with 106 cervical cancer-related targets responsible for the pharmacological effects. FDY003 targets were significantly associated with gene ontology terms related to the regulation of cellular behaviors, including cell proliferation, cell cycle processes, cell migration, cell apoptosis, cell death, and angiogenesis. The therapeutic targets of the herbal drug were further enriched in various oncogenic pathways that are implicated in the tumorigenesis and progression of cervical cancer, including the phosphatidylinositol 3-kinase, mitogen-activated protein kinase, focal adhesion, human papillomavirus infection, and tumor necrosis factor signaling pathways. Our study provides a systematic approach to explore the anticancer properties of herbal medicines against cervical cancer.
Social Hedonic Editing: People Prefer to Experience Events at the Same Time as Others
Authors: Shaddy Franklin , Tu Yanping , Fishbach Ayelet
Published: December 2020

Previous research testing the hedonic editing hypothesis examined preferences for the timing of events that happen to the self—asking, for example, whether people prefer to experience two positive or two negative events on the same or different day(s). Here, we examine preferences for the timing of events that happen to the self and to others— social hedonic editing. Across five studies ( N = 2,522), we find people prefer to experience a positive or negative event on the same day that (vs. a different day than) another person experiences a similar positive or negative event. Studies 1 and 2 document this “preference for integration” in interpersonal (i.e., for the self and others) but not intrapersonal (i.e., for the self) contexts, Studies 3 and 4 suggest people prefer integration because it increases interpersonal connection, and Study 5 highlights a boundary condition. People do not prefer integration for very emotionally impactful events.
A domestic robotic rehabilitation device for assessment of wrist function for outpatients
Authors: Panny Matthias , Mayr Andreas , Nagiller Marco , Kim Yeongmi
Published: December 2020

Introduction

Available robot-assisted stroke rehabilitation systems are often limited in their utilization in the home environment, due to several barriers such as high cost, absence of therapists, tedious training tasks, or encumbering interfaces. This paper presents a low-cost robotic rehabilitation and assessment device for restoring wrist function, offering wrist exercises incorporating pronation-supination and flexion-extension movements. Furthermore, the device is designed for the assessment of joint stiffness of the wrist, and range of motion in two degrees of freedom. Methods: Mechanical/electrical design of the device as well as the control system is described. A preliminary evaluation focused on the measurement of the torsional stiffness of the limb is presented. It is evaluated by reconstructing the known stiffness values of torsional springs by measuring the motor current required to displace them.

Results

The device demonstrates the ability to determine the stiffness of an object with low-cost hardware. Use case scenarios of the device for training and assessment of the wrist are presented, allowing for a range of motion of [Formula: see text] and [Formula: see text], for pronation-supination and flexion-extension respectively.

Conclusion

The device shows potential to help objectively quantify the stiffness of the wrist movement, which consecutively could be used to represent and quantify the degree of impairment of patients after stroke in a more objective manner. Further clinical study is necessary to examine this.
What Are the Risk Factors for Adjacent Vertebral Fracture After Vertebral Augmentation? A Meta-Analysis of Published Studies
Authors: Zhang Tianyu , Wang Yanhua , Zhang Peixun , Xue Feng , Zhang Dianying , Jiang Baoguo
Published: December 2020

Study Design:

Meta-analysis.

Objectives:

To provide up-to-date evidence-based outcomes for the incidence and risk factors of adjacent vertebral fracture (AVF) after the vertebral augmentation.

Methods:

The MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies assessing the risk factors of adjacent vertebral fracture after vertebral augmentation until June 2020. The AVF incidence and factors potentially affecting AVF were extracted and pooled.

Results:

A total of 16 studies, encompassing 2549 patients were included in the meta-analysis. The pooled incidence of AVF was 14% after vertebral augmentation. Female, lower T-score, thoracolumbar junction fracture, intravertebral cleft, more injected cement volume, intradiscal cement leakage significantly increased the risk of AVF. Age, body mass index, steroid medication, Cobb angle change, postoperative Cobb angle showed no significant association with AVF.

Conclusions:

Identifying the risk factors of AVF can facilitate prevention strategy to avoid the AVF. Female, T-score, thoracolumbar junction fracture, intravertebral cleft, more cement volume, and intradiscal cement leakage increased the risk of AVF.
Hamstring autograft and anatomical footprint evaluation for anterior talofibular ligament reconstruction: Cadaveric study
Authors: Karahan Nazım , Kaya Murat , Yılmaz Barış , Kurdal Demet Pepele , Keskinoz Elif Nedret , Çiçek Esma Esin Derin
Published: December 2020

Purpose:

The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction.

Methods:

16 fresh frozen cadaver specimens were dissected to gracilis and semitendinosus tendons and the anterior talofibular ligament. The origins, insertions, distances from osseous landmarks of fibular talus of ATFL were determined. The diameters of gracilis, semitendinosus and ATFL were calculated. There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). There was a weak correlation between body height and the distance between the apex of the lateral talar process and the talus adhesion site of ATFL in a single bundle (r: 28.4 p: 0.002). There was no correlation between the distance from proximal and distal adhesion side of ATFL and body height in the double bundle (p: 0.241).

Results:

There was no significant relationship between ATFL diameter and gracilis, semitendinosus and both hamstring in women. A significant relationship at 80.5% was determined between the ATFL and the gracilis diameter in man. A significant relationship at 92.6% was determined between the ATFL and the semitendinosus diameter in man.

Conclusion:

It was determined that there is not compatibility between the gracilis tendons, the semitendinosus tendon and ATFL in women. It should be supported by biomechanical and clinical studies whether this incompatibility has a clinical effect or not.
Regulation of the Fasciola hepatica newly excysted juvenile cathepsin L3 (FhCL3) by its propeptide: a proposed ‘clamp-like’ mechanism of binding and inhibition
Authors: Pritsch Izanara C. , Tikhonova Irina G. , Jewhurst Heather L. , Drysdale Orla , Cwiklinski Krystyna , Molento Marcelo B. , Dalton John P. , Verissimo Carolina De M.
Published: December 2020

Background

The zoonotic worm parasiteFasciola hepaticasecretes an abundance of cathepsin L peptidases that are associated with virulence, invasiveness, feeding and migration. The peptidases are produced as inactive zymogens that activate at low pH by autocatalytic removal of their N-terminal pro-domain or propeptide. Propeptides bind to their cognate enzyme with high specificity. Little is known, however, about the mechanism by which the propeptide of FhCL3, a cathepsin L peptidase secreted by the infective newly excysted juveniles (NEJs), regulates the inhibition and activation of the mature enzyme before it is secreted into host tissues.

Results

Immunolocalisation/immunoblotting studies show that the FhCL3 zymogen is produced and secreted by gastrodermal cells of the NEJs gut. A recombinant propeptide of FhCL3 (ppFhCL3) was shown to be a highly potent and selective inhibitor of native and recombinantF. hepaticaFhCL3 peptidase, and other members of the cathepsin L family; inhibition constant (Ki) values obtained for FhCL1, FhCL2 and FhCL3 were 0.04 nM, 0.004 nM and < 0.002 nM, respectively. These values are at least 1000-fold lower than thoseKiobtained for human cathepsin L (HsCL) and human cathepsin K (HsCK) demonstrating the selectivity of the ppFhCL3 for parasite cathepsins L. By exploiting 3-D structural data we identified key molecular interactions in the specific binding between the ppFhCL3 and FhCL3 mature domain. Using recombinant variants of ppFhCL3 we demonstrated the critical importance of a pair of propeptide residues (Tyr46Lys47) for the interaction with the propeptide binding loop (PBL) of the mature enzyme and other residues (Leu66and Glu68) that allow the propeptide to block the active site.

Conclusions

The FhCL3 peptidase involved in host invasion byF. hepaticais produced as a zymogen in the NEJs gut. Regulation of its activation involves specific binding sites within the propeptide that are interdependent and act as a “clamp-like” mechanism of inhibition. These interactions are disrupted by the low pH of the NEJs gut to initiate autocatalytic activation. Our enzyme kinetics data demonstrates high potency and selectivity of the ppFhCL3 for its cognate FhCL3 enzyme, information that could be utilised to design inhibitors of parasite cathepsin L peptidases.
ABCDE cognitive aid tool in patient assessment – development and validation in a multicenter pilot simulation study
Authors: Peran David , Kodet Jiri , Pekara Jaroslav , Mala Lucie , Truhlar Anatolij , Cmorej Patrik Christian , Lauridsen Kasper Glerup , Sari Ferenc , Sykora Roman
Published: December 2020

Background

The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment.

Methods

The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council.

A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios.

The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured.

Results

The Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR = 1.17, 95% CI: 1.02 to 1.35, p = 0.023) which were significantly more frequently performed in proper order (220: 338; OR = 1.68, 95% CI: 1.40 to 2.02, p < 0.0001). The use of ABCDE CAT did not prolong the time of patient assessment.

Conclusion

The cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.
Efficacy of 104-week Telbivudine-based optimization strategy in patients with HBeAg-negative chronic hepatitis B virus infections
Authors: Gan Weiqiang , Li Jianguo , Zhang Chunlan , Chen Xuefu , Lin Chaoshuang , Gao Zhiliang
Published: December 2020

Background

Evaluate the safety and efficacy of 104-week regimen of Telbivudine(LdT)-based optimization strategy for Chinese patients who have chronic hepatits B(CHB) with HBeAg-negative.

Methods

This multi-center, open-label, prospective study enrolled 108 HBeAg-negative CHB patients who received LdT (600 mg/day) for 24 weeks, Adefovir (ADV) was added if HBV DNA remained detectable at week 24, otherwise LdT was maintained to use until 104 weeks. HBV DNA, alanine amino transferase (ALT), hepatitis B surface antigen(HBsAg), creatinine kinase(CK), and estimated glomerular filtration rate (eGFR) were measured, safety was assessed.

Results

Eighty-eight patients (81%) had HBV-DNA undetectable at 24 weeks and maintained to receive LdT monotherapy until 104 weeks, whereas the other 20 patients had HBV-DNA detectable and ADV was used in combination. For all patients, 72% of patients reached ALT normalization at 24 weeks, which increased to 80% at 52 weeks and 104 weeks, respectively.. 81% of total patients had undetectable HBV-DNA at 24 weeks, 92% at 52 weeks, and 94% at 104 weeks. The HBsAg titre declined steadily from baseline to 104 weeks (3.62 vs. 2.98 log10 IU/mL, p < 0.05), and the eGFR increased steadily from baseline to 104 weeks (92.9 vs. 104.4 mL/min/1.73 m2, p < 0.05). Although 79 patients (73%) had at least one time of elevated CK, most of these patients had CK elevated in Grade 1/2.

Conclusions

LdT was well tolerated and effective, and 94% of patients achieved virological suppression after 104 weeks.

Trial registration

This study was registered in clinicaltrials.gov on January 31, 2012 and the ID No. was NCT01521975.
Socioeconomic inequality in intermittent preventive treatment using Sulphadoxine pyrimethamine among pregnant women in Nigeria
Authors: Muhammad Fatima Mahmud , Majdzadeh Reza , Nedjat Saharnaz , Sajadi Haniye Sadat , Parsaeian Mahboubeh
Published: December 2020

Background

Intermittent preventive treatment using Sulphadoxine pyrimethamine (IPTp-SP) for malaria prevention is recommended for all pregnant women in malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria and to decompose it into its contributing factors.

Methods

A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 21,621 pregnant women aged between 15 and 49 years and had live birth in the previous 2 years before the survey were included in this analysis. The study participants were recruited based on a stratified two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index.

Result

Totally 63.6% of pregnant women took at least one dose of IPTp-SP prophylaxis. Among IPTp-SP users, 35.1% took one dose, 38.6% took two doses and 26.2% took three doses and more. Based on both concentration index of 0.180 (p-value = < 0.001, 95% CI: 0.176 to 0.183) and Erreyger’s normalization concentration index 0.280 (p-value = < 0.001, 95% CI: 0.251 to 0.309), the IPTp-SP utilization was pro-rich. The largest contributors to the inequality in IPTp-SP uptake were wealth index (47.81%) and educational status (28.66%).

Conclusion

Our findings showed that IPTp-SP use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through free IPTp service expansion by targeting pregnant women from low socioeconomic status.
Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease
Authors: Tashiro Hiroki , Kurihara Yuki , Takahashi Koichiro , Sadamatsu Hironori , Haraguchi Tetsuro , Tajiri Ryo , Takamori Ayako , Kimura Shinya , Sueoka-Aragane Naoko
Published: December 2020

Background

Exacerbations are critical events in chronic pulmonary obstructive disease (COPD). The frequency of COPD exacerbations is associated with the prognosis, including mortality, but no useful biomarker has been established.

Methods

The present retrospective study investigated 481 COPD patients. Clinical features in the stable period were compared between patients who experienced severe exacerbation (n = 88, 18.3%) and those who never experienced severe exacerbation (n = 393, 81.7%). In the patients who experienced exacerbations, clinical features were also compared between frequent exacerbators (exacerbation rate ≥ 2 times/year, n = 27, 30.7%) and infrequent exacerbators (1 time/year, n = 61, 69.3%).

Results

Compared to COPD patients who never experienced exacerbations, body mass index (BMI), serum albumin, and pulmonary functions were significantly lower, and the cardiovascular disease comorbidity rate, COPD assessment test score, modified Medical Research Council dyspnea scale, and use of long-term oxygen therapy, long-acting β2 adrenergic agonist therapy, inhaled corticosteroid therapy, and macrolide therapy were significantly higher in COPD patients with exacerbations (all p < 0.01). In patients who experienced exacerbations, frequent exacerbators had significantly lower % forced expiratory volume in 1.0 s and a higher risk of critical exacerbations, percentage of blood eosinophils, history of mechanical ventilation use, and use of long-term oxygen therapy and of macrolide therapy than infrequent exacerbators (all p < 0.01). On multivariate analysis, the percentage of blood eosinophils was the parameter most correlated with exacerbation frequency (β value [95% confidence interval] 1.45 [1.12–1.88], p < 0.01).

Conclusion

Blood eosinophil in the stable period is the factor most correlated with the frequency of severe exacerbations.

Trial registration: The patients in this study was registered retrospectively
Using ultrasound features and radiomics analysis to predict lymph node metastasis in patients with thyroid cancer
Authors: Li Fu , Pan Denghua , He Yun , Wu Yuquan , Peng Jinbo , Li Jiehua , Wang Ye , Yang Hong , Chen Junqiang
Published: December 2020

Background

Lymph node metastasis (LNM) is an important factor for thyroid cancer patients’ treatment and prognosis. The aim of this study was to explore the clinical value of ultrasound features and radiomics analysis in predicting LNM in thyroid cancer patients before surgery.

Methods

The characteristics of ultrasound images of 150 thyroid nodules were retrospectively analysed. All nodules were confirmed as thyroid cancer. Among the assessed patients, only one hundred and twenty-six patients underwent lymph node dissection. All patients underwent an ultrasound examination before surgery. In the radiomic analysis, the area of interest was identified from selected ultrasound images by using ITK-SNAP software. The radiomic features were extracted by using Ultrosomics software. Then, the data were classified into a training set and a validation set. Hypothetical tests and bagging were used to build the model. The diagnostic performance of different ultrasound features was assessed, a radiomic analysis was conducted, and a receiver operating characteristic (ROC) curve analysis was performed to explore the diagnostic accuracy.

Results

Regarding the prediction of LNM, the ROC curves showed that the area under the curve (AUC) values of an irregular shape and microcalcification were 0.591 (P = 0.059) and 0.629 (P = 0.007), respectively. In the radiomics analysis, in the training set, the AUC value of LNM was 0.759, with a sensitivity of 0.90 and a specificity of 0.860. In the verification set, the AUC was 0.803, with a sensitivity of 0.727 and a specificity of 0.800.

Conclusions

Microcalcification and an irregular shape are predictors of LNM in thyroid carcinoma patients. In addition, radiomics analysis has promising value in screening meaningful ultrasound features in thyroid cancer patients with LNM. Therefore, the prediction of LNM based on ultrasound features and radiomic features is useful for making appropriate decisions regarding surgery and interventions before thyroid carcinoma surgery.
Enhanced recovery after surgery nursing program, a protective factor for stoma-related complications in patients with low rectal cancer
Authors: Shao Weiling , Wang Honggang , Chen Qun , Zhao Wen , Gu Yulian , Feng Guoqin
Published: December 2020

Background

This study aimed to investigate the association between enhanced recovery after surgery (ERAS) nursing program and stoma-related complications (SRCs) and prognosis in patients with low rectal cancer (LRC) undergoing abdominoperineal resection with sigmoidostomy.

Methods

LRC patients who underwent elective abdominoperineal resection with sigmoidostomy between May 2016 and May 2019 were retrospectively enrolled. The occurrence of early major or minor SRCs (within postoperative 30 days) was set as the primary end-point. Clinicopathological variables and laboratory tests were compared between patients with or without SRCs. The univariate and multivariate logistic regression analyses were performed to investigate risk factors for SRCs. Hospitalization satisfaction-related and prognosis-related variables were compared between LRC patients with or without ERAS nursing program.

Results

A total of 288 patients were enrolled and the incidence of SRCs was 26.7% (77/288). ERAS nursing program was the only independent risk factor for SRCs in LRC patients (OR 2.04, 95%CI 1.31–3.12, P = 0.016) by the multivariate logistic regression analysis. Moreover, ERAS nursing program was associated with higher hospitalization satisfaction rate, faster bowel function recovery, better psychological status, and higher quality of life.

Conclusions

ERAS nursing program was a protective factor for SRCs and associated with improved prognosis in LRC patients undergoing elective abdominoperineal resection with sigmoidostomy.