bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Collagen Scaffold With Bcl-2-Modified Adipose-Derived Stem Cells on Diabetic Mice Wound Healing
Authors: Ding Sheng , Xu Ye , Yan Xin , Lin Yue , Tan Qian
Published: November 2019

This study aimed at evaluating the effects of collagen scaffold with Bcl-2-modified adipose-derived stem cells (ADSCs) on wound repair in streptozotocin-induced diabetic mice. A round full thickness skin defect with a diameter of 7 mm was made in the mice model. The experimental mice were divided into 4 groups (n = 12 each): group A (control group), group B (scaffold group), group C (ADSCs-scaffold group), and group D (Bcl-2-ADSCs-scaffold group). On days 3, 7, 10, and 14 after surgery, characteristics of wound healing was observed, and wound tissues were sampled for histology characteristics via hematoxylin-eosin staining and immunohistochemical staining. Compared with other groups, the wound healing rate was significantly higher in group D a week after operation ( P < .05). On the seventh day postoperation, group D exhibited higher blood vessel in the wounds granulation tissue than other groups according to results of hematoxylin-eosin staining and immunohistochemistry. In conclusion, these findings demonstrated that collagen scaffold with Bcl-2 modified ADSCs may effectively improve the wound healing process in diabetic mice.
Function Allocation Considerations in the Era of Human Autonomy Teaming
Authors: Roth Emilie M. , Sushereba Christen , Militello Laura G. , Diiulio Julie , Ernst Katie
Published: November 2019

Function allocation refers to strategies for distributing system functions and tasks across people and technology. We review approaches to function allocation in the context of human machine teaming with technology that exhibits high levels of autonomy (e.g., unmanned aerial systems). Although most function allocation projects documented in the literature have employed a single method, we advocate for an integrated approach that leverages four key activities: (1) analyzing operational demands and work requirements; (2) exploring alternative distribution of work across person and machine agents that make up a human machine team (HMT); (3) examining interdependencies between human and autonomous technologies required for effective HMT performance under routine and off-nominal (unexpected) conditions; and (4) exploring the trade-space of alternative HMT options. Our literature review identified methods to support each of these activities. In combination, they enable system designers to uncover, explore, and weigh a range of critical design considerations beyond those emphasized by the MABA–MABA (“Men are better at, Machines are better at”) and Levels of Automation function allocation traditions. Example applications are used to illustrate the value of these methods to design of HMT that includes autonomous machine agents.
“Gaming the System”: Platform Paternalism and the Politics of Algorithmic Visibility
Authors: Petre Caitlin , Duffy Brooke Erin , Hund Emily
Published: November 2019

As the logic of data-driven metrification reconfigures various realms of social and economic life, cultural workers—from journalists and musicians to photographers and social media content creators—are pursuing online visibility in earnest. Despite workers’ patterned deployment of search engine optimization, reciprocal linking, and automated engagement-boosting, tech companies routinely denigrate such practices as gaming the system. This article critically probes discourses and practices of so-called system-gaming by analyzing three key moments when platforms accused cultural producers of algorithmic manipulation. Empirically, we draw upon textual analyses of news articles ( n = 105) and user guidelines published by Google, Facebook, and Instagram. Our findings suggest that the line between what platforms deem illegitimate algorithmic manipulation and legitimate strategy is nebulous and largely reflective of their material interests. However, the language used to invoke this distinction is strongly normative, condemning “system gamers” as morally bankrupt, while casting platform companies as neutral actors working to uphold the ideals of authenticity and integrity. We term this dynamic “platform paternalism” and conclude that gaming accusations constitute an important mechanism through which platforms legitimate their power and authority, to the detriment of less well-established cultural producers.
Theological educators and what it is like to be a minister: A qualitative study of five Protestant settings
Authors: Lincoln Timothy D
Published: November 2019

To increase the alignment between the lives of ministers serving congregations and what seminary professors think that congregational ministry is like, this study used qualitative methods to examine the themes voiced by seminary professors and graduates in ministry at five Protestant seminaries in the United States. There was some agreement about key themes in the lifeworld of ministers. However, there was little agreement between professors and graduates in ministry about which themes were most influential. Findings point to opportunities for seminaries to create ways to take seriously the experiences of ministers.
The Dietary Patterns of Japanese Hemodialysis Patients: A Focused Ethnography
Authors: Oka Michiyo , Yoneda Kaori , Moriyama Michiko , Takahashi Satsuki , Bull Claudia , Chaboyer Wendy
Published: November 2019

The relationship between diet and kidney disease outcomes has been established, and as a result, hemodialysis patients are required to modify their diet. However, there is a gap in understanding how diet is influenced by social factors, particularly among Japanese patients whose diet is known to be high in salt. The purpose was to explore the dietary patterns of Japanese hemodialysis patients and better understand the challenges they face in adhering to dietary restrictions. A focused ethnography, employing observational methods with six Japanese hemodialysis patients was undertaken. Fieldwork included observations, informal interviews, and weekly formal interviews for 6 weeks. Five categories were identified during the process of data analysis. This study highlights the strong influence of culture, tradition, and family on the dietary patterns of Japanese hemodialysis patients, which has rarely been acknowledged by Japanese health professionals.

The translated abstract was prepared by the author based on the accepted English version of the original abstract. Only light additional review of the translation has been completed by the journal.
Book review: Bhairabi Prasad Sahu and Kesavan Veluthat, eds., History and Theory: The Study of State, Institutions and Making of History
Authors: Habib Irfan
Published: November 2019

Bhairabi Prasad Sahu and Kesavan Veluthat, eds., History and Theory: The Study of State, Institutions and Making of History (Hyderabad: Orient Blackswan), 2019, 338 pp., ₹945 (Hb).
Book review: Semanti Ghosh, Different Nationalisms, Bengal 1905–1947
Authors: Ahmed Sahara
Published: November 2019

Semanti Ghosh, Different Nationalisms, Bengal 1905–1947 (New Delhi: Oxford University Press), 2017, 424 pp., ₹995 (Hb).
ING’s Agile Transformation—Teaching an Elephant to Race
Authors: Calnan Martin , Rozen Alon
Published: November 2019

The present article is a practitioner case study of an ongoing event for the period from 2010 to 2018. It examines a key period during which ING Bank has attempted to transform itself from a traditional bank to a ‘platform bank’ with the help of both benchmarked and ad hoc agile methods and mindset.

The research is extensively based on a review of the agile methods and creating value literature, semi-structured interviews of the key ING Group and ING Netherlands stakeholders, a documentary review of existing literature on ING’s transformation, ING public information (annual reports, special reports, marketing materials) as well as ING internal documents (presentations, internal documents, training materials, etc.).

To ensure multi-layered coverage of the full story, interviewees were chosen to capture the points of view of key participants in the transformation journey and who represent the full range of major internal stakeholders, namely representatives from IT, Business, HR and Corporate.

The aim of this case study is to gain a more granular understanding of the key factors, people, processes and insights that helped drive ING’s profound transformation of its operations, management, strategy and vision and how this ongoing ‘agile transformation’ is value accretive (or not) for ING and its stakeholders. The article identifies the three stages of a successful agile transformation as well as the underlying paradox for an organization to remain agile over time and at scale.
Magnetohydrodynamic bio-nano-convective slip flow with Stefan blowing effects over a rotating disc
Authors: Tuz Zohra Fatema , Uddin Mohammed Jashim , Basir Md Faisal , Ismail Ahmad Izani Md
Published: November 2019

Microfluidic-related technologies and micro-electromechanical systems–based microfluidic devices have received applications in science and engineering fields. This article is the study of a mathematical model of steady forced convective flow past a rotating disc immersed in water-based nanofluid with microorganisms. The boundary layer flow of a viscous nanofluid is studied with multiple slip conditions and Stefan blowing effects under the magnetic field influence. The microscopic nanoparticles move randomly and have the characteristics of thermophoresis, and it is being considered that the change in volume fraction of the nanofluid does not affect the thermo-physical properties. The governing equations are nonlinear partial differential equations. At first, the nonlinear partial differential equations are converted to system of nonlinear ordinary differential equations using suitable similarity transformations and then solved numerically. The influence of relevant parameters on velocities, temperature, concentration and motile microorganism density is illustrated and explained thoroughly. This investigation indicated that suction provides a better medium to enhance the transfer rate of heat, mass and microorganisms compared to blowing. This analysis has a wide range engineering application such as electromagnetic micro pumps and nanomechanics.
Ankle Blocks Can Minimize the Need for Opiates in Forefoot Surgery
Authors: Pountos Ippokratis , Tellisi Nazzar , Gupta Pawan
Published: November 2019

Category:

Midfoot/Forefoot

Introduction/Purpose:

Postoperative pain following forefoot surgery is often difficult to control with oral medications requiring large doses of opioid analgesia. Regional anaesthesia is an alternative approach that reduces the need for general anaesthetic and can provide adequate pain control in the immediate postoperative period. The purpose of this study was to analyse the effectiveness of ankle blocks in patients undergoing forefoot surgery.

Methods:

The authors prospectively included 22 consecutive patients undergoing forefoot surgery in the last semester of 2018. The blocks were performed by a senior anaesthetist with bupivacaine or levobupivacaine to posterior tibial (6-10mls), saphenous (2-4mls), superficial and deep peroneal (4-6mls) and sural nerve (4-6mls). Collected data included demographic information, pain scores and postoperative prescriptions, satisfactions questionnaires and post-operative outcomes.

Results:

The study group included 22 patients with a mean age of 50 years (range 23-81). There were 16 females and 6 males, overall BMI was 26,35 and the majority of patients were fit and well (86% ASA 1 or 2). The blocks lasted for an average 45 hours (range 20-92). In terms of the post-operative analgesia needs, 14% of the patients required no further analgesia, 45% required paracetamol and ibuprofen and 41% required dihydrocodeine. All 22 patients were highly satisfied with the analgesia provided, no complications were reported and no re-admissions occurred.

Conclusion:

Ankle blocks were a safe and reliable anaesthetic choice providing highly effective perioperative pain management in patients undergoing elective orthopaedic forefoot procedures. Patients with ankle block had better pain management, decreased opioid requirements and high satisfaction rates.
Green developmentalism and trade-offs between natural preservation and environmental exploitation in China
Authors: Hong Dong-Li , Chien Shiuh-Shen , Liao Yu-Kai
Published: November 2019

China is transitioning from the pursuit of growth at any cost to a stage in which the costs of growth and environmental sustainability have become a consideration. Career incentives for local government officials require them to simultaneously meet stringent targets for economic growth and environmental protection, but these goals are frequently in conflict. Against this backdrop, officials differentiate environment resources into two kinds: privileged and marginal, exploiting the latter to preserve the former. This ‘green self-contradiction’ is generated by two trade-offs: restriction–substitution relationship at the local level and supplement–compensation relationship at the national (trans-local) level. This trade-off framework is examined through two empirical cases: (1) a provincial policy of preservation of plain farmlands along with urbanization of outskirt hills in highland cities like Kunming and Yannan, and (2) a national scheme of stabilization for underground water in the Greater Beijing Region along with exploitation of cloud water from the distant Yangtze River provinces. We argue that these trade-offs embody the Chinese government’s ideological use of technology to preserve certain ‘green’ goals while maintaining a foundational ‘developmentalist’ logic, which we call ‘green developmentalism’.
Simultaneous sulfur hexafluoride and nitrogen multiple-breath washout (MBW) to examine inherent differences in MBW outcomes
Authors: Bayfield Katie J. , Horsley Alex , Alton Eric , Irving Samantha , Bush Andrew , Davies Jane C.
Published: November 2019

Multiple-breath washout (MBW) can be performed with different gases (sulfur hexafluoride (SF6­) and nitrogen (N2)) and different devices, all of which give discrepant results. This study aimed to confirm previously reported differences and explore factors influencing discrepant results; equipment factors or the physical properties of gases used.

Methods

Healthy controls (HCs) and participants with cystic fibrosis (CF) completed MBW trials on two commercially available devices (Exhalyzer D (N2) and Innocor (SF6)). Simultaneous washout of both gases at the same time on the commercial equipment and simultaneous washouts using a respiratory mass spectrometer (RMS) were completed in subsets. Primary outcomes were lung clearance index (LCI), breath number and time required to washout.

Results

Breath number was higher with N2washout than SF6in both HCs and patients with CF, whether washouts were completed individually or simultaneously. The difference was greater in more advanced disease, largely caused by differences in the final part of the washout. Results from commercial devices were similar to those obtained with the RMS.

Conclusions

N2MBW results were higher than SF6MBW, with some of the largest differences reported to date being observed. The biggest impact was at the end of the washout and this was even the case when gases were washed out simultaneously. N2and SF6MBW results are inherently different and should be considered as independent measurements.
Femoroacetabular impingement: question-driven review of hip joint pathophysiology from asymptomatic skeletal deformity to end-stage osteoarthritis
Authors: Pierannunzii L.
Published: November 2019

Femoroacetabular impingement (FAI), together with its two main pathomechanisms, cam and pincer, has become a trending topic since the end of the 1990s. Despite massive academic research, this hip disorder still conceals obscure aspects and unanswered questions that only a question-driven approach may settle. The pathway that leads a FAI asymptomatic morphology through a FAI syndrome to a FAI-related osteoarthritis is little known. Contact mechanics provides a shareable and persuasive perspective: cam FAI is based on shear contact stress at joint level with consequent cartilage wear; pincer FAI, contrariwise, determines normal contact stress between acetabular rim and femoral neck and squeezes the labrum in between, with no cartilage wear for many years from the onset. Pincer prognosis is then far better than cam. As a matter of fact, cartilage wear releases fragments of extracellular matrix which in turn trigger joint inflammation, with consequently worsening lubrication and further enhanced wear. Inflammation pathobiology feeds pathotribology through a vicious loop, finally leading to hip osteoarthritis. The association of cam and pincer, possibly overdiagnosed, is a synergic combination that may damage the joint rapidly and severely. The expectations after FAI surgical correction depend strictly on chondral layer imaging, on time elapsed from the onset of symptoms and on clinic-functional preoperative level. However, preemptive surgical correction is not recommended yet in asymptomatic FAI morphology.

Level of evidence

V.
Dyadic approach to post-stroke hospitalizations: role of caregiver and patient characteristics
Authors: Tyagi Shilpa , Koh Gerald C. H. , Luo Nan , Tan Kelvin B. , Hoenig Helen , Matchar David B. , Yoong Joanne , Chan Angelique , Lee Kim En , Venketasubramanian N. , Menon Edward , Chan Kin Ming , De Silva Deidre Anne , Yap Philip , Tan Boon Yeow , Chew Effie , Young Sherry H. , Ng Yee Sien , Tu Tian Ming , Ang Yan Hoon , Kong Keng He , Singh Rajinder , Merchant Reshma A. , Chang Hui Meng , Yeo Tseng Tsai , Ning Chou , Cheong Angela , Ng Yu Li , Tan Chuen Seng
Published: November 2019

Aim

To study the association of caregiver factors and stroke patient factors with rehospitalizations over the first 3 months and subsequent 3–12 months post-stroke in Singapore.

Methods

Patients with stroke and their caregivers were recruited in the Singapore Stroke Study, a prospective yearlong cohort. While caregiver and patient variables were taken from this study, hospitalization data were extracted from the national claims database. We used Poisson modelling to perform bivariate and multivariable analysis with counts of hospitalization as the outcome.

Results

Two hundred and fifty-six patient with stroke and caregiver dyads (N = 512) were analysed, with patients having spouse (60%), child (29%), sibling (4%) and other (7%) as their caregivers. Among all participants, 89% of index strokes were ischemic, 57% were mild in severity and more than half (59%) of the patients had moderate or severe disability post-stroke as measured on the Modified Rankin Scale. Having social support in the form of a foreign domestic worker for general help of caregiver reduced the hospitalization rate over 3 months post-stroke by 66% (IRR: 0.342; 95% CI: 0.180, 0.651). Compared to having a spousal caregiver, those with a child caregiver had an almost three times greater rate of hospitalizations over 3–12 months post-stroke (IRR: 2.896; 95% CI: 1.399, 5.992). Higher reported caregiving burden at the 3-month point was associated with the higher subsequent rate of hospitalization.

Conclusion

Recommendations include the adoption of a dyadic or holistic approach to post-stroke care provision by healthcare practitioners, giving due importance to both patients with stroke and their caregivers, integrating caregivers in the healthcare system to extend the care continuum to include informal care in the community and provision of timely support for caregivers.
Detection of fetal trisomy and single gene disease by massively parallel sequencing of extracellular vesicle DNA in maternal plasma: a proof-of-concept validation
Authors: Zhang Weiting , Lu Sen , Pu Dandan , Zhang Haiping , Yang Lin , Zeng Peng , Su Fengxia , Chen Zhichao , Guo Mei , Gu Ying , Luo Yanmei , Hu Huamei , Lu Yanping , Chen Fang , Gao Ya
Published: November 2019

Background

During human pregnancy, placental trophectoderm cells release extracellular vesicles (EVs) into maternal circulation. Trophoblasts also give rise to cell-free DNA (cfDNA) in maternal blood, and has been used for noninvasive prenatal screening for chromosomal aneuploidy. We intended to prove the existence of DNA in the EVs (evDNA) of maternal blood, and compared evDNA with plasma cfDNA in terms of genome distribution, fragment length, and the possibility of detecting genetic diseases.

Methods

Maternal blood from 20 euploid pregnancies, 9 T21 pregnancies, 3 T18 pregnancies, 1 T13 pregnancy, and 2 pregnancies with FGFR3 mutations were obtained. EVs were separated from maternal plasma, and confirmed by transmission electronic microscopy (TEM), western blotting, and flow cytometry (FACS). evDNA was extracted and its fetal origin was confirmed by quantitative PCR (qPCR). Pair-end (PE) whole genome sequencing was performed to characterize evDNA, and the results were compared with that of cfDNA. The fetal risk of aneuploidy and monogenic diseases was analyzed using the evDNA sequencing data.

Results

EVs separated from maternal plasma were confirmed with morphology by TEM, and protein markers of CD9, CD63, CD81 as well as the placental specific protein placental alkaline phosphatase (PLAP) were confirmed by western blotting or flow cytometry. EvDNA could be successfully extracted for qPCR and sequencing from the plasma EVs. Sequencing data showed that evDNA span on all 23 pairs of chromosomes and mitochondria, sharing a similar distribution pattern and higher GC content comparing with cfDNA. EvDNA showed shorter fragments yet lower fetal fraction than cfDNA. EvDNA could be used to correctly determine fetal gender, trisomies, and de novo FGFR3 mutations.

Conclusions

We proved that fetal DNA could be detected in EVs separated from maternal plasma. EvDNA shared some similar features to plasma cfDNA, and could potentially be used to detect genetic diseases in fetus.
Variable DNA methylation of aging-related genes is associated with male COPD
Authors: Du Xizi , Yuan Lin , Wu Mengping , Men Meichao , He Ruoxi , Wang Leyuan , Wu Shuangyan , Xiang Yang , Qu Xiangping , Liu Huijun , Qin Xiaoqun , Hu Chengping , Qin Ling , Liu Chi
Published: November 2019

Background

Chronic obstructive pulmonary disease (COPD) is a chronic lung inflammatory disease which has a close relationship with aging. Genome-wide analysis reveals that DNA methylation markers vary obviously with age. DNA methylation variations in peripheral blood have the potential to be biomarkers for COPD. However, the specific DNA methylation of aging-related genes in the peripheral blood of COPD patients remains largely unknown.

Methods

Firstly, 9 aging-related differentially expressed genes (DEGs) in COPD patients were screened out from the 25 aging-related genes profile through a comprehensive screening strategy. Secondly, qPCR and multiple targeted bisulfite enrichment sequencing (MethTarget) were used to detect the mRNA level and DNA methylation level of the 9 differentially expressed genes in the peripheral blood of 60 control subjects and 45 COPD patients. The candidate functional CpG sites were selected on the basis of the regulation ability of the target gene expression. Thirdly, the correlation was evaluated between the DNA methylation level of the key CpG sites and the clinical parameters of COPD patients, including forced expiratory volume in one second (FEV1), forced expiratory volume in one second as percentage of predicted volume (FEV1%), forced expiratory volume/ forced vital capacity (FEV/FVC), modified British medical research council (mMRC) score, acute exacerbation frequency and the situation of frequent of acute aggravation (CAT) score. Lastly, differentially methylated CpG sites unrelated to smoking were also determined in COPD patients.

Results

Of the 9 differentially expressed aging-related genes, the mRNA expression of 8 genes were detected to be significantly down-regulated in COPD group, compared with control group. Meanwhile, the methylated level of all aging-related genes was changed in COPD group containing 219 COPD-related CpG sites in total. Notably, 27 CpG sites of FOXO3 gene showed a lower False Discovery Rate (FDR) and higher methylation difference values. Also, some variable DNA methylation is associated with the severity of COPD. Additionally, of the 219 COPD-related CpG sites, 147 CpG sites were not related to smoking.

Conclusion

These results identified that the mRNA expression and DNA methylation level of aging-related genes were changed in male COPD patients, which provides a molecular link between aging and COPD. The identified CpG markers are associated with the severity of COPD and provide new insights into the prediction and identification of COPD.
Hepatitis C virus nonstructural protein 5A perturbs lipid metabolism by modulating AMPK/SREBP-1c signaling
Authors: Meng Ziyu , Liu Qiang , Sun Fujun , Qiao Ling
Published: November 2019

Background

Steatosis is an important clinical manifestation associated with chronic hepatitis C virus (HCV) infection. AMP-activated protein kinase (AMPK), a major mediator of lipid metabolism, regulates HCV-associated hepatic steatosis, but the underlying mechanisms remain obscure. Here we investigated the mechanism of HCV nonstructural protein 5A (NS5A)-induced lipid accumulation by the AMPK/SREBP-1c pathway.

Methods

We generated model mice by injecting recombinant lentiviral particles expressing the NS5A protein (genotype 3a) via the tail vein. The serum levels of alanine aminotransferase (ALT), free fatty acids (FFAs) and triglycerides (TG) were examined. H&E and Oil Red O staining were used to examine lipid droplets. Immunohistochemistry staining, quantitative real-time PCR and Western blotting were used to determine the expression of lipogenic genes.

Results

Our results showed that the serum levels of ALT, FFAs and TG, as well as the accumulation of hepatic lipid droplets, were increased significantly in mice infected with NS5A-expressing lentiviral particles. NS5A inhibited AMPK phosphorylation and increased the expression levels of sterol regulatory element binding protein-1c (SREBP-1c), acetyl-coenzyme A carboxylase 1 (ACC1) and fatty acid synthase (FASN) in vivo and in vitro. Further investigation revealed that pharmacological activation or ectopic expression of AMPK neutralized the upregulation of SREBP-1c, ACC1 and FASN, and ameliorated hepatic lipid accumulation induced by NS5A. Ectopic expression of SREBP-1c enhanced NS5A-induced hepatic lipid accumulation, which was dramatically reversed by pharmacological activation of AMPK.

Conclusions

Collectively, we demonstrate that NS5A induces hepatic lipid accumulation via the AMPK/SREBP-1c pathway.
Omission of adjuvant radiotherapy following breast-conserving surgery for elderly women with early-stage pure mucinous breast carcinoma
Authors: Wu San-Gang , Li Feng-Yan , Wang Jun , Lian Chen-Lu , Zhou Juan , He Zhen-Yu
Published: November 2019

Background

We aimed to ascertain population-based practice patterns and survival outcomes of postoperative radiotherapy following breast conserving-surgery (BCS) in elderly women (aged ≥65 years) with early-stage pure mucinous breast carcinoma (PMBC).

Methods

Patients aged ≥65 years diagnosed with T1–2N0 and hormone receptor-positive PMBC between 1990 and 2010 were identified from the Surveillance, Epidemiology, and End Results database. Binomial logistic regression, Kaplan-Meier method, Multivariate Cox proportional hazards models, and propensity score matching (PSM) were used for statistical analysis.

Results

We enrolled 3416 patients, including 1225 (35.9%) and 2191 (64.1%) in the no-radiotherapy and radiotherapy cohorts, respectively. The percentage of patients receiving postoperative radiotherapy following BCS was significantly lower after 2004 (59.5% between 2004 and 2010), relative to that before 2004 (71.1% between 1990 and 2003;P < 0.001). Before PSM, the 10-year breast cancer-specific survival (BCSS) rates were 98.1 and 93.2% for patients with and without postoperative radiotherapy (log-rank test,P < 0.001), respectively. In the PSM cohort, receiving postoperative radiotherapy was associated with better BCSS rates, with 10-year BCSS rates of 97.6 and 94.5% in patients with and without postoperative radiotherapy, respectively (log-rank test,P = 0.001). Multivariate Cox proportional analysis indicated that receiving postoperative radiotherapy was an independent factor associated with better BCSS before (P < 0.001) and after PSM (P = 0.001), relative to those not receiving postoperative radiotherapy.

Conclusions

This study shows a decreasing utilization of postoperative radiotherapy following BCS of elderly PMBC patients over time. However, postoperative radiotherapy following BCS should be administered for elderly women with PMBC owing to independent association with better survival.
Evaluating the optimal re-irradiation dose for locally recurrent esophageal squamous cell carcinoma after definitive radiotherapy
Authors: Xu Xiujuan , Wang Zhongming , Jiang Shunian , Shang Yuping , Wu Yan
Published: November 2019

Background

Re-irradiation (re-RT) has the active effect of relieving clinical symptoms and prolonging the survival of patients with recurrent esophageal squamous cell carcinoma (ESCC). However, the optimal re-RT dose is still uncertain. Here, we analyzed the prognostic factors associated with survival and explored the optimal re-RT dose for patients with recurrent ESCC following definitive radiotherapy.

Patients and methods

The data of 47 patients with recurrent ESCC who were retreated between 2010 and 2014 were retrospectively analyzed. All patients received a radiation dose > 50 Gy during the primary treatment. The median time to recurrence after primary radiotherapy was 26 months (range 6–120 months). All patients had in-field recurrence in the esophagus. Recurrence within the local site was observed in 37 patients (78.7%), and recurrence in both the local site and regional nodes were observed in 10 patients (21.3%). All patients received 3D conformal re-RT with a median dose of 58 Gy (range 26–64 Gy). Chemotherapy was sequentially used in 27.7% of the patients. Survival curves were constructed according to the Kaplan-Meier method and were compared by log-rank tests. The factors predictive of survival were identified with univariate and multivariate analyses.

Results

Dysphagia relief after re-RT was achieved in 20 of the 35 symptomatic patients (57.1%). The median survival time (MST) of all patients was 17 months, and the 1-, 2-, 3- and 5-year overall survival (OS) rates were 72.3, 25.5, 17.0 and 2.1%, respectively. In the univariate analysis, an Eastern Cooperative Oncology Group Performance Status (ECOG-PS) of 0–1 (P = 0.014), recurrence at the local site (P = 0.048), time to recurrence ≥24 months (P = 0.006) and re-RT dose ≥50 Gy (P < 0.001) were associated with favorable OS. In the multivariate analysis, only re-RT dose was an independent factor for OS (P = 0.007). Severe complications were observed in 7 patients, two of whom received a re-RT dose > 60 Gy.

Conclusion

Our results demonstrated that patients with recurrent ESCC following definitive radiotherapy had unfavorable OS. Re-RT could be considered a feasible and effective treatment modality. A re-RT dose > 50 Gy could improve the survival outcomes, and a dose > 60 Gy should be administered with caution due to the risk of severe complications.
Total aortic arch replacement surgery with a Core temperature of 34 °C
Authors: Li Quan , Qu Hong , Liu Tianqi , Yu Jianmin , Lv Meng
Published: November 2019

Background

Traditional aortic arch replacement surgery must be performed under moderate or deep hypothermia (22–28 °C) and circulatory arrest. Hypothermia and hypoperfusion can cause damage to the nervous system; therefore, postoperative brain and spinal cord complications are common. Improvements in surgical techniques are necessary to solve this problem. Herein, we report a method of total aortic arch replacement that can be performed at a core temperature of 34 °C, similar to other simple cardiac operations.

Case presentation

Four patients underwent surgery with this technique (3 males and 1 female, aged 48 to 67 years). Computed tomography angiography performed at admission showed a total aortic dissection, resulting in a diagnosis of Stanford type A aortic dissection. The patients underwent emergency aortic sinus remodelling, ascending aortic replacement, modified aortic arch replacement, and elephant trunk stenting. No patients had neurological complications. During a follow-up of more than 1-month, no patients had aortic valve regurgitation or anastomotic leak.

Conclusions

This technique can increase the operating temperature by approximately 6 to 12 °C and reduce the circulatory arrest time by approximately 18 to 28 min. All of the patients recovered well without any neurological complications, demonstrating the feasibility and safety of this technique. We believe that this technique can serve as a good alternative strategy for managing aortic dissection and aneurysm, especially for young surgeons who are acquiring experience in arch replacement surgery.
An abnormal left ventricular-atrial perforation after radiofrequency catheter ablation: a case report
Authors: Tao Tingting , Zheng Junnan , Xu Hongfei , Ni Yiming
Published: November 2019

Background

Cardiac radiofrequency ablation is a popular treatment for arrhythmias. However, it does have some complications, some of which are severe, even fatally. And there were limited reports on cardiac internal perforation after radiofrequency catheter ablation (RFCA) that required a surgical repair.

Case presentation

A 47-year-old male was admitted to our hospital due to chest congestion for 4 months. He received a radiofrequency catheter ablation (RFCA) 9 months prior to admission. On admission, an echocardiogram showed an abnormal perforation between the left ventricle and the left atrium with moderate mitral valve regurgitation. We therefore performed a mitral valve replacement (MVR) and fixed the abnormal atrial-ventricular breakage via median sternotomy.

Conclusions

Cardiac perforation is a severe complication of cardiac RFCA, operators should be extremely cautious to minimize radiofrequency associated perforations. Such a challenging and complex procedure should be deliberately considered by doctors and patients before implementation.
Passive hallux adduction decreases lateral plantar artery blood flow: a preliminary study of the potential influence of narrow toe box shoes
Authors: Jacobs Julia L. , Ridge Sarah T. , Bruening Dustin A. , Brewerton K. Annie , Gifford Jayson R. , Hoopes Daniel M. , Johnson A. Wayne
Published: November 2019

Background

Blood flow is essential in maintaining tissue health. Thus, compromised blood flow can prevent tissue healing. An adducted hallux, as seen inside a narrow shoe, may put passive tension on the abductor hallucis, compressing the lateral plantar artery into the calcaneus and restricting blood flow. The purposes of this study were to compare lateral plantar artery blood flow before and after passive hallux adduction and to compare blood flow with arch height.

Methods

Forty‐five healthy volunteers (20 female, 25 male; age = 24.8 ± 6.8 yr; height = 1.7 ± 0.1 m; weight = 73.4 ± 13.5 kg) participated in this cross‐over design study. Arch height index (AHI) was calculated, and blood flow measurements were obtained using ultrasound (L8‐18i transducer, GE Logiq S8). The lateral plantar artery was imaged deep to abductor hallucis for 120 s: 60 s at rest, then 60 s of passive hallux adduction. Maximal passive hallux adduction was performed by applying pressure to the medial side of the hallux. Blood flow was calculated in mL/min, and pre‐passive hallux adduction was compared to blood flow during passive hallux adduction.

Results

Log transformed data was used to run a paired t‐test between the preadduction and postadduction blood flow. The volume of blood flow was 22.2% lower after passive hallux adduction compared to before (− 0.250 ± 0.063, p < 0.001). As AHI decreased, there was a greater negative change in blood flow. As baseline blood flow increased, there was also a greater negative change in blood flow.

Conclusions

Our preliminary findings of decreased blood flow through passive hallux adduction indicate conditions that elicit passive hallux adduction (e.g. wearing narrow‐toed shoes) may have important effects on foot blood flow. Individuals with lower AHI appear to have a greater risk of decreased blood flow with passive hallux adduction.
MaveDB: an open-source platform to distribute and interpret data from multiplexed assays of variant effect
Authors: Esposito Daniel , Weile Jochen , Shendure Jay , Starita Lea M. , Papenfuss Anthony T. , Roth Frederick P. , Fowler Douglas M. , Rubin Alan F.
Published: November 2019

Multiplex assays of variant effect (MAVEs), such as deep mutational scans and massively parallel reporter assays, test thousands of sequence variants in a single experiment. Despite the importance of MAVE data for basic and clinical research, there is no standard resource for their discovery and distribution. Here, we present MaveDB (https://www.mavedb.org), a public repository for large-scale measurements of sequence variant impact, designed for interoperability with applications to interpret these datasets. We also describe the first such application, MaveVis, which retrieves, visualizes, and contextualizes variant effect maps. Together, the database and applications will empower the community to mine these powerful datasets.
Biochemical characteristics and synergistic effect of two novel alginate lyases from Photobacterium sp. FC615
Authors: Lu Danrong , Zhang Qingdong , Wang Shumin , Guan Jingwen , Jiao Runmiao , Han Naihan , Han Wenjun , Li Fuchuan
Published: November 2019

Background

Macroalgae and microalgae, as feedstocks for third-generation biofuel, possess competitive strengths in terms of cost, technology and economics. The most important compound in brown macroalgae is alginate, and the synergistic effect of endolytic and exolytic alginate lyases plays a crucial role in the saccharification process of transforming alginate into biofuel. However, there are few studies on the synergistic effect of endolytic and exolytic alginate lyases, especially those from the same bacterial strain.

Results

In this study, the endolytic alginate lyase AlyPB1 and exolytic alginate lyase AlyPB2 were identified from the marine bacteriumPhotobacteriumsp. FC615. These two enzymes showed quite different and novel enzymatic properties whereas behaved a strong synergistic effect on the saccharification of alginate. Compared to that when AlyPB2 was used alone, the conversion rate of alginate polysaccharides to unsaturated monosaccharides when AlyPB1 and AlyPB2 acted on alginate together was dramatically increased approximately sevenfold. Furthermore, we found that AlyPB1 and AlyPB2 acted the synergistic effect basing on the complementarity of their substrate degradation patterns, particularly due to their M-/G-preference and substrate-size dependence. In addition, a novel method for sequencing alginate oligosaccharides was developed for the first time by combining the1H NMR spectroscopy and the enzymatic digestion with the exo-lyase AlyPB2, and this method is much simpler than traditional methods based on one- and two-dimensional NMR spectroscopy. Using this strategy, the sequences of the final tetrasaccharide and pentasaccharide product fractions produced by AlyPB1 were easily determined: the tetrasaccharide fractions contained two structures, ΔGMM and ΔMMM, at a molar ratio of 1:3.2, and the pentasaccharide fractions contained four structures, ΔMMMM, ΔMGMM, ΔGMMM, and ΔGGMM, at a molar ratio of ~ 1:1.5:3.5:5.25.

Conclusions

The identification of these two novel alginate lyases provides not only excellent candidate tool-type enzymes for oligosaccharide preparation but also a good model for studying the synergistic digestion and saccharification of alginate in biofuel production. The novel method for oligosaccharide sequencing described in this study will offer a very useful approach for structural and functional studies on alginate.
Lytic cycle of Besnoitia besnoiti tachyzoites displays similar features in primary bovine endothelial cells and fibroblasts
Authors: Jiménez-Meléndez Alejandro , Fernández-Álvarez María , Calle Alexandra , Ramírez Miguel Ángel , Diezma-Díaz Carlos , Vázquez-Arbaizar Patricia , Ortega-Mora Luis Miguel , Álvarez-García Gema
Published: November 2019

Background

Bovine besnoitiosis, caused by the cyst-forming apicomplexan parasite Besnoitia besnoiti, is a chronic and debilitating cattle disease that continues to spread in Europe in the absence of control tools. In this scenario, in vitro culture systems are valuable tools to carry out drug screenings and to unravel host-parasite interactions. However, studies performed in bovine target cells are scarce.

Methods

The objective of the present study was to obtain primary bovine aortic endothelial cells (BAECs) and fibroblast cell cultures, target cells during the acute and the chronic stage of the disease, respectively, from healthy bovine donors. Afterwards, expression of surface (CD31, CD34 and CD44) and intracellular markers (vimentin and cytokeratin) was studied to characterize cell populations by flow cytometry. Next, the lytic cycle of B. besnoiti tachyzoites was studied in both target cells. Invasion rates (IRs) were determined by immunofluorescence at several time points post-infection, and proliferation kinetics were studied by quantitative PCR (qPCR). Finally, the influence of bovine viral diarrhea virus (BVDV) co-infection on the host cell machinery, and consequently on B. besnoiti invasion and proliferation, was investigated in BAECs.

Results

Morphology and cytometry results confirmed the endothelial and fibroblast origins. CD31 was the surface marker that best discriminated between BAECs and fibroblasts, since fibroblasts lacked CD31 labelling. Expression of CD34 was weak in low-passage BAECs and absent in high-passage BAECs and fibroblasts. Positive labelling for CD44, vimentin and cytokeratin was observed in both BAECs and fibroblasts. Regarding the lytic cycle of the parasite, although low invasion rates (approximately 3–4%) were found in both cell culture systems, more invasion was observed in BAECs at 24 and 72 hpi. The proliferation kinetics did not differ between BAECs and fibroblasts. BVDV infection favoured early Besnoitia invasion but there was no difference in tachyzoite yields observed in BVDV-BAECs compared to BAECs.

Conclusions

We have generated and characterized two novel standardized in vitro models for Besnoitia besnoiti infection based on bovine primary target BAECs and fibroblasts, and have shown the relevance of BVDV coinfections, which should be considered in further studies with other cattle pathogens.
Factors related to the use of opioids as early treatment in patients with knee osteoarthritis
Authors: Cho Soo-Kyung , Jung Sun-Young , Choi Seongmi , Im Seul Gi , Kim Hyoungyoung , Choi Woo Seok , Jang Eun Jin , Sung Yoon-Kyoung
Published: November 2019

Objective

To examine factors related to the use of opioids as an early treatment option for knee OA patients

Methods

Using the Korean nationwide claim database, we selected knee OA patients between 2013 and 2015. Among them, patients without any claim of knee OA for 2 years before the index date were included as our study population. We analyzed their first claim for prescriptions, including tramadol and stronger opioids, at the index date of each patient. Using a multinomial model, we identified factors associated with the early use of tramadol and stronger opioids in knee OA patients.

Results

Among a total of 2,857,999 knee OA patients, 12.2% (n = 348,516) were treated with opioids as their first treatment. However, the prevalence of stronger opioid use was only 0.07% (n = 1972). Male sex (OR 1.28 in tramadol, OR 1.13 in stronger opioids) and comorbidities with depression (OR 1.05, 1.46), low back pain (OR 1.13, 1.30), intervertebral disc disorder (OR 1.11, 1.40), and spinal stenosis (OR 1.27, 1.55) were the factors for the early use of tramadol or stronger opioids in knee OA patients. Patients in a tertiary referral hospital tended to use tramadol or stronger opioids than those in clinics (OR 1.04, 56.63, respectively).

Conclusion

In Korea, 12.2% of knee OA patients were treated with opioids as an early treatment, and tramadol was used more commonly than stronger opioids. Male sex and having comorbidities such as depression or musculoskeletal disease are patient factors associated with the early use of opioids in knee OA patients.
Validity of simplified, calibration-less exercise intensity measurement using resting heart rate during sleep: a method-comparison study with respiratory gas analysis
Authors: Matsuura Hirotaka , Mukaino Masahiko , Otaka Yohei , Kagaya Hitoshi , Aoshima Yasushi , Suzuki Takuya , Inukai Ayaka , Hattori Emi , Ogasawara Takayuki , Saitoh Eiichi
Published: November 2019

Background

The recent development of wearable devices has enabled easy and continuous measurement of heart rate (HR). Exercise intensity can be calculated from HR with indices such as percent HR reserve (%HRR); however, this requires an accurate measurement of resting HR, which can be time-consuming. The use of HR during sleep may be a substitute that considers the calibration-less measurement of %HRR. This study examined the validity of %HRR on resting HR during sleep in comparison to percent oxygen consumption reserve (%VO2R) as a gold standard. Additionally, a 24/7%HRR measurement using this method is demonstrated.

Methods

Twelve healthy adults aged 29 ± 5 years underwent treadmill testing using the Bruce protocol and a 6-min walk test (6MWT). The %VO2R during each test was calculated according to a standard protocol. The %HRR during each exercise test was calculated either from resting HR in a sitting position (%HRRsitting), when lying awake (%HRRlying), or during sleep (%HRRsleeping). Differences between %VO2R and %HRR values were examined using Bland-Altman plots. A 180-day, 24/7%HRR measurement with three healthy adults was also conducted. The %HRR values during working days and holidays were compared.

Results

In the treadmill testing, the mean difference between %VO2R and %HRRsleepingwas 1.7% (95% confidence interval [CI], − 0.2 to 3.6%). The %HRRsittingand %HRRlyingvalues were 10.8% (95% CI, 8.8 to 12.7%) and 7.7% (95% CI, 5.4 to 9.9%), respectively. In the 6MWT, mean differences between %VO2R and %HRRsitting, %HRRlyingand %HRRsleepingwere 12.7% (95% CI, 10.0 to 15.5%), 7.0% (95% CI, 4.0 to 10.0%) and − 2.9% (95% CI, − 5.0% to − 0.7%), respectively. The 180-day, 24/7%HRR measurement presented significant differences in %HRR patterns between working days and holidays in all three participants.

Conclusions

The results suggest %HRRsleepingis valid in comparison to %VO2R. The results may encourage a calibration-less, 24/7 measurement model of exercise intensity using wearable devices.

Trial registration

UMIN000034967.

Registered 21 November 2018 (retrospectively registered).
European Training Assessment Programme 2.0
Authors:   European Board of Radiology (EBR)
Published: November 2019

The European Training Assessment Programme (ETAP) 2.0 offers a structured assessment of radiology training institutions applying for certification, without geographical constraints. It applies, in fact, to both European and non-European institutions, which fulfill the eligibility criteria and wish to obtain a European certification.

ETAP 2.0 aims to provide centres that offer specialty training in radiology with an objective assessment by external assessors of their training programmes. ETAP 2.0 also aims to develop assessment systems and guidelines to be used by postgraduate education authorities at a national level.

The online evaluation system facilitates the application process as well as the assessment and subsequent certification. The platform enables users – both representatives of applicant institutions and assessors – to easily and efficiently store, access, and manage documents and information at any time, thereby facilitating the certification process.