bluuebunny/crossref_metadata_2025 huggingface dataset:
Image-Guided Intensity-Modulated Radiation Therapy for IgG4-Related Ophthalmic Disease
Authors: Sabol Rachel A. , Bubenzer Virginia , Moroz Krzysztof , Halat Shams , Dang Audrey , Ferdinand Keith , Traylor Angela , Boyd Carol , Harris Kendra
Published: September 2020

Background. IgG4-related ophthalmic disease is a rare, newly recognized entity with high failure rates on first-line therapy of systemic corticosteroids and no other proven management options. Case Presentation. Here, we present the clinical course of a patient with IgG4 ophthalmic disease who achieved a favorable response from radiotherapy. Our patient initially presented with a history of recurrent painful flares of orbital inflammation, a pathologic diagnosis follicular lymphoid hyperplasia from a right lacrimal gland biopsy, and MRI imaging noting expansion of the lateral rectus muscle of the right eye. Initial treatment with dacryoadenectomy and multiple courses of corticosteroids failed to keep his symptoms at bay. Further evaluation revealed florid IgG4 staining. In this context, he was evaluated for image-guided intensity-modulated radiotherapy (IG-IMRT) to the orbit to 20 Gy in 10 fractions. His ophthalmic symptoms resolved. Conclusions. This treatment experience suggests radiotherapy may be a favorable option for symptom relief in patients with IgG4-related ophthalmic disease not controlled by corticosteroids.
Multiple Sound Source Localization and Counting Using One Pair of Microphones in Noisy and Reverberant Environments
Authors: Fang Yuzhuo , Xu Zhiyong
Published: September 2020

A multiple sound source localization and counting method based on an angular spectrum is proposed in this paper. Local signal-to-noise ratio tracking, onset detection, and a coherence test are introduced to filter the generalized cross-correlation angular spectrum in the time-frequency domain for multiple sound source localization and counting in noisy and reverberant environments. Then, dual-width matching pursuit is introduced to replace peak search as the method of localization and counting. A comprehensive comparison of two statistical indicators, mean precision and mean absolute estimated error, indicates that the proposed localization and counting algorithm using both the filtered angular spectrum and dual-width matching pursuit method is more robust and accurate than the classic counterpart, especially in environments with low signal-to-noise ratio, strong reverberation, and abundant sound sources.
Study on Extraction Methods for Different Components in a Carbonate Digital Core
Authors: Xiao Xiaoling , Zhang Jiarui , Li Xinyu , Zhang Jing , Zhang Xiang
Published: September 2020

It is difficult to carry out petrophysical experiments because of the serious damage caused to cores in the development of fractures and pores in carbonate reservoirs. The development of a three-dimensional digital core in carbonate reservoirs has become a hot topic in rock physics research. Compared with the three-dimensional digital core, including basic rock skeletons and pores in sandstone reservoirs, carbonate reservoirs also include secondary structures such as microfractures. The carbonate contains different components, and extracting these components is a very difficult problem. The resolution on the electrical image log image is high, which can clearly reflect the macrocomponents in various reservoirs. There are some blank areas between electrodes on the electrical image log, which affects the extraction of components in a three-dimensional digital core. Aiming at the serious heterogeneities in the carbonate reservoirs and affecting image inpainting on the electrical image log image, a new method of image inpainting based on a combination of multipoint geostatistics and an interpolation method is put forward. The experimental results show that this method generates faster and better full-bore images than other methods. Due to the multipeak histogram, the maximum interclass variance in the two times method is proposed to extract macrocomponents such as basic rock skeletons, pores, and connected parts. The microfractures can be extracted from the CT scanned images by using image segmentation from the combination of the watershed and OTSU methods. The experimental results prove that using extraction methods for different components enables better results to be obtained.
Short-Term Results of Switch from Conbercept to Bevacizumab or Ranibizumab in Eyes with Persistent Neovascular Age-Related Macular Degeneration
Authors: Wang Zongyi , Li Mengyang , Yao Yuou , Hu Jie , Tang Jiyang , Tang Ran , Piao Zhenyu , Qu Jinfeng
Published: September 2020

Purpose. To study the short-term anatomical and functional outcomes in patients with neovascular age-related macular degeneration (nAMD) who were previously treated with conbercept and switched to ranibizumab or bevacizumab due to persistent activity. Methods. This retrospective single-arm study included nAMD patients who were followed up for at least three months after switching from at least 3 monthly intravitreal conbercept injections to bevacizumab or ranibizumab for persistent choroidal neovascularization (CNV) activity. The demographic data, treatments, best-corrected visual acuity (BCVA), central macular thickness (CMT), and the height of pigmented epithelial detachment (PED) before and after switching were recorded and analyzed. Results. A total of 64 eyes of 64 patients were included with a mean follow-up of 9.6 ± 3.0 months. The average number of injections of conbercept was 3.6 ± 0.8 (range, 3–5) before switching. 18 eyes were switched to bevacizumab, and the other 46 eyes were switched to ranibizumab. After switching, mean BCVA slowly improved from 0.73 ± 0.48 to 0.64 ± 0.41 (p=0.0132) at one month after the last intravitreal injection of ranibizumab or bevacizumab during the mean follow-up of 4.4 ± 2.0 months. One month after switching, the mean CMT decreased significantly from 294.9 ± 121.8 μm to 230.9 ± 107.0 μm (p<0.0001) and kept stable during the follow-up. There was a significant reduction of maximum PED height (mPEDH) at the first month after switching (from 384.3 ± 340.3 μm to 287.2 ± 245.2 μm, p=0.0018) and kept stable during the follow-up. The mean PED height at foveal center (cPEDH) showed a regression over time after switching (from 169.3 ± 230.6 μm to 130.5 ± 180.2 μm, p=0.0227) and also kept stable during the follow-up. The proportion of patients with IRF was slightly increased but not statistically significant before switching. After switching, this proportion decreased significantly from 96.9% to 81.3% at one month after the first intravitreal injection of ranibizumab or bevacizumab (p=0.0086). The proportion of patients with SRF did not change significantly before and after switching. The mean decrease of mPEDH and cPEDH at the last follow-up after switching was significantly larger in the IVR subgroup than in the IVB subgroup (p=0.023 and 0.010). Conclusion. Our results indicate that switching from intravitreal conbercept injections to bevacizumab or ranibizumab can lead to significant improvement of CMT, PED, and IRF and slight improvement of BCVA in a short period of time for persistent nAMD patients.
The Role of Lifestyle Factors in Controlling Blood Pressure among Hypertensive Patients in Two Health Facilities in Urban Ghana: A Cross-Sectional Study
Authors: Modey Amoah Emefa , Esinam Okai Darlene , Manu Adom , Laar Amos , Akamah Joseph , Torpey Kwasi
Published: September 2020

Introduction. Despite efforts to combat hypertension by pharmacotherapy, hypertension control rates remain low. Lifestyle modifications of individuals diagnosed with hypertension have prospects for the prevention and control of hypertension. This study assessed the effect of modifiable lifestyle factors on blood pressure control among adults in urban Accra. Methods. In this cross-sectional study, 360 diagnosed hypertensive patients who were ≥18 years old, selected from two secondary-level referral hospitals in the Greater Accra Region, were interviewed. Demographic information, diet components, and exercise assessments as well as blood pressure measurements were taken. Chi-squared tests and binomial logistic regression were used to determine the association between demographic and lifestyle factors with blood pressure control. Area under the receiver-operator curves (AUROC) was used to identify lifestyle factors predicting optimal blood pressure control among patients diagnosed with hypertension. Results. Approximately 54.2% of participants had no knowledge of either causes or complications of hypertension. Similarly, 52.5% of patients that had not achieved blood pressure control lacked knowledge of causes or complications of hypertension. Longer time since diagnosis of 2–5 years (AOR = 0.08 (95% CI: 0.01–0.47)) and 6–10 years (AOR = 0.08 (95% CI: 0.01–0.50)) and diets, mainly composed of meat (AOR = 0.13 (95% CI: 0.02–0.70)) and starch (AOR = 0.14 (95% CI: 0.03–0.79)), predicted poor blood pressure control compared to patients diagnosed within a year and diets without meat and starch as main components, respectively. Additionally, engaging in some physical activity of 30 minutes to one hour (AOR = 5.64 (95% CI: 2.08–15.32)) and more than an hour (AOR = 11.38, 95% CI: 2.01–64.47)) predicted blood pressure control. Conclusion. The study concludes that increased physical activity, abstaining from alcohol and smoking, increased intake of fruits and vegetables, and reduced intake of carbohydrates, meat, and fat have a positive influence on blood pressure control. Lifestyle modifying factors have a key role in complementing pharmacotherapy in hypertension control.
Deletion of Bmal1 Impairs Pancreatic β‐Cell Function via Mitochondrial Signaling Pathway
Authors: Ye Lu , Wu Huaxiang , Xu Weihong
Published: September 2020

Several studies have demonstrated that brain and muscle Arnt‐like protein‐1 (Bmal1) acts as a core clock gene for maintaining normal cell function, including hepatocytes and cardiomyocytes. Loss of Bmal1 is associated with type 2 diabetes due to pancreatic β‐cell failure. However, little information is available about its role and mechanism in pancreatic β‐cell. To address this, we investigated the consequences of Bmal1 inhibition in an insulinoma cell line (INS‐1) by using small interfering RNA (siRNA). We observed that knockout of Bmal1 impaired glucose‐stimulated insulin secretion in β‐cell. Meanwhile, the depletion of Bmal1 in β‐cell caused an adverse change in mitochondrial membrane potential and mitochondrial architecture. Deletion of Bmal1 attenuated mRNA and protein expression of mitofusin 1 (Mfn1) and mitofusin 2 (Mfn2) and enhanced the expression of fission 1 (Fis1). In summary, the deletion of Bmal1 impaired β‐cell function may be via the mitochondrial signaling pathway in INS‐1 cells.
Impuestos no tienen cuarentena
Authors: Borges Humberto , Gallardo Luis
Published: September 2020

Cuando en China se realizaba una cuarentena estricta y en parte de Europa se encendían las alarmas por la aparición del COVID-19, en Chile se promulgó la Ley 21.210, publicada el 24 de febrero de 2020, y denominada “Modernización Tributaria”. Además, de los cambios de regímenes tributarios, se han establecido nuevos tributos: los Impuestos a los Servicios Digitales (ISD) e Impuestos Regionales. Continuar leyendo...
Plataformas digitales
Authors: De Elejalde Ramiro
Published: September 2020

La pandemia ha resaltado la importancia de las plataformas digitales en la vida de las personas. Hacemos las compras en el supermercado con Cornershop. Nos movilizamos por Uber. Las reuniones de trabajo son vía Zoom o Microsoft Teams. Buscamos información con Google. Compramos ropa o juguetes por Amazon. Descargamos aplicaciones del Apple store o Google play. Continuar leyendo...
Metabolic Syndrome and Cognition: Follow-Up Study of Chinese Over-55-Year-Olds
Authors: Przybycien-Gaweda Paulina Maria , Gwee Xinyi , Gao Qi , Chua Denise Qian Ling , Fam Johnson , Ng Tze Pin
Published: September 2020

Background/Aim: Studies of the associations of the metabolic syndrome (MetS) with cognitive function and decline are inconclusive. We investigated the associations of the MetS with cognitive functions in 823 Chinese >55-year-olds followed up over 4.5 years. Methods: The relationships between the MetS and baseline and follow-up z-scores of cognitive domain functions were examined using mixed model analysis. Results: There were specific inverse cross-sectional associations of single cardiometabolic risk factors with cognition, such as hyperglycemia with processing speed (p = 0.045). The MetS was negatively associated with 3 out of 4 cognitive domains (p = 0.018 to p = 0.003), and the count of cardiometabolic risk factors with all cognitive domains (p = 0.025 to p = 0.002). Longitudinally, dyslipidemia was associated with worse decline in memory and learning (p = 0.022). The count of cardiometabolic risk factors was associated with worse declines in cognition (p = 0.032 for global cognition). Conclusion: Among middle-aged and older Asians, an increased number of component cardiometabolic risk factors of the MetS was associated with a worse decline in cognitive function over time.
Placebo Response in Phase 3 Trials of Systemic Therapies for Moderate-to-Severe Plaque Psoriasis: A Systematic Review and Meta-Analysis
Authors: Ambikaibalan Danni , Quaade Anna Sophie , Halling Anne-Sofie , Thyssen Jacob P. , Egeberg Alexander
Published: September 2020

Background: Wide fluctuations in placebo responses have been reported in phase 3 trials of systemic therapies for moderate-to-severe plaque psoriasis. Methods: In this systematic review and meta-analysis, we assessed placebo responses in phase 3 trials of systemic therapies for moderate-to-severe plaque psoriasis. The medical databases PubMed Medline, Embase, and Web of Science were searched for studies reporting on phase 3 psoriasis trials. A proportion meta-analysis determined the proportion of placebo-treated psoriasis patients obtaining a 75, 90, or 100% reduction in Psoriasis Area and Severity Index (PASI), that is, PASI75, PASI90, or PASI100, respectively, at week 12. In the assessment of PASI75 response, 44 trials with a total number of 7,972 patients were included. Conclusion: In pooled analyses, 5.2% (95% CI 4.7–5.7%) obtained PASI75, 2.1% (95% CI 1.7–2.4%) obtained PASI90, and 0.3% (95% CI 0.1–0.5%) obtained PASI100 among placebo receivers. No temporal changes were observed. The overall proportion of placebo responders in phase 3 psoriasis trials is low and does not appear to be increasing in recent years.
Comparison of Primary and Delayed Ureteroscopy for Ureteric Stones: A Prospective Non-Randomized Comparative Study
Authors: Mckay Alastair , Somani Bhaskar K. , Pietropaolo Amelia , Geraghty Robert , Whitehurst Lily , Kyriakides Rena , Aboumarzouk Omar M.
Published: September 2020

Background: Primary ureteroscopy (P-URS) has been shown to be as safe and as efficacious as preoperative stent insertion followed by a delayed ureteroscopy (D-URS). However, studies are of limited patient cohort. Methods: A prospective study comparing P-URS and laser fragmentation for ureteric stones to those who received a stent insertion followed by D-URS and stone fragmentation. Results: A total of 367 consecutive patients were included. P-URS was conducted on 235 patients and D-URS on 132 patients. There was no overall difference between patient or stone demographics between the 2 groups, although there were more proximal ureteric and pelvi-ureteric junction stones in the preoperative stent group. The mean operative times were comparable with a stone free rate of 97 and 94% in the preoperative stent and no-stent groups, respectively. The overall complication rates were comparable. Conclusion: The current study provides evidence for the feasibility, safety, and efficacy of P-URS for ureteric calculi in a publicly funded healthcare setting with results comparable to those patients with a preoperative stent and delayed procedure. Therefore, cumulatively, P-URS could lead to less hospitalization, length of stay, stent-related morbidity, and ultimately will be more cost-effective.
Pulse-heating infrared thermography inspection of bonding defects on carbon fiber reinforced polymer composites
Authors: Wen Bo , Zhou Zhenwei , Zeng Bin , Yang Caiqian , Fang Da , Xu Qing , Shao Yanchao , Wan Chunfeng
Published: September 2020

Non-destructive analysis of fiber reinforced polymer (FRP) composites is important for confirming the long-term safety and durability of concrete structures. In this study, a pulse-heating infrared thermography technique was used to detect and characterize bonding defects of externally bonded carbon fiber reinforced polymers (CFRP) on concrete surface structures. The CFRP composite contains various bonding defects of three different sizes located at five different depths. Sequential thermal images were obtained to describe the temperature contrast and shapes of the bonding defects. Through analysis of the maximum temperature response, we investigated the effects of defect size and depth on the defect temperature response. The relationship between the defect depth and maximum temperature response was used to quantitatively estimate the defect depth. In addition, finite element simulations were performed on the CFRP composites with bonding defects to investigate the temperature response of various defects, which showed good agreement with the experimental results. This confirms the effectiveness of the infrared thermography method to detect and characterize bonding defects of FRP composites bonded on concrete structures.
Design and performance analysis of a new optimization algorithm based on Finite Element Analysis
Authors: Ning Zhiqiang , Gao Youshan , Wang Aihong
Published: September 2020

Aiming at the problem that many algorithms could not effectively balance the global search ability and local search ability, a new optimization algorithm is proposed. Inspired by Finite Element Analysis (FEA) approach, a relationship of mapping between Finite Element Analysis approach and a population-based optimization algorithm is constructed through comparing the similarities and differences of FEA node and ideal particle. In algorithm framework, the stiffness coefficient corresponds to a user-defined function of the value of an objective function to be optimized, and the node forces among individuals are defined and an attraction-repulsion rule is established among them. The FEA approach that can simulate multi- states of matter is adopted to balance the global search ability and local search ability in the novel optimization algorithm. A theoretical analysis is made for algorithm parallelism. The conditions for convergence are deduced through analyzing the algorithm based on discrete-time linear system theory. In addition, the performance of the algorithm is compared with PSO for five states which include free state, diffusion state, solid state, entirely solid state, synthesis state. The simulation results of six benchmark functions show that the algorithm is effective. The algorithm supplies a new method to solve optimization problem.
Types of Vulnerable Household across Social Classes in Rural India
Authors: Deb Surajit
Published: September 2020

The eighth part of the Social Change Indicators series presents data on vulnerable households, that is, mean household size, percentage of female-headed households, percentage of households with no literate adult, percentage of households with no adult member and percentage of landless households dependent on manual casual labour across different social classes in rural areas of different states.
Development and Validation of a Clinical Score for Predicting the Risk of Tympanosclerosis Before Surgery
Authors: Dong Zhihuai , Zhou Mingguang , Ye Gaofei , Ye Jing , Xiao Mang
Published: September 2020

Objective:

To develop and validate a clinical score to predict the risk of tympanosclerosis before surgery.

Methods:

A sample of 404 patients who underwent middle ear microsurgery for otitis media was enrolled. These patients were randomly divided into 2 cohorts: the training cohort (n = 243, 60%) and the validation cohort (n = 161, 40%). The preoperative predictors of tympanosclerosis were determined by multivariate logistic regression analysis and implemented using a clinical score tool. The predictive accuracy and discriminative ability of the clinical score were determined by the area under the curve (AUC) and the calibration curve.

Results:

The multivariate analysis in the training cohort (n = 243, 60%) identified independent factors for tympanosclerosis as the female sex (odds ratio [OR]: 3.83; 95% CI: 1.66-9.37), the frequency-specific air-bone gap at 250 Hz ≥ 45 dB HL (OR: 3.68; 95% CI: 1.68-8.57), aditus ad antrum blockage (OR: 3.29; 95% CI: 1.38-8.43), type I eardrum calcification (OR: 25.37; 95% CI: 8.41-88.91) or type II eardrum calcification (OR: 18.86; 95% CI: 6.89-58.77), and a history of otitis media ≥ 10 years (OR: 4.10; 95% CI: 1.58-11.83), which were all included in the clinical score tool. The AUC of the clinical score for predicting tympanosclerosis was 0.89 (95% CI: 0.85-0.93) in the training cohort and 0.89 (95% CI: 0.84-0.95) in the validation cohort. The calibration curve also showed good agreement between the predicted and observed probability.

Conclusions:

The clinical score achieved an optimal prediction of tympanosclerosis before surgery. The presence of calcification pearls on the promontorium tympani is a strong predictor of tympanosclerosis with stapes fixation.
Precision Health and Nursing: Seeing the Familiar in the Foreign
Authors: Dewell Sarah , Benzies Karen , Ginn Carla
Published: September 2020

Precision health is the integration of personal genomic data with biological, environmental, behavioral, and other information relevant to the care of a patient. Genetics and genomics are essential components of precision health. Genetics is the study of the effects of individual genes, and genomics is the study of all the components of the genome and interactions between genes, environmental factors, and other psychosocial and cultural factors. Knowledge about the role of genetics and genomics on health outcomes has increased substantially since the completion of the human genome project in 2003. Insights about genetics and genomics obtained from bench science are now having positive clinical implications on patient health outcomes. Nurses have the potential to make distinct contributions to precision health due to their unique role in the health care system. In this article, we discuss gaps in the development of precision health in nursing and how nursing can expand the definition of precision health to actualize its potential. Precision health plays a role in nursing practice. Understanding this connection positions nurses to incorporate genetic and genomic knowledge into their nursing practice.
A Century of Political Influence: The Evolution of the Canadian Nurses Association’s Policy Advocacy Agenda
Authors: Chiu Patrick , Villeneuve Michael J. , Paul Pauline
Published: September 2020

The Canadian Nurses Association has a long-standing history of strengthening the nursing profession and the health system, supporting professional practice, and advocating for healthy public policy at the local, national, and global level. Historical writings have typically focused on the significant milestones achieved throughout the past century, and the various social, political, and economic contexts that have shaped the evolution of the association. While historical sources illustrate an organization with a strong track record of policy advocacy leadership and presence, there is little literature that has examined how the association’s policy advocacy agenda has evolved overtime. Using Shamian’s emerging “Bubble” Theory and Spheres of Policy Influence Model as an analytical framework, the authors use historical archives and documents to examine the internal and external drivers that have shaped the association’s policy advocacy agenda over the past century and conclude that the Canadian Nurses Association has established itself as a credible leader in shaping not only nursing but also health-care and public policy at the local, national, and global level.
Chinese NGOs at the interface between governmentality and local society: An actor-oriented perspective
Authors: Liu Qing , Palmer David A.
Published: September 2020

The relations between society and non-governmental organizations (NGOs) have been relatively neglected in the field of China NGO studies, which remains largely wedded to a state–NGO problematic within a state–society framework. In this anthropological study of an NGO’s post-Wenchuan earthquake recovery programme, we adopt an actor-oriented approach to identify the main lines of tension between the strategies, rationalities, and techniques deployed by the different actors in the field. Focusing on NGO–society relations, we take the NGO not as an incarnation of society vis-a-vis the state, nor as an incarnation of the state vis-a-vis society, but as a key link in a shifting chain of state and non-state actors that aims to introduce to local society an assemblage of techniques, discourses, and values for the promotion of self-government. This ‘international development package’ is a specific form of what social scientists have theorized as ‘governmentality’. In this case study, the modalities of participation and cooperative self-government promoted within this development package are in tension with local values, social relations, and political structures. The case shows that dynamic tensions between the actors are mediated by the deployment of practices of governance that circulate between international institutions and networks, state agencies, NGOs, and local authorities and actors.
Damage detection of bridges based on combining efficient cepstral coefficients
Authors: Babajanian Bisheh Hossein , Ghodrati Amiri Gholamreza , Nekooei Masoud , Darvishan Ehsan
Published: September 2020

In this article, a novel vibration-based damage detection approach is proposed based on selecting effective cepstral coefficients, consisting of three main stages: (1) signal processing and feature extraction, (2) damage detection by combining effective cepstral coefficients through feature selection methods, and (3) performance evaluation. First, two feature extraction techniques are used in damage identification systems, including linear prediction cepstral coefficients and mel frequency cepstral coefficients. Second, to improve the performance of damage detection, the combination of the effective cepstral coefficients is proposed as a damage index. By applying several feature selection methods, the most effective coefficients are found and then combined to create a subset that carries the most significant information about the structural damage. Finally, the support vector machine classifier is performed to evaluate the proposed approach in detecting the structural damage. The proposed technique is verified using a suite of numerical and full-scale studies. Results confirm that the proposed method achieves a significant performance with great accuracy and reduces false alarms.
Dr Hope Landrine, 1954–2019: In memoriam
Authors: Marks David F
Published: September 2020

A note of commemoration of the life and work and Dr Hope Landrine, 1954–2019. Dr Landrine was Associate Editor of the Journal of Health Psychology for two decades and a frequent contributor to the journal. Hope Landrine’s research in the health psychology and public health fields was pioneering and pathfinding. Dr Landrine’s focus on ethnic minorities, specifically those living in segregated and poor neighbourhoods, is a significant corpus of work that provides a challenging perspective on social justice in health care.
Use of Indocyanine Green and Fluorescence Angiography in Parathyroid Surgery: A Feasibility Study
Authors: Maser Christina , Kohlbrenner Amanda H. , Dirks Rachel
Published: September 2020

Background. Indocyanine green (ICG) with near-infrared (NIR) fluorescence is an established method for assessing vascularity in various clinical settings. We hypothesized that parathyroid adenomas, with increased capillary networks, may demonstrate a fluorescence which could aid intraoperative identification and confirmation of the abnormal parathyroid tissue. Methods. This prospective case–control study compared patients with primary hyperparathyroidism undergoing parathyroidectomy (cases) to normal parathyroid in thyroidectomy patients (controls). After exposing the parathyroid gland, ICG was injected and the fluorescence of parathyroid and thyroid was recorded and graded in comparison to the surrounding tissue and vasculature (0 = nonfluorescent and 5 = vasculature). Results. The intensity of parathyroid fluorescence was more in cases (4 ± 2) than controls (2 ± 1) when graded intraoperatively ( P = .001). Thyroid fluorescence did not differ (3 vs 3, P = .072); however, parathyroid fluorescence was more intense than thyroid in cases (parathyroid = 4 ± 2 and thyroid = 3 ± 1, P = .018). Conclusions. ICG fluorescence in diseased parathyroid was more intense than normal parathyroid and thyroid, suggesting the ICG/NIR technology may be a useful intraoperative tool for identification of abnormal parathyroid.
Upper Gastrointestinal Endoscopy in an Academic General Surgical Program: Implications for Acute Care Surgeons
Authors: Ross James T. , Liang Norah E. , Lebares Carter C. , Carter Jonathan T. , Harris Hobart W. , Cello John P. , Rogers Stanley J. , Lin Matthew Y. C.
Published: September 2020

Background. Esophagogastroduodenoscopy (EGD) is an important tool in the evolving specialty of acute care surgery (ACS). Understanding the types of nonelective EGDs performed by ACS groups is important for the development of ACS programs and the training of future general surgeons. Methods. We conducted a retrospective review of all EGDs performed by ACS surgeons at a single urban academic center over a 5-year period (January 2013-December 2018). Results. A total of 495 EGDs were performed, of which 129 (26%) were urgent, nonelective procedures. Patients who underwent urgent EGD were younger than those who underwent elective procedures (median 55 vs 60 years, P = .03), had higher American Society of Anesthesiologists (ASA) classes (median ASA 3 vs 2, P = .0002), and longer hospital stays (median 5 days vs 0 days, P < .0001). The most common indications for urgent endoscopies were the management of leak, dysphagia, or stenosis in patients with a history of foregut surgery, followed by the management of esophageal perforation. The success rate of endoscopic therapy was high (median 88%, interquartile range (IQR) 78-89%). However, some patients required multiple interventions (median 1, IQR 1-3), and patients treated for leaks were less likely to be successfully treated with endoscopic therapy alone than patients treated for other indications (success rate 65% vs 88%, P = .003). Conclusions. Our experience suggests that EGD has an important role in current ACS practice and that endoscopic management is safe and effective in a range of urgent surgical scenarios. Future ACS surgeons should be facile with endoscopic techniques.
Prevalence of oligomenorrhea among women of childbearing age in China: A large community-based study
Authors: He Yilei , Zheng Danni , Shang Wei , Wang Xiaohong , Zhao Shuyun , Wei Zhaolian , Song Xueru , Shi Xiaobo , Zhu Yimin , Wang Shuyu , Li Rong , Qiao Jie
Published: September 2020

Objective:

To investigate the prevalence and the related characteristics of oligomenorrhea among women within childbearing age in China.

Study design:

A large-scale community-based investigation was conducted from 2013 to 2015. A total of 12,964 women aged 18–49 years from 9 provinces/municipalities in China were recruited for healthcare screening in local community health centers. Outcome measures include clinical history, ultrasonographic exam, and hormonal and metabolic parameters.

Results:

Among women within childbearing age in China, the prevalence of oligomenorrhea was 12.2% (1,579/12,964). Both sociodemographic factors and medical history were significantly associated with oligomenorrhea ( P < 0.05). In such women, the prevalence of obesity, acne, seborrhea, acanthosis, larger ovarian size, and polycystic ovarian morphology was higher when compared with normal women; the prevalence of anti-Mullerian hormone, total testosterone, and androstenedione ( P < 0.05) was higher as well. The infertility rates of all women were higher in the oligomenorrhea group (17.2%, 272⁄1,579) than in the non-oligomenorrhea group (9.0%, 1,024⁄11,385), and among women without contraception, for the oligomenorrhea group, the infertility rate was 32.5% (128⁄394), and for the non-oligomenorrhea group, 17.9% (400⁄2,240). In the oligomenorrhea group, 57.4% (156/272) of the women underwent treatments for infertility, which was higher than the non-oligomenorrhea group 36.1% (370/1,024).

Conclusions:

Obesity, acne, seborrhea, acanthosis, larger ovarian size, and polycystic ovarian morphology were significantly associated with oligomenorrhea. The increase of anti-Mullerian hormone, total testosterone, and androstenedione level was also demonstrated in the oligomenorrhea group. Higher prevalence of infertility and medical treatment rate was observed in women with oligomenorrhea.
Contested technology: Social scientific perspectives of behaviour-based insurance
Authors: Tanninen Maiju
Published: September 2020

In this review, I analyse how ‘behaviour-based personalisation’ in insurance – that is, insurers’ increased interest in tracking and manipulating insureds’ behaviour with, for instance, wearable devices – has been approached in recent social scientific literature. In the review, I focus on two streams of literature, critical data studies and the sociology of insurance, discussing the new (i.e. health and life) insurance schemes that utilise sensor-generated and digital data. The aim of this review is to compare these two approaches and to analyse what kinds of understandings, methodologies and theoretical perspectives they apply to so-called ‘behaviour-based insurance’. The critical data studies literature emphasises the exploitative aspects of these new technologies and mobilises behaviour-based insurance to exemplify the negative outcomes of digital health. Scholars from the field of the sociology of insurance empirically analyse the practices of behavioural-based personalisation and study how regulating and ‘doing’ insurance affect attempts to personalise it. I highlight the importance of approaching insurance as a specific financial technology and argue that more research is needed to understand the practices of developing behaviour-based insurance schemes and the insureds’ experiences.
Oncocytic Cysts of the Nasopharynx: A Case Report
Authors: Hwang Joshua C. , Dedhia Raj D. , Bernard Joan E. , Steele Toby O.
Published: September 2020

Background

Nasopharyngeal oncocytic lesions are a spectrum of benign lesions that represent a reactive or hyperplastic response to chronic inflammation. Though oncocytic lesions are typically asymptomatic, unilateral, and benign, this article discusses a rare case of large, bilateral oncocytic cysts and downstream otologic sequelae with a focus on identifying and discussing similar disease processes.

Methods

Case report and literature review. Case Presentation: A 67-year-old patient with 57 pack year smoking history presented for one year of left sided hearing loss and aural fullness. Clinic endoscopic exam demonstrated severe inflammatory and cystic changes lining the bilateral tori. Imaging and tissue sampling confirmed the cause was minor salivary gland cysts with papillary projections lined by oncocytic cells within bilateral tori tubarius. He was successfully treated with myringotomy with pressure equalizing tube, counseling on tobacco cessation, and surveillance with serial nasopharyngoscopy.

Conclusions

Chronic eustachian tube dysfunction is a possible rare presentation and sequelae of large oncocytic cysts of the nasopharynx. Oncocytic cysts should be considered on the differential diagnosis for nasopharyngeal masses causing such dysfunction.
Genome Wide Analysis of the Transcriptional Profiles in Different Regions of the Developing Rice Grains
Authors: Wu Ting-Ying , Müller Marlen , Gruissem Wilhelm , Bhullar Navreet K.
Published: September 2020

Background

Rice is an important food source for humans worldwide. Because of its nutritional and agricultural significance, a number of studies addressed various aspects of rice grain development and grain filling. Nevertheless, the molecular processes underlying grain filling and development, and in particular the contributions of different grain tissues to these processes, are not understood.

Main Text

Using RNA-sequencing, we profiled gene expression activity in grain tissues comprised of cross cells (CC), the nucellar epidermis (NE), ovular vascular trace (OVT), endosperm (EN) and the aleurone layer (AL). These tissues were dissected using laser capture microdissection (LCM) at three distinct grain development stages. The mRNA expression datasets offer comprehensive and new insights into the gene expression patterns in different rice grain tissues and their contributions to grain development. Comparative analysis of the different tissues revealed their similar and/or unique functions, as well as the spatio-temporal regulation of common and tissue-specific genes. The expression patterns of genes encoding hormones and transporters indicate an important role of the OVT tissue in metabolite transport during grain development. Gene co-expression network prediction on OVT-specific genes identified several distinct and common development-specific transcription factors. Further analysis of enriched DNA sequence motifs proximal to OVT-specific genes revealed known and novel DNA sequence motifs relevant to rice grain development.

Conclusion

Together, the dataset of gene expression in rice grain tissues is a novel and useful resource for further work to dissect the molecular and metabolic processes during rice grain development.
Metabolome and transcriptome analyses of the molecular mechanisms of flower color mutation in tobacco
Authors: Jiao Fangchan , Zhao Lu , Wu Xingfu , Song Zhongbang , Li Yongping
Published: September 2020

Background

Anthocyanins determinate the flower color of many plants. Tobacco is a model plant for studying the molecular regulation of flower coloration. We investigated the mechanism underlying flower coloration in tobacco by profiling flavonoid metabolites,expression of anthocyanin biosynthetic structural genes and their regulator genes in the pink-flowered tobacco cultivar Yunyan 87 and white-flowered Yunyan 87 mutant.

Result

Significant down-accumulation of anthocyanins, including cyanidin 3-O-glucoside, cyanin, cyanidin 3-O-rutinoside, pelargonidin 3-O-beta-D-glucoside, cyanidin O-syringic acid, pelargonin, and pelargonidin 3-O-malonylhexoside (log2fold change < − 10), endowed the flower color mutation in Yunyan 87 mutant. Transcriptome analysis showed that the coordinately down-regulated anthocyanin biosynthetic genes including chalcone isomerase, naringenin 3-dioxygenase, dihydroflavonol 4-reductase and UDP-glucose:flavonoid 3-O-glucosyltransferase played critical roles in suppressing the formation of the aforesaid anthocyanins. Several genes encoding MYB and bHLH transcription factors were also found down-regulated, and probably the reason for the suppression of structural genes.

Conclusion

This is the first study of tobacco flower coloration combining metabolome and transcriptome analyses, and the results shed a light on the systematic regulation mechanisms of flower coloration in tobacco. The obtained information will aid in developing strategies to modify flower color through genetic transformation.
Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: a randomized, double-blind, placebo-controlled study
Authors: Feng Kunpeng , Wang Xiaohua , Feng Xuexin , Zhang Jinfeng , Xiao Wei , Wang Fengying , Zhou Qi , Wang Tianlong
Published: September 2020

Background

Hypotension following spinal anesthesia (SA) during cesarean delivery (CD) occurs commonly and is related with maternal and fetal complications. Norepinephrine infusion is increasingly used for prevention of post-SA hypotension; however, its effects as compared to the traditional phenylephrine infusion remain unclear. This study aimed to compare the effects of phenylephrine and norepinephrine administered as continuous infusion during elective CD on maternal hemodynamic parameters and maternal and fetal outcomes.

Methods

This prospective, single-center, randomized, controlled study included 238 consecutive term parturients who underwent CD from February 2019 to October 2019. They were randomized to receive continuous infusion of 0.25 μg/kg/min phenylephrine, 0.05 μg/kg/min norepinephrine, or placebo. Hemodynamic monitoring was performed at 10 time points using LiDCOrapid. We analyzed umbilical vein (UV), umbilical artery (UA), and peripheral vein (PV) blood gas indexes and recorded intraoperative complications.

Results

In phenylephrine group, the systolic blood pressure (SBP) remain during the whole operation. Compared to the control group, phenylephrine, but not norepinephrine, significantly increased the systemic vascular resistance (SVR) to counteract the SA-induced vasodilatation, 3 min following norepinephrine/phenylephrine/LR administration (T4): 957.4 ± 590.3 vs 590.1 ± 273.7 (P < 0.000001); 5 min following norepinephrine/phenylephrine/LR administration (T5): 1104 ± 468.0 vs 789.4 ± 376.2 (P = 0.000002). at the time of incision (T6): 1084 ± 524.8 vs 825.2 ± 428.6 (P = 0.000188). Parturients in the phenylephrine group had significantly lower UV (1.91 ± 0.43) (P = 0.0003) and UA (2.05 ± 0.61) (P = 0.0038) lactate level compared to controls. Moreover, the UV pH value was higher in the phenylephrine than in the control group7.37 ± 0.03(P = 0.0013). Parturients had lower incidence of nausea, tachycardia, hypotension in phenylephrine group.

Conclusions

In this dataset, continuous phenylephrine infusion reduced the incidence of SA-induced hypotension, ameliorated SVR, while decreasing overall maternal complications. Phenylephrine infusions are considered the better choice during CD because of the significant benefit to the fetus.

Trial registration

Clinicaltrial.gov Registry, NCT03833895, Registered on 1 February 2019.
The role of Asprosin in patients with dilated cardiomyopathy
Authors: Wen Ming-Shien , Wang Chao-Yung , Yeh Jih-Kai , Chen Chun-Chi , Tsai Ming-Lung , Ho Ming-Yun , Hung Kuo-Chun , Hsieh I-Chang
Published: September 2020

Background

Asprosin is a novel fasting glucogenic adipokine discovered in 2016. Asprosin induces rapid glucose releases from the liver. However, its molecular mechanisms and function are still unclear. Adaptation of energy substrates from fatty acid to glucose is recently considered a novel therapeutic target in heart failure treatment. We hypothesized that the asprosin is able to modulate cardiac mitochondrial functions and has important prognostic implications in dilated cardiomyopathy (DCM) patients.

Methods

We prospectively enrolled 50 patients (86% male, mean age 55 ± 13 years) with DCM and followed their 5-year major adverse cardiovascular events from 2012 to 2017. Comparing with healthy individuals, DCM patients had higher asprosin levels (191.2 versus 79.7 ng/mL, P < 0.01).

Results

During the 5-year follow-up in the study cohort, 16 (32.0%) patients experienced adverse cardiovascular events. Patients with lower asprosin levels (< 210 ng/mL) were associated with increased risks of adverse clinical outcomes with a hazard ratio of 7.94 (95% CI 1.88–33.50, P = 0.005) when compared patients with higher asprosin levels (≥ 210 ng/mL). Using cardiomyoblasts as a cellular model, we showed that asprosin prevented hypoxia-induced cell death and enhanced mitochondrial respiration and proton leak under hypoxia.

Conclusions

In patients with DCM, elevated plasma asprosin levels are associated with less adverse cardiovascular events in five years. The underlying protective mechanisms of asprosin may be linked to its functions relating to enhanced mitochondrial respiration under hypoxia.
A tutorial on methodological studies: the what, when, how and why
Authors: Mbuagbaw Lawrence , Lawson Daeria O. , Puljak Livia , Allison David B. , Thabane Lehana
Published: September 2020

Background

Methodological studies – studies that evaluate the design, analysis or reporting of other research-related reports – play an important role in health research. They help to highlight issues in the conduct of research with the aim of improving health research methodology, and ultimately reducing research waste.

Main body

We provide an overview of some of the key aspects of methodological studies such as what they are, and when, how and why they are done. We adopt a “frequently asked questions” format to facilitate reading this paper and provide multiple examples to help guide researchers interested in conducting methodological studies. Some of the topics addressed include: is it necessary to publish a study protocol? How to select relevant research reports and databases for a methodological study? What approaches to data extraction and statistical analysis should be considered when conducting a methodological study? What are potential threats to validity and is there a way to appraise the quality of methodological studies?

Conclusion

Appropriate reflection and application of basic principles of epidemiology and biostatistics are required in the design and analysis of methodological studies. This paper provides an introduction for further discussion about the conduct of methodological studies.
Feasibility of a mobility programme for people with dementia in the respite care setting: results of the DESKK study
Authors: Heinrich Steffen , Horstmannshoff Caren , Holle Bernhard
Published: September 2020

Background

Caring for people with dementia (PwD) is often challenging for caregiving relatives. Respite care (RC) is a commonly used short-term inpatient service. The provision of RC can serve as a link between home care and institutional care and can help to stabilize the care provided at home. During RC, the everyday functional skills of PwD can be improved or stabilized through systematic mobility training. However, no specific mobility programme exists for this setting. The aim of the DESKK study was to develop and test a mobility training programme for PwD in the RC setting in Germany.

Methods

A quasi-experimental pilot study was conducted in a specialized RC centre for PwD. Qualitative and quantitative data were collected and analysed using a mixed methods design.

Results

The DESKK mobility programme may be introduced in the RC setting depending on the required time and professional resources. The mobility programme had a high acceptance rate among the staff involved. Ongoing documentation of the mobility exercises were challenging. During their stay (2–4 weeks), the physical function level of the included PwD (n = 20) increased regarding leg strength, gross motor coordination, fine coordination of the fingers and hand strength.

Conclusions

The DESKK mobility programme showed a high acceptance rate by the staff and was usable in daily care routine for the most part. These aspects indicate that the programme has the potential to be successfully implemented in the RC setting. The DESKK concept is described in the form of a practice-friendly website to facilitate its use in clinical practice after its successful evaluation.