bluuebunny/crossref_metadata_2025 huggingface dataset:
Paradigm shift in the treatment options of hepatocellular carcinoma
Authors: Su Tung‐Hung , Hsu Shih‐Jer , Kao Jia‐Horng
Published: September 2021

Hepatocellular carcinoma (HCC) is prevalent worldwide with suboptimal therapeutic outcomes. The advancement of therapeutic options and the development of new systemic therapies expand the armamentarium to tackle HCC. Treatment options should be provided based on the hierarchy of efficacy in a multidisciplinary perspective, instead of the traditional stage‐guided scheme. In advanced HCC, lenvatinib has a comparable efficacy as sorafenib for the first‐line therapy of HCC; while regorafenib, cabozantinib, and ramucirumab have been approved as second‐line therapy after the failure of sorafenib. Immune checkpoint inhibitor therapy prolongs response rate and survival and enables long‐term cure. Atezolizumab plus bevacizumab is superior to sorafenib as the first‐line therapy for advanced HCC. Several emerging regimens by the combination of various systemic therapies are currently under clinical trials. Systemic therapy may be used in the neoadjuvant, adjuvant or even as initial therapy for intermediate‐stage HCC. The paradigm shift of HCC treatment will improve patient outcomes.
Helpful factors in a healthcare professional intervention for low‐back pain: Unveiled by Heidegger's philosophy
Authors: Angel Sanne
Published: September 2021

Low‐back pain can be invalidating physically as well as mentally. Despite professional help to treat and prevent low‐back pain, the pain often persists, and so do the problems related to low‐back pain. An intervention that made it possible for a significant part of patients with low‐back pain to improve health and well‐being raised the question: Why was it possible to help some and not others? The aim of the present paper was to achieve a deeper understanding of factors patients experienced as helpful in professional support related to low‐back pain. This was explored using a hermeneutic‐phenomenological approach while analysing 20 interviews with patients with low‐back pain purposively chosen interviews conducted in relation to the intervention. An analysis was made using Ricoeur's interpretation theory. Data on both positive and negative experiences were read and reflected upon. We found that healthcare professionals’ adoption of a narrative approach facilitating the patient's perspective was perceived as helpful. Patients experienced this as being taken seriously; an experience that could be explained at a deeper, more nuanced level using Heidegger's philosophy. Facilitating the patient's perspective was conditional not only on the professional obtaining access to the patient's perspective but also on understanding and acknowledging the patient's existence. The challenge for healthcare professionals in this respect is to bridge the gap between the consultation's fact‐focused concern with the medical implications of low‐back pain and the patient's concern with the implications low‐back pain has for his or her personal identity and life. Listening to the patient's perspective in itself supports the subjective recovery process, while also supporting the quality of patient‐centred support and strengthening the patient's trust in its helpfulness.
Robot‐Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Spondylolisthesis
Authors: Cui Guan‐yu , Han Xiao‐guang , Wei Yi , Liu Ya‐jun , He Da , Sun Yu‐qing , Liu Bo , Tian Wei
Published: September 2021

Objective

To compare the clinical efficacy between robot‐assisted minimally invasive transforaminal lumbar interbody fusion (robot‐assisted MIS‐TLIF) and traditional open TLIF surgery in the treatment of lumbar spondylolisthesis.

Methods

According to the inclusion and exclusion criteria, 48 cases with lumbar spondylolisthesis who received surgical treatment from June 2016 to December 2017 in the spinal surgery department of Beijing Jishuitan Hospital were analyzed in this study, including 23 patients who received robot‐assisted MIS‐TLIF and 25 patients who received traditional open TLIF surgery. The two groups were compared in terms of pedicle screw accuracy evaluated by Gertzbein‐Robbins classification on postoperative computed tomography (CT), operation time, blood loss, postoperative drainage, hospitalization, time to independent ambulation, low back pain evaluated by visual analog scale (VAS), lumbar function evaluated by Oswestry Disability Index (ODI), paraspinal muscles atrophy on magnetic resonance imaging (MRI), and complications.

Results

Postoperative CT showed that the rate of Grade A screws in the robot‐assisted MIS‐TLIF group was significantly more than that in the open surgery group (χ2 = 4.698, P = 0.025). Compared with the open surgery group, the robot‐assisted MIS‐TLIF group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospitalization, shorter time to independent ambulation, and lower VAS at 3 days post‐operation (P < 0.05). However, the duration of surgery was longer. The VAS of the robot‐assisted MIS‐TLIF group decreased from 6.9 ± 1.8 at pre‐operation to 2.1 ± 0.8 at post‐operation, 1.8 ± 0.7 at 6‐month follow‐up and 1.6 ± 0.5 at 2‐year follow‐up. The VAS of the open surgery group decreased from 6.5 ± 1.7 at pre‐operation to 3.7 ± 2.1 at post‐operation, 2.1 ± 0.6 at 6‐month follow‐up and 1.9 ± 0.5 at 2‐year follow‐up. The ODI of the robot‐assisted MIS‐TLIF group decreased from 57.8% ± 8.9% at pre‐operation to 18.6% ± 4.7% at post‐operation, 15.7% ± 3.9% at 6‐month follow‐up and 14.6% ± 3.7% at 2‐year follow‐up. The ODI of the open surgery group decreased from 56.9% ± 8.8% at pre‐operation to 20.8% ± 5.1% at post‐operation, 17.3% ± 4.2% at 6‐month follow‐up and 16.5% ± 3.8% at 2‐year follow‐up. Paraspinal muscle cross‐sectional area in 2‐year follow‐up in patients of the open surgery group decreased significantly compared to patients of robotic‐assisted MIS‐TLIF group (P = 0.016).

Conclusion

In the treatment of lumbar spondylolisthesis, robot‐assisted MIS‐TLIF may lead to more precise pedicle screw placement, less intraoperative blood loss, less postoperative drainage, less postoperative pain, quicker recovery, and less paraspinal muscle atrophy than traditional open surgery.
Investigation of Diagnostic Biomarkers for Osteoporosis Based on Differentially Expressed Gene Profile with QCT and mDixon‐Quant Techniques
Authors: Zhu Shan , Tian Aixian , Guo Lin , Xu Hua , Li Xiaofeng , Wang Zhi , He Feng
Published: September 2021

Objective

To develop a comprehensive differential expression profile for osteoporosis based on two independent data sources.

Methods

Using a hindlimb unloading (HLU) rat model to mimic osteoporosis syndrome in humans (animal experiments), the significant differentially expressed mRNAs in osteoporosis were analyzed using RNA‐seq. The enriched GO terms as well as KEGG signaling pathways were also deeply investigated. Using clinical specimens to verify the functions of potential hub genes (biomarkers) for osteoporosis (clinical experiments), 128 suspected cases for osteoporosis from January 2019 to December 2020 were randomly selected and analyzed by quantitative computed tomography (QCT) as well as modified Dixon quantification (mDixon‐Quant) techniques in the Tianjin hospital. Among these, 80 patients out of 128 suspected cases were finally diagnosed as the osteoporosis group. Meanwhile, 48 patients were selected for osteopenia group. There was no significant age and gender difference across participant subgroups. The protein levels of potential hub genes (FST, CCL3, and RAPGEF4) were determined by ELISA double antibody sandwich method for osteopenia and osteoporosis groups from peripheral blood.

Result

In the RNA‐seq analysis, compared with control group, a total of 803 differentially expressed mRNAs were identified, including 288 up‐regulated and 515 down‐regulated mRNAs. Of these, FST, CCL3, CPE, RAPGEF4, IL6, MDFI, PDZD2, and GATM were primary hub genes (biomarkers) for osteoporosis. These differentially expressed genes were significantly enriched in GO terms related to extracellular matrix process and KEGG signaling pathways including osteoclast differentiation. In the functional experiments, the protein expression level of FST, CCL3, and RAPGEF4 displayed a specific expression pattern between osteoporosis patients and control group. The protein concentration of FST was 23.63 ± 6.39 ng/mL in osteoporosis patients compared as 48.36 ± 9.12 ng/mL in osteopenia group (P < 0.01). Meanwhile, CCL3 was 1.03 ± 0.64 ng/mL in osteoporosis patients vs 0.56 ± 0.24 in osteopenia group (P < 0.01) and RAPGEF4 was 53.58 ± 11.42 ng/mL in osteoporosis patients vs 66.47 ± 13.28 ng/mL in osteopenia group (P < 0.05), respectively.

Conclusion

This study has identified potential gene biomarkers (the genes with most significantly differential expression and useful for distinguishing osteoporosis from other bone disorders) and established a differential expression profile for osteoporosis, which is a valuable reference for future clinical research.
Melanocytic nevi on the hyponychium with dermoscopic features of longitudinal brush pigmentation in children
Authors: Lee Jongeun , Bae Jaihee , Lee Dongyoun
Published: September 2021

The dermoscopic features of longitudinally aligned pigmentation on the hyponychium were previously described in pediatric patients with longitudinal melanonychia. We report four cases of biopsy‐proven acral melanocytic nevi on the hyponychium with a longitudinal brush pigmentation (LBP) pattern in dermoscopy. This LBP pattern on the hyponychium may be a counterpart of the fibrillar pattern of acral melanocytic nevi. Therefore, the LBP pattern in dermoscopy may provide a useful clue for distinguishing benign melanocytic nevi from melanoma in pediatric patients.
Disseminated and recurrent infundibulofolliculitis in children in Mexico
Authors: Sánchez‐Cárdenas Carlos Daniel , Vega‐Memije María Elisa , Flores‐Gavilán Paola , Romero Marina , Arenas Roberto , Sánchez Ramon L.
Published: September 2021

Disseminated and recurrent infundibulofolliculitis is an uncommon non‐infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.
Varieties of skeptical invariantism II
Authors: Kyriacou Christos
Published: September 2021

Abstarct

In the first installment of Varieties of Skeptical Invariantism, we set the scene for subsequent discussion with Unger's (1975) modern classic of global skepticism and distinguished three varieties of skeptical invariantism in recent literature: traditional skeptical invariantism, fallibilist science‐based skepticism and practical skepticism. We then presented fallibilist science‐based skepticism, that is, the position that relaxes the stringency of the standard of knowledge but still questions parts of our everyday knowledge on the basis of scientific reasons. In particular, we presented Frances’ (2005) ‘live’ skepticism and Hannon's (forthcoming) ‘hard‐hitting’ skepticism. In this second installment, we present the two other varieties of skeptical invariantism we identified: traditional skepticism (high‐standard and infallibilist) that respects all three commitments (intellectualism, invariantism, stringency) and practical skepticism that questions the intellectualist commitment.
Mutagenicity Profile Induced by UVB Light in Human Xeroderma Pigmentosum Group C Cells†
Authors: Quintero‐Ruiz Nathalia , Corradi Camila , Moreno Natália Cestari , de Souza Tiago Antonio , Pereira Castro Ligia , Rocha Clarissa Ribeiro Reily , Menck Carlos Frederico Martins
Published: September 2021

Nucleotide excision repair (NER) is one of the main pathways for genome protection against structural DNA damage caused by sunlight, which in turn is extensively related to skin cancer development. The mutation spectra induced by UVB were investigated by whole‐exome sequencing of randomly selected clones of NER‐proficient and XP‐C‐deficient human skin fibroblasts. As a model, a cell line unable to recognize and remove lesions (XP‐C) was used and compared to the complemented isogenic control (COMP). As expected, a significant increase of mutagenesis was observed in irradiated XP‐C cells, mainly C>T transitions, but also CC>TT and C>A base substitutions. Remarkably, the C>T mutations occur mainly at the second base of dipyrimidine sites in pyrimidine‐rich sequence contexts, with 5′TC sequence the most mutated. Although T>N mutations were also significantly increased, they were not directly related to pyrimidine dimers. Moreover, the large‐scale study of a single UVB irradiation on XP‐C cells allowed recovering the typical mutation spectrum found in human skin cancer tumors. Eventually, the data may be used for comparison with the mutational profiles of skin tumors obtained from XP‐C patients and may help to understand the mutational process in nonaffected individuals.
Distribution of major clonal lineages EU_13_A2, EU_2_A1, and EU_23_A1 of Phytophthora infestans associated with potato late blight across crop seasons and regions in Algeria
Authors: Beninal Lyes , Bouznad Zouaoui , Corbière Roselyne , Belkhiter Sihem , Mabon Romain , Taoutaou Abdelmoumen , Keddad Abdelaziz , Runno‐Paurson Eve , Andrivon Didier
Published: September 2021

Potato is one of the most important agricultural crops in Algeria and worldwide. Each year, potato late blight, caused by Phytophthora infestans, is responsible for significant damage that leads to large production losses, and is thus a direct threat to food security in Algeria. In this study, 131 isolates of P. infestans and 92 DNA fingerprints captured on FTA cards were sampled from commercial and seed production fields in three major potato production regions (western, eastern, and central) during the main‐season and late‐season in Algeria over six cropping seasons (2010–2016). Genotypes of P. infestans and population genetic diversity were analysed using a 17‐plex simple‐sequence repeat (SSR) marker assay, and the mating type of all isolates was characterized. Both mating types (A1 and A2) were found, and often occurred in the same field. Differences in mating type proportion were observed between regions and between sampling periods. Analysis with SSR markers showed the prevalence of the EU_13_A2 lineage (70%) over EU_2_A1 (16%), EU_23_A1 (10%), and 4% of unknown multilocus lineage (MLL). The EU_13_A2 showed differentiation within the group. EU_23_A1 was found mainly in late‐season crops. However, the cropping region did not influence the distribution of lineages due to the dispersal of the pathogen in Algeria by seeds. Genetic structure did not reveal a clear variation in distribution of the three lineages throughout the sampling regions. These data provide important new information on the composition and change over time of P. infestans populations in Algeria and open the way for a better understanding of the local epidemiology of this important pathogen.
Biological and molecular characterization of two closely related carlaviruses affecting brassica plants
Authors: Oliveira Agatha M. , Rodrigues Leilane K. , Chabi‐Jesus Camila , Chaves Alexandre L. R. , Kitajima Elliot W. , Harakava Ricardo , Banguela‐Castillo Alexander , Ramos‐González Pedro L. , Eiras Marcelo
Published: September 2021

Carlaviruses are plant‐infecting viruses with flexuous filamentous particles of approximately 650 nm in length and a positive single‐stranded hexacistronic RNA molecule as the genome. In this study, we analysed 14 samples of brassicas plants, reportedly affected by carlaviruses, that were collected in distant and edaphoclimatic distinct regions in Brazil. The genomes of four viral isolates detected in leaf kale (Brassica oleracea var. acephala) plants displayed the typical genomic organization of carlaviruses, subdivided into two contrasting identity profiles. Isolates T25, T107, and T110 showed a higher sequence identity among them (c.93%) than with T90 (c.67%), which had the highest nucleotide sequence identity (85.2%) with the only documented genomic fragment, approximately 1 kb of the RNA 3′‐end, of cole latent virus (CoLV). Identity values among the other three isolates and CoLV were consistently lower than 78.6%. Nucleotide and amino acid sequence identity values of the replicase cistron of the isolates T25 and T90 are below the threshold for species demarcation in the genus Carlavirus. Upon mechanical transmission, these two isolates induced different symptoms in brassicas and solanaceous plants. Overall, data indicated that these viruses belong to two related but distinct species of carlaviruses. While T90 was recognized as an isolate of CoLV, the remaining isolates were considered members of a new tentative carlavirus named Cole mild mosaic virus (CoMMV). Current work provides convincing support for the taxonomic status of the species Cole latent virus, enlarges the known diversity of carlaviruses, and makes available new molecular tools to improve surveys of brassica‐infecting viruses.
Volatility transmission and volatility impulse response functions in the main and the satellite Renminbi exchange rate markets
Authors: Funke Michael , Loermann Julius , Tsang Andrew
Published: September 2021

The contributions of this paper are two‐fold, one methodological and the other substantive. First, we propose a novel way of estimating volatility impulse response functions (VIRF) employing the Markov chain Monte Carlo algorithm. As a useful byproduct, the associated confidence bands can be constructed. Second, we analyze volatility spillovers between the on‐ and offshore Renminbi exchange rates toward the US dollar. The VIRF show that the satellite CNH exchange rate promptly reflects the global market demand and supply, while the main CNY exchange rate reacts with a time lag.
Language, culture, gender, and intersectionalities in suicide theory, research, and prevention: Challenges and changes
Authors: Canetto Silvia Sara
Published: September 2021

Over the decades suicidology has experienced many challenges and changes. Language, culture, gender, and intersectionalities of experience have been domains of challenge and change. In this article I document my contributions to suicidology’s transformation in these domains. These contributions include challenging stigmatizing and biased suicide‐language (e.g., expressions like “successful” and “failed” suicide); questioning gender myths of suicidal behaviors (e.g., the myth that women and men are opposites in terms of suicide motives); the gender‐paradox‐of‐suicide idea; and suicide‐scripts theory and research. I then describe the evolution of suicide‐scripts theory. Suicide‐scripts theory builds on evidence that in each culture there are unique situations when suicidal behavior is expected from specific people, using specific methods, and with specific social consequences. The theory posits that these scripts contribute to variations in suicidality across cultures, and within cultures, across sociodemographic groups, intersectionally. Studies using a diversity of methodologies and focusing on a diversity of sociodemographic groups and cultures point to the role of suicide scripts in suicidality. The article concludes with a discussion of the implications, for suicide prevention, of suicide‐scripts theory and evidence.
Incorporation or Quasi‐Incorporation? A Constructionist Account in Persian
Authors: Bahrami‐Khorshid Sahar , Ghorbanpour Amir
Published: September 2021

Noun incorporation is generally defined as a word formation process in which a noun, typically the direct object, is incorporated into the verb to form a compound verb. The present study, adopting a Construction Morphology perspective, examines the characteristics of the so‐called incorporative structure in Persian, to shed light on the process and to see as what kind of structure it can actually be regarded. Construction Morphology is a lexeme‐based theory taking the words as the starting point of morphological analysis. It makes use of the notion of “construction”, which is defined as a pairing of form and meaning, to describe the properties of complex words. Examining the characteristics of the incorporative structures in Persian makes it clear that these NV sequences form compounds with a specific constructional meaning that often denotes a nameworthy and conventional activity. The qualities examined suggest that this process in Persian and the resulting structure can best be analysed as a case of quasi‐incorporation, schematised as [N0 V0]V0, rather than a purely morphological incorporation.
Finite Element Modeling of Powder Bed Fusion at Part Scale by a Super-Layer Deposition Method Based on Level Set and Mesh Adaptation
Authors: Zhang Yancheng , Gandin Charles-André , Bellet Michel
Published: September 2021

A super-layer deposition method is developed for 3D macroscopic finite element modeling of heat transfer at part scale during the powder bed fusion (PBF) process. The proposed super-layer strategy consists of the deposition of batches of several layers. The main consideration is to deal with the effective heating times and with the inter-layer dwell time in a reasonable way. The material is deposited at once for each super-layer thanks to level set and mesh adaptation methods, while the energy input is prescribed, either by respecting the layer-by-layer thermal cycle or in a single thermal load. The level set method is used twice: first to track the interface between gas and the successive super-layers of powder bed and second to track the interface between the part in construction and the nonexposed powder. To preserve simulation accuracy, adaptive remeshing is used to maintain a fine mesh near the evolving construction front during the process. Simulation results obtained by means of this super-layer method are presented and discussed by comparison with those obtained by layer-by-layer strategy, considered here as a reference. It is shown that, when respecting certain conditions, temperature evolutions and distributions approaching the reference ones can be obtained with significant savings on computation time. Assessment is first performed on simple part, then on a more complex configuration.
Influence of the ultrasonic vibration on system dynamic responses in the multi-ball surface burnishing process
Authors: Cong Ding , Zhou Zhen-yu , Piao Zhong-yu , Mao Zhanpeng
Published: September 2021

With the urgent demand of high-end equipment for high quality surfaces, the technique of ultrasonic vibration-assisted burnishing is introduced to strengthen the surface properties. To explore the influence of the ultrasonic vibration on the dynamic response of a burnishing system, the burnishing friction force generated from a multi-ball surface burnishing system was characterized by chaos theory. The system had four assisted forms: no ultrasonic vibration, one-dimensional (1D) ultrasonic in x-axis, 1D ultrasonic in z-axis, and 2D ultrasonic in xz-axis. The results showed that any burnishing system had chaotic nature. Under the 2D ultrasonic vibration-assisted burnishing, the burnishing friction force was reconstructed to be a chaotic attractor with high convergence degree. Moreover, the burnishing system has notable complexity and stability. The burnished Al7075 alloy sample has an excellent surface with a higher smoothness and hardness. The burnishing with 2D ultrasonic vibration in xz-axis is a technique to enhance surface properties.
Analysis of Compositions of Flowback Water From Marcellus Shale Wells by Utilizing Data Mining Techniques
Authors: Pan Yuewei , Wang John Yilin
Published: September 2021

Volume and salt concentrations in Marcellus flowback water depend on geology, drilling and completions, stimulation and flowback operations. Recent studies include evaluations of geochemical origins based on the compostition concentrations, flowback sampling analysis and numerical studies. However, an in-depth understanding of chemical compositions as well as the changes of compositions is still needed. In this paper, we will first review the literature related to flowback water in Marcellus shale gas wells to fully understand the chemistry, geochemistry, and physics governing a fracture treatment, shut-in, and flowback. We will then gather all public and in-house flowback data, named as 3-week or 3-month flowback in this work, to build a data set of flowback water compositions. After data screening, we will then analyze this database using four different methods: geographical changes over time, linear regression, clustering, and multi-variable analysis. New understandings such as the magnitude and prevailing trends of concentrations for target constituents as well as the correlations among flowback compositions, the differentiation between early and late-time flowback water were obtained and explained on the basis of geochemistry and physics. This helps production companies and other stakeholders to better manage and reuse waste water for energy production.
Study on Coal Seam Damage Caused by Liquid Nitrogen Under Different Ground Temperature Conditions
Authors: Wang Zekai , Gao Feng , Cai Chengzheng , Su Shanjie , Du Menglin
Published: September 2021

The thermal stress caused by the ultra-low temperature of liquid nitrogen (LN2) can seriously affect the porosity of the coalbed. In this paper, the effects of various temperature differences on the LN2 damage were studied by changing the initial temperature, so as to explore the effect of LN2 on coal seam with different buried depth. The X-ray diffraction (XRD), scanning electron microscope (SEM), wave velocity, acoustic emission (AE), and uniaxial compression experiments were used in the experiments. The experimental results show that LN2 causes a lot of damage to coal and the LN2 effect increase at first and then decrease with the increase of the initial temperature. When the initial temperature is 293 K, before and after liquid nitrogen treatment, the wave velocity damage of the coal sample reaches 0.2207 and the compressive strength decreases by 27.92%. These two values are 0.3697 and 47.37% at the initial temperature of 323 K, and 0.2727 and 28.27% at the initial temperature of 353 K. This is because if the temperature exceeds 353 K, it will cause a 3.17% drop in water content, thus reducing the damage caused by LN2, resulting in the overall effect slightly lower than that at 323 K.
Maturity-Associated Variations in Resistance Exercise-Induced Hormonal Responses in Young Male Athletes
Authors: Sekine Yuta , Hirose Norikazu
Published: September 2021

Purpose: To examine differences in resistance exercise-induced hormonal responses among young athletes according to their maturity levels. Materials and Methods: A total of 12 collegiate and 32 junior high school male athletes were enrolled. The junior high school participants were divided into pre–peak height velocity (PHV) and post-PHV groups, according to their PHV ages. The salivary testosterone, cortisol, and human growth hormone levels were analyzed before (pre), immediately after (post), and at 15 minutes after performing body weight resistance exercise. Results: The testosterone levels were higher in the collegiate than in the junior high school group (P < .01) and increased after 15 minutes of exercise (P < .01). A significant decrease in the cortisol levels postexercise in the junior high school groups (P < .01) and an increase in the human growth hormone levels at 15 minutes after exercise in the post-PHV group were observed (P < .01). In the collegiate and post-PHV groups, the testosterone-to-cortisol ratio increased post and at 15 minutes after exercise (P < .01). The testosterone-to-cortisol ratio values were higher in the collegiate than in the post-PHV (at preexercise and at 15 min after [P < .01]) and pre-PHV groups (at all times [P < .01]). Conclusion: Exercise-induced acute hormonal responses to resistance exercise may depend on individuals’ maturity levels, even in those having the same age.
A Multivariable Analysis to Evaluate the Presence or Absence of Gender Differences in Baseline ImPACT Composite Scores and Symptom Severity Ratings in Student-Athletes Ages 12–18 Years
Authors: Hannah Theodore C. , Jumreornvong Oranicha , Marayati Naoum F. , Spiera Zachary , Ali Muhammad , Li Adam Y. , Durbin John R. , Dreher Nick , Gometz Alex , Lovell Mark , Choudhri Tanvir
Published: September 2021

Introduction: Gender differences in neurocognitive function have been reported over the past few decades. However, multiple studies that report gender differences in Immediate Post-Concussion Assessment and Cognitive Tests composite scores ignore potential confounders which may lead to inaccurate results. Methods: A total of 4829 male and 2477 female baseline Immediate Post-Concussion Assessment and Cognitive Tests from 2009 to 2019 of subjects ages 12–18 years were used to evaluate gender differences in baseline neurocognitive scores and symptom severity ratings. Regression analyses were used to assess the effects of gender on neurocognitive performance at baseline while controlling for a number of potential confounders including symptom burden at the time of testing. Results: Differences in 3 of 5 composite scores as well as severity rating scores were maintained in multivariate analysis. Females had increased Post-Concussion Symptom Scale (β = 3.54, 95% confidence interval, 2.91 to 4.16, P < .0001) along with higher verbal memory (β = 1.82, 95% confidence interval, 1.15 to 2.50, P < .0001) and visual motor (β = 1.29, 95% confidence interval, 0.85–1.72, P < .0001) scores. Conclusions: Statistically significant gender differences were found in baseline neurocognitive function. This study clarifies for the first time that gender differences in these neurocognitive domains are not simply an artifact of differences in symptom burden. However, the small effect sizes call into question the clinical relevance of these differences.
Species-Specific Differences in C-5 Sterol Desaturase Function Influence the Outcome of Azole Antifungal Exposure
Authors: Luna-Tapia Arturo , Parker Josie E. , Kelly Steven L. , Palmer Glen E.
Published: September 2021

The azole antifungals inhibit sterol 14α-demethylase (S14DM), leading to depletion of cellular ergosterol and the synthesis of an aberrant sterol diol that disrupts membrane function. In
Candida albicans
, sterol diol production is catalyzed by the C-5 sterol desaturase enzyme encoded by
ERG3
.
Mucosal Immunization with DTaP Confers Protection against
Bordetella pertussis
Infection and Cough in Sprague-Dawley Rats
Authors: Hall Jesse M. , Bitzer Graham J. , DeJong Megan A. , Kang Jason , Wong Ting Y. , Wolf M. Allison , Bevere Justin R. , Barbier Mariette , Damron F. Heath
Published: September 2021

Pertussis is a respiratory disease caused by the Gram-negative pathogen,
Bordetella pertussis
. The transition from a whole-cell pertussis vaccine (wP and DTP) to an acellular pertussis vaccine (aP, DTaP, and Tdap) correlates with an increase in pertussis cases, despite widespread vaccine implementation and coverage, and it is now appreciated that the protection provided by aP rapidly wanes.
Differential Surface Competition and Biofilm Invasion Strategies of Pseudomonas aeruginosa PA14 and PAO1
Authors: Kasetty Swetha , Katharios-Lanwermeyer Stefan , O’Toole George A. , Nadell Carey D.
Published: September 2021

Recent studies indicate that
P. aeruginosa
PAO1 and PA14 use distinct strategies to initiate biofilm formation. We investigated whether their respective colonization and matrix secretion strategies impact their ability to compete under different biofilm-forming regimes.
Novel Amiloride Derivatives That Inhibit Bacterial Motility across Multiple Strains and Stator Types
Authors: Islam M. I. , Bae J. H. , Ishida T. , Ridone P. , Lin J. , Kelso M. J. , Sowa Y. , Buckley B. J. , Baker M. A. B.
Published: September 2021

Here, we characterized two novel amiloride derivatives in the search for antimicrobial compounds that target bacterial motility. Our two compounds were shown to inhibit flagellar motility at 10 μM across multiple strains: from nonpathogenic
Escherichia coli
with flagellar rotation driven by proton or chimeric sodium-powered stators, to proton-powered pathogenic
E. coli
(enterohemorrhagic
E. coli
or uropathogenic
E. coli
[EHEC or UPEC, respectively]), and finally, sodium-powered
Vibrio alginolyticus
.
Carbon isotope excursions during the late Miocene recorded by lipids of marine Thaumarchaeota, Piedmont Basin, Mediterranean Sea
Authors: Sabino Mathia , Birgel Daniel , Natalicchio Marcello , Pierre Francesco Dela , Peckmann Jörn
Published: September 2021

Group I mesophilic Thaumarchaeota fix dissolved inorganic carbon (DIC), accompanied by a biosynthetic fractionation factor of ~20‰. Accordingly, the δ13C signature of their diagnostic biomarker crenarchaeol was suggested as a potential δ13CDIC proxy in marine basins if input from nonmarine Thaumarchaeota is negligible. Semi-enclosed basins are sensitive to carbon-cycle perturbations, because they tend to develop thermohaline stratification. Water column stratification typified the semi-enclosed basins of the Mediterranean Sea during the late Miocene (Messinian) salinity crisis (5.97–5.33 Ma). To assess how the advent of the crisis affected the carbon cycle, we studied sediments of the Piedmont Basin (northwestern Italy), the northernmost Mediterranean subbasin. A potential bias of our δ13CDIC reconstructions from the input of soil Thaumarchaeota is discarded, since high and increasing branched and isoprenoid tetraether (BIT) index values do not correspond to low and decreasing δ13C values for thaumarchaeal lipids, which would be expected in case of high input from soil Thaumarchaeota. Before the onset of the crisis, the permanently stratified distal part of the basin hosted a water mass below the chemocline with a δ13CDIC value of approximately −3.5‰, while the well-mixed proximal part had a δ13CDIC value of approximately −0.8‰. The advent of the crisis was marked by 13C enrichment of the DIC pool, with positive δ13CDIC excursions up to +5‰ in the upper water column. Export of 12C to the seafloor after phytoplankton blooms and limited replenishment of remineralized carbon due to the stabilization of thermohaline stratification primarily caused such 13C enrichment of the DIC pool.
Types of the Dipterans of the Families Cypselosomatidae, Micropezidae, and Tethinidae (Diptera, Acalyptratae) in the Collection of the Zoological Institute of the Russian Academy of Sciences in St. Petersburg
Authors: Nartshuk E. P. , Paramonov N. M. , Suleymanova T. A.
Published: September 2021

A catalogue of the types (holotypes, paratypes, lectotypes, and paralectotypes) of the species of the families Cypselosomatidae, Micropezidae, and Tethinidae (Diptera, Acalyptratae) described by T. Becker, V.L. Beschovski, E.P. Nartshuk, A.L. Ozerov, A.I. Shatalkin, and Á. Soós, deposited in the collection of the Zoological Institute of the Russian Academy of Sciences in St. Petersburg, is presented. The lectotype of Calobata nigrolamellata Becker, 1907 is designated. Photographs of the specimens and their labels are given.
Otoneurological presentations of COVID-19
Authors: Shinde Kiran J , Karanth Tulasi , Yeolekar Aditya M
Published: September 2021

COVID-19 usually begins with respiratory symptoms but may also cause neurological disturbances by direct (viral invasion) or indirect (immune-mediated) mechanism. Common neurological injury described in the literature include infectious toxic encephalopathy, viral encephalitis and Guillain-Barré syndrome. We present two cases diagnosed with COVID-19 who presented with isolated neurological deficit along facial nerve and vestibular nerve. Both recovered with medical management and rehabilitative exercises. Isolated neurological impairment in otorhinolaryngological practice may be the primary presentation or delayed feature of COVID-19.
First reported case of a coronal hamate fracture associated with intrusion of the fifth metacarpal base, together with a fracture of the fourth metacarpal base
Authors: Pace Valerio , Placella Giacomo , Rinonapoli Giuseppe , Caraffa Auro
Published: September 2021

We present a case reporting a rare combination of base of fourth metacarpal fracture and coronal body of hamate fracture, treated conservatively with excellent results. High index of suspicion for undetected bony injuries drove the execution of a CT scan, which allowed us to make a full correct diagnosis and plan treatment. Moreover, this case becomes the first reported case in the literature of such injury causing the intrusion of the base of the fifth metacarpal within the hamate bone, thus causing the coronal pattern of the hamate fracture. Differently from the common surgical management of this type of injury, we successfully treated this patient with close reduction and immobilisation, with full recovery after 3 months.
Pinckney fracture: do not underestimate trauma of the distal phalanx of the hallux
Authors: Nóbrega João , Ovídio Joana , Arcângelo Joana , Campagnolo João
Published: September 2021

Toe injuries are common in the emergency department and most of them are treated conservatively. In some circumstances, these injuries can present as a physeal fracture with concomitant soft-tissue injury affecting the nail bed and resulting in a hidden open fracture. To adequately treat these patients, a high index of suspicion is needed to diagnose and treat the open fractures and to prevent complications such as infection, osteomyelitis, malunion and premature physeal arrest.

We report a case of a patient that was admitted to the hospital with a Salter-Harris type I fracture of the distal phalanx of the hallux. After confirming the diagnosis, antibiotic treatment was started and the fracture was reduced and fixed.

The literature on this entity is sparse and most of the management protocols are based on its hand equivalent—the Seymour fracture, emphasising the low threshold for treating these lesions as an open fracture.
Maternal mental health and infant and young child undernutrition: protocol for a systematic review
Authors: Singh Manisha , Stacey Tomasina , Abayomi Julie , Simkhada Padam
Published: September 2021

Introduction

Mental health disorder, particularly depression, is one of the leading causes of ‘disease related disability’ in women that both affects the women but has adverse effect on their children. This can have an impact on mothers’ capacity of child care which ultimately increases the risk of infection, malnutrition, impaired growth and behavioural problems in children that might extend to adulthood too. Diminished child growth has an irreversible effect both short and long terms, affecting physical growth, brain development, performance in education, working capacity and increased risks to non-communicable diseases. To date, the reviews conducted are only limited to few countries or maternal depression or certain age group of children. Our aim is to provide a global perspective focusing on all early childhood undernutrition (under 5 years) and to see if the association between maternal mental health and child undernutrition has yielded similar or different result. Furthermore, we intend to explore the risk factors associated with copresence of maternal mental health issues and undernutrition in children.

Methods and analysis

MEDLINE (PubMed), PsycINFO, CINAHL, Cochrane Library, Global Health Library Relevant reports from the WHO, United Nations of Children Education Fund and organisations working in maternal and child health will also be searched. Database of systematic reviews and database of abstracts of reviews of effects will also be searched for relevant literature. Papers published from 1995 to 2020 in English will be included. Title, abstract or both will be screened independently by reviewers. For data analysis and synthesis, we will present all the outcomes mentioned in the studies and a subgroup analysis for age and sex will be conducted. This study aims to conduct a meta-analysis.

Ethics and dissemination

Ethical approval is not required to conduct this review.

PROSPERO registration number

CRD42020189315.
Efficacy of acupuncture in refractory irritable bowel syndrome: study protocol for a randomised controlled trial
Authors: Zhao Jun , Chen Min , Wang Xin , Ye Kun , Shi Suhua , Li Huixia , Wang Jianfang , Chen Xiaowei , Ni Jinxia , Wei Qingshuang , Shi Yunzhou , Hu Yu , Sun Jingwen , Li Da , Liu Siyuan , Li Zhigang , Zheng Hui , Yu Shu-guang
Published: September 2021

Introduction

Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder that presents with abdominal pain/discomfort and altered bowel patterns. IBS has multiple potential causes for which conventional medicines have had limited success, resulting in a significant number of patients who do not sensitively respond to pharmacotherapy for a period of 12 months and who develop a continuing symptom profile (described as refractory IBS) and seek help through (non)pharmacological treatments. The aim of this study is to investigate the efficacy and safety of acupuncture therapy for refractory IBS on the basis of conventional treatments.

Methods and analysis

A total of 170 eligible patients who meet the Rome IV criteria for refractory IBS will be randomly allocated to receive acupuncture or sham acupuncture. Each patient will receive 12 sessions of acupuncture over 4 weeks and a 4-week follow-up. The primary outcome will be the IBS Symptom Severity Score. Secondary outcomes will include the proportion of participants experiencing adequate relief of global IBS symptoms, the weekly frequency of defecation, the stool properties assessed by the Bristol Grading Scale, the Work and Social Adjustment Scale, the IBS-Quality of Life score, and the Self-Rating Depression Scale and Self-Rating Anxiety Scale anxiety and depression scores. Outcome measures will be collected at baseline, 2 and 4 weeks of the intervention, and 6 and 8 weeks after the intervention. Categorical variables will be compared with Fisher’s exact test or the Wilcoxon rank-sum test, and continuous variables will be compared using Student’s t-test or the Wilcoxon rank-sum test.

Ethics and dissemination

The entire project has been approved by the ethics committees of Beijing University of Chinese Medicine (2020BZYLL0507) and Sichuan Province Regional Institution for Conducting Research on Traditional Chinese Medicine (2020KL-025). The outcomes of the trial will be disseminated through peer-reviewed publications.

Trial registration number

NCT04276961.
Randomised controlled trial into the role of ramipril in fibrosis reduction in rheumatic heart disease: the RamiRHeD trial protocol
Authors: Ambari Ade Meidian , Setianto Budhi , Santoso Anwar , Radi Basuni , Dwiputra Bambang , Susilowati Eliana , Tulrahmi Fadilla , Wind Annemiek , Cramer Maarten Jan Maria , Doevendans Pieter
Published: September 2021

Introduction

Rheumatic heart disease (RHD) is a major burden in developing countries and accounts for 80% of all people living with the disease, where it causes most cardiovascular morbidity and mortality in children and young adults. Chronic inflammation and fibrosis of heart valve tissue due to chronic inflammation in RHD will cause calcification and thickening of the impacted heart valves, especially the mitral valve. This fibrogenesis is enhanced by the production of angiotensin II by increased transforming growth factor β expression and later by the binding of interleukin-33, which is known to have antihypertrophic and antifibrotic effects, to soluble sST2. sST2 binding to this non-natural ligand worsens fibrosis. Therefore, we hypothesise that ACE inhibitors (ACEIs) would improve rheumatic mitral valve stenosis.

Methods and analysis

This is a single-centre, double-blind, placebo-controlled, randomised clinical trial with a pre–post test design. Patients with rheumatic mitral stenosis and valve dysfunction will be planned for cardiac valve replacement operation and will be given ramipril 5 mg or placebo for a minimum of 12 weeks before the surgery. The expression of ST2 in the mitral valve is considered to be representative of cardiac fibrosis. Mitral valve tissue will be stained by immunohistochemistry to ST2. Plasma ST2 will be measured by ELISA. This study is conducted in the Department of Cardiology and Vascular Medicine, Universitas Indonesia, National Cardiac Center Harapan Kita Hospital, Jakarta, Indonesia, starting on 27 June 2019.

Ethics and dissemination

The performance and dissemination of this study were approved by the ethics committee of National Cardiovascular Center Harapan Kita with ethical code LB.02.01/VII/286/KEP.009/2018.

Trial registration number

NCT03991910.
First steps in the physician-scientist pipeline: a longitudinal study to examine the effects of an undergraduate extracurricular research programme
Authors: Ommering Belinda W C , van Blankenstein Floris M , Dekker Friedo W
Published: September 2021

Objectives

Medicine is facing a physician-scientist shortage. By offering extracurricular research programmes (ERPs), the physician-scientist training pipeline could already start in undergraduate phases of medical training. However, previous studies into the effects of ERPs are mainly retrospective and lack baseline measurements and control groups. Therefore, the current study mimics a randomised controlled trial to examine the effects of an ERP.

Design

Prospective cohort study with baseline measurement and comparable control group.

Setting

One cohort of 315 medical undergraduates in one Dutch University Medical Center are surveyed yearly. To examine the effects of the ERP on academic achievement and motivational factors, regression analyses were used to compare ERP students to students showing ERP-interest only, adjusted for relevant baseline scores.

Participants

Out of the 315 students of the whole cohort, 56 participated within the ERP and are thus included. These ERP students are compared with 38 students showing ERP-interest only (ie, control group).

Primary outcome measure

Academic achievement after 2 years (ie, in-time bachelor completion, bachelor grade point average (GPA)) and motivational factors after 18 months (ie, intrinsic motivation for research, research self-efficacy, perceptions of research, curiosity).

Results

ERP participation is related to a higher odds of obtaining a bachelor degree in the appointed amount of time (adjusted OR=2.95, 95% CI 0.83 to 10.52). Furthermore, starting the ERP resulted in higher levels of intrinsic motivation for research, also after adjusting for gender, age, first-year GPA and motivational baseline scores (β=0.33, 95% CI 0.04 to 0.63). No effect was found on research self-efficacy beliefs, perceptions of research and curiosity.

Conclusions

Previous research suggested that intrinsic motivation is related to short-term and long-term research engagement. As our findings indicate that starting the ERP is related to increased levels of intrinsic motivation for research, ERPs for undergraduates could be seen as an important first step in the physician-scientist pipeline.