bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Safety of Musculoskeletal Ultrasound Guided Aspiration and Intra-Lesional Corticosteroids Injection of Ruptured Baker’s Cyst: A Retrospective Observational Study
Authors: Mortada Mohamed , Amer Yomna A , Zaghlol Rabab S
Published: November 2020

Objective:

The aim of the work was to demonstrate the effectiveness and safety of ultrasonographic guided aspiration performed with corticosteroid injection intra-lesional for ruptured Baker cysts (BCs).

Methods:

Single-center retrospective study that included 42 patients with knee joint disorder associated with ruptured BCs were treated by ultrasonographic guided aspiration of fluid from the cyst and different points from the calf then intra-lesional injection of corticosteroids once or twice, 1 week apart. Follow up were done weekly until complete resolution of symptoms. Visual analog scale (VAS) and Rauschning-Lindgren and Lysholm Knee Scoring Scales (RLC) were used for assessment.

Results:

Clinical parameters (VAS and RLC) improved significantly in all patients at both post injection evaluation visits (1 week and 12 weeks). Ultrasonographic features improved significantly with complete disappearance of free fluid in the calf in 35 (83.3%) cases 1 week after the injection, and in 41 (97.6%) after 12 weeks. As regards BCs only 4 (9.5%) cases showed complete disappearance after 1 week and there was recurrent BCs in 38 (90.5%) cases which required reaspiration. While after 12 weeks, BCs were completely disappeared in 23 (54.8%) cases, most of the relapsed BCs were complex BCs. No side effects were reported in all cases.

Conclusion:

Ultrasonographic guided aspiration followed by injection of corticosteroids intra-lesional is an efficient and safe method for managing ruptured BCs.
Evaluation and optimization of axial piston pump textured slipper bearings with spherical dimples based on hybrid genetic algorithm
Authors: Tang Hesheng , Ren Yan , Xiang Jiawei , Anil Kumar
Published: November 2020

The spherical dimple texture have been designed on the rough surface of slipper bearing for improving the lubrication performance in axial piston pump. In this work, we have investigated and optimized the structure parameters of textures to obtain minimum friction coefficient as well as maximum loading capacity. Optimization of the geometry parameters of dimple texture by the integration of a hybrid evolutionary optimization method based on the sequential quadratic programming and genetic algorithm. Parametric analysis is applied for the evaluation of the impact level of geometry parameters on lubrication performance. The results shows that hybrid genetic method can be used for the optimization of slipper bearing with spherical dimple textures to generate lower friction coefficient and greater capacity of load carrying. The carrying capacity and friction coefficient of slipper bearing demonstrate a 64.8% and 4.5% improvements after multi-objective optimization. When the texture radius and depth are set to 18 µm and 0.8 µm, there exists the greatest load carrying force and lowest friction coefficient. This work presents a key designing guide for axial piston pump textured slipper bearings.
The COVID pandemic and social theory: Social democracy and public health in the crisis
Authors: Walby Sylvia
Published: November 2020

Social theory is developing in response to the coronavirus (COVID) crisis. Fundamental questions about social justice in the relationship of individuals to society are raised by Delanty in his review of political philosophy, including Agamben, Foucault and Žižek. However, the focus on the libertarian critique of authoritarianism is not enough. The social democratic critique of neoliberalism lies at the centre of the contesting responses to the COVID crisis. A social democratic perspective on public health, democracy and state action is contrasted with the anti-statists of left and right. This is addressed in debates on the relationship between science and governance, the place of crisis in theories of change and the conceptualisation of alternative forms of social formation. The crisis initiated by the pandemic, cascading through society, from health to economy, to polity and into violence, includes a contestation between social democratic and neoliberal visions of alternative forms of society.
Exploring the market to establish an advanced surgical community eye hospital
Authors: Sood Ishaana , Sabherwal Shalinder , DasGupta Shantanu , Chauhan Naval , Chinnakaran Anand , Nagappan Sathish , Chandra Suresh , Mishra Madhur , Kumar Mukesh , Mathur Umang , Saksena Ashish , Arora Arun K
Published: November 2020

Developing countries often cite shortage of human resource, limited accessibility, low affordability, and asymmetric availability of health care resources as the provider end barriers to health care service utilization. Using the example of a market research project undertaken to establish an advanced surgical eye hospital in the Indian state of Uttar Pradesh, a decision-grid is constructed whereby health care providers’ can make informed decisions regarding expansion and service delivery. The comparative and interpretive logic-based approach utilizes public domain data coupled with field research and is apt for those working in developing countries and/or resource-crunch settings. The paradigms laid out and discussed, provide building blocks for decision-making, which if harnessed effectively, have broad applicability in terms of reaching the previously unreached and ultimately in improving health outcomes.
A nonlinear dynamic vibration model of a defective bearing: the importance of modelling the angle of the leading and trailing edges of a defect
Authors: Larizza Francesco , Howard Carl Q , Grainger Steven , Wang Wenyi
Published: November 2020

Rolling element bearings eventually become worn and fail by developing surface defects, such as spalls, dents and pits. Previous researchers have tested bearings with defects that have sharp [Formula: see text] rectangular edges that were used to develop analytical models of a defective bearing. These models have limitations that require smooth surfaces and constant curvature of the bearing components; as well as assuming the defect profile. A method has been created to capture the surface topography of a bearing defect. A numerical model has been developed for a rolling element bearing that uses the measured defect profile and removes the limitations of models by previous researchers that use analytical expressions for contact area and force. The predicted vibration response of a bearing with a defect that has sloped leading and trailing edges on the outer and inner raceway was compared with experimental results. It was found that the new numerical model was able to predict the vibration response of a defective bearing. The defect topographies and the developed model have been made publicly available.
Dilemmas of an Academic Feminist as Manager in the Neoliberal Academy: Negotiating Institutional Authority, Oppositional Knowledge and Change
Authors: Mackay Fiona
Published: November 2020

While still rare, women are achieving important leadership roles as managers inside universities. This article explores the practical and theoretical dilemmas posed for academic feminists who enter such positions in the age of the rise of the ‘neoliberal academy’. These are familiar dilemmas for feminist bureaucrats – femocrats – working inside political, governmental, judicial and economic institutions but have been less explored with respect to the academy. What can academic feminists do when they take on middle or senior management roles? How do they experience being simultaneously the embodiment of institutional authority (to manage, regulate, quantify, monetise) as managers, as well as a source of oppositional knowledge as feminists? To what extent are there opportunities to work with the grain of an institution to challenge the gendered status quo from within? Or are academic feminists who manage inevitably co-opted and compromised? The article takes an autoethnographic approach to reflect upon the author’s experience as a ‘tempered radical’ in third tier management (as an executive dean and head of school) in a public research-intensive UK university, and to offer lessons about the radical potential of insider strategies of change.
Community-Based Social Marketing in Theory and Practice: Five Case Studies of Water Efficiency Programs in Canada
Authors: Fries Sarah , Cook Julie , Lynes Jennifer Kristin
Published: November 2020

Background:

Community-based social marketing (CBSM) offers a pragmatic five-step approach to developing a program that fosters sustainable behaviour. However, how the CBSM theoretical framework has been implemented into practice remains largely under-evaluated. To help address this gap, Lynes et al. developed 21 benchmarks to assess CBSM programs. This research builds upon these benchmarks by using both the benchmarks and additional assessment criteria to assess five Canadian programs that have used CBSM principles.

Focus:

This paper is related to research and evaluation of community-based social marketing.

Research Question:

How has the CBSM theoretical framework been implemented in practice at the community level?

Importance to the Social Marketing Field:

By exploring how five Canadian programs have implemented CBSM, this paper enables practitioners to align their programs with CBSM principles more closely. It also contributes to the literature on CBSM effectiveness.

Methods:

Five qualitative case studies were assessed, each featuring a Canadian community program seeking to influence residential water efficiency behaviour. In order to systematically assess each program’s adherence to the CBSM theoretical framework, a CBSM benchmark assessment tool that proposes additional assessment criteria to Lynes et al.’s 21 benchmarks was developed. The assessment tool allowed for replicable benchmark assessments across multiple programs. Triangulation of data from both primary (survey and interview) and secondary (peer-reviewed literature, gray literature, and online reporting) data sources informed the assessment of each case study.

Results:

On average, over the five case studies, just over half of the 21 benchmark criteria were fully integrated into the programs, whereas just under a third were partially integrated, and approximately one fifth were not integrated at all.

Recommendations for Research or Practice:

While the benchmarks were fairly well integrated overall, this paper outlines several recommendations that programs may consider to improve alignment with the CBSM theoretical framework and benchmarks. Recommendations for future research to explore CBSM effectiveness are also made.

Limitations:

Lack of generalizability due to small sample size, unable to make assessments of programmatic success, and inherent limitations of the benchmark assessment tool.
A Scoping Review of the Trauma Recovery and Empowerment Model (TREM)
Authors: Masin-Moyer Melanie , Kim Jessica Cho , Engstrom Malitta , Solomon Phyllis
Published: November 2020

The link between interpersonal trauma and negative biopsychosocial outcomes has been well-documented. Integrated treatments that address trauma, mental health, and substance use among women with trauma histories have been found to be more effective than treatments that focus separately on these concerns. Since the early 2000s, the Trauma Recovery and Empowerment Model (TREM) has been described as a “promising” integrated trauma group therapy for women. Despite widespread recognition and implementation of TREM, its effectiveness has not been clearly established. The present scoping review is the first systematic effort to describe the extant literature on TREM and aims to provide an understanding of TREM’s effectiveness by organizing and synthesizing the available empirical data. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, a systematic search was conducted using PubMed, PsycINFO, SW Abstracts, Scopus, Embase, and Web of Science. Quantitative dissertation findings not published elsewhere and peer-reviewed journal articles published in English that reported outcomes from TREM intervention research with adult women were included. Twelve of the initial 385 publications identified met the inclusion criteria and reported data from nine studies. TREM demonstrated statistically significant effects on posttraumatic stress disorder, anxiety, psychological/psychosomatic distress, and substance use. A more limited set of findings suggests that TREM may also be associated with additional gains, including self-esteem, relationship power, social support, attachment, and spiritual well-being. Future research should replicate findings, use random assignment to groups, involve larger sample sizes and more representative samples, examine optimal duration, and identify components that facilitate change.
Comprehensive Analysis of the Expression and Prognosis for MCMs in Human Gastric Cancer
Authors: Guo Fan , Kong Wei-Na , Feng Yang-Chun , Lv Jie , Zhao Gang , Wu Hui-Li , Ai Le , Zhou Xuan , Cai Xuan-Lin , Sun Wei , Ma Xiu-Min
Published: November 2020

Purposes:

Minichromosome maintenance (MCM) proteins play an important role in replication and cell cycle progression. Even so, their expression and prognostic roles in cancer remain controversial.

Methods:

To address this issue, the study investigated the roles of MCMs in the prognosis of GC by using ONCOMINE, GEPIA2, UALCAN, Cancer Cell Line Encyclopedia (CCLE), the Human Protein Atlas, Kaplan-Meier Plotter, cBioPortal, GeneMANIA, and DAVID databases.

Results:

Over expressions of mRNA and cell lines were found in all members of the MCM family, and MCMs were found to be significantly associated with pathological tumor grades in GC patients. Besides, higher mRNA expressions of MCM1/5/7 were found to be significantly associated with shorter overall survival (OS) and progression-free survival (FP) in GC patients, while higher mRNA expression of MCM4/6/9 were connected with favorable OS and FP. Moreover, a high mutation rate of MCMs (68%) was also observed in GC patients.

Conclusions:

The results indicated that MCM1/5/7 were potential targets of precision therapy for patients with GC. And MCM4/6/9 were new biomarkers for the prognosis of GC. The results of the study will contribute to supplement the existing knowledge, and help to explore therapeutic targets and enhance the accuracy of prognosis for patients with GC.
Endovascular and open surgical options in the treatment of uretero-arterial fistulas
Authors: Omran Safwan , Schäfer Hannah , Kapahnke Sebastian , Müller Verena , Bürger Matthias , Konietschke Frank , Frese Jan Paul Bernhard , Neymeyer Jörg , Greiner Andreas
Published: November 2020

Objective

To report and analyze the indications and results of endovascular and open surgical treatment for uretero-arterial fistula.

Methods

We retrospectively reviewed the clinical data of 25 consecutive patients with uretero-arterial fistulas admitted to our hospital from 2011 to 2020. Endpoints were technical success, freedom from open conversion, stent-graft/graft-related complications, and 30-day and one-year mortality.

Results

The study included 25 patients (68% female, n = 17) with 27 uretero-arterial fistulas by bilateral pathologies in two patients. The mean age was 61 ± 11 years (range 35–80). The most common predisposing factors for uretero-arterial fistula were history of pelvic operations for malignancy in 21 patients (84%), radiotherapy in 21 patients (84%), previous pelvic vascular bypass in 2 patients (8%), and iliac aneurysms in 2 patients (8%). On average, the period between the primary pelvic surgery and the diagnosis of uretero-arterial fistulas was 46 months (range 7–255). Twenty patients (80%) underwent endovascular treatment of the uretero-arterial fistulas. The primary technical success of the endovascular treatment was 95%, and the freedom from open conversion was 40% at six months and 30% at one year. Thirteen uretero-arterial fistulas (48%) underwent delayed open conversion due to recurrent bleeding in six cases (46%), stent-graft infection in three cases (23%), or pelvic abscess in four cases (31%). Primary open surgery was applied for five (20%) patients. After a mean follow-up of 34 months, early (<30 days) mortality was 8% (2/25), one-year mortality 16% (4/25), and overall mortality was 24% (6/25).

Conclusions

Uretero-arterial fistula is a late complication of prior pelvic surgery, radiation, and indwelling ureteral stents. Endovascular treatment remains an effective and less invasive modality in controlling the related life-threatening arterial bleeding of the uretero-arterial fistula. Open surgical treatment is still required for patients with local sepsis, previously failed endovascular treatment or infected stent-grafts.
Identification of DNA methylation associated enrichment pathways in adults with non-specific chronic low back pain
Authors: Aroke Edwin N , Overstreet Demario S , Penn Terence M , Crossman David K , Jackson Pamela , Tollefsbol Trygve O , Quinn Tammie L , Yi Nengjun , Goodin Burel R
Published: November 2020

Chronic low back pain (cLBP) that cannot be attributable to a specific pathoanatomical change is associated with high personal and societal costs. Still, the underlying mechanism that causes and sustains such a phenotype is largely unknown. Emerging evidence suggests that epigenetic changes play a role in chronic pain conditions. Using reduced representation bisulfite sequencing (RRBS), we evaluated DNA methylation profiles of adults with non-specific cLBP (n = 50) and pain-free controls (n = 48). We identified 28,325 hypermethylated and 36,936 hypomethylated CpG sites (p < 0.05). After correcting for multiple testing, we identified 159 DMRs (q < 0.01and methylation difference > 10%), the majority of which were located in CpG island (50%) and promoter regions (48%) on the associated genes. The genes associated with the differentially methylated regions were highly enriched in biological processes that have previously been implicated in immune signaling, endochondral ossification, and G-protein coupled transmissions. Our findings support inflammatory alterations and the role of bone maturation in cLBP. This study suggests that epigenetic regulation has an important role in the pathophysiology of non-specific cLBP and a basis for future studies in biomarker development and targeted interventions.
Age and sex distribution of beat-to-beat blood pressure variability after transient ischemic attack and minor stroke: A population-based study
Authors: Webb Alastair JS , Lawson Amy , Mazzucco Sara , Li Linxin , Rothwell Peter M
Published: November 2020

Background

Beat-to-beat blood pressure variability is associated with increased stroke risk but its importance at different ages is unclear.

Aims

To determine the age-sex distribution of blood pressure variability in patients with transient ischemic stroke or minor stroke.

Methods

In consecutive patients within six weeks of transient ischemic stroke or non-disabling stroke (Oxford Vascular Study), non-invasive blood pressure was measured beat-to-beat over five minutes (Finometer). The age-sex distribution of blood pressure variability (residual coefficient of variation) was determined for systolic blood pressure and diastolic blood pressure. The risk of top-decile blood pressure variability was estimated (logistic regression), unadjusted, and adjusted for age, sex, and cardiovascular risk factors.

Results

In 908 of 1013 patients, excluding 54 in atrial fibrillation and 51 with low quality recordings, residual coefficient of variation was positively skewed with a median systolic residual coefficient of variation of 4.2% (IQR 3.2–5.5) and diastolic residual coefficient of variation of 3.9% (3.0–5.5), with 90th centile thresholds of 7.2 and 7.3%. Median systolic residual coefficient of variation was higher in patients under 50 years (4.5 and 3.0–5.3) compared to 60–70 years (4.1 and 3.2–5.2), but rose to 4.5% (3.5–6.9) above 80 years, with an increasingly positive skew. The proportion of patients with markedly elevated blood pressure variability in the top-decile increased significantly per decade (OR 1.72, p < 0.001), after adjustment for sex and risk factors.

Conclusions

Median beat-to-beat blood pressure variability fell in midlife, reflecting loss of physiological, organized blood pressure variability. However, rates of markedly elevated blood pressure variability significantly increased with greater age, suggesting that blood pressure variability may be particularly important in older patients.
Servant leadership, leader effectiveness, and the role of political skill: A study of interscholastic sport administrators and coaches
Authors: Robinson G Matthew , Magnusen Marshall J , Neubert Mitchell , Miller Glenn
Published: November 2020

Servant leadership is a model of leadership based on ethics and benevolent service to others and has been associated with numerous positive outcomes for employees and organizations. Due to a limited number of studies examining servant leadership (SL) within sport, the purpose of this study was to investigate the relation of servant leadership and leader effectiveness outcomes in sport administration and to examine if political skill (i.e., how people influence others), was a moderator of servant leader effectiveness. A multilevel model was used to examine these questions within a sample of interscholastic athletic directors and head coaches. Findings revealed servant leadership was directly related to leader effectiveness (LE), affective organizational commitment (AOC), and job satisfaction (JS) of head coaches. Moreover, there was a significant negative interaction between servant leadership and political skill. The negative interaction may indicate that extreme values of servant leadership have opposite relations to leader effectiveness and other outcomes when political skill is present. Though a minimal effect, political skill detracts from LE in those who are perceived as exhibiting strong servant leader behaviors. Findings and limitations are discussed; questions for future research are suggested.
All-terminal network reliability estimation using convolutional neural networks
Authors: Davila-Frias Alex , Yadav Om Prakash
Published: November 2020

Estimating the all-terminal network reliability by using artificial neural networks (ANNs) has emerged as a promissory alternative to classical exact NP-hard algorithms. Approaches based on traditional ANNs have usually considered the network reliability upper bound as part of the inputs, which implies additional time-consuming calculations during both training and testing phases. This paper proposes the use of Convolutional Neural Networks (CNNs), without the reliability upper-bound as an input, to address the all-terminal network reliability estimation problem. The present study introduces a multidimensional matrix format to embed the topological and link reliability information of networks. The unique contribution of this article is the method to capture the topology of a network in terms of its adjacency matrix, link reliability, and topological attributes providing a novel use of CNN beyond image classification. Since CNNs have been successful for image classification, appropriate modifications are needed and introduced to use them in the estimation of network reliability. A regression output layer is proposed, preceded by a sigmoid layer to achieve predictions within the range of reliability characteristic, a feature that some previous ANN-based works lack. Several training parameters together with a filter multiplier (CNN architecture parameter) were investigated. The actual values and the ones predicted with the best trained CNN were compared in the light of RMSE (0.04406) and p-value (0.3) showing non-significant difference. This study provides evidence supporting the hypothesis that the network reliability can be estimated by CNNs from its topology and link reliability information, embedded as an image-like multidimensional matrix. Another important result of the proposed approach is the significant reduction in computational time. An average of 1.18 ms/network was achieved by the CNN, whereas backtracking exact algorithm took around 500 s/network.
A regularized logistic regression based model for supervised learning
Authors: Brito-Pacheco Carlos , Brito-Loeza Carlos , Martin-Gonzalez Anabel
Published: November 2020

In this work, we introduce a new regularized logistic model for the supervised classification problem. Current logistic models have become the preferred tools for supervised classification in many situations. They mostly use either L1 or L2 regularization of the weight vector of parameters. Here we take a different approach by applying regularization not to the weight vector but to the gradient vector of the function representing the separating hyper-surface. We present the mathematical analysis of the model in its continuous setting and provide experimental evidence to show that the new model is competitive with state of the art models.
Is operation safe for lung cancer patients with interstitial lung disease on computed tomography?
Authors: Tang Hai , Ren Yijiu , She Yunlang , Dai Chenyang , Wang Tingting , Su Hang , Sun Weiyan , Jiang Gening , Chen Chang
Published: November 2020

Aims:

Interstitial lung disease (ILD) is associated with the incidence of non-small cell lung cancer (NSCLC). Patients with ILD are at risk of acute exacerbation (AE) after pulmonary resection. However, there have been no recognized treatment guidelines for NSCLC patients with ILD on computed tomography (CT).

Methods:

We reviewed the medical records of 156 consecutive patients with ILD on high-resolution CT who have undergone pulmonary resection and between 2014 and 2018. Data regarding general information, imaging features, perioperative indicators, and long-term prognosis of patients were compared.

Results:

The mean patient age was 67.24 ± 6.80 years. Postoperative AE occurred in seven (4.5%) patients; five (71.4%) of the seven patients who had an AE died within 30 days. The incidence of postoperative AE was 5.3% among patients who underwent lobectomy ( n = 6). Overall survivals (OS) was significantly poorer in patients with possible usual interstitial pneumonia (UIP)/UIP [hazard ratio (HR) 2.34, 95% confidence interval (CI) 1.11–4.95, p = 0.026] and severe postoperative complications (Grade ⩾3) ( versus no complication: HR 2.58, 95% CI 1.11–6.02, p = 0.028; versus mild complications: HR 6.05, 95% CI 2.69–13.6, p < 0.001). Age (HR 1.071, 95% CI 1.006–1.137, p = 0.030) and ILD patterns (HR 2.420, 95% CI 1.024–5.716, p = 0.044) were independent prognostic factors for OS. Forced vital capacity (FVC) (odds ratio 0.351, 95% CI 0.145–0.850, p = 0.020) was an independent prognostic factor for patients who needed postoperative intensive care unit intervention.

Conclusion:

Pulmonary resection for NSCLC Patients with ILD on CT is a safe procedure. However, surgical indications for lobectomy need to be more carefully for these patients, especially for possible UIP/UIP patients and patients with lower FVC. The reviews of this paper are available via the supplemental material section.
Pan-transcriptome-based candidate therapeutic discovery for idiopathic pulmonary fibrosis
Authors: Wang Yunguan , Yella Jaswanth K. , Ghandikota Sudhir , Cherukuri Tejaswini C. , Ediga Harshavardhana H. , Madala Satish K. , Jegga Anil G.
Published: November 2020

Background:

There are two US Food and Drug Administration (FDA)-approved drugs, pirfenidone and nintedanib, for treatment of patients with idiopathic pulmonary fibrosis (IPF). However, neither of these drugs provide a cure. In addition, both are associated with several drug-related adverse events. Hence, the pursuit for newer IPF therapeutics continues. Recent studies show that joint analysis of systems-biology-level information with drug–disease connectivity are effective in discovery of biologically relevant candidate therapeutics.

Methods:

Publicly available gene expression signatures from patients with IPF were used to query a large-scale perturbagen signature library to discover compounds that can potentially reverse dysregulated gene expression in IPF. Two methods were used to calculate IPF–compound connectivity: gene expression-based connectivity and feature-based connectivity. Identified compounds were further prioritized if their shared mechanism(s) of action were IPF-related.

Results:

We found 77 compounds as potential candidate therapeutics for IPF. Of these, 39 compounds are either FDA-approved for other diseases or are currently in phase II/III clinical trials suggesting their repurposing potential for IPF. Among these compounds are multiple receptor kinase inhibitors (e.g. nintedanib, currently approved for IPF, and sunitinib), aurora kinase inhibitor (barasertib), epidermal growth factor receptor inhibitors (erlotinib, gefitinib), calcium channel blocker (verapamil), phosphodiesterase inhibitors (roflumilast, sildenafil), PPAR agonists (pioglitazone), histone deacetylase inhibitors (entinostat), and opioid receptor antagonists (nalbuphine). As a proof of concept, we performed in vitro validations with verapamil using lung fibroblasts from IPF and show its potential benefits in pulmonary fibrosis.

Conclusions:

As about half of the candidates discovered in this study are either FDA-approved or are currently in clinical trials for other diseases, rapid translation of these compounds as potential IPF therapeutics is possible. Further, the integrative connectivity analysis framework in this study can be adapted in early phase drug discovery for other common and rare diseases with transcriptomic profiles. The reviews of this paper are available via the supplemental material section.
Curcumin Oligosaccharides (Gluco-oligosaccharides) Penetrate the Blood-Brain Barrier in Mouse Brain: Glycoside (Polysaccharide) Modification Approach for Brain Drug Delivery Across the Blood-Brain Barrier and Tumor Drug Delivery
Authors: Hamada Hiroki , Nakayama Takahiro , Shimoda Kei , Matsuura Nobuyasu , Hamada Hatsuyuki , Iwaki Takafumi , Kiriake Yuya , Saikawa Tomohiro
Published: November 2020

In order to expand our drug delivery technique by glycosylation of chemical into brain delivery, it was demonstrated that oligosaccharide and monosaccharide modifications of curcumin enhanced its crossing ability of the blood-brain barrier (BBB) in mice. The brain sample prepared by glycosidase-catalyzed hydrolysis of brain tissue homogenates of mice, to which curcumin gluco-oligosaccharides were intraperitoneally injected, contained curcumin at 116 ng/1 g of tissue of brain, indicating that curcumin modified with gluco-oligosaccharides residues can smoothly cross the BBB in mouse brain. The brain samples of mice, which were treated with curcumin monosaccharide or curcumin itself, contained curcumin at 18 ng and 0 ng per 1 g of tissue of brain, respectively. On the other hand, after the administration of curcumin gluco-oligosaccharides to C57BL mouse with a large tumor for 5 days, the tumor disappeared.
Protective Effect of Corynoline in Sepsis-Induced Acute Lung Injury in Rats via Inhibition of NF-ĸB
Authors: Shu Min , Tang Yulu , Liu Jianzhen
Published: November 2020

The present study was conducted to determine the effect of corynoline (COR) against sepsis-induced acute lung injury (ALI) in Wistar rats. Results of the study suggested that COR causes significant inhibition of lipid peroxidation (malondialdehyde) together with inhibition of oxidative stress (superoxide dismutase, catalase, glutathione peroxidase, and myeloperoxidase). The level of various proinflammatory (tumor necrosis factor-alpha, interleukin-8, and migration inhibitory factor) was also found to be reduced in COR-treated rats after sepsis. The protective effect of COR was further substantiated by the histopathology of lung tissue, where it improves the architecture of alveolar spaces. In western blot analysis, COR causes significant inhibition of nuclear factor kappa-light-chain-enhancer of activated B cells activation in the lung tissue homogenate. Our results demonstrated that COR was able to prevent the progression of ALI in rats via inhibition of inflammation and oxidative stress.
A Unified Total Synthesis of Isocyclocapitelline and Cyclocapitelline
Authors: Srilatha Marepally , Satteyyanaidu Vallabhareddy , Reddy Chepyala Krishna , Basireddy Venkata Subba Reddy
Published: November 2020

A facile and concise synthesis of β-carboline alkaloids, such as (–)-isocyclocapitelline and (+)-cyclocapitelline, has been achieved from commercially available geraniol through a unified strategy. The key steps involved in this synthesis are Sharpless epoxidation, intramolecular ring opening of epoxide, Pictet-Spengler reaction, and dehydrogenative aromatization using 10% palladium/carbon in xylene under neutral conditions.
Healthcare Worker With Large Vessel Acute Ischemic Stroke Likely Related to Mild SARS-CoV-2 Infection
Authors: Castillo-Pinto Carlos , Lamotte Guillaume , Mehta Amit , Sonti Rajiv , Di Maria Gianluca , Ruiz Daniel , Kumar Princy N. , Stemer Andrew B. , Denny M. Carter
Published: November 2020

We report the case of a healthcare worker who presented with a large vessel acute ischemic stroke in setting of a mild SARS-CoV-2 infection and provide a review of the emerging literature on COVID-related stroke. A 43-year-old female presented with right-sided hemiparesis, aphasia and dysarthria. She had a nonproductive of cough for 1 week without fever, fatigue or dyspnea. A CT Head, CT angiography and CT perfusion imaging revealed a M1 segment occlusion of the left middle cerebral artery requiring transfer from a primary to a comprehensive stroke center. A nasopharyngeal swab confirmed SARS-CoV-2 infection prior to arrival at the accepting center. During the thrombectomy a 3 cm thrombus was removed. Thrombus was also evident in the 8 French short sheath during closure device placement so a hypercoagulable state was suspected. Stroke work-up revealed a glycosylated hemoglobin of 8.7%, elevation of inflammatory markers and an indeterminate level of lupus anticoagulant IgM. On discharge home, she had near complete neurological recovery.

This case highlights suspected mechanisms of hypercoagulability in SARS-CoV-2 infection and the importance of optimizing stroke care systems during the COVID-19 pandemic.
Pupillometry and Hindsight Bias: Physiological Arousal Predicts Compensatory Behavior
Authors: Sleegers Willem W. A. , Proulx Travis , van Beest Ilja
Published: November 2020

According to violation–compensation models of cognitive conflict, experiences that violate expected associations evoke a common, biologically based syndrome of aversive arousal, which in turn motivates compensation efforts to relieve this arousal. However, while substantial research shows that people indeed respond with increased arousal to expectancy violating events, evidence for the motivating role of arousal is rarely found. In two within-subjects studies ( N = 44 and N = 50), we demonstrate evidence for the motivating role of arousal in this violation–compensation process among university students. Using pupillometry and the hindsight bias phenomenon, we show that people respond with greater arousal when presented with expectancy violating information. In turn, we show that the pupillary response is positively related to the amount of hindsight bias being displayed. These findings provide further insights into the process underlying the hindsight bias and, crucially, support key predictions following from threat–compensation models.
Comprehensive proteomic atlas of skin biomatrix scaffolds reveals a supportive microenvironment for epidermal development
Authors: Leng Ling , Ma Jie , Sun Xuer , Guo Baolin , Li Fanlu , Zhang Wei , Chang Mingyang , Diao Jinmei , Wang Yi , Wang Wenjuan , Wang Shuyong , Zhu Yunping , He Fuchu , Reid Lola M , Wang Yunfang
Published: November 2020

Biomaterial scaffolds are increasingly being used to drive tissue regeneration. The limited success so far in human tissues rebuilding and therapy application may be due to inadequacy of the functionality biomaterial scaffold. We developed a new decellularized method to obtain complete anatomical skin biomatrix scaffold in situ with extracellular matrix (ECM) architecture preserved, in this study. We described a skin scaffold map by integrated proteomics and systematically analyzed the interaction between ECM proteins and epidermal cells in skin microenvironment on this basis. They were used to quantify structure and function of the skin’s Matrisome, comprised of core ECM components and ECM-associated soluble signals that are key regulators of epidermal development. We especially revealed that ECM played a role in determining the fate of epidermal stem cells through hemidesmosome components. These concepts not only bring us a new understanding of the role of the skin ECM niche, they also provide an attractive combinational strategy based on tissue engineering principles with skin biomatrix scaffold materials for the acceleration and enhancement of tissue regeneration.
Ceftriaxone- and ceftazidime-resistant Klebsiella species, Escherichia coli, and methicillin-resistant Staphylococcus aureus dominate caesarean surgical site infections at Mulago Hospital, Kampala, Uganda
Authors: Wekesa Yvonne N , Namusoke Fatuma , Sekikubo Musa , Mango Dennis Wandera , Bwanga Freddie
Published: November 2020

Objectives:

The aim of this study was to determine the proportion and mechanism of resistance to ceftriaxone and ceftazidime among Klebsiella species and Escherichia coli and examine the burden of methicillin-resistant Staphylococcus aureus from caesarean section surgical site infections in Uganda.

Methods:

Wound swabs from 109 caesarean section surgical site infections were cultured for pathogenic bacteria following standard microbiological procedures. The Kirby–Bauer disc diffusion technique was used for antimicrobial susceptibility testing. Methicillin-resistant S. aureus diagnosis was based on polymerase chain reaction testing for the mecA gene. Data were analysed using SPSS-IBM Statistics v.20.

Results:

A total of 118 pathogens were recovered from 93 (85%) of 109 surgical site infections swabs. Of the 118 pathogens, gram-negative bacteria were 69 (58.5%), including 44 (37.3%) Klebsiella species, 11 (9.3%) E. coli, 6 (5.1%) Citrobacter species, and 8 (6.8%) other gram-negative bacteria. In total, 49 of the 118 pathogens were gram-positive bacteria, including 34 (28.8%) S. aureus and 15 (12.7%) Enterococci species. Resistance to ceftriaxone was detected in all 11 (100%) of the E. coli and in 43 (97.7%) of the 44 Klebsiella species and to ceftazidime in all 11 (100%) of the E. coli and 40 (91%) of the 44 Klebsiella species. Extended-spectrum beta-lactamase explained resistance to ceftazidime in 10 (91%) of the 11 E. coli and 19 (48%) of the 40 Klebsiella species. Carbapenemase production explained 15 (38%) of the 40 ceftazidime-resistant Klebsiella species. Methicillin-resistant S. aureus was detected in 91% of S. aureus.

Conclusion:

Klebsiella species, E. coli, and S. aureus–majority methicillin-resistant S. aureus dominated the pathogens in caesarean section surgical site infections. Almost all of the E. coli and Klebsiella species were resistant to ceftriaxone or ceftazidime. Extended-spectrum beta-lactamase was the underlying resistance mechanism among almost all of the ceftriaxone- or ceftazidime-resistant E. coli. However, this mechanism accounted for less than half of ceftriaxone- or ceftazidime-resistant Klebsiella species, where carbapenemases accounted for 40% of the resistance, a finding previously unreported in Uganda.
The impact of group identity on coalition formation
Authors: Laroze Denise , Hugh-Jones David , Leininger Arndt
Published: November 2020

Bargaining and coalition building are a central part of modern politics. We argue that majoritarian bargaining is important for the formation of coalitions and that group-identity preferences have an impact on partner selection. We tested the effect of gender, race, and ideological distance in a majority-rule bargaining experiment and found that ideological distance significantly affected the likelihood and amount offered to potential partners. We concluded that formateurs are not necessarily purely rational actors pursuing policy goals and/or the benefits of office. Rather, they also care about the identity of their partners, preferring others who are like themselves.
Oncological Safety, Surgical Outcome, and Patient Satisfaction of Oncoplastic Breast-Conserving Surgery With Contralateral Balancing Reduction Mammoplasty
Authors: St Denis-Katz Hannah , Ghaedi Bahareh B. , Fitzpatrick Aisling , Zhang Jing
Published: November 2020

Introduction:

Oncoplastic breast-conserving surgery (OBCS) is considered a cornerstone in the management of locally invasive breast cancer. We evaluated patient-reported outcomes of OBCS with contralateral balancing breast reduction mammoplasty and reviewed its oncologic outcomes and complications.

Methods:

This is mixed method study design using retrospective chart review and prospective cohort study. Patient demographics were reviewed. Outcome measures included clinicopathologic characteristics, complications, margin status, local recurrence, tumor histopathologies, duration of follow-up, patient satisfaction, self-esteem, event-related stress, and quality of life.

Results:

A total of 48 patients were included in this study. Complete excision with negative margins was obtained in 42 (87.5%) patients, positive margins in 6 (12.5%) patients, all who had re-excision with repeat lumpectomy. Thirteen patients developed minor complications, defined as being managed as an outpatient. No patients developed major complications requiring inpatient admission. These complications did not delay commencement of chemotherapy or radiotherapy. Postsurgery BREAST-QTM26 scores demonstrated no statistical difference in satisfaction with breasts, nipples, and sexual well-being. There was high satisfaction with overall outcome with average score of 80.8%. For the Rosenberg self-esteem scale, the results were similar for 3- and 12-month post-operative indicating maintenance of normal self-esteem post-operatively. The Impact of Events Scale showed statistically significant difference at 12-month post-operative (25.1) when compared with preoperative scores indicating that patients had lower event-related stress. There was no significant change in Hospital Anxiety and Depression Scale.

Conclusion:

Our study has shown that the patient who undergo OBCS have high patient-reported outcomes with acceptable oncologic outcomes and complication rates.
Outcomes of Immediate Alloplastic Breast Reconstruction in Patients Receiving Post-Mastectomy Radiotherapy
Authors: Fan Stacy , Chen Hanny , Grant Aaron , DeLyzer Tanya
Published: November 2020

Background:

Immediate alloplastic breast reconstruction is traditionally avoided in patients who require post-mastectomy radiation therapy (PMRT). However, a subset of patients who undergo alloplastic reconstruction may unpredictably require adjuvant radiation. The purpose of this study was to compare outcomes and complications in patients at our institution who had undergone immediate alloplastic breast reconstruction and received PMRT to either the permanent implant or temporary tissue expander.

Materials and Methods:

A retrospective cohort study was performed looking at patients who underwent immediate alloplastic breast reconstruction over a 10-year period (2009-2019) at our regional breast centre. All patients who underwent immediate alloplastic breast reconstruction and had PMRT were included in the study. Major (wound dehiscence with device exposure, or reconstructive failure) and minor (infection, capsular contracture, revision surgery) complication rates between those patients receiving radiation to a tissue expander versus implant were compared using Fisher exact test ( P < .05).

Results:

Six-hundred ninety-two patients were identified, and 43 patients met inclusion criteria. Of this group, 29 received PMRT to implants and 14 received PMRT to tissue expanders. Complication rates were similar between groups for superficial wound infection (3.4% vs 7.1%), periprosthetic infection (3.4% vs 7.1%), capsular contracture (41.4% vs 21.4%), revision surgery for aesthetics (41.4% vs 21.4%), wound dehiscence and device exposure (3.4% vs 21.3%), and reconstructive failure (10.3% vs 6.7%). Total complication rates were similar between groups (51.7% vs 42.9%).

Discussion:

Overall 6.4% of patients who underwent immediate alloplastic breast reconstruction required PMRT over a 10-year period. Complication rates for infection, capsular contracture, revision surgery, wound dehiscence and device exposure, and reconstructive failure were similar between both groups. Total complication rates were similar between groups. This information will help to inform decision-making regarding immediate alloplastic reconstruction and expected complications when PMRT is needed.
Analysis of Plastic Surgery Consultations in a High-Volume Paediatric Emergency Department: A Quality Improvement Initiative
Authors: Neuhaus Kathrin , Ho Emily S. , Low Nelson , Forrest Christopher R.
Published: November 2020

Introduction:

Consult services influence emergency department (ED) workflow. Prolonged ED length of stay (LOS) correlates with ED overcrowding and as a consequence decreased quality of care and satisfaction of health team professionals. To improve management of paediatric ED patients requiring plastic and reconstructive surgery (PRS) expertise, current processes were analyzed.

Methods:

Patient characteristics and metrics of PRS consultations in our paediatric ED were collected over a 3-month period. Data analysis was followed by feedback education intervention to ED and PRS staff. Data collection was then resumed and results were compared to the pre-intervention period.

Results:

One hundred ninety-eight PRS consultations were reviewed, mean patient age was 6.3 years. Most common (52%) diagnoses were burns and hand trauma; 81% of PRS referrals were deemed appropriate; 25% of PRS consults were requested after hour with no differences in patient characteristics compared to regular hours; 60% of consultations involved interventions in the ED. Time between ED registration and PRS consultation request (116.5 minutes), quality of procedural sedation (52% rated inadequate), and overall ED LOS (289.2 minutes) were identified as main areas of concern and addressed during feedback education intervention. Emergency department LOS and quality of sedation did not improve in the post-intervention period.

Conclusion:

The study provides detailed insights in the characteristics of PRS consultation in the paediatric ED population. Despite high referral appropriateness and education feedback intervention, significant inefficiencies were identified that call for further collaborative efforts to optimize quality of care for paediatric ED patients and improve satisfaction of involved healthcare professionals.