bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonographic intestinal muscularis thickening in dogs with histologically confirmed inflammatory bowel disease: 13 cases (2010–2021)
Authors: Collins‐Webb Alexandra G. , Chong Deborah LA. , Cooley Stacy D.
Published: October 2022

Ultrasonographic intestinal muscularis thickening has not been described as an imaging feature of canine inflammatory bowel disease. In this retrospective case series, patients were identified by searching sonographic reports for “muscularis” and/or “muscular layer.” Patients were included if small intestinal muscularis thickening was reported, and sonographic images and histopathological samples of the small intestine were available for review. Cases with small intestines nodules, masses, or complete loss of wall layering were excluded. Sonographic images were retrospectively evaluated for jejunal muscularis layer thickness, and ratios of intestinal layer measurements were performed. Histological samples were retrospectively reviewed. Thirteen dogs met inclusion criteria: all dogs had sonographic intestinal muscularis thickening relative to the submucosa (>1.0, range of 1.3–2.5), and most dogs had muscular layer thickness above normal published ranges (11/13; all 13/13 above the weight‐specific mean). More than half of the patients had overall normal wall thickness (11/13) and several had normal mucosal echogenicity (6/13). Therefore, in some dogs, the only sonographic abnormality in the small intestine was muscularis thickening. No dogs had lymphadenomegaly. Endoscopic partial‐thickness (n = 11, duodenum and/or ileum) or surgical full‐thickness (n = 2) samples confirmed inflammatory bowel disease. Direct comparison between jejunum sonographic characteristics and histology features was limited due to both partial thickness biopsies and lack of direct comparison between anatomical locations of ultrasonographic assessment and biopsy site. However, no cases that met the inclusion criteria had normal small intestinal histology. Comparable to cats, dogs with ultrasonographic intestinal muscularis thickening may have inflammatory bowel disease, and further workup for enteropathy is indicated.
Combined explanations of B-physics anomalies, $$(g-2)_{e, \mu }$$ and neutrino masses by scalar leptoquarks
Authors: Chen Shao-Long , Jiang Wen-wen , Liu Ze-Kun
Published: October 2022

We extend the contents of the standard model (SM) by introducing TeV-scale scalar leptoquarks to generate neutrino masses and explain some current observed deviations from the SM predictions, including the anomalous magnetic moments of charged leptons (electron and muon) and B-physics anomalies ($$R_{K^{(*)}}$$

R

K

(

∗
)

and $$R_{D^{(*)}}$$

R

D

(

∗
)

). The model consists of $$\text {SU}(2)_L$$

SU

(
2
)

L

singlet leptoquark $$S_1\sim ({\bar{3}}, 1, 1/3)$$

S
1

∼

(

3

¯

,
1
,
1
/
3
)

, doublet leptoquark $${\tilde{R}}_2\sim (3, 2, 1/6)$$

R
~

2

∼

(
3
,
2
,
1
/
6
)

and triplet leptoquark $$S_3\sim ({\bar{3}}, 3, 1/3)$$

S
3

∼

(

3

¯

,
3
,
1
/
3
)

. We combine the constraints arising from the low-energy lepton flavor violation, meson decay and mixing observables. We perform a detailed phenomenological analysis and identify the minimized texture of leptoquark Yukawa matrices to accommodate a unified explanation of the anomalies and neutrino oscillation data.
SparseIMU: Computational Design of Sparse IMU Layouts for Sensing Fine-grained Finger Microgestures
Authors: Sharma Adwait , Salchow-Hömmen Christina , Mollyn Vimal Suresh , Nittala Aditya Shekhar , Hedderich Michael A. , Koelle Marion , Seel Thomas , Steimle Jürgen
Published: October 2022

Gestural interaction with freehands and while grasping an everyday object enables
always-available input
. To sense such gestures, minimal instrumentation of the user’s hand is desirable. However, the choice of an effective but minimal IMU layout remains challenging, due to the complexity of the multi-factorial space that comprises diverse finger gestures, objects, and grasps. We present
SparseIMU
, a rapid method for selecting minimal inertial sensor-based layouts for effective gesture recognition. Furthermore, we contribute a computational tool to guide designers with optimal sensor placement. Our approach builds on an extensive microgestures dataset that we collected with a dense network of 17 inertial measurement units (IMUs). We performed a series of analyses, including an evaluation of the entire combinatorial space for freehand and grasping microgestures (393 K layouts), and quantified the performance across different layout choices, revealing new gesture detection opportunities with IMUs. Finally, we demonstrate the versatility of our method with four scenarios.
Three-Dimensional Fluctuating Flow of a Second-Grade Fluid along an Infinite Horizontal Plate with Periodic Suction
Authors: Zafar Mehwish , Rana Muhammad Afzal , Latif Atifa
Published: October 2022

Laminar flow control plays a vital role in reducing drag resulting enhancement in the vehicle power by a significant amount. Theoretical and experimental studies have proven that the transition from laminar to turbulent flow (causing the drag coefficient to enhance) may be delayed/prevented by the suction of the fluid from the boundary layer to the wall. The purpose of this work is to study the effects of periodic suction on the unsteady 3-dimensional fluctuating flow of a second grade incompressible fluid flowing laminarly over a horizontal porous infinite plate. The plate is subjected to a sinusoidal transverse suction velocity while the free stream velocity oscillates in time about a constant mean. The flow turns out to be 3-dimensional because of transverse direction of the periodic suction velocity. By the series expansion method, analytic expressions for transient velocity, skin friction components, and pressure are attained. Impact of nondimensional parameters evolving in the mathematical model of the problem on these physical quantities are visualized graphically and discussed analytically. The velocity component u is found to be rising with a growth in suction parameter α. The pressure is noted to be growing with a growth in Reynolds number

R
e
.

Further, due to suction at the plate and transient free stream velocity, the pressure increases near the plate and then reaches to a steady value far-off the plate. The skin friction along the main flow is noticed to be decreasing with the rise in

α

for

0.5
≤
R
e
≤
1.4

, however, an exponential rise is observed for

R
e
>
1.4.

The skin friction along the cross flow is noted to be enhancing for the rising values of suction parameter and elastic parameter. The present results have excellent agreement with previous published results in the limiting sense. This study is beneficial in designing and manufacturing laminar flow control system to enhance the vehicle power requirement.
Symmetry Analysis, Invariant Solutions, and Conservation Laws of Fractional KdV-Like Equation
Authors: El Bahi Maria Ihsane , Hilal Khalid
Published: October 2022

In this paper, Lie symmetries of time-fractional KdV-Like equation with Riemann-Liouville derivative are performed. With the aid of infinitesimal symmetries, the vector fields and symmetry reductions of the equation are constructed, respectively; as a result, the invariant solutions are acquired in one case; we show that the KdV-like equation can be reduced to a fractional ordinary differential equation (FODE) which is connected with the Erdélyi-Kober functional derivative; for this kind of reduced form, we use the power series method for extracting the explicit solutions in the form of power series solution. Finally, Ibragimov’s theorem has been employed to construct the conservation laws.
A New Adaptive Switching Control Method for the Complex Operating Condition of the Grid-Connected Power System
Authors: Yu Miao , Zhang Yihui , Zhang Shouzhi , Hu Jingxuan , Yang Shuwei , Du Weijie , Li Jinglin
Published: October 2022

Due to the increase in wind power accessing power system in recent years, the low-frequency oscillation of power system is more complicated. Therefore, a new adaptive switching control method combined with a nonlinear system is proposed for the complex operating conditions of the grid-connected power system. Firstly, this method decomposes the low-frequency oscillation control problem of the power system into two parts, which are the linear system control and the nonlinear system control. Then, in the linear system control part, the iterative identification method is used to control this part. In the nonlinear system control part, the nonlinear term is decomposed into a combination of the previous beating measurable and the nonlinear estimation increment. Secondly, the nonlinear system is divided into three different operating conditions by the nonlinear estimation increment. Thus, four different adaptive controllers are obtained. Then, the designed controller is switched according to the controlled object with four controllers by the switching function, which not only ensures the stability of the closed-loop system, but also improves the control performance of the controller under different operating conditions. Finally, the feasibility and effectiveness of this method are verified, and the controller can fit the control efficiency of the real power system well.
Contribution of Arginine Catabolic Mobile Element and Copper and Mercury Resistance Element in Methicillin-Resistant Staphylococcus aureus: A Vantage Point
Authors: Shokrollahi Parya , Hasani Alka , Aghazadeh Mohammad , Memar Mohammad Yousef , Hasani Akbar , Zaree Maryam , Rezaee Mohammad Ahangarzadeh , Sadeghi Javid
Published: October 2022

Different clones of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are dominating geographically. One of the significant, hypervirulent, CA-MRSA and a significant health concern clones is USA3000, found worldwide regionally with varying frequencies. The clone harbors several mobile genetic elements (MGEs) including, arginine catabolic mobile element (ACME) and copper and mercury resistance genes (COMER), accomplished by horizontal gene transfer from S. epidermidis. Evidence suggests that ACME and COMER have a more prominent role in enhancing biofilm capacity and ultimately persistent infections. This review highlights the comprehensive view on ACME and COMER structure, their distribution, and the mechanism of action along with pathogenetic features of USA3000 encompassing their role in biofilm formation, adhesion, quorum sensing, resistance to antibiotics, chemotaxis, and nutrient uptake. We also provided an insight into the role of ACME and COMER genes in the survival of bacterium. Our results shed light on the emergence of two independent clones possessing ACME (North American) and COMER (South American) elements which later disseminated to other regions. ACME and COMER both are adjacent to staphylococcal cassette chromosome mec type IV (SCCmec IV). The acquisition of mecA, followed by COMER or ACME has been shown as a significant factor in the rise and fall of MRSA strains and their complex ability to adapt to hostile environments. The presence of ACME increases fitness, thereby allowing bacteria to colonize the skin and mucous membrane while COMER contributes to genetic stability by knocking over the copper-mediated killing in macrophages. Evidence suggests that ACME and COMER have a more prominent role in enhancing biofilm capacity and ultimately persistent infections. Interestingly, ACME strains have been shown to possess the ability to counteract skin acidity, thereby allowing increased skin colonization. A profound understanding of MGEs in S. aureus plays an important role in the prevention of epidemic clones.
Slaveholding in the Ottoman Central Lands (1460–1880)
Authors: Canbakal Hülya , Filiztekin Alpay
Published: October 2022

Using probate inventories from multiple locations in the Ottoman central lands, this article offers a quantitative perspective on long-term patterns of slaveholding, slave prices, and demand for slaves. Findings include a continual decline in slave-ownership and related indicators across all social groups and strata, and a decline in prices in connection with trafficking from Africa in the eighteenth century. The investment preferences of the top buyers and the composition of the slave population also indicate that the features of the demand for slaves were neither fixed in any period nor uniform across regions.
Who Will Watch the Watchers? A Critical Perspective on Police Brutality in Post-Apartheid South Africa
Authors: Tshoose Clarence Itumeleng , Rapatsa Mashele
Published: October 2022

Police brutality is a highly charged topic which has been prevalent both locally and internationally. Scholars contend that theory-based research has recently emerged to precisely explain this police behaviour. There are theorists from several schools of thought who seek to attribute causality for police violence. In this article, three of the more popular existing theories will be examined: social conflict theory, symbolic interactionism, and the control balance theory. To this end, the article has three objectives. Firstly, it scrutinises the relevant theories dealing with the issue of police brutality. Secondly, it discusses the relevant domestic and international instruments that seek to address the problem of police brutality. Lastly, this article makes recommendations regarding how the system of policing in South Africa can be revamped.
Fostering Business Growth through Generational Change: Is Guanxi Still Important?
Authors: Xavier Jesrina Ann , Siong Gan Khai , Yew Lee Kean , Jiang Nan , Alagappar Ponmalar N.
Published: October 2022

Malaysian Chinese family businesses have been dynamic in adapting to economic and political changes, given the challenges where policies have favored larger local ethnic groups. This study aims to explore the importance of Malaysian guanxi in nurturing business growth, while investigating the intra-ethnic and inter-ethnic business networks that are tapped by Malaysian Chinese family businesses through generational change. As this study investigates the history of Malaysian Chinese business, it is only apt that the case study method is utilized to identify the role of guanxi in business growth. Data for this study was collected through in-depth interviews with the successors of eight family businesses. Secondary data were collected in two folds for data triangulation. Findings suggest that Malaysian guanxi is crucial especially when the owners intend to grow the business as generations change. Of the eight cases, six cases presented the importance of Malaysian guanxi in business growth through generational change. Although there were two cases suggesting that guanxi could be insignificant in the long run, it is not denied that the cultivation of guanxi by the predecessor remains important to this day. The value of this study is seen in the importance of passing down guanxi through succession while fostering a wider inter-ethnic business network to achieve business growth.
The Inclusion of Women in the Curriculum of Philosophy: Challenges and Solutions
Authors: Kjems Bodil Hvass
Published: October 2022

Recently, an overwhelming amount of philosophical works by women has been made available by historians of philosophy. However, this (re)discovery is not adequately reflected in the curricula of philosophy departments in general. This paper discusses which argumentative strategy is most feasible in order to include significantly more women in the philosophy curriculum. In From the Exclusion of Women to the Transformation of Philosophy: Reclamation and its Possibilities (2014), Sarah Tyson identifies four reclamation models, which feminist scholars have utilized to contend why and how women should be included in the philosophy canon. It is shown that the key difference between the so-called corrective and transformative model is whether misogyny is considered an intrinsic feature of philosophy or merely an unfortunate development. It is argued that regardless of the ontological status of the philosophical discipline, both strategies promote engagement with women’s work in a way that revolutionizes current philosophical practice.
Collaborating in Class: Social Class Context and Peer Help-Seeking and Help-Giving in an Elite Engineering School
Authors: Johnson Anthony M.
Published: October 2022

Scholars have extensively documented social class differences in students’ relationships with educational institutions through their interactions with authority figures and the unequal institutional advantages these interactions yield. However, little is known about whether or how social class also shapes students’ peer interactions in ways that produce these inequalities. Using a qualitative case study of an elite engineering school in which I draw on participant observation and interviews with 88 undergraduates and six administrators, I argue that social class context—a proxy for social class—shapes the peer help-seeking and help-giving (collaborative) strategies students use, which can create inequalities in the institutional advantages they secure in the form of academic help, support, and learning opportunities. Focusing specifically on the social class context of students’ high schools, I find that compared to their less-privileged counterparts, privileged students—who came from class-advantaged high school contexts where they became familiar with collaboration and upper-middle-class cultural signals—more easily collaborated with their college classmates and displayed signals that communicated they were “good” collaborators. The findings highlight new mechanisms through which inequalities are reproduced in educational institutions and make theoretical contributions to research on cultural capital, inequality, and education.
Youth Mental Health Help-Seeking Information Needs and Experiences: A Thematic Analysis of Reddit Posts
Authors: Sit Meghan , Elliott Sarah A , Wright Kelsey S , Scott Shannon D , Hartling Lisa
Published: October 2022

Youth are vulnerable to mental health challenges. Social media presents an opportunity to evaluate disinhibited mental health discourse and self-disclosure. The objective of this study was to explore reported experiences and information needs related to youth seeking support for mental health on the social media platform, Reddit.com. We searched two subreddits: r/mental health and r/teenagers on Reddit.com for posts made by youth (13–24 years) relating to mental health help-seeking behaviors and information needs. Posts were screened and relevant data were extracted, coded, and analyzed using thematic analysis. Thematic analysis of relevant posts yielded four themes: (1) navigating mental health issues, (2) disclosing to others, (3) barriers to seeking care, and (4) experiences seeking care. Youth may have a diverse range of mental health help-seeking-related information needs and may face several barriers throughout the process of seeking care.
Traffic Conflict Prediction at Signal Cycle Level Using Bayesian Optimized Machine Learning Approaches
Authors: Zheng Lai , Hu Zhenlin , Sayed Tarek
Published: October 2022

This study develops non-parametric models to predict traffic conflicts at signalized intersections at the signal cycle level using machine learning approaches. Three different datasets were collected, one from Surrey, Canada, and the other two from Los Angeles and Georgia, U.S.A. From the datasets, traffic conflicts measured by modified time to collision and traffic parameters such as traffic volume, shockwave area, platoon ratio, and shockwave speed were extracted. Multilayer perceptron (MLP), support vector regression (SVR), and random forest (RF) models were developed based on the Surrey dataset, and the Bayesian optimization approach was adopted to optimize the model hyperparameters. The optimized models were applied to the Los Angeles and Georgia datasets to test their transferability, and they were also compared to a traditional safety performance function (SPF) developed using negative binominal regression. The results show that all the three Bayesian optimized machine learning models have high predictive accuracy and acceptable transferability, and the MLP model is a little better than the SVR and RF models. In addition, all three models outperform the traditional SPF with regard to predictive accuracy. The model sensitivity analysis also show that the traffic volume and shockwave area have positive effects on traffic conflicts, while the platoon ratio has negative effects.
Relationship of Regional, Freight, and Intermodal Market Access to Industry Location and Productivity
Authors: Weisbrod Glen , Goldberg Jenna
Published: October 2022

Although a significant body of research has focused on employment agglomeration at an urban level, this paper presents a broader view that also includes new empirical research on wider regional and intermodal access and its economic implications. The analysis shows how business clustering (employment agglomeration) can occur at different scales and in different forms, reflecting a range of needs to access local and regional populations, suppliers, and customers, as well as intermodal gateways that provide access to national and global markets. These different types of access have broader economic development and productivity implications that are particularly important for transportation planners who evaluate proposals for freight and passenger modal investments connecting communities and intermodal facilities. To address these issues, the paper brings together three complementary perspectives: (a) transportation planning literature that distinguishes types of transportation investment and plans; (b) site location literature that defines business location decision processes and their spatial scale; and (c) economic research that provides a basis for defining scale economies and productivity effects. It presents results of a new U.S. study that develops statistical relationships between types of access and industries in relation to their relative concentration and productivity at a county level. The results show the importance for transportation planners to consider freight access as well as customer and worker access. They also indicate the potential for decision bias if project prioritization and cost–benefit analyses fail to consider the full range of spatial scales relevant for assessing market access. The article discusses implications of these findings in terms practical applications for transportation investment planning, and it highlights remaining needs for further research.
The Negative Impact of Information and Communication Technologies Overuse on Student Performance: Evidence From OECD Countries
Authors: Gorjón Lucía , Osés Ainhoa
Published: October 2022

The increasing presence of technologies at school has triggered a vivid debate on the way ICT influences students’ learning process. Using PISA 2018 data for 15-year-old students and hierarchical linear models, we find an inverted U-shaped relationship between ICT use at school and students’ performance in mathematics in 22 OECD countries. In all cases, the excessive use of technology is associated with a lower academic performance, although this penalty differs across countries, which points to the importance of addressing country-specific analyses. The differentiated profile of those very intensive users, who suffer from above-average bullying exposure, draws into question whether the effect can be deemed as causal. Based on Inverse Probability Weighting techniques, the findings indicate that the very intensive use of ICT at school causes an underperformance of students equivalent to around half an academic course in Estonia, Finland and Spain. The results highlight the need for policy makers and instructors to ensure that the frequent use of ICT at school does not interfere with students’ learning process.
Naloxone Versus Methylnaltrexone for Opioid-Induced Constipation in Critically Ill Patients
Authors: Habeeb Ehsan A. , Tran Lena K. , Goodberlet Melanie Z. , Lupi Kenneth E. , DeGrado Jeremy R. , Dube Kevin M.
Published: October 2022

Background:

Opioid-induced constipation (OIC) may occur in up to 81% of critically ill patients and can lead to many complications. Opioid antagonists are a reasonable approach and may be used for managing OIC.

Objective:

The purpose of this study was to assess the efficacy of enteral naloxone (NLX) versus subcutaneous methylnaltrexone (MNTX) for the management of OIC in critically ill patients.

Methods:

A retrospective analysis was conducted on adult patients who received NLX or MNTX and a continuous opioid infusion for at least 48 hours. The primary end point was time to resolution of constipation, defined as hours to first bowel movement (BM) after the first dose of an opioid antagonist. Reversal of analgesia was assessed by comparing the total number of morphine milligram equivalents (MME) 24 hours preopioid and postopioid antagonist administration. Univariate and multivariate analyses were conducted to assess treatment response within 48 hours.

Results:

Baseline characteristics were similar between patients receiving NTX (n = 89) and MNTX (n = 71). However, the time to the first BM with NLX was 18 hours compared with 41 hours with MNTX ( P = 0.004). There was no difference in MME requirements 24 hours pre/post NLX or MNTX administration. Naloxone administration was identified as a statistically significant predictor of BM within 48 hours (odds ratio [OR] = 2.68 [1.33-5.38]).

Conclusion and Relevance:

The time to first BM was shorter with enteral NLX. Both NLX and MNTX appear to be effective for the management of OIC without causing reversal of analgesia. Future controlled, prospective trials comparing these agents are warranted.
Effect of Medically Supervised Prolonged Fasting Therapy on Vitamin D, B12, Body Weight, Body Mass Index, Vitality and Quality of Life: A Randomized Control Trial
Authors: Tewani Gulab Rai , Silwal Karishma , Sharma Gita , Yadav Dinesh , Siddiqui Aarfa , Kriplani Sucheta , Nathani Varsha Vijay , Sharma Neha , Keswani Jyoti , Sharma Hemanshu , Nair Pradeep MK
Published: October 2022

Background:

Recent research indicates prolonged fasting for more than 7 days is beneficial in priming the vitamin D metabolism. However, methodological limitations in previous studies, such as insufficient sample size and a lack of control group, limits its generalizability. The present study evaluated the impact of prolonged fasting (10 days) on vitamin D, vitamin B12, body mass index (BMI), weight, hemoglobin, vitality and quality of life (QoL) compared to a normal diet.

Methods:

This randomized control trial was conducted in an in-patient private yoga and naturopathy setting between February and April 2022. A total of 52 participants (mean age 51.57 ± 13.67 years) with varying medical conditions were randomized into a fasting group (FG) or a normal diet group (NDG) with 26 participants in each group. The FG was on a fasting diet (500 kCal/day) which included holy basil herbal tea, lemon honey water, and water (3 L). The NDG (1500 kCal/day) consumed a routine diet that included Indian bread, pulses, steamed rice, vegetable salads, and beverages.

Results:

The FG has shown significant increase in the Vitamin D levels ( P = .003, d = 0.475), vitality ( P = .006, d = 0.425), physical QoL ( P < .001, d = 0.549), psychological QoL ( P = .002, d = 0.488), and environmental QoL ( P = .004, d = 0.457) compared to NDG. No significant changes were observed in vitamin B12, weight, BMI, haemoglobin, and social QoL. A weak to moderate (ρ = 0.330-0.483) positive correlation was observed between vitality scores and QoL domains, whereas BMI scores showed an inverse correlation (ρ = −.280) with vitamin D levels.

Conclusion:

The results suggest that prolonged fasting for 10 days can improve vitamin D levels, improve vitality, and promote quality of life compared to a normal diet. Unlike previous studies, the FG does not differ from the NDG concerning weight and BMI. Nevertheless, fasting may be utilized as an effective tool to tackle vitamin D deficiency and associated health insufficiencies.
Community Participation in Conservation and Management of Cultural Heritage Resources in Yoruba Ethnic Group of South Western Nigeria
Authors: Oladeji Sunday Oladipo , Grace Oyeniran , Ayodeji Akeju Ayobami
Published: October 2022

The sustainability of cultural heritage resources is strongly linked to the effective participation of local communities in the conservation and management of these resources. This forms the basis for undertaken this project in the selected communities in Ondo and Ekiti State of Yoruba ethnic groups of South Western Nigeria. Multiple research methods were employed for this study including Key Informants Interview and administration of structured questionnaire to the purposively selected respondents. A sample of 768 respondents was selected from the total population of 895,406 using sample determination method. The selection of respondents was based on their proximity to the resources, their local knowledge, communal ownership, disposition and willingness to participate in the study. The data collected was rated on a 5 point Likert scale and then subjected to the weighted mean analysis. Spearman correlation and linear regression were used to test hypotheses in order to established relationships between sociodemographic characteristics and level of community participation. Output from this research, emphasizes the need to improve the state of heritage properties through effective conservation and sustainable management practices and increasing community involvement and participation. This will serve as a blueprint and developmental framework for policymakers in heritage resources conservation and management with the intention of linking these resources to increase direct economic benefits to local communities.
Emergency Department Visits Within 90 Days of Total Ankle Replacement
Authors: Ratnasamy Philip P. , Kammien Alexander J. , Gouzoulis Michael J. , Oh Irvin , Grauer Jonathan N.
Published: October 2022

Background:

Total ankle replacement (TAR) utilization in the United States has steeply increased in recent decades. Emergency department (ED) visits following TAR impacts patient satisfaction and health care costs and warrant exploration.

Methods:

This retrospective cohort study utilized the 2010 to 2019 M91Ortho PearlDiver data set to identify TAR patients with at least 90 days of follow-up. PearlDiver contains billing claims data across all sites of care throughout the United States for all indications for care. Patient factors extracted included age, sex, Elixhauser Comorbidity Index (ECI), region of the country in which surgery was performed, insurance plan, and postoperative hospital length of stay. Ninety-day postoperative ED visit incidence, timing, frequency, and primary diagnoses were identified and compared to 1-year postoperative ED visit baseline data. Univariate and multivariate logistic regression analyses were used to determine risk factors for ED visits.

Results:

Of 5930 TAR patients identified, ED visits within 90 days were noted for 497 (8.4%) patients. Of all ED visits, 32.0% occurred within 2 weeks following surgery. Multivariate analysis revealed several predictors of ED utilization: younger age (odds ratio [OR] 1.35 per decade decrease), female sex (OR 1.20), higher ECI (OR 1.32 per 2-point increase), TAR performed in the western US (OR 1.34), and Medicaid coverage (OR 2.70; 1.71-4.22 relative to Medicare) ( P < .05 each). Surgical site issues comprised 78.0% of ED visits, with surgical site pain (57.0%) as the most common problem.

Conclusion:

Of 5930 TAR patients, 8.4% returned to the ED within 90 days of surgery, with predisposing demographic factors identified. The highest incidence of ED visits was in the first 2 postoperative weeks, and surgical site pain was the most common reason. Pain management pathways following TAR should be able to be adjusted to minimize the occurrence of postoperative ED visits, thereby improving patient experiences and decreasing health care utilization/costs.

Level of Evidence:

Level III, retrospective cohort study.
Aerococcus viridans pyelonephritis in a young age female patient with type 1 diabetes mellitus: a rare case report
Authors: Bapir Rawa , Ahmed Shaho F. , Salih Abdulwahid M. , Kakamad Fahmi H. , Hussein Karokh F. Hama , Salih Karzan M. , Ali Rawa M. , Hussein Dlsoz M. , Mustafa Mohammed Q. , Abdalla Berun A. , Salih Rawezh Q.
Published: October 2022

Background

Aerococcus species are Gram-positive cocci, with negative catalase and oxidase activities and growth characteristics similar to viridans streptococci. They rarely cause infection in humans. However, there are reports of bacteremia, meningitis, septic arthritis, and endocarditis due to this pathogen in the literature. Herein we report a rare case of pyelonephritis due to A. viridans.

Case presentation

A 31-year-old-female patient with type 1 diabetes mellitus was presented with left loin pain, fever, nausea, and anorexia for 3 days. She had a history of obstructive nephropathy due to sloughed necrotic papillae 3 months earlier, mandating bilateral JJ stent insertion. She was treated with a 2 weeks course of doxycycline (100 mg, twice daily) based on the antibiotic susceptibility profile of her urine culture and responded well.

Conclusion

This case highlights the possibility of complicated urinary tracts infection due to a rare human pathogen.
Spontaneous regression of colloid cyst on the third ventricle: a case report with the review of the literature
Authors: Lee Joo-Hwan , Hong Jong-Hwan , Kim Yeong Jin , Moon Kyung-Sub
Published: October 2022

Background

Colloid cyst (CC) is a rare and benign cyst found in the third ventricle near the foramen of Monro. Although the role of surgical resection is well established in symptomatic large-sized CC, it remains debatable whether surgical removal of CC with no symptoms or minimal symptoms is necessary.

Case presentation

A 49-year-old male patient visited our institute for incidentally detected intracranial mass. MRI demonstrated typical, 12 mm-sized CC located in the third ventricle. It was noticed that the cyst spontaneously decreased in size from 12 mm to 4 mm on MRI at 18 months after the first visit.

Conclusion

Although spontaneous regression is a very rare phenomenon in CC, regular imaging study and frequent neurologic examination can be an alternative option for well-selected, asymptomatic cases.
Muscle magnetic resonance imaging abnormality in neuroleptic malignant syndrome: a case report
Authors: Kakinuma Yuki , Amano Ryota , Ishida Atsushi , Nishino Ichizo , Taki Katsumi
Published: October 2022

Background

Neuroleptic malignant syndrome (NMS) is a rare and occasionally fatal undesirable reaction to dopamine antagonists, and its phenotype is diverse owing to causative drugs. Classically, elevation of serum creatine kinase is described in NMS. Some reports have described muscular pathological findings; however, muscle magnetic resonance imaging (MRI) has not been reported previously.

Case presentation

A 63-year-old woman with a history of schizophrenia presented to our hospital with a high fever, excessive sweating, muscle weakness, and elevated serum creatine kinase levels. Muscle MRI revealed T2 high-intensity lesions in several muscles with gadolinium enhancement, and the pathology of the muscle biopsy showed a very mild presence of muscle fiber necrosis and regeneration with type 2c fibers without inflammation. Her symptoms resolved by treatment with levodopa/carbidopa, dantrolene. Finally, the patient was diagnosed with NMS.

Conclusions

This is the first report of muscle MRI abnormalities in a patient with NMS. Muscle MRI abnormalities in NMS may be associated with non-inflammatory myopathic changes. The cause of creatine kinase elevation cannot be explained by abnormal strong muscle contraction nor inflammation.
ATM kinase inhibitor AZD0156 in combination with irinotecan and 5-fluorouracil in preclinical models of colorectal cancer
Authors: Davis S. Lindsey , Hartman Sarah J. , Bagby Stacey M. , Schlaepfer Marina , Yacob Betelehem W. , Tse Tonia , Simmons Dennis M. , Diamond Jennifer R. , Lieu Christopher H. , Leal Alexis D. , Cadogan Elaine B. , Hughes Gareth D. , Durant Stephen T. , Messersmith Wells A. , Pitts Todd M.
Published: October 2022

Background

AZD0156 is an oral inhibitor of ATM, a serine threonine kinase that plays a key role in DNA damage response (DDR) associated with double-strand breaks. Topoisomerase-I inhibitor irinotecan is used clinically to treat colorectal cancer (CRC), often in combination with 5-fluorouracil (5FU). AZD0156 in combination with irinotecan and 5FU was evaluated in preclinical models of CRC to determine whether low doses of AZD0156 enhance the cytotoxicity of irinotecan in chemotherapy regimens used in the clinic.

Methods

Anti-proliferative effects of single-agent AZD0156, the active metabolite of irinotecan (SN38), and combination therapy were evaluated in 12 CRC cell lines. Additional assessment with clonogenic assay, cell cycle analysis, and immunoblotting were performed in 4 selected cell lines. Four colorectal cancer patient derived xenograft (PDX) models were treated with AZD0156, irinotecan, or 5FU alone and in combination for assessment of tumor growth inhibition (TGI). Immunofluorescence was performed on tumor tissues. The DDR mutation profile was compared across in vitro and in vivo models.

Results

Enhanced effects on cellular proliferation and regrowth were observed with the combination of AZD0156 and SN38 in select models. In cell cycle analysis of these models, increased G2/M arrest was observed with combination treatment over either single agent. Immunoblotting results suggest an increase in DDR associated with irinotecan therapy, with a reduced effect noted when combined with AZD0156, which is more pronounced in some models. Increased TGI was observed with the combination of AZD0156 and irinotecan as compared to single-agent therapy in some PDX models. The DDR mutation profile was variable across models.

Conclusions

AZD0156 and irinotecan provide a rational and active combination in preclinical colorectal cancer models. Variability across in vivo and in vitro results may be related to the variable DDR mutation profiles of the models evaluated. Further understanding of the implications of individual DDR mutation profiles may help better identify patients more likely to benefit from treatment with the combination of AZD0156 and irinotecan in the clinical setting.
Implication of extrinsic and intrinsic apoptotic pathways in the targeted therapy of hepatocellular carcinoma using aptamer-labeled viramidine nanoparticles
Authors: Abd-Rabou Ahmed A. , Ahmed Hanaa H. , Kishta Mohamed S.
Published: October 2022

Hepatocellular carcinoma (HCC) is a global health problem with regional differences in epidemiological statistics. Co-assembling the drug nanoparticles and targeting moieties could improve the therapeutic delivery of anti-cancer drugs. In this attempt, we tracked the extrinsic and intrinsic apoptotic pathways in HCC cells using viramidine (VRM)-loaded aptamer (APT) nanoparticles. In these NPs, both APT and VRM act as targeted ligands/drugs to HCC cells. The NPs were characterized using TEM, ESI–MS, FTIR, and 1H NMR. The results showed uniform particles with round and smooth shapes on the nano-scale. SRB-based cytotoxicity was performed and IC50 values were measured for HCC versus normal cells upon the proposed treatments. The flow cytometry technique was applied to determine apoptosis, then confirmed using genetic and protein analyses. In addition, nitric oxide (NO) and its enzyme (iNOS) were analyzed to examine the effect of reactive nitrogen species (RNS) on apoptosis induction. The present findings indicated that Huh-7 cells were more sensitive to APT-VRM NPs than HepG2 cells, recording the lowest IC50 values (11.23 ± 0.23 µM and 16.69 ± 1.12 µM), as well as the highest significant increase in the apoptotic cells (61.5% and 42%), respectively. Intriguingely, normal BHK-21 cells recorded undetectable IC50 values in the applied NPs, confirming their targeted delivery ability. The genetic expression and protein levels of c-FLIP, Bcl-2, and TNF-α were down-regulated, while FADD, caspase 8, caspase 3, caspase 9, and Bax were up-regulated upon treatment with APT-VRM NPs. The prepared VRM NPs labeled with APT could significantly elevate NO via activation of iNOS. In conclusion, APT-VRM NPs bioconjugate interferes with HCC cells through NO-mediated extrinsic and intrinsic apoptosis.
Usefulness of grayscale values of hypoechoic lesions matched with target lesions observed on magnetic resonance imaging for the prediction of clinically significant prostate cancer
Authors: Kim Dong Gyun , Yoo Jeong Woo , Koo Kyo Chul , Chung Byung Ha , Lee Kwang Suk
Published: October 2022

Background

To analyze grayscale values for hypoechoic lesions matched with target lesions evaluated using prebiopsy magnetic resonance imaging (MRI) according to the Prostate Imaging-Reporting and Data System (PI-RADS).

Methods

We collected data on 420 target lesions in patients who underwent MRI/transrectal ultrasound fusion-targeted biopsies between January 2017 and September 2020. Images of hypoechoic lesions that matched the target lesions on MRI were stored in a picture archiving and communication system, and their grayscale values were estimated using the red/green/blue scoring method through an embedded function. We analyzed imaging data using grayscale values.

Results

Of the 420 lesions, 261 (62.1%) were prostate cancer lesions. There was no difference in the median grayscale values between benign and prostate cancer lesions. However, grayscale ranges (41.8–98.5 and 42.6–91.8) were significant predictors of prostate cancer and clinically significant prostate cancer (csPC) in multivariable logistic regression analyses. Area under the curve for detecting csPC using grayscale values along with conventional variables (age, prostate-specific antigen levels, prostate volume, previous prostate biopsy results, and PI-RADS scores) was 0.839, which was significantly higher than that for detecting csPC using only conventional variables (0.828;P = 0.036). Subgroup analysis revealed a significant difference for PI-RADS 3 lesions between grayscale values for benign and cancerous lesions (74.5 vs. 58.8,P = 0.008). Grayscale values were the only significant predictive factor (odds ratio = 4.46,P = 0.005)for csPC.

Conclusions

Distribution of grayscale values according to PI-RAD 3 scores was potentially useful, and the grayscale range (42.6–91.8) was a potential predictor for csPC diagnosis.
Cosmesis and feasibility of transvaginal natural orifice Specimen extraction (NOSE) for large organ specimen: a prospective pilot study
Authors: Hwang Woo Yeon , Suh Dong Hoon , Lee Sangchul
Published: October 2022

Background

This study aimed to evaluate cosmetic outcomes and feasibility of transvaginal natural orifice specimen extraction (NOSE) in patients who underwent laparoscopic or robotic surgery for the treatment of benign or malignant diseases of the kidney, liver, stomach, adrenal gland, and bladder.

Methods

This prospective study was conducted at a tertiary hospital between March 2015 and May 2020. The main outcome was cosmetic outcomes of scars assessed using the Patient and Observer Scar Assessment Scale (POSAS) 1 and 8 weeks after surgery. The secondary outcomes were postoperative pain, operating time, and complications. Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire 6 months after surgery in 17 patients who were sexually active at the time of surgery.

Results

A total of 38 transvaginal NOSE procedures were performed for the extraction of 33 kidneys, 2 livers, 1 stomach, 1 adrenal gland, and 1 bladder. Observers rated pigmentation and relief scores as most deviant from normal skin (2.9 ± 1.7, 3.0 ± 2.1 at postoperative 1 week; 3.6 ± 1.9, 3.5 ± 2.2 at postoperative 8 weeks, respectively), but the overall scores of each item were low. The patients’ overall satisfaction with postoperative scars was high, and the mean scores for pain and itching were low, with significant improvement from the first week to the eighth week (P = 0.014 and P = 0.006, respectively). Patients also reported low scores on vaginal assessment items, indicating better symptoms, and bleeding improved significantly between the two time points (P = 0.001). Postoperative pain was reduced from moderate during the first 24 h after surgery to mild after 24 h. The mean operative time of the transvaginal NOSE procedure was 28.3 ± 13.3 min. No postoperative complications were associated with the procedure. The mean FSFI total score was 21.2 ± 8.7 (cutoff score for dysfunction is 21), with higher scores indicating better sexual functioning.

Conclusion

Transvaginal NOSE seems to be a feasible procedure with promising cosmetic benefits, for patients who undergo minimally invasive surgery for large organs including the kidney, liver, stomach, adrenal gland, and bladder. A prospective randomized clinical trial is needed to provide solid evidence to support transvaginal NOSE.

Trial registration:

This trial is registered at ClinicalTrials.gov (NCT05113134).
Hospital-based prostate cancer screening in vietnamese men with lower urinary tract symptoms: a classification and regression tree model
Authors: Cuong Nguyen Chi , Vien Nguyen Truong , Thien Nguyen Minh , Hai Phan Thanh , Dang Tran Ngoc
Published: October 2022

Background

Prostate cancer (PCa) is a common disease in men over 65 years of age, and should be detected early, while reducing unnecessary biopsies. This study aims to construct a classification and regression tree (CART) model (i.e., risk stratification algorithm) using multivariable approach to select Vietnamese men with lower urinary tract symptoms (LUTS) for PCa biopsy.

Methods

We conducted a case-control study on 260 men aged ≥ 50 years who visited MEDIC Medical Center, Vietnam in 2017–2018 with self-reported LUTS. The case group included patients with a positive biopsy and the control group included patients with a negative biopsy diagnosis of PCa. Bayesian Model Averaging (BMA) was used for selecting the most parsimonious prediction model. Then the CART with 5-fold cross-validation was constructed for selecting men who can benefit from PCa biopsy in steps by steps and intuitive way.

Results

BMA suggested five potential prediction models, in which the most parsimonious model including PSA, I-PSS, and age. CART advised the following cut-off points in the marked screening sequence: 18 < PSA < 33.5 ng/mL, I-PSS ≥ 19, and age ≥ 71. Patients with PSA ≥ 33.5 ng/mL have a PCa risk was 91.2%; patients with PSA < 18 ng/mL and I-PSS < 19 have a PCa risk was 7.1%. Patient with 18 ≤ PSA < 33.5ng/mL and I-PSS < 19 have a PCa risk is 70% if age ≥ 71; and is 16% if age < 71. In overall, CART reached high predictive value with AUC = 0.915. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CART at the 20% diagnosis probability threshold were 91.5%, 86.2%, 86.9%, 91.2%, and 88.9% respectively; at 80% diagnosis probability threshold were 79.2%, 92.3%, 91.2%, 81.6%, and 85.8% respectively.

Conclusion

CART combining PSA, I-PSS, and age has practical use in hospital-based PCa screening in Vietnamese men with lower urinary tract symptoms.