bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and Characterization of Lithium Ion Conductive Organic/Inorganic Composite Solid Electrolyte
Authors: Kim Kangsanin , Yi Eun-Jeong , Hwang Haejin
Published: March 2021

The purpose of this study was to improve the ionic conductivity and physical properties of a polymer electrolyte by complexing it with ceramic particles. First, a polymer/ceramic composite solid electrolyte was prepared by synthesizing a super porous silica aerogel powder and adding
it to a slurry containing a polyethylene oxide (PEO)-based polymer electrolyte; then, the electrochemical properties of electrolyte of different compositions were confirmed. PEO and polymethyl methacrylate (PMMA) were copolymerized, the optimum ratio of lithium salt, plasticizer, and silica
aerogel was determined, and ion conductivity of the composite electrolyte was improved. When the EO:Li ratio was 10:1, the glass transition temperature was the lowest, and the room-temperature ion conductivity was improved to 3.0 × 10−5 S/cm. As a result of XRD and thermal
analysis, it was confirmed that the stability and durability of the electrolyte interface can also be improved by complexation of the polymer electrolyte with ceramic particles.
GaP-TiO2-C Nanocomposite as High-Performance Sodium-Ion Batteries Anode
Authors: Huy Vo Pham Hoang , Hur Jaehyun
Published: March 2021

GaP-TiO2-C composites with three different C concentrations are synthesized via a high-energy mechanical milling. The analysis of the structural characteristics of GaP-TiO2-C using X-ray diffraction and high-resolution transmission electron microscopy reveals that
the nanosized GaP and TiO2 crystallites are uniformly distributed in the amorphous C matrix. The GaP-TiO2-C(20%) composite exhibits a high Na storage capacity of 266 mAh g−1 at the current density of 0.1 A g−1 after 100 cycles, and the
remarkable rate capability of 224 mAh g−1 even at the higher current density of 10 A g−1. In addition, the GaP-TiO2-C(20%) composite presents great cycling performance and the capacity of 213 mAh g−1 at the current density of 0.5
A g−1 after 300 cycles. The outstanding cycling performance and rate capability of GaP-TiO2-C(20%) anode can be attributed to the favorable morphology of GaP-TiO2-C composite that accommodates large volume changes during cycling.
9-(10-phenylanthracen-9-yl)-Benzo[b]Fluoreno[3,4-d] Thiophene Derivatives for Blue Organic Light-Emitting Diodes
Authors: Jang Beomsu , Han Giwoong , Kim Kiju , Lee Hakjun , Kim Youngkwan , Yoon Seungsoo
Published: March 2021

In this study, two blue fluorescence materials using phenylanthracene-substituted fluorene derivatives were synthesized and characterized for organic light-emitting diodes (OLEDs). To study their electroluminescent properties, OLED devices were fabricated using these two materials as
emissive layer (EML). A device using 7,7-diphenyl-9-(10-phenylanthracen-9-yl)-7H-benzo[b]fluoreno[3,4-d]thiophene in emitting layer showed the highest value of EQE value which is 3.51%. It also showed the luminance efficiency of 3.22 cd/A and power efficiency of 2.89 lm/W with the CIE coordinates
(0.15, 0.09).
Efficiency Enhancement by Insertion of ZnO Recombination Barrier Layer in CdS Quantum Dot-Sensitized Solar Cells
Authors: Razzaq Abdul , Zafar Muhammad , Saif Tahir , Lee Jun Young , Park Jung Ki , Kim Woo Young
Published: March 2021

In this investigation we report the formation of thin ZnO recombination barrier layer at TiO2/CdS interface aimed for the improvement in performance of CdS sensitized solar cell. The film was deposited upon nanocrystalline mesoporous TiO2 surface by following a
simple chemical process and characterized, using UV-Visible spectroscopy, X-ray diffraction and electron dispersive X-ray measurements. The insertion of ZnO thin layer enhances the QDSC (Quantum dot sensitized solar cell) performance, contributed mainly by an increase in open circuit voltage
(Voc) due to reduced electron back transfer from TiO2 conduction band. Moreover, the analysis of photovoltaic characteristics upon increasing the thickness of the ZnO film reveals that the ZnO recombination barrier layer with optimum thickness at porous TiO2/CdS
interface proved to be an effective potential barrier for minimizing electron back recombination.
Simultaneous Synthesis and Consolidation of Nanostructured HfB2–SiC Composite
Authors: Kim Seong-Eun , Yoon Jin-Kook , Shon In-Jin
Published: March 2021

A dense nanostructured 2HfB2-SiC composite was simultaneously synthesized and consolidated by the pulsed current activated sintering method in one step within very short time (two minutes) from mechanically activated 2Hf, B4C and Si powders. Simultaneous combustion
synthesis and consolidation were achieved through the combination of the effects of the pulsed current and mechanical pressure. A highly dense 2HfB2–SiC composite with 97.5% relative density was achieved under the simultaneous application of a pressure of 80 MPa and the pulsed
current. The fracture toughness of the 2HfB2–SiC composite was higher than that of monolithic HfB2.
Mechanical Properties and Synthesis of Nanocrystalline Ta – 1.67Al2O3 Composite by Pulsed Current Activated Heating
Authors: Park Na-Ra , Shon In-Jin
Published: March 2021

Mixtures of Ta2O5 and Al nanopowders were prepared using high energy ball milling method. Nanocrystalline Ta – 1.67Al2O3 composite was simultaneously synthesized and densified by pulsed current activated combustion synthesis method in
a short time from mechanically activated mixtures of Ta2O5 and Al powders. The relative density of the Ta – 1.67Al2O3 composites was 98%. The average grain sizes of Ta and Al2O3 in the Ta – 1.67Al2O3
composite heated up to 1520 °C were determined as 205 and 40 nm, respectively. A Vickers diamond indentation technique were used to evaluate the hardness and fracture toughness of the Ta – 1.67Al2O3 composite under applied load 20kgf. The average
Vickers hardness and fracture toughness value were 1340 kg/mm2 and 7.9 MPa·m1/2, respectively.
Culturally Relevant Pedagogy in the English Curriculum
Authors: Capper Kelley
Published: March 2021

As educators, whether in urban or suburban schools, we must tailor our curriculum to who is in our classrooms. Individualizing curriculum has always been taught in teacher preparation programs, but now instead of just individualizing curriculum based on learning styles, we must base it on who our students are racially and culturally as well. This research investigates student engagement within a culturally relevant English curriculum, specifically in a classroom that uses culturally relevant materials to reach to a higher level of student engagement with students of color.
Anxieties and Coping among Filipino New Fathers with Postnatal Depression
Authors: Baral Jay Errol V. , Guzman Rosalito de
Published: March 2021

Existing evidence suggests that postnatal depression is common in fathers of newborns among low- and middle-income countries because parents from this region experience socioeconomic difficulties. Common socioeconomic difficulties include educational attainment, employment status, and monthly income. Through the number of available participants, this study screened 50 new fathers coming from barangays of Cabanatuan City, Province of Nueva Ecija, Philippines. This study made use of the Becks Depression Inventory to carefully select new fathers without depression before childbirth. Remaining participants were administered Edinburgh Postnatal Depression Scale (EPDS) and Gotland Male Depression Scale (GMDS) 24–72 hours after the childbirth. From this, the researcher was left with seven new fathers who were invited for an in-depth interview. Using the role strain theory and depressive symptoms from the EPDS and GMDS, the researcher drafted a general idea of where to begin the interview. Structured questions were followed to meet the theoretical sensitivity and domains of the tools used (EPDS and GMDS). Qualitative analysis revealed FEAR among new fathers with Postnatal Depression coming from difficulties in financial responsibility, emotional responses, adaptability and role transition.
Muddled Measurement: A Historical Perspective on Questionable Practices in School Psychology’s Assessment of Learning Disabilities
Authors: Elias Eric
Published: March 2021

As school psychologists we are well trained with using and interpreting a variety of psychometric instruments, yet there are several studies that indicate that school psychologist’s interpretive practices veer off the intended path. The application of assessment to the process of identification of specific learning disabilities (SLD) has been noted as one of the more problematic areas in psychoeducational assessment for myriad reasons. While the medical field has begun to focus on de-implementing ineffective practices, the field of psychology has not followed as readily. This article considers the costs of poor decision making in the context of SLD evaluation and seeks to identify evidence-based assessment practices for SLD identification and decision making. After considering historical perspectives, approaches and practices for assessing SLD, actuarial interpretation, and treatment validity will be discussed.
Hyperviscosity-related retinopathy and serous macular detachment in Waldenström’s macroglobulinemia: A mortal case in 5 years
Authors: Lai Chun-Chieh , Chang Chun-Hsiang
Published: March 2021

Purpose:

To present a 5-year mortal case of Waldenström’s macroglobulinemia-related retinopathy and serous macular detachment.

Case report:

A 63-year-old man, with unremarkable medical history, presented with bilateral decreased vision for 2 months. Fundus examination revealed bilateral scattered retinal hemorrhages, exudates, venous tortuosity, and serous macular detachment. Hematologic and biochemistry profiles showed pancytopenia with blood smear demonstrating erythrocyte rouleaux formation. Hyperviscosity syndrome was suspected and later Waldenström’s macroglobulinemia was diagnosed by bone marrow biopsy and high concentration of serum IgM. Plasmapheresis and subsequent chemotherapy were arranged. In spite of resolution of most retinal abnormalities, his visual acuity still showed no improvement with a persistent bilateral macular detachment. The patient then died 5 years after the diagnosis of Waldenström’s macroglobulinemia.

Conclusions:

Long-term toxicity of IgM to the retinal pigment epithelium may impede the resolution of the persistent serous macular detachment, resulting in an inability of recovery in his vision. Therefore, early diagnosis and timely reduction of serum paraproteins by plasmapheresis and chemotherapy is critical for preventing permanent damages to patients’ health and vision.
Augmented trabeculectomy-outcomes of first hundred versus second hundred surgeries of a fellowship-trained glaucoma surgeon
Authors: Rattanasirivilai Pornjittra , Ali Zaria Christine , Khoo Dawnn Ira , Shankar Vikas
Published: March 2021

Purpose:

We aim to compare the outcomes of trabeculectomy with mitomycin-C by a fellowship-trained glaucoma surgeon in the first hundred compared to second hundred surgeries.

Patients and methods:

Retrospective review of 200 consecutive surgeries from May 2015 to January 2017. Primary outcomes were intraocular pressure (IOP) control and use of IOP-lowering medications. Success between first hundred (Group 1) and second hundred (Group 2) patients were reported using World Glaucoma Association guidelines. Kaplan-Meier survival demonstrated complete success and qualified success. Secondary outcome measures were postoperative complications, bleb interventions and additional procedures.

Results:

We found no statistical difference between the first hundred and second hundred patient’s postoperative IOP at week 4 ( p = 0.17), 3 months ( p = 0.74), 6 months ( p = 0.46), 12 months ( p = 0.47), 18 months ( p = 0.13) or at final follow up ( p = 0.53). The mean final follow up period was 3.6 ± 0.7 years. Mean IOP reduction in Group 1 was from 27.1 ± 10.8 to 12.6 ± 7.1 ( p < 0.0001) and Group 2 from 22.8 ± 8.4 to 11.3 ± 4.2 ( p < 0.0001). Kaplan-Meier graphs showed no significant difference in complete success ( p = 0.0693) or qualified success ( p = 0.0866) between Group 1 and Group 2. Bleb interventions were not statistically significant between two groups. There was a significantly higher rate of complications with the first hundred patients ( p < 0.0001).

Conclusion:

Both first hundred and second hundred patient groups achieved statistically similar outcomes in long term IOP control. Significant reduction of complications was achieved in the second group of patients.
Sacred Healings through Telling Story: Lessons from the Sacred Grounds
Authors: Pulis Jessica E. , Hollenberg Alexander , Wodabek Brianna
Published: March 2021

In Canada, women—in particular, Indigenous women—comprise the fastest growing population of those who are sentenced. These trends are evidence of the continued impact of colonialism and the residential school legacy that has been well documented by scholars in varying degrees and at all levels of the Canadian criminal justice system. However, changes to address discrimination and overrepresentation have mostly resulted in changes within the current system rather than changes to the system itself. Attempts to “indigenize the white system” through training, programming, legislation, employment, and funding continue to reinforce colonialism and fail those who are Indigenous, especially women and girls. In acknowledgment of such harm, Elizabeth Fry Peel-Halton and Correctional Services Canada (CSC) collaborated with local Elder, Little Brown Bear (Ernest W. Matton), to create space where women could participate in traditional sweat lodge ceremony and healing away from correctional facilities, with the goal of providing a more authentic experience for Indigenous women and other women who are sentenced. While there are sweat lodges at both federal and provincial facilities, the Sacred Grounds are the first off-site (i.e., away from the correctional institution) space like this in Canada. This research explores the ways the Sacred Grounds possibly reduces the settler-colonial imperatives of traditional bricks and bars corrections and may encourage and support women’s stories of resilience and reconciliation.
Cytokine release syndrome and neurological event costs in lisocabtagene maraleucel–treated patients in the TRANSCEND NHL 001 trial
Authors: Abramson Jeremy S. , Siddiqi Tanya , Garcia Jacob , Dehner Christine , Kim Yeonhee , Nguyen Andy , Snyder Sophie , McGarvey November , Gitlin Matthew , Pelletier Corey , Jun Monika P.
Published: March 2021

Chimeric antigen receptor (CAR) T-cell therapies have demonstrated high response rates in patients with relapsed/refractory large B-cell lymphoma (LBCL); however, these therapies are associated with 2 CAR T cell–specific potentially severe adverse events (AEs): cytokine release syndrome (CRS) and neurological events (NEs). This study estimated the management costs associated with CRS/NEs among patients with relapsed/refractory LBCL using data from the pivotal TRANSCEND NHL 001 trial of lisocabtagene maraleucel, an investigational CD19-directed defined composition CAR T-cell product with a 4-1BB costimulation domain administered at equal target doses of CD8+ and CD4+ CAR+ T cells. This retrospective analysis of patients from TRANSCEND with prospectively identified CRS and/or NE episodes examined relevant trial-observed health care resource utilization (HCRU) associated with toxicity management based on the severity of the event from the health care system perspective. Cost estimates for this analysis were taken from publicly available databases and published literature. Of 268 treated patients as of April 2019, 127 (47.4%) experienced all-grade CRS and/or NEs, which were predominantly grade ≤2 (77.2%). Median total AE management costs ranged from $1930 (grade 1 NE) to $177 343 (concurrent grade ≥3 CRS and NE). Key drivers of cost were facility expenses, including intensive care unit and other inpatient hospitalization lengths of stay. HCRU and costs were significantly greater among patients with grade ≥3 AEs (22.8%). Therefore, CAR T-cell therapies with a low incidence of severe CRS/NEs will likely reduce HCRU and costs associated with managing patients receiving CAR T-cell therapy. This clinical trial was registered at www.clinicaltrials.gov as #NCT02631044.
Revisiting IL-6 expression in the tumor microenvironment of classical Hodgkin lymphoma
Authors: Gholiha Alex Reza , Hollander Peter , Glimelius Ingrid , Hedstrom Gustaf , Molin Daniel , Hjalgrim Henrik , Smedby Karin E. , Hashemi Jamileh , Amini Rose-Marie , Enblad Gunilla
Published: March 2021

Interleukin-6 (IL-6) can induce therapeutic resistance for several cancer agents currently used to treat classical Hodgkin lymphoma (cHL). We aimed to investigate whether the presence of IL-6+ leukocytes and IL-6+ Hodgkin-Reed-Sternberg (HRS) cells in the tumor microenvironment (TME) was associated with adverse survival outcomes, expression of other immune markers, and serum IL-6 levels. We used a contemporarily treated cohort (n = 136), with a median follow-up of 13.8 years (range, 0.59-15.9 years). We performed immunohistochemistry with an IL-6 antibody on tissue microarrays from diagnostic biopsies of cHL patients. Patients with IL-6+ leukocytes ≥1% (n = 54 of 136) had inferior event-free survival (hazard ratio [HR] = 3.58; 95% confidence interval [CI], 1.80-7.15) and overall survival (HR = 6.71; 95% CI, 2.51-17.99). The adverse survival was maintained in multivariate Cox regression and propensity score-matched analyses, adjusting for well-known poor-prognostic covariates. The presence of IL-6+ HRS cells and high serum IL-6 levels were not associated with survival. IL-6+ leukocytes correlated with increased proportions of IL-6+ HRS cells (P < .01), CD138+ plasma cells (P < .01), CD68+ macrophages (P = .02), and tryptase-positive mast cells (P < .01). IL-6+ HRS cells correlated with increased proportions of CD68+ macrophages (P = .03), programmed death-ligand 1–positive (PD-L1+) leukocytes (P = .04), and PD-L1+ HRS cells (P < .01). Serum-IL-6 lacked correlation with IL-6 expression in the TME. This is the first study highlighting the adverse prognostic impact of IL-6+ leukocytes in the TME in a cohort of contemporarily treated adult patients with cHL.
Current Strategies for Noble Metal Nanoparticle Synthesis
Authors: Habibullah Giyaullah , Viktorova Jitka , Ruml Tomas
Published: March 2021

Noble metals have played an integral part in human history for centuries; however, their integration with recent advances in nanotechnology and material sciences have provided new research opportunities in both academia and industry, which has resulted in a new array of advanced applications, including medical ones. Noble metal nanoparticles (NMNPs) have been of great importance in the field of biomedicine over the past few decades due to their importance in personalized healthcare and diagnostics. In particular, platinum, gold and silver nanoparticles have achieved the most dominant spot in the list, thanks to a very diverse range of industrial applications, including biomedical ones such as antimicrobial and antiviral agents, diagnostics, drug carriers and imaging probes. In particular, their superior resistance to extreme conditions of corrosion and oxidation is highly appreciated. Notably, in the past two decades there has been a tremendous advancement in the development of new strategies of more cost-effective and robust NMNP synthesis methods that provide materials with highly tunable physicochemical, optical and thermal properties, and biochemical functionalities. As a result, new advanced hybrid NMNPs with polymer, graphene, carbon nanotubes, quantum dots and core–shell systems have been developed with even more enhanced physicochemical characteristics that has led to exceptional diagnostic and therapeutic applications. In this review, we aim to summarize current advances in the synthesis of NMNPs (Au, Ag and Pt).
Evaluation of Juniperus communis L. seed extract on benign prostatic hyperplasia induced in male Wistar rats
Authors: Akbari Fatemeh , Azadbakht Mohammad , Megha Kanu , Dashti Ayat , Vahedi Lale , Barzegar Nejad Ayob , Mahdizadeh Zahra , Abdi Sarkami Sahar , Sadati Mohammad
Published: March 2021

Background

Benign prostatic hyperplasia (BPH) is a common disease which causes various health problems for elderly men such as urinary retention, recurring urinary tract infection and bladder stones. The aim of this study is to evaluate the therapeutic effects ofJuniperus communisL.seed extract (JCS) on BPH in male Wistar rats.

Methods

To this end, 30 rats were divided into 5 groups (N = 6): group 1 (vehicle), group 2 (disease control), group 3 (standard medicine; 10 mg/kg finasteride), and groups 4 and 5 were treated with 300 mg/kg and 600 mg/kg of the hydroalcoholic JCS seed extract, respectively. Groups 2, 3, 4 and 5 received testosterone enanthate to induce prostatic hyperplasia. At the end of experimental period (28 days), prostate glands were cut off under anesthesia. Histopathological examination was done and biochemical parameters such as Malondialdehyde, Glutathione and protein carbonyl were also measured. Their body weights were also observed during the study. At the end of the experiment, prostate weights and prostate specific antigen (PSA) levels were measured. Prostate index, inhibition prostate weight and inhibition prostate index were also calculated.

Results

Both histopathological examination and biochemical parameter results showed significant improvements in rats treated with finasteride and 600 mg/kg JCS extract (p < 0.01). In addition, PSA levels showed significant decrease in comparison with the disease group. But acute toxicity test indicated that using JCS extract resulted in an increase in liver enzymes (ALP, LDH, SGOT, SGPT). As a result, the extract should be used with caution.

Conclusions

Oral administration of JCS extract is effective on preventing testosterone-induced benign prostatic hyperplasia.
Utilization of L-glutamate as a preferred or sole nutrient in Pseudomonas aeruginosa PAO1 depends on genes encoding for the enhancer-binding protein AauR, the sigma factor RpoN and the transporter complex AatJQMP
Authors: Lundgren Benjamin R. , Shoytush Joseph M. , Scheel Ryan A. , Sain Safreen , Sarwar Zaara , Nomura Christopher T.
Published: March 2021

Background

Glutamate and aspartate are preferred nutrients for a variety of microorganisms. In the case for manyPseudomonasspp., utilization of these amino acids is believed to be dependent on a transporter complex comprised of a periplasmic-solute binding protein (AatJ), two permease domains (AatQM) and an ATP-binding component (AatP). Notably, expression of this transporter complex is hypothesized to be regulated at the transcriptional level by the enhancer-binding protein AauR and the alternative sigma factor RpoN. The purpose of the current study was to determine the biological significance of the putativeaatJ-aatQMPoperon and its regulatoryaauRandrpoNgenes in the utilization of L-glutamate, L-glutamine, L-aspartate and L-asparagine inPseudomonas aeruginosaPAO1.

Results

Deletion of theaatJ-aatQMP,aauRorrpoNgenes did not affect the growth ofP. aeruginosaPAO1 on L-glutamate, L-glutamine, L-aspartate and L-asparagine equally. Instead, only growth on L-glutamate as the sole carbon source was abolished with the deletion of any one of these genes. Interestingly, growth of theaauRmutant on L-glutamate was readily restored via plasmid-based expression of theaatQMPgenes, suggesting that it is the function of AatQMP (and not AatJ) that is limiting in the absence of theaauRgene. Subsequent analysis of beta-galactosidase reporters revealed that bothaatJandaatQwere induced in response to L-glutamate, L-glutamine, L-aspartate or L-asparagine in a manner dependent on theaauRandrpoNgenes. In addition, bothaatJandaatQwere expressed at reduced levels in the absence of the inducing-amino acids and the regulatoryaauRandrpoNgenes. The expression of theaatJ-aatQMPgenes is, therefore, multifaceted. Lastly, the expression levels ofaatJwere significantly higher (> 5 fold) than that ofaatQunder all tested conditions.

Conclusions

The primary function of AauR inP. aeruginosaPAO1 is to activate expression of theaatJ-aatQMPgenes in response to exogenous acidic amino acids and their amide derivatives. Importantly, it is the AauR-RpoN mediated induction of theaatQMPgenes that is the pivotal factor enablingP. aeruginosaPAO1 to effectively utilize or consume L-glutamate as a sole or preferred nutrient.
Phenylketonuria and juvenile idiopathic arthritis: a case report
Authors: Zhu Ting Ting , Wu Jin , Wang Li Yuan , Sun Xiao Mei
Published: March 2021

Background

Phenylketonuria (PKU) is a genetic metabolic disorder in which patients have no ability to convert phenylalanine to tyrosine. Several autoimmune diseases have been reported to combine with PKU, co-existent of PKU and Juvenile Idiopathic Arthritis (JIA) has not been presented.

Case presentation

The girl was diagnosed with PKU at the age of 1 month confirmed by molecular data. At the age of 3.5 years, she presented with pain and swelling of her right ankle, right knee, and right hip joint. After a serial of examinations, she was diagnosed with JIA and treated with a nonsteroidal anti-inflammatory drug.

Conclusions

We report a rare case of a 4-year-old girl with PKU and JIA, which supports a possible interaction between PKU and JIA. Long-term metabolic disturbance may increase the susceptibility to JIA. Further chronic inflammation could alter the metabolism of tryptophan and tyrosine to increase blood Phe concentration. In addition, corticosteroid and methotrexate therapy for JIA may increase blood Phe concentration.
Correlation of osteoarthritis or rheumatoid arthritis with bone mineral density in adults aged 20–59 years
Authors: Zhu Zhongxin , Hu Gangfeng , Jin Fang , Yao Xiaocong
Published: March 2021

Background

It is reported that osteoporosis commonly occurs among patients with rheumatoid arthritis (RA), whereas the association between osteoporosis and osteoarthritis (OA) remains controversial. Our aim in this study was to investigate the association between BMD, as a marker of osteoporosis, and OA and RA among adults 20−59 years of age, using a population-based sample from the National Health and Nutrition Examination Survey (NHANES).

Methods

Our analysis was based on the NHANES data collected between 2011 and 2018. Data regarding arthritis status and the type of arthritis (OA or RA) were obtained from questionnaires. Lumbar BMD was measured by dual-energy X-ray absorptiometry. The association between OA, RA, and lumbar BMD was evaluated using logistic regression models. Subgroup analyses, stratified by gender and race, were performed. The association between duration of arthritis and lumbar BMD was also investigated.

Results

A total of 11,094 adults were included in our study. Compared to the non-arthritis group, participants with OA had a higher lumbar BMD (β = 0.023, 95% CI 0.011–0.035), with no significant association between lumbar BMD and RA (β = 0.014, 95% CI − 0.003 to 0.031). On subgroup analyses stratified by gender, males with OA had a higher lumbar BMD compared to those without OA (β = 0.047, 95% CI 0.028–0.066). In females, OA was not associated with lumbar BMD (β = 0.007, 95% CI − 0.008 to 0.021). There was no association between lumbar BMD and RA in both males (β = 0.023, 95% CI − 0.003 to 0.048) and females (β = 0.008, 95% CI − 0.015 to 0.031). Duration of arthritis was not associated with lumbar BMD for both OA (β = − 0.0001, 95% CI − 0.0017 to 0.0015) and RA (β = 0.0006, 95% CI − 0.0012 to 0.0025).

Conclusions

Lumbar BMD was associated with OA but not with RA. While a higher lumbar BMD was associated with OA in males, but not in females. Our findings may improve our understanding between OA, RA, and bone health.
Developing a task-sharing psychological intervention to treat mild to moderate symptoms of perinatal depression and anxiety in South Africa: a mixed-method formative study
Authors: Boisits Sonet , Abrahams Zulfa , Schneider Marguerite , Honikman Simone , Kaminer Debra , Lund Crick
Published: March 2021

Background

Symptoms of depression and anxiety are highly prevalent amongst perinatal women in low-resource settings of South Africa, but there is no access to standardised counselling support for these conditions in public health facilities. The aim of this study is to develop a task-sharing psychological counselling intervention for routine treatment of mild to moderate symptoms of perinatal depression and anxiety in South Africa, as part of the Health Systems Strengthening in sub-Saharan Africa (ASSET) study.

Methods

We conducted a review of manuals from seven counselling interventions for depression and anxiety in low- and middle-income countries and two local health system training programmes to gather information on delivery format and common counselling components used across task-sharing interventions. Semi-structured interviews were conducted with 20 health workers and 37 pregnant women from four Midwife Obstetric Units in Cape Town to explore perceptions and needs relating to mental health. Stakeholder engagements further informed the intervention design and appropriate service provider. A four-day pilot training with community-based health workers refined the counselling content and training material.

Results

The manual review identified problem-solving, psychoeducation, basic counselling skills and behavioural activation as common counselling components across interventions using a variety of delivery formats. The interviews found that participants mostly identified symptoms of depression and anxiety in behavioural terms, and lay health workers and pregnant women demonstrated their understanding through a range of local idioms. Perceived causes of symptoms related to interpersonal conflict and challenging social circumstances. Stakeholder engagements identified a three-session counselling model as most feasible for delivery as part of existing health care practices and community health workers in ward-based outreach teams as the best placed delivery agents. Pilot training of a three-session intervention with community-based health workers resulted in minor adaptations of the counselling assessment method.

Conclusion

Input from health workers and pregnant women is a critical component of adapting existing maternal mental health protocols to the context of routine care in South Africa, providing valuable data to align therapeutic content with contextual needs. Multisector stakeholder engagements is vital to align the intervention design to health system requirements and guidelines.
Correction to: The leishmanicidal efect of Lucilia sericata larval saliva and hemolymph on in vitro Leishmania tropica
Authors: Rahimi Sara , Khamesipour Ali , Akhavan Amir Ahmad , Rafnejad Javad , Ahmadkhaniha Reza , Bakhtiyari Mahmood , Veysi Arshad , Akbarzadeh Kamran
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Molecular features of untreated breast cancer and initial metastatic event inform clinical decision-making and predict outcome: long-term results of ESOPE, a single-arm prospective multicenter study
Authors: Callens Céline , Driouch Keltouma , Boulai Anaïs , Tariq Zakia , Comte Aurélie , Berger Frédérique , Belin Lisa , Bièche Ivan , Servois Vincent , Legoix Patricia , Bernard Virginie , Baulande Sylvain , Chemlali Walid , Bidard François-Clément , Fourchotte Virginie , Salomon Anne Vincent- , Brain Etienne , Lidereau Rosette , Bachelot Thomas , Saghatchian Mahasti , Campone Mario , Giacchetti Sylvie , Zafrani Brigitte Sigal , Cottu Paul
Published: March 2021

Background

Prognosis evaluation of advanced breast cancer and therapeutic strategy are mostly based on clinical features of advanced disease and molecular profiling of the primary tumor. Very few studies have evaluated the impact of metastatic subtyping during the initial metastatic event in a prospective study. The genomic landscape of metastatic breast cancer has mostly been described in very advanced, pretreated disease, limiting the findings transferability to clinical use.

Methods

We developed a multicenter, single-arm, prospective clinical trial in order to address these issues. Between November 2010 and September 2013, 123 eligible patients were included. Patients at the first, untreated metastatic event were eligible. All matched primary tumors and metastatic samples were centrally reviewed for pathological typing. Targeted and whole-exome sequencing was applied to matched pairs of frozen tissue. A multivariate overall survival analysis was performed (median follow-up 64 months).

Results

Per central review in 84 patients (out of 130), we show that luminal A breast tumors are more prone to subtype switching. By combining targeted sequencing of a 91 gene panel (n = 67) and whole-exome sequencing (n = 30), a slight excess of mutations is observed in the metastases. Luminal A breast cancer has the most heterogeneous mutational profile and the highest number of mutational signatures, when comparing primary tumor and the matched metastatic tissue. Tumors with a subtype change have more mutations that are private. The metastasis-specific mutation load is significantly higher in late than in de novo metastases. The most frequently mutated genes were TP53 and PIK3CA. The most frequent metastasis-specific druggable genes were PIK3CA, PTEN, KDR, ALK, CDKN2A, NOTCH4, POLE, SETD2, SF3B1, and TSC2. Long-term outcome is driven by a combination of tumor load and metastasis biology.

Conclusions

Profiling of the first, untreated, metastatic event of breast cancer reveals a profound heterogeneity mostly in luminal A tumors and in late metastases. Based on this profiling, we can derive information relevant to prognosis and therapeutic intervention, which support current guidelines recommending a biopsy at the first metastatic relapse.

Trial registration

The trial was registered at ClinicalTrials.gov (NCT01956552).
Giant Darier–Ferrand dermatofibrosarcoma protuberans of the abdomen and pelvis: a case report
Authors: Triki A. , Aloui M. , Ghalleb M. , Jbir I. , Naceur Ben , Hassouna J. Ben , Chargui R. , Rahal K.
Published: March 2021

Background

Darier–Ferrand dermatofibrosarcoma (DFS) is a rare malignant cutaneous neoplasm characterized by local aggressiveness, high risk of recurrence, and low metastatic potential.

Case presentation

A 60-year-old Tunisian man with recurrent abdominopelvic DFS for which he had undergone multiple excisions presented with an extensive DFS that invaded the external genitals. He underwent a large excision with emasculation and thin cutaneous graft of the abdominal wall and local skin flap in the pelvis.

Conclusion

DFS is a rare yet recurrent skin tumor. Wide excision with free margins remains the cornerstone of treatment. We report a case of a giant DFS treated with wide excision and reconstructive surgery to cover the defect.
Therapeutic effects of peripherally administrated neural crest stem cells on pain and spinal cord changes after sciatic nerve transection
Authors: Zhang Yang , Xu Xiang , Tong Yuxin , Zhou Xijie , Du Jian , Choi In Young , Yue Shouwei , Lee Gabsang , Johnson Blake N. , Jia Xiaofeng
Published: March 2021

Background

Severe peripheral nerve injury significantly affects patients’ quality of life and induces neuropathic pain. Neural crest stem cells (NCSCs) exhibit several attractive characteristics for cell-based therapies following peripheral nerve injury. Here, we investigate the therapeutic effect of NCSC therapy and associated changes in the spinal cord in a sciatic nerve transection (SNT) model.

Methods

Complex sciatic nerve gap injuries in rats were repaired with cell-free and cell-laden nerve scaffolds for 12 weeks (scaffold and NCSC groups, respectively). Catwalk gait analysis was used to assess the motor function recovery. The mechanical withdrawal threshold and thermal withdrawal latency were used to assess the development of neuropathic pain. Activation of glial cells was examined by immunofluorescence analyses. Spinal levels of extracellular signal-regulated kinase (ERK), NF-κB P65, brain-derived neurotrophic factor (BDNF), growth-associated protein (GAP)-43, calcitonin gene-related peptide (CGRP), and inflammation factors were calculated by western blot analysis.

Results

Catwalk gait analysis showed that animals in the NCSC group exhibited a higher stand index and Max intensity At (%) relative to those that received the cell-free scaffold (scaffold group) (p < 0.05). The mechanical and thermal allodynia in the medial-plantar surface of the ipsilateral hind paw were significantly relieved in the NCSC group. Sunitinib (SNT)-induced upregulation of glial fibrillary acidic protein (GFAP) (astrocyte) and ionized calcium-binding adaptor molecule 1 (Iba-1) (microglia) in the ipsilateral L4–5 dorsal and ventral horn relative to the contralateral side. Immunofluorescence analyses revealed decreased astrocyte and microglia activation. Activation of ERK and NF-κB signals and expression of transient receptor potential vanilloid 1 (TRPV1) expression were downregulated.

Conclusion

NCSC-laden nerve scaffolds mitigated SNT-induced neuropathic pain and improved motor function recovery after sciatic nerve repair. NCSCs also protected the spinal cord from SNT-induced glial activation and central sensitization.
Changes in the activity levels and financing sources of Israel’s private for-profit hospitals in the wake of reforms to the public-private divide
Authors: Barnea Royi , Niv-Yagoda Adi , Weiss Yossi
Published: March 2021

Background

The Israeli National Health Insurance Law provides permanent residents with a basket of healthcare services through non-profit public health insurance plans, independently of the individual’s ability to pay. Since 2015, several reforms and programs have been initiated that were aimed at reinforcing public healthcare and redressing negative aspects of the health system, and specifically the constant rise in private health expenditure. These include the “From Reimbursement-to-Networks Arrangement”, the “Cooling-off Period” program and the program to shorten waiting times. The objectives of this study were to identify, describe, and analyze changes in private hospitals in 1) the volume of publicly and privately funded elective surgical procedures; and 2) private health expenditure on surgical procedures.

Methods

Data on the volume and funding of surgical procedures during 2013–2018 were obtained from Assuta Medical Center, Hertzelia Medical Center, the Israeli Ministry of Health and the Central Bureau of Statistics. The changes in the volume and financing sources of surgical activities in private hospitals, in the wake of the reforms were analyzed using aggregate descriptive statistics.

Results

Between 2013 and 2018 the volume of surgical activities in private for-profit hospitals increased by 7%. Between 2013 and 2017, the distribution of financing sources of surgical procedures in private hospitals remained stable, with most surgical procedures (75–77%) financed by the voluntary health insurance programs of the health plans (HP-VHI). In 2018, following the regulatory reforms, a significant change in the distribution of financing sources was observed: there was a sharp decline in the volume of HP-VHI-funded surgical procedures to 26%.

Concurrently, the share of publicly-funded surgical procedures performed in private hospitals increased to 56% in 2018.,. During the study period, private spending on elective surgical procedures in private hospitals declined by 53% while public funding for them increased by 51%.

Conclusions and policy implications

In the wake of the reforms, there was a substantial shift from private to public financing of elective surgical activity in private hospitals.

Private for-profit hospitals have become important providers of publicly-funded procedures. It is likely that the reforms affected the public-private mix in the financing of elective surgical procedures in those hospitals, but due to the absence of a control group, causality cannot be proven. It is also unclear whether waiting times were shortened. Health reforms must be accompanied by a clear and comprehensive set of indicators for measuring their success.
In-house 3D-printed surgical guides for osseous lesions of the lower jaw: an experimental study
Authors: Postl Lukas , Mücke Thomas , Hunger Stefan , Bissinger Oliver , Malek Michael , Holberg Svenia , Burgkart Rainer , Krennmair Stefan
Published: March 2021

Background

The accuracy of computer-assisted biopsies at the lower jaw was compared to the accuracy of freehand biopsies.

Methods

Patients with a bony lesion of the lower jaw with an indication for biopsy were prospectively enrolled. Two customized bone models per patient were produced using a 3D printer. The models of the lower jaw were fitted into a phantom head model to simulate operation room conditions. Biopsies for the study group were taken by means of surgical guides and freehand biopsies were performed for the control group.

Results

The deviation of the biopsy axes from the planning was significantly less when using templates. It turned out to be 1.3 ± 0.6 mm for the biopsies with a surgical guide and 3.9 ± 1.1 mm for the freehand biopsies.

Conclusions

Surgical guides allow significantly higher accuracy of biopsies. The preliminary results are promising, but clinical evaluation is necessary.
Splenectomy is associated with altered leukocyte kinetics after severe trauma
Authors: Teuben Michel Paul Johan , Hollman Arne , Blokhuis Taco , Pfeifer Roman , Spijkerman Roy , Teuber Henrik , Pape Hans-Christoph , Leenen Luke Petrus Hendrikus
Published: March 2021

Background

Inadequate activation of the innate immune system after trauma can lead to severe complications such as Acute Respiratory Distress Syndrome and Multiple Organ Dysfunction Syndrome. The spleen is thought to modulate the cellular immune system. Furthermore, splenectomy is associated with improved outcome in severely injured trauma patients. We hypothesized that a splenectomy alters the cellular immune response in polytrauma.

Methods

All adult patients with an ISS ≥ 16 and suffering from splenic or hepatic injuries were selected from our prospective trauma database. Absolute leukocyte numbers in peripheral blood were measured. White blood cell kinetics during the first 14 days were compared between splenectomized patients, patients treated surgically for liver trauma and nonoperatively treated individuals.

Results

A total of 129 patients with a mean ISS of 29 were included. Admission characteristics and leukocyte numbers were similar in all groups, except for slightly impaired hemodynamic status in patients with operatively treated liver injuries. On admission, leukocytosis occurred in all groups. During the first 24 h, leukopenia developed gradually, although significantly faster in the operatively treated patients. Thereafter, leukocyte levels normalized in all nonoperatively treated cases whereas leukocytosis persisted in operatively treated patients. This effect was significantly more prominent in splenectomized patients than all other conditions.

Conclusions

This study demonstrates that surgery for intra-abdominal injuries is associated with an early drop in leucocyte numbers in peripheral blood. Moreover, splenectomy in severely injured patients is associated with an altered cellular immune response reflected by a persistent state of prominent leukocytosis after trauma.
Tumor mutation burden estimated by a 69-gene-panel is associated with overall survival in patients with diffuse large B-cell lymphoma
Authors: Chen Cunte , Liu Sichu , Jiang Xinmiao , Huang Ling , Chen Feili , Wei Xiaojun , Guo Hanguo , Shao Yang , Li Yangqiu , Li Wenyu
Published: March 2021

Background

Tumor mutation burden (TMB) as estimated by cancer gene panels (CGPs) has been confirmed to be associated with prognosis and is effective in predicting clinical benefit from immune checkpoint blockade (ICB) in solid tumors. However, whether the TMB calculated by CGPs is associated with overall survival (OS) for patients with diffuse large B-cell lymphoma (DLBCL) is worth exploring.

Methods

The prognostic value of panel-TMB, calculated by a panel of 69 genes (GP69), for 87 DLBCL patients in our clinical center (GDPH dataset) was explored. The results were further validated using 37 DLBCL patients from the Cancer Genome Atlas (TCGA) database (TCGA dataset).

Results

Spearman correlation analysis suggested that panel-TMB is positively correlated with the TMB calculated by whole-exome sequencing (wTMB) in the TCGA dataset (R = 0.76, P < 0.0001). Both GDPH and TCGA results demonstrated that higher panel-TMB is significantly associated with a poor OS for DLBCL patients (P < 0.05) where a panel of 13 genes was associated with poor OS, and another panel of 26 genes was correlated with a favorable OS for DLBCL patients. Further subgroup analysis indicated that higher panel-TMB had shorter OS in DLBCL patients with younger than 60 years, elevated LDH, greater than one extranodal involvement, stage III/IV, an IPI score of 3–5, or HBsAg, anti-HBc, or HBV-DNA negativity (P < 0.05). Interestingly, the nomogram model constructed by panel-TMB, stage, and IPI could individually and visually predict the 1-, 2- and 3-year OS rates of DLBCL patients.

Conclusions

We established GP69 for the evaluation of OS for Chinese DLBCL patients. panel-TMB might be a potential predictor for prognostic stratification of DLBCL patients.
Does access to credit reduce SMEs’ tax avoidance? Evidence from a regression discontinuity design
Authors: Kong Xiaowei , Si Deng-Kui , Li Haiyang , Kong Dongmin
Published: March 2021

This study investigates the effect of targeted reserve requirement ratio cuts (TRRRCs) on tax avoidance among small and micro enterprises (SMEs) with operating revenues below specific cutoffs in China. Using a regression discontinuity design, we causally show that, by increasing loan availability, TRRRCs significantly alleviate the financial constraints and cash dependence of SMEs and consequently reduce tax avoidance. This is especially the case among firms with lower market power and higher entertainment and travel costs. Our findings provide evidence for the real effect of TRRRCs on corporate tax avoidance and show the inclusive effect of TRRRCs on SMEs. In doing so, we indirectly reveal a rent-seeking channel underlying bank lending, thus offering clear policy implications for regulators.
Correction to: Erratum: Measurement of serum trace elements levels in patients with juvenile idiopathic arthritis
Authors: Soliman Yasser A. , Hashaad Nashwa I. , Mohammed Shuzan A. , El-Nouty Hala A.
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Challenges of Immunotherapy in Stage IV Non–Small-Cell Lung Cancer
Authors: Stock-Martineau Sophie , Magner Kate , Jao Kevin , Wheatley-Price Paul
Published: March 2021

Treatment for metastatic non–small-cell lung carcinoma has seen important advances in recent years with the introduction of targeted therapies and immunotherapy. Immune checkpoint inhibitors, which target the programmed death 1 receptor and programmed death ligand-1, alone or in combination with platinum-based chemotherapy, have become standard of care in the first-line setting for patients with advanced non–small-cell lung carcinoma without targetable driver mutations. However, several clinical questions have now since emerged. Physicians treating lung cancer lack guidance when treating patients who have a poor performance status, patients who are receiving corticosteroids, and those known for pre-existing autoimmune disorders. Furthermore, data are scarce on rechallenging a patient with immune checkpoint inhibitors after the occurrence of a significant immune-related adverse event. In this review, we aim to shed light on these topics.