bluuebunny/crossref_metadata_2025 huggingface dataset:
Guanxinshutong Alleviates Atherosclerosis by Suppressing Oxidative Stress and Proinflammation in ApoE−/− Mice
Authors: Lu Yingdong , Sun Yuchan , Jiang Zhilin , Zhang Dandan , Lin Hongchen , Qu Yi , Shang Chang , Zhao Mingjing , Cui Xiangning
Published: September 2020

Atherosclerosis (AS) is a chronic progressive disease related to dyslipidemia, inflammation, and oxidative stress. Guanxinshutong capsule (GXST), a traditional Chinese medicine, has been widely used in treating coronary atherosclerotic heart disease, while its mechanism actions on AS are still not to be well addressed. Our present study is aimed to examine the effect of GXST on AS and elucidate the multitarget mechanisms of GXST on AS. Network pharmacology analysis was employed to screen the multitarget mechanisms of GXST on AS. ApoE−/− mice were used to validate these effects. Circulating lipid profile and oxidative stress‐related factors were measured by the Elisa kit. Furthermore, the aortic trunk and aortic root were excised for oil red O staining, histopathological and immunohistochemical analysis. We first discovered that GXST was clued to exert synergistically antiatherosclerosis properties including lipid‐lowering, anti‐inflammation, and antioxidation through the computational prediction based on a network pharmacology simulation. Next, the validation experiments in atherosclerosis mice provided evidence that GXST significantly reduced atherosclerotic lesions, increased collagen deposition, and attenuated LV remodeling to some extent. Mechanistically, GXST modulated lipid profile, downregulated the level of inflammatory cytokines and NF‐κBp65. GXST also reduced the activity of oxidative parameter MDA and upregulated the activities of antioxidant enzymes (SOD and GSH) compared with the AS model group. In conclusion, GXST intervention might attenuate atherosclerosis by mechanisms involving reducing lipid deposition, modulating oxidative stress and inflammatory responses, but a larger controlled trial is necessary for confirmation.
Simulating Systems Thinking under Bounded Rationality
Authors: Sellers Mark W. , Sayama Hiroki , Pape Andreas D.
Published: September 2020

Brian Arthur’s El Farol bar model of bounded rationality provides a simple computer model of decision making in a complex, dynamic, and self-organized environment. Can systems thinking provide a viable alternative strategy to traditional methods for dealing with these types of problems? Nine different agents, designed from both traditional and systems perspectives, compete in fifteen variants of the El Farol environment and their performance in 4 categories—Winner, Top Performers, Competitive, and Vulnerable—is compared. We show that systems thinking is a competitive strategy that is, at least, on par with traditional strategies and may be less vulnerable to elimination or ruin. However, there are two consequential elements that emerge. First, all strategies have some environments where they succeed and others where they fail. Second, as the population of practitioners adopts these adaptive, systems-based strategies, the environment exhibits new behaviors with a new set of unintended consequences.
A New Nonlinear Active Disturbance Rejection Control for the Cable Car System to Restrain the Vibration
Authors: Hu Xinyan , Li Lina
Published: September 2020

The safety of the cable car system is very important for the lives of the people. But, it is easily affected by the environment such as the wind which causes the cable car system to have strong vibration disturbance, thus degrading the safety of the cable car system. In this paper, a new nonlinear active disturbance rejection control (ADRC) is proposed to restrain the vibration of the cable car. First, a new two-mass-spring system model is utilized to establish the cable car system model. The new translation vibration nonlinear model is derived by a linear-invariant two-mass-spring system. Then, a special nonlinear fal• is designed to restrain the vibration, and a new high-order nonlinear ADRC is presented for the cable car system. Finally, simulation results verify the feasibility and accuracy of the proposed model.
Neutrophil Oxidized-Modified Proteins and Neutrophil Extracellular Traps in Patients with Community-Acquired Pneumonia
Authors: Molotov-Luchanskiy Vilen , Nukhuly Altynbek , Muravlyova Larissa , Bakirova Ryszhan , Kossybayeva Aruna , Klyuyev Dmitry , Demidchik Ludmila , Beinikova Irina
Published: September 2020

Background and Objectives. Community-acquired pneumonia (CAP) has a high mortality rate among adult patients throughout the world. The highest mortality is registered in the older age group with a steady increase in the number of cases of morbidity among persons of working age. Neutrophils are one of the most urgent areas of research, since their condition largely determines the development and outcome of acute pneumonia. We study the indices of oxidative stress and oxidized-modified proteins of neutrophils in CAP patients, depending on the degree of severity, and also compare the detection frequency of neutrophil extracellular traps in the progression of pneumonia. Materials and Methods. 51 patients with CAP were divided into 2 groups depending on the severity of the pathological process. The first group (I) consisted of 32 patients with moderate severity of pneumonia. The second group (II) consisted of 19 patients with severe pneumonia. The third group (III), the comparison group, consisted of 14 CAP patients with chronic obstructive pulmonary disease (COPD). The control group consisted of 19 volunteers. Results. Statistically significant increase in the level of carbonyl derivatives (CD) in patients of all study groups relative to the control group was revealed. In the group of patients with moderate severity and severe pneumonia, also in CAP patients with COPD, the level of CD exceeded the control group. There was no statistically significant difference in the level of advanced oxidation protein products (AOPP) and myeloperoxidase (MPO) in blood neutrophils between the studied groups. Conclusion. Results indicate an oxidative imbalance in neutrophils and contribute to the worsening of the course of the disease.
Housing Vacancy Rate in Major Cities in China: Perspectives from Nighttime Light Data
Authors: Tan Zhiru , Wei Donglan , Yin Zixu
Published: September 2020

In recent years, the phenomenon of housing vacancy rate (HVR) has attracted considerable attention, especially concerning unjustified expansions of Chinese cities. The aforementioned trend is disadvantageous in that it will ultimately lead to tremendous wastage of valuable land that could otherwise be more productively utilized. Consequently, the methods for accurately determining the HVR are of great importance. Based on nighttime light data from the Luojia 1-01 nighttime light imagery provided by Wuhan University in June 2018 and the building data obtained from the Resources and Environmental Sciences Data Center, we estimated the HVRs of 49 cities in China by determining the building areas and considering the floor height. The results revealed that (1) the lowest (15%) and highest (24.3%) HVRs occur in Shenzhen and Nanning, respectively. (2) The urban HVR correlates positively with the three production structures (0.3143) but is significantly negatively correlated with population (0.3841), GDP (0.6139), and urban average housing prices (0.5083). (3) The first-tier, new first-tier, and second-tier cities showed the lowest (16.9%), relatively concentrated (20.5%), and highest (21.3%) average vacancy rates, respectively. (4) The vacancy rate is relatively low in the eastern coastal areas, whereas high in the northeast and western inland areas. The proposed method can help urban planners by identifying vacant areas and providing building information.
An Adaptive Large Neighborhood Search Algorithm for the Satellite Data Transmission Scheduling Problem
Authors: Chen Yingguo , Chen Ming , Wen Jun , Chen Yingwu , Xiang Wen
Published: September 2020

Satellite establishes a satellite ground station to satellite link with a ground station to complete data transmission. However, in China, satellite ground stations only exist within the country. With the rapid increase in the number of satellites, effectively dispatching satellite communications and maximizing the performance of ground stations are necessary. We propose a heuristic adaptive large neighborhood search algorithm (H-ALNS) to solve the satellite data transmission scheduling (SDTS) problem. The algorithm includes two heuristic rules for generating the initial scheme and the conflict reduction process after updating the neighborhood. A heuristic task assignment method is used to select the execution time window and position for the task sequence. The adaptive operator is used to update the delete operator and insert operator weights into the H-ALNS. The quality of the generated planning scheme improved through continuous neighborhood destruction and repair. Through experimental analysis, the algorithm we propose is feasible for solving SDTS problems and surpasses the planning results acquired using other comparison algorithms. The H-ALNS has good prospects for practical engineering applications.
Voluminous Intrapericardial Lipoma Mimicking Pericardial Effusion
Authors: Prado de Morais Fabíola , Romero Nakajima Noah , Félix Marconi Andalécio Olívia , de Santana Prudente Pedro , Emílio Ferreira Guilherme , de Martino Luppi Andrea , Costa Mundim Fernando , Lima Aguiar Olga Maria , Salomão Daud Melo Juliana , de Carvalho Dornelas Bruno
Published: September 2020

Lipomas are rare primary heart tumors and may involve the endocardium, myocardium, or pericardium. Signs and symptoms depend on the tumor location and size. The intrapericardial lipoma we report has massive dimensions and mimics a pericardial effusion. A 38-year-old male complained of dyspnea and precordial pain. On physical examination, heart sounds were diminished. The patient had received extensive medication for a clinically suspected pericardial effusion due to heart failure. A voluminous mass resembling fat within the pericardial sac was revealed by transesophageal echocardiography and a computed tomography scan. The tumor was removed successfully by a subxiphoid surgical approach. The diagnosis of a 635 gram intrapericardial lipoma was confirmed by pathological examination. After surgery, the patient recovered well and was completely asymptomatic at a follow-up at 90 days. No medications were being taken since. The diagnosis of a pericardial effusion should be secured by imaging exams to avoid unnecessary medications. Cardiac lipomas can be readily recognized by their typical features on radiologic imaging. The surgical pathology examination confirms the diagnosis and rules out malignancy criteria.
COVID-19: Proposing a Ketone-Based Metabolic Therapy as a Treatment to Blunt the Cytokine Storm
Authors: Bradshaw Patrick C. , Seeds William A. , Miller Alexandra C. , Mahajan Vikrant R. , Curtis William M.
Published: September 2020

Human SARS-CoV-2 infection is characterized by a high mortality rate due to some patients developing a large innate immune response associated with a cytokine storm and acute respiratory distress syndrome (ARDS). This is characterized at the molecular level by decreased energy metabolism, altered redox state, oxidative damage, and cell death. Therapies that increase levels of (R)-beta-hydroxybutyrate (R-BHB), such as the ketogenic diet or consuming exogenous ketones, should restore altered energy metabolism and redox state. R-BHB activates anti-inflammatory GPR109A signaling and inhibits the NLRP3 inflammasome and histone deacetylases, while a ketogenic diet has been shown to protect mice from influenza virus infection through a protective γδ T cell response and by increasing electron transport chain gene expression to restore energy metabolism. During a virus-induced cytokine storm, metabolic flexibility is compromised due to increased levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS) that damage, downregulate, or inactivate many enzymes of central metabolism including the pyruvate dehydrogenase complex (PDC). This leads to an energy and redox crisis that decreases B and T cell proliferation and results in increased cytokine production and cell death. It is hypothesized that a moderately high-fat diet together with exogenous ketone supplementation at the first signs of respiratory distress will increase mitochondrial metabolism by bypassing the block at PDC. R-BHB-mediated restoration of nucleotide coenzyme ratios and redox state should decrease ROS and RNS to blunt the innate immune response and the associated cytokine storm, allowing the proliferation of cells responsible for adaptive immunity. Limitations of the proposed therapy include the following: it is unknown if human immune and lung cell functions are enhanced by ketosis, the risk of ketoacidosis must be assessed prior to initiating treatment, and permissive dietary fat and carbohydrate levels for exogenous ketones to boost immune function are not yet established. The third limitation could be addressed by studies with influenza-infected mice. A clinical study is warranted where COVID-19 patients consume a permissive diet combined with ketone ester to raise blood ketone levels to 1 to 2 mM with measured outcomes of symptom severity, length of infection, and case fatality rate.
Research on the First Breaking Mechanism of the Main Roof of Coal Seam with High Dip Angle
Authors: Hu Xinyu , Cai Jinlong
Published: September 2020

In order to study the mechanism and characteristics of the first breaking of the roof in thick coal seams with high dip angles, a mechanical model of elastic thin plate with four clamped edges of the roof was established, and the expressions of the deflection and stress of the roof were obtained by the energy method. The influence of the change in seam dip angle on the first breaking distance of the roof was presented. Based on the stress solution, the roof breaking criterion was proposed, and the breaking distance of the roof was calculated. Combined with numerical simulation, the stress distribution characteristics of the upper and lower surfaces of the stope roof were analyzed. The results show that the first breaking distance of the roof is inversely proportional to the seam dip angle. Broken morphology of roof in high dip seam is different from the “O‐X” morphology of horizontal roof. The roof breaking order of the seam with high dip angle is middle‐middle upper‐middle lower‐upper‐lower. These research results have certain theoretical guiding significance for the study of the first breaking mechanism of the main roof of highly inclined working face of coal seams.
Ruptured Subcapsular Liver Hematoma: A Rare Complication of HELLP Syndrome
Authors: Singh Pratishtha , Warren Kayle , Collier Victor
Published: September 2020

Subcapsular liver hematoma (SLH) is a rare complication of HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. We report a previously healthy 16-year-old female presenting with pre-eclampsia requiring emergent C-section, who developed immediate postoperative bleeding and abdominal distention. Abdominal computed tomography angiography (CTA) revealed a large encapsulated liver hematoma with active extravasation. The patient was successfully treated with a multidisciplinary approach with medical and surgical management.
Design of Composite Feedback and Feedforward Control Law for Aircraft Inertially Stabilized Platforms
Authors: Azarskov Valerii , Tunik Anatoly , Sushchenko Olha
Published: September 2020

The design of the control systems of the inertially stabilized platforms (ISPs) as part of airborne equipment for the majority of aircraft has its peculiarity. The presence of rate gyros in the inertial measurement unit gives the possibility to measure the rotation rate of the ISP base, which is the main disturbance interfering with the ISP accuracy. Inclusion of the feedforward disturbance gain in the control law with the simplest PI feedback significantly improves the accuracy of stabilization by the invariance theory. A combination of feedback and feedforward controllers produces a synergetic effect, thus, improving ISP accuracy. This article deals with the design of the airborne ISP control systems consisting of two stages: the parametric optimization of the PI feedback control based on composite “performance-robustness” criterion and the augmentation of the obtained system with feedforward gain. To prove the efficiency of the proposed control laws, the simulation of the ISP was undertaken. We have used a simulation of the heading-hold system of the commuter aircraft Beaver and the yaw rate output of this closed-loop system we have used as a source of the disturbance. The results of modeling proved the efficiency of the proposed design method.
Applying the Large Parameter Technique for Solving a Slow Rotary Motion of a Disc about a Fixed Point
Authors: Ismail A. I.
Published: September 2020

In this paper, the motion of a disk about a fixed point under the influence of a Newtonian force field and gravity one is considered. We modify the large parameter technique which is achieved by giving the body a sufficiently small angular velocity component r0 about the fixed z-axis of the disk. The periodic solutions of motion are obtained in the neighborhood r0 tends to 0. This case of study is excluded from the previous works because of the appearance of a singular point in the denominator of the obtained solutions. Euler-Poison equations of motion are obtained with their first integrals. These equations are reduced to a quasilinear autonomous system of two degrees of freedom and one first integral. The periodic solutions for this system are obtained under the new initial conditions. Computerizing the obtained periodic solutions through a numerical technique for validation of results is done. Two types of analytical and numerical solutions in the new domain of the angular velocity are obtained. Geometric interpretations of motion are presented to show the orientation of the body at any instant of time t.
Dynamic Response of Rock Slopes under Obliquely Incident Seismic Waves
Authors: Liu Biao , Zhang Boyan
Published: September 2020

In this study, the seismic input model of slope is proposed to investigate the dynamic response of the rock slope under obliquely incident seismic wave on the basis of the time‐domain wave analysis method. The model includes viscoelastic boundary considering the infinite foundation radiation damping and the seismic obliquely incident method. The semi‐infinite space numerical example is simulated to verify the validity and accuracy of the model. Based on the established model, the effects of the variation of the seismic wave incident angles and slope angles on the dynamic response of a rock slope are analyzed. The results demonstrate that the changes of the incident angle and the slope angle have no discernible effect on the dynamic response of the rock slope when the P wave is obliquely incident. As the SV wave is obliquely incident, the peak ground acceleration amplification coefficient along the slope surface gradually increases with the increase of the incident angle; when the slope angle gradually increases, the peak ground acceleration amplification coefficient along the slope surface will also gradually increase at the upper part of the slope. The research results can provide some basis for the pseudostatic method to determine the seismic action coefficient.
Numerical Evaluation of Reinforced Concrete Columns Retrofitted with FRP for Blast Mitigation
Authors: Dong Jing , Zhao Junhai , Zhang Dongfang
Published: September 2020

Fiber reinforced polymer (FRP) material is commonly applied in retrofitting structures due to the advantages of high strength and well corrosion resistance. Previous studies indicated that retrofitting with FRP sheet was an effective way for protecting the existing structures to resist the blast loads, but little research made comprehensive comparison study on the blast response of RC columns with different retrofitting strategies. This paper proposed a series of FRP retrofitting strategies and evaluated their effect on blast mitigation using numerical analysis approach. Comparison studies were conducted on the effect of FRP type, FRP thickness, and retrofitting mode on blast mitigation. A finite element model of RC columns retrofitted with FRP under blast loading was developed. The model considered the strain rate effect of steel and concrete and the orthotropic property of FRP composites. The reliability of the proposed model was validated against the data from a field blast test. Based on the verified model, the blast responses of RC columns with different retrofitting strategies were numerically investigated. According to the result analysis, appropriate FRP type, FRP thickness, retrofitting mode, and retrofitting length were recommended.
Comparison of Erythrocyte Membrane Lipid Profiles between NAFLD Patients with or without Hyperlipidemia
Authors: Chen Wenbin , Shao Shanshan , Cai Hu , Han Jie , Guo Tian , Fu Yilin , Yu Chunxiao , Zhao Meng , Bo Tao , Yao Zhenyu , Zhao Jiajun , Zhang Qunye , Xu Guowang , Hu Chunxiu , Gao Ling
Published: September 2020

Objectives. Nonalcoholic fatty liver disease (NAFLD) and hyperlipidemia (HL) are common metabolic disorders due to overnutrition and obesity. NAFLD is often associated with hyperlipidemia. The aim of this study was to identify and compare the erythrocyte membrane lipids profile in NAFLD patients with or without HL.Methods. A total of 112 subjects (with similar age and body mass index) were divided into four groups: (1) normal controls, (2) NAFLD alone, (3) HL alone, and (4) NAFLD combined with HL (NAFLD + HL). Lipid was extracted from the erythrocyte membrane, and lipid profiles of subjects were analyzed by liquid chromatography mass spectrometry (LC-MS).Results. Data sets from 103 subjects were adopted for lipidomic analysis. Significant changes of lipid species were observed in patient groups, especially in the HL group and NAFLD + HL group. The HL group showed increased level of most lipid species, and decreased level of most lipid species was observed in the NAFLD + HL group. The weight percent of myristic acid, stearic acid, erucic acid, and docosahexaenoic acid also showed distinct variation between different groups.Conclusions. NAFLD, HL, and NAFLD + HL all had an impact on lipid profiling of the erythrocyte membrane. The influence of NAFLD alone is less important compared with HL. Some lipids should be highlighted because of their specific role in cell function and systemic metabolism.
Palbociclib and Trastuzumab in HER2-Positive Advanced Breast Cancer: Results from the Phase II SOLTI-1303 PATRICIA Trial
Authors: Ciruelos Eva , Villagrasa Patricia , Pascual Tomás , Oliveira Mafalda , Pernas Sonia , Paré Laia , Escrivá-de-Romaní Santiago , Manso Luis , Adamo Barbara , Martínez Eduardo , Cortés Javier , Vazquez Silvia , Perelló Antonia , Garau Isabel , Melé Mireia , Martínez Noelia , Montaño Alvaro , Bermejo Begoña , Morales Serafin , Echarri María J. , Vega Estela , González-Farré Blanca , Martínez Débora , Galván Patricia , Canes Jordi , Nuciforo Paolo , Gonzalez Xavier , Prat Aleix
Published: September 2020

Purpose:

To assess palbociclib in combination with trastuzumab with or without endocrine therapy in patients with HER2-positive advanced breast cancer.

Patients and Methods:

PATRICIA is a prospective, open-label, multicenter phase II trial. Patients had received 2–4 prior lines of anti-HER2–based regimens. Treatment consisted of palbociclib 200 mg daily for 2 weeks and 1 week off plus trastuzumab. The study was based on a Simon two-stage design comprising three cohorts: estrogen receptor (ER)-negative (cohort A), ER-positive (cohort B1), and ER-positive with letrozole (cohort B2). ER-positive patients were randomized to cohorts B1 or B2. Primary endpoint was progression-free survival rate at 6 months (PFS6). Secondary objectives included safety and evaluation of the PAM50 intrinsic subtypes.

Results:

Seventy-one patients were recruited (n = 15 in cohort A and 28 in each cohort B). The PFS6 rate in cohorts A, B1, and B2 was 33.3% (5/15), 42.8% (12/28), and 46.4% (13/28), respectively. Regarding safety, grade 1–2 and 3–4 toxicities occurred in 97.7% and 84.4% of patients, respectively. The most common grade 3–4 toxicities were neutropenia (66.4%) and thrombocytopenia (11.3%). Regarding PAM50, 59 (83.1%) tumors were profiled. Luminal disease defined by PAM50 was found independently associated with longer PFS compared with non-luminal disease (10.6 vs. 4.2 months median PFS; adjusted hazard ratio = 0.40; P = 0.003).

Conclusions:

Palbociclib in combination with trastuzumab is safe and exhibits promising survival outcomes in trastuzumab pretreated ER-positive/HER2-positive advanced breast cancer with a PAM50 Luminal A or B subtype. The enrollment was stopped prematurely, and a new randomized cohort was opened in this population.
Association of Aspirin, Metformin, and Statin Use with Gastric Cancer Incidence and Mortality: A Nationwide Cohort Study
Authors: Cho Mi Hee , Yoo Tae Gon , Jeong Su-Min , Shin Dong Wook
Published: September 2020

Anticancer effects of aspirin, metformin, and statins against gastric cancer, one of the most common cancers in the world, have been reported. This retrospective cohort study aimed to investigate independent associations of aspirin, metformin, and statin use with gastric cancer incidence and mortality after adjustment for concomitant use of other drugs, using pooled cohort data extracted from the Korean National Health Insurance claim database. Follow-up started on January 1, 2004 and ended at the date of gastric cancer diagnosis, death, or December 31, 2013. Exposures to drugs were defined as cumulative duration of use for aspirin and cumulative defined daily dose for metformin and statin, and were entered as time-dependent variables in Cox analysis models to avoid immortal time bias. Use of aspirin for longer than 182.5 and 547.5 days during 2-year interval was associated with reduced risks of gastric cancer incidence and mortality, respectively. Patients with diabetes were at higher risk of gastric cancer incidence and mortality than nondiabetic people, regardless of metformin treatment. However, metformin use among patients with diabetes was associated with a reduction in gastric cancer mortality in a dose-response manner. Statin use was also associated with a reduction of gastric cancer mortality in the general population, but not with gastric cancer incidence. In conclusion, long-term use of aspirin was independently associated with reduced incidence and mortality of gastric cancer in the general population, but metformin or statin use was only associated with a reduction of gastric cancer mortality in patients with diabetes and in the general population, respectively.

Prevention Relevance:

Long-term use of aspirin was independently associated with reduced incidence and mortality of gastric cancer in the general population. Metformin or statin use, however, was only associated with a reduction of gastric cancer mortality in diabetic patients and in the general population in a dose-response manner, respectively.
Utilization Pattern of Computed Tomographic Colonography in the United States: Analysis of the U.S. National Health Interview Survey
Authors: Hong Young-Rock , Xie Zhigang , Turner Kea , Datta Santanu , Bishnoi Rohit , Shah Chintan
Published: September 2020

CT colonography for colorectal cancer screening has been proved to be effective and cost-saving. CT colonography uses minimally invasive evaluation of colorectum and has better patient acceptance, which appears to be a promising screening modality to improve low colorectal cancer screening rate. This study investigated the utilization patterns of CT colonography and factors associated with its use among U.S. adult population. This retrospective cross-sectional study analyzed the National Health Interview Survey 2015 and 2018. U.S. adults ages 45 or older without a history of colorectal cancer were included. Survey design-adjusted Wald F tests were used to compare the utilization of CT colonography during the study period. Multivariable logistic regression was used to identify the predictors of CT colonography among individual socioeconomic and health-related characteristics. The study sample included 34,768 individuals representing 129,430,319 U.S. adult population ages 45 or older. The overall utilization of CT colonography increased from 0.79% in 2015 to 1.33% in 2018 (P < 0.001). 54.5% study participants reported being up-to-date on recommended colorectal cancer screening; of those, 1.8% used CT colonography. Compared with individuals ages 65+, those ages 45–49 years were 2.08 times (OR, 2.08, 95% confidence interval, 1.01–4.35) more likely to use CT colonography. Socioeconomically disadvantaged characteristics (e.g., racial/ethnic minority, low income, publicly funded insurance) were associated with a greater likelihood of CT colonography. This study demonstrated an increasing trend in utilization of CT colonography for colorectal cancer screening in U.S. adults. Younger individuals, racial/ethnic minorities, or those with lower income appear to have a higher CT colonography utilization.

Prevention Relevance:

Although computed tomographic (CT) colonography has been proved to be cost-effective and have better patient acceptance, its overall utilization for colorectal cancer (CRC) screening is low (<1.4%) among US adults aged 45+ in 2018. More efforts are needed to implement strategies to increase CT colonography for effective CRC prevention.
Risk Factors for Safety of Allergen-Specific Sublingual Immunotherapy in Children with Allergic Rhinitis
Authors: Liu Wenlong , Zeng Qingxiang , Yan Shengbao , Sun Changzhi , Tang Yiquan , Luo Renzhong
Published: September 2020

A good compliance often attributes to good efficacy and safety of sublingual immunotherapy (SLIT). However, few studies have been conducted on the safety of SLIT treatment in children. We aimed to confirm the pretreatment parameters to predict the safety in children who underwent SLIT. 601 children with allergic rhinitis (AR) treated with SLIT were enrolled in this study. Baseline clinical information and laboratory parameters were collected. The clinical response and adverse events (AEs) were recorded and evaluated. A multivariate logistic regression model was established to confirm the predictors for AEs. The AEs were reported in 75 children (13.8%). The serum-specific IgE (s-IgE) level was significantly correlated with the occurrence of AEs by multivariate logistic regression analysis. Our receiver operating characteristic (ROC) analysis of the serum s-IgE levels >21.6 IU/mL had the best sensitivity (83.7%) and specificity (76.7%) to predict safety. The serum s-IgE level was significantly correlated with safety of SLIT in children, which may be helpful for patient selection before SLIT.
Gamma Knife Radiosurgery as a Primary Treatment for Nonfunctioning Pituitary Adenoma Invading the Cavernous Sinus
Authors: Lee Won Jae , Cho Kyung-Rae , Choi Jung-Won , Kong Doo-Sik , Seol Ho Jun , Nam Do-Hyun , Lee Jung-Il
Published: September 2020

Objectives: Surgical resection of nonfunctioning pituitary adenoma (NFPA) invading the cavernous sinus (CS) remains a challenging and significant factor associated with incomplete resection. The residual tumor in CS is usually treated with adjuvant stereotactic radiosurgery (SRS), but there is little information concerning SRS as an initial treatment for CS-invading NFPA. In this study, we investigated the tumor control rate and clinical outcomes of the patients who received primary gamma knife radiosurgery (GKRS) for CS-invading NFPA. Methods: This was a single-institute retrospective analysis of 11 patients. CS invasion of tumor was categorized using the modified Knosp grading system. The median tumor volume and maximal diameter were 1.6 cm3 (range 0.4–6.5) and 17.2 mm (range 11.6–23.3), respectively. The median clinical follow-up period was 48.5 months (range 16.4–177.8). The median prescription dose at tumor margin was 15 Gy (range 11–25) and median prescription isodose was 50% (range 45–50). The maximum radiation dose to optic chiasm and optic nerve were 7.2 Gy (range 3.4–9.2) and 7.5 Gy (range 4.5–11.5), respectively. Results: Tumor control was achieved in all patients. The median tumor volume and maximal diameter at last follow-up were 0.4 cm3 (range 0.1–2.3) and 11.4 mm (range 4.7–19.5), respectively. The median volume reduction rate was 52% (range 33–88). Six patients showed downgrading of modified Knosp grade after GKRS. No patients developed GKRS-related complications such as hypopituitarism or visual disturbance. Conclusions: SRS may be an alternative primary treatment option for CS-invading NFPA if there is no urgent and absolute indication for surgery such as optic apparatus compression.
Patient-Reported Outcomes and Aesthetic Results after Immediate Breast Reconstruction Using Human Acellular Dermal Matrices: Results of a Multicenter, Prospective, Observational NOGGO-AWOGyn Study
Authors: Blohmer Jens-Uwe , Beier Lea , Faridi Andree , Ankel Christine , Krause-Bergmann Barbara , Paepke Stefan , Mau Christine , Keller Maren , Strittmatter Hans Joachim , Karsten Maria Margarete
Published: September 2020

Background: With the increased use of acellular dermal matrices (ADMs) in implant-based breast reconstructions (IBBRs), the evaluation of patient-reported outcomes becomes more important. Methods: Patients who underwent an immediate human ADM-assisted, submuscular IBBR were included in this noninterventional, multicenter, prospective cohort study. Patients with primary reconstruction (cohort A) and patients with a revision surgery after capsular fibrosis (cohort B) were followed up for 12 months after surgery. Quality of life (EORTC BR-23) and patient and surgeon satisfaction scores (1 [“very satisfied”] to 6 [“not satisfied”]) with the outcome and the aesthetic result evaluated by 2 independent, external experts were assessed. Results: Eighty-four patients were enrolled in the study. The mean patient satisfaction score was 2.1 ± 0.8, with higher satisfaction in cohort B (p = 0.041). The score did not change significantly during the follow-up (p = 0.479). The mean satisfaction score of the surgeons was 2.0 ± 0.7; it was also higher in cohort B (p = 0.016) and showed no changes over time (p = 0.473). The mean aesthetic result was 2.2 ± 0.7. 92.9% of the patients completed at least 1 quality of life questionnaire. Body image and sexual functioning increased during follow-up. One year after surgery, the mean scores were 77.2 ± 22.5 and 44.7 ± 27.3, respectively. Conclusion: The level of satisfaction among patients and surgeons and the score of the aesthetic result were constantly high among patients after ADM-assisted IBBR. Higher satisfaction scores could be observed after revision surgery caused by capsular fibrosis (cohort B) compared to primary reconstruction (cohort A). Quality of life increased during the first year after surgery.
Percutaneous Foramen Ovale Puncture: Usefulness of Intraoperative CT Control, in the Eventuality of a Narrow Foramen
Authors: Mendes Plinio Duarte , Martins da Cunha Pedro Henrique , Monteiro Kalinio de Kassio Oliveira , Quites Lucas Viana , Fonseca Filho Gilberto de Almeida
Published: September 2020

Background: Balloon compression of the gasserian ganglion has been a well-established percutaneous treatment of trigeminal neuralgia since the 1980s. However, puncture of the foramen ovale by conventional single-plane fluoroscopy can be difficult in cases of local anatomic abnormalities. Case Presentation: We present the case of a 49-year-old woman diagnosed with idiopathic trigeminal neuralgia refractory to pharmacological treatment. After failure of puncture by conventional fluoroscopy for percutaneous gasserian ganglion balloon compression due to a narrow foramen ovale, the patient was submitted to puncture guided by computed tomography. Conclusion: Alternative imaging methods, such as computed tomography, should be considered when puncture of the foramen ovale by conventional single-plane fluoroscopy fails, to minimize the risk of potential complications triggered by frustrated puncture attempts.
Microelectrode Recording and Radiofrequency Thalamotomy following Focused Ultrasound Thalamotomy
Authors: De Vloo Philippe , Milosevic Luka , Gramer Robert Matthew , Dallapiazza Robert F. , Lee Darrin J. , Fasano Alfonso , Hutchison William D. , Lozano Andres M. , Schwartz Michael L. , Kalia Suneil K.
Published: September 2020

Magnetic resonance imaging-guided focused ultrasound (MRgFUS) is a novel method for stereotactic brain lesioning and has primarily been applied for thalamotomies to treat essential tremor (ET). The electrophysiological properties of previously MRgFUS-sonicated thalamic neurons have not yet been described. We report on an ET patient who underwent an MRgFUS thalamotomy but experienced tremor recurrence. We expanded the MRgFUS-induced thalamic cavity using radiofrequency (RF), with good effect on the tremor but transient sensorimotor deficits and permanent ataxia. This is the first report of a patient undergoing RF thalamotomy after an unsuccessful MRgFUS thalamotomy. As we used microelectrode recording to guide the RF thalamotomy, we could also study for the first time the electrophysiological properties of previously sonicated thalamic neurons bordering the MRgFUS-induced cavity. These neurons displayed electrophysiological characteristics identical to those recorded from nonsonicated thalamic cells in ET patients. Hence, our findings support the widespread assumption that sonication below the necrotic threshold does not permanently alter neuronal function.
Influence of Light Spectra on the Production of Cannabinoids
Authors: Amrein Pascal , Rinner Stefan , Pittorino Tindaro , Espel Joan , Schmidmayr David
Published: September 2020

In recent years, more attention has been paid to cannabis from both medical and political points of view. This study investigates the influence of 5 different light spectra on the active substance content in THC-poor hemp of the Alessia chemotype II variety. The focus is on comparing conventional growing under metal halide lamps with growing under high-pressure sodium (HPS) vapor lamps with regard to different spectra of LED lighting modules. Growing was carried out in 10 growing boxes under controlled and mostly identical conditions for all boxes. The photoperiod during the vegetative phase was 18 h light and photosynthetic photon flux density ∼520 μmol⋅m−2 s−1. The flowering phase was 12 h light and ∼540 μmol⋅m−2 s−1. During the experiment, CO2, temperature, and humidity were measured and logged. Additionally, weekly measurements of chlorophyll, electric conductivity of the fertilizer, activity measurement (salt content) of the soil, and pH value of the soil were checked. The content of cannabinoids was measured by high-performance liquid chromatography (HPLC). Plant height and growth were monitored during the whole experiment by cameras taking pictures every 30 min and loading them onto a cloud storage platform. Cannabinoid content was measured using HPLC. Plant wet weight was determined at the end of the experiment and showed that plants under the high pressure lamp treatment had less flower weight than those under the LED treatment. In conclusion, it could be shown that certain LED spectra can considerably increase the amount of cannabinoids with respect to conventional illumination (HPS).
High Prevalence and Conservative Management of Acute Cholecystitis during Lenvatinib for Advanced Thyroid Cancer
Authors: Di Stefano Marta , Colombo Carla , De Leo Simone , Perrino Michela , Viganò Mauro , Persani Luca , Fugazzola Laura
Published: September 2020

Introduction: Lenvatinib (LEN) is a multitarget tyrosine kinase inhibitor currently used for advanced, radioiodine refractory differentiated thyroid cancer (RAI-R DTC). Among adverse events (AEs), nausea, vomiting, and decreased appetite have been frequently described. We aimed to evaluate the prevalence, the clinical presentation, and the effectiveness of conservative treatment of gallbladder disorders in a consecutive series of patient treated with LEN. Methods: Patients with RAI-R DTC experiencing clinical symptoms suggestive for gallbladder disorders during LEN treatment were evaluated with laboratory investigations and contrast-enhanced abdominal computed tomography (CT) and ultrasound scan (US). Results: After a median time of 2 months from the start of treatment, 5/13 patients (38.4%) complained of gastrointestinal symptoms, with increased biliary enzymes levels, especially γGT, and CT/US suggestive of acute cholecystitis (AC). The onset of symptoms and the peak of γGT levels frequently corresponded to the highest reduction in body weight during the first months of treatment. All patients were treated with supportive care and, when appropriate, with ursodeoxycholic acid; in 4 patients, LEN dose reduction or short interruption was needed, too. Conclusions: In patients with RAI-R DTC treated with LEN, a high prevalence of AC in the first months of treatment was documented. Mainly due to the low specificity of symptoms such as anorexia, nausea, and vomiting, this AE is likely to be frequently misdiagnosed. The onset of the disease was associated to the weight loss observed during the first months of treatment and contributes to further decrease in body weight. Therefore, particularly during the first months of treatment, or at any time of huge reduction of body weight, monitoring of γGT and US is crucial for prompt diagnosis and treatment. Conservative medical treatment and LEN dosage titration, together with dietary and rehabilitative supports, can limit or avoid the need for drug withdrawal and cholecystectomy.
Changes in Transfusion Practice in Children and Adolescents over Time
Authors: Piekarski Florian , Steinbicker Andrea , Zacharowski Kai , Meybohm Patrick
Published: September 2020

Introduction: In recent years, resource-saving handling of allogeneic blood products and a reduction of transfusion rates in adults has been observed. However, comparable published national data for transfusion practices in pediatric patients are currently not available. In this study, the transfusion rates for children and adolescents were analyzed based on data from the Federal Statistical Office of Germany during the past 2 decades. Methods: Data were queried via the database of the Federal Statistical Office (Destasis). The period covered was from 2005 to 2018, and those in the sample group were children and adolescents aged 0–17 years receiving inpatient care. Operation and procedure codes (OPS) for transfusions, procedures, or interventions with increased transfusion risk were queried and evaluated in detail. Results: In Germany, 0.9% of the children and adolescents treated in hospital received a transfusion in 2018. A reduction in transfusion rates from 1.02% (2005) to 0.9% (2018) was observed for the total collective of children and adolescents receiving inpatient care. Increases in transfusion rates were recorded for 1- to 4- (1.41–1.45%) and 5- to 10-year-olds (1.24–1.33%). Children under 1 year of age were most frequently transfused (in 2018, 40.2% of the children were cared for in hospital). Transfusion-associated procedures such as chemotherapy or machine ventilation and respiratory support for newborns and infants are on the rise. Conclusion: Transfusion rates are declining in children and adolescents, but the reasons for increases in transfusion rates in other groups are unclear. Prospective studies to evaluate transfusion rates and triggers in children are urgently needed.
A figura dos exilados políticos a partir de recortes de jornais presentes na pasta “Retorno de Exilados” do DOPS
Authors: Ferreira Gabriella Daphne Pereira
Published: September 2020

O texto a seguir é fruto de uma pesquisa para a disciplina de Brasil IV, trabalhando com textos sobre a Ditadura Militar brasileira, em conjunto com o tema da minha monografia que se trata sobre os exilados políticos nesse período. Sendo assim, para a escrita desse material, utilizei como fontes a pasta temática “Retorno de Exilados” organizada pelo DOPS durante seus serviços de monitoramento de atividades “subversivas” prestados ao regime militar, estas fontes estão presentes no acervo do Arquivo Público do Estado do Paraná. O objetivo do texto é analisar como era construída a figura dos exilados na imprensa paranaense partindo dos excertos contidos nessa pasta, principalmente depois da Lei da Anistia de 1979, a qual motivou um retorno de exilados do exterior e que, provavelmente, foi a razão de ser dessa investigação dos policiais do DOPS materializada nessa pasta.
Populações racializadas: um ensaio teórico sobre construção da memória coletiva, alteridade e a epidermização da inferioridade racial
Authors: Borges Dandriel Henrique da Silva
Published: September 2020

Esse ensaio se propõe a refletir sobre temáticas históricas e sociais como a memória, a alteridade e epidermização da inferioridade racial, além do próprio racismo, pensando nas consequências delas e de outras mais em populações racializadas, no caso, indígenas e negros. Para isso foi buscado apoio em escritos de intelectuais como Michael Pollak (1989), Frantz Fanon (2008), Valentin-Yves Mudimbe (2013) e bel hooks (2019).
How Big Is Too Big?
Authors: Krebs Elizabeth D. , Beller Jared P. , Mehaffey J. Hunter , Teman Nicholas R. , Kennedy Jamie L. W. , Ailawadi Gorav , Yarboro Leora T.
Published: September 2020

Background:

As the population becomes increasingly obese, so does the pool of potential organ donors. We sought to investigate the impact of donors with body mass index ≥40 (severe obesity) on heart transplant outcomes.

Methods:

Single-organ first-time adult heart transplants from 2003 to 2017 were evaluated from the United Network for Organ Sharing database and stratified by donor severe obesity status (body mass index ≥40). Demographics were compared, and univariate and risk-adjusted analyses evaluated the relationship between severe obesity and short-term outcomes and long-term mortality. Further analysis evaluated the prevalence of severe obesity within the pool of organ donation candidates.

Results:

A total of 26 532 transplants were evaluated, of which 939 (3.5%) had donors with body mass index ≥40, with prevalence increasing over time (2.2% in 2003, 5.3% in 2017). Severely obese donors more likely had diabetes mellitus (10.4% versus 3.1%,
P
<0.01) and hypertension (33.3% versus 14.8%,
P
<0.01), and 67.4% were size mismatched (donor weight >130% of recipient). Short-term outcomes were similar, including 1-year survival (10.6% versus 10.7%), with no significant difference in unadjusted and risk-adjusted long-term survival (log-rank
P
=0.67, hazard ratio, 0.928,
P
=0.30). Organ donation candidates also exhibited an increase in severe obesity over time, from 3.5% to 6.8%, with a lower proportion of hearts from severely obese donors being transplanted (19.5% versus 31.6%,
P
<0.01).

Conclusions:

Donor severe obesity was not associated with adverse post-transplant outcomes. Increased evaluation of hearts from obese donors, even those with body mass index ≥40, has the potential to expand the critically low donor pool.