bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of SoundBite Bone Conduction Hearing Aids on Speech Recognition and Quality of Life in Patients with Single-Sided Deafness
Authors: Luo Qiong , Shen Ying , Chen Ting , Zheng Zhong , Shi Haibo , Feng Yanmei , Chen Zhengnong
Published: September 2020

Objectives. To analyze the clinical application of SoundBite bone conduction hearing aids by assessing the improvement of speech recognition and the scores of the benefit scale questionnaire for patients with single-sided deafness (SSD). Design. Nine patients aged 24 to 61 years with SSD for more than 3 months were enrolled in this study. The patients could understand and repeat Mandarin and have good compliance with the study. The measurements were evaluated before and after one month of wearing hearing aids using the pure tone audiometry threshold, speech recognition in quiet and in noise, and the Glasgow Benefit Inventory (GBI) benefit scale score. Results. Pure tone audiometry results showed that the average hearing threshold of good ears and bad ears was 11.4±2.6 dB HL and 89.9±6.4 dB HL, respectively. The average hearing threshold of bad ears after wearing hearing aids was 23.5±9.0 dB HL. Statistical analysis showed that the hearing improvement for the bad ears after wearing hearing aids was significant. The speech audiometry results showed that the disyllable word recognition score of the bad ears in quiet increased significantly at 50 dB SPL by 40±12 percentage points and at 65 dB SPL by 71±15 percentage points. As for the speech recognition in noise, when the signal sound came from the bad ear side and the noise from the good ear side (SSSDNAH), the speech recognition score (SRS) significantly increased by 17±6 and 9±4 at a signal-to-noise ratio (SNR) of -2 dB and -5 dB, respectively, after wearing the hearing aids. When the signal sound came from the front of the patient and the noise from the bad ear side (S0NSSD), the SRS scores were reduced by 5±5 and 7±5 percentage points at SNR equal to -2 dB and -5 dB, which was significantly different from that before wearing the hearing aids. When the signal and noise both came from the front of the patients (S0N0), the SRS was not significantly increased by 5±4 percentage points at SNR equal to -2 dB compared to before wearing hearing aids. However, the SRS was significantly increased by 5±2 percentage points at SNR equal to -5 dB compared to before wearing hearing aids. The average total GBI score was 31±12 for the nine patients, with an average score of 32±10, 31±8, and 30±7 for general conditions, social support, and physical health, respectively. The results of the questionnaires showed that patients’ quality of life was improved after wearing SoundBite bone conduction hearing aids. Conclusions. SoundBite bone conduction hearing aids are a good choice for patients with SSD, as it could improve the speech recognition ability of patients both in a quiet and noisy environment and improves the quality of life after wearing hearing aids.
Investigating the Influences of Indentation Hardness and Brittleness of Rock-Like Material on Its Mechanical Crushing Behaviors
Authors: Zou Jiuqun , Han Jihuan , Yang Weihao
Published: September 2020

Indentation hardness and brittleness are the important factors to be considered in the study of rock-like materials’ mechanical crushing behaviors. The brittleness of rock-like materials is defined as the ratio of uniaxial compressive strength to tensile strength in this paper. In order to investigate the influences of hardness and brittleness on rock-like materials’ crushing behaviors, quartz sand and high strength α-hemi-hydrated gypsum were used to prepare rock-like materials with different hardness and brittleness through different mass ratios. The artificial rock-like materials can eliminate the effects of natural rock’s weak structure plane on experimental results. The indentation test, Uniaxial compressive test, and Brazilian tensile test were conducted for characterizing the indentation hardness and brittleness of this artificial rock-like materials. The experimental results showed that brittleness increased with the increase of indentation hardness with high correlation coefficient. The confining stress presented a positive impact on the indentation hardness of the rock-like materials. Based on those mechanical properties, the numerical rock models were calculated to study rock crushing behaviors using discrete element method (DEM). A series of rock crushing tests were conducted to investigate the influences of hardness and brittleness of rock-like materials on rock crushing behaviors using a conical pick cutter. The numerical results showed that the normalized specific energy was negatively correlated with indentation hardness index (IHI). The normalized specific energy decreased with the increase of brittleness index (BI) with a high correlation coefficient. This study is beneficial in utilizing IHI and BI to evaluate the mechanical properties, failure patterns, and mechanical crushing efficiency of rock-like materials.
5-Azacytidine-Induced Cardiomyocyte Differentiation of Very Small Embryonic-Like Stem Cells
Authors: Sun XiaoLin , Li HongXiao , Zhu Ye , Xu Pei , Zuo QiSheng , Li BiChun , Gu Xiang
Published: September 2020

The use of stem cells in generating cell-based pacemaker therapies for bradyarrhythmia is currently being considered. Due to the propensity of stem cells to form tumors, as well as ethical issues surrounding their use, the seed cells used in cardiac biological pacemakers have limitations. Very small embryonic-like stem cells (VSELs) are a unique and rare adult stem cell population, which have the same structural, genetic, biochemical, and functional characteristics as embryonic stem cells without the ethical controversy. In this study, we investigated the ability of rat bone marrow- (BM-) derived VSELs to differentiate in vitro into cardiomyocytes by 5-Azacytidine (5-AzaC) treatment. The morphology of VSELs treated with 10 μM 5-AzaC increased in volume and gradually changed to cardiomyocyte-like morphology without massive cell death. Additionally, mRNA expression of the cardiomyocyte markers cardiac troponin-T (cTnT) and α-sarcomeric actin (α-actin) was significantly upregulated after 5-AzaC treatment. Conversely, stem cell markers such as Nanog, Oct-4, and Sox2 were continuously downregulated posttreatment. On day 14 post-5-AzaC treatment, the positive expression rates of cTnT and α-actin were 18.41±1.51% and 19.43±0.51%, respectively. Taken together, our results showed that rat BM-VSELs have the ability to differentiate into cardiomyocytes in vitro. These findings suggest that VSELs would be useful as seed cells in exploring the mechanism of biological pacemaker activity.
Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS
Authors: Edwards Erin M. , Kegelmeyer Deborah A. , Kloos Anne D. , Nitta Manon , Raza Danya , Nichols-Larsen Deborah S. , Fritz Nora E.
Published: September 2020

Background. Individuals with multiple sclerosis (MS) experience deficits in motor and cognitive domains, resulting in impairment in dual-task walking ability. The goal of this study was to compare performance of forward walking and backward walking in single- and dual-task conditions in persons with MS to age- and sex-matched healthy controls. We also examined relationships between forward and backward walking to cognitive function, balance, and retrospective fall reports. Methods. All measures were collected in a single session. A 2×2×2 mixed model ANOVA was used to compare differences in forward and backward walking in single- and dual-task conditions between MS and healthy controls. Spearman correlations were used to examine relationships between gait and cognitive function, falls, and balance. Results. Eighteen individuals with relapsing-remitting MS and 14 age- and sex-matched healthy controls participated. Backward walking velocity revealed significant differences between groups for both single-task (p=0.015) and dual-task (p=0.014) conditions. Persons with MS demonstrated significant differences between single- and dual-task forward and backward walking velocities (p=0.023; p=0.004), whereas this difference was only apparent in the backward walking condition for healthy controls (p=0.004). In persons with MS, there were significant differences in double support time between single- and dual-task conditions in both backward (p<0.001) and forward (p=0.001) directions. More falls at six months were significantly associated with shorter backward dual-task stride length (r=−0.490; p=0.046) and slower velocity (r=−0.483; p=0.050). Conclusion. Differences in MS and age- and sex-matched healthy controls are more pronounced during backward compared to forward walking under single- and dual-task conditions. Future work with a larger sample size is needed to validate the clinical utility of backward walking and dual-task assessments and mitigate the limited sensitivity of the current dual-task assessments that primarily rely upon forward walking.
Ginseng-Sanqi-Chuanxiong (GSC) Extracts Ameliorate Diabetes-Induced Endothelial Cell Senescence through Regulating Mitophagy via the AMPK Pathway
Authors: Wang Xue , Zhang Jia-Qi , Xiu Cheng-Kui , Yang Jing , Fang Jing-Yi , Lei Yan
Published: September 2020

Vascular endothelial senescence induced by high glucose and palmitate (HG/PA) contributes to endothelial dysfunction, which leads to diabetic cardiovascular complications. Reduction of endothelial senescence may attenuate these pathogenic processes. This study is aimed at determining whether Ginseng-Sanqi-Chuanxiong (GSC) extracts, traditional Chinese medicine, can ameliorate human aortic endothelial cell (HAEC) senescence under HG/PA-stressed conditions and further explore the underlying mechanism. We found that GSC extracts significantly increased antisenescent activity by reducing the HG/PA-induced mitochondrial ROS (mtROS) levels in senescent HAECs. GSC extracts also induced cellular mitophagy formation, which mediated the effect of GSC extracts on mtROS reduction. Apart from this, the data showed that GSC extracts stimulated mitophagy via the AMPK pathway, and upon inhibition of AMPK by pharmacological and genetic inhibitors, GSC extract-mediated mitophagy was abolished which further led to reverse the antisenescence effect. Taken together, these data suggest that GSC extracts prevent HG/PA-induced endothelial senescence and mtROS production by mitophagy regulation via the AMPK pathway. Thus, the induction of mitophagy by GSC extracts may provide a novel therapeutic candidate for cardiovascular protection in metabolic syndrome.
Genes Involved in the PD-L1 Pathway Might Associate with Radiosensitivity of Patients with Gastric Cancer
Authors: Du Zixuan , Yan Derui , Li Zhongyang , Gu Jincheng , Tian Ye , Cao Jianping , Tang Zaixiang
Published: September 2020

The PD-1/PD-L1 pathway plays an important role in the treatment of cancers as immune checkpoint. However, the association of genes involved in the PD-L1 pathway and radiosensitivity of gastric cancer has not been fully characterized. This study aims to explore the relationship between the expression levels of genes involved in the PD-L1 pathway and radiosensitivity for gastric cancer patients. A total of 367 patients with clinical survival information and radiotherapy information were obtained in The Cancer Genome Atlas (TCGA). Genes involved in the PD-L1 pathway were categorized into high and low expression level groups according to the median value. The Cox proportional hazards model was used to find the association between gene expression level and radiosensitivity. The results show that high expression levels of CD274, EGFR, RAF1, RPS6KB1, PIK3CA, MTOR, CHUK, NFKB1, TRAF6, FOS, NFATC1, and HIF1A were associated with radiosensitivity of gastric cancer. While low expression level of HRAS was also associated with radiosensitivity in gastric cancer. The rates of a new tumor event and disease progression were lower for radiosensitivity patients than other patients. The relationship between the expression level of CD274 and other genes involved in the PD-L1 pathway is significant. GO (Gene Ontology) analysis shows that the biological process of 13 genes was mainly related to innate immune response activating the cell surface receptor signaling pathway. KEGG analysis demonstrated that 13 genes in gastric cancer are mainly related to the PD-L1 expression and PD-1 checkpoint pathway in cancer. The correlation between the expression level of CD274 and other genes involved in the PD-L1 pathway is significant. The present study offered more evidence for using PD-L1 and genes involved in the PD-L1 pathway as potential biomarkers to predict radiosensitive patients with gastric cancer.
Bufei Decoction Alleviated Bleomycin‐Induced Idiopathic Pulmonary Fibrosis in Mice by Anti‐Inflammation
Authors: Yang Shanjun , Cui Wenwen , Wang Mingye , Xing Luming , Wang Yue , Zhu Pengyu , Qu Qisheng , Tang Qiang
Published: September 2020

Objective. This study aimed to investigate the mechanistic action and therapeutic effects of Bufei decoction on idiopathic pulmonary fibrosis (IPF) after inhalation of bleomycin. Methods. Pulmonary fibrosis model in mice was prepared by atomization inhalation of bleomycin. Then, the mice were randomly divided into five groups (control group, model group, positive group, and treatment group) and administrated the drugs for 4 weeks. H&E and Masson’s staining of lung tissues were used to observe the morphological changes and deposition of fibers, and the degree of fibrosis was evaluated by hydroxyproline content. The expression and activation of NF‐κB were determined by western blotting and immunohistochemistry. The infiltration of macrophages was detected by immunostaining of CD45 and F4/80 in lung tissues. Results. In mouse IPF, Bufei decoction alleviated the pathological changes and the deposition of fibrosis by decreasing the content of hydroxyproline of lung tissues. The antipulmonary fibrosis might rely on the effects of preventing the infiltration of inflammatory cells and inhibiting the expression and activation of NF‐κB in lung tissue. Conclusion. Bufei decoction improved the process of pulmonary fibrosis by regulating the activation and expression of the NF‐κB signal transduction pathway, which provided a therapeutic option for IPF patients.
Urban vs Suburban: Is the Door-to-Balloon Time Affected by Geographic, Socioeconomic, or Racial Differences? A Tale of Two Campuses
Authors: Zughaib Marc , Ters Patrick , Singh Robby , Zughaib Marcel
Published: September 2020

Background. In 2004, the ACC/AHA released guidelines in the treatment of ST-segment elevation myocardial infarction (STEMI) within a time window from the time a patient physically enters the hospital to the time of percutaneous coronary intervention (PCI). This time window is defined as the door-to-balloon time (DTB) and is recommended to be under 90 minutes to improve patient mortality. To add another layer of complexity, patients with varying socioeconomic status and racial differences experience large disparities in health. Our institution provides care for patients in two locations separated by approximately 30 miles within the Detroit metropolitan area. We aimed this study to investigate any differences between DTB times of our two campuses (urban versus suburban population) as well as any differences in the components that comprise DTB times. Methods. We retrospectively collected data on all patients who presented to either Campus 1 or Campus 2 with a STEMI from 2016 to 17. DTB times, demographical, temporal, and anatomical data were collected and analyzed. Our search included 169 patients who met the full inclusion criteria. Results. The combined average of the overall DTB time for both campuses was 81 minutes, 15 seconds (95% CI: 78:05, 84:25). The average DTB time in Campus 1 was 78 minutes and 41 seconds (95% CI: 73:05, 84:18) versus 82 minutes and 46 seconds (95% CI: 78:55, 86:38) for Campus 2 (p=0.24). There were no statistically significant differences between either campuses within the separate metrics that comprise DTB times. Conclusions. Our study demonstrated that we have been able to provide high-quality care to all of our patients presenting with STEMI at either campus, regardless of socioeconomic differences in the populations they serve. Additionally, each campus has demonstrated DTB well below the nationally recommended guidelines.
Intraoperative Optical Coherence Tomography Analysis of Clear Corneal Incision: Effect of the Lateral Stromal Hydration
Authors: Cendelin Jiri , Rusnak Stepan , Hecova Lenka
Published: September 2020

Aim of the Study. The aim of this prospective study was to analyse the effect of lateral stromal hydration on the morphology of clear corneal incision architecture using the microscope integrated anterior segment OCT. Methods. The cohort included 65 clear corneal incisions of 49 patients who underwent cataract surgery. Corneal incisions were recorded using a Leica Proveo 8 microscope with an intraoperative OCT EnFocus™ device continuously during the surgery. Corneal incision morphology before and after lateral stromal hydration was analysed. Results. Good adaptation of the corneal incision before hydration was present in 39 cases (60%), in 16 cases (24.6%), the prominence of posterior lip was present, and, in 10 cases (15.4%), the posterior lip tongue was inverted/retracted into the incision. In 38 cases (58.5%), hydration had no effect on the incision architecture; most often, it was primarily a well-adapted corneal incision (46.2%), less often an incision with posterior lip prominence (10.8%), or tongue inversion into the incision (1.6%) prior to hydration. Hydration worsened the incision architecture in 14 cases (21.5%); most often, it induced/worsened posterior lip prominence (15.4%), less often posterior lip retraction (1.6%), tongue inversion into the incision (1.6%), gap development in the peripheral part of the corneal incision (1.6%), or incomplete opening of the corneal incision (1.6%). In 13 cases (20%), hydration improved the incision architecture, especially in cases with inverted or retracted posterior lip tongue (12.3%), less often in cases with posterior lip prominence (7.7%). Conclusion. Lateral stromal hydration seldom affects the condition of the corneal incision. Still, it can cause both deterioration and improvement of the corneal incision architecture. Intraoperative OCT provides real-time monitoring of corneal incision morphology during hydration procedure.
Work-Related Musculoskeletal Disorders and Associated Factors Among Bankers in Ethiopia, 2018
Authors: Kasaw Kibret Alemu , Fisseha Gebremeskel Berihu , Embaye Gezae Kebede , Solomon Tsegay Gebrerufael
Published: September 2020

Background. Work-related musculoskeletal disorders (WMSDs) are an important public health problem in working environments. WMSDs are the major causes of disability and cause individual suffering and financial burdens to the individual, families, industry or employer, healthcare system, and society at large. This study aims to assess the prevalence and associated factors of work-related musculoskeletal disorders among bankers working in Mekelle city, Tigray, Ethiopia, 2018. This study is based on an institutional-based cross-sectional study design, where 328 bankers are selected randomly from bankers working in Mekelle city from February to June 2018. Data were entered, organized, and analyzed by SPSS version 23. A final logistic model was run to identify factors associated with WMSDs, and the magnitude and direction of association were decided based on the adjusted odds ratio (AOR) and its corresponding 95% confidence interval (95% CI).Result. Out of 307 bankers, the annual prevalence rate of WMSDs was 65.5% (201). Significant predictors were being 30–39 years old [AOR = 5.552; 95% CI = 1.465–21.039] and above 40 years old [AOR = 5.719; 95% CI = 1.422–22.994], low educational level [AOR = 4.256; 95% CI = 1.139–15.895], working > 5 years [AOR = 3.892; 95% CI = 1.841–8.231], not doing physical exercises [AOR = 2.866; 95% CI = 1.303–6.304], stress [AOR = 4.723; 95% CI = 2.421–9.213], poor posture [AOR = 2.692; 95% CI = 1.339–5.411], breaks [AOR = 5.170; 95% CI = 2.070–12.912], and ergonomics [AOR = 3.801; 95% CI = 1.260–11.472].Conclusion. The prevalence of WMSDs among bankers was high. The significant associated factors responsible for the occurrence of work-related musculoskeletal disorders include longer working experience, being above 30 years old, low educational status, physical exercise, job stress, poor posture, absence of breaks during working hours, and absence of ergonomic training.
Enhancing the Performance of the Standalone Rooftop SPV Module during Peak Solar Irradiance and Ambient Temperature by the Active Cooling of the Rear Surface with Spraying Water and the Front Surface with Overflowing Water
Authors: Sargunanathan S. , Ramanathan K. , Mohideen S. Tharves , Suresh S.
Published: September 2020

The usage of the solar photovoltaic (SPV) module to meet the power demands, especially in residential and office buildings, is inevitable in forthcoming years. The objective of this study is to experimentally investigate the possibility of improving the performance of the standalone rooftop SPV module used in the residential and office buildings during peak solar irradiance and ambient temperature with active cooling of the rear surface alone by spraying water and the front surface alone by water overflowing over it and cooling of the rear and the front surfaces simultaneously. The underneath of the SPV module is attached with a tray with a length of 1580 mm, a width of 640 mm, and a depth of 100 mm. It is filled with 40-70 litres of water. Accouters are made for water overflowing from the tube over the front surface of the module and cooling of the rear surface by spraying water. The rear surface cooling, front surface cooling, and simultaneous cooling of both the surfaces reduce the average operating temperature of the module by 15.52°C (maximum 18.6°C), 24.29°C (maximum 28.7°C), and 28.52°C (maximum 34.7°C), respectively. This temperature reduction leads to the increase in the power output of the 150 W module by 10.70 W, 18.48 W, and 20.56 W and percentage increase in efficiency by 8.778%, 15.278%, and 16.895% for rear, front, and simultaneous cooling of surfaces, respectively. The net power output of the module with the front surface cooling by overflowing (0.9 litre/min) water is higher, i.e., 15.88 W/150 W, and produces installation capacity of 0.4234 watt-hour (Wh) of more energy per watt during the test period 10 AM to 2 PM in a day. The recommended cooling methods eliminate the need for freshwater and separate arrangements to dissipate the heat carried by the circulated water and reduced the power required and quantity of water circulated. They also reduced the heat loads of the room by the shadow effect and by maintaining the tray water above the roof.
The Mechanism of Interface Dilatancy of Cement Mortar Rockbolts
Authors: Zhan Yubao , Li Nan , Wang Hui , Zheng Pengqiang , Zhang Jun , Liu Qihua
Published: September 2020

In this paper, the mechanism of the interface dilatancy of cement mortar rockbolts is studied based on the phenomenon of splitting failure of samples with a high sand content in the grouting material in laboratory tests. A conceptual model of the interface layer is used to explain the dilatancy mechanism of the interface. Based on the thick‐walled cylinder theory, the causes of splitting failure of the samples are analyzed. By using the numerical simulation method, the influences of different dilatancy angles of the interface layer on the interface shear stress and the radial stress are analyzed. The results show that the sand content of the grouting material has a substantial effect on the bearing capacity of the rockbolt. The higher the sand content in the grouting material is, the more obvious the interface dilatancy will be, and the greater the radial stress generated by dilatancy will be, which will produce a higher bearing capacity of the anchorage system. Under the same load, the maximum shear stress of the interface layer increases with increasing dilatancy angle. Similarly, the larger the dilatancy angle of the interface layer is, the greater the radial stress caused by dilatancy will be. Away from the interface layer, the radial stress decays rapidly. The influence range of the radial stress caused by dilatancy is mainly in the interface layer and the rock nearby.
Critical Segments Identification for Link Travel Speed Prediction in Urban Road Network
Authors: Ru Xiaolei , Xu Xiangdong , Zhou Yang , Yang Chao
Published: September 2020

Predicting traffic operational condition is crucial to urban transportation planning and management. A large variety of algorithms were proposed to improve the prediction accuracy. However, these studies were mainly based on complete data and did not discuss the vulnerability of massive data missing. And applications of these algorithms were in high-cost under the constraints of high quality of traffic data collecting in real-time on the large-scale road networks. This paper aims to deduce the traffic operational conditions of the road network with a small number of critical segments based on taxi GPS data in Xi’an city of China. To identify these critical segments, we assume that the states of floating cars within different road segments are correlative and mutually representative and design a heuristic algorithm utilizing the attention mechanism embedding in the graph neural network (GNN). The results show that the designed model achieves a high accuracy compared to the conventional method using only two critical segments which account for 2.7% in the road networks. The proposed method is cost-efficient which generates the critical segments scheme that reduces the cost of traffic information collection greatly and is more sensible without the demand for extremely high prediction accuracy. Our research has a guiding significance on cost saving of various information acquisition techniques such as route planning of floating car or sensors layout.
A Case of InvasiveAspergillusRhinosinusitis Presenting with Unilateral Visual Loss and Subsequently Associated with Meningitis, Subarachnoid Hemorrhage, and Cerebral Infarction
Authors: Tsuzaki Koji , Murakata Kenji , Kamei Mayu , Kikuya Akihiro , Oka Yuwa , Hamano Toshiaki
Published: September 2020

Visual impairment can occur because of several mechanisms, including optic nerve disease and occasionally fungal sinusitis. An 87-year-old man presented with the loss of right visual acuity; he was diagnosed with optic neuritis. Steroid pulse therapy was not effective. One month later, he became unconscious because of meningitis, following which treatment with ceftriaxone and acyclovir was initiated. However, his consciousness deteriorated because of a subarachnoid hemorrhage caused by a ruptured aneurysm. Meningitis and vascular invasion caused by fungal rhinosinusitis were suspected, and the sinus mucosa was biopsied. He was pathologically diagnosed with invasiveAspergillusrhinosinusitis. Despite continuous liposomal amphotericin B administration, he died of cerebral infarction, following a right internal carotid artery occlusion. It is important to consider the possibility ofAspergillusas an etiological agent, especially when cerebrovascular events are associated with visual impairment.
Inflammatory Serum Biomarkers in Colorectal Cancer in Kazakhstan Population
Authors: Akhmaltdinova L. , Sirota V. , Zhumaliyeva V. , Babenko D. , Kadyrova I. , Tauesheva Z. , Taizhanova D. , Ibraeva A. , Maratkyzy M. , Turmukhambetova A.
Published: September 2020

Colorectal cancer is a type of oncopathology widespread in Kazakhstan. The genetic component, as well as the possible etiopathogenetic mechanisms, is widely studied. One of the most promising areas is the study of diagnostic and prognostic possibilities of inflammatory biomarkers in patients with different degrees of tumor differentiation. The following biomarkers were included in the study panel: stem cell factor (SCF), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF2), interleukin 6 (IL6), interleukin 8 (IL8), macrophage migration inhibitory factor (MIF), soluble Fas (SFAS), soluble Fas ligand (sFASL), transforming growth factor β (TGF), tumor necrosis factor (TNF), TNF-related apoptosis-inducing ligand (TRAIL), and programmed death ligand 1 (PD-L1). The data of our study show that most of the basic proinflammatory cytokines are involved in the systemic process and their levels do not depend on the level of tissue differentiation. Serum PD-L1 has shown itself to be a promising marker for tumor growth, which depends on the degree of differentiation.
Soil Contamination with Toxocara Eggs in Public Schools in Rural Areas of Southern Thailand
Authors: Phasuk Nonthapan , Kache Ratee , Thongtup Kanjana , Boonmuang Saowalee , Punsawad Chuchard
Published: September 2020

Soil is considered the primary source of Toxocara transmission to humans, especially children. The status of soil contamination with Toxocara eggs in southern Thailand is unknown. This study aimed at estimating the soil contamination with Toxocara eggs in public schools in Nakhon Si Thammarat province in southern Thailand. Soil samples were collected from 12 public schools between August and September 2017. At each site, ten soil samples were collected from the following five types of locations: (1) playgrounds, (2) football fields, (3) sidewalks, (4) schoolyards, and (5) areas around cafeterias. In total, 120 samples were examined for Toxocara eggs with a modified flotation method using a sucrose solution. Toxocara eggs were detected in 8 (66.7%) of the 12 studied public schools. Of the 120 soil samples, 22 (18.3%; 95% CI: 11.9, 26.4) were contaminated with Toxocara eggs. The highest levels of Toxocara egg contamination were observed in playgrounds (41.7%; 95% CI: 22.1, 63.4), followed by football fields (20.8%; 95% CI: 7.1, 42.2), sidewalks (12.5%; 95% CI: 2.7, 32.4), and schoolyards (12.5%; 95% CI: 2.7, 32.4). There were significant differences in the distribution of Toxocara eggs across location types p<0.05. The findings demonstrated that the soil samples from public schools were contaminated with Toxocara eggs. Playgrounds were the most heavily contaminated locations. Teaching children proper handwashing steps and discouraging geophagia should be implemented to reduce the distribution of Toxocara and limit future Toxocara infections.
Epithelial-to-Mesenchymal Transition is a Cause of Both Intrinsic and Acquired Resistance to KRAS G12C Inhibitor in KRAS G12C–Mutant Non–Small Cell Lung Cancer
Authors: Adachi Yuta , Ito Kentaro , Hayashi Yuko , Kimura Ryo , Tan Tuan Zea , Yamaguchi Rui , Ebi Hiromichi
Published: September 2020

Purpose:

KRAS is among the most commonly mutated oncogene in cancer including non–small cell lung cancer (NSCLC). In early clinical trials, inhibitors targeting G12C-mutant KRAS have achieved responses in some patients with NSCLC. Possible intrinsic and acquired resistance mechanisms to KRAS G12C inhibitors are not fully elucidated and will likely become important to identify.

Experimental Design:

To identify potential resistance mechanisms, we defined the sensitivity of a panel of KRAS G12C–mutant lung cancer cell lines to a KRAS G12C inhibitor, AMG510. Gene set enrichment analyses were performed to identify pathways related to the sensitivity, which was further confirmed biochemically. In addition, we created two cell lines that acquired resistance to AMG510 and the underlying resistance mechanisms were analyzed.

Results:

KRAS expression and activation were associated with sensitivity to KRAS G12C inhibitor. Induction of epithelial-to-mesenchymal transition (EMT) led to both intrinsic and acquired resistance to KRAS G12C inhibition. In these EMT-induced cells, PI3K remained activated in the presence of KRAS G12C inhibitor and was dominantly regulated by the IGFR–IRS1 pathway. We found SHP2 plays a minimal role in the activation of the PI3K pathway in contrast to its critical role in the activation of the MAPK pathway. The combination of KRAS G12C inhibitor, PI3K inhibitor, and SHP2 inhibitor resulted in tumor regressions in mouse models of acquired resistance to AMG510.

Conclusions:

Our findings suggest that EMT is a cause of both intrinsic and acquired resistance by activating the PI3K pathway in the presence of KRAS G12C inhibitor.
Modified Technique of Doubly Folded Peritoneal Flap Interposition in Transabdominal Vesicovaginal Fistula Repair: Our Experience of 36 Cases
Authors: Tewary Shashi Kant , Das Ranjit Kumar , Choudhary Arpan , Basu Supriyo , Dey Ranjan Kumar
Published: September 2020

Purpose: Correction of vesicovaginal fistula (VVF) using interpositional flaps is an established procedure. In open repair, omental flap gives good results. However, its availability in all the cases is questionable. We utilized our technique of doubly folded peritoneal flap and assessed the outcome of the repair. Methods: Retrospective observational study included 36 cases of open VVF repair, performed during 2010–2019. Preoperative clinical examination, cystoscopy, and imaging were performed routinely. Open transvesical repair as described by O’Conor was performed and doubly folded peritoneal flap was utilized. Intra- and postoperative parameters were recorded. The outcome was assessed after 21 days of catheter removal. A minimum of 6 months of follow-up was done. Results: Mean age was 44 ± 18 years, and 97.2% of VVF were iatrogenic, mainly after hysterectomy (75.0%) and caesarean section (22.2%). Fistula size ranged from 0.6 to 5.5 cm. Five cases had multiple fistulas and 3 cases were recurrent. Mean flap length and width were 8.0 ± 2.4 and 5.1 ± 1.1 cm, respectively. Mean operative time and estimated blood loss were 94 ± 15 min and 155 ± 45 mL, respectively. Fourteen of 36 patients developed complications of Clavien-Dindo grade I/II. Thirty-five out of 36 cases (97.2%) were cured and remained dry for 6 months after surgery. Three cases reported de-novo urgency and were treated medically. Satisfaction level was good in 91.2% of cases. Conclusion: Transvesical repair using doubly folded peritoneal flap provides an excellent and durable outcome. It is a suitable alternative to the omental interpositional flap.
Remission der anterioren Uveitis – was sind prädiktive Faktoren?
Authors: Dingerkus Vita , Becker Matthias D.
Published: September 2020

Purpose: To estimate the incidence of medication-free remission of chronic anterior uveitis and identify predictors thereof. Design: Retrospective cohort study. Participants: Patients diagnosed with anterior uveitis of longer than 3 months’ duration followed up at United States tertiary uveitis care facilities. Methods: Estimation of remission incidence and identification of associated predictors used survival analysis. Main outcome measures: Incidence of medication-free remission. For the primary analysis, remission was defined as inactive uveitis while off treatment at all visits spanning an interval of at least 90 days or-for patients who did not return for follow-up after 90 days-remaining inactive without receiving suppressive medications at all of the last visits. Association of factors potentially predictive of medication-free remission was also studied. Results: Two thousand seven hundred ninety-five eyes of 1634 patients with chronic anterior uveitis were followed up over 7936 eye-years (4676 person-years). The cumulative medication-free, person-year remission incidence within 5 years was 32.7% (95% confidence interval [CI], 30.4%–35.2%). Baseline clinical factors predictive of reduced remission incidence included longer duration of uveitis at presentation (for 2 to 5 years vs. less than 6 months: adjusted hazard ratio [aHR], 0.61; 95% CI, 0.44–0.83), bilateral uveitis (aHR, 0.75; 95% CI, 0.59–0.96), prior cataract surgery (aHR, 0.70; 95% CI 0.56–0.88), and glaucoma surgery (aHR, 0.63; 95% CI, 0.45–0.90). Two time-updated characteristics were also predictive of reduced remission incidence: keratic precipitates (aHR, 0.36; 95% CI, 0.21–0.60) and synechiae (aHR, 0.62; 95% CI, 0.41–0.93). Systemic diagnosis with juvenile idiopathic arthritis and spondyloarthropathy were also associated with reduced remission incidence. Older age at presentation was associated with higher incidence of remission (for age ≥40 years vs. <40 years: aHR, 1.29; 95% CI, 1.02–1.63). Conclusions: Approximately one third of patients with chronic anterior uveitis remit within 5 years. Longer duration of uveitis, younger age, bilateral uveitis, prior cataract surgery, glaucoma surgery, presence of keratic precipitates and synechiae, and systemic diagnoses of juvenile idiopathic arthritis and spondyloarthropathy predict reduced remission incidence; patients with these factors should be managed taking into account the higher probability of a longer disease course.
Clinical Course and Predictors of Poor Functional Outcome in Guillain-Barré Syndrome. A Retrospective Study
Authors: Shangab Maha , Al Kaylani Muhammad
Published: September 2020

Introduction: Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis. It carries great morbidity due to an overall high rate of poor functional outcome. This study is conducted to study the predictors of poor functional outcome. Methods: This study a retrospective observational study, which was conducted in Rashid Hospital Tertiary Center in Dubai between 2009 and 2019. Functional status was assessed and followed by the GBS disability score. Functional outcome at 6 months was evaluated for possible predicting factors as well as associated outcomes. Results: Out of the 82 cases, the mean age at presentation is 37 ± 14.4, with 64 (78%) males. Around one-third of cases (37.8%) had residual deficits at 6 months. Follow-up after 6 months showed that cases with a poor functional outcome are older (p = 0.035) and have presented with a high disability score (p < 0.001) and a higher need for mechanical ventilation (p < 0.001). Axonal type of nerve injury resulted in poor functional outcome at 6 months compared to the demyelinating type of nerve injury (p = 0.034). Lower rate of improvement at 1 month and poor functional outcome at 6 months resulted in a longer hospital stay (p < 0.001). Conclusion: A poor functional status at presentation, axonal type of nerve injury, and the early requirement for mechanical ventilation are found to predict poor functional improvement after 6 months from diagnosis. These factors must be kept in consideration to facilitate more vigilant management of patient’s associated high morbidity.
Long-Term Outcome in High-Risk Patients With Hypertrophic Cardiomyopathy After Primary Prevention Defibrillator Implants
Authors: Rowin Ethan J. , Burrows Austin , Madias Christopher , Estes N.A. Mark , Link Mark S. , Maron Martin S. , Maron Barry J.
Published: September 2020

Background:

The implantable cardioverter-defibrillator (ICD) is effective for preventing sudden death in patients with hypertrophic cardiomyopathy. However, data on performance and complications of implanted ICDs over particularly long time periods to inform clinical practice is presently incomplete.

Methods:

The study cohort comprises 217 consecutive hypertrophic cardiomyopathy patients with primary prevention ICDs implanted before 2008 and followed for ≥10 years (mean 12±4; range to 31).

Results:

Patients were 38±17 years at implant and 45 (21%) experienced appropriate interventions terminating ventricular tachycardia/ventricular fibrillation. The majority of ICD discharges occurred ≥5 years after implant (29 patients; 64%), including ≥10 years in 16 patients (36%). Initial device therapy increased in frequency from 2.3% of patients at <1 year to 8.5% of patients at ≥10-years after implant (
P
=0.005). Inappropriate ICD shocks in 39 patients occurred most commonly <5 years after implant (54%) and decreased in frequency with increasing time from implant (from 9.7% of patients at <5 years to 3.8% at ≥10 years,
P
=0.02). Other major device complications including infection and lead fractures and dislodgement occurred in 27 patients (12%) but did not increase in frequency over follow-up after implant (
P
=0.47). There were no arrhythmic sudden death events among the 217 patients with ICD.

Conclusions:

In hypertrophic cardiomyopathy, after a primary prevention implant, ICD therapy often followed prolonged periods of device dormancy and increased progressively in frequency over time, including one-third of patients with initial therapy after 5 to 9 years, and an additional one-third of patients at ≥10 years. Frequency of inappropriate shocks decreased over follow-up, likely reflecting standard changes in device programming, while occurrence of device complications, such as lead fractures/infection, did not increase during follow-up.
Sleep Duration and Stroke
Authors: Titova Olga E. , Michaëlsson Karl , Larsson Susanna C.
Published: September 2020

Background and Purpose:

Studies of sleep duration in relation to specific types of stroke are scarce. Moreover, the results are inconclusive and causality remains unclear. Our objective was to investigate whether sleep duration is associated with risk of stroke and its types using observational and Mendelian randomization designs.

Methods:

The prospective study included 79 881 women and men (45–79 years of age) who were followed up for incident stroke or death over a mean follow-up of 14.6 years (1 164 646 person-years) through linkage to Swedish Registers. For the Mendelian randomization study, single-nucleotide polymorphisms associated with sleep duration were identified from a genome-wide association study. Summarized data for genetic associations with stroke were obtained from publicly available data of the MEGASTROKE and the International Stroke Genetics Consortia.

Results:

Compared with normal sleep duration, long sleep (≥9 hours per day) was associated with increased risk of total and ischemic stroke (hazard ratios [95% CI], 1.12 [1.03–1.22] and 1.14 [1.03–1.24], respectively), whereas short sleep (<7 h/d) was linked to higher risk of intracerebral hemorrhage (hazard ratio [95% CI], 1.21 [1.03–1.41]). The 2-sample Mendelian randomization analysis supported no causal association of short or long sleep duration with ischemic stroke as a whole.

Conclusions:

In a prospective study, long sleep duration was associated with increased risk of total and ischemic stroke, whereas short sleep was linked to increased risk of intracerebral hemorrhage. However, the Mendelian randomization analysis did not show a significant detrimental effect of short or long sleep duration on the risk of total stroke or stroke types.
Free-Riders in the Nonprofit Industrial Complex: The Problem of Flexitarianism
Authors: Wrenn Corey Lee
Published: September 2020

Social movements have traditionally viewed free-riders as a problem for effective mobilization, but under the influence of the nonprofit industrial complex, it is possible that movements actively facilitate their presence. Free-riders become an economic resource to professionalized movements seeking to increase wealth and visibility in the crowded social movement space by discouraging meaningful attitude or behavior change from their audiences and concentrating power among movement elites. Actively cultivated free-riding is exemplified by the professionalized Nonhuman Animal rights movement which promotes flexitarianism over ethical veganism despite its goal of nonhuman liberation. Major social-psychological theories of persuasion in addition to 44 studies on vegan and vegetarian motivation are examined to illustrate how free-rider flexitarianism is at odds with stated goals, thereby suggesting an alternative utility in flexitarianism as a means of facilitating a disengaged public.
Critical revision of Stemonitis and Symphytocarpus (Myxomycetes) at the Natural History Museum London (BM)

Authors: MORENO G. , CASTILLO A. , THÜS H.
Published: September 2020

Light- and scanning electron microscopy are applied to re-assess diagnostic characters of type specimens and critical specimens of species in the genera Stemonitis and Symphytocarpus (Stemonitales, Myxomycetes) from the collections of the Natural History Museum London (BM). The results are used to discuss published data and the type status for specimens of Stemonitis ferruginea, S. flavogenita, S. herbatica, S. inconspicua, S. morganii, S. pallida, S. smithii, S. uvifera, S. virginiensis, S. webberi, Symphytocarpus amaurochaetoides, S. confluens, S. flaccidus and S. herbaticus. Due to severe shortcomings of the original description and the absence of preserved original material we regard S. axifera (Bull.) Macbride as a nomen ambiguum and propose to re-adopt the use of S. ferruginea as the valid name for the common taxon S. axifera auct. (non (Bull.) T.Macbr.). SEM characters support the treatment of Stemonitis smithii as a synonym of S. ferruginea. Stemonitis webberi instead is shown to be well separated from S. splendens by several independent characters. The importance of SEM characters for the correct identification of critical specimens of Stemonitis ferruginea, S.pallida and S. webberi is highlighted and accurate spore measurements based on SEM images are provided for all species.
Morphology and phylogeny of Pseudocercospora hamiltoniani—A new species comparable to Sirosporium from Uttarakhand, India

Authors: SINGH RAGHVENDRA , VERMA SANJEET KUMAR , YADAV SANJAY , BHOJAK PUJA , KUMAR SHAMBHU
Published: September 2020

Pseudocercospora hamiltoniani, a new asexual foliicolous hyphomycetous fungus was discovered on living leaves of Euonymus hamiltonianus (Celastraceae) is described and illustrated. This species is compared with closely related species of Pseudocercospora and other cercosporoid forms reported on the same host genus. The phylogeny of this species has been inferred from internal transcribed spacer (ITS). Phylogenetically, Ps. hamiltoniani differ from closely related Ps. ranjita in having smooth to verruculose mycelium; mostly solitary, highly septate, smooth to verruculose, longer and thicker conidiophores and highly septate with oblique septation, presence of rounded cells, smooth to verruculose, longer and thicker conidia.