bluuebunny/crossref_metadata_2025 huggingface dataset:
Kafka and the COVID-19 epidemic: Why the Sirens’ silence is more deadly than their song
Authors: Gabriel Yiannis
Published: May 2020

Seeking to examine the implications of social distancing, isolation and the silencing of public spaces brought about by the COVID-19 epidemic, I offer an interpretation of Kafka’s short story ‘The Silence of the Sirens’ contrasting it to the Homeric original. In Homer’s story, Odysseus resists the temptation of the Sirens’ deadly song by having himself tied to the mast of his ship, while his oarsmen, ears blocked with beeswax, sail quickly by. By contrast, in Kafka’s telling of the story, the Sirens fall silent. A solitary Odysseus, indifferent to them, sails by peacefully, his ears blocked, his ‘great eyes’ staring in the distance. Homer’s story has long been seen as a warning against the seductions of Siren voices like those of opportunist demagogues. Throughout the Odyssey, Odysseus himself offers a complex archetype of heroic leadership, navigating adroitly and prudently the dangers of stormy seas. Kafka’s character, by contrast, proposes a different archetype, one akin to the Stoics’ homo viator, the individual who sails through life’s adversities by accepting them and turning them into a source of inner strength and wisdom. In this way, Kafka offers two things: first, an insightful explanation of why silence and isolation can be deadly when they leaving us alone with our darkest fears and fantasies, and second, an archetype of hope that is attuned to our times on how to cope with pain and anxiety.
Western Pomeranian Experiences with Migration and Emigration: The Need for Local Solutions
Authors: Geblewicz Olgierd
Published: May 2020

The article describes the socio-demographic situation of Western Pomerania following Poland’s accession to the EU in 2004. Western Pomerania faced a number of challenges: a brain drain, a rapidly ageing society and a shortage of workers. The region’s demographic situation was particularly serious compared to Poland’s other regions. However, Western Pomerania is now profiting from an inflow of migrants, especially from Ukraine, which is boosting the region’s economy. The article describes the measures undertaken on the local and regional level to promote the inflow of economic migrants and to integrate them into the local society. The measures described are helping to form a broader regional strategy to tackle the challenges of people leaving the region, the ageing population and a departing workforce. The article argues that if the proper support for newcomers is provided, migration could become a positive factor for the local economy.
Inferior Oblique Entrapment After Orbital Fracture With Transection and Repair
Authors: Tooley Andrea A. , Levine Benjamin , Godfrey Kyle J. , Lisman Richard D. , Tran Ann Q. , Sherman John E.
Published: May 2020

Extraocular muscle (EOM) entrapment with resulting reduction in motility and diplopia is a known complication of orbital fractures. Less commonly, transection of the EOMs due to trauma, iatrogenic injury, or intentional myotomy may lead to persistent diplopia. The inferior oblique (IO) is often encountered during orbital surgery along the medial wall and floor, and may be disinserted to aid in visualization. The authors present a case of IO entrapment which occurred during zygomaticomaxillary fracture reduction. Intraoperatively, an IO transection was performed and the muscle was reattached within the orbit. Postoperatively, the patient did not develop diplopia or motility disruption. This technique may provide a useful solution to an unusual problem during orbital fracture repair.
Chronic Rhinosinusitis Patients With and Without Polyps Experience Different Symptom Perception and Quality of Life Burdens
Authors: Talat Rehab , Speth Marlene M. , Gengler Isabelle , Phillips Katie M. , Caradonna David S. , Gray Stacey T. , Sedaghat Ahmad R.
Published: May 2020

Objective

We sought to determine if chronic rhinosinusitis (CRS) patients with nasal polyps (CRSwNP) differentially perceived CRS symptom burden compared to patients without nasal polyps (CRSsNP) and to what extent CRS symptom severity was associated with quality of life (QOL) and patient-reported symptom control in the 2 groups.

Methods

A total of 600 patients (266 CRSwNP and 334 CRSsNP) presenting with CRS were recruited. CRS symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). SNOT-22 nasal, sleep, ear/facial discomfort, and emotional subdomain scores were calculated. General health-related QOL was assessed with the visual analog scale of the 5-dimensional EuroQol questionnaire (EQ-5D VAS). Patients rated their CRS symptom control on a 5-point scale.

Results

SNOT-22 scores did not differ between CRSwNP (mean: 35.6) and CRSsNP (mean: 36.3). There were no differences in nasal, sleep, and emotional subdomains of the SNOT-22. CRSsNP had higher ( P = .003) ear/facial subdomain scores than CRSwNP, while CRSwNP reported greater hyposmia ( P < .001). EQ-5D VAS was significantly lower ( P = .011) in CRSsNP (mean: 68.9) compared to CRSwNP (mean: 73.2). However, CRSwNP patients reported significantly less symptom control, compared to CRSsNP, in association with nasal and emotional symptoms.

Conclusion

CRSwNP and CRSsNP have differences in symptom profile, effect on health-related QOL, and patient-perceived symptom control. CRSsNP experience significantly greater burden of ear/facial discomfort, while CRSwNP report greater hyposmia. Although CRSsNP reports lower general health-related QOL overall, CRSwNP patients had lower levels of CRS symptom control for every incremental increase in symptom burden suggesting greater sensitivity/intolerance to CRS symptoms.
Analysis of Utility Assessment Scores to Objectify the Health Burden Caused by Breast Conservation Therapy
Authors: Blankensteijn Louise L. , Egeler Sabine A. , Sinno Hani H. , Ibrahim Ahmed M. S. , Izadpanah Ali , Vorstenbosch Joshua , Dionisopoulos Tassos , Tobias Adam M. , Lin Samuel J. , Lee Bernard T.
Published: May 2020

Background:

Lumpectomy followed by radiation, known as breast conservation therapy (BCT), is a viable surgical treatment option for early-stage breast cancer. However, the current literature suggests that patients prefer mastectomy over BCT, likely due to the wide variety of postmastectomy reconstructive options. Our aim is to investigate the objective health burden of living with BCT to help surgeons gain a better understanding of patient treatment preferences.

Methods:

Three validated health state utility tools were used to objectify the burden of living with post-BCT results: visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG). A prospective sample of the general population and medical students were recruited, and their responses analyzed to attain these scores.

Results:

Utility scores for living with BCT are VAS 0.81 ± 0.19, TTO 0.93 ± 0.10, and SG 0.92 ± 0.14. The TTO and SG suggest a willingness to trade 2.5 years of life years and an 8% chance of death undergoing reconstructive procedures to correct a BCT defect, respectively. Age, gender, race, education, and income were not statistically significant independent predictors for higher or lower utility scores.

Conclusion:

The impact of the health burden of BCT was ascertained using validated objective numeric utility scores. These indices demonstrate a willingness to trade less life years to undergo correction of a BCT defect than reconstruction following unilateral mastectomy. They can provide surgeons with the best objective understanding of patient preferences for shared decision-making in the management of breast cancer.
Donor Site Scar Preference in Patients Requiring Free Flap Reconstruction
Authors: McLeod Graham James , Islur Avinash
Published: May 2020

Introduction:

In traumatic reconstruction, surgeons frequently harvest flaps from donor sites that they are comfortable performing and with favourable tissue characteristics without determining the patients preferred site. The study’s goal was to determine participants free flap donor site preference based on aesthetics as it relates to the size of the defect being reconstructed.

Methodology:

Participants were asked to imagine that they were in a trauma that resulted in a wound of variable sizes. They were presented with a selection of common donor site scars produced from harvesting small, medium, and large free flaps. They were instructed to rank the donor sites in order of preference and score each donor site of 10.

Results:

Two hundred eighty-seven participants (mean age: 28, female: 62%) completed the survey. For small reconstructions, the preferred donor site scars were on the leg or back compared to arm or abdomen. For medium size reconstructions, scars on the back and upper thigh were preferred over scars on the abdomen and anterior thigh. In small and medium reconstructions, the midline abdominal scar scored significantly lower than other donor sites. Participants preferred donor sites on the back, the thigh, and lower abdomen for large reconstructions.

Conclusion:

Participants preferred back, thigh, and hip locations perhaps relating to the ability to conceal these scars under clothing. If multiple flaps sites could be harvested, providing options to trauma patients undergoing free tissue transfer may result in increased satisfaction.
Provider–Patient Interaction: Exploring Elderspeak in Simulated Preclinical Chiropractic Student Encounters
Authors: Cockrell Maurya D.
Published: May 2020

Objective: The purpose of this study was to identify whether or not elderspeak was evident in simulated provider–patient encounters in a chiropractic education program. This study was designed to answer the following three research questions (RQs): RQ 1: Is elderspeak present in simulated patient encounters in a chiropractic education program? RQ 2: If elderspeak is present, which categorization of elderspeak is most frequently used during simulated patient encounters? RQ 3: If elderspeak is present, is gender an influencing variable? Method: The presence of elderspeak in simulated chiropractic encounters was studied using a cross-sectional mixed methods observational research design. Results: A total of 331 occurrences of elderspeak were identified in 60 digitized recordings. The most common form of elderspeak was collective pronoun usage. Conclusion: Results indicated that the chiropractic industry is susceptible to elderspeak. Understanding elderspeak is important to prevent future ageist behaviors from affecting older adult patients and to improve their health outcomes.
How does internationalization begin? The role of age at entry and export experience in the early stages of the process
Authors: Casillas Jose C , Acedo Francisco J , Rodríguez-Serrano M Ángeles
Published: May 2020

This article deals with two important concepts in the prior literature on the internationalization process: age at entry and export experience. Against previous research, we analyze how both of them influence simultaneously international behavior in the early stages of the internationalization process as a trade-off. For that aim, we analyze the influence of both variables on international behavior in the early stages of the internationalization process, from a dynamic perspective, looking at initial export behavior and speed during this period. We analyze export development process of 106 Spanish small and medium-sized enterprises (SMEs), most of them international new ventures, in their first 8 years of export activity, combining the effect of age at entry and experiential learning during this period, finding that age at entry and export experience exert not only a direct effect but also a moderation influence on initial export development, observing a trade-off between such influence as experience grows.

JEL CLASSIFICATION: M16
Internationalization of Chinese SMEs: The role of networks and global value chains
Authors: Su Fang , Khan Zaheer , Kyu Lew Yong , Il Park Byung , Shafi Choksy Umair
Published: May 2020

This article examines the role of networks and global value chains (GVCs) and how they influence emerging economy small- and medium-sized enterprises’ (EE-SMEs) internationalization. Drawing on the insights, experiences, and perspectives of entrepreneurs and senior managers of small- and medium-sized enterprises (SMEs) that have originated from China, the study adopts qualitative approach and examines nine firms’ internationalization. We find that Chinese born-global manufacturing SMEs benefit from networks with quick insidership position into GVCs, but suffer from various obstacles that hinder their further development. The findings further indicate that network ties substantially facilitate EE-SMEs’ internationalization, but also restrict their future global development, as their low position within the GVCs impedes further business development and capability building. The case firms’ lower position within the GVCs weakens the networks’ influence on their GVC upgrading. The research identifies key enablers of GVC engagement and obstacles of GVC upgrading of the case firms which play an important role in the EE-SMEs’ internationalization.

JEL CLASSIFICATION: M10; M16
The State of City Diplomacy
Authors: Klaus Ian
Published: May 2020

Cities have organised into a global collective voice. Doing so has required diplomatic maturation and resulted in new diplomatic standing. Both these developments will be tested with the return of great power politics.
A fully human anti-BMP6 antibody reduces the need for erythropoietin in rodent models of the anemia of chronic disease
Authors: Petzer Verena , Tymoszuk Piotr , Asshoff Malte , Carvalho Joana , Papworth Jonathan , Deantonio Cecilia , Bayliss Luke , Wake Matthew Stephen , Seifert Markus , Brigo Natascha , Valente de Souza Lara , Hilbe Richard , Grubwieser Philipp , Demetz Egon , Dichtl Stefanie , Volani Chiara , Berger Sylvia , Böhm Felix , Hoffmann Alexander , Pfeifhofer-Obermair Christa , von Raffay Laura , Sopper Sieghart , Arndt Stephanie , Bosserhoff Anja , Kautz Léon , Perrier Prunelle , Nairz Manfred , Wolf Dominik , Weiss Guenter , Germaschewski Volker , Theurl Igor
Published: May 2020

Recombinant erythropoietin (EPO) and iron substitution are a standard of care for treatment of anemias associated with chronic inflammation, including anemia of chronic kidney disease. A black box warning for EPO therapy and concerns about negative side effects related to high-dose iron supplementation as well as the significant proportion of patients becoming EPO resistant over time explains the medical need to define novel strategies to ameliorate anemia of chronic disease (ACD). As hepcidin is central to the iron-restrictive phenotype in ACD, therapeutic approaches targeting hepcidin were recently developed. We herein report the therapeutic effects of a fully human anti-BMP6 antibody (KY1070) either as monotherapy or in combination with Darbepoetin alfa on iron metabolism and anemia resolution in 2 different, well-established, and clinically relevant rodent models of ACD. In addition to counteracting hepcidin-driven iron limitation for erythropoiesis, we found that the combination of KY1070 and recombinant human EPO improved the erythroid response compared with either monotherapy in a qualitative and quantitative manner. Consequently, the combination of KY1070 and Darbepoetin alfa resulted in an EPO-sparing effect. Moreover, we found that suppression of hepcidin via KY1070 modulates ferroportin expression on erythroid precursor cells, thereby lowering potentially toxic-free intracellular iron levels and by accelerating erythroid output as reflected by increased maturation of erythrocyte progenitors. In summary, we conclude that treatment of ACD, as a highly complex disease, becomes more effective by a multifactorial therapeutic approach upon mobilization of endogenous iron deposits and stimulation of erythropoiesis.
A rare intraoperative spinal cord injury caused by thoracic 8 nerve root interruption during posterior vertebral column resection surgery for severe congenital kyphoscoliosis: a case report
Authors: Wang Shujie , Ren Zhifu , Yang Zhen , Zhang Jianguo
Published: May 2020

Background

To our knowledge, the exposed nerve roots in thoracic spine are usually sacrificed to facilitate osteotomy during posterior vertebral column resection (PVCR) for severe spinal deformity. Currently we report a case with severe spine deformity in which intraoperative neurological monitoring (IOM) loss after interrupting T8 nerve root finally led to spinal cord injury during PVCR surgery.

Case presentation

The patient was a 14-year-old female with severe congenital kyphoscoliosis (CKS) without preoperative neurologic deficits. The IOM events (MEP loss and SSEP latency prolong) were showed when T8 nerve root at concave side was interrupted. And then we reduce the scope of osteotomy to control bleeding, raised blood pressure (MAP, 65–80) to increase blood supply for spinal cord, placed the bilateral rod to stabilized the spinal cord, used the methylprednisolone, explored the presence or absence of spinal cord compression, and prepared to change the surgical plan from PVCR to PSO. After that the IOM signals partial recovered from the lowest point. Postoperatively the patients showed transient motor function deficits of left lower limbs weak without somatosensory deficits, and come back to preoperative status 6 months later.

Conclusions

Interrupting the thoracic spine nerve root is danger to trigger the spinal cord injury during PVCR procedure of severe CKS. That probably because the increasing tension of contralateral anterior horn area of spinal cord via the nerve root pulling.
Association between hip muscle cross-sectional area and hip pain and function in individuals with mild-to-moderate hip osteoarthritis: a cross-sectional study
Authors: Peiris Waruna L. , Cicuttini Flavia M. , Constantinou Maria , Yaqobi Abbas , Hussain Sultana Monira , Wluka Anita E. , Urquhart Donna , Barrett Rod , Kennedy Ben , Wang Yuanyuan
Published: May 2020

Background

To examine the associations between hip muscle cross-sectional area and hip pain and function in community-based individuals with mild-to-moderate hip osteoarthritis.

Methods

This study included 27 participants with mild-to-moderate hip osteoarthritis. Cross-sectional area of hip muscles, including psoas major, rectus femoris, gluteus maximus, gluteus medius and minimus, adductor longus and magnus, obturator internus, and obturator externus, were measured from magnetic resonance images. Hip pain and function were evaluated using the Hip Disability and Osteoarthritis Outcome Score (HOOS) categorised into 5 subscales: pain, symptoms, activity of daily living, sport and recreation function, and hip-related quality of life (for each subscale 0 representing extreme problems and 100 representing no problems).

Results

Mean age of the 27 participants was 63.2 (SD 7.6) years and 66.7% (n = 18) were female. After adjusting for age and gender, greater cross-sectional area of adductor longus and magnus was associated with a higher HOOS score in quality of life (regression coefficient 1.4, 95% confidence interval (CI) 0.2–2.7, p = 0.02), activity of daily living (regression coefficient 1.3, 95% CI 0.1–2.6, p = 0.04) and sport and recreation function (regression coefficient 1.6, 95% CI 0.1–3.0, p = 0.04). There was a trend towards an association between greater cross-sectional area of psoas major and a higher quality of life score (regression coefficient 3.6, 95% CI − 0.5 to 7.7, p = 0.08). The cross-sectional area of hip muscles was not significantly associated with HOOS pain or symptom score.

Conclusion

Greater cross-sectional area of hip adductors was associated with better function and quality of life in individuals with mild-to-moderate hip osteoarthritis. Greater cross-sectional area of hip flexors might be associated with better quality of life. These findings, while need to be confirmed in longitudinal studies, suggest that targeting the hip adductor and flexor muscles may improve function and quality of life in those with mild-to-moderate hip osteoarthritis.
Iatrogenic biological fracture of the cervical spine during gradual halo traction for kyphotic deformity correction: case report
Authors: Lim Austin Samuel Laifun , Sali Azizul Akram Bin , Cheung Jason Pui Yin
Published: May 2020

Background

Severe kyphotic deformities carry high risk for neurological injuries as osteotomies are often required for correction. Surgeons often utilize a staged approach for dealing with these conditions starting with a period of halo traction to stretch tight soft tissues and partially correct the deformity, followed by surgery. Halo traction is a relatively safe procedure and complications are uncommon. We report a unique case of iatrogenic fracture of the cervical spine during gradual halo traction for deformity correction of a severe cervical kyphosis.

Case presentation

An 80-year-old female with previous cervical spine tuberculosis infection and C5-C6 anterior spinal fusion developed severe cervical kyphosis of 64° from C2-C6 and neck pain requiring deformity correction surgery. Gradual increase in traction weight was applied, aiming for a maximum traction weight of 45 pounds or half body weight. During the 1st stage halo-gravity traction, sudden neck pain and a loud cracking sound was witnessed during increase of the traction weight to 14 pounds. Imaging revealed a fracture through the C4 and reduction in kyphosis deformity to 11° from C2-C6. There was no neurological deficit. No further traction was applied and the patient underwent an in-situ occipital to T3 fusion without osteotomies. At 3-year follow-up, the patient was symptom-free and radiographs showed solid fusion and maintenance of alignment.

Conclusions

Iatrogenic fracture may occur with halo traction. Elderly patients with osteoporotic and diseased bone should be closely monitored during the treatment. A fracture without complications was a fortunate complication as the patient was able to avoid any high-risk osteotomies for deformity correction.

Level of evidence

IV
Effectiveness of circular external fixator in periprosthetic fractures around the knee
Authors: Nozaka Koji , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Saito Hidetomo , Kijima Hiroaki , Tsuchie Hiroyuki , Mita Motoki , Shimada Yoichi
Published: May 2020

Background

The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee.

Methods

We included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases.

Results

A 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3 ± 5.2 weeks (range, 8–38 weeks). The walking ability was the same level as before the injury in 13 cases.

Discussion

There are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures.

Conclusion

Circular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients.

Level of evidence

Level IV, retrospective case series.
Genomic history of the Italian population recapitulates key evolutionary dynamics of both Continental and Southern Europeans
Authors: Sazzini Marco , Abondio Paolo , Sarno Stefania , Gnecchi-Ruscone Guido Alberto , Ragno Matteo , Giuliani Cristina , De Fanti Sara , Ojeda-Granados Claudia , Boattini Alessio , Marquis Julien , Valsesia Armand , Carayol Jerome , Raymond Frederic , Pirazzini Chiara , Marasco Elena , Ferrarini Alberto , Xumerle Luciano , Collino Sebastiano , Mari Daniela , Arosio Beatrice , Monti Daniela , Passarino Giuseppe , D’Aquila Patrizia , Pettener Davide , Luiselli Donata , Castellani Gastone , Delledonne Massimo , Descombes Patrick , Franceschi Claudio , Garagnani Paolo
Published: May 2020

Background

The cline of human genetic diversity observable across Europe is recapitulated at a micro-geographic scale by variation within the Italian population. Besides resulting from extensive gene flow, this might be ascribable also to local adaptations to diverse ecological contexts evolved by people who anciently spread along the Italian Peninsula. Dissecting the evolutionary history of the ancestors of present-day Italians may thus improve the understanding of demographic and biological processes that contributed to shape the gene pool of European populations. However, previous SNP array-based studies failed to investigate the full spectrum of Italian variation, generally neglecting low-frequency genetic variants and examining a limited set of small effect size alleles, which may represent important determinants of population structure and complex adaptive traits. To overcome these issues, we analyzed 38 high-coverage whole-genome sequences representative of population clusters at the opposite ends of the cline of Italian variation, along with a large panel of modern and ancient Euro-Mediterranean genomes.

Results

We provided evidence for the early divergence of Italian groups dating back to the Late Glacial and for Neolithic and distinct Bronze Age migrations having further differentiated their gene pools. We inferred adaptive evolution at insulin-related loci in people from Italian regions with a temperate climate, while possible adaptations to pathogens and ultraviolet radiation were observed in Mediterranean Italians. Some of these adaptive events may also have secondarily modulated population disease or longevity predisposition.

Conclusions

We disentangled the contribution of multiple migratory and adaptive events in shaping the heterogeneous Italian genomic background, which exemplify population dynamics and gene-environment interactions that played significant roles also in the formation of the Continental and Southern European genomic landscapes.
What is the impact of the adjunctive use of omega-3 fatty acids in the treatment of periodontitis? A systematic review and meta-analysis
Authors: Kruse Anne B. , Kowalski Carolyn D. , Leuthold Sylvia , Vach Kirstin , Ratka-Krüger Petra , Woelber Johan P.
Published: May 2020

Background

Host modulation therapy has gained increasing interest in periodontal therapy. This systematic review aimed to evaluate the effects of adjunctive administration of omega-3 fatty acids in periodontal therapy.

Methods

The search strategy was determined using the “patient, intervention, comparison, outcome” model. A resulting search term was generated using keywords, and the databases were fed. The databases PubMed, Cochrane Library, and LIVIVO were used. Studies were selected for the literature review based on previously specified inclusion and exclusion criteria. Randomized, controlled, blinded studies, longitudinal studies, comparative studies, and clinical studies were included in the review. Additionally, they used omega-3 fatty acids in the treatment of periodontitis. The following parameters were observed: clinical attachment level (CAL), probing depth (PD), gingival index (GI), bleeding on probing (BOP) and plaque index (PI). A meta-analysis was performed for PD and CAL after 3 months. By analyzing the risk of bias, the validity of the results of each study was demonstrated, and its credibility and quality were assessed.

Results

Of 14 studies found, six were included. The results showed a significant reduction in PD and CAL compared to that in the placebo groups in four out of six involved studies, which was confirmed by the meta-analysis. In one study, a significant reduction in BOP was found. GI was significantly reduced in three included studies. PI also showed a significant reduction in three studies.

Conclusions

Within the study limitations, omega-3 fatty acids appear to have a positive effect on periodontal wound healing with regard to reduction in CAL and PD. Based on the results, patients receiving periodontal treatment might benefit from nutritional counseling.
Correction to: Health-related quality of life measured using the EQ-5D-5 L: population norms for the capital of Iran
Authors: Emrani Zahra , Sari Ali Akbari , Zeraati Hojjat , Olyaeemanesh Alireza , Daroudi Rajabali
Published: May 2020

An amendment to this paper has been published and can be accessed via the original article.
Added value of contrast-enhanced mammography (CEM) in staging of malignant breast lesions—a feasibility study
Authors: Åhsberg Kristina , Gardfjell Anna , Nimeus Emma , Rasmussen Rogvi , Behmer Catharina , Zackrisson Sophia , Ryden Lisa
Published: May 2020

Objectives

The aim of this feasibility study was to evaluate the added value of contrast-enhanced mammography (CEM) in preoperative staging of malignant breast lesions, beyond standard assessment with digital mammography and ultrasound, as a base for a future prospective randomized trial.

Materials and methods

Forty-seven patients, with confirmed or strongly suspected malignant breast lesions after standard assessment (digital mammography (DM) and ultrasound (US)), scheduled for primary surgery, were invited to undergo CEM as an additional preoperative procedure. The primary endpoint was change in treatment due to CEM findings, defined as mastectomy instead of partial mastectomy or contrariwise, bilateral surgery instead of unilateral or neoadjuvant treatment instead of primary surgery. Accuracy in tumour extent estimation compared to histopathology was evaluated by Bland-Altman statistics. Number of extra biopsies and adverse events were recorded.

Results

In 10/47 patients (21%), findings from CEM affected the primary treatment. Agreement with histopathology regarding extent estimation was better for CEM (mean difference − 1.36, SD ± 18.45) in comparison with DM (− 4.18, SD ± 26.20) and US (− 8.36, SD ± 24.30). Additional biopsies were taken from 19 lesions in 13 patients. Nine biopsies showed malignant outcome. No major adverse events occurred.

Conclusion

The feasibility of preoperative additional CEM was found to be satisfactory without any serious negative effects. Results imply an added value of CEM in preoperative staging of breast cancer. Further evaluation in larger prospective randomized trials is needed.

Trial registration

ClinicalTrials.gov, NCT03402529. Registered 18 January 2018—retrospectively registered
Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies
Authors: Agodirin Olayide S. , Aremu Isiaka , Rahman Ganiyu A. , Olatoke Samuel A. , Akande Halimat J. , Oguntola Adetunji S. , Olasehinde Olalekan , Ojulari Sheriff , Etonyeaku Amarachukwu , Olaogun Julius , Romanoff Anya
Published: May 2020

PURPOSE

The prevalence of themes linked to delay in presentation of breast cancer (BC) and their underlying factors vary considerably throughout Africa. Regional differences and trends are largely unreported. The purpose of this research was to provide summary estimates of the prevalence and distribution of the themes and underlying factors linked to delay in the presentation of BC, regional variation, and trends in an effort to identify targets for intervention.

DESIGN

We screened articles found through PubMed/Medline, African Journal OnLine, Science Direct, Google/Google Scholar, and ResearchGate. We included patient-reported surveys on the reasons linked to delayed presentation under 6 previously identified themes: symptom misinterpretation, fear, preference for alternative care, social influence, hospital-related factors, and access factors. The meta-analytical procedure in MetaXL used the quality-effect model.

RESULTS

Twelve of the 236 identified articles were eligible for this review. The overall summary estimate of late presentation (> 90 days) was 54% (95% CI, 23 to 85) and was worst in the eastern and central regions. Symptom misinterpretation was the most common theme (50%; 95% CI, 21 to 56), followed by fear (17%; 95% CI, 3 to 27), hospital-related theme (11%; 95% CI, 1 to 21), preference for alternative care (10%; 95% CI, 0 to 21), social influence (7%; 95% CI, 0 to 14), and access-related theme (6%; 95% CI, 0 to 13). The most common factor underlying symptom misinterpretation was mischaracterizing the breast lesion as benign (60%; 95% CI, 4 to 100) which surpassed lack of awareness in the last decade. Misdiagnosis and failure to refer were the dominant hospital-related factors.

CONCLUSION

Modifiable factors such as mischaracterizing malignant masses as benign, fear, misdiagnosis, and failure to refer were the prevalent factors contributing to delays throughout Africa. These factors are promising targets for intervention.
Impact of Magnesium Stearate Presence and Variability on Drug Apparent Solubility Based on Drug Physicochemical Properties
Authors: Zarmpi P. , Flanagan T. , Meehan E. , Mann J. , Fotaki Nikoletta
Published: May 2020

Excipients are major components of oral solid dosage forms, and changes in their critical material attributes (excipient variability) and/or amount (excipient variation) in pharmaceutical formulations may present a challenge for product performance. Understanding the biopharmaceutical factors affecting excipient performance is recommended for the successful implementation of excipient variability on Quality by Design (QbD) approaches. The current study investigated the impact of magnesium stearate (MgSt) variability on the apparent solubility of drugs with a wide range of physicochemical properties (drug ionization, drug lipophilicity, drug aqueous solubility). Compendial and biorelevant media were used to assess the role of gastrointestinal (GI) conditions on the excipient effects on drug apparent solubility. The lipophilic nature of MgSt decreased the apparent solubility of most compounds. The reduction in drug apparent solubility was more pronounced for highly soluble and/or highly ionized drugs and in presence of more highly crystalline or smaller particle size MgSt. The use of multivariate data analysis revealed the critical physicochemical and biopharmaceutical factors and the complex nature of excipient variability on the reduction in drug apparent solubility. The construction of a roadmap combining drug, excipient and medium characteristics allowed the identification of the cases where the presence of excipient or excipient variability may present risks for oral drug performance.
Chromogranin Serves as Novel Biomarker of Endocrine and Gastric Autoimmunity
Authors: Ebert Antonia , König Jochem , Frommer Lara , Schuppan Detlef , Kahaly George J
Published: May 2020

Context

The glycoprotein chromogranin A (CgA) is expressed by endocrine and neuroendocrine cells. High levels of serum CgA serve as markers of neuroendocrine tumors (NET), but its role in autoimmunity has not been assessed.

Objective

To investigate CgA utility as a marker of endocrine autoimmunity.

Methods

CgA serum levels were evaluated in 807 consecutive unselected participants (cross-sectional study) with the time-resolved amplified cryptate emission technology.

Results

Serum CgA concentrations were increased in 66%, 39%, 38%, and 24% of patients with NET, type 1 diabetes (T1D), autoimmune gastritis (AG) and autoimmune polyendocrinopathy (AP), respectively. Compared with healthy participant controls (C), the odds of positive CgA measurement were up to 28 times higher in the disease groups. In detail, the odds ratios (ORs) for positive CgA levels were 27.98, 15.22, 7.32 (all P < 0.0001) and 3.89 (P = 0.0073) in patients with NET, T1D, AG, and AP, respectively. In AG, CgA and serum gastrin correlated positively (r = 0.55; P < 0.0001). The area under the receiver operating characteristic curve to predict AG was higher for parietal cell antibody (PCA) positivity than for CgA (0.84 vs 0.67; P < 0.0001). However, in combination with PCA and intrinsic factor autoantibodies, CgA independently improved prediction of AG (OR 6.5; P = 0.031). An impact of age on CgA positivity and on CgA value was detected (P < 0.0001) while current smoking significantly increased CgA serum levels by 25% (P = 0.0080).

Conclusion

CgA qualifies as a novel biomarker for T1D, AP, and AG.
Excess Morbidity Persists in Patients With Cushing’s Disease During Long-term Remission: A Swedish Nationwide Study
Authors: Papakokkinou Eleni , Olsson Daniel S , Chantzichristos Dimitrios , Dahlqvist Per , Segerstedt Elin , Olsson Tommy , Petersson Maria , Berinder Katarina , Bensing Sophie , Höybye Charlotte , Edén-Engström Britt , Burman Pia , Bonelli Lorenza , Follin Cecilia , Petranek David , Erfurth Eva Marie , Wahlberg Jeanette , Ekman Bertil , Åkerman Anna-Karin , Schwarcz Erik , Bryngelsson Ing-Liss , Johannsson Gudmundur , Ragnarsson Oskar
Published: May 2020

Context

Whether multisystem morbidity in Cushing’s disease (CD) remains elevated during long-term remission is still undetermined.

Objective

To investigate comorbidities in patients with CD.

Design, Setting, and Patients

A retrospective, nationwide study of patients with CD identified in the Swedish National Patient Register between 1987 and 2013. Individual medical records were reviewed to verify diagnosis and remission status.

Main Outcomes

Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated by using the Swedish general population as reference. Comorbidities were investigated during three different time periods: (i) during the 3 years before diagnosis, (ii) from diagnosis to 1 year after remission, and (iii) during long-term remission.

Results

We included 502 patients with confirmed CD, of whom 419 were in remission for a median of 10 (interquartile range 4 to 21) years. SIRs (95% CI) for myocardial infarction (4.4; 1.2 to 11.4), fractures (4.9; 2.7 to 8.3), and deep vein thrombosis (13.8; 3.8 to 35.3) were increased during the 3-year period before diagnosis. From diagnosis until 1 year after remission, SIRs (95% CI were increased for thromboembolism (18.3; 7.9 to 36.0), stroke (4.9; 1.3 to 12.5), and sepsis (13.6; 3.7 to 34.8). SIRs for thromboembolism (4.9; 2.6 to 8.4), stroke (3.1; 1.8 to 4.9), and sepsis (6.0; 3.1 to 10.6) remained increased during long-term remission.

Conclusion

Patients with CD have an increased incidence of stroke, thromboembolism, and sepsis even after remission, emphasizing the importance of early identification and management of risk factors for these comorbidities during long-term follow-up.
The Chamorro Creation Story, Guam Land Struggles, and Contemporary Poetry
Authors: Perez Craig Santos
Published: May 2020

This essay focuses on the creation story of the Indigenous Chamorro people from the western Pacific Island of Guam. The essay presents and analyzes the deeper meaning of the story of Puntan and Fu’una as they birth the island of Guam and the Chamorro people. Moreover, it maps the history of Catholic missionization that displaced and replaced the Chamorro creation story. The essay covers the related issue of how colonization removed Chamorros from their ancestral lands and appropriated these lands for imperial, military, tourism, and urban development. Then it highlights the decades-long struggle of Chamorro activists to reclaim the land. Lastly, it turns to contemporary Chamorro poetry to illustrate how authors have revitalized and retold the story of Puntan and Fu’una to critique and protest the degradation of Chamorro lands and to advocate for the protection and return of the land.
Stories, Language, and the Land
Authors: Savageau Cheryl
Published: May 2020

When I listen to the old stories, I am struck by the attention the Ancestors gave to the world around them, and how that informs the old stories, how the Ancestors were reading the Land. The Land, for us, is epistemologically and ontologically primary. That is to say, we know what we know and we know who we are through the Land. We know what we know because the Ancestors paid attention and put it into stories. And through that attention to the Land, we know who we are because we recognize that our life is the life of the Land, the Forest—the lakes, rivers, swamps, ocean, and further, that they are all alive, all persons. I am Alnôbak, an Abenaki woman—Aben-aki, Dawn Land. Our name describes us as the Land we are part of.
A Central Sierra Miwok Origins Story
Authors: Cowell Andrew
Published: May 2020

This article examines an Indigenous origins narrative from central California. The text is an oral narrative about the theft of the sun by Coyote, recorded in the Central Sierra Miwok language. The article presents a formal analysis of the structure, language, and poetics of the text from the perspective of ethnopoetics, focusing on structural and lexical metaphors developed for describing the pathway of the sun. It then offers reflections on the ethnogeography and worldview presented in the text, linking it to Penutian migrations from the western Great Basin into central California’s Sierra Nevada several thousand years ago. The article also provides a general contextualization of the themes of the text in relation to California and western North American coyote stories and origins stories more generally.
A mutation affecting laminin alpha 5 polymerisation gives rise to a syndromic developmental disorder
Authors: Jones Lynelle K. , Lam Rachel , McKee Karen K. , Aleksandrova Maya , Dowling John , Alexander Stephen I. , Mallawaarachchi Amali , Cottle Denny L. , Short Kieran M. , Pais Lynn , Miner Jeffery H. , Mallett Andrew J. , Simons Cas , McCarthy Hugh , Yurchenco Peter D. , Smyth Ian M.
Published: May 2020

Laminin alpha 5 (LAMA5) is a member of a large family of proteins which trimerize and then polymerise to form a central component of all basement membranes. Consequently, the protein plays an instrumental role in shaping the normal development of the kidney, skin, neural tube, lung, limb and many other organs and tissues. Pathogenic mutations in some laminins have been shown to cause a range of largely syndromic conditions affecting the competency of the basement membranes to which they contribute. We report the identification of a mutation in the polymerization domain of LAMA5 in a patient with a complex syndromic disease characterised by defects in kidney, craniofacial and limb development and by a range of other congenital defects. Using CRISPR generated mouse models and biochemical assays we demonstrate the pathogenicity of this variant, showing that the change results in a failure of the polymerisation of α/β/γ laminin trimers. Comparing these in vivo phenotypes with those apparent upon gene deletion provides insights into the specific functional importance of laminin polymerization during development and tissue homeostasis.
Effect of External Magnetic Field on Hybrid Supercapacitors of Nitrogen-Doped Graphene with Magnetic Metal Oxides
Authors: Fite Misganu Chewaka , Rao Jhan-Ying , Imae Toyoko
Published: May 2020

In this report, nitrogen-, boron- and boron/nitrogen-doped graphene and nitrogen-doped carbon nanohorn were prepared. Electrochemical analysis has shown the higher capacitance performance of the nitrogen-doped graphene (NG) electrode, because nitrogen provides free valence electron to interact with electrolyte. Then magnetic metal oxides were in situ hybridized to a nitrogen-doped graphene to produce magnetic metal oxide/NG hybrid materials, and the electrochemical measurements of the prepared hybrid material electrodes were conducted without and with the external magnetic field (8.98 mT at the inflection point) of using a Helmholtz coil. The specific capacitance took an increasing order of NiO/NG (697 F/g, 747 F/g) < Co3O4/NG (963 F/g, 1092 F/g) < Fe3O4/NG (973 F/g, 1254 F/g) in an external magnetic field of (0 mT, 8.98 mT) at a scan rate of 5 mV/s. Although these electrodes displayed high capacitance and better charge/discharge profile, cycle retention (83 to 92% under no magnetic field) was not necessarily good or it fluctuated under 8.98 mT. These behaviours by the addition of magnetic metal oxides and external magnetic field are due to the electrical conductivity of metal oxides and the Lorentz force effect of the magnetic field, respectively. Thus, it can be confirmed that Fe3O4/NG hybrid has higher potential as a magnetic material electrode for supercapacitors and the magnetic field enhances the capacitance.
Detection and quantification of glycosylated queuosine modified tRNAs by acid denaturing and APB gels
Authors: Zhang Wen , Xu Ruyi , Matuszek Żaneta , Cai Zhen , Pan Tao
Published: May 2020

Queuosine (Q) is a conserved tRNA modification in bacteria and eukaryotes. Eukaryotic Q-tRNA modification occurs through replacing the guanine base with the scavenged metabolite queuine at the wobble position of tRNAs with G34U35N36 anticodon (Tyr, His, Asn, Asp) by the QTRT1/QTRT2 heterodimeric enzyme encoded in the genome. In humans, Q-modification in tRNATyr and tRNAAsp are further glycosylated with galactose and mannose, respectively. Although galactosyl-Q (galQ) and mannosyl-Q (manQ) can be measured by LC/MS approaches, the difficulty of detecting and quantifying these modifications with low sample inputs has hindered their biological investigations. Here we describe a simple acid denaturing gel and nonradioactive northern blot method to detect and quantify the fraction of galQ/manQ-modified tRNA using just microgram amounts of total RNA. Our method relies on the secondary amine group of galQ/manQ becoming positively charged to slow their migration in acid denaturing gels commonly used for tRNA charging studies. We apply this method to determine the Q and galQ/manQ modification kinetics in three human cells lines. For Q-modification, tRNAAsp is modified the fastest, followed by tRNAHis, tRNATyr, and tRNAAsn. Compared to Q-modification, glycosylation occurs at a much slower rate for tRNAAsp, but at a similar rate for tRNATyr. Our method enables easy access to study the function of these enigmatic tRNA modifications.
Revisiting the window of opportunity for cotranscriptional splicing in budding yeast
Authors: Aslanzadeh Vahid , Beggs Jean D.
Published: May 2020

We reported previously that, in budding yeast, transcription rate affects both the efficiency and fidelity of pre-mRNA splicing, especially of ribosomal protein transcripts. Here, we report that the majority of ribosomal protein transcripts with non-consensus 5′ splice sites are spliced less efficiently when transcription is faster, and more efficiently with slower transcription. These results support the “window of opportunity” model, and we suggest a possible mechanism to explain these findings.
Krytyka ujęć modelowych wielokulturowości
Authors: Paleczny Tadeusz
Published: May 2020

Model Multiculturalities. A Critical Approach

The article includes an overview of the factors and reasons for the crisis of ideology and multicultural policy. This crisis is reflected in the concepts and theories describing and explaining the mechanisms and processes of shaping multicultural civil societies. The consequence of this tendency is the growing criticism of the existing models of integration, assimilation and cultural pluralism, undertaken by supporters of populist, nationalistic and conservative concepts. The article focuses mainly on the characteristics of the negative consequences of migration, transculturation and cultural universalization. The article also aims to put forward preliminary general theses on the grounds of criticism of scientific models of multiculturalism.