bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic ultrasound-guided liver biopsy using a 20-gauge fine needle biopsy needle with the wet-heparinized suction technique
Authors: Sisman Gurhan , Barbur Erol , Saka Didem , Piyade Betul , Besli Sevval , Boynukara Can , Kirimlioglu Hale
Published: September 2020

Objectives

The primary aim of this study was to evaluate the histological adequacy of the liver tissue specimens obtained with a 20-gauge fine-needle biopsy needle and the secondary aim was to test the safety endoscopic ultrasound-guided liver biopsy with a 20-gauge fine-needle biopsy needle with the wet-heparinized suction technique.

Methods

Forty patients who underwent endoscopic ultrasound-guided liver biopsy were included in the study. A 20-gauge fine-needle biopsy needle was used with the wet-heparinized suction technique to make one pass each from the left and the right lobe. Histologic characteristics of the specimens were evaluated, and patients were observed after the procedure in order to intervene in case of an adverse event.

Results

The median longest core fragment was 22 mm from the left lobe [first quartile–third quartile 20–25 mm, interquartile range (IQR) 5 mm], and 20 mm (first quartile–third quartile 17–22 mm, IQR 5 mm) from the right lobe. The median cumulative core length per patient was 103 mm (91–108 mm, IQR 17 mm). The median cumulative number of complete portal triads per patient was 69.50 (52.25–82.25, IQR 30). The rate of diagnostic yield was 100%. Post-biopsy self-limiting abdominal pain was reported in two patients (5%). The most common histologic diagnosis was fatty liver disease (25%).

Conclusion

Endoscopic ultrasound-guided liver biopsy with the wet-heparinized suction technique using a 20-gauge fine-needle biopsy needle is a safe alternative method in clinical practice.
Comparing Outcomes of Robotically Assisted Latissimus Dorsi Harvest to the Traditional Open Approach in Breast Reconstruction
Authors: Winocour Sebastian , Tarassoli Sam , Chu Carrie K. , Liu Jun , Clemens Mark W. , Selber Jesse C.
Published: September 2020

Background:

Robotically assisted latissimus dorsi harvest permits harvest of the latissimus dorsi muscle without a back incision, as compared to the traditional open technique. The authors hypothesized that robotic harvest has lower donor-site complication rates, decreased opioid requirements, and a shorter length of stay than the traditional open technique.

Methods:

A retrospective review was performed of all consecutive pedicled latissimus dorsi flaps for breast reconstruction between 2011 and 2015. All procedures were conducted by two surgeons who performed both robotic and open cases.

Results:

Fifty-two patients were identified; 25 underwent robotically assisted latissimus dorsi harvest and 27 underwent the open technique. Demographic data between the two groups were similar. Median length of stay for robotic harvest was shorter than that for the traditional technique (2 days versus 3 days; p = 0.031). Postoperative morphine requirement was less in the robotic compared to the traditional technique, but the difference was not significant (158 mg versus 184 mg; p = 0.826). Seroma rate was higher in the robotic group (16 percent versus 0 percent; p = 0.034). The mean duration of surgery was longer in the robotic cohort (388 minutes versus 311 minutes; p = 0.002).

Conclusions:

This study demonstrates robotically assisted latissimus dorsi harvest as an effective alternative to the traditional open technique in select patients. Advantages of robotic harvest include no back scar, a shorter length of stay, and lower opioid requirements, although the difference was not significant; disadvantages include longer operative time and a higher seroma rate.

Clinical Question/Level of Evidence:

Therapeutic, III.
Systematic Surgical Approach to Alar Base Surgery in Rhinoplasty
Authors: Rohrich Rod J. , Savetsky Ira L. , Suszynski Thomas M. , Mohan Raja , Avashia Yash J.
Published: September 2020

In an era with smartphone photography and social media (specifically, “selfies”), basal view aesthetics is becoming increasingly important. Achieving balance between the nasal base and the remainder of the nose and face while preserving or restoring external valve function are essential to a successful rhinoplasty. Without a systematic approach to the nasal base, it is more difficult to achieve an ideal outcome from both aesthetic and functional standpoints. This article outlines an organized and systematic approach to the nasal base, beginning with comprehensive nasofacial analysis. The authors continue by describing idealized basal view aesthetics and provide a treatment algorithm for common deformities that include alar flaring and a wide nasal base. The authors attempt to provide a comprehensive approach to the treatment of the nasal base by discussing the implications of treating columellar deformities, tip positioning, or alar-columellar discrepancies on the overall aesthetics of the lower third of the nose. Furthermore, technical considerations are given for common surgical maneuvers addressing the alar base to help guide treatment and prevent complications such as poor scarring, notching, nostril asymmetry or stenosis (external valve obstruction), and alar deformities (“parenthesis” or “bowling pin”), to name a few.
Comparison of Superb Microvascular Imaging With Other Doppler Methods in Assessment of Testicular Vascularity in Cryptorchidism
Authors: Keçeli Merter , Keskin Zeynep , Keskin Suat
Published: September 2020

Superb microvascular imaging (SMI) is a new Doppler technique. Superb microvascular imaging can observe microvascular and low-velocity blood flow. Superb microvascular imaging is available in 2 modes: color SMI (cSMI) and monochrome SMI (mSMI). To evaluate testicular flow, we have compared color Doppler ultrasound (CDUS), power Doppler ultrasound (PDUS), Advanced Dynamic Flow (ADF), cSMI, and mSMI techniques.

Fifty-six participants less than 36 months of age were included in the study (mean age, 18.21 ± 1.5 months). One of the testes examined was in the scrotal sac, and the other was undescended testis (UT), and its location was at the level of the lower/middle inguinal canal. Testicular vascularization was evaluated with the CDUS, PDUS, ADF, and SMI techniques. Spot and linear signal encoding detected in the parenchyma were recorded between 0 and III for each technique. At the level of the testicle hilus, the outer boundary of the testicle was drawn manually along the long axis of each testis, and the vascularity index (VI) was automatically calculated from this area on the cSMI method.

There was no significant relationship between normal and undescended testicles in terms of age, weight, height, testicle volume, and VI. Superb microvascular imaging was found to be superior in showing testicular vascularity, especially UT. The power of detecting Doppler signal in mSMI is significantly higher than in other methods (P < 0.001). The most valuable method according to the power of detecting testicular vascularity was mSMI. Next were cSMI, ADF, PDUS, and CDUS.

In conclusion, the SMI technique should be included in vascular examination in pediatric patients with UT. The SMI technique can play an important role in assessing vascularization of UT.
Speech Outcomes Comparison Between Adult Velopharyngeal Insufficiency and Patients With Unrepaired Cleft Palate
Authors: Lou Qun , Wang Xudong , Chen Yang
Published: September 2020

Objective:

This study compared the speech outcomes of adult velopharyngeal insufficiency patients and adult cleft palate (ACP) patients, and explored whether there was any difference in the phonological level of these 2 types of patients.

Methods:

Perceptual evaluation was used to assess speech intelligibility, hypernasality and compensatory articulation in 89 adult patients with velopharyngeal insufficiency and 35 adult patients with unrepaired cleft palate. Each group was divided into complete cleft palate and incomplete cleft palate (including submucous cleft palate). The phonological differences were compared between the 2 groups of patients and 2 types of cleft palate.

Results:

The mean speech intelligibility was 43.04% in velopharyngeal insufficiency group and 32.87% in ACP group. There was a significant difference in speech intelligibility between the 2 groups by T test, t = 2.916 (P < 0.01), speech intelligibility between 2 types of cleft palate was no significant difference. Also, there was a significant difference between the 2 groups in the constitution of hypernasality degree by Chi-Square test,
x

2 = 31.650 (P < 0.01), compensatory articulation were present in 74.3% ACP patients (26/35) and 47.2% velopharyngeal insufficiency patients (42/89),
x

2 = 7.446 (P < 0.01), there was a significant difference in incidence of compensatory articulation between the 2 groups.

Conclusions:

Adult patients with unpaired cleft palate present an even worse speech intelligibility and hypernasality degree than velopharyngeal insufficiency patients after cleft palate repair, regardless of the cleft type. Additionally, patients in ACP group have a higher incidence of compensatory articulation than that in incomplete cleft palate group. In sequenced treatments of cleft lip and palate, evaluation and treatment of speech disorders cannot be ignored.
Cleft Lip Repair in Premature Infants With Cardiac Risk Factors
Authors: Kalmar Christopher L. , Patel Vijay A. , Taylor Jesse A.
Published: September 2020

Despite cleft lip repair having demonstrated safety when performed in the outpatient setting, patients with comorbidities are significantly more likely to be hospitalized overnight. There are several comorbidities overrepresented with inpatient admission, but only cardiac risk has any association with adverse outcomes in premature patients. The severity of cardiac risk is significantly associated with adverse events at all degrees of prematurity (P all ≤0.002). In premature patients with major cardiac risk factors, adverse events are significantly associated with younger age (P = 0.016) and lower weight (P = 0.013). Performing cleft lip repair on children older than 125 days (P < 0.001, before cutoff: 50.0% vs after cutoff: 6.4%) and weight greater than 10 lbs (P < 0.001, before cutoff: 56.4% vs after cutoff: 6.1%) provides a significant reduction in postoperative adverse events in premature patients with major cardiac risk factors.
Pattern of Maxillofacial Trauma and Associated Factors in Traffic Accident Victims
Authors: Porto Damião Edgleys , Araújo Jéssica Maria do Nascimento , Júnior Cledinaldo Lira , Andrade Emanuel Savio de Souza
Published: September 2020

Introduction:

Maxillofacial trauma (MFT) due to road traffic accidents are responsible for part of care provided at trauma centers.

Purpose:

This research aimed to analyze the pattern of MFTs and associated factors in victims of road traffic accidents.

Methods:

A total of 873 medical records of patients with MFTs in 2 reference hospitals for trauma in Northeastern Brazil during the period from January 2011 to December 2018 were analyzed. Data were included in the Tweedie multiple regression analysis to estimate the prevalence ratio (PR), with 95% confidence interval (95%CI) and P < 0.05.

Results:

Motorcycle accidents were the most prevalent (76.4%). Higher hospital costs were the result of patients victims of motorcycle accidents (PR = 1.56; 95%CI = 1.29–1.88; P < 0.001), diagnosed with mandible fracture (PR = 1.41; 95%CI = 1.07–1.86; P = 0.001) who had consumed alcoholic beverages (PR = 1.12; 95%CI = 1.00–1.25; P = 0.04) and did not use personal protective equipment (PPE) (PR = 1.29; 95%CI = 1.10–1.50; P = 0.001). Patients victims of motorcycle accidents remained in hospital longer than other etiologies (PR = 1.47; 95%CI = 1.23–1.76; P < 0.001). The consumption of alcoholic beverages resulted in more severe MFTs (PR = 2.05; 95%CI = 1.34–3.14; P = 0.001).

Conclusion:

Victims of motorcycle accidents remained hospitalized longer and resulted in higher hospital costs compared to other etiologies. Alcohol consumption increases hospital costs and the severity of MFTs. Higher hospital costs were also observed in patients who did not use PPE. Strategies need to be adopted to understand associated factors in MFTs such as the reallocation of resources to fund, implement and improve services and the surveillance in roads and highways, as well as prevention programs aimed at this health problem.
A Novel Classification of Relationship Between Nasal Septum and Inferior Turbinate Associated With Nasal Airway Obstruction in Patients With Unilateral Alveolar Cleft
Authors: Yan Huixin , Xu Yanbin , Wei Shuaishuai , Pan Yong-Chu , Wan Lin-Zhong , Du Yifei , Wang Yuli
Published: September 2020

Objective:

This study aims to investigate nasal morphologies associated with nasal airway obstruction in unilateral alveolar cleft patients.

Methods:

A total of 234 unilateral alveolar cleft cases were performed cone beam computed tomography scans. The digital imaging and communication in medicine data were imported into Simplant Pro software. The radiographic features including nasal septum deviation and inferior turbinate hypertrophy as well as nasal airway volume and sinusitis were analyzed.

Results:

A new radiographic classification of relationship between nasal septum and inferior turbinate (NS-IT) on the cleft side was proposed and three types of NS-IT relationship (type I, II and III) were identified in 234 cases. The statistical analysis revealed that the nasal airway volume on non-cleft side was significantly higher than that on cleft side in each of three types (P 
< 0.0001), while no difference of nasal airway volume on non-cleft side was found among three types. In addition, the nasal airway volume on non-cleft side in type I and II was significantly higher than that in type III (P < 0.0001). Also, type III presented higher rate of maxillary sinusitis (P = 0.0154) and ethmoid sinusitis on cleft side (P = 0.0490) than type I and II. The other indexes including clinical variances were not significant among three types.

Conclusions:

Unilateral alveolar cleft patients with type III NS-IT relationship could have nasal airway obstruction and higher rate of maxillary and ethmoid sinusitis on cleft side, which may be taken into account at primary cleft repair and alveolar bone grafting treatment.
Quantifying Upper Airway Changes Following Mandibular Orthognathic Surgery
Authors: Sahoo Nanda Kishore , Agarwal Shiv Shankar , Datana Sanjeev , Bhandari Sujit Kumar
Published: September 2020

The aim of this study was to quantify upper airway changes following mandibular orthognathic surgery. Treatment records of 50 patients who underwent mandibular orthognathic surgery were divided into 2 groups, that is, Group 1: Cases treated with Mandibular Advancement Surgery and Group 2: Cases treated with Mandibular Setback Surgery with 25 patients in each group. The Lateral Cephalogram and Acoustic Pharyngometry records of both groups were studied at T0 (01 week before surgery) and T1 (01 year postsurgery) for changes in linear airway measurements (Nasopharyngeal Airway Space - NAS, Superior Airway Space - SAS, Posterior Airway Space - PAS and Hypopharyngeal Airway Space (HAS)), hyoid bone position (Mandibular Plane Hyoid distance), mean area and mean volume. The percentage change and change in these parameters per millimeter advancement or setback of mandible at T1 was calculated. A significant increase in linear airway parameters (SAS and PAS); decrease in hyoid distance; and increase in volume and area of upper airway was observed at T1 in Group 1 and reverse was observed in Group 2. The change in airway parameters (SAS, PAS, mean volume and area) was more significant in Group 1 as compared to Group 2. In the current airway centric approach, meticulous assessment and prediction of long-term airway changes post surgery should be an integral part of ortho-surgical diagnosis and treatment planning and suitable modifications in the treatment plan must be made to cater for any potential adverse effects on airway.
The Impact of Palatal Fistulae on the Success of Alveolar Bone Grafting
Authors: Bradford Perry S. , Shaffrey Ellen C. , Le Paulina , Hoard Martin , Black Jonathan S.
Published: September 2020

Palatal fistulae are common complications of cleft palate surgery with a frequency of 5% to 29% and are challenging to repair. Optimal timing to repair palatal fistulae, in a staged fashion before alveolar bone grafting, or at the same time, still remains controversial. The primary aim of this study is to compare outcomes of 2 groups with regard to successful alveolar bone grafting in patients with cleft lip and palate and palatal fistulae. We describe a review of 85 consecutive patients identified as undergoing bone grafting from a single institution craniofacial team during 2003 to 2018. Twenty-eight required palatal fistula repair. All patients had a diagnosis of unilateral or bilateral complete cleft lip and palate. Patients with cleft lip and palate repairs were stratified based on preoperative or simultaneous palatal fistula repair. Panoramic radiographs were reviewed by 2 physicians to evaluate success of bone grafting. Comparison between cohorts was made by statistical analysis. Of the 28 that required palatal fistula repair, 15 (53.6%) patients underwent prebone grafting palatal fistula repair and 13 (46.4%) patients underwent simultaneous bone grafting with palatal fistula repair. Mean age at time of bone grafting and palatal fistula repair were 10.60 years old and 9.39 years old, respectively. Length to follow-up was 54.82 months. The average height of the healed alveolar cleft site for patients in the prebone grafting or simultaneous groups was 10.57 mm and 11.46 mm, respectively. Patients who underwent palatal fistula repair and simultaneous bone grafting had similar outcomes as those with palatal fistula repair preoperatively.
Insights from evolutionarily relevant models for human ageing
Authors: Emery Thompson Melissa , Rosati Alexandra G. , Snyder-Mackler Noah
Published: September 2020

As the world confronts the health challenges of an ageing population, there has been dramatically increased interest in the science of ageing. This research has overwhelmingly focused on age-related disease, particularly in industrialized human populations and short-lived laboratory animal models. However, it has become clear that humans and long-lived primates age differently than many typical model organisms, and that many of the diseases causing death and disability in the developed world are greatly exacerbated by modern lifestyles. As such, research on how the human ageing process evolved is vital to understanding the origins of prolonged human lifespan and factors increasing vulnerability to degenerative disease. In this issue, we highlight emerging comparative research on primates, highlighting the physical, physiological, behavioural and cognitive processes of ageing. This work comprises data and theory on non-human primates, as well as under-represented data on humans living in small-scale societies, which help elucidate how environment shapes senescence. Component papers address (i) the critical processes that comprise senescence in long-lived primates; (ii) the social, ecological or individual characteristics that predict variation in the pace of ageing; and (iii) the complicated relationship between ageing trajectories and disease outcomes. Collectively, this work provides essential comparative, evolutionary data on ageing and demonstrates its unique potential to inform our understanding of the human ageing process.

This article is part of the theme issue ‘Evolution of the primate ageing process’.
Social bonds, social status and survival in wild baboons: a tale of two sexes
Authors: Campos Fernando A. , Villavicencio Francisco , Archie Elizabeth A. , Colchero Fernando , Alberts Susan C.
Published: September 2020

People who are more socially integrated or have higher socio-economic status live longer. Recent studies in non-human primates show striking convergences with this human pattern: female primates with more social partners, stronger social bonds or higher dominance rank all lead longer lives. However, it remains unclear whether social environments also predict survival in male non-human primates, as it does in men. This gap persists because, in most primates, males disperse among social groups, resulting in many males who disappear with unknown fate and have unknown dates of birth. We present a Bayesian model to estimate the effects of time-varying social covariates on age-specific adult mortality in both sexes of wild baboons. We compare how the survival trajectories of both sexes are linked to social bonds and social status over the life. We find that, parallel to females, male baboons who are more strongly bonded to females have longer lifespans. However, males with higher dominance rank for their age appear to have shorter lifespans. This finding brings new understanding to the adaptive significance of heterosexual social bonds for male baboons: in addition to protecting the male's offspring from infanticide, these bonds may have direct benefits to males themselves.

This article is part of the theme issue ‘Evolution of the primate ageing process'.
Protein Abundance Prediction Through Machine Learning Methods
Authors: Ferreira Mauricio , Ventorim Rafaela , Almeida Eduardo , Silveira Sabrina , Silveira Wendel
Published: September 2020

Proteins are responsible for most physiological processes, and their abundance provides crucial information for systems biology research. However, absolute protein quantification, as determined by mass spectrometry, still has limitations in capturing the protein pool. Protein abundance is impacted by translation kinetics, which rely on features of codons. In this study, we evaluated the effect of codon usage bias of genes on protein abundance. Notably, we observed differences regarding codon usage patterns between genes coding for highly abundant proteins and genes coding for less abundant proteins. Analysis of synonymous codon usage and evolutionary selection showed a clear split between the two groups. Our machine learning models predicted protein abundances from codon usage metrics with remarkable accuracy, achieving R2values higher than previously reported in the literature. Upon integration of the predicted protein abundance in enzyme-constrained genome-scale metabolic models, the simulated phenotypes closely matched experimental data, which demonstrates that our predictive models are valuable tools for systems metabolic engineering approaches.
Insulin inhibits protein phosphatase 2A to impair β-adrenergic receptor function
Authors: Sahu Anita , Sun Yu , Mukherjee Sromona , Witherow Conner , Stenson Kate , Tesmer John J.G. , Mohan Maradumane L. , Naga Prasad Sathyamangla V.
Published: September 2020

Insulin impairs β2-adrenergic receptor (β2AR) function through G protein-coupled receptor kinase 2 (GRK2) by phosphorylation but less is known about dephosphorylation mechanisms mediated by protein phosphatase 2A (PP2A). Pharmacologic or genetic inhibition of phosphoinositide 3-kinase γ (PI3Kγ) unexpectedly resulted in significant reduction of insulin-mediated β2AR phosphorylation. Interestingly, β2AR-associated phosphatase activity was inhibited by insulin but was reversed by knock-down of PI3Kγ showing negative regulation of PP2A by PI3Kγ. Co-immunoprecipitation and surface plasmon resonance studies using purified proteins showed that GRK2 and PI3Kγ form a complex and could be recruited to β2ARs as GRK2 interacts with insulin receptor substrate following insulin treatment. Consistently, β-blocker pretreatment did not reduce insulin-mediated β2AR phosphorylation indicating agonist- and Gβγ-independent non-canonical regulation of receptor function. Mechanistically, PI3Kγ inhibits PP2A activity at the βAR complex by phosphorylating an intracellular inhibitor of PP2A (I2PP2A). Knock-down or CRISPR ablation of endogenous I2PP2A unlocked PP2A inhibition mediating β2AR dephosphorylation showing an unappreciated acute regulation of PP2A in mediating insulin-β2AR cross-talk.

Insulin impairs β2-adrenergic receptor (β2AR) function through G protein-coupled receptor kinase 2 (GRK2). We show that insulin simultaneously inhibits protein phosphatase 2A (PP2A) sustaining β2AR functional impairment. Unexpectedly, releasing PP2A inhibition by PI3Kγ preserves β2AR function despite intact insulin-driven GRK2-mechanisms.
Destabilizing role of futures markets on North American hard red spring wheat spot prices
Authors: Miljkovic Dragan , Goetz Cole
Published: September 2020

The objective of the paper is to determine if the futures prices of hard red spring wheat (HRSW) have stabilizing or destabilizing impact on spot HRSW price in North America. Several important results emerge from thorough empirical analysis. First, both Granger causality tests and directed acyclic graph algorithms (DAGs) point to two‐way causality between futures and spot HRSW prices and thus endogeneity in both prices formation. To the contrary, both procedures suggest that ending stocks are exogenous to spot and futures HRSW prices. Both vector error correction model and impulse response functions point to a large and long‐lasting impact of a shock to futures price on spot price level. Finally, variance decomposition analysis indicates that futures prices are responsible for the bulk of spot price volatility in both short and long run. Our result is consistent with those of theoretical models suggesting that when production (supply side) is the dominant disturbance, spot price is destabilized in both the short and the long run by futures prices. An important implication of this research is the need for alternative market mechanisms or alternative farm policy measures that would mitigate price risk and ensure sustainable farming of American HRSW farmers.
Electrocardiogram analysis of patients with different types of COVID‐19
Authors: Wang Yina , Chen Lie , Wang Jingyi , He Xingwei , Huang Fen , Chen Jing , Yang Xiaoyun
Published: September 2020

Background

Severe acute respiratory syndrome coronavirus 2 causes acute myocardial damage and arrhythmia in coronavirus disease 2019 (COVID‐19) patients. Studying the changes of electrocardiogram is of great significance for the diagnosis of patients with COVID‐19.

Methods

A retrospective analysis method was adopted to compare the electrocardiogram changes between COVID‐19 critically severe and severe patients. Univariate and multivariate logistic regression were used to analyze the correlation of the levels of serum indexes and past medical history with ST‐T changes and atrial fibrillation. And the correlation of ECG parameters with in‐hospital death and ventilator use were investigated by using the same methods.

Results

The incidence of male, stroke, elevated cardiac troponin I (cTnI), N‐terminal of the prohormone brain natriuretic peptide (NT‐proBNP), d‐dimer, high‐sensitivity C‐reactive protein (hs‐CRP), hyperkalemia, and hypocalcemia in the critically ill patients was higher than that in severe patients. There were differences in ST‐T changes, sinus tachycardia, atrial fibrillation, and atrial tachycardia between the two groups. Multivariate logistic regression analysis showed that elevated cTnI and NT‐proBNP were the independent risk factors of ST‐T changes. Elevated NT‐proBNP and age were the independent risk factors of atrial fibrillation. Sinus tachycardia and atrial fibrillation were the independent risk factors of in‐hospital death and ventilator use.

Conclusion

ST‐T changes, sinus tachycardia, and atrial fibrillation are with great significance in the diagnosis of the severity, myocardia injury, and cardiac insufficiency of COVID‐19 patients. Sinus tachycardia and atrial fibrillation could be used as independent variables predicting in‐hospital death and ventilator use.
Mobilizing collective hatred through humour: Affective–discursive production and reception of populist rhetoric
Authors: Sakki Inari , Martikainen Jari
Published: September 2020

This research examines the mobilization of populist rhetoric of the 2019 Finns Party election video. By focusing on both the FP’s election video (production) and Youtube users’ comments (reception), we examine the constructions and uses of social categories and humour as well as responses to their rhetorical deployment among like‐minded supporters and opponents. The multimodal analysis of the production of a populist campaign video demonstrates the construction of social categories and humour through the five steps of collective hate. These humorous messages are differently received by like‐minded and opposing YouTube users. Two supportive affective–discursive practices – glorification and schadenfreude – both express shared joy and laughter, but while glorification emphasizes the positive self‐understanding of the in‐group, schadenfreude belittles the ‘political Other’. Two opposing affective–discursive practices – irritation and scorn – place FP voters in subject positions of morally and intellectually inferior fascists, racists, and idiots. The populist message fosters expressions of social anger and polarization between FP supporters and opponents. Humour entangled with hatred encourages a sense of moral superiority in both groups. This study contributes to the current knowledge of mobilizing populist rhetoric and polarization, and responds to the call to broaden analysis of political communication in the field of multimodality.
Effect of vitamin D supplementation versus placebo on essential hypertension in patients with vitamin D deficiency: a double‐blind randomized clinical trial
Authors: Sheikh Vida , Mozaianimonfared Azadeh , Gharakhani Mohsen , Poorolajal Jalal , Ph.D
Published: September 2020

Findings from randomized trials addressing the effect of vitamin D supplementation and blood pressure are inconsistent and have been the subject of recent debate. This study aimed to assess the effect of vitamin D supplementation on primary hypertension. This double‐blind randomized clinical trial was conducted on patients aged 26‐84 years with essential hypertension from March 2017 to April 2019. Patients with vitamin D insufficiency (serum vitamin D levels 20‐30 ng/ml) or vitamin D deficiency (serum vitamin D levels <20 ng/ml) were enrolled in the study. Patients were randomly assigned to receive vitamin D supplementation or placebo. Systolic and diastolic blood pressure was measured before the intervention and one and two months thereafter. Of 208 patients enrolled, 171 patients remained for analysis. The effect of vitamin D supplementation on systolic blood pressure was statistically significant in the first and second months after the intervention (P=0.004 and P=0.024, respectively). The effect of vitamin D supplementation on diastolic blood pressure was statistically significant in the first month after the intervention (P=0.046), but not in the second month (P=0.885). No evidence of drug side effects was reported in the two groups. The results of this trial are suggestive of the potential benefits of vitamin D supplementation on blood pressure end points. Therefore, the use of vitamin D may be recommended as an adjuvant drug in the treatment of essential hypertension in patients with vitamin D deficiency because it is safe and well‐tolerated by the patients and can significantly reduce the systolic and diastolic blood pressure.

Trial registration: Iranian Registry of Clinical Trials registration number: IRCT201703129014N151.
Epidemiology of hypertensive crisis in the Buea Regional Hospital, Cameroon
Authors: Nkoke Clovis , Noubiap Jean Jacques , Dzudie Anastase , M. Jingi Ahmadou , Njume Debimeh , Teuwafeu Denis , Aseneh Jerry , Nkouonlack Cyrille , Menanga Alain , Kingue Samuel
Published: September 2020

Hypertensive crisis (HC) includes hypertensive urgency (HU) and hypertensive emergency (HE). There is scarcity of data on the epidemiology of patients presenting with HC in Cameroon. The aim of this study was to determine the prevalence, clinical characteristics, and outcome of HU and HE. We conducted a cross‐sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis were systolic and/or diastolic blood pressure ≥180/110 mm Hg. We compared HU vs HE. Out of the 1536 patients admitted, 95(6.2%) had a HC. There were 49(51.6%) men and 56 (58.9%) had a HE. The mean age was 51.1 ± 14.9 years. A history of hypertension was found in 75.3% of the patients but only 24.2% were on treatment. 33.7% consumed alcohol and 24.2% had chronic kidney disease. Headache (34.7%), dyspnea (34.7%), and neurological deficit (23.2%) were the most common symptoms. Patients with HE had higher systolic and diastolic blood pressures though the difference was not significant. The most frequent forms of HE were acute left ventricular failure with pulmonary edema (44.6%), intracerebral hemorrhage (21.4%), and cerebral infarction (16.1%). The most commonly prescribed medication was labetalol (44.2%). Mean length of hospital stay was 8.4 days. Patients with HE had a longer hospital stay (9.8 vs 6.3 days, P < .001). In‐hospital case fatality was 6.3%. Hypertensive crisis accounted for 6.2% of admissions in the medical unit with HE being more common than HU. Acute left ventricular failure with pulmonary edema and stroke were the most frequent target organ lesions in HE.
Non‐epistemic perception as technology
Authors: Sylvan Kurt
Published: September 2020

Some epistemologists and philosophers of mind hold that the non‐epistemic perceptual relation of which feature‐seeing and object‐seeing are special cases is the foundation of perceptual knowledge. This paper argues that such relations are best understood as having only a technological role in explaining perceptual knowledge. After introducing the opposing view in §1, §2 considers why its defenders deny that some cases in which one has perceptual knowledge without the relevant acquaintance relations are counterexamples, detailing their case for lurking inferential epistemology. §§3–4 suggest that this strategy fails in many other cases. While there is a computational tale that might be deemed ‘inferential’ in these cases, there is no corresponding tale in epistemic structure, not even if one rejects what Siegel (2017) calls the ‘Reckoning Model’ of inference. §5 offers a more fundamental dilemma. §6 concludes that there is only a technological role for non‐epistemic perception in grounding perceptual knowledge, but allows that it might play a more‐than‐technological role elsewhere.
The feasibility and utility of optical coherence tomography directed histopathology for surgical margin assessment of canine mast cell tumours
Authors: Dornbusch Josephine A. , Cocca Christina , Jennings Ryan , Samuelson Jonathan , Vieson Miranda , Huang Pin‐Chieh , Boppart Stephen A. , Wavreille Vincent A. , Selmic Laura E.
Published: September 2020

Histopathologic surgical margin assessment in veterinary patients is an imprecise science with assessment limited to a small proportion of the surgical margin due to time and finances. Incomplete excision of canine mast cell tumours (MCTs) alters treatment recommendations and prognosis. Optical coherence tomography (OCT) is a novel imaging modality that has been reported in a single veterinary study for surgical margin assessment. Twenty‐five dogs with 34 MCTs were enrolled in a prospective pilot‐study to assess the imaging characteristics of canine MCTs with OCT and to evaluate the feasibility and utility of OCT‐guided histopathology. All dogs underwent routine surgical excision of MCTs. OCT imaging was used to assess the entire surgical margin prior to placement in formalin. Either normal areas or areas suspected of incomplete MCT excision were inked. Standard histopathologic sectioning and tangential sectioning of inked areas were performed and compared to OCT results. OCT identified MCT near the surgical margin in 10 of 26 specimens (38.4%). Four specimens suspicious for incomplete margins on OCT had incomplete MCT excision that was missed on standard histopathologic sectioning. Six specimens had OCT‐guided sections taken as suspicious, which did not show MCT on histopathology. OCT‐guided pathology sections were able to detect incompletely excised MCT near the surgical margin with a sensitivity of 90% and specificity of 56.2% in this preliminary study. OCT imaging shows promise for guiding pathologists to areas of interest to improve the diagnostic accuracy of surgical margin assessment in excised canine MCTs.
TORSIONAL SHEAR STRENGTH PROPERTIES OF MALAYSIAN TROPICAL TIMBER IN STRUCTURAL SIZE
Authors: Mohd Puaad Muhammad Bazli Faliq , Ahmad Zakiah , Abu Talip Adrina Ros­seira , Mat Salleh Mohd Zulkhairi , Moham­mad Shahrul Nizam
Published: September 2020

The shear strength of timber joists in timber design is important, especially to provide an adequate torsional stability and to avoid vibrational serviceability problems. In Malaysia, the data of shear strength of timber is available in MS544 Part 2. The data were developed by shear block test with small samples without defect known as small clear samples. Torsion test is one of the other approaches that can be used to attain the state of pure shear as it does produce a purer and a clearer shear stress distribution in the specimen, allowing measurement of the pure shear properties. However, in Malaysia, very little attention has been paid to the use of the torsion test in evaluating shear strength. Therefore, this study aims to investigate the torsional shear strength of selected Malaysian tropical timbers of different strength groupings (SG) namely Balau (SG1), Kempas (SG2), Kelat (SG3), Kapur (SG4), Resak (SG4), Keruing (SG5), Mengkulang (SG5), Light Red Meranti (SG6), and Geronggang (SG 7) using structural size timbers in accordance with BS:EN 408 and then compared with published by MS554: Part 2. The result shows contradictions of strength grouping between findings and published by MS554: Part 2. Resak (SG4) and Mengkulang (SG5) grade stress value have risen towards SG 3. Geronggang is currently in the SG6. Also from the findings, Kelat (SG3), Kapur (SG4) and Keruing (SG5) grade stresses are at par towards each other, even though they are completely in the different strength group as stated in MS544: Part 2. In conclusion, shear strength data need to be re-examined, since the strength for the tested specimen is much higher than the data given in MS 544 Part 2. This will lead to the increment in section and wastage in cost.
Hadronic light-by-light contribution to $$(g-2)_\mu $$ from lattice QCD with SU(3) flavor symmetry
Authors: Chao En-Hung , Gérardin Antoine , Green Jeremy R. , Hudspith Renwick J. , Meyer Harvey B.
Published: September 2020

We perform a lattice QCD calculation of the hadronic light-by-light contribution to $$(g-2)_\mu $$

(
g
-
2
)

μ

at the SU(3) flavor-symmetric point $$m_\pi =m_K\simeq 420\,$$

m
π

=

m
K

≃
420

MeV. The representation used is based on coordinate-space perturbation theory, with all QED elements of the relevant Feynman diagrams implemented in continuum, infinite Euclidean space. As a consequence, the effect of using finite lattices to evaluate the QCD four-point function of the electromagnetic current is exponentially suppressed. Thanks to the SU(3)-flavor symmetry, only two topologies of diagrams contribute, the fully connected and the leading disconnected. We show the equivalence in the continuum limit of two methods of computing the connected contribution, and introduce a sparse-grid technique for computing the disconnected contribution. Thanks to our previous calculation of the pion transition form factor, we are able to correct for the residual finite-size effects and extend the tail of the integrand. We test our understanding of finite-size effects by using gauge ensembles differing only by their volume. After a continuum extrapolation based on four lattice spacings, we obtain $$a_\mu ^{\mathrm{hlbl}}= (65.4\pm 4.9 \pm 6.6)\times 10^{-11}$$

a
μ
hlbl

=

(
65.4
±
4.9
±
6.6
)

×

10

-
11

, where the first error results from the uncertainties on the individual gauge ensembles and the second is the systematic error of the continuum extrapolation. Finally, we estimate how this value will change as the light-quark masses are lowered to their physical values.
Effects of long-term and brain-wide colonization of peripheral bone marrow-derived myeloid cells in the CNS
Authors: Hohsfield Lindsay A. , Najafi Allison R. , Ghorbanian Yasamine , Soni Neelakshi , Hingco Edna E. , Kim Sung Jin , Jue Ayer Darling , Swarup Vivek , Inlay Mathew A. , Green Kim N.
Published: September 2020

Background

Microglia, the primary resident myeloid cells of the brain, play critical roles in immune defense by maintaining tissue homeostasis and responding to injury or disease. However, microglial activation and dysfunction has been implicated in a number of central nervous system (CNS) disorders, thus developing tools to manipulate and replace these myeloid cells in the CNS is of therapeutic interest.

Methods

Using whole body irradiation, bone marrow transplant, and colony-stimulating factor 1 receptor inhibition, we achieve long-term and brain-wide (~ 80%) engraftment and colonization of peripheral bone marrow-derived myeloid cells (i.e., monocytes) in the brain parenchyma and evaluated the long-term effects of their colonization in the CNS.

Results

Here, we identify a monocyte signature that includes an upregulation inCcr1,Ms4a6b,Ms4a6c,Ms4a7,Apobec1,Lyz2,Mrc1,Tmem221,Tlr8,Lilrb4a,Msr1,Nnt, andWdfy1and a downregulation ofSiglech,Slc2a5, andCcl21a/b. We demonstrate that irradiation and long-term (~ 6 months) engraftment of the CNS by monocytes induces brain region-dependent alterations in transcription profiles, astrocytes, neuronal structures, including synaptic components, and cognition. Although our results show that microglial replacement with peripherally derived myeloid cells is feasible and that irradiation-induced changes can be reversed by the replacement of microglia with monocytes in the hippocampus, we also observe that brain-wide engraftment of peripheral myeloid cells (relying on irradiation) can result in cognitive and synaptic deficits.

Conclusions

These findings provide insight into better understanding the role and complexity of myeloid cells in the brain, including their regulation of other CNS cells and functional outcomes.
Documentation of individualized preoperative risk assessment: a multi-center study
Authors: Bloomstone Joshua A. , Houseman Benjamin T. , Sande Evora Vicents , Brantley Ann , Curran Jessica , Maccioli Gerald A. , Haddad Tania , Steinshouer James , Walker David , Moonesinghe Ramani
Published: September 2020

Background

Individual surgical risk assessment (ISRA) enhances patient care experience and outcomes by informing shared decision-making, strengthening the consent process, and supporting clinical management. Neither the use of individual pre-surgical risk assessment tools nor the rate of individual risk assessment documentation is known. The primary endpoint of this study was to determine the rate of physician documented ISRAs, with or without a named ISRA tool, within the records of patients with poor outcomes. Secondary endpoints of this work included the effects of age, sex, race, ASA class, and time and type of surgery on the rate of documented presurgical risk.

Methods

The records of non-obstetric surgical patients within 22 community-based private hospitals in Arizona, Colorado, Nebraska, Nevada, and Wyoming, between January 1 and December 31, 2017, were evaluated. A two-sample proportion test was used to identify the difference between surgical documentation and anesthesiology documentation of risk. Logistic regression was used to analyze both individual and group effects associated with secondary endpoints.

Results

Seven hundred fifty-six of 140,756 inpatient charts met inclusion criteria (0.54%, 95% CI 0.50 to 0.58%). ISRAs were documented by 16.08% of surgeons and 4.76% of anesthesiologists (p < 0.0001, 95% CI −0.002 to 0.228). Cardiac surgeons documented ISRAs more frequently than non-cardiac surgeons (25.87% vs 16.15%) [p = 0.0086, R-squared = 0.970%]. Elective surgical patients were more likely than emergency surgical patients (19.57 vs 12.03%) to have risk documented (p = 0.023, R-squared = 0.730%). Patients over the age of 65 were more likely than patients under the age of 65 to have ISRA documentation (20.31 vs 14.61%) [p = 0.043, R-squared = 0.580%]. Only 10 of 756 (1.3%) records included documentation of a named ISRA tool.

Conclusions

The observed rate of documented ISRA in our sample was extremely low. Surgeons were more likely than anesthesiologists to document ISRA. As these individualized risk assessment discussions form the bedrock of perioperative informed consent, the rate and quality of risk documentation must be improved.
The Output Hypothesis and its influence in the second language learning/teaching: An interview with Merrill Swain
Authors: Sales Antonia De  Jesus
Published: September 2020

ABSTRACT: This paper presents an interview with Merrill Swain, a Canadian researcher who proposed the Output Hypothesis, a way to understand the relevance of producing (by speaking/writing) the foreign language during its learning. According to Output Hypothesis, the learner may notice gaps while, test cognitive hypothesis and think in a metalinguistic way while producing the foreign language. This hypothesis influenced plenty of research in the second language learning/teaching field around the world, considering Brazil as well.
The Content Mastery among Islamic Education Teachers in Junior Islamic Secondary Schools in Surakarta
Authors: Munadi Muhammad
Published: September 2020

The study aims to describe the content mastery among Islamic Education teachers in all MTs/N (Islamic Secondary School) located in Surakarta. A mixed method was used in this study, where the teachers of MTsN and private MTs in Surakarta involved in this study. Test, interview and documentation became the instruments of this study. For ensuring the validity, the researcher used expert judgment. The data was analyzed by using descriptive statistics. The results of the study showed that in overall the average scores in the Islamic Education materials had been 74 – which was quite low for a teacher. Meanwhile, some of the teachers got only 47 as compared to100 for the maximum score. From four subjects in the Islamic Education, the score of the teachers’ academic test from the highest to the lowest would be displayed as follows: Qur’an Hadits were 76.40; Fiqh was 76.40; SKI was 73.46; and Aqidah Akhlak was 72.40. It Indicated that the content mastery in the Qur’an – Hadits and Aqidah Akhlak had been higher than that of Fiqh and SKI.