bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the Electronic Customer Relationship Management Success Key Factors in the Telecommunication Companies: A Pilot Study
Authors: Anaam Elham Abdulwahab , Abu Bakar Khairul Azmi , Mohd Satar Nurhizam Safie , Ma’arif Muhamad Yusnorizam
Published: April 2020

The Electronic Customer Relationship Management (E-CRM) is a moderately new field of researches. There are some issues facing telecommunication companies about the use of E-CRM systems. In this study, the researchers suggest a model of a relationship in that a quantitative research
design selected to validate the proposed factors and to build relationships between them. The main factors that may influence the employee satisfaction stated as three classifications: technology (service quality, system quality, and information quality), organization (top management support,
training, and individual (skills, experience, efficacy, accessibility) and supposed effectiveness. To ensure that a design questionnaire, which is reliable and acceptable, two steps of verification have followed. First, a validation phase in which, the questionnaire checked by a panel of professionals
in the field of the information system. The feedback received followed up before proceeding to the next phase. Second, the pilot study proceeding to investigate the consistency of the instrument analyzed through Cronbach’s Alpha coefficient reliability screening in SPSS 21 software package.
Moreover, the results found that all the items were reliable and the Cronbach’s Alpha coefficient above 0.7.
The Effect of National Culture on Fourth Industrial Revolution and Organizational Sustainability
Authors: Jayashree Sreenivasan , Malarvizhi C. A. , Hassan Reza Mohammad Nurul
Published: April 2020

The Fourth Industrial Revolution (IR 4.0) represents an important transformation of the total industrial manufacturing through the alliance of smart technologies and the Internet. It tends to enhance communication among employees, technological equipment and resources, in order to convert
centralized manufacturing control processes to a decentralized and independentmodel. This study aims to aid the organizations by providing wide-ranging direction and explore the dimensions of national culture. The source of the samples is Malaysian SMEs and the survey will be conducted by
Questionnaire Method. The study implies that there an important relationship between the dimensions of national culture and IR 4.0 that can help Malaysia to build a green and sustainable manufacturing process.
Relationship Performance of Cylindrical Detention Pond (CDP) as Depression Storage and Runoff Reduction Under Fully Saturated Condition
Authors: Maseri H. , Selaman O. S. , Mannan M. A. , Taib S. N. L.
Published: April 2020

Permeable pavements are a key Storm water management measure employed both to attenuate surface runoff in urban areas and to filter urban storm water pollutants. Existing permeable pavements (PP) are design with the specific percentage porosity whereby enabling excess rainwater to infiltrate
through the system and acting as a depression storage at the same time. Depression storage basically refers to the volume of water trapped in the depression when the precipitation of a storm reaches the ground and filled up all the depression before it can flow over the surface. Cylindrical
Detention Pond (CDP) is an alternative paving material that may alleviate many of the hydrological problems caused by urban runoff from developed areas. CDP consist of three basic component; top cover, bottom cover and hollow cylindrical at centre (300 mm thickness). The hollow cylindrical
has approximate 50 percent porosity from the total solid of component, which is every 1 inch (25 mm) of pavement depth can hold 0.5 inches (12.5 mm) of rain in theoretical. In this study, the depression storage rate of CDP was investigated under three different rainfall intensity scenarios
which are 77 mm/hr (low), 153 mm/hr (medium), and 230 mm/hr (heavy) respectively whereby it function to monitoring the analytical trend line. The experiment was conducted in model box in the laboratory under fully saturated condition. It found that the CDP can performed to detent the water
until 180 min of excess rainfall for all 2 year ARI, 5 year ARI, 10 year ARI, 20 year ARI, 50 year ARI and 100 year ARI with different rates. CDP’s able to reduce the runoff up to 77% of the total rainfall volume. The result was proved the hollow cylindrical at centre of CDP very effective
in runoff volume reduction according to the different ARI trend line projection.
The Intersection Property of Annihilators of Both Modules and Maximal Submodules Belonging to the Same Module
Authors: Khalaf Hatam Yahya , Shihab Buthyna Nijad
Published: April 2020

During that article T stands for a commutative ring with identity and that S stands for a unitary module over T. The intersection property of annihilatoers of a module X on a ring T and a maximal submodule W of M has been reviewed under
this article where he provide several examples that explain that the property. Add to this a number of equivalent statements about the intersection property have been demonstrated as well as the direct sum of module that realize that the characteristic has studied here we proved that the modules
that achieve the intersection property are closed under the direct sum with a specific condition. In addition to all this, the relationship between the modules that achieve the above characteristics with other types of modules has been given.
Hemi-laryngopharyngeal Spasm (HeLPS): Defining a New Clinical Entity
Authors: Hu Amanda , Morrison Murray , Honey Christopher R.
Published: April 2020

Objective:

Hemi-laryngopharyngeal spasm (HeLPS) has recently been described in the neurosurgical literature as a cause of intermittent laryngopharyngeal spasm and cough due to vascular compression of the vagus nerve at the cerebellopontine angle. We present the diagnostic criteria for this syndrome.

Methods:

A retrospective chart review of six patients with HeLPS and three patients misdiagnosed with this condition are presented. All patients were diagnosed and treated at a tertiary care academic centre from July 2013 to July 2017.

Results:

Patients with HeLPS had five defining characteristics: 1) All patients had symptoms of episodic laryngopharyngeal spasm and coughing. Patients were asymptomatic between episodes and were refractory to speech therapy and reflux management. 2) Laryngoscopy showed hyperactive twitching of the ipsilateral vocal fold in two of the six patients. No other inter-episodic abnormalities were seen. 3) Botulinum toxin A injections into the thyroarytenoid muscle on the affected ipsilateral side reduced laryngopharyngeal spasms. Botulinum toxin injection in the contralateral thyroarytenoid muscle did not improve laryngopharyngeal spasm. 4) Magnetic resonance imaging revealed ipsilateral neurovascular compression of the vagus nerve rootlets by the posterior inferior cerebellar artery. 5) Microvascular decompression (MVD) surgery of the ipsilateral vagus nerve resolved all symptoms (follow-up 2-4 years).

Conclusion:

The diagnostic criteria for hemi-laryngopharyngeal spasm (HeLPS) are proposed. Otolaryngology recognition of this new clinical entity may lead to a surgical cure and avoid the unnecessary therapies associated with misdiagnosis.

Level of Evidence:

4
L’authenticité comme valeur centrale de l’engagement religieux dans la culture de consommation: le cas des pratiquants bouddhistes en France et en République tchèque
Authors: Bártová Zuzana
Published: April 2020

Dans notre article, nous montrons que l’identité religieuse ne devrait pas nécessairement être appréhendée par le concept de converti mais plutôt comme une identité personnelle formée dans le cadre d’un style de vie. À travers l’étude des pratiquants bouddhistes en France et en République tchèque nous analysons les discours sur l’engagement religieux qui accentuent les sentiments intérieurs. De cette manière, différentes dimensions de l’engagement bouddhiste comme la pratique religieuse, le collectif, l’enseignement et la symbolique bouddhistes sont recadrés comme expression authentique de la subjectivité des pratiquants bouddhistes, se conformant au primat de l’authenticité. Nous estimons que cette authenticité est socialement construite au travers d’interactions sociales et par des processus sociaux macrosociologiques, dont les rapports sociaux de classe et l’éthos consumériste.
Knowledge, Attitude, and Barriers Toward ADRs Reporting Among Health-Care Professionals at Tertiary Care Health Settings in Peshawar, Pakistan: A Web Based Study
Authors: Ali Iftikhar , Ahmad Wiqar , Ullah Arslan Rahat , Khan Faheemullah , Ijaz Muhammad , Khan Sheraz , Khan Tahir Mehmood
Published: April 2020

Background: Underreporting of adverse drug reactions (ADRs) is considered a major determinant of poor ADR signal detection in Pakistan. Considering this, the study was proposed to evaluate healthcare professionals’ (HCPs) knowledge attitude toward and the barriers that discourse ADRs reporting. Methods: A cross-sectional survey was distributed among HCPs in 3 major tertiary care facilities of Peshawar. A self-administered, 31 items questionnaire was circulated online to collect the required information. Relative index ranking was used to identify the top barriers to the ADR reporting process. Results: HCPs (n = 322) were requested, and over one-third (n = 122) responded. Of the total, 97 (79.5%) were males, and by designation, 59(48.4%) were resident medical officers. About 45% of the HCPs did not identify the appropriate pharmacovigilance (PV) definition. More than half of the HCPs (52.2%) distinguished the appropriate PV purpose. Nearly 80% HCPs did not know the acceptable reporting time frame, while 22.1% HCPs knew that regulatory body for ADRs does not exist in Pakistan. The majority (95.08%) of the HCPs either strongly agreed or agreed that reporting an ADRs is a professional obligation and all the HCPs were of the opinion that PV should be taught in detail to HCPs. Exploring the barriers, it was identified that the key barriers to ADRs reporting were “unavailability of professional environment to discuss ADRs,” Relative Importance Index (RII) = 0.813, “lack of incentives for reporting” (RII = 0.774), “lack of knowledge regarding reporting” (RII = 0.693), and “insufficient knowledge of pharmacotherapy in detecting ADRs” (RII = 0.662). In addition to these, “complicated reporting forms” (RII = 0.616), “lack of motivation for reporting ADRs” (RII = 0.610), and “absence of professional confidence” were seen as major hindrances in effective reporting of ADRs (RII = 0.598). Conclusion: Concerning PV and ADR reporting poor knowledge was noted. However, the majority of the HCPs showed an explicit attitude regarding ADRs reporting. The majority of the HCPs disclosed unavailability of professional environment to discuss about ADRs, lack of incentives, and how to report the main factors hindering the ADRs reporting. It is emphasized that health authorities carve out a niche for a well purposeful PV center and pledge educational activities and trainings for increasing understanding and approaches regarding reporting of ADR.
The Salivary Mycobiome Contains 2 Ecologically Distinct Mycotypes
Authors: Hong B.Y. , Hoare A. , Cardenas A. , Dupuy A.K. , Choquette L. , Salner A.L. , Schauer P.K. , Hegde U. , Peterson D.E. , Dongari-Bagtzoglou A. , Strausbaugh L.D. , Diaz P.I.
Published: April 2020

A broad range of fungi has been detected in molecular surveys of the oral mycobiome. However, knowledge is still lacking on interindividual variability of these communities and the ecologic and clinical significance of oral fungal commensals. In this cross-sectional study, we use internal transcribed spacer 1 amplicon sequencing to evaluate the salivary mycobiome in 59 subjects, 36 of whom were scheduled to receive cancer chemotherapy. Analysis of the broad population structure of fungal communities in the whole cohort identified 2 well-demarcated genus-level community types (mycotypes), with Candida and Malassezia as the main taxa driving cluster partitioning. The Candida mycotype had lower diversity than the Malassezia mycotype and was positively correlated with cancer and steroid use in these subjects, smoking, caries, utilizing a removable prosthesis, and plaque index. Mycotypes were also associated with metabolically distinct bacteria indicative of divergent oral environments, with aciduric species enriched in the Candida mycotype and inflammophilic bacteria increased in the Malassezia mycotype. Similar to their fungal counterparts, coexisting bacterial communities associated with the Candida mycotype showed lower diversity than those associated with the Malassezia mycotype, suggesting that common environmental pressures affected bacteria and fungi. Mycotypes were also seen in an independent cohort of 24 subjects, in which cultivation revealed Malassezia as viable oral mycobiome members, although the low-abundance Malassezia sympodialis was the only Malassezia species recovered. There was a high degree of concordance between the molecular detection and cultivability of Candida, while cultivation showed low sensitivity for detection of the Malassezia mycotype. Overall, our work provides insights into the oral mycobiome landscape, revealing 2 community classes with apparently distinct ecologic constraints and specific associations with coexisting bacteria and clinical parameters. The utility of mycotypes as biomarkers for oral diseases warrants further study.
Trump’s Daddy Issues Continue to Take a Toll
Authors: Wruble Steve
Published: April 2020

The Chapter I contributed to the book The Dangerous Case of Donald Trump, called “Trump’s Daddy Issues—A Toxic Mix for America,” compared my relationship with my powerful father to Trump’s relationship with his and how it has effected our identity formation and behavior. The piece also exposed the difficulties I have had dealing with my Orthodox Jewish father’s support of Donald Trump’s presidency and the continued impact it has had on our already strained relationship. I offer how my father and I navigate the murky waters through which most fathers and sons, including the Trumps, must travel in the quest for each individual’s striving for identity. Just as there is a price to pay in my family as my father and I work through our unique issues, so too do the effects of the toxic relationship between Donald and his father. The difference is that with the Trumps, there is the risk of a much larger toll on innocent bystanders.
The corporate power of the British monarchy: Capital(ism), wealth and power in contemporary Britain
Authors: Clancy Laura
Published: April 2020

This article offers a critical analysis of the British monarchy within wider political economies of wealth and power. While sociology has renewed its interest in ‘the elites’, the British monarchy is often positioned as an archaic institution, an anachronism in relation to corporate forms of wealth and power, and therefore irrelevant. This article counters this framing by revealing the mechanics, technologies and actors ‘behind the scenes’, in order to expose and demystify the relationship between the symbolic and political-economic functions of the monarchy. To do this, I (re)conceptualise the monarchy as a corporation, ‘The Firm’, oriented towards, and historically entrenched in, processes of capital accumulation, profit extraction and other forms of exploitation. The article maps out The Firm’s labour relations, financial arrangements, inter/national relationships and networks, and the legal status of The Crown and its components in order to demonstrate how ‘old’ and ‘new’ forms of wealth intersect and converge in contemporary Britain. This article is intended as a provocation to sociological studies of elites to suggest that, in overlooking monarchy, we are overlooking a key component of contemporary capitalism, and a key component in the reproduction of inequalities today.
Anti-ultraviolet properties of β-cyclodextrin-grafted cotton fabrics dyed by broadleaf holly leaf extract
Authors: Liu Jinshu , Ma Xiaoyan , Shi Wenzhao , Xing Jianwei , Ma Chaoqun , Li Susong , Huang Yayi
Published: April 2020

The aim of the study was to investigate the anti-ultraviolet properties of β-cyclodextrin-grafted cotton fabrics dyed with broadleaf holly leaf extract. Flavonoids were extracted from broadleaf holly leaf by maceration and a stoichiometry of 1:1 inclusion complex with β-cyclodextrin was formed. Characterized by the fluorescence spectrum and ultraviolet spectrophotometry, the fluorescence intensities and ultraviolet absorption of the macerated extract were enhanced by increasing the amount of cyclodextrin. Cotton fabrics were grafted with β-cyclodextrin through a crosslinking reaction based on citric acid in the presence of sodium hypophosphite then dyed with the macerated extract of broadleaf holly leaf used as a natural ultraviolet absorbent. The anti-ultraviolet property of fabrics dyed by a macerated extract was characterized in terms of the ultraviolet protection factor. It was noted that the cotton fabrics grafted with β-cyclodextrin exhibit enhanced anti-ultraviolet and wrinkle recovery properties compared to the unmodified samples and show an excellent durability against 30 washing cycles, accompanied by a loss of tensile strength.
Predictors of Pediatric Tracheostomy Outcomes in the United States
Authors: Friesen Tzyynong L. , Zamora Steven M. , Rahmanian Ronak , Bundogji Nour , Brigger Matthew T.
Published: April 2020

Objectives

To investigate the outcomes of pediatric tracheostomy as influenced by demographics and comorbidities.

Study Design

Retrospective national database review.

Setting

Fifty‐two children’s hospitals across the United States.

Subjects and Methods

Hospitalization records from Pediatric Health Information System database dated 2010 to 2018 with patients younger than 18 years and procedure codes for tracheostomy were extracted. The primary outcome was total length of stay. The secondary outcomes were 30‐day readmission, mortality, and posttracheostomy length of stay.

Results

A total of 14,155 children were included in the analysis. The median total length of stay was 77 days and increased from 59 to 103 days between 2010 and 2018 (P <. 001). The median posttracheostomy length of stay was 34 days and also increased from 27 to 49 days (P <. 001). On multivariate regression analyses, the total and posttracheostomy lengths of stay were significantly increased in children younger than 1 year, patients of black race, hospitals in the non‐West regions, those discharged to home, and those with comorbidities. Socioeconomic indicators such as insurance type and estimated household income were associated with no difference or small effect sizes. Regions and comorbidities were associated with differences in 30‐day readmission (overall 26%), while in‐hospital mortality was primarily associated with age and comorbidities (overall 8.6%).

Conclusion

Pediatric tracheostomy requires substantial health care resources with length of stay escalating over recent years. Age, race, region, discharge destination, and comorbidities were associated with differences in length of stay.
Optimized mouse model of embolic MCAO: From cerebral blood flow to neurological outcomes
Authors: Wang Rongrong , Wang Hailian , Liu Yaan , Chen Di , Wang Yangfan , Rocha Marcelo , Jadhav Ashutosh P , Smith Amanda , Ye Qing , Gao Yanqin , Zhang Wenting
Published: April 2020

The embolic middle cerebral artery occlusion (eMCAO) model mimics ischemic stroke due to large vessel occlusion in humans and is amenable to thrombolytic therapy with rtPA. However, two major obstacles, the difficulty of the eMCAO surgery and unpredictable occurrence of clot autolysis, had impeded its application in mice. In this study, we modified catheters to produce suitable fibrin-rich embolus and optimized the eMCAO model using cerebral blood flow (CBF) monitored by both laser Doppler flowmetry (LDF) and 2D laser speckle contrast imaging (LSCI) to confirm occlusion of MCA. The results showed that longer embolus resulted in higher mortality. There was a compensatory increase in MCA territory perfusion after eMCAO associated with decreased infarct volume; however, this was only partly dependent on recanalization as clot autolysis was only observed in ∼30% of mice. Cortical CBF monitoring with LSCI showed that the size of peri-core area at 3 h displayed the best correlation with infarct volume that is attributed to compensatory collateral blood flow. The peri-core area best predicted functional outcome after eMCAO. In summary, we developed a reliable eMCAO mouse model that better mimics embolic ischemic stroke in humans, which will increase the potential for successful translation of stroke neuroprotective therapies.
Impact of mandated prospectively reported apparent diffusion coefficient values on the rates of positivity for clinically significant prostate cancer by PI-RADS score
Authors: Shaish Hiram , Casals Randy , Ahmed Firas , Makkar Jasnit , Wenske Sven
Published: April 2020

Background

Prior research has shown that retrospectively measured apparent diffusion coefficient (ADC) of prostate magnetic resonance imaging (MRI) lesions is associated with clinically significant prostate cancer (csPCa) on targeted biopsy suggesting that ADC should be measured and reported prospectively.

Purpose

To assess the impact of mandatory prospective measurement of ADC on the rates of positivity across PI-RADS scores for csPCa.

Material and Methods

Consecutive patients who underwent ultrasound (US)-MRI fusion prostate biopsy from August 2018 to July 2019 and who had prospectively reported ADC were compared to control patients who did not. Rates of positivity by PI-RADS category were computed and compared using Chi-square. Multivariable regression was performed.

Results

In total, 126 patients (median age 65 years) with 165 prostate lesions (19, 51, 70, and 25 PI-RADS 2, 3, 4, and 5, respectively) and prospectively reported ADC values were compared to 113 control patients (median age 66 years) with 157 prostate lesions (17, 42, 64, and 34 PI-RADS 2, 3, 4, and 5, respectively). Rates of positivity across PI-RADS scores were similar between the two cohorts; 11%, 25%, 55%, and 76% and 0%, 21%, 56%, and 62% for PI-RADS 2, 3, 4, and 5 in the test and control cohorts, respectively (Chi-square P = 0.78). Multivariate logistic regression showed no significant association between the presence of prospectively measured ADC and csPCa (odds ratio 1.1, 95% confidence interval 0.7–1.7, P = 0.82).

Conclusion

Prospective ADC measurement may not impact PI-RADS category assignments or positivity rates for csPCa under current guidelines. Future versions of PI-RADS may need to incorporate ADC into scoring rules to realize their potential.
Effect of anesthetic technique on serum vascular endothelial growth factor C and prostaglandin E2 levels in women undergoing surgery for uterine leiomyomas
Authors: Zhang Yonghai , Yu Jingfang , Yang Fan , Zhao Liyan , Ma Ling , Zhang Huiwen , Chen Xuexin , Ma Hanxiang
Published: April 2020

Objective

Angiogenesis is essential for growth and recurrence of uterine leiomyomas, and angiogenesis is mediated by vascular endothelial growth factor C (VEGF-C) and prostaglandin E2 (PGE2). This study investigated whether spinal anesthesia (SA) with continuous postoperative epidural analgesia attenuates postoperative changes in these angiogenic factors compared with general anesthesia (GA) with patient-controlled intravenous analgesia.

Methods

Forty-four women with uterine leiomyomas undergoing abdominal myomectomy were randomized to receive either standard SA or GA. Blood samples were taken before anesthesia and at 48 hours after surgery for measuring serum VEGF-C and PGE2 levels, which were analyzed by using enzyme-linked immunosorbent assays. Visual analog scale pain scores were used to evaluate postoperative pain.

Results

Serum VEGF-C and PGE2 levels were not significantly different preoperatively between the SA and GA groups, but they were decreased in each group at 48 hours after surgery compared with preoperatively. The change in pre- and postoperative VEGF-C levels was smaller in the GA group than in the SA group.

Conclusions

Removal of uterine leiomyomas by surgery can reduce serum VEGF-C and PGE2 levels. The anesthetic technique affects serum VEGF-C levels, which are associated with angiogenesis in surgery for leiomyomas.
Changes in Treg numbers and activity in papillary thyroid carcinoma with and without Hashimoto’s thyroiditis
Authors: Zhao Na , Liu Xin , Wu Chao , Liu Yuanchao , Zhao Xiangnan , He Xianghui
Published: April 2020

Background

Hashimoto’s thyroiditis (HT) is a common autoimmune disease, and an increasing number of papillary thyroid carcinoma (PTC) cases are being diagnosed in HT patients. The aim of this study was to investigate the proportion and function of different T cell subtypes in peripheral blood, especially CD4+Foxp3+ regulatory T cells (Tregs), in PTC with and without HT. We also studied the effect of HT on PTC.

Methods

Flow cytometry was used to detect the proportions of CD4+ T cells, CD8+ T cells, CD4+Foxp3+ Tregs, and the level of interleukin-10 (IL-10) secreted by CD4+ T cells in the peripheral blood of PTC patients with and without HT. AimPlex bead-based immunoassays were used to determine serum cytokine levels.

Results

No significant differences were observed in the proportion of CD4+ or CD8+ T cells in the two groups of PTC patients. The percentage of CD4+FoxP3+ Tregs and their levels of IL-10 were significantly lower in PTC patients with HT than in those without HT.

Conclusions

Our findings suggest that CD4+Foxp3+ Tregs have vital regulatory functions in the initiation and progression of PTC by secreting the inhibitory cytokine IL-10.
A Beaded Scarab in the Victoria and Albert Museum
Authors: Hinson Benjamin
Published: April 2020

This article is the publication of a beaded scarab from a mummy-net, excavated at Lahun in 1889–90 and donated to the Victoria and Albert Museum.
Action of the insecticide cyfluthrin on Ca2+ signal transduction and cytotoxicity in human osteosarcoma cells
Authors: Lu Y-C , Liang W-Z , Kuo C-C , Hao L-J , Chou C-T , Jan C-R
Published: April 2020

Cyfluthrin is a pyrethroid insecticide and common household pesticide. The effect of cyfluthrin on Ca2+-related physiology in human osteosarcoma is unclear. This study investigated the effect of cyfluthrin on cytosolic-free Ca2+ concentrations ([Ca2+]i) and viability in MG63 human osteosarcoma cells. Cyfluthrin concentration-dependently induced [Ca2+]i rises. Cyfluthrin-induced Ca2+ entry was confirmed by the Mn2+-induced quench of fura-2 fluorescence. Cyfluthrin at concentrations of 10–100 μM induced [Ca2+]i rises. Ca2+ removal reduced the signal by approximately 50%. Cyfluthrin (100 μM) induced Mn2+ influx suggesting Ca2+ entry. Cyfluthrin-induced Ca2+ entry was inhibited 50% by protein kinase C (PKC) activator (phorbol 12-myristate 13-acetate) and inhibitor (GF109203X) and also by three inhibitors of store-operated Ca2+ channels: nifedipine, econazole, and SKF96365. In Ca2+-free medium, treatment with the endoplasmic reticulum Ca2+ pump inhibitor thapsigargin (TG) completely inhibited cyfluthrin-evoked [Ca2+]i rises. Conversely, treatment with cyfluthrin abolished TG-evoked [Ca2+]i rises. Inhibition of phospholipase C (PLC) with 1-[6-[((17β)-3-methoxyestra-1,3,5[10]-trien-17-yl)amino]hexyl]-1H-pyrrole-2,5-dion abolished cyfluthrin-induced [Ca2+]i rises. Cyfluthrin at 25–65 μM decreased cell viability, which was not reversed by pretreatment with the Ca2+ chelator 1,2-bis(2-aminophenoxy)ethane- N, N, N′, N′-tetraacetic acid–acetoxymethyl ester. Together, in MG63 cells, cyfluthrin induced [Ca2+]i rises by evoking PLC-dependent Ca2+ release from the endoplasmic reticulum and Ca2+ entry via PKC-sensitive store-operated Ca2+ entry. Cyfluthrin also caused Ca2+-independent cell death.
Molecular Aspects of Adipose-Derived Stromal Cell Senescence in a Long-Term Culture: A Potential Role of Inflammatory Pathways
Authors: Pokrywczynska Marta , Maj Małgorzata , Kloskowski Tomasz , Buhl Monika , Balcerczyk Daria , Jundziłł Arkadiusz , Szeliski Kamil , Rasmus Marta , Drewa Tomasz
Published: April 2020

Long-term culture of mesenchymal stromal/stem cells in vitro leads to their senescence. It is very important to define the maximal passage to which the mesenchymal stromal/stem cells maintain their regenerative properties and can be used for cellular therapies and construction of neo-organs for clinical application. Adipose-derived stromal/stem cells were isolated from porcine adipose tissue. Immunophenotype, population doubling time, viability using bromodeoxyuridine assay, MTT assay, clonogencity, β-galactosidase activity, specific senescence-associated gene expression, apoptosis, and cell cycle of adipose-derived mesenchymal stromal/stem cells (AD-MSCs) were analyzed. All analyses were performed through 12 passages (P). Decreasing viability and proliferative potential of AD-MSCs with subsequent passages together with prolonged population doubling time were observed. Expression of β-galactosidase gradually increased after P6. Differentiation potential of AD-MSCs into adipogenic, chondrogenic, and osteogenic lineages decreased at the end of culture (P10). No changes in the cell cycle, the number of apoptotic cells and expression of specific AD-MSC markers during the long-term culture were revealed. Molecular analysis showed increased expression of genes involved in activation of inflammatory response. AD-MSCs can be cultured for in vivo applications without loss of their properties up to P6.
Factors Associated with Costs in Chimeric Antigen Receptor T-Cell Therapy for Patients with Relapsed/Refractory B-Cell Malignancies
Authors: Zhu Feng , Wei Guoqing , Zhang Mingming , Zhao Houli , Wu Wenjun , Yang Luxin , Hu Yongxian , Huang He
Published: April 2020

Background:

Chimeric antigen receptor T cells (CAR-Ts) constitute a novel therapeutic strategy for relapsed/refractory B-cell malignancies. CAR-T therapy has been extensively applied in the clinical setting; however, few systematic studies have evaluated the cost of CAR-T treatment. This study was conducted to evaluate the total cost and cost structure of CAR-T therapy and identify potential risk factors leading to increased costs.

Methods:

We identified the associated risk factors in 89 patients in a phase 1/2 study. The cohort included patients with acute lymphoblastic leukemia (ALL, n = 55) and non-Hodgkin’s lymphoma (NHL, n = 34).

Results:

Overall, the treatment of the ALL cohort was costlier than that of the NHL cohort ( P < 0.001). Furthermore, in the ALL cohort, it was costlier to treat patients with a high tumor burden ( P < 0.001), high cytokine release syndrome (CRS) grade ( P < 0.001), and complications of infection after CAR-T cell infusion (CTI) in the whole cohort ( P = 0.013) than patients with a low tumor burden, with low CRS grade, and without infection, respectively. CRS grade and length of stay ( P ≤ 0.005) were independent risk factors associated with the total cost in both the ALL and NHL cohorts during CAR-T therapy. A high tumor burden, duration of fever, and treatment with tocilizumab were independent risk factors associated with the total cost in the ALL cohort ( P < 0.05).

Conclusions:

CAR-T treatment should be extended to patients with a low tumor burden or patients in a state of complete remission, and a corticosteroid approach, as opposed to tocilizumab, may reduce costs.
Friction and wear of two polyethylenes under different tribological contact conditions
Authors: Harsha AP , Wäsche R , Joyce TJ
Published: April 2020

Tribological properties of ultrahigh-molecular weight polyethylene (UHMWPE) and cross-linked polyethylene (XLPE) were studied in two different wear modes. Firstly, reciprocating sliding wear studies under non-conformal contact investigated the effects of counterface surface roughness (polished, lapped and ground) of Ti6Al4V on the friction and wear of the polyethylenes. Secondly, two-body abrasive wear studies in conformal contact against different abrasive grit size papers were also carried out to ascertain the wear sensitivity of the polyethylenes under these adverse conditions. Wear mechanisms were studied using optical and scanning electron micrographs. The results of the reciprocating sliding wear studies showed that surface roughness of the counterface influenced friction and wear characteristics although no correlation was found between the coefficient of friction and specific wear rate. XLPE demonstrated wear sensitivity, particularly under severe abrasive wear condition. The results indicated that the performance of the polyethylenes greatly depends upon the tribological system under which it is operating.
Posterior reversible encephalopathy syndrome: A rare neurotoxicity after capecitabine
Authors: Monti Manlio , Barone Domenico , Amadori Elena , Bartolini Giulia , Ruscelli Silvia , Frassineti Giovanni Luca
Published: April 2020

Background

Posterior reversible encephalopathy syndrome (PRES) is a condition characterized by seizures, headache, visual disturbances, paresis, nausea and altered mental status. Risk factors include hypertension, eclampsia/pre-eclampsia, infection/sepsis, transplantation (allograft, bone marrow and solid organ) and immunosuppression, especially in association with autoimmune disorders and use of cyclosporine or chemotherapy.

Case report

A few days after starting the first cycle of treatment with capecitabine, a 50-year-old female with metastatic breast cancer experienced serious adverse events consisting of severe hematological, gastrointestinal and neurological toxicity. A brain magnetic resonance imaging, performed because of the severe state of confusion of the patient, confirmed PRES.

Management and outcome

The patient was admitted to the hospital; capecitabine was stopped and treatment was started with antibiotics, growth factor therapy and blood and platelet transfusions. Her clinical conditions slowly improved and the PRES resolved. A dihydropyrimidine dehydrogenase deficiency was identified.

Discussion

The patient had previously been treated with another fluoropyrimidine, 5-fluorouracil, but without toxicity. A literature search was performed, and only six cases of PRES associated with capecitabine were found. Our case suggests that capecitabine differs from 5-fluorouracil in its mechanism of action and that at least one of the metabolites of capecitabine has the ability to cross the blood–brain barrier, causing neurotoxicity. We believe that it is useful to test for dihydropyrimidine dehydrogenase deficiency before using fluoropyrimidines and would encourage the reporting of such cases of PRES to gain a better overall picture of its incidence in this setting.

Naranjo score

7
Atlas Sampling for Prone Breast Automatic Segmentation of Organs at Risk: The Importance of Patients’ Body Mass Index and Breast Cup Size for an Optimized Contouring of the Heart and the Coronary Vessels
Authors: Wang Xinzhuo , Miralbell Raymond , Fargier-Bochaton Odile , Bulling Shelley , Vallée Jean Paul , Dipasquale Giovanna
Published: April 2020

Objective:

Delineation of organs at risk is a time-consuming task. This study evaluates the benefits of using single-subject atlas-based automatic segmentation of organs at risk in patients with breast cancer treated in prone position, with 2 different criteria for choosing the atlas subject. Together with laterality (left/right), the criteria used were either (1) breast volume or (2) body mass index and breast cup size.

Methods:

An atlas supporting different selection criteria for automatic segmentation was generated from contours drawn by a senior radiation oncologist (RO_A). Atlas organs at risk included heart, left anterior descending artery, and right coronary artery. Manual contours drawn by RO_A and automatic segmentation contours of organs at risk and breast clinical target volume were created for 27 nonatlas patients. A second radiation oncologist (RO_B) manually contoured (M_B) the breast clinical target volume and the heart. Contouring times were recorded and the reliability of the automatic segmentation was assessed in the context of 3-D planning.

Results:

Accounting for body mass index and breast cup size improved automatic segmentation results compared to breast volume-based sampling, especially for the heart (mean similarity indexes >0.9 for automatic segmentation organs at risk and clinical target volume after RO_A editing). Mean similarity indexes for the left anterior descending artery and the right coronary artery edited by RO_A expanded by 1 cm were ≥0.8. Using automatic segmentation reduced contouring time by 40%. For each parameter analyzed (eg, D2%), the difference in dose, averaged over all patients, between automatic segmentation structures edited by RO_A and the same structure manually drawn by RO_A was <1.5% of the prescribed dose. The mean heart dose was reliable for the unedited heart segmentation, and for right-sided treatments, automatic segmentation was adequate for treatment planning with 3-D conformal tangential fields.

Conclusions:

Automatic segmentation for prone breast radiotherapy stratified by body mass index and breast cup size improved segmentation accuracy for the heart and coronary vessels compared to breast volume sampling. A significant reduction in contouring time can be achieved by using automatic segmentation.
Walking Interviews and Wandering Behavior: Ethical Insights and Methodological Outcomes While Exploring the Perspectives of Older Adults Living With Dementia
Authors: Adekoya Adebusola A. , Guse Lorna
Published: April 2020

While the use of walking interviews is not new in health care research, this method has not been used to study the wandering behavior of older adults living with dementia in long-term care (LTC) homes. The aim of this article is to describe ethical insights and consequential methodological outcomes when walking interviews were used as a means of exploring the perspectives of older adults living with mild to moderate dementia. We suggest that our use of walking interviews with older adults who presented with wandering behavior respected participants’ agency and, at times, placed the first author in the situation of “ethical vulnerability” in the roles of researcher and clinician. The first author, an experienced nurse clinician, walked with eight participants while interviewing them about why they walk and their intended destinations. Walking interviews provided the opportunity not only to interview participants but also to observe their walking behavior and interaction with others in the LTC home. Walking interviews with older adults living with dementia who are highly mobile in the LTC home acknowledge the primacy of the research participant and the researcher as learner.
Non-singular terminal sliding mode control for redundantly actuated parallel mechanism
Authors: Zhang Haiqiang , Fang Hairong , Zou Qi
Published: April 2020

In this article, the trajectory tracking control is developed by implementing a non-singular terminal sliding mode control for the redundantly actuated parallel mechanism system. The proposed control scheme could guarantee that the tracking errors converge to zero asymptotically. The problem of singularity with regard to conventional terminal sliding mode control scheme can be eliminated with the presented novel non-singular terminal sliding mode surface as well. The corresponding stability of the proposed control scheme has also been proved theoretically in terms of Lyapunov method. In addition, simulations and experiments are conducted for trajectory tracking to validate the effectiveness of the proposed scheme. The illustrative results demonstrate that the proposed scheme is available to solve the uncertainties and external disturbances with self-tuning in real time. Furthermore, the prominent characteristics of the presented control scheme are quick convergence, high accuracy, and high robustness, which can achieve excellent tracking performance as compared with computed torque control scheme and conventional sliding mode control scheme.
Short- to Midterm Follow-up of Cemented Total Ankle Replacement Using the INBONE II: A Retrospective Chart Review
Authors: Berlet Gregory C. , Brandão Roberto A. , Consul Devon , Ebaugh Pierce , Hyer Christopher F.
Published: April 2020

Background: Total ankle arthroplasty is a viable option for the treatment of end stage ankle arthritis. The purpose of this study is to report on the mid-term results with a cemented total ankle prosthesis, the Inbone™ II implant over a 5 year period. Methods: A retrospective, single-center chart and radiographic review of all patients with end stage ankle arthritis treated with Inbone™ II TAR) as the primary index procedure from 12/1/2012 to 3/1/2017. Clinical data were evaluated at 3 month, 6 month, 1 year and subsequent intervals for the study period. Preoperative diagnosis, pertinent patient demographics adjunctive procedures, implant associated complications, subsequent surgeries, and revisions were recorded. Results: 121 total ankles met our inclusion criteria. Patients had an INBONE™ II TAR implant placed with bone cement with a minimum of a 12 months follow up. Average age was 62.88 (range, 32-87) years, average body mass index was 32.74 (range, 21.8-56.04) kg/m2 and average follow up was 28.51(range, 12-69) months. Using the COFAS complication classification there were 14 minor, 11 moderate, and 5 major complications. 6/121 (5.0%) revisions which included: polyethylene exchange, device explant/fusion, and antibiotic spacer in situ. No complications over the course of this study ended in amputation. Conclusion: Total Ankle Arthroplasty utilizing the cemented INBONE™ II yielded good midterm results with regards to minor, moderate, and major complications. Rate of revision 6/121 (5.0%) was within the reported range with only 5 patients converted to fusion during the study period resulting in a 95% survivability at mid-term follow up.

Levels of Evidence: Level IV: Retrospective case series
“The Harder One Tries …”: Findings and Insights From the Application of Covert Response Pressure Assessment Technology in Three Studies of Visual Perception
Authors: Tsikandilakis Myron , Bali Persefoni , Haralabopoulos Giannis , Derrfuss Jan , Chapman Peter
Published: April 2020

In this article, we present a force measuring method for assessing participant responses in studies of visual perception. We present a device disguised as a mouse pad and designed to measure mouse-click-pressure and click-press-to-release-time responses by unaware, as regards to the physiological assessment, participants. The aim of the current technology, in the current studies, was to provide a physiological assessment of confidence and task difficulty. We tested the device in three experiments. The studies comprised of a gender-recognition study using morphed male and female faces, a visual suppression study using backwards masking, and a target-search study that included deciding whether a letter was repeated in a subsequently presented letter string. Across all studies, higher task difficulty was associated with higher click-release-time responses. Higher task difficulty was, intriguingly, also associated with lower click pressure. Higher confidence ratings were consistently associated with higher click pressure and shorter click-release time across all experiments. These findings suggest that the current technology can be used to assess responses relating to task difficulty and participant confidence in studies of visual perception. We suggest that the assessment of release times can also be implemented using standard equipment, and we provide manual and easy-to-use code for the implementation.
Risk of hepatotoxicity with trastuzumab emtansine in breast cancer patients: a systematic review and meta-analysis
Authors: Cobert Amani M. , Helms Catherine , Larck Chris , Moore Donald C.
Published: April 2020

Background:

Trastuzumab emtansine (T-DM1) is an anti-HER2 antibody-drug conjugate indicated for the treatment of HER2-positive breast cancer. One of the most severe adverse events reported with T-DM1 is hepatotoxicity. The objective of our meta-analysis is to investigate the risk of hepatic adverse events in patients with breast cancer receiving T-DM1 compared with controls.

Methods:

We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) comparing T-DM1 with a control treatment in patients with HER2-positive breast cancer. Phase II/III RCTs with available event number or event rate of hepatic toxicity with an assessable sample size were included. Relative risk (RR) and corresponding 95% confidence intervals (CI) for all grade and high-grade (grade 3/4) aspartate aminotransferase (AST) and alanine aminotransferase (ALT) elevations were calculated.

Results:

Seven RCTs were deemed eligible and were included in the meta-analysis. The RR for all-grade AST and ALT elevations were 3.24 (95% CI 2.16–4.86; p < 0.00001) and 2.90 (95% CI 1.98–4.23; p < 0.00001), respectively. The RR for high-grade AST and ALT elevations were 2.73 (95% CI 1.07–6.93; p = 0.03) and 2.17 (95% CI 1.34–3.50; p = 0.002), respectively.

Conclusions:

Our meta-analysis demonstrates that T-DM1-based therapy is associated with an increased risk of AST and ALT elevations.
The new urban managerialism in geopolitical context
Authors: Jonas Andrew EG
Published: April 2020

This commentary critically examines Phelps and Miao’s concept of the new urban managerialism (NUM) in light of three geopolitical processes operating around the state and urban politics: (1) the geopolitics of city-regionalism; (2) the geopolitics of urban environmental management; and (3) the geopolitical implications of the public–private financing of urban infrastructure. It argues that the NUM remains fundamentally a territorialized political project and raises questions about where to draw conceptual and territorial boundaries around the urban public interest.