bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound versus thoracoscopic-guided paravertebral block during thoracotomy
Authors: Hegazy Mohammed A , Awad Gehad , Abdellatif Amr , Saleh Mohamed Elshabrawy , Sanad Mohammed
Published: October 2020

Background

Paravertebral block can be performed with the aid of surgical landmarks, ultrasound, or a thoracoscope. This study was designed to compare ultrasound-guided paravertebral block with the thoracoscopic technique.

Methods

This prospective randomized comparative study included 40 adults scheduled for elective thoracic surgery. Study participants were randomized to an ultrasound group or a thoracoscope group. A catheter for paravertebral block was inserted prior to thoracotomy with real-time ultrasound visualization in the ultrasound group, and under thoracoscopic guidance in the thoracoscope group. Total analgesic consumption, visual analogue pain score, technical difficulties, and complications were compared between the 2 groups.

Results

Total analgesic consumption in the first 24 hours was less in the ultrasound group than in the thoracoscope group (rescue intravenous fentanyl 121.25 ± 64.01 µg in the ultrasound group vs. 178.75 ± 91.36 µg in the thoracoscope group; p = 0.027). Total paravertebral bupivacaine consumption was 376.00 ± 33.779 mg in the ultrasound group and 471.50 ± 64.341 mg in the thoracoscope group ( p < 0.001). Technical difficulties and complications in terms of time consumed during the maneuver, more than one needle pass, and pleural puncture were significantly lower in the ultrasound group than in the thoracoscope group.

Conclusion

Ultrasound-guided paravertebral catheter insertion is more effective, technically easier, and safer than the thoracoscope-assisted technique.
Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study
Authors: Alnababteh Muhtadi , Hashmi Muhammad D , Vedantam Karthik , Chopra Rajus , Kohli Akshay , Hayat Fatima , Kriner Eric , Molina Ezequiel , Pratt Alexandra , Oweis Emil , Zaaqoq Akram M
Published: October 2020

Introduction:

The pandemic of the coronavirus disease 2019 (COVID-19) and associated pneumonia represent a clinical and scientific challenge. The role of Extracorporeal Membrane Oxygenation (ECMO) in such a crisis remains unclear.

Methods:

We examined COVID-19 patients who were supported for acute respiratory failure by both conventional mechanical ventilation (MV) and ECMO at a tertiary care institution in Washington DC. The study period extended from March 23 to April 29. We identified 59 patients who required invasive mechanical ventilation. Of those, 13 patients required ECMO.

Results:

Nine out of 13 ECMO (69.2%) patients were decannulated from ECMO. All-cause ICU mortality was comparable between both ECMO and MV groups (6 patients [46.15%] vs. 22 patients [47.82 %], p = 0.92). ECMO non-survivors vs survivors had elevated D-dimer (9.740 mcg/ml [4.84-20.00] vs. 3.800 mcg/ml [2.19-9.11], p = 0.05), LDH (1158 ± 344.5 units/L vs. 575.9 ± 124.0 units/L, p = 0.001), and troponin (0.4315 ± 0.465 ng/ml vs. 0.034 ± 0.043 ng/ml, p = 0.04). Time on MV as expected was significantly longer in ECMO groups (563.3 hours [422.1-613.9] vs. 247.9 hours [101.8-479] in MV group, p = 0.0009) as well as ICU length of stay 576.2 hours [457.5-652.8] in ECMO group vs. 322.2 hours [120.6-569.3] in MV group, p = 0.012).

Conclusion:

ECMO is a supportive intervention for COVID-19 associated pneumonia that could be considered if the optimum mechanical ventilation is deemed ineffective. Biomarkers such as D-dimer, LDH, and troponin could help with discerning the clinical prognosis in patients with COVID-19 pneumonia.
Mathieu Forceps: A Learners Aid for Positioning the Weldable Molar Tube
Authors: Ram RSVM Raghu , Ranganayakulu I , K Anand Viswanadh
Published: October 2020

Lack of control while handling tiny objects like weldable molar tubes is the most common problem faced by the learners in orthodontics. They are prone to slippage and at times alter in position during spot welding. Here, we provide an easy-going clinical tip for accurate positioning and grasping of weldable molar tubes through spot welding using the Mathieu forceps.
Current clinical practice in 24-hour postural management and the impact on carers and service users with severe neurodisability
Authors: Stinson May , Crawford Shelley , Madden Emma
Published: October 2020

Introduction

The clinical benefits of 24-hour postural management are widely recognised by occupational therapists, but little is known about its impact on service users and carers or whether clinical practice is consistent across regions. The aim of this research was to investigate the use of 24-hour postural management by occupational therapists and to explore its impact on service users with neurodisability and their carers.

Methods

Quantitative and qualitative methods were employed in two phases: (a) online survey with 96 occupational therapists across one UK region, with data analysed by descriptive statistics and correlations; (b) focus groups with service users and/or carers ( n = 9), with data analysed by thematic analysis.

Results

Findings showed moderate positive correlation between frequency of use and (a) all key intervention skills and (b) knowledge of night-time positioning ( p < 0.001). Moderate positive correlations were found between level of training and (a) assessment skills and (b) knowledge of night-time positioning ( p < 0.001). The overarching theme from focus groups was ‘reliance on individualised equipment’, with overwhelming frustration from lack of support, loss of identity, equipment cost, insufficient focus on preventative strategies and accessibility issues.

Conclusion

A clinical practice guideline, including training, is crucial to direct practice. Providers must engage with service users and carers to address their frustrations.
Experimental investigations on atomization characteristics of dual-orifice atomizers part I: Optimization method formation
Authors: Fan Xiongjie , Liu Cunxi , Mu Yong , Wang Yulan , Wang Kaixing , Xu Gang
Published: October 2020

In this paper, influences of structure parameters on mass flow and atomization characteristics (spray cone angle, SMD, liquid film fusion and separation) of dual-orifice atomizers were investigated using Fraunhofer diffraction optical instrument and high-speed shadowgraph technique. The main influential structure parameters are obtained by structural parameter sensitivity analysis. Liquid film fusion and separation is an important atomization characteristic lacking of in-depth research. Results of liquid film fusion and separation illustrate that three patterns (separation-fusion-secondary separation) of main stage liquid film and pilot stage liquid film appear with the increase of Δ P. Liquid film fusion makes SMD larger, and there is a delay in liquid film separation when reduce Δ P after liquid film fusion. In addition, mass flow and spray cone angle are key factors which affect liquid film fusion pressure, liquid film secondary separation pressure and distance between two liquid films. The smaller the pilot stage mass flow is, the larger the effect of the main stage on pilot stage spray cone angle will be. Results in this paper could be used to the design and optimization of new dual-orifice atomizers.
Protective effects of quercetin and crocin in the kidneys and liver of obese Sprague-Dawley rats with Type 2 diabetes: Effects of quercetin and crocin on T2DM rats
Authors: Lai Ling-Lin , Lu Hui-Qin , Li Wen-Na , Huang Hui-Ping , Zhou He-Ying , Leng En-nian , Zhang Yue-yue
Published: October 2020

Quercetin and crocin are the main active constituents of Eucommia and Gardenia species, respectively. This study was conducted to explore the effects of quercetin and crocin on fat reduction and renal fibrosis and the relationship of these compounds with autophagy. First, a model of high-fat diet- and streptozotocin-induced type 2 diabetes was established and then subjected model animals to 8 weeks of metformin, quercetin and crocin gavage. Then, a high glucose-induced rat mesangial cells (RMCs) model was established, and these cells were cocultured with quercetin and crocin. The results showed that quercetin and crocin can decrease fasting blood glucose levels, reduce fat accumulation in the liver, alleviate renal fibrosis, and reduce blood lipid levels. Quercetin and crocin increased autophagy-related protein (LC3, Atg5, Beclin-1 and p-AMPK) levels in the liver and decreased autophagy-related protein (LC3, Atg5, Beclin-1 and p-AMPK) levels in the kidneys. Moreover, quercetin and crocin inhibited the excessive proliferation of RMCs induced by high-glucose (HG) conditions, decreased autophagy-related protein (LC3, Atg5, Beclin-1 and p-AMPK) levels, and decreased TGF-β1 expression. Importantly, cotreatment with quercetin and crocin had a more significant effect than treatment with either compound alone. These results suggest that combined administration of quercetin and crocin can more significantly reduce blood glucose/lipid levels and improve renal fibrosis than administration of either compound alone and that AMPK-dependent autophagy might be involved in this process. Eucommia ulmoides Oliv. and Gardenia could be developed as drugs for Type 2 diabetes treatment.
Beliefs That Contribute to Dissatisfaction in Romantic Relationships
Authors: Zagefka Hanna , Bahul Krisztina
Published: October 2020

Some lay beliefs people hold are harmful to their romantic relationships because they reduce relationship satisfaction. Two studies were conducted in two different national settings ( N = 253 in the UK and N = 132 in Hungary) to test the effects of three potential dysfunctional beliefs: an aversion to disagreement between the partners, an expectation that mindreading should happen, and a belief that relationships are formed due to destiny. When predicting two different indices of relationship satisfaction, consistently across both national settings, results revealed that an aversion to disagreement was negatively linked with relationship outcomes, whereas the other two beliefs were not. Findings are discussed in terms of their applied value: Those working with struggling couples will want to know which lay beliefs, out of several potentially dysfunctional beliefs, have the strongest negative effect on relationship outcomes because those should be tackled first in interventions.
ERISA Reform as Health Reform
Authors: McCuskey Elizabeth Y.
Published: October 2020

If federal health reforms continue to rely on employer-sponsored health care coverage, ERISA preemption reform should be part of the next steps. State-level reform has acquired greater urgency, while the justifications for preempting that source of reform has eroded. This article recommends a statutory waiver for ERISA preemption as a feasible way to adapt to these circumstances. It offers proposed statutory text for reformers inclined to pursue ERISA reform as health reform.
Payment Theory and the Last Mile Problem
Authors: Jacobi John V.
Published: October 2020

Health reform debate understandably focuses on large system design. We should not omit attention to the “last mile” problem of physician payment theory. Achieving fundamental goals of integrative, patient-centered primary care depends on thoughtful financial support. This commentary describes the nature and importance of innovative primary care payment programs.
Designing Policy Solutions to Build a Healthier Rural America
Authors: Vohra Sameer , Pointer Carolyn , Fogleman Amanda , Albers Thomas , Patel Anish , Weeks Elizabeth
Published: October 2020

Disparities exist in the health, livelihood, and opportunities for the 46-60 million people living in America’s rural communities. Rural communities across the United States need a new energy and focus concentrated around health and health care that allows for the designing capturing, and spreading of existing and new innovations. This paper aims to provide a framework for policy solutions to build a healthier rural America describing both the current state of rural health policy and the policies and practices in states that could be used as a national model for positive change.
Structural Racism and Maternal Health Among Black Women
Authors: Taylor Jamila K.
Published: October 2020

Historical foundations rooted in reproductive oppression have implications for how racism has been integrated into the structures of society, including public policies, institutional practices, and cultural representations that reinforce racial inequality in maternal health. This article examines these connections and sheds light on how they perpetuate both racial disparities in maternal health and high rates of maternal mortality and morbidity among Black women.
A new approach for tuning control rule based on hedge algebras theory and application in structural vibration control
Authors: Bui Hai-Le , Tran Quy-Cao
Published: October 2020

The hedge algebras theory has the potential to make significant applications in the field of computational intelligence. The purpose of the present study is to improve the control performance of the hedge algebras–based controller by tuning its control rules and apply the hedge algebras–based controller using the tuned rule base in vibration control of structures. The authors propose a “tuning coefficient” to express the impact of each rule of the controller in the control process. These control rules are adjusted by optimizing the above tuning coefficient. The tuned controller is then used to reduce the dynamic response of structures subjected to different excitations. The adjusted rule base is more appropriate for the model to be controlled, and it allows enhancing the control performance of the system. The proposed approach is uncomplicated and transparent, and it allows preserving the monotonous feature of the rule base.
Distally-fixed non-modular monoblock fluted long-stem hemiarthroplasty versus proximal femoral nailing for elderly patients with an osteoporotic intertrochanteric fracture: a retrospective comparative study
Authors: Çiloğlu Osman , Karaali Evren , Kuşvuran Özkan Aslıhan , Ekiz Timur
Published: October 2020

Background:

The treatment of Intertrochanteric fractures in the elderly osteoporotic patient is still controversial. The aim of this study was to compare the outcomes of proximal femoral nailing (PFN) and a distally-fixed non-modular monoblock fluted long-stem hemiarthroplasty (HA) in elderly patients with an osteoporotic intertrochanteric fracture.

Methods:

This retrospective study included patients who had undergone surgery for an unstable intertrochanteric fracture. The patients were separated into PFN and HA groups. The demographic features of the 2 groups were compared. All patients were evaluated using the Singh index, ASA score, AO/OTA classification, Harris Hip Score (HHS), and Parker and Palmer mobility score.

Results:

The most common complications were nonunion (12.0%) and cut-out of the screw (10.7%) in the PFN group, and dislocation of the prosthesis (6.7%) and wound infection (5.7%) in the HA group. Overall, the 2-year mortality rate was 29.3%. Mortality, particularly within the first 3 months, was 2.4 times higher in the PFN Group than in the HA group (40% vs. 19.75%). Although the HHS was significantly higher in the first year for the HA group, no significant difference was seen between the 2 groups at 24 months.

Conclusions:

Although PFN and HA have similar good outcomes at 2 years, HA allows earlier mobilisation and has fewer complications and a lower mortality rate.
The Management of Long-Term Psychiatric Sequelae in a Young Woman Who Suffered From Suspected Autoimmune Limbic Encephalitis
Authors: Fusar-Poli Laura , Gabbiadini Alberto , Battaglia Giulia , Signorelli Maria Salvina , Aguglia Eugenio
Published: October 2020

We report the case of a 23-year-old woman who presented to our Psychiatry Unit with a complex psychiatric symptomatology, 6 years after suffering from a form of encephalopathy which was retrospectively and hypothetically labeled as autoimmune limbic encephalitis. Over the years, several psychopharmacological therapies had been initiated, but none of them led to substantial remission of symptomatology. During the first visit, symptoms were characterized by dysphoric mood with suicidal ideation, anxiety, delusional thoughts. Self-harm and psychogenic seizures with daily frequency were also reported. A therapy with slow-release lithium sulfate, lurasidone, and lorazepam was prescribed. After 6 months of treatment, psychopathological manifestations significantly improved.
Development of a frequency-dependent constitutive model for hysteresis of shape memory alloys
Authors: Shakiba Saeid , Yousefi-Koma Aghil , Ayati Moosa
Published: October 2020

In this study, a constitutive model based on Liang-Rogers’s relations is developed to characterize the effect of the excitation frequency in the hysteresis of shape memory alloys. Shape memory alloys are good candidates as smart actuators because of their high strain and power density, although the complex hysteresis behavior barricades their usage. Although constitutive models are one of the most potent methods to predict the shape memory alloys behavior, they cannot consider the effect of excitation frequency in active applications. In this paper, the Liang-Rogers model is modified to consider this effect using a linear relation between the excitation frequency and martensite transformation temperatures. A shape memory alloy-driven actuator as a morphing wing is employed to characterize the frequency effect on shape memory alloy hysteresis. Experimental results show that the hysteresis is widened when the excitation frequency increases. The modeling results show that the original model significantly fails to predict the correct behavior when the frequency increases, whereas the proposed model can adequately handle the frequency effect on the behavior of the shape memory alloy-driven actuator.
Gender and dementia national strategy policymaking: Working toward health equity in Canada through gender-based analysis plus
Authors: Wyndham-West Michelle
Published: October 2020

This article discusses the results of a content and critical discourse analysis of Canadian federal policy documentation relating to the development of a national Canadian dementia strategy. These documents span from 2013 and focus upon Canadian federal policy directives and directions up to the release, and including the release, of a national strategy in June 2019. The analyses, supplemented by a subtextual examination of these documents guided by Bacchi's (2012) “What's the Problem Represented to be?” framework, focuses upon the treatment of gender in policy documentation and the specific gender related policy framework, known as GBA+ (gender-based analysis and intersectionality), which is intended to bring about health equity to disadvantaged groups. As women, particularly, working class women and their carers, as well as women with additional intersecting factors, such as being lesbian or bisexual, are less likely to receive the dementia related care and services they need, precipitating a premature move to residential care, GBA+ is an essential policy framework in the attempt to address these inequities. However, findings point to a superficial treatment of gender, GBA and GBA+ in federal policy documents and lack a meaningful invocation of women's gendered and intersectional lived experiences of dementia. Additionally, the Canadian federal government's Dementia Strategy for Canada: Together We Aspire (2019) is grounded in a rendition of citizenship that do not work to unearth the complex relationships between citizenship, old age, gender and intersectional factors. As a result, the Dementia Strategy for Canada: Together We Aspire (2019) presents a version of citizenship that homogenizes older adults and prevents representations of older adults as diverse, complex and continually changing groupings. Therefore, inspired by Bartlett et al. (2018), I advocate for the application of a feminist and intersectional citizenship lens in Canadian federal dementia-related policymaking documentation going forward.
A labour of love: Reward and satisfaction for nurses: Findings from a grounded theory study in dementia care
Authors: Gilbert Julia , Ward Louise , Walter Ruby
Published: October 2020

Aim

To understand nurses’ perceptions of quality nursing care in the dementia-specific care unit. As the world’s population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses’ perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units.

Method

A grounded theory study was conducted to understand nurses’ perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis.

Findings

Three themes emerged from this study— Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love.
The F Word: The Role of Women’s Friendships in Navigating the Gendered Workplace of Academia
Authors: Kaeppel Kristi , Grenier Robin S. , Björngard-Basayne Emma
Published: October 2020

This conceptual paper contributes a new perspective on the role of women academics’ friendships in helping them navigate and counter the masculine culture of academia. Drawing on Self-Determination Theory and Relational Cultural Theory, we contend that women’s friendships allow women to thrive by meeting core psychological needs that are threatened in a marginalized work environment. Women’s intra-gender friendships act as counterspaces that challenge deficit notions women often hold about themselves, which are particularly prevalent for early career academics and women of color. We examine these workplace friendships through the belief that the academy is a gendered workplace which results in women often experiencing significant challenges to their career success. Furthermore, we consider how women’s friendships can mitigate the effects of workplace marginalization and enhance well-being that results in career success. We conclude by challenging HRD scholars to consider how academia can make space for and value women’s friendships in the workplace to benefit both individuals and institutions.
Single-Stage Localization and Thoracoscopic Removal of Nonpalpable Pulmonary Nodules in a Hybrid Operating Room
Authors: Mazza Federico , Venturino Massimiliano , Peano Enrico , Balderi Alberto , Turello Davide , Locatelli Alessandro , Melloni Giulio
Published: October 2020

Objective

We report our experience with simultaneous localization and thoracoscopic removal for nonpalpable undiagnosed pulmonary nodules.

Methods

All patients with nonpalpable lesions requiring video-assisted thoracoscopic surgery (VATS) wedge resection underwent localization of the targets and surgical removal in a hybrid operating room. Lesions were considered nonpalpable if they were small (<1 cm), deep (>1 cm from the surface), subsolid, or located within a dystrophic area. In all cases, intraoperative cone-beam computed tomography was performed for nodule localization and targeting, metal hookwires, or coils were alternatively used for intraoperative marking.

Results

From April 2016 to November 2019, 39 image-guided VATS (iVATS) were performed. The mean lesion size was 12 ± 6 mm. The mean distance from the deep edge of the lesion to the pleural surface was 24 ± 9 mm. The localization was performed with 20 hookwires and 19 coils. iVATS localization was successful in 36 patients (92.3%). Thirty-seven wedge resections were completed by VATS, 2 (5%) required conversion to thoracotomy. In 9 patients with intraoperative diagnosis of lung cancer, a lobectomy was performed (7 VATS and 2 thoracotomies). Mean length of iVATS localization was 30 ± 13 minutes. Median postoperative length of stay was 4 days (IQR 3 to 5).

Conclusions

iVATS seems to be a helpful tool for simultaneous localization and removal of nonpalpable nodules. A versatile approach using different devices seems advisable for the removal of targets in every clinical scenario reducing VATS conversion rate. Future research is required to compare iVATS with traditional preoperative localization techniques.
Balancing Support for Staff and Patient Centeredness Through the Design of Immediate and Relational Space: A Case Study of Ambulatory Care Center Layouts
Authors: Zook Julie , Spence Timothy J. , Joy Teri
Published: October 2020

Purpose:

This descriptive case study of ambulatory care center typologies builds a layout-based approach to patient-centered care and care team work using theory and methods from space syntax and a recently developed approach to floorplan analysis focused on visibility.

Background:

Calibrating support for care team work and patient centeredness is a persistent dilemma in ambulatory care settings.

Method:

A review of literature and floorplan layout analysis are used.

Results:

The center-stage layout more strongly integrates staff and patients, while the onstage–offstage layout provides greater privacy to the care team. The integration values for exam rooms in each layout were roughly equivalent. Analysis of variations on each floor plan demonstrates ways relatively small variations can modulate visibility conditions without altering integration patterns.

Conclusion:

Decoupling design of immediate visual properties and relational layout properties can act as a strategy to address competing demands.
Impact of COVID-19 Pandemic on Ambulatory and Operating Room Rhinology Practice in the US
Authors: Papagiannopoulos P. , Ganti A. , Kim Y. J. , Raad R. A. , Kuan E. C. , Losavio P. , Tajudeen B. A. , Batra P. S.
Published: October 2020

Introduction

The pandemic caused by the novel coronavirus virus has altered all facets of clinical practice in the United States. The goal of this study is to better understand the impact of COVID-19 on rhinologic ambulatory and operative practice.

Methods

A 27-item survey to assess these objectives was created and approved by the Division of Rhinology faculty at Rush University Medical Center in April 2020. The survey was then distributed to rhinologists in a web based format via www.surveymonkey.com from April 10 through April 23, 2020.

Results

A total of 277 U.S based rhinologists responded to the survey (23.04%). The most common practice types were single specialty private (44.9%) and academic (24.6%). 90.2% practice in a state under a shelter in place order. Comparing pre-COVID baseline to during-COVID, there was statistically significant reduction in the number of patients of seen daily in clinic ( p < 0.001). The number of nasal endoscopies in the office and surgical procedures fell dramatically. Overall, 5 respondent rhinologists have been infected with COVID-19 and 27 have been furloughed.

Conclusion

COVID-19 has drastically affected rhinologic practice. There is a dramatic reduction of in person care in the office setting and surgical management of sinonasal and skull base disease. Enhanced PPE is being used in only half of potentially aerosolizing procedures which represents an area of further education. Novel approaches such as use of virtual encounters and point of care testing should be considered as options to facilitate care.
Is radiofrequency ablation safe and effective in treating osteoid osteomas? A prospective single-center study with atypical cases
Authors: Yuce Gokhan , Aytekin Nedim , Eren Serhan , Genç Birgul , Ateş Ömer Faruk , Canyiğit Murat
Published: October 2020

Purpose:

Osteoid osteomas are benign and nonprogressive lesions. The clinical presentation of osteoid osteoma is typical with night pain responsive to nonsteroidal anti-inflammatory agents. The typical radiological appearance is lucent nidus and adjacent reactive sclerosis. The most traditional management of osteoid osteoma is surgical removal which is associated with significant morbidity. This article aims to demonstrate our single-center experience of 55 patients with osteoid osteoma treated with percutaneous radiofrequency ablation (RFA).

Methods:

Fifty-five symptomatic patients who were seen at our orthopedics outpatient clinics, diagnosed with osteoid osteoma, and referred to interventional radiology department between May 2015 and April 2019 were enrolled. The nidus size, pain numeric rating scale score, and intramedullary edema diameter before and after RFA were compared. Clinical and technical success, intervention-related complications, and need for subsequent ablation were recorded.

Results:

Of the 55 patients, including 12 pediatric cases, 6 had atypical locations such as metatarsal, vertebra, and scapula, while 1 case had osteoid osteoma with multiple nidus. The mean age was 18.5 ± 9.6 years. Preintervention maximum nidus diameter, pain score, and edema diameter were significantly lower in postintervention measurements ( p < 0.001). Technical success rate was 98.1%, and clinical success was 96.36%. Severe complication occurred in one patient with soft tissue burn and osteomyelitis.

Conclusion:

This is one of the largest series of osteoid osteoma treated with RFA done in a single center with atypical cases. In conclusion, RFA is safe and effective in both pediatric and adult patients with rare complications even in challenging cases with atypical locations.
Are patterns of vacant lots random? Evidence from empirical spatiotemporal analysis in Chiba prefecture, east of Tokyo
Authors: Usui Hiroyuki , Perez Joan
Published: October 2020

According to the Japanese government, vacant lots are randomly generated and accumulated (without being rebuilt after demolition) in the process of increasing vacant lots, a phenomenon called urban perforation. Urban perforation in urban areas may trigger a high degree of inefficiency in public infrastructure management. However, this observation lacks theoretical and empirical foundations, a lacuna to which this paper will focus on. Consequently, our research objectives are to confirm: (1) whether or not vacant lots are randomly generated and (2) whether or not vacant lots are randomly accumulated as a result of random generation. The methodology includes a consistent and bottom-up approach to delineate urban areas (alongside statistical spatial analysis). Through theoretical and empirical analyses in Chiba Prefecture (situated in the eastern part of the Tokyo metropolitan region), we find that the random generation of vacant lots does not tend to continue in the same urban areas. Rather, in most urban areas, this process is a temporary phenomenon. Subsequently, phase transition generally shifts from random to clustered generation or vice versa. Nevertheless, once vacant lots are randomly accumulated in an urban area, this process tends to continue. The contributions of this article are not only to provide important spatiotemporal findings regarding the generation and accumulation patterns of vacant lots, but also to discuss how to apply policy for urban perforation where phenomena are significantly pronounced.
Encapsulation of Mesenchymal Stem Cells: Dissecting the Underlying Mechanism of Mesenchymal Stem Cell Transplantation Therapy
Authors: Kin Kyohei , Yasuhara Takao , Date Isao
Published: October 2020

Mesenchymal stem cells (MSCs) are widely considered good candidates for cell transplantation therapy. Various central nervous system disorders have been suggested as suitable targets for MSC transplantation therapy. In this context, a great deal of basic and clinical research has been conducted to explore its clinical uses. Although depression is one of the most common diseases in the world, the response rate to the currently available treatment is insufficient and new treatments are much needed. Despite the fact that MSC transplantation therapy has the potential to elicit an antidepressant effect, few studies have been conducted on this topic to date and the underlying mechanism remains poorly understood. To address the development of a new treatment for depression, we evaluated the effect of MSCs using the encapsulation technique and Wistar-Kyoto rats. Encapsulation enables dissection of the complicated underlying mechanism of MSC transplantation therapy. Wistar-Kyoto rats that exhibit treatment-resistant depressive-like behaviors allow us to compare the effect of MSCs with that of conventional antidepressant treatment. In this commentary, we briefly summarize our recent published results and discuss future research prospects.
Experimental study of lateral resistance of bolted joints using Japanese cedar (Cryptomeria japonica) treated with resin impregnation
Authors: Ogawa Keita , Fukuta Satoshi , Kobayashi Kenji
Published: October 2020

The development of wooden joints possessing high resistance performance has become an important issue for the construction of newer buildings. This study attempts to strengthen the lateral resistance of bolted joints using the previously reported plasticizing technique. This technique consists of two processing stages: incising the surface of the wood using an ultraviolet wavelength short-pulse laser and impregnating the resin into the incised area. This technique makes it possible to plasticize only a local part of the wood surface. Bolted joint specimens were assembled using plasticized wood around the bolt hole, and the lateral tests were conducted. Acrylic monomer and urethane prepolymer were used as the impregnating resins and their incision depths were set as 4 and 10 mm. When the lateral load acted parallel to the grain, changes in the lateral resistance characteristics were observed, especially for the stiffness and yield load. For example, when acryl was used, and the incision depth was 10 mm, an increment of 73% in the yield load was observed, as compared to the non-impregnated specimens. The specimen groups impregnated with acryl exhibited greater changes in their properties than those using urethane. When loaded perpendicular to the grain, an increase in properties were observed; however, these increments were lower than those of the groups loaded parallel to the grain.
Monocyte Chemoattractant Protein-1 stimulates the differentiation of rat stem and progenitor Leydig cells during regeneration
Authors: Zhan Xiangcheng , Zhang Jingwei , Li Saiyang , Zhang Xiaolu , Li Linchao , Song Tiantian , Liu Qunlong , Lu Jun , Xu Yunfei , Ge Ren-Shan
Published: October 2020

Background

Monocyte chemoattractant protein-1(MCP-1) is a chemokine secreted by Leydig cells and peritubular myoid cells in the rat testis. Its role in regulating the development of Leydig cells via autocrine and paracrine is still unclear. The objective of the current study was to investigate the effects of MCP-1 on Leydig cell regeneration from stem cells in vivo and on Leydig cell development in vitro.

Results

Intratesticular injection of MCP-1(10 ng/testis) into Leydig cell-depleted rat testis from post-EDS day 14 to 28 significantly increased serum testosterone and luteinizing hormone levels, up-regulated the expression of Leydig cell proteins, LHCGR, SCARB1, CYP11A1, HSD3B1, CYP17A1, and HSD17B3 without affecting progenitor Leydig cell proliferation, as well as increased ERK1/2 phosphorylation. MCP-1 (100 ng/ml) significantly increased medium testosterone levels and up-regulated LHCGR, CYP11A1, and HSD3B1 expression without affecting EdU incorporation into stem cells after in vitro culture for 7 days. RS102895, a CCR2 inhibitor, reversed MCP-1-mediated increase of testosterone level after culture in combination with MCP-1.

Conclusion

MCP-1 stimulates the differentiation of stem and progenitor Leydig cells without affecting their proliferation.
Proteotranscriptomics assisted gene annotation and spatial proteomics of Bombyx mori BmN4 cell line
Authors: Levin Michal , Scheibe Marion , Butter Falk
Published: October 2020

Background

The process of identifying all coding regions in a genome is crucial for any study at the level of molecular biology, ranging from single-gene cloning to genome-wide measurements using RNA-seq or mass spectrometry. While satisfactory annotation has been made feasible for well-studied model organisms through great efforts of big consortia, for most systems this kind of data is either absent or not adequately precise.

Results

Combining in-depth transcriptome sequencing and high resolution mass spectrometry, we here use proteotranscriptomics to improve gene annotation of protein-coding genes in the Bombyx mori cell line BmN4 which is an increasingly used tool for the analysis of piRNA biogenesis and function. Using this approach we provide the exact coding sequence and evidence for more than 6200 genes on the protein level. Furthermore using spatial proteomics, we establish the subcellular localization of thousands of these proteins. We show that our approach outperforms current Bombyx mori annotation attempts in terms of accuracy and coverage.

Conclusions

We show that proteotranscriptomics is an efficient, cost-effective and accurate approach to improve previous annotations or generate new gene models. As this technique is based on de-novo transcriptome assembly, it provides the possibility to study any species also in the absence of genome sequence information for which proteogenomics would be impossible.
Genome-wide small RNA profiling reveals tiller development in tall fescue (Festuca arundinacea Schreb)
Authors: Hu Tao , Wang Tao , Li Huiying , Wassie Misganaw , Xu Huawei , Chen Liang
Published: October 2020

Background

Tall fescue (Festuca arundinacea Schreb.) is a major cool-season forage and turfgrass species. The low tiller density and size dramatically limits its turf performance and forage yield. MicroRNAs (miRNA)-genes modules play critical roles in tiller development in plants. In this study, a genome-wide small RNA profiling was carried out in two tall fescue genotypes contrasting for tillering production (‘Ch-3’, high tiller production rate and ‘Ch-5’, low tiller production rate) and two types of tissue samples at different tillering development stage (Pre-tillering, grass before tillering; Tillering, grass after tillering). ‘Ch-3’, ‘Ch-5’, Pre-tillering, and Tillering samples were analyzed using high-throughput RNA sequencing.

Results

A total of 222 million high-quality clean reads were generated and 208 miRNAs were discovered, including 148 known miRNAs belonging to 70 families and 60 novel ones. Furthermore, 18 miRNAs were involved in tall fescue tiller development process. Among them, 14 miRNAs displayed increased abundance in both Ch-3 and Tillering plants compared with that in Ch-5 and Pre-tillering plants and were positive with tillering, while another four miRNAs were negative with tiller development. Out of the three miRNAs osa-miR156a, zma-miR528a-3p and osa-miR444b.2, the rest of 15 miRNAs were newfound and associated with tiller development in plants. Based on our previous full-length transcriptome analysis in tall fescue, 28,927 potential target genes were discovered for all identified miRNAs. Most of the 212 target genes of the 18 miRNAs were dominantly enriched into “ubiquitin-mediated proteolysis”, “phagosome”, “fatty acid biosynthesis”, “oxidative phosphorylation”, and “biosynthesis of unsaturated fatty acids” KEGG pathways. In addition, bdi-miR167e-3p targets two kinase proteins EIF2AK4 and IRAK4, and osa-miR397a targets auxin response factor 5, which may be the significant miRNA-genes controllers in tillering development.

Conclusions

This is the first genome-wide miRNA profiles analysis to identify regulators involved in tiller development in cool-season turfgrass. Tillering related 18 miRNAs and their 212 target genes provide novel information for the understanding of the molecular mechanisms of miRNA-genes mediated tiller development in cool-season turfgrass.
Comprehensive analysis of AGPase genes uncovers their potential roles in starch biosynthesis in lotus seed
Authors: Sun Heng , Li Juanjuan , Song Heyun , Yang Dong , Deng Xianbao , Liu Juan , Wang Yunmeng , Ma Junyu , Xiong Yaqian , Liu Yanling , Yang Mei
Published: October 2020

Background

Starch in the lotus seed contains a high proportion of amylose, which endows lotus seed a promising property in the development of hypoglycemic and low-glycemic index functional food. Currently, improving starch content is one of the major goals for seed-lotus breeding. ADP-glucose pyrophosphorylase (AGPase) plays an essential role in regulating starch biosynthesis in plants, but little is known about its characterization in lotus.

Results

We describe the nutritional compositions of lotus seed among 30 varieties with starch as a major component. Comparative transcriptome analysis showed that AGPase genes were differentially expressed in two varieties (CA and JX) with significant different starch content. Seven putative AGPase genes were identified in the lotus genome (Nelumbo nucifera Gaertn.), which could be grouped into two subfamilies. Selective pressure analysis indicated that purifying selection acted as a vital force in the evolution of AGPase genes. Expression analysis revealed that lotus AGPase genes have varying expression patterns, with NnAGPL2a and NnAGPS1a as the most predominantly expressed, especially in seed and rhizome. NnAGPL2a and NnAGPS1a were co-expressed with a number of starch and sucrose metabolism pathway related genes, and their expressions were accompanied by increased AGPase activity and starch content in lotus seed.

Conclusions

Seven AGPase genes were characterized in lotus, with NnAGPL2a and NnAGPS1a, as the key genes involved in starch biosynthesis in lotus seed. These results considerably extend our understanding on lotus AGPase genes and provide theoretical basis for breeding new lotus varieties with high-starch content.
Thrombolysis implementation intervention and clinical outcome: a secondary analysis of a cluster randomized trial
Authors: Hasnain Md Golam , Paul Christine L. , Attia John R. , Ryan Annika , Kerr Erin , Oldmeadow Christopher , D’Este Catherine A. , Bivard Andrew , Hubbard Isobel J. , Milton Abul Hasnat , Levi Christopher R.
Published: October 2020

Background

Multiple studies have attempted to increase the rate of intravenous thrombolysis for ischemic stroke using interventions to promote adherence to guidelines. Still, many of them did not measure individual-level impact. This study aimed to make a posthoc comparison of the clinical outcomes of patients in the “Thrombolysis ImPlementation in Stroke (TIPS)” study, which aimed to improve rates of intravenous thrombolysis in Australia.

Methods

A posthoc analysis was conducted using individual-level patient data. Excellent (Three-month post treatment modified Rankin Score 0–2) and poor clinical outcome (Three-month post treatment modified Rankin Score 5–6) and post treatment parenchymal haematoma were the three main outcomes, and a mixed logistic regression model was used to assess the difference between the intervention and control groups.

Results

There was a non-significant higher odds of having an excellent clinical outcome of 57% (odds ratio: 1.57; 95% CI: 0.73–3.39) and 33% (odds ratio: 1.33; 95% CI: 0.73–2.44) during the active-and post-intervention period respectively, for the intervention compared to the control group. A non-significant lower odds of having a poor clinical outcome was also found in the intervention, relative to control group of 4% (odds ratio: 0.96; 95% CI: 0.56–2.07) and higher odds of having poor outcome of 44% (odds ratio: 1.44 95% CI: 0.61–3.41) during both active and post-intervention period respectively. Similarly, a non-significant lower odds of parenchymal haematoma was also found for the intervention group during the both active- (odds ratio: 0.53; 95% CI: 0.21–1.32) and post-intervention period (odds ratio: 0.96; 95% CI: 0.36–2.52).

Conclusion

The TIPS multi-component implementation approach was not effective in reducing the odds of post-treatment severe disability at 90 days, or post-thrombolysis hemorrhage.

Trial registration

Clinical Trial Registration-URL: http://www.anzctr.org.au/ Unique Identifier: ACTRN12613000939796.
Development and implementation of a Telenephrology dashboard for active surveillance of kidney disease: a quality improvement project
Authors: Swee Melissa L. , Sanders M. Lee , Phisitkul Kantima , Bailey George , Thumann Angie , Neuzil Nikki , Kumar Bharat , O’Shea Amy M. J. , Dixon Bradley S.
Published: October 2020

Background

Kidney disease accounts for more than 49 billion dollars in healthcare expenditures annually. Early detection and intervention may reduce the burden of disease. We describe a quality improvement project to develop a telenephrology dashboard that proactively monitors kidney disease.

Methods

One hundred eighty-four thousands Veterans within the Iowa City Veterans Affairs Health Care System were eligible for telenephrology consultation. The dashboard accessed the charts of 53,085 Veterans at risk for kidney disease. We utilized Lean-Six Sigma tools and principles and the Define-Measure-Analyze-Improve-Control Framework to develop and deploy a telenephrology dashboard in 4 community-based outpatient clinics (CBOCs). The primary measure was the number of days to complete consultation. Secondary measures included number of electronic consultations per month, distance and cost of Veteran travel saved, and number of steps for completion of consult.

Results

The data of 1384 Veterans at the 4 CBOCs were analyzed by the telenephrology dashboard, of which 459 generated telenephrology consults. The number of days to complete any type of consultation was unchanged (48.9 days in 2019, compared to 41.6 days in 2017). The average Veteran saved between $21.60 to $63.90 per trip to Iowa City. Between March 2019 and August 2019, there were 27.3 telenephrology consults per month. The number of steps needed to complete the consult request was decreased from 13 to 9.

Conclusions

Utilization of the telenephrology dashboard system contributed to an increase in consultations completed through electronic means without decreasing face-to-face consults. Electronic consults now outnumber traditional face-to-face consultations at our institution. Telenephrology consultation improved early detection and identification of kidney disease and saved time and costs for Veterans in travel, but did not decrease the average number of days to complete consultation requests.