bluuebunny/crossref_metadata_2025 huggingface dataset:
Fast deep swept volume estimator
Authors: Chiang Hao-Tien Lewis , Baxter John EG , Sugaya Satomi , Yousefi Mohammad R , Faust Aleksandra , Tapia Lydia
Published: August 2020

Despite decades of research on efficient swept volume computation for robotics, computing the exact swept volume is intractable and approximate swept volume algorithms have been computationally prohibitive for applications such as motion and task planning. In this work, we employ deep neural networks (DNNs) for fast swept volume estimation. Since swept volume is a property of robot kinematics, a DNN can be trained off-line once in a supervised manner and deployed in any environment. The trained DNN is fast during on-line swept volume geometry or size inferences. Results show that DNNs can accurately and rapidly estimate swept volumes caused by rotational, translational, and prismatic joint motions. Sampling-based planners using the learned distance are up to five times more efficient and identify paths with smaller swept volumes on simulated and physical robots. Results also show that swept volume geometry estimation with a DNN is over 98.9% accurate and 1,200 times faster than an octree-based swept volume algorithm.
Georg Lukács and Leo Tolstoy
Authors: Heller Agnes , Fengming Deng
Published: August 2020

Tolstoy was a frame of reference in the work of Lukács twice, during 1914–16 and 1935–6 respectively. His first-time encounter with Tolstoy was presented in the chapter of The Theory of the Novel involving both Dostoevsky and Tolstoy, but the former was given more credit and reckoned as the prophet of a new world. It was not until the 1930s that Lukács’ taste changed, and his top priority went to Tolstoy instead. Yet, with due respect to the vicissitudes of his life throughout the 1910s until the 1930s, Lukács remained faithful to his philosophy of history in terms of aesthetic judgment. His preference for the grand artworks was not new as his admiration for Homer showed, but his belief in the resurrection of grand art as realism was rooted in a new and false illusion. Still, his essays on Tolstoy of the 1930s are rich in aesthetic analysis, such as the different aspects of temporality.
In Between the Missing and Murdered: The Need for Indigenous-Led Responses to Trafficking
Authors: Olson-Pitawanakwat Brianna , Baskin Cyndy
Published: August 2020

This article, written by two Indigenous female identifying social work practitioners, academics, and researchers with lived experience of violence, is based on a preliminary research project with survivors of trafficking and those who offer them support services. It includes the voices of women, two-spirit, and trans women who have been trafficked, tackle the issues of the current impacts of colonization and structural racism as the root of gender-based violence, and offer pathways forward at the grassroots and systemic levels. The authors also argue that research into gender-based violence toward Indigenous women, girls, two-spirit, and trans women be controlled and owned by Indigenous peoples and communities.
Feasibility, Acceptance, and Initial Evaluation of a Telephone-Based Program Designed to Increase Socialization in Older Veterans
Authors: Juang Christine , Huh J. W. Terri , Iyer Sowmya , Beaudreau Sherry A. , Gould Christine E.
Published: August 2020

Loneliness is a public health issue, particularly for older Veterans. To increase older Veterans’ access for socialization opportunities, a community-based telephone-delivered activity program was developed, in which Veterans can call in and engage in social activities through telephone. This paper illustrates the feasibility, acceptance, and preliminary outcomes of this program using a mixed-methods design. Thirty-two Veterans enrolled in the program, with 14 attendees who called in to the program at least once. Attendees were more likely to be depressed than those who did not call in at baseline. Program was acceptable with high client satisfaction. Perceived benefits included a structured program with interesting topics to spend time on and the opportunity to socialize, exchange ideas, and connect with other Veterans. Individual challenges (e.g., hearing difficulty) and program-level challenges (e.g., complicated procedures) were reported during qualitative interviews. Among attendees, a significant decrease in loneliness from baseline to 3-months was found but should be interpreted with caution based on the small sample size. While positive findings emerged regarding feasibility, acceptance, preliminary benefits of this program, further refinement is needed to improve future program implementation.
Artificial intelligence approaches to predict coronary stenosis severity using non-invasive fractional flow reserve
Authors: Carson Jason M , Chakshu Neeraj Kavan , Sazonov Igor , Nithiarasu Perumal
Published: August 2020

Fractional flow reserve is the current reference standard in the assessment of the functional impact of a stenosis in coronary heart disease. In this study, three models of artificial intelligence of varying degrees of complexity were compared to fractional flow reserve measurements. The three models are the multivariate polynomial regression, which is a statistical method used primarily for correlation; the feed-forward neural network; and the long short-term memory, which is a type of recurrent neural network that is suited to modelling sequences. The models were initially trained using a virtual patient database that was generated from a validated one-dimensional physics-based model. The feed-forward neural network performed the best for all test cases considered, which were a single vessel case from a virtual patient database, a multi-vessel network from a virtual patient database, and 25 clinically invasive fractional flow reserve measurements from real patients. The feed-forward neural network model achieved around 99% diagnostic accuracy in both tests involving virtual patients, and a respectable 72% diagnostic accuracy when compared to the invasive fractional flow reserve measurements. The multivariate polynomial regression model performed well in the single vessel case, but struggled on network cases as the variation of input features was much larger. The long short-term memory performed well for the single vessel cases, but tended to have a bias towards a positive fractional flow reserve prediction for the virtual multi-vessel case, and for the patient cases. Overall, the feed-forward neural network shows promise in successfully predicting fractional flow reserve in real patients, and could be a viable option if trained using a large enough data set of real patients.
Self-sensing state estimation of switch-controlled energy harvesters
Authors: Hara Yushin , Yamamoto Yuta , Makihara Kanjuro
Published: August 2020

Vibration energy harvesters are expected to become a new source of electrical power. Piezoelectric vibration energy harvesters that employ a piezoelectric transducer, a rectifier, and a storage capacitor are being used widely as electro-mechanical harvesters. Synchronized switch harvesting on inductor enhances harvesting performance due to employing a simple additional circuit and incorporating suitable switch control functionality. Switching is usually based on the displacement of a vibrating structure; hence, sensing the vibrational states is of critical importance. Conventionally, the structural displacement is measured by displacement sensors or accelerometers attached to the target vibrating structure. Although enhancement of performance through synchronized switch harvesting on inductor equipped with sensors is important, the arrangement requirements of sensors have adverse effects on the compactness and usability of the harvesters. This study aimed to eliminate the use of sensors from switch-controlled harvesters. We developed a new state estimation method that uses the piezoelectric transducer’s voltage as an observation value. Using the proposed state estimation method, the modal state values of the vibrating structure can be determined by simply measuring the voltage of the transducer. With the switch device being controlled by the estimated modal state values, no sensors are required for ensuring effective harvesting. A comparison of the harvesting performances by the proposed self-sensing state estimation method and the conventional sensor-equipped state estimation method showed that there is little difference in harvested power between the two methods over a wide range of load resistances. The proposed method is superior to the sensor-equipped method in terms of compactness and usability as it does not require any external sensors.
Are Dental Maturation, Skeletal Maturation, and Chronological Age Associated With Complete Cleft Lip and Palate?
Authors: Ozturk Taner , Gumus Husniye , Ozturk Gulce
Published: August 2020

Objective:

The relationship between dental and skeletal development levels was determined in individuals with cleft lip and palate and a control group comprising individuals without cleft lip and palate.

Design:

Retrospective, cross-sectional study.

Setting:

A university clinic specializing in orthodontic and pedodontic care.

Patients:

A total of 198 patients with cleft lip and palate (99 females, 11.66 ± 2.36 years; 99 males, 12.44 ± 2.33 years) and 198 patients without cleft lip and palate (99 females, 11.88 ± 2.26 years; 99 males, 12.99 ± 2.25 years).

Interventions:

None.

Main Outcome Measures:

The Demirjian method and cervical vertebra maturation method were used to evaluate panoramic and lateral cephalometric radiographs, respectively. The Fishman maturation predictors were determined from hand-wrist radiographs.

Results:

Statistically significant correlations were found between the chronological age and the dental age in both the groups ( P < .05). Significant correlations between skeletal maturation indicators and dental maturation indicators were observed in both groups and sexes ( P < .05), with a stronger correlation among teeth with incomplete dental maturation. Dental age was found to be significantly lower (female, P = .001; male, P = .001) in individuals with cleft lip and palate (female, 11.71 ± 2.58 years; male, 12.51 ± 2.62 years) compared to those in the control group (female, 12.95 ± 2.47 years; male, 13.64 ± 2.37 years).

Conclusions:

A high correlation between the results of the evaluated radiographic methods and chronological age supports their use for accurate age estimation in the patients with cleft lip and palate.
Dynamic analysis of thick beams with functionally graded porous layers and viscoelastic support
Authors: Akbaş Şeref D , Bashiri Abdullateef H , Assie Amr E , Eltaher Mohamed A
Published: August 2020

This study presents dynamic responses of a composite thick beam with a functionally graded porous layer under dynamic sine pulse load. The boundary conditions of the composite beam are considered as viscoelastic supports. Three layers are considered, and face sheet layers have porous functionally graded materials in which the distribution of material gradation through the graded layer is described by the power law function, and the porosity is depicted by three different distributions (i.e., symmetric distribution, X distribution, and ◊ distribution). The layered composite thick beam is modeled as a two-dimensional plane stress problem. The equation of motion is obtained by Lagrange’s equations. In formation of the problem, the finite element method is used with a 12-node 2D plane element. In the solution process of the dynamic problem, a numerical time integration method of the Newmark method is used. In numerical analyses, influences of stiffness and damping coefficients of viscoelastic supports, material gradation index, porosity parameter, and porosity models on the dynamic response of thick functionally graded porous beam are investigated under the pulse load.
Continuation of aspirin therapy before pars plana vitrectomy: Safe or not?
Authors: Wang Jin , Li Qingjian , Zhang Yu , Che Xin , Jiang Jing , Qian Yiwen , Wang Zhiliang
Published: August 2020

Purpose:

To assess the safety of pars plana vitrectomy (PPV) in patients undergoing systemic treatment with aspirin.

Methods:

This prospective study enrolled consecutive patients undergoing PPV under percutaneous retrobulbar anesthesia between February 2016 and July 2018. Sixty-seven eyes from 67 patients on regular aspirin therapy were randomized into two groups: the continuation group (33 eyes), with aspirin continued during the perioperative period; and the discontinuation group (34 eyes), with aspirin discontinued for 3 to 7 days before surgery. Forty-three eyes from 43 patients who had no antiplatelet/anticoagulant therapy were used as a control group.

Results:

There was no significant difference in the incidence of hemorrhagic complications or the need for additional operations due to hemorrhagic complications among the three groups ( p = 0.740 and p = 0.324, respectively). None of the patients in these three groups suffered from thromboembolic events during the follow-up period. Except for one case (3.0%) of lid ecchymosis in the continuation group, no eye experienced bleeding complications associated with the retrobulbar local anesthesia. In the continuation group, three eyes (9.1%) demonstrated postoperative hyphema that resolved spontaneously. In the discontinuation group, two eyes (5.9%) suffered from postoperative vitreous hemorrhage, of which one eye required secondary surgery and the other cleared spontaneously. One eye (2.9%) in the discontinuation group demonstrated postoperative hyphema that absorbed spontaneously. Three eyes (7.0%) in the control group experienced hyphema that absorbed spontaneously.

Conclusion:

The outcomes of our study indicate that PPV under retrobulbar anesthesia can be safely performed without discontinuing systemic aspirin therapy.
Extreme corneal flattening following collagen crosslinking for progressive keratoconus
Authors: Padmanabhan Prema , Belin Michael W , Padmanaban Vasanthi , Sudhir Rachapalle Reddi
Published: August 2020

Purpose:

To study the clinical, tomographic and densitometric features of eyes that showed >5 D of corneal flattening following collagen crosslinking (CXL) for progressive keratoconus and to identify preoperative predictive factors for such a response.

Methods:

This was a retrospective case control study of 548 eyes with progressive keratoconus which had undergone epithelium-off CXL (Dresden protocol) with a follow-up of 1 to 10 years. Eyes that showed ⩾5 D corneal flattening in maximum keratometry (Kmax) following CXL (group A) were compared with one eye of the remaining patients in the same cohort (group B). Changes in refraction and visual acuity, Kmax and thinnest pachymetry were compared between both groups. Univariate and multivariate regression analysis identified preoperative risk factors for unusual corneal flattening.

Results:

Forty three eyes in group A were compared with 502 eyes in group B. At the time of maximum flattening, group A showed more flattening (−7.6 ± 3.2 D) and thinning (−53.7 ± 45.2 µ) than group B (−1.69 ± 2.9 D and −26.6 ± 36.7 µ, respectively). Multivariate analysis based on parameters suggested by a univariate regression analysis identified pre-op Kmax to be the most significant predictor of intense corneal flattening. A subgroup analysis of K-matched eyes revealed that the duration of time following CXL was a significant risk factor for extreme corneal flattening following CXL

Conclusion:

An intense corneal flattening >5 D in Kmax was documented in 7.85% of a cohort of keratoconus patients who underwent CXL. High preoperative Kmax and the duration of time following CXL were significant predictors of this response which was accompanied by significant corneal thinning.
Brachio-brachial arteriovenous fistula combined with superficialization of the brachial artery using a short skin incision for hemodialysis
Authors: Takashima Tsuyoshi , Nakashima Yui , Suenaga Atsuhiko , Yamashita Yuki , Nonaka Yasunori , Fukuda Makoto , Rikitake Shuichi , Miyazono Motoaki , Rikitake Kazuhisa , Ikeda Yuji
Published: August 2020

A brachio-brachial arteriovenous fistula with superficialization of the brachial vein and superficialization of the brachial artery are useful vascular access techniques for hemodialysis patients. However, both typically require a long skin incision from the antecubital fossa toward the axillary fossa. In addition, the brachio-brachial arteriovenous fistula in particular, which is created with not a one-stage but a two-stage procedure, requires a relatively long time of 2–3 months before it can be used for hemodialysis. Furthermore, superficialization of the brachial artery usually requires nonarterialized superficial veins for blood return. In cases where patients have no adequate superficial veins for creating an arteriovenous fistula, we have adopted a one-stage operative technique to create a brachio-brachial arteriovenous fistula with superficialization of not only the brachial vein but also the brachial artery using a short skin incision. This technique of a brachio-brachial arteriovenous fistula with superficialization of the brachial artery has several advantages over traditional approaches, including a minimally invasive procedure and early use for vascular access. To our knowledge, the presently described technique and the related data have not been previously reported in the English literature. We herein report the steps of this technique and the midterm follow-up outcomes.
Approach to Chilblains During the COVID-19 Pandemic
Authors: Ladha Malika A. , Luca Nadia , Constantinescu Cora , Naert Karen , Ramien Michele L.
Published: August 2020

Coronavirus disease (COVID-19) chilblains is a well-reported cutaneous pattern of severe acute respiratory syndrome coronavirus (SARS-CoV-2). Through this narrative review, we provide an evidence-based overview of idiopathic and secondary chilblains, distinguishing features of COVID-19 chilblains, and a systematic clinical approach to history, examination, investigations, and treatment. In the absence of cold or damp exposure, COVID-19 should be considered as a cause of acute chilblains. The timing of onset of COVID-19 chilblains relative to active SARS-CoV-2 viremia remains unclear. Patients with suspected COVID-19 chilblains should thus follow public health guidelines for COVID-19 testing and self-isolation.
The value in de-emphasizing structure in liquidity
Authors: Eckhardt Giana M. , Bardhi Fleura
Published: August 2020

In the set of commentaries on liquidity entitled “The continuing significance of social structure in liquid modernity,” three sets of authors set out to examine the relationship between liquidity and structure, value, and distinction. In doing so, they attempt to marry theories which argue against sociologist Zygmunt Bauman’s central thesis that societal structures are shifting with his seminal construct of liquidity, an exercise that has mixed results. All three sets of authors have engaged with Bauman’s conceptualization of liquid modernity as well as our conceptualization of liquid consumption and its consequences. In this response to the commentaries, we clarify how we understand Bauman and how we have used his ideas in our theorizing, engage with the three sets of author’s advocacy for emphasizing the continuing relevance of structure within liquidity, and, finally, sum up how de-emphasizing structure has and can continue to lead to important new insights in marketing theory.
Study on ship operation performance in actual seaways using time-domain free-running simulation
Authors: Lee Jae-Hoon , Kim Yonghwan
Published: August 2020

This study considers the evaluation of ship operational performance in real sea states using a time-domain approach. The current seakeeping-maneuvering coupling approach consists of two modules. First, in the seakeeping module, the time-domain three-dimensional Rankine panel method is applied to compute wave-induced forces and resultant ship motion. To validate this module, the computational results for wave drift force are compared with the existing experimental data for various forward speeds and regular wave conditions. Second, in the maneuvering module, the equations of motion with 4 degrees of freedom that are based on the Maneuvering Modeling Group are solved to simulate the ship navigation. The computed seakeeping and maneuvering values are immediately transferred between the two modules in the time domain, and so they are directly integrated. By applying this coupling method, a free-running simulation for a ship navigating along a given route is performed. The trajectory tracking method based on a proportional–derivative-based rudder control is adopted for straight course-keeping. Not only the speed loss but also the attitude for route maintenance is evaluated for various environmental load conditions. The simulation results are validated by a comparison with those of the existing free-running model test. Based on comparisons, environmental load effects and resultant quantities on operational performance are discussed.
Experimental modeling of the interaction between waves and submerged flexible mound breakwaters
Authors: Jafarzadeh Elham , Kabiri-Samani Abdorreza , Mansourzadeh Shahriar , Bohluly Asghar
Published: August 2020

A submerged flexible mound breakwater can be employed for wave control in shallow water as an advanced alternative to the conventional rigid submerged designs. This study presents a flexible breakwater with an innovative geometry based on model experimentation. Experimental studies were performed to compare the wave energy dissipation by the flexible mound and rigid structures, over a range of test conditions, for example, three different diameters of structure, three water depths, and different regular wave heights for three different beach slopes. Results indicate that the present submerged flexible mound breakwater is stable, being appropriate for most operational sea conditions. Large amplitude waves can induce significant motions of the structure; therefore, the interaction between radiating and scattering waves is highly contributing to the wave energy dissipation. The wave energy dissipation at breaking zone of the present submerged flexible mound breakwater is significantly greater than that of the other types of flexible and rigid formerly investigated structures.
Are early childhood educators in Southern Ontario being sufficiently prepared for teaching Indigenous students?
Authors: Lamb Iris
Published: August 2020

Research highlights the importance of inclusive and culturally responsive teaching. This study sought to understand to what extent Early Childhood Educators (ECEs) in Southern Ontario, upon graduation from their pre-service programmes, feel they are prepared for teaching Indigenous students and supporting Indigenous families in an inclusive, culturally relevant environment. The study took a pragmatist, two-phase approach which consisted of a document review of Ontario Early Childhood Education college programmes, followed by an online survey in which recently graduated Early Childhood Educators were asked about their college experiences regarding education in Indigenous Studies. Of the 23 examined colleges, only 1, or 4.34 per cent, offered a mandatory course in Indigenous Studies, and of the 34 surveyed Early Childhood Educators, only 8.82 per cent indicated they felt that their pre-service training sufficiently prepared them for teaching Indigenous students. Consequently, there appears to be a gap in Early Childhood Education pre-service training regarding Indigenous awareness and education. This study recommends that more research be conducted in this specific area, as the sample size for both phases of this study was small, and the apparent correlation does not equal causation; nevertheless, the resulting data from this study are alarming and provide an impetus for further research.
Making Knowledge Hereditary: Public–Private Partnership Drives Progress in Rare Disease Community
Authors: Mulally Amanda , Bias Val , Konkle Barbara , Watson Crystal , Yellen Ilana , Maxwell Allison
Published: August 2020

Background:

Hemophilia is a rare and complex inherited bleeding disorder in which people may experience prolonged, painful, and debilitating bleeds due to an inability of their blood to clot properly. Although there has been great progress in the management of the disease over the past 50+ years, many important scientific questions have gone unanswered. Further, despite decades-long interest and desire by medical providers and scientists, the U.S. government and the hemophilia community to conduct comprehensive genetic testing to better understand the disorder, challenges such as cost, access, and privacy concerns served as ongoing obstacles.

Focus of the Article:

To overcome these challenges and address this unmet need, four community organizations and a health communications and social marketing agency came together in 2011 to create a first-of-its kind public–private partnership (PPP) called My Life, Our Future (MLOF) to provide people with hemophilia information about their disorder while also furthering scientific understanding.

Importance to the Social Marketing Field:

This article will explain how MLOF utilized social marketing to drive broad community engagement, ultimately genotyping more than one third of the U.S. male hemophilia population through the program and opening the MLOF Research Repository, the largest research repository of its kind. It will also discuss the key learnings gleaned through the establishment and implementation of this program, notably the strength of a PPP in health care.
ALDH3B1 Is an Independent Prognostic Biomarker of Lung Adenocarcinoma
Authors: Sun Hongmei , Zhang Mingying , Li Li , Huang Zongwen
Published: August 2020

Background:

Lung cancer is the leading cause of cancer-related death, and adenocarcinoma is the most common type of lung cancer. Although emerging evidence implicates the role of several aldehyde dehydrogenases in cancer progression, the expression and clinical significance of aldehyde dehydrogenase 3B1 in lung adenocarcinoma has never been studied.

Materials:

In our study, the expression of aldehyde dehydrogenase 3B1 in 250 cases of lung adenocarcinoma was detected with immunohistochemistry, and the patients were further divided into subgroups with different aldehyde dehydrogenase 3B1 expression. Using real-time polymerase chain reaction, we investigated the aldehyde dehydrogenase 3B1 messenger RNA in 20 lung adenocarcinoma and paired normal lung tissues. With the χ2 test, we evaluated the clinical significance of aldehyde dehydrogenase 3B1 by analyzing its correlation with the clinicopathological factors. Propensity score matching was performed to balance the baseline of cohort. With univariate and multivariate analyses, we screened the prognostic factors of lung adenocarcinoma and identified the independent prognostic factors before and after the propensity score matching.

Results:

Aldehyde dehydrogenase 3B1 expression was significantly associated with the sex and age of patients, tumor size, and histological grade. High expression of aldehyde dehydrogenase 3B1 predicted the poor prognosis ( P = .003). Moreover, male patients ( P = .020), large tumor size ( P = .009), advanced T stage ( P = .001), positive lymphatic invasion ( P < .001), and advanced tumor–node–metastasis stage ( P < .001) were all the prognostic factors for unfavorable outcome. Aldehyde dehydrogenase 3B1 was an independent prognostic biomarker of lung adenocarcinoma, indicating the poor prognosis. In addition, after balancing the baseline characteristics by propensity score matching, we also demonstrated that aldehyde dehydrogenase 3B1 was an independent prognostic biomarker of lung adenocarcinoma ( P = .007).

Conclusions:

Aldehyde dehydrogenase 3B1 was an independent prognostic biomarker of lung adenocarcinoma, indicating the unfavorable prognosis. Postoperative detection of aldehyde dehydrogenase 3B1 would help stratify the high-risk patients with lung adenocarcinoma and guide individual treatment.
Type II Endoleaks After EVAR: A Literature Review of Current Concepts
Authors: Gonzalez-Urquijo Mauricio , Lozano-Balderas Gerardo , Fabiani Mario Alejandro
Published: August 2020

Endoleak is the most frequent complication following endovascular aneurysm repair, which is not present in the surgical counterpart. The most frequent type of endoleak corresponds to type II, and its natural history remains poorly understood. Therefore, their treatment continues to be a topic of debate. The vast majority of the studies found in the literature are of a retrospective nature, and there are no prospective studies comparing intervention versus a conservative approach. Future studies should aim to compare not only different approaches to resolve type II endoleak but also when should be the right time to treat them, with the primary purpose of avoiding sac rupture. The objective of this review is to provide the reader with a literature overview about type II endoleaks to help in the decision-making process on this topic.
Gaming When Things Get Tough? Examining How Emotion Regulation and Coping Self-Efficacy Influence Gaming During Difficult Life Situations
Authors: Caro Camila , Popovac Maša
Published: August 2020

Research suggests that gaming can play an important role in dealing with life difficulties, but few studies have examined this directly. Building on recent research, the current study set out to develop a measure of gaming in difficult life situations (GDLS) and explored the role of emotion regulation and coping self-efficacy as predictors of this behaviour. A total of 667 gamers completed the online survey. Initial analyses demonstrated validity and reliability of the GDLS scale (α = .92), with players turning to gaming as a distraction from life difficulties, to feel a sense of achievement, to connect with others, and for in-game connection and simulation. Multiple regression analysis showed that younger age, more time spent gaming in general, and lower coping self-efficacy predicted GDLS, but emotion regulation was non-significant. The study presents novel insights and a new measure for future research in this area.
Phyllathin From Phyllanthus Amarus Ameliorates Epileptic Convulsion and Kindling Associated Post-Ictal Depression in Mice via Inhibition of NF-κB/TLR-4 Pathway
Authors: Tao Zhang , Chun-Yan Hu , Hua Peng , Bin-Bin Yang , Xiaoping Tang
Published: August 2020

Background:

Epilepsy is a chronic, complex, unprovoked, and recurrent disorder of the nervous system that affected several people worldwide. Phyllanthus amarus (PA) has been documented to have neuroprotective potential.

Aim:

To evaluate the potential of standardized extract of PA and its possible mechanism of action against the Pentylenetetrazol (PTZ)-induced convulsion and kindling associated post-ictal depression in experimental mice.

Materials and Methods:

Phyllathin was isolated from methanolic extract of PA and well-characterized using HPTLC, ESI-MS/MS, and LC/MS. Phyllathin containing a standardized extract of PA (50, 100, and 200 mg/kg) was administered in convulsed and kindled mice, followed by an assessment of various parameters.

Results:

The spectral analysis confirmed the molecular formula and weight of phyllanthin as C24H34O6 and 418.2342 Da. PA (100 and 200 mg/kg) significantly ameliorated PTZ-induced ( p < 0.05) duration, onset of tonic-clonic convulsion, and mortality in mice. It also significantly attenuated ( p < 0.05) PTZ-induced kindling in mice. Alteration in brain GABA, dopamine, and glutamate, Na+K+ATPase, Ca+2-ATPase activities, and oxido-nitrosative stress in kindled mice was significantly restored ( p < 0.05) by PA treatment. It also significantly ( p < 0.05) down-regulated brain mRNA expressions of NF-κB, TNF-α, IL-1β, COX-2, and TLR-4. Histological aberrations induced by PTZ in the brain of a kindled rat was significantly ( p < 0.05) ameliorated by PA.

Conclusion:

Phyllanthin containing a standardized extract of PA exerts its antiepileptic potential via balancing excitatory (glutamate) and inhibitory (GABA) brain monoamines, voltage-gated ion channels (Na+K+/Ca+2-ATPase) and inhibition of NF-κB/TLR-4 pathway to ameliorate neuroinflammation (TNF-α, IL-1β, and COX-2) in experimental mice.
Induction of Erythrocyte Shrinkage by Omeprazole
Authors: Naveed Ayesha , Jilani Kashif , Siddique Abu Bakar , Akbar Muhammad , Riaz Muhammad , Mushtaq Zahid , Sikandar Muhammad , Ilyas Sajida , Bibi Ismat , Asghar Asma , Rasool Ghulam , Irfan Muhammad
Published: August 2020

Omeprazole, a proton pump inhibitor blocks the H+/K+-ATPase channels of gastric parietal cells. It is used for the treatment of peptic ulcer. Prolonged use of omeprazole may involve in inducing anemia. The key marker of eryptosis includes membrane blebbing, cell shrinkage and phosphatidylserine (PS) exposure at the cell surface. In current study, the eryptotic, oxidative as well as hemolytic effects of therapeutical doses (0.5, 1 and 1.5 µM) of omeprazole were investigated after exposing erythrocytes for 48 hours. Investigation of eryptosis was done by cell size measurement, PS exposure determination and calcium channel inhibition. As a possible mechanism of omeprazole induced eryptosis, oxidative stress was investigated by determining the catalase, glutathione peroxidase and superoxide dismutase activities. Similarly, necrotic effect of omeprazole on erythrocytes was also evaluated through hemolysis measurement. Results of our study illustrated that 1.5 µM of omeprazole may induce significant decrease in superoxide dismutase, glutathione peroxidase and catalase activities as well as triggered the erythrocytes shrinkage, PS exposure and hemolysis. Role of calcium was also confirmed in inducing erythrocyte shrinkage. It is concluded that the exposure of erythrocytes with 1.5 µM omeprazole may enhance the rate of eryptosis and hemolysis by inducing oxidative stress.
Differential functional connectivity in thalamic and dopaminergic pathways in restless legs syndrome: a meta-analysis
Authors: Kocar Thomas Derya , Müller Hans-Peter , Kassubek Jan
Published: August 2020

Objective:

Restless legs syndrome (RLS) is a sensorimotor disorder with alterations in somatosensory processing in association with a dysfunctional cerebral network, involving the basal ganglia, limbic network, and sensorimotor pathways. Resting state functional magnetic resonance imaging (MRI) is a powerful tool to provide in vivo insight into functional processing and as such is of special interest in RLS considering the widespread pattern of networks involved in this disorder. In this meta-analysis of resting state functional MRI studies, we analyzed the preponderance of functional connectivity changes associated with RLS and discussed possible links to sensorimotor dysfunction and somatosensory processing.

Methods:

A systematic research using the online library PubMed was conducted and a total of seven studies passed the inclusion criteria of the meta-analysis. The results of these studies were merged and a statistical probability map was generated that indicated the likelihood of functional connectivity changes within the combined cohort, both for increased and decreased connectivity.

Results:

The meta-analysis demonstrated decreased functional connectivity within the dopaminergic network in participants with RLS compared with healthy controls, including the nigrostriatal, mesolimbic, and mesocortical pathways. Increased functional connectivity was observed bilaterally in the thalamus, including its ventral lateral, ventral anterior, and ventral posterior lateral nuclei, and the pulvinar.

Discussion:

Sensorimotor dysfunction in RLS seems to be reflected by decreased functional connectivity within the dopaminergic pathways. Network extension in the thalamus can be regarded as an adaptation to somatosensory dysfunction in RLS. This differential functional connectivity pattern extends prior findings on cerebral somatosensory processing in RLS and offers an explanation for the efficacy of dopaminergic treatment.
Pseudotumor Cerebri Syndrome Complicated by Diffuse Ophthalmoparesis and Polyradiculopathy
Authors: Nathan Cody , O’Kula Susanna , Bausell Rebecca , Hamedani Ali
Published: August 2020

Pseudotumor cerebri syndrome (PTCS), also known as idiopathic intracranial hypertension (IIH), is defined by elevated intracranial pressure in the absence of a structural or cerebrospinal fluid (CSF) abnormality. Typical features include headache, visual symptoms, and pulsatile tinnitus. Cranial nerve deficits are seen in a minority of cases, most often sixth nerve palsies. We present a unique cause of PTCS complicated by diffuse ophthalmoparesis and polyradiculopathy. A 27-year-old healthy woman presented with 2 weeks of blurry vision, diplopia, and facial and arm weakness. On examination, she had decreased visual acuity, markedly constricted visual fields in both eyes, with severe bilateral optic disc edema on fundus examination. There was diffuse ophthalmoparesis, right upper and lower facial weakness, and bilateral arm weakness. Magnetic resonance imaging brain revealed optic disc protrusion and a partially empty sella but no other abnormalities. Electromyogram (EMG) was consistent with bilateral C5-6 radiculopathies. Lumbar puncture revealed an opening pressure of 56 cm H2O with otherwise normal CSF constituents. She was treated with high-dose acetazolamide and methylprednisolone followed by optic nerve sheath fenestration. Due to progressive vision loss, she ultimately required ventriculoperitoneal shunting, after which her papilledema, ophthalmoparesis, and facial and arm weakness rapidly improved. This is a unique case of PTCS associated with diffuse ophthalmoparesis and polyradiculopathy. This constellation of abnormalities usually suggests an underlying inflammatory process in the subarachnoid space. However, once this has been excluded, the possibility of PTCS should be considered as early treatment can result in rapid reversal of symptoms and preserve visual function.
The Selective Communication of Political Information
Authors: Ekstrom Pierce D. , Lai Calvin K.
Published: August 2020

People seek out and interpret political information in self-serving ways. In four experiments, we show that people are similarly self-serving in the political information they share with others. Participants learned about positive and negative effects of increasing the minimum wage (in Studies 1–3) or of banning assault weapons (Study 4). They then indicated how likely they would be to mention each effect to close others. Participants were more inclined to share information that was consistent with their political orientation than information that was not. This effect persisted even when participants believed the information, suggesting that selective communication is not just a reflection of motivated skepticism. We also observed ideological differences. Liberals were most biased with their political opponents, whereas conservatives were most biased with their political allies. This biased information sharing could distort the flow of political information through social networks in ways that exacerbate political polarization.
Calcaneoplasty coupled with an insertional Achilles tendon reattachment procedure for the prevention of secondary calcaneal impingement: a retrospective study
Authors: Pi Yanbin , Hu Yuelin , Guo Qinwei , Jiang Dong , Xie Xin , Zhao Feng , Chen Linxin , Ao Yingfang , Jiao Chen
Published: August 2020

Background:

Posterior heel pain may occur after an Achilles insertional rupture reattachment procedure and could be attributed to an impingement between the calcaneal tuberosity and Achilles tendon, which could be observed using postoperative magnetic resonance imaging (MRI). Moreover, such impingement, which may be associated with postoperative pain symptoms, could be relieved by calcaneoplasty.

Methods:

Postoperative Visual Analog Pain Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, Foot Function Index (FFI), Ankle Activity Score (AAS), and Tegner score were obtained and compared between 10 patients who underwent calcaneoplasty (calcaneoplasty group) and 11 patients who did not receive calcaneoplasty (non-calcaneoplasty group). Several signs of calcaneal tuberosity impingement identified in MRI were also compared between the two groups, which included retrocalcaneal bursitis, postoperative tendinopathy, tendon calcification, bone marrow edema, increased Achilles tendon diameter, and bony spurs.

Results:

The VAS score was 2.00 ± 1.41 and 2.18 ± 1.83 ( p = 0.803), the AOFAS score was 90.60 ± 4.22 and 81.82 ± 7.77 ( p = 0.005), the FFI was 5.00 ± 2.86 and 17.18 ± 15.92 ( p = 0.028), the AAS was 5.50 ± 2.55 and 5.82 ± 2.04 ( p = 0.750), and the Tegner score was 4.30 ± 1.49 and 4.45 ± 1.21 ( p = 0.797) in the calcaneoplasty and non-calcaneoplasty groups, respectively. The AOFAS score and FFI were significantly different between the groups. MRI findings revealed that the non-calcaneoplasty group had significant signs of calcaneal impingement compared with the calcaneoplasty group.

Conclusions:

Secondary calcaneal impingement due to insertional tendon enlargement may occur, and prophylactic calcaneoplasty coupled with an insertional reattachment procedure could achieve promising postoperative outcomes for patients with insertional Achilles tendon rupture.
The Effect of Irreducible Dislocation on Functional Outcomes in Knees With Multiligament Injuries: A Matched-Cohort Analysis
Authors: Zhang Zhong , Zhang Kai-Bo , Mao Bei-Ni , Lai Si-Ke , Li Jian , Fu Wei-Li
Published: August 2020

Background:

Most cases of bicruciate knee dislocation (KD) with associated posteromedial disruption (KD-IIIM) are reducible, but some cannot be reduced by closed reduction because of soft tissue incarceration.

Purpose:

To compare the clinical characteristics and functional outcomes of KD-IIIM injuries in patients with or without incarceration of soft tissue requiring open or arthroscopic reduction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This retrospective cohort study of patients with KD was conducted between January 2013 and December 2017 at a single large institution. We applied a 1:2 matching ratio between patients with irreducible KD-IIIM injuries (irreducible group; n = 14) and those with reducible KD-IIIM injuries (control group; n = 28). There were 13 patients in the irreducible group and 25 in the control group who completed follow-up (≥2 years) and were included in our analysis. The efficacy of treatment in patients with KD was evaluated based on range of motion, the Tegner score, the Lysholm score, and the International Knee Documentation Committee (IKDC) score.

Results:

At the end of follow-up, the mean Tegner score was 4.5 (range, 4-6), the mean Lysholm score was 79.2 (range, 60-95), and the mean IKDC score was 78.6 (range, 60.9-95.4) in the irreducible group. The respective results in the control group were 4.6 (range, 3-8), 83.1 (range, 39-100), and 80.6 (range, 42.5-96.6). These scores did not differ significantly between the 2 groups. Similarly, mean range of motion was similar between groups (irreducible, 118.1°; control, 124.8°). In the irreducible group, the acute subgroup showed significantly higher Lysholm and IKDC scores than the chronic subgroup, while the acute and chronic subgroups in the control group showed no significant differences in these respective outcome scores.

Conclusion:

In the present study, the treatment of irreducible KD led to similar functional outcomes compared with reducible KD. However, the treatment of chronic irreducible KD led to worse outcomes compared with acute irreducible KD, and therefore, urgent reduction is recommended in these patients.
Feasibility and clinical impact of out-of-ICU noninvasive respiratory support in patients with COVID-19-related pneumonia
Authors: Franco Cosimo , Facciolongo Nicola , Tonelli Roberto , Dongilli Roberto , Vianello Andrea , Pisani Lara , Scala Raffaele , Malerba Mario , Carlucci Annalisa , Negri Emanuele Alberto , Spoladore Greta , Arcaro Giovanna , Tillio Paolo Amedeo , Lastoria Cinzia , Schifino Gioachino , Tabbì Luca , Guidelli Luca , Guaraldi Giovanni , Ranieri V. Marco , Clini Enrico , Nava Stefano
Published: August 2020

Introduction

The severe acute respiratory syndrome-coronavirus 2 outbreak spread rapidly in Italy and the lack of intensive care unit (ICU) beds soon became evident, forcing the application of noninvasive respiratory support (NRS) outside the ICU, raising concerns over staff contamination. We aimed to analyse the safety of the hospital staff and the feasibility and outcomes of NRS applied to patients outside the ICU.

Methods

In this observational study, data from 670 consecutive patients with confirmed coronavirus disease 2019 referred to pulmonology units in nine hospitals between March 1 and May 10, 2020 were analysed. Data collected included medication, mode and usage of NRS (i.e.high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), noninvasive ventilation (NIV)), length of stay in hospital, endotracheal intubation (ETI) and deaths.

Results

42 (11.1%) healthcare workers tested positive for infection, but only three of them required hospitalisation. Data are reported for all patients (69.3% male), whose mean±sdage was 68±13 years. The arterial oxygen tension/inspiratory oxygen fraction ratio at baseline was 152±79, and the majority (49.3%) of patients were treated with CPAP. The overall unadjusted 30-day mortality rate was 26.9%, with 16%, 30% and 30% for HFNC, CPAP and NIV, respectively, while the total ETI rate was 27%, with 29%, 25% and 28%, respectively; the relative probability of death was not related to the NRS used after adjustment for confounders. ETI and length of stay were not different among the groups. Mortality rate increased with age and comorbidity class progression.

Conclusions

The application of NRS outside the ICU is feasible and associated with favourable outcomes. Nonetheless, it was associated with a risk of staff contamination.
Correction of CFTR function in intestinal organoids to guide treatment of cystic fibrosis
Authors: Ramalho Anabela S. , Fürstová Eva , Vonk Annelotte M. , Ferrante Marc , Verfaillie Catherine , Dupont Lieven , Boon Mieke , Proesmans Marijke , Beekman Jeffrey M. , Sarouk Ifat , Vazquez Cordero Carlos , Vermeulen Francois , De Boeck Kris
Published: August 2020

Rationale

Given the vast number of cystic fibrosis transmembrane conductance regulator (CFTR) mutations, biomarkers predicting benefit from CFTR modulator therapies are needed for subjects with cystic fibrosis (CF).

Objectives

To study CFTR function in organoids of subjects with common and rareCFTRmutations and evaluate correlations between CFTR function and clinical data.

Methods

Intestinal organoids were grown from rectal biopsies in a cohort of 97 subjects with CF. Residual CFTR function was measured by quantifying organoid swelling induced by forskolin and response to modulators by quantifying organoid swelling induced by CFTR correctors, potentiator and their combination. Organoid data were correlated with clinical data from the literature.

Results

Across 28 genotypes, residual CFTR function correlated (r2=0.87) with sweat chloride values. When studying the same genotypes, CFTR function rescue by CFTR modulators in organoids correlated tightly with mean improvement in lung function (r2=0.90) and sweat chloride (r2=0.95) reported in clinical trials. We identified candidate genotypes for modulator therapy, such as E92K, Q237E, R334W and L159S. Based on organoid results, two subjects started modulator treatment: one homozygous for complex allele Q359K_T360K, and the second with mutation E60K. Both subjects had major clinical benefit.

Conclusions

Measurements of residual CFTR function and rescue of function by CFTR modulators in intestinal organoids correlate closely with clinical data. Our results for reference genotypes concur with previous results. CFTR function measured in organoids can be used to guide precision medicine in patients with CF, positioning organoids as a potentialin vitromodel to bring treatment to patients carrying rareCFTRmutations.