bluuebunny/crossref_metadata_2025 huggingface dataset:
Acquired haemophilia a secondary to multiple myeloma: management of a patient with a mechanical mitral valve
Authors: Pinchover Lisa B , Alsharif Rami , Bernal Talia
Published: September 2020

A 77-year-old man with a mechanical mitral valve on warfarin presented with an acute drop in haemoglobin and large spontaneous haematoma. He was found to have a new coagulopathy with initial labs notable for a prolonged activated partial thromboplastin time (APTT). Further workup revealed factor VIII levels less than 1%, abnormal mixing studies and elevated Bethesda titres, which was consistent with an acquired factor VIII inhibitor. Given his bone marrow biopsy result, which was positive for plasma cell myeloma, this coagulopathy was thought to be an acquired haemophilia A secondary to multiple myeloma. Anticoagulation was a challenge in this patient given his mechanical mitral valve and acquired haemophilia A. Although the patient was at risk of thrombosis due to a mechanical mitral valve, he had a bleeding diathesis and anaemia not responsive to transfusion. The decision was made to hold anticoagulation and the patient was started on myeloma treatment which included CyBorD, rituximab and daratumumab. After initiation of treatment APTT and factor VIII normalised. He eventually restarted anticoagulation under direction of his primary care doctor.
Fourth branchial pouch anomaly presenting as a neonatal neck lump
Authors: Reading Jacob , Nash Robert , Hartley Benjamin
Published: September 2020

A 1-week-old female infant presented with a transilluminating neck lump that increased in size with crying. The presumptive diagnosis was lymphatic malformation, but imaging raised the possibility of an abscess or necrotic tumour. A biopsy revealed a likely developmental cyst with local inflammatory change. Microlaryngoscopy revealed a fourth branchial pouch sinus, which was cauterised. The sinus and neck lump resolved without need for further treatment.
Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI
Authors: Cooke Jonathan , Llor Carl , Hopstaken Rogier , Dryden Matthew , Butler Christopher
Published: September 2020

Antimicrobial resistance (AMR) continues to be a global problem and continues to be addressed through national strategies to improve diagnostics, develop new antimicrobials and promote antimicrobial stewardship. Patients who attend general (ambulatory) practice with symptoms of respiratory tract infections (RTIs) are invariably assessed by some sort of clinical decision rule (CDR). However, CDRs rely on a cluster of non-specific clinical observations. A narrative review of the literature was undertaken to ascertain the value of C reactive protein (CRP) point-of-care testing (POCT) to guide antibacterial prescribing in adult patients presenting to general practitioner (GP) practices with symptoms of RTI. Studies that were included were Cochrane reviews, systematic reviews, randomised controlled trials, cluster randomised trials, controlled before and after studies, cohort studies and economic evaluations. An overwhelming number of studies demonstrated that the use of CRP tests in patients presenting with RTI symptoms reduces index antibacterial prescribing. GPs and patients report a good acceptability for a CRP POCT and economic evaluations show cost-effectiveness of CRP POCT over existing RTI management in primary care. POCTs increase diagnostic precision for GPs in the better management of patients with RTI. With the rapid development of artificial intelligence, patients will expect greater precision in diagnosing and managing their illnesses. Adopting systems that markedly reduce antibiotic consumption is a no-brainer for governments that are struggling to address the rise in AMR.
Early conscious prone positioning in patients with COVID-19 receiving continuous positive airway pressure: a retrospective analysis
Authors: Winearls Stuart , Swingwood Ema L , Hardaker Charlotte L , Smith Amy M , Easton Fraser M , Millington Katherine J , Hall Rebecca S , Smith Ann , Curtis Katrina J
Published: September 2020

The global pandemic of COVID-19 has challenged the management of hypoxaemic respiratory failure and strained intensive care unit resources. While prone positioning (PP) is an established therapy in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), its role in conscious patients is less well defined. We retrospectively reviewed our experience of implementing early PP in a cohort of 24 patients with acute hypoxaemic respiratory failure due to COVID-19 who required support with continuous positive airway pressure (CPAP). The use of PP alongside CPAP significantly increased both the ROX index and arterial oxygen pressure:fractional inspired oxygen (PaO2:FiO2) ratio from baseline values (ROX index: 7.0±2.5 baseline vs 11.4±3.7 CPAP+PP, p<0.0001; PaO2:FiO2ratio: 143±73 mm Hg baseline vs 252±87 mm Hg CPAP+PP, p<0.01), and the changes to both the ROX index and PaO2:FiO2ratio remained significant 1 hour after cessation of proning. The mean duration of PP in the first 24 hours was 8±5 hours. Few complications were observed and PP was continued for a mean of 10±5 days. From our experience in a dedicated COVID-19 respiratory high care unit, PP alongside CPAP therapy was feasible, tolerated, safe and improved oxygenation. The use of conscious PP in ARDS warrants further investigation in randomised controlled trials.
Delayed thromboembolic events after coiling of unruptured intracranial aneurysms in a prospective cohort of 335 patients
Authors: Pierot Laurent , Barbe Coralie , Herbreteau Denis , Gauvrit Jean-Yves , Januel Anne-Christine , Bala Fouzi , Ricolfi Frédéric , Desal Hubert , Velasco Stéphane , Aggour Mohamed , Chabert Emmanuel , Sedat Jacques , Trystram Denis , Marnat Gaultier , Gallas Sophie , Rodesch Georges , Clarençon Frédéric , Papagiannaki Chrysanthi , White Phil , Spelle Laurent
Published: September 2020

Background

Coiling is the first-line treatment for the management of unruptured intracranial aneurysms (UIAs), but delayed thromboembolic events (TEEs) can occur after such treatment. ARETA (Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm) is a prospective multicenter study conducted to analyze aneurysm recanalization. We analyzed delayed TEEs in the UIA subgroup.

Methods

Sixteen neurointerventional departments prospectively enrolled patients treated for ruptured and unruptured aneurysms between December 2013 and May 2015. Participant demographics, aneurysm characteristics, and endovascular techniques were recorded. Data were analyzed from participants with UIA treated by coiling or balloon-assisted coiling. We assessed the rates, timing, management, clinical outcomes, and risk factors for delayed TEEs using univariable and multivariable analyses.

Results

The rate of delayed TEEs was 2.4% (95% CI 1.0% to 4.6%) in patients with unruptured aneurysms, with all events occurring in the week following the procedure. In multivariate analysis, two factors were associated with delayed TEEs: autosomal dominant polycystic kidney disease (ADPKD): 20.0% in patients with ADPKD vs 1.9% in patients without ADPKD (OR 27.3 (95% CI 3.9 to 190.2), p=0.0008) and post-procedure aneurysm remnant: 9.4% in patients with post-procedure aneurysm remnant vs 1.6% in patients with adequate occlusion (OR 9.9 (95% CI 1.0 to 51.3), p=0.006). We describe modalities of management as well as clinical outcomes.

Conclusions

Delayed TEE is a relatively rare complication after coiling of UIAs. In this series, all occurred in the week following the initial procedure. Two factors were associated with delayed TEE: ADPKD and aneurysm remnant at procedure completion.

Clinical trial registration

NCT01942512
Surgery for trapeziometacarpal osteoarthritis in relation to cumulative occupational hand force requirements: a Danish nationwide cohort study
Authors: Kirkeby Lone , Svendsen Susanne Wulff , Hansen Torben Bæk , Frost Poul
Published: September 2020

Objectives

To evaluate if higher cumulative occupational hand force requirements are associated with higher risks of surgery for trapeziometacarpal osteoarthritis and with surgery earlier in life.

Methods

The study was based on Danish national registers. Among all persons born in Denmark 1931 to 1990, we included those who had been employed for at least 5 years since 1991 by the end of 2000, or later when this employment criterion was reached, up until the end of 2016. Cumulative exposure estimates for 10-year time windows (force-years) were assessed by combining individual year-by-year information on occupational codes with an expert based hand-arm job exposure matrix. First-time events of surgery for trapeziometacarpal osteoarthritis 2001 to 2017 constituted the outcome. Surgery rates were analysed by a logistic regression technique equivalent to discrete survival analysis using a 1-year lag. We also calculated rate advancement periods.

Results

A total of 2 860 448 persons contributed with around 48 million person-years of follow-up, during which 3977 cases appeared (821 among men and 3156 among women). Compared with <5 force-years, the adjusted OR (ORadj) for ≥5 to <10 force-years was 1.39 (95% CI 1.14 to 1.68) and for ≥10 to 30 force-years 1.47 (95% CI 1.26 to 1.71) among men and 1.64 (95% CI 1.50 to 1.78) and 1.29 (95% CI 1.16 to 1.43) among women. The sex combined ORadjwere 1.59 (95% CI 1.47 to 1.72) and 1.36 (95% CI 1.25 to 1.48). Among the exposed, surgery was advanced by 3 to 7 years.

Conclusion

Medium/high cumulative hand force requirements were associated with elevated hazard rates of surgery for trapeziometacarpal osteoarthritis and advanced the time of surgery by several years.
Changes in outdoor air pollution due to COVID-19 lockdowns differ by pollutant: evidence from Scotland
Authors: Dobson Ruaraidh , Semple Sean
Published: September 2020

Objectives

To examine the impact of COVID-19 lockdown restrictions in March/April 2020 on concentrations of nitrogen dioxide (NO2) and ambient fine particulate matter (PM2.5) air pollution measured at roadside monitors across Scotland by comparing data with previous years.

Methods

Publicly available data of PM2.5concentrations from reference monitoring systems at sites across Scotland were extracted for the 31-day period immediately following the imposition of lockdown rules on 23 March 2020. Similar data for 2017, 2018 and 2019 were gathered for comparison. Mean period values were calculated from the hourly data and logged values compared using pairwise t-tests. Weather effects were corrected using meteorological normalisation.

Results

NO2concentrations were significantly lower in the 2020 lockdown period than in the previous 3 years (p<0.001). Mean outdoor PM2.5concentrations in 2020 were much lower than during the same period in 2019 (p<0.001). However, despite UK motor vehicle journeys reducing by 65%, concentrations in 2020 were within 1 µg/m3of those measured in 2017 (p=0.66) and 2018 (p<0.001), suggesting that traffic-related emissions may not explain variability of PM2.5in outdoor air in Scotland.

Conclusions

The impact of reductions in motor vehicle journeys during COVID-19 lockdown restrictions may not have reduced ambient PM2.5concentrations in some countries. There is also a need for work to better understand how movement restrictions may have impacted personal exposure to air pollutants generated within indoor environments.
Lung ultrasound in the COVID-19 pandemic
Authors: Jackson Karl , Butler Robert , Aujayeb Avinash
Published: September 2020

Lung ultrasound has been described for over a decade and international protocols exist for its application. It is a controversial area among pulmonologists and has had more uptake with emergency as well as intensive care physicians. We discuss the basics and evidence behind the use of lung ultrasound in respiratory failure, and what role we see it playing in the current 2019 novel coronavirus pandemic.
Revisiting the association between worldwide implementation of the MPOWER package and smoking prevalence, 2008–2017
Authors: Husain Muhammad Jami , Datta Biplab Kumar , Nargis Nigar , Iglesias Roberto , Perucic Anne-Marie , Ahluwalia Indu B , Tripp Angela , Fatehin Sohani , Husain Muhammad Mudabbir , Kostova Deliana , Richter Patricia
Published: September 2020

Background

We revisited the association between progress in MPOWER implementation from 2008 to 2016 and smoking prevalence from 2009 to 2017 and offered an in-depth understanding of differential outcomes for various country groups.

Methods

We used data from six rounds of the WHO Reports on the Global Tobacco Epidemic and calculated a composite MPOWER Score for each country in each period. We categorised the countries in four initial conditions based on their tobacco control preparedness measured by MPOWER score in 2008 and smoking burden measured by age-adjusted adult daily smoking prevalence in 2006: (1) High MPOWER – high prevalence (HM-HP). (2) High MPOWER – low prevalence (HM-LP). (3) Low MPOWER – high prevalence (LM-HP). (4) Low MPOWER – low prevalence (LM-LP). We estimated the association of age-adjusted adult daily smoking prevalence with MPOWER Score and cigarette tax rates using two-way fixed-effects panel regression models including both year and country fixed effects.

Results

A unit increase of the MPOWER Score was associated with 0.39 and 0.50 percentage points decrease in adult daily smoking prevalence for HM-HP and HM-LP countries, respectively. When tax rate was controlled for separately from MPOWE, an increase in tax rate showed a negative association with daily smoking prevalence for HM-HP and LM-LP countries, while the MPOWE Score showed a negative association for all initial condition country groups except for LM-LP countries.

Conclusion

A decade after the introduction of the WHO MPOWER package, we observed that the countries with higher initial tobacco control preparedness and higher smoking burden were able to reduce the adult daily smoking prevalence significantly.
NATURAL RESOURCES AND QUALITY OF LIFE: INTERNATIONAL EVIDENCE
Authors: VASKOVSKYI ANTON
Published: September 2020

There has been a growing scholarly interest in the links between natural resources and socio-economic development. While numerous studies offer robust evidence on the detrimental effects of natural resource dependence on economic outcomes, no study has robustly investigated the link between natural resource dependence and quality of life across countries. The aim of this study is to address this gap in the literature by investigating the relationship between natural resource dependency and social progress. Using the cross-country data from 143 countries for the period of 2012 to 2019, we find that resource rents are significantly and negatively linked to the Social Progress Index. Moreover, this effect remains robust even after controlling the potential transmission channels such as governance, economic development and human capital accumulation.
Nimbro-OP2X: Affordable Adult-Sized 3D-Printed Open-Source Humanoid Robot for Research
Authors: Ficht Grzegorz , Farazi Hafez , Rodriguez Diego , Pavlichenko Dmytro , Allgeuer Philipp , Brandenburger André , Behnke Sven
Published: September 2020

For several years, high development and production costs of humanoid robots restricted researchers interested in working in the field. To overcome this problem, several research groups have opted to work with simulated or smaller robots, whose acquisition costs are significantly lower. However, due to scale differences and imperfect simulation replicability, results may not be directly reproducible on real, adult-sized robots. In this paper, we present the NimbRo-OP2X, a capable and affordable adult-sized humanoid platform aiming to significantly lower the entry barrier for humanoid robot research. With a height of 135[Formula: see text]cm and weight of only 19[Formula: see text]kg, the robot can interact in an unmodified, human environment without special safety equipment. Modularity in hardware and software allows this platform enough flexibility to operate in different scenarios and applications with minimal effort. The robot is equipped with an on-board computer with GPU, which enables the implementation of state-of-the-art approaches for object detection and human perception demanded by areas such as manipulation and human–robot interaction. Finally, the capabilities of the NimbRo-OP2X, especially in terms of locomotion stability and visual perception, are evaluated. This includes the performance at RoboCup 2018, where NimbRo-OP2X won all possible awards in the AdultSize class.
THE INFLUENCE OF NETWORK BUILDING ON THE INNOVATIVE WORK BEHAVIOUR OF SELF-MONITORING INDIVIDUALS: INTEGRATING PERSONALITY AND SOCIAL CAPITAL PERSPECTIVES
Authors: NASAJ MOHAMED , BADI SULAFA
Published: September 2020

Network building ability is an important skill that has positive implications for individuals’ innovative work behaviour. Although high self-monitors are capable of building strategic relationships, little is known about how this capability helps these individuals innovate in service organisations, particularly generating, promoting and realising innovative ideas. We proposed that network building ability may act as an important mediator through which self-monitoring links to innovative work behaviour. Using structural equation modelling to analyse 417 completed questionnaires from employees in the United Arab Emirates service sector, we found that high self-monitors were more likely to have high network building abilities, which in turn help support their innovative work behaviour. The evidence suggests that network building ability fully mediates the relationship between self-monitoring and idea generation and idea promotion, while partially mediating the relationship between self-monitoring and idea realisation. We discuss the theoretical contributions and managerial implications of the study.
Dual-Electronic Nanomaterial (Synthetic Clay) for Effective Removal of Toxic Cationic and Oxyanionic Metal Ions from Water
Authors: Nguyen Van Phuong , Nguyen Khanh Thien Tran , Ton Loc That , Nguyen Dong Thanh , Nguyen Khuong Quoc , Vu Mai Thi , Tran Hai Nguyen
Published: September 2020

A synthetic clay (Mg/Al-layered double hydroxides; LDH) was directly synthesized through a simple coprecipitation method under a low-supersaturation condition. The clay was applied to remove metal cations (Cd2+, Cu2+, Pb2+, Ni2+, and Cr3+) and oxyanions (MnO4– and Cr2O72–) from a single aqueous solution. The result demonstrated that LDH exhibited a poor porosity (its specific surface area and total pore volume: 23.2 m2/g and 0.161 cm3/g, respectively) and positively charged surface within solution pH from 3.0 to 12. The X-ray powder diffraction (XRD) data suggested that the basal spacing of LDH was 0.773 nm. The presence of active CO32– anions in the interlayer region of LDH that played an extremely important role in the adsorption process was identified by XRD and Fourier-transform infrared spectroscopy (FTIR). Energy-dispersive X-ray spectroscopy (SEM) analysis indicated that LDH possessed a surface morphology like a plate with a hexagonal shape. The adsorption isotherms of LDH towards various potentially toxic metals were conducted at 1.0 g/L, pHEquilibrium 5.0, 30°C, and 24 h. The Langmuir maximum adsorption capacity of LDH towards the target metals exhibited the following order: 1.299 mmol/g (for Ni2+ adsorption) > 0.880 mmol/g (Cd2+) > 0.701 mmol/g (Cr3+) > 0.657 mmol/g (Pb2+) > 0.601 mmol/g (Cu2+) > 0.589 mmol/g (Cr2O72–) > 0.522 mmol/g MnO4–. The synthetic clay can adsorb both cations and anions in the solution. Therefore, such LDH material can serve as a potential dual-electronic adsorbent for effectively eliminating various oxyanionic and cationic metal ions from water media.
Prediction of the Factors Influencing the Shengjing Classification of Portal Vein Thrombosis after Splenectomy for Portal Hypertension in Cirrhosis: A Single‐Center Retrospective Case‐Control Study
Authors: Song Zimin , Feng Hanxin , Yang Chunbo , Dai Chaoliu
Published: September 2020

Objective. To compare the survival time of patients with portal vein thrombosis after splenectomy for portal hypertension in cirrhosis and explore the influencing factors of the Shengjing classification. Methods. Clinical data of 108 patients with portal vein thrombosis after splenectomy in the department of general surgery of our hospital from November 2011 to December 2018 were selected, and a retrospective analysis was performed. Results. Among 108 patients with postoperative PVST formation, 9 had type Ia, 32 type Ib, 39 type IIa, 20 type IIb, 5 type IIIa, 3 type IIIb, and 0 type IV. Survival analysis showed that the difference in survival time distribution among the Shengjing typing groups was statistically significant (P < 0.05). The higher the classification level, the shorter the survival time and the higher the risk of death. The results of a single‐factor analysis showed that there were statistically significant differences in the PVST Shengjing typing groups between the preoperative group with or without hepatitis, preoperative d‐dimer level, and postoperative day 14 fibrinogen (FIB) level (P < 0.05). Multivariate logistic regression analysis showed that the OR value of higher PVST Shengjing typing in patients with hepatitis was 4.634 times higher than that in patients without hepatitis (95% CI: 1.593‐13.478, χ2 = 7.922, P = 0.005 < 0.05). Preoperative d‐dimer volume increased by 1 μg/L; the OR value of higher grade PVST Shengjing typing was 1.001 times higher (95% CI: 1.000‐1.002) than that of lower grade PVST Shengjing typing (χ2 = 8.369, P = 0.004 < 0.05). Conclusions. The survival time of patients with portal vein system thrombosis after splenectomy was significantly different among Shengjing typing groups, and the higher the classification level, the shorter the survival time and the higher the risk of death. In patients with portal hypertension in cirrhosis and PVST formation after splenectomy, if the preoperative d‐dimer level is high or accompanied by hepatitis virus, the formation of PVST will involve a wide range, the disease is more serious, and the prognosis is also poor, so corresponding preventive measures should be taken to avoid the aggravation of PVST.
Extraskeletal Myxoid Chondrosarcoma: Long-Term Survival in the Setting of Metastatic Disease
Authors: Masrouha Karim , Multani Iqbal , Bhatt Om , Ghert Michelle
Published: September 2020

Three cases of extraskeletal myxoid chondrosarcoma (EMC) in patients who presented with pulmonary metastases and were managed with long-term close observation without systemic intervention are presented. Follow-up imaging showed slow progression of their disease over several years, and the patients remained asymptomatic from their pulmonary metastases. This clinical experience provides insight into the natural history of the disease and suggests that some patients may experience long-term survival and remain asymptomatic even without systemic intervention, thereby improving their quality of life by avoiding potentially debilitating treatments.
Fire Behavior of Continuous Assembled Monolithic Hollow‐Ribbed Slabs
Authors: Li B. , Ren X. Y. , Lin Y. Q. , Liu L. L.
Published: September 2020

To further understand the fire behavior of assembled monolithic hollow‐ribbed (AMH) slab floor, a fire test was performed on six small‐scale continuous AMH slabs (two by three). In this paper, the special designed furnace and relevant experimental phenomena are briefly introduced. Detailed experimental results in the form of furnace temperatures, temperature distributions, vertical deflections, and failure criteria are presented. The test data indicate that almost all the AMH slabs showed upward displacements during the fire tests, which is very distinct with the isolated AMH slab under fire. As the edge girders transformed into the frame girders gradually, the edge girders would show displacement plateaus. The integrity of the AMH slab under elevated temperature should receive more critical role to serve as its failure criterion compared with the load bearing function. Except fire environment, boundary constraint conditions also have a considerable effect on the elevated temperature deformations of the structural elements. At last, several rational suggestions are provided to improve the fire resistance of the AMH slabs.
Overexpression of Ubiquitin-Specific Protease 2 (USP2) in the Heart Suppressed Pressure Overload-Induced Cardiac Remodeling
Authors: Xing Junhui , Li Pengcheng , Hong Jin , Wang Mengyu , Liu Yuzhou , Gao Yueqiao , Dong Jianzeng , Gu Heping , Li Ling
Published: September 2020

Ubiquitin-specific protease 2 (USP2) is an important member of the deubiquitination system. GEO dataset revealed that USP2 was downregulated in the hearts under pressure overload. However, the cardiomyocyte-specific function of USP2 in the setting of pressure overload is unknown. In the current study, a mouse model of pressure overload was induced by transverse aortic constriction (TAC, 2 weeks). Overexpression of USP2 in the heart was conducted by AAV9 infection. Changes in heart histology were detected by Masson’s trichrome staining and hematoxylin-eosin staining (H&E). Echocardiography was used to assess cardiac function. The size of cardiomyocytes was examined by wheat germ agglutinin (WGA) staining. Cardiac oxidative stress was detected by dihydroethidine staining. Our results showed that USP2 was downregulated in the cardiomyocytes following 2 weeks of TAC. Overexpression of cardiac USP2 preserved ventricular function following 2 weeks of TAC. Overexpression of cardiac USP2 inhibited TAC-induced cardiac remodeling, by suppressing cardiac hypertrophy, inhibiting inflammatory responses and fibrosis, and attenuating oxidative stress. Our findings reveal a previously unrecognized role of USP2 in regulating pressure overload-induced cardiac remodeling.
Effectiveness of Propofol versus Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Ear, Nose, and Throat Surgery in Tikur Anbessa Specialized Hospital and Yekatit 12th Hospital, Addis Ababa, Ethiopia
Authors: Tilahun Bantie Abere , Admasu Wosenyeleh , Mulugeta Sintayehu , Bacha Abera Regassa , Getnet Demsie Desalegn
Published: September 2020

Background. Postoperative nausea and vomiting (PONV) remain as common and unpleasant and highly distressful experience following ear, nose, and throat surgery. During ENT surgery, the incidence of PONV could be significantly reduced in patients who receive dexamethasone and propofol as prophylaxis. However, the comparative effectiveness of the two drugs has not been assessed. The aim of this study was to compare the effectiveness of propofol and dexamethasone for prevention of PONV in ear, nose, and throat surgery. Methods. This study was conducted in 80 patients, with ASA I and II, aged 18–65 years, and scheduled for ENT surgery between December 20, 2017, and March 20, 2018. Patients were randomly assigned to Group A and Group B. Immediately after the procedure, Group A patients received single dose of intravenous (IV) dexamethasone (10 mg/kg) and Group B patients were given propofol (0.5 mg/kg, IV), and equal follow-up was employed. The incidence of PONV was noted at 6th, 12th, and 24th hour of drug administration. Independent t-test and Mann–Whitney test were used for comparison of symmetric numerical and asymmetric data between groups, respectively. Categorical data were analyzed with the chi-square test, and p value of < 0.05 was considered as level of significance. Results. The incidences of PONV throughout the 24-hour postoperative period were 35% in the propofol group and 25% in the dexamethasone group. Statistical significance was found in incidence of PONV (0% versus 22.5%) and use of antiemetic (0% versus 5%) between dexamethasone and propofol groups, respectively, at 12–24 hours. Over 24 hours, 5% in dexamethasone group and 12.5% in propofol group developed moderate PONV, while none of the participants felt severe PONV. Conclusions. Dexamethasone was more effective than propofol to prevent PONV with lower requirements of rescue antiemetics.
Efficacy and Safety of Nicorandil in Preventing Contrast-Induced Nephropathy after Elective Percutaneous Coronary Intervention: A Pooled Analysis of 1229 Patients
Authors: Yi Bin , Mo Shaoyan , Jiang Yumei , Yi Dingwu , Luo Jinwen , Chen Xiang , Rong Jian
Published: September 2020

Background. Nicorandil in reducing contrast-induced nephropathy (CIN) following elective percutaneous coronary intervention (PCI) is an inconsistent practice. This article aims to evaluate the efficacy and safety of nicorandil in preventing CIN after elective PCI. Methods. This is a pooled analysis of patients treated with elective PCI. The primary outcome was the incidence of CIN. The secondary outcomes were major adverse events, including mortality, heart failure, recurrent myocardial infarction, stroke, and renal replacement therapy. Results. A total of 1229 patients were recruited in our study. With statistical significance, nicorandil lowered the risk of CIN (odds ratio = 0.26; 95% confidence interval = 0.16–0.44; P<0.00001; I2 = 0%) in patients who underwent elective PCI. In addition, no significant differences were observed in the incidence of mortality, heart failure, recurrent myocardial infarction, stroke, and renal replacement therapy between the two groups (P>0.05). Conclusions. Our article indicated that nicorandil could prevent CIN without increasing the major adverse events. Furthermore, sufficiently powered and randomized clinical studies are still needed in order to determine the role of nicorandil in preventing CIN after elective PCI.
Improved Corrosion Resistance of Magnesium Alloy in Simulated Concrete Pore Solution by Hydrothermal Treatment
Authors: Wang Ye , Wu Guosong , Sun Jiapeng
Published: September 2020

Magnesium alloys are considered for building materials in this study due to their natural immunity to corrosion in alkaline concrete pore solution. But, chloride ions attack often hinders the application of most metals. Therefore, it is necessary to conduct a preliminary corrosion evaluation and attempt to find an effective way to resist the attack of chloride ions in concrete pore solution. In our study, hydrothermal treatment is carried out to modify Mg-9.3 wt. % Al alloy. After the treatment in NaOH solution for 10 h, scanning electron microscopy (SEM) reveals that a layer of dense coating with a thickness of about 5 μm is formed on Mg alloy. Energy dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and X-ray Diffraction (XRD) are combined to analyze the coating, and it is thereby confirmed that the coating is mainly composed of Mg(OH)2. As expected, both immersion test and electrochemical corrosion test show that the coated magnesium alloy has a better corrosion resistance than the uncoated one in simulated concrete pore solution with and without chloride ions. In summary, it indicates that hydrothermal treatment is a feasible method to improve the corrosion resistance of Mg alloys used for building engineering from the perspective of corrosion science.
Mining Database for the Clinical Significance and Prognostic Value of ESRP1 in Cutaneous Malignant Melanoma
Authors: Wang Baihe , Li Yang , Kou Caixia , Sun Jianfang , Xu Xiulian
Published: September 2020

Background. Epithelial splicing regulatory protein 1 (ESRP1) has been described as an RNA‐binding protein involved in cancer development. However, the expression and regulatory network of ESRP1 in cutaneous malignant melanoma (CMM) remain unclear. Methods. From the sequencing data of 103 CMM samples in The Cancer Genome Atlas database, the expression level of ESRP1 and its correlation with the clinicopathological characteristics were analyzed using the Oncomine 4.5, Gene Expression Profiling Interactive Analysis (GEPIA), and UALCAN tools, while LinkedOmics was used to identify differential gene expression with ESRP1 and to analyze Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Gene enrichment analysis examined target networks of kinases, miRNAs, and transcription factors. Finally, TIMER was used to analyze the relationship between ESRP1 and tumor immune cell infiltration. Results. We found that ESRP1 was lowly expressed in CMM tissues, and a low level of ESRP1 expression correlated with better overall survival. Expression of this gene was linked to functional networks involving the condensed chromosomes, epidermal development, and translation initiation. Functional network analysis suggested that ESRP1 regulated ribosome metabolism, drug metabolism, and chemical carcinogenesis via pathways involving several cancer‐related kinases, miRNAs, and transcription factors. Furthermore, our results suggested that ESRP1 played an important role in regulating tumor‐associated macrophage polarization, dendritic cell infiltration, Treg cells, and T cell exhaustion. Conclusion. Our study demonstrates ESRP1 expression, prognostic value, and potential regulatory networks in CMM, thereby shedding light on the clinical significance of ESRP1, and provides a novel biomarker for determining prognosis and immune infiltration in CMM.
Efficiency Improvement of a Capacitive Deionization (CDI) System by Modifying 3D SWCNT/RVC Electrodes Using Microwave-Irradiated Graphene Oxide (mwGO) for Effective Desalination
Authors: Aldalbahi Ali , Rahaman Mostafizur , Almoiqli Mohammed , Meriey Al Yahya , Periyasami Govindasami
Published: September 2020

This work is aimed at improving the electrosorption capacity of carbon nanotube/reticulated vitreous carbon- (CNT/RVC-) based 3D electrodes and decreasing the duration of electrosorption-desorption cycles by facilitating the ions’ adsorption and desorption on the electrode surface. This was achieved by preparing composites of microwave-irradiated graphene oxide (mwGO) with CNT. All composite materials were coated on RVC by the dip-coating method. The highest loading level was 50 mg. This is because it exhibited the maximum electrosorption capacity when tested in terms of geometric volume. The results showed that the 9-CNT/mwGO/RVC electrode exhibited 100% capacitive deionization (CDI) cyclic stability within its 1st five cycles. Moreover, 27.78% time was saved for one adsorption-desorption cycle using this electrode compared to the CNT/RVC electrode. In addition, the ion removal capacity of NaCl by the 9-CNT/mwGO/RVC electrode with respect to the mass of the electrode (3.82 mg/g) has increased by 18.27% compared to the CNT/RVC electrode (3.23 mg/g) when measured at the optimum conditions. In a complete desalination process, the water production per day for the 9-CNT/mwGO/RVC electrode was increased by 67.78% compared to the CNT/RVC electrode when measured within the same CDI cell using NaCl solution of concentration less than 1 mg/L. When considered volume of 1 m3, this optimum 9-CNT/mwGO/RVC electrode produces water 29,958 L per day. The highest electrosorption capacity, when measured experimentally at 500 mg/L NaCl feed concentration, was 10.84 mg/g for this optimum electrode, whereas Langmuir isotherm gave the theoretically calculated highest value as 16.59 mg/g. The results for the 9-CNT/mwGO/RVC composite electrode demonstrate that it can be an important electrode material for desalination in CDI technology.
Experimental Study on Moisture Migration of Unsaturated Loess during the Freezing Process
Authors: Zhang Hui , Wang Tiehang , Liu Enlong , Hu Mengling
Published: September 2020

To reveal the water‐heat transfer mechanism of unsaturated loess, the effects of soil dry density (1.30 g/cm3, 1.50 g/cm3, and 1.65 g/cm3), moisture content (13.3%, 16.2%, and 19.4%), cold end temperature (−7°C, −10°C, and −13°C), and freezing mode on moisture migration in unsaturated loess in this paper are studied through indoor tests of moisture migration under the freezing action of large‐size unsaturated loess. The results show that the temperature change in soil samples in the freezing process can be divided into three stages: rapid cooling stage, slow cooling stage, and stable stage. The higher the dry density, the closer the freezing front is to the cold end, with the initial moisture content having little effect on the freezing front, while the temperature at the cold end has a significant effect on the location of the freezing front. The total amount of moisture migration decreases with the increase of dry density, increases with the increase of moisture content, and increases with the decrease of cold end temperature. The freezing mode directly affects the distribution of moisture content and total amount of moisture migration in the frozen area.
Multimodal Detection for Cryptogenic Epileptic Seizures Based on Combined Micro Sensors
Authors: Shen Zhitian , Jiao Yang , Xu Yiwen , Shi Wei , Yang Chen , Li Dan , Ma Hongtao , Shao Weiwei , Li Zhangjian , Cui Yaoyao
Published: September 2020

The cryptogenic epilepsy of the neocortex is a disease in which the seizure is accompanied by intense cerebral nerve electrical activities but the lesions are not observed. It is difficult to locate disease foci. Electrocorticography (ECoG) is one of the gold standards in seizure focus localization. This method detects electrical signals, and its limitations are inadequate resolution which is only 10 mm and lack of depth information. In order to solve these problems, our new method with implantable micro ultrasound transducer (MUT) and photoplethysmogram (PPG) device detects blood changes to achieve higher resolution and provide depth information. The basis of this method is the neurovascular coupling mechanism, which shows that intense neural activity leads to sufficient cerebral blood volume (CBV). The neurovascular coupling mechanism established the relationship between epileptic electrical signals and CBV. The existence of mechanism enables us to apply our new methods on the basis of ECoG. Phantom experiments and in vivo experiments were designed to verify the proposed method. The first phantom experiments designed a phantom with two channels at different depths, and the MUT was used to detect the depth where the blood concentration changed. The results showed that the MUT detected the blood concentration change at the depth of 12 mm, which is the position of the second channel. In the second phantom experiments where a PPG device and MUT were used to monitor the change of blood concentration in a thick tube, the results showed that the trend of superficial blood concentration change provided by the PPG device is the same as that provided by the MUT within the depth of 2.5 mm. Finally, in the verification of in vivo experiments, the blood concentration changes on the surface recorded by the PPG device and the changes at a certain depth recorded by the MUT all matched the seizure status shown by ECoG. These results confirmed the effectiveness of the combined micro sensors.
Seasonal and Weather Effects on Rheumatoid Arthritis: Myth or Reality?
Authors: Azzouzi Hamida , Ichchou Linda
Published: September 2020

Introduction. Many of our rheumatic patients report that weather and seasons affect their symptoms. Objective. The purpose of this study was to examine the effect of meteorological parameters within seasons on rheumatoid arthritis (RA) symptoms. Methods. A retrospective longitudinal study from July 2017 to August 2018 was conducted. Data from three consultations for three seasons were collected and included a tender and swollen joint count, a disease activity score for 28 joints (DAS28), and patient’s pain assessment from their computerized medical record. The weather conditions (minimum and maximum temperature, precipitation, humidity, atmospheric pressure, and wind speed) registered during the same day of consultation for each patient were obtained. Then, the statistical correlation between each meteorological parameter and RA parameters was determined using the multiple linear regression analysis. Results. The data of 117 patients with a mean age of 50.45 ± 12.17 years were analyzed. The mean DAS28 at baseline was 2.44 ± 0.95. The winter in Oujda is cold (average temperature between 10°C and15°C) compared to summer (24.5°C–32.7°C). The spring is wetter with a 71% average humidity. Overall, the tender joint count was significantly correlated with hygrometry (p=0.027) in winter. A similar result was obtained in summer with precipitation (p=0.003). The pain intensity in the summer was negatively correlated with minimum temperatures and atmospheric pressure. However, there was no correlation between meteorological parameters and disease objective parameters for all seasons. Multiple linear regression analysis showed that weather parameters appeared to explain the variability in four RA predictors in the summer. No significant associations were observed in the spring. Conclusion. Our study supported the physicians’ assumption regarding the effect of climate on pain in RA patients.
Serum Leptin as a Marker for Severity of Endometriosis
Authors: Hussein Shatha Sami , Farhan Fatin Shallal , Ibrahim Ali Alaa
Published: September 2020

Background. Endometriosis a disease of theories, and one of the important causes of chronic pelvic pain, dysmenorrhea, dyspareunia, and subfertility. Surgery is the mainstay step for the diagnosis; noninvasive test is the goal in the future. Aim of Study. To test the role of serum leptin in determination of severity of endometriosis. Study Design. A cross-sectional study done in Al-Yarmouk Teaching Hospital from 1st of January 2018 to 1st of January 2019. Methods. 60 BMI-matched patients were involved in the study. A study group of 30 patients were operated either by laparoscopy or laparotomy for many reasons diagnosed as endometriosis by histopathology, and 30 normal women as a control group underwent elective surgery. Blood sample was taken from all patients in the theater room when laparoscopy finding went with endometriosis, and classifying according to surgical staging of endometriosis, the level of serum leptin was measured by ELISA using Human LEP (Leptin) ELISA Kit. The recording of finding of laparoscopy after conforming of diagnosis by histopathology was compared with the result of serum leptin. Result. The result shows no significant difference between the two groups regarding parity and age; however, the level of serum leptin was significantly high in the endometriosis group than in the control group. The P value was less than 0.05. Also, the result shows no significant differences between serum leptin in both groups according to the symptom but there was a significant difference with surgical staging. The mean of the level of serum leptin in stage 1 was 214.8, while it was 340.3 in stage 4. Conclusion. Serum leptin can be used as a marker of severity of endometriosis.
Fatigue and Mental Status of Caregivers of Severely Chronically Ill Patients
Authors: Kang Sung-Goo , Song Sang-Wook , Kim Se-Hong , Kang Yi-Jin , Kim Young-Rye , Eun Youngmi
Published: September 2020

Background and Aims. Fatigue is an unpleasant experience accompanied by functional deterioration involving both mental and physical factors. Caregivers of patients with severe illnesses who require long-term treatment often experience marked physical and mental fatigue. This study investigated the factors affecting fatigue among caregivers of patients with severe chronic diseases. Methods. The study enrolled 100 caregivers of patients providing home care nursing at a university hospital in Gyeonggi-do of Korea, including 47 caregivers caring for cancer patients and 53 caregivers caring for chronic disease patients (e.g., dementia, amyotrophic lateral sclerosis, and Parkinson’s disease). The degree of fatigue was measured using the Korean version of the multidimensional fatigue inventory (MFI-K). Caregiver depression and anxiety were examined using the Hospital Anxiety and Depression Scale. Results. The average MFI-K score of all caregivers was 60.43 ± 13.77 and did not differ significantly between those caring for cancer patients and those caring for patients with severe chronic diseases (62.15 ± 13.27 vs. 58.49 ± 14.20, respectively, p=0.186). The longer the disease duration, the greater the general and physical fatigue of the caregiver (r = 0.284, p=0.004). However, caregiver mental fatigue did not differ according to disease duration (r = 0.169, p=0.094). The main factors affecting caregiver general and physical fatigue were caregiver anxiety and depression and patient’s disease duration. Conclusions. The caregivers of patients with cancer or chronic severe illnesses experience high levels of fatigue: the longer the disease duration, the greater the degrees of depression, anxiety, and physical fatigue experienced by the caregivers. Such caregivers need strategies to manage their fatigue and depression.
Observational Study Comparing Efficacy and Safety between Neoadjuvant Concurrent Chemoradiotherapy and Chemotherapy for Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer
Authors: Yeh Yung-Sung , Huang Ming-Yii , Ma Cheng-Jen , Huang Ching-Wen , Tsai Hsiang-Lin , Chen Yen-Cheng , Li Ching-Chun , Yu Fang-Jung , Shih Hsiang-Yao , Wang Jaw-Yuan
Published: September 2020

Objective. Dismal outcomes in patients with locally advanced or metastatic gastric cancer (GC) highlight the need for effective systemic neoadjuvant treatment strategies to improve clinical results. Neoadjuvant multimodality strategies vary widely. This study compared the efficacy, safety, and clinical outcomes of neoadjuvant CCRT and chemotherapy for such patients. Materials and Methods. Sixty-five patients with histologically confirmed locally advanced or metastatic GC following neoadjuvant CCRT or computed tomography (CT) were retrospectively enrolled between January 2010 and April 2019. Clinical outcomes included response, progression-free survival (PFS), and overall survival (OS), and toxicity was compared between the two groups. Results. Of the 65 patients, 18 (27.7%) were in the response group (2 patients with a complete response and 16 with a partial response) and 47 (72.3%) in the nonresponse group (29 patients with a stable disease and 18 with a progressive disease). Multivariate analysis revealed no independent response predictor between CCRT and chemotherapy groups (all P>0.05). Furthermore, results revealed no statistical differences in toxicity between the two groups (all P>0.05). With a follow-up median of 12 months (ranging 6–48 months), 12-month OS and PFS were 39.7% and 20.4% in the CCRT group and 30.3% and 13.2% in the chemotherapy group, respectively. The median OS and PFS were 14.0 months (95% CI 9.661–18.339) and 9.0 months (95% CI 6.805–11.195) in the CCRT group and 10.0 months (95% CI 6.523–13.477) and 8.0 months (95% CI 6.927–9.073) in the chemotherapy group, respectively. Both OS (P=0.011) and PFS (P=0.008) in patients with CCRT were significantly better than those in patients with chemotherapy alone. Conclusion. Neoadjuvant CCRT achieved more favorable OS and PFS than did neoadjuvant chemotherapy alone, without significant increases of toxicity in patients. However, prospective randomized trials comparing treatment modalities are necessary to confirm the potential advantages of neoadjuvant CCRT.