bluuebunny/crossref_metadata_2025 huggingface dataset:
Is a fixed low-dose protamine better at reducing postoperative bleeding in off pump coronary artery bypass grafting?
Authors: Murugesh Wali R , Prasad Shetty Shyam , Ramachandrappa Sujay K , Dinesh Kumar Uyyamballi S
Published: February 2021

Context

Protamine is used ubiquitously in all cardiac surgeries for reversal of heparin. Risk of postoperative bleeding is increased with inadequate heparin reversal or due to anticoagulant side effects of protamine; hence, it is important to dose protamine properly. This study compares 80% protamine dose with full dose on postoperative bleeding and transfusion needs in OPCAB.

Aims

The aim of our study was to find whether lower dose of protamine could reduce postoperative bleeding and need for blood product transfusions in off pump coronary artery bypass grafting as compared to the regular dose of protamine.

Settings and design

This was a double-blinded randomised controlled trial where patients posted for off pump CABG meeting the inclusion criteria were included in the study.

Methods and material

Ninety patients were randomised to two groups, group F receiving full dose of protamine of 1 mg per mg heparin used, and group L received 0.8 mg per mg. Postoperative activated clotting time, bleeding at 1 h, 4 h, 24 h and total drainage till drains removal and blood product transfusion requirements were noted. Statistical analysis used: SPSS software.

Results

Both groups were matched in demographics, preoperative cessation of heparin and aspirin and platelet counts. Both groups received equal heparin dose, activated clotting time before protamine, activated clotting time post protamine in OT and ICU were equal as were the conduits used. There was no significant difference between the groups in post-operative drainage over time or in the need for blood product transfusions.

Conclusions

Eighty per cent of the dose of protamine can adequately reverse the heparin used during off pump cardiac surgery without any increase in incidence of postoperative bleeding or need for blood product transfusions.
Mental Health Associations with Academic Performance and Education Behaviors in Canadian Secondary School Students
Authors: Duncan Markus J. , Patte Karen A. , Leatherdale Scott T.
Published: February 2021

Course grades, as an indicator of academic performance, are a primary academic concern at the secondary school level and have been associated with various aspects of mental health status. The purpose of this study is to simultaneously assess whether symptoms of mental illness (depression and anxiety) and mental well-being (psychosocial well-being) are associated with self-reported grades (in their primary language [English or French] and math courses) and education behaviors (school days missed due to health, truancy, and frequency of incomplete homework) in a sample of secondary school students across Canada ( n = 57,394). Multivariate imputation by chained equations and multilevel proportional odds logistic regressions were used to assess associations between mental health scores, academic performance and education behaviors. Lower depression and higher psychosocial well-being scores were associated with better grade levels in both math and language courses, as well as better education behaviors. In turn, better education behaviors were associated with higher course grades. Depression scores and psychosocial well-being scores remained associated with higher grades after controlling for education behaviors, however the magnitude of association was diminished. Results indicate that the effects of mental health factors were partially attenuated by education behaviors, suggesting while reduced class attendance and poor homework adherence were associated with both academic outcomes and mental health, they do not account entirely for the association between lower grades and worse mental health.
The Role of Histones and Heparin in Sepsis: A Review
Authors: Zhang Xiaojuan , Li Xin
Published: February 2021

Septic shock with multiple organ failure is a devastating situation in clinical settings. Through the past decades, much progress has been made in the management of sepsis and its underlying pathogenesis, but a highly effective therapeutic has not been developed. Recently, macromolecules such as histones have been targeted in the treatment of sepsis. Histones primarily function as chromosomal organizers to pack DNA and regulate its transcription through epigenetic mechanisms. However, a growing body of research has shown that histone family members can also exert cellular toxicity once they relocate from the nucleus into the extracellular space. Heparin, a commonly used anti-coagulant, has been shown to possess life-saving capabilities for septic patients, but the potential interplay between heparin and extracellular histones has not been investigated. In this review, we summarize the pathogenic roles of extracellular histones and the therapeutic roles of heparin in the development and management of sepsis and septic shock.
Child Maltreatment and Subjective Well-being in Chinese Emerging Adults: A Process Model Involving Self-esteem and Self-compassion
Authors: Wu Qinglu , Cao Hongjian , Lin Xiuyun , Zhou Nan , Chi Peilian
Published: February 2021

Child maltreatment is negatively associated with subjective well-being in emerging adulthood, but the understanding of the mechanisms of this relationship is incomplete. Guided by the stress process model incorporated with a life-course perspective, the present study examined the protective roles of self-related resources (self-esteem and self-compassion) in this association, while considering various maltreatment types (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse). The Childhood Trauma Questionnaire-Short Form, Rosenberg Self-esteem Scale, Self-compassion Scale, and Satisfaction with Life Scale were used to measure the key variables through an online survey of 358 Chinese college students (226 females, mean age = 19.18) Direct effect of one type of maltreatment on life satisfaction and the three indirect effects through (a) self-esteem; (b) self-compassion; and (c) self-esteem and self-compassion in sequence were examined while controlling for age, gender, and the other four maltreatment types. The results showed that psychological maltreatment was negatively associated with life satisfaction through self-esteem and through the pathway from self-esteem to self-compassion. Indirect effects of the other three types of maltreatment were not significant. This suggests that self-processes are more vulnerable to psychological maltreatment than to other maltreatment types. The type of maltreatment experienced in childhood is worth considering when investigating the extending effect of child maltreatment on individual developmental outcomes. Our findings broaden the understanding of the mechanisms of the stress process model integrated with a life-course perspective. Self-related resources appear to play substantial roles in the long-term association between early stressors of psychological maltreatment in childhood and subjective well-being in emerging adulthood. Highlighting the need to work on improved self-related resources, including self-compassion and self-esteem, might help practitioners to provide treatment for survivors of adverse childhood experiences..
The association between depressive symptoms and neurocognitive impairment in people with well-treated HIV in Switzerland
Authors: Santos Galia , Locatelli Isabella , Métral Mélanie , Berney Alexandre , Nadin Isaure , Calmy Alexandra , Tarr Philip , Gutbrod Klemens , Hauser Christoph , Brugger Peter , Kovari Helen , Kunze Ursi , Stoeckle Marcel , Früh Severin , Schmid Patrick , Rossi Stefania , Di Benedetto Caroline , Du Pasquier Renaud , Darling Katharine , Cavassini Matthias ,   the NAMACO study group and Swiss HIV Cohort Study
Published: February 2021

Background: Depression may contribute to neurocognitive impairment (NCI) in people with HIV (PWH). Attributing NCI to depression rather than to HIV is complicated as depression may be both a causal factor and an effect of NCI. This study aimed to determine the association between depressive symptoms and NCI among PWH with well-controlled infection. Methods: The Neurocognitive Assessment in the Metabolic and Ageing Cohort study is an ongoing, prospective, longitudinal study of PWH aged ≥45 years old nested within the Swiss HIV Cohort Study. Neurocognitive Assessment in the Metabolic and Ageing Cohort study participants underwent neurocognitive assessment and grading of depressive symptoms using the Centre for Epidemiological Studies Depression Scale. Neurocognitive impairment categories were defined using Frascati criteria. Participants with NCI related to neurological or psychiatric confounders other than depression were excluded. The cross-sectional association between the Centre for Epidemiological Studies Depression score and neurocognitive impairment was examined taking Centre for Epidemiological Studies Depression score as a continuous variable and then as a binary variable using two score thresholds, 16 and 27. Results: Excluding 79 participants with confounding factors, 902 participants were studied: 81% were men; 96% had plasma viral loads <50 copies/ml; 35% had neurocognitive impairment; 28% had Centre for Epidemiological Studies Depression scores ≥16. Higher Centre for Epidemiological Studies Depression scores were associated with female sex ( p = 0.0003), non-Caucasian origin ( p = 0.011) and current/past intravenous drug use ( p = 0.002). Whilst neurocognitive impairment was associated with higher Centre for Epidemiological Studies Depression scores, the Centre for Epidemiological Studies Depression score was a poor predictor of having neurocognitive impairment (area under the ROC curve 0.604). Applying a Centre for Epidemiological Studies Depression score threshold of 16 predicted the presence of neurocognitive impairment with a sensitivity of 38.3% (specificity 77.2%), increasing the threshold to 27 lowered sensitivity to 15.4% (specificity 93.6%). Conclusion: In this large cohort of PWH in Switzerland, we did not observe a Centre for Epidemiological Studies Depression score threshold that was sensitive in predicting neurocognitive impairment. As neurocognitive impairment was however associated with higher Centre for Epidemiological Studies Depression scores, the data support the screening for and treatment of depression among PWH diagnosed with neurocognitive impairment.
Does Neuronal Recycling Result in Destructive Competition? The Influence of Learning to Read on the Recognition of Faces
Authors: van Paridon Jeroen , Ostarek Markus , Arunkumar Mrudula , Huettig Falk
Published: February 2021

Written language, a human cultural invention, is far too recent a development for dedicated neural infrastructure to have evolved in its service. Newly acquired cultural skills, such as reading, thus recycle evolutionarily older circuits that originally evolved for different, but similar, functions (e.g., visual object recognition). The destructive-competition hypothesis predicts that this neuronal recycling has detrimental behavioral effects on the cognitive functions for which a cortical network originally evolved. In a study with 97 literate, low-literate, and illiterate participants from the same socioeconomic background, we found that even after adjusting for cognitive ability and test-taking familiarity, learning to read was associated with an increase, rather than a decrease, in object-recognition abilities. These results are incompatible with the claim that neuronal recycling results in destructive competition and are consistent with the possibility that learning to read instead fine-tunes general object-recognition mechanisms, a hypothesis that needs further neuroscientific investigation.
A review on modern control applications in wind energy conversion system
Authors: Sahu Shrabani , Behera Sasmita
Published: February 2021

To meet the energy demand, over and above to build a clean pollution-free environment, wind energy is playing an incredible role. The development in the field of wind power generation is rising speedily. Operation and maintenance of the nonlinear wind energy conversion system (WECS) with stochastic wind input are pivoted on the control techniques used for the overall system. Many research works are undergoing which are based on various control schemes for different parts of WECS. Thus, this paper presents a review of advanced modern control strategies utilized in different parts of WECS with two popular types of grid-connected generators to achieve the desired power level and fault-free operation developed in the last 15 years. The review paper intends to provide a suitable reference for further research in the field of wind energy to have a bird’s eye view from the tabulated information and presentation.
Challenges of AI Adoption in the UAE Healthcare
Authors: Al Badi Fatma Khamis , Alhosani Khawla Ali , Jabeen Fauzia , Stachowicz-Stanusch Agata , Shehzad Nazia , AMANN Wolfgang
Published: February 2021

The purpose of this study is to prioritize the challenges of adopting Artificial Intelligence (AI) in the healthcare sector of the United Arab Emirates (UAE). An Analytic Hierarchy Process (AHP) method was used, and the data were collected from the managerial-level executives ( n = 27) involved in AI adoption in their respective healthcare organizations. The results prioritized the AI main criteria and sub-criteria based on their priority weights in the healthcare sector. The results also revealed that accuracy, privacy and security criteria are the most important factors to optimize the healthcare sector with AI. The research findings shall help policymakers formulate suitable strategies with current adoption and acceptance of AI in the healthcare sector. The findings will help policymakers utilize this study’s outcomes to create a well-defined picture of AI’s actual adoption and acceptance in the healthcare sector.
Intersex adolescents seeking help for their depression: the case study of SPARX in New Zealand
Authors: Lucassen Mathijs F G , Perry Yael , Frampton Christopher , Fleming Theresa , Merry Sally N , Shepherd Matthew , Stasiak Karolina
Published: February 2021

Objective:

SPARX is a computerized cognitive behavioral therapy self-help program for adolescent depression that is freely available in New Zealand. At registration, users identify themselves as either male, female, intersex, or transgender. We aimed to describe the mental health of adolescent intersex users.

Method:

A secondary analysis of SPARX usage data over 5 years.

Results:

Of the 8922 adolescents users, 0.6% ( n = 50) identified as intersex. Based on Patient Health Questionnaire 9 – modified for Adolescents (PHQ-A) results, 78.3% of intersex users had high levels of depression and/or self-harm and suicidal ideation. The mean PHQ-A scores for intersex users were significantly higher than for males and females ( p < .001). As only three intersex users completed SPARX Level 4 or more (of the seven-level program), we were unable to meaningfully investigate any reductions in their depressive symptoms over time.

Conclusions:

There is a dearth of empirical data on the mental health of intersex adolescents. These results suggest that intersex adolescents seeking help from an online resource have high mental health needs compared with other young people, possibly because they defer seeking help.
A Review of Fam-Trastuzumab Deruxtecan-nxki in HER2-Positive Breast Cancer
Authors: Nguyen Xoan , Hooper Morgan , Borlagdan Jared Paul , Palumbo Alison
Published: February 2021

Objective:

To review the pharmacology, efficacy, and safety of antibody-drug conjugate fam-trastuzumab deruxtecan-nxki in the treatment of advanced, unresectable, or metastatic breast cancer.

Data Sources:

Relevant information was identified through a MEDLINE/PubMed (January 2015 to December 2020) literature search. The new drug application, prescribing information, clinical practice guideline, and abstracts from scientific meetings were also reviewed.

Study Selection and Data Extraction:

The literature search was limited to human studies published in the English language. All studies evaluating the pharmacology, efficacy, or safety of fam-trastuzumab deruxtecan-nxki for breast cancer were included.

Data Synthesis:

Fam-trastuzumab deruxtecan-nxki is composed of an anti–human epidermal growth factor receptor 2 (HER2) antibody and topoisomerase I inhibitor (DXd), which causes DNA damage and apoptotic cell death. Major phase I and phase II clinical trials established the efficacy and safety of fam-trastuzumab deruxtecan-nxki for treatment of HER2-positive advanced, unresectable, or metastatic breast cancers that are refractory or intolerant to standard treatment. In these trials, the response rate was 60.9% (95% CI = 53.4-68.0) Common adverse effects included fatigue, nausea, vomiting, decreased appetite, constipation, diarrhea, alopecia, neutropenia, anemia, and thrombocytopenia. Serious adverse effects included interstitial lung disease or pneumonia, febrile neutropenia, left ventricular dysfunction, and embryo-fetal toxicity.

Relevance to Patient Care and Clinical Practice:

Fam-trastuzumab deruxtecan-nxki is an option for HER2-positive breast cancer following 2 previous lines of HER2-targeted therapy.

Conclusions:

Fam-trastuzumab deruxtecan-nxki is an effective treatment for HER2-positive breast cancer in the metastatic setting, but randomized controlled trials are needed.
Investigating the Associations of Everyday Discrimination and Inflammation in Latina Women: A Pilot Study
Authors: Caceres Billy A. , Barcelona Veronica , Vo Danny , Suero-Tejeda Niurka , Jackman Kasey , Taylor Jacquelyn , Corwin Elizabeth
Published: February 2021

Introduction:

Discrimination is associated with negative health outcomes among Latinos. Research on the link between discrimination and inflammation in adults has focused on pro-inflammatory markers rather than characterizing the more informative balance of pro- and anti-inflammatory markers. The purpose of this cross-sectional study was to examine the associations of everyday discrimination with inflammation ratio (defined as the ratio of pro- to anti-inflammatory cytokines) in a sample of middle-aged and older Latinas.

Methods:

Latinas were recruited from an existing study in New York City. Participants reported frequency and count of everyday discrimination. Peripheral blood was used to analyze pro- (IL-1 B and IL-6) and anti-inflammatory (IL-4 and IL-10) cytokines. The inflammation ratio was calculated by dividing the sum of pro-inflammatory cytokines by the sum of anti-inflammatory cytokines. We used linear regression to assess the link between everyday discrimination and inflammation ratio.

Results:

The final sample included 40 Latinas (mean age = 63.2 years). Approximately 68% had household incomes less than $15,000. More than half (53%) reported experiencing some form of everyday discrimination. Regression models showed everyday discrimination was not associated with individual pro- and anti-inflammatory cytokines. In adjusted regression models, the frequency of everyday discrimination was not associated with inflammation ratios ( B[ SE] = 0.57[0.30], p = .07). However, a higher count of everyday discrimination was associated with inflammation ratios ( B[ SE] = 1.15[0.55], p = .04).

Conclusions:

The count of everyday discrimination was positively associated with inflammation in Latina women. Future studies should replicate these findings using longitudinal assessment of discrimination and inflammatory markers.
Long-term follow-up of retinal sensitivity assessed by microperimetry in patients with internal limiting membrane peeling
Authors: Blautain Benjamin , Glacet-Bernard Agnès , Blanco-Garavito Rocio , Toutée Adélaïde , Jung Camille , Ortoli Manon , Souied Eric H
Published: February 2021

Purpose:

To evaluate anatomical and functional changes in patients with vitreomacular interface disease after internal limiting membrane (ILM) peeling, using microperimetry along with usual clinical and multimodal retinal imaging.

Methods:

Patients with vitreomacular interface disease requiring vitrectomy underwent multimodal retinal evaluation, including visual acuity assessment, fundus color photograph, Spectral-Domain Optical Coherence Tomography, Optical Coherence Tomography-Angiography, and microperimetry. They were examined at baseline (M0), 6 months (M6) and 18 months (M18) after surgery. Retinal sensitivity was subdivided into three concentric polygons: Large, Medium, Small.

Results:

Eleven eyes of 11 patients were analyzed, including 10 epiretinal membranes (ERMs). Best-corrected visual acuity (BCVA) improved in all patients from 0.51 logarithm of the minimal angle of resolution (logMAR) to 0.067 ( p = 0.0074). Retinal sensitivity improved between M0 and M6 in all polygons and continued to improve between M6 and M18 for polygons Medium (M) and Small (S) with no statistical significance. At M18, BCVA and retinal sensitivity were similar in the operated eye compared with the fellow eye for all patients. Dissociated optic nerve fiber layer appearance was observed in 8 patients at M18. It was not correlated with either retinal sensitivity or BCVA or microscotomas. No recurrence of ERM or macular hole occurred during follow-up.

Conclusion:

After surgery, the retinal sensitivity assessed by microperimetry gradually improved until the 18th month and was not different from the values of the fellow eye. These results seemed to confirm that ILM peeling can be an effective and safe technique to treat patients with vitreomacular interface disease.
Graphene, an Interesting Nanocarbon Allotrope for Biosensing Applications: Advances, Insights, and Prospects
Authors: Menaa Farid , Fatemeh Yazdian , Vashist Sandeep K , Iqbal Haroon , Sharts Olga N , Menaa Bouzid
Published: February 2021

Graphene, a relatively new two-dimensional (2D) nanomaterial, possesses unique structure (e.g. lighter, harder, and more flexible than steel) and tunable physicochemical (e.g. electronical, optical) properties with potentially wide eco-friendly and cost-effective usage in biosensing. Furthermore, graphene-related nanomaterials (e.g. graphene oxide, doped graphene, carbon nanotubes) have inculcated tremendous interest among scientists and industrials for the development of innovative biosensing platforms, such as arrays, sequencers and other nanooptical/biophotonic sensing systems (e.g. FET, FRET, CRET, GERS). Indeed, combinatorial functionalization approaches are constantly improving the overall properties of graphene, such as its sensitivity, stability, specificity, selectivity, and response for potential bioanalytical applications. These include real-time multiplex detection, tracking, qualitative, and quantitative characterization of molecules (i.e. analytes [H2O2, urea, nitrite, ATP or NADH]; ions [Hg2+, Pb2+, or Cu2+]; biomolecules (DNA, iRNA, peptides, proteins, vitamins or glucose; disease biomarkers such as genetic alterations in BRCA1, p53) and cells (cancer cells, stem cells, bacteria, or viruses). However, there is still a paucity of comparative reports that critically evaluate the relative toxicity of carbon nanoallotropes in humans. This manuscript comprehensively reviews the biosensing applications of graphene and its derivatives (i.e. GO and rGO). Prospects and challenges are also introduced.
The influence of small groups on leader stability and task engagement in the language classroom
Authors: Leeming Paul
Published: February 2021

Groupwork has become ubiquitous in language education, with the clear benefits of interaction and output on language acquisition. A body of research has investigated this interaction in pairs and small groups, and there is an increased understanding that individual group context is a key factor in determining the behavior of students. This article reports on a study that first investigated emergent leadership within groups, and the influence of the group on leader stability. The study then examined how leadership is represented in student task engagement. Students were placed into fixed small groups for the first semester, and then allowed to self-select into groups for the second semester. Perceptions of leadership were measured three times in each semester, and leaders were identified in each group. Results showed that changing group membership had a considerable impact on leadership stability, and student interaction was then analysed to determine how leadership influenced engagement with tasks. Students with high leadership displayed high engagement with tasks, and took a central role in driving the conversation. When a student chose to reject the role of leader there was a dramatic impact on their engagement in conversation. The stability of leadership and its impact on performance has practical implications both for researchers and teachers.
A future so close: Mapping 10 years of promises and futures across the augmented reality development cycle
Authors: Liao Tony , Iliadis Andrew
Published: February 2021

When the augmented reality (AR) industry was first forming, many hyperbolic futures were imagined. These futures served important functions, whether it was growing the community, motivating investors, or setting priorities for AR companies. Over time, however, futures and collective expectations for the technology can change dramatically. This study analyzes two futures data sets to understand 10 years of futures surrounding AR—one from years of participant observation at AR conferences, the other from a digital archive of media about wearable technologies called FABRIC. By comparing a 10-year period of futures as AR moved across stages of the development cycle, this study identifies specific ways in which flows of discourses worked to shape the conferences, which in turn shaped the collective futures and expectations about AR. This study builds on our empirical and theoretical understanding of futures by comparing futures across multiple levels (macro/micro) and longitudinally mapping the interrelationships between streams of futures.
Couplehood as a compass: Spousal perspectives on the diminished everyday competence of partners
Authors: Hellström Ingrid , Torres Sandra
Published: February 2021

Research on spousal relations and caregiving, when one of the persons in the dyad has a dementia diagnosis, has recognized that the degree of diminished everyday competence (DEC) the person with dementia is experiencing has implications for these relations and for how spousal caregiving is ultimately experienced. The present exploratory study uses an inductive approach to analyze data from 22 qualitative interviews with and observation notes on couples living with dementia to shed light on the ways in which the person without dementia views the DEC his/her partner is experiencing. The findings show that spouses can choose to disregard their partners’ DEC or to acknowledge it in either an egocentric or a couple-centered way; they also show that spouses’ choice of approach does not seem to be dictated by how cognitively impaired their partners have become. This suggests that spouses’ approach to partners’ DEC deserves more of our attention as it could have implications not only for transitions into spousal caregiving but also for caregiving experiences as such.
In defence of a liberal realism and a realist political ethics: On Edward Hall’s Value, Conflict, and Order
Authors: Szűcs Zoltán Gábor
Published: February 2021

This review argues that Edward Hall’s outstanding new book on the political thought of three outstanding 20th-century thinkers – Isaiah Berlin, Stuart Hampshire and Bernard Williams – has three major substantial contributions to contemporary realism: it offers convincing realist interpretations of their oeuvres, extracts inspiring new ideas from their works for future theorizing and provides powerful arguments in defence of a liberal realist position. However, given Hall’s expertise in Williams’ thought, it might be surprising that the chapters about Hampshire seem the most interesting and most convincing parts of the book because they address some of the most fundamental issues of realism in an especially concise and well-written form.
Potentiality of MWCNT fillers on the lateral crashworthiness behaviour of polymer composite cylindrical tubes under quasi-static loading
Authors: Praveen Kumar A , Nagarjun J , Ma Quanjin
Published: February 2021

In recent years, light-weight nano composite materials have been progressively employed in the aviation, defense, naval and automotive manufacturing applications owing to their outstanding mechanical and crashworthiness characteristics. In this regard, nano composite cylindrical tubes could be significantly utilized as energy absorbing elements for dissipating the impact energy during vehicle collisions. The present research study aimed to examine the lateral crashworthiness response of Multi-Walled Carbon Nano Tubes (MWCNT) filled epoxy composite (basalt fabric and glass fabric) tubes of three different inner diameters using quasi-static crushing experiments. Crushing profiles and crush force–deformation curves of all the recommended typical tube samples are computed and discussed elaborately. The results obtained revealed that better crashworthiness characteristics of MWCNT reinforced epoxy composite tubes with a larger diameter, were owing to more promising crushing modes occurring during lateral compression. It is also found that the lateral crashworthiness response of the MWCNT filled glass fabric epoxy composite tubes was marginally superior to that of the MWCNT filled basalt fabric epoxy composite tubes. However, both the recommended composite cylindrical tubes with nano-fillers might be employed as energy dissipating elements in modern vehicles.
Maggot Treatment of Necrotic Toe Developed After Traumatic Subtotal Amputation
Authors: Sahin Erdem , Karaismailoglu Bedri , Tutuncu Mehmed Nuri , Polat Erdal , Botanlioglu Huseyin
Published: February 2021

Maggot debridement therapy (MDT) has been used for years in the treatment of chronic wounds and necrotic tissues. We report a case of subtotally amputated third toe that was treated with MDT after reattachment and developing complete necrosis. The necrotic toe was replaced with viable tissue and the wound healed completely after 2 weeks of MDT application. This case points out the regenerative effects of MDT besides its mechanical debridement effect on the necrotic tissue.
Short-chain fatty acids contribute to neuropathic pain via regulating microglia activation and polarization
Authors: Zhou Feng , Wang Xian , Han Baoyu , Tang Xiaohui , Liu Ru , Ji Qing , Zhou Zhiqiang , Zhang Lidong
Published: February 2021

Microglia activation and subsequent pro-inflammatory responses play a key role in the development of neuropathic pain. The process of microglia polarization towards pro-inflammatory phenotype often occurs during neuroinflammation. Recent studies have demonstrated an active role for the gut microbiota in promoting microglial full maturation and inflammatory capabilities via the production of Short-Chain Fatty Acids (SCFAs). However, it remains unclear whether SCFAs is involved in pro-inflammatory/anti-inflammatory phenotypes microglia polarization in the neuropathic pain. In the present study, chronic constriction injury (CCI) was used to induce neuropathic pain in mice, the mechanical withdrawal threshold, thermal hyperalgesia were accomplished. The levels of microglia markers including ionized calcium-binding adaptor molecule 1 (Iba1), cluster of differentiation 11b (CD11b), pro-inflammatory phenotype markers including CD68, interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and anti-inflammatory phenotype markers including CD206, IL-4 in the hippocampus and spinal cord were determined on day 21 after CCI. The results showed that CCI produced mechanical allodynia and thermal hyperalgesia, and also increased the expressions of microglia markers (Iba1, CD11b) and pro-inflammatory phenotype markers (CD68, IL-1β, and TNF-α), but not anti-inflammatory phenotype marker (CD206, IL-4) in the hippocampus and spinal cord, accompanied by increased SCFAs in the gut. Notably, antibiotic administration reversed these abnormalities, and its effects was also bloked by SCFAs administration. In conclusion, data from our study suggest that CCI can lead to mechanical and thermal hyperalgesia, while SCFAs play a key role in the pathogenesis of neuropathic pain by regulating microglial activation and subsequent pro-inflammatory phenotype polarization. Antibiotic administration may be a new treatment for neuropathic pain by reducing the production of SCFAs and further inhibiting the process of microglia polarization.
Modulation of microglial activation states by spinal cord stimulation in an animal model of neuropathic pain: Comparing high rate, low rate, and differential target multiplexed programming
Authors: Smith William J , Cedeño David L , Thomas Samuel M , Kelley Courtney A , Vetri Francesco , Vallejo Ricardo
Published: February 2021

While numerous studies and patient experiences have demonstrated the efficacy of spinal cord stimulation as a treatment for chronic neuropathic pain, the exact mechanism underlying this therapy is still uncertain. Recent studies highlighting the importance of microglial cells in chronic pain and characterizing microglial activation transcriptomes have created a focus on microglia in pain research. Our group has investigated the modulation of gene expression in neurons and glial cells after spinal cord stimulation (SCS), specifically focusing on transcriptomic changes induced by varying SCS stimulation parameters. Previous work showed that, in rodents subjected to the spared nerve injury (SNI) model of neuropathic pain, a differential target multiplexed programming (DTMP) approach provided significantly better relief of pain-like behavior compared to high rate (HRP) and low rate programming (LRP). While these studies demonstrated the importance of transcriptomic changes in SCS mechanism of action, they did not specifically address the role of SCS in microglial activation. The data presented herein utilizes microglia-specific activation transcriptomes to further understand how an SNI model of chronic pain and subsequent continuous SCS treatment with either DTMP, HRP, or LRP affects microglial activation. Genes for each activation transcriptome were identified within our dataset and gene expression levels were compared with that of healthy animals, naïve to injury and interventional procedures. Pearson correlations indicated that DTMP yields the highest significant correlations to expression levels found in the healthy animals across all microglial activation transcriptomes. In contrast, HRP or LRP yielded weak or very weak correlations for these transcriptomes. This work demonstrates that chronic pain and subsequent SCS treatments can modulate microglial activation transcriptomes, supporting previous research on microglia in chronic pain. Furthermore, this study provides evidence that DTMP is more effective than HRP and LRP at modulating microglial transcriptomes, offering potential insight into the therapeutic efficacy of DTMP.
Intestinal barrier dysfunction in irritable bowel syndrome: a systematic review
Authors: Hanning Nikita , Edwinson Adam L. , Ceuleers Hannah , Peters Stephanie A. , De Man Joris G. , Hassett Leslie C. , De Winter Benedicte Y. , Grover Madhusudan
Published: February 2021

Background and Aim:

Irritable bowel syndrome (IBS) is a complex and heterogeneous disorder. Sensory, motor and barrier dysfunctions are the key physiological endophenotypes of IBS. Our aim is to review studies evaluating barrier dysfunction in adults and children with IBS, as well as to link those changes with IBS symptomatology and quality of life.

Methods:

A comprehensive and systematic review of multiple databases was performed up to March 2020 to identify studies comparing intestinal permeability in IBS patients with healthy controls. Both in vivo and in vitro studies were considered.

Results:

We identified 66 studies, of which 27 used intestinal probes to quantify barrier function. The prevalence of barrier dysfunction differed between PI-IBS (17–50%), IBS-D (37–62%) and IBS-C (4–25%). At a group level, permeability was increased compared with healthy controls in IBS-D (9/13 studies) and PI-IBS (4/4 studies), but only a minority of IBS-C (2/7 studies) and not in the only IBS-M study. All four studies in children with IBS demonstrated loss of barrier function. A heterogeneous set of tight junction genes were found to be altered in small and large intestines of adults with IBS, but these have not been evaluated in children. Positive associations were identified between barrier dysfunction and bowel disturbances (6/9 studies), abdominal pain (9/13 studies), overall symptom severity (1/6 studies), depression and anxiety (1/1 study) and quality of life (1/4 studies). Fecal slurry or supernatants of IBS patients were found to induce barrier disruption in animal models (5/6 studies).

Conclusions:

Barrier dysfunction is present in a significant proportion of adult and all pediatric IBS studies, especially in the IBS-D and PI-IBS subtype. The majority of studies indicated a positive association between loss of barrier function and symptoms such as abdominal pain and changes in the bowel function.
Chemical Diversity of Liverworts From Frullania Genus
Authors: Ludwiczuk Agnieszka , Asakawa Yoshinori
Published: February 2021

Frullania is one of the largest and taxonomically most complex genus of leafy liverworts. Current morphology-based estimates of Frullania diversity are close to 400 species; however, species level-classification of Frullania has been regarded notoriously difficult and subject to many studies. The liverworts classified in this genus have been studied using morphological evidence and molecular markers but also in terms of secondary metabolite composition. Up to now 98 Frullania species have been chemically investigated. As a result, it is known that Frullania species are characterized by a remarkable chemical diversity. The most characteristic compounds present in this liverwort genus are sesquiterpene lactones with eudesamnolides as the most diverse group, and aromatic compounds belonging to bibenzyls. In this review paper we report the distribution of secondary metabolites in all chemically investigated Frullania species and discuss some aspects concerning the division of this genus into chemotypes.
Outcomes of pulmonary vasodilator use in Veterans with pulmonary hypertension associated with left heart disease and lung disease
Authors: Gillmeyer Kari R. , Miller Donald R. , Glickman Mark E. , Qian Shirley X. , Klings Elizabeth S. , Maron Bradley A. , Hanlon Joseph T. , Rinne Seppo T. , Wiener Renda S.
Published: February 2021

Randomized trials of pulmonary vasodilators in pulmonary hypertension due to left heart disease (Group 2) and lung disease (Group 3) have demonstrated potential for harm. Yet these therapies are commonly used in practice. Little is known of the effects of treatment outside of clinical trials. We aimed to establish outcomes of vasodilator treatment for Groups 2/3 pulmonary hypertension in real‐world practice. We conducted a retrospective cohort study of 132,552 Medicare‐eligible Veterans with incident Groups 2/3 pulmonary hypertension between 2006 and 2016, and a secondary nested case–control study. Our primary outcome was a composite of death by any cause or selected acute organ failures. In our cohort analysis, we calculated adjusted risks of time to our outcome using Cox proportional hazards models with facility‐specific random effects. In our case–control analysis, we used logistic mixed‐effects models to estimate the effect of any past, recent, and cumulative exposure on our outcome. From our cohort study, 3249 (2.5%) Veterans were exposed to pulmonary vasodilators. Exposure to vasodilators was associated with increased risk of our primary outcome, in both Group 3 (HR: 1.58 (95% CI: 1.37–1.82)) and Group 2 (HR: 1.26 (95% CI: 1.12–1.41)) pulmonary hypertension patients. The case–control study determined odds of our outcome increased by 11% per year of exposure (OR: 1.11 (95% CI: 1.07–1.16)). Treating Groups 2/3 pulmonary hypertension with vasodilators in clinical practice is associated with increased risk of harm. This extension of trial findings to a real‐world setting offers further evidence to limit use of vasodilators in Groups 2/3 pulmonary hypertension outside of clinical trials.
Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross‐sectional study
Authors: Nakazato Layse , Mendes Felipe , Paschoal Ilma A. , Oliveira Daniela C. , Moreira Marcos M. , Pereira Mônica C.
Published: February 2021

Pulmonary arterial hypertension impairs exercise tolerance and daily physical activity. Aside from the hemodynamic limitations, physical, cognitive, and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the physical activity level and psychological disorders, health‐related quality of life, and daily activities. We also searched for an association of the physical activity level with clinical factors and functional capacity. This was an analytical, cross‐sectional, observational study conducted in a Brazilian University Hospital. Twenty stable pulmonary arterial hypertension subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF‐36), as well as the Hospital Anxiety and Depression scale, and the Manchester Respiratory Activities of Daily Living questionnaire. Transthoracic echocardiography, the six‐minute walk test, the one‐minute sit‐to‐stand test, and spirometry were performed. For statistical analysis, we used Chi‐square tests or Fisher’s test as appropriate and the Mann–Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic pulmonary arterial hypertension, and 20% had connective tissue disease. The mean daily step count was 4280 ± 2351, and the mean activity time was 41.6 ± 19.3 min. The distance covered (six‐minute walk test) was 451.5 m, and the number of movements (one‐minute sit‐to‐stand test) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (Hospital Anxiety and Depression scale). There was a significant correlation between accelerometer data and walking distance (six‐minute walk test), number of movements (one‐minute sit‐to‐stand test), level of daily physical activity (Manchester Respiratory Activities of Daily Living questionnaire), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with pulmonary arterial hypertension.
Impact of the new definition for pulmonary hypertension in patients with lung disease: an analysis of the United Network for Organ Sharing database
Authors: Nathan Steven D. , Barnett Scott D. , King Christopher S. , Provencher Steeve , Barbera Joan A. , Pastre Jean , Shlobin Oksana A. , Seeger Werner
Published: February 2021

The implications of the recent change in the definition of pulmonary hypertension on epidemiology and outcomes are not known. We sought to determine the percentage of patients with the two most common lung diseases that would be reclassified regarding the presence/absence of pulmonary hypertension with the revised definition. A query of the United Network for Organ Sharing database was performed. The percentage of patients meeting the current and previous definition of pulmonary hypertension was described. Outcomes of patients stratified by the current and previous definitions were compared. There were 15,563 patients with right heart catheterization data analyzed. Pulmonary hypertension was more prevalent in both chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis under the new definition at 52.4% versus 82.4%, and 47.6% versus 73.6%, respectively. “Pre‐capillary” pulmonary hypertension by the new definition was lower at 28.1% for chronic obstructive pulmonary disease and 36.8% for idiopathic pulmonary fibrosis. Of the patients with pulmonary hypertension by the old definition, 23.9% of chronic obstructive pulmonary disease patients and 18.7% of idiopathic pulmonary fibrosis patients were not classified as pulmonary hypertension by the new definition. Conversely, 15.9% of chronic obstructive pulmonary disease patients and 15.1% of idiopathic pulmonary fibrosis patients who did not meet diagnostic criteria for pulmonary hypertension by the old definition did have pulmonary hypertension by the new definition. Patients in both disease categories had shorter transplant‐free waitlist survival in the presence of pulmonary hypertension by both the new and old definitions. There was a trend toward the new definition of pre‐capillary pulmonary hypertension better discerning outcomes compared to the old definition of pulmonary hypertension in idiopathic pulmonary fibrosis patients. Most patients with advanced lung disease who are listed for lung transplantation have pulmonary hypertension, but fewer have pre‐capillary pulmonary hypertension than pulmonary hypertension by the old definition. Both the old and new definition of precapillary pulmonary hypertension appear to discern outcomes among the two groups of lung disease analyzed, with some evidence to suggest that the new definition performs slightly better in the idiopathic pulmonary fibrosis population.
Contemporary approaches to bifurcation stenting
Authors: Raphael Claire E , O’Kane Peter D
Published: February 2021

Bifurcation lesions are common and associated with higher risks of major cardiac events and restenosis after percutaneous coronary intervention (PCI). Treatment requires understanding of lesion characteristics, stent design and therapeutic options. We review the evidence for provisional vs 2-stent techniques. We conclude that provisional stenting is suitable for most bifurcation lesions. We detail situations where a 2-stent technique should be considered and the steps for performing each of the 2-step techniques. We review the importance of lesion preparation, intracoronary imaging, proximal optimization (POT) and kissing balloon inflation
The case for research on the marketing–finance interface: A commentary
Authors: Morvan Jérémy , Le Gall-Ely Marine
Published: February 2021

The aim of this article is to comment on the proposals set out by Hanssens in his article ‘The case for research on the marketing–finance interface’. For each insight, we present the main aspects of finance theory and discuss the scope as well as the possible research avenues. We think it would be interesting to conduct research on the investor figure. Indeed, although marketing easily considers the consumer as an actor subject to biases, and who acts within the framework of a limited rationality, finance still struggles to define the investor as an economic actor subject to individual and collective biases.