bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of maternal milk ejection characteristics during pumping using infant-derived and 2-phase vacuum patterns
Authors: Gardner Hazel , Kent Jacqueline C. , Lai Ching Tat , Geddes Donna T.
Published: November 2019

Background

Milk ejection characteristics remain consistent throughout 12 months of lactation in women who expressed breastmilk with an electric breast pump. In addition these characteristics appear to remain constant when women are breastfeeding or pumping suggesting that milk ejection is a robust physiological response. It is not known whether the stimulation of an infant at the breast in the early post partum period influences milk ejection patterns or whether this is a programmed event. However, as more data become available on the mechanisms involved in infant feeding, pumping patterns mimicking the infant more closely may provide enhanced results. The objective of this study was to compare milk ejection characteristics obtained when using a novel infant-derived pumping pattern with an established 2-phase pattern.

Methods

A convenience sample of ten lactating mothers, 1 to 40 weeks of lactation with normal milk production were recruited in 2015. Each participated in two pumping sessions in which either a 2-phase pattern or infant-derived pattern were randomly assigned. Milk volume and milk ejection characteristics were recorded and the percentage of available milk removed (PAMR) was calculated. Statistical analysis used linear mixed effects modeling to determine any differences between breasts and pump patterns with the consideration of individual variability as a random effect.

Results

The number of milk ejections and milk ejection characteristics did not differ between patterns. Milk volumes removed were 53.6 ± 28.5 ml (PAMR 58.2 ± 28.4) for the 2-phase pattern and and 54.2 ± 26.3 ml (PAMR 52.2 ± 22.3) for the infant derived pattern. Peak milk flow rates were positively associated with the available milk (p = 0.0003) and PAMR (p = 0.0001), as was the volume of milk removed during each milk ejection (p = 0.001 and p = 0.0001).

Conclusion

An experimental pumping pattern designed to resemble infant sucking characteristics did not alter milk ejection characteristics or milk removal parameters compared with an established 2-phase pattern. Theses findings provide further evidence that milk ejection is a robust physiological response.
Methadone associated long term hearing loss and nephrotoxicity; a case report and literature review
Authors: Ghasemi Saeedeh , Izadpanahi Shadi , Yaghoubi Mohammad Ali , Brent Jeffrey , Mehrpour Omid
Published: November 2019

Background

Methadone is a long-acting opioid receptor agonist. Reported adverse effects of methadone include constipation, respiratory depression, dizziness, nausea, vomiting, itching, sweating, rhabdomyolysis, QT prolongation, and orthostatic hypotension. Hearing loss has been rarely reported following methadone use, and when reported, long term follow-up is rare.

Herein we report a case of methadone poisoning with rhabdomyolysis, acute kidney injury, and persistent hearing loss documented by a 2 year follow up.

Case presentation

The patient was a 34 years old male who presented with a reduced level of consciousness and acute hearing loss after suicidal ingestion of 40 mg of methadone while experiencing family-related stresses. He had no prior history of methadone use, abuse, or addiction.

Initial laboratory testing was significant for a serum creatinine concentration of 4.1 mg/dl, a mixed metabolic and respiratory acidosis, thrombocytopenia, abnormal hepatic transaminases, and coagulation tests. The patient then developed severe rhabdomyolysis. Also, audiometry showed a bilateral sensorineural hearing loss. The patient required hemodialysis for 11 days while his metabolic abnormalities gradually resolved. However, his hearing loss was persistent, as demonstrated by 2 years of follow up.

Conclusion

Our patient simultaneously had kidney failure, rhabdomyolysis, and permanent hearing loss following methadone poisoning. Although rare, ototoxicity and permanent hearing loss may happen in cases of methadone poisoning. While opioid-induced hearing loss is uncommon, methadone toxicity should be taken into account for any previously healthy patient presenting with acute hearing loss with or without rhabdomyolysis.
Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures
Authors: Yoshii Yuichi , Totoki Yasukazu , Sashida Satoshi , Sakai Shinsuke , Ishii Tomoo
Published: November 2019

Background

Recently, computerized virtual surgery planning has been increasingly applied in various orthopedic procedures. In this study, we developed an image fusion system for 3D preoperative planning and fluoroscopy for the osteosynthesis. To assess the utility of image fusion system, we evaluated the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures with using the image fusion system, and compared with the reproducibility of the patients without using the image fusion system.

Methods

Forty-two wrists of 42 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The patients were divided into two groups. Image fusion group utilized three-dimensional (3D) preoperative planning and image fusion system. Control group utilized only 3D preoperative planning. In both groups, 3D preoperative planning was performed in order to determine reduction, placement, and choice of implants. In the image fusion group, the outline of planned image was displayed on a monitor overlapping with fluoroscopy images during surgery. Reductions were evaluated by volar tilt and radial inclination of 3D images. Plate positions were evaluated with distance to joint surface, plate center axis position, and inclination relative to the radius axis. Screw choices were recorded for the plan and actual choices for each screw hole. Differences in the parameters between pre- and postoperative images were evaluated. Differences in reduction shape, plate positions, and screw choices were compared between groups.

Results

The differences in the distance from plate to joint surface were significantly smaller in the image fusion group compared to the control group (P < 0.01). The differences in the distal screw choices were significantly smaller in the image fusion group compared to the control group (P < 0.01).

Conclusions

The image fusion system was useful to reproduce the planned plate position and distal screw choices in the osteosynthesis of distal radius fractures.

Trial registration

ClinicalTrials.gov, NCT03764501
Tissue discrimination by bioelectrical impedance during PLL resection in anterior decompression surgery for treatment of cervical spondylotic myelopathy
Authors: Shao Fuqiang , Bai He , Tang Muyao , Xue Yuan , Dai Yu , Zhang Jianxun
Published: November 2019

Background

The electrical properties of biological tissues differ depending on their physical properties. This study aimed to explore if bioelectrical impedance (modulus and phase) would discriminate tissues relevant to resection of the posterior longitudinal ligament (PLL) in anterior cervical decompression surgery.

Methods

PLL resection via an anterior approach was performed on the C4/5 segments in six mini-pigs. The bioelectrical impedance measurements were performed for two tissue groups (annulus fibrosus, endplate cartilage, sub-endplate cortical bone, and PLL; PLL, dura mater, spinal cord, and nerve root) using a novel probe and a precision inductance-capacitance-resistance meter. For each group, impedance was analyzed in terms of modulus and phase along a broad spectrum of frequencies (200–3000 kHz) using a nonparametric statistical analysis (Kruskal-Wallis).

Results

The analysis showed a clear difference among the tissues. The modulus and phase show the same changing trend with frequency and present lower values at higher frequencies. Among annulus fibrosus, endplate cartilage, sub-endplate cortical bone, and PLL, it was possible to discriminate each tissue at every frequency point, considering the phase (p < 0.05), while this was not always the case (i.e., annulus fibrosus vs PLL at frequency of 200 kHz, 400 kHz, and 3000 kHz, p > 0.05) for modulus. Among PLL, dura mater, spinal cord, and nerve root, for every comparison, a statistically significant difference was reported in the modulus, phase, or both (p < 0.05).

Conclusions

The results indicated the potential of bioelectrical impedance to provide real-time tissue differentiation and enhance safe PLL resection in anterior cervical decompression surgery, particularly in robot-assisted minimally invasive surgery (RMIS).
Factors associated with the length of stay in total knee arthroplasty patients with the enhanced recovery after surgery model
Authors: Li Guoqing , Weng Jian , Xu Chang , Wang Deli , Xiong Ao , Zeng Hui
Published: November 2019

Objectives

The purpose of this study is to identify the factors that influence the length of stay (LOS) in total knee arthroplasty (TKA) patients with an enhanced recovery after surgery (ERAS) program.

Methods

Information from 167 patients (31 males and 136 females, range from 43 years to 88 years old) who underwent the unilateral elective primary TKA from January 2017 to January 2019 were reviewed retrospectively. Factors were analyzed by single-factor variance and multi-factor linear regression.

Results

By single-factor variance analysis, American Society of Anesthesiologists (ASA) physical status classification system, pre-operation albumin, pre-operation erythrocyte sedimentation rate (ESR), primary and merge diseases, hidden blood loss, and length of operation were correlated with LOS (P < 0.05). Multi-factor linear regression results suggested that gender, ASA class, pre-operation Alb, and pre-operation ESR were associated with LOS (P < 0.05). Moreover, ASA class 3 (Bvalue 4.84), pre-operation Alb < 30 g/L (Bvalue 18.33), and pre-operation ESR > 15 mmol/h (Bvalue 2.21) could increase the LOS, while males (Bvalue − 3.56) had a shortened LOS.

Conclusions

Overall, our research found that female, ASA class 3, pre-operation Alb < 30 g/L, and pre-operation ESR > 15 mmol/h could extend LOS in TKA patients with ERAS.
Safety and long-term efficacy of thoracoscopic Epicardial ablation in patients with paroxysmal atrial fibrillation: a retrospective study
Authors: Johnkoski John , Miles Bryan , Sudbury Anna , Osman Mohammed , Munir Muhammad Bilal , Balla Sudarshan , Benjamin Mina M.
Published: November 2019

Background

The aim of this study is to report the long-term efficacy and safety of thoracoscopic epicardial left atrial ablation (TELA) in patients with paroxysmal atrial fibrillation (AF).

Methods

This was a retrospective review of medical records. We included all patients diagnosed with paroxysmal AF who underwent TELA at our institution between 04/2011 and 06/2017. TELA included pulmonary vein isolation, LA dome lesions and LA appendage exclusion. All (n = 55) patients received an implantable loop recorder (ILR), 30 days post-operatively. Antiarrhythmic and anticoagulation therapy were discontinued at 90 and 180 days postoperatively, respectively, if patients were free of AF recurrence. Failure was defined as ≥two minutes of continuous AF, or atrial tachycardia.

Results

Fifty-five patients (78% males, mean age = 61.6 years) qualified for the study. The average duration in AF was 3.64 +/− 3.4 years, mean CHA2DS2-VASc Score was 2.0 +/− 1.6. The procedure was attempted in 57 patients and completed successfully in 55 (96.5%). Two patients experienced a minor pulmonary vein bleed that was managed conservatively. Post procedure, one patient experienced pulmonary edema, another experienced a pneumothorax requiring a chest tube and another experienced acute respiratory distress syndrome resulting in longer hospitalization. Otherwise, there were no major procedural complications. Success rates were 89.1% (n = 49/55), 85.5% (n = 47/55) and 76.9% (n = 40/52) at 6, 12 and 24 months, respectively. In the multivariate cox-proportional hazard model, survival at the mean of covariates was 86 and 74% at 12 and 24 months, respectively.

Conclusion

In this single center experience, TELA was a safe and efficacious procedure for patients with paroxysmal AF.
The relationship between dietary inflammatory index and psychosomatic complaints profiles: results from SEPAHAN cross-sectional study
Authors: Haghighatdoost Fahimeh , Feizi Awat , Esmaillzadeh Ahmad , Feinle-Bisset Christine , Hassanzadeh Keshteli Ammar , Roohafza Hamidreza , Afshar Hamid , Adibi Peyman
Published: November 2019

Background

Although the dietary inflammatory index (DII) has been evaluated in relation to psychological disorders risk, the association between DII and psychosomatic complaints is unclear. This study aimed to determine the association between DII, as a proxy measure of the inflammatory potential of the diet, and psychosomatic complaints.

Methods

This cross-sectional study included 2818 people from the general population, aged 19 to 69 years, of Isfahan province in Iran. Dietary intake was assessed using a validated dish-based food-frequency questionnaire. Psychosomatic complaints were assessed using a self-administered validated Persian questionnaire. Twenty-seven nutrients or foods were included in the calculation of DII. Each of them received a score based on their inflammatory ability, thus, a higher DII score indicated a more pro-inflammatory diet. The risk of being in the top median of a psychosomatic complaints profile across the tertiles of DII was assessed using logistic regression.

Results

Four psychosomatic complaints profiles (psychological, gastrointestinal, neuro-skeletal and pharyngeal- respiratory) were identified. After controlling for potential confounders, individuals in the top tertile of DII had higher odds for experiencing high somatic complaints scores for the psychological (odds ratio (OR) = 1.44, 95% confidence interval (CI): 1.10, 1.89; P trend = 0.009), gastrointestinal (OR = 1.22, 95% CI: 0.99, 1.75;P = 0.058) or neuro-skeletal (OR = 1.56, 95% CI: 1.10, 2.22;P = 0.013) profile. The association for pharyngeal-respiratory complaints did not remain significant after adjustment for stressful life events, medical condition, and anti-psychotropic medicine use.

Conclusion

The significant positive link between DII and the various psychosomatic complaints profiles suggests that a diet with anti-inflammatory potential might be favourably related to psychosomatic complaints. Further studies, particularly clinical trials and longitudinal studies, are warranted to investigate the inflammatory potential of diet in relation to psychosomatic complaints.
Apatinib potentiates irradiation effect via suppressing PI3K/AKT signaling pathway in hepatocellular carcinoma
Authors: Liao Junbin , Jin Huilin , Li Shaoqiang , Xu Lixia , Peng Zhenwei , Wei Guangyan , Long Jianting , Guo Yu , Kuang Ming , Zhou Qi , Peng Sui
Published: November 2019

Background

Limited effective intervention for advanced hepatocellular carcinoma (HCC) is available. This study aimed to investigate the potential clinical utility of apatinib, a highly selective inhibitor of the vascular endothelial growth factor receptor-2 (VEGFR2) tyrosine kinase, as a radiosensitizer in the treatment of HCC.

Methods

Four human HCC cell lines SMMC-7721, MHCC-97H, HCCLM3 and Hep-3B were treated with apatinib, irradiation or combination treatment. Colony formation assay, flow cytometry and nuclear γ-H2AX foci immunofluorescence staining were performed to evaluate the efficacy of combination treatment. RNA sequencing was conducted to explore the potential mechanism. The impact of combination treatment on tumor growth was assessed by xenograft mice models.

Results

Colony formation assay revealed that apatinib enhanced the radiosensitivity of HCC cell lines. Apatinib suppressed repair of radiation-induced DNA double-strand breaks. Flow cytometry analysis showed that apatinib increased radiation-induced apoptosis. Apatinib radiosensitized HCC via suppression of radiation-induced PI3K/AKT pathway. Moreover, an in vivo study indicated apatinib combined with irradiation significantly decreased xenograft tumor growth.

Conclusions

Our results indicate that apatinib has therapeutic potential as a radiosensitizer in HCC, and PI3K/AKT signaling pathway plays a critical role in mediating radiosensitization of apatinib.
Microbial 2-butanol production with Lactobacillus diolivorans
Authors: Russmayer Hannes , Marx Hans , Sauer Michael
Published: November 2019

Background

Biobutanol has great potential as biofuel of the future. However, only a few organisms have the natural ability to produce butanol. Amongst them, Clostridium spp. are the most efficient producers. The high toxicity of biobutanol constitutes one of the bottlenecks within the biobutanol production process which often suffers from low final butanol concentrations and yields. Butanol tolerance is a key driver for process optimisation and, therefore, in the search for alternative butanol production hosts. Many Lactobacillus species show a remarkable tolerance to solvents and some Lactobacillus spp. are known to naturally produce 2-butanol from meso-2,3-butanediol (meso-2,3-BTD) during anaerobic sugar fermentations. Lactobacillus diolivorans showed already to be highly efficient in the production of other bulk chemicals using a simple two-step metabolic pathway. Exactly, the same pathway enables this cell factory for 2-butanol production.

Results

Due to the inability of L. diolivorans to produce meso-2,3-BTD, a two-step cultivation processes with Serratia marcescens has been developed. S. marcescens is a very efficient producer of meso-2,3-BTD from glucose. The process yielded a butanol concentration of 10 g/L relying on wild-type bacterial strains. A further improvement of the maximum butanol titer was achieved using an engineered L. diolivorans strain overexpressing the endogenous alcohol dehydrogenase pduQ. The two-step cultivation process based on the engineered strain led to a maximum 2-butanol titer of 13.4 g/L, which is an increase of 34%.

Conclusion

In this study, L. diolivorans is for the first time described as a good natural producer for 2-butanol from meso-2,3-butanediol. Through the application of a two-step cultivation process with S. marcescens, 2-butanol can be produced from glucose in a one-vessel, two-step microbial process.
High resolution melting analysis of the 18S rRNA gene for the rapid diagnosis of bovine babesiosis
Authors: Wang Jinming , Liu Aihong , Zhang Shangdi , Gao Shandian , Rashid Muhammad , Li Youquan , Liu Junlong , Ma Quanying , Li Zhi , Liu Zhijie , Luo Jianxun , Guan Guiquan , Yin Hong
Published: November 2019

Background

Bovine babesiosis is caused by protozoan parasites of the genus Babesia and presents a wide spectrum of clinical manifestations. Disease severity depends on the type of Babesia species infection. Generally, B. bovis and B. bigemina are considered as the causative agents of bovine babesiosis; in addition, Babesia ovata and B. major are a group of benign bovine piroplasms. Therefore, species identification is important for diagnosis, epidemiological investigations and follow-up management.

Methods

Real-time PCR combined with high resolution melting (RT-PCR-HRM) analysis was used to detect and discriminate four Babesia species infective to cattle, including Babesia bovis, B. bigemina, B. major and B. ovata. The melting profiles and melting temperatures (Tm) of the amplicon targeting 18S rRNA revealed differences that can discriminate the four Babesia spp. Sensitivity and specificity of the analytical method were evaluated using 50 blood samples collected from experimentally infected cattle and 240 blood samples from areas where bovine babesiosis is an issue.

Results

RT-PCR-HRM analysis allowed to detect and discriminate four Babesia spp. (B. bovis, B. bigemina, B. major and B. ovata), which were responsible for bovine babesiosis in China. The protocol was validated with DNA samples from experimentally infected cattle and field infection in cattle.

Conclusions

Our results indicate that RT-PCR-HRM is a fast and robust tool for the simultaneous detection and discrimination of four Babesia species that are responsible for bovine babesiosis in China. This approach is applicable for both field and experimental samples, thus it could be useful in epidemiological investigations and diagnoses of bovine babesiosis.
Finite Morse index solutions of the Hénon Lane–Emden equation
Authors: Harrabi Abdellaziz , Zaidi Cherif
Published: November 2019

In this paper, we are concerned with Liouville-type theorems of the Hénon Lane–Emden triharmonic equations in whole space. We prove Liouville-type theorems for solutions belonging to one of the following classes: stable solutions and finite Morse index solutions (whether positive or sign-changing). Our proof is based on a combination of the Pohozaev-type identity, monotonicity formula of solutions and a blowing down sequence.
The effect of root pruning on the arbuscular mycorrhizal symbiosis in grapevine rootstocks
Authors: Holland Taylor , Bowen Pat , Kokkoris Vasilis , Richards Andrew , Rosa Daniel , Hart Miranda
Published: November 2019

Background

Arbuscular mycorrhizal fungi provide benefits to plants, especially under stressful growing conditions. These symbiotic fungi can be applied as biofertilizers prior to transplant in order to increase establishment success in the field. Roots are often trimmed at the time of transplant to reduce the probability of J-rooting, the upward orientation of roots within a planting hole which can lead to root death and disease. The effect of root trimming on the mycorrhizal symbiosis is unknown. It is possible that trimming may remove the active mycelium, nullifying the effect of inoculation. We conducted a greenhouse study to test the effect of root trimming on the mycorrhizal symbiosis in grapevine.

Results

The mycorrhizal symbiosis persisted after root trimming. Trimming reduced the abundance of AM fungi in older roots. The fungi were able to recolonize the new roots in trimmed vines, and these roots had more arbuscules compared to older roots, which had mostly vesicles. Trimmed vines had lower shoot, but not root, biomass.

Conclusions

The mycorrhizal symbiosis persisted in the roots, despite trimming, likely due to fungal structures in older, untrimmed roots serving as propagules. We conclude that inoculation with AM fungi prior to field transplant is robust to root trimming, at least for the isolate examined in this study.
Identification of essential attributes in conclusions of student reports
Authors: López-López Aurelio , González-López Samuel , García-Gorrostieta Jesús Miguel
Published: November 2019

This work seeks to help students in improving their first research reports, based on natural language processing techniques. We present a Conclusion model that includes three schemes: Goal Connectedness, Judgment and Speculation. These subsystems try to account for the main expected attributes in conclusions, specifically the Connectedness with the general objective of the research, the evidence of value Judgments, and the presence of Future work as a result of the student reflection after the inquiry. The article details the schemes, a validation of the approach in an annotated corpus, and a pilot test with undergraduate students. Results of a prior validation indicate that student writings indeed adhere to such attributes, especially at graduate level. Statistical results of the pilot test showed that undergraduate students in an experimental group achieved improved conclusion content when compared with the control group.
Patterns and drivers of species richness and turnover of neo-endemic and palaeo-endemic vascular plants in a Mediterranean hotspot: the case of Crete, Greece
Authors: Lazarina Maria , Kallimanis Athanasios S. , Dimopoulos Panayotis , Psaralexi Maria , Michailidou Danai-Eleni , Sgardelis Stefanos P.
Published: November 2019

Background

Exploring species richness and turnover patterns and their drivers can provide new insights into underlying mechanisms shaping community assembly, with significant implications for biodiversity conservation. Here, we explored diversity patterns of non-endemic, neo-endemic and palaeo-endemic vascular plants in Crete, Greece, a Mediterranean hotspot of plant richness and endemism. We evaluated the relationship between α-diversity and environmental (bioclimatic variables, topography), and anthropogenic variables by Generalized Additive Models, after accounting for spatial autocorrelation. Then, we quantified turnover using the novel concept of zeta diversity (the number of shared species by multiple sites), a framework which allows to explore the full spectrum of compositional turnover, the contribution of rare and widespread species to observed patterns and the underlying processes shaping them. Finally, we explored the abiotic and biotic effects, i.e. how well one category of species (non-endemics, palaeo-endemics, neo-endemics) predicts the patterns of the other categories, on zeta diversity by multi-site Generalized Dissimilarity Modelling.

Results

We found a strong correlation between neo-endemic and palaeo-endemic α-diversity, with climate, topography, and human impact driving species richness. Zeta diversity analysis revealed a sharper decrease of shared palaeo-endemic species, followed by neo-endemics, and then by non-endemics with the number of sites considered to estimate compositional turnover. Perhaps, the narrow distributions of palaeo-endemics as relict species and often habitat specialists, thus persisting locally, and of neo-endemics that may have not reached yet their potential geographical range, resulted in the observed zeta diversity decline pattern. Deterministic processes controlled species turnover of rare non-endemic and neo-endemic species, while deterministic and stochastic processes contributed similarly to palaeo-endemic turnover. However, stochasticity dominates in the case of widespread species in all occasions. The environmental and anthropogenic variables were poor predictors of compositional turnover, especially of widespread species. However, the non-endemic species composition was correlated to rare palaeo-endemics and neo-endemics, highlighting the importance of biotic effects in driving turnover patterns.

Conclusions

It seems that centers of neo-endemism of vascular plants coincide with centers of palaeo-endemism in Crete, but species richness and species turnover are shaped by different drivers.
Polatuzumab Vedotin in Relapsed or Refractory Diffuse Large B-Cell Lymphoma
Authors: Sehn Laurie H. , Herrera Alex F. , Flowers Christopher R. , Kamdar Manali K. , McMillan Andrew , Hertzberg Mark , Assouline Sarit , Kim Tae Min , Kim Won Seog , Ozcan Muhit , Hirata Jamie , Penuel Elicia , Paulson Joseph N. , Cheng Ji , Ku Grace , Matasar Matthew J.
Published: November 2019

PURPOSE

Patients with transplantation-ineligible relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) fare poorly, with limited treatment options. The antibody-drug conjugate polatuzumab vedotin targets CD79b, a B-cell receptor component.

METHODS

Safety and efficacy of polatuzumab vedotin with bendamustine and obinutuzumab (pola-BG) was evaluated in a single-arm cohort. Polatuzumab vedotin combined with bendamustine and rituximab (pola-BR) was compared with bendamustine and rituximab (BR) in a randomly assigned cohort of patients with transplantation-ineligible R/R DLBCL (primary end point: independent review committee [IRC] assessed complete response [CR] rate at the end of treatment). Duration of response, progression-free survival (PFS), and overall survival (OS) were analyzed using Kaplan–Meier and Cox regression methods.

RESULTS

Pola-BG and pola-BR had a tolerable safety profile. The phase Ib/II pola-BG cohort (n = 27) had a CR rate of 29.6% and a median OS of 10.8 months (median follow-up, 27.0 months). In the randomly assigned cohort (n = 80; 40 per arm), pola-BR patients had a significantly higher IRC-assessed CR rate (40.0% v 17.5%; P = .026) and longer IRC-assessed PFS (median, 9.5 v 3.7 months; hazard ratio [HR], 0.36, 95% CI, 0.21 to 0.63; P < .001) and OS (median, 12.4 v 4.7 months; HR, 0.42; 95% CI, 0.24 to 0.75; P = .002; median follow-up, 22.3 months). Pola-BR patients had higher rates of grade 3-4 neutropenia (46.2% v 33.3%), anemia (28.2% v 17.9%), and thrombocytopenia (41% v 23.1%), but similar grade 3-4 infections (23.1% v 20.5%), versus the BR group. Peripheral neuropathy associated with polatuzumab vedotin (43.6% of patients) was grade 1-2 and resolved in most patients.

CONCLUSION

Polatuzumab vedotin combined with BR resulted in a significantly higher CR rate and reduced the risk of death by 58% compared with BR in patients with transplantation-ineligible R/R DLBCL.
Estimated Association Between Cytokines and the Progression to Diabetes: 10-year Follow-Up From a Community-Based Cohort
Authors: Cho Nam H , Ku Eu Jeong , Jung Kyoung Yeon , Oh Tae Jung , Kwak Soo Heon , Moon Jae Hoon , Park Kyong Soo , Jang Hak C , Kim Yoon Ji , Choi Sung Hee
Published: November 2019

Context

The long-term association between multiple cytokines and progression to diabetes is still uncertain.

Objective

To identify which cytokines could predict progression to prediabetes and type 2 diabetes over 10 years.

Methods

The study included 912 participants aged 40 to 69 years at baseline from the Ansung cohort, part of the Korea Genome Epidemiology Study. At baseline, a 75-g oral glucose tolerance test and 8 cytokines were measured: plasminogen activator inhibitor 1 (PAI-1), resistin, interleukin 6, leptin, monocyte chemoattractant protein 1, tumor necrosis factor alpha, retinol binding protein 4 (RBP4), and adiponectin. People with normal glucose tolerance (NGT, n = 241) and prediabetes (n = 330) were followed-up biennially for 10 years. Multinomial logistic regression analysis was used to evaluate the predictability of cytokines on the new-onset prediabetes and type 2 diabetes.

Results

At 10 years, 38 (15.8%) and 82 (34.0%) of those with NGT had converted to prediabetes and type 2 diabetes, respectively. Of those with prediabetes, 228 (69.1%) had converted to type 2 diabetes. In people with NGT or prediabetes at baseline, the highest tertile of RBP4 was associated with a 5.48-fold and 2.43-fold higher risk of progression to type 2 diabetes, respectively. The odds for converting from NGT to prediabetes in the highest tertile of PAI-1 and the lowest tertile of adiponectin were 3.23 and 3.37, respectively. In people with prediabetes at baseline, those in the highest tertile of resistin were 2.94 time more likely to develop type 2 diabetes (all P < 0.05).

Conclusions

In this 10-year prospective study, NGT with higher serum RBP4 and PAI-1, and with lower adiponectin were associated with new-onset prediabetes and type 2 diabetes.
The Use and Misuse of Historical Controls in Regulatory Toxicology: Lessons from the CLARITY-BPA Study
Authors: Vandenberg Laura N , Prins Gail S , Patisaul Heather B , Zoeller R Thomas
Published: November 2019

For many endocrine-disrupting chemicals (EDCs) including Bisphenol A (BPA), animal studies show that environmentally relevant exposures cause harm; human studies are consistent with these findings. Yet, regulatory agencies charged with protecting public health continue to conclude that human exposures to these EDCs pose no risk. One reason for the disconnect between the scientific consensus on EDCs in the endocrinology community and the failure to act in the regulatory community is the dependence of the latter on so-called “guideline studies” to evaluate hazards, and the inability to incorporate independent scientific studies in risk assessment. The Consortium Linking Academic and Regulatory Insights on Toxicity (CLARITY) study was intended to bridge this gap, combining a “guideline” study with independent hypothesis-driven studies designed to be more appropriate to evaluate EDCs. Here we examined an aspect of “guideline” studies, the use of so-called “historical controls,” which are essentially control data borrowed from prior studies to aid in the interpretation of current findings. The US Food and Drug Administration authors used historical controls to question the plausibility of statistically significant BPA-related effects in the CLARITY study. We examined the use of historical controls on 5 outcomes in the CLARITY “guideline” study: mammary neoplasms, pituitary neoplasms, kidney nephropathy, prostate inflammation and adenomas, and body weight. Using US Food and Drug Administration–proposed historical control data, our evaluation revealed that endpoints used in “guideline” studies are not as reproducible as previously held. Combined with other data comparing the effects of ethinyl estradiol in 2 “guideline” studies including CLARITY-BPA, we conclude that near-exclusive reliance on “guideline” studies can result in scientifically invalid conclusions.
Structure and function analysis of the essential 3′X domain of hepatitis C virus
Authors: Castillo-Martínez Jesús , Ovejero Tamara , Romero-López Cristina , Sanmartín Isaías , Berzal-Herranz Beatriz , Oltra Elisa , Berzal-Herranz Alfredo , Gallego José
Published: November 2019

The 3′X domain of hepatitis C virus has been reported to control viral replication and translation by modulating the exposure of a nucleotide segment involved in a distal base-pairing interaction with an upstream 5BSL3.2 domain. To study the mechanism of this molecular switch, we have analyzed the structure of 3′X mutants that favor one of the two previously proposed conformations comprising either two or three stem–loops. Only the two-stem conformation was found to be stable and to allow the establishment of the distal contact with 5BSL3.2, and also the formation of 3′X domain homodimers by means of a universally conserved palindromic sequence. Nucleotide changes disturbing the two-stem conformation resulted in poorer replication and translation levels, explaining the high degree of conservation detected for this sequence. The switch function attributed to the 3′X domain does not occur as a result of a transition between two- and three-stem conformations, but likely through the sequestration of the 5BSL3.2-binding sequence by formation of 3′X homodimers.
The why, when, and how of computing in biology classrooms
Authors: Wright April M. , Schwartz Rachel S. , Oaks Jamie R. , Newman Catherine E. , Flanagan Sarah P.
Published: November 2019

Many biologists are interested in teaching computing skills or using computing in the classroom, despite not being formally trained in these skills themselves. Thus biologists may find themselves researching how to teach these skills, and therefore many individuals are individually attempting to discover resources and methods to do so. Recent years have seen an expansion of new technologies to assist in delivering course content interactively. Educational research provides insights into how learners absorb and process information during interactive learning. In this review, we discuss the value of teaching foundational computing skills to biologists, and strategies and tools to do so. Additionally, we review the literature on teaching practices to support the development of these skills. We pay special attention to meeting the needs of diverse learners, and consider how different ways of delivering course content can be leveraged to provide a more inclusive classroom experience. Our goal is to enable biologists to teach computational skills and use computing in the classroom successfully.
Reporting of academic degrees in high-impact medical journals
Authors: Stankovic Nikola , Nolan Jerry P. , Andersen Lars W.
Published: November 2019

Academic degrees following author names are often included in medical research papers. However, it remains unclear how many journals choose to include academic degrees and whether this is more common in certain types of journals. We examined the 100 highest impact medical journals and found that only 24 medical journals reported academic degrees. Moreover, this was substantially more common in journals based in North America compared with Europe. Further research is required to explore the implications of listing academic degrees on the readers’ attitude towards research quality.
iCOMPARE, what value does it add to resident duty-hour discussions?
Authors: Hopkins Zachary H. , Secrest Aaron M.
Published: November 2019

Discussions regarding resident duty-hour restrictions have been ongoing and heated. One influential argument for restrictions has been patient safety. Two trials, FIRST and iCOMPARE, were performed to investigate this relationship with surgical and medicine training, respectively. As the authors are approaching this discussion from a medicine-based perspective, iCOMPARE will serve as the primary basis of our discussion. Results from the iCOMPARE trial comparing flexible (28-hour shifts allowed) to the original 2011 ACGME shift requirements (maximum 16 hours) were recently published in the New England Journal of Medicine. This non-inferiority trial used 30-day post-hospitalization mortality as its primary endpoint. Results met qualifications for non-inferiority, and ACGME policy was changed to allow for 28-hour shifts for medicine residents. iCOMPARE results were highly lauded and used as primary justification for extending resident duty hours. Despite this sweeping impact, few have critically evaluated what this study actually adds to the literature. Herein, we argue that serious questions regarding trial design are apparent. Most importantly, the non-inferiority margins chosen were large, and represent an ambiguous marker of resident performance. Additionally, we question the lack of both patient consenting and direct patient-reported or patient-centered outcomes within the hospital stay. As more discussion arises in the medical literature surrounding patient-reported outcomes and shared decision making, we argue that the results of iCOMPARE disregarded the patient perspective or meaningful patient outcomes in an attempt to maintain status quo. Lastly, we discuss how iCOMPARE missed the broader question of actual duty-hour restrictions, and some practical methods already in practice at some programs, which may more directly balance resident work hours with patient care and resident learning.
Political systems of post-Soviet States
Authors: Кузьмин Петр , Kuz'min Petr
Published: November 2019

In the textbook based on the study of various literary sources and the basic laws of post-Soviet States set out a theoretical-methodological situation analysis the political system of society, are considered key components of political systems of emerging post-Soviet societies. The main attention is focused on the functional characteristics of state institutions, the role of political parties, political culture and ideology in the formation and development of political systems of post-Soviet countries.
It is intended for students studying in the direction of training 41.03.04 "political Science". It can be useful for students of other fields of study, graduate students and all interested in political science problems of the post-Soviet States.
The systemic quantums of technological processes in the production and construction of objects and complexes (2 izd)
Authors: Миронова Альвина , Mironova Al'vina , Миронов Юрий , Mironov Yuriy
Published: November 2019

In the manual the basics of power supply of industrial enterprises are considered; data on electrotechnological installations as receivers of the electric power are given; characteristics of the main types of electric equipment and schemes of power supply of electrotechnological installations are described.
Meets the requirements of the Federal state educational standards of higher education of the last generation.
It is intended for students studying in the direction of training 13.03.02 "electric power and electrical engineering", specialty "Electrotechnological processes and installations, devices of electric heating". It can also be useful for undergraduates, graduate students and industry professionals.
Technology of special concretes on sulfur and sulfur-bitumen binders
Authors: Усов Борис , Usov Boris , Горбунова Татьяна , Gorbunova Tatiana
Published: November 2019

The publication is a textbook for teaching and studying in technical higher educational institutions of modern technologies for the production of special concretes on sulfur and sulfur-bitumen binders. The results of foreign and domestic researchers on the use of sulfur in structures, products operating in an aggressive environment, and types of modification of road bitumen and asphalt.
Meets the requirements of the Federal state educational standards of higher education of the last generation.
For students studying in the areas of training 08.03.01 and 08.04.01 "Construction" and specialty 08.05.01 "Construction of unique buildings and structures", as well as for graduate students. It is also useful for self-study.
Cervical cancer screening programme
Authors: Peate Ian
Published: November 2019

Screening for cervical cancer saves lives. This article provides an overview of cervical screening programmes offered by the NHS. All four countries in the UK provide a cervical cancer screening programme.

Cervical screening identifies apparently healthy women who may be at increased risk of a disease or condition; this then provides an opportunity for earlier treatment or better informed decisions. In some instances, the healthcare assistant and assistant practitioner (HCA and AP) may be needed in order to provide assistance with the screening procedure, offering the woman physical and psychological support. This article offers the reader an overview of the cervix, along with a brief description of signs and symptoms of cervical cancer.
‘So, do you miss clinical work?’ Reflections on a journey through veterinary leadership
Authors: Elwood Clive
Published: November 2019

The author describes his path into and out of leading a large veterinary referral practice, and reflects on the challenges and rewards of leadership. Moving into a leadership role generally requires development of new skills and insight, and may mean old roles have to be passed on. The value of skills transferable from the clinic, such as listening, questioning, problem solving and trusting, are highlighted. The demands of task management, relationship management, external networking and change management are discussed. Reflecting from outside of the role, the importance of leadership development, self-care, daring, personal growth and change are acknowledged.
Cruciate ligament disease and the role of the Balto Knee Brace
Authors: Corral Cheryl
Published: November 2019

Cruciate disease is the most prevalent cause of hindlimb lameness among the canine population. As a result of the prevalent nature of the condition, improved management strategies are continually being sought from both a surgical and conservative perspective. This article discusses cruciate disease, and the KVP ‘Balto’ brace in relation to its use as part of conservative management strategy.
Save the planet!
Authors: Ives Tim
Published: November 2019

Telling our patients to turn off taps when brushing teeth is kinder to the environment. Dental hygienist Tim Ives explains why
Philosophical dialogue in palliative care and hospice work
Authors: Schuchter Patrick
Published: November 2019

Dealing with existential questions is a constitutive part of palliative care. Interestingly, if we admit that border situations at the end of life give rise to clearly ‘philosophical’ questions, in the contexts of practice, these questions are perceived (nearly) without any reference to explicit philosophical traditions or to ‘philosophical practice’. Existential questions in palliative care are usually approached from other perspectives and within other organisational forms of reflection and dialogue (psychotherapy, supervision, spiritual care, moral case deliberation). This piece considers how philosophical dialogue and reflection could contribute to palliative care and hospice work.
María Fernanda Barcos, Sol Lanteri y Daniela Marino (directoras), Tierra, agua y monte. Estudios sobre derechos de propiedad en América, Europa y África (siglos XIX y XX), Buenos Aires, Editorial Teseo, 2017, 388 p., ISBN 9789877231441
Authors: Castelao Ofélia Rey
Published: November 2019

https://doi.org/10.14195/0870-4147_50_18
Teatro Fúnebre
Authors: Pessa de Oliveira Ricardo
Published: November 2019

A irmandade do Santíssimo Sacramento da paróquia lisboeta de Santa Justa gozou da proteção e das esmolas dos duques de Cadaval, tendo D. Nuno, D. Luís e D. Jaime sido seus juízes perpétuos. Essa ligação justificou as solenes exéquias promovidas pelos irmãos do Santíssimo a membros daquela Casa, não só aos referidos duques mas também às duquesas D. Margarida de Lorena e D. Luísa. A partir das relações dessas cerimónias fúnebres, manuscritas e impressas, e dos sermões, recitados nessas ocasiões, que foram dados à estampa, pretende-se analisar os preparativos das exéquias, a forma como as mesmas decorreram e a sua complexidade, os principais tópicos abordados na parenética encomendada e a importância que tais solenidades e a sua posterior divulgação representaram para o crédito e imagem pública da irmandade.
The State and Society in Conflict Resolution in Indonesia (Conflict Area of West Kalimantan and Central Kalimantan)
Authors: Cahyono Heru
Published: November 2019

Several bloody communal conflicts shook some areas in Indonesia from the late 1990s to early 2000s, including widespread violent conflicts in West and Central Kalimantan. Two groups, the Dayaks and the Malays, both asserting their status as indigenous ethnic groups, fought another ethnic group, migrants from Madura (the Madurese). The disturbances began in late February 2001 in Central Kalimantan. Thousands of Dayaks attacked the Madurese. There was violence and killing in almost all villages. The disturbances began in Sampit City and spread to Kuala Kapuas, Pangkalan Bun and Palangka Raya. More than 400 Madurese died and 80 000 people were forced to leave Kalimantan (Cahyono 2004: 47-48).
The Making of Indonesian Education: An overview on Empowering Indonesian Teachers
Authors: Zulfikar Teuku
Published: November 2019

Education is one of the fundamental priorities of nation building. For this reason, the Indonesian government continuously seeks to improve the quality of its education. Empowering education can be done using many strategies, such as reforming school curricula or school systems or both. This article approaches the improvement of Indonesian education from a different angle, by considering teachers and the teaching profession. Before proposing an agenda for improving teachers, the article considers two main problems of Indonesian teachers: the practice of teacher-centred classroom pedagogy; and the emphasis on rote learning in the classroom. In response to these phenomena, this article suggests two main factors responsible for the persistence of such teaching styles: institutional cultures and the nature of assessment systems in Indonesian schools. This article has three recommendations to help Indonesian teachers improve. However, the author is aware that the agendas for improvement are complex and institutional reforms are needed; for example, the reform of teacher recruitment; teacher evaluation and also the reform of assessment systems. This article includes a discussion of what makes for a good teacher, which will help Indonesian teachers to gain an insight to their profession, and a discussion of the changes that could be made to enable the quality of teaching to improve.
Introduction: Understanding Indonesia
Authors: Epstein Stephen J.
Published: November 2019

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If Indonesia is Too Hard to Understand, Let�s Start with Bali
Authors: MacRae Graeme
Published: November 2019

Stereotypical representations, especially those by the media, are for most outsideobservers, the means and an obstacle to understanding Indonesia. One way aroundsuch stereotypes is to look at the way Indonesians themselves understand Indonesia. This essay reports and re?ects on Balinese understandings of Indonesia in the wake of the political, economic and terrorist upheavals of the early years of the twenty-first century. It concludes with an epilogue and update, arguing that the real issues for understanding Indonesia are now environmental.