bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug‐Induced Sleep Endoscopy in Children With Positional Obstructive Sleep Apnea
Authors: Kirkham Erin M. , Melendez Jonathan B. , Hoi Karen , Chervin Ronald D.
Published: August 2020

Objective

Positional obstructive sleep apnea (POSA)—defined as obstructive sleep apnea twice as severe supine than nonsupine—may offer clues to the underlying pattern of upper airway collapse in children. We compared drug‐induced sleep endoscopy (DISE) findings in children with and without POSA. We hypothesized that children with POSA would have significantly higher obstruction at the gravity‐dependent palate and tongue base but not at the adenoid, lateral wall, or supraglottis.

Study Design

Retrospective case series.

Setting

Tertiary pediatric hospital.

Subjects and Methods

We included children aged 1 to 12 years with obstructive sleep apnea diagnosed by polysomnography who underwent DISE from July 2014 to February 2019. Scores were dichotomized as ≥50% obstruction (Chan‐Parikh 2 or 3) vs <50% obstruction (Chan‐Parikh 0 or 1).

Results

Of 99 children included, 32 (32%) had POSA and 67 (68%) did not. Children with POSA did not differ from children without POSA in age, overall apnea‐hypopnea index, sex, race, syndromic diagnoses, obesity, or history of adenotonsillectomy. In logistic regression models, odds of ≥50% obstruction were significantly higher at the tongue base (odds ratio, 2.77; 95% CI, 1.04‐7.39) after adjustment for age, sex, obesity, previous adenotonsillectomy, and syndrome. No difference was noted at the adenoid, velum, lateral wall, or supraglottis.

Conclusion

POSA was associated with higher odds of obstruction on DISE at the tongue base but not at other levels.
The effect of climate on the spread of the COVID-19 pandemic: A review of findings, and statistical and modelling techniques
Authors: Briz-Redón Álvaro , Serrano-Aroca Ángel
Published: August 2020

The new SARS-CoV-2 coronavirus has spread rapidly around the world since it was first reported in humans in Wuhan, China, in December 2019 after being contracted from a zoonotic source. This new virus produces the so-called coronavirus 2019 or COVID-19. Although several studies have supported the epidemiological hypothesis that weather patterns may affect the survival and spread of droplet-mediated viral diseases, the most recent have concluded that summer weather may offer partial or no relief of the COVID-19 pandemic to some regions of the world. Some of these studies have considered only meteorological variables, while others have included non-meteorological factors. The statistical and modelling techniques considered in this research line have included correlation analyses, generalized linear models, generalized additive models, differential equations, or spatio-temporal models, among others. In this paper we provide a systematic review of the recent literature on the effects of climate on COVID-19’s global expansion. The review focuses on both the findings and the statistical and modelling techniques used. The disparate findings reported seem to indicate that the estimated impact of hot weather on the transmission risk is not large enough to control the pandemic, although the wide range of statistical and modelling approaches considered may have partly contributed to the inconsistency of the findings. In this regard, we highlight the importance of being aware of the limitations of the different mathematical approaches, the influence of choosing geographical units and the need to analyse COVID-19 data with great caution. The review seems to indicate that governments should remain vigilant and maintain the restrictions in force against the pandemic rather than assume that warm weather and ultraviolet exposure will naturally reduce COVID-19 transmission.
Structural Characterization of Fractured Portland Cement Concrete Pavements in Pennsylvania from Falling Weight Deflectometer Data
Authors: Ramirez Luis , Morian Dennis
Published: August 2020

Hot mix asphalt (HMA) overlays on fractured Portland cement concrete (PCC) is a common rehabilitation alternative used for PCC pavements in Pennsylvania. Several fracture techniques including rubblization, crack and seat (C&S), and break and seat (B&S) have been used for decades to minimize reflective cracking by reducing the effective slab length and, with it, expansion/contraction movement. The design of this type of overlay requires knowledge of the structural capacity of the fractured PCC layer. The AASHTO 93 and Pavement ME design methods are used by the Pennsylvania Department of Transportation (DOT). These methods and the Pennsylvania DOT documentation recommend certain values to characterize the structural capacity of the fractured PCC. However, the guidance envisaged the selection of these values provided by these design methods and the Pennsylvania DOT documentation is limited. The objective of this study is to determine realistic Pennsylvania-specific elastic modulus (EPCC) values and layer coefficients (LC) to characterize the in situ behavior of fractured PCC layer for jointed reinforced concrete pavements (JRCP) and jointed plain concrete pavements (JPCP). To obtain these structural properties, 11 different rehabilitation projects located in Pennsylvania were analyzed using falling weight deflectometer (FWD) data, backcalculation programs, and statistical methods. Based on this analysis, the recommended values of EPCC and LC for C&S overlay design are 360 ksi (kips per square inch) and 0.32, respectively. In the case of B&S overlay design, these values correspond to 400 ksi and 0.34, respectively. The variability of the slab fracturing process and the reduction of the structural capacity caused by fracturing were also analyzed in this investigation.
Clinicoepidemiologic Profile of Pediatric Traumatic Brain Injury: Experience of a Tertiary Care Hospital From Northern India
Authors: Madaan Priyanka , Agrawal Deepak , Gupta Deepak , Kumar Atin , Jauhari Prashant , Chakrabarty Biswaroop , Pandey R. M. , Paul Vinod Kumar , Misra M. C. , Gulati Sheffali
Published: August 2020

Traumatic brain injury is an important cause of acquired brain injury. The current study brings to light the clinicoepidemiologic profile of pediatric traumatic brain injury in India. Retrospective record analysis of children (aged ≤ 16 years) with traumatic brain injury presenting to an apex-trauma-center in North India over 4 years was done. Of more than 15 000 patients with a suspected head injury, 4833 were children ≤16 years old. Of these, 1074 were admitted to the inpatient department; 65% were boys with a mean age at presentation being 6.6 years. Most patients (85%) had a Glasgow Coma Scale score of 13 to 15 at presentation while Glasgow Coma Scale scores of ≤8 was seen in 10% of patients. Neuroimaging (computed tomography [CT]) abnormalities were seen in 12% of patients, with the commonest abnormality being skull fracture, followed by contusions, and extradural hemorrhage. Around 2% of patients required decompressive craniotomy whereas 3% of patients succumbed to their illness.

Among the inpatients with pediatric traumatic brain injury, two-thirds were boys with a mean age at presentation of 7.6 years. Severity of traumatic brain injury varied as mild (64%), moderate (11%), and severe (25%). The most common mode of injury was accidental falls (59%) followed by road traffic and rail accidents (34%). Neuroimaging abnormalities were seen in half of inpatients with pediatric traumatic brain injury, with the commonest abnormality being skull fracture. Pediatric head injuries are an important public health problem and constitute a third of all head injuries. They are more common in boys, and the most common modes of injury are accidental falls, followed by road traffic accidents.
Leading complementary schools as non-profit social entrepreneurship: Cases from Lithuania
Authors: Melnikova Julija
Published: August 2020

The article explores the topic of leading complementary schools as models of non-profit social enterprises, reflecting the way the sector has developed in Lithuania. Complementary schools in Lithuania provide educational services often related to language and cultural education focusing on different groups such as minorities, immigrants and people with disabilities. They use client-focused activities to achieve social goals and maintain financial self-sufficiency. Therefore, the leadership of these organizations is of major importance. Group discussions were conducted with 32 heads of complementary schools to explore their perceptions of the entrepreneurship competencies they need to meet the challenges they face in establishing and sustaining their non-profit organizations. Viewing complementary schools as non-profit social enterprises and their leaders as social entrepreneurs contributes to the understanding of them as organizations and the wide range of competencies and practices needed to lead such schools effectively with implications for pre-service and in-post leadership development.
Thermally driven characteristic and highly photocatalytic activity based on N-isopropyl acrylamide/high-substituted hydroxypropyl cellulose/g-C3N4 hydrogel by electron beam pre-radiation method
Authors: Liu Guo , Li Ting-Ting , Song Xiao-Fang , Yang Jin-Yu , Qin Jiang-Tao , Zhang Fang-Fang , Wang Zheng-Xi , Chen Hong-Guo , Wu Ming-Hu , Li Yue-Sheng
Published: August 2020

A new type of N-isopropyl acrylamide/high-substituted hydroxypropyl cellulose/graphite carbon nitride (NIPAAm/HHPC/g-C3N4) smart hydrogel-based photocatalyst with thermally driven characteristic was successfully prepared by electron beam pre-radiation polymerization and radiation cross-linking methods. The agglomeration and loss of g-C3N4 nanosheets can be avoided effectively, and ensured high photocatalytic activity under visible light, once the g-C3N4 nanosheets are uniformly dispersed into the skeleton of a thermosensitive NIPAAm/HHPC hydrogel. NIPAAm/HHPC/g-C3N4 (NHC) hydrogel was characterized by nuclear magnetic resonance spectroscopy, Fourier-transform infrared spectroscopy, differential scanning calorimetry, thermogravimetric analysis, X-ray diffraction, X-ray photoelectron spectroscopy, and diffuse reflectance spectroscopy. The microstructure of NHC was further characterized by scanning electron microscopy, transmission electron microscopy, and Brunauer–Emmett–Teller. The adsorption–photocatalytic removal rate of rhodamine B reached 71.4% at the mass ratio of g-C3N4 of 0.8% (NHC-0.8%) hydrogel in an aqueous medium under visible light. The thermal shrinkage ratio can reach 90.6% at 60°C after 5 min and could effectively achieve the function of recycling-free in a portable photocatalytic reaction device under the optimal conditions. Possible mechanism of adsorption–photocatalysis and thermally driven recycling-free on NHC hydrogel was also obtained. These thermally driven recycling-free characteristic and highly photocatalytic properties of the hybrid hydrogel-based photocatalyst show that it can be used as a promising new material with extensive applications in wastewater treatment.
Theoretical study and experimental measurement of the gas liquid two-phase flow through a vertical Venturi meter
Authors: Zeghloul Ammar , Messilem Abdelkader , Ghendour Nabil , Al-Sarkhi Abdelsalam , Azzi Abdelwahid , Hasan Abbas
Published: August 2020

An accurate two-phase flow rate measurement is essential in many applications and industries such as; oil/gas, chemical, pipeline transportation and nuclear industry. This paper presents the findings obtained from two-phase flow rate measurements using Venturi meters coupled with conductance probe sensors. The measurement system and presented methodology can be used to directly and continuously measure the mass flow rate of gas-liquid flows without any need for using a separator. Most of the available data in literature on mass flow rate using Venturis in gas-liquid two phase flows are limited/valid to a certain flow regime. However, the experimental data presented in this paper covered a wide range of flows (i.e. bubbly, slug and churn flows).

Three Venturis with different diameter ratios, β = 0.40, β = 0.55 and β = 0.75 have been employed using an air-water vertical test section. The effect of the Venturi’s geometry on the flow behaviour was also evaluated. The average void fraction and void fraction time series have been measured along the test section by nine different conductance probe sensors covering the convergent, throat and divergent sections. In addition, the two-phase pressure drop across the Venturi was measured. Moreover, a new correlation for the gas-liquid slip ratio was proposed in this paper, which is necessary for calculating the two-phase mass flow rate. The proposed slip ratio correlation showed more accuracy than the ones available in literature. It was found that the correlation proposed by Chisholm to predict the two-phase mass flow rate in Venturis with a diameter ratio, β = 0.55, shows the best accuracy among others such as; Murdock, Lin, James and Zhang correlations.
Numerical simulation of blood nanofluid flow over three different geometries by means of gyrotactic microorganisms: Applications to the flow in a circulatory system
Authors: Basha H Thameem , Sivaraj R
Published: August 2020

Biomedical engineers, medical scientists, and clinicians are expressing a notable interest in the measurement of blood flow rate because it is used to detect cardiovascular diseases such as atherosclerosis and arrhythmia. Several researchers have adopted various non-Newtonian fluid models to investigate blood flow in the circulatory system. Because many non-Newtonian fluid models like Herschel Buckley, Powell-Eyring fluid, tangent hyperbolic fluid, and Williamson fluid exhibit the characteristics of blood. The tangent hyperbolic fluid model expresses the rheological characteristics of blood more accurately due to its shear-thinner properties. This work is performed to express the significance of the induced magnetic field and gyrotactic microorganisms on the flow of tangent hyperbolic nanofluid over a plate, wedge and stagnation point of the plate. Suitable self-similarity variables are employed to convert the fluid transport equations into ordinary differential equations which have been solved with the use of the Runge-Kutta-Fehlberg (RKF) approach. The impacts of active parameters on transport properties of the fluid are illustrated with graphs and tables. The growing magnetic parameter lessens the blood nanofluid velocity over three geometries. Blood nanofluid has a higher heat transfer rate over a stagnation point compared with other two geometries. Blood nanofluid temperature augments for uplifting the thermophoresis parameter. Peclet number shows a high impact on microorganisms density in a blood nanofluid. This exploration can provide a clear view regarding the heat and mass transfer behavior of blood flow in a circulatory system and various hyperthermia treatments like treatment of cancer.
Effects of smart flap on aerodynamic performance of sinusoidal leading-edge wings at low Reynolds numbers
Authors: Mehraban AA , Djavareshkian MH , Sayegh Y , Forouzi Feshalami B , Azargoon Y , Zaree AH , Hassanalian M
Published: August 2020

Sinusoidal leading-edge wings have shown a high performance after the stall region. In this study, the role of smart flaps in the aerodynamics of smooth and sinusoidal leading-edge wings at low Reynolds numbers of 29,000, 40,000 and 58,000 is investigated. Four wings with NACA 634-021 profile are firstly designed and then manufactured by a 3 D printer. Beam bending equation is used to determine the smart flap chord deflection. Next, wind tunnel tests are carried out to measure the lift and drag forces of proposed wings for a wide range of angles of attack, from zero to 36 degrees. Results show that using trailing-edge smart flap in sinusoidal leading-edge wing delays the stall point compared to the same wing without flap. However, a combination of smooth leading-edge wing and smart flap advances the stall. Furthermore, it is found that wings with smart flap generally have a higher lift to drag ratio due to their excellent performance in producing lift.
Exposure to paraquat associated with periodontal disease causes motor damage and neurochemical changes in rats
Authors: Fernandes LC , Santos AG , Sampaio TB , Sborgi SMS , Prediger RDS , Ferro MM , Franco GCN , Lipinski L , Miyoshi E
Published: August 2020

Exposure to paraquat is possibly involved with the development of several conditions, including neurodegenerative diseases, such as Parkinson’s disease (PD). This condition is mainly characterized by the loss of dopaminergic neurons in the nigrostriatal pathway and the development of classical motor symptoms. Etiology includes exposure to environmental factors, such as the paraquat exposure, and inflammatory diseases may exacerbate paraquat neurotoxicity. The aim of the study was to investigate whether the exposure to paraquat associated with the presence of periodontal disease is able to induce motor and biochemical changes in rats similar to that observed in PD. Adult male Wistar rats were sent to ligature. After 48 h, they were sent to daily treatment paraquat (1 mg/kg/day; 2 mL/kg; intragastric) or vehicle for 4 weeks. Twenty-four hours after the last administration, the open field test was performed. The rats were euthanized and the left hemimandibles and striatum were dissected for the analysis of dopaminergic and inflammatory markers. Only the combination of periodontal disease model plus paraquat exposure induced motor impairments. Remarkably, the paraquat exposure increased the ligature-induced alveolar bone loss in hemimandibles. Moreover, only the combination of periodontal disease and paraquat exposure induced the loss of dopaminergic neurons and astrocyte activation in the striatum.
“Old School” Islet Purification Based on the Unit Gravity Sedimentation as a Rescue Technique for Intraportal Islet Transplantation—A Case Report
Authors: Gołębiewska Justyna E. , Gołąb Karolina , Gorycki Tomasz , Śledziński Maciej , Gulczyński Jacek , Żygowska Iwona , Wolnik Bogumił , Hoffmann Michał , Witkowski Piotr , Ricordi Camillo , Szurowska Edyta , Śledziński Zbigniew , Dębska-Ślizień Alicja
Published: August 2020

Here, we present a case that required a supplemental “old school” islet purification for a safe intraportal infusion. Following pancreas procurement from a brain-dead 26-year-old male donor (body mass index: 21.9), 24.6 ml of islet tissue was isolated after continuous density gradient centrifugation. The islet yield was 504,000 islet equivalent (IEQ), distributed among the following three fractions: 64,161 IEQ in 0.6 ml of pellet, 182,058 IEQ in 10 ml, and 258,010 IEQ in 14 ml with 95%, 20%, and 10% purity, respectively. After a 23-h culture, we applied supplemental islet purification, based on the separation of tissue subfractions during unit gravity sedimentation, a technique developed over 60 years ago (“old school”). This method enabled the reduction of the total pellet volume to 11.6 ml, while retaining 374,940 IEQ with a viability of over 90%. The final islet product was prepared in three infusion bags, containing 130,926 IEQ in 2.6 ml of pellet, 108,079 IEQ in 4 ml of pellet, and 135,935 IEQ in 5 ml of pellet with 65%, 40%, and 30% purity, respectively, and with the addition of unfractionated heparin (70 units/kg body weight). Upon the islet infusion from all three bags, portal pressure increased from 7 to 16 mmHg. Antithrombotic prophylaxis with heparin was continued for 48 h after the infusion, with target activated partial thromboplastin time 50–60 s, followed by fractionated heparin subcutaneous injections for 2 weeks. β-Cell graft function assessed on day 75 post-transplantation was good, according to Igls criteria, with complete elimination of severe hypoglycemic episodes and 50% reduction in insulin requirements. Time spent within the target glucose range (70–180 mg/dl) improved from 42% to 98% and HbA1c declined from 8.7% to 6.7%. Supplemental “old school” islet purification allowed for the safe and successful utilization of a robust and high-quality islet preparation, which otherwise would have been discarded.
Bridging Silos: A Research Agenda for Local Environmental Health Initiatives
Authors: Korfmacher Katrina Smith
Published: August 2020

The environment and public health are managed by separate institutions that often operate in isolation from each other. This system is often referred to as managing in “silos.” The resulting lack of coordination, inadequate consideration of cumulative effects, and diffuse targets for change contribute to the persistence of many environmental justice problems. There are many barriers to bridging these silos, particularly at state and federal levels. Local collaborations, however, may have greater potential for changing these systems. There has been limited assessment of successful local environmental health initiatives. This paper explores three case studies of local collaboration: lead poisoning prevention in Rochester, New York; promoting a healthy and equitable built environment in Duluth, Minnesota; and increasing consideration of community health in decisions around the ports of Los Angeles and Long Beach, California. It develops a research agenda to inform future collaborations to improve environmental health equity through local systems change.
Criterion A Scales: Convergent, Discriminant, and Structural Relationships
Authors: McCabe Gillian A. , Oltmanns Joshua R. , Widiger Thomas A.
Published: August 2020

The alternative model of personality disorder was created to address the apparent failings of Diagnostic and Statistical Manual of Mental Disorders–Fourth edition–text revision personality disorder diagnostic categories and consists of Criterion A (i.e., personality functioning) and Criterion B (i.e., pathological personality traits). There are now four alternative measures of the Criterion A impairments but, perhaps surprisingly, no study has yet compared any one of them with any one of the other three. The current study assesses the convergent (and discriminant) validity of all four, as well as their structural relationship with the five-factor model (FFM), a widely accepted model for understanding the structure of normal and pathological personality traits. Exploratory structural equation modeling analyses of the Criterion A measures and FFM scales demonstrate that the Criterion A self-identity scale can be understood as a maladaptive variant of FFM neuroticism. Moreover, results indicate no appreciable discriminant validity in the assessment of the Criterion A impairments—the Criterion A scales correlated more highly within measures than across alternative measures, even when measuring the same construct. Implications of these findings for the conceptualization and assessment of Criterion A self and interpersonal impairments are discussed.
The Differences in Imaging Findings Between Painless and Painful Osteoarthritis of the Hip
Authors: Kijima Hiroaki , Yamada Shin , Konishi Natsuo , Kubota Hitoshi , Tazawa Hiroshi , Tani Takayuki , Suzuki Norio , Kamo Keiji , Okudera Yoshihiko , Fujii Masashi , Sasaki Ken , Kawano Tetsuya , Iwamoto Yosuke , Nagahata Itsuki , Miura Takanori , Miyakoshi Naohisa , Shimada Yoichi
Published: August 2020

Purpose:

In osteoarthritis of the hip, the pain may be strong even if the deformity is mild, but the pain may be mild even if the deformity is severe. If the factors related to the pain can be identified on imaging, reducing such factors can alleviate the pain, and effective measures can be taken for cases where surgery cannot be performed. In addition, imaging findings related to the pain are also important information for determining the procedures and the timing of surgery. Thus, the purpose of this study was to identify the differences in features of osteoarthritis seen on imaging between painless and painful osteoarthritis of the hip.

Methods:

The subjects were the patients with hip osteoarthritis who visited our department in 2015 and who underwent x-ray, computed tomography (CT), and magnetic resonance imaging (MRI), a total of 29 patients (54 hip joints; mean age 63 years; 8 males and 21 females). The degree of osteoarthritis was determined using the Tönnis grade from the x-ray image. The cartilage morphology, intensity changes of bone marrow on MRI (subchondral bone marrow lesions [BMLs]), osteophytes, joint effusions, and paralabral cysts were scored based on the Hip Osteoarthritis MRI Scoring System (HOAMS). The cross-sectional area of the psoas major muscle at the level of the iliac crest was measured on CT, and the psoas index (PI; the cross-sectional area ratio of the psoas major muscle to the lumbar 4/5 intervertebral disc) was calculated to correct for the difference in physique. Then, the relationships between these and visual analog scale (VAS) scores of pains were evaluated.

Results:

The average VAS was 55.4 ± 39 mm. The PI and all items of HOAMS correlated with the VAS. The average VAS of Tönnis grade 3 osteoarthritis was 75.8 ± 26 mm. When investigating only Tönnis grade 3 osteoarthritis, the differences between cases with less than average pain and those with above average pain were the BML score in the central-inferior femoral head ( P = .0213), the osteophyte score of the inferomedial femoral head ( P = .0325), and the PI ( P = .0292).

Conclusion:

Investigation of the differences between painless and painful osteoarthritis of the hip showed that the cases with more pain have BMLs of the femoral head on MRI that extend not only to the loading area, but also to the central-inferior area. Even with the same x-ray findings, the pain was stronger in patients with severe psoas atrophy. Thus, the instability due to muscle atrophy may also play a role in the pain of hip osteoarthritis.
Welfare sanctions and the right to a subsistence minimum: A troubled marriage
Authors: Gantchev Valery
Published: August 2020

Can welfare sanctions and the right to a subsistence minimum coexist? The present article sheds light on this question by examining recent developments in German social assistance law and placing them in the broader international legal context. In November 2019, the German Constitutional Court declared a large portion of the applicable regime unconstitutional because it violated the basic right to a guaranteed subsistence minimum. The first part of the article examines this German basic right and the way its normative requirements are applied by the Constitutional Court to welfare sanctions. Two important points of reference which are discussed relate to the effectiveness of the measures and the availability of sanction mitigation instruments that safeguard the constitutionally guaranteed subsistence minimum. The second part of the article carries out a similar examination into the international human right to social assistance and the respective case law of the international supervisory bodies. A comparative legal analysis is carried out in the third part, which highlights the similarities between the German and the international legal approach to minimum social protection and welfare sanctions. The article concludes with the observation that welfare sanctions and the right to a subsistence minimum can only coexist under the condition that states respect the absolute nature of minimum social protection and reconcile the adopted measures with the primary objective of social assistance: reintegration and social inclusion.
The role of home learning environments and socioeconomic status in children’s learning in Tanzania: A comparison study of naturalized refugee, rural majority, and urban majority population groups
Authors: Ndijuye Laurent Gabriel
Published: August 2020

This study investigated the role of home learning environments and family socioeconomic status in children’s learning in Tanzania. A total of 303 participants from the naturalized refugees, rural, and urban majority groups were recruited. Data were collected using parents’ questionnaires, interviews, Bracken’s Basic Concept Scale–Receptive, Early Grades Reading Assessment, and Early Grades Mathematics Assessment. The results indicate that although naturalized refugees’ home learning environments were comparable to those of the rural majority, and had lower socioeconomic status than the urban majority, their learning attainments were as good as those of the more-advantaged urban majority. Parental beliefs and expectations were the possible reasons for their demonstrating better learning attainments. These findings broaden our understandings of various protective and supportive factors which have implications on children’s development and learning across contexts.
Iliac Branch Devices With Standard vs Fenestrated/Branched Stent-Grafts: Does Aneurysm Complexity Produce Worse Outcomes? Insights From the pELVIS Registry
Authors: Spanos Konstantinos , Kölbel Tilo , Scheerbaum Martin , Donas Konstantinos P. , Austermann Martin , Rohlffs Fiona , Verzini Fabio , Tsilimparis Nikolaos , Bosiers Michel , Inchingolo Mirjam , Torsello Giovanni , Weiss Kristin , Branzan Daniela , Scheinert Dirk , Schmidt Andrej , Haulon Stéphan , Pitoulias Georgios A. , Parlani Gianbattista , Simonte Gioele , Dorigo Walter , Fargion Aaron , Masciello Fabrizio , Pratesi Carlo , Vergata Tor , Barbante Matteo , Ippoliti Arnaldo , Pratesi Giovanni , Forlanini San Camillo , Cao Piergiorgio , Ferrer Ciro
Published: August 2020

Purpose: To compare the outcomes of iliac branch devices (IBD) used in combination with standard endovascular aneurysm repair (EVAR) vs with fenestrated/branched EVAR (f/bEVAR) to treat complex aortoiliac aneurysms. Materials and Methods: The pELVIS Registry database containing the outcomes of IBD use at 8 European centers was interrogated to identify all IBD procedures that were combined with either standard EVAR or f/bEVAR. Among 669 patients extracted from the database, 629 (mean age 72.1±8.8 years; 597 men) had received an IBD combined with standard EVAR vs 40 (mean age 71.1±8.0 years; 40 men) who underwent f/bEVAR with an IBD. The mean aortic aneurysm diameters were 46.4±13.3 mm in the f/bEVAR patients vs 45.0±15.5 mm in the standard EVAR cases. The groups were similar in terms of baseline clinical characteristics and aneurysm morphology. The Kaplan-Meier method was used to compare patient survival, IBD occlusion, type III endoleak, and aneurysm-related reinterventions in follow-up. The estimates are presented with the 95% confidence interval (CI). Results: Technical success was 100% in the f/bEVAR+IBD group and 99% in the EVAR+IBD group (p=0.85). The 30-day mortality was 0% vs 0.5%, respectively (p=0.66), while the 30-day reintervention rates were 7.5% vs 4.1% (p=0.31). The mean follow-up was 32.1±21.3 months for f/bEVAR+IBD patients (n=30) and 35.5±26.8 months for EVAR+IBD patients (n=571; p=0.41). The 12-month survival estimates were 93.4% (95% CI 93.2% to 93.6%) in the EVAR+IBD group vs 93.6% (95% CI 93.3% to 93.9%) for the f/bEVAR+IBD group (p=0.93). There were no occlusions or type III endoleaks in the f/bEVAR+IBD group at 12 months, while the estimates for freedom from occlusion and from type III endoleak in the EVAR+IBD group were 97% (95% CI 96.8% to 97.2%) and 98.5% (95% CI 98.4% to 98.6%), respectively. The 12-month estimates for freedom for aneurysm-related reintervention were 93% (95% CI 92.7% to 93.3%) in the EVAR+IBD group vs 86.4% (95% CI 85.9% to 86.9%) in the f/bEVAR+IBD patients (p=0.046). Conclusion: Treatment of complex aortoiliac disease with f/bEVAR+IBD can achieve equally good early and 1-year outcomes compared to treatment with IBDs and standard bifurcated stent-grafts, except for a somewhat higher reintervention rate in f/bEVAR patients.
Calliandra portoricensisameliorates ovarian and uterine oxido-inflammatory responses inN-methyl-N-nitrosourea and benzo[a]pyrene-treated rats
Authors: Adefisan Adedoyin O , Madu Judith C , Owumi Solomon E , Adaramoye Oluwatosin A
Published: August 2020

Reproductive dysfunction stemming from chemical agents may lead to infertility. We examined the protective effects of Calliandra portoricensis ( CP) extract on benzo[a]pyrene (BaP) and N-methyl- N-nitrosourea (NMU)-induced ovarian and uterine toxicity in rat, treated as follows: control (group 1), NMU + BaP (group 2), groups 3 and 4 received (NMU + BaP), and CP (50 and 100 mg/kg), respectively. Group 5: CP (100 mg/kg) alone, group 6: (NMU + BaP) and vincristine (VIN: 0.5 mg/kg) and group 7: VIN alone. Rats were injected at age 7, 10, and 13 weeks with single doses of NMU and BaP for 10 consecutive weeks. NMU + BaP significantly ( P < 0.05) increased ovarian and uterine weight, and decreased bodyweight, while the organo-somatic index (OSI) of uterus and ovary increased 2.3 and 1.4 folds, respectively. CP co-treatment ameliorated the observed weight changes. Lipid peroxidation increased by 58% in the ovary, accompanied by decreases in ovarian and uterine GST, GPx, catalase activities, and total sulfhydryl level in NMU + BaP-treated rats. Uterine and ovarian myeloperoxidase activities, as well as nitric oxide levels also increased. CP co-treatment ameliorated the observed changes in antioxidant enzymes and inflammatory biomarkers. Furthermore, histopathology revealed fibrotic ovarian stroma, while uterine endometrium was infiltrated with inflamed cells. Immunohistochemistry showed weak expression of FSH, LH, p53, caspase-3, and Bax, whereas progesterone, iNOS, and Bcl-2 were strongly expressed in NMU + BaP-treated rats. CP treatment restored the architecture of these tissues. Conclusively, the root bark fraction of CP decreases oxido-inflammatory damage in ovarian and uterine tissues of NMU- and BaP-treated rats.

Impact statement

Infertility resulting from reproductive impairment is traumatic in families. Exposure to chemicals may play insidious roles not easily connected to infertility. We examined benzo[a]pyrene (BaP), and N-methyl nitrosourea (NMU)-induced ovarian and uterine toxicity and the role of Calliandra portoricensis in mitigating toxicity. In a bid to illuminate folk medical claims cloaked in mystery, unearthing lost knowledge, advance natural chemopreventive agents, and report new evidence lacking in the literature attributed to CP. Although CP is known to exhibit anticonvulsant, antidiarrheal, antipyretic, antirheumatic, and analgesic effects in humans, its possible roles for mitigating toxicity stemming from inadvertent chemical exposures are reported here. Our findings affirm and further show that CP abates toxic response incumbent on oxidative damage and inflammatory responses associated with NMU and BaP exposure. Development of phytochemical derived from CP may serve as a potential natural therapy against chemical toxicities in individuals inadvertently exposed, and promote human health and reproductive satiety.
Authorized generics vs. branded generics: A perspective
Authors: Latwal Bharti , Chandra Amrish
Published: August 2020

Nowadays, there are many generic medications available in the market. Their sale is increasing day by day due to their lower cost and affordability by most of the customers. Generic medications are pharmaceuticals that are therapeutically equivalent to an original off patent drug. Both authorized generics and branded generics are the versions of generic medications. They offer lucrative business and increase competition for ordinary generics. They supply medications having quality of branded drugs at lower prices and this establishes their recognition among the masses who earlier has limited options to buy only brand-name drugs. They are cheaper than brand name drugs but costlier than ordinary generics. Authorized generics are sold only by Innovator Companies but the branded generics can be sold by both innovator companies and generic companies. They both are different from one another and have their own impact on the brand drug companies, generic companies and consumers.
Situating Netflix’s Original Adult Animation: Observing Taste Cultures and the Legacies of ‘Quality’ Television through BoJack Horseman and Big Mouth
Authors: Falvey Eddie
Published: August 2020

This article aims to expand upon a key aspect of Mareike Jenner’s work on Netflix original comedy by considering how the streaming network’s original adult animated series reflect developments occurring within the sitcom format post-TV III. Using Netflix original animations BoJack Horseman (2014–) and Big Mouth (2017–) as case studies, this article will consider how thematically complex, ostensibly ‘smart’ animated shows illustrate changing industrial dynamics and taste cultures. While exhibiting qualities found in preceding key adult animated shows such as South Park (Comedy Central 1997–) and Family Guy (Fox 1999–), including lewd humour, metatextual in-jokes and topicality, the knotty storytelling and ambiguous characterizations of the shows under discussion reflect links to other contexts of TV production. Exploring these links, this article uses BoJack Horseman and Big Mouth to explore current trends in animated television, situating their characteristics and reception within a broader network of influences. The author argues that the turn towards complex storytelling manifests both in inherited production tactics, changing taste cultures and in the multifaceted and multifarious potentialities provided by the medium itself.
A further look at ageing and word predictability effects in Chinese reading: Evidence from one-character words
Authors: Zhao Sainan , Li Lin , Chang Min , Wang Jingxin , Paterson Kevin B
Published: August 2020

Older adults are thought to compensate for slower lexical processing by making greater use of contextual knowledge, relative to young adults, to predict words in sentences. Accordingly, compared to young adults, older adults should produce larger contextual predictability effects in reading times and skipping rates for words. Empirical support for this account is nevertheless scarce. Perhaps the clearest evidence to date comes from a recent Chinese study showing larger word predictability effects for older adults in reading times but not skipping rates for two-character words. However, one possibility is that the absence of a word-skipping effect in this experiment was due to the older readers skipping words infrequently because of difficulty processing two-character words parafoveally. We therefore took a further look at this issue, using one-character target words to boost word-skipping. Young (18–30  years) and older (65+ years) adults read sentences containing a target word that was either highly predictable or less predictable from the prior sentence context. Our results replicate the finding that older adults produce larger word predictability effects in reading times but not word-skipping, despite high skipping rates. We discuss these findings in relation to ageing effects on reading in different writing systems.
Effects of axial load on in vivo scaphoid and lunate kinematics using four-dimensional computed tomography
Authors: Brinkhorst Michelle , Streekstra Geert , van Rosmalen Joost , Strackee Simon , Hovius Steven
Published: August 2020

This in vivo study investigated the effect of axial load on lunate and scaphoid kinematics during flexion–extension and radial–ulnar deviation of the uninjured wrist using four-dimensional computed tomography. We found that applying axial load to the wrist results in a more flexed, radially deviated and pronated position of the lunate and scaphoid during flexion–extension of the wrist compared with when no load is applied. A larger pronation and supination range of the lunate and scaphoid was seen when the wrist was flexed and extended under axial load, whereas a larger flexion and extension range of the lunate and scaphoid occurred during radial–ulnar deviation of the wrist when axial load was applied.
To what extent are we confident that tapentadol induces less constipation and other side effects than the other opioids in chronic pain patients? a confidence evaluation in network meta-analysis
Authors: Forget Patrice , Vermeersch Mathieu
Published: August 2020

Background:

A confidence evaluation helps to make informed decisions about the results of meta-analyses. The goal of this work is to perform a confidence evaluation of results of a network meta-analysis (NMA) on the digestive side effects of tapentadol in patients with chronic pain.

Methods:

An updated search in PubMed/Medline and Web of Science search until March 2020 was done to perform pairwise meta-analyses with NMA using random-effect models and confidence in network meta-analysis (CiNeMA) for the confidence analysis.

Results:

Twenty-five studies were included in the final analyses. Pairwise and indirect comparisons showed a reduced risk of constipation with tapentadol compared to oxycodone. The confidence evaluation did not raise any concerns in terms of confidence for the oxycodone versus tapentadol comparisons. The oxycodone-naloxone versus tapentadol comparisons showed some concerns, particularly in terms of imprecision and incoherence. Regarding the overall risk of any side effects, the confidence evaluation showed a major concern regarding imprecision, but not for the comparison between tapentadol and oxycodone. However, this comparison showed a major heterogeneity.

Discussion and conclusions:

A confidence evaluation in meta-analysis on the effect of tapentadol compared to other opioids in chronic pain showed possible imprecision, heterogeneity and/or incoherence. However, with a high level of confidence, tapentadol was associated with a lower incidence of constipation than oxycodone. Confidence analyses can help to get more information from meta-analyses.
A huge bladder diverticulum in an elderly: A case report
Authors: Jiang ShuangHong , Ren Quan , Wang XianFei , Yang GuoDong , Wei ShouJiang , Zhao QiongHui , Xu Hao
Published: August 2020

An 81-year-old male patient presented to the department of gastroenterology with increasing lower abdominal pain for 2 years, aggravated with bloody stool for 1 month. Computed tomographic examination revealed a huge cyst (207 × 93 × 208 mm3) in the abdominal cavity, absence of bladder, thickening and strengthening of the rectal wall, and benign prostatic hyperplasia. Colonoscopy showed colon cancer and surgery was planned. Interestingly, after magnetic resonance imaging and cystography, we found colon cancer and a large bladder diverticulum rather than tumor metastasis or others. Severe bacteremia occurred in the elderly chronic obstructive pulmonary disease patient before operation. After careful consideration, we decided to take a large risk and combined urology and gastrointestinal surgery professionals to carry out bladder diverticulectomy, cystostomy, radical resection of rectal carcinoma, and so on. Fortunately, the patient recovered well after the operation. In addition to the common tumor metastasis and cystadenoma, the abdominal mass should also be alert to the rare bladder diverticulum, which eventually leads to diagnostic confusion. Multidisciplinary diagnosis and treatment has become an important treatment for complex diseases.
Canadian Society of Nephrology Commentary on the Kidney Disease Improving Global Outcomes 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder
Authors: Holden Rachel M. , Mustafa Reem A. , Alexander R. Todd , Battistella Marisa , Bevilacqua Micheli U. , Knoll Greg , Mac-Way Fabrice , Reslerova Martina , Wald Ron , Acott Philip D. , Feltmate Patrick , Grill Allan , Jindal Kailash K. , Karsanji Meena , Kiberd Bryce A. , Mahdavi Sara , McCarron Kailee , Molnar Amber O. , Pinsk Maury , Rodd Celia , Soroka Steven D. , Vinson Amanda J. , Zimmerman Deborah , Clase Catherine M.
Published: August 2020

Purpose of review:

(1) To provide commentary on the 2017 update to the Kidney Disease Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD); (2) to apply the evidence-based guideline update for implementation within the Canadian health care system; (3) to provide comment on the care of children with chronic kidney disease (CKD); and (4) to identify research priorities for Canadian patients.

Sources of information:

The KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of CKD-MBD.

Methods:

The commentary committee co-chairs selected potential members based on their knowledge of the Canadian kidney community, aiming for wide representation from relevant disciplines, academic and community centers, and different geographical regions.

Key findings:

We agreed with many of the recommendations in the clinical practice guideline on the diagnosis, evaluation, prevention, and treatment of CKD-MBD. However, based on the uncommon occurrence of abnormalities in calcium and phosphate and the low likelihood of severe abnormalities in parathyroid hormone (PTH), we recommend against screening and monitoring levels of calcium, phosphate, PTH, and alkaline phosphatase in adults with CKD G3. We suggest and recommend monitoring these parameters in adults with CKD G4 and G5, respectively. In children, we agree that monitoring for CKD-MBD should begin in CKD G2, but we suggest measuring ionized calcium, rather than total calcium or calcium adjusted for albumin. With regard to vitamin D, we suggest against routine screening for vitamin D deficiency in adults with CKD G3-G5 and G1T-G5T and suggest following population health recommendations for adequate vitamin D intake. We recommend that the measurement and management of bone mineral density (BMD) be according to general population guidelines in CKD G3 and G3T, but we suggest against routine BMD testing in CKD G4-G5, CKD G4T-5T, and in children with CKD. Based on insufficient data, we also recommend against routine bone biopsy in clinical practice for adults with CKD or CKD-T, or in children with CKD, although we consider it an important research tool.

Limitations:

The committee relied on the evidence summaries produced by KDIGO. The CSN committee did not replicate or update the systematic reviews.
Examining the importance of the Sino-Africa swap formula in creating backward and forward linkages
Authors: Omoruyi Ehizuelen Michael Mitchell
Published: August 2020

African nations are trying to diversify their economies in order to induce industrialization that will help them eradicate poverty and create employment for their young workforce. One of the continent’s key challenges continues to be the shortage of physical infrastructure. Therefore, finding ways to overcome this problem has become of large importance. China has identified this and has thus enhanced its involvement in Africa primarily via its swap formula. The formula enables the financing and development of infrastructure that African nations critically need by depending on their resource wealth. However, the mounting involvement of the formula has continued to stimulate questions on its impact regarding creating backward and forward linkages. As such, one of the significant aims of this article is to identify linkages that emerge from the Chinese swap formula that involve long-term concessionary loans from China’s Exim Bank to finance major infrastructure projects in Africa. It examines whether the swap formula is creating backward and forward linkages in Africa, and what the infrastructure leads to concerning creating novel opportunities for the continent, by theoretically answering this question: “Can China’s swap formula create backward and forward linkages?” Furthermore, the article theoretically identifies the benefits and linkages of the formula via a case study – that of Abuja-Kaduna railway. Arguably, the article discovers that the formula has multiple benefits and linkages for Africa. It is also seen by the Chinese government as a way of fulfilling its strategic goals in Africa.