bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-Related Injuries From Escalators
Authors: Caswell Shayne R. , Cash Chad , Gratton Andrew , Yon James , Colosimo Christina , Kubasiak John , Mentzer Caleb J.
Published: November 2021

Introduction

Escalators and moving stairways are omnipresent in modern life. No study to date has examined nationwide incidence and outcomes associated with injuries directly related to escalator use. The aim of this study was to describe the injury patterns, incidence, and disposition as it pertains to youth compared to adults.

Methods

Descriptive and comparative analyses were performed using National Electronic Injury Surveillance System data. The frequencies of categorical variables were calculated across the two age groups. Chi-squared test was performed on all categorical variables. Significance was defined as two-tailed P < 0.05. Logistic regression was used on variables that were determined to be significant from the frequency tables, with additional variable selection being used to arrive on a final model for each outcome.

Results

From 2009 to 2019, there were 810 youth and 3669 adults injured in escalator-associated emergency department visits. Incidence in the youth population decreased over time. Disposition was similar between groups. Injury types were similar among groups. White female adults were more likely to sustain injuries related to escalator use. Adult patients were also significantly more likely to sustain head/neck/facial trauma. Last, adult patients were found to be more likely to suffer a fatal event in comparison to the youth population.

Discussion

Differences in the injury patterns between youth and adult patients related to the use of escalators illustrate a need for improved injury prevention. Improved education and safety guidelines, particularly in individuals in ages 18 and up, would likely lessen the discrepancies between age groups identified in this study.
Clinicopathological Features of Remnant Gastric Cancer After Gastrectomy
Authors: Iwasaki Kenichi , Barroga Edward , Shimoda Yota , Enomoto Masaya , Yamada Erika , Miyoshi Kenta , Watanabe Takafumi , Ota Yoshihiro , Osaka Yoshiaki , Nakagawa Yuichi , Katsumata Kenji , Tsuchida Akihiko
Published: November 2021

Background

Remnant gastric cancer (RGC) encompasses all cancers arising from the remnant stomach. Various studies have reported on RGC and its prognosis, but no consensus on its surgical treatment and postoperative management has been reached. Moreover, the correlation between the clinicopathological characteristics and long-term outcomes of RGC remains unclear. This study investigated the clinicopathological factors associated with the long-term survival of RGC patients.

Methods

The medical records (March 1993-September 2020) of 104 RGC patients from Tokyo Medical University Hospital database were analyzed. Of these 104 patients, the medical records of 63 patients who underwent surgical curative resection were analyzed using R. Kaplan-Meier plots of cumulative incidence of RGC were made. Differences in survival rates were compared using the log-rank test. Prognostic factors were analyzed using multivariate Cox regression analysis ( P < .05).

Results

Of the 104 RGC patients, 63 underwent total remnant stomach excision. The median time from the first surgery to the total excision was 10 years. The 5-year survival rate of the 63 RGC patients was .55 ((95% CI); .417-.671). The clinicopathological factors that were significantly associated with the long-term outcome of the RGC patients were tumor diameter (≥3.5 cm), presence or absence of combined resection of multiple organs, tumor invasion (deeper than T2), TNM stage, and postoperative morbidity. The multivariate Cox regression analysis showed that tumor invasion depth was the only independent prognostic factor for RGC patients [HR (95% CI): 5.49 (2.629-11.5), P ≤ .005].

Conclusions

Among prognostic factors, tumor invasion depth was the only independent factor affecting RGC’s long-term outcome.
Precarious Work in Midlife: Long-Term Implications for the Health and Mortality of Women and Men
Authors: Donnelly Rachel
Published: November 2021

Although prior research documents adverse health consequences of precarious work, we know less about how chronic exposure to precarious work in midlife shapes health trajectories among aging adults. The present study uses longitudinal data from the Health and Retirement Study to consider how histories of precarious work in later midlife (ages 50–65) shape trajectories of health and mortality risk after age 65. Results show that greater exposure to unemployment, job insecurity, and insufficient work hours in midlife predicts more chronic conditions and functional limitations after age 65. Characteristics of precarious work also predict increased mortality risk in later life. Findings indicate few gender differences in linkages between precarious work and health; however, women are more likely than men to experience job insecurity throughout midlife. Because precarious work is unlikely to abate, results suggest the need to reduce the health consequences of working in precarious jobs.
Cross-Category Add-On Bundling: Impact of the Consumption Nature of Bundled Products on Discount Framing Effectiveness
Authors: Song Myungkeun , Noone Breffni M. , Mattila Anna S.
Published: November 2021

In a series of three studies, we explore the effectiveness of two types of discount frames—add-on discount frame (ADF) and bundle discount frame (BDF)—in driving consumers’ purchase intentions for cross-category, add-on travel bundles. Consistent with the analytical mindset induced by a utilitarian core product, we found that an ADF is most effective in driving purchase intentions for utilitarian core-hedonic add-on bundles due to the heightened sense of savings and ease of justification (Study 1). Conversely, consumers tend to adopt a heuristic mindset when evaluating a hedonic core product. Hence, heightened perceptions of attractiveness associated with a BDF (vs. ADF) yield higher purchase intentions for hedonic core-utilitarian add-on bundles (Study 2). Study 3 provides process evidence for the hypothesized effects.
Tissue-type plasminogen activator induces TNF-α-mediated preconditioning of the blood-brain barrier
Authors: Diaz Ariel , Woo Yena , Martin-Jimenez Cynthia , Merino Paola , Torre Enrique , Yepes Manuel
Published: November 2021

Ischemic tolerance is a phenomenon whereby transient exposure to a non-injurious preconditioning stimulus triggers resistance to a subsequent lethal ischemic insult. Despite the fact that not only neurons but also astrocytes and endothelial cells have a unique response to preconditioning stimuli, current research has been focused mostly on the effect of preconditioning on neuronal death. Thus, it is unclear if the blood-brain barrier (BBB) can be preconditioned independently of an effect on neuronal survival. The release of tissue-type plasminogen activator (tPA) from perivascular astrocytes in response to an ischemic insult increases the permeability of the BBB. In line with these observations, treatment with recombinant tPA increases the permeability of the BBB and genetic deficiency of tPA attenuates the development of post-ischemic edema. Here we show that tPA induces ischemic tolerance in the BBB independently of an effect on neuronal survival. We found that tPA renders the BBB resistant to an ischemic injury by inducing TNF-α-mediated astrocytic activation and increasing the abundance of aquaporin-4-immunoreactive astrocytic end-feet processes in the neurovascular unit. This is a new role for tPA, that does not require plasmin generation, and with potential therapeutic implications for patients with cerebrovascular disease.
Effect of early enteral nutrition on critical care outcomes in patients with acute ischemic stroke
Authors: Mizuma Atsushi , Netsu Shizuka , Sakamoto Masaki , Yutani Sachiko , Nagata Eiichiro , Takizawa Shunya
Published: November 2021

Objective

Stroke-associated pneumonia (SAP) is a comorbidity of ischemic stroke related to clinical outcomes. Early enteral nutrition (EEN; within 48 hours) reduces the incidence of infection and length of intensive care unit (ICU)/hospital stay. The relationship between EEN and critical care outcomes, including SAP, in patients with ischemic stroke has been insufficiently studied.

Methods

We recruited 499 patients in this retrospective observational study. We evaluated SAP incidence within 14 days from admission. Patients were divided into an EEN group and a late EN group (LEN; start later than EEN). We compared groups regarding background and length of ICU/hospital stay.

Results

EN was started within 48 hours in 236 patients. SAP was diagnosed in 94 patients (18.8%), with most in the LEN group (28.1% vs. 8.5%). Median [interquartile range] lengths of hospitalization (22 [12–30] days vs. 35 [20–45] days) and ICU stay (4 [2–5] days vs. 6 [3–8] days) were longer in the LEN group. EEN reduced the incidence of SAP. By contrast, consciousness disturbance and worsening consciousness level increased the SAP incidence. Increased age and National Institutes of Health Stroke Scale score were associated with start of prolonged EN.

Conclusions

We found that EEN may reduce SAP risk.
Legal affordances in global wealth chains: How platform firms use legal and spatial scaling
Authors: Grasten Maj , Seabrooke Leonard , Wigan Duncan
Published: November 2021

Firms can use legal and spatial scaling to increase their control and capacity to exploit assets. Here we examine how platform firms, like AirBnB, Uber, and Bird, scale their operations through global wealth chains. Their use of law is to maximize wealth creation and protection, while their services use local spaces to extract value from established property, labor, and public thoroughfares. We examine how such ‘networked accumulation’ platform firms use legal and spatial scaling through legal affordances. This includes opportunities for absences, ambiguities and arbitrage that are realized via multi and inter-scalar strategies and produce variegation. Our analysis draws on legal documents, as well as interviews, from Barcelona and San Francisco. The article contributes with a model of how platform firms use legal and spatial scaling, as well as how activists can challenge their operations.
Ulnar Neuritis and Its Affect on Outcomes of Elbow Ulnar Collateral Ligament Reconstruction
Authors: De Giacomo Anthony F. , Keller Robert A. , Banffy Michael , ElAttrache Neal S.
Published: November 2021

Background:

No study has specifically evaluated how ulnar neuritis and ulnar nerve transposition affect outcomes in baseball players undergoing ulnar collateral ligament (UCL) reconstruction (UCLR).

Purpose:

To evaluate the effects of ulnar neuritis and ulnar nerve transposition in baseball pitchers undergoing UCLR in regard to return to sport, time to return to sport, and need for revision or additional surgery.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

At a single institution, all consecutive baseball pitchers undergoing UCLR between 2002 and 2015 were identified. Ulnar neuritis was diagnosed preoperatively by the following criteria: ulnar nerve symptoms, Tinel sign at the elbow, symptomatic subluxation, and numbness/paresthesia in an ulnar nerve distribution of the hand. The primary outcome of the study was return to sport. The secondary outcomes of the study were time to return to sport, length of playing career, and revision or additional surgery.

Results:

A total of 578 UCLRs were performed in baseball players; of these, 500 UCLRs were performed in pitchers. Ulnar neuritis was diagnosed in 97 (19.4%) baseball pitchers presenting with UCL injury. There were no significant differences in patient characteristics or surgical techniques performed for reconstruction between baseball pitchers with and without ulnar neuritis. In review of injury characteristics, ulnar neuritis was significantly more likely to be diagnosed in pitchers with an acute onset of UCL injury ( P = .03). Transposition of the ulnar nerve was more commonly performed in players with ulnar neuritis (47%) versus those without ulnar neuritis (10%; P = .0001). The players who had ulnar neuritis and underwent UCLR had a significantly lower odds of returning to sport (odds ratio, 0.45; P = .04); however, no significant difference was found for time to return to sport and length of playing career for those with and without ulnar neuritis ( P = .38 and .51, respectively).

Conclusion:

The study suggests that ulnar neuritis, when present preoperatively in baseball pitchers undergoing UCLR, may adversely affect their ability to return to sport, whereas ulnar nerve transposition at the time of UCLR does not alter the ability to return to sport.
The effect of maternal exposure to titanium dioxide nanoparticles on the pain response in offspring mice using formalin test
Authors: Ilani Mojtaba , Sajedianfard Javad , Tarlan Mitra , Nazifi Saeed , Fathi Mazyar
Published: November 2021

This study was conducted to evaluate the effect of maternal exposure to TiO2 nanoparticles on the pain response in offspring mice. 30 female mice with a mean ± SD weight of 30 ± 5 g were randomly divided into three groups: the control group (group 1) received only the basal diet; the sham group (group 2) received saline plus as a carrier (100 μL/mice) subcutaneously on days 3, 7, 10, and 14 post-mating; and the test group (group 3) received 100 μL/mice TNPs subcutaneously on days 3, 7, 10, and 14 post-mating. Offspring were divided into 6 groups 21 days after birth and underwent formalin test. Blood samples were taken to evaluate possible oxidative changes in total antioxidant capacity (TAC) and malondialdehyde (MDA). Exposure to TNPs significantly ( p < 0.05) decreased pain perception. Except for a significant difference between the sham group and the control group, MDA and TAC were not significantly different among the studied groups. Injection of TNPs to pregnant mice would affect the pain perception in their offspring. This may be attributable to the ability of these particles to pass through the placenta to produce free radicals.
The Effectiveness of Grassroots Lobbying at the Regional Level in Poland: The Cases of Opole and Subcarpathian Region
Authors: Olejnik Maciej
Published: November 2021

This article examines the effectiveness of grassroots lobbying at the regional level in Poland. For the purpose of the article, “loyalty to the citizens versus party theory” was formulated. It distinguishes two stages of the policy-making process within which the councilors react differently to grassroots lobbying. The first stage refers to the preparation of the law by the region’s board. The theory assumes that the more people pressure the legislator to persuade the board to their initiative, the more inclined he is to endorse it. This way he proves loyalty to the citizens and secures his reelection. The second stage concerns the legislators’ voting behavior. In this case, grassroots lobbying has a neutral impact on them. The councilors remain loyal to the party leaders and vote accordingly so that their position on the party list is guaranteed in the next election. In order to verify the theory, a study consisting of anonymous interviews with sixty legislators from the Opole and Subcarpathian Assembly was conducted. The outcome of the research indicates that (1) a considerable majority of legislators were positively influenced by grassroots lobbying to pressure the region’s board; (2) the voting behavior of the majority of legislators was not impacted by grassroots lobbying; (3) grassroots lobbying is the most effective at the first stage of the policy-making process; (4) the structure of government does not determine the legislators’ reaction to grassroots lobbying; (5) the party’s status (in power or in opposition) impacts the legislator’s voting behavior.
Effects of hybrid Al2O3- SiO2 nanoparticles in deionized water on the removal rate and surface roughness during electrical discharge machining of Ti-6Al-4V
Authors: Oskueyan Saeed , Abedini Vahid , Hajialimohammadi Alireza
Published: November 2021

Nowadays, special attention is paid to the application of nanoparticles to improve the performance of Electrical Discharge Machining (EDM). In this paper, modeling and optimizing the process parameters of Nanopowder Mixed Electrical Discharge Machining (NPMEDM) is studied. In this study, the effect of aluminum oxide (Al2O3) and silicon oxide (SiO2) nanoparticles on the deionized water dielectric is investigated simultaneously in the process of electrical discharge machining of Ti-6Al-4V alloy. After analyzing the parameters, the discharge current, concentration, pulse on time, and relative composition are considered as input factors. Response Surface Methodology (RSM) using Design-Expert software is employed for the design of the experiments, analysis of the results, and optimization of the parameters. The results show that the best surface morphology is obtained by machining with the addition of nanoparticles in the relative composition of 50%. In this percentage of the composition, the surface of the workpiece has the least value of crack and recast layer. In addition, the maximum value of the material removal rate (MRR) and minimum value of tool wear rate (TWR) can be achieved in the discharge current of 12 A, pulse on-time of 100 μs, and relative composition of 75% Al2O3 – 25% SiO2.
Single kernel sorting of high and normal oleic acid peanuts using near infrared spectroscopy
Authors: O’Connor Daniel J , Meder Roger , Furtado Angelo , Henry Robert J , Wright Graeme C , Rachaputi Rao CN
Published: November 2021

Peanuts are known to contain nutrients that deliver cardiovascular and health benefits. One such compound is oleic acid, an omega-9 monounsaturated fatty acid, which occurs naturally in peanuts in the concentration range 40–55% m/m, while some varieties are known to contain oleic acid above 75% m/m. These high oleic peanuts have been shown to have cardiovascular health benefit by lowering lipid levels. Breeders are therefore interested in selecting for peanuts with high oleic acid content in a rapid, non-destructive manner. Near infrared spectra acquired on single peanut kernels was used to classify the kernels as either high oleic content or normal, low oleic content, by means of partial least squares discriminant analysis with an overall error rate in classification of 3.3%.
Evaluating Incidence, Location, and Predictors of Positive Surgical Margin Among Chinese Men Undergoing Robot-Assisted Radical Prostatectomy
Authors: Qu Wugong , Yu Shuanbao , Tao Jin , Dong Biao , Fan Yafeng , Du Haopeng , Deng Haotian , Liu Junxiao , Zhang Xuepei
Published: November 2021

Purpose

To evaluate the incidence and locations of positive surgical margin (PSM) among Chinese men undergoing RARP and identify the preoperative predictors for PSM.

Methods

We retrospectively identified 393 patients who underwent RARP according to inclusion criteria by single surgeon in our hospital. PSM was defined as the presence of cancer adjacent to inked surface of the specimen and categorized into four groups based on locations: apex, posterolateral, base, and multifocal. Logistic regression analysis was performed to identify the predictors of overall and location-specific PSM.

Results

The overall PSM rate was 133/393 (34%). The PSM rates for pT2, pT3, and pT4 stage were 63/278 (23%), 50/89 (56%), and 20/26 (77%), respectively. The estimated rates for apical, posterolateral, basal, and multifocal PSM were 8%, 4%, 7%, and 14%, respectively. In univariate analysis, overall PSM related to tPSA, f/tPSA, percentage of positive needles, and Gleason score. Multifocal PSM correlated with smoking history, drinking history, tPSA, f/tPSA, percentage of positive needles, and Gleason score. In multivariate analysis, percentage of positive needles reminded the only independent predictor for overall (OR = 10.5, 95% CI: 2.58–44.4) and basal PSM (OR = 24.0, 95% CI: 3.22–179.4). The f/tPSA (OR = 2.59, 95% CI: 2.18–5.71) and percentage of positive needles (OR = 31.0, 95% CI: 3.17–303) were independent risk factors for multifocal PSM.

Conclusion

The multifocal sites were the most common location of positive surgical margin, followed by apical and basal sites among Chinese patients undergoing RARP. The percentage of positive needles was an independent predictor for overall, basal, and multifocal PSM.
Modelling of contact and tribotechnical parameters of metal–polymer gears taking into account wear and correction of teeth
Authors: Chernets Myron , Kornienko Anatolii , Chernets Yuriy , Fedorchuk Svetlana
Published: November 2021

The estimation and the analysis of the arising contact pressures and tribotechnical parameters, that is, wear and durability, of metal-polymer spur gears using the author's computational method are presented in this study. Gears with a steel gear and pinion made of polyamide PA6 modified with dispersed carbon fibers (CF) or glass fibers (GF) whose content was 30%, PA6 + 30CF and PA6 + 30GF correspondingly, are studied. This took into account the parity of engagement, the effect of composite pinion teeth wear and gear correction. Quantitative and qualitative regularities of change of the specified parameters depending on composite type and gear correction type are established. It is found that the teeth wear of composite toothed wheels has a significant effect on reducing the values of the initial maximum contact pressures in the engagement. The distribution of linear wear along the teeth working profile and the localization of its maximum values, depending on the correction of engagement, are determined. The minimum durability of metal–polymer gears is calculated by simplified and improved methods. The optimal values of the correction coefficients at which the minimum durability is highest for both combination types of metal–polymer gears with height and angular teeth correction are established. The durability of metal–polymer gears with a driving pinion made of PA6 + 30CF composite calculated with the improved method is about seven times higher than the pinion made of PA6 + 30GF composite. In contrast to the methods of calculation of metal gears known from publications, the method presented in this study takes into account such practically significant factors as change of radii of tooth profile curvature owing to wear, their correction and number of teeth pairs at the engagement. In metal–polymer gears, there are no analytical calculation methods for modelling wear and tribological durability compared with that of the author's method.
Deadpan humour, the comic disposition and the interpretation of ironic ambiguity online
Authors: Holm Nicholas
Published: November 2021

This article explores how the prevalence of deadpan and ironic modes of humour undermines the possibility of clear and stable interpretation in online contexts. Analysing key examples of online deadpan humour through the lens of literary and critical models of irony, I argue that the decontextualisation of deadpan humour in online spaces accentuates the deadpan comic mode’s tendency towards ambiguity in ways that hypothetically destabilise any claim to textual certainty. Drawing on the work of Pierre Bourdieu, I propose the ‘comic disposition’ as a means to theorise how audiences learn to process the comic ambiguity of online deadpan humour, and suggest how the ‘comic disposition’ can be understood to inform observed tendencies towards distrust and confusion in digital culture.
Prevalence and associated factors of dysglycemia among patients with chronic obstructive pulmonary disease
Authors: Zulkifli Khairil K , Mohamed Shah Fatimah Z , Ismail Ahmad I , Abdul Rahman Thuhairah H , Ghani Rohana A
Published: November 2021

Objectives

Dysglycemia is known to be a common comorbidity of chronic obstructive pulmonary disease (COPD). However, undiagnosed dysglycemia and the associated factors remain under-reported. This study aimed to determine the prevalence and the associated factors of dysglycemia among COPD patients.

Methods

This was a cross-sectional, single-center study involving adults with established COPD ( n = 186) divided into those with or without hospital admissions for acute exacerbation. Oral glucose tolerance test (OGTT) was performed in patients with no known history of dysglycemia.

Results

There were 16 patients who had overt diabetes, and 32 had prediabetes following the OGTT. Forty percent had histories of hospital admissions for COPD exacerbations. Both groups demonstrated similar 2-h post prandial glucose, glycated hemoglobin (HbA1c) and fasting blood glucose. The incidences of newly diagnosed dysglycemia were higher in both groups (40.8% vs 34.6%, p = 0.57). Cumulative days of admission (≥6 days/year) and weight (≥65 kg) were identified as predictors for dysglycemia within the study population.

Discussion

This study demonstrated a high number of overt and newly diagnosed dysglycemia among COPD patients who had no previous history of abnormal glucose. Recent acute exacerbations of COPD could have a negative impact on glycemia, although the results did not attain statistical significance. However, there is a need for adequate screening for dysglycemia, particularly among those with frequent acute exacerbations of their condition.
Exploring Effects of Aerobic Exercise and Mindfulness Training on Cognitive Function in Older Adults at Risk of Dementia: A Feasibility, Proof-of-Concept Study
Authors: Salmoirago-Blotcher Elena , Trivedi Dyuti , Dunsiger Shira , Harris Kristie , Breault Christopher , Yang Santos Cláudia , Walaska Kristen , Snyder Peter , Cohen Ronald
Published: November 2021

Objectives: This study sought to explore feasibility, acceptability, and preliminary effects of aerobic training (AT), mindfulness training (MT), or both (MT + AT) on cognitive function in older individuals at risk of dementia. Method: Participants were randomized to AT, MT, both, or usual care (UC). Z-scores of attention, verbal fluency, and episodic memory for non-demented adults (ZAVEN) were computed at baseline, end of treatment (EOT), and 6 months since baseline. Results: Of the 36 enrolled participants (12 M, 24 F, mean age = 70.1 years), 97% were retained in the study at 6 months. At EOT, MT had higher ZAVEN scores than UC (b = .43, P =.03) and AT (b = .26, P = .10), while no differences were seen with MT + AT. A similar pattern was observed at a 6 month follow-up (all P values = .10). Discussion: MT may improve cognitive function in older individuals at risk of dementia. These preliminary findings need to be confirmed in a fully powered RCT.
The role of directional atherectomy in critical-limb ischemia
Authors: Krishnan Prakash , Tarricone Arthur , Chen Simon , Sharma Samin
Published: November 2021

Background:

Our aim was to review the current literature of the use of directional atherectomy (DA) in the treatment of lower extremity critical-limb ischemia.

Methods:

A search for relevant literature was performed in PubMed and PubMed Central on 16 April 2020, sorted by best match. Three searches across two databases were performed. Articles were included that contained clinical and procedural data of DA interventions in lower extremity critical-limb ischemia patients. All studies that were systematic reviews were excluded.

Results:

Eleven papers were included in this review. Papers were examined under several parameters: primary patency and secondary patency, limb salvage/amputation, technical/procedural success, complications/periprocedural events, and mean lesion length. Primary and secondary patency rates ranged from 56.3% to 95.0% and 76.4% to 100%, respectively. Limb salvage rates ranged from 69% to 100%. Lesion lengths were highly varied, representing a broad population, ranging from 30 ± 33 mm to 142.4 ± 107.9 mm.

Conclusions:

DA may be a useful tool in the treatment of lower extremity critical-limb ischemia.
History of closed reduction techniques and initial management for shoulder dislocations: From classical antiquity to modern times
Authors: van Spanning Sanne H , Verweij Lukas PE , Verweij Emma EZ , van den Bekerom Michel PJ , Somford Matthijs P
Published: November 2021

This review gives a summary of the records of shoulder dislocation management throughout history until the point that anaesthetics were introduced and modern medicine improved dislocation management exponentially. A dislocation is a mechanical injury that has been managed in different ways throughout history. The shoulder reduction methods described in Hippocrates Corpus have been described and adjusted throughout history by later physicians. For example, in ancient Greek, Hippocrates considered the ambe, a device used to reduce the shoulder, to be the most powerful tool. However, Cooper, a physician in the 19th century, considered it to be the last resort due to substantial damage to the ribs and discomfort of the patient. This review demonstrates that there were many physicians that contributed to shoulder dislocation management. These physicians paved the way for modern shoulder dislocation treatment strategies.
The Impact of Trading Information Sets on Exchange Rate Change and Volatility: Evidence From Taiwan
Authors: Liu Ying-Sing
Published: November 2021

This study explores the Taiwan Dollar (TWD) as the currency of a small island economy, uses the trading information sets from overseas and the market itself to examine the impacts on the adjustment of daily spot exchange rates. The daily USD/TWD is explained by the trading information sets, contain which the daily trading activities and the ratio of the real body on the daily candlestick chart of technical analysis on the Taipei Foreign Exchange Market, as well as the US-dollar index return to explain the USD/TWD spot rate change. The results showed that some of the USD/TWD changes were related to the US-dollar index return on overseas, and that the effect of the US-dollar index return was not limited to the adjustment rate from the previous closing rate to the opening rate on the day, which would affect the adjustment spot exchange rate in the intraday opening-to-closing period. There is a significant positive relationship between the real body ratio of the daily candlestick chart and the return of the exchange rate, supporting the real body ratio related to the change of the exchange rate. The study model can greatly improve the model interpretation ability of the change of exchange rate by about 50% after considering the trading activity factors. Finally, this study found that the volatility has a positive effect on Mondays and the 2008-financial crisis, and based on the shock that the news of depreciation was higher than the news of appreciation, so there exist asymmetry volatility.
Glitter and Guts: Narrative Portrayal of Sportswomen’s Experiences on a Coached Masters Team
Authors: Currie Chelsea , Callary Bettina , Young Bradley W.
Published: November 2021

This qualitative investigation explored the lived meaningful experiences of adult women in a coached Masters synchronized ice-skating team and the role of the coach in these experiences. Data were collected via semi-structured interviews with 11 team members (mean age = 39) and their 32 year-old female coach, over multiple time points in their season. Observational field notes were taken during training, competition, and social engagements. Story analyst methods were used for data collection and analysis, to then present the results in the form of realist tales (Smith & Sparkes, 2009a; 2009b) about the novelties of identifying with a women’s Masters team. Stories respectively highlighted (1) how notions of team included compliance to social norms despite individual differences, (2) women’s unique empowerment through sport, sisterhood, and what that meant for their respective identities, and (3) the value of surrounding support networks and social negotiations. Intertwined within these three stories was a fourth narrative characterizing the coach’s involvement in the culture, interactions, and climate of the team. The coach had implicit and explicit roles, was integrated into the team, and shared power which enhanced athletes’ experiences. This study points toward the meaningfulness of sport by illustrating the inherent social dimensions and connectedness within a team sport for adult women.
Differential receptor tyrosine kinase phosphorylation in the uterus of rats following developmental exposure to tetrabromobisphenol A
Authors: Castro Lysandra , Liu Jingli , Yu Linda , Burwell Alanna D , Saddler Trey O , Santiago Lindsay A , Xue William , Foley Julie F , Staup Michael , Flagler Norris D , Shi Min , Birnbaum Linda S , Dixon Darlene
Published: November 2021

Tetrabromobisphenol A (TBBPA) is a brominated flame retardant that induces endometrial adenocarcinoma and other uterine tumors in Wistar Han rats; however, early molecular events or biomarkers of TBBPA exposure remain unknown. We investigated the effects of TBBPA on growth factor receptor activation [phospho-receptor tyrosine kinases (RTKs)] in uteri of rats following early-life exposures. Pregnant Wistar Han rats were exposed to TBBPA (0, 0.1, 25, and 250 mg/kg bw/day) via oral gavage on gestation day 6 through weaning of pups on postnatal day (PND) 21. Pups were exposed in utero, through lactation, and by daily gavage from PND 22 to PND 90. Uterine horns were collected (at PND 21, PND 33, and PND 90) and formalin-fixed or frozen for histologic, immunohistochemical, phospho-RTK arrays, or western blot analysis. At PND 21, the phospho-RTKs, fibroblast growth factor receptor 2 and 3 (FGFR2 and FGFR3), neurotrophic tyrosine kinase receptor type 3 (TRKC), and EPH receptor A1 (EPHA1) were significantly increased at different treatment concentrations. Several phospho-RTKs were also significantly overexpressed at PND 33 which included epithelial growth factor receptor (EGFR), FGFR2, FGFR3, FGFR4, insulin-like growth factor receptor 1 (IGF1R), insulin receptor (INSR), AXL receptor tyrosine kinase (AXL), MER proto-oncogene, tyrosine kinase (MERTK), platelet derived growth factor receptor alpha and beta (PDGFRA and PDGFRB), ret proto-oncogene (RET), tyrosine kinase with immunoglobulin-like and EGF-like domains 1 and 2 (TIE1 and TIE2), TRKA, kinase insert domain receptor (KDR;VEGFR2), fms related receptor tyrosine kinase (FLT4; VEGFR3), and EPHA1 at different treatment concentrations. EGFR, a RTK overexpressed in endometrial cancer in women, remained significantly increased for all treatment groups at PND 90. Erb-B2 receptor tyrosine kinase 2 (ERBB2) and IGF1R were overexpressed at PND 33 and remained increased through PND 90, although ERBB2 was statistically significant at PND 90. The phospho-RTKs, FGFR3, AXL, TYRO3 protien tyrosine kinase (TYRO3; DTK), HGFR, TRKC, FLT1/VEGFR1, and EPHB2 and 4 were also statistically significant at PND 90 at different treatment doses. The downstream effector, phospho-MAPK44/42, was also increased in uteri of treated rats. Our findings show RTKs are dysregulated following early-life TBBPA exposures and their sustained activation may contribute to TBBPA-induced uterine tumors observed in rats later in life.
Systemic IL-15 promotes allogeneic cell rejection in patients treated with natural killer cell adoptive therapy
Authors: Berrien-Elliott Melissa M. , Becker-Hapak Michelle , Cashen Amanda F. , Jacobs Miriam , Wong Pamela , Foster Mark , McClain Ethan , Desai Sweta , Pence Patrick , Cooley Sarah , Brunstein Claudio , Gao Feng , Abboud Camille N. , Uy Geoffrey L. , Westervelt Peter , Jacoby Meagan A. , Pusic Iskra , Stockerl-Goldstein Keith E. , Schroeder Mark A. , DiPersio John F. , Soon-Shiong Patrick , Miller Jeffrey S. , Fehniger Todd A.
Published: November 2021

Natural killer (NK) cells are a promising alternative to T cells for cancer immunotherapy. Adoptive therapies with allogeneic, cytokine-activated NK cells are being investigated in clinical trials. However, the optimal cytokine support after adoptive transfer to promote NK cell expansion, and persistence remains unclear. Correlative studies from 2 independent clinical trial cohorts treated with major histocompatibility complex-haploidentical NK cell therapy for relapsed/refractory acute myeloid leukemia revealed that cytokine support by systemic interleukin-15 (IL-15; N-803) resulted in reduced clinical activity, compared with IL-2. We hypothesized that the mechanism responsible was IL-15/N-803 promoting recipient CD8 T-cell activation that in turn accelerated donor NK cell rejection. This idea was supported by increased proliferating CD8+ T-cell numbers in patients treated with IL-15/N-803, compared with IL-2. Moreover, mixed lymphocyte reactions showed that IL-15/N-803 enhanced responder CD8 T-cell activation and proliferation, compared with IL-2 alone. Additionally, IL-15/N-803 accelerated the ability of responding T cells to kill stimulator-derived memory-like NK cells, demonstrating that additional IL-15 can hasten donor NK cell elimination. Thus, systemic IL-15 used to support allogeneic cell therapy may paradoxically limit their therapeutic window of opportunity and clinical activity. This study indicates that stimulating patient CD8 T-cell allo-rejection responses may critically limit allogeneic cellular therapy supported with IL-15. This trial was registered at www.clinicaltrials.gov as #NCT03050216 and #NCT01898793.
Comparison of carbohydrate ABC importers from Mycobacterium tuberculosis
Authors: De la Torre Lilia I. , Vergara Meza José G. , Cabarca Sindy , Costa-Martins André G. , Balan Andrea
Published: November 2021

Background

Mycobacterium tuberculosis, the etiological agent of tuberculosis, has at least four ATP-Binding Cassette (ABC) transporters dedicated to carbohydrate uptake: LpqY/SugABC, UspABC, Rv2038c-41c, and UgpAEBC. LpqY/SugABC transporter is essential for M. tuberculosis survival in vivo and potentially involved in the recycling of cell wall components. The three-dimensional structures of substrate-binding proteins (SBPs) LpqY, UspC, and UgpB were described, however, questions about how these proteins interact with the cognate transporter are still being explored. Components of these transporters, such as SBPs, show high immunogenicity and could be used for the development of diagnostic and therapeutic tools. In this work, we used a phylogenetic and structural bioinformatics approach to compare the four systems, in an attempt to predict functionally important regions.

Results

Through the analysis of the putative orthologs of the carbohydrate ABC importers in species of Mycobacterium genus it was shown that Rv2038c-41c and UgpAEBC systems are restricted to pathogenic species. We showed that the components of the four ABC importers are phylogenetically separated into four groups defined by structural differences in regions that modulate the functional activity or the interaction with domain partners. The regulatory region in nucleotide-binding domains, the periplasmic interface in transmembrane domains and the ligand-binding pocket of the substrate-binding proteins define their substrates and segregation in different branches. The interface between transmembrane domains and nucleotide-binding domains show conservation of residues and charge.

Conclusions

The presence of four ABC transporters in M. tuberculosis dedicated to uptake and transport of different carbohydrate sources, and the exclusivity of at least two of them being present only in pathogenic species of Mycobacterium genus, highlights their relevance in virulence and pathogenesis. The significant differences in the SBPs, not present in eukaryotes, and in the regulatory region of NBDs can be explored for the development of inhibitory drugs targeting the bacillus. The possible promiscuity of NBDs also contributes to a less specific and more comprehensive control approach.
Land use and life history constrain adaptive genetic variation and reduce the capacity for climate change adaptation in turtles
Authors: Byer Nathan W. , Fountain Emily D. , Reid Brendan N. , Miller Kristen , Kulzer Paige J. , Peery M. Zachariah
Published: November 2021

Background

Rapid anthropogenic climate change will require species to adapt to shifting environmental conditions, with successful adaptation dependent upon current patterns of genetic variation. While landscape genomic approaches allow for exploration of local adaptation in non-model systems, most landscape genomics studies of adaptive capacity are limited to exploratory identification of potentially important functional genes, often without a priori expectations as to the gene functions that may be most important for climate change responses. In this study, we integrated targeted sequencing of genes of known function and genotyping of single-nucleotide polymorphisms to examine spatial, environmental, and species-specific patterns of potential local adaptation in two co-occuring turtle species: the Blanding’s turtle (Emydoidea blandingii) and the snapping turtle (Chelydra serpentina).

Results

We documented divergent patterns of spatial clustering between neutral and putatively adaptive genetic variation in both species. Environmental associations varied among gene regions and between species, with stronger environmental associations detected for genes involved in stress response and for the more specialized Blanding’s turtle. Land cover appeared to be more important than climate in shaping spatial variation in functional genes, indicating that human landscape alterations may affect adaptive capacity important for climate change responses.

Conclusions

Our study provides evidence that responses to climate change will be contingent on species-specific adaptive capacity and past history of exposure to human land cover change.
MSMEG_3955 from Mycobacterium smegmatis is a FMN bounded homotrimeric NAD(P)H:Flavin mononucleotide (FMN) oxidoreductase
Authors: Khosla Neha , Thayil Seema Madhumal , Kaur Rajinder , Kesavan Anup Kumar
Published: November 2021

Background

Tuberculosis (TB) remains an important public health problem since it is the major cause of elevated morbidity and mortality globally. Previous works have shown that Mycobacterium tuberculosis (Mtb); the prime causative agent of the deadly disease has dormancy survival regulator (DosR) regulon, a two-component regulatory system which controls the transcription of more than 50 genes. However, the structure and detailed functions of these DosR regulated genes are largely undetermined. Out of many DosR regulon genes, Rv3131 gets up regulated in hypoxic conditions and was believed to encode for a nitroreductase flavoprotein. The utilization of mycobacteria-specific model systems has greatly added to our understanding of the molecular mechanisms involved in the life cycle and pathogenesis of Mtb.

Results

In this study the non-pathogenic mycobacterial model organism Mycobacterium smegmatis (Msmeg) was used to reveal the structure and function of MSMEG_3955; which is a homologue of Rv3131 from Mtb. Using chromatography and spectroscopy techniques it was revealed that cofactor flavin mononucleotide (FMN) was bound to flavoprotein MSMEG_3955. Consistent with the homology modelling predictions, Circular Dichroism (CD) analysis indicated that the MSMEG_3955 is composed of 39.3% α-helix and 24.9% β-pleated sheets. In contrast to the current notions, the enzymatic assays performed in the present study revealed that MSMEG_3955 was not capable of reducing nitro substrates but showed NADPH dependent FMN oxidoreductase activity. Also, gel permeation chromatography, dynamic light scattering and native acidic gels showed that MSMEG_3955 exists as a homotrimer. Furthermore, the presence of NADPH dependent FMN oxidoreductase and homotrimeric existence could be an alternative function of the protein to help the bacteria survive in dormant state or may be involved in other biochemical pathways.

Conclusion

MSMEG_3955 is a FMN bound flavoprotein, which exits as a trimer under in vitro conditions. There is no disulphide linkages in between the three protomers of the homotrimer MSMEG_3955. It has a NADPH dependent FMN oxidoreductase activity.
Urgent transcatheter aortic valve implantation in an all-comer population: a single-centre experience
Authors: Lux Arpad , Veenstra Leo F. , Kats Suzanne , Dohmen Wim , Maessen Jos G. , van ’t Hof Arnoud W. J. , Maesen Bart
Published: November 2021

Background

When compared with older reports of untreated symptomatic aortic valve stenosis (AoS), urgent transcatheter aortic valve implantation (u-TAVI) seems to improve mortality rates. We performed a single centre, retrospective cohort analysis to characterize our u-TAVI population and to identify potential predictors of worse outcomes.

Methods

We performed a retrospective analysis of 631 consecutive TAVI patients between 2013 and 2018. Of these patients, 53 were categorized as u-TAVI. Data was collected from the local electronic database.

Results

Urgent patients had more often a severely decreased left ventricular ejection fraction (LVEF < 30%) and increased creatinine levels (115.5 [88–147] vs 94.5 [78–116] mmol/l; p = 0.001). Urgent patients were hospitalised for 18 [10–28] days before and discharged 6 [4–9] days after the implantation. The incidence of peri-procedural complications and apical implantations was comparable among the study groups. Urgent patients had higher in-hospital (11.3% vs 3.1%; p = 0.011) and 1-year mortality rates (28.2% vs 8.5%, p < 0.001). An increased risk of one-year mortality was associated with urgency (HR 3.5; p < 0.001), apical access (HR 1.9; p = 0.016) and cerebrovascular complications (HR 4.3; p = 0.002). Within the urgent group, the length of pre-hospital admission was the only significant predictor of 1-year mortality (HR 1.037/day; p = 0.003).

Conclusions

Compared to elective procedures, u-TAVI led to increased mortality and comparable complication rates. This detrimental effect is most likely related to the length of pre-procedural hospitalisation of urgent patients.
Impact of anemia on in-stent restenosis after percutaneous coronary intervention
Authors: Hu Huilin , Wang Shijun , Tang Guanmin , Zhai Changlin , Shen Liang
Published: November 2021

Background

Anemia is a common risk factor for post-percutaneous coronary intervention (PCI) adverse events; however, data on its association with in-stent restenosis (ISR) is limited.

Methods

538 patients who underwent PCI between January 2017 and September 2019 and follow-up angiography 9–12 months after the initial PCI were enrolled in this study. Baseline clinical and procedural characteristics were compared between the ISR and non-ISR groups, and independent predictors of ISR were determined using propensity score matching.

Results

The incidence of anemia was 53.5% in patients with ISR and 19.0% in those without ISR. Univariable logistic regression analyses showed that anemia (OR, 4.283; 95% CI, 1.949–9.410; P < 0.001), diabetes mellitus (OR, 2.588; 95% CI, 1.176–5.696; P = 0.018), chronic kidney disease (OR, 3.058; 95% CI, 1.289–7.252; P = 0.011), multiple stenting (OR, 2.592; 95% CI, 1.205–5.573; P = 0.015), bifurcation lesion (OR, 2.669; 95% CI, 1.236–5.763; P = 0.012), and calcification (OR, 3.529; 95% CI, 1.131–11.014; P = 0.030) were closely associated with ISR. Low-density lipoprotein cholesterol (LDL-c) levels and stent diameter were also significantly linked to ISR, as was anemia (P = 0.009) after propensity score matching.

Conclusion

Anemia is closely associated with post-PCI ISR, and patients with lower hemoglobin levels are at a higher risk of ISR.