bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of the Predictive Value of the Glasgow Coma Scale and the Kampala Trauma Score for Mortality and Length of Hospital Stay in Head Injury Patients at a Tertiary Hospital in Uganda: A Diagnostic Prospective Study
Authors: Ariaka Herbert , Kiryabwire Joel , Hussein Ssenyonjo , Ogwal Alfred , Nkonge Emmanuel , Oyania Felix
Published: October 2020

Introduction. The prevalence rates of head injury have been shown to be as high as 25% among trauma patients with severe head injury contributing to about 31% of all trauma deaths. Triage utilizes numerical cutoff points along the scores continuum to predict the greatest number of people who would have a poor outcome, “severe” patients, when scoring below the threshold and a good outcome “non severe” patients, when scoring above the cutoff or numerical threshold. This study aimed to compare the predictive value of the Glasgow Coma Scale and the Kampala Trauma Score for mortality and length of hospital stay at a tertiary hospital in Uganda. Methods. A diagnostic prospective study was conducted from January 12, 2018 to March 16, 2018. We recruited patients with head injury admitted to the accidents and emergency department who met the inclusion criteria for the study. Data on patient’s demographic characteristics, mechanisms of injury, category of road use, and classification of injury according to the GCS and KTS at initial contact and at 24 hours were collected. The receiver operating characteristics (ROC) analysis and logistic regression analysis were used for comparison. Results. The GCS predicted mortality and length of hospital stay with the GCS at admission with AUC of 0.9048 and 0.7972, respectively (KTS at admission time, AUC 0.8178 and 0.7243). The GCS predicted mortality and length of hospital stay with the GCS at 24 hours with AUC of 0.9567 and 0.8203, respectively (KTS at 24 hours, AUC 0.8531 and 0.7276). At admission, the GCS at a cutoff of 11 had a sensitivity of 83.23% and specificity of 82.61% while the KTS had 88.02% and 73.91%, respectively, at a cutoff of 13 for predicting mortality. At admission, the GCS at a cutoff of 13 had sensitivity of 70.48% and specificity of 66.67% while the KTS had 68.07% and 62.50%, respectively, at a cutoff of 14 for predicting length of hospital stay. Conclusion. Comparatively, the GCS performed better than the KTS in predicting mortality and length of hospital stay. The GCS was also more accurate at labelling the head injury patients who died as severely injured as opposed to the KTS that categorized most of them as moderately injured. In general, the two scores were sensitive at detection of mortality and length of hospital stay among the study population.
Reactive Oxygen Species Induce Endothelial Differentiation of Liver Cancer Stem-Like Sphere Cells through the Activation of Akt/IKK Signaling Pathway
Authors: Zhao Zhengbin , Gao Jing , Li Caili , Xu Xiaoli , Hu Yihuan , Huang Shuangsheng
Published: October 2020

Cancer stem cells (CSCs) from various cancers are able to transdifferentiate into endothelial cells and further form functional blood vessels, indicating another possible resistance mechanism to antiangiogenic agents. However, it remains unclear whether CSCs from hepatocellular carcinoma have the ability to differentiate into endothelial cells, and thus resulting in resistance to antiangiogenic therapy targeting VEGF. Reactive oxygen species (ROS) are involved in the self-renewal and differentiation of CSCs, yet, their role in endothelial differentiation of CSCs has been poorly understood. In this study, we found that cancer stem-like sphere cells enriched from human hepatocellular carcinoma cell line Hep G2 could differentiate into endothelial cells morphologically and functionally, and this process could be blocked by Akt1/2 kinase inhibitor and IKK-β inhibitor BAY 11-7082 but not by Bevacizumab, a VEGFA-binding antibody, and DAPT, a γ-secretase inhibitor. Both hydrogen peroxide and BSO (an inhibitor of GSH biosynthesis) induce the differentiation of cancer stem-like sphere cells into endothelial cells, which can be canceled by the antioxidant N-Acetyl-L-cysteine (NAC). We also found that hydrogen peroxide or BSO induces the phosphorylation of Akt and IKK of endothelial differentiated sphere cells. Accordingly, both Akt1/2 kinase inhibitor and BAY 11-7082 inhibited hydrogen peroxide and BSO-mediated endothelial differentiation of cancer stem-like sphere cells. Collectively, the results of the present study demonstrate that cancer stem-like sphere cells from Hep G2 are able to differentiate into endothelial cells both morphologically and functionally, and this process is independent of VEGF and NOTCH signaling but dependent on the activation of Akt and IKK. ROS promote endothelial differentiation of cancer stem-like sphere cells through activation of Akt/IKK signaling pathway. Therefore, our study reveals a novel mechanism of resistance to conventional antiangiogenic therapy and may provide a potential therapeutic target for liver cancer treatment.
Oxidative Stress in Parkinson’s Disease: Potential Benefits of Antioxidant Supplementation
Authors: Percário Sandro , da Silva Barbosa Aline , Varela Everton Luiz Pompeu , Gomes Antônio Rafael Quadros , Ferreira Michelli Erica Souza , de Nazaré Araújo Moreira Thayana , Dolabela Maria Fani
Published: October 2020

Parkinson’s disease (PD) occurs in approximately 1% of the population over 65 years of age and has become increasingly more common with advances in age. The number of individuals older than 60 years has been increasing in modern societies, as well as life expectancy in developing countries; therefore, PD may pose an impact on the economic, social, and health structures of these countries. Oxidative stress is highlighted as an important factor in the genesis of PD, involving several enzymes and signaling molecules in the underlying mechanisms of the disease. This review presents updated data on the involvement of oxidative stress in the disease, as well as the use of antioxidant supplements in its therapy.
Phillyrin Mitigates Apoptosis and Oxidative Stress in Hydrogen Peroxide-Treated RPE Cells through Activation of the Nrf2 Signaling Pathway
Authors: Du Yuanyuan , You Longtai , Ni Boran , Sai Na , Wang Wenping , Sun Mingyi , Xu Rui , Yao Yu , Zhang Zhiqin , Qu Changhai , Yin Xingbin , Ni Jian
Published: October 2020

Oxidative stress-induced dysfunction or apoptosis in retinal pigment epithelial (RPE) cells is an important cause of dry age-related macular degeneration (AMD). Although phillyrin has been shown to exert significant antioxidant effects, the underlying mechanism of action remains unclear. The purpose of this study was to investigate the protective effect of phillyrin on hydrogen peroxide- (H2O2-) induced oxidative stress damage in RPE cells and the potential mechanism involved. It was found that phillyrin significantly protected RPE cells from H2O2 cytotoxicity. Furthermore, phillyrin alleviated oxidative stress-induced apoptosis via inhibition of endogenous and exogenous apoptotic pathways. Compared with the H2O2-treated group, the expressions of cleaved caspase-3, cleaved caspase-9, cleaved polymerase (PARP), death receptor Fas, and cleaved caspase-8, as well as Bax/Bcl-2 ratio were decreased in RPE cells after the phillyrin intervention. In addition, phillyrin reversed the oxidative stress-induced reductions in superoxide dismutase (SOD) and glutathione (GSH) levels and annulled the elevations in reactive oxygen species (ROS) and malondialdehyde (MDA), thereby restoring oxidant-antioxidant homeostasis. Phillyrin treatment upregulated the expressions of cyclin E, cyclin-dependent kinase 2 (CDK2), and cyclin A and downregulated the expressions of p21 and p-p53, thereby reversing the G0/G1 cell cycle arrest in H2O2-treated RPE cells. Pretreatment with phillyrin also increased the expressions of nuclear factor-erythroid 2-related factor 2 (Nrf2), total Nrf2, heme oxygenase-1 (HO-1), and NAD(P)H: quinone oxidoreductases-1 (NQO-1) in RPE cells and inhibited the formation of Kelch-like ECH-associated protein 1 (Keap1)/Nrf2 protein complex. Thus, phillyrin effectively protected RPE cells from oxidative stress through activation of the Nrf2 signaling pathway and inhibition of the mitochondria-dependent apoptosis pathway.
Evaluation of the Diagnostic Efficacy of Xpert CT/NG for Chlamydia trachomatis and Neisseria gonorrhoeae
Authors: Xie Tian-Ao , Liu Ye-Ling , Meng Rui-Chun , Liu Xiao-Shan , Fang Ke-Ying , Deng Shu-Ting , Fan Shu-Jin , Chen Chu-Mao , Lin Qin-Rong , He Zhi-Jian , Li Zhen-Xing , Ouyang Shi , Zhu Guo-Dong , Ji Tian-Xing , Xia Yong , Pan Zhi-Yong , Guo Xu-Guang
Published: October 2020

Background. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widely spread across the world. Asymptomatic or inconspicuous CT/NG infections are difficult to diagnose and treat. Traditional methods have the disadvantages of low detection rate, inaccurate results, and long detection time. However, Xpert CT/NG makes up for the aforementioned shortcomings and has research value and popularization significance. Methods. PubMed, Embase, Cochrane Library, and Web of Science were systematically searched, and studies were screened using Xpert CT/NG for diagnosing CT/NG. QUADAS‐2 was used to evaluate the quality of the eligible studies. Then, two groups of researchers independently extracted data from these studies. Meta‐analyses of sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC) of the summary receiver operating characteristic (SROC) curve were conducted using Meta‐DiSc 1.4. Finally, Deek’s funnel plots were made using Stata 12.0 to evaluate publication bias. Results. 14 studies were identified, and 46 fourfold tables were extracted in this meta‐analysis. The pooled SEN, SPE, PLR, NLR, DOR, and AUC in diagnosing CT were 0.94 (95% confidence interval (CI): 0.93–0.95), 0.99 (95% CI: 0.99–1.00), 97.17 (95% CI: 56.76–166.32), 0.07 (95% CI: 0.04–0.12), 1857.25 (95% CI: 943.78–3654.86), and 0.9960, respectively. The pooled SEN, SPE, PLR, NLR, DOR, and AUC in diagnosing NG were 0.95 (95% CI: 0.93–0.96), 1.00 (95% CI: 1.00–1.00), 278.15 (95% CI: 152.41–507.63), 0.08 (95% CI: 0.06–0.12), 4290.70 (95% CI: 2161.78–8516.16), and 0.9980, respectively. Conclusions. Xpert CT/NG had high diagnostic sensitivity and specificity for CT and NG. However, more evidence is required to confirm that Xpert CT/NG might serve as the primary method for detecting CT and NG and even the gold standard for diagnosis in the future.
Object Detection from the Video Taken by Drone via Convolutional Neural Networks
Authors: Sun Chenfan , Zhan Wei , She Jinhiu , Zhang Yangyang
Published: October 2020

The aim of this research is to show the implementation of object detection on drone videos using TensorFlow object detection API. The function of the research is the recognition effect and performance of the popular target detection algorithm and feature extractor for recognizing people, trees, cars, and buildings from real-world video frames taken by drones. The study found that using different target detection algorithms on the “normal” image (an ordinary camera) has different performance effects on the number of instances, detection accuracy, and performance consumption of the target and the application of the algorithm to the image data acquired by the drone is different. Object detection is a key part of the realization of any robot’s complete autonomy, while unmanned aerial vehicles (UAVs) are a very active area of this field. In order to explore the performance of the most advanced target detection algorithm in the image data captured by UAV, we have done a lot of experiments to solve our functional problems and compared two different types of representative of the most advanced convolution target detection systems, such as SSD and Faster R-CNN, with MobileNet, GoogleNet/Inception, and ResNet50 base feature extractors.
Global Stability Analysis of Neural Networks with Constant Time Delay via Frobenius Norm
Authors: Thoiyab N. Mohamed , Muruganantham P. , Rajchakit Grienggrai , Gunasekaran Nallappan , Unyong Bundit , Humphries Usa , Kaewmesri Pramet , Lim Chee Peng
Published: October 2020

This paper deals with the global asymptotic robust stability (GARS) of neural networks (NNs) with constant time delay via Frobenius norm. The Frobenius norm result has been utilized to find a new sufficient condition for the existence, uniqueness, and GARS of equilibrium point of the NNs. Some suitable Lyapunov functional and the slope bounded functions have been employed to find the new sufficient condition for GARS of NNs. Finally, we give some comparative study of numerical examples for explaining the advantageous of the proposed result along with the existing GARS results in terms of network parameters.
Luminescent Supramolecular Nano- or Microstructures Formed in Aqueous Media by Amphiphile-Noble Metal Complexes
Authors: Cretu Carmen , Maiuolo Loredana , Lombardo Domenico , Szerb Elisabeta I. , Calandra Pietro
Published: October 2020

The involvement of metal ions within the self-assembly spontaneously occurring in surfactant-based systems gives additional and interesting features. The electronic states of the metal, together with the bonds that can be established with the organic amphiphilic counterpart, are the factors triggering new photophysical properties. Moreover, the availability of stimuli-responsive supramolecular amphiphile assemblies, able to disassemble in a back-process, provides reversible switching particularly useful in novel approaches and applications giving rise to truly smart materials. In particular, small amphiphiles with an inner distribution, within their molecular architecture, of various polar and apolar functional groups, can give a wide variety of interactions and therefore enriched self-assemblies. If it is joined with the opportune presence and localization of noble metals, whose chemical and photophysical properties are undiscussed, then very interesting materials can be obtained. In this minireview, the basic concepts on self-assembly of small amphiphilic molecules with noble metals are shown with particular reference to the photophysical properties aiming at furnishing to the reader a panoramic view of these exciting problematics. In this respect, the following will be shown: (i) the principles of self-assembly of amphiphiles that involve noble metals, (ii) examples of amphiphiles and amphiphile-noble metal systems as representatives of systems with enhanced photophysical properties, and (iii) final comments and perspectives with some examples of modern applications.
Feibi Recipe Reduced Pulmonary Fibrosis Induced by Bleomycin in Mice by Regulating BRP39/IL‐17 and TGFβ1/Smad3 Signal Pathways
Authors: Wang Wei , Liu Zhaoheng , Niu Jie , Yang Haojie , Long Qi , Liu Haoge , Gu Xiaofeng , Jiao Yang
Published: October 2020

Fibrotic remodeling has become the result of many lung diseases, and these disorders can be categorized with known as well as unknown etiologies. Idiopathic pulmonary fibrosis is the most fatal disease among the unknown etiology. TGFβ1/Smad3 signal pathway plays an important role in lung fibrosis and epithelial regeneration. This study investigated the effects and mechanism of Feibi Recipe (FBR) on pulmonary fibrosis. In this experiment, C57BL/6 mice were used and bleomycin was used to induce the lung injury. Meanwhile, the study showed a significant reduction in pathological response and mediators of inflammation and fibrosis such as IL‐6, ICAM‐1, IL‐13, IL‐17, BRP‐39, TGFβ1, Smad3, and Smad7 were identified. Collectively, the FBR appears to attenuate the lung injury and the modeling of fibrosis in mice.
The Effect of High‐Frequency Electrical Stimulation of Bilateral Nucleus Accumbens on the Behavior of Morphine‐Induced Conditioned Place Preference Rats at Extinction and Reinstatement Phases
Authors: Yang Chunhui , Qiu Yiqing , Hu Xiaowu , Chen Jianchun , Wu Yina , Wu Xi
Published: October 2020

Objective. To explore the optimal time points for deep brain stimulation (DBS) on the treatment of morphine addiction and its possible mechanisms by investigating how high‐frequency stimulation (HFS) in bilateral nucleus accumbens (NAc) at different time points influences the addictive behaviors of rats with drug addiction. Methods. The rats were randomly divided into extinction stimulation group (n = 20) and postextinction stimulation group (n = 20). Ten rats in the extinction stimulation group were treated using 120 Hz HFS during extinction stage while another 10 rats with pseudostimulation were served as control group. The CPP scores were evaluated at the second day after intervention, with total 9 sections accomplished. The CPP scores were evaluated at the second day of the intervention. In the postextinction stimulation group, 120 Hz HFS was intervened during the postextinction stage in 10 experimental rats and pseudostimulation was performed in 10 control rats. Stimulation was performed for 7 days continuously, and a small dose of morphine was administrated to induce relapse after the postextinction period. Results. During the extinction phase, CPP scores after HFS were significantly higher. During the postextinction phase, relapse CPP scores after HFS were dramatically lower. Conclusion. HFS of bilateral NAc inhibits the extinction of addictive behavior during the extinction phase, and HFS during the postextinction period suppresses relapse of drug seeking behavior.
Classical Solutions to the Initial-Boundary Value Problems for Nonautonomous Fractional Diffusion Equations
Authors: Mu Jia , Liu Yang , Zhang Huanhuan
Published: October 2020

In this paper, we investigate a class of nonautonomous fractional diffusion equations (NFDEs). Firstly, under the condition of weighted Hölder continuity, the existence and two estimates of classical solutions are obtained by virtue of the properties of the probability density function and the evolution operator family. Secondly, it focuses on the continuity and an estimate of classical solutions in the sense of fractional power norm. The results generalize some existing results on classical solutions and provide theoretical support for the application of NFDE.
Optimal Simulation of Sandcastle Life in Dynamic Environment Based on Stability Principle
Authors: Yang Peng-Hui , Jiang Ya-Yu , Tang Qi , Li Yi-Fang , Zhu Jia-Ming
Published: October 2020

This paper mainly studies to explore a three-dimensional geometric model including three modules of a sandcastle foundation with optimal stability. Firstly, based on the knowledge of streamline structure, structural mechanics, and fluid mechanics, the most stable sand pile foundation model under the action of tidal current and wave is established. Secondly, by limiting the degree of allowable aggregation, the discrete global optimization algorithm based on the continuous descent method is adopted to find out the optimal water-sand ratio. Finally, we apply the above results to verify the reliability of the optimal model by comprehensively considering the influence of rainfall factors on sandcastles.
Frequency Spectrum and Wavelet Packet Analyses of Blasting Vibration Signals for Different Charge Structures in Blasting Peripheral Holes
Authors: Man Ke , Liu Xiaoli , Song Zhifei
Published: October 2020

Based on the blasting principle of the cutting seam cartridge, smooth blasting with the charge structures of the usual cartridge and cutting seam cartridge has been designed and implemented, respectively, for different peripheral holes in the same face. Meanwhile, the blasting vibration has been monitored. Through the analysis of the frequency spectrum of blasting vibration signals, it is found that the maximum blasting vibration velocity of the cutting seam cartridge charge is lower than that of the usual cartridge charge, from 0.21 m/s to 0.12 m/s. Moreover, the blasting energy distribution is more balanced. Especially in the low‐frequency part, the blasting energy is less, and there is a transferring trend to the high‐frequency part, which shows that the cutting seam cartridge charge has a better optimization effect. Furthermore, using wavelet packet analysis, the cutting seam cartridge charge could effectively reduce the energy concentration in the low‐frequency part. The energy distribution is much more dispersed, and the disturbance to the structure could be less, which is conducive to the stability of the structure. According to the blasting effect, the overbreak and underexcavation quantity at the cutting seam cartridge charge is better than that at the usual cartridge charge.
Similarities in Risk for COVID-19 and Cancer Disparities
Authors: Newman Lisa A. , Winn Robert A. , Carethers John M.
Published: October 2020

Coronavirus disease 2019 (COVID-19) is a novel infectious disease that has spread worldwide. In the United States, COVID-19 disproportionately affects racial and ethnic minorities, particularly African Americans, with an observed 2-fold higher rate for hospitalization and greater than 2-fold higher rate for death as compared with White Americans. The disparity seen with COVID-19 is consistent with patterns of disparities observed for cancer; it is well documented that 5-year survival rates for multiple cancers are lower in African Americans compared with White Americans. Root cause contributions for the disparity overlap between COVID-19 and cancer. While cancer is a genetic disease that is influenced by tissue microenvironment, COVID-19 is an infectious disease that is enabled by cellular expression of angiotensin-converting enzyme 2 receptors. However, socioeconomic disadvantages, level of education, lifestyle factors, health comorbidities, and limited access to medical care appear to fuel underlying risk for both cancer and COVID-19 disparities. In addition to African Americans demonstrating higher risk of acquiring and dying from either disease, they are underrepresented in clinical trials involving cancer or COVID-19. Long-term disparities are present with survivorship from cancer and may be likely with survivorship from COVID-19; both have revealed untoward effects on postdiagnosis economic viability for African Americans. Collaborative strategies that include community engagement, diverse participation in cancer and COVID-19 clinical trials, providing insurance for affected persons who lost employment due to either disease, and supporting safety-net and public hospitals for health care access will be critical to stem these disparities.
Development of Tumor-Targeting IRE-1 Inhibitors for B-cell Cancer Therapy
Authors: Shao Andong , Xu Qin , Spalek Walker T. , Cain Christopher F. , Kang Chang Won , Tang Chih-Hang Anthony , Del Valle Juan R. , Hu Chih-Chi Andrew
Published: October 2020

The IRE-1 kinase/RNase splices the mRNA of the XBP-1 gene, resulting in the spliced XBP-1 (XBP-1s) mRNA that encodes the functional XBP-1s transcription factor that is critically important for the growth and survival of B-cell leukemia, lymphoma, and multiple myeloma (MM). Several inhibitors targeting the expression of XBP-1s have been reported; however, the cytotoxicity exerted by each inhibitor against cancer cells is highly variable. To design better therapeutic strategies for B-cell cancer, we systematically compared the ability of these compounds to inhibit the RNase activity of IRE-1 in vitro and to suppress the expression of XBP-1s in mouse and human MM cell lines. Tricyclic chromenone-based inhibitors B-I09 and D-F07, prodrugs harboring an aldehyde-masking group, emerged as the most reliable inhibitors for potent suppression of XBP-1s expression in MM cells. The cytotoxicity of B-I09 and D-F07 against MM as well as chronic lymphocytic leukemia and mantle cell lymphoma could be further enhanced by combination with inhibitors of the PI3K/AKT pathway. Because chemical modifications of the salicylaldehyde hydroxy group could be used to tune 1,3-dioxane prodrug stability, we installed reactive oxygen species-sensitive structural cage groups onto these inhibitors to achieve stimuli-responsive activities and improve tumor-targeting efficiency.
Metastatic Pancreatic Cancer with BRAF and P53 Mutations: Case Report of Therapeutic Response to Doublet Targeted Therapy
Authors: Sasankan Shenthol , Rebuck Lorraine , Darrah Gloria , Harari Turquie Moises , Rabinowitz Ian
Published: October 2020

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.
Modern Radiotherapy and Risk of Cardiotoxicity
Authors: Koutroumpakis Efstratios , Palaskas Nicolas L. , Lin Steven H. , Abe Jun-ichi , Liao Zhongxing , Banchs Jose , Deswal Anita , Yusuf Syed Wamique
Published: October 2020

Despite the advancements of modern radiotherapy, radiation-induced heart disease remains a common cause of morbidity and mortality amongst cancer survivors. This review outlines the basic mechanism, clinical presentation, risk stratification, early detection, possible mitigation, and treatment of this condition.
Are Systemic Corticosteroids Causing Psoriasis Flare-Ups? Questionnaire for Danish Dermatologists, Gastroenterologists and Rheumatologists
Authors: Schwarz Christopher Willy , Loft Nikolai , Andersen Vibeke , Juul Lars , Zachariae Claus , Skov Lone
Published: October 2020

Background: Psoriasis flare-ups and the change of morphology from nonpustular to pustular psoriasis following tapering and withdrawal of systemic corticosteroids have been reported. Despite these risks, systemic corticosteroids are still widely prescribed for patients with psoriasis, but the knowledge about psoriasis flare-ups and whether the physicians take precautions during these treatments is limited. Methods: We conducted a questionnaire study among all dermatologists, gastroenterologists and rheumatologists in Denmark who work at a hospital or in a private practice to investigate the use, opinion and experience with oral, intramuscular and intra-articular corticosteroids in the treatment of patients with psoriasis. Results: We received answers from a total of 248 physicians. Compared with oral and intramuscular corticosteroids, intra-articular corticosteroids were the most reported treatment in patients with psoriasis and only used by the rheumatologists. It was mainly the dermatologists and rheumatologists who had observed psoriasis flare-ups following treatment with oral, intramuscular and intra-articular corticosteroids. Half of the dermatologists (50%) and a fourth of the rheumatologists (29%) had observed at least one psoriasis flare-up following treatment with oral corticosteroids. About 10% of both the dermatologists and the rheumatologists had observed at least one psoriasis flare-up following treatment with intramuscular and/or intra-articular corticosteroids. Overall, 44% of the respondents took precautions, when they treated a patient with psoriasis with oral, intramuscular and intra-articular corticosteroids. Conclusion: The results from the questionnaire indicate that systemic corticosteroids for patients with psoriasis can cause flare-ups and should be used with care.
Clinical Data on Immunotherapy in Breast Cancer
Authors: Radosa Julia Caroline , Stotz Lisa , Müller Carolin , Kaya Askin Canguel , Solomayer Erich-Franz , Radosa Marc Philipp
Published: October 2020

Background: Breast cancer has traditionally been considered to have a low immunogenic potential compared to other tumor entities. Summary: The most extensively studied immunotherapeutic agents for breast cancer to date are immune checkpoint inhibitors, with the results of the IMpassion130 trial leading to the approval of atezolizumab plus nab-paclitaxel for first-line treatment of programmed cell death ligand 1-positive, metastatic, triple-negative breast cancer, and studies in earlier stages have yielded promising results. Other immunotherapeutic options being assessed in phases 2 and 3 trials include vaccine-based therapies and treatment with anti-human epidermal growth factor receptor 2 (H-directed immune-linked antibodies) and substances evaluated in early clinical trials as cellular therapies (adoptive cell therapy and chimeric antigen receptor T cells). Key Messages: Immunotherapy is an emerging modality for the treatment of breast cancer, as evidenced by the plethora of preclinical and clinical concepts and ongoing trials. Early studies established the role of immunotherapeutic agents in the metastatic setting. Ongoing studies will expand our knowledge about the timing of administration, best partners for combination therapy, and predictive biomarkers to guide immunotherapy for breast cancer.
National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Authors: Pendyal Akshay , Rothenberg Craig , Scofi Jean E. , Krumholz Harlan M. , Safdar Basmah , Dreyer Rachel P. , Venkatesh Arjun K.
Published: October 2020

Background

Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015.

Methods and Results

We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively).

Conclusions

National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.
Differential contributions of static and time-varying functional connectivity to human behavior
Authors: Eichenbaum Adam , Pappas Ioannis , Lurie Daniel , Cohen Jessica R. , D’Esposito Mark
Published: October 2020

Measures of human brain functional connectivity acquired during the resting-state track critical aspects of behavior. Recently, fluctuations in resting-state functional connectivity patterns—typically averaged across in traditional analyses—have been considered for their potential neuroscientific relevance. There exists a lack of research on the differences between traditional “static” measures of functional connectivity and newly considered “time-varying” measures as they relate to human behavior. Using functional magnetic resonance imagining (fMRI) data collected at rest, and a battery of behavioral measures collected outside the scanner, we determined the degree to which each modality captures aspects of personality and cognitive ability. Measures of time-varying functional connectivity were derived by fitting a hidden Markov model. To determine behavioral relationships, static and time-varying connectivity measures were submitted separately to canonical correlation analysis. A single relationship between static functional connectivity and behavior existed, defined by measures of personality and stable behavioral features. However, two relationships were found when using time-varying measures. The first relationship was similar to the static case. The second relationship was unique, defined by measures reflecting trialwise behavioral variability. Our findings suggest that time-varying measures of functional connectivity are capable of capturing unique aspects of behavior to which static measures are insensitive.
The Lost Liquid Cosmogony of Johannes Daniel Schlichting (1705–1765)
Authors: Begley Justin
Published: October 2020

The focus of this paper is a fascinating but hitherto unstudied 1742 manuscript treatise by Johannes Daniel Schlichting (1705–1765) titled “Sapientiæ Problema” that contains something extremely rare in the mid-eighteenth century: a full-blown speculative cosmogony. As this article reveals, Schlichting developed a distinctive vital liquid matter in an effort to account for the generation of all natural bodies and combat the stamina-based theories that were dominant in his day. He hoped that his treatise would be published in the Philosophical Transactions of the Royal Society, but an accompanying abridgment by the FRS Henry Baker (1698–1774) strongly implies that Schlichting’s speculative bent and desire to divulge causal explanations were unacceptable to the Englishman and generally ill-suited to the intellectual climate of mid-century England.
Acoustic variability among male gladiator frogs, Boana goiana (Lutz, 1968) (Anura: Hylidae): an 18-year analysis across several reproductive seasons
Authors: Andreani Tainã L. , Bastos Rogério P. , Dias Tailise M. , Prado Cynthia P.A. , Morais Alessandro R.
Published: October 2020

Male anurans emit different call types in specific social contexts. Such calls represent a communication pathway for species recognition, mate choice, and male-male competition mediation. The acoustic parameters of these calls can be under directional and/or stabilizing selection due to female choice, which influences intra- and inter-individual call variation. Herein, we investigated the inter-year variation of the advertisement and aggressive calls of the gladiator frog Boana goiana, analysing a temporal series encompassing 18 years of sampling (1996-2014). We measured and analysed the following acoustic parameters: call duration, call repetition rate, number of pulses, pulse duration, pulse repetition rate, and dominant frequency. For both call types, the dominant frequency was classified as a static parameter (CVintra < 5%), while call duration was a dynamic parameter (CVintra > 12%). The advertisement call of B. goiana presents the attributes that could allow individual recognition in the chorus, and we suggest that the aggressive calls might also be important for the individual recognition process. Pulse duration of the advertisement and aggressive calls decreased over the years, as well as the repetition rate of the aggressive calls, which could be related to male body size decrease over the years probably related to habitat alteration. This study provides data on the variation of anuran acoustic features over the longest time span ever analysed. Such studies are less invasive and useful for conservation purposes, since they can detect changes in the reproductive behaviour of populations that might be under environmental modification pressure.
Influence of biotic and abiotic factors on adult Odonata (Insecta) in Amazon streams
Authors: Calvão Lenize Batista , de Paiva Carina Kaory Sasahara , da Silva Brito Joás , Fares Ana Luisa , Maia Calebe , Michelan Thaisa Sala , de Assis Montag Luciano Fogaça , Juen Leandro
Published: October 2020

Abiotic and biotic factors play an essential role in the structuring of natural communities. Aquatic ecosystems have complex interaction networks, encompassing predator/prey relationships and structural support. Among aquatic organisms, the order Odonata is a model group for understanding those relationships since they can be both predators and prey. Our hypotheses were that Zygoptera are (i) influenced positively by Ephemeroptera, Plecoptera and Trichoptera (EPT) and the Habitat Integrity Index (HII), and negatively by fish and macrophytes; and (ii) Anisoptera are affected positively by EPT and macrophytes, and negatively by fish and HII. We found that Zygoptera were affected by the fish functional trophic groups, while Anisoptera were affected by macrophytes, EPT, fish and HII. Macrophytes affected anisopterans positively because they provide perching sites for adults. The results for EPT and HII may be related since these organisms are also sensitive to environmental changes. More open areas have lower HII values and the negative relationship with Anisoptera may be explained by physiological constraints. The negative relationship between EPT and Anisoptera could be explained by the low occurrence of EPT in open sites, which are the sites that were highly rich in Anisoptera. Finally, the dominance of specific functional trophic groups of fish influences Odonata suborders in different ways. In conclusion, the results show the importance of ecological interactions for Odonata in Amazonian streams in both direct and indirect ways.
Forestry control in the Brazilian Amazon I: wood and charcoal anatomy of three endangered species
Authors: Perdigão Celine Raphaela Vasconcelos , Júnior Marcelo Mendes Braga , Gonçalves Thaís Alves Pereira , Araujo Claudionisio de Souza , Mori Fábio Akira , Barbosa Ana Carolina Maioli Campos , de Souza Fernanda Ilkiu Borges , Motta Javan Pereira , Melo Luiz Eduardo de Lima
Published: October 2020

The Brazilian Amazon is vastly deforested by unsustainable practices. Several species of trees are threatened by extinction and their exact number is hard to quantify. Federal laws prohibit the harvest of endangered forest species. It is a vast challenge to control the illegal trade of wood and especially charcoal in Brazil. The goal of this work is to contribute to an identification database. It presents the anatomy of wood and charcoal ofBertholletia excelsa,Hevea brasiliensisandSwietenia macrophylla. Structural modifications due to carbonization were also studied. OneEucalyptussp. hybrid was analysed as a comparison with native species. Anatomical features were well preserved in charcoals. Quantitative modifications, such as mass loss, increase of vessel and ray density, and reduction of vessel diameter and ray height, were seen in all species. The native species were easily distinguished from eucalypt in both wood and charcoal, and this study will allow easily sorting these species in cases of illegal trading. Since Amazon conservancy is highly dependent on the knowledge of native species, our results contribute to avoid illegal charcoal trade.
Identification of wood species used in particleboard production
Authors: Sieburg-Rockel Jördis , Koch Gerald
Published: October 2020

Wood and wood products including particleboard imported into the European Union (EU) are subject to the EU Timber Trade Regulation (EUTR) since 2013. With regard to the correct and complete required declaration, many such products not produced in the EU are currently investigated independently. The particles processed for the manufacture of particleboard are significantly smaller than solid wood samples. Thus, the preparation for anatomical analysis is more complex, as is their identification. The composition of the taxa identified allows a distinction between certain assortments according to the origin of the processed wood: temperate Europe; plantation-grown (worldwide); tropical and subtropical Asia; temperate Asia; tropical Africa. Important information for the evaluation of EUTR-subjected timbers in particleboard is provided.
Kräusel’s eight genera for fossil softwoods: types, nomenclature, and taxonomy
Authors: Philippe M. , Wilde V.
Published: October 2020

Seventy years after its publication Kräusel’s review of fossil conifer woods is still among the most quoted references in this field. Several of his earlier contributions are foundational works, but they have largely been overlooked, which has led to some misinterpretations. We reviewed the taxonomy and nomenclature of the eight genera Kräusel described for fossil conifer wood. Two of them should not be used. The genus Protophyllocladoxylon is neotypified. Several synonymies are proposed and the way Kräusel used generic names is briefly discussed.
Description of a new water mite of the genus Utaxatax (Acari, Hydrachnidia: Anisitsiellidae) from Kazakhstan
Authors: TUZOVSKIJ PETR V.
Published: October 2020

A new species of the genus Utaxatax (s.s.), U. stolbovi n. sp., is described from theAksu-Zhabagly Nature Reserve in the Republic of Kazakhstan. It is most similar to the Himalayan U. brahmeri Panesar, 2004. Similarities and morphological differences are discussed.
Role of the Cold Okhotsk Sea on the Climate of the North Pacific Subtropical High and Baiu Precipitation
Authors: Kawasaki Kenta , Tachibana Yoshihiro , Nakamura Tetsu , Yamazaki Koji
Published: October 2020

Summertime temperatures in marginal seas are, in general, colder than on the surrounding continent because of the large contrast in heat capacity between the land and the ocean. The Okhotsk Sea, which is covered by sea ice until early summer, is much colder than the surrounding continent in summer. The Okhotsk Sea is thus located in an area with one of the largest temperature contrasts of all the marginal seas in summertime midlatitudes. Cooled air over the Okhotsk Sea may have an impact on remote summer climates, such as by serving as the source of cold-air advection that results in a poor crop harvest in Japan. Here, we examine the role of the Okhotsk Sea on the early summer climate of the western part of the North Pacific through an ideal numerical experiment by artificially changing the model’s default oceanic condition in the Okhotsk Sea to a condition of land cover. Simulation results reveal that the presence of the Okhotsk Sea increases precipitation of the baiu/mei-yu front through strengthening of the northward moisture flux at the western edge of an intensified North Pacific subtropical high. The Okhotsk influence farther extends toward western North America to which the strengthened jet stream with a storm track extends. This remote influence is achievable through feedback from a transient eddy anomaly that is activated by the surface temperature gradient between the cold Okhotsk Sea and the warm Pacific Ocean. The findings imply that the existence of the Okhotsk Sea strengthens the East Asian summer monsoons.
Synoptic-to-Regional-Scale Analysis of Rainfall in the Atacama Desert (18°–26°S) Using a Long-Term Simulation with WRF
Authors: Reyers Mark , Boehm Christoph , Knarr Leon , Shao Yaping , Crewell Susanne
Published: October 2020

In this study, reanalysis data and a long-term simulation with the regional climate model WRF (1982–2017; 10 km resolution) is used to analyze synoptic and regional processes associated with rainfall events in the Atacama Desert. Five composites, each with 10 WRF-simulated rainfall events, are studied. They are selected based on a clustering and comprise the top winter events in South Atacama (23°–26°S), Southeast Atacama, and North Atacama (18°–23°S), and the top summer events in North Atacama and Northeast Atacama. Winter rainfall events in South Atacama are mostly associated with strong low pressure systems over the southeast Pacific and atmospheric rivers at their foreside, while cutoff lows occurring anomalously far north facilitate strong rainfall in North Atacama. Accordingly, tropical continental areas and the remote tropical and subtropical Pacific are identified as primary moisture sources, and moisture transport toward the Atacama Desert mainly takes place in the free troposphere (above 800 hPa). Strong summer rainfall events in North Atacama and Northeast Atacama are associated with a southward displaced Bolivian high. During rainfall events in North Atacama the high is shifted westward when compared to the Northeast Atacama events. Consequently, northern Chile is located at the northern periphery of the Bolivian high and the resulting strong easterlies may push strong convective systems from the Altiplano, toward the Atacama coast. Detailed analyses of individual rainfall events reveal that the most important synoptic patterns associated with rainfall not only control the synoptic-scale moisture transport into the Atacama Desert, but also decisively influence the regional atmospheric circulation.
Optimal Duration of Antibiotics Following Appendectomy for Patients With Complicated Appendicitis
Authors: Panshin Maclean S. , Alnachoukati Omar K. , Schroeppel Thomas J. , Metzler Michael , McFann Kim , Dunn Julie A.
Published: October 2020

Background

Complicated appendicitis patients typically undergo appendectomy followed by antibiotics. The optimal course of antibiotics for complicated appendicitis is poorly defined.

Methods

Data were collected from patients presenting with acute appendicitis and underwent appendectomy at the index hospitalization (2015-2017). Primary outcomes were readmission rate, superficial surgical site infection (SSI), deep space infection (DSI), which includes abscess. Length of post-operative antibiotic use was recorded and an average intent-to-treat (ITT) by operative grade was calculated.

Results

Two hundred seventy-two patients (23%) were diagnosed with complicated appendicitis. SSI occurred in 4% of patients (n = 11); SSI rates ranged from 0% to 14.6% by ITT group with 3-4 days being the lowest (0%) and <3 days the highest (14.6%) ( P = .008). DSI including abscesses occurred in 27 (9.9%) patients; least frequently in the 5-6 day ITT group (7.4%). Length of stay (LOS) was significantly related to longer antibiotic use ( P < .001) and increasing operative grade ( P < .01).

Conclusions

Given the lower incidence of postoperative complications between 3 and 6 days and no added benefit for ITT >6 days, we recommend limiting antibiotic treatment to 3-6 days for all complicated appendicitis cases with additional workup warranted if infectious symptoms persist.
The Enhanced Recovery After Surgery (ERAS) Elements that Most Greatly Impact Length of Stay and Readmission
Authors: Olson Kristofor A. , Fleming R. Y. Declan , Fox April W. , Grimes Andrew E. , Mohiuddin S. Sameer , Robertson Henry T. , Moxham Jamie , Wolf J. Stuart
Published: October 2020

Background

Enhanced recovery after surgery (ERAS) protocols have been shown to decrease length of stay (LOS) and improve patient outcomes in a wide variety of surgical fields; however, barriers exist preventing the implementation of all elements. We hypothesize that a subset of ERAS elements are most influential on LOS and readmission following colorectal surgery.

Study Design

A retrospective review of 840 patients was performed and their compliance with 24 ERAS components evaluated. Two independent machine-learning statistical algorithms were employed to determine which subset of ERAS elements was most impactful on LOS <3 days and hospital readmission.

Results

Increasing compliance with ERAS elements had an inverse linear relationship with LOS. Open (vs minimally invasive) surgery was associated with increased LOS. Early mobilization and multimodal pain management are the elements most protective against increased LOS. Readmissions increase with the number of morphine milligram equivalents (MME)/day. The subset of patients who underwent minimally invasive procedures, had multimodal pain control, and less than 16 MME per day were least likely (23%) to have >3-day LOS. Those patients who underwent an open procedure with less than 15 ERAS elements completed were most likely (84%) to have >3-day LOS.

Conclusion

While increasing compliance with ERAS protocols and minimally invasive procedures decrease LOS and readmission overall, a subset of components—multimodal pain control, limited opioid use, and early mobilization—was most associated with decreased LOS and readmission. This study provides guidance on which ERAS elements should be emphasized.