bluuebunny/crossref_metadata_2025 huggingface dataset:
A Three-Step Method for the Treatment of Radioulnar Synostosis with Posterior Radial Head Dislocation
Authors: Tsumura Takuya , Matsumoto Taiichi , Matsushita Mutsumi , Kishimoto Katsuma , Murase Tsuyoshi , Shiode Hayao
Published: December 2020

Congenital radioulnar synostosis with posterior dislocation of the radial head remains challenging to treat. We describe a three-step treatment method that combines radial shaft osteotomy with a custom-made device, ulnar shaft osteotomy, and local adipofascial flap elevation procedures. For posterior radial head dislocation treatment, osteotomy near the proximal radius cannot recover physiological rotation of the radial head. Thus, we chose a precise radial shaft osteotomy with a custom-made device according to preoperative planning based on three-dimensional evaluation of the bone deformation. Performing radial shaft osteotomy alone, however, may not be enough to achieve sufficient supination range of motion. We, therefore, also performed ulnar shaft osteotomy. Finally, we elevated the local adipofascial flap to prevent re-adhesion. In three patients, the range of motion of the elbow improved postoperatively. In conclusion, our three-step method does not require a microsurgical technique and is easy to perform.
Unintentional Injuries and Sociodemographic Factors among Households in Ethiopia
Authors: Mulugeta Hailemichael , Tefera Yifokire , Abegaz Teferi , Thygerson Steven M.
Published: December 2020

Background. Unintentional injuries are a public health problem throughout the world including Africa. Most of the injury studies in Ethiopia are from the healthcare facility or workplace that does not reflect the problem at the community level. Therefore, this study aimed to assess the unintentional injuries and sociodemographic factors among households in Ethiopia. Methods. This study was done from the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about unintentional injuries and injury mechanisms in the past 12 months among 16,650 households. The selection of households was from nine regions and two city administrations of Ethiopia using a stratified cluster sampling procedure. Descriptive statistics were used to characterize the data and the chi-square test was applied as a test of significance and a p value of <0.05 was considered statistically significant. Result. Of the 16,650 households that participated in the study, 394 (2.4%) reported that at least one household member suffered from an unintentional injury in the past 12 months. The leading mechanisms of injury were unintentional falls (152 falls, 33.2%) and road traffic incidents (96 incidents, 21.0%). Among household members who were injured, 84.3% survived and 15.7% died because of the injury. Divorce marital status of the household head [AOR: 2.12, 95% CI (1.12–4.41)] and family size of the household ≥ 6 [AOR:1.65, 95% CI (1.21–2.26)] were associated with high likelihood of occurrence of an injury, while lowest household wealth index [AOR: 0.69, 95% CI (0.50–0.95)] was protective against injuries. Conclusion. A low prevalence of unintentional injury was found from the community in this survey, which might be due to the tendency of the community to report severe injuries. Fall and road traffic accidents were the leading mechanisms of selected sociodemographic factors of the households that were associated with unintentional injuries. Injury prevention efforts should focus on falls and transportation injuries with special attention to the sociodemographic context of the communities.
Mucopolysaccharidoses I and II: Brief Review of Therapeutic Options and Supportive/Palliative Therapies
Authors: Nan Haiyan , Park Chanbum , Maeng Sungho
Published: December 2020

Purpose. Mucopolysaccharidoses (MPS) are group of inherited lysosomal storage diseases caused by mutations of enzymes involved in catalyzing different glycosaminoglycans (GAGs). MPS I and MPS II exhibit both somatic and neurological symptoms with a relatively high disease incidence. Hematopoietic stem cell therapy (HSCT) and intravenous enzyme replacement therapy (ERT) have had a significant impact on the treatment and comprehension of disease. This review is aimed at providing a comprehensive evaluation of the pros and cons of HSCT and ERT, as well as an up‐to‐date knowledge of new drugs under development. In addition, multiple disease management strategies for the uncontrollable manifestations of MPS I and MPS II to improve patients’ quality of life are presented. Findings. Natural history of MPS I and MPS II shows that somatic and neurological symptoms occur earlier in severe forms of MPS I than in MPS II. ERT increases life expectancy and alleviates some of the somatic symptoms, but musculoskeletal, ophthalmological, and central nervous system (CNS) manifestations are not controlled. Additionally, life‐long treatment burdens and immunogenicity restriction are unintended consequences of ERT application. HSCT, another treatment method, is effective in controlling the CNS symptoms and hence has been adopted as the standard treatment for severe types of MPS I. However, it is ineffective in MPS II, which can be explained by the relatively late diagnosis. In addition, several factors such as transplant age limits or graft‐versus‐host disease in HSCT have limited its application for patients. Novel therapies, including BBB‐penetrable‐ERT, gene therapy, and substrate reduction therapy, are under development to control currently unmanageable manifestations. BBB‐penetrable‐ERT is being studied comprehensively in the hopes of being used in the near future as a method to effectively control CNS symptoms. Gene therapy has the potential to “cure” the disease with a one‐time treatment rather than just alleviate symptoms, which makes it an attractive treatment strategy. Several clinical studies on gene therapy reveal that delivering genes directly into the brain achieves better results than intravenous administration in patients with neurological symptoms. Considering new drugs are still in clinical stage, disease management with close monitoring and supportive/palliative therapy is of great importance for the time being. Proper rehabilitation therapy, including physical and occupational therapy, surgical intervention, or medications, can benefit patients with uncontrolled musculoskeletal, respiratory, ophthalmological, and neurological manifestations.
Zone Fare System Design in a Rail Transit Line
Authors: Yang Yi , Deng Lianbo , Wang Qing , Zhou Wenliang
Published: December 2020

As a widely existing form of public transit fare structures, zone fare system is traditionally designed in a separate way, which may lead to suboptimal results. This paper aims to concurrently address the zone division and fare calculation issues of the zone fare system design in a rail transit line. It is necessary to consider passengers as well as operators to find an impartial zone fare system. A fair zone fare system is one where the zone fares are as close as possible to the distance-based fares, for the fares of the distance-based fare system are highly correlated with the actual distance of trips. Thus, the fare deviations for the trips between the zone fare system and the distance-based fare system are utilized as the evaluation metric of fairness. To achieve the goal of minimizing fare deviations for all trips, we introduce three indexes: average absolute deviation, average squared deviation, and maximum mileage fare deviation. With the three indexes as the objective functions, we develop a joint optimization algorithm where a novel zone boundary adjustment scheme is proposed as the key technique. Numerical results show that the proposed algorithm can effectively provide a joint optimal scheme and the optimal number of planned zones is 5 for Changsha Metro Line 2. The proposed algorithm can provide guidance for the practical design and adjustment of the zone fare system.
The Calcilytic Drug Calhex-231 Ameliorates Vascular Hyporesponsiveness in Traumatic Hemorrhagic Shock by Inhibiting Oxidative Stress and miR-208a-Mediated Mitochondrial Fission
Authors: Lei Yan , Peng Xiaoyong , Hu Yi , Xue Mingying , Li Tao , Liu Liangming , Yang Guangming
Published: December 2020

Background. The calcium-sensing receptor (CaSR) plays a fundamental role in extracellular calcium homeostasis in humans. Surprisingly, CaSR is also expressed in nonhomeostatic tissues and is involved in regulating diverse cellular functions. The objective of this study was to determine if Calhex-231 (Cal), a negative modulator of CaSR, may be beneficial in the treatment of traumatic hemorrhagic shock (THS) by improving cardiovascular function and investigated the mechanisms. Methods. Rats that had been subjected to THS and hypoxia-treated vascular smooth muscle cells (VSMCs) were used in this study. The effects of Cal on cardiovascular function, animal survival, hemodynamics, and vital organ function in THS rats and the relationship to oxidative stress, mitochondrial fusion-fission, and microRNA (miR-208a) were investigated. Results. Cal significantly improved hemodynamics, elevated blood pressure, increased vital organ blood perfusion and local oxygen supply, and markedly improved the survival outcomes of THS rats. Furthermore, Cal significantly improved vascular reactivity after THS in vivo and in vitro. Cal also restored the THS-induced decrease in myosin light chain (MLC) phosphorylation (the key element for VSMC contraction). Inhibition of MLC phosphorylation antagonized the Cal-induced restoration of vascular reactivity following THS. Cal suppressed oxidative stress in THS rats and hypoxic-VSMCs. Meanwhile, THS induced expression of mitochondrial fission proteins Drp1 and Fis1 and decreased expression of mitochondrial fusion protein Mfn1 in vascular tissues. Cal reduced expression of Drp1 and Fis1. In hypoxic-VSMCs, Cal inhibited mitochondrial fragmentation and preserved mitochondrial morphology. In addition, miR-208a mimic decreased Fis1 expression, and miR-208a inhibitor prevented Cal-induced Fis1 downregulation in hypoxic-VSMCs. Conclusion. Calhex-231 exhibits outstanding potential for effective therapy of traumatic hemorrhagic shock, and the beneficial effects result from its protection of vascular function via inhibition of oxidative stress and miR-208a-mediated mitochondrial fission.
The Effect of Fluid Overload on Attributable Morbidity after Cardiac Surgery: A Retrospective Study
Authors: Koc Vildan , Delmas Benito Laura , de With Eldert , Boerma E. Christiaan
Published: December 2020

Introduction. Although the detrimental effects of excessive perioperative fluid administration are generally well established, data in the setting of cardiac surgery remain less robust. Methods. In this retrospective single-center observational study, the total fluid balance in the first 12 hours during and after surgery was evaluated. Primary endpoint was the relationship between total fluid balance and the incidence of prolonged mechanical ventilation. For this purpose, data were divided into quartiles (Q); prolonged mechanical ventilation and prolonged length of stay (LOS) in the ICU were defined as Q4. Secondary endpoints were prolonged LOS in the ICU, incidence of acute kidney injury (AKI; defined as a 1.5-fold increase in serum creatinine during, relative to baseline), and ICU mortality. Results. In a 3-year period, 748 patients were included. In a univariate analysis, the median duration of mechanical ventilation was 2.9 h [2.4–3.7] in Q1 of the fluid balance and increased significantly to 4.7 h [3.1–9.2] in Q4 of the fluid balance

p
<
0.001

. In addition, patients in Q4 of the fluid balance had a significantly longer LOS in the ICU, as well as a higher incidence of AKI and ICU mortality. In a multivariate analysis, Q4 of the fluid balance was independently associated with prolonged mechanical ventilation (OR 4.9, CI 2.9–8.4,

p
<
0.001

) and prolonged LOS in the ICU (OR 11.3 CI 6.1–20,9,

p
<
0.001

), but not with the incidence of AKI or ICU mortality. Conclusions. Perioperative fluid administration in cardiac surgery patients was independently associated with prolonged mechanical ventilation and prolonged LOS in the ICU.
Prone versus Supine Position Ventilation in Adult Patients with Acute Respiratory Distress Syndrome: A Meta-Analysis of Randomized Controlled Trials
Authors: Cao Zanfeng , Yang Zhanzheng , Liang Zijing , Cen Qingyan , Zhang Zuopeng , Liang Hengrui , Liu Rong , Zeng Liangbo , Xie Yubao , Wang Youping
Published: December 2020

The purpose of this meta-analysis was to compare the efficacy and safety of prone versus supine position ventilation for adult acute respiratory distress syndrome (ARDS) patients. The electronic databases of PubMed, Embase, and the Cochrane Library were systematically searched from their inception up to September 2020. The relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were employed to calculate pooled outcomes using the random-effects models. Twelve randomized controlled trials that had recruited a total of 2264 adults with ARDS were selected for the final meta-analysis. The risk of mortality in patients who received prone position ventilation was 13% lower than for those who received supine ventilation, but this effect was not statistically significant (RR: 0.87; 95% CI: 0.75–1.00;P = 0.055). There were no significant differences between prone and supine position ventilation on the duration of mechanical ventilation (WMD: −0.22;P = 0.883) or ICU stays (WMD: –0.39;P = 0.738). The pooled RRs indicate that patients who received prone position ventilation had increased incidence of pressure scores (RR: 1.23;P = 0.003), displacement of a thoracotomy tube (RR: 3.14;P = 0.047), and endotracheal tube obstruction (RR: 2.45;P = 0.001). The results indicated that prone positioning during ventilation might have a beneficial effect on mortality, though incidence of several adverse events was significantly increased for these patients.
Age‐Related Immune Profile of the T Cell Receptor Repertoire, Thymic Recent Output Function, and miRNAs
Authors: Xu Yan , Xu Ling , Chen Cunte , Zhang Yikai , Zeng Chengwu , Jin Zhenyi , Chen Shaohua , Li Bo , Zha Xianfeng , Yin Zhinan , Li Yangqiu
Published: December 2020

Background. T cell immunity plays a central role in the body’s defense system, including maintaining homeostasis and preventing tumorigenesis and viral infection. Immune system functions degenerate with age, leading to immune senescence. Physiologically, immune senescence is characterized by a decrease in T cell receptor diversity, naive T cell deficiency, and alterations in T cell immune‐related miRNAs. However, little is known about the characteristics of T cell immunosenescence in Chinese individuals. Results. A significant decrease in the miR‐17, miR‐92a, and miR‐181a levels in PBMCs was detected with age. The miR‐92a and miR‐181a levels were upregulated in CBMCs when comparing healthy individuals to group I (0~9 years), whereas miR‐17 was downregulated. The sjTREC level in PBMCs was negatively correlated with age, and a sharp decrease in sjTRECs was found between groups I and II (10~19 years). Twenty‐four TCR Vβ subfamilies could be detected in most samples, and most displayed polyclonality, while skewed expression of the Vβ subfamilies as well as an increased oligoclonal tendency was found with age. Similarly, the frequencies of the TCR Vγ and Vδ subfamilies decreased with age, and the alteration in clonality appeared to be stable at different ages. Conclusion. We made the novel observation of T cell immunosenescence with age in Chinese individuals, which may provide information for immune targets to enhance the T cell immune response in immunotherapy settings for elderly patients.
Roux‐en‐Y and Billroth II Reconstruction after Pancreaticoduodenectomy: A Meta‐Analysis of Complications
Authors: Ma Fulin , Fan Yong , Zhang Lina , Zhao Zhiqiang , Nie Yuanhua , Chen Minxue , Wang Chen
Published: December 2020

Objective. To evaluate Roux‐en‐Y and Billroth II reconstruction following pancreaticoduodenectomy (PD). Methods. PubMed, Embase, the Cochrane Library, and the Web of Science were searched to identify randomized controlled trials (RCTs) and controlled clinical trials that compared Roux‐en‐Y and Billroth II reconstruction following PD up to December 2019. RevMan 5.3 software was used for the statistical analysis. Results. Four RCTs and five controlled clinical trials were included, with a total of 1,072 patients (500 and 572 patients in the Roux‐en‐Y and Billroth II groups, respectively). No significant differences in delayed gastric emptying (DGE), A‐grade DGE, B‐grade DGE, or C‐grade DGE were observed between the Roux‐en‐Y and Billroth II reconstruction groups after PD (odds ratio [OR] = 1.01, 95% confidence interval [CI]: 0.50–2.03, P = 0.98; OR = 0.49, 95% CI: 0.17–1.45, P = 0.20; OR = 0.63, 95% CI: 0.29–1.38, P = 0.25; and OR = 2.13, 95% CI: 0.38–11.99, P = 0.39). No significant difference in the incidence of postoperative pancreatic fistula, abscess, bile leaks, infection, postoperative bleeding, or the length of the postoperative hospital stay was observed between the Roux‐en‐Y and Billroth II groups (P > 0.05), but the operation time was significantly different (mean difference [MD] = 31.65, 95% CI: 7.14–56.17, P = 0.01). Conclusions. Billroth II reconstruction after PD did not significantly reduce the incidence of DGE or other complications but shortened the operation time compared to Roux‐en‐Y reconstruction. However, the results must be verified by further high‐quality, large RCTs or controlled clinical trials.
Faults Detection for Photovoltaic Field Based on K-Means, Elbow, and Average Silhouette Techniques through the Segmentation of a Thermal Image
Authors: Et-taleby Abdelilah , Boussetta Mohammed , Benslimane Mohamed
Published: December 2020

Clustering or grouping is among the most important image processing methods that aim to split an image into different groups. Examining the literature, many clustering algorithms have been carried out, where the K-means algorithm is considered among the simplest and most used to classify an image into many regions. In this context, the main objective of this work is to detect and locate precisely the damaged area in photovoltaic (PV) fields based on the clustering of a thermal image through the K-means algorithm. The clustering quality depends on the number of clusters chosen; hence, the elbow, the average silhouette, and NbClust R package methods are used to find the optimal number K. The simulations carried out show that the use of the K-means algorithm allows detecting precisely the faults in PV panels. The excellent result is given with three clusters that is suggested by the elbow method.
Nuclear Alarmin Cytokines in Inflammation
Authors: Jiang Lili , Shao Yijia , Tian Yao , Ouyang Changsheng , Wang Xiaohua
Published: December 2020

Pathogen-associated molecular patterns (PAMPs) are some nonspecific and highly conserved molecular structures of exogenous specific microbial pathogens, whose products can be recognized by pattern recognition receptor (PRR) on innate immune cells and induce an inflammatory response. Under physiological stress, activated or damaged cells might release some endogenous proteins that can also bind to PRR and cause a harmful aseptic inflammatory response. These endogenous proteins were named damage-associated molecular patterns (DAMPs) or alarmins. Indeed, alarmins can also play a beneficial role in the tissue repair in certain environments. Besides, some alarmin cytokines have been reported to have both nuclear and extracellular effects. This group of proteins includes high-mobility group box-1 protein (HMGB1), interleukin (IL)-33, IL-1α, IL-1F7b, and IL-16. In this article, we review the involvement of nuclear alarmins such as HMGB1, IL-33, and IL-1α under physiological state or stress state and suggest a novel activity of these molecules as central initiators in the development of sterile inflammation.
Sheehan Syndrome Presenting with Psychotic Manifestations Mimicking Schizophrenia in a Young Female: A Case Report and Review of the Literature
Authors: de Silva Nipun Lakshitha , Galhenage Janith , Dayabandara Madhubhashinee , Somasundaram Noel
Published: December 2020

Introduction. Sheehan syndrome presents with features of multiple hormone deficiencies including lactation failure and amenorrhoea as well as with features of central hypothyroidism and adrenocorticotropic hormone deficiency. Psychiatric manifestations are mostly limited to cognitive impairment. Psychotic presentations are rare and limited to case reports. Case Presentation. A 32-year-old female was evaluated for fearfulness and delusions for one year. She had persecutory and bizarre delusions, delusion of thought possession, and elementary auditory hallucinations. These began four months after the birth of her third child. The delivery had been complicated with postpartum haemorrhage. Her symptoms caused the functional decline and progressively worsened, resulting in suicidal ideation. Cognitive assessment revealed mild impairment in attention. Further inquiry revealed lethargy, constipation, cold intolerance, and lactation failure. She was slow, having dry skin, puffy face, and bradycardia with a blood pressure of 80/60 mmHg (supine) and 70/50 mmHg (standing). She had hyponatraemia, elevated creatine phosphokinase, low thyroxine, prolactin, FSH, LH, and IGF-1. She had poor cortisol and growth hormone response to the insulin tolerance test. MRI-pituitary showed empty sella. A diagnosis of Sheehan syndrome was made. Her symptoms improved completely after the initiation of levothyroxine and hydrocortisone. Conclusions. Sheehan syndrome can present with psychotic symptoms mimicking schizophrenia with variable involvement of cognition. Detailed reporting of these patients would enhance better characterization of the clinical presentation and risk profile of these patients.
The Integration of a Dual-Wavelength Super Pulsed Diode Laser for Consistent Tissue Ablation in the Esthetic Zone: A Case Series
Authors: Kamar Affendi Nur Hafizah , Ahmad Rohana , Vahidi Farhad , Hassan Mohd Zulkifli , Rahimi Siti Nadia
Published: December 2020

Introduction. A diode laser is one of the universally compact accepted laser systems used fundamentally for soft tissue applications. Most diode laser devices have a single wavelength of either 810 nm for superior coagulation or 980 nm for tissue ablation. In these case series, the use of dual wavelengths (810 nm and 980 nm) in combination with super pulsing has provided a cleaner cut (no charring) with faster healing that eases the placement of the final restoration in the esthetic zone. Case Description. The present case series describe four cases in the esthetic zone that achieved hemostasis ablation without collateral damage to enhance gingival balance of definitive restoration. The gingivoplasty and gingivectomy modes are used to achieve efficient tissue ablation. Although there is no specific mode indicated in the FDA laser requirement for gingival depigmentation, the procedure could be safely performed with the dual-wavelength diode laser Result. All four patients revealed a good esthetic outcome and reported no pain postoperatively. Healing was uneventful, and definitive restoration was delivered within two to four weeks postoperatively. Conclusion. Within the limitation of these case series, the dual-wavelength super pulsed diode laser has the capacity to deliver peak powers resulting in efficient cutting and less tissue charring and also as an alternative tool for removal of gingival pigmentation. Prospective clinical research with larger sample size is needed for conclusive results.
Antithrombotic Agents for tPA‐Induced Cerebral Hemorrhage: A Systematic Review and Meta‐Analysis of Preclinical Studies
Authors: Ye Yang , Zhang Fu‐Tao , Wang Xiao‐Yi , Tong Hong‐Xuan , Zhu Yu‐Tian
Published: December 2020

Background

tPA (tissue‐type plasminogen activator) remains the only approved drug for acute ischemic stroke, with a potentially serious adverse effect: hemorrhagic transformation. The effects of antithrombotic agents on tPA‐induced hemorrhagic transformation after ischemic stroke are not clearly defined. We performed a systematic review and meta‐analysis in preclinical studies aiming to evaluate the efficacy of antithrombotic agents on tPA‐induced hemorrhagic transformation after ischemic stroke.

Methods and Results

We conducted a systematic review and meta‐analysis of studies testing antithrombotic agents in animal models of tPA‐induced hemorrhagic transformation. The pooled effects were calculated using random‐effects models, and heterogeneity was explored through meta‐regression and subgroup analyses. Publication bias was assessed using trim and fill method and the Egger test. The efficacy of 18 distinct interventions was described in 22 publications. The pooled data showed a significant improvement in cerebral hemorrhage, infarct size, and neurobehavioral outcome in treated compared with control animals (standardized mean difference, 0.45 [95% CI, 0.11–0.78]; standardized mean difference, 1.18 [95% CI, 0.73–1.64]; and standardized mean difference, 0.91 [95% CI, 0.49–1.32], respectively). Subgroup analysis indicated that quality score, random allocation, control of temperature, anesthetic used, stroke model used, route of drug delivery, time of drug administration, and time of assessment were significant factors that influenced the effects of interventions.

Conclusions

Administration with antiplatelet agents revealed statistically significant improvement in all the outcomes. Anticoagulant agents showed significant effects in infarct size and neurobehavioral score, but fibrinolytic agents did not show any significant improvement in all the outcomes. The conclusions should be interpreted cautiously given the heterogeneity and publication bias identified in this analysis.
Quality of Life and Diverse Temporalities amid Fast Urbanism
Authors: Cho Mihye
Published: December 2020

Quality-of-life research leans toward measuring placed-based attributes of a locale while less attention has been given to understanding what people mean by quality of life. This paper reiterates that quality-of-life research is intrinsically about juxtaposing life conditions and life evaluation, thereby unveiling critical issues immanent in a society (Castells, 1983). This paper draws on interviews conducted in public housing neighbourhoods in Singapore to examine the colloquial meanings of quality of life and the normative connotations that people attach to it. It unveils the efforts to reconcile fast and slow and discusses the different temporalities underpinning life domains and how spatial planning could engage with the issue of time to improve quality of life. The Singapore case is insightful to contemplate the challenges of reconciling the increasing needs of going slower amid an accelerated pace of life, which is a contradictory yet pervasive characteristic of life in contemporary capitalist societies.
The Social Adaptation of Khmer Rouge Perpetrators in the Aftermath of the Cambodian Genocide
Authors: Kanavou Angeliki Andrea , Path Kosal
Published: December 2020

This paper explores the social adaptation of 157 former Khmer Rouge (KR) cadres. The cadres lived in relative isolation in the former KR stronghold, the semi-autonomous Anlong Veng, under the leadership of their commander, Chhit Chhoeun (alias Ta Mok). With the help of survey analysis, the paper presents findings regarding the cadres’ traumatisation, their views on assigning responsibility for actions during the genocide (1975–1979), as well as the cadres’ feelings of shame and lack of trust. The cadres demonstrated avoidance and a lack of self-confrontation and, similarly, manifested limited reflection about their individual and collective participation in the genocidal regime of the KR. The paper concludes with the long-lasting impact of thought reform and obedience to authority. Community re-building in post-genocide societies requires efforts at collective rehabilitation of collaborators of genocidal regimes and survivors alike.
Towards a New History of Elite Cultural Expression in Japanese-Occupied China
Authors: Taylor Jeremy E. , Yang Zhiyi
Published: December 2020

This paper provides a ‘state of the field’ view of what the authors refer to as the ‘new cultural history’ of Japanese-occupied China. It explores how this small but growing field is beginning to provide new perspectives on questions of ‘collaboration’ and ‘resistance’ that have dominated many recent studies of wartime China. In addition, the authors argue that more research needs to focus on elite forms of Chinese cultural expression under occupation (a topic which has hitherto eluded serious academic scrutiny). This introduction also introduces the four key papers which make up this special issue.
The Sarawak Dabogong Festival and Its Social Significance in the Chinese Community in Malaysia
Authors: Yu-Tsuen Hsu , Wei-An Chang , Han-Pi Chang
Published: December 2020

Dabogong is a Chinese deity with a widespread following in Sarawak; however, the connections between Dabogong temples are underdeveloped compared with that between Chinese subethnic associations.1 Therefore, Sibu Dabogong Temple proposed to establish an association to plan and oversee the Sarawak Dabogong Festival in 2009. Since then, the scope of the organization’s membership and activities has become national as well as international. To learn how the social meaning of the festival is understood by the participants, we reviewed the local historical literature, conducted field research, and administered a questionnaire survey during the third Sarawak Dabogong Festival at Kuching 10 Miles in Sarawak in 2011. First, we explored the defining characteristic of Dabogong temples in Sarawak, the prominence of Dabogong in the Sarawak Chinese community, reasons for building temples, the accompanying gods in a Dabogong temple, and the timing of temple construction. Next, we examined the formation of the Dabogong Festival and the characteristics of the participants. Finally, we determined that the social significance of the festival can be attributed to its role in the transmission of Chinese tradition and the promotion of Dabogong belief.
Beyond Mencius and Xunzi: A Third Approach to Confucianism
Authors: Ren Jiantao
Published: December 2020

After Confucius died, his disciples formed the Eight Confucian Factions [rujia ba pai 儒家八派]. The most influential among them were the moral idealist school of Mencius 孟子, which proposed the doctrine of heart-mind and human nature [xinxing 心性], and the political idealist school of Xunzi 荀子, which posited a political interpretation of Confucianism. The Mencian approach emphasized the ethics of Confucianism, whereas the Xunzian approach focused on the political application of Confucianism. Their respective weaknesses have become evident in the present. It is hoped that we can overcome their shortcomings by integrating them and formulating a new approach to modern Confucianism that uses their advantages. However, modern Confucianism had made important contributions not only in its synthesis of Mencian and Xunzian thought but, more importantly, as it carries on the approach advocated by Dong Zhongshu 董仲舒. This involves not only examining the political applications of a particular kind of scholarship on the Chunqiu gongyang zhuan 春秋公羊傳 [The Gongyang Commentary on the Spring and Autumn Annals] developed by Dong known as Gongyang scholarship [gongyang xue 公羊學] but also integrating the internal principles and politics of Confucianism. In theory, it requires an integration of the strengths of various schools to achieve a Confucian ideological system that embraces the Hundred Schools of Thought [zhuzi baijia 諸子百家]. In practice, it entails actual political application taken from a melting pot of the theoretical and political ambitions of Confucianism that is superior to the form of Confucianism that originated in the pre-Qin period [221 BCE] and other schools of thought and their successors.
Experimental Analysis of Extracellular Enzymes Activity of Grifola frondosa Supplemented with Rhizoma gastrodiae Alcohol Extract by Submerged Fermentation
Authors: Lu Hong-Yun , Wu Tian-Xiang , Zhou Jing , Nie Wen-Qiang , Zhong Min
Published: December 2020

Grifola frondosa was cultured with Rhizoma gastrodiae alcohol extract by submerged fermentation to study the growth of mycelia and analyze the changes in the activity of extracellular enzymes related to substrate degradation. It turned out that Rhizoma gastrodiae
alcohol extract at 7 g/L significantly increased the biomass of Grifola frondosa. Interestingly, levels of reducing sugars in the medium initially increased and then decreased at the last stage. Moreover, dynamic detection of mycelial biomass and extracellular enzymes involved in degradation
of nutritional ingredients of the medium indicated that Rhizoma gastrodiae alcohol extract at 7 g/L stimulated the growth of mycelia and augmented the activity of extracellular enzymes to a variable extent and thus increased degradation ability of Grifola frondosa. This paper
firstly revealed the mechanism for the stimulation of mycelial biomass growth in Grifola frondosa by Rhizoma gastrodiae alcohol extract in liquid culture through activity of extracellular enzymes related to the degradation of the substrates.
Delayed Surgery Does Not Increase Risk in Urgent Colectomy for Ulcerative Colitis
Authors: Tiu Simon Peter T. , Hajirawala Luv N. , Leonardi Claudia , Davis Kurt G. , Orangio Guy R. , Barton Jeffrey S.
Published: December 2020

Background

Medical management is the cornerstone of therapy for ulcerative colitis (UC). In the setting of fulminant disease, hospitalized patients may undergo medical rescue therapy (MRT) or urgent surgery. We hypothesized that delayed attempts at MRT result in increased morbidity and mortality following urgent surgery for UC.

Objective

The aim is to assess the outcomes for patients requiring urgent, inpatient surgery for UC in a prompt or delayed fashion.

Design

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) general and colectomy-specific databases from 2013 to 2016 were queried. Urgent surgery was defined as nonelective, nonemergency surgery. Patients were divided into prompt and delayed groups based on time from admission to surgery of <48 hours or >48 hours. Baseline characteristics and 30-day outcomes were compared using univariate and multivariate analyses.

Setting

The ACS NSQIP database from 2013 to 2016 was evaluated.

Patients

Adult patients undergoing nonelective, nonemergency colectomy for UC.

Main Outcome Measures

30-day morbidity and mortality.

Results

921 patients underwent urgent inpatient surgery for UC. In univariate analysis, there was no significant difference between prompt and delayed surgery for wound infection, sepsis, return to operating room, or readmission.

Limitations

Retrospective study of a quality improvement database. Patients who underwent successful MRT did not receive surgery, so are not included in the database.

Conclusions

Delaying surgery to further attempt MRT does not alter short-term outcomes and may allow conversion to elective future surgery. Contrarily, medical optimization does not improve short-term outcomes.
A Bad Job of Doing Good: Does Corporate Transparency on a Country and Company Level Moderate Corporate Social Responsibility Effectiveness?
Authors: Heinberg Martin , Liu Yeyi , Huang Xuan , Eisingerich Andreas B.
Published: December 2020

Numerous studies argue that corporate social responsibility (CSR) helps companies build strong and positive relationships with consumers. However, it is not well understood why certain companies are more effective in their CSR activities than others. Some studies have attributed this difference to the country setting, but results are inconclusive. Building on signaling theory, this study explores corporate transparency as a boundary condition of the effects of CSR activities on the consumer–brand relationship. Three experiments and one large survey across three countries examine how a lack of corporate transparency undermines firms’ CSR efforts. Importantly, the authors theorize that country environments differ in terms of transparency, which is then reflected in different levels of corporate transparency. Different country levels of transparency help explain the discrepancies of CSR effectiveness for increasing brand attachment and building consumer behavior. Finally, the authors tie the diminishing effect of CSR in the case of low corporate transparency to an increase in consumer skepticism.
Flow diverter device placement for cerebral aneurysm is not effective for the patient with parent artery occlusion for contralateral aneurysm
Authors: Fujii Takashi , Oishi Hidenori , Teranishi Kohsuke , Yatomi Kenji , Suzuki Kazumoto
Published: December 2020

Purpose

There have been many reports on the risks of enlargement and rupture of residual aneurysms and de novo aneurysm formation in the contralateral internal carotid artery after parent artery occlusion (PAO). In the present study, we investigated the efficacy of flow diverter device placement (FDDP) for the treatment of contralateral internal carotid artery aneurysms after PAO.

Methods

After 11 patients, who had bilateral large or giant internal carotid aneurysms, were treated for either side with PAO or FDDP, they underwent FDDP for residual lesions in our hospital between October 2015 and June 2018. The patients were divided into two groups, depending on the prior procedure: PAO or FDDP. The embolic state after subsequent FDDP was evaluated by angiography. The embolic state was graded using the O’Kelly Marotta scale. Patients’ characteristics and the embolic state of intracranial aneurysms after FDDP were compared between the two groups.

Results

Comparing patients’ characteristics between the PAO group and FDDP group, statistically significant differences were observed in laterality of the lesions and the interval between prior treatment and FDDP for residual aneurysms ( p < 0.05). The embolic state at the one-year follow-up revealed that there could be significantly sufficient embolisation in the FDDP group ( p < 0.05).

Conclusion

When FDDP is performed for the contralateral lesion after PAO treatment, it is difficult to attain sufficient embolisation of intracranial aneurysms because haemodynamic load in this procedure is large compared to that in a regular FDDP.
Left-sided carotid arteries have a higher prevalence of intraplaque hemorrhage than right-sided: An asymmetric conundrum
Authors: Larson Anthony S , Brinjikji Waleed , Savastano Luis , Scharf Eugene , Huston John , Benson John C
Published: December 2020

Purpose

To assess whether an asymmetry exists in the prevalence of carotid artery intraplaque hemorrhage (IPH) between right- and left-sided arteries.

Materials and methods

The records of all patients with atherosclerotic carotid artery disease that underwent neck magnetic resonance angiography imaging with high-resolution plaque sequences between 2017 and 2020 at our institution were retrospectively reviewed. The prevalence of stenosis and IPH was determined for all patients and compared between the left and right carotid arteries of those with unilateral anterior circulation ischemic strokes. Multiple regression analysis was performed to determine potential independent associations of IPH laterality with ischemic strokes.

Results

A total of 368 patients were included overall and 241 were male (65.4%). There were a total of 125 asymptomatic patients and 211 patients with unilateral anterior circulation ischemic strokes. Of patients with ischemic strokes, 55.5% had left-sided strokes compared with 44.5% who had right-sided strokes ( p = 0.03). Patients with left-sided strokes had a higher prevalence of ipsilateral IPH than those with right-sided strokes (64.1% versus 36.2%, p < 0.0001), despite similar degrees of stenosis. Both age (odds ratio (OR): 1.0; 95% confidence interval (CI): 1.0–1.1; p = 0.007) and the presence of left-sided IPH (OR: 3.2; 95% CI: 1.5–6.8; p = 0.003) were independently associated with unilateral ischemic strokes.

Conclusions

Left-sided plaques more frequently have IPH and may be more likely to result in ipsilateral ischemic strokes compared with right-sided plaques. The underlying mechanism of asymmetric distribution of IPH between right and left carotids remains unclear.
Magnetic resonance imaging (MRI) versus computed tomographic scan (CT scan) of brain in evaluation of suspected cavernous sinus syndrome
Authors: Bhatkar Sanath , Mahesh Karthik Vinay , Sachdeva Julie , Goel Abeer , Goyal Manoj K , Takkar Aastha , Ray Sucharita , Shree Ritu , Balaini Neeraj , Singh Paramjit , Singh Ramandeep , Patnaik Shiv Narayan , Prabhat Nandita , Lal Vivek
Published: December 2020

Background and purpose

The cavernous sinus is a unique region owing to anatomical factors and the pathologies affecting it. The diagnosis of cavernous sinus syndrome (CSS) predominantly relies on clinicoradiological correlation. We studied the utility of computed tomographic (CT) scan versus magnetic resonance imaging (MRI) in the diagnosis of CSS.

Methods

A prospective observational study was conducted in a tertiary care center in north India. All patients presenting with a clinical syndrome of cavernous sinus involvement with radiologically confirmed lesions were enrolled in the study. MRI and CT scan with cavernous sinus cuts were done and reviewed by experienced neuroradiologists for cavernous sinus lesions and compared with the final diagnosis. Sensitivity and specificity were calculated.

Results

We included 48 patients in our study. A final diagnosis was achieved in 41 out of 48 (85.6%) patients. Fungal infections (16 (33.3%)) constituted the commonest cause of CSS, followed by neoplastic involvement (13 (27.1%)) and Tolosa–Hunt syndrome (12 (25%)). Vascular involvement was seen in three (6.3%) patients. Other rare causes were seen in four (8.3%) patients. CT scan had an overall sensitivity of 14.6% in achieving a final diagnosis, whereas MRI had an overall sensitivity of 70.7%, with a statistically significant difference ( p < 0.001).

Conclusions

Although CT scan is a relatively cheap and accessible resource, its role in CSS diagnosis and management is limited because of poor yield. Hence, it is prudent to do an MRI as an initial investigation in cases of CSS.
Rapid single-molecule digital detection of protein biomarkers for continuous monitoring of systemic immune disorders
Authors: Song Yujing , Sandford Erin , Tian Yuzi , Yin Qingtian , Kozminski Andrew G. , Su Shiuan-Haur , Cai Tao , Ye Yuxuan , Chung Meng Ting , Lindstrom Ryan , Goicochea Annika , Barabas Jenny , Olesnavich Mary , Rozwadowski Michelle , Li Yongqing , Alam Hasan B. , Singer Benjamin H. , Ghosh Monalisa , Choi Sung Won , Tewari Muneesh , Kurabayashi Katsuo
Published: December 2020

Digital protein assays have great potential to advance immunodiagnostics because of their single-molecule sensitivity, high precision, and robust measurements. However, translating digital protein assays to acute clinical care has been challenging because it requires deployment of these assays with a rapid turnaround. Herein, we present a technology platform for ultrafast digital protein biomarker detection by using single-molecule counting of immune-complex formation events at an early, pre-equilibrium state. This method, which we term “pre-equilibrium digital enzyme-linked immunosorbent assay” (PEdELISA), can quantify a multiplexed panel of protein biomarkers in 10 µL of serum within an unprecedented assay incubation time of 15 to 300 seconds over a 104 dynamic range. PEdELISA allowed us to perform rapid monitoring of protein biomarkers in patients manifesting post-chimeric antigen receptor T-cell therapy cytokine release syndrome, with ∼30-minute sample-to-answer time and a sub–picograms per mL limit of detection. The rapid, sensitive, and low-input volume biomarker quantification enabled by PEdELISA is broadly applicable to timely monitoring of acute disease, potentially enabling more personalized treatment.
Challenges in treatment of patients with acute leukemia and COVID-19: a series of 12 patients
Authors: Ghandili Susanne , Pfefferle Susanne , Roedl Kevin , Sonnemann Piet , Karagiannis Panagiotis , Boenisch Olaf , Kluge Stefan , Schmiedel Stefan , Ittrich Harald , Rohde Holger , Lütgehetmann Marc , Weisel Katja , Bokemeyer Carsten , Wichmann Dominic , Fiedler Walter , Jarczak Dominik , Modemann Franziska
Published: December 2020

Key Points

Patients with acute leukemia present with a prolonged and severe course of COVID-19, which is paralleled by high rates of viremia. Low-intensive chemotherapy seems to be more feasible in patients with acute myeloid leukemia and concomitant SARS-CoV-2 infection.
Management of toxicities associated with targeted therapies for acute myeloid leukemia: when to push through and when to stop
Authors: Wang Eunice S. , Baron Jeffrey
Published: December 2020

The recent advent of myriad targeted therapies for acute myeloid leukemia (AML) has led to new hope for our patients but has also introduced new challenges in managing the disease. For clinicians, the ability to treat AML in the outpatient setting with novel agents of equal or greater efficacy than 7+3 has been transformative. Despite the enthusiasm, however, the reality is that many patients are still frail and remain at risk for treatment-related complications. Translating the results of clinical trials into improved outcomes for these individuals requires an understanding of how best to manage the adverse effects of these agents. Which patients benefit most and what to watch for? When to stop therapy? Using illustrative case presentations, this review details the unique toxicities associated with each of the approved mutation-specific and nonspecific targeted drugs for AML. The goal of this review is to help clinicians determine the risk:benefit ratio in decision making for individual patients with AML.
“TEG talk”: expanding clinical roles for thromboelastography and rotational thromboelastometry
Authors: Selby Rita
Published: December 2020

Viscoelastic assays (VEAs) that include thromboelastography and rotational thromboelastometry add value to the investigation of coagulopathies and goal-directed management of bleeding by providing a complete picture of clot formation, strength, and lysis in whole blood that includes the contribution of platelets, fibrinogen, and coagulation factors. Conventional coagulation assays have several limitations, such as their lack of correlation with bleeding and hypercoagulability; their inability to reflect the contribution of platelets, factor XIII, and plasmin during clot formation and lysis; and their slow turnaround times. VEA-guided transfusion algorithms may reduce allogeneic blood exposure during and after cardiac surgery and in the emergency management of trauma-induced coagulopathy and hemorrhage. However, the popularity of VEAs for other indications is driven largely by extrapolation of evidence from cardiac surgery, by the drawbacks of conventional coagulation assays, and by institution-specific preferences. Robust diagnostic studies validating and standardizing diagnostic cutoffs for VEA parameters and randomized trials comparing VEA-guided algorithms with standard care on clinical outcomes are urgently needed. Lack of such studies represents the biggest barrier to defining the role and impact of VEA in clinical care.