bluuebunny/crossref_metadata_2025 huggingface dataset:
miR‐144‐3p ameliorates the progression of osteoarthritis by targeting IL‐1β: Potential therapeutic implications
Authors: Lin Yen‐You , Ko Chih‐Yuan , Liu Shan‐Chi , Wang Yu‐Han , Hsu Chin‐Jung , Tsai Chun‐Hao , Wu Tsung‐Ju , Tang Chih‐Hsin
Published: March 2021

The pro‐inflammatory cytokine interleukin 1 beta (IL‐1β) plays a critical role in osteoarthritis (OA) disease pathogenesis. MicroRNA (miRNA) activity is related to inflammation in OA and some miRNAs specifically regulate IL‐mediated degradation of cartilage type II collagen. Previous studies have indicated that miR‐144‐3p is a useful target in the regulation of pro‐inflammatory cytokines in different diseases. However, the role of miR‐144‐3p in OA is unclear. In this study, we observed a negative correlation between miR‐144‐3p and IL‐1β expression in OA. miR‐144‐3p mimic transfection of OA synovial fibroblasts downregulated levels of IL‐1β expression, while blocking the MAPK, PI3K/Akt, and NF‐κB signaling pathways relating to IL‐1β production, and effectively increased miR‐144‐3p expression in OASFs. Findings from an anterior cruciate ligament transection rat model revealed that administration of miR‐144‐3p mimic effectively ameliorated OA progression and reduced the numbers of IL‐1β‐positive cells in synovial tissue. This study suggests that miR‐144‐3p is a useful therapeutic target in OA disease.
Glycine suppresses kidney calcium oxalate crystal depositions via regulating urinary excretions of oxalate and citrate
Authors: Lan Yu , Zhu Wei , Duan Xiaolu , Deng Tuo , Li Shujue , Liu Yang , Yang Zhou , Wen Yaoan , Luo Lianming , Zhao Shankun , Wang Jiamin , Zhao Zhijian , Wu Wenqi , Zeng Guohua
Published: March 2021

An abnormal urine composition is a key reason for kidney stone formation, but little is known about the roles of small metabolites in the urine during kidney stone formation. Here, we found urine glycine in patients with kidney calcium oxalate (CaOx) stone was significantly lower than that in healthy people via 1H NMR spectra detection, and investigated the role and underlying mechanism of glycine in the regulation of CaOx stone formation. Our results showed that glycine could significantly attenuate ethylene glycol‐induced CaOx crystal depositions in rat kidney via decreasing urine oxalate and increasing urine citrate. Mechanism studies revealed that glycine could decrease urine oxalate through downregulating Slc26a6 expression, whereas increase urine citrate via inhibiting Nadc1 expression. Moreover, glycine decreased the protein expression of both Slc26a6 and Nadc1 via increasing the expression of miRNA‐411‐3p, which directly bound to the 3′‐untranslated regions of Slc26a6 and Nadc1 messenger RNAs, in vitro and in vivo. Together, our results revealed a novel role of glycine in the regulation of kidney CaOx crystal formation and provided a potential target for the treatment of kidney CaOx stone.
Frailty in patients undergoing transcatheter aortic valve replacement: prognostic value of the Geriatric Nutritional Risk Index
Authors: Seoudy Hatim , Al‐Kassou Baravan , Shamekhi Jasmin , Sugiura Atsushi , Frank Johanne , Saad Mohammed , Bramlage Peter , Seoudy Anna Katharina , Puehler Thomas , Lutter Georg , Schulte Dominik M. , Laudes Matthias , Nickenig Georg , Frey Norbert , Sinning Jan‐Malte , Frank Derk
Published: March 2021

Background

Malnutrition is a hallmark of frailty, is common among elderly patients, and is a predictor of poor outcomes in patients with severe symptomatic aortic stenosis (AS). The Geriatric Nutritional Risk Index (GNRI) is a simple and well‐established screening tool to predict the risk of morbidity and mortality in elderly patients. In this study, we evaluated whether GNRI may be used in the risk stratification and management of patients undergoing transcatheter aortic valve replacement (TAVR).

Methods

Patients with symptomatic severe AS (n = 953) who underwent transfemoral TAVR at the University Hospital Schleswig‐Holstein Kiel, Germany, between 2010 and 2019 (development cohort) were divided into two groups: normal GNRI ≥ 98 (no nutrition‐related risk; n = 618) versus low GNRI < 98 (at nutrition‐related risk; n = 335). The results were validated in an independent (validation) cohort from another high‐volume TAVR centre (n = 977).

Results

The low‐GNRI group had a higher proportion of female patients (59.1% vs. 52.1%), higher median age (82.9 vs. 81.8 years), prevalence of atrial fibrillation (50.4% vs. 40.0%), median logistic EuroSCORE (17.5% vs. 15.0%) and impaired left ventricular function (<35%: 10.7% vs. 6.8%), lower median estimated glomerular filtration rate (50 vs. 57 mL/min/1.73 m2) and median albumin level (3.5 vs. 4.0 g/dL) compared with the normal‐GNRI group. Among peri‐procedural complications, Acute Kidney Injury Network (AKIN) Stage 3 was more common in the low‐GNRI group (3.6% vs. 0.6%, p = 0.002). After a mean follow‐up of 21.1 months, all‐cause mortality was significantly increased in the low‐GNRI group compared with the normal‐GNRI group (p < 0.001). This was confirmed in the validation cohort (p < 0.001). Low GNRI < 98 was identified as an independent risk factor for all‐cause mortality (hazard ratio 1.44, 95% CI 1.01–2.04, p = 0.043). Other independent risk factors included albumin level < median of 4.0 g/dL, high‐sensitive troponin T in the highest quartile (> 45.0 pg/mL), N‐terminal pro‐B‐type natriuretic peptide in the highest quartile (> 3595 pg/mL), grade III–IV tricuspid regurgitation, pulmonary arterial hypertension, life‐threatening bleeding, AKIN Stage 3 and disabling stroke.

Conclusions

Low GNRI score was associated with an increased risk of all‐cause mortality in patients undergoing TAVR, implying that this vulnerable group may benefit from improved preventive measures.
Autoantibody of NRIP, a novel AChR‐interacting protein, plays a detrimental role in myasthenia gravis
Authors: Tsai Li‐Kai , Chen I‐Hsin , Chao Chi‐Chao , Hsueh Hsueh‐Wen , Chen Hsin‐Hsiung , Huang Yun‐Hsin , Weng Rong‐Wei , Lai Tzu‐Yun , Tsai Yi‐Chieh , Tsao Yeou‐Ping , Chen Show‐Li
Published: March 2021

Background

Nuclear receptor interaction protein (NRIP) co‐localizes with acetylcholine receptor (AChR) at the neuromuscular junction (NMJ), and NRIP deficiency causes aberrant NMJ architecture. However, the normal physiological and pathophysiological roles of NRIP in NMJ are still unclear.

Methods

We investigated the co‐localization and interaction of NRIP with AChR‐associated proteins using immunofluorescence and immunoprecipitation assay, respectively. The binding affinity of AChR‐associated proteins was analysed in muscle‐restricted NRIP knockout mice and NRIP knockout muscle cells (C2C12). We further collected the sera from 43 patients with myasthenia gravis (MG), an NMJ disorder. The existence and features of anti‐NRIP autoantibody in sera were studied using Western blot and epitope mapping.

Results

NRIP co‐localized with AChR, rapsyn and α‐actinin 2 (ACTN2) in gastrocnemius muscles of mice; and α‐bungarotoxin (BTX) pull‐down assay revealed NRIP with rapsyn and ACTN2 in complexes from muscle tissues and cells. NRIP directly binds with α subunit of AChR (AChRα) in vitro and in vivo to affect the binding affinity of AChR with rapsyn and rapsyn with ACTN2. In 43 patients with MG (age, 58.4 ± 14.5 years; female, 55.8%), we detected six of them (14.0%) having anti‐NRIP autoantibody. The presence of anti‐NRIP autoantibody correlated with a more severe type of MG when AChR autoantibody existed (P = 0.011). The higher the titre of anti‐NRIP autoantibody, the more severe MG severity (P = 0.032). The main immunogenic region is likely on the IQ motif of NRIP. We also showed the IgG subclass of anti‐NRIP autoantibody mainly to be IgG1.

Conclusions

NRIP is a novel AChRα binding protein and involves structural NMJ formation, which acts as a scaffold to stabilize AChR–rapsyn–ACTN2 complexes. Anti‐NRIP autoantibody is a novel autoantibody in MG and plays a detrimental role in MG with the coexistence of anti‐AChR autoantibody.
Paroxysmal exercise‐induced dyskinesia without involuntary movements
Authors: Ishizuka Kosuke , Tsukamoto Tomoko , Ikusaka Masatomi
Published: March 2021

A 66‐year‐old British man was referred to our department because of a 2.5 year history of bilateral paroxysmal weakness of the lower limbs. It occurred when he walked for about 10 minutes, so he would stop in place and spontaneously rest for up to 15 minutes. When carbamazepine 200 mg/day was administered, the severity and frequency of the symptoms reduced by half and resolved when the dose was increased to 300 mg/day. Even if no involuntary movement is observed, paroxysmal exercise‐induced dyskinesia should be considered in patients with paroxysmal painless gait disturbance, and a therapeutic trial of anticonvulsants may be helpful.
Risk factor analysis for early rebleeding after endoscopic treatment for colonic diverticular bleeding with stigmata of recent hemorrhage
Authors: Yamauchi Atsushi , Kou Tadayuki , Kishimoto Takuya , Mori Yuki , Osawa Kazuki , Iimori Kei , Iwano Kosuke , Kawai Yuya , Sawada Kenji , Hamada Kensuke , Nishimura Satoshi , Mori Yoshiharu , Watanabe Kotaro , Azuma Shunjiro , Morita Toshihiro , Kurita Akira , Kawaguchi Kiyotaka , Suginoshita Yoshiki , Katayama Toshiro , Yazumi Shujiro
Published: March 2021

Background and Aim

Colonic diverticular bleeding is a common cause of acute lower gastrointestinal bleeding. Endoscopic hemostasis is generally selected as the first‐line treatment; however, a considerable number of patients experience early rebleeding after endoscopic treatment. We investigated the risk factors for early rebleeding after endoscopic treatment.

Methods

We retrospectively evaluated the data of 142 consecutive patients who underwent endoscopic treatment (endoscopic clipping or endoscopic band ligation) for colonic diverticular bleeding with stigmata of recent hemorrhage between April 2012 and April 2020. Multivariate logistic regression analysis was conducted to evaluate the statistical relationship between patient characteristics and the incidence of early rebleeding occurring within 30 days after endoscopic treatment.

Results

Of 142 patients, early rebleeding was detected in 34 (23.9%) patients. According to univariate analysis, platelet count of <10 × 104/μL, bleeding from the left‐sided colon, and endoscopic clipping usage were associated with early rebleeding (P < 0.05). The subsequent multivariate logistic regression analysis identified bleeding from the left‐sided colon (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.73–10.0; P = 0.001) and endoscopic clipping usage (OR, 2.92; 95% CI, 1.21–7.00; P = 0.017) as the independent risk factors for early rebleeding.

Conclusions

Bleeding from the left‐sided colon and endoscopic clipping usage were the risk factors for early rebleeding after endoscopic treatment. Using endoscopic band ligation was associated with a decreased risk for early rebleeding compared with the use of endoscopic clipping, indicating that endoscopic band ligation was a preferable endoscopic modality to prevent early recurrent bleeding.
Exact bipartite Turán numbers of large even cycles
Authors: Li Binlong , Ning Bo
Published: March 2021

The bipartite Turán number, denoted by , is the maximum number of edges in an ‐free bipartite graph with two parts of sizes and , respectively. In this article, we prove for any positive integers with , which confirms (in a strong form) the unsolved case of a conjecture of Győri. Let be a bipartite graph with and . Suppose that for some . We prove that contains cycles of all even lengths from 4 to if . This result sharpens a theorem on long cycles in bipartite graphs due to Jackson. As a main tool, for a longest cycle in a bipartite graph, we prove an upper bound of the number of edges which are incident with at most one vertex in , which is a bipartite analogue of a classical theorem of Bondy. Our proof technique is structural.
Iodine‐DMSO catalyzed chemoselective oxidative aromatization and deallylation, nondeallylation of aryl allyl ether of tetrahydro‐β‐carboline
Authors: Gaikwad Sunil V. , Gaikwad Milind V. , Lokhande Pradeep D.
Published: March 2021

We have developed a simple method for the chemoselective aromatization of tetrahydro‐β‐carboline with selective nondeallylation O‐allyl groups in the presence of iodine (100 mol %) in dimethyl sulfoxide/H2O2. A convergent approach toward the oxidative aromatization with selective deallylation (deprotection) of O‐allyl‐tetrahydro‐β‐carboline using iodine in dimethyl sulfoxide/HCl has been described. The present protocol contains cheap catalyst, easy work up, normal reaction conditions, and high selectivity.
A Prospective, Longitudinal Magnetic Resonance Imaging Evaluation of Cerebrovascular Reactivity and Infarct Development in Patients With Intracranial Stenosis
Authors: Juttukonda Meher R. , Davis Larry T. , Lants Sarah K. , Waddle Spencer L. , Lee Chelsea A. , Patel Niral J. , Jordan Lori C. , Donahue Manus J.
Published: March 2021

Background

Patients with symptomatic atherosclerotic and non‐atherosclerotic (i.e., moyamoya) intracranial steno‐occlusive disease experience high 2‐year infarct rates.

Purpose

To investigate whether cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) measures may provide biomarkers of 1‐to‐2‐year infarct risk.

Study Type

Prospective, longitudinal study.

Subjects

Adult participants (age = 18–85 years) with symptomatic intracranial atherosclerotic disease (N = 26) or non‐atherosclerotic (i.e., moyamoya; N = 43) and stenosis ≥50% of a major intracranial artery were initially scanned within 45 days of stroke. Follow‐up imaging (target  = 1.5 years) was acquired for new infarct assessment.

Field Strength/Sequence

3.0 Tesla with normocapnic arterial spin labeling (ASL) and blood oxygenation level‐dependent (BOLD) imaging acquired during an interleaved hypercapnic (3 minutes) and normocapnic (3 minutes) respiratory stimulus.

Assessment

CBF, maximum CVR, and time‐to‐maximum CVR (i.e., CVRDELAY) were calculated. Laterality indices (difference between infarcted and contralesional hemispheres divided by sum of absolute values) of metrics at enrollment were contrasted between participants with vs. without new infarcts on follow‐up.

Statistical Tests

Laterality indices were compared using non‐parametric Wilcoxon tests (significance: two‐sided P < 0.05) and effect sizes as Cohen's d. Continuous variables are presented as mean ± SD.

Results

New infarcts were observed on follow‐up in 15.0% of participants. The laterality index of the CVRDELAY was elevated (P = 0.01) in participants with atherosclerosis with new infarcts (index = 0.13) compared to participants without new infarcts (index = 0.05).

Data Conclusion

Elevated CVRDELAY may indicate brain parenchyma at increased risk for new infarcts in patients with symptomatic intracranial atherosclerotic disease treated with standard‐of‐care medical management.

Level of Evidence

2

Technical Efficacy Stage

3
The academic leadership framework: A guide for systematic assessment and improvement of academic administrative work
Authors: Niewiesk Stefan , Garrity‐Rokous E. Gates
Published: March 2021

Universities, particularly those in the United States, administer their operations through a multitude of disparate, siloed initiatives and processes. Approaches toward academic administrative leadership deserve a more concentrated focus. We propose a simple framework to provide a structure for the evaluation and improvement of administrative processes within a university. Based on an analysis of the literature on academic administration, and input from participants in academic leadership programs at Ohio State University, the proposed framework seeks to create a structure to harmonize administrative work across the university, afford consistency while allowing for unit‐specific adjustments, and offer a basis for defining and measuring ongoing improvement. The framework is organized in six domains of competence, with their respective competencies, which enables administrators to talk about their work using a common language. The framework is contrasted with other approaches to the evaluation of academic administrative work and some general conclusions about it uses are drawn.
Mid‐term outcomes and periodontal prognostic factors of autotransplanted third molars: A retrospective cohort study
Authors: Lucas‐Taulé Ernest , Llaquet Marc , Muñoz‐Peñalver Jesús , Nart José , Hernández‐Alfaro Federico , Gargallo‐Albiol Jordi
Published: March 2021

Background

Tooth autotransplantation is a valid method for replacing non‐restorable teeth. This study aimed to assess mid‐term survival and success of autotransplanted third molars and the clinical periodontal parameters and factors predicting successful periodontal attachment apparatus regeneration.

Methods

In total, 36 patients who had undergone extraction and subsequent autotransplantation of 36 third molars using virtual planning and computer‐aided rapid prototyping models by an oral surgeon and endodontist were eligible. Probing pocket depth (PPD), gingival recession (REC), clinical attachment level (CAL), pulpal and periapical healing, root resorption, and radiographic bone loss (RBL) were evaluated. Additionally, a questionnaire evaluated patient‐reported outcomes.

Results

The mean age of the participants was 30.2 years with a mean follow‐up duration of 29.42 ± 14.56 months. The overall survival and success rates were 97.2% and 91.7%, respectively. No statistically significant differences were found in success and survival rates between open and closed apex groups or between compromised and intact buccal bone groups. No signs of pulp necrosis were found in the open apex group. Progressive replacement resorption was detected in one closed apex case. The mean PPD was 2.7 ± 0.45 mm for all transplanted teeth. REC was 0.13 mm higher in transplanted teeth than in previous hopeless teeth. CAL changes were neither clinically relevant (−0.17 ± 0.66 mm) nor statistically significant. The reported patient satisfaction was high.

Conclusions

Autotransplantation of third molars is a predictable treatment method, with a 2.5‐year cumulative tooth survival and success of 97.2% and 91.7%, respectively, which were not influenced by recipient site integrity or root development.
Environments of the climatic optimum of MIS 11 in Britain: evidence from the tufa sequence at Hitchin, southeast England
Authors: Sherriff J. E. , Schreve D. C. , Candy I. , Palmer A. P. , White T. S.
Published: March 2021

Marine Oxygen Isotope Stage 11 (MIS 11, Hoxnian Interglacial) is an important interval for understanding both climate change in an interglacial partially analogous to the Holocene and the response of geomorphic processes, biotic systems, and hominin populations to these changes. In Britain, many sites correlated to MIS 11 have not been studied since the mid‐20th century and require reinvestigation, including the Hitchin tufa sequence, where a rich, non‐marine molluscan assemblage was originally recovered. Re‐excavation of the Hitchin tufa sequence for this study was focussed on combined sedimentological, micromorphological and geochemical analyses of the deposits. These indicate that tufa formation occurred within a perched springline system under temperate climatic conditions. Shifts between paludal and fluvial tufa facies within this system occur concomitantly with changes in carbonate geochemistry, representing increased humidity caused by a change in rainfall amount or seasonality. This research enables a correlation of the sequence to the climatic optimum of MIS 11c, the main warm phase of MIS 11, and permits further insights into temperature and hydrological changes in this interval by generating the first geochemical records of hydroclimatic evolution during the MIS 11 thermal maximum in Britain.
Stathmin expression in metastatic colorectal cancer
Authors: Leiphrakpam Premila D. , Lazenby Audrey J. , Smith Lynette M. , Brattain Michael G. , Are Chandrakanth
Published: March 2021

Objectives

To evaluate the relationship between stathmin expression and clinical outcome in colorectal cancer (CRC).

Background

Stathmin is a phosphoprotein involved in the regulation of microtubule dynamics and integration of intracellular signaling pathways. Stathmin has been implicated in the tumorigenesis of several cancers and is a potential therapeutic target.

Methods

Stathmin expression was evaluated in 25 metastatic CRC (mCRC) patients by immunohistochemistry (IHC). Ki67 IHC and TUNEL assay were also evaluated in mCRC for cell proliferation and apoptosis.

Results

High expression of stathmin was correlated with CRC metastasis (p = .0084), and significantly worse overall survival (OS) in CRC patients (p = .036). There was a significant increase in cell proliferation and a decrease in apoptosis in liver metastasis compared with CRC primary tumors as determined by Ki67 IHC and TUNEL assay (p < .0001). We also observed a significant positive correlation between stathmin level and cell proliferation in both CRC primary tumor and liver metastasis (p = .0429 to 0.0451; r = .4236 to .4288).

Conclusion

Stathmin expression correlated with worse patient prognosis in mCRC patients and positively correlated with increased cell proliferation. Together, our findings indicate stathmin as a novel potential marker for increased risk of CRC‐specific mortality and identify stathmin as an attractive therapeutic target for the treatment of mCRC.
Assessing the immediate impact of COVID‐19 on surgical oncology practice: Experience from an NCI‐designated Comprehensive Cancer Center in the Northeastern United States
Authors: Gazivoda Victor , Greenbaum Alissa , Roshal Joshua , Lee Jenna , Reddy Lekha , Rehman Shahyan , Kangas‐Dick Aaron , Gregory Stephanie , Kowzun Maria , Stephenson Ruth , Laird Amanda , Alexander H. R. , Berger Adam C.
Published: March 2021

Background

The effects of the coronavirus disease 2019 (COVID‐19) pandemic on surgical oncology practice are not yet quantified. The aim of this study was to measure the immediate impact of COVID‐19 on surgical oncology practice volume.

Methods

A retrospective study of patients treated at an NCI‐Comprehensive Cancer Center was performed. “Pre‐COVID” era was defined as January–February 2020 and “COVID” as March–April 2020. Primary outcomes were clinic visits and operative volume by surgical oncology subspecialty.

Results

Abouyt 907 new patient visits, 3897 follow‐up visits, and 644 operations occurred during the study period. All subspecialties experienced significant decreases in new patient visits during COVID, though soft tissue oncology (Mel/Sarc), gynecologic oncology (Gyn/Onc), and endocrine were disproportionately affected. Telehealth visits increased to 11.4% of all visits by April. Mel/Sarc, Gyn/Onc, and Breast experienced significant operative volume decreases during COVID (25.8%, p = 0.012, 43.6% p < 0.001, and 41.9%, p < 0.001, respectively), while endocrine had no change and gastrointestinal oncology had a slight increase (p = 0.823) in the number of cases performed.

Conclusions

The effects of the COVID‐19 pandemic are wide‐ranging within surgical oncology subspecialties. The addition of telehealth is a viable avenue for cancer patient care and should be considered in surgical oncology practice.
Psychometric Properties of the Syrian Arabic Version of the Impact of Event Scale–Revised in the Context of the Syrian Refugee Crisis
Authors: Grassi Michele , Pellizzoni Sandra , Vuch Marta , Apuzzo Gian Matteo , Agostini Tiziano , Murgia Mauro
Published: March 2021

The Impact of Event Scale–Revised (IES‐R) is a widely used self‐report questionnaire used to assess symptoms of posttraumatic stress disorder (PTSD). Although the IES‐R has been translated and validated in multiple languages, no previous version has employed the Arabic dialect commonly spoken in Syria. The present work aimed to assess the psychometric properties of a Syrian Arabic version of the IES‐R. Syrian citizens (N = 288) living in refugee camps in Turkey were administered the Syrian Arabic IES‐R as part of a humanitarian aid project focused on providing psychological assistance. The data were analyzed with respect to 10 previously published factor solutions. We found that the best‐fitting model was a four‐factor structure that included factors involving Avoidance–Numbing, Intrusion, Hyperarousal, and Sleep Disturbance. The model showed strong measurement invariance between male and female subsamples, allowing for meaningful comparisons of the factor means. Overall, the present findings support the validity of a new version of the IES‐R, which can be used by both researchers and clinicians responding to the urgent need for psychological care for Syrian refugees fleeing war‐related violence.
The Effects of Microaggressions on Depression in Young Adults of Color: Investigating the Impact of Traumatic Event Exposures and Trauma Reactions
Authors: Auguste Evan E. , Cruise Keith R. , Jimenez Maria C.
Published: March 2021

Microaggressions are a common way that individuals experience racism in the United States. The current study examined the extent to which microaggressions contribute to mental health difficulties, namely trauma reactions and depression, after controlling for other traumatic event exposures. We sought to address gaps in the literature by quantitatively assessing the associations among microaggressions, posttraumatic stress symptoms, and depression symptoms. Participants were 140 young adults of color (68.8% female) who were recruited online. Linear regression analyses evidenced that microaggressions were uniquely associated with depression symptoms, B = 0.27, after controlling for lifetime traumatic event exposures, with this association partially mediated by trauma reactions, B = 0.49. These results suggest that microaggressions are a clinically relevant factor in understanding mental health problems reported by Black, Indigenous, and People of Color in the United States and warrant analysis, assessment, and intervention through a trauma lens.
Incorporating Virtual Reality to Improve Otolaryngology Resident Wellness: One Institution's Experience
Authors: Weitzman Rachel E. , Wong Kevin , Worrall Douglas M. , Park Christopher , McKee Sean , Tufts Ryan E. , Teng Marita S. , Iloreta Alfred M.
Published: March 2021

Objective

Burnout is defined as work‐related emotional exhaustion, depersonalization, and decreased sense of accomplishment. Virtual reality (VR) has emerged as an effective treatment modality for various conditions related to anxiety, however, few studies have assessed its role for stress management in residents. We hypothesize that VR‐based mindfulness meditation can reduce resident burnout in real‐world settings.

Study Design

Prospective randomized crossover trial.

Methods

Resident participants completed the validated Maslach Burnout Inventory (MBI). One group used a VR‐based meditation app; the second group received no intervention. After a 2‐month rotation, all subjects completed an MBI and crossed over to the other arm. Wilcoxon rank‐sum tests were used to compare MBI scores before and after intervention, and to compare results by gender and postgraduate year. Mann‐Whitney U tests were used to assess qualitative differences between participants.

Results

Eighteen residents completed the study. Five participants were female and 13 were male. Weekly use of VR‐guided meditation and paced breathing was associated with a significant decrease in emotional exhaustion (P = .009), and on subgroup analysis, male gender specifically was associated with a decrease in emotional exhaustion (P = .027). In the post‐intervention survey, 42.9% subjects reported that VR encouraged them to employ paced breathing techniques, 71.4% reported that they would use the technology if regularly available, and 21.4% reported they would use paced breathing in the future.

Conclusion

VR‐based therapy may serve as a successful tool in stress management and reduce the rate of burnout among otolaryngology residents.

Level of Evidence

NA Laryngoscope, 131:1972–1976, 2021
Surface runoff from an area undergoing soil rehabilitation after bauxite mining in southeastern Brazil
Authors: Spletozer Aline Gonçalves , da Silveira Lucas Jesus , Sato Aurora Yoshiko , Lorenzon Alexandre Simões , Zanuncio José Cola , Dias Herly Carlos Teixeira
Published: March 2021

Changing hydrological processes and soil characteristics are of major environmental concern in surface mining. Runoff may be the best factor for determining the efficiency of rehabilitation after this type of mining, and needs more in‐depth studies, but the environmental factors require more attention in order to control that runoff. The objective of this study was to compare the runoff during post‐mining rehabilitation after the extraction of bauxite with that before mining, and to identify the factors that most affect it. Runoff from before the mining operations and during the rehabilitation after those operations were collected in seven plots in the area of a bauxite mine in southeastern Minas Gerais State, Brazil. The physical‐environmental and anthropic factors interfering with the runoff were characterized for both periods, and their results were submitted to principal component analysis to define the parameters, which most demand attention in the mining rehabilitation stage. This study provides the first records of runoff in the field in areas rehabilitated after surface mining in Brazil, where the runoff decreased (1.75‐times or 42.79%) from 0.76 to 0.30% of the precipitation during rehabilitation, compared to the reference area. The total porosity, density, and resistance of the soil, associated with the maintenance of slope, surface roughness, and vegetation cover, are the factors demanding more attention during the rehabilitation stage of surface mining in order to minimize runoff.
Simulation of the impacts of native vegetation and polyacrylamide on hydraulic properties and heavy metal concentrations at mine dumps
Authors: Zhou Tao , Su Zheng'an , He Zhouyao , Zhang Xiaobo , Wang Xiaoyi , Wang Junjie , Liu Yihan , Wu Zuo , Wang Lijuan
Published: March 2021

The ecological restoration of mine dumps is challenging because of the loose soil structure, toxic heavy metal, and severe soil erosion at such sites. The impacts of native grass and polyacrylamide (PAM) on the soil sediment concentration, hydraulic properties, and heavy metals at mine dumps were investigated via scouring tests with a flow discharge of 90 L min−1. In the initial stages of the tests, fluctuating decreasing trends in the soil sediment concentration, flow velocity, and flow Ni concentration were observed, while a fluctuating increasing trend was observed in the flow resistance f. After a period of adjustment, the steady‐state soil sediment concentrations, hydraulic properties, and Ni concentrations in the flow were attained. An increasing–decreasing trend for the V concentration and a decreasing–increasing trend for the Cu concentration in the flow were observed over time. In addition, Zn was not dissolved or transported by the overland flow. A significant correlation between the heavy metal concentration in the flow and soil sediment concentration was observed (p ≤  0.01). Both native grass and PAM could effectively control soil loss and change hydraulic properties by increasing the surface roughness. The steady‐state flow velocity of B5 was 1.11–1.36 times higher than in the other treatments, while the steady‐state resistance f of B5 was 12.54–45.02% lower than in the other treatments. However, the native grass and PAM had different effects on the transport of heavy metals. The native grass could effectively reduce the mobility of V, while the PAM could reduce the mobility of Cu and V.
Moisture Curable Hybrid Polyhydroxyurethanes from Sugar‐Derived Dicarbonates
Authors: Younes Georges R. , Maric Milan
Published: March 2021

A new set of polyhydroxyurethanes (PHUs) is synthesized from bio‐based sorbitol bicarbonate (SBC) and mannitol bicarbonate (MBC). The synthesized dicarbonates are polymerized with two long chain diamines, telelechelic amine terminated poly(propylene glycol) (PPG), and poly(dimethylsiloxane) (PDMS). Despite the high melting points of SBC and MBC, PHU prepolymers are prepared in bulk at moderate temperatures of 60–100 °C. The structural and thermal properties of the resulting PHUs are qualitatively and quantitatively characterized in order to evaluate them as potential sealants and adhesives, and they are end‐capped with moisture curing agents and left to cure at ambient conditions (22 °C and 20–30% humidity) with the curing processes monitored rheologically. The chemical stability of the novel partially sustainable hybrid PHUs (HPHUs) in pure water is investigated to check the viability of applying them outdoors. Only SBC or MBC‐PDMS HPHUs are found to be hydrophobic with water contact angles of 105° and 109°, respectively, but they are brittle. Small and wide‐angle X‐ray scattering of these water‐resistant films show that they are potentially composed of three different phases due to microphase separation: the PDMS matrix, a hard segments phase, and a third phase mixing the PDMS diamine end‐segments and some dissolved hard segments.
Foreign direct investment and export performance using the hierarchical Bayesian vector autoregression framework
Authors: Dhannur Vijaykumar , John Ashwin R.
Published: March 2021

The paper investigates the interrelationship between the exports (EXP) and foreign direct investment (FDI) inflows with reference to the Indian pharmaceutical industry. It employs the hierarchical Bayesian vector autoregression (BVAR) framework, which is known to generate accurate out‐of‐sample predictions by selecting appropriate amount of shrinkage and tighter priors. It also performs well in terms of accuracy of the impulse response functions in identified VARs. A unidirectional positive impact from FDI to EXP has been found from the impulse responses drawn from the BVAR model. This result is most likely because most of the Indian pharma multinational corporations (MNCs) infuse their foreign investments to boost EXP from India.
A Phase 2 Proof‐of‐Concept, Randomized, Placebo‐Controlled Trial of CX‐8998 in Essential Tremor
Authors: Papapetropoulos Spyros , Lee Margaret S. , Versavel Stacey , Newbold Evan , Jinnah Hyder A. , Pahwa Rajesh , Lyons Kelly E. , Elble Rodger , Ondo William , Zesiewicz Theresa , Hedera Peter , Handforth Adrian , Elder Jenna , Versavel Mark
Published: March 2021

Background

Available essential tremor (ET) therapies have limitations.

Objectives

The objective of this study was to evaluate CX‐8998, a selective T‐type calcium channel modulator, in essential tremor.

Methods

Patients 18–75 years old with moderate to severe essential tremor were randomized 1:1 to receive CX‐8998 (titrated to 10 mg twice daily) or placebo. The primary end point was change from baseline to day 28 in The Essential Tremor Rating Assessment Scale performance subscale scored by independent blinded video raters. Secondary outcomes included in‐person blinded investigator rating of The Essential Tremor Rating Assessment Scale performance subscale, The Essential Tremor Rating Assessment Scale activities of daily living subscale, and Kinesia ONE accelerometry.

Results

The video‐rated The Essential Tremor Rating Assessment Scale performance subscale was not different for CX‐8998 (n = 39) versus placebo (n = 44; P = 0.696). CX‐8998 improved investigator‐rated The Essential Tremor Rating Assessment Scale performance subscale (P = 0.017) and The Essential Tremor Rating Assessment Scale activities of daily living (P = 0.049) but not Kinesia ONE (P = 0.421). Adverse events with CX‐8998 included dizziness (21%), headache (8%), euphoric mood (6%), and insomnia (6%).

Conclusions

The primary efficacy end point was not met; however, CX‐8998 improved some assessments of essential tremor, supporting further clinical investigation. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
Mitochondrial DNA insert into CD40 ligand gene‐associated X‐linked hyper‐IgM syndrome
Authors: Li Xuejing , Xu Dan , Cheng Beilei , Zhou Yunlian , Chen Zhimin , Wang Yingshuo
Published: March 2021

Background

X‐linked hyper‐IgM (X‐HIGM), which results from mutations in the CD40LG gene located on chromosome Xq26.3, is the most common form of HIGM. To date, more than 130 variants of the CD40L gene have been reported. We described a patient with novel de novo nuclear mitochondrial DNA sequences (NUMTs) in the CD40LG gene that have resulted in X‐HIGM.

Methods

Whole‐exome sequencing (WES) analysis was used to screen for causal variants in the genome, and the candidate breakpoint was confirmed by Sanger sequencing.

Results

A new mutation of CD40LG, which deletes A at position 17 followed by a 147‐nucleotide from mitochondrial DNA copies insertion in exon 1, was detected in a 20‐month‐old boy harbouring an X‐HIGM combined with immunodeficiency syndrome.

Conclusion

This is one of the few cases of a human genetic disease caused by nuclear mitochondrial DNA sequences (NUMTs). The presented data serve to demonstrate that de novo NUMT transfer of nucleic acid is a novel mechanism of X‐HIGM.
Optimal design of dielectric flat lens utilizing Bayesian optimization
Authors: Kudo Koji , Morimoto Keita , Iguchi Akito , Tsuji Yasuhide , Kashiwa Tatsuya
Published: March 2021

In recent years, various kinds of optimal design approaches are intensively studied for exploring novel and higher performance microwave and optical devices beyond human knowledge. In this article, we first apply a design approach based on Bayesian optimization (BO) to design of dielectric flat lens which is expected to be used in microwave and millimeter wave region because of its excellent features, such as thin and light weight. BO is able to efficiently search optimal values of design variables compared with population based optimization, without requiring sensitivity analysis which is mandatory in the gradient method.
A novel antipodal tapered slot antenna integrated with half mode substrate integrated waveguide‐based bandpass filter for K and Ka band applications
Authors: P Prasanna Kumar , Saxena Prerna
Published: March 2021

In this article, we present a novel half mode substrate integrated waveguide (HMSIW)‐based bandpass filter fed antipodal tapered slot antenna. We employ a novel feed consisting of three horizontal slots with two gaps arranged periodically on the top metal layer of HMSIW to obtain |S11|<‐10 dB and |S21|≃0 dB over the passband from 21.6 to 40 GHz. We incorporate sinusoidal corrugations at the antenna outer edges along with ground plane slots. We control the operating bandwidth of the antenna over 21.6–40 GHz with |S11|<‐10 dB using the proposed feed. The antenna offers gain of 10–12.44 dB and stable radiation pattern over the controlled band. The proposed antenna, 16 × 30.3 × 0.254 mm3 in volume, is fabricated and tested for validation. The measurement results show good agreement with simulations. The proposed antenna compares favorably with the state‐of‐the‐art. It is compact and exhibits stable gain and stable radiation pattern over the controlled bandwidth.
Artifact reduction in free‐breathing, free‐running myocardial perfusion imaging with interleaved non‐selective RF excitations
Authors: Haji‐Valizadeh Hassan , Guo Rui , Kucukseymen Selcuk , Cai Xiaoying , Rodriguez Jennifer , Pierce Patrick , Goddu Beth , Manning Warren , Nezafat Reza
Published: March 2021

Purpose

To reduce inflow and motion artifacts in free‐breathing, free‐running, steady‐state spoiled gradient echo T1‐weighted (SPGR) myocardial perfusion imaging.

Method

Unsaturated spins from inflowing blood or out‐of‐plane motion cause flashing artifacts in free‐running SPGR myocardial perfusion. During free‐running SPGR, 1 non‐selective RF excitation was added after every 3 slice‐selective RF excitations to suppress inflow artifacts by forcing magnetization in neighboring regions to steady‐state. Bloch simulations and phantom experiments were performed to evaluate the impact of the flip angle and non‐selective RF frequency on inflowing spins and tissue contrast. Free‐running perfusion with (n = 11) interleaved non‐selective RF or without (n = 11) were studied in 22 subjects (age = 60.2 ± 14.3 years, 11 male). Perfusion images were graded on a 5‐point Likert scale for conspicuity of wall enhancement, inflow/motion artifact, and streaking artifact and compared using Wilcoxon sum‐rank testing.

Result

Numeric simulation showed that 1 non‐selective RF excitation applied after every 3 slice‐selective RF excitations produced superior out‐of‐plane signal suppression compared to 1 non‐selective RF excitation applied after every 6 or 9 slice‐selective RF excitations. In vitro experiments showed that a 30° flip angle produced near‐optimal myocardial contrast. In vivo experiments demonstrated that the addition of interleaved non‐selective RF significantly (P < .01) improved conspicuity of wall enhancement (mean score = 4.4 vs. 3.2) and reduced inflow/motion (mean score = 4.5 vs. 2.5) and streaking (mean score = 3.9 vs. 2.4) artifacts.

Conclusion

Non‐selective RF excitations interleaved between slice‐selective excitations can reduce image artifacts in free‐breathing, ungated perfusion images. Further studies are warranted to assess the diagnostic accuracy of the proposed solution for evaluating myocardial ischemia.
Simultaneous proteoglycans and hypoxia mapping of chondrosarcoma environment by frequency selective CEST MRI
Authors: Autissier Roxane , Mazuel Leslie , Maubert Elise , Bonny Jean‐Marie , Auzeloux Philippe , Schmitt Sébastien , Traoré Amidou , Peyrode Caroline , Miot‐Noirault Elisabeth , Pagés Guilhem
Published: March 2021

Purpose

To evaluate the relevance of CEST frequency selectivity in simultaneous in vivo imaging of both of chondrosarcoma’s phenotypic features, that are, its high proteoglycan concentration and its hypoxic core.

Methods

Swarm rat chondrosarcomas were implanted subcutaneously in NMRI nude mice. When tumors were measurable (12‐16 days postoperative), mice were submitted to GAG, guanidyl, and APT CEST imaging. Proteoglycans and hypoxia were assessed in parallel by nuclear imaging exploiting 99mTc‐NTP 15‐5 and 18F‐FMISO, respectively. Data were completed by ex vivo analysis of proteoglycans (histology and biochemical assay) and hypoxia (immunofluorescence).

Results

Quantitative analysis of GAG CEST evidenced a significantly higher signal for tumor tissues than for muscles. These results were in agreement with nuclear imaging and ex vivo data. For imaging tumoral pH in vivo, the CEST ratio of APT/guanidyl was studied. This highlighted an important heterogeneity inside the tumor. The hypoxic status was confirmed by 18F‐FMISO PET imaging and ex vivo immunofluorescence.

Conclusion

CEST MRI simultaneously imaged both chondrosarcoma properties during a single experimental run and without the injection of any contrast agent. Both MR and nuclear imaging as well as ex vivo data were in agreement and showed that this chondrosarcoma animal model was rich in proteoglycans. However, even if tumors were lightly hypoxic at the stage studied, acidic areas were highlighted and mapped inside the tumor.
Resilience in the face of pelvic pain: A pilot study in males and females affected by urologic chronic pelvic pain
Authors: Giannantoni Antonella , Gubbiotti Marilena , Balzarro Matteo , Rubilotta Emanuele
Published: March 2021

Aims

Resilience represents a fundamental element in the experience of pain, as it allows adaptation to suffering and increases psychological social well‐being and quality of life (QoL). We investigated resilience in patients affected by urologic chronic pelvic pain (UCPP) and the relationships with pain severity and distribution, catastrophizing and psychological distress.

Methods

Forty‐eight consecutive UCPP patients were classified on a pain body map as being affected by pelvic pain only or widespread pain (WP), and underwent the evaluation of resilience with the 14‐item Resilience Scale (RS‐14), with higher scores indicating high resilience levels; scores < 56 denote very poor resilience. Pelvic and nonpelvic pain intensity and the bother of urinary symptoms on QoL were measured by means of Pain Numerical Rating Scale (PNRS) and Visual Analog Scale (VAS). Pain Catastrophizing Scale (PCS) and Depression Anxiety Stress Scales (DASS‐21) investigated catastrophizing and psychological conditions.

Results

Overall, RS‐14 mean ± SD total score was 50.2 ± 12.5 in patients with pelvic pain only and 40.2 ± 10.2 in those with WP. Significant relationships were observed between low resilience levels and high scores of pelvic and nonpelvic PNRS, VAS, pain catastrophizing scale and depression and anxiety, stress scale (for all: p < 0.001). Significantly lower RS‐14 scores were detected in females and in patients with WP.

Conclusions

A very poor resilience has been identified in UCPP patients, particularly in those with greater catastrophizing and mood alterations. WP and female gender were mostly affected. In UCPP patients, low resilience appears as a crucial factor in pain experience.
Care difficulties and burden during COVID‐19 pandemic lockdowns among caregivers of people with schizophrenia: A cross‐sectional study
Authors: Yasuma Naonori , Yamaguchi Sosei , Ogawa Makoto , Shiozawa Takuma , Abe Makiko , Igarashi Momoka , Kawaguchi Takayuki , Sato Sayaka , Nishi Daisuke , Kawakami Norito , Fujii Chiyo
Published: March 2021

Aims

The purpose of this study was to retrospectively investigate care difficulties experienced by caregivers of people with schizophrenia during COVID‐19 pandemic lockdowns in Japan (April 7‐May 25, 2020) and examine associations between these care difficulties during lockdowns and daily caregiver burden.

Methods

Data were collected from 132 participants of the LINE Schizophrenia Family Association using an online survey.

Results

Caregivers were mostly concerned about who would care for people with schizophrenia if caregivers become infected with COVID‐19. A significant association was found between higher daily caregiver burden and more difficult care experiences during COVID‐19 pandemic lockdowns (B = 0.58, 95% confidence interval, 0.40‐0.75, P < .01, adjusted R‐squared = .34).

Conclusions

Further studies and supports for caregivers of people with schizophrenia are needed.
Augmented Lagrangian methods for optimal control problems governed by mixed quasi‐equilibrium problems with applications
Authors: Chadli Ouayl , Ansari Qamrul Hasan , Al‐Homidan Suliman
Published: March 2021

The main goal of this article is to study a general augmented Lagrangian method for optimal control problems governed by mixed (quasi‐)equilibrium problems. We establish zero duality gap properties between a primal problem and its augmented Lagrangian dual problem. As a consequence, we give some existence results for optimal control problem governed by evolutionary quasi‐variational inequalities. An application to optimal control of obstacle problems described by quasi‐hemivariational inequalities is studied. The results obtained in this article are new and improves considerably many recent results in literature.