bluuebunny/crossref_metadata_2025 huggingface dataset:
Undercutting Justice – Why legal representation should not be allocated by the market
Authors: Agmon Shai
Published: August 2020

The adversarial legal system is traditionally praised for its normative appeal: it protects individual rights; ensures an equal, impartial, and consistent application of the law; and, most importantly, its competitive structure facilitates the discovery of truth – both in terms of the facts, and in terms of the correct interpretation of the law. At the same time, legal representation is allocated as a commodity, bought and sold in the market: the more one pays, the better legal representation one gets. In this article, I argue that the integration of a market in legal representation with the adversarial system undercuts the very normative justifications on which the system is based. Furthermore, I argue that there are two implicit conditions, which are currently unmet, but are required for the standard justifications to hold: that there is (equal opportunity for) equality of legal representation between parties, and that each party has (equal opportunity for) a sufficient level of legal representation. I, therefore, outline an ideal proposal for reform that would satisfy these conditions.
MicroRNA-199a Inhibits Cell Proliferation, Migration, and Invasion and Activates AKT/mTOR Signaling Pathway by Targeting B7-H3 in Cervical Cancer
Authors: Yang Xiang , Feng Kai-Xun , Li Hu , Wang Li , Xia Hong
Published: August 2020

Cervical cancer is a deadly disease. Some microRNAs are involved in tumor invasion and metastasis. Decreased expression of microRNA-199a has been correlated with tumorigenesis. In our study, the quantitative real-time polymerase chain reaction results indicated that microRNA-199a was expressed at lower levels in cervical cancer tissues, and the expression level of B7-H3 was significantly increased compared with that in the adjacent normal tissues, and the expression levels of B7-H3 and microRNA-199a in cervical cancer tissues and in adjacent normal tissues were inversely correlated. We also found that the expression of microRNA-199a was downregulated in cervical cancer cell lines when compared to immortalized cells. In this study, B7-H3 was identified as a novel target of microRNA-199a in cervical cancer. TargetScan ( http://www.targetscan.org/ ) bioinformatics analysis was used to predict that the 3′-untranslated region of B7-H3 is a direct target of microRNA-199a. The result was also verified by the luciferase reporter assay. MicroRNA-199a could directly target the 3′-untranslated region of B7-H3, but the specific signaling pathways that were involved in regulating B7-H3 expression remained unclear. To clarify whether the suppressive effect of microRNA-199a was mediated through B7-H3, a series of experiments were performed. We found that the overexpression of microRNA-199a inhibited cell proliferation, migration, and invasion via direct binding to B7-H3. Epithelial–mesenchymal transition is a major factor involved in cervical cancer metastasis. Quantitative real-time polymerase chain reaction and western blot results indicated that microRNA-199a inhibits tumor progression in cervical cancer by targeting B7-H3. The microRNAs regulatory network is quite complex. We further examined the effect of microRNA-199a on the AKT/mTOR signaling pathway. We explored the regulatory role of microRNA-199a and first demonstrated that highly expressed microRNA-199a inhibits tumor growth and activates the AKT/mTOR signaling pathway by targeting B7-H3 in vivo and in vitro. Our findings not only provide a better understanding of the pathogenesis of cervical cancer but also provide novel findings and theoretical support for potential targeted therapeutic tools for cervical cancer.
A Comparative Study of Liquid-Based Cytology and DNA Image Cytometry in the Diagnosis of Serous Effusion
Authors: Wang Shaohua , Li Dan , Wang Jieqiong , Wan Yu , Huang Conggai , Yang Bo , Tang Xiaoqin , Tian Gang , Yang Zhihui
Published: August 2020

Background:

Liquid-based cytology is one of the most useful methods to diagnose a patient with serous effusion, especially when malignancy is suspected. As an alternative to the use of liquid-based cytology only, the serous effusion can be further processed using the technique of DNA image cytometry, which may augment diagnostic utility. The aim of this study was to compare the diagnostic yields of liquid-based cytology, DNA image cytometry, and both in combination, regardless of serous-effusion etiology.

Methods:

We conducted a descriptive study on patients with serous effusions from July 2016 to June 2018. All samples were submitted for liquid-based cytology and DNA image cytometry techniques. We compared the results of cytopathological studies to the final diagnoses.

Results:

For a total of 798 samples, final diagnoses included 412 (51.6%) malignancies, 280 (35.1.%) inflammatory diseases, and 106 (13.3%) transudative serous effusions. Liquid-based cytology had a more sensitive diagnostic yield than DNA image cytometry did (38.8% vs 30.7%; P < .05), but the combination of both had a higher yield (43.7%; P < .05) compared with that of liquid-based cytology alone. For the 412 malignant serous effusions, diagnostic yields of liquid-based cytology and DNA image cytometry were 73.8% and 59.5%, respectively. The difference in sensitivity was significant ( P < .05). Combined liquid-based cytology + DNA image cytometry improved diagnostic yield to 83.3% ( P < .05). However, both liquid-based cytology and DNA image cytometry had low diagnostic yields for inflammatory diseases and transudative serous effusions.

Conclusion:

In serous effusion, liquid-based cytology’s diagnostic performance is better than that of DNA image cytometry. Application of both techniques can significantly increase diagnostic yield.
The Role of Ultrasound Therapy in the Management of Musculoskeletal Soft Tissue Pain
Authors: Papadopoulos Emmanuel S. , Mani Raj
Published: August 2020

Ultrasound is an invaluable physical modality widely used for diagnosis and therapy in humans and animals. It is noninvasive, atraumatic, and may be used repeatedly. As a therapeutic tool, ultrasound has been in use for some 6 decades. Therapeutic ultrasound (TUS) is used for the treatment of musculoskeletal disorders, including acute soft tissue injuries, overuse syndromes, as well as chronic orthopedic and rheumatologic conditions. The aim of this review was to investigate the clinical effectiveness of TUS in musculoskeletal acute and chronic pain, mainly through the control of inflammation and the promotion of soft tissue injury healing. Based on the evidence presented, TUS is clinically effective in some musculoskeletal soft tissue pain conditions, but due to conflicting results in some studies, no specific positive recommendations can be made, nor does it permit exclusion of TUS from clinical practice. In phonophoresis, TUS plays a significant role, without reported adverse effects. There is scope for improving the evidence base with better designed studies.
Resistance to Antiplatelet Therapy Is Associated With Symptoms of Cerebral Ischemia in Carotid Artery Disease
Authors: Ball Stephen T. E. , Taylor Rachael , McCollum Charles N.
Published: August 2020

Background:

Platelet inhibitory therapy is prescribed to prevent arterial thromboembolism in patients with atherosclerotic disease. Although taken by millions of people, around 30% are resistant to the treatment they are being prescribed.

Aims:

To determine whether symptoms of cerebral ischemia, or pre-operative cerebral emboli, in patients admitted for a carotid endarterectomy were associated with resistance to aspirin or clopidogrel.

Methods:

Venous blood from 133 patients immediately before carotid endarterectomy (CEA) was analyzed for resistance to aspirin and clopidogrel by multiplate impedance aggregometry. The number of emboli/hour entering the ipsilateral middle cerebral artery was counted by transcranial Doppler (TCD) on the day before surgery in 33 of these patients.

Results:

Resistance was found in 21 (26.3%) of 100 patients taking aspirin and 14 (42%) of 33 taking clopidogrel. Mean (sd) residual platelet aggregation was significantly higher at 41.9(32) Au in patients who had suffered recent symptoms of cerebral ischemia compared with 30.8(16) Au in asymptomatic patients (p = 0.012). Residual platelet aggregation also correlated significantly with the number of emboli/hour counted by TCD in the ipsilateral middle cerebral artery (r = 0.45, p = 0.009).

Conclusion:

Antiplatelet resistance was associated with the frequency of cerebral emboli and recent symptoms of cerebral ischemia in patients with carotid disease. Definitive clinical studies are needed to explore whether testing for antiplatelet resistance should be undertaken routinely in patients starting platelet inhibitory therapy for cardiovascular disease.
Analysis of the factors affecting the dimensional stability of socks using full-factorial experimental design method
Authors: Basra Sikander Abbas , Asfand Norina , Azam Zeeshan , Iftikhar Khurram , Irshad Muhammad Awais
Published: August 2020

Socks, which are a necessary item of clothing, need to be comfortable, affordable, and retain their quality throughout their life. Dimensional stability is one of the basic requirements of socks. The purpose of this study is to investigate the contributing factors, that is, elastane percentage, main yarn material, and process type on dimensional stability of socks. Four different percentages of elastane in plaiting yarn (4%, 6%, 8%, and 10%), two main yarns materials (100% cotton and polyester/cotton 52/48), and two process types (wash and bleach) were taken as level of input variables to study the effect on dimensional stability of socks using full-factorial experimental design method. Statistical tool (analysis of variance) was used to check the significant effect of different factors. It was found that with the increase in elastane percentage, shrinkage was decreased. Cotton was found to have more shrinkage percentage as compared to polyester/cotton. In addition, it was observed that washing treatment produced significantly lesser shrinkage than bleaching. These data present a great interest to sock manufacturers who can make better choices to manufacture, dimensionally stable socks.
Whole-Food Plant-Based Lifestyle Program and Decreased Obesity
Authors: Jakše Boštjan , Jakše Barbara , Pinter Stanislav , Pajek Jernej , Fidler Mis Nataša
Published: August 2020

Failure of weight-loss programs is high. We evaluated a whole-food plant-based (WFPB) lifestyle program. We investigated the obesity indices of 151 healthy adults who were on our ongoing, community-based program for the short (0.5 to ≤2 years), medium (2 to ≤5 years), or long term (5 to 10 years). Body composition indices were measured by medically approved bioimpedance. Body composition changes were favorable for all 3 groups and both genders. There were no differences in body composition between the males for all 3 groups, while there were lower body mass (BM), body mass index (BMI), and muscle mass in females on long-term versus short-term programs. All participants experienced a decrease in BMI (−2.5 kg/m2), BM (−7.1 kg), and body fat percentage (−6.4%; P < .001 for all). The reductions for those with a baseline BMI of obese, overweight, and normal were −5.6, −2.4, and −0.9 kg/m2 for BMI, −16.1, −7.1, and −2.5 kg for total BM, and −9.5%, −6.6%, and −4.8% for body fat percentage (baseline vs current; P < .001 for all). A total of 86% of parents of underage children introduced the WFPB lifestyle to children. Our WFPB lifestyle program provides a long-term reversal of obesity.
The classification in Para swimming: Analysis of a Paralympic champion’s withdraw case
Authors: Barbosa Augusto C , Araújo Leonardo T , Kanayama Tatiana OC , de Souza João Paulo C , Lourenço Thiago F , Leis Leonardo V , Winckler Ciro , Barroso Renato
Published: August 2020

This study compared the in-water bilateral leg kick speed difference between a Paralympic and an Olympic athlete. The Paralympic (former S10) was not eligible after his reclassification in 2019, whereas the Olympic was a semi-finalist in 50 m freestyle in Rio 2016. Kick performance was assessed by a speedometer in one push-off ∼15 m maximal kick sprint. Ten complete cycles were analyzed, and the average speed of each leg in each cycle was calculated. Computerized planimetry assessed plantar feet areas. Differences between right and left feet areas were –22% and –2.1% for the Paralympic and Olympic, respectively. The left kick was slower in the Paralympic (p < 0.0001, ES: 2.35, very large), whereas no difference was found for the Olympic (p = 0.55, ES: 0.27, small). There is a substantial bilateral leg kick speed difference for the Paralympic, but not for the Olympic. The impact of Paralympic’s impairment on his kick performance considerably differs when using quantitative and qualitative assessments.
Patients With Opioid Use Disorder Have Increased Readmission Rates, Emergency Room Visits, and Costs Following a Hallux Valgus Procedure
Authors: Parrish James M. , Vakharia Rushabh M. , Benson Dillon C. , Hoyt Aaron K. , Jenkins Nathaniel W. , Kaplan Jonathan R. M. , Rush Augustus J. , Roche Martin W. , Aiyer Amiethab A.
Published: August 2020

Background

Patients with a history of opioid use disorder (OUD) tend to have more complications, higher readmission rates, and increased costs following orthopaedic procedures. This study evaluated patients undergoing hallux valgus correction for their odds of increased (1) readmission rates, (2) emergency room (ER) visits, and (3) costs.

Methods

Patients undergoing hallux valgus corrections with OUD history were identified using a national Medicare administrative claims database of approximately 24 million orthopaedic surgery patients. OUD patients were matched to non–opioid use disorder (NUD) patients in a 1:4 ratio by age, sex, Elixhauser-Comorbidity Index (ECI), diabetes mellitus, hyperlipidemia, hypertension, and tobacco use. The query yielded 6318 patients (OUD = 1276; NUD = 5042) who underwent a hallux valgus correction. Primary outcomes analyzed included odds of 90-day readmission rates, 30-day ER visits, and 90-day episode-of-care costs. Demographics, odds ratios (ORs), ECI, and cost were assessed as appropriate using a Pearson χ2 test, logistic regression, and a t test. A P value <.05 was considered statistically significant.

Results

There were no significant differences in demographics between OUD and NUD patients. OUD patients had higher incidence and odds of 90-day readmission (9.56% vs 6.04%; OR = 1.55; P < .001) and 30-day ER visits (0.86% vs 0.35%; OR = 2.42; P = .021) and incurred greater 90-day episode-of-care costs ($7208.28 vs $6134.75; P < .001) compared with NUD patient controls.

Conclusion

The study demonstrates the possible influence of OUD on higher odds of readmission, ER visits, and costs following a hallux valgus correction.

Levels of Evidence

Level III: Retrospective cohort study
Optimum Degree of Head Elevation/Reverse Trendelenburg Position for Sinus Surgery: Systematic Review
Authors: Iftikhar Haissan , Ahmed Shahzada Khuram , Abbas Syed Akbar , Ikram Mubasher , Mustafa Khawaja , Das Jai K.
Published: August 2020

Background

This review aims to evaluate the effect of Reverse Trendelenburg Position (RTP) on bleeding and Boezaart score and to determine the optimum degree of head elevation through a systematic review and meta-analysis. Methodology: We conducted a systematic review according to PRISMA guidelines and a literature search was performed on PubMed, Web of Science, Cochrane, Dental and Oral Science, Google scholar and Clinicaltrials.gov and included randomized controlled trials (RCTs) in English language only. We extracted all relevant data and conducted quality assessment using Cochrane risk of Bias tool (Version 2). We also performed quality assessment of the outcomes using GRADE. Meta-analysis for all the outcomes using conducted on RevMan version 5.3.

Results

The search identified 629 articles and three RCTs that met our inclusion criteria. Two were included in the meta-analysis. A total of 124 patients were assessed for bleeding during sinus surgery and there was a significant reduction in total blood loss in RTP (10–15°) when compared to horizontal position by 134 ml (Mean Difference (MD): −134.23; 95% confidence interval (CI): −184.13 to −67.27). RTP also had a significant reduction in bleeding per minute by 1.07 ml/min (MD: −1.07; 95%CI: (−1.69 to −0.44), while the Boezaart score was significantly lower in the RTP group (MD: −0.69; 95%CI: −0.94 to −0.43) when compared to horizontal position.

Conclusion

Though with limited evidence RTP for ESS reduces total blood loss, blood loss per minute and improves visualization. Further studies are needed to assess the actual impact and optimal degree of head elevation.
Venlafaxine-induced encephalopathy in term newborn
Authors: Maalouli Walid M , Hilliard Brian S
Published: August 2020

The use of venlafaxine, a selective serotonin and norepinephrine reuptake inhibitor, for the management of depression in women of childbearing age has been on the rise, and there have been multiple case reports in the literature tying venlafaxine in-utero exposure to a form of neonatal encephalopathy presenting as neonatal abstinence syndrome. We present the case of a 5-day-old term infant whose mother was on venlafaxine throughout her pregnancy and presented with hypothermia, poor feeding, and decreased activity level. She subsequently had a negative sepsis workup and required nasogastric tube feedings for 2 weeks with spontaneous recovery and no clinical sequelae post-discharge. This case highlights the non-trivial potential risk of venlafaxine withdrawal in exposed newborns and the need for close observation. We propose a management framework for such situations in affected infants.
Combining bottom-up monitoring and top-down accountability: A field experiment on managing corruption in Uganda
Authors: Buntaine Mark T. , Daniels Brigham
Published: August 2020

Citizen monitoring of government performance is often ineffective at improving performance, perhaps because information from monitoring does not make it far enough up in the chain of bureaucracy where the authority to punish public mismanagement rests. In a field experiment, we test whether delivering regular, officially certified reports derived from citizen monitoring and describing specific problems with the implementation of public projects to high-level bureaucrats charged with overseeing the projects improved their delivery. We do not find evidence that this treatment improved the delivery of public projects. Follow-up interviews revealed that the targeted officials seemed to avoid knowledge of the monitoring, perhaps to avoid taking on the responsibility that would come from such knowledge. However, the treatment also provided information to citizens about what they should expect from local governments, which instigated several direct complaints that the targeted officials did not ignore. Based on this alternative channel, which we did not anticipate, we conclude that citizen monitoring must be deployed in ways that make knowledge of problems undeniable for authorities who have a responsibility to address them.
Disentangling Mental Illness Labeling Effects from Treatment Effects on Well-Being
Authors: Thoits Peggy A.
Published: August 2020

The emerging field of Mad Studies has returned attention to deficiencies of the medical model, refocusing scholars on social causes of mental health problems and on consumers’/survivors’ experiences of labeling and stigma. These themes echo issues addressed in traditional and modified labeling theories. A fundamental labeling premise is that professional categorization as “mentally ill” is a major determinant of individuals’ poorer psychological well-being. However, this relationship has not been tested appropriately because past studies frequently measured formal labeling by a person’s involvement in treatment. Treatment involvement can indicate the receipt of potentially beneficial services or harmful categorization with a stigmatizing label. Independent measures of these constructs in the National Comorbidity Survey-Replication enable reexamining traditional and modified labeling hypotheses for individuals with (N = 1,255) and without (N = 4,172) a recurrent clinical disorder. Supporting labeling theory’s central proposition, formal labeling was linked to more negative affect and disability days in both groups. These relationships were not spurious products of preexisting serious symptoms, refuting a psychiatric explanation. Treatment involvement effects differed noticeably between the groups, underscoring the need to keep treatment and labeling measures distinct.
Green Brand Benefits and Brand Outcomes: The Mediating Role of Green Brand Image
Authors: Bashir Shahid , Khwaja Muddasar Ghani , Rashid Yasir , Turi Jamshid Ali , Waheed Tariq
Published: August 2020

This study develops a test model that can conceptually contribute to the formation of a green brand image for the hospitality market. A conceptual model highlighting the mediating role of green brand image based on two antecedent constructs (consumer’s perceived functional and emotional benefits of green hotels) and four outcome constructs (green brand preferences, trust, loyalty, and corporate image) was tested using 347 Malaysian lodging consumers. The findings indicate that the increase in consumer’s perceived functional and emotional benefits will initially increase their green brand image, and eventually increase their green brand preferences, trust, loyalty, and corporate image. Moreover, the role of green brand image as a mediator exists between consumers’ perceived benefits and their green brand preferences, trust, loyalty, and corporate image. Based on these findings, the managers can devise green branding strategies for their hotels, and show how green campaigns can highlight ecological concerns among green hotel consumers.
Resilience Among Unemployed and Underemployed Emerging Adults: A Cross-Sectional Study of How Stress and Coping Relate to Depressive Symptoms
Authors: McGee Robin E. , Windle Michael , Cooper Hannah L. F. , Thompson Nancy J.
Published: August 2020

Unemployed and underemployed emerging adults (EAs) are at increased risk for depression. However, limited research has examined resilience and coping in this population. This study tested the resilience process by examining whether coping processes mediate the relationship between perceived stress and depression among unemployed and underemployed EAs. Data from 193 unemployed and underemployed EAs (ages 18–25) were collected through an online questionnaire. Path analysis tested the mediation model. Post hoc moderation analyses tested whether coping buffered the impact of stress on depression. The sample was diverse, consisting of Black (37%), White (37%), and other race/ethnicity (26%) participants. The proposed mediating model did not fit the data well. Of four interaction terms tested, one was significant (Perceived Stress × Coping Self-Efficacy [CSE]; p = .043). As CSE increased, the relationship between perceived stress and depression decreased. The interaction results suggest that CSE buffers the relationship between perceived stress and depression.
Modelling Teachers Accountability in the Higher Educational Institutions Using Decision-making Trial and Evaluation Laboratory Approach
Authors: Srivastava Shefali , Prakash Gyan , Gauba Ritika
Published: August 2020

This article aims to identify teachers’ accountability in the context of higher educational institutions (HEIs). Most of the literature has used student-oriented outcomes as basic building blocks of accountability. This article contributes to the literature by gauging teachers’ perceptions in conceptualising accountability in the HEIs. Indicators of accountability have been identified from the literature. Decision-making trial and evaluation laboratory (DEMATEL) method has been used to explore the nature of interrelationships among these indicators. Results reveal that accountability indicators have varying impact and some of these indicators have cause and effect type of relationship among them. The article underscores the role of performance-based accountability system (PBAS) which will help in assessing and evaluating teachers in the HEIs. It is argued that accountability strengthens the autopoietic nature of the HEIs and enables underlying knowledge generation and dissemination processes. Using accountability indicators, teachers can self-assess their performance and adapt to evolving needs of students, businesses, and societal stakeholders. The relationships among accountability indicators can be used by policymakers to steer the HEIs.
Outcomes and Complications After Primary Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis for Superior Labral Anterior-Posterior Tears or Biceps Abnormalities: A Systematic Review and Meta-analysis
Authors: Deng Zi Jun , Yin Clark , Cusano Joseph , Abdul-Rassoul Hussein , Curry Emily J. , Novikov David , Ma Richard , Li Xinning
Published: August 2020

Background:

Biceps tenodesis is a surgical treatment for both superior labral anterior-posterior (SLAP) tears and long head of the biceps tendon (LHBT) abnormalities. Biceps tenodesis can be performed either above or below the pectoralis major tendon with arthroscopic or open techniques.

Purpose:

To analyze the outcomes and complications comparing primary arthroscopic suprapectoral versus open subpectoral biceps tenodesis for either SLAP tears or LHBT disorders.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A search strategy based on the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) protocol was used to include 18 articles (471 patients) from a total of 974 articles identified. Overall exclusion criteria included the following: non–English language, non–full text, biceps tenodesis with concomitant rotator cuff repair, review articles, meta-analyses, and case reports. Data were extracted and analyzed according to procedure type and tenodesis location: arthroscopic suprapectoral biceps tenodesis (295 patients) versus open subpectoral bicepts tenodesis (176 patients).

Results:

For arthroscopic suprapectoral biceps tenodesis, the weighted mean American Shoulder and Elbow Surgeons (ASES) score was 90.0 (97 patients) and the weighted mean Constant score was 88.7 (108 patients); for open subpectoral biceps tenodesis, the mean ASES score was 91.1 (199 patients) and mean Constant score was 84.7 (65 patients). Among the 176 patients who underwent arthroscopic biceps tenodesis, there was an overall complication rate of 9.1%. Among the 295 patients who underwent open biceps tenodesis, there was an overall complication rate of 13.5%. Both residual pain (5.7% vs 4.7%, respectively) and Popeye deformity (1.7% vs 1.0%, respectively) rates were similar between the groups. Open subpectoral biceps tenodesis had higher reoperation (3.0% vs 0.0%, respectively), wound complication (1.0% vs 0.0%, respectively), and nerve injury (0.7% vs 0.0%, respectively) rates postoperatively. A meta-analysis of 3 studies demonstrated that both methods had similar ASES scores ( P = .36) as well as all-cause complication rates (odds ratio, 0.76 [95% CI, 0.13-4.48]; P = .26).

Conclusion:

Patients undergoing arthroscopic suprapectoral biceps tenodesis for either SLAP tears or LHBT abnormalities had similar outcome scores and complication rates compared with those undergoing open subpectoral biceps tenodesis. Additionally, both residual pain and Popeye deformity rates were similar between the 2 groups.
Distribution of Osteochondral Lesions in Patients With Simple Elbow Dislocations Based on MRI Analysis
Authors: Kim Hyojune , Kholinne Erica , Kwak Jae-Man , Park Dongjun , Shin Myung-Jin , Kim Dong-Min , Lim Tae Kang , Koh Kyoung-Hwan , Jeon In-Ho
Published: August 2020

Background:

The clinical relationship between osteochondral lesions and long-term outcomes and patterns in the elbow joint has not yet been established. A sole evaluation from plain standard radiography may underestimate the severity of bony lesions in patients with simple dislocations. It has been suggested that the mechanism of a posterior elbow dislocation could be inferred from the pattern of bony contusions and osteochondral lesions visible on magnetic resonance imaging (MRI) in patients with simple elbow dislocations.

Purpose/Hypothesis:

The purpose of this study was to describe the incidence and distribution of osteochondral lesions based on MRI findings in patients with simple elbow dislocations. We hypothesized that (1) osteochondral lesions are consistently found in patients with simple elbow dislocations and (2) the distribution and severity of osteochondral lesions may explain the mechanism of the simple elbow dislocation.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review of 43 patients with simple elbow dislocations was performed in tertiary-level hospitals from January 2010 to August 2019. Two orthopaedic surgeons separately assessed the initial plain radiographs and MRI scans. Osteochondral lesions were evaluated and categorized based on whether they were located (1) on the lateral side (posterolateral capitellum and radial head; type 1) or (2) on the medial side (posterior trochlea and anteromedial facet of the coronoid; type 2). The severity of the osteochondral lesions was assessed according to the Anderson classification.

Results:

Of the 43 patients, 21 (48.8%) presented with osteochondral lesions on MRI. The type 1 pattern of osteochondral lesions was the most frequently observed on MRI in patients with simple elbow dislocations (69.8% of cases), and these were confirmed by simple radiography. Posterolateral capitellum osteochondral lesions were found in 13 patients. Among them, 10 (76.9%) were advanced-stage lesions (stages III and IV according to the Anderson classification).

Conclusion:

Osteochondral lesions were found on MRI after simple elbow dislocations at a rate of 48.8%. Osteochondral lesions in the posterolateral capitellum were associated with an advanced stage. Clinically, these findings may help surgeons in the diagnosis of osteochondral lesions and in determining how to manage patients with the progression of arthritic changes.
B-Cell-Targeted 3DNA Nanotherapy Against Indoleamine 2,3-Dioxygenase 2 (IDO2) Ameliorates Autoimmune Arthritis in a Preclinical Model
Authors: Merlo Lauren MF , Bowers Jessica , Stefanoni Tony , Getts Robert , Mandik-Nayak Laura
Published: August 2020

The tryptophan catabolizing enzyme indoleamine 2,3-dioxygenase 2 (IDO2) has been identified as an immunomodulatory agent promoting autoimmunity in preclinical models. As such, finding ways to target the expression of IDO2 in B cells promises a new avenue for therapy for debilitating autoimmune disorders such as rheumatoid arthritis. IDO2, like many drivers of disease, is an intracellular protein expressed in a range of cells, and thus therapeutic inhibition of IDO2 requires a mechanism for targeting this intracellular protein in specific cell types. DNA nanostructures are a promising novel way of delivering small molecule drugs, antibodies, or siRNAs to the cytoplasm of a cell. These soluble, branched structures can carry cell-specific targeting moieties along with their therapeutic deliverable. Here, we examined a 3DNA nanocarrier specifically targeted to B cells with an anti-CD19 antibody. We find that this 3DNA is successfully delivered to and internalized in B cells. To test whether these nanostructures can deliver an efficacious therapeutic dose to alter autoimmune responses, a modified anti-IDO2 siRNA was attached to B-cell-directed 3DNA nanocarriers and tested in an established preclinical model of autoimmune arthritis, KRN.g7. The anti-IDO2 3DNA formulation ameliorates arthritis in this system, delaying the onset of joint swelling and reducing total arthritis severity. As such, a 3DNA nanocarrier system shows promise for delivery of targeted, specific, low-dose therapy for autoimmune disease.
Dynamic electrical characteristics of carbon fiber-reinforced polymer composite under low intensity lightning current impulse
Authors: Sun Jinru , Li Xuanjiannan , Tian Xiangyu , Chen Jingliang , Yao Xueling
Published: August 2020

The distribution and conduction path of lightning current inside carbon fiber-reinforced polymer (CFRP) composites subjected to lightning strikes are determined by their dynamic conductive characteristics. An experimental platform that generates lightning current impulses with variable parameters was established to obtain the equivalent conductivities of CFRPs with different laminated structures. The experimental results indicated that the through-thickness conductivity (10−3 S/mm) was much lower than the in-plane conductivity (100 S/mm). Then, the dynamic conduction model of CFRPs was analyzed based on the anisotropic nonlinear conductivities of CFRPs under lightning currents of 50–1000 A. The CFRP laminate could be regarded as a series circuit of resistance and inductance. The dynamic conductance of the CFRP laminate first increased and then decreased during the single lightning current strike process, which was closely related to the conductive properties of the interlaminar resin. The inductive properties of the CFRP material were manifested in the test results, which showed that the voltage reached the peak value prior to the current waveform and the equivalent conductivities of the CFRPs increased as the rate of increase decreased and the duration increased. In addition, the equivalent inductance of the carbon fiber network was found to be an important part of the inductive effect of CFRP laminates. This research is helpful for understanding the complicated relationships in the lightning current conducting process and can provide experimental and theoretical support for CFRP coupled electrical–thermal simulation studies of lightning direct effects.
Changes in thiamine concentrations, fatty acid composition, and some other lipid-related biochemical indices in Baltic Sea Atlantic salmon (Salmo salar) during the spawning run and pre-spawning fasting
Authors: Vuorinen Pekka J. , Rokka Mervi , Ritvanen Tiina , Käkelä Reijo , Nikonen Soili , Pakarinen Tapani , Keinänen Marja
Published: August 2020

Salmonines in the Baltic Sea and North American lakes suffer from thiamine (vitamin B1) deficiency, which is connected to an abundant lipid-rich diet containing substantial amounts of polyunsaturated fatty acids (PUFAs). In the Baltic region, this is known as the M74 syndrome. It affects both adult salmon (Salmo salar) and especially their offspring, impairing recruitment. However, very little is known about the thiamine and lipid metabolism of salmon during feeding and spawning migrations in the Baltic Sea. In this study, salmon females were sampled along the spawning run from the southern Baltic Proper in four locations at sea and finally at spawning in a river at the Bothnian Bay in a year with insignificant M74 mortality. Changes in concentrations of thiamine and its components in muscle, ovaries, and the liver and other biochemical indices potentially relating to lipid and fatty acid metabolism were investigated. The results provide further evidence of the role of peroxidation of PUFAs in eliciting thiamine deficiency in salmon: During the entire spawning run, the muscle total lipid content decreased by 50%, palmitic acid (16:0) by 62%, and docosahexaenoic acid (DHA, 22:6n-3) by 45%. The concentration of total thiamine decreased significantly until the spawning in the liver and ovaries, 66 and 70% respectively. In the muscle, the proportion of thiamine pyrophosphate of total thiamine increased with the use of muscular lipid stores. There was no trend in the concentration of total carotenoids during the spawning run. The doubling of the concentration of hepatic malondialdehyde indicated peroxidation of PUFAs, and the mobilisation of body lipids suppressed the activity of glucose-6-phosphate dehydrogenase, as consumed dietary lipids would also have done.
Polymorphisms of brain-derived neurotrophic factor genes are associated with anxiety and body mass index in fibromyalgia syndrome patients
Authors: Nugraha Boya , Anwar Sumadi Lukman , Gutenbrunner Christoph , Korallus Christoph
Published: August 2020

Objective

Fibromyalgia syndrome has been associated with familial clusters although the specific genetic predisposition is not clear. Accordingly, studies concerning genetic factors associated with this disease are important. Brain-derived neurotrophic factor (BDNF) has been shown to play a role in patients with fibromyalgia syndrome, particularly in mediating manifestations of pain and mood-related symptoms. Research on genetic factors, including genetic variations or single nucleotide polymorphisms, especially related toBDNFin fibromyalgia is very limited. Therefore, this study was aiming at determining the association of polymorphisms ofBDNF, particularly rs2049046 (A>T) and rs7124442 (A>G), with body mass index (BMI) and mood-related symptoms in FMS.

Results

In fibromyalgia syndrome cases,BDNFpolymorphisms were associated with body mass index and anxiety score, specifically rs7124442 (A>G) (Fisher’s exact test χ2;p < 0.05; odds ratio (OR): 1.02) and rs2049046 (A>T) (Fisher’s exact test χ2;p < 0.05; OR: 0.55), respectively. Additionally, patients with fibromyalgia syndrome who have AA (95% CI (8.71, 11.63)) and AT (95% CI (9.32, 11.74)) alleles of rs2049046 showed higher score of anxiety compared to patients with TT (95% CI (3.98, 8.20) allele (ANOVA test;p < 0.01). These results suggest thatBDNFpolymorphisms (rs7124442 and rs2049046) are associated with body mass index and anxiety symptoms in patients with fibromyalgia syndrome.
HIF-1α overexpression in mesenchymal stem cell-derived exosomes mediates cardioprotection in myocardial infarction by enhanced angiogenesis
Authors: Sun Jiacheng , Shen Han , Shao Lianbo , Teng Xiaomei , Chen Yueqiu , Liu Xuan , Yang Ziying , Shen Zhenya
Published: August 2020

Background

Myocardial infarction (MI) is a severe disease that often associated with dysfunction of angiogenesis. Cell-based therapies for MI using mesenchymal stem cell (MSC)-derived exosomes have been well studied due to their strong proangiogenic effect. Genetic modification is one of the most common methods to enhance exosome therapy. This study investigated the proangiogenic and cardioprotective effect of exosomes derived from hypoxia-inducible factor 1-alpha (HIF-1α)-modified MSCs.

Methods

Lentivirus containing HIF-1α overexpressing vector was packaged and used to infect MSCs. Exosomes were isolated from MSC-conditioned medium by ultracentrifugation. Human umbilical vein endothelial cells (HUVECs) were treated under hypoxia condition for 48 h co-cultured with PBS, control exosomes, or HIF-1α-overexpressed exosomes, respectively. Then the preconditioned HUVECs were subjected to tube formation assay, Transwell assay, and EdU assay to evaluate the protective effect of exosomes. Meanwhile, mRNA and secretion levels of proangiogenic factors were measured by RT-qPCR and ELISA assays. In vivo assays were conducted using the rat myocardial infarction model. PBS, control exosomes, or HIF-1α-overexpressed exosomes were injected through tail vein after MI surgery. Heart function was assessed by echocardiography at days 3, 14, and 28. At day 7, mRNA and protein expression levels of proangiogenic factors in the peri-infarction area and circulation were evaluated, respectively. At day 28, hearts were collected and subjected to H&E staining, Masson’s trichrome staining, and immunofluorescent staining.

Results

HIF-1α-overexpressed exosomes rescued the impaired angiogenic ability, migratory function, and proliferation of hypoxia-injured HUVECs. Simultaneously, HIF-1α-overexpressed exosomes preserved heart function by promoting neovessel formation and inhibiting fibrosis in the rat MI model. In addition, both in vitro and in vivo proangiogenic factors mRNA and protein expression levels were elevated after HIF-1α-overexpressed exosome application.

Conclusion

HIF-1α-overexpressed exosomes could rescue the impaired angiogenic ability, migration, and proliferation of hypoxia-pretreated HUVECs in vitro and mediate cardioprotection by upregulating proangiogenic factors and enhancing neovessel formation.
Alternating double t-values and T-values
Authors: Quan Junjie
Published: August 2020

Recently, Hoffman (Commun. Number Theory Phys. 13:529–567, 2019), Kaneko and Tsumura (Tsukuba J. Math. (in press), 2020) introduced and systematically studied two variants of multiple zeta values of level two, i.e., multiplet-values and multipleT-values, respectively. In this paper, by the contour integration and residue theorem, we establish two general identities, which further reduce to the expressions of the alternating doublet-values andT-values. Some examples are also provided.
Assessment of a decentralized grid-connected photovoltaic (PV) / wind / biogas hybrid power system in northern Nigeria
Authors: Jumare Ismail Abubakar , Bhandari Ramchandra , Zerga Abdellatif
Published: August 2020

Electricity is considered a fundamental service which is highly correlated with sustainable development. Nigeria will serve as a case study that has been experiencing an energy deficit, and severely needs a strong adoption of alternative energy sources.

This paper provides a detailed assessment of a grid-connected photovoltaic/wind/biogas hybrid energy system in the northern part of Nigeria using a combined Hybrid Optimization Model for Electric Renewables (HOMER), Microsoft Excel, and Ganzleitliche Bilanz (GaBi) tools. They are based on techno-economic modeling and optimization as well as comparison with the same configuration in its off-grid form. Sensitivity analysis as well as an energy efficiency assessment of the proposed grid-connected system was carried out, followed by a supplementary economic benefit assessment of a system switch over and an evaluation of the impacts of life cycle emissions. A wrap-up reliability assessment based on the utility grid status quo and policy implications was also carried out.

The results of the analysis for the grid-connected system showed a 3% increase in the overall energy supply, and a 68% and 85% decrease in net present costs (NPC) and levelized costs of energy (LCOE), respectively, with avoided emissions as compared to its comparable off-grid configuration. Moreover, the energy efficiency (EE) determined for the proposed grid-connected system resulted in a massive reduction in the component sizing, energy supply, and an ultimate 88% and 81% reduction in overall NPC and LCOE, respectively. The sensitivity analysis as well as the other supplementary evaluations indicated clear impacts on the different performance measures.

This approach is worthy of adoption coupled with expansions for an effective solution to the energy deficit and its sustainability in the case study country. This could be successfully provided if all the reliability concerns for the utility grid and policy measures are addressed significantly.
Prevalence of healthcare-associated infections and antimicrobial use among inpatients in a tertiary hospital in Fiji: a point prevalence survey
Authors: Loftus M. J. , Curtis S. J. , Naidu R. , Cheng A. C. , Jenney A. W. J. , Mitchell B. G. , Russo P. L. , Rafai E. , Peleg A. Y. , Stewardson A. J.
Published: August 2020

Background

Healthcare-associated infections (HAIs) and antimicrobial use (AMU) are important drivers of antimicrobial resistance, yet there is minimal data from the Pacific region. We sought to determine the point prevalence of HAIs and AMU at Fiji’s largest hospital, the Colonial War Memorial Hospital (CWMH) in Suva. A secondary aim was to evaluate the performance of European Centre for Diseases Prevention and Control (ECDC) HAI criteria in a resource-limited setting.

Methods

We conducted a point prevalence survey of HAIs and AMU at CWMH in October 2019. Survey methodology was adapted from the ECDC protocol. To evaluate the suitability of ECDC HAI criteria in our setting, we augmented the survey to identify patients with a clinician diagnosis of a HAI where diagnostic testing criteria were not met. We also assessed infection prevention and control (IPC) infrastructure on each ward.

Results

We surveyed 343 patients, with median (interquartile range) age 30 years (16–53), predominantly admitted under obstetrics/gynaecology (94, 27.4%) or paediatrics (83, 24.2%). Thirty patients had one or more HAIs, a point prevalence of 8.7% (95% CI 6.0% to 12.3%). The most common HAIs were surgical site infections (n = 13), skin and soft tissue infections (7) and neonatal clinical sepsis (6). Two additional patients were identified with physician-diagnosed HAIs that failed to meet ECDC criteria due to insufficient investigations. 206 (60.1%) patients were receiving at least one antimicrobial. Of the 325 antimicrobial prescriptions, the most common agents were ampicillin (58/325, 17.8%), cloxacillin (55/325, 16.9%) and metronidazole (53/325, 16.3%). Use of broad-spectrum agents such as piperacillin/tazobactam (n = 6) and meropenem (1) was low. The majority of prescriptions for surgical prophylaxis were for more than 1 day (45/76, 59.2%). Although the number of handwashing basins throughout the hospital exceeded World Health Organization recommendations, availability of alcohol-based handrub was limited and most concentrated within high-risk wards.

Conclusions

The prevalence of HAIs in Fiji was similar to neighbouring high-income countries, but may have been reduced by the high proportion of paediatric and obstetrics patients, or by lower rates of inpatient investigations. AMU was very high, with duration of surgical prophylaxis an important target for future antimicrobial stewardship initiatives.
Ultrafast and accurate 16S rRNA microbial community analysis using Kraken 2
Authors: Lu Jennifer , Salzberg Steven L.
Published: August 2020

Background

For decades, 16S ribosomal RNA sequencing has been the primary means for identifying the bacterial species present in a sample with unknown composition. One of the most widely used tools for this purpose today is the QIIME (Quantitative Insights Into Microbial Ecology) package. Recent results have shown that the newest release, QIIME 2, has higher accuracy than QIIME, MAPseq, and mothur when classifying bacterial genera from simulated human gut, ocean, and soil metagenomes, although QIIME 2 also proved to be the most computationally expensive. Kraken, first released in 2014, has been shown to provide exceptionally fast and accurate classification for shotgun metagenomics sequencing projects. Bracken, released in 2016, then provided users with the ability to accurately estimate species or genus relative abundances using Kraken classification results. Kraken 2, which matches the accuracy and speed of Kraken 1, now supports 16S rRNA databases, allowing for direct comparisons to QIIME and similar systems.

Methods

For a comprehensive assessment of each tool, we compare the computational resources and speed of QIIME 2’s q2-feature-classifier, Kraken 2, and Bracken in generating the three main 16S rRNA databases: Greengenes, SILVA, and RDP. For an evaluation of accuracy, we evaluated each tool using the same simulated 16S rRNA reads from human gut, ocean, and soil metagenomes that were previously used to compare QIIME, MAPseq, mothur, and QIIME 2. We evaluated accuracy based on the accuracy of the final genera read counts assigned by each tool. Finally, as Kraken 2 is the only tool providing per-read taxonomic assignments, we evaluate the sensitivity and precision of Kraken 2’s per-read classifications.

Results

For both the Greengenes and SILVA database, Kraken 2 and Bracken are up to 100 times faster at database generation. For classification, using the same data as previous studies, Kraken 2 and Bracken are up to 300 times faster, use 100x less RAM, and generate results that more accurate at 16S rRNA profiling than QIIME 2’s q2-feature-classifier.

Conclusion

Kraken 2 and Bracken provide a very fast, efficient, and accurate solution for 16S rRNA metataxonomic data analysis.