bluuebunny/crossref_metadata_2025 huggingface dataset:
Citrullinated Antigens with Multiple Citrulline Similar Motif in the Diagnosis of Rheumatoid Arthritis: A Preliminary Single-Center Study
Authors: Chen Zhu , Fang Weiting , Qin Yi , Jin Yin-Zhao , Yang Xiang , Lou Jianrong
Published: August 2021

The presence of anti-citrullinated protein antibodies (ACPAs) in the serum is one of the immunological features of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide (CCP) assay has been widely used in clinic for the diagnosis of RA. However, up to 40% of RA patients are anti-CCP negative and the diagnostic sensitivity in this population needs to be improved for better clinical management. In this study, peptides with Multiple Citrulline Similar Motif (MCSM) were synthesized and a new ELISA system, which we called RA_CP, was developed to detect citrullinated antigens with MCSM present in the serum. 106 RA,48 other arthritis patients and 41 sex- and age-matched healthy controls (HCs) were included in this study. Patients with RA have a significantly higher amount of citrullinated antigens with MCSM than other arthritis patients and HCs. RA patients with positive anti-CCP are also MCSM positive, whereas 75% anti-CCP negative patients are positive for MCSM. The diagnostic sensitivity for anti-CCP and MCSM was 81.1% and 95.3%, while the specificity was 100% and 94.4%, respectively. ROC curve analyses showed that the area under the curve (AUC) values were 0.906 (95% CI: 0.860-0.951) for anti-CCP and 0.948 (95% CI: 0.912-0.985) for MCSM while the combination of MCSM and anti-CCP test has the highest AUC (0.971, 95% CI: 0.946–0.996). Our results suggest that detection of citrullinated antigens with MCSM has improved sensitivity compared with anti-CCP assay and could serve as a biomarker in diagnosis of RA patients.
Gold Nanoparticle: Recent Progress on Its Antibacterial Applications and Mechanisms
Authors: Tian Er-Kang , Wang Yue , Ren Ruiyang , Zheng Wenyue , Liao Wen
Published: August 2021

Gold nanoparticles (AuNP) is a new type of metal nanomaterials used in the biomedical field. Compared with ordinary metal materials and other metal nanomaterials, AuNP can be very unique. AuNP has been proven to have good performance against a variety of pathogens, and research on its antibacterial activity and mechanism has also become a hot topic in recent years. This article summarizes the antibacterial properties and clinical applications of AuNP against different kinds of bacteria and analyzes and discusses its existing and potential antibacterial mechanisms. At the same time, we also put forward the current challenges and problems to be solved by AuNP and look forward to its future development prospects, in order to correctly and comprehensively introduce this new antibacterial method.
On Two Banach-Type Fixed Points in Bipolar Metric Spaces
Authors: Gaba Yaé Ulrich , Aphane Maggie , Sihag Vizender
Published: August 2021

In this article, we propose two Banach-type fixed point theorems on bipolar metric spaces. More specifically, we look at covariant maps between bipolar metric spaces and consider iterates of the map involved. We also propose a generalization of the Banach fixed point result via Caristi-type arguments.
Characterization and Physical and Biological Properties of Tissue Conditioner Incorporated with Carum copticum L.
Authors: Hejazi Maryam , Zareshahrabadi Zahra , Ashayeri Sepideh , Saharkhiz Mohammad Jamal , Iraji Aida , Alishahi Mohsen , Zomorodian Kamiar
Published: August 2021

Aim. One of the main problems in dentistry is the injury caused by the long‐term application of an ill‐fitting denture. The existence of multiple microorganisms along with the susceptibility of the tissue conditioners to colonize them can lead to denture stomatitis. This study is aimed at developing a tissue conditioner incorporated with Carum copticum L. (C. copticum L.) for the effective treatment of these injuries. Materials and Methods. The Carum copticum L. essential oil composition was determined by gas chromatography‐mass (GC‐mass) spectrometry. The antimicrobial activity of the essential oil against the standard strains of bacterial and fungal species was determined by broth microdilution methods as suggested by the Clinical and Laboratory Standards Institute (CLSI). The physical and chemical properties of the prepared tissue conditioner were investigated by viscoelasticity, FTIR assays, and the release study performed. Furthermore, the antibiofilm activity of the Carum copticum L. essential oil‐loaded tissue conditioner was evaluated by using the XTT reduction assay and scanning electron microscopy (SEM). Results. The main component of the essential oil is thymol, which possesses high antimicrobial activity. The broth microdilution assay showed that the essential oil has broad activity as the minimum inhibitory concentration was in the range of 32‐128 μg mL-1. The viscoelasticity test showed that the essential oil significantly diminished the viscoelastic modulus on the first day. The FTIR test showed that Carum copticum L. essential oil was preserved as an independent component in the tissue conditioner. The release study showed that the essential oil was released in 3 days following a sustained release and with an ultimate cumulative release of 81%. Finally, the Carum copticum L. essential oil exhibited significant activity in the inhibition of microbial biofilm formation in a dose‐dependent manner. Indeed, the lowest and highest amounts of biofilm formation on the tissue conditioner disks are exhibited in the Streptococcus salivarius and Candida albicans by up to 22.4% and 71.4% at the 64 μg mL-1 concentration of C. copticum L. with a statistically significant difference (P < 0.05). Conclusion. The obtained results showed that the Carum copticum L. essential oil‐loaded tissue conditioner possessed suitable physical, biological, and release properties for use as a novel treatment for denture stomatitis.
Successful Treatment of Incomplete Susac Syndrome with Simultaneous Corticosteroids and Plasmapheresis Followed by Rituximab
Authors: Reedy Mick B. , Wang Yanping , Beinlich Brad R. , Rose William Nicholas
Published: August 2021

We present a case report of a patient with incomplete Susac syndrome. He had cognitive impairment, corpus callosum lesions, and vestibulocochlear dysfunction on brainstem auditory evoked responses. He was treated with methylprednisolone and plasmapheresis, improved, and then, also received rituximab. His improvement has been lasting as of this writing. This case shares our experience with a successful treatment of this rare condition that is incompletely understood and lacks well-established treatment guidelines.
Experimental Study on Creep Behavior and Crack Evolution of Stratified Structural Sandstone under Segmental Constant Load
Authors: Yang Yiran , Li Yanzhong , Pan Jiaojiao , Luo Tao , Lu Zidong
Published: August 2021

The hazards induced by stratified rock mass creep are still one of the major problems that threaten the safety of underground engineering. This paper takes safe construction of underground roadway in Urumqi mining area as the research background. In this study, we mainly adopted rock mechanics experiments to accomplish the research on creep behavior and crack evolution of stratified structural sandstone. Creep deformation characteristics of stratified structural sandstone under different load were revealed; also, we analyzed the reason why a part of rock samples failed but others were not under the same load. Creep behavior and crack evolution of rock samples without stratified structure have significant randomness. The crack evolution and failure characteristics of stratified structural rock samples were mainly manifested as failure along and cutting through structural plane and their combined forms. Creep strain, creep duration, and creep rate of rock samples with stratified structure had a nonlinear relationship with applied load, such as exponential function or logarithmic function. Understanding the evolutionary relationship between the above parameters and load provides a basis for obtaining the creep behavior of stratified rock mass under different load conditions.
Investigation on Shear Wave Velocity and Triaxial Mechanical Performance of Tailings Core from Tailings Dam
Authors: Luo Pengfei
Published: August 2021

The physical and mechanical parameters of tailings are important to study the stability of tailings dams (TDs). In this study, a series of laboratory experiments (shear wave velocity, triaxial compressive, and peak strain strength testing) were conducted to obtain the mechanical properties of tailings from TD. The results showed the following. (1) The linear function fitting could characterize the quantitative relationship between shear wave velocity and hole depth. (2) The corresponding static pressure coefficient increased as the confining pressure increased. The exponential fitting could characterize the quantitative function relation between the static pressure coefficient and the confining pressure. (3) The cohesion and internal friction angle of the tailings sample were 20 kPa and 41°, respectively, and the logarithmic fitting could better characterize the quantitative relation between shear peak strength and confining pressure. The results of this study can provide important references for further research on the stability of TD.
Transient Neonatal Diabetes Mellitus with the Rare Association of Nonsuppurative Sialadenitis and Genetic Defects in 6q24
Authors: Mustafa Manal , Ramdas Nitin , Elhalik Mahmoud , Faquih Arif
Published: August 2021

Background. Transient neonatal diabetes mellitus (TNDM) is the most common cause of diabetes in the first week of life, with an overall incidence of 1 in 90,000 to 160,000 live births. TNDM occurs soon after birth and undergoes spontaneous remission during infancy; however, it may relapse to a permanent form of diabetes mellitus in childhood or adolescence. We report a case of TNDM due to hypomethylation on chromosome 6q24, associated with a rare clinical finding of nonsuppurative submandibular sialadenitis managed by subcutaneous insulin, and who underwent remission by three months of age. Case Presentation. We report a male neonate of Arab ancestry delivered by caesarean section at 37 weeks of gestation. He had intrauterine growth retardation with a birth weight of 2.099 kg. He presented with hyperglycemia on the first day of life, which was managed with parenteral insulin infusion. Blood glucose control was initially difficult to achieve due to difficulties in preparing such small doses of insulin and the significant variations in blood glucose concentrations, without ketosis. Blood tests revealed low serum insulin and C-peptide levels. Genetic analysis revealed multiple loci hypomethylation of the PLAGL1/HYMAI-DMR in the TNDM region in chromosome 6q24 and two pathogenic heterozygous variants in the ZFP57 gene. Segregation analysis showed that both parents were heterozygous carriers of familial ZFP57 variants. The clinical course was associated with bilateral nonsuppurative sialadenitis, which is extremely rare among newborns. Conclusion. Sialadenitis is a well-known phenomenon that is rarely diagnosed in neonates. To the best of our knowledge, this is the first case report to describe the exceedingly rare association of nonsuppurative submandibular sialadenitis in a neonate with TNDM due to multiple loci hypomethylation of the PLAGL1/HYMAI-DMR in the TNDM region in 6q24 and heterozygous pathogenic variants in the ZFP57 gene.
Effects of Thermal Treatment on Mineral Composition and Pore Structure of Coal
Authors: Liu Bin , Teng Teng , Jiao Zhenhua , Li Shaobo
Published: August 2021

With the increasing depth of coalbed methane (CBM) exploitation, temperature becomes the main factor affecting the efficiency of CBM exploitation. The change of temperature has significant influence on the mineral composition and pore structure of coal. To study the effects of thermal treatment on mineral composition and pore structure of coal, X-ray diffraction (XRD) test, scanning electron microscopy (SEM) test, and mercury intrusion test were carried out for three groups of coal. The mineral composition and pore structure of coal specimens after thermal treatment (25, 50, 75, and 100°C) were analyzed. The results show that the main mineral compositions of three groups of coal specimens after different temperatures are basically unchanged, and the maximum diffracted intensity after different temperature treatments decreases first and then increases with the increasing temperature. The count of fissures decreases first and then increases with temperature, and the count of pores increases first and then decreases with the increasing temperature. The velocity of mercury injection in high pressure (100~400 MPa) of coal specimens increases first and then decreases with temperature. The porosity, pore area, median pore diameter, and average pore diameter increase with the increasing temperatures. The volume of microfracture decreases, then increases, and finally decreases. The volume of macropore and mesopore increases slowly, and that of transition pore decreases slowly with the increasing temperature. Meanwhile, the volume of micropore increases first and then decreases during the process of thermal treatment. The fractal dimension of pore size ranges from 2.6 to 2.9 and increases linearly with the increasing temperature.
Flow Mechanism and Strength Characteristics of Textile Reinforced Concrete Mixed with Colloidal Nano-SiO2
Authors: Xu Ping , Shi Rui , Wang Chao , Cui Yuhao , Zhang Minxia
Published: August 2021

In order to develop textile reinforced concrete (TRC) with good flowability and strength, colloidal nano-SiO2 (CNS) is adopted to improve the performance of TRC. The flowability, compressive strength, flexural strength, and four-point bending tests of TRC matrix with CNS are carried out, and the changes of internal micromorphological characteristics of TRC matrix are analyzed by combining with scanning electron microscopy. The results show that the CNS has an inhibitory effect on the flowability of TRC matrix, and the greater the amount of admixture is, the smaller the slump expansion of TRC matrix is. The compressive strength and flexural strength of TRC matrix show a trend of increasing and then decreasing as the amount of CNS increases, and the compressive strength reaches the maximum at each age (7 d, 14 d, 28 d) when CNS and silica fume replace 5% cement by 1 : 4 equal mass. The flexural strength reaches the maximum at each age (7 d, 14 d, 28 d) when 5% cement is replaced by CNS and silica fume with 3 : 7 equal mass. The flexural strength increases with the increase of CNS admixture. It is found by electron microscope scanning that the incorporation of CNS consumes more Ca(OH)2, refines the Ca(OH)2 crystal size, and generates more C-S-H gels. These C-S-H gels are distributed in a net-like pattern inside the concrete, filling the internal pores, effectively densifying the interfacial transition zone between the cementitious material and the aggregates, and optimizing the internal structure.
Biomechanical Characteristics on the Lower Extremity of Three Typical Yoga Manoeuvres
Authors: Whissell Elizabeth , Wang Lin , Li Pan , Li Jing Xian , Wei Zhen
Published: August 2021

This study was aimed at exploring the biomechanical characteristics of the lower extremity amongst three typical yoga manoeuvres. A total of thirteen experienced female yoga practitioners were recruited in the current study; they were all certified with the Yoga Alliance. A three-dimensional motion capture system with 10 cameras combined with four synchronised force plates was used to collect kinematics of the lower extremity and ground reactive force whilst the participants performed the crescent lunge pose, warrior II pose, and triangle pose. One-way repeated ANOVA was used in exploring the differences amongst the three yoga movements, and the significance was set to

alpha
<
0.05

. The triangle pose performed the largest range of motion (ROM) of the hip (

90.5

°

±

22.9

°

), knee (

68.8

°

±

23.1

°

), and ankle (

46.4

°

±

11.3

°

) in the sagittal plane and the hip (

54.8

°

±

6.5

°

), knee (

42.4

°

±

12.8

°

), and ankle (

4.8

°

±

1.7

°

) in the frontal plane amongst the three manoeuvres (

P
<
0.05

). No significant difference was found for the hip and ankle joint moment amongst the three manoeuvres (

P
>
0.05

). Knee joint travelled into 9.5° of extension and slight adduction of 1.94° whilst expressing the largest knee joint adduction moments (

0.30
±
0.22
 
Nm
/
kg

) in the triangle pose. The distribution of the angular impulse of the lower limb joints indicated that the hip joint contributed significantly the most in the sagittal and frontal planes of the three yoga manoeuvres (

P
<
0.05

), ranging from 51.67% to 70.56%. Results indicated that triangle pose may be superior to the other two manoeuvres, which improved hip joint ROM, strength, and dynamic stability. However, knee injuries such as osteoarthritis (OA) should be considered because of the large knee extensor angle and adductor moments.
Mathematical and Numerical Calculation of the Interlayer Slip of a Two-Layer Glued Beam
Authors: Doumia Benoît , Sanda Abo Omarou , Nwagoum Tuwa Peguy Roussel , Woafo Paul
Published: August 2021

This study analyses the spatial variation of the deflection, rotation, and slip at the interface of two-layer bamboo scrimber-concrete composite beam simply supported under uniform transverse load on its entire length. The Timoshenko model is considered, and the equations are solved using the analytical methods and direct numerical simulation based on finite differences schemes and a Fortran code. The results obtained show that it is a good agreement between the results from the mathematical calculation and those obtained from the numerical simulation.
Friend or Foe? Spontaneous Portosystemic Shunts in Cirrhosis—Current Understanding and Future Prospects
Authors: Rajesh Sasidharan , Philips Cyriac Abby , Ahamed Rizwan , Abduljaleel Jinsha K , Nair Dinu Chandran , Augustine Philip
Published: August 2021

Portal hypertension (PHT) in cirrhosis results from increased resistance to splanchnic blood flow secondary to parenchymal and vascular changes within the liver. In an attempt to counteract the increased portal pressure, two mechanisms simultaneously occur: splanchnic vasodilatation and formation of spontaneous portosystemic shunts (SPSS). Long considered to be a compensatory mechanism to decompress the portal venous system, it is now well established that SPSS are not only inefficient in decreasing the portal pressure but also contribute to reduced hepatocyte perfusion and increased splanchnic blood flow and resistance, associated with worsening PHT. Recent studies have described a high prevalence of SPSS in cirrhosis patients, increasing with liver dysfunction, and observed an association between the presence of SPSS and worse clinical outcomes. In cirrhosis patients with preserved liver functions, the presence of SPSS independently increases the risk of hepatic encephalopathy, variceal bleeding, and ascites, and reduces transplant-free survival. Moreover, the presence of SPSS in patients undergoing transjugular intrahepatic portosystemic shunting and liver transplant has been shown to variably affect the postprocedural outcome. This article provides an overview of the current understanding of the role of SPSS in the natural history of liver cirrhosis and their status as a therapeutic target and an imaging biomarker to identify patients at higher risk of developing complications of PHT.
Efficacy of Sorafenib Combined with Interventional Therapy on Primary Liver Cancer Patients and Its Effect on Serum AFP, VEGF, and GGT
Authors: Jia Ying , Xing Yufei , Yang Meitian
Published: August 2021

Objective. To explore the efficacy of sorafenib combined with interventional therapy on primary liver cancer (PLC) patients and its effect on serum AFP, VEGF, and GGT. Methods. 120 PLC patients admitted to our hospital from January 2016 to January 2020 were selected as the research object and divided into group A and group B according to the admission order, with 60 cases each. Interventional therapy was performed to both groups, and sorafenib was given to group A additionally to compare their treatment effect, survival, adverse reaction rate (ARR), and serum AFP, VEGF, and GGT levels. Results. After treatment, group A obtained significantly higher objective remission rate (ORR) and disease control rate (DCR) (

p
<
0.05

), higher one-year survival rate and two-year survival rate (

p
<
0.05

), lower ARR of skin reactions, gastrointestinal reactions, hepatorenal reactions, and hyperbilirubinemia (

p
<
0.05

), and lower serum AFP, VEGF, and GGT levels (

p
<
0.001

). Conclusion. The combination of sorafenib and interventional therapy can inhibit the growth and migration of PLC, improve the immune function, prolong the survival period of patients, and lower ARR, so it should be promoted in practice.
Physical Activity, Obesity, and Hypertension among Adults in a Rapidly Urbanised City
Authors: Dun Qianqian , Xu Wanglin , Fu Maozhen , Wu Nengjian , Moore Justin B. , Yu Ting , Li Xin , Du Yating , Zhang Biao , Wang Qiaomai , Duan Yiting , Meng Ziqi , Tian Shuangshuang , Zou Yuliang
Published: August 2021

Background. Few studies have explored the relationship between the level of physical activity and the occurrence or prevalence of obesity and hypertension among people residing in urbanised areas. Method. A cross-sectional study involving a sample of 1,001 adults was conducted. Descriptive statistics were used to describe sociodemographic variables, physical activity levels, body mass index (BMI), and prevalence of hypertension. Logistic regression models were adopted to investigate the relationship between these factors. Results. A total of 939 respondents who provided valid responses were included. Among them, 56.5% of the participants reported engaging in high levels of physical activity. However, 40.4% of the respondents were classified as overweight or obese, and 31.9% had diagnosed hypertension. After adjusting for sociodemographic factors, logistic regression analysis revealed that physical activity levels were negatively correlated with the prevalence of BMI (OR = 0.564, 95% CI: 0.352–0.905; OR = 0.583, 95% CI: 0.375–0.907) and hypertension (OR = 0.556, 95% CI: 0.348–0.888). Conclusions. Our study confirms recent evidence regarding the amount of physical activity that is associated with lower prevalence of obesity and hypertension in Pingshan District. Furthermore, different physical activities of various intensity levels had different effects on hypertension. Residents should be encouraged to engage in physical activities and maintain a healthy weight to improve their quality of life.
Modified Arytenoid Adduction Operation for the Treatment of Unilateral Vocal Fold Paralysis
Authors: Liu Chao , Qiu Yuanzheng , Zhang Xin , Liu Yong , Li Guo , Huang Donghai
Published: August 2021

Introduction: Unilateral vocal fold paralysis (UVFP) was a relative common glottic insufficiency disease; however, a completely satisfactory treatment of UVFP was elusive. This study was aimed to evaluate the surgical efficacy of modified arytenoid adduction with fenestration of the thyroid cartilage in the management of patients with UVFP, including voice and aspiration outcomes, and to summarize the postoperative complications. Methods: A retrospective analysis was performed on a total of 21 patients who underwent modified arytenoid adduction operation with fenestration of the thyroid cartilage for UVFP from July 2012 to June 2017. The scores of Grade, Roughness, Breathiness, Asthenia, Strain scale (GRBAS), voice self-satisfaction, dynamic laryngoscopy and the voice acoustic data (fundamental frequency [F0], fundamental frequency perturbation [jitter], loudness, amplitude perturbation [shimmer], and maximal phonatory time [MPT], etc.) were statistically analyzed preoperatively and 3–6 months postoperatively. The occurrence of postoperative complications was also summarized. Results: The voice subjective perception of 21 patients was significantly improved after operation. The rate of voice self-satisfaction was 90.5%. The mean values of voice acoustics parameters were significantly improved. The MPT was significantly longer (p < 0.001), and the ratings of postoperative aspiration were significantly decreased compared with the preoperation. Among the 21 patients, 15 cases had sense of laryngeal obstruction, 8 cases had of 1–2° laryngemphraxis (recovered after 10–15 days). There were 2 cases of laryngeal stridor, 1 case of incision infection, 1 case of pharyngeal fistula, and 1 case of falsetto (corrected by voice training). No patient had laryngeal hematoma, neck hematoma, or laryngospasm. Conclusion: The modified arytenoid adduction operation with fenestration of the thyroid cartilage can significantly improve the vocal function of patients with UVFP and effectively reduce the aspiration, with fewer postoperative complications, less trauma, and more convenient advantages.
Converting and Standardizing Various Measures of Arterial Stiffness to Pulse Wave Velocity
Authors: Alhalimi Taha , Lim Jisok , Gourley Drew , Tanaka Hirofumi
Published: August 2021

Background: A variety of arterial stiffness measures have been used to assess the impacts of disease states and various interventions without clear consensus among them. One of the primary problems faced by investigators conducting systematic reviews and meta-analyses is the lack of standardized methodology with a same unit to evaluate and compare investigations using different arterial stiffness measures. Therefore, the purpose of this study was to derive and summarize standardized equations to convert commonly used image-based measures of arterial stiffness to local pulse wave velocity (PWV). Methods: We first conducted a literature search to obtain and summarize conversion equations in the published literature such that these equations can be found in one convenient location. Then, we generated regression equations using the data collected in a well-controlled laboratory-based study, in which all measures of arterial stiffness were obtained in 49 apparently healthy participants. Results: All literature-based conversion equations produced similar local PWV values and were moderately and significantly correlated with directly measured carotid-femoral PWV (cfPWV) with a Pearson’s r ranging from 0.41 to 0.50. The local PWV using laboratory-based equations were modestly associated with cfPWV (r = 0.39–0.49) with an exception of incremental elastic modulus (r = 0.15, p > 0.05). Conclusion: Commonly used measures of ultrasound-based arterial stiffness can be converted to local PWV and compared with a reference standard measure of arterial stiffness.
Utility of the Novel SpyGlassTM DS II System and Laser Lithotripsy for Choledocholithiasis in Pregnancy
Authors: Dalal Ankit , Patil Gaurav , Kamat Nagesh , Daftary Rajen , Vora Sehajad , Maydeo Amit
Published: August 2021

Background and Aim: Endoscopic retrograde cholangiopancreatography (ERCP) is considered a safe therapeutic modality even in pregnant women; however, adequate care needs to be taken. The utility of the SpyGlassTM DS II system in choledocholithiasis among pregnant women is unexplored. Methods: We retrospectively analyzed patients who underwentERCP for choledocholithiasis in the absence of fluoroscopy using the SpyGlass DS II system from October 2019 to November 2020. Depending on the size and location of the stones, we used laser lithotripsy (LL) for large impacted stones, the balloon extraction technique for multiple stones, and the SpyGlass retrieval basket for single solitary stones. Results: A total of 10 (100% female) patients with a mean (±SD) age of 29.5 (±2.5) years underwent ERCP. Abdominal pain was the commonest presenting symptom in all patients. Four (40%) patients had cholangitis and 3 (30%) had pancreatitis. The majority of the patients (9; 90%) were in the second trimester. MRCP was the commonest radiological entity, used in 9 (90%) patients. ERCP was technically successful and the stones were removed from all of the patients in a mean (±SD) time of 30 (±3.5) min. LL was used successfully in 4 (40%) patients, balloon extraction in 3 (30%) patients, and the SpyGlass retrieval basket in 3 (30%) patients. There were no pre- or post-procedural complications. All of the patients had an uneventful childbirth, after which they underwent cholecystectomy and subsequent stent removal 2 weeks later. Conclusions: Use of the SpyGlass DS II system and LL during ERCP appears safe and effective for the treatment of choledocholithiasis among pregnant women.
Retreatment of Irinotecan in Later Lines of Therapy for Metastatic Colorectal Cancer: A Retrospective Study
Authors: Choi Moon Ki , Cha Yongjun , Baek Ji Yeon
Published: August 2021

Background: Due to few efficacious options in later lines of therapy in metastatic colorectal cancer (mCRC), there has been considerable interest in the possibility of retreatment with previously administered agents. This study investigated the efficacy and safety of irinotecan retreatment (IRI2) in patients with refractory mCRC. Methods: We performed a retrospective analysis of patients with mCRC who were retreated with irinotecan-based regimens. The retreatment regimens with anti-epidermal growth factor receptor therapies were excluded. Results: A total of 64 patients were included. Patients had a median age of 56 years and were offered mainly in the setting of third- or fourth-line therapy with IRI2. The disease control rate was 78.2% including an objective response of 23.5%. Median progression-free survival and overall survival were 5.5 and 19.3 months, respectively. The most frequent grade 3 or higher toxicities were nausea/vomiting (27.9%) and neutropenia (25%). Conclusion: IRI2 might be a reasonable option for heavily pretreated patients with mCRC who achieved disease control with prior irinotecan therapy.
Pediatric Moderate-Severe Traumatic Brain Injury and Gray Matter Structural Covariance Networks: A Preliminary Longitudinal Investigation
Authors: Tuerk Carola , Dégeilh Fanny , Catroppa Cathy , Anderson Vicki , Beauchamp Miriam H.
Published: August 2021

Pediatric traumatic brain injury (TBI) is prevalent and can disrupt ongoing brain maturation. However, the long-term consequences of pediatric TBI on the brain’s network architecture are poorly understood. Structural covariance networks (SCN), based on anatomical correlations between brain regions, may provide important insights into brain topology following TBI. Changes in global SCN (default-mode network [DMN], central executive network [CEN], and salience network [SN]) were compared sub-acutely (<90 days) and in the long-term (approximately 12–24 months) after pediatric moderate-severe TBI (n = 16), and compared to typically developing children assessed concurrently (n = 15). Gray matter (GM) volumes from selected seeds (DMN: right angular gyrus [rAG], CEN: right dorsolateral prefrontal cortex [rDLPFC], SN: right anterior insula) were extracted from T1-weighted images at both timepoints. No group differences were found sub-acutely; at the second timepoint, the TBI group showed significantly reduced structural covariance within the DMN seeded from the rAG and the (1) right middle frontal gyrus, (2) left superior frontal gyrus, and (3) left fusiform gyrus. Reduced structural covariance was also found within the CEN, that is, between the rDLPFC and the (1) calcarine sulcus, and (2) right occipital gyrus. In addition, injury severity was positively associated with GM volumes in the identified CEN regions. Over time, there were no significant changes in SCN in either group. The findings, albeit preliminary, suggest for the first time a long-term effect of pediatric TBI on SCN. SCN may be a complementary approach to characterize the global effect of TBI on the developing brain. Future work needs to further examine how disruptions of these networks relate to behavioral and cognitive difficulties.
Neoplasm Reports in Food and Drug Administration Adverse Event Reporting System Following Angiotensin Receptor Blocker Recalls
Authors: Cohen Sedgh Robert , Moon Jungyeon , Jackevicius Cynthia A.
Published: August 2021

Background:

A worldwide voluntary recall of valsartan in July 2018 due to the potential carcinogen N-nitrosodimethylamine received extensive media and public attention. This was followed by more Food and Drug Administration (FDA) recalls regarding other contaminated ARB (angiotensin receptor blocker) products. Our study investigated the association between the FDA recalls and ARB neoplasm adverse events (AEs) reported to the FDA adverse event reporting system.

Methods:

In this cross-sectional study, data were retrospectively collected from the FDA adverse event reporting system database from January 2015 to December 2019. Reporting odds ratios (RORs) were estimated to detect signals of association between ARBs (valsartan, irbesartan, and losartan) and reported neoplasm AEs using negative (amoxicillin and sertraline) and positive (omeprazole and ranitidine) control exposures. The χ
2
was used to compare categorical variables.

Results:

A total of 2 181 524 AEs, including 10 461 nonmetastatic neoplasm AEs were analyzed. Monthly RORs (95% CI) of valsartan-associated neoplasms versus controls (ROR*: valsartan/negative exposures; ROR†: valsartan/omeprazole; and ROR‡: valsartan/ranitidine) showed the highest signals after the recall date in July 2018 (7.64 [4.78–12.19]*; 4.77 [3.36–6.79]†; 4.13 [2.50–6.84]‡) and August 2018 (7.87 [5.19–11.94]*; 5.65 [4.12–7.75]†; and 7.20 [4.46–11.63]‡). In contrast, the highest cancer signals for the irbesartan and losartan recalls detected in March 2019 (4.80*; 4.06†; and 3.38‡) and April 2019 (3.63*; 3.69†; and 2.52‡) respectively, were lower. One-year postrecall reported neoplasm AEs were ≈2-fold higher for valsartan than irbesartan (OR, 1.77 [95% CI, 1.47–2.13],
P
<0.0001) and losartan (OR, 2.07 [95% CI, 1.85–2.32],
P
<0.0001). Although all ARBs had the same nitrosamine contamination, we found 1-year postrecall versus prerecall cancer signals for valsartan were 3-fold higher versus control exposures, while the changes in RORs for irbesartan and losartan were only 20-30% higher.

Conclusions:

Significantly more postrecall neoplasms were reported for valsartan, with higher valsartan-associated cancer signals compared with irbesartan and losartan, although they all contained the same carcinogenic contaminant. Extensive media coverage of the FDA valsartan recall may have alarmed patients and generated these abrupt, biologically infeasible cancer signals.
atg7
-Based Autophagy Activation Reverses Doxorubicin-Induced Cardiotoxicity
Authors: Wang Yong , Lu Xiaoguang , Wang Xiaoping , Qiu Qi , Zhu Ping , Ma Lin , Ma Xiao , Herrmann Joerg , Lin Xueying , Wang Wei , Xu Xiaolei
Published: August 2021

Rationale:

Anthracycline-induced cardiotoxicity (AIC) is a major side effect that limits the use of anthracyclines as effective chemotherapeutics. No mechanism-based therapy is available when cardiac function deteriorates.

Objective:

We aim to elucidate the dynamic autophagic defects in AIC and to identify a mechanism-based therapy via both genetic and pharmacological studies.

Method and Results:

Through phenotyping an adult AIC zebrafish model, we detected a biphasic response in autophagy: activation in the early stage and suppression in the later phase that is characterized by a decline in cardiac function. We conducted conditional genetic studies with
atg7
, which encodes a rate-limiting autophagy core protein, and found that
atg7
overexpression leads to therapeutic effects in the late phase but deleterious effects in the early phase of adult AIC. We then assessed the therapeutic effects of 37 Food and Drug Administration–approved autophagy activators using an embryonic AIC zebrafish model and identified spironolactone, pravastatin, and minoxidil as top-ranking drugs. We demonstrated the therapeutic efficacy of these Food and Drug Administration–approved autophagy activators in the adult AIC model and confirmed that these drugs exert therapeutic effects in the late phase but not in the early AIC phase. Finally, we demonstrated that the time-dependent therapeutic effects are conserved in a mouse AIC model and that spironolactone and rapamycin activated autophagy in an Atg7-dependent fashion.

Conclusions:

Our findings suggest that atg7-based autophagy activation is an effective therapeutic avenue to reversing the decline in cardiac function in AIC, highlighting the time-dependent nature of autophagy-based therapy.
Regime Stability and the Persistence of Traditional Practices
Authors: Poyker Michael
Published: August 2021

I examine why the harmful tradition of female genital mutilation (FGM) persists in certain countries but in others it has been eradicated. People are more willing to abandon their traditions if they are confident that the government is durable enough to set up long-term replacements for them. Using a country-ethnicity panel data set spanning 23 countries from 1970 to 2013 and artificial partition of African ethnic groups by national borders, I show that a one-standard-deviation larger increase in political regime durability leads to a 0.1-standard-deviation larger decline in the share of newly circumcised women, conditional on the presence of an anti-FGM government policy.
Skill Versus Voice in Local Development
Authors: Casey Katherine , Glennerster Rachel , Miguel Edward , Voors Maarten
Published: August 2021

Where the state is weak, traditional authorities control the local provision of public goods. These leaders come from an older, less educated generation and often rule in an authoritarian and exclusionary fashion. This means the skills of community members may not be leveraged in policymaking. We experimentally evaluate two solutions to this problem in Sierra Leone: one encourages delegation to higher-skill individuals, and a second fosters broader inclusion in decision making. In a real-world infrastructure grants competition, a public nudge to delegate led to better outcomes than the default of chiefly control, whereas attempts to boost participation were largely ineffective.
Valuing Domestic Transport Infrastructure: A View from the Route Choice of Exporters
Authors: Fan Jingting , Lu Yi , Luo Wenlan
Published: August 2021

A key input to quantitative evaluations of transport infrastructure projects is their impact on transport costs. We propose a new method of estimating this impact relying on widely accessible customs data: by using the route choice of exporters. We combine our method with a spatial equilibrium model to study the effects of the massive expressway construction in China between 1999 and 2010. We find transport costs are 20% lower on expressways than on regular roads. The expressways construction increases aggregate exports by 10% and domestic trade by 14%. It generates 5.1% welfare gains, implying a 150% net return to investment.
Bootstrap Inference for Quantile Treatment Effects in Randomized Experiments with Matched Pairs
Authors: Jiang Liang , Liu Xiaobin , Phillips Peter C. B. , Zhang Yichong
Published: August 2021

This paper examines methods of inference concerning quantile treatment effects (QTEs) in randomized experiments with matched-pairs designs (MPDs). Standard multiplier bootstrap inference fails to capture the negative dependence of observations within each pair and is therefore conservative. Analytical inference involves estimating multiple functional quantities that require several tuning parameters. Instead, this paper proposes two bootstrap methods that can consistently approximate the limit distribution of the original QTE estimator and lessen the burden of tuning parameter choice. Most especially, the inverse propensity score weighted multiplier bootstrap can be implemented without knowledge of pair identities.
Long-Term Care Hospitals: A Case Study in Waste
Authors: Einav Liran , Finkelstein Amy , Mahoney Neale
Published: August 2021

There is substantial waste in U.S. healthcare but little consensus on how to combat it. We identify one source of waste: long-term care hospitals (LTCHs). Using the entry of LTCHs into hospital markets in an event study design, we find that most LTCH patients would have counterfactually received care at Skilled Nursing Facilities—facilities that provide medically similar care but are paid significantly less—and that substitution to LTCHs leaves patients unaffected or worse off on all dimensions we can objectively measure. Our results imply Medicare could save about $4.6 billion per year by not allowing discharge to LTCHs.
The Effects of Career and Technical Education: Evidence from the Connecticut Technical High School System
Authors: Brunner Eric J. , Dougherty Shaun M. , Ross Stephen L.
Published: August 2021

We examine the effect of attending stand-alone technical high schools in Connecticut using regression discontinuity. Male students are 10 percentage points more likely to graduate from high school and have half a semester less time enrolled in college. Male students have 32% higher average quarterly earnings. Earnings effects may in part reflect general skills: male students have higher attendance rates and test scores, industry fixed effects explain less than one-third of earnings gains, and large earnings gains persist past traditional college going years. Attending a technical high school does not affect the outcomes of female students.
The Missionaries of Africa and the Rwandan Genocide
Authors: Denis Philippe
Published: August 2021

On the basis of documentary evidence, this paper examines the position of the Missionaries of Africa, also known as White Fathers, in political and ethnic matters during the buildup to the genocide in Rwanda, the genocide itself, and the postgenocide period. It argues that the Missionaries of Africa responded to the genocide in different ways. Some, especially those who returned to Rwanda after 1994, recognised the errors done by the church and tried to restart their ministry on a new foundation. However, many, particularly in Belgium, the country from where half of them originated, adopted a more defensive attitude. They subscribed, explicitly or not, to the double genocide theory according to which the crimes of the Rwandan Patriotic Front equalled or even surpassed those of the Rwandan authorities and the militias during the genocide. On the whole, the General Council of the congregation in Rome reacted to the Rwandan situation in a nonpartisan manner.
Revision of the genera Habetia Kirby, 1906 and Parahabetia gen. nov. from New Guinea (Orthoptera, Tettigoniidae, Conocephalinae, Agraeciini)
Authors: INGRISCH SIGFRID
Published: August 2021

The genus Habetia Kirby, 1906 previously known from only four species or subspecies is revised based on unidentified specimens found in museum collections. H. multispinulosa Griffini, 1908 is given full species status, while H. pictifrons Karny, 1911 is removed from Habetia based on male and female characters and becomes the type species of the new genus Parahabetia gen. nov. Sixteen new species are described in Habetia, and one new species and two new subspecies in Parahabetia. The most significant characters for the differentiation of species of Habetia are male tenth abdominal tergite, cerci, subgenital plate, and male internal genitalia with the titillators that basically form a pair of roughly U-shaped sclerites that vary between species from simple, curved sclerites to modified structures with additional sclerotized branches and the sclerites can be connected with septa to form complex shapes. In contrast, males of Parahabetia have elongate titillators provided at end with a crest. In the larger species of Habetia the stridulatory file on the underside of the male left tegmen has a step in pre-apical area that is missing in the smaller species; one species with a weak step is intermediate between both groups. Unique modifications of single species in Habetia are an apical dorsal extension of the male subgenital plate in H. imitatrix Karny, 1912 and a hardened phallus sheath between phallus and subgenital plate in H. tuta sp. nov. Females of Habetia have straight ovipositors that vary in length and in the shape of the dorsal margin between species. Females can also be differentiated by species specific modifications of the subgenital plate. In Parahabetia the ovipositor is rather short and curved similar to the condition in the genus Philmontis Willemse, 1966 but has the apical area slightly recurved. Keys to the species of both genera are provided. Habetia species have been found throughout New Guinea except so far for Papua Barat; although they were mainly found in the North and the East. Parahabetia species are currently only known from the East of New Guinea. The following species and subspecies are described as new: Habetia bivittata sp. nov., H. curvata sp. nov., H. dentata sp. nov., H. elevata sp. nov., H. kondiu sp. nov., H. lalibu sp. nov., H. nigricauda sp. nov., H. pallida sp. nov., H. pedala sp. nov., H. pilleata sp. nov., H. pinnigera sp. nov., H. quatrispina sp. nov., H. simbai sp. nov., H. sororcula sp. nov., H. tuta sp. nov., H. wau sp. nov., Parahabetia bispinosa sp. nov., P. pictifrons obtusa ssp. nov., P. pictifrons acuta ssp. nov.
A new species and taxonomic changes relating to the Notodontidae (Lepidoptera) of Trinidad, West Indies
Authors: COCK MATTHEW J.W.
Published: August 2021

In preparation for a general account of the Notodontidae of Trinidad and Tobago, the following taxonomic acts are required. Apella [sic] ovalis Rothschild, 1917 (Notodontidae) is transferred to the combination Lephana ovalis (Rothschild) comb. nov. (Erebidae, Anobinae). Crinodes insularis Rothschild, 1917 stat. nov. is removed from synonymy with C. fuscipennis Rothschild, 1917. Oligocentria brunnipennis Kaye, 1923 stat rev. is reinstated as a valid species. The following are new synonyms: Anoba suffusa Hampson, 1924 syn. nov. of Lephana muffula Guenée, 1852 (Erebidae, Anobinae); Farigia xenopithia Druce, 1911 syn. nov. of F. magniplaga Schaus, 1905; Oligocentria guianensis Thiaucourt, 2015 syn. nov. of Oligocentria brunnipennis Kaye, 1923; Skaphita aroensis (Schaus, 1901) and S. sexnotata (Kaye, 1925) syn. nov. of S. cubana (Grote, 1865). The holotype of S. kalodonta (Kaye, 1923) is recognised. Skaphita indirae sp. nov. is described from Trinidad.
Four new Neotropical species of Episcepsis Butler, 1877 (Lepidoptera: Erebidae: Arctiinae)
Authors: MANTILLA KARLA , GRADOS JUAN
Published: August 2021

The genus Episcepsis Butler, 1877 is widely distributed in the Neotropical region and currently includes 43 valid species many of them described solely based on external morphology. The existence of species complexes makes their identification difficult without examination of genital morphology. Four new species from Brazil, Cuba and Peru are described herein; Episcepsis andina sp. nov., E. diversa sp. nov., E. insularis sp. nov. and E. travassosi sp. nov. Comparisons with other similar species as well as photographs of external morphology and male genitalia are provided.
Review of the genus Merarius Fairmaire (Coleoptera: Anthribidae), with description of two new species from China
Authors: TRÝZNA MILOŠ , BAŇAŘ PETR
Published: August 2021

The genus Merarius (Anthribidae: Anthribinae: Tropiderini) from the Oriental and Palaearctic regions is reviewed. Two new species, M. alexandrae Trýzna & Baňař sp. nov. and M. korinae Trýzna & Baňař sp. nov., from China are described. Male and female genitalia of M. korinae are studied and illustrated. A key to the now five known species of the genus, colour photographs and new data on distributions are provided.