bluuebunny/crossref_metadata_2025 huggingface dataset:
IPO Underpricing and Media Sentiments: Avenue Supermarts and Vaswani Industries
Authors: Gupta Vikas , Singh Shveta , Yadav Surendra S.
Published: March 2020

This case tries to analyse the impact of media sentiments on Initial Public Offering (IPO) underpricing. To delve deeper into the concept, two firms (Avenue Supermarts and Vaswani Industries Limited) are considered in this case, and the significance of media sentiments on IPO underpricing is highlighted. Through these two real-life examples, the case could show that the manner in which media reports an IPO can significantly impact their first-day returns. 1 This highlights the emerging role of qualitative data apart from quantitative data in explaining the dilemma of IPO underpricing. This case will try to encourage the discussion in the class regarding the role of media in explaining the reasons for high over/under priced IPOs. This facilitates discussion on the emerging role of behaviour finance in decision-making. This case also provides new learning to students regarding dealing with qualitative data in finance and basics of sentiment analysis.

Dilemma: How to match the expectation of the market for pricing of an IPO.

Theory: Information asymmetry

Type of the case: Decisional and applied

Protagonist: Not needed

Options

Underwriters can price the IPO below the price institutional investors are ready to pay or above it.

Discussions and Case Questions

What is the role of institutional investors? What will happen if the locking period is waived for the institutional investors? What are the sources of information for retail investors? Describe the role of media in influencing the sentiment of small investors.
Danone India: The Challenges of Expanding into an Emerging Market
Authors: Pandey Pallavi , Yadav Rambalak
Published: March 2020

The case is about struggles of Danone India, a French based firm that envisioned high stakes in the Indian dairy market but had to exit early due to its inability to adapt to the Indian market conditions. The firm had a vision of “giving fresh impetus to the business and conquering the world” that transcended boundaries by providing healthier dairy products to the customers. Danone plans to expand into emerging markets by 2020, an endeavor driving 12 percent of its dairy business. The 22-billion-USD French food giant entered in India in the year 2010. It forayed into India’s dairy market with milk products such as flavored yogurt, buttermilk, cold coffee, curd, and smoothies. Danone was known to excel in its nutrition-based products, which were more than 90 percent of the business in India. However, having covered 200,000 retail outlets in 20 cities once, Danone struggled to expand and failed to capture the Indian dairy market, leading to its exit in 2018.

Dilemma:

How much will the nutritional product market get affected by Danone’s decision to quit the milk product market?

Theory:

Environment scanning and selecting the right strategy to quit Type of the case: Observation-based applied single case study

Protagonist:

Not needed. Case written with information drawn from secondary sources

Options:

Out of the various exit strategies such as acquisition, merger, IPO, or shutting down operations, why did Danone choose the last option?

Discussions and case questions:

The case discusses the reasons for the failure of the Danone milk business in India. Was pricing the most dominant factor behind the exit of Danone from India? Further, the case also discusses what lessons Danone should learn from its milk segment failure in India that may help it grow in the nutrition business in India. How can the company withstand the competition in the category of nutritional products? Will the firm re-enter the Indian market in the near future?
Comparison of Four Implant-Supported Fixed Rehabilitation Options of the Edentulous Mandible: A 3D Finite Element Analysis
Authors: Kucukkurt Sercan , Tukel Huseyin Can
Published: March 2020

Aim:

This study aims to compare four implant-supported rehabilitation concepts of an edentulous mandible and determines the most biomechanically advantageous technique.

Materials and Methods:

Five models with four implants in different configurations were formed: four axial interforaminal implants, All-on-4 concept (two anterior axial and two posterior distally tilted implants), All-on-4v4 concept (four distally tilted interforaminal implants), All-on-4W (two anterior mesially tilted and two posterior distally tilted implants), and two axial interforaminal implants and two posterior extra-short implants. Straumann bone-level (4.1 × 12 mm) and tissue-level (4.1 × 4 mm) extra-short implants were used for this study. Spherical loadings from canine and molar regions were applied to evaluate tension, compression, and von Mises stresses by implementing 3D finite element analysis.

Results:

Among the alternative concepts, the classic All-on-4 and the All-on-4v4 techniques were the most successful treatment option in biomechanical terms. On the other hand, the use of extra-short implants in the posterior region was found to be the last method of choice. This was because of the high stresses on bones in most conditions, even though it balances the forces from the molar region on the implants.

Conclusion:

The results of the present study indicate that the classic All-on-4 and the All-on-4v4 techniques were the most successful treatment options in biomechanical terms for the rehabilitation of an edentulous mandible with four implant-supported fixed full-arch prostheses.
How soon do single mothers have another child? A competing risk analysis of second premarital childbearing in sub-Saharan African countries
Authors: Odimegwu Clifford O. , Olamijuwon Emmanuel O. , Chisumpa Vesper H. , Akinyemi Joshua O. , Singini Mwiza G. , Somefun Oluwaseyi D.
Published: March 2020

Background

A considerable number of previous studies have examined the trends, correlates, and consequences of premarital childbearing among adolescents and young women in Africa. However, very little is known about whether and how soon single mothers have another premarital birth in sub-Saharan African countries. This study examines the timing of a second premarital birth among single mothers and assesses how it may differ across key socio-demographic variables.

Methods

We pooled recent Demographic and Health Surveys from 25 sub-Saharan African countries to create a database of 57, 219 single mothers aged 15–49 years. Cumulative incidence graphs and Fine and Gray’s competing risk models were used to delineate the timing of a second premarital birth and its socio-demographic correlates.

Results

More than one-third of single mothers in 16 countries have had a second premarital birth in their reproductive life. We also observed that more than 15% of the single mothers in Angola, Benin, the Republic of Chad, Liberia, Namibia, Nigeria, Sierra Leone, and Uganda, have had another premarital birth three years after the first. The incidence of a second premarital birth was significantly lower among women with secondary or higher education, compared to women with less than secondary education (p < 0.05) in most countries. Residence in an urban area compared to rural, was also significantly associated with a low incidence of second premarital birth in 10 countries (p < 0.05).

Conclusions

Findings indicate a rapid progression to having a second premarital birth in some sub-Sahara African countries, particularly among socio-economically disadvantaged women. The findings suggest the need for tailored interventions for improving the quality of life of single mothers, to reduce the associated burden and consequences of having a premarital birth.
Impact of a health marketing campaign on sugars intake by children aged 5–11 years and parental views on reducing children’s consumption
Authors: Bradley Jennifer , Gardner Grace , Rowland Maisie K. , Fay Michaela , Mann Kay , Holmes Richard , Foster Emma , Exley Catherine , Don Bosco Ann , Hugueniot Orla , Moynihan Paula
Published: March 2020

Background

The association between Free Sugars intake and non-communicable diseases such as obesity and dental caries is well documented and several countries are taking measures to reduce sugars intakes. Public Health England (PHE) instigated a range of approaches to reduce sugars, including a national health marketing campaign (Sugar Smart). The campaign aimed to raise awareness of the amount of sugars in foods and drinks and to encourage parents to reduce their children’s intake. The aim of this study was to determine whether the campaign was effective in altering dietary behaviour, by assessing any impact of the campaign on sugars intake among children aged 5–11 years. Parental perceptions of the campaign and barriers to reducing sugars intake were also explored.

Methods

Parents of 873 children aged 5–11 years, identified from an existing PHE database, were invited to take part. Dietary information was collected online using Intake24 before, during, and at 1, 10 and 12 months following the campaign. Change in sugars intake was assessed using mixed effects linear regression models. One-to-one telephone interviews were conducted with a purposive sample of parents to explore perceptions of the campaign and identify barriers and facilitators to reducing children’s sugars intake.

Results

Completion rates for dietary assessment ranged from 61 to 72% across the follow up time points. Qualitative telephone interviews were conducted with 20 parents. Total sugars intake decreased on average by ~ 6.2 g/day (SD 43.8) at peak campaign and the percentage of energy from total sugars significantly decreased immediately and 1 year post campaign. The percentage of energy from Free Sugars significantly decreased across all time points with the exception of the long term follow up at 12-months post campaign. The percentage of energy intake from total fat increased. Parents expressed a willingness to reduce sugars intakes, however, identified barriers including time constraints, the normalisation of sugary treats, and confusing information.

Conclusions

A health marketing campaign had a positive impact in reducing sugars intake but reductions in sugars were not sustained. Parents want to reduce their child’s sugars intake but societal barriers and confusion over which sources of sugars to avoid hamper efforts to change.
Contralateral C7 transfer to axillary and median nerves in rats with total brachial plexus avulsion
Authors: Liu Yuzhou , Xiao Feng , Zhuang Yongqing , Lao Jie
Published: March 2020

Background

Contralateral cervical 7 nerve (cC7) was used to repair two recipient nerves simultaneously for patients with total brachial plexus avulsion (TBPA).

Objective

To evaluate the effect of cC7 transfer to axillary and median nerves in rats with TBPA.

Methods

Eighty S-D rats were divided into 4 groups randomly on average. Group A: cC7-median nerve, Group B: cC7-axillary nerve, Group C: cC7-median and axillary nerves, Group D: TBPA without repair. The evaluation tools included behavioral tests, electromyogram (EMG), measurement of cross-sectional area of muscle fiber, nerve fiber count and gene expression assay.

Results

The effective rates of EMG were 90 and 70% in Flexor Carpi Radialis (FCR) in Group A and C, while 70 and 60% in deltoid (DEL) in Group B and C, respectively. In behavioral test, the differences of effective rates between groups were not significant. The mean cross-sectional area of FCR in Group A or C was significantly larger than that in Group D. Either the number of median or axillary nerve fibers in Group A, B or C was statistically more than that in Group D. No matter for FCR or DEL, there were no significant differences in the ratios of relative expression of Muscle Atrophy F-box(MAFBOX)and Muscle RING Finger 1(MURF1)among these groups.

Conclusion

Compared with cC7 transfer to median nerve, cC7 transfer to both median and axillary nerves did not affect median nerve recovery. The deltoid muscle also could be restored. The recovery proportion of axillary nerve was less than that of median nerve.
Using motivational interviewing to reduce parental risk related behaviors for early childhood caries: a pilot study
Authors: Blue Christine M. , Arnett Michelle C. , Ephrem Hiwet , Lunos Scott , Ruoqiong Chen , Jones Robert
Published: March 2020

Background

Decades of epidemiological studies have documented high rates of early childhood caries (ECC) among American Indian and Alaska Native (AIAN) children. The aim of this pilot study was to investigate if a motivational interviewing (MI) intervention improved oral self-care behaviors of AIAN caregivers of infants, and determine if the MI intervention promoted positive changes in caregivers’ ECC risk-related behaviors.

Methods

Caregivers of infants presenting for well- child visits in a medical clinic were randomized to treatment and control groups. At the first visit, a caries risk test (CRT) for cariogenic bacteria was completed for both groups. The Parental Care of Child’s Teeth (PCCT) was administered at the second visit and used to assess ECC risk-related behaviors. Over the course of four well-child visits, caregivers in the treatment group participated in a MI discussion focusing on behavior changes and desired outcomes for their personal oral health and their child’s. The duration of the intervention was 1 year. The control group was given oral health information traditionally provided at well-child visits. At the fourth well-child visit, the CRT and PCCT questionnaire were administered again.

Results

The mean bacterial load for mutans streptococcus (MS) was similar at both visits. A slight reduction in the mean bacterial levels of lactobacilli was observed in both the test and control groups after the last visit, although not at a level of statistical significance. The treatment group showed minimal improvement in child feeding practices and nighttime bottle habits.

Conclusions

Motivational Interviewing had little effect on oral self-care behaviors as measured by bacterial load, nor did MI reduce parental risk related behavior for early childhood caries.

Trial registration

Clinicaltrials.gov#NCT04286256. Retrospectively registered, February 26, 2020.
Melatonin antagonizes lipopolysaccharide-induced pulpal fibroblast responses
Authors: Kantrong Nutthapong , Jit-Armart Piyabhorn , Arayatrakoollikit Uthaiwan
Published: March 2020

Background

Pulpal inflammation is known to be mediated by multiple signaling pathways. However, whether melatonin plays regulatory roles in pulpal inflammation remains unclear. This study aimed at elucidating an in situ expression of melatonin and its receptors in human pulpal tissues, and the contribution of melatonin on the antagonism of lipopolysaccharide (LPS)-infected pulpal fibroblasts.

Methods

Melatonin expression in pulpal tissues harvested from healthy teeth was investigated by immunohistochemical staining. Its receptors, melatonin receptor 1 (MT1) and melatonin receptor 2 (MT2), were also immunostained in pulpal tissues isolated from healthy teeth and inflamed teeth diagnosed with irreversible pulpitis. Morphometric analysis was subsequently performed. After LPS infection of cultured pulpal fibroblasts, cyclo-oxygenase (COX) and interleukin-1 β (IL-1 β) transcripts were examined by using reverse transcription-polymerase chain reaction (RT-PCR). Analysis of mRNA expression was performed to investigate an antagonism of LPS stimulation by melatonin via COX and IL-1 β induction. Mann-Whitney U test and One-way ANOVA were used for statistical analysis to determine a significance level.

Results

Melatonin was expressed in healthy pulpal tissue within the odontoblastic zone, cell-rich zone, and in the pulpal connective tissue. Furthermore, in health, strong MT1 and MT2 expression was distributed similarly in all 3 pulpal zones. In contrast, during disease, expression of MT2 was reduced in inflamed pulpal tissues (P-value< 0.001), but not MT1 (P-value = 0.559). Co-culturing of melatonin with LPS resulted in the reduction of COX-2 and IL-1 β expression in primary pulpal fibroblasts, indicating that melatonin may play an antagonistic role to LPS infection in pulpal fibroblasts.

Conclusions

Human dental pulp abundantly expressed melatonin and its receptors MT1 and MT2 in the odontoblastic layers and pulpal connective tissue layers. Melatonin exerted antagonistic activity against LPS-mediated COX-2 and IL-1 β induction in pulpal fibroblasts, suggesting its therapeutic potential for pulpal inflammation and a possible role of pulpal melatonin in an immunomodulation via functional melatonin receptors expressed in dental pulp.
Sensitivity to gene dosage and gene expression affects genes with copy number variants observed among neuropsychiatric diseases
Authors: Yamasaki Maria , Makino Takashi , Khor Seik-Soon , Toyoda Hiromi , Miyagawa Taku , Liu Xiaoxi , Kuwabara Hitoshi , Kano Yukiko , Shimada Takafumi , Sugiyama Toshiro , Nishida Hisami , Sugaya Nagisa , Tochigi Mamoru , Otowa Takeshi , Okazaki Yuji , Kaiya Hisanobu , Kawamura Yoshiya , Miyashita Akinori , Kuwano Ryozo , Kasai Kiyoto , Tanii Hisashi , Sasaki Tsukasa , Honda Makoto , Tokunaga Katsushi
Published: March 2020

Background

Copy number variants (CNVs) have been reported to be associated with diseases, traits, and evolution. However, it is hard to determine which gene should have priority as a target for further functional experiments if a CNV is rare or a singleton. In this study, we attempted to overcome this issue by using two approaches: by assessing the influences of gene dosage sensitivity and gene expression sensitivity. Dosage sensitive genes derived from two-round whole-genome duplication in previous studies. In addition, we proposed a cross-sectional omics approach that utilizes open data from GTEx to assess the effect of whole-genome CNVs on gene expression.

Methods

Affymetrix Genome-Wide SNP Array 6.0 was used to detect CNVs by PennCNV and CNV Workshop. After quality controls for population stratification, family relationship and CNV detection, 287 patients with narcolepsy, 133 patients with essential hypersomnia, 380 patients with panic disorders, 164 patients with autism, 784 patients with Alzheimer disease and 1280 healthy individuals remained for the enrichment analysis.

Results

Overall, significant enrichment of dosage sensitive genes was found across patients with narcolepsy, panic disorders and autism. Particularly, significant enrichment of dosage-sensitive genes in duplications was observed across all diseases except for Alzheimer disease. For deletions, less or no enrichment of dosage-sensitive genes with deletions was seen in the patients when compared to the healthy individuals. Interestingly, significant enrichments of genes with expression sensitivity in brain were observed in patients with panic disorder and autism. While duplications presented a higher burden, deletions did not cause significant differences when compared to the healthy individuals. When we assess the effect of sensitivity to genome dosage and gene expression at the same time, the highest ratio of enrichment was observed in the group including dosage-sensitive genes and genes with expression sensitivity only in brain. In addition, shared CNV regions among the five neuropsychiatric diseases were also investigated.

Conclusions

This study contributed the evidence that dosage-sensitive genes are associated with CNVs among neuropsychiatric diseases. In addition, we utilized open data from GTEx to assess the effect of whole-genome CNVs on gene expression. We also investigated shared CNV region among neuropsychiatric diseases.
The association between serum growth differentiation factor 15 levels and lower extremity atherosclerotic disease is independent of body mass index in type 2 diabetes
Authors: He Xingxing , Su Jiaorong , Ma Xiaojing , Lu Wei , Zhu Wei , Wang Yufei , Bao Yuqian , Zhou Jian
Published: March 2020

Background

Clinical and basic investigations have indicated a significant association between circulating growth differentiation factor 15 (GDF15) and cardiovascular disease; however, the relationship between GDF15 and lower extremity atherosclerotic disease (LEAD) has been less studied. The present study aimed to explore the association between GDF15 and LEAD in Chinese patients with type 2 diabetes mellitus (T2DM). Considering that obesity is an important factor associated with circulating GDF15 levels, whether the relationship between serum GDF15 levels and LEAD is affected by body mass index (BMI) was also analysed.

Methods

A total of 376 hospitalized T2DM patients were enrolled (161 with LEAD and 215 without LEAD). A sandwich enzyme-linked immunosorbent assay was used to detect the serum GDF15 levels. The femoral intima-media thickness (F-IMT) and LEAD were assessed by ultrasonography.

Results

Patients with LEAD had significantly higher serum GDF15 levels than those without LEAD, regardless of whether their BMI was < 25 kg/m2or ≥ 25 kg/m2(bothP < 0.05). Serum GDF15 levels were independently positively related to the F-IMT (standardizedβ = 0.162,P = 0.002). After adjusting for confounding factors, per 1-standard deviation (SD) increase in the serum GDF15 levels was significantly related to an approximately 1.4-fold increased risk of LEAD in the total population (P < 0.05). Regardless of whether the BMI was < 25 kg/m2or ≥ 25 kg/m2, this association remained significant, with approximately 1.6- and 1.4-fold increased risks of LEAD, respectively (bothP < 0.05).

Conclusions

High serum GDF15 levels were significantly correlated with an increased risk of LEAD in T2DM patients, and this relationship was independent of BMI.
Association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance in older adults: National Health and nutrition examination Survey (NHANES) 2011–2014
Authors: Dong Xue , Li Shiru , Chen Jiahao , Li Yan , Wu Yanjun , Zhang Dongfeng
Published: March 2020

Background

Current evidence on the association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance is inconsistent. Therefore, the aim is to explore the association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance in the U.S. noninstitutionalized population of older adults.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Intakes of ω-3 and ω-6 fatty acids were obtained through two 24-h dietary recalls and were adjusted by energy. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer’s disease (CERAD) Word Learning sub-test, Animal Fluency test and Digit Symbol Substitution Test (DSST). For each cognitive test, people who scored lower than the lowest quartile in each age group were defined as having low cognitive performance. Binary logistic regression and restricted cubic spline models were applied to evaluate the association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance.

Results

A total of 2496 participants aged 60 years or older were included. In the full-adjusted model, the odds ratios (ORs) with 95% confidence interval (CI) of CERAD test score, Animal Fluency test score and DSST test score were 0.58 (0.38–0.88), 0.68 (0.47–0.99) and 0.59 (0.37–0.92) for the highest versus lowest tertile of dietary ω-3 fatty acids intake, respectively; the ORs with 95% CI of CERAD test score, Animal Fluency test score and DSST test score were 0.48 (0.31–0.75), 0.60 (0.40–0.92) and 0.50 (0.34–0.75) for the highest versus lowest tertile of dietary ω-6 fatty acids intake, respectively. The association between ω-6: ω-3 ratio and cognitive performance was not statistically significant in three tests. In dose-response relationship analysis, L-shaped associations were apparent for ω-3 and ω-6 fatty acids intake with CERAD test score, Animal Fluency test score and DSST test score.

Conclusions

Dietary ω-3 and ω-6 fatty acids intake might be inversely associated with low cognitive performance.
Hundred year projected carbon loads and species compositions for four National Forests in the northwestern USA
Authors: Fekety Patrick A. , Crookston Nicholas L. , Hudak Andrew T. , Filippelli Steven K. , Vogeler Jody C. , Falkowski Michael J.
Published: March 2020

Background

Forests are an important component of the global carbon balance, and climate sensitive growth and yield models are an essential tool when predicting future forest conditions. In this study, we used the dynamic climate capability of the Forest Vegetation Simulator (FVS) to simulate future (100 year) forest conditions on four National Forests in the northwestern USA: Payette National Forest (NF), Ochoco NF, Gifford Pinchot NF, and Siuslaw NF. Using Forest Inventory and Analysis field plots, aboveground carbon estimates and species compositions were simulated with Climate-FVS for the period between 2016 and 2116 under a no climate change scenario and a future climate scenario. We included a sensitivity analysis that varied calculated disturbance probabilities and the dClim rule, which is one method used by Climate-FVS to introduce climate-related mortality. The dClim rule initiates mortality when the predicted climate change at a site is greater than the change in climate associated with a predetermined shift in elevation.

Results

Results of the simulations indicated the dClim rule influenced future carbon projections more than estimates of disturbance probability. Future aboveground carbon estimates increased and species composition remained stable under the no climate change scenario. The future climate scenario we tested resulted in less carbon at the end of the projections compared to the no climate change scenarios for all cases except when the dClim rule was disengaged on the Payette NF. Under the climate change scenario, species compositions shifted to climatically adapted species or early successional species.

Conclusion

This research highlights the need to consider climate projections in long-term planning or future forest conditions may be unexpected. Forest managers and planners could perform similar simulations and use the results as a planning tool when analyzing climate change effects at the National Forest level.
The role of cancer-derived microRNAs in cancer immune escape
Authors: Yi Ming , Xu Linping , Jiao Ying , Luo Suxia , Li Anping , Wu Kongming
Published: March 2020

During malignant transformation, accumulated somatic mutations endow cancer cells with increased invasiveness and immunogenicity. Under selective pressure, these highly immunogenic cancer cells develop multiple strategies to evade immune attack. It has been well established that cancer cells could downregulate the expression of major histocompatibility complex, acquire alterations in interferon pathway, and upregulate the activities of immune checkpoint pathways. Besides, cancer cells secret numerous cytokines, exosomes, and microvesicles to regulate the functions and abundances of components in the tumor microenvironment including immune effector cells and professional antigen presentation cells. As the vital determinant of post-transcriptional regulation, microRNAs (miRNAs) not only participate in cancer initiation and progression but also regulate anti-cancer immune response. For instance, some miRNAs affect cancer immune surveillance and immune escape by interfering the expression of immune attack-associated molecules. A growing body of evidence indicated that cancer-derived immune modulatory miRNAs might be promising targets to counteract cancer immune escape. In this review, we summarized the role of some miRNAs in cancer immune escape and discussed their potential clinical application as treatment targets.
The dawn of physiological closed-loop ventilation—a review
Authors: Platen Philip von , Pomprapa Anake , Lachmann Burkhard , Leonhardt Steffen
Published: March 2020

The level of automation in mechanical ventilation has been steadily increasing over the last few decades. There has recently been renewed interest in physiological closed-loop control of ventilation. The development of these systems has followed a similar path to that of manual clinical ventilation, starting with ensuring optimal gas exchange and shifting to the prevention of ventilator-induced lung injury. Systems currently aim to encompass both aspects, and early commercial systems are appearing. These developments remain unknown to many clinicians and, hence, limit their adoption into the clinical environment. This review shows the evolution of the physiological closed-loop control of mechanical ventilation.
Reduction of circulating innate lymphoid cell progenitors results in impaired cytokine production by innate lymphoid cells in patients with lupus nephritis
Authors: Ryu Seungwon , Lee Eun Young , Kim Dong Ki , Kim Yon Su , Chung Doo Hyun , Kim Ji Hyung , Lee Hajeong , Kim Hye Young
Published: March 2020

Background

Innate lymphoid cells (ILCs) play an essential role in maintaining homeostasis; however, they can also cause chronic inflammation and autoimmune disease. This study aimed to identify the role of ILCs in the pathogenesis of lupus nephritis (LN).

Methods

The percentage of ILCs within the peripheral blood mononuclear cell (PBMC) population and urine of patients with LN (n = 16), healthy controls (HC; n = 8), and disease controls (ANCA-associated vasculitis (AAV; n = 6), IgA nephropathy (IgAN; n = 9), and other glomerular diseases (n = 5)) was determined by flow cytometry analysis. In addition, ILCs were sorted and cultured with plasma from LN patients or HC to elucidate whether the reduced population of CD117+ ILCs observed in LN was due to changes in the ILC progenitor population.

Results

The percentage of total ILCs and CD117+ ILCs in LN was significantly lower than that in HC. The percentage of cytokine-secreting ILCs was also lower in LN; however, when the disease stabilized, cytokine production was restored to levels similar to those in HC. The increase in the number of exhausted ILCs (cells unable to secrete cytokines) correlated positively with disease activity. When CD117+ ILCs were cultured with LN plasma, the number of CD117+ ILCs fell, but that of other ILC subsets increased.

Conclusions

The percentage of CD117+ ILCs and the capacity of ILCs to secrete cytokines fell as LN severity increased, suggesting that an inflammatory environment of LN induces persistent differentiation and exhaustion of ILCs.
The immune microenvironment of uterine adenosarcomas
Authors: Ali Ali Mohammed Refaat , Tsai Jen-Wei , Leung Cheuk Hong , Lin Heather , Ravi Vinod , Conley Anthony P. , Lazar Alexander J. , Wang Wei-Lien , Nathenson Michael J.
Published: March 2020

Background

Uterine adenosarcoma (UA) is an extremely rare sarcoma subtype. There has been limited evaluation of the immune microenvironment in these tumors. The objective of this study is to examine and describe the immune infiltrate and PD-1/PD-L1 expression in UA and to correlate these changes in the tumor micro-environment with the overall survival status or the disease-free survival status (DFSS), respectively.

Methods

Patients (pts) treated at our center from 1982 to 2014 with UA were identified. Fifteen cases had tumor paraffin-embedded blocks available. Immunohistochemistry studies for CD3, CD8, FOXP3, CD163, PD-1 and PD-L1 (clone 22C3) were performed. Image analysis was used to assess the density (cells/mm2), except in PD-L1, where the percentage of membranous staining on tumor cells was noted.

Results

Immune infiltrate analysis median (range) density in cells/mm2 varied broadly: CD3 178 (15–802); CD8 117 (11–661); FoxP3 4.8 (0.2–82); CD163 791 (264–1861); and PD1 5 (1–65). 3 cases had rare (1%) PD-L1 tumor membranous labeling. The reports yielded that ten pts were alive, and 5 were dead. Pts who were alive had significant higher CD3 and CD8 median densities in tumors than those who were dead (p = 0.040). There was no correlation between DFSS and CD3 or CD8 median densities. Patients who had no local recurrence had significantly higher CD3 and CD8 median densities in tumors than those who had local recurrence (p = 0.040).

Conclusions

In conclusion, this is the first report characterizing the presence of immune infiltrate and PD-1/PD-L1 expression in UA. CD3+ CD8+ T-cells density may be prognostic. The immune-responsiveness of UA needs to be further investigated in a larger study.
Flow diversion in challenging vascular anatomies: the use of low profile stent retrievers for safe and accurate positioning of the microcatheter
Authors: Quäschling Ulf , Kläver Monika , Richter Cindy , Hamerla Gordian , Mucha Simone , Scherlach Cordula , Maybaum Jens , Hoffmann Karl-Titus , Schob Stefan
Published: March 2020

Background

Hemodynamic therapy with Flow-Diverters has become a fundamental option for treatment of cerebral aneurysms. A major obstacle of Flow-Diverters is the comparatively stiff microcatheter required for implantation. Consequentially, maneuverability is limited and primary catheterization of peripheral targets may be difficult or even futile in challenging vascular anatomies. To overcome this, a highly navigable microcatheter must be used to attain the desired vascular segment, followed by a hardly controllable exchange-maneuver via a long microwire, involving a high risk for wire-perforation. Our study aimed to investigate the value of low-profile stent-retrievers as a railway for introduction of the required microcatheter, which allows to maintain a stable endovascular position and reduce the risk for procedural vessel injury.

Methods

14cases (8females, mean-age 59y) of Flow-Diverter-Implantation requiring the use of a low-profile stent-retriever were reviewed. All cases featured a challenging vascular anatomy. After micro-catheterization of the desired segment, the stent-retriever was carefully deployed as an anchor in a secure, distal location. In all cases a pREset/LITE-stent-retriever was used for introduction of the equipment required for implantation.

Results

In all cases the anchoring-maneuver was performed without technical complications. The stent-retrievers maintained a stable position after deployment in all situations. No potential traumatic sudden movements of the microcatheter occurred. No procedure-related perforations, dissections or vasospasms were observable during the interventions or their aftermath.

Conclusions

In our experience the stent-retriever-anchoring-maneuver represents a potentially essential and safe amendment for flow diverter treatment in technically challenging situations.
A combined medical/surgical appendicitis pathway decreases pediatric CT utilization, perforation, and negative appendectomy rates
Authors: Johnson Sidney M. , Puapong Devin P. , Peebles Charles , Ishihara Kelli , Bogenberger Kenneth , Woo Russell K.
Published: March 2020

Background

We sought to improve the care of pediatric patients with possible appendicitis by decreasing unnecessary CT scanning. In an early QI initiative, we systematically emphasized the superiority of Ultrasonography (US) over CT, but did not find a decrease in CT utilization in practice. We therefore redoubled our initiative using a multimodal approach. We hypothesized a combined diagnostic and treatment pathway that allowed residual diagnostic uncertainty and used both surgery and antibiotic therapy for appendicitis that would decrease the need for diagnostic CT scanning.

Results

Prior to implementation of the protocol, 33% of ER patients with appendicitis typical abdominal pain were treated for appendicitis (with surgery); after implementation, the total number treated remained unchanged 32.5% (p = NS), but the appendectomy rate dropped from 33 (204/619) to 23% after implementation of the pathway (96/419, p < 0.0005) with 50 patients treated with antibiotics. There was a reduction in CT scanning (pre 39% vs. 11%, p < 0.0001) while the use of US increased (pre 30% vs. 53%, p < 0.0001). The perforation rate decreased from 12 to 5% (p < 0.002) and negative appendectomy decreased from 13 to 4% (p < 0.0001). Of the 50 patients treated with antibiotics, 10 eventually crossed over to surgery.

Conclusion

The use of a diagnostic and therapeutic pathway that offers antibiotic therapy for early probable appendicitis decreases the need for diagnostic CT scanning without increasing morbidity in pediatric appendicitis. Adherence to a medical/surgical treatment protocol that reserves surgery for clinically advanced appendicitis results in a reduction in CT scanning, perforation rates, negative appendectomy rates, and overall surgery for appendicitis.
Source location with cross-coherence migration
Authors: Liu Yujin , Ma Yue , Luo Yi
Published: March 2020

Locating microseismic source positions using seismic energy emitted from hydraulic fracturing is essential for choosing optimal fracking parameters and maximizing the fracturing effects in hydrocarbon exploitation. Interferometric crosscorrelation migration (ICCM) and zero-lag autocorrelation of time-reversal imaging (ATRI) are two important passive seismic source locating approaches that are proposed independently and seem to be substantially different. We have proven that these two methods are theoretically identical and produce very similar images. Moreover, we have developed cross-coherence that uses normalization by the spectral amplitude of each of the traces, rather than crosscorrelation or deconvolution, to improve the ICCM and ATRI methods. The adopted method enhances the spatial resolution of the source images and is particularly effective in the presence of highly variable and strong additive random noise. Synthetic and field data tests verify the equivalence of the conventional ICCM and ATRI and the equivalence of their improved versions. Compared with crosscorrelation- and deconvolution-based source locating methods, our approach shows a high-resolution property and antinoise capability in numerical tests using synthetic data with single and multiple sources, as well as field data.
A robust Q estimation scheme for adaptively handling asymmetric wavelet spectrum variations in strongly attenuating media
Authors: Li Huijian , Greenhalgh Stewart , Chen Shijun , Liu Xu , Liu Bo
Published: March 2020

The central frequency shift technique for estimating wave attenuation in seismic exploration assumes a quasi-symmetric amplitude spectrum and has its limitations in low quality factor ([Formula: see text]) regions. The asymmetry of the wavelet amplitude spectrum becomes more pronounced during wave propagation, so using a constant parameter [Formula: see text] (the asymmetry index estimated) in the modified frequency-weighted exponential formula method to estimate [Formula: see text] still leads to errors and can degrade the results of inverse [Formula: see text]-filtering. We have derived a new [Formula: see text]-estimation scheme that does not require constant parameter fitting that also works for strongly asymmetric receiver spectra. It is based on forming a synthetic wavelet as the geometric mean of the source spectrum (approximated by the near-source receiver spectrum) and the subsequent attenuated (receiver) wavelet spectrum. The changing centroid frequency and variance of this new wavelet as a function of traveltime can automatically adapt to a changing asymmetric spectrum caused by attenuation. It yields more stable and accurate results, especially in low-[Formula: see text] regions. This adopted approach is successfully applied to synthetic data and vertical seismic profile field survey data and proves to be superior to previous frequency-shift methods.
Joint inversion of logging-while-drilling multipole acoustic data to determine formation shear-wave transverse isotropy
Authors: Li Yang-Hu , Xu Song , Jiang Can , Su Yuan-Da , Tang Xiao-Ming
Published: March 2020

Seismic-wave anisotropy has long been an important topic in the exploration and development of unconventional reservoirs, especially in shales, which are commonly characterized as transversely isotropic ([TI] or vertical TI [VTI]) media. At present, the shear-wave (S-wave) TI properties have mainly been determined from monopole Stoneley- or dipole flexural-wave measurements in wireline acoustic logging, but the feasibility of those obtained from logging-while-drilling (LWD) acoustic data needs to be established. We have developed a joint inversion method for simultaneously determining formation S-wave transverse isotropy and vertical velocity from LWD multipole acoustic data. Our theoretical analysis shows that the presence of anisotropy strongly influences LWD Stoneley- and quadrupole-wave dispersion characteristics. Although the monopole Stoneley and quadrupole waves are sensitive to the formation S-wave TI parameters, they suffer from the typical nonuniqueness problem when using the individual-wave data to invert parameters alone. Thus, the respective dispersion data can be jointly used to estimate the formation S-wave TI properties. By the joint inversion, the nonuniqueness problem in the parameter inversion can also be effectively alleviated. The feasibility of the method has been verified by the processing results of theoretical synthetic data and field LWD acoustic-wave data. Therefore, the result offers an effective method for evaluating VTI formation anisotropy from acoustic LWD data.
Zebrafish cyp11c1 Knockout Reveals the Roles of 11-ketotestosterone and Cortisol in Sexual Development and Reproduction
Authors: Zhang Qifeng , Ye Ding , Wang Houpeng , Wang Yaqing , Hu Wei , Sun Yonghua
Published: March 2020

Androgen is essential for male development and cortisol is involved in reproduction in fishes. However, the in vivo roles of cortisol and specific androgens such as 11-ketotestosterone (11-KT) in reproductive development need to be described with genetic models. Zebrafish cyp11c1 encodes 11β-hydroxylase, which is essential for the biosynthesis of 11-KT and cortisol. In this study, we generated a zebrafish mutant of cyp11c1 (cyp11c1-/-) and utilized it to clarify the roles of 11-KT and cortisol in sexual development and reproduction. The cyp11c1-/- fish had smaller genital papilla and exhibited defective natural mating but possessed mature gametes and were found at a sex ratio comparable to the wildtype control. The cyp11c1-/- males showed delayed and prolonged juvenile ovary-to-testis transition and displayed defective spermatogenesis at adult stage, which could be rescued by treatment with 11-ketoandrostenedione (11-KA) at certain stages. Specifically, during testis development of cyp11c1-/- males, the expression of insl3, cyp17a1, and amh was significantly decreased, suggesting that 11-KT is essential for the development and function of Leydig cells and Sertoli cells. Further, spermatogenesis-related dmrt1 was subsequently downregulated, leading to insufficient spermatogenesis. The cyp11c1-/- females showed a reduction in egg spawning and a failure of in vitro germinal vesicle breakdown, which could be partially rescued by cortisol treatment. Taken together, our study reveals that zebrafish Cyp11c1 is not required for definite sex differentiation but is essential for juvenile ovary-to-testis transition, Leydig cell development, and spermatogenesis in males through 11-KT, and it is also involved in oocyte maturation and ovulation in females through cortisol.
Electroencephalography-Guided Anesthetic Delivery for Preventing Postoperative Delirium in Adults: An Updated Meta-analysis
Authors: Sun Yi , Ye Fan , Wang Jing , Ai Pan , Wei Changwei , Wu Anshi , Xie Wuxiang
Published: March 2020

BACKGROUND:

Postoperative delirium is a major debilitating complication for patients and is associated with poor outcomes. Previous studies have suggested that excessive general anesthesia may lead to postoperative delirium. Electroencephalography (EEG)-based monitors have been administered in clinical practice in an attempt to deliver appropriate anesthesia. The aim of this updated meta-analysis was to evaluate the current body of research concerning the effects of EEG-based monitor on postoperative delirium.

METHODS:

We conducted a meta-analysis of randomized controlled trials of the effect of processed EEG monitor on postoperative delirium as the primary outcome. The search was performed in CENTRAL, MEDLINE, and EMBASE, with no language restrictions from inception until June 23, 2019. Two independent reviewers screened records and full-text articles for inclusion. Data extraction and risk-of-bias assessment were conducted by 3 independent reviewers. Random-effects models were used to calculate combined-effect estimates. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence.

RESULTS:

Of 5904 records screened, 5 studies met our inclusion criteria, including 3612 patients. Meta-analysis revealed no significant effect of EEG-based monitors on postoperative delirium (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.60–1.05; I
2 = 73%). The results showed a statistically significant reduction in intensive care unit (ICU) length of stay (3 studies, weight mean difference [WMD] −0.29 days; 95% CI, −0.53 to −0.05) in patients with EEG monitored. EEG-guided anesthesia did not have a statistically significant difference in all-cause mortality (3 studies, RR, 0.63; 95% CI, 0.31–1.29) and hospital length of stay (4 studies, WMD −0.61 days; 95% CI, −1.34 to 0.11). Few studies investigated the effects of EEG-guided anesthesia on perioperative major nonneurological complications and did not come up with promising results.

CONCLUSIONS:

The current evidence is not sufficient to support the prevention effects of EEG monitor on postoperative delirium. More robustly designed and well-conducted studies with emphasis on this matter are warranted.
Lung Ultrasound Findings in the Postanesthesia Care Unit Are Associated With Outcome After Major Surgery: A Prospective Observational Study in a High-Risk Cohort
Authors: Zieleskiewicz Laurent , Papinko Mickael , Lopez Alexandre , Baldovini Alice , Fiocchi David , Meresse Zoe , Boussuges Alain , Thomas Pascal Alexandre , Berdah Stephane , Creagh-Brown Ben , Bouhemad Belaid , Futier Emmanuel , Resseguier Noémie , Antonini François , Duclos Gary , Leone Marc
Published: March 2020

Background:

Postoperative pulmonary complications are associated with increased morbidity. Identifying patients at higher risk for such complications may allow preemptive treatment.

METHODS:

Patients with an American Society of Anesthesiologists (ASA) score >1 and who were scheduled for major surgery of >2 hours were enrolled in a single-center prospective study. After extubation, lung ultrasound was performed after a median time of 60 minutes by 2 certified anesthesiologists in the postanesthesia care unit after a standardized tracheal extubation. Postoperative pulmonary complications occurring within 8 postoperative days were recorded. The association between lung ultrasound findings and postoperative pulmonary complications was analyzed using logistic regression models.

RESULTS:

Among the 327 patients included, 69 (19%) developed postoperative pulmonary complications. The lung ultrasound score was higher in the patients who developed postoperative pulmonary complications (12 [7–18] vs 8 [4–12]; P < .001). The odds ratio for pulmonary complications in patients who had a pleural effusion detected by lung ultrasound was 3.7 (95% confidence interval, 1.2–11.7). The hospital death rate was also higher in patients with pleural effusions (22% vs 1.3%; P < .001). Patients with pulmonary consolidations on lung ultrasound had a higher risk of postoperative mechanical ventilation (17% vs 5.1%; P = .001). In all patients, the area under the curve for predicting postoperative pulmonary complications was 0.64 (95% confidence interval, 0.57–0.71).

CONCLUSIONS:

When lung ultrasound is performed precociously <2 hours after extubation, detection of immediate postoperative alveolar consolidation and pleural effusion by lung ultrasound is associated with postoperative pulmonary complications and morbi-mortality. Further study is needed to determine the effect of ultrasound-guided intervention for patients at high risk of postoperative pulmonary complications.