bluuebunny/crossref_metadata_2025 huggingface dataset:
Bisphenol A Exacerbates Allergic Inflammation in an Ovalbumin-Induced Mouse Model of Allergic Rhinitis
Authors: Wang Yunxiu , Cao Zhiwei , Zhao He , Ren Yaoyao , Hao Liying , Gu Zhaowei
Published: September 2020

Purpose. Bisphenol A (BPA) is found in many plastic products and is thus a common environmental endocrine disruptor. Plastic-related health problems, including allergic diseases, are attracting increasing attention. However, few experimental studies have explored the effect of BPA on allergic rhinitis (AR). We explore whether BPA was directly related to the allergic inflammation induced by ovalbumin (OVA) in AR mice. Methods. We first constructed OVA-induced mouse model, and after BPA administration, we evaluated nasal symptoms and measured the serum OVA-specific IgE levels by ELISA. Th2 and Treg-related cytokines of nasal mucosa were measured by cytometric bead array. Th2 and Treg-specific transcription factor levels were assayed by PCR. The proportions of CD3+CD4+IL-4+Th2 and CD4+Helios+Foxp3+ T cells (Tregs) in spleen tissue were determined by flow cytometry. Results. Compared to OVA-only-induced mice, BPA addition increased nasal symptoms and serum OVA-specific IgE levels. OVA and BPA coexposure significantly increased IL-4 and IL-13 protein levels compared to those after OVA exposure alone. BPA plus OVA tended to decrease the IL-10 protein levels compared to those after OVA alone. Coexposure to OVA and BPA significantly increased the GATA-3-encoding mRNA level, and decreased the levels of mRNAs encoding Foxp3 and Helios, compared to those after OVA exposure alone. BPA increased the Th2 cell proportion, and decreased that of Tregs, compared to the levels with OVA alone. Conclusion. BPA exerted negative effects by exacerbating AR allergic symptoms, increasing serum OVA-specific IgE levels, and compromising Th2 and Treg responses.
Partition Selection for Large-Scale Data Management Using KNN Join Processing
Authors: Hu Yue , Peng Ge , Wang Zehua , Cui Yanrong , Qin Hang
Published: September 2020

For the data processing with increasing avalanche under large datasets, the k nearest neighbors (KNN) algorithm is a particularly expensive operation for both classification and regression predictive problems. To predict the values of new data points, it can calculate the feature similarity between each object in the test dataset and each object in the training dataset. However, due to expensive computational cost, the single computer is out of work to deal with large-scale dataset. In this paper, we propose an adaptive vKNN algorithm, which adopts on the Voronoi diagram under the MapReduce parallel framework and makes full use of the advantages of parallel computing in processing large-scale data. In the process of partition selection, we design a new predictive strategy for sample point to find the optimal relevant partition. Then, we can effectively collect irrelevant data, reduce KNN join computation, and improve the operation efficiency. Finally, we use a large number of 54-dimensional datasets to conduct a large number of experiments on the cluster. The experimental results show that our proposed method is effective and scalable with ensuring accuracy.
Livability Assessment of Urban Communities considering the Preferences of Different Age Groups
Authors: Liang Xiaojin , Liu Yaolin , Qiu Tianqi
Published: September 2020

Livability is one of the major guiding principles for urban planning and policymaking, of which the definition and evaluation have become the crucial research topic. As the progress in socioeconomic development accelerates, the microscale living conditions require more urgent attention. However, few researchers have addressed the assessment of urban livability at a finer spatial scale such as the community scale. Thus, this article aims to evaluate the urban environmental quality at the community level given the residential community as the basic unit of urban living areas. We select eighteen objective indicators from five dimensions to establish an objective indicator system. Taking the preferences of different age groups into account, a comprehensive evaluation framework for the livability of communities combining both subjective perceptions and objective indicator is constructed. Then, it is applied to evaluate the livability of 1,394 residential communities in Ningbo City. There are three significant results from the study. First, different age groups have diverse preferences of demands to the livability of an urban community. The indicators they valued most concentrated in the following two dimensions: the convenience of transportation and the completeness of supporting facilities. Second, there exists significant heterogeneity in the livability of communities among districts. Third, the livability of communities shows a decreasing spatial pattern from the city center to the surroundings. These empirical results can be advantageous to urban planning departments and other relevant stakeholders.
Study on the Intelligent Selection Model of Fuzzy Semantic Optimal Solution in the Process of Translation Using English Corpus
Authors: Bei Li
Published: September 2020

In order to improve the accuracy and reasonableness of using English corpus for translation, a method of using English corpus to perform translation tasks based on fuzzy semantic optimal solution intelligent selection and inspired computing for wireless networks is proposed. The information extraction model using English corpus for translation is constructed, and the fuzzy semantic keyword feature directivity model of English corpus translation is established. Fuzzy semantic ontology feature registration method is used to calculate the fuzzy semantic intelligence optimal solution vector in English translation. The semantic fuzzy feature matching and adaptive subject word registration are realized in English translation. The fuzzy link relation of semantic ontology is established, and the fuzzy semantic optimal solution is obtained. The accuracy of machine translation in English corpus is improved. The experimental results show that the fuzzy semantic optimal solution has better registration performance and the feature matching degree of the subject words is higher, which improves the reasonableness and accuracy of translation in English corpus. At the same time, it provides a new idea for intelligent computation and recognition of wireless network.
Mechanical Analysis of Mining Stress Transfer on Isolated Island Face in Extra-Thick Fully Mechanized Top-Coal Caving Mining
Authors: Tu Min , Bu Qingwei , Fu Baojie , Wang Yu
Published: September 2020

The mining spatial structure of isolated island face in extra-thick fully mechanized top-coal caving mining is unique, which leads to a complex mining stress distribution and serious safety hazards. In this study, combined with a specific engineering example, the mining stress distribution characteristics of isolated island face are expounded, and a bearing structural mechanical model of the continuous beam of overlying strata is established using elastic–plastic mechanics theory. The mechanical equations of the mining stress distribution and failure depth of coal–rock mass are then obtained. Comparison of theoretical calculation results with numerical simulation and field measurement results shows basically consistent stress distribution characteristics. The derived mechanical equations can provide an estimation method for the analysis of mining dynamics on isolated island face in extra-thick fully mechanized top-coal caving mining. The following conclusions are acquired. The coal–rock mass should bear not only the lateral mining superposition influence but also the advance mining influence in front of the coal wall, so the isolated island face is in the complex environment of multiple mining stress superposition. In the mining process, the maximum advance mining stress concentration factor is 4.0–6.0 and is located at the upper and lower ends of the isolated island face. The lateral mining failure depth of the coal wall of the isolated island face increases by 2.0–5.0 m under the influence of advance mining. Therefore, compared with the nonisolated island face, the mining pressure appearance is intense. The mining influence in the range of 20–30 m of the upper and lower ends is intense, and the mining stress in this area is characterized by “cone distribution.” This zone is an important hidden danger area with coal–rock mass mining instability on isolated island face, which requires special attention to avoid mining disasters. According to the analysis of the influencing mining factors and laws of isolated island face, it is concluded that the longer the isolated island face size is, the closer the goaf size on both sides of the isolated island face is, the smaller the coal seam buried depth is, the better the mechanical conditions of coal and rock medium are, and the smaller the mining height of coal seam is, the more favorable the safe mining of isolated island face is.
Study on In Situ Stress Measurement and Surrounding Rock Control Technology in Deep Mine
Authors: Qin Zhongcheng , Cao Bin , Liu Yongle , Li Tan
Published: September 2020

In situ stress is the direct cause of roadway deformation and failure in the process of deep mining activities. The measured data of in situ stress in the Shuanghe coal mine show that the maximum principal stress is 44.94~50.61 MPa, and the maximum principal stress direction is near horizontal direction, which belongs to tectonic stress field. The maximum horizontal principal stress is 1.66~1.86 of the vertical stress. The horizontal principal stress controls the deep stress field. According to the measured data of in situ stress, the high-strength prestress bolt and cable collaborative support form is designed in the Shuanghe coal mine. Based on the stress field research of bolt and cable, the optimal prestress ratio of bolt and cable is proposed as 3. When the prestress ratio of bolt and cable is constant, the smaller the length ratio of bolt and cable is, the better the effect of prestressed field formed by cooperative support is. The results are applied to the support design of the mining roadway in the Shuanghe coal mine. Through the field monitoring test results, it is found that the maximum roof subsidence is 86 mm, the maximum floor deformation is 52 mm, and the maximum deformation of two sides is 125 mm. The surrounding rock control effect of the roadway is good, and the surrounding rock deformation conforms to the engineering technology standard requirements. The research results of this paper can provide some reference for the surrounding rock support of high ground stress mining roadway under similar conditions.
Research on AE Source Location of Linear and Plane Rock Mass
Authors: Wang Haiyan , Ma Ji , Wang Gongda , Gao Han , Cui Guangyong , Li Xiaoshen
Published: September 2020

The occurrence of rockburst dynamic disaster is a process from the microdamage to macroinstability of coal and rock mass, which is accompanied by the acoustic emission (AE) phenomenon. The application of AE technology can reliably help to judge and predict the damage evolution of coal and rock mass, as the most basic problem in the study of AE is the location of the AE source. In this work, the AE source localization experiments of rod-shaped rocks and plate-shaped rocks were carried out. The influence of calibration wave velocity of linear and plane positioning on the location of the AE source was studied. The feasibility analysis of the AE source localization of a plate-shaped rock with different sensor arrays was conducted. The result of the plane location was optimized by wavelet packet analysis combined with cross correlations. The results show that the homogeneity of marble members in this work is suitable, and the positioning error is least affected by wave velocity. In the positioning of the plane AE source, it is suitable to choose a diamond sensor array. The positioning source should be located near the center of the array network. The positioning effect of the rod-shaped rock is generally better than that of the plate-shaped rock. In the actual source positioning work, it should be simplified as much as possible as a linear positioning problem. A more accurate AE signal delay could be obtained using wavelet packet analysis combined with cross-correlation technology, which can greatly reduce the positioning error caused by the accuracy of time difference. The purpose of this work is to provide a basis for determining a more accurate location of the fracture source of rock materials, which is of great significance and application value on the prediction and control of rockburst dynamic disaster.
Contrast-Induced Sialadenitis of the Sublingual Glands
Authors: Park Ki Wan , Han Albert Y. , Kim Christine M. , Tam Kenric , Chhetri Dinesh K.
Published: September 2020

Contrast-induced sialadenitis (CIS) is a rare, delayed pseudoallergic reaction from iodine containing contrast. Previously reported cases of CIS demonstrated that the two major salivary glands (parotid and submandibular) can be affected. The initial encounter of this entity can raise alarms to physicians as the differential diagnoses include serious infectious and inflammatory conditions such as Ludwig’s angina and angioedema. Subsequently, it may lead to unnecessary testing and increased healthcare cost. Here we present a 60-year-old male who presented with bilateral sublingual gland swelling following exposure to iodinated contrast. With timely diagnosis by the otolaryngologist, the patient received conservative management that led to a full resolution within a few days. To date, this is the first case of CIS only involving the sublingual glands. We conclude that CIS can involve any of the major salivary glands.
The Innovative Design of Deep In Situ Pressure Retained Coring Based on Magnetic Field Trigger Controller
Authors: Liu Guikang , Gao Mingzhong , Yang Zhiwen , Chen Ling , Fu Maoquan , Xie Heping
Published: September 2020

Deep rock mass theory has not yet been completely established, which leads to a lack of theoretical guidance for deep resource development and poor continuity among engineering activities. The foundation of deep rock mechanics theory is to achieve the deep in situ rock fidelity coring (including the retaining of the pore pressure and temperature). To realize this, pressure‐retaining coring technology is required. A self‐triggered pressure‐retaining controller based on magnetic control is proposed in this paper. The pressure‐retaining controller realizes pressure‐retaining coring in any direction by triggering the closure of the valve cover by a magnetic force, forming a magnetic seal. Fifteen combined magnetic circuit design schemes are proposed. The magnetic flux density norm distribution and magnetic force evolution law of different schemes are then quantitatively analyzed by the finite element method. The results show that a complex magnetization combination can weaken the nonlinear negative correlation between the magnetic force and distance. The optimal design of the valve seat magnetic circuit is Scheme 9, with the valve seat consisting of four shape identical tile magnets. Among the schemes, for Scheme 9, the magnetic flux density norm of the valve cover is the most concentrated. The maximum magnetic flux density norm is in the middle, and the magnetic force at 35 mm from the valve cover to the valve seat is 2.915 N. Scheme 9 satisfies the minimum condition of the mechanical model and verifies the feasibility of magnetic field triggering. This research can be used to gain a better understanding of deep Earth properties and provides technology for the improved design of deep in situ pressure‐retaining coring devices.
Burkitt-Like Lymphoma with 11q Aberration: A Case Report and Review of a Rare Entity
Authors: Asadbeigi Sepideh N. , Deel Chelsey D.
Published: September 2020

Burkitt-like lymphoma with 11q aberration is a rare diagnostic entity commonly occurring in children and young adults with a nodal presentation. This entity shares many similar morphologic and immunophenotypic features with conventional Burkitt lymphoma and other aggressive B-cell lymphomas, making its recognition challenging. However, the presence of its characteristic 11q gain/loss pattern is helpful in the diagnosis. We report a case of Burkitt-like lymphoma presenting as a right neck mass in a 17-year-old female patient that demonstrated no improvement with antibiotic therapy. The neoplasm displayed a diffuse proliferation of intermediate-sized atypical lymphoid cells with prominent nucleoli in a background of apoptotic debris, morphologically raising concern for conventional Burkitt lymphoma. Subsequent immunohistochemical and cytogenetic studies established the most likely diagnosis of Burkitt-like lymphoma with 11q aberration. Though rare, Burkitt-like lymphoma exhibits significant morphologic overlap with other high-grade B-cell lymphomas, making it an important entity to consider on the differential diagnosis of these lesions.
Cardioprotective Effects of Sirtuin-1 and Its Downstream Effectors
Authors: Packer Milton
Published: September 2020

The cardioprotective effects of SGLT2 (sodium-glucose cotransporter 2) inhibitors may be related to their ability to induce a fasting-like paradigm, which triggers the activation of nutrient deprivation pathways to promote cellular homeostasis. The most distinctive metabolic manifestations of this fasting mimicry are enhanced gluconeogenesis and ketogenesis, which are not seen with other antihyperglycemic drugs. The principal molecular stimulus to gluconeogenesis and ketogenesis is activation of SIRT1 (sirtuin-1) and its downstream mediators: PGC-1α (proliferator-activated receptor gamma coactivator 1-alpha) and FGF21 (fibroblast growth factor 21). These three nutrient deprivation sensors exert striking cardioprotective effects in a broad range of experimental models. This benefit appears to be related to their actions to alleviate oxidative stress and promote autophagy—a lysosome-dependent degradative pathway that disposes of dysfunctional organelles that are major sources of cellular injury. Nutrient deprivation sensors are suppressed in states of perceived energy surplus (ie, type 2 diabetes mellitus and chronic heart failure), but SGLT2 inhibitors activate SIRT1/PGC-1α/FGF21 signaling and promote autophagy. This effect may be related to their action to trigger the perception of a system-wide decrease in environmental nutrients, but SGLT2 inhibitors may also upregulate SIRT1, PGC-1α, and FGF21 by a direct effect on the heart. Interestingly, metformin-induced stimulation of AMP-activated protein kinase (a nutrient deprivation sensor that does not promote ketogenesis) has not been shown to reduce heart failure events in clinical trials. Therefore, promotion of ketogenic nutrient deprivation signaling by SGLT2 inhibitors may explain their cardioprotective effects, even though SGLT2 is not expressed in the heart.
Temporal Trend of Age at Diagnosis in Hypertrophic Cardiomyopathy
Authors: Canepa Marco , Fumagalli Carlo , Tini Giacomo , Vincent-Tompkins Justin , Day Sharlene M. , Ashley Euan A. , Mazzarotto Francesco , Ware James S. , Michels Michelle , Jacoby Daniel , Ho Carolyn Y. , Olivotto Iacopo ,   The SHaRe Investigators
Published: September 2020

Background:

Over the last 50 years, the epidemiology of hypertrophic cardiomyopathy (HCM) has changed because of increased awareness and availability of advanced diagnostic tools. We aim to describe the temporal trends in age, sex, and clinical characteristics at HCM diagnosis over >4 decades.

Methods:

We retrospectively analyzed records from the ongoing multinational Sarcomeric Human Cardiomyopathy Registry. Overall, 7286 patients with HCM diagnosed at an age ≥18 years between 1961 and 2019 were included in the analysis and divided into 3 eras of diagnosis (<2000, 2000–2010, >2010).

Results:

Age at diagnosis increased markedly over time (40±14 versus 47±15 versus 51±16 years,
P
<0.001), both in US and non-US sites, with a stable male-to-female ratio of about 3:2. Frequency of familial HCM declined over time (38.8% versus 34.3% versus 32.7%,
P
<0.001), as well as heart failure symptoms at presentation (New York Heart Association III/IV: 18.1% versus 15.8% versus 12.6%,
P
<0.001). Left ventricular hypertrophy became less marked over time (maximum wall thickness: 20±6 versus 18±5 versus 17±5 mm,
P
<0.001), while prevalence of obstructive HCM was greater in recent cohorts (peak gradient >30 mm Hg: 31.9% versus 39.3% versus 39.0%,
P
=0.001). Consistent with decreasing phenotypic severity, yield of pathogenic/likely pathogenic variants at genetic testing decreased over time (57.7% versus 45.6% versus 38.4%,
P
<0.001).

Conclusions:

Evolving HCM populations include progressively greater representation of older patients with sporadic disease, mild phenotypes, and genotype-negative status. Such trend suggests a prominent role of imaging over genetic testing in promoting HCM diagnoses and urges efforts to understand genotype-negative disease eluding the classic monogenic paradigm.
Contribution of the Renal Nerves to Hypertension in a Rabbit Model of Chronic Kidney Disease
Authors: Sata Yusuke , Burke Sandra L. , Gueguen Cindy , Lim Kyungjoon , Watson Anna M.D. , Jha Jay C. , Eikelis Nina , Jackson Kristy L. , Lambert Gavin W. , Denton Kate M. , Schlaich Markus P. , Head Geoffrey A.
Published: September 2020

Overactivity of the sympathetic nervous system and high blood pressure are implicated in the development and progression of chronic kidney disease (CKD) and independently predict cardiovascular events in end-stage renal disease. To assess the role of renal nerves, we determined whether renal denervation (RDN) altered the hypertension and sympathoexcitation associated with a rabbit model of CKD. The model involves glomerular layer lesioning and uninephrectomy, resulting in renal function reduced by one-third and diuresis. After 3-week CKD, blood pressure was 13±2 mm Hg higher than at baseline (
P
<0.001), and compared with sham control rabbits, renal sympathetic nerve activity was 1.2±0.5 normalized units greater (
P
=0.01). The depressor response to ganglion blockade was also +8.0±3 mm Hg greater, but total norepinephrine spillover was 8.7±3.7 ng/min lower (both
P
<0.05). RDN CKD rabbits only increased blood pressure by 8.0±1.5 mm Hg. Renal sympathetic activity, the response to ganglion blockade and diuresis were similar to sham denervated rabbits (non-CKD). CKD rabbits had intact renal sympathetic baroreflex gain and range, as well as normal sympathetic responses to airjet stress. However, hypoxia-induced sympathoexcitation was reduced by −9±0.4 normalized units. RDN did not alter the sympathetic response to hypoxia or airjet stress. CKD increased oxidative stress markers Nox5 and MCP-1 (monocyte chemoattractant protein-1) in the kidney, but RDN had no effect on these measures. Thus, RDN is an effective treatment for hypertension in this model of CKD without further impairing renal function or altering the normal sympathetic reflex responses to various environmental stimuli.
Elevated Cellular Oxidative Stress in Circulating Immune Cells in Otherwise Healthy Young People Who Use Electronic Cigarettes in a Cross‐Sectional Single‐Center Study: Implications for Future Cardiovascular Risk
Authors: Kelesidis Theodoros , Tran Elizabeth , Arastoo Sara , Lakhani Karishma , Heymans Rachel , Gornbein Jeffrey , Middlekauff Holly R.
Published: September 2020

Background

Tobacco cigarettes (TCs) increase oxidative stress and inflammation, both instigators of atherosclerotic cardiac disease. It is unknown if electronic cigarettes (ECs) also increase immune cell oxidative stress. We hypothesized an ordered, “dose‐response” relationship, with tobacco‐product type as “dose” (lowest in nonsmokers, intermediate in EC vapers, and highest in TC smokers), and the “response” being cellular oxidative stress (COS) in immune cell subtypes, in otherwise, healthy young people.

Methods and Results

Using flow cytometry and fluorescent probes, COS was determined in immune cell subtypes in 33 otherwise healthy young people: nonsmokers (n=12), EC vapers (n=12), and TC smokers (n=9). Study groups had similar baseline characteristics, including age, sex, race, and education level. A dose‐response increase in proinflammatory monocytes and lymphocytes, and their COS content among the 3 study groups was found: lowest in nonsmokers, intermediate in EC vapers, and highest in TC smokers. These findings were most striking in CD14
dim
CD16
+
and CD14
++
CD16
+
proinflammatory monocytes and were reproduced with 2 independent fluorescent probes of COS.

Conclusions

These findings portend the development of premature cardiovascular disease in otherwise healthy young people who chronically vape ECs. On the other hand, that the COS is lower in EC vapers compared with TC smokers warrants additional investigation to determine if switching to ECs may form part of a harm‐reduction strategy.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03823885.
Unraveling Representations in Scene-selective Brain Regions Using Scene-Parsing Deep Neural Networks
Authors: Dwivedi Kshitij , Cichy Radoslaw Martin , Roig Gemma
Published: September 2020

Visual scene perception is mediated by a set of cortical regions that respond preferentially to images of scenes, including the occipital place area (OPA) and parahippocampal place area (PPA). However, the differential contribution of OPA and PPA to scene perception remains an open research question. In this study, we take a deep neural network (DNN)-based computational approach to investigate the differences in OPA and PPA function. In a first step, we search for a computational model that predicts fMRI responses to scenes in OPA and PPA well. We find that DNNs trained to predict scene components (e.g., wall, ceiling, floor) explain higher variance uniquely in OPA and PPA than a DNN trained to predict scene category (e.g., bathroom, kitchen, office). This result is robust across several DNN architectures. On this basis, we then determine whether particular scene components predicted by DNNs differentially account for unique variance in OPA and PPA. We find that variance in OPA responses uniquely explained by the navigation-related floor component is higher compared to the variance explained by the wall and ceiling components. In contrast, PPA responses are better explained by the combination of wall and floor, that is, scene components that together contain the structure and texture of the scene. This differential sensitivity to scene components suggests differential functions of OPA and PPA in scene processing. Moreover, our results further highlight the potential of the proposed computational approach as a general tool in the investigation of the neural basis of human scene perception.
Temporal Expectations Prepare Visual Working Memory for Behavior
Authors: Jin Wen , Nobre Anna C. , van Ede Freek
Published: September 2020

Working memory enables us to retain past sensations in service of anticipated task demands. How we prepare for anticipated task demands during working memory retention remains poorly understood. Here, we focused on the role of time—asking how temporal expectations help prepare for ensuing memory-guided behavior. We manipulated the expected probe time in a delayed change-detection task and report that temporal expectation can have a profound influence on memory-guided behavioral performance. EEG measurements corroborated the utilization of temporal expectations: demonstrating the involvement of a classic EEG signature of temporal expectation—the contingent negative variation—in the context of working memory. We also report the influence of temporal expectations on 2 EEG signatures associated with visual working memory—the lateralization of 8- to 12-Hz alpha activity, and the contralateral delay activity. We observed a dissociation between these signatures, whereby alpha lateralization (but not the contralateral delay activity) adapted to the time of expected memory utilization. These data show how temporal expectations prepare visual working memory for behavior and shed new light on the electrophysiological markers of both temporal expectation and working memory.
Diagnostic Utility of Salivary Pepsin as Compared With 24‐Hour Dual pH/Impedance Probe in Laryngopharyngeal Reflux
Authors: Zhang Michael , Chia Clemente , Stanley Claire , Phyland Debra J. , Paddle Paul M.
Published: September 2020

Objective

Laryngopharyngeal reflux (LPR) is defined as the retropulsion of gastric contents into the larynx, oropharynx, and/or nasopharynx. The 24‐hour combined hypopharyngeal‐esophageal multichannel intraluminal impedance with dual pH probe (24h‐HEMII‐pH) is currently the gold standard in LPR diagnosis; however, it is invasive, user dependent, and not always tolerated. This study assesses the diagnostic utility of salivary pepsin (Peptest) at different thresholds and during symptomatic periods as compared with the 24h‐HEMII‐pH probe in diagnosing LPR.

Study Design

Prospective cohort study.

Setting

Private laryngology clinic in Melbourne, Australia.

Subjects and Methods

Thirty‐five patients with a clinical history and endoscopic findings of LPR were recruited and simultaneously evaluated for LPR via 24h‐HEMII‐pH probe and salivary pepsin analysis at 5 key time points over the same 24‐hour period.

Results

Salivary pepsin was 76.9% sensitive and had a positive predictive value (PPV) of 87.0% at a threshold of 16 ng/mL when compared with the 24h‐HEMII‐pH probe. If the pathologic pepsin threshold was raised to 75 ng/mL, salivary pepsin had a sensitivity of 57.7%, a specificity of 75.0%, and a PPV of 93.8%. Symptomatic testing conferred a superior specificity at 16 ng/mL (66.7%) and 75 ng/mL (100.0%) and a superior PPV at 16 ng/mL (92.3%) and 75 ng/mL (100.0%).

Conclusion

Salivary pepsin detection is a simpler, more cost‐effective, and less traumatic universal first‐line alternative to 24h‐HEMII‐pH probe in diagnosing LPR. Superior specificities conferring greater diagnostic value may be achieved with higher thresholds and symptomatic testing. If clinical suspicion remains high following negative salivary pepsin analysis, a 24h‐HEMII‐pH study could provide further diagnostic information.
Pediatric Aural Foreign Body Extraction: Comparison of Efficacies Among Clinical Settings and Retrieval Methods
Authors: Shih Michael , Brock Linda , Liu Yi‐Chun Carol
Published: September 2020

Objectives

To compare the efficacy of aural foreign body (FB) extractions among medical care settings and determine if certain methods of extraction resulted in higher failure rates and procedural complications.

Study Design

Case series with chart review.

Setting

Emergency departments (EDs), urgent cares (UCs), pediatric primary care providers (PCPs), and otolaryngologists (ENTs).

Methods

A total of 366 pediatric patients with EAC foreign bodies at a tertiary children’s hospital and associated satellite clinics.

Results

The ED/UCs (17.46%), PCPs (75.22%), and ENTs (94.54%) exhibited highly variable success rates for pediatric aural FB extractions. Complications were considerably higher for attempts by ED/UCs (22.22%) as compared with PCPs (2.61%) and those of unclear etiology (2.73% of all attempts). Use of balloon‐tipped catheters and adhesive‐tipped probes (eg, cyanoacrylate/superglue) for FB extraction exhibited 0% success rates with high severity of complications.

Conclusion

Our statistics provide an example in which ED/UCs had higher failure rates at pediatric aural FB removals when compared with PCPs and ENTs. If a single provider (PCP or ED/UC) fails to retrieve an aural FB or if the provider is not comfortable conducting the procedure, then referral to an ENT is preferable to another PCP or ED/UC. Our evidence reveals that balloon‐tipped catheters and adhesive‐tipped probes for FB removal in the pediatric population are prone to failure and higher rates/severity of complications.
Perioperative management of distal radius fractures
Authors: Lim Jiang An , Loh Bryan LC , Sylvester George , Khan Wasim
Published: September 2020

Fractures of the distal radius are the most common upper limb fracture and account for over a sixth of all fractures seen in emergency departments. Although most of these fractures are managed non-operatively, a significant number of complex injuries undergo operative management. This educational review of up to date guidelines discusses the perioperative management of distal radius fractures and provides readers with continuing professional development activities.
The Gap Between Subjective Return to Sports and Subjective Athletic Performance Intensity After Anterior Cruciate Ligament Reconstruction
Authors: Ohji Shunsuke , Aizawa Junya , Hirohata Kenji , Ohmi Takehiro , Koga Hideyuki , Okawa Atsushi , Jinno Tetsuya , Yagishita Kazuyoshi
Published: September 2020

Background:

On a questionnaire administered to athletes who had undergone anterior cruciate ligament reconstruction (ACLR), some answered “yes” to a question regarding return to sports (RTS) at the preinjury level despite having lower postoperative subjective athletic performance (PoSAP) intensity compared with preoperative levels.

Purpose:

To investigate the agreement between responses regarding RTS and PoSAP intensity after ACLR.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

A total of 44 individuals, 24.8 ± 18.4 months after ACLR, participated in this study. They completed a questionnaire in which PoSAP was graded as a percentage of preoperative performance level. They also gave dichotomous responses (yes/no) to the question of whether they had been able to RTS at the same level as before their injury (RTS question). Participants were divided into 2 groups according to their PoSAP scores using different cutoff values (100%, 90%, 80%, and 70%), and an exploratory analysis was conducted of the cutoff value for dividing PoSAP scores that provided the greatest agreement with the response to the RTS question.

Results:

The mean PoSAP score was 87.5% ± 14.9%, and 33 participants (75%) answered “yes” to the RTS question. The agreement between the PoSAP score and the RTS question was lowest when the cutoff value was 100% (κ = 0.294) and highest when the cutoff value was 80% (κ = 0.676) and 90% (κ = 0.632).

Conclusion:

More athletes who had undergone ACLR answered “yes” to the RTS question even when their PoSAP score was around 80%. Asking only for dichotomous responses may result in overestimating the level to which these athletes’ performance has recovered after ACLR.
Adsorption ofLippia multifloraessential oil on two surfactant-modified clays: qualitative approach
Authors: Gueu Soumahoro , Tia Vama Etienne , Bartier Danièle , Barres Odile , Soro Fatogoma Dolourou
Published: September 2020

This paper deals with the adsorption of an essential oil (EO) on a kaolinite-rich clay and a smectite-rich clay. The two clays were modified with a quaternary alkyl ammonium surfactant to create a lipophilic environment for better adsorption of the EO. The preparation of the clay/EO hybrids avoided the use of a slurry and organic solvent. The selected EO was that ofLippia multiflora. This EO has insecticidal properties. The surfactant was trioctyl methylammonium (TOMA). The modified clays were characterized by X-ray diffraction (XRD) and infrared (IR) spectroscopy. The smectite-rich clay displayed greater adsorption of theL. multifloraEO compared to the kaolinite-rich clay. The interlayer space of the kaolinite-rich clay was not affected by the adsorption of the TOMA and/or EO molecules, which suggests that the adsorption in this clay took place on the external surface. By contrast, a significant increase in the interlayer space of the smectite-rich clay was observed, suggesting that the adsorption process of TOMA and/or EO took place on both the external and internal surfaces. The IR analysis showed that the surfactant loading in the interlayer space of the smectite-rich clay introduces a gauche conformation in the alkyl chains. A formulation mixing this local smectite-rich clay and theL. multifloraEO has potential for the manufacture of new biopesticides.
Identification of functional cooperative mutations of GNAO1 in human acute lymphoblastic leukemia
Authors: Song Lili , Yu Bo , Yang Yi , Liang Jianwei , Zhang Yingwen , Ding Lixia , Wang Tianyi , Wan Xinyu , Yang Xiaomin , Tang Jingyan , Wang Shengyue , Li Benshang , Li Yanxin , Feng Haizhong
Published: September 2020

Leukemogenesis is characterized by chromosomal rearrangements with additional molecular disruptions, yet the cooperative mechanisms are still unclear. Using whole-exome sequencing of a pair of monozygotic twins who were discordant for childhood acute lymphoblastic leukemia (ALL) with ETV6-RUNX1 (E/R) gene fusion successively after birth, we identified the R209C mutation of G protein subunit α o1 (GNAO1) as a new ALL risk loci. Moreover, GNAO1 missense mutations are recurrent in ALL patients and are associated with E/R fusion. Ectopic expression of the GNAO1 R209C mutant increased its GTPase activity and promoted cell proliferation and cell neoplastic transformation. Combined with the E/R fusion, the GNAO1 R209C mutation promoted leukemogenesis through activating PI3K/Akt/mTOR signaling. Reciprocally, activated mTORC1 phosphorylated p300 acetyltransferase, which acetylated E/R and thereby enhanced the E/R transcriptional activity of GNAO1 R209C. Thus, our study provides clinical evidence of the functional cooperation of GNAO1 mutations and E/R fusion, suggesting GNAO1 as a therapeutic target in human leukemia.
Concomitant use of a dual Src/ABL kinase inhibitor eliminates the in vitro efficacy of blinatumomab against Ph+ ALL
Authors: Leonard Jessica T. , Kosaka Yoko , Malla Pavani , LaTocha Dorian , Lamble Adam , Hayes-Lattin Brandon , Byrd Kaelan , Druker Brian J. , Tyner Jeffrey W. , Chang Bill H. , Lind Evan
Published: September 2020

Blinatumomab is currently approved for use as a single agent in relapsed and refractory acute lymphoblastic leukemia (ALL). Cytotoxicity is mediated via signaling through the T-cell receptor (TCR). There is now much interest in combining blinatumomab with targeted therapies, particularly in Philadelphia chromosome–positive ALL (Ph+ ALL). However, some second- and third-generation ABL inhibitors also potently inhibit Src family kinases that are important in TCR signaling. We combined ABL inhibitors and dual Src/ABL inhibitors with blinatumomab in vitro from both healthy donor samples and primary samples from patients with Ph+ ALL. Blinatumomab alone led to both T-cell proliferation and elimination of target CD19+ cells and enhanced production of interferon-γ (IFN-γ). The addition of the ABL inhibitors imatinib or nilotinib to blinatumomab did not inhibit T-cell proliferation or IFN-γ production. However, the addition of dasatinib or ponatinib inhibited T-cell proliferation and IFN-γ production. Importantly, there was no loss of CD19+ cells treated with blinatumomab plus dasatinib or ponatinib in healthy samples or samples with a resistant ABL T315I mutation by dasatinib in combination with blinatumomab. These in vitro findings bring pause to the excitement of combination therapies, highlighting the importance of maintaining T-cell function with targeted therapies.
A prospective, blinded study of a PF4-dependent assay for HIT diagnosis
Authors: Samuelson Bannow Bethany , Warad Deepti M. , Jones Curtis G. , Pechauer Shannon M. , Curtis Brian R. , Bougie Daniel W. , Sharma Ruchika , Grill Diane E. , Redman Mary W. , Khalighi Parisa R. , Leger Rachel R. , Pruthi Rajiv K. , Chen Dong , Sabath Daniel E. , Aster Richard H. , Garcia David A. , Padmanabhan Anand
Published: September 2020

Heparin-induced thrombocytopenia (HIT) is a life-threatening, prothrombotic, antibody-mediated disorder. To maximize the likelihood of recovery, early and accurate diagnosis is critical. Widely available HIT assays, such as the platelet factor 4 (PF4) heparin enzyme-linked immunosorbent assay (ELISA) lack specificity, and the gold-standard carbon 14–labeled serotonin release assay (SRA) is of limited value for early patient management because it is available only through reference laboratories. Recent studies have demonstrated that pathogenic HIT antibodies selectively activate PF4-treated platelets and that a technically simpler assay, the PF4-dependent P-selectin expression assay (PEA), may provide an option for rapid and conclusive results. Based upon predefined criteria that combined 4Ts scores and HIT ELISA results, 409 consecutive adults suspected of having HIT were classified as disease positive, negative, or indeterminate. Patients deemed HIT indeterminate were considered disease negative in the primary analysis and disease positive in a sensitivity analysis. The ability of PEA and SRA to identify patients judged to have HIT was compared using receiver operating characteristic curve statistics. Using these predefined criteria, the diagnostic accuracy of PEA was high (area under the curve [AUC], 0.94; 95% confidence interval [CI], 0.87-1.0) and similar to that of SRA (AUC, 0.91; 95% CI, 0.82-1.0). In sensitivity analysis, the AUCs of PEA and SRA were also similar at 0.88 (95% CI, 0.78-0.98) and 0.86 (95% CI, 0.77-0.96), respectively. The PEA, a technically simple nonradioactive assay that uses ∼20-fold fewer platelets compared with the SRA, had high accuracy for diagnosing HIT. Widespread use of the PEA may facilitate timely and more effective management of patients with suspected HIT.
3D cone-beam CT with a twin robotic x-ray system in elbow imaging: comparison of image quality to high-resolution multidetector CT
Authors: Grunz Jan-Peter , Weng Andreas Max , Kunz Andreas Steven , Veyhl-Wichmann Maike , Schmitt Rainer , Gietzen Carsten Herbert , Pennig Lenhard , Herz Stefan , Ergün Süleyman , Bley Thorsten Alexander , Gassenmaier Tobias
Published: September 2020

Background

Elbow imaging is challenging with conventional multidetector computed tomography (MDCT), while cone-beam CT (CBCT) provides superior options. We compared intra-individually CBCT versus MDCT image quality in cadaveric elbows.

Methods

A twin robotic x-ray system with new CBCT mode and a high-resolution clinical MDCT were compared in 16 cadaveric elbows. Both systems were operated with a dedicated low-dose (LD) protocol (equivalent volume CT dose index [CTDIvol(16 cm)] = 3.3 mGy) and a regular clinical scan dose (RD) protocol (CTDIvol(16 cm) = 13.8 mGy). Image quality was evaluated by two radiologists (R1 and R2) on a seven-point Likert scale, and estimation of signal intensity in cancellous bone was conducted. Wilcoxon signed-rank tests and intraclass correlation coefficient (ICC) statistics were used.

Results

The CBCT prototype provided superior subjective image quality compared to MDCT scans (for RD, p ≤ 0.004; for LD, p ≤ 0.001). Image quality was rated very good or excellent in 100% of the cases by both readers for RD CBCT, 100% (R1) and 93.8% (R2) for LD CBCT, 62.6% and 43.8% for RD MDCT, and 0.0% and 0.0% for LD MDCT. Single-measure ICC was 0.95 (95% confidence interval 0.91–0.97; p < 0.001). Software-based assessment supported subjective findings with less “undecided” pixels in CBCT than dose-equivalent MDCT (p < 0.001). No significant difference was found between LD CBCT and RD MDCT.

Conclusions

In cadaveric elbow studies, the tested cone-beam CT prototype delivered superior image quality compared to high-end multidetector CT and showed a potential for considerable dose reduction.
Using a Collaborative, Virtual Discussion Platform to Mobilize Oncologic Expertise for the COVID-19 Pandemic
Authors: Bejjani Anthony , Burt Lindsay , Washington Christina , Terao Michael , Housri Samir , Housri Nadine
Published: September 2020

PURPOSE

COVID-19 is a rapidly emerging worldwide pandemic that has drastically changed health care across the United States. Oncology patients are especially vulnerable. Novel point-of-care resources may be useful to rapidly disseminate peer-reviewed information from oncology experts nationwide. We describe our initial experience with distributing this information through a private, curated, virtual collaboration question-and-answer (Q&A) platform for oncologists.

METHODS

The Q&A database was queried for a 2-month period from March 12 to May 12, 2020. We collected the total number of views and unique viewers for the questions. We classified the questions according to their emphasis (practice management, clinical management, both) and disease type across radiation oncology, medical oncology, gynecologic oncology, and pediatric oncology.

RESULTS

Seventy-nine questions were approved, 67 of which were answered and generated 49,494 views with 5,148 unique viewers. Most discussions covered clinical management, with breast cancer being the most active disease site. Ten questions covered pediatric oncology and gynecologic oncology. Forty-seven percent of the 11,010 users of the platform visited the website during the 2-month period.

CONCLUSION

Discussions on the Q&A platform reached a substantial number of oncologists throughout the nation and may help oncologists to modify their treatment in real time with the rapidly evolving COVID-19 pandemic.
Cellular and Molecular Mechanisms of Metformin Action
Authors: LaMoia Traci E , Shulman Gerald I
Published: September 2020

Metformin is a first-line therapy for the treatment of type 2 diabetes, due to its robust glucose-lowering effects, well-established safety profile, and relatively low cost. While metformin has been shown to have pleotropic effects on glucose metabolism, there is a general consensus that the major glucose-lowering effect in patients with type 2 diabetes is mostly mediated through inhibition of hepatic gluconeogenesis. However, despite decades of research, the mechanism by which metformin inhibits this process is still highly debated. A key reason for these discrepant effects is likely due to the inconsistency in dosage of metformin across studies. Widely studied mechanisms of action, such as complex I inhibition leading to AMPK activation, have only been observed in the context of supra-pharmacological (>1 mM) metformin concentrations, which do not occur in the clinical setting. Thus, these mechanisms have been challenged in recent years and new mechanisms have been proposed. Based on the observation that metformin alters cellular redox balance, a redox-dependent mechanism of action has been described by several groups. Recent studies have shown that clinically relevant (50-100 μM) concentrations of metformin inhibit hepatic gluconeogenesis in a substrate-selective manner both in vitro and in vivo, supporting a redox-dependent mechanism of metformin action. Here, we review the current literature regarding metformin’s cellular and molecular mechanisms of action.
STRATEGI PEMASARAN USAHA KECIL MENENGAH PADA IBU-IBU AISYIAH MUHAMMADIYAH BALI
Authors: Budiyanto Tri
Published: September 2020

Most of the Aisyiah womens in the Muhammadiyah Bali region have side jobs as housewives. Various businesses include Small Medium Enterprises (in Bahasa Indonesia, Usaha Kecil dan Menengah) engaged in grocery stalls, selling cloth, food stalls, furniture businesses, Muslim fashion stores and others. Some of the obstacles faced in developing their businesses include capitalization, management and location determination, as well as the quality of production as well as marketing.The purpose of this service activity is to equip Aisyiah Muhammadiyah Bali women in implementing marketing strategies that are in line with their business and competing in marketing. The benefits of this dedication for Aisyiah's mothers are getting knowledge and understanding related to the marketing field.