bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of incombustibles in the feedstock to incineration facilities in Republic of Korea for optimum sorting and management
Authors: Kim Kyuyeon , Lee Suyoung , Yang Wonseok , Choi Gyunggoo , Lee Wonseok , Shin Sunkyoung
Published: October 2020

The Ministry of Environment, Republic of Korea has implemented the “Framework Act on Resource Recirculation” to activate waste resource recovery. However, industrial waste treatment facilities have some problems related to diversity of waste received for proper management of wastes. Waste incineration facilities are required to receive and process combustible waste and are forbidden to re-consign waste to other waste treatment facilities without any processing. In reality, a large quantity of incombustibles is injected into the incinerator because it is impossible to completely separate the incombustible materials. Therefore, it is necessary to develop additional management criteria for optimal operation of the incineration facility. This study was conducted to improve institutional management of incineration facilities in Korea. Through a literature review and statistics study, incombustible waste management trends were investigated. The characteristics of waste entering incineration facilities were surveyed. Physical composition and proximate analysis of incoming waste were conducted, and properties of the incombustibles mixed in feedstock to waste incineration facilities were examined. As a result of this study, incombustibles mainly consisting of the construction and demolition waste, such as soil, glass, and metals should be separated from feed sent to incinerators. A mechanical screening technique that sorts particles of 30–40 mm in size can be used to separate the incombustibles. Also, management criteria could be proposed to sort and re-consign the incombustibles.
Remaking History
Authors: Nazzaro Joe
Published: October 2020

This article follows Wesley Wofford's Journey to Freedom Harriet Tubman monument. From its origins as a private commission, to becoming a much needed and relevant voice during these tumultuous times, Harriet Tubman is a historic figure that inspires hope in everyone. The poetic parallels of this statue traveling around the country during the Black Lives Matter movement is nothing short of serendipitous.
The Clinical Value of the Faux Pas Test for Diagnosing Behavioral-Variant Frontotemporal Dementia
Authors: Delbeuck Xavier , Pollet Marianne , Pasquier Florence , Bombois Stéphanie , Moroni Christine
Published: October 2020

Objective:

We studied the clinical value of the faux pas test to diagnose behavioral-variant frontotemporal dementia.

Methods:

The faux pas test was administered to patients referred to a memory clinic in a context of behavioral disturbances. The diagnosis of behavioral-variant frontotemporal dementia (n = 14) or not (n = 25) was confirmed after a 3 years follow-up.

Results:

The faux pas test displayed a high sensitivity for behavioral-variant frontotemporal dementia (.83) however its specificity was only moderate (.64).

Conclusions:

Our results confirm that the FPT capture’s specific cognitive impairments in patients with behavioral-variant frontotemporal dementia. However, some patients with psychiatric disease or other neurological diseases may also show impaired scores.
Changes in Self- and Informant-Reported Frontal Behaviors in Parkinson’s Disease: A Longitudinal Study
Authors: Pluim Celina F. , Nakhla Marina Z. , Split Molly , Filoteo J. Vincent , Litvan Irene , Moore Raeanne C. , Lessig Stephanie , Schiehser Dawn M.
Published: October 2020

Objective:

Frontal behaviors (i.e., executive dysfunction, disinhibition, apathy) are common in Parkinson’s disease (PD). However, it is unclear if patient and informant reports of patient frontal behaviors are in agreement over time.

Method:

Sixty-two PD patients without dementia and their informants (87% spouses/partners) completed the self- and informant-versions of the Frontal Systems Behavior Scale at baseline and 2-year follow-up. Dyad ratings were compared and predictors of behavior ratings were examined.

Results:

Patient and informant reports at baseline and follow-up were in agreement, with significant increases in overall frontal behaviors, executive dysfunction, and apathy. Higher levels of baseline patient depression and caregiver burden predicted decrements in patient-reported executive function; worse patient cognition at baseline predicted worsening apathy as rated by informants.

Conclusions:

PD patients and their informants are concordant in their ratings of worsening frontal behaviors over time. Targeting patient depression, cognition, and caregiver burden may improve decrements in frontal behaviors (executive dysfunction and apathy) in PD.
Urban Children’s Well-Being Factors and Qualities of Being and Doing in Natural Space: Nature Immersion
Authors: Nagata Misako , Liehr Patricia
Published: October 2020

Research has suggested positive effects of nature immersion–a state of being or an act of doing in natural space–for urban children who were otherwise at risk for emotional or behavioral problems. However, few studies have systematically investigated natural space qualities that predict child well-being at the clinical level. The purpose of this study was to increase the understanding of natural space qualities as factors of urban child well-being. Explanatory mixed methods were used. Quantitative data ( N = 174) included a survey and two parental reports of child well-being. Interviews provided qualitative data ( N = 15). Data were analyzed using generalized linear model and content analysis. Both data streams were merged into a point of meta-inference that contributed to parental assessment of enhanced child well-being: More frequent nature–child space-time immersion combined with parental valuing of nature connection ( p < .001) as a soothing and safe resource. The factors of urban nature immersion affected child well-being over parental socioeconomic affluence alone. The evidence corresponds to Nightingale’s tenet that an act of doing, which is considered an action of the child’s own will, affects one’s sense of well-being. The findings indicate that nature immersion can be applied to urban child self-care and holistic nursing modalities.
Lipid emulsion attenuates extrinsic apoptosis induced by amlodipine toxicity in rat cardiomyoblasts
Authors: Ok Seong-Ho , Ahn Seung Hyun , Kim Hyun-Jin , Lee Soo Hee , Bae Sung Il , Park Kyeong-Eon , Hwang Yeran , Shin Il-Woo , Yoon Sangcheol , Sohn Ju-Tae
Published: October 2020

Amlodipine-induced toxicity has detrimental effects on cardiac cells. The aim of this study was to examine the effect of lipid emulsion on decreased H9c2 rat cardiomyoblast viability induced by amlodipine toxicity. The effects of amlodipine, lipid emulsion, LY 294002, and glibenclamide, either alone or in combination, on cell viability and count, apoptosis, and expression of cleaved caspase-3 and -8, and Bax were examined. LY 294002 and glibenclamide partially reversed lipid emulsion-mediated attenuation of decreased cell viability and count induced by amlodipine. Amlodipine increased caspase-3 and -8 expression, but it did not alter Bax expression. LY 294002 and glibenclamide reversed lipid emulsion-mediated inhibition of cleaved caspase-3 and -8 expression induced by amlodipine. Lipid emulsion inhibited early and late apoptosis induced by amlodipine. LY 294002 and glibenclamide inhibited lipid emulsion-mediated inhibition of late apoptosis induced by amlodipine, but they did not significantly alter lipid emulsion-mediated inhibition of early apoptosis induced by amlodipine. Lipid emulsion decreased amlodipine-induced TUNEL-positive cells. These results suggest that lipid emulsion inhibits late apoptosis induced by amlodipine at toxic dose via the activation of phosphoinositide-3 kinase and ATP-sensitive potassium channels in the extrinsic apoptotic pathway.
Glycyrrhizic acid ameliorates sodium nitrite-induced lung and salivary gland toxicity: Impact on oxidative stress, inflammation and fibrosis
Authors: Elsherbini Amira M , Maysarah Nadia M , El-Sherbiny Mohamed , Al-Gayyar Mohammed MH , Elsherbiny Nehal M
Published: October 2020

Despite wide application of sodium nitrite (SN) as food additive, it exhibits considerable side effects on various body organs at high dose or chronic exposure. The aim of this study was to test whether Glycyrrhizic acid (GA) could ameliorate SN-induced toxicity in lung and submandibular salivary gland (SMG). A sample size of 30 adult male albino rats was randomly allocated into 3 groups. Group 1 served as control group. Rats were treated orally with 80 mg/kg of SN in group 2 or SN preceded by (15 mg/kg) GA in group 3. Lung & SMG tissues were used for oxidative stress assessment, examination of histopathological changes, fibrosis (MTC, TGF-β and α-SMA) and inflammation (TNF-α, IL-1β and CD-68). Concurrent administration of GA ameliorated pulmonary and salivary SN-induced toxicity via restoring the antioxidant defense mechanisms with reduction of MDA levels. GA reduced the key regulators of fibrosis TGF-β and α-SMA and collagen deposition. In addition to reduction of inflammatory cytokine (TNF-α, IL-1β) and macrophages recruitments, GA amended both pulmonary and salivary morphological changes. The present study proposed GA as a promising natural herb with antioxidant, anti-inflammatory and antifibrotic effects against pulmonary and salivary SN-induced toxicity.
The Paracrine Function of Mesenchymal Stem Cells in Response to Pulsed Focused Ultrasound
Authors: Razavi Mehdi , Rezaee Melika , Telichko Arsenii , Inan Hakan , Dahl Jeremy , Demirci Utkan , Thakor Avnesh S.
Published: October 2020

We studied the paracrine function of mesenchymal stem cells (MSCs) derived from various sources in response to pulsed focused ultrasound (pFUS). Human adipose tissue (AD), bone marrow (BM), and umbilical cord (UC) derived MSCs were exposed to pFUS at two intensities: 0.45 W/cm2 ISATA (310 kPa PNP) and 1.3 W/cm2 ISATA (540 kPa PNP). Following pFUS, the viability and proliferation of MSCs were assessed using a hemocytometer and confocal microscopy, and their secreted cytokine profile determined using a multiplex ELISA. Our findings showed that pFUS can stimulate the production of immunomodulatory, anti-inflammatory, and angiogenic cytokines from MSCs which was dependent on both the source of MSC being studied and the acoustic intensity employed. These important findings set the foundation for additional mechanistic and validation studies using this novel noninvasive and clinically translatable technology for modulating MSC biology.
Special Issue: Genealogies of Indefinite Detention
Authors: San Roque Mehera
Published: October 2020

This introduction provides an overview of the collection of papers in this special issue on genealogies of indefinite detention. This collection of papers builds on the work of Professor Penny Pether (1957 - 2013), in particular her book proposal, ‘“Perverts,” “terrorists,” and business as usual: Comparative Indefinite Detentions before and after 9/11’.
The emerging role of targeting cancer metabolism for cancer therapy
Authors: Farhadi Pegah , Yarani Reza , Dokaneheifard Sadat , Mansouri Kamran
Published: October 2020

Glucose, as the main consuming nutrient of the body, faces different destinies in cancer cells. Glycolysis, oxidative phosphorylation, and pentose phosphate pathways produce different glucose-derived metabolites and thus affect cells’ bioenergetics differently. Tumor cells’ dependency to aerobic glycolysis and other cancer-specific metabolism changes are known as the cancer hallmarks, distinct cancer cells from normal cells. Therefore, these tumor-specific characteristics receive the limelight as targets for cancer therapy. Glutamine, serine, and fatty acid oxidation together with 5-lipoxygenase are main pathways that have attracted lots of attention for cancer therapy. In this review, we not only discuss different tumor metabolism aspects but also discuss the metabolism roles in the promotion of cancer cells at different stages and their difference with normal cells. Besides, we dissect the inhibitors potential in blocking the main metabolic pathways to introduce the effective and non-effective inhibitors in the field.
Serrated Lesions in Inflammatory Bowel Disease: Genotype-Phenotype Correlation
Authors: Brcic Iva , Dawson Heather , Gröchenig Hans Peter , Högenauer Christoph , Kashofer Karl
Published: October 2020

Background

Patients with inflammatory bowel disease (IBD) and hyperplastic/serrated polyposis have an increased risk of colorectal cancer. The aim of our study was to elucidate the nature of serrated lesions in IBD patients.

Materials and Methods

Sixty-five lesions with serrated morphology were analyzed in 39 adult IBD patients. Lesions were classified according to the WHO 2019 criteria or regarded as reactive, and molecular analysis was performed.

Results

82.1% of patients had ulcerative colitis, 17.9% had Crohn’s disease; 51.3% were female, and the mean age was 54.5 years. The duration of IBD varied significantly (16.7 ± 11.4 years). Endoscopy showed polypoid lesions in 80.3%; the size ranged from 2 to 20 mm. A total of 21.6% of the lesions were located in the right colon. Five lesions were classified as inflammatory pseudopolyps, 28 as hyperplastic polyp, 21 and 2 as sessile serrated lesion without and with dysplasia, respectively, and 9 as traditional serrated adenoma with low-grade dysplasia. Analysis of all true serrated lesions revealed 31 mutations in KRAS and 32 in BRAF gene. No mutations were identified in inflammatory pseudopolyps. In the right colon BRAF mutations were more frequent than KRAS (16 vs 3), while KRAS mutations prevailed on the left side (28 vs 16, P < .001). One patient with traditional serrated adenomas progressed to an adenocarcinoma after 61 months.

Conclusion

The molecular analysis could help discriminate true serrated lesions (IBD-associated or not) from reactive pseudopolyps with serrated/hyperplastic epithelial change. These should help in more accurate classification of serrated lesions.
Making Authoritarian Environmentalism Accountable? Understanding China’s New Reforms on Environmental Governance
Authors: Shen Wei , Jiang Dong
Published: October 2020

One of the key puzzles of authoritarian environmentalism is its dubious effectiveness due to fragmented interests among different political and market actors, which are often found undermining centrally crafted environmental regulations and targets. China recently launched a series of institutional reforms to fix its notorious local implementation gaps on environmental policies. By setting up a stringent central inspection system and holding frequent inquiry meetings with local government leaders, Beijing aims to reconfigure central–local power relations on environmental governance. We argue that these institutional reforms are essentially transforming environmental governance in China into a highly politicized task by enforcing party disciplines rather than legal frameworks. The aim is to rein environmental officers and hold local political leaders accountable. These reforms may significantly reduce local protectionism, yet such highly politicized approach based on coercive party rules and disciplines bears the risk of weakening the role of legal enforcement and can breed discontent among local officers. Consequently, how these new reforms can achieve a desirable central–local relation for addressing China’s environmental crisis in the long run is far from certain.
A Retrospective Analysis of the Coagulation Dysfunction in COVID-19 Patients
Authors: Chen Xu , Wang Qinghua , Xu Min , Li Chengbin
Published: October 2020

To discuss the coagulation dysfunction in COVID-19 patients and to find new biomarkers to separate severe COVID-19 patients from mild ones. We use a retrospective analysis of 88 COVID-19 patients, and compare the coagulation function between severe and mild groups. We found the prothrombin time (PT), thrombin time (TT), D-dimer were significantly higher in the severe group ( P < 0.05), and the highest area under the curve (AUC) is 0.91 for D-dimer, while the AUC of PT and TT were 0.80 and 0.61 respectively. We identified that D-dimer has a better value in predicting patients who are likely to develop into severe cases, with the sensitivity and specificity were 84.4% and 88.8%, respectively. D-dimer may be a good biomarker to separate the severe COVID-19 patients from the mild ones.
Pemetrexed-induced Sweet Syndrome: First case report in the medical literature
Authors: Korkmaz Mustafa , Eryılmaz Melek Karakurt , Karaağaç Mustafa , Demirkıran Aykut , Araz Murat , Artaç Mehmet
Published: October 2020

Introduction

Sweet Syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disease characterized by the sudden emergence of painful, edematous, and erythematous papules, plaques, or nodules on the skin, which usually fully responsive to systemic corticosteroids. Skin lesions are often accompanied by fever and leukocytosis. Here we present a case of Sweet Syndrome caused by pemetrexed in metastatic lung adenocarcinoma.

Case report

A 52-year-old patient with metastatic lung adenocarcinoma received multiple lines of chemotherapy. The patient presented with extensive skin lesions after performing of pemetrexed chemotherapy. He had a fever and elevations in blood levels of C-reactive protein (CRP), sedimentation, leucocytes, and neutrophils. Neutrophil predominant perivascular and interstitial dermatitis, focal micropustule formation, and severe neutrophilic dermatosis were reported in skin biopsy. Topical steroid and oral antihistamine treatment were started as initial treatment. Discussion and conclusions: Cutaneous side effects related to pemetrexed are often reported as ‘skin rash,' which is a non-specific term. Therefore, the diagnosis of Sweet Syndrome must be confirmed by skin biopsy. It is essential to exclude the presence of an infection and medication history. Recovery in drug-induced Sweet Syndrome occurs after the drug that caused it was discontinued. Systemic corticosteroids are the first-line treatment for most cases.
A pharmacist’s review of the treatment of systemic light chain amyloidosis
Authors: Hughes David M. , Staron Andrew , Sanchorawala Vaishali
Published: October 2020

Objective

Systemic light-chain (AL) amyloidosis is an uncommon hematologic plasma cell dyscrasia that is becoming increasingly recognized. Therapeutic agents used in AL amyloidosis overlap with those used in multiple myeloma; however, differences in disease features change treatment efficacy and tolerance. Pharmacists must be cognizant of these distinctions. Herein, this review article provides an up-to-date guide to treatment considerations for systemic AL amyloidosis in both the front-line and relapsed settings. Data sources: A comprehensive literature search was performed using the PubMed/Medline database for articles published through (June 2020) regarding treatments for AL amyloidosis. Search criteria included therapies that are FDA approved for multiple myeloma, as well as investigational agents. This review of chemotherapeutic agents reflects the current clinical practice guidelines endorsed by NCCN along with commentary based on the experience of pharmacists from a tertiary-referral center treating many patients with AL amyloidosis. Data consists of randomized controlled trials, observational cohorts, case reports, and ongoing clinical trials. Data summary: Frontline options discussed here include high-dose melphalan with autologous stem cell transplantation and bortezomib-based regimens. Regarding the relapsed setting, supporting data are compiled and summarized for: bortezomib, ixazomib, carfilzomib, lenalidomide, pomalidomide, daratumumab, elotuzumab, isatuximab, venetoclax, NEOD001, and melflufen.

Conclusions

The treatment platform for AL amyloidosis is expanding with novel agents traditionally used in multiple myeloma being adopted and modified for use in AL amyloidosis. The pharmacist’s familiarity with the clinical evidence base for these agents and how they fit into standard protocols for AL amyloidosis is critical as dosing and monitoring recommendations are unique from multiple myeloma.
Detecting DIF in Multidimensional Forced Choice Measures Using the Thurstonian Item Response Theory Model
Authors: Lee Philseok , Joo Seang-Hwane , Stark Stephen
Published: October 2020

Although modern item response theory (IRT) methods of test construction and scoring have overcome ipsativity problems historically associated with multidimensional forced choice (MFC) formats, there has been little research on MFC differential item functioning (DIF) detection, where item refers to a block, or group, of statements presented for an examinee’s consideration. This research investigated DIF detection with three-alternative MFC items based on the Thurstonian IRT (TIRT) model, using omnibus Wald tests on loadings and thresholds. We examined constrained and free baseline model comparisons strategies with different types and magnitudes of DIF, latent trait correlations, sample sizes, and levels of impact in an extensive Monte Carlo study. Results indicated the free baseline strategy was highly effective in detecting DIF, with power approaching 1.0 in the large sample size and large magnitude of DIF conditions, and similar effectiveness in the impact and no-impact conditions. This research also included an empirical example to demonstrate the viability of the best performing method with real examinees and showed how a DIF and a DTF effect size measure can be used to assess the practical significance of MFC DIF findings.
A Diagnostic Nomogram of Pathologic Grade for Preoperative Risk Stratification in Upper Tract Urothelial Carcinoma
Authors: Ma Runzhuo , Xia Haizhui , Qiu Min , Tao Liyuan , Lu Min , Huang Rui , Lu Jian , Ma Lulin
Published: October 2020

Background:

To develop a novel nomogram to improve the preoperative diagnosis of pathological grade of upper tract urothelial carcinoma (UTUC).

Methods:

Retrospective study was conducted with 245 patients with UTUC treated by radical nephroureterectomy from 2002 to 2016. Of the cohort, 57.6% received ureteroscopic (URS) biopsy and 35.9% received urine cytology examination. Preoperative clinical characteristics and examination results were collected. Final pathological grade was diagnosed by postoperative pathology. Univariable and multivariable binary logistic regressions were applied to establish a preoperative predictive model for tumor grade, and significant factors were included in the nomogram. The area under curve (AUC) was used to show the predictive efficacy, and the calibration plot was drawn for validation.

Results:

Of the 245 patients, 72.7% were diagnosed with pathological high-grade disease. Age (odds ratio [OR] = 1.03, P = .039), sessile (OR = 3.86, P = .021), positive urinary cytology (OR = 6.87, P = .035), and biopsy high-grade result (OR = 10.85, P < .001) were independent predictors for pathological high-grade disease. The predictive nomogram containing these factors achieved an AUC of 0.78, which was significantly better than URS biopsy alone (AUC = 0.62, P = .003) in the whole cohort. In the URS biopsy subgroup, the nomogram achieved an AUC of 0.79, better than biopsy alone (AUC = 0.76), but was not statistically significant ( P = .431). When the cutoff value of the nomogram was set at 0.64, the sensitivity of detecting a high-grade lesion versus low-grade lesion was 80.3%, better than that of URS biopsy alone (sensitivity = 65.7%).

Conclusions:

Advanced age, sessile, positive urinary cytology, and biopsy high-grade were independent predictors of pathological high-grade disease in patients with UTUC. A nomogram containing these factors can improve diagnostic accuracy, potentially reducing the risk of “undergrading” by URS biopsy.
Contemporary Endovascular Outcomes for Critical Limb Ischemia Are Still Failing to Meet Society for Vascular Surgery Objective Performance Goals
Authors: Latz Christopher A. , Wang Linda J. , Boitano Laura , DeCarlo Charles , Sumpio Brandon , Schwartz Samuel , Lee Cheong J. , Dua Anahita
Published: October 2020

Objectives:

The Society for Vascular Surgery (SVS) created Objective Performance Goals (OPGs) for critical limb ischemia (CLI) in 2009. It was previously shown that endovascular therapy for CLI was not meeting these benchmarks. The OPG for all peripheral interventions is <8% for major adverse cardiac events (MACE), <8% for major adverse limb events (MALE), and <3% for major amputation. The goal of this study is to evaluate if outcomes have improved for CLI in recent years, specifically 2015-2018.

Methods:

The Targeted Vascular Module from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) was queried to identify patients who underwent endovascular intervention for critical limb ischemia from 2011-2018. Cohorts were divided into 2011-2014 and 2015-2018. Primary 30-day outcomes were MACE, MALE, and major amputation. Univariate analyses were performed using the Fisher’s exact test and the Wilcoxon rank-sum test. Multivariate analysis comparing groups was performed using inverse probability weights and trend over time analysis was performed using logistic regression with year of intervention as a continuous variable.

Results:

From 2011 to 2018, 7,168 patients underwent an endovascular intervention for CLI. 28% were classified as “OPG high anatomic risk,” and 17% were classified as “OPG high clinical risk.” The 2015-2018 cohort vs. the 2011-14 cohort experienced MACE in 3.3% vs. 2.7% (p = .23), MALE in 9.1% vs. 8.9% (p = 0.83), and amputation in 4.0% vs. 4.2% (p = 0.71). When only high anatomic risk patients were considered (n = 1988), MACE was experienced in 2.4% vs. 2.2% (p = 0.87), MALE by 9.5% vs. 10.6% (p = 0.47) and amputation by 5.1% vs. 6.0% (p = 0.40). When only high clinical risk patients were considered (n = 1224), MACE was experienced in 5.2% vs. 3.9% (p = 0.33), MALE by 8.0% vs. 7.4% (p = 0.74) and amputation by 3.9% vs. 3.7% (p = 0.88). Comparing 2015-2018 to the reference 2011-2014, MALE adjusted odds ratio (AOR) = 0.99, 95% CI [0.83-1.18], MACE AOR = 1.19 95% CI [0.88-1.60], and major amputation AOR = 0.91 95% CI [0.70-1.17]. There were no decreases in the trend over time for MALE (AOR per year 0.97, CI [.94-1.02], major amputation (AOR per year: 0.97, CI [0.91-1.03], nor for MACE (AOR per year: 1.05, CI [.98-1.13]).

Conclusion:

Outcomes following endovascular interventions for CLI continue to underperform when compared to OPG benchmarks for MALE and amputations. There is no decrease over time for these target outcomes. Target MACE events remain acceptable despite the increasing clinical complexity of patients being treated.
An External Iliac Artery Pseudoaneurysm Resulting From Stent Graft Migration
Authors: Tokuda Takahiro , Oba Yasuhiro , Koshida Ryoji , Kagase Ai , Matsuda Hiroaki , Suzuki Yoriyasu , Murata Akira , Ito Tatsuya
Published: October 2020

The case of an 80-year-old male with claudication of his left foot who was referred to our hospital for evaluation and treatment. Computed tomography (CT) angiography revealed occlusion of left common and external iliac (EIA) arteries. Recanalization of the EIA lesion under intravascular ultrasound (IVUS) guidance and placement of 2 stent grafts was completed successfully. Nine months later, 27 × 29 mm pseudoaneurysm of the left EIA was identified that appeared to have developed secondary to migration of the original stent graft. A new stent graft was placed.
A host–parasite structural analysis of industrial robots
Authors: Wei Wei , Cai Ganwei , Gong Junjie , Ban Caixia
Published: October 2020

Most driving torques in serial industrial robots are used to overcome the weight of the robot. Although actuators account for a large proportion of the total mass of a robot, they have yet to become a positive factor that enables the robot to achieve gravity balance. This study presents a host–parasite structure to reconstruct the distribution of actuators and achieve gravity balance in robots. First, based on the characteristics of tree–rattan mechanisms, a method for calculating the degrees of freedom and a symbolic representation method for the distribution of branched chains are formulated for host–parasite mechanisms. Second, a configuration analysis and optimization method for host–parasite structure-based robots and a robot prototype are presented. Finally, four host–parasite mechanisms/robots (A, B, C, and D) are compared. The results are as follows. If more parasitic branched chains are added to the yz plane, the loads along axes 2 and 3 become more balanced, which significantly increases the stiffnesses of the mechanism in the y- and z-directions ( Ky and Kz, respectively). If the additional branched chains are closer to the site of maximum deformation, the stiffness of the mechanism in the z-direction ( Kz) increases more significantly. Of the four mechanisms, mechanism D has the best overall performance. The joint torques of mechanism D along axes 2 and 3 are lower than those of mechanism A by 99.78% and 99.18%, respectively. In addition, Kx, Ky, and Kz of mechanism D are 100.56%, 336.19%, and 385.02% of those of mechanism A, respectively. Moreover, the first-order natural frequency of mechanism D is 135.94% of that of mechanism A. Host–parasitic structure is conducive to improving the performance of industrial robots.
EPS mid-career prize 2018: Inference within episodic memory reflects pattern completion
Authors: Binte Mohd Ikhsan Siti Nurnadhirah , Bisby James A , Bush Daniel , Steins David S , Burgess Neil
Published: October 2020

Recollection of episodic memories is a process of reconstruction where coherent events are inferred from subsets of remembered associations. Here, we investigated the formation of multielement events from sequential presentation of overlapping pairs of elements (people, places, and objects/animals), interleaved with pairs from other events. Retrievals of paired associations from a fully observed event (e.g., AB, BC, AC) were statistically dependent, indicating a process of pattern completion, but retrievals from a partially observed event (e.g., AB, BC, CD) were not. However, inference for unseen “indirect” associations (i.e., AC, BD or AD) from a partially observed event showed strong dependency with each other and with linking direct associations from that event. In addition, inference of indirect associations correlated with the product of performance on the linking direct associations across events (e.g., AC with ABxBC) but not on the non-linking association (e.g., AC with CD). These results were seen across three experiments, with greater differences in dependency between indirect and direct associations when they were separately tested, but similar results following single and repeated presentations of the direct associations. The results could be accounted for by a simple auto-associative network model of hippocampal memory function. Our findings suggest that pattern completion supports recollection of fully observed multielement events and the inference of indirect associations in partly observed multielement events, mediated via the directly observed linking associations (although the direct associations themselves were retrieved independently). Together with previous work, our results suggest that associative inference plays a key role in reconstructive episodic memory and does so through hippocampal pattern completion.
Outcome of arthrodesis for severe recurrent proximal interphalangeal joint contractures in Dupuytren’s disease
Authors: Bolt Alexander M. , Giele Henk , McNab Ian S. H. , Spiteri Michelle
Published: October 2020

We report long-term outcomes of proximal interphalangeal joint arthrodesis for treatment of severe recurrent joint contractures secondary to Dupuytren’s disease. The patients had at least two previous procedures for Dupuytren’s contracture that involved the same joint, before undergoing joint fusion. Patient demographics, satisfaction, functional outcome, complications, revision and re-operation rates are reported. Eleven patients were included with a mean age of 64 years (range 53–73). The mean proximal interphalangeal joint contracture at presentation was 102° (range 80°–120°). None required revision surgery at a mean of 8 years and 9 months (range 9–199 months). All patients were able to perform their activities of daily living and would recommend this operation to family and friends. This series shows that proximal interphalangeal joint arthrodesis combined with needle fasciotomy or segmental fasciectomy provides a satisfactory salvage procedure in cases of severe recurrent Dupuytren’s disease.

Level of evidence: IV
Accuracy, inter-unit reliability and comparison between GPS and UWB-based tracking systems for measuring centripetal force during curvilinear locomotion
Authors: Granero-Gil Paulino , Bastida-Castillo Alejandro , Rojas-Valverde Daniel , Gómez-Carmona Carlos D , de la Cruz Sánchez Ernesto , Pino-Ortega José
Published: October 2020

Curvilinear locomotion is important for team sports performance and requires data collection and monitoring of centripetal forces. Currently, the centripetal force can be measured by different sensors that compose inertial devices, but its accuracy needs to be assessed. Therefore, this research aimed to analyze the accuracy and inter-unit reliability of both global positioning (GPS)-based and ultra-wideband (UWB)-based systems for practical application in the field. Following institutional ethical approval and familiarization, 10 elite-level male soccer players performed six circuits on four tracks (6-m radius circle, 9.15-m radius circle, 12-m radius circle, and combined track locomotion) in both directions (three counter-clockwise and three clockwise) and were monitored by two tracking systems (GPS and UWB). The direct measurement was compared with the theoretical centripetal force calculated by photocells and spatial references. The UWB technology showed better accuracy (clockwise, bias =−1.34 N; counter-clockwise, bias = 1.09 N) than the GPS (clockwise, bias = −2.19 N; counter-clockwise, bias = 1.75 N) in centripetal force measurements. However, both tracking technologies obtained very large to nearly perfect reliability results (GPS: ICC = 0.76-0.96; UWB: ICC = 0.76–0.98). In conclusion, even though both technologies proved to be reliable and data could be compared between units, the UWB-based system demonstrated better accuracy than the GPS-based system to detect centripetal force during curvilinear locomotion.
Fragile X syndrome
Authors: Dunphy Rebecca
Published: October 2020

Fragile X syndrome is one of the most common genetic causes of learning disability. Patients with this and other neurodevelopmental disorders will often present to primary care before a diagnosis is made, and this can be challenging and worrying for patients and other carers. These patients may face a number of barriers in accessing healthcare services including communication, behavioural and sensory difficulties. It may be difficult to understand whether symptoms are part of their condition or because of a comorbidity that needs to be addressed. Input from families and carers can be vital in helping with diagnosis. This article aims to outline the key clinical features, diagnosis and management of this syndrome.
Writing letters to characters in bullying-themed stories: An approach to educating about bullying in early childhood
Authors: Wee Su-Jeong , Lee Youngmi
Published: October 2020

In spite of increasing international concern and the long-term effects of bullying on children’s development, bullying in early childhood has been overlooked and underestimated, with both children and adults having difficulties in recognizing and understanding it. This study explores how young children respond to bully-themed stories, what and how they expressed in writing letters to characters from the stories, and how their attitudes towards and understanding of bullying have changed through a series of reading, discussing and writing about bullying. Drawing from social-constructivist theory, this study was conducted in a classroom of 20 5-year-old children in a metropolitan city in Korea using a qualitative study approach. The children were involved in a large group reading about bullying and follow-up letter-writing activities led by their teacher. The findings show that the approach used in this study helped children clearly understand and recognize bullying. Specifically, the letter-writing activities after reading and discussing bully-themed stories enhanced their understanding of bullying and helped them empathize with the characters. The children also showed various ways of solving problems/issues and practised getting along with other children. Approaches to more meaningful and effective planning and implementing activities for bullying education in the early childhood classroom are discussed.
The effects of a phonological awareness and alphabet knowledge intervention on four-year-old children in an early childhood setting
Authors: Rachmani Rachel
Published: October 2020

Phonological awareness (PA) and alphabet knowledge (AK) are two of the strongest predictors of reading acquisition, and evidence shows that many New Zealand children are entering school with low levels of emergent literacy (EL) skills. The current research showed that four-year-old children identified as having low levels of EL, who participated in an evidence-based 10-week intervention using games and books, made significant gains in PA and AK in comparison to a control group. The children were assessed pre-intervention and post-intervention using the Phonological Awareness Literacy Screening PreK and it was found that the PA and AK intervention used in this research was effective in significantly raising the levels of upper-case letter naming, letter-sound awareness and beginning sound awareness.
Efficacy and safety of prolonged release budesonide granules in mesalazine‐refractory ulcerative colitis: A multi‐centre Phase IIa study (TOPICAL‐1)
Authors: Fellermann Klaus , Schiefke Ingolf , Rácz István , Derova Jelena , Jonaitis Laimas , Wehrum Sarah , Nacak Tanju , Greinwald Roland
Published: October 2020

Background

In patients with mesalazine‐refractory ulcerative colitis, systemic corticosteroids are the treatment of choice.

Objective

To evaluate the efficacy and safety of prolonged release budesonide granules for the induction of remission in patients with mesalazine‐refractory ulcerative colitis.

Methods

Patients with mesalazine‐refractory ulcerative colitis discontinued mesalazine at baseline and received 9 mg prolonged release budesonide granules daily for 8 weeks in this open‐label, phase IIa study, followed by a 2‐week follow‐up phase wherein patients continued treatment on alternate days (EudraCT number 2014‐005635‐14; ClinicalTrials.gov identifier NCT02550418). The primary endpoint was clinical remission (Clinical Activity Index ≤4; stool frequency <18 per week; absence of rectal bleeding) at Week 8. Secondary endpoints included clinical, endoscopic and histological measures of disease at Week 8. A post hoc analysis assessed histo‐endoscopic mucosal healing. Treatment‐emergent adverse events and morning cortisol levels were assessed throughout the treatment and follow‐up phases.

Results

A total of 61 patients were included in the intention‐to‐treat population; 50 were included in the follow‐up analysis set. Clinical remission was achieved in 29 patients (47.5%; 95% confidence interval: 34.6–60.7%) by Week 8. Mean stool and bloody stool frequency decreased significantly from 32.5 to 22.9 per week (p <0.0001) and from 17.6 to 8.1 per week (p <0.0001), respectively. Rates of mucosal healing, endoscopic remission and histological remission were 58.0%, 54.0% and 36.0%, respectively. Histo‐endoscopic mucosal healing was achieved by 34.0% of patients. Twenty‐four patients (39.3%) experienced treatment‐emergent adverse events, of which gastrointestinal disorders (16.4%) were the most common. Mean morning cortisol levels were not significantly suppressed by Week 8.

Conclusions

Treatment with prolonged release budesonide granules for 8 weeks was associated with clinical, endoscopic and histological remission and demonstrated a favourable safety profile in patients with mesalazine‐refractory ulcerative colitis. These results warrant further investigation into the potential of prolonged release budesonide granules as an alternative treatment for this patient population.
The First North American Experience Using Glycosorb Immunoadsorption Columns for Blood Group–Incompatible Kidney Transplantation
Authors: Pavenski Katerina , Buchholz Megan , Cheatley Patti Lou , Krok Elizabeth , Anderson Monique , Prasad GV Ramesh , Qureshi Mohammed Azfar , Meliton Galo , Zaltzman Jeffrey
Published: October 2020

Background:

Blood group incompatibility (ABOi) is the most common barrier to living donor kidney transplantation. Options for such recipients include kidney paired donation (KPD) or desensitization methodology to reduce blood antibody response.

Objective:

The objective of this study is to report on the first North America experience in ABOi living donor kidney transplantation using Glycosorb ABO immunoadsorption columns.

Design:

Retrospective observational cohort study.

Setting:

Renal transplant program at St. Michael’s Hospital, Unity Health Toronto, University of Toronto.

Patients:

Twenty-six ABOi living donor transplants from August 2011 through February 2020 were undertaken at our center.

Measurements:

Renal allograft and patient survival postdesensitization for ABOi living donor transplants and isohemagglutinin titer reduction.

Methods:

Preoperative immunosuppressive regimen consisted of a single dose of Rituximab 375 mg/m2 IV on day −28; tacrolimus, mycophenolic acid, and prednisone to start on day −7. Immunoadsorption treatments with Glycosorb A or B columns were performed on day −7 through day −1 based on anti-A or anti-B titers on Spectra Optia Apheresis System. Immunosuppression included basiliximab, solumedrol followed by oral prednisone, once-daily tacrolimus, and mycophenolic acid. The mean follow-up was 53 months (3-96 months).

Results:

A total of 26 individuals underwent an attempt at desensitization of whom 24 patients underwent immediate transplant. One patient had a rebound in titers and subsequently was transplanted from a blood group compatible living donor. A second patient had an unrelated medical issue and desensitization was discontinued. Five-year patient survival was 96% and death censored allograft survival was 92%. Posttransplant anti-A or anti-B titers were monitored daily for the first 7 days posttransplant and every 2 days from days 7 to 14. There were no acute rejections seen in this cohort of transplant recipients.

Limitations:

As our protocol was first initiated as proof of concept, a few recipients had low initial isohemagglutinin titers. This may have contributed to improved clinical outcomes.

Conclusions:

ABO column immunoadsorption with specific columns is a safe and effective method for ABOi living donor kidney transplantation, and an option when KPD is less than ideal. Trial not registered as this was a retrospective cohort review.
Pre- and postoperative offset and femoral neck version measurements and validation using 3D computed tomography in total hip arthroplasty
Authors: Geijer Mats , Kiernan Sverrir , Sundberg Martin , Flivik Gunnar
Published: October 2020

Background

Restoration of a correct biomechanical situation after total hip arthroplasty is important.

Purpose

To evaluate proximal femoral symmetry of acetabular and femoral offset and femoral neck anteversion pre- and postoperatively in hip arthroplasty by semi-automated 3D-CT and to validate the software measurements by inter- and intraobserver agreement calculations.

Material and Methods

In low-dose CT on 71 patients before and after unilateral total hip arthroplasty, two observers used a digital 3D templating software to measure acetabular offset, true and functional femoral offset, and femoral neck anteversion. Observer agreements were calculated using intraclass correlation. Hip measurements were compared in each patient and between pre- and postoperative measurements.

Results

Preoperatively, acetabular offset (2.4 mm), true (2.2 mm), and functional global offset (2.7 mm) were significantly larger on the osteoarthritic side without side-to-side differences for true and functional femoral offset or femoral neck anteversion. Postoperatively, acetabular offset was significantly smaller on the operated side (2.1 mm) with a concomitantly increased true (2.5 mm) and functional femoral offset (1.5 mm), resulting in symmetric true and functional global offsets. There were no differences in postoperative femoral neck anteversion. Inter- and intraobserver agreements were near-perfect, ranging between 0.92 and 0.98 with narrow confidence intervals (0.77–0.98 to 0.94–0.99).

Conclusion

Acetabular and concomitantly global offset are generally increased in hip osteoarthritis. Postoperative acetabular offset was reduced, and femoral offset increased to maintain global offset. 3D measurements were reproducible with near-perfect observer agreements. 3D data sets should be used for pre- and postoperative measurements in hip arthroplasty.
Silencing of miR-223 expression inhibits the apoptosis of H2O2-induced cardiomyocytes by increasing the activity of the IGF-1R/PI3K/AKT pathway
Authors: Zhou Qianqian , Li Yufen , Gu Tianjin
Published: October 2020

To study the: (1) function of micro (mi)R-223 on H2O2-induced H9C2 cells; (2) relationship between miR-223 and insulin-like growth factor 1 receptor (IGF-1R); and (3) role of miR-223 on the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway.

H9C2 cells were selected to establish the H2O2-injury model. Overexpression/low expression of miR-223 in H9C2 cells was constructed, respectively. Flow cytometry and western blotting were applied to measure the apoptosis, cell activity, and expression of related proteins. Dual-luciferase reporter gene assays (DLRGAs) were applied to test if miR-223 targeted IGF-1R. Overexpression/low expression of IGF-1R was constructed to test if miR-223 regulated IGF-1R expression negatively.

Increases in miR-223 expression were observed in H2O2-induced H9C2 cells. miR-223 absence improved H2O2-induced H9C2-cell apoptosis accompanied by an increase in B-cell lymphoma (Bcl)-2 expression and decrease in expression of Bax and cleaved caspase-3 ( P < 0.05). miR-223 silencing increased expression of IGF-1R, p-PI3K, and p-AKT in H2O2-induced H9C2 cells ( P < 0.05). miR-223 overexpression aggravated H2O2-induced H9C2-cell apoptosis and reduced expression of the proteins of IGF-1R, p-PI3K, and p-AKT. DLRGAs showed IGF-1R to be a downstream gene of miR-223. IGF-1R silencing significantly inhibited expression of p-PI3K and p-AKT proteins ( P < 0.05). miR-223 negatively regulated IGF-1R expression for H9C2-cell apoptosis and the PI3K/AKT pathway.

miR-223 absence can ameliorate H2O2-induced cardiomyocyte apoptosis by targeting IGF-1R to regulate PI3K/AKT activity.
Tension Bullae With Peripheral Pneumothorax
Authors: Bajaj Tushar , Malik Bushra , Thangarasu Sudhagar
Published: October 2020

The differentiation between tension bullae, chronic tension pneumothorax, and atypical pneumothorax is difficult just from history and physical examination alone. A chest X-ray may help determine the underlying etiology; however, further imaging with computed tomography in stable patients may be necessary for accurate assessment of size, number, and location before considering any interventions. In this article, we present a rare case report of tension bullae with peripheral pneumothorax and recommend against needle thoracostomy in stable patients with tension bullae in order to obtain further imaging that may result in a change in the standard management.