bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomarker testing for personalized, first-line therapy in advanced nonsquamous non-small cell lung cancer patients in the real world setting in Japan: a retrospective, multicenter, observational study (the BRAVE study)
Authors: Shimizu Junichi , Masago Katsuhiro , Saito Haruhiro , Nishino Kazumi , Kurata Takayasu , Itoh Yohji , Yoshimura Yoko , Yabuki Yutaka , Dosaka-Akita Hirotoshi
Published: February 2020

Background:

Molecular diagnostic testing is necessary to guide optimal first-line treatment. The number of patients who receive first-line treatment based on biomarker analysis in Japan is unknown. We aimed to determine the proportion of nonsquamous non-small cell lung cancer (NSCLC) patients for whom first-line treatment was selected based on biomarker testing.

Methods:

This retrospective, multicenter, observational study registered patients aged ⩾20 years with locally advanced or metastatic nonsquamous NSCLC who started first-line treatment between August and December 2017 in Japan. Data were collected from medical records between January and May 2018. The primary endpoint was the proportion of patients with confirmed biomarker status for first-line treatment decision.

Results:

Among 202 patients enrolled from 11 centers, 161 (79.7%; 95% confidence interval, 74.2–85.2%) had confirmed biomarker status. The testing rate was highest for epidermal growth factor receptor ( EGFR; 97.5%), followed by anaplastic lymphoma kinase ( ALK; 88.1%), programmed death ligand-1 (PD-L1; 87.1%), and ROS1 (67.3%). For first-line treatment, 70/75 patients with EGFR-positive tumors were administered an EGFR-TKI; 14/15 patients with ALK-positive tumors received an ALK inhibitor; 2/2 patients with ROS1-positive tumors received a ROS1 inhibitor; and 29/36 driver mutation-negative patients with a PD-L1 tumor proportion score ⩾50% were administered an anti-PD-1 monoclonal antibody. Median times from confirmed diagnosis date to first-line treatment initiation, and from first biomarker test order to last biomarker test result were 19 and 11 days, respectively.

Conclusions:

The proportion of nonsquamous NSCLC patients with confirmed biomarker status for first-line treatment was considered insufficient and in need of improvement.
Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity
Authors: Reilly Erin K. , Huntley Colin T. , Boon Maurits S. , Epps Gregory , Vimawala Swar , Chitguppi Chandala , Patel Jena , Murphy Kira , Nyquist Gurston G. , Rosen Marc R. , Evans James J. , Rabinowitz Mindy R.
Published: February 2020

Background

For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic sinus and skull base surgery.

Objective

The goal of this study is to translate a previously developed cadaveric model for evaluating CPAP pressures in the sinonasal cavity by showing safety in vivo and quantifying the effect of positive pressurized air flow on the nasal cavity of healthy individuals where physiologic effects are at play.

Methods

A previously validated cadaveric model using intracranial sensor catheters has proved to be a reliable technique for measuring sinonasal pressures. These sensors were placed in the nasal cavity of 18 healthy individuals. Pressure within the nose was recorded at increasing levels of CPAP.

Results

Overall, nasal cavity pressure was on average 85% of delivered CPAP. The amount of pressure delivered to the nasal cavity increased as the CPAP increased. The percentage of CPAP delivered was 77% for 5 cmH2O and increased to 89% at 20 cmH2O. There was a significant difference in mean intranasal pressures between all the levels of CPAP except 5 cmH2O and 8 cmH2O ( P < .001).

Conclusion

On average, only 85% of the pressure delivered by CPAP is transmitted to the nasal cavity. Higher CPAP pressures delivered a greater percentage of pressurized air to the nasal cavity floor. Our results are comparable to the cadaver model, which demonstrated similar pressure delivery even in the absence of anatomic factors such as lung compliance, nasal secretions, and edema. This study demonstrates the safety of using sensors in the human nasal cavity. This technology can also be utilized to evaluate the resiliency of various repair techniques for endoscopic skull base surgery with CPAP administration.
Secukinumab-induced Raynaud’s phenomenon: first report in the literature
Authors: Kobak Senol
Published: February 2020

Secukinumab is an IL-17A antagonist that has proven efficacy in the treatment of patients with ankylosing spondylitis (AS) and psoriatic arthritis. Side effects of the drug include infections, skin rashes, and allergic reactions. Raynaud’s phenomenon (RP), a vasospastic syndrome and an important feature of different connective tissue diseases, is not an expected finding in AS patients. This article reports the development of secukinumab-related RP in a 35-year-old female patient with AS. Treatment with secukinumab was continued and RP was treated with low-dose aspirin and a calcium-channel blocker.
Machine learning in prediction of individual patient readmissions for elective carotid endarterectomy, aortofemoral bypass/aortic aneurysm repair, and femoral-distal arterial bypass
Authors: Amato Alexandre Campos Moraes , Santos Ricardo Virgínio dos , Saucedo Dumitriu Zunino , Amato Salvador José de Toledo Arruda
Published: February 2020

Objective:

Early hospital readmissions have been rising and are increasingly used for public reporting and pay-for-performance. The readmission problem is fundamentally different in surgical patients compared with medical patients. There is an opportunity to intervene preoperatively to decrease the risk of readmission postoperatively.

Methods:

A predictive model of 90-day hospital readmission for patients undergoing elective carotid endarterectomy, aortofemoral bypass/aortic aneurysm repair, and femoral-distal arterial bypass was developed using data from the Healthcare Cost and Utilization Project State Inpatient Database for Florida State. The model training followed a nested resampling method with subsampling to increase execution speed and reduce overfitting. The following predictors were used: age, gender, race, median household income, primary expected payer, patient location, admission type, Elixhauser–van Walraven Comorbidity Index, Charlson comorbidity score, main surgical procedure, length of stay, disposition of the patient at discharge, period of the year, hospital volume, and surgeon volume.

Results:

Our sample comprised data on 246,405 patients, of whom 30.3% were readmitted within 90 days. Readmitted patients were more likely to be admitted via emergency (47.2% vs 30%), included a higher percentage with a Charlson score greater than 3 (35.8% vs 18.7%), had a higher mean van Walraven score (8.32 vs 5.34), and had a higher mean length of hospital stay (6.59 vs 3.51). Endarterectomy was the most common procedure, accounting for 19.9% of all procedures. When predicting 90-day readmission, Shrinkage Discriminant Analysis was the best performing model (area under the curve = 0.68). Important variables for the best predictive model included length of stay in the hospital, comorbidity scores, endarterectomy procedure, and elective admission type. The survival analysis for the time to readmission after the surgical procedures demonstrated that the hazard ratios were higher for subjects who presented Charlson comorbidity score above three (2.29 (2.26, 2.33)), patients transferred to a short-term hospital (2.4 (2.23, 2.59)), home healthcare (1.64 (1.61, 1.68)), other type of facility (2.59 (2.54, 2.63)) or discharged against medical advice (2.06 (1.88, 2.26)), and those with greater length of stay (1.89 (1.86, 1.91)).

Conclusion:

The model stratifies readmission risk on the basis of vascular procedure type, which suggests that attempts to decrease vascular readmission should focus on emergency procedures. Given the current focus on readmissions and increasing pressure to prevent unplanned readmissions, this score stratifies patients by readmission risk, providing an additional resource to identify and prevent unnecessary readmissions.
Secondary hemosiderosis presented by porphyria cutanea tarda in a kidney dialysis patient: A case report
Authors: AlGahtani Farjah H , Stuckey Ruth , Alqahtany Fatima S
Published: February 2020

A 68-year-old woman with chronic kidney disease receiving dialysis and iron supplementation presented to our hospital with painful blisters, fragile skin, and changes to skin pigmentation on the dorsal side of both upper and lower limbs. Skin biopsy findings and an increase in urine porphyrins confirmed the diagnosis of porphyria cutanea tarda. Upon examination, extremely high serum ferritin levels (6000 µg/L) suggested iron overload. Oral iron supplementation was immediately discontinued, and the patient received treatment with the iron chelators deferoxamine, 10 mg/kg/day intravenously for 4 days, and deferasirox, 540 mg/day orally. After a 4-month follow-up, ferritin levels were normal (97.7 µg/L) and the cutaneous manifestations of porphyria cutanea tarda had improved. Complete remission has been maintained for the last 2 years, and the patient’s liver and heart function are normal. This case of porphyria cutanea tarda caused by secondary hemosiderosis highlights the potential toxicity of iron accumulation as a result of excessive iron supplementation. Although not approved for the treatment of patients on hemodialysis, we report the efficacy of deferasirox without any adverse effects in this case. We also stress the importance of the close monitoring of serum iron levels in kidney dialysis—and indeed all iron-supplemented—patients to avoid potential hepatic, cardiac, and endocrine damage.
Pharmacologic Therapies for Aortic Stiffness in End-Stage Renal Disease: A Systematic Review and Meta-Analysis
Authors: Rodriguez Rosendo A. , Spence Matthew , Hae Richard , Agharazii Mohsen , Burns Kevin D.
Published: February 2020

Background:

Increased carotid-femoral pulse wave velocity (cf-PWV), a surrogate of increased aortic stiffness, is a risk factor for cardiovascular events and all-cause mortality in end-stage renal disease (ESRD). To minimize the deleterious effects of an increased aortic stiffness in ESRD patients, several interventions have been developed and cf-PWV has been used to monitor responses.

Objective:

The aim of this study was to determine the effects of pharmacologic interventions that target aortic stiffness on cf-PWV and systolic blood pressure (SBP) in adults with ESRD.

Study design:

This study implements a systematic review and meta-analysis.

Data sources:

MEDLINE, EMBASE, Cochrane Central, Health Technology Assessment, and EBM databases were searched.

Study eligibility, participants, and interventions:

Randomized and non-randomized studies involving adults (>18 years) with ESRD of any duration, receiving or not renal replacement therapy (hemodialysis, peritoneal dialysis) and exposed to a pharmacologic intervention whose effects were assessed by cf-PWV.

Methods:

Study screening, selection, data extraction, and quality assessments were performed by 2 independent reviewers. Narrative synthesis and quantitative data analysis summarized the review.

Results:

We included 1027 ESRD participants from 13 randomized and 5 non-randomized studies. Most pharmacologic interventions targeted bone mineral metabolism disorder or hypertension. Treatment with vitamin D analogues or cinacalcet did not decrease cf-PWV or SBP over placebo or matched controls ( P > .05). Calcium-channel blockers (CCB) decreased cf-PWV and SBP compared with placebo or standard care ( P < .05). Renin-angiotensin system inhibitors did not show any advantage over placebo in decreasing cf-PWV ( P > .05).

Limitations:

Quality of evidence ranged from very low to moderate. Overall evidence was limited by the low number of studies, small sample sizes, and methodological inconsistencies.

Conclusions:

Pharmacologic interventions targeting aortic stiffness in ESRD have mixed effects on reducing cf-PWV, with some strategies suggesting potential benefit. The quality of evidence, however, is insufficient to draw definitive conclusions on their use to slow progression of aortic stiffness in ESRD. Further well-designed studies are needed to confirm these associations and their impact on cardiovascular outcomes in ESRD. Registered in PROSPERO (CRD42016033463)
Eremostachys laciniata as effective as rectal diclofenac suppository in cesarean section pain relief: A triple-blind controlled clinical trial
Authors: Mohammad Pour Shabnam , Hakimi Sevil , Delazar Abbas , Javad Zadeh Yousef , Mallah Fatemeh
Published: February 2020

Background:

Pain and distress are two common complications of cesarean section. Among complementary therapies, Eremostachys was introduced as a pain mitigator. This study aimed at investigating the effect of Eremostachys laciniata on cesarean section pain and distress.

Materials and methods:

This randomized clinical trial was conducted on 86 women who gave childbirth by cesarean section. The control group received 50 mg rectal diclofenac suppository every 8 h for 3 days, and the intervention group received 35 mg E. laciniata total extract suppository every 8 h up to three doses. Pain was measured with the Visual Analogue Scale at 8, 16, and 24 h after cesarean section. The Symptom Distress Scale was completed at 8 and 24 h after cesarean section. The Redness, Edema, Ecchymosis, Discharge, Approximation scale was completed 5 days after cesarean section.

Findings:

Pain score at 8, 16, and 24 h after surgery (15 min after intervention) was not significantly different between the intervention and control groups. The distress score 24 h after cesarean section showed a significant difference in favor of the control group according to Friedman’s test. There was a significant difference between the two groups in wound healing score, which indicated better efficacy of rectal diclofenac suppository than E. laciniata suppository. We assessed nausea, vomiting, headache, massive hemorrhage, and any type of anaphylactic reaction. No side events were observed in two groups.

Conclusion:

Rectal E. laciniata suppository could be introduced as a low-complication, appropriate, and effective medication in controlling pain and distress after cesarean section; more studies should be conducted on this matter.
What Are the Effects of Remplissage on 6-Month Strength and Range of Motion After Arthroscopic Bankart Repair? A Multicenter Cohort Study
Authors: Frantz Travis L. , Everhart Joshua S. , Cvetanovich Gregory L. , Neviaser Andrew , Jones Grant L. , Hettrich Carolyn M. , Wolf Brian R. ,   MOON Shoulder Group, Bishop Julie , Miller Bruce , Brophy Robert H. , Ma C. Benjamin , Cox Charlie L. , Baumgarten Keith M. , Feeley Brian T. , Zhang Alan L. , McCarty Eric C. , Kuhn John E.
Published: February 2020

Background:

Patients who have undergone shoulder instability surgery are often allowed to return to sports, work, and high-level activity based largely on a time-based criterion of 6 months postoperatively. However, some believe that advancing activity after surgery should be dependent on the return of strength and range of motion (ROM).

Hypothesis:

There will be a significant loss of strength or ROM at 6 months after arthroscopic Bankart repair with remplissage compared with Bankart repair alone.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 38 patients in a prospective multicenter study underwent arthroscopic Bankart repair with remplissage (33 males, 5 females; mean age, 27.0 ± 10.2 years; 82% with ≥2 dislocation events in the past year). Strength and ROM were assessed preoperatively and at 6 months after surgery. Results were compared with 104 matched patients who had undergone Bankart repair without remplissage, although all had radiographic evidence of a Hill-Sachs defect.

Results:

At 6 months, there were no patients in the remplissage group with anterior apprehension on physical examination. However, 26% had a ≥20° external rotation (ER) deficit with the elbow at the side, 42% had a ≥20° ER deficit with the elbow at 90° of abduction, and 5% had persistent weakness. Compared with matched patients who underwent only arthroscopic Bankart repair, the remplissage group had greater humeral bone loss and had a greater likelihood of a ≥20° ER deficit with the elbow at 90° of abduction ( P = .004). Risk factors for a ≥20° ER deficit with the elbow at 90° of abduction were preoperative stiffness in the same plane ( P = .02), while risk factors for a ≥20° ER deficit with the elbow at the side were increased number of inferior quadrant glenoid anchors ( P = .003), increased patient age ( P = .02), and preoperative side-to-side deficits in ER ( P = .04). The only risk factor for postoperative ER weakness was preoperative ER weakness ( P = .04), with no association with remplissage ( P = .26).

Conclusion:

Arthroscopic Bankart repair with remplissage did not result in significant strength deficits but increased the risk of ER stiffness in abduction compared with Bankart repair without remplissage at short-term follow-up.
Revision of failed Latarjet procedure by arthroscopy-assisted Eden-Hybbinette with endobutton fixation
Authors: Boileau Pascal , Duysens Christophe , Saliken David , Lemmex Devin B. , Bonnevialle Nicolas
Published: February 2020

Background:

The literature reports recurrent instability after the Latarjet procedure in 1 to 5% of the cases. Therefore, the Eden-Hybbinette technique, which consists of harvesting bone from the iliac crest, has been proposed in case of revision surgery. The objective of this study was to evaluate the clinical and radiographic results of a series of patients treated by an all-arthroscopic Eden-Hybbinette technique with endobutton graft fixation.

Methods:

Seven patients (5 men, 2 women, mean age 30.7 years (17-47)), with recurrent anterior instability after Latarjet procedure, associated with glenoid bone defect of more than 15% were treated by arthroscopic Eden-Hybbinette technique. The bone graft fixed with an endobutton (Bone-LinkTM) was introduced through the rotator cuff interval. Specific guides and a dynamometer were used to fix the graft by compression on the anterior edge of the glenoid cavity. Previous broken screws were left in place in 3 cases. Patients were clinically followed and the position of the graft and its consolidation were evaluated by CT scan.

Results:

At mean follow-up of 21 months (12-39), 7/6 patients had a stable shoulder and were satisfied with the result. 5/7 resumed their sporting activity. The mean Constant score increased from 32 to 81 points and the Subjective Shoulder Value from 31 to 87% (p > 0.001). The mean Walch-Duplay and Rowe scores were 85.7 points (65-100) and 86.4 points (70-100) respectively. No neurological complications were reported, and no patients required a new procedure. On the CT scan analysis, the graft did not overhang and was sub-equatorial and healed in all cases.

Conclusion:

The recurrence of instability after a Latarjet graft can be successfully treated by the Eden-Hybbinette technique under arthroscopy. Endobutton fixation is reliable and optimizes the position and consolidation of the bone graft. In addition, this fixation method is an appropriate option in case of broken hardware left in place.
Twilight of the Proletariat: Reading Critical Balkanology as Liberal Ideology
Authors: Zinaić Rade
Published: February 2020

Critical Balkanology is a sub-discipline of Central and East European Studies that deconstructs and renders arbitrary the claims of ethnic nationalisms and Western “colonial” representations of the Balkans. Yet, this critical and nominally anti-racist project is parasitic on a hegemonic Euro-Atlantic liberal ideology in that it cannot see beyond the singular individual as victim and vanguard, thereby obscuring and/or effacing an awareness of class inequality. Tomislav Longinović's Vampire Nation: Violence as Cultural Imaginary (2011) is emblematic of this project. I place this text under an immanent critique and a contrapuntal reading as an example of how one can rescue class consciousness from this literature and push the limits of its politics while, in Longinović's case, reading it against the socioeconomic contradictions of post-MiloŠević Serbia. Longinović's tracing of the vampire metaphor as a way of understanding the consumptive nature of both ethnic nationalism and Western imperialism reveals a politics that stigmatizes Serbia's plebeian history in favour of a Westernized and urban middle class youth cult of techno-culture, rock music, and the disembodied voices of (male) intellectuals – a form of epistemic violence that parallels processes of privatization, social cleansing, and class oppression consuming the bodies of (sub)proletarians.
The Wrong Critiques: Why Internal Border Controls Don't Mean the End of Schengen
Authors: VotoupalovÁ Markéta
Published: February 2020

Since 2015, the collapse of the EU's Area of Freedom, Security and Justice has been widely discussed due to the re-impositions of internal border controls which seemingly undermine the premise of Schengen as a borderless area. Yet, three years later, Schengen is still alive. Employing Krasner's conceptualisation of sovereignty, this article offers a systematic analysis of why Schengen seems to be so resilient by addressing three common, yet inaccurate critiques. Firstly, it claims that re-impositions of internal controls cannot be seen as a violation of Schengen but, contrarily, as an inherent part of it. Secondly, states do not use re-impositions to selfishly regain their sovereignty. Rather, they follow the Schengen Acquis, and re-impositions are but a corrective to the legislation not being observed adequately. Indeed, what seems to define Schengen is the wish to follow the rules, not to change them. Thirdly, as current events demonstrate, if the Schengen area is to be endangered, it will be due to insufficient external border controls, not due to re-impositions or a lack of solidarity.
Forgotten Velvet: Understanding Eastern Slovakia's 1989
Authors: Mullins Marty Manor
Published: February 2020

By focussing on the experience of Eastern Slovakia during Czechoslovakia's 1989 Velvet Revolution, this article examines the motivations propelling local revolutionaries who opposed the Communist regime at great risk to themselves and their families. It asks what inspired those who countered the government 30 years ago and argues that, for many, ideological factors were the primary driver, rather than economic considerations. Exploring these questions through the lens of Košice provides a counterpoint to accounts of the Velvet Revolution in Prague and Bratislava, which have come to dominate understandings of Czechoslovakia in 1989 and which obscure the particularities of the revolution in other significant places across the country. The text draws on regional archival and period newspaper accounts which foreground the voices of students, steel workers, dramatists, minorities and local Communist Party leaders. These sources indicate the active but uncertain nature of civil society in those crucial November and December days. The article also underscores the urban rivalry between Bratislava and Košice, which manifested itself when Košice sided with Prague's protest organization over Bratislava's. The 30th anniversary of the fall of Communism in Eastern Europe provides a timely platform for a glimpse into the largely untold story of Eastern Slovakia's Velvet Revolution.
Influenza vaccines: the potential benefits of cell-culture isolation and manufacturing
Authors: Rajaram Sankarasubramanian , Boikos Constantina , Gelone Daniele K. , Gandhi Ashesh
Published: February 2020

Influenza continues to cause severe illness in millions and deaths in hundreds of thousands annually. Vaccines are used to prevent influenza outbreaks, however, the influenza virus mutates and annual vaccination is required for optimal protection. Vaccine effectiveness is also affected by other potential factors such as the human immune system, a mismatch with the chosen candidate virus, and egg adaptation associated with egg-based vaccine production. This article reviews the influenza vaccine development process and describes the implications of the changes to the cell-culture process and vaccine strain recommendations by the World Health Organization since the 2017 season. The traditional manufacturing process for influenza vaccines relies on fertilized chicken eggs that are used for vaccine production. Vaccines must be produced in large volumes and the complete process requires approximately 6 months for the egg-based process. In addition, egg adaptation of seed viruses occurs when viruses adapt to avian receptors found within eggs to allow for growth in eggs. These changes to key viral antigens may result in antigenic mismatch and thereby reduce vaccine effectiveness. By contrast, cell-derived seed viruses do not require fertilized eggs and eliminate the potential for egg-adapted changes. As a result, cell-culture technology improves the match between the vaccine virus strain and the vaccine selected strain, and has been associated with increased vaccine effectiveness during a predominantly H3N2 season. During the 2017–2018 influenza season, a small number of studies conducted in the United States compared the effectiveness of egg-based and cell-culture vaccines and are described here. These observational and retrospective studies demonstrate that inactivated cell-culture vaccines were more effective than egg-based vaccines. Adoption of cell-culture technology for influenza vaccine manufacturing has been reported to improve manufacturing efficiency and the additional benefit of improving vaccine effectiveness is a key factor for future policy making considerations.
Senior Project Leadership Skills and Career Stallers: Analysis of Perception Differences and Implications for Careers
Authors: Floris Maurizio , Wiblen Sharna L. , Anichenko Ekaterina
Published: February 2020

We know little about which leadership skills matter most and according to whom in the career progression of project leaders. This research suggests that high-performing senior project leader talent have few skill or career staller blind spots that may endanger their careers. However, this may not be the case for all senior project leaders. It is therefore recommended that, as part of proactive career management, they seek feedback from managers who impact their careers the most. The research further suggests treating feedback from peers or direct reports with some caution as their ratings are significantly more generous than self ratings.
Surface Quality Improvement in Machining an Aluminum Honeycomb by Ice Fixation
Authors: Wang Yongqing , Gan Yongquan , Liu Haibo , Han Lingsheng , Wang Jinyu , Liu Kuo
Published: February 2020

A honeycomb structure is widely used in sandwich structure components in aeronautics and astronautics; however, machining is required to reveal some of its features. In honeycomb structures, deficiencies, such as burrs, edge subsiding, and cracking, can easily appear, owing to poor specific stiffness in the radial direction. Some effective fixation methods based on a filling principle have been applied by researchers, including approaches based on wax, polyethylene glycol, iron powder, and (especially) ice. However, few studies have addressed the optimization of the cutting parameters. This study focused on optimizing the cutting parameters to obtain a better surface roughness (calculated as a roughness average or Ra) and surface morphology in the machining of an aluminum alloy honeycomb by an ice fixation method. A Taguchi method and an analysis of variance were used to analyze the effects and contributions of spindle speed, cutting depth, and feed rate. The optimal cutting parameters were determined using the signal-to-noise ratio combined with the surface morphology. An F-value and P-value were calculated for the value of the Ra, according to a “smaller is better” model. Additionally, the optimum cutting parameters for machining the aluminum honeycomb by ice fixation were found at different levels. The results of this study showed that the optimal parameters were a feed rate of 50 mm/min, cutting depth of 1.2 mm, and spindle speed of 4000 r/min. Feed rate was the most significant factor for minimizing Ra and improving the surface morphology, followed by spindle speed. The cutting depth had little effect on Ra and surface morphology. After optimization, the value of Ra could reach 0.218 μm, and no surface morphology deterioration was observed in the verified experiment. Thus, this research proposes optimal parameters based on ice fixation for improving the surface quality.
Dynamic Analysis and Performance Verification of a Novel Hip Prosthetic Mechanism
Authors: Song Majun , Guo Sheng , Wang Xiangyang , Qu Haibo
Published: February 2020

To assist an amputee in regaining his or her daily quality of life, based on analysis of the motion characteristics of the human hip, a 2-UPR/URR parallel mechanism with a passive limb was designed. The inverse kinematics of this mechanism was analyzed based on a closed-loop vector method. The constrained Jacobian matrix and kinematic Jacobian matrix of each limb were then analyzed, and a 6 × 6 fully Jacobian matrix was constructed. Based on this, kinematic performances were analyzed and summarized. Finally, the dynamic model of the mechanism was constructed based on the virtual work principle, and its theoretical solution was compared with the numerical results, which were obtained in a simulation environment. Results showed that the prosthetic mechanism had a larger rotating workspace and better mechanical performance, which accorded a range of motion and bearing capacity similar to that of the human hip in multiple gait modes. Moreover, the validity of the dynamic model and inverse kinematics were verified by comparing the theoretical and simulation results. Furthermore, with flexion and extension, the torque change in the hip prosthetic mechanism was similar to that of the human hip, which demonstrated the feasibility of the hip prosthetic mechanism and its good dynamic performance.
Evaluation of Irvingia kernels extract as biobased wood adhesive
Authors: Alawode A. O. , Eselem-Bungu P. S. , Amiandamhen S. O. , Meincken M. , Tyhoda L.
Published: February 2020

Irvingia tree species have been earmarked for domestication in many countries due to their potential as raw materials for various applications, which include biodiesel, cosmetics, perfume, soap, etc. Presently, there is no information on the utilization of kernel seed extract as a potential source of green wood adhesive. This study is focused on investigating the properties of adhesives produced from kernel seeds of two Irvingia wood species i.e. Irvingia gabonensis (IG) and Irvingia wombolu (IW), as well as investigating the improved properties derived from the effect of modification using a few selected modifying agents including glutaraldehyde, glyoxal, epichlorohydrin (EPI) and an acid/base type process modification. Polyethylene (PE) was used along with the glutaraldehyde, glyoxal and epichlorohydrin modifiers in the modification process. Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and thermogravimetric analysis (TGA) were conducted to study the effect of modification on adhesive properties. The glycosidic carbon of the unmodified extracts and that of the EPI modified sample were not sensitive to chain conformations. Principal components (PC) 1 and 2 explained 85.19 and 9.54%, respectively, of the total variability in FTIR spectra among the modified and unmodified adhesives. The unmodified samples for IG and IW exhibited one peak with crystallization temperatures of 18.7 and 14.4 °C, respectively, indicating only one component exhibits some low degree crystallinity. The adhesive properties of the modified extracts were tested on wood veneers according to ASTM standard. The shear strength of the modified adhesives ranged from 1.5 to 3.93 MPa and 1.7 to 4.05 MPa for IG and IW, respectively. The modified samples containing PE showed marked improvement in the shear strength. The highest values were about 63% higher than the shear strength of unmodified samples with least shear strength. The results indicated that the modification of Irvingia-based adhesives had a great contribution to their performance as natural wood adhesives.
Preparation of Nano-Copper Sulfide and Its Adsorption Properties for 17α-Ethynyl Estradiol
Authors: Zhang Sifeng , Meng Wenxiang , Wang Lulu , Li Lingxin , Long Yanju , Hei Yunrui , Zhou Luting , Wu Shenglan , Zheng Ziguang , Luo Lijun , Jiang Fengzhi
Published: February 2020

In the present work, a tubular nano-copper sulfide was successfully synthesized by hydrothermal method. The physical and chemical properties of the prepared materials were characterized by XRD, SEM, TEM, and BET. The synthesized copper sulfide was used as an adsorbent for removing 17α-ethynyl estradiol (EE2) and exhibited excellent adsorption properties. At 25 °C, 15 mg of adsorbent was applied for 50 mL of 5 mg/L EE2 solution, adsorption equilibrium was reached after 180 min, and the adsorption rate reached nearly 90%. In addition, the kinetics, isothermal adsorption, and thermodynamics of the adsorption process were discussed on the basis of theoretical calculations and experimental results. The theoretical maximum adsorption capacity of copper sulfide was calculated to be 147.06 mg/g. The results of this study indicated that copper sulfide was a stable and efficient adsorbent with promising practical applications.
Differential physiological, transcriptomic and metabolomic responses of Arabidopsis leaves under prolonged warming and heat shock
Authors: Wang Li , Ma Kai-Biao , Lu Zhao-Geng , Ren Shi-Xiong , Jiang Hui-Ru , Cui Jia-Wen , Chen Gang , Teng Nian-Jun , Lam Hon-Ming , Jin Biao
Published: February 2020

Background

Elevated temperature as a result of global climate warming, either in form of sudden heatwave (heat shock) or prolonged warming, has profound effects on the growth and development of plants. However, how plants differentially respond to these two forms of elevated temperatures is largely unknown. Here we have therefore performed a comprehensive comparison of multi-level responses of Arabidopsis leaves to heat shock and prolonged warming.

Results

The plant responded to prolonged warming through decreased stomatal conductance, and to heat shock by increased transpiration. In carbon metabolism, the glycolysis pathway was enhanced while the tricarboxylic acid (TCA) cycle was inhibited under prolonged warming, and heat shock significantly limited the conversion of pyruvate into acetyl coenzyme A. The cellular concentration of hydrogen peroxide (H2O2) and the activities of antioxidant enzymes were increased under both conditions but exhibited a higher induction under heat shock. Interestingly, the transcription factors, class A1 heat shock factors (HSFA1s) and dehydration responsive element-binding proteins (DREBs), were up-regulated under heat shock, whereas with prolonged warming, other abiotic stress response pathways, especially basic leucine zipper factors (bZIPs) were up-regulated instead.

Conclusions

Our findings reveal that Arabidopsis exhibits different response patterns under heat shock versus prolonged warming, and plants employ distinctly different response strategies to combat these two types of thermal stress.
Community-level socioeconomic inequality in the incidence of ischemic heart disease: a nationwide cohort study
Authors: Gwon Jun Gyo , Choi Jimi , Han Young Jin
Published: February 2020

Background

The purpose of this study was to confirm that inequalities in community-level social economic status (SES) do actually impact the incidence of ischemic heart disease (IHD) using the Korean population-based cohort study of the National Health Insurance Service–National Sample Cohort (NHIS-NSC) database.

Methods

This study used the NHIS-NSC database, a population-based cohort database established by the NHIS in South Korea. Community-level SES was classified into three categories, i.e. low, moderate, and high, according to the rank. The outcome measure of interest was IHD, which was defined according to the International Classification of Disease, 10th Revision (ICD-10) codes.

Results

In the low community-level SES group, the incidence of IHD was 3.56 per 1000 person years (cumulative incidence rate, 1.78%), and in the high community level SES group, it was 3.13 per 1000 person years (cumulative incidence rate, 1.57%). Multivariate analysis showed that the incidence of IHD was higher in the low community-level SES group (p = 0.029). The log-rank test showed that the cumulative incidence of IHD was higher in the low community level SES group than the high community-level SES group (adjusted hazard ratio, 1.16; 95% CI, 1.01–1.32).

Conclusions

People living in areas with low community-level SES show an increased incidence of IHD. Therefore, intervention in active, health-risk behavior corrections at the local level will be required to reduce the incidence of IHD.
Dual-task training with progression from variable- to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults: A protocol for a randomized controlled trial
Authors: Trombini-Souza Francis , de Maio Nascimento Marcelo , da Silva Tarcísio Fulgêncio Alves , de Araújo Rodrigo Cappato , Perracini Mônica Rodrigues , Sacco Isabel C. N.
Published: February 2020

Background

Functional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, particularly during activities with variable- and fixed-priority attention. The aim of this study is to compare the dual-task training with progression from variable- to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults.

Methods

This is an assessor- and participant-blinded, two-arm, randomized controlled trial with 60 community-dwelling male and female older adults between the ages of 60 and 80 years old. Participants will be randomly allocated into either the intervention group or the control group using a computer-generated permuted block randomization schedule. The intervention group will undertake a progressive dual-task training in which the participants will be progressively submitted to dual-task walking and postural balance exercises with variable- to fixed-priority instructions. The control group will be submitted to dual-task training with variable-priority attention exercises. Both groups will receive 48 sessions lasting for 60 min each over 24 weeks. The primary outcome will be the gait speed under single- and dual-task conditions. Secondary outcomes will include spatiotemporal gait parameters, functional balance, executive function, falls, quality of life, and depression symptoms. All the analyses will be based on the intention-to-treat principle.

Discussion

This is the first assessor- and participant-blinded, two-arm, randomized controlled trial with 6 months of intervention and an additional 6-month post-training follow up aiming to evaluate the effectiveness of training with progression from variable- to fixed-priority instructions on gait biomechanics, postural balance, falls episodes, executive functioning, and quality of life in community-dwelling older adults. If our hypotheses are confirmed, this training protocol can be implemented widely to improve gait speed and other functional activities and quality of life in community-dwelling older adults. This study protocol can be used to improve these functional aspects of community-dwelling older adults. This study may also contribute to future guidelines for the improvement of these clinical and biomechanical aspects in older people.

Trial registration

ClinicalTrials.govIdentifier -NCT03886805, Registered 22 March 2019.
MicroRNA expression profiling of peripheral blood mononuclear cells associated with syphilis
Authors: Huang Tao , Zhang Jun , Ke Wujian , Zhang Xiaohui , Chen Wentao , Yang Jieyi , Liao Yiwen , Liang Fangwen , Mei Shuqing , Li Mingjiu , Luo Zhenzhou , Zhang Qiwei , Yang Bin , Zheng Heping
Published: February 2020

Background

Treponema pallidum(T. pallidum) infection evokes significant immune responses, resulting in tissue damage. The immune mechanism underlyingT. palliduminfection is still unclear, although microRNAs (miRNAs) have been shown to influence immune cell function and, consequently, the generation of antibody responses during other microbe infections. However, these mechanisms are unknown forT. pallidum.

Methods

In this study, we performed a comprehensive analysis of differentially expressed miRNAs in healthy individuals, untreated patients with syphilis, patients in the serofast state, and serologically cured patients. miRNAs were profiled from the peripheral blood of patients obtained at the time of serological diagnosis. Then, both the target sequence analysis of these different miRNAs and pathway analysis were performed to identify important immune and cell signaling pathways. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) was performed for microRNA analysis.

Results

A total of 74 differentially regulated miRNAs were identified. Following RT-qPCR confirmation, three miRNAs (hsa-miR-195-5p, hsa-miR-223-3p, hsa-miR-589-3p) showed significant differences in the serofast and serologically cured states (P < 0.05). One miRNA (hsa-miR-195-5p) showed significant differences between untreated patients and healthy individuals.

Conclusions

This is the first study of miRNA expression differences in peripheral blood mononuclear cells (PBMCs) in different stages ofT. palliuminfection. Our study suggests that the combination of three miRNAs has great potential to serve as a non-invasive biomarker ofT. palliuminfections, which will facilitate better diagnosis and treatment ofT. palliuminfections.
Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study
Authors: Van Le Hong , Phu Phan Trieu , Vinh Dao Nguyen , Son Vo Thanh , Hanh Nguyen Thi , Nhat Le Thanh Hoang , Lan Nguyen Huu , Vinh Truong Van , Trang Nguyen Thi Mai , Ha Dang Thi Minh , Thwaites Guy E. , Thuong Nguyen Thuy Thuong
Published: February 2020

Background

Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam.

Methods

This retrospective study included 2266 patients who initiated MDR-TB treatment between 2011 and 2015 in HCMC. Treatment outcomes were available for 2240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program.

Results

Among 2266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011 to 2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1 kg/m2 of BMI for patients with BMI < 21).

Conclusion

The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011 and 2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.
The relation between prescribing of different antibiotics and rates of mortality with sepsis in US adults
Authors: Goldstein Edward , Lipsitch Marc
Published: February 2020

Background

Antibiotic use contributes to the rates of sepsis and the associated mortality, particularly through lack of clearance of resistant infections following antibiotic treatment. At the same time, there is limited information on the effects of prescribing of some antibiotics vs. others on subsequent sepsis and sepsis-related mortality.

Methods

We used a multivariable mixed-effects model to relate state-specific rates of outpatient prescribing overall for oral fluoroquinolones, penicillins, macrolides, and cephalosporins between 2014 and 2015 to state-specific rates of mortality with sepsis (ICD-10 codes A40–41 present as either underlying or contributing causes of death on a death certificate) in different age groups of US adults between 2014 and 2015, adjusting for additional covariates and random effects associated with the ten US Health and Human Services (HHS) regions.

Results

Increase in the rate of prescribing of oral penicillins by 1 annual dose per 1000 state residents was associated with increases in annual rates of mortality with sepsis of 0.95 (95% CI (0.02,1.88)) per 100,000 persons aged 75-84y, and of 2.97 (0.72,5.22) per 100,000 persons aged 85 + y. Additionally, the percent of individuals aged 50-64y lacking health insurance, as well as the percent of individuals aged 65-84y who are African-American were associated with rates of mortality with sepsis in the corresponding age groups.

Conclusions

Our results suggest that prescribing of penicillins is associated with rates of mortality with sepsis in older US adults. Those results, as well as the related epidemiological data suggest that replacement of certain antibiotics, particularly penicillins in the treatment of different syndromes should be considered with the aim of reducing the rates of severe outcomes, including mortality related to bacterial infections.