bluuebunny/crossref_metadata_2025 huggingface dataset:
In vitro treatment of 3 T3-L1 adipocytes with recombinant Calcium/calmodulin-dependent Protein Kinase IV (CaMKIV) limits ER stress and improves insulin sensitivity through inhibition of autophagy via the mTOR/CREB signaling pathway
Authors: Liu Jiali , Yang Ruihua , Meng Hao , Zhou Ting , He Qian
Published: July 2020

Background

Recently, CaMKIV has been identified as a potential regulator of skeletal muscle glucose metabolism, it can also affect insulin gene expression in pancreas. However, its effects on adipose insulin resistance have yet to be explored. Autophagy has been shown as a potential therapeutic target for ER (endoplasmic reticulum) stress and insulin resistance. The purpose of this study is to investigate the effects of CaMKIV on ER stress, autophagic function and insulin signaling in tunicamycin-treated adipocytes.

Methods

In this study, mature 3 T3-L1 adipocytes were treated with tunicamycin to induce ER stress. Tunicamycin-treated 3 T3-L1 adipocytes were treated with recombinant CaMKIV in the presence or absence of targeted-siRNA mediated down-regulation of CREB and mTOR. The ER stress markers, autophagy activation, mTOR/CREB signaling and insulin sensitivity were analyzed by western blotting or electron microscopy.

Results

Treatment with CaMKIV significantly reversed tunicamycin-induced expression of p-PERK, cleaved-ATF6, Atg7 and LC3II. It also reduced p62 expression. In addition, levels of p-Akt and p-IRS-1 were increased. Moreover, CaMKIV inhibited activated ER stress and insulin resistance in Atg7 siRNA transfected adipocytes. However, the protective effects of CaMKIV on ER stress, insulin signaling, and autophagy function were nullified by suppression of mTOR or CREB in tunicamycin-treated adipocytes.

Conclusion

This study proves recombinant CaMKIV inhibits tunicamycin-induced ER stress and insulin resistance by regulating autophagy. The protective effect of CaMKIV in adipocytes is affected at least partly through mTOR/CREB signaling. Our finding may offer novel opportunities for treating obesity and type 2 diabetes.
Erosion of universal health coverage and trend in the frequency of physician consultations in Spain
Authors: Lostao Lourdes , Ronda Elena , Pascual Cruz , Cea-Soriano Lucía , Moreno Almudena , Regidor Enrique
Published: July 2020

Background

We studied the frequency of physician visits in the native and immigrant populations in Spain before and after implementation of a governmental measure to restrict the use of public healthcare services by undocumented immigrants beginning in 2012.

Methods

Data were taken from the 2009 and 2014 European Health Surveys carried out in Spain. We investigated any physician consultation in the last 4 weeks before the interview, as well as visits to a family physician, public specialist physician and private specialist physician. We estimated the frequency of visits in 2009 and in 2014 in the native and immigrant populations and the difference in the frequency between the two populations, by calculating the percentage ratio estimated by binomial regression and adjusted for different confounders that are indicators of the need for assistance.

Results

The percentage of persons who consulted any physician in 2009 and 2014 was 31.7 and 32.9% in the native population, and 25.6 and 30.1% in the immigrant population, respectively. In the immigrant population, the frequency of visits to the general practitioner and public specialist physician increased, whereas in the native population only public specialist physician visits increased. The frequency of private specialist visits remained stable in both populations. After adjusting for the indicators of need for healthcare, no significant differences between the immigrant and native populations were seen in the frequency of visits, except for private specialist consultations, which were less frequent among immigrants.

Conclusion

The restriction of universal healthcare coverage in Spain did not reduce the frequency of physician visits between 2009 and 2014, as the frequency of these consultations was seen to increase in both the native and immigrant populations.
Relationship between the non-HDLc-to-HDLc ratio and carotid plaques in a high stroke risk population: a cross-sectional study in China
Authors: Liu Yan , Zhang Zhenwen , Xia Binlan , Wang Liping , Zhang Hengzhong , Zhu Yan , Liu Chao , Song Bin
Published: July 2020

Background

Evidence on the association between the non-high-density lipoprotein cholesterol (non-HDLc)-to-high-density lipoprotein cholesterol (HDLc) ratio (non-HDLc/HDLc) and carotid plaques is still limited. This study aims to assess the relationship between the non-HDLc/HDLc and carotid plaques in a population with a high risk of stroke.

Methods

A cross-sectional study based on the community was conducted in Yangzhou, China. Residents (no younger than 40 years old) underwent questionnaire interviews, physical examinations, and laboratory testing during 2013–2014. The subjects with a high risk of stroke were further selected (at least three of eight risk factors including hypertension, atrial fibrillation, type 2 diabetes mellitus, dyslipidaemia, smoking, lack of exercise, overweight, and family history of stroke) or a transient ischaemic attack (TIA) or stroke history. Carotid ultrasonography was then performed on the high stroke risk participants. Carotid plaque was defined as a focal carotid intima-media thickness (cIMT) ≥1.5 cm or a discrete structure protruding into the arterial lumen at least 50% of the surrounding cIMT. Logistic regression was employed to evaluate the relationship between the non-HDLc/HDLc and carotid plaques.

Results

Overall, 839 subjects with a high risk of stroke were ultimately included in the analysis, and carotid plaques were identified in 341 (40.6%) of them. Participants in the highest non-HDLc/HDLc tertile group presented a higher proportion of carotid plaques than did those in the other two groups. After adjustment for other confounders, each unit increase in the non-HDLc/HDLc was significantly associated with carotid plaques (OR 1.55, 95%CI 1.28–1.88). In the subgroup analysis, the non-HDLc/HDLc was positively and significantly associated with the presence of carotid plaques in most subgroups. Additionally, the non-HDLc/HDLc interacted significantly with three stratification variables, including sex (OR 1.31 for males vs. OR 2.37 for females, P interaction = 0.016), exercise (OR 1.18 for subjects without lack of exercise vs. OR 1.99 for subjects with lack of exercise, P interaction = 0.004) and heart diseases (OR 1.40 for subjects without heart diseases vs. OR 3.12 for subjects with heart diseases, P interaction = 0.033).

Conclusion

The non-HDLc/HDLc was positively associated with the presence of carotid plaques in a Chinese high stroke risk population. A prospective study or randomized clinical trial of lipid-lowering therapy in the Chinese population is needed to evaluate their causal relationship.
The clinical utility of routine spinal radiographs by chiropractors: a rapid review of the literature
Authors: Corso Melissa , Cancelliere Carol , Mior Silvano , Kumar Varsha , Smith Ali , Côté Pierre
Published: July 2020

Introduction

When indicated by signs or symptoms of potentially serious underlying pathology (red flags), chiropractors can use radiographs to inform their diagnosis. In the absence of red flags, the clinical utility of routine or repeat radiographs to assess the structure and function of the spine is controversial.

Objectives

To determine the diagnostic and therapeutic utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. Investigate whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. The research objectives required that we determine the validity, diagnostic accuracy and reliability of radiographs for the structural and functional evaluation of the spine.

Evidence review

We searched MEDLINE, CINAHL, and Index to Chiropractic Literature from inception to November 25, 2019. We used rapid review methodology recommended by the World Health Organization. Eligible studies (cross-sectional, case-control, cohort, randomized controlled trials, diagnostic and reliability) were critically appraised. Studies of acceptable quality were included in our synthesis. The lead author extracted data and a second reviewer independently validated the data extraction. We conducted a qualitative synthesis of the evidence.

Findings

We identified 959 citations, screened 176 full text articles and critically appraised 23. No relevant studies assessed the clinical utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. No studies investigated whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. Nine low risk of bias studies investigated the validity (n = 2) and reliability (n = 8) of routine or repeat radiographs. These studies provide no evidence of clinical utility.

Conclusion

We found no evidence that the use of routine or repeat radiographs to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients. Given the inherent risks of ionizing radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine.
Predictors of adherence to wearing therapeutic footwear among people with diabetes
Authors: Jarl Gustav , Tranberg Roy , Johansson Ulf , Alnemo John , Lundqvist Lars‐Olov
Published: July 2020

Aims

People at increased risk of developing diabetic foot ulcers often wear therapeutic footwear less frequently than is desirable. The aims were to identify patient groups prone to nonadherence to wearing therapeutic footwear and modifiable factors associated with adherence.

Materials and methods

A questionnaire was mailed to 1230 people with diabetes who had been fitted with therapeutic footwear. Independent variables were categorized into five domains. For each domain, variables that were associated with adherence in a univariate regression analysis were entered into a multiple regression analysis.

Results

A total of 429 (34.9%) questionnaires were analyzed. Multiple regression analyses showed significant associations (p < 0.05) between higher adherence and paid employment, current foot ulcer, previous foot ulcer, satisfaction with follow‐up, self‐efficacy, understanding of lost/reduced sensation as a risk factor for foot ulcerations, visible storage of therapeutic footwear at home, storage of conventional footwear out of sight, consistent choices about which footwear type to wear, and a belief that therapeutic footwear promotes ulcer healing. The five multivariate models explained 2–28% of the variance in adherence, with the strategies for footwear use domain explaining the most.

Conclusions

Patients without paid employment or without foot ulcer experience are more prone to nonadherence. To improve adherence, clinicians should advise patients to store therapeutic footwear in a visible place at home and put conventional footwear away and encourage patients' self‐efficacy and habitual use of therapeutic footwear. Future studies should investigate this topic further and explore ways to promote changes in habits. A study limitation was that all variables were self‐reported.
Functional crosstalk between mTORC1/p70S6K pathway and heterochromatin organization in stress-induced senescence of MSCs
Authors: Liu Hailong , Huang Biao , Xue Shaolong , U Kin Pong , Tsang Lai Ling , Zhang Xiaohu , Li Gang , Jiang Xiaohua
Published: July 2020

Background

Stem cell senescence has been proposed as one of the major drivers of aging, and MSC senescence contributes to aging-related diseases. Activation of mTORC1 pathway and heterochromatin organization have been characterized as two characteristics of senescent cells; however, whether mTORC1 pathway interacts with heterochromatin organization and contributes to MSC senescence remains unknown. In this study, we investigated the interaction between heterochromatin organization and mTORC1/p70S6K pathway in stress-induced MSC senescence.

Methods

The stress-induced senescence models were established in human umbilical cord-derived MSCs by doxorubicin (Dox) or H2O2. Cellular senescence was evaluated by β-Gal activity, upregulation of cell cycle suppressor genes, and expression of SASP. Activation of heterochromatin organization and mTORC1 pathway was determined by Western blot and immunofluorescent staining. A D-galactose (D-Gal)-induced aging model was established in rats to evaluate the crosstalk between heterochromatin and mTORC1 pathway in vivo.

Results

We found that heterochromatin organization was provoked at the early stage of Dox- or H2O2-induced senescence. Disruption of heterochromatin organization led to robust DNA damage response and exacerbated cellular senescence. Suppression of mTORC1/p70S6K pathway by either rapamycin or p70S6K knockdown promoted heterochromatin organization and ameliorated Dox- or H2O2-induced DNA damage and senescence. In contrast, direct activation of mTORC1 by MHY1485 impaired heterochromatin organization and aggravated stress-induced senescence. Moreover, concomitant activation of mTORC1 pathway and heterochromatin organization was found in D-galactose-induced osteoporosis model in rats. Rapamycin alleviated cellular senescence and promoted heterochromatin organization in BMSCs derived from D-galactose-treated rats.

Conclusions

Altogether, our study indicates the existence of a complex interplay between the mTORC1/p70S6K pathway and the heterochromatin organization during stress-induced MSC senescence, with important implications for the understanding of aging as well as for its prevention and treatment.
Population structure, genetic diversity and pathotypes of Streptococcus suis isolated during the last 13 years from diseased pigs in Switzerland
Authors: Scherrer Simone , Rosato Giuliana , Spoerry Serrano Nathalie , Stevens Marc J. A. , Rademacher Fenja , Schrenzel Jacques , Gottschalk Marcelo , Stephan Roger , Peterhans Sophie
Published: July 2020

Streptococcus (S.) suis is a globally important swine pathogen, which comprises certain zoonotic serotypes. In this study, a detailed characterization of 88 porcine S. suis isolates was performed by analyzing capsular (cps) types, multilocus sequence typing (MLST) and investigation of the minimum core genome (MCG). In order to focus on the virulence potential of presumable invasive disease-associated S. suis isolates, virulence-associated gene profiles were assessed followed by screening a chosen subset of S. suis strains with a molecular pathotyping tool. Results showed a high genetic variability within this strain collection. In total, seventeen cps types were identified with a predominance of cps type 9 (15.9%) and 6 (14.8%). MLST revealed 48 sequence types (STs) including 41 novel ones. The population structure of S. suis was heterogenous and isolates belonged to eight different clonal complexes (CCs) including CC28 (9.1%), CC1109 (8%), CC13/149 (6.8%), CC1237 (5.7%), CC1 (3.4%), CC17 (3.4%), CC87 (2.3%), and CC1112 (1.1%), whereas a significant portion of isolates (60.2%) could not be assigned to any described CCs. Virulence-associated markers, namely extracellular protein factor (epf), muramidase-released protein (mrp), and suilysin (sly), showed a link with STs rather than with cps types. With this study an expanded knowledge about the population structure and the genetic diversity of S. suis could be achieved, which helps to contribute to an optimal public health surveillance system by promoting a focus on strains with an increased virulence and zoonotic potential.
Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
Authors: Buetti Niccolò , Ruckly Stéphane , Lucet Jean-Christophe , Bouadma Lila , Schwebel Carole , Mimoz Olivier , Timsit Jean-François
Published: July 2020

Background

The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results.

Results

We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69).

Conclusions

Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance.

Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682).
Local infiltration of tramadol as an effective strategy to reduce post-operative pain: a systematic review protocol and meta-analysis
Authors: Passavanti Maria Beatrice , Piccinno Giacomo , Alfieri Aniello , Di Franco Sveva , Sansone Pasquale , Mangoni Giuseppe , Pota Vincenzo , Aurilio Caterina , Pace Maria Caterina , Fiore Marco
Published: July 2020

Objective

The purpose of this review is to evaluate the use and effectiveness of the local administration of tramadol in reducing post-operative pain during surgical interventions.

Methods

The PubMed, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases will be searched for this review. This systematic review will include studies evaluating the clinical efficacy of the local infiltration of tramadol, with no study design restrictions. Only studies that present clear descriptions of local tramadol administration are published in peer-reviewed journals in the English, Italian, Spanish, French, Portuguese or German language and are published in full will be taken into consideration. A meta-analysis will be performed when there is sufficient clinical homogeneity among the retrieved studies, and only randomized controlled studies and quasi-randomized controlled studies will be included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty in the evidence. If a quantitative analysis cannot be conducted, a qualitative description of the results of the retrieved studies will be provided.

Results

A high-quality synthesis of the current evidence on the local administration of tramadol for managing post-surgical pain will be illustrated using subjective reports and objective measures of performance. The primary outcomes will include the magnitude of post-operative pain intensity improvement, with improvement being as defined by a reduction by at least 2 points in the visual analogue scale (VAS) score or numerical rating scale (NRS) score. The secondary outcomes will be the magnitude of reduction in tramadol rescue doses and in other analgesic drug doses.

Conclusion

This protocol will present evidence on the efficacy of tramadol in relieving post-surgical pain.

Systemic review registration

PROSPERO CRD42018087381
Volcanological challenges to understanding explosive large-scale eruptions
Authors: Geshi Nobuo
Published: July 2020

An explosive eruption, associated with the formation of a large ignimbrite sheet and collapsed caldera, is the most severe volcanic disaster on Earth. As modern society has little experience with natural disasters triggered by such events, the integration of volcanological knowledge from geological, petrological, geochemical, and geophysical disciplines is necessary for risk assessment and hazard management planning of large-scale explosive eruptions. Here, I review current volcanological attempts at revealing the mechanisms underlying large-scale explosive eruptions to highlight future objectives. The detection of massive magma storage regions with the potential to generate large-scale explosive eruptions should be the first objective of risk evaluation and assessment for caldera-forming eruption scenarios. This detection requires the development of geophysical techniques used for structural exploration. Geochemical and petrological explorations of leaked gas and magma during precursory eruptions can be useful for investigating the state of a body of underground magma. Evaluation of the eruptibility of a magma chamber is also important for risk assessment, as is the estimation of the timescales of magma accumulation. Defining the triggers that destabilize large volume magma chambers that serve as zones of long-term storage is crucial for being able to provide short-term alerts. Petrological investigations of the magmatic products from past large-scale explosive eruptions are a key tool for such a goal. Modeling the distribution of erupted material, such as huge ignimbrite sheets and co-ignimbrite ash fall, is also crucial for risk assessment of large-scale explosive eruptions. Advancing the understanding of the mechanisms and effects of large-scale explosive eruptions requires development in various fields of volcanology along with the integration of knowledge from multiple disciplines, thus promoting progress and interaction across various areas of volcanology and science and technology.
Absence of instabilities and intra-prosthetic dislocations at 7 to 11 years following THA using a fourth-generation cementless dual mobility acetabular cup
Authors: Chouteau Julien , Rollier Jean-Charles , Bonnin Michel P. , Saffarini Mo , Nover Luca , Chatelet Jean-Christophe , Jacquot Laurent
Published: July 2020

Purpose

Dual-mobility (DM) cups are increasingly used in total hip arthroplasty (THA) but there lacks literature on their long-term results. We aimed to investigate outcomes of a fourth-generation cementless DM acetabular cup at 7–11 years.

Methods

We retrospectively evaluated 240 consecutive hips that received cementless THA using the same dual mobility cup (Novae Sunfit TH) and femoral stem (Corail). Patients were recalled at ≥7 years to collect Oxford hip scores (OHS), Harris hip scores (HHS), and inspect for radiolucent lines and granulomas. Multi-variable analyses were performed to determine whether HHS or OHS were associated with pre- or intra-operative variables.

Results

At 8.4 ± 0.8 years (range, 7–11), 6 hips were revised (2.5%), 54 deceased (22.5%), and 14 could not be reached (5.8%). Four revisions (2 cup+stem, 2 liners only) were due to sepsis (1.7%), one (cup and stem) for trauma (0.4%), and one (stem) due to aseptic loosening (0.4%). For the remaining 166 hips, HHS was 83.6 ± 13.2 and OHS was 20.3 ± 6.7. Multi-variable analysis confirmed that HHS (β = − 0.38; p = 0.039) and OHS (β = 0.36; p < 0.001) worsened with age, and that OHS was worse for Charnley C patients (β = 3.17; p = 0.009). Neither granulomas nor radiolucenies were observed around any cups, but radiolucenies were seen around 25 stems (20.3%).

Conclusions

This fourth-generation DM cup demonstrated satisfactory outcomes at 7–11 years, with no instabilities or cup revisions due to aseptic loosening. Better OHS was observed for younger patients and those presenting higher Charnley grade.

Level of evidence

Level IV, retrospective case study.
Effect of different kinematics and operational temperature on cyclic fatigue resistance of rotary NiTi systems
Authors: Ismail Amira Galal , Galal Manar , Nagy Mohamed Mokhtar
Published: July 2020

Background

The aim of this study was to compare the effect of different kinematics and operational temperature on cyclic fatigue resistance of Protaper Next, WaveOne Gold, and Twisted File Adaptive files in a static model.

Methodology

An artificial canal, made of stainless steel with an inner diameter of 1.5 mm, a 60° angle of curvature, and a curvature radius of 2 mm, was used for the cyclic fatigue test immersed in a water bath for temperature adjustment (37 °C and 20 °C). A total of 120 files were divided into three groups according to the type of motion continuous rotation motion (CRM), adaptive motion (AM), and reciprocation motion (RM). Each group was further subdivided into two subgroups according to the operational temperature (37 °C and 20 °C), All instruments were operated until fracture occurred, and the time to fracture was recorded in seconds. Mean number of cycles to failure and standard deviations were calculated for each group, and data were analyzed statistically using two-way ANOVA followed by Tukey’s post hoc test (P ≤ 0.05).

Results

The continuous rotation motion exhibited significantly lower cyclic fatigue resistance than reciprocating or adaptive motion (p ≤ 0.001) at 37 °C and 20 °C.

Conclusions

Cyclic fatigue resistance of NiTi files was affected by the motion used during root canal preparation. Reciprocation motion and adaptive motion resulted in extended fatigue. The operational temperature affects the cyclic fatigue resistance of the twisted file.
Comparison of Pupillometry With Surgical Pleth Index Monitoring on Perioperative Opioid Consumption and Nociception During Propofol–Remifentanil Anesthesia: A Prospective Randomized Controlled Trial
Authors: Kim Jong Hae , Jwa Eun Kyung , Choung Youjin , Yeon Hyo Jin , Kim Soo Yeon , Kim Eugene
Published: July 2020

BACKGROUND:

Intraoperative monitoring with pupillometry has shown promising results for nociception/antinociception balance monitoring. However, its benefits in clinical practice remain unproven. The aim of this study was to evaluate the efficacy of intraoperative pupillometry monitoring on intraoperative opioid consumption and postoperative pain compared to surgical pleth index (SPI), another widely investigated monitoring.

METHODS:

American Society of Anesthesiologists (ASA) I–II patients scheduled for elective laparoscopic cholecystectomy were included. This prospective, parallel-arm, single-center study was conducted in 2 steps. First, we evaluated the feasibility of using pupillometry and SPI monitoring compared with conventional hemodynamic monitoring. Next, a parallel-arm, double-blind randomized study compared the peak postoperative pain measured with numerical rating scale (NRS) from 0 (no pain) to 10 (extreme pain) as a primary outcome between pupillometry (pupillometry group, n = 43) and SPI monitoring (SPI group, n = 43) using Mann-Whitney U test. Secondary outcomes included intraoperative remifentanil consumption, postoperative opioid responsiveness (a decrease in NRS by ≥1 after fentanyl administrations), number of analgesic administrations, and opioid-related complications.

RESULTS:

In the preliminary study (n = 50), remifentanil consumption was less under pupillometry monitoring compared to SPI monitoring, and peak postoperative pain was lower under pupillometry compared to conventional monitoring. In the main study (n = 86), peak postoperative pain and intraoperative remifentanil consumption were lower in the pupillometry group (median [first to third quartile], 5 [4–6]; mean ± standard deviation [SD], 0.078 ± 0.019 μg·kg−1·minute−1) compared to the SPI group (7 [5–8] and 0.0130 ± 0.051 μg·kg−1·minute−1; P < .001), with the median difference in peak postoperative pain of −1 and its 95% confidence interval between −2 and −0.5. The pupillometry group had better responsiveness to fentanyl (84.6% vs 61.0%; P = .005) and lower number of analgesic administrations (2 [1–2] vs 2 [1–3]; P = .048) compared to the SPI group.

CONCLUSIONS:

Intraoperative pupillometry monitoring reduced intraoperative remifentanil consumption and postoperative pain. It may be an alternative option for intraoperative opioid control under general anesthesia in adult patients.
Aneconomy, Indirection, Undecidability
Authors: Khan Azeen
Published: July 2020

This essay explores how, in each of Jacques Derrida’s late encounters with psychoanalysis, he critiques the limit of a certain economic principle of the Freudian death drive, opening up its deterministic logic to a principle of indetermination. The essay draws out three key terms—aneconomy from Archive Fever, indirection from “Psychoanalysis Searches the States of Its Soul,” and undecidability from Glas and The Death Penalty seminars—to show how Derrida suggests a move beyond an “economy of the possible,” thereby showcasing the potentiality of a properly deconstructive psychoanalytic thought. With these three movements, the essay traces the implications of Derrida’s “principled” critique of the economy of the death drive for his consideration of the death penalty.
Development of an informatics system for accelerating biomedical research.
Authors: Navale Vivek , Ji Michele , Vovk Olga , Misquitta Leonie , Gebremichael Tsega , Garcia Alison , Fann Yang , McAuliffe Matthew
Published: July 2020

The Biomedical Research Informatics Computing System (BRICS) was developed to support multiple disease-focused research programs. Seven service modules are integrated together to provide a collaborative and extensible web-based environment. The modules—Data Dictionary, Account Management, Query Tool, Protocol and Form Research Management System, Meta Study, Data Repository and Globally Unique Identifier —facilitate the management of research protocols, to submit, process, curate, access and store clinical, imaging, and derived genomics data within the associated data repositories. Multiple instances of BRICS are deployed to support various biomedical research communities focused on accelerating discoveries for rare diseases, Traumatic Brain Injury, Parkinson’s Disease, inherited eye diseases and symptom science research. No Personally Identifiable Information is stored within the data repositories. Digital Object Identifiers are associated with the research studies. Reusability of biomedical data is enhanced by Common Data Elements (CDEs) which enable systematic collection, analysis and sharing of data. The use of CDEs with a service-oriented informatics architecture enabled the development of disease-specific repositories that support hypothesis-based biomedical research.
Willingness-to-pay for a hypothetical Ebola vaccine in Indonesia: A cross-sectional study in Aceh
Authors: Mudatsir Mudatsir , Anwar Samsul , Fajar Jonny Karunia , Yufika Amanda , Ferdian Muhammad N. , Salwiyadi Salwiyadi , Imanda Aga S. , Azhars Roully , Ilham Darul , Timur Arya U. , Sahputri Juwita , Yordani Ricky , Pramana Setia , Rajamoorthy Yogambigai , Wagner Abram L. , Jamil Kurnia F. , Harapan Harapan
Published: July 2020

Background: Some Ebola vaccines have been developed and tested in phase III clinical trials. However, assessment of whether public have willingness to purchase or not, especially in unaffected areas, is lacking. The aim of this study was to determine willingness to pay (WTP) for a hypothetical Ebola vaccine in Indonesia.

Methods: A cross-sectional study was conducted from 1 August to 30 December 2015 in five cities in Aceh province of Indonesia. Patients’ family members who visited outpatient departments were approached and interviewed about their sociodemographic characteristics, knowledge of Ebola, attitude towards vaccination practice and their WTP for a hypothetical Ebola vaccine. A multivariable linear regression model assessed the relationship between these explanatory variables and WTP.

Results: During the study, 500 participants were approached and interviewed. There were 424 (84.8%) respondents who completed the interview and 74% (311/424) expressed their acceptance for an Ebola vaccine. There were 288 participants who were willing to pay for an Ebola vaccine (92.6% out of 311). The mean of WTP was US$2.08 (95% CI: 1.75-2.42). The final multivariable model indicated that young age, high educational attainment, working as a private employee, entrepreneur or civil servant (compared to farmers), being unmarried, and residing in a suburb (compared to a city) were associated with higher WTP.

Conclusions: Although the proportion of the participants who would accept the Ebola vaccine was relatively high, the amount they were willing to pay for Ebola vaccine was very low. This finding would indicate the need of subsidies for Ebola vaccine in the country.
Recent advances in managing axial spondyloarthritis
Authors: Agrawal Priyanka , Machado Pedro M.
Published: July 2020

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that predominantly affects the axial skeleton. The advent of biologic drugs has transformed the management of patients with axSpA. However, non-steroidal anti-inflammatory drugs remain the first-line drug treatment for axSpA. The optimal management of patients with axSpA requires a combination of pharmacological and non-pharmacological treatment modalities, namely exercise and physical therapy. This review looks at novel therapeutic options in patients with axSpA. It also summarises current evidence regarding radiographic progression and treat-to-target in axSpA.
New antipsychotic drugs for the treatment of agitation and psychosis in Alzheimer’s disease: focus on brexpiprazole and pimavanserin
Authors: Caraci Filippo , Santagati Mario , Caruso Giuseppe , Cannavò Dario , Leggio Gian Marco , Salomone Salvatore , Drago Filippo
Published: July 2020

Behavioral and psychological symptoms of dementia are symptoms of disturbed perception, mood, behavior, and thought content that occurred frequently. These symptoms, which include apathy, depression, anxiety, psychosis, agitation, and aggression, can serve as predictors of and early clinical diagnostic markers for Alzheimer’s disease (AD) and are common precipitants of institutional care. Agitation and psychosis are associated with accelerated disease progression and increased tau phosphorylation in patients with AD. Current guidelines recommend the use of second-generation antipsychotics for the treatment of agitation and psychosis in AD, but only after first-line non-pharmacological interventions and for no longer than 12 weeks because long-term use of these drugs is associated with an increased risk of mortality and an increased frequency of cerebrovascular events. Therefore, new antipsychotic drugs with improved efficacy and safety are needed as an alternative to current antipsychotic drugs. In this report, we discuss some of the most relevant advances in the field of agitation and psychosis in AD and focus on the recent positive clinical evidence observed with two new antipsychotics drugs: brexpiprazole and pimavanserin. Brexpiprazole is a receptor partial agonist (D2, D3, 5-HT1A), receptor antagonist (5-HT2A/B, α1B/α2C) according to the neuroscience-based nomenclature. Two recent phase III clinical trials have shown that brexpiprazole 2 mg/day is effective for the treatment of agitation in patients with AD and has an improved tolerability and safety profile compared with currently available second-generation antipsychotics. Pimavanserin is a receptor antagonist (5-HT2A, 5-HT2C) that has been given market authorization for psychosis occurring in Parkinson’s disease. Recent phase II studies suggest that this drug is effective in AD patients with more severe psychosis, although further long-term studies are needed to better define the efficacy and long-term safety profile of pimavanserin for the treatment of psychosis in AD.
Workplace management initiatives and talent engagement in the Nigerian pharmaceutical industry
Authors: Falola Hezekiah O. , Ogueyungbo Opeyemi O. , Ojebola Oluwatunmise O.
Published: July 2020

Background: Talent engagement is increasingly gaining the attention of pharmaceutical industry, particularly in developing nations like Nigeria. The existing literature shows that the subject of workplace management initiatives and talent engagement in the Nigerian pharmaceutical industry has not been sufficiently researched. This study investigates the influence of workplace management initiatives on talent engagement in some selected pharmaceutical companies in Nigeria.

Methods: In total, 600 respondents were surveyed across various departments and units of ten selected pharmaceutical companies in Nigeria using multiple sampling techniques. Only 429 copies of the questionnaire, representing a 71.5% response rate, were returned and analyzed using Smart PLS 3.0.

Results: The outcomes of the statistical analysis show that recognition, employees’ wellbeing, learning and development as well as diversity and inclusion had significant influence on talent, emotional, cognitive and behavioural engagements.

Conclusions: In line with the statistical results, the study concludes that workplace management initiatives influenced talent engagement. The study emphasized the need for the review of many workplace management initiatives in order to determine its suitability within the context of pharmaceutical industry in Nigeria.
Automation of Nondestructive Testing of Composite Materials
Authors: Borisenko Vyacheslav
Published: July 2020

Composite materials appear to be an ideal solution to a complex problem with conflicting conditions: how to simultaneously obtain sufficient strength, reliability and durability of the structure, while providing the minimum possible mass of it. However, non-destructive testing of products from them raises more and more questions. In the mass production of composite pipes for pipelines, the only possible option from the point of view of ensuring the necessary reliability, information capacity of the results of the performed inspection of products and productivity is the automation of the inspection process, which includes special methods for identifying defects. Statistical methods, including capability ratio and Shewhart control charts, should be used to estimate the error in determining the size of defects.
On the Preparation of Teachers for the Implementation of the Educational Program «Origins»
Authors: Fugelova Tatiana
Published: July 2020

The education and spiritual development of a person, his ability to realize and analyze his actions, value himself and other people depends on the teacher. All this is the basis of sustainable development of society.

This study involves the development and description of a teacher training program for the implementation of the program on spiritual and moral education and development of students.

The program is focused on the formation of teachers' competencies in designing activities for spiritual and moral education of students. Training involves mastering school teachers by monitoring in the field of spiritual and moral education of students.

The article presents the contents of the teacher training program on the topic: “Parenting on socio-cultural experience: theoretical and practical aspects of the work of primary school teachers in the process of implementing the “Origins” program. In the process of implementing the continuing education program, the concept of spiritual and moral education of students, which is the basis of the socio-cultural educational program “Origins”, was revealed. Teachers were offered methodological tools for organizing individual and group work with children in the process of implementing the “Origins” training course.
Didactic Capabilities of the Digital Educational Environment "Mobile E-Education"
Authors: Amirhanova L. , Zenkina S. , Savel'eva O.
Published: July 2020

The article discusses the didactic possibilities of the digital educational environment "Mobile e-education" as one of the tools of pedagogical practice for distance learning, with its own specifics of knowledge delivery and user-friendly interface. Using the example of a specific online geography lesson developed using the capabilities of the digital educational environment, it is shown how to build an individual educational trajectory for each student, includes children with disabilities and children with special educational needs.
Forecasting combat readiness of military personnel of information and technical divisions of the Russian aerospace forces
Authors: Petrov Vladislav , Panferova Evgeniya
Published: July 2020

The article is devoted to the development and verification of a model for psychodiagnostic forecasting of readiness of military personnel of information and technical units of the Russian aerospace forces to perform combat duty. The longitudinal study used standardized test tools (the method "Motivational profile of the individual", the personal questionnaire "Big five", the method of diagnosing the tendency to deviate behavior, the multi-level personal questionnaire" Adaptability", the method of studying the features of thinking), a questionnaire and expert assessment. Participants were 119 experts and 255 military personnel serving under a contract. The main difference in subgroups of military personnel of various degrees of readiness for combat duty was the presence of purposefulness and awareness of activity. In the regression model of predicting military readiness, the success of activity is associated with the presence of adaptive abilities, consciousness and intellectual potential. Combat readiness is reduced due to the soldier's tendency to aggression and violence, power and recognition, as well as utilitarian motivation. The results of the research allow us to improve the procedure for professional psychological selection of candidates for military service under a contract and preventative work with personnel, optimize training and combat training of military personnel, and ultimately increase the combat readiness of units and formations of constant readiness.
Formação social brasileira: interface com as relações raciais
Authors: Corato Carmen
Published: July 2020

O presente artigo tem por objetivo analisar a formação social brasileira; para tanto, é necessário abarcar a categoria de modo de produção, a partir da tradição marxista. Nosso interesse é destacar a escravidão como uma particularidade na constituição do capitalismo nesse país, o que nos impele a estudar as consequências dessa particularidade, uma vez que a escravidão durou quase 400 anos, produzindo algumas alterações na forma de produção e acumulação da riqueza. Na medida em que os traços capitalistas deram os seus primeiros sinais, as elites trataram de garantir no pós-abolição um total abandono da população negra, a qual produziu toda riqueza até então. Palavras-Chave: modo de produção; formação social; relações étnico-raciais no Brasil.
O genocídio da juventude negra brasileira: luta pelo direito a vida e o Serviço Social
Authors: Juliano Dayana Christina Ramos de Souza
Published: July 2020

O referido artigo, de forma ensaística, apresenta algumas reflexões sobre o genocídio da juventude negra e a importância do Serviço Social brasileiro no seu enfrentamento. Para este fim, utilizamos como aporte metodológico o estudo de caso, dialogando com a análise das relações sociais, no campo das desigualdades de cunho étnico-racial e de classe. Entendemos que o fato abordado não deve ser apreendido de forma aleatória e isolada, mas como resultado de uma violência histórica motivada, sobretudo, pelo racismo. Utilizamos, também, dados oficiais e indicadores estatísticos para pontuar o fenômeno social denominado Genocídio da juventude Negra brasileira. Este artigo é resultado do trabalho de conclusão de curso de especialização Lato Sensu em Políticas sociais e Intersetorialidade no Instituto Fernandes Figueira / FioCruz, no ano de 2018.Palavras-chave: Questão Social; Racismo; Juventude Negra e Serviço Social.
Racismo, trabalho e previdência social no Brasil
Authors: Da Silva Maria Lucia Lopes , Lima Jéssika Larissa Sousa
Published: July 2020

Este artigo propõe-se a contribuir com as reflexões sobre a relação entre o racismo, mercado de trabalho   e os limites de acesso da população negra à previdência social no Brasil. Para tanto fez-se uma revisão bibliográfica no campo da   tradição marxista acerca da relação entre a chamada acumulação primitiva, a origem e o desenvolvimento do capitalismo, o processo de colonização das américas e a escravidão; sobre a dinâmica social brasileira em que   as relações raciais se desenvolveram, originando e   enraizando o racismo no país; e, acerca da condição atual  do trabalho e da previdência social. Ademais, recorreu-se aos dados disponíveis no Instituto Brasileiro de Geografia e Estatística (IBGE) sobre população negra, mercado de trabalho e previdência social, para subsidiar as reflexões.Palavras-chave: racismo; trabalho; população negra; previdência social.
“Zonas de Não Ser”: mulheres negras sem-teto e deslocamento nos Estados Unidos
Authors: Smith Christen A. , Machicote Michaela
Published: July 2020

As mulheres negras, silenciadas, invisíveis e pobres da classe trabalhadora lutam apenas para sobreviver em Austin, Texas, EUA. Este artigo argumenta que as experiências das mulheres negras sem teto e a discriminação habitacional nos Estados Unidos indicam que a gentrificação não é apenas um processo social limitante, mas também mortal. Existe uma relação niítida, porém implícita, entre gentrificação e a supremacia branca patriarcal estrutural e interpessoal. Esse processo racializado de renovação da cidade também tem um gênero agudo. Existe uma relação dialética entre gentrificação e o apagamento específico de mulheres negras do espaço público. Em nenhum lugar isso é mais evidente do que nas experiências das mulheres negras sem-teto. Essas mulheres em Austin ocupam uma “zona de não-ser” em que não têm direitos à cidade, espaço territorial doméstico e pouco ou nenhum acesso a serviços sociais. Palavras-chaves: mulheres negras; sem-teto; discriminação habitacional; Estados Unidos, gentrificação.
Raising awareness of seizure triggers and pre-seizure behaviour changes in dogs
Authors: Packer Rowena
Published: July 2020

A new study by the Royal Veterinary College (RVC) has identified pre-seizure behavioural changes and potential seizure triggers that may help owners predict when a seizure is going to occur. The RVC’s animal behaviour scientist Dr Rowena Packer explains.
Orthodontics at Times of National Emergency: Past and Current Crises Part 2. COVID-19: Implications for Clinical Practice
Authors: Lee Tara V N , Fowler Peter V , Williams Julie C , Ellis Pamela , Atack Nikki E , Ireland Anthony J
Published: July 2020

This paper explores the disease COVID-19 caused by the SARS-CoV-2 virus. This disease has caused a global pandemic affecting the way society both works and lives. COVID-19 is spread through droplets from the mouth and nose, which has implications for how we practice orthodontics. Our clinical practice will therefore need to be adapted to keep both patients and staff safe. This paper addresses the adaptations that should be considered. We also address what the future of orthodontics may look like in light of the issues with cross infection that COVID-19 has raised.

CPD/Clinical Relevance: How to adapt our clinical practice to keep both staff and patients safe.