bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of Low-dose Dexmedetomidine for Prevention of Postoperative Delirium after Intracranial Operations: A Pilot Randomized Controlled Trial
Authors: Cheng Kun-Ming , He Xuan , Duan Yu-Qing , Xu Shan-Shan , Gao Hao-Ran , Miao Ming-Yue , Li Hong-Liang , Chen Kai , Yang Yan-Lin , Zhang Linlin , Gu Hong-Qiu , Zhou Jian-Xin
Published: April 2021

Background: Clinical trials have shown that dexmedetomidine might decrease the occurrence of postoperative delirium after major surgery, but neurosurgical patients were excluded from these studies. We aimed to determine the feasibility of conducting a full-scale randomized controlled trial of the effect of prophylactic low-dose dexmedetomidine on postoperative delirium in patients after elective intracranial operation for brain tumors.Methods: This single-center, parallel-arm pilot randomized controlled trial was conducted in a twenty-bed intensive care unit (ICU) at an academic affiliated hospital. Adult patients who underwent an elective intracranial operation for brain tumors and admitted to the ICU were recruited. Dexmedetomidine (0.1 mg/kg/hour) or placebo was continuously infused from ICU admission on the day of surgery until 08:00 AM on postoperative day one. Adverse events during the study-drug administration were recorded. The primary feasibility endpoint was the occurrence of study-drug interruption. Delirium was assessed twice daily with the Confusion Assessment Method for the ICU during the first five postoperative days. The assessable rate of delirium evaluation was documented.Results: Sixty participants were randomly assigned to receive either dexmedetomidine (n=30) or placebo (n=30). The study-drug was stopped in two patients (6.7%) in the placebo group due to desaturation after new-onset unconsciousness and an unplanned reoperation for hematoma evacuation and in one patient (3.3%) in the dexmedetomidine group due to unplanned discharge from the ICU (P=0.554). During the study-drug infusion, no bradycardia occurred, and hypotension occurred in one patient (3.3%) in the dexmedetomidine group. Dexmedetomidine tended to decrease the incidence of tachycardia (10.0% vs. 23.3%) and hypertension (3.3% vs. 23.3%), but the difference was not statistically significant (P=0.299 and 0.052). Respiratory depression, desaturation, and unconsciousness occurred in the same patient with study-drug interruption in the placebo group (3.3%). Delirium was evaluated 600 times, of which 590 (98.3%) attempts were assessable except in one patient in the placebo group who remained in a coma after an unplanned reoperation.Conclusions: The low rate of study-drug interruption and high assessable rate of delirium evaluation supported a fully powered trial to determine the effectiveness of low-dose dexmedetomidine on postoperative delirium in patients after intracranial operation for brain tumors.Trial registration: The trial was registered at ClinicalTrials.gov (NCT04494828) on July 31, 2020.
Theoretical Modeling and Machining Experiments of Cylindrical Microstructure Assisted by Single Point Diamond Turning
Authors: Li Jingjin , Ji Shijun , Zhao Ji , Li Jianfeng , Dai Handa
Published: April 2021

Micro structure requires nanometer-scale surface roughness and micro- or even sub-micron form error accuracy in different applications. Two kinds of modeling theories and methods of micro-feature of rotating body and non-rotating body are studied, and the corresponding tool turning trajectory planning method is put forward. In order to process the designed micro-feature structure successfully and avoid the interference and overcutting between tool and workpiece caused by improper selection of tool parameters, the cutting parameters are analyzed and two error theories are proposed. Then a precision driven turning trajectory planning method is proposed, which can optimize the turning parameters according to the setting error and then optimize the trajectory. The experiments are carried out to verify the proposed theory. The surface roughness and surface accuracy of the features were measured by Talysurf PGI 1240 and KEYENCE vhx900 respectively. The surface roughness and surface accuracy of the cylindrical sine wave groove micro feature surface are 0.1714µm and 1.32µm respectively. The surface roughness and surface accuracy of the cylindrical sinusoidal mesh micro feature surface are 0.1625µm and 1.8µm respectively. The results meet expectations and verify the reliability of the error theory and the trajectory optimization theory.
A Case of Granulomatosis With Polyangiitis With Pulmonary Nodules and Masses
Authors: Wu Qian , Zhang Limin , Yang Qingrui , Sun Hongsheng
Published: April 2021

Background: Granulomatosis with polyangiitis (GPA) is autoimmune-mediated, necrotizing granulomatous vasculitis, primarily involving the upper and lower respiratory tract and kidneys. Pulmonary parenchymal necrosis, vasculitis, and granulomatous inflammation are the main pathological features. Pulmonary imaging visualizes various manifestations, like lung consolidation, ground-glass shadow, speckle shadow, nodules and mass shadows, cavitation, pulmonary interstitial change, pleural effusion, and multiple mediastinal lymph nodes enlargements, and stenosis or occlusion of a lobe or bronchus segment. Case presentation: We report a 53-year-old patient diagnosed with Granulomatous polyangiitis with multiple pulmonary nodules and masses, by ultrasound-guided lung mass puncture biopsy. After treatment with methylprednisolone, Mycophenolate Mofetil, compound sulfamethoxazole and cyclophosphamide, the patient's condition improved and the pulmonary lesions were better than before.Conclusions: In addition to specific infections and tumors, immunological diseases, especially granulomatous polyangiitis, should be considered when treating patients in a clinical setting with multiple pulmonary nodules and weights. Through close multidisciplinary cooperation and communication, the disease will be hopefully received timely diagnosis and early treatment, relieving pain for more patients.
Association between sedentary behaviour inside and outside preschools and executive function in preschoolers
Authors: Bezerra Thayna , Esteban-Cornejo Irene , Goulart Natalia Batista Albuquerque , Mota Jorge Augusto Pinto Silva , Filho Anastácio Neco Souza , Bandeira Paulo Felipe Ribeiro , Martins Clarice Maria
Published: April 2021

Preschool children spend a large part of their day at school, and a large part of that time they spend in sedentary behaviour (SB). Although SB negatively affects regions of the brain responsible for cognition, it is believed that the type of SB performed can favour executive functions' performance. The present study aimed to analyse the association between SB inside and outside preschools and EF tasks in preschool children. Thus, 73 pre-school children (60.3% girls) were evaluated, with a mean age of 55.0 ± 9.1 months. The SB and physical activity (PA) were objectively assessed using accelerometers. The executive function (EF) was assessed using the Go / No Go paradigm by Early Years Toolbox – YET, and for the purposes of analysis, the inverse efficiency of Go and No Go accuracy were considered. Body Mass Index (BMI) was calculated [weight/height² (kg/m2)]. The preschool secretary provided the children's sex and age. To assess possible associations between EF and SB, with sex, age, BMI and PA as covariates, a structural equation model, using multivariate linear regression analysis, was conducted. A significant and positive association between SB in weekend days and IE of Go (b = 0.61; p < 0.001) was observed. The model´s general explaining 51.9% of IE, and 2% of Ac-No Go. Conclusion: the model presented in this study showed that SB on weekend days showed a significant and adverse association with children´s IE, suggesting that excessive SB on these days may be harmful to EF in early child.
Prevalence of Inconsistency and Its Association With Network Structural Characteristics in 201 Published Networks of Interventions
Authors: Veroniki Areti Angeliki , Tsokani Sofia , White Ian R. , Schwarzer Guido , Rücker Gerta , Mavridis Dimitris , Higgins Julian P.T. , Salanti Georgia
Published: April 2021

Background: Network meta-analysis (NMA) has attracted growing interest in evidence-based medicine. Consistency between different sources of evidence is fundamental to the reliability of the NMA results. The purpose of the present study was to estimate the prevalence of inconsistency and describe its association with different NMA characteristics. Methods: We updated our collection of NMAs with articles published up to July 2018. We included networks with randomised clinical trials, at least four treatment nodes, at least one closed loop, a dichotomous primary outcome, and available arm-level data. We assessed consistency using the design-by-treatment interaction (DBT) model. We estimated the prevalence of inconsistency and its association with different network characteristics (e.g., number of studies, treatments, treatment comparisons, loops), and evaluated heterogeneity in NMA and DBT models.Results: We included 201 published NMAs. The p-value of the design-by-treatment interaction (DBT) model was lower than 0.05 in 14% of the networks and lower than 0.10 in 20% of the networks. Networks comparing few interventions in many studies were more likely to have small DBT p-values (less than 0.10), which is probably because they yielded more precise estimates and power to detect differences between designs was higher. In the presence of inconsistency (DBT p-value lower than 0.10), the consistency model displayed higher heterogeneity than the DBT model. Conclusions: Our findings show that inconsistency was more frequent than what would be expected by chance, suggesting that researchers should devote more resources to exploring how to mitigate inconsistency. The results of this study highlight the need to develop strategies to detect inconsistency (because of the relatively high prevalence of inconsistency in published networks), and particularly in cases where the existing tests have low power.
The effects of PI3K/Akt/mTOR Signaling Pathway Inhibitors on Immune Evasion Mechanisms of Acute Myeloid Leukemia Cell Line
Authors: Taghiloo Saeid , Norozi Saeid , Asgarian-Omran Hossein
Published: April 2021

Purpose: One of the most important immune escape mechanisms of AML is the up-regulation of immune checkpoint ligands. Herein, we have investigated the relationship between the inhibition of these pathways and the expression regulation of the immune checkpoint ligands in AML cells. Methods: HL-60 cell line was treated with different inhibitors including idelalisib as PI3K inhibitor, MK-2206 as Akt inhibitor, and everolimus as mTOR inhibitor either in single or combination therapy. Cell viability and apoptosis were evaluated using MTT and flow cytometry assays, respectively. The relative expression of PD-L1, galectin-9, and CD155 was determined by Real-Time PCR. Results: Our findings demonstrated decreasing in proliferation and increasing in apoptosis of HL60 cells after treatment with idelalisib, MK-2206, and everolimus. As expected, combined treatment showed more growth inhibition when compared to single treatment. Interestingly, our results demonstrated that the expression of PD-L1 and Gal-9 but not MK-2206, was decreased after treatment with idelalisib and everolimus. Regarding CD155, the expression of this molecule was downregulated after treatment with everolimus, but not idelalisib and MK-2206. However, combined treatment of HL-60 cells with two or three inhibitors decreased the expression levels of PD-L1, Gal-9 and CD155 checkpoint ligands. Conclusion: We showed that PI3K/Akt/mTOR pathway inhibitors not only serve as cytotoxic drugs, but also regulate the expression of immune checkpoint ligands and interfere with the immune evasion mechanisms of AML leukemic cells. Combinational therapy approaches to block these pathways might be a promising and novel therapeutic strategy for AML patients via interfering in immune escape mechanisms.
Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression
Authors: Zhao Zhen , Chai Songshan , Wang Jiajing , Jiang Xiaobing , Nie Chuansheng , Zhao Hongyang
Published: April 2021

Objective: Vertebrobasilar dolichoectasia (VBD) is one of the uncommon causes of trigeminal neuralgia (TN). The main surgical treatments for TN caused by VBD (VBD-TN) are invasive microvascular decompression (MVD) and mini-invasive Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically reported, so this study evaluated the outcomes of MVD and GKRS for patients with VBD-TN.Methods: The retrospective study of patients diagnosed with VBD-TN in Wuhan Union Hospital was performed from March 2011 to March 2019. A total of 80 patients were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. Among patients in the GKRS group, all performed by two isocenters gamma knife. The imaging data, intraoperative findings, outcomes, and complications of the two groups were analyzed and compared.Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, p=0.03). The average follow-up was 61.1 months for the MVD group and was 56.8 months for the GKRS group. The favorable outcomes (BNI score I-II) occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (P=0.009). The favorable outcomes in the percentage of patients after MVD 1,3,5 and 7 years were 95.7%, 85.1%, 74.2%, and 74.2%. The corresponding percentages after GKRS were 76.5%, 66.2%, 56.6% and 47.2%, respectively (P=0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (P=0.036), but the incidence of new and worsening facial numbness was higher in the GKRS group (P<0.001).Conclusions: For VBD-TN, MVD is superior to GKRS in obtaining and maintaining favorable outcomes, but it also comes with more complications other than facial sensation. Treatment choice can be tailored to a patient’s unique condition and wishes.
The Density of Calretinin Striatal Interneurons Is Decreased in 6-OHDA-Lesioned Mice
Authors: Petryszyn Sarah , Saidi Lydia , Gagnon Dave , Parent André , Parent Martin
Published: April 2021

Interneurons play a significant role in the functional organization of the striatum and some of them display marked plastic changes in dopamine-depleted conditions. Here, we applied immunohistochemistry on brain sections from 6-hydroxydopamine (6-OHDA) mouse model of Parkinson’s disease and sham animals to characterize the regional distribution and the morphological and neurochemical changes of striatal interneurons expressing the calcium binding protein calretinin (CR). Two morphological subtypes of calretinin-immunostained (CR+) interneurons referred respectively as small and medium-sized CR+ interneurons were detected in 6-OHDA and sham-lesioned animals. The small cells (9-12 µm) prevail in the anterior and dorsal striatal regions; they stain intensely for CR and display a single slightly varicose and moderately arborized process. The medium-sized CR+ interneurons (15-20 µm) are slightly more numerous than the small CR+ cells and rather uniformly distributed within the striatum; they stain weakly for CR and display 2-3 long, slightly varicose and poorly branched dendrites. The density of medium CR+ interneurons is significantly decreased in the dopamine-depleted striatum (158 ± 15 neurons/mm3), when compared to sham animals (370 ± 41 neurons/mm3), whereas that of the small-sized CR+ interneurons is unchanged (174 ± 46 neurons/mm3 in 6-OHDA-lesioned striatum and 164 ± 22 neurons/mm3 in sham-lesioned striatum). The nucleus accumbens is populated only by medium-sized CR+ interneurons, which are distributed equally among the core and shell compartments and whose density is unaltered after dopamine denervation. Our results provide the first evidence that the medium-sized striatal interneurons expressing low level of CR are specifically targeted by dopamine denervation, while the small and intensely immunoreactive CR+ cells remain unaffected. These findings suggest that high expression of the calcium binding protein CR might protect striatal interneurons against an increase in intracellular calcium level that is believed to arise from altered glutamate corticostriatal transmission in Parkinson’s disease.
CT Image Analysis Using Grayscale Statistics to Categorise Severity of Lung Abnormalities of COVID-19 Patients
Authors: Ghashghaei Sara , Wood David A. , Sadatshojaei Erfan , Jalilpoor Mansooreh
Published: April 2021

Grayscale image attributes from 456 images extracted from CT scan slices of 53 patients (49 with COVID-19 and 4 without) are used to establish a visual scale of severity of lung abnormalities (five classes: 0 to 4). The complex trends of these easy-to-derive image attributes can be used graphically to discern the visual scale of lung abnormalities in broad terms. With the aid of machine learning algorithms, the visual classes can be distinguished with close to 95% accuracy using combinations of selected grayscale attributes. Confusion matrices reveal that the best-performing machine learning models are able to distinguish more accurately between certain classes than visual inspection of CT images by experts. The adaboost, decision tree and random forest models confused on average less than 25 of the 456 CT-scan image extracts evaluated between the visual classes of lung abnormalities.
The 5-Factor Modified Frailty Index Predicts Complications and Worsening After Meningioma Surgery in Non-elderly Rather Than Elderly Patients: A Nationwide Registry Study
Authors: Ikawa Fusao , Michihata Nobuaki , Oya Soichi , Hidaka Toshikazu , Matsuda Shingo , Ozono Iori , Ohata Kenji , Saito Kiyoshi , Yoshida Kazunari , Fushimi Kiyohide , Yasunaga Hideo , Tominaga Teiji , Kurisu Kaoru
Published: April 2021

The simplified 5-factor modified frailty index (mFI-5) is a useful indicator of outcome for patients undergoing surgeries and considered as an important risk factor in elderly patients. However, its usefulness has not been validated based on age groups. We aimed to investigate the risk factors including the mFI-5 across age groups for complications and worse outcomes in meningioma surgery using data obtained from the nationwide database in Japan. We extracted data from the nationwide registry database in Japan between 2010 and 2015. Age (< 65, 65–74, and ≥ 75 years), sex, Barthel Index (BI), mFI-5 scores, and complications were evaluated. Multivariate logistic regression analyses identified risk factors across all age groups for worsening BI scores and complications after surgery. In 8,138 included cases, an mFI-5 score ≥ 2 items was a significant risk factor for worsening BI scores in patients aged < 65 years (odds ratio: 2.00; 95% confidence interval: 1.31-3.06), but not in patients aged 65-74 years and those aged ≥ 75 years. Similar results were noted for complications in patients aged < 65 years (2.40; 1.67–3.44), but not in patients aged 65-74 years and those aged ≥ 75 years. In conclusion, the mFI-5 scores can predict the risk of worsening outcome and complications in non-elderly patients aged < 65 years rather than in elderly patients aged ≥ 65 years. In meningioma surgeries, care must be taken when making decisions using the mFI-5 scores based on the patients’ age.Trial RegistrationName: Study on treatment method, age group, complications, and outcome of meningiomas and hemangioblastomas using DPC, URL: http://www.umin.ac.jp/ctr/index-j.htmID: UMIN000038486, No.: R000043856
Growth and physio-biochemical responses of Azolla filiculoides subjected to short span of phenol exposure
Authors: Paul Bittu , Sarkar Ashis , Roy Swarnendu
Published: April 2021

Phenol and phenolic compounds are one of the major water pollutants increasing at an alarming rate due to uncontrolled anthropogenic activities. Aquatic plants are in the frontline to face the toxic effects of these pollutants. The present study attempts to study the effect of external phenols on a floating fern - Azolla filiculoides. In this context, the effect of four concentrations of crystalline phenol (0.5, 1, 2 and 3 mM) along with a control set (0 mM) were used to evaluate the changes in the responses of A. filiculoides plants in terms of the major morphological, physiological and biochemical markers, after being exposed for 3 and 6 days. In this study, relative growth rate, relative frond number, relative frond surface area, relative water content, chlorophyll a and carotenoids decreased significantly both with increasing phenol concentration and also with the duration of treatment. Frond necrotic area, electrolyte leakage and malondialdehyde content increased significantly which demonstrated the negative effects of phenol. However, increase in proline content, total sugars, activities of antioxidative enzymes like superoxide dismutase, catalase and peroxidase indicated the presence of an inherent tolerance mechanism in this plant. Accumulation of H2O2 also supported by the in situ localization of H2O2 along with the changes in growth parameters and physio-biochemical indicators demonstrated that the extent of phenol toxicity increased with the increasing concentrations of phenol. The overall findings also suggest that the A. filiculoides plants can maintain their growth and physiology up to a concentration of 1 mM phenol.
An Exploration of Changes in Plantar Pressure Distributions During Walking With Standalone and Supported Lateral Wedge Insole Designs 
Authors: Tse Calvin , Ryan Michael , Dien Jason , Scott Alex , Hunt Michael
Published: April 2021

Background: Lateral wedge insoles (LWI), standalone or with medial arch support (supported-LWI), have been thoroughly investigated for their effects on modifying gait biomechanics for people with knee osteoarthritis. However, plantar pressure distribution between these insole types has not been investigated and could provide insight towards insole prescription with concomitant foot symptoms taken into consideration.Methods: In a sample of healthy individuals (n = 40), in-shoe plantar pressure was measured during walking with LWI, with or without medial arch support (variable- and uniform-stiffness designs), and a flat control insole condition. Pressure data from the plantar surface of the foot was divided into seven regions: medial/lateral rearfoot, midfoot, medial/central/lateral forefoot, hallux. Plantar pressure outcomes assessed were the medial-lateral pressure index (MLPI) for the whole foot, and the peak pressure, pressure-time integral (PTI), and contact area in each plantar region. Comfort in each insole condition was rated as a change relative to the flat control insole condition. Repeated-measures analyses of variance were calculated to compare the plantar pressure outcomes between insole conditions. Results: Regionally, medial rearfoot and forefoot pressure were reduced by all wedged insoles, with the variable-stiffness supported-wedge showing greater reductions than the standalone wedge. Lateral rearfoot and forefoot pressure were reduced by both supported-LWI, but unchanged by the standalone wedge. In the midfoot, the standalone wedge maintained pressure but reduced regional contact area, while both supported-LWI increased midfoot pressure and contact area. All LWI increased the MLPI, indicating a lateral shift in plantar pressure distribution throughout the weightbearing phase of gait. Comfort ratings were not significantly different between insole conditions. ﻿Conclusions: Regional differences in plantar pressure may help determine an appropriate lateral wedge insole variation to avoid exacerbation of concomitant foot symptoms by minimizing pressure in symptomatic regions. Lateral shifts in plantar pressure distribution were observed in all laterally wedged conditions, including one supported-LWI that was previously shown to be biomechanically ineffective for modifying knee joint load distribution. Thus, shifts in foot centre of pressure may not be a primary mechanism by which LWI can modify knee joint load distribution for people with knee osteoarthritis.
Clinical and molecular epidemic characterization of rotavirus infection among children under five years old in Shandong province, China.
Authors: Dong Shixiao , Huang Deyu , Wang Zheng , Zhang Guanyou , Zhang Fengjuan , Sai Lintao
Published: April 2021

Rotavirus was the an important causative agent of acute gastroenteritis in children. In China, rotavirus was positive in approximately 30% of the diarrhea children and become a serious public problem. This study was carried out to investigate the clinical and molecular epidemic characterization of rotavirus infection among children under 5 years old with acute diarrhea in Shandong province, China. From July 2017 to June 2018, a total of 1211 fecal specimens were detected and the prevalence of rotavirus infection was 32.12%. The mean age of positive children was 12.2 ± 10.9 months and the highest infection rate was observed in children aged 7–12 months with a rate of 41.64%. G9P[8] (76.61%) was the most prevalent combinations followed by G2P[4] (7.20%), G3P[8] (3.60%) and G9P[4] (2.06%). In addition to diarrhea, vomiting, fever and dehydration were the most common accompanied symptoms. In general, there was no significant difference in clinical manifestations among different age groups. However, the clinical manifestations between vaccinated and unvaccinated children were significantly different. Vaccinated children showed lower incidence and frequency of vomiting, lower incidence and degree of dehydration, lower incidence of severe cases than unvaccinated children. The findings suggested necessary to continue rotavirus strains surveillance in order to monitor the change of prevalent genotype. Moreover, introducing vaccine into national immunization program to prevent and control rotavirus infections is needed in China.
The Immunolocalization of Cadherins and Beta-Catenin in the Cervix and Vagina of Cycling Cows
Authors: Liman Narin , Sağsöz Hakan
Published: April 2021

The adherens junction (AJ) maintains the structural integrity and barrier function of the epithelial cell layers. AJs also play a key role in a variety of biological and pathological processes, from morphogenesis to tumor progression. AJs perform these functions through the cadherin-catenin adhesion complex. In this study, we investigated the presence, cell-specific localization, and temporal distribution of AJ components such as cadherins and beta-catenin in the cow cervix and vagina during the oestrous cycle using immunohistochemistry. The cow genitalia (n = 30) were collected from an abattoir and the cervix and vagina were categorized into the follicular and luteal groups based on cyclicity. Results demonstrated constitutive expression of beta-catenin and placental (P)- and epithelial (E)-cadherins, but not neural (N)-cadherin, in ciliated and non-ciliated columnar cervical cells, the luminal, parabasal, intermediate, and basal layers of the stratified vaginal epithelium of the bovine cervix and vagina throughout the oestrous cycle. The honeycomb-like membrane staining pattern for selected junctional molecules was observed in the epithelial cells. While there were no noticeable variations in the immunostaining intensity of P- and E-cadherin and beta-catenin proteins in the cervical and vaginal epithelium between the oestrous phases, the immunolocalization patterns altered by structural changes that occurred in response to oestrogen and progesterone hormone levels during the oestrous cycle. These results may indicate that P- and E-cadherin and beta-catenin participate in maintaining the integrity and barrier function of the cervical and vaginal epithelium throughout the oestrous cycle, thus helping to maintain the sterility of the uterine cavity.
Title: Initial results of reoperative bariatric surgery: a retrospective feasibility and safety study at a low-volume unit
Authors: Wu Sheng Mao , Lo Hung Chieh
Published: April 2021

Background This study assessed the feasibility and results of revisional bariatric surgery at a low-volume unit.Methods This retrospective study was conducted from January 2017 to August 2020; the revision group comprised patients treated for weight regain (WR, n = 6), insufficient weight loss (IWL, n =3), and various complications (n=6). Clinical characteristics and 30-day outcomes were assessed and compared with those of primary bariatric procedures (control, n=173). Results A total of 8.0% (15/188) of patients underwent revisional procedures and tended to be elderly (40.1 vs. 38.2 years), be female (73.3% vs. 54.9%), and have a significantly lower body mass index (33.1 vs. 39.9 kg/m2) and fewer comorbidities than controls. Gastric bypass was the most prevalent revisional procedure. A significantly longer operative duration (155 and 96 min; p < 0.001), longer length of stay (3.7 and 2.4 days) and higher 30-day complication rate (20.0% vs. 4.6%) were found in the revision group, including one case of leakage and another of jejunojejunostomy obstruction. There were no cases of conversion to open surgery or mortality. A total of 5/6 WR patients achieved excessive weight loss >50%, versus only one IWL patient who reached this goal. Complications, including marginal ulcer, fistula and post-sleeve gastrectomy stenosis, were alleviated after revision.Conclusion Revisional surgery appears to be feasible and effective in a low-volume practice in patients with WR and complications after primary bariatric procedures; however, the benefits should be weighed against the risks. More robust evidence is required to support ongoing practice.
Comparison of Hidden Blood Loss Between Cortical Bone Trajectory Screw Fixation and Traditional Pedicle Screw Fixation
Authors: Hu Xinli , Wu Chenyu , Xu Cong , Zhou Kailiang , Li Xiaobin , Jin Chenqiang , Chen Yanlin , Zhang Haojie , Su Haohan , Ni Wenfei
Published: April 2021

Objective: This research aimed at examining the volume of hidden blood loss (HBL) in lumbar fusion surgery with two kinds of screw implanting techniques and evaluating HBL-related factors in the patient population receiving lumbar fusion surgeryMethods: A retrospective study was conducted targeting 104 patients with lumbar degenerative diseases and treated with TLIF from January 2017 to December 2018, and the CBT (cortical bone trajectory) technique and conventional PS (pedicle screw) technique were applied to 45 and 59 patients, respectively. The collected data covered patients’ weight, height, BMI index, and operation time. It was followed by the recording of preoperative and postoperative hematocrit (HCT) of patients, based on which the blood loss was calculated by Gross’s formula. Results: The CBT and PS groups presented no significant difference in demographic characteristics (p > 0. 05), but the average HBL of 280±227 mL and 298±232 mL as well as the average TBL of 603±232 mL and 728±321 mL, respectively. It indicated the difference of the two groups in TBL, but no significant difference in HBL. In addition, an association of HBL of two screw techniques with operation time, concomitant disease and age was found from the data analysis.Conclusion: Large total blood loss incurred in lumbar fusion surgery, specifically with a lower value by the CBT technique than by the PS technique. Nonetheless, HBL occupied a large part of the total blood loss and it was identified in both groups. Thus, a good understanding of HBL will improve postoperative rehabilitation and guarantee patients’ safety.
Catastrophic Failure and Metallosis of the Acetabular Component in Total Hip Arthroplasty
Authors: OZAN FIRAT , Kahraman Murat , Baktır Ali , Gençer Kürşat
Published: April 2021

Background: To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis. Methods: Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification. Results: The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised. Conclusions: Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.
Peritoneal inclusion cyst in a patient with glycogen storage disease type Ib and Crohn’s like disease
Authors: Grünert Sarah Catharina , Teufel-Schäfer Ulrike , Berg Sebastian , Schumann Anke , Grimm Juliane , Rosenbaum-Fabian Stefanie , Spiekerkoetter Ute
Published: April 2021

Background

Glycogen storage disease type Ib (GSD Ib) due to biallelic mutations in SLC37A4 is often associated with inflammatory bowel disease. Peritoneal inclusion cysts (PICs) are variable sized, fluid-filled, mesothelial-lined cysts that usually occur in premenopausal woman. Risk factors for the development of PICS comprise prior abdominal surgeries and inflammatory diseases.
Results

We herein report on a female patient with GSD Ib and Crohn’s like disease who underwent recurrent abdominal surgery due to suspected intraabdominal abscesses. At the age of 36, abdominal pain and an increase in the abdominal girth was observed. MRI revealed a large PIC. Due to multiple previous complications conservative management was chosen, and the cyst remained stable in size during a 1-year follow-up.
Conclusions

PIC should be included in the differential diagnosis of abdominal cystic masses especially in premenopausal women with either IBD or previous abdominal surgery. Radiologist, gynecologist, and gastroenterologist should be aware of this rare condition to prevent inappropriate and aggressive treatments.
Early Treatment with Integrase Inhibitor Achieves a Functional Cure for Pediatric SIV Infection
Authors: Wang Xiaolei , Vincent Eunice , Shao Jiasheng , Lu Hong , Siddiqui Summer , Blair Robert , Wu Xueling , Doyle-Meyers Lara A , Russell-Lodrigue Kasi E. , Ziani Widade , Bohm Rudolf P. , Veazey Ronald S. , Xu Huanbin
Published: April 2021

Neonatal HIV infection causes rapid disease progression to end-stage of AIDS if untreated. To date, there are no reported cases of a genuine functional cure in Pediatric AIDS ClinicalTrial Group lacking integrase inhibitor regimen, even when initiated early. In this study, three infant rhesus macaques born on the same day were intravenously infected with SIV on the day of birth and received ART containing tenofovir, FTC, and dolutegravir (DTG) initiated 3 days post infection and continued daily for 9 months. The results showed early ART combination effectively suppressed viral replication to undetectable viremia throughout the treatment course. Remarkably, two of three infants showed complete virologic remission and intestinal CD4+ T cell preservation throughout the period of studyafter analytical treatment interruption (ATI), as well as undetectable cell-associated proviral DNA in PBMCs, axillary lymph nodes (LNs), and rectal biopsies. However, viral rebound was observed in one of the three infants at two months post ATI. Notably, very low levels of integrated proviral SIV DNA were detected in the lymph node of this animal under cART. Sustained virologic remission was achieved in the other two infants despite absence of protective MHC alleles or neutralizing antibody responses. These findings suggest that early integrase inhibitor-based ART, initiated before irreversible proviral reservoir seeding, can completely suppress viral replication and effectively block new viral genome integration, providing a proof of concept that HIV functional cure and possibly a cure is possible, at least in a proportion of infants postnatally infected with HIV.
Design of SiN waveguides integrated with graphene oxide films for nonlinear optics
Authors: Qu Yang , Wu Jiayang , Zhang Yuning , Jia Linnan , Liang Yao , Jia Baohua , Moss David
Published: April 2021

We theoretically investigate and optimize four-wave mixing (FWM) in silicon nitride (SiN) waveguides integrated with two-dimensional (2D) layered graphene oxide (GO) films. Based on extensive previous measurements of the material parameters of the GO films, we perform detailed analysis for the influence of device parameters including waveguide geometry, GO film thickness, length, and coating position on the FWM conversion efficiency (CE) and conversion bandwidth (CB). The influence of dispersion and photo-thermal changes in the GO films is also discussed. Owing to the strong mode overlap between the SiN waveguides and the highly nonlinear GO films, FWM in the hybrid waveguides can be significantly enhanced. We obtain good agreement with previous experimental results and show that by optimizing the device parameters to balance the trade-off between Kerr nonlinearity and loss, the FWM CE can be improved by as much as ~20.7 dB and the FWM CB can be increased by ~4.4 folds, relative to the uncoated waveguides. These results highlight the significantly enhanced FWM performance that can be achieved in SiN waveguides by integrating 2D layered GO films.
Clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems
Authors: Moghaddam M. , Naghi A.A.
Published: April 2021

This article reviews information on the clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems. Antibodies to many of the antigens in these groups are rarely encountered because of the high prevalence of the associated antigens in most populations. For many of these antibodies, the clinical significance—that is, the potential to cause reduced survival of transfused antigen-positive red blood cells or a transfusion reaction (e.g., anti-P, anti-Jra, and anti-Lan), and/or hemolytic disease of the fetus and newborn (e.g., anti-RHAG4 and anti-Vel)—has been documented. For other antibodies, their prevalence is so rare that information on the clinical significance of their antibodies is not available (e.g., anti-FORS1).
Immunohematology

2018;34:85–90.
Virulence of Steinernema ceratophorum against different pest insects and their potential for in vivo and in vitro culture
Authors: Yan Xun , Chen Guimei , Chen Yuqing , Sun Bingjiao , Gu Xinghui , Ruan Weibing , Han Richou
Published: April 2021

Entomopathogenic nematodes (EPN) are biological control agents used to control different insect pests. Indigenous EPN resources are important for the successful control of endemic pests. A native EPN isolate collected in Yunnan, China that showed high virulence against Spodoptera litura was identified and studied for virulence and production potential. The EPN isolate was identified as Steinernema ceratophorum and showed high virulence against different larval stages of Spodoptera exigua, Ostrinia nubilalis, Helicoverpa armigera, and the 2nd instar larvae of Spodoptera frugiperda when applied at 50 IJ/larva under in vitro conditions. In vivo culture of the S. ceratophorum isolate showed that Galleria mellonella larvae were the most suitable host compared to Tenebrio molitor and S. litura. The highest yield in in vivo culture was 1.15 × 105 IJ/larva when cultured in G. mellonella with inoculum concentration of 50 IJ/larva at 25°C. For in vitro solid culture, the highest yield for S. ceratophorum was 2.09 × 106 IJ/g when cultured at optimal temperature of 25°C. Nematodes from the in vivo and in vitro culture, both retained their virulence against the G. mellonella larvae. The S. ceratophorum showed high potential to be mass produced, which will enable the commercial use of this EPN isolate. This is the first attempt to mass culture the S. ceratophorum species. The study explores the usage of S. ceratophorum and provides basis for the commercialization of the EPN species.
HABITAT PERKOTAAN DI KOTA KUPANG
Authors: Liem Yoseph , Mahagarmitha Rilia Rigina
Published: April 2021

Title: Urban Habitat in Kupang City

The issue of urban space clash in Indonesia is not only in the level of space occupation but also in the loss of habitat-driving force in the city. It is also happening in the city of Kupang as capital of East Nusa Tenggara Province, and also as the border region with the state of Timor Leste. The city of Kupang developing at this time, continues to carry out the growth to the coastal areas . It is in fact contradictory to the regulations that have been made before. The area in this case study of the research is Pasir Panjang Beach - Kelapa Lima, where it is locate in previously a habitat for fishermen colonies in the coastal area of Kupang City. Next to this location is a public space. This study aims to determine the conflict of interest in the space utilization in the city of Kupang. The descriptive research methods will be used, through literature studies, Kupang City government documents, observations, and interviews with local communities. Based on the results of the analysis, there are deviations in the function of urban space, which initially is a public space, then turned into a commercial area. Thus, in this study, it can be concluded that urban space can be assessed in terms of its function and role within the city in reallity can be influenced through the process of adaptation, negotiation, and power play. Changes in function of the urban space can cause various kinds of urban problems, including social issues, the environment, and unbalanced city growth.
PENDEKATAN NARRATIVE DALAM PERANCANGAN KONEKTIVITAS RUANG SEMPADAN DI JALAN TAMAN KEMANG
Authors: Pantan Robert Christopher , Dewi Julia , Yanuar Andreas
Published: April 2021

Title: Narrative Approach in the Design of Integrated Space Connectivity in Taman Kemang

As a commercial area the Taman Kemang street has certain activities based on its functions such as parking ,working, selling (street vendors), eating and relaxing, people who just walk to Lippo Mall Kemang and activities from online transportation to deliver and pick up. However, as a commercial area, the Taman Kemang street does not have the balance of the daily activities as the city space. This is because different activities are defined by time from morning to night and weekdays and weekends. This is because the bordering space that are formed are utilized as parking lots and selling places of the street vendors which it should be utilized more as public spaces. Therefore, in this research, the author uses a narrative approach as an analysis process towards the design stage through the stages of the story - narrative - narration as a problem-solving solution. The process of analysis is based on activities on the Taman Kemang street through the motives of community activities that form events in a certain time. So that in the narrative stage a story concept is formed which is how to revive the bordering space of the daily narrative formed on the Taman Kemang street. Then supported by strategies at the stage of narration through 5 narrative landscape strategies and forming quality space, namely the formation of activity identity, space identity and continuity of the results of the integration of bordering space elements.
EFEKTIVITAS KOMUNIKASI PROSES PEMBELAJARAN JARAK JAUH (DARING)
Authors: Widyaningsih Eka
Published: April 2021

Title: Communication Efficacy During Distance Learning Process (Online)
The Coronavirus pandemic has been forcing us to avoid physical contact in the working field and educational institutions. We have to deal with many ostacles in this new learning and working environment, both technical and non-technical. Unstable internet connectivity and the financial challenge to provide online access for students at home are among the fundamental problems caused by this distance learning process. As a consequence of this study, material delivery and student’s comprehension are at risk. Based on these facts, lecturers and institutions must have proper/ better  planning strategies to increase learning outcomes in an academic program as a whole and each course for more aimed results. In an architecture department, studio courses are essential. One strategy example of dealing with today’s situation is a collaboration among 2-3 studio courses on the same level to enhance mutual achievement, creating better synergy between methods. This learning strategy’s objective is to make the learning process delivery more efficient and comprehensible to students.
KOMUNIKASI BARU BIRO ARSITEK DI MASA PANDEMI DALAM PANDANGAN POSTKOLONIALISME HOMI K BHABHA
Authors: Utomo Gayuh Budi , Damayanti Rully , Agustin Dyan
Published: April 2021

Title: New Communication of The Architecture Firms in Pandemic Era; Following the Homi  K Bhabha Post Colonial View
A new order called the new normal is a central issue at this time. The period before the pandemic which became a standard value and became a reference suddenly was not compatible with the arrival of the Covid-19 pandemic outbreak. This is happening in Indonesia and around the world. Everyone is in a pandemic situation for a certain period time and there is no certainty that it will end. This of course also affects how to communicate in all aspects including the architectural bureau. New ways of communicating are carried out at architectural bureaus related to social distancing and physical distancing which are considered as effective prevention methods from the COVID-19 pandemic. The types of communication that have changed are communication with clients, communication with the team and communication with interns. There are significant differences in how to communicate from offline activities to online activities where we can still be connected both ways but not in the same place. This situation is a momentum to free the bonds of limitations that have occurred in terms of communication. We want to interpret this in the postcolonialism approach of Homi K Bhabha which is very relevant to the views of hybridity, ambivalence and the third space as a way of communicating new normal discourses.