bluuebunny/crossref_metadata_2025 huggingface dataset:
Group-based music intervention in Parkinson’s disease – findings from a mixed-methods study
Authors: Pohl Petra , Wressle Ewa , Lundin Fredrik , Enthoven Paul , Dizdar Nil
Published: February 2020

Objective:

To evaluate a group-based music intervention in patients with Parkinson’s disease.

Design:

Parallel group randomized controlled trial with qualitative triangulation.

Setting:

Neurorehabilitation in primary care.

Subjects:

Forty-six patients with Parkinson’s disease were randomized into intervention group ( n = 26), which received training with the music-based intervention, and control group ( n = 20) without training.

Interventions:

The intervention was delivered twice weekly for 12 weeks.

Main measures:

Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists.

Results:

No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success.

Conclusion:

Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinson’s disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.
Resilience and lifestyle-related factors as predictors for health-related quality of life among early adolescents: a cross-sectional study
Authors: Bottolfs Marthe , Støa Eva Maria , Reinboth Michael Sæther , Svendsen Martin Veel , Schmidt Sabrina Krogh , Oellingrath Inger Margaret , Bratland-Sanda Solfrid
Published: February 2020

Objective

To examine whether lifestyle-related factors and resilience predict health-related quality of life (HRQoL) in a sample of early adolescents.

Methods

A total of 611 eighth grade pupils (response rate: 79%) participated in this cross-sectional study. The variables measured were physical activity (accelerometer), cardiorespiratory fitness (Andersen test) and a questionnaire assessing dietary habits, sleep disturbance, resilience (Resilience Scale for Adolescents) and HRQoL (KIDSCREEN-27).

Results

A total of 36% of the sample met the official recommendations of 60 minutes of daily physical activity. Univariate analysis identified physical activity, dietary habits, sleep disturbances, body mass index (BMI), cardiorespiratory fitness and resilience, but not sedentary time, as predictors of HRQoL. Multivariate regression analysis identified resilience as a positive predictor (β 0.18 to 0.27) of all HRQoL domains and sleep disturbance as a negative predictor (β −0.65 to −0.24) of four HRQoL domains. BMI (β = −0.27) and cardiorespiratory fitness (β = 0.021) were predictors of the HRQoL domain physical well-being. Adherence to dietary recommendations was both a positive and a negative predictor of HRQoL (β −0.45 to 0.59).

Conclusion

Resilience and sleep disturbances were the main predictors of HRQoL.
Association between thyroid hormone parameters during early pregnancy and gestational hypertension: a prospective cohort study
Authors: Lai Hua , Zhan Zheng-Yu , Liu Huai
Published: February 2020

Objective

Thyroid dysfunction may play a role in the development of gestational hypertension. However, this relationship remains unclear. This study was performed to evaluate the association between thyroid hormone parameters during early pregnancy and gestational hypertension.

Methods

Women with singleton pregnancies were recruited into this prospective cohort study at 9 to 13 gestational weeks, and their serum thyroid-stimulating hormone, free thyroxine, and free triiodothyronine concentrations were measured using electrochemiluminescence immunoassays. In total, 1226 participants were included in the final analysis.

Results

Of the 1226 participants, 81 subsequently developed gestational hypertension (overall incidence of 6.6%). Compared with women with euthyroidism, both pregnant women with hypothyroidism and those with subclinical hypothyroidism had an increased risk of gestational hypertension (adjusted odds ratio [OR], 3.61; 95% confidence interval [CI], 1.52–8.57 and OR, 2.24; 95% CI, 1.06–4.72, respectively). When the thyroid-stimulating hormone and free thyroxine concentrations were analyzed by quintiles, the women in the highest thyroid-stimulating hormone quintile had a higher risk of gestational hypertension (adjusted OR, 4.22; 95% CI, 1.78–9.05) than the women in the middle quintile.

Conclusion

Our results suggest that hypothyroidism, subclinical hypothyroidism, and a high thyroid-stimulating hormone concentration during early pregnancy are risk factors for gestational hypertension.
Artificial neural network–based sensorless control of wind energy conversion system driving a permanent magnet synchronous generator
Authors: Elbeji Omessaad , Hannachi Marwa , Benhamed Mouna , Sbita Lassaad
Published: February 2020

Due to the wind characteristic, wind speed measure requires more than one sensor. However, to track the maximum power point of the wind, knowing the wind speed or mechanical speed is necessary. So, the solution is to use a sensorless control. This article is mainly focused on a sensorless control of a wind energy conversion system that employs an artificial neural network observer. The detailed mathematical model of the studied system is presented. It includes a permanent magnet synchronous generator. The contribution of the studied wind energy conversion system is to integrate a three-cell DC–DC converter. For the generation of maximum power from the wind, an algorithm to track the maximum power is developed. Then, to avoid the disadvantages of using sensors, an artificial neural network observer is implemented. The capabilities and contributions of the proposed control scheme are demonstrated by simulation results using MATLAB/Simulink.
Outcomes of Multidetector Computed Tomography Pulmonary Angiography in Pregnant and Postpartum Women With Suspected Pulmonary Embolism
Authors: Sun Simon , Diaconescu Marius , Zhe Tian , Mesurolle Benoit , Semionov Alexandre
Published: February 2020

Purpose:

Verify whether there is a difference in likelihood of developing pulmonary embolism (PE) between pregnant women, nonpregnant women of reproductive age, and postpartum (up to 6 weeks) women, by comparing their outcomes on computed tomography pulmonary angiography (CTPA) done for suspicion of PE.

Materials and Methods:

Retrospective cohort study of 1463 CTPA done for suspicion of PE in females of reproductive age (18-40 years), nonpregnant, pregnant (antepartum), and postpartum, from 2 tertiary-care academic hospitals between October 2006 and September 2015. Primary outcome was diagnosis of PE on imaging. Additional assessment was made of technical adequacy of the studies and method of delivery for the postpartum cohort (vaginal vs caesarean birth). Twenty-nine technically nondiagnostic studies were excluded. The effect of any potential variable on PE status was tested using univariate logistic regression. Subgroup analysis was performed after excluding patients with independent risk factors for PE.

Results:

The rate of CTPA positive for PE was less among pregnant patients compared to early postpartum and nonpregnant women of similar age, 2.9% vs 11.5% and 10.3%, respectively. Pregnancy was associated with statistically significant decreased odds ratio of developing a PE on CTPA, 0.23 (0.09-0.89), P value = .004. After excluding patients with additional independent risk factors for PE, there was no statistically significant odds ratio association between presence of PE on CTPA and pregnancy 0.41 (0.13-1.34), P value = .14.

Conclusion:

Rate of CTPA positive for PE in pregnant women was lower than in nonpregnant and early postpartum women. Pregnancy was statistically significantly less likely to be associated with positive PE on a CTPA study. The common perception that pregnancy (antepartum state) is associated with an increased risk of PE may require a thorough critical reappraisal.
Carbon Geoengineering and the Metabolic Rift: Solution or Social Reproduction?
Authors: Stuart Diana , Gunderson Ryan , Petersen Brian
Published: February 2020

Using the concepts of metabolism and metabolic rift as a framework, this paper examines carbon geoengineering technologies as a solution to climate change and explores if it is possible to mend an ecological metabolic rift without fundamental changes in the social metabolic order. Carbon geoengineering technologies have become a key component of scenarios to limit the extent of global warming and are being discussed as a means to sequester carbon and, therefore, mend the carbon cycle. However, most applications of carbon geoengineering thus far do not result in net negative emissions. Strategies to make operations profitable result in neutral or positive, rather than negative, emissions. While these strategies have the potential to reduce greenhouse gas concentrations, the current social order constrains their use and effectiveness. Instead of being applied as part of the solution to climate change, carbon geoengineering is being strategically promoted by the fossil fuel industry in ways that serve to reproduce and maintain the current social order.
The intimate workings of culture: An introduction
Authors: Berk Christopher D , Friedman Joshua B
Published: February 2020

This Cultural Dynamics Special Issue on “The Intimate Workings of Culture” examines the complex ways power, audience, and imagination are implicated in the social practices and politics of cultural intimacy. First theorized by Michael Herzfeld in 1997, cultural intimacy has proven to be a productive lens through which to explore the dialectic between the construction and contestation of collective identities. The contributors—Joshua Friedman, Jamie Shenton, Christopher Berk, and Tamar Shirinian—expand the concept’s geographical and contextual scope by applying it to Indigenous Australia, post-soviet states, American ethnic identity politics, and social media. The contributors’ shared emphasis on the emergent and indeterminate interrelationships between audience, imagination, power, and politics within the intimate workings of culture provides valuable templates for new arenas of analysis and inquiry.
Experimental design and sample size considerations in longitudinal magnetic resonance imaging-based biomarker detection for multiple sclerosis
Authors: Hu Menghan , Schindler Matthew K , Dewey Blake E , Reich Daniel S , Shinohara Russell T , Eloyan Ani
Published: February 2020

Several modeling approaches have been developed to quantify differences in multiple sclerosis lesion evolution on magnetic resonance imaging to identify the effect of treatment on disease progression. These studies have limited clinical applicability due to onerous scan frequency and lengthy study duration. Efficient methods are needed to reduce the required sample size, study duration, and sampling frequency in longitudinal magnetic resonance imaging studies. We develop a data-driven approach to identify parameters of study design for evaluation of longitudinal magnetic resonance imaging biomarkers of multiple sclerosis lesion evolution. Our design strategies are considerably shorter than those described in previous studies, thus having the potential to lower costs of clinical trials. From a dataset of 36 multiple sclerosis patients with at least six monthly magnetic resonance imagings, we extracted new lesions and performed principal component analysis to estimate a biomarker that recapitulated lesion recovery. We tested the effect of multiple sclerosis disease modifying therapy on the lesion evolution index in three experimental designs and calculated sample sizes needed to appropriately power studies. Our proposed methods can be used to calculate required sample size and scan frequency in observational studies of multiple sclerosis disease progression as well as in designing clinical trials to find effects of treatment on multiple sclerosis lesion evolution.
Tetanus in animals
Authors: Popoff Michel R.
Published: February 2020

Tetanus is a neurologic disease of humans and animals characterized by spastic paralysis. Tetanus is caused by tetanus toxin (TeNT) produced by Clostridium tetani, an environmental soilborne, gram-positive, sporulating bacterium. The disease most often results from wound contamination by soil containing C. tetani spores. Horses, sheep, and humans are highly sensitive to TeNT, whereas cattle, dogs, and cats are more resistant. The diagnosis of tetanus is mainly based on the characteristic clinical signs. Identification of C. tetani at the wound site is often difficult.
Steatohepatitis due to FOLFIRINOX regimen in adjuvant pancreas cancer treatment mimicking liver metastasis
Authors: Bozkurt Duman Berna , Çil Timuçin
Published: February 2020

Introduction

The combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) is more toxic than gemcitabine, but it is a safe regimen with manageable toxicities.

Case report

We report a case with steatohepatitis mimicking liver metastasis as toxicity that was not seen in study patient population. Management and outcome: In the adjuvant statement with FOLFIRINOX due to biopsy, we give the same regimen by excluding metastasis.

Discussion

The adverse events of drugs are important predictive factor for treatment management, as important as efficacy. Especially the new lesion and metastasis is the most important factor for changing treatment. The clinicians must be careful about adverse events of regimens.

Conclusion

FOLFIRINOX regimen is the most important combination in pancreas cancer adjuvant setting. This case shows us the different presentation of usual adverse event.
The properties and breadmaking potential of freshly baked and frozen bakery products during partial replacement of wheat flour with spelt flour
Authors: Frakolaki Georgia , Giannou Virginia , Tzia Constantina
Published: February 2020

The aim of this work was the evaluation of the breadmaking potential of spelt flour when combined with wheat flour in various proportions, both in freshly baked and frozen form, and determine the optimal ratio for products with satisfactory quality characteristics. Freshly baked samples were prepared using different spelt–wheat flour mixtures ranging from 0 to 100% spelt at 10% intervals, while batches containing 0, 30, 50, 80, and 100% spelt were prepared in the case of frozen dough samples. The characteristics of the final baked products (dough volume expansion, specific volume, crust and crumb color, hardness, and water activity) were evaluated. Results showed that spelt flour proportions up to 20% provide bread with quality and sensory characteristics similar to wheat, while proportions higher than 70% lead to products with inferior properties. Therefore, samples with spelt content between 30 and 60%, although slightly degraded, remained highly acceptable.
Impact of body posture change on peripherally inserted central catheter tip position in Chinese cancer patients
Authors: Liu Chunli , Jiang Dingbiao , Jin Tao , Chen Chuanyin , Shi Ruchun , Liu Lagen , Mao Jing , Gu Lili , Xu Liyong , Meng Aifeng
Published: February 2020

Purpose:

To evaluate the influence of body posture change on the peripherally inserted central catheter tip position in Chinese cancer patients.

Methods:

A prospective observational trial was conducted in a tertiary cancer hospital from August to September 2018. After the insertion of peripherally inserted central catheter, chest X-ray films were taken to check the catheter tip in the upright and supine positions, respectively. The distance from the carina to the catheter tip was separately measured on both chest films by nurses. The primary study outcome was the distance and direction of the catheter tip movement. The secondary study outcome was to analyze the influence factors on the catheter tip movement. The third study outcome was to observe the related adverse events caused by the catheter tip movement.

Results:

A total of 79 patients were included, the results showed that 61 moved cephalad, 14 moved caudally, and 4 did not move with body change from the supine to the upright position. When moved cephalad, the mean distance was 19.34 ± 11.95 mm; when moved caudally, the mean distance was –15.83 ± 8.97 mm. The difference between the two positions was statistically significant ( p < 0.001). There was also a statistically significant difference between catheter tip movement direction and body mass index ( p = 0.009) and height ( p = 0.015). Two patients developed arrhythmias; no cardiac tamponade was found due to body posture change.

Conclusion:

The results of this work implied that the tips of the catheter tend to shift toward the cephalad with body change from the supine to the upright position. A study involving a larger sample size is needed to find more information in the future.
Optimizing Communication About Topical Corticosteroids: A Quality Improvement Study
Authors: Johnson Girard Valérie , Hill Ashley , Glaser Emma , Lussier Marie-Thérèse
Published: February 2020

Background

Patients are often non-adherent to topical corticosteroids (TCS). This may be in part due to poor communication between patients and dermatologists.

Objectives

This quality improvement (QI) study aims to describe dermatologist–patient communication about TCS treatments and to compare communication before and after the implementation of an educational intervention.

Methods

This QI study assesses the communication between dermatologists and new dermatology outpatients receiving a TCS prescription in a tertiary care center. The QI intervention is 2-pronged, consisting of an educational pamphlet for patients and a communication workshop for the dermatology team. Encounters were audiotaped, and communication was analyzed using a coding system (MEDICODE). Phase 1 recordings happened preintervention and reflect the usual dermatologist–patient communication in this practice setting and phase 2 recordings were postintervention.

Results

Phase 1 reveals that dermatologists frequently address informational medication themes, such as naming the medications and informing patients about their proper use. They less frequently discuss patient experience themes, such as goals of treatment, adverse effects of treatments, and exploring patients’ emotions about medications (such as anxiety, fears, etc.). After the intervention, there was more frequent discussion of patient experience themes without increasing consultation length. But, in both phases, physicians address most themes as a monolog with little verbal input from patients.

Conclusions

Our study raises awareness regarding dermatologists’ communication patterns about TCS, identifying specific areas for improvement, such as discussions of adverse effects, and explicitly addressing patients’ attitudes and emotions. This is an essential step to foster a sense-making of TCS for patients.
Not the exercise type? Personality traits and anxiety sensitivity as predictors of objectively measured physical activity and sedentary time
Authors: Hearon Bridget A , Harrison Thomas J
Published: February 2020

Personality traits have been investigated as predictors of sedentary behavior, while both personality traits and anxiety sensitivity have been investigated as predictors of physical activity; however, few studies employed objective measurement of these behaviors. The current study recruited 64 young adults who completed the Anxiety Sensitivity Index–3 and NEO-Personality Inventory-3, then wore accelerometers for 1 week. Results revealed that agreeableness and anxiety sensitivity were inversely associated with moderate intensity or greater physical activity; however, none of the investigated constructs predicted sedentary time. These results highlight the importance of objective measurement when studying these behaviors and clinical implications for the identification of individuals at risk for physical activity avoidance.
Opening the (Muslim) woman’s space—The Soviet politics of emancipation in the 1920s–1930s
Authors: Gradskova Yulia
Published: February 2020

The emancipation of the “woman of the East” constituted an important part of the Soviet cultural revolution campaign of the 1920s–1930s. This article has as its aim the exploration of the Soviet discourses and the practices of emancipation of the “woman of the East,” with a focus on the Muslim woman of the Volga-Ural region. I show that the Bolshevik attempts at transforming the everyday life of the “woman of the East,” in spite of their anti-colonial rhetoric, often followed the Russian imperial scripts and the logic of the civilizing mission. In contrast to Muslim modernism’s ideas on the compatibility of modernity with Islam, the Bolshevik secular and declaratively ungendered modernity aimed for the destruction of the separateness of male and female spaces and their conversion to the common space of the communist collectivity. However, the discourse on the special “backwardness” and “slave-like” situations of the Muslim woman contradicted these aspirations and led to her “Otherness” rather than emancipation and equality inside the Soviet system.
A Retrospective Study of Gemcitabine and Carboplatin With or Without Intravenous Vitamin C on Patients With Advanced Triple-Negative Breast Cancer
Authors: Ou Junwen , Zhu Xinyu , Zhang Hongyu , Du Yanping , Chen Pengfei , Wang Junhua , Peng Xiufan , Bao Shuang , Zhang Xinting , Zhang Tao , Pang Clifford L. K.
Published: February 2020

Background: This is a retrospective study to examine the effect of chemotherapy with or without intravenous vitamin C (IVC) on women with advanced triple-negative breast cancer (TNBC). Methods: From 2008 to 2016, a total of 113 patients with pathologically confirmed TNBC at Clifford Hospital were evaluated, and 70 patients were matched and divided into IVC (treatment group) and non-IVC groups (control group). The match was according to age, menopausal status, and metastatic sites. In the control group, 35 patients received gemcitabine and carboplatin. In the treatment group, 35 patients received the same chemotherapy plus IVC. Results: Baseline characteristics were not significantly different between the 2 groups. According to the criteria of RECIST 1.1 (Response Evaluation Criteria in Solid Tumors), enhanced computed tomography scan was compared after 2 cycles of chemotherapy. In the treatment group, 2/35 cases had a complete remission (CR), 15/35 cases had partial remission (PR), and 13/35 cases had stable disease (SD). The response rate was 48.6%. In the control group, there were no CR cases, 14/35 cases had PR, 14/35 cases had SD, and the response rate was 40.0% ( P > .05). The median progression-free survival time and median overall survival time was 7 months (95% confidence interval [CI] =1.5-28.5 months) and 27 months (95% CI = 4-40 months) in the treatment group compared with 4.5 months (95% CI = 1.5-8 months) and 18 months (95% CI = 3-26 months) in the control group ( P < .05). All patients experienced diverse reactions in the gastrointestinal tract and myelosuppression. The incidence of adverse reactions in the treatment group was significantly lower than that of the control group ( P < .05). Conclusion: IVC may have an effect on improving the prognosis of patients with advanced TNBC.
Design of a robotic manipulator for handling products of automotive industry
Authors: Blatnický Miroslav , Dižo Ján , Gerlici Juraj , Sága Milan , Lack Tomáš , Kuba Erik
Published: February 2020

Automation is a process of handling and transport of products, which allows replacing man’s control by operation of manipulators and robots. It represents a highly complex process, which includes several operations and they are usually performed automatically by particular devices. In this article, a technical design of a universal versatile robotic manipulator for handling with automotive products is presented. The designed device is intended for handling with automotive products with a maximum weight of 25 kg. The technical solution of the manipulator comes from required specifications and operation conditions given by the customer, who will install it as a part of an automatic line. A particularity of the manipulator is the special functionality, which allows handling with objects of both circular and angular shapes. This is ensured by adaptable gripping fingers, which are able to adjust their position by means of a well-considered mechanism. The technical design of the manipulator includes calculation of forces needed for reliable gripping of manipulated objects, choice of a working screw and calculation of the load and carrying out of strength analyses of the main loaded part of the manipulator. Based on results, there is recommended an appropriate material for the manufacture of the device to reach its optimal accuracy of positioning of handled objects during a long-term operation.
Collagen 2A Type B Induction after 3D Bioprinting Chondrocytes In Situ into Osteoarthritic Chondral Tibial Lesion
Authors: Gatenholm Birgitta , Lindahl Carl , Brittberg Mats , Simonsson Stina
Published: February 2020

Objective

Large cartilage defects and osteoarthritis (OA) cause cartilage loss and remain a therapeutic challenge. Three-dimensional (3D) bioprinting with autologous cells using a computer-aided design (CAD) model generated from 3D imaging has the potential to reconstruct patient-specific features that match an articular joint lesion.

Design

To scan a human OA tibial plateau with a cartilage defect, retrieved after total knee arthroplasty, following clinical imaging techniques were used: (1) computed tomography (CT), (2) magnetic resonance imaging (MRI), and (3) a 3D scanner. From such a scan, a CAD file was obtained to generate G-code to control 3D bioprinting in situ directly into the tibial plateau lesion.

Results

Highest resolution was obtained using the 3D scanner (2.77 times more points/mm2 than CT), and of the 3 devices tested, only the 3D scanner was able to detect the actual OA defect area. Human chondrocytes included in 3D bioprinted constructs produced extracellular matrix and formed cartilage tissue fragments after 2 weeks of differentiation and high levels of a mature splice version of collagen type II (Col IIA type B), characteristic of native articular cartilage and aggrecan (ACAN). Chondrocytes had a mean viability of 81% in prints after day 5 of differentiation toward cartilage and similar viability was detected in control 3D pellet differentiation of chondrocytes (mean viability 72%).

Conclusion

Articular cartilage can be formed in 3D bioprints. Thus, this 3D bioprinting system with chondrocytes simulating a patient-specific 3D model provides an attractive strategy for future treatments of cartilage defects or early OA.
Increasing Concentration of Sinovial: Effect on Cartilage Protection in a Rabbit ACLT Model
Authors: Boissier Pomme , Mainil-Varlet Pierre , Mautone Giuseppe R.
Published: February 2020

Objective

This study aimed to test the hypothesis that administration of increasing doses of Sinovial (hyaluronic acid [HA]), would exhibit a dose-dependent effect on the prevention of cartilage degradation, without local and systemic toxicity.

Methods

Twenty-seven adult rabbits were subjected to anterior cruciate ligament transection (ACLT). Two Sinovial products containing HA concentrations of 1.6% and 2.4% were used as active treatment, and 0.9% saline was used as control and injected intra-articularly 7 days post ACLT. Radiographs were taken prior to surgery, at injection and sacrifice times. After euthanasia, 8 weeks postsurgery, knee joints were observed macroscopically using India ink staining with OARSI (Osteoarthritis Research Society International) scoring and histologically using modified Mankin scoring. The synovial membranes were analyzed using Cake classification.

Results

No intraoperative complications were observed. One week postinjection, 4 animals in the HA 2.4% group developed subcutaneous nodules that disappeared spontaneously. No inflammation of the synovial membrane was ever observed. The control group exhibited the maximum uptake of India ink 2.22 ± 0.14. HA groups exhibited a dose-dependent ( P = 0.02) reduction in India ink uptake: 1.75 ± 0.17 for HA 1.6% and 1.58 ± 0.14 for HA 2.4%. The most marked dose-dependent effect of this study was a reduction of modified Mankin score for HA groups, with the 2.4% treatment achieving a statistically significant improvement as compared with the control group (7.19 ± 0.85 for saline, 4.65 ± 0.66 for HA 1.6%, and 3.53 ± 0.59 for HA 2.4%; P = 0.005).

Conclusions

A dose-dependent protective effect on cartilage was observed after injection of both HA solutions.
Corporate Governance Deviance: A Case Study of Infosys
Authors: Chatterjee Anindita , Hazarika Deepti D.
Published: February 2020

The major organizational transformation journey of Indian software bellwether firm, Infosys, from 2014 until 2017 under the leadership of first non-founder member is captured in this case study. The entrepreneurial ambitions and zeal to grow through organic and inorganic moves saddled with lack of cognizance of corporate governance resulted in deviance leading to turmoil followed by the resignation of the CEO. The company values, the roles of founder members, institutional investors, shareholders and other aspects came under the scanner to understand the reasons behind the corporate governance deviance.

Dilemma

Though the company got a clean chit against the corporate governance deviance charges, the conflict between the board of governors and founders, particularly the ex-CEO continued which culminated into the resignation of the CEO. What are the roles of founder members, board of governors, institutional investors and shareholders in case of corporate governance deviance? Theory: Models of Corporate Governance Type of the case: Decisional, applied Protagonist: CEO of the firm

Options

After obtaining clean chit against the corporate governance deviance charges, the CEO could have continued. Instead he decided to resign.

Discussions and Case Questions

Why the chairman of the board was indecisive in questioning the CEO undertaking deviant business practices? Why were the founders not happy with the ‘non-transparent’ way in which the board had decided to raise Dr Sikka’s annual compensation package from US$7.08 million to US$11 million even when it was linked with the company’s progress towards ‘Vision 2020’? What kind of risk did the founders saw in the appointment of the wife a sitting minister in the Indian government as an independent director? Why the board decided to give a generous severance package to ex-CFO without the approval of the chairperson of Nominations and Remuneration Committee?
Primary or secondary wound healing of the pin sites after removal of the external fixator: study protocol for a prospective, randomized controlled, monocenter trial
Authors: Roth Franz , Cagienard Flavio , Link Björn C. , Hodel Sandro , Lehnick Dirk , Babst Reto , Beeres Frank J. P.
Published: February 2020

Background

Temporary fixation with an external fixator is used for numerous indications in orthopedic trauma surgery. It is unclear whether primary wound healing or secondary open-wound healing after removal of the external fixator should be advocated for the pin site. This study compares primary wound closure with secondary wound healing for the pin site. The primary aim is to compare pin-site infection rates. The secondary aim is to compare time to wound healing and esthetic outcome. The hypothesis was that primary wound closure does not lead to more infections than secondary wound healing.

Methods and design

This is a prospective, randomized controlled, blinded, monocenter study based on a non-inferiority design. To obtain an equal patient population and groups, all pin-entry sites of the patients are treated alternately at the time of removal of the external fixator with primary wound closure and secondary wound healing. Patients are randomized according to whether the proximal pin-entry site is treated with wound closure or by secondary open-wound healing, from which the further sequence develops. The pre- and postoperative protocol is standardized for all pin-entry sites. A photo documentation of the pin-entry sites takes place 2 and 52 weeks postoperatively during the routine clinical follow-up visits. Further controls take place at 6, 12 and 26 weeks after pin removal.

The primary outcome was to demonstrate the non-inferiority of primary wound closure compared to secondary wound healing in terms of postoperative wound infections according to the Center of Disease Control and Prevention (CDC) definitions.

The secondary outcomes are time to complete wound healing (days) and esthetical outcome (subjective preference of patients and Vancouver Scar Scale score).

Discussion

This study aims to answer how to deal with the pin site after removal of the external fixator. To date, no routine and generally accepted protocol exists for the management of pin sites after removal of the external fixator. This prospective, randomized controlled, blinded monocenter trial should determine whether primary wound closure or secondary wound healing should be advocated after removal of the external fixator.

Trial registration

ClinicalTrials.gov, ID: NCT03842956. Registered retrospectively on 13 February 2019.
Yellow fever epizootics in non-human primates, Southeast and Northeast Brazil (2017 and 2018)
Authors: Mares-Guia Maria Angélica Monteiro de Mello , Horta Marco A. , Romano Alessandro , Rodrigues Cíntia D. S. , Mendonça Marcos C. L. , dos Santos Carolina C. , Torres Maria C. , Araujo Eliane S. M. , Fabri Allison , de Souza Everton R. , Ribeiro Roberta O. R. , Lucena Fabiana P. , Junior Luiz C. A. , da Cunha Rivaldo V. , Nogueira Rita M. R. , Sequeira Patricia C. , de Filippis Ana M. Bispo
Published: February 2020

Background

Yellow fever (YF) is a severe, infectious, but non-communicable arboviral hemorrhagic disease. In the last decades, yellow fever virus (YFV) infections have been prevalent in endemic areas in Brazil, affecting human and non-human primate (NHP) populations. Monitoring of NHP infection started in 1999, and reports of epizootic diseases are considered important indicators of viral transmission, particularly in relation to the sylvatic cycle. This study presents the monitoring of YFV by real-time RT-PCR and the epidemiological findings related to the deaths of NHPs in the south-eastern states and in the north-eastern state of Bahia, during the outbreak of YF in Brazil during 2017 and 2018.

Methods

A total of 4198 samples from 2099 NHPs from south-eastern and north-eastern Brazilian states were analyzed by real-time reverse transcription polymerase chain reaction (rtRT-PCR).

Results

A total of 4198 samples from 2099 NHPs from south-eastern and north-eastern Brazilian states were collected between 2017 and 2018. The samples were subjected to molecular diagnostics for YFV detection using real-time reverse transcription polymerase chain reaction (rtRT-PCR) techniques. Epizootics were coincident with human YF cases. Furthermore, our results showed that the YF frequency was higher among marmosets (Callithrix sp.) than in previous reports. Viremia in species of the genus Alouatta and Callithrix differed greatly.

Discussion

Our results indicate a need for further investigation of the role of Callithrix spp. in the transmission cycles of YFV in Brazil. In particular, YFV transmission was observed in a region where viral circulation has not been recorded for decades and thus vaccination has not been previously recommended.

Conclusions

This highlights the need to straighten epizootic surveillance and evaluate the extent of vaccination programmes in Brazil in previously considered “YFV-free” areas of the country.
A chromosomal connectome for psychiatric and metabolic risk variants in adult dopaminergic neurons
Authors: Espeso-Gil Sergio , Halene Tobias , Bendl Jaroslav , Kassim Bibi , Ben Hutta Gabriella , Iskhakova Marina , Shokrian Neda , Auluck Pavan , Javidfar Behnam , Rajarajan Prashanth , Chandrasekaran Sandhya , Peter Cyril J. , Cote Alanna , Birnbaum Rebecca , Liao Will , Borrman Tyler , Wiseman Jennifer , Bell Aaron , Bannon Michael J. , Roussos Panagiotis , Crary John F. , Weng Zhiping , Marenco Stefano , Lipska Barbara , Tsankova Nadejda M. , Huckins Laura , Jiang Yan , Akbarian Schahram
Published: February 2020

Background

Midbrain dopaminergic neurons (MDN) represent 0.0005% of the brain’s neuronal population and mediate cognition, food intake, and metabolism. MDN are also posited to underlay the neurobiological dysfunction of schizophrenia (SCZ), a severe neuropsychiatric disorder that is characterized by psychosis as well as multifactorial medical co-morbidities, including metabolic disease, contributing to markedly increased morbidity and mortality. Paradoxically, however, the genetic risk sequences of psychosis and traits associated with metabolic disease, such as body mass, show very limited overlap.

Methods

We investigated the genomic interaction of SCZ with medical conditions and traits, including body mass index (BMI), by exploring the MDN’s “spatial genome,” including chromosomal contact landscapes as a critical layer of cell type-specific epigenomic regulation. Low-input Hi-C protocols were applied to 5–10 × 103 dopaminergic and other cell-specific nuclei collected by fluorescence-activated nuclei sorting from the adult human midbrain.

Results

The Hi-C-reconstructed MDN spatial genome revealed 11 “Euclidean hot spots” of clustered chromatin domains harboring risk sequences for SCZ and elevated BMI. Inter- and intra-chromosomal contacts interconnecting SCZ and BMI risk sequences showed massive enrichment for brain-specific expression quantitative trait loci (eQTL), with gene ontologies, regulatory motifs and proteomic interactions related to adipogenesis and lipid regulation, dopaminergic neurogenesis and neuronal connectivity, and reward- and addiction-related pathways.

Conclusions

We uncovered shared nuclear topographies of cognitive and metabolic risk variants. More broadly, our PsychENCODE sponsored Hi-C study offers a novel genomic approach for the study of psychiatric and medical co-morbidities constrained by limited overlap of their respective genetic risk architectures on the linear genome.
The status of Clibanarius erythropus after a recent range expansion to Great Britain, with the highest latitude recording of a gravid individual
Authors: Patterson Christophe , Slater Matt , Early Regan , Laing Chris
Published: February 2020

Background

In 2016, the range of the hermit crab Clibanarius erythropus expanded to South West Britain for the second time. C. erythropus primarily lives in the Mediterranean and the Atlantic coast of Europe from the Bay of Biscay to Morocco. The species has now been recorded on both the north and south coast of the South West peninsula of the UK from Newtrain Bay, on the north coast of Cornwall, to Wembury, on the south coast of Devon. It is unknown if the crab’s reappearance in the UK has been caused by a one-off colonisation event or by a continued influx of larvae.

Results

The population in the UK is made up of individual within a narrow size bracket, indicating a single colonisation event took place, and that the population is an ageing one. However, we also report the highest latitude recording of a gravid individual for the species.

Conclusion

A lack of gravid individuals was suggested to be why the species was unable to sustain its presence in the UK following a previous colonisation in 1960. This discovery hints that rising water temperatures may allow C. erythropus and other warm-water species to expand and sustain themselves in the UK. We also found crossover in shell utilisation between C. erythropus and the native hermit crab Pagurus bernhardus, suggesting that competition might occur between the two species.
Nutritional value and impact of wheatgrass juice (Green Blood Therapy) on increasing fertility in male albino rats
Authors: Eissa Hesham A. , Mohamed Sherif S. , Hussein Ahmed M. S.
Published: February 2020

Background and objective

The wheatgrass juice (WGJ) contains a high concentration of vitamin C. WGJ contains a lot of highly functional nutritive ingredients potent to unify the liver with the kidneys for detoxification of the organs and filtration of the blood to build a strong immune system. Also, it boosts fertility and increases sexual desire because of the high magnesium content in phytochemical pigment (chlorophyll) which boosts the production of the enzymes that restores sex steroids.

Materials and methods

The experimental animals were divided into 3 groups of 8 rats. The first group (G1) was fed on the standard normal diet. The same feeding was used also in the second group (G2) and third group (G3). But in the G2, a pharmaceutical formula (contain zinc and vitamin A) was used as a food supplement to increase fertility, and in the G3, wheatgrass juice of 11 mg/day was applied. Hunter L, a, and b values; glucose, fructose, and sucrose contents; pH; total soluble solids (TSS); acidity; concentration of vitamin C and vitamin B complex contents; and phenolic compounds of wheatgrass quality juice were measured.

Results

The juice samples showed L* value of 21.78 (as a lightness index), a* value of − 7.11 (as a redness index), b* values of 17.35 (as a yellowness index), pH (6.7), TSS (5°Bx), and acidity (0.00992%). In the same time, wheatgrass chlorophyll represents 70% of its total chemical constituents that is an antioxidant and rebuilds the bloodstream. In addition, it gives the juice its distinctive green color which is the major quality factor in juice products. The results amounted to normal values of vital organs such as the liver and kidney functions in all groups. The values of aspartate aminotransferase (AST) were 27.88 ± 2.10, 22.50 ± 4.93, and 23.25 ± 4.71 μ/ml in G1, G2, and G3, respectively. Meanwhile, also the results of sexual hormones indicated an elevation in testosterone hormone in G3 (2.90 ± 0.26 ng/ml) than the normal negative control (2.78 ± 0.23 ng/ml) and pharmaceutical formula positive control (2.04 ± 0.40 ng/ml). However, follicle-stimulating hormone (FSH) decreased to 1.44 ± 0.28 IU/L and 1.45 ± 0.24 for G3 and G2, respectively, compared to 1.65 ± 0.23 IU/L in G1.

Conclusion

The findings proved that WGJ increased fertility and promoted youthfulness, and the wheatgrass (WG) has the potential to be used as a “functional herb” containing natural bioactive compounds.
Atezolizumab (atezo) therapy for upper tract (UT) urothelial carcinoma (UC): Subgroup analysis of the single-arm international SAUL study in pretreated locally advanced/metastatic urinary tract carcinoma.
Authors: Sternberg Cora N. , Loriot Yohann , Tambaro Rosa , Buttigliero Consuelo , Morelli Franco , Papai Zsuzsanna , Retz Margitta , Necchi Andrea , Van Der Heijden Michiel Simon , Faust Guy , Cardona Zorrilla Andres Felipe , Lainez Nuria , Panni Stefano , Etxaniz Olatz , Krieger Laurence , Mendez Vidal Maria Jose José , Los Maartje , de Ducla Sabine , Fear Simon , Merseburger Axel Stuart
Published: February 2020

488

Background: UTUC is rarer than bladder UC and typically responds poorly to standard chemotherapy. Analysis of 220 biomarker-evaluable atezo-treated patients (pts) in phase II/III trials suggested worse outcomes in UT vs lower tract UC [Galsky, ESMO 2018]. We explored clinical outcomes in pts with UTUC (renal pelvis or ureter) treated with atezo in the SAUL study. Methods: The single-arm SAUL study (NCT02928406) [Sternberg, Eur Urol 2019] enrolled a broader pt population, including pts with poor clinical characteristics and/or immune-mediated conditions, more representative of real-world practice than typically enrolled in randomized phase III immunotherapy trials. Pts with urinary tract carcinoma received atezo 1200 mg q3w until disease progression/unacceptable toxicity. Baseline characteristics, safety and efficacy were analyzed in subgroups of pts with UTUC (subdivided into renal pelvis or ureter UC) vs bladder UC. Results: Baseline characteristics in the 4 subgroups were generally similar, except for a numerically lower proportion of pts with 0 prior lines of therapy for metastatic disease in the UTUC vs bladder UC subgroup (30% vs 41%). Treatment exposure, safety and efficacy are shown below. Conclusions: These exploratory analyses of SAUL showed very similar efficacy and safety in UT vs bladder UC. This provides reassurance that atezo is active and has an acceptable safety profile in pts with UTUC, who are generally expected to have worse outcomes than bladder UC pts. Clinical trial information: NCT02928406 . [Table: see text]
Perioperative chemoimmunotherapy with durvalumab (Durva) in combination with cisplatin/gemcitabine (Cis/Gem) for operable muscle-invasive urothelial carcinoma (MIUC): Preplanned interim analysis of a single-arm phase II trial (SAKK 06/17).
Authors: Cathomas Richard , Petrausch Ulf , Hayoz Stefanie , Schneider Martina , Schardt Julian Andreas , Seiler Roland , Erdmann Andreas , Rothschild Sacha , Aeppli Stefanie , Mach Nicolas , Strebel Raeto , Hadaschik Boris A. , Berthold Dominik R. , Pless Miklos , Zihler Deborah , Schmid Mathias , Biaggi Rudolf Christine , Spahn Martin
Published: February 2020

499

Background: Cisplatin-based neoadjuvant chemotherapy followed by surgery is the standard of care for patients (pts) with MIUC but relapse rates remain high. Immune checkpoint inhibitors have demonstrated efficacy in advanced urothelial carcinoma (UC). We hypothesize that the integration of the PD-L1 inhibitor durvalumab into perioperative management of MIUC improves outcome. Methods: SAKK 06/17 is an open label single arm phase II study including 61 pts. Operable MIUC cT2-T4a cN0-1 pts without contraindication for Cis were eligible. Four cycles of preoperative Cis/Gem q3w are administered in combination with 4 cycles Durva 1500mg q3w starting at cycle 2. Durva is continued after surgery q4w for 10 cycles. Primary endpoint is event free survival at 2 years. We report a preplanned interim analysis of the secondary endpoints safety, pathological complete remission ypT0 N0 (pCR,) and pathological response rate (PaR, defined as ≤ypT1N0) on the first 30 resected pts. Results: Among 34 eligible pts (27M, 7F; median age 70, range 41-81 years) included from 07/18 – 02/19, 33 pts (97%) had primary bladder cancer and 1 pt had upper tract UC. Clinical T2, T3, T4 and TxN1 stage were present at diagnosis in 68%, 18%, 15% and 15%, respectively. Four cycles of chemo-immunotherapy were completed per protocol in 34 pts (100%). No tumor progression was noted at preoperative restaging. AE related to Durvalumab were G3 in 5 pts (15%) and G4 in 3 pts (9%). Surgery was performed as planned in 30 pts (88%), 3 pts refused surgery and 1 pt had a frozen pelvis. Operation technique was open in 20 pts (67%) and laparoscopic/robot-assisted in 10 pts (33%). Postoperative complications included Clavien-Dindo III in 6 pts (20%) and IV in 2 pts (7%) with infections being most common (5 pts, 17%). pCR was found in 9 pts (30%) and additional 6 pts (20%) had ypT1/ypTis for a PaR of 50%. Conclusions: The combination of Cis/Gem and Durva as neoadjuvant treatment for MIUC is feasible with manageable toxicities and pCR and PaR rates in the expected range. The rate of postoperative complications warrants further close follow up. Clinical trial information: 2017-003565-10.