bluuebunny/crossref_metadata_2025 huggingface dataset:
Separating Poor Playmates: Untangling Commuter Rail from Freight
Authors: Allen John G. , Newmark Gregory L.
Published: January 2020

North American commuter railroads run their trains largely on tracks shared with freights (and in the northeastern US, often shared with intercity passenger trains). This sharing makes commuter rail relatively affordable to implement. However, as freight traffic grows, so does the potential for delays. If freight and commuter operations affect each other’s performance, it may be necessary to consider separation measures, not adding to the existing shared-track capacity. Temporal separation can work on low-volume operations. Busier lines may require physical separation, which can be implemented in several forms for trunk lines (grade separation at junctions, freight bypass, partial trunk line separation, and full trunk line separation), as well as physical separation in downtown areas. This article identifies these separation options, describes their attributes, presents representative examples, and outlines criteria for evaluation.
Bauman as a refugee: We should not call refugees ‘migrants’
Authors: Wagner-Saffray Izabela
Published: January 2020

This paper claims that Bauman’s personal experiences deeply shaped his work. In the first part, I draw upon my own research, combining archive documents and interviews data, as well as – for the very first time – details taken from Zygmunt Bauman’s own unpublished autobiography, accessed courtesy of the Zygmunt and Janina Bauman Archive project at the University of Leeds. The second part of the paper draws upon my wider ethnographical study into the lived experiences of asylum seekers, conducted between 2017 and 2019 in Southern Europe. I focus here upon their experience of escape and their present life conditions in order to highlight important parallels with Bauman’s own experiences as a refugee. The conclusion draws both cases together in order to understand a less overt aspect of Bauman’s sociology and to claim that the term ‘migrant’ is both discriminatory and, in academic terms, incorrect. I argue that this diagnosis is reinforced further by the voices of intellectuals who themselves experienced the status of refugees: namely, Zygmunt Bauman and Hannah Arendt.
Patient-Specific 3D-Printed Rhinoplasty Operative Guides
Authors: Locketz Garrett D. , Silberthau Kara , Lozada Kirkland N. , Becker Daniel G.
Published: January 2020

Three-dimensional (3D) imaging technology has become a popular clinical technology for surgical planning and simulation in rhinoplasty. This technology offers the opportunity to translate a simulated 3D image into a surgical plan in the operating room in a quantitative manner. Herein, we describe a technique for creating patient-specific 3D-printed rhinoplasty marking templates from preoperative 3D imaging. Five adult patients presenting for primary rhinoplasty were recruited as subjects. 3D photographs were captured of each patient, and goals of surgery were digitally simulated based on patient preference. Simulated and baseline digital renderings were exported to a third-party 3D printing company. 3D-printed plastic molds were created to precisely fit the patient’s preoperative nose when overlaid on the dorsum. Molds included windows through the lateral walls corresponding to the preoperative simulation whereby the patient’s desired dorsal height and contour was marked on the skin immediately prior to surgery. 3D image capture, digital rendering, and goals of surgery simulations were created using standard office-based 3D imaging equipment and added an additional 10 minutes the standard preoperative rhinoplasty consultation. Turnaround time was 5 days and cost was $100 per patient. The senior author found the patient-specific marking templates to effectively transfer the patient’s desired dorsal height and contour onto the patient in the form of skin markings. The technique described herein aids quantitative translation of patient goals in dorsal reduction rhinoplasty into the operating room and onto the patient in the form of preoperative marking. The workflow is fast, cost-effective, uses standard office-based technology, and requires little technological expertise.
Economic growth, exports, and role of energy conservation: Evidence from panel co-integration-based causality models in South Asia
Authors: Shakeel Muhammad , Ahmed Aziz
Published: January 2020

This study examines the relationship among energy use, real gross domestic product, and exports and thereby the impact of energy conservation for the quest of a sustainable environment-gross domestic product growth in the panel of five South Asian countries. The aggregate production function framework is estimated by employing first/second generational panel co-integration-based models for the panel data covering the years 1980–2014. The empirical findings demonstrate a statistically significant panel error correction mechanism among real gross domestic product, capital, labor, and energy use in both export-added and export-excluded models. The findings of panel causality test depict a significant causal relationship running from export and energy use towards gross domestic product in the long run. Furthermore, a significant feedback relationship between energy use and gross domestic product and between exports and gross domestic product has been found in the short run. These findings of vector error correction model-based panel causality test imply that reducing/cutting the extant aggregate energy use (fossil fuel dominant) via conservation policies are somewhat wanting and could be implemented at the cost of lower gross domestic product and export growths, ceteris paribus. Therefore, for reducing the level of carbon emissions arising from fossil fuel-based energy use and for a sustainable aggregate energy use to the production sector per se, there is an immense need of developing environment friendly/green sources of energy in the region. These consolidated and concerted strides of developing and substituting environment friendly energy options into the extant aggregate energy use will, inter alia, ensure the sustainability of environment-gross domestic product growth in South Asia.
Attitudes of Polish Nurses Toward Selected National Groups
Authors: Zalewska-Puchała Joanna , Bodys-Cupak Iwona , Majda Anna
Published: January 2020

Introduction: Opening up to global migration processes has contributed to increasing the cultural diversity of Polish society. The diagnosis of nurses’ attitudes toward cultural differences is important in the assessment of training needs and in providing professional care. Method: Cross-sectional studies, was carried out in 2018 among 1,271 nurses. In the research, the following scales and questionnaire were used: Bogardus Social Distance and Social Dominance Orientation Scales; Social Approbation Questionnaire and author’s questionnaire. Results: The respondents showed the highest social distance toward Russians, Vietnamese, and Chechens. There was a significant dependence of the level of social distance of respondents from age, job seniority, place of residence, education, frequency of contact with representatives of other nationalities, living abroad, care for a person of other nationality, training on transcultural nursing, participation in cultural events regarding representatives of other nationalities. Conclusions: The results of the research indicate the need to train nurses in the field of transcultural nursing.
One Multidisciplinary Cleft and Craniofacial Team’s Experience in Shifting to Family-Centered Care
Authors: Pfeifauf Kristin D. , Snyder-Warwick Alison K. , Scheve Sibyl , Grellner Cheryl L. , Skolnick Gary B. , Wilkey Andrew , Foy Jordan , Naidoo Sybill D. , Patel Kamlesh B.
Published: January 2020

Family-centered care is a high-priority focus area in health care and is associated with increased family satisfaction and quality of life, better health outcomes and family follow-up, decreased burden of care, and improved efficiency of resource utilization. Motivated by our aim to improve clinic efficiency and patient retention, our multidisciplinary cleft palate and craniofacial center has been undergoing a complex family-centered reorganization over the past 3 years. We seek to share our experience in hope the information will be a useful starting point to other teams in structuring their own family-centered improvements. We suggest the following stepwise method to achieve a more family-centered process: (1) gathering preintervention data, (2) brainstorming challenges with stakeholders, (3) brainstorming solutions with stakeholders, (4) implementation, (5) follow-up and troubleshooting, (6) further implementation, and (7) gathering postintervention data. Additionally, we found the use of institutional resources added substantial value to our efforts.
Glomus Tumor of Sella Turcica With Synaptophysin Expression Mimicking Pituitary Adenoma
Authors: Tsang Jason C. H. , Ng C. S. , Fung C. F. , Chan John K. C. , Cheuk Wah
Published: January 2020

Glomus tumor can rarely arise in the central nervous system as a sella turcica mass. In this article, we report a case of sellar glomus tumor in a female patient who presented at the age of 8 years with visual impairment. The tumor recurred at 4 years and 26 years after initial excision and gamma knife therapy. Histologic examination showed a monotonous population of oval cells accompanied by delicate blood vessels, features mimicking pituitary adenoma. The tumor showed histologic progression at the second recurrence. Synaptophysin staining was positive, but chromogranin and CD56 were negative. The tumor cells were negative for epithelial markers but expressed actin and SMA. Awareness of the rare occurrence of glomus tumor at this region, careful analysis of morphology, and appropriate immunohistochemical workup are essential to solve this diagnostic challenge. The clinicopathologic features of all previously reported cases are reviewed.
Vibration transmission path identification in a hydropower house based on a time-delayed transfer entropy method
Authors: Zhang Liaojun , Wang Shuo , Yin Guojiang , Guan Chaonian
Published: January 2020

This article aims to explore the vibration transmission path in the hydropower house using the time-delayed transfer entropy method. A three-dimensional fluid-concrete structure-hydraulic machinery coupling simulation model of the Xiangjiaba hydropower house was established, and the vibration acceleration and equivalent stress of the structure were calculated in the time domain based on the two-way iterative fluid-structure interaction method. The characteristic indexes of information transmission were quantitatively presented, including the rate of information transmission, transmission path contribution, to describe the vibration energy transmission paths and transmission characteristics of different vibration variables as well as different directions of the same variable in the hydropower house. The study indicates that the vertical acceleration can identify more abundant vibration transmission paths, and the lower bracket contributes most to the vibration transmission of the powerhouse. The research outcome can provide a scientific basis for structural optimization, vibration attenuation, and isolation design of the hydropower house.
Application of KW-ANOVA statistics to generate evidence for cytotoxic drug wastage induced financial burden among cancer patients: A clinical pharmacist observation
Authors: Jyoti K , Manjula G , Ganachari MS
Published: January 2020

Background

Very little is known about the effects of drug wastage costs among cancer patients in terms of “financial toxicity” leading to poor health and nonhealth outcomes. But reducing this drug waste is an attractive strategy for cost-cutting with regard to improving the health-related quality of life of the cancer patients. Thus, the objective of the study was to determine drug wastage and to generate evidence for cytotoxic drug waste and financial burden among cancer patients. Methodology: On Ethics Committee approval, a prospective-observational study was conducted in cancer patients. The data were collected in data collection form. Daily monitoring was done to analyze the quantity of drug wastage which was interpreted using KW-ANOVA and further evidence was developed for corrective mitigation strategies applicable to intent drugs.

Results

Among 90 patients, 52 patients experienced drug wastage that includes 9 intent drugs which figured out unnecessary monetary units and quantity wastage that range from 80 to 50,000 INR and 10 to 500 mg, respectively. The median price value for cost of drug wastage was 237.30 INR.

Conclusion

The study generates evidence that concludes the mandatory requirement of implementation of drug wastage mitigation strategies for the drugs expected to cause wastage. Clinical pharmacist extensively contributes in oncology pharmacy practice setting to identify the intent drugs and to abate the drug wastage among medications intending to cause potential increment in drug expenditure among cancer patients on chemotherapy clinical pharmacist.
Acute cerebellar toxicity induced by high dose of cytarabine (HiDAC): A case report
Authors: Rahmani Hamid , Radmehr Mojan , Hadjibabaie Molouk , Solduzian Mohammad
Published: January 2020

Cytarabine is a pyrimidine analogue that is used for the treatment of acute myeloid leukemia at different doses. Standard doses of cytarabine are used for induction therapy, while high doses are used for post-remission (consolidation) and relapsed/refractory treatment. One of the major side effects of its high doses is acute cerebellar toxicity occurring in 10 to 25% of patients. We report a case that developed this side effect after receiving two doses of high-dose cytarabine. The patient’s symptoms improved after withholding the drug. Thereafter, the patient tolerated treatment continuation with lower doses.
Numerical crashworthiness analysis of a novel functionally graded foam-filled tube
Authors: Najibi Amir , Ghazifard Payman , Alizadeh Parisa
Published: January 2020

The thin-walled tubes used in the front rails of the vehicle’s body in white play a major role in absorbing the energy of the collision. In this work, the energy absorption characteristics of the functionally graded foam-filled thin-walled tubes are studied by using quasi-static finite element analysis. The simulation of all specimens has been conducted by utilizing finite element software ABAQUS/Explicit™. A high-precision constitutive equation is used to obtain mechanical properties of foam in different densities. Uniform density foam-filled and functionally graded foam-filled tubes with various gradient functions and configurations are simulated, and force–displacement and energy–displacement diagrams are extracted and compared to each other. The simulation carried out on the layered samples showed that the 13-layered sample is an appropriate approximation for the continuous variations of density along the axial direction. According to the results, linear variations have had better energy absorption characteristics compared to the samples with gradient exponent of [Formula: see text] = 2 and [Formula: see text] = 5 for an ascending density variation. In this study, the innovative density variation patterns as high-low-high and low-high-low are also simulated in which the high-low-high sample has better energy absorption than other specimens. It is shown for 13-layered samples, the specific energy absorption in the high-low-high design is 3 and 6.6% higher than the ascending pattern ( m = 1) and the low-high-low samples, respectively.
Psychosocial adjustment to Mild Cognitive Impairment: The role of illness perceptions, cognitive fusion and cognitive impairment
Authors: Guzmán Azucena , Gillanders David , Stevenson Amanda , Ross Kerry
Published: January 2020

Background and objective

Receiving a Mild Cognitive Impairment diagnosis and adjusting to this condition is challenging, given the uncertain clinical trajectory surrounding progression to dementia. We aimed to explore the influence of illness perceptions and cognitive fusion on coping and emotional responses in a sample of people diagnosed with Mild Cognitive Impairment. Research design and method: A cross-sectional study of 34 participants with Mild Cognitive Impairment (47% female and 53% male; mean age 76.4 years) evaluated the relationships between cognitive impairment, illness perceptions and cognitive fusion on levels of distress and quality of life. Participants completed standardised measures for cognitive assessment, illness perceptions, cognitive fusion, depression, anxiety and quality of life. Relationships between variables were analysed using correlation, regression and conditional process analyses.

Results

At the group level, illness perceptions were found to be a stronger predictor of depression and quality of life in the current sample than objective cognitive impairment. Illness perceptions did not directly predict anxiety, rather cognitive fusion significantly mediated this relationship. Cognitive fusion also significantly mediated the relationship between illness perceptions and depression. Illness perceptions had a significant, direct effect on quality of life; however, there was no significant indirect effect via cognitive fusion. Greater fusion with threatening illness perceptions was significantly related to increased anxiety and depression. Discussion and implications: Data suggest multiple potential treatment targets in helping people diagnosed with Mild Cognitive Impairment to successfully adapt and adjust. Targeting appraisals (illness perceptions) using Cognitive Therapy is one potential treatment target. In addition, psychological treatments such as Acceptance and Commitment Therapy, which target cognitive fusion, could also warrant further investigation in this population, due to the significant indirect paths from illness perceptions to distress and quality of life, via cognitive fusion.
Collaboration and Context in the Design of Community-Engaged Research Training
Authors: Ziegahn Linda , Joosten Yvonne , Nevarez Lucinda , Hurd Thelma , Evans Jill , Dumbauld Jill , Eder Milton “Mickey”
Published: January 2020

Collaboration between academic researchers and community members, clinicians, and organizations is valued at all levels of the program development process in community-engaged health research (CEnR). This descriptive study examined a convenience sample of 30 projects addressing training in CEnR methods and strategies within the Clinical and Translational Science Awards (CTSA) consortium. Projects were selected from among posters presented at an annual community engagement conference over a 3-year period. Study goals were to learn more about how community participation in the design process affected selection of training topics, how distinct community settings influenced the selection of training formats, and the role of evaluation in preparing training participants to pursue future health research programming. Results indicated (1) a modest increase in training topics that reflected community health priorities as a result of community (as well as academic) participation at the program design stage, (2) a wide range of community-based settings for CEnR training programs, and (3) the majority of respondents conducted evaluations, which led in turn to revisions in the curricula for future training sessions. Practice and research implications are that the collaboration displayed by academic community teams around CEnR training should be traced to see if this participatory practice transfers to the design of health promotion programs. Second, collaborative training design tenets, community formats and settings, and evaluation strategies should be disseminated throughout the CTSA network and beyond. Third, common evaluative metrics and indicators of success for CEnR training programs should be identified across CTSA institutions.
Blood rheology biomarkers in sickle cell disease
Authors: Lu Madeleine , Rab Minke AE , Shevkoplyas Sergey S , Sheehan Vivien A
Published: January 2020

Sickle cell disease (SCD) is the most common inherited blood disorder, affecting approximately 100,000 patients in the U.S. and millions more worldwide. Patients with SCD experience a wide range of clinical complications, including frequent pain crises, stroke, and early mortality, all originating from a single-point mutation in the β-globin subunit. The RBC changes resulting from the sickle mutation lead to a host of rheological abnormalities that diminish microvascular blood flow, and produce severe anemia due to RBC hemolysis, and ischemia from vaso-occlusion initiated by sticky, rigid sickle RBCs. While the pathophysiology and mechanisms of SCD have been investigated for many years, therapies to treat the disease are limited. In addition to RBC transfusion, there are only two US Food and Drug Administration (FDA)-approved drugs to ameliorate SCD complications: hydroxyurea (HU) and L-glutamine (Endari™). The only curative therapy currently available is allogeneic hematopoietic stem cell transplantation (HSCT), which is generally reserved for individuals with a matched related donor, comprising only 10–15% of the total SCD population. Potentially curative advanced gene therapy approaches for SCD are under investigation in ongoing clinical trials. The ultimate goal of any curative treatment should be to repair the hemorheological abnormalities caused by SCD, and thus normalize blood flow and prevent clinical complications. Our mini-review highlights a set of key hemorheological biomarkers (and the current and emerging technologies used to measure them) that may be used to guide the development of novel curative and palliative therapies for SCD, and functionally assess outcomes.

Impact statement

Severe impairment of blood rheology is the hallmark of SCD pathophysiology, and one of the key factors predisposing SCD patients to pain crises, organ damage, and early mortality. As novel therapies emerge to treat or cure SCD, it is crucial that these treatments are functionally evaluated for their effect on blood rheology. This review describes a comprehensive panel of rheological biomarkers, their clinical uses, and the technologies used to obtain them. The described technologies can produce highly sensitive measurements of the ability of current treatments to improve blood rheology of SCD patients. The goal of curative therapies should be to achieve blood rheology biomarkers measurements in the range of sickle cell trait individuals (HbAS). The use of the panel of rheological biomarkers proposed in this review could significantly accelerate the development, optimization, and clinical translation of novel therapies for SCD.
Short chain fatty acids and methylamines produced by gut microbiota as mediators and markers in the circulatory system
Authors: Onyszkiewicz Maksymilian , Jaworska Kinga , Ufnal Marcin
Published: January 2020

Ample evidence suggests that gut microbiota-derived products affect the circulatory system functions. For instance, short chain fatty acids, that are the products of dietary fiber bacterial fermentation, have been found to dilate blood vessels and lower blood pressure. Trimethylamine, a gut bacteria metabolite of carnitine and choline, has recently emerged as a potentially toxic molecule for the circulatory system. To enter the bloodstream, microbiota products cross the gut–blood barrier, a multilayer system of the intestinal wall. Notably, experimental and clinical studies show that cardiovascular diseases may compromise function of the gut–blood barrier and increase gut-to-blood penetration of microbiota-derived molecules. Hence, the bacteria products and the gut–blood barrier may be potential diagnostic and therapeutic targets in cardiovascular diseases. In this paper, we review research on the cardiovascular effects of microbiota-produced short chain fatty acids and methylamines.

Impact statement

Despite a progress in the diagnosis and treatment of cardiovascular diseases, there are still significant gaps in understanding complex mechanisms underlying cardiovascular pathology. Increasing evidence suggests that gut microbiota products such as short chain fatty acids or methylamines may affect the circulatory system in health and disease. Hence, the microbiota-derived molecules are potential diagnostic and therapeutic targets in cardiovascular diseases. Therapeutic options may include administration of selected bacterial strains (probiotics) producing desired metabolites or administration of direct gut microbiota products.
Newburgh’s “Last Chance”: The Elusive Promise of Urban Renewal in a Small and Divided City
Authors: Pfau Ann , Sewell Stacy Kinlock
Published: January 2020

This article is a case study of failure at the federal, state, and local levels. In 1956, Newburgh, New York, undertook an ambitious, arguably oversized, urban renewal program. Between 1962 and 1974, city officials successfully cleared roughly 120 acres of prime waterfront real estate for redevelopment, displacing a largely black population. But combined with economic recession and changing federal and state policies, conflict between and among white city officials and black residents prevented reconstruction. Newburgh's greatest assets were its scenic waterfront and historic architecture. Clearance of the former led to destruction of the latter. Newburgh's waterfront remains largely empty even today.
A Novel Diagnostic Test for End-Stage Sensory Failure Associated With Diabetic Foot Ulceration: Proof-of-Principle Study
Authors: Chantelau Ernst-Adolf
Published: January 2020

Background:

Diabetic foot ulceration (DFU) affects only a subgroup of patients with diabetic neuropathy, that is, those with pain-insensitivity due to end-stage sensory failure. Pain perception failure develops insidiously and remains asymptomatic until first DFU. As loss of pain perception is clinically significant, timely detection is mandatory.

Objectives:

A novel suprathreshold pinprick pain stimulus of 512 mN force made from optical glass-fiber was explored in a prospective cross-sectional diagnostic accuracy study to detect DFU-related end-stage sensory failure.

Methods:

A total of 116 participants were studied (25 healthy people, 22 patients with diabetes without relevant complications, 19 patients with previous painful foot or leg injuries, and 50 patients with previous or active painless DFU [reference standard]). Palmar and plantar surfaces were stimulated in a standardized fashion. At the feet, the second and third toe skinfolds and the middle of the plantar arch were stimulated. Participants scored stimulated pricking discomfort or pain intensity 0 to 10 on a numerical rating scale.

Results:

At hands, intensity was rated on average 5 (1-10) [median (range)] by 114/116 participants. Per foot, participants without DFU scored 5 (1-10), while those with DFU scored 0 (0-3) ( P < .0001). At plantar toe skinfolds, the absence of pinprick pain perception detected DFU-associated sensory failure with an accuracy of 99.5% (sensitivity 99.5%, specificity 99.4%, positive likelihood ratio 248, and negative likelihood ratio 0.005).

Conclusion:

In this pilot study, nociceptive stimulation of a plantar toe skinfold with a 512 mN optical glass-fiber pinprick accurately identified DFU-associated end-stage sensory failure.
Future of Nursing 2020-2030 Philadelphia Town Hall: Lessons Shared From a Relentless School Nurse
Authors: Cogan Robin
Published: January 2020

The Robert Wood Johnson Foundation in partnership with the National Academy of Medicine held Town Meeting discussions the summer of 2019 at three sites across the country on the Future of Nursing 2030. Included in the testimony were both invited presentation and public testimony. This article is the transcript of the invited testimony of Robin Cogan, a school nurse who has established a voice for advocacy and the creator of the blog titled The Relentless School Nurse and is one of four presentations featured in this issue of the NASN School Nurse. In her January 2020 letter, NASN’s President Laurie Combe discussed the Future of Nursing 2030 and the importance of school nurse advocacy.
Unruptured giant intracavernous aneurysms untolerate internal carotid artery occlusion test: Untreated and treated with flow-diversion
Authors: Lv Xianli , Yu Jianjun , Liao Ting , Wang Jin , Wang Guihuai
Published: January 2020

Background and objective

Giant intracavernous aneurysms (GICAs) are located in extradural space; their clinical manifestation and treatment are different from other intradural aneurysms. This study reports clinical outcomes of GICAs untolerate internal carotid artery occlusion tests.

Methods

Between January 2012 and September 2017, 14 consecutive cases of GICAs untolerated internal carotid artery occlusion test were retrospectively reviewed. A total of nine patients were not treated and five patients were treated using a Pipeline Embolization Device.

Results

Of the 14 patients, 12 had compression symptoms and 2 were incidental. In nine untreated patients, during 34 months' (range, 7–64 months) follow-up, four worsened to headaches or ablepsia (more than 34 months). One patient, who presented with ophthalmoplegia and diplopia, showed spontaneous resolution of symptoms at 32-month follow-up. Symptoms in four patients remained unchanged during less than 36-month follow-up period. In five (100%, 95% confidence interval 57% to 100%) treated patients, symptoms recovered completely during 11 months' follow-up after transient worsening of mass compression.

Conclusions

GICAs frequently result in intractable cranial neuropathy requiring treatment. The Pipeline Embolization Device is an effective option for these complex aneurysms in selective cases.
Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: A multicentre study of 1117 cases
Authors: Olesen Søren S , Poulsen Jakob L , Novovic Srdan , Nøjgaard Camilla , Kalaitzakis Evangelos , Jensen Nanna M , Engjom Trond , Tjora Erling , Waage Anne , Hauge Truls , Haas Stephan L , Vujasinovic Miroslav , Barauskas Giedrius , Pukitis Aldis , Ozola‐Zālīte Imanta , Okhlobystin Alexey , Parhiala Mikael , Laukkarinen Johanna , Drewes Asbjørn M
Published: January 2020

Background

Diabetes mellitus is a common complication of chronic pancreatitis. It is traditionally considered to develop as a consequence of beta cell loss, but there might be additional factors. Recent studies have highlighted the importance of type 2 diabetes‐related risk factors in this context and population‐based studies show increased risk of diabetes following acute pancreatitis. The aim of this study was to explore multiple risk factors for diabetes in patients with chronic pancreatitis.

Methods

We conducted a multicentre, cross‐sectional study of patients with definitive chronic pancreatitis according to the M‐ANNHEIM criteria. We used multivariable logistic regression models to determine risk factors independently associated with diabetes.

Results

The study included 1117 patients of whom 457 (40.9 %) had diabetes. The mean age was 52.8 ± 14.2 years and 67% were men. On multivariate analysis, parameters indicative of beta cell loss (pancreatic calcification, exocrine insufficiency, pancreatic resection) were confirmed as independent risk factors for diabetes (allp  ≤ 0.02). In addition, type 2 diabetes‐related risk factors (dyslipidaemia and overweight/obesity) were associated with the presence of diabetes (all p  ≤ 0.002). Patients with a history of pancreatic fluid collections (indicative of previous attacks of acute pancreatitis) had a marginally increased risk of diabetes (p  = 0.07).

Conclusion

In patients with chronic pancreatitis the presence of diabetes is associated with multiple risk factors including type 2 diabetes‐related factors. Our observations attest to the understanding of this entity and may have implications for treatment.
Therapeutic potential role of exosomes for ischemic stroke
Authors: Zhu Zhihan , Kalyan Bikram Shah , Chen Lukui
Published: January 2020

Exosomes are extracellular vesicles with a diameter of 30–100 nm, which are released into the extracellular space by fusion of multivesicular and plasma membranes. These vesicles actually play a distinct role in cell communication, although they were considered as membrane debris in the past. The endosomal sorting complex required for transport (ESCRT)-dependent and ESCRT-independent mechanisms are currently considered to be involved in the sorting of exosomes, and the release of exosomes is related to the members of Rab protein family and SNARE family. In recent years, the therapeutic potential of exosomes has become apparent. For example, via the direct transplantation of exosomes, the ischemic area after stroke is reduced, and the neurological function is improved significantly. Furthermore, they can be used as effective drug delivery vehicles due to their unique characteristics such as low immunogenicity and nanometer size. In conclusion, exosomes provide a cell-free treatment for ischemic stroke.
Identification of biomarkers in common chronic lung diseases by co-expression networks and drug-target interactions analysis
Authors: Maghsoudloo Mazaher , Azimzadeh Jamalkandi Sadegh , Najafi Ali , Masoudi-Nejad Ali
Published: January 2020

Background

asthma, chronic obstructive pulmonary disease (COPD), and idiopathic pulmonary fibrosis (IPF) are three serious pulmonary diseases that contain common and unique characteristics. Therefore, the identification of biomarkers that differentiate these diseases is of importance for preventing misdiagnosis. In this regard, the present study aimed to identify the disorders at the early stages, based on lung transcriptomics data and drug-target interactions.

Methods

To this end, the differentially expressed genes were found in each disease. Then, WGCNA was utilized to find specific and consensus gene modules among the three diseases. Finally, the disease-disease similarity was analyzed, followed by determining candidate drug-target interactions.

Results

The results confirmed that the asthma lung transcriptome was more similar to COPD than IPF. In addition, the biomarkers were found in each disease and thus were proposed for further clinical validations. These genes included RBM42, STX5, and TRIM41 in asthma, CYP27A1, GM2A, LGALS9, SPI1, and NLRC4 in COPD, ATF3, PPP1R15A, ZFP36, SOCS3, NAMPT, and GADD45B in IPF, LRRC48 and CETN2 in asthma-COPD, COL15A1, GIMAP6, and JAM2 in asthma-IPF and LMO7, TSPAN13, LAMA3, and ANXA3 in COPD-IPF. Finally, analyzing drug-target networks suggested anti-inflammatory candidate drugs for treating the above mentioned diseases.

Conclusion

In general, the results revealed the unique and common biomarkers among three chronic lung diseases. Eventually, some drugs were suggested for treatment purposes.
Trophoblast cell differentiation in the bovine placenta: differentially expressed genes between uninucleate trophoblast cells and trophoblast giant cells are involved in the composition and remodeling of the extracellular matrix and O-glycan biosynthesis
Authors: Polei Marina , Günther Juliane , Koczan Dirk , Fürbass Rainer
Published: January 2020

Background

In the bovine placenta, intimate fetomaternal contacts are restricted to discrete placentomes. Here, widely branched fetal chorionic villi interdigitate with corresponding maternal caruncular crypts. The fetal trophoblast epithelium covering the chorionic villi consists of approximately 80% uninucleate trophoblast cells (UTCs) and 20% binuclear trophoblast giant cells (TGCs). The weakly invasive TGCs migrate toward the caruncle epithelium and eventually fuse with individual epithelial cells to form short-lived fetomaternal hybrid cells. In this way, molecules of fetal origin are transported across the placental barrier and released into the maternal compartment. The UTC/TGC ratio in the trophoblast remains almost constant because approximately as many new TGCs are produced from UTCs as are consumed by the fusions. The process of developing TGCs from UTCs was insufficiently understood. Therefore, we aimed to detect differentially expressed genes (DEGs) between UTCs and TGCs and identify molecular functions and biological processes regulated by DEGs.

Results

We analyzed gene expression patterns in virtually pure UTC and TGC isolates using gene arrays and detected 3193 DEGs (p < 0.05; fold change values < − 1.5 or > 1.5). Of these DEGs, 1711 (53.6%) were upregulated in TGCs and 1482 (46.4%) downregulated. Gene Ontology (GO) analyses revealed that molecular functions and biological processes regulated by DEGs are related to the extracellular matrix (ECM) and its interactions with cellular receptors, cell migration and signal transduction. Furthermore, there was some evidence that O-glycan biosynthesis in TGCs may produce sialylated short-chain O-glycans (Tn antigen, core 1 O-glycans), while the synthesis of other O-glycan core structures required for the formation of complex (i.e., branched and long-chain) O-glycans appears to be decreased in TGCs.

Conclusion

The differentiation of UTCs into TGCs particularly regulates genes that enable trophoblast cells to interact with their environment. Significant differences between UTCs and TGCs in ECM composition indicate reduced anchoring of TGCs in the surrounding matrix, which might contribute to their migration and their weakly invasive interaction with the maternal endometrium. Furthermore, increased expression of sialylated short chain O-glycans by TGCs could facilitate the modulation of maternal immune tolerance.
Capturing multiple interaction effects in L1 and L2 object-naming reaction times in healthy bilinguals: a mixed-effects multiple regression analysis
Authors: Schramm Severin , Tanigawa Noriko , Tussis Lorena , Meyer Bernhard , Sollmann Nico , Krieg Sandro M.
Published: January 2020

Background

It is difficult to set up a balanced higher-order full-factorial experiment that can capture multiple intricate interactions between cognitive and psycholinguistic factors underlying bilingual speech production. To capture interactions more fully in one study, we analyzed object-naming reaction times (RTs) by using mixed-effects multiple regression.

Methods

Ten healthy bilinguals (median age: 23 years, seven females) were asked to name 131 colored pictures of common objects in each of their languages. RTs were analyzed based on language status, proficiency, word choice, word frequency, word duration, initial phoneme, time series, and participant’s gender.

Results

Among five significant interactions, new findings include a facilitating effect of a cross-language shared initial phoneme (mean RT for shared phoneme: 974 ms vs. mean RT for different phoneme: 1020 ms), which profited males less (mean profit: 10 ms) than females (mean profit: 47 ms).

Conclusions

Our data support language-independent phonological activation and a gender difference in inhibitory cognitive language control. Single word production process in healthy adult bilinguals is affected by interactions among cognitive, phonological, and semantic factors.
Comparative transcriptome analysis reveals the molecular regulation underlying the adaptive mechanism of cherry (Cerasus pseudocerasus Lindl.) to shelter covering
Authors: Tian Tian , Qiao Guang , Wen Zhuang , Deng Bin , Qiu Zhilang , Hong Yi , Wen Xiaopeng
Published: January 2020

Background

Rain-shelter covering is widely applied during cherry fruit development in subtropical monsoon climates with the aim of decreasing the dropping and cracking of fruit caused by excessive rainfall. Under rain-shelter covering, the characteristics of the leaves and fruit of the cherry plant may adapt to the changes in the microclimate. However, the molecular mechanism underlying such adaptation remains unclear, although clarifying it may be helpful for improving the yield and quality of cherry under rain-shelter covering.

Results

To better understand the regulation and adaptive mechanism of cherry under rain-shelter covering, 38,621 and 3584 differentially expressed genes were identified with a combination of Illumina HiSeq and single-molecule real-time sequencing in leaves and fruits, respectively, at three developmental stages. Among these, key genes, such as those encoding photosynthetic-antenna proteins (Lhca and Lhcb) and photosynthetic electron transporters (PsbP, PsbR, PsbY, and PetF), were up-regulated following the application of rain-shelter covering, leading to increased efficiency of light utilization. The mRNA levels of genes involved in carbon fixation, namely, rbcL and rbcS, were clearly increased compared with those under shelter-free conditions, resulting in improved CO2 utilization. Furthermore, the transcription levels of genes involved in chlorophyll (hemA, hemN, and chlH) and carotenoid synthesis (crtB, PDS, crtISO, and lcyB) in the sheltered leaves peaked earlier than those in the unsheltered leaves, thereby promoting organic matter accumulation in leaves. Remarkably, the expression levels of key genes involved in the metabolic pathways of phenylpropanoid (PAL, C4H, and 4CL) and flavonoid (CHS, CHI, F3’H, DFR, and ANS) in the sheltered fruits were also up-regulated earlier than of those in the unsheltered fruits, conducive to an increase in anthocyanin content in the fruits.

Conclusions

According to the physiological indicators and transcriptional expression levels of the related genes, the adaptive regulation mechanism of cherry plants was systematically revealed. These findings can help understand the effect of rain-shelter covering on Chinese cherry cultivation in rainy regions.
The TRANSFER Approach for assessing the transferability of systematic review findings
Authors: Munthe-Kaas Heather , Nøkleby Heid , Lewin Simon , Glenton Claire
Published: January 2020

Background

Systematic reviews are a key input to health and social welfare decisions. Studies included in systematic reviews often vary with respect to contextual factors that may impact on how transferable review findings are to the review context. However, many review authors do not consider the transferability of review findings until the end of the review process, for example when assessing confidence in the evidence using GRADE or GRADE-CERQual. This paper describes the TRANSFER Approach, a novel approach for supporting collaboration between review authors and stakeholders from the beginning of the review process to systematically and transparently consider factors that may influence the transferability of systematic review findings.

Methods

We developed the TRANSFER Approach in three stages: (1) discussions with stakeholders to identify current practices and needs regarding the use of methods to consider transferability, (2) systematic search for and mapping of 25 existing checklists related to transferability, and (3) using the results of stage two to develop a structured conversation format which was applied in three systematic review processes.

Results

None of the identified existing checklists related to transferability provided detailed guidance for review authors on how to assess transferability in systematic reviews, in collaboration with decision makers. The content analysis uncovered seven categories of factors to consider when discussing transferability. We used these to develop a structured conversation guide for discussing potential transferability factors with stakeholders at the beginning of the review process. In response to feedback and trial and error, the TRANSFER Approach has developed, expanding beyond the initial conversation guide, and is now made up of seven stages which are described in this article.

Conclusions

The TRANSFER Approach supports review authors in collaborating with decision makers to ensure an informed consideration, from the beginning of the review process, of the transferability of the review findings to the review context. Further testing of TRANSFER is needed.
Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease
Authors: Ge Peicong , Zhang Qian , Ye Xun , Liu Xingju , Deng Xiaofeng , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong
Published: January 2020

Background

The research on postoperative collateral formation for hemorrhagic moyamoya disease (MMD) evaluated by using digital subtraction angiography (DSA) is limited. Our study objective was to investigate the postoperative collateral formation after indirect bypass for hemorrhagic MMD.

Methods

All consecutive inpatients with hemorrhagic MMD who received indirect bypass at Beijing Tiantan Hospital, Capital Medical University from January 2010 through December 2018 were screened. The site of the hemorrhage was classified as either anterior or posterior. Postoperative collateral formation was evaluated on lateral views using the Matsushima scale. Univariate and multivariate logistic regression analyses were carried out to determine the factors influencing postoperative collateral formation.

Results

Six-four patients (64 hemispheres) were included in this study. After a median 8.5 months DSA follow-up, 14 (21.9%) hemispheres had grade A collateral circulation, 13 (20.3%) had grade B, and 37 (57.8%) had grade C. Twenty-seven (42.2%) hemispheres had good postoperative collateral formation and 37 (57.8%) had poor postoperative collateral formation. The univariate logistic regression analyses showed that age at operation (OR, 0.954; 95% CI, 0.908–1.003; p = 0.066), hemorrhagic site (OR, 4.694; 95% CI, 1.582–13.923; p = 0.005), and PCA involvement (OR, 3.474; 95% CI, 0.922–13.086; p = 0.066) may effect postoperative collateral formation. The multivariate logistic regression analyses showed that only anterior hemorrhage (OR, 5.222; 95% CI, 1.605–16.987; p = 0.006) was significantly related to good postoperative collateral formation.

Conclusion

Anterior hemorrhage was significantly related to good postoperative collateral formation after indirect bypass.
A case report of adult-onset Alexander disease clinically presenting as Parkinson’s disease: is the comorbidity associated with genetic susceptibility?
Authors: Park Jongkyu , Park Sung-Tae , Kim Jieun , Kwon Kyum-Yil
Published: January 2020

Background

Alexander disease is a rare neurological disease characterized by progressive spastic quadriparesis and bulbar palsy. Moreover, certain patients with adult-onset Alexander disease were often misdiagnosed as other neurodegenerative disorders.

Case presentation

Herein, we report an adult a 58-year-old woman presented with typical parkinsonism with good levodopa-responsiveness. The patient’s dopamine transporter scanning showed significant striatal depletion, while her brain magnetic resonance imaging revealed bilateral tadpole shape of medulla oblongata and bilateral high signal intensity at both cerebellar dentate nuclei in T2-weighted images, suggesting the possibility of a genetic disorder beyond Parkinson’s disease. The patient’s genetic test resulted in known pathogenic glial fibrillary acidic protein variant, indicating Alexander disease.

Conclusion

This unique case highlights genetically diagnosed Alexander disease may present with clinical Parkinson’s disease.