bluuebunny/crossref_metadata_2025 huggingface dataset:
Preclinical Evaluation of Gilteritinib on NPM1-ALK–Driven Anaplastic Large Cell Lymphoma Cells
Authors: Kuravi Sudhakiranmayi , Cheng Janice , Fangman Gabrielle , Polireddy Kishore , McCormick Sophia , Lin Tara L. , Singh Anurag K. , Abhyankar Sunil , Ganguly Siddhartha , Welch Danny R. , Jensen Roy A. , McGuirk Joseph P. , Balusu Ramesh
Published: January 2021

Anaplastic large cell lymphoma (ALCL) is an aggressive type of non-Hodgkin lymphoma. More than three-fourths of anaplastic lymphoma kinase (ALK)-positive ALCL cases express the nucleophosmin 1 (NPM1)-ALK fusion gene as a result of t(2;5) chromosomal translocation. The homodimerization of NPM1-ALK fusion protein mediates constitutive activation of the chimeric tyrosine kinase activity and downstream signaling pathways responsible for lymphoma cell proliferation and survival. Gilteritinib is a tyrosine kinase inhibitor recently approved by the FDA for the treatment of FMS-like tyrosine kinase mutation–positive acute myeloid leukemia. In this study, we demonstrate for the first time gilteritinib-mediated growth inhibitory effects on NPM1-ALK–driven ALCL cells. We utilized a total of five ALCL model cell lines, including both human and murine. Gilteritinib treatment inhibits NPM1-ALK fusion kinase phosphorylation and downstream signaling, resulting in induced apoptosis. Gilteritinib-mediated apoptosis was associated with caspase 3/9, PARP cleavage, the increased expression of proapoptotic protein BAD, and decreased expression of antiapoptotic proteins, survivin and MCL-1. We also found downregulation of fusion kinase activity resulted in decreased c-Myc protein levels. Furthermore, cell-cycle analysis indicated gilteritinib induced G0–G1-phase cell-cycle arrest and reduced CD30 expression. In summary, our preclinical studies explored the novel therapeutic potential of gilteritinib in the treatment of ALCL cells expressing NPM1-ALK and potentially in other ALK or ALK fusion–driven hematologic or solid malignancies.

Implications:

Our preclinical results explore the use of gilteritinib for the treatment of NPM1-ALK–driven ALCL cells and pave a path for developing future clinical trials.
The Effect of Metformin in Treatment of Adenomas in Patients with Familial Adenomatous Polyposis
Authors: Park Jae Jun , Kim Byung Chang , Hong Sung Pil , Seo Yoojeong , Lee Hye Sun , Park Young Sook , Na Soo-Young , Park Sung Chul , Park Jongha , Kim Jae Hak , Moon Chang Mo , Huh Kyu Chan , Park Soo Jung , Cheon Jae Hee , Kim Won Ho , Kim Tae Il
Published: January 2021

Familial adenomatous polyposis (FAP) is a hereditary disease characterized by the development of numerous colorectal adenomas in young adults. Metformin, an oral diabetic drug, has been shown to have antineoplastic effects and a favorable safety profile. We performed a randomized, double-blind, controlled trial to evaluate the efficacy of metformin on the regression of colorectal and duodenal adenoma in patients with FAP. Thirty-four FAP patients were randomly assigned in a 1:2:2 ratio to receive placebo, 500 mg metformin, or 1,500 mg metformin per day orally for 7 months. The number and size of polyps and the global polyp burden were evaluated before and after the intervention. This study was terminated early based on the results of the interim analysis. No significant differences were determined in the percentage change of colorectal and duodenal polyp number over the course of treatment among the three treatment arms (P = 0.627 and P = 1.000, respectively). We found no significant differences in the percentage change of colorectal or duodenal polyp size among the three groups (P = 0.214 and P = 0.803, respectively). The overall polyp burdens of the colorectum and duodenum were not significantly changed by metformin treatment at either dosage. Colon polyps removed from the metformin-treated patients showed significantly lower mTOR signal (p-S6) expression than those from patients in the placebo arm. In conclusion, 7 months of treatment with 500 mg or 1,500 mg metformin did not reduce the mean number or size of polyps in the colorectum or duodenum in FAP patients (ClinicalTrials.gov ID: NCT01725490).

Prevention Relevance:

A 7-month metformin treatment (500 mg or 1,500 mg) did not reduce the number or size of polyps in the colorectum or duodenum of FAP patients as compared to placebo. These results do not support the use of metformin to promote regression of intestinal adenomas in FAP patients.
Lúpus Eritematoso Sistêmico: relação entre os diferentes tratamentos e evolução clínica
Authors: Macedo Rafaela Melo , ´Ribeiro Garcia Thaís , Castanheira Eduarda Pereira , Costa Noleto Débora , Freitas Thales Vieira Medeiros , Freitas Aline de Araújo
Published: January 2021

O Lúpus Eritematoso Sistêmico (LES) é uma doença inflamatória crônica de origem autoimune que apresenta manifestações clínicas variáveis, sendo progressiva e potencialmente fatal, se não tratado. Os tratamentos padrões incluem antimaláricos, corticosteroides (CS) e imunossupressores. No entanto, apesar do melhor entendimento do processo da doença, ainda há uma necessidade significativa e não atendida de novo tratamento devido ao alto risco continuado de mortalidade e progressão de danos aos órgãos. Assim, o objetivo do presente estudo foi fazer um levantamento bibliográfico acerca dos diferentes tratamentos publicados para o manejo do LES relacionando com a melhora clínica do paciente. Para tanto, utilizou-se as bases de dados Lilacs, SciELO, PubMed e Google Acadêmico e os Descritores em Ciências da Saúde (DeCS) utilizados foram: “lúpus eritematoso sistêmico”, “terapêutica” e “qualidade de vida”. Os artigos selecionados foram publicados em língua inglesa e portuguesa, entre os anos de 2014 e 2020. As referências encontradas permitiram constatar que os antimaláricos e a infusão de plasma fresco congelado são os recursos terapêuticos com maior eficácia. Além disso, a suplementação com vitamina D apresentou mostrou ter função benéfica sob o quadro clínico de pacientes lúpicos. Outro tratamento efetivo para as lesões dermáticas foi a utilização de laser de corante pulsado. Desse modo, são necessários mais estudos acerca da demonstração da eficácia dos diferentes tratamentos para o LES, a fim de elucidar a eficácia e a segurança das diversas terapias utilizadas.
Manifestações clínicas e laboratoriais do novo coronavírus (COVID-19) em gestantes e análise do possível risco de transmissão vertical intrauterina: uma revisão sistemática
Authors: Pereira Otávio Augusto , Wendt Guilherme Welter
Published: January 2021

Os números da pandemia do novo coronavírus (COVID-19) ultrapassaram os outros membros da família Coronaviridae acumulando até o presente, mais de 24 milhões de casos da doença. O conhecimento adquirido pelos surtos anteriores sugere que gestantes e seus fetos são mais suscetíveis a prognósticos indesejáveis. Dessa forma, a presente revisão sistemática tem como objetivo avaliar as principais manifestações da infecção pelo vírus SARS-CoV-2 em gestantes e a possibilidade de transmissão vertical. Para isso, incluiu manuscritos que, ao todo, apresentavam dados de 205 gestantes e 76 neonatos. Entre os resultados, foi evidenciado que os sintomas apresentados pelas gestantes eram os mesmos que pacientes não grávidas, assim como as alterações laboratoriais, como linfopenia e a opacidade em vidro-fosco na tomografia computadorizada. No total, foram realizadas 163 cesáreas com a indicação de estado respiratório comprometido, com óbito de apenas uma paciente. Em relação aos resultados dos testes do novo coronavírus em neonatos, apenas um neonato, com seu estudo publicado em julho de 2020, encaixou-se nos critérios diagnósticos de infecção congênita por SARS-CoV-2. Os outros 5 neonatos que se apresentaram positivo logo após o nascimento, não apresentavam os testes corretos e o risco de infecção durante o parto nas primeiras horas não foi descartado. Dessa forma, estudos são necessários para embasar o exato risco de transmissão vertical, avaliando a influência da carga viral materna e outros dados como a idade gestacional de maior risco para a transmissão.
Economia circular: preservação de Recursos naturais e práticas urbanas. Uma análise comparativa (Tours, França e Recife, Brasil)
Authors: Carrière Jean-Paul , Diniz Fabiano , Mora Luis de lade la
Published: January 2021

A economia circular (EC) é definida como uma resposta ao desafio do esgotamento dos recursos naturais em escala global e, assim, relaciona-se com diferentes campos de ação e com todo o ciclo de vida dos produtos. Ela inscreve-se na perspectiva do desenvolvimento sustentável dos territórios. Sua implementação depende de uma abordagem que valorize a proximidade organizacional e geográfica, notadamente urbana... Uma diferença notável emergedo cotejamento dos casos do Recife, no Brasil, e de Tours Métropole, na França, no que diz respeito ao peso relativo da informalidade nas operações levadas a efeito nesse campo, o que nos leva a questionar a diversidade de formas assumidas pela EC. Por outro lado, nos dois casos estudados, ainda é prematuro falar de uma estratégia global de implementação da EC em escala urbana.
Nature et Ville : L’impossible compromis?
Authors: Hamdouch Abdelillah
Published: January 2021

L’histoire des relations entre nature et urbanisation est tout sauf un “long fleuve tranquille“. “Faire la ville“ a depuis les origines de l’urbanisation signifié utiliser, contrôler voire asservir la Nature (certes, à des degrés divers) pour les besoins de l’Homme se voyant désormais “urbain“. Cependant, jusqu’au début de l’industrialisation en Europe il y a un peu plus de deux siècles, l’intrusion de la ville dans la nature est restée somme toute mesurée, l’économie urbaine naissante dépendant encore très largement de ressources forestières, fluviales ou maritimes, et de productions agricoles en grande partie “de proximité“
A propos des relations entre nature et ville . Bilan des dialogues franco-lusophones de Tours: es questionnements pour des recherches futures
Authors: Carrière Jean-Paul
Published: January 2021

Les journées franco-lusophones organisées à Tours du 13 au 15 juin 2018, et dédiées à la question des rapports entre nature et ville, s’inscrivent dans le cadre du programme “Attilio“ et de la cinquième édition des dialogues en aménagement et urbanisme. Dans la première partie de ce texte, on rappelle la genèse de ces rencontres, pour ensuite présenter les axes thématiques abordés lors de ces journées. Cette présentation peut être lue comme une invitation adressée aux chercheurs en urbanisme des deux aires culturelles et linguistiques de la francophonie et de la lusophonie à continuer à explorer ces axes de réflexion
Questões da Verticalização Urbana na França e no Brasil. Projeto Highrise
Authors: Alves Manoel Rodrigues , Camargo Camila Moreno de , Cardozo Luiana
Published: January 2021

Entende-se que o espaço urbano seja produto e produtor das dinâmicas que regem o seu tempo e que, portanto, reflita as contradições de seu processo de produção. Neste momento, este processo encontra-se, via de regra, condicionado por uma articulação entre Estado e agentes privados que promove oposições e tensões entre domínios, legalidades, usos e práticas urbanas, demandando novas interpretações das relações estabelecidas. O projeto ‘Highrise Living and the Inclusive City’ investiga o processo de verticalização em São Paulo, Brasil e Lyon, França, a partir determinados eixos e escalas de análise, cruzando processos metodológicos que abrangem análises espaciais e a construção de cartografias críticas pós-representacionais e narrativas espaço-temporais. Essa comunicação apresenta os resultados da pesquisa em escalas mais reduzidas.
Chromatin Accessibility of Human Mitral Valves and Functional Assessment of MVP Risk Loci
Authors: Kyryachenko Sergiy , Georges Adrien , Yu Mengyao , Barrandou Takiy , Guo Lilong , Bruneval Patrick , Rubio Tony , Gronwald Judith , Baraki Hassina , Kutschka Ingo , Aras Kedar K. , Efimov Igor R. , Norris Russel A. , Voigt Niels , Bouatia-Naji Nabila
Published: January 2021

Rationale:

Mitral valve prolapse (MVP) is a common valvopathy that leads to mitral insufficiency, heart failure, and sudden death. Functional genomic studies in mitral valves are needed to better characterize MVP-associated variants and target genes.

Objective:

To establish the chromatin accessibility profiles and assess functionality of variants and narrow down target genes at MVP loci.

Methods and Results:

We mapped the open chromatin regions in nuclei from 11 human pathogenic and 7 nonpathogenic mitral valves by an assay for transposase-accessible chromatin with high-throughput sequencing. Open chromatin peaks were globally similar between pathogenic and nonpathogenic valves. Compared with the heart tissue and cardiac fibroblasts, we found that MV-specific assay for transposase-accessible chromatin with high-throughput sequencing peaks are enriched near genes involved in extracellular matrix organization, chondrocyte differentiation, and connective tissue development. One of the most enriched motifs in MV-specific open chromatin peaks was for the nuclear factor of activated T cells family of TFs (transcription factors) involved in valve endocardial and interstitial cell formation. We also found that MVP-associated variants were significantly enriched (
P
<0.05) in mitral valve open chromatin peaks. Integration of the assay for transposase-accessible chromatin with high-throughput sequencing data with risk loci, extensive functional annotation, and gene reporter assay suggest plausible causal variants for rs2641440 at the
SMG6/SRR
locus and rs6723013 at the
IGFBP2/IGFBP5/TNS1
locus. CRISPR-Cas9 deletion of the sequence including rs6723013 in human fibroblasts correlated with increased expression only for
TNS1
. Circular chromatin conformation capture followed by high-throughput sequencing experiments provided evidence for several target genes, including
SRR
,
HIC1
, and
DPH1
at the
SMG6/SRR
locus and further supported
TNS1
as the most likely target gene on chromosome 2.

Conclusions:

Here, we describe unprecedented genome-wide open chromatin profiles from human pathogenic and nonpathogenic MVs and report specific gene regulation profiles, compared with the heart. We also report in vitro functional evidence for potential causal variants and target genes at MVP risk loci involving established and new biological mechanisms.

Graphic Abstract:

A
graphic abstract
is available for this article.
Implicit Regularization and Momentum Algorithms in Nonlinearly Parameterized Adaptive Control and Prediction
Authors: Boffi Nicholas M. , Slotine Jean-Jacques E.
Published: January 2021

Stable concurrent learning and control of dynamical systems is the subject of adaptive control. Despite being an established field with many practical applications and a rich theory, much of the development in adaptive control for nonlinear systems revolves around a few key algorithms. By exploiting strong connections between classical adaptive nonlinear control techniques and recent progress in optimization and machine learning, we show that there exists considerable untapped potential in algorithm development for both adaptive nonlinear control and adaptive dynamics prediction. We begin by introducing first-order adaptation laws inspired by natural gradient descent and mirror descent. We prove that when there are multiple dynamics consistent with the data, these non-Euclidean adaptation laws implicitly regularize the learned model. Local geometry imposed during learning thus may be used to select parameter vectors—out of the many that will achieve perfect tracking or prediction—for desired properties such as sparsity. We apply this result to regularized dynamics predictor and observer design, and as concrete examples, we consider Hamiltonian systems, Lagrangian systems, and recurrent neural networks. We subsequently develop a variational formalism based on the Bregman Lagrangian. We show that its Euler Lagrange equations lead to natural gradient and mirror descent-like adaptation laws with momentum, and we recover their first-order analogues in the infinite friction limit. We illustrate our analyses with simulations demonstrating our theoretical results.
The Effect of Class Imbalance on Precision-Recall Curves
Authors: Williams Christopher K. I.
Published: January 2021

In this note, I study how the precision of a binary classifier depends on the ratio r of positive to negative cases in the test set, as well as the classifier's true and false-positive rates. This relationship allows prediction of how the precision-recall curve will change with r, which seems not to be well known. It also allows prediction of how Fβ and the precision gain and recall gain measures of Flach and Kull (2015) vary with r.
Deep Network With Approximation Error Being Reciprocal of Width to Power of Square Root of Depth
Authors: Shen Zuowei , Yang Haizhao , Zhang Shijun
Published: January 2021

A new network with super-approximation power is introduced. This network is built with Floor (⌊x⌋) or ReLU (max{0,x}) activation function in each neuron; hence, we call such networks Floor-ReLU networks. For any hyperparameters N∈N+ and L∈N+, we show that Floor-ReLU networks with width max{d,5N+13} and depth 64dL+3 can uniformly approximate a Hölder function f on [0,1]d with an approximation error 3λdα/2N-αL, where α∈(0,1] and λ are the Hölder order and constant, respectively. More generally for an arbitrary continuous function f on [0,1]d with a modulus of continuity ωf(·), the constructive approximation rate is ωf(dN-L)+2ωf(d)N-L. As a consequence, this new class of networks overcomes the curse of dimensionality in approximation power when the variation of ωf(r) as r→0 is moderate (e.g., ωf(r)≲rα for Hölder continuous functions), since the major term to be considered in our approximation rate is essentially d times a function of N and L independent of d within the modulus of continuity.
Shifting Priorities: Are Attitudes Changing at the International Criminal Court about Trials in absentia?
Authors: Wheeler Caleb H.
Published: January 2021

A recent decision by the International Criminal Court’s Appeals Chamber in the Gbagbo and Blé Goudé case raised the possibility of a shift away from the long-standing practice of only holding trial in the presence of the accused. The final paragraphs of the 28 May 2020 decision asserts that any future trial proceedings in the Gbagbo et al. case could be held in the absence of the defendants should Mr Gbagbo and Mr Blé Goudé be released from custody and then later fail to appear for trial. This article examines the Appeals Chamber’s decision in light of the Court’s Statute, existing jurisprudence at the icc and within the larger context of international criminal law. It concludes that the Appeals Chamber’s decision fails to properly understand the right to be present at trial as it exists in the Rome Statute nor does it comply with any identified general principle of law.
Climatology of Borneo Vortices in the HadGEM3-GC3.1 General Circulation Model
Authors: Liang Ju , Catto Jennifer L. , Hawcroft Matthew , Hodges Kevin I. , Tan Mou Leong , Haywood James M.
Published: January 2021

Borneo vortices (BVs) are intense precipitating winter storms that develop over the equatorial South China Sea and strongly affect the weather and climate over the western Maritime Continent because of their association with deep convection and heavy rainfall. In this study, the ability of the Hadley Centre Global Environment Model 3–Global Coupled, version 3.1 (HadGEM3-GC3.1), global climate model to simulate the climatology of BVs at different horizontal resolutions is examined using an objective feature-tracking algorithm. The HadGEM3-GC3.1 at the N512 (25 km) horizontal resolution simulates BVs with well-represented characteristics, including their frequency, spatial distribution, and lower-tropospheric structures when compared with BVs identified in a climate reanalysis, whereas the BVs in the N96 (~135 km) and N216 (~65 km) simulations are much weaker and less frequent. Also, the N512 simulation better captures the contribution of BVs to the winter precipitation in Borneo and the Malay Peninsula when compared with precipitation from a reanalysis data and from observations, whereas the N96 and N216 simulations underestimate this contribution because of the overly weak low-level convergence of the simulated BVs. The N512 simulation also exhibits an improved ability to reproduce the modulation of BV activity by the occurrence of northeasterly cold surges and active phases of the Madden–Julian oscillation in the region, including increased BV track densities, intensities, and lifetimes. A sufficiently high model resolution is thus found to be important to realistically simulate the present-climate precipitation extremes associated with BVs and to study their possible changes in a warmer climate.
The Child Maltreatment Prevention Landscape: Where Are We Now, and Where Should We Go?
Authors: Jones Harden Brenda , Simons Cassandra , Johnson-Motoyama Michelle , Barth Richard
Published: January 2021

Child maltreatment calls for a broad range of preventative policies and practices, but limited governmental funding and leadership has been devoted to the problem. Effective strategies to prevent maltreatment exist, but they have had limited uptake in the child welfare system. In this article, we trace how government responsibility for the prevention of child maltreatment became centered within the nation’s child protection response. Further, we discuss developments in prevention science, review the existing literature on the effectiveness of a range of prevention strategies, and present a public health approach to prevention. The article concludes with a set of recommendations to inform future efforts to prevent child maltreatment through approaches that seek to expand capacity for the implementation of evidence-based prevention programs, while addressing the adverse community experiences that exacerbate risk for child maltreatment.
The influence of peer and coach relationships in after-school sports on perceptions of school climate
Authors: Ross Allison , Legg Eric , Wilson Kevin
Published: January 2021

Objective:

Sport is an important source of physical, social and emotional health and well-being among children. Sports participation at school may provide young people with the opportunity to build interpersonal skills and develop supportive social relationships with peers and adults, which may translate to positive experiences during the school day. School climate represents the relationships, values and beliefs within a school system and is associated with positive social, emotional and psychological health outcomes. This research examines the influence of social relationships developed during an after-school sports programme on indicators of school climate.

Method:

Students in grades 4–8 ( n = 230) at a school in Phoenix (Arizona) completed an online survey to measure perceptions of peer and coach relationships in after-school sports and indicators of school climate in the form of engagement with students, teachers and the school itself and perceptions of the school environment. Associations between sports relationships and school engagement and environment were examined through structural equation modelling (SEM).

Results:

Feeling coaches care about players and feeling like part of a team were positively associated with reported levels of school engagement. Feeling like other students shared similar values during sports, feeling a sense of belonging and feeling that coaches cared were associated with positive perceptions of school environment.

Conclusion:

Participation in an after-school sports programme can provide an opportunity for young people to develop positive social relationships with peers and coaches which may contribute to positive perceptions of the learning environment and student engagement during the school day. Findings support efforts to increase opportunities and accessibility to sports during the school day.
Successful Use of Aspirin, Apixaban, and Viscoelastography in a Patient with Severe COVID Disease and Allergy to Porcine Products
Authors: Reeder Jacob A. , Reynolds Tessa R. , Gilbert Brian W.
Published: January 2021

Coagulation abnormalities are frequently described in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Common thromboprophylaxis and anticoagulation treatment strategies include the use of heparinoid therapy. We describe a 57-year-old woman with an allergy to porcine products that was started on apixaban for anticoagulation therapy given her allergy profile and need for venous thromboembolism prophylaxis. Apixaban and aspirin therapy were optimized with the support of serial viscoelastography and platelet function assays. Our patient experienced respiratory failure requiring intubation for 7 days but was successfully weaned to room air, tolerated a regular diet, and ultimately discharged to home after a 17-day hospital course. Here we report the safe and successful use of aspirin, apixaban, and viscoelastography for COVID-19-associated coagulopathy.
Book review: B. B. Mohanty, Agrarian Transformation in Western India: Economic Gains and Social Costs
Authors: Mishra Deepak K.
Published: January 2021

B. B. Mohanty, Agrarian Transformation in Western India: Economic Gains and Social Costs. New Delhi: Routledge, 2019, 386 pp., ₹1,495 (hardback). ISBN: 978-0367247294.
Professor Arvind Manilal Shah: Researcher, Teacher and Institution Builder
Authors: Patel Tulsi
Published: January 2021

The shock of Professor A. M. Shah’s (AMS) demise is fresh in our minds as is his memory as an interactive, alert, productive and disciplined scholar at the ripe age of 89. This article tries to summarise his enormous contribution to the discipline of sociology in India. First, it takes up his path-breaking, analytically sharp mind towards conceptual clarity to match with empirical data that questioned many prevailing assumptions. He put forth the household dimension as the processual dimension of family in India, caste division as a feature of many urban castes, besides hierarchy, which alone was assumed to characterise caste in India. Next, it looks at his brand of work with historical and contemporary empirical perspective in the areas of kinship, marriage, lineage, old age and family policy, religion and sects through his research publications. Next, it describes AMS as a simple and upright person and a dedicated teacher who enjoyed teaching and focused on clarity and understanding without fashionable jargon. His strict but compassionate and no-nonsense approach towards students contributed also to the high status of sociology in the Delhi University. This is followed by his selfless commitment to academic administration in the Delhi University and wider institution-building acumen that benefitted Indian Sociological Society among others.
Simulating the Fiscal Impact of Anti-Obesity Medications as an Obesity Reduction Strategy
Authors: Kabiri Mina , Sexton Ward Alison , Ramasamy Abhilasha , Kee Rebecca , Ganguly Rahul , Smolarz Brian Gabriel , Zvenyach Tracy , Baumgardner James R. , Goldman Dana P.
Published: January 2021

While substantial public health investment in anti-smoking initiatives has had demonstrated benefits on health and fiscal outcomes, similar investment in reducing obesity has not been undertaken, despite the substantial burden obesity places on society. Anti-obesity medications (AOMs) are poorly prescribed despite evidence that weight loss is not sustained using other strategies alone.

We used a simulation model to estimate the potential impact of 100% uptake of AOMs on Medicare and Medicaid spending, disability payments, and taxes collected relative to status quo with negligible AOM use. Relative to status quo, AOM use simulation would result in Medicare and Medicaid savings of $231.5 billion and $188.8 billion respectively over 75 years. Government tax revenues would increase by $452.8 billion. Overall, the net benefit would be $746.6 billion. Anti-smoking efforts have had substantial benefits for society. A similar investment in obesity reduction, including broad use of AOMs, should be considered.
The effects of mometasone furoate and strontium chloride in a rat model of allergic rhinitis
Authors: Altuntaş Emine Elif , Doğan Ömer Tamer , Saraç Bülent , Turgut Nergiz Hacer , Durmuş Kasım , Akyol Melih
Published: January 2021

Neurogenic inflammation plays a role in the pathophysiology of allergic rhinitis. Highly effective in reducing the sensory irritation caused by some substances, strontium salts directly affect C-type nerve fibers. The aim of this study was to compare the efficacy of mometasone furoate and strontium chloride on early-phase symptoms in a rat model of allergic rhinitis. Wistar albino rats (n = 24) were randomly divided into three groups: the mometasone group, receiving 1 μg mometasone furoate (2 µl/site); the strontium 3% group, receiving 3% strontium chloride (2 μl/site); and the strontium 5% group, receiving 5% strontium chloride (2 μl/site). To induce significant nasal symptoms of allergic rhinitis, 5 µmol of histamine dihydrochloride (HDC) (2 µl/site) was administered. Symptoms of allergic rhinitis were recorded as frequencies of sneezing and nasal rubbing during a 15-minute interval. On days 1 and 2, respectively, 0.9% sodium chloride (NaCl) (2 μl/site to each nasal cavity) and HDC were administered in all of the study groups. On days 3 and 4, the study drugs were administered 10 and 30 minutes before the administration of HDC. On day 5, the study drugs were administered 10 minutes after the administration of HDC. The results of the present study revealed that when strontium chloride or mometasone furoate was administered 30 minutes before the onset of symptoms, a significant decrease was observed in sneezing and nasal rubbing. The number of sneezing occurrences was significantly lower and the number of nasal rubbing occurrences was higher in the strontium 3% group compared to the groups in which mometasone furoate and 5% strontium chloride were administered after onset of symptoms. Recent studies have investigated the efficacy and safety of strontium chloride nasal drops compared with common pharmacologic treatments of allergic rhinitis. These studies have revealed that allergic rhinitis can be successfully and safely treated with strontium-chloride-containing products, thus offering a potential new treatment strategy.
Physical Therapy for Benign Positional Vertigo of Posterior Canal: The Role of Alternated Epley and Semont Maneuvers
Authors: Lovato Andrea , Marioni Gino , Monzani Daniele , Rossettini Giacomo , Genovese Elisabetta , de Filippis Cosimo
Published: January 2021

Objective:

To investigate if alternated Epley (EP) and Semont (ST) maneuvers could be more effective than repetition of the same in benign paroxysmal positional vertigo of posterior semicircular canal (pBPPV).

Design:

We retrospectively reviewed the outcome of pBPPV patients treated with a second maneuver for the persistence of positional nystagmus.

Study Sample:

Forty-seven patients underwent 2 STs, 64 with 2 EPs, and 71 EPs followed by ST. Videonystagmography and Dizziness Handicap Inventory (DHI) questionnaire were performed.

Results:

Absence of positional nystagmus was achieved after 2 maneuvers in 136 patients with pBPPV: 65.9% in the ST group, 70.3% in the EP group, and 84.5% in the EP-ST group. Alternated EP and ST were significantly more effective than repeated ST ( P = .03), while we found no significant difference when compared with repeated EP ( P = .07). At 1-month follow-up, 12 patients showed persistent positional nystagmus without difference between groups. After 1 month, the 46 patients with negative outcome had significantly higher DHI values ( P = .01) than other 136 patients with pBPPV.

Conclusions:

Alternated EP and ST seemed more effective than repeating the same maneuver in treating pBPPV, and this should be confirmed in prospective clinical studies. Resolution of nystagmus after maneuvers was fundamental to reduce handicap deriving from dizziness as reported in DHI.
Democracy’s critical infrastructure: Rethinking intermediary powers
Authors: Müller Jan-Werner
Published: January 2021

Ever since the 19th century, political parties and free media were widely deemed indispensable for the proper functioning of representative democracy. They constituted what one might call the critical infrastructure of democracy, an infrastructure which enabled citizens to use their basic rights effectively and also to reach each other (and be reached). Both intermediary institutions are undergoing major structural transformations today (or might disappear altogether, if processes of ‘disintermediation’ continue). It has proven difficult to judge these changes, partly because we lack a proper account of the distinctive normative roles of intermediary institutions beyond standard claims of ‘connecting citizens to the political system’. The essay argues that intermediary powers remain indispensable in staging political conflict, in providing external and internal pluralism and in properly structuring political time.
Rural Masculinities and Fathering: The Lived Experiences of Chinese Farmers
Authors: Liu Yanping , Zheng Jianhong
Published: January 2021

Little attention has been paid to the process of Chinese fathers in the countryside representing themselves as men while encountering rapid social changes. This qualitative study explored how rural Chinese men construct masculinities through stories about their fathering experiences. Fifteen farmers from southwest China were interviewed about their involvement in childrearing. The fathers were identified to have constructed configurations of masculinity fitting their social context, which were negotiated using various personal, interpersonal, and contextual resources. The participants presented themselves as family supporters, collaborative husbands, and strict but caring fathers who envisioned relying on their children near death. Gender inequalities were revealed, and participants legitimized these by emphasizing the instrumentality of such gender relations in childrearing and family development. Study limitations and implications for future research and practices related to rural Chinese fathers are discussed.
Echocardiographic predictors of exercise induced pulmonary hypertension in patients with asymptomatic moderate to severe mitral regurgitation and preserved left ventricular ejection fraction
Authors: Žvirblytė Rūta , Montvilaitė Aistė , Tamulėnaitė Eglė , Saniukaitė Agnė , Ereminienė Eglė , Vaškelytė Jolanta Justina
Published: January 2021

Background:

The significant role of mitral regurgitation (MR) in development of pulmonary hypertension (PH) has been proved in previous studies. Experts suggest systolic pulmonary arterial pressure (SPAP) ⩾60 mmHg during exercise as a significant threshold of negative prognostic value in patients with MR.

Purpose:

The aim of this study was to evaluate the changes of SPAP and to ascertain the determinants of exercise induced pulmonary hypertension (EIPH) in patients with asymptomatic primary MR.

Methods:

We performed a prospective study that included 50 patients with asymptomatic primary moderate to severe MR with preserved left ventricular ejection fraction (LV EF ⩾60%) at rest. They were divided into two groups according to the presence (PH group; n = 13) or absence (non-PH group; n = 37) of EIPH. Rest and stress (bicycle ergometry) echocardiography and speckle-tracking offline analysis were performed.

Results:

An increment of SPAP from rest to peak stress was higher in PH group ( p < 0.001). Multivariate regression analysis showed that MR effective regurgitation orifice area (EROA; p = 0.008) and regurgitant volume (RVol; p = 0.006) contributed significantly to SPAP at rest. Higher increment of MR EROA during stress and worse parameters of LV diastolic function at rest (E, A, E/e’) correlated significantly with higher SPAP during peak stress and they had a major role in predicting EIPH according to univariate logistic regression analysis. In ROC analysis SPAP >33.1 mmHg at rest could predict EIPH with 84.6% sensitivity and 87.1% specificity (95%CI 0.849–1.000; p < 0.001).

Conclusions:

Parameters of MR severity (EROA and RVol) were significant determinants of SPAP at rest, while the increment of MR EROA during stress and parameters of resting LV diastolic function were the best predictors of significant EIPH.
The effect of proprioceptive training on postural control in people with diabetes: A randomized clinical trial comparing delivery at home, under supervision, or no training
Authors: Borges Nathalia Cristina de Souza , Pletsch Ariane Hidalgo Mansano , Buzato Mariana Barbosa , Terada Natalia Akemi Yamada , Cruz Fernanda Maria Ferreira da , Guirro Rinaldo Roberto de Jesus
Published: January 2021

Objective:

Analyze postural control in the bipedal position as well as during gait and functional tests in patients with type 2 diabetes mellitus after supervised and unsupervised proprioceptive training.

Design:

A three-group randomized controlled trial.

Setting:

Physiotherapeutic Resources Lab, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo

Subjects:

Eighty patients with type 2 diabetes allocated to three groups: control, home training, and supervised training.

Interventions:

The supervised and home training groups performed two weekly sessions of proprioceptive exercises for 12 weeks. The control group was not submitted to any of treatment.

Main measures:

Bipedal balance, gait, and performance on functional tests were evaluated before and after 12 weeks using the Balance Evaluation Systems Test (BESTest) and the force plate.

Results:

No significant improvements were found regarding postural control, gait, or performance on the functional tests, as evidenced by the inter-group comparisons of the total BESTest score [control: 90.7 (81.5–92.6); home training: 85.2 (77.8–90.3); supervised training: 88.4 (82.6–91.4), P > 0.05] as well as the tests performed on the force plate ( P > 0.05). The clinical effect size of the proposed intervention was less than 0.2, demonstrating no effect for the main outcome variable evaluated by the “Sensory Orientation” item of the BESTest and by the mCTSIB (pressure plate).

Conclusions:

The proposed proprioceptive training did not lead to improvements in postural control in patients with type 2 diabetes with no clinical signs of diabetic distal polyneuropathy when analyzed using the BESTest clinical evaluation and a force plate.

Trial registration:

NCT01861392 (clinicaltrials.gov).
Vascular injury-related in-hospital mortality in Ontario between 1991 and 2009
Authors: Altoijry Abdulmajeed , Lindsay Thomas F. , Johnston K. Wayne , Mamdani Muhammad , Al-Omran Mohammed
Published: January 2021

Objective

Trauma-related vascular injuries are major contributors to morbidity and mortality worldwide. We conducted a retrospective, population-based, cross-sectional study to examine temporal trends and factors associated with traumatic vascular injury-related in-hospital mortality in Ontario, Canada from 1991 to 2009.

Methods

We obtained data on Ontario hospital admissions for traumatic vascular injury, including injury mechanism and body region; and patient age, sex, socioeconomic status, and residence from the Canadian Institute for Health Information Discharge Abstract Database and Registered Persons Database from fiscal years 1991 to 2009. We performed time series analysis of vascular injury-related in-hospital mortality rates and multivariable logistic regression analysis to identify significant mortality-associated factors.

Results

The overall in-hospital mortality rate for trauma-related vascular injury was 5.5%. A slight but non-significant decline in mortality occurred over time. The likelihood of vascular injury-related in-hospital mortality was significantly higher for patients involved in transport-related accidents (odds ratio [OR[=2.21, 95% confidence interval [CI], 1.76–2.76), age ≥65 years (OR = 4.34, 95% CI, 2.25–8.38), or with thoracic (OR = 2.24, 95% CI, 1.56–3.20) or abdominal (OR = 2.45, 95% CI, 1.75–3.42) injuries.

Conclusions

In-hospital mortality from traumatic vascular injury in Ontario was low and stable from 1991 to 2009.
Implementation of the “awakening and breathing trials, choice of drugs, delirium management, and early exercise/mobility” bundle in the pediatric intensive care unit of tertiary hospitals in southwestern China: a cross-sectional survey
Authors: Huang Xiaoming , Lei Lei , Zhang Shuai , Yang Jinrong , Yang Lin , Xu Min
Published: January 2021

Objective

To investigate management and implementation of the “awakening and breathing trials, choice of drugs, delirium management, and early exercise/mobility” (ABCDE) bundle in the pediatric intensive care unit (PICU) in southwestern China

Methods

A self-designed questionnaire for determining implementation of the ABCDE bundle was distributed to healthcare professionals in the PICU. Multiple linear regression was used to analyze results.

Results

A total of 270 questionnaires were collected. There was no significant difference in the awareness of the ABCDE bundle rate among Sichuan, Guizhou, and Yunnan workers. Only dynamic adjustment of drug dose accounted for more than half (55.5%) of “frequent implementation” and “general implementation”, followed by implementation of sedation assessment, pain assessment, and spontaneous breathing trials (46.4%, 39.3%, and 35.6%, respectively). A total of 80.4% of healthcare professionals never performed screening of delirium. Multivariate analysis showed that the healthcare professionals’ scores of ABCDE bundle behavior significantly differed regarding awareness of the ABCDE bundle, years of work at the hospital, the region of hospitals, and occupational category.

Conclusion

Implementation of the ABCDE bundle in the PICU in southwestern China is not sufficient. Existing problems need to be identified and a standardized sedation and analgesia management model needs to be established.
Cerebrospinal fluid tumor markers predict treatment response in a patient with carcinomatous meningitis
Authors: Lin Jiacai , Wu Siting , Tian Chenglin , Shi Qiang
Published: January 2021

We report on a 56-year-old female patient diagnosed with carcinomatous meningitis caused by lung cancer. The diagnosis was confirmed by lung computed tomography, enhanced brain magnetic resonance imaging, histopathology, cerebrospinal fluid (CSF) cytology, and serum and CSF tumor markers. Genetic testing detected an epidermal growth factor receptor gene exon 19 deletion. The patient survived for 29 months after systemic treatment with gefitinib, radiotherapy, and chemotherapy. Dynamic monitoring of CSF and serum tumor markers was carried out during the treatment process. We considered that CSF tumor marker levels may have allowed the early diagnosis of meningeal carcinomatosis, and that systemic therapy in the early stage of the disease may prolong survival.
Risky Driving Behaviors of Drivers Who Use Alcohol and Cannabis
Authors: Kelley-Baker Tara , Villavicencio Leon , Arnold Lindsay S. , Benson Aaron J. , Anorve Victoria , Tefft Brian C.
Published: January 2021

Many drivers in the United States use alcohol or cannabis, including some who co-use both substances. Using data from a nationally representative survey, self-reported engagement in various risky driving behaviors is examined among drivers who co-use alcohol and cannabis, those who use alcohol but not cannabis, those who use cannabis but not alcohol, and those who use neither. Results were adjusted for age, gender, education, and race. Co-users, compared with those who use only alcohol, were more likely to engage in nearly all of the risky behaviors measured in the survey, including driving under the influence of alcohol. Compared with those who neither drink nor use cannabis, those who use only cannabis were more likely to drive under the influence of prescription drugs, engage in aggressive driving, and ride with an intoxicated driver. Results of this and future related research will assist with understanding the differences in driving behavior among users of alcohol, cannabis, or both, so more effective interventions can be developed to improve traffic safety.
The Impact of Gender Diversity and Disparity on Organizational Performance: Evidence from Korean Local Government-Owned Enterprises
Authors: An Sunmin , Lee Soo-Young
Published: January 2021

Previous studies have shown inconsistent results regarding the impact of diversity on organizational performance. To address this issue, it is imperative to not only discuss diversity with regard to numerical balance, but also hierarchical composition of groups. We categorized diversity into variety and disparity. Variety refers to the categorical composition of groups and disparity indicates the vertical distribution of power or the power dynamics between groups. Focusing on gender diversity, we conduct empirical research on the impact of diversity on organizational performance. We find that variety as well as disparity, that is, the evenly distributed power between groups, have positive impacts on organizational performance. These results imply that diversity is practically beneficial to organizations with multifaceted characteristics. We suggest that beyond considering the normative view, social movements promoting gender-equal employment in overall levels and managerial positions should emerge and be discussed as a strategy to enhance organizational performance.
Vitamin C, Thiamine, and Hydrocortisone in the Treatment of Sepsis: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials
Authors: Zayed Yazan , Alzghoul Bashar N. , Banifadel Momen , Venigandla Hima , Hyde Ryan , Sutchu Selina , Khasawneh Majd , Borok Zea , Urbine Daniel , Jantz Michael , Reddy Raju
Published: January 2021

Background:

There is a conflicting body of evidence regarding the benefit of vitamin C, thiamine, and hydrocortisone in combination as an adjunctive therapy for sepsis with or without septic shock. We aimed to assess the efficacy of this treatment among predefined populations.

Methods:

A literature review of major electronic databases was performed to include randomized controlled trials (RCTs) evaluating vitamin C, thiamine, and hydrocortisone in the treatment of patients with sepsis with or without septic shock in comparison to the control group.

Results:

Seven studies met our inclusion criteria, and 6 studies were included in the final analysis totaling 839 patients (mean age 64.2 ± 18; SOFA score 8.7 ± 3.3; 46.6% female). There was no significant difference between both groups in long term mortality (Risk Ratio (RR) 1.05; 95% CI 0.85-1.30; P = 0.64), ICU mortality (RR 1.03; 95% CI 0.73-1.44; P = 0.87), or incidence of acute kidney injury (RR 1.05; 95% CI 0.80-1.37; P = 0.75). Furthermore, there was no significant difference in hospital length of stay, ICU length of stay, and ICU free days on day 28 between the intervention and control groups. There was, however, a significant difference in the reduction of SOFA score on day 3 from baseline (MD −0.92; 95% CI −1.43 to −.41; P < 0.05). In a trial sequential analysis for mortality outcomes, our results are inconclusive for excluding lack of benefit of this therapy.

Conclusion:

Among patients with sepsis with or without septic shock, treatment with vitamin C, thiamine, and hydrocortisone was not associated with a significant reduction in mortality, incidence of AKI, hospital and ICU length of stay, or ICU free days on day 28. There was a significant reduction of SOFA score on day 3 post-randomization. Further studies with a larger number of patients are needed to provide further evidence on the efficacy or lack of efficacy of this treatment.