bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound Measurement Error and Its Implications for Carpal Tunnel Syndrome Diagnosis
Authors: Gao Timothy , Demino Cory , Fowler John R.
Published: July 2020

Background: Ultrasound (US) measurement of the cross-sectional area (CSA) of peripheral nerves has been validated as a method for diagnosing peripheral nerve compression; however, the accuracy of US measurements and variation among examiners have not been well established. The purpose of this study was to determine the percent error from a known measurement among multiple US examiners using a gel phantom model. Methods: A US phantom gel, with 2 embedded, premeasured cylindrical objects, was constructed, and 9 residents, fellows, and attending physicians with upper-extremity US experience were recruited to use US to measure the CSA of each object. Percent error was calculated based on the premeasured value of each object, which was measured using digital calipers, and was calculated using the formula for CSA of a cylinder ( A = pi × r2) prior to insertion into the gel phantom. Results: The mean percent error for examiners’ CSA measurements was 9.0% ± 4.7% (range, 1.6%-17.0%). There was a greater mean percent error for the smaller measured object compared with the larger one. There was a very minimal decline in percent error with increase in years of training experience (slope = −0.029, R2 = 0.0002). Conclusion: This study demonstrates that US examiners were able to measure CSAs of premeasured objects with approximately 10% error. When considering the use of US for the diagnosis of carpal tunnel syndrome, a cutoff value of 10 mm2 is often used, and therefore in cases where measurements are within 10% of the diagnostic threshold, caution should be exercised in interpreting the results.
Outcomes of rheolytic thrombectomy in phlegmasia cerulea dolens
Authors: Saydam Onur , Serefli Deniz
Published: July 2020

Objective

The purpose of this study was to assess the clinical features of phlegmasia cerulea dolens and present the treatment outcomes with rheolytic thrombectomy device.

Methods

From January 2014 and March 2019, 329 patients were diagnosed and hospitalized for acute iliofemoral deep vein thrombosis, and among those patients, seven patients diagnosed with lower extremity phlegmasia cerulea dolens were consecutively enrolled. Diagnosis of phlegmasia cerulea dolens was initially made on clinical findings followed by imaging with Doppler ultrasound. The rheolytic thrombectomy device was used in all patients with a combination of catheter-directed thrombolysis as an adjunctive therapy to facilitate more rapid thrombus clearance except for one patient who had a contraindication to the use of tissue plasminogen activator.

Results

Seven patients (four men, three women; median age, 63 years, range 52–68 years) were included. One patient had a relative contradiction to thrombolysis due to history of coronary artery bypass graft surgery; all other patients underwent pharmaco-mechanical thrombectomy with power pulse mode. The upper limit of 480 s was completed in all patients, and this time was not exceeded to prevent hemolysis-related complications. Six Fr catheters were used in four (57.1%) patients, and 8 Fr catheters were used in three patients (42.9%). Mean thrombolytic infusion duration was 28 ± 6.2 h for patients who received tissue plasminogen activator. After catheter-directed thrombolysis, total radiological success was achieved in two patients, and partial radiologic success was achieved in five patients; however, in all seven patients, clinical success was achieved. The mean duration for complete regression of cyanosis was 18.9 ± 8.1 h. Although no patients required blood replacement, mean decreases in hemoglobin and hematocrit were 2.7 ± 1.37 g/dl and 6.42 ± 4.47%, respectively. Acute kidney injury developed in three patients (42.9%). One patient required continuous renal replacement therapy. No cardiac complication was observed. One (14.3%) patient died of ventilator-related pneumonia on postprocedural day 10. The median duration of intensive care unit stay and hospital stay were 72 h (min–max: 24–264 h) and six days (min–max: 5–33 days), respectively.

Conclusion

Rheolytic thrombectomy was less invasive and effective strategy for early stage phlegmasia cerulea dolens at creating rapid thrombus clearance to establish clinical success and facilitate more conservative management with catheter-directed thrombolysis.
Decay of inhibition in motor imagery
Authors: Bart Victoria KE , Koch Iring , Rieger Martina
Published: July 2020

During motor imagery, global inhibition and effector-specific inhibition contribute to prevent actual movements. We investigated the decay of inhibition using an action-mode switching paradigm. Participants switched between imagined and executed hand movements. Response–stimulus intervals (RSIs) were varied (200, 700, 1,300, and 2,000 ms). As inhibition (due to imagination) or activation (due to execution) in one trial affects performance in the subsequent trial, we analysed sequential effects. Evidence for the contribution of global inhibition (e.g., switch benefits in execution [E]—imagination [I] sequences compared with I-I sequences) and effector-specific inhibition (e.g., hand repetition costs after an imagination trial) was observed. Sequential effects decreased with increasing RSIs, indicating that both forms of inhibition are subject to decay. However, the decrease of sequential effects was less pronounced for global inhibition than for effector-specific inhibition. This indicates that global inhibition may decay slowly, whereas effector-specific inhibition decays rather quickly. In conclusion, global inhibition may be at least partly implemented in all contexts in which motor imagery has to be performed, whereas effector-specific inhibition may contribute to motor imagery only as soon as the exact movement parameters are known and may decay quickly after the imagined movement has been performed.
Modelling generalisation gradients as augmented Gaussian functions
Authors: Lee Jessica C , Mills Llewellyn , Hayes Brett K , Livesey Evan J
Published: July 2020

Studying generalisation of associative learning requires analysis of response gradients measured over a continuous stimulus dimension. In human studies, there is often a high degree of individual variation in the gradients, making it difficult to draw conclusions about group-level trends with traditional statistical methods. Here, we demonstrate a novel method of analysing generalisation gradients based on hierarchical Bayesian curve-fitting. This method involves fitting an augmented (asymmetrical) Gaussian function to individual gradients and estimating its parameters in a hierarchical Bayesian framework. We show how the posteriors can be used to characterise group differences in generalisation and how classic generalisation phenomena such as peak shift and area shift can be measured and inferred. Estimation of descriptive parameters can provide a detailed and informative way of analysing human generalisation gradients.
Mixed ligand cobalt and palladium complexes containing triphenylphosphine and a hydrazone: Synthesis and application in non-linear optics
Authors: Ramakrishna Dileep
Published: July 2020

Mixed ligand complexes of cobalt and palladium containing triphenylphosphine and a hydrazone derived from furfural and hydrazine hydrate have been designed, synthesized, evaluated, and characterized from their spectral properties, elemental analysis, and magnetic susceptibility measurements. The spectral techniques suggest that the complexes exhibit square planar geometry. The monomeric properties of the complexes are evaluated from their magnetic susceptibility values. The complexes were subjected to z-scan analysis for third-order non-linear optical measurements. Non-linear transmission measurements performed using laser pulses at 532 nm in nanosecond indicate that the complexes may show good potential as optical limiters.
Country images and identities in times of populism: Swiss media discourses on the ‘stop mass immigration’ initiative
Authors: Dolea Alina , Ingenhoff Diana , Beju Anabella
Published: July 2020

The construction of certain country images and identities is traditionally studied in relation to public diplomacy, strategic communication and nation branding practices of state and non-state actors. However, we notice the increased instrumentalization of country images and identities in debates on issues beyond strategic promotional practices, such as those articulated around elections, referendums or migration. We analyse how Swiss media constructed Switzerland's image and identity in the debate following the 2014 referendum on ‘stop mass immigration’ initiative, in times of populism, a communication phenomenon and ideology discursively articulated by political and media actors. Thus, we: (1) bridge streams of research on country images, identities, migration and populism that have yet to be integrated; (2) propose critical discourse analysis to identify specific discursive strategies (offering insights into alternative methodologies for studying populist political communication content and style); (3) highlight the role of media in reproducing populist discourses on country images and identities.
Health-related quality of life in premenopausal women with hormone-receptor-positive, HER2-negative advanced breast cancer treated with ribociclib plus endocrine therapy: results from a phase III randomized clinical trial (MONALEESA-7)
Authors: Harbeck Nadia , Franke Fabio , Villanueva-Vazquez Rafael , Lu Yen-Shen , Tripathy Debu , Chow Louis , Babu Govind K , Im Young-Hyuck , Chandiwana David , Gaur Anil , Lanoue Brad , Rodriguez-Lorenc Karen , Bardia Aditya
Published: July 2020

Background:

This analysis evaluated patient-reported outcomes (PROs) to assess health-related quality of life (HRQoL) in the phase III MONALEESA-7 trial, which previously demonstrated improvements in progression-free survival (PFS) and overall survival (OS) with ribociclib (cyclin-dependent kinase 4/6 inhibitor) + endocrine therapy (ET) compared with placebo + ET in pre- and perimenopausal patients with hormone-receptor-positive, HER2-negative (HR+/HER2−) advanced breast cancer (ABC).

Methods:

The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life questionnaire C30 (QLQ-C30) and the EQ-5D-5L were used to evaluate HRQoL.

Results:

EORTC QLQ-C30 assessments were evaluable for 335 patients in the ribociclib arm and 337 patients in the placebo arm. Adherence rates at baseline and ⩾1 postbaseline time point were 90% and 83%, respectively. Patients treated with ribociclib + ET had a longer time to deterioration (TTD) ⩾ 10% in global HRQoL {hazard ratio (HR), 0.67 [95% confidence interval (CI), 0.52–0.86]}. TTD ⩾ 10% in global HRQoL was delayed in ribociclib-treated patients without versus with disease progression [HR, 0.31 (95% CI, 0.21–0.48)]. TTD ⩾ 10% in pain was longer with ribociclib + ET than with placebo + ET [HR, 0.65 (95% CI, 0.45–0.92)]. Patients who received a nonsteroidal aromatase inhibitor experienced similar benefits with ribociclib versus placebo in global HRQoL and pain.

Conclusion:

HRQoL was maintained longer in patients who received ribociclib + ET versus placebo + ET. These data, combined with previously reported improvements in PFS and OS, support a strong clinical benefit-to-risk ratio with ribociclib-based treatment in pre- and perimenopausal patients with HR+/HER2− ABC.
Pre-exercise Trehalose Ingestion Enhanced Exercise Performance in Male Collegiate Distance Runners
Authors: Suzuki Yoshio , Sato Kotaro , Sakuraba Keishoku , Akaishi Tatsuyuki , Sugiyama Kana , Suzuki Hiroyuki , Ymawaki Koudai
Published: July 2020

A total of 10 male collegiate distance runners participated in a randomized crossover trial. After completing a warm-up, each participant ingested 300 mL of a test drink and performed 2 sets of pedaling for the duration of 10 minutes (tests 1 and 3) and a 30-second sprint test (tests 2 and 4) with 3-minute interval. During the exercise tests, participants were instructed to make a full power output in 30-second sprint tests and to keep the effort equivalent to their own pace in 10 000 m track race without a final push in the 10-minute pedaling phase. The test drinks allocated to the participants were either trehalose (6% w/v), glucose (6% w/v), or water. During the 4 tests, trehalose presented with the highest mean power outputs compared to that of glucose and water. It was statistically significant against water and glucose especially in the first 10 minutes of pedaling (test 1) and the last 30 seconds of sprint tests (test 4). Therefore, data indicate that trehalose may enhance exercise performance.
Antinociceptive Effects of Emodin on CFA-Induced Inflammatory Pain in Rats
Authors: Ni Wan , Wang Nianyun , Tian Shenglan , Xu Qingbang
Published: July 2020

The effect of emodin on complete Freund’s adjuvant (CFA)-induced inflammatory pain in rats and its potential molecular mechanism was investigated. For this, a rat model of inflammatory pain induced by CFA was established and rats were treated with emodin by intraperitoneal injection. The pain threshold was evaluated by the von Frey, thermo hyperalgesia, and cold plate tests. The mRNA expression of transient receptor potential channel ankyrin type-1 ( Trpa1) and transient receptor potential vanilloid 1 ( Trpv1) was detected by quantitative reverse transcription polymerase chain reaction, and the level of inflammatory cytokines was determined by enzyme-linked immunosorbent assay. The mechanical and thermal pain thresholds of CFA-treated rats were significantly lower than those of the control rats, while the paw withdrawal responses in response to cold stimulation were higher than that of the control group. Emodin treatment significantly improved CFA-induced hyperalgesia. Further results showed that emodin inhibits the upregulation of Trpa1 and Trpv1 mRNA expression in the dorsal root ganglion (DRG) of rats with inflammatory pain compared with the control group. Emodin also significantly reduced the levels of tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) in the serum of rats with inflammatory pain. Thus, emodin may inhibit hyperalgesia induced by inflammatory stimulation by downregulating the mRNA expression of Trpa1 and Trpv1 in DRG neurons and reducing the levels of TNF-α, IL-1β, and IL-6.
Metabolic control achievement in a population with premature coronary artery disease: results of the genetics of atherosclerotic disease study
Authors: Medina-Urrutia Aida X , Martínez-Sánchez Froylan D , Posadas-Romero Carlos , Jorge-Galarza Esteban , Martínez-Alvarado María del Rocío , González-Salazar María del Carmen , Osorio-Alonso Horacio , Juárez-Rojas Juan Gabriel
Published: July 2020

Background and aims:

To the best of our knowledge, no studies have investigated the metabolic control of patients with premature coronary artery disease (CAD). The present study analyzes the metabolic control, defined as the simultaneous target in blood pressure, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and hemoglobin A1c, as well as the factors associated with its achievement in patients with premature CAD.

Methods:

The study included 1206 patients with CAD diagnosed before the age of 55 and 65 years in men and women, respectively. Sociodemographic, clinical and biochemical data were collected to know the prevalence of cardiovascular risk factors, including individual components of metabolic control plus smoking cessation and body mass index (BMI) <25 kg/m2. Non-strict and strict targets were used to evaluate metabolic control.

Results:

Participants were 54 ± 8 years old, 19.7% were women and had a median CAD evolution of 2.4 years. Non-strict and strict metabolic control was achieved by 18.4% and 6.2% of patients, respectively. Moreover, 79.8% and 67.6% met a composite of three or more cardiovascular risk factor goals using both criteria. BMI <25 kg/m2 was independently associated with 1.734 (95% confidence interval: 1.207–2.492) and 2.541 (95% confidence interval: 1.608–4.014) higher probabilities to meet non-strict or strict metabolic control.

Conclusion:

Our results show that 18.4% and 6.2% of subjects with premature CAD achieved non-strict and strict metabolic control, respectively. BMI <25 kg/m2 was found to be associated with the achievement of metabolic control. Multidisciplinary strategies including healthy lifestyle changes and pharmacological therapies could decrease the socioeconomic and clinical impact of premature CAD.
Governance models for robotic process automation: The case of Nordea Bank
Authors: Kedziora Damian , Penttinen Esko
Published: July 2020

The teaching case addresses the governance of robotic process automation at Nordea, a large banking group operating primarily in the Nordic region. Nordea has deployed numerous software robots, for a wide range of business processes, from transaction-processing work and both internal and external reporting all the way to interaction with end users in handling of General Data Protection Regulation (GDPR)-related queries. The scene is set with a meeting where three people discuss the current state of robotic process automation implementation at Nordea: Group Head of Robotics Agnieszka Belowska Gosławska, Head of Robotic Process Automation Operations Piotr Stolarczyk and Acting Head of Robotics Execution Jaroslaw Motylewski. The presentation outlines several governance-related issues and decision points that must be addressed in connection with any deployment of robotic process automation at somewhat large scale within a company. The key issues are related to the software’s development and maintenance, robotic process automation governance and IT infrastructure. Students who have worked through the case should be able to (1) describe archetypal and hybrid governance modes for robotic process automation and (2) evaluate their advantages and disadvantages for solid infrastructure and effective software development and maintenance.
Substantial clinical benefit, responsiveness, and sensitivity to change of three common outcome measures following shoulder arthroplasty
Authors: Razmjou Helen , Rahnama Leila , Holtby Richard , Drosdowech Darren , Richards Robin
Published: July 2020

Objectives:

It is important for clinicians involved in the care of patients with advanced glenohumeral osteoarthritis to determine clinically significant change when using outcome measures. There is little information on the amount of substantial clinical benefit in shoulder outcomes after shoulder arthroplasty. The purpose of this study was twofold: (1) to quantify substantial clinical benefit for the American Shoulder and Elbow Surgery score, the Constant Murley Score, and the Western Ontario Osteoarthritis of the Shoulder index and (2) to provide estimates of responsiveness and sensitivity to change for these measures following shoulder arthroplasty.

Methods:

The study involved a secondary analysis of previously collected data. The substantial clinical benefit and responsiveness of the measures were calculated based on external anchors related to change in pain, range of motion, and ability to carry out activities of daily living. The areas under curve and standardized response mean represented responsiveness and sensitivity to change.

Results:

The data of 159 and 131 patients with complete follow-up at 6 months and 2 years were reviewed. The amount of substantial clinical benefit was dependent on the outcome measure and the external anchor and increased for all measures from 6 months to 2 years. Responsiveness was high (areas under curve > 0.80) at 6 months and further improved at 2 years (areas under curve > 0.88). The standardized response mean values of both time points were over 2.00, indicating high effect sizes. The standardized response means of the Constant Murley Score were statistically significantly higher than the standardized response means of the American Shoulder and Elbow Surgery and Western Ontario Osteoarthritis of the Shoulder.

Conclusion:

Amount of substantial clinical improvement in pain, range of motion, and activities of daily living following shoulder arthroplasty depends on the type of outcome measure used. All three measures, the American Shoulder and Elbow Surgery, absolute and relative Constant Murley Score, and Western Ontario Osteoarthritis of the Shoulder, demonstrated good to excellent accuracy and optimal standardized response means.

Level of evidence:

Level III, Retrospective Cohort study
Reflections on the Use of SSCI Papers in Evaluating Social Sciences Research in Chinese Universities
Authors: Liu Li , Xue Huilin , Li Jing
Published: July 2020

Purpose:

This review demonstrates how to position Social Sciences Citation Index (SSCI) papers reasonably in order to promote the reform and development of the system for evaluating social sciences research (E-SSR) in China.

Design/Approach/Methods:

This review examines the contributions made by SSCI papers after such papers became a tool in the E-SSR system in Chinese universities, and the resultant issues. This review analyzes documents pertaining to the E-SSR systems of more than 50 world-class universities with consideration to the inherent characteristics and historical mission of social sciences research in China. The findings serve as the basis from which to examine the future trends in the reform of the E-SSR system in Chinese universities.

Findings:

The application of SSCI papers as an E-SSR tool is not common in world-class universities. To date, the reform of the E-SSR system in Chinese universities has involved: (i) establishing a pluralistic evaluation mechanism, with equal importance placed on SSCI papers and other research achievements; (ii) emphasizing the need for caution in using SSCI papers as an E-SSR tool and instituting distinct treatments for various disciplines; (iii) reducing the importance attached to journal language and ranking, while emphasizing innovation quality and practical contributions; and (iv) establishing China’s E-SSR standards in order to achieve an equilibrium between internationalization and localization.

Originality/Value:

This review argues that although SSCI papers constitute an indicator of E-SSR system, their importance must not be overstated. The main purpose of the E-SSR system is to facilitate the development of social sciences with a style and characteristics unique to China.
Active Within Structures: Predictors of Esports Gameplay and Spectatorship
Authors: Tang Tang , Kucek Jake , Toepfer Steven
Published: July 2020

This study puts both esports gameplay and spectatorship into consideration and pinpoints how individual and structural factors explain why people play and watch esports to better understand the complexities and intricacies of esports consumption. Results indicate that both measures commonly associated with active audience, and structural theories played a significant role in explaining esports consumption. Specifically, esports gameplay was explained relatively more by structural factors than by individual factors. Different from esports gameplay, esports spectatorship was driven significantly more by individual factors. Preferences, motivations, availability, and access significantly predicted both esports gameplay and spectatorship. Sports fandom and use of interactive features, on the other hand, only predicted esports spectatorship but did not influence gameplay. By employing an integrative approach, this study aids in the development of conceptual framework that will serve to predict esports consumer behavior.
Porcine bone-patellar tendon-bone xenograft in a caprine model of anterior cruciate ligament repair
Authors: Lombardi Jared A , Hoonjan Amardeep , Rodriguez Neil , Delossantos Aubrey , Monteiro Gary , Sandor Maryellen , Xu Hui
Published: July 2020

The use of human tissue-derived autografts and allografts continues to be the gold standard in anterior cruciate ligament (ACL) repair. However, autografts and allografts have their own set of associated risks. Many alternative options, including synthetic replacements, have failed to demonstrate long-term success. In this study, sterile acellular porcine bone-tendon-bone (BTB) xenografts were created using a proprietary process and tested against BTB autografts in goats for 13 and 52 weeks. At 13 weeks, all xenograft-implanted animals ( n = 9) had subjective hind leg motor function (HLMF) that was categorized as either normal (score = 0) or a slight limp (score = 1) compared with two of nine autograft-implanted animals having a moderate limp (score = 2). At 39 weeks, there was HLMF improvement with each autograft-implanted and xenograft-implanted animal having normal HLMF or only a slight limp. At 13 weeks, six of nine animals in each group achieved normal anterior drawer scores, which increased to nine of nine animals in each group by 39 weeks. Both autografts and xenografts exhibited minimal inflammation with excellent integration of the fibrous tendon portion of the graft to host bone, as evidenced histologically by Sharpey’s fiber formation. At 52 weeks, maximum mechanical load at failure for xenografts was 1092.0 ± 586.4 N compared with 1037.0 ± 422.6 N for autografts. These results demonstrate that a sterile acellular porcine BTB xenograft can perform equivalently to BTB autograft in a caprine model of ACL repair.
‘Using’ Crisis of Governance as an Opportunity for ‘Re-invention’: Why the Supreme Court of India Took To Hearing Public Interest Litigations—A Case Study
Authors: Biswas Subrata
Published: July 2020

What do the different State organs do when they face a crisis? Do the suffering institutions successfully re-invent themselves or is it that some other institution uses the crisis to find an ‘opportunity’ to re-invent itself? Can one’s crisis be another’s opportunity?

This case-study analyses how the Supreme Court of India (hereinafter SCI) reinvented itself in a bid to further the cause of good governance in the country ever since emergency had been clamped on the nation towards the end of 1970s. Surely there has been a crisis of governance in India, caused by the pathetic performance of both the legislature and the executive. It has led to myriad problems in both social and political arenas. If left unaddressed, Indian people might have turned more violent than they already are and that could have perpetrated a failure of democracy in the country. But the SCI has successfully played a positive role in this regard. If the other institutions have failed the people, the Supreme Court has championed their cause. The world’s largest democracy stands saved until now.

But is it wholly the judges’ heartfelt concern for the people that has prompted the Supreme Court to function in this fashion? Did anything go wrong during the emergency? Why is it that it has been more and more active ever since the emergency ended? And why is it that there has been an exponential growth in public interest litigations (hereinafter PILs) in the Supreme Court even though it cannot handle so many cases because of infrastructural paucities?

Situating itself in the specific context of PILs entertained by the SCI and supporting it with the theoretical inputs of the so-called ‘principal-agent framework’, this essay argues that there has been a competition (i.e., between the court and the elected politicians) for ‘occupying’ more space in the domain of governance since the inception of the Constitution and it is only the Supreme Court that got the right ‘opportunity’ to achieve its objective in the wake of crisis in governance that became so visible in Indian politics ever since the fag-end of the 1970s.

While the court tried other instruments earlier in its game plan vis-a-vis the elected politicians, the crisis situation since the end of the 1970s made it ‘invent’ a new tool in the form of PILs capable of safeguarding the interests of the people and insulating them against the mindless functioning of multiple state agencies.

But how far can the SCI (hereinafter SCI) proceed with this new tool? Is there a risk of ‘overusing’ it? Does the court not have its own limitations in this regard, too? What should the Supreme Court do in order to avert a fresh ‘crisis’?
Mast cell activation in the systemic sclerosis esophagus
Authors: Tom Kevin , Mehta Bhaven K , Hoffmann Aileen , Aren Kathleen , Carns Mary , Lee Jungwha , Martyanov Viktor , Popovich Dillon , Kosarek Noelle , Wood Tammara A. , Brenner Darren , Carlson Dustin A , Ostilla Lorena , Willcocks Emma , Bryce Paul , Wechsler Joshua B , Whitfield Michael L , Hinchcliff Monique
Published: July 2020

Introduction:

Previously, we discovered similar esophageal gene expression patterns in patients with systemic sclerosis and eosinophilic esophagitis where eosinophil/mast cell–targeted therapies are beneficial. Because systemic sclerosis and eosinophilic esophagitis patients experience similar esophageal symptoms, we hypothesized that eosinophil/mast cell–directed therapy may potentially benefit systemic sclerosis patients. Herein, we determine the association between esophageal mast cell quantities, gene expression, and clinical parameters in order to identify systemic sclerosis patients who may benefit from eosinophil/mast cell–directed therapy.

Methods:

Esophageal biopsies from systemic sclerosis patients and healthy participants were stained for tryptase, a mast cell marker, and associations with relevant clinical parameters including 24-h esophageal pH testing were assessed. Intra-epithelial mast cell density was quantified by semi-automated microscopy. Microarray data were utilized for functional and gene set enrichment analyses and to identify intrinsic subset assignment, a systemic sclerosis molecular classification system that includes inflammatory, proliferative, limited, and normal-like subsets.

Results:

Esophageal biopsies from 40 systemic sclerosis patients (39 receiving proton pump inhibition) and eleven healthy participants were studied. Mast cell numbers in both the upper esophagus ( rs = 0.638, p = 0.004) and the entire (upper + lower) esophagus ( rs = 0.562, p = 0.019) significantly correlated with acid exposure time percentage. The inflammatory, fibroproliferative, and normal-like intrinsic subset originally defined in skin biopsies were identified in esophageal biopsies. Although esophageal mast cell numbers in systemic sclerosis patients and healthy participants were similar, gene expression for mast cell–related pathways showed significant upregulation in the inflammatory intrinsic subset of systemic sclerosis patients compared to patients classified as proliferative or normal-like.

Discussion:

Esophageal mast cell numbers are heterogeneous in systemic sclerosis patients and may correlate with acid exposure. Patients with inflammatory intrinsic subset profiles in the esophagus demonstrate more tryptase staining. Mast cell–targeted therapy may be a useful therapeutic approach in systemic sclerosis patients belonging to the inflammatory intrinsic subset, but additional studies are warranted.
Pulmonary arterial hypertension screening practices in scleroderma patients among Canadian rheumatologists
Authors: Quinn Ryan , Koh Deborah , Kelly Dylan , Beattie Karen A. , Larché Maggie J.
Published: July 2020

Background:

Current international guidelines recommend annual screening for pulmonary arterial hypertension with transthoracic echocardiogram and pulmonary function testing in all patients with scleroderma (systemic sclerosis). Our objectives were to determine Canadian rheumatologists’ screening practices for pulmonary arterial hypertension in patients with systemic sclerosis and identify reasons why current guideline recommendations may not be followed.

Methods:

A survey was emailed to all Canadian Rheumatology Association members. They self-identified as systemic sclerosis experts or non-experts and provided basic demographic data. Participants were asked how frequently they screened with transthoracic echocardiogram and pulmonary function testing and, if applicable, why they did not adhere to recommendations.

Results:

A total of 71 rheumatologists participated, of whom 43 identified as non-experts. Overall, 81.4% ordered annual transthoracic echocardiogram and 77.6% annual pulmonary function testing. Rates of annual transthoracic echocardiogram testing were similar between experts and non-experts, whereas experts ordered annual pulmonary function testing more often. Clinicians with a higher proportion of systemic sclerosis patients in their practice were more likely to follow guidelines. There was an inverse relationship between years in practice and adherence to screening guidelines. The most common reason for not following screening guidelines was disagreement with recommendations, followed by unfamiliarity with guidelines.

Conclusions:

Pulmonary arterial hypertension screening rates remain sub-optimal in Canada but have improved since 2012. Failure to adopt guidelines is due to rheumatologists disagreeing with or not knowing current recommendations. Future studies should examine why rheumatologists disagree with guidelines and how to improve awareness.
Rationale for American Society of Retina Specialists Best Practice Recommendations for Conducting Vitreoretinal Surgery During the Coronavirus Disease-19 Era
Authors: Chao Daniel L. , Sridhar Jayanth , Kuriyan Ajay E. , Leng Theodore , Barnett Brad P. , Carlin Aaron F. , Wykoff Charles C. , Gayer Stephen , Mruthyunjaya Prithvi , Yonekawa Yoshihiro , Fawzi Amani A. , Berrocal Audina M. , Yeh Steven , Ting Daniel , Modi Yasha , Zacks David N. , Yannuzzi Nicholas , Afshari Natalie A. , Murray Timothy
Published: July 2020

Purpose:

This review details the rationale behind recommendations recently published by the American Society of Retina Specialists (ASRS) and outlines best practices for safety of vitreoretinal surgeons and staff while performing vitreoretinal surgery during the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

The Committee for ASRS Best Practices for Retinal Surgery During the COVID-19 Pandemic reviewed existing evidence and information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and risk factors during vitreoretinal surgery. Recommendations were based on best available published data, cumulative clinical experiences, and recommendations and policies from other organizations. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the strength of recommendations and confidence in the evidence. These serve as interim recommendations that will be routinely updated given the current gaps of knowledge and lack of high-quality data on this evolving subject.

Results:

Relevant existing literature related to methods of transmission and ocular manifestations of SARS-CoV-2 are summarized. The data and clinical experiences driving recommendations for preoperative, intraoperative, and postoperative surgical considerations and anesthesia choice as well as considerations for intravitreal injections are provided.

Conclusions:

Recommendations are provided with the goal of protecting vitreoretinal surgeons and associated personnel from exposure to SARS-CoV-2 during interventional vitreoretinal procedures. This is a rapidly evolving topic with numerous remaining gaps in our current knowledge. As such, recommendations will evolve and the present article is intended to serve as a foundation for continued dialogue on best practices.
The basic grammatological unit in  Vietnam’s Nom script and its relationship with those in Chinese script
Authors: Phạm Văn-Khoái
Published: July 2020

The basic grammatological unit (grapheme) is a universal one for all writing systems. Chữ 𡨸 is such a basic unit in Nom script. When analyzing chữ 𡨸, the basic unit of a derivative script such as Nom script, the researcher thinks that apart from attention paid to the relations to language units recorded by it, as basic units of the source writing system such as wen (文) and zi (字) in Chinese script, it is necessary for the researcher to attach importance to the corresponding relations right in this derivative writing system. The expression of chữ 𡨸 in the corresponding internal relations also needs to be taken into consideration as a documentary fact for the study of graphemes in writing systems renovated from the hieroglyphs of Chinese script in particular, as well as in grammatology in general.
Impact of a Brief, Bystander Bullying Prevention Program on Depressive Symptoms and Passive Suicidal Ideation: A Program Evaluation Model for School Personnel
Authors: Midgett Aida , Doumas Diana M. , Peralta Claudia , Bond Laura , Flay Brian
Published: July 2020

The purpose of this article is to present a study that can serve as a model of program evaluation for school personnel that can be used to improve services and demonstrate program efficacy to key stakeholders. The study presented in this article evaluated the impact of a brief, bystander bullying program (“stealing the show,” “turning it over,” “accompanying others,” and “coaching compassion,” [STAC]) on depressive symptoms and passive suicidal ideation among middle school students in a rural, low-income community ( N = 130). This topic was selected as there is limited research examining the efficacy of bystander programs on improving mental health outcomes for students trained to intervene. Results of the study indicated students trained in the STAC program reported reductions in depressive symptoms and passive suicidal ideation at a 6-week follow-up compared with an increase in symptoms reported by students in the control group. We discuss these findings and the use of program evaluation by school personnel to support prevention programming.
The impact of bereavement support on wellbeing: a comparative study between Australia and Ireland
Authors: Aoun Samar M. , Keegan Orla , Roberts Amanda , Breen Lauren J.
Published: July 2020

Background:

There is a dearth of national and international data on the impact of social support on physical, mental, and financial outcomes following bereavement.

Methods:

We draw from two large, population-based studies of bereaved people in Australia and Ireland to compare bereaved people’s experience of support. The Australian study used a postal survey targeting clients of six funeral providers and the Irish study used telephone interviews with a random sample of the population.

Results:

Across both studies, the vast majority of bereaved people reported relying on informal supporters, particularly family and friends. While sources of professional help were the least used, they had the highest proportions of perceived unhelpfulness. A substantial proportion, 20% to 30% of bereaved people, reported worsening of their physical and mental health and about 30% did not feel their needs were met. Those who did not receive enough support reported the highest deterioration in wellbeing.

Discussion:

The compassionate communities approach, which harnesses the informal resources inherent in communities, needs to be strengthened by identifying a range of useful practice models that will address the support gaps. Ireland has taken the lead in developing a policy framework providing guidance on level of service provision, associated staff competencies, and training needs.
Host Akkermansia muciniphila Abundance Correlates With Gulf War Illness Symptom Persistence via NLRP3-Mediated Neuroinflammation and Decreased Brain-Derived Neurotrophic Factor
Authors: Kimono Diana , Bose Dipro , Seth Ratanesh K , Mondal Ayan , Saha Punnag , Janulewicz Patricia , Sullivan Kimberly , Lasley Stephen , Horner Ronnie , Klimas Nancy , Chatterjee Saurabh
Published: July 2020

Neurological disorders are commonly reported among veterans who returned from the Gulf war. Veterans who suffer from Gulf War illness (GWI) complain of continued symptom persistence that includes neurological disorders, muscle weakness, headaches, and memory loss, that developed during or shortly after the war. Our recent research showed that chemical exposure associated microbial dysbiosis accompanied by a leaky gut connected the pathologies in the intestine, liver, and brain. However, the mechanisms that caused the symptoms to persist even 30 years after the war remained elusive to investigators. In this study, we used a rodent model of GWI to investigate the persistence of microbiome alterations, resultant chronic inflammation, and its effect on neurotrophic and synaptic plasticity marker BDNF. The results showed that exposure to GW chemicals (the pesticide permethrin and prophylactic drug pyridostigmine bromide) resulted in persistent pathology characterized by the low relative abundance of the probiotic bacteria Akkermansia muciniphila in the gut, which correlated with high circulatory HMGB1 levels, blood-brain barrier dysfunction, neuroinflammation and lowered neurotrophin BDNF levels. Mechanistically, we used mice lacking the NLRP3 gene to investigate this inflammasome’s role in observed pathology. These mice had significantly decreased inflammation and a subsequent increase in BDNF in the frontal cortex. This suggests that a persistently low species abundance of Akkermansia muciniphila and associated chronic inflammation due to inflammasome activation might be playing a significant role in contributing to chronic neurological problems in GWI. A therapeutic approach with various small molecules that can target both the restoration of a healthy microbiome and decreasing inflammasome activation might have better outcomes in treating GWI symptom persistence.
BET inhibitors synergize with venetoclax to induce apoptosis in MYC-driven lymphomas with high BCL-2 expression
Authors: Cummin Thomas E. C. , Cox Kerry L. , Murray Tom D. , Turaj Anna H. , Dunning Lisa , English Vikki L. , Fell Rachel , Packham Graham , Ma Yan , Powell Ben , Johnson Peter W. M. , Cragg Mark S. , Carter Matthew J.
Published: July 2020

Although the MYC oncogenic network represents an attractive therapeutic target for lymphoma, MYC inhibitors have been difficult to develop. Alternatively, inhibitors of epigenetic/ transcriptional regulators, particularly the bromodomain and extraterminal (BET) family, have been used to modulate MYC. However, current benzodiazepine-derivative BET inhibitors (BETi) elicit disappointing responses and dose-limiting toxicity in relapsed/refractory lymphoma, potentially because of enrichment of high-risk molecular features and chemical backbone-associated toxicities. Consequently, novel nonbenzodiazepine BETi and improved mechanistic understanding are required. Here we characterize the responses of aggressive MYC-driven lymphomas to 2 nonbenzodiazepine BETi: PLX51107 and PLX2853. Both invoked BIM-dependent apoptosis and in vivo therapy, associated with miR-17∼92 repression, in murine Eµ-myc lymphomas, with PLX2853 exhibiting enhanced potency. Accordingly, exogenous BCL-2 expression abrogated these effects. Because high BCL-2 expression is common in diffuse large B-cell lymphoma (DLBCL), BETi were ineffective in driving apoptosis and in vivo therapy of DLBCL cell lines, mirroring clinical results. However, BETi-mediated BIM upregulation and miR-17∼92 repression remained intact. Consequently, coadministration of BETi and ABT199/venetoclax restored cell death and in vivo therapy. Collectively, these data identify BIM-dependent apoptosis as a critical mechanism of action for this class of BETi that, via coadministration of BH3 mimetics, can deliver effective tumor control in DLBCL.
Transcriptome analysis of the uterus of hens laying eggs differing in cuticle deposition
Authors: Poyatos Pertiñez Sandra , Wilson Peter W. , Icken Wiebke , Cavero David , Bain Maureen M. , Jones Anita C. , Dunn Ian C.
Published: July 2020

Background

Avian eggs have a proteinaceous cuticle. The quantity of cuticle varies and the deposition of a good cuticle in the uterus (Shell-gland) prevents transmission of bacteria to the egg contents.

Results

To understand cuticle deposition, uterus transcriptomes were compared between hens with i) naturally good and poor cuticle and, ii) where manipulation of the hypothalamo-pituitary-gonadal-oviduct axis produced eggs with or without cuticle. The highest expressed genes encoded eggshell matrix and cuticle proteins, e.g. MEPE (OC-116), BPIFB3 (OVX-36), RARRES1 (OVX-32), WAP (OVX-25), and genes for mitochondrial oxidative phosphorylation, active transport and energy metabolism. Expression of a number of these genes differed between hens laying eggs with or without cuticle. There was also a high expression of clock genes. PER2, CRY2, CRY1, CLOCK and BMAL1 were differentially expressed when cuticle deposition was prevented, and they also changed throughout the egg formation cycle. This suggests an endogenous clock in the uterus may be a component of cuticle deposition control. Cuticle proteins are glycosylated and glycosaminoglycan binding genes had a lower expression when cuticle proteins were deposited on the egg. The immediate early genes, JUN and FOS, were expressed less when the cuticle had not been deposited and changed over the egg formation cycle, suggesting they are important in oviposition and cuticle deposition. The uterus transcriptome of hens with good and poor cuticle deposition did not differ.

Conclusions

We have gained insights into the factors that can affect the production of the cuticle especially clock genes and immediate early genes. We have demonstrated that these genes change their expression over the period of eggshell formation supporting their importance. The lack of differences in expression between the uterus of hens laying eggs with the best and worse cuticle suggest the genetic basis of the trait may lie outside the oviduct.
Primary care visits increase utilization of evidence-based preventative health measures
Authors: Hostetter Jeffrey , Schwarz Nolan , Klug Marilyn , Wynne Joshua , Basson Marc D.
Published: July 2020

Background

Primary care visits can serve many purposes and potentially influence health behaviors. Although previous studies suggest that increasing primary care provider numbers may be beneficial, the mechanism responsible for the association is unclear, and have not linked primary care access to specific preventative interventions. We investigated the association between the number of times patients accessed their primary care provider team and the likelihood they received selected preventative health interventions.

Methods

Patients with complete data sets from Sanford Health were categorized based on the number of primary care visits they received in a specified time period and the preventative health interventions they received. Patient characteristics were used in a propensity analysis to control for variables. Relative risks and 95% confidence intervals were calculated to estimate the likelihood of obtaining preventative measures based on number of primary care visits compared with patients who had no primary care visits during the specified time period.

Results

The likelihood of a patient receiving three specified preventative interventions was increased by 127% for vaccination, 122% for colonoscopy, and 75% for mammography if the patient had ≥ 1 primary care visit per year. More primary care visits correlated with increasing frequency of vaccinations, but increased primary care visits beyond one did not correlate with increasing frequency of mammography or colonoscopy.

Conclusions

One or more primary care visits per year is associated with increased likelihood of specific evidence-based preventative care interventions that improve longitudinal health outcomes and decrease healthcare costs. Increasing efforts to track and increase the number of primary care visits by clinics and health systems may improve patient compliance with select preventative measures.