bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiosurgery-Based AVM Scale Is Proposed for Combined Embolization and Gamma Knife Surgery for Brain Arteriovenous Malformations
Authors: Meng Xiangyu , He Hongwei , Liu Peng , Gao Dezhi , Chen Yu , Sun Shibin , Liu Ali , Li Youxiang , Jin Hengwei
Published: March 2021

Background and purpose: To evaluate whether a radiosurgery-based arteriovenous malformation (AVM) scale (RBAS) could be used to predict obliteration of brain arteriovenous malformations (bAVMs) supposed for combined endovascular embolization (EMB) and gamma knife surgery (GKS) treatment.

Methods: bAVM patients who underwent GKS with or without previous EMB from January 2011 to December 2016 at our institution were retrospectively reviewed. The patients were categorized into a combined treatment group and a GKS group. A 1:1 propensity score matching (PSM) was used to match the two groups. Pre-EMB and pre-GKS RBAS were assessed for every patient. Multivariate analysis was performed to find factors associated with complete obliteration in the combined treatment group. Survival analysis based on sub-groups according to RBAS was performed to compare obliteration rate and find cutoffs for appropriate treatment modalities.

Results: A total of 96 patients were involved, and each group comprised 48 patients. There was no difference between the two groups in terms of obliteration rate (75.0 vs. 83.3%, p = 0.174). Pre-EMB RBAS (p = 0.010) and the number of feeding arteries (p = 0.014) were independent factors associated with obliteration rate in the combined treatment group. For the combined treatment patients, sub-group analysis according to pre-EMB RBAS (score <1.0, 1.0–1.5, and >1.5) showed statistical difference in obliteration rate (p = 0.002). Sub-group analysis according to RBAS between the two groups showed that the obliteration rate of the GKS group is significantly higher than the combined group when RBAS >1.5 (47.4 vs. 66.7%, p = 0.036).

Conclusions: The RBAS is proposed to be efficient in predicting obliteration of bAVMs supposed to receive combined EMB and GKS treatment. Patients with RBAS >1.5 are inclined to be more suitable for GKS instead of the combined treatment.
Cerebrospinal Fluid Biomarkers of Myeloid and Glial Cell Activation Are Correlated With Multiple Sclerosis Lesional Inflammatory Activity
Authors: Masvekar Ruturaj , Phillips Jonathan , Komori Mika , Wu Tianxia , Bielekova Bibiana
Published: March 2021

Multiple sclerosis (MS)-related inflammation can be divided into lesional activity, mediated by immune cells migrating from the periphery to the central nervous system (CNS) and non-lesional activity, mediated by inflammation compartmentalized to CNS tissue. Lesional inflammatory activity, reflected by contrast-enhancing lesions (CELs) on the magnetic resonance imaging (MRI), is effectively inhibited by current disease modifying therapies (DMTs). While, the effect of DMTs on non-lesional inflammatory activity is currently unknown. Reliable and simultaneous measurements of both lesional and non-lesional MS activity is necessary to understand their contribution to CNS tissue destruction in individual patients. We previously demonstrated that CNS compartmentalized inflammation can be measured by combined quantification of cerebrospinal fluid (CSF) immune cells and cell-specific soluble markers. The goal of this study is to develop and validate a CSF-biomarker-based molecular surrogate of MS lesional activity. The training cohort was dichotomized into active (CELs > 1 or clinical relapse) and inactive lesional activity (no CELs or relapse) groups. Matched CSF and serum samples were analyzed for 20 inflammatory and axonal damage biomarkers in a blinded fashion. Only the findings from the training cohort with less than 0.1% probability of false positive (i.e.,p< 0.001) were validated in an independent validation cohort. MS patients with lesional activity have elevated IL-12p40, CHI3L1, TNFα, TNFβ, and IL-10, with the first two having the strongest effects and validated statistically-significant association with lesional activity in an independent validation cohort. Marker of axonal damage, neurofilament light (NfL), measured in CSF (cNfL) was also significantly elevated in MS patients with active lesions. NfL measured in serum (sNfL) did not differentiate the two MS subgroups with pre-determined significance, (p= 0.0690) even though cCSF and sNfL correlated (Rho = 0.66,p< 0.0001). Finally, the additive model of IL12p40 and CHI3L1 outperforms any biomarker discretely. IL12p40 and CHI3L1, released predominantly by immune cells of myeloid lineage are reproducibly the best CSF biomarkers of MS lesional activity. The residuals from the IL12p40/CHI3L1-cNfL correlations may identify MS patients with more destructive inflammation or contributing neurodegeneration.
Spatiotemporal Correlation of Epileptiform Activity and Gene Expression in vitro
Authors: Schlabitz Sophie , Monni Laura , Ragot Alienor , Dipper-Wawra Matthias , Onken Julia , Holtkamp Martin , Fidzinski Pawel
Published: March 2021

Epileptiform activity alters gene expression in the central nervous system, a phenomenon that has been studied extensively in animal models. Here, we asked whether also in vitro models of seizures are in principle suitable to investigate changes in gene expression due to epileptiform activity and tested this hypothesis mainly in rodent and additionally in some human brain slices. We focused on three genes relevant for seizures and epilepsy: FOS proto-oncogene (c-Fos), inducible cAMP early repressor (Icer) and mammalian target of rapamycin (mTor). Seizure-like events (SLEs) were induced by 4-aminopyridine (4-AP) in rat entorhinal-hippocampal slices and by 4-AP/8 mM potassium in human temporal lobe slices obtained from surgical treatment of epilepsy. SLEs were monitored simultaneously by extracellular field potentials and intrinsic optical signals (IOS) for 1–4 h, mRNA expression was quantified by real time PCR. In rat slices, both duration of SLE exposure and SLE onset region were associated with increased expression of c-Fos and Icer while no such association was shown for mTor expression. Similar to rat slices, c-FOS induction in human tissue was increased in slices with epileptiform activity. Our results indicate that irrespective of limitations imposed by ex vivo conditions, in vitro models represent a suitable tool to investigate gene expression. Our finding is of relevance for the investigation of human tissue that can only be performed ex vivo. Specifically, it presents an important prerequisite for future studies on transcriptome-wide and cell-specific changes in human tissue with the goal to reveal novel candidates involved in the pathophysiology of epilepsy and possibly other CNS pathologies.
Safety of Prolonged Wait Time for Nephrectomy for Clinically Localized Renal Cell Carcinoma
Authors: Qi Nienie , Zhao Fangzheng , Liu Xiaoxiao , Wei Wei , Wang Junqi
Published: March 2021

Background

There is usually a surgical wait time before nephrectomy for patients with clinically localized renal cell carcinoma, and many factors can influence this preoperative wait time. A relatively prolonged wait time may cause tumor progression. Therefore, we assessed the effect of preoperative wait time on the prognosis of patients with clinically localized renal cell carcinoma.

Methods

The outcomes of 561 patients with clinically localized renal cell carcinoma who underwent nephrectomy between July 2011 and March 2017 were retrospectively evaluated. According to the wait time before surgery, we divided the patients into three groups: short-wait group (≤ 30 days), intermediate-wait group (> 30 and ≤ 90 days), and long-wait group (>90 days). The clinicopathological characteristics were evaluated, and the survival rates of the three groups were compared.

Results

This study included 370 male (66%) and 191(34%) female patients, with a median age of 64 years. There were 520 patients with stage T1 and 41 patients with stage T2 tumors. The median interval between diagnosis and surgery was 21 days. There were no significant differences in age, sex, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index, tumor size, surgical approach, surgical procedure, pathological subtype, tumor stage, tumor grade, and residual tumor among the three groups. Overall survival(OS) and cancer-specific survival (CSS) were comparable; the 5-year OS of the short-, intermediate-, and long-wait time groups were 84.2%, 82.0%, and 89.8%, respectively (P=0.732). The 5-year CSS rates of the short-, intermediate-, and long-wait time groups were 87.1%, 88.9%, and 90.4%, respectively (P=0.896). Multivariate analysis revealed that wait time was not an independent prognostic factor for OS or CSS.

Conclusion

Prolonged surgical wait time (> 90 days) does not influence survival in patients with clinically localized renal cell carcinoma.
Establishment of a Novel Risk Score System of Immune Genes Associated With Prognosis in Esophageal Carcinoma
Authors: Fei Zhenghua , Xie Rongrong , Chen Zhi , Xie Junhui , Gu Yuyang , Zhou Yue , Xu Tongpeng
Published: March 2021

Background

Few studies have addressed the role of immune-related genes in the survival and prognosis of different esophageal cancer (EC) sub-types. We established two new prognostic model indexes by bioinformatics analysis to select patients with esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) who may benefit from immunotherapy.

Methods

Based on TCGA and ImmPort data sets, we screened immune genes differentially expressed between tumor and normal tissues in ESCC and EAC and analyzed the relationship between these genes and patient survival outcomes. We established the risk score models of immune-related genes in ESCC and EAC by multivariate COX regression analysis.

Results

We identified 12 and 11 immune-related differentially expressed genes associated with the clinical prognosis of ESCC and EAC respectively, based on which two prognostic risk score models of the two EC sub-types were constructed. It was found that the survival probability of patients with high scores was significantly lower than that of patients with low scores (p < 0.001). BMP1, EGFR, S100A12, HLA-B, TNFSF18, IL1B, MAPT and OXTR were significantly related to sex, TNM stage or survival outcomes of ESCC or EAC patients (p < 0.05). In addition, the risk score of ESCC was significantly correlated with the level of B cell infiltration in immune cells (p < 0.05).

Conclusions

The prognosis-related immune gene model indexes described herein prove to be useful prognostic biomarkers of the two EC sub-types in that they may provide a reference direction for looking for the beneficiaries of immunotherapy for EC patients.
NM23-H1 Expression of Head and Neck Squamous Cell Carcinoma in Association With the Response to Irradiation
Authors: Wang Yi-Fen , Lin Yi-Ke , Lin Chin-Ping , Chen Yu-Jen , Chang Chun-Ju
Published: March 2021

A low NM23-H1 expression in head and neck squamous cell carcinoma (HNSCC) was found to be associated with poor clinical outcome. Therefore, we investigated the role of NM23-H1 in the susceptibility of HNSCC cells to irradiation and its clinical significance. An in vitro study was also conducted to validate the results. Furthermore, we used immunohistochemistry to analyze NM23-H1 expression found in specimens of 50 HNSCC patients with cervical metastases receiving postoperative radiotherapy. Low tumor NM23-H1 expression was associated with locoregional recurrence of HNSCC (p=0.040; Hazard ratio=5.62) and poor clinical outcome (p=0.001; Hazard ratio=4.90). To confirm the effect of NM23-H1 on radiation-induced cytotoxicity, we generated several stable clones derived from a human HNSCC cell line (SAS) using knockdown and overexpression of NM23-H1. Knockdown of NM23-H1 decreased the radio-sensitivity of SAS cells, possibly associated with a decrease in the radiation-induced G2/M-phase accumulation and upregulation of cyclin B1. On the contrary, overexpression of NM23-H1 can reverse the aforementioned adverse results. Consequently, we suggest that NM23-H1 expression may be considered as a potential therapeutic treatment option for HNSCC patients.
A Local and Low-Dose Chemotherapy/Autophagy-Enhancing Regimen Treatment Markedly Inhibited the Growth of Established Solid Tumors Through a Systemic Antitumor Immune Response
Authors: Yuan Jia , Yuan Xianlin , Wu Kunlong , Gao Junxia , Li Liangping
Published: March 2021

Chemotherapy is one of the main options for the treatment of a variety of malignant tumors. However, the severe side effects resulting from the killing of normal proliferating cells limit the application of cancer-targeting chemotherapeutic drugs. To improve the efficacy of classic systemic chemotherapy, the local delivery of high-dose chemotherapeutic drugs was developed as a method to enhance local drug concentrations and minimize systemic toxicity. Studies have demonstrated that chemotherapy is often accompanied by cancer-associated immunogenic cell death (ICD) and that autophagy is involved in the induction of ICD. To improve the efficacy of local cancer chemotherapy, we hypothesized that the local delivery of chemotherapeutic plus autophagy-enhancing agents would enhance the promotive effects of ICD on the antitumor immune response. Here, we report that a low-dose chemotherapy/autophagy enhancing regimen (CAER) not only resulted in the increased death of B16F10 and 4T1 tumor cells, but also induced higher levels of autophagy in vitro. Importantly, the local delivery of the CARE drugs significantly inhibited tumor growth in B16F10 and 4T1 tumor-bearing mice. Systemic antitumor T-cell immunity was observed in vivo, including neoantigen-specific T-cell responses. Furthermore, bioinformatic analysis of human breast cancer and melanoma tissues showed that autophagy-associated gene expression was upregulated in tumor samples. Increased autophagy and immune cell infiltration in tumor tissues were positively correlated with good prognosis of tumor patients. This work highlights a new approach to improve the effects of local chemotherapy and enhance systemic antitumor immunity.
Clinical and Molecular Differentiation Between Malignant Rhabdoid Tumor of the Kidney and Normal Tissue: A Two-Case Report
Authors: Zhanghuang Chenghao , Chen Shuo , Li Li , Yang Zhen , Xie Yucheng , Li Jiwei , Tang Haoyu , He Xiaoli , Dong Liuyi , Yan Bing
Published: March 2021

Background

Malignant rhabdoid tumor of the kidney (MRTK) is a rare type of tumor that lacks typical clinical manifestations. Herein, we presented clinical data of 2 children with MRTK. In addition, we used a high-throughput RNA-sequencing (RNA-seq), GO analysis, and KEGG signaling pathway analysis to examine gene expression differences at the transcripts level between 2 patients with MRTK and 3 patients with non-tumor diseases without other symptoms.

Case report

Preoperative B-scan ultrasonography and computed tomography (CT) examination in 2 cases suggested nephroblastoma. Both patients were treated with radical nephrectomy. After the operation, MRTK was confirmed by pathological examination. Child 1 and Child 2 then received 7 courses and 12 courses of regular chemotherapy, respectively. Child 1 was followed up for 2 years, and Child 2 for 3.1 years without showing symptoms. RNA-seq results showed 2203 differential genes (DEGs) in the kidney tissue of children with MRTK compared to normal tissue (p <0.01). GO analysis suggested that most DEGs participate in protein binding. KEGG results showed that the DEGs were mainly involved in the PI3K-Akt signaling pathway and microRNA-related proteins.

Conclusion

The PI3K-Akt signaling pathway and microRNA-related proteins as targets have extremely high potential value for the diagnosis and treatment of MRTK.
Perineural Invasion Is a Strong Prognostic Factor but Not a Predictive Factor of Response to Adjuvant Chemotherapy in Node-Negative Colon Cancer
Authors: Tu Junhao , Yao Zongxi , Wu Wenqing , Ju Jianxiang , Xu Yinkai , Liu Yulin
Published: March 2021

Purpose

To validate the prognostic value and evaluate the predictive value of response to adjuvant chemotherapy of perineural invasion (PNI) in node-negative colon cancer using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 18 tumor registry database.

Methods

Patients diagnosed with colon cancer from the SEER database between January 1, 2010 and December 31, 2015 were identified. Chi-square analysis was performed to evaluate different demographic and clinical features of patients between PNI-negative (PNI (−)) and PNI-positive (PNI (+)) groups. Univariate and multivariate Cox proportional hazard regression models were built to examine the relationship of demographic and clinical features and survival outcomes with the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

In total, 57,255 node-negative colon cancer patients were extracted from the SEER database. The receipt of chemotherapy was not an independent prognostic factor for CSS in T3 colon cancer with or without the presence of PNI (P >0.05). The receipt of chemotherapy was independently associated with 34.0% decreased risk of cancer-specific mortality compared with those without the receipt of chemotherapy in T4 colon cancer without the presence of PNI (HR = 0.660, 95%CI = 0.559–0.779, P <0.001); the receipt of chemotherapy was independently associated with 36.0% decreased risk of cancer-specific mortality compared with those without the receipt of chemotherapy in T4 colon cancer with the presence of PNI (HR = 0.640, 95%CI = 0.438–0.935, P = 0.021).

Conclusions

The present study demonstrated the poor prognosis of PNI (+) in both stage I and II colon cancer. However, the presence of PNI was not a predictive factor of response to adjuvant chemotherapy in node-negative colon cancer.
One-Size-Fits All: A Scalable Solution to Formal Telemedicine Provider Training to Support the COVID-19 Pandemic Response
Authors: Schinasi Dana A. , An-Grogan Yuemi , Stephen Rebecca , Shimek Aric , Furney Marisa , Bohling M. Katie
Published: March 2021

Introduction: Formalized training in telemedicine addresses barriers to provider adoption and engagement and assures a level of competence for independent practice. We previously developed a blended-model training program, customizable according to role and specialty; this method of training was not feasible in the pandemic response. We describe the development and implementation of a multi- and interdisciplinary telemedicine provider training program enabling the rapid scaling of telemedicine at our institution.

Methods: An existing curriculum was pared down to a 1-h session delivered synchronously, covering the foundational components of telemedicine practice. Supplemental materials were available for asynchronous learning via the hospital intranet. Completion of training was required of all clinicians who practice telemedicine.

Results: We conducted 35 sessions for 1,070 providers over 12 weeks. Attendees included clinicians across numerous roles and specialties. Additional resources were created and available through the Telemedicine Virtual Handbook and housed in specific toolkits.

Discussion: Telemedicine training is necessary for consistent, competent practice of telemedicine in pediatrics. We describe a training process that can be easily replicated and rapidly deployed to providers of telemedicine across roles and disciplines. Combining a mandatory and brief synchronous provider training session with a repository of online resources creates a foundation for consistent practice, while allowing for more individualized resources accessible on demand. Standardized telemedicine training followed by mechanisms for ongoing professional practice evaluation allow institutions to ensure consistent and competent practice of telemedicine. Further study is needed to determine the best modality for training, and optimal assessment tools according to professional role.
Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
Authors: Sun Ling , Zhang Hong , Bao Yingying , Li Wenying , Wu Jingyuan , He Yuanyuan , Zhu Jiajun
Published: March 2021

Unlike other complications among very low birth weight infants (VLBW), the incidence of bronchopulmonary dysplasia (BPD) has not decreased substantially, partly because of the different definitions of BPD applied by different researchers. In this retrospective cohort study, we aimed to compare the 2018 revised definition and the 2001 consensus definition of BPD proposed by the National Institute of Child Health and Human Development (NICHD), as well as to identify which definition better predicts severe respiratory morbidities or death. We included 417 infants born at a gestational age <32 weeks and classified them as having BPD or without BPD based on the two definitions, with a final follow-up at 18–24 months. We performed between-group comparisons of death and respiratory outcomes. Statistical analyses were performed using descriptive statistics, comparative tests, and receiver operating characteristic curves. The mean ± standard deviation gestational age and birth weight of the 417 eligible infants were 29.1 ± 1.4 weeks and 1186.6 ± 197.8 g, respectively. Among the included infants, five and three infants died before and after 36 weeks of post-menstrual age (PMA), respectively, with 68 and 344 infants evaluated at discharge and 36 weeks' PMA, respectively. We diagnosed 163 (39.1%) and 70 (16.8%) infants with BPD according to the 2001 and 2018 NICHD definitions, respectively. The 2001 NICHD definition displayed a higher sensitivity (0.60 vs. 0.28), better negative predictive value (0.89 vs. 0.85), and larger area under the receiver operating characteristic curve (0.66 vs. 0.57), but a lower specificity (0.65 vs. 0.87) and worse positive predictive value (0.26 vs. 0.31), than the 2018 definition for serious respiratory morbidity or mortality at a corrected age of 18–24 months. Compared with the 2018 NICHD definition of BPD, the 2001 NICHD consensus definition may result in more cases of false-positive or unclassified severity. However, it may be a better indicator of severe respiratory morbidities or death during the first 18–24 months. Nevertheless, there is a need for future studies to assess the validity of the new diagnostic criteria.
Disturbances in Brain Physiology Due to Season Play: A Multi-Sport Study of Male and Female University Athletes
Authors: Churchill Nathan W. , Hutchison Michael G. , Graham Simon J. , Schweizer Tom A.
Published: March 2021

High-performance university athletes experience frequent exertion, resulting in disrupted biological homeostasis, but it is unclear to what extent brain physiology is affected. We examined whether athletes without overtraining symptoms show signs of increased neurophysiological stress over the course of a single athletic season, and whether the effects are modified by demographic factors of age, sex and concussion history, and sport-related factors of contact exposure and season length. Fifty-three university-level athletes were recruited from multiple sports at a single institution and followed longitudinally from beginning of season (BOS) to end of season (EOS) and 1 month afterwards, with a subset followed up at the subsequent beginning of season. MRI was used to comprehensively assess white matter (WM) diffusivity, cerebral blood flow (CBF), and brain activity, while overtraining symptoms were assessed with Hooper’s Index (HI). Although athletes did not report increased HI scores, they showed significantly increased white matter diffusivity and decreased CBF at EOS and 1 month afterwards, with recovery at follow-up. Global brain activity was not significantly altered though, highlighting the ability of the brain to adapt to exercise-related stressors. Male athletes had greater white matter diffusivity at EOS, but female athletes had greater declines in CBF at 1 month afterwards. Post-season changes in MRI measures were not related to change in HI score, age, concussion history, contact exposure, or length of athletic season. Hence, the brain shows substantial but reversible neurophysiological changes due to season play in the absence of overtraining symptoms, with effects that are sex-dependent but otherwise insensitive to demographic variations. These findings provide new insights into the effects of training and competitive play on brain health.
ECG-Based Indices to Characterize Persistent Atrial Fibrillation Before and During Stepwise Catheter Ablation
Authors: McCann Anna , Vesin Jean-Marc , Pruvot Etienne , Roten Laurent , Sticherling Christian , Luca Adrian
Published: March 2021

Background: Consistently successful patient outcomes following catheter ablation (CA) for treatment of persistent atrial fibrillation (pers-AF) remain elusive. We propose an electrocardiogram (ECG) analysis designed to (1) refine selection of patients most likely to benefit from ablation, and (2) examine the temporal evolution of AF organization indices that could act as clinical indicators of ongoing ablation effectiveness and completeness.

Method: Twelve-lead ECG was continuously recorded in 40 patients (61 ± 8 years) during stepwise CA (step-CA) procedures for treatment of pers-AF (sustained duration 19 ± 11 months). Following standard pre-processing, ECG signals were divided into 10-s epochs and labeled according to their temporal placement: pre-PVI (baseline), dur-PVI (during pulmonary vein isolation), and post-PVI (during complex-fractionated atrial electrograms and linear ablation). Instantaneous frequency (IF), adaptive organization index (AOI), sample entropy (SampEn) and f-wave amplitude (FWA) measures were calculated and analyzed during each of the three temporal steps. Temporal evolution of these measures was assessed using a statistical test for mean value transitions, as an indicator of changes in AF organization. Results were then compared between: (i) patients grouped according to step-CA outcome; (ii) patients grouped according to type of arrhythmia recurrence following the procedure, if applicable; (iii) within the same patient group during the three different temporal steps.

Results: Stepwise CA patient outcomes were as follows: (1) left-atrium (LA) terminated, not recurring (LTN, n = 8), (2) LA terminated, recurring (LTR, n = 20), and (3) not LA terminated, all recurring at follow-up (NLT, n = 12). Among the LTR and NLT patients, recurrence occurred as AF in seven patients and atrial tachycardia or atrial flutter (AT/AFL) in the remaining 25 patients. The ECG measures indicated the lowest level of organization in the NLT group for all ablation steps. The highest organization was observed in the LTN group, while the LTR group displayed an intermediate level of organization. Regarding time evolution of ECG measures in dur-PVI and post-PVI recordings, stepwise ablation led to increases in AF organization in most patients, with no significant differences between the LTN, LTR, and NLT groups. The median decrease in IF and increase in AOI were significantly greater in AT/AFL recurring patients than in AF recurring patients; however, changes in the SampEn and FWA parameters were not significantly different between types of recurrence.

Conclusion: Noninvasive ECG measures, though unable to predict arrhythmia recurrence following ablation, show the lowest levels of AF organization in patients that do not respond well to step-CA. Increasing AF organization in post-PVI may be associated with organized arrhythmia recurrence after a single ablation procedure.
From the Imaginary to Theory of the Gaze in Lacan
Authors: Licitra Rosa Carmelo , Antonucci Carla , Siracusano Alberto , Centonze Diego
Published: March 2021

To understand Lacan’s thinking process on vision, the entirety of his teaching must be taken into consideration. Until the 60s, the visual field is the imaginary, the constitutive principle of reality in its phenomenal giving to the experience of a subject. This register is the opposite of the field of the word with the L schema and, subsequently, as subordinated to the symbolic system according to the model of the optical schema of the inverted flower vase of Bouasse. It is only with the 1964 seminar that Lacan makes a daring turnaround through which the visual becomes a sign of the emergence of a real that is irreducible to both reality and the mediation of the subject of knowledge. The split that separates reality and the real is reproduced in Lacan within the visual field, which is, on the one hand, the cardinal principle of the consistency of the experience of reality (as imaginary), and on the other, it is an element of irreducibility to reality (as object gaze). This produces a cascade of consequences: first of all, the modification of the presentation of the mirror stage. Unlike the voice, which through prosody, tone, and volume, finds some strips with which anchor itself imaginatively to reality, the gaze, invisible and elusive, escapes the imaginary grasp. Captured in myths, it reveals its power and ability to annihilate—as in the myth of Medusa’s gaze—or to make people fall in love but only with a narcissistic love that leads inexorably to death as in the myth of Narcissus. The gaze is elusive because the subject is dependent on it in the field of desire. Like the voice, it is about the desire on which the subject is supported; it is one of the objects on which the phantom depends. In our opinion, thanks to this characteristic, the gaze object can make remote psychoanalytic treatment possible through easily accessible videoconferencing tools and, at the same time, create new conditions within it that should be carefully evaluated to understand its implications in the session itself.
Precarious Employment and Stress: The Biomedical Embodiment of Social Factors. PRESSED Project Study Protocol
Authors: Bolibar Mireia , Belvis Francesc Xavier , Jódar Pere , Vives Alejandra , Méndez Fabrizio , Bartoll-Roca Xavier , Pozo Oscar J. , Gomez-Gomez Alex , Padrosa Eva , Benach Joan , Julià Mireia
Published: March 2021

The PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to fill this gap from an interdisciplinary perspective, integrating the social and biomedical standpoints to comprehensively address the complex web of consequences of precarious employment and its effects on workers' stress, health and well-being, including health inequalities. The project objectives are: (1) to analyze the association between multidimensional precarious employment and chronic stress among salaried workers in Barcelona, measured both subjectively and using biological indicators; (2) to improve our understanding of the pathways and mechanisms linking precarious employment with stress, health and well-being; and (3) to analyze health inequalities by gender, social class and place of origin for the first two objectives. The study follows a sequential mixed design. First, secondary data from the 2017 Survey on Workers and the Unemployed of Barcelona is analyzed (N= 1,264), yielding a social map of precarious employment in Barcelona that allows the contextualization of the scope and characteristics of this phenomenon. Drawing on these results, a second survey on a smaller sample (N= 255) on precarious employment, social precariousness and stress is envisaged. This study population is also asked to provide a hair sample to have their levels of cortisol and its related components, biomarkers of chronic stress, analyzed. Third, a sub-sample of the latter survey (n = 25) is selected to perform qualitative semi-structured interviews. This allows going into greater depth into how and why the experience of uncertainty, the precarization of living conditions, and the degradation of working conditions go hand-in-hand with precarious employment and have an impact on stress, as well as to explore the potential role of social support networks in mitigating these effects.
Angiotensin (1–7) Expressing Probiotic as a Potential Treatment for Dementia
Authors: Hernandez Abbi R. , Banerjee Anisha , Carter Christy S. , Buford Thomas W.
Published: March 2021

Increasing life expectancies are unfortunately accompanied by increased prevalence of Alzheimer's disease (AD). Regrettably, there are no current therapeutic options capable of preventing or treating AD. We review here data indicating that AD is accompanied by gut dysbiosis and impaired renin angiotensin system (RAS) function. Therefore, we propose the potential utility of an intervention targeting both the gut microbiome and RAS as both are heavily involved in proper CNS function. One potential approach which our group is currently exploring is the use of genetically-modified probiotics (GMPs) to deliver therapeutic compounds. In this review, we specifically highlight the potential utility of utilizing a GMP to deliver Angiotensin (1–7), a beneficial component of the renin-angiotensin system with relevant functions in circulation as well as locally in the gut and brain.
Augmented Reality in Medical Practice: From Spine Surgery to Remote Assistance
Authors: Cofano Fabio , Di Perna Giuseppe , Bozzaro Marco , Longo Alessandro , Marengo Nicola , Zenga Francesco , Zullo Nicola , Cavalieri Matteo , Damiani Luca , Boges Daniya J. , Agus Marco , Garbossa Diego , Calì Corrado
Published: March 2021

Background: While performing surgeries in the OR, surgeons and assistants often need to access several information regarding surgical planning and/or procedures related to the surgery itself, or the accessory equipment to perform certain operations. The accessibility of this information often relies on the physical presence of technical and medical specialists in the OR, which is increasingly difficult due to the number of limitations imposed by the COVID emergency to avoid overcrowded environments or external personnel. Here, we analyze several scenarios where we equipped OR personnel with augmented reality (AR) glasses, allowing a remote specialist to guide OR operations through voice and ad-hoc visuals, superimposed to the field of view of the operator wearing them.

Methods: This study is a preliminary case series of prospective collected data about the use of AR-assistance in spine surgery from January to July 2020. The technology has been used on a cohort of 12 patients affected by degenerative lumbar spine disease with lumbar sciatica co-morbidities. Surgeons and OR specialists were equipped with AR devices, customized with P2P videoconference commercial apps, or customized holographic apps. The devices were tested during surgeries for lumbar arthrodesis in a multicenter experience involving author's Institutions.

Findings: A total number of 12 lumbar arthrodesis have been performed while using the described AR technology, with application spanning from telementoring (3), teaching (2), surgical planning superimposition and interaction with the hologram using a custom application for Microsoft hololens (1). Surgeons wearing the AR goggles reported a positive feedback as for the ergonomy, wearability and comfort during the procedure; being able to visualize a 3D reconstruction during surgery was perceived as a straightforward benefit, allowing to speed-up procedures, thus limiting post-operational complications. The possibility of remotely interacting with a specialist on the glasses was a potent added value during COVID emergency, due to limited access of non-resident personnel in the OR.

Interpretation: By allowing surgeons to overlay digital medical content on actual surroundings, augmented reality surgery can be exploited easily in multiple scenarios by adapting commercially available or custom-made apps to several use cases. The possibility to observe directly the operatory theater through the eyes of the surgeon might be a game-changer, giving the chance to unexperienced surgeons to be virtually at the site of the operation, or allowing a remote experienced operator to guide wisely the unexperienced surgeon during a procedure.
Design, Manufacturing, and Characterization of Thin, Core-Free, Rolled Dielectric Elastomer Actuators
Authors: Kunze Julian , Prechtl Johannes , Bruch Daniel , Fasolt Bettina , Nalbach Sophie , Motzki Paul , Seelecke Stefan , Rizzello Gianluca
Published: March 2021

In this work, we develop a coreless rolled dielectric elastomer actuator (CORDEA) to be used as artificial muscles in soft robotic structures. The new CORDEA concept is based on a 50 µm silicone film with screen-printed electrodes made of carbon black suspended in polydimethylsiloxane. Two printed silicone films are stacked together and then tightly rolled in a spiral-like structure. Readily available off-the-shelf components are used to implement both electrical and mechanical contacts. A novel manufacturing process is developed to enable the production of rolled actuators without a hollow core, with a focus on simplicity and reliability. In this way, actuator systems with high energy density can be effectively achieved. After presenting the design, an experimental evaluation of the CORDEA electromechanical behavior is performed. Finally, actuator experiments in which the CORDEA is pre-loaded with a mass load and subsequently subject to cycling voltage are illustrated, and the resulting performance is discussed.
Numerical Investigation of a Dynamic Stall on a Single Rotating Blade
Authors: Ruan Yin , Hajek Manfred
Published: March 2021

Dynamic stall is a phenomenon on the retreating blade of a helicopter which can lead to excessive control loads. In order to understand dynamic stall and fill the gap between the investigations on pitching wings and full helicopter rotor blades, a numerical investigation of a single rotating and pitching blade is carried out. The flow phenomena thereupon including the Ω-shaped dynamic stall vortex, the interaction of the leading edge vortex with the tip vortex, and a newly noticed vortex structure originating inboard are examined; they show similarities to pitching wings, while also possessing their unique features of a rotating system. The leading edge/tip vortex interaction dominates the post-stall stage. A newly noticed swell structure is observed to have a great impact on the load in the post-stall stage. With such a high Reynolds number, the Coriolis force exerted on the leading edge vortex is negligible compared to the pressure force. The force history/vortex structure of the slice r/R = 0.898 is compared with a 2D pitching airfoil with the same harmonic pitch motion, and the current simulation shows the important role played by the swell structure in the recovery stage.
Diversity of Colletotrichum Species Associated with Anthracnose Disease in Tropical Fruit Crops—A Review
Authors: Zakaria Latiffah
Published: March 2021

In tropical fruit crops, anthracnose is mainly caused by species belonging to the fungal genus, Colletotrichum. These phytopathogens can infect several parts of the fruit crops; however, infection during postharvest or ripening stages is responsible for major economic losses. Due to the formation of black to dark brown sunken lesions on the fruit surface, anthracnose reduces fruit quality and marketability. Among the most common tropical fruit crops susceptible to anthracnose are mango, papaya, banana, avocado, guava, and dragon fruit; these are economically relevant products in many developing countries. It is important to document that the newly recorded Colletotrichum spp. associated with fruit anthracnose can infect multiple hosts, but some species may be host-specific. By using multiple markers, many phylogenetic species of Colletotrichum have been reported as anthracnose-causing pathogens. Taking into account that disease management strategies strongly rely on adequate knowledge of the causative agents, updated information on Colletotrichum species and the hazard posed by the most recently identified species in tropical fruit plantations and harvested fruits becomes vital. Besides, the newly recorded species may be important for biosecurity and should be listed as quarantine pathogens, considering that tropical fruits are traded worldwide.
RNAseq Reveals Differential Gene Expression Contributing to Phytophthora nicotianae Adaptation to Partial Resistance in Tobacco
Authors: Jin Jing , Shi Rui , Lewis Ramsey Steven , Shew Howard David
Published: March 2021

Phytophthora nicotianae is a devastating oomycete plant pathogen with a wide host range. On tobacco, it causes black shank, a disease that can result in severe economic losses. Deployment of host resistance is one of the most effective means of controlling tobacco black shank, but adaptation to complete and partial resistance by P. nicotianae can limit the long-term effectiveness of the resistance. The molecular basis of adaptation to partial resistance is largely unknown. RNAseq was performed on two isolates of P. nicotianae (adapted to either the susceptible tobacco genotype Hicks or the partially resistant genotype K 326 Wz/Wz) to identify differentially expressed genes (DEGs) during their pathogenic interactions with K 326 Wz/Wz and Hicks. Approximately 69% of the up-regulated DEGs were associated with pathogenicity in the K 326 Wz/Wz-adapted isolate when sampled following infection of its adapted host K 326 Wz/Wz. Thirty-one percent of the up-regulated DEGs were associated with pathogenicity in the Hicks-adapted isolate on K 326 Wz/Wz. A broad spectrum of over-represented gene ontology (GO) terms were assigned to down-regulated genes in the Hicks-adapted isolate. In the host, a series of GO terms involved in nuclear biosynthesis processes were assigned to the down-regulated genes in K 326 Wz/Wz inoculated with K 326 Wz/Wz-adapted isolate. This study enhances our understanding of the molecular mechanisms of P. nicotianae adaptation to partial resistance in tobacco by elucidating how the pathogen recruits pathogenicity-associated genes that impact host biological activities.
Total and Hot-Water Extractable Organic Carbon and Nitrogen in Organic Soil Amendments: Their Prediction Using Portable Mid-Infrared Spectroscopy with Support Vector Machines
Authors: Wehrle Ralf , Welp Gerhard , Pätzold Stefan
Published: March 2021

Against the background of climate change mitigation, organic amendments (OA) may contribute to store carbon (C) in soils, given that the OA provide a sufficient stability and resistance to degradation. In terms of the evaluation of OA behavior in soil, total organic carbon (TOC), total nitrogen (TN), and the ratio of TOC to TN (CN-ratio) are important basic indicators. Hot-water extractable carbon (hwC) and nitrogen (hwN) as well as their ratios to TOC and TN are appropriate to characterize a labile pool of organic matter. As for quickly determining these properties, mid-infrared spectroscopy (MIRS) in combination with calibrations based on machine learning methods are potentially capable of analyzing various OA attributes. Recently available portable devices (pMIRS) might replace established benchtop devices (bMIRS) as they have potential for on-site measurements that would facilitate the workflow. Here, we used non-linear support vector machines (SVM) to calibrate prediction models for a heterogeneous dataset of greenwaste composts and biochar compost substrates (BCS) (n = 45) using bMIRS and pMIRS instruments on ground samples. Calibrated models for both devices were validated on separate test sets and showed similar results. Ten OA were sieved to particle size classes (psc’s) of >4 mm, 2–4 mm, 0.5–2 mm, and <0.5 mm. A universal SVM model was then developed for all OA and psc’s (n = 162) via pMIRS. Validation revealed that the models provided reliable predictions for most parameters (R2 = 0.49–0.93; ratio of performance to interquartile distance (RPIQ) = 1.19–5.70). We conclude that (i) the examined parameters are sensitive towards chemical composition of OA as well as particle size distribution and can therefore be used as indicators for labile carbon and nitrogen pools of OA, (ii) prediction models based on SVM and pMIRS are a feasible approach to predict the examined C and N pools in organic amendments and their particle size class, and (iii) pMIRS can provide valuable information for optimized application of OA on cultivated soils at low costs and efforts.
The Site of Origin of Canine Abdominal Masses Correlates with the Risk of Malignancy: Retrospective Study of 123 Cases
Authors: Valenti Paola , Pellegrino Valeria , Muscatello Luisa Vera , Brunetti Barbara , Zambon Elisa , Gerboni Gian Marco , Alberti Monica , Avallone Giancarlo
Published: March 2021

The detection of an abdominal mass represents a common finding in clinical practice. The aim of this study was to retrospectively describe the tissue distribution and diagnosis of abdominal masses amenable to surgical removal in a canine population. Dogs with abdominal masses with a minimum diameter of 3 cm were selected. Cases were classified, based on the anatomical location, as splenic, gastrointestinal, hepatobiliary, genital, and masses not associated with any organ. Masses were surgically removed and formalin-fixed for the histological examination. Collected data were statistically analyzed. A total of 123 masses were collected from 122 dogs. Sixty-nine masses were classified as malignant neoplasia, 15 as benign, and 39 as non-neoplastic. The abdominal masses were 5.8-fold more likely to be malignant if located in the gastrointestinal tract (p = 0.01). A significant association between the size and the site of the masses was identified, the masses not associated with any organ being larger than the genital and splenic lesions (p = 0.008). This case series describes the most frequent location in association with the histopathological diagnosis of canine abdominal masses and suggests that the gastrointestinal location was related to a higher risk of representing a malignant neoplasm.
Biochemical Methane Potential of Cork Boiling Wastewater at Different Inoculum to Substrate Ratios
Authors: Mota-Panizio Roberta , Hermoso-Orzáez Manuel Jesús , Carmo-Calado Luis , Lourinho Gonçalo , Brito Paulo Sérgio Duque de
Published: March 2021

The present study evaluates the digestion of cork boiling wastewater (CBW) through a biochemical methane potential (BMP) test. BMP assays were carried out with a working volume of 600 mL at a constant mesophilic temperature (35 °C). The experiment bottles contained CBW and inoculum (digested sludge from a wastewater treatment plant (WWTP)), with a ratio of inoculum/substrate (Ino/CBW) of 1:1 and 2:1 on the basis of volatile solids (VSs); the codigestion with food waste (FW) had a ratio of 2/0.7:0.3 (Ino/CBW:FW) and the codigestion with cow manure (CM) had a ratio of 2/0.5:0.5 (Ino/CBW:CM). Biogas and methane production was proportional to the inoculum substrate ratio (ISR) used. BMP tests have proved to be valuable for inferring the adequacy of anaerobic digestion to treat wastewater from the cork industry. The results indicate that the biomethane potential of CBWs for Ino/CBW ratios 1:1 and 2:1 is very low compared to other organic substrates. For the codigestion tests, the test with the Ino/CBW:CM ratio of 2/0.7:0.3 showed better biomethane yields, being in the expected values. This demonstrated that it is possible to perform the anaerobic digestion (AD) of CBW using a cosubstrate to increase biogas production and biomethane and to improve the quality of the final digestate.