bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in the Role and Mode of Liver Resection for Hepatocellular Carcinoma Over 20 Years: A Single‐Center Analysis
Authors: Eguchi Susumu , Hidaka Masaaki , Kugiyama Tota , Soyama Akihiko , Hara Takanobu , Nagakawa Kantoku , Adachi Tomohiko , Tanaka Takayuki , Yoshimoto Tomoko , Hamada Takashi , Matsushima Hajime , Ito Sinichiro , Kanetaka Kengo
Published: January 2021

Introduction

The aim of this study was to analyze changes in characteristics of HCC and the modes of LR over 20 years in order to show the impact of those changes in the outcome of LR. In addition, BCLC staging was used to assess the limitations of this classification system and changes over the decade.

Patients and methods

In our department, 500 liver resections (LR) were performed for hepatocellular carcinoma (HCC) over the 20 years between January 2000 and February 2020. The 208 cases performed through 2009 were designated as Era 1, and the 292 cases between 2010 and February 2020 were termed Era 2. We analyzed changes in the characteristics of HCC and mode of LR (Study 1), and final outcomes of LR are shown according to the BCLC staging classifications and eras using data from the 5 years after LR (Study 2).

Results

In Era 1, the mean age of the patients was 68, while in Era 2 the mean age was 71, which was significantly older than the patients in Era 1. HCC that developed from non‐B, non‐C liver cirrhosis was significantly increased in Era 2 (45%) as compared to that in Era 1 (34%). Laboratory data were all comparable between the eras in patients undergoing LR for HCC. The size and numbers of the HCC as well as tumor markers were similar between the eras. As to the mode of LR, although the extent of LR was similar between the eras, the laparoscopic method was significantly increased in Era 2. Blood loss was significantly lower in Era 2 (mean 519 g) than in Era 1 (1,085 g). Patient survival and recurrence‐free survival (RFS) were similar between the two eras, while RFS at 5 years after LR was better in Era 2. Even in the BCLC A category, only patients with a single HCC less than 5 cm showed best results, while patients with HCC within the rest of BCLC A and BCLC B showed a dismal outcome. There was no difference in OS and RFS between the eras after stratification by BCLC.

Conclusion

There are conspicuous changes in the baseline characteristics and mode of LR over 20 years, which should be taken into account for patient care and informed consent for patients undergoing LR going forward.
The Association Between BMI and Mortality in Surgical Patients
Authors: Dotan Idit , Shochat Tzipora , Shimon Ilan , Akirov Amit
Published: January 2021

Background

While obesity is commonly associated with increased morbidity and mortality, in patients with chronic diseases, it has have been associated with a better prognosis, a phenomenon known as the ‘obesity paradox’.

Objective

We investigated the relationship between mortality, length of hospital stay (LOHS), and body mass index (BMI) in patients hospitalized to general surgical wards.

Methods

We extracted data of patients admitted to the hospital between January 2011 and December 2017. BMI was classified according to the following categories: underweight (< 18.5), normal weight (18.5–24.9), overweight (25–29.9), obesity (30–34.9) and severe obesity (≥ 35). Main outcomes were mortality at 30‐day mortality and at the end‐of‐follow‐up mortality), as well as LOHS.

Results

A total of 27,639 patients (mean age 55 ± 20 years; 48% males; 19% had diabetes) were included in the study. Median LOHS was longer in patients with diabetes vs. those without diabetes (4.0 vs 3.0 days, respectively), with longest LOHS among underweight patients. A 30‐day mortality was 2% of those without (371/22,297) and 3% of those with diabetes (173/5,342). In patients with diabetes, 30‐day mortality risk showed a step‐wise decrease with increased BMI: 10% for underweight, 6% for normal weight, 3% for overweight, 2% for obese and only 1% for severely obese patients. In patients without diabetes, 30‐day mortality was found to be 6% for underweight, 3% for normal weight and 1% across the overweight and obese categories. Mortality rate at the end‐of‐follow‐up was 9% of patients without diabetes and 18% of those with diabetes (adjusted OR = 1.3, 95% CI, 1.2–1.5). In patients with diabetes, mortality risk showed an inverse association with respect to BMI: 52% for underweight, 29% for normal weight, 17% for overweight, 14% for obesity and 7% for severely obese patients, with similar trend in patients without diabetes.

Conclusions

The results support the ‘obesity paradox’ in the general surgical patients as those with and without diabetes admitted to surgical wards, BMI had an inverse association with short‐ and long‐term mortality.
Impact of donor and recipient Epstein-Barr Virus serostatus on outcomes of allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis
Authors:   on behalf of Infectious Diseases Working Party, European Society for Blood and Marrow Transplantation, Kołodziejczak Michalina , Gil Lidia , de la Camara Rafael , Styczyński Jan
Published: January 2021

Allogeneic hematopoietic cell transplant (allo-HCT) is a potentially curative therapeutic strategy that showed encouraging long-term outcomes in hematological diseases. A number of factors can influence post-transplant clinical outcomes. While Epstein-Barr virus (EBV) constitutes a trigger for development of various adverse conditions, no clinical study yet has been powered to assess the effect of EBV serostatus on the clinical outcomes in allo-HCT population. To systematically summarize and analyze the impact of donor and recipient EBV serostatus on transplant outcomes in allo-HCT recipients, meta-analyses were conducted. Selected endpoints were overall survival (OS), relapse-free survival (RFS), relapse incidence (RI), non-relapse mortality (NRM), acute graft-versus-host disease (aGVHD), chronic graft-versus-host disease (cGVHD), and de novo cGVHD. Three studies with 26,650 patients, transplanted for acute leukemias, lymphomas, chronic hematological malignancies, or non-malignant hematological diseases were included in the meta-analysis. In the whole population, with a total of 53,300 donors and recipients, the rate of EBV seropositivity was 85.1%, including 86.6% and 83.6% among transplant recipients and healthy donors, respectively. Donor EBV seropositivity increased the risk of cGVHD by 17%, de novo cGVHD by 14%, and aGHVD by 5%. Recipient EBV seropositivity increased the risk of cGVHD by 12%, de novo cGVHD by 17%; increased NRM by 11%, increased RI by 11%, decreased OS by 14%, and decreased RFS by 11%. In performed meta-analyses, donor and recipient EBV seropositivity was found to have a significant impact on transplant outcomes in patients after allo-HCT.
Correction to: Diagnostic accuracy of ultra-low-dose CT for torsion measurement of the lower limb
Authors: Keller Gabriel , Afat Saif , Ahrend Marc-Daniel , Springer Fabian
Published: January 2021

A Correction to this paper has been published: 10.1007/s00330-021-07691-6
Paediatric gastric organoids as a tool for disease modelling and clinical translation
Authors: Jones Brendan C. , Calà Giuseppe , De Coppi Paolo , Giobbe Giovanni Giuseppe
Published: January 2021

Purpose

Knowledge of gastric epithelial homeostasis remains incomplete, lacking human-specific models for study. This study establishes a protocol for deriving gastric epithelial organoids from paediatric gastric biopsies, providing a platform for modelling disease and developing translational therapies.

Methods

Full-thickness surgical samples and endoscopic mucosal biopsies were obtained from six patients. Gastric glands were isolated by a chemical chelation protocol and then plated in 3D culture in Matrigel® droplets in chemically defined medium. After formation, organoids were passaged by single cell dissociation or manual disaggregation. Cell composition and epithelial polarity of organoids were assessed by bright field microscopy and immunofluorescence analysis, comparing them to native paediatric gastric tissue.

Results

Gastric glands were successfully isolated from all six patients who were aged 4 months to 16 years. Gastric glands from all patients sealed to form spherical gastric organoids. These organoids could be passaged by manual disaggregation or single cell dissociation, remaining proliferative up to 1 year in culture. Organoids retained normal epithelial cell polarity, with the apical surface orientated towards the central lumen. Organoids expressed markers of mature gastric epithelial cell types, except for parietal cells.

Conclusion

Gastric organoids can be reliably generated from paediatric biopsies and are a representative in vitro model for studying gastric epithelium.
Supratentorial ependymoma in childhood: more than just RELA or YAP
Authors: Zschernack Valentina , Jünger Stephanie T. , Mynarek Martin , Rutkowski Stefan , Garre Maria Luisa , Ebinger Martin , Neu Marie , Faber Jörg , Erdlenbruch Bernhard , Claviez Alexander , Bielack Stefan , Brozou Triantafyllia , Frühwald Michael C. , Dörner Evelyn , Dreschmann Verena , Stock Annika , Solymosi Laszlo , Hench Jürgen , Frank Stephan , Vokuhl Christian , Waha Andreas , Andreiuolo Felipe , Pietsch Torsten
Published: January 2021

Two distinct genetically defined entities of ependymoma arising in the supratentorial compartment are characterized by the presence of either a C11orf95-RELA or a YAP-MAMLD1 fusion, respectively. There is growing evidence that supratentorial ependymomas without these genetic features exist. In this study, we report on 18 pediatric non-RELA/non-YAP supratentorial ependymomas that were systematically characterized by means of their histology, immunophenotype, genetics, and epigenomics. Comprehensive molecular analyses included high-resolution copy number analysis, methylation profiling, analysis of fusion transcripts by Nanostring technology, and RNA sequencing. Based upon histological and immunohistochemical features two main patterns were identified—RELA-like (n = 9) and tanycytic ependymomas (n = 6). In the RELA-like group histologically assigned to WHO grade III and resembling RELA-fused ependymomas, tumors lacked nuclear expression of p65-RelA as a surrogate marker for a pathological activation of the NF-κB pathway. Three tumors showed alternative C11orf95 fusions to MAML2 or NCOA1. A methylation-based brain tumor classifier assigned two RELA-like tumors to the methylation class “EP, RELA-fusion”; the others demonstrated no significant similarity score. Of the tanycytic group, 5/6 tumors were assigned a WHO grade II. No gene fusions were detected. Methylation profiling did not show any association with an established methylation class. We additionally identified two astroblastoma-like tumors that both presented with chromothripsis of chromosome 22 but lacked MN1 breaks according to FISH analysis. They revealed novel fusion events involving genes in chromosome 22. One further tumor with polyploid cytogenetics was interpreted as PFB ependymoma by the brain tumor methylation classifier but had no relation to the posterior fossa. Clinical follow-up was available for 16/18 patients. Patients with tanycytic and astroblastoma-like tumors had no relapse, while 2 patients with RELA-like ependymomas died. Our data indicate that in addition to ependymomas discovered so far, at least two more supratentorial ependymoma types (RELA-like and tanycytic) exist.
Re-interpreting mesenteric vascular anatomy on 3D virtual and/or physical models: positioning the middle colic artery bifurcation and its relevance to surgeons operating colon cancer
Authors: Andersen Bjarte T. , Stimec Bojan V. , Edwin Bjørn , Kazaryan Airazat M. , Maziarz Przemyslaw J. , Ignjatovic Dejan
Published: January 2021

Background

The impact of the position of the middle colic artery (MCA) bifurcation
and the trajectory of the accessory MCA (aMCA) on adequate lymphadenectomy when
operating colon cancer have as of yet not been described and/or analysed in the
literature. The aim of this study was to determine the MCA bifurcation position to
anatomical landmarks and to assess the trajectory of aMCA.

Methods

The colonic vascular anatomy was manually reconstructed in 3D from
high-resolution CT datasets using Osirix MD and 3-matic Medical and analysed. CT
datasets were exported as STL files and supplemented with 3D printed models when
required.

Results

Thirty-two datasets were analysed. The MCA bifurcation was left to the
superior mesenteric vein (SMV) in 4 (12.1%), in front of SMV in 17 (53.1%) and right
to SMV in 11 (34.4%) models. Median distances from the MCA origin to bifurcation were
3.21 (1.18–15.60) cm. A longer MCA bifurcated over or right to SMV, while a shorter
bifurcated left to SMV (r = 0.457, p = 0.009). The main MCA direction was towards right in
19 (59.4%) models. When initial directions included left, the bifurcation occurred
left to or anterior to SMV in all models. When the initial directions included right,
the bifurcation occurred anterior or right to SMV in all models. The aMCA was found
in 10 (31.3%) models, following the inferior mesenteric vein (IMV) in 5 near the
lower pancreatic border. The IMV confluence was into SMV in 18 (56.3%), splenic vein
in 11 (34.4%) and jejunal vein in 3 (9.4%) models.

Conclusion

Awareness of the wide range of MCA bifurcation positions reported is
crucial for the quality of lymphadenectomy performed. The aMCA occurs in 31.3% models
and its trajectory is in proximity to the lower pancreatic border in one half of
models, indicating that it needs to be considered when operating splenic flexure
cancer.
Impact of 0.1% octenidine mouthwash on plaque re-growth in healthy adults: a multi-center phase 3 randomized clinical trial
Authors: Jockel-Schneider Yvonne , Schlagenhauf Ulrich , Petsos Hari , Rüttermann Stefan , Schmidt Jana , Ziebolz Dirk , Wehner Christian , Laky Markus , Rott Thea , Noack Michael , Noack Barbara , Lorenz Katrin
Published: January 2021

Objectives

To investigate plaque inhibition of 0.1% octenidine mouthwash (OCT) vs. placebo over 5 days in the absence of mechanical plaque control.

Materials and methods

For this randomized, placebo-controlled, double-blind, parallel group, multi-center phase 3 study, 201 healthy adults were recruited. After baseline recording of plaque index (PI) and gingival index (GI), collection of salivary samples, and dental prophylaxis, subjects were randomly assigned to OCT or placebo mouthwash in a 3:1 ratio. Rinsing was performed twice daily for 30 s. Colony forming units in saliva were determined before and after the first rinse. At day 5, PI, GI, and tooth discoloration index (DI) were assessed. Non-parametric van Elteren tests were applied with a significance level of p < 0.05.

Results

Treatment with OCT inhibited plaque formation more than treatment with placebo (PI: 0.36 vs. 1.29; p < 0.0001). OCT reduced GI (0.04 vs. placebo 0.00; p = 0.003) and salivary bacterial counts (2.73 vs. placebo 0.24 lgCFU/ml; p < 0.0001). Tooth discoloration was slightly higher under OCT (DI: 0.25 vs. placebo 0.00; p = 0.0011). Mild tongue staining and dysgeusia occurred.

Conclusions

OCT 0.1% mouthwash inhibits plaque formation over 5 days. It therefore can be recommended when regular oral hygiene is temporarily compromised.

Clinical relevance

When individual plaque control is compromised, rinsing with octenidine mouthwash is recommended to maintain healthy oral conditions while side effects are limited.
The art of robotic colonic resection: a review of progress in the past 5 years
Authors: Liu Hongyi , Xu Maolin , Liu Rong , Jia Baoqing , Zhao Zhiming
Published: January 2021

Surgery is developing in the direction of minimal invasiveness, and robotic surgery is becoming increasingly adopted in colonic resection procedures. The ergonomic improvements of robot promote surgical performance, reduce workload for surgeons and benefit patients. Compared with laparoscopy-assisted colon surgery, the robotic approach has the advantages of shorter length of hospital stay, lower rate of conversion to open surgery, and lower rate of intraoperative complications for short-term outcomes. Synchronous robotic liver resection with colon cancer is feasible. The introduction of the da Vinci Xi System (Intuitive Surgical, Inc., Sunnyvale, CA, USA) has introduced more flexibility to colonic operations. Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection. Single-port robotic colectomy reduces the number of robotic ports for better looking and faster recovery. Intestinal anastomosis methods using totally robotic surgery result in shorter time to bowel function recovery and tolerance to a solid diet, although the operative time is longer. Indocyanine green is used as a tracer to assess blood supplementation in the anastomosis and marks lymph nodes during operation. The introduction of new surgical robots from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes. The present article reviews recent advances in robotic colonic resection over the past five years.
CD8+ T cells in the central nervous system of mice with herpes simplex infection are highly activated and express high levels of CCR5 and CXCR3
Authors: Lind Liza , Svensson Alexandra , Thörn Karolina , Krzyzowska Malgorzata , Eriksson Kristina
Published: January 2021

Herpes simplex virus type 2 (HSV-2) is a neurotropic virus that can cause meningitis, an inflammation of the meninges in the central nervous system. T cells are key players in viral clearance, and these cells migrate from peripheral blood into the central nervous system upon infection. Several factors contribute to T cell migration, including the expression of chemokines in the inflamed tissue that attract T cells through their expression of chemokine receptors. Here we investigated CD8+ T cell profile in the spinal cord in a mouse model of herpes simplex virus type 2 neuroinflammation. Mice were infected with HSV-2 and sacrificed when showing signs of neuroinflammation. Cells and/or tissue from spinal cord, spleen, and blood were analyzed for expression of activation markers, chemokine receptors, and chemokines. High numbers of CD8+ T cells were present in the spinal cord following genital HSV-2-infection. CD8+ T cells were highly activated and HSV-2 glycoprotein B -specific effector cells, some of which showed signs of recent degranulation. They also expressed high levels of many chemokine receptors, in particular CCR2, CCR4, CCR5, and CXCR3. Investigating corresponding receptor ligands in spinal cord tissue revealed markedly increased expression of the cognate ligands CCL2, CCL5, CCL8, CCL12, and CXCL10. This study shows that during herpesvirus neuroinflammation anti-viral CD8+ T cells accumulate in the CNS. CD8+ T cells in the CNS also express chemotactic receptors cognate to the chemotactic gradients in the spinal cord. This indicates that anti-viral CD8+ T cells may migrate to infected areas in the spinal cord during herpesvirus neuroinflammation in response to chemotactic gradients.
Highly Sensitive Ultrathin Flexible Thermoplastic Polyurethane/Carbon Black Fibrous Film Strain Sensor with Adjustable Scaffold Networks
Authors: Wang Xin , Liu Xianhu , Schubert Dirk W.
Published: January 2021

In recently years, high-performance wearable strain sensors have attracted great attention in academic and industrial. Herein, a conductive polymer composite of electrospun thermoplastic polyurethane (TPU) fibrous film matrix-embedded carbon black (CB) particles with adjustable scaffold network was fabricated for high-sensitive strain sensor. This work indicated the influence of stereoscopic scaffold network structure built under various rotating speeds of collection device in electrospinning process on the electrical response of TPU/CB strain sensor. This structure makes the sensor exhibit combined characters of high sensitivity under stretching strain (gauge factor of 8962.7 at 155% strain), fast response time (60 ms), outstanding stability and durability (> 10,000 cycles) and a widely workable stretching range (0–160%). This high-performance, wearable, flexible strain sensor has a broad vision of application such as intelligent terminals, electrical skins, voice measurement and human motion monitoring. Moreover, a theoretical approach was used to analyze mechanical property and a model based on tunneling theory was modified to describe the relative change of resistance upon the applied strain. Meanwhile, two equations based from this model were first proposed and offered an effective but simple approach to analyze the change of number of conductive paths and distance of adjacent conductive particles.
Utilization of WRF 3D Meteorological Data to Calculate Slant Total Delay for InSAR Atmospheric Correction
Authors: Wang Xinyi , Zeng Qiming , Jiao Jian
Published: January 2021

The atmosphere introduces excess delays into the synthetic aperture radar (SAR) signal trajectory, especially in the troposphere. InSAR atmospheric correction methods include the use of SAR data and external water vapor products. The latter is more effective. However, since the removal of atmospheric effects should use atmospheric delay products in the direction of the line of sight (LOS), it is necessary to convert the zenith total delay to slant delay in the LOS direction. Conventionally, the zenith delay is divided by the cosine of the average incident angles to obtain slant phase delays. But this method could cause large errors because it ignores the atmospheric horizontal gradient change and the small-scale vertical structure. These problems can be solved by using three-dimensional atmospheric data simulated by numerical models, especially in the case of intense weather changes or complex terrain. However, few scholars paid attention to the application into InSAR atmospheric correction, because of the computation complexity and low efficiency. As the requirement for higher accuracy and the introduction of large errors caused by increasing incidence angles, it is significantly imperative to make the utmost of this method. Weather Research Forecast (WRF) model can provide the precipitate water vapor (PWV) and refraction index at different levels in the three dimensions, and then the slant total delay can be obtained for removing the atmospheric effect on the InSAR process. The results demonstrate that using 3D data can obtain more accurate slant total delay and improve the accuracy of surface deformation from InSAR technology.
Application of Y–ZrO2 microtubes as dielectric barrier material in a He atmospheric pressure micro-plasma jet
Authors: Talviste Rasmus , Jõgi Indrek , Tätte Tanel , Part Marko , Raud Jüri , Paris Peeter
Published: January 2021

This work focused on the application of novel 8% yttria-stabilized Zr2O3 (YSZ) microtubes with an inner diameter of 60 µm as dielectric material in an atmospheric pressure micro-plasma jet (APPJ). Furthermore, a comparison with quartz microtubes allowed to study the effect of tube material on plasma properties. Optical emission spectroscopy was employed to determine various spectral line ratios including ratios of He lines 667 nm (31D-21P) to 728 nm (31S-21P) which is indicative of electric field strength. The 667/728 nm line ratio in the YSZ microtube was about 2/3 the value in the 60-µm quartz tube. However, increasing the quartz tube’s inner diameter from 60 to 500 µm decreased the 667/728 nm line ratio 40 times. Additionally, the spatio-temporal evolution of the ionization wave was measured in the YSZ microtube and the velocity of the ionization wave was determined to accelerate from 67 km/s near the powered electrode to 161 km/s near the tube orifice.
Extraction efficiency of alcohols from activated carbon and silica gel sampling agents in the low concentration region
Authors: Abiko Hironobu
Published: January 2021

Activated carbon and silica gel adsorbents are commonly used as sampling agents in small glass tube products for work environment measurements of organic solvent vapor in air. In the measurements, extraction efficiency of organic solvent components from sampling agents is very important for accuracy of the determination. We have investigated the effect of two representative efficiency determination methods as established by the Industrial Safety and Health Act in Japan: the direct addition and phase equilibrium methods, using both of these adsorbent materials found in typical recent sampling tube products in Japan and four types of alcohol. The results indicate that the phase equilibrium method has a tendency to show slightly higher values compared with the direct addition method for each adsorbent. In addition, compared with silica gel, petroleum-based activated carbon can be a preferable sampling agent of alcohols in the extremely low concentration region, below approximately 10 ppm.
Effects of hybrid Al2O3–CuO nanofluids on surface roughness and machining forces during turning AISI 4340
Authors: Haghnazari Shahin , Abedini Vahid
Published: January 2021

This paper presents an effort to model the process parameters involved in turning of alloy steel AISI 4340 workpiece material with Al2O3 and CuO hybrid nanofluids using the minimum quantity lubrication (MQL) method. In this paper, the effect of mixing two nanoparticles (Al2O3 and CuO) with different weight percent in environmentally friendly water-based cutting fluid, the rotational speed, and the feed rate has been investigated on the surface roughness and the machining forces using the response surface method. The results of the experiments show that the hybrid nanofluid containing 0.75 CuO with 0.25 Al2O3 has the best output for the machining forces and the surface roughness. Also, in the best composition of the nanoparticles (0.75 CuO with 0.25 Al2O3), the lowest value of machining forces has been achieved at a feed rate of 0.08 mm per revolution and the rotational speed 1000 rpm as well as the lowest value of the surface roughness at a feed rate of 0.08 mm per revolution and the rotational speed 710 rpm.
Physicochemical, nutritional, bioactive compounds and fatty acid profiling of Pumpkin flower (Cucurbita maxima), as a potential functional food
Authors: Ghosh Payel , Rana Sandeep Singh
Published: January 2021

The edible flowers and its several products gaining its importance as functional food. Pumpkin flower mainly consumed in India and Mexico but due to lack of scientific research there is a neophobia among people. The objective of the paper is to analyse the physicochemical, biochemical properties, proximate analysis, antioxidant activities, anthocyanin content and fatty acid profiling. The fresh pumpkin flower was having an average moisture content of 85% (wb) with a dimension of 90 × 51 x 22 mm (l x w x t). The (L, a*, b*) value signifies the bright yellow color having gumminess (26 g) and chewiness (4.70 mJ). In this study the nutritional properties of the pumpkin flower were also determined and significant amount of Sodium (11.5 mg/100 g), Potassium (18.2 mg/100 g), Calcium (17.6 mg/100 g), phenol (17.39 µg/ml), flavonoid (17.13 µg/ml), antioxidant (51.65%DPPH) and anthocyanin (10.3 mg/100 g) was present. Among several fatty acids’ oleic acid (21%), myristic acid (15.99%) and stearic acid (15.19%) was maximum. The presence of several phytonutrients and fatty acids makes pumpkin flower a potential source of functional food in near future.

Graphical abstract
Development of ionic liquid microemulsion for transdermal delivery of a chemotherapeutic agent
Authors: Sharma Harish , Kumar Sahu Gyanesh , Kaur Chanchal Deep
Published: January 2021

Nowadays skin cancers have become a major area of concern because of the continuous exposure to sun rays (UV rays). Hence, the present work focused on the synthesis of an innovative 5-Fluorouracil (5-FU) microemulsion as a topical delivery system mainly used to treat various forms of skin cancer. The topical administration of most of the active compounds is impaired by limited skin permeability due to the presence of skin barriers. In this sequence, the microemulsion represents a cost-effective and convenient drug carrier system that successfully delivers the drug to and across the skin. Unfortunately, 5-FU reveals high toxicity and low tumor affinity became inefficient for patients with the risk of serious side effects. For decreasing of eluding some of its disadvantages we made it more effective by preparing its microemulsion with tween 80 (surfactant), isopropyl alcohol (co-surfactant), oleic acid (oil) in a four-component system. This study emphasized increasing the drug release by multiple times and a topical gel has been formulated and designs to elongate the drug release. All preparation of 5-FU microemulsion was characterized by physicochemical and drug release studies. The size of the 5-FU microemulsion was 550–600 nm confirmed by transmission electron microscopy (TEM) and Zetasizer. The clear microemulsion was prepared at pH 5–6. It shows viscosity in the limit of 13.52–18.23 Pa s. The outcome of the present work is satisfactory for skin cancer treatment.
Petrochemical constrains on the origin and tectonic setting of mafic to intermediate dykes from Tikar plain, Central Cameroon Shear Zone
Authors: Ntieche Benjamin , Ram Mohan M. , Moundi Amidou , Wokwenmendam Nguet Pauline , Mounjouohou Mahomed Aziz , Nchouwet Zakari , Mfepat Daouda
Published: January 2021

The Tikar plain is located on the Cameroon Central Shear Zone. It is also part of the North Equatorial Pan-African Belt. It is formed of granitoids intruded in places by mafic and intermediate dykes. The mafic dykes are essentially banded gabbros composed of plagioclases, pyroxenes, amphiboles, biotites and opaques. Their textures range from porphyroblastic to porphyritic. The intermediate dykes are monzonites and monzodiorites and are characterized, respectively, by cataclastic and mylonitic textures. The minerals identified are amphiboles, potassium feldspar, pyroxenes, epidotes, sphenes and opaques. Seritization reaction is mostly present on the mafic and intermediate dykes, while chloritization is much more pronounced on the intermediate dykes. The Tikar plain dykes are high-k calc-alkaline to shoshonitic. They are characterized by low to moderate SiO2content (42.08–61.96 wt%), low to high TiO2(0.47–2 wt%) and low Ni (1.48–99.18 ppm) contents. The mafic dykes show fractional trends with negative anomalies of Zr, U and P and positive Rb, Ba, Ta, Pb and Sr in multi-element diagrams, while the intermediate dykes present negative anomalies of Nb, Ta, Zr, Sr P and Ti and relative positive anomalies of Rb, Ba and Pb. The rare-earth elements (REE) patterns show positive Eu anomalies for the mafic dykes and negative anomalies for the intermediate dykes. The REE spectrum of all the dykes shows enrichment in LREE with relatively flat HREE, which can indicate arc magmatism. In the Zr–Ti/100–Sr/2 diagram, the mafic dykes plot in the island arc tholeiite and calc-alkaline basalt fields. The Th, Nb and LREE concentrations indicate that the subducted lithosphere with crustal component contributed to generation of the intermediate dykes of the Tikar plain. The geochemical characteristics of the mafic to intermediate dykes suggest their derivation from a various degree of partial melting in the garnet spinel facies, probably between depths of 80 and 100 km. The collision between the Central African Fold Belt and the northern edge of the Congo craton resulting in crustal thickening, sub-crustal lithospheric delamination and upwelling of the asthenosphere may have been the principal process in the generation of the intermediate dykes in the Tikar plain. The magma for the mafic and intermediate dyke would have migrated through the faults network of the Central Cameroon Shear Zone before crystallizing in the granito-gneissic basement rocks.
Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review
Authors: Berryhill McCarty E. , Soldatova Liuba , Brant Jason A. , Newman Jason G.
Published: January 2021

Objective

Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID‐19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID‐19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need.

Data Sources

PubMed, Ovid/Medline, and Scopus

Methods

A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English‐language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID‐19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed.

Results

A total of 41 papers met inclusion criteria and were organized into 5 categories (‘General Recommendations for Otolaryngologic Surgery’, ‘Equipment Shortage Solutions’, ‘Airway Procedures’, ‘Nasal Endoscopy and Skull Base Procedures’, and ‘Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID‐19 pandemic. Creative solutions such as application of topical viricidal agents, make‐shift mask filters, three‐dimensional (3‐D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID‐19 transmission.

Conclusions

Persistent risk of COVID‐19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID‐19 positive patients present asymptomatically. This review examines and organizes creative solutions that have been proposed and utilized in the otolaryngology. These solutions have a potential to minimize the risk of viral transmission in the current clinical environment and to create safer outpatient and operating room conditions for patients and healthcare staff.
Cultivating Normative Authority: The Biden Administration, Migration, and the International Legal Order
Authors: Ramji-Nogales Jaya
Published: January 2021

President Biden faces many hurdles to constructing an effective international legal order on migration, not least of which is the absence of any such structure even prior to the dual challenges of the nationalist fallout of the Trump administration's rhetoric and policies and the COVID-19 pandemic. Yet the excesses of cruelty under Trump and the social instability resulting from the pandemic may have created political space for the Biden administration to lay the groundwork for a more comprehensive international structure that governs migration of all kinds. To that end, President Biden should cultivate normative authority in the migration arena by shifting the national discourse, shoring up international agreements and institutions, and building regional cooperation.
Center for clinical and translational research COVID-19 clinical trial committee: The development of a review and prioritization matrix during a pandemic
Authors: Bobb Leslie , Ballance Lisa Richman , Abbate Antonio , Bain Jesse C. , Sime Patricia J. , Moeller F. Gerard , Lessard Margaret K. , Montpetit Alison J. , Harmon Mary P. , Stevens Michael P. , DiazGranados Deborah
Published: January 2021

The rate at which the coronavirus disease (COVID-19) spread required a rapid response across many, if not all, industries. Academic medical centers had to rapidly evaluate, prioritize, and coordinate the multiple requests for clinical trial participation. This involved redirecting resources and developing a collaborative system for assessment, decision making, and implementation. Our institution formed a team with diverse representation from multiple stakeholders to review and prioritize all research protocols related to COVID-19. To accomplish this, a prioritization matrix was developed to help determine the order in which the protocols should be placed for consideration by the treating clinician. The purpose of the team was to review the COVID-19 clinical trials in the pipeline, prioritize those trials that best met the needs of our patients, oversee training and resource needs, and lead the formulation of procedures for integration with clinical care. Resources from the Clinical Research Unit were then allocated to support the swift execution of such studies. This manuscript describes that process, the challenges encountered, and the lessons learned on how to make all clinical trials more successful in a complex and dynamic environment.
Reductions in vancomycin and meropenem following the implementation of a febrile neutropenia management algorithm in hospitalized adults: An interrupted time series analysis
Authors: Trinh Trang D. , Strnad Luke , Damon Lloyd , Dzundza John H. , Graff Larissa R. , Griffith Laura M. , Hilts-Horeczko Alexandra , Olin Rebecca , Shenoy Samantha , DeVoe Catherine , Wang Lusha , Rodriguez-Monguio Rosa , Gu Tina M. , Hampton Scott R. , Macapinlac Brian Allan C. , Yang Katherine , Doernberg Sarah B.
Published: January 2021

Objective:

To evaluate broad-spectrum intravenous antibiotic use before and after the implementation of a revised febrile neutropenia management algorithm in a population of adults with hematologic malignancies.

Design:

Quasi-experimental study.

Setting and population:

Patients admitted between 2014 and 2018 to the Adult Malignant Hematology service of an acute-care hospital in the United States.

Methods:

Aggregate data for adult malignant hematology service were obtained for population-level antibiotic use: days of therapy (DOT), C. difficile infections, bacterial bloodstream infections, intensive care unit (ICU) length of stay, and in-hospital mortality. All rates are reported per 1,000 patient days before the implementation of an febrile neutropenia management algorithm (July 2014–May 2016) and after the intervention (June 2016–December 2018). These data were compared using interrupted time series analysis.

Results:

In total, 2,014 patients comprised 6,788 encounters and 89,612 patient days during the study period. Broad-spectrum intravenous (IV) antibiotic use decreased by 5.7% with immediate reductions in meropenem and vancomycin use by 22 (P = .02) and 15 (P = .001) DOT per 1,000 patient days, respectively. Bacterial bloodstream infection rates significantly increased following algorithm implementation. No differences were observed in the use of other antibiotics or safety outcomes including C. difficile infection, ICU length of stay, and in-hospital mortality.

Conclusions:

Reductions in vancomycin and meropenem were observed following the implementation of a more stringent febrile neutropenia management algorithm, without evidence of adverse outcomes. Successful implementation occurred through a collaborative effort and continues to be a core reinforcement strategy at our institution. Future studies evaluating patient-level data may identify further stewardship opportunities in this population.
Mass severe acute respiratory coronavirus 2 (SARS-CoV-2) testing of asymptomatic healthcare personnel
Authors: Roberts Scott C. , Peaper David R. , Thorne Craig D. , Sussman L. Scott , Murray Thomas S. , Choi Steven J. , Pettker Christian M. , Russi Mark B. , Martinello Richard A.
Published: January 2021

Mass asymptomatic SARS-CoV-2 nucleic acid amplified testing of healthcare personnel (HCP) was performed at a large tertiary health system. A low period-prevalence of positive HCP was observed. Of those who tested positive, half had mild symptoms in retrospect. HCP with even mild symptoms should be isolated and tested.
give as a put verb in German – A case of German-Czech language contact?
Authors: Lenz Alexandra N. , Fleißner Fabian , Kim Agnes , Newerkla Stefan Michael
Published: January 2021

This contribution focuses on the use of geben ‘give’ as a put verb in Upper German dialects in Austria from a historical and a recent perspective. On the basis of comprehensive historical and contemporary data from German varieties and Slavic languages our analyses provide evidence for the central hypothesis that this phenomenon traces back to language contact with Czech as already suggested by various scholars in the 19th century. This assumption is also supported by the fact that Czech dát ‘give’ in put function has been accounted for since the Old Czech period as well as by its high frequency in both formal and informal Czech written texts. Moreover, our data analyses show that geben ‘give’ as a put verb has been and is still areally distributed along and spreading from the contact area of Czech and Upper German varieties.
BOUNDNESS OF INTERSECTION NUMBERS FOR ACTIONS BY TWO-DIMENSIONAL BIHOLOMORPHISMS
Authors: Ribón Javier
Published: January 2021

We say that a group G of local (maybe formal) biholomorphisms satisfies the uniform intersection property if the intersection multiplicity

$(\phi (V), W)$
takes only finitely many values as a function of G for any choice of analytic sets V and W of complementary dimension. In dimension

$2$
we show that G satisfies the uniform intersection property if and only if it is finitely determined – that is, if there exists a natural number k such that different elements of G have different Taylor expansions of degree k at the origin. We also prove that G is finitely determined if and only if the action of G on the space of germs of analytic curves has discrete orbits.
Beethoven's String Quintet in C major, Op. 29, and Brahms's String Sextets: A Wallflower Blooms
Authors: Horne William
Published: January 2021

Beethoven's String Quintet, Op. 29, has been described as a ‘wallflower’ work that, without enough suitors, remains on the sidelines of the string chamber music repertoire. But in the nineteenth century it had a prominent champion, Joseph Joachim, whose performances of the quintet must have attracted the attention of his close friend, Johannes Brahms. The opening theme of Brahms's String Sextet, Op. 18, is clearly reminiscent of the beginning of Beethoven's quintet. Evidence from Donald Francis Tovey's recollections of Joachim, Joachim's correspondence with the Brahms biographer Max Kalbeck, and the manuscript of Op. 18 shows that Joachim influenced an important revision that aligns the beginning of Brahms's sextet closely with the opening of Beethoven's Op. 29 also in terms of texture and formal design.

The striking tremolo opening and virtuosic scale passages in the finale of Beethoven's quintet prefigure similar elements in the last movement of Brahms's Op. 36 sextet. But the deeper relationship between these movements lies in certain shared formal elements: a common emphasis on sound, texture and sharp contrasts between agitato and pastoral elements as defining features of the overall form – and several distinctive similarities of contrapuntal strategy, form and tonal design between the substantial fugatos that dominate the development sections of both movements.

It is often observed that Brahms wrote chamber works in pairs. Scholars have often posited that his two string sextets form such a pair, but the separation of four years in their inceptions and his extensive use of Baroque-style materials composed in the 1850s in the later sextet have made this argument tenuous. It now emerges that an unusual pairing feature of Brahms's string sextets is that both works respond to Beethoven's ‘wallflower’ masterpiece.
Multiple herbicide-resistant Palmer amaranth (Amaranthus palmeri) in Connecticut: confirmation and response to POST herbicides
Authors: Aulakh Jatinder S. , Chahal Parminder S. , Kumar Vipan , Price Andrew J. , Guillard Karl
Published: January 2021

Palmer amaranth is the latest pigweed species documented in Connecticut; it was identified there in 2019. In a single-dose experiment, the Connecticut Palmer amaranth biotype survived the field-use rates of glyphosate (840 g ae ha−1) and imazaquin (137 g ai ha−1) herbicides applied separately. Additional experiments were conducted to (1) determine the level of resistance to glyphosate and acetolactate synthase (ALS) inhibitors in the Connecticut-resistant (CT-Res) biotype using whole-plant dose-response bioassays, and (2) evaluate the response of the CT-Res biotype to POST herbicides commonly used in Connecticut cropping systems. Based on the effective dose required for 90% control (ED90), the CT-Res biotype was 10-fold resistant to glyphosate when compared with the Kansas-susceptible (KS-Sus) biotype. Furthermore, the CT-Res biotype was highly resistant to ALS-inhibitor herbicides; only 18% control was achieved with 2,196 g ai ha−1 imazaquin. The CT-Res biotype was also cross-resistant to other ALS-inhibitor herbicides, including chlorimuron-ethyl (13.1 g ai ha−1), halosulfuron-methyl (70 g ai ha−1), and sulfometuron-methyl (392 g ai ha−1). The CT-Res Palmer amaranth was controlled 75% to 100% at 21 d after treatment (DAT) with POST applications of 2,4-D (386 g ae ha−1), carfentrazone-ethyl (34 g ai ha−1), clopyralid (280 g ae ha−1), dicamba (280 g ae ha−1), glufosinate (595 g ai ha−1), lactofen (220 g ai ha−1), oxyfluorfen (1,121g ai ha−1), and mesotrione (105 g ai ha−1) herbicides. Atrazine (2,240 g ai ha−1) controlled the CT-Res biotype only 52%, suggesting the biotype is resistant to this herbicide as well. Here we report the first case of Palmer amaranth from Connecticut with multiple resistance to glyphosate and ALS inhibitors. Growers should proactively use all available weed control tactics, including the use of effective PRE and alternative POST herbicides (tested in this study), for effective control of the CT-Res biotype.
The relationship between different C-peptide level and insulin dose of insulin pump
Authors: Wei Yihan , Quan Li , Zhou Ting , Du Guoli , Jiang Sheng
Published: January 2021

Background

This study aims to explore the insulin requirement profiles, and analyze the related factors of type-2 diabetes mellitus (T2DM) with different C-peptide levels on insulin pump therapy.

Methods

A retrospective study was conducted on 271 T2DM patients treated with insulin pumps from 2016 to 2018. These patients were divided into groups according to the ratio of C-peptide at 2 h after meals to fasting C-peptide (C2h/C0), and the dosage of insulin and influencing factors were analyzed.

Results

In comparing group A (C2h/C0 < 2.5) with group B (C2h/C0 ≥ 2.5), the percentage of the base amount in total (%TBa, 0.50 ± 0.06) in group A was higher than that in group B (0.48 ± 0.05) (P < 0.05). Furthermore, there was a correlation between C2h/C0and waist circumference, HbA1c, Fasting Plasma Glucose (FPG) and Blood glucose 2 h after meal (2hPG) (r = −0.137, −0.154, −0.471, and −0.172; all,P < 0.05). The multiple linear regression analysis revealed that BMI and FPG were independent factors of %TBa (β′ = 0.124 and 0.144; all,P < 0.05), and BMI and FPG were independent factors of C2h/C0(β′ = −0.134 and −0.502; all,P < 0.05).

Conclusions

The basal premeal dose ratio of T2DM with different C-peptide levels differs during intensive insulin pump therapy. Parameters that indicate the glycemic control and β-cell function should be taken into consideration for total insulin requirements.