bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association Between the XRCC1 Arg399Gln Polymorphism and the Risk of Head and Neck Cancer: An Updated Meta-Analysis Including 14586 Subjects
Authors: Xia Shitong , Wu Sihai , Wang Minghao
Published: July 2021

Background:

Accumulated evidence shows that DNA repair gene X-ray repair cross complementing group 1 (XRCC1) may determine individual susceptibility to head and neck cancer (HNC) as a major DNA repair gene. However, the results from previous studies have been conflictive and inconsistent. In order to more accurately estimate and integrate the association between XRCC1 Arg399Gln polymorphism and HNC risk, we conducted a meta-analysis including 14586 subjects.

Methods:

In this meta-analysis, literatures were collected up until September 15, 2020 through multifarious retrieval strategies by searching through electronic databases of PubMed, Cochrane Library, EMBASE, Medline, Web of Science and CNKI. The association between the XRCC1 Arg399Gln polymorphism and HNC was analyzed through calculating summary odds ratios (OR) and 95% confidence intervals (CI).

Results:

Thirty-one studies consisting of 6025 cases and 8561 controls were identified and analyzed. No significant association between XRCC1 Arg399Gln polymorphisms and HNC risk was found under the allelic (OR = 0.94, 95% CI: 0.82-1.07, P = 0.35), homozygous (OR = 0.99, 95% CI: 0.81-1.21, P = 0.91), heterozygous (OR = 1.01, 95% CI: 0.90-1.13, P = 0.91), dominant (OR = 1.05, 95% CI: 0.85-1.29, P = 0.67) or recessive (OR = 0.93, 95% CI: 0.80-1.08, P = 0.35) genetic models in the overall comparison. In addition, subgroup analyses according to tumor site also displayed no significant association between XRCC1 Arg399Gln polymorphisms and HNC risk. However, subgroup analyses based on ethnicity indicated that HNC risk was significantly related to Arg399Gln genetic heterozygous model (OR = 1.21, 95%CI: 1.04-1.42, P = 0.02) and dominant model (OR = 1.27, 95%CI: 1.02-1.60, P = 0.04) in Caucasians populations.

Conclusion:

The results from this meta-analysis suggest that the XRCC1 Arg399Gln variants (Arg/Gln and Arg/Arg+Arg/Gln) may contribute to high HNC risk among Caucasians. Further well-designed studies and larger sample sizes are needed to validate our findings.
EMT Participates in the Regulation of Exosomes Secretion and Function in Esophageal Cancer Cells
Authors: Chen Chuangui , Ma Zhao , Jiang Hongjing
Published: July 2021

Epithelial-mesenchymal transition (EMT) is a key step in tumor invasion and distant metastasis. Abundant evidence has documented that exosomes can mediate EMT of tumor cells and endow them with the ability of invasion and migration. However, there are few studies focusing on whether EMT can reverse the secretion of exosomes. In this study, 2 esophageal cancer cells (FLO-1 and SK-GT-4) were selected to compare the migration ability and EMT activation, and to further analyze the secretion ability of exosomes of the 2 cell lines. According to the results, inhibited activation of EMT in FLO-1 cells with relatively high migration ability could effectively reduce the secretion of exosomes. Besides, in SK-GT-4 cells, EMT activation induced by TGF-β could promote the secretion of exosomes. FLO-1 cell derived exosomes exhibited a paracrine effect of promoting the migration of SK-GT-4 cells, and the use of EMT inhibitors could weaken this ability. Furthermore, inhibition of EMT could change the relative content of some miRNAs in exosomes, with a particularly significant downregulation in the expression of miR-196-5p, miR-21-5p and miR-194-5p. Significantly, artificial transfection of the 3 miRNAs into exosomes by electroporation resulted in the recovery of migration-promoting effect of exosomes. Subsequent experiments further revealed that the effect of EMT on these miRNAs could be explained by the intracellular transcription level or the specific sorting mechanism of exosomes. To sum up, our study undoubtedly reveals that EMT has a regulatory effect on exosomes in the quantity and contents in esophageal cancer cells. Significantly, findings in our study provide experimental evidence for the interaction of EMT with the secretion and sorting pathway of exosomes, and also give a new direction for the further study of tumor metastasis.
Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil
Authors: Gasparini Matheus S , dos Santos Leandro M , Hamade Ahmad MA , Gross Luísa G , Favarato Arthur P , de Vasconcellos José PC , de Melo Mônica B , Parise Pierina L , Simeoni Camila L , Silva Natália B , da Silva Mori Marcelo A , Vieira André S , dos Santos Farias Alessandro , Granja Fabiana , Schreiber Angelica Z , Moretti Maria L , Proença-Modena José L , Alves Mônica
Published: July 2021

In this cross-sectional study, we investigate the presence of Severe Acute Respiratory Syndrome Coronavirus 2 Ribonucleic Acid (SARS-CoV-2 RNA) in the tears of hospitalized COVID-19 patients. After laboratory confirmation of SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR) analysis, tear samples from both eyes of each patient were collected using conjunctival swab for RT-PCR. Detailed demographic profile, systemic and ocular symptoms, comorbidities, clinical, ancillary, and ocular manifestations were evaluated. Of the 83 patients enrolled in the study, 7 (8.43%) had SARS-CoV-2 RNA detected in the tear samples. Neutrophils’ count, C-reactive protein, and D-dimer were higher in patients with SARS-CoV-2 detected in tears than in patients without virus in ocular surface samples. One patient with SARS-CoV-2 in tears showed mild ocular eyelid edema, hyperemia, and chemosis. No relevant ocular manifestations were detected in the other patients. Although the levels of viral RNA on ocular surface samples were low for most patients (5/7), with positivity only for gene N and CT higher than 30, two patients were positive for all viral targets tested ( N, E, and RpRd), with viral load near 1 × 105 ePFU/mL, indicating that the ocular transmission of SARS-CoV-2 is a possibility that needs to be considered, especially in the hospital environment. Further studies need to be conducted to demonstrate whether infective viral particles could be isolated from tears.
What the World Needs Now: Lifestyle Medicine for All Women
Authors: BA Dopke , BA Somers , MD McHugh
Published: July 2021

Over the last several centuries, economic progress has allowed millions of women to move from rural subsistence agriculture to urban, more economically prosperous lifestyles. This trend is set to continue, even accelerate in the next century. Due to changes in diet, activity, and lifestyle, non-communicable diseases, such as cancer and heart disease, will continue to rise for women globally. At this time, we are uniquely positioned to anticipate this impact and empower women in both the developed and the developing world to learn from what has worked. Choosing the best approaches to nutrition, exercise, sleep, connectedness, substances, and stress can optimize women’s health span across the globe.
Shifting histories: Film and nationalist mythmaking through trauma
Authors: Rupka Sean
Published: July 2021

National histories do not simply exist in the past but rather are curated from the present. This curation reveals dominant contemporary dynamics of power and the mythmaking quality of national narratives of the past. Narratives of heroism and sacrifice, which form the genesis of the nation, become challenged by alternative histories they try to obfuscate, which is particularly true when national histories contain moments of great suffering and trauma. The author argues that certain counter-narratives resist these national histories and bring to light not simply the inconsistencies of a nation’s history but, more importantly, the continued labour and oppression involved in the continuation of these stories in the present. To illustrate this argument, he draws upon two films, Waltz with Bashir and The Act of Killing, and shows how these ‘psuedodocumentaries’ exemplify the persistence of alternative historical narratives derived from trauma and demonstrate the discontinuity and precarity of dominant national narratives.
Do Multi-Party Municipal Councils Improve Local Governance? Municipal Councillors’ Opinions in El Salvador
Authors: Córdova Abby , España-Nájera Annabella
Published: July 2021

As decentralisation reforms devolved greater responsibilities to local governments, improving local governance has become central to strengthening democracy. With the promise of increasing citizen representation and government transparency at the local level, in 2015 El Salvador implemented a new electoral system. The new system allowed for the election of opposition parties in municipal councils for the first time. In the context of El Salvador, we examine how opposition parties’ numerical representation influences the views of governing and opposition party members about multi-party councils’ effectiveness to improve local governance. To test our hypotheses, we rely on data from an original elite survey of 303 municipal councillors in 101 municipalities, which we complement with qualitative information. Contrary to what the literature suggests, we do not find evidence that a stronger opposition leads to more negative evaluations among members of governing parties, notwithstanding the country’s polarised party system.
Olaratumab’s failure in soft tissue sarcoma
Authors: Bou Zerdan Maroun , Bidikian Aram H , Alameh Ibrahim , Nakib Clara El , Assi Hazem I
Published: July 2021

Soft tissue sarcomas remain one of the rarest malignancies with numerous subtypes that go undiagnosed. The PDGFRα antagonist Olaratumab (Lartruvo) was withdrawn from the market due to disappointing findings in the phase III studies. We share our experience with this medication in a tertiary care center in the Middle East and North Africa region. Monitor the effect of Olaratumab on sarcomas when it was used prior to its withdrawal, and compare our findings with the literature. We performed a retrospective analysis of adult patients with advanced-/metastatic soft tissue sarcomas treated with at least two cycles of Olaratumab at a tertiary care center in Lebanon during the period from January 1, 2017 to December 31, 2018. Fifteen patients were included in the study. The mean age was 49 with a range of 26–75 years. The median duration of the use of Olaratumab was 21.3 months with a range of 7.3–37 months. The average number of number of cycles received per patient was four. Five patients were deceased. Median PFS was 7.87 months (95% CI 5.28–10.45), and mean OS was 12.26 months (95% CI 8.47–16.05) Median OS was 9.8 months (95% CI 6.07–13.53). Olaratumab has been withdrawn from the market, and it is currently being investigated as part of the phase II ANNOUNCE 2 trial. Our experience from a tertiary care center shows results similar to those reported in the literature. The immunogenicity and heterogeneity of soft tissue sarcomas pose a challenge to the treatment of soft tissue sarcomas, but they also allow a wide array of possible management solutions.
Inhabiting the ‘posts’
Authors: Oldfield Sophie
Published: July 2021

In this commentary, I reflect on Myriam Houssay-Holzschuch’s critical re-conceptualization of the ‘post’ as space-time regime and a means to unearth and engage complex geographies of change in South Africa and other post-colonial and post-socialist contexts. I situate our parallel imperatives to work through entanglements: in Myriam’s case, through metaphors that help engage the complex directionalities that might articulate space-time configurations and their possibilities; in my case, in the wide array of practices, the dialogues and collaboration, the contestations, which root intellectual practice, and the ways in which we inhabit ‘post space-time’. I particularly explore her invitation to engage critically with language to create vocabularies – metaphors and ordinary words – which help ground our work in the imperatives and urgencies, as well as the productive tensions and inspirations, which shape complex ‘post’ configurations.
Transition from parenteral prostacyclins to selexipag: safety and feasibility in selected patients
Authors: Aldweib Nael , Verlinden Nathan J. , Kassis‐George Hayah , Raina Amresh
Published: July 2021

There are limited data regarding the feasibility of transitioning from intravenous prostacyclins to selexipag in pulmonary arterial hypertension patients. We present a case series of successful transitions from intravenous prostacyclins to selexipag in the majority of carefully selected five stable pulmonary arterial hypertension patients using a standardized protocol in the outpatient setting.
Development of an interdisciplinary specialist facial pain management programme
Authors: Tetlow John , Ainsley Christian , Twiddy Hannah , Derbyshire Graham , Chawla Rajiv
Published: July 2021

Aims:

This article aims to describe the development of a specialist chronic facial pain (CFP) management programme within an already well-established pain management service, including the content from a multidisciplinary perspective, and present preliminary descriptive 6-month outcomes from patients who have attended the programme.

Methods:

Authors used their clinical experience of working with people who have a diagnosis of CFP. They researched available literature, liaised with CFP support organisations and visited an existing UK-based CFP programme. Programme content was designed based on findings. The roles of pain interdisciplinary team members involved in delivering the programme are described, as well as a brief description of the structure of the programme and programme sessions provided by each discipline.

Results:

Clinical outcomes from programme participants were collected at assessment, end of treatment and 6 months post-treatment, which measured relevant outcomes for a pain management programme (PMP). Outcomes from 36 participants at both end of programme and 6 months following completion of programme demonstrate promising improvements. Qualitative data from patient satisfaction questionnaires completed at the end of programme suggest that providing a CFP-specific programme was beneficial for participants, with the main critique being that the programme sessions should be longer than 45 minutes.

Conclusion:

Attending a CFP-specific programme demonstrated positive 6-month changes in relevant outcome measures for people with CFP. With a small sample size, there is a need for further research into the effectiveness. It would also be beneficial to compare outcomes from the usual PMP treatment with people who have CFP, with outcomes from a CFP-specific programme.
Peritoneal Dialysis After Liver Transplantation: A Systematic Review
Authors: Côté Jean Maxime , Ethier Isabelle , Cardinal Héloïse , Pépin Marie-Noëlle
Published: July 2021

Background:

Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear.

Objective:

To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis.

Design:

Systematic review.

Setting:

Interventional and observational studies reporting the use of PD after liver transplantation.

Patients:

Adult liver transplant recipients with kidney failure treated with maintenance KRT.

Measurements:

Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate.

Methods:

The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results.

Results:

From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function.

Limitations:

Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution.

Conclusions:

Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed.

Registration (PROSPERO):

CRD42020218374.
Early Extubation in a Pediatric Cardiac Surgery Program Located at High Altitude
Authors: Tamariz-Cruz Orlando José , García-Benítez Luis Antonio , Díliz-Nava Hector , Acosta-Garduño Felipa , Barrera-Fuentes Marcela , Hernández-Beltrán Edgar , Motta Pablo , Palacios-Macedo Alexis
Published: July 2021

Background:

Early extubation is performed either in the operating room or in the cardiovascular intensive care unit during the first 24 postoperative hours; however, altitude might possibly affect the process. The aim of this study is the evaluation of early extubation feasibility of patients undergoing congenital heart surgery in a center located at 2,691 m (8,828 ft.) above sea level.

Material and Methods:

Patients undergoing congenital heart surgery, from August 2012 through December 2018, were considered for early extubation. The following variables were recorded: weight, serum lactate, presence or not of Down syndrome, optimal oxygenation and acid–base status according to individual physiological condition (biventricular or univentricular), age, bypass time, and ventricular function. Standardized anesthetic management with dexmedetomidine–fentanyl–rocuronium and sevoflurane was used. If extubation in the operating room was considered, 0.08 mL/kg of 0.5% ropivacaine was injected into the parasternal intercostal spaces bilaterally before closing the sternum.

Results:

Four hundred seventy-eight patients were operated and 81% were early extubated. Mean pre- and postoperative SaO2 was 92% and 98%; postoperative SaO2 for Glenn and Fontan procedures patients was 82% and 91%, respectively. Seventy-three percent of patients who underwent Glenn procedure, 89% of those who underwent Fontan procedure (all nonfenestrated), and 85% with Down syndrome were extubated in the operating room. Reintubation rate in early extubated patients was 3.6%.

Conclusion:

Early extubation is feasible, with low reintubation rates, at 2,691 m (8,828 ft.) above sea level, even in patients with single ventricle physiology.
Results of Coarctation Repair by Thoracotomy in Pediatric Patients: A Single Institution Experience
Authors: Heremans Louis , Henkens Arnaud , de Beco Geoffroy , Carbonez Karlien , Moniotte Stéphane , Rubay Jean E. , Momeni Mona , Houtekie Laurent , Poncelet Alain J.
Published: July 2021

Background:

Aortic coarctation is among the most common cardiovascular congenital abnormalities requiring repair after birth. Besides mortality, morbidity remains an important aspect. Accordingly, we reviewed our 20-year experience of aortic coarctation repair by thoracotomy, with emphasis on both short- and long-term outcomes.

Methods:

From 1995 through 2014, 214 patients underwent coarctation repair via left thoracotomy. Associated arch lesions were distal arch hypoplasia (n = 117) or type A interrupted aortic arch (n = 6). Eighty-four patients had isolated coarctation (group 1), 66 associated ventricular septal defect (group 2), and 64 associated complex cardiac lesions (group 3). Median follow-up was 8.4 years.

Results:

There was one (0.5%) procedure-related death. Nine (4.2%) patients died during index admission. In-hospital mortality was 0.7% in group 1 and 2 and 12.5% in group 3 ( P < .001). No patient had paraplegia. Actuarial five-year survival was 97.5% in group 1, 94% group 2 and 66% in group 3. Recurrent coarctation developed in 29 patients, all but four (1.8%) successfully treated by balloon dilatation. Freedom from reintervention (dilatation or surgery) at five years was 86%. At hospital discharge, 28 (13.5%) patients were hypertensive. At follow-up, hypertension was present in 11 (5.3%) patients.

Conclusions:

Long-term results of aortic coarctation repair by thoracotomy are excellent, with percutaneous angioplasty being the procedure of choice for recurrences. Patient prognosis is dependent on associated cardiac malformations. In this study, the prevalence of late arterial hypertension was lower than previously reported.
Off-Pump Aortic Bypass for Hypoplastic Arch and Aortic Coarctation Via Anterolateral Thoracotomy
Authors: Chi Li-Qun , Liang Lin , Kong Qing-Yu , Liu Jia-Ji
Published: July 2021

We report the case of a 21-year-old woman who was referred with uncontrolled hypertension. Computed tomography angiography revealed aortic arch hypoplasia and severe aortic coarctation. An off-pump ascending-to-descending aortic bypass surgery using synthetic graft was performed via left anterolateral thoracotomy. The patient recovered well and was discharged home uneventfully after five days. This procedure was performed without touching the head vessels or any collateral vessels. We consider this a safe and less invasive alternative technique for adult coarctation patients who have aortic hypoplasia or interrupted aorta.
Risk Factors for Reoperation After Arterial Switch Operation
Authors: Patel Parth M. , Herrmann Jeremy L. , Bain Eric , Ladowski Joseph M. , Colgate Cameron , Rodefeld Mark D. , Turrentine Mark W. , Brown John W.
Published: July 2021

Objective:

The timing and nature of and risk factors for reoperation after the arterial switch operation in the setting of d-transposition of the great arteries requires further elucidation.

Methods:

A total of 403 patients who underwent arterial switch operation from 1986 to 2017 were reviewed. Institutional preference was for pulmonary artery reconstruction using a pantaloon patch of fresh autologous pericardium. The targets for coronary artery reimplantation were identified by intermittent root distension. Multivariable analysis was used to identify risk factors for reoperation.

Results:

Median follow-up was 8.6 years (interquartile range [IQR]: 2-16.9). Pulmonary arterioplasty was the most common reoperation (n = 11, 2.7%) at 3.3 years (IQR: 1.4-11.4) postoperatively. Subvalvar right ventricular outflow tract reconstruction (RVOTR) was required in nine (2.2%) patients at 2.5 years (IQR: 1.1-5.3) postoperatively. Aortic valve repair or replacement (AVR/r) was required in seven (1.7%) patients at 13.6 years (IQR: 10.0-15.8) postoperatively. Aortic root replacement (ARR) and Coronary Artery Bypass Graft/coronary patch arterioplasty were required in five (1.2%) patients each at 13.6 years (IQR: 11.0-15.3) and 11.3 years (IQR: 2.3-13.6) postoperatively, respectively. Taussig-Bing anomaly was a risk factor for any reoperation ( P = .034). Risk factors for specific reoperations included ventricular septal defect for AVR/r ( P = .038), Taussig-Bing anomaly for RVOTR ( P = .004), and pulmonary artery banding for ARR ( P = .028).

Conclusions:

Pantaloon patch pulmonary artery reconstruction and intermittent neo-aortic root distension during coronary reimplantation have minimized respective outflow tract reoperations. Certain anatomic subsets carry different risks for late reoperation, and pulmonary artery and/or RVOT reinterventions tend to occur sooner than aortic reinterventions. Special attention to these higher risk subpopulations will be critical to optimizing lifelong outcomes.
Toe Clearance Rehabilitative Slippers for Older Adults With Fall Risk: A Randomized Controlled Trial
Authors: Satoh Atsuko , Kudoh Yukoh , Lee Sangun , Saitoh Masumi , Miura Miwa , Ohnuma Yuka , Fukushi Naoki , Sasaki Hidetada
Published: July 2021

Introduction:

To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults.

Materials and Methods:

This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase.

Results:

After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores.

Discussion:

Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported.

Conclusions:

Rehabilitation training slippers may reduce falls in older adults.
Rate and Predictors of Failure in the Conservative Management of Stable Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis
Authors: Tan Terence , Huang Milly S. , Rutges Joost , Marion Travis E. , Fitzgerald Mark , Hunn Martin K. , Tee Jin
Published: July 2021

Study Design:

Systematic review.

Objectives:

Management of stable traumatic thoracolumbar burst fractures in neurologically-intact patients remains controversial. Conservative management fails in a subset of patients who require subsequent surgical fixation. The aim of this review is to (1) determine the rate of conservative management failure, and (2) analyze predictive factors at admission influencing conservative management failure.

Methods:

A systematic review adhering to PRISMA guidelines was performed. Studies with data pertaining to traumatic thoracolumbar burst fractures without posterior osteoligamentous injury (e.g. AO Type A3/A4) and/or the rate and predictive factors of conservative management failure were included. Risk of bias appraisal was performed. Pooled analysis of rates of failure was performed with qualitative analysis of predictors of conservative management failure.

Results:

16 articles were included in this review (11 pertaining to rate of conservative management failure, 5 pertaining to predictive risk factors). Rate of failure of conservative management from a pooled analysis of 601 patients is 9.2% (95% CI: 4.5%-13.9%). Admission factors predictive of conservative management failure include age, greater initial kyphotic angle, greater initial interpedicular distance, smaller initial residual canal size, greater Load Sharing Classification (LSC) score and greater admission Visual Analog Scale (VAS) pain scores.

Conclusion:

A proportion (9.2%) of conservatively managed, neurologically-intact thoracolumbar burst fractures fail conservative management. Among other factors, age, kyphotic angle, residual canal area and interpedicular distance should be investigated in prospective studies to identify the subset of patients prone to failure of conservative management. Surgical management should be carefully considered in patients with the above risk factors.
Clinical Outcomes of Selective Single-Level Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression of Multilevel Lumbar Spinal Stenosis and Risk Factors of Reoperation
Authors: Yoshikane Koichi , Kikuchi Katsuhiko , Okazaki Ken
Published: July 2021

Study Design:

Retrospective cohort study.

Objectives:

To investigate the usefulness of selective single-level lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) in patients with radiological multilevel lumbar spinal stenosis (LSS) and clarify the predictive factors of reoperation.

Methods:

A total of 128 patients who underwent LE-ULBD of radiological multilevel LSS were retrospectively examined. Single-level decompression was selected clinically and supplemented radiologically. Clinical outcomes were assessed with the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), numeric rating scale (NRS), and Macnab criteria (mean follow-up period, 28.6 months [range, 24-63 months]). Stenosis severity was classified as grades M (moderate) and S (severe) based magnetic resonance imaging findings. Multilevel LSS was classified as SS, SM, and MM according to the number of grade S levels.

Results:

The follow-up rate was 74.2%. All domains of the JOABPEQ and NRS significantly improved during follow-up. The Macnab outcome classification was “excellent” or “good” in 77.9% of the patients. The reoperation rate was 10.2%. None of the patients with unilateral symptoms required reoperation. The SS type was a significant risk factor of reoperation for multilevel LSS with bilateral symptoms. Additional LE-ULBD was performed for all the reoperation with the “excellent” or “good” results of the Macnab criteria in 69% of the patients.

Conclusions:

Selective single-level LE-ULBD provided favorable results for multilevel LSS. However, information about the risks of reoperation for multilevel severe stenosis with bilateral symptoms should be shared between surgeons and patients.
How Providers in Child Neurology Transitioned to Telehealth During COVID-19 Pandemic
Authors: Bain Jennifer M. , Dyer Codi-Ann , Galvin Megan , Goldman Sylvie , Selman Jay , Silver Wendy G. , Tom Sarah E.
Published: July 2021

To understand child neurology care practices in telehealth (TH), we conducted an online survey interested in identifying which patients should be triaged for in-person evaluations in lieu of telehealth management. We also sought to identify provider and patient/parent limitations of the TH experience. One hundred fourteen clinicians completed the online survey. The majority of child neurologists transitioned within 3 weeks of the pandemic onset and found it inappropriate to evaluate a child under 1 year of age via TH. We identified specific disorders considered inappropriate for initial evaluation via TH, including neuromuscular disease, neuropathy, weakness, autoimmune disease and autism spectrum disorders. Patient and parent technical and economic issues are significant limitations of TH. We suggest quality improvement measures to provide additional training, focusing on particular disorders and increased access for those patients currently excluded from or limited in using or accessing TH.
Slum Dwellers Perception Towards Ujjwala Yojana, a Government-Lead LPG Intervention Programme in India: An Empirical Investigation
Authors: Ray Koustubh Kanti
Published: July 2021

Numerous studies are available in the academic literature that investigates the customer perception under different contexts. In the present research the researcher tries to investigate the customer perception towards the Indian Government-sponsored social programme from the slum dwellers’ prospective. The author believes that the customer perception towards the government-lead liquefied petroleum gas intervention programme is influenced by multiple functional factors. The functional factors include both process or delivery variables and the outcome factors. In order to test the hypothesis, machine learning binary classifiers like logit, support vector machine, linear discriminant analysis, quadratic discriminant analysis and artificial neural network models are adopted. The binary classifier model efficiencies are analysed with multiple performance measurement parameters like accuracy rate, error rate, F-score, precision, kappa coefficient, Matthews correlation coefficient and area under receiver operating characteristic. While evaluating between the degree of accuracy between actual and predicted cases, the model efficiency results indicate a better predictive power of the classifier models. In relative performance of classifier models, artificial neural network outperformed the other models adopted in the empirical research.
Diunsa: An Entrepreneurial Family’s Digital Response to COVID-19
Authors: Union Lauri , Suen Carmen , Mancha Rubén
Published: July 2021

On March 15, 2020, in response to the Covid-19 pandemic, the Honduran government unexpectedly announced a state of emergency and mandated immediate closure of all businesses. Diunsa closed its six stores. The family-owned retailer had anticipated supply chain disruptions, stocked from alternative suppliers, and formed a crisis management team. Now, to keep the business afloat during the unexpected closure and retain all its employees on the payroll, the company had to move sales from the brick-and-mortar stores to an incomplete online retail site. The third generation in the family business—the Faraj siblings, all in their 20’s—led the critical transition online and response to setbacks. As digital-native millennials, they helped improve the website, customer service, operations, and delivery in a short amount of time and using external resources and various technologies. As the situation stabilized, Diunsa’s leadership asked: How will Diunsa build on the momentum for digital transformation and turn its tactical actions into a digital strategy? How can we continue to tap into the leadership of our up-and-coming generation to achieve these goals?
Tennantite-(Hg), Cu6(Cu4Hg2)As4S13, a new tetrahedrite-group mineral from the Lengenbach quarry, Binn, Switzerland
Authors: Biagioni Cristian , Sejkora Jiří , Raber Thomas , Roth Philippe , Moëlo Yves , Dolníček Zdenĕk , Pasero Marco
Published: July 2021

Tennantite-(Hg), Cu6(Cu4Hg2)As4S13, was approved as a new mineral species (IMA2020-063) from the Lengenbach quarry, Imfeld, Binn Valley, Canton Valais, Switzerland. It was identified as an aggregate of black metallic tetrahedral crystals, less than 0.1 mm in size, intimately associated with sinnerite, and grown on realgar. In reflected light, tennantite-(Hg) is isotropic, grey in colour, with creamy tints. Minimum and maximum reflectance data for COM wavelengths in air are [λ (nm): R (%)]: 470: 29.1; 546: 29.1; 589: 28.5; 650: 27.7. Electron microprobe analysis gave (in wt.% – average of 7 spot analyses): Cu 32.57(42), Ag 6.38(19), Tl 0.29(14), Zn 0.04(5), Hg 17.94(2.27), Pb 0.70(51), As 17.83(61), Sb 0.34(8), S 24.10(41), total 100.19(1.04). The empirical formula of the sample studied, recalculated on the basis of ΣMe = 16 atoms per formula unit, is (Cu4.69Ag1.04Tl0.03)Σ5.76(Cu4.35Hg1.58Pb0.06Zn0.01)Σ6.00(As4.20Sb0.05)Σ4.25S13.26. Tennantite-(Hg) is cubic, I$\overline 4$3m, with a = 10.455(7) Å, V = 1143(2) Å3 and Z = 2. The crystal structure of tennantite-(Hg) has been refined by single-crystal X-ray diffraction data to a final R1 = 0.0897 on the basis of 214 unique reflections with Fo > 4σ(Fo) and 22 refined parameters. Tennantite-(Hg) is isotypic with other members of the tetrahedrite group. Mercury is hosted at the tetrahedrally coordinated M(1) site, in accord with the relatively long M(1)–S(1) distance (2.389 Å), similar to that observed in tetrahedrite-(Hg). Minor Ag is located at the triangularly-coordinated and split M(2) site. Other occurrences of tennantite-(Hg) are briefly reviewed and the Lengenbach finding is described within the framework of previous knowledge about the Hg mineralogy at this locality.
Targeting intracellular WT1 in AML with a novel RMF-peptide-MHC-specific T-cell bispecific antibody
Authors: Augsberger Christian , Hänel Gerulf , Xu Wei , Pulko Vesna , Hanisch Lydia Jasmin , Augustin Angelique , Challier John , Hunt Katharina , Vick Binje , Rovatti Pier Eduardo , Krupka Christina , Rothe Maurine , Schönle Anne , Sam Johannes , Lezan Emmanuelle , Ducret Axel , Ortiz-Franyuti Daniela , Walz Antje-Christine , Benz Jörg , Bujotzek Alexander , Lichtenegger Felix S. , Gassner Christian , Carpy Alejandro , Lyamichev Victor , Patel Jigar , Konstandin Nikola , Tunger Antje , Schmitz Marc , von Bergwelt-Baildon Michael , Spiekermann Karsten , Vago Luca , Jeremias Irmela , Marrer-Berger Estelle , Umaña Pablo , Klein Christian , Subklewe Marion
Published: July 2021

Antibody-based immunotherapy is a promising strategy for targeting chemoresistant leukemic cells. However, classical antibody-based approaches are restricted to targeting lineage-specific cell surface antigens. By targeting intracellular antigens, a large number of other leukemia-associated targets would become accessible. In this study, we evaluated a novel T-cell bispecific (TCB) antibody, generated by using CrossMAb and knob-into-holes technology, containing a bivalent T-cell receptor–like binding domain that recognizes the RMFPNAPYL peptide derived from the intracellular tumor antigen Wilms tumor protein (WT1) in the context of HLA-A*02. Binding to CD3ε recruits T cells irrespective of their T-cell receptor specificity. WT1-TCB elicited antibody-mediated T-cell cytotoxicity against AML cell lines in a WT1- and HLA-restricted manner. Specific lysis of primary acute myeloid leukemia (AML) cells was mediated in ex vivo long-term cocultures by using allogeneic (mean ± standard error of the mean [SEM] specific lysis, 67 ± 6% after 13-14 days; n = 18) or autologous, patient-derived T cells (mean ± SEM specific lysis, 54 ± 12% after 11-14 days; n = 8). WT1-TCB–treated T cells exhibited higher cytotoxicity against primary AML cells than an HLA-A*02 RMF-specific T-cell clone. Combining WT1-TCB with the immunomodulatory drug lenalidomide further enhanced antibody-mediated T-cell cytotoxicity against primary AML cells (mean ± SEM specific lysis on days 3-4, 45.4 ± 9.0% vs 70.8 ± 8.3%; P = .015; n = 9-10). In vivo, WT1-TCB–treated humanized mice bearing SKM-1 tumors exhibited a significant and dose-dependent reduction in tumor growth. In summary, we show that WT1-TCB facilitates potent in vitro, ex vivo, and in vivo killing of AML cell lines and primary AML cells; these results led to the initiation of a phase 1 trial in patients with relapsed/refractory AML (#NCT04580121).
Anti–platelet factor 4 antibodies causing VITT do not cross-react with SARS-CoV-2 spike protein
Authors: Greinacher Andreas , Selleng Kathleen , Mayerle Julia , Palankar Raghavendra , Wesche Jan , Reiche Sven , Aebischer Andrea , Warkentin Theodore E. , Muenchhoff Maximilian , Hellmuth Johannes C. , Keppler Oliver T. , Duerschmied Daniel , Lother Achim , Rieg Siegbert , Gawaz Meinrad Paul , Mueller Karin Anne Lydia , Scheer Christian S. , Napp Matthias , Hahnenkamp Klaus , Lucchese Guglielmo , Vogelgesang Antje , Flöel Agnes , Lovreglio Piero , Stufano Angela , Marschalek Rolf , Thiele Thomas ,   for the Immune-Response in COVID-19 Vaccination Study Group
Published: July 2021

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe adverse effect of ChAdOx1 nCoV-19 COVID-19 vaccine (Vaxzevria) and Janssen Ad26.COV2.S COVID-19 vaccine, and it is associated with unusual thrombosis. VITT is caused by anti-platelet factor 4 (PF4) antibodies activating platelets through their FcγRIIa receptors. Antibodies that activate platelets through FcγRIIa receptors have also been identified in patients with COVID-19. These findings raise concern that vaccination-induced antibodies against anti-SARS-CoV-2 spike protein cause thrombosis by cross-reacting with PF4. Immunogenic epitopes of PF4 and SARS-CoV-2 spike protein were compared using in silico prediction tools and 3D modeling. The SARS-CoV-2 spike protein and PF4 share at least 1 similar epitope. Reactivity of purified anti-PF4 antibodies from patients with VITT was tested against recombinant SARS-CoV-2 spike protein. However, none of the affinity-purified anti-PF4 antibodies from 14 patients with VITT cross-reacted with SARS-CoV-2 spike protein. Sera from 222 polymerase chain reaction–confirmed patients with COVID-19 from 5 European centers were tested by PF4-heparin enzyme-linked immunosorbent assays and PF4-dependent platelet activation assays. We found anti-PF4 antibodies in sera from 19 (8.6%) of 222 patients with COVID-19. However, only 4 showed weak to moderate platelet activation in the presence of PF4, and none of those patients developed thrombotic complications. Among 10 (4.5%) of 222 patients who had COVID-19 with thrombosis, none showed PF4-dependent platelet-activating antibodies. In conclusion, antibodies against PF4 induced by vaccination do not cross-react with the SARS-CoV-2 spike protein, indicating that the intended vaccine-induced immune response against SARS-CoV-2 spike protein is not the trigger of VITT. PF4-reactive antibodies found in patients with COVID-19 in this study were not associated with thrombotic complications.
Influence of soil properties on the heartwood colour of Juglans mandshurica var. sachalinensis in a cool temperate forest
Authors: Makoto Kobayashi , Susloparova Elizaveta , Tsuyama Ikutaro , Shimase Takuya , Nakaba Satoshi , Takahashi Naoki , Yoshida Toshiya
Published: July 2021

Heartwood colour is often an important factor in determining timber prices. However, the determinants of intraspecific variation in heartwood colour, which is useful information for sustainable wood marketing, are little understood, especially at the local scale in cool temperate forests. Because heartwood is produced as a secondary compound and photosynthesis is regulated by nitrogen (N) in cool temperate forests, we hypothesized that (1) soil conditions determine heartwood colour even at a local scale within a tree species and (2) N, specifically, can be an important driver of the intraspecific variation in heartwood colour in the trees of cool temperate forests. To test these hypotheses, we investigated the relationship between the colour values (luminescence, redness, and yellowness) of heartwood from Juglans mandshurica var. sachalinensis and the soil parameters in a cool temperate forest. Among the soil properties, not soil N but soil magnesium (Mg) contents alone had a significant influence on the redness and yellowness of the heartwood. Higher soil Mg contents resulted in increased greenness and yellowness of the heartwood in our study, probably due to the increase in phenolics and the colouring of the tannins in the heartwood with Mg. Our results indicate that even at a local scale, soil condition can determine the intraspecific variation in heartwood colour and that forest managers can utilize edaphic information to predict heartwood colour for timber marketing.
The chronobiology of migraine: a systematic review
Authors: Poulsen Amanda Holmen , Younis Samaira , Thuraiaiyah Janu , Ashina Messoud
Published: July 2021

Background

The paroxysmal nature of migraine is a hallmark of the disease. Some patients report increased attack frequency at certain seasons or towards the end of the week, while others experience diurnal variations of migraine attack onset. This systematic review investigates the chronobiology of migraine and its relation to the periodicity of attacks in existing literature to further understand the oscillating nature of migraine.

Main body

PubMed and Embase were systematically searched and screened for eligible articles with outcome measures relating to a circadian, weekly or seasonal distribution of migraine attacks. We found that the majority of studies reported morning hours (6 am–12 pm) as the peak time of onset for migraine attacks. More studies reported Saturday as weekly peak day of attack. There was no clear seasonal variation of migraine due to methodological differences (primarily related to location), however four out of five studies conducted in Norway reported the same yearly peak time indicating a possible seasonal periodicity phenomenon of migraine.

Conclusions

The findings of the current review suggest a possible role of chronobiologic rhythms to the periodicity of migraine attacks. Future studies are, however, still needed to provide more knowledge of the oscillating nature of migraine.
Risk factors and predictive value of perioperative neurocognitive disorders in elderly patients with gastrointestinal tumors
Authors: Li Yong-Li , Huang Hui-Fan , Le Yuan
Published: July 2021

Background

This study aims to investigate the risk factors of perioperative neurocognitive disorders (PNDs) mainly including postoperative cognitive dysfunction (POCD) in elderly patients with gastrointestinal tumors, and evaluate its predictive value.

Methods

A total of 222 eligible elderly patients (≥65 years) scheduled for elective gastroenterectomy under general anesthesia were enrolled. The cognitive function assessment was carried out 1 day before surgery and 7 days after surgery. Receiver operating characteristic curve analysis was performed to evaluate the predictive value of risk factors for early POCD. The risk factors for POCD were analyzed using univariate and multivariate logistic regression model.

Results

Of all the 222 enrolled patients, 91 (41.0%) developed early POCD and 40 (18.0%) were identified as major POCD within 7 days after the surgery. Visual analogue score (VAS, 1st day, resting) ≥4 (OR = 7.618[3.231–17.962], P < 0.001) and alcohol exposure (OR = 2.398[1.174–4.900], P = 0.016) were independent risk factors for early POCD. VAS score (1st, resting) ≥4 (OR = 13.823[4.779–39.981], P < 0.001), preoperative white blood cell (WBC) levels ≥10 × 10*9/L (OR = 5.548[1.128–26.221], P = 0.035), blood loss ≥500 ml (OR = 3.317[1.094–10.059], P = 0.034), history of hypertension (OR = 3.046[1.267–7.322], P = 0.013), and neutrophil–lymphocyte ratio (NLR) ≥2 (OR = 3.261[1.020–10.419], P = 0.046) were independent risk factors for major POCD. Receiver operating characteristic curve analysis indicated that VAS score (1st day, resting) was a significant predictor for major POCD with a cut-off value of 2.68 and an area under the curve of 0.860 (95% confidence interval: 0.801–0.920, P < 0.001).

Conclusions

The risk factors for early POCD after gastroenterectomy included high VAS score (1st day, resting) and alcohol exposure. High VAS score, preoperative WBC levels ≥10 × 10*9/L, blood loss ≥500 ml, NLR ≥2, and history of hypertension were independent risk factors for major POCD. Among them, VAS score was one of the important predictors.