bluuebunny/crossref_metadata_2025 huggingface dataset:
OASIS 1: Retrospective analysis of four different microprocessor knee types
Authors: Campbell James H , Stevens Phillip M , Wurdeman Shane R
Published: November 2020

Introduction

Microprocessor knee analyses to date have been primarily limited to microprocessor knees as a category rather than comparisons across different models. The purpose of the current analysis was to compare outcomes from four common knee models.

Methods

A retrospective analysis of clinical outcomes was performed. Outcomes for functional mobility, quality of life, satisfaction with amputee status, and injurious falls were compared. Specific knee types represented were C-Leg (Ottobock), Orion (Blatchford), Plié (Freedom Innovations), and Rheo (Össur).

Results

Outcomes from 602 individuals were included. No significant differences were noted for functional mobility (H = 2.91, p = 0.406) or satisfaction (H = 4.43, p = 0.219). For quality of life, differences existed for C-Leg versus Plié (p = 0.010). For injurious falls, C-Leg (χ2(1,137) = 10.99, p < 0.001) and Orion (χ2(1,119) = 4.34, p = 0.037) resulted in significantly reduced injurious falls compared to non-microprocessor knee users. C-Leg (H = 19.63, p < 0.001) and Plié (H = 14.04, p = 0.003) users saw declines with advanced aging.

Conclusions

Our data indicate relative parity among the 4 microprocessor knees with regard to functional mobility and satisfaction. In contrast to mobility, neither satisfaction nor quality of life values reflected declines with aging. Finally, when compared to non-microprocessor knees, significant differences were observed across the microprocessor knee types in relation to the reduction of injurious falls. Keywords: MPK, mobility, quality of life, falls, amputee, outcomes
Nurses’ experiences of ethical responsibility: A hermeneutic phenomenological design
Authors: Tollefsen Annette Strand , Olsen Aid Bredal , Clancy Anne
Published: November 2020

There is a lack of studies on ethical responsibility in nursing. Nurses experience ethical responsibility in all settings where patients are exposed and vulnerable. The authors’ interest in public health and intensive care nursing provided a motivation to study these settings. The study aimed to explore how intensive care and public health nurses experience ethical responsibility. A qualitative design was chosen and 10 individual interviews were carried out. The data were analysed using hermeneutic phenomenological analysis. The study is reported in accordance with COREQ. Levinasian ethics provided the theoretical framework. The analysis resulted in four themes: Feeling alone, Feeling worried and uncertain, A sense of satisfaction, A personal commitment. Even though the settings differed, experiences of aspects of ethical responsibility were the same. Further in-depth studies in different settings can enhance an understanding of moral responsibility and facilitate the development of a theory of ethical responsibility in nursing practice.
Repair of Incidental Durotomy Using Sutureless Nonpenetrating Clips via Biportal Endoscopic Surgery
Authors: Heo Dong Hwa , Ha Ji Soo , Lee Dong Chan , Kim Hyeun Sung , Chung Hoon Jae
Published: November 2020

Study Design:

Technical report.

Objectives:

Dural tear is one of the most common complications of endoscopic spine surgery. Although endoscopic dural repair of the durotomy area may be difficult, we successfully repaired the dural tear area using nonpenetrating clips during biportal endoscopic surgery. We introduce the surgical technique of dural repair using nonpenetrating titanium clips in biportal endoscopic spine surgery and report its clinical outcome.

Methods:

We retrospectively reviewed and analyzed 5 patients who were treated via primary dural repair using nonpenetrating titanium clips during biportal endoscopic lumbar surgery. The 2 methods of dural clipping and repair include 2 or 3 portals. We analyzed radiological parameters such as cerebrospinal fluid collection as well as clinical parameters, including postoperative clinical outcomes.

Results:

Five patients underwent biportal endoscopic dural repair using nonpenetrating clips. Incidental durotomy was successfully repaired using nonpenetrating titanium clips in all 5 patients. No cerebrospinal fluid collection was detected in the postoperative magnetic resonance images. Clinically, preoperative symptoms improved significantly after surgery ( P < .05).

Conclusions:

We repaired the dural tear area completely using nonpenetrating titanium vascular anastomosis clips in biportal endoscopic lumbar surgery. Dural repair via clipping method may be an effective alternative for incidental durotomy.
Automated Sample Handling - Part 2
Authors: Steven Sue E. , Schmidt Thomas D.
Published: November 2020

This is the second of a two part article about SmithKline Beecham Clinical Laboratories automation facility at Norristown, Pennsylvania. This article responds to the criteria necessary in selecting an automation platform and describes three applications of the automation product manufactured by Megamation.
Development and Implementation of Network-Resident Clinical Laboratory Tools in an Integrated Health Delivery System
Authors: Sendek Michael E. , Virji Mohamed A.
Published: November 2020

The conceptual approach to a system of network resident-training tools for use in a clinical pathology laboratory is described and specific modules developed for use in an integrated health care delivery system. The modules have been developed to be accessible throughout an organization, are amenable to customization, are designed for use by personnel with varied knowledge of laboratory techniques, and can be updated readily. The modules designed are for dry slide clinical chemistry analyses, white blood cell maturation sequence, and flow cytometry. The concept can be applied to other laboratory functions including point-of-care testing service. The modules incorporate flexibility of integrating text with digital images, sound and animation. The core of the system is based on readily available software for Internet. Therefore, the system of laboratory tools can provide the means for rapidly accessible, current data resources for a variety of purposes for a laboratory to operate in an integrated delivery system.
Automating Your Existing Clinical Instruments
Authors: Holman William , Turner Randy , Felder Robin A.
Published: November 2020

Laboratory automation systems (LAS) provide full automation of the pre-, peri-, and post-analytical specimen processing tasks in clinical laboratories. However, many existing instruments are difficult to interface, both mechanically and electronically, to specimen transportation systems. The AxSYM (Abbott Laboratories, Abbott Park, IL) analyzer is a popular method to perform immunoassay and toxicology measurements. In order for the large installed base of AxSYM instruments to take advantage of the efficiencies of automation, a prototype interface was developed for a popular LAS, the Coutler/IDS Model CLA (Coulter Corporation, Miami, FL). The automated instrument interface was designed for automatic loading and unloading of the AxSYM analyzer. The automated system can accept one or two AxSYM analyzers depending on the throughput and sample distribution needs of the laboratory. At the heart of the AxSYM automation is a CRS (Burlington, Ontario, Canada) robotic arm that is used to remove specimens from the model CLA, place them in an AxSYM sample tray, load the analyzer, and then automatically unload the finished specimens and return them to the Coulter/IDS. The system is projected to load and unload up to 200 specimens per hour from and to the conveyor system. While supporting automated loading, the system allows the AxSYM analyzer(s) to run manually loaded specimens. Minimal interfacing is required to install and operate the automated AxSYM so that the system can be up and running quickly. No physical connections are made to the Coulter/IDS thus simplifying installation and maintenance.
Tough Decisions During the COVID 19 Pandemic: A Frail Latino Patient
Authors: Huayanay Irma , Luu Stephanie
Published: November 2020

The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had overwhelmed the healthcare system worldwide with multiple ethical dilemmas. Several tools have been used to assess risk factors in these patients. One of them, the Clinical Frailty scale, has shown good correlation between the patient functional status and hospital stay with overall mortality. We present a case were the Clinical Frailty Scale was used to assess patient management and goals of care.
The Fellowship of Suffering: Insights from Trauma Healing
Authors: Hill Harriet
Published: November 2020

In a world brimming over with trauma and suffering, what is the gospel? And what is the church? In this article, Harriet Hill explores the church as a fellowship of suffering, drawing insights from her years of experience in trauma healing. She describes the first “Healing the Wounds of Trauma” workshop in 2002 with pastors from war zones across Africa. Then she explores factors that prevent churches from engaging in this fellowship of suffering, countered with reasons the church is ideally placed to be a fellowship of suffering.
Das Personalwesen als Kooperationspartner interner Service-Bereiche
Authors: Reiß Michael , Schuster Hermann
Published: November 2020

Die Kundenorientierung des Personalwesens hat in den letzten Jahren zu einer sehr intensiven Beschäftigung mit den Möglichkeiten und Grenzen der Kooperation zwischen Personalabteilung und den direkten Bereichen im Unternehmen geführt. Deutlich weniger Aufmerksamkeit wurde der Zusammenarbeit zwischen Personalwesen und den anderen indirekten Bereichen (Service-Einheiten) wie Controlling, Org/DV, Recht, Qualitätswesen, Öffentlichkeitsarbeit u.ä. geschenkt. Tatsächlich ergibt sich jedoch angesichts der Rationalisierungsprozesse sowie zahlreicher, flächendeckend angelegter Change-Projekte in den Unternehmen ein beträchtliches Volumen an Kooperationsbeziehungen auch innerhalb der Zentrale. Offen ist jedoch vor allem, nach welchen Spielregeln für die Arbeits- und Machtverteilung sich eine Zusammenarbeit zwischen Experten bei solchen Vorhaben vollziehen soll. Das vertraute Kooperationsparadigma der Kunden-Lieferanten-Beziehung läßt sich nämlich nicht direkt auf diesen Kooperationsbereich übertragen. In der vorliegenden State-of-the art-Analyse werden die Kooperationsbedarfe und Kooperationsformen sowie Erfolgs- und Mißerfolgsfaktoren dieser Kooperationsarena untersucht. Diese Analyse basiert auf einer Reihe von Fallstudien, der Analyse von Befragungen zu benachbarten Themen sowie der Anwendung des Transaktionskostenansatzes auf die Kooperation in dezentralen Unternehmungen.
Telearbeit im Spannungsfeld der Interessen betrieblicher Akteure: Implikationen für das Personalmanagement
Authors: Büssing André , Aumann Sandra
Published: November 2020

Vor dem Hintergrund eines Trends zur Dezentralisierung bestimmter höherqualifizierter Informationsarbeit werden die Interessen der Akteure an Telearbeit und die organisationale Wirklichkeit dieser neuen Arbeitsform analysiert. Die Ergebnisse zeigen: Es wird Interesse an einer Flexibilisierung von Arbeitszeit und Arbeitsort mittels Telearbeit sowohl von Arbeitgeber- als auch von Arbeitnehmerseite geäußert. Während sich die betrieblichen Interessen vor allem auf eine Steigerung der Wirtschaftlichkeit, eine stärkere Kundenorientierung und auf die organisationale Bindung qualifizierter Arbeitskräfte richten, wollen Arbeitnehmer/-innen die Telearbeit häufig zur autonomeren Arbeits(zeit)gestaltung und zur besseren Vereinbarung von Beruf und Familie nutzen. Dieses Spannungsfeld stellt das Personalmanagement vor neue Aufgaben. Ortsungebundene, zeitflexible Arbeit fordert neue Wege der Führung von Telearbeitnehmer/-innen; sie ist vor allem durch die Notwendigkeit von Selbstorganisation, von verändertem Zeit- und Informationsmanagement sowie durch die Schnittstellen zwischen Organisation, Familie und Freizeit geprägt.
Hocus pocus? Spirituality and soil care in biodynamic agriculture
Authors: Pigott Anna
Published: November 2020

In this article, I participate in efforts to re-imagine soils as lively, complex, more-than-human ecologies, by turning to the largely sidestepped subject of spirituality in agriculture. Spiritual knowledge practices rarely sit comfortably alongside technoscientific, productivist accounts of soil health, and yet they can re-configure how soils are conceptualised and managed, with implications for relationships of care. Drawing on an extended period of learning with a Community Supported Agriculture project in south Wales, the article explores how care is cultivated through a non-conventional method of farming known as biodynamics, which incorporates astrological and spiritual principles. I suggest that biodynamic narratives and rituals encourage attentiveness to more-than-human agency and energy, to depth (not only underground but also above-ground influences of the air and celestial bodies), and to reciprocity between soil biota and humans. Biodynamic practices also make space for mystery, thereby resisting drives to measure and map, and offering possibilities for disrupting anthropocentric approaches to soil care. However, the example presented here also highlights how, despite biodynamic’s growing popularity, its spiritual elements have a tendency to be kept quiet, their presence sidelined by more familiar, secular, narratives. Nonetheless, I contend that if effective soil care demands more diverse knowledge practices than those that are currently obliterating critical soil communities at an alarming rate, then there can be much to learn from a touch of magic.
Improvement in surface quality of diamond-turned aluminium substrate by using hydrogen peroxide: a molecular dynamics simulation study
Authors: Ranjan Prabhat , Sharma Anuj , Balasubramaniam R.
Published: November 2020

In this work, the atomic mechanism of chemical treatment on diamond-turned aluminium surface due to aqueous H2O2 is investigated using a reactive molecular dynamics simulation (R-MDS). This study is carried out to understand the mechanism of surface quality improvement of a diamond-turned aluminium workpiece due to chemical treatment. Surface quality improvement is focused to analyse the effect of chemical treatment process for improving surface finish, reflectance and chemical stability of the workpiece. It is observed that the diamond-turned surface contains a higher cohesive energy as compared to atomically smooth surfaces. Chemical treatment does more material removal on nano-peaks with respect to the smooth surface, and this helps to reduce the cohesive energy as low as naturally possible. By applying this treatment, the optical quality of the workpiece gets enhanced drastically. R-MDS also reveals that the nano-peaks of diamond turn machining (DTM) surface can further improve surface finish by using the chemical treatment process, and the same is validated by experiments. Experimental data also support that due to the reduction of surface roughness, reflectance increases in a broad band of wavelength. The present work shows that material removal from the nano-peaks of workpiece occurs due to the oxygen radicals generated from H2O2, which raise the local temperature, followed by temperature-assisted chemical reaction. When most of the nano-peak atoms are removed, further material removal stops. Experimental results also support the mechanism of such process of chemical treatment. Hence, the diamond turned surface can be further improved beyond the capability of the diamond turning process to cater the need for optics and astronomical mirror at-least one step ahead in the domain of ultra-precision manufacturing.
Progression signature underlies clonal evolution and dissemination of multiple myeloma
Authors: Shen Yu Jia , Mishima Yuji , Shi Jiantao , Sklavenitis-Pistofidis Romanos , Redd Robert A. , Moschetta Michele , Manier Salomon , Roccaro Aldo M. , Sacco Antonio , Tai Yu-Tzu , Mercier Francois , Kawano Yawara , Su Nang Kham , Berrios Brianna , Doench John G. , Root David E. , Michor Franziska , Scadden David T. , Ghobrial Irene M.
Published: November 2020

Clonal evolution drives tumor progression, dissemination, and relapse in multiple myeloma (MM), with most patients dying of relapsed disease. This multistage process requires tumor cells to enter the circulation, extravasate, and colonize distant bone marrow (BM) sites. Here, we developed a fluorescent or DNA-barcode clone-tracking system on MM PrEDiCT (progression through evolution and dissemination of clonal tumor cells) xenograft mouse model to study clonal behavior within the BM microenvironment. We showed that only the few clones that successfully adapt to the BM microenvironment can enter the circulation and colonize distant BM sites. RNA sequencing of primary and distant-site MM tumor cells revealed a progression signature sequentially activated along human MM progression and significantly associated with overall survival when evaluated against patient data sets. A total of 28 genes were then computationally predicted to be master regulators (MRs) of MM progression. HMGA1 and PA2G4 were validated in vivo using CRISPR-Cas9 in the PrEDiCT model and were shown to be significantly depleted in distant BM sites, indicating their role in MM progression and dissemination. Loss of HMGA1 and PA2G4 also compromised the proliferation, migration, and adhesion abilities of MM cells in vitro. Overall, our model successfully recapitulates key characteristics of human MM disease progression and identified potential new therapeutic targets for MM.
Relapse risk following truncation of pegylated asparaginase in childhood acute lymphoblastic leukemia
Authors: Gottschalk Højfeldt Sofie , Grell Kathrine , Abrahamsson Jonas , Lund Bendik , Vettenranta Kim , Jónsson Ólafur G. , Frandsen Thomas L. , Wolthers Benjamin O. , Marquart Hanne Vibeke , Vaitkeviciene Goda , Lepik Kristi , Heyman Mats , Schmiegelow Kjeld , Albertsen Birgitte Klug
Published: November 2020

Truncation of asparaginase treatment due to asparaginase-related toxicities or silent inactivation (SI) is common and may increase relapse risk in acute lymphoblastic leukemia (ALL). We investigated relapse risk following suboptimal asparaginase exposure among 1401 children aged 1 to 17 years, diagnosed with ALL between July 2008 and February 2016, treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol (including extended asparaginase exposure [1000 IU/m2 intramuscularly weeks 5-33]). Patients were included with delayed entry at their last administered asparaginase treatment, or detection of SI, and followed until relapse, death, secondary malignancy, or end of follow-up (median, 5.71 years; interquartile range, 4.02-7.64). In a multiple Cox model comparing patients with (n = 358) and without (n = 1043) truncated asparaginase treatment due to clinical toxicity, the adjusted relapse-specific hazard ratio (HR; aHR) was 1.33 (95% confidence interval [CI], 0.86-2.06; P = .20). In a substudy including only patients with information on enzyme activity (n = 1115), the 7-year cumulative incidence of relapse for the 301 patients with truncation of asparaginase treatment or SI (157 hypersensitivity, 53 pancreatitis, 14 thrombosis, 31 other, 46 SI) was 11.1% (95% CI, 6.9-15.4) vs 6.7% (95% CI, 4.7-8.6) for the 814 remaining patients. The relapse-specific aHR was 1.69 (95% CI, 1.05-2.74, P=.03). The unadjusted bone marrow relapse-specific HR was 1.83 (95% CI, 1.07-3.14, P=.03) and 1.86 (95% CI, 0.90- 3.87, P=.095) for any central nervous system relapse. These results emphasize the importance of therapeutic drug monitoring and appropriate adjustment of asparaginase therapy when feasible. This trial was registered at www.clinicaltrials.gov as #NCT03987542.
A regimen with caplacizumab, immunosuppression, and plasma exchange prevents unfavorable outcomes in immune-mediated TTP
Authors: Coppo Paul , Bubenheim Michael , Azoulay Elie , Galicier Lionel , Malot Sandrine , Bigé Naïke , Poullin Pascale , Provôt François , Martis Nihal , Presne Claire , Moranne Olivier , Benainous Ruben , Dossier Antoine , Seguin Amélie , Hié Miguel , Wynckel Alain , Delmas Yahsou , Augusto Jean-François , Perez Pierre , Rieu Virginie , Barbet Christelle , Lhote François , Ulrich Marc , Rumpler Anne Charvet , de Witte Sten , Krummel Thierry , Veyradier Agnès , Benhamou Ygal
Published: November 2020

The anti–von Willebrand factor nanobody caplacizumab was licensed for adults with immune-mediated thrombotic thrombocytopenic purpura (iTTP) based on prospective controlled trials. However, few data are available on postmarketing surveillance. We treated 90 iTTP patients with a compassionate frontline triplet regimen associating therapeutic plasma exchange (TPE), immunosuppression with corticosteroids and rituximab, and caplacizumab. Outcomes were compared with 180 historical patients treated with the standard frontline treatment (TPE and corticosteroids, with rituximab as salvage therapy). The primary outcome was a composite of refractoriness and death within 30 days since diagnosis. Key secondary outcomes were exacerbations, time to platelet count recovery, the number of TPE, and the volume of plasma required to achieve durable remission. The percentage of patients in the triplet regimen with the composite primary outcome was 2.2% vs 12.2% in historical patients (P = .01). One elderly patient in the triplet regimen died of pulmonary embolism. Patients from this cohort experienced less exacerbations (3.4% vs 44%, P < .01); they recovered durable platelet count 1.8 times faster than historical patients (95% confidence interval, 1.41-2.36; P < .01), with fewer TPE sessions and lower plasma volumes (P < .01 both). The number of days in hospital was 41% lower in the triplet regimen than in the historical cohort (13 vs 22 days; P < .01). Caplacizumab-related adverse events occurred in 46 patients (51%), including 13 major or clinically relevant nonmajor hemorrhagic events. Associating caplacizumab to TPE and immunosuppression, by addressing the 3 processes of iTTP pathophysiology, prevents unfavorable outcomes and alleviates the burden of care.
PM2.5 exposure and DLEC1 promoter methylation in Taiwan Biobank participants
Authors: Chou Ying-Hsiang , Tantoh Disline Manli , Wu Ming-Chi , Tyan Yeu-Sheng , Chen Pei-Hsin , Nfor Oswald Ndi , Hsu Shu-Yi , Shen Chao-Yu , Huang Chien-Ning , Liaw Yung-Po
Published: November 2020

Background

Particulate matter (PM) < 2.5 μm (PM2.5) or fine PM is a serious public health concern. It affects DNA methylation and heightens carcinogenesis. Deleted in lung and esophageal cancer 1 (DLEC1) is a tumor suppressor gene. However, aberrant methylation of the gene is associated with several cancers. We evaluated the association between PM2.5and DLEC1 promoter methylation in Taiwanese adults based on regular outdoor exercise.

Methods

We obtained DNA methylation and exercise data of 496 participants (aged between 30 and 70 years) from the Taiwan Biobank (TWB) database. We also extracted PM2.5data from the Air Quality Monitoring Database (AQMD) and estimated participants’ exposure using residential addresses.

Results

DLEC1 methylation and PM2.5were positively associated: beta coefficient (β) = 0.114 × 10−3;pvalue = 0.046. The test for interaction between exercise and PM2.5on DLEC1 methylation was significant (pvalue = 0.036). After stratification by exercise habits, PM2.5and DLEC1 methylation remained significantly associated only among those who exercised regularly (β= 0.237 × 10−3;pvalue = 0.007). PM2.5quartile-stratified analyses revealed an inverse association between regular exercise and DLEC1 methylation at PM2.5< 27.37 μg/m3(β= − 5.280 × 10−3;pvalue = 0.009). After combining exercise habits and PM2.5quartiles, one stratum (i.e., regular exercise and PM2.5< 27.37 μg/m3) was inversely associated with DLEC1 methylation (β= -5.160 × 10−3,pvalue = 0.007).

Conclusions

We found significant positive associations between PM2.5and DLEC1 promoter methylation. Regular exercise at PM2.5< 27.37 μg/m3seemingly regulated DLEC1 promoter methylation.
Associations between thyroid-stimulating hormone and hypertension according to thyroid cyst status in the general population: a cross-sectional study
Authors: Shimizu Yuji , Nabeshima-Kimura Yuko , Kawashiri Shin-Ya , Noguchi Yuko , Nagata Yasuhiro , Maeda Takahiro , Hayashida Naomi
Published: November 2020

Background

The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. However, the association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. Therefore, we evaluated the association between TSH level and hypertension stratified by thyroid cyst status.

Methods

We conducted a cross-sectional study of 1724 euthyroid Japanese individuals aged 40–74 years who participated in an annual health checkup in 2014.

Results

In the study population, 564 and 686 participants had thyroid cysts and hypertension, respectively. A significant positive association was observed between TSH and hypertension in subjects without a thyroid cyst but not in subjects with thyroid cysts. There was a significant positive association between hypertension and TSH in subjects without a thyroid cyst (odds ratio [OR] 1.27; 95% confidence intervals [CI] 1.01, 1.61) but not in subjects with thyroid cysts (OR 0.79; CI 0.57, 1.09) in the model fully adjusted for known confounding factors. The correlation between the TSH and free triiodothyronine (fee T3) levels (simple correlation coefficient [r] = − 0.13, p < 0.01) was stronger in the subjects without thyroid cysts than in those with thyroid cysts (r = − 0.03, p = 0.525).

Conclusions

TSH is positively associated with hypertension only in individuals without thyroid cysts. The correlation between the TSH and free T3 levels was stronger in the subjects without thyroid cysts than in those with thyroid cysts. Therefore, the absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating that the subjects without thyroid cysts had limited thyroid hormone reserves. Therefore, the absence of thyroid cysts could indicate the latent functional damage of the thyroid.
The pelvis urinary microbiome in patients with kidney stones and clinical associations
Authors: Liu Fengping , Zhang Nan , Wu Yunhong , Jiang Peng , Jiang Tingting , Wang Yang , Zhang Yuwei , Zhai Qixiao , Zou Yeqing , Feng Ninghan
Published: November 2020

Background

The long-held notion that, without urinary tract or circulatory infection, bladder urine and blood are sterile biofluids has been disproven. There have been no previous reports on the kidney pelvis urinary microbiome after bladder disinfection in kidney stone patients. This study aimed to determine whether a kidney pelvis urinary microbiome is present after eliminating the influence of the bladder urinary microbiome, whether the microbiome composition is different in patients with stone kidney pelvis (SKP) and non-stone kidney pelvis (NSKP), and the correlation between SKP and patient clinical characteristics.

Results

Comparisons of bacterial diversity and community structure exhibited that urine in bladder was similar to SKP and NSKP. However, the comparisons showed that urine samples were different from blood. The most common operational taxonomic units were shared by all three types of urine samples.Corynebacteriumwas significantly higher in SKP compared to NSKP. Several bacteria were associated with patient characteristics, includingLactobacillus, which was positively correlated with fasting blood glucose, andPrevotellawas negatively correlated with BMI.Lactobacilluswas significantly higher in SKP compared to blood but not in NSKP compared to blood.

Conclusions

The composition of the kidney pelvis urinary microbiome after disinfection of the bladder and its similarity to the bladder microbiome indicate that bladder urine can be used to replace kidney pelvis urine in microbiome research. Additionally, the comparison of SKP and NSKP and clinical associations suggest that the occurrence of kidney stones is responsible for the SKP urinary microbiome.
Should we remain hopeful? The key 8 weeks: spatiotemporal epidemic characteristics of COVID-19 in Sichuan Province and its comparative analysis with other provinces in China and global epidemic trends
Authors: Xu Xinyin , Zeng Jing , Liu Runyou , Liu Yang , Zhou Xiaobo , Zhou Lijun , Dong Ting , Cha Yuxin , Wang Zhuo , Deng Ying , Zhang Yu , Feng Liao , Pu Chen , Wu Xianping , Zhong Bo
Published: November 2020

Background

The COVID-19 spread worldwide quickly. Exploring the epidemiological characteristics could provide a basis for responding to imported cases abroad and to formulate prevention and control strategies in areas where COVID-19 is still spreading rapidly.

Methods

The number of confirmed cases, daily growth, incidence and length of time from the first reported case to the end of the local cases (i.e., non-overseas imported cases) were compared by spatial (geographical) and temporal classification and visualization of the development and changes of the epidemic situation by layers through maps.

Results

In the first wave, a total of 539 cases were reported in Sichuan, with an incidence rate of 0.6462/100,000. The closer to Hubei the population centres were, the more pronounced the epidemic was. The peak in Sichuan Province occurred in the second week. Eight weeks after the Wuhan lockdown, the health crisis had eased. The longest epidemic length at the city level in China (except Wuhan, Taiwan, and Hong Kong) was 53 days, with a median of 23 days. Spatial autocorrelation analysis of China showed positive spatial correlation (Moran’s Index > 0,p < 0.05). Most countries outside China began to experience a rapid rise in infection rates 4 weeks after their first case. Some European countries experienced that rise earlier than the USA. The pandemic in Germany, Spain, Italy, and China took 28, 29, 34, and 18 days, respectively, to reach the peak of daily infections, after their daily increase of up to 20 cases. During this time, countries in the African region and Southeast Asian region were at an early stage of infections, those in the Eastern Mediterranean region and region of the Americas were in a rapid growth phase.

Conclusions

After the closure of the outbreak city, appropriate isolation and control measures in the next 8 weeks were key to control the outbreak, which reduced the peak value and length of the outbreak. Some countries with improved epidemic situations need to develop a continuous “local strategy at entry checkpoints” to to fend off imported COVID-19.
Standardized multimodal intervention for stress-induced exhaustion disorder: an open trial in a clinical setting
Authors: van de Leur Jakob Clason , Buhrman Monica , Åhs Fredrik , Rozental Alexander , Jansen Gunilla Brodda
Published: November 2020

Background

Long-term sick-leave due to stress-related ill-health is increasing in several economically developed countries. Even though different forms of interventions are administered in regular care for stress-related disorders, such as Stress-induced Exhaustion disorder (SED), the scientific evidence for the effectiveness of such treatments is sparse. The objective of this study was to explore changes in SED-symptoms and return-to-work-rates in a large group of SED-patients participating in a standardized Multimodal intervention (MMI) in a clinical setting.

Method

This open clinical trial tracked 390 patients who fulfilled the criteria for SED undergoing a 24-week MMI, including return-to-work-strategies. Before inclusion, all patients underwent a multi-professional assessment by a team of licensed physicians, licensed psychologists, and licensed physiotherapists. Self-rated questionnaires were administered before treatment, at treatment-start, mid-treatment, post-treatment, and at 12-month follow-up. Within-group change was evaluated over time with mixed-effects models. Beyond different symptoms, working time, sick-leave compensation, and adverse effects were also measured.

Results

There were significant improvements in symptoms of SED, burnout, anxiety, depression, and insomnia, with large within-group effect sizes (d = 0.91–1.76), improvements that were maintained at 12-month follow-up. Furthermore, there was a significant increase in quality of life and large improvements in average working time and sick-leave compensation. Some adverse effects were reported, mainly concerning an increase in stress, anxiety, and worry.

Conclusion

SED-patients participating in this standardized MMI reported large symptom alleviation, increased working time and reduced sick-leave compensation, indicating a beneficial treatment. There were some adverse effects, but no more so than other psychological treatments. This study confirms previous findings that high levels of depression and anxiety decrease to sub-clinical levels during treatment, while symptoms of SED also decline, yet still persists above sub-clinical levels at 12-month follow-up. On the whole, this open clinical trial suggests that a standardized MMI, administered in a clinical setting, improves symptoms and return-to-work rates in a clinically representative SED-population.

Trial registration

This study was registered on Clinicaltrials.gov 2017.12.02 (Identifier: NCT03360136).
Occupational influences on Spondylolysis and Spondylolisthesis in a cohort of 18-year-old male military conscripts
Authors: Zack Oren , Barak Yair , Finestone Aharon S. , Krakov Ayala , Slodownik Dani , Alperovitch-Najenson Deborah , Moshe Shlomo
Published: November 2020

Background

The reported prevalence of spondylolysis (SL) in the adult population is 6–7%. Data concerning adolescent-onset spondylolisthesis (SLS) and the impact of certain activities on it is scarce. We examined the risk of clinical progression of SL and SLS as a function of primary severity and occupational strain among military recruits.

Methods

Based on the Israel defense Force (IDF) central human resources database, we identified 1521 18-year-old males inducted to the IDF with SL/SLS between the late nineteen nineties and early two-thousands. We followed changes in the SL/SLS status during the 3 years of obligatory military service. Disease severity was classified as Cat2: radiological findings of SL without clinical findings; Cat3: painful SL or asymptomatic grade 1 SLS; Cat4: grade 1 SLS with pain; Cat5: Grade 2 SLS. The soldiers were subdivided into the following occupational categories: administrative, combat, maintenance, and driving. The purpose was to compare the progression rates in different medical categories and job assignments.

Results

There were 162 recruits in Cat2, 961 in Cat3, and 398 recruits in Cat4. The overall progression rate to Cat5 (grade 2 SLS) was 1.02%. Significant progression rates were seen amongst administrative soldiers with a relatively higher risk of progression from Cat4 (painful-grade-1 SLS: 2.2%) vs. Cat3 (asymptomatic SLS: 0.5%, relative risk = 4.7, p < 0.02). Other occupational categories did not exhibit significant progression rates.

Conclusion

Progression of SL/SLS was highest in Cat4, i.e. for recruits already diagnosed with painful SLS (i.e. with a more severe baseline disorder). Progression did not correlate with military occupation. We recommend further follow-up studies that include, aside from progression rates, incidence rates of newly diagnosed grade 2 SL during military service.
Low-density lipoprotein receptor (LDLR) regulates NLRP3-mediated neuronal pyroptosis following cerebral ischemia/reperfusion injury
Authors: Sun Rui , Peng Mengna , Xu Pengfei , Huang Feihong , Xie Yi , Li Juanji , Hong Ye , Guo Hongquan , Liu Qian , Zhu Wusheng
Published: November 2020

Background

Inflammatory response has been recognized as a pivotal pathophysiological process during cerebral ischemic stroke. NLRP3 inflammasome, involved in the regulation of inflammatory cascade, can simultaneously lead to GSDMD-executed pyroptosis in cerebral ischemia. Low-density lipoprotein receptor (LDLR), responsible for cholesterol uptake, was noted to exert potential anti-inflammatory bioactivities. Nevertheless, the role of LDLR in neuroinflammation mobilized by cerebral ischemia/reperfusion (I/R) has not been investigated.

Methods

Ischemic stroke mice model was accomplished by middle cerebral artery occlusion. Oxygen-glucose deprivation was employed after primary cortical neuron was extracted and cultured. A pharmacological inhibitor of NLRP3 (CY-09) was administered to suppress NLPR3 activation. Histological and biochemical analysis were performed to assess the neuronal death both in vitro and in vivo. In addition, neurological deficits and behavioral deterioration were evaluated in mice.

Results

The expression of LDLR was downregulated following cerebral I/R injury. Genetic knockout of Ldlr enhanced caspase-1-dependent cleavage of GSDMD and resulted in severe neuronal pyroptosis. LDLR deficiency contributed to excessive NLRP3-mediated maturation and release of IL-1β and IL-18 under in vitro and in vivo ischemic conditions. These influences ultimately led to aggravated neurological deficits and long-term cognitive dysfunction. Blockade of NLRP3 substantially retarded neuronal pyroptosis in Ldlr−/− mice and cultured Ldlr−/− neuron after experimental stroke.

Conclusions

These results demonstrated that LDLR modulates NLRP3-mediated neuronal pyroptosis and neuroinflammation following ischemic stroke. Our findings characterize a novel role for LDLR as a potential therapeutic target in neuroinflammatory responses to acute cerebral ischemic injury.
Microbial BMAA elicits mitochondrial dysfunction, innate immunity activation, and Alzheimer’s disease features in cortical neurons
Authors: Silva Diana F. , Candeias Emanuel , Esteves A. Raquel , Magalhães João D. , Ferreira I. Luísa , Nunes-Costa Daniela , Rego A. Cristina , Empadinhas Nuno , Cardoso Sandra M.
Published: November 2020

Background

After decades of research recognizing it as a complex multifactorial disorder, sporadic Alzheimer’s disease (sAD) still has no known etiology. Adding to the myriad of different pathways involved, bacterial neurotoxins are assuming greater importance in the etiology and/or progression of sAD. β-N-Methylamino-l-alanine (BMAA), a neurotoxin produced by some microorganisms namely cyanobacteria, was previously detected in the brains of AD patients. Indeed, the consumption of BMAA-enriched foods has been proposed to induce amyotrophic lateral sclerosis-parkinsonism-dementia complex (ALS-PDC), which implicated this microbial metabolite in neurodegeneration mechanisms.

Methods

Freshly isolated mitochondria from C57BL/6 mice were treated with BMAA and O2 consumption rates were determined. O2 consumption and glycolysis rates were also measured in mouse primary cortical neuronal cultures. Further, mitochondrial membrane potential and ROS production were evaluated by fluorimetry and the integrity of mitochondrial network was examined by immunofluorescence. Finally, the ability of BMAA to activate neuronal innate immunity was quantified by addressing TLRs (Toll-like receptors) expression, p65 NF-κB translocation into the nucleus, increased expression of NLRP3 (Nod-like receptor 3), and pro-IL-1β. Caspase-1 activity was evaluated using a colorimetric substrate and mature IL-1β levels were also determined by ELISA.

Results

Treatment with BMAA reduced O2 consumption rates in both isolated mitochondria and in primary cortical cultures, with additional reduced glycolytic rates, decrease mitochondrial potential and increased ROS production. The mitochondrial network was found to be fragmented, which resulted in cardiolipin exposure that stimulated inflammasome NLRP3, reinforced by decreased mitochondrial turnover, as indicated by increased p62 levels. BMAA treatment also activated neuronal extracellular TLR4 and intracellular TLR3, inducing p65 NF-κB translocation into the nucleus and activating the transcription of NLRP3 and pro-IL-1β. Increased caspase-1 activity resulted in elevated levels of mature IL-1β. These alterations in mitochondrial metabolism and inflammation increased Tau phosphorylation and Aβ peptides production, two hallmarks of AD.

Conclusions

Here we propose a unifying mechanism for AD neurodegeneration in which a microbial toxin can induce mitochondrial dysfunction and activate neuronal innate immunity, which ultimately results in Tau and Aβ pathology. Our data show that neurons, alone, can mount inflammatory responses, a role previously attributed exclusively to glial cells.
Retraction Note: Long noncoding RNA MLK7-AS1 promotes ovarian cancer cells progression by modulating miR-375/YAP1 axis
Authors: Yan Huan , Li Hong , Li Pengyun , Li Xia , Lin Jianjian , Zhu Linlin , Silva Maria A. , Wang Xiaofang , Wang Ping , Zhang Zhan
Published: November 2020

This article has been retracted. Please see the Retraction Notice for more detail: 10.1186/s13046-020-01746-0.
An approximate analytical solution of the Navier–Stokes equations within Caputo operator and Elzaki transform decomposition method
Authors: Hajira  , Khan Hassan , Khan Adnan , Kumam Poom , Baleanu Dumitru , Arif Muhammad
Published: November 2020

In this article, a hybrid technique of Elzaki transformation and decomposition method is used to solve the Navier–Stokes equations with a Caputo fractional derivative. The numerical simulations and examples are presented to show the validity of the suggested method. The solutions are determined for the problems of both fractional and integer orders by a simple and straightforward procedure. The obtained results are shown and explained through graphs and tables. It is observed that the derived results are very close to the actual solutions of the problems. The fractional solutions are of special interest and have a strong relation with the solution at the integer order of the problems. The numerical examples in this paper are nonlinear and thus handle its solutions in a sophisticated manner. It is believed that this work will make it easy to study the nonlinear dynamics, arising in different areas of research and innovation. Therefore, the current method can be extended for the solution of other higher-order nonlinear problems.
Professional and Psychological Impacts of the COVID-19 Pandemic on Oncology Residents: A National Survey
Authors: Hilmi Marc , Boilève Alice , Ducousso Anabelle , Michalet Morgan , Turpin Anthony , Neuzillet Cindy , Naoun Natacha
Published: November 2020

PURPOSE

The COVID-19 pandemic has severely affected clinical practice in oncology, leading to organizational, ethical, and medical issues. In particular, it has raised challenges in the context of competing care priorities between COVID-19 and cancer treatment. Residents on the front line face difficulties related to increasing care needs and urgent reorganization of health care systems while managing psychological stress and uncertainty. We aimed to evaluate the impact of the COVID-19 pandemic on oncology residents.

METHODS AND MATERIALS

We conducted a national survey (39 questions) in France among oncology and radiation therapy residents to determine the psychological impact and professional difficulties (eg, reassignment, training/research time, supervision, teleworking, management of patients) associated with the first peak of the COVID-19 pandemic.

RESULTS

Overall, 222 residents (medical oncologists, 61%; radiation therapists, 39%) participated in our survey, representing approximately one third of all residents and fellows in France. One third of respondents had been reassigned to a COVID-19 ward. Training and research activity decreased for 89% and 41% of respondents, respectively. Two thirds (70%) of respondents declared that they had faced ethical issues, 35% felt worried about their own health, and 23% experienced psychological distress. According to the Hospital Anxiety and Depression Scale, 32% were anxious and 17% depressed. Consumption of tobacco, psychostimulants, and alcohol increased in 31%, 24%, and 29% of respondents, respectively.

CONCLUSION

French oncology residents were highly affected by the first peak of the COVID-19 pandemic in terms of professional activity and psychological impact. This national survey can be used as a basis for improved management, medical reorganization, and training of residents during the ongoing COVID-19 pandemic.
Immune Co-inhibitory Receptors PD-1, CTLA-4, TIM-3, LAG-3, and TIGIT in Medullary Thyroid Cancers: A Large Cohort Study
Authors: Shi Xiao , Li Cui-Wei , Tan Li-Cheng , Wen Shi-Shuai , Liao Tian , Zhang Yan , Chen Tong-Zhen , Ma Ben , Yu Peng-Cheng , Lu Zhong-Wu , Qu Ning , Wang Yu , Shi Rong-Liang , Wang Yu-Long , Ji Qing-Hai , Wei Wen-Jun
Published: November 2020

Context

Programmed cell death protein-1 (PD-1), cytotoxic T-lymphocyte antigen 4 (CTLA-4), T-cell immunoglobulin and mucin-domain containing-3 (TIM-3), lymphocyte activation gene-3 (LAG-3), and T-cell immunoglobulin and ITIM domain (TIGIT) are considered major immune co-inhibitory receptors (CIRs) and the most promising immunotherapeutic targets in cancer treatment, but they are largely unexplored in medullary thyroid carcinoma (MTC).

Objective

We aimed to provide the first evidence regarding the expression profiles and clinical significance of CIRs in a large cohort of MTC patients.

Design and Patients

In total, 200 MTC patients who received initial surgery in our hospital were included. Immunohistochemistry was performed to evaluate CIR expressions in tissue microarrays (TMAs). Combined with the results of our previous programmed cell death ligand-1 (PD-L1) study, clinicopathologic and prognostic correlations of these proteins were retrospectively analyzed.

Results

TIM-3, PD-1, CTLA-4, LAG-3, and TIGIT positivity was detected in 96 (48.0%), 27 (13.5%), 25 (12.5%), 6 (3.0%), and 6 (3.0%) patients, respectively, in whom TIM-3, PD-1, and CTLA-4 expressions were positively correlated. Log-rank tests and multivariate Cox analyses both indicated that TIM-3, CTLA-4 expression, and PD-1/PD-L1 coexpression were associated with worse structural recurrence-free survival. In addition, among 20 patients who developed advanced disease during follow-up, 12 (60%) showed TIM-3 positivity, among whom 6 cases also had concurrent moderate to strong PD-1, PD-L1, or CTLA-4 expression.

Conclusions

Using the currently largest TMA cohort of this rare cancer, we delineated the CIR expression profiles in MTC, and identified TIM-3, CTLA-4 expression, and PD-1/PD-L1 coexpression as promising biomarkers for tumor recurrence. Furthermore, a subset of advanced MTCs are probably immunogenic, for which single or combined immunotherapy including TIM-3, PD-1, PD-L1, or CTLA-4 blockade may be potential therapeutic approaches in the future.
An Archive of Violence
Authors: Delgado Moya Sergio
Published: November 2020

This essay makes the case for sensationalism as an archive of violence. It traces the ways in which the Mexican filmmaker Felipe Cazals draws from the sensationalist tabloid Alarma! in the making of his film Las Poquianchis (1976), a film version of the story of human trafficking that led the tabloid to popularity. The visuality of sensationalism works mostly in the service of power: it keeps certain kinds of violence both out of sight and overexposed. Cazals and other artists and writers who draw materials from sensationalism complicate this visuality and counter it, but they do so by staying close to the kind of obscenity characteristic of sensationalism. The last segment of the essay revisits Elaine Scarry's seminal analysis of the relationship between language and pain. It offers a frame of interpretation for the most disturbing moments in sensationalism and in Cazals's film: moments defined by the screening of gruesome violence, traumatic bodily injury, violence by sexual means, and death.