bluuebunny/crossref_metadata_2025 huggingface dataset:
Aberrant TTF-1 Expression in Peripheral T-Cell Lymphomas: A Diagnostic Pitfall
Authors: Chang Sheng-Tsung , Chen Shang-Wen , Chen Bo-Jung , Pan Shien-Tung , Karube Kennosuke , Chuang Shih-Sung
Published: August 2020

Background

Thyroid transcription factor-1 (TTF-1) is a useful marker for identifying thyroid and lung cancers in diagnostic pathology, particularly for the investigation of unknown primary cancers. However, some other tumors such as colorectal cancer might aberrantly express TTF-1, particularly with the less specific clone SPT24. Occasional diffuse large B-cell lymphoma (DLBCL) cases have been reported to be TTF-1-positive, yet there is no information on TTF-1 expression in peripheral T-cell lymphoma (PTCL).

Methods

We investigated a series of PTCL and DLBCL by immunohistochemistry for TTF-1 expression using 2 commercially available clones.

Results

We found that 33% (5/15) adult T-cell leukemia/lymphomas (ATLLs) and 25% (2/8) angioimmunoblastic T-cell lymphomas (AITLs) were positive by clone SPT24 and only 2ATLL cases were positive by clone 8G7G3/1. Overall TTF-1 expression rates of PTCL by SPT24 and 8G7G3/1 were 16% (7/43) and 5% (2/43), respectively. All DLBCLs were negative.

Conclusion

Although TTF-1 is a relatively specific marker for thyroid and lung cancers, it might be expressed in some lymphomas, particularly PTCL when using clone SPT24. Pathologist should be aware of this possible diagnostic pitfall when using TTF-1 in investigating tumors of unknown origin.
Improvement of bioactive compounds content in granadilla (Passiflora ligularis) seeds after solid-state fermentation
Authors: Santos Tacila RJ , Feitosa Paula RB , Gualberto Nayjara C , Narain Narendra , Santana Luciana CLA
Published: August 2020

Fermentation improves the bioactivity of fruit by-products; therefore, this study aimed to increase the bioactive compound content in granadilla ( Passiflora ligularis) seed flour (with 50% and 70% initial moisture) through solid-state fermentation using the fungus Aspergillus niger. The extracts were obtained with distilled water, 40% acetone, 80% acetone, 40% ethanol, or 80% ethanol. The highest total phenolic (4713.3 of gallic acid equivalent/100 g of granadilla seed flour in dry basis) and total flavonoid (1910.4 mg of quercetin/100 g of granadilla seed flour in dry basis) contents were obtained with granadilla flour at 50% initial moisture fermented for 48 h with 80% acetone extractor solvent. The highest antioxidant activity was obtained with 80% acetone from flour fermented for 168 h. The chromatographic analysis showed 10 compounds identified in the 80% acetone extracts of fermented flour; gallic acid and epigallocatechin were the major compounds. Gallic acid, catechin, 6,2′-di-hydroxyflavone, ethyl gallate and coumarin had higher concentrations in extracts of fermented flours when compared with unfermented ones. Only fermented flours showed the presence of protocatechuic acid compound. The solid-state fermentation was efficient to obtain extracts of granadilla seed flour enrichment of antioxidant bioactive compounds with potential of application in food, cosmetic and pharmaceutical industries.
Children with Attention-Deficit/Hyperactivity Disorder Grown Up: An 18-Year Follow-Up after Multimodal Treatment
Authors: Döpfner Manfred , Mandler Janet , Breuer Dieter , Schürmann Stephanie , Dose Christina , Walter Daniel , von Wirth Elena
Published: August 2020

Objective:

ADHD treatment has positive effects on behavioral symptoms and psychosocial functioning, but studies that follow children treated for ADHD into adulthood are rare.

Method:

This follow-up study assessed symptom severity and functional outcomes of adults ( n = 70) who had received individualized ADHD treatment in the Cologne Adaptive Multimodal Treatment (CAMT) Study at ages 6 to 10 years.

Results:

Despite symptomatic improvement, participants reported poorer educational and occupational outcomes than expected (e.g., currently unemployed: 17%). They had also been in contact with the justice system more often than expected (e.g., lifetime convictions: 33%) and were impaired on health-related outcomes (e.g., substance use problems: 15%). Several social outcomes were favorable (e.g., long-term relationship/married: 63%).

Conclusion:

Compared to the general population or norm samples, CAMT participants had a higher relative risk ( RR) of functional impairments, demonstrating the need for continued support for a substantial proportion of the young adults.
Management of a Pediatric Patient With a Left Ventricular Assist Device and Symptomatic Acquired von Willebrand Syndrome Presenting for Orthotopic Heart Transplant
Authors: Flannery Kaitlin M , Kamra Komal , Maeda Katsuhide , Shuttleworth Paul , Almond Christopher , Navaratnam Manchula
Published: August 2020

We present the successful perioperative management of an 11-year-old patient presenting for heart transplant with a left ventricular assist device, symptomatic acquired von Willebrand syndrome, and recent preoperative intracranial hemorrhage. A brief review of the pathophysiology of acquired von Willebrand syndrome is included. As the number of pediatric patients supported with ventricular assist devices continues to increase, the management of symptomatic acquired von Willebrand syndrome during the perioperative period is an important consideration for anesthesiologists.
Evaluating asynchronous Schwarz solvers on GPUs
Authors: Nayak Pratik , Cojean Terry , Anzt Hartwig
Published: August 2020

With the commencement of the exascale computing era, we realize that the majority of the leadership supercomputers are heterogeneous and massively parallel. Even a single node can contain multiple co-processors such as GPUs and multiple CPU cores. For example, ORNL’s Summit accumulates six NVIDIA Tesla V100 GPUs and 42 IBM Power9 cores on each node. Synchronizing across compute resources of multiple nodes can be prohibitively expensive. Hence, it is necessary to develop and study asynchronous algorithms that circumvent this issue of bulk-synchronous computing. In this study, we examine the asynchronous version of the abstract Restricted Additive Schwarz method as a solver. We do not explicitly synchronize, but allow the communication between the sub-domains to be completely asynchronous, thereby removing the bulk synchronous nature of the algorithm.

We accomplish this by using the one-sided Remote Memory Access (RMA) functions of the MPI standard. We study the benefits of using such an asynchronous solver over its synchronous counterpart. We also study the communication patterns governed by the partitioning and the overlap between the sub-domains on the global solver. Finally, we show that this concept can render attractive performance benefits over the synchronous counterparts even for a well-balanced problem.
Assessing the Impact of Brand Equity and Demographic Characteristics on Brand Loyalty: The Mediating Role Played By Customer Experience in United Arab Emirates’ Hotel Industry
Authors: Nuseir Mohammed T.
Published: August 2020

The hotel industry has grown rapidly in recent years, becoming the most competitive environment. As a result, industry players strive to outsmart competitors by creating brand equity to enhance brand loyalty; however, the impact of brand equity and demographic characteristics on brand loyalty is sketchy. In this study, we assess this impact in United Arab Emirates’ hotel industry by using customer experience as the mediating role. We selected a total of 694 participants at three 3-star hotels and two 5-star hotels in the United Arab Emirates. The Mann–Whitney test showed no statistically significant differences in brand loyalty ( p < .05) by gender, and the Kruskal–Wallis test showed a moderately statistically significant difference ( p > .05) and a highly statistically significant difference ( p > .07) in brand loyalty by age and income groups, respectively. A positive correlation was found between customer experience and the different dimensions of brand equity. Similarly, a positive relationship ( R = .716) was found between customer experience and brand loyalty using linear regression analysis. These findings will benefit managing authorities and key decision makers who seek to increase the productivity and profitability of their hotels.
Intertwined parliamentary arenas: Why parliamentarians attend international parliamentary institutions
Authors: Lipps Jana
Published: August 2020

The internationalisation of political authority elongates the chain of delegation between the citizen and elected representatives. It increases executive dominance while weakening parliamentary control. International Parliamentary Institutions (IPIs), parliamentary assemblies affiliated with international organisations, could potentially mitigate the ‘parliamentary deficit’ of global governance but are commonly criticised for their weak authority. This paper revisits this critical perspective and argues that IPIs provide access to information circumventing the privileged access of governments. Thereby, IPIs strengthen national parliaments’ capability to control the executive. This benefit explains the motivation of national MPs to attend IPIs. The study is based on novel data on the attendance of parliamentarians to the sessions of the Parliamentary Assembly of the Council of Europe and the Organization for Security and Co-operation in Europe Parliamentary Assembly from 2007 to 2015. The results speak in favour of intertwined parliamentary arenas, as attributes of national parliaments drive attendance. For one, parliaments with higher scrutiny capacity participate more in delegations to IPIs. Moreover, the composition of delegations is related to control incentives, causing a difference in attendance patterns of government and opposition parties.
A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics
Authors: Wiener Chelsea H , Cassisi Jeffrey E , Blaney Cerissa L , Newins Amie R , Gros Bernard
Published: August 2020

Research on lifestyle programs for patients with coronary artery disease (CAD) has largely recruited from hospitals and/or recruited following acute coronary syndrome. By contrast, this study evaluated a 3-session behavioral health program for patients with stable CAD treated in an outpatient cardiology clinic. Thirty-three patients were randomized to the behavioral lifestyle intervention or to Treatment as Usual (TAU). A priori feasibility and acceptability criteria were met, and reliable change analyses revealed that at post-treatment and 30-day follow-up, significantly more intervention participants than TAU participants exhibited increased self-efficacy compared with baseline.
Association of fear-avoidance and self-efficacy on pain disability in individuals with co-morbid post-traumatic stress and chronic pain
Authors: Devlin Anna , Casey Sara , Williams Scott , Giummarra Melita J
Published: August 2020

This study investigated relationships between post-traumatic stress symptoms (PTSS) and pain disability. Fifty people with chronic pain (probable PTSD, n = 22) completed measures assessing pain interference, PTSS, fear avoidance, and pain self-efficacy. We hypothesized that people with probable PTSD would have higher fear avoidance and lower pain self-efficacy; and that PTSS would be indirectly associated with pain disability via fear avoidance and self-efficacy. People with probable PTSD had higher fear avoidance, but there were no differences in self-efficacy, pain severity or disability. There was an indirect association between PTSS and pain disability via fear avoidance, but not via self-efficacy.
Sharing clinical notes, and placebo and nocebo effects: Can documentation affect patient health?
Authors: Blease Charlotte R , Delbanco Tom , Torous John , Ponten Moa , DesRoches Catherine M , Hagglund Maria , Walker Jan , Kirsch Irving
Published: August 2020

This paper connects findings from the field of placebo studies with research into patients’ interactions with their clinician’s visit notes, housed in their electronic health records. We propose specific hypotheses about how features of clinicians’ written notes might trigger mechanisms of placebo and nocebo effects to elicit positive or adverse health effects among patients. Bridging placebo studies with (a) survey data assaying patient and clinician experiences with portals and (b) randomized controlled trials provides preliminary support for our hypotheses. We conclude with actionable proposals for testing our understanding of the health effects of access to visit notes.
Beyond the eye-catchers: A large-scale study of social movement organizations’ involvement in online protests
Authors: Bozarth Lia , Budak Ceren
Published: August 2020

Existing studies of social movement organizations (SMOs) commonly focus only on a small number of well-known SMOs or SMOs that belong to a single social movement industry (SMI). This is partially because current methods for identifying SMOs are labor-intensive. In contrast to these manual approaches, in our article, we use Twitter data pertaining to BlackLivesMatter and Women’s movements and employ crowdsourcing and nested supervised learning methods to identify more than 50K SMOs. Our results reveal that the behavior and influence of SMOs vary significantly, with half having little influence and behaving in similar ways to an average individual. Furthermore, we show that collectively, small SMOs contributed to the sharing of more diverse information. However, on average, large SMOs were significantly more committed to movements and decidedly more successful at recruiting. Finally, we also observe that a large number of SMOs from an extensive set of SMIs, including Occupy Wall Street, participated in solidarity or even as leaders in BlackLivesMatter. In comparison, few SMIs participated in Women’s movement.
Allocating political attention in the EU’s foreign and security policy: The effect of supranational agenda-setters
Authors: Häge Frank M
Published: August 2020

Supranational bureaucracies are often promoted as a solution to collective action problems. In the European Union context, investing the High Representative for Foreign Affairs and Security Policy with new agenda-setting powers was expected to improve the coherence, continuity and efficiency of foreign policy-making. Relying on novel fine-grained and comprehensive data about the content and duration of working party meetings, the study maps and analyses the allocation of political attention to different foreign policy issues between 2001 and 2014. The results show that the empowerment of the High Representative by the Lisbon Treaty had little immediate effect on the Council’s foreign policy agenda. However, the study also indicates that this result might be due to a lack of capability and ambition rather than weak institutional prerogatives.
Tailoring thermal stratification to enable high load low temperature combustion with wet ethanol on a gasoline engine architecture
Authors: Gainey Brian , Yan Ziming , Moser Sean , Vorwerk Erik , Lawler Benjamin
Published: August 2020

Wet ethanol is a biofuel with unique fuel properties: a high latent heat of vaporization and low equivalence ratio sensitivity. These two fuel properties enable control over the heat release process in low temperature combustion through the enhancement of in-cylinder thermal stratification. In this work, it is shown that the direct injection of wet ethanol 80 (80% ethanol, 20% water, by mass) during the intake stroke on a mid-compression ratio engine with a side-mounted gasoline direct injector does not fully premix with incoming air, leaving stratification in the cylinder which elongates the combustion process, enabling high-load low temperature combustion without engine-damaging knock. As a result, the load under naturally aspirated conditions was only limited by oxygen content as the global equivalence ratio approached stoichiometry. The results show that swirl can not only modulate the induced stratification effectively by increasing the amount of bulk motion in the cylinder but also cause a thermal efficiency penalty, since swirl increases heat transfer losses. Modulation over the induced stratification can be achieved without an efficiency penalty by employing either a dual injector system where a fraction of the total fuel is injected into the port or a split injection strategy where a fraction of the total fuel is injected during the compression stroke. This strategy enables high-load low temperature combustion, while reducing the number of regions that form NOx and avoiding excessively rich regions that contribute to combustion inefficiency.
Large eddy simulation of diesel spray–assisted dual-fuel ignition: A comparative study on two n-dodecane mechanisms at different ambient temperatures
Authors: Kannan Jeevananthan , Gadalla Mahmoud , Tekgül Bulut , Karimkashi Shervin , Kaario Ossi , Vuorinen Ville
Published: August 2020

In dual-fuel compression ignition engines, a high-reactivity fuel, such as diesel, is directly injected to the engine cylinder to ignite a mixture of low-reactivity fuel and air. This study targets improving the general understanding on the dual-fuel ignition phenomenon using zero-dimensional homogeneous reactor studies and three-dimensional large eddy simulation together with finite-rate chemistry. Using the large eddy simulation framework, n-dodecane liquid spray is injected into the lean ambient methane–air mixture at [Formula: see text]. The injection conditions have a close relevance to the Engine Combustion Network Spray A setup. Here, we assess the effect of two different chemical mechanisms on ignition characteristics: a skeletal mechanism with 54 species and 269 reaction steps (Yao mechanism) and a reduced mechanism with 96 species and 993 reaction steps (Polimi mechanism). Altogether three ambient temperatures are considered: 900, 950, and 1000 K. Longer ignition delay time is observed in three-dimensional large eddy simulation spray cases compared to zero-dimensional homogeneous reactors, due to the time needed for fuel mixing in three-dimensional large eddy simulation sprays. Although ignition is advanced with the higher ambient temperature using both chemical mechanisms, the ignition process is faster with the Polimi mechanism compared to the Yao mechanism. The reasons for differences in ignition timing with the two mechanisms are discussed using the zero-dimensional and three-dimensional large eddy simulation data. Finally, heat release modes are compared in three-dimensional large eddy simulation according to low- and high-temperature chemistry in dual-fuel combustion at different ambient temperatures. It is found that Yao mechanism overpredicts the first-stage ignition compared to Polimi mechanism, which leads to the delayed second-stage ignition in Yao cases compared to Polimi cases. However, the differences in dual-fuel ignition for Polimi and Yao mechanisms are relatively smaller at higher ambient temperatures.
Reimagining higher education during and post-COVID-19: Challenges and opportunities
Authors: Neuwirth Lorenz S , Jović Svetlana , Mukherji B Runi
Published: August 2020

The coronavirus (COVID-19) pandemic has required faculty and students to adapt to an unprecedented challenge and rapidly transition from traditional face-to-face instruction to distance learning formats through virtual classrooms. While most campuses trained faculty to ensure quality and maintenance of the curriculum through virtual classrooms, less consideration has been given to training students, who face equal challenges in adapting to this abrupt change in the delivery of the curriculum. Few approaches have been developed for students to facilitate their involuntary transition to virtual classrooms and maintenance of appropriate online learning behaviours and etiquette. Presented here are a series of propositions to help to maintain and enhance the quality of college student engagement and activity in the virtual classroom. These guidelines are from one example of the State University of New York public educational system perspective, at the pandemic’s epicentre, while serving a diverse student population. Initiating a meaningful dialogue between faculty, who are engaged in efforts to cope and adapt to the pandemic, may prove useful in re-envisioning and re-designing future curriculum. This may facilitate future discussions on creating best practices guidelines for asynchronous/synchronous virtual classrooms post the pandemic. The present rapid communication suggests a framework for faculty to develop such guidelines to address the current gap in the literature.
Online Crowdsourcing as a Quasi-Experimental Method for Collecting Data on the Perpetration of Alcohol-Related Partner Aggression
Authors: Crane Cory A. , Berbary Cassandra , Schlauch Robert C. , Easton Caroline J.
Published: August 2020

Cross-sectional survey, prospective, and experimental data have been evaluated to better understand the role of alcohol as a contributing cause of intimate partner aggression. Laboratory-based alcohol administration studies provide controlled data regarding causality, but the use of this methodology lacks ecological validity and has been hampered by rigorous procedural and financial demands. Online crowdsourcing is an emerging pseudoexperimental methodology with low costs, rapid data collection, access to diverse populations, greater ecological validity, and the potential to facilitate prolific research to supplement the chronic scarcity of experimental data. The current rapid review first summarizes prior methodological approaches to investigating the proximal influence of alcohol on partner aggression, then reviews prior crowdsourcing research in the disparate areas of alcohol and partner aggression, then describes aggression paradigms that may be readily adapted to online administration. We conclude by introducing recommendations for future quasi-experimental research investigating alcohol-related partner aggression research using the online crowdsourcing methodology. Initial evidence suggests that online crowdsourcing may yield appropriate samples and that existing paradigms may be adapted to rapidly, efficiently, and ethically supplement experimental alcohol-related partner aggression research.
Apoptosis-Promoting Effects on A375 Human Melanoma Cells Induced by Exposure to 35.2-GHz Millimeter Wave
Authors: Zhao Ruiting , Liu Yonghong , Liu Sida , Luo Tong , Zhong Guang Yuan , Liu Anqi , Zeng Qiang , Xin Sherman Xuegang
Published: August 2020

Malignant tumors pose a major problem in the medical field. Millimeter wave (MMW) exposure have potential apoptosis-promoting effects on several types of tumors. Considering that the penetration depth of millimeter wave is usually several millimeters, we study the apoptosis-promoting effects of millimeter wave exposure on A375 human melanoma tumor cells in vitro, and this topic has not been explored in the previous literature. In this study, we use the A375 human melanoma cell line as an experimental model exposed to 35.2 GHz millimeter wave in vitro to determine any positive effect and further explore the underlying mechanisms. In this study, 2 groups namely, exposed and sham groups, were set. The exposed groups included 4 exposure time periods of 15, 30, 60, and 90 minutes. The cells in the sham group did not receive millimeter wave exposure. After millimeter wave exposure, the A375 cells in the exposed and sham groups were collected for further experimental procedures. The cell viability after exposure was determined using a cell counting kit, and the apoptosis of A375 cells was assessed by Annexin V/propidium iodide. Changes in the expression of apoptosis-related proteins, including cleaved-caspase-3, and -8, were examined by Western blot. We observed that the millimeter wave exposure could inhibit the viability and induce apoptosis in A375 cells, and the expression of cleaved caspase-3 and -8 were upregulated ( P < .05). The results indicated that the millimeter wave at 35.2 GHz exerted apoptosis-promoting effects on the A375 cells via a pathway by activating of caspase-8 and -3.
Ultrasound Use in Diagnosis and Management of Venous Leg Ulcer
Authors: Srisuwan Tanop , Inmutto Nakarin , Kattipathanapong Thanate , Rerkasem Amaraporn , Rerkasem Kitttipan
Published: August 2020

Leg ulcers caused by venous diseases are effectively assessed by Doppler ultrasonography. The examination provides clear anatomical and physiological information for the diagnosis, treatment planning, and real-time guiding during the surgical treatment. Diagnostic Doppler ultrasonography assesses deep, superficial, and perforator veins, starting from patency assessment by direct visualization and simply compression test. The internal flow can be assessed by pulse wave analysis, which is used for rule out downstream flow obstruction and valvular incompetence. The venous valve function of deep, superficial, and perforator systems can be evaluated by measuring the time of the retrograde flow after flow augmentation performing in the upright position. At the end of the study, the venous map will be obtained and this map will guide clinicians to target treatment where the culprit is. The ultrasound technology has made a big shift in the treatment in the venous disease. In recent years, after the evolution and wide availability of ultrasound, newer treatment modalities have emerged for venous treatment. These include endovenous thermal ablation, endovenous adhesive closure, and ultrasound-guided foam sclerotherapy. Patients no longer require general anesthesia or hospitalization. Therefore utilization of duplex ultrasound has also surged and played an essential role in both diagnosis and therapy in venous ulcer. This article has dedicated to reviewing basic anatomy, the technique in diagnosis, and treatment.
Vagus Nerve Stimulation Attenuates Early Traumatic Brain Injury by Regulating the NF-κB/NLRP3 Signaling Pathway
Authors: Tang Yunliang , Dong Xiaoyang , Chen Gengfa , Ye Wen , Kang Junwei , Tang Yang , Feng Zhen
Published: August 2020

Background

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Oxidative stress, inflammation, and apoptosis are vital pathophysiological features post-TBI.

Objectives

Research has shown that vagus nerve stimulation (VNS) can attenuate oxidative stress in various diseases. However, the critical role of VNS in TBI is still not completely understood. This study investigated the protective effects and potential mechanism of VNS on TBI.

Methods

Male Sprague-Dawley rats were randomized into 3 groups: sham, TBI, and TBI + VNS. The TBI model was induced in rats by the free-fall drop method. The vagal nerve trunk was separated, and VNS was performed after establishing the TBI model.

Results

The results showed that VNS significantly ameliorated tissue damage, neurological deficits, and cerebral edema, compared with the sham VNS group. Additionally, VNS alleviated oxidative stress, inflammation, and apoptosis in the pericontusive cortex of rats after TBI. VNS also significantly suppressed expression of the nuclear factor-κB (NF-κB) protein in the nucleus and activation of the nucleotide-binding domain–like receptor protein 3 (NLRP3) inflammasome.

Conclusions

Taken together, the present study indicates that VNS may attenuate brain damage after TBI by inhibiting oxidative stress, inflammation, and apoptosis, possibly through the NF-κB/NLRP3 signaling pathway.
A parallel multi-objective genetic algorithm for scheduling scientific workflows in cloud computing
Authors: Sardaraz Muhammad , Tahir Muhammad
Published: August 2020

Recent developments in cloud computing have made it a powerful solution for executing large-scale scientific problems. The complexity of scientific workflows demands efficient utilization of cloud resources to satisfy user requirements. Scheduling of scientific workflows in a cloud environment is a challenge for researchers. The problem is considered as NP-hard. Some constraints such as a heterogeneous environment, dependencies between tasks, quality of service and user deadlines make it difficult for the scheduler to fully utilize available resources. The problem has been extensively studied in the literature. Different researchers have targeted different parameters. This article presents a multi-objective scheduling algorithm for scheduling scientific workflows in cloud computing. The solution is based on genetic algorithm that targets makespan, monetary cost, and load balance. The proposed algorithm first finds the best solution for each parameter. Based on these solutions, the algorithm finds the superbest solution for all parameters. The proposed algorithm is evaluated with benchmark datasets and comparative results with the standard genetic algorithm, particle swarm optimization, and specialized scheduler are presented. The results show that the proposed algorithm achieves an improvement in makespan and reduces the cost with a well load balanced system.
Does Intolerance of Single-Lung Ventilation Preclude Robotic Off-Pump Totally Endoscopic Coronary Bypass Surgery?
Authors: Balkhy Husam H. , Nisivaco Sarah , Tung Avery , Torregrossa Gianluca , Mehta Sachin
Published: August 2020

Objective

Robotic off-pump totally endoscopic coronary artery bypass (TECAB) usually requires isolated single (right) lung ventilation to adequately expose the surgical site. However, in some patients, persistent oxygen desaturation may occur and conversion to cardiopulmonary bypass (CPB) or sternotomy may be necessary. We reviewed the characteristics and clinical outcomes in patients who did not tolerate single-lung ventilation during TECAB surgery.

Methods

After Institutional Review Board approval we reviewed 440 patients undergoing robotic TECAB at our institution between July 2013 and April 2019. Patients were separated into 2 groups based on their ability to tolerate single-lung ventilation during the procedure. Group 1 included patients able to tolerate single-lung ventilation and Group 2 were patients who required double-lung ventilation to tolerate the procedure. Early and mid-term outcomes were compared.

Results

Group 2 (121 patients) had higher Society of Thoracic Surgeons scores, higher body mass index, and more triple-vessel disease than Group 1 (319 patients). Group 2 had more bilateral internal mammary artery use, multivessel grafting, and longer operative times. One patient underwent conversion to sternotomy and 5 required CPB (all in Group 1). Intensive care unit and hospital length of stay were longer in Group 2. Observed/expected mortality did not differ between groups (1.06% in Group 2 vs 0.4% in Group 1; P = 0.215). At mid-term follow-up, cardiac-related/overall mortality and freedom from major adverse cardiac events were similar.

Conclusions

In our cohort, intolerance of single-lung ventilation did not preclude robotic off-pump TECAB. Double-lung ventilation is feasible during the procedure and may prevent conversions to sternotomy or use of CPB, resulting in excellent early and mid-term outcomes.
The safety and efficacy of staged angioplasty for treating carotid stenosis with a high risk of hyperperfusion: A single-center retrospective study
Authors: Wan Yue , Wang Hui , Wang Dapeng , Tian Hao , Zuo Jing , Fang Qi
Published: August 2020

Objective

Hyperperfusion syndrome (HPS) following carotid artery stenting (CAS) is a rare but life-threatening complication. Staged angioplasty (SAP) is an alternative method that prevents HPS by preventing a sudden increase in cerebral blood flow. In this study, we investigated the safety and efficacy of SAP.

Methods

A total of 114 patients with carotid stenosis underwent CAS treatment in our hospital between September 2014 and September 2019. Patients with severe stenosis and poor collateral circulation shown on digital subtraction angiography (DSA) and hypoperfusion of the ipsilateral diseased blood vessel shown on computed tomography perfusion (CTP) imaging were subjected to SAP treatment (the SAP group), and other patients received regular CAS treatment (the RS group).

Results

Twenty-two patients (19.3%) with a high risk of HPS underwent SAP treatment, 1 of whom had carotid dissection after stage I balloon angioplasty and underwent regular CAS. This patient had HPS after surgery. None of the other patients in either group had HPS. One patient in the SAP group (4.5%) had hyperperfusion phenomenon (HPP) after stage II stenting, and 2 patients in the RS group (2.2%) had HPP. One patient in the SAP group (4.5%) and 4 patients in the RS group (4.3%) had symptomatic ischemic complications postoperatively. None of the differences between the 2 groups were statistically significant. Three patients had reduced modified Rankin Scale (mRS) scores at 90 days after discharge.

Conclusion

This research suggests that SAP appears to be an effective method to prevent HPS for patients with a high risk of HPS.
Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease
Authors: Korkmaz Ufuk Turan Kursat , Yuksel Ahmet , Cetinkaya Ayhan , Velioglu Yusuf , Ucaroglu Erhan Renan , Cayir Mustafa Cagdas , Kumtepe Gencehan , Borulu Ferhat , Bal Ceylan , Erdem Kemalettin , Gok Gamze , Devay Seda Duygulu
Published: August 2020

Objective

To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease.

Methods

One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case–control study. Participants’ baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups.

Results

Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group ( p = 0.045, p = 0.000 and p = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group ( p = 0.000, p = 0.000 and p = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease.

Conclusion

Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.
Inferior selective crossectomy for great saphenous vein incompetence: Our experience
Authors: Pagano Maurizio , Passaro Giovanna , Flore Roberto , Tondi Paolo
Published: August 2020

Objective

To describe the mid-term outcome after inferior selective crossectomy in a subset of patients with symptomatic chronic venous disease and both great saphenous vein and suprasaphenic valve incompetence. Methodsː Retrospective analysis of prospectively collected data was conducted. During an eight-year period, 1095 ligations of all saphenofemoral junction inferior tributaries and great saphenous vein stripping were performed in 814 Clinical, Etiology, Anatomy, Pathophysiology C2–C6 patients. Duplex ultrasound follow-up examinations were performed after 30 days, 6 months, and 2 years, and saphenofemoral junction hemodynamic patterns and varicose veins recurrence rates were evaluated.

Results

Two hundred and twenty patients completed the two-year follow-up period. At the 30-day Duplex ultrasound evaluations, two different hemodynamic patterns were described. Type 1, with physiological drainage of saphenofemoral junction superior tributaries, was observed in 214 patients. Type 2, without flow in saphenofemoral junction superior tributaries, was observed in six patients. Overall varicose vein recurrence rates were 0, 2.3, and 2.7% at the 30-day, 6-month, and 2-year follow-up examinations, respectively. At the two-year follow-up, Type 1 patients showed 0% varicose vein recurrence, while Type 2 patients showed 100%. Conclusionsː Inferior selective crossectomy seems to be a valid and safe option in case of both suprasaphenic valve and great saphenous vein incompetence. Duplex ultrasound evaluation, according to our protocol, allows us to identify two different saphenofemoral junction hemodynamic patterns that could predict varicose vein recurrence at mid-term. An optimal stump washing after inferior selective crossectomy, warranted by patency and large caliber saphenofemoral junction superior tributaries, seems to be the key point in preventing varicose vein recurrence in this context. However, large prospective studies regarding saphenofemoral junction modifications and varicose vein recurrence are needed to confirm these preliminary observations.
Paediatric focal nodular hyperplasia: A case study of typical contrast-enhanced ultrasound findings with quantitative analysis and correlated with magnetic resonance imaging
Authors: Panayiotou Andreas , Rafailidis Vasileios , Deganello Annamaria , Sellars Maria , Sidhu Paul S
Published: August 2020

Introduction

Focal nodular hyperplasia, a benign liver tumour, is the second most common focal benign liver lesion, after a cavernous haemangioma. Contrast-enhanced ultrasound is used increasingly for the diagnostic work up and follow-up of focal liver lesions in adults, but is particularly valuable in the paediatric population, with the ability to reduce radiation and the nephrotoxic contrast agents used in computed tomography or magnetic resonance imaging. Confident recognition of focal nodular hyperplasia is important; it is benign, usually asymptomatic, of no clinical significance, of no clinical consequence or malignant potential. We present a case of focal nodular hyperplasia of the liver with its characteristic findings on conventional ultrasound, contrast-enhanced ultrasound with quantitative analysis and correlated with magnetic resonance imaging. Case presentation: A 15-year-old female with right upper quadrant abdominal pain was referred for liver ultrasound. A focal liver lesion was detected on B-mode ultrasound examination, and colour Doppler demonstrated no specific features. Contrast-enhanced ultrasound examination demonstrated early arterial enhancement, with a characteristic spoke-wheel pattern, centrifugal uniform filling of the lesion on the late arterial phase and sustained enhancement on the portal venous phase. Quantitative contrast-enhanced ultrasound has been performed, showing a typical curve of enhancement, as well as characteristic parametric images, supporting the interpretation of contrast-enhanced ultrasound and assisting the diagnosis. Magnetic resonance imaging demonstrated a central T2 hyperintense scar and similar enhancement characteristics as contrast-enhanced ultrasound on T1 gadolinium-enhanced sequences.

Conclusion

Contrast-enhanced ultrasound is a useful technique for the differentiation of benign from malignant liver lesions and has the potential to establish the diagnosis of focal nodular hyperplasia, based on the enhancement pattern, which is similar to that observed on magnetic resonance imaging but can be better appreciated with superior temporal, contrast and spatial resolution of contrast-enhanced ultrasound.
Cognitive behavioral therapy in 22q11.2 deletion syndrome: A case study of two young adults with an anxiety disorder
Authors: Buijs Petra CM , Bassett Anne S , Gold David A , Boot Erik
Published: August 2020

Background:

The prevalence of anxiety disorders is high in 22q11.2 deletion syndrome (22q11.2DS), an under-recognized multisystem condition. Prominent features include an array of somatic, cognitive, and neuropsychiatric disorders. This case study reports for the first time on the application of individual cognitive behavioral therapy in 22q11.2DS.

Method:

Two young adults with 22q11.2DS and an anxiety disorder received cognitive behavioral therapy based on standard protocols. Feasibility and efficacy were assessed through clinical interviews, clinical observations by the therapist, and questionnaires.

Results:

Both participants were engaged in the therapy and showed understanding of basic cognitive behavioral therapy principles. However, they did not show a clear clinical improvement. Adjustments to the protocol were required, including increased flexibility and a proactive approach by the therapist, additional time per session, written information, and significant involvement of the family and multidisciplinary team.

Conclusions:

Our findings may help identify required adaptations to cognitive behavioral therapy protocols for this and similar genetic conditions.
Parents’ Role in Addressing Children’s Racial Bias: The Case of Speculation Without Evidence
Authors: Scott Katharine E. , Shutts Kristin , Devine Patricia G.
Published: August 2020

Children begin displaying racial biases early in development, which has led many authors of popular-press articles to generate suggestions for preventing and decreasing such biases. One common theme in the popular press is that parents should play a role in addressing children’s biases. In the present article, we analyze the current recommendations parents receive about addressing their children’s biases and consider their utility. We conclude that the evidence base supporting the effectiveness of parental intervention to reduce children’s biases is scant. Next, we offer suggestions for how to construct a useful evidence base from which good recommendations could be drawn. In so doing, we issue a call to action for researchers to conduct research that will yield empirically supported, specific, shareable suggestions for parents who are seeking advice about how to engage with their children in this important domain. We also suggest that researchers become actively involved in the dissemination of the research findings so as to improve the lives of those who receive and express biases.
Crime and justice research: The current landscape and future possibilities
Authors: Sparks Richard
Published: August 2020

The contributions in this themed section developed from conversations that took place at an event hosted by the British Society of Criminology and Criminology & Criminal Justice in April 2019. The papers that follow respond to a ‘think-piece’ presented by Richard Sparks at that event, and engage with the subsequent debate about the future of funding for crime and justice research. Contributors reflect on the opportunities and challenges arising from recent shifts in funding allocations and priorities, from their different vantage points. Highlighting the importance of interdisciplinary and international work, they consider priorities for future investment in crime and justice research and draw attention to the impact of an increasingly restrictive and risk-averse climate on critical research. The papers explore the consequences for criminology as a discipline and warn of the potential reinforcement of existing inequalities in academia unless action is taken to support the development of future researchers.
C3, C5a and anti-acetylcholine receptor antibody as severity biomarkers in myasthenia gravis
Authors: Aguirre Florencia , Manin Analisa , Fernandez Victoria C. , Justo Mariano E. , Leoni Juliana , Paz Mariela L. , Villa Andres M.
Published: August 2020

Background:

Although the pathogenesis of myasthenia gravis (MG) is well known, prognostic markers are not yet available. We assessed the utility of anti-acetylcholine receptor (AChR) antibody (AChR-ab) titer and concentration of C3, C4, and C5a as potential severity biomarkers in MG.

Methods:

Levels of C3, C4, C5a, and AChR-ab were measured in 60 AChR-ab-positive patients with MG. Their relationship with clinical severity was analyzed using the activities of daily living (ADL) and MG composite (MGC) scales.

Results:

AChR-ab titer correlated with severity of MG according to ADL ( p = 0.002) and MGC scales ( p = 0.001). When patients were classified according to disease duration, a statistically significant correlation between AChR-ab titer and clinical severity was only found in the subgroup of patients with fewer than 5 years from symptoms onset. C5a levels showed a positive correlation with MG severity according to the ADL scale ( p = 0.041; τb = 0.18), although C5a levels were not different from the control group.

Discussion:

AChR-ab titers and C5a levels could potentially be considered markers of severity in patients with MG.
Healthcare Professional Perceptions of Blood Glucose Meter Features That Support Achievement of Self-Management Goals Recommended by Clinical Practice Guidelines
Authors: Greenwood Deborah A. , Grady Mike
Published: August 2020

Background:

Blood glucose meters remain an effective tool for blood glucose monitoring (BGM) but not all meters provide the same level of insight beyond the numerical glucose result.

Objective:

To investigate healthcare professional (HCP) perceptions of four meters and how these meters support the achievement of self-management goals recommended by diabetes clinical practice guidelines.

Methods:

Three hundred and fifty-three HCPs from five countries reviewed the features and benefits of four meters using interactive webpages and then responded to statements about the utility of each meter and ranked each meter in terms of clinical value.

Results:

Meter D ranked significantly higher in terms of clinical utility for all 13 guideline questions (70%-84%, P < .05) compared to other meters. Endocrinologists (69%-85%), primary care physicians (PCP; 63%-80%), and diabetes nurses (DN; 80%-89%) consistently ranked meter D highest for all guideline questions. DNs ranked selected questions significantly higher compared to PCPs (8 of 13) or endocrinologists (3 of 13; P < .05). Meter D achieved strong endorsement from HCPs in France and Germany, followed by the United States and Canada, with comparatively lower responses from Italian HCPs ( P < 0.05). With respect to self-management, 80% of HCPs selected meter D as their first choice for patients with type 1 diabetes to help patients improve diabetes management or understand their numbers to help them stay in range.

Conclusions:

HCPs had strong preference for a meter providing additional insights, messages, and guidance direct to the patient to support achievement of self-management goals recommended by diabetes clinical practice guidelines.