bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Screening Technique Used to Estimate the Mechanism of Adhatoda vasica Nees for the Treatment of Rheumatoid Arthritis Based on Network Pharmacology and Molecular Docking
Authors: Wang Wenxiang , Zhang Yunsen , Luo Jie , Wang Rushan , Tang Ce , Zhang Yi
Published: September 2020

Adhatoda vasica Nees (AVN) is commonly used to treat joint diseases such as rheumatoid arthritis (RA) in ethnic minority areas of China, especially in Tibetan and Dai areas, and its molecular mechanisms on RA still remain unclear. Network pharmacology, a novel strategy, utilizes bioinformatics to predict and evaluate drug targets and interactions in disease. Here, network pharmacology was used to investigate the mechanism by which AVN acts in RA. The chemical compositions and functional targets of AVN were retrieved using the systematic pharmacological analysis platform PharmMapper. The targets of RA were queried through the DrugBank database. The protein‐protein interaction network (PPI), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of key targets were constructed in the STRING database, and the network visualization analysis was performed in Cytoscape. Maestro 11.1, a type of professional software, was used for verifying prediction and analysis based on network pharmacology. By comparing the predicted target information with the targets of RA‐related drugs, 25 potential targets may be related to the treatment of RA, among which MAPK1, TNF, DHODH, IL2, PTGS2, and JAK2 may be the main potential targets for the treatment of RA. Finally, the chemical components and potential target proteins were scored by molecular docking, and compared with the ligands of the protein, the prediction results of network pharmacology were preliminarily verified. The active ingredients and mechanism of AVN against RA were firstly investigated using network pharmacology. Additionally, this research provided a solid foundation for further experimental studies.
Distinguishable Immunologic Characteristics of COVID-19 Patients with Comorbid Type 2 Diabetes Compared with Nondiabetic Individuals
Authors: Zhao Ruxing , Sun Yujing , Zhang Yongyuan , Wang Weili , Wang Shouyu , Wang Chuang , Liu Jinbo , Gao Ling , Hu Zhao , Fei Jianchun , Hou Xinguo , Zheng Huizhen , Chen Li , Migliorini Paola
Published: September 2020

Background. COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has threatened every civilian as a global pandemic. The immune system poses the critical interactive chain between the human body and the virus. Here, we make efforts to examine whether comorbidity with type 2 diabetes (T2D) affects the immunological response in COVID-19 patients. Methods. We conducted a retrospective pilot study investigating immunological characteristics of confirmed cases of COVID-19 with or without comorbid T2D. Two subcohorts of sex- and age-matched participants were eligible for data analysis, of which 33 participants were with T2D and the remaining 37 were nondiabetic (NDM). Cellular immunity was assessed by flow cytometric determination of surface markers including CD3, CD4, CD8, CD19, CD16, and CD56 in peripheral blood. Levels of C reactive protein, immunoglobulin (IgG, IgM, IgA, and IgE), and complements (C3, C4) were detected by rate nephelometry immunoassay. And Th1/Th2 cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were detected by Cytometric Bead Array. Results. Neutrophil counts were found to be significantly higher in the T2D group than in the NDM group and had a significant relevance with clinical severity. Lymphocyte frequencies showed no significant differences in the two groups. However, the proportions and absolute counts of T, Tc, Th, and NK cells decreased in both groups to different degrees. An abnormal increase in neutrophil count and a decrease in lymphocyte subpopulations may represent risk factors of COVID-19 severity. The level of IgG, IgM, IgA, C3, and C4 showed no significant difference between the two groups, while the IgE levels were higher in the T2D group than in the NDM group (

p
<
0.05

). Th1 cytokines including IFN-γ, TNF-α, and IL-6, as well as CRP, appeared significantly higher in the T2D group. Conclusions. The COVID-19 patients comorbid with T2D demonstrated distinguishable immunological parameters, which represented clinical relevancies with the predisposed disease severity in T2D.
Intelligent Rehabilitation Assistance Tools for Distal Radius Fracture: A Systematic Review Based on Literatures and Mobile Application Stores
Authors: Chen Yalan , Yu Yijun , Lin Xin , Han Zhenwei , Feng Zhe , Hua Xinyi , Chen Dongliang , Xu Xiaotao , Zhang Yuanpeng , Wang Guheng , Huang Chenxi
Published: September 2020

Objective. To systematically analyze the existing intelligent rehabilitation mobile applications (APPs) related to distal radius fracture (DRF) and evaluate their features and characteristics, so as to help doctors and patients to make evidence-based choice for appropriate intelligent-assisted rehabilitation. Methods. Literatures which in regard to the intelligent rehabilitation tools of DRF were systematic retrieved from the PubMed, the Cochrane library, Wan Fang, and VIP Data. The effective APPs were systematically screened out through the APP markets of iOS and Android mobile platform, and the functional characteristics of different APPs were evaluated and analyzed. Results. A total of 8 literatures and 31 APPs were included, which were divided into four categories: intelligent intervention, angle measurement, intelligent monitoring, and auxiliary rehabilitation games. These APPs provide support for the patients’ home rehabilitation guidance and training and make up for the high cost and space limitations of traditional rehabilitation methods. The intelligent intervention category has the largest download ratio in the APP market. Angle measurement tools help DRF patients to measure the joint angle autonomously to judge the degree of rehabilitation, which is the most concentrated type of literature research. Some of the APPs and tools have obtained good clinical verification. However, due to the restrictions of cost, geographic authority, and applicable population, a large number of APPs still lack effective evidence to support popularization. Conclusion. Patients with DRF could draw support from different kinds of APPs in order to fulfill personal need and promote self-management. Intelligent rehabilitation APPs play a positive role in the rehabilitation of patients, but the acceptance of the utilization for intelligent rehabilitation APPs is relatively low, which might need follow-up research to address the conundrum.
Effects of miR-373 Inhibition on Glioblastoma Growth by Reducing Limk1 In Vitro
Authors: Peng Tao , Wang Tiejun , Liu Guohui , Zhou Lixiang , Teng Zenghui
Published: September 2020

Glioblastoma (GBM) is an aggressive brain tumor with shorter median overall survival time. It is urgent to find novel methods to enhance the therapeutic efficiency clinically. miR-373 is related to the biological development process of cancers, but there are no reports whether modulation on miR-373 could affect GBM development or modify the efficiency of chemo- or radiotherapy yet. Our current study found that the higher level of miR-373 was observed in U-251 cells. Inhibition on miR-373 could reduce the U-251 cell number by 65% and PCNA expression obviously. In addition, inhibition on miR-373 sensitized U-251 cells to chemo- or radiotherapy. The cell cycle of U-251 cells could be modulated by miR-373 knockdown, which could enhance the p21 expression and reduce the cdc2 level. Anti-miR-373 could increase the Bax/Bcl-2 ratio of U-251 cells and induce cell apoptosis significantly. These above effects of miR-373 could be reversed by Limk1 overexpression. Thus, our experimental data confirmed the fact that miR-373 could be a new therapeutic target to enhance the efficiency of chemo- or radiotherapy for clinical GBM patients.
Vibration Analysis of Driving-Point System with Uncertainties Using Polynomial Chaos Expansion
Authors: Xiao Bin , Zhou Yu-long , Gao Chao , Shi Shuang-Xia , Sun Ze-Xi , Song Zong-biao , Petrov Evgeny
Published: September 2020

A vibration transfer analysis method based on polynomial chaos expansion (PCE) is proposed in this study and is used to analyze the stochastic dynamic compliance of uncertain systems with the Gaussian distribution. The random dynamic compliance is established by utilizing mode superposition on the system as the parameters of system uncertainties are regarded as input variables. Considering the asymptotic probability density function of mode shape, the dynamic compliance is decomposed into the mean of mode shape and the subsystem represented as an orthogonal polynomial expansion. Following this, the vibration transmission analysis approach is proposed for the random vibration. Results of a numerical simulation carried out employing the PCE approach show that broad-band spectrum analysis is more effective than narrow-band spectrum analysis because the former jump of the dynamic compliance amplitude is weakened. This proposed approach is valid and feasible, but since broad-band spectrum analysis loses some important information about the random vibration, both the aforementioned processes need to simultaneously be applied to analyze the random vibration transmission of low-medium frequency systems.
First Case of COVID-19-Associated Collapsing Glomerulopathy in Sub-Saharan Africa
Authors: Nlandu Yannick M. , Makulo Jean-Robert R. , Pakasa Nestor M. , Sumaili Ernest K. , Nkondi Clarisse N. , Bukabau Justine B. , Beya François K. , Nseka Nazaire M. , Lepira François B. , Bergner Raoul
Published: September 2020

Although the lungs remain the main target of SARS-CoV-2, other organs, such as kidneys, can be affected, which has a negative impact on the outcomes of COVID-19 patients. Although previous studies of kidney disease in COVID-19 reported mainly SARS-CoV-2-induced tubular and interstitial injury, there is growing evidence coming out of Africa of glomerular involvement, especially collapsing glomerulopathy seen particularly in people of African descent. We report a case of collapsing glomerulopathy revealed by acute kidney injury and a new onset of full blown nephrotic syndrome in a black Congolese patient coinfected with COVID-19 and malaria.
Dynamic Stress Analysis of a Circular‐Lined Tunnel in Composite Strata‐SH Wave Incidence
Authors: Qi Hui , Zhang Yang , Guo Jing , Chu Fuqing
Published: September 2020

It is necessary to study the problem of seismic wave scattering in composite stratum for tunnel engineering because the existence of composite strata will make the stress of tunnels more complicated during earthquakes. In this thesis, a series solution of the scattering wave field of the composite strata and lining is obtained using the complex function method. According to the stress and displacement boundary conditions between the composite stratum and the lining, a series of equations are established and are solved by means of Fourier transformation and finite term truncation, and the calculation errors are also discussed. Through programming calculations, the dynamic stress concentration factor (DSCF) of circular tunnels in the two types of composite strata, “hard‐over‐soft” and “soft‐over‐hard,” is analyzed when SH waves propagate, and certain conclusions on the scattering of SH waves that are distinguished from the case of single homogeneous layers are reached. The research in this article reveals some phenomena. For the Q345 steel lining in the calculation examples, it is found in this paper that increasing the thickness of the lining is effective to reduce the influence of the DSCF. But, for C30 concrete, increasing the thickness of the lining reduces the DSCF of the outer surface while increasing the DSCF of the inner surface.
Electroacupuncture Pretreatment Elicits Tolerance to Cerebral Ischemia/Reperfusion through Inhibition of the GluN2B/m-Calpain/p38 MAPK Proapoptotic Pathway
Authors: Zhang Bao-yu , Wang Guan-ran , Ning Wen-hua , Liu Jian , Yang Sha , Shen Yan , Wang Yang , Zhao Meng-xiong , Li Li , Chen Yongjun
Published: September 2020

Background. As one of the first steps in the pathology of cerebral ischemia, glutamate-induced excitotoxicity progresses too fast to be the target of postischemic intervention. However, ischemic preconditioning including electroacupuncture (EA) might elicit cerebral ischemic tolerance through ameliorating excitotoxicity. Objective. To investigate whether EA pretreatment based on TCM theory could elicit cerebral tolerance against ischemia/reperfusion (I/R) injury, and explore its potential excitotoxicity inhibition mechanism from regulating proapoptotic pathway of the NMDA subtype of glutamate receptor (GluN2B). Methods. The experimental procedure included 5 consecutive days of pretreatment stage and the subsequent modeling stage for one day. All rats were evenly randomized into three groups: sham MCAO/R, MCAO/R, and EA+MCAO/R. During pretreatment procedure, only rats in the EA+MCAO/R group received EA intervention on GV20, SP6, and PC6 once a day for 5 days. Model preparation for MCAO/R or sham MCAO/R started 2 hours after the last pretreatment. 24 hours after model preparation, the Garcia neurobehavioral scoring criteria was used for the evaluation of neurological deficits, TTC for the measurement of infarct volume, TUNEL staining for determination of neural cell apoptosis at hippocampal CA1 area, and WB and double immunofluorescence staining for expression and the cellular localization of GluN2B and m-calpain and p38 MAPK. Results. This EA pretreatment regime could improve neurofunction, decrease cerebral infarction volume, and reduce neuronal apoptosis 24 hours after cerebral I/R injury. And EA pretreatment might inhibit the excessive activation of GluN2B receptor, the GluN2B downstream proapoptotic mediator m-calpain, and the phosphorylation of its transcription factor p38 MAPK in the hippocampal neurons after cerebral I/R injury. Conclusion. The EA regime might induce tolerance against I/R injury partially through the regulation of the proapoptotic GluN2B/m-calpain/p38 MAPK pathway of glutamate.
Prognostic Value of Microvessel Density in Head and Neck Squamous Cell Carcinoma: A Meta-Analysis
Authors: Dong Yanbo , Ma Guangzhi , Liu Yukun , Lu Siyu , Liu Liangfa , Foddis Rudy
Published: September 2020

The prognostic value of microvessel density (MVD) in head and neck squamous cell carcinoma (HNSCC) remains disputable. The purpose of this study was to comprehensively determine the prognostic value of MVD in HNSCC. Relevant literatures were identified using PubMed, Embase, and Cochrane Library. A meta-analysis was performed to clarify the prognostic role of MVD in HNSCC patients and different subgroups. A total of 14 eligible articles were included in this meta-analysis. The combined hazard ratio (HR) and 95% confidence interval (95% CI) for overall survival (OS) of 11 studies was 1.663 (1.236-2.237,P=0.001), and the pooled HR and 95% CI for progression-free survival (PFS) of 7 studies was 2.069 (1.281-3.343,P=0.003). Subgroup analyses were also performed on different issues, such as regional distribution of patients, age, tumor location, antibody, and treatment strategy. To conclude, high MVD is associated with worse OS and PFS in patients with HNSCC.
The Effects of Sand Particles on the Synergy of Cavitation Erosion-Corrosion of MIG Welding Stainless Steel Coating in Saline Water
Authors: Pan Haodan , Tao Jun , E Meng , Hu Hongxiang , Wang Zhengbin , Chen Jian
Published: September 2020

Cavitation erosion (CE) is a common problem troubling many flow-handling equipment such as valves, orifice plate pipes, and propellers. The coating technique is a widely used strategy to resist CE. It is important to understand the CE-corrosion behavior of the coatings in the corrosive solution, especially in the sand-containing saline water. A newly designed MIG welding precipitated hardened martensitic stainless steel (PHMSS) coating was performed, and its silt-CE was investigated in a suspension composed of 3.5 wt.% sodium chloride and 3% silica sand using an ultrasonic vibrator processor. The microstructure of the coating was characterized by optical microscopy and scanning electron microscopy. The effects of the sand particles on the CE-corrosion were analyzed using mass loss measurement, potentiodynamic polarization curve, and surface morphology observation. The results showed that the PHMSS coating was mainly composed of the lath martensitic phase alone. Its mass loss rate was in ascending order in the solution of distilled water alone, sand-containing distilled water, saline water alone, and sand-containing saline water. Sand particles played more roles in the CE in the distilled water than in the saline water. The synergy of CE and corrosion was much less in the sand-free saline than in the sand-containing saline. The maximum component was the erosion enhancement due to the corrosion in the saline without sand particles but was the pure erosion component in the saline with sand particles. The mechanism of the sand particles’ effect on the CE was also discussed.
Long-Term Follow-Up of a Portuguese Single-Centre Cohort of Persons with Haemophilia and Hepatitis C Virus Infection
Authors: Pereira Guedes Tiago , Garrido Mónica , Kuttner Magalhães Ricardo , Moreira Teresa , Rocha Marta , Maia Luís , Manuel Ferreira José , Morais Sara , Pedroto Isabel
Published: September 2020

Introduction: Persons with haemophilia (PWH) used to represent a population with a high prevalence of hepatitis C virus (HCV) infection due to the use of contaminated blood products. Although the goals of antiviral therapy are the same as the general population, long real-life follow-up data regarding their outcomes are still scarce. Our aim was to report the outcomes of HCV infection and the results of antiviral therapy in PWH. Methods: A retrospective analysis was performed in a single-centre cohort of PWH with positive HCV antibody. Outcomes registered were rate of spontaneous clearance of HCV, sustained virologic response (SVR) achievement, development of end-stage liver disease, and all-cause and liver-related mortality. Results: Out of 131 PWH, 73 (55.7%) had positive HCV antibody. During a median follow-up time of 22 years, 46 patients (63.9%) developed chronic hepatitis C, of which 16 (34.8%) developed cirrhosis. Treatment was pursued in 34 PWH. Most (n = 32) were first treated with interferon (IFN)-based regimens with SVR rates of 40.6%. Direct-acting antivirals were used in 14 IFN-experienced and 2 naïve patients, with an overall SVR rate of 100%. Overall, 17 patients (23.3%) died during the follow-up, only 4 related to liver disease. Of these, none had achieved SVR. Conclusions: We describe the outcomes of a cohort of Portuguese PWH and hepatitis C exposure after two decades of follow-up, with a lower mortality than previously described. Our response rates to HCV treatment were comparable to those in the general population and stress the importance of early treatment.
Oxaliplatin-Induced Thrombotic Microangiopathy in a Patient with Stage IV Gallbladder Carcinoma: Primary Association or Multiple Hits?
Authors: Fuentes-Lacouture María Cynthia , Barrera-Garavito Edgar Camilo
Published: September 2020

Thrombotic microangiopathies (TMA) include a variety of vascular disorders characterized by the presence of microthrombi, coagulopathy by platelet activation and consumption, and systemic damage. The most frequent secondary causes are infections and some medications. However, the presence of chemotherapeutic agents is not so common, and the induction of TMA by oxaliplatin is poorly understood, with few published case reports. We present the case of a patient with a history of gallbladder carcinoma, in whom findings compatible with TMA were documented, and with a temporal and sole relation to oxaliplatin.
Distant Metastasis after Surgery for Encapsulated Papillary Carcinoma of the Breast: A Case Report
Authors: Kitahara Miyuki , Hozumi Yasuo , Takeuchi Naoto , Ichinohe Satoko , Fujiwara Saori , Machinaga Mitsuki , Saitoh Hitoaki , Iijima Tatsuo
Published: September 2020

In the absence of clear interstitial invasion, encapsulated papillary carcinoma (EPC) of the breast may be attributed to an extremely good prognosis if handled similarly to ductal carcinoma in situ (DCIS) with suitable local treatment. Here, we report our experience with a case of EPC of the breast that presented with carcinomatous pleuritis and lymphangitis carcinomatosa postoperatively, which rapidly resulted in a poor outcome. A 67-year-old woman was diagnosed with DCIS of the left breast and underwent left partial mastectomy and sentinel lymph node biopsy. EPC was diagnosed because the pathological examination showed no sign of interstitial infiltration. Postoperative radiation therapy was performed. Five years and 9 months postoperatively, the patient began experiencing cough and shortness of breath on exertion. Imaging showed right pleural effusion and consolidation of the lung field, but nothing suggesting local recurrence in the preserved left breast, local lymph nodes, or opposite breast was observed. Postoperative recurrence of breast cancer, carcinomatous pleuritis, and lymphangitis carcinomatosa were diagnosed based on the results of pleural fluid cytology. One month later, multiple brain metastases were found, and the patient died of the primary disease 5 months after recurrence. After surgery for EPC without clear interstitial infiltration, there was a small possibility of a poor outcome from distant metastasis. Therefore, although distant metastasis is uncommon, regular examination and testing should be performed.
Extracorporeal Partial Nephrectomy with Orthotopic Autotransplantation under Pharmaco-Cold Ischaemia for Cancer of a Single Kidney: A Case Report
Authors: Baitman Tatiana , Miroshkina Irina , Gritskevich Alexander , Teplov Alexander , Zotikov Andrey , Kochetov Alexander , Demidova Valentina , Chupin Andrey , Stepanova Yulia , Schima Wolfgang , Karmazanovsky Grigory
Published: September 2020

Up to 10% of patients with renal cell carcinoma (RCC) have locally advanced disease with venous tumour thrombosis involving the inferior vena cava (IVC). 30–50% of them present with synchronous metastatic disease. Surgical treatment remains the only potentially radical method for patients suffering from RCC and IVC tumour thrombosis without distant metastases. Five-year cancer-specific survival for such patients is 40–60%. The role of surgery in the treatment of RCC is significant, even if only cytoreductive operation is possible. Nephron-sparing surgery (NSS) is reasonably preferable for patients suffering from single kidney RCC, but it is not always radical enough. Extracorporeal approach allows to perform a radical dissection of the tumour in special complicated cases, but it is seldom used because of technical difficulties. We present a case of successful NSS by extracorporeal approach in our modification for RCC with IVC tumour thrombosis.
Sicherheit von synthetischen und biologischen DMARDs für die Behandlung der rheumatoiden Arthritis
Authors: Mihai Carmen-Marina
Published: September 2020

Objectives: To perform a systematic literature review (SLR) concerning the safety of synthetic (s) and biological (b) disease-modifying anti rheumatic dugs (DMARDs) to inform the 2019 update of the EULAR recommendations for the management of rheumatoid arthritis (RA). Methods: An SLR of observational studies comparing safety outcomes of any DMARD with another intervention for the management of RA. A comparator group was required for inclusion. For treatments still without registry data (eg, sarilumab and the Janus kinase (JAK) inhibitors baricitinib, upadacitinib), randomized controlled trials (RCTs) and long-term extensions (LTEs) were used. Risk of bias (RoB) was assessed according to standard procedures. Results: Forty-two observational studies fulfilled the inclusion criteria, addressing safety outcomes with bDMARDs and sDMARDs. Nine studies showed no difference in the risk of serious infections across bDMARDs and two studies (high RoB) showed an increased risk with bDMARDs compared with conventional synthetic (cs) DMARDs (adjusted incidence rate ratio 3.1–3.9). The risk of Herpes zoster infection was similar across bDMARDs, but one study showed an increased risk with tofacitinib compared with abatacept (adjusted HR (aHR) 2.0). Five studies showed no increased risk of cancer for bDMARDs compared with csDMARDs. An increased risk of lower intestinal perforation was found for tocilizumab compared with csDMARDs (aHR 4.5) and tumour necrosis factor inhibitor (TNFi) (aHR 2.6–4.0). Sixty manuscripts reported safety data from RCTs/LTEs. Overall, no unexpected safety outcomes were found, except for the possibly increased risk of venous thromboembolism (VTE) with JAK inhibitors. Conclusion: Data obtained by this SLR confirm the known safety profile of bDMARDs. The risk of VTE in RA, especially in patients on JAK inhibitors, needs further evaluation.
Molecular Characteristics of Sequence Variants in GATA4 in Patients with 46,XY Disorders of Sex Development without Cardiac Defects
Authors: Choi Jin-Ho , Lee Yena , Oh Arum , Kim Gu-Hwan , Yoo Han-Wook
Published: September 2020

A GATA4 haploinsufficiency has been well described in patients with congenital heart defects (CHDs), whilst only a few studies have reported mutations related to a 46,XY disorder of sex development (DSD) phenotype. This study investigated the clinical phenotypes and molecular characteristics of two 46,XY DSD patients harboring GATA4 variants. Mutation analysis was performed using a targeted gene panel or whole-exome sequencing. The transactivation activity of each variant protein was examined by in vitro luciferase reporter assay using the AMH and SRY promoters. Subject 1 presented with a micropenis and hypospadias. Subject 2 showed complete female external genitalia with a 46,XY karyotype. Both patients were responsive to hCG stimulation tests and did not manifest CHD. A novel heterozygous variant, c.643A>G (p.R215G), in GATA4 was identified in Subject 1, whereas Subject 2 harbored a previously reported variant, c.1220C>A (p.P407Q), in GATA4 and a previously known pathogenic mutation, i.e., c.226C>T (p.Q76*) in the AR gene. The reporter assays using the SRY and AMH promoters revealed decreased transcriptional activity of both p.P407Q and p.R215G. However, the GATA4 p.P407Q variant was classified as likely benign. In conclusion, it is essential to integrate clinical features and endocrine findings when interpreting sequence variants.
Impact of Intravitreal Ranibizumab Therapy on Vision Outcomes in Diabetic Macular Edema Patients: A Meta-Analysis
Authors: Falcão Manuel
Published: September 2020

Purpose: Evaluation of the impact of the injection frequency of ranibizumab on best-corrected visual acuity (BCVA) outcomes in patients with diabetic macular edema (DME). Methods: A meta-analysis of randomized controlled trials (RCTs) and real-world studies was performed to quantify the effect of ranibizumab treatment on BCVA and central foveal thickness (CFT) in DME as well as the relationship between the number of injections and the change in BCVA/CFT. Results: All combined sources (29 RCTs and 11 real-life studies) showed a significant increase in BCVA from baseline following anti-vascular endothelial growth factor (VEGF) treatment (8.2, 9.4, and 10.3 ETDRS letters gained after 12, 24, and 36 months of ranibizumab treatment, respectively). The largest changes in BCVA were observed in RCTs and the smallest in real-life studies at 12 months. A significant relationship was found between the number of injections and change in BCVA at 12 months. Conclusions: Inferior vision outcomes were observed in clinical practice compared with RCTs and might be partly attributable to administration of fewer anti-VEGF injections. Physicians should be aware that early and appropriate anti-VEGF treatment regimens are necessary to obtain the results reported in RCTs and help prevent irreversible vision loss in DME patients.
Retinal Vasculitis Secondary to Durvalumab
Authors: Andrade Antonio R. , Moll-Udina Aina , Martin Ruth , Cilveti Esther , Subirà Olaia , Disfetano Laura , García-Arumí Jose
Published: September 2020

Ocular manifestations are very rarely reported as side effects to checkpoint inhibitors. We present a case of a 64-year-old Caucasian man in treatment with durvalumab for non-small-cell lung carcinoma who presented a retinal vasculitis with macular edema. After three boluses of methylprednisolone, the retinal vasculitis resolved and macular edema improved during follow-up. There was no need for durvalumab to be withdrawn.
A Time Frame for Testing Negative for SARS-COV2 in People with Obesity
Authors: Dicker Dror , Lev Shaul , Gottesman Tamar , Kournos Tatiana , Dotan Maya , Ashorov Nina , Marcoviciu Dana , Golan Rachel
Published: September 2020

Objective: Obesity is a major risk factor for becoming seriously ill with the 2019 novel coronavirus (COVID-19). One difficulty faced by clinicians and by patients is the unknown time frame of hospitalization until discharge of symptomatic patients. Methods: We followed 34 patients with laboratory-confirmed COVID-19 infection who recovered fromthe infection. All diagnoses were given using semi-quantitative RT-PCR on nasopharyngeal swabs. Envelope protein gene (E), RNA-dependent RNA polymerase gene (RdRP), and nucleocapsid gene (N) were measured by RT-PCR. Weight was measured and height was self-reported. Results: Mean ± SD age was 51.8 ± 16.7 years. Mean ± SD body mass index (BMI) was 27.4 ± 4.7 kg/m2. 26% (9/34) had obesity, with BMI above 30 kg/m2. Fifteen patients had BMI between 25 and 29.9 kg/m2. The mean length of hospital stay was longer for those with a BMI >25 kg/m2 (n = 24) than for those with a normal BMI (19.2 vs. 16.0 days, p = 0.08). Comparing people with obesity (BMI >30 kg/m2 or above) to those without obesity, the difference was larger (20.6 vs. 16.0 days, p = 0.06). A trend for correlation between body weight and the time to negative detection of RdRp gene was found (r = 0.33, p = 0.09). Conclusions: Our results highlight the need for priority of early detection and testing, and early therapy for people with obesity and COVID-19 infections.
Le gouvernement de l’homme royal dans le Politique : une utopie assumée
Authors: Balansard Anne
Published: September 2020

The object of this article, which analyses Statesman 291a1-303d3, is to show how the good, the object of politics qua knowledge, makes the regime with which it is associated a utopia. The good cannot be actualized anywhere in the sensible realm, because no city can be governed without laws, and the laws define what is good most often for the greatest number. A government of the good, without laws, is a utopia, but the laws, to the extent that they aim at the common interest, are in themselves the imprint of the good. I defend the thesis, at first sight paradoxical, that the true politicians are not those who know the good and imitate it, but those who recognise the utility of laws and agree to submit themselves to their authority. Thus Plato dismisses all existing regimes as sophistic regimes where power is exercised in the interest of the rulers and not of the ruled. Not every regime, however, bears the imprint of the good equally. By making politics a branch of knowledge, Plato imposes a numerical criterion on the classification of regimes; he crosses the criterion of number with that of law. I therefore argue for another paradox: the best possible regime is a monarchy in which the rulers obey the laws, the best existing regime is none other than democracy.
Politics as Architectonic Expertise? Against Taking the So-called ‘Architect’ (ἀρχιτέκτων) in Plato’s Statesman to Prefigure this Aristotelian View
Authors: Lane Melissa
Published: September 2020

This article rejects the claim made by other scholars that Plato in the Statesman, by employing the so-called ‘architect’ (ὁ ἀρχιτέκτων) in one of the early divisions leading to the definition of political expertise, prefigured and anticipated the architectonic conception of political expertise advanced by Aristotle. It argues for an alternative reading in which Plato in the Statesman, and in the only other of his works (Gorgias) in which the word appears, closely tracks the existing social role of the architektōn, who was designated as such only in virtue of appointment by a city to a role that was crucially defined as epitactic, involving overseeing the workers on site engaged in constructing some civic building works. It is this epitactic dimension of the role on which Plato relies in the Statesman, as opposed to the kind of claim to overarching integrative expertise that Aristotle would use the figure of architectonic political knowledge to make.
Sign of the Times: the Rise and Fall of Politics in Plato’s Statesman
Authors: Weigelt Charlotta
Published: September 2020

This article argues that the Statesman should be read as a historically informed reflection on the nature and possibility of political rule, and that it presents us with a dilemma precisely in this regard. On the one hand, as indicated by the famous myth on the evolution of the cosmos, politics is only possible today, in the age of Zeus, when man no longer is like a sheep, ruled by a caring herdsman, as he used to be in the age of Cronus. Instead, he has become an expert who is capable of some degree of self-rule. On the other hand, however, as a ‘technocratic’ age, the present is marked by its loss of the ‘natural’ model for statesmanship. More specifically, when politics tends to be identified with technical expertise, it becomes difficult to make sense of the very idea of political rule.
Three new species and DNA sequence data of the rare South American water beetle genus Adelphydraena Perkins, 1989 (Coleoptera: Hydraenidae)
Authors: PERKINS PHILIP D. , RIBERA IGNACIO
Published: September 2020

Three new species of the very rarely collected water beetle genus Adelphydraena Perkins, 1989 are described from Brazil, Guyana, and Suriname. Illustrations of the male genitalia of the two previously known species in the genus, A. orchymonti Perkins and A. spangleri Perkins from Venezuela, are presented for the first time. High resolution digital images of the habitus of all species are given, and geographical distributions mapped. New species described are Adelphydraena amazonica n. sp. (Brazil), A. spinosa n. sp. (Guyana), and A. surinamensis n. sp. (Suriname). Mitochondrial and nuclear DNA sequence data is given for three of the five species currently known (A. orchymonti, A. spangleri, and A. amazonica). The monophyly of the genus Adelphydraena was strongly supported, but relationships between the sequenced species remain uncertain.
The Bavarian Commentary and Ovid
Authors: Wahlsten Böckerman Robin
Published: September 2020

The Bavarian Commentary and Ovid is the first complete critical edition and translation of the earliest preserved commentary on Ovid’s Metamorphoses.

Today, Ovid’s famous work is one of the touchstones of ancient literature, but we have only a handful of scraps and quotations to show how the earliest medieval readers received and discussed the poems—until the Munich Bayerische Staatsbibliothek clm 4610. This commentary, which dates from around the year 1100 is the first systematic study of the Metamorphoses, founding a tradition of scholarly study that extends to the present day.

Despite its significance, this medieval commentary has never before been published or analysed as a whole. Böckerman’s groundbreaking work includes a critical edition of the entire manuscript, together with a lucid English translation and a rigorous and stimulating introduction, which sets the work in its historical, geographical and linguistic contexts with precision and clarity while offering a rigorous analysis of its form and function.

The Bavarian Commentary and Ovid is essential reading for academics concerned with the reception of Ovid or that of other ancient authors. It will also be of great interest for Classical scholars, those investigating medieval commentaries and media history, and for anyone intrigued to know more about how the work of Ovid has echoed through history.
Convective Coupling in Tropical-Depression-Type Waves. Part II: Moisture and Moist Static Energy Budgets
Authors: Feng Tao , Yu Jia-Yuh , Yang Xiu-Qun , Huang Ronghui
Published: September 2020

The companion of this paper, Part I, discovered the characteristics of the rainfall progression in tropical-depression (TD)-type waves over the western North Pacific. In Part II, the large-scale controls on the convective rainfall progression have been investigated using the ERA-Interim data and the TRMM 3B42 precipitation-rate data during June–October from 1998 to 2013 through budgets of moist static energy (MSE) and moisture. A buildup of column-integrated MSE occurs in advance of deep convection, and an export of MSE occurs following deep convection, which is consistent with the MSE recharge–discharge paradigm. The MSE recharge–discharge is controlled by horizontal processes, whereby horizontal moisture advection causes net MSE import prior to deep convection. Such moistening by horizontal advection creates a moist midtroposphere, which helps destabilize the atmospheric column, leading to the development of deep convective rainfall. Following the heaviest rainfall, negative horizontal moisture advection dries the troposphere, inhibiting convection. Such moistening and drying processes explain why deep convection can develop without preceding shallow convection. The advection of moisture anomalies by the mean horizontal flow controls the tropospheric moistening and drying processes. As the TD-type waves propagate northwestward in coincidence with the northwestward environmental flow, the moisture, or convective rainfall, is phase locked to the waves. The critical role of the MSE import by horizontal advection in modulating the rainfall progression is supported by the anomalous gross moist stability (AGMS), where the lowest AGMS corresponds to the quickest increase in the precipitation rate prior to the rainfall maximum.
Multiple Environmental Influences on the Lightning of Cold-Based Continental Cumulonimbus Clouds. Part I: Description and Validation of Model
Authors: Phillips Vaughan T. J. , Formenton Marco , Kanawade Vijay P. , Karlsson Linus R. , Patade Sachin , Sun Jiming , Barthe Christelle , Pinty Jean-Pierre , Detwiler Andrew G. , Lyu Weitao , Tessendorf Sarah A.
Published: September 2020

In this two-part paper, influences from environmental factors on lightning in a convective storm are assessed with a model. In Part I, an electrical component is described and applied in the Aerosol–Cloud model (AC). AC treats many types of secondary (e.g., breakup in ice–ice collisions, raindrop-freezing fragmentation, rime splintering) and primary (heterogeneous, homogeneous freezing) ice initiation. AC represents lightning flashes with a statistical treatment of branching from a fractal law constrained by video imagery.

The storm simulated is from the Severe Thunderstorm Electrification and Precipitation Study (STEPS; 19/20 June 2000). The simulation was validated microphysically [e.g., ice/droplet concentrations and mean sizes, liquid water content (LWC), reflectivity, surface precipitation] and dynamically (e.g., ascent) in our 2017 paper. Predicted ice concentrations (~10 L−1) agreed—to within a factor of about 2—with aircraft data at flight levels (−10° to −15°C). Here, electrical statistics of the same simulation are compared with observations. Flash rates (to within a factor of 2), triggering altitudes and polarity of flashes, and electric fields, all agree with the coincident STEPS observations.

The “normal” tripole of charge structure observed during an electrical balloon sounding is reproduced by AC. It is related to reversal of polarity of noninductive charging in ice–ice collisions seen in laboratory experiments when temperature or LWC are varied. Positively charged graupel and negatively charged snow at most midlevels, charged away from the fastest updrafts, is predicted to cause the normal tripole. Total charge separated in the simulated storm is dominated by collisions involving secondary ice from fragmentation in graupel–snow collisions.
Cloud-Resolving Model Applied to Nowcasting: An Evaluation of Radar Data Assimilation and Microphysics Parameterization
Authors: Vendrasco Eder P. , Machado Luiz A. T. , Ribeiro Bruno Z. , Freitas Edmilson D. , Ferreira Rute C. , Negri Renato G.
Published: September 2020

This research explores the benefits of radar data assimilation for short-range weather forecasts in southeastern Brazil using the Weather Research and Forecasting (WRF) Model’s three-dimensional variational data assimilation (3DVAR) system. Different data assimilation options are explored, including the cycling frequency, the number of outer loops, and the use of null-echo assimilation. Initially, four microphysics parameterizations are evaluated (Thompson, Morrison, WSM6, and WDM6). The Thompson parameterization produces the best results, while the other parameterizations generally overestimate the precipitation forecast, especially WDSM6. Additionally, the Thompson scheme tends to overestimate snow, while the Morrison scheme overestimates graupel. Regarding the data assimilation options, the results deteriorate and more spurious convection occurs when using a higher cycling frequency (i.e., 30 min instead of 60 min). The use of two outer loops produces worse precipitation forecasts than the use of one outer loop, and the null-echo assimilation is shown to be an effective way to suppress spurious convection. However, in some cases, the null-echo assimilation also removes convective clouds that are not observed by the radar and/or are still not producing rain, but have the potential to grow into an intense convective cloud with heavy rainfall. Finally, a cloud convective mask was implemented using ancillary satellite data to prevent null-echo assimilation from removing potential convective clouds. The mask was demonstrated to be beneficial in some circumstances, but it needs to be carefully evaluated in more cases to have a more robust conclusion regarding its use.
Computed Tomography for Acute Appendicitis Diagnosis and Confirmation in Men
Authors: Westfall Kristen M. , Purcell Laura N. , Charles Anthony G.
Published: September 2020

Introduction

The classic findings of acute appendicitis—right lower quadrant pain, anorexia, and leukocytosis—have been well known. However, emergency medicine and surgical providers continue to rely on imaging to confirm the diagnosis. We aimed to evaluate the increase in reliance on computed tomography (CT) scans for acute appendicitis diagnosis over time.

Methods

We conducted a retrospective study of patients ≥18 years presenting to UNC Hospitals with signs and symptoms of acute appendicitis who subsequently underwent appendectomy from 2011 to 2015. Demographic, clinical, laboratory, and pathologic data were reviewed. We evaluated the incidence of CT scans stratified by year, age, and sex.

Results

Within our male population, 55.2% (278/504) had classic appendicitis symptoms. Of the 278 male patients with classic appendicitis symptoms, 248 underwent CT imaging. Male patients <45 years of age were more likely to present with classic appendicitis symptoms (216/357, 60.5%) compared with patients aged 46-65 (52/108, 48.1%) or >65 (10/39, 25.6%). Of the male patients <45 years with classic appendicitis symptoms, the incidence of CT scans increased over time (68.3% in 2011, 84.2% in 2012, 92.3% in 2013, 93.9% in 2014, 92.3% in 2015). When considering the 216 CT scans that could have been avoided in our population, we calculate an approximate savings of $173 998.80 over 5 years.

Conclusion

The incidence of CT scans for acute appendicitis confirmation has increased over time even in men. CT scans for the diagnosis or confirmation of acute appendicitis should rarely be indicated in men aged <45 years with classic appendicitis symptoms.
Only as fast as its troop contributors: Incentives, capabilities, and constraints in the UN’s peacekeeping response
Authors: Lundgren Magnus , Oksamytna Kseniya , Coleman Katharina P
Published: September 2020

International organizations’ ability to respond promptly to crises is essential for their effectiveness and legitimacy. For the UN, which sends peacekeeping missions to some of the world’s most difficult conflicts, responsiveness can save lives and protect peace. Very often, however, the UN fails to deploy peacekeepers rapidly. Lacking a standing army, the UN relies on its member states to provide troops for peacekeeping operations. In the first systematic study of the determinants of deployment speed in UN peacekeeping, we theorize that this speed hinges on the incentives, capabilities, and constraints of the troop-contributing countries. Using duration modeling, we analyze novel data on the deployment speed in 28 peacekeeping operations between 1991 and 2015. Our data reveal three principal findings: All else equal, countries that depend on peacekeeping reimbursements by the UN, are exposed to negative externalities from a particular conflict, or lack parliamentary constraints on sending troops abroad deploy more swiftly than others. By underlining how member state characteristics affect aggregate outcomes, these findings have important implications for research on the effectiveness of UN peacekeeping, troop contribution dynamics, and rapid deployment initiatives.
Causes of sudden death related to oesophageal carcinoma
Authors: Byard Roger W
Published: September 2020

Two cases of recently diagnosed oesophageal squamous-cell carcinomas in men, both aged 72 years, are reported that resulted in rapid clinical deterioration and death from upper-airway occlusion and haemorrhage, respectively. In the first case, direct growth of the tumour from metastatic deposits in the paratracheal lymph nodes through the wall of the trachea resulted in lethal acute airway occlusion. In the second case, local extension of the tumour through the wall of the oesophagus into the adjacent aorta resulted in an aorto-oesophageal fistula which led to catastrophic and fatal haemorrhage. Although rare, oesophageal squamous-cell carcinomas may cause unexpected death due to quite different mechanisms, and result in the need for a detailed medico-legal assessment.
Development of self-care textile wearables with thermally stimulated drug delivery function via biological and physical investigations
Authors: Wai Cheung Tin , Li Li
Published: September 2020

Previous studies have examined and verified the drug loading and releasing functionality from the interior channels of hollow fibers. An integrated design for self-care textile wearables with a thermally stimulated drug delivery function was proposed. To progress the in-depth development of the proposed self-care wearables, physical and biological investigations, including i) liquid release with thermal stimulation and ii) drug release upon thermal stimulation, were conducted. Physical investigation revealed that the concentration of dyes released from the heated specimens increased with higher temperature during the initial first hour of delivery. Moreover, higher cytotoxic effect could be induced with drugs delivered through heated specimens under higher thermal stimulated energy through biological examination. These results set up milestones for demonstrating the influence of thermal energy on different therapeutic requirements, such as rapid-onset transdermal medication.