bluuebunny/crossref_metadata_2025 huggingface dataset:
Active membranes: 3D printing of elastic fibre patterns on pre-stretched textiles
Authors: Agkathidis Asterios , Berdos Yorgos , Brown André
Published: September 2018

There has been a steady growth, over several decades, in the deployment of fabrics in architectural applications; both in terms of quantity and variety of application. More recently, three-dimensional printing and additive manufacturing have added to the palette of technologies that designers in architecture and related disciplines can call upon. Here, we report on research that brings those two technologies together – the development of active membrane elements and structures. We show how these active membranes have been achieved by laminating three-dimensional printed elasto-plastic fibres onto pre-stretched textile membranes. We report on a set of experimentations involving one-, two- and multi-directional geometric arrangements that take TPU 95 and polypropylene filaments and apply them to Lycra textile sheets, to form active composite panels. The process involves a parameterised design, actualised through a fabrication process including stress-line simulation, fibre pattern three-dimensional printing and the lamination of embossed patterns onto a pre-stretched membrane; followed by the release of tension afterwards in order to allow controlled, self-generation of the final geometry. Our findings document the investigation into mapping between the initial two-dimensional geometries and their resulting three-dimensional doubly curved forms. We also reflect on the products of the resulting, partly serendipitous, design process.
Patient Journeys of Nonintegration in Hungary: A Qualitative Study of Possible Reasons for Considering Medical Modalities as Mutually Exclusive
Authors: Zörgő Szilvia , Olivas Hernández Olga L.
Published: September 2018

Introduction: Complementary and alternative medicine (CAM) use has been increasing in the past decades in tandem with changes regarding the notions of health and illness. Comparing conventional medicine (CM) and CAM in how they address health problems has been a point of focus for both the health sciences and individuals dealing with health problems. Various social, cultural, political, economic, and personal factors play a role in whether different health approaches are integrated or not when addressing illness experiences. Methods: The qualitative study comprised semistructured interviews (N = 9) and participant observation involving 105 patients conducted between January 2015 and May 2017 at 4 clinics of Traditional Chinese Medicine in Budapest, Hungary. Code structures were created inductively with Interpretative Phenomenological Analysis. Results: The mutually exclusive view of CM/CAM use occurred due to loss of trust in the doctor-patient relationship causing problems in communication, and also as a result of the patient espousing certain cultural dispositions. Significant dispositions included a preference for the “natural” and psychologization, the latter often manifested in psychosocial etiology, vitalism, and illness symbolism. Discussion: A polarized choice of therapy may occur as a result of a competitive health care market in which medical modalities and their underlying cultural systems compete within a global milieu of information proliferation and a hybridization of individual worldviews. Through a process of “cultural creolization”, changing concepts of health and illness create varying patient expectations and meanings regarding illness, which in turn affect therapy choice as well. Conclusion: Mirrored in the articulation of an individual’s illness trajectory is a tension that is also reflected in the struggles in the health care system to more adequately understand health/illness processes from a pluralistic perspective. The power relations in the health arena (among CAM/CM practitioners and systems) play a role in legitimizing or undermining different health practices, which as consequence affects the possibility of integrating them into the processes of care. Thus, therapy choice is not only linked to changing notions of health and illness, but also to shifting conceptualizations of self, identity, and the practitioner-patient relationship.
The Preferred Perceptual Learning Styles of Hispanic Higher Education Students
Authors: Lui Catherine J. , Ferrin Scott E. , Baum Donald R. , Randall Vance E.
Published: September 2018

This article addresses the question of whether higher education Hispanic students of different nationalities have different perceptual learning style preferences. Independent samples t test results suggest students of non-Mexican heritage prefer visual learning styles more than students of Mexican heritage. ANOVA results show older students and students from families with greater levels of education have greater preference for visual learning, and higher household income is related to lower preferences for group learning style, and vice versa.
Location-assistant content distribution scheme for emergency rescue
Authors: Zhang Guomin , Song Lihua , Wang Haitao , Hu Chao , Wang Na
Published: September 2018

In order to optimize the timeliness and pertinence of message delivery in emergency rescue scenarios and improve the service performance of emergency communications network, we propose a location-assistant content distribution scheme based on delay tolerant network. First of all, considering that the movement patterns of rescue teams tend to follow a predetermined course of action, we design a location-based group mobility model. Due to the intermittent network connectivity and variety of emergency service, a content-classification-based publish/subscribe architecture and a GenericSpray routing algorithm based on the prediction of overlap opportunity in spatio-temporal positions are proposed. Furthermore, we also give a cache management strategy based on the content significance. Since location-assistant content distribution scheme can predict the overlap of activity between rescue teams through the course of action, not only can the number of copy forwarding and message delivery delays be significantly reduced but also the priority delivery of important messages can be ensured by message classification. Simulation experiments show that compared with the traditional delay tolerant network routing algorithm and the classic first-in-first-out caching strategy, location-assistant content distribution scheme improves the performance of message delivery rate, transmission delay, and control overhead significantly.
A multidimensional discrete digital chaotic encryption system
Authors: Li Wangshu , Wang Chuanfu , Feng Kai , Huang Xin , Ding Qun
Published: September 2018

In this article, a new multidimensional discrete chaotic system is proposed, and the characteristics and advantages of the multidimensional discrete chaotic system are analyzed. The multidimensional discrete chaotic system is designed using digital technology, and the system has the complexity of hyper-chaotic system, and it can avoid the choice of step size, at the same time, the design of the circuit is simple, the resource occupancy rate is low, it is suitable for the design of digital system, and so on. It can be used in constructing chaotic sequence generator, chaotic encryption, and visual sensor networks.
ClusterRep: A cluster-based reputation framework for balancing privacy and trust in vehicular participatory sensing
Authors: Wang Jin , Wang Youyuan , Gu Xiang , Chen Liang , Wan Jie
Published: September 2018

In vehicular participatory sensing, vehicles may provide false data or low-quality data. Building trust in vehicular ad hoc networks is an efficient way to deal with this issue. On one hand, vehicles need to disclose necessary information to demonstrate their trustworthiness. On the other hand, vehicles tend to hide their sensitive information to preserve user privacy. Therefore, privacy and trust are conflict in vehicular ad hoc networks. A cluster-based reputation framework named ClusterRep is proposed to balance privacy and trust in vehicular ad hoc networks. In this framework, the cluster head collaborates with cluster members to change pseudonyms and reputation values. The experiments show the scalability and the effectiveness of the ClusterRep compared with Beta strategy and IncogniSense-floor strategy.
Study of the influence of slipper parameters on the power efficiency of axial piston pumps
Authors: Haidak Gaston , Wang Dongyun , Shiju E , Liu Jun
Published: September 2018

This article presents the influence and impact of the gap between the outer and the inner diameter of the slipper on the performance of axial piston pumps. For this, a mathematical model establishing and evaluating the quantities involved in the total power loss is established. Four slippers having a different values of the ratio between their diameters are considered; for which the study and the simulation concerning the fluid film thickness, the forces, the flow and the total power loss between the slipper and the swash plate are developed and compared. After the analysis of all these parameters for different slippers, the results of the simulation show that for each slipper, there are values of the optimum fluid film thickness for which the pump has the minimum in terms of power loss between the slipper and the swash plate. And after the comparison, the favourable ratio between the diameters of the slipper for good lubrication is given. The accuracy between the mathematical model and simulation results is checked, and a discussion is made. Finally, a conclusion based on the results of the lost power is made.
A novel mode controllable hybrid valve pressure control method for soft robotic gripper
Authors: Huang Haiming , Wu Linyuan , Lin Junhao , Fang Bin , Sun Fuchun
Published: September 2018

Compared with traditional rigid gripper with joint-linkage structure, novel soft robotic gripper gives rise to continuous concern for the advantages of no-damage grasping, convenient manufacture, easy control, and low cost. In this study, we design and built two kinds of soft robotic grippers with four fiber-reinforced soft actuators which are distributed in circular and rectangle shapes for single and twin contacts grasping. A novel hybrid valve pneumatic control scheme combining proportional and solenoid valves is proposed. Also, a mode controllable hybrid valve pressure control method is proposed to adjust internal pressure of soft robotic grippers to adapt to different grasping tasks. The experiment results verify that the performances of hybrid valve outperform those of individual proportional valve or solenoid valve in the aspects of response time and steady-state accuracy. The hybrid valve has wide range of pressure regulation, result in that the soft robotic grippers are qualified to grasp various objects with different shapes, sizes, and weights.
A clinical review and introduction of the diagnostic algorithm for thalidomide embryopathy (DATE)
Authors: Mansour Sahar , Baple Emma , Hall Christine M
Published: September 2018

Thalidomide embryopathy results from the ingestion of thalidomide in the first trimester during pregnancy, causing multiple forms of congenital abnormalities of variable severity that involve all systems. The skeletal findings most frequently affect the limbs, particularly the upper limbs and hands. Increasingly, several genetic disorders with similar birth defects have been identified. New cases of malformations owing to possible exposure to thalidomide continue to present through both historical and current usage. However, inadequate proof of ingestion, marked phenotypic variation and the possibility of an alternative genetic condition, hinder the diagnosis of thalidomide embryopathy. We introduce a ‘diagnostic algorithm for thalidomide embryopathy’ (DATE) diagnostic software that can potentially provide a numerical score for the likelihood of birth defects in an individual as being caused by exposure to thalidomide and to provide a differential diagnosis based on the pattern of malformation.
Glycemic Control Maintained over Time and Joint Stiffness in Young Type 1 Patients: What Is the Mathematical Relationship?
Authors: Francia Piergiorgio , Sorelli Michele , Piccini Barbara , Iannone Giulia , Capirchio Laura , Toni Sonia , Gulisano Massimo , Bocchi Leonardo
Published: September 2018

Background:

It is widely known that diabetes can induce stiffness and adversely affect joint mobility even in young patients with type 1 diabetes mellitus (T1D). The aim of this study was to identify a mathematical model of diabetes mellitus long-term effects on young T1D patients.

Methods:

Ankle joint mobility (AJM) was evaluated using an inclinometer in 48 patients and 146 healthy, sex- BMI-, and age-matched controls. Assuming time invariance and linear superposition of the effects of hyperglycemia, the influence of T1D on AJM was formalized as an impulse response putting into relationship past supernormal HbA1c concentrations with the ankle total range of motion. The proposed model was identified by means of a nonlinear evolutionary optimization algorithm.

Results:

AJM was significantly reduced in young T1D patients ( P < .001). AJM in both plantar and dorsiflexion was significantly lower in subjects with diabetes than in controls ( P < .001). The identified impulse response indicates that impaired metabolic control requires 3 months to bring out its maximum effect on the reduction of AJM, while the following long-lasting decay phase with the expected AJM recovery times, normally depends on the slow turnover of collagen. HbA1c concentration levels above 7.2% are sufficient to produce a reduction of ankle ROM.

Conclusions:

In young patients with T1D the lack of glycemic control over time affects AJM. HbA1c levels can serve as a relevant prognostic factor for assessing the progression of LJM in subjects with diabetes.
Association of obesity with colonic findings in screening colonoscopy in a large population‐based study
Authors: Kobiela Jarek , Wieszczy Paulina , Reguła Jarosław , Kamiński Michał F
Published: September 2018

Background and aims

Obesity is associated with an increased incidence of and mortality from colorectal cancer (CRC). Screening colonoscopy seems particularly important for individuals with obesity. The aim of this study is to analyse the characteristics of screening colonoscopy in individuals with obesity.

Methods

We performed a cross‐sectional analysis of records of 75,278 patients from a national colonoscopy screening programme in Poland. The database contained demographic data, colonoscopy results, self‐reported data on weight and height, a standardized screenees’ experience questionnaire and colorectal findings.

Results

Adenoma detection rate and advanced neoplasia detection rate increased significantly in groups of increasing body mass index (BMI). In subjects with morbid obesity, odds ratios for proximal adenoma and proximal advanced neoplasia were 1.69 (95% confidence interval (CI) 1.28–2.21) and 1.66 (95% CI 1.01–2.72), respectively, despite the fact that with BMI increasing over 30 the preparation for colonoscopy was worse. Moreover, caecal intubation increased with increasing BMI. Tolerance of colonoscopy was better and preparation for colonoscopy was less inconvenient in individuals with obesity.

Conclusions

Obesity and morbid obesity are associated with increased detection of colorectal precursor lesions and better performance of screening colonoscopy. Participation in screening colonoscopy should be emphasized among individuals with obesity, taking into account the burden of CRC in this population.
What causes fibromyalgia? An online survey of patient perspectives
Authors: Furness Penny J , Vogt Katharina , Ashe Simon , Taylor Sophie , Haywood-Small Sarah , Lawson Kim
Published: September 2018

Fibromyalgia is a severe chronic pain condition that affects every aspect of life. Causes of the condition remain unclear, and quantitative research cannot account for patients’ personal illness narratives and perceptions. This online survey gathered qualitative accounts of the perceived causes of their condition from 596 people with fibromyalgia, which were analyzed thematically. Themes were “Bodily assault, ill-health, and change”; “Emotional trauma and distress”; “Stress and vulnerability”; and “Explaining and authenticating fibromyalgia.” Discussion focuses on the complexity of causation, the importance of understanding and having symptoms validated, and the potential for benefiting from patient expertise in building better practitioner–client relationships.
What Does It Mean to Be Single in Indonesia? Religiosity, Social Stigma, and Marital Status Among Never-Married Indonesian Adults
Authors: Himawan Karel Karsten , Bambling Matthew , Edirippulige Sisira
Published: September 2018

The increasing number of never-married individuals has become a global phenomenon. Like many Asian countries, the sociocultural standard in Indonesia defines being married as a desirable social achievement, which leaves single adults vulnerable to derogation. Religiosity is also highly valued in Indonesian society, to the extent that those who show religious attributes tend to be positively regarded. This study aims to describe how Indonesian society defines the status and to explore the role of religiosity in overcoming its negative stigma. This is a narrative literature review study of relevant published literature from the last two decades. Our literature analysis showed that religiosity may mitigate the effect of being undervalued both by increasing the capacity to cope and by providing socially valued attributes that are regarded positively by Indonesian society. However, there is a risk that although singles can use religiosity as a primary coping mechanism to manage their social difficulties, society as a whole does not undergo genuine cultural shifts toward accepting a later age for marriage or singlehood as life choices. Although future studies are needed to comprehensively address the issues, the social acts of reducing stigma toward Indonesian singles are urgently needed.
Fusion Rates of Lateral Lumbar Interbody Fusion Using Recombinant Human Bone Morphogenetic Protein-2
Authors: Nourian Ardalan A. , Harrington Justin , Pulido Pamela A. , McCauley Julie C. , Bruffey James D. , Eastlack Robert K.
Published: September 2018

Study Design:

Retrospective observational case series.

Objectives:

Lateral lumbar interbody fusion (LLIF) has been widely performed with recombinant human bone morphogenetic protein-2 (rhBMP-2), but the fusion rates using this graft alternative have not been well studied. We aimed to evaluate fusion rates in 1- and 2-level LLIF with rhBMP-2 and their relationship with fixation, as well as rates of BMP-related complications.

Methods:

Institutional review board (IRB)–approved spine registry cohort of 93 patients who underwent LLIF with rhBMP-2 (71 one-level cases and 22 two-level cases). Minimum 1-year clinical follow-up and computed tomography (CT) scan for fusion assessment. Postoperative CT scans were used to evaluate the rate of fusion in all patients. Instrumentation and complications were collected from chart and imaging review.

Results:

Average age was 65 years (67% female). For 1-level cases, 92% (65/71) had complete fusion and 8% (6/71) had either incomplete or indeterminate fusion. Three of the 6 patients who had incomplete or indeterminate fusion had bilateral pedicle screw instrumentation, 1 patient had unilateral posterior fixation, and 2 had no fixation. In 2-level cases, 86% (19/22) had complete fusion and 14% (3/22) had either incomplete or indeterminate fusion. The 3 patients who had incomplete or indeterminate fusion did not have fixation.

Conclusion:

Interbody fusion rates with rhBMP-2 via LLIF was 92% in 1-level cases and 86% in 2-level cases, indicating that rhBMP-2 may be used as a viable graft alternative to allograft options for LLIF. Higher rates of pseudarthrosis occurred when not using fixation.
Millennials and Gamification: Guerilla Tactics for Making Learning Fun
Authors: Jain Aman , Dutta Debolina
Published: September 2018

Gamification, as a technique to engage members of the millennial generation, has gained considerable traction at workplace. The purpose of this study is to provide a contextual overview of gamification as an effective mechanism aligned with the learning preferences and characteristics of the millennial cohort. The suggested framework helps organizations effectively design and incorporate learning mechanisms appropriate to new cohort entering and dominating the workforce. The insights developed are critical for learning and development professionals and instructional designers in enabling them to create effective and gamified training modules for this cohort.
Quadriceps Strength Deficits After a Femoral Nerve Block Versus Adductor Canal Block for Anterior Cruciate Ligament Reconstruction: A Prospective, Single-Blinded, Randomized Trial
Authors: Runner Robert P. , Boden Stephanie A. , Godfrey William S. , Premkumar Ajay , Samady Heather , Gottschalk Michael B. , Xerogeanes John W.
Published: September 2018

Background:

Peripheral nerve blocks, particularly femoral nerve blocks (FNBs), are commonly performed for anterior cruciate ligament (ACL) reconstruction. However, associated quadriceps muscle weakness after FNBs is well described and may occur for up to 6 months postoperatively. The adductor canal block (ACB) has emerged as a viable alternative to the FNB, theoretically causing less quadriceps weakness during the immediate postoperative period, as it bypasses the majority of the motor fibers of the femoral nerve that branch off proximal to the adductor canal.

Purpose/Hypothesis:

This study sought to identify if a difference in quadriceps strength exists after an ACB or FNB for ACL reconstruction beyond the immediate postoperative period. Beyond the immediate postoperative period, we anticipated no difference in quadriceps strength between patients who received ACBs or FNBs for ACL reconstruction.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A total of 102 patients undergoing primary ACL reconstruction using a variety of graft types were enrolled between November 2015 and April 2016. All patients were randomized to receive an ACB or FNB before surgery, and the surgeon was blinded to the block type. All patients underwent aggressive rehabilitation without functional bracing postoperatively. The time to the first straight-leg raise was reported by the patient. Isokinetic strength testing was performed at 3 and 6 months postoperatively.

Results:

Data for 73 patients were analyzed. There was no significant difference in patient demographics of age, body mass index, sex, or tourniquet time between the FNB (n = 35) and ACB (n = 38) groups. The mean time to the first straight-leg raise was similar, at 13.1 ± 1.0 hours for the FNB group and 15.5 ± 1.2 hours for the ACB group ( P = .134). The mean extension torque at 60 deg/s increased significantly for both the ACB (53.7% ± 3.4% to 68.3% ± 2.9%; P = .008) and the FNB (53.3% ± 3.3% to 68.5% ± 4.1%; P = .006) groups from 3 to 6 months postoperatively. There was also no significant difference in mean extension torque at 60 deg/s or 180 deg/s between the FNB and ACB groups at 3 and 6 months. There were no significant differences in postoperative complications (infection, arthrofibrosis, retear) between groups.

Conclusion:

Although prior studies have shown immediate postoperative benefits of ACBs compared with FNBs, with a faster return of quadriceps strength, in the current study there was no statistically or clinically significant difference in quadriceps strength at 3 and 6 months postoperatively in patients who received ACBs or FNBs for ACL reconstruction.
MSC-derived exosomes ameliorate erectile dysfunction by alleviation of corpus cavernosum smooth muscle apoptosis in a rat model of cavernous nerve injury
Authors: Ouyang Xi , Han Xiaoyan , Chen Zehong , Fang Jiafeng , Huang Xuna , Wei Hongbo
Published: September 2018

Background

This study investigated the therapeutic effects of MSC-derived exosomes (MSC-Exos) on erectile function in a rat model of cavernous nerve injury (CNI).

Methods

MSCs were isolated from rat bone marrow and exosomes were isolated from the supernatants by ultracentrifugation. The tissue explant adherent method was used to isolate and culture corpus cavernosum smooth muscle cells (CCSMCs). MSCs and CCSMCs were identified by flow cytometry, in vitro differentiation or immunofluorescence staining. Thirty-two 10-week-old male Sprague Dawley (SD) rats were divided into four groups: a sham operation group and bilateral CNI groups that received intracavernosal (IC) injection of either PBS, MSCs or MSC-Exos. Four weeks after CNI and treatment, the erectile function of the rats was measured by electrically stimulating the cavernous nerve. The penile tissues were harvested for blinded histologic analysis and western blotting. H2O2 was used to induce apoptosis in the CCSMCs, and a flow cytometer was used to measure the cell viability of the CCSMCs treated with or without exosomes in vitro.

Results

Recovery of erectile function was observed in the MSC-Exos group. The MSC-Exos treatment significantly enhanced smooth muscle content and neuronal nitric oxide synthase in the corpus cavernosum. The ratio of smooth muscle to collagen in the corpus cavernosum was significantly improved in the MSC-Exos treatment group compared to the PBS vehicle group. WB confirmed these biological changes. Cell viability of the CCSMCs was increased in the MSC-Exos-treated groups, and caspase-3 expression was decreased after the MSC-Exos treatment in vivo and in vitro.

Conclusions

Exosomes isolated from MSCs culture supernatants by ultracentrifugation could ameliorate CNI-induced ED in rats by inhibiting apoptosis in CCSMCs, with similar potency to that observed in the MSCs-treated group. Therefore, this cell-free therapy has great potential for application in the treatment of CNI-induced ED for replacing cell therapy.

Graphical abstract

MSC-derived exosomes ameliorate erectile dysfunction in a rat model of cavernous nerve injury
Micro-CT – a digital 3D microstructural voyage into scaffolds: a systematic review of the reported methods and results
Authors: Cengiz Ibrahim Fatih , Oliveira Joaquim Miguel , Reis Rui L.
Published: September 2018

Background

Cell behavior is the key to tissue regeneration. Given the fact that most of the cells used in tissue engineering are anchorage-dependent, their behavior including adhesion, growth, migration, matrix synthesis, and differentiation is related to the design of the scaffolds. Thus, characterization of the scaffolds is highly required. Micro-computed tomography (micro-CT) provides a powerful platform to analyze, visualize, and explore any portion of interest in the scaffold in a 3D fashion without cutting or destroying it with the benefit of almost no sample preparation need.

Main body

This review highlights the relationship between the scaffold microstructure and cell behavior, and provides the basics of the micro-CT method. In this work, we also analyzed the original papers that were published in 2016 through a systematic search to address the need for specific improvements in the methods section of the papers including the amount of provided information from the obtained results.

Conclusion

Micro-CT offers a unique microstructural analysis of biomaterials, notwithstanding the associated challenges and limitations. Future studies that will include micro-CT characterization of scaffolds should report the important details of the method, and the derived quantitative and qualitative information can be maximized.
Synthesis and characterization of thiolated hexanoyl glycol chitosan as a mucoadhesive thermogelling polymer
Authors: Cho Ik Sung , Oh Hye Min , Cho Myeong Ok , Jang Bo Seul , Cho Jung-Kyo , Park Kyoung Hwan , Kang Sun-Woong , Huh Kang Moo
Published: September 2018

Background

Mucoadhesive polymers, which may increase the contact time between the polymer and the tissue, have been widely investigated for pharmaceutical formulations. In this study, we developed a new polysaccharide-based mucoadhesive polymer with thermogelling properties.

Methods

Hexanoyl glycol chitosan (HGC), a new thermogelling polymer, was synthesized by the chemical modification of glycol chitosan using hexanoic anhydride. The HGC was further modified to include thiol groups to improve the mucoadhesive property of thermogelling HGC. The degree of thiolation of the thiolated HGCs (SH-HGCs) was controlled in the range of 5–10% by adjusting the feed molar ratio. The structure of the chemically modified polymers was characterized by
1
H NMR and ATR-FTIR. The sol-gel transition, mucoadhesiveness, and biocompatibility of the polymers were determined by a tube inverting method, rheological measurements, and in vitro cytotoxicity tests, respectively.

Results

The aqueous solution (4 wt%) of HGC with approximately 33% substitution showed a sol-gel transition temperature of approximately 41 °C. SH-HGCs demonstrated lower sol-gel transition temperatures (34 ± 1 and 31 ± 1 °С) compared to that of HGC due to the introduction of thiol groups. Rheological studies of aqueous mixture solutions of SH-HGCs and mucin showed that SH-HGCs had stronger mucoadhesiveness than HGC due to the interaction between the thiol groups of SH-HGCs and mucin. Additionally, we confirmed that the thermogelling properties might improve the mucoadhesive force of polymers. Several in vitro cytotoxicity tests showed that SH-HGCs showed little toxicity at concentrations of 0.1–1.0 wt%, indicating good biocompatibility of the polymers.

Conclusions

The resultant thiolated hexanoyl glycol chitosans may play a crucial role in mucoadhesive applications in biomedical areas.
Injectable hydrogels delivering therapeutic agents for disease treatment and tissue engineering
Authors: Lee Jin Hyun
Published: September 2018

Background

Injectable hydrogels have been extensively researched for the use as scaffolds or as carriers of therapeutic agents such as drugs, cells, proteins, and bioactive molecules in the treatment of diseases and cancers and the repair and regeneration of tissues. It is because they have the injectability with minimal invasiveness and usability for irregularly shaped sites, in addition to typical advantages of conventional hydrogels such as biocompatibility, permeability to oxygen and nutrient, properties similar to the characteristics of the native extracellular matrix, and porous structure allowing therapeutic agents to be loaded.

Main body

In this article, recent studies of injectable hydrogel systems applicable for therapeutic agent delivery, disease/cancer therapy, and tissue engineering have reviewed in terms of the various factors physically and chemically contributing to sol-gel transition via which gels have been formed. The various factors are as follows: several different non-covalent interactions resulting in physical crosslinking (the electrostatic interactions (e.g., the ionic and hydrogen bonds), hydrophobic interactions, π-interactions, and van der Waals forces), in-situ chemical reactions inducing chemical crosslinking (the Diels Alder click reactions, Michael reactions, Schiff base reactions, or enzyme-or photo-mediated reactions), and external stimuli (temperatures, pHs, lights, electric/magnetic fields, ultrasounds, or biomolecular species (e.g., enzyme)). Finally, their applications with accompanying therapeutic agents and notable properties used were reviewed as well.

Conclusion

Injectable hydrogels, of which network morphology and properties could be tuned, have shown to control the load and release of therapeutic agents, consequently producing significant therapeutic efficacy. Accordingly, they are believed to be successful and promising biomaterials as scaffolds and carriers of therapeutic agents for disease and cancer therapy and tissue engineering.
Layer-by-layer assembled polymeric thin films as prospective drug delivery carriers: design and applications
Authors: Park Sohyeon , Han Uiyoung , Choi Daheui , Hong Jinkee
Published: September 2018

Background

The main purpose of drug delivery systems is to deliver the drugs at the appropriate concentration to the precise target site. Recently, the application of a thin film in the field of drug delivery has gained increasing interest because of its ability to safely load drugs and to release the drug in a controlled manner, which improves drug efficacy. Drug loading by the thin film can be done in various ways, depending on type of the drug, the area of exposure, and the purpose of drug delivery.

Main text

This review summarizes the various methods used for preparing thin films with drugs via Layer-by-layer (LbL) assembly. Furthermore, additional functionalities of thin films using surface modification in drug delivery are briefly discussed. There are three types of methods for preparing a drug-carrying multilayered film using LbL assembly. First methods include approaches for direct loading of the drug into the pre-fabricated multilayer film. Second methods are preparing thin films using drugs as building blocks. Thirdly, the drugs are incorporated in the cargo so that the cargo itself can be used as the materials of the film.

Conclusion

The appropriate designs of the drug-loaded film were produced in consideration of the release amounts and site of the desired drug. Furthermore, additional surface modification using the LbL technique enabled the preparation of effective drug delivery carriers with improved targeting effect. Therefore, the multilayer thin films fabricated by the LbL technique are a promising candidate for an ideal drug delivery system and the development possibilities of this technology are infinite.
Clinical development of photodynamic agents and therapeutic applications
Authors: Baskaran Rengarajan , Lee Junghan , Yang Su-Geun
Published: September 2018

Background

Photodynamic therapy (PDT) is photo-treatment of malignant or benign diseases using photosensitizing agents, light, and oxygen which generates cytotoxic reactive oxygens and induces tumour regressions. Several photodynamic treatments have been extensively studied and the photosensitizers (PS) are key to their biological efficacy, while laser and oxygen allow to appropriate and flexible delivery for treatment of diseases.

Introduction

In presence of oxygen and the specific light triggering, PS is activated from its ground state into an excited singlet state, generates reactive oxygen species (ROS) and induces apoptosis of cancer tissues. Those PS can be divided by its specific efficiency of ROS generation, absorption wavelength and chemical structure.

Main body

Up to dates, several PS were approved for clinical applications or under clinical trials. Photofrin® is the first clinically approved photosensitizer for the treatment of cancer. The second generation of PS, Porfimer sodium (Photofrin®), Temoporfin (Foscan®), Motexafin lutetium, Palladium bacteriopheophorbide, Purlytin®, Verteporfin (Visudyne®), Talaporfin (Laserphyrin®) are clinically approved or under-clinical trials. Now, third generation of PS, which can dramatically improve cancer-targeting efficiency by chemical modification, nano-delivery system or antibody conjugation, are extensively studied for clinical development.

Conclusion

Here, we discuss up-to-date information on FDA-approved photodynamic agents, the clinical benefits of these agents. However, PDT is still dearth for the treatment of diseases in specifically deep tissue cancer. Next generation PS will be addressed in the future for PDT. We also provide clinical unmet need for the design of new photosensitizers.
Continuous Erector Spinae Plane and Intrathecal Opioid Analgesia: Novel Regimen Avoiding Thoracic Epidural Analgesia and Systemic Morphine in Open Radical Cystectomy: A Case Series
Authors: Warusawitharana Chinthaka , Tariq Zubair , Jackson Benjamin , Niraj G.
Published: September 2018

There has been a significant shift away from epidural analgesia after radical cystectomy within an enhanced recovery program. Alternative techniques reported including continuous erector spinae plane analgesia require supplemental systemic morphine. A new analgesic regimen is described that avoids both thoracic epidural analgesia and systemic morphine. Three adult patients undergoing open radical cystectomy, who refused thoracic epidural analgesia, were offered continuous erector spinae plane and intrathecal opioid analgesia. Median length of hospital stay was reduced by a third. The novel analgesic regimen may have the potential to enhance recovery after open radical cystectomy.
Implementation of Routine Cognitive Screening in the Preoperative Assessment Clinic
Authors: Sherman Julia B. , Chatterjee Abhirup , Urman Richard D. , Culley Deborah J. , Crosby Gregory J. , Cooper Zara , Javedan Houman , Hepner David L. , Bader Angela M.
Published: September 2018

Traditional systems of anesthesia evaluation do not routinely incorporate cognitive screening into preoperative assessments of vital organ systems. Increasing recognition of the importance of preoperative cognitive assessment of the elderly surgical patient has resulted in a “call to action” from experts in this area. A paradigm shift will be necessary to make this screening routine and not just a research tool. We describe our preliminary experience with developing a training program and implementing routine cognitive screening in a preoperative evaluation clinic. We outline a process showing our successful clinical implementation of sustainable cognitive stratification and documentation of routine cognitive screening.
Recent advances in understanding dendritic cell development, classification, and phenotype
Authors: Schlitzer Andreas , Zhang Wei , Song Mei , Ma Xiaojing
Published: September 2018

Dendritic cells (DCs) play an essential role in the induction of adaptive immune responses against infectious agents and in the generation of tolerance to self-antigens. In this mini-review, we summarize new evidence suggesting that the tissue of residence significantly shapes the last developmental steps of DCs into locally adapted cellular entities, enabling them to perform tissue-specific tasks while maintaining the core DC properties. We also discuss recent advances that have highlighted DCs’ rather complex phenotypic and functional heterogeneity in the tumor microenvironment, based on their physical characteristics, such as activation status, maturity, and polarization, illustrating a key role for DCs in the induction of anti-tumor immunity.
HIV treatment and monitoring patterns in routine practice: a multi-country retrospective chart review of patient care
Authors: Musa Baba M , Ibekwe Everistus , Mwale Stanley , Eurien Daniel , Oldenburg Catherine , Chung Gary , Heller Richard F
Published: September 2018

Background: A study of patient records in four HIV clinics in three sub-Saharan African countries examined routine clinical care patterns and variations.

Methods: Clinic characteristics were described, and patient data extracted from a sample of medical records. Data on treatment, CD4 count and viral load (VL) were obtained for the last visit in the records, dates mainly between 2015 and 2017, patient demographic data were obtained from the first clinic visit.

Results: Four clinics, two in Nigeria, one in Zambia and one in Uganda, all public facilities, using national HIV treatment guidelines were included. Numbers of patients and health professionals varied, with some variation in stated frequency of testing for CD4 count and VL. Clinical guidelines were available in each clinic, and most drugs were available free to patients. The proportion of patients with a CD4 count in the records varied from 84 to 100 percent, the latest median count varied from 269 to 593 between clinics. 35% had a record of a VL test, varying from 1% to 63% of patients. Lamivudine (3TC) was recorded for more than 90% of patients in each clinic, and although there was variation between clinics in the choice of antiretroviral therapy (ART), the majority were on first line drugs consistent with guidelines.  Only about 2% of the patients were on second-line ARTs. In two clinics, 100% and 99% of patients were prescribed co-trimoxazole, compared with 7% and no patients in the two other clinics.

Conclusions: The wide variation in available clinic health work force, levels and frequency of CD4 counts, and VL assessment and treatment indicate sub-optimal adherence to current guidelines in routine clinical care. There is room for further work to understand the reasons for this variation, and to standardise record keeping and routine care of HIV positive patients.
Pulpotomy versus pulpectomy in the treatment of vital pulp exposure in primary incisors. A systematic review and meta-analysis.
Authors: Gadallah Lamia , Hamdy Mahmoud , El Bardissy Adel , Abou El Yazeed Mohamed
Published: September 2018

Background: Early childhood caries is a serious public health problem in both developing and industrialized countries. When caries extend to involve the pulp, various forms of pulp treatment are tried to stimulate tooth repair. The choice of proper technique is as important as choosing between different pharmacotherapeutic agents used in treatment of primary teeth. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure but there is a trend among many dentists to perform pulpectomies for pulp treatment of vital primary anterior teeth. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors.

Methods: We searched Pubmed and Cochrane library databases up to March, 2018, OpenGrey for grey literature and ClinicalTrials.gov for ongoing trials. Randomized controlled trials comparing between pulpotomy and pulpectomy in treatment of vital pulp exposure in primary incisors were included. Primary outcomes were clinical failure and radiological failure. Data synthesis was performed with a pair wise meta-analysis using fixed-effect models.

Results: Four trials were identified for qualitative assessment, only three trials were included in meta-analysis after exclusion of one trial due to its high risk of bias. The pooled results of the longest follow up period for clinical and radiographic failure showed no statistically significant difference between pulpotomy and pulpectomy. The relative risk (RR) was 0.74 with 95% CI 0.46 to 1.21 for radiographic failure and RR 2.69, 95% CI 0.76 to 9.58 for clinical failure.  The evidence was limited by the small number of trials included in the meta-analysis.

Conclusions: Both pulpotomy and pulpectomy can be used successfully in the treatment of vital pulp exposure in primary incisors. Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time.
Tranexamic acid for significant traumatic brain injury (The CRASH-3 trial): Statistical analysis plan for an international, randomised, double-blind, placebo-controlled trial
Authors: Roberts Ian , Belli Antonio , Brenner Amy , Chaudhri Rizwana , Fawole Bukola , Harris Tim , Jooma Rashid , Mahmood Abda , Shokunbi Temitayo , Shakur Haleema ,   CRASH-3 trial collaborators
Published: September 2018

Background: Worldwide, traumatic brain injury (TBI) kills or hospitalises over 10 million people each year. Early intracranial bleeding is common after TBI, increasing the risk of death and disability. Tranexamic acid reduces blood loss in surgery and death due to bleeding in trauma patients with extra-cranial injury. Early administration of tranexamic acid in TBI patients might limit intracranial bleeding, reducing death and disability. The CRASH-3 trial aims to provide evidence on the effect of tranexamic acid on death and disability in TBI patients. We will randomly allocate about 13,000 TBI patients (approximately 10,000 within 3 hours of injury) to an intravenous infusion of tranexamic acid or matching placebo in addition to usual care. This paper presents a protocol update (version 2.1) and statistical analysis plan for the CRASH-3 trial.

Results: The primary outcome is head injury death in hospital within 28 days of injury for patients treated within 3 hours of injury (deaths in patients treated after 3 hours will also be reported). Because there are reasons to expect that tranexamic acid will be most effective in patients treated immediately after injury and less effective with increasing delay, the effect in patients treated within one hour of injury is of particular interest. Secondary outcomes are all-cause and cause-specific mortality, vascular occlusive events, disability based on the Disability Rating Scale and measures suggested by patient representatives, seizures, neurosurgical intervention, neurosurgical blood loss, days in intensive care and adverse events. Sub-group analyses will examine the effect of tranexamic acid on head injury death stratified by time to treatment, severity of TBI and baseline risk.

Conclusion: The CRASH-3 trial will provide reliable evidence of the effectiveness and safety of tranexamic acid in patients with acute TBI.

Registration: International Standard Randomised Controlled Trials registry ( ISRCTN15088122) 19/07/2011, and ClinicalTrials.gov ( NCT01402882) 25/07/2011.
Glucose and glutamine availability regulate HepG2 transcriptional responses to low oxygen
Authors: Lai Alvina G. , Forde Donall , Chang Wai Hoong , Yuan Fang , Zhuang Xiaodong , Orbegozo Rubio Claudia , Song Chun-Xiao , McKeating Jane A.
Published: September 2018

Background: Little is known about the impact of nutrients on cellular transcriptional responses, especially in face of environmental stressors such as oxygen deprivation. Hypoxia-inducible factors (HIF) coordinate the expression of genes essential for adaptation to oxygen-deprived environments. A second family of oxygen-sensing genes known as the alpha-ketoglutarate-dependent dioxygenases are also implicated in oxygen homeostasis and epigenetic regulation. The relationship between nutritional status and cellular response to hypoxia is understudied. In vitro cell culture systems frequently propagate cells in media that contains excess nutrients, and this may directly influence transcriptional response in hypoxia.

Methods: We studied the effect of glucose and glutamine concentration on HepG2 hepatoma transcriptional response to low oxygen and expression of hypoxia inducible factor-1α (HIF-1α). Mass spectrometry confirmed low oxygen perturbation of dioxygenase transcripts resulted in changes in DNA methylation.

Results: Under normoxic conditions, we observed a significant upregulation of both HIF-target genes and oxygen-dependent dioxygenases in HepG2 cells cultured with physiological levels of glucose or glutamine relative to regular DMEM media, demonstrating that excess glutamine/glucose can mask changes in gene expression. Under hypoxic conditions, CA9 was the most upregulated gene in physiological glutamine media while TETs and FTO dioxygenases were downregulated in physiological glucose. Hypoxic regulation of these transcripts did not associate with changes in HIF-1α protein expression. Downregulation of TETs suggests a potential for epigenetic modulation. Mass-spectrometry quantification of modified DNA bases confirmed our transcript data. Hypoxia resulted in decreased DNA hydroxymethylation, which correlated with TETs downregulation. Additionally, we observed that TET2 expression was significantly downregulated in patients with hepatocellular carcinoma, suggesting that tumour hypoxia may deregulate TET2 expression resulting in global changes in DNA hydroxymethylation.  

Conclusion: Given the dramatic effects of nutrient availability on gene expression, future in vitro experiments should be aware of how excess levels of glutamine and glucose may perturb transcriptional responses.