bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of inlet/outlet on thermal performance of naturally ventilated building
Authors: Maher Dhahri , Hana Aouinet , Arjmand Jamal Tabe , Issakhov Alibek , Sammouda Habib , Sheremet Mikhail , Sharma Shubham
Published: July 2021

Ventilation is a way of improving the air quality of rooms by circulation. The position of the inlet and outlet greatly influences the thermal comfort. This attempt proposes to analyse the effect of the position of window openings for a room building with natural ventilation and the air flow and temperature distribution numerically using a commercial computational fluid dynamics (CFD) code. This proposed study consists of (i) approving the numerical model against experimental data gathered in an environment similar to the one used in simulations and (ii) applying the CFD model to explore the results of four varying configurations of ventilator on the natural ventilation system and thermal comfort. For the varying arrangements, the wind speed is 0.2 m⋅s−1 perpendicular to the openings for a wind, (iii) evaluating the comfort level utilizing the Air Diffusion Performance Index (ADPI) on the basis of ASHRAE 55-210 criteria. The obtained results show that the positions of outlet and inlet openings highly affect the performance in the thermal comfort while they have a trivial effect on the occupied zone mean velocity. The computational results showed that the two cases (a) and (b) present results very close to each other with a slight difference at the center of the chamber. Most of the calculated values (effective draft temperature, EDT) are between (−1.7 and 1.1). Then ADPI is over 70% for case (a) and over 75% for case (b), so all points they are located in the comfort zone. The results affirmed also that configuration with inlet openings set at 1.022 m above ground and an outlet opening set at 0.52 m brings about the most applicable solution ventilation efficiency and give the best EDT that fulfills the criteria of ASHRAE 55-210 with an ADPI of ~90%.
The Effects of Gunshot Residue Components (Pb, Ba, and Sb) on the Life History Traits ofLucilia sericata(Diptera: Calliphoridae)
Authors: Kökdener Meltem , Yılmaz Ahmet Fazıl
Published: July 2021

The present study aimed to investigate the impact of gunshot residue (GSR) components (Pb, Sb, and Ba) on the life history parameters of Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae). This experiment was carried out at the Zoology Department, the Ondokuz Mayıs University in 2020. About 50 larvae, respectively were exposed to the chicken liver with four different concentrations of GSR particles and life history parameters recorded. A two-way analysis of variance (Two way ANOVA) was used on the larval weight, and length, development time, percentage of pupal and larval survival. Pearson’s correlation coefficient was used to assess the association between life-history parameters and the concentration of GSR. The total development times decreased with increasing Sb, Ba, and Pb concentrations in the diets 1–3 d when compared to the control The results showed that Ba and Sb significantly decreased larval and pupal survival and GSR decreased the pupa and adult weight as compared to the control. We concluded that life-history parameters of L. sericata are sensitive to GSR residue and heavy metal changes in the environment. The presence of gunshot residue in the corpse should be kept in mind in a criminal investigation.
Evaluating the Effectiveness of the Italian Interlocking Ban: An Empirical Analysis of the Personal Ties Among The Largest Banking and Insurance Groups in Italy
Authors: Ghezzi Federico , Picciau Chiara
Published: July 2021

In 2011, Italy introduced a ban on interlocking directorates in the financial sector, prohibiting members of the boards of directors and of the internal control bodies, as well as top managers of banking, insurance, and financial companies, from holding any such office in a competing company or group. Empirical studies have demonstrated conflicting results concerning the effectiveness of the Italian anti-interlocking provision. Some studies claim that interlocking directorates have decreased but have not been completely eliminated, which suggests possible persisting limits to competition. Other studies instead show the ban to have a procompetitive effect, at least in the banking sector, which would be at odds with a slight reduction in personal ties. Our article addresses this inconsistency by mapping the interlocking directorates among the 25 largest banking groups and the 25 largest insurance groups operating in Italy before and after the introduction of the ban. We show that although interlocking directorates were widespread at the end of 2010, the interlocking ban reached its goal in the banking and insurance sectors. Anticompetitive effects may, however, still exist, especially considering that the anti-interlocking provision does not affect ownership connections among competing financial companies and groups.
Migration distance is a fundamental axis of the slow-fast continuum of life history in boreal birds
Authors: Winger Benjamin M , Pegan Teresa M
Published: July 2021

Seasonal migration is intrinsically connected to the balance of survival and reproduction, but whether migratory behavior influences species’ position on the slow-fast continuum of life history is poorly understood. We found that boreal-breeding birds that migrate long distances exhibit higher annual adult survival and lower annual reproductive investment relative to co-distributed boreal species that migrate shorter distances to winter closer to their breeding grounds. Our study uses “vital rates” data on reproductive output and survivorship compiled from the literature for a species assemblage of 45 species of mostly passerine birds. These species breed sympatrically in North American boreal forests but migrate to a diversity of environments for the northern winter. After controlling for body size and phylogeny, migration distance and apparent annual adult survival are positively related across species. Both migration distance and survival are positively correlated with wintering in environments that are warmer, wetter, and greener. At the same time, longer migrations are associated with reduced time spent on the breeding grounds, lower clutch sizes, and lower fecundity (clutch size × maximum number of broods per year). Although seasonal migration is often associated with high mortality, our results suggest that long-distance migration imposes selection pressures that both confer and demand high adult survival rates. That is, owing to the reproductive cost of long-distance migration, this strategy can only persist if balanced by high adult survival. Our study supports the idea that migration evolves to promote survival of species breeding in seasonal environments. In boreal birds, the evolution of the longest migrations yields the highest survival, but at an inherent cost to annual fecundity. Our results therefore reveal migratory distance as a fundamental axis of the slow-fast continuum that predicts, and is inextricable from, the balance of survival and reproduction.
Comparing minds and machines: implications for financial stability
Authors: Buckmann Marcus , Haldane Andy , Hüser Anne-Caroline
Published: July 2021

Is human or artificial intelligence more conducive to a stable financial system? To answer this question, we compare human and artificial intelligence with respect to several facets of their decision-making behaviour. On that basis, we characterize possibilities and challenges in designing partnerships that combine the strengths of both minds and machines. Leveraging on those insights, we explain how the differences in human and artificial intelligence have driven the usage of new techniques in financial markets, regulation, supervision, and policy-making, and discuss their potential impact on financial stability. Finally, we describe how effective mind–machine partnerships might be able to reduce systemic risks.
COVID-19, conspiracies and manufactured consent
Authors: Kahambing Jan Gresil S
Published: July 2021

Questions about what comes next for the coronavirus disease 2019 pandemic have been posed by the editors to everyone except those who proliferate conspiracy theories. Conspiracy theories have consequences for public health. Making these dangers known can initiate discussions on public trust. The problem is that the pressing concerns of the pandemic have enabled manufactured consent to be a suspicious thing known of the propaganda model more than ever. Although such a model can be put into question, the public must also be able to practice empathy and true choice so that asking and responding to the questions at hand considers a responsibility to public health.
Vanishing mediators in public health during COVID-19
Authors: Kahambing Jan Gresil
Published: July 2021

Public health interventions during the coronavirus disease 2019 pandemic aim to ensure that the lessons learned of the crises can prevent historical recurrences. Such interventions can mean vanishing mediators that must cater to a post-pandemic structure. Learning from large-scale political and scientific histories or advances—emancipatory projects, pandemic histories and vaccine developments—as well as individual agencies—physical activity and exercise—at the moment become crucial in rethinking and enacting utopian possibilities.
The U.K. as a Technological Follower: Higher Education Expansion and the College Wage Premium
Authors: Blundell Richard , Green David A , Jin Wenchao
Published: July 2021

The proportion of U.K. people with university degrees tripled between 1993 and 2015. However, over the same period the time trend in the college wage premium has been extraordinarily flat. We show that these patterns cannot be explained by composition changes. Instead, we present a model in which firms choose between centralized and decentralized organizational forms and demonstrate that it can explain the main patterns. We also show the model has implications that differentiate it from both the exogenous skill-biased technological change model and the endogenous invention model, and that U.K. data fit with those implications. The result is a consistent picture of the transformation of the U.K. labour market in the last two decades.
Fetal programming effects of early weaning on subsequent parity calf performance
Authors: Oattes Jack L , Shao Taoqi , Henley Parker A , Shike Daniel W
Published: July 2021

Mature Simmental × Angus cows [n = 147; body weight (BW) = 590 ± 72 kg] were used to evaluate the effects of early weaning on subsequent parity calf growth performance and carcass characteristics. Cows were assigned to one of two treatments based on their previous calf’s weaning age: early wean (EW) or conventional wean (CW). Dams assigned to the EW treatment had calves previously weaned at 88 ± 6 d of age, whereas dams assigned to the CW treatment had calves previously weaned at 185 ± 6 d of age. Cow BW and body condition scores (BCS) were monitored during the experiment. All cows were managed as a common group from the onset of the experiment at breeding until final pregnancy check of their next production cycle 462 d later. All calves in the experiment were managed as one group and weaned at a single time point, then feedlot performance and carcass characteristics were evaluated. Initial cow BW was different (P < 0.05), so it was included as a covariate for cow BW analysis. There was a treatment × date interaction (P < 0.01) for cow BW and cow BCS. Cow BW was consistently greater for the EW treatment from day 39 to the end of the experiment (P < 0.01). Cow BCS were not different at the onset of the experiment (P = 0.20), although after breeding and throughout lactation, BCS diverged between treatments and the EW treatment consistently had greater (P < 0.01) BCS than the CW treatment throughout the entire subsequent lactation. Gestation length was not different (P = 0.21) between treatments, yet calf birth BW was greater (P = 0.05) for the EW treatment. Neither artificially inseminated pregnancy percentage nor overall pregnancy percentage was different between treatments (P ≥ 0.61). Despite the greater birth BW for the EW treatment and no difference (P = 0.25) in milk production, weaning BW was not different (P = 0.50) between treatments. Feedlot performance measures were not different (P ≥ 0.13) between treatments, including feedlot arrival weight, final BW, average daily gain, dry matter intake, and gain to feed. Final carcass characteristics were not different (P ≥ 0.33) between treatments, including dressing percentage, hot carcass weight, LM area, 12th rib fat thickness, kidney, pelvic, heart fat percentage, USDA yield grade, and marbling score. Thus, early weaning resulted in improved BW and BCS of cows as well as increased birth BW of subsequent calf, although that did not transpire into differences in postnatal growth performance or carcass traits.
Effects of replacing wet distillers grains with supplemental SoyPass in forage-based growing cattle diets
Authors: Spore Tyler J , Carlson Zac E , Wilke Karla H , Erickson Galen E , Klopfenstein Terry J , MacDonald Jim C , Watson Andrea K
Published: July 2021

One hundred twenty individually fed steers (initial BW 283 kg ± 32) were utilized in an 84-d growing trial to evaluate the effects of increased metabolizable lysine from non-enzymatically browned soybean meal (SoyPass) in grass hay-based diets containing wet distillers grains plus solubles (WDGS). The treatments were arranged as a 2 × 3 factorial with two levels of protein supplement as 20% (low; DL20) or 35% (high; DL35) of dietary DM using WDGS as the basal protein source, and three increments of SoyPass (SP) replacing 0%, 30%, or 60% of the WDGS DM in the protein supplement yielding six dietary treatments. Average daily gain (ADG), dry matter intake (DMI), gain:feed (G:F), and plasma urea N (PUN) data were analyzed using the MIXED procedure of SAS as a 2 × 3 factorial. Animal was the experimental unit and fixed effects included body weight block, dietary inclusion of distillers grains (DL20, DL35), dietary inclusion of SoyPass (SP) (3 levels), and DL × SP inclusion interactions. Linear and quadratic interactions between DL and SP inclusion were analyzed using covariate regression. No interactions were detected for ADG between SP and DL (P = 0.76). Additionally, SP had no effect on ADG (P = 0.49). However, ADG was increased for steers consuming the DL35 diet compared to DL20 (1.13 vs. 0.86 kg/d, respectively; P < 0.01). A DL × SP interaction was detected for DMI (P = 0.01). As SP replaced WDGS in the DL35 diet, DMI increased linearly from 8.10 to 8.93 kg/d (P = 0.02). In the DL20 diet, DMI was not different as SP replaced WDGS (P ≥ 0.11). Therefore, G:F tended to decrease linearly (P = 0.06) as SP replaced WDGS in the DL35 diet, while no difference (P ≥ 0.11) was detected in the DL20 diet, suggesting SP contained less energy than WDGS but did improve dietary lysine balance. Furthermore, plasma urea nitrogen (PUN) increased linearly as SP replaced WDGS in the DL20 diet (P < 0.01) but was not affected by SP substitution in the DL35 diet (P ≥ 0.19). When WDGS is fed at a low (20% DM) or high (35% DM) inclusion rate in a forage-based diet, replacing the distillers with a source of protected amino acids supplied through heat-treated soybean meal, did not improve performance. A more concentrated or energy-dense form of amino acids may be beneficial in forage-based growing cattle diets containing 20% distillers grains but is not needed in diets with 35% distillers grains.
Complete Genome Resources for Ralstonia Bacterial Wilt Strains UW763 (Phylotype I); Rs5 and UW700 (Phylotype II); and UW386, RUN2474, and RUN2279 (Phylotype III)
Authors: Steidl Olivia R. , Truchon Alicia N. , Hayes Madeline M. , Allen Caitilyn
Published: July 2021

We share whole genome sequences of six strains from the Ralstonia solanacearum species complex, a diverse group of Betaproteobacteria that cause plant vascular wilt diseases. Using single-molecule real-time technology, we sequenced and assembled full genomes of Rs5 and UW700, two phylotype IA-sequevar 7 (IIA-7) strains from the southeastern United States that are closely related to the R. solanacearum species type strain, K60, but were isolated >50 years later. Four sequenced strains from Africa include a soil isolate from Nigeria (UW386, III-23), a tomato isolate from Senegal (UW763, I-14), and two potato isolates from the Madagascar highlands (RUN2474, III-19 and RUN2279, III-60). This resource will support studies of the genetic diversity, ecology, virulence, and microevolution of this globally distributed group of high-impact plant pathogens.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Endophytic Bacillus subtilis TR21 Improves Banana Plant Resistance to Fusarium oxysporum f. sp. cubense and Promotes Root Growth by Upregulating the Jasmonate and Brassinosteroid Biosynthesis Pathways
Authors: Sun Yunhao , Huang Bingzhi , Cheng Ping , Li Chunji , Chen Yanhong , Li Yongjian , Zheng Li , Xing Juejun , Dong Zhangyong , Yu Guohui
Published: July 2021

The banana (Musa spp.) industry experiences dramatic annual losses from Fusarium wilt of banana disease, which is caused by the fungus Fusarium oxysporum f. sp. cubense (FOC). Pisang Awak banana ‘Fenza No. 1’ (Musa spp. cultivar Fenza No. 1), a major banana cultivar with high resistance to F. oxysporum f. sp. cubense race 4, is considered to be ideal for growth in problematic areas. However, ‘Fenza No. 1’ is still affected by F. oxysporum f. sp. cubense race 1 in the field. TR21 is an endophytic Bacillus subtilis strain isolated from orchids (Dendrobium sp.). Axillary spraying of banana plants with TR21 controls Fusarium wilt of banana, decreasing the growth period and increasing yields in the field. In this study, we established that TR21 increases root growth in different monocotyledonous plant species. By axillary inoculation, TR21 induced a similar transcriptomic change as that induced by F. oxysporum f. sp. cubense race 1 but also upregulated the biosynthetic pathways for the phytohormones brassinosteroid and jasmonic acid in ‘Fenza No. 1’ root tissues, indicating that TR21 increases Fusarium wilt of banana resistance, shortens growth period, and increases yield of banana by inducing specific transcriptional reprogramming and modulating phytohormone levels. These findings will contribute to the identification of candidate genes related to plant resistance against fungi in a nonmodel system and facilitate further study and exploitation of endophytic biocontrol agents.
Efficacy and Safety of Tranexamic Acid in Resection and Endoprosthetic Reconstruction of Distal Femoral Osteosarcomas in Children: A Retrospective Cohort Study
Authors: Sofulu Omer , Ozturk Ozer , Polat Murat , Buyuktopcu Omer , Kesimer Mehmet D. , Erol Bulent
Published: July 2021

Background:

This study aimed to investigate the effect of intravenous tranexamic acid (TXA) on blood loss and transfusion rates in children who underwent resection and endoprosthetic reconstruction of distal femoral osteosarcomas.

Methods:

The medical records of 56 patients who underwent resection and endoprosthetic reconstruction for distal femoral osteosarcomas between 2017 and 2019 were retrospectively reviewed. Patients were divided into 2 groups: group 1 consisted of 25 patients (11 male and 14 female, mean age 15.2±3 y) who received preoperative 15 mg/kg intravenous TXA, and group 2 consisted of 31 control patients (18 male and 13 female, mean age 14.3±2.6 y) who did not receive TXA. The groups were compared based on their total blood loss, intraoperative blood loss, hidden blood loss, postoperative drain output, transfusion requirements, preoperative and postoperative hemoglobin (Hb) and hematocrit (Htc) difference, length of hospital stays, operative time, and complications.

Results:

The mean total blood loss was lower in intravenous TXA group (1247.5±300.9 mL) when compared with control group (1715.7±857.0 mL) (P=0.018). The mean intraoperative blood loss in intravenous TXA group (386±109 mL) was lower than that in control group (977.4±610.7 mL) (P<0.001). Postoperative drain output at 24 and 48 hours was 198.0±61.8 and 72.4±27.4 mL in intravenous TXA group, respectively, and was low compared with 268.4±118.2 and 117.1±67.8 mL in control group (P=0.028 and 0.006). The rate of patients requiring transfusion was significantly lower in intravenous TXA group (56%) than in control group (83.9%). Preoperative and postoperative 6, 24, and 72 hours Hb and Htc differences were significantly lower in intravenous TXA group [(−1.7±1.8 g/dL P<0.001; −2.0±1.5 g/dL P<0.001; −2.3±1.7 g/dL P<0.001, for Hb) (−5.7±4.6, P<0.001; −6.9±4.0, P<0.001; −9.6±9.1, P<0.001, for Htc)]. Intravenous TXA group had shorter hospital stay time in comparison to control group (P<0.001). The operative time was significantly longer in the control group (P<0.05). No increase in pulmonary embolism or venous thromboembolism rate was observed with intravenous TXA use.

Conclusion:

We conclude that administration of intravenous TXA reduces intraoperative and postoperative blood loss, transfusion rates, and hospital stay in resection and endoprosthetic reconstruction of the distal femoral osteosarcomas in children.

Type of Study:

This was a retrospective comparative study.

Level of Evidence:

Level III.
Update on Upper Cervical Injury Classifications
Authors: Vaccaro Alexander R. , Karamian Brian A. , Levy Hannah A. , Canseco Jose A. , Rajasekaran Shanmuganathan , Benneker Lorin M. , Oner F. Cumhur , Kandziora Frank , Schnake Klaus J. , Kepler Christopher K. , Schroeder Gregory D.
Published: July 2021

The upper cervical spine accounts for the largest proportion of cervical range of motion afforded by a complex system of bony morphology and ligamentous stability. Its unique anatomy, however, also makes it particularly vulnerable during both low and high energy trauma. Trauma to this area, referred to as upper cervical spine trauma, can disrupt the stability of the upper cervical spine and result in a wide spectrum of injury. Numerous upper cervical injury classification systems have been proposed, each of which have distinct limitations and drawbacks that have prevented their universal adoption. In this article, we provide an overview of previous classifications, with an emphasis on the development of the new AO Spine Upper Cervical Classification System (AO Spine UCCS).
A Systematic Review of Risk Factors Associated With Distal Junctional Failure in Adult Spinal Deformity Surgery
Authors: McDonnell Jake M. , Ahern Daniel P. , Wagner Scott C. , Morrissey Patrick B. , Kaye Ian D. , Sebastian Arjun S. , Butler Joseph S.
Published: July 2021

Background:

The surgical management of adult spinal deformity (ASD) is a major surgical undertaking associated with considerable perioperative risk and a substantial complication profile. Although the natural history and risk factors associated with proximal junctional kyphosis (PJK) and proximal junctional failure are widely reported, distal junctional failure (DJF) is less well understood.

Study Design:

A systematic review was carried out.

Objectives:

The primary objective is to identify the risk factors associated with DJF. The secondary objective is to delineate the incidence rate and causative factors associated with DJF.

Methods:

A systematic review of articles in Medline/PubMed and The Cochrane Library databases was performed according to preferred reporting items for systematic reviews and meta-analyses guidelines. Data was collated to determine the prevalence of DJF and overall revision rates, and identify potential risk factors for development of DJF.

Results:

Twelve studies were included for systematic review. There were 81/2261 (3.6%) cases of DJF. Overall, DJF represented 27.3% of all revision surgeries. Anterior-posterior surgery had a reduced incidence of postoperative DJF [5.0% vs. 8.7%; P=0.08; relative risk (RR)=1.73], as did patients below 60 years of age at the time of surgery (2.9% vs. 3.9%; P=0.09; RR=1.34). There was a higher incidence of DJF among those patients who received interbody fusion (9.9% vs. 5.1%; P=0.06; RR=1.93) compared with those who did not. However, none of these findings reached statistical significance. There were significantly more rates of DJF for fusions ending on L5 compared with constructs fused to the sacrum (11.7% vs. 3.6%; P=0.02; RR=3.28).

Conclusions:

Cohorts 60 years and above of age at the time of surgery and patients managed with posterior-only fusion or interbody fusion have increased incidences of DJF. Fusion to L5 instead of the sacrum significantly influences DJF rates. However, the quality of available evidence is low and further high-quality studies are required to more robustly analyze the clinical, radiographic, and surgical risk factors associated with the development of DJF after ASD surgery.
Cephalomedullary Nail as a Definitive Antibiotic Spacer for Multidrug Resistant Periprosthetic Infection of a Proximal Femoral Endoprosthesis
Authors: Connors John P. , Lindsay Adam D. , Witmer Daniel K.
Published: July 2021

Introduction:

Periprosthetic hip infections in the setting of massive proximal femoral bone loss pose a complex challenge to both patients and arthroplasty surgeons alike. As these patients are often multiply revised and can be infected with multidrug resistant organisms, the likelihood for a successful outcome with the gold-standard 2-stage revision is significantly diminished, and definitive management is often achieved with amputation or an antibiotic eluting cement spacer. With reduced bone stock and poor soft tissue tension, creation of such a spacer to not only provide local drug delivery, but also achieve length, stability, and confer some degree of mobility to these patients is technically demanding, and has been fraught with mechanical complications in recent literature.

Materials and Methods:

The purpose of this article is to report on a novel technique for definitive management of prosthetic joint infection in the setting of massive proximal femoral bone loss. This is a case of a 61-year-old medically complex patient with an infected proximal femoral endoprosthesis colonized with multidrug resistant bacteria, treated with creation of a novel articulating antibiotic eluting massive proximal femoral cement spacer with a cephalomedullary nail as definitive management.

Results:

In our patient we have had successful suppression of his life-threatening infection and enabled partial weight bearing on the affected extremity at 1 year postoperatively.

Conclusion:

Articulating antibiotic eluting cement proximal femoral spacer with a cephalomedullary nail is a viable surgical option for definitive management of prosthetic joint infection in the setting of massive proximal femoral bone loss.
Immunotherapy in rare ovarian cancer
Authors: Laga Tina , Vergote Ignace , Van Nieuwenhuysen Els
Published: July 2021

Purpose of review

Ovarian cancer (OC) is a heterogeneous disease and a mounting body of evidence shows that a ‘one-size-fits-all’ approach is obsolete. Differences in epidemiology, tumor biology, genetic profiles and treatment responses of these different types necessitate a tumor and patient-specific approach. Ninety percentage consists of epithelial OC with 70% being high-grade serous OC. The other rarer subtypes are low-grade serous (5%), clear cell (12%), endometrioid (11%) and mucinous carcinoma (3%). The remaining 10% are nonepithelial rare OCs: germ cell (3%) and sex-cord stromal tumors (7%).

Recent findings

Over the past few decades, the 5-year survival rates have only improved modestly, therefore novel therapies are urgently needed. Recently, immunotherapy has been introduced into clinical practice in a number of solid tumors. Although preclinical data confirm the presence of an immunogenic microenvironment in a number of ovarian tumor types, no single-agent immune checkpoint inhibitor has been approved hitherto. Identifying suitable treatment combinations, adequate patient selection and thus correct implementation of immunotherapy remain major challenges.

In this review, we focus on the rationale of incorporating immune therapy in rare OC, we summarize the recent developments with preclinical data and results of clinical trials, with particular focus on rare ovarian histological subtypes.
Epigenetic focus on angioimmunoblastic T-cell lymphoma: pathogenesis and treatment
Authors: Tari Gamze , Lemonnier François , Morschhauser Franck
Published: July 2021

Purpose of review

Angioimmunoblastic T-cell lymphoma (AITL) is a frequent peripheral T-cell lymphoma affecting elderly patients with a poor outcome when treated with conventional chemotherapy. Molecular studies revealed a homogenous mutational landscape gathering anomalies in genes regulating the DNA methylation and hydroxymethylation and anomalies in T-cell signalling.

Recent findings

Recent studies indicate that AITL emerges from a TET2 and/or DNMT3A mutated clonal haematopoiesis. This clonal haematopoiesis bearing mutations altering DNA hydroxymethylation can explain the observed coexistence of AITL with myeloid neoplasms. In addition, AITL development requires AITL-specific mutations, such as the RHOAG17V mutations. Combination of TET2 and RHOA

G17V alterations results in the development of AITL-like disease in mouse models. The impact of the presence of these mutations on patient outcome seems limited and new biological factor predicting treatment response and survival remains to be determined. At the therapeutic level, therapies targeting epigenetic changes, such as histone deacetylase inhibitors and the hypomethylating 5-azacytidine agent, could have efficacy in this disease and gave promising results. Recent progress in mouse model development should allow development of new treatments.

Epigenetic changes are frequent in AITL and could be a promising target.
A Second Case of Localized Cutaneous Amyloid Elastosis: Expanding the Discussion of Associations With a Unique Histopathologic Entity
Authors: Roberts Sammie J. , Dittmer Martin R. , Vidal Claudia I. , Sellinger Erin E. , Hurley M. Yadira
Published: July 2021

Amyloid elastosis is an exceedingly rare form of amyloidosis characterized by amyloid material deposited on dermal elastic fibers. Most reported cases have been associated with systemic amyloid light-chain amyloidosis. A single previously reported case of amyloid elastosis showed evidence that the amyloid material was derived from light-chain proteins and was associated with a monoclonal plasma cell infiltrate but failed to demonstrate systemic involvement. As a result, the case was felt to represent localized cutaneous amyloid elastosis. We present a case of localized cutaneous amyloid elastosis that is not associated with a definitive monotypic plasma cell population or with systemic amyloidosis. We also review the clinical and histopathologic features of reported cases of amyloid elastosis and discuss possible etiologic considerations. Because amyloid elastosis can be either localized to the skin or associated with systemic involvement, additional workup to exclude an underlying plasma cell dyscrasia or hematologic malignancy is warranted.
Disproportionate Representation of Children of Color and Parents with Disabilities in the Child Welfare System: The Intersection of Race/Ethnicity, Immigration Status, and Disability
Authors: Loe Irene M. , Buysse Christina A. , deBlank Michelle , Kirshbaum Megan , Augustyn Marilyn
Published: July 2021

CASE:

An almost 5-year-old girl is referred to a developmental-behavioral clinician for developmental evaluation because of language and learning concerns. Her developmental screening in the primary pediatrics office showed scores concerning for delays in communication, social-emotional, gross, and fine motor domains. Her mother has concerns about her language. Her mother's primary language is Spanish, but the patient and her siblings speak primarily English. She speaks in short phrases and sentences with grammatical errors. Her mother understands approximately 75% of what she says, and strangers understand approximately 50%. She uses gestures and facial expression, is social and friendly, demonstrates pretend play, and plays well with her siblings and other children her age. She has occasional meltdowns, but there are no other major behavioral concerns. She feeds herself with utensils and is able to dress herself. She toilet trained recently, at about age 4.5 years.

She did not receive early intervention before age 3 years and had no previous evaluations. She did not attend preschool or child care. Her mother reported that they were referred to the school district twice, but she had trouble requesting the evaluation.

She lives with her parents and 2 brothers. The patient's parents immigrated to the United States from Mexico 7 years ago. They are both farm workers, and extended family members are in Mexico. On reviewing family history, the clinician learns that the patient's mother had trouble learning and attended school until she was 12 years old. She did not receive extra help at school. The child's mother said that she forgets things and “has trouble with reading and writing fast.” The patient's 10-year-old brother has an individualized education plan and is in a substantially separate classroom. He has inclusion activities of recess, art, and music. He receives speech-language therapy and academic support for reading and writing. The patient's mother becomes tearful and shares that Child Protective Services was notified because of her inability to request the school evaluation, but a case was not opened.

Developmental evaluation reveals expressive language at a 33-month-old level and receptive language at a 39-month-old level. Cognitive testing shows extremely low verbal comprehension, borderline visual spatial skills, and fluid reasoning in the low average range. Working memory and processing speed fall in the borderline range. The clinician learns at a follow-up visit that the patient's mother was evaluated by state disability services and has mild intellectual disability.

What is your next step in management? What feedback or resources would you provide to the pediatric clinician and family?
How Can We Achieve Sustainable Development Goal-5: Gender Equality for All by 2030?
Authors: Summerfield Jenny , Regan Lesley
Published: July 2021

The Sustainable Development Goals (SDGs) were launched in 2016 to expand the 2000 Millennium Development Goals. SDG-5 calls on governments to achieve gender equality and empowerment of all girls, highlighting the importance of sexual and reproductive health (SRH). There are large variations across the globe in maternity safety and there is clear evidence that a significant percentage of maternity mortality is preventable through the provision of reliable contraception and safe abortion services for women. If SDG-5 is to be achieved by 2030, it is essential that women have access to appropriate life-saving healthcare and support services.
STRUCTURAL AND FUNCTIONAL MACULAR CHANGES AFTER RETINECTOMY FOR RETINAL DETACHMENT COMPLICATED BY PROLIFERATIVE VITREORETINOPATHY
Authors: Grassi Piergiacomo , Melville Saffron , Hariprasad Anu-Sree , Winder Stephen , Ramkissoon Yashin , Spiteri-Cornish Kurt , Cabrera Raquel G. , Subramani Siddharth , Chawla Anand
Published: July 2021

Purpose:

To report anatomical and functional outcomes of nonprimary retinectomy for rhegmatogenous retinal detachment with Grade C proliferative vitreoretinopathy, to assess the structural and functional macular changes in successful eyes.

Methods:

Retrospective single-center cohort study: one hundred-one consecutive retinectomies of 101 eyes affected by rhegmatogenous retinal detachment with C proliferative vitreoretinopathy between January 2014 and February 2020 were included.

Results:

The mean preoperative best-corrected visual acuity (BCVA) was 1.48 ± 0.71 logarithm of the minimal angle of resolution (20/604 Snellen equivalent). The anatomical success rate was 78.2% after one retinectomy and 83.1% after two retinectomies. The final BCVA ≥ 20/200 was achieved in 29% of cases, 8% gained ≥ 20/80. The final mean postoperative BCVA of successes with oil in situ was 1.68 ± 0.59 (20/957 Snellen equivalent) compared with 1.07 ± 0.63 logarithm of the minimal angle of resolution (20/235 Snellen equivalent) of successes after oil removal (P = 0.00005). Postoperative macular optical coherence tomography was obtained from 60/84 successes (71%). The normal macular profile was found in 3%, whereas majority demonstrated exudative maculopathy (51.5%), macular atrophy (22%), tractional maculopathy (21.5%), and macular disciform scar (2%). Bivariate linear relationship between final central foveal thickness and BCVA was statistically significant (P = 0.000013).

Conclusion:

Satisfactory anatomical and functional outcome is possible after retinectomy for C proliferative vitreoretinopathy. Positive prognostic factors include the removal of oil without redetachment, normal macular status, and lower central foveal thickness. The functional outcome was influenced by macular changes, as final BCVA and central foveal thickness correlated.
Complications of retinopathy of prematurity treatment
Authors: Barnett Joshua M. , Hubbard G. Baker
Published: July 2021

Purpose of review

The purpose of this review is to summarize complications of treatment for retinopathy of prematurity (ROP) and to compare complications of laser and intravitreal antivascular endothelial growth factor (VEGF) injections.

Recent findings

Poor structural outcomes and myopia are more common with laser for severe ROP than with anti-VEGF. Clinical trial data show unfavourable outcomes in 9.1–9.5% of laser treated, and 1.4–3.6% of anti-VEGF treated eyes. Additional randomized trial data show risk for very high myopia (≥-8.00D) to be 3.8 and 51.4% for zone I eyes treated with bevacizumab and laser, respectively. However, anti-VEGF may be complicated by late recurrence and is more likely to require retreatment than laser. Laser often necessitates general anaesthesia with its attendant risks, including worse short-term respiratory outcomes. Neurodevelopmental complications have been reported with anti-VEGF, but existing studies are subject to bias.

Treatment complications are substantially different for the two modalities in common use today. In more severe cases, risk of poor structural outcome and myopia favour treatment with anti-VEGF. In less severe ROP, risk of recurrence and the need for additional treatments may favour laser. Additional data are needed to establish comparative risks of neurodevelopmental complications.
Venous Thromboembolism Among Patients With Inflammatory Bowel Diseases is Not Related to Increased Thrombophilia
Authors: Ollech Jacob E. , Waizbard Amir , Lubetsky Aaron , Kopylov Uri , Goren Idan , Dotan Iris , Yanai Henit
Published: July 2021

Goal:

The aim was to assess whether thrombophilia significantly contributes to the risk of venous thromboembolic events (VTEs) in patients with inflammatory bowel disease (IBD).

Background:

Patients with IBD have a high risk of VTE. The underlying mechanism has been only partially defined.

Methods:

A case-control study in adults with IBD and an episode of VTE (IBD-VTE) were matched and compared with non–IBD patients with a VTE (non–IBD-VTE). The study population was comprised of patients seen in 2 tertiary medical centers in Israel between 2000 and 2013. Characteristics of IBD and risk factors for VTE were retrieved from medical charts, and a comprehensive thrombophilia panel was completed in all patients.

Results:

Forty-four IBD-VTE cases (27 Crohn’s disease) were matched with 127 non–IBD-VTE controls. The majority of VTE had a clear etiology and were considered provoked events. Provoked and unprovoked VTE rates were not different between the 2 groups. Likewise, thrombophilia rates were similar among patients with IBD-VTE and controls (40.9% vs. 53.5%, respectively, P=0.14). However, among patients with unprovoked VTE, thrombophilia rates were significantly lower in the IBD-VTE group compared with controls (42.1% vs. 70.7%, respectively, P=0.03). Among patients with IBD-VTE, an unprovoked event, and negative thrombophilia, 77% had active inflammation at the time of VTE.

Conclusion:

Thrombophilia rates are similar among patients with IBD-VTE and controls but are less common among patients with unprovoked IBD-VTE. This finding suggests that either inflammation or other novel pathways drive VTE in patients with IBD.
The progressive fibrotic phenotype in current clinical practice
Authors: Wells Athol U. , Brown Kevin K. , Cottin Vincent
Published: July 2021

Purpose of review

The progressive fibrotic phenotype (PFP), a term that covers large sub-groups of patients with fibrotic lung diseases that clinically progress despite appropriate usual management, is now an everyday problem for patients and clinicians alike. This review covers recent data that are relevant to major clinical uncertainties.

Recent findings

The clinical relevance of the PFP is covered by a brief review of data from which this entity was constructed. Estimates of the prevalence of the PFP are cited. The importance of an accurate initial diagnosis is emphasized – with refutation of the belief that diagnosis now matters less because of recent antifibrotic trial data. Pivotal trials are reviewed briefly with emphasis on the range of diseases studied and the efficacy signals. Included in this section are analyses of treatment effects in individual diseases and data that validate the progression criteria that define the PFP.

Clinicians can now implement the findings from recent antifibrotic trials in non-idiopathic pulmonary fibrosis lung diseases. However, the appropriate application of recent data requires an understanding of the critical importance of initial diagnosis, key measures of disease progression and knowledge of the strengths and weaknesses of trial data. Important clinical uncertainties not informed by current data include the evaluation of the adequacy of traditional management (before antifibrotic therapy is introduced) and agreement on the exact definition of disease progression that should trigger consideration of antifibrotic therapy.
Case reports of one-lung ventilation using Fuji Uniblocker bronchial blockers for infants under one-year-old in uniportal video-assisted thoracoscopic surgery
Authors: Chang Szu-Ling , Lai Chih-Hung , Chen Guan-Yu , Chou Chia-Man , Huang Sheng-Yang , Chen Yung-Ming , Liu Tsun-Jui , Lai Hui-Chin
Published: July 2021

Introduction:

Uniportal video-assisted thoracoscopic surgery (VATS) for various pulmonary diseases provides advantages of less postoperative pain and earlier post-operative recovery over traditional open surgery. The inherent limitation of this surgical modality in manipulation of surgical instruments renders intra-operative one-lung ventilation a requisite to increase the substantially restricted working space and thus visibility of the surgical filed.

Patient concerns:

Patient 1, an 8-month-old, 9-kg, and 70 cm-in-height male infant was diagnosed as congenital pulmonary airway malformation (CPAM) over left lower lobe.

Patient 2, a 9-month-old, 8-kg and 72 cm-in-height male infant was diagnosed as CPAM over right lower lobe.

Patient 3, an 8-month-old, 8-kg and 67 cm-in-height female infant was diagnosed as CPAM over left lower lobe.

This facilitating one-lung ventilation yet was rarely conducted in infants under one year of age for the extremely small body size, the unavailability of dedicated tools, and therein the very tough techniques demanded.

Diagnosis:

Infants with congenital cystic adenomatoid malformation

Interventions:

Here we report three infants of less than one year of age in whom one-lung ventilation was successfully achieved by intraluminal use of 5-Fr Fuji Uniblocker Bronchial Blocker devices and in turn assisted the completion of uniportal VATS for congenital cystic adenomatoid malformation in unilateral lungs.

Outcomes:

Three infants received VATS under uniblocker smoothly. Patient 1 had two episode of balloon dislodgement and desaturation and solved by re-insertion. And he had subglottic tracheal stenosis which treatment with laser coagulation. Patient 2 had overall blood loss 80 ml. Patient 3 had one episode of desaturation after stapling the bronchus and fiberoptic bronchoscope revealed obstruction by blood and secretion which solved by suction.

Conclusion:

In conclusion, OLV in infants undergoing uniportal VATs could be successfully achieved by Fuji 5 Fr Uniblocker bronchial blockers for as long as 4 hours, as exemplified by our three cases, and balloon poor sealing and dislodgment can be immediately solved by bronchoscope-guided re-positioning without compromising surgical proceeding or outcome.
Effects of nonpharmacological intervention on sleep quality in hemodialysis patients
Authors: Li Hui , Zuo Long , Long Siyu , Li Baifei
Published: July 2021

Background:

Nonpharmacological intervention can improve the sleep quality of hemodialysis patients. However, there are many types of nonpharmacological interventions, which makes it difficult to determine the best one. Therefore, this study carried out network meta-analysis to evaluate the effects of nonpharmacological intervention on sleep quality of hemodialysis patients, so as to provide evidence for the selection of the optimal nonpharmacological intervention for the improvement of sleep quality of hemodialysis patients clinically.

Methods:

Randomized controlled trials on the effects of nonpharmaceutical interventions on sleep quality in hemodialysis patients were conducted by searching English databases (PubMed, Cochrane Library, EMBASE, and Web of Science) and Chinese databases (Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, and China Biomedical Literature Database) on computer. The retrieval time was from the establishment of the database to May 2021. Literature screening, data extraction, and evaluation of the risk of bias in the included studies were conducted independently by two researchers. Data analysis was performed with STATA14.0 and GEMTC 0.14.3 software.

Results:

We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.

Conclusions:

This study will provide the best evidence-based evidence to support the effects of non-pharmacological interventions on sleep quality in hemodialysis patients.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/4BPKT.
Epidemiological analysis of single center of acute poisoning cases based on poisoning treatment platform
Authors: Jun-hua Shen , Jin-song Zhang , Li Qiao , Lei Wang , Bao-feng Zhu , Jia Li , Ying Liu , Jian-Rong Cheng
Published: July 2021

To studied epidemiological characteristics of 493 cases of acute poisoning in Nantong city, Jiangsu province.

Based on the analysis platform of poisoning treatment, adopted single center and prospective investigation method, analyzed data of acute poisoning patients from May 2015 to December 2018 in the second affiliated hospital of Nantong University.

Among 493 patients with acute poisoning, men 227 (46.04%), women 266 (53.96%). Age ranged from 12 to 89 years old, average age 41.6 years. In the occupational distribution, farmers were 30.02%; 351 cases (71.20%) visited the hospital within 6 hours after exposure. Oral exposure poisoning 415 cases (84.18%). Pesticide poisoning accounted for 45.45% of deaths.

Using the poisoning treatment platform to analyze the clinical characteristic had accurately and reliably in Nantong. The fatality rate of pesticide poisoning in cases of acute poisoning is high. Management of highly toxic pesticides should be continued and effective health education on pesticide use should be carried out.