bluuebunny/crossref_metadata_2025 huggingface dataset:
Concepts in cardiac oncology
Authors: Bisceglia Irma , Cartoni Domenico , Petrolati Sandro
Published: November 2020

Cardiac oncology is a subspecialty of cardiology engaging cardiologists and oncologists alike, in order to provide the best possible oncologic treatment for patients at high cardiovascular risk or developing cardio-toxicity during the course of their treatment, thus avoiding discontinuing it, and aiming at improving survival and quality of life. Early diagnosis and the effectiveness of the newer cancer treatments delivered an increasing number of long-term survivors (presently almost 30 million worldwide), at high risk of developing cardiovascular diseases. This predisposition has been correlated not only to the toxic side effects of the oncologic treatment but also to a real vulnerability to the risk factors in this patients population. For decades, the concept of cardio-toxicity in cardiac oncology has been restricted to ventricular dysfunction, but during the last few years the Food and Drug Administration has approved hundreds of new molecules and cardiac oncology has escalated its complexity. The introduction of new target therapy, proteasome inhibitors, immuno-modulators, and inhibitors of the immunitary checkpoint, magnified the concept of cardio-toxicity to a wider definition of ‘cardiovascular toxicity’ incorporating arterial hypertension, ischaemia, cardiomyopathy, myocarditis, arrhythmic complications, long QT, and arterial and venous thrombosis. We are still lacking guidelines on the new and varied forms of toxicity, as well as monitoring strategies in the short- and long-term follow-up.
Is there a relationship between blood pressure values and dementia?
Authors: Desideri Giovambattista , Bocale Raffaella
Published: November 2020

The relationship between arterial hypertension and cognitive decline, two among the conditions with higher prevalence in the elderly population, has gained significant interest, in the scientific community, during the last few years, stemming from the numerous epidemiologic, experimental, and therapeutic evidences suggesting a non-casual correlation between the two conditions. In fact, the brain, for its substantial metabolic and functional complexity, is more susceptible to the harmful effect of high blood pressure than the other target organs. Chronic ischaemic impairment, microvascular damage, and neurodegenerative phenomena are the likely pathophysiologic basis for the correlation between hypertension and cognitive decline. Vascular dementia and Alzheimer’s disease, the two prominent forms of senile dementia, seem to represent the end result of the chronic exposure, during the lifetime, to harmful stimuli, among which the most relevant are the cardiovascular risk factors, at least from an epidemiological perspective. Evidences from interventional studies, although limited, seems to support the concept that to limit the spread of senile dementia, the early optimization of the control of cardiovascular risk factors, first and foremost hypertension, is crucial. The occurrence of a variable degree of mental decline, till overt dementia, in the hypertensive patient, represents the final step of a pathophysiologic process that began many years before. There is, then, the clear opportunity to control the pathophysiologic mechanisms leading to cognitive decline in the hypertensive patient.
Early risk of mortality, cardiovascular events, and bleeding in patients with newly diagnosed atrial fibrillation
Authors: Cavallari Ilaria , Patti Giuseppe
Published: November 2020

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is independently associated with a 1.5- to 2.0-fold higher risk of all-cause death and increased morbidity, in particular for heart failure and stroke. Previous studies have shown that the annual rate of death in AF patients is ∼5%; however, emerging data indicate that the risk of death, but also of thromboembolic and bleeding complications, is highest early after the diagnosis, especially during the first month. In light of these observations, patients with newly diagnosed AF deserve close monitoring and may benefit from a comprehensive care targeting modifiable risk factors for death, such as heart failure, diabetes, renal impairment, and vascular disease. Aim of this report is to focus on timing and causes of death as well as on temporal trends of cardiovascular and bleeding complications in patients with newly diagnosed AF.
The PEP-pyruvate-oxaloacetate node: variation at the heart of metabolism
Authors: Koendjbiharie Jeroen G , van Kranenburg Richard , Kengen Servé W M
Published: November 2020

At the junction between the glycolysis and the tricarboxylic acid cycle—as well as various other metabolic pathways—lies the phosphoenolpyruvate (PEP)-pyruvate-oxaloacetate node (PPO-node). These three metabolites form the core of a network involving at least eleven different types of enzymes, each with numerous subtypes. Obviously, no single organism maintains each of these eleven enzymes; instead, different organisms possess different subsets in their PPO-node, which results in a remarkable degree of variation, despite connecting such deeply conserved metabolic pathways as the glycolysis and the tricarboxylic acid cycle. The PPO-node enzymes play a crucial role in cellular energetics, with most of them involved in (de)phosphorylation of nucleotide phosphates, while those responsible for malate conversion are important redox enzymes. Variations in PPO-node therefore reflect the different energetic niches that organisms can occupy. In this review, we give an overview of the biochemistry of these eleven PPO-node enzymes. We attempt to highlight the variation that exists, both in PPO-node compositions, as well as in the roles that the enzymes can have within those different settings, through various recent discoveries in both bacteria and archaea that reveal deviations from canonical functions.
Orphans at play in Cría cuervos (1976) and Estiu 1993 (2017): Reconsidering the playspace
Authors: Beaney Rachel
Published: November 2020

This article seeks to explore the presentation of play in two child-centred Spanish films. Carlos Saura’s Cría cuervos (1976) and Carla Simón’s Estiu 1993 (2017) demonstrate that playful interactions offer cinematic child protagonists a plethora of ways to speak in the narratives. A reconsideration of the child orphan character in Spanish cinema will allow us to move away from limited understandings of the filmic child of much Civil-War themed cinema as a mute witness or cipher of victimhood. This essay will use a tripartite approach, with the transition to democracy as a lens, examining the beginning of the transition in the 1970s as seen in Cría. The consequences of the transition that are apparent in 1990s cinematic childhoods in Estiu will then also be explored. Through a comparative analysis, I demonstrate that the protagonists frequently turn to play to make sense of the dramatic social and political changes that envelop their world. Both Saura and Simón remind audiences that children were indeed present for, and affected by, the historical events of the Franco regime (in Cría cuervos) and the AIDS crisis of 1980s and 1990s Spain (in Estiu 1993).
Effects of a community health worker delivered intervention on maternal depressive symptoms in rural Tanzania
Authors: Bliznashka Lilia , Yousafzai Aisha K , Asheri Geofrey , Masanja Honorati , Sudfeld Christopher R
Published: November 2020

Maternal depression affects one in four women in sub-Saharan Africa, yet evidence on effective and scalable interventions is limited. Our objective was to evaluate the effect of a community health worker (CHW) delivered home visit responsive stimulation, health and nutrition intervention, and conditional cash transfers (CCTs) for antenatal care and child growth monitoring attendance on maternal depressive symptoms. We conducted a cluster-randomized controlled trial in 12 villages in rural Ifakara, Tanzania (September 2017 to May 2019). Study villages were randomly assigned to one of three arms: (1) CHW, (2) CHW + CCT and (3) Control. Pregnant women and mothers with a child <12 months were enrolled. Maternal depressive symptoms were assessed using a Tanzanian-adapted version of the Hopkins Symptoms Checklist-25 (HSCL-25) after 18 months of follow-up. We used linear mixed-effects models to estimate intervention effects on HSCL-25 scores. Results showed that the CHW intervention significantly reduced HSCL-25 scores as compared with control [unadjusted mean difference (MD) −0.31, 95% confidence interval (CI) −0.47, −0.15]. The CHW + CCT intervention also appeared to lower HSCL-25 scores (MD −0.17, 95% CI −0.33, −0.01), but results were not statistically significant. Our findings showed that a low-intensity CHW-delivered home visit responsive stimulation, health and nutrition intervention, which did not explicitly aim to improve mental health, reduced maternal depressive symptoms, though the precise mechanisms of action remain unknown. CCTs for antenatal care and child growth monitoring appeared to provide limited to no additional benefit. Community-based integrated interventions that broadly consider maternal and child health, development and well-being have the potential to promote maternal mental health in rural Tanzania and similar settings.
Lidocaine activates autophagy of astrocytes and ameliorates chronic constriction injury-induced neuropathic pain
Authors: Yuan Jiaqi , Fei Yue
Published: November 2020

Lidocaine is a commonly used drug to alleviate neuropathic pain (NP). This work aims to investigate the mechanism of lidocaine in alleviating NP. Chronic constriction injury (CCI) rats were established by surgery to induce NP. We observed the mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) of rats. Immunofluorescence staining was performed to determine the LC3/glial fibrillary acidic protein (GFAP)-positive cells. Rat astrocytes were treated with lipopolysaccharide (LPS) to induce CCI, and then treated with lidocaine or 3-MA (autophagy inhibitor). CCK-8 was performed to detect cell proliferation. Western blot and enzyme-linked immunosorbent assay were performed to detect the level of protein and inflammatory factor. CCI rats exhibited a decrease of MWT and TWL, which was effectively abolished by lidocaine. Lidocaine enhanced the number of LC3/GFAP-positive cells in CCI rats. Moreover, lidocaine inhibited the expression of GFAP and p62, and enhanced LC3-II/LC3-I expression in the LPS-treated astrocytes. Lidocaine inhibited the level of TNF-α and IL-1β in the LPS-treated astrocytes. The influence conferred by lidocaine was effectively abolished by 3-MA. In conclusion, our work demonstrates that lidocaine activates autophagy of astrocytes and ameliorates CCI-induced NP. Thus, our study provides a further experimental basis for the mechanism of lidocaine to alleviate NP.
Expression and prognostic significance of NKD2 in ovarian cancer
Authors: Wei Wei , Zheng Lisi , Gao Ying , He Minjun , Yang Fan
Published: November 2020

Purpose

Naked2 (NKD2) is a negative regulator of Wnt signaling pathway and associates with transforming growth factor secretion. The role of NKD2 in ovarian cancer is unknown.

Patients and methods

Gene expression profiles were measured and compared in nine patients by RNA sequencing. NKD2 expressions in ovarian cancer were measured by reverse transcription polymerase chain reaction and western blot. Tissue slides of 79 patients were stained and scored for NKD2 expression. In vitro experiments were conducted to explore the role of NKD2 in ovarian cancer. The prognostic role of NKD2 was evaluated by survival analysis.

Results

NKD2 was upregulated in patients with better survival by mRNA and protein expression. Patients were classified as NKD2-high group (n = 30) and NKD2-low group (n = 49) according to immunohistochemical score. High NKD2 was correlated with lower recurrence rate (P = 0.002) and higher percentage of platinum-sensitive recurrence (P = 0.006). Median progression-free survival was significantly longer for NKD2-high patients than NKD2-low patients (49.1 vs.14.1 months, P < 0.001). Accordingly, there was a significantly difference in terms of overall survival time between two groups (hazard ratio: 3.04; 95% confidence interval: 1.58–5.85, P < 0.001). Multivariate regression suggested that NKD2 was independently prognostic factors in terms of progression-free survival (hazard ratio: 2.91; 95% confidence interval: 1.61–5.27, P < 0.001) and overall survival (hazard ratio: 3.6; 95% confidence interval: 1.80–7.21, P < 0.001). In vitro studies further demonstrated that NKD2 suppressed ovarian cancer cell proliferation, colony formation and cell migration.

Conclusion

NKD2 is a novel prognostic marker and could suppress tumor progression in ovarian cancer.
The effect of redshift degeneracy and the damping effect of viscous medium on the information extracted from gravitational wave signals
Authors: Ning Shou-Li , Xu LiXin
Published: November 2020

Considering the cosmological redshift zc, the mass of GW source extracted from GW signal is 1 + zc times larger than its intrinsic value, and distance between detector and GW source should be regarded as luminosity distance. However, besides cosmological redshift, there are other kinds of redshifts should be considered, which is actually ignored, in the analysis of GW data, such as Doppler redshift and gravitational redshift, so the parameters extracted from GW may deviate from their intrinsic values. Another factor that may affect GW is the viscous medium in propagation path of GW, which may damp the GW with a damping rate of 16πGη. Some studies indicate dark matter may interact with each other, thus dark matter may be the origin of viscosity of cosmic medium. Then the GW may be rapidly damped by the viscous medium that is made of dark matter, such as dark matter ‘mini-spike’ around intermediate-mass black hole. In this article, we mainly discuss how Doppler and gravitational redshift, together with the damping effect of viscous medium, affect the informations, such as the mass and redshift of GW source, extracted from GW signals.
A warm molecular ring in AG Car: composing the mass-loss puzzle
Authors: Bordiu C , Bufano F , Cerrigone L , Umana G , Rizzo J R , Buemi C S , Leto P , Cavallaro F , Ingallinera A , Loru S , Trigilio C , Riggi S
Published: November 2020

We present APEX observations of CO J = 3 → 2 and ALMA observations of CO J = 2 → 1, 13CO J = 2 → 1, and continuum towards the Galactic luminous blue variable AG Car. These new observations reveal the presence of a ring-like molecular structure surrounding the star. Morphology and kinematics of the gas are consistent with a slowly expanding torus located near the equatorial plane of AG Car. Using non-LTE line modelling, we derived the physical parameters of the gas, which is warm (∼50 K) and moderately dense (∼103 cm−3). The total mass of molecular gas in the ring is 2.7 ± 0.9 M⊙. We analysed the radio continuum map, which depicts a point-like source surrounded by a shallow nebula. From the flux of the point-like source, we derived a current mass-loss rate of $\dot{M} = (1.55\pm 0.21)\times 10^{-5}\, \mathrm{M}_{\odot}$ yr−1. Finally, to better understand the complex circumstellar environment of AG Car, we put the newly detected ring in relation to the main nebula of dust and ionized gas. We discuss possible formation scenarios for the ring, namely, the accumulation of interstellar material due to the action of the stellar wind, the remnant of a close binary interaction or merger, and an equatorially enhanced mass-loss episode. If molecular gas formed in situ as a result of a mass eruption, it would account for at least a $30{{\ \rm per\ cent}}$ of the total mass ejected by AG Car. This detection adds a new piece to the puzzle of the complex mass-loss history of AG Car, providing new clues about the interplay between LBV stars and their surroundings.
Competition for Flow and Short-Termism in Activism
Authors: Burkart Mike , Dasgupta Amil
Published: November 2020

We develop a dual-layered agency model to study blockholder monitoring by activist funds competing for investor flow. Competition for flow affects the manner in which activist funds govern as blockholders. In particular, funds inflate their short-term performance by increasing payouts that are financed by higher (net) leverage. Doing so subsequently discourages value-creating interventions during economic downturns because of debt overhang. Our theory suggests a new channel via which asset manager incentives may foster economic fragility and links together the observed procyclicality of activist investments with the documented effect of such funds on the leverage of their target companies. (JEL G34, G23)

Received July 2, 2020; editorial decision August 8, 2020; Editor Uday Rajan.
Financing Corporate Growth
Authors: Frank Murray Z , Sanati Ali
Published: November 2020

Considerable research tackles the aggregate impact of debt financing. We show that equity is more important for firm growth than generally understood. A dollar of equity issuance is associated with an extra $\$0.93$ of real assets, whereas a dollar of debt issuance is associated with an extra $\$0.14$. Firms issue equity first, then increase real assets, and, finally, issue debt while repurchasing equity. We explain this sequence using a model in which debt is tax preferred relative to equity but is subject to limited commitment. We use the estimated model to evaluate how several government policies affect corporate growth.
Collagens in primary frozen shoulder: expression of collagen mRNA isoforms in the different phases of the disease
Authors: Marker Line , Schjerling Peter , Mackey Abigail L , Hansen Thomas , Jakobsen Jens , Kjær Michael , Krogsgaard Michael R
Published: November 2020

Objectives

Primary frozen shoulder (pFS) has three phases that differ in clinical presentation. It is characterized by contracture of the joint capsule. We hypothesized that there is a general upregulation of collagens in pFS, and that this is highest in the first phase of the disease. The aims of this study were to investigate the expression of various collagens and degradation of collagens in patients with primary pFS and relate this to the three phases of the condition.

Methods

From twenty-six patients with pFS and eight control patients with subacromial impingement, biopsies were obtained during shoulder arthroscopy from the middle glenohumeral ligament and the anterior capsule, and mRNA levels for collagens, MMP-2 and -14 and TGF-β1, - β2 and -β3 in the tissue were analysed using real-time PCR.

Results

Genes for collagens type I, III, IV, V, VI and XIV, were activated in pFS, and the total mRNA for all collagens was increased (P < 0.05). This upregulation was independent of disease phases in pFS. In addition, MMP-2, MMP-14, TGF-β1 and TGF-β3 were upregulated in all phases of the disease.

Conclusion

There is a general upregulation and an increased degradation of collagens in pFS in all three phases of the disease. This indicates a constantly increased turnover of the fibrotic tissue in the capsule from pFS. The difference in clinical presentation of pFS observed in the three phases of the disease is not primarily a result of variations in collagen production.
Cognitive Aids in Obstetric Units: Design, Implementation, and Use
Authors: Abir G. , Austin N. , Seligman K.M. , Burian B.K. , Goldhaber-Fiebert S.N.
Published: November 2020

(Anesth Analg. 2020;130:1341–1350)

Entire multidisciplinary teams are required for effective responses to obstetric crisis situations. Evidence for the benefits of cognitive aid tools in helping such teams successfully coordinate their responses exist, but challenges in regards to proper design, use, and implementation of such tools hinder their effectiveness. The authors’ intent of this current article was 2-fold: first, to summarize currently available resources, and second, to explore existing gaps which could be used to motivate advancement in the field of cognitive aid tools.
The Most Influential Publications in Obstetric Anesthesiology, 1998-2017: Utilizing the Delphi Method for Expert Consensus
Authors: Reale S.C. , Tsen L.C. , Camann W.R. , Bateman B.T. , Farber M.K.
Published: November 2020

(Anesth Analg. 2020;131:239–244)

Obstetric anesthesiology has seen many advances in the past 20 years. Identifying publications that have substantially influenced not only the practice of obstetric anesthesiology but also that of medicine, have relied upon analyses of bibliometric data or cited references, or a nomination process by select experts or panelists. This study sought to use the Delphi method to identify the most influential publications in the field of obstetric anesthesiology.
Incidences of Obstetric Outcomes and Sample Size Calculations: A Danish National Registry Study Based on All Deliveries From 2008 to 2015
Authors: Hoegh S. , Thellesen L. , Christensen K.B. , Bergholt T. , Hedegaard M. , Sorensen J.L.
Published: November 2020

(Acta Obstet Gynecol Scand. 2020;99:34–41)

As adverse obstetric outcomes become less frequent in high-income countries, the ability to demonstrate significant effects of new interventions becomes more challenging. This is because many study designs do not have adequate statistical power to validate rare outcomes attributed to a specific intervention. The aim of this study was to report the incidence of relevant obstetric outcomes from existing literature and based on this data, to calculate sample sizes needed for tentative future randomized clinical trials (RCTs) to ensure the quality of scientific findings.
Do Obstetricians Apply the National Guidelines? A Vignette-based Study Assessing Practices for the Prevention of Preterm Birth
Authors: Rousseau A. , Azria E. , Baumann S. , Deneux-Tharaux C. , Senate M.V.
Published: November 2020

(BJOG. 2020;127:467–476)

While clinical guidelines are developed by synthesizing scientific evidence with the intent to assist clinicians’ in decision-making, studies show generally low levels of adherence to those guidelines, especially in obstetrics. This may be in part to inadequate dissemination of guidelines. International guidelines for the management of spontaneous preterm birth have been recently issued, yet management practices continue to vary widely. This study aimed to describe clinician practices for preventing spontaneous preterm birth before and following guideline issuance and identify factors that may affect adherence to guidelines.
Association Between Perinatal Anemia and Postpartum Depression: A Prospective Cohort Study of Japanese Women
Authors: Maeda Y. , Ogawa K. , Morisaki N. , Yoshiyuki T. , Horikawa R. , Sago H.
Published: November 2020

(Int J Gynecol Obstet. 2020;148:48–52)

Anemia affects >40% of women in the world and can cause symptoms of fatigue, irritability, apathy, and depression. Because of these symptoms, anemia during pregnancy or the postpartum period has been identified as a possible physiological risk factor for postpartum depression (PPD). The aim of this study was to review the association between anemia and PPD in the second trimester, third trimester, and postpartum period.
Apgar Score and Risk of Neonatal Death Among Preterm Infants
Authors: Cnattingius S. , Johansson S. , Razaz N.
Published: November 2020

(N Engl J Med. 2020;383:49–57)

Neonatal death in preterm infants is associated with a number of factors, including gestational age, sex, and Apgar scores. Yet, as a predictor of neonatal survival, a low Apgar score may reflect biological immaturity in an otherwise healthy infant rather than fetal depression. Moreover, a recent policy statement of the American Academy of Pediatrics stated that the Apgar score should not be used as a predictor for individual neonatal mortality or neurological outcome. Because of this, the value of the Apgar score has been called into question. The aim of this study was to investigate the associations between the risk of neonatal death and Apgar scores and gestational age.
Universal Screening for SARS-CoV-2 in Women Admitted for Delivery
Authors: Sutton D. , Fuchs K. , D’Alton M. , Goffman D.
Published: November 2020

(N Engl J Med. 2020;382:2163–2164)

The obstetrical population in New York City presents a unique challenge during the current SARS-CoV-2 pandemic, as patients typically interact with the health care system multiple times before eventually being admitted to the hospital for delivery. Following 2 initially asymptomatic but ultimately SARS-CoV-2 positive patients, universal nasopharyngeal swab testing was implemented for all women admitted for delivery at this institution.
The Physiology of Intrapartum Fetal Compromise at Term
Authors: Turner J.M. , Mitchell M.D. , Kumar S.S.
Published: November 2020

(Am J Obstet Gynecol. 2020;222:17–26)

Nearly a quarter (23%) of neonatal deaths are estimated to be caused by intrapartum complications. Perinatal hypoxia is a major cause of stillbirth, hypoxic ischemic encephalopathy, and cerebral palsy. Three quarters of cases of severe fetal hypoxia are caused by uterine contractions, which reduce uteroplacental perfusion by as much as 60%. While most fetuses can tolerate some reduction of placental perfusion, some cannot. This paper reviewed the physiology of placental development, mechanisms by which intrapartum hypoxia at term manifests in fetuses, and methods of identifying at-risk fetuses.
Umbilical Cord Abnormalities and Stillbirth
Authors: Hammad I.A. , Blue N.R. , Allshouse A.A. , Silver R.M. , Gibbins K.J. , Page J.M. , Goldenberg R.L. , Reddy U.M. , Saade G.R. , Dudley D.J. , Thorsten V.R. , Conway D.L. , Pinar H. , Pysher T.J.
Published: November 2020

(Obstet Gynecol. 2020;135:644–652).

Colloquially known as “cord accidents,” stillbirths due to umbilical cord abnormalities occur when blood supply through the umbilical cord is disrupted severely enough to cause fetal death. Unfortunately, the reported rates of umbilical cord abnormalities associated with stillbirth range widely from 2.5% to 30%, and the diagnostic criteria for these abnormalities have not been clearly defined. This study aimed to rigorously characterize stillbirths associated with cord abnormalities, and further examine the maternal and clinical factors associated with these perinatal losses.
Low-dose Aspirin for the Prevention of Preterm Delivery in Nulliparous Women With a Singleton Pregnancy (ASPIRIN): A Randomized, Double-blind, Placebo-controlled Trial
Authors: Hoffman M.K. , Goudar S.S. , Kodkany B.S. , Metgud M. , Somannavar M. , Okitawutshu J. , Lokangaka A. , Tshefu A. , Bose C.L. , Mwapule A. , Mwenechanya M. , Chomba E. , Carlo W.A. , Chicuy J. , Figueroa L. , Garces A. , Krebs N.F. , Jessani S. , Zehra F. , Saleem S. , Goldenberg R.L. , Kurhe K. , Das P. , Patel A. , Hibberd P.L. , Achieng E. , Nyongesa P. , Esamai F. , Liechty E.A. , Goco N. , Hemingway-Foday J. , Moore J. , Nolen T.L. , McClure E.M. , Koso-Thomas M. , Miodovnik M. , Silver R. , Derman R.J.
Published: November 2020

(Lancet. 2020;395:285–293)

Preterm birth is a common cause of infant morbidity and mortality, especially in low- and middle-income countries with limited resources. Previous studies of aspirin used to prevent preeclampsia also suggested that low-dose aspirin may help lower the incidence of preterm births. However, no large-scale trial has specifically evaluated the use of low-dose aspirin initiated in early pregnancy with the primary purpose of preventing preterm birth. The aim of this study (the ASPIRIN trial) was to determine if low-dose aspirin administered daily starting in early pregnancy reduced the incidence of preterm delivery.
Effectiveness of Nitrous Oxide in External Cephalic Version on Success Rate: A Randomized Controlled Trial
Authors: Douchez V. , Esbelin J. , Misbert E. , Arthuis C. , Drouard A. , Badon V. , Fenet O. , Thubert T. , Winer N.
Published: November 2020

(Acta Obstet Gynecol Scand. 2020;99:391–398)

Successful external cephalic version (ECV) can reduce the likelihood of cesarean delivery and other adverse outcomes. Both the overall rate of ECV and the success rate may be increased by decreasing the pain involved in ECV. Regional anesthesia is effective in ECV but has some negative effects. Nitrous oxide is less invasive and is used during labor. This study aimed to assess the success rate of ECV with nitrous oxide mixed with oxygen (N2O/O2).
Association Between Neuraxial Analgesia and Postpartum Opioid Use Following Vaginal Delivery
Authors: Badreldin N. , Grobman W.A. , Yee L.M.
Published: November 2020

(Am J Obstet Gynecol. 2020;222:278–279)

While neuraxial analgesia is highly effective and the most common pain management strategy during labor, there is a lack of information on opioid consumption following vaginal delivery with neuraxial analgesia. This study aimed to investigate the association between intrapartum neuraxial analgesia for vaginal delivery and postpartum opioid use.
Variation in the Temperature of Local Anaesthetic During Spinal Anaesthesia Influences Shivering in Cesarean Section Patients
Authors: Khan R.M. , Kaul N. , Haris A. , Al Jadidi A.
Published: November 2020

(Acta Anaesthesiol Scand. 2020;64:1028)

This letter responds to the findings of the study above by Wódarski and colleagues that analyzed risk factors for shivering during cesarean section. The authors of this letter note that Wódarski and colleagues did not include the temperature of injected intrathecal local anesthetic and narcotic as a potential cause of shivering. Having recently studied this, they found that the incidence of shivering in patients undergoing cesarean section was 14% versus 62% when the intrathecal injectate was at 37°C versus 22°C, respectively. They hypothesize that this relationship is due to thermosensitivity in the spinal cord, which produces heat gain and loss mechanisms—including shivering—in response to local changes in temperature. Overall, this letter argues that temperature of injected local anesthetic may be an important risk factor for shivering in patients undergoing cesarean section with spinal anesthesia.
Personalized Analgesic Management for Cesarean Delivery
Authors: Carvalho B. , Habib A.S.
Published: November 2020

(Int J Obstet Anesth. 2019;40:91–100)

Women often experience postoperative pain after cesarean delivery; this pain has been associated with many adverse effects, including increased opioid use, delayed functional recovery, increased risk of postpartum depression, decreased breastfeeding success, and chronic pain. The current one-size-fits-all analgesic management strategy for women undergoing cesarean delivery is often inadequate. This review explored a personalized pain management plan which considers adaptations for women who may be more likely to experience more severe pain, and outlines methods to identify at-risk women and involve patients in decision-making.
Early Lymphopenia and Infections in Nontraumatic Subarachnoid Hemorrhage Patients
Authors: Attanasio Laila , Grimaldi David , Akhtar Ramiz Raja , Schuind Sophie , Scolletta Sabino , Adinolfi Luigi E. , Creteur Jacques , Taccone Fabio S. , Gouvêa Bogossian Elisa
Published: November 2020

Introduction:

Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality. A certain degree of immunodepression has been reported during critical illness, and lymphopenia identified as an independent predictor of poor outcome; no data are available for critically ill SAH patients. We aimed to evaluate the prevalence of lymphopenia among SAH patients and its association with hospital-acquired infection.

Methods:

Retrospective cohort study of adult patients admitted to an intensive care unit with nontraumatic SAH between January 2011 and May 2016. Lymphocyte count was obtained daily for the first 5 days; lymphopenia was defined as lymphocyte count <1000/mm3. The occurrence of infection during the first 21 days after hospital admission, hospital mortality, and unfavorable neurological outcome (Glasgow Outcome Scale score 1 to 3 at 3 mo) were recorded.

Results:

Data from 270 patients were analyzed (median age 54 y; male 45%); 121 (45%) patients had lymphopenia and 62 (23%) patients developed infections. Median (25th to 75th percentiles) lymphocyte count at hospital admission was 1280 (890 to 1977)/mm3. Lymphopenia patients had more episodes of infection (38/121, 31% vs. 24/139, 17%; P=0.003) than nonlymphopenia patients, while mortality and unfavorable outcome were similar. Lymphopenia was not independently associated with the development of infection, unfavorable neurological outcome or with mortality.

Conclusions:

Early lymphopenia is common after SAH, but is not significantly associated with the development of infections or with poor outcome.
Agent-Based Modeling Simulation of Nurse Medication Administration Errors
Authors: Berg Thomas A. , Li Xueping , Sawhney Rupy , Wyatt Tami
Published: November 2020

It has been 20 years since the National Academy of Medicine released its report, “To Err Is Human,” which shocked the healthcare community on the pervasiveness of medical error. While errors in medication administration are a significant contributor to medical error, research seeking to understand the complex systems nature and occurrence of medication administration error is limited. Computer modeling is increasingly being used in the healthcare industry to assess the impact of changes made to healthcare processes. The objective of the study is to evaluate the use of agent-based modeling, a type of computer modeling that allows the simulation of virtual individuals and their behavior, to simulate nurse performance in the medication administration process. The model explores the effect of Just-in-Time information, as an intervention, on the occurrence of medication error. The model demonstrated significant utility in understanding the interplay of the system elements of the nurse medication administration process. Therefore this approach, using systems-level computer simulation such as agent-based models, can help administrators understand the effects of changes to the medication administration process as they work to reduce errors and increase performance.
Hypopigmented Mycosis Fungoides: A Clinical and Histopathology Analysis in 9 Children
Authors: Chen Yunliu , Xu Jiaosheng , Qiu Lei , Fu Libing , Liang Yuan , Wei Li , Xiang Xin , Wang Zhaoyang , Xu Zigang , Ma Lin
Published: November 2020

Background:

Hypopigmented mycosis fungoides (HMF) is an uncommon variant of mycosis fungoides.

Aims:

To study the clinical and histopathology presentation in children with HMF.

Method:

We reviewed 9 children diagnosed with HMF. The clinical data were collected and analyzed.

Result:

Eight boys and 1 girl were included, with a median onset age of 7.4 year old and median age of diagnosis of 10.5 year old. Multiple hypopigmented patches were observed in all patients, and 5 patients exhibited multiple scaly erythema at the center of hypopigmented patches. Histopathology showed atypical lymphocytes with hyperchromatic, irregular, and cerebriform nuclei, infiltrated in the epidermis and dermis. Pautrier's microabscesses was noted in 6 of 9 patients, and papillary dermal fibroplasia was noted in 6 of 9 patients. CD8 predominance was detected in 4 of 6 patients. Four patients were simultaneously subjected to skin biopsy on hypopigmented patches and scaly erythema simultaneously. Compared with hypopigmented specimens, erythema biopsy detected deeper and denser infiltration of atypical lymphoid cells in 3 of 4 patients, higher CD4+/CD8+ ratio in 4 of 4 patients, more CD5 loss in 2 of 4 patients, and more CD7 loss in 2 of 4 patients. TCR gene monoclonal rearrangement was detected in 2 of 5 patients. Narrowband ultraviolet B phototherapy was applied in 7 patients. One of 7 patients achieved complete response, and 6 of 7 patients achieved partial response. No recurrence was noted with the median follow-up period of 6 months.

Conclusion:

HMF could occur in young patients, with indolent and benign course. HMF could gradually seem as scaly erythema based on hypopigmented patches. The histopathology indicated a more advanced stage of the scaly erythema lesions than hypopigmented patches.
Serum essential trace elements and toxic metals in Chinese diabetic retinopathy patients
Authors: Zhu Xinmiao , Hua Rui
Published: November 2020

Trace elements are essential for the proper functioning of proteins, enzymes, and transcriptional factors. However, toxic metals will compete with essential trace elements, and damage enzymatic activities and various physiological functions. We aimed to investigate the status of serum essential trace elements and toxic metals in Chinese diabetic retinopathy (DR) patients, and to analyze their associations.

This retrospective study included 33 normal subjects (normal group), 44 type 2 diabetes mellitus (T2D) patients with DR (DR group), and 58 T2D patients without DR (diabetes mellitus [DM] group). Serum levels of zinc (Zn), manganese (Mn), cadmium (Cd), and cesium (Cs), were measured for all participants using inductively coupled plasma-mass spectrometry.

The serum concentrations of Mn (0.0226 μg/L) and Zn (98.162 μg/L) were significantly lower in DR group, compared with both the DM group and normal group (P < 0.05). In contrast, the serum levels of Cs (0.0354 μg/L) and Cd (0.0149 μg/L) were significantly higher in DR group, compared with the normal group (Cs: z = 3.136, P = .002; Cd: z = 3.766, P < .0001). Similarly, the serum Cs level in the DM group was 0.0323 μg/L, which was significantly higher than that in the normal group (0.0167 μg/L, z = 2.692, P = .007). Moreover, the area under the receiver-operating characteristic curve values of Mn (0.753 [95% confidence interval, CI 0.635–0.872, P = .002]), and Cd (0.797 [95% CI 0.643–0.952, P = .003]) were significantly greater than those of Zn and Cs, for DR identification.

Our results suggest that deficient essential trace elements and accumulated toxic metals were highly associated with the presence of DR.
Group congruent labelling leads to subjective expansion of time
Authors: Tewari Shruti , Makwana Mukesh , Srinivasan Narayanan
Published: November 2020

Given top-down effects on perception, we examined the effect of group identity on time perception. We investigated whether the duration of an ambiguous sound clip is processed differently as a function of group congruent or incongruent source attribution. Group congruent (in-group) and incongruent (out-group) context was created by attributing the source of an identical ambiguous sound clip to Hindu or Muslim festivals. Participants from both the religious groups (Hindus and Muslims) prospectively listened to a 20 s long ambiguous sound clip and reproduced its duration (experiment 1a). Both groups reproduced significantly longer durations when the sound clip was associated with the group congruent compared to the group incongruent festival contexts. The two groups did not differ significantly in reproduced duration when the sound attributed to a non-religious common (busy city street) context (experiment 1b). With multiple durations (1, 5, 10 and 20 s), longer durations were reproduced for group congruent labelling at objectively longer durations (experiment 2). According to the internal clock model of time perception, the significant slope effect indicated that the group congruent context influences temporal experience through changes in pacemaker frequency. We argue that the duration appearing relevant to one's own group is processed differently possibly owing to differences in attentional deployment, which influences the pacemaker frequency.
Adherence to Menzerath's Law is the exception (not the rule) in three duetting primate species
Authors: Clink Dena J. , Lau Allison R.
Published: November 2020

Across diverse systems including language, music and genomes, there is a tendency for longer sequences to contain shorter constituents; this phenomenon is known as Menzerath's Law. Whether Menzerath's Law is a universal in biological systems, is the result of compression (wherein shortest possible strings represent the maximum amount of information) or emerges from an inevitable relationship between sequence and constituent length remains a topic of debate. In non-human primates, the vocalizations of geladas, male gibbons and chimpanzees exhibit patterns consistent with Menzerath's Law. Here, we use existing datasets of three duetting primate species (tarsiers, titi monkeys and gibbons) to examine the wide-scale applicability of Menzerath's Law. Primate duets provide a useful comparative model to test for the broad-scale applicability of Menzerath's Law, as they evolved independently under presumably similar selection pressures and are emitted under the same context(s) across taxa. Only four out of the eight call types we examined were consistent with Menzerath's Law. Two of these call types exhibited a negative relationship between the position of the note in the call and note duration, indicating that adherence to Menzerath's Law in these call types may be related to breathing constraints. Exceptions to Menzerath's Law occur when notes are relatively homogeneous, or when species-specific call structure leads to a deterministic decrease in note duration. We show that adherence to Menzerath's Law is the exception rather than the rule in duetting primates. It is possible that selection pressures for long-range signals that can travel effectively over large distances was stronger than that of compression in primate duets. Future studies investigating adherence to Menzerath's Law across the vocal repertoires of these species will help us better elucidate the pressures that shape both short- and long-distance acoustic signals.
Fusion of multi-view ultrasonic data for increased detection performance in non-destructive evaluation
Authors: Wilcox Paul D. , Croxford Anthony J. , Budyn Nicolas , Bevan Rhodri L. T. , Zhang Jie , Kashubin Artem , Cawley Peter
Published: November 2020

State-of-the-art ultrasonic non-destructive evaluation (NDE) uses an array to rapidly generate multiple, information-rich views at each test position on a safety-critical component. However, the information for detecting potential defects is dispersed across views, and a typical inspection may involve thousands of test positions. Interpretation requires painstaking analysis by a skilled operator. In this paper, various methods for fusing multi-view data are developed. Compared with any one single view, all methods are shown to yield significant performance gains, which may be related to the general and edge cases for NDE. In the general case, a defect is clearly detectable in at least one individual view, but the view(s) depends on the defect location and orientation. Here, the performance gain from data fusion is mainly the result of the selective use of information from the most appropriate view(s) and fusion provides a means to substantially reduce operator burden. The edge cases are defects that cannot be reliably detected in any one individual view without false alarms. Here, certain fusion methods are shown to enable detection with reduced false alarms. In this context, fusion allows NDE capability to be extended with potential implications for the design and operation of engineering assets.
A free boundary mechanobiological model of epithelial tissues
Authors: Tambyah Tamara A. , Murphy Ryan J. , Buenzli Pascal R. , Simpson Matthew J.
Published: November 2020

In this study, we couple intracellular signalling and cell-based mechanical properties to develop a novel free boundary mechanobiological model of epithelial tissue dynamics. Mechanobiological coupling is introduced at the cell level in a discrete modelling framework, and new reaction–diffusion equations are derived to describe tissue-level outcomes. The free boundary evolves as a result of the underlying biological mechanisms included in the discrete model. To demonstrate the accuracy of the continuum model, we compare numerical solutions of the discrete and continuum models for two different signalling pathways. First, we study the Rac–Rho pathway where cell- and tissue-level mechanics are directly related to intracellular signalling. Second, we study an activator–inhibitor system which gives rise to spatial and temporal patterning related to Turing patterns. In all cases, the continuum model and free boundary condition accurately reflect the cell-level processes included in the discrete model.
The relation between quantum and classical field theory with a classical source
Authors: Fulling S. A. , Landulfo A. G. S. , Matsas G. E. A.
Published: November 2020

Classical field theory is about fields and how they behave in space–time. Quantum field theory, in practice, usually seems to be about particles and how they scatter. Nevertheless, classical fields must emerge from quantum field theory in appropriate limits, and Michael Duff showed how this happens for the Schwarzschild solution in perturbative quantum gravity. In a series of papers, we and others have shown how classical radiation from an accelerated charge emerges from quantum field theory when the Unruh thermal effect is taken into account. Here, we sharpen those conclusions by showing that, even at finite times, the quantum picture is meaningful and is in close agreement with the classical picture.
Local supertwistors and conformal supergravity in six dimensions
Authors: Howe P. S. , Lindström U.
Published: November 2020

The local supertwistor formalism, which involves a superconformal connection acting on the bundle of such objects over superspace, is used to investigate superconformal geometry in six dimensions. The geometry corresponding to (1, 0) and (2, 0) off-shell conformal supergravity multiplets, as well the associated finite super-Weyl transformations, are derived.
Behavioural flexibility and reputation formation
Authors: McNamara John M. , Barta Zoltan
Published: November 2020

Limited flexibility in behaviour gives rise to behavioural consistency, so that past behaviour is partially predictive of current behaviour. The consequences of limits to flexibility are investigated in a population in which pairs of individuals play a game of trust. The game can either be observed by others or not. Reputation is based on trustworthiness when observed and acts as a signal of behaviour in future interactions with others. Individuals use the reputation of partner in deciding whether to trust them, both when observed by others and when not observed. We explore the effects of costs of exhibiting a difference in behaviour between when observed and when not observed (i.e. a cost of flexibility). When costs are low, individuals do not attempt to signal that they will later be trustworthy: their signal should not be believed since it will always pay them to be untrustworthy if trusted. When costs are high, their local optimal behaviour automatically acts as an honest signal. At intermediate costs, individuals are very trustworthy when observed in order to convince others of their trustworthiness when unobserved. It is hypothesized that this type of strong signalling might occur in other settings.