bluuebunny/crossref_metadata_2025 huggingface dataset:
Polyamide Amine Dendrimer Nanoparticles Conjugated with Cis-Diamminedichloroplatinum (CDDP) and miRNA-200c Inhibitor Suppresses Lung Cancer Cell Proliferation
Authors: Zhang Fang , Zou Jili , Huang Dandan
Published: August 2021

Our study elucidates the effect of folate polyamide amine dendrimer nanoparticles targeting delivery of miRNA-200c inhibitor and CDDP on lung cancer cells proliferation. We established polyamide amine dendrimer nanoparticles binding with CDDP and miRNA-200c inhibitor (Den-PEI-CDDP-siRNA-FA),
TEM was employed to detect the morphology of nanoparticles. Agarose gel assay was selected for stabilization test. Cell proliferation were detected by trypanosoma blue exclusion method. The expression of miRNA-200c targeted APKPA12 and apoptosis-related proteins were detected by Western blot
and PCR. Finally, apoptosis was analyzed by flow cytometry. Den-PEI-CDDP-siRNA-FA nanoparticles showed excellent stability and drug encapsulation ability. Nanoparticles targeting for FRA to co-deliver siRNA and CDDP could significantly promote cell apoptosis, increase apoptosis-related protein
expression, and inhibit cell proliferation. Besides, nanoparticles exerted less venomous effect than untargeted nanoparticles in MRC9 lung fibroblast. Den nanoparticle targeting FRA might be used as the carrier for joint applications with siRNA and CDDP for treating lung cancer.
Bone Marrow Mesenchymal Stem Cell (BMSC) Exosomes Inhibit Angiogenesis and Enhance Autophagy Through Decreasing miR-21 in Cervical Cancer
Authors: Chen Kewei , Ouyang Yiqin , Liang Junhua , Li Huaifang , Tong Xiaowen , Yang Yang
Published: August 2021

We aimed to explore the mechanism underlying the role of miR-21 derived from bone marrow mesenchymal stem cell exosomes (BMSC-exos) in cervical cancer (CC) and the relation between angiogenesis and autophagy. In this study, BMSC-exos were co-cultured with CC stem cells followed by analysis
of miR-21 expression by RT-qPCR, autophagy after hunger-induced feeding by Acridine Orange fluorescent staining, angiogenesis by tube formation assay. Co-culture of BMSC-exos effectively reduced miR-21 expression in CC stem cells and enhanced autophagy as demonstrated by upregulated Beclin1
and LC3B with assembly of autophagosome (p < 0.05), but the autophagy restored later. Moreover, in the presence of BMSC-exos, CC stem cell angiogenesis was suppressed by 79%. In conclusion, BMSC-exos enhance autophagy and inhibit angiogenesis in CC through decreasing miR-21, which
provides a novel insight into etiology of CC.
Textile-based fiber optic sensors for health monitoring: A systematic and citation network analysis review
Authors: Lee Ka-Po , Yip Joanne , Yick Kit-Lun , Lu Chao , Lo Chris K
Published: August 2021

Receptivity towards textile-based fiber optic sensors that are used to monitor physical health is increasing as they have good flexibility, are light in weight, provide wear comfort, have electromagnetic immunity, and are electrically safe. Their superior performance has facilitated their use for obtaining close to body measurements. However, there are many related studies in the literature, so it is challenging to identify the knowledge structure and research trends. Therefore, this article aims to provide an objective and systematic literature review on textile-based fiber optic sensors that are used for monitoring health issues and to analyze their trends through a citation network analysis. A full-text search of journal articles was conducted in the Web of Science Core Collection, and a total of 625 studies was found, with 47 that were used as the sample. Also, CitNetExplorer was used for analyzing the research domains and trends. Three research domains were identified, among them, “Flexible sensors for vital signs monitoring” is the largest research cluster, and most of the articles in this cluster focus on respiratory monitoring. Therefore, this area of study should probably be on the academic radar. The collection of data on textile-based fiber optic sensors is invaluable for evaluating degree of rehabilitation, detecting diseases, preventing accidents, as well as gauging the performance and training successfulness of athletes.
System Justification or Social Dominance? A Multilevel Test of the Ideological Motivators of Perceived Discrimination
Authors: Bahamondes Joaquín , Sibley Chris G. , Osborne Danny
Published: August 2021

Although system-justifying beliefs often mitigate perceptions of discrimination, status-based asymmetries in the ideological motivators of perceived discrimination are unknown. Because the content and societal implications of discrimination claims are status-dependant, social dominance orientation (SDO) should motivate perceptions of (reverse) discrimination among members of high-status groups, whereas system justification should motivate the minimization of perceived discrimination among the disadvantaged. We tested these hypotheses using multilevel regressions among a nationwide random sample of New Zealand Europeans ( n = 29,169) and ethnic minorities ( n = 5,118). As hypothesized, group-based dominance correlated positively with perceived (reverse) discrimination among ethnic-majority group members, whereas system justification correlated negatively with perceived discrimination among the disadvantaged. Furthermore, the proportion of minorities within the region strengthened the victimizing effects of SDO-Dominance, but not SDO-Egalitarianism, among the advantaged. Together, these results reveal status-based asymmetries in the motives underlying perceptions of discrimination and identify a key contextual moderator of this association.
The opioid epidemic from the acute care hospital front line
Authors: Macintyre Pamela E
Published: August 2021

Prescription opioid use has risen steeply for over two decades, driven primarily by advocacy for better management of chronic non-cancer pain, but also by poor opioid stewardship in the management of acute pain. Inappropriate prescribing, among other things, contributed to the opioid ‘epidemic’ and striking increases in patient harm. It has also seen a greater proportion of opioid-tolerant patients presenting to acute care hospitals. Effective and safe management of acute pain in opioid-tolerant patients can be challenging, with higher risks of opioid-induced ventilatory impairment and persistent post-discharge opioid use compared with opioid-naive patients. There are also increased risks of some less well known adverse postoperative outcomes including infection, earlier revision rates after major joint arthroplasty and spinal fusion, longer hospital stays, higher re-admission rates and increased healthcare costs. Increasingly, opioid-free/opioid-sparing techniques have been advocated as ways to reduce patient harm. However, good evidence for these remains lacking and opioids will continue to play an important role in the management of acute pain in many patients.

Better opioid stewardship with consideration of preoperative opioid weaning in some patients, assessment of patient function rather than relying on pain scores alone to assess adequacy of analgesia, prescription of immediate release opioids only and evidence-based use of analgesic adjuvants are important. Post-discharge opioid prescribing should be contingent on an assessment of patient risk, with short-term only use of opioids. In partnership with pharmacists, nursing staff, other medical specialists, general practitioners and patients, anaesthetists remain ideally positioned to be involved in opioid stewardship in the acute care setting.
Are Older Drivers Safe on Interchanges? Analyzing Driving Errors Causing Crashes
Authors: Monyo Denis Elia , Haule Henrick J. , Kitali Angela E. , Sando Thobias
Published: August 2021

Older drivers are prone to driving errors that can lead to crashes. The risk of older drivers making errors increases in locations with complex roadway features and higher traffic conflicts. Interchanges are freeway locations with more driving challenges than other basic segments. Because of the growing population of older drivers, it is vital to understand driving errors that can lead to crashes on interchanges. This knowledge can assist in developing countermeasures that will ensure safety for all road users when navigating through interchanges. The goal of this study was to determine driver, environmental, roadway, and traffic characteristics that influence older drivers’ errors resulting in crashes along interchanges. The analysis was based on three years (2016–2018) of crash data from Florida. A two-step approach involving a latent class clustering analysis and the penalized logistic regression was used to investigate factors that influence driving errors made by older drivers on interchanges. This approach accounted for heterogeneity that exists in the crash data and enhanced the identification of contributing factors. The results revealed patterns that are not obvious without a two-step approach, including variables that were not significant in all crashes, but were significant in specific clusters. These factors included driver gender and interchange type. Results also showed that all other factors, including distracted driving, lighting condition, area type, speed limit, time of day, and horizontal alignment, were significant in all crashes and few specific clusters.
The White Right: A Gendered Look at the Links Between “Victim” Ideology and Anti-Black Lives Matter Sentiments in the Era of Trump
Authors: Isom Deena A , Boehme Hunter M , Cann Deanna , Wilson Amber
Published: August 2021

Employing a racialized gendered lens, we explore the perceptions of status threat and victimhood among a sample of White Americans following the 2016 presidential election. Specifically, we draw upon such theoretical and empirical work to frame our analyses of the associations between perceptions of a white “victim” ideology and anti-Black Lives Matter (BLM) sentiments and how such associations may be conditioned by support for Trump and holding patriarchal gender normative beliefs. We propose that the BLM movement may be perceived as a “threat” to many White Americans. Furthermore, we believe Whites’ anti-BLM sentiments will be enhanced by support for Trump, given his racist, misogynistic, xenophobic, and oppressive tendencies. Moreover, we believe that these associations will differ based on gender and beliefs in patriarchal gender norms, as White men and women are likely to feel status threat in varied ways. Mix support for our propositions and complex gendered differences are revealed. Implications are discussed.
Review on mobile robots that exploit resonance
Authors: Schonebaum Johan K , Alijani Farbod , Radaelli Giuseppe
Published: August 2021

It is expected that mobile robots can benefit from the exploitation of their resonance in terms of actuation and efficiency. Therefore, a study is conducted on the existing terrestrial mobile robots that use resonance to obtain or improve locomotion. An overview of these robots is provided, and their advantages over robots that do not use resonance are examined. A classification with fifteen subclasses is introduced based on the locomotion mechanisms that mobile robots use. In five of the fifteen subclasses, examples of mobile robots that use resonance are found. These robots prove that they can be up to 16 times more efficient and much simpler to actuate and control than their imposed counterparts. Four different methods to make use of the resonance of a mobile robot are distinguished. A systematic design approach that combines these four methods with the fifteen subclasses is proposed, which can be used to obtain unexplored concepts for mobile robots that benefit from the exploitation of their resonance.
Numerical assessment on the performance of variable area single- and two-stage ejectors: A comparative study
Authors: Kumar Anil , Kumar Virendra , Subbarao PMV , Yadav Surendra K , Singhal Gaurav
Published: August 2021

The two-stage ejector has been suggested to replace the single-stage ejector geometrical configuration better to utilize the discharge flow’s redundant momentum to induce secondary flow. In this study, the one-dimensional gas dynamic constant rate of momentum change theory has been utilized to model a two-stage ejector along with a single-stage ejector. The proposed theory has been utilized in the computation of geometry and flow parameters of both the ejectors. The commercial computational fluid dynamics tool ANSYS-Fluent 14.0 has been utilized to predict performance and visualize the flow. The performance in terms of entrainment ratio has been compared under on- design and off-design conditions. The result shows that the two-stage ejector configuration has improved (≈57%) entrainment capacity than the single-stage ejector under the on-design condition.
Centrifugal pump performance enhancement: Effect of splitter blade and optimization
Authors: Siddique Mohammed Hamid , Samad Abdus , Hossain Shakhawat
Published: August 2021

The shape of impeller blades of a centrifugal pump affects the best efficiency point (BEP), and splitter blades improve the pump performance at BEP. In this work, multiple parameters such as number of blades, length of splitter blade, splitter blade angle at hub, and wrap angle were modified to maximize head and minimize input power. The problem was solved by a numerical and experimental approach. Initially, an impeller was designed and tested in a laboratory setup. The same impeller was simulated in a computational fluid dynamics (CFD) solver, checked the accuracy of the CFD results, optimized by an in-house surrogate-based optimization code and finally the optimal designed manufactured and tested again. The mix and match of the splitter blade with the other parameters improved the pump performance i.e. head by 8.2% and overall efficiency by 3%. The improvement was due to the reduction in pressure fluctuations and uniform blade loading throughout the impeller blade span.
The digital resurrection of Margaret Thatcher: Creative, technological and legal dilemmas in the use of deepfakes in screen drama
Authors: Lees Dominic , Bashford-Rogers Tom , Keppel-Palmer Marcus
Published: August 2021

This article develops from the findings of an interdisciplinary research project that has linked film practice research with computer science and law, in an exercise that seeks to digitally resurrect Margaret Thatcher to play herself in a contemporary film drama. The article highlights the imminent spread of machine learning techniques for digital face replacement across fiction content production, with central research questions concerning the ethical and legal issues that arise from the appropriation of the facial image of a deceased person for use in drama.
Police self-legitimacy and democratic orientations: Assessing shared values
Authors: White David R , Kyle Michael J , Schafer Joseph A
Published: August 2021

Using a sample of frontline police officers from several mid-sized municipal police departments in the United States, this study explores the relationships between frontline police officers’ self-legitimacy, organizational fit, moral alignment with policed communities, and attitudes toward democratic policing principles. Using partial least squares structural equation modeling, the analysis frames democratic policing using a formative latent construct to test several hypotheses. The results support a direct positive relationship between self-legitimacy and attitudes toward democratic policing, and suggest the relationship is partially mediated by officers' perceptions of moral alignment with their policed communities. The results further demonstrate that self-legitimacy is significantly related to organizational fit, but organizational fit does not appear to mediate the relationship between self-legitimacy and attitudes toward democratic policing.
No place like home? Producing and consuming eldercare design
Authors: Nicholas Claire , Casto Mary Alice , Smith Alyssa , Francisco Katie
Published: August 2021

As the American eldercare industry prepares to attract and receive consumers from the “baby boomer” generation, facility designers and administrators are increasingly concerned with catering to the lifestyles and taste preferences of aging adults perceived to be more “active,” affluent, and accustomed to “choice” than previous generations. This article considers these trends in terms of their material, aesthetic, and discursive impacts on the socio-material construction of space in residential eldercare facilities. The study draws on discourse and visual analysis of winning entries in published design competitions sponsored by the architecture, interior design, and eldercare industries. Through this analysis, eldercare spaces emerge as sites of consumption where designers privilege both “household/home-like” and “commercial/hospitality” aesthetics and atmospheres. In recent years, placemaking strategies to create home-like environments increasingly overlap with social spaces inspired by the hospitality industry. Our discussion demonstrates how these strategies materialize in structures and interiors increasingly open to the non-resident public and integrated into their surrounding communities. As such, we argue that the negotiation of degrees and kinds of “publicness” and “privateness” in spaces of care reflect shifting views of the roles and characteristics of acts of consumption and consumers in these facilities and in the broader healthcare industry.
The influence of running performance on scoring the first goal in a soccer match
Authors: Klemp Maximilian , Memmert Daniel , Rein Robert
Published: August 2021

Previous studies investigating running distance in high performance soccer have led to contradictory evidence, potentially due to ignoring contextual information during match phases. The present study therefore examined the relationship between running performance and goal scoring in a football match for a standardised score line. In a sample of 302 matches from the first German Bundesliga, the first goal was modelled as a function of the teams’ running performance and team strength using logistic regression. Goodness of fit was assessed by the prediction accuracy of the model utilising cross-validation. The best model showed a mean accuracy of 77%, reflecting a strong relationship between running performance and the probability of scoring the first goal. This relationship was strongest for total running distance compared to high-speed, sprint or in-possession running distance. We propose two different potential mechanisms to explain the relationship between running performance and goal-scoring found in the present study. These are (1) better ability to reach tactical aims or (2) accumulation of fatigue in the opponent. Future studies should build on these results by further examining the relationship between running performance and success using a more granular segmentation of matches.
Odontogenic Keratocyst: A Clinical Entity With Favorable Response to Active Decompression and Distraction Sugosteogenesis
Authors: Porte Juan-Pablo , Guerrero Lidia M. , Rivera Bonifacio , Wiscovitch Andres , Castro-Núñez Jaime
Published: August 2021

Objective:

The purpose of this study was to determine the usefulness of active decompression and distraction sugosteogenesis (ADDS) for the management of non-syndromic odontogenic keratocysts (OKC).

Materials and Methods:

A retrospective case series study was designed and implemented. The study observed the Declaration of Helsinki on medical protocol and ethics and it was approved by the university’s Institutional Review Board (IRB). The medical files of all patients who underwent ADDS for OKCs of the jaws at the Department of Oral and Maxillofacial Surgery of a tertiary university-affiliated medical center were reviewed. Data were collected on patient’s age, gender, presenting signs and symptoms, lesion location, locularity, pre-ADDS, size of the lesion, post-ADDS, pain, days with bloody discharge and/or proteinaceous fluid inside the system’s external unit, days to achieve hermetic seal, size of the lesion 2 weeks after ADDS, percentage of reduction, patient’s complaints/complications, and follow-up period. Pre- and post-ADDS panoramic radiographs were reviewed for reduction parameters.

Results:

Six patients, 5 males and 1 female, with an average age of 45.16 years (range 16-74 years) were studied. ADDS was performed during 4 weeks in all patients. During the therapy, the extraoral unit collected blood during 2.83 days in average. In average, after the third day, the cystic cavity started to drain a proteinaceous fluid for about 9.33 days (range 6-15 days). The average pre-ADDS Standard Lesional Area Index (SLAI) was 18.17 cm2 (range 4.40 cm2-34.58 m2) and, after 2 weeks of ADDS, the average SLAI was 5.47 cm2 (range 0.49 cm2-15.39 cm2). The average percentage of reduction, after 2 weeks, was 73.93% (range 55.49%-97.51%), which yielded an overall good reaction of OKCs to ADDS. No significant reduction of the lesions was observed from week 2 to week 4, when ADDS ceased. All lesions were enucleated after 3 months. After an average of 14 months of follow-up (12 to 17 months), no signs of recurrence have been observed.
Acute Airway Compromise After Isolated Mandibular Subcondyle Fracture in a Patient With a Hemi-Mandible: A Case Report
Authors: Pyfer Bryan James , Cason Roger William , Mundy Lily , Powers David Bryan , Erdmann Detlev
Published: August 2021

Evaluation of the airway is the first step in any trauma protocol, and this is particularly important in instances of facial trauma. While airway compromise is not uncommon in blunt or penetrating facial trauma, it is rarely a significant concern in instances of an isolated mandibular fracture. We report a rare case of immediate airway compromise in an elderly, edentulous female who sustained an isolated mandibular subcondyle fracture, complicated by her history of a remote hemimandibulectomy for management of her oral cancer. Initial airway management was performed conservatively with prone or lateral positioning under continuous pulse oximetry monitoring in the intensive care unit, followed promptly by open anatomic reduction and internal fixation of the fracture under more optimal operative conditions. After stabilizing the subcondylar fracture, the patient followed a mechanical soft/no-chew diet for 6 weeks until the fracture was healed. She has experienced no airway concerns since her surgery. This case report stresses the importance of a comprehensive evaluation of the airway in facial trauma patients with altered baseline anatomy, as well as highlights the considerations for emergent surgical airway versus immediate or delayed surgical fracture fixation.
Preemptive Utilization of Anterior Belly of the Digastric Muscle Flaps in Transoral Robotic Radical Tonsillectomy
Authors: Daigle Olivia , Gardner James Reed , King Deanne , Moreno Mauricio Alejandro , Sunde Jumin , Vural Emre
Published: August 2021

Objective

To demonstrate the use of an anterior belly of the digastric muscle flap (ABDMF) during transoral robotic radical tonsillectomy (TORRT) with concomitant neck dissection with the intent of preventing the formation of postoperative pharyngocutaneous fistulas.

Study Design

Retrospective study.

Setting

Single academic tertiary care center.

Methods

In this study, all patients were included who underwent TORRT plus limited pharyngectomy with concomitant neck dissection and ABDMF for the treatment of oropharyngeal squamous cell carcinoma between September 2012 and September 2020. The rate of fistula formation was assessed in patients with preemptive utilization of ABDMF.

Results

A total of 43 patients underwent TORRT with neck dissection and ABDMF. No patients developed a fistula in the postoperative period or associated morbidity with the use of this flap.

Conclusion

Preemptive use of ABDMF in TORRT with concomitant neck dissection represents a reconstructive option that may help prevent the formation of pharyngocutaneous fistula by reinforcing the posteroinferior boundary of the parapharyngeal space.
Prevalence and molecular characterization of group B streptococcus in pregnant women from hospitals in Ohangwena and Oshikoto regions of Namibia
Authors: Haimbodi Erastus Lafimana , Mukesi Munyaradzi , Moyo Sylvester Rodgers
Published: August 2021

Background

The main purpose of this study was to investigate the prevalence rate, antimicrobial susceptibility patterns and molecular characteristics of Streptococcus agalactiae isolated from pregnant women at 35 weeks of gestation and above, who attended antenatal screening at selected hospitals in Ohangwena and Oshikoto regions of Namibia.

Results

Out of 210 women screened for Group B Streptococcus (GBS), 12 (5.7%) were colonised of which 25.0% were colonised rectovaginally, 58.0% vaginally and 17.0% rectally. No significant association was reported between GBS colonisation and maternal age, geographic location, marital status, education, employment, parity, still births and miscarriages (P values > 0.05). Antimicrobial susceptibility was reported at 100% for ampicillin, penicillin & ceftriaxone which are commonly used for empiric treatment of infection with GBS. Resistance to tetracycline was reported at 100%. Tetracycline resistance gene tet(M) was present in 88.9% of the isolates only and none of the isolates presented with tet(O). Polysaccharide capsular type Ia was found in 9(50%) and Ib was found in 1(5.5%) of the total isolates. The remaining isolates were not typeable using PCR.

Conclusion

Streptococcus agalactiae’s positive rate was 5.7% among the pregnant women examined. Socio-demographic and obstetric factors had no influence on GBS colonisation (P values > 0.05). No resistance was reported to ampicillin, penicillin and ceftriaxone. No sensitivity was reported to tetracycline. Fifty percent of the isolates were capsular type Ia, 5.5% were type Ib and 44.4% were not typeable using PCR. The study provides crucial information for informing policy in screening of GBS in pregnant women.
RRM1 and ERCC1 as biomarkers in patients with locally advanced and metastatic malignant pleural mesothelioma treated with continuous infusion of low-dose gemcitabine plus cisplatin
Authors: Muñoz-Montaño Wendy , Muñiz-Hernández Sae , Avilés-Salas Alejandro , Catalán Rodrigo , Lara-Mejía Luis , Samtani-Bassarmal Suraj , Cardona Andres F. , Mendoza-Desión Jorge , Hernández-Cueto Daniel , Maldonado Altagracia , Baay-Guzmán Guillermina , Huerta-Yepes Sara , Arrieta Oscar
Published: August 2021

Background

Malignant Pleural Mesothelioma (MPM) is a rare but aggressive neoplasia that usually presents at advanced stages. Even though some advances have been achieved in the management of patients with MPM, this malignancy continuous to impose a deleterious prognosis for affected patients (12–18 months as median survival, and 5–10% 5-year survival rate), accordingly, the recognition of biomarkers that allow us to select the most appropriate therapy are necessary.

Methods

Immunohistochemistry semi-quantitative analysis was performed to evaluate four different biomarkers (ERCC1, RRM1, RRM2, and hENT-1) with the intent to explore if any of them was useful to predict response to treatment with continuous infusion gemcitabine plus cisplatin. Tissue biopsies from patients with locally advanced or metastatic MPM were analyzed to quantitatively asses the aforementioned biomarkers. Every included patient received treatment with low-dose gemcitabine (250 mg/m2) in a 6-h continuous infusion plus cisplatin 35 mg/m2 on days 1 and 8 every 3 weeks as first-line therapy.

Results

From the 70 eligible patients, the mean and standard deviation (SD) for ERCC1, RRM1, RRM2 and hENT-1 were 286,178.3 (± 219, 019.8); 104,647.1 (± 65, 773.4); 4536.5 (± 5, 521.3); and 2458.7 (± 4, 983.4), respectively. Patients with high expression of RRM1 had an increased median PFS compared with those with lower expression (9.5 vs 4.8 months, p = < 0.001). Furthermore, high expression of RRM1 and ERCC1 were associated with an increased median OS compared with their lower expression counterparts; [(23.1 vs 7.2 months for RRM1 p = < 0.001) and (17.4 vs 9.8 months for ERCC1 p = 0.018)].

Conclusions

ERCC1 and RRM1 are useful biomarkers that predict better survival outcomes in patients with advanced MPM treated with continuous infusion of gemcitabine plus cisplatin.
Mild knee osteoarthritis predicts dissatisfaction after total knee arthroplasty: a prospective study of 186 patients aged 65 years or less with 2-year follow-up
Authors: Leppänen Sanni , Niemeläinen Mika , Huhtala Heini , Eskelinen Antti
Published: August 2021

Background and aims

The incidence of total knee arthroplasty (TKA) is increasing, especially among younger working-age patients. However, dissatisfaction rates in this population are higher than among older patients. The aim of this study was to assess the rates of dissatisfaction and persistent pain after TKA and to evaluate those factors that predict these outcomes.

Material and methods

In total, 186 patients undergoing unilateral TKA aged 65 years or less were enrolled into this prospective observational study with 2-year follow-up. To assess the outcome, the visual analogue scales regarding satisfaction and persistent pain at rest and during exercise were used. In addition, the association between patients´ demographics, radiographic severity of knee osteoarthritis (OA), patient-reported outcome measures (PROMs) and dissatisfaction and persistent pain were tested by univariate logistic regression analysis. Mild OA was defined as Kellgren-Lawrence (KL) grade 2 and severe OA as KL grade 3–4. Furthermore, multiple logistic regression analysis was also conducted to test statistically significant relations.

Results

After 2 years, 12 % (n = 23) of patients were dissatisfied with the outcome of TKA, 27 % (n = 50) reported persistent pain during exercise and 10 % (n = 18) at rest. Patients with mild knee OA were significantly more dissatisfied (28.6 %) than patients with more severe OA (8.7 %) (p = 0.003). Younger patients had an increased risk for both dissatisfaction and persistent pain. Apart from KOOS Quality of Life, poor preoperative KOOS subscores were also predictive for these outcomes.

Conclusion

Mild radiographic knee OA was the main predicting factor for dissatisfaction after TKA. Thus, performing TKA for such patients should be carefully considered. Furthermore, these patients should be informed about the increased risk for dissatisfaction and the same seems to apply to younger patients. Interestingly, when TKA is performed for patients with more severe knee OA, the satisfaction rates seem to be somewhat higher than those previously reported.

Trial registration

The study was retrospectively registered with ClinicalTrials.gov (registration number NCT03233620) on 28 July 2017.
Emergency surgery for hemobilia due to hepatic artery pseudoaneurysm rupture complicated by Mirizzi syndrome type II: a case report
Authors: Shishido Yutaka , Fujimoto Koji , Yano Yasumichi , Mitsuoka Eisei , Komatsubara Takashi , Shio Seiji , Ishii Masayuki , Higashiyama Hiroshi
Published: August 2021

Background

Hemobilia refers to bleeding into the biliary tract. Hepatic artery pseudoaneurysm (HAP) rupture is an uncommon cause of hemobilia, and cases of HAP associated with Mirizzi syndrome are extremely rare. Although transarterial embolization is recommended as the first-line treatment for hemobilia, surgery is sometimes required.

Case presentation

A 76-year-old woman was referred to our hospital with epigastric pain. She was febrile and had conjunctival icterus and epigastric tenderness. Laboratory tests revealed abnormal white blood cell count and liver function. An abdominal computed tomography (CT) revealed multiple calculi in the gallbladder, an incarcerated calculus in the cystic duct, and a slightly dilated common hepatic duct. Based on examination findings, she was diagnosed with Mirizzi syndrome type I, complicated by cholangitis. Intravenous antibiotics were administered, and we performed endoscopic retrograde cholangiopancreatography (ERCP) to place a drainage tube. The fever persisted; therefore, contrast-enhanced CT (CECT) was performed. This revealed portal vein thrombosis and hepatic abscesses; therefore, heparin infusion was administered. The following day, she complained of melena, and laboratory tests showed that she was anemic. ERCP was performed to change the drainage tube in the bile duct; however, bleeding from the papilla of Vater was observed. CECT demonstrated a right HAP with high-density fluid in the gallbladder and gallbladder perforation. Finally, she was diagnosed with hemobilia caused by HAP rupture, and emergency surgery was performed to secure hemostasis and control the infection. During laparotomy, we found that a right HAP had ruptured into the gallbladder. The gallbladder made a cholecystobiliary fistula, which indicated Mirizzi syndrome type II. Although we tried to repair the right hepatic artery, we later ligated it due to arterial wall vulnerability. Then, we performed subtotal cholecystectomy and inserted a T-tube into the common bile duct. There were no postoperative complications except for minor leakage from the T-tube insertion site. The patient was discharged after a total hospital stay of 7 weeks.

Conclusions

We experienced an extremely rare case of emergency definitive surgery for hemobilia due to HAP rupture complicated by Mirizzi syndrome type II. Surgery might be indicated when controlling underlying infections was required.
Origin of MMP-8 and Lactoferrin levels from gingival crevicular fluid, salivary glands and whole saliva
Authors: Ramenzoni Liza L. , Hofer Deborah , Solderer Alex , Wiedemeier Daniel , Attin Thomas , Schmidlin Patrick R.
Published: August 2021

Background

Pathologically elevated levels of matrix metalloproteinase-8 (MMP-8) and Lactoferrin in oral fluids have been associated with the presence of gingivitis/periodontitis. This study aimed to assess the origin of MMP-8 and Lactoferrin in periodontitis patients and to identify the degree to which conventional clinical parameters correlate with their presence.

Methods

A total of ten periodontitis and ten healthy patients were included in this study. Whole saliva (stimulated and unstimulated), parotid/sublingual glandular fluid and gingival crevicular fluid from pockets and sulci were tested for MMP-8 and Lactoferrin and protein concentrations were quantified using an ELISA assay. Clinical parameters were checked for potential associations with MMP-8 and Lactoferrin levels.

Results

Periodontal patients presented higher concentrations of MMP-8 and Lactoferrin in pockets than other sources (P = 0.03). Lactoferrin measurement was higher in the parotid compared to sublingual glandular fluid in periodontitis patients (P = 0.03). Increased probing pocket depth was positively correlated with high MMP-8 and Lactoferrin levels.

Conclusions

Periodontal pockets appear to be the major source of active matrix metalloproteinase and Lactoferrin, which also may also enter the oral cavity through the salivary glands. Since clinically healthy sites in periodontitis patients also had elevated biomarker levels, gingival crevicular fluid biomarker testing may be more predictive of future tissue breakdown than conventional clinical parameters.
Pregnant women utilization of dental services: still a challenge in low resource setting
Authors: Onwuka Chidozie , Onwuka Chidinma Ifechi , Iloghalu Emeka Ifeanyi , Udealor Peter Chukwudi , Ezugwu Euzebus Chinonye , Menuba Ifeanyi Emmanuel , Ugwu Emmanuel Onyebuchi , Ututu Chinyere
Published: August 2021

Background

Poor oral health in pregnancy can be associated with poor pregnancy outcome, however, dental consultation among pregnant women appears to be low.

Methods

This was a questionnaire-based study of 413 women who attended the antenatal clinic of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu. The information obtained was analyzed using SPSS version 22. A p-value of less than 0.05 was considered statistically significant.

Results

Only 36 (8.7%) of the respondents had dental consultations in index pregnancy for complaints such as tooth ache and decay (66.7%) and pain as well as swelling of the gum (33.3%). The most common reason given for not visiting a dentist during the index pregnancy was the visit not being relevant to their pregnancy outcome (69.2%). After counseling them, only 249 (60.3%) agreed to have dental consultation during subsequent pregnancies. The relationship between visiting the dentist and place of residence (< 0.001), occupation (0.019) and frequency of brushing/ changing of brush (0.005, < 0.001 respectively) were statistically significant.

Conclusion

The prevalence of dental consultation during pregnancy is very low. Pregnant women should be encouraged to have routine dental consultation with oral health counseling and check-up incorporated as part of routine antenatal care.
Bayesian semi-parametric spatial modelling of intimate partner violence in Namibia using 2013 Demographic Health Survey Data
Authors: Ojifinni Oludoyinmola , Maposa Innocent , Ibisomi Latifat
Published: August 2021

Background

Intimate partner violence (IPV) is an important public health problem with health and socioeconomic consequences and is endemic in Namibia. Studies assessing risk factors for IPV often use logistic and Poisson regression without geographical location information and spatial effects. We used a Bayesian spatial semi-parametric regression model to determine the risk factors for IPV in Namibia; assess the non-linear effects of age difference between partners and determine spatial effects in the different regions on IPV prevalence.

Methods

We used the couples’ dataset of the 2013–2014 Namibia Demographic and Health Survey (DHS) obtained on request from Measure DHS. The DHS domestic violence module included 2226 women. We generated a binary variable measuring IPV from the questions “ever experienced physical, sexual or emotional violence?” Covariates included respondent’s educational level, age, couples’ age difference, place of residence and partner’s educational level. All estimation was done with the full Bayesian approach using R version 3.5.2 implementing the R2BayesX package.

Results

IPV country prevalence was 33.3% (95% CI = 30.1–36.5%); Kavango had the highest [50.6% (95% CI = 41.2–60.1%)] and Oshana the lowest [11.5% (95% CI = 3.2–19.9%)] regional prevalence. IPV prevalence was highest among teenagers [60.8% (95% CI = 36.9–84.7%)]). The spatial semi-parametric model used for adjusted results controlled for regional spatial effects, respondent’s age, age difference, respondent’s years of education, residence, wealth, and education levels. Women with higher education were 50% less likely to experience IPV [aOR: 0.46, 95% CI = 0.23–0.87]. For non-linear effects, the risk of IPV was high for women ≥ 5 years older or ≥ 25 years younger than their partners. Younger and older women had higher risks of IPV than those between 25 and 45 years. For spatial variation of IPV prevalence, northern regions had low spatial effects while western regions had very high spatial effects.

Conclusion

The prevalence of IPV among Namibia women was high especially among teenagers, with higher educational levels being protective. The risk of IPV was lower in rural than urban areas and higher with wide partner age differences. Interventions and policies for IPV prevention in Namibia are needed for couples with wide age differences as well as for younger women, women with lower educational attainment and in urban and western regions.
Breathing variability—implications for anaesthesiology and intensive care
Authors: van den Bosch Oscar F. C. , Alvarez-Jimenez Ricardo , de Grooth Harm-Jan , Girbes Armand R. J. , Loer Stephan A.
Published: August 2021

The respiratory system reacts instantaneously to intrinsic and extrinsic inputs. This adaptability results in significant fluctuations in breathing parameters, such as respiratory rate, tidal volume, and inspiratory flow profiles. Breathing variability is influenced by several conditions, including sleep, various pulmonary diseases, hypoxia, and anxiety disorders. Recent studies have suggested that weaning failure during mechanical ventilation may be predicted by low respiratory variability. This review describes methods for quantifying breathing variability, summarises the conditions and comorbidities that affect breathing variability, and discusses the potential implications of breathing variability for anaesthesia and intensive care.
Assessment of CareStart G6PD rapid diagnostic test and CareStart G6PD biosensor in Mauritania
Authors: Djigo Oum Kelthoum Mamadou , Ould Khalef Yacoub , Ould Ahmedou Salem Mohamed Salem , Gomez Nicolas , Basco Leonardo , Briolant Sébastien , Ould Mohamed Salem Boukhary Ali
Published: August 2021

Background

The elimination of Plasmodium vivax malaria requires 8-aminoquinolines, which are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency due to the risk of acute haemolytic anaemia. Several point-of-care devices have been developed to detect G6PD deficiency. The objective of the present study was to evaluate the performance of two of these devices against G6PD genotypes in Mauritania.

Methods

Outpatients were screened for G6PD deficiency using CareStart™ rapid diagnostic test (RDT) and CareStart™ G6PD biosensor in Nouakchott, Mauritania, in 2019–2020. African-type and Mediterranean-type G6PD genotypes commonly observed in Africa were determined by polymerase chain reaction-restriction fragment length polymorphism and sequencing. Qualitative variables were compared using Fisher’s exact test.

Results

Of 323 patients (74 males and 249 females), 5 males and 2 homozygous females had the African-type A- genotype: A−(202) in 3 males and 2 females and G6PD A−(968) in 2 males. Among heterozygous females, 13 carried G6PD A−(202), 12 G6PD A−(968), and 3 G6PD A−(542) variants. None had the Mediterranean-type G6PD genotype. Eight had a positive G6PD RDT result, including all 7 hemizygous males and homozygous females with A- or A-A- (0.12 to 2.34 IU/g haemoglobin, according to G6PD biosensor), but RDT performed poorly (sensitivity, 11.1% at the cut-off level of < 30%) and yielded many false negative tests. Thirty-seven (50.0%) males and 141 (56.6%) females were anaemic. The adjusted median values of G6PD activity were 5.72 and 5.34 IU/g haemoglobin in non-anaemic males (n = 35) and non-anaemic males and females (n = 130) with normal G6PD genotypes using G6PD biosensor, respectively. Based on the adjusted median of 5.34 IU/g haemoglobin, the performance of G6PD biosensor against genotyping was as follows: at 30% cut-off, the sensitivity and specificity were 85.7% and 91.7%, respectively, and at 80% cut-off, the sensitivity was 100% while the specificity was 64.9%.

Conclusions

Although this pilot study supports the utility of biosensor to screen for G6PD deficiency in patients, further investigation in parallel with spectrophotometry is required to promote and validate a more extensive use of this point-of-care device in areas where P. vivax is highly prevalent in Mauritania.

Graphic abstract
Warnings against romanticising moral injury
Authors: Molendijk Tine
Published: August 2021

Interest in the concept of moral injury among researchers, clinicians and policy makers can have undesirable consequences that are rarely considered. It can lead to misunderstanding of post-traumatic stress disorder, risks of primary and secondary gains for affected individuals and tertiary gains for third parties. This editorial calls for critical assessment of this sensitive matter.
TERT Promoter Mutations Are Enriched in Oral Cavity Cancers and Associated With Locoregional Recurrence
Authors: Yu Yao , Fan Dan , Song Xinmao , Zakeri Kaveh , Chen Linda , Kang Jung , McBride Sean , Tsai C. Jillian , Dunn Lara , Sherman Eric , Katabi Nora , Dogan Snjezana , Cracchiolo Jennifer , Cohen Marc , Boyle Jay O. , Lee Mark , Valero Cristina , Wang Jingming , Wong Richard , Morris Luc , Riaz Nadeem , Lee Nancy
Published: August 2021

PURPOSE

Telomerase reverse transcriptase ( TERT) promoter mutations are prognostic in many cancers and have been observed in human papillomavirus (HPV)–negative head and neck squamous cell carcinomas (HNSCCs). However, the role of TERT promoter mutations in HPV-negative HNSCCs remains poorly understood in these cancers, which have increased risk for locoregional failure (LRF).

PATIENTS AND METHODS

We retrospectively identified patients who were diagnosed with HNSCC between July 1, 2004, and October 12, 2017, at Memorial Sloan Kettering Cancer Center and whose tumors underwent next-generation sequencing using the MSK-IMPACT panel. Patients with HPV-positive oropharyngeal squamous cell carcinoma (SCC) were excluded. Cumulative incidence of LRF, patterns of failure, and overall survival were measured.

RESULTS

We identified 117 patients with SCC of the oral cavity (OSCC), larynx, hypopharynx, or HPV-negative oropharynx whose tumors underwent next-generation sequencing. Sequencing was performed on 95 tumors that were obtained after recurrence and 22 that were obtained before recurrence. TERT promoter mutations were enriched in OSCC compared with laryngopharyngeal cancers (81.1% v 7.0%; P < .001), which was the largest genetic difference between these anatomic disease subsites. TERT promoter mutations were associated with LRF in OSCCs (Gray's test, P < .001) and in the overall cohort (Gray's test, P < .001). On multivariate analysis, TERT promoter mutations were associated with an increased risk for LRF (subdistribution hazard ratio, 2.82; 95% CI, 1.47 to 5.42; P = .0019), independent of oral cavity primary site and TP53 mutation status.

CONCLUSION

TERT promoter status is associated with the cumulative incidence of LRF and patterns of failure. TERT promoter mutations may define a subset of OSCCs with unique pathogenesis that is associated with an increased risk of LRF. Validation in prospective cohorts is warranted.
QuantifyPolarity, a new tool-kit for measuring planar polarized protein distributions and cell properties in developing tissues
Authors: Tan Su Ee , Tan Weijie , Fisher Katherine H. , Strutt David
Published: August 2021

The coordination of cells or structures within the plane of a tissue is known as planar polarization. It is often governed by the asymmetric distribution of planar polarity proteins within cells. A number of quantitative methods have been developed to provide a readout of planar polarized protein distributions. However, previous planar polarity quantification methods can be affected by variation in cell geometry. Hence, we developed a novel planar polarity quantification method based on Principal Component Analysis (PCA) that is shape insensitive. Here, we compare this method with other state-of-the-art methods on simulated models and biological datasets. We found that the PCA method performs robustly in quantifying planar polarity independently of variation in cell geometry and other image conditions. We designed a user-friendly graphical user interface called QuantifyPolarity, equipped with three polarity methods for automated quantification of polarity. QuantifyPolarity also provides tools to quantify cell morphology and packing geometry, allowing the relationship of these characteristics to planar polarization to be investigated. This tool enables experimentalists with no prior computational expertise to perform high-throughput cell polarity and shape analysis automatically and efficiently.
Zur baulichen Entwicklung einer Häuserzeile am Birsig
Authors: Matt Christoph Ph. , Jaggi Bernard
Published: August 2021

Zu Beginn des Jahres 1989 wurde die Liegenschaft Falknerstrasse 29 vor dem Abbruch von der Archäologischen Bodenforschung und von der Basler Denkmalpflege gemeinsam untersucht. Die Untersuchungen erbrachten über die Parzelle hinaus auch für die Nachbarhäuser Ergebnisse zur Bau- und Entwicklungsgeschichte der Häuserzeile, die im vorliegenden Bericht vorgestellt werden.
Ein neuer Aufschluss der Inneren Stadtmauer am Leonhardsgraben Nr. 3 (1989/27)
Authors: Helmig Guido
Published: August 2021

Das gesamte Terrain des Hofes und Vorgartens der Liegenschaft Leonhardsgraben Nr. 3 wurde leicht abgesenkt, wobei die Abbruchkronen der Inneren Stadtmauer und weiterer Mauerzüge nur wenige Zentimeter unter der alten Pflästerung oberflächlich freigelegt wurden.