bluuebunny/crossref_metadata_2025 huggingface dataset:
Spontaneous arterial thrombosis in a patient with advanced ovarian clear cell cancer: a case report and literature review
Authors: Chen Jing , Sun Huimin , Wu Minrong , Zhong Xiaolin , Zhang Yuqin
Published: June 2020

Patients with ovarian cancer are often in a hypercoagulable state and have a high risk of venous thrombosis, including deep vein thrombosis and pulmonary embolism. However, arterial thrombosis is relatively rare in ovarian cancer. We report a case a 46-year-old woman with ovarian clear cell carcinoma who developed arterial and venous thrombosis in the lower extremities as the first manifestation. Her arterial thrombosis-related ischemic symptoms were not responsive to anticoagulant treatment of low-molecular-weight heparin, but improved after neoadjuvant chemotherapy and surgery. Therefore, we hypothesize that the optimal therapy for arterial thrombosis in ovarian cancer is treatment for the underlying disease (i.e., ovarian cancer). A thorough investigation is required to determine the relationships between arterial thrombosis and ovarian cancer and antithrombotic treatments for ovarian cancer related-arterial thrombosis.
Characteristics of cortical spreading depression and c-Fos expression in transgenic mice having a mutation associated with familial hemiplegic migraine 2
Authors: Tang Chunhua , Unekawa Miyuki , Shibata Mamoru , Tomita Yutaka , Izawa Yoshikane , Sugimoto Hiroki , Ikeda Keiko , Kawakami Kiyoshi , Suzuki Norihiro , Nakahara Jin
Published: June 2020

Background

Cortical spreading depression is thought to be the underlying mechanism of migraine aura. In 2006, three relatives having the point mutation E700K in ATP1A2 exon 15 were diagnosed with familial hemiplegic migraine 2 characterized by complicated forms of aura. Here, we generated a transgenic mouse model having the human E700K mutation in the Atp1a2 orthologous gene.

Objective

To investigate the characteristics of cortical spreading depression in a mouse model with E700K mutation in the Atp1a2.

Methods

Cortical spreading depression was induced by applying stepwise increases of KCl concentration or electrical stimulation intensity to C57BL/6J-Tg(Atp1a2*E700K)9151Kwk mice (Tg, both sexes) and corresponding wild-type animals. Under urethane anesthesia, the responsiveness and threshold to cortical spreading depression were examined and the distribution of c-Fos expression, a neuronal activity marker, was immunohistochemically determined.

Results

Overall, Tg mice showed significantly faster propagation velocity ( p < 0.01) and longer full-width-at-half-maximum ( p < 0.01) than wild-type animals, representing a slower recovery from direct current potential deflection. The cortical spreading depression threshold tended to be lower in Tg, especially in females. c-Fos-positive cells were significantly enhanced in the ipsilateral somatosensory cortex, piriform cortex, amygdala and striatum (each p < 0.05 vs. contralateral side). Numbers of c-Fos positive cells were significantly higher in the ipsilateral amygdala of Tg, as compared with wild-type animals ( p < 0.01).

Conclusion

The effect of cortical spreading depression may be greater in E700K transgenic mice than that in wild-type animals, while the threshold for cortical spreading depression shows little change. Higher c-Fos expression in the amygdala may indicate alterations of the limbic system in Tg, suggesting an enhanced linkage between cortical spreading depression and amygdala connectivity in familial hemiplegic migraine 2 patients.
Effect of Platelet-Rich Plasma on Nonsurgically Treated Acute Achilles Tendon Ruptures: A Randomized, Double-Blinded Prospective Study
Authors: Boesen Anders Ploug , Boesen Morten Ilum , Hansen Rudi , Barfod Kristoffer Weisskirchner , Lenskjold Anders , Malliaras Peter , Langberg Henning
Published: June 2020

Background:

An acute Achilles tendon rupture (ATR) is a long-lasting and devastating injury. Possible biological augmentation to promote and strengthen tendon healing after an ATR would be desirable.

Purpose:

To determine whether the application of a platelet-rich plasma (PRP) injection in nonsurgically treated ATRs may promote healing and thereby improve functional outcomes.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

A total of 40 men (aged 18-60 years) with an ATR incurred within 72 hours were included, and 38 were followed for 12 months. All patients were treated with an orthosis with 3 wedges for 8 weeks; full weightbearing from day 1 was allowed, combined with either 4 PRP or 4 placebo injections (a few drops of saline, <0.5 mL, under the skin) 14 days apart. All patients received the same instructions on an exercise program starting from week 9. Outcomes included the self-reported Achilles tendon Total Rupture Score (ATRS) as well as heel-rise work, heel-rise height, tendon elongation, calf circumference, and ankle dorsiflexion range of motion.

Results:

The mean ATRS score improved in both groups at all time points ( P < .001), but there was no difference between the groups at any time points (12 months: 90.1 points in PRP group and 88.8 points in placebo group). No differences in all functional outcomes at any time points were seen between the groups. At 12 months, the injured leg did not reach normal functional values compared with the uninjured leg.

Conclusion:

The application of PRP in nonsurgically treated ATRs did not appear to show any superior clinical and functional improvement.

Registration:

NCT02417922 (ClinicalTrials.gov identifier)
Polyvinylpyrrolidone with ammonium iodide and plasticizer ethylene carbonate solid polymer electrolyte for supercapacitor application
Authors: Nath Gaurav , Dhapola Pawan S , Sahoo NG , Singh Shruti , Singh Vijay , Singh Pramod K
Published: June 2020

The present work deals a new polymer electrolyte, that is, polyvinylpyrrolidone doped with salt ammonium iodide and plasticizer ethylene carbonate (EC) prepared via solution casting technique for supercapacitor application. Electrochemical impedance spectroscopy was carried out using CH instrument electrochemical work station which shows enhancement in conductivity ( σ) value by doping EC. Polarized optical microscopy confirms the reduction of crystallinity in the polymer electrolyte which established a good relation with our conductivity data. Fourier transform spectroscopy proves the composite nature of plasticized polymer electrolyte. X-Ray diffraction shows the decrease in the crystallinity in polymer matrix after incorporation with the plasticizer. A laboratory-scale electrical double-layer capacitor has been fabricated using graphene oxide electrode and maximum conducting polymer electrolyte which shows reasonable performance.
Thermal and optical properties of aromatic polyamide–hydrazides modified with multiwalled carbon nanotubes
Authors: Mohamed Nadia A , Selim SalahE , Galal Ahmed
Published: June 2020

Three wholly aromatic polyamide–hydrazides I–III containing various amounts of meta-/para-phenylene rings and their multiwalled carbon nanotube (MWCNT) composites have successfully been synthesized. These polymers were synthesized via a low-temperature solution polycondensation reaction of either meta-aminobenzhydrazide or para-aminobenzhydrazide (PABH) with an equimolar amount of isophthaloyl chloride (ICl) producing polymer I (100% meta-phenylene rings) and II (50% para-phenylene rings/50% meta-phenylene rings), respectively. The polymer III (75% para-phenylene rings/25% meta-phenylene rings) was synthesized by reacting PABH with mixture of equimolar ratios of terephthaloyl chloride and ICl. MWCNTs (0.1 wt%) have been incorporated into these three polymer matrices via a solution sonication technique. The structures of the polymers were confirmed by elemental analyses, Fourier-transform infrared, and proton nuclear magnetic resonance spectroscopy. The homogeneous distribution of the MWCNTs within the polymer matrices was proved by field emission scanning electron microscopy, transmission electron microscopy, and atomic force microscopy observations. Thermal and optical properties of the as-prepared polymers were being enhanced to some extent upon inclusion of MWCNTs as illustrated from the results of thermogravimetric analysis and ultraviolet–visible spectroscopy.
Chief Executive Officer Compensation and Financial Performance: Evidence from the Alternative Investment Market in the UK
Authors: Jeff Boakye Danquah , Sam Ahinful Gabriel , Nsor-Ambala Randolph
Published: June 2020

Purpose: This article investigates the relationship between executive compensation and financial performance for Alternative Investment Market (AIM)-listed firms in the UK. While most studies have looked at the impact of executive compensation on financial performance, this study argues that the issue of reverse causality cannot be ignored even if it is controlled and therefore investigates the extent to which financial performance can also impact on executive remuneration.

Design/methodology/approach: The study relies on a sample of 201 AIM-listed firms in the UK from 2011 to 2016 to examine the relationship between executive compensation and financial performance. It draws on agency and tournament theories to model the relationships between executive compensation and financial performance using various panel regression models.

Findings: The findings from the study revealed that the chief executive officer (CEO) remuneration impact on both accounting- and market-based measures of financial performance. It also showed that while performance-based incentives like bonus and other long-term incentives linked to performance significantly impact on financial performance, salary, a cash-based non-performance-related compensation rather negatively affects performance. It was also discovered that financial performance can also influence the level of executive compensation and not always vice versa.

Value/originality: The study adds novelties to the existing literature by introducing tournament theory to the studies on the relationship between executive compensation and financial performance. Most of the existing studies have been one sided and emphasise only on the influence of executive remuneration on financial performance. However, based on the tournament theory, the study argued that the issue of reverse causality between the two should not be overemphasised even if it is controlled.
KCNB1 gene polymorphisms and related indel as predictor biomarkers of treatment response for colorectal cancer – toward a personalized medicine
Authors: Barbirou Mouadh , Sghaier Ikram , Bedoui Sinda , Ben Abderrazek Rahma , Kraiem Hazar , Farah Azer , Hassiki Rym , Mokrani Amina , Mezlini Amel , Almawi Wassim Y , Loueslati-Yacoubi Besma , Bouhaouala-Zahar Balkiss
Published: June 2020

The KCNB1 gene variants were differentially associated with cancers. However, their association with colorectal cancer has not yet been explored. We investigated the contribution of the KCNB1 gene variants rs3331, rs1051295, and indel (insertion/deletion) rs11468831 Polymorphism as predictors of the treatment response in colorectal cancer patients. A retrospective study, which involved 291 Tunisian colorectal cancer patients (aged 60.0 ± 13.1 years), who were stratified into responder and non-responder groups, according to TNM stages and their responsiveness to chemotherapy based on fluorouracil. KCNB1 genotyping was performed with amplification-refractory mutation system–polymerase chain reaction, and was confirmed by Sanger sequencing. Sex-specific response was found and colorectal cancer females are less likely to achieve a positive response during the chemotherapy strategy, compared to males. Weight and body mass index, tumor size, and tumor localization are considered as predictive factors to treatment responsiveness. Carriage of rs11468831 Ins allele was significantly associated with successful therapy achievement ( p adjusted < 0.001). Stratification of colorectal cancer patients’ response according to tumor localization and TNM stages reveals negative association of rs3331 Major allele to treatment response among the patients with advanced cancer stages (subgroup G2). The presence of rs3331 (homozygous minor) C/C genotype was positively associated with decline in carcino-embryonic antigen ( p = 0.043) and CA19-9 ( p = 0.014) serum levels. On the other hand, the presence of rs1051295 (homozygous minor) A/A genotype was correlated with marked decline in CA19-9 serum levels. KCNB1 haplotype did not reveal any association between haplotypes and treatment response. The results obtained suggest that gender-specific strategies for screening treatment and prevention protocols as well as KCNB1 variants may constitute an effective model for ongoing personalization medicine.
Exploring behaviours of concern including aggression, self-harm, sexual harm and absconding within an Australian inpatient mental health service
Authors: Kang Matthew , Bushell Hannah , Lee Stuart , Berry Caitlin , Hollander Yitzchak , Rauchberger Ilan , Whitecross Fiona
Published: June 2020

Objective:

Patients admitted to mental health services may exhibit behaviours of concern (BOCs) such as aggression, self-harm, absconding and sexual harm. BOCs can lead to restrictive interventions, which have adverse effects on patients, carers and staff. This paper aims to explore the nature and outcome of BOCs within an adult inpatient mental health setting.

Methods:

A retrospective audit was conducted at a metropolitan inpatient service between 1 August 2016 and 31 July 2017. The frequency, nature and outcomes of BOC episodes were described and thematic analysis was used to summarise BOC antecedents.

Results:

A BOC was documented for 179 (18.2%) patients who also showed high rates of drug abuse, homelessness and longer admission. Most self-harm and sexual harm events occurred outside of normal business hours. Medications and verbal de-escalation were commonly used interventions. Episodes of deliberate self-harm were likely to result in patient and staff injury or mechanical restraint, whereas aggression was associated with seclusion. Mental state, care engagement, physiological stress and situational stressor were identified as BOC antecedents.

Conclusion:

Multiple forms of BOCs were experienced with mental state, physical and interpersonal contributors identified. Improving multidisciplinary input into early assessment and treatment of BOC causes is needed to improve safety.
The impact of maternal perinatal depression on exposure to reading and screen time for their infants: pilot findings from the MPEWS Study
Authors: Cowderoy Grace , Power Josephine , Lewis Andrew , Watson Stuart , Galbally Megan
Published: June 2020

Objective:

To explore the association between maternal depression and the screen and reading time experienced by their infants.

Methods:

This study utilises data on 158 women and infants, collected within the Mercy Pregnancy and Emotional Wellbeing Study. Women less than 20 weeks gestation were diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Six months postpartum they completed questionnaires about themselves, their infant and early parenting practices.

Results:

Children of women with a past diagnosis of depression were exposed to fewer days of 15-minute reading time per week compared to the children of women with no diagnosis. While the current depression group showed a lower average reading time, this difference was not statistically significant. There were no significant differences in infant screen time between groups.

Conclusions:

A maternal past diagnosis of depression is correlated with decreased reading time in infants. This may present a practical point for screening and intervention or suggest a causal pathway for poorer outcomes in children of those with depression.
Exploring associations between age of onset and quality of life of people with eating disorder behaviours and weight/shape overvaluation: a general population study
Authors: Wong Melody Nga Ting , Hay Phillipa
Published: June 2020

Objective:

To identify the age of onset of eating disorder behaviours (EDBs) and weight/shape overvaluation in a community sample and to evaluate the association between the age of onset and duration of EDBs with health related quality of life (HRQoL).

Method:

Data were extracted from the 2008/2009 Health Omnibus Survey (HOS). In 2008, 3034 and in 2009, 3007 participants from a randomly selected sample of households in the Australian population were interviewed for current and age of onset of EDBs. In 2008, mental and physical HRQoL was assessed with the Short Form 12-item instrument (SF-36-2). In 2009, role impairment was assessed with reported days out of role in the past month.

Results:

There were no significant associations between ages of onset of EDBs with the overall summary measures of physical or mental HRQoL. There was a significant positive association between the duration of EDBs with role impairment. The age of onset of EDBs had a significant negative association with physical HRQoL subscales of SF-36-2 but effect sizes were small.

Conclusions:

The age of onset of EDBs did not appear to have a significant impact on overall HRQoL measures but duration of symptoms impacted on current role function.
Moonlighting to the Side Hustle: The Effect of Working an Extra Job on Household Poverty for Households With Less Formal Education
Authors: Scott Jennifer , Edwards Kathryn , Stanczyk Alexandra
Published: June 2020

Although working more than one job to avoid economic hardship is not a new strategy for U.S. workers, official estimates suggest it is infrequent. These may not, however, include new conceptualizations of work like “side hustles.” To understand who works multiple jobs and its effect on economic well-being, we expanded the definition and used the Survey of Income and Program Participation to estimate (a) prevalence and (b) the effect of secondary earnings on household poverty. We found that 18.2% of households held multiple jobs and that secondary earnings reduced household poverty, and more effectively for consistent multiple jobholders. Integrating this understanding into economic well-being practice and policy interventions that expand employee benefits could better support multiple jobholding as a poverty reduction strategy.
The Wicked Problem of Stigma for Youth Living With Anxiety
Authors: Woodgate Roberta Lynn , Comaskey Brenda , Tennent Pauline , Wener Pamela , Altman Gary
Published: June 2020

Anxiety disorders typically emerge in childhood and, if left untreated, can lead to poor health and social outcomes into adulthood. Stigma contributes to the burden of mental illness in youth. Mental health stigma has been conceptualized as a wicked problem and efforts to address this complexity require a greater understanding of how stigma operates in the lives of youth. Fifty-eight youth in Manitoba, Canada aged 10 to 22 years and living with anxiety took part in the study. Data collection involved in-depth interviews and arts-based methodologies. Youth living with anxiety faced stigma at three levels: (a) interpersonal, (b) intrapersonal, and (c) structural. Stigma held by others, internalized by youth and embedded in social institutions led to compromised relationships with family and peers, low self-esteem and self-efficacy, reduced help-seeking, and discrimination in school, workplace and health care settings. Implications and potential strategies for addressing these levels of stigma are discussed.
Feminist-Informed Protective Factors for Subthreshold Eating Disorders
Authors: Wacker Emily C. , Dolbin-MacNab Megan L.
Published: June 2020

Despite knowledge that the larger sociocultural context contributes to the development of eating disorders, few studies have examined protective factors for women with subthreshold eating disorders. Using feminist-informed constructivist grounded theory methodology, 15 women (ages 18–25 years) with subthreshold eating disorders were interviewed. Results suggest that participants spoke of their subthreshold eating disorders in an externalized way and used protective factors to guide decision making toward their preferred values. A grounded theory model was developed to illustrate this process. Protective factors included (a) people who provide emotional and tangible support, (b) support people who challenge the eating disorder, (c) personal sense of agency, and (d) community activism and involvement. Participants experiencing subthreshold eating disorders demonstrated a capacity to distinguish their own thoughts and values from those of the “eating disorder voice,” and protective factors facilitated this process. Implications for future research and practice are discussed.
Clinical Data for the Use of Cannabis-Based Treatments: A Comprehensive Review of the Literature
Authors: Inglet Shannon , Winter Bradly , Yost Sarah E. , Entringer Sophia , Lian Anh , Biksacky Meryl , Pitt Renee D. , Mortensen Whitney
Published: June 2020

Objective:

To compile and synthesize the available literature describing medical cannabis use across various disease states.

Data Sources:

PubMed, EBSCO, and Google Scholar searches were conducted using MeSH and/or keywords.

Study Selection and Data Extraction:

Studies were included if they described the use of cannabis-based products and medications in the treatment of a predefined list of disease states in humans and were published in English. The extraction period had no historical limit and spanned through April 2019.

Data Synthesis:

Evidence was compiled and summarized for the following medical conditions: Alzheimer disease, amyotrophic lateral sclerosis, autism, cancer and cancer-associated adverse effects, seizure disorders, human immunodeficiency virus, inflammatory bowel disease, multiple sclerosis (MS), nausea, pain, posttraumatic stress disorder, and hospice care.

Relevance to Patient Care and Clinical Practice:

Based on identified data, the most robust evidence suggests that medical cannabis may be effective in the treatment of chemotherapy-induced nausea and vomiting, seizure disorders, MS-related spasticity, and pain (excluding diabetic neuropathy). Overall, the evidence is inconsistent and generally limited by poor quality. The large variation in cannabis-based products evaluated in studies limits the ability to make direct comparisons. Regardless of the product, a gradual dose titration was utilized in most studies. Cannabis-based therapies were typically well tolerated, with the most common adverse effects being dizziness, somnolence, dry mouth, nausea, and euphoria.

Conclusions:

As more states authorize medical cannabis use, there is an increasing need for high-quality clinical evidence describing its efficacy and safety. This review is intended to serve as a reference for clinicians, so that the risks and realistic benefits of medical cannabis are better understood.
Advocacy for Couples and Families: New Directions APA Publication Manual (7th Edition)
Authors: Noble Nicole , Bradley Loretta , Hendricks Bret
Published: June 2020

The 7th edition APA Publication Manual ( Manual) was released in October 2019. The significant changes between the 6th edition and 7th edition of the Manual were described in a previous issue of The Family Journal: Counseling and Therapy for Couples and Families. This article is written to expand on the substantial changes to the Manual’ s guidelines and to focus on bias-free language and inclusivity. Using the International Association of Marriage and Family Counselors Code of Ethics as a cornerstone, this article will focus on such diverse issues as advocacy, bias-free language, gender, inclusivity, racial/ethnic identity, sensitivity (avoiding labels), socioeconomic, and intersectionality issues. Recommendations are made, and examples are provided to help couple and family counselors become cognizant of the changes.
Modified wavelet method for solving fractional variational problems
Authors: Dehestani Haniye , Ordokhani Yadollah , Razzaghi Mohsen
Published: June 2020

In this article, a newly modified Bessel wavelet method for solving fractional variational problems is considered. The modified operational matrix of integration based on Bessel wavelet functions is proposed for solving the problems. In the process of computing this matrix, we have tried to provide a high-accuracy operational matrix. We also introduce the pseudo-operational matrix of derivative and the dual operational matrix with the coefficient. Also, we investigate the error analysis of the computational method. In the examples section, the behavior of the approximate solutions with respect to various parameters involved in the construction method is tested to illustrate the efficiency and accuracy of the proposed method.
Navigating the Decisions and Ethics of Authorship: An Examination of Graduate Student Journal Article Authorship
Authors: Baykaldi Sevgi , Miller Serena
Published: June 2020

Authorship and authorship order are visual shortcuts that communicate student success. We content analyzed to what extent graduate students published as lead authors in 10 refereed communication and media journals over a decade (2007–2016) examining student authorship, coauthorship, and affiliations. Graduate students appeared in approximately 23% of the sampled articles with graduate students most often appearing as lead author on multiauthored articles. If there is an increasing expectation to secure lead authorship, students may need to navigate the authorship process. Guidelines are provided on how to assess and negotiate authorship based on intellectual contributions, tasks, and sustained commitment.
Youth Risk-taking and Leisure: A Multifactorial Model in the Italian Context
Authors: Panarese Paola , Mingo Isabella
Published: June 2020

Literature on youth and risk has traditionally been dominated by psycho-dynamic explanations of social action, studied within a set of adult discourses and searching for single causes for risk-taking in practices like the abuse of alcohol and drugs, unprotected sex and dangerous driving.

To overcome these limitations, we listened to young Italian people through a survey conducted on a sample of 1,175 secondary school students and aimed at collecting their viewpoints on and experiences of the relationship between risk and leisure.

With an awareness of a plurality of factors influencing risk-taking among the young, this study hypothesizes a contiguity between voluntary risk exposure and gender, age, sociocultural family status, and leisure activities.

Both statistical textual analysis methods and logistic regression models were applied to reach the results. The findings show different semantic dimensions of risk according to different social factors.
Infrequent Monitoring of the Effects of Valproate and Carbamazepine Therapy in Patients With Epilepsy in Nigeria
Authors: Eshiet Unyime Israel , Ubaka Chukwuemeka Michael , Ukwe Chinwe Victoria
Published: June 2020

Background:

Carbamazepine and valproate are widely used in the treatment of epileptic seizures. However, these agents exhibit certain adverse effects including hematopoietic disorders (carbamazepine) and severe hepatotoxicity (valproate).

Purpose:

To determine the extent of monitoring of the hematologic effects of carbamazepine as well as the extent of monitoring of the hepatic effects of valproate in patients with epilepsy receiving treatment with these agents.

Method:

A cross-sectional antiepileptic drug use study using case notes of patients with epilepsy managed at the neurologic clinics of 2 tertiary medical facilities in Nigeria between January and December 2017.

Results:

Carbamazepine was the most frequently prescribed antiepileptic drug (48.24%), followed by valproate (29.34%) and levetiracetam (9.24%). Pretreatment monitoring of hematologic effect was carried out in only 61.11% of patients placed on carbamazepine therapy while follow-up monitoring was done in 3.7% of these patients. Also, in patients placed on valproate therapy, pretreatment and follow-up monitoring of the hepatic effect was done in only 33.71% and 19.0% of the patients, respectively.

Conclusions:

The extent of monitoring of the hematologic effects of carbamazepine, as well as the hepatic effects of valproate in the cohort studied, is poor.
Leading or led? A critical exploration of youth leadership development
Authors: Carroll Brigid , Firth Joshua
Published: June 2020

Leadership development for youth is an increasingly large global business that has to date lacked sustained critical scrutiny. Our inquiry is based on application, interview and reflection data from participants in a university-based leadership programme, capturing them at the point they transition to early work lives. We argue that leadership has become such a prevalent career and work discourse that the leadership development that happens in youth offers a unique window into new organisational workers, the leadership development industry and a complex leadership theoretical terrain. A set of five ‘leading’ discourses – separate, suspended, small, self and semi – were identified that invite critical inquiry. While youth leadership scholars have previously noted the suspended and separate discourses, we empirically refine those and offer the other three (small, self and semi) as important to current contestations between leaders, leadership and leadership development. In doing so, we question whether current leadership development for youth creates substantive leadership capacity in individuals, organisations or society.
Professor William Macewen (1848-1924): The Scottish Pioneer of Surgery
Authors: Laios Konstantinos , Xanthoulis Panagiotis , Mavrommatis Evangelos , Manes Konstantinos , Karambas Vassileios , Androutsos George
Published: June 2020

Professor William Macewen (1848-1924) is one of the most important figures in world’s surgery during 18th and early 19th century. He managed to provide numerous innovative techniques and instruments in various fields of surgery such as general surgery, orthopedic surgery, neurosurgery, and thoracic surgery. His innovations had a great impact after his time and constituted the fundaments for further surgical developments. He also was a pioneer in clinical photography with the creation of a huge archive. During his surgical career, he received many honors.
Recruiting African American parents of school-aged children in a physical activity study: Lessons learned
Authors: Webber-Ritchey Kashica J , Taylor-Piliae Ruth E , Loescher Lois J
Published: June 2020

Objectives

To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6–12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans’ physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge.

Methods

Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment.

Results

We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers ( n = 87, 69%) and males/fathers ( n = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust.

Discussion

Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.
Downregulation of GRK6 in arcuate nucleus promotes chronic visceral hypersensitivity via NF-κB upregulation in adult rats with neonatal maternal deprivation
Authors: Li Xin , Xu Yu-Cheng , Tian Yuan-Qin , Zhang Ping-An , Hu Shu-Fen , Wang Lin-Hui , Jiang Xing-Hong , Xu Guang-Yin
Published: June 2020

Aims

The arcuate nucleus is a vital brain region for coursing of pain command. G protein-coupled kinase 6 (GRK6) accommodates signaling through G protein-coupled receptors. Studies have demonstrated that GRK6 is involved in inflammatory pain and neuropathic pain. The present study was designed to explore the role and the underlying mechanism of GRK6 in arcuate nucleus of chronic visceral pain.

Methods

Chronic visceral pain of rats was induced by neonatal maternal deprivation and evaluated by monitoring the threshold of colorectal distension. Western blotting, immunofluorescence, real-time quantitative polymerase chain reaction techniques, and Nissl staining were employed to determine the expression and mutual effect of GRK6 with nuclear factor κB (NF-κB).

Results

Expression of GRK6 in arcuate nucleus was significantly reduced in neonatal maternal deprivation rats when compared with control rats. GRK6 was mainly expressed in arcuate nucleus neurons, but not in astrocytes, and a little in microglial cells. Neonatal maternal deprivation reduced the percentage of GRK6-positive neurons of arcuate nucleus. Overexpression of GRK6 by Lentiviral injection into arcuate nucleus reversed chronic visceral pain in neonatal maternal deprivation rats. Furthermore, the expression of NF-κB in arcuate nucleus was markedly upregulated in neonatal maternal deprivation rats. NF-κB selective inhibitor pyrrolidine dithiocarbamate suppressed chronic visceral pain in neonatal maternal deprivation rats. GRK6 and NF-κB were expressed in the arcuate nucleus neurons. Importantly, overexpression of GRK6 reversed NF-κB expression at the protein level. In contrast, injection of pyrrolidine dithiocarbamate once daily for seven consecutive days did not alter GRK6 expression in arcuate nucleus of neonatal maternal deprivation rats.

Conclusions

Present data suggest that GRK6 might be a pivotal molecule participated in the central mechanisms of chronic visceral pain, which might be mediated by inhibiting NF-κB signal pathway. Overexpression of GRK6 possibly represents a potential strategy for therapy of chronic visceral pain.
Pandemic ethics: the case for risky research
Authors: Chappell Richard Yetter , Singer Peter
Published: June 2020

There is too much that we do not know about COVID-19. The longer we take to find it out, the more lives will be lost. In this paper, we will defend a principle of risk parity: if it is permissible to expose some members of society (e.g. health workers or the economically vulnerable) to a certain level of ex ante risk in order to minimize overall harm from the virus, then it is permissible to expose fully informed volunteers to a comparable level of risk in the context of promising research into the virus. We apply this principle to three examples of risky research: skipping animal trials for promising treatments, human challenge trials to speed up vaccine development, and low-dose controlled infection or “variolation.” We conclude that if volunteers, fully informed about the risks, are willing to help fight the pandemic by aiding promising research, there are strong moral reasons to gratefully accept their help. To refuse it would implicitly subject others to still graver risks.
Insights into visual working memory precision at the feature- and object-level from a hemispheric encoding manipulation
Authors: Galeano Weber Elena M , Keglovits Haley , Fisher Arin , Bunge Silvia A
Published: June 2020

Mnemonic precision is an important aspect of visual working memory (WM). Here, we probed mechanisms that affect precision for spatial (size) and non-spatial (colour) features of an object, and whether these features are encoded and/or stored separately in WM. We probed precision at the feature-level—that is, whether different features of a single object are represented separately or together in WM—and the object-level—that is, whether different features across a set of sequentially presented objects are represented in the same or different WM stores. By manipulating whether stimuli were encoded by the left and/or right hemisphere, we gained further insights into how objects are represented in WM. At the feature-level, we tested whether recall fidelity for the two features of an object fluctuated in tandem from trial to trial. We observed no significant coupling under either central or lateralized encoding, supporting the claim of parallel feature channels at encoding. At the level of WM storage of a set of objects, we found asymmetric feature interference under central encoding, whereby an increase in colour load led to a decrease in size precision. When objects were encoded by a single hemisphere, however, we found largely independent feature stores. Precision for size was more resistant to interference from the size of another object under right-hemisphere encoding; by contrast, precision for colour did not differ across hemispheres, suggesting a more distributed WM store. These findings suggest that distinct features of a single object are represented separately but are then partially integrated during maintenance of a set of sequentially presented objects.
Switching from omalizumab to mepolizumab: real-life experience from Southern Italy
Authors: Carpagnano Giovanna Elisiana , Pelaia Corrado , D’Amato Maria , Crimi Nunzio , Scichilone Nicola , Scioscia Giulia , Resta Onofrio , Calabrese Cecilia , Pelaia Girolamo , Quarato Carla Maria Irene , Foschino Barbaro Maria Pia
Published: June 2020

Background:

Current availability of several biologic treatments for severe asthma makes it possible to choose the most appropriate for each patient. Sometimes a good percentage of patients with severe asthma may be eligible for biologics that target either the allergic phenotype or the eosinophilic one, but not all respond to that selected as first choice. The aim of our real-life study was to assess whether, for patients with severe eosinophilic allergic asthma, not previously controlled by the anti-IgE omalizumab, the shift to another biologic targeting interleukin-5, such as mepolizumab, may represent a good therapeutic choice.

Methods:

A total of 41 consecutive patients with severe, persistent allergic, eosinophilic asthma, uncontrolled despite treatment with omalizumab, were enrolled in seven certified Clinical Respiratory Units of Southern Italy (Catania, Catanzaro, Foggia, Bari, Palermo, and two University Respiratory Units of Naples) and shifted to mepolizumab without a wash-out period. Data at baseline, after at least 12 months of therapy with omalizumab, and after at least 12 months of treatment with mepolizumab were collected.

Results:

After at least 12 months of therapy with mepolizumab, patients experienced a significant decrease in the number of exacerbations/year (5.8 ± 1.8 versus 0.7 ± 0.9, p < 0.0001), an increment of asthma control test score (12 ± 2.7 versus 21.9 ± 2.7, p < 0.0001), an increase in pre-bronchodilator forced expiratory volume in 1 s (1.56 ± 0.45 l versus 1.86 ± 0.52 l, p < 0.0001), and a reduction of blood eosinophils (584 ± 196 cells/µl versus 82 ± 56 cells/µl, p < 0.0001). The percentage of patients who were dependent on corticosteroids significantly decreased from 46% at baseline to 5% during treatment with mepolizumab.

Conclusion:

Results of our real-life multicentric experience confirms that the shift to mepolizumab could be a good therapeutic strategy in severe eosinophilic allergic asthma not previously controlled by omalizumab. The reviews of this paper are available via the supplemental material section.
Mechanical heart valves and pregnancy: Issues surrounding anticoagulation. Experience from two obstetric cardiac centres
Authors: Dos Santos Francois , Baris Lucia , Varley Alice , Cornette Jerome , Allam Joanna , Steer Philip , Swan Lorna , Gatzoulis Michael , Roos-Hesselink Jolien , Johnson Mark R
Published: June 2020

Background

Pregnant women with mechanical heart valves are at significant risk of obstetric/cardiac complications. This study compares the anticoagulation management in two obstetric cardiac centres.

Methods

Retrospective case-note review from Chelsea and Westminster/Royal Brompton Hospitals (CR) and Erasmus Medical Centre (EMC). Main outcome measure was mechanical heart valve thrombosis.

Results

Nineteen pregnancies from CR and 25 pregnancies from EMC were included. Most women were on low-molecular-weight heparin (LMWH) throughout pregnancy at CR, whereas at EMC most had LMWH in the first trimester and vitamin K antagonists in subsequent trimesters. Peak anti-factor Xa were performed monthly at CR, levels 0.39–1.51 IU/mL (mean 0.82 IU/mL). Anticoagulation management peri-partum was inconsistent. Delivery was mainly by caesarean section at CR (74%) and vaginal delivery at EMC (64%). No maternal deaths and only one mechanical heart valve thrombosis at CR. Two mechanical heart valve thromboses and one maternal death at EMC.

Conclusion

Peri-partum anticoagulation strategies, anticoagulation monitoring and mode of delivery inconsistencies reported.
The functional role of long noncoding RNA in resistance to anticancer treatment
Authors: Qu Yidi , Tan Hor-Yue , Chan Yau-Tuen , Jiang Hongbo , Wang Ning , Wang Di
Published: June 2020

Chemotherapy is one of the fundamental methods of cancer treatment. However, drug resistance remains the main cause of clinical treatment failure. We comprehensively review the newly identified roles of long noncoding RNAs (lncRNAs) in oncobiology that are associated with drug resistance. The expression of lncRNAs is tissue-specific and often dysregulated in human cancers. Accumulating evidence suggests that lncRNAs are involved in chemoresistance of cancer cells. The main lncRNA-driven mechanisms of chemoresistance include regulation of drug efflux, DNA damage repair, cell cycle, apoptosis, epithelial-mesenchymal transition (EMT), induction of signaling pathways, and angiogenesis. LncRNA-driven mechanisms of resistance to various antineoplastic agents have been studied extensively. There are unique mechanisms of resistance against different types of drugs, and each mechanism may have more than one contributing factor. We summarize the emerging strategies that can be used to overcome the technical challenges in studying and addressing lncRNA-mediated drug resistance.
Body mass index and outcomes in ischaemic versus non-ischaemic heart failure across the spectrum of ejection fraction
Authors: Gentile Francesco , Sciarrone Paolo , Zamora Elisabet , De Antonio Marta , Santiago Evelyn , Domingo Mar , Aimo Alberto , Giannoni Alberto , Passino Claudio , Codina Pau , Bayes-Genis Antoni , Lupon Josep , Emdin Michele , Vergaro Giuseppe
Published: June 2020

Aims

Obesity is related to better prognosis in heart failure with either reduced (HFrEF; left ventricular ejection fraction (LVEF) < 40%) or preserved LVEF (HFpEF; LVEF ≥50%). Whether the obesity paradox exists in patients with heart failure and mid-range LVEF (HFmrEF; LVEF 40–49%) and whether it is independent of heart failure aetiology is unknown. Therefore, we aimed to test the prognostic value of body mass index (BMI) in ischaemic and non-ischaemic heart failure patients across the whole spectrum of LVEF.

Methods

Consecutive ambulatory heart failure patients were enrolled in two tertiary centres in Italy and Spain and classified as HFrEF, HFmrEF or HFpEF, of either ischaemic or non-ischaemic aetiology. Patients were stratified into underweight (BMI < 18.5 kg/m2), normal-weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), mild-obese (BMI 30–34.9 kg/m2), moderate-obese (BMI 35–39.9 kg/m2) and severe-obese (BMI ≥40 kg/m2) and followed up for the end-point of five-year all-cause mortality.

Results

We enrolled 5155 patients (age 70 years (60–77); 71% males; LVEF 35% (27–45); 63% HFrEF, 18% HFmrEF, 19% HFpEF). At multivariable analysis, mild obesity was independently associated with a lower risk of all-cause mortality in HFrEF (hazard ratio, 0.78 (95% confidence interval (CI) 0.64–0.95), p = 0.020), HFmrEF (hazard ratio 0.63 (95% CI 0.41–0.96), p = 0.029), and HFpEF (hazard ratio 0.60 (95% CI 0.42–0.88), p = 0.008). Both overweight and mild-to-moderate obesity were associated with better outcome in non-ischaemic heart failure, but not in ischaemic heart failure.

Conclusions

Mild obesity is independently associated with better survival in heart failure across the whole spectrum of LVEF. Prognostic benefit of obesity is maintained only in non-ischaemic heart failure.
Impact of environmental pollution and weather changes on the incidence of ST-elevation myocardial infarction
Authors: Biondi-Zoccai Giuseppe , Frati Giacomo , Gaspardone Achille , Mariano Enrica , Di Giosa Alessandro D , Bolignano Andrea , Dei Giudici Angela , Calcagno Simone , Scappaticci Massimiliano , Sciarretta Sebastiano , Valenti Valentina , Casati Rebecca , Visconti Giuseppe , Penco Maria , Giannico Maria B , Peruzzi Mariangela , Cavarretta Elena , Budassi Simone , Cosma Joseph , Federici Massimo , Roever Leonardo , Romeo Francesco , Versaci Francesco
Published: June 2020

Background

Environmental pollution and weather changes unfavorably impact on cardiovascular disease. However, limited research has focused on ST-elevation myocardial infarction (STEMI), the most severe yet distinctive form of acute coronary syndrome.

Methods and results

We appraised the impact of environmental and weather changes on the incidence of STEMI, analysing the bivariate and multivariable association between several environmental and atmospheric parameters and the daily incidence of STEMI in two large Italian urban areas. Specifically, we appraised: carbon monoxide (CO), nitrogen dioxide (NO2), nitric oxide (NOX), ozone, particulate matter smaller than 10 μm (PM10) and than 2.5 μm (PM2.5), temperature, atmospheric pressure, humidity and rainfall. A total of 4285 days at risk were appraised, with 3473 cases of STEMI. Specifically, no STEMI occurred in 1920 (44.8%) days, whereas one or more occurred in the remaining 2365 (55.2%) days. Multilevel modelling identified several pollution and weather predictors of STEMI. In particular, concentrations of CO (p = 0.024), NOX (p = 0.039), ozone (p = 0.003), PM10 (p = 0.033) and PM2.5 (p = 0.042) predicted STEMI as early as three days before the event, as well as subsequently, and NO predicted STEMI one day before (p = 0.010), as well as on the same day. A similar predictive role was evident for temperature and atmospheric pressure (all p < 0.05).

Conclusions

The risk of STEMI is strongly associated with pollution and weather features. While causation cannot yet be proven, environmental and weather changes could be exploited to predict STEMI risk in the following days.
A review of nutrition and dietary interventions in oncology
Authors: Gray Ashley , Dang Brian N , Moore Theodore B , Clemens Roger , Pressman Peter
Published: June 2020

The complex cellular mechanisms and inter-related pathways of cancer proliferation, evasion, and metastasis remain an emerging field of research. Over the last several decades, nutritional research has prominent role in identifying emerging adjuvant therapies in our fight against cancer. Nutritional and dietary interventions are being explored to improve the morbidity and mortality for cancer patients worldwide. In this review, we examine several dietary interventions and their proposed mechanisms against cancer as well as identifying limitations in the currently available literature. This review provides a comprehensive review of the cancer metabolism, dietary interventions used during cancer treatment, anti metabolic drugs, and their impact on nutritional deficiencies along with a critical review of the following diets: caloric restriction, intermittent fasting, ketogenic diet, Mediterranean diet, Japanese diet, and vegan diet.