bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Work Students’ Experiences of Ethical Difficulties in Field Placements: A Qualitative Study in China
Authors: Wu Lei , Huang Yunong , Chen Qiang , Shi Yu
Published: September 2020

Field placements provide social work students with opportunities to learn to handle ethical difficulties in a professional manner. In many developed countries, field staff are generally employed to supervise social work students’ field placements. ‘Code of Ethics’ and other ethics documents have also been developed to guide students’ professional activities. However, there is a lack of field staff, ‘Code of Ethics’ and other ethics documents in China, which may lead to ethical difficulties amongst students during their field placements. Based on the interviews of twenty-four social work students who completed field placements in 2016 at a university in China, this research revealed that students encountered many ethical difficulties in field placements. They tried to handle the difficulties in the beginning, but gradually adapted to the difficulties passively due to the lack of support. Most students also reported that they adhered to social work values and ethics in field placements and learned from field placements. The findings suggested that social work profession associations, Departments or Schools of Social Work, social work agencies and social work academia in China need to collaborate to create a more professional and supportive environment for students’ field placements.
Recalibrating the epigenetic clock: implications for assessing biological age in the human cortex
Authors: Shireby Gemma L , Davies Jonathan P , Francis Paul T , Burrage Joe , Walker Emma M , Neilson Grant W A , Dahir Aisha , Thomas Alan J , Love Seth , Smith Rebecca G , Lunnon Katie , Kumari Meena , Schalkwyk Leonard C , Morgan Kevin , Brookes Keeley , Hannon Eilis , Mill Jonathan
Published: September 2020

Human DNA methylation data have been used to develop biomarkers of ageing, referred to as ‘epigenetic clocks’, which have been widely used to identify differences between chronological age and biological age in health and disease including neurodegeneration, dementia and other brain phenotypes. Existing DNA methylation clocks have been shown to be highly accurate in blood but are less precise when used in older samples or in tissue types not included in training the model, including brain. We aimed to develop a novel epigenetic clock that performs optimally in human cortex tissue and has the potential to identify phenotypes associated with biological ageing in the brain. We generated an extensive dataset of human cortex DNA methylation data spanning the life course (n = 1397, ages = 1 to 108 years). This dataset was split into ‘training’ and ‘testing’ samples (training: n = 1047; testing: n = 350). DNA methylation age estimators were derived using a transformed version of chronological age on DNA methylation at specific sites using elastic net regression, a supervised machine learning method. The cortical clock was subsequently validated in a novel independent human cortex dataset (n = 1221, ages = 41 to 104 years) and tested for specificity in a large whole blood dataset (n = 1175, ages = 28 to 98 years). We identified a set of 347 DNA methylation sites that, in combination, optimally predict age in the human cortex. The sum of DNA methylation levels at these sites weighted by their regression coefficients provide the cortical DNA methylation clock age estimate. The novel clock dramatically outperformed previously reported clocks in additional cortical datasets. Our findings suggest that previous associations between predicted DNA methylation age and neurodegenerative phenotypes might represent false positives resulting from clocks not robustly calibrated to the tissue being tested and for phenotypes that become manifest in older ages. The age distribution and tissue type of samples included in training datasets need to be considered when building and applying epigenetic clock algorithms to human epidemiological or disease cohorts.
Lewis Blood-group Antigens Are Associated With Altered Susceptibility to Shigellosis
Authors: Leslie Jhansi L , Weddle Erin , Yum Lauren K , Lin Ye , Jenior Matthew L , Lee Benjamin , Ma Jennie Z , Kirkpatrick Beth D , Nayak Uma , Platts-Mills James A , Agaisse Herve F , Haque Rashidul , Petri William A
Published: September 2020

In a cohort of infants, we found that lack of the Lewis histo-blood group antigen was associated with increased susceptibility to shigellosis. Broadly inhibiting fucosylation in epithelial cells in vitro decreased invasion by Shigella flexneri. These results support a role for fucosylated glycans in susceptibility to shigellosis.
Anaemia and acute kidney injury: the tip of the iceberg?
Authors: Lombardi Yannis , Ridel Christophe , Touzot Maxime
Published: September 2020

Acute kidney injury (AKI) is a common disorder that complicates the hospital course of many patients. AKI is linked with an independent risk of death, hospital length of stay and chronic kidney disease (CKD). Several preoperative predictors are found to be associated with AKI after surgery independent of its origin (cardiac versus non-cardiac). Among these, anaemia has been widely recognized and studied. Anaemia is more common within the surgical population for various reasons (iron deficiency, blood loss, anaemia of chronic disease such as inflammatory state, malignancy or CKD). Both pre- and postoperative anaemia have a deleterious impact on different clinical outcomes including AKI. In this issue, Nishimoto et al. investigated whether AKI could be a risk factor for anaemia (and not the opposite) and whether anaemia could be an independent mediator of mortality after AKI.
An efficient dynamic Bayesian network classifier structure learning algorithm: application to sport epidemiology
Authors: Peterson Kyle D
Published: September 2020

Exposing an athlete to intense physical exertion when their organism is not ready for the mobilization of such resources can lead to musculoskeletal injury. In turn, sport practitioners regularly monitor athlete readiness in hopes of mitigating these tragic events. Rapid developments in athlete monitoring technologies has thus resulted in sport practitioners aspiring to siphon meaningful insight from high-throughput datasets. However, revealing the temporal sequence of biological adaptation while yielding accurate probabilistic predictions of an event, demands computationally efficient and accurate algorithms. The purpose of the present study is to create a model in the form of the intuitively appealing dynamic Bayesian network (DBN). Existing DBN approaches can be split into two varieties: either computationally burdensome and thus unscalable, or place structural constraints to increase scalability. This article introduces a novel algorithm ‘rapid incremental search for time-varying associations’ $(Rista)$, to be time-efficient without imposing structural constraints. Furthermore, it offers such flexibility and computational efficiency without compromising prediction performance. The present algorithm displays comparable results to contemporary algorithms in classification accuracy while maintaining superior speed.
Old wine in new wineskins? Understanding the cooperative movement: Catalonia, 1860–1939
Authors: Medina-Albaladejo Francisco J , Añón Higón Dolores , Díez-Minguela Alfonso , Lana-Berasain José-Miguel
Published: September 2020

Different factors have been proposed to explain why in some regions there is a greater tendency to form cooperatives. The debate remains open. In this study, we look at the spread of cooperativism within Catalonia from 1860 to 1939. Catalonia was not just the leading industrial region in Spain but also where cooperatives first emerged and had a greater presence. In line with the existing evidence, we find that cooperativism spread from coastal municipalities to the hinterland. In particular, it seems that local conditions (literacy and social capital) facilitated this process, while accessibility to the transport network and neighbouring effects also played a significant role.
On exact controllability of linear perturbed boundary systems: a semigroup approach
Authors: Lasri Marieme , Bounit Hamid , Hadd Said
Published: September 2020

The purpose of this paper is to investigate the robustness of exact controllability of perturbed linear systems in Banach spaces. Under some conditions, we prove that the exact controllability is preserved if we perturb the generator of an infinite-dimensional control system by appropriate Miyadera–Voigt perturbations. Furthermore, we study the robustness of exact controllability for perturbed boundary control systems. As application, we study the robustness of exact controllability of neutral equations. We mention that our approach is mainly based on the concept of feedback theory of infinite-dimensional linear systems.
Wayfinding in Virtual Environments With Landmarks on Overview Maps
Authors: Chen Chien-Hsiung , Chen Meng-Xi
Published: September 2020

This study aims to improve users’ positive experiences in wayfinding in virtual environments through empirical research on the influence of different designs of landmarks on overview maps. The experiment adopted a four (landmark) x two (gender) between-subjects design. Landmarks with symbols, symbols and images, symbols and text, and symbols, images and text were examined. Fifty-six participants were invited to complete three wayfinding tasks and fill out questionnaires. The generated results indicated that: (1) Landmark presentation styles significantly affect wayfinding performance on overview maps in virtual environments. (2) Concerning subjective rationality, system usability and perceived usefulness, the use of text in landmark design can significantly improve users’ evaluations of overview maps. (3) In terms of gender, females’ system usability evaluations and subjective intentions of using overview map with landmarks are significantly more positive than males’.
Topical Review: Crowdsourcing as a Novel Approach to Qualitative Research
Authors: Sood Erica , Wysocki Tim , Alderfer Melissa A , Aroian Karen , Christofferson Jennifer , Karpyn Allison , Kazak Anne E , Pierce Jessica
Published: September 2020

Objective 

To describe a novel, five-phase approach to collecting qualitative data from hard-to-reach populations using crowdsourcing methods.

Methods 

Drawing from experiences across recent studies with type 1 diabetes and congenital heart disease stakeholders, we describe five phases of crowdsourcing methodology, an innovative approach to conducting qualitative research within an online environment, and discuss relevant practical and ethical issues.

Results 

Phases of crowdsourcing methodology are: (I) Preparing; (II) Forming Crowds; (III) Collecting Crowdsourced Data; (IV) Coding and Analyzing Crowdsourced Data; and (V) Generating and Disseminating Findings. Iterative feedback from stakeholders is obtained in all five phases. Practical and ethical issues include accessing diverse stakeholders, emotional engagement of crowd participants, responsiveness and transparency of crowdsourcing methodology, and limited personal contact with crowd participants.

Conclusions 

Crowdsourcing is an innovative, efficient, feasible, and timely approach to engaging hard-to-reach populations in qualitative research.
Professional fission in medical routines: medical scribes and physicians in two US hospital departments
Authors: Bryan Ann L , Lammers John C
Published: September 2020

In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US’ federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes’ roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians’ work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.
The kinase module of the Mediator complex: an important signalling processor for the development and survival of plants
Authors: Agrawal Rekha , Jiří Fajkus , Thakur Jitendra K
Published: September 2020

Mediator, a multisubunit protein complex, is a signal processor that conveys regulatory information from transcription factors to RNA polymerase II and therefore plays an important role in the regulation of gene expression. This megadalton complex comprises four modules, namely, the head, middle, tail, and kinase modules. The first three modules form the core part of the complex, whereas association of the kinase module is facultative. The kinase module is able to alter the function of Mediator and has been established as a major transcriptional regulator of numerous developmental and biochemical processes. The kinase module consists of MED12, MED13, CycC, and kinase CDK8. Upon association with Mediator, the kinase module can alter its structure and function dramatically. In the past decade, research has established that the kinase module is very important for plant growth and development, and in the fight against biotic and abiotic challenges. However, there has been no comprehensive review discussing these findings in detail and depth. In this review, we survey the regulation of kinase module subunits and highlight their many functions in plants. Coordination between the subunits to process different signals for optimum plant growth and development is also discussed.
Overgrowth mutants determine the causal role of gibberellin GA2oxidaseA13 in Rht12 dwarfism of wheat
Authors: Buss Wolfram , Ford Brett A , Foo Eloise , Schnippenkoetter Wendelin , Borrill Philippa , Brooks Brenton , Ashton Anthony R , Chandler Peter M , Spielmeyer Wolfgang
Published: September 2020

The induced dwarf mutant Rht12 was previously shown to have agronomic potential to replace the conventional DELLA mutants Rht-B1b/Rht-D1b in wheat. The Rht12 dwarfing gene is not associated with reduced coleoptile length (unlike the DELLA mutants) and it is dominant, characteristics which are shared with the previously characterized dwarfing genes Rht18 and Rht14. Using the Rht18/Rht14 model, a gibberellin (GA) 2-oxidase gene was identified in the Rht12 region on chromosome 5A. A screen for suppressor mutants in the Rht12 background identified tall overgrowth individuals that were shown to contain loss-of-function mutations in GA2oxidaseA13, demonstrating the role of this gene in the Rht12 dwarf phenotype. It was concluded that Rht12, Rht18, and Rht14 share the same height-reducing mechanism through the increased expression of GA 2-oxidase genes. Some of the overgrowth mutants generated in this study were semi-dwarf and taller than the original Rht12 dwarf, providing breeders with new sources of agronomically useful dwarfism.
PROTAC-DB: an online database of PROTACs
Authors: Weng Gaoqi , Shen Chao , Cao Dongsheng , Gao Junbo , Dong Xiaowu , He Qiaojun , Yang Bo , Li Dan , Wu Jian , Hou Tingjun
Published: September 2020

Proteolysis-targeting chimeras (PROTACs), which selectively degrade targeted proteins by the ubiquitin-proteasome system, have emerged as a novel therapeutic technology with potential advantages over traditional inhibition strategies. In the past few years, this technology has achieved substantial progress and two PROTACs have been advanced into phase I clinical trials. However, this technology is still maturing and the design of PROTACs remains a great challenge. In order to promote the rational design of PROTACs, we present PROTAC-DB, a web-based open-access database that integrates structural information and experimental data of PROTACs. Currently, PROTAC-DB consists of 1662 PROTACs, 202 warheads (small molecules that target the proteins of interest), 65 E3 ligands (small molecules capable of recruiting E3 ligases) and 806 linkers, as well as their chemical structures, biological activities, and physicochemical properties. Except the biological activities of warheads and E3 ligands, PROTAC-DB also provides the degradation capacities, binding affinities and cellular activities for PROTACs. PROTAC-DB can be queried with two general searching approaches: text-based (target name, compound name or ID) and structure-based. In addition, for the convenience of users, a filtering tool for the searching results based on the physicochemical properties of compounds is also offered. PROTAC-DB is freely accessible at http://cadd.zju.edu.cn/protacdb/.
EP-7041, a Factor XIa Inhibitor as a Potential Antithrombotic Strategy in Extracorporeal Membrane Oxygenation: A Brief Report
Authors: Pollack Charles V. , Kurz Michael A. , Hayward Neil J.
Published: September 2020

Objectives:

Current approaches to systemic antithrombotic therapy in support of extracorporeal membrane oxygenation are limited and are hampered by both thrombotic and hemorrhagic complications. An alternative approach is needed.

Design:

Inhibition of coagulation factor XI/activated factor XI is an appealing pathway for antithrombotic support of extracorporeal membrane oxygenation. Selective inhibition of the contact pathway of coagulation could reduce bleeding risk, and because factor XI is linked with the inflammatory and complement systems, it can also be viewed as a biologically plausible target for the prevention of abnormal thrombosis during extracorporeal membrane oxygenation.

Conclusions:

We introduce initial information on EP-7041, a parenteral, potent, and selective, small-molecule activated factor XIa inhibitor with pharmacodynamic and pharmacokinetic characteristics that appear well suited for use in a critical care environment.
Inline Positive End-Expiratory Pressure Valves: The Essential Component of Individualized Split Ventilator Circuits
Authors: Roy Steven , Bunting Leonard , Stahl Stefan , Textor Dominik
Published: September 2020

Background:

As resources are overwhelmed with the coronavirus disease 2019 pandemic, multiple approaches to produce individualized split-ventilator designs have emerged. These designs attempt to address the significant limitations and safety concerns of coventilation practices by allowing practitioners to adjust pressure settings for individual patients connected with specialized circuits to a single ventilator. The critical component in virtually all individualized circuit designs is the adjustable inline positive end-expiratory pressure valve.

Methods:

We reviewed the literature on the mechanics of inline positive end-expiratory pressure valve function, the implications and considerations for advanced application of inline positive end-expiratory pressure valves in individualized circuits, available methods of adapting commercial positive end-expiratory pressure valves in the resource-restricted setting, and major caveats of the use of inline positive end-expiratory pressure valves.

Results and Conclusions:

The function of adjustable inline positive end-expiratory pressure valves in advanced individualized ventilator circuits has not been described. Adjustable inline positive end-expiratory pressure valves are critical to individualized circuit reliability and patient safety when attempting to extend ventilator capacity in the setting of extreme ventilator shortages. Adjustable inline positive end-expiratory pressure valves provide a means to reduce delivered peak inspiratory pressure to an individual patient circuit, a method to increase positive end-expiratory pressure for an individual patient circuit, and act as an one-way valve to ensure unidirectional gas flow through the divided circuit. Adjustable inline positive end-expiratory pressure valves can be adapted from commercial valves or printed de novo when commercial options are unavailable. Noncommercial sourcing of ventilator components should only be considered in the setting of extreme ventilator shortages under the supervision of a knowledgeable anesthesiologist or intensivist.
Management of Acute Ischemic Stroke
Authors: Herpich Franziska , Rincon Fred
Published: September 2020

Objectives:

Concise “synthetic” review of the state of the art of management of acute ischemic stroke.

Data Sources:

Available literature on PubMed.

Study Selection:

We selected landmark studies, recent clinical trials, observational studies, and professional guidelines on the management of stroke including the last 10 years.

Data Extraction:

Eligible studies were identified and results leading to guideline recommendations were summarized.

Data Synthesis:

Stroke mortality has been declining over the past 6 decades, and as a result, stroke has fallen from the second to the fifth leading cause of death in the United States. This trend may follow recent advances in the management of stroke, which highlight the importance of early recognition and early revascularization. Recent studies have shown that early recognition, emergency interventional treatment of acute ischemic stroke, and treatment in dedicated stroke centers can significantly reduce stroke-related morbidity and mortality. However, stroke remains the second leading cause of death worldwide and the number one cause for acquired long-term disability, resulting in a global annual economic burden.

Conclusions:

Appropriate treatment of ischemic stroke is essential in the reduction of mortality and morbidity. Management of stroke involves a multidisciplinary approach that starts and extends beyond hospital admission.
Transcatheter Mitral Valve Replacement: Procedural Planning, Utility, and Applicability
Authors: Alexis Sophia L. , Sengupta Aditya , Zaid Syed , Kaple Ryan , Ahmad Hasan , Malik Aaqib , Biswas Medha , Tang Gilbert H. L.
Published: September 2020

Since the first native transcatheter mitral valve implantation in 2012, transcatheter mitral valve replacement (TMVR) has expanded its use to degenerated bioprostheses, failed annuloplasty ring repair, and mitral annular calcification. However, high-screen failure rates in trials have persisted due to predicted left ventricular outflow tract obstruction and unfavorable anatomy. Preprocedural planning in this patient population with multidetector computed tomography and transesophageal echocardiography is paramount to intraprocedural success. In patients with favorable left ventricular outflow tract anatomy who are not surgical candidates, the transseptal approach is preferred. In those who are surgical candidates, TMVR can be performed via a transapical or transatrial approach. Currently, a plethora of TMVR devices targeting the native mitral pathologies are undergoing clinical trials. Data have consistently shown the greatest benefit of this procedure in native mitral regurgitation and failed bioprostheses rather than failed annuloplasty rings or mitral annular calcification. With technological advancement and careful patient selection, this therapy will serve as a complement to surgical and TMV repair and will continue to expand to address MV diseases in a broader patient population.
Impact of Anatomic Extent of Nodal Metastasis on Adjuvant Chemotherapy Outcomes in Stage III Colon Cancer
Authors: Woo In Teak , Park Jun Seok , Kang Byung Woog , Park Soo Yeun , Kim Hye Jin , Choi Gyu-Seog , Gwang Kim Jong
Published: September 2020

BACKGROUND:

An oxaliplatin-based chemotherapy regimen improves the survival outcomes of patients with stage III colon cancer. However, its complications are well-known.

OBJECTIVE:

The purpose of this study was to distinguish between the survival outcomes of patients who underwent curative resection for stage III colon cancer with oxaliplatin chemotherapy and those who underwent such resection without oxaliplatin chemotherapy.

DESIGN:

This was a retrospective analytical study based on prospectively collected data.

SETTINGS:

This study used data on patients who underwent surgery at our hospital between January 2010 and December 2014.

PATIENTS:

A cohort of 254 consecutive patients who underwent curative resection for stage III colon cancer was included in this study. The patients were divided into 2 groups: patients with isolated pericolic lymph node metastasis (n = 175) and those with extrapericolic lymph node metastasis (n = 79).

MAIN OUTCOME MEASURES:

Clinicopathologic features and 3-year survival outcomes were analyzed with and without oxaliplatin therapy in the pericolic lymph node group.

RESULTS:

The pericolic lymph node group showed significantly improved overall survival compared with the extrapericolic lymph node group at a median follow-up of 48.5 months (95.8% vs 77.8%; p < 0.001). In contrast, there was no significant difference in overall survival (99.0% vs 92.0%; p = 0.137) and disease-free survival (89.1% vs 88.2%; p = 0.460) between the oxaliplatin and nonoxaliplatin subgroups of the pericolic lymph node group. Multivariate analysis showed that the administration of oxaliplatin chemotherapy to the pericolic lymph node group did not lead to a significant difference in the overall survival (p = 0.594).

LIMITATIONS:

The study was limited by its retrospective design and single institutional data analysis.

CONCLUSIONS:

This study suggests that the anatomic extent of metastatic lymph nodes could affect patient prognosis, and the effect of oxaliplatin-based adjuvant chemotherapy may not be prominent in stage III colon cancer with isolated pericolic lymph node metastasis.
New-onset intra-operative hyperthermia in a large surgical patient population
Authors: Mittnacht Alexander J.C. , Lin Hung-Mo , Liu Xiaoyu , Wax David
Published: September 2020

BACKGROUND

Intra-operative hypothermia has been extensively investigated. However, the incidence of intra-operative hyperthermia has not been investigated in detail.

OBJECTIVE

The main objective of this study was to assess the incidence and risk factors of new-onset intra-operative hyperthermia in a large surgical patient population.

DESIGN

Retrospective database review.

SETTING

Tertiary-care teaching hospital.

PATIENTS

Patients undergoing surgery with general anaesthesia between 1 January 2002 and 31 December 2017 were included.

MAIN OUTCOME MEASURES

The primary outcome measurement was new-onset intra-operative hyperthermia (>37.5 °C). A logistic regression model was fitted to identify risk factors for intra-operative hyperthermia.

RESULTS

A total of 103 648 patients were included in the final analyses. The incidence of new-onset hyperthermia in the overall patient cohort was 6.45%, reaching 20 to 30% after prolonged (>8 h) surgery, and was up to 26.5% in paediatric patients. The use of forced air active patient warming, larger amounts of fluid administration, longer surgery, younger age and smaller body size were all independently associated with intra-operative hyperthermia. The adoption of the Surgical Care Improvement Project (SCIP) temperature measures was associated with an increased incidence of intra-operative hyperthermia.

CONCLUSION

Mild intra-operative hyperthermia is not uncommon particularly in longer procedures and small children.
A Study of Physical Activity, Frailty, and Health-Related Quality of Life Among Community-Dwelling Older Adults in Taiwan
Authors: LI Pei-Shan , HSIEH Chia-Jung , MIAO Nae-Fang
Published: September 2020

Background

Health-related quality of life (HRQoL) in community-dwelling older adults increases as physical activity improves, and age-related frailty has a negative effect on HRQoL. Research on these associations is lacking.

Purpose

The aims of this study were to (a) analyze the effect of demographic characteristics on HRQoL, (b) explore the correlation between physical activity and HRQoL, (c) analyze the effect of frailty on HRQoL, and (d) investigate the potential predictors of HRQoL in community-dwelling older adults.

Methods

In this cross-sectional study, a convenience sample of 150 older adults was recruited from community care sites in Shilin and Beitou Districts in Taipei City, Taiwan. Data were collected at baseline using a demographic characteristics datasheet, the Center for Epidemiologic Studies Depression Scale, the Physical Activity Scale for the Elderly, and the 12-Item Short Form Health Survey. The Senior Fitness Test and hand-grip strength test were also performed. Student t test, chi-square test, analysis of variance, Pearson correlation coefficient, and hierarchical regression were applied to analyze the statistical results using IBM SPSS Statistics Version 22.0.

Results

Being of older age, experiencing a higher number of falls, having more chronic diseases, and having a higher body mass index were identified as factors that significantly affect HRQoL. Moreover, HRQoL was found to be significantly affected by the performance of physical activity or status of frailty. Furthermore, the prefrail period was shown to be an important predictor of HRQoL after adjusting for demographic variables, history of chronic illness, history of falls, and physical activity.

Conclusions/Implications for Practice

In this study, HRQoL was found to be significantly affected by upper limb dysfunction and the prefrail period. Community health promotion activities should focus greater attention on the physical functioning of older adults. Furthermore, providing information on age-related frailty and promoting active participation in community activities may increase the attention given by community-dwelling older adults to physical fitness and quality of life.
Transimpedance Matrix (TIM) Measurement for the Detection of Intraoperative Electrode Tip Foldover Using the Slim Modiolar Electrode: A Proof of Concept Study
Authors: Klabbers Tim M. , Huinck Wendy J. , Heutink Floris , Verbist Berit M. , Mylanus Emmanuel A.M.
Published: September 2020

Objectives:

The aim of this study is to report on our preliminary experience with Transimpedance Matrix (TIM)-measurement for the detection of cochlear implant electrode tip foldovers compared with intraoperative imaging in patients implanted with the slim modiolar electrode (SME).

Study Design:

Proof of concept study.

Setting:

Tertiary university referral center.

Patients:

Twenty five ears (in 22 patients) implanted consecutively with the SME.

Intervention(s):

Following cochlear implantation, intraoperative TIM-measurement and fluoroscopy were performed. One week postoperatively, the electrode position was evaluated using Computed Tomography (CT)-imaging.

Main Outcome Measures:

Electrode array tip foldover.

Results:

Electrode array tip foldover occurred in three of the 25 cochlear implantations performed (12%). In each case, the foldover was detected by both TIM and fluoroscopy, leading to reposition and correct intracochlear placement of the array.

Conclusions:

TIM-measurement is a promising method for the intraoperative detection of an electrode array tip foldover. The TIM-tool with intuitive heatmap display is easy to use, fast, and readily available to clinics using TIM-software in the operating theatre.
Middle Cranial Fossa Approach to Vestibular Schwannoma Resection in the Older Patient Population
Authors: Kohlberg Gavriel D. , Lipschitz Noga , Raghavan Arun M. , Breen Joseph T. , Pensak Myles L. , Zuccarello Mario , Samy Ravi N.
Published: September 2020

Objective:

Compare outcomes of middle cranial fossa approach (MCF) to vestibular schwannoma (VS) resection in patients 60 years of age and older to patients under 60.

Study Design:

Retrospective case series.

Setting:

Tertiary referral center.

Patients:

Charts of 216 consecutive VS patients over 18 years of age were reviewed to identify 67 patients who underwent MCF approach to VS resection between 2006 and 2017.

Intervention(s):

Age at time of surgery.

Main Outcome Measure(s):

Measured outcomes included postoperative hearing results, facial nerve function, length of hospital stay, wound complications, cerebrospinal fluid leak, myocardial infarction, cerebrovascular accident, seizure, deep vein thrombosis, 30-day readmission, and return to operating room.

Results:

Sixty-seven patients underwent VS resection via MCF approach including 16 patients > = 60 years (mean 64.4 SD 3.3) and 51 patients < 60 years (mean 45.7 SD 10.2). Between these two groups, there were no differences in sex, tumor laterality, tumor size (10.4 mm versus 9.8 mm, p = 0.6), or other demographic characteristics. Postoperatively, there were no differences between groups in complication rates. Rates of HB 1 or 2 facial nerve function were similar (93.8% versus 88.2%, p = 0.7) as were rates of maintenance of class A or B hearing (58.3% versus 44.4%, p = 0.7).

Conclusions:

Patients over 60 undergoing MCF for VS resection experienced similar rates of postoperative complications, facial nerve outcomes, and hearing preservation compared with younger patients. MCF for VS may be considered in the older population. Further research is warranted to evaluate appropriate limitations for this approach based on age.
Clinical evaluation of kit based Tc-99m-HYNIC-RGD2 for imaging angiogenesis in breast carcinoma patients
Authors: Vatsa Rakhee , Madaan Shivani , Chakraborty Sudipta , Dash Ashutosh , Singh Gurpreet , Mittal Bhagwant Rai , Shukla Jaya
Published: September 2020

Background

Radiolabeled RGD peptide can be used for noninvasive in vivo imaging of αvβ3 integrin receptors leading to early detection of tumor cells and hence improving the clinical outcomes. In the present study single vial kit based HYNIC RGD2 was radiolabeled with Tc-99m and evaluated in patients with breast carcinoma.

Methods

Radiolabeling was performed via bifunctional chelator method. Tc-99m 1110–2960 MBq (30–80 mCi) was added to the HYNIC-RGD2 vial. The reaction mixture was heated for 20 minutes at 100°C. After performing the quality checks, whole-body planar imaging was performed in 20 patients at 2–2.5 h post i.v. injection of 555–740 MBq (15–20 mCi) of the radiotracer.

Results

Radiolabeling yield of ≥98% was observed in all the formulations. Quality control tests indicated the suitability of radiopharmaceutical for intravenous administration. Physiological uptake of Tc-99m HYNIC-RGD2 was observed in the nasopharynx, salivary glands, liver, spleen, and intestine. Good uptake of radiotracer was observed in breast lesions of 18 patients. Two patients were observed to be negative. Increased uptake was also seen in metastatic sites in two patients and in lymph nodes in three patients. Scintigraphy findings were in corroboration with pathological observations.

Conclusion

The single vial cold kit based radiolabeling of Tc-99m HYNIC-RGD2 is facile leading to its easy availability. Tc-99m HYNIC-RGD2 is a promising radiopharmaceutical which can be used for the molecular imaging of angiogenesis in breast carcinoma patients.
New paradigms in the management of recurrent urinary tract infections
Authors: Taich Lior , Zhao Hanson , Cordero Camila , Anger Jennifer T.
Published: September 2020

Purpose of review

Recurrent urinary tract infections (rUTIs) represent a large burden on the healthcare system. Recent guidelines from the AUA/CUA/SUFU and advancements in the field reflect a paradigm shift for clinician and patients, steering away from empiric antibiotic therapy towards judicious antibiotic use.

Recent findings

Antibiotic stewardship, including increasing awareness of the collateral damage of antibiotics and the risks of bacterial resistance are a major focus of the new guidelines. Accurate diagnosis of rUTIs is imperative. Urine cultures are necessary to document rUTI and should be obtained prior to any treatment. First line treatment options (trimethoprim–sulfamethoxazole, nitrofurantoin, and fosfomycin) should be used whenever possible. Asymptomatic bacteriuria should not be treated in these patients with rUTI. Although antibiotic prophylaxis methods are effective, nonantibiotic regimens show promise.

The management of rUTIs has evolved significantly with the goal of antibiotic stewardship. It is increasingly important to ensure the accuracy of diagnosis with a positive urine culture in the setting of cystitis symptoms, and standardize treatment with first-line therapies to minimize antibiotic side effects.
Endoscopic Resection of a T-Shaped Benign Fibrous Histiocytoma at the Skull Base in a Pediatric Patient
Authors: Li Chen , Wang Xingdong , Li Yuping , Zhang Xiaobiao , Dong Lun , Zhang Hengzhu
Published: September 2020

Background:

Benign fibrous histiocytoma (BFH) is a benign tumor composed of cells with characteristics of histiocytes and with fibroblastic components. BFHs are rare lesions, especially in the skull base.

Clinical Presentation:

Here, the authors report the case of a 9-year-old girl presented with reduced binocular vision for 2 months. The computerized tomography (CT) of the tumor appearance was high-density annular sclerosis. The tumor was removed via nasal endoscopic approach. Final pathologic diagnosis was benign fibrous histiocytoma. The post-operative period was uneventful after 8 months, and the visual acuity was improved to some extent.

Discussion and Conclusion:

This is the first case of BFH in a pediatric patient that was removed by endoscope. For similar case, endoscopic resection might be the first choice, including pediatric patient. Moreover, the CT feature and literature review may provide further insight into the diagnosis and management.
Temporomandibular Joint Dysplasia in Cranio-Maxillofacial Dysplasia: A Retrospective Study. Guideline Treatment Proposal
Authors: Ferri Joël , Schlund Matthias , Touzet-Roumazeille Sandrine , Sciote James J. , Nicot Romain
Published: September 2020

Introduction:

Cranio-Maxillofacial Dysplasias (CMD), including Craniofacial Microsomias, syndromes (such as Treacher Collins or Williams) and isolated Condylo-Mandibulo-Dysplasia, is a controversial subject with treatments as diverse as diagnostic classifications. The authors present here a retrospective study of 85 patients, with congenital condyle dysplasia arising from these 3 main types of CMD, treated with different techniques that aimed to normalize the facial skeleton and occlusion.

Methods:

The authors studied retrospectively 85 patients, aged from 3 to 53 years old, affected by different types of CMD. Treatment options included: costochondral grafts, orthognathic surgeries, distraction osteogenesis procedures, orthodontic and dentofacial orthopedic treatments, and soft tissues surgeries. Outcomes were evaluated by the surgical team.

Results:

Seventeen patients were treated with costochondral grafting, 14 with distraction osteogenesis, 17 with orthodontic and dentofacial orthopedic, and 45 with orthognathic surgery. The authors did not perform any nerve grafting or temporomandibular joints prosthesis placement. Fifty-one patients presented an excellent result, 10 a good result, 9 a poor result, 2 a bad result, and 14 an unknown result.

Discussion:

Several different treatments of CMD can be proposed. The authors think that major defect in children should undergo costochondral grafting because of its growth potential while in case of minor defect, orthopedic treatment should be tried in the first place. Distraction osteogenesis should be reserved for cases with poor response after orthopedic treatment or growth insufficiency with costochondral grafting. Orthognathic surgery is often necessary at the end of the growth period to obtain an excellent result. Temporomandibular joints prosthesis should be reserved for extreme cases.
Study of the Effect of Topical Ozonated Oil on Healing of Calvarial Defect
Authors: Dorry Sepehr , Moslemi Hamid Reza , Yousefi Mohammad Hassan , Hamedani Mahmood Ahmadi , Khaligh Sahar Ghaffari
Published: September 2020

Background:

Fracture healing is one of the important issues in medicine and veterinarian medicine. A new technique should be detected with fewer side effects which improves the speed of the healing. This study was conducted to evaluate the effect of topical ozonated oil on the healing of bone defects created in rat calvarium.

Methods:

Defects of 7 mm were induced with a trephine in the calvaria of 45 male Sprague–Dawley rats. The animals were divided into 3 groups, and the defects in each group were filled with ozonated oil, olive oil, or left empty as a control. The animals were euthanized at 3 different time points (14, 28, and 42 days post-operation). Histological and serological (alkaline phosphatase) assessments were carried out on 14, 28, and 42 days post-operation.

Results:

On 14 and 28 days post-operation, in the edges of the defect, there was a significant difference between the ozonated oil group and olive oil as well as control groups (P≤ 0.05). However, in the center of the defect, there were no statistically significant differences between the 3 groups (P > 0.05). On day 42, in the edges and center of the defect, there was a significant difference between the ozonated oil group and olive oil as well as control groups statistically (P≤ 0.05).

Conclusion:

The results of this study indicate the potential efficacy of ozonated oil as a bone substitute in a rat calvarial defect model.
Neurogenic Blepharoptosis After Medial Orbital Wall Reconstruction
Authors: Lee Jun Yong , Shin Jeonghwan , Baek Sang Oon
Published: September 2020

Neurogenic blepharoptosis after orbital wall reconstruction is a rare complication. It can either present as an isolated blepharoptosis, or accompany with other ocular symptoms. The authors introduce 4 cases of post-operative neurogenic blepharoptosis after reconstruction of medial orbital wall via transcaruncular approach.

Immediately after the surgery, 2 adolescent patients experienced unilateral islolated complete blepharoptosis with no other ocular symptoms. The other 2 adult patients presented unilateral complete blepharoptosis accompanied by lateral displacement of the globe and evident extraocular movement limitations. The 2 adolescent patients were observed with no particular treatment, whereas the other 2 adult patients were treated with intravenous systemic steroids. The blepharoptosis symptom began to improve at 2 weeks post-operatively and completely recovered within 3 to 4 months in all patients, while the globe displacement and extraocular movement limitation started to improve at 4 weeks after the surgery and fully recovered within 6 months.

Although neurogenic blepharoptosis after medial orbital wall reconstruction is a very rare complication, it can be critical once it occurs. According to the author's experience, it fortunately shows a favorable clinical course of spontaneous recovery. Post-operative neurogenic blepharoptosis usually recovers between 2 weeks and 4 months and other ocular symptoms related to oculomotor nerve injury recovers within 6 months after the surgery.
Preclinical Research Reporting in Shock: Room for Improvement
Authors: Reynolds Penny S. , Garvan Cynthia W.
Published: September 2020

The ARRIVE (Animals in Research: Reporting In Vivo Experiments) guidelines were endorsed by the Shock Society in 2012, but to date there has been no systematic evaluation of research reporting quality for Shock. We systematically assessed 100 randomly selected animal-based research articles published between 2014 and 2018 for reporting quality and statistical practice, compared with 40 pre-ARRIVE studies. More than half of surveyed papers omitted verifiable ethical oversight information and basic animal descriptive information. Few papers reported best-practice methods, such as sample size justification (10%), randomization (43%), randomization method (7%), blinding (23%). Only one paper reported effect sizes to interpret study results. Most troubling was inadequate reporting of welfare-related information (anesthesia, analgesia, humane endpoints, euthanasia). Almost a decade after ARRIVE endorsement, our findings show that reporting deficiencies have persisted with little sign of correction. There is a clear need for investigators to increase transparency of research methods reporting, and drastically improve skills in experimental design. Improvement in standards and greater attention paid to reporting will lead to improvement in reproducibility, replicability, and research quality. It is incumbent upon the research community to improve reporting practices; accurate and transparent reporting is integral to producing rigorous and ethical science.
Quality of Life After Elective Laparoscopic Sigmoidectomy for Symptomatic Uncomplicated Diverticular Disease
Authors: Mari Gulio M. , Crippa Jacopo , Roscio Francesco , Scandroglio Ildo , Cocozza Eugenio , Borroni Giacomo , Berselli Mattia , Achilli Pietro , Costanzi Andrea T.M. , Maggioni Dario
Published: September 2020

Introduction:

Symptomatic uncomplicated diverticular disease (SUDD) is characterized by abdominal pain and altered bowel function and may affect quality of life. When symptoms are severe and conservative therapy is ineffective, surgical intervention becomes an option.

Objective:

This study aims to investigate quality of life after elective sigmoidectomy for patients affected by SUDD.

Materials and Methods:

Retrospective multicenter review of consecutive patients affected by SUDD that underwent elective laparoscopic sigmoidectomy from January 2015 to March 2018. SUDD was defined as the presence of diverticula with persistent localized pain and diarrhea or constipation without macroscopic inflammation. Quality of life was investigated using the Gastrointestinal Quality of Life Index questionnaire at baseline, and at 6 and 12 months after surgery. Readmissions, unplanned clinical examination, mesalazine resumption, and emergency department visit for abdominal symptoms were recorded.

Results:

Fifty-two patients were included in the analysis. Gastrointestinal Quality of Life Index score at 6 months from surgery did not statistically differ from baseline (96±10.2 vs. 89±11.2; P>0.05), while patients reported a better quality of life at 12 months after surgery (109±8.6; P<0.05). Within the first year of follow-up, 3 patients (5.8%) were readmitted for acute enteritis, 8 patients (15.4%) had emergency room access for abdominal pain, and 8 patients had unplanned outpatients’ medical examinations for referred lower abdominal pain and bowel changes. Mesalazine was resumed in 17.3% of patients.

Conclusion:

Elective laparoscopic sigmoidectomy for SUDD is safe and effective in improving quality of life, although in some cases symptoms may persist.