bluuebunny/crossref_metadata_2025 huggingface dataset:
Compositional characteristics of cherry kernel oil as influenced by gamma irradiation and storage periods
Authors: Al-Bachir M , Koudsi Y
Published: September 2020

This research work was undertaken to evaluate the physicochemical parameters of oil from the cherry kernel non-irradiated and irradiated at 3 and 6 kGy of gamma irradiation for two storage periods (0 and 12 months). The acid value, peroxide value, thiobarbituric acid reactive substances value, iodine value, saponification value refractive index (peroxide value), and the color parameters of cherry kernel oils were determined. The results indicated that the extracted cherry kernel oils were liquid at room temperature with color varying from light yellow to deep red. The physicochemical properties of cherry kernel oils including acid value, peroxide value, thiobarbituric acid reactive substances, iodine value, saponification value, and refractive index values were 1.19 mg KOH g−1, 9.01 meq2 kg−1, 0.014 mg MDA kg−1, 99.48 KOH g−1 I2 100 g−1, 194.50 mg KOH g−1, and 1.472, respectively. Generally, gamma irradiation doses and storage time increased acid value, peroxide value, thiobarbituric acid reactive substances, and refractive index value of cherry kernel oils, whereas no significant (p > 0.05) change due to irradiation was recorded in iodine value, saponification value, and in color parameter (L*, a*, b*, and ΔE values) of cherry kernel oils. However, the properties of cherry kernel oils revealed that the cherry kernel is a good source of oil which could be used for industrial purposes.
Trabectome, trabecular aspiration and phacoemulsification in a triple procedure for treating exfoliation glaucoma: A long-term follow-up
Authors: Widder Randolf Alexander , Hild Matthias , Dietlein Thomas Stefan , Kühnrich Pia , Rennings Corinna , Szumniak Alexander , Lappas Alexandra , Roessler Gernot Franz
Published: September 2020

Purpose:

This study investigates the long-term intraocular pressure (IOP) lowering potential, risk profile and success rate of a triple procedure comprising phacoemulsification, trabecular aspiration and trabectome (Microsurgical Technology, Redmond, WA, USA) for treating exfoliation glaucoma.

Methods:

A total of 117 eyes of 117 patients with exfoliation glaucoma underwent a combination of phacoemulsification, trabectome and trabecular aspiration. They were followed up for up to 7 years. The success rates were designated according to criteria based on the Tube versus Trabeculectomy Study and the World Glaucoma Association guidelines: A (no resurgery); B/C (IOP < 21/18 mmHg, no resurgery, IOP reduction > 20%); D (IOP ⩽ 15 mmHg, no resurgery, IOP reduction ⩾ 40%).

Results:

The mean follow-up period was 46 months. IOP showed a 38% reduction from 24.5 ± 6.1 to 15.2 ± 3.6 mmHg ( p < 0.0001). The Medication Score decreased by 23% from 2.2 ± 0.9 to 1.7 ±1.0 ( p < 0.0001). The success rates were 87, 76, 74 and 38% according to criteria A, B, C and D. In eyes with an initial IOP of >30 mmHg, a 57% reduction from 34.2 ± 4.4 to 14.8 ± 3.2 mmHg ( p < 0.0001) was observed, and the success rates were 91, 91, 82 and 59% for criteria A, B, C and D, respectively.

Discussion:

We conclude that the triple procedure may effectively lower IOP in patients with exfoliation glaucoma over a mean follow-up period of 46 months without significant side effects. Therefore, the triple procedure may serve as first-line surgery for patients with exfoliation and cataract, even with a high initial IOP.
The role of surgery for assisted maturation after endovascular and percutaneous arteriovenous fistula creation
Authors: Illig Karl A , Lok Charmaine , Rajan Dheeraj K , Aruny John , Peden Eric , Nelson Peter , London Mark J , Ross John R
Published: September 2020

Even in the best of circumstances, a significant number of patients will require adjunctive endovascular and/or surgical revision prior to achieving functional patency after endovascular or percutaneous AVF creation, at least within the United States. This rate appears to be higher after percutaneous AVF than after endovascular AVF, although because published reports of the former are mostly derived from American experience and those of the latter derived from experience outside the United States, it is unclear whether these differences are due to the technique itself or cultural and/or anatomic differences in dialysis access practices and patient populations. If arterial inflow is poor, this should be corrected first. When flow is adequate (perhaps 900 cc/min) but no single vein is cannulatable, a dominant suitable vein can be superficialized or transposed. If no suitable vein is dominant (most accurately assessed by using an intraoperative flowmeter), the best vein can be used, with or without occlusion of the other veins or reimplantation into the brachial artery. Finally, if the original anastomosis remains the sole supply to the cannulated vein, the original fistula has achieved assisted primary maturation (and assisted primary patency continues), while if a new arteriovenous anastomosis has been constructed, the original fistula has failed. We point out that for this reason as well as to best utilize the upper arm for later access, endovascular and percutaneous AVFs should be constructed and maintained within an atmosphere where both surgeons and non-surgeons work together on the overall access plan.
Capitalising on chaos – exploring the impact and future of social media influencer engagement during the early stages of a global pandemic
Authors: Archer Catherine , Wolf Katharina , Nalloor Joseph
Published: September 2020

This article examines the role of influencers during the early stages of the COVID-19 pandemic, as well as the impact of the global pandemic on Social Media Influencers’ (SMIs) lifestyle and business model, using the concept of Disaster Capitalism as a springboard for discussion. Worldwide it first appeared that the global pandemic would severely impact SMI sole traders, as income from travel, luxury goods and other ‘lifestyle’ brands dried up. However, we suggest that brands and influencers themselves have pivoted to meet the COVID challenge, with some brands exploiting the opaque influence of these micro-celebrities. We further suggest that while a handful of governments and health organisations have recognised the reach and social capital of SMIs, their potential in health communication has been underutilised. We write this essay as a starting point, raising questions and calling for further research to be conducted to inform the understanding of SMIs’ role and potential as conveyors of public health information.
Demographic change and backlash: Identity politics in historical perspective
Authors: Gest Justin
Published: September 2020

Why are backlash politics so prevalent in the context of demographic change? And so that we may understand how to mitigate social conflict, what role do government and political actors play in their inflammation or reconciliation? Drawing from a larger study of six societies that have dealt with significant demographic change, I review the ways that government and political leaders’ actions can produce three different social cleavages: (1) an overriding and enduring cleavage between ethnic constituencies in national politics, (2) an overriding cleavage that is suppressed by political actors, or (3) a new definition of social cleavages that re-constructs public understandings of the nation. I find that the drivers of these different trajectories relate to state actions in the construction of national identities, which either exclude certain subgroups or absorb them into a state of coexistence. I identify five ways governments channel backlash politics towards exclusion or coexistence, and provide examples from Hawai‘i, a case where historical cleavages between natives and immigrants nearly disappeared. Ultimately, I find that these politics are subject to competing understandings of the nation – the pivotal sense of ‘we’ – that can unite or divide a multiethnic society.
Issues in reporting of systematic review methods in health app-focused reviews: A scoping review
Authors: Grainger Rebecca , Devan Hemakumar , Sangelaji Bahram , Hay-Smith Jean
Published: September 2020

No guidelines exist for the conduct and reporting of manuscripts with systematic searches of app stores for, and then appraisal of, mobile health apps (‘health app-focused reviews’). We undertook a scoping review including a systematic literature search for health app-focused reviews describing systematic app store searches and app appraisal, for apps designed for patients or clinicians. We created a data extraction template which adapted data elements from the PRISMA guidelines for systematic literature reviews to data elements operationalised for health app-focused reviews. We extracted the data from included health app-focused reviews to describe: (1) which elements of the adapted ‘usual’ methods of systematic review are used; (2) methods of app appraisal; and (3) reporting of clinical efficacy and recommendations for app use. From 2798 records, the 26 included health app-focused reviews showed incomplete or unclear reporting of review protocol registration; use of reporting guidelines; processes of screening apps; data extraction; and appraisal tools. Reporting of clinical efficacy of apps or recommendations for app use were infrequent. The reporting of methods in health app-focused reviews is variable and could be improved by developing a consensus reporting standard for health app-focused reviews.
Impact of a Healthy Retail Intervention on Fruits and Vegetables and Total Sales in Tribally Owned Convenience Stores: Findings From the THRIVE Study
Authors: Williams Mary B. , Wang Wenyu , Taniguchi Tori , Salvatore Alicia L. , Groover William K. , Wetherill Mariana , Love Charlotte , Cannady Tamela , Grammar Mandy , Standridge Joy , Fox Jill , Jernigan Valarie Blue Bird
Published: September 2020

Background

Healthy retail interventions are a recommended intervention strategy to address diet-related diseases, such as obesity and diabetes; however, retail managers are concerned about their bottom line. This study’s aim was to assess the impact of a healthy retail intervention on fruits and vegetables (FV) sales, as well as total sales, in tribally owned convenience stores where grocery stores are scarce.

Method

We analyzed weekly sales data over the first 6 months of a healthy retail intervention. We assessed the proportion of sales from two FV baskets. The FV basket included all fresh, canned, and dried FV sold at stores; while the fruits, vegetables, and salads (FVS) basket included all FV items as well as all salads sold. We compared mean weekly sales rates in intervention and control stores over the 6-month period using generalized estimating equations models to account for repeated measures.

Results

Mean weekly FV basket sales rates were higher in intervention stores than control stores in both Nations. Mean weekly FVS baskets sales were significantly higher in intervention stores than control stores in one Nation and were higher, but not statistically significant, in intervention stores in the other Nation. Total sales remained steady throughout the intervention period.

Conclusions

The THRIVE (Tribal Health and Resilience in Vulnerable Environments) intervention increased FV sales without negatively affecting total sales. Policy and Practice Implications. Healthy retail interventions in tribal convenience stores, where many Native Americans living in rural areas shop due to scarcity of grocery stores, could improve diet-related disparities without reducing total sales.
State Laws and Regulations Addressing Nurse-Initiated Protocols and Use of Nurse-Initiated Protocols in Emergency Departments: A Cross-Sectional Survey Study
Authors: Castner Jessica , Boris Lenore
Published: September 2020

Introduction

State regulations may impede the use of nurse-initiated protocols to begin life-saving treatments when patients arrive to the emergency department. In crowding and small-scale disaster events, this could translate to life and death practice differences. Nevertheless, research demonstrates nurses do utilize nurse-initiated protocols despite legal prohibitions. The purpose of this study was to explore the relationship of the state regulatory environment as expressed in nurse practice acts and interpretive statements prohibiting the use of nurse-initiated protocols with hospital use of nurse-initiated protocols in emergency departments.

Methods

A cross-sectional approach was used with a nationwide survey. The independent variable categorized the location of the hospital in states that have a protocol prohibition. Outcomes included protocols for blood laboratory tests, X-rays, over-the-counter medication, and electrocardiograms. A second analysis was completed with New York State alone because this state has the strongest language prohibiting nurse-initiated protocols.

Results

A total of 350 participants returned surveys from 48 states and the District of Columbia. A hospital was more likely to have policies supporting nurse-initiated protocols if they were not in a state with the scope of practice prohibitions. Four categories emerged such as advantages, approval, prohibition, and conditions under which the protocols can be used. Prohibitive language was associated with less protocol use for emergency care.

Conclusion

State scope of practice inconsistencies create misalignment with emergency nurse education and training, which may impede timely care and contribute to inequalities and inefficiencies in emergency care. In addition, prohibitive language places practicing nurses responding to emergencies in crowded work environments at risk.
Thymoquinone and Difluoromethylornithine (DFMO) Synergistically Induce Apoptosis of Human Acute T Lymphoblastic Leukemia Jurkat Cells Through the Modulation of Epigenetic Pathways
Authors: Alhosin Mahmoud , Razvi Syed Shoeb I. , Sheikh Ryan A. , Khan Jalaluddin A. , Zamzami Mazin A. , Choudhry Hani
Published: September 2020

Thymoquinone (TQ), a natural anticancer agent exerts cytotoxic effects on several tumors by targeting multiple pathways, including apoptosis. Difluoromethylornithine (DFMO), an irreversible inhibitor of the ornithine decarboxylase (ODC) enzyme, has shown promising inhibitory activities in many cancers including leukemia by decreasing the biosynthesis of the intracellular polyamines. The present study aimed to investigate the combinatorial cytotoxic effects of TQ and DFMO on human acute T lymphoblastic leukemia Jurkat cells and to determine the underlying mechanisms. Here, we show that the combination of DFMO and TQ significantly reduced cell viability and resulted in significant synergistic effects on apoptosis when compared to either DFMO or TQ alone. RNA-sequencing showed that many key epigenetic players including Ubiquitin-like containing PHD and Ring finger 1 (UHRF1) and its 2 partners DNA methyltransferase 1 (DNMT1) and histone deacetylase 1 (HDAC1) were down-regulated in DFMO-treated Jurkat cells. The combination of DFMO and TQ dramatically decreased the expression of UHRF1, DNMT1 and HDAC1 genes compared to either DFMO or TQ alone. UHRF1 knockdown led to a decrease in Jurkat cell viability. In conclusion, these results suggest that the combination of DFMO and TQ could be a promising new strategy for the treatment of human acute T lymphoblastic leukemia by targeting the epigenetic code.
Foot Angiosomes: Instructions for Use
Authors: Ferraresi Roberto , Clerici Giacomo , Casini Andrea , Ucci Alessandro , Caminiti Maurizio Santi , Minnella Daniela , Frykberg Robert G.
Published: September 2020

In the last 15 years an abundance of literature has demonstrated that angiosome-targeted revascularization, either endovascular or open, can lead to better clinical results in patients with chronic limb-threatening ischemia. According to this literature, the angiosome concept should guide our treatment strategy in every chronic limb-threatening ischemia patient. However, in our daily practice, its application is often difficult or impossible. Most foot wounds spread over multiple angiosomes and, moreover, the value of an angiosome-guided revascularization approach can vary according to vascular anatomy, collateral vessel network, type of revascularization, and wound. The aim of this article is to explore values and limits of the angiosome concept, and to propose some “instructions for use” regarding its application in our daily practice.
Bilateral Acute Lower Limb Ischemia Secondary to COVID-19
Authors: Veerasuri Sowmya , Kulkarni Sachin R. , Wilson William R. , Paravastu Sharath C. V.
Published: September 2020

COVID-19 has to date affected over 5 million people worldwide and caused in excess of 300000 deaths. One of the principal finding is that of a thrombotic tendency within the lungs leading to high mortality. There have been increasing number of reports of peripheral arterial thrombosis as well. Most cases of arterial thrombosis is noted in patient in intensive care setting. Here-in we report a case of acute bilateral lower limb arterial thrombosis in a patient recovering at home with mild COVID-19 symptoms, highlighting that patients with milder symptoms may also suffer from prothrombotic state resulting in acute arterial occlusions. Arterial thrombosis should be suspected in these patients despite the absence of predisposing factors.
A three-miRNA panel in serum as a noninvasive biomarker for colorectal cancer detection
Authors: Peng Xiqi , Wang Jingyao , Zhang Chunduo , Liu Kaihao , Zhao Liwen , Chen Xuan , Huang Guocheng , Lai Yongqing
Published: September 2020

Background:

Circulating miRNAs have been proved to be promising biomarkers for disease detection in recent years. The present study aimed at exploring available serum miRNA biomarkers for the detection of colorectal cancer.

Methods:

A three-phase study was performed to select and validate candidate miRNAs with significant dysregulation in colorectal cancer using quantitative reverse transcription-polymerase chain reaction. This study recruited 137 colorectal cancer patients and 145 healthy controls. The diagnostic values of miRNAs were evaluated by receiver operating characteristic analysis. Bioinformatics analyses were utilized to predict target genes of miRNAs, and to conduct functional annotation and enrichment.

Results:

miR-30e-3p, miR-31-5p, miR-34b-3p and miR-146a-5p, miR-148a-3p and miR-192-5p were significantly dysregulated in colorectal cancer serum when compared with healthy controls. The panel composed of miR-30e-3p, miR-146a-5p, and miR-148a-3p exhibited strong diagnostic ability. The area under the receiver operating characteristic curve of the three-miRNA panel was 0.883, with a sensitivity of 0.800 and specificity of 0.787.

Conclusion:

The present study identified a three-miRNA panel in serum with a strong diagnostic ability of colorectal cancer, which may be able to serve as a novel noninvasive biomarker for colorectal cancer detection.
Presidential Delegation to Foreign Ministries: A Study of Argentina, Brazil, and Mexico (1946–2015)
Authors: Amorim Neto Octavio , Malamud Andrés
Published: September 2020

When do presidents delegate policy-making authority to their foreign ministries? And is foreign policy unique in this respect? We posit that six international, national, and personal factors determine the opportunity and motivation of presidents to delegate, and then analyse the cases of Argentina, Brazil, and Mexico in 1946–2015. By applying fuzzy-set qualitative comparative analysis, we find that four combinations of factors are sufficient paths to delegation: (1) international stability and elite consensus on foreign policy; (2) international stability, right-wing president, and low diplomatic professionalisation; (3) international stability, right-wing president, and low presidential expertise on foreign policy; or (4) absence of authoritarianism combined with elite consensus on foreign policy and right-wing president. Our study of foreign ministries reinforces some of the main findings of the scholarly literature on other ministries, thus challenging the view of foreign policy-making as different from domestic policy areas.
From Research to Practice: Is Rethinking Architectural Education the Remedy?
Authors: Tvedebrink Tenna Doktor Olsen , Jelić Andrea
Published: September 2020

Objectives:

Our aim is to investigate how a new master studies course “Architecture, Health, and Well-being” (AHW) supports development of students’ skills in understanding and assessing health-related research as well as applying research-based knowledge through unfolding of user perspectives in their design projects.

Background:

With the growing focus on health-related research in Danish design practice, knowing how to translate research findings into research-informed design strategies becomes a preferable, if not (yet) a critical, skill. This calls for architecture educations to reconsider their graduate profiles and teaching curricula, thereby addressing research-to-practice gap.

Method:

Based on design project hand-ins, we evaluate whether students participating in the AHW course demonstrate greater sensibility toward user experiences and research-based design (RBD) in their master thesis projects, compared to students attending a more traditional architectural tectonic track. Evaluation relates to the use of scientific literature and theoretical frameworks on topics like “healing architecture” and applied user-oriented methods (interviews, personas, demographics).

Results:

Our explorative analysis indicates that students have the skills to make a detailed user analysis when it comes to well-defined user groups in a highly specialized building (e.g., hospice patients and staff). The extent to which health-related research and user perspectives are applied in the design process seems to be primarily driven by thematic focus of the project (welfare buildings in contrast to housing).

Conclusion:

Despite the challenges in teaching students to assess and apply academic literature, a RBD paradigm in architectural education can help bridge emerging research knowledge with design skills and professional competencies.
Different Criteria for Evaluation of the Conservation Status of Ceratozamia Miqueliana (Zamiaceae)
Authors: Carvajal-Hernández César I. , Juárez-Fragoso Mauricio A. , Armenta-Montero Samaria , Demeneghi-Calatayud Ana P. , Vázquez-Torres Mario
Published: September 2020

Ceratozamia miqueliana is a cycad (Zamiaceae) species endemic to southeastern Mexico. It is currently listed on the International Union for Conservation of Nature (IUCN) Red List as “Critically Endangered” and under Mexican law as “Endangered”. The objective was to complement the evaluation of C. miqueliana based on criterion B of the IUCN, and the method proposed by the Mexican Norm. This information is in turn reinforced with the potential distribution model. We collected data from different herbaria and field visits and obtained the EOO and AOO using GIS and the GeoCat portal, the distribution of the species was modeled using the Maxent program. According to the IUCN guidelines (Geographic distribution, Criterion B) and Mexican law, the species could be considered Endangered and Subject to Special Protection, respectively. The comparison of AOO and EOO obtained by GIS and the GeoCat portal show that both methodologies used coincide in assigning the same categories based on geographic criteria. The integration of the potential distribution helps to identify the environmental factors that influence its habitat, in addition to identifying the ideal sites for its conservation. Is necessary to carry out evaluations of microendemic species such as Ceratozamia miqueliana from different approaches (populations, geographic aspects and habitat evaluation) to obtain more precise results. C. miqueliana must be protected by national and international laws.
Meningitis in the Setting of Frontoethmoidal and Temporal Meningoencephaloceles
Authors: Kumar Arooshi , Shah Jugal , Melmed Kara , Pacione Donato , Lieberman Seth , Lewis Ariane
Published: September 2020

This is a patient with multiple meningoencephaloceles which resulted in bacterial meningitis and subsequent status epilepticus. We identify impressive imaging findings demonstrating herniation of the meninges from nasal and bitemporal skull base defects possibly as a result of intracranial hypertension.
Evaluating the Relationship Between Olfactory Function and Loneliness in Community-Dwelling Individuals: A Cross-sectional Study
Authors: Desiato Vincent M. , Soler Zachary M. , Nguyen Shaun A. , Salvador Craig , Hill Jonathan B. , Lamira Jensine , Rowan Nicholas R. , Yoo Frederick , Little Ryan E. , Matthews Lois J. , Dubno Judy R. , Schlosser Rodney J.
Published: September 2020

Background

Olfactory dysfunction (OD) has been reported to impact social interactions. However, the relationship between OD and loneliness has received little attention. The purpose of this study was to determine the association between OD and loneliness, controlling for patient factors.

Methods

Subjects without otolaryngic complaints were enrolled and olfactory function was assessed using: Sniffin’ Sticks test to measure threshold, discrimination and identification (TDI), Questionnaire of Olfactory Disorders Negative Statements (QOD-NS) and 9 – item Olfactory-Visual Analogue Scale (VAS). Loneliness was assessed using the De Jong Gierveld (DJG) and University of California Los Angeles (UCLA) loneliness scales. Bivariate analysis was performed followed by regression analysis, controlling for confounders.

Results

In total, 221 subjects were included with a mean age of 50.5 years (range 20 to 93), 133 (60.2%) females and 161 (72.9%) white. Mean TDI score was 29.3 (7.0) and 49.5% of the cohort was dysosmic. Using DJG, 36.4% of the cohort were classified as lonely, whereas 35.0% were lonely using UCLA. Olfactory measures were significantly associated with DJG, including TDI (β = −0.03, p = 0.050), olfactory discrimination (β = −0.111, p = 0.005), QOD-NS (β = 0.058, p < 0.001) and olfactory-VAS (β = 0.032, p < 0.001). UCLA scores were significantly associated with QOD-NS (PR 1.061 [CI 1.018–1.107], p = 0.005) and olfactory-VAS scores (PR 1.027, [CI 1.007–1.049], p = 0.009). After controlling for confounders, the association between DJG and olfactory discrimination, as well as DJG and olfactory-VAS remained significant.

Conclusions

In this community-based sample of older adults, both OD and loneliness were common. Those subjects with worse olfactory function were more likely to report loneliness. Further research is necessary to establish causality, as well as explore the role of depression.
Long-Term Survivorship and Clinical Outcomes of Osteochondral Autologous Transplantation for Steroid-Induced Osteonecrosis of the Knee
Authors: Nishitani Kohei , Nakagawa Yasuaki , Kobayashi Masahiko , Nakamura Shinichiro , Mukai Shogo , Kuriyama Shinichi , Matsuda Shuichi
Published: September 2020

Objective

Treatments for steroid-induced osteonecrosis of the knee remains challenging, and there has not been sufficient evidence to support joint preservation surgery. This study evaluated long-term outcomes of osteochondral autologous transplantation (OAT) for steroid-induced osteonecrosis of the knee.

Design

This retrospective case series included patients who underwent OAT for steroid-induced osteonecrosis of the knee from 1998 to 2008. The survivorship and need for secondary surgery were evaluated, and the clinical outcome was evaluated with the International Knee Documentation Committee (IKDC) subjective score. Preoperative and final Kellgren-Lawrence (KL) grade of the femorotibial and patellofemoral joints were individually evaluated.

Results

Fourteen knees of 10 patients whose mean age was 32.5 (95%CI 26.4-38.6) years were included and followed for 14.0 (12.4-15.7) years. The mean lesion size of 6.9 (5.3-8.5) cm2 was repaired using 4 median (minimum 2, maximum 5) osteochondral plugs. No revision surgeries were performed for transplanted osteochondral plugs. The IKDC subjective score improved from 32.9 (24.5-41.3) to 74.2 (61.9-88.5) ( P < 0.001). Knee flexion was improved at the final follow-up, and Seiza sitting was finally possible in 9 knees in 7 patients. Although the osteoarthritic change did not progress in femorotibial joint, patellofemoral joint showed early osteoarthritic changes at the final follow-up (mean KL grade: 0.8 [0.5-1.1]).

Conclusions

Prosthetic joint replacement was successfully avoided for at least the first decade by OAT in young patients with steroid-induced osteonecrosis of the knee. The progression of KL grade of the patellofemoral joint is of concern.
Fick principle and exercise pulmonary hemodynamic determinants of the six‐minute walk distance in pulmonary hypertension
Authors: Joseph Phillip , Oliveira Rudolf K.F. , Eslam Roza B. , Agarwal Manyoo , Waxman Aaron B. , Systrom David M.
Published: September 2020

The six‐minute walk test is widely used to assess the severity and prognosis of pulmonary hypertension. However, the pathophysiology underlying a compromised six‐minute walk distance is incompletely characterized. The purpose of this study is to evaluate the Fick principle and pulmonary hemodynamic determinants of the six‐minute walk distance in patients with suspected pulmonary hypertension. Twenty‐nine patients were retrospectively studied and underwent a right heart catheterization for the evaluation of suspected pulmonary hypertension. With the pulmonary artery catheter in place, patients were moved to a treadmill and completed a six‐minute walk test. Fick cardiac output and indices of right heart afterload were calculated using continuous measurements of pulmonary vascular pressures, gas exchange, and mixed venous blood samples. Fifteen subjects who walked ≤ 348 m were compared to 14 subjects who walked > 348 m. Systemic oxygen delivery was impaired in six‐minute walk distance ≤ 348 m compared to six‐minute walk distance > 348 m (15.2 ± 6.2 vs. 23.2 ± 6.8 mL/kg/min, p < 0.01). Impaired oxygen delivery was due to a depressed cardiac index and decreased cardiac reserve demonstrated by the change in the stroke volume index (3.0 ± 14 vs. 17 ± 15 mL/min/m2, p = 0.02). The six‐minute walk distance positively correlated with oxygen delivery (r = 0.501, p = 0.006) and inversely correlated with oxygen extraction (r = 0.369, p = 0.049). A decreased six‐minute walk distance was associated with an increased total pulmonary resistance (r = 0.502, p = 0.006) and pulmonary vascular resistance (r = 0.530, p = 0.003). In patients with suspected pulmonary hypertension, a decreased six‐minute walk distance is due to compromised oxygen delivery, decreased cardiac reserve, and increased right ventricular afterload.
Performance on the mini-mental state exam and the Montreal cognitive assessment in a sample of old age psychiatric patients
Authors: Korsnes Maria Stylianou
Published: September 2020

Objective:

This study assesses to what extent the Mini-Mental State Exam and the Montreal Cognitive Assessment scores may predict the presence of dementia in a sample of typical old age psychiatric patients who may or may not have temporally or permanently reduced cognitive abilities.

Methods:

A total of 141 inpatients completed the Mini-Mental State Exam and the Montreal Cognitive Assessment at arrival. All patients were subsequently diagnosed during their stay at the age-psychiatric unit. Receiver operating characteristics and analysis of variance were used to compare the results of the two tests for different patient groups.

Results:

The Montreal Cognitive Assessment is slightly more sensitive and specific than the Mini-Mental State Exam for dementia prediction. Age, sex, and education only account for approximately 2% of the variance in both tests. Patients with more than one diagnosis across the diagnostic groups included in this study (dementia, psychoses, affective disorder, and depression) performed significantly poorer on both tests than patients with a single diagnosis.

Conclusions:

Both tests are efficient in detecting cognitive impairment, but neither test can effectively exclude other reasons for low test results in our sample of elderly psychiatric patients. The sensitivity for ruling out dementia is 27 points for the Mini-Mental State Exam and 23 points for the Montreal Cognitive Assessment in the current patient sample.
Etiological factors and treatment challenges in an adolescent male with body dysmorphic disorder: A case report
Authors: Khoodoruth Mohamed Adil Shah , Khan Yasser Saeed
Published: September 2020

There are very few existing reports in adolescents about the clinical presentation and treatment challenges associated with body dysmorphic disorder coexisting with suicidal behaviour. This case report describes a 13-year old male with body dysmorphic disorder, who was completely convinced that his belief related to the disorder is true (delusional belief) and therefore had no insight into his condition. His preoccupation with the shape of his nose progressed significantly over a 2-year period to the extent that he wore a surgical mask on a daily basis to camouflage the perceived defect. The distress due to the persistent preoccupation and intrusive thinking became so severe that he started to experience suicidal ideation and attempted suicide twice with no harm sustained. This case report focuses on three treatment challenges faced by the treating team: the need of continued treatment with pharmacotherapy and psychotherapy following a cosmetic procedure, the impact of the mother’s preoccupation with her physical appearance on the recovery of the young person, and the management of suicidality. We have also highlighted the probable causative factors of the development of the illness in this patient which are consistent with the established aetiology of body dysmorphic disorder.
Exploring mainstream Euroscepticism: Similarities and differences between Eurosceptic claims of centre-right and radical right parties
Authors: Treib Oliver
Published: September 2020

Euroscepticism has traditionally occurred among radical left and radical right parties. But opposition to European integration has recently also spread to the political mainstream, especially to centre-right parties. Yet, we know comparatively little about the nature of Eurosceptic claims made by these parties. Do they rely on the same repertoire as radical parties, or do they develop their own specific versions of Euroscepticism? A comparative content analysis of Eurosceptic claims in the 2014 and 2019 European election manifestos of centre-right and radical right parties in Austria, France, Germany and the Netherlands shows that centre-right parties do not draw to a significant extent on the existing discourse of radical right parties. Instead, they predominantly create their own Eurosceptic claims, which are tailor-made to their entrenched programmatic brands. These findings resonate well with the assumptions of saliency approaches to party competition.
Selling international law enforcement: Elite justifications and public values
Authors: Lee Melissa M. , Prather Lauren
Published: September 2020

International law enforcement is an understudied but indispensable factor for maintaining the international order. We study the effectiveness of elite justifications in building coalitions supporting the enforcement of violations of the law against territorial seizures. Using survey experiments fielded in the USA and Australia, we find that the effectiveness of two common justifications for enforcement—the illegality of a country’s actions, and the consequences of those actions for international order—increase support for enforcement and do so independently of two key public values: ideology and interpersonal norm enforcement. These results imply elites can build a broad coalition of support by using multiple justifications. Our results, however, highlight the tepidness of public support, suggesting limits to elite rhetoric. This study contributes to the scholarship on international law by showing how the public, typically considered a mechanism for generating compliance within states, can impede or facilitate third-party enforcement of the law between states.
Evidence-Based Education: The (Not So Simple) Case of French-Speaking Belgium
Authors: Dachet Dylan , Baye Ariane
Published: September 2020

Purpose:

Taking the case of educational reform in French-speaking Belgium (the Pact for Educational Excellence), this article aims to describe the process of integrating evidence-based education (EBE) into an educational reform within a country where the influence of qualitative research is important.

Design/Approach/Methods:

A narrative case study was conducted to analyze and understand the stages of the ongoing educational reform process and the successive involvements of our research center in the work of this reform. Inspired by the paradigm of EBE, we initiated both the consultation processes intended to set the direction of educational decisions and programs.

Findings:

According to Slavin (2017, 2019), providing educator-friendly reviews, making available a broad range of proven education programs, and providing resources to help schools to implement proven programs are levers for implementing evidence-based reform within an educational system. This article shows that one of the three levers is fully met. For the other two, work being done on EBE in the U.S. and the UK in particular can save us time.

Originality/Value:

This article highlights concrete actions that will ensure the gradual establishment and acceptance by political and educational actors of an evidence-based reform.
A Case of Extracorporeal Membrane Oxygenation as a Salvage Therapy for COVID-19-Associated Severe Acute Respiratory Distress Syndrome: Mounting Evidence
Authors: Rajdev Kartikeya , Farr Lyndie A. , Saeed Muhammad Ahsan , Hooten Rorak , Baus Joseph , Boer Brian
Published: September 2020

Coronavirus disease 2019 (COVID-19) caused by a novel human coronavirus has led to a tsunami of viral illness across the globe, originating from Wuhan, China. Although the value and effectiveness of extracorporeal membrane oxygenation (ECMO) in severe respiratory illness from COVID-19 remains unclear at this time, there is emerging evidence suggesting that it could be utilized as an ultimate treatment in appropriately selected patients not responding to conventional care. We present a case of a 32-year-old COVID-19 positive male with a history of diabetes mellitus who was intubated for severe acute respiratory distress syndrome (ARDS). The patient’s hypoxemia failed to improve despite positive pressure ventilation, prone positioning, and use of neuromuscular blockade for ventilator asynchrony. He was evaluated by a multidisciplinary team for considering ECMO for refractory ARDS. He was initiated on venovenous ECMO via dual-site cannulation performed at the bedside. Although his ECMO course was complicated by bleeding, he showed a remarkable improvement in his lung function. ECMO was successfully decannulated after 17 days of initiation. The patient was discharged home after 47 days of hospitalization without any supplemental oxygen and was able to undergo active physical rehabilitation. A multidisciplinary approach is imperative in the initiation and management of ECMO in COVID-19 patients with severe ARDS. While ECMO is labor-intensive, using it in the right phenotype and in specialized centers may lead to positive results. Patients who are young, with fewer comorbidities and single organ dysfunction portray a better prognosis for patients in which ECMO is utilized.
Sound Externalization: A Review of Recent Research
Authors: Best Virginia , Baumgartner Robert , Lavandier Mathieu , Majdak Piotr , Kopčo Norbert
Published: September 2020

Sound externalization, or the perception that a sound source is outside of the head, is an intriguing phenomenon that has long interested psychoacousticians. While previous reviews are available, the past few decades have produced a substantial amount of new data.In this review, we aim to synthesize those data and to summarize advances in our understanding of the phenomenon. We also discuss issues related to the definition and measurement of sound externalization and describe quantitative approaches that have been taken to predict the outcomes of externalization experiments. Last, sound externalization is of practical importance for many kinds of hearing technologies. Here, we touch on two examples, discussing the role of sound externalization in augmented/virtual reality systems and bringing attention to the somewhat overlooked issue of sound externalization in wearers of hearing aids.
Rare earth mineral diversity controlled by REE pattern shapes
Authors: Anenburg Michael
Published: September 2020

The line connecting rare earth elements (REE) in chondrite-normalised plots can be represented by a smooth polynomial function using λ shape coefficients as described by O'Neill (2016). In this study, computationally generated λ combinations are used to construct artificial chondrite-normalised REE patterns that encompass most REE patterns likely to occur in natural materials. The dominant REE per pattern is identified, which would lead to its inclusion in a hypothetical mineral suffix, had this mineral contained essential REE. Furthermore, negative Ce and Y anomalies, common in natural minerals, are considered in the modelled REE patterns to investigate the effect of their exclusion on the relative abundance of the remainder REE. The dominant REE in a mineral results from distinct pattern shapes requiring specific fractionation processes, thus providing information on its genesis. Minerals dominated by heavy lanthanides are rare or non-existent, even though the present analysis shows that REE patterns dominated by Gd, Dy, Er and Yb are geologically plausible. This discrepancy is caused by the inclusion of Y, which dominates heavy REE budgets, in mineral name suffixes. The focus on Y obscures heavy lanthanide mineral diversity and can lead to various fractionation processes to be overlooked. Samarium dominant minerals are known, even though deemed unlikely by the computational model, suggesting additional fractionation processes that are not well described by λ shape coefficients. Positive Eu anomalies only need to be moderate in minerals depleted in the light REE for Eu to be the dominant REE, thus identifying candidate rocks in which the first Eu dominant mineral might be found. Here, I present an online tool, called ALambdaR that allows interactive control of λ shape coefficients and visualisation of resulting REE patterns.
Amino acid depletion triggered by ʟ-asparaginase sensitizes MM cells to carfilzomib by inducing mitochondria ROS-mediated cell death
Authors: Soncini Debora , Minetto Paola , Martinuzzi Claudia , Becherini Pamela , Fenu Valeria , Guolo Fabio , Todoerti Katia , Calice Giovanni , Contini Paola , Miglino Maurizio , Rivoli Giulia , Aquino Sara , Dominietto Alida , Cagnetta Antonia , Passalacqua Mario , Bruzzone Santina , Nencioni Alessio , Zucchetti Massimo , Ceruti Tommaso , Neri Antonino , Lemoli Roberto M. , Cea Michele
Published: September 2020

Metabolic reprogramming is emerging as a cancer vulnerability that could be therapeutically exploitable using different approaches, including amino acid depletion for those tumors that rely on exogenous amino acids for their maintenance. ʟ-Asparaginase (ASNase) has contributed to a significant improvement in acute lymphoblastic leukemia outcomes; however, toxicity and resistance limit its clinical use in other tumors. Here, we report that, in multiple myeloma (MM) cells, the DNA methylation status is significantly associated with reduced expression of ASNase-related gene signatures, thus suggesting ASNase sensitivity for this tumor. Therefore, we tested the effects of ASNase purified from Erwinia chrysanthemi (Erw-ASNase), combined with the next-generation proteasome inhibitor (PI) carfilzomib. We observed an impressive synergistic effect on MM cells, whereas normal peripheral blood mononuclear cells were not affected. Importantly, this effect was associated with increased reactive oxygen species (ROS) generation, compounded mitochondrial damage, and Nrf2 upregulation, regardless of the c-Myc oncogenic-specific program. Furthermore, the cotreatment resulted in genomic instability and DNA repair mechanism impairment via increased mitochondrial oxidative stress, which further enhanced its antitumor activity. Interestingly, carfilzomib-resistant cells were found to be highly dependent on amino acid starvation, as reflected by their higher sensitivity to Erw-ASNase treatment compared with isogenic cells. Overall, by affecting several cellular programs, Erw-ASNase makes MM cells more vulnerable to carfilzomib, providing proof of concept for clinical use of this combination as a novel strategy to enhance PI sensitivity in MM patients.
A Novel Ni-Free Zr-Based Bulk Metallic Glass with High Glass Forming Ability, Corrosion Resistance and Thermal Stability
Authors: Luo Yu , Jiang Yidong , Zhang Pei , Wang Xin , Ke Haibo , Zhang Pengcheng
Published: September 2020

Zr-based Bulk metallic glasses exhibit incredible corrosion resistance and glass forming ability, however, these properties need further enhancement to meet the practical use. In this study, Zr63Fe2.5Cu23Al11.5, a new type of Zr-based bulk metallic glass was fabricated. Potentiodynamic polarization techniques were used to measure the corrosion resistance of this alloy. Furthermore, crystallization behavior and kinetics of Zr63Fe2.5Cu23Al11.5 bulk metallic glass were investigated by using differential scanning calorimetry of non-isothermal model. Kissinger and Ozawa methods were used for calculating activation energies of crystallization and the mechanism of crystallization was analyzed by Johnson-Mehl-Avrami-Kolmogorow methods. The results suggest that this specified metallic glass system possesses a relatively high thermal stability and glass forming ability. Moreover, the crystallization procedure is mainly dominated by nucleation with an increasing rate. The study demonstrates that the slight composition adjustment of Zr–Fe–Cu–Al system bulk metallic glass can make a considerable contribution to higher glass forming and thermal stability as well as corrosion resistance.
Color change and termite resistance of fast-growing tropical woods treated with kesambi (Schleichera oleosa) smoke
Authors: Hadi Yusuf Sudo , Massijaya Muh Yusram , Nandika Dodi , Arsyad Wa Ode Muliastuty , Abdillah Imam Busyra , Setiono Loedy , Amin Yahya
Published: September 2020

Smoke treatment can be used to enhance wood resistance to subterranean termite attack. In this study, kesambi (Schleichera oleosa) wood was pyrolyzed to produce charcoal. The smoke produced as a by-product of pyrolysis was used to treat sengon (Falcataria moluccana), jabon (Anthocephalus cadamba), mangium (Acacia mangium), and pine (Pinus merkusii) wood samples for 1, 2, or 3 weeks. Following the smoke treatment, the wood specimens were exposed to subterranean termites (Coptotermes curvignathusHolmgren) according to the Indonesian standard 7207-2014 in a laboratory. The color change caused by smoke treatment was observed, and chemical analysis of smoke was also done. The results showed that chemical compounds of kesambi smoke predominantly consisted of acetic acid, phenol, ketones, amines, and benzene. The color of smoked wood became darker, less yellow, and a little redder, while a longer smoking period produced a darker color which was more resistant to termite attack. Smoke treatment enhanced the resistance of wood to subterranean termite attack, and the resistance levels were not significantly different based on the duration of the smoke treatment.