bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatiotemporal metabolic dynamics of the photosensitizer talaporfin sodium in carcinoma and sarcoma
Authors: Saito Takuma , Tsukahara Tomohide , Suzuki Takeshi , Nojima Iyori , Tadano Hiroki , Kawai Noriko , Kubo Terufumi , Hirohashi Yoshihiko , Kanaseki Takayuki , Torigoe Toshihiko , Li Liming
Published: November 2020

Photodynamic therapy (PDT) using the photosensitizer talaporfin sodium (talaporfin) is a new mode of treatment for cancer. However, the metabolic mechanism of talaporfin has not been clarified. Thus, we investigated the uptake, transportation, and elimination mechanisms of talaporfin in carcinoma and sarcoma. The results showed that talaporfin co‐localized in early endosomes and lysosomes. Talaporfin uptake was via clathrin‐ and caveolae‐dependent endocytosis and a high amount of intracellular ATP was essential. Inhibition of lysosomal enzymes maintained intracellular talaporfin levels. Inhibition of K‐Ras signaling reduced talaporfin uptake in carcinoma and sarcoma cell lines. Talaporfin was taken up by clathrin‐ and caveolae‐dependent endocytosis, translocated from early endosomes to lysosomes, and finally degraded by lysosomes. We also demonstrated that ATP is essential for the uptake of talaporfin and that activation of K‐Ras is involved as a regulatory mechanism. These results provide new insights into the metabolism of talaporfin in cancer cells for the enhancement of PDT for carcinoma and sarcoma.
Quantitative assessment of contractile reserve of systemic right ventricle in post‐Senning children: Incorporating speckle‐tracking strain and dobutamine stress echocardiography
Authors: Taha Fatma Aboalsoud , Elshedoudy Sahar , Adel Mona
Published: November 2020

Introduction

The systemic load on the right ventricle (RV) after Senning atrial switch leads to ventricular dysfunction. Quantitative assessment of RV contractile reserve is mandatory to anticipate the need for anti‐fibrotic treatment. We aimed to quantitatively assess RV contractile reserve in Senning children by estimating speckle‐based global longitudinal strain (GLS) during dobutamine stress echocardiography (DSE).

Methods

This prospective study compared thirty‐one post‐Senning children (group I) and thirty controls (group II). In post‐Senning children, echocardiographic RV systolic function using one‐plane ejection fraction (RVEF), RV fractional area change (RVFAC), tricuspid annulus plane systolic excursion (TAPSE), its Z‐score, and RVGLS were recorded at rest and peak DSE. Contractile reserve was defined as improvement >5% in RVEF, >2% in GLS, and/or to near normal TAPSE.

Results

RVEF, RVFAC, TAPSE, and TAPSE Z‐score were significantly lower in patients than controls [RVEF:40.13 ± 2.93% vs 53.17 ± 3.17% (P < .001*), RVFAC: 21.17 ± 2.37% vs 37.23 ± 2.13% (P < .001*), TAPSE:13.81 ± 1.26 vs 17.45 ± 2.93 mm (P < .001*), TAPSE Z‐score: −3.47 ± 0.46 vs −2.09 ± 0.48 (P < .001*)]. Also, RVGLS was significantly impaired in Senning children than controls[ (−11.89 ± 2.31% vs −22.35 ± 6.73% (P < .001*)]. At peak DSE, contractile reserve was not evident as measured by RVEF which increased none significantly to 42.47 ± 2.80% (P = .063). However, RVGLS improved significantly to −15.78 ± 0.93% (P < .001*) and discovered the masked contractile reserve in Senning children. The 19(61.29%) children who showed masked contractile reserve (improvement in RVGLS > 2%) underwent continuation of anti‐fibrotic medications.

Conclusions

Despite systemic RV function in post‐Senning children was impaired at rest and during DSE, RVGLS was useful in quantitative assessment of masked contractile thus promoted continuing anti‐fibrotic treatment.
Retromandibular transparotid approach for subcondylar mandibular fracture: A retrospective study
Authors: Koirala Ujjwal , Subedi Sushil
Published: November 2020

Introduction

The retromandibular transparotid approach provides the shortest and the most direct access to mandibular sub‐condylar fractures. However, this approach is less preferred due to the fear of facial nerve injury. The aim of this study was to evaluate the safety and morbidity of the retromandibular transparotid approach for open reduction and internal fixation of sub‐condylar mandibular fractures.

Methods

A retrospective cohort study of 29 patients with 35 sub‐condylar mandibular fractures who underwent open reduction and internal fixation through the retromandibular transparotid approach was conducted. The primary study variable was facial nerve palsy, whereas the secondary variables were infection, sialocele, salivary fistula, stability of the fractured segments, post‐operative malocclusion, Frey's syndrome, and unesthetic scar. All patients were followed up for 6 months. Predictor variables included age, gender, side, location, displacement, etiology, concomitant maxillofacial fractures, and healing status. Fisher's exact test was calculated to find the association between primary variables and predictor variables.

Result

Out of 35 sub‐condylar fractures (29 patients; 23 male, 6 female), four (11.42%) developed transient facial nerve palsy. Fractures at the condylar neck level (P = .045) and with displacement (P = .026) were significantly associated with the development of facial nerve palsy. Four patients (13.8%) developed slight malocclusion, two had surgical site infections, two developed sialoceles, and one had a salivary fistula.

Conclusion

The retromandibular transparotid approach is safe and effective with rare major complications in the management of sub‐condylar fractures of the mandible. Condylar neck fractures and displaced fractured segments are associated with an increased risk of development of facial nerve palsy.
Histology of the spleen in immune thrombocytopenia: clinical‐pathological characterization and prognostic implications
Authors: Pizzi Marco , Friziero Alberto , Vianello Fabrizio , Binotto Gianni , Da Dalt Gianfranco , Zoletto Simone , Carraro Elisa , Fassan Matteo , Sbaraglia Marta , Sperti Cosimo , Baldan Nicola , D’Amore Fabio , Bertozzi Irene , Righi Simona , Pierobon Elisa Sefora , Moletta Lucia , Capovilla Giovanni , Grego Andrea , Sabattini Elena , Fabris Fabrizio , Merigliano Stefano , Dei Tos Angelo Paolo
Published: November 2020

Objective

Immune thrombocytopenia (ITP) is an acquired disorder, characterized by immune‐mediated platelet destruction. The spleen plays a key pathogenic role in ITP and splenectomy is a valuable second‐line therapy for this disease. Little is known on ITP spleen histology and response to splenectomy is unpredictable. This study aims to characterize ITP spleen histology and assess possible predictors of splenectomy outcome.

Methods

A series of 23 ITP spleens were retrospectively assessed for the following histological parameters: density of lymphoid follicles (LFs), marginal zones (MZs), T helper and cytotoxic T cells; presence of reactive germinal centers (GCs); width of perivascular T cell sheaths; and red pulp features. Clinical and histological data were matched with postsplenectomy platelet counts to assess their prognostic relevance.

Results

Three histological patterns were documented: a hyperplastic white pulp pattern, a non‐activated white pulp pattern (lacking GCs), and a white pulp‐depleted pattern. Poor surgical responses were associated with presplenectomy high‐dose steroid administration, autoimmune comorbidities and low T follicular helper cell density. The combination of such parameters stratified patients into different splenectomy response groups. The removal of accessory spleens was also associated with better outcome.

Conclusion

ITP spleens are histologically heterogeneous and clinical‐pathological parameters may help predict the splenectomy outcome.
Predictive significance of selected gene mutations in relapsed and refractory chronic lymphocytic leukemia patients treated with ibrutinib
Authors: Machnicki Marcin M. , Górniak Patryk , Pępek Monika , Szymczyk Agnieszka , Iskierka‐Jażdżewska Elżbieta , Steckiewicz Paweł , Bluszcz Aleksandra , Rydzanicz Małgorzata , Hus Marek , Płoski Rafał , Makuch‐Łasica Hanna , Nowak Grażyna , Juszczyński Przemysław , Jamroziak Krzysztof , Stokłosa Tomasz , Puła Bartosz
Published: November 2020

Background

Ibrutinib, an inhibitor of the Bruton's kinase (BTK), is characterized by high efficacy in the therapy of patients with relapsed and refractory chronic lymphocytic leukemia (RR‐CLL).

Aims

To analyze the potential significance of the mutational status of selected 30 genes on the disease outcome in 45 patients with RR‐CLL using custom‐made gene panel and sequencing on Illumina MiSeq FGx platform.

Results

The highest rate of mutations was observed in TP53 (n = 18; 40.0%), NOTCH1 (n = 13; 28.8%), SF3B1 (n = 11; 24.4%), ATM (n = 7; 15.6%), MED12 (n = 6, 13.3%), CHD2 (n = 5; 11.1%), XPO1 (n = 5; 11.1%), NFKBIE (n = 5; 11.1%), BIRC3 (n = 4; 8.9%), SPEN (n = 4; 8.9%), POT1 (n = 4; 8.9%), EGR2 (n = 3; 6.7%), and RPS15 (n = 3; 6.7%). With a median observation time of 45.9 months, the median progression‐free survival (PFS) and overall survival (OS) were not reached. The 36‐month estimated rate of PFS and OS were 64% and 68.2%, respectively. The overall response rate was noted in 23 patients (51.1%), while twenty (44.4%) patients achieved stability. Progression was noted in 2 (4.5%) cases. Analyzed molecular factors had no impact on PFS and OS.

Conclusion

Despite accumulation of several poor prognostic factors in our real‐life cohort of heavily pretreated patients with CLL, ibrutinib treatment showed long‐term clinical benefit.
Establishing criteria for pediatric epilepsy surgery center levels of care: Report from the ILAE Pediatric Epilepsy Surgery Task Force
Authors: Gaillard William D. , Jette Nathalie , Arnold Susan T. , Arzimanoglou Alexis , Braun Kees P. J. , Cukiert Arthur , Dick Alexander , Harvey A. Simon , Jacobs Julia , Rydenhag Bertil , Udani Vrajesh , Wilmshurst Jo M. , Cross J. Helen , Jayakar Prasanna ,   Task Force for Pediatric Epilepsy Surgery, Commission for Pediatrics, and the Surgical Commission of the International League Against Epilepsy
Published: November 2020

Presurgical evaluation and surgery in the pediatric age group are unique in challenges related to caring for the very young, range of etiologies, choice of appropriate investigations, and surgical procedures. Accepted standards that define the criteria for levels of presurgical evaluation and epilepsy surgery care do not exist. Through a modified Delphi process involving 61 centers with experience in pediatric epilepsy surgery across 20 countries, including low–middle‐ to high‐income countries, we established consensus for two levels of care. Levels were based on age, etiology, complexity of presurgical evaluation, and surgical procedure. Competencies were assigned to the levels of care relating to personnel, technology, and facilities. Criteria were established when consensus was reached (≥75% agreement). Level 1 care consists of children age 9 years and older, with discrete lesions including hippocampal sclerosis, undergoing lobectomy or lesionectomy, preferably on the cerebral convexity and not close to eloquent cortex, by a team including a pediatric epileptologist, pediatric neurosurgeon, and pediatric neuroradiologist with access to video‐electroencephalography and 1.5‐T magnetic resonance imaging (MRI). Level 2 care, also encompassing Level 1 care, occurs across the age span and range of etiologies (including tuberous sclerosis complex, Sturge‐Weber syndrome, hypothalamic hamartoma) associated with MRI lesions that may be ill‐defined, multilobar, hemispheric, or multifocal, and includes children with normal MRI or foci in/abutting eloquent cortex. Available Level 2 technologies includes 3‐T MRI, other advanced magnetic resonance technology including functional MRI and diffusion tensor imaging (tractography), positron emission tomography and/or single photon emission computed tomography, source localization with electroencephalography or magnetoencephalography, and the ability to perform intra‐ or extraoperative invasive monitoring and functional mapping, by a large multidisciplinary team with pediatric expertise in epilepsy, neurophysiology, neuroradiology, epilepsy neurosurgery, neuropsychology, anesthesia, neurocritical care, psychiatry, and nursing. Levels of care will improve safety and outcomes for pediatric epilepsy surgery and provide standards for personnel and technology to achieve these levels.
Progress report on new antiepileptic drugs: A summary of the Fifteenth Eilat Conference on New Antiepileptic Drugs and Devices (EILAT XV). I. Drugs in preclinical and early clinical development
Authors: Bialer Meir , Johannessen Svein I. , Koepp Matthias J. , Levy René H. , Perucca Emilio , Perucca Piero , Tomson Torbjörn , White H. Steve
Published: November 2020

Since 1992, the Eilat Conferences have provided a forum for all stakeholders in the epilepsy community to appraise the latest data on new antiepileptic drugs and emergency seizure treatments, including, in recent years, updates on progress with the development of novel monitoring and therapeutic devices. Because of the COVID‐19 pandemic, the Fifteenth Eilat Conference on New Antiepileptic Drugs and Devices (EILAT XV) was held as a fully virtual conference on July 27‐30, 2020 for the sessions on drugs and on August 3, 2020 for the sessions on devices, and was attended during the 5 days by >500 participants from 63 countries. This progress report summarizes key preclinical and initial (phase 1) clinical data on eight investigational treatments that are currently in early development, including 2‐deoxy‐D‐glucose, GAO‐3‐02, JNJ‐40411813, NBI‐921352, NTX‐001, sec‐butylpropylacetamide, XEN1101, and XEN496. This report provides an overview of current scenarios in the area of treatment discovery and development. The information presented illustrates a variety of innovative strategies, including exploration of compounds with novel mechanisms of action, transplantation of interneurons into epileptogenic brain regions, and the targeting of rare, previously neglected syndromes.
Epilepsy with myoclonic‐atonic seizures (Doose syndrome): Clarification of diagnosis and treatment options through a large retrospective multicenter cohort
Authors: Nickels Katherine , Kossoff Eric H. , Eschbach Krista , Joshi Charuta
Published: November 2020

Objective

Epilepsy with myoclonic‐atonic seizures (EMAS) is a rare childhood onset epileptic encephalopathy. There is no clear consensus for recommended treatments, and pharmacoresistance is common. To better assess the clinical phenotype, most effective treatment, and determinants of cognitive and seizure outcomes, three major pediatric epilepsy centers combined data, creating the largest cohort of patients with EMAS ever studied to date.

Methods

Authors performed a retrospective chart review of patients with EMAS who received care at the authors’ institutions.

Results

A total of 166 children were identified. Global developmental delay (>1 domain) was present in 2% of children at onset and 49% during the course of the disease. Afebrile seizures occurred after the age of 2 years in 88%, generalized tonic‐clonic seizures in 60%, and drop attack or myoclonic seizures in 30%. At onset, electroencephalography (EEG) found 28% normal, background slowing in 20%, and epileptiform discharges or seizures in 69%. Subsequent EEG found slowing in 62% and discharges or seizures in 90%. Response (>50% seizure reduction) to the first three antiseizure drugs (ASDs) was 26% (levetiracetam, 17%; valproic acid, 31%; other ASDs combined, 26%). Diet therapy was used as a second or third therapy in 19% and ultimately used in 57%; response was 79%, significantly greater than the first three ASDs (P = .005, χ2). Seizure freedom occurred in 57% and was less likely in the case of persistent global developmental delays (P < .001), seizure recorded on subsequent EEGs (P = .027), and failure to respond to diet therapy (P = .005). Development was normal in 47%, and 12% had delays in one domain, which was less likely in the case of global developmental delay after epilepsy onset (P < .001) and failure to achieve seizure freedom (P < .001).

Significance

This large cohort of children with EMAS clarifies areas of variability in practice. Diet therapy is by far the most effective treatment; failure to respond was associated with failure to attain seizure freedom. This therapy should be used early in the treatment in EMAS. This study also identified a bidirectional link between cognitive and seizure outcomes.
Does sustainable investing reduce portfolio risk? A multilevel analysis
Authors: Maxfield Sylvia , Wang Liu
Published: November 2020

This study complements and extends prior research on the risk mitigation role of sustainable investing. We use a continuous measure of funds' sustainability traits, rather than a categorical approach, and assess impact on risk directly rather than by looking at fund performance in up versus down markets. We find that sustainable investing plays a significant role in mitigating total, systematic, and idiosyncratic risk of equity funds, even after controlling for other fund characteristics. Further evidence indicates that the explanation for the risk reduction role of sustainable funds largely runs through traits of the firms held in the funds.
Going up the hill: chromatin‐based barriers to epigenetic reprogramming
Authors: Arabacı Dilşad H. , Terzioğlu Gizem , Bayırbaşı Büşra , Önder Tamer T.
Published: November 2020

The establishment and maintenance of cellular identity are crucial during development and tissue homeostasis. Epigenetic mechanisms based largely on DNA methylation and histone modifications serve to reinforce and safeguard differentiated cell states. Somatic cell nuclear transfer (SCNT) or transcription factors such as Oct4, Sox2, Klf4, c‐MYC (OSKM) can erase somatic cell identity and reprogram the cells to a pluripotent state. In doing so, reprogramming must reset the chromatin landscape, silence somatic‐specific gene expression programs, and, in their place, activate the pluripotency network. In this viewpoint, we consider the major chromatin‐based barriers for reprogramming of somatic cells to pluripotency. Among these, repressive chromatin modifications such as DNA methylation, H3K9 methylation, variant histone deposition, and histone deacetylation generally block the activation of pluripotency genes. In contrast, active transcription‐associated chromatin marks such as DOT1L‐catalyzed H3K79 methylation, FACT‐mediated histone turnover, active enhancer SUMOylation, and EP300/CBP bromodomain‐mediated interactions act to maintain somatic‐specific gene expression programs. We highlight how genetic or chemical inhibition of both types of barriers can enhance the kinetics and/or efficiency of reprogramming. Understanding the mechanisms by which these barriers function provides insight into how chromatin marks help maintain cell identity.
Targeting cellular senescence based on interorganelle communication, multilevel proteostasis, and metabolic control
Authors: Cavinato Maria , Madreiter‐Sokolowski Corina T. , Büttner Sabrina , Schosserer Markus , Zwerschke Werner , Wedel Sophia , Grillari Johannes , Graier Wolfgang F. , Jansen‐Dürr Pidder
Published: November 2020

Cellular senescence, a stable cell division arrest caused by severe damage and stress, is a hallmark of aging in vertebrates including humans. With progressing age, senescent cells accumulate in a variety of mammalian tissues, where they contribute to tissue aging, identifying cellular senescence as a major target to delay or prevent aging. There is an increasing demand for the discovery of new classes of small molecules that would either avoid or postpone cellular senescence by selectively eliminating senescent cells from the body (i.e., ‘senolytics’) or inactivating/switching damage‐inducing properties of senescent cells (i.e., ‘senostatics/senomorphics’), such as the senescence‐associated secretory phenotype. Whereas compounds with senolytic or senostatic activity have already been described, their efficacy and specificity has not been fully established for clinical use yet. Here, we review mechanisms of senescence that are related to mitochondria and their interorganelle communication, and the involvement of proteostasis networks and metabolic control in the senescent phenotype. These cellular functions are associated with cellular senescence in in vitro and in vivo models but have not been fully exploited for the search of new compounds to counteract senescence yet. Therefore, we explore possibilities to target these mechanisms as new opportunities to selectively eliminate and/or disable senescent cells with the aim of tissue rejuvenation. We assume that this research will provide new compounds from the chemical space which act as mimetics of caloric restriction, modulators of calcium signaling and mitochondrial physiology, or as proteostasis optimizers, bearing the potential to counteract cellular senescence, thereby allowing healthy aging.
Comparing the diversity and composition of waterbird functional traits between natural, restored, and artificial wetlands
Authors: Almeida Bia A. , Sebastián‐González Esther , dos Anjos Luiz , Green Andy J.
Published: November 2020

The restoration of degraded areas and the creation of artificial ecosystems have partially compensated for the continuing loss of natural wetlands. However, the success of these wetlands in terms of the capacity of supporting biodiversity and ecosystem functions is unclear. Research is needed to improve our understanding of the value of restored and constructed wetlands for functional diversity of freshwater fauna.

We compared natural, restored, and artificially created wetlands present within the Doñana Natural Space, Spain and valued as important for waterbirds. We evaluated if these wetlands are equivalent in terms of waterbird functional trait diversity and composition, during both the wintering and breeding seasons. We modelled functional diversity measures and functional group species richness describing species diet, body mass, and foraging techniques with generalised linear mixed models in 20 wetlands monitored between 2006 and 2011. We used three different statistical approaches to evaluate the robustness of our results.

Artificial wetlands constructed for conservation failed to reach the functional diversity of natural and restored wetlands. Unexpectedly, artificial ponds constructed for fish production performed better, and even exceeded natural wetlands for functional richness during winter. Fish ponds stood out as having a unique functional composition, connected with increase in richness of opportunistic gulls and decrease of species sensitive to high salinity. Overall, the functional structure of breeding communities was more affected by wetland type than wintering communities.

Our findings suggest that compensating the loss of natural wetlands with restored and artificial wetlands results in systems with altered waterbird‐supported functions, such as seed dispersal or nutrient cycling. Protection of natural Mediterranean wetlands is vital to maintain the original diversity and composition of waterbird functional traits. Furthermore, restoration must be prioritised over the creation of artificial wetlands, which, even when intended for conservation, may not provide an adequate replacement.
Erenumab‐Induced Severe Nausea Leading to Smoking Cessation: A Retrospective Case Series
Authors: Mathew Paul G. , Krivitski David , Sharon Roni
Published: November 2020

Objective

Erenumab is a novel treatment modality with a relatively benign and safe side effect profile, currently approved for the prevention of migraine headache. We present 3 cases with chronic migraine who are cigarette smokers were prescribed erenumab, and developed an intense smoking‐induced nausea which eventually led to smoking cessation.

Methods

A multicenter retrospective review of 3 cases with cigarette smoking, one of whom was also smoking marijuana, suffering from chronic migraine resistant to multiple preventive therapies was studied. All were prescribed monthly injections of erenumab 70 mg. Response in terms of headache frequency and intensity and smoking habits was obtained through medical record review.

Results

Out of 3 patients, 2 reported reduced headache frequency and intensity. All patients developed severe nausea while smoking cigarettes after their first dose of erenumab, leading to smoking cessation. One patient co‐smoked marijuana, which did not result in nausea after being treated.

Conclusion

To the best of our knowledge, this is the first report of severe nausea secondary to erenumab administration and smoking cigarettes, which finally resulted in complete cigarette smoking cessation. As such, further study is indicated on the benefit of erenumab and other calcitonin gene‐related peptide antagonists in migraineurs who smoke to promote smoking cessation.
Surface properties and flexural strength of a monolithic zirconia submitted to grinding and regenerative heat treatment
Authors: Fratucelli Érick Dante de Oliveira , Candido Lucas Miguel , Pinelli Lígia Antunes Pereira
Published: November 2020

The present study evaluated the average (Ra) and total (Rz) roughness, crystallography (XRD), flexural strength (FS), and Weibull modulus (m) of a monolithic zirconia subjected to grinding (G) and heat treatments (HT). Specimens were submitted or not to grinding with a diamond stone in low rotation. HT was conduced in two protocols, one at 900°C for 60 minutes and the other at 1000°C for 30 minutes. Roughness was evaluated in a profilometer, crystallography in X‐ray diffractometer, and FS by four‐point flexural strength in a mechanical testing machine. Grinding increased Ra, Rz, and FS. HT had no influence on roughness and for the FS, just decreased in the group that was ground and heat treated with 1000°C for 30 minutes. Neither G nor HT changed the m of the groups. In addition, the HT was able to reverse all monoclinic phases. By the properties evaluated, both HTs could be done without damaging the material.
Customers response to online food delivery services during COVID‐19 outbreak using binary logistic regression
Authors: Mehrolia Sangeeta , Alagarsamy Subburaj , Solaikutty Vijay Mallikraj
Published: November 2020

This study aims to empirically measure the distinctive characteristics of customers who did and did not order food through Online Food Delivery services (OFDs) during the COVID‐19 outbreak in India. Data are collected from 462 OFDs customers. Binary logistic regression is used to examine the respondents’ characteristics, such as age, patronage frequency before the lockdown, affective and instrumental beliefs, product involvement and the perceived threat, to examine the significant differences between the two categories of OFDs customers. The binary logistic regression concludes that respondents exhibiting high‐perceived threat, less product involvement, less perceived benefit on OFDs and less frequency of online food orders are less likely to order food through OFDs. This study provides specific guidelines to create crisis management strategies.
Supine extraperitoneal laparoscopic nephroureterectomy without patient repositioning
Authors: Miki Jun , Yanagisawa Takafumi , Iwatani Kosuke , Obayashi Koki , Fukuokaya Wataru , Mori Keiichiro , Urabe Fumihiko , Tsuzuki Shunsuke , Kimura Shoji , Kimura Takahiro , Egawa Shin
Published: November 2020

Objective

To describe a novel technique allowing laparoscopic nephroureterectomy with bladder cuff excision and lymphadenectomy, in a complete supine position, without patient repositioning.

Methods

Between January 2016 and October 2018, 20 consecutive patients with upper urinary tract urothelial carcinoma underwent supine extraperitoneal laparoscopic nephroureterectomy. The patients were placed in the complete supine position. A 4‐cm pararectal skin incision was made and the extraperitoneal space was developed. We used a unique port placement that permits complete access for nephroureterectomy, bladder cuff excision and concomitant lymphadenectomy. Operative parameters and pathological data were analyzed.

Results

The median age was 70 years (range 49–88 years), the mean operative time was 234 min (range 175–293 min) and the mean estimated blood loss was 67 mL (range 50–200 mL). There were no intraoperative complications, and no patients required transfusion or open conversion. The median number of removed lymph nodes was 10; only one patient had node metastasis. The total operative time and time for nephroureterectomy were significantly longer in the first 10 patients (first group) than in the second 10 patients (second group). Times required for bladder cuff excision and lymphadenectomy did not differ between the two groups.

Conclusions

Our novel technique, which enables completion of the entire procedure of nephrouretectomy with bladder cuff excision and lymphadenectomy in the supine position without patient repositioning, is safe and minimizes operative time while maintaining oncological efficacy. We believe this approach might become a standard option for patients with upper urinary tract urothelial carcinoma.
Identifying oil price shocks and their consequences: The role of expectations in the crude oil market
Authors: Fueki Takuji , Nakajima Jouchi , Ohyama Shinsuke , Tamanyu Yoichiro
Published: November 2020

This paper proposes a simple but comprehensive structural vector autoregressive model to examine the underlying factors of oil price dynamics. The distinguishing feature is to explicitly assess the role of expectations about future aggregate demand and oil supply in addition to the traditional realized aggregate demand and supply factors. Our empirical analysis shows that identified future demand and supply shocks are as important as the traditional realized demand and supply shocks in explaining historical oil price fluctuations. The empirical result indicates that the influence of oil price changes on global output varies according to the nature of each shock.
Facile synthesis of hollow F‐doped SnO2 nanofibers and their efficiency in ethanol sensing
Authors: Nascimento Emanuel P. , Firmino Hellen C. T. , Santos Adillys M. C. , Sales Herbet B. , Silva Vinícius D. , Macedo Daniel A. , Neves Gelmires A. , Medeiros Eliton S. , Menezes Romualdo R.
Published: November 2020

This paper reports for the first time the facile synthesis of hollow F‐doped SnO2 nanofibers by solution blow spinning (SBS) and their ethanol sensing performance. The as‐prepared nanofibers were characterized using scanning electron microscopy (SEM), x‐ray diffraction (XRD), Brunauer–Emmett–Teller (BET), Fourier‐transform infrared spectroscopy (FTIR), and electrochemical impedance spectroscopy (EIS). The gas sensing behavior of the F‐doped SnO2 nanofibers was investigated using a homemade test chamber. The results revealed the preparation of mesoporous F‐doped SnO2 hollow fibers with a diameter ranging from 207 ± 43 to 355 ± 41 nm. The combination of nanocrystalline hollow structure and F doping led to fast high‐responsive ethanol sensors at room temperature (RT) with good reproducibility and long‐term stability. These results indicate that F‐doped SnO2 hollow nanofibers are good candidates for building practical low‐temperature ethanol gas sensors.
Sex difference in sympathetic nervous system activity and blood pressure in hypertensive patients
Authors: Huang Chin‐Chou , Chung Chia‐Min , Leu Hsin‐Bang , Huang Po‐Hsun , Wu Tao‐Cheng , Lin Liang‐Yu , Lin Shing‐Jong , Pan Wen‐Harn , Chen Jaw‐Wen
Published: November 2020

Increased sympathetic nervous system (SNS) activity leads to increased risk of cardiovascular morbidity and mortality. This study investigated whether there were sex differences in SNS activity among Chinese patients with hypertension. Ethnic Chinese non‐diabetic hypertensive patients aged 20–50 years were enrolled in Taiwan. A total of 970 hypertensive patients (41.0 ± 7.2 years) completed the study, 664 men and 306 women. They received comprehensive evaluations including office blood pressure (BP) measurement, 24‐h ambulatory BP monitoring, and 24‐h urine sampling assayed for catecholamine excretion. Compared to women, men were younger, had higher body mass index (BMI), office systolic BP (SBP), office diastolic BP (DBP), 24‐h ambulatory BP, and 24‐h urine catecholamine excretion. In men, 24‐h urine total catecholamine levels were correlated with 24‐h SBP (r = 0.103, p = .008) and 24‐h DBP (r = 0.083, p = .033). In women, however, there was no correlation between 24‐h urine total catecholamine levels and 24‐h ambulatory BP. Multivariate linear regression indicated that being male (β = 1.65, 95% confidence interval [CI] 0.01–3.29, p = .048) and 24‐h urine total catecholamine (β = 5.03, 95% CI 0.62–9.44, p = .025) were both independently associated with 24‐h SBP; being male was independently associated with 24‐h DBP (β = 3.55, 95% CI 2.26–4.85, p < .001). In conclusion, Chinese men with hypertension had higher SNS activity than women, and SNS activity was independently associated with 24‐h ambulatory BP in men rather than in women. These findings suggest that different hypertensive treatment strategies should be considered according to patient sex.
Host shifting and host sharing in a genus of specialist flies diversifying alongside their sunflower hosts
Authors: Hippee Alaine C. , Beer Marc A. , Bagley Robin K. , Condon Marty A. , Kitchen Andrew , Lisowski Edward A. , Norrbom Allen L. , Forbes Andrew A.
Published: November 2020

Congeneric parasites are unlikely to specialize on the same tissues of the same host species, likely because of strong multifarious selection against niche overlap. Exceptions where >1 congeneric species use the same tissues reveal important insights into ecological factors underlying the origins and maintenance of diversity. Larvae of sunflower maggot flies in the genusStrauziafeed on plants in the family Asteraceae. AlthoughStrauziatend to be host specialists, some species specialize on the same hosts. To resolve the origins of host sharing among these specialist flies, we used reduced representation genomic sequencing to infer the first multilocus phylogeny of genusStrauzia. Our results show thatHelianthus tuberosusandHelianthus grosseserratuseach host three differentStrauziaspecies and that the flies co‐occurring on a host are not one another's closest relatives. Though this pattern implies that host sharing is most likely the result of host shifts, these may not all be host shifts in the conventional sense of an insect moving onto an entirely new plant. Many hosts ofStrauziabelong to a clade of perennial sunflowers that arose 1–2 MYA and are noted for frequent introgression and hybrid speciation events. Our divergence time estimates for all of theHelianthus‐associatedStrauziaare within this same time window (<1 MYA), suggesting that rapid and recent adaptive introgression and speciation inHelianthusmay have instigated the diversification ofStrauzia, with some flies converging upon a single plant host after their respective ancestral host plants hybridized to form a new sunflower species.
Bargaining with informational and payoff externalities
Authors: Drugov Mikhail
Published: November 2020

This paper studies a dynamic bargaining model with informational externalities between bargaining pairs. Two principals bargain with their respective agents about the price for their work while its cost is agents' private information and is correlated between them. Depending on the equilibrium, information from the other pair helps or hinders principals' ability to offer low prices. A higher correlation can then either increase or decrease principals' payoffs, delay, and welfare.
Life cycle assessment of salinity gradient energy recovery using reverse electrodialysis
Authors: Mueller Katelyn E. , Thomas Jeffrey T. , Johnson Jeremiah X. , DeCarolis Joseph F. , Call Douglas F.
Published: November 2020

This study is the first comprehensive life cycle assessment (LCA) of reverse electrodialysis (RED), a technology that converts salinity gradient energy into electricity. Our goal is to identify RED system components of environmental concern and provide insights on potential environmental impacts. We conduct an attributional LCA of two RED scenarios: large‐scale energy generation from natural bodies of water and smaller‐scale energy generation from industrial processes. A functional unit of 1 MWh of net electricity production enables comparison to existing renewable energy technologies, including wind and solar photovoltaics. Under theoretical, favorable conditions, environmental impacts from RED are found to be comparable to, and often lower than, established renewable energy technologies. Processes associated with membrane manufacture are primary contributors to six of the nine evaluated impact categories. Under baseline assumptions, impacts are an average of 50% higher for the Natural Water scenario compared to the Concentrated Brine scenario because of the increased power density achieved with concentrated brines. This early‐stage LCA demonstrates that the expected environmental impacts of RED are comparable to existing renewable technologies and a large improvement over fossil‐based generation. However, eutrophication, ecotoxicity, and carcinogenic impacts are larger for RED than other technologies under some assumptions.
Extracts of Antrodia cinnamomea mycelium as a highly potent tyrosinase inhibitor
Authors: Chen Hung‐Yueh , Cheng Kuan‐Chen , Wang Hsueh‐Ting , Hsieh Chang‐Wei , Lai Ying‐Jang
Published: November 2020

Background

Ganoderma has been known as a cure for diseases since ancient times, and been used as a medicinal mushroom for more than 2000 years. By many accounts, Ganoderma lucidum extracts from fruit bodies exhibited the comparable tyrosinase inhibition activity.

Aims

To validate A. cinnamomea mycelia anti‐melanogenesis activity. Ethanolic extracts of A. cinnamomea mycelia were evaluated using in vitro cell‐free tyrosinase assay, cell‐based and zebrafish phenotype‐based method. Meanwhile, safety assessment was also conducted to ensure the feasibility as the novel ingredients in cosmetic and pharmaceutic industries.

Methods

The major regulatory enzymes being in charge of cutaneous pigmentation, was investigated in both cell‐free and cellular enzyme systems, and in phenotype‐based zebrafish model. A high‐throughput TLC in vitro screening system was introduced to perform the initial evaluation of those with anti‐melanin formation activity.

Results

Among the fractions, 50% ethanol extracted fraction (AC_Et50_Hex) exhibited highest anti‐melanin formation activity. AC_Et50_Hex (at 100 ppm) reduced 30% intracellular melanin of B16‐F10 cells through suppression of tyrosinase activity and its protein expression. For animal study, not only does AC_Et50_Hex exhibited similar depigmenting efficacy to kojic acid (56.1% vs 52.3%) with lower dosage (50 ppm vs 1400 ppm), but showed less toxicity to zebrafish.

Conclusion

A. cinnamomea mycelium extracts can be an ideal candidate/substitute for skin‐whitening since kojic acid has been reported with carcinogenic effect. AC_Et50_Hex was recognized as a potential tyrosinase inhibitor throughout in vitro and in vivo analysis studies. The mass production of A. cinnamomea mycelium from agitated fermentation realizes the natural mushroom extracts for commercial application.
Coeliac disease in childhood: An overview
Authors: Bishop Jonathan , Ravikumara Madhur
Published: November 2020

Coeliac disease (CD) is an autoimmune condition, characterised by an immunological response to ingestion of gluten in genetically susceptible individuals, affecting about 1% of the population in many regions of the world. Increased knowledge regarding the pathogenesis, improved diagnostic techniques and increased awareness over the years have transformed our understanding of CD such that it is no longer a rare enteropathy, but rather a common multisystem disorder which affects individuals of all ages and results in wide‐ranging clinical manifestations. Only a minority of children now present with the classical clinical picture of profound diarrhoea and malnutrition. An increasing number of children with CD present with either mild, non‐specific gastrointestinal symptoms or extra‐intestinal manifestations or even be asymptomatic, as in many screening‐detected children. Knowledge about these diverse manifestations and a high index of suspicion is essential so that appropriate investigations can be undertaken, diagnosis established and treatment initiated. Although traditionally small bowel biopsy is considered essential for the diagnosis, recent guidelines from various professional bodies have paved the way to a biopsy‐free diagnosis in a subset of symptomatic children. Life long, strict gluten‐free diet still remains the only effective treatment at present, although several novel therapeutic agents are in various phases of clinical trials.
Paediatric constipation for general paediatricians: Review using a case‐based and evidence‐based approach
Authors: Bolia Rishi , Safe Mark , Southwell Bridget R , King Sebastian K , Oliver Mark R
Published: November 2020

Constipation is a common problem in childhood. The most common type of constipation is functional, accounting for 90–95% of all cases. The aim of this review is to provide clinical scenarios with treatment using evidence‐based information, and management strategies and a clinical algorithm to guide the management of constipation in children. Recent guidelines and online information sites are detailed. Clinical red flags and organic causes of constipation are included. Four clinical scenarios are presented: case (1) 4‐month‐old child with constipation since birth and likely Hirschsprung disease; case (2) 6‐month‐old infant with infant dyschezia; case (3) 4‐year old with functional constipation; and; case (4) 9‐year old with treatment resistant constipation. Children with functional constipation need a thorough history and physical exam to rule out the presence of any ‘red flags’ but do not require laboratory investigations. Management includes education and demystification, disimpaction followed by maintenance therapy with oral laxatives, dietary counselling and toilet training. Treatment options differ between infants and children. Disimpaction and maintenance regimens for common laxatives are presented. On treatment failure or on suspicion of organic disease the patient should be referred for further evaluation. The radionuclide intestinal transit study (scintigraphy) is a useful modality for evaluation and planning of management in treatment‐resistant children. Treatment options for treatment‐resistant patients are presented. High‐level evidence (meta‐analyses) for pharmalogical and non‐pharmalogical treatment modalities are reviewed and an algorithm for assessment and treatment are presented.
Intraoperative dextrose rate during exploratory laparotomies in neonates and the incidence of postoperative hyperglycemia: A retrospective observational study
Authors: Kolesky Scott E. , Nyshadham Soumya , Williams Helen O. , Trinh Tuan A. , Tucker Amber J. , Lam Humphrey , Austin Thomas M.
Published: November 2020

Introduction

Compared with the older pediatric population, neonates have greater perioperative morbidity and mortality. Difficulty with glucose regulation may be a contributing modifiable risk factor during perioperative anesthetic management. To mitigate the risk of hyperglycemia in neonates, some providers empirically halve the preoperative rate of dextrose‐containing infusions during surgery.

Aim

To assess the association between halving the preoperative maintenance dextrose rate and postoperative euglycemia in neonatal intensive care unit patients undergoing exploratory laparotomies.

Methods

Neonatal intensive care unit patients who underwent exploratory laparotomy under general anesthesia from 1/1/2014 to 11/21/2019 were included in this analysis. Hyperglycemia and hypoglycemia were defined as >150 mg/dL and <46 mg/dL. A calculated dextrose ratio was utilized to categorize patients into full and half intraoperative dextrose rate cohorts. Univariate analyses were performed with Fisher's exact test, the Wilcoxon rank sum test, or Spearman's correlation. Multivariable analyses with regression models were conducted after graphical evaluation of a predetermined set of independent variables.

Results

107 patients were included in the full dextrose rate cohort and 96 patients in the half dextrose rate cohort with postoperative hyperglycemia occurring in 47 and 28 patients, respectively. On univariate analysis, halving the preoperative dextrose rate was associated with decreased postoperative hyperglycemia (odds ratio: 0.53; 95% CI: 0.28‐0.98, P = 0.041). This association continued in the regression model (adjusted odds ratio: 0.49; 95% CI: 0.25‐0.80, P = 0.008) after controlling for preoperative dextrose rate, preoperative serum glucose, preoperative pH, surgical duration, postmenstrual age at surgery, and the presence of necrotizing enterocolitis. Only one patient was hypoglycemic postoperatively, and they were in the full dextrose cohort.

Conclusion

Halving of preoperative dextrose rates intraoperatively during exploratory laparotomy in neonatal intensive care unit patients was associated with a decreased risk of postoperative hyperglycemia without substantially increasing the occurrence of postoperative hypoglycemia. The practice of halving preoperative dextrose rates may be an effective empirical approach for intraoperative glucose management in the high‐risk neonatal population when blood glucose monitoring is challenging.
The transition to flowering in winter rapeseed during vernalization
Authors: Matar Sarah , Kumar Avneesh , Holtgräwe Daniela , Weisshaar Bernd , Melzer Siegbert
Published: November 2020

Flowering time is a major determinant of adaptation, fitness and yield in the allopolyploid species rapeseed (Brassica napus). Despite being a close relative to Arabidopsis thaliana, little is known about the timing of floral transition and the genes that govern this process. Winter, semi‐winter and spring type plants have important life history characteristics that differ in vernalization requirements for flowering and are important for growing rapeseed in different regions of the world. In this study, we investigated the timing of vernalization‐driven floral transition in winter rapeseed and the effect of photoperiod and developmental age on flowering time and vernalization responsiveness. Microscopy and whole transcriptome analyses at the shoot apical meristems of plants grown under controlled conditions showed that floral transition is initiated within few weeks of vernalization. Certain Bna.SOC1 and Bna.SPL5 homeologs were among the induced genes, suggesting that they are regulating the timing of cold‐induced floral transition. Moreover, the flowering response of plants with shorter pre‐vernalization period correlated with a delayed expression of Bna.SOC1 and Bna.SPL5 genes. In essence, this study presents a detailed analysis of vernalization‐driven floral transition and the aspects of juvenility and dormancy and their effect on flowering time in rapeseed.