bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of SWS Strength and Concrete Air Void Composite Defects on Performance of CFST Arch Bridge Rib
Authors: Lu Zhengran , Guo Chao
Published: April 2020

Most large-diameter concrete-filled steel tube (CFST) arch bridges adopt spiral-welded steel tubes for technical and economic reasons. However, during the steel tube manufacturing process, the welding temperature and other factors lead to a decreased spiral-welded seam (SWS) strength initially. Furthermore, for the CFST arch bridges using ordinary concrete, the laitance and air void defects inevitably appear, especially 20 years ago when there was no air-entraining agent in China. This paper presents a group of scale model experiments and finite element model analysis of the bearing capacity of a serviced CFST arch bridge rib with decreased SWS strength and concrete air void composite defects, under small eccentric axial compression on ultrasonic scanning field data. Parametric analyses were also performed to investigate the influence of the air void and SWS strength on the bearing capacity of the rib. Finally, a new ultimate strength index of the rib with composite defects was proposed, and a simplified formula was presented to estimate the effects of the air void and SWS strength decrease on the ultimate strength of the CFST arch bridge rib.
Delineating Mixed Urban “Jobs-Housing” Patterns at a Fine Scale by Using High Spatial Resolution Remote-Sensing Imagery
Authors: Yao Yao , Qian Chen , Hong Ye , Guan Qingfeng , Chen Jingmin , Dai Liangyang , Jiang Zhangwei , Liang Xun
Published: April 2020

The spatial distribution pattern of jobs and housing plays a vital role in urban planning and traffic construction. However, obtaining the jobs-housing distribution at a fine scale (e.g., the perspective of individual jobs-housing attribute) presents difficulties due to a lack of social media data and useful models. With user data acquired from a location-based service provider in China, this study employs a deep bag-of-features network (BagNet) to classify remote-sensing (RS) images into various jobs-housing types. Considering Wuhan, one of the fastest developing cities in China, as a case study area, three jobs-housing types (i.e., only working, only living, and both working and living) at the land-parcel level are obtained. We demonstrate that the multiscale random sampling method can reduce the influence of image noise, increase the utilization of training data, and reduce network overfitting. By altering the network structure and the training strategy, BagNet achieved excellent fitting accuracy for identifying each jobs-housing type (overall accuracy > 0.84 and kappa > 0.8). For the first time, we demonstrate that urban socioeconomic characteristics can be obtained from high-resolution RS images using deep learning techniques. Additionally, we conclude that the total level of mixing within Wuhan is not high at present; however, Wuhan is continuously improving the mixture of jobs and housing. This study has reference value for extracting urban socioeconomic characteristics from RS images and could be used in urban planning as well as government management.
Prognostic Significance of Thyroglobulin Antibodies in Differentiated Thyroid Cancer
Authors: Reverter Jordi L. , Rosas-Allende Irene , Puig-Jove Carlos , Zafon Carles , Megia Ana , Castells Ignasi , Pizarro Eduarda , Puig-Domingo Manel , Granada M. Luisa
Published: April 2020

Objective. To investigate whether variations in thyroglobulin autoantibodies (TgAb) are related to the recurrence or persistence of differentiated thyroid carcinoma (DTC) and may therefore be useful as surrogate tumor markers. Design and Methods. We retrospectively studied 98 subjects (83 women, 47 ± 15 years old) from an initial cohort of 1017 patients treated for DTC in five hospitals, with positive TgAb at any time during the follow-up. Patients presented five different patterns of evolution of serum TgAb concentrations: (1) stable positive TgAb, (2) de novo appearance, (3) an increase of more than 50%, (4) TgAb levels from positive to negative, and (5) a decrease of more than 50%. Results. In the group of 11 patients with stable TgAb, four cases presented persistence of the disease with structural incomplete response. In the group of 22 patients with sustained increasing trend rising more than 50% or de novo detectable TgAb levels, three patients were diagnosed with structural incomplete response. There was no evidence of recurrence or persistence of the disease in any of the 65 patients who showed a significant decrease in (n = 35) or disappearance of (n = 30) TgAb. Conclusions. Our results suggest that not only the appearance of a significant increase in TgAb but also stable concentrations of TgAb should be regarded as a sufficient risk condition for an active search for recurrent or persistent disease. Conversely, a significant decrease in TgAb levels can represent a good prognostic sign.
Correlation between Galectin-3 and Early Herpes Zoster Neuralgia and Postherpetic Neuralgia: A Retrospective Clinical Observation
Authors: Wang Tingting , Fei Yong , Yao Ming , Tao Jiachun , Deng Jiajia , Huang Bing
Published: April 2020

This study aims to explore the value of serum galectin-3 in patients with herpes zoster neuralgia (HZN) and postherpetic neuralgia (PHN) and other factors influencing HZN and PHN occurrence. Samples from forty patients with herpes zoster neuralgia (HZN) (Group H), 40 patients with nonherpes zoster neuralgia (Group N), and 20 cases of health check-up were collected. Patients were divided into PHN group (Group A) and non-PHN group (Group B) according to the occurrence of PHN in Group H. Galectin-3, T-lymphocyte subsets, and IL-6 were recorded in all patients. The changes of galectin-3 in patients with early HZN and PHN were analyzed by single-factor analysis and multifactor analysis. The age (P=0.012) and NRS scores (P<0.001) of PHN patients were significantly higher than those of non-PHN patients and other neuralgia patients. The ratio of CD3+ (F = 80.336, P<0.001), CD4+ (F = 12.459, P<0.001) lymphocyte subsets, and CD4+/CD8+ (F = 15.311, P<0.001) decreased significantly in PHN patients. The level of blood IL-6 (F = 139.446, P<0.001) in PHN patients was significantly increased. Serum galectin-3 was significantly higher in HZN patients than in PHN patients (P<0.05); IL-6 (OR = 10.002, 95% CI: 3.313–30.196, P<0.001) and galectin-3 (OR = 3.719, 95% CI: 1.261–10.966, P=0.017) were the risk factors for HZN; galectin-3 (OR = 17.646, 95% CI: 2.795–111.428, P=0.002) was also the risk factor for PHN. ROC curve analysis also showed that serum galectin-3 was a better predictor of poor prognosis (AUC = 0.934, P<0.001). Therefore, as an independent risk factor of HZN and PHN, serum galectin-3 may be used as a new biochemical marker in clinical practice.
Optimization of the Influencing Variables on the Corrosion Property of Steel Alloy 4130 in 3.5 wt.% NaCl Solution
Authors: El-Shamy A. M. , El-Hadek M. A. , Nassef A. E. , El-Bindary R. A.
Published: April 2020

In this work, the aqueous Lawsonia inermis extract (LI) is investigated as an economic and green deterioration inhibitive formula for steel alloy 4130 in 3.5 wt.% NaCl solutions. The water-based extraction process is considered as one of the cheapest techniques for preparation of active ingredients of natural products. These ingredients play an important role in corrosion mitigation of steel alloy 4130 in saline media. This extract was subjected to three different parameters: inhibitor concentration, rotation speed, and temperature in 3.5 wt.% NaCl solutions. The electrochemical techniques are used to perceive the corrosion behavior, and the obtained results were dedicated to theoretical explorations to assess the features of corrosion inhibition and the adsorption over the steel substrate in 3.5 wt.% NaCl solutions. Affording to the electrochemical techniques of LI showed very promising results against corrosion depending on the inhibitor concentrations. The inhibition efficiency of LI was additionally appraised at three diverse temperatures, and the results disclosed that the inhibition efficiency is decreased. Additionally, the theoretical aspects illuminated that the main active ingredients of LI have a proclivity to coagulate on the steel substrates allowing these areas to paradigm a protecting layer on the steel surfaces. This behavior is in provision of investigational results. Statistical studies were used to examine the consequence of chief constraints (i.e., inhibitor concentration, temperature, and rotation speed) on the inhibition efficiency and the rate of corrosion of steel alloy 4130. The inhibitive effect of LI in contradiction of the corrosion of steel alloy 4130 surfaces is considered by resources of DFT/6-31G(d) calculations. The quantum chemical parameters interrelated to the inhibition efficiency are considered.
Secretion of Acid Sphingomyelinase and Ceramide by Endothelial Cells Contributes to Radiation-Induced Intestinal Toxicity
Authors: Leonetti Daniela , Estéphan Hala , Ripoche Natacha , Dubois Nolwenn , Aguesse Audrey , Gouard Sébastien , Brossard Lisa , Chiavassa Sophie , Corre Isabelle , Pecqueur Claire , Neunlist Michel , Hadchity Elie , Gaugler Marie-Hélène , Mahé Maxime M. , Paris François
Published: April 2020

Ceramide-induced endothelial cell apoptosis boosts intestinal stem cell radiosensitivity. However, the molecular connection between these two cellular compartments has not been clearly elucidated. Here we report that ceramide and its related enzyme acid sphingomyelinase (ASM) are secreted by irradiated endothelial cells and act as bystander factors to enhance the radiotoxicity of intestinal epithelium. Ceramide and the two isoforms of ASM were acutely secreted in the blood serum of wild-type mice after 15 Gy radiation dose, inducing a gastrointestinal syndrome. Interestingly, serum ceramide was not enhanced in irradiated ASMKO mice, which are unable to develop intestinal failure injury. Because ASM/ceramide were secreted by primary endothelial cells, their contribution was studied in intestinal epithelium dysfunction using coculture of primary endothelial cells and intestinal T84 cells. Adding exogenous ASM or ceramide enhanced epithelial cell growth arrest and death. Conversely, blocking their secretion by endothelial cells using genetic, pharmacologic, or immunologic approaches abolished intestinal T84 cell radiosensitivity. Use of enteroid models revealed ASM and ceramide-mediated deleterious mode-of-action: when ceramide reduced the number of intestinal crypt-forming enteroids without affecting their structure, ASM induced a significant decrease of enteroid growth without affecting their number. Identification of specific and different roles for ceramide and ASM secreted by irradiated endothelial cells opens new perspectives in the understanding of intestinal epithelial dysfunction after radiation and defines a new class of potential therapeutic radiomitigators.

Significance:

This study identifies secreted ASM and ceramide as paracrine factors enhancing intestinal epithelial dysfunction, revealing a previously unknown class of mediators of radiosensitivity.
Golgi-Localized PAQR4 Mediates Antiapoptotic Ceramidase Activity in Breast Cancer
Authors: Pedersen Line , Panahandeh Pouda , Siraji Muntequa I. , Knappskog Stian , Lønning Per Eystein , Gordillo Ruth , Scherer Philipp E. , Molven Anders , Teigen Knut , Halberg Nils
Published: April 2020

The metabolic network of sphingolipids plays important roles in cancer biology. Prominent sphingolipids include ceramides and sphingosine-1-phosphate that regulate multiple aspects of growth, apoptosis, and cellular signaling. Although a significant number of enzymatic regulators of the sphingolipid pathway have been described in detail, many remained poorly characterized. Here we applied a patient-derived systemic approach to identify and molecularly define progestin and adipoQ receptor family member IV (PAQR4) as a Golgi-localized ceramidase. PAQR4 was approximately 5-fold upregulated in breast cancer compared with matched control tissue and its overexpression correlated with disease-specific survival rates in breast cancer. Induction of PAQR4 in breast tumors was found to be subtype-independent and correlated with increased ceramidase activity. These findings establish PAQR4 as Golgi-localized ceramidase required for cellular growth in breast cancer.

Significance:

Induction of and cellular dependency on de novo sphingolipid synthesis via PAQR4 highlights a central vulnerability in breast cancer that may serve as a viable therapeutic target.
Bone Conduction Trial Device to Eliminate the Effect of Transcranial Attenuation: A Prospective Observational Study in Single-Sided Deaf Subjects
Authors: Claes Annes , Bouzegta Rajae , Van Rompaey Vincent , Vanderveken Olivier , Van de Heyning Paul , Mertens Griet
Published: April 2020

Objectives: The contact miniTM (CM) is a nonimplantable, digital bone conduction device (BCD) consisting of 2 isolated units: an electronic housing, including the microphone, and a vibrator housing. The study investigated whether the CM can be used as an alternative test device for a BCD trial in single-sided deaf (SSD) adults with the microphone placed at the SSD ear and the vibrator at the normal-hearing (NH) ear (i.e., cross position). Methods: Twenty SSD adults (mean age: 50 [±13.2] years) participated in a 2-week BCD trial with the CM on the headband in cross position. Prior to the trial, the subjects performed adaptive speech-in-noise tests in an unaided condition. After the trial, speech-in-noise tests were performed with the CM in cross position (CMcross) and ipsilateral position, i.e., both units at the SSD ear (CMipsi). Five different speech-in-noise configurations were used (S0N0; S0NNH; S0NSSD; S0°NNH+SSD; and SSSDNNH). Speech reception thresholds (SRT) were analyzed comparing the unaided, the CMcross condition, and the CMipsi condition. Results: Friedman’s test revealed no significant differences in SRTs between the CMcross, CMipsi, and the unaided condition for the S0N0, S0NNH, S0NSSD, and S0°NNH+SSD configuration. However, in the SSSDNNH configuration, a significant effect was found (p < 0.001). Wilcoxon pairwise comparisons with Bonferroni correction indicated that SRTs in the CMcross condition were significantly lower (i.e., better speech understanding) than those in the unaided (p < 0.001) and the CMipsi condition (p < 0.05). Conclusion: The CM may be a good alternative for patients with SSD, resulting in significantly better speech recognition when noise is presented to the NH ear and speech to the SSD ear. As the speech recognition results are better in the cross than the ipsilateral position, the CMcross might help to overcome the negative effect of transcranial attenuation during BCD trials.
Genetic Analysis of Afibrinogenemia and Hypofibrinogenemia: Novel Mutations in the FGB Gene in the Turkish Population
Authors: Özkan Didem Torun  , Sarper Nazan , Akar Nejat
Published: April 2020

Introduction: Congenital afibrinogenemia is a rare autosomal recessive disorder characterized by bleeding that varies from mild to severe and by complete absence or extremely low levels of plasma and platelet fibrinogen. Hypofibrinogenemia is characterized by fibrinogen levels <1.5 g/L. Objective: In this study, we analyzed fibrinogen beta chain gene mutations in Turkish afibrinogenemia and hypofibrinogenemia patients. Methods: We evaluated 20 afibrinogenemia and hypofibrinogenemia patients and 80 healthy controls. We have sequenced all exons of the FGB gene using the DNA isolated from the peripheral blood samples of patients and controls. Results and Conclusion: We found a nonsense mutation in exon 4 at nucleotide 630 that encoded serine amino acid, and in the same exon a missense mutation of T to C at nucleotide 647, resulting in a transition from leucine to proline (p.L198P) in a child with hypofibrinogenemia. These mutations have been shown for the first time in the same patient of Turkish descent. Furthermore, there was a novel heterozygous guanine-to-adenine nucleotide change in exon 3. This caused the change of arginine amino acid to threonine amino acid at position 136 (p.A136T) in a protein, which has not been described in the literature before.
Testing the Interpersonal-Cognitive Model of Auditory Verbal Hallucinations in Youths with Either Early-Stage Borderline Personality Disorder or First-Episode Schizophrenia Spectrum Disorder
Authors: Cavelti Marialuisa , Thompson Katherine , Hulbert Carol , Betts Jennifer , Jackson Henry , Francey Shona , McCutcheon Louise , Chanen Andrew M.
Published: April 2020

This is the first study to explore interpersonal schemata in outpatient youths (age 15–25 years) with early-stage borderline personality disorder (BPD) and auditory verbal hallucinations (AVH). It also aimed to replicate, in a transdiagnostic youth sample, the finding from studies of adults with AVH that negative beliefs about the self and others lead to negative appraisals of voices, which in turn elicits depression. The following 3 groups were compared: youth with BPD+AVH (n = 23), youth with schizophrenia spectrum disorder (SZ) with AVH (SZ+AVH, n = 20), and youths with BPD who did not experience AVH (BPD no AVH, n = 23). The BPD+AVH group reported more negative and fewer positive self schemata than the SZ+AVH group. They also saw themselves as being more socially inferior to others than did the SZ+AVH group, but they did not differ in appraisals of self or others, compared with the BPD no AVH group. In youths with AVH (BPD+AVH, SZ+AVH combined), the indirect effect of beliefs about self or others, via negative appraisals of voices on depression, was not significant. Instead, a significant indirect effect of negative appraisals of voices on depression, via negative beliefs about self, was found. The experience of AVH during adolescence and young adulthood, when the identity is still being formed, might have a more profound effect on the developing self than during later adulthood, when the self is more stable and resilient. Negative self-appraisals might constitute a treatment target for early intervention for youths with distressing voices, including those with BPD.
Integrative Analysis of Long Noncoding RNAs in Patients with Graft-versus-Host Disease
Authors: Wang Feiyan , Luo Lan , Gu Zhenyang , Yang Nan , Wang Li , Gao Chunji
Published: April 2020

Background: Chronic graft-versus-host disease (cGVHD) remains a major cause of late non-recurrence mortality despite remarkable improvements in the field of allogeneic hematopoietic stem cell transplantation. Although recent studies have found that B-cell receptor (BCR)-activated B cells contribute to pathogenesis in cGVHD, the specific molecular mechanisms of B cells in this process remain unclear. Methods: In our study, human long noncoding RNA (lncRNA) microarrays and bioinformatic analysis were performed to identify different expressions of lncRNAs in peripheral blood B cells from cGVHD patients compared with healthy ones. The differential expression of lncRNA was confirmed in additional samples by quantitative real-time polymerase chain reaction (qRT-PCR). Results: The microarray analysis revealed that 106 of 198 differentially expressed lncRNAs were upregulated and 92 were downregulated in cGVHD patients compared with healthy controls. Intergenic lncRNAs accounted for the majority of differentially expressed lncRNAs. A KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis showed that the differentially expressed mRNAs, which were coexpressed with lncRNA, between the cGVHD group and the healthy group were significantly enriched in the BCR signaling pathway. Further analysis of the BCR signaling pathway and its coexpression network identified three lncRNAs with the strongest correlation with BCR signaling and cGVHD, as well as a series of protein-coding genes and transcription factors associated with them. The three candidate lncRNAs were further validated in another group of cGVHD patients by qRT-PCR. Conclusions: This is the first study on the correlation between lncRNA and cGVHD using lncRNA microarray analysis. Our study provides novel enlightenment in exploring the molecular pathogenesis of cGVHD.
Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System
Authors: Chang Yifan , Xu Weidong , Lu Xiaojun , Zhou Yi , Ji Ming , Xiao Yu-Tian , Sun Yinghao , Ren Shancheng
Published: April 2020

Purpose: To investigate the feasibility and surgical technique of robotic perineal radical prostatectomy (RPRP). Materials and Methods: We retrospectively analyzed 6 consecutive patients diagnosed with prostate cancer from December 2018 to May 2019 who underwent RPRP at our center. Perioperative outcomes were recorded for safety and feasibility analysis. Results: Six patients successfully underwent RPRP with no conversion to open procedures. Operative time was 140 (interquartile range [IQR] 123.75–148.75) min, console time was 70 (IQR 62.5–70) min, with an estimated blood loss of 125 (IQR 100–187.5) mL. Patients were discharged 2 days postoperatively (IQR range 1–3) with pelvic drainages removed. The Foley catheter was removed 2 weeks after surgery. Postoperative pathology revealed 5 patients with locally advanced disease (apical margin-positive prostate cancer [pT3a]bNx). Two patients had a positive surgical margin (33.3%). No complications of Clavien grade 3 and above were recorded; 1 patient had a delay in wound-healing of 1 week. Postoperative continence was achieved for 2 patients immediately after Foley catheter removal, 2 recovered 1-month postoperatively, and 1 recovered within 3 months, and 1 still had mild incontinence at the latest follow-up 1-month postoperatively. Conclusion: RPRP is a safe and feasible alternative for the transperitoneal route in selected patients. Further investigation is required to assess its oncological and quality-of-life results.
Immunophenotypic Conversion between Primary and Relapse Breast Cancer and its Effects on Survival
Authors: Blancas Isabel , Muñoz-Serrano Antonio Jesús , Legerén Marta , Ruiz-Ávila Isabel , Jurado José Miguel , Delgado María Teresa , Garrido José Manuel , González Beatriz , Bayo Virginia , Rodríguez-Serrano Fernando
Published: April 2020

Background: The differential expression of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2) or Ki-67 between primary tumour and the recurrence has been described. We aimed to determine these changes and their prognostic implications. Patients and Methods: We retrospectively reviewed 45 breast cancer patients with relapsed biopsy that were classified into local relapse (LR) or metastatic disease (MD) groups. We analyzed the conversion rate and the value of the immunophenotype of the primary tumour and the relapse as a prognostic factor for relapse-free survival (RFS), progression-free survival (PFS) and overall survival (OS). Results: The conversion rate was 34.8% for Ki-67, 20% for ER, 20% for PR, and 15.6% for HER2. For the LR group, the RFS was 71.9 months and the OS was 141.6 months, without statistical differences according to the immunophenotype of the primary or the relapsed biopsy. For the MD group, the PFS was 20.8 months. According to immunophenotype of the relapse, the PFS were ER+ 24.7 months vs. ER– 9.3 months; PR+ 25.1 months vs. PR– 12.7 months without statistical differences according to HER2 or Ki67. The OS for MD group was 54.4 months without statistical differences according to immunophenotype. Conclusion: The characteristics of breast cancer can change over the time. Variations of the ER or PR status in MD group have prognostic value for PFS. To perform a biopsy of relapses is warranted in order to establish the prognostic of the current disease, and probably a more accurate treatment.
Automated Remote Monitoring for Peritoneal Dialysis and Its Impact on Blood Pressure
Authors: Yeter Hasan Haci , Akcay Omer Faruk , Ronco Claudio , Derici Ulver
Published: April 2020

Introduction: Peritoneal dialysis (PD) provides a safe, home-based continuous renal replacement therapy for patients. The adherence of the patients to the prescribed dialysis fluids cannot always be monitored by physicians. Remote monitoring automated peritoneal dialysis (RM-APD) can affect patients’ compliance with treatment and, thus, clinical outcomes. Objective: We aimed to evaluate the clinical outcomes of patients with a remote access program. Methods: This was an observational study. We analyzed the effect of RM-APD on treatment adherence, dialysis adequacy, and change in blood pressure control, sleep quality, and health-related quality of life during the 6 months of follow-up. Results: A total of 15 patients were enrolled in this study. It was found that there was a significant decrease (99 ± 19 vs. 89 ± 11 mm Hg) in mean arterial blood pressure of patients, and a considerable increase in Kt/V was observed in the sixth month after the RM-APD switch (2.11 ± 0.4 vs. 2.25 ± 0.5). A significant increase was found when comparing the 3-month and 6-month ultrafiltration amounts before RM-APD and the ultrafiltration amount within 6 months after RM-APD (800 mL [500–1,000] and 752 mL [490–986] vs. 824 mL [537–1,183]). The daily antihypertensive pill need (4 [0–7] vs. 2 [0–6]) and alarms received from the device decreased (from 4 [3–8] to 2 [0–3]) at the sixth month of the switch. There was no significant change in sleep quality and health-related quality of life within 6 months. Conclusion: This study showed that treatment adherence and ultrafiltration amounts of patients increased with the use of RM-APD, as well as better blood pressure control with fewer antihypertensive drugs.
Association between Shoulder Range of Motion and Pain Catastrophizing Scale in Breast Cancer Patients after Surgery
Authors: Akbas Ahmet , Dagmura Hasan , Daldal Emin , Dasiran Fatih Mehmet , Deveci Hülya , Okan Ismail
Published: April 2020

Background: Prolonged survival period as a result of early diagnosis and treatment in breast cancer has increased the importance of postoperative morbidities. The aim of the present study was to investigate the association of pain ca­tastrophizing with shoulder pain in patients with decreased shoulder range of motion in the postoperative period. Patients and Methods: The present study included 53 patients who underwent surgery due to breast cancer. Patients who had bilateral mastectomy, distant metastases, cervical-cranial originated lesions, patients with problems involving one of the shoulders or upper extremities before the operation, and patients with cognitive impairment, heart failure, or low albumin levels (liver parenchyma disease or renal failure) were excluded. Shoulder range of motion was measured in the postoperative period, and two study groups were established: one with a limited shoulder range of motion level and the other with a normal level. Effects of pain catastrophizing and shoulder pain severity on shoulder range of motion limitation were compared between the two groups. Results: The average age of 53 female patients who had breast surgery was 52.3 ± 10.5 years. In the group with limited shoulder range of motion, the median pain catastrophizing scale value was 27 (range 5–32) and the shoulder pain severity score was 4 (range 0–8), while in the group with normal shoulder range of motion these values were 11 (range 3–39) and 2 (range 0–6), respectively (p < 0.05). In addition, it was found that factors such as surgical treatment modality and postoperative radiotherapy did not significantly affect shoulder range of motion limitation. Conclusion: Determining the pain catastrophizing scale of patients and controlling pain in the early postoperative period could have positive effects on shoulder range of motion.
Cognitive Impairment Correlates Linearly with Mean Flow Velocity by Transcranial Doppler below a Definable Threshold
Authors: Marshall Randolph S. , Pavol Marykay A. , Cheung Ying Kuen  , Asllani Iris , Lazar Ronald M.
Published: April 2020

Introduction: Low cerebral blood flow can affect cognition in patients with high-grade asymptomatic internal carotid artery stenosis. Current clinical algorithms use stroke risk to determine which patients should undergo revascularization without considering cognitive decline. Although correlations between low-flow and cognitive impairment have been reported, it is not known whether a threshold exists below which such a correlation expresses itself. Such information would be critical in treatment decisions about whether to intervene in patients with high-grade carotid artery stenosis who are at risk for cognitive decline. Objective: To determine how reduced blood flow correlates with lower cognitive scores. Methods: Patients with ≥80% unilateral internal carotid artery stenosis with no history of stroke were recruited from inpatient and outpatient practices at a single, large, comprehensive stroke center. Patients underwent bilateral insonation of middle cerebral arteries with standard 2-Hz probes over the temporal windows with transcranial Doppler. Cognitive assessments were performed by an experienced neuropsychologist using a cognitive battery comprising 14 standardized tests with normative samples grouped by age. Z-scores were generated for each test and averaged to obtain a composite Z-score for each patient. Multivariable linear regression examined associations between mean flow velocity (MFV) and composite Z-score, adjusting for age, education, and depression. The Davies test was used to determine if there was a breakpoint for a non-zero difference in slope of a segmented relationship over the range of composite Z-score values. Results: Forty-two patients with unilateral high-grade internal carotid artery stenosis without stroke were enrolled (26 males, age = 74 ± 9 years, education = 16 ± 3 years). Average composite Z-score was –0.31 SD below the age-specific normative mean (range –2.8 to +1.2 SD). In linear regression adjusted for age, education, and depression, MFV correlated with cognitive Z-score (β = 0.308, p = 0.043). A single breakpoint in the range of composite Z-scores was identified at 45 cm/s. For MFV <45 cm/s, Z-score decreased 0.05 SD per cm/s MFV (95% CI: 0.01–0.10). For MFV >45 cm/s, Z-score change was nonsignificant (95% CI: –0.07 to 0.05). Conclusions: In high-grade, asymptomatic carotid artery stenosis, cognitive impairment correlated linearly with lower flow in the hemisphere fed by the occluded internal carotid artery, but only below a threshold of MFV = 45 cm/s. Identifying a hemodynamic threshold for cognitive decline using a simple, noninvasive method may influence revascularization decision-making in otherwise “asymptomatic” carotid disease.
Neoadjuvant Radio(chemo)therapy for Breast Cancer: An Old Concept Revisited
Authors: Matuschek Christiane , Nestle-Kraemling Carolin , Kühn Thorsten , Fehm Tanja , Bölke Edwin , Corradini Stefanie , Fastner Gerd , Maas Kitti , Seidel Clemens , Budach Wilfried
Published: April 2020

Background: The international standard of care for the treatment of high-risk breast cancer (BC) consists of neoadjuvant chemotherapy (NACT) and surgery followed by adjuvant whole breast/chest wall irradiation. In this setting, the time interval from the start of NACT to the end of radiotherapy (RT) is usually postponed to 6 months or longer. In addition to this, a high percentage of capsular fibrosis may occur when breast implants are irradiated. Most of these disadvantages could be avoided by using preoperative RT (PRT). PRT is already the standard of care in several other tumor entities (rectal cancer, esophagus carcinoma, lung cancer, and soft tissue sarcoma). Nevertheless, PRT in BC has been tested in several trials, but randomized prospective trials using modern radiation technology and systemic therapies are lacking. The available evidence summarized in this review indicates that PRT may improve survival and reduce long-term toxicity in patients with a higher risk of recurrence and should be consequently tested in a randomized trial. Summary: Prospective, randomized trials concerning PRT in high-risk BC are needed. We plan to conduct a NeoRad trial (NACT followed by PRT in high-risk BC). Key Messages: Prospective, randomized studies concerning PRT in high-risk BC are needed.
Return of Research-Related Genetic Test Results and Genetic Discrimination Concerns: Facilitators and Barriers of Genetic Research Participation in Diverse Groups
Authors: Burnett-Hartman Andrea N. , Blum-Barnett Erica , Carroll Nikki M. , Madrid Sarah D. , Jonas Cabell , Janes Kristen , Alvarado Monica , Bedoy Ruth , Paolino Valerie , Aziz Nazneen , McGlynn Elizabeth A.
Published: April 2020

Background: Most genetics studies lack the diversity necessary to ensure that all groups benefit from genetic research. Objectives: To explore facilitators and barriers to genetic research participation. Methods: We conducted a survey on genetics in research and healthcare from November 15, 2017 to February 28, 2018 among adult Kaiser Permanente (KP) members who had been invited to participate in the KP biobank (KP Research Bank). We used logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing the willingness to participate in genetic research under different return of results scenarios and genetic discrimination concerns between groups, according to their demographic characteristics. Results: A total of 57,331 KP members were invited to participate, and 10,369 completed the survey (18% response rate). Respondents were 65% female, 44% non-Hispanic White (NH White), 22% Asian/Native Hawaiian or other Pacific Islander (Asian/PI), 19% non-Hispanic Black (NH Black), and 16% Hispanic. Respondents willing to participate in genetic research ranged from 22% with no results returned to 87% if health-related genetic results were returned. We also found variation by race/ethnicity; when no results were to be returned, Asian/PIs, Hispanics, and NH Blacks were less likely to want to participate than NH Whites (p < 0.05). However, when results were returned, disparities in the willingness to participate disappeared for NH Blacks and Hispanics. Genetic discrimination concerns were more prevalent in Asian/PIs, Hispanics, and NH Blacks than in NH Whites (p < 0.05). Conclusions: Policies that prohibit the return of results and do not address genetic discrimination concerns may contribute to a greater underrepresentation of diverse groups in genetic research.
Update on Shunt Surgery
Authors: Glowka Tim R. , Kalff Jörg C. , Manekeller Steffen
Published: April 2020

Background: Bleeding from esophagogastric varices is a life-threatening complication from portal hypertension. It occurs in 15% of patients and has a mortality rate of 20–35%. Summary: The primary therapy for variceal bleeding is medical. In cases of recurrent bleeding, a definitive therapy is required. In cases of parenchymal decompensation, liver transplantation is the causal therapy, but if liver function is preserved, portal decompression is the therapy of choice. The use of the transjugular intrahepatic portosystemic shunt (TIPS) has achieved widespread acceptance, although evidence for surgical shunts is comparable or better in patients with good hepatic reserve. The type of surgical shunt depends on the patent veins of the portomesenteric system. If total occlusion is present, a devascularization procedure might be indicated. Key Messages: Therapy, taking into account liver function, morphology of the portovenous system, and imminent liver transplantation, should be performed by an interdisciplinary team of gastroenterologists, interventional radiologists, and gastrointestinal surgeons.
Ablation of Supraventricular Tachycardias From Concealed Left-Sided Nodoventricular and Nodofascicular Accessory Pathways
Authors: Cardona-Guarache Ricardo , Han Frederick T. , Nguyen Duy T. , Chicos Alexandru B. , Badhwar Nitish , Knight Bradley P. , Johnson Colleen J. , Heaven David , Scheinman Melvin M.
Published: April 2020

Background:

Nodoventricular and nodofascicular accessory pathways (AP) are uncommon connections between the atrioventricular node and the fascicles or ventricles.

Methods:

Five patients with nodofascicular or nodoventricular tachycardia were studied.

Results:

We identified 5 patients with concealed, left-sided nodoventricular (n=4), and nodofascicular (n=1) AP. We proved the participation of AP in tachycardia by delivering His-synchronous premature ventricular contractions that either delayed the subsequent atrial electrogram or terminated the tachycardia (n=3), and by observing an increase in VA interval coincident with left bundle branch block (n=2). The APs were not atrioventricular pathways because the septal VA interval during tachycardia was <70 ms in 3, 1 had spontaneous atrioventricular dissociation, and in 1 the atria were dissociated from the circuit with atrial overdrive pacing. Entrainment from the right ventricle showed ventricular fusion in 4 out of 5 cases. A left-sided origin of the AP was suspected after failed ablation of the right inferior extension of atrioventricular node in 3 cases and by observing a VA increase with left bundle branch block in 2 cases. The nodofascicular and 3 of the nodoventricular AP were successfully ablated from within the proximal coronary sinus (CS) guided by recorded potentials at the roof of the CS, and 1 nodoventricular AP was ablated via a transseptal approach near the CS os.

Conclusions:

Left-sided nodofascicular and nodoventricular AP appear to connect the ventricles with the CS musculature in the region of the CS os. Mapping and successful ablation sites can be guided by recording potentials within or near the CS os.
CP Complements to D
Authors: Hankamer Jorge , Mikkelsen Line
Published: April 2020

Despite their apparent simplicity, the structure of DPs containing “complement” CPs (what we will call DCs) has long been obscure. One major strand of investigation has attempted to assimilate DCs to (close) nominal apposition, implying that N and CP form a structural unit that then combines with D. Danish has two kinds of DCs, a bare DC with the superficial structure [D N CP] and a prepositional DC in which the CP is encased in a PP. Exploiting clues provided by the allomorphy of the definite morpheme, we argue that the bare and prepositional DCs have very different structures, neither of which can be assimilated to apposition between N and CP. We further show that the two kinds of DC have distinct semantic and pragmatic properties. We then argue that English also has two different structures for DCs, and that they are plausibly parallel to the structures we establish for Danish. We conclude by arguing that two distinct structures give rise to the “apposition” relation: in one case it is between coarguments of D and in the other it is nonrestrictive composition.
Metrical Structure and Licensing: An Argument from Ukrainian
Authors: Mołczanow Janina , Łukaszewicz Beata
Published: April 2020

It has been debated in phonological literature whether word stress should be modeled using metrical grids or feet and how its directionality is assigned. In this article, we discuss new data from Ukrainian, which has a hybrid metrical system with unpredictable lexical stress and grammatical iterative secondary stress. We demonstrate that Ukrainian poses a challenge for current metrical theories relying on gradient alignment and propose an analysis based on categorical alignment coupled with a rhythmic licensing constraint mandating that lapses are located near the main stress (LAPSE-AT-PEAK). We argue that LAPSE-AT-PEAK is required regardless of the stress representations (feet or grids) assumed.
New record of the sponge-dwelling shrimp Typton distinctus Chace, 1972
(Decapoda: Caridea: Palaemonidae) in São Paulo State, Brazil
Authors: MORAES ISABELA R. R. , BERGAMASCO GIOVANNA R. , SANTOS RAFAEL C. , ANTUNES MARIANA , SOLEDADE GUIDOMAR O. , COSTA ROGERIO C. , CASTILHO ANTONIO L.
Published: April 2020

Among the Caridea Infraorder, the palaemonid shrimp from the genus Typton Costa, 1844 are commonly found in association with sponges, frequently feeding on the tissues of their hosts ((Ďuriš et al. 2011; Almeida et al. 2014; Pachelle et al. 2015; Soledade et al. 2017). Typton is mostly characterized by morphological features related to their sponge-dwelling lifestyle, as a simple and compressed rostrum, carapace smooth and antennal spines present, antennae extremely reduced and scaphocerite rudimentary. Mandible without palp, incisor process normal, reduced or absent. Second legs unequal, asymmetrical, without molar process on major chela (Bruce, 1972)
Discovery of Viridotheres Manning, 1996 in the southwestern Pacific and first record of Discorsotheres camposi Ahyong, 2018 from New Caledonia (Crustacea: Brachyura: Pinnotheridae)
Authors: AHYONG SHANE T.
Published: April 2020

The pinnotherid crab genus, Viridotheres Manning, 1996, is recorded for the first time from the southwestern Pacific in the new species, V. asaphis, described based on specimens from Australia and New Caledonia. The new species most closely resembles V. sanguinolariae (Pillai, 1951) from India, differing chiefly in the proportional length of the walking legs; both species are hosted by bivalve molluscs of the family Psammobiidae, but of different genera. The pinnotherid crab Discorsotheres camposi Ahyong, 2018, an associate of the bivalve Spondylus, is recorded for the first time from New Caledonia. Fifteen species of pinnotherid are now known from Australian waters and five from New Caledonia.
Civilian Contention in Civil War: How Ideational Factors Shape Community Responses to Armed Groups
Authors: Masullo Juan
Published: April 2020

Why do some communities overtly declare their opposition to violent groups, while others disguise it by engaging in seemingly unrelated activities? Why do some communities manifest their dissent using nonviolent methods instead of organizing violence of their own? I argue that ideational factors are crucial to answering these questions: normative commitments can restrict civilian contention to nonviolent forms of action, while exposure to oppositional ideologies can push civilians toward more confrontational forms of noncooperation with armed groups. Furthermore, I contend that the role of political entrepreneurs activating and mobilizing this ideational content is crucial for it to shape contention. I support this argument with a wealth of microlevel evidence collected in various warzones in Colombia, analyzed within a purposively designed comparative structure. My findings support the growing conflict scholarship that stresses that ideology matters in war, but extends its application beyond armed actors’ behavior to that of civilian communities.
Have Low-Cost Carriers Crowded Out Full Services and Charter Carriers in Tourism Destinations? A Trivariate Structural Time Series Analysis
Authors: Eugenio-Martin Juan L. , Perez-Granja Ubay
Published: April 2020

Long-haul tourist arrivals depend on the airline market, its size, and the degree of competition. This article studies the entry and exit of full service carriers (FSCs), charter carriers (CCs) and low-cost carriers (LCCs) from two origins: the United Kingdom and Germany, and five sun-and-beach destinations in Spain. The relationship among all types of airlines is captured with a trivariate structural time series model to disentangle the airlines’ responses under common shocks of airlines’ entry and/or exit and provides estimates of immediate responses and indicators of responses over time. The results show that in the British market, the entry of LCCs has crowded out FSCs and CCs. However, in the German market, the results are heterogeneous and overall do not support the existence of such crowding out effect.
Rhinoliths: Analysis of 24 Interesting Forgotten Foreign Body Cases
Authors: Yildiz Erkan , Kuzu Selçuk , Ulu Şahin , Kahveci Orhan Kemal , Günebakan Çağlar , Bucak Abdulkadir
Published: April 2020

Rhinoliths are petrified masses formed by accumulation of endogenous or exogenous salts around a nidus. Although rarely formed by the body, the most common cause is foreign bodies forgotten in the nose at childhood. Rhinoliths are rare and have been reported as a single case report in the literature. In this study, 24 different and different cases will be analyzed. Twenty-four interesting patients who were operated for rhinolith in the otorhinolaryngology clinic between 2014 and 2019 and were not seen in the literature before were analyzed retrospectively. The characteristics of these patients such as age, sex, additional pathology, foreign body coexistence, type of anesthesia used, and previous surgical status were analyzed. Fourteen patients were male and 10 were female (58.3% male, 41.7% female). The mean age was 30.4 (minimum 2, maximum 62). Twelve of the foreign bodies were on the right and 12 on the left (50%). Foreign body localization was 13 (54.1%) between the inferior turbinate (IT) and septum and 11 (45.9%) between the middle turbinate and septum. Tissue destruction was seen in 12 (50%; 7 septum, 5 IT) patients. Fifteen patients had additional pathology (mostly septum deviation). General anesthesia was used in 14 patients and local anesthesia was used in 10 (58.3%-41.7%) patients. Two patients (n = 2) had rhinoliths due to forgotten nasal packing after surgery and forgotten silicone nasolacrimal tube after dacryocystorhinostomy surgery. Rhinoliths should be considered with unilateral malodorous runny nose and resistant sinusitis attacks. The diagnosis is rigid endoscope and computed tomography imaging. It usually occurs as a result of forgotten foreign bodies. Rhinoliths may also form as a result of forgotten tampon after previous nose or eye surgery.
Laryngeal Myofibroblastic Tumor: A New Therapeutic Approach. A Case Report
Authors: Gómez-Hervás Javier , Moreno-Romera Manuel , Arias Fabio Hugo Escobar , Gálvez Esteban Merino
Published: April 2020

Myofibroblastic tumors are rare lesions which can affect any part of the body. Although benign, their mass effect causes symptoms that can become life-threatening. Supraglottic laryngeal involvement is extremely rare, with only 4 cases described in the English literature. Because the pathophysiology is unknown and the incidence is so low, there is no standardized therapeutic management, although for laryngeal tumors surgery has traditionally been the preferred initial option. Another less common option is intravenous and oral corticosteroid therapy, but this is usually reserved for myofibroblastic tumors in other head and neck sites that are more difficult to access surgically, or patients who cannot undergo surgery. These lesions have a very high tendency to recur, and morbidity rates are therefore also high. We present a case of supraglottic myofibroblastic tumor in which we elected high-dose corticosteroid therapy as the only form of treatment. With this new therapeutic approach, we avoided the undesirable effects of the usual type of surgery. At the 12-month follow-up, the patient is in complete remission.