bluuebunny/crossref_metadata_2025 huggingface dataset:
How a participatory process with inclusive structural design allocates resources toward poor neighborhoods: the case of participatory budgeting in Seoul, South Korea
Authors: No Won , Hsueh Lily
Published: August 2020

This study examines the relationship between inclusiveness with respect to the structural design of the participatory process and resource allocation outcomes in participatory budgeting. Empirically, this article examines the case of participatory budgeting in Seoul, South Korea, where redistribution is not an explicit goal. Findings suggest that creating organizational structures that enable and encourage public participation has led Seoul’s participatory budgeting to distribute public funds toward poor neighborhoods.

Points for practitioners

Participatory budgeting is an exemplar practice of public participation in the government decision-making process. It is a local budgeting practice that allows the public to participate, discuss, deliberate, and decide where and how to spend public money. This study highlights the importance of designing inclusive organizational structures in participatory budgeting to encourage public participation. Empirical results underscore the link between inclusive organizational structures and more equitable allocation outcomes.
Physical and Cognitive Performance During Upper-Extremity Versus Full-Body Exercise Under Dual Tasking Conditions
Authors: Duckworth Sarah C. , Higginbotham Carrie S. , Pederson Joseph A. , Rogers Rebecca R. , Marshall Mallory R. , Williams Tyler D. , Ballmann Christopher G.
Published: August 2020

The purpose of this study was to investigate physical and cognitive performance during dual task conditions of upper-extremity (UE) or full-body (FB) rowing exercise. In a crossover counterbalanced design, college-aged male and female participants completed five conditions: (a) Sitting, (b) Single task UE rowing, (c) Single task FB rowing, (d) Dual task UE rowing, and (e) Dual task FB rowing. For single task UE and FB rowing conditions, participants were asked to row as hard as possible. After sitting and dual-task conditions, we administered the Paced Auditory Serial Addition Test (PASAT) and a word-list memory test. We analyzed participants’ absolute differences (single task – dual task) in power output and their cognitive test scores to compare UE and FB rowing. There were no significant absolute differences from sitting to dual task conditions of UE and FB rowing for either PASAT ( p = 0.958) or word list memory ( p = 0.899) cognitive scores. Absolute power output loss from single to dual task conditions was significantly higher in FB versus UE for PASAT ( p = 0.039; d = 0.54) and word list memory ( p = 0.021; d = 0.66) in the dual task condition. These results suggest that, while cognitive performance was preserved regardless of the amount of muscle mass activated during dual task rowing, physical performance suffered more during FB than UE rowing under the dual task condition. These findings have important implications for optimizing cognitive and physical performance in dual task situations.
Research on dual-wheel-independent-drive control of electric forklift based on optimal slip ratio
Authors: Zhang Zhilu , Xiao Benxian
Published: August 2020

Introduction:

As an important transportation, the research on the control strategy of forklift has not been widely carried out.

Objectives:

This article proposes a turning slip regulation control strategy, which includes the improved electronic differential velocity control and turning slip regulation control, to track the optimal slip ratio.

Methods:

First, combined with the basic structure and characteristics of dual-wheel-independent-drive electric forklift, the vehicle model, Ackermann–Jeantand steering model, tire-ground model, and tire model of the driving wheel are established respectively. Second, according to these models, an improved electronic differential control strategy considering the influence of vertical load on tire force is proposed and it can reasonably allocate the driving torque of the two driving wheels of electric forklift. Moreover, the optimal slip ratio is given out and the turning slip regulation control strategy, which can track the optimal slip ratio of electric forklift under the conditions of different road surfaces is designed.

Results:

The simulation result and vehicle test show that the control strategy can optimize the slip ratio of electric forklift and greatly improve the stability of electric forklift.

Conclusion:

The turning slip regulation control strategy can be implemented on the TFC35 forklift to improve the safety and stability.
A modular modeling approach for investigating wool critical buckling from biologically variable along-fiber microstructure
Authors: Vetharaniam Indrakumar , Plowman Jeffrey E , Brorens Peter , Harland Duane
Published: August 2020

Mammalian hair fibers are internally sophisticated. We introduce a modeling approach aimed at use in research that derives value from understanding how microstructural organization generates effects at the macroscopic level in the context of natural biological variation. Critical buckling load is solved using a numerical approach applied to a modular fiber microstructure model where fibers of arbitrary length are made up of snippets composed of serial cross-sections at 25 micrometer intervals. As an example, the model is applied to investigate how much effect changes to single microstructural properties (fiber ellipticity, cortical cell type distribution and cell type proportion) have on critical buckling load in the context of prickle. Potential uses and key weak areas in our knowledge of wool fiber morphology and biophysics are discussed.
Working Toward an mHealth Platform for Adolescents with Type 1 Diabetes: Focus Groups With Teens, Parents, and Providers
Authors: Sinisterra Manuela , Kelly Katherine Patterson , Shneider Caitlin , El-Zein Ashley , Swartwout Ellen , Deyo Patricia , Streisand Randi
Published: August 2020

Purpose

The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform.

Methods

Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors.

Results

Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families.

Conclusion

Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.
Improving Sleep among Adults with Multiple Sclerosis using Mindfulness plus Sleep Education
Authors: Lorenz Rebecca A. , Auerbach Samantha , Nisbet Patricia , Sessanna Loralee , Alanazi Nouf , Lach Helen , Newland Pamela , Fisher Nadine , Pandey Krupa , Thomas Florian P. , Chang Yu-Ping
Published: August 2020

We explored the feasibility of a mindfulness plus sleep education intervention, SleepWell!, delivered via videoconference compared to onsite among adults with MS. A non-randomized wait-list control design was used. Participants wore actigraphy watches and kept sleep diaries for seven days pre- and post intervention. Questionnaires were completed pre-intervention, post-intervention, and three months post-intervention. One group was conducted onsite. Three groups participated via videoconference. Attrition among videoconference groups was 23% compared to 57% in the onsite group. Within group analysis showed moderate-to-large effect sizes on sleep efficiency (d=0.78) and total sleep time (d=0.54) in the videoconference groups. One-way repeated measures ANOVA post-hoc analysis suggested small-to-medium effect over three months on sleep quality (ηp2 =0.28), physical health quality of life (ηp2 =0.42), mental health quality of life (ηp2 =0.13), and mindfulness (ηp2 =0.29). Results indicate feasibility of providing our intervention via videoconferencing. Preliminary analysis suggests that SleepWell! improves sleep and mindfulness among adults with MS.
Pleural and serum markers for diagnosis of malignant pleural effusion
Authors: Allama Amr M , Abou-Elela Dalia H , Ibrahim Islam M
Published: August 2020

Background

Differentiation between benign and malignant exudative pleural effusion remains a clinical challenge. Recently, several markers have been reported to increase the diagnostic accuracy of malignant pleural effusion, with controversial results.

Methods

Patients with exudative pleural effusion were divided into 2 groups: a malignant pleural effusion group (39 patients) diagnosed by malignant cells in pleural fluid cytology or by malignant infiltration of the pleura on pleural biopsy, and a benign pleural effusion group (51 patients) with neither malignant cells in pleural fluid cytology nor malignant infiltration of the pleura on pleural biopsy. Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were determined in both serum and pleural fluid samples, using commercially available enzyme-linked immunosorbent assay kits.

Results

The etiology of malignant pleural effusion in the malignant group was breast cancer in 43.6% and bronchogenic carcinoma in 25.6%. There was a statistically significant difference between the 2 groups regarding sex, with more males in the benign group. There was no significant difference between groups regarding age. The median levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were higher in the malignant group than in the benign group, and the differences were highly significant in both pleural fluid ( p < 0.001) and serum ( p < 0.001).

Conclusion

Matrix metaloproteinase-9 and tissue inhibitor of metalloproteinase-1 in serum and pleural fluid samples might be valuable markers for differentiating benign from malignant pleural effusions.
Comparative efficacy and life quality effects of surgical stripping, radiofrequency ablation, and cyanoacrylate embolization in patients undergoing treatment for great saphenous vein insufficiency
Authors: Ay Yasin , Gunes Esra , Turkkolu Sevket Tuna , Selcuk Emre , Calim Muhittin , Akal Ramazan , Aydin Cemalettin , Inan Bekir , Koksal Cengiz , Kahraman Ay Nuray
Published: August 2020

Objectives

To compare traditional surgery with two minimally invasive endo-venous procedures in terms of their long-term effect on the quality of life in great saphenous vein insufficiency (GSV).

Method

This prospective observational study included 217 patients that underwent surgical stripping (n = 62), radiofrequency ablation (n = 70), or cyanoacrylate embolization (n = 85) for the treatment of GSV insufficiency. Venous Clinical Severity Score (VCSS) assessments were made, 36-item Short-Form Health Survey (SF-36) questionnaire and Chronic Venous Insufficiency quality of life Questionnaire (CIVIQ-14) were administered, before and 1 year after the treatments.

Results

Surgical stripping group had significantly higher closure rates than the other groups (p < 0.05). At 12 months, decrease in VCSS scores was less pronounced in the cyanoacrylate embolization group when compared to the other two groups (p < 0.05). Improvement in CIVIQ-14 scores was better in the radiofrequency ablation group when compared to the cyanoacrylate embolization group (p < 0.05). Surgical stripping or radiofrequency ablation groups performed better on several domains of SF-36, when compared to the cyanoacrylate embolization group.

Conclusions

Surgical stripping and radiofrequency ablation seem to provide a better quality of life results at one year in patients undergoing treatment for GSV insufficiency.
Diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging for malignant ovarian tumors: a systematic review and meta-analysis
Authors: Wei Mingxiang , Bo Fan , Cao Hui , Zhou Wei , Shan Wenli , Bai Genji
Published: August 2020

Background

Accurate preoperative diagnosis of malignant ovarian tumors (MOTs) is particularly important for selecting the optimal treatment strategy and avoiding overtreatment.

Purpose

To evaluate the diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for MOTs.

Material and Methods

A systematic search was performed in PubMed, Embase, the Cochrane Library, and Web of Science databases to find relevant original articles up to October 2019. The included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Studies on the diagnosis of MOTs with quantitative or semi-quantitative DCE-MRI were analyzed separately. The bivariate random-effects model was used to assess the diagnostic authenticity. Meta-regression analyses were performed to analyze the potential heterogeneity.

Results

For semi-quantitative DCE-MRI, the pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic curves (AUC) were 85% (95% confidence interval [CI] 0.75–0.92), 85% (95% CI 0.77–0.91), 5.8 (95% CI 3.8–8.8), 0.17 (95% CI 0.10–0.30), 33 (95% CI 18–61), and 0.92 (95% CI 0.89–0.94), respectively. For quantitative DCE-MRI, the pooled sensitivity, specificity, positive LR, negative LR, DOR, and AUC were 88% (95% CI 0.65–0.96), 93% (95% CI 0.78–0.98), 12.3 (95% CI 3.4–43.9), 0.13 (95% CI 0.04–0.45), 91 (95% CI 10–857), and 0.96 (95% CI 0.94–0.98), respectively.

Conclusion

DCE-MRI has great diagnostic value for MOTs. Semi-quantitative DCE-MRI may be a relatively mature approach; however, quantitative DCE-MRI appears to be more promising than semi-quantitative DCE-MRI.
Face Familiarity and Image-Specific Memory
Authors: Kramer Robin S. S. , Berry Chloe J. , Jones Alex L , Gous Georgina
Published: August 2020

Face familiarity produces advantages for both memory and matching. By developing an internal representation through repeated experience, viewers extract identity-specific information that aids subsequent recognition. However, researchers have recently argued that this process may also result in a familiarity disadvantage, whereby specific instances of the face are more difficult to remember, perhaps due to this process of prioritising identity- over image-specific information. Although previous experiments found no evidence of this disadvantage in working memory, initial research has demonstrated an effect in longer term storage. Here, we attempted to replicate this finding by focussing on the ability to learn images of a single (un)familiar identity. Our results failed to demonstrate a familiarity disadvantage while replicating the finding that familiarity influences response bias. As researchers continue to investigate how familiarity alters both internal representations and associated processes, it is important to establish which processes may or may not be affected.
The feasibility and effects of eye movement training for visual field loss after stroke: a mixed methods study
Authors: Hazelton Christine , Pollock Alex , Dixon Diane , Taylor Anne , Davis Bridget , Walsh Glyn , Brady Marian C
Published: August 2020

Introduction

Visual field loss affects around 20% of stroke survivors, reducing quality of life. Eye movement training is a promising rehabilitation method, and several different interventions are used by occupational therapists. This study aimed to explore the feasibility and effects of four eye movement training interventions for stroke survivors with visual field loss.

Method

A mixed methods study – quantitative n-of-1 with qualitative interviews. The participants were 11 home-dwelling stroke survivors with visual field loss. The interventions used were MyHappyNeuron, NVT, Rainbow Readers and VISIOcoach, delivered in a randomised order. Visual search, reading speed, activities of daily living and quality of life were assessed three times before intervention use, then immediately after each intervention; these were analysed visually. A final semi-structured interview was then analysed using framework methods.

Results

Evidence of effect was divergent. Quantitatively there was no measured effect, but qualitatively participants reported benefits in visual skills, daily life skills and emotions, which varied by intervention. Median training time was 3–4 hours (range 0.5–6.5) for NVT, Rainbow Readers and MyHappyNeuron, and 9.5 hours (range 2.3–16.8) for VISIOcoach.

Conclusion

Eye movement training interventions were feasible for stroke survivors at home. Qualitative evidence suggests that variations in the eye movements trained and delivery modality underlie variations in perceived effect.
Measurement of older adults’ performance in digital technology-mediated occupations and management of digital technology
Authors: Fischl Caroline , Malinowsky Camilla , Nilsson Ingeborg
Published: August 2020

Introduction

Supporting older adults’ digital engagement requires an understanding of how occupational performance and technology use are related, as well as having a range of methods that can assist occupational therapists while observing occupational performance and management of technology. The study objectives were to investigate how older adults’ ability to perform digital technology-mediated occupations and ability to manage digital technology could be measured and to examine the association between these two abilities.

Method

Twenty-five older adults were observed performing digital technology-mediated occupations and managing digital technologies, and were scored on two instruments: the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. FACETS was used to generate respective multifaceted Rasch measurement models for scores on the instruments. The Spearman correlation test was used to investigate correlation between person ability measures from respective Rasch models of the instruments.

Results

The results include item, occupation, and technology difficulty estimates, as well as person ability measures that could illustrate older adults’ ability to perform occupations and to manage technology. There is also a strong positive correlation between these abilities.

Conclusion

Insight into an older person’s ability to manage technology can provide information about his or her ability to perform digital technology-mediated occupations and vice versa.
Feminist economic geography and the future of work
Authors: Reid-Musson Emily , Cockayne Daniel , Frederiksen Lia , Worth Nancy
Published: August 2020

Scholars have recently begun to account for the absence of feminist analyses in the popular and academic discourse surrounding ‘the future of work’. In this article we offer a critical synthesis of emerging research from feminist economic geography to propose a series of questions about the future of work, conceptualized as both an object of intellectual inquiry and an emerging empirical reality. Feminist economic geography emphasizes difference, embodiment, and conceives of workplaces as dynamic, uneven, and untidy spaces, an emphasis which can help recenter discussions about the future of work on workers and their experience of work. Our discussion features a series of analytically rigorous, theoretically informed, and empirically rich conference papers, organized around three critical questions: Who are the subjects of the future of work? What counts as work? And where should we look? We highlight a broad concept of work developed through debates among feminist scholars across disciplinary fields as a key frame for understanding the global economy, including difference, social reproduction, and the spatial division of labor. Feminist economic geographers are pluralizing the subjects, forms, and geographies of work, which may help enhance our understanding of the future of work in economic geography.
Leadership in intensive care: A review
Authors: Brewster David J , Butt Warwick W , Gordon Lisi J , Rees Charlotte E
Published: August 2020

An integrative review of the literature specific to leadership within the intensive care unit was planned to guide future research. Four databases were searched. Study selection was based on predetermined inclusion and exclusion criteria and a quality check was done. Data extraction and synthesis involved developing a preliminary thematic coding framework based on a sample of papers. The coding framework and all selected papers were entered into NVivo software. All papers were then coded to the previously identified themes. Themes were summarised and presented with illustrative quotes highlighting key findings. In total, 1102 relevant quotations were coded across the 28 included papers. Four themes pertaining to leadership were described and analysed: (a) leadership dimensions and discourses; (b) leadership experiences; (c) facilitators and/or barriers to leadership; and (d) leadership outcomes. The literature was found to focus on leader behaviours, as well as the leader dimensions of role allocation, clinical and communication skills and traditional hierarchies. Positive behaviours mentioned included good decision-making, staying calm under pressure and being approachable. Leadership experiences (and outcomes) are typically reported to be positive. Personal individual factors seem the biggest enablers and barriers to leadership within the intensive care unit. Training is considered to be a facilitator of leadership within the intensive care unit. This study highlights the current literature on leadership in intensive care medicine and provides a basis for future research on interventions to improve leadership in the intensive care unit.
PolyMet-HA nanocomplexs regulates glucose uptake by inhibiting SHIP2 activity
Authors: Yuan Xinlu , Ding Ling , Diao Jianjun , Wen Song , Xu Chenglin , Zhou Ligang , Du Anqing
Published: August 2020

Metformin, the first-line drug to treat type 2 diabetes, inhibits mitochondrial glycerolphosphate dehydrogenase in the liver to suppress gluconeogenesis. The major adverse effects caused by metformin were lactic acidosis and gastrointestinal discomfort. Therefore, there is need to develop a strategy with excellent permeability and appropriate retention effects.In this study, we synthesized a simple and biocompatible PolyMetformin (denoted as PolyMet) through conjugation of PEI1.8K with dicyandiamide, and then formed PolyMet-hyaluronic acid (HA) nanocomplexs by electrostatic self-assembly of the polycationic PolyMet and polyanionic hyaluronic acid (HA). Similar to metformin, the PolyMet-HA nanocomplexs could reduce the catalytic activity of the recombinant SHIP2 phosphatase domain in vitro. In SHIP2-overexpressing myotubes, PolyMet-HA nanocomplexes ameliorated glucose uptake by downregulating glucose transporter 4 endocytosis. PolyMet-HA nanocomplexes also could restore Akt signaling and protect the podocyte from apoptosis induced by SHIP2 overexpression. In essence, the PolyMet-HA nanocomplexes act similarly to metformin and increase glucose uptake, and maybe have a potential role in the treatment of type 2 diabetes.
Morphing wings review: aims, challenges, and current open issues of a technology
Authors: Ameduri S , Concilio A
Published: August 2020

The scope of this work is to provide a critical review on the expectations about the morphing wing technology against the current open issues and showstoppers.

In synergy to other emerging and promising technologies, morphing is asked for bridging the evident gap between the current growth trend of the aerospace compartment and its impact onto the environment. The potential of morphing, in particular, its primary impact on the aerodynamic efficiency of the aircraft, primed the investigation of different technologies, achieving interesting results but often highlighting limitations and showstoppers against the airworthiness regulations.

The authors focus their attention on some specific aspects that characterize the morphing wing attachments and that may represent weakness points for the maturation of the technology: the load transmission of the movable parts to the supporting wing box, the way the flexibility–rigidity paradox is addressed by specific critical components (the skin), the scalability dependence of the morphing architectures, and the specific aeroelastic behavior of the nonconventional architectures.
An IB-LBM design of a microfluidics-based cell capture system
Authors: Ma Jing-Tao , Zu Wen-Hong , Tang Xiao-Ying , Xu Yuan-Qing
Published: August 2020

The capture of cells in a microfluidic device based on U-shaped sieves is numerically investigated by the immersed boundary-lattice Boltzmann method (IB-LBM). The effects of the width of the inlet ( h), the radius of sieves ([Formula: see text]), and the radius of posts ([Formula: see text]) on the efficiency of the device on trapping cells are studied. It is found that a narrower inlet improves the capability of the device to capture cells and promotes the uniform trapping of cells. In addition, the device is not sufficiently efficient in capturing cells when the radius [Formula: see text] is small. By increasing [Formula: see text] gradually, the cells trapped in the device are found to grow up first and then decrease. This can be explained as an optimal size of apertures between posts to induce the cells to enter the sieve, and then the cells can plug up these apertures. Finally, the effects of the post size on the cell-capturing are studied. It is found that more cells can be captured as [Formula: see text] experiences a slight increase, while the capturing efficiency will not improve if continuing to increase [Formula: see text].
Influence of piezoelectric actuator hysteresis on saturation control efficiency
Authors: Mitura Andrzej , Warminski Jerzy
Published: August 2020

The main purpose of this paper is to analyze the impact of hysteresis of a piezoelectric subsystem on the nonlinear beam dynamics with active vibration control. The investigated model considers geometric and inertia nonlinearities of the beam (plant), nonlinear coupling of the controller, and hysteresis of the piezoelectric actuator. The developed numerical model of the electromechanical system allows a comparison of responses given by a simplified model and a model with a complete description of the piezoelectric subsystem, including hysteresis. Obtained results provide information about the effect of hysteresis on the beam and controller dynamics. Quantitative and qualitative changes due to considering the effect of hysteresis are presented in the paper.
Buckling analysis of beam structure with absolute nodal coordinate formulation
Authors: Wang Jia , Wang Tengfei
Published: August 2020

Absolute nodal coordinate formulation (ANCF) was applied to the buckling analysis. A delicate analysis scheme based on dichotomy method was proposed to solve the buckling problem with beam elements whose tangent stiffness matrix is a highly nonlinear function of nodal coordinates. Three existing planar beam elements are employed to show the application. The accuracy and capability of the ANCF beam for buckling analysis was validated with benchmark cases. Additionally, the influence of the shear effect on the buckling load is thoroughly investigated by comparing the solutions associated with different shear stiffness and slenderness.
Maternal and fetal outcomes of lupus pregnancies: A collective effort by Karnataka Rheumatologists
Authors: Janardana Ramya , Haridas Vikram , Priya Vishnu , Bhat Vasudha , Singh Yogesh , Rao Vijay K , Jois Ramesh , Srikantiah Chandrashekara , Pinto Benzeeta , Shobha Vineeta
Published: August 2020

Introduction

Identifying factors predicting adverse pregnancy outcomes involving systemic lupus erythematosus (SLE) is a research priority. The aims of this study were to investigate (a) the maternal and fetal outcomes of pregnant lupus patients and the factors associated with adverse pregnancy outcomes, and (b) the effect of pregnancy on lupus disease activity of these patients.

Methods

This was an ambi-directional study collecting information from five multi-specialist referral centres across the state of Karnataka, India over 5 years (2013–2018). Clinical details of pregnancies and outcomes that were temporally associated with lupus disease were recorded using a structured pro forma. The Safety of Estrogen in SLE National Assessment-SLE Disease Activity Index (SELENA-SLEDAI) was used to assess lupus activity during the 6 months prior to pregnancy and the intra- and post-partum periods. Modifications suggested in the SLE Pregnancy Disease Activity Index were considered while scoring.

Results

A total of 121 pregnancies in 80 SLE patients with a mean age of 27.1 (±4.5) years and with a mean disease duration of 4.6 (±4.1) years were reviewed. Largely patients were in clinical remission (109/121; 90.1%). Antiphospholipid antibody positivity was seen in 45/121 (37.2%) patients. A history of lupus nephritis was noted in 29/121 (24%) patients. Maternal complications (32%) were mainly due to hypertensive disorders of pregnancy (HDP; 19/121; 15.7%). Adverse fetal outcomes (58%) were mainly in the form of spontaneous first-trimester abortions (21/121; 16%), stillbirth (14/121; 11.6%) and prematurity (24/121; 20%). HDP is strongly associated with stillbirth and prematurity and is independent of active lupus. Disease activity was associated with a three-fold increased risk of adverse fetal outcome in univariate analysis. The risk of major flare during pregnancy is low (4.1%) when conception occurs during stable disease. Hydroxychloroquine (HCQ) use was associated with reduced risk of flare ( p = 0.001) in patients in remission at the time of conception.

Conclusions

The risk of major flare during pregnancy is low when conception happens during stable disease. HCQ use was associated with reduced risk of flare in patients in remission at the time of conception. HDP was strongly associated with stillbirth and prematurity and are independent of active lupus in our cohort.
Identifying co-morbid fibromyalgia in patients with systemic lupus erythematosus using the Multi-Dimensional Health Assessment Questionnaire
Authors: Huang Frank F , Fang Ray , Nguyen Matthew H , Bryant Katherine , Gibson Kathryn A , O’Neill Sean G
Published: August 2020

Objective

Fibromyalgia (FM) is prevalent but often under-recognized in patients with systemic lupus erythematosus (SLE). Patient-reported outcomes (PROs) from the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) can identify co-morbid FM in patients with rheumatic diseases. The present study examined the utility of the MDHAQ in recognizing FM in patients with SLE during routine consultations.

Methods

Patients with SLE completed an MDHAQ. FM status was determined by the validated 2016 revision of the ACR 2010/2011 preliminary FM criteria. Individual PROs from the MDHAQ and composite Fibromyalgia Assessment Tool (FAST) indices of the discriminatory PROs were compared between patients with and without FM using Student’s unpaired t-test and receiver operating characteristic curve analysis to determine the area under the curve (AUC). The physician’s clinical impression of FM was recorded, and the SLE Disease Activity Index was used to assess disease activity.

Results

Of 88 patients with SLE, 23 (26%) satisfied the 2016 FM criteria. The FAST3 composite measure of two out of three of pain (≥6/10), joint count (≥16/48) and symptom checklist (≥16/60) correctly classified 89% of patients (AUC=0.90, kappa=0.71). Physician diagnosis demonstrated moderate agreement with the 2016 FM criteria (kappa=0.43) but missed 43% of patients with FM. In the presence of active disease, the FAST3 correctly classified 91% of patients.

Conclusions

Co-morbid FM is prevalent in SLE yet often underdiagnosed by physicians. The simple FAST3 index of the MDHAQ provides an easy-to-use self-reported tool to improve identification of FM in patients with SLE.
Characteristics of lupus nephritis in Saudi lupus patients: A retrospective observational study
Authors: Albirdisi Majed R , Al-Homood Ibrahim A
Published: August 2020

Objectives

Systemic lupus erythematosus (SLE) is a chronic autoimmune multi-systemic disorder of the connective tissue, characterized mainly by involvement of the skin, joints, kidneys, and serosal membranes. It affects females particularly at childbearing age more commonly than males. Lupus nephritis affects around half of patients with SLE. Data about SLE and lupus nephritis in Saudi Arabia are still scarce. In this study, we aimed to evaluate the prevalence, clinical and laboratory findings of SLE and different histological types of lupus nephritis among Saudi patients at King Fahad Medical City.

Methods

This is a retrospective study for adult patients who have been evaluated at king Fahad medical city between 2014 and 2019 and fulfilled the Systemic Lupus International Collaborating Clinics classification criteria (SLICC).

Results

112 patients, 103 (92%) females and 9 (8%) males, with confirmed diagnoses of SLE were reviewed. Skin rash (69.6%), photosensitivity (61.6%), mucosal ulcerations (45.9%), arthralgia and/or arthritis (44.6%) are the most common clinical features. Ninety seven (86.6%) out of 112 patients had a recorded first visit 24 hour urine protein level, out of those only 26 (23.2) patients presented with significant proteinuria of more than 0.5grams per day. Forty four (39.2%) have undergone kidney biopsy. Class IV and III lupus nephritis are the most common reported biopsy results (43.18% and 27.28% respectively). During the study period, three patients (2.7%) developed end-stage kidney disease requiring dialysis and five (4.5%) had renal transplant.

Conclusion

Our study provided insight on the demographics, characteristics and presentation of SLE patients and the outcome of lupus nephritis in Saudi Arabia.
A glimpse into the history of description of the antiphospholipid syndrome
Authors: Nour-Eldine Wared , Noureldine Hussein A , Haydar Batoul A , Eldine Mariam Nour , Noureldine Mohammad Hassan A , Uthman Imad
Published: August 2020

Prior to 1983, several landmark reports prepared the stage for a detailed description of the Antiphospholipid (Hughes) syndrome (APS). Formerly depicted as lupus-like, APS exhibits a wide spectrum of symptoms that overlap with Sjogren’s, Hashimoto, and other autoimmune diseases. In this review, we take a glimpse into the history of description of APS, discussing the events that led to its recognition as one of the most common autoimmune diseases and the enormous impact of that recognition in the rheumatology field.
Age at diagnosis and health-related quality of life are associated with fatigue in systemic lupus erythematosus patients: Data from the Almenara Lupus Cohort
Authors: Elera-Fitzcarrald Claudia , Reátegui-Sokolova Cristina , Gamboa-Cárdenas Rocío V , Medina Mariela , Zevallos Francisco , Pimentel-Quiroz Victor R , Zeña-Huancas Paola A , Pastor-Asurza César A , Perich-Campos Risto A , Rodríguez-Bellido Zoila J , Alarcón Graciela S , Ugarte-Gil Manuel F
Published: August 2020

Objective

To define the factors associated with fatigue in Mestizo patients with Systemic Lupus Erythematosus (SLE).

Methods

This is a cross-sectional study of SLE patients from a single center cohort. Visits were performed every six months. For these analyses, the first visit between October 2017 and December 2018 was included. Demographic and clinical characteristics as well as treatment were recorded at every visit. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FT), Health-Related Quality of Life (HRQoL) with the LupusQoL, disease activity with the Systemic Lupus Erythematosus Disease Activity Index –2 K (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology damage index (SDI). Prednisone use was recorded as current daily dose. Immunosuppressive drugs and antimalarial use were recorded as current, past or never. Univariable and multivariable analyses were performed using linear regression models. For the multivariable analyses, model selection followed a backward elimination procedure.

Results

Two hundred and twenty-six patients were evaluated. The mean (SD) age at diagnosis was 35.6 (13.1) years, 211 (93.4%) were female; and disease duration was 11.0 (7.3) years. The mean SLEDAI and SDI were 2.4 (3.5) and 1.3 (1.5), respectively. The mean FACIT-FT was 33.1 (10.8). On the multivariable analysis, age at diagnosis and some domains of HRQoL (physical health, emotional health and fatigue) remained associated.

Conclusions

Age at diagnosis is negatively associated with fatigue whereas HRQoL domains like physical health, emotional health and fatigue are positively associated with fatigue.
Medication discrepancies in hospitalized cancer patients: Do we need medication reconciliation?
Authors: Moghli Maram Abu , Farha Rana Abu , Hammour Khawla Abu
Published: August 2020

Objective

This study aimed to identify and point out the number and types of medication discrepancies among cancer patients admitted to Jordan University Hospital.

Method

This is a cross-sectional observational study that was conducted on cancer patients in the internal medicine department at Jordan University Hospital, Amman, Jordan. During a period of six months, a convenience sample of cancer patients was recruited, and their medical records were reviewed to collect information regarding their demographics, clinical, and medication information. Also, patients’ Best Possible Medication History (BPMH) was collected using different methods, and a comparison between patients’ BPMH and their current medications was conducted where discrepancies were recognized.

Results

Seventy-eight medical records were reviewed, with a total of 166 discrepancies identified. Of these, 110 discrepancies (66.3%) were unintentional. Exactly 67.9% of the study participants ( n = 53) were found to have at least one unintentional discrepancy, with the most common type being omissions ( n = 71, 65.1%,) and the second most common type being additions ( n = 16, 14.7%). Most of the discrepancies ranged between low to moderate in severity. Fifty-six (33.7%) intentional undocumented discrepancies (documentation errors) were also identified.

Conclusion

This study revealed a high rate of medication discrepancies among hospitalized cancer patients, most commonly unintentional omissions. Nevertheless, undocumented intentional discrepancies can equally harm this critically ill population. So, do we need medication reconciliation in cancer patients? Yes. Cancer patients are critically ill, and therefore more effort should be paid towards implementing medication reconciliation services in their treatment plan.
Evaluation of the Lewis acidity of metal complexes using ESI mass spectrometry
Authors: Zhang Rong , Li Ping-Ping , Gu Ge-Ge , Ren Wei-Min
Published: August 2020

Metal complexes have extensive applications in catalysis, however, the efficient evaluation of Lewis acidity of metal complexes is still a challenge. Herein, we report a method by using electrospray ionization mass spectrometry (ESI-MS) to evaluate the Lewis acidity of metal complexes in the presence of a reference Lewis base, in which the value of the Lewis acidity can be quantized by the bond dissociation energy (BDE) of the resultant Lewis acid-base pairs. Using this method, the Lewis acidity of tetradentate Schiff-base metal complexes (designated as salenMX), a class of common metal complexes in the homogeneous catalysis, was studied in detail. For the salenM(III)X complexes (M = Al, Cr, Fe, Co), the Lewis acidity tendency is Al > Cr > Fe > Co due to a strong affinity between the Al complex and the reference Lewis base while a weak affinity concerning on the Co complex. Additionally, the effect of ligand steric and electronic nature on the Lewis acidity was studied by using Co complex. Furthermore, density functional theory (DFT) was employed to calculate the BDE, which consists with the results obtained from ESI-MS. The ESI-MS method provides a convenient and efficient method for evaluating the Lewis acidity of metal complexes.
Circulating serum exosomal miR-20b-5p and miR-3187-5p as efficient diagnostic biomarkers for early-stage non-small cell lung cancer
Authors: Zhang Zhi-Jun , Song Xing-Guo , Xie Li , Wang Kang-Yu , Tang You-Yong , Yu Miao- , Feng Xiao-Dong , Song Xian-Rang
Published: August 2020

Circulating exosomal microRNAs (ExmiRNAs) provide an ideal non-invasive method for cancer diagnosis. In this study, we evaluated two circulating ExmiRNAs in NSCLC patients as a diagnostic tool for early-stage non-small lung cancer (NSCLC). The exosomes were characterized by qNano, transmission electron microscopy, and Western blot, and the ExmiRNA expression was measured by microarrays. The differentially expressed miRNAs were verified by RT-qPCR using peripheral blood specimens from NSCLC patients ( n = 276, 0 and I stage: n = 104) and healthy donors ( n = 282). The diagnostic values were measured by receiver operating characteristic (ROC) analysis. The results show that the expression of both ExmiR-20b-5p and ExmiR-3187-5p was drastically reduced in NSCLC patients. The area under the ROC curve (AUC) was determined to be 0.818 and 0.690 for ExmiR-20b-5p and ExmiR-3187-5p, respectively. When these two ExmiRNAs were combined, the AUC increased to 0.848. When the ExmiRNAs were administered with either carcinoembryonic antigen (CEA) or cytokeratin-19-fragment (CYFRA21-1), the AUC was further improved to 0.905 and 0.894, respectively. Additionally, both ExmiR-20b-5p and ExmiR-3187-5p could be used to distinguish early stages NSCLC (0 and I stage) from the healthy controls. The ROC curves showed that the AUCs were 0.810 and 0.673, respectively. Combination of ExmiR-20b-5p and ExmiR-3187-5p enhanced the AUC to 0.838. When CEA and CYFRA21-1 were administered with the ExmiRNAs, the AUCs were improved to 0.930 and 0.928, respectively. In summary, circulating serum exosomal miR-20b-5p and miR-3187-5p could be used as effective, non-invasive biomarkers for the diagnosis of early-stage NSCLC, and the effects were further improved when the ExmiRNAs were combined.

Impact statement

The high mortality of non-small cell lung cancer (NSCLC) is mainly because the cancer has progressed to a more advanced stage before diagnosis. If NSCLC can be diagnosed at early stages, especially stage 0 or I, the overall survival rate will be largely improved by definitive treatment such as lobectomy. We herein validated two novel circulating serum ExmiRs as diagnostic biomarkers for early-stage NSCLC to fulfill the unmet medical need. Considering the number of specimens in this study, circulating serum exosomal miR-20b-5p and miR-3187-5p are putative NSCLC biomarkers, which need to be further investigated in a larger randomized controlled clinical trial.
Ferrotoxicity and its amelioration by endogenous vitamin D in experimental acute kidney injury
Authors: Annamalai Chandrashekar , Ganesh Rajesh N , Viswanathan Pragasam
Published: August 2020

Acute kidney injury causes significant morbidity and mortality. This experimental animal study investigated the simultaneous impact of iron and vitamin D on acute kidney injury induced by iohexol, an iodinated, non-ionic monomeric radiocontrast agent in Wistar rats. Out of 36 healthy male Wistar rats, saline was injected into six control rats (group 1) and iohexol into the remaining 30 experimental rats (groups 2 to 6 comprising six rats each). Biochemical, renal histological changes, and gene expression of iron-regulating proteins and 1 α-hydroxylase were analyzed. Urinary neutrophil gelatinase-associated lipocalin (NGAL), serum creatinine, urine protein, serum and urine catalytic iron, 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and tissue lipid peroxidation were assayed. Rats injected with iohexol showed elevated urinary NGAL (11.94 ± 6.79 ng/mL), serum creatinine (2.92 ± 0.91 mg/dL), and urinary protein levels (11.03 ± 9.68 mg/mg creatinine) together with histological evidence of tubular injury and iron accumulation. Gene expression of iron-regulating proteins and 1 α-hydroxylase was altered. Serum and urine catalytic iron levels were elevated (0.57 ± 0.17; 48.95 ± 29.13 µmol/L) compared to controls (0.49 ± 0.04; 20.7 ± 2.62 µmol/L, P < 0.001). Urine catalytic iron positively correlated with tissue peroxidation (r = 0.469, CI 0.122 to 0.667, P = 0.004) and urinary NGAL (r = 0.788, CI 0.620 to 0.887, P < 0.001). 25-hydroxyvitamin D3 (61.58 ± 9.60 ng/mL) and 1,25-dihydroxyvitamin D3 (50.44 ± 19.76 pg/mL) levels increased simultaneously. In a multivariate linear regression analysis, serum iron, urine catalytic iron, and tissue lipid peroxidation independently and positively predicted urinary NGAL, an acute kidney injury biomarker. This study highlights the nephrotoxic potential of catalytic iron besides demonstrating a concurrent induction of vitamin D endogenously for possible renoprotection in acute kidney injury.

Impact statement

This work provides in-depth insights on catalytic iron-induced cytotoxicity and the resultant triggering of endogenous vitamin D synthesis in experimental acute kidney injury. Our results reveal significantly elevated levels of catalytic iron culminating in oxidant-mediated renal injury and a concomitant increase in 1,25-dihdyroxyvitamin D3 levels. Also, changes in other iron-related proteins including transferrin, ferritin, and hepcidin were observed both in the serum as well as in their mRNA expression. We consider all these findings vital since no connection between catalytic iron and vitamin D has been established so far. Furthermore, we believe that this work provides new and interesting results, with catalytic iron emerging as an important target in ameliorating renal cellular injury, possibly by timely administration of vitamin D. It also needs to be seen if these observations made in rats could be translated to humans by means of robust clinical trials.