bluuebunny/crossref_metadata_2025 huggingface dataset:
In Situ Laser Fenestration Technique: Bench-Testing of Aortic Endograft to Guide Clinical Practice
Authors: Grima Matthew Joe , Wanhainen Anders , Lindström David
Published: August 2022

Purpose:

In situ laser fenestration (ISLF) is a recently introduced technology that offers the potential to perform total endovascular treatment of aortic arch and thoracoabdominal aortic pathologies in the acute setting. This experiment’s aim was to assess ISLF in some currently common aortic endografts and bridging stent-grafts.

Materials and Methods:

Three different aortic endografts were evaluated: (1) Zenith Alpha, (2) Zenith TX2, and (3) Conformable GORE TAG. Each endograft was submerged in 37°C saline to create fenestrations using the 308 nm CVX-300 Excimer Laser System fitted with a 2.3 mm diameter Turbo-Elite laser atherectomy catheter compatible with a 0.018″ guidewire. Three different 8 mm bridging stent-grafts were evaluated: (1) BeGraft peripheral, (2) BeGraft peripheral plus, and (3) GORE VIABAHN VBX Balloon Expandable. All bridging stent-grafts were deployed and exposed to different balloon sizes and pressures. The ISLFs and bridging stent-grafts were then evaluated for any tears, stenoses, and seal.

Results:

A laser fenestration was consistently rapidly obtained in the Zenith Alpha and the Zenith TX2 endografts while it proved difficult to achieve a timely fenestration in the C-TAG. No fabric tears were noted in the Zenith Alpha and Zenith TX2 when inflating Armada (Abbott) 8 mm balloon in the fenestrations with pressures up to 15 atmospheres (rated burst pressure) nor when flaring bridging stent-grafts with balloons up to 12 mm in diameter at 10 atmospheres, while major tears were frequently noted in the C-TAG when the Armada 8 mm balloons were inflated. BeGraft Peripheral and BeGraft Peripheral Plus were all firmly attached to the fenestrations showing good seal on manual testing, while every sixth VBX bridging stent-graft displayed poorer attachment to the fenestration before dilatation at high pressure. Commonly, significant stenoses remained in the bridging stent-grafts after dilatation at nominal pressure, which could only be eradicated with high-pressure balloons.

Conclusion:

In this limited bench-test, Dacron endografts responded well to the ISLF technology. Satisfactory deployment of the bridging stent was noted only after inflation and/or flaring with high-pressure balloons. Further work with different types of commercially-available bridging stent-grafts and endografts to assess the durability of in situ fenestration (ISF) and bridging stents in ISF is recommended.

Clinical Impact

This report on experimental in situ laser fenestration provide important insights for clinicians considering using in situ laser fenestration of aortic stentgrafts in vivo. In particular, different laser settings were tested together with a selection of aortic stentgrafts. Also, the target pressure needed in PTA balloons to dilate the fenestrations and any subsequent tears in the fabric were noted. This was followed by deployment of assorted balloon-expandable stentgrafts with estimation of residual stenosis and seal.
Long-term Survival After Diverse Therapeutic Modalities in Malignant Phyllodes Tumors of the Breast
Authors: Zhang Hongyi , Tang Shasha , Biskup Ewelina , Zhang Yi , Yong Liyun , Chen Lijun , Cai Fengfeng
Published: August 2022

Background and Objects: Malignant phyllodes tumor of the breast (MPTB) is a rare tumor for which surgery or surgery combined with radiotherapy (RT) is the primary treatment method. However, recently, the therapeutic effect of RT on MPTB has been controversial. We aimed to explore the role of RT, chemotherapy (CT), and surgical modalities in patients with MPTB. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to select patients with MPTB who met the criteria between 2010 and 2018. Kaplan–Meier curves and Cox proportional risk regression models were used to analyze the effects of RT on MPTB patients. Based on this, we compared the effects of breast-conserving surgery (BSC) and mastectomy on the postoperative survival of MPTB. Results: A total of 298 patients with MPTB were included in this study. RT was received by 22.1% (n  =  66) of the patients while 77.9% (n  =  232) did not receive RT. CT was received by 4.7% (n  =  14) patients while 95.3% (n  =  284) did not receive CT. According to Kaplan–Meier curves, RT and CT combined resulted in a decrease in breast cancer-specific survival (BCSS) and overall survival (OS) compared to patients who did not receive RT. Mastectomy improved the OS and BCSS of the patients more than BCS). The findings of univariate and multivariate Cox regression analyses suggested that “distant metastasis”, “tumor grade” and “number of positive lymph node biopsies” affected OS of breast cancer, while “distant metastasis”, “tumor grade”, “surgery combined with radiotherapy/surgery”, and “radiotherapy/chemotherapy or not”, had a significant effect on BCSS. Conclusion: RT and CT did not significantly improve the long-term survival of MPTB patients. Mastectomy improved OS and BCSS of the patient more than BCS. RT in an early stage improved early prognosis moderately in MPTB patients with tumor diameter less than 50 mm.
Identifying a novel serum microRNA biomarker panel for the diagnosis of childhood asthma
Authors: He Linjuan , Liu Jiyan , Wang Xiaoyue , Wang Yuanzhao , Zhu Jiawen , Kang Xuexue
Published: August 2022

The pathological mechanism of childhood asthma is complex, and timely diagnosis is the key to effective prevention and control of childhood asthma. We collected 170 serum samples from 95 children with asthma and 75 healthy children. Serum miRNA biomarkers were analyzed by Illumina sequencing for childhood asthma. Differentially serum miRNAs were confirmed with quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay. The Illumina sequencing data showed the differential expression of 111 serum miRNAs among asthmatic and healthy children. After confirmation of miRNAs expression through qRT-PCR, four of them (namely hsa-miR-106a-5p, hsa-miR-18a-5p, hsa-miR-144-3p, and hsa-miR-375) manifested significant differential expression between asthmatic children and healthy controls. The biomarkers classification tree model created with these four miRNAs using the Biomarker Patterns Software could effectively separate childhood asthma and healthy children, with a specificity of 88.3%, a sensitivity of 95.0%, and an area under the curve (AUC) value of 0.942. The regulatory networks containing miRNAs and their gene targets suggested that the four miRNAs might have gene targets implicated in inflammation, immunity, and transcriptional efficiency. Taken together, this four-serum-miRNA panel is a promising biomarker to diagnose childhood asthma noninvasively.
Under Pressure: Leadership for Literacy and Cultural Responsiveness
Authors: Thompson Lisa D. , Brezicha Kristina
Published: August 2022

This case considers the literacy leadership practices of Principal Howard at Pinecrest Academy Title I elementary school in the southeastern United States. An award-winning school, Pinecrest Academy serves over 500 students, 98% of whom are students of color. Through the lens of instructional leadership for literacy and culturally responsive school leadership for literacy, this case study examines how the principal used school improvement planning to (a) bolster the literacy outcomes of third-grade students of color, (b) form partnerships with the parents and families of third-grade students of color to increase literacy outcomes, and (c) reframe the literacy focus when external and internal factors threatened to derail the school’s progress.
Functional Activity After Flatfoot Reconstruction With Lateral Column Lengthening
Authors: Sequeira Sean B. , Burke John F. , Casp Aaron , Cooper Minton T. , Park Joseph S. , Perumal Venkat
Published: August 2022

Background

The objective of this study was to evaluate return to activity following flatfoot reconstruction with lateral column lengthening (LCL) by assessing functional postoperative data and identifying patient characteristics associated with poor function following surgery.

Methods

Consecutive patients that underwent operative flatfoot correction including LCL and other necessary procedures from 2014 to 2019 by 3 fellowship trained foot and ankle orthopedic surgeons were retrospectively administered Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and FAAM Sports questionnaires with no preoperative scoring available. Patient demographic factors, comorbidities, and radiographic features were evaluated as predictors of outcome scores to simulate return to activity. Statistical analysis, including student’s t-tests and analysis of variance, was performed.

Results

A total of 54 patients were included. A body mass index (BMI) of 30 kg/m2 or greater was associated with a lower ADL score (P = .002) and Sports score (P = .002). Preoperative hindfoot valgus of 9° or higher was associated with higher ADL scores (P = .040). Neither age nor any flatfoot radiographic parameters yielded significant differences in functional scores.

Conclusion

This study demonstrated relatively high average FAAM scores in both the ADL and the sports subscales, consistent with previous studies. This study also identified lower BMI and greater preoperative hindfoot valgus as potential predictors of improved functional outcome following reconstruction.

Level of Evidence:

Level III: Retrospective case control
Arachnoid granulations may be protective against the development of shunt dependent chronic hydrocephalus after aneurysm subarachnoid hemorrhage**
Authors: Almohaimede Khaled , Zaccagna Fulvio , Kumar Ashish , da Costa Leodante , Wong Erin , Heyn Chris , Kapadia Anish
Published: August 2022

Background and purpose

Chronic hydrocephalus may develop as a sequela of aneurysmal subarachnoid hemorrhage, requiring long-term cerebrospinal fluid shunting. Several clinical predictors of chronic hydrocephalus and shunt dependence have been proposed. However, no anatomical predictors have been identified.

Materials and methods

A retrospective cohort study was performed including 61 patients with aneurysmal subarachnoid hemorrhage. Clinical characteristics were noted for each patient including presentation World Federation of Neurosurgical Societies grade, modified Fischer grade, aneurysm characteristics, requirement for acute and chronic cerebrospinal fluid diversion, and 3-month modified Rankin scale. CT images were evaluated to determine the Evans’ index and to enumerate the number of arachnoid granulations. Association between the clinical characteristics with ventriculoperitoneal shunt insertion and the 3-month modified Rankin scale were assessed.

Results

The initial Evans’ index was positively associated with mFisher grade and age, but not the number of arachnoid granulations. 16.4% patients required insertion of a ventriculoperitoneal shunt. The number of arachnoid granulations were a significant negative predictor of ventriculoperitoneal shunt insertion [OR: 0.251 (95% CI:0.073–0.862; p = 0.028)]. There was significant difference in the number of arachnoid granulations between those with and without ventriculoperitoneal shunt ( p = 0.002). No patient with greater than 4 arachnoid granulations required a ventriculoperitoneal shunt, irrespective of severity of initial grade.

Conclusion

Arachnoid granulations may be protective against the development of shunt dependent chronic hydrocephalus after aneurysmal subarachnoid hemorrhage. This is irrespective of presenting hemorrhage severity. This is a potentially novel radiologic biomarker and anatomic predictor of shunt dependence.
Stature estimation of Malaysians using post-mortem computed tomography images of the spine
Authors: Chainchel Singh Mansharan Kaur , Lai Poh Soon , Sidek Sabrilhakim , Mohd Noor Mohamad Helmee , Abdul Rashid Saiful Nizam , Siew Sheue Feng
Published: August 2022

Background

Stature estimation is important in medical investigations to identify victims and is most accurate using anatomical methods utilizing the entire skeleton. However, in cases of mass fatalities, it has been calculated using regression analysis formulas of different body parts. Radiology especially post-mortem computed tomography (PMCT) is increasingly being used in victim identification as it is non- invasive and allows for multi planar reconstruction.

Methods

This study aims to generate stature estimation formulae using regression analysis of the vertebral column incorporating population that form the Malaysian ancestry i.e. Malay, Chinese and Indian using PMCT. This was a retrospective study involving 115 subjects who had a PMCT. Subjects consisted of Malaysian males and females (92 males and 23 females) aged 18–70 years. Cervical length (CL), thoracic length (TL), lumbar length and the whole spine length (WSL) incorporating cervical, thoracic and lumbar length were compared against cadaveric length.

Results

Whole spine length had the highest correlation coefficient of 0.570 and showed highest correlation with cadaveric length among female subjects compared to males. Whole spine length amongst the Malay was the highest followed by the Chinese and Indian ethnic groups (r = 0.671, 0.629, 0.402).

Conclusion

Our study concluded that the use of WSL from PMCT images can be used for body height estimation amongst Malaysians. This study has also successfully generated population-specific database for Malaysian experts to perform stature estimation using measurements of the vertebral column.
Terra incognita: Victim Participation Rights, Sexual Offending and Brexit
Authors: Casey Juliette
Published: August 2022

Over the past four decades, the importance of safeguarding the rights of victims of crimes has been progressively recognised. While the European Convention on Human Rights, the EU Charter of Fundamental Rights, as well as the European Union Directive on the Rights of Victims of Crime Directive 2012/20 EU have all contributed to this change, this recognition has been driven primarily by EU law. 1 By contrast with the general provisions of the European Convention on Human Rights adopted in 1950, 2 which seeks merely to establish minimum standards in 46 very different States, the Directive sets out in detail the component elements of rights in a legislative text. Further, it enjoys probably both direct effect and certainly supremacy and has the overt intention to harmonise the law in the Member State to which it applies. 3 Increasingly, victims are seen as rights-holders. There is now a growing consensus that victims of crime have an inherent interest in the manner in which criminal justice is administered with accompanying rights as a participant. This concern is heightened 4 in cases of sex offending and has resulted in national reviews and inquiries into the investigation and prosecution of sexual offences 5 in the adversarial criminal jurisdictions of the UK and Ireland. One of the rights focussed on in these reports was the substantive participatory right to state-funded independent legal representation for defence applications to question the victim in relation to sexual history or character evidence at the pre-trial stage. Ireland played a significant leadership role in these initiatives and it extended the already established right from the trial to the pre-trial stage. By contrast, a report commissioned by the Victims’ Commissioner indicates that England and Wales is far behind in providing substantive participatory rights to victims of crime 6 while proposals exist in Scotland and Northern Ireland to follow the Irish approach and place the right on a statutory footing. The decision of the UK to leave the EU now means that the domestic implementing measures and any unimplemented provisions are converted to retained EU law by the European Union (Withdrawal) Act 2018. 7 Further, the Act removes Charter rights from domestic law on exit day 8 while retaining in domestic law fundamental rights or principles which exist irrespective of the Charter. 9 I will explore here some of the challenges for the UK courts in defining and interpreting these retained law rights. Crucially, any future development will not have access to the “benchmark” 10 of either EU law or a written constitution. The UK’s relationship with the Convention is an evolving one and, while general Convention protections continue to apply, for now at least, 11 I will focus here on implications for the UK’s uncodified constitutional order. This now diluted legal order will be more reliant on common law rights which, by contrast with rights in a written constitution, generally lack a hard -fundamental status.
Transforaminal Versus Interlaminar Endoscopic Lumbar Discectomy for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis
Authors: Jitpakdee Khanathip , Liu Yanting , Kotheeranurak Vit , Kim Jin-Sung
Published: August 2022

Study Design

Meta-analysis and systematic review.

Objective

This study aims to investigate and compare patient-reported outcomes, perioperative data, and complications between 2 common endoscopic approaches for lumbar disc herniation: transforaminal and interlaminar endoscopic lumbar discectomy, by published high-quality evidence.

Methods

Electronic databases were searched for reported outcomes following TELD and IELD. Oswestry Disability Index (ODI), visual analog scale of back (VASB) and leg pain (VASL), and MacNab criteria were evaluated. Operative time, hospital stays, blood loss, radiation exposure, and complications were investigated. Odds ratio (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using random and fixed-effect models.

Results

Total of 1948 patients from 18 studies were included, consisting of 1006 patients (51.6%) in TELD group and 942 (48.4%) patients in IELD group. TELD had better improvement of postoperative ODI (MD = 1.26; 95% CI: .07-2.16; P = .04), postoperative VASB (MD = −.23; 95% CI: −.40 to −.05; P = .01) and last follow-up VASB (MD = −.25; 95% CI: −.41 to −.09; P = .002), but with longer operative time (MD = 10.1 min; 95% CI: 1.925-18.77; P < .00001) and more fluoroscopic time (SMD = 4.12; 95% CI: 3.22-5.03; P < .00001), especially in L5-S1 operation. Bed rest time was significantly longer following IELD, with no difference in VASL, hospital stays, or complication.

Conclusion

We found comparable clinical outcomes in terms of ODI, VAS, patient satisfaction, hospital stays, and complication between both techniques. TELD required more radiation exposure and longer operative time at L5-S1 level than IELD. Our study provided results to help consider appropriate approaches for selected patients and informed consent of benefits from each approach.
A Systematic Review and Meta-Analysis of the Success of Resin Composite Restorations
Authors: Kölüş Türkay , Uçar Arzu Yağmur
Published: August 2022

Aim:

This review examines the studies on resin composites within the past decade and evaluates the materials’ application methods and success through Fédération Dentaire Internationale (FDI) scores.

Materials and Methods:

Search results from three databases (a total of 3295 studies) were transferred to Mendeley Desktop (Mendeley, London, UK) software and deduplicated (2638 studies). Eight studies were included in this meta-analysis after scanning the title, abstract, and full-text screening. Risk of bias analysis was performed using the Cochrane Handbook tool. Shapiro–Wilk, Kolmogorov–Smirnov, Kruskal–Wallis, and post hoc Tamhane’s T2 were used for statistical analysis.

Results:

Conventional composite’s surface staining FDI score was higher than flowable and silorane composites (no difference between these two). Also, conventional composite has the highest score in terms of staining. Conventional composite + two-step self-etch adhesive and bulk fill composite + two-step self-etch adhesive have lower FDI scores in marginal staining. In noncarious cervical lesions (NCCL), conventional composite + two-step total-etch adhesive has a higher score than flowable composite + two-step self-etch adhesive. Flowable composite + two-step self-etch adhesive and conventional composite + single-step self-etch adhesive have the highest FDI scores for marginal adaptation (no statistical difference between them). Conventional composite + two-step self-etch adhesive and bulk fill composite + two-step self-etch have the lowest scores (no statistical difference between them). For recurrence of caries, all groups have Score 1, the best score, and there is no significant difference between them.

Conclusions:

Each restorative material and adhesive system has different advantages, and the practitioner must choose the most appropriate.
Estimation of Salivary Neopterin Levels in Aggressive and Chronic Periodontitis After Nonsurgical Periodontal Therapy: A Cohort Study
Authors: Gottumukkala Sruthima Naga Venkata Satya , A. Chaitanya , Venkata Ramesh Konathala Santhosh , Penmetsa Gautami S. , Koneru Suneetha , Pasupuleti Swetha
Published: August 2022

Aim:

Neopterin is a marker associated with cell-mediated immunity produced by interferon-Ɣ-stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies, and allograft rejections. Recently, it was shown to be associated with the initiation and progression of periodontal disease. This investigation was designed to explore the use of salivary neopterin in predicting the outcome of nonsurgical periodontal therapy (NSPT) in aggressive and chronic periodontitis patients.

Materials and Methods:

This case-control study with stratified sampling comprised 45 subjects divided into three groups: a control group of 15 periodontally healthy participants, a test Group A of 15 participants with chronic periodontitis, and a test Group B of 15 participants with aggressive periodontitis. Periodontal parameters, including plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL), were recorded at baseline and three months after scaling and root planing (SRP). An enzyme-linked immunosorbent assay (ELISA) analysis was performed to measure neopterin levels in saliva in study groups before and after SRP. Kruskal–Wallis analysis of variance and Mann–Whitney U tests were done for intra- and intergroup comparisons. The correlation between salivary neopterin levels with clinical parameters was done by Karl Pearson’s correlation coefficient.

Results:

Baseline salivary neopterin levels were least in the control group (5 62 nmol/L), higher in test Group A (9.30 nmol/L), and highest in test Group B (9.76 nmol/L). Three months after SRP, there was a significant reduction in all the clinical parameters, and the reduction in mean salivary neopterin levels were 2.79 and 2.57 in test Group A and test Group B, respectively; the difference was not statistically significant.

Conclusion:

Salivary neopterin levels have the potential to be utilized as a diagnostic tool for detecting the presence, activity of the disease, and the course of the lesions. It cannot, however, be utilized to distinguish between chronic and aggressive periodontitis.
Advancing Public Service Innovation Through Empathy: An Analysis of Bangladesh’s Intrepid Approach
Authors: Ehsan Shah Md Azimul , Hossain Farhad , Eldridge Derek , Bhuiyan Shahjahan
Published: August 2022

This study attempts to understand, explore and analyse how Bangladesh public administration has made considerable progress in fostering public service innovation (PSI) by instilling empathy among the public bureaucrats through the Empathy Training Programme (ETP). By employing qualitative methods, this study collected data from both primary and secondary sources. The empirical findings of the study suggest that ETP has been able to change the paternalistic and colonial mindset of public bureaucrats. In addition, the study further reveals that public bureaucrats are bringing this knowledge of empathy-led innovation to their workplaces, where they are effectively practising it, indicating that the ETP has not only been able to generate a cultural change in the Bangladesh Civil Service (BCS) but also has created a sense of responsiveness and self-accountability among public bureaucrats. However, there are still areas of concern in terms of the sustainability of the ETP approach. The study also identified some critical building blocks, which have been considered responsible for the limited scaling up of the pilot projects. Finally, the study has come up with a set of recommendations for making this intrepid approach to Bangladesh public administration more effective.
The Interfacing History and Narrative Representation of Bengali Dalit Refugeehood in Jatin Bala’s Stories of Social Awakening: Reflections of Dalit Refugee Lives of Bengal
Authors: Pal Bidisha , Rahman Md Mojibur
Published: August 2022

Bengali Dalit refugees and refugeehood fall under the less discussed chapter in the streamlined flow of history and narratives. Often within the hegemonic macro-narratives of partition, the ‘common minimal narratives’ (Kaur, 2008, Narrative absence: An ‘Untouchable’ account of partition migration. Contributions to Indian Sociology, vol. 42, p. 286) of the Bengali Dalit refugees get suppressed and subsided. The Dalit refugee accounts contribute a significant lot to the constructing cartographies of history. The article focuses on the representation of Dalit refugees in the anthology Stories of Social Awakening: Reflections of Dalit Refugee Lives in Bengal (2017) by the refugee author Jatin Bala. While providing a vent for polyphonic refugee voices, Bala creates an interface of history and narrative representation of the existential and identity crisis of Dalit refugees with concepts of resettlement and partitioning reality, violence, trauma memory and struggle for sustenance. The study extends its inquiry to the much curious trajectory of history and narrative of Bengali Dalit refugeehood; how the lopsided relationship and crucial junctures between the objective history and the subjective narrative representations make interplay of past and present in portraying violence and memory in the lives of the Dalit refugees. The study also explores how the narrative short fictions deconstruct the ‘essential victimhood’ of the refugees who rise above the harrowing experiences of the spatiotemporal boundary of history and reconstruct the fractured identities to be the true conscious souls of the society in building solidarity.
Caste and Access to Education in Rural Punjab: A Case of Premarket Discrimination
Authors: Singh Harpreet
Published: August 2022

Education enables the growth and development of nations and individuals through multiple channels. However, everyone may not have access to education in general and to quality education in particular. This article is a modest attempt to explore the issue of caste-based premarket discrimination in rural Punjab. Caste-wise differences in access to education are analysed using the primary survey data collected in 2015–2016 from 12 villages spread across three districts— Bathinda, Jalandhar and Rupnagar—of Punjab. The analyses show that Scheduled Castes (SC) lack access to education facilities. Compared to the non-SC, a significantly larger proportion of the SC is found illiterate. It is observed that almost, at every level of education the percentage of SC possessing that level of qualification is lesser than that of the non-SC. The females are facing dual discrimination as their access to education is relatively poor in general and poorest for females belonging to the SC community in particular. Caste consciousness among the students is observed in case of their close friendship relations with peer group and seating preferences in the class.
Tribal Imprint on Goa’s Cultural Identity: Kunbi-Gawdaization of Goa
Authors: Fernandes Mozinha , Desouza Shaila
Published: August 2022

Discussions around Goa’s unique cultural identity and debates around the need for a special status for the state of Goa within India are not new. Reasons ascribed to this have oscillated between Goa’s colonial history, the geography of being nestled in the Western Ghats with a long-indented coastline, the tourism industry and the friendliness of the local people. This article based on an ethnographic study of the Kunbi-Gawda tribal community in Goa explores the tribal contribution to the framing of Goa’s cultural identity. Using the tribal icon of dress, namely the dhentulli this article illustrates how Kunbi-Gawdaization is the current cultural identity of the State as tribal icons are used in the imaging of Goa.
Resilient Urban Heritage: Vulnerability Assessment and Evaluation of Conservation Strategies for Disaster Risk Reduction of Srinagar City
Authors: Malik Umar Farooq , Shah Bilquis , Noureen
Published: August 2022

Srinagar, an ancient city, is well known for its heritage wealth with more than 1,200 years of urban history established in the region by passing through the greatest kingdoms in the past. Globally, due to many challenges, such as extreme urbanization, rapid population growth and climate change crisis, the urban heritage buildings, monuments and sites are subject to degradation and extinction over time. The present study intends to identify and evaluate the heritage sites located in the Srinagar city and assess their spatial and structural vulnerabilities. An extensive field survey was conducted by which 20 structural heritage sites dating back to the 1800s and before has been identified for evaluation. Vulnerability analysis of sites was done based on seven selected parameters fabricated within the 300-metre buffer zones in the geographic information system (GIS) environment. An insight into conservation strategies and planning measures and challenges in the disaster risk reduction of heritage resources have been portrayed in the study. The results show that the Srinagar city has significant heritage structures with beautiful architecture that is now in a dilapidated and deserted condition with limited implication of the conservation strategies and less involvement of the stakeholders. The results indicate a dire need for sustainable conservation measures incorporated for disaster risk reduction of the urban heritage. The study holds great significance for the decision-makers in policy development and planning, especially for the management of the sites.
Anatomic and Reverse Stemless Shoulder Arthroplasty: Functional and Radiological Evaluation
Authors: Galhoum Mohamed S. , Elsheikh Ahmed A. , Wood Amanda , Yin Qi , Frostick Simon P.
Published: August 2022

Background

Stemless shoulder arthroplasty was developed to restore the glenohumeral centre of rotation without violation of the humeral shaft. It allows the preservation of humeral bone stock. Complications related to stem malalignment and periprosthetic fractures can be avoided.

Patient and methods

This is a prospective observational study that reports outcomes of 46 patients who received stemless shoulder arthroplasty “Comprehensive Nano implant ®.” The series includes Group (A): 30 anatomic and one hemiarthroplasty. Group (B): 15 reverse stemless replacement. Functional outcomes were assessed by visual analog score (VAS), satisfaction, range motion, Constant score, and American Shoulder and Elbow Score (ASES).

Results

The mean follow-up was 40.4  ±  12 months (range, 24 months to 60 months). Group (A): VAS and satisfaction improved by 5.3 and 67.5 points respectively. Constant score significantly improved from 28.5  ±  14.5 to 62.5  ±  23 P = <0.001. The radiological assessment showed the mean centre of rotation (COR) deviation was 2.8  ±  1.9 mm. 27% of patients have COR discrepancy of more than 4 mm. In Group (B), patients reported a significant improvement in VAS, Satisfaction, and ASES P  =  0.002, 0.002, and 0.003, respectively. Complications include shoulder pain with progressive loss of movements, aseptic loosening early subscapularis rupture, glenohumeral dislocations, and humeral component migration.

Conclusion

Anatomic Stemless total shoulder arthroplasty offers acceptable results and improvement of overall functional outcomes.
Increased risk of all-cause, Alzheimer’s, and vascular dementia in adults with migraine in Korea: a population-based cohort study
Authors: Hurh Kyungduk , Jeong Sung Hoon , Kim Seung Hoon , Jang Suk-Yong , Park Eun-Cheol , Jang Sung-In
Published: August 2022

Background

Studies investigating the association between migraine and dementia have reported inconsistent findings. This study aimed to evaluate whether patients with migraine have an increased risk of dementia compared to individuals without migraine.

Methods

We obtained data from the 2002–2019 Korean National Health Insurance Health Screening Cohort. Non-migraine controls were selected using a 1:1 risk-set matching with a time-dependent propensity score. The main outcome was the development of all-cause dementia, and the secondary outcome was the development of each cause of dementia (Alzheimer’s, vascular, mixed or other specified, and unspecified dementia). The incidence rate of dementia was calculated using Poisson regression, and the association between migraine and dementia was evaluated using Cox proportional hazards regression.

Results

Among 88,390 participants, 66.1% were female, and the mean baseline age was 55.3 ± 9.4 years. During the study period, dementia cases were identified in 4,800 of the 44,195 patients with migraine and 3,757 of the 44,915 matched controls. The incidence rate of dementia was 139.6 (95% confidence interval [CI], 135.7–143.5) and 107.7 (95% CI, 104.3–111.1) cases per 10,000 person-years in patients with migraine and matched controls, respectively. Patients with migraine had a 1.30 (hazard ratio [HR], 1.30; 95% CI, 1.25–1.35), 1.29 (HR, 1.29; 95% CI, 1.23–1.35), 1.35 (HR, 1.35; 95% CI, 1.19–1.54), 1.36 (HR, 1.36; 95% CI, 1.00–1.83), and 1.30 (HR, 1.30; 95% CI, 1.17–1.45) times higher risk of developing all-cause dementia, Alzheimer’s dementia, vascular dementia, mixed or other specified dementias, and unspecified dementia than their matched controls, respectively.

Conclusion

Our results suggest that migraine is associated with an increased risk of subsequent dementia. Further research is warranted to confirm these findings and to reveal the underlying mechanisms.
Screening of primary open-angle glaucoma diagnostic markers based on immune-related genes and immune infiltration
Authors: Suo Lingge , Dai Wanwei , Qin Xuejiao , Li Guanlin , Zhang Di , Cheng Tian , Yao Taikang , Zhang Chun
Published: August 2022

Purpose

Primary open-angle glaucoma (POAG) continues to be a poorly understood disease. Although there were multiple researches on the identification of POAG biomarkers, few studies systematically revealed the immune-related cells and immune infiltration of POAG. Bioinformatics analyses of optic nerve (ON) and trabecular meshwork (TM) gene expression data were performed to further elucidate the immune-related genes of POAG and identify candidate target genes for treatment.

Methods

We performed a gene analysis of publicly available microarray data, namely, the GSE27276-GPL2507, GSE2378-GPL8300, GSE9944-GPL8300, and GSE9944-GPL571 datasets from the Gene Expression Omnibus database. The obtained datasets were used as input for parallel pathway analyses. Based on random forest and support vector machine (SVM) analysis to screen the key genes, significantly changed pathways were clustered into functional categories, and the results were further investigated. CIBERSORT was used to evaluate the infiltration of immune cells in POAG tissues. A network visualizing the differences between the data in the POAG and normal groups was created. GO and KEGG enrichment analyses were performed using the Metascape database. We divided the differentially expressed mRNAs into upregulated and downregulated groups and predicted the drug targets of the differentially expressed genes through the Connectivity Map (CMap) database.

Results

A total of 49 differentially expressed genes, including 19 downregulated genes and 30 upregulated genes, were detected. Five genes ((Keratin 14) KRT14, (Hemoglobin subunit beta) HBB, (Acyl-CoA Oxidase 2) ACOX2, (Hephaestin) HEPH and Keratin 13 (KRT13)) were significantly changed. The results showed that the expression profiles of drug disturbances, including those for avrainvillamide-analysis-3, cytochalasin-D, NPI-2358, oxymethylone and vinorelbine, were negatively correlated with the expression profiles of disease disturbances. This finding indicated that these drugs may reduce or even reverse the POAG disease state.

Conclusion

This study provides an overview of the processes involved in the molecular pathogenesis of POAG in the ON and TM. The findings provide a new understanding of the molecular mechanism of POAG from the perspective of immunology.
Host-pathogen coevolution drives innate immune response to Aphanomyces astaci infection in freshwater crayfish: transcriptomic evidence
Authors: Boštjančić Ljudevit Luka , Francesconi Caterina , Rutz Christelle , Hoffbeck Lucien , Poidevin Laetitia , Kress Arnaud , Jussila Japo , Makkonen Jenny , Feldmeyer Barbara , Bálint Miklós , Schwenk Klaus , Lecompte Odile , Theissinger Kathrin
Published: August 2022

Background

For over a century, scientists have studied host-pathogen interactions between the crayfish plague disease agent Aphanomyces astaci and freshwater crayfish. It has been hypothesised that North American crayfish hosts are disease-resistant due to the long-lasting coevolution with the pathogen. Similarly, the increasing number of latent infections reported in the historically sensitive European crayfish hosts seems to indicate that similar coevolutionary processes are occurring between European crayfish and A. astaci. Our current understanding of these host-pathogen interactions is largely focused on the innate immunity processes in the crayfish haemolymph and cuticle, but the molecular basis of the observed disease-resistance and susceptibility remain unclear. To understand how coevolution is shaping the host’s molecular response to the pathogen, susceptible native European noble crayfish and invasive disease-resistant marbled crayfish were challenged with two A. astaci strains of different origin: a haplogroup A strain (introduced to Europe at least 50 years ago, low virulence) and a haplogroup B strain (signal crayfish in lake Tahoe, USA, high virulence). Here, we compare the gene expression profiles of the hepatopancreas, an integrated organ of crayfish immunity and metabolism.

Results

We characterised several novel innate immune-related gene groups in both crayfish species. Across all challenge groups, we detected 412 differentially expressed genes (DEGs) in the noble crayfish, and 257 DEGs in the marbled crayfish. In the noble crayfish, a clear immune response was detected to the haplogroup B strain, but not to the haplogroup A strain. In contrast, in the marbled crayfish we detected an immune response to the haplogroup A strain, but not to the haplogroup B strain.

Conclusions

We highlight the hepatopancreas as an important hub for the synthesis of immune molecules in the response to A. astaci. A clear distinction between the innate immune response in the marbled crayfish and the noble crayfish is the capability of the marbled crayfish to mobilise a higher variety of innate immune response effectors. With this study we outline that the type and strength of the host immune response to the pathogen is strongly influenced by the coevolutionary history of the crayfish with specific A. astaci strains.
Early assessment of ventricular synchronization and function after left bundle-branch-area pacing with right bundle-branch block
Authors: Zhao Ruohan , Xiong Feng , Deng Xiaoqi , Wang Shuzhen , Liu Chunxia , Xu Min , Tan Kunyue , Wang Xiuxiu
Published: August 2022

Aim

To evaluate ventricular synchronization and function in patients with right bundle-branch block after left bundle-branch-area pacing (LBBAP) by echocardiography.

Methods

Forty patients who successfully received LBBAP were selected and divided into the right bundle-branch block group (RBBB group) and the non-RBBB group by pre-operation ECG. Echocardiography and follow-up were performed 1 month after operation. Interventricular synchronization was evaluated by tissue Doppler (TDI), tissue mitral annular displacement (TMAD), and interventricular mechanical delay. The tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tricuspid annulus sidewall systolic velocity (TV-s’), left ventricular global ventricular longitudinal strain (GLS), right ventricular free wall longitudinal strain (LS-RV), standard deviation of left ventricular 18 segments peak time difference (SDt-L) and standard deviation of right ventricular free wall 3 segments peak time difference (SDt-R) were applied to evaluate intraventricular synchronization and ventricular function.

Results

The difference of displacement peak time of the tricuspid and mitral valves, namely ΔPTTV-MV measured by TMAD, the difference of systolic time to peak of the tricuspid and mitral valves, namely ΔTsTV-MV measured by TDI, were statistically different between the two groups (P < 0.05). Compared with the non-RBBB group, there were no statistically significant differences in the GLS, RVFAC, LS-RV, TAPSE, TV-s’, SDt-L, SDt-R (P > 0.05).

Conclusion

Echocardiography technology including two-dimensional speckle tracking imaging (2D-STI), TDI, and TMAD can effectively analyze interventricular synchronization, intraventricular synchronization, and ventricular function. Although the movement of the right ventricular myocardium in the RBBB group was slightly later than that of the left ventricular myocardium after LBBAP, LBBAP could still be applied in RBBB patients with pacing indication.
Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study
Authors: Johansson Katarina , Mustonen Harri , Seppänen Hanna , Lehtimäki Tiina E.
Published: August 2022

Background

No previous studies have examined the possible relationship between intraductal papillary mucinous neoplasm (IPMN) and the developmental ductal variations of the pancreas, such as an ansa pancreatica and a meandering main pancreatic duct (MMPD).

Methods

This retrospective cross-sectional study enrolled 214 patients, 108 with IPMN disease and 106 subjects from a community at the tertiary care unit. The main pancreatic duct (MPD) was evaluated in the head of the pancreas by its course, which were non-MMPD: descending, vertical, and sigmoid, or MMPD including loop types, reverse-Z subtypes, and an N-shape, which was identified for the first time in this study. IPMN patients were also evaluated for worrisome features (WF) or high-risk stigmata (HRS), and the extent of IPMN cysts.

Results

Among IPMN patients, 18.4% had MMPD, which we observed in only 3.0% of the control group (P < 0.001). Patients with MMPD were more likely to belong to the IPMN group compared with non-MMPD patients [odds ratio (OR) 6.4, 95% confidence interval (CI) 2.2–24.9]. Compared with a descending shape MPD, IPMN patients with an N-shaped MPD were more likely to have a cystic mural nodule (OR 5.9, 95% CI 1.02–36.0). The presence of ansa pancreatica associated with more extent IPMN disease (OR 12.8, 95% CI 2.6–127.7).

Conclusions

IPMN patients exhibited an MMPD more often than control patients. Ansa pancreatica associated with multiple cysts. Furthermore, an N-shape in IPMN patients associated with cystic mural nodules, suggesting that this shape serves as a risk factor for more severe IPMN.
Clinical and psychosocial outcomes following correction of supination deformity in obstetrical brachial plexus palsy patients: A retrospective study
Authors: Hamdi Nezar B. , Doubi Motaz , Abalkhail Talal B. , Mortada Hatan
Published: August 2022

Background

Forearm supination contracture is the mostAQ common deformity of the forearm following obstetric brachial plexus palsy (OBPP). Supination deformities in OBPP may be corrected by performing forearm osteotomy; however, the high recurrence rate limits patient satisfaction. Apart from the cosmetic impairment of this deformity, there are no previous reports on the clinical and psychosocial outcomes of forearm osteotomy in patients with supination deformities secondary to OBPP. Therefore, our study aimed to assess the clinical, functional, and psychosocial outcomes following forearm pronation osteotomy in OBPP patients with supination deformity.

Methods

This retrospective study was conducted after a chart review of all OBPP sequelae with supination forearm deformity in patients who underwent forearm pronating osteotomy from 2006 to 2018. Data relating to OBPP were gathered, and functional and psychosocial outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire through interviews

Results

This study included 60 patients with a mean age of 8.7 years at the time of surgery. A total of 46 patients had lesions involving C5-T1 (76.7%). The mean preoperative supination deformity position was 68.5°, the mean amount of correction was 98.9°, and the mean forearm position was 30.5°, postoperatively. In the DASH assessment scale used postoperatively, 24 patients (42.9%) reported no restrictions on their daily activities, 25 patients (44.6%) believed that their social activities were unaffected, and 20 patients (35.7%) strongly disagreed with feeling less capable or less confident due to arm, shoulder, or hand problems. The factors significantly affecting position at the final follow-up were the amount of correction (p = 0.011), postoperative position (p = 0.005), and degree of pronation achieved (p = 0.02). The amount of correction significantly affected both self-confidence (p = 0.049) and activities of daily living (p = 0.033).

Conclusion

In conclusion, our study showed that the position at the final follow-up, the degree of pronation achieved intraoperatively, and the postoperative position significantly affected the position at follow-up and the outcome assessment. The amount of intraoperative correction was significantly associated with higher self-confidence and normal activities of daily living.