bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Chronic and Painful Corneal Defects with a
Complete or Partial Conjunctival Flap
Authors: Kohlhaas Markus , Perdikakis Georgios , Iraklis Vastardis , Gökel Gürol , Avermann Carsten , Fili Sofia
Published: November 2020

Background The coverage of chronic and painful corneal defects with a
complete or partial conjunctival flap is a surgical practice that is still
applied to advanced stage of keratopathies, which insist despite repeated
treatments with a therapeutic contact lens, corneal transplantation or amniotic
membrane transplantation.

Material and Methods 37 cases of refractory corneal defects were treated
between January 2006 and December 2019 with conjunctival flap. 27 cases
underwent a complete and 10 cases a partial conjunctival flap. The mean age of
the patients (n = 37, 23 women and 14 men subjects) was 73 years (23 – 87
years). Unsuccessful efforts of intensive conservative treatment and repetitive
surgical procedures for several weeks or even months ended up to the indication
of performance of a conjunctival flap. Conjunctival flap was performed using the
Gundersen technique. A very thin flap of the upper bulbar conjunctiva is
dissected downward towards the limbus without creating buttonholes. When the
limbus is reached, the resultant flap is freed and without tension it is pulled
over the corneal defect and sutured with nylon sutures placed at the limbus
(complete conjunctival flap) or at the stroma of healthy cornea (partial
conjunctival flap).

Results This kind of conjunctival flap has low rates of complication. The
postoperative follow-up after the partial or complete conjunctival flap was
satisfying in 34 cases and showed a good healing process without major
complications. Partial conjunctival flap shrinkage was observed in 3 cases,
which could be revised in 2 of them. One case underwent enucleation, because of
recurrent severe keratopathy.

Conclusion Conjunctival flap is an established surgical procedure that is
applied rarely. The more frequent performance of this technique is suggested as
it consists the ultima ratio for the treatment of refractory neurotrophic
keratitis and non-healing epithelial defects.
Der Migrationshintergrund als Grenze der Palliativversorgung am Lebensende?
Authors: Banse Christian , Owusu-Boakye Sonja , Schade Franziska , Jansky Maximiliane , Marx Gabriella , Nauck Friedemann
Published: November 2020

Hintergrund Menschen mit Migrationshintergrund nutzen nach dem Stand der Forschung das palliative Versorgungsangebot wenig. Die möglichen Gründe sind weitgehend unklar. Häufig werden kulturelle Unterschiede geltend gemacht. Eine Untersuchung der Bedürfnisse von krebskranken Patienten mit Migrationshintergrund, ihren Angehörigen und medizinischen und pflegenden Versorgenden in Deutschland bietet einen Überblick über die Versorgungsprobleme.

Methoden In dem qualitativen Forschungsdesign stehen biografische Erzählungen der Patienten, ihrer Angehörigen und der medizinischen und pflegenden Versorgenden im Vordergrund. Mit der Grounded Theory wurde eine Zeile-für-Zeile-Analyse der Daten durchgeführt, mit der verschiedene Kategorien und Handlungsstrategien im Umgang mit der Krankheit und der Versorgungssituation gefunden werden konnten.

Ergebnisse Wenn schwerkranke Patienten mit Migrationshintergrund in einer palliativen Versorgungsstruktur ankommen, erleben sie in dieser politische und soziale Abgrenzungen. Migrationsspezifische Einflüsse erschweren deshalb die Bearbeitung der Krankheit und die palliativmedizinische Behandlung und Versorgung am Lebensende. Angehörige und medizinische und pflegende Versorgende erleben die Situation als eine Herausforderung, weil sie den Erwartungen der Patienten nicht entsprechen können und auf Übersetzer und Vermittler angewiesen sind. Viele Probleme werden kulturellen Unterschieden zugerechnet, obwohl die Patienten am Lebensende eher allgemeine Bedürfnisse formulieren.

Schlussfolgerung Die Palliativversorgung von Menschen mit Migrationshintergrund findet häufig ohne spezifische Kenntnisse der Migrationsbiografie statt. Um den politischen und sozialen Einflüssen gerecht zu werden, bedarf es einer Unterstützung, die die Migrationsbiografie berücksichtigt.
Seasonal climate summary for the southern hemisphere (spring 2018): positive Indian Ocean Dipole and Australia’s driest September on record
Authors: Trewin Blair
Published: November 2020

This is a summary of the southern hemisphere atmospheric circulation patterns and meteorological indices for spring 2018; an account of seasonal rainfall and temperature for the Australian region and broader southern hemisphere is also provided. A positive phase of the Indian Ocean Dipole developed during the season, and the central and eastern equatorial Pacific were warmer than average without reaching El Niño thresholds. It was Australia’s driest September on record, before rainfall of closer to average in October and November. It was warmer than average, especially in northern Australia, with coastal Queensland affected by extreme heat and wildfires in November. It was one of the three warmest springs on record for the southern hemisphere as a whole, and was notably dry in southern and eastern Africa.
Investigation of the microstructure and mechanical performance of bimetal components fabricated using CMT-based wire arc additive manufacturing
Authors: Han Shaohua , Zhang Zhongzhong , Liu Zhisen , Zhang Hong , Xue Dingqi
Published: November 2020

Traditionally, wear-resistant components are manufactured by cladding hard facing material on the base metal. This production process is typically complicated, expensive, and time-consuming. This study proposes a method of fabricating components with high wear resistance requirements utilizing cold metal transfer based wire and arc additive manufacturing with hard facing welding wire as the consumable material. Thin-walled and block components were manufactured by depositing a combination of a low alloy steel, ER80S-G, and a hard facing material, MF6–55GP. Microstructure characterization and mechanical properties (hardness, tensile and Block-on-Ring wear test) were performed. The results revealed that the ER80S-G/MF6–55GP bimetal components were able to be fused with no detectable defects near the border. As the deposited height was increased, the residual stress also increased; this internal residual stress combined with the external tensile load lead to a very low tensile strength of 447.79 ± 24.32 MPa of the ER80S-G/MF6-55GP/ER80S-G sandwich structure. The microstructures, constituent phases, and hardness distributions differ greatly among the layers due to their different thermal histories. The wear weight loss varies as the load condition changes for both the MF6-55G and Cr12MoV steels. Compared to Cr12MoV, MF6-55GP weld metal exhibits better wear resistance at higher loads in dry sliding wear tests.
Properties of stainless-steel surface after hollow cathode assisted plasma nitriding
Authors: Zhang Zhehao , Bi Yongjie , Zhang Minyi , Li Yang , Zhao Fushuai , Zhang Shangzhou , He Yongyong
Published: November 2020

AISI 304 stainless steel was nitrided at different temperature in the plasma equipment using a new auxiliary device. The proposed hollow cathode auxiliary device improves the plasma density, thereby accelerating the nitriding process. The modified surface was characterized by x-ray diffraction, scanning and transmission electron microscopies, atomic force microscopy, surface microhardness testing. Electrochemical corrosion test was used to measure the localized corrosion resistance of the samples. Single S-phase layer without the CrN precipitation was obtained by hollow cathode plasma nitriding at 450 °C, which improved the microhardness, wear and corrosion resistance of the steel surface. Nitriding at higher temperature of 550 °C resulted in substitution of the S-phase towards layer composed from CrN and α-Fe phases, improving the microhardness but decreasing the corrosion resistance.
A large plane set intersecting lines in infinitely many directions in at most one point
Authors: Eiderman Vladimir , Larsen Michael
Published: November 2020

We prove that for every at most countable family

{

f
k

(
x
)
}

\{f_k(x)\}

of real functions on

[
0
,
1
)

[0,1)

there is a single-valued real function

F
(
x
)

F(x)

,

x
∈
[
0
,
1
)

x\in [0,1)

, such that the Hausdorff dimension of the graph

Γ
\Gamma

of

F
(
x
)

F(x)

equals 2, and for every

C
∈

R

C\in \mathbb {R}

and every

k
k

, the intersection of

Γ
\Gamma

with the graph of the function

f
k

(
x
)
+
C

f_k(x)+C

consists of at most one point. We also construct a family of functions of cardinality continuum and a function

F
F

with similar properties.
Areas spanned by point configurations in the plane
Authors: McDonald Alex
Published: November 2020

We consider an over-determined Falconer type problem on

(
k
+
1
)

(k+1)

-point configurations in the plane using the group action framework introduced in by Greenleaf, Iosevich, Liu, and Palsson in [Rev. Mat. Iberoam. 31 (2015), pp. 799–810]. We define the area type of a

(
k
+
1
)

(k+1)

-point configuration in the plane to be the vector in

R

(

k
+
1

2

)

\mathbb {R}^{\binom {k+1}{2}}

with entries given by the areas of parallelograms spanned by each pair of points in the configuration. We show that the space of all area types is

2
k
−
1

2k-1

dimensional, and prove that a compact set

E
⊂

R

d

E\subset \mathbb {R}^d

of sufficiently large Hausdorff dimension determines a positve measure set of area types.
Simplicial approximation and refinement of monoidal topological complexity
Authors: Tanaka Kohei
Published: November 2020

This paper presents a combinatorial approximation of the monoidal topological complexity

T
C

M

\mathrm {TC}^M

of a simplicial complex

K
K

that controls reserved robot motions in

K
K

. We introduce an upper bound

S
C

r
M

\mathrm {SC}^M_r

of

T
C

M

\mathrm {TC}^M

using the

r
r

-iterated barycentric subdivision of

K
×
K

K \times K

modulo the diagonal and consider the refinement of the approximation. We show that

T
C

M

\mathrm {TC}^M

can be described as

S
C

r
M

\mathrm {SC}^M_r

for sufficiently large

r
≥
0

r \geq 0

. As an example, we consider a simplicial model

S
n

S_n

of an

n
n

-sphere and demonstrate that

S
C

r
M

(

S
n

)

\mathrm {SC}^M_r(S_n)

presents the best estimate of the monoidal topological complexity of an

n
n

-sphere for

r
≥
1

r \geq 1

.
Whole-genome screen identifies diverse pathways that negatively regulate ciliogenesis
Authors: Failler Marion , Giro-Perafita Ariadna , Owa Mikito , Srivastava Shalini , Yun Chi , Kahler David J. , Unutmaz Derya , Esteva Francisco J. , Sánchez Irma , Dynlacht Brian D.
Published: November 2020

A whole-genome RNAi screen has uncovered a novel network of genes linking integrin signaling and cellular adhesion to the extracellular matrix with inhibition of ciliation in both normal and cancer cells. Our findings suggest an unanticipated reciprocal relationship between ciliation and cellular adhesion to the extracellular matrix.
Three Weeks Versus Six Weeks of Antibiotic Therapy for Diabetic Foot Osteomyelitis: A Prospective, Randomized, Noninferiority Pilot Trial
Authors: Gariani Karim , Pham Truong-Thanh , Kressmann Benjamin , Jornayvaz François R , Gastaldi Giacomo , Stafylakis Dimitrios , Philippe Jacques , Lipsky Benjamin A , Uçkay lker
Published: November 2020

Background

In patients with diabetic foot osteomyelitis (DFO) who underwent surgical debridement, we investigated whether a short (3 weeks) duration compared with a long (6 weeks) duration of systemic antibiotic treatment is associated with noninferior results for clinical remission and adverse events (AEs).

Methods

In this prospective, randomized, noninferiority pilot trial, we randomized (allocation 1:1) patients with DFO after surgical debridement to either a 3-week or a 6-week course of antibiotic therapy. The minimal duration of follow-up after the end of therapy was 2 months. We compared outcomes using Cox regression and noninferiority analyses (25% margin, power 80%).

Results

Among 93 enrolled patients (18% females; median age 65 years), 44 were randomized to the 3-week arm and 49 to the 6-week arm. The median number of surgical debridements was 1 (range, 0–2 interventions). In the intention-to-treat (ITT) population, remission occurred in 37 (84%) of the patients in the 3-week arm compared with 36 (73%) in the 6-week arm (P = .21). The number of AEs was similar in the 2 study arms (17/44 vs 16/49; P = .51), as were the remission incidences in the per-protocol (PP) population (33/39 vs 32/43; P = .26). In multivariate analysis, treatment with the shorter antibiotic course was not significantly associated with remission (ITT population: hazard ratio [HR], 1.1 [95% confidence interval {CI}, .6–1.7]; PP population: HR, 0.8 [95% CI: .5–1.4]).

Conclusions

In this randomized controlled pilot trial, a postdebridement systemic antibiotic therapy course for DFO of 3 weeks gave similar (and statistically noninferior) incidences of remission and AE to a course of 6 weeks.

Clinical Trials Registration

NCT03615807; BASEC 2016-01008 (Switzerland).
The omics of channelopathies and cardiomyopathies: what we know and how they are useful
Authors: Pappone Carlo , Micaglio Emanuele , Locati Emanuela T , Monasky Michelle M
Published: November 2020

Sudden cardiac death results from arrhythmias commonly caused by channelopathies and cardiomyopathies, often due to several genetic factors. An emerging concept is that these disease states may in fact overlap, with variants in traditionally classified ‘cardiomyopathy genes’ resulting in ‘channelopathies phenotypes’. Another important concept is the influence of both genetic and non-genetic factors in disease expression, leading to the utilization of systems biology approaches, such as genomics/epigenomics, transcriptomics, proteomics, metabolomics, lipidomics, and glycomics, to understand the disease severity and progression and to determine the prognosis and the best course of treatment. In fact, our group has discovered significant differences in metabolites, proteins, and lipids between controls and Brugada syndrome patients. Omics approaches are useful in overcoming the dogma that both channelopathies and cardiomyopathies exist as Mendelian disorders (caused by a mutation in a single gene). This shift in understanding could lead to new diagnostic and therapeutic approaches.
Temporal changes in the microbiome of stingless bee foragers following colony relocation
Authors: Hall Mark A , Brettell Laura E , Liu Hongwei , Nacko Scott , Spooner-Hart Robert , Riegler Markus , Cook James M
Published: November 2020

Maintaining beneficial interactions with microbial symbionts is vital for animal health. Yet, for social insects, the stability of microbial associations within and between cohorts is largely unknown. We investigated temporal changes in the microbiomes of nine stingless bee (Tetragonula carbonaria) colonies at seven timepoints across a 10-month period when moved between two climatically and florally different sites. Bacterial 16S rRNA gene and fungal ITS amplicon sequencing confirmed that microbiomes varied considerably between colonies initially at site one. However, following relocation, considerable changes occurred in bacterial community composition within each colony, and the microbiome composition became more similar across colonies. Notably, Snodgrassella disappeared and Zymobacter appeared as relatively abundant taxa. Remarkably, bacterial communities within colonies continued to shift over time but remained similar across colonies, becoming dominated by Acinetobacter six months after returning to the original site. Our results indicate that the stingless bee microbiome can undergo major changes in response to the environment, and that these changes can be long-lasting. Such legacy effects have not been reported for corbiculate bees. Further understanding the microbial ecology of stingless bees will aid future management of colonies used in agricultural production.
The student-centered classroom: the new gut feeling
Authors: Lyles Jennifer K , Oli Monika
Published: November 2020

A student-centered, interactive course-based undergraduate research experience (CURE) was implemented in a microbiology course in order to provide an authentic research experience and to stimulate student interest and improve understanding of fermentation, probiotics, the human microbiome and related topics. Students were immersed in the scientific process as they used fundamental techniques to investigate the probiotic composition of a fermented milk beverage, kefir—an unknown question with no predetermined outcomes. In order to assess the benefits and effect of this learning experience on the students, pre- and post-study surveys were administered using Qualtrics. Post-study, 93% of participants agreed that fermented foods are beneficial to human health (compared to 52% pre-study), and notably, 100% of participants indicated that they plan to apply this material in both their personal and professional lives and would suggest consuming probiotics or fermented products to alleviate gastrointestinal issues. As evidenced by demographic data, this CURE is suitable for implementation at both large and small institutions with diverse student populations. Collectively, these data indicate that this collaborative, discovery-based learning experience is a powerful educational tool, encouraging students to make real-life connections between microbiology, medicine and their own health.
Sin taxes and their effect on consumption, revenue generation and health improvement: a systematic literature review in Latin America
Authors: Miracolo Aurelio , Sophiea Marisa , Mills Mackenzie , Kanavos Panos
Published: November 2020

Sin or public health taxes are excise taxes imposed on the consumption of potentially harmful goods for health [sugar-sweetened beverages (SSBs), tobacco, alcohol, among others], aiming to reduce consumption, raise additional revenue and/or improve population health. This paper assesses the extent to which sin taxes (a) can reduce consumption of potentially harmful goods, (b) raise revenue for national health systems and (c) contribute to population health in Latin America. A systematic literature review was conducted on peer-reviewed and grey literature; endpoints included: impact of raising sin taxes on consumption, ability to raise revenue for health and the possibility of population health improvements. Risk of bias for each study was assessed. The synthesis of the literature on sin tax implementation showed improvements in all three endpoints across the study countries. Following the introduction of sin taxes or by simulating their potential impact, nearly all studies explicitly reported that consumption of potentially harmful goods (mainly SSBs and tobacco) declined; revenue was found to have increased in almost all countries, suggesting that there may be additional scope for further tax increase. Simulated improvements in population health have also been shown, by demonstrating a relationship between sin tax increases and reduction in prevalence of diabetes, stroke, heart attacks and associated deaths. However, sin tax effects on health would be better quantified over the long-term. Data quality and availability challenges did place some limitations on sin tax impact assessment. Sin taxes can be effective in reducing consumption of potentially harmful goods, improve population health and generate additional revenue. Promoting further research on this topic should be a priority.
The enabling technologies of industry 4.0: examining the seeds of the fourth industrial revolution
Authors: Martinelli Arianna , Mina Andrea , Moggi Massimo
Published: November 2020

Technological revolutions mark profound transformations in socio-economic systems. They are associated with the development and diffusion of general-purpose technologies (GPTs) that display very high degrees of pervasiveness, dynamism and complementarity. This article provides an in-depth examination of the technologies underpinning the “factory of the future” as profiled by the Industry 4.0 paradigm. It contains an exploratory comparative analysis of the technological bases and the emergent patterns of development of Internet of Things, big data, cloud, robotics, artificial intelligence, and additive manufacturing. We qualify the “enabling” nature of these technologies. We then test whether, taken together and individually, they display the characteristics of generality, originality, and longevity associated with GPTs. Finally, we discuss key themes for future research on this topic from an industrial structural change perspective.
Children on the Run: The Reception and Integration of Unaccompanied Minors in Israel and Germany
Authors: KÄckmeister Hannes , Yaron Mesgena Hadas
Published: November 2020

Over the past 20 years both Israel and Germany have become destination countries for unaccompanied minors (UM), albeit at different speeds and scales and in contrasting geopolitical settings. This article compares the reception and integration of UM in the two countries with a particular focus on their access to education and employment. The movement of UM over borders goes hand in hand with the drawing of legal, ideological, and conceptual boundaries within these two countries that discriminate between citizens and foreigners. However, the answers provided by the respective migration regimes could not be more different, even though both countries are signatories to the relevant international conventions on UM: while in Germany the primacy of child and youth welfare is applied, the Israeli authorities consider UM as illegal ‘infiltrators’ and a threat to national security and the Jewish State.
Metastatic spine oncology: symptom-directed management
Authors: Ruppert Lisa Marie , Reilly Julia
Published: November 2020

Spinal tumors pose significant treatment challenges for the physicians treating them. Understanding the location of the tumor within the intramedullary, intradural extramedullary, or extradural (epidural) space is not only critical in determining a differential diagnosis but may also provide important information about current and future neurologic deficits. Despite significant advances in the treatment of spinal tumors over the past few decades, these patients may still experience significant symptoms related to the tumor or its treatment, such as pain, weakness, impaired sensation, and bowel and bladder dysfunction. Treatment of spinal tumors should involve a multidisciplinary team of neuro-oncologists, spine surgeons, medical and radiation oncologists, physiatrists, and pain specialists to provide comprehensive oncologic management, while optimizing the patient’s functional status and quality of life.
Different conformational responses of the β2-adrenergic receptor-Gs complex upon binding of the partial agonist salbutamol or the full agonist isoprenaline
Authors: Yang Fan , Ling Shenglong , Zhou Yingxin , Zhang Yanan , Lv Pei , Liu Sanling , Fang Wei , Sun Wenjing , Hu Liaoyuan A , Zhang Longhua , Shi Pan , Tian Changlin
Published: November 2020

G protein-coupled receptors (GPCRs) are responsible for most cytoplasmic signaling in response to extracellular ligands with different efficacy profiles. Various spectroscopic techniques have identified that agonists exhibiting varying efficacies can selectively stabilize a specific conformation of the receptor. However, the structural basis for activation of the GPCR-G protein complex by ligands with different efficacies is incompletely understood. To better understand the structural basis underlying the mechanisms by which ligands with varying efficacies differentially regulate the conformations of receptors and G proteins, we determined the structures of β2AR-Gαs$\beta $γ bound with partial agonist salbutamol or bound with full agonist isoprenaline using single-particle cryo-electron microscopy at resolutions of 3.26 Å and 3.80 Å, respectively. Structural comparisons between the β2AR-Gs-salbutamol and β2AR-Gs-isoprenaline complexes demonstrated that the decreased binding affinity and efficacy of salbutamol compared with those of isoprenaline might be attributed to weakened hydrogen bonding interactions, attenuated hydrophobic interactions in the orthosteric binding pocket and different conformational changes in the rotamer toggle switch in TM6. Moreover, the observed stronger interactions between the intracellular loop 2 or 3 (ICL2 or ICL3) of β2AR and Gαs with binding of salbutamol versus isoprenaline might decrease phosphorylation in the salbutamol-activated β2AR-Gs complex. From the observed structural differences between these complexes of β2AR, a mechanism of β2AR activation by partial and full agonists is proposed to provide structural insights into β2AR desensitization.
Coronavirus Disease 2019 (COVID-19) and Pregnancy: What Obstetricians Need to Know
Authors: Rasmussen S.A. , Smulian J.C. , Lednicky J.A. , Wen T.S. , Jamieson D.J.
Published: November 2020

(Am J Obstet Gynecol. 2020;222:415–426)

As Coronavirus Disease 2019 (COVID-19) spreads across the globe, infecting more than the reported cases for Middle East Respiratory Syndrome Coronavirus (MERS) and Severe Acute Respiratory Syndrome Coronavirus (SARS) combined, this paper reviews relevant information on COVID-19 for practicing obstetricians. As little is known at this time about COVID-19, information on SARS and MERS and their effects on pregnancy is also reviewed.
Predicting Falls Among Community-Dwelling Older Adults
Authors: Yang Rumei , Plasek Joseph M. , Cummins Mollie R. , Sward Katherine A.
Published: November 2020

Data science skills are increasingly needed by informatics nurses and nurse scientists, but techniques such as machine learning can be daunting for those with clinical, rather than computer science or technical, backgrounds. With the increasing quantity of publicly available population-level datasets, identification of factors that predict clinical outcomes is possible using machine learning algorithms. This study demonstrates how to apply a machine learning approach to nursing-relevant questions, specifically an approach to predict falls among community-dwelling older adults, based on data from the 2014 Behavioral Risk Factor Surveillance System. A random forest algorithm, a common approach to machine learning, was compared to a logistic regression model. Explanations of how to interpret the models and their associated performance characteristics are included to serve as a tutorial to readers. Machine learning methods constitute an increasingly important approach for nursing as population-level data are increasingly being made available to the public.
Efficacy and safety of complementary and alternative medicine therapy for gastroparesis
Authors: Sun Manqiang , Chen Qi , Li Quanwang , Gao Lei , Zhou Qin , Zhou Tian , Wang Jianfeng , Duan Hua , Pang Haoyue , Hu Kaiwen
Published: November 2020

Background:

Gastroparesis affects the quality of life of many patients, but there is no effective treatment. Now, complementary and alternative medicine originated from China is gradually accepted by the world because of its unique treatment principles and relatively safe treatment methods. However, at present, there is still a lack of more definitive clinical application evidence for the treatment of gastroparesis with complementary and alternative medicine to confirm the safety and efficacy of complementary and alternative medicine in the treatment of gastroparesis caused by various causes. More comprehensive and stronger evidence-based medicine evidence is needed.

Methods:

We will retrieve literatures using Medline, Embase, the Cochrane Library database, Web of science, CNKI, VIP, CBM, and WanFang. We will look for RCTs or CCTs on the use of complementary and alternative medicine in the treatment of gastroparesis, and extract relevant data into the excel sheet. The whole retrieval and data extraction process were carried out by 2 researchers independently. Then we will use meta-analysis to make statistical analysis of all the results and make a systematic review of all the included literatures.

Results:

All results and safety data were analyzed for a comprehensive evaluation and/or descriptive analysis of the efficacy and safety of complementary and alternative therapies for gastroparesis.

Conclusion:

This study will provide more comprehensive clinical evidence for the treatment of gastroparesis with complementary and alternative therapies.

Registration:

The research has been registered and approved on the INPLASY.COM website. The registration number is INPLASY2020100033.
Dynamic Change in Serum Alpha-fetoprotein Level Predicts Treatment Response and Prognosis of Alpha-fetoprotein-producing Gastric Cancer
Authors: Wang Ruhan , Li Jing , Xu Dan , Li Ruiyang , Gong Ping
Published: November 2020

Alpha-fetoprotein (AFP)-producing gastric cancer (AFPGC) is rare and associated with a suboptimal prognosis. The aim of this retrospective study was to identify prognostic factors, with a particular focus on the dynamics of serum AFP levels during treatment, in AFPGC patients.

Data of patients with pathologically diagnosed primary gastric cancer treated with various modalities electronically collected in the medical management systems of 2 hospitals (ie, Shihezi People's Hospital and Shihezi Hospital) in Shihezi city, northwest China, from January 2007 to October 2018 were reviewed. Patients with AFPGC were identified based on serum AFP levels. Associations of the change in serum AFP levels and clinicopathological parameters with treatment response, including the overall response rate and disease control rate, and outcomes, including overall survival (OS) and progression-free survival (PFS), were compared among different groups.

Of 2354 patients diagnosed with gastric cancer, 96 patients with AFPGC were identified. The objective response rate and disease control rate were significantly higher in patients whose AFP level decreased by ≥50% than in patients whose AFP level decreased by <50% (68.8% vs. 40.6%, and 87.5% vs. 53.1%, respectively, both P < .05). The median OS and PFS were 32.0 (4-74) and 24.0 (1-66) months, respectively, in patients with a ≥50% decline in AFP, and 12.5 (0-69) and 9.0 (0-63) months, respectively, in those with a <50% decline in AFP (both P < .05). On univariate and multivariate analyses, tumor, node, metastasis staging classification stage, liver metastasis, curable surgery, and the decline in the serum AFP level were associated with OS and PFS.

A significant decline in the serum AFP level was associated with good treatment response and prognosis in AFPGC. Along with a decline in the serum AFP level, tumor, node, metastasis staging classification stage, liver metastasis, and curable surgery were also independent factors associated with prognosis.
Periurethral Lidocaine Does Not Decrease Pain After Urodynamic Testing in Women: A Double-Blinded Randomized Control Trial
Authors: Avondstondt Andrea M. , Chiu Stephanie , Salamon Charbel
Published: November 2020

Objective

Urodynamic testing of women is a common procedure to evaluate lower urinary tract symptoms but may cause discomfort. The objective of our study was to determine the effect of externally applied periurethral 2% lidocaine gel on pain scores after complex urodynamic testing in women.

Methods

This prospective, double-blinded, placebo-controlled randomized trial compared 2% lidocaine gel to water-based lubricant applied to the periurethral area before urodynamic testing in women. Discomfort was measured using a visual analog pain scale (VAS) ranging from 0 to 100. The primary outcome was the difference in VAS from baseline to 4 to 6 hours after urodynamic testing. Secondary outcomes included: VAS difference from baseline to immediately postprocedure and 24 hours after urodynamic testing; VAS scores: at baseline, immediately postprocedure, after 4–6 hours, and after 24 hours; urodynamic testing results; and any adverse events. Sixty-four women per group were needed to provide a power of 80% to detect a 10-mm difference on a 100-point VAS.

Results

From January 2018 to March 2019, 134 subjects were randomized, 6 subjects were excluded, which resulted in 64 subjects in both the water-based lubricant group and 2% lidocaine gel group. There was no difference in baseline demographics. There was no significant difference in the change in VAS from baseline to 4 to 6 hours after UDT (0, 0 P = 0.88). No difference in secondary outcomes was noted.

Conclusions

Topically applied 2% lidocaine gel does not decrease pain compared with water-based lubricant. For most women, complex urodynamic testing is not associated with any significant pain.

Clinical Trial Registration:
www.ClinicalTrials.gov,—NCT03390790, “Lidocaine for Pain After Urodynamic Testing”.
FGF signaling dynamics regulates epithelial patterning and morphogenesis
Authors: Sumbal Jakub , Vranova Tereza , Koledova Zuzana
Published: November 2020

Single cell assays revealed that growth factor signaling dynamics is actively sensed by a cell and ultimately controls cell fate. However, the effects of growth factor signaling dynamics at the tissue level have been unknown. We used mammary epithelial organoids, time-lapse imaging, fibroblast growth factor 2 (FGF2) variants of different stabilities, mathematical modeling, and perturbation analysis to study the role of FGF2 signaling dynamics in epithelial morphogenesis. We found that fluctuant and sustained FGF signaling dynamics induced distinct morphological and functional states of mammary epithelium through differential employment of intracellular effectors ERK and AKT. ERK activity domains determined epithelial branch size, while AKT activity drove epithelial stratification. Furthermore, FGF signaling dynamics affected epithelial tissue mechanoresponsiveness to extracellular matrix, thereby impinging upon branch elongation. Our study provides new insights into regulation of epithelial patterning and branching morphogenesis by FGF signaling dynamics and into downstream signaling effectors that regulate cellular outcomes.
Development and validation of behavioral biases scale: a SEM approach
Authors: Ritika  , Kishor Nawal
Published: November 2020

Purpose

This paper attempts to identify the biases in decision-making of individual investors. The paper aims to develop and validate a higher-order behavioral biases scale.

Design/methodology/approach

Scale development is done by identifying the relevant items of the scale through existing literature and then, adding new items for some biases. In phase 1, using a structured questionnaire, data was collected from 274 investors who invest in financial markets. The major dimensions of the scale have been pruned by using exploratory factor analysis administered on data collected in phase 1. Higher-order CFA is used to analyze the data and to validate the scale on another set of data (collected in phase 2) containing 576 investors.

Findings

The study reveals that the scale for measuring behavioral biases has many dimensions. It has two second-order factors and 13 zero-order constructs. Two second-order constructs have been modeled on the basis of cause of errors in investment decision-making, that is, biases caused due to cognition, biases caused due to emotions.

Originality/value

Behavioral biases are yet to receive a due attention, especially, in the Indian context. The present research is focusing on providing an empirically tested scale to test the behavioral biases. Some of the biases, which have been analyzed using secondary data in previous studies, have been tested with the help of statements in this study.
Ketamine as a rescue treatment for severe acute behavioural disturbance: A prospective prehospital study
Authors: Isoardi Katherine Z , Parker Lachlan E , Page Colin B , Humphreys Michael A , Harris Keith , Rashford Stephen , Isbister Geoffrey K
Published: November 2020

Objective

Rapidly and safely managing severe acute behavioural disturbance (ABD) in the prehospital setting is important for the welfare of both patient and prehospital clinician alike. We investigated the safety and effectiveness of ketamine as rescue sedation in patients with severe ABD.

Methods

This prospective observational study investigated ketamine use by a state ambulance service as rescue sedation for patients with severe ABD who remained agitated following droperidol administration. The primary outcome was the proportion of adverse events (vomiting, hypersalivation, emergence, over‐sedation, airway obstruction, laryngospasm, hypoxia, bradypnoea and intubation). Secondary outcomes included time to sedation, requirement for additional sedation and rate of successful sedation.

Results

There were 105 presentations (males 69/102 [69%]; median age 31 years (16–83 years). The commonest causes of ABD were illicit drug (39%) and alcohol (33%) intoxication. The median total dose of intramuscular ketamine was 200 mg (interquartile range [IQR] 150–200 mg). There were 64 adverse events in 40 (38%) patients. Four had vomiting, two had hypersalivation, two had emergence, 15 were oversedated, four had hypoxia, three had bradypnoea and 16 were intubated. Sedation was achieved in 103 (98%) patients at a median time post‐ketamine of 8 min (IQR 5–13 min). Additional sedation was administered to 41 patients (nine prehospital and 37 within 1 h of arriving to hospital). In 44 (42%) patients, ketamine successfully sedated the patient with no adverse effects and no ongoing sedation requirement.

Conclusion

The use of ketamine as rescue sedation in prehospital patients with severe ABD is effective. Adverse events are common but can be managed supportively.
The impact of voluntary capital adequacy disclosure on bank lending and liquidity creation
Authors: Zelenyuk Natalya , Faff Robert , Pathan Shams
Published: November 2020

Using a sample of 40 US banks that make voluntary disclosure of capital adequacy, we investigate the extent to which such voluntary disclosures influence growth in bank lending and liquidity creation. Combining two theories linked to the performance effects of (i) voluntary disclosure and (ii) leverage adjustment, we document novel evidence in favour of our hypotheses: a positive relation between voluntary bank disclosure and bank lending (liquidity creation). Our analysis provides some evidence that these positive linkages occur through a cost of capital channel.
Joint Sustainability Development in a Supply Chain
Authors: Yoon Jiho , Song Ju Myung , Choi Ji‐Hung (Ryan) , Talluri Srinivas (Sri)
Published: November 2020

Intense media scrutiny and public backlash stimulate consumers to be conscientious about sustainability issues from the supply chain (SC) perspective. Accordingly, our focus in this article is on joint sustainability issues in a manufacturer–supplier relationship under a contract that possibly shares sustainability‐related costs, when there exists a supplier's potentially deficient sustainability effort. We find that the manufacturer may prefer indirect (i.e., paying a higher component price to its supplier) rather than direct support (i.e., increasing subsidies for a supplier's sustainability expenditures) when consumers are sensitive to the supplier's sustainability. We further find that as consumers' sensitivity to the supplier's sustainability increases, an uncoordinated SC will gradually approach the coordinated SC. This occurs because the increased sensitivity encourages greater cooperation among SC members. Our findings will help establish a better understanding of the joint sustainability development issues in an SC.
Topical application with conjugated linoleic acid ameliorates 2, 4‐dinitrofluorobenzene‐induced atopic dermatitis‐like lesions in BALB/c mice
Authors: Tang Liu , Cao Xiaoqin , Li Xiaolei , Ding Hong
Published: November 2020

Atopic dermatitis (AD) is a multifactorial chronic inflammatory skin disease characterized by skin barrier dysfunction, eczematous lesions, pruritus, and abnormal immune responses. In this study, we assessed the therapeutic effect of topical applied conjugated linoleic acid (CLA) on a murine AD model that was developed by repetitive applications of 2, 4‐dinitrofluorobenzene (DNFB). 2% or 5% CLA could markedly ameliorate AD‐like skin lesions, scratching behaviour and skin inflammation as evidenced by the reduced inflammatory blood cells, IgE and Th2‐related cytokine levels, and the infiltration of mast cells and inflammatory cells to the dermal tissues. Moreover, topical application with CLA modulated skin barrier repair including maintaining a balanced skin pH and increasing skin hydration, partially mediated by upregulating skin barrier‐related protein, filaggrin (FLG). In addition, topical CLA significantly dose‐dependently inhibited pro‐inflammatory cytokines including interleukin (IL)‐6, IL‐1β, tumour necrosis factor (TNF)‐α and pro‐inflammatory enzyme expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase‐2 (COX‐2) in inflamed mice skin. Its anti‐inflammatory effect was associated with the inhibition of DNFB‐stimulated IκBα and NF‐κB p65 phosphorylation in mouse skin. Taken together, our results suggest that locally applied CLA exerts potentially protective effects against AD lesional skin at least in part, due to regulation of skin barrier function and inflammatory response.
ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children
Authors: Wollenberg A. , Christen‐Zäch S. , Taieb A. , Paul C. , Thyssen J.P. , de Bruin‐Weller M. , Vestergaard C. , Seneschal J. , Werfel T. , Cork M.J. , Kunz B. , Fölster‐Holst R. , Trzeciak M. , Darsow U. , Szalai Z. , Deleuran M. , von Kobyletzki L. , Barbarot S. , Heratizadeh A. , Gieler U. , Hijnen D.J. , Weidinger S. , De Raeve L. , Svensson Å. , Simon D. , Stalder J.F. , Ring J. ,   for the European Task Force on Atopic Dermatitis/EADV Eczema Task Force
Published: November 2020

Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and pathogenic variabilities, the patient’s age and also target flare prevention. Basic therapy includes hydrating and barrier‐stabilizing topical treatment universally applied, as well as avoiding specific and unspecific provocation factors. Visible skin lesions are treated with anti‐inflammatory topical agents such as corticosteroids and calcineurin inhibitors (tacrolimus and pimecrolimus), which are preferred in sensitive locations. Topical tacrolimus and some mid‐potency corticosteroids are proven agents for proactive therapy, which is defined as the long‐term intermittent anti‐inflammatory therapy of frequently relapsing skin areas. Systemic anti‐inflammatory or immunosuppressive treatment is a rapidly changing field requiring monitoring. Oral corticosteroids have a largely unfavourable benefit–risk ratio. The IL‐4R‐blocker dupilumab is a safe, effective and licensed, but expensive, treatment option with potential ocular side‐effects. Other biologicals targeting key pathways in the atopic immune response, as well as different Janus kinase inhibitors, are among emerging treatment options. Dysbalanced microbial colonization and infection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R‐blockers) only have limited effects on AD‐related itch and eczema lesions. Adjuvant therapy includes UV irradiation, preferably narrowband UVB or UVA1. Coal tar may be useful for atopic hand and foot eczema. Dietary recommendations should be patient‐specific, and elimination diets should only be advised in case of proven food allergy. Allergen‐specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress‐induced exacerbations. Efficacy‐proven 'Eczema school' educational programmes and therapeutic patient education are recommended for both children and adults.
Influence of acquirer boards on M&A value creation: Evidence from Continental Europe
Authors: Defrancq Corneel , Huyghebaert Nancy , Luypaert Mathieu
Published: November 2020

We examine how the size and the composition of acquirer boards are associated with shareholder abnormal returns for 2,230 M&As made by listed firms in Continental Europe. Although board size proves insignificant, our findings do offer some evidence as to a beneficial effect of board diversity on M&A value creation. Gender diversity appears marginally positively associated with acquirer shareholder abnormal returns. The fraction of foreign directors is in general not significantly positive, unless the rule of law in the acquirer country is weak. Nonetheless, nationality diversity in the board turns out harmful in purely domestic takeovers. The influence of age diversity is marginally positive, yet only in domestic and horizontal takeovers. Next, the fraction of independent directors has a robust positive effect on the acquirer CAR, while directors with multiple board appointments prove valuable especially through preventing firms from pursuing poor takeovers. Finally, CEO duality is detrimental only in industry‐diversifying deals initiated by acquirers that are not controlled by an individual or a family shareholder. Any negative CEO‐duality effect is mitigated when the acquirer‐country rule of law is strong.
Activation and expression of endogenous CREB‐regulated transcription coactivators (CRTC) 1, 2 and 3 in the rat adrenal gland
Authors: Smith Lorna I. F. , Zhao Zidong , Walker Jamie , Lightman Stafford , Spiga Francesca
Published: November 2020

The activation and nuclear translocation of cAMP‐response element binding protein (CREB)‐regulated transcription coactivator (CRTC)2 occurs in the rat adrenal gland, in response to adrenocorticotrophic hormone (ACTH) and stressors, and has been implicated in the transcriptional regulation of steroidogenic acute regulatory protein (StAR). We have recently demonstrated the activation of CRTC isoforms, CRTC1 and CRTC3, in adrenocortical cell lines. In the present study, we aimed to determine the activation and expression of the three CRTC isoforms in vivo in relation to Star transcription, under basal conditions and following a robust endotoxic stress challenge. Rat adrenal glands and blood plasma were collected following i.v. administration of either an ultradian‐sized pulse of ACTH or administration of lipopolysaccharide, as well as under unstressed conditions across the 24‐hour period. Plasma ACTH and corticosterone (CORT) were measured and the adrenal glands were processed for measurement of protein by western immunoblotting, RNA by a quantitative reverse transcriptase‐polymerase chain reaction and association of CRTC2 and CRTC3 with the Star promoter by chromatin immunoprecipitation. An increase in nuclear localisation of CRTC2 and CRTC3 followed increases in both ultradian and endotoxic stress‐induced plasma ACTH, and this was associated with increased CREB phosphorylation and corresponding increases in Star transcription. Both CRTC2 and CRTC3 were shown to associate with the Star promoter, with the dynamics of CRTC3 binding corresponding to that of nuclear changes in protein levels. CRTC isoforms show little variation in ultradian expression or variation across 24 hours, although evidence of long‐term down‐regulation following endotoxic stress was found. We conclude that co‐transcription factors CRTC2 and, more clearly, CRTC3 appear to act alongside phosphorylated CREB in the generation of ultradian pulses of Star transcription, essential for the maintenance of basal StAR expression. Similarly, our findings suggest CRTC2 and CRTC3 mediate Star transcriptional initiation following an endotoxic stressor; however, other transcription factors are likely to be responsible for the long‐term up‐regulation of adrenal Star transcription.