bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of multiple nursing interventions (cluster nursing) in ABO hemolytic disease of neonates and evaluation of its effect
Authors: Wang Wei , Tang Chi , Ji Qing-Lian , Xiu Hong , Shao Hui , Yu Xiao-Man
Published: January 2020

Objective

This study aimed to create a group of nursing intervention (cluster nursing) strategies of phototherapy for neonates and to evaluate clinical effects of intervention measures on reducing neonatal jaundice in neonates.

Methods

We performed a prospective study. A total of 141 patients with neonatal ABO hemolytic jaundice were included and randomly divided into two groups: intervention group and control group. The intervention group adopted cluster nursing measures in combination with continuous phototherapy (blue light), while the control group adopted routine nursing together with continuous phototherapy (blue light).

Results

No differences were observed in general characteristics between the groups. On the seventh day of treatment, percutaneous bilirubin levels were significantly lower in the intervention group than in the control group. On the seventh day of treatment, milk intake was significantly higher and the duration of hospitalization was significantly shorter in the intervention group than in the control group.

Conclusion

Use of cluster nursing measures in combination with phototherapy in neonatal ABO hemolysis can effectively reduce bilirubin levels, improve symptoms of jaundice, and shorten the course of the disease.
Application of fast-track surgery combined with a clinical nursing pathway in the rehabilitation of patients undergoing total hip arthroplasty
Authors: Zhang Chunhua , Xiao Jun
Published: January 2020

Objective

To explore the effect of fast-track surgery combined with a clinical nursing pathway in the rehabilitation of patients treated with total hip arthroplasty (THA).

Methods

We enrolled 70 patients diagnosed with avascular necrosis who were treated with a THA. All patients were randomly divided into either a control or a study group. The control group received routine nursing during the perioperative period while the study group received a fast-track surgery combined with a clinical nursing pathway.

Results

There was no significant difference in general condition between the two groups, including the Harris hip score and the SF-36 scale of health. At the third week and the third month after the operation, the Harris hip score and the health SF-36 score of the study group increased significantly compared with the control group. In addition, the study group had a lower incidence of total complications and a shorter hospitalization time, as well as higher satisfaction scores for nursing work compared with the control group.

Conclusion

Fast-track surgery combined with a clinical nursing pathway can effectively improve the clinical symptoms and self-efficacy of patients undergoing THA, and improve the patients' satisfaction with hospitalization.
High expression of VCAN is an independent predictor of poor prognosis in gastric cancer
Authors: Li Wenfei , Han Fang , Fu Min , Wang Zhanqiu
Published: January 2020

Objective

Versican (VCAN) has been reported as a potential biomarker in some cancers. However, its role in gastric cancer (GC) is poorly understood.

Methods

Associations between clinical variables and VCAN were assessed. The diagnostic value of VCAN expression in GC patients was determined through receiver operating characteristic (ROC) curve analysis. Cox regression and the Kaplan–Meier method were used to explore clinicopathologic factors related to overall survival in GC patients. The Gene Expression Omnibus and the Human Protein Atlas were used for further validation. Gene set enrichment analysis (GSEA) was performed using The Cancer Genome Atlas dataset.

Results

High expression of VCAN was associated with high stage and T classification in GC. The area under the ROC curve was 0.853. Patients with high VCAN expression had worse prognoses than those with low VCAN expression. Multivariate analysis showed that VCAN was an independent risk factor for overall survival in both cohorts. GSEA identified pathways involved in cancer, ECM-receptor interaction, Wnt signaling, T cell receptor signaling, and chemokine signaling as differentially enriched in GCs with high VCAN expression.

Conclusion

We demonstrated that VCAN is expressed at high levels in GC, and represents a potential independent molecular marker for diagnosis and prognosis of GC.
Clinical significance of the monocyte:lymphocyte ratio for ankylosing spondylitis patients with thoracolumbar kyphotic deformities
Authors: Zhuang Jianxiong , Huang Yongxiong , Liang Guoyan
Published: January 2020

Purpose

This study aimed to determine the clinical significance of the monocyte:lymphocyte ratio (MLR) in ankylosing spondylitis (AS) patients with thoracolumbar kyphotic deformity.

Methods

Ninety AS patients and 45 healthy controls were retrospectively enrolled. AS patients were divided into thoracolumbar kyphotic deformity (AS deformity) and spine normal (AS normal) groups. Blood parameters including C-reactive protein and erythrocyte sedimentation rate were determined. Receiver operating characteristic (ROC) curves and binary logistic regression analysis were conducted.

Results

Counts of white blood cells, neutrophils, and monocytes, and the neutrophil:lymphocyte ratio, platelet:lymphocyte ratio, and MLR were significantly higher in the AS than the control group. ROC curve results showed that the MLR yielded a higher area under the curve (AUC) value than other parameters, compared with controls. The MLR and monocyte count were higher in the AS deformity group than the AS normal group. ROC curve results indicated that the MLR yielded a higher AUC value than other parameters, compared with the AS normal group. Logistic regression suggested that the MLR was an independent predictor for thoracolumbar kyphotic deformity.

Conclusions

The MLR was elevated in AS patients, and was shown to be an independent predictor for thoracolumbar kyphotic deformity.
Obesity affects graft function but not graft loss in kidney transplant recipients
Authors: Bellini Maria Irene , Koutroutsos Kostas , Nananpragasam Hannah , Deurloo Emily , Galliford Jack , Herbert Paul Elliot
Published: January 2020

Objective

This study was performed to examine the suitability of transplantation in kidney transplant recipients (KTRs) with a high body mass index (BMI).

Methods

In total, 370 consecutive KTRs stratified according to the World Health Organization BMI categories were retrospectively analysed. The estimated glomerular filtration rate (eGFR) was used to assess allograft function.

Results

The mean BMI was 26.2 kg/m2. Among all patients, 148 (40.0%) were pre-obese, 47 (12.7%) were class I obese, 11 (3.0%) were class II obese, and 9 (2.4%) were class III obese. A linear trend for male sex and younger age was observed from the normal BMI group through the progressively higher groups. Overweight and obese KTRs had a significantly higher incidence of pre-transplant diabetes, but there was no difference in post-transplant new-onset hyperglycaemia. Obesity was not a significant risk factor for a lower eGFR at the 1-year follow-up, but it became significant at the 2- and 3-year follow-ups. Graft loss occurred in 28 patients, and 25 patients died during follow-up. No difference in all-cause allograft loss was found among the different BMI groups during follow-up.

Conclusion

Obesity affects the eGFR in the long term. Allograft survival was lower, but not significantly.
Anaesthetic considerations for patients with antiphospholipid syndrome undergoing non-cardiac surgery
Authors: Kim Jae Won , Kim Tae Woo , Ryu Keon Hee , Park Sun Gyoo , Jeong Chang Young , Park Dong Ho
Published: January 2020

Antiphospholipid syndrome (APS) is an acquired thrombotic autoimmune disorder that is clinically characterized by the development of thrombosis and obstetric morbidities in patients with antiphospholipid antibodies. Due to hypercoagulability, the focus of management is anticoagulation for the prevention of thrombosis and its recurrence. When such patients undergo surgery, however, the underlying risk of thrombosis increases as a result of anticoagulant withdrawal, immobilization, and/or intimal injury. Conversely, there is also an increased risk of bleeding due to thrombocytopaenia, possible disseminated intravascular coagulation, or progression to catastrophic APS, as a result of excessive anticoagulation, surgery, and infection. Measures for appropriate perioperative anticoagulation are discussed in this review, as well as anaesthetic considerations for preventing perioperative complications in patients with APS undergoing non-cardiac surgery.
Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture
Authors: Zhang Chu , Zhang Miao , Wang Haiyong , Ma Zhifeng , Wu Yuanlin , Fu Linhai , Zhu Ting , Yu Guangmao
Published: January 2020

Objective

Manipulating the instruments during uniportal video-assisted thoracoscopic surgery (U-VATS) bullectomy requires a relatively large incision. This study aimed to investigate the feasibility of next-day discharge following U-VATS bullectomy using an anchoring suture.

Methods

A stapler and a scope were inserted through a single incision in the anchoring group. The bullae were retracted by the suture, which was inserted from outside of the chest wall into the thorax, and then bullectomy was performed. For those in the control group, resection of the bullae was performed with the assistance of a grasping forceps.

Results

The length of the incision of the patients in the anchoring group ([13.2 ± 2.2] mm) was significantly smaller than in the control group ([26.2 ± 3.9] mm). In addition, the number of staplers used in the anchoring group was significantly less than in the control group ([1.2 ± 0.4] vs. [1.4 ± 0.5]). Furthermore, 36 (92.3%) cases in the anchoring group were uneventfully discharged within 24 hours after bullectomy.

Conclusion

Next-day discharge after U-VATS bullectomy through a small incision assisted with an anchoring suture is safe and feasible.
A survey of perioperative intravenous lidocaine use by anaesthetists in Australia and New Zealand
Authors: Bailey Martin A , Toner Andrew J , Corcoran Tomas B
Published: January 2020

Perioperative intravenous lidocaine administration by anaesthetists is purported to confer a variety of benefits across a range of surgical procedures. It remains unclear whether the available evidence regarding efficacy and safety is sufficient to influence Australasian practice broadly, and whether significant barriers to uptake exist. We therefore conducted a survey of Fellows of the Australian and New Zealand College of Anaesthetists to evaluate patterns of lidocaine use, and perceptions relating to benefit and safety. Of 979 survey invitations, 295 (30.1%) responded. Of these, 51.9% of anaesthetists incorporate lidocaine administration into their practice. Amongst users, the most common indication is open abdominal or pelvic surgery (88.9%), with the principal intent of reducing acute pain and opioid use (both 92.2%). Only 51% perceive lidocaine to have a role in the prevention of chronic post-surgical pain, and less than a third administer it for operations strongly linked to this condition. Nearly all (91%) users deliver the drug by intraoperative bolus and infusion, with the majority using doses between 1.0 and 1.5 mg/kg for both the bolus and the hourly infusion rate. When parallel local anaesthetic techniques are employed, 44.4% restrict the dose, 37.3% turn the lidocaine infusion off first and 15.7% make no modifications. Most respondents terminate infusions by the end of surgery (52.3%) or in the post-anaesthesia care unit (26.8%). Few deliver postoperative infusions without electrocardiographic monitoring (5.9%). There were no reports of life-threatening events. The dichotomy in Australasian use of perioperative lidocaine revealed by this survey confirms that large multicentre trials are now required to guide practice accurately.
Asymmetric superior oblique split Z-tendon lengthening for face turn in bilateral asymmetric superior oblique overaction and exotropia
Authors: Serafino Massimiliano , Scaramuzzi Matteo , Specchia Claudia , Bonsignore Francesco , Nucci Paolo
Published: January 2020

Introduction:

The aim was to evaluate the effectiveness of the procedure of the superior oblique split Z-tendon lengthening to collapse A pattern and treat face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique overaction.

Methods:

We retrospectively reviewed the clinical records of patients with facial turn associated with intermittent exotropia and bilateral asymmetric superior oblique overaction, who underwent superior oblique muscle split tendon lengthening and concurrent horizontal surgery between 2009 and 2017.

Results:

A total of eight patients met the inclusion criteria. The preoperative average face turn was 26.8° (range, 20°–5°), and it significantly improved to 5.4° (range, 2°–8°) ( p < 0.05). All the patients showed an improvement in the face turn with neutralization of the vertical deviation. The vertical deviation in the right gaze for the patient with a right turn and the left gaze in patients with left turn improved significantly (values of p < 0.05).

Conclusion:

The superior oblique split Z-tendon lengthening was an effective procedure to collapse the A pattern and the treatment of the face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique muscle overaction with less complications, and less varying results.
Applying discrete choice models to understand sport tourists’ heterogeneous preferences for Winter Olympic travel products
Authors: Lyu Seong Ok
Published: January 2020

This study aims to better understand how South Korean sport tourists show their preferences for Winter Olympic travel products. Comparing a series of discrete choice model (DCM) techniques, this study also investigates what attributes comprising PyeongChang Winter Olympic travel products are considered by sport tourists important and how they make trade-offs among those attributes for purchasing an optimal product. Study findings suggest that respondents place distinctive importance on each attribute to yield their greatest amount of utility through jointly considering a set of Olympic travel product attributes. Results also indicate that sport tourists put high willingness-to-pay values for multiple opportunities of attending skating competitions and popular tournaments while they show strong interests in more sightseeing and recreational experiences. Based on different DCM estimation results, several management strategies are presented for developing quality Olympic travel products.
Traditional healers’ and biomedical practitioners’ perceptions of collaborative mental healthcare in low- and middle-income countries: A systematic review
Authors: Green Bethany , Colucci Erminia
Published: January 2020

Access to mental healthcare in low- and middle-income countries (LMICs) is one of the greatest challenges in public health today. One suggestion for improving accessibility is through collaboration between biomedical practitioners and traditional healers. This paper reviews studies of traditional healers’ and biomedical practitioners’ perceptions of collaboration. We conducted a systematic review of online databases, selected journals, and reference lists for relevant studies. Eligible papers were assessed using a tool designed for this review for quality and study characteristics, and qualitative data demonstrating participants’ views were extracted. A total of 14 papers from seven countries were included. The published literature on this topic is relatively homogenous and studies are of variable quality. The findings suggest that, despite differing conceptualisations of mental illness causation, both traditional healers and biomedical practitioners recognise that patients can benefit from a combination of both practices and demonstrate a clear willingness to work together. There are concerns about patients’ safety and human rights regarding traditional methods and some healers are sceptical about the effectiveness of Western psychiatric medication. Despite keeping the inclusion criteria open to all LMICs, 13 of the studies were conducted in Africa, seven of which were in South Africa. This limits the applicability of the findings of this review to the wider LMIC context. The paper concludes with recommendations for research and practice.
The real digital househusbands of China: The alienable affects of China’s male ‘virtual lovers’
Authors: Tan Chris K. K. , Xu Zhiwei
Published: January 2020

As China continues to neoliberalize in the new millennium, the Internet also enables new subjects of affective labour to emerge. Since 2014, young men have been hawking their services as xuni lianren (‘virtual lovers’) on popular Chinese websites. These men explicitly state that while they neither sell sex nor meet their clients in person, they behave otherwise as actual boyfriends would: over chatting apps, they talk to clients for leisure and provide relief from frustrations accumulated from family, school and work. We frame this study as one of the ‘digital housewife’, a conceptual figure who produces two use-values of alienable user data and inalienable affects like offline houseworkers do. Male virtual lovers, however, commodify even their supposedly inalienable affects, so we argue that they (as digital househusbands) embody digital housewife-ness even more so than Jarrett’s original formulation.
An Unusual Suspect for a Traumatic Arteriovenous Fistula in the Left Vertebral Artery
Authors: Noh Cassey Y.
Published: January 2020

This case study discusses an unusual vertebral arteriovenous fistula of a patient with no history of an invasive medical procedure or underlying genetic disorders. The patient is a 54-year-old female with a history of tinnitus for 6 months behind the left ear prior to coming to the vascular laboratory. There was a connection between the left vertebral artery and the vertebral vein, which showed a mosaic pattern with a high velocity. The spectral Doppler waveform in the vertebral vein post the unintended anastomosis showed an arterialized venous Doppler waveform, confirming that the area of the interest was indeed an arteriovenous fistula. The image of the screening computed tomography performed on the same day did not show this connection or dilated venous system, possibly because of the small size of the fistula. A published literature suggests hyperextension as a possible suspect. There are a few test modalities that can identify an arteriovenous fistula, but ultrasound maybe the most desirable due to the fact that it does not involve an invasive procedure or a contrast dye. It is very important for a sonographer to learn the advanced information such as how to identify a true arteriovenous fistula with the analysis of Doppler waveform in the vein post the anastomosis. In doing so, it will increase the sonographer’s knowledge as well as promoting the field of ultrasound overall.
Near-infrared spectroscopy as a predictor of cerebral ischaemia during carotid endarterectomy in awake patients
Authors: Inčiūra Donatas , Antuševas Aleksandras , Aladaitis Adomas , Gimžauskaitė Agnė , Velička Linas , Kavaliauskienė Žana
Published: January 2020

Objectives

The aim of our study was to evaluate the near-infrared spectroscopy monitoring system to detect cerebral ischaemia, find indications for selective shunting during carotid endarterectomy and compare it with an internal carotid artery stump pressure monitoring technique in patients operated under local anaesthesia.

Methods

During January 2015 and November 2018, 131 patients undergoing carotid endarterectomy under local anaesthesia were prospectively included in the study. Near-infrared spectroscopy as intraoperative monitoring was applied and compared with stump pressure.

Results

Carotid endarterectomy was performed successfully in 106 patients operated under local anaesthesia. Meanwhile, 25 patients developed neurological changes (motor or consciousness impairment, weakness of extremities, cognitive decline) during clamping, and all of them received a shunt. ΔrSO2, stump pressure and rSO2 (–11 ± 8%, 31 ± 6mmHg, 58 ± 11) values were smaller in the group of shunted subjects versus non-shunted group subjects (–2 ± 5%, 61 ± 17 mmHg, 64 ± 8) after 1 min of internal carotid artery clamping ( p < 0.05). Statistical analysis showed a sensitivity of 90% (95% CI: 0.85–0.95) and a specificity of 70% (95% CI: 0.62–0.78) for a ≥10% drop in ΔrSO2 to predict ischaemia symptoms during carotid clamping. Using stump pressure with a cut-off value of ≤40 mmHg for predicting symptoms, the sensitivity was 82% and specificity 54%.

Conclusions

Near-infrared spectroscopy is a suitable non-invasive cerebral oxygenation monitoring method during carotid endarterectomy. A 10% decrease of ΔrSO2 had a good correlation with clinical cerebral ischaemia signs and matched well with the stump pressure cut-off value of ≤40 mmHg. There is a possibility of near-infrared spectroscopy to replace stump pressure in cerebral oxygenation monitoring during carotid endarterectomy. However, we need larger prospective multicentre studies to identify the optimal threshold for shunt requirement.
Does a previous aortic endograft confer any protective effect during abdominal aortic aneurysm rupture? Systematic review and meta-analysis of comparative studies
Authors: Galanakis Nikolaos , Kontopodis Nikolaos , Tavlas Emmanouil , Tsetis Dimitrios , Ioannou Christos V
Published: January 2020

Objectives

Whether prior endovascular aneurysm repair confers a protective effect in patients with ruptured abdominal aortic aneurysm (rAAA) is not known. We aimed to systematically review and compare the outcomes of rAAA in patients with and without prior endovascular aneurysm repair.

Methods

We performed a systematic review that conformed to the Preferred Reporting Items for Systematic Reviews and Meta-analysis. We selected studies comparing the outcomes in patients with rAAA after prior endovascular aneurysm repair (group 1) and those with de novo rAAAs (group 2). We conducted a proportion meta-analysis of perioperative mortality and obtained summary estimates of odds ratios (ORs) and 95% confidence intervals (CIs) using random-effects models.

Results

We included four studies (retrospective observational studies) in quantitative synthesis reporting a total of 719 patients (group 1 (89) group 2 (630)). The perioperative mortality in groups 1 and 2 was 30.4% and 41%, respectively, and there was no statistical significant difference between the groups (OR 0.66, 95% CI 0.30–1.43, P = 0.29, I2=58%). However, patients presenting with rAAA following previous endovascular aneurysm repair were more hemodynamically stable (OR 0.33, 95% CI 0.12–0.90, P = 0.03, I2=74%). The choice between endovascular or open surgery treatment in group 1 did not affect the perioperative mortality (OR 1.12, 95% CI 0.41–3.04  P = 0.82, I2=0%). Endoleak types I and III were the main causes of rAAA in group 1.

Conclusions

Perioperative mortality was similar for rAAA either de novo or after prior endovascular aneurysm repair. However, ruptures in patients with prior endovascular aneurysm repair presented hemodynamically more stable.
Lives as Collections of Strands: An Essay in Descriptive Psychology
Authors: Kubovy Michael
Published: January 2020

In this article I generalize the notion of multiple self-aspects to create a descriptive framework in which lives are partitioned into containers of activities called strands. Strands are nearly decomposable life modules, structured, stable, and concurrent longitudinal streams of extended duration whose momentary cross-sections constitute self-aspects. They are differentiated by five features: the person’s role, the cast, the setting, norms and values, and habits and routines. Strands contain projects and episodes and are replete with narrative. Each strand is continuous (i.e., strands persist when a person moves between them), and for the most part strands are mutually asynchronous. From a first-person perspective, the strands are continuous and concurrent, but only one strand is in the foreground at a given time (i.e., transitions between strands are akin to a figure-ground reversal). Furthermore, a life is different from the sum of its strands: It is a nonlinear system that can take on configurations not predictable from a comprehensive description of the individual strands. Two such examples are the achievement of greatness despite severe handicaps and instances of extreme self-sacrifice. I also discuss the research potential of a proposed smartphone app called LifeMaps.
Fixation of fifth metacarpal neck fractures: a comparison of medial locking plates with intramedullary K-wires
Authors: Chen Kuan-Jung , Wang Jung-Pan , Yin Cheng-Yu , Huang Hui-Kuang , Chang Ming-Chau , Huang Yi-Chao
Published: January 2020

Surgical treatment for metacarpal neck fractures may be indicated for malrotation, palmar angulation exceeding 30° or metacarpal shortening exceeding 3 mm, although these thresholds have not been firmly established. In a retrospective study, we compared the clinical and radiographic results of 54 patients with displaced fifth metacarpal neck fractures who were treated with either medial locking plates (14 patients) or retrograde intramedullary K-wires (40 patients). At a mean follow-up of 26 months (range 12 to 62), metacarpal shortening and angulation were 2 mm greater and 4° greater, respectively, in the K-wire group. The plate group had an earlier return to work and greater aesthetic satisfaction, but operative time and complication incidence were higher. Range of motion, time to union, grip strength and Quick Disability of the Arm, Shoulder and Hand scores were similar. We conclude that medial plating offers no clear advantage over K-wire fixation in treating metacarpal neck fractures.

Level of evidence: III
HR Journey in a Family-owned Business: The Evolved Owner Makes a Difference
Authors: Bhargava Pankaj
Published: January 2020

What does it take for a family-run business that has a legacy of generations to become known as a best-in-class professionally run organisation—preferred as a workplace by talent, creating leaders for the industry and ambassadorship among employees and alumni?

This is the HR journey of Marico, led by an evolved owner, Mr Harsh Mariwala.

In this article, we discuss four key HR practices of attracting talent, induction and probation of recruited talent, building accountability and developing talent. These practices work on principles that have withstood the test of time, evolving with the changing context of the business and external environment. These also represent the evolution of the HR role over a period of time.

The author then elaborates how a professional work culture got institutionalised in Marico.
RGL2 Deficiency Impairs Human Erythropoiesis By Altering Terminal Erythroid Differentiation and Apoptosis
Authors: Lesmana Harry , Christakopoulos Georgios E , Risinger Mary , Sakthivel Haripriya , Niss Omar , Kalfa Theodosia A.
Published: January 2020

Several members of the Ras-GTPases have been shown to play major roles as molecular switches in various signaling pathways in hematopoietic cells. The roles of Ras/MAPKs/ERK signaling pathways in EPO-induced erythroid differentiation have been explored in the past on animal models. Recently, the Ras/RalGEFs/Ral pathway has been a focus of research in oncology given its roles in tumorigenesis. However, its role in normal human erythropoiesis is poorly understood. The seven RalGEF family members are guanine nucleotide exchange factors with unique as well as overlapping roles. They bridge activated Ras to activation of RalA and RalB while they have also been shown to promote Akt activation. Recently, we identified and characterized a homozygous splicing variant (c.1580+4T>A) in RGL2 (Ral Guanine Nucleotide Dissociation Stimulator-Like 2) gene, one of the RalGEFs, in a 16 month-old female patient with a recessive form of familial syndromic pancytopenia, more severe in the erythroid lineage with transfusion-dependent anemia, hepatosplenomegaly, liver fibrosis, and cardiac dysfunction. We verified by RT-PCR that this splicing variant was associated by a decrease in the RGL2 expression levels by 70-96% in the white blood cells and reticulocytes of the patient. We hypothesized that decreased RGL2 expression leads to defective human erythropoiesis by altering terminal erythroid differentiation, erythroblast cell cycle progression and/or apoptosis.

To test our hypothesis, we transduced human bone marrow derived CD34+ cells (donated by healthy volunteers under an IRB-approved research protocol in our institution) with lentivirus encoding shRNA targeting RGL2 mRNA and then cultured them in a previously validated 3-phase culture system that recapitulates erythropoiesis ex vivo. A scrambled shRNA sequence was used as control. The efficiency of the shRNAs used to knock-down (KD) RGL2 expression was initially validated by qRT-PCR after transduction of K562 cells. Our study demonstrated that knockdown of RGL2 expression resulted in decreased erythroid cell growth in ex vivo erythropoiesis accompanied by increased apoptosis. We further showed that knockdown of RGL2 expression also led to delayed terminal erythroid differentiation by flow cytometric analysis using glycophorin A (GPA), band 3, and α4-integrin as markers of maturing erythroblasts. This finding was corroborated by morphology studies using Wright staining in cytospins from RGL2-KD cultures and control. Together, our studies indicate an essential role for RGL2 and the Ras/RGL2/Ral pathway in human erythropoiesis, affecting both terminal erythroid differentiation and apoptosis. Our findings not only provide insights into regulation of normal erythropoiesis but also indicate that RGL2 may be a novel candidate gene associated with inherited bone marrow failure syndromes.

Disclosures

No relevant conflicts of interest to declare.
Cytotoxycity and antiplasmodial activity of phenolic derivatives from Albizia zygia (DC.) J.F. Macbr. (Mimosaceae)
Authors: Koagne Romeol Romain , Annang Frederick , Cautain Bastien , Martín Jesús , Pérez-Moreno Guiomar , Bitchagno Gabin Thierry M. , González-Pacanowska Dolores , Vicente Francisca , Simo Ingrid Konga , Reyes Fernando , Tane Pierre
Published: January 2020

Background

The proliferation and resistance of microorganisms area serious threat against humankind and the search for new therapeutics is needed. The present report describes the antiplasmodial and anticancer activities of samples isolated from the methanol extract of Albizia zygia (Mimosaseae).

Material

The plant extract was prepared by maceration in methanol. Standard chromatographic, HPLC and spectroscopic methods were used to isolate and identify six compounds (1–6). The acetylated derivatives (7–10) were prepared by modifying 2-O-β-D-glucopyranosyl-4-hydroxyphenylacetic acid and quercetin 3-O-α-L-rhamnopyranoside, previously isolated from A. zygia (Mimosaceae). A two-fold serial micro-dilution method was used to determine the IC50s against five tumor cell lines and Plasmodium falciparum.

Results

In general, compounds showed moderate activity against the human pancreatic carcinoma cell line MiaPaca-2 (10 < IC50 < 20 μM) and weak activity against other tumor cell lines such as lung (A-549), hepatocarcinoma (HepG2) and human breast adenocarcinoma (MCF-7and A2058) (IC50 > 20 μM). Additionally, the two semi-synthetic derivatives of quercetin 3-O-α-L-rhamnopyranoside exhibited significant activity against P. falciparum with IC50 of 7.47 ± 0.25 μM for compound 9 and 6.77 ± 0.25 μM for compound 10, higher than that of their natural precursor (IC50 25.1 ± 0.25 μM).

Conclusion

The results of this study clearly suggest that, the appropriate introduction of acetyl groups into some flavonoids could lead to more useful derivatives for the development of an antiplasmodial agent.
Mesenchymal stem cells promote human melanocytes proliferation and resistance to apoptosis through PTEN pathway in vitiligo
Authors: Zhu Lifei , Lin Xi , Zhi Lin , Fang Yushan , Lin Keming , Li Kai , Wu Liangcai
Published: January 2020

Background

Vitiligo is an acquired chronic and recurrent skin disease that causes a depigmentation disorder, resulting in selective destruction of melanocytes (MC). However, the mechanism that leads to melanocyte dysfunction and death remains unclear.

Methods

We performed RNA sequencing, immunohistochemistry, and immunoblotting to characterize the patterns of phosphatase and tensin homolog (PTEN)/phosphatidylinositol 3 kinase (PI3K)/protein kinase B (AKT) pathway activation in vitiligo. We also cocultured primary melanocytes with mesenchymal stem cells (MSCs) in a Transwell system to explore how MSCs inhibit the PTEN/PI3K/AKT pathway in melanocytes.

Results

We identified that vitiligo normal-lesional junction skin presented with high expression of PTEN, which led to the inhibition of AKT phosphorylation (p-AKT) at S-473. Furthermore, PTEN overexpression led to oxidative stress-induced apoptosis in melanocytes. Coculturing with MSCs enhanced the cell proliferation of human melanocytes and repressed PTEN expression, which inhibited oxidative stress-induced apoptosis.

Conclusion

We report that vitiligo patients present with high PTEN expression, which may play a role in the impairment of melanocytes. Furthermore, our study provides evidence that MSCs target the PTEN/PI3K/AKT pathway to regulate cell proliferation and apoptosis in human melanocytes, indicating that MSCs may serve as a promising therapy for vitiligo.
Recombinant expression and biochemical characterization of a novel keratinase BsKER71 from feather degrading bacterium Bacillus subtilis S1-4
Authors: Yong Bin , Fei Xueting , Shao Huanhuan , Xu Pan , Hu Youwen , Ni Weimin , Xiao Qiuju , Tao Xiang , He Xinyi , Feng Hong
Published: January 2020

Bacillus subtilis S1-4, isolated from chicken feather could efficiently degrade feathers by secreting several extracellular proteases. In order to get insight into the individual protease involved in keratin hydrolysis, a keratinase designed as BsKER71 was cloned and expressed in Bacillus subtilis WB600. In silico analysis revealed that BsKER71 protein contained a mature protein of 36.1 kDa. Further, purified BsKER71 could hydrolyze a variety of natural proteins, such as fibrous protein, collagen protein, casein, keratin and bovine serum albumin. In addition, this keratinase exhibited high enzyme activity in a wide range of pH and optimal pH of 10.0 and 9.0 in the hydrolysis of casein and keratin, respectively. Similarly, the optimal temperature was 55 °C and 50 °C for the hydrolysis of above two substrates, respectively. The hydrolytic activity was significantly inhibited by phenylmethanesulfonyl fluoride (PMSF), indicating the presence of serine residue in the active site. Moreover, ethylenediaminetetraacetic acid (EDTA) and phenanthroline moderately inhibited the hydrolytic activity. The catalytic activity was stimulated by Mg2+ and Ca2+, but greatly inhibited by Cu2+. Furthermore, several chemicals exhibited different effects on the hydrolysis of casein and keratin by BsKER71. These results provided a better understanding of BsKER71 from feather degrading bacterium B. subtilis S1-4.
Sagittal alignment in an MR-TRUS fusion biopsy using only the prostate contour in the axial image
Authors: Igarasihi Riki , Koizumi Norihiro , Nishiyama Yu , Tomita Kyohei , Shigenari Yuka , Shoji Sunao
Published: January 2020

Purpose

This paper examines the feasibility of automated alignment in sagittal direction in MR-TRUS fusion biopsy of the prostate by comparing the prostate contour in axial images between different modalities. In the treatment of prostate cancer, an important factor affecting the prognosis of patients is focal therapy of cancer within the prostate. Therefore, MR-TRUS fusion biopsy of the prostate is attracting attention as one of the most effective localization techniques. Because the accuracy of this biopsy is highly dependent on the doctor performing it, automation should reduce variability in diagnostic performance.

Method

The MR image is scaled to the same scale as the TRUS image, and the contours of the prostate on the MR and TRUS images are compared in polar coordinates. In addition, this method makes it possible to perform a robust comparison against deformation by comparing specific angle ranges. It is also possible to improve the accuracy of error calculation by accumulating contour data.

Result

The axial image selected by the proposed method using the prostate contour obtained from the doctor-labeled segmentation image has an error of about 4 mm in the sagittal direction on average compared to the axial image selected by the doctor did. Furthermore, using the inaccurate prostate contours obtained by performing segmentation with U-Net only slightly reduced the accuracy. In addition, it was found that alignment accuracy is improved by using the angler weight.

Conclusion

It has been shown that sagittal alignment can be performed with some degree of accuracy using only axial images. Also, the angular weight values used indicate that when comparing axial images, it may be an important factor in determining the same axial cross section to compare the parts that deform due to probe pressure.
Metachronous liver metastases after long-term follow-up of endoscopic resection for rectal neuroendocrine neoplasms: a report of three cases
Authors: Hane Yuma , Tsuchikawa Takahiro , Tanaka Kimitaka , Nakanishi Yoshitsugu , Asano Toshimichi , Noji Takehiro , Kurashima Yo , Ebihara Yuma , Murakami Soichi , Nakamura Toru , Okamura Keisuke , Takeuchi Satoshi , Shichinohe Toshiaki , Hirano Satoshi
Published: January 2020

Background

Rectal neuroendocrine neoplasms (NENs) are rare, but their incidence has increased in recent years. The metastasis rate is low in cases of a tumor diameter < 1 cm or depth of invasion lower than the submucosa; therefore, the European Neuroendocrine Tumor Society (ENETS) and the North American Neuroendocrine Tumor Society (NANETS) consensus guidelines recommend endoscopic resection. Since little has been reported on the long-term prognosis of endoscopic resection for rectal NEN, consensus is lacking regarding the follow-up period after endoscopic resection.

Case presentation

Here, we report three cases of metachronous liver metastasis after long-term follow-up of endoscopic mucosal resection (EMR) for rectal NEN. The pathological findings indicated a depth lower than the submucosa and complete radical resection in all cases and lymphovascular invasion in only one case. All three cases showed metachronous multiple liver metastases after 9–13 years of follow-up for EMR, despite achieving complete resection and without muscular invasion.

Conclusions

Metachronous liver metastases may occur after long interval following endoscopic resection; thus, long-term follow-up is necessary after endoscopic resection for rectal NEN.
Effect of different fermentation strategies on Bacillus thuringiensis cultivation and its toxicity towards the bagworm, Metisa plana Walker (Lepidoptera: Psychidae)
Authors: Masri Mohamed Mazmira Mohd , Ariff Arbakariya Bin
Published: January 2020

The effect of batch and fed-batch fermentation on the cultivation performance of Bacillus thuringiensis was investigated using a 5-l stirred tank bioreactor. Significantly higher viable cell count (> 1.5 × 1012 CFU/ml) was obtained in the fed-batch compared to batch fermentation (1.4 × 1012 CFU/ml). Glucose feeding during the fermentation seemed to enhance cell growth but failed to enhance the sporulation rate. It was found that sporulation and δ-endotoxin synthesis in fed-batch fermentation could be enhanced by the application of optimal dissolved oxygen tension (DOT) control strategy without affecting the cell growth. Fed-batch cultivation with feeding at the exponential growth phase where the DOT was switched from 80 to 40% at 12 h of cultivation recorded the highest spore count of 7.1 × 1011 spore/ml. Cultures obtained from batch cultivation, as well as fed-batch cultivation with feeding at lag or exponential growth phase and the application of optimal DOT control strategy, recorded the presence of δ-endotoxin; however, none was detected in intermittent fed-batch fermentation. Bioassay data against the bagworm Metisa plana Walker (Lepidoptera: Psychidae) recorded the highest corrected mortality (80%) at 7 days of treatment (DAT), using the culture obtained from fed-batch cultivation with feeding during the exponential growth phase, and the DOT was switched from 80 to 40% at 12 h of cultivation. It is important to note that all cultures containing δ-endotoxin exhibited 100% mortality towards M. plana at 14 DAT.
A second-take on the role of science: the case for applying public administration theory to natural resource management
Authors: Brock Philippa M. , Tan Daniel K. Y.
Published: January 2020

Background

Natural resource management theory has been informed by disciplines such as ecology, agricultural science, economics and engineering; but much less so by the literature of planning and public administration. This paper demonstrates that applying an incremental view to what is traditionally seen as a rational-comprehensive discipline provides insights into resource management theory and practice, including adaptive management.

Results

We show how current theory and practice in natural resource management are not aligned to the degree that is routinely presumed. In particular, the prevailing focus on optimality creates conflicts, especially during democratic decision-making, whereas adopting a participatory-incremental hybrid approach should provide a superior solution, which is discussed here in the context of Life Cycle Assessment by resource managers.

Conclusion

Resource management tends to be both incremental and participatory; and whilst decisions are strongly informed by science, on reflection, the process of formulating decisions is rarely rational-comprehensive. We suggest greater retrospective analysis of resource management decisions at a theoretical level. This may result in adoption of a theoretical framework which better supports practice, a reduction in tensions between those trained in the arts and sciences; and more ‘freedom’ in practice, through a softening of the focus on optimality.
Magnetic resonance spectroscopy in pediatric brain tumors: how to make a more confident diagnosis
Authors: Attia Noha M. , Sayed Samy Abdel Aziz , Riad Khaled Fathy , Korany Ghada Mahmoud
Published: January 2020

Background

Non-invasive diagnosis of pediatric brain tumors can be challenging due to diverse tumor pathologies and similar imaging appearances. Magnetic resonance spectroscopy (MRS), when combined with high spatial resolution anatomic imaging obtained with conventional magnetic resonance imaging (MRI), provides metabolic information within the lesion as well as the surrounding tissue. The differentiation of neoplastic from non-neoplastic lesions and low-grade from high-grade neoplasms is essential for determining the choice of treatment and the best treatment plan. We aimed to measure specific metabolic ratios and evaluate metabolic profiles of various lesions by MRS to assist in making a more confident diagnosis.

Results

The choline/creatine (Cho/Cr), choline/N-acetylaspartate (Cho/NAA), and Cho/NAA+Cr ratios all had statistically significant values for the differentiation between neoplastic and non-neoplastic lesions at cutoffs 1.8, 2, and 0.8 respectively. The Cho/NAA, Cho/Cr, Cho/NAA+Cr, and myo-inositol/creatine (mI/Cr) ratios all had statistically significant values for the differentiation of high-grade from low-grade neoplasms at cutoffs 3.3, 3.5, 1.3, and 1.5 respectively. The presence of a lipid lactate peak was only significant for differentiating high-grade from low-grade neoplasms. Medulloblastomas, diffuse pontine gliomas, and choroid plexus carcinoma all showed characteristic metabolic profiles on MRS. Metastasis showed lower Cho/NAA and Cho/Cr ratios outside the tumor margin than high-grade neoplasms.

Conclusion

The use of certain metabolite ratios with high sensitivity and specificity to distinguish neoplastic from non-neoplastic lesions and low-grade from high-grade neoplasms while assessing the metabolic profile of the lesion aids in the non-invasive diagnosis of pediatric brain tumors. MRS facilitates earlier treatment planning by determining tumor spatial extent and predicting tumor behavior with potential to solve sampling problems of inaccessible and heterogenous lesions as well as unnecessary sampling of benign lesions.
Leucine-rich repeat containing 8A contributes to the expansion of brain ventricles in zebrafish embryos
Authors: Tseng Yen-Tzu , Ko Chun-Lin , Chang Chia-Teng , Lee Yen-Hua , Huang Fu Wei-Chun , Liu I-Hsuan
Published: January 2020

The sodium osmotic gradient is necessary for the initiation of brain ventricle inflation, but a previous study predicted that organic and inorganic osmolytes play equivalently important roles in osmotic homeostasis in astrocytes. To test whether organic osmoregulation also plays a role in brain ventricle inflation, the core component for volume-regulated anion and organic osmolyte channel, lrrc8a, was investigated in zebrafish model. RT-PCR and whole-mount in situ hybridization indicated that both genes were ubiquitously expressed through 12 hpf, and around the ventricular layer of neural tubes and the cardiogenic region at 24 hpf. Knocking down either one lrrc8a paralog with morpholino oligos resulted in abnormalities in circulation at 32 hpf. Morpholino oligos or CRISPR interference against either paralog led to smaller brain ventricles at 24 hpf. Either lrrc8aa or lrrc8ab mRNA rescued the phenotypic penetrance in both lrrc8aa and lrrc8ab morphants. Supplementation of taurine in the E3 medium and overexpression csad mRNA also rescued lrrc8aa and lrrc8ab morphants. Our results indicated that the two zebrafish lrrc8a paralogs are maternal message genes and were ubiquitously expressed in early embryos. The two genes play redundant roles in the expansion of brain ventricles and the circulatory system and taurine contribute to the brain ventricle expansion via volume-regulated anion and organic osmolyte channel.
Introduction
Authors: Jurgutienė Aušra , Talviste Katre
Published: January 2020

Introduction
Folk Tradition and Multimedia in Contemporary Estonian Culture
Authors: Mihkelev Anneli
Published: January 2020

The legends of the kratt or the treasure-bearer have existed in lively oral tradition in Estonian culture for a very long time. These myths and legends have traversed from the oral tradition to literary works, visual culture and music. All these texts on the kratt exist in the culture as metatexts which create the world of the kratt, where different cultural memories and interpretations are intertwined. This means that the kratt as a cultural text is also a multimedial text. Different media use different tools and this makes the interpretations more playful and interesting. Andrus Kivirähk’s novel Rehepapp (The Old Barny, 2000) is the central literary work on the kratt in contemporary Estonian literature. Kivirähk combines the mythical kratt with the figure of Old Barny (rehepapp), who is the unofficial leader of the village and a cunning manor house barn-keeper. There are several cultural texts based on Kivirähk’s novel, but the most important are the opera Rehepapp (2013) by Tauno Aints, libretto by Urmas Lennuk, and the film November (2016) by Rainer Sarnet. The 2015 production of the ballet Kratt (1943) by Eduard Tubin is more contemporary in its setting and represents everyday life in the modern factory. The article analyses how different multimedial texts about the kratt and Old Barny use and combine multimedia to create and convey the social meaning of the kratt, and how multimedia use audio-visual poetics to convey a greater number of emotions and aesthetic values in the cultural text. The film by Rainer Sarnet and the ballet by Eduard Tubin represent harmony with different poetics factors and the meanings of the cultural texts.