bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Stage–Discharge Relationship Stability Based on Historical Ratings
Authors: Rojas Marcela , Quintero Felipe , Young Nathan
Published: June 2020

We explored the stability of the rating curves at six streamflow gauging sites in the state of Iowa, USA, to examine temporal variability of their stage–discharge relationships. The analyzed sites have up to 10 years of rating and shift records. Rating curve shifts reflect the alteration of channel geometry caused by scouring and sediment deposition. We studied how rating shifts are connected to the occurrence of flood events and drought periods over time. We found that most rating curve changes take place during spring and summer, which are the seasons with more precipitation in Iowa. We quantified stability in terms of standard deviation of stages for a continuous range of discharges in a rating curve, and show that most of the sites exhibit greater standard stage deviation for discharge–flood ratios smaller than 1, while for larger discharge–flood ratios, the deviation decreases. In stable rating curves, the stage deviation tends to decrease as discharge increases. Non-stable rating curves exhibit large stage deviation in the stage–discharge relationship throughout all stages.
How Does Perfectionism Influence the Development of Psychological Strengths and Difficulties in Children?
Authors: Melero Silvia , Morales Alexandra , Espada José Pedro , Fernández-Martínez Iván , Orgilés Mireia
Published: June 2020

This study aimed to examine differences in gender, age, and psychopathology, according to the perfectionism level, and to analyze how perfectionism dimensions contribute to the development of psychological strengths and difficulties in children. Participants were 319 Spanish students (52.4% girls) between 7 and 11 years old (M = 9.38, SD = 1.15). Children completed self-reported measures of perfectionism and psychological strengths and difficulties. The sample was divided into groups based on the perfectionism level (high, medium, and low). A one-way ANOVA (Analysis of variance), t-test, Pearson correlations, and 3-step hierarchical regression analyses were run. Results showed that 27.6% of the children belonged to the high perfectionism group, characterized by an elevated Socially Prescribed Perfectionism (SPP). Compared to girls, boys presented higher scores in all perfectionism measures. The younger children presented higher SPP and lower Self-oriented Perfectionism-Critical (SOP-Critical) than the older group. High perfectionism was related to psychological problems. The SOP-Critical increased the likelihood of developing emotional symptoms and total difficulties, and SPP was associated with behavioral and peer problems. In contrast, Self-oriented Perfectionism-Striving (SOP-Striving) was related to greater prosocial behavior. This research has important implications for the design of transdiagnostic strategies targeting the prevention and intervention of psychological difficulties in schoolchildren.
Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations
Authors: Martínez-Sanz José Miguel , Fernández Nuñez Ana , Sospedra Isabel , Martínez-Rodríguez Alejandro , Domínguez Raúl , González-Jurado José Antonio , Sánchez-Oliver Antonio J.
Published: June 2020

During the last few years, the numbers of competitors in endurance and ultra-endurance sports modalities have increased significantly. This type of competition is an extreme challenge for athletes. Therefore, they have an increased the risk of developing medical and nutritional problems. The aim of the work is to estimate the incidence of nutrition-related adverse outcomes in endurance and ultra-endurance sports, considering the variables that influence them. A critical review was carried out based on the PubMed database, by means of a search strategy based on keywords separated by Boolean connectors. For all the results obtained in a period from 2008 to 2019, a series of inclusion/exclusion criteria was applied to select only the studies that fitted the objective of the present study. Results and discussion: Of the 871 publications identified, 33 met the inclusion criteria. The adverse outcomes found included exercise-associated hyponatremia (EAH), heat stroke by exertion (EHS), gastrointestinal (GI) problems, dehydration, and hypothermia; the provision of misinformation to athletes about nutrient intake and hydration during competition was identified as the main cause. Conclusions: The main adverse outcomes in endurance and ultra-endurance sports modalities are EAH, GI inconveniences, and EHS. These problems can affect the performance and health status of the athlete during and post-competition. Several nutritional guidelines have been suggested that can prevent these adverse outcomes, and it is essential to individualize and adjust the nutritional intake and hydration status according to the characteristics of each competition.
Hiking Time Trial Performance in the Heat with Real-Time Observation of Heat Strain, Hydration Status and Fluid Intake Behavior
Authors: Linsell Joshua D. , Pelham Emily C. , Hondula David M. , Wardenaar Floris C.
Published: June 2020

This study investigated the real-time progression of heat strain in mountain hikers during time trials (TT). Participants (n = 12; 7M/5F; age 21.6 ± 2.47) attempted to climb Tempe Butte (~1.1 mi) four times in HOT and MOD trials (wet bulb globe temperature 31.6 °C vs. 19.0 °C). Performance, physiological outcomes, and fluid intake behavior were measured in real-time. Hot conditions significantly impaired hiking TT performance by 11%, reduced aerobic capacity by 7%, increased peak rate of perceived exertion (RPE) by 19%, and elevated core temperature (Tc) by 0.7 °C compared to MOD (all p < 0.03). Less-aerobically-fit participants were most negatively-affected by heat stress. Based on sweat lost, participants in HOT required 2.26 ± 0.91 L of fluids, brought 1.52 ± 0.83 L, and consumed 1.54 ± 0.49 L, losing an average of 1.1% ± 1.0%BM. Participants in MOD required 1.28 ± 0.39 L of fluids, brought 1.57 ± 1.09 L, and consumed 0.79 ± 0.57 L, losing an average of 1.0% ± 0.8%BM. Morning-after urine specific gravity (USG) values revealed 75% of hikers were hypohydrated (USG ≥ 1.020) after HOT; 67% after MOD. Heat stress impairs hiking TT performance while increasing RPE and Tc. Fitter participants showed less performance and physiological impairment from heat stress. Although hikers in both conditions lost similar body weight, hikers were limited in HOT by fluid availability, whereas in MOD, fluid was available and dehydration was voluntary.
Effect of Morning vs. Evening Turmeric Consumption on Urine Oxidative Stress Biomarkers in Obese, Middle-Aged Adults: A Feasibility Study
Authors: Blanton Cynthia , Gordon Barbara
Published: June 2020

The circadian rhythm of biological systems is an important consideration in developing health interventions. The immune and oxidative defense systems exhibit circadian periodicity, with an anticipatory increase in activity coincident with the onset of the active period. Spice consumption is associated with enhanced oxidative defense. The objective of this study was to test the feasibility of a protocol comparing the effects of morning vs. evening consumption of turmeric on urine markers of oxidative stress in obese, middle-aged adults. Using a within-sample design, participants received each of four clock time x treatment administrations, each separated by one week: morning turmeric; evening turmeric; morning control; evening control. Participants prepared for each lab visit by consuming a low-antioxidant diet for two days and fasting for 12 h. Urine was collected in the lab at baseline and one-hour post-meal and at home for the following five hours. The results showed that the processes were successful in executing the protocol and collecting the measurements and that participants understood and adhered to the instructions. The findings also revealed that the spice treatment did not elicit the expected antioxidant effect and that the six-hour post-treatment urine collection period did not detect differences in urine endpoints across treatments. This feasibility study revealed that modifications to the spice treatment and urine sampling timeline are needed before implementing a larger study.
Primary Care Professionals’ Acceptance of Medical Record-Based, Store and Forward Provider-to-Provider Telemedicine in Catalonia: Results of a Web-Based Survey
Authors: Vidal-Alaball Josep , López Seguí Francesc , Garcia Domingo Josep Lluís , Flores Mateo Gemma , Sauch Valmaña Gloria , Ruiz-Comellas Anna , Marín-Gomez Francesc X , García Cuyàs Francesc
Published: June 2020

While telemedicine services enjoy a high acceptance among the public, evidence regarding clinician’s acceptance, a key factor for sustainable telemedicine services, is mixed. However, telemedicine is generally better accepted by both patients and professionals who live in rural areas, as it can save them significant time. The objective of this study is to assess the acceptance of medical record-based, store and forward provider-to-provider telemedicine among primary care professionals and to describe the factors which may determine their future use. This is an observational cross-sectional study using the Catalan version of the Health Optimum questionnaire; a technology acceptance model-based validated survey comprised of eight short questions. The online, voluntary response poll was sent to all 661 primary care professionals in 17 primary care teams that had potentially used the telemedicine services of the main primary care provider in Catalonia, in the Central Catalan Region. The majority of respondents rated the quality of telemedicine consultations as “Excellent” or “Good” (83%). However, nearly 60% stated that they sometimes had technical, organizational or other difficulties, which might affect the quality of care delivered. These negatively predicted their declared future use (p = 0.001). The quality of telemedicine services is perceived as good overall for all the parameters studied, especially among nurses. It is important that policymakers examine and provide solutions for the technical and organizational difficulties detected (e.g., by providing training), in order to ensure the use of these services in the future.
Effects of Particulate Matter Education on Self-Care Knowledge Regarding Air Pollution, Symptom Changes, and Indoor Air Quality among Patients with Chronic Obstructive Pulmonary Disease
Authors: Guo Su-Er , Chi Miao-Ching , Hwang Su-Lun , Lin Chieh-Mo , Lin Yu-Ching
Published: June 2020

The burden of illness resulting from adverse environmental exposure is significant. Numerous studies have examined self-care behaviors among patients with chronic obstructive pulmonary disease (COPD), but seldom assess these behaviors in relation to air pollution. The study aims to examine the effects of particulate matter (PM) education on prevention and self-care knowledge regarding air pollution, symptom changes, and indoor PM concentration levels among patients with COPD. A longitudinal, quasi-experimental design using a generalized estimating equation examined the effectiveness of the education intervention. Participants were 63 patients with COPD, of whom only 25 received intervention. Levels of PM2.5 and PM10 decreased in the first-month follow-up in the experimental group. Improvement of knowledge and prevention regarding PM in the first and third months were also greater in the experimental group compared to the control. Regarding the COPD assessment test and physical domain scores, the experimental group exhibited a greater improvement in the first-month follow-up. Scores on the psychological domain significantly changed in the sixth-month follow-up. The PM education coordinated by nurses improved the health of participants, maintaining six-month effects. Further studies should evaluate the practice barriers and effects of health education on preventive self-care behaviors regarding indoor PM among patients with COPD.
Hospital Staff Report It Is Not Burnout, but a Normal Stress Reaction to an Uncongenial Work Environment: Findings from a Qualitative Study
Authors: Kendrick Madeleine , Kendrick Kevin , Morton Peter , Taylor Nicholas F. , Leggat Sandra G.
Published: June 2020

(1) Background: The issue of burnout in healthcare staff is frequently discussed in relation to occupational health. In this paper, we report healthcare staff experiences of stress and burnout. (2) Methods: In total, 72 healthcare staff were interviewed from psychiatry, surgery, and emergency departments at an Australian public health service. The sample included doctors, nurses, allied health professionals, administrators, and front-line managers. Interview transcripts were thematically analyzed, with participant experiences interpreted against descriptors of burnout in Maslach’s Burnout Inventory and the International Statistical Classification of Diseases and Related Health Problems (ICD-11). (3) Results: Staff experiences closely matched the ICD-11 description of stress associated with working in an uncongenial workplace, with few reported experiences which matched the ICD-11 descriptors of burnout. (4) Conclusion: Uncongenial workplaces in public health services contribute to healthcare staff stress. While previous approaches have focused on biomedical assistance for individuals, our findings suggest that occupational health approaches to addressing health care staff stress need greater focus on the workplace as a social determinant of health. This finding is significant as organizational remedies to uncongenial stress are quite different from remedies to burnout.
“Too Grey To Be True?” Sexual Violence in Older Adults: A Critical Interpretive Synthesis of Evidence
Authors: Nobels Anne , Vandeviver Christophe , Beaulieu Marie , Cismaru Inescu Adina , Nisen Laurent , Van Den Noortgate Nele , Vander Beken Tom , Lemmens Gilbert , Keygnaert Ines
Published: June 2020

Sexual violence (SV) is an important public health issue with a major impact on victims and their peers, offspring and community. However, SV in older adults is under-researched. This paper aims to establish the prevalence and nature of SV in older adults in Europe, link this with existing policies and health care workers’ response to sexual health needs in older age, and critically revise the currently used frameworks in public health research. To fill this gap in the literature, we applied a Critical Interpretative Synthesis (CIS) approach. The CIS approach uses techniques from grounded theory and processes from systematic review. It allows to critically interpret key findings from both academic as well as grey literature, engendering theory refining. In the first phase of purposive sampling, we conducted a systematic review of academic sources and included 14 references. The cut-off age used to define old age varied between 60 and 70 years old among the included studies. Subsequently we added another 14 references in the second phase of theoretical sampling. We ultimately included 16 peer-reviewed articles and 12 documents from the grey literature. The CIS results demonstrate that knowledge of SV in older adults is still limited. The current research suggests that SV in older adults rarely occurs, however, prevalence rates are likely to be underestimated because of methodological shortcomings. The complexity of SV in older adults is not acknowledged in ongoing research due to the conflation of SV with other types of violence. Information on specific risk factors and about assailants committing SV in old age is absent. Policy documents dealing with sexual and reproductive health, rights and ageing make no mention of SV in older adults. In clinical practice, the sexual health needs of older adults often remain unmet. In conclusion, our findings suggest that older adults are forgotten in prevention and response to SV. Greater awareness about this topic could contribute to a revision of current policies and health care practices, leading to more tailored care for older victims of SV.
Geovisualization of the Excavation Process in the Lesvos Petrified Forest, Greece Using Augmented Reality
Authors: Papadopoulou Ermioni-Eirini , Kasapakis Vlasios , Vasilakos Christos , Papakonstantinou Apostolos , Zouros Nikolaos , Chroni Athanasia , Soulakellis Nikolaos
Published: June 2020

Augmented reality (AR), in conjunction with 3D geovisualization methods, can provide significant support in monitoring geoconservation activities in protected geosites, such as the excavation process in fossil sites. The excavation process requires a monitoring methodology that will provide a complete and accurate overview of the fossils, their dimensions, and location within the different pyroclastic horizons, and the progress of the excavation works. The main purpose of this paper is the development of a user-friendly augmented map application, specifically designed for tracking the position of petrified tree trunks, providing information for their geometric features, and mapping the spatiotemporal changes occurring in the surrounding space. It also aims to probe whether the rapid acquisition of a 4K video can generate cartographic derivatives of petrified findings during a geosite excavation. A database accumulated 2D and 3D cartographic information, while the geovisualization environment displayed the surface alterations, at two scales: a) 1:500 (excavation area) and b) 1:50 (trench level). Unmanned aerial systems (UASs), used for data acquisition in three excavation periods, consisted of two flights at two different altitudes: one to record changes throughout the study area and the other to provide information on trunks at trench level, via a high-resolution (4K) video. Image-based 3D modeling followed, in which image georeferencing was conducted with ground control points (GCPs). Finally, 2D and 3D geovisualizations were created to depict the excavation changes through time. The cartographic products generated at two cartographic scales depicted the spatiotemporal changes of the excavation.
Flight Planning for LiDAR-Based UAS Mapping Applications
Authors: Alsadik Bashar , Remondino Fabio
Published: June 2020

In the last two decades, unmanned aircraft systems (UAS) were successfully used in different environments for diverse applications like territorial mapping, heritage 3D documentation, as built surveys, construction monitoring, solar panel placement and assessment, road inspections, etc. These applications were correlated to the onboard sensors like RGB cameras, multi-spectral cameras, thermal sensors, panoramic cameras, or LiDARs. According to the different onboard sensors, a different mission plan is required to satisfy the characteristics of the sensor and the project aims. For UAS LiDAR-based mapping missions, requirements for the flight planning are different with respect to conventional UAS image-based flight plans because of different reasons related to the LiDAR scanning mechanism, scanning range, output scanning rate, field of view (FOV), rotation speed, etc. Although flight planning for image-based UAS missions is a well-known and solved problem, flight planning for a LiDAR-based UAS mapping is still an open research topic that needs further investigations. The article presents the developments of a LiDAR-based UAS flight planning tool, tested with simulations in real scenarios. The flight planning simulations considered an UAS platform equipped, alternatively, with three low-cost multi-beam LiDARs, namely Quanergy M8, Velodyne VLP-16, and the Ouster OS-1-16. The specific characteristics of the three sensors were used to plan flights and acquired dense point clouds. Comparisons and analyses of the results showed clear relationships between point density, flying speeds, and flying heights.
Evaluation of Key Security Issues Associated with Mobile Money Systems in Uganda
Authors: Ali Guma , Ally Dida Mussa , Elikana Sam Anael
Published: June 2020

Smartphone technology has improved access to mobile money services (MMS) and successful mobile money deployment has brought massive benefits to the unbanked population in both rural and urban areas of Uganda. Despite its enormous benefits, embracing the usage and acceptance of mobile money has mostly been low due to security issues and challenges associated with the system. As a result, there is a need to carry out a survey to evaluate the key security issues associated with mobile money systems in Uganda. The study employed a descriptive research design, and stratified random sampling technique to group the population. Krejcie and Morgan’s formula was used to determine the sample size for the study. The collection of data was through the administration of structured questionnaires, where 741 were filled by registered mobile money (MM) users, 447 registered MM agents, and 52 mobile network operators’ (MNOs) IT officers of the mobile money service providers (MMSPs) in Uganda. The collected data were analyzed using RStudio software. Statistical techniques like descriptive analysis and Pearson Chi-Square test was used in data analysis and mean (M) > 3.0 and p-value < 0.05 were considered statistically significant. The findings revealed that the key security issues are identity theft, authentication attack, phishing attack, vishing attack, SMiShing attack, personal identification number (PIN) sharing, and agent-driven fraud. Based on these findings, the use of better access controls, customer awareness campaigns, agent training on acceptable practices, strict measures against fraudsters, high-value transaction monitoring by the service providers, developing a comprehensive legal document to run mobile money service, were some of the proposed mitigation measures. This study, therefore, provides a baseline survey to help MNO and the government that would wish to implement secure mobile money systems.
Analysis of Recent Interception Records Reveals Frequent Transport of Arboreal Ants and Potential Predictors for Ant Invasion in Taiwan
Authors: Lee Ching-Chen , Weng Yi-Ming , Lai Li-Chuan , Suarez Andrew V. , Wu Wen-Jer , Lin Chung-Chi , Yang Chin-Cheng Scotty
Published: June 2020

We uncovered taxonomic diversity, country of origin and commodity type of intercepted ants at Taiwanese borders based on an 8 year database of 439 interception records. We found intercepted ants arrived predominantly via timber, a pattern likely reflecting the high domestic demand for foreign timber in Taiwan. The most frequently intercepted species were either arboreal or wood-dwelling ants, raising a concern of these ants constituting a next wave of ant invasion in Taiwan. Further analyses indicate that the taxonomic composition of intercepted ants does not match that of established non-native ant species, suggesting that interception data alone fails to provide adequate power to predict the establishment success of ants. Yet, interception frequency and selected life-history traits (i.e., flexible colony founding mode and general nesting habits) were shown to jointly serve as a practical predictor of the establishment risk of non-native ants. Consistent with other border interception databases, secondary introduction (i.e., species arriving from their introduced ranges instead of their native ranges) also represents a major pathway for transport of invasive ants into Taiwan, suggesting its role in shaping the global invasion of ants. Our findings offer baseline information for constructing a prediction framework for future ant invasions and assist in the decision-making process of quarantine authorities in Taiwan.
Optimizing Trap Characteristics to Monitor the Leaffooted Bug Leptoglossus zonatus (Heteroptera: Coreidae) in Orchards
Authors: Wilson Houston , Maccaro Jessica , Daane Kent
Published: June 2020

The leaffooted bug, Leptoglossus zonatus (Heteroptera: Coreidae), has become a key pest of almonds, pistachios, and pomegranates in California. Adults and nymphs directly feed on nuts and fruits, which reduces crop yield and quality and can facilitate pathogen infections. Current monitoring strategies require growers to actively sample the tree canopy, with no economic thresholds being developed for this pest. To improve monitoring of L. zonatus, a three-year study was conducted to identify an optimal trap. A hanging cross-vane panel trap was identified as the best trap type in Year 1, and subsequent work in Years 1–3 focused on refining its use by modifying surface texture and color. Results indicated that coating trap surfaces with the lubricant fluon improved trap catching ability, and adults were most frequently recovered in yellow traps. A hanging cross-vane panel trap with these features could serve as the basis for the development of a new monitoring system for this pest in orchards, which could be improved further if semiochemical lures will be developed.
N-Glycosylation Alteration of Serum and Salivary Immunoglobulin A Is a Possible Biomarker in Oral Mucositis
Authors: Gebri Enikő , Kovács Zsuzsanna , Mészáros Brigitta , Tóth Ferenc , Simon Ádám , Jankovics Hajnalka , Vonderviszt Ferenc , Kiss Attila , Guttman András , Hortobágyi Tibor
Published: June 2020

Background: Oral and enteral mucositis due to high-dose cytostatic treatment administered during autologous and allogeneic stem-cell transplantation increases mortality. Salivary secretory immunoglobulin A (sIgA) is a basic pillar of local immunity in the first line of defense. Altered salivary sialoglycoprotein carbohydrates are important in the pathologies in the oral cavity including inflammation, infection and neoplasia. Therefore, we assessed whether changes in the salivary and serum IgA glycosylation correlated with development and severity of oral mucositis. Methods: Using capillary electrophoresis, comparative analysis of serum and salivary IgA total N-glycans was conducted in 8 patients with autologous peripheral stem-cell transplantation (APSCT) at four different stages of transplantation (day −3/−7, 0, +7, +14) and in 10 healthy controls. Results: Fourteen out of the 31 structures identified in serum and 6 out of 38 in saliva showed significant changes upon transplantation compared with the control group. Only serum core fucosylated, sialylated bisecting biantennary glycan (FA2BG2S2) showed significant differences between any two stages of transplantation (day −3/−7 and day +14; p = 0.0279). Conclusion: Our results suggest that changes in the serum IgA total N-glycan profile could serve as a disease-specific biomarker in patients undergoing APSCT, while analysis of salivary IgA N-glycan reflects the effect of APSCT on local immunity.
Role of Advanced Glycation End Products on Aortic Calcification in Patients with Type 2 Diabetes Mellitus
Authors: Sanchis Pilar , Rivera Rosmeri , Fortuny Regina , Río Carlos , Mas-Gelabert Miguel , Gonzalez-Freire Marta , Grases Felix , Masmiquel Luis
Published: June 2020

The aim of this study was to evaluate the relationship between serum levels of advanced glycation end products (AGEs) and abdominal aortic calcification (AAC) in patients with type 2 diabetes mellitus (DM2). This was a prospective cross-sectional study. One-hundred and four consecutive patients with DM2 were given lateral lumbar X-rays in order to quantify abdominal aortic calcification (AAC). Circulating levels of AGEs and classical cardiovascular risk factors were determined. Clinical history was also registered. Patients with higher AGEs values had higher grades of aortic calcification and higher numbers of diabetic-related complications. Multivariate logistic regression analysis showed that being older, male and having high levels of AGEs and triglycerides were the independent risk factors associated to moderate-severe AAC when compared to no-mild AAC. Our results suggest that AGEs plays a role in the pathogenesis of aortic calcifications. In addition, the measurement of AGEs levels may be useful for assessing the severity of AAC in the setting of diabetic complications.
COVID-19: Specific and Non-Specific Clinical Manifestations and Symptoms: The Current State of Knowledge
Authors: Baj Jacek , Karakuła-Juchnowicz Hanna , Teresiński Grzegorz , Buszewicz Grzegorz , Ciesielka Marzanna , Sitarz Ryszard , Forma Alicja , Karakuła Kaja , Flieger Wojciech , Portincasa Piero , Maciejewski Ryszard
Published: June 2020

Coronavirus disease 2019 (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become an epidemiological threat and a worldwide concern. SARS-CoV-2 has spread to 210 countries worldwide and more than 6,500,000 confirmed cases and 384,643 deaths have been reported, while the number of both confirmed and fatal cases is continually increasing. COVID-19 is a viral disease that can affect every age group—from infants to the elderly—resulting in a wide spectrum of various clinical manifestations. COVID-19 might present different degrees of severity—from mild or even asymptomatic carriers, even to fatal cases. The most common complications include pneumonia and acute respiratory distress syndrome. Fever, dry cough, muscle weakness, and chest pain are the most prevalent and typical symptoms of COVID-19. However, patients might also present atypical symptoms that can occur alone, which might indicate the possible SARS-CoV-2 infection. The aim of this paper is to review and summarize all of the findings regarding clinical manifestations of COVID-19 patients, which include respiratory, neurological, olfactory and gustatory, gastrointestinal, ophthalmic, dermatological, cardiac, and rheumatologic manifestations, as well as specific symptoms in pediatric patients.
Speech Perception Changes in the Acoustically Aided, Nonimplanted Ear after Cochlear Implantation: A Multicenter Study
Authors: Svirsky Mario A. , Neuman Arlene C. , Neukam Jonathan D. , Lavender Annette , Miller Margaret K. , Aaron Ksenia A. , Skarzynski Piotr H. , Cywka Katarzyna B. , Skarzynski Henryk , Truy Eric , Seldran Fabien , Hermann Ruben , Govaerts Paul , De Ceulaer Geert , Bergeron Francois , Hotton Matthieu , Moran Michelle , Dowell Richard C. , Goffi-Gomez Maria Valeria Schmidt , Magalhães Ana Tereza de Matos , Santarelli Rosamaria , Scimemi Pietro
Published: June 2020

In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in the acoustically stimulated ear. This multicenter retrospective study examined pre- to postoperative changes in speech perception in the nonimplanted ear, the implanted ear, and both together. Results in the latter two conditions showed the expected increases, but speech perception in the nonimplanted ear showed a modest yet meaningful decrease that could not be completely explained by changes in unaided thresholds, hearing aid malfunction, or several other demographic variables. Decreases in speech perception in the nonimplanted ear were more likely in individuals who had better levels of speech perception in the implanted ear, and in those who had better speech perception in the implanted than in the nonimplanted ear. This raises the possibility that, in some cases, bimodal listeners may rely on the higher quality signal provided by the implant and may disregard or even neglect the input provided by the nonimplanted ear.
Early Spinal Injury Stabilization in Multiple-Injured Patients: Do All Patients Benefit?
Authors: Kobbe Philipp , Krug Patrick , Andruszkow Hagen , Pishnamaz Miguel , Hofman Martijn , Horst Klemens , Meyer Carolin , Scheyerer Max Joseph , Faymonville Christoph , Stein Gregor , Hildebrand Frank , Herren Christian
Published: June 2020

Background: Thoracolumbar spine fractures in multiple-injured patients are a common injury pattern. The appropriate timing for the surgical stabilization of vertebral fractures is still controversial. The purpose of this study was to analyse the impact of the timing of spinal surgery in multiple-injured patients both in general and in respect to spinal injury severity. Methods: A retrospective analysis of multiple-injured patients with an associated spinal trauma within the thoracic or lumbar spine (injury severity score (ISS) >16, age >16 years) was performed from January 2012 to December 2016 in two Level I trauma centres. Demographic data, circumstances of the accident, and ISS, as well as time to spinal surgery were documented. The evaluated outcome parameters were length of stay in the intensive care unit (ICU) (iLOS) and length of stay (LOS) in the hospital, duration of mechanical ventilation, onset of sepsis, and multiple organ dysfunction syndrome (MODS), as well as mortality. Statistical analysis was performed using SPSS. Results: A total of 113 multiple-injured patients with spinal stabilization and a complete dataset were included in the study. Of these, 71 multiple-injured patients (63%) presented with an AOSpine A-type spinal injury, whereas 42 (37%) had an AOSpine B-/C-type spinal injury. Forty-nine multiple-injured patients (43.4%) were surgically treated for their spinal injury within 24 h after trauma, and showed a significantly reduced length of stay in the ICU (7.31 vs. 14.56 days; p < 0.001) and hospital stay (23.85 vs. 33.95 days; p = 0.048), as well as a significantly reduced prevalence of sepsis compared to those surgically treated later than 24 h (3 vs. 7; p = 0.023). These adverse effects were even more pronounced in the case where cutoffs were increased to either 72 h or 96 h. Independent risk factors for a delay in spinal surgery were a higher ISS (p = 0.036), a thoracic spine injury (p = 0.001), an AOSpine A-type spinal injury (p = 0.048), and an intact neurological status (p < 0.001). In multiple-injured patients with AOSpine A-type spinal injuries, an increased time to spinal surgery was only an independent risk factor for an increased LOS; however, in multiple-injured patients with B-/C-type spinal injuries, an increased time to spinal surgery was an independent risk factor for increased iLOS, LOS, and the development of sepsis. Conclusion: Our data support the concept of early spinal stabilization in multiple-injured patients with AOSpine B-/C-type injuries, especially of the thoracic spine. However, in multiple-injured patients with AOSpine A-type injuries, the beneficial impact of early spinal stabilization has been overemphasized in former studies, and the benefit should be weighed out against the risk of patients’ deterioration during early spinal stabilization.
Final Results from a Phase II Trial of Osimertinib for Elderly Patients with Epidermal Growth Factor Receptor t790m-Positive Non-Small Cell Lung Cancer That Progressed during Previous Treatment
Authors: Nakao Akira , Hiranuma Osamu , Uchino Junji , Sakaguchi Chikara , Araya Tomoyuki , Hiraoka Noriya , Ishizuka Tamotsu , Takeda Takayuki , Kawasaki Masayuki , Goto Yasuhiro , Imai Hisao , Hattori Noboru , Nakatomi Keita , Uramoto Hidetaka , Uryu Kiyoaki , Fukuda Minoru , Uchida Yasuki , Yokoyama Toshihide , Akai Masaya , Mio Tadashi , Nagashima Seiji , Chihara Yusuke , Tamiya Nobuyo , Kaneko Yoshiko , Mouri Takako , Yamada Tadaaki , Yoshimura Kenichi , Fujita Masaki , Takayama Koichi
Published: June 2020

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are used for treating EGFR-mutated lung cancer, and osimertinib is effective in cases that acquired T790M mutations after treatment with the first- and second-generation EGFR-TKIs. However, no study has evaluated its safety and efficacy in older patients. This phase II trial (jRCTs071180002) evaluated osimertinib in T790M mutation-positive Japanese patients who were ≥75 years old and had experienced relapse or progression after previous EGFR-TKI treatment. Our previous report that enrolled 36 patients showed the overall response rate (58.3%) and disease control rate (97.2%), while this report describes the results for the progression-free survival (PFS), overall survival (OS), and safety analyses. The median PFS was 11.9 months (95% confidence interval (CI): 7.9–17.5), and the median OS was 22.0 months (95% CI: 16.0 months–not reached). The most frequent adverse events were anemia/hypoalbuminemia (27 patients, 75.0%), thrombocytopenia (21 patients, 58.3%), and paronychia/anorexia/diarrhea/neutropenia (15 patients, 41.7%). Pneumonitis was observed in four patients (11.1%), including two patients (5.6%) with Grade 3–4 pneumonitis. These results suggest that osimertinib was relatively safe and effective for non-small cell lung cancer that acquired T790M mutations after previous EGFR-TKI treatment, even among patients who were ≥75 years old.
Anti-VEGF Drugs in the Treatment of Multiple Myeloma Patients
Authors: Ria Roberto , Melaccio Assunta , Racanelli Vito , Vacca Angelo
Published: June 2020

The interaction between the bone marrow microenvironment and plasma cells plays an essential role in multiple myeloma progression and drug resistance. The vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) pathway in vascular endothelial cells activates and promotes angiogenesis. Moreover, VEGF activates and promotes vasculogenesis and vasculogenic mimicry when it interacts with VEGF receptors expressed in precursor cells and inflammatory cells, respectively. In myeloma bone marrow, VEGF and VEGF receptor expression are upregulated and hyperactive in the stromal and tumor cells. It has been demonstrated that several antiangiogenic agents can effectively target VEGF-related pathways in the preclinical phase. However, they are not successful in treating multiple myeloma, probably due to the vicarious action of other cytokines and signaling pathways. Thus, the simultaneous blocking of multiple cytokine pathways, including the VEGF/VEGFR pathway, may represent a valid strategy to treat multiple myeloma. This review aims to summarize recent advances in understanding the role of the VEGF/VEGFR pathway in multiple myeloma, and mainly focuses on the transcription pathway and on strategies that target this pathway.
Silibinin and SARS-CoV-2: Dual Targeting of Host Cytokine Storm and Virus Replication Machinery for Clinical Management of COVID-19 Patients
Authors: Bosch-Barrera Joaquim , Martin-Castillo Begoña , Buxó Maria , Brunet Joan , Encinar José Antonio , Menendez Javier A.
Published: June 2020

COVID-19, the illness caused by infection with the novel coronavirus SARS-CoV-2, is a rapidly spreading global pandemic in urgent need of effective treatments. Here we present a comprehensive examination of the host- and virus-targeted functions of the flavonolignan silibinin, a potential drug candidate against COVID-19/SARS-CoV-2. As a direct inhibitor of STAT3—a master checkpoint regulator of inflammatory cytokine signaling and immune response—silibinin might be expected to phenotypically integrate the mechanisms of action of IL-6-targeted monoclonal antibodies and pan-JAK1/2 inhibitors to limit the cytokine storm and T-cell lymphopenia in the clinical setting of severe COVID-19. As a computationally predicted, remdesivir-like inhibitor of RNA-dependent RNA polymerase (RdRp)—the central component of the replication/transcription machinery of SARS-CoV-2—silibinin is expected to reduce viral load and impede delayed interferon responses. The dual ability of silibinin to target both the host cytokine storm and the virus replication machinery provides a strong rationale for the clinical testing of silibinin against the COVID-19 global public health emergency. A randomized, open-label, phase II multicentric clinical trial (SIL-COVID19) will evaluate the therapeutic efficacy of silibinin in the prevention of acute respiratory distress syndrome in moderate-to-severe COVID-19-positive onco-hematological patients at the Catalan Institute of Oncology in Catalonia, Spain.
Optimal Endoscopic Resection Technique for Selected Gastric GISTs. The Endoscopic Suturing System Combined with ESD—a New Alternative?
Authors: Pawlak Katarzyna M. , Raiter Artur , Kozłowska-Petriczko Katarzyna , Szełemej Joanna , Petriczko Jan , Wojciechowska Katarzyna , Wiechowska-Kozłowska Anna
Published: June 2020

Background and Study Aim: In terms of therapeutic management, gastrointestinal stromal tumors (GISTs) seem to be the most difficult group of subepithelial gastrointestinal lesions (SELs). Despite various treatment option, choice of optimal management remains a dilemma in daily practice. Our aim was to evaluate a new hybrid resection technique of gastric GISTs type III as a modality of endoscopic full-thickness resection. Methods: Three males and one female (mean age of 68) were qualified for the procedure. Endoscopic full-thickness resections consisted of the endoscopic resection combined with suturing by Apollo OverStitch System. The main inclusion criterium was a complete diagnosis of GISTs (computed tomography (CT), endoscopic ultrasound (EUS), fine-needle biopsy (FNB)) with the evaluation of the tumor features, especially, the location in the gastric wall. All of the tumors were type III with a diameter between 20–40 mm. The lesions were located in the corpus (1), antrum (1) and between gastric body and fundus (2). All procedures were performed in 2019. Results: The technical and therapeutic success rate was 100% and the mean resection time 107.5 min. Neither intra- nor postprocedural complications were observed. In all four cases, R0 resection was achieved. Histopathologic assessment confirmed GIST with <5mitose/50HPF in all of the tumors, with very low risk. Conclusion: Based on our outcomes, endoscopic resection combined with the sewing by Apollo OverStitch of gastric GISTs type III, with the diameter between 20–40 mm, seems to be an effective therapeutic option with a good safety profile, however further studies with a larger treatment group are needed.
Pathogenesis and Clinical Management of Mesenteric Fibrosis in Small Intestinal Neuroendocine Neoplasms: A Systematic Review
Authors: Koumarianou Anna , Alexandraki Krystallenia I. , Wallin Göran , Kaltsas Gregory , Daskalakis Kosmas
Published: June 2020

Mesenteric fibrosis (MF) constitutes an underrecognized sequela in patients with small intestinal neuroendocrine neoplasms (SI-NENs), often complicating the disease clinical course. The aim of the present systematic review, carried out by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, is to provide an update in evolving aspects of MF pathogenesis and its clinical management in SI-NENs. Complex and dynamic interactions are present in the microenvironment of tumor deposits in the mesentery. Serotonin, as well as the signaling pathways of certain growth factors play a pivotal, yet not fully elucidated role in the pathogenesis of MF. Clinically, MF often results in significant morbidity by causing either acute complications, such as intestinal obstruction and/or acute ischemia or more chronic conditions involving abdominal pain, venous stasis, malabsorption and malnutrition. Surgical resection in patients with locoregional disease only or symptomatic distant stage disease, as well as palliative minimally invasive interventions in advanced inoperable cases seem clinically meaningful, whereas currently available systemic and/or targeted treatments do not unequivocally affect the development of MF in SI-NENs. Increased awareness and improved understanding of the molecular pathogenesis of MF in SI-NENs may provide better diagnostic and predictive tools for its timely recognition and intervention and also facilitates the development of agents targeting MF.
Herbal Medicines (Danggui Liuhuang Decoctions) for Management of Menopausal Symptoms: A Systematic Review of Randomized Controlled Trials
Authors: Jun Ji Hee , Lee Hye Won , Zhang Junhua , Yang Fengwen , Lee Myeong Soo
Published: June 2020

Danggui Liuhuang (DLH) decoctions are traditional herbal medicines that are widely used for menopausal symptoms. The objective of this systematic review was to investigate evidence of the efficacy of DLH decoctions for menopausal symptoms. Fifteen databases were searched from inception until 29 May, 2020. We included randomized controlled trials (RCTs) testing any type of DLH decoction. All RCTs investigating DLH decoctions or modified DLH decoctions were included. The methodological quality of the RCTs was evaluated using Cochrane’s risk of bias assessment tool. We measured the certainty of evidence (CoE) according to the GRADE approach. A total of five RCTs met all of the inclusion criteria and were analyzed. The included RCTs had unclear risks of bias in most domains. Based on studies using the Kupperman index for the measurement of menopausal symptoms, DLH decoctions may have ameliorative effects on menopausal symptoms equivalent to those of conventional drug therapies, but we are very uncertain (MD 3.03, 95% CI −3.17 to 9.25, two studies, very low CoE). Compared with conventional drug therapies, DLH decoctions may reduce hot flashes (MD 0.17, 95% CI 0.28 to 0.06, three studies, low CoE). The difference in the response rate between treatments is very uncertain (risk ratio 1.1, 95% CI 1.07 to 1.25, three studies, very low CoE); the results may indicate that compared with drug therapy, DLH decoction therapy elicits responses in 84 more cases per 1000 cases. In conclusion, there is limited evidence that DLH decoctions improve menopausal symptoms equivalently compared with conventional drug therapies. However, the studies had unclear risks of bias, and the CoEs were very low in general. Additional large and rigorous studies are needed.
Diabetic Foot Infections: The Diagnostic Challenges
Authors: Lauri Chiara , Leone Antonio , Cavallini Marco , Signore Alberto , Giurato Laura , Uccioli Luigi
Published: June 2020

Diabetic foot infections (DFIs) are severe complications of long-standing diabetes, and they represent a diagnostic challenge, since the differentiation between osteomyelitis (OM), soft tissue infection (STI), and Charcot’s osteoarthropathy is very difficult to achieve. Nevertheless, such differential diagnosis is mandatory in order to plan the most appropriate treatment for the patient. The isolation of the pathogen from bone or soft tissues is still the gold standard for diagnosis; however, it would be desirable to have a non-invasive test that is able to detect, localize, and evaluate the extent of the infection with high accuracy. A multidisciplinary approach is the key for the correct management of diabetic patients dealing with infective complications, but at the moment, no definite diagnostic flow charts still exist. This review aims at providing an overview on multimodality imaging for the diagnosis of DFI and to address evidence-based answers to the clinicians when they appeal to radiologists or nuclear medicine (NM) physicians for studying their patients.