bluuebunny/crossref_metadata_2025 huggingface dataset:
What Can China Learn From Evidence-Based Educational Reform? A Comparative Review of Educational Technology Programs’ Effects on Mathematics Achievement
Authors: Xie (谢晨) Chen
Published: August 2020

Purpose:

This review contrasts the U.S. and Chinese mainland in terms of educational technology programs’ effects on mathematics achievement. The existing evaluation studies are assessed and compared, especially from the perspective of research quality. Moreover, this review finds out what intervention programs work in these two countries and classifies evidence levels of effective programs.

Design/Approach/Methods:

A systematic review and meta-analysis method is used.

Findings:

The application of educational technology programs produced a better effect in Chinese mainland than in the U.S., however, the quantity and quality of evaluation studies is concerning in Chinese mainland. Since 2010, four programs in the U.S. and one program in Chinese mainland have qualified for strong evidence of effectiveness, which are worthy of receiving scale-up grants.

Originality/Value:

This is the first systematic review to contrast the U.S. and China in terms of educational technology programs’ effects on mathematics achievement. Determining what works through high-quality experiments is probably the most important requirement for evidence-based reform in education. This review compares the developments of the U.S., a leader of the movement, with those of China, an undecided observer. The review may provide enlightenment for the undecided countries and regions.
Special Education Teachers’ Perceptions of Their Preparedness to Teach Students With Severe Disabilities in Inclusive Classrooms: A Saudi Arabian Perspective
Authors: Aldabas Rashed
Published: August 2020

Successful inclusive education for students with severe disabilities (SD) relies on the preparedness of their teachers. This descriptive study investigated special education teachers’ perceptions of their preparedness to teach students with SD in inclusive educational settings. A survey was sent to 382 teachers of such students. In general, findings indicate that participants were confident that they were prepared to teach students with SD in inclusive education. Findings also show that the lowest levels of confidence were reported by participants with the shortest working experience, participants who have taught students with moderate and severe intellectual disabilities and those with multiple disabilities, participants who have taught in the lower grades, and those who have already taught in general classrooms. The practical implications of the findings are discussed for supporting successful implementation of inclusive education for students with SD in terms of improving special education teachers’ preparedness.
Emerging research trends and foci of studies on the meniscus: A bibliometric analysis
Authors: Zhou Tianping , Xu Yihong , Xu Weidong
Published: August 2020

Introduction:

Meniscus has always been the focus of sport medicine with thousands of articles published annually. Few study has tried to analyze these papers with bibliometric methods. The purpose of this study is to statistically analyze the output of meniscus research and determine emerging research trends and hot spots.

Methods:

Papers related to the meniscus published from 2010 to 2019 were downloaded from the Web of Science Core Collection. Information about annual publications and journal distribution was analyzed by Excel 2016. Co-occurrence analysis of the countries/regions, institutions, authors, and keywords were performed with CiteSpace V, which was also used to perform a co-cited analysis of the references and generate corresponding knowledge maps as well as detect burst keywords.

Results:

A total of 10,066 articles regarding meniscus were published between 2010 and 2019. The number of articles annual about meniscus increased from 786 to 1300. Knee Surgery Sports Traumatology Arthroscopy, the United States, University of Pittsburgh, and LaPrade RF were journal, country, institution, and author with the most publications, respectively. Makris EA et al. in 2011 was the most cited articles, with a citation of 198. Osteoarthritis, tear repair, anterior cruciate ligament, and articular cartilage were keywords with occurrence of more than 500. Meniscal extrusion, scaffold, and tissue engineering were terms with most burst strength.

Conclusions:

Meniscus-related publications showed a gradual rising trend from 2010 to 2019. Osteoarthritis, tear repairs, and the anterior cruciate ligament are the current research hot spots. Extrusion and scaffolds may be the frontiers of meniscus research in the next few years.

Level of evidence:

IV.
Relationship Between Age at Adult Height and Knee Mechanics During a Drop Vertical Jump in Men
Authors: Steffensmeier Andrew M. , Lamont Sarah M. , Metoyer Garyn , DiPaolo Zachary , Froehle Andrew W.
Published: August 2020

Background:

Anterior cruciate ligament (ACL) injuries are relatively common among younger athletes, with significant physical, psychological, and financial consequences. Research has largely focused on female athletes by identifying specific risk factors for an ACL injury, including variation in pubertal growth timing. There is less known about risk factors in males, and little is known about the effects of pubertal development on ACL injury risk in men.

Purpose/Hypothesis:

The purpose of this study was to analyze the relationship between an indicator of pubertal growth timing (age at adult height) and biomechanical risk for ACL injuries in men. We hypothesized that earlier age at adult height is correlated with riskier landing biomechanics during a drop vertical jump (DVJ) in men.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 21 recreationally active male students (age range, 20-33 years) were included. Participants completed a questionnaire on age at adult height and limb dominance, and anthropometric measurements were taken. There were 6 DVJ tests performed, with participants landing on a force plate while digital cameras recorded kinematic data from retroreflective markers placed according to the Helen Hayes marker system. Primary outcomes were sagittal and frontal plane knee kinematics and kinetics during contact. Data were analyzed using Pearson product-moment correlation.

Results:

In both limbs, age at achieving adult height was significantly negatively correlated with knee flexion/extension angle at toe-off (dominant: r = –0.79, P < .01; nondominant: r = –0.74, P < .01) and with peak flexion (dominant: r = –0.63, P < .01; nondominant: r = –0.70, P < .01) and extension (dominant: r = –0.66, P < .01; nondominant: r = –0.56, P = .01) angles during contact. In the nondominant limb, age at adult height was significantly negatively correlated with varus/valgus angle at initial contact ( r = –0.43; P = .05) and toe-off ( r = –0.44; P = .04) and was positively correlated with peak varus moment during contact ( r = 0.42; P = .06). Age at adult height was also positively correlated with peak vertical ground-reaction force ( r = 0.58; P < .01).

Conclusion:

Later age at adult height was correlated with riskier landing profiles in this study. This suggests that males with later or longer pubertal growth may have increased mechanical risk for ACL injuries. A better understanding of the effects of pubertal growth on landing biomechanics can improve the early identification of male athletes at greater risk for injuries.
Cochlear Implantation in Cases of Asymmetric Hearing Loss: Subjective Benefit, Word Recognition, and Spatial Hearing
Authors: Dillon Margaret T. , Buss Emily , Rooth Meredith A. , King English R. , McCarthy Sarah A. , Bucker Andrea L. , Deres Ellen J. , Richter Margaret E. , Thompson Nicholas J. , Canfarotta Michael W. , O’Connell Brendan P. , Pillsbury Harold C. , Brown Kevin D.
Published: August 2020

A prospective clinical trial evaluated the effectiveness of cochlear implantation in adults with asymmetric hearing loss (AHL). Twenty subjects with mild-to-moderate hearing loss in the better ear and moderate-to-profound hearing loss in the poorer ear underwent cochlear implantation of the poorer hearing ear. Subjects were evaluated preoperatively and at 1, 3, 6, 9, and 12 months post-activation. Preoperative performance was evaluated unaided, with traditional hearing aids (HAs) or with a bone-conduction HA. Post-activation performance was evaluated with the cochlear implant (CI) alone or in combination with a contralateral HA (bimodal). Test measures included subjective benefit, word recognition, and spatial hearing (i.e., localization and masked sentence recognition). Significant subjective benefit was reported as early as the 1-month interval, indicating better performance with the CI compared with the preferred preoperative condition. Aided word recognition with the CI alone was significantly improved at the 1-month interval compared with preoperative performance with an HA and continued to improve through the 12-month interval. Subjects demonstrated early, significant improvements in the bimodal condition on the spatial hearing tasks compared with baseline preoperative performance tested unaided. The magnitude of the benefit was reduced for subjects with AHL when compared with published data on CI users with normal hearing in the contralateral ear; this finding may reflect significant differences in age at implantation and hearing sensitivity across cohorts.
Considerations for Pregnant Dental and Health Care Workers amid COVID-19
Authors: Mann A. , Dahiya A. , Souza L.C. , Letra A.
Published: August 2020

Introduction:

Coronavirus disease 2019 (COVID-19) is a highly contagious disease that quickly reached pandemic levels. Over 5 million COVID-19 cases and approximately 330,000 deaths have been recorded worldwide. Transmission is primarily spread through direct, indirect (through contaminated objects or surfaces), or close contact with infected people via respiratory droplets, the mouth, and/or nose secretions. Health care professionals (HCPs), including dental HCPs, are recognized to be at considerably high risk for infection due to the close proximity to patients and aerosol-generating procedures. During pregnancy, HCPs may be at even higher risk since pregnancy substantially increases the susceptibility to infectious diseases.

Objectives:

Here, we present the posed risks and potential effects of COVID-19 on maternal and fetal health. Current prevention and management strategies for COVID-19 on pregnant dental and HCPs are also discussed.

Results:

Significant progress is being made in understanding the pathogenesis and clinical consequences of COVID-19. Pregnant women are affected more adversely with viral illnesses, although evidence of vertical transmission of COVID-19 is controversial. Based on the presence of atypical symptoms, the significant numbers of asymptomatic individuals who are COVID-19 positive, and the high susceptibility to viral diseases observed in pregnant women, recommendations have been put forth to limit the exposure of COVID-19–positive or even suspected cases to pregnant HCPs, and these are likely to evolve as new information becomes available.

Conclusion:

Pregnant HCPs require extra caution: not only are they considered a high-risk population, but their work at the frontline in a pandemic may expose them to additional risks. Complete awareness of the effects of COVID-19 on maternal and fetal/infant health, as well as prevention and management guidelines for pregnant HCPs, will allow for a safer work environment. Health care institutional policies aimed at protecting pregnant HCPs should consider avoiding their assignment as first responders, especially if equally trained staff are available.

Knowledge Transfer Statement:

Dental and health care professionals can use the information in this review to improve their awareness of COVID-19 risks, signs, and symptoms and the associated effects on the health of pregnant health care professionals and their unborn/newborn children.
Antagonistic landscapes
Authors: Sen Somdeep
Published: August 2020

This article introduces and develops the concept of “antagonistic landscapes” on the basis of fieldwork conducted in the Israeli settlement Efrat in the occupied West Bank and the Hebrew University of Jerusalem campus on Mount Scopus. The concept refers to the ways in which powerful actors antagonize “unwanted” communities by means of the physicality of the landscape. Both fieldwork sites, built on hills, use higher ground to tower over, yet overlook, the presence of “unwanted” Palestinian communities in the valleys below, thereby constituting prototypically antagonistic landscapes. That said, as expressions of utopian dreams, antagonistic landscapes require the erasure of what already exists. But, Palestinians continue to lay claim to the landscape. As a consequence then, these dreams remain utopian since by simply persisting and refusing to be entirely effaced the antagonized inscribe themselves into the fabric of the landscape. Antagonistic landscapes thus display both the dreams that the antagonizers hoped to realize, and the narratives of those whom they failed to replace.
A computer-assisted expert algorithm for real estate valuation in Spanish cities
Authors: Larraz Beatriz , Alfaro-Navarro José-Luis , L Cano Emilio , Alfaro-Cortes Esteban , Garcia Noelia , Gámez Matías
Published: August 2020

Some of the most overlooked valuation systems in current literature are those based on expert algorithms. Yet these algorithms can form the basis of a good estimation of the value of real estate since they allow simple computational methods that use big data to be integrated with the appraiser’ own knowledge of the situation. The main usefulness of the methodology is an ongoing mortgage risk appraisal for banking institutions. The current expert algorithms based on the sales comparison approach use the arithmetic mean of the comparable prices. But this mean gives equal importance to all neighbouring dwellings instead of giving more importance to those dwellings which are more similar and are nearer to the target dwelling. Improving the classical arithmetic mean or the more robust median, this article proposes a computer-assisted expert algorithm which includes a weighted estimator able to consider the differences in characteristics compared to similar properties and their relative locations. It allows to estimate, in a simple and rapid way using objective criteria, the value of any residential property in Spain. The results show good fit for large cities in terms of the usual error margins while improving the results with regards to smaller cities. In all cases, in terms of mean absolute percentage error, the weighted estimator improves the arithmetic mean or median results.
Nosology of the Sexual Dysfunctions: Are They Appropriate to Older Adults?
Authors: D’cruz Migita , Andrade Chittaranjan
Published: August 2020

The International Classification of Diseases, Tenth Revision ( ICD-10), describes sexual dysfunction on the basis of the inability of the individual to participate in a sexual relationship. On the other hand, the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5) describes it as the inability to respond sexually or experience sexual pleasure. Neither diagnostic manual addresses age as a contextual factor in sexual response, though DSM-5 notes that aging may be associated with a normative decrease in sexual response. In this review, we argue that the diagnosis of sexual dysfunction in the elderly should be based on age-related expectations. As examples, in older women, diagnostic criteria should factor in the considerations that vaginal dryness is associated with genital pain on penetration and with anorgasmia, as components of the genitourinary syndrome of menopause. In older men, the criteria for rigidity of erection and time to ejaculation may be unduly stringent and are not calibrated to changes in autonomic function with age.

The lack of consideration of aging physiology in diagnostic systems and the predominance of ageist stereotypes restrict the validity of diagnoses of sexual dysfunction in older adults; there is the possibility of both under and over diagnosis, based upon the attribution models of the patient and the clinician. Age sensitivity during medical training would help reduce ageist stereotyping in clinical practice. Sexual health education in older adults would help familiarize them with and relieve distress related to body changes that may be distressing and that may impact their quality of sexual life.
The 2018 version of the Global Earthquake Model: Hazard component
Authors: Pagani Marco , Garcia-Pelaez Julio , Gee Robin , Johnson Kendra , Poggi Valerio , Silva Vitor , Simionato Michele , Styron Richard , Viganò Daniele , Danciu Laurentiu , Monelli Damiano , Weatherill Graeme
Published: August 2020

In December 2018, at the conclusion of its second implementation phase, the Global Earthquake Model (GEM) Foundation released its first version of a map outlining the spatial distribution of seismic hazard at a global scale. The map is the result of an extensive, joint effort combining the results obtained from a collection of probabilistic seismic hazard models, called the GEM Mosaic. Together, the map and the underlying database of models provide an up-to-date view of the earthquake threat globally. In addition, using the Mosaic, a synopsis of the current state-of-practice in modeling probabilistic seismic hazard at national and regional scales is possible. The process adopted for the compilation of the Mosaic adhered to the maximum extent possible to GEM’s principles of collaboration, inclusiveness, transparency, and reproducibility. For each region, priority was given to seismic hazard models either developed by well-recognized national agencies or by large collaborative projects involving local scientists. The version of the GEM Mosaic presented herein contains 30 probabilistic seismic hazard models, 14 of which represent national or sub-national models; the remainder are regional-scale models. We discuss the general qualities of these models, the underlying framework of the database, and the outlook for the Mosaic’s utility and its future versions.
Calendering analysis of non-isothermal viscous nanofluid containing Cu-water nanoparticles using two counter-rotating rolls
Authors: Abbas Zaheer , Khaliq Sabeeh
Published: August 2020

This study is a non-isothermal analysis of the calendering process using a water based nanofluid with Cu-nanoparticles. The basic flow equations are simplified under the lubrication approximation theory (LAT) and non-dimensionalized. Theoretical velocity and pressure gradient solutions are achieved, and temperature distribution is numerically computed by finite difference method. The impact of nanoparticle volume fraction on pressure distribution, fluid velocity, temperature distribution, power input, and separating force are presented through graphs and discussed. Nanoparticle volume fraction enhances the magnitude of pressure, pressure gradient, and temperature distribution. Power input and roll-separating force also rise for higher nanoparticle volume fraction. Model II of dynamic viscosity of nanofluid has a greater impact on physical parameters as compared to the model I of dynamic viscosity.
A phase 3 randomized study (HOMER) of ofatumumab vs rituximab in iNHL relapsed after rituximab-containing therapy
Authors: Maloney David G. , Ogura Michinori , Fukuhara Noriko , Davis Jaclyn , Lasher Janet , Izquierdo Miguel , Banerjee Hiya , Tobinai Kensei
Published: August 2020

Because of high relapse rates with rituximab combinations, there is an unmet need for new therapeutic agents for treatment of indolent B-cell non-Hodgkin lymphoma (iNHL) or follicular lymphoma (FL). In previous trials, ofatumumab in combination with chemotherapy showed good results in relapsed/refractory FL pretreated with rituximab. This phase 3 trial evaluated the efficacy and safety of single-agent ofatumumab vs single-agent rituximab in rituximab-sensitive relapsed FL that relapsed at least 6 months after completing the last prior treatment with single-agent rituximab or a rituximab-containing regimen. Patients were randomized 1:1 to receive either ofatumumab (1000 mg) or rituximab (375 mg/m2) every week for 4 weeks for the induction phase, followed by once every 2 months for 4 additional doses. The primary endpoint, progression-free survival (PFS) and secondary endpoints, overall response rate (ORR) and overall survival (OS), were evaluated. Overall, 438 patients were assigned to receive ofatumumab (n = 219) and rituximab (n = 219). Baseline characteristics were similar in both arms. The independent review committee assessed whether median PFS was shorter in the ofatumumab arm than in the rituximab arm (16.33 vs 21.29 months), with no significant difference (hazard ratio, 1.15; 95% confidence interval, 0.89-1.49; P = .29) and also showed a lower ORR (50%) compared with the rituximab arm (66%). At the time of analysis, data were not matured for OS results. The number of grade >3 adverse events was higher in the ofatumumab arm (37%) than the rituximab arm (28%). Ofatumumab showed no superiority over rituximab in patients with FL who had relapsed after a rituximab-containing therapy. This study was registered at www.clinicaltrials.gov as #NCT01200589.
Investigating cystic lung disease: a respiratory detective approach
Authors: Ennis Samantha , Silverstone Elizabeth J. , Yates Deborah H.
Published: August 2020

The cystic lung diseases are rare orphan lung disorders that most physicians will see infrequently in their everyday practice. Diagnostic and treatment options have improved over recent decades, with opportunities for slowing rate of progression and improving outcome for patients. This review provides a summary of the clinical approach to these lung disorders, including how to differentiate between different imaging patterns, clinical features, differential diagnosis and characteristics of the commonest presenting disorders.

Educational aims

To understand the clinical, pathological and radiological features of cystic lung disorders

To explore the differential diagnosis of cystic lung disease

To be familiar with the key features (clinical, radiological, physiological and pathological) of the commoner cystic lung diseases, which assist in differentiating between these
Formability of Materials with Small Tools in Incremental Forming
Authors: Wei Hongyu , Hussain G. , Shi X. , Isidore B. B. L , Alkahtani Mohammed , Abidi Mustufa Haider
Published: August 2020

Single point incremental forming (SPIF) is an innovative sheet forming process with a high economic pay-off. The formability in this process can be maximized by executing forming with a tool of specific small radius, regarded as threshold critical radius. Its value has been reported as 2.2 mm for 1 mm thick sheet materials. However, with a change in the forming conditions specifically in the sheet thickness and step size, the critical radius is likely to alter due to a change in the bending condition. The main aim of the present study is to undertake this point into account and develop a relatively generic condition. The study is composed of experimental and numerical investigations. The maximum wall angle (θmax) without sheet fracturing is regarded as sheet formability. A number of sheet materials are formed to fracture and the trends correlating formability with normalized radius (i.e., R/To where R is the tool-radius and To is the sheet thickness) are drawn. These trends confirm that there is a critical tool-radius (Rc) that maximizes the formability in SPIF. Furthermore, it is found that the critical radius is not fixed rather it shows dependence on the sheet thickness such that Rc = βTo, where β varies from 2.2 to 3.3 as the thickness increases from 1 mm to 3 mm. The critical radius, however, remains insensitive to variation in step size ranging from 0.3 mm to 0.7 mm. This is also observed that the selection of tool with R < Rc narrows down the formability window not only on the higher side but also on the lower side. The higher limit, as revealed by the experimental and FEA results, diminishes due to excessive shearing because of in-plane biaxial compression, and the lower limit reduces due to pillowing in the bottom of part. The new tool-radius condition proposed herein study would be helpful in maximizing the formability of materials in SPIF without performing experimental trials.
First insight into the whole-genome sequence variations in Mycobacterium bovis BCG-1 (Russia) vaccine seed lots and their progeny clinical isolates from children with BCG-induced adverse events
Authors: Narvskaya Olga , Starkova Daria , Levi Diana , Alexandrova Natalia , Molchanov Vladimir , Chernyaeva Ekaterina , Vyazovaya Anna , Mushkin Alexander , Zhuravlev Viacheslav , Solovieva Natalia , Vishnevskiy Boris , Mokrousov Igor
Published: August 2020

Background

The only licensed live Bacille Calmette-Guérin (BCG) vaccine used to prevent severe childhood tuberculosis comprises genetically divergent strains with variable protective efficacy and rates of BCG-induced adverse events. The whole-genome sequencing (WGS) allowed evaluating the genome stability of BCG strains and the impact of spontaneous heterogeneity in seed and commercial lots on the efficacy of BCG-vaccines in different countries. Our study aimed to assess sequence variations and their putative effects on genes and protein functions in the BCG-1 (Russia) seed lots compared to their progeny isolates available from immunocompetent children with BCG-induced disease (mainly, osteitis).

Results

Based on the WGS data, we analyzed the links between seed lots 361, 367, and 368 used for vaccine manufacture in Russia in different periods, and their nine progeny isolates recovered from immunocompetent children with BCG-induced disease. The complete catalog of variants in genes relative to the reference genome (GenBank: CP013741) included 4 synonymous and 8 nonsynonymous single nucleotide polymorphisms, and 3 frameshift deletions. Seed lot 361 shared variants with 2 of 6 descendant isolates that had higher proportions of such polymorphisms in several genes, including ppsC, eccD5, and eccA5 involved in metabolism and cell wall processes and reportedly associated with virulence in mycobacteria. One isolate preserved variants of its parent seed lot 361 without gain of further changes in the sequence profile within 14 years.

Conclusions

The background genomic information allowed us for the first time to follow the BCG diversity starting from the freeze-dried seed lots to descendant clinical isolates. Sequence variations in several genes of seed lot 361 did not alter the genomic stability and viability of the vaccine and appeared accumulated in isolates during the survival in the human organism. The impact of the observed variations in the context of association with the development of BCG-induced disease should be evaluated in parallel with the immune status and host genetics. Comparative genomic studies of BCG seed lots and their descendant clinical isolates represent a beneficial approach to better understand the molecular bases of efficacy and adverse events during the long-term survival of BCG in the host organism.
Systematic characterization of the branch point binding protein, splicing factor 1, gene family in plant development and stress responses
Authors: Zhang Kai-Lu , Feng Zhen , Yang Jing-Fang , Yang Feng , Yuan Tian , Zhang Di , Hao Ge-Fei , Fang Yan-Ming , Zhang Jianhua , Wu Caie , Chen Mo-Xian , Zhu Fu-Yuan
Published: August 2020

Background

Among eukaryotic organisms, alternative splicing is an important process that can generate multiple transcripts from one same precursor messenger RNA, which greatly increase transcriptome and proteome diversity. This process is carried out by a super-protein complex defined as the spliceosome. Specifically, splicing factor 1/branchpoint binding protein (SF1/BBP) is a single protein that can bind to the intronic branchpoint sequence (BPS), connecting the 5′ and 3′ splice site binding complexes during early spliceosome assembly. The molecular function of this protein has been extensively investigated in yeast, metazoa and mammals. However, its counterpart in plants has been seldomly reported.

Results

To this end, we conducted a systematic characterization of the SF1 gene family across plant lineages. In this work, a total of 92 sequences from 59 plant species were identified. Phylogenetic relationships of these sequences were constructed, and subsequent bioinformatic analysis suggested that this family likely originated from an ancient gene transposition duplication event. Most plant species were shown to maintain a single copy of this gene. Furthermore, an additional RNA binding motif (RRM) existed in most members of this gene family in comparison to their animal and yeast counterparts, indicating that their potential role was preserved in the plant lineage.

Conclusion

Our analysis presents general features of the gene and protein structure of this splicing factor family and will provide fundamental information for further functional studies in plants.
Permanent left bundle branch area pacing utilizing intracardiac echocardiogram
Authors: Feng Xiang-Fei , Zhang Peng-Pai , Liu Bo , Zhao Yan , Lu Qiu-Fen , Li Yi-Gang
Published: August 2020

Background

Recently, left bundle branch area pacing (LBBAP) has been shown to be feasible. However, the right ventricular (RV) implantation site for LBBAP remains elusive. We believe that the RV implantation site should be located at the posteromedial basal septum, and in this paper, we propose a new method to help guide lead implantation. The aim of this study is to demonstrate the feasibility of the proposed method.

Methods

The RV implantation site was positioned by a combination of a nine-grid system on fluoroscopy and the use of intracardiac echocardiogram (ICE) and then verified by ICE.

Results

Fifteen patients were enrolled for LBBAP using our method. The acute success rate was 86.7% (13/15), which demonstrated that our method is useful for assisting with lead implantation. According to ICE, the distance between the implantation site and apex (the front) and the distance between the implantation site and tricuspid annulus (the back) were 44.9 ± 10.7 and 33.2 ± 10.4 mm, respectively, and the ratio of the front and the back was 1.57 ± 0.80. The distance between the implantation site and the front junction point of the left-right ventricle (the upper) and the distance between the implantation site and the back junction point (the lower) were 33.4 ± 10.6 and 24.5 ± 10.2 mm, respectively. The ratio of the upper to the lower was 1.76 ± 1.36. These results suggest that the implantation site was at the posteromedial basal septum. The width of the QRS duration increased from 110.4 ± 33.1 ms at baseline to 114.1 ± 16.1 ms post LBBAP (P > 0.05). The operation time was 133 ± 32.9 min. The time of X-ray fluoroscopy was 21.2 ± 5.9 min. The mean time for lead positioning during LBBAP was 33.8 ± 16.6 min. During a follow-up of 3 months, the LBB capture threshold remained stable in 12 patients, except for one patient who had an increase in the LBB capture threshold to 3.0 v/0.4 ms.

Conclusions

Our preliminary results indicate that the posteromedial basal septum could be seen as the implantation site for LBBAP. As a technique for LBBAP, ICE is a useful method for assisting with lead implantation. It is feasible and safe to use a nine-grid system combined with ICE for LBBAP.
Non-invasively measured central and peripheral factors of oxygen uptake differ between patients with chronic heart failure and healthy controls
Authors: Brochhagen Joana , Coll Barroso Michael Thomas , Baumgart Christian , Freiwald Jürgen , Hoppe Matthias Wilhelm
Published: August 2020

Background

Maximum oxygen uptake is an established measurement of diagnosing chronic heart failure and underlies various central and peripheral factors. However, central and peripheral factors are little investigated, because they are usually measured invasively. The aim of this study was to compare non-invasively measured central and peripheral factors of oxygen uptake between patients with chronic heart failure and healthy controls.

Methods

Ten male patients with heart failure with reduced ejection fraction (62 ± 4 years; body mass index: 27.7 ± 1.8 kg/m2; ejection fraction: 30 ± 4%) and ten male healthy controls (59 ± 3 years; body mass index: 27.7 ± 1.3 kg/m2) were tested for blood pressure, heart rate, stroke volume, cardiac output, and cardiac power output (central factors) as well as muscle oxygen saturation of the vastus lateralis and biceps brachii muscle (peripheral factors) during an incremental cycling test. Stroke volume and muscle oxygen saturation were non-invasively measured by a bioreactance analysis and near-infrared spectroscopy, respectively. Additionally, a maximum isometric strength test of the knee extensors was conducted. Magnitude-based inferences were computed for statistical analyses.

Results

Patients had a likely to most likely lower oxygen uptake, mean arterial pressure, and heart rate at maximum load as well as very likely lower isometric peak torque. Contrary, patients had a possibly to likely higher stroke volume and muscle oxygen saturation of the vastus lateralis muscle at maximum load. Differences in cardiac output, cardiac power output, and muscle oxygen saturation of the biceps brachii muscle at maximum load were unclear.

Conclusions

Non-invasively measured central and peripheral factors of oxygen uptake differ between patients with chronic heart failure and healthy controls. Therefore, it is promising to measure both types of factors in patients with chronic heart failure to optimize the diagnosis and therapy.
Efficacy of a high-dose proton pump inhibitor in patients with gastroesophageal reflux disease: a single center, randomized, open-label trial
Authors: Cho Jae Ho , Shin Cheol Min , Yoon Hyuk , Park Young Soo , Kim Nayoung , Lee Dong Ho
Published: August 2020

Background

The extraesophageal manifestations of gastroesophageal reflux disease (GERD) are more difficult to manage than the typical symptoms. The efficacy of high-dose and standard-dose proton pump inhibitors against these atypical symptoms is not yet established.

Methods

In this single center, randomized, open-label study, patients with GERD received rabeprazole for 8 weeks, either 20 mg once daily (standard-dose group) or 20 mg twice daily (high-dose group). Patients were assessed before treatment and at weeks 4 and 8 with a 5-graded scale questionnaire consisting of 2 typical symptoms (heartburn and acid regurgitation) and 8 atypical symptoms (chest pain, cough, globus, wheezing, laryngopharyngitis, hoarseness, belching, and dysphagia). Sufficient improvement of reflux symptoms was defined as ≥50% reduction from the initial questionnaire score.

Results

Final analyses included 35 patients in the standard-dose group and 38 patients in the high-dose group. The rate of sufficient improvement for typical symptoms was significantly higher in the high-dose group than in the standard-dose group (100.0% vs. 84.0%, P = 0.040). For atypical symptoms, the rate of sufficient improvement tended to be higher in the high-dose group than in the standard-dose group (82.4% vs. 63.0%, P = 0.087). Scores of typical and some atypical symptoms (cough and globus) improved after treatment, with significant inter-group differences in time-course changes.

Conclusions

High-dose rabeprazole is more effective for relieving typical GERD symptoms and some atypical symptoms such as cough and globus than a standard-dose regimen.

Trial registration

This research was enrolled in a registry of clinical trials run by United States National Library of Medicine at the National Institutes of Health (ClinicalTrials.gov Protocol Registration and Results system ID: NCT04001400). This study was registered on June 26, 2019 - Retrospectively registered.
Left-sided portal hypertension caused by peripancreatic lymph node tuberculosis misdiagnosed as pancreatic cancer: a case report and literature review
Authors: Yu Dajun , Li Xiaolan , Gong Jianping , Li Jinzheng , Xie Fei , Hu Jiejun
Published: August 2020

Background

Left-sided portal hypertension (LSPH) is an extremely rare clinical syndrome, and it is the only form of curable portal hypertension. It is primarily caused by pancreatic disease, and is associated with complications that cause spleen vein compression. Specific symptoms are often lacking, rendering it difficult to diagnose. Splenectomy is the main treatment for cases complicated by variceal bleeding, and the effects of treatment primarily depend on the condition of the primary disease.

Case presentation

The patient was a 29-year-old woman who was admitted to the hospital for repeated hematemesis and black stool. She had been misdiagnosed with pancreatic cancer 7 years prior. Combined imaging and endoscopic examination indicated varicose gastric fundus veins, a pancreatic mass, and enlarged peripancreatic lymph nodes. Laboratory investigations revealed reduced erythrocyte, platelet, and leukocyte counts, the interferon gamma release assay was positive, and liver function was normal. Abdominal exploration, splenectomy, varicose vein dissection, and lesion resection were performed via laparotomy. Postoperative biopsy analysis confirmed the diagnosis of lymph node tuberculosis. Based on the above-described factors, LSPH caused by peripancreatic lymph node tuberculosis was a diagnosed.

Conclusions

Herein we describe the first reported case of LSPH caused by peripancreatic lymph node tuberculosis. When left portal hypertension occurs simultaneously, peripancreatic lymph node tuberculosis is often misdiagnosed as pancreatic cancer. Further studies are necessary to develop a more favorable diagnostic method for pancreas masses and more advantageous therapy for LSPH, especially in cases caused by mechanical compression.
An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 2018
Authors: Tesfaye Brook , Sowe Alieu , Kisangau Ngina , Ogange John , Ntoburi Stephen , Nekar Irene , Muitherero Charles , Camara Yaya , Gathenji Carolyne , Langat Daniel , Sergon Kibet , Limo Hilary , Nzunza Rosemary , Kiptoon Shem , Kareko David , Onuekwusi Iheoma
Published: August 2020

Background

The poliovirus has been targeted for eradication since 1988. Kenya reported its last case of indigenous Wild Poliovirus (WPV) in 1984 but suffered from an outbreak of circulating Vaccine-derived Poliovirus type 2 (cVDPV2) in 2018. We aimed to describe Kenya’s polio surveillance performance 2016–2018 using WHO recommended polio surveillance standards.

Methods

Retrospective secondary data analysis was conducted using Kenyan AFP surveillance case-based database from 2016 to 2018. Analyses were carried out using Epi-Info statistical software (version 7) and mapping was done using Quantum Geographic Information System (GIS) (version 3.4.1).

Results

Kenya reported 1706 cases of AFP from 2016 to 2018. None of the cases were confirmed as poliomyelitis. However, 23 (1.35%) were classified as polio compatible. Children under 5 years accounted for 1085 (63.6%) cases, 937 (55.0%) cases were boys, and 1503 (88.1%) cases had received three or more doses of Oral Polio Vaccine (OPV). AFP detection rate substantially increased over the years; however, the prolonged health workers strike in 2017 negatively affected key surveillance activities. The mean Non-Polio (NP-AFP) rate during the study period was 2.87/ 100,000 children under 15 years, and two adequate specimens were collected for 1512 (88.6%) AFP cases. Cumulatively, 31 (66.0%) counties surpassed target for both WHO recommended AFP quality indicators.

Conclusions

The performance of Kenya’s AFP surveillance system surpassed the minimum WHO recommended targets for both non-polio AFP rate and stool adequacy during the period studied. In order to strengthen the country’s polio free status, health worker’s awareness on AFP surveillance and active case search should be strengthened in least performing counties to improve case detection. Similar analyses should be done at the sub-county level to uncover underperformance that might have been hidden by county level analysis.
A case report of hypocomplementemic urticarial vasculitis presenting with membranoproliferative glomerulonephritis
Authors: Vallianou Kalliopi , Skalioti Chrysanthi , Liapis George , Boletis John N. , Marinaki Smaragdi
Published: August 2020

Background

Hypocomplementemic urticarial vasculitis syndrome is an infrequent condition characterized by ocular, renal, gastrointestinal and pulmonary involvement with low serum complement levels and autoantibodies. Renal manifestations vary from microscopic hematuria to nephrotic syndrome and acute kidney injury. Accordingly differing histologic patterns have been reported.

Case presentation

We present the case of a 65 years old woman with a history of chronic uveitis who presented with arthralgias, urticarial rush, nephrotic syndrome, glomerular hematuria and low serum complement. Kidney biopsy revealed an immune-complex membranoproliferative glomerulonephritis. The patient received induction therapy with steroids, cyclophosphamide and hydroxychloroquine followed by rapid clinical improvement and remission of proteinuria. Maintenance treatment consisted of rituximab pulses.

Conclusions

The majority of hypocomplementemic urticarial vasculitis syndrome cases is idiopathic, although an association to drugs, infections or other autoimmune disorders has been recorded. Given the rarity and heterogeneity of the disease, no standard treatment is established.
Can Samba and Forró Brazilian rhythmic dance be more effective than walking in improving functional mobility and spatiotemporal gait parameters in patients with Parkinson’s disease?
Authors: dos Santos Delabary Marcela , Monteiro Elren Passos , Donida Rebeca Gimenes , Wolffenbuttel Mariana , Peyré-Tartaruga Leonardo Alexandre , Haas Aline Nogueira
Published: August 2020

Background

Parkinson’s disease (PD) causes motor and nonmotor disorders in patients. Unlike aerobic training, potential adaptations from the practice of dance are less understood in PD, particularly compared with better known exercise modes. This study aimed to verify and compare the effects of a Brazilian dance program, inspired by Samba and Forrró rhythms, and a walking program on functional mobility and spatiotemporal gait parameters in patients with PD.

Methods

Eighteen participants with PD were divided into a dance group (DG) and a walking group (WG) and were assessed before and after an intervention period of 24 1-h sessions, performed twice per week for 12 weeks. The timed-up-and-go test (TUG) and walking kinematics at self-selected speed (SSS) and fast speed (FS) were determined. The generalized estimating equation method was used to compare the DG and WG pre- and post-intervention and to evaluate the group*time interaction (α <  0.05).

Results

Both groups demonstrated a significant improvement in TUG test at SSS (p = 0.02; effect size [ES] = 0.42) and FS (p = 0.02; ES = 0.24). In general, spatiotemporal parameters remained unchanged, except at SSS, in which the DG increased the stride frequency (p = 0.011; ES = 0.72). At FS, the swing time demonstrated a significant group*time interaction (p <  0.001; ES = 1.10), in which the two groups exhibited different behaviors: DG decreased (p = 0.015) and WG increased (p = 0.012).

Conclusions

Functional mobility improved similarly in both groups. The results suggest that a 12-week program of Brazilian dance was sufficient to produce improvements in functional mobility and gait in individuals with PD.

Trial registration

This study is registered with the International Clinical Trial Registry under number NCT03370315. Registered December 28, 2017 - Retrospectively registered.
Improving clinical management of colon cancer through CONNECTION, a nation-wide colon cancer registry and stratification effort (CONNECTION II trial): rationale and protocol of a single arm intervention study
Authors: van den Berg I. , van de Weerd S. , Roodhart J. M. L. , Vink G. R. , van den Braak R. R. J. Coebergh , Jimenez C. R. , Elias S. G. , van Vliet D. , Koelink M. , Hong E. , van Grevenstein W. M. U. , van Oijen M. G. H. , Beets-Tan R. G. H. , van Krieken J. H. J. M. , IJzermans J. N. M. , Medema J. P. , Koopman M. ,   on behalf of the CONNECTION-study group
Published: August 2020

Background

It is estimated that around 15–30% of patients with early stage colon cancer benefit from adjuvant chemotherapy. We are currently not capable of upfront selection of patients who benefit from chemotherapy, which indicates the need for additional predictive markers for response to chemotherapy.

It has been shown that the consensus molecular subtypes (CMSs), defined by RNA-profiling, have prognostic and/or predictive value. Due to postoperative timing of chemotherapy in current guidelines, tumor response to chemotherapy per CMS is not known, which makes the differentiation between the prognostic and predictive value impossible. Therefore, we propose to assess the tumor response per CMS in the neoadjuvant chemotherapy setting. This will provide us with clear data on the predictive value for chemotherapy response of the CMSs.

Methods

In this prospective, single arm, multicenter intervention study, 262 patients with resectable microsatellite stable cT3–4NxM0 colon cancer will be treated with two courses of neoadjuvant and two courses of adjuvant capecitabine and oxaliplatin. The primary endpoint is the pathological tumor response to neoadjuvant chemotherapy per CMS. Secondary endpoints are radiological tumor response, the prognostic value of these responses for recurrence free survival and overall survival and the differences in CMS classification of the same tumor before and after neoadjuvant chemotherapy. The study is scheduled to be performed in 8–10 Dutch hospitals. The first patient was included in February 2020.

Discussion

Patient selection for adjuvant chemotherapy in early stage colon cancer is far from optimal. The CMS classification is a promising new biomarker, but a solid chemotherapy response assessment per subtype is lacking. In this study we will investigate whether CMS classification can be of added value in clinical decision making by analyzing the predictive value for chemotherapy response. This study can provide the results necessary to proceed to future studies in which (neo) adjuvant chemotherapy may be withhold in patients with a specific CMS subtype, who show no benefit from chemotherapy and for whom possible new treatments can be investigated.

Trial registration

This study has been registered in the Netherlands Trial Register (NL8177) at 11–26-2019, https://www.trialregister.nl/trial/8177. The study has been approved by the medical ethics committee Utrecht (MEC18/712).