bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovative need-based low-cost kangaroo mother care (KMC) chair
Authors: Jain Ashish , Sekhar Jerin C , Kumari Nisha , Jain Nidhi
Published: June 2020

Objectives

Low birthweight neonates contribute substantially to mortality and morbidity. Their management in low-income countries is difficult due to shortage of skilled staff and limited resources. Kangaroo mother care (KMC) is an effective way of providing warmth, stimulation and protection against infection, thereby decreasing mortality. We intended to perform a need-based survey among mothers and to develop an economic and comfortable chair to facilitate and optimise KMC. We also evaluated the level of satisfaction among mothers using the developed chair.

Design

Iterative product development.

Setting

A tertiary teaching hospital having level 3 neonatal intensive care and KMC ward.

Methods

An initial design for KMC chair was developed based on the structured response of 40 mothers to a need-based questionnaire. The prototype was reviewed by experts, including nursing staff, and a comfortable chair with minimum logistics was developed. A formative assessment of satisfaction was done using a questionnaire after introducing it in clinical practice.

Results

67.5% of mothers were satisfied with the head rest, inclination and height, while 72.5% were satisfied with the in-built KMC cloth and platform for placing utensils. 86.6% of nurses found the chair helpful to mothers; 83.3% were satisfied with the length of in-built KMC cloth; and 80% expressed their overall satisfaction in the KMC chair. 70% of nurses found the chair to facilitate safe position for the baby and to improve breast feeding.

Conclusion

This innovative and need-based KMC chair would help mothers of different builds perform KMC comfortably. This might prolong the duration of KMC, thereby having beneficial effects on the neonate.
Involvement of the M-CSF/IL-34/CSF-1R pathway in malignant pleural mesothelioma
Authors: Blondy Thibaut , d'Almeida Sènan Mickael , Briolay Tina , Tabiasco Julie , Meiller Clément , Chéné Anne-Laure , Cellerin Laurent , Deshayes Sophie , Delneste Yves , Fonteneau Jean-François , Boisgerault Nicolas , Bennouna Jaafar , Grégoire Marc , Jean Didier , Blanquart Christophe
Published: June 2020

Background

Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer related to asbestos exposure. The tumor microenvironment content, particularly the presence of macrophages, was described as crucial for the development of the disease. This work aimed at studying the involvement of the M-CSF (CSF-1)/IL-34/CSF-1R pathway in the formation of macrophages in MPM, using samples from patients.

Methods

Pleural effusions (PEs), frozen tumors, primary MPM cells and MPM cell lines used in this study belong to biocollections associated with clinical databases. Cytokine expressions were studied using real-time PCR and ELISA. The Cancer Genome Atlas database was used to confirm our results on an independent cohort. An original three-dimensional (3D) coculture model including MPM cells, monocytes from healthy donors and a tumor antigen-specific cytotoxic CD8 T cell clone was used.

Results

We observed that high interleukin (IL)-34 levels in PE were significantly associated with a shorter survival of patients. In tumors, expression ofCSF1was correlated with ‘M2-like macrophages’ markers, whereas this was not the case withIL34expression, suggesting two distinct modes of action of these cytokines. Expression ofIL34was higher in MPM cells compared with primary mesothelial cells. Particularly, high expression ofIL34was observed in MPM cells with an alteration ofCDKN2A. Finally, using 3D coculture model, we demonstrated the direct involvement of MPM cells in the formation of immunosuppressive macrophages, through activation of the colony stimulating factor-1 receptor (CSF1-R) pathway, causing the inhibition of cytotoxicity of tumor antigen-specific CD8+T cells.

Conclusions

The M-CSF/IL-34/CSF-1R pathway seems strongly implicated in MPM and could constitute a therapeutic target to act on immunosuppression and to support immunotherapeutic strategies.
CD3xCD19 DART molecule treatment induces non-apoptotic killing and is efficient against high-risk chemotherapy and venetoclax-resistant chronic lymphocytic leukemia cells
Authors: Martens Anne W J , Janssen Susanne R , Derks Ingrid A M , Adams III Homer C , Izhak Liat , van Kampen Roel , Tonino Sanne H , Eldering Eric , van der Windt Gerritje J W , Kater Arnon P
Published: June 2020

Background

Bispecific antibodies are promising new therapeutics in B cell malignancies. Whether they lead to potent T cell activation despite described T cell dysfunction in chronic lymphocytic leukemia (CLL), and are able to effectively target high-risk or venetoclax-resistant samples, is currently unknown.

Methods

CD19+cell lines or primary (high-risk) CLL were cocultured in vitro with healthy donor (HD) or CLL-derived T cells in the presence of a CD3xCD19 dual affinity retargeting molecule (CD3xCD19 DART). Cell cytotoxicity, T cell activation, proliferation and effector molecule production were analyzed using flow cytometry.

Results

Here, we report that a bispecific CD3xCD19 DART mediates efficient killing by HD T cells of CD19+cell-lines and primary CLL cells, regardless of immunoglobulin heavy chain variable region (IGHV) mutational status TP53 status or chemotherapy, ibrutinib or venetoclax sensitivity. Whereas TCR stimulation of CLL-derived T cells resulted in dysfunctional T cell activation and proliferation, treatment with CD3xCD19 DART led to a similar activation profile in CLL-derived and HD-derived T cells. Consistently, co-culture of CLL derived T cells with JeKo-1 or CLL cells in the presence of CD3xCD19 DART resulted in significant cytotoxicity by both CD4+and CD8+T cells. On stimulation of CLL cells with CD40L, CLL cells become resistant to the specific inhibitor of anti-apoptotic Bcl-2 protein venetoclax, due to upregulation of Bcl-2 family members such as Bcl-XL. Nevertheless, CD40L stimulated CLL cells were as efficiently lysed on CD3xCD19 DART treatment as unstimulated CLL cells. Further examination of the mechanism of CD3xCD19 DART mediated killing showed that lysis was dependent on granules, but was independent of BAX/BAK or caspase activity, indicating non-apoptotic cell death.

Conclusions

These data show that CD3xCD19 DART in CLL leads to robust T cell activation and lysis of high-risk venetoclax resistant CLL cells through a non-apoptotic mechanism.
Ipilimumab plus nivolumab for patients with metastatic uveal melanoma: a multicenter, retrospective study
Authors: Najjar Yana G , Navrazhina Kristina , Ding Fei , Bhatia Roma , Tsai Katy , Abbate Kelly , Durden Barbara , Eroglu Zeynep , Bhatia Shailender , Park Song , Chowdhary Akansha , Chandra Sunandana , Kennedy Jonathan , Puzanov Igor , Ernstoff Marc , Vachhani Pankit , Drabick Joseph , Singh Arun , Xu Tan , Yang Jessica , Carvajal Richard , Manson Daniel , M Kirkwood John , Cohen Justine , Sullivan Ryan , Johnson Douglas , Funchain Pauline , Shoushtari Alexander
Published: June 2020

Background

Uveal melanoma (UM) is the most common intraocular malignancy in adults. In contrast to cutaneous melanoma (CM), there is no standard therapy, and the efficacy and safety of dual checkpoint blockade with nivolumab and ipilimumab is not well defined.

Methods

We conducted a retrospective analysis of patients with metastatic UM (mUM) who received treatment with ipilimumab plus nivolumab across 14 academic medical centers. Toxicity was graded using National Cancer Institute Common Terminology Criteria for Adverse Events V.5.0. Progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier methodology.

Results

89 eligible patients were identified. 45% had received prior therapy, which included liver directed therapy (29%), immunotherapy (21%), targeted therapy (10%) and radiation (16%). Patients received a median 3 cycles of ipilimumab plus nivolumab. The median follow-up time was 9.2 months. Overall response rate was 11.6%. One patient achieved complete response (1%), 9 patients had partial response (10%), 21 patients had stable disease (24%) and 55 patients had progressive disease (62%). Median OS from treatment initiation was 15 months and median PFS was 2.7 months. Overall, 82 (92%) of patients discontinued treatment, 34 due to toxicity and 27 due to progressive disease. Common immune-related adverse events were colitis/diarrhea (32%), fatigue (23%), rash (21%) and transaminitis (21%).

Conclusions

Dual checkpoint inhibition yielded higher response rates than previous reports of single-agent immunotherapy in patients with mUM, but the efficacy is lower than in metastatic CM. The median OS of 15 months suggests that the rate of clinical benefit may be larger than the modest response rate.
Regional hyperperfusion in cognitively normalAPOE ε4allele carriers in mid-life: analysis of ASL pilot data from the PREVENT-Dementia cohort
Authors: McKiernan Elizabeth Frances , Mak Elijah , Dounavi Maria-Eleni , Wells Katie , Ritchie Craig , Williams Guy , Su Li , O'Brien John
Published: June 2020

Background

Regional cerebral hypoperfusion is characteristic of Alzheimer’s disease (AD). Previous studies report conflicting findings in cognitively normal individuals at high risk of AD. Understanding early preclinical perfusion alterations may improve understanding of AD pathogenesis and lead to new biomarkers and treatment targets.

Methods

3T arterial spin labelling MRI scans from 162 participants in the PREVENT-Dementia cohort were analysed (cognitively normal participants aged 40–59, stratified by future dementia risk). Cerebral perfusion was compared vertex-wise according toAPOE ε4status and family history (FH). Correlations between individual perfusion, age and cognitive scores (COGNITO battery) were explored.

Results

Regional hyperperfusion was found inAPOE ε4+group (left cingulate and lateral frontal and parietal regions p<0.01, threshold-free cluster enhancement, TFCE) and in FH +group (left temporal and parietal regions p<0.01, TFCE). Perfusion did not correlate with cognitive test scores.

Conclusions

Regional cerebral hyperperfusion in individuals at increased risk of AD in mid-life may be a very early marker of functional brain change related to AD. Increased perfusion may reflect a functional ‘compensation’ mechanism, offsetting the effects of early neural damage or may itself be risk factor for accelerating spread of degenerative pathology.
Dual SAVE technique for mechanical thrombectomy rescue on MCA bifurcation clots
Authors: Moreu M , Pérez-García C , Gómez-Escalonilla C , Rosati S
Published: June 2020

The Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique in mechanical thrombectomy consists of the simultaneous use of a stent retriever and a distal aspiration catheter, with the removal of both as a unit when performing the thrombectomy pass. This is a safe procedure that provides a high rate of first-pass reperfusion.1 In the distal M1 segment of the middle cerebral artery (MCA) occlusions, with the distal portion of the clot extending to the upper and lower MCA branches, mechanical thrombectomy can be challenging since the thrombus is not fully trapped, with risk of distal clot migration to the branch in which the retriever is not placed. In these cases the double stent-retriever technique has been described as a rescue strategy.2–4 We describe a case of the combined use of SAVE and double stent-retriever techniques as a rescue strategy in a patient with tandem occlusion of the proximal internal carotid artery and distal MCA—the D-SAVE technique. (video 1)
Prognostic value of systemic immune–inflammation index in acute/subacute patients with cerebral venous sinus thrombosis
Authors: Li Shen , Liu Kai , Gao Yuan , Zhao Lu , Zhang Rui , Fang Hui , Tao Yongli , Liu Hongbing , Zhao Jiawei , Xia Zongping , Xu Yuming , Song Bo
Published: June 2020

Objective

To evaluate the prognosis values of systemic immune–inflammation index (SII) in non-chronic cerebral venous sinus thrombosis (CVST).

Methods

patients with CVST, admitted to the First Affiliated Hospital of Zhengzhou University, were retrospectively identified from January 2013 to December 2018. We selected patients in acute/subacute phase from database. Functional outcomes of patients were evaluated with the modified Rankin Scale (mRS)—mRS 3–6 as poor outcomes and mRS 6 as death. The overall survival time was defined as the date of onset to the date of death or last follow-up date. Survival analysis was described by the Kaplan-Meier curve and Cox regression analysis. Multivariate logistic regression analysis assessed the relationship between SII and poor functional outcome. The area under the Receiver Operating Curve curve (AUC) was estimated to evaluate the ability of SII in prediction.

Results

A total of 270 patients were included and their duration of follow-up was 22 months (6–66 months), of whom 31 patients had poor outcomes and 24 patients dead. Cox regression analysis showed that SII (HR=1.304, 95% CI: 1.101 to 1.703, p=0.001) was a predictor of death in non-chronic CVST. Patients with higher SII presented lower survival rates (p=0.003). The AUC of SII was 0.792 (95% CI: 0.695 to 0.888, p=0.040) with a sensitivity of 69.6% and specificity of 80.1%. Subgroups analysis demonstrated that SII was an important predictor of poor outcomes in male (OR=1.303, 95% CI: 1.102 to 1.501, p=0.011) and pregnancy/puerperium female (OR=1.407, 95% CI: 1.204 to 1.703, p=0.034).

Conclusions

SII was a potential predictor in the poor prognosis of patients with acute/subacute CVST, especially in male and pregnancy/puerperium female.
Carbon dioxide narcosis due to human error in a dog
Authors: Phillips Victoria , Mathis Alessandra
Published: June 2020

Incorrect assembly of a parallel Lack (Mapleson A) breathing system resulted in carbon dioxide narcosis in a dog due to rebreathing of expiratory gases. A seven‐year‐old, male neutered Rottweiler, weighing 49 kg, failed to recover after discontinuation of inhalational anaesthesia following a forequarter amputation for osteosarcoma. During recovery, the endotracheal tube had been connected to a parallel Lack anaesthetic breathing system delivering 100 per cent oxygen at 5 l/minute. Although a prolonged recovery, 30 minutes, all vital parameters were considered within normal limits until a severe increase in respiratory effort was noted. Capnography revealed rebreathing with an end‐tidal carbon dioxide tension of >150 mm Hg (>19.9 kPa). The dog was transferred to a circle breathing system, and with normalisation of the capnogram, recovery proceeded without further complications. Visual inspection of the parallel Lack breathing system revealed misassembly which had resulted in rebreathing of expiratory gases, extreme hypercapnia causing prolonged recovery due to narcosis.
COUNTERPARTY CREDIT RISK IN A CLEARING NETWORK
Authors: FELBERT ALEXANDER VON
Published: June 2020

In this paper, we offer a network model that derives the expected counterparty risk of an arbitrary market after netting in a closed-form expression. Graph theory is used to represent market participants and their relationship among each other. We apply the powerful theory of characteristic functions (c.f.) and Hilbert transforms to determine the expected counterparty risk. The latter concept is used to express the c.f. of the random variable (r.v.) [Formula: see text] in terms of the c.f. of the r.v. [Formula: see text]. This paper applies this concept for the first time in mathematical finance in order to generalize results of Duffie & Zhu (2011), in several ways. The introduced network model is applied to study the features of an over-the-counter and a centrally cleared market. We also give a more general answer to the question of whether it is more advantageous for the overall counterparty risk to clear via a central counterparty or classically bilateral between the two involved counterparties.
A note on CAP-subgroups in finite groups
Authors: Liang Dengfeng , Qian Guohua
Published: June 2020

A subgroup [Formula: see text] of a finite group [Formula: see text] is called a CAP-subgroup if [Formula: see text] covers or avoids every chief factor of [Formula: see text]. Let [Formula: see text] be a normal subgroup of a finite group [Formula: see text] and [Formula: see text] be a prime power such that [Formula: see text] or [Formula: see text]. In this note, we show that if all subgroups of order [Formula: see text], and all subgroups of order [Formula: see text] when [Formula: see text] and [Formula: see text] has a nonabelian Sylow [Formula: see text]-subgroup, of [Formula: see text] are CAP-subgroups of [Formula: see text], then every [Formula: see text]-chief factor of [Formula: see text] is either a [Formula: see text]-group or of order [Formula: see text].
EPILEPTIC EEG IDENTIFICATION BASED ON HYBRID FEATURE EXTRACTION
Authors: LIU XIAOCHEN , SHEN JIZHONG , ZHAO WUFENG
Published: June 2020

Electroencephalogram (EEG) signals are widely used as an effective method for epilepsy analysis and diagnosis. For the establishment of an accurate and efficient epilepsy EEG identification system, it is very important to properly extract the features of EEG signals and select appropriate combination features. This paper proposes an automatic epileptic EEG identification method based on hybrid feature extraction. It uses temporal and frequency domain analysis, nonlinear analysis and one-dimensional local pattern recognition method to extract epileptic EEG features. Gradient energy operator and local speed pattern are proposed to better reflect typical feature in the active EEG signals measured during seizure-free intervals. The genetic algorithm is used to select the obtained hybrid features; then the AdaBoost classifier is used to classify epileptic EEG under various classification conditions. Classification results on the dataset developed by University of Bonn show that the proposed method can be used to classify normal EEG, interictal EEG and seizure activity with only a few features. Compared with related researches using the same dataset, the proposed method can obtain an equally satisfactory classification accuracy while the feature amount is reduced by 61–95%. In particular, the classification accuracy of the interictal and normal EEG can reach 99%.
Improved Moving Least Square-Based Multiple Dimension Decomposition (MDD) Technique for Structural Reliability Analysis
Authors: Rathi Amit Kumar , Chakraborty Arunasis
Published: June 2020

This paper presents the state-of-the-art on different moving least square (MLS)-based dimension decomposition schemes for reliability analysis and demonstrates a modified version for high fidelity applications. The aim is to improve the performance of MLS-based dimension decomposition in terms of accuracy, number of function evaluations and computational time for large-dimensional problems. With this in view, multiple finite difference high dimension model representation (HDMR) scheme is developed. This anchored decomposition is implemented starting from an initial reference point and progressively evolving in successive iterations. Most probable point (MPP) of failure is identified in every iteration and is used as the reference point for the next decomposition until it converges. Hermite polynomials in MLS framework are used between the support points for efficient interpolation. The support points are generated sequentially using multiple sparse grids based on the Clenshaw–Curtis scheme. Once the global response surface is constructed using the support points generated in each iteration, importance sampling is employed for reliability analysis. Six different benchmark problems are solved to show its performance vis-à-vis other methods. Finally, reliability-based design of a composite plate is demonstrated, clearly showing the advantage and superiority of the proposed improvements in MLS-based multiple dimension decomposition (MDD).
Flexible organic–inorganic hybrid bioceramic for bone tissue regeneration
Authors: Chen Jing , Zhang Xingmei , Li Beibei , Yang Yawei
Published: June 2020

Development of novel biomaterials for bone regeneration is based on the sufficient bone-bonding ability, bioactivity and biocompatibility. In this study, novel flexible poly(butylene succinate)/polydimethysiloxane-modified bioactive glass/nano-hydroxyapatite (PBSu/PDMS-BG/nHA) hybrid bioceramic with various nHA concentration on the in vitro bone-like hydroxyapatite (HA) formation, biomineralization activity and osteoblast cell biocompatibility were investigated. The rapid precipitation of HA on the hybrid bioceramic surfaces was found after being immersed in simulated body fluid (SBF) for seven days. Results show that the amount of HA deposition increased with the increase of nHA concentration. The optimized PBSu/PDMS-BG/nHA hybrid bioceramic exhibited good flexibility, high biomineralization activity and good osteoblast cell biocompatibility.
Nongenomic Actions of Thyroid Hormone: The Integrin Component
Authors: Davis Paul J. , Mousa Shaker A. , Lin Hung-Yun
Published: June 2020

The extracellular domain of plasma membrane integrin αvβ3 contains a cell surface receptor for thyroid hormone analogues. The receptor is largely expressed and activated in tumor cells and rapidly dividing endothelial cells. The principal ligand for this receptor is l-thyroxine (T4), usually regarded only as a prohormone for 3,5,3′-triiodo-l-thyronine (T3), the hormone analogue that expresses thyroid hormone in the cell nucleus via nuclear receptors that are unrelated structurally to integrin αvβ3. At the integrin receptor for thyroid hormone, T4regulates cancer and endothelial cell division, tumor cell defense pathways (such as anti-apoptosis), and angiogenesis and supports metastasis, radioresistance, and chemoresistance. The molecular mechanisms involve signal transduction via mitogen-activated protein kinase and phosphatidylinositol 3-kinase, differential expression of multiple genes related to the listed cell processes, and regulation of activities of other cell surface proteins, such as vascular growth factor receptors. Tetraiodothyroacetic acid (tetrac) is derived from T4and competes with binding of T4to the integrin. In the absence of T4, tetrac and chemically modified tetrac also have anticancer effects that culminate in altered gene transcription. Tumor xenografts are arrested by unmodified and chemically modified tetrac. The receptor requires further characterization in terms of contributions to nonmalignant cells, such as platelets and phagocytes. The integrin αvβ3 receptor for thyroid hormone offers a large panel of cellular actions that are relevant to cancer biology and that may be regulated by tetrac derivatives.
The Effects of Dietary Nutrition on Sleep and Sleep Disorders
Authors: Zhao Mingxia , Tuo Houzhen , Wang Shuhui , Zhao Lin
Published: June 2020

Sleep disorder significantly affects the life quality of a large number of people but is still an underrecognized disease. Dietary nutrition is believed to play a significant impact on sleeping wellness. Many nutritional supplements have been used trying to benefit sleep wellness. However, the relationship between nutritional components and sleep is complicated. Nutritional factors vary dramatically with different diet patterns and depend significantly on the digestive and metabiotic functions of each individual. Moreover, nutrition can profoundly affect the hormones and inflammation status which directly or indirectly contribute to insomnia. In this review, we summarized the role of major nutritional factors, carbohydrates, lipids, amino acids, and vitamins on sleep and sleep disorders and discussed the potential mechanisms.
A Wideband Rectenna Using High Gain Fractal Planar Monopole Antenna Array for RF Energy Scavenging
Authors: Fakharian Mohammad M.
Published: June 2020

This paper introduces a wideband rectenna that can scavenge ambient wireless power to a range of frequency band from 0.91 GHz to 2.55 GHz efficiently. The proposed rectenna is based on a wideband 2 × 2 fractal monopole antenna array with omnidirectional radiation patterns and high gains of 5 to 8.3 dBi at the desired bands. An improved two-branch impedance matching technique is presented which is designed to enhance the rectifier circuit performance with a relatively low input power ranging from −25 dBm to 10 dBm. Also, a full-wave wideband rectifier that can suitably improve the RF-to-DC power conversion efficiency is designed for the rectenna. A peak efficiency of 76%, 71%, 61%, and 62% is obtained at 950, 1850, 2100, and 2450 MHz, respectively. Measurement results show that a conversion efficiency of 68% has been achieved over an optimal 4.7 kΩ resistor when the simultaneous four-band input power level is −10 dBm. Moreover, an output DC voltage of around 243 mV with voltage varying within 160–250 mV can be achieved by gathering the low ambient wireless power inside laboratory. This study proves that the proposed rectenna can be applied to a range of many low-power electronic applications.
Seed Morphometry of Native Indonesian Orchids in the Genus Dendrobium
Authors: Hariyanto Sucipto , Pratiwi Intan Ayu , Utami Edy Setiti Wida
Published: June 2020

In this study, seeds of 10 species of epiphytic orchids were examined using light and scanning electron microscope. Quantitative and qualitative characters were analyzed. All the presently investigated seeds showed are transparent with visible embryo and remarkable embryo color variations (such as pale yellow, light yellow, shiny yellow to yellow, orange, and white). The species showed two groups in seed shape (fusiform and filiform), prolate and oval-shaped embryo, positioned at the center of the long axis and near apical pole. Embryo in prolate shaped and near apical pole position was only in D. antennatum. Based on our investigation, there are variations in seed and embryo volume as well as percentage air space in different taxa of orchids. The highest air space percentages were found in D. leporinum. According to the ornamentation of testa cells, 3 types of seeds were discovered in this genus. Additionally, the clear variation in the testa ornamentation pattern includes the species of D. leporinum, where the testa cells were in the medial regular rectangles, but in the apical and basal pole they are polygonal and irregularly oriented; the testa cells of D. antennatum are polygonal and irregularly oriented and those of D. purpureum are longitudinally oriented with regular rectangles.
Response to Ipilimumab/Nivolumab Rechallenge and BRAF Inhibitor/MEK Inhibitor Rechallenge in a Patient with Advanced Metastatic Melanoma Previously Treated with BRAF Targeted Therapy and Immunotherapy
Authors: Myrdal Caitlyn N. , Sundararajan Srinath
Published: June 2020

Little is known about the optimal sequencing of targeted therapy and immunotherapy in the treatment of patients with BRAFV600-mutated metastatic melanoma. BRAF/MEK inhibition often has the benefit of rapid disease regression; however, resistance is frequently seen with long-term use. Treatment with immune checkpoint inhibitors offers the potential for long-term response but displays a lower rate of objective response. The benefit of synergy between therapies is apparent; however, there is limited data regarding optimal sequencing in the treatment of advanced melanoma. We present the case of a 62-year-old gentleman with advanced BRAFV600-mutated melanoma who followed an unconventional treatment path. After progressing on single-agent vemurafenib, he had response to multiple modalities of immunotherapy before progression. After, he had a substantial response to multiple BRAF/MEK inhibitor rechallenges before developing resistance. The patient is now stable after a retrial of combination immunotherapy. Our case illustrates that with the right sequencing of therapy, meaningful clinical responses can be elicited with rechallenging of targeted therapy and immunotherapy in metastatic melanoma.
The Research and Mechanism of Extracting Vitamin B6 Using Aqueous Two-Phase Systems
Authors: Lu Changyu , Gao Luning , Chen Aibing , Li Duo , Zhou Yahong
Published: June 2020

The aim of this work is to investigate the quaternary systems which contain (polyethylene glycol/isopropyl alcohol) + ethanol + salt (Na2SO4/Na2CO3) + water to understand their liquid-liquid equilibrium (LLE) and salting-out ability and apply them to definite uses. For this purpose, phase diagrams and liquid-liquid equilibrium (LLE) data of the investigated quaternary systems were experimentally determined at 308.15, 318.15, and 328.15 K. Binodal curves were fitted to three empirical nonlinear equations, whereas tie-lines were fitted to the Setschenow-type equation and another two-parameter equation. All the models were successfully correlated with the experimental data. What is more, factors such as temperature, different organic solvent, and type of salt are studied. It was demonstrated that temperature has no influence in binodal curves and the salting-out ability follows the order Na2CO3 > Na2SO4. Finally, we chose the best system (isopropyl alcohol + ethanol + Na2CO3 + H2O) to find out the extraction efficiency when dealing with vitamin B6. The results show that when the temperature is 308.15 K and pH is 5.02, the extraction efficient can reach a top level. It serves as a theoretical basis for the extraction, separation, and purification.
Effect of Acupuncture on Chronic Pain with Depression: A Systematic Review
Authors: Yan Bin , Zhu Shibai , Wang Yu , Da Gula , Tian Guoqing
Published: June 2020

Background. Numerous studies suggested that chronic pain and depression were closely related and widespread in the population. When patients have symptoms of chronic pain and depression, the corresponding treatment will become difficult. Acupuncture, a unique therapeutic method of traditional Chinese medicine, has been reported to potentially serve as an alternative treatment for patients with comorbid chronic pain and depression by many research studies. Methods. A comprehensive search was conducted through the online database, including the Cochrane Library, PubMed, EMBASE, SinoMed, CNKI, and Wanfang database. Trials were RCTs published in the English or Chinese language, recruiting participants with chronic pain and depression comorbidity. The primary outcomes were the Visual Analogue Scale (VAS) and Hamilton Depression Scale (HAMD). Statistical analyses were conducted using Review Manager 5.3. Each trail was quality appraised with the five‐point Jadad Score. Results. 7 eligible RCTs involving 535 patients were included. Better therapeutic effect and safety could be observed in the experimental group compared with the control group. There was a significant decrease in the VAS (mean difference (MD) = −0.68 (−1.24, −0.12), P = 0.02) and HAMD (MD = −2.18 (−3.09, −1.26), P < 0.00001) scores and the incidence of adverse events between two groups. Conclusion. In the treatment of chronic pain with depression, acupuncture could not only get better clinical efficacy, but also have higher security compared with medicine therapy, which can be used in patients with poorer response to the conventional medication or suffering from serious side effects.
[Retracted] CircANXA2 Promotes Myocardial Apoptosis in Myocardial Ischemia‐Reperfusion Injury via Inhibiting miRNA‐133 Expression
Authors: Zong Liang , Wang Weixin
Published: June 2020

Objective. This project is aimed at investigating whether CircANXA2 can promote the apoptosis of myocardial cells by inhibiting miR‐133 expression and thereby participate in the development of myocardial ischemia‐reperfusion injury. Materials and Method. Quantitative real‐time polymerase chain reaction (qRT‐PCR) was used to detect the expression level of CircANXA2 in H9c2 cells after hypoxia/reoxygenation (H/R) treatment. Evaluation of myocardial injury markers in H9c2 cells was performed using commercial kits, including lactate dehydrogenase (LDH), malonaldehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidation (GSH‐PX). MTT analysis and flow cytometry were used to detect myocardial cell proliferation and apoptosis, respectively. Western blot was used to detect the protein expression of apoptosis‐related genes. Result. qRT‐PCR results showed that compared with the control, the expression of CircANXA2 was upregulated and the expression level of miR‐133 was significantly decreased in H/R‐treated H9c2 cells. CircANXA2 overexpression increased LDH, MDA, SOD, and GSH‐PX activity in H/R‐treated H9c2 cells. At the same time, CircANXA2 overexpression inhibited the proliferation of H/R‐treated cells, and CircANXA2 was able to induce cardiomyocyte apoptosis. Western blot results showed that after overexpression of CircANXA2, the proapoptotic genes Bax and cytochrome C was upregulated, while the antiapoptotic gene Bcl‐2 was downregulated. In H9c2 cells, upregulating miR‐133 can reverse the inhibition of proliferation induced by CircANXA2 overexpression and increase apoptosis. Conclusions. CircANXA2 promotes cardiomyocyte apoptosis in myocardial ischemia‐reperfusion injury by inhibiting the expression of miR‐133. CircANXA2 may be a potential target for myocardial ischemia‐reperfusion injury.
Combined Therapy of Catheter Ablation and Left Atrial Appendage Closure for Patients with Atrial Fibrillation: A Case-Control Study
Authors: Mo Bin-Feng , Sun Jian , Zhang Peng-Pai , Li Wei , Chen Mu , Yuan Jia-Li , Yu Yi , Wang Qun-Shan , Li Yi-Gang
Published: June 2020

Aim. The feasibility and safety of performing the combined procedure of catheter ablation (CA) and left atrial appendage closure (LAAC) for atrial fibrillation (AF) have been reported by observational studies without controls. The aim of this study was to compare the procedural and long-term outcomes of combined procedures with isolated CA or LAAC. Methods and Results. This study included patients who underwent combined CA and LAAC (combined group), CA alone (CA-only group), or LAAC alone (LAAC-only group). Propensity score matching was used to select controls from the CA-only and LAAC-only groups. Each group contained 76 subjects. The procedures were successfully performed in all the patients. Procedure-related complications of the combined group included one pericardial effusion and two groin haematomas, which did not differ significantly with those of the CA-only group (3.9% vs. 2.6%, P=0.650) or the LAAC-only group (3.9% vs. 2.6%, P=0.650), respectively. The AF-free rate of the combined group was comparable with that of the CA-only group after a mean of 2 years follow-up (67.1% vs. 69.7%, P=0.727). Compared with the LAAC-only group, the combined group achieved similar complete occlusion rate at implant (94.7% vs. 93.4%) and at 45 days (82.9% vs. 85.5%). At the end of follow-up, ischemic stroke and bleeding events of the combined group were low (3.9%) and were comparable with those of the CA-only group (5.3%) and the LAAC-only group (2.6%). Conclusions. The combination of AF-CA and LAAC is safe and efficacious compared with single procedures alone.
An Atypical Presentation of Extrapulmonary Sarcoidosis
Authors: Rawala Muhammad Shabbir , Ahmed Amna Saleem , Helmick Kristen
Published: June 2020

Sarcoidosis is an idiopathic, chronic, multisystem, granulomatous, inflammatory disease involving almost all organs. Sarcoidosis can occur with an atypical presentation of hepatosplenic involvement, like in the case of our patient. In this case report, we present a rare case of extrapulmonary sarcoidosis with isolated involvement of the liver and spleen in a 39-year-old Caucasian female. There is a possibility of this isolated involvement of an organ in the complete absence of pulmonary disease, which makes the diagnosis of sarcoidosis very difficult as it is usually not suspected. Ultrasound and CT are important in ruling out other differential diagnoses, but a definitive diagnosis is possible only on histological examination, differentiating sarcoid lesions from tuberculosis, primary biliary cirrhosis, metastasis, malignancy, and other granulomatous infections or diseases. Hence, the most credible criterion for diagnosis remains histology. After diagnosis, regular follow-up for systemic manifestations is recommended. Asymptomatic patients with hepatosplenic sarcoidosis have a good prognosis without any medical intervention, while patients with abnormal labs or symptoms must commence treatment.
Spontaneous Tuberculosis-Associated Tension Pneumothorax: A Case Report and Literature Review
Authors: Pradana Aditya Doni
Published: June 2020

Secondary spontaneous pneumothorax (SSP) is one of the major complications of pulmonary tuberculosis (TB), and it can be a life-threatening condition if it progresses to tension pneumothorax. A correct initial assessment and prompt intervention will prevent a hemodynamic deterioration in tension pneumothorax. Needle decompression followed by large-bore chest tube insertion is usually required in the management of SSP. We present a case of spontaneous TB-associated tension pneumothorax in a young adult which resolved with needle decompression without chest tube insertion.
A checklist of ‘Psocoptera’ (Psocodea) from Brazil: an update to the list of 2009 of García Aldrete and Mockford, with an identification key to the families
Authors: Silva Neto Alberto Moreira da , García Aldrete Alfonso Neri
Published: June 2020

The described species of Psocoptera currently known for Brazil are listed, with state distribution and biogeographic status. An identification key to the families recorded in Brazil is presented.
Prevalence of Infective Endocarditis in Streptococcal Bloodstream Infections Is Dependent on Streptococcal Species
Authors: Chamat-Hedemand Sandra , Dahl Anders , Østergaard Lauge , Arpi Magnus , Fosbøl Emil , Boel Jonas , Oestergaard Louise Bruun , Lauridsen Trine K. , Gislason Gunnar , Torp-Pedersen Christian , Bruun Niels Eske
Published: June 2020

Background:

Streptococci frequently cause infective endocarditis (IE), yet the prevalence of IE in patients with bloodstream infections (BSIs) caused by different streptococcal species is unknown. We aimed to investigate the prevalence of IE at species level in patients with streptococcal BSIs.

Methods:

We investigated all patients with streptococcal BSIs, from 2008 to 2017, in the Capital Region of Denmark. Data were crosslinked with Danish nationwide registries for identification of concomitant hospitalization with IE. In a multivariable logistic regression analysis, we investigated the risk of IE according to streptococcal species adjusted for age, sex, ≥3 positive blood culture bottles, native valve disease, prosthetic valve, previous IE, and cardiac device.

Results:

Among 6506 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men) the IE prevalence was 7.1% (95% CI, 6.5–7.8). The lowest IE prevalence was found with
Streptococcus pneumoniae
(
S pneumoniae
) 1.2% (0.8–1.6) and
Spyogenes
1.9% (0.9–3.3). An intermediary IE prevalence was found with
Sanginosus
4.8% (3.0–7.3),
Ssalivarius
5.8% (2.9–10.1), and
Sagalactiae
9.1% (6.6–12.1). The highest IE prevalence was found with
Smitis/oralis
19.4% (15.6–23.5),
Sgallolyticus
(formerly
Sbovis
) 30.2% (24.3–36.7),
Ssanguinis
34.6% (26.6–43.3),
Sgordonii
44.2% (34.0–54.8), and
Smutans
47.9% (33.3–62.8). In multivariable analysis using
S pneumoniae
as reference, all species except
S pyogenes
were associated with significantly higher IE risk, with the highest risk found with
S gallolyticus
odds ratio (OR) 31.0 (18.8–51.1),
S mitis/oralis
OR 31.6 (19.8–50.5),
S sanguinis
OR 59.1 (32.6–107),
S gordonii
OR 80.8 (43.9–149), and
S mutans
OR 81.3 (37.6–176).

Conclusions:

The prevalence of IE in streptococcal BSIs is species dependent with
S mutans, S gordonii, S sanguinis, S gallolyticus
, and
S mitis/oralis
having the highest IE prevalence and the highest associated IE risk after adjusting for IE risk factors.
Icons of Hell 7 Dictators, 700 Portraits, 7 Pages
Authors: Zakharov Vadim
Published: June 2020

Without an encounter with the unknown, creativity is impossible. In this encounter, there is no possibility for understanding anything, neither in terms of culture nor psychology. This is no dead end. Quite on the contrary: by finding your way out of the dead end, you can attain total freedom. Encounters with the unknown are extremely rare. The unknown is something you need to search out, overcoming the stereotypes of your thinking, the attitudes of your life and the dummies of your emotions. Our (creative) paths need to strike up against the unknown, no matter how thoroughly we build them and no matter which goal we pursue. The edges of my activity are always in some extreme, liminal state. My face is turned toward the unknown, while my masks address that which can be recognized by culture.
Opałek and Ross on Directives and Norms: A Comparative Study
Authors: Kosielińska-Grabowska Urszula
Published: June 2020

In his monograph Z teorii dyrektyw i norm [From the Theory of Directives and Norms] (1974) Kazimierz Opałek, apart from other issues, analyzes directives, optatives and evaluative statements as utterances belonging to the directive discourse and deals with a question of the logical-semantic status of the utterances. Opałek’s main critique concerns the logical-semantic status of the topic – the concept introduced by Alf Ross. Opałek demonstrates that directives cannot be represented by Ross’s formula: ‘d(T)’ (where d stands for the directive operator and T represents the neutral phrase, called ‘topic’). Polish legal theorist claims that the correct symbolic formula for directive structure is: ‘D(ut p)’. Such a formula for directive contains, besides the directive operator D, a sentence in a subjunctive mood, introduced by the ut- or utinam- connective clause.
Why the Enculturative Context of Moral Education Matters
Authors: Mapana Kedmon Elisha
Published: June 2020

Auto-ethnography is an effective methodology to reflect upon the moral values and their acquisition among the Wagogo people in central Tanzania against the background of postmodernity. In so doing I have identified the enculturative contexts within which I came to acquire the moral values that I live by, in particular my immediate family (i.e. my parents), the religion I was brought up in, and traditional school experiences (i.e. my initiation). I argue that despite contemporary theories of African character formation generating from the impact in Africa of cultural diversity and neuroscientific research, our traditional enculturative contexts of parenting, religious upbringing, and indigenous initiation ceremonies continue to have a central and enduring impact on the development of moral values among the Wagogo people of central Tanzania.
A new species of succulent plants from the Muko-jima group of the Bonin Islands, Japan: Sedum mukojimense (Crassulaceae)

Authors: ITO TAKURO , GOTO MASAFUMI , NAKANO HIDETO , KOKUBUGATA GORO
Published: June 2020

A taxonomic re-examination of Sedum boninense, which is endemic to the Muko-jima and Chichi-jima groups of the Bonin Islands, Japan, was carried out. Morphological and physiological comparisons revealed differences between plants from the Muko-jima and Chichi-jima groups in the shape and size of leaves and underground bulb scale leaves, plant habit, habitat and flowering season. Molecular phylogenetic analysis using the ITS region revealed that the plants from respective island groups formed sister clades. Therefore, the plant from Muko-jima group is described as a new species of S. mukojimense.
Syzygium anamalaianum (Myrtaceae), a new tree species from the Western Ghats of Tamil Nadu, India

Authors: RAMASUBBU RAJU , SURENDRAN ANJANA , KASI KARUPPA SAMY
Published: June 2020

Syzygium anamalaianum, a new species from Anamalai Tiger Reserve, Tamil Nadu, India is described. This species is closely allied to Syzygium bharathii and S.caryophyllatum, but differs from it by having thick elliptic or ovate–lanceolate leaves with deeply grooved midrib, 4–angled prominently winged peduncle, smaller flower, funnel or pyriform hypanthium, inwardly curved stamens of varying lengths and obovate or subglobular seeds. This combination of characters makes determining the relationships of Syzygium anamalaianum difficult.
COVID-19 and Total Laryngectomy—A Report of Two Cases
Authors: Paderno Alberto , Fior Milena , Berretti Giulia , Del Bon Francesca , Schreiber Alberto , Grammatica Alberto , Mattavelli Davide , Deganello Alberto
Published: June 2020

Objective:

To date, no cases have been reported on the effects of COVID-19 in laryngectomees.

Case Presentation:

We herein presented two clinical cases of laryngectomized patients affected by COVID-19, detailing their clinical course and complications.

Discussion:

In our experience, permanent tracheostomy did not significantly affect the choice of treatment. However, dedicated devices and repeated tracheal toilettes may be needed to deal with oxygen-therapy-related tracheal crusting.

Conclusion:

In conclusion, laryngectomees should be considered a vulnerable population that may be at risk for worse outcomes of COVID-19 due to anatomical changes in their airways. The role of the ENT specialist is to guide airway management and inform the support-staff regarding specific needs of these patients.
High strength expansive concrete-encased-steel filled carbon fiber reinforced polymer tubes under axial monotonic and cyclic load
Authors: Cao Qi , Lv Xianrui , Li Xiaojun , Zhou Changjun , Song Shide
Published: June 2020

High-strength concrete-encased-steel filled CFRP (carbon fiber reinforced polymer) tube (HCSFC) takes advantages of high strength of concrete, steel and confinement of FRP, resulting in enhanced structural load carrying capacity and deformability. In this study, expansive high-strength concrete is filled between CFRP tube and sectional steel to study the mechanical properties of high-strength expansive concrete-encased-steel filled CFRP tube (HECSFC) under monotonic and cyclic axial compression. Twenty-four specimens were fabricated in this study. The variables included the number of CFRP layers (0, 1, 2 layers), cross-sectional shape (circular and square), self-stress level (with or without self-stress) and loading mode (monotonic and cyclic). Test results show that the peak load of HCSFC specimen is greater than their nominal load-carrying capacity, which indicates that CFRP plays a confinement role on the internal core concrete-encased-steel. As the number of layers increases, both the normalized peak load and the ultimate axial strain increase. For specimens under the same number of layers, cross sectional shape and loading mode, the ultimate axial strain and strain reduction factor of self-stressing specimens are higher than those of nonprestressed specimens. At the same time, it is found that the confinement efficiency of CFRP on circular specimen is higher than that of square specimen. Analytical results show that the modified existing stress-strain models of CFRP confined concrete predict well with the experimental results.
LepR-Expressing Stem Cells Are Essential for Alveolar Bone Regeneration
Authors: Zhang D. , Zhang S. , Wang J. , Li Q. , Xue H. , Sheng R. , Xiong Q. , Qi X. , Wen J. , Fan Y. , Zhou B.O. , Yuan Q.
Published: June 2020

Stem cells play a critical role in bone regeneration. Multiple populations of skeletal stem cells have been identified in long bone, while their identity and functions in alveolar bone remain unclear. Here, we identified a quiescent leptin receptor–expressing (LepR+) cell population that contributed to intramembranous bone formation. Interestingly, these LepR+ cells became activated in response to tooth extraction and generated the majority of the newly formed bone in extraction sockets. In addition, genetic ablation of LepR+ cells attenuated extraction socket healing. The parabiosis experiments revealed that the LepR+ cells in the healing sockets were derived from resident tissue rather than peripheral blood circulation. Further studies on the mechanism suggested that these LepR+ cells were responsive to parathyroid hormone/parathyroid hormone 1 receptor (PTH/PTH1R) signaling. Collectively, we demonstrate that LepR+ cells, a postnatal skeletal stem cell population, are essential for alveolar bone regeneration of extraction sockets.