bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Antimicrobial Resistance Detected in Environmental and Clinical Isolates from Historical Data for the US
Authors: Hua Megan , Huang William , Chen Albert , Rehmet Michael , Jin Cade , Huang Zuyi
Published: April 2020

Antimicrobial resistance (AMR) has become an urgent public health issue, as pathogens are becoming increasingly resistant to commonly used antimicrobials. While AMR isolate data are available in the NCBI Pathogen Detection Isolates Browser (NPDIB) database, few researches have been performed to compare antimicrobial resistance detected in environmental and clinical isolates. To address this, this work conducted the first multivariate statistical analysis of antimicrobial‐resistance pathogens detected in NPDIB clinical and environmental isolates for the US from 2013 to 2018. The highly occurring AMR genes and pathogens were identified for both clinical and environmental settings, and the historical profiles of those genes and pathogens were then compared for the two settings. It was found that Salmonella enterica and E. coli and Shigella were the highly occurring AMR pathogens for both settings. Additionally, the genes fosA, oqxB, ble, floR, fosA7, mcr-9.1, aadA1, aadA2, ant(2”)-Ia, aph(3”)-Ib, aph(3’)-Ia, aph(6)-Id, blaTEM-1, qacEdelta1, sul1, sul2, tet(A), and tet(B) were mostly detected for both clinical and environmental settings. Ampicillin, ceftriaxone, gentamicin, tetracycline, and cefoxitin were the antimicrobials which got the most resistance in both settings. The historical profiles of these genes, pathogens, and antimicrobials indicated that higher occurrence frequencies generally took place earlier in the environmental setting than in the clinical setting.
Splenic Abscess after Sleeve Gastrectomy
Authors: Aoun Rany , Gabriel Michel , El Haddad Elias , Noun Roger , Chakhtoura Ghassan
Published: April 2020

Splenic abscess is a very rare complication of laparoscopic sleeve gastrectomy (LSG). Clinical presentation includes fever, leucocystosis, and abdominal pain. CT SCAN is a must for diagnosis. The preferred treatment is either conservative, with intravenous antibiotics and percutaneous drainage, or splenectomy. We report the thirteen case of a splenic abscess after LSG. In our patient, the abscess occurred three weeks after LSG in a 21-year-old man, and it was successfully treated conservatively.
Technical Efficiency Evolution Model of the Integration of Information Technology and Manufacturing Technology
Authors: Wu Dingjuan , Zhu Jianhua
Published: April 2020

The integration of information technology and manufacturing technology (IOITMT) is a strategic idea proposed by China. As the smallest unit of integration, manufacturing enterprises can be seen as the root of IOITMT. However, the current situation of IOITMT in China shows that intelligent manufacturing still has a long way to go and that the implementation effect of IOITMT requires urgent improvement. The dynamic evolution of IOITMT is accompanied by the integration and coevolution of internal technologies and also affects the performance of enterprises. Taking technical efficiency as a measure of IOITMT, the purpose of the current study is to develop an internal dynamic evolutionary mechanism framework for IOITMT of a single cycle in manufacturing enterprises. The framework is based on the theory of self-organization and convergence and uses convergence theory to discuss the evolution mode of technical efficiency in the three stages of IOITMT under the guidance of order parameters. This paper finds that the technical efficiency of IOITMT is influenced by the ratio of convergence parameters r1/r2, and adjusting the convergence intensity can effectively improve the performance of enterprises. Hence, this paper provides important theoretical guidance for the advancement of IOITMT of Chinese manufacturing enterprises.
The Mechanisms of the Herbal Components of CRSAS on HK‐2 Cells in a Hypoxia/Reoxygenation Model Based on Network Pharmacology
Authors: Ye Naijing , Xie Dengpiao , Yang Bing , Li Mingquan
Published: April 2020

Background. Acute kidney injury is a global problem, which brings a great burden to the society and family. The component of rhubarb, Salvia miltiorrhiza, Astragalus membranaceus, and safflower (CRSAS) has been proved as an useful agent to treat acute kidney injury (AKI) patients in China. Objective. To assess the effect of CRSAS on human renal tubular epithelial cells (HK‐2) after the hypoxia/reoxygenation (H/R) and investigate the potential mechanisms. Methods. Network pharmacology was used to predict the potential pathways shared by CRSAS and AKI. Cell counting kit‐8 (CCK‐8) was used to assess the HK‐2 vitality. Apoptosis of HK‐2 cells was detected by carboxyfluorescein succinimidyl ester/propidium iodide (CFSF/PI) staining. Expression of GRP78, CHOP, caspase‐3, and Bax was detected by western blot and quantitative real‐time RT‐PCR. Result. CRSAS and AKI shared the endoplasmic reticulum stress (ERS) pathway based on network pharmacology analysis. CRSAS increases the vitality of HK‐2 cells and reduces the apoptosis of HK‐2 cells induced by H/R injury. The expression of GRP78 and CHOP in CRSAS groups was lower than that of control groups. Conclusions. H/R can induce HK‐2 cell apoptosis and ERS. CRSAS can reduce HK‐2 cell apoptosis by inhibiting the ERS. Therefore, CRSAS might be able to treat kidney disease due to I/R injury. Animal experiment should be done to further prove our finding.
RAS Mutational Status Detection in Tissue, Plasma, and Stool Samples for Colorectal Cancer
Authors: Zhu Liuying , Wang Yuanhe , Zhou Yang , Dong Qian , Liu Yunpeng , Zhang Jingdong
Published: April 2020

Objective. RAS gene testing on tumor tissue biopsies is required for metastatic colorectal cancer (CRC) patients. However, it is infeasible for patients after curative surgery and repeated biopsy. This study is aimed at evaluating the consistency of RAS genes in patient’s plasma, stool, and tumor tissue samples, to explore whether plasma and stool samples can supplement or replace tumor tissue to assess baseline RAS gene status. Methods. Between June 2016 and October 2017, 53 patients with stage I‐IV CRC from the Liaoning Cancer Hospital and the Department of Medical Oncology of the First Hospital of China Medical University were enrolled in the study. Patient tissues, peripheral blood, and stool samples were collected, and RAS gene tests were performed. Results. Analysis of the KRAS gene in tissue, plasma, and stool samples from 53 CRC patients detected 25 cases (47%) of KRAS gene mutations in the tissue samples, 20 cases (38%) of KRAS gene mutations in plasma, and 18 (34%) KRAS gene mutations in fecal samples. The overall consistency of KRAS gene status between tissue samples and plasma samples was 77.4% (p ≤ 0.05) and between tissue samples and stool samples was 83% (p ≤ 0.05). In stage IV cases, the agreement of KRAS gene status between tissue and plasma samples was 93.8% (p ≤ 0.05) and 93.8% (p ≤ 0.05) between tissue and stool samples. Conclusion. There was a high overall consistency in KRAS mutational assessment between plasma, stool, and tissue samples. In stage IV patients, the consistency of KRAS gene detection between tissue and stools or plasma was higher.
The New Biomarker for Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma (CESC) Based on Public Database Mining
Authors: Ding Hao , Xiong Xiao-Xing , Fan Guan-Lan , Yi Yue-Xiong , Chen Yu-Rou , Wang Jing-Tao , Zhang Wei
Published: April 2020

To reconstruct the ceRNA biological network of cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) and to select an appropriate mRNA as a biomarker that could be used for CESC early diagnosis and prognosis evaluation. We downloaded CESC data from the TCGA public database, and statistical analysis was conducted with the R software to find out differential expressed genes encoding for lncRNAs, miRNAs, and mRNAs. The differentially expressed mRNAs (DEmRNAs) screened in the ceRNA network were analyzed for survival to find the mRNAs with significantly linked to the survival prognosis. These mRNAs were searched in the Pathological Atlas to identify the final appropriate mRNAs. Differential expression analysis revealed 773 lncRNAs, 94 miRNAs, and 2466 mRNAs. Survival analysis of DEmRNAs in the ceRNA network indicated that ADGRF4, ANXA8L1, HCAR3, IRF6, and PDE2A (P < 0.05) were negatively correlated with survival time. Verification of these six DEmRNAs in the Pathology Atlas indicated that PDE2A was a possible biomarker for CESC patients. PDE2A might be a biomarker for early diagnosis and prognosis evaluation of CESC patients, but due to the lack of available data, further studies may be needed for confirmation.
A Comparative Study on the Wettability of Two Coal Samples during Deep Burial Metamorphism
Authors: Yan Guochao , Bai Longjian , Feng Jianping , Zhang Zhiqiang
Published: April 2020

In order to investigate the effect of deep burial metamorphism on the wettability of coal during deep burial metamorphism, a superficial coal sample (∼90 m) and a deep coal sample (∼490 m) collected from two main mining seams were selected to simulate the deep burial metamorphism process. The wettability of two coal samples during deep burial metamorphism was investigated by X-ray photoelectron spectroscopy (XPS), FTIR, zeta potential, and contact angle measurements. Besides, comprehensive DLVO interaction analyses between two coal samples from different mining depths were carried out through the zeta potentials measurements under different pH values. The XPS results demonstrate that the content of surface oxygen atom and oxygen-containing functional group for superficial coal tends to be higher than that of deep coal. The FTIR results indicate that the peak intensity of oxygen-containing functional groups for the superficial is higher than that of deep coal, implying the stronger surface hydrophobicity of deep coal compared to superficial coal. The contact angle of superficial coal is lower than that of deep coal. The zeta potential and DLVO theory analyses of superficial particles and deep coal particles indicate that deep burial metamorphism process might be favorable for bubble-particle collision and attachment, while might be unfavorable for the wetting process oppositely. Based on the surface chemistry characterization and theory analyses, this study is expected to give a theoretical insight into the efficient processing or dedusting process of coals experiencing different deep burial metamorphism processes in the future.
Comparative Phytochemical Constituents and Antioxidant Activity of Wild and Cultivated Alepidea amatymbica Eckl & Zeyh
Authors: Mangoale Ramatsobane Maureen , Afolayan Anthony Jide
Published: April 2020

There is a need to scientifically validate the claim that wild species of medicinal plants are more potent than the cultivated plants. Thus, this study evaluated the phytochemical and antioxidant properties of wild and cultivated Alepidea amatymbica. Acetone, methanol, and water extracts of the rhizome of wild and cultivated A. amatymbica were evaluated for total phenol, flavonol, flavonoid, tannin, proanthocyanidin, saponin, and alkaloid contents using spectrophotometric methods. In vitro antioxidant activity was measured using 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH), 2,2 ′‐azino‐bis(3‐ethylbenzothiazoline)‐6‐sulfonic acid (ABTS), ferric reducing antioxidant power (FRAP), nitric oxide (NO), and hydrogen peroxide assays. The wild extracts had higher phytochemical contents in most of the assays than cultivated extracts. Total phenol in the wild extracts ranged from 32.30 to 117.8 mg GAE/g with the acetone extracts having the highest content while the water extracts were the least. The range in the total phenol of the cultivated species was 66.46 to 98.44 mg GAE/g with the methanol extracts having the highest content while water extracts was the least. The flavonoid content ranged from 55.01 to 99.09 mg QE/g and from 48.65 to 67.32 mg QE/g for the wild and cultivated plants, respectively. The alkaloid contents ranged from 14.70 to 17.80% in the wild species while it ranged from 11.98 to 13.21% in the cultivated species. The wild species also showed higher antioxidant activities in most of the assays evaluated. This study has implications for both pharmacological and conservation purposes.
Existence of Positive Weak Solutions for Quasi-Linear Kirchhoff Elliptic Systems via Sub-Supersolutions Concept
Authors: Menaceur Amor , Boulaaras Salah Mahmoud , Guefaifia Rafik , Alharbi Asma
Published: April 2020

By using the sub- and supersolutions concept (Schmitt, 2007), we prove in this paper the existence of positive solutions of quasi-linear Kirchhoff elliptic systems in bounded smooth domains. This work is an extension of the recent work of Boulaaras et al., 2020.
Role of Albumin as a Nutritional and Prognostic Marker in Elective Intestinal Surgery
Authors: Galata Christian , Busse Linda , Birgin Emrullah , Weiß Christel , Hardt Julia , Reißfelder Christoph , Otto Mirko
Published: April 2020

Background. The aim of this study was to investigate albumin, nutritional status, and inflammation in the perioperative course of patients undergoing elective intestinal surgery. Methods. A retrospective analysis of patients with preoperative measurements of nutritional parameters who underwent intestinal surgery between April 2017 and August 2018 at our institution was performed. Preoperatively, the correlation of albumin levels with markers for inflammation and nutritional status was investigated. Postoperatively, albumin levels were assessed with regard to high-grade morbidity and inflammation. Results. A total of 105 patients were included. Preoperatively, albumin levels were correlated with both markers for nutritional status and inflammation, with phase angle (PA) (p=0.004) and C-reactive protein (CRP) (p<0.001) as independent factors predicting the albumin levels in multivariable analysis. Postoperatively, the reduction in serum albumin (∆-albumin) on postoperative day (POD) 1/2 (p=0.025) and POD 4/5 (p=0.003) was significantly associated with Clavien–Dindo complications ≥grade III. A cut-off value of 27.3% for ∆-albumin on POD 1/2 predicted postoperative high-grade morbidity (sensitivity 75% and specificity 69%). The product of ∆-albumin and CRP on POD 4/5 identified patients with major complications more reliably than ∆-albumin or CRP alone (sensitivity 91% and specificity 72%). Conclusion. Preoperatively, albumin was a marker for nutritional status even if an inflammatory component was present. Postoperatively, ∆-albumin on POD 1/2 predicted high-grade morbidity. A new marker to identify patients with major complications on POD 4/5 is presented.
PredDBP‐Stack: Prediction of DNA‐Binding Proteins from HMM Profiles using a Stacked Ensemble Method
Authors: Wang Jun , Zheng Huiwen , Yang Yang , Xiao Wanyue , Liu Taigang
Published: April 2020

DNA‐binding proteins (DBPs) play vital roles in all aspects of genetic activities. However, the identification of DBPs by using wet‐lab experimental approaches is often time‐consuming and laborious. In this study, we develop a novel computational method, called PredDBP‐Stack, to predict DBPs solely based on protein sequences. First, amino acid composition (AAC) and transition probability composition (TPC) extracted from the hidden markov model (HMM) profile are adopted to represent a protein. Next, we establish a stacked ensemble model to identify DBPs, which involves two stages of learning. In the first stage, the four base classifiers are trained with the features of HMM‐based compositions. In the second stage, the prediction probabilities of these base classifiers are used as inputs to the meta‐classifier to perform the final prediction of DBPs. Based on the PDB1075 benchmark dataset, we conduct a jackknife cross validation with the proposed PredDBP‐Stack predictor and obtain a balanced sensitivity and specificity of 92.47% and 92.36%, respectively. This outcome outperforms most of the existing classifiers. Furthermore, our method also achieves superior performance and model robustness on the PDB186 independent dataset. This demonstrates that the PredDBP‐Stack is an effective classifier for accurately identifying DBPs based on protein sequence information alone.
Interaction of Cyclic Loading (Low‐Cyclic Fatigue) with Stress Corrosion Cracking (SCC) Growth Rate
Authors: Bashir Rehmat , Xue He , Guo Rui , Bi Yueqi , Usman Muhammad
Published: April 2020

The structural integrity analysis of nuclear power plants (NPPs) is an essential procedure since the age of NPPs is increasing constantly while the number of new NPPs is still limited. Low‐cyclic fatigue (LCF) and stress corrosion cracking (SSC) are the two main causes of failure in light‐water reactors (LWRs). In the last few decades, many types of research studies have been conducted on these two phenomena separately, but the joint effect of these two mechanisms on the same crack has not been discussed yet though these two loads exist simultaneously in the LWRs. SCC is mainly a combination of the loading, the corrosive medium, and the susceptibility of materials while the LCF depends upon the elements such as compression, moisture, contact, and weld. As it is an attempt to combine SCC and LCF, this research focuses on the joint effect of SCC and LCF loading on crack propagation. The simulations are carried out using extended finite element method (XFEM) separately, for the SCC and LCF, on an identical crack. In the case of SCC, da/dt(mm/sec) is converted into da/dNScc (mm/cycle), and results are combined at the end. It has been observed that the separately calculated results for SCC (da/dNScc) and LCF (da/dNm) of crack growth rate are different from those of joint/overall effect, . By applying different SCC loads, the overall crack growth is measured as SCC load becomes the main cause of failure in LWRs in some cases particularly in the presence of residual stresses.
Acute Portal Vein Thrombosis Treated with Recombinant Human Soluble Thrombomodulin Combined with Antithrombin III
Authors: Nakayama Satoshi , Murashima Naoya
Published: April 2020

Portal vein thrombosis is a major complication associated with liver cirrhosis. In cirrhotic patients, a decrease in procoagulant and anticoagulant factors and an unstable balance between them is observed, and a relative decrease in the activation of anticoagulant drivers is one of the main causes of portal vein thrombosis (PVT). Herein, we report a case of acute portal thrombosis associated with liver cirrhosis and treated with a recombinant form of soluble thrombomodulin (thrombomodulin alpha, TM-α) in combination with antithrombin III. TM-α was administered in accordance with the dosage and route of administration for disseminated intravascular coagulation therapy and resulted in dissolution of PVT with a gradual decrease in D-dimer levels. No adverse events were observed during the course of treatment. In the future, in addition to conventional anticoagulation therapy using heparin or antivitamin K drugs, novel therapies targeting protein C activation using a recombinant form of soluble thrombomodulin may play an important role in the treatment of acute PVT.
Preparation and Characterization of Hydrophilic Wetting-Modified Polyamide Fibers
Authors: Li Liang , Liu Shuping , Liu Rangtong , Geng Changjun , Hu Zedong
Published: April 2020

To improve the moisture absorption and air permeability of polyamide (PA) fibers, the modified fibers with porous structure were fabricated by melt spinning using polyethylene glycol (PEG) as the pore-forming agent due to its high solubility in water. The effects of pores caused by different PEG contents on the structure and properties of modified fibers were analyzed by electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and water contact angle. These results indicate that the porosity of modified fibers increases with PEG content increasing. Moreover, the formation of pores obviously affects the crystal forms of modified fibers. The alpha crystal gradually decreases and the gamma crystal increases with the porosity increasing. Furthermore, with respect to the modified fibers obtained from 47.33% PEG content, its water absorption increases from 3.78% of pure PA to 19.76% and its contact angle decreases from 116° to 85°. In addition, due to the interaction of hydrogen bond occurring between PA and PEG during the spinning process, the elongation at break, rupture work, and initial modulus of modified fibers were improved when the porosity was not more than 4.23%.
Brachial-Ankle Pulse Wave Velocity Predicts New-Onset Hypertension and the Modifying Effect of Blood Pressure in a Chinese Community-Based Population
Authors: Jiang Yimeng , Fan Fangfang , Jia Jia , Li Jianping , Xia Yulong , Zhou Jing , Huo Yong , Zhang Yan
Published: April 2020

Brachial-ankle pulse wave velocity (baPWV) was proven to be a prognostic indicator of cardiovascular events. However, the modifying effect of blood pressure (BP) on the longitudinal association between baPWV and new-onset hypertension is not well established. This study included 1849 non-hypertensive Chinese subjects from Shougang cohort study during December 2011 to July 2014. BaPWV was obtained using an Omron Colin BP-203RPE III device. Multivariate logistic regression models were used to evaluate associations of baPWV and outcomes. During a mean follow-up time of 2.36 years, 248 (13.41%) developed hypertension. BaPWV independently and gradably predicted the risk of incident hypertension and the SBP level at revisit (odds ratio or β (95% confidence interval) for participants with baPWV in quartile 4 vs. quartile 1: 2.72 (1.54, 4.78) for incident hypertension and 5.92 (4.26, 7.58) for SBP, P for trend: <0.001) after adjusting demonstrated risk factors. Besides, the effects of baseline baPWV on either incident hypertension or SBP at revisit were interactively modified by the level of baseline SBP; the effect size increased as the SBP level decreased. baPWV independently predicted the risk of hypertension and BP progression, modified by the level of SBP at baseline in this Chinese community-based population. The combination of baPWV and SBP can help differentiate the potential high-risk candidates who will develop hypertension quickly and benefit from early diagnosis and treatment.
Mathematical and Engineering Aspects of Chemically Reactive Tangent Hyperbolic Nanofluid over a Cone and Plate with Mixed Convection
Authors: Bilal Sardar , Shah Zahir , Kumam Poom , Thounthong Phatiphat
Published: April 2020

Current disquisition is expressed to elucidate the mathematical and engineering aspects of tangent hyperbolic liquid over a cone and plate which has valuable applications in industrial technological instruments such as cone and plate viscometer, spinning column technology, and biomass pyrolysis processing. The role of mixed convection and chemical reaction on physical features of fluid is considered. The attained coupled system is scrutinized by the aid of self-coded shooting method. In order to produce accuracy and refinement in the consequences, the coefficients of Runge–Kutta scheme are obliged. To get complete intellect about the current pagination, the impact of flow controlling variables on pertinent profiles are evaluated in quantitative and qualitative manner. The computations of wall drag force and heat and mass fluxes are presented pictorially and tabularly. From the thorough analysis, it is deduced that surface drag and convective thermal coefficient for cone is more in magnitude compared with those of plate. Similarly, dominance in thermal field is noted for cone compare with that in plate. Increment of velocity profile is revealed with enhancement in mixed convection parameter, whereas contrasting behavior is observed by varying Williamson and magnetic field parameters. Declining aptitude in thermal profile is exhibited against Prandtl number, whereas temperature of fluid mounts by changing the Brownian movement and thermophoresis parameters.
Diagnostic Role of Plasma MicroRNA-21 in Stable and Unstable Angina Patients and Association with Aging
Authors: Ali Sheikh Md Sayed
Published: April 2020

The present study explored the clinical value of plasma microRNA-21 as a novel biomarker for early prediction of stable and unstable angina patients and its relationship with aging. A total of 255 participants, 123 patients with chronic stable angina, 82 patients with unstable angina, and 50 healthy subjects, were included in our study. Stable coronary and unstable coronary patients were confirmed following AHA/ACC clinical protocols. Total RNA was extracted from plasma by using miRNA-based TRIzol reagent. Plasma miR-21 expression levels were determined by real-time polymerase chain reaction. To evaluate the diagnosis accuracy, the receiver operating characteristic (ROC) curves were used. Plasma microRNA-21 concentration levels were significantly elevated in stable and unstable angina patients as compared with control subjects P<0.001. The area under the ROC curves of circulating microRNA-21 was accurately distinguished in stable angina patients (AUC 0.921) and unstable angina patients (AUC 0.944) from healthy subjects. MicroRNA-21 expression gradually elevated with increasing aging in all the populations. Moreover, the current study also demonstrated that the expression of plasma miR-21 levels was significantly associated with different age groups within healthy subjects and stable and unstable angina patients P<0.001. This research finding suggested that plasma microRNA-21 may be considered as a suitable new biomarker for early detection of stable and unstable angina patients, and it has a strong correlation with aging.
Spectrophotometric Determination of Calcium with Dibromo-p-methylsulfonazo
Authors: Li Xiao-Dong , Zhai Qing-Zhou
Published: April 2020

Calcium is a necessary trace element in the human body, and its low or high content in the human body is not appropriate. It is very meaningful to study the level of calcium in the human body and to determine calcium content in blood. As people take calcium through food, the determination of calcium content in certain tea and calcium supplements is of great significance. In this study, a new method for the determination of calcium was established using dibromo-p-methylsulfonazo as a chromogenic agent. In this article, the optimal conditions for the color reaction of Ca2+ with dibromo-p-methylsulfonazo were established. In a hydrochloric acid medium, Ca2+ and dibromo-p-methylsulfonazo form a blue complex. At 624 nm maximum absorption wavelength, the apparent molar absorptivity for the determination of calcium is 3.32 × 104 L·mol−1·cm−1. Beer’s law is applied for 0–0.60 μg/mL. The method has already been used in the determination of calcium in blood serum, whole blood, tea leaf, and calcium fudge with satisfactory results.
Angiosarcoma of an Arteriovenous Fistula for Hemodialysis in a Kidney Transplant Recipient Affected by Lowe’s Syndrome
Authors: D’Ambrosio V. , Silvestri P. , Aureli F. , Sturniolo A. , Grandaliano G. , Ferraro P. M.
Published: April 2020

Objective/Background. To describe an uncommon, life-threatening condition such as angiosarcoma of a fistula for hemodialysis occurring in a transplant recipient affected by Lowe’s syndrome. Summary. We present the case of a 56-year-old male kidney transplant recipient affected by Lowe’s syndrome, also known as oculocerebrorenal syndrome, a rare X-linked disorder characterized by congenital cataracts, hypotonia, intellectual disability, and Fanconi-like renal tubular dysfunction, who was diagnosed with angiosarcoma of a functioning arteriovenous fistula for hemodialysis. Conclusion. Angiosarcoma is a rare soft tissue tumor, and only 22 cases of angiosarcoma of arteriovenous fistulae were described so far; although a correlation between Lowe’s syndrome and a higher risk of tumor compared to the general population has not been described so far, the mechanisms of disease causation could be an interesting starting point for future studies on a possible connection between the two events.
Association between Dietary Tomato Intake and the Risk of Hepatocellular Carcinoma: The Singapore Chinese Health Study
Authors: Thomas Claire E. , Luu Hung N. , Wang Renwei , Adams-Haduch Jennifer , Jin Aizhen , Koh Woon-Puay , Yuan Jian-Min
Published: April 2020

Background:

Intake of tomato and/or lycopene has been associated with reduced risk of several cancers, but there is no report on the association with risk of hepatocellular carcinoma (HCC).

Methods:

The associations of tomato and lycopene consumption with risk of HCC were examined in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese ages 45 to 74 years at enrollment. Diet was assessed using a validated semiquantitative food frequency questionnaire. Cox proportional hazard regression models were used to estimate HR and its 95% confidence interval (CI) of HCC with the consumption of tomato and lycopene among all cohort participants, and unconditional logistic regression was used to assess the association by hepatitis B surface antigen (HBsAg) positivity in a nested case–control study.

Results:

After a mean follow-up of 17.6 years, 561 incident HCC cases were identified. Higher tomato intake was associated with lower risk of HCC after adjustment for potential confounders (Ptrend < 0.001). Compared with the lowest quartile, HRs (95% CIs) of HCC for the second, third, and fourth quartile of tomato intake were 0.70 (0.56–0.88), 0.73 (0.58–0.92), and 0.63 (0.49–0.81). Among HBsAg-negative individuals, the inverse association remained (Ptrend = 0.03). There was no association between lycopene intake and HCC risk (Ptrend = 0.54).

Conclusions:

Tomato intake may offer protection against the development of HCC, particularly among individuals without chronic infection with hepatitis B virus.

Impact:

Tomato intake is a low-cost preventative measure against HCC that may help reduce risk due to increasing rates of nonalcoholic fatty liver disease.
An FDA Review of Drug Development in Nonmetastatic Castration-resistant Prostate Cancer
Authors: Brave Michael , Weinstock Chana , Brewer Jamie R. , Chi Dow-Chung , Suzman Daniel L. , Cheng Joyce , Zhang Lijun , Sridhara Rajeshwari , Ibrahim Amna , Kluetz Paul G. , Pazdur Richard , Beaver Julia A.
Published: April 2020

The FDA has approved three androgen receptor inhibitors—enzalutamide, apalutamide, and darolutamide—for the treatment of patients with nonmetastatic castration-resistant prostate cancer (nmCRPC). These approvals were all based on randomized, double blind, placebo-controlled trials demonstrating large improvements in metastasis-free survival (MFS) and internally consistent evidence of benefit seen across secondary endpoints. In this article, we summarize the FDA regulatory history of MFS and we describe the design, conduct, and results of the three pivotal trials supporting these important treatment options for patients with nmCRPC.
Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association
Authors: Arnold Suzanne V. , Bhatt Deepak L. , Barsness Gregory W. , Beatty Alexis L. , Deedwania Prakash C. , Inzucchi Silvio E. , Kosiborod Mikhail , Leiter Lawrence A. , Lipska Kasia J. , Newman Jonathan D. , Welty Francine K. ,   On behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health and Council on Clinical Cardiology
Published: April 2020

Although cardiologists have long treated patients with coronary artery disease (CAD) and concomitant type 2 diabetes mellitus (T2DM), T2DM has traditionally been considered just a comorbidity that affected the development and progression of the disease. Over the past decade, a number of factors have shifted that have forced the cardiology community to reconsider the role of T2DM in CAD. First, in addition to being associated with increased cardiovascular risk, T2DM has the potential to affect a number of treatment choices for CAD. In this document, we discuss the role that T2DM has in the selection of testing for CAD, in medical management (both secondary prevention strategies and treatment of stable angina), and in the selection of revascularization strategy. Second, although glycemic control has been recommended as a part of comprehensive risk factor management in patients with CAD, there is mounting evidence that the mechanism by which glucose is managed can have a substantial impact on cardiovascular outcomes. In this document, we discuss the role of glycemic management (both in intensity of control and choice of medications) in cardiovascular outcomes. It is becoming clear that the cardiologist needs both to consider T2DM in cardiovascular treatment decisions and potentially to help guide the selection of glucose-lowering medications. Our statement provides a comprehensive summary of effective, patient-centered management of CAD in patients with T2DM, with emphasis on the emerging evidence. Given the increasing prevalence of T2DM and the accumulating evidence of the need to consider T2DM in treatment decisions, this knowledge will become ever more important to optimize our patients’ cardiovascular outcomes.
Long-Term Outcomes After Revascularization for Stable Ischemic Heart Disease
Authors: Madhavan Mahesh V. , Redfors Björn , Ali Ziad A. , Prasad Megha , Shahim Bahira , Smits Pieter C. , von Birgelen Clemens , Zhang Zixuan , Mehran Roxana , Serruys Patrick W. , Maehara Akiko , Leon Martin B. , Kirtane Ajay J. , Stone Gregg W.
Published: April 2020

Background:

Whether revascularization improves prognosis in stable ischemic heart disease is controversial.

Methods:

Individual patient-level data from 19 prospective, randomized stent trials were pooled. Rates of 5-year major adverse cardiovascular events (MACE; a composite of cardiac death, myocardial infarction, or ischemia-driven target lesion revascularization) were assessed and compared after percutaneous coronary intervention with bare-metal stents (BMS) and first-generation and second-generation drug-eluting stents (DES1 and DES2, respectively). Poisson multivariable regression analysis was performed to identify predictors of adverse events.

Results:

Among 10 987 patients treated with percutaneous coronary intervention for stable ischemic heart disease, 1550, 2776, and 6661 received BMS, DES1, and DES2, respectively. The 5-year rates of MACE progressively declined with evolution in stent technology (BMS: 24.1% versus DES1: 17.9% versus DES2: 13.4%,
P
<0.0001). However, MACE rates between 1 and 5 years increased from BMS to DES1, then declined with DES2 (BMS: 7.4% versus DES1: 10.2%, DES2: 8.5%,
P
=0.02).

Conclusions:

Patients with stable ischemic heart disease remain at substantial risk for long-term MACE after revascularization with percutaneous coronary intervention, even with contemporary DES. New approaches to reduce the ongoing risk of MACE beyond 1 year after stent implantation are necessary.
Global Approach to High Bleeding Risk Patients With Polymer-Free Drug-Coated Coronary Stents
Authors: Krucoff Mitchell W. , Urban Philip , Tanguay Jean-François , McAndrew Thomas , Zhang Yiran , Rao Sunil V. , Morice Marie-Claude , Price Matthew J. , Cohen David J. , Abdel-Wahab Mohamed , Mehta Shamir R. , Faurie Benjamin , McLaurin Brent , Diaz Corie , Stoll Hans-Peter , Pocock Stuart , Leon Martin B.
Published: April 2020

Background:

High bleeding risk (HBR) patients undergoing percutaneous coronary intervention have been widely excluded from randomized device registration trials. The LF study (LEADERS FREE) reported superior outcomes of HBR patients receiving 30-day dual antiplatelet therapy after percutaneous coronary intervention with a polymer-free drug-coated stent (DCS). LFII was designed to assess the reproducibility and generalizability of the benefits of DCS observed in LF to inform the US Food and Drug Administration in a device registration decision.

Methods:

LFII was a single-arm study using HBR inclusion/exclusion criteria and 30-day dual antiplatelet therapy after percutaneous coronary intervention with DCS, identical to LF. The 365-day rates of the primary effectiveness (clinically indicated target lesion revascularization) and safety (composite cardiac death and myocardial infarction) end points were reported using a propensity-stratified analysis compared with the LF bare metal stent arm patients as controls.

Results:

A total of 1203 LFII patients were enrolled with an average 1.7 HBR criteria per patient, including 60.7% >75 years of age, 34.1% on anticoagulants, and 14.7% with renal failure. Propensity-adjusted 365-day clinically indicated target lesion revascularization was significantly lower with DCS (7.2% versus 9.2%; hazard ratio, 0.72 [95% CI, 0.52–0.98];
P
=0.0338 for superiority), as was the primary safety (cardiac death and myocardial infarction) composite (9.3% versus 12.4%; hazard ratio, 0.72 [95% CI, 0.55–0.94];
P
=0.0150 for superiority). Stent thrombosis rates were 2.0% DCS and 2.2% bare metal stent. Major bleeding at 1 year occurred in 7.2% DCS patients and 7.2% bare metal stent.

Conclusions:

LFII reproduces the results of the DCS arm of LF in an independent, predominantly North American cohort of HBR patients.
Association Between Immigration Status and Acute Stroke Care
Authors: Vyas Manav V. , Laupacis Andreas , Austin Peter C. , Fang Jiming , Silver Frank L. , Kapral Moira K.
Published: April 2020

Background and Purpose—

Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is known about the care and outcomes of stroke in immigrants.

Methods—

We used linked clinical and administrative data to conduct a retrospective cohort study of adults seen in the emergency department or hospitalized with ischemic stroke or transient ischemic attack between July 1, 2003, and April 1, 2013, and included in the provincial stroke registry. We ascertained immigration status using immigration records and compared processes of stroke care delivery between immigrants (defined as those immigrating after 1985) and long-term residents. In the subgroup with ischemic stroke, we calculated inverse probability treatment weight (IPTW)–adjusted risk ratios for disability on discharge (modified Rankin Scale score of 3 to 5), accounting for demographic characteristics and comorbid conditions to compare outcomes between immigrants and long-term residents.

Results—

We included 34 987 patients with ischemic stroke or transient ischemic attack, of whom 2649 (7.6%) were immigrants. Immigrants were younger than long-term residents at the time of stroke/transient ischemic attack (median age 67 years versus 76 years;
P
<0.001). In the subgroup with ischemic stroke, there were no differences in stroke care delivery, except that a higher proportion of immigrants received thrombolysis than long-term residents (21.2% versus 15.5%;
P
<0.001). Immigrants with ischemic stroke had a higher adjusted risk of being disabled on discharge (adjusted risk ratio, 1.18; 95% CI, 1.13–1.22) compared to long-term residents.

Conclusions—

Stroke care is similar in Canadian immigrants and long-term residents. Future research is needed to confirm the observed association between immigration status and disability after stroke and to identify factors underlying the association.
The Political Power of Proxies: Why Nonstate Actors Use Local Surrogates
Authors: Moghadam Assaf , Wyss Michel
Published: April 2020

Studies of conflicts involving the use of surrogates focus largely on states, viewing the relationship between sponsors and proxies primarily as one in which states utilize nonstate actors as proxies. They have devoted far less attention to sponsor-proxy arrangements in which nonstate actors play super-ordinate roles as sponsors in their own right. Why and how do nonstate actors sponsor proxies? Unlike state sponsors, which value proxies primarily for their military utility, nonstate sponsors select and utilize proxies mainly for their perceived political value. Simply put, states tend to sponsor military surrogates, whereas nonstate actors sponsor political ancillaries. Both endogenous actor-based traits and exogenous structural constraints account for these different approaches. An analysis of three case studies of nonstate sponsors that differ in terms of ideology and capacity—al-Qaida in the Arabian Peninsula, the People's Protection Units in Syria, and Hezbollah in Lebanon—confirms this argument, but also suggests that the ability and desire to control proxies varies with the sponsor's capacity. High-capacity nonstate sponsors such as Hezbollah behave similarly to state sponsors, but remain exceptional. Most nonstate sponsors are less dominant, rendering the relationships to their proxies more transactional and pragmatic, and ultimately less enduring than those of state sponsors and their clients.
Selective Wilsonianism: Material Interests and the West's Support for Democracy
Authors: Grigoryan Arman
Published: April 2020

When a mass movement broke out in 2013 against the corrupt government of Viktor Yanukovich in Ukraine, the United States and its West European allies mobilized to support it. The policy was justified by the Wilsonian logic of promoting democracy and celebrated as such by liberals. Realists for the most part agreed with the liberal argument regarding the motive of that support, but criticized it as delusional and argued that the subsequent civil war in Ukraine was the consequence of that policy. This is a puzzle, because five years prior to the Ukrainian events, a mass movement had rocked Armenia— another post-Soviet state. The West's attitude toward that movement, however, ranged from indifference to hostility, even though the Wilsonian motives for supporting that movement should have been stronger. The difference in the West's response resulted from the different positions of the two movements toward Russia: the Ukrainian movement was intensely hostile toward Russia, whereas the Armenian movement was not. In other words, where Wilsonianism dovetailed with a geopolitical motive, it was triggered; where it diverged, Wilsonianism remained dormant. This is not a deviation from the general pattern either. Contrary to the popular narrative, the West has supported democracy only when that support has been reinforced by material interests, and rarely, if ever, when it has posed a threat to such interests.
MJO Teleconnections over the PNA Region in Climate Models. Part II: Impacts of the MJO and Basic State
Authors: Wang Jiabao , Kim Hyemi , Kim Daehyun , Henderson Stephanie A. , Stan Cristiana , Maloney Eric D.
Published: April 2020

In an assessment of 29 global climate models (GCMs), Part I of this study identified biases in boreal winter MJO teleconnections in anomalous 500-hPa geopotential height over the Pacific–North America (PNA) region that are common to many models: an eastward shift, a longer persistence, and a larger amplitude. In Part II, we explore the relationships of the teleconnection metrics developed in Part I with several existing and newly developed MJO and basic state (the mean subtropical westerly jet) metrics. The MJO and basic state diagnostics indicate that the MJO is generally weaker and less coherent and propagates faster in models compared to observations. The mean subtropical jet also exhibits notable biases such as too strong amplitude, excessive eastward extension, or southward shift. The following relationships are found to be robust among the models: 1) models with a faster MJO propagation tend to produce weaker teleconnections; 2) models with a less coherent eastward MJO propagation tend to simulate more persistent MJO teleconnections; 3) models with a stronger westerly jet produce stronger and eastward shifted MJO teleconnections; 4) models with an eastward extended jet produce an eastward shift in MJO teleconnections; and 5) models with a southward shifted jet produce stronger MJO teleconnections. The results are supported by linear baroclinic model experiments. Our results suggest that the larger amplitude and eastward shift biases in GCM MJO teleconnections can be attributed to the biases in the westerly jet, and that the longer persistence bias is likely due to the lack of coherent eastward MJO propagation.
Mutualism Despite Ostensible Difference: HuShamwari, Kuhanyisana, and Conviviality Between Shona Zimbabweans and Tsonga South Africans in Giyani, South Africa
Authors: Chekero Tamuka , Morreira Shannon
Published: April 2020

This ethnographic study explores forms of mutuality and conviviality between Shona migrants from Zimbabwe and Tsonga-speaking South Africans living in Giyani, South Africa. To analyse these forms of mutuality, we draw on Southern African concepts rather than more conventional development or migration theory. We explore ways in which the Shona concept of hushamwari (translated as “friendship”) and the commensurate xiTsonga category of kuhanyisana (“to help each other to live”) allow for conviviality. Employing the concept of hushamwari enables us to move beyond binaries of kinship versus friendship relations and examine the ways in which people create reciprocal friendships that are a little “like kin.” We argue that the cross-cutting forms of collective personhood that underlie both Shona and Tsonga ways of being make it possible to form social bonds across national lines, such that mutuality can be made between people even where the wider social context remains antagonistic to “foreigners.”
Dynamics of Everyday Life within Municipal Administrations in Francophone and Anglophone Africa
Authors: Sabbi Matthew , Doumbia Lamine , Neubert Dieter
Published: April 2020

Decentralisation in sub-Saharan Africa promises to build responsive institutions, hold officials to account and promote popular participation. Still, existent studies ignore the everyday interface between decentralised structures and citizens, as well as how decentralised institutions function in relation to their local contexts and other “authorities” on the margins. These contexts shape service provision and the impact of local power structures on local communities. Against this backdrop, our conference in Dakar, Senegal, on “Dynamics of Everyday Life within Municipal Administrations in Francophone and Anglophone Africa,” which took place in May 2019, demonstrated three key points of interest: namely, how actors within local bureaucracies interface with those who are outside; how ordinary citizens appropriate the bureaucratic techniques of the state and how these actors negotiate and adapt to the daily practices of municipal administrations. In general, decentralisation is not simply implemented, rather, it creates new frameworks and spaces for both formal and informal public action.
Leading Inclusive Schools: Principal Perceptions, Practices, and Challenges to Meaningful Change
Authors: DeMatthews David E. , Serafini Amy , Watson Terri N.
Published: April 2020

Background: For over 50 years, special education has been used as a tool to maintain racial segregation, particularly in schools located in low-income communities of color. This study utilized tenets found in disability critical race theory (DisCrit) and inclusive school leadership literature to examine the perceptions, practices, and challenges associated with meaningful change in inclusive schools. Purpose: The purpose of this article was to understand how six elementary school principals, identified as effective inclusive leaders, perceived students with disabilities within a low-income Mexican American immigrant community along the U.S.–Mexico border. Findings: Our study highlights the important role principals play in creating inclusive schools and the ways in which race, disability, family background, language, and immigration status effect principals in their efforts to promote inclusion. While each principal recognized the noted factors above and confronted a multitude of challenges, they differed in their beliefs and approaches to creating inclusive schools. Some leadership practices were aligned to research focused on effective school leadership while others more closely resembled social justice leadership practices. Conclusion: Findings suggest that principals must take into consideration a variety of factors to create inclusive schools and must draw upon a broad range of practices amid resistance and challenges to meaningful change.