bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure–response assessment of cancer mortality in styrene-exposed boatbuilders
Authors: Daniels Robert Douglas , Bertke Stephen J 
Published: May 2020

ObjectivesTo improve exposure estimates and reexamine exposure–response relationships between cumulative styrene exposure and cancer mortality in a previously studied cohort of US boatbuilders exposed between 1959 and 1978 and followed through 2016.MethodsCumulative styrene exposure was estimated from work assignments and air-sampling data. Exposure–response relationships between styrene and select cancers were examined in Cox proportional hazards models matched on attained age, sex, race, birth cohort and employment duration. Models adjusted for socioeconomic status (SES). Exposures were lagged 10 years or by a period maximising the likelihood. HRs included 95% profile-likelihood CIs. Actuarial methods were used to estimate the styrene exposure corresponding to 10-4extra lifetime risk.ResultsThe cohort (n= 5163) contributed 201 951 person-years. Exposures were right-skewed, with mean and median of 31 and 5.7 ppm-years, respectively. Positive, monotonic exposure–response associations were evident for leukaemia (HR at 50 ppm-years styrene = 1.46; 95% CI 1.04 to 1.97) and bladder cancer (HR at 50 ppm-years styrene =1.64; 95% CI 1.14 to 2.33). There was no evidence of confounding by SES. A working lifetime exposure to 0.05 ppm styrene corresponded to one extra leukaemia death per 10 000 workers.ConclusionsThe study contributes evidence of exposure–response associations between cumulative styrene exposure and cancer. Simple risk projections at current exposure levels indicate a need for formal risk assessment. Future recommendations on worker protection would benefit from additional research clarifying cancer risks from styrene exposure.
Analgesic efficacy of cannabinoids for acute pain management after surgery: a systematic review and meta-analysis
Authors: Abdallah Faraj W , Hussain Nasir , Weaver Tristan , Brull Richard 
Published: May 2020

BackgroundEvidence regarding the role of cannabinoids in managing acute postoperative pain is conflicting. The purpose of this systematic review and meta-analysis was to determine the analgesic efficacy of perioperative cannabinoid compounds for acute pain management after surgery.MethodsOriginal research articles evaluating the addition of cannabinoids to standard opioid-based systemic analgesia (Control) in the postoperative period were sought. Our primary outcomes were cumulative oral morphine equivalent consumption and rest pain severity at 24 hours postoperatively. We also assessed analgesic consumption in the postanesthesia care unit (PACU), pain scores in PACU, 6 and 12 hours postoperatively, and opioid-related and cannabinoid-related side effects, patient satisfaction, and quality of recovery as secondary outcomes.ResultsEight randomized controlled trials (924 patients) and four observational studies (4259 patients) were analyzed and included. There were insufficient data to pool for quantification of differences in cumulative oral morphine equivalent consumption and rest pain severity at 24 hours postoperatively with the addition of cannabinoids in comparison to Control. Qualitative synthesis revealed no differences in cumulative oral opioid consumption or pain at rest 24 hours postoperatively with the addition of cannabinoids in comparison to Control. Patients receiving cannabinoids appeared to have an increased weighted mean difference 95% CI of pain at 12 hours by 0.83 cm (0.04 to 1.63) (p=0.04). Patients receiving cannabinoids also appeared to have 3.24 times increased odds of developing hypotension postoperatively (95% CI 1.12 to 9.36) (p=0.03). Qualitative and quantitative synthesis revealed no differences in any other secondary outcomes.ConclusionsOur quantitative and qualitative review of the literature suggests that the analgesic role of perioperative cannabinoid compounds is limited, with no clinically important benefits detected when cannabinoids are added to traditional systemic analgesics compared with traditional systemic analgesics alone. Notably, there appears to be a signal towards increased postoperative pain and hypotension associated with the addition of perioperative cannabinoids to traditional systemic analgesics. These results do not support the routine use of cannabinoids to manage acute postoperative pain at the present time.
Successful transforaminal epidural blood patch in a patient with multilevel spinal fusion
Authors: Choi Hanwool Ryan , Fuller Benjamin , Bottros Michael Magdy 
Published: May 2020

IntroductionEpidural blood patch (EBP) is a vital tool in treating postdural puncture headache (PDPH). Traditional interlaminar epidural needle insertion into the epidural space, however, may be challenging due to anatomical variations. As an alternative method, we successfully performed an EBP via transforaminal approach.Case reportA mid-50-year-old male patient with multilevel spinal fusion developed PDPH after a failed spinal cord stimulator electrode placement. A transforaminal EBP was carried out by injecting a total of 8 mL of autologous blood into the neuroforamen at the L1–L2 level bilaterally. Our patient’s positional headache resolved immediately after the procedure.DiscussionTo our knowledge, this is the first case reported of a transforaminal EBP in a patient with diffuse epidural adhesive fibrosis secondary to multilevel laminectomies and spinal fusion. This case report highlights potential risks and benefits of this novel technique and also discusses its therapeutic mechanism of action. We believe that a transforaminal EBP should be considered in patients who are poor candidates for the traditional interlaminar EBP.
Berberine Induces <b><i>CYP2J2</i></b> Expression in Human U251 Glioma Cells via Regulation of Peroxisome Proliferator-Activated Receptor Alpha
Authors: Yu Xuming , Wang Shanshan , Wang Jia , Gong Jie , Shi Jinmin , Yu Shirong 
Published: May 2020

<b><i>Background:</i></b> Berberine is a promising natural drug that has a potential therapeutic effect on neurodegenerative diseases. <b><i>Objectives:</i></b> Using U251 cells in vitro, we investigated whether berberine exerts its neuroprotective effect via regulation of <i>CYP2J2</i>. <b><i>Method:</i></b> After pretreatment with increasing concentrations (1, 3, and 10 μmol/L) of berberine for 0.5 h, U251 cells were stimulated with 1 μg/mL of lipopolysaccharide (LPS). Cell viability was measured 24 h later using a CCK8 kit. mRNA and protein levels of <i>CYP2J2</i> and peroxisome proliferator-activated receptor alpha (<i>PPARα</i>) were measured by quantitative real-time-polymerase chain reaction and western blotting, respectively, after 24 h of exposure to 1, 3, or 10 μmol/L berberine. Fluorescence immunocytochemistry was also used to evaluate <i>PPARα</i> protein expression after treatment of U251 cells with 10-μmol/L berberine for 24 h. Transient transfection (cotransfection with the plasmid of <i>PPARα</i>- and <i>RXRα</i>-containing) followed by luciferase and chromatin immunoprecipitation assays was used to elucidate the molecular mechanism underlying the observed effects. <b><i>Results:</i></b> Compared to the control, LPS-induced U251 cell death was attenuated by berberine in a dose-dependent manner. After 24 h, cell viability was found to be 52.3% (<i>p</i> &#x3c; 0.05), 66.2% (<i>p</i> &#x3c; 0.01), and 70.9% (<i>p</i> &#x3c; 0.001) using 1, 3, and 10 μmol/L berberine treatment, respectively. At these concentrations, berberine increased the <i>CYP2J2</i> mRNA levels by 1.31-fold (<i>p</i> &#x3c; 0.05), 1.48-fold (<i>p</i> &#x3c; 0.01), and 1.88-fold (<i>p</i> &#x3c; 0.01), respectively, and increased the <i>PPARα</i> mRNA levels 1.17-fold (<i>p</i> &#x3c; 0.05), 1.29-fold (<i>p</i> &#x3c; 0.05), and 1.53-fold (<i>p</i> &#x3c; 0.01), respectively, compared with the respective control groups. In addition, the <i>CYP2J2</i> and <i>PPARα</i> protein level was also significantly upregulated in U251 cells by berberine (concentrations in 1, 3, and 10 μmol/L) in a dose-dependent manner, compared with the respective control groups. Further investigation indicated that berberine enhances the heterodimerization of <i>PPARα</i> and <i>RXRα</i>, which together bind to the <i>CYP2J2</i> promoter to induce the expression of <i>CYP2J2</i> in U251 cells. <b><i>Conclusion:</i></b> Upon exposure of U251 cells to berberine, <i>CYP2J2</i> expression is induced as a result of <i>PPARα</i> stimulation, resulting in a neuroprotective effect.
Self-Maintenance of Cardiac Resident Reparative Macrophages Attenuates Doxorubicin-Induced Cardiomyopathy Through the SR-A1-c-Myc Axis
Authors: Zhang Hanwen , Xu Andi , Sun Xuan , Yang Yaqing , Zhang Lai , Bai Hui , Ben Jingjing , Zhu Xudong , Li Xiaoyu , Yang Qing , Wang Zidun , Wu Wei , Yang Di , Zhang Yongjie , Xu Yong , Chen Qi 
Published: May 2020

Rationale:
Doxorubicin-induced cardiomyopathy (DiCM) is a primary cause of heart failure and mortality in cancer patients, in which macrophage-orchestrated inflammation serves as an essential pathological mechanism. However, the specific roles of tissue-resident and monocyte-derived macrophages in DiCM remain poorly understood.

Objective:
Uncovering the origins, phenotypes, and functions of proliferative cardiac resident macrophages and mechanistic insights into the self-maintenance of cardiac macrophage during DiCM progression.

Methods and Results:
Mice were administrated with doxorubicin to induce cardiomyopathy. Dynamic changes of resident and monocyte-derived macrophages were examined by lineage tracing, parabiosis, and bone marrow transplantation. We found that the monocyte-derived macrophages primarily exhibited a proinflammatory phenotype that dominated the whole DiCM pathological process and impaired cardiac function. In contrast, cardiac resident macrophages were vulnerable to doxorubicin insult. The survived resident macrophages exhibited enhanced proliferation and conferred a reparative role. Global or myeloid specifically ablation of SR-A1 (class A1 scavenger receptor) inhibited proliferation of cardiac resident reparative macrophages and, therefore, exacerbated cardiomyopathy in DiCM mice. Importantly, the detrimental effect of macrophage SR-A1 deficiency was confirmed by transplantation of bone marrow. At the mechanistic level, we show that c-Myc (Avian myelocytomatosis virus oncogene cellular homolog), a key transcriptional factor for the SR-A1-P38-SIRT1 (Sirtuin 1) pathway, mediated the effect of SR-A1 in reparative macrophage proliferation in DiCM.

Conclusions:
The SR-A1-c-Myc axis may represent a promising target to treat DiCM through augmentation of cardiac resident reparative macrophage proliferation.
Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19
Authors: Escalard Simon , Maïer Benjamin , Redjem Hocine , Delvoye François , Hébert Solène , Smajda Stanislas , Ciccio Gabriele , Desilles Jean-Philippe , Mazighi Mikael , Blanc Raphael , Piotin Michel 
Published: May 2020

Background and Purpose:
Higher rates of strokes have been observed in patients with coronavirus disease 2019 (COVID-19), but data regarding the outcomes of COVID-19 patients suffering from acute ischemic stroke due to large vessel occlusion (LVO) are lacking. We report our initial experience in the treatment of acute ischemic stroke with LVO in patients with COVID-19.

Methods:
All consecutive patients with COVID-19 with acute ischemic stroke due to LVO treated in our institution during the 6 first weeks of the COVID-19 outbreak were included. Baseline clinical and radiological findings, treatment, and short-term outcomes are reported.

Results:
We identified 10 patients with confirmed COVID-19 treated for an acute ischemic stroke due to LVO. Eight were men, with a median age of 59.5 years. Seven had none or mild symptoms of COVID-19 at stroke onset. Median time from COVID-19 symptoms to stroke onset was 6 days. All patients had brain imaging within 3 hours from symptoms onset. Five patients had multi-territory LVO. Five received intravenous alteplase. All patients had mechanical thrombectomy. Nine patients achieved successful recanalization (mTICI2B-3), none experienced early neurological improvement, 4 had early cerebral reocclusion, and a total of 6 patients (60%) died in the hospital.

Conclusions:
Best medical care including early intravenous thrombolysis, and successful and prompt recanalization achieved with mechanical thrombectomy, resulted in poor outcomes in patients with COVID-19. Although our results require further confirmation, a different pharmacological approach (antiplatelet or other) should be investigated to take in account inflammatory and coagulation disorders associated with COVID-19.
Political Marxism and the Rules of Reproduction of Capitalism: A Historicist Critique
Authors: Knafo Samuel , Teschke Benno 
Published: May 2020

Abstract
Marxism has often been associated with two different legacies. The first rests on a strong exposition and critique of the logic of capitalism, grounded in a systematic analysis of the laws of motion of capitalism as a system. The second legacy refers to a strong historicist perspective grounded in a conception of social relations that emphasises the centrality of power and social conflict to the analysis of history. This article challenges the prominence of structural accounts of capitalism by showing how the tension between these legacies has played out within Political Marxism, both orientations already having co-existed, somewhat uneasily, within Robert Brenner’s original contributions to the Transition Debate. Through this internal critique and re-formulation of Political Marxism, we wish to open a broader debate within Marxism on the need for a more agency-based account of capitalism, which builds more explicitly on the concept of social relations, to recover the historicist legacy of Marxism.
Marx’s Theory of Metabolism in the Age of Global Ecological Crisis
Authors: Saito Kohei 
Published: May 2020

Abstract
When the existing order cannot offer a solution, the solution to climate crisis must come from the radical left, and this is precisely why Karl Marx’s idea of ecosocialism is more important than ever. In this context, it is worth revisiting not only the legacy of István Mészáros’s theory of ‘social metabolism’ and that of his successors – who can be categorised as comprising the ‘metabolic rift school’, which includes John Bellamy Foster, Paul Burkett, and Brett Clark –, but also Karl Marx’s own theory of metabolism. In order to highlight the contemporary importance of Marx’s theory of metabolism after its long suppression in the twentieth century, this paper aims at classifying the three different levels of Marx’s concept of ‘metabolic rift’, which also entails clarifying three different levels of ‘metabolic shift’ as the theoretical foundation for updating Marx’s theory of postcapitalism in the age of global ecological crisis.
Do Ultrafine Cloud Condensation Nuclei Invigorate Deep Convection?
Authors: Grabowski Wojciech W. , Morrison Hugh 
Published: May 2020

AbstractNumerical simulations of the impact of ultrafine cloud condensation nuclei (CCN) on deep convection are analyzed to investigate the idea proposed by Fan et al. that addition of ultrafine CCN to an otherwise pristine environment leads to convective invigoration. The piggybacking methodology is applied, allowing rigorous separation of the impact of aerosols from different flow realizations that typically occur when even a small element of the model physics or modeling setup is changed. The setup follows the case of daytime convective development over land based on observations during the Large-Scale Biosphere–Atmosphere (LBA) experiment in Amazonia. Overall, the simulated impacts of ultrafine CCN are similar to the previous study by the authors on the impact of pollution on deep convection. There is no convective invigoration above the freezing level, but there is a small invigoration (increase in vertical velocities) below due to the supersaturation and buoyancy differences in conditions with additional ultrafine CCN compared to unperturbed pristine conditions. As in the previous study, the most significant impact is on the upper-tropospheric convective anvils that feature higher cloud fractions in conditions with ultrafine CCN. The increase comes from purely microphysical considerations as the increased cloud droplet concentrations from ultrafine CCN lead to increased ice crystal concentrations and, consequently, smaller sizes and fall velocities, and longer residence times. Mesoscale organization due to low-level shear has a small effect on the simulated ultrafine CCN impacts. Finally, an alternative explanation of increased lightning above oceanic shipping lines seen in satellite observations and argued to result from convective invigoration is provided.
Convective-Scale Sampling Error and Its Impact on the Ensemble Radar Data Assimilation System: A Case Study of a Heavy Rainfall Event on 16 June 2008 in Taiwan
Authors: Wu Pin-Ying , Yang Shu-Chih , Tsai Chih-Chien , Cheng Hsiang-Wen 
Published: May 2020

ABSTRACT
Sampling error stems from the use of ensemble-based data assimilation (EDA) with a limited ensemble size and can result in spurious background error covariances, leading to false analysis corrections. The WRF-LETKF radar assimilation system (WLRAS) is performed separately with 256 and 40 members to investigate the characteristics of convective-scale sampling errors in the EDA and its impact on precipitation prediction based on a heavy rainfall event on 16 June 2008. The results suggest that the sampling errors for this event are sensitive to the relationships between the simulated observations and model variables, the intensity of reflectivity, and how the prevailing wind projects to the radial wind in the areas that the radar cannot resolve U or V wind. The sampling errors lead to an underprediction of heavy rainfall when the horizontal localization radius is inadequately large, but this can be mitigated when a more accurate moisture condition is provided. In addition, being able to use a larger vertical localization plays an important role in providing necessary adjustments for representing the vertical thermodynamical structure of convection, which further improves precipitation prediction. A strategy mitigating the impact of sampling errors associated with the limitation of radial wind measurement by inflating the observation error over sensitive areas can bring benefits to precipitation prediction.
Surgical Intervention for Laryngomalacia: Age-Related Differences in Postoperative Sequelae
Authors: Patel Vijay A. , Adkins David , Ramadan Jad , Williamson Adrian , Carr Michele M. 
Published: May 2020

Objective: Identify risk factors and determine perioperative morbidity of children undergoing surgery for laryngomalacia (LM). Methods: A retrospective analysis of the multi-institutional American College of Surgeons National Surgical Quality Improvement Program-Pediatric Database (ACS-NSQIP-P) was performed to abstract patients aged <18 years with LM (ICD-10 code Q31.5) who underwent laryngeal surgery (CPT code 31541) from 2015 to 2017. Analyzed clinical variables include patient demographics, hospital setting, length of stay, medical comorbidities, postoperative complications, readmission, and reoperation. Results: A total of 491 patients were identified, 283 were male (57.6%) and 208 were female (42.4%). The mean age at time of surgery was 1.07 years (range .01-17 years). Younger patients were more likely to undergo surgery in the inpatient setting compared to their counterparts ( P < .001). Infants were more likely to have prolonged duration of days from admission to surgery ( P < .001), days from surgery to discharge ( P < .001), and total length of stay ( P<.0010). Finally, there was no significant difference between age groups with respect to 30-day general surgical complications ( P = .189), with an overall low incidence of reintubation (1.2%), readmission (3.1%), and reoperation (1.6%). Conclusion: This analysis supports laryngeal surgery as a safe surgical procedure for LM. However, younger children are more likely to undergo operative intervention in the inpatient setting, endure delays from hospital admission to surgical intervention, and experience a prolonged length of stay due to their overall medical complexity. Recognition of key factors may assist in optimizing perioperative risk assessment and promote timely procedural planning in this unique pediatric patient subpopulation.
The Clinical Significance of IGF-1R and Relationship with Epstein–Barr Virus Markers: LMP1 and EBERs in Tunisian Patients with Nasopharyngeal Carcinoma
Authors: Baizig Nehla Mokni , Wided Ben Ayoub , Amine Olfa El , Gritli Said , ElMay Michele 
Published: May 2020

Objectives: Tunisia is in the endemic area of nasopharyngeal carcinoma. Epstein–Barr virus (EBV) based assays have been commonly used as standard markers for screening and monitoring the disease. So, it is very important to find novel factors for the early diagnostic and prognostic evaluation of this cancer. The aim of the study was to evaluate the expression of IGF-1R (Insulin Growth Factor Receptor 1), LMP 1 (Latent Membrane Protein 1) and EBERs (EBV encoded RNAs) in order to determine their correlation with clinicopathologic parameters and survival rates in patients with nasopharyngeal carcinoma (NPC). We also looked for the relationship between these biomarkers. Methods: IGF-1R and LMP1 expression was performed by means of immunohistochemical method and EBERs were detected using in situ hybridization of paraffin embedded tumor tissues of 94 patients with nasopharyngeal carcinoma and 45 non-cancerous nasopharyngeal mucosa samples. Results: Our findings demonstrated that IGF-1R was over expressed in 47.87% of NPC patients and only in 2.22% of controls. Positive LMP1 expression was detected in 56.38% of NPC patients and all NPC patients were positive for the EBV-encoded RNAs staining. A statistically significant positive correlation was observed between IGF-1R expression and the tumor size ( P < .001). Kaplan–Meier survival curves showed that NPC patients with a strong IGF-1R expression level have shorter median and 5-year Overall Survival than those with weak expression rates (100.15 vs 102.68 months, P = .08). In addition, median and 5-year Disease-Free Survival was significantly lower in the LMP1 positive NPC patients than in the LMP1 negative ones (53.38 vs 93.37 months, P = .03). Moreover, LMP1 expression correlated strongly with IGF-1R expression ( P = .018). The relationship between these two biomarkers could influence patient survival. Conclusion: IGF1-R and LMP1 could be valuable prognostic markers in Tunisian NPC patients.