bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Quantitative Ex Vivo Model of Functional Mitral Regurgitation
Authors: Pasrija Chetan , Quinn Rachael , Ghoreishi Mehrdad , Eperjesi Thomas , Lai Eric , Gorman Robert C. , Gorman Joseph H. , Gorman Robert C. , Pouch Alison , Cortez Felino V. , D'Ambra Michael N , Gammie James S.
Published: August 2020

Objective

Durability of mitral valve (MV) repair for functional mitral regurgitation (FMR) remains suboptimal. We sought to create a highly reproducible, quantitative ex vivo model of FMR that functions as a platform to test novel repair techniques.

Methods

Fresh swine hearts ( n = 10) were pressurized with air to a left ventricular pressure of 120 mmHg. The left atrium was excised and the altered geometry of FMR was created by radially dilating the annulus and displacing the papillary muscle tips apically and radially in a calibrated fashion. This was continued in a graduated fashion until coaptation was exhausted. Imaging of the MV was performed with a 3-dimensional (3D) structured-light scanner, which records 3D structure, texture, and color. The model was validated using transesophageal echocardiography in patients with normal MVs and severe FMR.

Results

Compared to controls, the anteroposterior diameter in the FMR state increased 32% and the annular area increased 35% ( P < 0.001). While the anterior annular circumference remained fixed, the posterior circumference increased by 20% ( P = 0.026). The annulus became more planar and the tenting height increased 56% (9 to 14 mm, P < 0.001). The median coaptation depth significantly decreased (anterior leaflet: 5 vs 2 mm; posterior leaflet: 7 vs 3 mm, P < 0.001). The ex vivo normal and FMR models had similar characteristics as clinical controls and patients with severe FMR.

Conclusions

This novel quantitative ex vivo model provides a simple, reproducible, and inexpensive benchtop representation of FMR that mimics the systolic valvular changes of patients with FMR.
Oleuropein Improved Post Cerebral Stroke Cognitive Function by Promoting Histone Acetylation and Phosphorylation of cAMP Response Element-Binding Protein in MCAO Rats
Authors: Gao Yang , Li Xiaojin , Xu Rongjian , Guo Yan , Yin Haiyan , Tan Ruifeng , Qi Ze , Liu Guangzhe , Liang Jiahui , Ya Bailiu
Published: August 2020

Background:

Post-stroke cognitive impairment (PSCI) is commonest clinical disorder in which peripheral cholinergic activity is important. Oleuropein (OLP) is polyphenol is present in olive oil. Here we evaluated the effect of OLP in cognitive dysfunction rats in post cerebral stroke model.

Methods:

The post cerebral stroke cognitive dysfunction PSD rat model was created by occlusion of transient middle cerebral artery. The rats were divided into 6 groups named, Sham + Vehicle, Sham + OLP (50 mg/kg), PSD rats + Vehicle, PSD rats + OLP (20, 50 or 100 mg/kg). The spatial learning was assessed by Morris water maze (MWM). The expression of choline acetyltransferase (ChAT), acetylcholine (ACH), extent of histone acetylation and phosphorylation of cAMP response element-binding protein (CREB) were evaluated by Western blot assay and immunofluorescence staining.

Results:

Treatment of OLP at various doses showed higher number of spontaneous and rewarded alterations and lesser percentage bias compared to vehicle treated PSD rats. OLP resulted in decreased levels of ChAT and ACH, whereas the degree of histone acetylation and phosphorylation of CREB improved in dose dependent pattern.

Conclusion:

treatment of OLP improved PSCI via increasing the phosphorylation of CREB and histone acetylation, thus attenuating cholinergic activity.
Radial artery neuro guide catheter entrapment during mechanical thrombectomy for acute ischemic stroke: Rescue brachial plexus block
Authors: Satti Sudhakar R , Sivapatham Thinesh , Eden Tim
Published: August 2020

To our knowledge, radial artery catheter entrapment during mechanical thrombectomy for acute ischemic stroke using an 8 F neuro guiding catheter (.088 in ID) and successful use of a brachial plexus block has not been described in the literature. In this technical note, we describe a patient that underwent rapid and successful radial access mechanical thrombectomy for an acute right middle cerebral artery occlusion, however, during withdrawal of the Balt Ballast 0.088 inch long sheath (Balt USA, Irvine, CA, USA), radial/brachial artery entrapment was encountered. We describe a modified step-wise approach to previously published online article by Pitta et al. from 2017 SCAI communication in the management of catheter entrapment and describe the technique for ultrasound guided brachial plexus block, which helped avoid need for surgical removal.
Machine Learning of Concepts Hard Even for Humans: The Case of Online Depression Forums
Authors: Németh Renáta , Sik Domonkos , Máté Fanni
Published: August 2020

Social scientists of mixed-methods research have traditionally used human annotators to classify texts according to some predefined knowledge. The “big data” revolution, the fast growth of digitized texts in recent years brings new opportunities but also new challenges. In our research project, we aim to examine the potential for natural language processing (NLP) techniques to understand the individual framing of depression in online forums. In this paper, we introduce a part of this project experimenting with NLP classification (supervised machine learning) method, which is capable of classifying large digital corpora according to various discourses on depression. Our question was whether an automated method can be applied to sociological problems outside the scope of hermeneutically more trivial business applications. The present article introduces our learning path from the difficulties of human annotation to the hermeneutic limitations of algorithmic NLP methods. We faced our first failure when we experienced significant inter-annotator disagreement. In response to the failure, we moved to the strategy of intersubjective hermeneutics (interpretation through consensus). The second failure arose because we expected the machine to effectively learn from the human-annotated sample despite its hermeneutic limitations. The machine learning seemed to work appropriately in predicting bio-medical and psychological framing, but it failed in case of sociological framing. These results show that the sociological discourse about depression is not as well founded as the biomedical and the psychological discourses—a conclusion which requires further empirical study in the future. An increasing part of machine learning solution is based on human annotation of semantic interpretation tasks, and such human-machine interactions will probably define many more applications in the future. Our paper shows the hermeneutic limitations of “big data” text analytics in the social sciences, and highlights the need for a better understanding of the use of annotated textual data and the annotation process itself.
Successful surgical management of a ruptured popliteal artery aneurysm with acute common peroneal nerve neuropathy: A rare case
Authors: Wang Tiehao , Zhao Jichun , Yuan Ding
Published: August 2020

Objectives

Ruptured popliteal artery aneurysm is a rare entity, which can cause severe nerve neuropathy. Open surgical repair is the preferred treatment for ruptured popliteal artery aneurysm but may aggravate nerve injuries or lead to postoperative aneurysm enlargement. The current surgical techniques for ruptured popliteal artery aneurysm have some deficiencies.

Methods

We present the case of a 78-year-old woman with sudden swelling of left knee joint and left foot drop, which was caused by the ruptured popliteal artery aneurysm and its compression. A modified open surgical repair was applied in our case, and glucocorticoid therapy was given perioperatively.

Results

The motor function of left lower limb had rapidly recovered after operation, and six-month follow-up showed patency of prosthetic vessel and significant shrinkage of aneurysm sac.

Conclusions

Our modified open surgical repair can relieve the compression and prevent possible “type II endoleak” without dissecting in popliteal fossa. Acute common peroneal nerve neuropathy and foot drop are reversible with immediate removal of compression and glucocorticoid therapy for patients with ruptured popliteal artery aneurysm.
Control of trotting gait for load-carrying quadruped walking vehicle with eccentric torso
Authors: Tan Yongying , Chao Zhiqiang , Li Huaying , Han Shousong , Jin Ying
Published: August 2020

Aiming at the problems of common methods in trotting gait control of a load-carrying quadruped walking vehicle, a control method, combining virtual model and centroidal dynamics, is proposed. The control of the walking vehicle is divided into two parts, meaning the motion control of the vehicle body and the motion control of the swing leg. The virtual model control method is used to work out the accelerations of the vehicle body, while the centroidal dynamics approach is used to obtain the resultant forces acting on the vehicle. Next, quadratic programming is used to distribute the resultant forces to the foot-ends of the supporting legs. Last, combining the Jacobian matrices of supporting legs, the vehicle body’s motion control is achieved. The virtual forces, acting on the swing leg foot-end, are obtained using the virtual model control method. Combining the swing leg’s Jacobian matrix, joint torques of swing leg are worked out. Simulink and Adams are adopted to jointly simulate omnidirectional trotting of the vehicle, under the condition of fixed and shifting position of eccentric weight. The effects of the virtual model and centroidal dynamics control method are compared with that of the virtual model control method. The results show that the errors of roll angle and pitch angle are reduced by 50%, 89% and 50%, 80%, respectively, as derived by virtual model and centroidal dynamic control method, under the two conditions. The proposed control algorithm is proved effective.
Reduced skeletal muscle independently predicts 1-year aggravated joint destruction in patients with rheumatoid arthritis
Authors: Lin Jian-Zi , Liu Yin , Ma Jian-Da , Mo Ying-Qian , Chen Chu-Tao , Chen Le-Feng , Li Qian-Hua , Yang Ze-Hong , Zheng Dong-Hui , Ling Li , Miossec Pierre , Dai Lie
Published: August 2020

Background:

Numerous cross-sectional studies have reported the associations between rheumatoid arthritis (RA) and reduced skeletal muscle. We firstly explored the dynamic change of skeletal muscle and its effect on RA clinical outcomes in a real-world prospective cohort.

Methods:

Consecutive RA patients were treated according to the treat-to-target strategy and completed at least 1-year follow up. Clinical data and muscle index (assessed by bioelectric impedance analysis) were collected at baseline and visits at 3, 6, 9 and 12 months. Myopenia was defined by appendicular skeletal muscle mass index ⩽7.0 kg/m2 in men and ⩽5.7 kg/m2 in women. A 1-year radiographic progression as primary outcome was defined by a change in the total Sharp/van der Heijde modified score ⩾0.5 units.

Results:

Among 348 recruited patients, 315 RA patients (mean age 47.9 years, 84.4% female) completed 1-year follow up. There were 143 (45.4%) RA patients showing myopenia at baseline. Compared with those without baseline myopenia, RA patients with baseline myopenia had higher rate of 1-year radiographic progression (43.4% versus 21.5%, all p < 0.05). Baseline myopenia was an independent risk factor for 1-year radiographic progression with adjusted odds ratio (AOR) of 2.5-fold, especially among RA patients in remission at baseline both defined by Disease Activity Score in 28 joints (DAS28) including C-reactive protein (DAS28-CRP) or erythrocyte sedimentation rate (DAS28-ESR) with AOR of 18.5~42.9-fold. Further analysis of six subtypes of dynamic skeletal muscle change showed that newly acquired myopenia at endpoint was associated with radiographic progression (AOR of 5.4-fold).

Conclusions:

Reduced skeletal muscle is an independent predicting factor for 1-year aggravated joint destruction, especially in remission RA. The importance of dynamic monitoring of skeletal muscle and muscle improvement therapy are worth exploration.
Patients With Diabetes Using a New Glucose Meter With Blood Sugar Mentor and Dynamic Color Range Indicator Features Show Improved Interpretation and Willingness to Act on Blood Glucose Results (ASCEND Study)
Authors: Grady Mike , Cameron Hilary , Katz Laurence B.
Published: August 2020

Background

We examined whether dynamic color range indicator (DCRI) and blood sugar mentor (BSM) features in a new blood glucose meter could improve interpretation of results and encourage patient action.

Methods

One hundred and thirty three people with type 2 (T2D) ( n = 73) or type 1 diabetes (T1D) ( n = 60) evaluated information first without and then with DCRI or BSM guidance using interactive exercises.

Results

Subjects improved their ability to categorize results into low, in range, or high glycemic ranges by 29% (T2D) and 22% (T1D) (each P < .001). There was significantly greater willingness to act on high and low results shown with DCRI or BSM screens. Subjects also expressed a high degree of satisfaction with these features.

Conclusions

Use of DCRI and BSM in this meter may help patients improve their diabetes management decisions.
Building a Data-Driven Multiple Daily Insulin Therapy Model Using Smart Insulin Pens
Authors: Harbison Rocio , Hecht Michele , MacLeod Janice
Published: August 2020

A growing suite of connected devices including Bluetooth or cellular-enabled glucose monitoring devices, smart insulin pens, pumps, fitness trackers, blood pressure, and heart rate and weight monitors present a golden opportunity to build a data-driven clinical practice model including remote monitoring capability and virtual care. This paper will discuss this approach using diabetes as a case study and smart insulin pens as a use case. As payment and practice approaches evolve, there is growing interest from both patients and their health care teams in virtual care made possible by remote monitoring capability. Here, we will define the category of smart insulin pens, describe the hallmarks of a data-driven practice model, and delineate the steps to take to incorporate remote monitoring capability with smart insulin pens into diabetes care for injection therapy patients.
Traditional Herbal Medicine for the Prevention and Treatment of Cold and Flu in the Autumn of 2020, Overlapped With COVID-19
Authors: Shahrajabian Mohamad Hesam , Sun Wenli , Cheng Qi
Published: August 2020

Many herbs and plants included in several traditional systems have promising bioactive compounds for modern drug therapy. The second round of COVID-19 cases will be accompanied by the spread of seasonal influenza in the fall. The combination of the influenza season and the second wave of COVID-19 may lead to more confusion and put more pressure on public health systems. A literature survey was accomplished using multiple databases including PubMed, Science Direct, ISI web of knowledge, and Google Scholar. The most important antiviral herbs for cold and flu are Thymus vulgaris, honeysuckle flowers, Andrographis, yarrow, peppermint leaf and oil, and Calendula. The most important expectorant herbs for flu and cold are tulsi, snake root, licorice root, clove, slippery elm root, marshmallow osha root, and sage leaf. Immunostimulant herbs for these 2 diseases are Echinacea root, Eucalyptus, garlic, ginseng, marshmallow, slippery elm, Isatisroot, Usnea lichen, myrrh resin, and ginger root. In this mini-review, we mention the key role of some of the most important herbal plants and prescriptions against influenza and cold on the basis of traditional Asian medicine.
Coronavirus disease 2019 presenting with rhabdomyolysis
Authors: Mah Trina Jo , Lum Ying Hui , Fan Bingwen Eugene
Published: August 2020

Rhabdomyolysis is a clinical condition characterised by the breakdown of skeletal muscle. It has been attributed to viral infections. We describe a case of coronavirus disease 2019 (COVID-19) in a young male who presented with rhabdomyolysis. Myalgia and fatigue are common complaints in COVID-19 patients. We suggest that patients with COVID-19 be screened for rhabdomyolysis in order to facilitate early treatment with intravenous hydration, thus preventing complications such as acute kidney injury.
Renal salvage using stent graft placement after acute renal artery occlusion with prolonged ischemic time
Authors: Gao Yue , Miserlis Dimitrios , Longo G Matthew , Garg Nitin
Published: August 2020

Purpose

To describe a patient with acute renal artery occlusion who underwent successful revascularization procedure after experiencing a protracted ischemic period, which resulted in successful retrieval of renal function.

Case report

A 58-year-old male with a history of left renal artery stenosis and stent graft placement presented with symptoms of chest pain, shortness of breath, and flank pain. The patient was admitted to the Intensive Care Unit with the diagnosis of multiorgan failure and subsequent anuria that led to the initiation of hemodialysis. Computed tomography angiography demonstrated an aortic occlusion along with bilateral proximal renal artery occlusion with reconstitution of the mid to distal renal arteries via collateralization. The patient underwent angioplasty with bilateral renal artery stent-graft placement and successful revascularization of proximal renal arteries. Post-operatively, his renal function and urine output improved, and the patient was able to be weaned off hemodialysis along with the benefit of concurrent amelioration of his renovascular hypertension.

Conclusion

For select patients with renal artery occlusion, revascularization of the renal arteries may result in dialysis independence and stabilization of renovascular hypertension, despite prolonged time of ischemia.
Tachyarrhythmia improved by management of low back pain in a patient with delayed diagnosis of infective spondylodiscitis: A case report
Authors: Ota Koshi , Onishi Naoya , Fujii Kensuke , Nakamura Eriko , Oishi Yasuo , Oka Masahiro , Ota Kanna , Sano Yohei , Yokoyama Hiroki , Takasu Akira
Published: August 2020

A 77-year-old man presented to the emergency room with a 1-month history of persistent low back pain with the absence of vital sign abnormalities. On several previous orthopedic surgery clinic visits, pathological back pain had not been considered and pain killers had been prescribed because he had low back pain due to lumbar spinal canal stenosis. He was admitted to the intensive care unit for infectious spondylodiscitis and infective endocarditis with disseminated abscess caused by methicillin-resistant Staphylococcus aureus. Shock refractory tachyarrhythmia could not be managed with antiarrhythmic agent in the intensive care unit. Intractable low back pain and persistent tachyarrhythmia were adequately managed by pain control with fentanyl in the intensive care unit. Infectious spondylodiscitis and infective endocarditis were effectively managed with anti–methicillin-resistant Staphylococcus aureus drugs, initially in rotational usage, but the patient died of extended-spectrum beta-lactamase-producing Escherichia coli pneumonia on day 50 of hospitalization. Infectious spondylodiscitis should have been considered for persistent low back pain with hemodialysis, fever, and a history of device implantation. Pain management may be necessary for persistent tachycardia that proves unresponsive to usual antiarrhythmic medications.
Heuristics and political accountability in complex governance: An experimental test
Authors: Bertelli Anthony M. , Van Ryzin Gregg G.
Published: August 2020

A growing body of empirical work suggests that identifying the actors formally tasked with implementing policy can focus attention away from incumbent politicians. We examine the effects on blame attribution and voting intention of (a) the identifiability of a responsible policy worker (administrator), and (b) the evaluability of the policy work or outcome (policy failure), in the context of programs at two federal agencies (loans by the Small Business Administration and inspections by the U.S. Department of Agriculture). Using a set of online survey experiments with 1105 US adults, we find that the evaluability of a (negative) outcome generally reduces voting intention, but that the identifiability of a policy worker (administrator) tends to shift blame away from the incumbent politician and thus to increase voting intention. These experimental findings provide at least partial support for our theoretical expectations.
Inner nuclear layer and olfactory threshold are interlinked and reflect inflammatory activity in multiple sclerosis
Authors: Bsteh Gabriel , Hegen Harald , Altmann Patrick , Berek Klaus , Auer Michael , Zinganell Anne , Di Pauli Franziska , Rommer Paulus , Leutmezer Fritz , Deisenhammer Florian , Berger Thomas
Published: August 2020

Background

Retinal inner nuclear layer (INL) and olfactory threshold (OT) are associated with inflammatory activity in multiple sclerosis (MS).

Objective

The study aims to investigate (a) whether there is an association of INL and OT in MS and (b) if changes in INL and OT follow a time pattern in relation to MS relapse.

Methods

We assessed INL by optical coherence tomography and OT by Sniffin’ Sticks in three different cohorts: a cross-sectional MS cohort ( n = 260), a longitudinal, 3-year cohort of MS ( n = 141) and healthy controls ( n = 30), and a longitudinal, 24-weeks cohort with acute MS relapse ( n = 28) and stable MS controls ( n = 27).

Results

Cross-sectionally, INL and OT were strongly correlated with number but not localization of relapse in the previous 12 months and INL correlated with OT. Longitudinally, INL was thicker and OT score was lower short term in times of relapse activity, but not long term and independent of relapse localization. In acute MS relapse, INL and OT were altered compared with stable MS, again, independent of relapse localization resolving over 12–24 weeks with faster approximation to stable MS after escalation of disease-modifying treatment.

Conclusions

INL and OT are interlinked markers of short-term inflammatory activity, following a nearly congruent time pattern and independent of relapse localization, possibly reflecting a proinflammatory state within the central nervous system.
Between the Mundane and the Political: Women’s Self-Representations on Instagram
Authors: Caldeira Sofia P. , De Ridder Sander , Van Bauwel Sofie
Published: August 2020

Women’s self-representation on Instagram is often discussed in popular media in polarizing terms, as either an empowering practice or as boring and mundane. However, the political and the mundane are inevitably interwoven. This article grounds the discussions on how “the political” can be expressed through mundane Instagram practices on the analysis of individual self-representations of “ordinary” Instagram users (i.e., not celebrities or Insta-famous users). This research is based on a qualitative textual analysis of a sample of 77 randomly selected female Instagram users, ages 18–35, analyzing their photographic self-representations and its surrounding textual context—captions, comments, and likes. It explores how Instagram can broaden the scope of who and what is considered photographable, allowing for the representation of a wider variety of women and femininities underrepresented in popular media, and how this has the potential to upend hegemonic hierarchies of visibility. Following an Instagrammable aesthetic, these self-representations often take place in mundane contexts, as the photographable becomes extended to overlooked, yet essential, aspects of everyday life. It is in the context of these everyday self-representation practices that tangentially political themes become embedded, appearing in brief and often passing mentions that express self-worth, celebrate marginalized identities, or proclaim personal agency.
The (Parkland) kids are alright
Authors: Eckstein Justin
Published: August 2020

Wounds materialize in the wake of the event, when rhetoric inadequately indexes what is present in a situation. Such a position bypasses ethics from the transcendental ought or the purely descriptive is to an ethics grounded in an immanent occurrence. To give an example of this kind of rhetorical ethics, I turn to an example of a recent wound, the shooting at Marjory Stoneman Douglas High School, where the pathology of gun violence has created a wound that shattered our rhetorical sensorium. In the immediate aftermath, Emma Gonzales, a student and survivor of the Parkland shooting, seized upon this perspective on the wound to forge a new figure, the Parkland Kid, and with it new lines of argument. I argue her capacity to turn a wounding into a new subject illustrates a new rhetorical ethics that is inclusive; she became a subject of the shooting, the new Parkland Kid, that anyone is welcome to join. My contribution departs from the wound as a damaged attachment for its understanding as a productive force.
A Study on Challenges to Health Care Delivery Faced by Cancer Patients in India During the COVID-19 Pandemic
Authors: Mitra Manasij , Basu Maitraye
Published: August 2020

Introduction

Access to health care and care delivery during the COVID-19 pandemic may be challenging for cancer patients. Several guidelines have been developed, which recommend treatment adjustments depending on the site of cancer, grade, and stage. However, few studies in India and across the globe have looked into the real challenges faced by cancer patients and assessed the effectiveness of the adopted interventions. This study was undertaken with the objective to study the challenges faced by cancer patients in India during the COVID-19 pandemic.

Materials and Methods

This was a cross-sectional study undertaken between May 1, 2020 and May 15, 2020. A link to a prestructured questionnaire was sent through email to 100 randomly selected cancer patients in different stages of treatment and follow-up. Data were decoded and entered in Microsoft Excel 2010 and analyzed using descriptive statistics.

Results

Slot availability for teleconsultation, network issues, deferral of radiotherapy dates and long waiting hours beyond appointment time, transportation problems from residence to hospital, restriction of visitors/attendants, deferral of surgery, deferral of tumor boards, delay and deferral of advice of the nutritionist, problems faced in extension of visa, unavailability of peer group support services and psychological counseling sessions, difficulty in maintaining precautionary measures, availability of chemotherapy medications and availability of chemotherapy slots in day care were cited as problems faced by cancer patients. Majority (91.7%) of the study respondents mentioned an increase in their anxiety levels.

Conclusion

As highlighted in the study, cancer patients faced challenges in cancer care delivery during the COVID-19 pandemic. This study suggests the need for larger studies on cancer patient care during a pandemic.
Drug-Induced Liver Injury: A Unique Presentation of Single-Dose Administration of Propylthiouracil
Authors: Weissman Simcha , Rajaratnam Nishan G. , Qureshi Nabeel , Inayat Faisal , Elias Sameh
Published: August 2020

Antithyroid drug-induced severe liver injury is an uncommon but serious complication. We hereby delineate the case of a 38-year-old female who presented to the emergency department for an impending thyroid storm. After initiation of a single dose of propylthiouracil, her liver enzymes went into the thousands. She was subsequently admitted to the intensive care unit. Propylthiouracil was discontinued and corticosteroids were initiated with the resolution of her elevated liver enzymes. On follow-up, her liver function was at its baseline and thyroid hormone levels were under control. We hope this report will encourage clinicians to cast a broad differential diagnosis in patients presenting with liver injury in the acute setting. Furthermore, it is imperative to raise awareness regarding the ever-increasing list of pharmacologic agents that can perpetuate drug-induced hepatotoxicity.
A Rare Case of an Immunocompetent Male With Zoster Meningitis
Authors: Faluk Mohammed Ali , Makadia Shraddhadevi , Abdelmaseih Ramy , Hasan S. Mustajab , Abusaada Khalid
Published: August 2020

Varicella zoster meningitis is an uncommon complication of herpes zoster, especially in immunocompetent patients. We report a case of a healthy 45-year-old male who developed aseptic meningitis as a result of reactivated varicella zoster virus infection. This case highlights the importance of remaining cognizant of varicella zoster virus as a cause of meningitis in not only the elderly or immunocompromised patients but also in patients who are healthy.
IgG4-Related Disease Manifesting as Hypocomplementemic Tubulointerstitial Nephritis: A Rare Case Report and Literature Review
Authors: Bhattad Pradnya Brijmohan , Joseph David L. , Peterson Eric
Published: August 2020

Immunoglobulin G4–related disease (IgG4-RD) is a chronic fibrosing inflammatory systemic disorder that has been recognized relatively recently in the medical literature. Little is known about the exact disease pathogenesis and epidemiology. IgG4-RD may be asymptomatic or may have minimal symptoms or involve multiple organs with overt symptoms. The different phenotypes of IgG4-RD can lead to delayed or incorrect diagnosis. We report the case of a 66-year-old male with coal worker’s pneumoconiosis who presented with progressive kidney disease and was diagnosed with tubulointerstitial nephritis due to IgG4-RD. The patient was noted to have progressive kidney disease, skin involvement, worsening interstitial lung disease, complete vision loss in the left eye, and retroperitoneal fibrosis. Serologic workup revealed elevated inflammatory markers, IgG4 and IgG1 levels, and hypocomplementemia. A tissue biopsy helped us establish a definitive diagnosis of IgG4-RD and initiate treatment with glucocorticoids to prevent further progression of kidney disease and other end-organ damage.
Impact of Aging and the Electrode-to-Neural Interface on Temporal Processing Ability in Cochlear-Implant Users: Amplitude-Modulation Detection Thresholds
Authors: Shader Maureen J. , Gordon-Salant Sandra , Goupell Matthew J.
Published: August 2020

Although cochlear implants (CIs) are a viable treatment option for severe hearing loss in adults of any age, older adults may be at a disadvantage compared with younger adults. CIs deliver signals that contain limited spectral information, requiring CI users to attend to the temporal information within the signal to recognize speech. Older adults are susceptible to acquiring auditory temporal processing deficits, presenting a potential age-related limitation for recognizing speech signals delivered by CIs. The goal of this study was to measure auditory temporal processing ability via amplitude-modulation (AM) detection as a function of age in CI users. The contribution of the electrode-to-neural interface, in addition to age, was estimated using electrically evoked compound action potential (ECAP) amplitude growth functions. Within each participant, two electrodes were selected: one with the steepest ECAP slope and one with the shallowest ECAP slope, in order to represent electrodes with varied estimates of the electrode-to-neural interface. Single-electrode AM detection thresholds were measured using direct stimulation at these two electrode locations. Results revealed that AM detection ability significantly declined as a function of chronological age. ECAP slope did not significantly impact AM detection, but ECAP slope decreased (became shallower) with increasing age, suggesting that factors influencing the electrode-to-neural interface change with age. Results demonstrated a significant negative impact of chronological age on auditory temporal processing. The locus of the age-related limitation (peripheral vs. central origin), however, is difficult to evaluate because the peripheral influence (ECAPs) was correlated with the central factor (age).
Effect of Directional Microphone Technology in Hearing Aids on Neural Correlates of Listening and Memory Effort: An Electroencephalographic Study
Authors: Winneke Axel H. , Schulte Michael , Vormann Matthias , Latzel Matthias
Published: August 2020

The aim of the study was to compare the effect of different spatial noise-processing algorithms in hearing aids on listening effort and memory effort on a subjective, behavioral, and neurophysiological level using electroencephalography (EEG). Two types of directional microphone (DM) technologies for spatial noise processing were chosen: one with a wide directionality (wide DM) and another with a narrower directionality (narrow DM) to accentuate the speech source. Participants with a severe hearing loss were fitted with hearing aids and participated in two EEG experiments. In the first one, participants listened to sentences in cafeteria noise and were asked to rate the experienced listening effort. The second EEG experiment was a listening span task during which participants had to repeat sentence material and then recall the final words of the last four sentences. Subjective listening effort was lower with narrow than wide DM and EEG alpha power was reduced for the narrow DM. The results of the listening span task indicated a reduction in experienced memory effort and better memory performance. During the memory retention phase, EEG alpha level for the narrow relative to the wide DM was reduced. This effect was more pronounced during linguistically difficult sentences. This study extends previous findings, as it reveals a benefit for narrow DM in terms of cognitive performance and memory effort also on a neural level, and when speech intelligibility is almost 100%. Together, this indicates that a narrow and focused DM allows for a more efficient neurocognitive processing than a wide DM.
Delayed Sequelae Related to Mild Traumatic Brain Injury in Children
Authors: Chendrasekhar Akella , Kuczabski Brandon , Cohen Douglas , Grageda Melissa , Genovese-Scullin Daniel , Patwari Jakey , Harris Loren
Published: August 2020

Delayed sequelae from mild traumatic brain injury (Glasgow Coma Score at admission >13, TBI) has been documented in case reports however larger studies of these effects are sparse. We undertook a telephone based survey to assess the long term sequelae of TBI. We tracked 100 pediatric TBI patients via our trauma registry for demographic data including age, injury severity, and mechanism of injury. Then we proceeded to contact these patient’s parents via telephone. We asked regarding residual symptoms and signs of concussive injury.

Duration out from initial concussive injury ranged from 4 to 68 months. The parents of 66 boys and 34 girls were surveyed. The age of the patients at the time of mild TBI ranged from 1 to 14 years. The injury severity score ranged from 1 to 21. One being the most common Injury severity score. Thirty-three percent of patients had residual effects of concussion at the time of telephone survey. Fourteen percent had memory loss issues, 21% had anxiety/depression issues, 20% had learning disability issues, and 15% had sleep disturbance issues. Duration of time post concussive injury, mechanism, and age did not influence incidence of sequelae. Mild traumatic brain injury has significant long term sequelae. Better identifying characteristics are needed to characterize patients susceptible to long term residual effects of concussion.
Analysis of Online Urologist Ratings: Are Rating Differences Associated With Subspecialty?
Authors: Zillioux Jacqueline , Pike C William , Sharma Devang , Rapp David E
Published: August 2020

Patients are increasingly using online rating websites to obtain information about physicians and to provide feedback. We performed an analysis of urologist online ratings, with specific focus on the relationship between overall rating and urologist subspecialty. We conducted an analysis of urologist ratings on Healthgrades.com . Ratings were sampled across 4 US geographical regions, with focus across 3 practice types (large and small private practice, academic) and 7 urologic subspecialties. Statistical analysis was performed to assess for differences among subgroup ratings. Data were analyzed for 954 urologists with a mean age of 53 (±10) years. The median overall urologist rating was 4.0 [3.4-4.7]. Providers in an academic practice type or robotics/oncology subspecialty had statistically significantly higher ratings when compared to other practice settings or subspecialties ( P < 0.001). All other comparisons between practice types, specialties, regions, and sexes failed to demonstrate statistically significant differences. In our study of online urologist ratings, robotics/oncology subspecialty and academic practice setting were associated with higher overall ratings. Further study is needed to assess reasons underlying this difference.
The Effect of in-Service Methodology on Learning Transfer for School Personnel Managing Students following Concussion
Authors: Parent-Nichols Jennifer , Mousseau Angela DeSilva , Cleland Joshua , Lichtenstein Jonathan D. , Maerlender Arthur
Published: August 2020

Background

It is essential to increase the knowledge base of teachers involved in facilitating return to learning in middle school students following a concussion. However, the best method to enhance the transfer of learning for teachers remains to be elucidated. Application of Adult Learning Theory (ALT) is a plausible solution to this problem.

Purpose

The purpose of this randomized post-test study was to examine the effects of ALT on the transfer of learning in teachers who work with individuals with concussion.

Methods

A convenience sample of 169 teachers at four middle schools were randomized to receive an in-service regarding concussion management either in ALT or traditional lecture format. Vignettes approximating classroom practice evaluated learning transfer.

Results

one-way between subjects ANOVA revealed no significant difference between the methods of educational delivery on group assessment scores (p = .22). Additionally, a regression analysis did not identify any demographic variables that predicted learning transfer (p = .65). A statistically significant difference existed for four questions (1, 4, 7, 25) between the groups (p = .03, .02, .01, .00, respectively). These vignettes were those that assessed information that was likely novel to the learner.

Discussion

The current study demonstrated that ALT applied to teacher in-service did not impact transfer of learning immediately post training compared to a traditional lecture format. Future research should continue to examine the effects of various educational strategies to enhance learning transfer for teachers managing students in the classroom after concussion.
Impact of donor age and kinship on clinical outcomes after T-cell–replete haploidentical transplantation with PT-Cy
Authors: Mariotti Jacopo , Raiola Anna Maria , Evangelista Andrea , Carella Angelo Michele , Martino Massimo , Patriarca Francesca , Risitano Antonio , Bramanti Stefania , Busca Alessandro , Giaccone Luisa , Brunello Lucia , Merla Emanuela , Savino Lucia , Loteta Barbara , Console Giuseppe , Fanin Renato , Sperotto Alessandra , Marano Luana , Marotta Serena , Frieri Camilla , Sica Simona , Chiusolo Patrizia , Harbi Samia , Furst Sabine , Santoro Armando , Bacigalupo Andrea , Blaise Didier , Angelucci Emanuele , Mavilio Domenico , Castagna Luca , Bruno Benedetto
Published: August 2020

Donor selection contributes to improve clinical outcomes of T-cell–replete haploidentical stem cell transplantation (haplo-SCT) with posttransplant cyclophosphamide (PT-Cy). The impact of donor age and other non-HLA donor characteristics remains a matter of debate. We performed a multicenter retrospective analysis on 990 haplo-SCTs with PT-Cy. By multivariable analysis, after adjusting for donor/recipient kinship, increasing donor age and peripheral blood stem cell graft were associated with a higher risk of grade 2 to 4 acute graft-versus-host-disease (aGVHD), whereas 2-year cumulative incidence of moderate-to-severe chronic GVHD was higher for transplants from female donors into male recipients and after myeloablative conditioning. Increasing donor age was associated with a trend for higher nonrelapse mortality (NRM) (hazard ratio [HR], 1.05; P = .057) but with a significant reduced risk of disease relapse (HR, 0.92; P = .001) and improved progression-free survival (PFS) (HR, 0.97; P = .036). Increasing recipient age was a predictor of worse overall survival (OS). Risk of relapse was higher (HR, 1.39; P < .001) in patients aged ≤40 years receiving a transplant from a parent as compared with a sibling. Moreover, OS and PFS were lower when the donor was the mother rather than the father. Pretransplant active disease status was an invariably independent predictor of worse clinical outcomes, while recipient positive cytomegalovirus serostatus and hematopoietic cell transplant comorbidity index >3 were associated with worse OS and PFS. Our results suggest that younger donors may reduce the incidence of aGVHD and NRM, though at higher risk of relapse. A parent donor, particularly the mother, is not recommended in recipients ≤40 years.
Forced expression of miR-143 and -145 in cardiomyocytes induces cardiomyopathy with a reductive redox shift
Authors: Ogawa Kota , Noda Akiko , Ueda Jun , Ogata Takehiro , Matsuyama Rumiko , Nishizawa Yuji , Qiao Shanlou , Iwata Satoru , Ito Morihiro , Fujihara Yoshitaka , Ichihara Masatoshi , Adachi Koichi , Takaoka Yuji , Iwamoto Takashi
Published: August 2020

Background

Animal model studies show that reductive stress is involved in cardiomyopathy and myopathy, but the exact physiological relevance remains unknown. In addition, the microRNAs miR-143 and miR-145 have been shown to be upregulated in cardiac diseases, but the underlying mechanisms associated with these regulators have yet to be explored.

Methods

We developed transgenic mouse lines expressing exogenous miR-143 and miR-145 under the control of the alpha-myosin heavy chain (αMHC) promoter/enhancer.

Results

The two transgenic lines showed dilated cardiomyopathy-like characteristics and early lethality with markedly increased expression of miR-143. The expression of hexokinase 2 (HK2), a cardioprotective gene that is a target of miR-143, was strongly suppressed in the transgenic hearts, but the in vitro HK activity and adenosine triphosphate (ATP) content were comparable to those observed in wild-type mice. In addition, transgenic complementation of HK2 expression did not reduce mortality rates. Although HK2 is crucial for the pentose phosphate pathway (PPP) and glycolysis, the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSG) was unexpectedly higher in the hearts of transgenic mice. The expression of gamma-glutamylcysteine synthetase heavy subunit (γ-GCSc) and the in vitro activity of glutathione reductase (GR) were also higher, suggesting that the recycling of GSH and its de novo biosynthesis were augmented in transgenic hearts. Furthermore, the expression levels of glucose-6-phosphate dehydrogenase (G6PD, a rate-limiting enzyme for the PPP) and p62/SQSTM1 (a potent inducer of glycolysis and glutathione production) were elevated, while p62/SQSTM1 was upregulated at the mRNA level rather than as a result of autophagy inhibition. Consistent with this observation, nuclear factor erythroid-2 related factor 2 (Nrf2), Jun N-terminal kinase (JNK) and inositol-requiring enzyme 1 alpha (IRE1α) were activated, all of which are known to induce p62/SQSTM1 expression.

Conclusions

Overexpression of miR-143 and miR-145 leads to a unique dilated cardiomyopathy phenotype with a reductive redox shift despite marked downregulation of HK2 expression. Reductive stress may be involved in a wider range of cardiomyopathies than previously thought.
Kinetics and Specificity of HEK293T Extracellular Vesicle Uptake using Imaging Flow Cytometry
Authors: Jurgielewicz Brian J. , Yao Yao , Stice Steven L.
Published: August 2020

Extracellular vesicles (EVs) are nanosized lipid bilayer-bound vesicles that are naturally secreted from most cell types as a communication mechanism to deliver proteins, lipids, and genetic material. Despite the therapeutic potential of EVs, there is limited information on EV uptake kinetics and specificity. Here, we optimized an imaging flow cytometry (IFC)-based platform to quantitatively assess dose, time, and recipient cell specificity effects on human embryonic kidney cell (HEK293T) EV internalization in a high-throughput manner. We found that HEK293T EV uptake is an active process that is dose and time dependent. Further, the selectivity of EV uptake was quantified in vitro, and we found that HEK293T EVs were internalized at higher quantities by cells of the same origin. Lastly, neural stem cells internalized significantly more HEK293T EVs relative to mature neurons, suggesting that stem cells or progenitors, which are more metabolically active than terminally differentiated cells, may have higher rates of active EV internalization. The characterization of EV uptake, notably specificity, dose and time dependence, and kinetic assays will help inform and develop targeted and efficient EV-based therapeutics.
Investigation of mechanisms underlying chaotic genetic patchiness in the intertidal marbled crab Pachygrapsus marmoratus (Brachyura: Grapsidae) across the Ligurian Sea
Authors: Iannucci A. , Cannicci S. , Caliani I. , Baratti M. , Pretti C. , Fratini S.
Published: August 2020

Background

Studies on marine community dynamics and population structures are limited by the lack of exhaustive knowledge on the larval dispersal component of connectivity. Genetic data represents a powerful tool in understanding such processes in the marine realm. When dealing with dispersion and connectivity in marine ecosystems, many evidences show patterns of genetic structure that cannot be explained by any clear geographic trend and may show temporal instability. This scenario is usually referred to as chaotic genetic patchiness, whose driving mechanisms are recognized to be selection, temporal shifts in local population dynamics, sweepstakes reproductive success and collective dispersal.

In this study we focused on the marbled crab Pachygrapsus marmoratus that inhabits the rocky shores of the Mediterranean Sea, Black Sea and East Atlantic Ocean, and disperses through planktonic larvae for about 1 month. P. marmoratus exhibits unexpectedly low connectivity levels at local scale, although well-defined phylogeographic patterns across the species’ distribution range were described. This has been explained as an effect of subtle geographic barriers or due to sweepstake reproductive success. In order to verify a chaotic genetic patchiness scenario, and to explore mechanisms underlying it, we planned our investigation within the Ligurian Sea, an isolated basin of the western Mediterranean Sea, and we genotyped 321 individuals at 11 microsatellite loci.

Results

We recorded genetic heterogeneity among our Ligurian Sea samples with the occurrence of genetic clusters not matching the original populations and a slight inter-population divergence, with the geographically most distant populations being the genetically most similar ones. Moreover, individuals from each site were assigned to all the genetic clusters. We also recorded evidences of self-recruitment and a higher than expected within-site kinship.

Conclusions

Overall, our results suggest that the chaotic genetic patchiness we found in P. marmoratus Ligurian Sea populations is the result of a combination of differences in reproductive success, en masse larval dispersion and local larval retention. This study defines P. marmoratus as an example of marine spawner whose genetic pool is not homogenous at population level, but rather split in a chaotic mosaic of slightly differentiated genetic patches derived from complex and dynamic ecological processes.