bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of 5‐Aminolevulinic Acid Photodynamic Therapy with Transfer Factor Capsules in the Treatment of Multiple Plantar Warts
Authors: Wu Chen , Qiu Xiamin , He Caifeng , Ci Chao
Published: November 2022

Background. Plantar warts are a common cutaneous disease of the sole of the foot caused by human papillomavirus. Photodynamic therapy has gained increasing attention in the treatment of plantar warts. Objective. To investigate the effect of photodynamic therapy combined with transfer factor capsules in the treatment of multiple plantar warts. Methods. Sixty‐one patients with multiple plantar warts who visited our outpatient department from September 2017 to August 2019 were randomly divided into two groups. Twenty‐three patients received photodynamic therapy (treatment group) and thirty‐eight received cryotherapy (control group). Both groups also received immune modulator transfer factor capsules. Skin lesion score, numeric rating scale‐ (NRS‐) 10 score, recurrence rate, adverse reactions, and Dermatology Life Quality Index (DLQI) were analyzed in both groups. Results. The mean skin lesion score improved from 13.39 ± 3.88 before treatment to 1.48 ± 2.50 after the last treatment in the treatment group and from 12.47 ± 2.99 before treatment to 4.47 ± 3.67 after the last treatment in the control group. The success rate after 3 months of treatment was 86.96% in the treatment group and 39.47% in the control group. After 3 months of follow‐up, the recurrence rate was significantly lower in the treatment group (20%) than in the control group (53.33%). The mean DLQI score at three months after treatment was significantly lower in the treatment group (3.61 ± 1.16) than in the control group (6.31 ± 2.59). Conclusion. Photodynamic therapy combined with immunomodulators significantly increased the cure rate and reduced the recurrence rate of multiple plantar warts compared with traditional cryotherapy combined with immunomodulators.
Associations of Maternal Fructosamine before Delivery in Gestational Diabetes Mellitus Pregnancies with Neonatal Glucometabolic Disorders
Authors: Mao Zhengxia , Wu Ruilin , Yu Huan , Zhang Yujiao , Dong Wenbin , Zou Lile , Lei Xiaoping
Published: November 2022

Background. The offspring of pregnant women with gestational diabetes mellitus (GDM) are vulnerable to be glucometabolic disorders. However, to date, few current studies focused on the associations of maternal accumulated glucose exposure before delivery with neonatal glucometabolic disorders and large for gestational age (LGA) infants. This study is aimed at exploring the associations of maternal fructosamine (FMN) before delivery in GDM pregnant women with neonatal glucometabolic disorders in the first 3 days of life and LGA infants. Methods. The study subjects were the GDM pregnant women, who gave birth in our hospital from September 1, 2018 to January 31, 2021, and their newborns. The maternal FMN adjusted by serum albumin (FMNALB) before delivery was selected as exposure factors. A multivariate logistical regression model was used to calculate the odds ratios (OR) for neonatal glucometabolic disorders, hypoglycemia needing intervention (<2.6 mmol/L), and glucose intolerance (>7.0 mmol/L) in the first 3 days and LGA infants. Results. In GDM pregnant women, the newborns in the maternal

FM

N

ALB

≥
75
th
 
percentile

(≥5.89 mmol/g) group had higher risks in neonatal glucometabolic disorders (aOR 2.50, 95% CI 1.34-4.65,

P
=
0.004

) and hypoglycemia (aOR 2.18, 95% CI 1.16-4.10,

P
=
0.016

). However,

FM

N

ALB

≥
75
th
 
percentile

seemed to be not predictive of the glucose intolerance (aOR 1.76, 95% CI 0.82-3.79,

P
=
0.149

) and LGA (aOR 1.56, 95% CI 0.81-3.02,

P
=
0.185

). Further, in the sensitivity analysis, the newborns in the maternal

FM

N

ALB

≥
90
th
 
percentile

(≥6.40 mmol/g) group also had higher risks in neonatal glucometabolic disorders (aOR 5.70, 95% CI 2.18-14.89,

P
<
0.001

) and hypoglycemia (aOR 3.72, 95% CI 1.48-9.31,

P
=
0.005

). Conclusions. The maternal FMNALB before delivery in GDM pregnant women was a useful biomarker to identify the offspring with high risk of neonatal glucometabolic disorders. However, the association between maternal FMNALB and the risk of LGA infants was not so strong.
San-Huang-Yi-Shen Capsule Ameliorates Diabetic Kidney Disease through Inducing PINK1/Parkin-Mediated Mitophagy and Inhibiting the Activation of NLRP3 Signaling Pathway
Authors: Li Hanzhou , Wang Yuansong , Su Xiuhai , Wang Qinghai , Zhang Shufang , Sun Wenjuan , Zhang Tianyu , Dong Mengxue , Zhang Zhaiyi , Lv Shuquan
Published: November 2022

San-Huang-Yi-Shen capsule (SHYS) has been used in the treatment of diabetic kidney disease (DKD) in clinics. However, the mechanism of SHYS on DKD remains unclear. In this study, we used a high-fat diet combined with streptozocin (STZ) injection to establish a rat model of DKD, and different doses of SHYS were given by oral gavage to determine the therapeutic effects of SHYS on DKD. Then, we studied the effects of SHYS on PINK1/Parkin-mediated mitophagy and the activation of NLRP3 inflammasome to study the possible mechanisms of SHYS on DKD. Our result showed that SHYS could alleviate DKD through reducing the body weight loss, decreasing the levels of fasting blood glucose (FBG), and improving the renal function, insulin resistance (IR), and inhibiting inflammatory response and oxidative stress in the kidney. Moreover, transmission electron microscopy showed SHYS treatment improved the morphology of mitochondria in the kidney. In addition, western blot and immunoflourescence staining showed that SHYS treatment induced the PINK1/Parkin-mediated mitophagy and inhibited the activation of NLRP3 signaling pathway. In conclusion, our study demonstrated the therapeutic effects of SHYS on DKD. Additionally, our results indicated that SHYS promoted PINK1/Parkin-mediated mitophagy and inhibited NLRP3 inflammasome activation to improve mitochondrial injury and inflammatory responses.
Electroacupuncture Activates Neuroplasticity in the Motor Cortex and Corticospinal Tract via the mTOR Pathway in a Rat P‐MCAO Model
Authors: Zhang You , Yin Ya-Long , Jin Zi-Yan , Hu Qi-Ping , Wu Xin-gui
Published: November 2022

Electroacupuncture (EA) combines traditional Chinese medicine acupuncture theory with modern scientific technology. It is a promising therapy for the treatment of cerebrovascular diseases such as cerebral infarction. A large number of clinical studies have shown that EA promotes recovery of neurological function after cerebral infarction, however, the underlying mechanisms behind its effects remain unclear. We tested whether EA stimulation of the Zusanli (ST36) and Neiguan (PC6) acupoints activates neuroplasticity in rats with ischemic stroke and whether this involves the regulation of axonal regeneration through the mTOR pathway. 24 h after permanent middle cerebral artery occlusion (p‐MCAO) in rats, EA treatment was started for 20 min, daily, for 14 days. We found that EA significantly reduced Modified Neurological Severity Scores (mNSS), cerebral infarct volume, and apoptosis of neuronal cells. EA also significantly increased the expression of the neuroplasticity‐associated proteins GAP‐43 and SYN and upregulated the phosphorylation levels of AKT, mTOR, S6, and PTEN to promote CST axon sprouting in the spinal cord at C1–C4 levels. The positive effects of EA were blocked by the administration of the mTOR inhibitor Rapamycin. In short, we found that EA of the Zusanli (ST36) and Neiguan (PC6) acupoints in p‐MCAO rats induced neuroprotective and neuroplastic effects by regulating the mTOR signaling pathway. It promoted neuroplasticity activated by axon regeneration in the contralateral cortex and corticospinal tract. Activation of such endogenous remodeling is conducive to neurological recovery and may help explain the positive clinical effects seen in patients with infarcts.
Uranium Dust Cloud Combustion: Burning Characteristics and Absorption Spectroscopy Measurements
Authors: Weerakkody Emily N. , Read Brian A. , Clemenson Michael D. , Glumac Nick G.
Published: November 2022

This study characterized uranium metal dust cloud combustion using absorption spectroscopy, imaging, and broadband emission measurements. Other metals were similarly combusted to establish correlations between results from this study and those found in the literature. It was determined that the burn temperature of uranium was limited to the volatilization temperature of uranium dioxide. Combustion behavior was similar to that of other refractory metals in terms of burn time and the observation of exploding particle behavior.
Anti-Onchocercal Properties of Extracts of Scoparia dulcis and Cylicodiscus gabunensis
Authors: Tiku Tiku Edward , Samje Moses , Mfonku Napoleon , Cho-Ngwa Fidelis
Published: November 2022

Introduction. The elimination of onchocerciasis is hampered by the absence of suitable drugs that are effective against adult filariae. This study is aimed at assessing the anti-onchocercal effects of extracts of Scoparia dulcis and Cylicodiscus gabunensis that could serve as drug leads against onchocerciasis. Methods. Different parts of the plants (Scoparia dulcis and Cylicodiscus gabunensis) were extracted with hexane, methylene chloride, and methanol. The extracts were tested in vitro against the bovine model parasite, Onchocerca ochengi. Adult female worm viability was determined biochemically by MTT/formazan colorimetry, while the adult male and microfilariae viability were determined by microscopy based on % inhibition of worm motility score. Cytotoxicity and acute toxicity of active extracts were tested on monkey kidney epithelial cells (LLC-MK2) and Balb/C mice, respectively. Results. The hexane extract of Scoparia dulcis recorded the highest activity, with IC50s of 50.78 μg/ml on both adult male and female worms and 3.91 μg/ml on microfilariae. For Cylicodiscus gabunensis extract, the highest activity was seen with the methylene chloride extract, with IC50s of 50.78 μg/ml, 62.50 μg/ml, and 16.28 μg/ml on, respectively, adult male, female, and microfilariae. The 50% cytotoxic concentration on the LLC-MK2 cells was 31.25 μg/ml for the most active extracts. No acute toxicity was recorded for the extracts. Phytochemical analysis of the extracts revealed the presence of alkaloids, flavonoids, sterols, saponins, phenols, and glycosides. Conclusion. This study validates the traditional use of these plants in treating onchocerciasis and suggests S. dulcis and C. gabunensis as new potential sources for the isolation of anti-onchocerca lead compounds.
Performance Evaluation of ICT Companies Using Hybrid MCDM Method in Iran
Authors: Nasri Seyed Amir , Safaie Nasser , Sarabi AmirHossein , Eghbali Ali , Barkhordari Gholamreza
Published: November 2022

The essential principles in sustainable development are information and communication technology and their influence on the country’s economic progress. In essence, in culture, politics, economics, and society, information and communication technology are the driving force behind globalization. This has a significant impact on the emergence of the network society and cross-national awareness, and it is the primary driver behind global markets. A descriptive-analytical method is used in a scrolling manner, and a scientific approach is taken from the methodology’s standpoint. ICT companies in a selected region of Iran were surveyed in a questionnaire survey. “Success” in ICT standard setting is discussed in this study. A fuzzy analytical hierarchy process (FAHP) and VIKOR methods were used to analyze data and prioritize the beneficial factors that contribute to the success of ICT companies. Twenty five ICT companies were evaluated using these methods. Utilizing the expert’s opinion and previous research, 21 criteria into five categories were elicited and estimated near Tehran (Qom), Iran’s capital. In this research, native influential factors are compared with other countries’ general vital factors, which are distinct from previous studies. Based on the results, in-company management factors, technological and marketing factors, financial costs, government policies, and native features were the most important critical factors. As significant factors that influence the success of ICT companies, employee involvement, teamwork, customer focus, the state of the economy, and conflict of interest between governmental and private sectors were selected.
Evaluation of Reservoir Parameters and Well Productivity Based on Production Data: A Field Case in Xinjiang Oilfield, China
Authors: Chen Rui , Guo Qiao , Li Jiaqi , Zhang Yijun , Bai Wenpeng , Cheng Shiqing , Wang Yang
Published: November 2022

The understanding of formation has always been a challenge for field development. In this paper, we evaluate the reservoir parameters and gas well productivity based on production data. The model of nonuniform conductivity of fractures in multistage fracturing horizontal wells (MFHW) is used to interpret the transient pressure data. Binomial and exponential deliverability equations and pressure dimensionless productivity formula are combined to evaluate the gas well productivity. After that, the key factors that influence gas well production are analyzed, and the gas rate vs. oil nozzle is presented. Results show that the fracture half-length and conductivity for high- and low-conductivity fractures, respectively, are obtained, apart from the reservoir pressure, permeability, skin factor, etc. The test time in each oil nozzle is recommended to extend to achieve stability and to obtain a more accurate absolute open flow potential. The findings of this study provides a guidance for the production data analysis of nonuniform conductivity of fractures in MFHW in the future work. And it can help for the better understanding of predicting gas production rates in MFHW.
Uncontrolled Hypertension and Behavioral Risk Factors among Adult Hypertensive Patients at Saint Paul’s Hospital, Millennium Medical College, Addis Ababa, Ethiopia
Authors: Sisay Yemisirach , Abera Hana , Biratu Tolesa Diriba , Legesse Tesfaye Girma
Published: November 2022

Introduction. Uncontrolled hypertension is a state of systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg even though the patients are on antihypertension. The WHO states that it is the most prevalent risk factor for death and disability worldwide, particularly in developing nations. The goal of the current study was to investigate behavioral risk factors for uncontrolled hypertension among adult hypertensive patients in Ethiopia. Methods. From October to November 2020, a cross-sectional study design was carried out in the hypertension follow-up clinic at Saint Paul’s Hospital, Millennium Medical College. The choice of 474 study participants was made using a straightforward random sampling method. A semistructured questionnaire was used to obtain data through a chart review as well as an interview. The data were coded before being imported into Epi-data version 7.0 and exported to SPSS version 25 for analysis. To determine the factors associated with uncontrolled hypertension, a multivariate logistic regression model (AOR, 95% CI, and

p

value 0.05) was used. Result. This study found that 52.1% of hypertensive patients had uncontrolled hypertension. Among hypertensive patients who are alcoholics, smokers, or salt consumers, the odds of having uncontrolled hypertension are AOR = 16.7, 95% CI = (8.13–34.346); AOR = 7.4, 95% CI = (1.211–45.29); and AOR = 13.4, 95% CI = (7.355–25.098), respectively. Uncontrolled hypertension is 3 (AOR and 95% CI) and 1.5 (AOR and 95% CI) times more prevalent in illiterates and obese people, correspondingly. Hypertensive patients from urban areas, those who did not engage in physical activity, and those who were overweight had uncontrolled hypertension odds that were 0.55, 0.43, and 0.25 (AOR and 95% CI) times lower, respectively. Conclusion. Uncontrolled hypertension is very common among adult hypertensive patients at the hospital. Behavioral practices and lifestyles factors have a strong association with uncontrolled hypertension. Health education and awareness are on the effect of poor behavior practices and lifestyles to increase adherence to hypertension-controlling medical advice.
Grouting Treatment and Parameters Optimization in Watery Karst Areas of High Speed Railway Tunnel Based on Comprehensive Geological Forecast: A Case Study
Authors: Wu Shan , Qiu Weichao , Liu Dunwen , Tang Yu
Published: November 2022

Based on the failure of the initial grouting scheme in tunnel engineering, an integrated geological forecasting system incorporating an industrial endoscope was used to detect watery karst areas in this tunnel. Numerical simulations were used to analyze the change patterns of arch top settlement, arch bottom bulge, and water surge in the tunnel under different grouting thicknesses. Compared to the displacement of the support structure, curtain grouting thickness is mainly reflected in reducing the amount of water surge. When the grouting thickness exceeds 5 m, the water-stopping effect of the tunnel is almost unchanged. Finally, a grout thickness of 5 m and a grout length of 25 m were selected as the grouting range for this project. During grouting, the combination of the three grouting techniques can effectively solve the problems of high water surges and difficult hole formation. The principle of “combination of exploration and injection” was followed to obtain real-time geological information and optimize the subsequent grouting plan. After the grouting, the grouting evaluation results and the field construction conditions showed that the grouting effect was good.
Cutaneous Larvae Migrans Treated with a Single Dose of Ivermectin
Authors: Harrison Iris S. , Lukose Kiran , Dass Bhagwan , Radhakrishnan Nila S.
Published: November 2022

Hookworm-related cutaneous larva migrans (HrCLM) is a clinical diagnosis based on a history of exposure to contaminated soil and is associated with a characteristic red serpiginous lesion that migrates within the epidermis. Our patient presented with a red, tortuous migratory rash with localized pruritus on the left plantar foot of 1-month duration. He lacked recent travel history outside the southeastern United States. Upon admission, he presented with peripheral blood eosinophilia, an uncommon feature of HrCLM. A single dose of ivermectin was sufficient for treatment, and symptoms resolved within 3 days. This case highlights the increased incidence of domestically acquired hookworm infections, explores this epidemiological shift, and emphasizes relevant differential diagnoses.
The Role of Oxidative Stress in Acute Ischemic Stroke-Related Thrombosis
Authors: Li Zhifang , Bi Rentang , Sun Shuai , Chen Shengcai , Chen Jiefang , Hu Bo , Jin Huijuan
Published: November 2022

Acute ischemic stroke is a serious life-threatening disease that affects almost 600 million people each year throughout the world with a mortality of more than 10%, while two-thirds of survivors remain disabled. However, the available treatments for ischemic stroke are still limited to thrombolysis and/or mechanical thrombectomy, and there is an urgent need for developing new therapeutic target. Recently, intravascular oxidative stress, derived from endothelial cells, platelets, and leukocytes, has been found to be tightly associated with stroke-related thrombosis. It not only promotes primary thrombus formation by damaging endothelial cells and platelets but also affects thrombus maturation and stability by modifying fibrin components. Thus, oxidative stress is expected to be a novel target for the prevention and treatment of ischemic stroke. In this review, we first discuss the mechanisms by which oxidative stress promotes stroke-related thrombosis, then summarize the oxidative stress biomarkers of stroke-related thrombosis, and finally put forward an antithrombotic therapy targeting oxidative stress in ischemic stroke.
Reprogramming the Canine Glioma Microenvironment with Tumor Vaccination plus Oral Losartan and Propranolol Induces Objective Responses
Authors: Ammons Dylan T. , Guth Amanda , Rozental Aaron J. , Kurihara Jade , Marolf Angela J. , Chow Lyndah , Griffin John F. , Makii Rebecca , MacQuiddy Brittany , Boss Mary-Keara , Regan Daniel P. , Frank Chad , McGrath Stephanie , Packer Rebecca A. , Dow Steven
Published: November 2022

Purpose:

Malignant gliomas have a highly immune-suppressive tumor microenvironment (TME) which renders them largely unresponsive to conventional therapeutics. Therefore, the current study evaluated a therapeutic protocol designed to overcome the immune barrier by combining myeloid cell–targeted immunotherapy with tumor vaccination.

Experimental Design:

We utilized a spontaneously occurring canine glioma model to investigate an oral TME modifying immunotherapy in conjunction with cancer stem cell (CSC) vaccination. Dogs were treated daily with losartan (monocyte migration inhibitor) and propranolol (myeloid-derived suppressor cell depleting agent) plus anti-CSC vaccination on a biweekly then monthly schedule. Tumor volume was monitored by MRI and correlated with patient immune responses.

Results:

Ten dogs with histologically confirmed gliomas were enrolled into a prospective, open-label clinical trial to evaluate the immunotherapy protocol. Partial tumor regression was observed in 2 dogs, while 6 dogs experienced stable disease, for an overall clinical benefit rate of 80%. Overall survival times (median = 351 days) and progression-free intervals (median = 163 days) were comparable with prior studies evaluating surgical debulking followed by immunotherapy. Dogs with detectable anti-CSC antibody responses had an increased overall survival time relative to dogs that did not generate antibody responses (vaccine responder MST = 500 days; vaccine nonresponder MST = 218 days; P = 0.02).

Conclusions:

These findings suggest that combining myeloid cell–targeted oral immunotherapy with tumor vaccination can generate objective tumor responses, even in the absence of conventional therapy. Overall, this approach has promise as a readily implemented therapeutic strategy for use in patients with brain cancer.

Significance:

In a pilot study of 10 dogs with glioma, we found that orally administered losartan and propranolol plus vaccination induced durable tumor responses in 8 of 10 treated dogs. The immunotherapy protocol was well tolerated, without systemic or local toxicities. These findings indicate that continuous oral immunotherapy plus tumor vaccination is a promising new strategy for glioma management that can be readily applied in clinical trials.
A Rare Case of Castrate-Resistant Prostate Adenocarcinoma with a Unilateral Testicular Metastasis Mimicking a Primary Testicular Tumour
Authors: Hong Jun Hee , Nindra Udit , Nguyen Rebecca , Gassner Paul , Balakrishnar Bavanthi , Rutland Tristan
Published: November 2022

Prostate adenocarcinoma with testicular metastasis is rare, present in up to 4% of autopsy diagnoses, and presents symptomatically in less than 0.5% of cases. We report an unusual case of a 55-year-old male who developed a symptomatic testicular metastasis from primary prostate cancer 4 years after initial diagnosis of metastatic castrate-sensitive prostate cancer with nodal and bone-only involvement. The patient had orchidectomy, histologically confirming the metastasis and revealing sparing of the spermatic cord. Prior treatment for his metastatic castrate-sensitive prostate cancer had included androgen deprivation therapy and upfront docetaxel chemotherapy. He had received palliative radiotherapy for symptomatic bone metastasis and managed on enzalutamide for castrate-resistant disease for the preceding 22 months with ongoing PSA response at the time of diagnosis of new testicular metastasis, with a further significant PSA response following his “testicular metastasectomy.” At the time of diagnosis of testicular metastasis, he did not have any evidence of other visceral metastases, and his metastatic disease otherwise remained radiologically stable. We describe his disease course, treatment and outline the rare nature of his case of testicular metastasis from prostate cancer.
K-METTA: Kognitive Techniken und Metta-Meditationen zur Reduktion traumabezogener Schuld- und Schamgefühle – Darstellung der Intervention anhand von zwei Fallbeispielen
Authors: Kümmerle Stella , Hammerstein Svenja , Helmig Ella-Marie , Müller-Engelmann Meike
Published: November 2022

Hintergrund: Angst- und Ohnmachtsgefühle wurden lange als zentrale Emotionen der PTBS betrachtet. Neuere For­schungsergebnisse legen jedoch nahe, dass insbesondere nach interpersonellen Gewalterfahrungen Schuld- und Schamgefühle eine entscheidende Rolle für die Entstehung und Aufrechterhaltung einer PTBS spielen. Metta-Meditationen (deutsch: Liebende Güte) zielen darauf ab, sich selbst und anderen Menschen bedingungsloses Wohlwollen und Freundlichkeit entgegenzubringen. Durch das Praktizieren von Metta lässt sich Selbstkritik reduzieren und das Gefühl der sozialen Verbundenheit stärken. Methoden: K-METTA ist eine Intervention (6 Sitzungen) zur Reduktion traumabezogener Schuld- und Schamgefühle, bei der kognitive Techniken mit Metta-Meditationen kombiniert werden. Hierbei werden in den Sitzungen 1 und 2 zunächst den Schuldgefühlen zugrunde liegende Kognitionen im sokratischen Dialog hinterfragt. Der Schwerpunkt der Sitzungen 3–6 liegt, neben der Vertiefung der kognitiven Interventionen, auf Metta-Meditationen. Hierbei üben Patient*innen, gute Wünsche an sich selbst und andere zu richten. Fallberichte: Die Behandlung von zwei Patientinnen, die Opfer von sexueller Gewalt geworden sind, wird exemplarisch dargestellt. Deskriptive prä-post Vergleiche zeigen eine Reduktion traumabezogener Schuld- und Schamgefühle sowie der PTBS-Symptomatik und weiterer psychischer Symptome. Schlussfolgerung: Gezielte Interventionen zur Verringerung traumabezogener Schuld- und Schamgefühle können dazu beitragen, die Wirksamkeit traumatherapeutischer Behandlungen zu verbessern. Hierfür erscheint eine Kombinationsbehandlung aus kognitiven Techniken und Metta-Meditationen vielversprechend.
Extensive Macular Atrophy with Pseudodrusen in a Japanese Patient Evaluated by Wide-Field OCTA
Authors: Sato Shigeru , Morimoto Takeshi , Fujikado Takashi , Tanaka Sayaka , Tsujikawa Motokazu , Nishida Kohji
Published: November 2022

Extensive macular atrophy with pseudodrusen (EMAP) is a relatively newly proposed clinical entity that was first reported in 2009. Although no definitive diagnostic criteria have been defined, characteristic findings can distinguish it from other diseases, especially dry age-related macular dystrophy (AMD). Herein, we present the case of a patient with EMAP who underwent a comprehensive ophthalmic examination and whole-exome sequencing (WES). A 72-year-old Japanese man complained of progressive visual impairment in his right eye and nyctalopia. Ophthalmic examination revealed that the best-corrected visual acuity (BCVA) in decimal units was 0.08 on the right and 0.8 on the left. Fundoscopy and fundus autofluorescence (FAF) revealed well-demarcated symmetrical macular atrophy, with a vertical axis larger than the horizontal axis, which reached the vascular arcade inferiorly and exceeded it superiorly. Pseudodrusen were widespread throughout the retina in both eyes. Paving-stone degeneration was not observed in the extreme periphery of either eye. Seven months later, his left BCVA decreased to 0.3 without major changes on multimodal imaging. Based on the above findings, we diagnosed EMAP. Wide-field optical coherence tomography angiography (OCTA) showed no significant changes in the retinal vessels, but the density of choroidal vessels was reduced in the degenerated areas. We thought that this finding suggests that EMAP originates between the deep retina and choroid. WES did not reveal any candidate mutations in known pathogenic genes. To the best of our knowledge, this is the first report of a Japanese patient with EMAP, and no data for analysis of wide-field OCTA or equatorial OCT images of EMAP cases have been found in previous reports. EMAP is not well recognized in Asia and may be incorrectly diagnosed as dry-type AMD. EMAP should be included in the differential diagnosis of dry AMD, and this may lead to more Asians being diagnosed with EMAP in the future.
Botryoid Wilms Tumor with Left-Sided Inferior Vena Cava: A Case Report
Authors: Chi Yidi , Li Minglei , Chen Shuofan , Zhang Weiping , Liu Pei
Published: November 2022

Wilms tumor (WT) is the second most common solid tumor in pediatric population. Botryoid WT is an uncommon growth pattern of WT, which is characterized by tumor extension into collecting system. A case of a 27-month-old boy with botryoid WT and left-sided inferior vena cava is reported in this article to emphasize the importance of preoperative imaging in preoperative planning.
Being Elderly Is Associated with Infectious and Fatal Postoperative Complications in Ulcerative Colitis Patients
Authors: Horio Yuki , Uchino Motoi , Kusunoki Kurando , Minagawa Tomohiro , Kuwahara Ryuichi , Kimura Kei , Kataoka Kozo , Beppu Naohito , Ikeda Masataka , Ikeuchi Hiroki
Published: November 2022

Introduction: It is well known that the infectious complications and mortality rates are increased among elderly individuals with ulcerative colitis (UC) during medical treatment. However, there have been few reports on surgery in elderly individuals with UC, and some cohort studies have reported surgical complication and mortality rates similar to those in nonelderly individuals. Methods: UC patients who underwent colectomy at the Hyogo College of Medicine between April 2012 and March 2020 were included in this study. The patients were classified as elderly (≥65) or nonelderly (<65). Characteristics and postoperative complications were analyzed and compared between the groups; possible risk factors for infectious and fatal complications were also analyzed. Results: In all, 136/599 (22.7%) elderly patients were included. The incidence of infectious and fatal complications was 177/599 (29.5%) and 18/599 (3%), respectively. These complication rates were significantly higher in the elderly than the nonelderly group (p < 0.01). Age ≥65 years at surgery (OR = 2.92, 95% CI: 1.87–4.57, p < 0.01) was identified as an independent risk factor for infectious complications. Age ≥65 years at surgery (OR = 8.03, 95% CI: 2.16–29.83, p < 0.01), American Society of Anesthesiologists score ≥3 (OR = 6.00, 95% CI: 1.40–25.6 p = 0.02), and urgent/emergent surgery (OR = 16.24, 95% CI: 1.70–154.95, p = 0.02) were identified as independent risk factors for fatal complications. Discussion/Conclusion: Age ≥65 years was identified as a risk factor for infectious and fatal complications. It is important to avoid urgent/emergent surgery in elderly patients with an ASA score >3 by emphasizing surgical and medical collaboration and optimizing the timing of surgery.
Reactivation of Multifocal Choroiditis Associated with Treatment in Latent Tuberculosis
Authors: Bartimote Christopher , Dunn Hamish , Fraser-Bell Samantha
Published: November 2022

Tuberculosis (TB) causes significant morbidity and mortality worldwide. Ocular manifestations of TB can lead to severe and sight-threatening complications. Initiating treatment in ocular TB with anti-tubercular therapy (ATT) may be necessary to prevent long-term visual complications. We present a case of the reactivation of bilateral multifocal choroiditis (MFC) in a patient with latent TB after commencing ATT. An asymptomatic 36-year-old Indian male was referred to an ophthalmologist with extensive inactive bilateral MFC close to his fovea despite no previous medical or ocular history. Latent TB was subsequently diagnosed via TB specific antigens and antibodies. After a period of stable observation without evidence of active eye or systemic disease, the patient was commenced on quadruple ATT with the aim of reducing the risk of visual loss with the MFC. However, after commencing treatment, MFC reactivation was observed. This settled with the addition of high-dose oral prednisone. The steroid was slowly weaned and ceased with the cessation of ATT. There have been no further episodes of active choroiditis since treatment was ceased. TB is a significant cause of mortality worldwide, and ocular manifestations can cause severe and sight-threatening complications in active and latent TB. The treatment of TB, however, may lead to further complications. We present the case of a visually asymptomatic patient with latent TB, with before and after fundal images, demonstrating the reactivation of the MFC after commencing ATT.
Comparison between Transpancreatic Sphincterotomy and Needle-Knife Precut in Difficult Cannulation of Endoscopic Retrograde Cholangiopancreatography: An Up-To-Date Meta-Analysis and Systematic Review
Authors: Lyu Yunxiao , Ye Shenjian , Wang Bin , Zhao Sicong
Published: November 2022

Background: Selective cannulation, which is essential for endoscopic retrograde cholangiopancreatography (ERCP), may be difficult. The aim of this study was to compare transpancreatic sphincterotomy (TPS) and needle-knife precut (NKP) in difficult cannulation during ERCP. Methods: PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched for relevant studies from January 1990 to April 2022. A meta-analysis focusing on cannulation success and post-ERCP complications was performed using Review Manager. Results: Seventeen eligible studies involving 2,340 patients were included. Our results showed that the TPS group had a higher cannulation success rate (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.27–0.87, p = 0.02) and less bleeding (OR 1.94, 95% CI: 1.09–3.47, p = 0.03) compared with the NKP group. There was no significant difference between NKP and TPS in the rates of post-ERCP pancreatitis (OR 0.83, 95% CI: 0.59–1.18, p = 0.30), perforation (OR 2.04, 95% CI: 0.69–6.03, p = 0.20), and adverse events (OR 1.29, 95% CI: 0.94–1.77, p = 0.12). Conclusion: TPS appears to be associated with a higher cannulation success rate and less bleeding than those with NKP, with equal post-ERCP pancreatitis, perforation, and adverse event rates between TPS and NKP. Further large-scale trials are warranted to support our findings.
Attributes That Affect the Choice of Treatment for Preschool Age Children Who Stutter: An Observational Study
Authors: Van Eerdenbrugh Sabine , Uijterlinde Irma , Eggers Kurt , Franken Marie-Christine
Published: November 2022

Introduction: Little is known about the clinical decision-making process that speech-language pathologists (SLPs) make when they decide which treatment approach they will use with preschool age children who stutter (PCWS). Frequently used approaches are the Lidcombe Program, RESTART-DCM, Mini-KIDS, the Palin Parent-Child Interaction program, and the Social Cognitive Behavior Therapy. In this study, we explored which attributes play a role in the complex process that precedes this clinical decision. We also explored if SLPs from the Netherlands, who are expected to follow the recommendations formulated in the Dutch professional stuttering guidelines, use different treatment approaches than SLPs from Belgium, who do not have specific guidelines to follow. Finally, we explored whether the number of years of experience of SLPs had an impact on the choice for treatment. Methods: This study used an observational design in which 36 SLPs, additionally qualified in the treatment of stuttering, completed a questionnaire. The SLPs spoke Dutch, resided in the Netherlands or Belgium, and used more than one treatment approach for PCWS in their standard practice. Results: The following attributes affected the choice for treatment approach of most SLPs: (1) the child’s reactions to the stuttering, (2) the child’s language (and speech) skills, (3) the child’s age, (4) the family’s lifestyle, (5) the parent’s ease to understand a treatment approach as judged by the SLPs, and (6) the amount and quality of published research-based evidence. The decision-making of experienced SLPs is significantly more affected by the child’s stuttering severity and time since onset compared to less experienced SLPs (both U = 90, p = 0.05). Dutch SLPs did not take other attributes into account than Belgian SLPs. Discussion/Conclusion: This study was a first attempt to explore which attributes affect the decision for a specific treatment. Further prospective research is needed.
Analysis of bioelectric potential of cabbage waste (Brassica oleraceae var. capitata) using microbial fuel cells
Authors: Meylani Vita , Nurfauziah Elsa , Hernawati Diana
Published: November 2022

Vegetable waste, one of which is cabbage waste, has long been recognized as a cause of a significant environmental problems in traditional markets and must be addressed. However, cabbage waste can be used as an alternative energy source through the Microbial Fuel Cell process. The purpose of this study was to determine the potential of cabbage waste as a producer of bioelectricity and the storage time of cabbage waste that produces the largest bioelectricity using Microbial Fuel Cells. This research was conducted in February 2022 at Laboratory of Microbiology and Botany, Universitas Siliwangi. The study employed a completely randomized design (CRD), with treatment consisting of a control group (without storage), five storage treatments, namely: treatment 1 (2 days storage), treatment 2 (4 days storage), treatment 3 (6 days storage), treatment 4 (eight days storage), and treatment 5 (10 days storage). All treatments were repeated 4 times. A digital multimeter is used to determine the resulting electric current.  The results indicated that the highest average total electric current generated was 0.022 mA from the 4 days storage treatment. The lowest average total electric current generated was 0.010 mA from the 10th days storage. These data indicate that the treatment of storage time of up to 4 days can increase the amount of electric current generated, then it decreases with increasing length of storage. It is influenced by several variables, including the growth phase of the bacterium, the availability of organic molecules, and the population of bacterium.
Mulheres na atuação, encenação e iluminação: rupturas nas dinâmicas do modelo patriarcal
Authors: Martins Iassanã
Published: November 2022

Este artigo é um recorte de pesquisa de doutorado em andamento e tem por objetivo identificar a inserção das mulheres na atuação, encenação e iluminação, trabalhos tradicionalmente exercidos somente por homens e a eles atribuídos tácita e historicamente. A partir do diálogo com autoras como Elaine Aston, Grada Kilomba, Dodi Leal, Lucia Romano e Elizabeth Lobo, o trabalho é desenvolvido em Porto Alegre, sob a perspectiva de ampliar as narrativas do teatro para além das produções do eixo Rio-São Paulo.
José Carlos Matos: articulações políticas e engajamento artístico no teatro amador cearense (1972-1982)
Authors: Moreira Thaís Paz de Oliveira
Published: November 2022

Este artigo analisa a figura de José Carlos Matos e seu poder de articulação política e engajamento artístico no teatro amador cearense durante a ditadura civil-militar brasileira. O texto apresenta quem foi José Carlos Matos, as motivações que incitam um estudo sobre sua trajetória e a importância do teatro amador para as conquistas e articulações que se desdobraram em políticas públicas culturais para o Ceará. Nosso recorte está compreendido entre 1972, ano de estreia do espetáculo O Romance do Pavão Mysterioso, da Cooperativa de Teatro e Arte, dirigida por Matos, e 1982, ano de seu falecimento. Portanto, buscou-se compreender a construção da identidade a partir da memória da figura articuladora, política e intelectual de José Carlos, a cultura política e o apego a lideranças carismáticas, bem como o poder cultural e simbólico a partir do Campo Intelectual e Artístico.
Um pedaço no meio do mundo: Travessias do Teatro no Tocantins
Authors: Santos Adailson Costa dos , Fachini Kenedy Sinomar Dias
Published: November 2022

Este artigo tem como objetivo discutir os assuntos levantados a partir do estudo dos acervos escaneados pelo projeto Existeatro em Gurupi? visando contextualizar os documentos em reflexões históricas sobre o Teatro, na década de 1980. A metodologia é baseada nas experiências do Acervo Recordança, em Pernambuco, e no projeto Memória do Movimento, na Paraíba. O projeto encontra-se em desenvolvimento, todavia já se tem muito a discutir sobre os documentos do Projeto Timbá e sua grande influência para as artes cênicas nesse período histórico.
Teatro negro em Belo Horizonte: Maurício Tizumba, Coletivo Negras Autoras e outros aquilombamentos
Authors: Tizumba Júlia
Published: November 2022

Neste trabalho, a autora realiza investigações sobre Teatro Negro a partir de um breve panorama da história do Teatro Negro na cidade de Belo Horizonte, apresentando e refletindo sobre os trabalhos de Maurício Tizumba, Coletivo Negras Autoras e outros aquilombamentos. Para tanto, foi realizada revisão bibliográfica sobre performances negras, observação participante, entrevistas e estudos de documentos primários dos trabalhos artísticos estudados.
Recurrent Out-of-Hospital Sudden Cardiac Arrest: Prevalence and Clinical Factors
Authors: Held Elizabeth P. , Reinier Kyndaron , Chugh Harpriya , Uy-Evanado Audrey , Jui Jonathan , Chugh Sumeet S.
Published: November 2022

Background:

Despite improvements in management following survival from sudden cardiac arrest (SCA) and wide availability of implantable cardioverter defibrillators for secondary prevention, a subgroup of individuals will suffer multiple distinct episodes of SCA. The objective of this study was to characterize and evaluate the burden of recurrent out-of-hospital SCA among survivors of SCA in a single large US community.

Methods:

SCA cases were prospectively ascertained in the Oregon Sudden Unexpected Death Study. Individuals that experienced recurrent SCA were identified both prospectively and retrospectively.

Results:

We ascertained 6649 individuals with SCA (2002–2020) and 924 (14%) survived to hospital discharge. Of these, 88 survivors (10%) experienced recurrent SCA. Of the nonsurvivors (n=5725), 35 had suffered a recurrent SCA. Of the total 123 SCA cases with recurrent SCA, >60% occurred at least 1 year after the initial SCA (median 23 months, range: 6 days to 31 years). SCA occurred despite a secondary prevention implantable cardioverter defibrillator in 22% (n=26). Prevalence of coronary disease (36% versus 25%), hypertension (69% versus 43%), diabetes (44% versus 21%), and chronic kidney disease (35% versus 14%) was significantly higher in recurrent SCA versus single SCA survivors (n=80,
P
=0.01). Among individuals with no secondary prevention implantable cardioverter defibrillators before recurrent SCA, the majority had apparently reversible etiologies identified at initial SCA, with one-quarter undergoing coronary revascularization and over half diagnosed with noncoronary cardiac etiologies.

Conclusions:

At least 10% of SCA survivors had recurrent SCA, and a large subgroup suffered their repeat SCA despite treatment for an apparently reversible etiology. A renewed focus on careful assessment of cardiac substrate as well as management of coronary disease, hypertension, diabetes, and chronic kidney disease in SCA survivors could reduce recurrent SCA.
Effect of Sex on Coronary Endothelial Dysfunction in People Living With HIV
Authors: Minhas Anum S. , Leucker Thorsten M. , Goerlich Erin , Soleimani‐Fard Alborz , Schär Michael , Ziogos Efthymios , Miller Eliza , Gerstenblith Gary , Hays Allison G.
Published: November 2022

Background

Impaired coronary endothelial function (CEF) predicts cardiovascular events and occurs in people living with HIV (PLWH). Women compared with men living with HIV have worse cardiovascular outcomes, but prior CEF studies included few women. The authors aimed to compare CEF in women with HIV versus without HIV, investigate sex differences in CEF and PCSK9 (proprotein convertase subtilisin/kexin type 9) (a proinflammatory biomarker), and evaluate whether increased serum levels of PCSK9 are associated with CEF in PLWH.

Methods and Results

Magnetic resonance imaging was performed to measure CEF (as percent change in coronary cross‐sectional area and coronary blood flow during isometric handgrip exercise, an endothelial‐dependent stressor) and serum PCSK9 levels were measured in 106 PLWH and 76 people without HIV. CEF was significantly reduced in women with versus without HIV (cross‐sectional area change −0.5%±9.7 versus 9.5%±3.2, respectively). After adjustment for age, body mass index, and menopausal status, women with HIV still had reduced CEF (percentage of cross‐sectional area: ß −8.3 [−13 to −3.6],
P
=0.001) compared with women without HIV. PCSK9 was elevated in women living with HIV versus without (306 ng/mL [200–412 ng/mL] versus 180 ng/mL [154–223 ng/mL],
P
<0.001), and no sex differences in either CEF or PCSK9 were detected in PLWH. Elevated PCSK9 was associated with impaired CEF in PLWH; however, no significant sex differences in the association were detected.

Conclusions

Among PLWH, coronary endothelial dysfunction is present in women and comparable to men. PCSK9 is higher in women with versus without HIV and a significant inverse relationship between PCSK9 and CEF was shown. Future studies should determine whether PLWH would benefit from interventions to improve endothelial function.
Long‐Term Outcomes of Chronic Type B Aortic Dissection Treated by Thoracic Endovascular Aortic Repair
Authors: Jiang Xiaolang , Liu Yifan , Zou Lingwei , Chen Bin , Jiang Junhao , Fu Weiguo , Dong Zhihui
Published: November 2022

Background

The treatment of chronic type B aortic dissection by thoracic endovascular aortic repair has some challenges, and its long‐term outcomes remain unclear. This study aimed to analyze the 5‐year clinical outcomes of thoracic endovascular aortic repair of chronic type B aortic dissection, compare the differences between patients with and without adverse aortic events (AAEs), and identify risk factors for AAEs.

Methods and Results

Patients who underwent thoracic endovascular aortic repair of chronic type B aortic dissection from January 2009 to June 2017 were retrospectively enrolled. The primary end points were AAEs, including aorta‐related death, procedural complications, and disease progression requiring reintervention. Clinical outcomes were described at the 5‐year follow‐up visit. The secondary end point was the comparison of the results between patients with and without AAEs. Univariable and multivariable logistic analyses were used to identify potential risk factors for AAEs. A total of 214 patients were enrolled. AAEs occurred in 46 (21.5%) patients. Compared with patients without AAEs, those with AAEs had higher rates of residual type A aortic dissection (26.1% versus 4.2%,
P
<0.001) and aortic diameter ≥5.5 cm (69.6% versus 11.3%,
P
<0.001), and a lower rate of complete false lumen thrombosis (23.9% versus 89.9%,
P
<0.001). Meanwhile, the median interval from symptom onset to intervention was longer in patients with AAEs (26 months versus 12 months,
P
=0.004). Partial or no false lumen thrombosis (adjusted odds ratio [AOR], 14.71 [95% CI, 5.67–38.14;
P
<0.001]) and aortic diameter ≥5.5 cm (AOR, 10.16 [95% CI, 3.86–26.73;
P
<0.001]) were identified as independent risk factors for AAEs.

Conclusions

While thoracic endovascular aortic repair of chronic type B aortic dissection might be challenging in some cases, its long‐term outcomes appeared promising as this treatment was effective in preventing catastrophic aortic events. Patients with AAEs showed higher rates of residual type A aortic dissection and aortic diameter ≥5.5 cm, a lower rate of complete false lumen thrombosis, and a longer median interval from symptom onset to intervention. Failure of complete false lumen thrombosis and an aortic diameter ≥5.5 cm were predictors of AAEs.