bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Hemodialysis and Peritoneal Dialysis on Glycometabolism in Patients with End-Stage Diabetic Nephropathy
Authors: Chen Xiao-xia , Duan Ying , Zhou Yue
Published: December 2020

Objective: The objective is to study the fluctuation pattern of blood glucose spectrum in patients with end-stage diabetic nephropathy (ESDN) receiving hemodialysis (HD) and peritoneal dialysis (PD), respectively, and to compare the influences of these 2 dialysis methods on glycometabolism. Methods: Sixty-four dialysis patients with ESDN were recruited, including 35 HD patients and 29 PD patients. The 24-h blood glucose on dialysis days of the 2 groups was monitored by the continuous glucose monitoring system, and the relevant glycometabolism indexes were recorded and compared. Results: The control of blood glucose in both groups was not satisfactory. At the same blood glucose level, the dosage of exogenous insulin needed by patients in the PD group was larger than that in the HD group (p < 0.05). However, the fluctuation of blood glucose and consequently the incidence of hyperglycemia and hypoglycemia in HD group were greater than that in PD group (p < 0.05). The patients’ blood glucose levels decreased progressively during the course of HD. The mean blood glucose (MBG) values estimated by glycosylated hemoglobin (HbA1c) in both groups were lower than the actual measured blood glucose values (p < 0.05). Preliminary correlation analysis showed that the deviation of the MBG values estimated by HbA1c was positively correlated with the degree of anemia. Conclusion: HD patients have larger glycemic variability as compared with PD patients, while PD patients have overall increased blood glucose levels. Hypoglycemic programs should be made according to the corresponding changes in blood glucose. The HbA1c value of dialysis patients has a large deviation, so it is necessary to explore its influencing factors and develop more accurate blood glucose assessment indicators.
Dystonia and Contractures are Potential Early Signs of CACNA1E-Related Epileptic Encephalopathy
Authors: Ortiz Cabrera Nelmar V. , Duat Rodríguez Anna , Fernández Garoz Bárbara , Bernardino Cuesta Beatriz , Jiménez Legido María , Cantarín Extremera Verónica , García Peñas Juan J.
Published: December 2020

Epileptic encephalopathy related to CACNA1E has been described as a severe neurodevelopmental disorder presenting with early-onset refractory seizures, hypotonia, macrocephaly, hyperkinetic movements, and contractures and is associated with an autosomal dominant inheritance pattern. Most pathogenic variants described to date are missense variants with a gain of function effect, and the role of haploinsufficiency has yet to be clarified. We describe 2 cases of CACNA1E encephalopathy. Notable findings include congenital contractures and movement disorders predating onset of epilepsy, particularly dystonia. We further compared the key phenotypic features depending on variant location. In conclusion, the appearance of congenital contractures, areflexia, and movement disorders before the onset of epilepsy may provide key guidance in the diagnosis of epileptic CACNA1E encephalopathy. A genotype-phenotype correlation was found between the presence of movement disorders and severe intellectual disability and the location of the variant in the CACNA1E gene.
Real-Life Clinical and Functional Effects of Fluticasone Furoate/Umeclidinium/Vilanterol-Combined Triple Therapy in Patients with Chronic Obstructive Pulmonary Disease
Authors: Pelaia Corrado , Procopio Giada , Deodato Maria Rosaria , Florio Olivia , Maglio Angelantonio , Sciacqua Angela , Vatrella Alessandro , Pelaia Girolamo
Published: December 2020

Background: Triple therapy consisting of a drug association including an inhaled corticosteroid, a long-acting muscarinic receptor antagonist and a long-acting β2-adrenergic agonist, delivered via a single device, can be a valuable treatment for chronic obstructive pulmonary disease (COPD) patients experiencing frequent disease exacerbations. Objectives: The aim of this real-life, single-center, observational study was to evaluate, in 44 COPD patients with recurrent exacerbations, the effects of the triple inhaled therapy combining fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI). Methods: Within such a therapeutic context, several clinical and lung functional parameters were considered at baseline and after 24 weeks of treatment with combined inhaled triple therapy. Results: With respect to baseline, after 24 weeks of treatment with FF/UMEC/VI, significant changes were recorded with regard to Modified British Medical Research Council (p < 0.0001) and COPD Assessment Test (p < 0.0001) scores, COPD exacerbations (p < 0.001), forced expiratory volume in the first second (p < 0.001), residual volume (p < 0.01), forced mid-expiratory flow between 25 and 75% of FVC (p < 0.0001), inspiratory capacity (p < 0.01), forced vital capacity (p < 0.05), and peak expiratory flow (p < 0.0001). Moreover, in a subgroup of 28 patients, a significant increase of diffusion lung capacity (p < 0.01) was also detected. Conclusions: In conclusion, our real-life results suggest that triple inhaled therapy with FF/UMEC/VI, when given to COPD patients with frequent exacerbations, is able to positively impact on dyspnea and global health status as well as to significantly decrease COPD exacerbations and improve airflow limitation and lung hyperinflation.
The Future of Electricity and Electricity as the Future: The Sociotechnical Imagination of Russian Electrical Engineers in the 19th Century
Authors:   National Reserach University, Moscow, Nikiforova Natalia
Published: December 2020

This article examines Russian engineers’ social imagination about the future through the professional discussions held at the electrotechnical congresses in the nineteenth century. Formulating the prospective future of the industry, the state and society was a collective endeavor, a process in which the identity and mission of engineers were crystallized. Through envisioning the future of technology and its role in the society, engineers revealed their cultural role as mediators between technological innovation, and both the wider public and the state. In order to better understand the manifestations of the shared cultural understandings of a desirable future and social order, the article resorts to Sheila Jasanoff’s concept of sociotechnical imaginaries (Jasanoff & Kim, 2015). The engineering community’s sociotechnical imagination about electricity was shaped around the transformative possibilities of this technology. It was believed that electrical engineering was able not only to accelerate industrial production, but also to solve social, medical and cultural problems, thereby uniting the Russian Empire. Descriptions of the rational, comfortable and beautiful world of the electrified future overlapped in engineering discussions, journalism and science fiction. Positive scenarios emphasized the advantages of electrical engineering and bypassed the problems associated with electrification, constructing an idea of its inevitability. The electrical engineer became a kind of a new cultural hero, who knew how to make a working device or system, and also filled the task of linking the development of technology to the development of society.
Vitaly Grigorevsky’s Contribution to the Development of International Cooperation in Photometric Studies of Artificial Earth Satellites
Authors:   Odessa National Polytechnic University, Hrushytska Iryna
Published: December 2020

This article highlights the participation of the Ukrainian scientist, Professor Vitaly Mikhailovich Grigorevsky, doctor of physical and mathematical sciences, and representative of the scientific school of Vladimir Platonovich Tsesevich, in the organization and development of international cooperative partnership in the field of satellite astronomy and photometric studies of artificial satellites of the Earth. The activity of the scientist in the coordination of scientific research of the countries of Eastern Europe in 1965–1973 under the SPIN program, carried out under the auspices of the Astronomical Council of the USSR Academy of Sciences, is discussed. The article explores the main forms of Grigorevsky’s scientific cooperation with the world’s leading experts in the field of satellite astronomy—the British scientist Desmond King-Hele, the Czech astronomer František Link, Hungarian researchers Iván Almár and D. Toth, and others. Also, the achievements of the Latvian researchers Māris Ābele and Kasimirs Lapushka in the creation of photographic cameras of surveillance of satellites are analysed.
Knowledge and Technology Transfer in the Age of Enlightenment: The Scientific Correspondence between Franciszek Bieliński (1683-1766) and Henri Louis Duhamel du Monceau (1700-1782)
Authors:   Jan Dlugosz University in Częstochowa, Durbas Małgorzata
Published: December 2020

The scientific life in mid-seventeenth-century Europe was characterised by numerous academies of sciences and scientific associations whose aim was to propagate the development of the sciences, art and literature. Some have called it “the new Age of Academies all over Europe”. These institutions brought together not only educated professionals but also a large number of amateur scientists. They called for the deliberate abandonment of verbal dispute in favour of visual demonstration/experimentation, and for the creation of paid scientific professionals who would devote their full time to the enterprise. These scientists conducted numerous experiments, the results of which were demonstrated at academic sessions. Franciszek Bieliński became Grand Marshal of the Crown in 1742. During the many years of his public service, he aimed to improve the well-being of Warsaw inhabitants, especially by paving the streets and creating a modern sewerage system. In the light of recent scholarly studies, Franciszek Bieliński is perceived as a figure of very wide horizons, striving to join the Parisian academic scientific discourse in order to transfer knowledge and technology to Poland. Bieliński exchanged letters with the eminent member and three-time president of the Paris Academy of Sciences (1666–1803), Henri Louis Duhamel du Monceau, who among numerous other projects tested new methods of horticulture, agriculture and forestry. The article aims to discuss the scientific research undertaken by Bieliński in regards to technology transfer in the area of agriculture, on the basis of unanalysed documents. Recently found correspondence shows that Grand Marshal Bieliński was involved in experimental research supervised by Duhamel du Monceau, under the aegis of the Paris Academy of Sciences. It pertained to modern agricultural crops and the application of new technologies. The agricultural experiments that Bieliński carried out on his private lands in Otwock over many years focused on improving and increasing agricultural production in accordance with the instructions given by Duhamel du Monceau. An interesting research finding was the detailed description of one of the earliest transfers of advanced technology in the field of agricultural machinery. Reports of the work conducted in Poland, which were sent to Duhamel du Monceau, proved to be so useful and important that the latter mentioned these in the proceedings of the Paris Academy of Sciences.
Obese and Type 2 Diabetic Youth Have Increased Forward and Backward Wave Reflections
Authors: Tran Andrew H. , Kimball Thomas R. , Khoury Philip R. , Dolan Lawrence M. , Urbina Elaine M.
Published: December 2020

Objective:

Pulse wave analysis estimates arterial wave reflections relating to left ventricular dysfunction and cardiovascular event risk in adults. Forward and backward waves (Pf and Pb) may improve risk stratification for cardiovascular events. Data in youth are lacking. We hypothesized that a significant difference in wave reflections would be identified in young subjects with adverse cardiovascular risk factors.

Approach and Results:

Vital signs and labs were obtained in 551 patients aged 10 to 24 years who were lean (L=199), obese (O=173), or had type 2 diabetes (T=179). Wave separation was performed. Differences in cardiovascular risk factors and wave reflections were assessed using ANOVA. General linear models were constructed to elucidate independent predictors of wave reflections. O and T subjects had an adverse cardiovascular risk profile versus L. O and T subjects had higher Pf and Pb versus L (
P
≤0.05). When adjusted for adiposity and other cardiovascular risk factors, reflection magnitude increased from L to O to T with higher T versus L values (
P
≤0.05) and near-significant O versus L values (
P
=0.06). Adiposity and blood pressure were major determinants of wave reflections. Pb influenced log left ventricular mass index, log E/e′, and log composite carotid intima-media thickness.

Conclusions:

Adolescents and young adults with obesity and type 2 diabetes have altered forward and backward wave reflections versus lean controls related to adiposity, BP, and insulin levels. These parameters may help risk stratify patients with adverse cardiovascular risk factors.
Cross-Priming Dendritic Cells Exacerbate Immunopathology After Ischemic Tissue Damage in the Heart
Authors: Forte Elvira , Perkins Bryant , Sintou Amalia , Kalkat Harkaran S. , Papanikolaou Angelos , Jenkins Catherine , Alsubaie Mashael , Chowdhury Rasheda A. , Duffy Theodore M. , Skelly Daniel A. , Branca Jane , Bellahcene Mohamed , Schneider Michael D. , Harding Sian E. , Furtado Milena B. , Ng Fu Siong , Hasham Muneer G. , Rosenthal Nadia , Sattler Susanne
Published: December 2020

Background:

Ischemic heart disease is a leading cause of heart failure and despite advanced therapeutic options, morbidity and mortality rates remain high. Although acute inflammation in response to myocardial cell death has been extensively studied, subsequent adaptive immune activity and anti-heart autoimmunity may also contribute to the development of heart failure. After ischemic injury to the myocardium, dendritic cells (DC) respond to cardiomyocyte necrosis, present cardiac antigen to T cells, and potentially initiate a persistent autoimmune response against the heart. Cross-priming DC have the ability to activate both CD4
+
helper and CD8
+
cytotoxic T cells in response to necrotic cells and may thus be crucial players in exacerbating autoimmunity targeting the heart. This study investigates a role for cross-priming DC in post–myocardial infarction immunopathology through presentation of self-antigen from necrotic cardiac cells to cytotoxic CD8
+
T cells.

Methods:

We induced type 2 myocardial infarction–like ischemic injury in the heart by treatment with a single high dose of the β-adrenergic agonist isoproterenol. We characterized the DC population in the heart and mediastinal lymph nodes and analyzed long-term cardiac immunopathology and functional decline in wild type and
Clec9a
-depleted mice lacking DC cross-priming function.

Results:

A diverse DC population, including cross-priming DC, is present in the heart and activated after ischemic injury.
Clec9a
−/−
mice deficient in DC cross-priming are protected from persistent immune-mediated myocardial damage and decline of cardiac function, likely because of dampened activation of cytotoxic CD8
+
T cells.

Conclusion:

Activation of cytotoxic CD8
+
T cells by cross-priming DC contributes to exacerbation of postischemic inflammatory damage of the myocardium and corresponding decline in cardiac function. Importantly, this provides novel therapeutic targets to prevent postischemic immunopathology and heart failure.
Myocardial Injury After Balloon Predilatation Versus Direct Transcatheter Aortic Valve Replacement: Insights From the DIRECTAVI Trial
Authors: Akodad Mariama , Roubille François , Marin Gregory , Lattuca Benoit , Macia Jean‐Christophe , Delseny Delphine , Gandet Thomas , Robert Pierre , Schmutz Laurent , Piot Christophe , Maupas Eric , Robert Gabriel , Targosz Frederic , Albat Bernard , Cayla Guillaume , Leclercq Florence
Published: December 2020

Background

Myocardial injury is associated with higher mortality after transcatheter aortic valve replacement (TAVR) and might be increased by prior balloon aortic valvuloplasty (BAV). We aimed to evaluate the impact of prior BAV versus direct prosthesis implantation on myocardial injury occurring after (TAVR) with balloon‐expandable prostheses.

Methods and Results

The DIRECTAVI (Direct Transcatheter Aortic Valve Implantation) trial, an open‐label randomized study, demonstrated noninferiority of TAVR without BAV (direct TAVR group) compared with systematic BAV (BAV group) with the Edwards SAPIEN 3 valve. High‐sensitivity troponin was assessed before and the day after the procedure. Incidence of myocardial injury after the procedure (high‐sensitivity troponin elevation >15× the upper reference limit [14 ng/L]) was the main end point. Impact of myocardial injury on 1‐month adverse events (all‐cause mortality, stroke, major bleeding, major vascular complications, transfusion, acute kidney injury, heart failure, pacemaker implantation, and aortic regurgitation) was evaluated. Preprocedure and postprocedure high‐sensitivity troponin levels were available in 211 patients. The mean age of patients was 83 years (78–87 years), with 129 men (61.1%). Mean postprocedure high‐sensitivity troponin was 124.9±81.4 ng/L in the direct TAVR group versus 170.4±127.7 ng/L in the BAV group (
P
=0.007). Myocardial injury occurred in 42 patients (19.9%), including 13 patients (12.2%) in the direct TAVR group and 29 (27.9%) in the BAV group (
P
=0.004). BAV increased by 2.8‐fold (95% CI, 1.4–5.8) myocardial injury probability. Myocardial injury was associated with 1‐month adverse events (
P
=0.03).

Conclusions

BAV increased the incidence and magnitude of myocardial injury after TAVR with new‐generation balloon‐expandable valves. Myocardial injury was associated with 1‐month adverse events. These results argue in favor of direct SAPIEN 3 valve implantation.

Registration

URL:
https://www.Clinicaltrials.gov
; Unique identifier: NCT02729519.
From Lebensreform to Swadeshi
Authors: Alter Joseph S.
Published: December 2020

As an institutionalized “indigenous” system of medicine in India, nature cure derives directly from ideas and practices developed within the rubric of Lebensreform, a radical, back-to-nature health reform movement that took shape in late nineteenth- and early twentieth-century central Europe. Nature cure developed in twentieth-century India as a deeply embodied manifestation of Swadeshi, a social, cultural, and anticolonial political movement intimately concerned with independence and liberation. Significant parallels between Lebensreform and Swadeshi point toward an understanding of medicine based on the habitus of class and global countercultural practices. Using examples from the work of Adolf Just and other Germans writing at the turn of the nineteenth century and the case of Arogya Mandir, a nature cure hospital established by Vithal Das Modi in Gorakhpur in 1940, this essay examines how the radical, utopian ideals of Lebensreform were translated into institutionalized medical practice that facilitated the embodiment of Swadeshi as a political philosophy of health reform in colonial India.
A new species of Limnonectes (Amphibia: Anura: Dicroglossidae) from Vietnam
Authors: PHAM CUONG THE , DO DANG TRONG , LE MINH DUC , NGO HANH THI , NGUYEN LUAN THANH , ZIEGLER THOMAS , NGUYEN TRUONG QUANG
Published: December 2020

A new species of Limnonectes from Phu Yen Province, South-central Vietnam is described based on morphological and molecular differences. Morphologically, the new species is distinguishable from its congeners on the basis of a combination of the following diagnostic characters: SVL 49.8–77.9 mm in males, 40.8–61.8 mm in females; males with moderately enlarged head (HL/SVL 0.47, HW/SVL 0.48); head slightly broader than long (HL/HW 0.97 in males, 0.95 in females); vomerine teeth present; external vocal sacs absent; rostral length short (RL/SVL 0.15); tympanum invisible; dorsal surface of head, body and flanks with ridges and tubercles; dorsal surface of tibia and foot distinctly tuberculate, covered with moderately dense, small, low tubercles; supratympanic fold present; dorsolateral fold absent; Finger I with nuptial pad, composed of minute spines on dorsal surface and medial edge in males; toes webbed to distal of terminal phalanx, webbing formula I0–0II0–0III0–0IV0-–0V0; in life, dorsum yellowish brown with dark brown markings; ventral surface white with brown markings. In phylogenetic analyses, the new species from Vietnam and Limnonectes fastigatus as well as L. kiziriani form a clade, which is sister to L. fragilis from China, although the nodal support values for the set of relationships are insignificant from all analyses.
Urbanization Effects on Estimates of Global Trends in Mean and Extreme Air Temperature
Authors: Zhang Panfeng , Ren Guoyu , Qin Yun , Zhai Yaqian , Zhai Tianlin , Tysa Suonam Kealdrup , Xue Xiaoying , Yang Guowei , Sun Xiubao
Published: December 2020

Identifying and separating the signal of urbanization effects in current temperature data series is essential for accurately detecting, attributing, and projecting mean and extreme temperature change on varied spatial scales. This paper proposes a new method based on machine learning to classify the observational stations into rural stations and urban stations. Based on the classification of rural and urban stations, the global and regional land annual mean and extreme temperature indices series over 1951–2018 for all stations and rural stations were calculated, and the urbanization effects and the urbanization contribution of global land annual mean and extreme temperature indices series are quantitatively evaluated using the difference series between all stations and the rural stations. The results showed that the global land annual mean time series for mean temperature and most extreme temperature indices experienced statistically significant urbanization effects. The urbanization effects in the mean and extreme temperature indices series generally occurred after the mid-1980s, and there were significant differences of the magnitudes of urbanization effects among different regions. The urbanization effect on the trends of annual mean and extreme temperature indices series in East Asia is generally the strongest, which is consistent with the rapidly urbanization process in the region over the past decades, but it is generally small in Europe during the recent decades.
Downstream Suppression of Baroclinic Waves
Authors: Boljka Lina , Thompson David W. J. , Li Ying
Published: December 2020

Baroclinic waves drive both regional variations in weather and large-scale variability in the extratropical general circulation. They generally do not exist in isolation, but rather often form into coherent wave packets that propagate to the east via a mechanism called downstream development. Downstream development has been widely documented and explored. Here we document a novel but also key aspect of baroclinic waves: the downstream suppression of baroclinic activity that occurs in the wake of eastward propagating disturbances. Downstream suppression is apparent not only in the Southern Hemisphere storm track as shown in previous work, but also in the North Pacific and North Atlantic storm tracks. It plays an essential role in driving subseasonal periodicity in extratropical eddy activity in both hemispheres, and gives rise to the observed quiescence of the North Atlantic storm track 1–2 weeks following pronounced eddy activity in the North Pacific sector. It is argued that downstream suppression results from the anomalously low baroclinicity that arises as eastward propagating wave packets convert potential to kinetic energy. In contrast to baroclinic wave packets, which propagate to the east at roughly the group velocity in the upper troposphere, the suppression of baroclinic activity propagates eastward at a slower rate that is comparable to that of the lower to midtropospheric flow. The results have implications for understanding subseasonal variability in the extratropical troposphere of both hemispheres.
A Conceptual Model of Polar Overturning Circulations
Authors: Haine Thomas W. N.
Published: December 2020

The global ocean overturning circulation carries warm, salty water to high latitudes, both in the Arctic and Antarctic. Interaction with the atmosphere transforms this inflow into three distinct products: sea ice, surface Polar Water, and deep Overflow Water. The Polar Water and Overflow Water form estuarine and thermal overturning cells, stratified by salinity and temperature, respectively. A conceptual model specifies the characteristics of these water masses and cells given the inflow and air–sea–land fluxes of heat and freshwater. The model includes budgets of mass, salt, and heat, and parameterizations of Polar Water and Overflow Water formation, which include exchange with continental shelves. Model solutions are mainly controlled by a linear combination of air–sea–ice heat and freshwater fluxes and inflow heat flux that approximates the meteoric freshwater flux plus the sea ice export flux. The model shows that for the Arctic, the thermal overturning is likely robust, but the estuarine cell appears vulnerable to collapse via a so-called heat crisis that violates the budget equations. The system is pushed toward this crisis by increasing Atlantic Water inflow heat flux, increasing meteoric freshwater flux, and/or decreasing heat loss to the atmosphere. The Antarctic appears close to a so-called Overflow Water emergency with weak constraints on the strengths of the estuarine and thermal cells, uncertain sensitivity to parameters, and possibility of collapse of the thermal cell.
Assessment of Pain and Analgesic Use in Children Following Otologic Surgery
Authors: Benchetrit Liliya , Kwock Megan , Ronner Evette A. , Goldstein Sheli , Shu Edina , Lee Daniel J. , Mankarious Leila A. , Caloway Christen , Kempfle Judith , Cohen Michael S.
Published: December 2020

Objective

To compare postoperative pain and analgesic use in children following transcanal endoscopic ear surgery (TEES) vs non–transcanal endoscopic ear surgery (non‐TEES).

Study Design

Prospective case series.

Setting

Tertiary care center.

Methods

Surveys using the Wong‐Baker FACES Pain Rating Scale and recording the frequency and dosage of consumed analgesics were administered prospectively to caregivers of children undergoing otologic surgery between May 2018 to February 2020. Pain intensity and medication use were recorded twice daily for 6 days, starting on postoperative day 0. Mean pain scores and mean number of consumed analgesic doses were compared between groups.

Results

Survey response rate was 57.9%. Among 53 patients who completed the survey, 35 (66.0%) underwent TEES and 18 (34.0%) underwent non‐TEES. Mean pain ratings on postoperative days 0 and 1 were significantly lower among children undergoing TEES (2.2 and 2.1) vs non‐TEES (4.0 and 4.1), P =. 045 and P =. 008, respectively (Mann‐Whitney U test). The mean pain ratings across the 6 days were similar in TEES (1.7) and non‐TEES (2.6) (P =. 140, Mann‐Whitney U test). The mean number of analgesic doses consumed per half‐day over the 6 days was significantly lower among children undergoing TEES (0.3) vs non‐TEES (0.6; P =. 049, Mann‐Whitney U test).

Conclusion

Postoperative pain following TEES and non‐TEES in children was overall low. Children undergoing TEES had a small but statistically significant decrease in pain on postoperative days 0 and 1 and decreased use of pain medications compared to non‐TEES.
MicroRNA Biomarkers in Canine Diffuse Large B-Cell Lymphoma
Authors: Elshafie Nelly O. , Nascimento Naila C. do , Lichti Nathanael I. , Kasinski Andrea L. , Childress Michael O. , Santos Andrea P. dos
Published: December 2020

Lymphoma is among the most common cancer in dogs. Diffuse large B-cell lymphoma (DLBCL) is the predominant type, accounting for up to half of all cases. Definitive diagnosis of DLBCL relies on cytologic evaluation with immunophenotyping, or histopathology and immunohistochemistry when needed. A rapid and specific molecular test aiding in the diagnosis could be beneficial. Noncoding microRNAs (miRNAs) are regulators of gene expression involved in a variety of cellular processes, including cell differentiation, cell cycle progression, and apoptosis. Not surprisingly, miRNA expression is aberrant in diseases such as cancers. Their high stability and abundance in tissues make them promising biomarkers for diagnosing and monitoring diseases. This study aimed to identify miRNA signatures of DLBCL to develop ancillary molecular diagnostic tools. miRNA was isolated from formalin-fixed, paraffin-embedded lymph node tissue from 22 DLBCL and 14 nonneoplastic controls. Relative gene expression of 8 tumor-regulating miRNAs was achieved by RT-qPCR (reverse transcriptase quantitative polymerase chain reaction). The results showed downregulation of the let-7 family of miRNAs and miR-155, whereas miR-34a was upregulated in DLBCL compared to the controls. We demonstrated that the combination of expression levels of miR-34a and let-7f or of let-7b and let-7f achieved 100% differentiation between DLBCL and controls. Furthermore, let-7f alone discriminated DLBCL from nonneoplastic tissue in 97% of cases. Our results represent one step forward in search of a rapid and accurate ancillary diagnostic test for DLBCL in dogs.
Man Made Beautiful: The Social Role of Grooming and Body Work in Performing Middle-aged Corporate Masculinity in South Korea
Authors: Elfving-Hwang Joanna K.
Published: December 2020

This article examines how middle-aged urban men in South Korea relate to age-relevant ideas of beauty in a society in which youthful muscular bodies are increasingly presented as the ideal or, arguably, even as a norm. Drawing on in-depth interviews with 13 male participants aged 36–56 years residing in the Seoul metropolitan area, it seeks to outline what role grooming and aesthetic labor play in their everyday social interactions. The findings suggest that men’s aesthetic practices in the workplace are strongly linked to considerations of in-group harmony, competency at work, and maintaining social hierarchies. Rather than being motivated by a desire to emulate hegemonic masculinity embodied by male celebrities of similar age, men in this age group engage with body work primarily for the homosocial gaze of other men in their workplace in order to embody their membership and belonging to it. These micro-contexts of men’s aesthetic labor help to illustrate how not all aesthetic labor can be explained in terms of considering the body simply as an object of investment. The participants’ reflections also illustrate how men’s bodies as neoliberal objects in the contemporary Korean workplace are not interpellated by societal or cultural influences in identical ways. For white collar workers, the role of aesthetic labor was clearly seen as more significant than for those in blue collar roles, suggesting a degree of social stratification of body work. Despite the relatively easy access to affordable technologies of the body in Korea, for workers in lower-middle class jobs where grooming and fitness are not considered an essential part of their job, partaking in aesthetic labor came with the anxiety that it might be encoded as “excessive” by others. This suggests that Korean beauty cultures continue to be highly class- and context-specific rather than relatively uniform as often (mis)understood in existing literature.
From first symptoms to diagnosis: Initial clinical presentation of primary brain tumors
Authors: Alther B , Mylius V , Weller M , Gantenbein AR
Published: December 2020

Background:

Despite modern imaging methods, a long symptom-to-diagnosis interval can be observed in patients with primary brain tumors.

Objective:

The study evaluated the initial and subsequent clinical presentation of patients with brain tumors in the context of time to diagnosis, localization, histology, and tumor grading.

Methods:

In this retrospective analysis of 85 consecutive patients with primary brain tumors, we assessed the presenting symptoms and signs. The analyses were based on entries from medical records at the Department of Neurology of Zurich University Hospital between 2005 and 2010.

Results:

A total of 54 men and 31 women with a mean age at diagnosis of 48 years were included. 60% of the patients present with a malignant tumor (World Health Organization grading III–IV), 24.7% with a benign tumor (I–II), and 15.3% were not classified. The interval between symptom onset and diagnosis varied from 1 day to 96 months (median: 39 days). High-grade tumors (III–IV) were diagnosed significantly earlier than low-grade tumors (II) after the first symptoms occurred (median: 26 vs. 138 days; z = −3.847, p < 0.001).

Conclusions:

Symptoms with a short symptom-to-diagnosis interval such as nausea/vomiting, seizures, as well as of personality change are assumed to contribute to a faster diagnosis in high-grade tumors. Visual disturbances and headaches, although occurring relatively seldom, did not contribute to a decrease in time to diagnosis and should therefore be considered for further diagnostic workup.
Prognostic impact of complete remission with MRD negativity in patients with relapsed or refractory AML
Authors: Short Nicholas J. , Rafei Hind , Daver Naval , Hwang Hyunsoo , Ning Jing , Jorgensen Jeffrey L. , Kadia Tapan M. , DiNardo Courtney D. , Wang Sa A. , Jabbour Elias , Popat Uday , Oran Betul , Cortes Jorge , Konopleva Marina , Yilmaz Musa , Issa Ghayas C. , Kantarjian Hagop , Ravandi Farhad
Published: December 2020

In relapsed/refractory acute myeloid leukemia (AML), the prognostic impact of complete remission (CR) and measurable residual disease (MRD) negativity is not well established. We retrospectively analyzed 141 patients with relapsed/refractory AML who received first salvage therapy and had MRD assessed by multiparameter flow cytometry at the time of response. Patients who achieved CR with full hematologic recovery as best response vs those with incomplete hematology recovery had lower cumulative incidence of relapse (P = .01) and better relapse-free survival (P = .004) but not overall survival (P = .15); a similar trend was observed in patients who achieved MRD negativity vs those who were MRD positive (P = .01, P = .05, and P = .21, respectively). By multivariate analysis, CR and MRD negativity were each independently associated with lower cumulative incidence of relapse (P = .001 and P = .003, respectively) and better relapse-free survival (P < .001 and P = .02) but not overall survival. Patients who achieved CR with MRD negativity had the lowest rates of relapse and best survival (2-year overall survival rate, 37%), which was driven largely by lower rates of early relapse and an increased ability in this group to undergo hematopoietic stem cell transplantation (HSCT); however, post-HSCT outcomes were similar regardless of response to salvage chemotherapy. Overall, in patients with relapsed/refractory AML, CR with MRD negativity was associated with the best outcomes, supporting it as the optimal response in this setting.
Limited english proficiency and concordance of CKD awareness among primary care providers and patients
Authors: Velazquez Alexis F. , Velasquez Alexandra , Tuot Delphine S.
Published: December 2020

Background

Patient awareness of CKD and primary care provider (PCP) recognition of CKD are lower than for other chronic conditions. Understanding how patients may become aware of CKD is critical to their participation in healthy behaviors to slow CKD progression. We examined factors associated with the concordance of CKD awareness among patients and providers and hypothesized that concordance of CKD awareness would be influenced by social and demographic factors that impact communication, such as limited English proficiency (LEP) and health literacy.

Methods

Between July 2011 to July 2014, patients with CKD from three primary care clinics in a public healthcare delivery system were surveyed with questions regarding their health, including awareness of their CKD status. Chart review was performed to identify PCP recognition of CKD, defined as CKD listed anywhere in the problem list within nine months before patient enrollment into the study. We used logistic regression to determine the association between provider recognition and patient awareness of kidney disease among those patients with CKD, adjusting for patient demographics, co-morbidities, and provider training.

Results

The study population (n = 152) had a mean age of 57.4 (SD 13), was 48.7% male and was racially/ethnically and linguistically diverse: 89.5% self-identified as Black, Hispanic, or Asian and 32.2% had LEP. Most patients had hypertension (89.5%) and diabetes (77.6%); mean eGFR was 66.1 ml/min/1.73m2 (SD 32.8). Positive concordance of CKD awareness was 42% (n = 64). Odds of positive concordance with their providers were much higher among patients with LEP compared to English speaking patients (adjusted odds ratio = 11.07, 95%CI 1.60–76.39).

Conclusions

Concordance of CKD awareness among PCPs and their patients with CKD in one public delivery system was higher among patients with LEP. While speculative, this may be due to greater caution in provider communication about CKD with LEP patients.
Autoimmune glial fibrillary acidic protein astrocytopathy manifesting as subacute meningoencephalitis with descending myelitis: a case report
Authors: Wang Han , Chin Jerome H. , Fang Bo-yan , Chen Xi , Zhao Ai-lin , Ren Hai-tao , Guan Hong-zhi
Published: December 2020

Background

Glial fibrillary acidic protein (GFAP) autoimmune astrocytopathy is characterized by GFAP autoantibody positive encephalitis, meningoencephalitis or meningoencephalomyelitis. The initial clinical presentation may be similar to central nervous system infections making early diagnosis challenging.

Case presentation

A Chinese female patient presented with subacute meningitis with symptoms of headache, vomiting, and fever. Cerebrospinal fluid (CSF) analysis showed monocytic pleocytosis, elevated protein level, low glucose level, and negative basic microbiological studies including Xpert MTB/RIF. Brain magnetic resonance imaging (MRI) showed bilateral cerebral cortical and white matter hyperintensities on FLAIR sequences. The patient was diagnosed with possible tuberculous meningitis and started on anti-tuberculosis therapy (ATT). Three months later, the patient developed cervical myelopathy and encephalopathy with persistent CSF pleocytosis. Five months later, tissue-based and cell-based assays demonstrated GFAP antibodies in blood and CSF. Her symptoms improved with repeated administration of intravenous immunoglobulin (IVIG) and corticosteroids. One-and-a-half -year follow-up showed neither clinical progression nor relapses.

Conclusions

Anti-GFAP astrocytopathy should be included in the differential diagnosis of patients who present with subacute meningitis with negative microbiological studies and a progressive clinical course including encephalitis and/or myelitis.
A bispecific T cell engager targeting Glypican-1 redirects T cell cytolytic activity to kill prostate cancer cells
Authors: Lund Maria E. , Howard Christopher B. , Thurecht Kristofer J. , Campbell Douglas H. , Mahler Stephen M. , Walsh Bradley J.
Published: December 2020

Background

Glypican-1 is a heparan sulfate proteoglycan that is overexpressed in prostate cancer (PCa), and a variety of solid tumors. Importantly, expression is restricted in normal tissue, making it an ideal tumor targeting antigen. Since there is clinical and preclinical evidence of the efficacy of Bispecific T cell Engager (BiTE) therapy in PCa, we sought to produce and test the efficacy of a GPC-1 targeted BiTE construct based on the Miltuximab® sequence. Miltuximab® is a clinical stage anti-GPC-1 antibody that has proven safe in first in human trials.

Methods

The single chain variable fragment (scFv) of Miltuximab® and the CD3 binding sequence of Blinatumomab were combined in a standard BiTE format. Binding of the construct to immobilised recombinant CD3 and GPC-1 antigens was assessed by ELISA and BiaCore, and binding to cell surface-expressed antigens was measured by flow cytometry. The ability of MIL-38-CD3 to activate T cells was assessed using in vitro co-culture assays with tumour cell lines of varying GPC-1 expression by measurement of CD69 and CD25 expression, before cytolytic activity was assessed in a similar co-culture. The release of inflammatory cytokines from T cells was measured by ELISA and expression of PD-1 on the T cell surface was measured by flow cytometry.

Results

Binding activity of MIL-38-CD3 to both cell surface-expressed and immobilised recombinant GPC-1 and CD3 was retained. MIL-38-CD3 was able to mediate the activation of peripheral blood T cells from healthy individuals, resulting in the release of inflammatory cytokines TNF and IFN-g. Activation was reliant on GPC-1 expression as MIL-38-CD3 mediated only low level T cell activation in the presence of C3 cells (constitutively low GPC-1 expression). Activated T cells were redirected to lyse PCa cell lines PC3 and DU-145 (GPC-1 moderate or high expression, respectively) but could not kill GPC-1 negative Raji cells. The expression of PD-1 was up-regulated on the surface of MIL-38-CD3 activated T cells, suggesting potential for synergy with checkpoint inhibition.

Conclusions

This study reports preclinical findings into the efficacy of targeting GPC-1 in PCa with BiTE construct MIL-38-CD3. We show the specificity and efficacy of the construct, supporting its further preclinical development.
Risk of tuberculosis in patients with spondyloarthritis: data from a centralized electronic database in Hong Kong
Authors: Ciang Natalia Chu-Oi , Chan Shirley Chiu Wai , Lau Chak Sing , Chiu Eva Tsz Fung , Chung Ho Yin
Published: December 2020

Background/ objective

Tuberculosis (TB) is one of the most infectious comorbidities in spondyloarthritis (SpA). Our goals were to determine the crude incidence rate of and risk factors for TB in SpA.

Method

Clinical data of 2984 patients with SpA from 11 rheumatology centres were reviewed. This included demographics, duration of follow-up, comorbidities including diabetes, chronic kidney disease, chronic heart disease, chronic lung disease, stroke and malignancies, date of diagnosis of tuberculosis, use of non-steroidal anti-inflammatory drugs, duration of glucocorticoid therapy for more than 6 months, conventional (cDMARD) and biological (bDMARD) disease modifying anti-rheumatic drug therapies. Crude incidence rates were reported. Cox regression models were used to determine the risk factors for TB in patients with SpA.

Results

Forty-three patients had TB, of which 4 (9.3%) were extra-pulmonary. The crude incidence rate of TB was 1.57 in patients with SpA, compared with 0.58 in the general population in Hong Kong. Independent risk factors identified from the multivariate Cox regression model were: alcohol use (HR 2.62;p = 0.03), previous TB (HR 13.62;p < 0.001), chronic lung disease (HR 3.39;p = 0.004), duration of glucocorticoid therapy greater than 6 months (HR 3.25;p = 0.01) and infliximab therapy (HR 5.06;p < 0.001). Age was associated with decreased risk (HR 0.93;p < 0.001).

Conclusion

Incidence of TB was higher in patients with SpA. Glucocorticoid therapy beyond 6 months and infliximab therapy increased the risk of TB. Rheumatologists should avoid prolonged use of glucocorticoids and consider DMARDs other than infliximab in the treatment of at-risk patients.
Low-grade myofibroblastic sarcoma of the levator scapulae muscle: a case report and literature review
Authors: Yonezawa Hirotaka , Yamamoto Norio , Hayashi Katsuhiro , Takeuchi Akihiko , Miwa Shinji , Igarashi Kentaro , Langit Mickhael Bang , Kimura Hiroaki , Shimozaki Shingo , Kato Takashi , Morinaga Sei , Araki Yoshihiro , Asano Yohei , Ikeda Hiroko , Nojima Takayuki , Tsuchiya Hiroyuki
Published: December 2020

Background

Low-grade myofibroblastic sarcoma (LGMS) is described as a distinct atypical myofibroblastic tumor often with fibromatosis-like features and predilection for the head and neck, especially the oral cavity and larynx. LGMS arising in the levator scapulae muscle is extremely rare.

Case presentation

A 69-year-old woman was admitted to our hospital because she noticed a hard mass in her left neck six months prior. Magnetic resonance images (MRI) showed a soft tissue tumor of the left levator scapulae muscle. A core needle biopsy showed cellular fascicles or a storiform growth pattern of spindle-shaped tumor cells with minimally atypia. Immunohistochemistry revealed focally positive for α-smooth muscle actin (α-SMA), negative for S-100, and a low-grade spindle cell sarcoma was suspected. Following a biopsy, the tumor was resected with a wide surgical margin. Immunohistochemical staining was a positive for vimentin and α-SMA and negative for desmin, CD34, nuclear β-catenin, and h-caldesmon. LGMS diagnosis was determined based on the histopathological findings. The patient was alive with no evidence of disease eight years after the surgery.

Conclusions

To the best of our knowledge, this is the first case report of LGMS arising in the levator scapulae muscle. In addition to the case report, 48 reports with 103 LGMS cases are reviewed and discussed. In previous reports of LGMS, there were 43 females and 60 males, with a mean age of 43.0 years (range, 2–75). There were 13 (12.6%) patients aged < 18 years, 67 (65.1%) patients aged 18 to 59 years, and 23 (22.3%) patients aged ≥60 years. The average tumor size was 4.4 cm (range: 0.4–22.0). The commonest sites of LGMS was the tongue. Tumor growth patterns were evaluated in 52 cases, and 44 cases (84.6%) showed infiltrative growth patterns. Local recurrence was 26.7%, and distant metastasis was 4.4%. Because of the locally aggressive feature, it is important to diagnose LGMS with biopsy and to excise the tumor with an adequately wide margin.