bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiplasmodial and Antipyretic Activity and Safety Evaluation of the Methanolic Leaf Extract of Murraya exotica (L.)
Authors: Forkuo Arnold Donkor , Mensah Kwesi Boadu , Ameyaw Elvis Ofori , Antwi Aaron Opoku , Kusi-Boadum Nana Kofi , Ansah Charles
Published: August 2020

Background. The increasing mortality and morbidity of malaria in Africa coupled with the recent reports of antimalarial drug resistance reinforces the need for novel antimalarial agents from natural plant products with folkloric use for the disease. Murraya exotica (L.) (Rutaceae) is widely used as an ornamental plant used indigenously to treat fever, cough, and infectious wounds and eliminate pain from injury and trauma. This study was conducted to evaluate extracts of the leaves of Murraya exotica (L.) (Rutaceae) for its safety and antipyretic and antimalarial activity in rodent models. Method. In this study, the Peters 4-day suppressive and curative test in Plasmodium berghei-infected mice was used to demonstrate the antiplasmodial activity of the methanolic leaf extract of Murraya exotica (L.) (MEE). The study also evaluated the subacute toxicity study and the antipyretic activity of MEE on baker’s yeast-induced hyperthermia in rodent models. Results. Murraya exotica (L.) extract demonstrated curative antimalarial activity, with a percentage suppression of 45.84, 64.32±0.33, 56.74±2.16, and 64.61±0.67 at doses of 50, 100, 300, and 600 mg/kg, respectively. In the Peters 4-day suppressive test, MEE at dose 600 mg/kg had the highest chemosuppression (76.02±1.38%) compared with artesunate (2 mg/kg, p.o.) (82.56±0.97%). Subacute oral toxicity studies in Sprague-Dawley rats documented no deaths, with no significant changes in clinical signs, organ weights, and hematological and biochemical parameters. The LD50 of MEE was estimated to be above 1000 mg/kg in Sprague-Dawley rats. All doses of MEE and paracetamol reduced pyrexia in 1 h and 2 h after their administration. The percentage reduction of rectal temperature (TR) for the positive control (paracetamol, 150 mg/kg, p.o.) was 44.36% while the Murraya exotica extract at doses 50 mg/kg, 100 mg/kg, 300 mg/kg, and 600 mg/kg recorded 67.74%, 40.78%, 66.42%, and 59.42%, respectively. Murraya exotica at dose 100 mg/kg exhibited significant reduction (p<0.05) in baker’s yeast-induced pyrexia. Conclusions. The findings in this study show the antipyretic, curative, and suppressive antiplasmodial activity as well as the safety of the methanolic leaf extract of Murraya exotica (L.) supporting its traditional use for malaria and fever.
Genotypic Variation in Trichomonas vaginalis Detected in South African Pregnant Women
Authors: Chetty Rennisha , Mabaso Nonkululeko , Abbai Nathlee
Published: August 2020

Background. Trichomonas vaginalis is the causative agent of trichomoniasis. The genetic characterisation of T. vaginalis isolates reveals significant genetic diversity in this organism. Data on the prevalence of different genotypes of T. vaginalis in South African populations is lacking. This study investigated the diversity of T. vaginalis in a pregnant population in South Africa. Methods. In this study, 362 pregnant women from the King Edward VIII Hospital in Durban, South Africa, provided vaginal swabs to be tested for the presence of T. vaginalis. T. vaginalis was detected using the TaqMan assay using commercially available primers and probes specific for this protozoan (Pr04646256_s1). The actin gene from T. vaginalis was amplified with gene-specific primers. The actin amplicons were digested with HindII, MseI, and RsaI, and the banding patterns were compared across the three digests for assignment of genotypes. Phylogenetic analysis was conducted using MEGA. Results. The prevalence of T. vaginalis in the study population was 12.9% (47/362). Genotype G was the most frequent genotype in our study population. Genotypes H and I were detected in one sample each. According to the multiple sequence alignments and phylogenetic analysis, a level of diversity was observed across and within genotypes. Four different single-nucleotide changes in the actin gene were detected. Sample TV358 (H genotype) contained a single amino acid substitution from glutamine to lysine. Sample TV184 (G genotype) contained a single amino acid substitution from glutamic acid to arginine. Sample TV357 (G genotype) contained two amino acid substitutions, arginine to leucine and glycine to aspartic acid. Conclusion. Three different genotypes were observed in the pregnant population. Diversity was observed across and within genotypes. The observed diversity can be challenging for future vaccine design and development of antigen-based rapid diagnostic tests for trichomoniasis.
Discrete-Time Angle Constraint Interception with Model-Assisted Target Maneuver Estimator
Authors: Sheng Y. I. , Jiang W. A. N. G. , Pei Pei , Yongjia Zhou
Published: August 2020

This paper investigates the problem of designing angle constraint guidance law against unknown maneuvering targets based on discrete-time sliding mode control theory. Invoking the fact that the future course of action of the target, an independent entity, cannot be predicted beforehand due to its complexity and unpredictability, a model-assisted discrete-time disturbance observer in cooperation with a singularity-free strategy is proposed first to estimate the target maneuver. Based on the reconstructed signal and a fast convergence time-varying sliding surface, a new chattering-mitigated super-twisting-like discrete-time impact angle constraint guidance law is then synthesized. Stability analysis shows that the closed-loop system trajectory can be forced to enter into a small region around the sliding surface. Simulations and comparisons with classical discrete-time sliding mode guidance law validate the effectiveness of the proposed guidance law.
Bus Voltage Stabilization Control of Photovoltaic DC Microgrid Based on Fuzzy-PI Dual-Mode Controller
Authors: Zhang Yu , Wei Shuhao , Wang Jin , Zhang Lieping
Published: August 2020

The photovoltaic DC microgrid has strong nonlinearity and time variation. Therefore, traditional dual closed-loop control strategy of voltage and current based on PI controller cannot effectively restrain the fluctuation and impact of DC bus voltage when the dynamic response of the system is improved. Under this situation, in this paper, the fuzzy-PI dual-mode controller is designed to upgrade the traditional dual closed-loop control, taking voltage outer ring into consideration, which is adopted to achieve good transient performance while the bus voltage deviation is large. While the bus voltage deviation is small, the PI controller is utilized for good steady-state performance. Hence, simulation and experimental results show that the fuzzy-PI dual-mode controller has the same advantages with both fuzzy control and PI control; in other words, it has the features of speedy response, low overshoot, good robustness, and strong anti-interference under different working conditions.
The Impact of Comorbid Diabetes on Short‐Term Postoperative Outcomes in Stage I/II Colon Cancer Patients Undergoing Open Colectomy
Authors: Lee Ko-Chao , Chung Kuan-Chih , Chen Hong-Hwa , Cheng Kung-Chuan , Wu Kuen-Lin , Song Ling-Chiao , Hu Wan-Hsiang
Published: August 2020

Purpose. This study aimed at evaluating the impact of comorbid diabetes on short‐term postoperative outcomes in patients with stage I/II colon cancer after open colectomy. Methods. The data were extracted from the National Inpatient Sample database (2005‐2010). Short‐term surgical outcomes included in‐hospital mortality, postoperative complications, and hospital length of stay. Results. A total of 49,064 stage I/II colon cancer patients undergoing open surgery were included, with a mean age of 70.35 years. Of them, 21.94% had comorbid diabetes. Multivariable analyses revealed that comorbid diabetes was significantly associated with a lower risk of in‐hospital mortality and postoperative complications. Compared to patients without diabetes, patients with uncomplicated diabetes had lower percentages of in‐hospital mortality and postoperative complications, but patients with complicated diabetes had a higher percentage of postoperative complications. In addition, patients with diabetes only, but not patients with diabetes and hypertension only, had a lower percentage of in‐hospital mortality than patients without any comorbidity. Conclusion. The present results suggested the protective effects of uncomplicated diabetes on short‐term surgical outcomes in stage I/II colon cancer patients after open colectomy. Further studies are warranted to confirm these unexpected findings and investigate the possible underlying mechanisms.
Impact of Matching Point Selections on Image Registration Accuracy between Optical Scan and Computed Tomography
Authors: Mai Hai Yen , Lee Du-Hyeong
Published: August 2020

The point‐based surface registration method involves the manual selection process of paired matching points on the data of computed tomography and optical scan. The purpose of this study was to investigate the impact of selection error and distribution of fiducial points on the accuracy of image matching between 3‐dimensional (3D) images in dental planning software programs. Computed tomography and optical scan images of a partial edentulous dental arch were obtained. Image registration of the optical scan image to computed tomography was performed using the point‐based surface registration method in planning software programs under different conditions of 3 fiducial points: point selection error (0, 1, or 2 mm), point distribution (unilateral, bilateral), and planning software (Implant Studio, Blue Bio Plan) (n = 5 per condition, N = 60). The accuracy of image registration at each condition was evaluated by measuring linear discrepancies between matched images at X, Y, and Z axes. Kruskal‐Wallis test, Mann‐Whitney U test with Bonferroni correction, and 3‐way analysis of variance were used to statistically analyse the measurement data (α = 0.05). No statistically significant difference was exhibited between the 0 and 1 mm point mismatch conditions in either unilateral or bilateral point distributions. The discrepancy values in the 2 mm mismatch condition were significantly different from the other mismatch conditions, especially in the unilateral point distribution (P < 0.05). Strong interactions among point selection error, distribution, and software programs on the image registration were found (P < 0.001). Minor matching point selection error did not influence the accuracy of point‐based automatic image registration in the software programs. When the fiducial points are distributed unilaterally with large point selection error, the image matching accuracy could be decreased.
Lateral Seismic Response and Self-Centering Performance of a Long-Span Railway Continuous Beam-Arch Bridge
Authors: Shi Yan , Zhang Zhanhong , Qin Hongguo , Zhao Xiangyu , Yang Xiong
Published: August 2020

Based on the seismic isolation design concept of functional separation, a seismic isolation system with bearings and braces combination for railway bridge was proposed. The sliding bearings afford the vertical loads, and the self-centering energy dissipation brace (SCED) and buckling restrained brace (BRB) control the horizontal displacement of the beam, so the functional separation was achieved under the combined action. Taking a long-span railway continuous beam-arch bridge as an example, the corresponding analysis model was established to study lateral seismic response and the girder’s displacement pattern of the continuous beam-arch bridge under the earthquake excitations. The seismic response of bridges with different seismic isolation schemes was studied. The result showed that the presence of arch rib in a continuous beam-arch bridge amplifies the transverse displacement response of the girder compared with that in a continuous beam bridge of equal mass. The seismic isolation system with sliding bearings and energy dissipation braces can control the relative displacement between the pier and beam greatly, and the SCED can reduce or even eliminate the residual displacement between pier and beam. Furthermore, under the strong ground motions, the combined use of SCED and BRB can achieve the seismic isolation to the maximum extent when the self-centering force ratio ζ, the ratio of self-centering force to superstructure weight, is 0.074.
Icariin Ameliorates Lower Back Pain in Rats via Suppressing the Secretion of Cytokine‐Induced Neutrophil Chemoatractant‐1
Authors: Li Jitian , Luo Manli , Wang Shaochun , Jin Guoguo , Han Zongchang , Ma Yan , Tang Guoqing , Guo Zhiping
Published: August 2020

Purpose. To investigate whether icariin (ICA), a well‐known medicine extracted from the stem and leaf of Epimedium brevicornum Maxim, had analgesic effect on lower back pain (LBP) in rats. Methods. In a puncture‐induced LBP rat model, the severity of LBP was quantified using the paw/foot withdrawal threshold method after intragastric administration of ICA at a dosage of 50 mg/kg/d or 100 mg/kg/d. The pain‐related peptides of substance P (SP) and calcitonin gene‐related peptide (CGRP) were also measured in intervertebral disc (IVD) tissue using RT‐PCR after ICA treatment. In addition, the expression of cytokine‐induced neutrophil chemoattractant‐1 (CINC‐1) in IVD was quantified using RT‐PCR and ELISA examination. Results. ICA treatment resulted in a significant amelioration of mechanical allodynia in a dose‐response manner, and the analgesic effect could last for two weeks even during the washout period. More importantly, the mechanism of analgesic pharmacological effect in ICA was to suppress the upregulated CINC‐1, the homolog of IL‐8 in rats, which is a crucial proalgesic factor contributing to LBP, in IVDs. Conclusion. ICA is a novel herbal extract to relieve LBP, and it may be a promising alternative pain killer in the future.
A Comparative Study on 5hmC Targeting Regulation of Neurons in AD Mice by Several Natural Compounds
Authors: Cao Dongyi , Jiang Dewei , Zhou Dongming , Yu Hong , Li Jiali
Published: August 2020

A series of studies have confirmed that DNA methylation disorder (5mC/5hmC) is closely related to the occurrence and development of some diseases, such as Alzheimer’s disease (AD). This study aims at discovering natural compounds that could adjust and control 5‐hydroxymethylcytosine (5hmC) levels and improve Alzheimer’s disease (AD) neuronal status. Cordycepin and cordycepic acid were selected as research materials, with resveratrol as positive control. The results of Dot Blot indicated that cordycepin, cordycepic acid, and resveratrol significantly increased the expression level of 5hmC. Combined with qPCR results, it was revealed that cordycepin increased the expression of ten‐eleven translocation (TETs) mRNA compared with the abovementioned cordycepic acid and resveratrol. Besides, cordycepin dramatically reduced the transcription level of Apolipoprotein E (ApoE), suggesting that cordycepin might hinder the formation of NFTs (neurofibrillary tangles) and the accumulation of amyloid β‐protein (Aβ) in the brain by reducing the expression of ApoE, resulting in affecting the progression of AD. Meanwhile, the immunofluorescence (IF) staining results demonstrated that the percentage of differentiation of SHSY‐5Y cells reasonably increased after the treatment of cordycepin and cordycepic acid. Simultaneously, the length of axons and the number of dendritic branches in mouse primary neurons were substantially increased by cordycepin. The screening results illustrated that cordycepin had a positive influence on the level of 5hmC and the morphology of neurons, and most of the effects were better compared to the positive control (resveratrol). It indicated that cordycepin delayed the progression of neurodegenerative diseases such as AD. However, the specific mechanism of action still needs to be further investigated. Our research provided a foundation for further discussion about the influence of cordycepin on AD and a new idea for the pathological study of related diseases.
The Effect of Foundation Flexibility on Probabilistic Seismic Performance of Plan‐Asymmetric Buildings with Different Strength Distributions
Authors: Mohammadzadeh Osalu Sahar , Shakib Hamzeh
Published: August 2020

In this research, the probabilistic seismic performance of asymmetric reinforced concrete wall‐frame buildings with different strength distributions incorporating foundation flexibility effects is examined. By using probability‐based performance evaluation approach, it is possible to provide a more accurate prediction of the different strength distribution effect on the seismic performance of asymmetric buildings and find the most efficient strength distribution for meeting each performance level. These efficient distributions can be adopted in the performance‐based design of asymmetric buildings. For this purpose, first, the regression analysis and the concepts of efficiency and sufficiency were used to determine an optimal intensity measure (IM) for incremental dynamic analysis and evaluating the seismic response of the considered building models. Then, the proper magnitude of interstory drift capacity for this type of buildings in each limit state was estimated using the damage index concept. Finally, the effects of different strength distributions and the flexibility of foundation were studied on the seismic performance of the asymmetric buildings by investigating the mean annual frequencies of exceeding structural performance levels and confidence levels to satisfy performance objectives. It is concluded that irregular distributions of stiffness and strength in the plan of a building highly affect the seismic performance of buildings. Also, the results show that the optimum strength distribution is a function of the objective performance level and these optimum strength distributions are the same for both fixed‐ and flexible‐base conditions. Meanwhile, the flexible effect of foundation increases the mean annual frequencies of exceedance within the range of 10% to 45% and significantly decreases the confidence levels in most cases.
Impact of Acute Pancreatic Injury on Sphingolipid Metabolism in the Salivary Glands
Authors: Żendzian-Piotrowska Małgorzata , Ziembicka Dominika M. , Łukaszuk Bartłomiej , Kurek Krzysztof
Published: August 2020

Acute pancreatic injury can be related to both parenchymal (responsible for exocrine functions) and islet (mainly β‐cells, responsible for endocrine functions) damage. During embryonic development, both the salivary glands and the pancreas originate from the foregut, which explains many of the observed histological and functional similarities between these two organs. The relationship between several diseases of the pancreas and salivary glands, resulting from morphological and functional similarities, is well established. Sphingolipids constitute a class of biologically active molecules involved in numerous physiological and pathological processes, including acute pancreatitis (AP) and diabetes mellitus. However, the effect of AP on sphingolipid metabolism in the salivary glands remains uncertain. In the presented study, we examined the effect of AP and type 1 diabetes mellitus on sphingolipid metabolism in the salivary glands of rats. We demonstrated that acute pancreatic injury, related to both exocrine and endocrine functions, affects the metabolism of sphingolipids in the parotid, but not submandibular, salivary glands.
Evaluating the Effect of Roadway and Development Factors on the Rural Road Safety Risk Index
Authors: Afandizadeh Shahriar , Hassanpour Shahab
Published: August 2020

As roadway and development factors are identified as the most effective factors contributing to road traffic accidents, investigating these factors could lead to reducing the accident frequency rate. However, previous works focused on investigating the effect of roadway factors on the accident frequency rate using statistical analysis. The present study aimed to evaluate the effect of roadway and development factors on the accident frequency rate using ANOVA and Chi‐square tests on a rural road. Secondly, it aimed to develop a rural road safety risk index based on K‐means clustering and Gaussian models. The findings indicated that the operating speed and the differences between posted speed limits and the operating speed are the pivotal influencing factors on the accident frequency rate. Moreover, clustering analysis of the roadway and development factors on the two‐lane, two‐way road of Borujerd‐Khorramabad indicated six clusters which were identified as highly, relatively highly, moderately, relatively lowly, lowly risky, and not risky (safe) clusters. Regarding clusters, the accident frequency rate increased by decreasing the difference between the posted speed limits and the operating speed from the safe cluster. In addition, the risky index model based on the Gaussian model showed that the average reducing factor of accident frequency rate reached 0.99 by increasing per km/hr in the difference between the posted speed limits and the operating speed among low risky and safe clusters, while it was equal to 1.17 in risky and unsafe clusters. The comparison of the clusters revealed that accident occurrence probability in risky clusters was more than the ones in low risky or safe clusters. Therefore, the maximum and minimum values of the safety risk index were observed in the sixth and the third clusters, respectively.
Hepatic Polarization Accelerated by Mechanical Compaction Involves HNF4α Activation
Authors: Yang Jinlian , Liang Jiaen , Zheng Yongjian , Li Shiying , Li Yang , Liu Haiyan , Chen Guanzhong , Ma Jing , Liao Ziyu , Lin Jiezhao , Jiang Zesheng , Wang Yan
Published: August 2020

There remain few data about the role of homeostatic compaction in hepatic polarization. A previous study has found that mechanical compaction can accelerate hepatocyte polarization; however, the cellular mechanism underlying the effect is mostly unclear. Hepatocyte nuclear factor 4 alpha (HNF4α) is crucial for hepatic polarization in liver morphogenesis. Therefore, we sought to identify any possible involvement of HNF4α in the process of hepatocyte polarization accelerated by mechanical compaction. We first verified in the nonhepatic cell model HEK‐293T, and the hepatic cell model primary hepatocytes that the mechanical compaction on cell aggregates simulated by using transient centrifugation can directly activate the expression of HNF4α promoters. Moreover, data using primary hepatocytes showed that the HNF4α expression is positively associated with the levels of compaction force: 2.1‐folds higher at the mRNA level and 2.1‐folds higher at the protein level for 500 g vs. 0 g. Furthermore, activated HNF4α expression is associated with the enhanced biliary canalicular formation and the increased production of albumin and urea. Pretreatment with Latrunculin B, an inhibitor of F‐actin, and SHE78‐7, an inhibitor of E‐cadherin, which both interrupt the pathway of mechanical transduction, partially but significantly reduced the HNF4α expression and production of albumin and urea. In conclusion, HNF4α can be actively involved in the hepatic polarization in the context of environmental mechanical compaction.
Revisiting the Warburg Effect: Diet‐Based Strategies for Cancer Prevention
Authors: Tran Quangdon , Lee Hyunji , Kim Chaeyeong , Kong Gyeyeong , Gong Nayoung , Kwon So Hee , Park Jisoo , Kim Seon-Hwan , Park Jongsun
Published: August 2020

It is widely acknowledged that cancer cell energy metabolism relies mainly on anaerobic glycolysis; this phenomenon is described as the Warburg effect. However, whether the Warburg effect is caused by genetic dysregulation in cancer or is the cause of cancer remains unknown. The exact reasons and physiology of this abnormal metabolism are unclear; therefore, many researchers have attempted to reduce malignant cell growth in tumors in preclinical and clinical studies. Anticancer strategies based on the Warburg effect have involved the use of drug compounds and dietary changes. We recently reviewed applications of the Warburg effect to understand the benefits of this unusual cancer‐related metabolism. In the current article, we summarize diet strategies for cancer treatment based on the Warburg effect.
Stakeholder Conflict Amplification of Large-Scale Engineering Projects in China: An Evolutionary Game Model on Complex Networks
Authors: He Zhengqi , Huang Dechun , Fang Junmin , Wang Bo
Published: August 2020

Large-scale engineering projects make tremendous contributions to China’s social and economic development; meanwhile, due to the diversity of stakeholders, the dispersion of time and space, and the complexity of information dissemination, large-scale engineering projects are easy to cause conflicts among stakeholders that affect social stability. The previous studies on stakeholder conflicts of large-scale engineering projects mainly focused on the game model among stakeholders, without considering the influence of stakeholders’ interaction complex networks formed by social relations on the conflict amplification. For the two main stakeholders of the government and the resident that play a key role in China’s large-scale engineering projects, this paper constructs an evolutionary game model of the main stakeholder conflict amplification and analyzes the evolutionary results of the conflict between the government and the resident in different situations. The small-world network is chosen as the complex network type of the simulation study since it is very similar with the topology of the realistic social network. Based on the NetLogo simulation platform, the stakeholder conflict amplification process of large-scale engineering projects on the small-world network is analyzed, and relevant management measures are proposed to defuse the stakeholder conflict of large-scale engineering projects. By using the evolutionary game model on complex networks, this paper studies the stakeholder conflict on the small-world network, providing reference for stakeholder conflict management of large-scale engineering projects in China.
Designing Evolutionary-based Interception Strategies to Block the Transition from Precursor Phases to Multiple Myeloma
Authors: Maura Francesco , Landgren Ola , Morgan Gareth J.
Published: August 2020

The development of next-generation sequencing technology has dramatically improved our understanding of the genetic landscape of multiple myeloma. Several new drivers and recurrent events have been reported and linked to a potential driver role. This complex landscape is enhanced by intraclonal mutational heterogeneity and variability introduced through the dimensions of time and space. The evolutionary history of multiple myeloma is driven by both the accumulation of different genomic drivers and by the activity of different mutational processes active overtime. In this review, we describe how these new findings and sequencing technologies have been progressively allowed to understand and reshape our knowledge of the complexity of multiple myeloma at each of its developmental stages: premalignant, at diagnosis, and in relapsed/refractory states. We discuss how these evolutionary concepts can be utilized in the clinic to alter evolutionary trajectories providing a framework for therapeutic intervention at early-disease stages.
CD49d Is Upregulated in Circulating T Lymphocytes from HTLV-1-Infected Patients
Authors: Janahú L.T. Araújo , Da Costa Carlos Araujo , Vallinoto Antonio Carlos Rosário , Santana Barbara Brasil , Ribeiro-Lima Jessica , Santos-Oliveira Joanna Reis , Chometon Thaize Quiroga , Bertho Alvaro Luis , Savino Wilson , Da-Cruz Alda Maria , Gomes-Silva Adriano
Published: August 2020

Introduction: HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive myelopathy associated with an inflammation of the central nervous system (CNS), being characterized by perivascular infiltration of inflammatory cells. HTLV-1-infected cells have the capacity to migrate through endothelial layers by enhancing adhesion receptor expression and corresponding ligands. T cells interact with the extracellular matrix via integrin receptors and these interactions affect both cell migration and proliferation. The importance of these interactions in retrovirus-induced diseases, however, remains less clear. Methods: Herein we studied the expression of 3 integrin alpha chains (CD49d, CD49e, and CD49f) on the membrane of T-cell subsets in patients infected by HTLV-1, both HAM/TSP patients and oligo/asymptomatic subjects who were asymptomatic or presented slight manifestations related to the virus infection. Results: We observed higher peripheral blood frequency of CD49dhiCD4+ and CD49dhiCD8+ T cells in HTLV-1-infected patients. Conclusion: Our findings suggest that the increased expression of adhesion molecules, such as CD49d on T lymphocytes from HTLV-1-infected patients may contribute to the pathogenesis of the disease, in both oligo/asymptomatic and HAM/TSP-infected subjects. Accordingly, it is conceivable that there is a potential use of CD49d as target for a therapeutic approach aiming at blocking migration of activated T cells from HTLV-1-infected patients into the CNS, thus avoiding the progression to HAM/TSP.
Prognostic Value of Ionized Calcium Levels in Neonatal Sepsis
Authors: Liu Yalan , Chai Yannan , Rong Zhihui , Chen Yan
Published: August 2020

Background: Despite recent advances in the treatment of neonatal infection, mortality rates and comorbidities associated with neonatal sepsis remain high. Hypocalcemia has been reported in critically ill patients, especially in as­sociation with sepsis. However, the importance of hypo­calcemia in neonatal sepsis has not been explored in detail. Objectives: The purpose of this study was to evaluate the prognostic value of hypocalcemia in neonatal sepsis patients and to identify the risk factors associated with sepsis-related mortality. Methods: This retrospective study examined perinatal data from patients in a level IV neonatal in­tensive care unit between January 2010 and June 2016. Univariate analysis was performed to understand the differences in clinical and laboratory characteristics between patients with and without neonatal sepsis. Neonates with sepsis were further stratified as having ionized hypocalcemia (if serum ionized calcium [iCa] <1.0 mmol/L) or not. Uni- and multivariate logistic regression analyses were utilized to evaluate the predictive potential of iCa for identifying sepsis-related mortality. Results: A total of 472 neonates were enrolled in this study, including 169 neonates diagnosed with culture-proven sepsis and 303 neonates without infection (control group). The comparison of neonates with and without sepsis highlighted significant differences in levels of iCa (0.97 ± 0.26 vs. 1.12 ± 0.25 mmol/L), magnesium (0.75 ± 0.22 vs. 0.89 ± 0.12 mmol/L), and phosphate (2.26 ± 1.08 vs. 1.65 ± 0.85 mmol/L; all p < 0.001). When neonates with sepsis were stratified into 2 subgroups based on serum iCa, neonates with hypocalcemia showed higher rates of organ dysfunction than those with normal iCa, as well as higher rates of cardiovascular system dysfunction (37.35 vs. 17.44%), renal dysfunction (34.94 vs. 30.95%), disseminated intravascular coagulation (26.51 vs. 11.63%), and seizure (16.04 vs. 5.8%; all p < 0.05). Among all neonates who had sepsis, the mortality rate was 13.61%, and this rate was higher among neonates with hypocalcemia than among those with normal iCa (20.48 vs. 6.98%, p < 0.05). Uni- and multivariate analyses showed that acidosis, hypoalbuminemia, hypocalcemia, and hyperphosphatemia were independent prognostic markers of sepsis-related mortality. In receiver-operating characteristic curve analysis, the areas under the curve were 0.70 (95% CI 0.624–0.768; p = 0.0004), 0.74 (95% CI 0.671–0.808; p < 0.0001), 0.73 (95% CI 0.653–0.792; p = 0.0002), and 0.67 (95% CI 0.59–0.737; p = 0.0154) for serum albumin, iCa, phosphate, and acidosis, respectively. Based on these findings, we developed a nomogram to predict sepsis-related mortality. Conclusions: Hypocalcemia is common in neonates with sepsis and is significantly associated with organ dysfunction and sepsis-related mortality.
Hair Loss in Patients Treated with Vismodegib: A Single-Center Retrospective Study
Authors: Villani Alessia , Fabbrocini Gabriella , Costa Claudia , Scalvenzi Massimiliano
Published: August 2020

Locally advanced basal cell carcinoma had always represented a form of skin cancer which had been difficult to treat until the hedgehog inhibitor vismodegib was approved. This small molecule acts by inhibiting the hedgehog signaling pathway that plays a critical role in the process of tumorigenesis. Although several trials have demonstrated the high efficacy of this drug, different adverse events have been described. Muscle spasms, dysgeusia, weight loss, and alopecia are the adverse events most frequently reported. The objective of this study was to report the incidence of alopecia arising in patients treated with vismodegib, assessing its characteristics, grade of severity, and time of onset.
Four-Dimensional Volume-Strain Expression in Asymptomatic Primary Hypertension Patients Presenting with Subclinical Left Atrium-Ventricle Dysfunction
Authors: Ran Hong , Schneider Matthias , Wan Lin-lin , Ren Jun-yi , Ma Xiao-wu , Zhang Ping-yang
Published: August 2020

Objective: The purpose of this study was to evaluate the different components of left atrial (LA) dysfunction predictors in asymptomatic primary systemic hypertension patients with preserved left ventricular (LV) ejection fraction, particularly using LA 4-dimensional (4D) longitudinal and circumferential strain values. Methods and Results: Patients with no left ventricular hypertrophy (NLVH) and left ventricular hypertrophy (LVH) are all asymptomatic regarding primary blood hypertension. Thirty NLVH patients and 30 LVH patients according to LV mass index and 40 controls analyzed by 4D echocardiography were prospectively enrolled. LA volumes and longitudinal and circumferential strains were measured using 4D volume-strain echocardiography with a Vivid E95 Version 203 instrument. Correlation analysis indicated a significant relation between LV 4D mass index and LA 4D longitudinal/circumferential strain (r = –0.446 to 0.381, p = 0.000–0.042). LVH patients had a reduced LA emptying fraction compared with NLVH patients and control subjects (p < 0.01). NLVH patients had an impaired LA conduit function and increased contractile function compared with the control group (p < 0.01). LVH patients had increased LA volumes and significantly decreased reservoir, conduit and contractile functions compared with the controls (p < 0.01). LVH patients had increased LA volumes and decreased reservoir and contractile functions compared with NLVH patients (p < 0.01). The clinical utility of LA 4D volume-strain measurement was verified by receiver-operating characteristic curve analysis showing larger net benefits as evaluated with NLVH, LVH and control group comparisons. Interclass correlation coefficients of interobserver and intraobserver assessments in the LV and LA 4D value evaluations were >0.75 and >0.85, respectively. Conclusions: LVH patients showed increased LA volumes and decreased LA emptying fractions. LA reservoir, conduit and contractile functions were significantly impaired in LVH patients. Decreased LA conduit function and increased contractile function were revealed in NLVH patients. LA volumetric and functional analyses with 4D volume-strain echocardiography may facilitate the recognition of subtle LA and LV dysfunctions in asymptomatic systemic hypertension patients.
Intravitreal Voriconazole for Treatment of Bilateral Endogenous Candida Chorioretinitis
Authors: Sim Ha Eun , Kang Min Ji , Kim Jae Suk , Hwang Je Hyung
Published: August 2020

This report describes a patient with bilateral endogenous candida chorioretinitis. The patient had a 2-day history of bilateral blurred vision. Fundus photography revealed multiple chorioretinal infiltrations in both eyes and a parafoveal hemorrhage in the left eye. After 2 days, fundus examination showed an increased number of infiltrations and hemorrhages in both eyes and worsening vitreous inflammation. A large infiltrative intraretinal lesion and a retinal hemorrhage of the left eye were discovered on optical coherence tomography. Candida albicans was diagnosed from blood culture. The bilateral candida chorioretinitis had not responded to systemic or topical antifungal medication. The chorioretinitis was refractory to intravitreal amphotericin B as well. Intravitreal voriconazole injection in both eyes and intravitreal bevacizumab injection in the left eye were performed thereafter. The chorioretinal infiltrations and hemorrhages decreased in both eyes. Intravitreal voriconazole injection was effective in the treatment of intractable candida chorioretinitis.
Recommendations for Diagnosis and Treatment of Pseudohypoparathyroidism and Related Disorders: An Updated Practical Tool for Physicians and Patients
Authors: Mantovani Giovanna , Bastepe Murat , Monk David , de Sanctis Luisa , Thiele Susanne , Ahmed S. Faisal , Bufo Roberto , Choplin Timothée , De Filippo Gianpaolo , Devernois Guillemette , Eggermann Thomas , Elli Francesca M. , Garcia Ramirez Aurora , Germain-Lee Emily L. , Groussin Lionel , Hamdy Neveen A.T. , Hanna Patrick , Hiort Olaf , Jüppner Harald , Kamenický Peter , Knight Nina , Le Norcy Elvire , Lecumberri Beatriz , Levine Michael A. , Mäkitie Outi , Martin Regina , Martos-Moreno Gabriel Ángel , Minagawa Manasori , Murray Philip , Pereda Arrate , Pignolo Robert , Rejnmark Lars , Rodado Rebeca , Rothenbuhler Anya , Saraff Vrinda , Shoemaker Ashley H. , Shore Eileen M. , Silve Caroline , Turan Serap , Woods Philip , Zillikens M. Carola , Perez de Nanclares Guiomar , Linglart Agnès
Published: August 2020

Patients affected by pseudohypoparathyroidism (PHP) or related disorders are characterized by physical findings that may include brachydactyly, a short stature, a stocky build, early-onset obesity, ectopic ossifications, and neurodevelopmental deficits, as well as hormonal resistance most prominently to parathyroid hormone (PTH). In addition to these alterations, patients may develop other hormonal resistances, leading to overt or subclinical hypothyroidism, hypogonadism and growth hormone (GH) deficiency, impaired growth without measurable evidence for hormonal abnormalities, type 2 diabetes, and skeletal issues with potentially severe limitation of mobility. PHP and related disorders are primarily clinical diagnoses. Given the variability of the clinical, radiological, and biochemical presentation, establishment of the molecular diagnosis is of critical importance for patients. It facilitates management, including prevention of complications, screening and treatment of endocrine deficits, supportive measures, and appropriate genetic counselling. Based on the first international consensus statement for these disorders, this article provides an updated and ready-to-use tool to help physicians and patients outlining relevant interventions and their timing. A life-long coordinated and multidisciplinary approach is recommended, starting as far as possible in early infancy and continuing throughout adulthood with an appropriate and timely transition from pediatric to adult care.
Nail Unit Blue Nevi: A 11-Case Series and Review of the Literature
Authors: Dehavay Florence , Goettmann Sophie , Zaraa Ines , Moulonguet Isabelle , André Josette , Caucanas Marie , Baran Robert , Richert Bertrand ,   for the Groupe Ongle de la Société française de Dermatologie
Published: August 2020

Background: Blue nevus of the nail apparatus is a rare entity and only isolated cases are reported in the literature. Objective: The aim of this study was to better characterize blue nevus at the nail unit. Methods: Retrospective analysis of all nail unit blue nevi from the Nail Group of the French Society of Dermatology was compared to the literature. Results: Eleven cases were retrieved from 2002 to 2019 with an average age of 45 years. The majority were women (9/11) and acquired (10/11). Hands were more frequently involved (9/11) with a predilection for the thumb and 2 cases were located on the hallux. Nail unit blue nevus mostly presented as a well-delimited blue spot of the lunula (9/11) and histologically was of the common type (10/11). There was no malignancy. Conclusion: Nail unit blue nevus is a rare asymptomatic benign entity, mostly acquired on the thumb or the hallux of women. The most frequent presentation is a painless blue spot on the lunula. Congenital blue nevi seem to only affect the paronychium. Main differential diagnosis is melanoma and histopathological examination is mandatory.
Enlarged Foveal Avascular Zone after Whiplash Injury-Acquired Berlin’s Edema
Authors: Drača Nataša , Cerovski Branimir , Lazić Ratimir , Kovačević Damir , Gabrić Krešimir , Gabrić Ivan
Published: August 2020

We describe a case of optical coherence tomography angiography (OCTA) changes in the foveal avascular zone (FAZ) in a patient that had suffered Berlin’s edema after a whiplash neck injury. The patient reported central scotoma throughout the 1-year follow-up, confirmed by visual field examination. OCTA showed FAZ enlargement of the left eye as compared to the healthy right eye in the superficial capillary layer and even more in the deep capillary layer. To the best of our knowledge, FAZ enlargement has not been previously described by OCTA after whiplash-related macular injury.
Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement From the American Heart Association
Authors: Page Robert L. , Allen Larry A. , Kloner Robert A. , Carriker Colin R. , Martel Catherine , Morris Alanna A. , Piano Mariann R. , Rana Jamal S. , Saucedo Jorge F. ,   On behalf of the American Heart Association Clinical Pharmacology Committee and Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; Council on Basic Cardiovascular Sciences; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Lifestyle and Cardiometabolic Health; and Council on Quality of Care and Outcomes Research
Published: August 2020

Cannabis, or marijuana, has potential therapeutic and medicinal properties related to multiple compounds, particularly Δ-9-tetrahydrocannabinol and cannabidiol. Over the past 25 years, attitudes toward cannabis have evolved rapidly, with expanding legalization of medical and recreational use at the state level in the United States and recreational use nationally in Canada and Uruguay. As a result, the consumption of cannabis products is increasing considerably, particularly among youth. Our understanding of the safety and efficacy of cannabis has been limited by decades of worldwide illegality and continues to be limited in the United States by the ongoing classification of cannabis as a Schedule 1 controlled substance. These shifts in cannabis use require clinicians to understand conflicting laws, health implications, and therapeutic possibilities. Cannabis may have therapeutic benefits, but few are cardiovascular in nature. Conversely, many of the concerning health implications of cannabis include cardiovascular diseases, although they may be mediated by mechanisms of delivery. This statement critically reviews the use of medicinal and recreational cannabis from a clinical but also a policy and public health perspective by evaluating its safety and efficacy profile, particularly in relationship to cardiovascular health.
Apennocoris pilosulus: rediscovery of a forgotten big-eyed bug taxon from New Caledonia (Heteroptera: Lygaeoidea: Geocoridae)
Authors: KÓBOR PÉTER
Published: August 2020

Apennocoris pilosulus Montandon, 1907 (Hemiptera: Heteroptera: Lygaeoidea: Geocoridae), a peculiar representative of Geocorinae endemic to New Caledonia unreported since its original description is redescribed and illustrated based on its lectotype (designated in the present paper) and an additional non-type specimen. The placement of this monotypic genus within the subfamily Geocorinae is discussed.
Taxonomic notes on the genus Pseumenes Giordani Soika, 1935 (Hymenoptera: Vespidae: Eumeninae) from Vietnam with key to all known species in the Oriental region
Authors: LIEN NGUYEN THI PHUONG , NGAT TRAN THI , MINH HOANG GIA
Published: August 2020

There are two species of the genus Pseumenes Giordani Soika, 1935 occurring in Vietnam, Pseumenes depressus depressus (de Saussure, 1855) and a new species, Pseumenes fulvus Nguyen. The new species is described and figured. A key to all known species of this genus from the Oriental region is provided.
Redescription of Afissa gibbera (Crotch, 1874) and Uniparodentata circummaculata (Pang & Mao, 1977) (Coccinellidae: Epilachnini) from India
Authors: DAS PRIYANKA , CHANDRA KAILASH , GUPTA DEVANSHU
Published: August 2020

Two poorly known species of the tribe Epilachnini (Coleoptera: Coccinellidae) are redescribed and diagnosed from India: Afissa gibbera (Crotch) and Uniparodentata circummaculata (Pang & Mao), supported with photographs of the male genitalia. Also, U. circummaculata is a new record to India.
Multilevel Models of the Relationship Between Music Achievement and Reading and Math Achievement
Authors: Bergee Martin J. , Weingarten Kevin M.
Published: August 2020

We used multilevel mixed modeling to test the extent to which students’ music achievement scores were related to their reading and math achievement scores. Of the four levels examined (individual students, classrooms, schools, and districts), only individuals and districts accounted for a significant portion of the total variance in achievement scores. We studied several background variables potentially affecting academic achievement among individuals: grade level, gender, educational attainment of parents/guardians, free/reduced-price lunch, ethnicity, and urbanicity. We also incorporated district-level variables of sex, ethnicity, parent/guardian education level, and free/reduced-price lunch along with principal component scores for four district-level latent variables—district achievement, district behavior, available funds, and local revenue. Fourth through eighth graders ( N = 1,081) from seven midwestern school districts participated in the study. Students sat for a representative portion of the first two of the Music Achievement Tests (MAT-1 and MAT-2). We developed separate models for reading and math achievement. No significant differences were found among the districts’ intercepts or slopes. With the aforementioned variables controlled for, both MAT-1 and MAT-2 (controlling for one another as well) demonstrated a strong relationship with reading and math achievement ( ps < .0001).
Simulation-based optimization methods applied in hospital emergency departments: A systematic review
Authors: Yousefi Milad , Yousefi Moslem , Fogliatto Flavio S
Published: August 2020

Since high performance is essential to the functioning of emergency departments (EDs), they must constantly pursue sensible and empirically testable improvements. In light of recent advances in computer science, an increasing number of simulation-based approaches for studying and implementing ED performance optimizations have become available in the literature. This paper aims to offer a survey of these works, presenting progress made on the topic while indicating possible pitfalls and difficulties in EDs. With that in mind, this review considers research studies reporting simulation-based optimization experiments published between 2007 and 2019, covering 38 studies. This paper provides bibliographic background on issues covered, generates statistics on methods and tools applied, and indicates major trends in the field of simulation-based optimization. This review contributes to the state of the art on ED modeling by offering an updated picture of the present state of the field, as well as promising research gaps. In general, this review argues that future studies should focus on increasing the efficiency of multi-objective optimization problems by decreasing their cost in time and labor.