bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of ASM/Cer/TXNIP signaling module in the NLRP3 inflammasome activation
Authors: Jiang Jianjun , Shi Yining , Cao Jiyu , Lu Youjin , Sun Gengyun , Yang Jin
Published: February 2021

Background

This study aimed to explore the effects of ceramide (Cer) on NLRP3 inflammasome activation and their underlying mechanisms.

Methods

Lipopolysaccharide (LPS)/adenosine triphosphate (ATP)-induced NLRP3 inflammasome activation in J774A.1 cells and THP-1 macrophages was used as an in vitro model of inflammation. Western blotting and real-time PCR (RT-PCR) were used to detect the protein and mRNA levels, respectively. IL-1β and IL-18 levels were measured by ELISA. ASM assay kit and immunofluorescence were used to detect ASM activity and Cer content.

Results

Imipramine, a well-known inhibitor of ASM, significantly inhibited LPS/ATP-induced activity of ASM and the consequent accumulation of Cer. Additionally, imipramine suppressed the LPS/ATP-induced expression of thioredoxin interacting protein (TXNIP), NLRP3, caspase-1, IL-1β, and IL-18 at the protein and mRNA level. Interestingly verapamil, a TXNIP inhibitor, suppressed LPS/ATP-induced activation of TXNIP/NLRP3 inflammasome but did not affect LPS/ATP-induced ASM activation and Cer formation. TXNIP siRNA and verapamil inhibited C2-Cer-induced upregulation of TXNIP and activation of the NLRP3 inflammasome. In addition, the pretreatment of cells with sulfo-N-succinimidyl oleate (SSO), an irreversible inhibitor of the scavenger receptor CD36, blocked Cer-induced upregulation of nuclear factor-κB (NF-κB) activity, TXNIP expression, and NLRP3 inflammasome activation. Inhibition of NF-κB activation by SN50 prevented Cer-induced upregulation of TXNIP and activation of the NLRP3 inflammasome but did not affect CD36 expression.

Conclusion

This study demonstrated that the ASM/Cer/TXNIP signaling pathway is involved in NLRP3 inflammasome activation. The results documented that the CD36-dependent NF-κB-TXNIP signaling pathway plays an essential role in the Cer-induced activation of NLRP3 inflammasomes in macrophages.
Comparison of open and intracorporeal modified ureterosigmoidostomy (Mainz II) after laparoscopic radical cystectomy with bladder cancer
Authors: Zheng Duo , Liu Junyao , Wu Gongjin , Yang Shujun , Luo Chuang , Du Tianci , Luo Yao , Bao Junsheng , Tian Junqiang , Wang Zhiping , Shang Panfeng , Yue Zhongjin
Published: February 2021

Objective

To compare perioperative and oncologic outcomes of open modified ureterosigmoidostomy urinary diversion (OMUUD) and intracorporeal modified ureterosigmoidostomy urinary diversion (IMUUD) following laparoscopic radical cystectomy (LRC).

Patients and methods

We retrospectively reviewed our single institutional collected database patients undergoing LRC from October 2011 to October 2019. The perioperative characteristics were compared between OMUUD and IMUUD, and overall survival (OS) and progression-free survival (PFS) were evaluated by the Kaplan-Meier method.

Results

Overall, 84 patients were included. OMUUD and IMUUD were performed in 63 (75%) and 21 (25%) patients, respectively. IMUUD patients demonstrated shorter postoperative length of stay (16.24 ± 3.91 days vs. 18.98 ± 7.41 days, P = 0.033), similar operation time (498.57 ± 121.44 vs. 462.24 ± 99.71, P = 0.175), similar estimated blood loss [400 (200–475) ml vs. 400 (200–700) ml, P = 0.095], and similar overall complication rate within 30 days (19.05% vs. 25.40%, P = 0.848) and 90 days (23.81% vs. 17.46%, P = 0.748). Complete urinary control rate was 87.3% (55/63) in the OMUUD group. In IMUUD, the complete urinary control rate was 90.5% (19/21). There was no significant difference in OS (χ2 = 0.015, P = 0.901) and PFS (χ2 = 0.107, P = 0.743) between the two groups.

Conclusion

IMUUD postoperative recovery is faster; other perioperative outcomes and oncology results are not significantly different with OMUUD. It is indicated that IMUUD can be utilized safely and effectively in the urinary diversion after LRC.
First two-stage robotic ALPPS in HCC patients with hepatic vein invasion: a step-by-step procedure from a clinical case
Authors: Hu Ming-Gen , Wang Jin , Yin Zhu-Zeng , Liu Rong
Published: February 2021

Background

The associating liver partitioning and portal vein occlusion for staged hepatectomy (ALPPS) procedure is gaining interest because it brings hope to patients who cannot undergo radical surgical resection due to insufficient remnant liver volume. However, the indications and technical aspects of this procedure are still under debate. This report demonstrates the technical aspects of the first two-stage robotic ALPPS for HCC.

Case presentation

A 55-year-old man with type II portal vein variation was diagnosed with hepatocellular carcinoma. Preoperative 3D reconstruction of the liver based on CT showed a future liver remnant/standard liver volume (FLR/SLV) of 24.45%. The ALPPS procedure was performed using the da Vinci Si system. At the first stage of the operation, we removed the gallbladder and ligated the right anterior branch of the portal vein and the right posterior branch. Following blocking of the hepatic hilum, the liver parenchyma was removed 1 cm away from the right side of the falciform ligament in an incision manner from the top to the bottom and from shallow to deep. The second-stage operation was performed on the 12th postoperative day with a FLR/SLV of 45.13%. During this step, the right hemiliver plus left medial section was separated and removed. Postoperative pathology showed a negative margin. The operative times were 195 and 217 min, respectively. Estimated blood loss was 250 and 500 ml, respectively. There was no need for transfusion or hospitalization in intensive care. The patient was discharged on the 6th postoperative day. Recovery was uneventful after both stages, and the patient did not present any sign of liver failure. Elevation of liver enzymes was minimal. The patient had no evidence of the disease 14 months after the procedure.

Conclusions

The two-stage robotic ALPPS procedure is a safe and feasible technique for select patients with HCC.
Novel variants in DNAH9 lead to nonsyndromic severe asthenozoospermia
Authors: Tang Dongdong , Sha Yanwei , Gao Yang , Zhang Jingjing , Cheng Huiru , Zhang Junqiang , Ni Xiaoqing , Wang Chao , Xu Chuan , Geng Hao , He Xiaojin , Cao Yunxia
Published: February 2021

Background

Asthenozoospermia is one of the most common causes of male infertility, and its genetic etiology is poorly understood. DNAH9 is a core component of outer dynein arms in cilia and flagellum. It was reported that variants of DNAH9 (OMIM: 603330) might cause primary ciliary dyskinesia (PCD). However, variants in DNAH9 lead to nonsyndromic severe asthenozoospermia have yet to be reported.

Methods

Whole exome sequencing (WES) was performed for two individuals with nonsyndromic severe asthenozoospermia from two non-consanguineous families, and Sanger sequencing was performed to verify the identified variants and parental origins. Sperm routine analysis, sperm vitality rate and sperm morphology analysis were performed according the WHO guidelines 2010 (5th edition). Transmission electron microscopy (TEM, TECNAI-10, 80 kV, Philips, Holland) was used to observe ultrastructures of sperm tail. Quantitative realtime-PCR and immunofluorescence staining were performed to detect the expression of DNAH9-mRNA and location of DNAH9-protein. Furthermore, assisted reproductive procedures were applied.

Results

By WES and Sanger sequencing, compound heterozygous DNAH9 (NM_001372.4) variants were identified in the two individuals with nonsyndromic severe asthenozoospermia (F1 II-1: c.302dupT, p.Leu101fs*47 / c.6956A > G, p.Asp2319Gly; F2 II-1: c.6294 T > A, p.Phe2098Leu / c.10571 T > A, p.Leu3524Gln). Progressive rates less than 1% with normal sperm morphology rates and normal vitality rates were found in both of the two subjects. No respiratory phenotypes, situs inversus or other malformations were found by detailed medical history, physical examination and lung CT scans etc. Moreover, the expression of DNAH9-mRNA was significantly decreased in sperm from F1 II-1. And expression of DNAH9 is lower in sperm tail by immunofluorescence staining in F1 II-1 compared with normal control. Notably, by intracytoplasmic sperm injection (ICSI), F1 II-1 and his partner successfully achieved clinical pregnancy.

Conclusions

We identified DNAH9 as a novel pathogenic gene for nonsyndromic severe asthenospermia, and ICSI can contribute to favorable pregnancy outcomes for these patients.
Interactions of neuroimmune signaling and glutamate plasticity in addiction
Authors: Gipson Cassandra D. , Rawls Scott , Scofield Michael D. , Siemsen Benjamin M. , Bondy Emma O. , Maher Erin E.
Published: February 2021

Chronic use of drugs of abuse affects neuroimmune signaling; however, there are still many open questions regarding the interactions between neuroimmune mechanisms and substance use disorders (SUDs). Further, chronic use of drugs of abuse can induce glutamatergic changes in the brain, but the relationship between the glutamate system and neuroimmune signaling in addiction is not well understood. Therefore, the purpose of this review is to bring into focus the role of neuroimmune signaling and its interactions with the glutamate system following chronic drug use, and how this may guide pharmacotherapeutic treatment strategies for SUDs. In this review, we first describe neuroimmune mechanisms that may be linked to aberrant glutamate signaling in addiction. We focus specifically on the nuclear factor-kappa B (NF-κB) pathway, a potentially important neuroimmune mechanism that may be a key player in driving drug-seeking behavior. We highlight the importance of astroglial-microglial crosstalk, and how this interacts with known glutamatergic dysregulations in addiction. Then, we describe the importance of studying non-neuronal cells with unprecedented precision because understanding structure-function relationships in these cells is critical in understanding their role in addiction neurobiology. Here we propose a working model of neuroimmune-glutamate interactions that underlie drug use motivation, which we argue may aid strategies for small molecule drug development to treat substance use disorders. Together, the synthesis of this review shows that interactions between glutamate and neuroimmune signaling may play an important and understudied role in addiction processes and may be critical in developing more efficacious pharmacotherapies to treat SUDs.
The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with post-thrombolysis early neurological outcomes in patients with acute ischemic stroke
Authors: Gong Pengyu , Liu Yukai , Gong Yachi , Chen Gang , Zhang Xiaohao , Wang Siyu , Zhou Feng , Duan Rui , Chen Wenxiu , Huang Ting , Wang Meng , Deng Qiwen , Shi Hongchao , Zhou Junshan , Jiang Teng , Zhang Yingdong
Published: February 2021

Background and purpose

To investigate the association of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) with post-thrombolysis early neurological outcomes including early neurological improvement (ENI) and early neurological deterioration (END) in patients with acute ischemic stroke (AIS).

Methods

AIS patients undergoing intravenous thrombolysis were enrolled from April 2016 to September 2019. Blood cell counts were sampled before thrombolysis. Post-thrombolysis END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increase of ≥ 4 within 24 h after thrombolysis. Post-thrombolysis ENI was defined as NIHSS score decrease of ≥ 4 or complete recovery within 24 h. Multinomial logistic regression analysis was performed to explore the relationship of NLR, PLR, and LMR to post-thrombolysis END and ENI. We also used receiver operating characteristic curve analysis to assess the discriminative ability of three ratios in predicting END and ENI.

Results

Among 1060 recruited patients, a total of 193 (18.2%) were diagnosed with END and 398 (37.5%) were diagnosed with ENI. Multinomial logistic model indicated that NLR (odds ratio [OR], 1.385; 95% confidence interval [CI] 1.238–1.551,P= 0.001), PLR (OR, 1.013; 95% CI 1.009–1.016,P= 0.001), and LMR (OR, 0.680; 95% CI 0.560–0.825,P= 0.001) were independent factors for post-thrombolysis END. Moreover, NLR (OR, 0.713; 95% CI 0.643–0.791,P= 0.001) served as an independent factor for post-thrombolysis ENI. Area under curve (AUC) of NLR, PLR, and LMR to discriminate END were 0.763, 0.703, and 0.551, respectively. AUC of NLR, PLR, and LMR to discriminate ENI were 0.695, 0.530, and 0.547, respectively.

Conclusions

NLR, PLR, and LMR were associated with post-thrombolysis END. NLR and PLR may predict post-thrombolysis END. NLR was related to post-thrombolysis ENI.
Interleukin-1β mediates alterations in mitochondrial fusion/fission proteins and memory impairment induced by amyloid-β oligomers
Authors: Batista Andre F. , Rody Tayná , Forny-Germano Leticia , Cerdeiro Suzana , Bellio Maria , Ferreira Sergio T. , Munoz Douglas P. , De Felice Fernanda G.
Published: February 2021

Background

The lack of effective treatments for Alzheimer’s disease (AD) reflects an incomplete understanding of disease mechanisms. Alterations in proteins involved in mitochondrial dynamics, an essential process for mitochondrial integrity and function, have been reported in AD brains. Impaired mitochondrial dynamics causes mitochondrial dysfunction and has been associated with cognitive impairment in AD. Here, we investigated a possible link between pro-inflammatory interleukin-1 (IL-1), mitochondrial dysfunction, and cognitive impairment in AD models.

Methods

We exposed primary hippocampal cell cultures to amyloid-β oligomers (AβOs) and carried out AβO infusions into the lateral cerebral ventricle of cynomolgus macaques to assess the impact of AβOs on proteins that regulate mitochondrial dynamics. Where indicated, primary cultures were pre-treated with mitochondrial division inhibitor 1 (mdivi-1), or with anakinra, a recombinant interleukin-1 receptor (IL-1R) antagonist used in the treatment of rheumatoid arthritis. Cognitive impairment was investigated in C57BL/6 mice that received an intracerebroventricular (i.c.v.) infusion of AβOs in the presence or absence of mdivi-1. To assess the role of interleukin-1 beta (IL-1β) in AβO-induced alterations in mitochondrial proteins and memory impairment, interleukin receptor-1 knockout (Il1r1−/−) mice received an i.c.v. infusion of AβOs.

Results

We report that anakinra prevented AβO-induced alteration in mitochondrial dynamics proteins in primary hippocampal cultures. Altered levels of proteins involved in mitochondrial fusion and fission were observed in the brains of cynomolgus macaques that received i.c.v. infusions of AβOs. The mitochondrial fission inhibitor, mdivi-1, alleviated synapse loss and cognitive impairment induced by AβOs in mice. In addition, AβOs failed to cause alterations in expression of mitochondrial dynamics proteins or memory impairment in Il1r1−/− mice.

Conclusion

These findings indicate that IL-1β mediates the impact of AβOs on proteins involved in mitochondrial dynamics and that strategies aimed to prevent pathological alterations in those proteins may counteract synapse loss and cognitive impairment in AD.
The effect of the mGlu8 receptor agonist, (S)-3,4-DCPG on acquisition and expression of morphine-induced conditioned place preference in male rats
Authors: Kahvandi Nazanin , Ebrahimi Zahra , Karimi Seyed Asaad , Shahidi Siamak , Salehi Iraj , Naderishahab Marzieh , Sarihi Abdolrahman
Published: February 2021

Background

The nucleus accumbens (NAc) plays a principal role in drug reward. It has been reported that metabotropic glutamate receptors (mGlu receptors) play a key role in the rewarding pathway(s). Previous studies have shown the vast allocation of the different types of mGlu receptors, including mGlu8 receptors, in regions that are associated with opioid rewards, such as the NAc. The aim of the present study was to evaluate the role of mGlu8 receptors within the NAc in the acquisition and expression phases of morphine induced conditioned place preference (CPP). Adult male Wistar rats were bilaterally implanted by two cannulas' in the NAc and were evaluated in a CPP paradigm. Selective mGlu8 receptor allosteric agonist (S-3,4-DCPG) was administered at doses of 0.03, 0.3, and 3 μg/0.5 μL saline per side into the NAc on both sides during the 3 days of morphine (5 mg/kg) conditioning (acquisition) phase, or before place preference test, or post-conditioning (expression) phase of morphine-induced CPP.

Results

The results revealed that intra-accumbal administration of S-3,4-DCPG (0.3 and 3 μg) markedly decreased the acquisition in a dose-dependent manner but had no effect on expression of morphine-induced CPP.

Conclusions

The findings suggest that activation of mGlu8 receptors in the NAc dose-dependently blocks the establishment of morphine-induced CPP and reduces the rewarding properties of morphine which may be related to the glutamate activity into the NAc and in reward pathway(s). These data suggest that mGlu8 receptor may be involved in conditioned morphine reward.
Endobronchial sialolipoma. Case report
Authors: Nodar Severino Rey , Yllán Verónica García , Ferrer Nohelia Rojas , Solis Onay , Boccara Hugo D.
Published: February 2021

Background

A 52-year-old woman presented with shortness of breath and cough. An endobronchial sialolipoma was found at the left entrance of the main bronchus. Sialolipoma is an exceedingly rare type of lipoma reported of the minor salivary glands, especially within the bronchus.

Case presentation

A 52-year-old woman presented with shortness of breath and cough with 6 months´ evolution. Endobronchial endoscopy revealed a tumour at the left entrance of the main bronchus. The entire removal of the tumour was removed using a cryoprobe device. Pathological examination showed a tumour consistent with the diagnosis of sialolipoma due to the presence of mature adipose cells blended with acinar, ductal, basal, and myoepithelial cells. The patient had a favourable outcome.

Conclusion

The infrequent tracheobronchial presentation of this tumour can be challenging for correct diagnosis.
Succinate dehydrogenase deficient gastrointestinal stromal tumor in a three month old boy with a fatal clinical course: a case report and review of literature
Authors: Lv Bei-Bei , Li Jia-Mei , Yao Zhi-Gang , Cheng Xian-Kui , Ren Fu-Xin , Su Wen-Jing , Qin Ye-Jun , Wang Zhou , Cao Zhi-xin
Published: February 2021

Background

Succinate dehydrogenase deficient gastrointestinal stromal tumors (SDH-deficient GISTs), which lack KIT or PDGFRA mutations demonstrate unique clinical and pathological features, and they respond poorly to standard targeted therapy. We herein present a novel case of SDH-deficient GIST in a three-month-old infant’s colon mesentery, and he is the youngest patientto date.

Case presentation

The infantpresented with complaints of blood in the stool. CT showed a 6.3 × 4.6 cm mass in the left lower retroperitoneal. Complete resection of tumor and segmental bowel resection was performed without regional lymphadenectomy. Histologically, tumor cells were distinctive in their multinodular colon wall involvement with interspersed tracts of colon wall smooth muscle. The tumor was composed mainly of epithelioid cells. Immunohistochemically, the tumor cells were positive for Vim, CD117, PDGFR, while negative for SDHB. Mutational analysis showed a synonymous mutation for SDHB and wild-type for KIT and PDGFRA. Two months after surgery, metastases were found and Imatinib was administered. Unfortunately, the disease continued to progress, and the infant died 5 months after surgery.

Conclusions

SDH-deficient GISTs comprise a subgroup of a relatively rare tumor type and show a number of clinically and biologically unique features, especially for infants. It is of great importance to developing new therapeutic targets and novel specific drugs.
The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature
Authors: D’Addona Alessio , Izzo Andrea , Di Vico Giovanni , Rosa Donato , Maffulli Nicola
Published: February 2021

Background

Popliteomeniscal fascicles (PMF) are considered the posterolateral meniscocapsular extensions which connect the lateral meniscus to the edge of the tibia. PMFs disruption leads to hypermobility of the lateral meniscus with pain and locking sensation. Recognition and treatment of PMFs tear remain very challenging. The aim of this systematic review is to collect and analyse the articles concerning popliteomeniscal fascicle disruption from diagnosis to surgical approach.

Methods

PubMed, Scopus, Web of Science and EMBASE were searched. Various combinations of the keywords “Popliteomeniscal Fascicles”, “Lateral Meniscus”, “Popliteal Hiatus”, “Posterolateral Corner”, “Tear” and “Surgical Repair” were used. The original literature search identified a total of 85 articles comprising of duplicates. The PRISMA guidilines were followed. Studies in English language and published in peer-reviewed journals were included. Articles with level of evidence I to IV were included

Results

A total of three articles were included in the qualitative analysis. All the articles included are retrospective case series, with a level of evidence IV. Studies concerning patients with pre-operative imaging MRI and clinical assessment, reporting surgical technique and clinical outcomes assessed by physical examination and/or subjective evaluation scales were analysed.

Conclusions

MRI and the Figure-4 test allow to assess PMF tears pre-operatively. Arthroscopic evaluation constitutes the gold standard to confirm the diagnosis. Although surgery is considered resolutive for symptoms, there is still controversy about the most appropriate technique. Further higher quality studies are required.
Silymarin modulates catabolic cytokine expression through Sirt1 and SOX9 in human articular chondrocytes
Authors: Wu Wen-Tien , Chen Yi-Ru , Lu Dai-Hua , Senatov Fedor Svyatoslavovich , Yang Kai-Chiang , Wang Chen-Chie
Published: February 2021

Background

Silymarin (SMN), a polyphenolic flavonoid, is involved in multiple bioactive functions including anti-inflammation. Pretreatment with SMN demonstrated chondroprotection against tumour necrosis factor-alpha (TNF-α) stimulation in a chondrocyte cell line. However, pre- and posttreatment with phytochemicals have varying effects on osteoarthritis (OA) chondrocytes, and the therapeutic potential of SMN after catabolic cytokine stimulation is not fully elucidated.

Methods

The cytotoxicity of SMN (12.5, 25, 50 and 100 μM) was evaluated in human primary chondrocytes. The chondrocytes were supplemented with SMN (25 and 50 μM) after interleukin-1beta (IL-1β) stimulation. The mRNA expression and protein production of catabolic/anabolic cytokines as well as extracellular matrix (ECM) components were evaluated.

Results

High-dose SMN (100 μM) impaired the mitochondrial activity in chondrocytes, and 50 μM SMN further caused cell death in IL-1β-stimulated cells. The addition of 25 μM SMN ameliorated cell senescence; downregulated the catabolic genes of inducible nitric oxide synthase, IL-1β, TNF-α, matrix metalloproteinase-3 (MMP-3), MMP-9 and MMP-13; upregulated the anabolic genes of tissue inhibitor of metalloproteinase-1 (TIMP-1) and collagen type II alpha 1; and restored the expression of chondrogenic phenotype genes SOX9 and sirtuin-1 (Sirt1). In addition, the production of IL-1β, MMP-3 and MMP-9 decreased with an increase in TIMP-1 secretion. However, the mRNA levels of IL-6, IL-8 and IL-10 and protein production remained high. The addition of nicotinamide, a Sirt1 inhibitor, downregulated SOX9 and attenuated the therapeutic effects of SMN on IL-1β-stimulated chondrocytes.

Conclusion

SMN regulates the chondrocyte phenotype through Sirt1 and SOX9 to improve ECM homeostasis and may serve as a complementary therapy for early-stage knee OA.
Changes in emotions and worries during the Covid-19 pandemic: an online-survey with children and adults with and without mental health conditions
Authors: Rothe Josefine , Buse Judith , Uhlmann Anne , Bluschke Annet , Roessner Veit
Published: February 2021

Background

The novel coronavirus disease (Covid-19) has spread quickly worldwide with dramatic consequences on our daily lives. Adverse psychosocial consequences of Covid-19 might be particularly severe for children and adolescents, parents of young children and people with mental health conditions (mhc), who are more prone to the experience of psychosocial stress and who are more dependent on the access to professional psychosocial support. The present survey therefore aimed to explore perceived stress and the emotional responses of children and adolescents as well as adults with and without mhc during the social restrictions due to the Covid-19 pandemic.

Methods

The survey gathered information about 284 children and adolescent (parent-on-child-reports) and 456 adults (including 284 parents, self-reports). The participants were allocated to four groups: children and adolescents with mhc, children and adolescent without mhc, adults with mhc and adults without mhc. The survey included general questions about socio-demographic characteristics and mental health status, the CoRonavIruSHealth Impact Survey and the Perceived Stress Scale (only data on adults). Wilcoxon signed-rank tests were used for comparing the emotional responses during the Covid-19 pandemic with emotions before the Covid-19 pandemic. Independent sample t-test were used to compare the level of perceived stress between the adult groups, linear regression analyses were conducted to examine which variables predicted perceived stress during the Covid-19 restrictions.

Results

An increase to the worse during the Covid-19 restrictions was observed for most emotions and worries in all four groups (children and adolescents with mhc, children and adolescents without mhc, adults with mhc, adults without mhc). Contrary to our expectations, a greater number of emotions worsened significantly for children and adolescents as well as adults without mhc as compared to those with mhc. We found higher perceived stress in parents as compared to adults without children in the same household and in adults with mhc as compared to those without mhc.

Discussion

Covid-19-related social restrictions and potential health risks seem to affect emotions and perceived stress in children, adolescents and adults. Especially, Covid-19 seems to be have worsened the mental well-being of children and adolescent and their families, who were mentally healthy before the Covid-19 pandemic.
Infected thoracoabdominal aortic aneurysm related to an implanted long-term arterial catheter for chemotherapy: a case report
Authors: Takemoto Kiyoshi , Nakamura Michitaka , Sakuraya Masaaki , Yamamoto Tomonori , Iwanaga Wataru , Atagi Kazuaki , Yamanaka Kazuo , Matsuyama Takeshi
Published: February 2021

Background

An infected aortic aneurysm is a rare and life-threatening vascular condition with a high incidence of arterial rupture and recurrence even after treatment. One of the most common causes of an infected aortic aneurysm is catheter-related bloodstream infection. Although infection due to indwelling catheters is possible, the incidence of this is rare, especially for long-term implanted arterial catheters.

Case presentation

A 78-year-old Japanese man with a past medical history of rectal cancer with metastasis to the liver presented to our hospital as a result of low back pain. Remission had been achieved following surgery and adjuvant chemotherapy via an implanted catheter for arterial infusion. However, the original catheter that was inserted from the femoral artery to the hepatic artery via the celiac artery was still present more than 10 years after diagnosis, without being replaced, in case of a recurrence. On the day of admission, computed tomography scan of the chest and abdomen with contrast revealed an irregularly shaped aortic aneurysm at the origin of the celiac artery and a partially expanded common hepatic artery with disproportionate fat stranding along the implanted arterial catheter without extravasation. Although the initial impression was an impending rupture of the acute thoracoabdominal aortic aneurysm, a catheter-related infection was considered as a differential diagnosis. Surgery was performed, which revealed a catheter-related infected aortic aneurysm based on images along the catheter, pus cultures, and tissue pathology examination results.

Conclusions

This is an extremely rare case of an infectious aneurysm caused by prolonged implantation of an arterial catheter for chemotherapy. It should be noted that an indwelling arterial catheter not only causes bloodstream infections but can also cause an infection of a thoracoabdominal aortic aneurysm.
Stand structure and species diversity regulate biomass carbon stock under major Central Himalayan forest types of India
Authors: Kaushal Siddhartha , Baishya Ratul
Published: February 2021

Background

Data on the impact of species diversity on biomass in the Central Himalayas, along with stand structural attributes is sparse and inconsistent. Moreover, few studies in the region have related population structure and the influence of large trees on biomass. Such data is crucial for maintaining Himalayan biodiversity and carbon stock. Therefore, we investigated these relationships in major Central Himalayan forest types using non-destructive methodologies to determine key factors and underlying mechanisms.

Results

TropicalShorea robustadominant forest has the highest total biomass density (1280.79 Mg ha−1) and total carbon density (577.77 Mg C ha−1) along with the highest total species richness (21 species). The stem density ranged between 153 and 457 trees ha−1with large trees (> 70 cm diameter) contributing 0–22%. Conifer dominant forest types had higher median diameter andCedrus deodaraforest had the highest growing stock (718.87 m3ha−1); furthermore,C.deodaracontributed maximally toward total carbon density (14.6%) among all the 53 species combined.Quercus semecarpifolia–Rhododendron arboreumassociation forest had the highest total basal area (94.75 m2ha−1). We found large trees to contribute up to 65% of the growing stock. Nine percent of the species contributed more than 50% of the carbon stock. Species dominance regulated the growing stock significantly (R2 = 0.707,p< 0.001). Temperate forest types had heterogeneous biomass distribution within the forest stands. We found total basal area, large tree density, maximum diameter, species richness, and species diversity as the predominant variables with a significant positive influence on biomass carbon stock. Both structural attributes and diversity influenced the ordination of study sites under PCA analysis. Elevation showed no significant correlation with either biomass or species diversity components.

Conclusions

The results suggest biomass hyperdominance with both selection effects and niche complementarity to play a complex mechanism in enhancing Central Himalayan biomass carbon stock. Major climax forests are in an alarming state regarding future carbon security. Large trees and selective species act as key regulators of biomass stocks; however, species diversity also has a positive influence and should also reflect under management implications.
Occupation-specific wage returns: shedding light on differentials between employees with a VET degree either with or without an Abitur
Authors: Friedrich Anett , Hirtz Sandra
Published: February 2021

This study seeks to reveal the heterogeneity in occupation-specific wage returns among graduates of the German vocational education and training (VET) system. We distinguish between VET graduates with and without a higher education entrance certificate (i.e. an Abitur). To implement our hierarchical multi-level analyses, we exploit the latest wave of the BIBB/BAuA Employment Survey from 2018. By estimating occupation-specific wage returns, we reveal gaps between VET graduates with and without an Abitur. Additionally, we analyse several occupational characteristics to show how they contribute to the gaps in wage returns between our study groups. Our results show that employees combining an Abitur with a VET degree achieve higher wage returns than those VET graduates without an Abitur across all occupations. Employees holding a VET degree without an Abitur display greater inequality of occupation-specific wage returns. Among the occupational characteristics, task composition is the main driver of the differences in wage returns.
Identification of an anti-plant-virus molecule in Alpinia zerumbet
Authors: Hatanaka Tadashi , Narusaka Mari , Uraji Misugi , Yamaji Yasuyuki , Narusaka Yoshihiro
Published: February 2021

In plants, viral diseases are second only to fungal diseases in terms of occurrence, and cause substantial damage to agricultural crops. The aqueous extracts of shell ginger,Alpinia zerumbetexhibit inhibitory effects against virus infections in belonging to the Solanaceae family. In this study, we isolated an anti-plant-virus molecule from the extracts using a conventional method involving a combination of reversed phase column chromatography, dialysis, and lyophilization. The anti-plant-virus molecule was identified as proanthocyanidin, which mostly consisted of epicatechin and exhibited more than 40 degrees of polymerization.
A High Proportion of Novel ACAN Mutations and Their Prevalence in a Large Cohort of Chinese Short Stature Children
Authors: Lin Li , Li Mengting , Luo Jingsi , Li Pin , Zhou Shasha , Yang Yu , Chen Ka , Weng Ying , Ge Xiuying , Mireguli Maimaiti , Wei Haiyan , Yang Haihua , Li Guimei , Sun Yan , Cui Lanwei , Zhang Shulin , Chen Jing , Zeng Guozhang , Xu Lijun , Luo Xiaoping , Shen Yiping
Published: February 2021

Context

Aggrecan, encoded by the ACAN gene, is the main proteoglycan component in the extracellular cartilage matrix. Heterozygous mutations in ACAN have been reported to cause idiopathic short stature. However, the prevalence of ACAN pathogenic variants in Chinese short stature patients and clinical phenotypes remain to be evaluated.

Objective

We sought to determine the prevalence of ACAN pathogenic variants among Chinese short stature children and characterize the phenotypic spectrum and their responses to growth hormone therapies.

Patients and Methods

Over 1000 unrelated short stature patients ascertained across China were genetically evaluated by next-generation sequencing–based test.

Result

We identified 10 novel likely pathogenic variants and 2 recurrent pathogenic variants in this cohort. None of ACAN mutation carriers exhibited significant dysmorphic features or skeletal abnormities. The prevalence of ACAN defect is estimated to be 1.2% in the whole cohort; it increased to 14.3% among those with advanced bone age and to 35.7% among those with both advanced bone age and family history of short stature. Nonetheless, 5 of 11 ACAN mutation carries had no advanced bone age. Two individuals received growth hormone therapy with variable levels of height SD score improvement.

Conclusion

Our data suggest that ACAN mutation is 1 of the common causes of Chinese pediatric short stature. Although it has a higher detection rate among short stature patients with advanced bone age and family history, part of affected probands presented with delayed bone age in Chinese short stature population. The growth hormone treatment was moderately effective for both individuals.
Insulin Pulse Characteristics and Insulin Action in Non-diabetic Humans
Authors: Laurenti Marcello C , Dalla Man Chiara , Varghese Ron T , Andrews James C , Jones John G , Barosa Cristina , Rizza Robert A , Matveyenko Aleksey , De Nicolao Giuseppe , Bailey Kent R , Cobelli Claudio , Vella Adrian
Published: February 2021

Objective

Pulsatile insulin secretion is impaired in diseases such as type 2 diabetes that are characterized by insulin resistance. This has led to the suggestion that changes in insulin pulsatility directly impair insulin signaling. We sought to examine the effects of pulse characteristics on insulin action in humans, hypothesizing that a decrease in pulse amplitude or frequency is associated with impaired hepatic insulin action.

Methods

We studied 29 nondiabetic subjects on two occasions. On 1 occasion, hepatic and peripheral insulin action was measured using a euglycemic clamp. The deuterated water method was used to estimate the contribution of gluconeogenesis to endogenous glucose production. On a separate study day, we utilized nonparametric stochastic deconvolution of frequently sampled peripheral C-peptide concentrations during fasting to reconstruct portal insulin secretion. In addition to measuring basal and pulsatile insulin secretion, we used approximate entropy to measure orderliness and Fourier transform to measure the average, and the dispersion of, insulin pulse frequencies.

Results

In univariate analysis, basal insulin secretion (R2 = 0.16) and insulin pulse amplitude (R2 = 0.09) correlated weakly with insulin-induced suppression of gluconeogenesis. However, after adjustment for age, sex, and weight, these associations were no longer significant. The other pulse characteristics also did not correlate with the ability of insulin to suppress endogenous glucose production (and gluconeogenesis) or to stimulate glucose disappearance.

Conclusions

Overall, our data demonstrate that insulin pulse characteristics, considered independently of other factors, do not correlate with measures of hepatic and peripheral insulin sensitivity in nondiabetic humans.
The Effect of Low-Dose Intraoperative Ketamine on Closed-Loop-Controlled General Anesthesia: A Randomized Controlled Equivalence Trial
Authors: Napoleone Gabby , van Heusden Klaske , Cooke Erin , West Nicholas , Görges Matthias , Dumont Guy A. , Ansermino J. Mark , Merchant Richard N.
Published: February 2021

BACKGROUND:

Closed-loop control of propofol-remifentanil anesthesia using the processed electroencephalography depth-of-hypnosis index provided by the NeuroSENSE monitor (WAVCNS) has been previously described. The purpose of this placebo-controlled study was to evaluate the performance (percentage time within ±10 units of the setpoint during the maintenance of anesthesia) of a closed-loop propofol-remifentanil controller during induction and maintenance of anesthesia in the presence of a low dose of ketamine.

METHODS:

Following ethical approval and informed consent, American Society of Anesthesiologist (ASA) physical status I–II patients aged 19–54 years, scheduled for elective orthopedic surgery requiring general anesthesia for >60 minutes duration, were enrolled in a double-blind randomized, placebo-controlled, 2-group equivalence trial. Immediately before induction of anesthesia, participants in the ketamine group received a 0.25 mg·kg−1 bolus of intravenous ketamine over 60 seconds followed by a continuous 5 µg·kg−1·min−1 infusion for up to 45 minutes. Participants in the control group received an equivalent volume of normal saline. After the initial study drug bolus, closed-loop induction of anesthesia was initiated; propofol and remifentanil remained under closed-loop control until the anesthetic was tapered and turned off at the anesthesiologist’s discretion. An equivalence range of ±8.99% was assumed for comparing controller performance.

RESULTS:

Sixty patients participated: 41 males, 54 ASA physical status I, with a median (interquartile range [IQR]) age of 29 [23, 38] years and weight of 82 [71, 93] kg. Complete data were available from 29 cases in the ketamine group and 27 in the control group. Percentage time within ±10 units of the WAVCNS setpoint was median [IQR] 86.6% [79.7, 90.2] in the ketamine group and 86.4% [76.5, 89.8] in the control group (median difference, 1.0%; 95% confidence interval [CI] −3.6 to 5.0). Mean propofol dose during maintenance of anesthesia for the ketamine group was higher than for the control group (median difference, 24.9 µg·kg−1·min−1; 95% CI, 6.5-43.1; P = .005).

CONCLUSIONS:

Because the 95% CI of the difference in controller performance lies entirely within the a priori equivalence range, we infer that this analgesic dose of ketamine did not alter controller performance. Further study is required to confirm the finding that mean propofol dosing was higher in the ketamine group, and to investigate the implication that this dose of ketamine may have affected the WAVCNS.
Activation of GABAergic Neurons in the Rostromedial Tegmental Nucleus and Other Brainstem Regions Promotes Sedation and Facilitates Sevoflurane Anesthesia in Mice
Authors: Vlasov Ksenia , Pei JunZhu , Nehs Christa J. , Guidera Jennifer A. , Zhang Edlyn R. , Kenny Jonathan D. , Houle Timothy T. , Brenner Gary J. , Taylor Norman E. , Solt Ken
Published: February 2021

Many general anesthetics potentiate gamma-aminobutyric acid (GABA) A receptors but their neuroanatomic sites of action are less clear. GABAergic neurons in the rostromedial tegmental nucleus (RMTg) send inhibitory projections to multiple arousal-promoting nuclei, but the role of these neurons in modulating consciousness is unknown. In this study, designer receptors exclusively activated by designer drugs (DREADDs) were targeted to RMTg GABAergic neurons of Vgat-ires-Cre mice. DREADDs expression was found in the RMTg and other brainstem regions. Activation of these neurons decreased movement and exploratory behavior, impaired motor coordination, induced electroencephalogram (EEG) oscillations resembling nonrapid eye movement (NREM) sleep without loss of righting and reduced the dose requirement for sevoflurane-induced unconsciousness. These results suggest that GABAergic neurons in the RMTg and other brainstem regions promote sedation and facilitate sevoflurane-induced unconsciousness.
Case Report of Fulminant Eosinophilic Myocarditis With Concomitant Pheochromocytoma
Authors: Levin Benjamin S. , DeNino Walter F. , Jara Clara B. , Schwartzman Andrew D. , Butterly Arielle D. , Sauer William J.
Published: February 2021

A 33-year-old woman presented with fulminant eosinophilic myocarditis requiring venoarterial extracorporeal membrane oxygenation (ECMO). A computed tomography (CT) scan revealed a retroperitoneal mass that was eventually diagnosed as a pheochromocytoma. This case highlights the need for a comprehensive diagnostic workup for acute cardiomyopathy manifesting as cardiogenic shock in young patients and the benefit of early initiation of mechanical support facilitating both diagnosis and recovery.
Use of Airway Ultrasound in Infants With Unexpected Subglottic Stenosis During Anesthesia Induction: A Case Report
Authors: Lee Ji-Hyun , Cho Sung-Ae , Ji Sang-Hwan , Jang Young-Eun , Kim Eun-Hee , Kim Hee-Soo , Kim Jin-Tae
Published: February 2021

Point-of-care ultrasound has been integrated into airway management because it allows for rapid and noninvasive assessments. We present 2 cases of unexpected subglottic stenosis in infants during induction of anesthesia. Intubation failed even with endotracheal tubes that were small for patients’ age. Airway ultrasound was used to measure the subglottic airway diameters, which were 2.0 and 3.0 mm in first and second cases, respectively. The severity of subglottic stenosis in the first case was grade III, requiring emergent tracheostomy. In conclusion, airway ultrasound helps to assess possibility of intubation and plan further airway management in children with unexpected difficult airway.
Nebulized Nitroglycerin for Coronavirus Disease 2019–Associated Acute Respiratory Distress Syndrome: A Case Report
Authors: Daxon Benjamin T. , Lark Erin , Matzek Luke J. , Fields Amanda R. , Haselton Kyle J.
Published: February 2021

We present a case where nitroglycerin tablets dissolved in saline and intravenous nitroglycerin solution were nebulized as surrogates for inhaled nitric oxide (iNO) after our iNO supply was depleted during the coronavirus disease 2019 (COVID-19) surge in New York. We gave this treatment to a COVID-19 patient with severe acute respiratory distress syndrome (ARDS) and hypercarbia. In response, the patient had immediate and clinically meaningful improvement in multiple organ systems despite no other interventions or ventilator changes.
Ladrones de Luz: Policing Electricity in Mexico City, 1901–1918
Authors: Montaño Diana J.
Published: February 2021

This essay explores Mexico City's electrification in the early twentieth century through the lens of power theft. The arrest and resulting trial of dozens of capitalinos (Mexico City residents) suspected of power theft allow us to document the nuances of policing and prosecuting a modern crime and thus to explore how notions of policing, private property, space, honor, and even decency influenced how people secured and used electricity. Using 63 cases tried before the Tribunal Superior de Justicia del Distrito Federal (Federal District Higher Court) and newspaper and legal debate on power theft, this article examines how capitalinos could flip seamlessly between the elitist, scripted, proper use of electricity and the ad-libbed, improper use that fit their needs in specific circumstances. By grounding electrification in everyday life, this article argues that capitalinos emerge as agents of technological change, people who understood the importance of electricity to transform their lives and spaces.
Abdominal Organ Injuries in Youth Soccer: A Case Series and Review of Literature
Authors: Khakimov Sayyar , Zaki Peter , Hess Joseph , Hennrikus William
Published: February 2021

We describe 13 children who presented to the Penn State Health Milton S. Hershey Medical Center (HMC) with pediatric soccer-related abdominal organ injuries. A review of the Pennsylvania Trauma System Foundation's Trauma Registry was performed between 2001 and 2015 for children with soccer injuries hospitalized at trauma centers across Pennsylvania. Out of 52 children at Hershey Medical Center, 13 suffered abdominal organ injuries. Injuries included the spleen [5], kidney [4], liver [2], and combined organ involvement [2]. All patients presented with abdominal and/or flank pain. All patients with kidney injuries presented with hematuria. All patients presented after a player-to-player (P2P) contact. Nearly all patients (12/13) were treated nonsurgically. Our findings showed that abdominal organ injuries constitute a substantial portion of pediatric soccer injuries requiring hospitalization, with spleen being the organ injured most frequently. Soccer-related abdominal organ injuries should be suspected in players who suffer abdominal and/or flank pain, and/or hematuria after a P2P contact.
Creating an Assessment Tool for Clinical Musculoskeletal Knowledge
Authors: Yu Jonathan , Li Alexander D. , Leggit Jeffrey C.
Published: February 2021

Studies show that medical school curriculums do not prepare graduates to manage the most common musculoskeletal (MSK) injuries they will encounter in the outpatient setting. The authors proposed a new multiple-choice assessment to identify individual and program deficiencies for curriculum improvement. A multiple-choice MSK assessment tool was administered to learners at various stages of training. Students took the examination after completing their core clerkship year; residents took the examination near the beginning of their respective academic year. Outcome measures included average examination score, percent correct for each question, and overall examination reliability. Average examinees scores were 75.6% with higher scores based on training years. No statistical differences were found between MD/DO, male/female, or military/civilian examinees. The tool was found to be a statistically valid method of determining cognitive knowledge in basic MSK topics, identifying individual deficiencies, and highlighting gaps in training programs' MSK curriculums.