bluuebunny/crossref_metadata_2025 huggingface dataset:
Oct4 promotes M2 macrophage polarization through upregulation of macrophage colony-stimulating factor in lung cancer
Authors: Lu Chia-Sing , Shiau Ai-Li , Su Bing-Hua , Hsu Tsui-Shan , Wang Chung-Teng , Su Yu-Chu , Tsai Ming-Shian , Feng Yin-Hsun , Tseng Yau-Lin , Yen Yi-Ting , Wu Chao-Liang , Shieh Gia-Shing
Published: June 2020

Background

Expression of Oct4 maintains cancer stem cell (CSC)-like properties in lung cancer cells and is correlated with poor prognosis of lung adenocarcinoma. M2-type tumor-associated macrophages (TAMs) promote cancer cell migration and metastasis. Tumor microenvironments promote monocyte differentiation into M2 TAMs via a complex cytokine-based connection. We explored the role of Oct4 in cytokine secretion in lung cancer and its impact on M2 TAM polarization.

Methods

Monocytes co-cultured with the conditioned medium from Oct4-overexpressing lung cancer cells were used to investigate M2 TAM differentiation. The inflammatory factors in the conditioned medium of Oct4-overexpressing A549 cells were examined using human inflammation antibody arrays. The correlations of Oct4, macrophage colony-stimulating factor (M-CSF), and M2 TAMs were validated in lung cancer cells, syngeneic mouse lung tumor models, and clinical samples of non-small cell lung cancer (NSCLC).

Results

Oct4-overexpressing A549 cells expressed elevated levels of M-CSF, which contributed to increased M2 macrophages and enhanced tumor migration. Overexpression of Oct4 enhanced tumor growth and reduced the survival of lung tumor-bearing mice, which was correlated with increased number of M2 macrophages in lung cancer. Notably, NSCLC patients with high expression levels of Oct4, M-CSF, and M2 TAMs had the poorest recurrence-free survival. A positive correlation between Oct4, M-CSF, and M2 TAMs was observed in the tumor tissue of NSCLC patient. Treatment with all-trans retinoic acid exerted anti-tumor effects and reduced M2 TAMs in tumor-bearing mice.

Conclusions

Our results indicate that Oct4 expressed by lung cancer cells promotes M2 macrophage polarization through upregulation of M-CSF secretion, leading to cancer growth and metastasis. Our findings also implicate that the Oct4/M-CSF axis in M2 macrophage polarization may be potential therapeutic targets for lung cancer.
Proteomic signatures of metronidazole-resistant Trichomonas vaginalis reveal novel proteins associated with drug resistance
Authors: Lin Hsin-Chung , Chu Lichieh Julie , Huang Po-Jung , Cheng Wei-Hung , Zheng Yu-Hsing , Huang Ching-Yun , Hong Shu-Wen , Chen Lih-Chyang , Lin Hsin-An , Wang Jui-Yang , Chen Ruei-Min , Lin Wei-Ning , Tang Petrus , Huang Kuo-Yang
Published: June 2020

Background

Trichomoniasis is the most common non-viral sexually transmitted disease caused by the protozoan parasite Trichomonas vaginalis. Metronidazole (MTZ) is a widely used drug for the treatment of trichomoniasis; however, increased resistance of the parasite to MTZ has emerged as a highly problematic public health issue.

Methods

We conducted iTRAQ-based analysis to profile the proteomes of MTZ-sensitive (MTZ-S) and MTZ-resistant (MTZ-R) parasites. STRING and gene set enrichment analysis (GESA) were utilized to explore the protein-protein interaction networks and enriched pathways of the differentially expressed proteins, respectively. Proteins potentially related to MTZ resistance were selected for functional validation.

Results

A total of 3123 proteins were identified from the MTZ-S and MTZ-R proteomes in response to drug treatment. Among the identified proteins, 304 proteins were differentially expressed in the MTZ-R proteome, including 228 upregulated and 76 downregulated proteins. GSEA showed that the amino acid-related metabolism, including arginine, proline, alanine, aspartate, and glutamate are the most upregulated pathways in the MTZ-R proteome, whereas oxidative phosphorylation is the most downregulated pathway. Ten proteins categorized into the gene set of oxidative phosphorylation were ATP synthase subunit-related proteins. Drug resistance was further examined in MTZ-S parasites pretreated with the ATP synthase inhibitors oligomycin and bafilomycin A1, showing enhanced MTZ resistance and potential roles of ATP synthase in drug susceptibility.

Conclusions

We provide novel insights into previously unidentified proteins associated with MTZ resistance, paving the way for future development of new drugs against MTZ-refractory trichomoniasis.
DAMEfinder: a method to detect differential allele-specific methylation
Authors: Orjuela Stephany , Machlab Dania , Menigatti Mirco , Marra Giancarlo , Robinson Mark D.
Published: June 2020

Background

DNA methylation is a highly studied epigenetic signature that is associated with regulation of gene expression, whereby genes with high levels of promoter methylation are generally repressed. Genomic imprinting occurs when one of the parental alleles is methylated, i.e., when there is inherited allele-specific methylation (ASM). A special case of imprinting occurs during X chromosome inactivation in females, where one of the two X chromosomes is silenced, to achieve dosage compensation between the sexes. Another more widespread form of ASM is sequence dependent (SD-ASM), where ASM is linked to a nearby heterozygous single nucleotide polymorphism (SNP).

Results

We developed a method to screen for genomic regions that exhibit loss or gain of ASM in samples from two conditions (treatments, diseases, etc.). The method relies on the availability of bisulfite sequencing data from multiple samples of the two conditions. We leverage other established computational methods to screen for these regions within a new R package called DAMEfinder. It calculates an ASM score for all CpG sites or pairs in the genome of each sample, and then quantifies the change in ASM between conditions. It then clusters nearby CpG sites with consistent change into regions. In the absence of SNP information, our method relies only on reads to quantify ASM. This novel ASM score compares favorably to current methods that also screen for ASM. Not only does it easily discern between imprinted and non-imprinted regions, but also females from males based on X chromosome inactivation. We also applied DAMEfinder to a colorectal cancer dataset and observed that colorectal cancer subtypes are distinguishable according to their ASM signature. We also re-discover known cases of loss of imprinting.

Conclusion

We have designed DAMEfinder to detect regions of differential ASM (DAMEs), which is a more refined definition of differential methylation, and can therefore help in breaking down the complexity of DNA methylation and its influence in development and disease.
Parasitic infections in irritable bowel syndrome patients: evidence to propose a possible link, based on a case–control study in the south of Iran
Authors: Shafiei Zohreh , Esfandiari Farideh , Sarkari Bahador , Rezaei Zahra , Fatahi Mohammad Reza , Hosseini Asl Seyed Mohammad Kazem
Published: June 2020

Objectives

The current study aimed to evaluate the prevalence of parasitic infections and their possible association with irritable bowel syndrome (IBS), through a case–control study. Stool samples were collected from patients with IBS and healthy subjects and were examined microscopically to detect intestinal parasites.

Results

A total of 200 subjects were enrolled in the study including 100 patients with IBS and 100 healthy controls. The patients were selected based on the Rome III criteria. Of the 100 patients with IBS, 65 (65%) were female and 35 (35%) were male, with a mean age of 42.57 (± 4.07) years. Of these, 30 (30%) were infected with at least one intestinal parasite; the most common ones were Blastocystis hominis and Giardia lamblia. Of the control cases, 64 (64%) were female and 36 (36%) were male, with a mean age of 41.82 (± 11.75) years. Of these, 16 (16%) were infected with at least one intestinal parasite; the most common were B. hominis and Endolimax. There was a significant difference between the rate of parasitic infections between the patients with IBS and the control in particular, B. hominis and G. lamblia. The findings of the study support a possible link between parasitic infections and IBS.
Differential cellular proliferation underlies heterochronic generation of cranial diversity in phyllostomid bats
Authors: Camacho Jasmin , Moon Rachel , Smith Samantha K. , Lin Jacky D. , Randolph Charles , Rasweiler John J. , Behringer Richard R. , Abzhanov Arhat
Published: June 2020

Background

Skull diversity in the neotropical leaf-nosed bats (Phyllostomidae) evolved through a heterochronic process called peramorphosis, with underlying causes varying by subfamily. The nectar-eating (subfamily Glossophaginae) and blood-eating (subfamily Desmondontinae) groups originate from insect-eating ancestors and generate their uniquely shaped faces and skulls by extending the ancestral ontogenetic program, appending new developmental stages and demonstrating peramorphosis by hypermorphosis. However, the fruit-eating phyllostomids (subfamilies Carollinae and Stenodermatinae) adjust their craniofacial development by speeding up certain developmental processes, displaying peramorphosis by acceleration. We hypothesized that these two forms of peramorphosis detected by our morphometric studies could be explained by differential growth and investigated cell proliferation during craniofacial morphogenesis.

Results

We obtained cranial tissues from four wild-caught bat species representing a range of facial diversity and labeled mitotic cells using immunohistochemistry. During craniofacial development, all bats display a conserved spatiotemporal distribution of proliferative cells with distinguishable zones of elevated mitosis. These areas were identified as modules by the spatial distribution analysis. Ancestral state reconstruction of proliferation rates and patterns in the facial module between species provided support, and a degree of explanation, for the developmental mechanisms underlying the two models of peramorphosis. In the long-faced species,Glossophaga soricina, whose facial shape evolved by hypermorphosis, cell proliferation rate is maintained at lower levels and for a longer period of time compared to the outgroup speciesMiniopterus natalensis. In both species of studied short-faced fruit bats,Carollia perspicillataandArtibeus jamaicensis, which evolved under the acceleration model, cell proliferation rate is increased compared to the outgroup.

Conclusions

This is the first study which links differential cellular proliferation and developmental modularity with heterochronic developmental changes, leading to the evolution of adaptive cranial diversity in an important group of mammals.
Maslinic acid induces anticancer effects in human neuroblastoma cells mediated via apoptosis induction and caspase activation, inhibition of cell migration and invasion and targeting MAPK/ERK signaling pathway
Authors: Liu Yusheng , Lu Hongting , Dong Qian , Hao Xiwei , Qiao Lingyan
Published: June 2020

Maslinic acid is an active member of pentacyclic triterpenes predominantly found in dietary plants including hawthorn berries and olive fruit skins. It has been reported to show immense pharmacological and biological importance including anticancer property. This research was initiated to explore the anticancer potential of maslinic acid against human neuroblastoma. The effects of maslinic acid on cellular apoptosis, ROS generation, cell migration and invasion, caspase activation and targeting MAPK/ERK signaling pathway were investigated. The proliferation percentage was calculated by performing of MTT assay. AO/EB and annexin V/PI staining assays along with western blotting were used to monitor the apoptosis and expressions of apoptosis connected proteins. Spectrofluorometry was used for ROS monitoring. To assess the anti-metastatic effects of maslinic acid on neuroblastoma cells, transwell chambers assays for migration as well as invasion were executed. Western blotting was implemented to establish the expressions of MAPK/ERK signaling pathway connected proteins. Results evidenced remarkable anticancer potential of maslinic acid against human neuroblastoma. It induced dose as well as time reliant anti-proliferative effects against SHSY-5Y cells selectively. The underlying mechanism of cancer suppressive effects of maslinic acid was found to mediate via caspase-dependent apoptosis. Further, ROS production amplified terrifically with exposure of SHSY-5Y to higher maslinic acid doses. Cell migration and invasion in SHSY-5Y cells were both reduced remarkably by maslinic acid. Finally, the activity of proteins associated with MAPK/ERK signaling pathway was found to be significantly reduced with increasing maslinic acid doses. In conclusion, it was observed that maslinic acid possesses a great anti-neuroblastoma potential and could be considered for its chemotherapy provided further investigations are recommended.
Dynamics of Clostridium genus and hard-cheese spoiling Clostridium species in anaerobic digesters treating agricultural biomass
Authors: Fontana Alessandra , Soldano Mariangela , Bellassi Paolo , Fabbri Claudio , Gallucci Francesco , Morelli Lorenzo , Cappa Fabrizio
Published: June 2020

Biogas plants are a widespread renewable energy technology. However, the use of digestate for agronomic purposes has often been a matter of concern. It is controversial whether biogas plants might harbor some pathogenic clostridial species, which represent a biological risk. Moreover, the inhabitance of Clostridium hard-cheese spoiling species in anaerobic digesters can be problematic for hard-cheese manufacturing industries, due to the issue of cheese blowing defects. This study investigated the effect of mesophilic anaerobic digestion processes on the Clostridium consortia distribution over time. Specifically, three lab-scale CSTRs treating agricultural biomass were characterized by considering both the whole microbial community and the cultivable clostridial spores. It is assessed an overall reduction of the Clostridium genus during the anaerobic digestion process. Moreover, it was evidenced a slight, but steady decrease of the cultivable clostridial spores, mainly represented by two pathogenic species, C. perfringens and C. bifermentans, and one hard-cheese spoiling species, C. butyricum. Thus, it is revealed an overall reduction of the clostridial population abundance after the mesophilic anaerobic digestion treatment of agricultural biomass.
Opial integral inequalities for generalized fractional operators with nonsingular kernel
Authors: Mohammed Pshtiwan Othman , Abdeljawad Thabet
Published: June 2020

We consider the well-known classes of functions$\mathcal{U}_{1}(\mathbf{v},\mathtt{k})$U1(v,k)and$\mathcal{U}_{2}(\mathbf{v},\mathtt{k})$U2(v,k), and those of Opial inequalities defined on these classes. In view of these indices, we establish new aspects of the Opial integral inequality and related inequalities, in the context of fractional integrals and derivatives defined using nonsingular kernels, particularly the Caputo–Fabrizio (CF) and Atangana–Baleanu (AB) models of fractional calculus.
Using soil bacterial communities to predict physico-chemical variables and soil quality
Authors: Hermans Syrie M. , Buckley Hannah L. , Case Bradley S. , Curran-Cournane Fiona , Taylor Matthew , Lear Gavin
Published: June 2020

Background

Soil ecosystems consist of complex interactions between biological communities and physico-chemical variables, all of which contribute to the overall quality of soils. Despite this, changes in bacterial communities are ignored by most soil monitoring programs, which are crucial to ensure the sustainability of land management practices. We applied 16S rRNA gene sequencing to determine the bacterial community composition of over 3000 soil samples from 606 sites in New Zealand. Sites were classified as indigenous forests, exotic forest plantations, horticulture, or pastoral grasslands; soil physico-chemical variables related to soil quality were also collected. The composition of soil bacterial communities was then used to predict the land use and soil physico-chemical variables of each site.

Results

Soil bacterial community composition was strongly linked to land use, to the extent where it could correctly determine the type of land use with 85% accuracy. Despite the inherent variation introduced by sampling across ~ 1300 km distance gradient, the bacterial communities could also be used to differentiate sites grouped by key physico-chemical properties with up to 83% accuracy. Further, individual soil variables such as soil pH, nutrient concentrations and bulk density could be predicted; the correlations between predicted and true values ranged from weak (R2 value = 0.35) to strong (R2 value = 0.79). These predictions were accurate enough to allow bacterial communities to assign the correct soil quality scores with 50–95% accuracy.

Conclusions

The inclusion of biological information when monitoring soil quality is crucial if we wish to gain a better, more accurate understanding of how land management impacts the soil ecosystem. We have shown that soil bacterial communities can provide biologically relevant insights on the impacts of land use on soil ecosystems. Furthermore, their ability to indicate changes in individual soil parameters shows that analysing bacterial DNA data can be used to screen soil quality.
Human rabies in China: evidence-based suggestions for improved case detection and data gathering
Authors: Li Hao , Liu Jia-Jia , Ding Shu-Jun , Cai Liang , Feng Yun , Yu Peng-Cheng , Liu Shu-Qing , Lu Xue-Xin , Tao Xiao-Yan , Zhu Wu-Yang
Published: June 2020

Background

China still suffers heavily from rabies, although reported human cases continue to decrease year over year. There are far fewer laboratory-confirmed human cases than clinically diagnosed cases, which is a big problem that needs to be addressed. In this report, we summarize analyses of all specimens from human cases tested in our laboratory over the past 15 years, in order to promote laboratory diagnosis of rabies.

Methods

From 2005 to 2019, a total of 271 samples from 164 suspected rabies cases were collected from local hospitals by the local Centers for Disease Control and Prevention (CDCs) in China. Saliva, cerebrospinal fluid (CSF), serum (blood) and urine were collected for ante-mortem diagnosis, and brain tissue, neck skin tissue and cornea were collected for post-mortem diagnosis. All of the specimens were tested by reverse transcription-polymerase chain reaction (RT-PCR), and brain tissues were also tested using fluorescent antibody test (FAT). The number of positive test results obtained using different fluids or tissues, and at different stages of the disease, were compared using a chi-square test and a more effective sampling program is recommended.

Results

As the national reference laboratory for rabies surveillance in China, our laboratory has tested 271 samples from 164 suspected rabies cases collected by local CDCs since 2005. We found that saliva gave the highest number of positive test results (32%), compared with CSF and other fluids. We also found that serum or blood specimens collected in the last 3 days of life can test positive by RT-PCR.

Conclusions

Serum or blood samples collected in the last 3 days of a patient’s life can be used to measure viral RNA, which means that serum samples, as well as saliva and CSF, can be used to detect viral RNA for anti-mortem diagnosis of rabies. Because of our findings, we have modified our “National Surveillance Project for Human Rabies”, by adding the collection and testing of serum samples from the end of the survival period. This will improve our national surveillance and laboratory diagnosis of human rabies.
Aflatoxins as a risk factor for liver cirrhosis: a systematic review and meta-analysis
Authors: Mekuria Abraham Nigussie , Routledge Michael N. , Gong Yun Yun , Sisay Mekonnen
Published: June 2020

Background

Liver cirrhosis is characterized by fibrosis and nodule formation in the liver, due to a chronic injury, and subsequent alteration of the normal architecture of the liver. Even though there is a huge effort to elucidate the possible etiologic factors of liver cirrhosis, a significant number of cases are cryptogenic, especially in Sub Saharan Africa, where there is a high burden of aflatoxin exposure. Aflatoxins are known to cause hepatocellular carcinoma, which share similar etiologic factors with liver cirrhosis. This study aimed to assess the association between aflatoxin exposure and the risk of liver cirrhosis.

Methods

Relevant studies were identified through systematic searches conducted in Ovid MEDLINE, PubMed and Google Scholar. Also, by searching the references of retrieved articles. The abstracts and full text were screened for eligibility and the risk of bias was assessed for each study using Joanna Briggs Institute (JBI) critical appraisal checklist for observational studies. The extracted data from included studies using Microsoft Excel were exported to Stata software version 15.0 for analyses. The overall pooled estimation of outcomes was calculated using a random-effects model of DerSimonian–Laird method at a 95% confidence level. The heterogeneity of studies was determined using I2 statistics. The presence of publication bias between studies was evaluated using the Begg’s and Egger’s tests and funnel plot. The protocol of this systematic review and meta-analysis was registered in the Prospero database with reference number ID: CRD42019148481.

Results

A total of 5 studies published between the years 2005 and 2018 that met the pre-defined inclusion and exclusion criteria were included. The meta-analysis showed that a significant increase in the risk of liver cirrhosis is associated with aflatoxin exposure (unadjusted pooled odds ratio (OR) = 3.35, 95% CI: 2.74–4.10, p = 0.000; I2 = 88.3%, p = 0.000; adjusted OR = 2.5, 95% CI: 1.84–3.39, p = 0.000; I2 = 0%, p = 0.429).

Conclusions

The present meta-analysis suggests that aflatoxin exposure is associated with a higher risk of liver cirrhosis.
Analyzing MRI scans to detect glioblastoma tumor using hybrid deep belief networks
Authors: Reddy Annapareddy V. N. , Krishna Ch. Phani , Mallick Pradeep Kumar , Satapathy Sandeep Kumar , Tiwari Prayag , Zymbler Mikhail , Kumar Sachin
Published: June 2020

Glioblastoma (GBM) is a stage 4 malignant tumor in which a large portion of tumor cells are reproducing and dividing at any moment. These tumors are life threatening and may result in partial or complete mental and physical disability. In this study, we have proposed a classification model using hybrid deep belief networks (DBN) to classify magnetic resonance imaging (MRI) for GBM tumor. DBN is composed of stacked restricted Boltzmann machines (RBM). DBN often requires a large number of hidden layers that consists of large number of neurons to learn the best features from the raw image data. Hence, computational and space complexity is high and requires a lot of training time. The proposed approach combines DTW with DBN to improve the efficiency of existing DBN model. The results are validated using several statistical parameters. Statistical validation verifies that the combination of DTW and DBN outperformed the other classifiers in terms of training time, space complexity and classification accuracy.
Bigdata analytics identifies metabolic inhibitors and promoters for productivity improvement and optimization of monoclonal antibody (mAb) production process
Authors: Morris Caitlin , Polanco Ashli , Yongky Andrew , Xu Jianlin , Huang Zhuangrong , Zhao Jia , McFarland Kevin S. , Park Seoyoung , Warrack Bethanne , Reily Michael , Borys Michael C. , Li Zhengjian , Yoon Seongkyu
Published: June 2020

Recent advances in metabolite quantification and identification have enabled new research into the detection and control of titer inhibitors and promoters. This paper presents a bigdata analytics study to identify both inhibitors and promoters using multivariate data analysis of metabolomics data. By applying multi-way partial least squares (PLS) model to metabolite data from four fed-batch bioreactor conditions where feed formulation and selection agent concentrations varied, metabolites which exhibited the most significant impact on titer during cultivation were ranked from highest to lowest. The model outputs were then constrained to reduce the number of statistically relevant inhibitors or promoters to the top ten, which were used to conduct metabolic pathway analysis. Furthermore, a method is presented for identifying amino acids that prevent the accumulation of the inhibitors and/or enhance the formation of promoters during production. Finally, the metabolomics and pathway analysis results were integrated and validated with transcriptomics data to characterize metabolic changes occurring among different growth conditions. From these results, new feeding strategies were implemented which resulted in increased fed-batch production titer. Methodology from this work could be applied to future process optimization strategies for biotherapeutic production.
A case of spontaneous mesenteric hematoma with diagnostic difficulty
Authors: Tanioka Nobuhisa , Maeda Hiromichi , Tsuda Sachi , Iwabu Jun , Namikawa Tsutomu , Iguchi Mitsuko , Hanazaki Kazuhiro
Published: June 2020

Background

Spontaneous mesenteric hematoma (SMH) is a rare condition characterized by intraperitoneal hemorrhage of unknown etiology. SMH without worsening of general status allows conservative management; however, patients showing chronological changes on imaging require surgical intervention to rule out possible malignancy.

Case presentation

A 69-year-old man was referred to our hospital to evaluate an abdominal mass with no associated clinical symptoms. He had a history of chronic hepatitis C and diabetes mellitus. Six months earlier, computed tomography (CT) revealed a 75-mm tumor arising from the jejunum, suspected to be a gastrointestinal stromal tumor (GIST) of the small intestine. Following a further 6 months of observation, the patient was referred to our hospital. Abdominal contrast-enhanced CT revealed a well-defined heterogeneous round tumor with a maximum diameter of 75 mm adjacent to the upper jejunum. The tumor was accompanied by calcification at the periphery, with no evidence of augmentation over the prior 6 months. Diffuse lymphadenopathy was observed around the aorta and splenic artery. Under the diagnosis of GIST arising from small intestine, the patient underwent elective surgery. The resection revealed an elastic soft tumor at the mesentery adjacent to the upper jejunum with severe adhesion between the tumor and jejunum. The tumor origin was unclear; thus, we performed mesenteric excision and partial enterectomy without lymph node dissection.

The tumor was surrounded by fibrous capsular tissue containing massive hemosiderin deposits and cholesterol crystals showing partial calcification, resulting in a diagnosis of spontaneous hematoma of the mesentery.

Conclusions

We report a case of SMH mimicking small intestinal GIST. It is difficult to diagnose long-established SMH because its radiological features change with time, and more case reports are needed to improve the accuracy of diagnosis.
Laparoscopic surgery for urachal remnants in pubescent children: a case series
Authors: Hashizume Naoki , Ohtaki Masahiro , Nihei Kouei , Sakamoto Kaoru , Shirahata Yasuhiro , Shimada Tetsuya , Ohta Eriko , Yamai Daisuke , Takeshi Akihiro , Sato Kaito , Suzuki Satoshi , Yagi Minoru
Published: June 2020

Background

Various techniques are applied in laparoscopic surgery for the treatment of urachal remnants, which are less invasive and associated with lower morbidity. We herein report a case series in which we treated urachal remnants and medial umbilical ligaments using a laparoscopic approach.

Case presentation

From 2015 to 2019, seven patients (male, n = 5; female, n = 2) with a urachal remnant were treated by laparoscopic surgery in our institute. Five boys and two girls with a median age of 11 years (range 10–15 years) were enrolled in this series. The clinical results of laparoscopic treatment, the perioperative records, and the pathologic results were evaluated. The operation was performed with the use of three ports and an EZ access® (Hakko Medical, Nagano, Japan), which is a silicon cap for the wound retractor (Lap Protector®, Hakko Medical, Nagano, Japan). The removal of the urachal remnant and medial umbilical ligaments was completed with a median operative time of 92 min (range 69–128). The median hospital stay after surgery was 4 days (range 2–5). No patients developed intra-postoperative complications or recurrence.

Conclusions

Although our data are preliminary, complete laparoscopic removal of symptomatic urachal remnants and medial umbilical ligaments was a safe and effective minimally invasive approach, with better cosmetic outcomes.
Chyle leakage after axillary node sampling in a patient with breast cancer: a case report
Authors: Kohno Norio , Kimoto Takeo , Okamoto Akiko , Tanino Hirokazu
Published: June 2020

Background

Chyle leakage is a well-known complication after thoracic surgery, such as esophagectomy, cardiac surgery, mediastinal lymph node dissection, and neck surgery. However, chyle leakage is a rare complication after dissections of the lateral or subclavian axillary nodes for breast surgery. It is particularly unusual for chyle leakage to occur after minimally invasive dissection of the axillary nodes. Most cases of chyle leakage subside with conservative management, but some cases require surgery.

Case report

An 80-year-old woman had invasive lobular cancer of the left breast (cT1 [1.7 cm], cN0, M0) for which she underwent breast-conservative surgery and biopsy of an axillary sentinel lymph node. Because two of the three sentinel lymph nodes tested positive for cancer, seven lateral axillary lymph nodes (level I) were subsequently removed for the additional sampling. On postoperative day 11, the patient visited our outpatient clinic because of swelling in her left axillary region and breast. Centesis of the axilla yielded 670 mL of milky fluid, which suggested chyle leakage. We commenced the conservative management at first; however, the persistent leakage made us perform the surgical management. The operation was not only ligating the opening of the chyle duct but needed total mastectomy because the postoperative pathology report showed invasive lobular carcinoma; the nipple and the caudal surgical margin of the lumpectomy were positive for cancer. The patient agreed to our recommendation of total mastectomy and surgical management of the chyle leakage. Ligation of the opening completely resolved the chylous discharge.

Conclusion

We here report a case of large-volume leakage of chyle after sampling dissection of the lateral axillary lymph nodes for left breast cancer; the leakage persisted despite the standard conservative therapy but was resolved after surgical treatment. Chyle leakage can occur even after minimally invasive dissection of the axillary nodes.
Stent graft treatment for ruptured pseudoaneurysms of the splanchnic arteries after pancreaticoduodenectomy: a case report
Authors: Nemoto Masaru , Koyama Ken , Enokido Midori , Kudo Shohei , Yoshimi Fuyo
Published: June 2020

Background

Hemorrhage due to a ruptured splanchnic pseudoaneurysm followed by the formation of a postoperative pancreatic fistula is the most severe complication of a pancreatectomy, sometimes leading to a fatal outcome. Stent graft placement to control the hemorrhage due to the pseudoaneurysm is a validated treatment option, but once the stent graft is infected, infection control is complicated. We report a case of a ruptured pseudoaneurysm of the splanchnic artery after pancreaticoduodenectomy to evaluate the stent graft treatment.

Case presentation

A 77-year-old man underwent pylorus-preserving pancreaticoduodenectomy for suspected distal bile duct cancer. Hemorrhage from a pseudoaneurysm of the common hepatic artery due to the formation of the pancreatic fistula was detected on postoperative day 9, and a stent graft was successfully placed with the preservation of hepatic arterial blood flow. On postoperative day 12, new-onset hemorrhage from a pseudoaneurysm of the right hepatic artery developed, and a stent graft was similarly placed, but immediately occluded. Refractory pancreatic and biliary fistulas developed and required continuous drainage. On postoperative day 85, computed tomography revealed the presence of air within the latter stent graft, which indicated infection of the stent graft. The patient died due to sepsis caused by the graft infection.

Conclusion

Stent graft placement for the treatment of hemorrhage of a pseudoaneurysm secondary to a postoperative pancreatic fistula, following pancreaticoduodenectomy, is an effective treatment option as it achieves immediate hemostasis and maintains end-organ perfusion. However, stent graft infection is the most detrimental complication.
Gaining favorable identities of Iranian EFL teachers: a single case study of transition from elementary schools to universities
Authors: Rostami Farzad , Yousefi Mohammad Hosssein , Amini Davoud
Published: June 2020

Adopting the self-concept framework as a lens and interpretative case study as a methodological tool, the present study set out to examine how the professional identity of an elementary school teacher is socially (re) constructed while his transition from teaching at elementary schools to teach at universities. The design of the study was the intrinsic case study. The focal participant was an assistant professor of TEFL who has been teaching in elementary, middle, and high schools prior to starting his academic work 10 years ago. For the purpose of the data collection, in-depth interview was conducted. Another source of the data was the participant’s stories, as well as the diaries he had kept over the years. For the data analysis, thematic analysis was employed. Results indicate that the transition was seen to be in parallel with the transition from lower identity perception to higher identity perception. The transition can be best expressed in terms of identity promotion. The results indicate that the transitions were two main and noticeable ones. The data analyses also indicate that three themes, including personal-self, social self, and learners were the driving forces for the case’s professional identity development. The study has a number of implications for teacher education, policymakers, and teachers.
Lessons learned from participatory research to enhance client participation in long-term care research: a multiple case study
Authors: Scheffelaar Aukelien , Bos Nanne , de Jong Marjan , Triemstra Mattanja , van Dulmen Sandra , Luijkx Katrien
Published: June 2020

Background

Although participatory research is known to have advantages, it is unclear how participatory research can best be performed. This study aims to report on lessons learned in collaboration with service users involved as co-researchers in three participatory teams in long-term care.

Methods

A multiple case study design was chosen to explore the collaboration in three teams, each covering one specific client group receiving long-term care: physically or mentally frail elderly people, people with mental health problems or people with intellectual disabilities.

Results

A good working environment and a good collaboration were found to be crucial requirements for participatory research. A good working environment was developed by discussing reasons for engagement and wishes, formulating basic rules, organizing training sessions, offering financial appreciation, and the availability of the researcher to give travel support. The actual collaboration was established by developing a bond and equal positioning, deciding on the role division, holding on to transparency and a clear structure, and have sufficient time for the collaboration. Moreover, the motivations and unique contributions of the co-researchers and differences between the teams were reported. The motivations of co-researchers ranged from individual goals – such as personal development, creating a new social identity and belonging to a social group – to more external goals, such as being valuable for other service users and increasing the quality of care. An inclusive collaboration required valuing the individual contributions of co-researchers and adjustment to team differences.

Conclusions

The results showed the importance of developing a good working environment and establishing a good collaboration for participatory research. Furthermore, the study shows that individual and team differences should be taken into account. These results can be used by researchers for designing and shaping future research projects in long-term care in collaboration with co-researchers.
Development of a dynamic Chest Wall and operating table simulator to enhance congenital heart surgery simulation
Authors: Peel Brandon , Voyer-Nguyen Pascal , Honjo Osami , Yoo Shi-Joon , Hussein Nabil
Published: June 2020

Background

The Hands-On Surgical Training in Congenital Heart Surgery (HOST-CHS) program using 3D printed heart models has received positive feedback from attendees. However, improvements were necessary in the simulator set up to replicate the ergonomics experienced in the operating room. This paper illustrates the development of a dynamic chest wall and operating table simulator to enhance the simulation experience.

Methods

The simulator was designed to address the limitations with the existing set up. This included a suboptimal operating position, unrealistic surgical exposure and limitations in illuminating the operative field and recording procedures. A combination of computer-aided design and various 3D-printing techniques were used to build the components. The simulator’s usefulness was evaluated by surgeons who attended the 5th annual HOST course via a questionnaire.

Results

The simulator consists of three components; an operating table simulator which allows height adjustment and pitch-and-roll motion; a suture retraction disc, which holds sutures under tension to improve exposure; and a pediatric chest wall cavity to replicate a surgeon’s access experience during surgery. Nineteen surgeons completed the questionnaire. All surgeons agreed that the addition of the simulator was acceptable for surgical simulation and that it helped replicate the ergonomics experienced in the operating room.

Conclusions

The inclusion of the HOST-CHS simulator adds value to simulation in congenital heart surgery (CHS) as it replicates the view and exposure a surgeon experiences. Improvements like these will help develop high-fidelity simulation programs in CHS, which could be utilized to train surgeons globally.
Diffusion tensor magnetic resonance imaging of optic pathway in cases of suprasellar masses
Authors: El-Hady Nada Ashraf Abd , Alashwah Mohammad Mahmoud Alhousini , Emam Haitham Haroun , Rahil Ashraf Mohamed Farid
Published: June 2020

Background

Diffusion tensor imaging (DTI) is a novel MRI technique which can provide information of the compressed tissue’s microstructural properties. The evaluation of visual function is important for the clinical management of patients with suprasellar mass lesion. Compression of the optic nerve and chiasm due to pituitary mass lesions often leads to impaired visual function. The evaluation and prognosis of visual function are important for patient management. The aim of this work is to evaluate the feasibility of DTI in the evaluation of the optic pathway in patients with suprasellar masses. Fifty patients were included in the study, 24 cases with suprasellar masses and 26 cases without suprasellar masses as a control group. All patients underwent detailed history taking, MRI of the sella with coronal and sagittal T1, and coronal T2 sequences and DTI. The region of interests (ROIs) were set on the optic chiasm as well as the anterior and posterior optic tracts. For each ROI, axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), and apparent diffusion coefficient (ADC) values were calculated. DTI parameters of cases group were compared with normal control group parameters.

Results

The result of this study showed that in cases with suprasellar masses, there were significantly lower mean AD and ADC values and higher mean FA value than control group with no masses.

Conclusion

The DTI is a useful technique in the assessment of optic pathway compression degree by suprasellar masses. This will provide the clinicians and surgeons with precise information about the degree of the visual field compromise in correlation with the clinical data.
Undetermined and accidental mortality rates as possible sources of underreported suicides: population-based study comparing Islamic countries and traditionally religious Western countries
Authors: Pritchard Colin , Iqbal Wajid , Dray Rosslyn
Published: June 2020

Background

Four Western countries (Greece, Ireland, Italy and Portugal) with strong Orthodox and Catholic traditions have been associated with the underreporting of death by suicide, and underreported suicides are sometimes found among deaths recorded as ‘undetermined’ or ‘accidental’.

Aims

This population-based study tests whether there are any significant difference in patterns of suicides, undetermined deaths and accidental deaths between these four Western countries and 21 predominately Islamic countries.

Method

World Health Organization age-standardised death rates per million population were used to compare suicide rates with combined undetermined death and accidental death (UnD+AccD) rates, from which odds ratios were calculated. Substantial odds ratios (OR > 2.0) were taken as indicative of likely underreporting of suicides. The Islamic countries come from four different historico-cultural regions, described as: less-traditional Islamic countries; former USSR countries; Gulf Arab states; and Middle Eastern and North African countries. χ2-tests were used to determine any significant differences between the Western comparator countries and the Islamic regions.

Results

For the Western comparator countries, the average suicide rate was 66 per million population, the average undetermined death rate 56 per million and the average accidental death rate 58 per million, yielding a suicide:UnD+AccD odds ratio (OR) of 1.73. The average values for the other three groups were as follows. Less-traditional Islamic countries: suicide rate, 31 per million; UnD+AccD rate, 101 per million; suicide:UnD+AccD OR = 3.3. Former USSR countries: suicide rate, 61 per million; UnD+AccD rate, 221 per million; suicide:UnD+AccD OR = 3.6. Gulf Arab states: suicide rate, 10 per million; UnD+AccD rate, 76 per million; suicide:UnD+AccD OR = 8.6. Middle Eastern and North African countries: suicide rate, 6 per million; UnD+AccD rate, 151 per million; suicide:UnD+AccD OR = 25.2. The patterns of these mortalities in the Islamic countries was significantly different from Western comparator countries.

Conclusions

The results indicate underreporting of suicides in Islamic countries. This might inadvertently lead to reduced access to mental health preventive services in both Western and Islamic countries.
In Anticipation of Extirpation
Authors: Nunn Patrick D.
Published: June 2020

As concern about sea level rise grows and optimal solutions are sought to address its causes and effects, little attention has been given to past analogs. This article argues that valuable insights into contemporary discussions about future sea level rise can be gained from understanding those of the past, specifically the ways in which coastal peoples and societies reacted during the period of postglacial sea level rise. For much of the Holocene, most continental people eschewed coastal living in favor of inland areas. In many places large coastal settlements appeared only after the development of polities and associated crosswater networks. Postglacial sea level rise affected coastal living in ways about which we remain largely ignorant. Yet, millennia-old stories from Australia and northwest Europe show how people responded, from which we can plausibly infer their motivations. Stories from Australia say the people have succeeded in halting sea level rise, whereas those from northwest Europe indicate that people have failed, leading to the drowning of coastal cities such as Ys (Brittany) and Cantre’r Gwaelod (Wales). This distinction is explained by the contrasting duration of postglacial sea level rise in these regions; around Australia, sea level stopped rising 7,000 years ago, while along many coasts of northwest Europe it has risen unceasingly since the last ice age ended. The nature of past human and societal responses to postglacial sea level rise holds important insights for the future.
The Economics of Language
Authors: Ginsburgh Victor , Weber Shlomo
Published: June 2020

This paper brings together methodological, theoretical, and empirical analysis into the framework of linguistic diversity. It reflects both historical and contemporary research by economists and other social scientists on the impact of language on economic outcomes and public policies. We examine whether and how language influences human thinking (including emotions) and behavior, and analyze the effects of linguistic distances on trade, migrations, financial markets, language learning, and its returns. The quantitative foundations of linguistic diversity, which rely on group identification, linguistic distances as well as fractionalization, polarization, and disenfranchisement indices are discussed in terms of their empirical challenges and uses. We conclude with an analysis of linguistic policies and examine the trade-offs between the development of labor markets and the social costs that they generate in various countries. (JEL N30, Z13)
Purulent chondritis of thyroid cartilage
Authors: Learned Kim O , Vu Thinh H. , Choi Jeanie M. , Gule-Monroe Maria K. , Pytynia Kristen B. , Ginsberg Lawrence E.
Published: June 2020

We report a case of a 77-year-old female with purulent chondritis of the thyroid cartilage who was initially referred for laryngeal neoplasm. Purulent chondritis of the laryngeal cartilage is a rare entity with three reports in the literature. The unique CT imaging features of expansile laryngeal cartilage with peripheral rim enhancement and central fluid-attenuation correlate to the abscess formation between the inner and outer perichondria. The correct imaging assessment prompts surgical management and avoid misdiagnosis.
Case Report: Use of hydroxychloroquine and N-acetylcysteine for treatment of a COVID-19 positive patient
Authors: Puyo Carlos , Kreig Danielle , Saddi Venugopal , Ansari Essam , Prince Oliver
Published: June 2020

There is worldwide concern for lack of specific therapy against the novel Betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This case report presents the results of a pharmacological intervention aimed at modulating the inflammatory effects of coronavirus disease 2019 (COVID-19), in an effort to avoid the use of mechanical ventilation. A COVID-19 positive patient was admitted with multisystem organ dysfunction, including acute respiratory insufficiency, and was treated with a combination of low oral doses of hydroxychloroquine and intravenous N-acetylcysteine (NAC). The combination therapy resulted in noticeable clinical improvement and a quantifiable decrease of several of the inflammatory markers measured, in particular ferritin levels, C-reactive protein (CRP) and lactic acid. He also developed pulmonary embolism (PE) and deep vein thrombosis (DVT), both known side effects of COVID-19 infection. Following thrombolysis and heparinization his clinical evolution continued a positive trend until discharge.

The therapeutic approach utilized in this case suggests that early intervention not only decrease acute organ dysfunction but also may decrease the need for mechanical ventilation in COVID-19 positive patients.