bluuebunny/crossref_metadata_2025 huggingface dataset:
659 Non-Burn Etiologies Treated with Autologous Skin Cell Suspension: A Case Series Demonstrating the Efficacy in Complex Wounds
Authors: Qumsiyeh Yazen , Kopari Nicole M
Published: May 2021

Introduction

Complex wounds (CW) resulting from necrotizing soft tissue infections (NSTIs) and soft tissue traumatic injuries create unique challenges. Radical debridement is often the first step in management but can result in disfigurement with impaired function and compromised cosmesis. The standard of care at our institution for full-thickness burn injuries of similar complexity is widely meshed autografting with application of autologous skin cell suspension (ASCS). Our study is a case series reviewing outcomes using ASCS for CW from non-burn etiology.

Methods

A retrospective chart review from March 2019 through July 2020 was performed to evaluate the effectiveness of ASCS and widely meshed autografting in CW. Patients presenting with CW underwent serial excisions of devitalized tissue by acute care and burn surgeons. Dermal substitute utilization for wound preparation was at the discretion of the surgeon. Definitive wound closure was achieved using ASCS in combination with a widely meshed autograft. The wounds were covered with a non-adherent, non-absorbent, small pore primary dressing along with bismuth-impregnated, petroleum-based gauze or negative pressure wound therapy dependent on wound bed contour. Further padding with gauze was applied along with compressive dressing.

Results

In total, 8 patients with CW were included in this review. The mean age was 58 years (range 27-85) with an equal number of males and females. Wound etiology included NSTI (n=5), degloving injury (n=2), and traumatic amputation (n=1). The average wound size measured 1,300cm2 (range 300-3,000). 50% of the patients were treated with a dermal substitute and negative pressure wound therapy prior to ASCS and autograft placement. 7 of 8 patients received split-thickness skin grafting in the ratio of 3:1 with one patient grafted at a 2:1 expansion. 7 of the 8 patients had >90% wound closure within 8-10 days of ASCS and autograft application. One patient had significant graft failure after removing surgical dressings and autograft in the early post-operative period secondary to dementia. One patient expired during the follow-up period secondary to medical comorbidities. The 6 remaining patients had durable wound closure and acceptable cosmetic outcome. All patients were discharged within 10 days of ASCS application with 4 patients discharging home and 4 patients discharging to an acute inpatient rehabilitation.

Conclusions

This study is the first case series to review ASCS in combination with widely meshed skin grafts in the management of CW from a non-burn etiology. Durable, timely wound closure and an acceptable cosmetic outcome was achieved in these often-challenging CW.
A Dangerous Balance: Indiscriminate Counterterrorism Measures and Mobilization against the State
Authors: Mathieson Nicola
Published: May 2021

This paper explores the unintended consequences of counterterrorism measures by reconceptualizing them as forms of state repression. In line with the study of state repression, this paper distinguishes between two types of counterterrorism measures—selective and indiscriminate. Therefore, I argue the impacts of both forms of counterterrorism measures mirror those of selective and indiscriminate state repression. This paper is particularly concerned with the relationship between indiscriminate counterterrorism measures and consequent mobilization against the state. Drawing on cases of indiscriminate counterterrorism measures in Northern Ireland and Bosnia and Herzegovina, this paper argues that indiscriminate counterterrorism measures, like indiscriminate state repression, exacerbate divisions between the state and its citizens, increasing the risk of the violence that counterterrorism measures are assumed to prevent.

Cet article explore les conséquences involontaires des mesures antiterroristes en les reconceptualisant en tant que formes de répression étatique. S'alignant sur l’étude de la répression étatique, cet article distingue deux types de mesures antiterroristes: les mesures sélectives et les mesures indiscriminées. Je soutiens donc que l'impact de ces deux formes de mesures antiterroristes reflète celui des deux formes de répression étatique: la répression sélective et la répression indiscriminée. Cet article s'intéresse particulièrement à la relation entre les mesures antiterroristes indiscriminées et la mobilisation contre l’État qui en résulte. Il s'appuie sur des cas de mesures antiterroristes indiscriminées qui ont été employées en Irlande du Nord et en Bosnie-Herzégovine et soutient que les mesures antiterroristes indiscriminées, tout comme la répression étatique indiscriminée, exacerbent les divisions entre l’État et ses citoyens, accroissant ainsi le risque de violence que les mesures antiterroristes sont supposées empêcher.

En este artículo, se exploran las consecuencias imprevistas de las medidas antiterroristas al reconceptualizarlas como formas de represión estatal. En línea con el estudio de la represión estatal, en este documento se distinguen entre dos tipos de medidas antiterroristas: selectivas e indiscriminadas. Por lo tanto, sostengo que el impacto de ambas formas de medidas antiterroristas refleja el de la represión estatal selectiva e indiscriminada. En este documento, se aborda especialmente la relación entre las medidas antiterroristas indiscriminadas y la consiguiente movilización contra el Estado. En función de los casos de medidas antiterroristas indiscriminadas en Irlanda del Norte y Bosnia y Herzegovina, en este documento se argumenta que las medidas antiterroristas indiscriminadas, al igual que la represión estatal indiscriminada, exacerban las divisiones entre el Estado y sus ciudadanos, y potencian el riesgo de casos de violencia que se supone que las medidas antiterroristas deben evitar.
Interpretative Challenges in the Archive: An Introduction
Authors: Freije Vanessa , Nolan Rachel
Published: May 2021

The twenty-first century has already seen extensive handwringing over how disinformation, “fake news,” and conspiracy theories shape contemporary politics. While social media and new technologies have undoubtedly accelerated the dissemination of such information, the problem of how unauthorized, dubious, or discredited claims shape political subjectivities and historical events is not new. In Latin America and the Caribbean, as elsewhere, conflicts over credibility and truth abound in the historical archive, leaving traces of rumor, denunciation, and even outright forgery that pose interpretative challenges for historians. We argue that dubious or challenged claims, instead of unreliable narratives to be separated out and discarded, are an important constitutive part of the historical record and often altered material realities. Introducing readers to select historical cases from Latin America and the Caribbean, we argue that some especially resonant denunciations, forgeries, rumors, and counter-narratives behave less like plot than like event.
Overstable convective modes in rotating early-type stars
Authors: Lee Umin
Published: May 2021

We calculate overstable convective (OsC) modes of 2-, 4-, and $20\hbox{-}{\rm M}_\odot$ main-sequence stars. To compute non-adiabatic OsC modes in the core, we assume $(\nabla \cdot \rm{\boldsymbol {F}}_{\rm C})^\prime =0$ as a prescription for the approximation called frozen-in convection in pulsating stars, where $\rm{\boldsymbol {F}}_{\rm C}$ is the convective energy flux and the prime ′ indicates Eulerian perturbation. We find that the general properties of the OsC modes are roughly the same as those obtained by Lee & Saio, who assumed $\delta (\nabla \cdot \rm{\boldsymbol {F}}_{\rm C})=0$, except that no OsC modes behave like inertial modes when they tend towards complete stabilization with increasing rotation frequency, where δ indicates the Lagrangian perturbation. As the rotation frequency of the stars increases, the OsC modes are stabilized to resonantly excite g modes in the envelope when the core rotates slightly faster than the envelope. The frequency of the OsC modes that excite envelope g modes is approximately given by σ ∼ |mΩc| in the inertial frame and hence σm = −2 ≈ 2σm = −1, where m is the azimuthal wavenumber of the modes and Ωc is the rotation frequency of the core. We find that the modal properties of OsC modes do not strongly depend on the mass of the stars. We discuss angular momentum transport by OsC modes in resonance with envelope g modes in the main-sequence stars. We suggest that angular momentum transfer takes place from the core to the envelope and that the OsC modes may help the stars rotate uniformly and keep the rotation frequency of the core low during their evolution as main-sequence stars.
A near-range plant invasion homogenizes riparian vegetation but leads to more productive bird communities
Authors: Stinson Lani T , Pejchar Liba
Published: May 2021

Biological invasions are a leading driver of biodiversity loss and population declines worldwide. While much research has focused on understanding the effects of long-distance (e.g., cross-continental) invasion, the potential impacts of species that invade close to or within their native ranges are relatively understudied. We investigated the effects of the near-range introduction of a non-native plant, New Mexico locust (Robinia neomexicana), on riparian plant and bird communities in northwestern Colorado, USA. By surveying plant and bird communities and examining nest success and productivity in riparian forest with and without locust, we evaluated the following ecological responses to invasion: (1) tree and shrub richness and density; (2) bird species richness, occupancy, and abundance; and (3) avian reproductive success. Our results demonstrate biotic homogenization of the plant community with increasing intensity of locust invasion, yet we found little evidence for negative effects on avian habitat use or reproductive success. Instead, locust invasion showed a positive effect on nest productivity, with significantly higher brood sizes and numbers of young fledged for nests in invaded habitats compared to those where locust was absent. Because climate change is already leading to shifts in species distribution patterns, we suggest that understanding the ecological consequences of plant invasions that occur within or near historic ranges will advance the science and practice of invasive species biology in a changing world. Our findings of mostly neutral to positive effects of locust suggest that near-range plant invasions may not always negatively impact community structure.
Variation in incubation length and hatching asynchrony in Eastern Kingbirds: Weather eclipses female effects
Authors: Gillette Samantha M , Klehr Amanda L , Murphy Michael T
Published: May 2021

Incubation length and hatching asynchrony are integral elements of the evolved reproductive strategies of birds. We examined intra- and interpopulation variation in both traits for Eastern Kingbird (Tyrannus tyrannus) populations from New York (NY), Kansas (KS), and Oregon (OR) and found that both incubation length and hatching asynchrony were not repeatable among females, after controlling for a repeatable trait, clutch size. Instead, incubation length and clutch size were influenced by ambient temperature and precipitation. Incubation length exhibited the same median (15 days) and range (13–17 days) at all sites. Model selection results indicated that incubation periods for the smallest and largest clutches were longer in NY than KS when rain was frequent throughout incubation, in replacement nests, and likely when ambient temperatures were low during egg-laying. Full hatching usually required 2 days (but up to 3), with synchronous hatching associated with small clutch sizes, short incubation periods, frequent rain during the egg-laying period, and low ambient temperatures during the first half of incubation. Nestling starvation was uncommon (5–9% of nestlings monitored) and not associated with greater hatching asynchrony. These results indicate that while clutch size, a repeatable female trait, contributed to variation in incubation length and hatching asynchrony in Eastern Kingbirds, weather was a greater source of variation, especially for incubation length.
“Screaming, ‘No! No!’ It was Literally Like Being Raped”: Connecting Sexual Assault Trauma and Coerced Obstetric Procedures
Authors: Morris Theresa , Robinson Joan H , Spiller Keridwyn , Gomez Amanda
Published: May 2021

How does the victimization of women’s bodies in medical interactions contribute to their experience of gendered violence? We answer this question by joining sexual assault and birth trauma literatures with the medical sociology conversation on the power of hospitals as organizations and the hierarchy of the doctor-patient relationship to analyze the interviews of 101 women who identify as having experienced a coerced, pressured, or forced labor or birth procedure. We find some respondents analogize their experiences to that of someone who has been sexually assaulted, and they and other respondents describe the aftermath effects in ways similar to those who have been victims of sexual assault. Our research demonstrates that clinicians and hospitals are harming patients, often through the normal application of established hospital protocols and behaviors, when women do not feel involved in decisions about their care.
Peritubular Macrophages Are Recruited to the Testis of Peripubertal Rats After Mono-(2-Ethylhexyl) Phthalate Exposure and Is Associated With Increases in the Numbers of Spermatogonia
Authors: Gillette Ross , Tiwary Richa , Voss Jorine J L P , Hewage Shavini N , Richburg John H
Published: May 2021

Peripubertal exposure of male rodents to the phthalate metabolite mono-(2-ethylhexyl) phthalate (MEHP) causes testicular inflammation, spermatocyte apoptosis, and disruption of the blood-testis barrier. The MEHP-induced inflammatory response in the testis includes an infiltration of macrophages and neutrophils, although the cause and purpose of this response is unknown. Recently, a population of testicular macrophages known as peritubular macrophages that are phenotypically distinct from those resident in interstitium was described in mice. Peritubular macrophages aggregate near the spermatogonial stem cell niche and are believed to stimulate their differentiation. We hypothesized that if testicular peritubular macrophages do indeed stimulate spermatogonial differentiation, MEHP exposure would result in an increase of peritubular macrophages to stimulate the replacement of lost spermatocytes. Male rats were exposed to 700 mg/kg MEHP or corn oil (vehicle control) via oral gavage at postnatal day 28 and euthanized at 48 h, 1 or 2 weeks later. Seminiferous tubules were stained with immunofluorescent markers for macrophages (major histocompatibility complex class II [MHC-II+]) and undifferentiated spermatogonia (PLZF). Peritubular macrophages were observed in rat testis: MHC-II+ cells on the surface of seminiferous tubules with heterogeneous morphology. Quantification of MHC-II+ cells revealed that, unlike in the mouse, their numbers did not increase through puberty (2-week period). MEHP increased macrophage presence by 6-fold 48 h after exposure and remained elevated by 2-fold 2 weeks after exposure. An increase of differentiating spermatogonia occurred 2 weeks after MEHP exposure. Taken together, our results suggest that peritubular macrophages play a crucial role in the testis response to acute injury and the subsequent recovery of spermatogenesis.
Baseline Sensitivity and Control Efficacy of Strobilurin Fungicide Pyraclostrobin AgainstSclerotium rolfsii
Authors: You Jingmao , Tang Tao , Wang Fanfan , Mao Ting , Yuan Bin , Guo Jie , Guo Xiaoliang , Duan Yuanyuan , Huang Junbin
Published: May 2021

Sclerotium rolfsii is a fungi pathogen of southern blight with broad host range. The quinone outside inhibitor fungicide pyraclostrobin was officially approved for controlling many diseases in 2015. In this study, baseline sensitivity of S. rolfsii to pyraclostrobin was established by measuring the 50% effective concentration (EC50) values of 155 isolates of S. rolfsii. The EC50values ranged from 0.0291 to 1.0871 µg/ml, with a mean EC50of 0.4469 ± 0.2490 µg/ml (mean ± standard deviation). In a preventive fungicide in vitro experiment and a field experiment, pyraclostrobin preventive efficacy reached 90% and 80%, respectively, which were much higher than that of the control agent carbendazim. Curative efficacy of pyraclostrobin was significantly lower than its preventive efficacy. Pyraclostrobin at 0.1, 0.5, and 2 μg/ml significantly reduced the number of sclerotia produced on potato dextrose agar medium, but had no significant influence on their total weight. Pyraclostrobin had no significant influence on mycelial cell membrane permeability, but it significantly reduced oxalate secretion and protein synthesis of S. rolfsii. Our findings are of great significance for resistance monitoring of S. rolfsii and also provide new insight into the action mechanism of pyraclostrobin against S. rolfsii.
Genome Sequence Data of Three Formae Speciales of Phytophthora vignae Causing Phytophthora Stem Rot on Different Vigna Species
Authors: Sun Feifei , Sun Suli , Ye Wenwu , Duan Canxing , Li Benjin , Shan Weixing , Zhu Zhendong
Published: May 2021

Phytophthora vignae is an important oomycete pathogen causing Phytophthora stem rot on some Vigna spp. Three P. vignae isolates obtained from mung bean, adzuki bean, and cowpea exhibited high similarities in morphology and physiology but are specialized to infect different hosts. Here, we report the first de novo assembly of the draft genomes of three P. vignae isolates, which were performed using the PacBio SMRT Sequel platform. This study will extend the genomic resource available for the Phytophthora genus and provide a good foundation for further research on comparative genomics of Phytophthora spp. and interaction mechanism between hosts and pathogens.
COVID-19 and the golden years
Authors: Kroll Nicole L. , Sanchez-Jones Tamika , Atchley Megan Danielle , Etcher LuAnn
Published: May 2021

The impact of COVID-19 on older adults may not be readily apparent. Personal protective and social distancing measures can reduce activity levels, increase feelings of isolation and loss, and result in lapsed medical care. NPs must recognize detrimental impacts on overall health and wellness and assist older adults in overcoming them.
Recognizing risk and presence of posttraumatic stress disorder in women
Authors: Heavey Elizabeth
Published: May 2021

US women who report having experienced significant trauma at some point in their lives range from 50% to 90%. Yet posttraumatic stress disorder (PTSD) goes largely unrecognized in women. This article discusses ways to monitor, screen, and intervene for PTSD in women.
Low-dose Buprenorphine Initiation in Hospitalized Adults With Opioid Use Disorder: A Retrospective Cohort Analysis
Authors: Button Dana , Hartley Jennifer , Robbins Jonathan , Levander Ximena A. , Smith Natashia J. , Englander Honora
Published: May 2021

Objectives:

Patients with opioid use disorder (OUD) can initiate buprenorphine without requiring a withdrawal period through a low-dose (sometimes referred to as “micro-induction”) approach. Although there is growing interest in low-dose buprenorphine initiation, current evidence is limited to case reports and small case series.

Methods:

We performed a retrospective cohort study of patients with OUD seen by a hospital-based addiction medicine consult service who underwent low-dose buprenorphine initiation starting during hospital admission. We then integrated our practice-based experiences with results from the existing literature to create practice considerations.

Results:

Sixty-eight individuals underwent 72 low-dose buprenorphine initiations between July 2019 and July 2020. Reasons for low-dose versus standard buprenorphine initiation included co-occurring pain (91.7%), patient anxiety around the possibility of withdrawal (69.4%), history of precipitated withdrawal (9.7%), opioid withdrawal intolerance (6.9%), and other reason/not specified (18.1%). Of the 72 low-dose buprenorphine initiations, 50 (69.4%) were completed in the hospital, 9 (12.5%) transitioned to complete as an outpatient, and 13 (18.1%) were terminated early. We apply our experiences and findings from literature to recommendations for varied clinical scenarios, including acute illness, co-occurring pain, opioid withdrawal intolerance, transition from high dose methadone to buprenorphine, history of precipitated withdrawal, and rapid hospital discharge. We share a standard low-dose initiation protocol with potential modifications based on above scenarios.

Conclusions:

Low-dose buprenorphine initiation offers a well-tolerated and versatile approach for hospitalized patients with OUD. We share lessons from our experiences and the literature, and provide practical considerations for providers.
Cannabis Use and Stroke: Does a Risk Exist?
Authors: Swetlik Carol , Migdady Ibrahim , Hasan Leen Z. , Buletko Andrew Blake , Price Carrie , Cho Sung-Min
Published: May 2021

Aims:

Cannabis use has been reported as a risk factor for stroke. We systematically review the prevalence and outcomes of stroke in people with cannabis use.

Methods:

We searched MEDLINE and 6 other databases from inception to January 2020 for studies on the relationship between cannabis use and stroke. We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Two independent reviewers extracted the data. Study quality was assessed by the Newcastle-Ottawa Scale for cohort and case-control studies.

Results:

Seventeen studies involving 3,185,560 people with cannabis use were included. Descriptive statistics demonstrated 18,676 (median 1.1%, interquartile range [IQR] 0.3%–1.3%) experienced stroke compared with 0.8% of those without use (Odds Ratio 1.17, 95% CI 1.10–1.25). Among people with cannabis use, median age was 26.2 years (IQR 25.2–34.3 years) and mostly male (median 57.8%). Of stroke subtypes, ischemic stroke was most prevalent (median 1.2%, IQR 0.4%–1.9%), followed by undefined stroke subtype (median 1.2%, IQR 1.1%–1.2%) and hemorrhagic stroke (median 0.3%, IQR 0.1%–0.6%). The majority of people with cannabis use who experienced stroke survived (median: 85.1%, IQR 83%–87.5%) and 64.0% of people experienced a good neurologic outcome, defined as modified Rankin Scale of 0 to 3. Few studies included outcomes of vasospasm or seizure.

Conclusions:

In people with cannabis use, the prevalence of ischemic stroke and hemorrhagic stroke was 1.2% and 0.3%, respectively, higher than the prevalence of people without use (0.8% and 0.2%). There is insufficient information on timing, exposure, duration, and dose-responsive relationship.
A Case of Kratom Use: Implications for Managing Addiction and Addressing Comorbidity in Overdose Survivors, and for the Education of Clinicians Who Are Not Addiction Specialists
Authors: Donroe Joseph H. , Fiellin David A.
Published: May 2021

As overdose mortality rises, overdose morbidity – complications seen as a result of overdose events – is rising too. Although comorbidity is often thought of as psychiatric or psychological, a case report of compartment syndrome, rhabdomyolysis, and acute renal insufficiency in a patient with loss of consciousness for 6 hours after smoking Kratom highlights medical comorbidity. The case is a reminder that a broad range of medical comorbidities can occur in patients with overdose and with unhealthy substance use. Patients with these comorbidities will often be cared for by clinicians who are not addiction specialists, who will need to have sufficient training to recognize and address them.
Curcumin suppresses renal carcinoma tumorigenesis by regulating circ-FNDC3B/miR-138-5p/IGF2 axis
Authors: Xue Li , Tao Yuhua , Yuan Yanjuan , Qu Wei , Wang Wei
Published: May 2021

Curcumin has a vital role in the development of renal carcinoma. Nevertheless, the mechanism of curcumin in renal carcinoma tumorigenesis remains largely unknown. Thirty renal carcinoma patients were recruited. Renal carcinoma cell lines CAKI-1 and ACHN were exposed to curcumin. The levels of circular RNA fibronectin type III domain–containing protein 3B (circ-FNDC3B), microRNA (miR)-138-5p and insulin-like growth factor 2 (IGF2) were detected via quantitative reverse transcription PCR or western blot. Cell proliferation and apoptosis were investigated via 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide, colony formation analysis, flow cytometry and western blot. Target association between miR-138-5p and circ-FNDC3B or IGF2 was analyzed via dual-luciferase reporter analysis. The function of curcumin in vivo was assessed via a xenograft model. circ-FNDC3B level was enhanced and miR-138-5p abundance was declined in renal carcinoma tissues and cells. Curcumin restrained renal carcinoma cell proliferation and promoted apoptosis. circ-FNDC3B overexpression or miR-138-5p knockdown weakened the influence of curcumin. circ-FNDC3B knockdown hindered cell proliferation and promoted apoptosis by increasing miR-138-5p. IGF2 was targeted via miR-138-5p and positively regulated via circ-FNDC3B. Curcumin decreased xenograft tumor growth via reducing circ-FNDC3B in vivo. Curcumin suppressed renal carcinoma tumorigenesis in vitro and in vivo via regulating circ-FNDC3B/miR-138-5p/IGF2 axis, proposing new insight into renal carcinoma tumorigenesis.
Efficacy and safety of toripalimab combined with doxorubicin as first-line treatment for metastatic soft tissue sarcomas: an observational study
Authors: Liu Zhiyong , Liu Cuiping , Yao Weitao , Gao Songtao , Wang Jiaqiang , Zhang Peng , Ge Hong
Published: May 2021

Programmed cell death protein 1 (PD-1) inhibitors have demonstrated promising activity among patients with advanced soft tissue sarcomas (STS) in phase II trials. The purpose of this study was to assess the efficacy and safety of toripalimab (a novel PD-1 inhibitor) combined with doxorubicin as first-line treatment in patients with metastatic STS between December 2018 and September 2019. A total of 30 patients with metastatic STS were included and followed up retrospectively. One patient had complete response (CR), 10 patients obtained partial response, and 13 patients achieved stable disease. The objective response rate was 36.7% and the disease control rate was 80%. The median progression-free survival (PFS) was 8 months (95% CI: 6.30–10.64). The most frequent any grade adverse events were nausea (66.7%), fatigue (60%), and vomiting (40%). Neutropenia (20%) was the most common grade 3/4 adverse events, followed by leucopenia (13.3%) and febrile neutropenia (6.7%). No death related to treatment was observed during the drugs administration. Toripalimab combined with doxorubicin is effective in patients with metastatic STS as first-line treatment with manageable adverse events.
Systemic and Coronary Hemodynamic Effects of Tobacco Products on the Cardiovascular System and Potential Pathophysiologic Mechanisms
Authors: Klein Lloyd W.
Published: May 2021

Tobacco product usage is the single most preventable cause of death in the United States. Smoking promotes atherosclerosis, producing disease in the coronary arteries, the aorta, the carotid and cerebral arteries and the large arteries in the peripheral circulation. The cardiovascular consequences of tobacco products have been the subject of intensive study for several decades. Despite the overwhelming epidemiologic association between smoking and vascular disease, the pathophysiologic mechanisms by which smoking exerts its deleterious effects remain incompletely understood. This review addresses the acute and long-term systemic and coronary hemodynamic effects of tobacco, with an emphasis of the impact on coronary blood flow and pathophysiologic mechanisms.
Magnesium Disorders and Prognosis in Heart Failure: A Systematic Review
Authors: Voultsos Petros , Bazmpani Maria-Anna , Papanastasiou Christos A. , Papadopoulos Christodoulos E. , Efthimiadis Georgios , Karvounis Haralambos , Kalogeropoulos Andreas P. , Karamitsos Theodoros D.
Published: May 2021

Magnesium is an essential mineral for the human body and plays an important role in cardiovascular health. Hypomagnesaemia has been linked with increased cardiovascular mortality in heart failure; however, previous studies have yielded conflicting results. Even fewer studies have addressed the association between hypermagnesemia and prognosis in heart failure. The aim of the present systematic review was to investigate the association of serum magnesium levels with cardiovascular and all-cause mortality in patients with heart failure and reduced ejection fraction (HFrEF). Cardiovascular morbidity, referring to heart failure rehospitalizations and ventricular arrhythmias, was also investigated. Eligible studies were identified by searching PubMed and Scopus. The Quality in Prognosis (QUIPS) tool was used to assess the quality of included studies. Eight studies (total of 13,539 patients with HFrEF) that assessed the effects of serum magnesium levels on cardiovascular mortality, all-cause mortality, and cardiovascular morbidity met inclusion criteria. In half of the studies, hypomagnesemia was found to be an independent risk factor for cardiovascular mortality, including sudden cardiac death. Only 1 study reported that hypermagnesemia (serum magnesium levels above 2.4 mg/dL) is a prognostic factor for noncardiac mortality suggesting that hypermagnesemia is more likely an indicator of comorbidities rather than a true independent prognostic marker. Finally, low serum magnesium levels were not associated with readmissions for heart failure or ventricular arrhythmias in patients with HFrEF.
Efficacy and Safety of Simultaneous Application of HIFEM and Synchronized Radiofrequency for Abdominal Fat Reduction and Muscle Toning: A Multicenter Magnetic Resonance Imaging Evaluation Study
Authors: Jacob Carolyn , Kent David , Ibrahim Omer
Published: May 2021

BACKGROUND

Radiofrequency and high-Intensity Focused Electromagnetic (HIFEM) field procedure are well-known, stand-alone, body-shaping modalities, yet their simultaneous application has not been investigated.

OBJECTIVE

The aim is to evaluate the efficacy of a novel device simultaneously delivering HIFEM and radiofrequency for subcutaneous fat reduction and muscle toning.

MATERIALS AND METHODS

Forty-one subjects with an average age of 39.7 ± 11.5 years were recruited. The subjects received 3 abdominal treatments (one per week). Magnetic resonance imaging images of the treated area were evaluated at baseline and at 1-, 3-, and 6-month visits for changes in subcutaneous fat, muscle thickness, and abdominal separation (AS). Anthropometric data and digital photographs were collected. Subject satisfaction and therapy comfort were evaluated.

RESULTS

The muscle mass increase peaked at 3 months, showing 26.1% thickening. The fat thickness reduction was most prominent at 3 months, showing a 30.8% reduction. The AS decreased by 18.8% at 3 months after treatment. The waist circumference reduced by 5.87 ± 3.64 cm at a 3-month follow-up. Six-month data showed maintenance of these outcomes. The treatment was considered as comfortable with high patient satisfaction.

CONCLUSION

The analysis of magnetic resonance imaging images and waist measurements showed that the therapy combining HIFEM and radiofrequency is highly effective in reducing subcutaneous fat and muscle thickening.
Contribution of lncRNA CASC8, CASC11, and PVT1 Genetic Variants to the Susceptibility of Coronary Heart Disease
Authors: Lu Yan , Yuan Wei , Wang Lan , Ning Mingan , Han Yuan , Gu Wenjuan , Zhao Tingting , Shang Fenqing , Guo Xuan
Published: May 2021

The purpose of this study was to explore the relationship between lncRNA CASC8, CASC11, and plasmacytoma variant translocation 1 (PVT1). genetic variants and coronary heart disease (CHD) susceptibility among a Chinese Han population. Five single nucleotide polymorphisms were genotyped by Agena MassARRAY platform among 464 CHD patients and 510 healthy controls. Binary logistic regression models by calculating odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between selected single nucleotide polymorphisms and CHD risk. Multifactor dimensionality reduction analysis was performed to analyze gene–gene interaction. PVT1 rs4410871 (OR = 0.77, P = 0.040) was associated with a reduced risk of CHD occurrence in the Chinese population. CASC11 rs9642880 (OR = 1.49, P = 0.021) was a risk factor for increased CHD susceptibility in subjects over 60 years old, and PVT1 rs4410871 was a protective factor for CHD susceptibility in males (OR = 0.67, P = 0.015) and smokers (OR = 0.62, P = 0.047). Complications (hypertension or diabetes) of CHD influenced the association between CASC8, CASC11, and PVT1 genetic polymorphisms and CHD predisposition. Moreover, CASC8, CASC11, and PVT1 polymorphisms were related to the number of pathological branches and Gensini score in CHD patients. The study displayed the contribution of CASC8, CASC11, and PVT1 genetic polymorphisms to CHD predisposition, and these variants could serve as potential biomarkers of CHD susceptibility. These findings contribute to enhancing the understanding of the role of lncRNA polymorphisms in CHD risk.
Recent Insights Into the Protective Mechanisms of Paeoniflorin in Neurological, Cardiovascular, and Renal Diseases
Authors: Jiao Feng , Varghese Kevin , Wang Shaoxun , Liu Yedan , Yu Hongwei , Booz George W. , Roman Richard J. , Liu Ruen , Fan Fan
Published: May 2021

The monoterpene glycoside paeoniflorin (PF) is the principal active constituent of the traditional Chinese herbal medicines, Radix Paeoniae Alba and Radix Paeoniae Rubra, which have been used for millennia to treat cardiovascular diseases (eg, hypertension, bleeding, and atherosclerosis) and neurological ailments (eg, headaches, vertigo, dementia, and pain). Recent evidence has revealed that PF exerts inhibitory effects on inflammation, fibrosis, and apoptosis by targeting several intracellular signaling cascades. In this review, we address the current knowledge about the pharmacokinetic properties of PF and its molecular mechanisms of action. We also present results from recent preclinical studies supporting the utility of PF for the treatment of pain, cerebral ischemic injury, and neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. Moreover, new evidence suggests a general protective role of PF in heart attack, diabetic kidney, and atherosclerosis. Mechanistically, PF exerts multiple anti-inflammatory actions by targeting toll-like receptor-mediated signaling in both parenchymal and immune cells (in particular, macrophages and dendritic cells). A better understanding of the molecular actions of PF may lead to the expansion of its therapeutic uses.
Carbon Monoxide–Saturated Polymerized Placenta Hemoglobin Optimizes Mitochondrial Function and Protects Heart Against Ischemia–Reperfusion Injury
Authors: Zhang Yarong , Nie Hongfei , Li Shen , Deng Yan , Zhou Wentao , Wu Wei , Xu Xuewen , Yu Haiyang , Li Tao
Published: May 2021

Ischemia–reperfusion (I-R) injury is detrimental to cardiovascular system. This study was designed to investigate whether carbon monoxide–saturated polymerized human placenta hemoglobin (CO-PolyPHb) attenuates cardiac I-R injury and to elucidate the underlying mechanism(s). Sixty male adult Sprague-Dawley rats were randomly divided into 6 groups: saline + sham group, PolyPHb + sham group, CO-PolyPHb + sham group, saline + I-R group, PolyPHb + I-R group, and CO-PolyPHb + I-R group. Rats were pretreated with injection of PolyPHb, CO-PolyPHb (0.5 g Hb/kg/d), or an equivalent volume of saline via caudal vein for 3 days. After pretreatment, hearts were isolated Langendorff perfused and subjected to 30-minute no-flow ischemia and 120-minute reperfusion. As compared with the saline + I-R group, pretreatment with CO-PolyPHb greatly improved the recovery of cardiac function, reduced infarct size, and suppressed the release of cardiac enzyme. Importantly, CO-PolyPHb showed more prominent cardioprotective effect than PolyPHb, exhibiting a promising therapeutic potential in cardiac I-R injury. Further study demonstrated that CO-PolyPHb activated molecular signaling toward mitophagy and significantly elevated the mitochondrial respiratory function in the heart. In addition, CO-PolyPHb upregulated the phosphorylation of the proteins in insulin signaling pathway and increased the glucose uptake rate in cardiomyocytes. Pharmacological inhibition of this pathway by wortmannin abrogated the anti-I-R effect of CO-PolyPHb. In conclusion, using an isolated rat heart model, we have demonstrated that pretreatment with CO-PolyPHb provided protective effect against cardiac I-R injury, and this protection was mediated by the improvement of mitochondrial function and activation of insulin signaling pathway in the heart.
Altered Properties of Neurons and Astrocytes and the Effects of Food Components in Stroke-Prone Spontaneously Hypertensive Rats
Authors: Yamagata Kazuo , Yamori Yukio
Published: May 2021

In stroke-prone spontaneously hypertensive rats (SHRSP), stroke induces neuronal vulnerability and neuronal death, while astrocytes show a weakened support function toward neurons. Moreover, certain food components have been demonstrated to prevent the occurrence of stroke. This review aims to explain the stroke-related properties of SHRSP-derived neurons and astrocytes. In addition, it describes the effects of particular dietary phytochemicals on SHRSP. In this study, we obtained information using PubMed, ScienceDirect, and Web of Science. We searched for the functions of neurons and astrocytes and the molecular mechanism of ischemic stroke induction. We summarized the recent literature on the underlying mechanisms of stroke onset in SHRSP and the alleviating effects of typical food-derived phytochemical components. Neuronal death in SHRSP is induced by hypoxia-reoxygenation, suggesting the involvement of oxidative stress. Furthermore, the production of lactate, l-serine, and glial cell line-derived neurotrophic factor in SHRSP-derived astrocytes was reduced compared with that in control Wistar–Kyoto rats. Vitamin E exerts an inhibitory effect on hypoxia-reoxygenation–induced neuronal death in SHRSP. Curcumin, epigallocatechin gallate, resveratrol, and carotenoids can prevent the development of stroke in SHRSP. In particular, the properties of SHRSP-derived neurons and astrocytes affect stroke-induced neuronal death. This review suggests the potential and therapeutic applications of dietary phytochemicals in reducing stroke risk and lowering blood pressure in SHRSP, respectively, by targeting various processes, including oxidative stress, apoptosis, and inflammation. Thus, future research on SHRSP brain cells with a genetic predisposition to stroke can consider using these food ingredients to develop approaches for stroke prevention.
Temporoparietal Fascia Flaps in Children Under 15 Years of Age: An Anatomic Investigation and Its Clinical Implications in Auricular Reconstruction
Authors: Kim Young Soo
Published: May 2021

Background:

The temporoparietal fascia (TPF) flap has been successfully used in the treatment of microtia with primary or secondary cases. The literature contains numerous studies about its structure and vascular anatomy in adults. However, it is rare to study its vasculature and characteristics in children.

Methods:

From September of 2013 to May of 2020, 188 patients with average age of 9.8 years (range, 5–14 years) underwent total ear reconstruction with costal cartilage in 67 patients (68 ears) or porous polyethylene framework in 121 patients (128 ears) using 196 TPF flaps. The TPF flap was most commonly used in second-stage operations to elevate the reconstructed auricle in the costal cartilage group. Contrastingly, the TPF flap was routinely used in the porous polyethylene framework group. The vascular pattern and characteristics of the TPF flap were evaluated during flap elevation.

Results:

Only 140/196 cases (71.4%) showed a typical pattern with the superficial temporal artery and the superficial temporal vein in this study; others (28.6%) were supplied by combinations of the posterior auricular artery or vein, occipital vein, diploic vein, and superficial artery or vein. Meanwhile, there are variants of the STA and posterior origin-superficial temporal artery, which originates posterior to the lobule beneath the cartilage remnant (3/196, 1.5%).

Conclusion:

Surgeons should inspect the pattern of the TPF flap thoroughly before elevation in children, because of the variety of the vessels and anatomic patterns of TPF.
Impact of visit-to-visit blood pressure variability on hypertensive-mediated target organ damage and future cardiovascular events: the Campania salute network
Authors: Mancusi Costantino , Trimarco Valentina , Losi Maria Angela , Canciello Grazia , Morisco Carmine , Manzi Maria Virginia , Arnone Maria Immacolata , Fucile Ilaria , de Simone Giovanni , Izzo Raffaele , De Luca Nicola , Trimarco Bruno
Published: May 2021

Background:

Exaggerated variability of blood pressure (BP) poses additional stress on cardiovascular system independent of BP average value, increasing risk of target organ damage (HMOD) and cardiovascular events. We assessed the impact of visit-to-visit variability (VVV) of BP on development of cardiovascular events and HMOD.

Methods:

Standard deviation (SD) and coefficient of variability of mean SBP and DBP were calculated in 3555 patients from the Campania Salute Network registry, with available echocardiogram and more than six visits during follow-up. Values from the first visit were excluded. The impact of VVV of BP on cardiovascular events, and mediation of HMOD were assessed at final visit.

Results:

Mean number of visits was 11 ± 6 with mean interval between visits of 9.1 ± 3.7 months. Mean visit-to-visit SD during follow-up was 13 ± 5 for systolic and 8 ± 3 mmHg for DBP; coefficients of variability were 9.7 ± 3.5 and of 9.6 ± 3.2, respectively. In multivariable analysis, left ventricular mass at follow-up was correlated with systolic VVV of BP independently of significant effect of age, BMI, mean SBP during follow-up and initial left ventricular mass. Follow-up GFR was inversely associated with systolic and diastolic VVV, independently of significant effect of age, mean glucose and SBP during follow-up, and initial GFR. In Cox regression, high VVV of BP was also associated with increased risk of cardiovascular events (hazard ratio 1.49, 95% confidence interval 1.08–2.06, P = 0.015), independently of significant effect of HMOD.

Conclusion:

VVV is associated with prevalent HMOD and development of cardiovascular events, independently of mean BP value during follow-up and HMOD.
Predictive value of within-visit and visit-to-visit blood pressure variability for all-cause mortality: the Minhang Study
Authors: Cai Enheng , Chen Ling , Wang Yajuan , An Dewei , Zhang Jin , Tang Xiaofeng , Li Yan , Wang Yan , Zhu Dingliang
Published: May 2021

Background:

Blood pressure variability is a common physiological phenomenon; however, the association between within-visit and visit-to-visit variability in blood pressure and all-cause mortality remains uncertain.

Methods:

We conducted a retrospective analysis of blood pressure variability among 11 721 adults who underwent blood pressure measurement on three occasions within a period of 6 months. Within-visit and visit-to-visit variability was quantified using the standard deviation and maximum--minimum difference between measures. The predictive effect of this variability on all-cause mortality was evaluated using Kaplan--Meier survival curves and Cox regression analysis.

Results:

The incidence of all-cause mortality was significantly higher for participants in the top quintile of within-visit and visit-to-visit blood pressure variability and for those with sustained high within-visit variability. Within-visit variability was not retained as a risk factor after adjustment in Cox regression models. The hazard ratio for mortality increased from 48 to 55% for the top quintile of visit-to-visit blood pressure variability and from 56 to 61% for sustained high within-visit variability. The risk of mortality remained statistically higher even if visit-to-visit blood pressure variability was added to the model, including consistency of within-visit blood pressure variability and vice versa.

Conclusion:

Visit-to-visit and sustained high within-visit blood pressure variability were significant positive prognostic factors for all-cause mortality. Our findings underlined the clinical significance of achieving stable blood pressure in an effective plan of hypertension management.
Birth weight, childhood obesity and risk of hypertension: a Mendelian randomization study
Authors: Fan Jingwen , Shi Xuezhong , Jia Xiaocan , Wang Yuping , Zhao Yang , Bao Junzhe , Zhang Haomin , Yang Yongli
Published: May 2021

Purposes:

Observational studies indicate that birth weight and childhood obesity are associated with essential hypertension, but their causal effect on essential hypertension remains unclear. The aim of our study is to elucidate the causal relationship between birth weight, childhood obesity, and essential hypertension by Mendelian randomization (MR) with genetic variants as instrumental variables (IVs).

Methods:

We identified IVs based on single nucleotide polymorphisms (SNPs) associated with birth weight (n = 160 295) and childhood obesity (n = 6889, 1509 cases and 5380 controls) from the meta-analysis of a genome-wide association study. Summary level data from the UK Biobank essential hypertension consortium (n = 463 010, 54 358 cases and 408 652 controls) was used to analyze the relationship between IVs and essential hypertension. Two MR analysis methods, two threshold values of selecting IVs, and leave-one-out analysis were used to ensure the robustness of the results.

Results:

Genetic predisposition to higher birth weight did not increase the risk of essential hypertension. In contrast, per one standard deviation increase in childhood body mass index was significantly associated with an increased risk of essential hypertension (odds ratio = 1.0075, 95% confidence interval: 1.0035–1.0116) when using seven SNPs that achieved genome-wide significance (P < 5 × 10−8). Sensitivity analysis and MR-Egger regression indicated that the results were robust and not influenced by pleiotropy.

Conclusions:

No evidence of an association between birth weight and essential hypertension was found. Childhood obesity, however, showed a causal relationship with the risk of essential hypertension, which was helpful to understand the mechanisms of essential hypertension and develop strategies for its prevention.