bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of extragalactic planetary nebulae populations based on spectroscopy. I. Data compilation and first findings
Authors: Delgado-Inglada G , García-Rojas J , Stasińska G , Rechy-García J S
Published: August 2020

We compile published spectroscopic data and [O iii] magnitudes of almost 500 extragalactic planetary nebulae (PNe) in 13 galaxies of various masses and morphological types. This is the first paper of a series that aims to analyse the PN populations and their progenitors in these galaxies. Although the samples are not complete or homogeneous, we obtain some first findings through the comparison of a few intensity line ratios and nebular parameters. We find that the ionized masses and the luminosities in H β, LH β, of around 30 objects previously identified as PNe indicate that they are most likely compact H ii regions. We find an anticorrelation between the electron densities and the ionized masses in M 31, M 33, and NGC 300 that suggests that most of the PNe observed in these galaxies are probably ionization bounded. This trend is absent in LMC and SMC suggesting that many of their PNe are density bounded. The He ii λ4686/H β values found in many PNe in LMC and some in M 33 and SMC are higher than in the other galaxies. Photoionization models predict that these high values can only be reached in density bounded PNe. We also find that the brightest PNe in the sample are not necessarily the youngest since there is no correlation between electron densities and the H β luminosities. The strong correlation found between LH β and $L_{[\rm {O}\, \small {III}] }$ implies that the so far not understood cut-off of the planetary nebula luminosity function (PNLF) based on [O iii] magnitudes can be investigated using LH β, a parameter much easier to study.
High cryptic diversity in the kleptoparasitic genus Hyalorisia Dall, 1889 (Littorinimorpha: Capulidae) with the description of nine new species from the Indo-West Pacific
Authors: Fassio Giulia , Russini Valeria , Buge Barbara , Schiaparelli Stefano , Modica Maria Vittoria , Bouchet Philippe , Oliverio Marco
Published: August 2020

Species in the family Capulidae (Littorinimorpha: Capuloidea) display a wide range of shell morphologies. Several species are known to live in association with other benthic invertebrates—mostly bivalves and sabellid worms, but also other gastropods—and are believed to be kleptoparasitic filter feeders that take advantage of the water current produced by the host. This peculiar trophic ecology, implying a sedentary lifestyle, has resulted in highly convergent shell forms. This is particularly true for the genus Hyalorisia Dall, 1889, which occurs in deep water in the Caribbean and Indo-West Pacific provinces, with two nominal species recognized so far. Combining morphological, ecological and molecular data, we assessed the diversity of the genus, its phylogenetic position inside the family and its association with its bivalve host, the genus Propeamussium de Gregorio, 1884 (Pectinoidea), resulting in the description of nine new cryptic species. When sympatric, species of Hyalorisia are associated with different host species, but the same species of Propeamussium may be the host of several allopatric species of Hyalorisia.
Renal denervation: where do we stand and what is the relevance to the nephrologist?
Authors: Schmieder Roland E
Published: August 2020

Catheter-based renal denervation to reduce high blood pressure (BP) has received well-deserved attention after a recent series of sham-controlled trials reported significant antihypertensive efficacy and very favourable tolerability and safety of the intervention. This emerging treatment option is of high relevance to nephrologists. Patients with chronic kidney disease (CKD) are at elevated risk of cardiovascular adverse events and often present with hypertension, which is very difficult to control with medication. Renal denervation promises a new tool to reduce BP and to prevent loss of renal function in this population. The current review considers the role of the kidney and neurohormonal activation in the development of hypertension and the rationale for renal denervation. The current state of the evidence for the effectiveness and tolerability of the procedure is considered from the nephrologists’ perspective, with a focus on the potential future role of renal denervation in the management of CKD patients with hypertension.
Historically Black Colleges and Universities in the United States
Authors: Sanders Crystal
Published: August 2020

Historically black colleges and universities (HBCUs) in the United States total more than one hundred, including public and private institutions, two-year and four-year schools, medical schools, law schools, and community colleges. These institutions provided educational opportunities to black students during the era of legal segregation when southern white institutions prohibited black students and northern white institutions admitted only a few black students, if any at all. The Higher Education Act of 1965, as amended, defines an HBCU as “any historically black college or university that was established prior to 1964, whose principal mission was, and is, the education of black Americans, and that is accredited by a nationally recognized accrediting agency or association.” The first HBCU, now called Cheyney University, was founded in Pennsylvania in 1837, although most black colleges were founded after the Civil War and are located in the South. Many HBCUs have religious affiliations. The African Methodist Episcopal Church established several schools, including Morris Brown College, Paul Quinn College, Wilberforce University, and Edward Waters College. The Colored Methodist Episcopal Church (renamed the Christian Methodist Episcopal Church in the 1950s) and the African Methodist Episcopal Zion Church set up black colleges as well. Northern white benevolent groups, including the American Missionary Association and the Presbyterian Board of Missions for Freedmen, also founded black colleges. Black colleges stand out for the social, cultural, political, and economic contributions they have made to the world. Some of the most well-known writers and artists of the Harlem Renaissance, including Langston Hughes and James Weldon Johnson received their training at HBCUs. Six historically black Greek-lettered organizations were founded on black college campuses. A host of the most successful coaches and athletes in American history developed their skills and set records at these institutions. Despite these successes, many HBCUs faced extreme financial hardship and declining enrollment beginning in the 1970s because of desegregation in higher education. Interestingly, black students began to enroll at white institutions in large numbers during this period because of the successful efforts of HBCU graduates to dismantle Jim Crow. In the 21st century, HBCUs enroll students of every ethnicity and nationality. The list of HBCU alumni who have made significant contributions to the United States and to the world is long. Notable graduates include US Supreme Court Justice Thurgood Marshall, Nobel Prize and Pulitzer Prize–winning author Toni Morrison, US Senator Kamala Harris, and Nnamdi Azikiwe, Nigeria’s first president.
Politics of Extraction: Theories and New Concepts for Critical Analysis
Authors: Kröger Markus
Published: August 2020

The politics of extraction have not been in the limelight of international relations (IR) theory or scholarship. This situation is starting to change, however, with the rapid expansion of climate change, which has started to make it impossible to discuss any key topic of IR without taking the changing planet and environment seriously into consideration, even placing this as the key issue, for example by interweaving world-ecology within theories. An increasing number of IR scholars are calling climate change an imminent emergency and catastrophe that is already starting to have major impacts on global politics. The linkages between politics of extraction, globally expanding extractivisms, and the climate and ecological crises are not always straightforward, as much of the new extraction is taking place under the label of sustainability, bioeconomy, or green economy transitions. These politics can involve however dire land conflicts with enclosures, violence and armed struggles around the establishment of so-called green energy plantations, capacities for biofuel production, or extensive tree plantations displacing forests, in the name of fighting climate change. This has led to major conflicts between many carbon-focused climate policies and indigenous communities, for example. Several new schools of theorizing have risen to explain and follow these politics in the interface of global extractivisms, land rushes, green grabs, resource scrambles, and carbon, energy, and climate interfaces. Uncovering the dynamics of these politics in the interface of current climate and ecological crises and their solution attempts requires critical theoretical approaches. After an overview of journals, books, databases, and methodology, major theoretical approaches and the differences between them are surveyed, including the literature on global environmental governance, political ecology, and the Marxist and post-Cartesian approaches. Finally, the latest and most important concepts used to study the politics of extraction are explored. These organizing concepts include land grabbing, extractivism, resource frontiers, and the green economy, and their analysis crosses many fields and has provided much development in the field of the politics of extraction in recent years. This field is evolving rapidly, and concepts such as extractivism are gaining ground in a rising number of different applications and theoretical advancements. The methods, theoretical approaches, and organizing concepts reviewed here can be used for different types of analyses of natural resource politics across differing sectors and targets of extraction, which are assessed in detail in the Oxford Bibliographies article “Natural Resources, Energy Politics, and Environmental Consequences.”
Socioeconomic Inequalities in Adolescent Health
Authors: Wold Bente , Samdal Oddrun
Published: August 2020

Among adults, there is solid evidence of socioeconomic inequalities in health, with regard to both objective measures (such as mortality and morbidity) and subjective measures (such as self-rated health, health complaints, well-being, and health behaviors). Socioeconomic inequalities denote a range of differences in socioeconomic status (SES) linked with a person’s work experience and economic and social position in relation to others, based on income, education, wealth, and occupation. During adolescence, socioeconomic inequalities in health may be less profound, partly because adolescents (in the Western world) generally are in good health. Moreover, adolescents are in a transit position between the SES of their family of origin and the SES they obtain as adults, and upward or downward social mobility may mask inequalities in this specific period. Nevertheless, adolescence is regarded as a pivotal life phase in the development of health inequalities. Such inequalities probably reflect a way of life that is caused both by life choices and by life opportunities. Life opportunities refer to social position and access to resources in the environment, which may differ widely among adolescents and thus limit or enable their potential for healthy development. Adolescence is a crucial period for making important life choices in terms of education and occupation, as well as choices of lifestyle (including health habits such as food consumption, physical activity, or drug use). The combination of vulnerable life circumstances and unwise life choices is likely to yield negative consequences for adolescent health, and, during the life course, these accumulate to produce poorer adult health, compared to a combination of growing up in a prosperous environment and making choices that are conducive to good health. Globalization and economic and political development lead to changes in “modern” values, including an increasing emphasis on quality of life, self-expression, and freedom of choice. While such development may infer increased opportunities for adolescents to achieve good health and well-being, it can also marginalize those who do not have the capability to “make it” on their own, rendering significant segments of the populations at risk and creating a new type of health inequality.
Charity and Shame: Towards Reciprocity
Authors: Parsell Cameron , Clarke Andrew
Published: August 2020

Across rich nations with welfare states, charity continues as a dominant force in the lives of people who are poor. Inadequate state welfare and high housing costs drive people in poverty to seek daily support from charities. Based on in-depth interviews with 24 volunteers providing charity and 57 people receiving charity in Australia, as well as on observations of the provision and receipt of charity in practice, this article examines the experiences and meaning of charity from those who provide and receive it. The analysis shows that people receiving charity feel shame, and this shame derives from the judgements of volunteers and the position of recipients as passively receiving what is given. The findings also show that some volunteers actively engage with recipients to mitigate shame, and the dynamic interaction between provider and receiver of charity can reduce the shame people experience. Despite these successes in mitigating shame, the unidirectional provision of charity to people in poverty fails to take account of the value people place – and society expects – on reciprocity. Prioritizing the interests of those in poverty who receive charity, the article argues for the necessity of transforming charity to create conditions for reciprocity.
Inhibition of rat brain and human red cell acetylcholinesterase by thiocarbamate herbicides
Authors: Lock Edward A
Published: August 2020

Thiocarbamates are a major class of herbicides that were used extensively in the agricultural industry. Toxicological evaluation showed molinate caused reproductive impairment in male rats, whilst others produced behavioural effects at high doses. Rats dosed with molinate either as a single large oral dose of 100 mg/kg or as multiple doses of 50 mg/kg for 7 days produced inhibition of brain acetylcholinesterase (AChE). Molinate and other thiocarbamate herbicides undergo metabolism to form sulphoxides that can carbamoylate thiol’s such as glutathione and proteins. We have chemically synthesised the sulphoxide and sulphone metabolites of six thiocarbamate herbicides and examined their ability to inhibit rat brain and human red cell AChE in vitro. Parent thiocarbamates were inactive, whilst the sulphoxides produced inhibition with IC50’s in the 1–10 mM range, the sulphone metabolites were the most active with IC50’s for molinate, pebulate, EPTC and vernolate in the μM range. Inhibition was both time- and dose-dependent with biomolecular rate constants for the inhibition of the human red cell enzyme of 0.3 × 102 and 2.0 × 102 M−1 min−1 for molinate sulphoxide and sulphone, respectively. No recovery of enzyme activity, with either enzyme, was seen following dilution of the inhibitor to a concentration that does not inhibit the enzyme for up to 24 h at 25°C at pH 7.4. The metabolites of these thiocarbamate herbicides are rather poor inhibitors of AChE when compared to the organophosphorus ester, paraoxon or the monomethylcarbamate, eserine. Unlike eserine the inhibition produced by the thiocarbamates is irreversible.
Integrative taxonomy and phylogeography of Colomys and Nilopegamys (Rodentia: Murinae), semi-aquatic mice of Africa, with descriptions of two new species
Authors: Giarla Thomas C , Demos Terrence C , Monadjem Ara , Hutterer Rainer , Dalton Desiré , Mamba Mnqobi L , Roff Emily A , Mosher Frank M , Mikeš Václav , Kofron Christopher P , Kerbis Peterhans Julian C
Published: August 2020

The semi-aquatic African murine genera Colomys and Nilopegamys are considered monotypic and thought to be closely related to one another. Colomys occurs across forested regions of equatorial Africa, whereas Nilopegamys is known only from the Ethiopian holotype, making it among the rarest mammalian genera in the world – and possibly extinct. Using morphological and genetic data, we reassess the taxonomy of Colomys and Nilopegamys. A multilocus phylogeny with outgroups demonstrates that Nilopegamys is sister to Colomys. In addition, we recognize at least four morphologically diagnosable and genetically distinct species within Colomys: C. eisentrauti (elevated from subspecies and restricted to north-west Cameroon), C. goslingi (with a more restricted range than previously reported) and two new species (one from Liberia and Guinea and one from central and southern Democratic Republic of the Congo and Angola). We also review the status of four other taxa currently recognized within Colomys goslingi (bicolor, denti, goslingi and ruandensis) and demonstrate that these names lack phylogenetic and/or morphological support. Finally, we discuss potential biogeographic barriers that may have played a role in the evolution of Colomys and Nilopegamys, emphasizing the importance of rivers in both facilitating and, possibly, limiting dispersal within these genera.
Artificial Intelligence and Clinical Decision Making: The New Nature of Medical Uncertainty
Authors: Harish Vinyas , Morgado Felipe , Stern Ariel D. , Das Sunit
Published: August 2020

Estimates in a 1989 study indicated that physicians in the United States were unable to reach a diagnosis that accounted for their patient’s symptoms in up to 90% of outpatient patient encounters. Many proponents of artificial intelligence (AI) see the current process of moving from clinical data gathering to medical diagnosis as being limited by human analytic capability and expect AI to be a valuable tool to refine this process. The use of AI fundamentally calls into question the extent to which uncertainty in medical decision making is tolerated. Uncertainty is perceived by some as fundamentally undesirable and thus, for them, optimal decision making should be based on minimizing uncertainty. However, uncertainty cannot be reduced to zero; thus, relative uncertainty can be used as a metric to weigh the likelihood of various diagnoses being correct and the appropriateness of treatments. Here, the authors make the argument, using as examples the experiences of 2 AI systems, IBM Watson on Jeopardy and Watson for Oncology, that medical decision making based on relative uncertainty provides a better lens for understanding the application of AI to medicine than one that minimizes uncertainty. This approach to uncertainty has significant implications for how health care leaders consider the benefits and trade-offs of AI-assisted and AI-driven decision tools and ultimately integrate AI into medical practice.
Are Some Randomized Clinical Trials Impossible?
Authors: Rios Jonathan J. , Richards B. Stephens , Stevenson David A. , Oberlander Beverly , Viskochil David , Gross Andrea M. , Dombi Eva , Widemann Brigitte C. , Plotkin Scott R. , May Collin J. , Ullrich Nicole J. , Goldstein Rachel Y. , Jain Viral , Schorry Elizabeth K.
Published: August 2020

Congenital tibial pseudarthrosis is a rare condition seen in neurofibromatosis type 1 (NF1), and treatment is complex. A randomized, placebo-controlled trial of bone morphogenetic protein (rhBMP-2; INFUSE bone graft) at time of tibial surgery was developed by the Neurofibromatosis Clinical Trials Consortium. Patients were randomized to receive rhBMP-2 that would, or would not, be added to the standard surgical procedure consisting of resection of pseudarthrosis tissue, insertion of a rigid intramedullary rod, and placement of autogenous iliac crest bone graft. Despite involvement of 16 centers with wide experience with NF1 orthopaedic management, only 5 patients (of 54 required) were able to be enrolled in the study during a 3-year time period. Because of the inability to recruit sufficient patients, this study was closed in June 2019, with plans to terminate. The obstacles that were encountered during the study are summarized. The authors question whether a randomized, placebo-controlled trial of a rare pediatric orthopaedic condition is possible to accomplish. Recommendations are provided to guide future studies of orthopaedic manifestations of NF1.

Level of Evidence: Level V.
Retrograde Femur Technique for Motorized Internal Limb Lengthening
Authors: Thaller Peter H. , Wolf Florian
Published: August 2020

Deformities of the femur that combine deviations of axis and torsion with length discrepancies are seen quite often. Nevertheless, the surgical treatment can be demanding, especially if fully implantable lengthening nails are used for simultaneous lengthening and deformity correction. The technique of retrograde insertion of a lengthening nail into the femur offers a wider range for correction and allows the treatment of even complex deformities with a single-step procedure. The key to successful application of the technique is meticulous preoperative analysis and planning. The surgical procedure should follow a standardized protocol to avoid pitfalls. A complete overview of the technique of retrograde insertion of lengthening nails into the femur is given.
Views from the Front: Inner-City and Rural Pandemic Perspectives
Authors: Egan Tim , Bonar Lynette
Published: August 2020

For populations experiencing the preexisting conditions of poverty and all its related social inequalities, the COVID-19 pandemic further complicates the delivery of healthcare. Two members of the American College of Healthcare Executives—Tim Egan, president and CEO of Roseland Community Hospital on the South Side of Chicago, Illinois, and Lynette Bonar, RN, FACHE, CEO of Tuba City Regional Health Care Corporation on the Navajo and Hopi reservations in Arizona—deal with those complications daily. Presented here together, their perspectives show resilience, cultural sensitivity, and commitment to protect the well-being of their diverse communities.
Mechanisms of myocardial infarction with nonobstructive coronary atherosclerosis: a multifaceted play of different actors with guarded prognosis
Authors: Opolski Maksymilian P.
Published: August 2020

Purpose of review

Myocardial infarction (MI) with nonobstructive coronary atherosclerosis (MINOCA) on invasive angiography (stenosis severity <50%) is a heterogenous clinical entity with a prevalence between 6 and 8% of all MI. Whereas the long-term prognosis of MINOCA is not benign, the identification of its underlying mechanism is critical for appropriate risk stratification and tailored secondary prevention strategies.

Recent findings

The current review summarizes the contemporary data on the mechanisms, diagnosis, management strategies and outcomes of MINOCA.

MINOCA is a relatively common form of MI with guarded prognosis. The use of additional diagnostic tests (particularly intracoronary imaging and cardiac magnetic resonance) is paramount to determine the exact cause of MINOCA and implement tailored medical interventions.
Nonimmune-acquired factor XIII deficiency: a cause of high volume and delayed postoperative hemorrhage
Authors: Chuliber Fernando A. , Schutz Natalia P. , Viñuales Estela S. , Penchasky Diana L. , Otero Victoria , Villagra Iturre Maximiliano J. , López Marina S. , Mezzarobba Daniela , Barrera Luis H. , Privitera Verónica , Arbelbide Jorge A. , Martinuzzo Marta E.
Published: August 2020

Factor XIII (FXIII) levels may decrease because of surgical consumption. Acquired FXIII deficiency could be a cause of postoperative hemorrhage usually underdiagnosed in clinical practice. To determine the diagnosis confirmation rate of acquired FXIII deficiency in postsurgical patients with clinical suspicion and to compare the characteristics and evolution of patients with or without FXIII deficiency. We performed a retrospective cohort study, which included 49 inpatients who were attended at our university hospital from 2014 to 2018 with suspicion of acquired FXIII deficiency because of disproportionate postoperative hemorrhage. FXIIIA levels less than 50% was considered a deficiency. Persistence of bleeding for more than 48 h, drop in hematocrit points, red blood cells transfused units, hemoglobin levels 12–36 h after bleeding, and time elapsed from the procedure to the bleeding were assessed as outcome variables. Logistic regression was employed for both univariate and multivariate analyses. Of the 49 patients included, 27(55%) had FXIII deficiency, with a median level of 34% [interquartile range (IQR) 19–42]. Abdominal surgery was the most common [n = 21 (43%)]. All patients had routine coagulation tests within the hemostatic range. FXIII deficiency was associated with a drop of more than 4 points in hematocrit [OR 59.69 (95% CI 4.71–755.30)], red blood transfused units >2 [OR 45.38 (95% CI 3.48–590.65)], and delayed bleeding >36 h after surgery [OR 100.90 (95% CI 3.78–2695.40)]. Plasma-derived FXIII concentrate was administered to eight patients with life-threatening bleeding with resolution within 24 h. Only one deficient patient died from bleeding. FXIII levels were measured 15 days after diagnosis or more in 20 out of 27 deficient patients, with normal results. Acquired FXIII deficiency may be a frequent underdiagnosed entity that should be considered when high-volume and delayed postoperative hemorrhage is present in patients with hemostatic routine coagulation test results.
Therapeutic hypothermia for cardiac arrest due to non-shockable rhythm
Authors: Zhu Yibing , Huang Huibin , Feng Jingzhi , Ren Yu , Li Wei
Published: August 2020

Background:

The effectiveness of therapeutic hypothermia (TH) for patients following cardiac arrest with non-shockable rhythm is debated. We plan to conduct a systematic review and meta-analysis with all available randomized controlled trials (RCTs) to explore the efficacy and safety of TH in in this population.

Methods:

PubMed, EMBASE and Cochrane Library will be searched to identify RCTs published from inception through December 2020 without language restriction. Patients following cardiac arrest due to non-shockable rhythm will be included. The primary outcome is the hospital mortality. The secondary outcome is the favorable neurological outcome. The pooled effects will be analyzed as mean differences using the inverse-variance method for continuous data or as risk ratios using the Mantel–Haenszel method for dichotomous data. Subgroup and sensitivity analyses will be conducted. The Egger's test and/or the funnel plot will be used to test the publication bias. The grades of recommendation assessment, development, and evaluation (GRADE) methodology will be used to assess the quality of evidence. The trial sequential analysis will be used to test whether the meta-analysis is conclusive.

Results:

The RCTs on the effectiveness of TH for patients following cardiac arrest with non-shockable rhythm will be systematically reviewed and advance evidence will be provided.

Conclusion:

Advanced evidence of TH for cardiac arrest due to non-shockable rhythm will be provided for physicians.

PROSPERO registration number:

CRD42020161823.
Relationship between saline infusion and blood pressure variability in non-critically patients with hypertension
Authors: Wu Jianhua , Nie Junjie , Wang Yue , Zhang Yingpei , Wu Dongfang
Published: August 2020

Saline is a commonly used intravenous solvent, however, its excessive infusion may increase drug-induced sodium intake. To investigate the effects of saline infusion on blood pressure variability (BPV) in patients with hypertension, a retrospective study was performed in 1010 patients with hypertension. The patients who received saline infusion before surgery for continuous 3 to 5 days were divided into 2 groups according to the saline infusion volume during the hospitalization, which are >500 mL per day group and <500 mL per day group. The overall incidence of abnormal BPV was 11.58%. As for the incidence of abnormal BPV in the <500 mL per day group with 698 patients was 9.17%, while that in the >500 mL per day group with 312 patients was as high as 16.99%. Additionally, >500 mL of daily saline infusion for continuous 3 to 5 days (Pfor trend = .004, odds ratio [OR] = 1.911, 95% confidence interval [CI] for OR 1.226–2.977), medical history of diabetes mellitus (P < .001, OR = 4.856, 95% CI for OR 3.118–7.563) and cardiovascular diseases (P < .001, OR = 2.498, 95% CI for OR 1.549–4.029) may be risk factors of abnormal BPV; while anti-hypertensive therapy with diuretics (P < .001, OR = 0.055, 95% CI for OR 0.024–0.125) may be the protective factor. Our study suggests that >500 mL of daily saline infusion for continuous 3 to 5 days may have disadvantages in the blood pressure control for hypertensive patients, especially for the patients with diabetes mellitus and cardiovascular diseases.
Long-term patient-reported outcomes following laparoscopic cholecystectomy
Authors: Han In Woong , Lee Hyeon Kook , Park Dae Joon , Choi Yoo Shin , Lee Seung Eun , Kim Hongbeom , Kwon Wooil , Jang Jin-Young , Lee Huisong , Heo Jin Seok
Published: August 2020

Several studies have reported short-term results for post-cholecystectomy symptoms and quality of life (QoL). However, reports on long-term results are still limited. This study aimed to identify risk factors affecting short- and long-term patient-reported outcome (PRO) following laparoscopic cholecystectomy.

From 2016 to 2017, a total of 476 patients from 5 institutions were enrolled. PRO was examined using the Numeric Rating Scale (NRS) pain score and the Gastrointestinal (GI) QoL Index questionnaire at postoperative 1 month and 1 year.

Most of patients recovered well at postoperative 1 year compared to postoperative 1 month for the NRS pain score, QoL score, and GI symptoms. A high operative difficulty score (HR 1.740, P = .031) and pathology of acute or complicated cholecystitis (HR 1.524, P = .048) were identified as independent risk factors for high NRS pain scores at postoperative 1 month. Similarly, female sex (HR 1.571, P = .003) at postoperative 1 month and postoperative complications (HR 5.567, P = .001) at postoperative 1 year were independent risk factors for a low QoL. Also, age above 50 (HR 1.842, P = .001), female sex (HR 1.531, P = .006), and preoperative gallbladder drainage (HR 3.086, P = .001) were identified as independent risk factors for GI symptoms at postoperative 1 month.

Most patients showed improved long-term PRO measurement in terms of pain, QoL, and GI symptoms. There were no independent risk factors for long-term postoperative pain and GI symptoms. However, postoperative complications were identified to affect QoL adversely at postoperative 1 year. Careful and long-term follow up is thus necessary for patients who experienced postoperative complications.
Clinical relevance of multi-drug resistance gene C3435T polymorphism in diffuse large B-cell lymphoma in Xinjiang
Authors: Liu Wei , Li Yan , Zhao Zhenhui , Li Xun
Published: August 2020

To explore the relationship between C3435T polymorphism of multi-drug resistance gene (MDR1) gene and susceptibility, clinicopathological characteristics, curative effect and hematological toxicity of diffuse large B-cell lymphoma (DLBCL) in XinJiang.

The peripheral venous blood samples of 54 patients with DLBCL and 60 healthy controls were collected. The alleles and genotypes of MDR1 gene C3435T were detected by DNA direct extraction with PCR technique, and the frequency of C3435T allele and genotypes were detected by the chi-square test. The relationship between the allele and genotype distribution of C3435T locus and the susceptibility, clinicopathological characteristics, curative effect and hematological toxicity of DLBCL were analyzed.

1 the frequency of CT heterozygote and CC homozygote mutation was significantly higher in the case group (46.3% in CT genotype and 42.6% in CC genotype) compared to the control group (P < 0.05). The frequency of CC genotype mutation in the case group was 42.6%, which was significantly higher than that in the control group (P < 0.05, OR 3.209, 95% CI: 1.288-7.997). 2 the genotypes of C3435T locus of MDR1 gene were distributed in age, sex, nationality, pathological characteristics, clinical-stage, IPI index, B symptoms, infection with EB virus, clinicopathological characteristics and clinical efficacy of hepatitis B in patients with DLBCL. There was no significant difference in myelosuppression (P > 0.05).

The homozygous mutation genotype of CC is the risk genotype of DLBCL. The alleles and genotypes are not associated with the clinicopathological characteristics, efficacy and myelosuppression toxicity of DLBCL.
Efficacy and safety of ACEI/ARB drugs in patients with COVID-19 combined with diabetes mellitus
Authors: Yang Yan , Liu Xiaoke , Liu Yan , Chen Yalin , Tian Yuan , Fu Xiaoxu , Zhong Wen , Xie Chunguang
Published: August 2020

Background:

Novel coronavirus pneumonia (COVID-19) has become a worldwide epidemic, causing huge loss of life and property. Because of its unique pathological mechanism, diabetes affects the prognosis of patients with COVID-19 in many aspects. At present, there are many controversies about whether angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) should be used in the treatment of patients with diabetes mellitus and COVID-19 comorbidities. There is an urgent need to provide evidence for the use of ACEI/ARB through high-quality systematic evaluation and meta-analysis.

Methods:

We will search electronic databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang database using keywords related to COVID-19, diabetes mellitus, ACEI/ARB drugs, and randomized controlled trials . We will manually search gray literature, such as conference proceedings and academic degree dissertations, and trial registries. Two independent reviewers will screen studies, extract data, and evaluate risk of bias. Data analysis will be conducted using the Review Manager software version 5.3.5 and stata 14.0 software for Mac. Statistical heterogeneity will be assessed using a standard chi-square test with a significance level of P < .10. Biases associated with study will be investigated using funnel plots.

Results:

This study will provide a high-quality synthesis of efficacy and safety of ACEI/ARB drugs in patients with COVID-19 combined with diabetes mellitus, providing evidence for clinical treatment of diabetes mellitus combined with COVID-19. And the results will be published at a peer-reviewed journal.

Conclusion:

Our study will draw conclusions on the efficacy and safety of ACEI / ARB drugs in patients with diabetes mellitus complicated with covid-19, so as to provide theoretical guidance for clinical practice of diabetes mellitus with covid-19.

INPLASY registration number:

INPLASY 202060111.
Anorexia nervosa manifesting as massive ascites, hypercholesterolemia, and sequential binge eating in an 11-year-old girl
Authors: Fan Hung-Hao , Lin I-Cheng , Chen Jing-Er , Lee Wei-Hua , Fang Shiuh-Bin
Published: August 2020

Rationale:

Anorexia nervosa (AN) is a serious eating disorder associated with a distorted body image. Hypercholesterolemia has been found in patients with AN but the mechanism of hyperlipidemia in AN remains little known. Ascites in patients with AN has been attributed to hypoalbuminemia and liver diseases, but massive ascites without the aforementioned etiologies has never been reported in AN.

Patient concerns:

An 11-year-old girl was admitted for exclusion of organic underlying diseases due to severe body weight loss (18% within 3 weeks), poor appetite, and hypercholesterolemia (274 mg/dL). She complained of heartburn sensation, nausea, vomiting, constipation, and postprandial dull abdominal pain with fullness.

Diagnoses:

The patient's condition met with all 3 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for diagnosing AN. On admission, her total cholesterol level was 337 mg/dL and hypocomplementemia (C3 55.5 mg/dL) was also found. Abdominal sonography and computed tomography scans showed massive ascites. However, neither proteinuria nor hypoalbuminemia was found. Upper gastroduodenal endoscopy showed chronic superficial gastritis and colonoscopy revealed negative findings. Ascites obtained by paracentesis demonstrated a transudate without bacterial infection, tuberculosis, or pancreatitis. Exploratory laparoscopy showed nonpurulent ascites. However, biopsies from the small intestine, mesentery, and liver showed chronic inflammation and fibrosis.

Interventions:

The intensive nutritional therapy by increasing total energy intake stepwise with a combination of high-energy formula and her favorite foods.

Outcomes:

Her hypercholesterolemia, hypocomplementemia, and massive ascites resolved after her weight was restored. She developed binge eating with continuous weight gain after discharge. Her weight significantly increased to an obese level (body mass index [BMI] 25.9 kg/m2) after loss to follow-up for 4 years until she returned to our emergency room due to suicide attempt.

Conclusion:

Diagnostic crossover between subtypes in anorexia nervosa might be a potential risk factor for illness severity and poor prognosis. AN can manifest as massive ascites with normal albumin concentrations that could possibly be due to chronic inflammation of the intestinal serosa, mesentery, and peritoneal surface of the liver.
Application effect of catgut-embedding therapy combined with minimally invasive surgery for slow transit constipation
Authors: Xie Yanpeng , Fan Yihua , Fan Wei , Yang Xiangdong , Xiang Yanfei , Zhao Tianyu
Published: August 2020

Background:

Catgut-embedding therapy combined with minimally invasive surgery has been used for treating slow transit constipation (STC) widely. However, the application effect of catgut-embedding therapy combined with minimally invasive surgery for STC are unclear. This study aims to evaluate the application effect of catgut-embedding therapy combined with minimally invasive surgery for STC.

Methods:

Randomized controlled trials of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC will be searched in PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database from inception to July, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3.

Results:

This study will summarize the present evidence by exploring the application effect of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC.

Conclusions:

The findings of the study will provide helpful evidence for the application effect of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC, facilitating clinical practice and further scientific studies.

Ethics and dissemination:

The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/7HVZB
Low correlation between biometric parameters, cardiovascular risk factors and aortic dimensions by computed tomography coronary angiography
Authors: Forte Ernesto , Punzo Bruna , Salvatore Marco , Maffei Erica , Nistri Stefano , Cavaliere Carlo , Cademartiri Filippo
Published: August 2020

To analyze the relationship between aortic measures and biometric parameters in a large cohort of consecutive patients undergoing computed tomography coronary angiography.

1170 patients (717 men/453 women) performing computed tomography coronary angiography for coronary evaluation were retrospectively evaluated. Aortic diameters and areas were measured at reproducible anatomic landmarks, perpendicular to the axis of vessel, at the level of the aortic root (AoR), the sinotubular junction (STJ), and the tubular ascending aorta (TAo). Biometric parameters and cardiovascular risk factors were recorded.

The average values of AoR, STJ, and TAo were 35.63 ± 5.00 mm, 30.56 ± 4.82 mm, 35.07 ± 5.84 mm. Hypertension was significantly associated with aortic dimensions.

Aortic measures were significantly different between men and women (37.56 ± 4.77 mm vs 32.58 ± 3.68 mm for AoR, 31.88 ± 4.84 mm vs 28.47 ± 3.98 mm for STJ and 35.93 ± 5.86 mm vs 33.70 ± 5.54 mm for TAo) (P < .001) and linearly increased with age. Low Spearman correlation coefficients were found and the correlation of TAo diameters with age displayed the highest values (ρ = 0.372 for male and ρ = 0.373 for female, P < .001). Multiple linear regression analysis models were compared by R
2. The best model used body surface area (BSA) and age as independent variables and TAo diameter as dependent variable (R
2 = 0.29 for AoR; R
2 = 0.21 for STJ, and R
2 = 0.20 for TAo).

In conclusion, in our population low correlation between aortic dimensions and biometric parameters highlights the difficulty of identifying normal ranges, as well as issues related to normalization using conventional biometric parameters.
Perioperative patient blood management during parallel transverse uterine incision cesarean section in patient with pernicious placenta previa
Authors: Ma Yushan , Luo Xi , Jiang Xiaoqin , Liu Hui , Wu Lan
Published: August 2020

Pernicious placenta previa (PPP) is the main cause of severe obstetric postpartum hemorrhage and hysterectomy and often requires donor blood transfusion. Prophylactic internal iliac artery (IIA) balloon occlusion (BO) combined with cell salvage is increasingly being deployed in parallel transverse uterine incision (PTUI) cesarean section (CS). The aim of this study was to explore the differences in blood management in PTUI CS with or without prophylactic IIA BO and to evaluate the safety and efficacy of cell salvage to reduce the need for donor blood transfusion during PTUI CS.

This retrospective study included all women who were diagnosed with PPP and PA and underwent PTUI CS from October 1, 2016, to October 31, 2018. Sixty-four patients were included: 34 underwent prophylactic IIA BO (IIA group), whereas 30 were treated without prophylactic IIA BO (control group). The primary outcome was a composite measure of perioperative blood management outcomes, including the estimated blood loss (EBL), donor blood transfusion, salvaged blood returned, fresh frozen plasma (FFP), pre- and postoperative serum hemoglobin and hematocrit. In addition, the baseline conditions of mother and neonates were compared.

EBL was significantly higher in the IIA group compared to the control group (2883.5 mL in the IIA group vs 1868.7 mL in the control group, P = .001). Overall, the donor blood transfusion rate was 23.5% (8/34), averaging 4.2 U, in the IIA group versus 30% (9/30), averaging 3.4 U, in the control group, which were not significantly different. The FFP transfusion rate was 47%, averaging 765.6 mL, in the IIA group versus 20%, averaging 816.7 mL, in the control group. In the IIA group, 97.1% used cell savage and had salvaged blood returned, averaging 954.9 mL. In the control group, 90% had salvaged blood returned, averaging 617.9 mL. No cases of amniotic fluid embolism were observed with leukocyte depletion filters.

Prophylactic IIA BO during PTUI CS in women with PPP and PA does not lead to a statistically significant reduction in EBL. Cell salvage was associated with a reduction in the rate of donor blood transfusion during PTUI CS.
Follicular dendritic cell sarcoma in the right chest wall
Authors: Xu Hongli , Chen Bin , Jiang Chengwei , Yang Zhaoying , Wang Keren
Published: August 2020

Rationale:

Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor that originates from germinal center follicular dendritic cells, and can occur at both nodal and extranodal sites. There are very few described cases of FDCS arising in the chest wall.

Patient concerns:

A 44-year-old male patient presented with a history of right chest wall pain for 5 months.

Diagnoses:

Positron emission tomography/computed tomography showed a significant increase in 18F-fluorodeoxyglucose uptake and multiple small axillary lymph nodes without hypermetabolic lesions. Immunohistochemistry results of a core-needle biopsy indicated FDCS, which was consistent with the postoperative pathological examination.

Interventions:

The patient underwent tumor resection with lymphadenectomy of level I axillary nodes. No metastasis in the lymph nodes was observed in the postoperative pathological examination. The patient did not accept chemotherapy or radiotherapy.

Outcomes:

After 18 months, the patient remains in good condition with no evidence of disease recurrence.

Lessons:

This report highlights a rare case of a FDCS arising in the chest wall. Accurate clinical diagnosis and staging of this rare malignant sarcoma is essential for the developmnt of effective treatment strategies. Preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography scanning combined with core-needle biopsy could provide differentiation between benign and malignant tumors, as well as lymph node involvement and metastatic status.
Familial hypocalciuric hypercalcemia caused by homozygous CaSR gene mutation
Authors: Wang Feifei , Hu Jia , Mei Chao , Lin Xia , Zhang Ling
Published: August 2020

Introduction:

Familial hypocalciuric hypercalcemia (FHH) is a group of autosomal dominant genetic diseases with persistent hypercalcemia and hypocalciuria. The calcium-sensitive receptor (CaSR) plays an important role in calcium and phosphorus metabolism.

Patient concerns:

A 32-year-old man who had diabetes was admitted to our hospital due to poor glycemic control, and was found to have hypercalcemia, hypophosphatemia, and hyperparathyroidism. Single-Photon Emission Computed Tomography (SPECT) (99-mTcMIBI) examination result was negative. The result of 24-h urine calcium was 2.18 mmol/24 h, and the 24-h urinary calcium to creatinine ratio (UCCR) was 0.006. Family survey showed that all of the family members had hypercalcemia.

Diagnosis:

The CaSR gene mutation study revealed that the proband had a homozygous mutation for a T>C nucleotide substitution at c.1664 in exon 6, while both the mother and the father had heterozygous mutations at the same site of exon 6. The clinical diagnosis was considered to be FHH type1.

Interventions:

The patient was treated with conventional calcium-lowering therapy which was not effective. Cinacalcet was suggested but not used. The patient received salmon calcitonin nasal spray and furosemide tablets treatment for 1 month after discharge, and then stopped the medication.

Outcomes:

On follow up 4 months after being discharged, the serum calcium level was 3.18 mmol/L, and the PTH level was 275.4 ng/mL. He had felt fatigued, intermittent abdominal pain and lost 3.9 kg of weight.

Conclusion:

This case studied a family with FHH, and the CaSR gene c.1664T>c mutation was the possible pathogenic cause. If parathyroid location examination is unclear for hyperparathyroidism, the possibility of FHH should be considered. For FHH patients, conventional calcium reduction therapy was ineffective and parathyroid surgery cannot alleviate their hypercalcemia.