bluuebunny/crossref_metadata_2025 huggingface dataset:
Leveraging Administrative Capacity to Manage Landscape-Scale, Cross-Boundary Disturbance in the Black Hills: What Roles for Federal, State, Local, and Nongovernmental Partners?
Authors: Steen-Adams M M , Abrams J B , Huber-Stearns H R , Bone C , Moseley C
Published: August 2021

Public land management agencies, such as the USDA Forest Service (USFS), confront challenges in leveraging limited administrative capacity to effectively manage landscape-scale, cross-boundary disturbances. Using case study methods, we investigated the ~1996–2016 outbreak of mountain pine beetle (Dendroctonus ponderosae Hopkins) in the Black Hills, a 1.5 million acre region in South Dakota and Wyoming. We identified four practices that can promote the leveraging of administrative capacity: (1) establishing multilevel governance networks; (2) performing both distinct and shared (“redundant”) partner roles; (3) maximizing the collaborative toolbox: drawing upon the variety of policy tools (older, newer) and modes of use (conventional, experimental); and (4) engaging a multilevel, multiorganizational network, with attention to the ways that a variety of network linkages can deploy a variety of policy tool types. This case demonstrates how the government-led model of network governance can be applied to leverage administrative capacity. These findings point to strategies to promote landscape-scale, cross-boundary management.
Effects of latitude and soil microbes on the resistance of invasiveSolidago canadensisto its co-evolved insect herbivoreCorythucha marmorata
Authors: Yuan Yongge , Jin Huifei , Li Junmin
Published: August 2021

There is an increasing likelihood that invasive plants are again exposed to their co-evolved specialist herbivores in the non-native range. However, whether there is a latitudinal pattern associated with the resistance of an invasive plant to its co-evolved herbivores and how soil microbes affect resistance has been little explored. We hypothesized that the resistance of invasive Solidago canadensis to its co-evolved insect herbivore Corythucha marmorata could increase with latitude, and that local rhizosphere microbes could facilitate invasive plants to become resistant to their co-evolved herbivores. We conducted a field survey and a greenhouse experiment to examine whether there was a latitudinal pattern in the abundance of C. marmorata and in the damage it caused to S. canadensis in China. We tested whether local rhizosphere microbes of invasive plants can promote the resistance of S. canadensis to C. marmorata herbivory. In the field survey, both density of C. marmorata and damage level of S. canadensis were positively correlated with latitude, and with S. canadensis plant growth, indicating a latitudinal pattern in the resistance of S. canadensis to C. marmorata. However, in the greenhouse experiment, S. canadensis from different latitudes did not suffer significantly from different levels of damage from C. marmorata. Additionally, the damage level of S. canadensis was lower when rhizosphere soil and rhizomes originated from field S. canadensis with same damage level than with different damage levels. This result indicates that local rhizosphere soil microbes promote the adaptation of S. canadensis to resistance of C. marmorata.
Interactions between invasive plants and heavy metal stresses: a review
Authors: Li Jian , Leng Zhanrui , Wu Yueming , Du Yizhou , Dai Zhicong , Biswas Asim , Zheng Xiaojun , Li Guanlin , Mahmoud Esawy Kasem , Jia Hui , Du Daolin
Published: August 2021

Global changes have altered the distribution pattern of the plant communities, including invasive species. Anthropogenic contamination may reduce native plant resistance to the invasive species. Thus, the focus of the current review is on the contaminant biogeochemical behavior among native plants, invasive species and the soil within the plant–soil ecosystem to improve our understanding of the interactions between invasive plants and environmental stressors. Our studies together with synthesis of the literature showed that (i) the impacts of invasive species on environmental stress were heterogeneous, (ii) the size of the impact was variable and (iii) the influence types were multidirectional even within the same impact type. However, invasive plants showed self-protective mechanisms when exposed to heavy metals (HMs) and provided either positive or negative influence on the bioavailability and toxicity of HMs. On the other hand, HMs may favor plant invasion due to the widespread higher tolerance of invasive plants to HMs together with the ‘escape behavior’ of native plants when exposed to toxic HM pollution. However, there has been no consensus on whether elemental compositions of invasive plants are different from the natives in the polluted regions. A quantitative research comparing plant, litter and soil contaminant contents between native plants and the invaders in a global context is an indispensable research focus in the future.
Cosmological impact of redshift drift measurements
Authors: Esteves J , Martins C J A P , Pereira B G , Alves C S
Published: August 2021

The redshift drift is a model-independent probe of fundamental cosmology, but choosing a fiducial model one can also use it to constrain the model parameters. We compare the constraining power of redshift drift measurements by the Extremely Large Telescope (ELT), as studied by Liske et al., with that of two recently proposed alternatives: the cosmic accelerometer of Eikenberry et al., and the differential redshift drift of Cooke. We find that the cosmic accelerometer with a 6-yr baseline leads to weaker constraints than those of the ELT (by 60 per cent); however, with identical time baselines it outperforms the ELT by up to a factor of 6. The differential redshift drift always performs worse than the standard approach if the goal is to constrain the matter density; however, it can perform significantly better than it if the goal is to constrain the dark energy equation of state. Our results show that accurately measuring the redshift drift and using these measurements to constrain cosmological parameters are different merit functions: an experiment optimized for one of them will not be optimal for the other. These non-trivial trade-offs must be kept in mind as next-generation instruments enter their final design and construction phases.
Combination of Developmental Behaviors and Transcriptome Reveals Differential Response Mechanisms of Phytophthora sojae to Aspartic Acid and Glucose in Seed Exudates
Authors: Gao Xinying , Liu Haixu , Yu Han , Zhang Zhuoqun , Bi Xiangqi , Zhao Yifan , An Tai , Wen Jingzhi
Published: August 2021

Isoflavones in soybean seed and root exudates are host-specific signal molecules for Phytophthora sojae to recognize its host, soybean. G protein and calcium signaling pathways are involved in the chemotaxis of zoospores in the recognition of isoflavones. The role played by non-host-specific signaling molecules (sugars and amino acids) found in seed and root exudates on zoospore chemotaxis and mycelial growth was studied. The transcriptome of P. sojae responding to aspartic acid (Asp) and glucose (Glc) was analyzed in parellel by the RNA-seq method. We found that the relative in situ concentrations of amino acids and sugars significantly promoted zoospore chemotaxis, as do isoflavones. Transcriptomics showed that both similarities and differences existed in response mechanisms of P. sojae to Asp and Glc. Asp and Glc activated mitogen-activated protein kinase signaling pathways and the phosphatidylinositol signaling system but not the G-protein signaling pathway, which have been reported to be responsible for zoospore chemotaxis. In addition, ubiquitin-mediated proteolysis and ATP binding cassette transporters were also activated by Asp and Glc. Meanwhile, the glutathione signaling pathway uniquely participated in the response of P. sojae to Asp but was not involved in the response process to Glc, which will be evaluated in another study. Our results provide new insights into the molecular mechanisms of zoospore response to Asp and Glc.
An Ultrasound-guided Percutaneous Surgical Technique for Trigger Finger Release Using a Minimally Invasive Surgical Knife
Authors: Cromheecke Michiel , Haignère Vincent , Mares Olivier , De Keyzer Pieter-Bastiaan , Louis Pascal , Cognet Jean-Michel
Published: August 2021

Triggering of the finger at the A1 pulley is one of the most frequent pathologies encountered in hand surgery and a common cause of hand pain. Open release of the A1 pulley is currently still regarded as the golden-standard procedure. Nevertheless, there is an increasing interest in minimally invasive percutaneous techniques for the treatment of this condition. Current techniques range from percutaneous needle techniques without imaging, to the use of hook knives, with ultrasound guidance. Because of concerns about possible complications or incomplete releases, hand surgeons remain wary. The objective of this study was to introduce a new ultrasound-guided percutaneous surgical technique for trigger finger release, using a second-generation minimally invasive surgical knife. In this series of 78 releases, complete resolution of the symptoms was found in 98.7% of the cases. One recurrence of triggering was observed. There were no tendon injuries, infections, or neurovascular lesions recorded. This paper contains technical pearls and possible pitfalls to ensure the surgeon of a complete release and to avoid complications. A video of the technique was also included as Supplemental Digital Content (http://links.lww.com/BTH/A143). We can conclude that the procedure can be considered as safe and highly effective for the treatment of triggering at the A1 pulley.
Antagonizing the CX3CR1 Receptor Markedly Reduces Development of Cardiac Hypertrophy After Transverse Aortic Constriction in Mice
Authors: Nemska Simona , Gassmann Max , Bang Marie-Louise , Frossard Nelly , Tavakoli Reza
Published: August 2021

Left-ventricular hypertrophy, characterized by cardiomyocyte hypertrophy, interstitial cell proliferation, and immune cell infiltration, is a high risk factor for heart failure and death. Chemokines interacting with G protein-coupled chemokine receptors probably play a role in left-ventricular hypertrophy development by promoting recruitment of activated leukocytes and modulating left-ventricular remodeling. Using the minimally invasive model of transverse aortic constriction in mice, we demonstrated that a variety of chemokine and chemokine receptor messenger Ribonucleic Acid are overexpressed in the early and late phase of hypertrophy progression. Among the chemokine receptors, Cx3cr1 and Ccr2 were most strongly overexpressed and were significantly upregulated at 3, 7, and 14 days after transverse aortic constriction. Ligands of CX3CR1 (Cx3cl1) and CCR2 (Ccl2, Ccl7, Ccl12) were significantly overexpressed in the left ventricle at the early stages after mechanical pressure overload. Pharmacological inhibition of CX3CR1 signaling using the antagonist AZD8797 led to a significant reduction of hypertrophy, whereas inhibition of CCR2 with the RS504393 antagonist did not show any effect. Furthermore, AZD8797 treatment reduced the expression of the hypertrophic marker genes Nppa and Nppb as well as the profibrotic genes Tgfb1 and Col1a1 at 14 days after transverse aortic constriction. These findings strongly suggest the involvement of the CX3CR1/CX3CL1 pathway in the pathogenesis of left-ventricular hypertrophy.
Human Angiopoietin-like Protein 3/ANGPTL3 Antibodies: Adding to the Armamentarium in the Management of Dyslipidemia
Authors: Wiggins Barbara S.
Published: August 2021

Cardiovascular (CV) disease remains the leading cause of death in the United States. In addition to lifestyle modifications, current guidelines primarily focus on lowering low-density lipoprotein cholesterol (LDL-C) to reduce atherosclerotic CV disease risk. However, despite aggressive management, a degree of residual risk remains, suggesting that focusing on lowering LDL-C alone may be inadequate and that other lipid parameters may need to be targeted. In patients who remain at high risk despite current pharmacologic options either because of inadequate response, elevated levels of other lipoproteins, or those who have genetic variants predisposing them to atherosclerotic CV disease, additional treatment strategies continue to be sought. One such group is the homozygous familial hypercholesterolemia population, especially those patients carrying the null low-density lipoprotein receptor mutation as they often fail to derive the same benefit from traditional LDL-C lower strategies such as statins and proprotein convertase subtilisin/kexin type 9 inhibitors that work by upregulating the LDL receptor. Emerging data also suggest that patients with increased levels of triglyceride-rich lipoproteins are also at increased risk as elevated levels are proposed to have a role in various pathways promoting atherogenesis. Angiopoietin-life protein 3 (ANGLTPL3) has recently become a target of interest because of the discovery that inhibiting its action leads to reductions in lipid parameters. Although the mechanism of action of ANGLTPL3 inhibitors is independent of the LDL receptor, their ability to significantly lower triglycerides and LDL-C make them an attractive option particularly in patients with homozygous familial hypercholesterolemia and hypertriglyceridemia. The efficacy and safety of 2 ANGLTPL3 inhibitor agents have been evaluated in clinical trials. In this review, the lipid lowering, metabolic effects, and safety are reported. Ongoing trials assessing CV outcomes as well as long-term safety data are still needed to provide a more definitive role for these agents in the overall management in these populations.
The Etiology of Pneumonia in HIV-uninfected Children in Kilifi, Kenya
Authors: Awori Juliet O. , Kamau Alice , Morpeth Susan , Kazungu Sidi , Silaba Micah , Sande Joyce , Karani Angela , Nyongesa Sammy , Mwarumba Salim , Musyimi Robert , Bett Anne , Wande Siti , Shebe Mohammed , Ngama Mwanajuma , Munywoki Patrick K. , Muturi Neema , Nokes D. James , Feikin Daniel R. , Murdoch David R. , Prosperi Christine , O’Brien Katherine L. , Deloria Knoll Maria , Hammitt Laura L. , Scott J. Anthony G.
Published: August 2021

Background:

In the 1980s, Streptococcus pneumoniae and Haemophilus influenzae were identified as the principal causes of severe pneumonia in children. We investigated the etiology of severe childhood pneumonia in Kenya after introduction of conjugate vaccines against H. influenzae type b, in 2001, and S. pneumoniae, in 2011.

Methods:

We conducted a case–control study between August 2011 and November 2013 among residents of the Kilifi Health and Demographic Surveillance System 28 days to 59 months of age. Cases were hospitalized at Kilifi County Hospital with severe or very severe pneumonia according to the 2005 World Health Organization definition. Controls were randomly selected from the community and frequency matched to cases on age and season. We tested nasal and oropharyngeal samples, sputum, pleural fluid, and blood specimens and used the Pneumonia Etiology Research for Child Health Integrated Analysis, combining latent class analysis and Bayesian methods, to attribute etiology.

Results:

We enrolled 630 and 863 HIV-uninfected cases and controls, respectively. Among the cases, 282 (44%) had abnormal chest radiographs (CXR positive), 33 (5%) died in hospital, and 177 (28%) had diagnoses other than pneumonia at discharge. Among CXR-positive pneumonia cases, viruses and bacteria accounted for 77% (95% CrI: 67%–85%) and 16% (95% CrI: 10%–26%) of pneumonia attribution, respectively. Respiratory syncytial virus, S. pneumoniae and H. influenza, accounted for 37% (95% CrI: 31%–44%), 5% (95% CrI: 3%–9%), and 6% (95% CrI: 2%–11%), respectively.

Conclusions:

Respiratory syncytial virus was the main cause of CXR-positive pneumonia. The small contribution of H. influenzae type b and pneumococcus to pneumonia may reflect the impact of vaccine introductions in this population.
The Etiology of Childhood Pneumonia in The Gambia
Authors: Howie Stephen R. C. , Ebruke Bernard E. , McLellan Jessica L. , Deloria Knoll Maria , Dione Michel M. , Feikin Daniel R. , Haddix Meredith , Hammitt Laura L. , Machuka Eunice M. , Murdoch David R. , O’Brien Katherine L. , Ofordile Ogochukwu , Olutunde Oluyinka E. , Parker David , Prosperi Christine , Salaudeen Rasheed A. , Shamsul Arifin , Mackenzie Grant , Antonio Martin , Zaman Syed M. A.
Published: August 2021

Background:

Pneumonia remains the leading cause of death in young children globally. The changing epidemiology of pneumonia requires up-to-date data to guide both case management and prevention programs. The Gambia study site contributed a high child mortality, high pneumonia incidence, low HIV prevalence, Haemophilus influenzae type b and pneumococcal conjugate vaccines-vaccinated rural West African setting to the Pneumonia Etiology Research for Child Health (PERCH) Study.

Methods:

The PERCH study was a 7-country case-control study of the etiology of hospitalized severe pneumonia in children 1–59 months of age in low and middle-income countries. Culture and nucleic acid detection methods were used to test nasopharyngeal/oropharyngeal swabs, blood, induced sputum and, in selected cases, lung or pleural fluid aspirates. Etiology was determined by integrating case and control data from multiple specimens using the PERCH integrated analysis based on Bayesian probabilistic methods.

Results:

At The Gambia study site, 638 cases of World Health Organization-defined severe and very severe pneumonia (286 of which were chest radiograph [CXR]-positive and HIV-negative) and 654 age-frequency matched controls were enrolled. Viral causes predominated overall (viral 58% vs. bacterial 28%), and of CXR-positive cases respiratory syncytial virus (RSV) accounted for 37%, Streptococcus pneumoniae 13% and parainfluenza was responsible for 9%. Nevertheless, among very severe cases bacterial causes dominated (77% bacterial vs. 11% viral), led by S. pneumoniae (41%); Mycobacterium tuberculosis, not included in “bacterial”, accounted for 9%. 93% and 80% of controls ≥1 year of age were, respectively, fully vaccinated for age against Haemophilus influenzae and S. pneumoniae.

Conclusions:

Viral causes, notably RSV, predominated in The Gambia overall, but bacterial causes dominated the severest cases. Efforts must continue to prevent disease by optimizing access to existing vaccines, and to develop new vaccines, notably against RSV. A continued emphasis on appropriate case management of severe pneumonia remains important.
The Etiology of Childhood Pneumonia in Mali
Authors: Tapia Milagritos D. , Sylla Mamadou , Driscoll Amanda J. , Touré Aliou , Kourouma Nana , Sissoko Seydou , Tamboura Boubou , Diakité Abdoul Aziz , Panchalingam Sandra , Keïta Adama M. , Tennant Sharon , Onwuchekwa Uma , Roose Anna , Deloria Knoll Maria , Higdon Melissa M. , Prosperi Christine , Hammitt Laura L. , Feikin Daniel R. , Murdoch David R. , O’Brien Katherine L. , Sow Samba O. , Kotloff Karen L.
Published: August 2021

Background:

We present findings from the Pneumonia Etiology Research for Child Health (PERCH) site in Bamako, Mali.

Methods:

Cases were patients 28 days to 59 months of age, admitted to hospital with severe or very severe pneumonia (2005 World Health Organization definition). Community controls were frequency matched by age. Both provided nasopharyngeal and oropharyngeal swabs for multiplex polymerase chain reaction and Streptococcus pneumoniae culture. Cases underwent blood culture and induced sputum culture for Mycobacterium tuberculosis. A subset had pleural fluid and lung aspirates collected for culture and polymerase chain reaction. Primary analyses included participants with negative or unknown HIV status (HIV−) and cases with abnormal chest radiographs (CXR+). Cases and controls were compared using logistic regression adjusting for age. Etiologic fractions were calculated by a Bayesian nested partially latent class analysis, the PERCH integrated analysis.

Results:

Between January 1, 2012, and January 14, 2014, we enrolled 241 CXR+/HIV− cases and 725 HIV− controls. Compared with controls, cases were more likely to have moderate-to-severe wasting (43.1% vs. 14.1%, P < 0.001) and stunting (26.6% vs. 9.4%, P < 0.001). Predominant etiologies were respiratory syncytial virus [24.0%; 95% credible interval (CrI): 18.3%–31.1%], S. pneumoniae (15.2%; 95% CrI: 9.5–21.6), human metapneumovirus (11.8%; 95% CrI: 8.3%–16.2%) and parainfluenza virus type 3 (9.0%; 95% CrI: 5.8%–13.3%). Case fatality was 13.3%, with Staphylococcus aureus, Pneumocystis jirovecii and Haemophilus influenzae type b predominating (40% of fatal cases).

Conclusions:

PERCH uncovered high case fatality among children with severe pneumonia in Mali, highlighting a role for new interventions (eg, respiratory syncytial virus vaccines) and a need to improve vaccine coverage and strengthen healthcare delivery.
Dermatologic Manifestations of Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis
Authors: Solhjoo Mahdis , Hojjati Mehrnaz
Published: August 2021

The antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides are a group of small-vessel vasculitides that results in inflammation of the small blood vessels.

It has a diverse range of clinical manifestations that commonly involve not only the upper airways, lungs, and kidneys but also the eyes, skin, joints, nerves, and, potentially, many other sites. This diversity is why ANCA-associated vasculitides can have such a wide scope of clinical presentations and disease severity.

Entities in this group of diseases include granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly known as Churg–Strauss syndrome).

Skin involvement is a common clinical feature in all three forms of ANCA-associated vasculitis, with various manifestations.
An organ systems-based review of outcomes associated with sleep apnea in hospitalized patients
Authors: Sheikh Maaz , Kuperberg Stephen
Published: August 2021

The current global health crisis due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has prompted the medical community to investigate the effects of underlying medical conditions, including sleep-disordered breathing, on inpatient care. Obstructive sleep apnea (OSA) is a common form of sleep-disordered breathing that may complicate numerous acquired conditions, particularly in inpatient and critical care settings. Viral pneumonia is a major contributor to intensive care unit (ICU) admissions and often presents more severely in patients with underlying pulmonary disease, especially those with obesity and OSA. This review summarizes the most recent data regarding complications of both OSA and obesity and highlights their impact on clinical outcomes in hospitalized patients. Additionally, it will highlight pertinent evidence for the complications of OSA in an organ-systems approach. Finally, this review will also discuss impatient treatment approaches for OSA, particularly in relation to the SARS-CoV-2 pandemic.
Bladder paraganglioma managed with transurethral holmium laser resection
Authors: Zhu Xin , Zhou Mi , Yu Haitao , Kuang Youlin , Chen Yong , Li Heqiu , Gou Xin
Published: August 2021

Rationale:

Bladder paraganglioma is characterized by headache, palpitations, hypertension, blurred vision, or sweating during voiding. Transurethral holmium laser resection is a safe and efficacious alternative method for the resection of bladder neoplasms.

Patient concerns:

A 24-year-old female had a 2-year history of intermittent headaches, palpitation, and sweating during micturition.

Diagnosis:

Physical examination revealed a rise in the patient's blood pressure to 180/90 mmHg after micturition. Laboratory examination found that the blood catecholamine metabolites were significantly increased. Abdominal ultrasound and computed tomography (CT) scan indicated a 37 mm × 31 mm paraganglioma situated at the right anterolateral wall of the bladder. A diagnosis of bladder paraganglioma was considered based on a comprehensive evaluation of the physical examination, laboratory examination, ultrasound and computerized tomography scan.

Interventions:

Preoperative oral administration of a nonselective α-adrenergic receptor antagonist (phenoxybenzamine, 10 mg three times a day,) accompanied by a high-sodium diet and generous fluid intake, was initiated 2 weeks before the surgery to stabilize intraoperative hemodynamics. As the patient was newly married and nulligravid, management with transurethral resection was considered superior to open or partial cystectomy and was selected as the treatment method.

Outcomes:

Transurethral holmium resection of the bladder paraganglioma was successfully performed with blood loss less than 20 ml and well-controlled intraoperative blood pressure. The 1-year follow-up results demonstrated well-controlled symptoms. Cystoscopy and evaluation of blood catecholamine metabolites revealed no disease recurrence.

Lessons:

Transurethral holmium laser resection is a good alternative approach for the resection of bladder paraganglioma, given its advantages of safety and efficacy.
Comparison between core needle biopsy and excisional biopsy for breast neoplasm
Authors: Sun Chunjie , Lu Qun , Zhang Xinrong , Zhang Yuehong , Jia Shuai , Wang Jing , Zhu Hailun , He Wen , Zhang Zhongqiu
Published: August 2021

This study aimed to explore clinical significance of core needle biopsy (CNB) in pathological diagnosis of breast neoplasm.

Seventy one breast neoplasm samples were obtained from Tongzhou Maternal and Child Health Hospital of Beijing between the years of 2006 and 2014. Forty five specimens were obtained via CNB and cases offering 26 of them received neoadjuvant chemotherapy. Pathology, histology, and immunohistochemistry results were compared between CNB specimens and excisional biopsy.

Upward and downward tendencies could be observed in CNB specimens and excisional biopsy, respectively, in all items. Tumor proportion of CNB tissues was (33 + 2)/45 = 77.78%, when ductal carcinoma in situ detected by both CNB and excisional biopsy was 31/45 = 68.89%, with a consistency of (31 + 3)/45 = 75.56%. Tumor thrombus detected by both CNB and excisional biopsy was 2/45 = 4.44%. Among cases receiving neoadjuvant chemotherapy, CNB and excisional biopsy, in mitotic figure, cytological scoring and histological grading, showed a total change rate of >50% (50%–75%), while changes in duct and cellular heteromorphism were not distinct. Cases showing changes were up to 73.08%, with 8/26 = 30.77% for rise and 11/26 = 42.31% for descent.

CNB could be used for preoperative diagnosis of breast neoplasm, and help to determine proper treatment regimen, thus elevating the rate of breast conserving. However, this method still has several limitations, particularly in immunohistochemical tests of human epidermal receptor protein-2. Neoadjuvant chemotherapy may influence the accuracy of CNB diagnosis.
Clinical course after the onset of choroidal neovascularization in eyes with central serous chorioretinopathy
Authors: Kim Rae-Young , Ma Gun-Jung , Park Woo-Kyung , Kim Mirinae , Park Young-Gun , Park Young-Hoon
Published: August 2021

Chronic central serous chorioretinopathy (CSC) can be complicated with choroidal neovascularization (CNV); however, the timing of its occurrence and its clinical significance are not well understood. This study aimed to observe the time of choroidal neovascularization detection after CSC diagnosis and determine whether clinical features and prognosis differed in patients with chronic CSC or age-related retinal degeneration.

In this retrospective study, medical records of CSC patients complicated with CNV who visited Seoul St. Mary's hospital of Korea between October 2009 and December 2020 were reviewed. The presence of CNV was determined using fluorescein, indocyanine green, or optical coherent tomography angiography (OCTA). Based on the patients’ medical records, we observed the change of clinical pattern, best-corrected visual acuity (BCVA) and central macular thickness (CMT) at CNV detection and at 6 months, 1 year, 3 years, and 5 years following CNV detection.

Thirty eyes of 30 patients (male: female ratio of 13:17) were enrolled. Mean age at diagnosis of CSC was 54.0 ± 8.5 years (mean ± standard deviation). On average, CNV was detected 1.65 ± 2.30 years after the diagnosis of CSC. The mean CMT was significantly decreased at 6 months, 1 year, and 3 years after choroidal neovascularization detection (P < .001, P < .001, P = .001 respectively). BCVA tend to improve after CNV detection, but there was no statistical significance at 6 months, 1 year, 3 years, and 5 years (all with P > .05). There were no clinical findings suggesting age-related macular degeneration such as intraretinal, subretinal hemorrhage or drusen in any of the case during follow-up. None of the subjects had severe visual acuity loss of 1.0 logarithm of the minimum angle of resolution (logMAR) (20/200 Snellen equivalent) or greater. Among the subjects, 6 patients (20%) did not require any treatment during observation, while 24 other patients required anti-vascular endothelial growth factor (anti-VEGF) or photodynamic therapy. At the last visit, 22 patients (73.3%) remained stable for more than 6 months, without subretinal fluid recurrence.

Choroidal neovascularization was detected earlier than previously reported. There was no rapid deterioration of visual acuity or clinical features even after CNV detection.
Safety of transrectal ultrasound-guided prostate biopsy in patients receiving aspirin
Authors: Chen Di , Liu Gang , Xie Yurun , Chen Changsheng , Luo Zhihua , Liu Yujun
Published: August 2021

Background:

The management of aspirin before transrectal prostate puncture-guided biopsy continues to be controversial. The conclusions in newly published studies differ from the published guideline. Therefore, an updated meta-analysis was performed to assess the safety of continuing to take aspirin when undergoing a transrectal ultrasound-guided prostate biopsy (TRUS-PB).

Methods:

We searched the following databases for relevant literature from their inception to October 30, 2020: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Medline, Web of Science, Sinomed, Chinese National Knowledge Internet, and WANGFANG. Studies that compared the bleeding rates between aspirin that took aspirin and non-aspirin groups were included. The quality of all included studies was evaluated using the Newcastle-Ottawa Scale. Revman Manger version 5.2 software was employed to complete the meta-analysis to assess the risk of hematuria, hematospermia, and rectal bleeding.

Results:

Six articles involving 3373 patients were included in this meta-analysis. Our study revealed that compared with the non-aspirin group, those taking aspirin exhibited a higher risk of rectal bleeding after TRUS-PB (risk ratio [RR] = 1.27, 95% confidence interval [CI] [1.09–1.49], P = .002). Also, the meta-analysis results did not reveal any significant difference between the 2 groups for the risk of hematuria (RR = 1.02, 95%CI [0.91–1.16], P = .71) and hematospermia (RR = 0.93, 95%CI [0.82–1.06], P = .29).

Conclusion:

Taking aspirin does not increase the risk of hematuria and hematospermia after TRUS-PB. However, the risk of rectal bleeding, which was slight and self-limiting, did increase. We concluded that it was not necessary to stop taking aspirin before undergoing TRUS-PB.
Incidents and risk factors of biliary complications after orthotropic liver transplantation
Authors: Zeair Samir , Stasiuk Robert , Zair Labib , Wawrzynowicz-Syczewska Marta , Rybicka Anita , Grochans Elżbieta , Kazimierczak Arkadiusz
Published: August 2021

Biliary complications (BC) especially stenosis and strictures are the most common complications after orthotropic liver transplantation (OLT) procedure in adult recipients. The intention of this study was analyzed BC in 273 patients after OLT for the last 4 years in our department.

Retrospective study of 273 patients underwent cadaveric donor liver transplantation between January 2014 and December 2017. Most of them (n = 268) have anastomosed bile duct in end to end, rest of them (n = 5) underwent hepaticojejunostomy. Statistical analysis was performed using Fischer exact test and Student t test. A P value <.05 was considered significant.

BC were developed in 48/273 transplants (17.6%). The most frequent was biliary stricture (n = 42, 87.5%) followed by bile leak (n = 4, 8.3%) and choledocholitiasis (n = 2, 4.2%). Treatment was usually using endoscopic retrograde cholangiopancreatography. Recipients with hypotension during and after OLT treated by norepinephrine have a higher index of BC.

Self-expanding metal stents implantation seems to be more effective than repeated balloon dilatation of anastomotic strictures with subsequent plastic biliary stent placement and associated with similar complication rate. Good fluid management against inotropic therapy may reduce risk of BC.
The effects on pain and disability of traditional Chinese non-pharmacological therapy for knee osteoarthritis
Authors: Chang Wei , Guo Weina , Wang Rongjun , Lin Xingxi , Sun Sifei , Shi Yibin
Published: August 2021

Background:

Knee osteoarthritis (KOA) is a common chronic joint disease with serious health economic burden. More and more randomized controlled trials have indicated that traditional Chinese non-pharmacological therapy, including acupuncture, Tai Chi, Tuina, etc can significantly improve pain and physical function of patients with KOA. However, the effects of traditional Chinese non-pharmacological therapy for KOA remain controversial. Most previous systematic reviews did not focus on the effects of traditional Chinese non-pharmacological therapy for KOA as a whole. In Chinese community hospital, however, acupuncture, Tuina, and Tai Chi are usually in the management of KOA as whole-body treatment.

Methods:

The electronic databases (PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, China Knowledge Resource Integrated Database, and Wanfang Data) will be searched. The search will include all documents from their inception to December 2021. Two reviewers independently extracted the data and assessed the risk of bias by the Cochrane Risk of Bias Tool for randomized controlled trials. The meta-analysis will be conducted with a random or fixed effect model to calculate the standardized mean difference and 95% confidence intervals based on different heterogeneity using the Review Manager Version 5.3 software. The heterogeneity will be examined by Higgins I2 statistic. The subgroup analysis will be conducted based on different types of traditional Chinese non-pharmacological therapy and different outcomes. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation.

Results:

The current systematic review and meta-analysis will be conducted to investigate the effects of traditional Chinese non-pharmacological therapy in the management of KOA. The main outcomes will include pain and disability. The secondary outcomes will include quality of life and adverse events.

Conclusion:

To provide evidence for evidence-based medicine and clinical researchers to choose more effective traditional Chinese non-pharmacological therapy for KOA.

INPLASY registration number:

INPLASY202170098.
Meta-analysis of the efficacy of Da Vinci robotic or laparoscopic distal subtotal gastrectomy in patients with gastric cancer
Authors: Zhang Zibo , Zhang Xiaolin , Liu Yu , Li Yong , Zhao Qun , Fan Liqiao , Zhang Zhidong , Wang Dong , Zhao Xuefeng , Tan Bibo
Published: August 2021

Background:

Robotic-assisted gastrectomy has been used for treating gastric cancer since 2002. This meta-analysis was conducted to systematically evaluate the efficacy of Da Vinci robotic distal subtotal gastrectomy (RDG) or laparoscopic distal subtotal gastrectomy (LDG) in patients with gastric cancer.

Methods:

We conducted searches in domestic and foreign databases, and collected literature in Chinese and English on the efficacy of RDG and LDG for gastric cancer that have been published since the inception of the database. RevMan 5.4.1 was used for meta-analysis and drawing and Stata14.0 was used for publication bias analysis.

Results:

A total of 3293 patients in 15 studies were included, including 1193 patients in the RDG group and 2100 patients in the LDG groups respectively. The meta-analysis showed that intraoperative blood loss was significantly lower and the number of resected lymph nodes was higher in the RDG group compared to that in the LDG group. In addition, the times to first postoperative food intake and postoperative hospital stay were shortened, and there was a longer length of distal resection margin and prolonged duration of operation. No significant differences were found between the 2 groups with respect to the first postoperative anal exhaust time, length of proximal resection margin, total postoperative complication rate, postoperative anastomotic leakage rate, incidence of postoperative gastric emptying disorder, pancreatic fistula rate, recurrence rate, and mortality rate.

Conclusion:

RDG is a safe and feasible treatment option for gastric cancer, and it is non-inferior or even superior to LDG with respect to therapeutic efficacy and radical treatment.
Hope, death anxiety and simplified coping style scores of nursing students during the outbreak of COVID-19
Authors: Cheng Linan , Guo Xiaoyan , Liu Haijing , Chen Qian , Cui Renshan
Published: August 2021

Nursing students are the main force of future nursing development, and their hope and death anxiety are important aspects of their coping styles and clinical practice.

The present study examined the relationships between hope, death anxiety and simplified coping style scores of nursing students during the outbreak of COVID-19.

Between February and April 2020, a cross-sectional descriptive study was performed using a Sojump online survey, and 870 nursing students completed the herth hope (HH), death anxiety scale (DAS) and simplified coping style questionnaire. The data were analyzed using t-tests, one-way analysis of variance (ANOVA), and multiple linear regression in SPSS 23.0 (IBM Corp, Armonk, NY).

The average HH, DAS and active and passive coping scores of the 870 nursing students were 3.07 ± 0.32, 3.01 ± 0.37, 2.84 ± 0.48, and 2.25 ± 0.50, respectively. Participants with contact experience with individuals with suspected or confirmed COVID-19 were more likely to adopt passive coping styles than students without contact experience (t = 5.019, P = .025). Being older and having higher inner positive readiness and expectancy, a lower inner sense of temporality and future, and lower time awareness were predictors of passive coping styles (P < .05). Living in cities (vs towns) and having a higher inner positive readiness and expectancy, a higher inner sense of temporality and future and lower cognition of death were predictors of active coping styles (P < .05).

The findings of this study suggest that hope and death anxiety are important aspects of the coping styles of nursing students. Nursing educators should emphasize the role of hope, further deepen the death education mode, and perform scientific and reasonable death education programmes to reduce the death anxiety level of nursing students to promote their coping styles in crisis.
Comparison of perfusion 18F-FP-CIT PET and 99mTc-ECD SPECT in parkinsonian disorders
Authors: Chun KyungAh , Kong EunJung , Cho IhnHo
Published: August 2021

Early and accurate identification of various conditions that can cause parkinsonian symptoms is important for determining treatment policies. Currently dopamine transporter (DAT) imaging using FP-CIT, glucose metabolism imaging using fluorodeoxyglucose, cerebral blood flow image using ethyl cysteinate dimer (ECD), and others are used for differentiation. However, the use of multiple modalities is inconvenient and costly. In the present retrospective study, we evaluated the correlation between regional brain uptake ratios (URs) in perfusion FP-CIT PET and ECD SPECT images.

Twenty patients with Parkinson's symptoms underwent perfusion DAT positron emission tomography (18F-FP-CIT PET/CT) and cerebral blood flow tomography (99mTc-ECD SPECT) within a 2-week period. Perfusion 18F-FP-CIT PET/CT and 99mTc-ECD SPECT URs of 19 brain regions (bilateral frontal, temporal, parietal and occipital lobes, bilateral caudate nucleus, bilateral putamen, bilateral insula, bilateral cingulate gyrus, bilateral thalamus, and brainstem) were directly compared and correlations were analyzed.

Average 18F-FP-CIT PET/CT regional perfusion URs were higher than 99mTc-ECD SPECT URs. Uptake ratios were well correlated in all 19 regions (except right putamen), and especially in dopamine poor regions (cerebral cortex). In left putamen, URs were significantly correlated, but the correlation coefficient was lower than those of other regions.

A single tracer dual phase N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane test seems to be helpful for differential diagnosis of parkinsonian disorders. Large-scale, longitudinal studies on complementary diseases with parkinsonian patterns are required to investigate differences in correlations between perfusion 18F-FP-CIT PET/CT and 99mTc-ECD SPECT over time.
Role of rs193922155 in the etiopathogenesis of osteogenesis imperfecta with description of the phenotype
Authors: Płomiński Janusz , Szwabowicz Marek , Fiedorowicz Ewa , Grzybowski Roman , Latacz Maria , Cieślińska Anna
Published: August 2021

Introduction:

Osteogenesis imperfecta (OI) is a disorder of the connective tissue that mainly causes the bones to become excessively brittle. The vast majority of OI cases are associated with mutations in the genes encoding the I alpha.

Patient concerns:

A 57-year-old woman office worker was admitted because of severe, long-lasting pain in the thoracic spine while bending down. She and her daughter have a history of multiple atraumatic fractures form early childhood.

Diagnosis:

Both women were pre-diagnosed with OI based on their phenotype. The genetic testing has shown single nucleotide polymorphism (rs193922155) in the gene encoding the collagen type I alpha 1 which until now was only likely pathogenic.

Interventions:

Bone mineral density measurement revealed osteoporosis. The mother was prescribed with Vitamin D3 and calcium supplementation, but the daughter does not take any medication. The mother had vertebroplasty performed because of Th 9–12 vertebral body compression fractures. The cardiovascular diseases, spontaneous hematomas, joint dislocations were excluded.

Outcomes:

For mother postoperative pain reduction was achieved.

Conclusion:

To the best of our knowledge, this is the first publication that confirms the pathogenic effect of this mutation and describes the phenotype.
Nephrogenic adenoma of the renal pelvis
Authors: Zhang Feilong , Wu Jiyue , Sun Zejia , Xie Dawei , Yang Xiaoyong , Wang Wei
Published: August 2021

Rationale:

Nephrogenic adenoma (NA) is a rare benign lesion of the urinary tract, which rarely occurs in the renal pelvis. Only 19 cases have been reported in the literature. However, there is no detailed report on the clinicopathological features of NA of the renal pelvis.

Patient concerns:

This case report describes a 46-year-old male patient who was admitted to the hospital for one month because of painless gross hematuria with blood clots. He had a history of hyperuricemia and a family history of gastric cancer.

Diagnoses:

NA of the renal pelvis was diagnosed pathologically and immunohistochemical.

Interventions:

The patient underwent laparoscopic nephroureterectomy.

Outcomes:

The patient recovered well after the operation with no discomfort. In addition, we followed up with the patient regularly post-discharge (approximately 20 months). There were no obvious abnormalities in the results of routine urine culture, computed tomography scan of the abdomen, and cystoscopy during the follow-up period, and the symptoms disappeared completely and did not recur.

Lessons:

NA of the renal pelvis is extremely rare in the clinic, which can be easily misdiagnosed and overtreated. However, for pathological diagnosis of this disease, specific immunohistochemical staining for preoperative biopsy was reported to be significant, which should be considered by the urologists and pathologists.
Acupuncture treatment on attention deficit hyperactivity disorder
Authors: Xing Liwei , Ren Zeqin , Yue Xianwu , Chen Hongxi , Xia Chunlin , Liu Fan , Dong Qinzuo , Wu Kenan , Zhao Rong
Published: August 2021

Background:

Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder in childhood. Acupuncture treatment of ADHD has formed a relatively systematic theoretical and clinical treatment system which achieved satisfactory results. However, there has been no systematic evaluation of its effectiveness and safety. The purpose of this study was to evaluate the efficacy and safety of acupuncture in the treatment of ADHD.

Methods:

A systematic search of literature will be conducted in PubMed, Cochrane Library, the Web of Science, Excerpt Medica Database, Chinese Biomedical Literature Database, VIP, Wanfang database, China National Knowledge Infrastructure database for articles published up to September, 2019. The searching terms include “attention deficit”, “hyperactivity”, “mild brain dysfunction”, “acupuncture”, “electroacupuncture”. The search is limited to studies published in Chinese and English. Two reviewers will extract and evaluate the information independently. Cochrane Collaboration tool and Jadad scale will be used to evaluate the quality of the studies. Review Manager Version 5.3 (Cochrane Collaboration's software) will be used to carry out the meta-analysis.

Results:

High-quality synthesis and/or descriptive analysis of current evidence will be provided from effective rate, total score of traditional Chinese medicines syndromes, conners child hyperactivity-diagnosis rating scale, conners index of hyperactivity, the recurrence rate, and adverse events.

Conclusion:

This study will provide the evidence of whether acupuncture is an effective and safe intervention to ADHD.

INPLASY registration number:

INPLASY202140022