bluuebunny/crossref_metadata_2025 huggingface dataset:
Females with Type 2 Diabetes Mellitus Are Prone to Diabetic Retinopathy: A Twelve-Province Cross-Sectional Study in China
Authors: Li Mei , Wang Yina , Liu Zifeng , Tang Xixiang , Mu Panwei , Tan Ying , Wang Jing , Lin Bairun , Deng Juan , Peng Ruiping , Zhang Rongyu , He Zhihui , Li Dongling , Zhang Yongjun , Yang Caixian , Li Yuan , Chen Yuming , Liu Xun , Chen Yanming
Published: April 2020

Aims. To investigate the distribution of diabetic retinopathy (DR) by sex in patients with type 2 diabetes mellitus (T2DM) in a twelve-province cross-sectional study in China. Methods. Patients with T2DM, whose ages were ≥18 years, were recruited from 76 cities/counties in 12 provinces in mainland China between January 2015 and December 2018. All participants received a standardized interview, eye examinations, and digital fundus photography. The presence and severity of DR were diagnosed and classified by retina specialists according to the DR domestic typing method. Results. A total of 12,766 participants (5963 males and 6803 females) were eligible for this study. The total prevalence of DR was 30.1%. Females exhibited a significantly higher prevalence of DR than males (31.1% vs. 29.0%, P=0.011). A multivariate logistic regression analysis confirmed that female sex was an independent predictor for a higher prevalence of DR after adjusting for age, the duration of diabetes, economic status, and the presence of hypertension (OR: 1.096, 95% CI: 1.013-1.186, P=0.023). Even after stratification by the diabetic duration, age, and economic status, female sex was still independently associated with the presence of DR in patients whose T2DM history was more than 10 years, whose ages were over 60 years, or who were in a relatively intermediate economic area. Conclusion. Females had a higher prevalence of DR than males in T2DM patients with a diabetic history of more than 10 years, ages over 60 years, or a relatively intermediate economic status.
Network-Aware Data Placement Strategy in Storage Cluster System
Authors: Shao Bilin , Song Dan , Bian Genqing , Zhao Yu
Published: April 2020

The dramatic increase of storage devices in distributed storage cluster system and the inherent characteristics of distributed deployment mode make network resources become one of the bottlenecks of data storage process. By analyzing the functional characteristics of data flow transmission of the components of the storage system, the network topology structure of the storage system is constructed, and the evaluation index of node flow load is put forward based on the degree centrality and the betweenness centrality theory of the network to explore the network topology and real-time flow characteristics. According to the evaluation index of node flow load, a network-aware data layout scheme is proposed. By balancing the flow load of bottleneck link, congestion and transmission delay can be reduced to further shorten the total task execution time and improve the efficiency of data writing.
Protective Effect of Shenqi Maixintong Capsule against ox‐LDL‐Induced Injury in RAW264.7 Macrophages
Authors: Ma Qianqian , Liang Min , Cai Tiange , Yu Yingjia , Liang Xinjian , Chen Qingzhuang , Du Manling , Ouyang Yong , Chen Chaojun , Cai Yu
Published: April 2020

Shenqi Maixintong capsule (SMC), a traditional Chinese medicine compound, exerts various therapeutic effects, including nourishing one’s vitality, improving blood circulation, regulating vital energy, and promoting coronary circulation. Studies have demonstrated that SMC could effectively alleviate atherosclerosis (AS) and delay its development. However, the effect of SMC on lipid metabolism remains unclear. Herein, we investigated the mechanism of SMC on lipid metabolism of RAW264.7 cells induced by oxidized low‐density lipoprotein (ox‐LDL). Drug‐containing serum was prepared by intragastric administration of SD (Sprague Dawley) rats. RAW264.7 cells were transformed into foam cells with 25 mg/L ox‐LDL. SMC‐treated rat serum increased the survival rate of ox‐LDL‐induced RAW264.7 cells. Oil Red staining, total cholesterol, and free cholesterol detection data showed that the intermediated dose of SMC had the best effect on reducing the lipid accumulation, lipid droplets, intracellular cholesterol, and total cholesterol content of RAW264.7 cells. The results of western blotting showed that the expression of ABCA1, ABCG1, LXRα, PPARγ, and peroxisome proliferation‐activated receptor alpha (PPARα) was increased by SMC, and proprotein convertase subtilisin/kexin type 9 (PCSK9) was reduced, which promoted reverse cholesterol transport (RCT) of RAW264.7 cells and inhibited foam cell formation. Furthermore, SOD and MDA data indicated that SMC could reduce the senescence of RAW264.7 cells. These findings suggest that SMC might prevent ox‐LDL‐induced damage of macrophages in AS patients by improving cell viability and slowing down lipid accumulation and senescence.
Awareness, Self‐Use, Perceptions, Beliefs, and Attitudes toward Complementary and Alternative Medicines (CAM) among Health Professional Students in King Saud bin Abdulaziz University for Health Sciences Jeddah, Saudi Arabia
Authors: Khan Aslam , Ahmed Mohamed Eldigre , Aldarmahi Ahmed , Zaidi Syed Faisal , Subahi Ahmad M. , Al Shaikh Adnan , Alghamdy Zackary , Alhakami Lujain Ali
Published: April 2020

Background. Around 75% of the world’s population relies on the use of complementary and alternative medicines (CAM) for their healthcare. Thus, we aimed at assessing the attitude and perception of health professional students about CAM and correlate the results with their demographical data. Methods. An observational cross‐sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU‐HS), Jeddah, Saudi Arabia, by enrolling 350 students. A self‐administered questionnaire was used for data collection. Descriptive and inferential statistical analysis was performed using SPSS. Results. Results of our data suggested that majority of students were aware of the CAM modalities and considered prayers/spirituality (83.6%), massage (72.5%), nutritional supplements (74.1%), cupping (68.5%), herbal medicine (66.2), and yoga (61.6%) as most effective and least harmful CAM modalities. The students acquired more information about CAM from media (55%), books (56%), friends/relatives (59.7%), and other health professionals (58.4%), however, very little information from formal CAM courses or training (36.7%), which shows the lack of courses and trained health professional in the field of CAM. Despite utilizing nonreliable sources of CAM information, the majority of students had positive attitudes and perceptions about CAM usage. Majority of the students (75.8%) believe in the use of CAM for the mental and spiritual aspect of health and think that CAM providers give good information on maintaining a healthy lifestyle. The data also showed a significant (P < 0.05) association between awareness about CAM and gender. A significantly higher percentage of female students were using yoga and aromatherapy, while cupping was mostly used by male students. Similarly, a significant association was found among the different colleges and level of students in most of the CAM modalities. However, no association was found between the awareness and use of CAM with the educational level of parents or relatives in health sector except for acupuncture and cupping, where student’s awareness about acupuncture and cupping was found to have a significant positive association with mother educational level. On the other hand, a significant inverse association was found between acupuncture, yoga, cupping, and aromatherapy with family income. Conclusion. In conclusion, despite the lack of proper courses and professionally trained healthcare providers in the field of CAM, students demonstrated positive attitudes and beliefs toward the safety and effectiveness of CAM.
Congenital Hepatic Fibrosis in Children and Adults: Clinical Manifestations, Management, and Outcome—Case Series and Literature Review
Authors: Zhu Beidi , Du Zunguo , Wang Zhengxin , Li Yang , Zhang Jiming , Zhu Haoxiang
Published: April 2020

Background. Congenital hepatic fibrosis is a hereditary fibropolycystic disease caused by ductal plate malformation. It is characterized by portal hypertension, but the manifestations, management, and outcome vary in children and adults. To raise awareness of medical staff, we have comprehensively compared the clinical features of congenital hepatic fibrosis between children and adults. Methods. We retrospectively enrolled all patients diagnosed with congenital hepatic fibrosis at the Huashan Hospital from August 2015 to August 2017 and analyzed their familial, clinical, laboratory, imaging, treatment, and follow-up data in detail. In addition, we reviewed cases with congenital hepatic fibrosis reported in the past 20 years in China and analyzed them according to the patients’ age. Results. A total of eight patients were diagnosed with congenital hepatic fibrosis in the study, including four children and four adults. The onset age of the children, who suffered from severe complications of portal hypertension and needed liver transplantation, ranged from 1 to 15 years old. The disorder developed in adults aged 26 to 60 years old. Three adults complained of recurrent abnormal liver function at the onset of illness, and they mainly received conservative treatments. The literature review included 30 children and 33 adults. In comparison, hepatomegaly was more common in children than in adults (57% vs. 21%, p=0.004). Malformation of kidneys and bile duct abnormalities were common, and multisystem involvement included eyes, other digestive organs, and genital and central nervous systems. Conclusions. Serious complications of portal hypertension developed in children requiring liver transplantation, while adults often had mild-to-moderate liver injuries upon onset. Adults with CHF varied a lot in clinical manifestations. Multiorgan involvement and unusual course are helpful to make a diagnosis. Timely histological assessment by liver biopsy and multidisciplinary cooperation are crucial for definitive diagnosis and early intervention.
A Method of Uncertainty Measurements for Multidimensional Z-number and Their Applications
Authors: Li Yanfei , Wu Tao , Mao Junjun , Guo Haiyan , Yao Aiting
Published: April 2020

Z-number provides the reliability of evaluation information, and it is widely used in many fields. However, people usually describe things from various aspects, so multidimensional Z-number has more advantages over traditional Z-number in describing evaluation information. In view of the uncertainty of the multidimensional Z-number, the entropy of multidimensional Z-number is defined and an entropy formula of multidimensional Z-number is established. Furthermore, the entropy is used to construct an average operator of multidimensional Z-numbers. In addition, a novel distance measure is introduced to measure the distance between two multidimensional Z-numbers. Moreover, the group decision model in the multidimensional Z-number environment is constructed by combining the average operator with the TOPSIS decision-making method. Finally, an illustrative example is given to verify the feasibility and effectiveness of the proposed method.
High-Score US-Suspicious Subcentimeter Thyroid Nodules: What Factors Affect Adequate Sampling of US-Guided Fine-Needle Aspiration Biopsy?
Authors: Li Yang , Yu Jin Hong , Du Ping Jie , Xie Yu , Das Sushant Kumar , Li Bing , Zhang Chuan
Published: April 2020

Background. Fine-needle aspiration biopsy (FNAB) is diagnostic standard for thyroid nodules. However, the influence of adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules is not known well. Objectives. To assess the factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules. Methods. Three hundred and forty-nine consecutive US-guided FNAB procedures were performed in 344 patients with subcentimeter thyroid nodules. The adequate sample rate was analyzed for all nodules on the basis of nodule-related and technical factors. The factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules were determined by multivariate logistic regression. Results. The adequate sample rate increased with larger nodules (72.7% for 3–6 mm nodules and 84.9% for 7–10 mm nodules (P=0.007)). The adequate sample rate was 63.9%, 81.3%, and 90.6% in nodules with macrocalcifcation, microcalcification, and no calcification, respectively (P<0.001). The adequate sample rate was 71.8% for biopsies performed with a perpendicular needle path and 85.0% with a parallel needle path (P=0.004). The significant factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules were nodule size (P<0.001; odds ratio (OR) for 7–10 mm nodules was approximately 3.0 times higher than that for 3–6 mm nodules), calcification (P<0.001; OR for nodules without calcification was approximately 5.3 times higher than that for the nodules with macrocalcification), and needle path (P=0.044; OR for the use of the parallel needle path was about 1.8 times higher than that for the perpendicular needle path). Conclusion. Nodule size, calcification, and needle path were the determinants of sample adequacy. The adequate sample rate was higher in larger nodules, in nodules without calcification, and upon using a parallel needle path for biopsy.
In Vivo Antiplasmodial Activity of Different Solvent Extracts of Myrianthus libericus Stem Bark and Its Constituents in Plasmodium berghei‐Infected Mice
Authors: Baah Michael Kwesi , Mensah Abraham Yeboah , Asante-Kwatia Evelyn , Amponsah Isaac Kingsley , Forkuo Arnold Donkor , Harley Benjamin Kingsley , Adjei Silas
Published: April 2020

The emergence and resurgence of P. falciparum resistance to generations of antimalarial drugs have prompted the search for new, effective, and safe antimalarial agents. This study aimed at investigating the in vivo antiplasmodial activity of the 70% hydroethanolic extract and constituents of the stem bark of Myrianthus libericus based on its ethnomedicinal use as an antimalarial agent. The antiplasmodial activity was assessed in Swiss albino mice employing the 4‐day suppressive and Rane’s tests. MLB significantly (p < 0.0001) suppressed parasitaemia by 52.26%, 65.40%, and 77.11% at 50, 100, and 200 mg·kg−1 doses, respectively, in the 4‐day suppressive test. In Rane’s test, the highest parasitaemia suppression of 72.50% was recorded at a dose of 200 mg·kg−1 of the extract. Fractionation of the bioactive ethyl acetate fraction by solvent‐solvent partitioning and column chromatography led to the isolation of friedelan‐3‐one and stigmasterol being reported for the first time from this species. The compounds demonstrated remarkable antiplasmodial activity by suppressing parasitaemia by 65–72% in the suppressive test and 61–70% in the curative test at doses of 10–30 mg·kg−1. Both the extract and the isolated compounds significantly prolonged the survival time of infected mice and averted the cardinal signs associated with P. berghei‐induced malaria including weight loss, hypothermia, and haemolysis. The results obtained confirm the prospect of M. libericus as an important source of new antimalarial compounds and justifies its folkloric use as an antimalarial agent.
An Evolutionary Multiagent Framework for Multiobjective Optimization
Authors: Zhang Zihui , Han Qiaomei , Li Yanqiang , Wang Yong , Shi Yanjun
Published: April 2020

This article proposes an evolutionary multiagent framework of the co-operative co-evolutionary multiobjective model (CCMO-EMAS), specifically for equipment layout optimization in engineering. In this framework, each agent is set in a multiobjective cooperative co-evolutionary mode along with the algorithms and corresponding settings. In each iteration, agents are executed in turn, and each agent optimizes a subpopulation from system decomposition. Additionally, the collaboration mechanism is addressed to build complete solutions and evaluate individuals in the co-operative co-evolutionary algorithm. Each subpopulation is optimized once, and the corresponding agent is evaluated based on the improvement of the system memory. Moreover, the agent team is also evolved through an elite genetic algorithm. Finally, the proposed CCMO-EMAS framework is verified in a multimodule satellite equipment layout problem.
A Study of Fluoride-Containing Bioglass System for Dental Materials Derived from Clam Shell and Soda Lime Silica Glass
Authors: Abdul Jalil Rohaniah , Amin Matori Khamirul , Mohd Zaid Mohd Hafiz , Zainuddin Norhazlin , Ahmad Khiri Mohammad Zulhasif , Abdul Rahman Nadia Asyikin , Wan Jusoh Wan Nurshamimi , Kul Esra
Published: April 2020

The alumino-silicate-fluoride (ASF) bioglass system with empirical formula [(45-x)SiO2-xCaF2-20P2O5-20Al2O3-15CaO] where x = 5, 10, 15, and 20 (wt.%) has been synthesised by using conventional melt-quenching method. In this study, soda lime silica (SLS) glass and clam shell (CS) vitreous waste were utilized as a source of silicon dioxide (SiO2) and calcium oxide (CaO), respectively. The different physical behaviors of ASF bioglass were closely related to the CaF2 content in each composition. The structural analysis shows the presence of various chemical bonds showing the formation of ASF bioglass. The ASF bioglass has many applications in dental field and efforts to improve its formulation can promise a better future in medical procedures.
Study on Floor Mechanical Failure Characteristics and Stress Evolution in Double Predriven Recovery Rooms
Authors: Feng Guorui , Li Songyu , Wang Pengfei , Guo Jun , Qian Ruipeng , Sun Qiang , Hao Chenliang , Wen Xiaoze , Liu Jianan
Published: April 2020

This paper takes the double predriven recovery rooms (DPRR) of 31109 panel of a coal mine in Inner Mongolia as a case study. DPRRs are used to withdraw mining equipment, which play a significant role in safe and efficient production in the final longwall mining stage. Theoretical analysis and numerical simulation were carried out to study the reasonable size of the front abutment pillar between DPRR (inter-DPRR pillar) and the damage depth of the DPRR floor. The results show that (1) the stress distribution of the fender (the remnant longwall panel) can be approximately divided into three stages with the advance of the working face: stress redistribution (the first) stage, stress superimposed growth (the second) stage, and stress transfer (the third) stage. (2) According to stress distribution and the corresponding failure mode of the fender, the calculation model of the slippage damage of the DPRR floor is rectified, and the damage range of the floor is rezoned to make it more suitable for the damage depth of the room. (3) The zone of influence of the front abutment pressure is 40–50 m, and the stress around the DPRR increases significantly in the final mining stage. When the size of the inter-DPRR pillar is greater than 15 m, the effect of increasing the coal pillar size on lowering the peak stress of the main predriven recovery room is limited. (4) Floor heave tends to increase at first and then decrease with depth and reaches the maximum in the depth of 5 m in the final mining stage, indicating that 5 m is the starting point for the initial depth of the floor heave. (5) The theoretical calculation shows that the reasonable size of the inter-DPRR pillar is 20 m, and the critical width of the fender is 18.48 m, which can guide the secondary support to prevent dynamic disasters. Floor grouting and constructing concrete floor are effective and economic ways to control the floor heave.
Serum Concentrations of Emerging Vitamin D Biomarkers and Detection of Prevalent High-Risk HPV Infection in Mid-adult Women
Authors: Troja Catherine , Hoofnagle Andrew N. , Szpiro Adam , Stern Joshua E. , Lin John , Winer Rachel L.
Published: April 2020

Background:

Vitamin D has potential immunomodulating benefits in infection. One prior population-based cross-sectional study showed a protective association between serum concentrations of 25(OH)D and high-risk human papillomavirus (hrHPV) detection. Additional biomarkers present at different stages along the vitamin D metabolic pathway may more completely characterize vitamin D status but have not yet been evaluated in relation to hrHPV infection.

Methods:

Stored sera from women aged 30–50 years (N = 404) enrolled in an HPV natural history study from 2011–2012 were tested for 25(OH)D and 4 novel vitamin D biomarkers: 1,25(OH)2D, 24,24(OH)2D3, free vitamin D, and vitamin D–binding protein. Cross-sectional associations between vitamin D serum concentrations and cervicovaginal hrHPV detection were estimated using logistic regression.

Results:

25(OH)D serum concentrations were not associated with hrHPV. After adjusting for age, race, season, education, oral contraceptive use, smoking status, body mass index, and serum concentrations of calcium and phosphate, each 1 ng/mL increase in 24,25(OH)2D3 was nearly statistically significantly associated with higher likelihood of hrHPV detection [aOR = 1.22; 95% confidence interval (CI), 0.97–1.52]. No significant associations were observed for other biomarkers.

Conclusions:

25(OH)D serum concentrations were unassociated with prevalent hrHPV. Higher levels of one novel biomarker, 24,25(OH)2D3, were positively associated with hrHPV, an unexpected finding.

Impact:

Inconsistent with previous findings of a protective association between 25(OH)D and prevalent hrHPV infection, these results suggest serum concentrations of 4 vitamin D biomarkers are unassociated with detection of hrHPV in mid-adult women.
Improving AML Classification Using Splicing Signatures
Authors: Bowman Teresa V.
Published: April 2020

Mutations in spliceosomal components are prevalent in myelodysplastic syndromes, but less so in acute myeloid leukemia (AML). However, aberrant splicing is prolific in AML, suggesting deregulated splicing could contribute broadly to tumorigenesis. Elevated stress responses correlate with splicing dysfunction across myeloid malignancies, representing potentially novel therapeutic targets.

See related article by Anande et al., p. 3597
Physical Activity and Risk of Hepatocellular Carcinoma Among U.S. Men and Women
Authors: Luo Xiao , Yang Wanshui , Ma Yanan , Simon Tracey G. , Meyerhardt Jeffrey A. , Chan Andrew T. , Giovannucci Edward L. , Zhang Xuehong
Published: April 2020

Mounting evidence indicates a potential beneficial effect of vigorous-intensity physical activity on hepatocellular carcinoma (HCC). However, the association between moderate-intensity physical activity, such as brisk walking, and the risk of HCC remains largely unknown. Two prospective cohorts of 77,535 women from the Nurses' Health Study and 44,540 men from the Health Professionals Follow-up Study were included. Weekly time spent on physical activities were updated biennially. The Cox proportional hazard regression model was used to calculate multivariable hazard ratios (HR) and 95% confidence intervals (95% CI). After an average 23-year follow-up, we identified 138 incident HCC cases. A higher amount of total physical activity was not significantly associated with a reduced risk of HCC (top tertile vs. bottom tertile; HR = 0.78; 95% CI, 0.51–1.18; Ptrend = 0.33). For the same comparison, there was an inverse association between moderate-intensity activity and HCC risk (HR = 0.60; 95% CI, 0.38–0.94; Ptrend = 0.04), whereas no statistically significant association with vigorous-intensity activity (HR = 0.88; 95% CI, 0.56–1.37; Ptrend = 0.74). Engaging in brisk walking was significantly associated with a lower risk of HCC (over 1 hour/week vs. non-brisk walking; HR = 0.50; 95% CI, 0.31–0.78; Ptrend = 0.006). The association between brisk walking and HCC risk was generally present across all subgroups, including age, body mass index, type 2 diabetes mellitus, smoking status, aspirin use, and alcohol consumption (all Pinteraction ≥ 0.05). In conclusion, moderate-intensity activity, especially brisk walking, was associated with reduced risk of HCC among U.S. men and women. If confirmed, brisk walking might serve a feasible way for HCC prevention.
Randomized Phase IIB Trial of the Lignan Secoisolariciresinol Diglucoside in Premenopausal Women at Increased Risk for Development of Breast Cancer
Authors: Fabian Carol J. , Khan Seema A. , Garber Judy E. , Dooley William C. , Yee Lisa D. , Klemp Jennifer R. , Nydegger Jennifer L. , Powers Kandy R. , Kreutzjans Amy L. , Zalles Carola M. , Metheny Trina , Phillips Teresa A. , Hu Jinxiang , Koestler Devin C. , Chalise Prabhakar , Yellapu Nanda Kumar , Jernigan Cheryl , Petroff Brian K. , Hursting Stephen D. , Kimler Bruce F.
Published: April 2020

We conducted a multiinstitutional, placebo-controlled phase IIB trial of the lignan secoisolariciresinol diglucoside (SDG) found in flaxseed. Benign breast tissue was acquired by random periareolar fine needle aspiration (RPFNA) from premenopausal women at increased risk for breast cancer. Those with hyperplasia and ≥2% Ki-67 positive cells were eligible for randomization 2:1 to 50 mg SDG/day (Brevail) versus placebo for 12 months with repeat bio-specimen acquisition. The primary endpoint was difference in change in Ki-67 between randomization groups. A total of 180 women were randomized, with 152 ultimately evaluable for the primary endpoint. Median baseline Ki-67 was 4.1% with no difference between arms. Median Ki-67 change was −1.8% in the SDG arm (P = 0.001) and −1.2% for placebo (P = 0.034); with no significant difference between arms. As menstrual cycle phase affects proliferation, secondary analysis was performed for 117 women who by progesterone levels were in the same phase of the menstrual cycle at baseline and off-study tissue sampling. The significant Ki-67 decrease persisted for SDG (median = −2.2%; P = 0.002) but not placebo (median = −1.0%). qRT-PCR was performed on 77 pairs of tissue specimens. Twenty-two had significant ERα gene expression changes (<0.5 or >2.0) with 7 of 10 increases in placebo and 10 of 12 decreases for SDG (P = 0.028), and a difference between arms (P = 0.017). Adverse event incidence was similar in both groups, with no evidence that 50 mg/day SDG is harmful. Although the proliferation biomarker analysis showed no difference between the treatment group and the placebo, the trial demonstrated use of SDG is tolerable and safe.
Preliminary Presentation of Metastatic Non-Small Cell Carcinoma of the Lung as Atraumatic Avulsion Fracture of the Lesser Trochanter
Authors: Creissen Adam , Rajeev Aysha , Jain Kumud , Banaszkiewicz Paul
Published: April 2020

Traumatic avulsion fractures of the lesser trochanter are usually seen along with fractures of the proximal femur and with young adolescents involved in high-intensity sporting injuries. Atraumatic isolated lesser trochanter avulsion in adults are most commonly associated with malignancy. We describe a case of a female in her sixties who was previously fit and healthy with no systemic illness and no history of trauma presenting with groin pain. The X-ray demonstrated an isolated lesser trochanter avulsion fracture. Further imaging including MRI and a staging CT scan of the neck, chest, abdomen and pelvis revealed a pulmonary tumour. Biopsy later confirmed this as a non-small cell carcinoma of the lung. At the time of publication, she had been started on palliative chemotherapy (afatinib) with encouraging results.
Higher Prevalence of Nickel and Palladium Hypersensitivity in Patients with Ulcerative Colitis
Authors: Kageyama Yasunari , Shimokawa Yutaka , Kawauchi Kimihiko , Morimoto Masafumi , Aida Koichi , Akiyama Tetsu , Nakamura Tsutomu
Published: April 2020

Background: The etiology of ulcerative colitis (UC) remains elusive even though many genetic and environmental pathogenic factors have been reported. Aberrant inflammatory responses mediated by specific subsets of T cells have been observed in ulcerative lesions of UC patients. Objectives: To elucidate the involvement of a delayed-type hypersensitivity reaction in UC, we focused on dental metal hypersensitivity, a T cell-mediated, delayed-type allergic reaction that causes oral contact mucositis and systemic cutaneous inflammation. Method: We recruited 65 Japanese UC patients and 22 healthy controls (HC) and used the in vitro lymphocyte stimulation test to quantify their sensitivity to zinc, gold, nickel, and palladium – the metals that have been widely used in dentistry. All subjects were users of metallic dental implants and/or prostheses containing zinc, gold, nickel, and/or palladium as major constituents. Results: Sixty percent of the UC patients were hypersensitive to at least one metal species, whereas 32% of the HC were hypersensitive to only a single metal species. The overall incidence of metal hypersensitivity was significantly higher for UC patients than for HC. Furthermore, a significantly greater proportion of UC patients were hypersensitive to nickel or palladium. The severity of the sensitivity to nickel and palladium was also significantly greater for UC patients than for HC. Conclusions: This pilot study demonstrates that UC patients have a significantly higher incidence of hypersensitivity to nickel and palladium, suggesting the possible involvement of dental metal hypersensitivity in UC pathogenesis.
Relations between Creaky Voice and Vocal Symptoms of Fatigue
Authors: Laukkanen Anne-Maria , Rantala Leena
Published: April 2020

Background: The use of a creaky voice in speech has become more common. Laryngeal findings relate creaky voice with strong adductive tension in the glottis, and thus it may be expected to be related to an increased risk of vocal fatigue. Methods: The present study investigated the relation of creaky voice use and vocal symptoms in 104 Finnish female university students (mean age 24.3 years, SD 6.3 years). They had no known pathology of voice or hearing. The participants were recorded while reading aloud a text of approximately 40 s in duration. They also filled in a questionnaire consisting of the Voice Handicap Index (VHI, translation in Finnish), and half of them also answered questions about the frequency and severity of symptoms of vocal fatigue. The samples were perceptually analysed for the amount of creakiness and strain by a speech therapist and a voice trainer. Results: The interrater reliability of the listeners was acceptable (Pearson’s χ2 = 100.159, p = 0.000 for creak; χ2 = 69.199, p = 0.000 for strain). Neither creakiness nor strain correlated with vocal symptoms. Participants with a low and a high amount of creakiness or strain did not differ from each other in terms of vocal symptoms or VHI scores. Symptoms’ total score correlated with VHI total score and total scores of VHI’s physical subscale. Creakiness and strain correlated positively with each other (r = 0.40, p = 0.000). Conclusion: No significant relations were found between creakiness or strain and vocal symptoms in this sample of university students.
Hemifacial Spasm Associated with Compression of the Facial Colliculus by a Choroid Plexus Papilloma of the Fourth Ventricle
Authors: Navarro-Olvera José Luis , Covaleda-Rodriguez Juan Camilo , Diaz-Martinez Jose Armando , Aguado-Carrillo Gustavo , Carrillo-Ruiz José Damian , Velasco-Campos Francisco
Published: April 2020

Background: Hemifacial spasm is an involuntary condition that involves muscles innervated by the ipsilateral facial nerve. There are secondary causes of hemifacial spasm that can produce a typical presentation of symptoms. Extrinsic compression of the facial colliculus at the floor of the fourth ventricle is responsible for <0.6% of the causes of secondary hemifacial spasm, as the cases with this origin reported in the literature are rare. Case Reports: We present the case of a 43-year-old female with hemifacial spasm of typical characteristics 6 months after onset. Upon clinical examination, a severe contraction of the orbicularis oculi, orbicularis oris, and superficial muscles of the neck displaying 50 crisis per hour was revealed. Brain magnetic resonance imaging showed absence of the facial nerve vascular loop in the cisternal portion, with evidence of an intraventricular tumor in relation with the medial portion of the fourth ventricle at the facial colliculus level, indicating a secondary origin of hemifacial spasm. Preoperative electromyography demonstrated irritative electric activity in the muscular branches of the facial nerve. A telovelar approach was performed to the fourth ventricle with intraoperative electrophysiology monitoring, with immediate resolution of the irritative activity after complete tumor resection. The result of the histopathologic study was a choroid plexus papilloma. Conclusion: Fourth ventricle tumors with extrinsic compression of the facial colliculus represent <0.6% of the causes of hemifacial spasm. Its relationship with choroid plexuses papilloma is being described as the first case reported in the literature. Clinical correlation, imaging, and intraoperative findings in conjunction with intraoperative electrophysiology recordings allow to predict the resolution of symptoms after resecting the lesion.
Quality of Patient Information by Urologists Is Associated with Mental Distress in Bladder Cancer Patients
Authors: Mani Jens , Neuberth Marie-Therese , Fettel Jens , Senf Bianca , Khoder Wael , Vallo Stefan
Published: April 2020

Aims: The study aimed to evaluate the prevalence of mental distress in patients with newly diagnosed bladder cancer, the cancer-information search behavior, and the influence of information seeking on distress. Methods: One hundred and one bladder cancer patients answered 2 established questionnaires (“Hospital Anxiety and Depression Scale” [HADS] and the “Fragebogen zur Belastung von Krebskranken” [FBK-R23]) for evaluation of mental distress and a self-developed questionnaire with questions concerning information seeking and socioeconomic facts. Results: Regarding risk group stratification, 57.4% were classified as high-risk and 42.6% as low-risk tumor-bearing patients. Analysis of mental distress showed that 23.2% had a score above the HADS-A cutoff, 25.3% above the HADS-D cutoff, and 21.4% showed a pathologic FBK-R23 score. Overall, 75% felt well informed about their illness. Risk group stratification did not correlate with HADS-A, HADS-D, or FBK-R23 score. Furthermore, active search for information or the use of the Internet did not correlate with the HADS-A, HADS-D, or FBK-R23 score. However, the quality of the urologist’s information and the feeling of being informed correlated with the grade of mental distress. Conclusion: Besides the treatment of bladder cancer, informing the patient about the disease in a psychologically wholesome manner and working together with psycho-oncologically trained psychologists are essential tasks for the treating urologist.
Novel Echocardiographic Approach to Hemodynamic Phenotypes Predicts Outcome of Patients Hospitalized With Heart Failure
Authors: Mele Donato , Pestelli Gabriele , Dini Frank Lloyd , Dal Molin Davide , Smarrazzo Vittorio , Trevisan Filippo , Luisi Giovanni Andrea , Ferrari Roberto
Published: April 2020

Background:

Although in clinical practice heart failure (HF) patients are classified using left ventricular ejection fraction (LVEF), this categorization is insufficient for prognosis, especially when LVEF is preserved or there is a concomitant right ventricular (RV) dysfunction. We hypothesized that a combined noninvasive evaluation of LV forward flow, filling pressure, and RV function would be better than LVEF in predicting all-cause mortality of hospitalized patients with HF.

Methods:

Transthoracic echocardiographic examinations of 603 patients hospitalized with HF were analyzed. In a subsample of 200 patients with HF, LV stroke volume index, LV filling pressure estimation, tricuspid annular plane systolic excursion, and systolic pulmonary artery pressure were combined to determine 4 hemodynamic profiles: normal flow-normal pressure, normal flow-high pressure, low flow without RV dysfunction, and low flow with RV dysfunction profile. This model was then applied in a validation cohort (n=403).

Results:

Prognosis worsened from the normal flow-normal pressure profile to the low flow with right ventricular dysfunction profile. At the multivariate survival analysis, the model showed independent high risk-stratification capability (
P
<0.001), even in subgroups of patients with LVEF < or ≥50% (
P
=0.011 and
P
<0.001, respectively) and < or ≥40% (
P
=0.044 and
P
<0.001, respectively). LVEF and HF classification based on LVEF did not predict outcome.

Conclusions:

Echocardiographic-derived profiling of LV forward flow, filling pressure, and RV function allowed categorization of patients hospitalized with HF and predicted all-cause mortality independently of LVEF. This model is based on conventional echocardiography, is easy to apply, and is, therefore, suggested for clinical practice.
Mesenchymal Stromal Cell–Derived Small Extracellular Vesicles Induce Ischemic Neuroprotection by Modulating Leukocytes and Specifically Neutrophils
Authors: Wang Chen , Börger Verena , Sardari Maryam , Murke Florian , Skuljec Jelena , Pul Refik , Hagemann Nina , Dzyubenko Egor , Dittrich Robin , Gregorius Jonas , Hasenberg Mike , Kleinschnitz Christoph , Popa-Wagner Aurel , Doeppner Thorsten R. , Gunzer Matthias , Giebel Bernd , Hermann Dirk M.
Published: April 2020

Background and Purpose—

Small extracellular vesicles (sEVs) obtained from mesenchymal stromal cells (MSCs) were shown to induce neurological recovery after focal cerebral ischemia in rodents and to reverse postischemic lymphopenia in peripheral blood. Since peripheral blood cells, especially polymorphonuclear neutrophils (PMNs), contribute to ischemic brain injury, we analyzed brain leukocyte responses to sEVs and investigated the role of PMNs in sEV-induced neuroprotection.

Methods—

Male C57Bl6/j mice were exposed to transient intraluminal middle cerebral artery occlusion. After reperfusion, vehicle or sEVs prepared from conditioned media of MSCs raised from bone marrow samples of 3 randomly selected healthy human donors were intravenously administered. sEVs obtained from normoxic and hypoxic MSCs were applied. PMNs were depleted in vehicle and MSC-sEV–treated mice. Neurological deficits, ischemic injury, blood-brain barrier integrity, peripheral blood leukocyte responses, and brain leukocyte infiltration were evaluated over 72 hours.

Results—

sEV preparations of all 3 donors collected from normoxic MSCs significantly reduced neurological deficits. Preparations of 2 of these donors significantly decreased infarct volume and neuronal injury. sEV-induced neuroprotection was consistently associated with a decreased brain infiltration of leukocytes, namely of PMNs, monocytes/macrophages, and lymphocytes. sEVs obtained from hypoxic MSCs (1% O
2
) had similar effects on neurological deficits and ischemic injury as MSC-sEVs obtained under regular conditions (21% O
2
) but also reduced serum IgG extravasation—a marker of blood-brain barrier permeability. PMN depletion mimicked the effects of MSC-sEVs on neurological recovery, ischemic injury, and brain PMN, monocyte, and lymphocyte counts. Combined MSC-sEV administration and PMN depletion did not have any effects superior to PMN depletion in any of the readouts examined.

Conclusions—

Leukocytes and specifically PMNs contribute to MSC-sEV–induced ischemic neuroprotection. Individual MSC-sEV preparations may differ in their neuroprotective activities. Potency assays are urgently needed to identify their therapeutic efficacy before clinical application.

Visual Overview—

An online
visual overview
is available for this article.
Controversies and discrepancies in the effect of dietary fat and cholesterol on cardiovascular risk
Authors: Leong WYA , Ngiam JN , Tan RS , Lim SL , Poh KK
Published: April 2020

Cardiovascular disease (CVD) is the leading cause of death worldwide. The top ten causes of death in Singapore include many cardiovascular-related diseases such as ischaemic heart disease. The increasing prevalence of CVD poses a burden to both the economy and healthcare system of a country. Dietary habits, in particular dietary fats and cholesterol intake, have been shown to greatly influence CVD risks. Therefore, reference and adherence to relevant dietary guidelines could be crucial in CVD prevention. Recent research findings have provided novel insights into the relationship between certain dietary fats or cholesterol intake and CVD risks, challenging or reinforcing previous guidelines. These findings may, however, be conflicting, and there are still controversies over the effects of dietary fats and cholesterol as well as their association with cardiovascular risk. This review paper aims to evaluate common controversies, identify gaps in relevant research areas and summarise evidence-based dietary recommendations.
The Japanese Supreme Court as a Litmus Test for Generic Constitutionalism?
Authors: Bertolini Elisa , Romeo Graziella
Published: April 2020

Scholars have, at times, resorted to the concept of generic constitutional law to describe commonalities emerging across jurisdictions with regard to the way in which constitutional law protects rights and prescribes how they can be limited. Comparative law studies on fundamental rights underline how courts, operating in diverse legal cultures all influenced by the Western Legal Tradition, tend to resort to some adjudication techniques such as the reasonableness test and the proportionality test. Those comparative studies, nonetheless, concede that constitutional adjudication techniques may be differently articulated and applied according to diverse degrees of strictness. However, those differences do not receive much attention when it comes to the comparison of legal reasoning concerning rights. Adjudication techniques seem to be able to trigger the same theory of rights at any latitude, the same understanding of the dialectic between liberty and authority. Against this backdrop, our paper aims at arguing that the Japanese Supreme Court uses both proportionality and reasonableness with a clear cultural imprinting, thus potentially questioning generic constitutionalism, proving that the cultural context may alter the functioning of the abstract models of the constitutional aggregates.
Facing Democratic Crisis in the EU: the New European Citizens’ Initiative Regulation
Authors: González Cadenas Diego
Published: April 2020

For some scholars, the possibilities for diminishing the European democratic deficit and the Union’s legitimacy crisis are intertwined with the creation of a European demos and a European public sphere, that, in turn, can create a European civil solidarity. The European citizens’ initiative, which has recently been re-regulated, was precisely designed to help to solve these problems. As we shall see, the new Regulation includes a whole series of positive technical issues that will improve the usage of the mechanism. However, the European citizens’ initiative is still far from being a popular initiative and, therefore, to contribute to diminish the perception of distance between institutions and citizens of the EU or promoting the creation of a European demos. In this vein, after an overview of the European citizens’ initiative new Regulation main innovations and weaknesses, I will present a set of measures in order to achieve a more effective development of the mechanism.
A Sketch of the Controversy de auxiliis
Authors: Matava R. J.
Published: April 2020

In the 16th century, the Dominicans and the Jesuits engaged in a polarized theological debate about how God can move the human will in a way that neither compromises human free choice nor makes God the author of moral evil. This debate, called the “controversy de auxiliis,” was never resolved. In 1607, Pope Paul v decreed that neither side was heretical and forbade further publishing on the issue without his explicit permission. This article explains the main theological points of the various Dominican and Jesuit actors, the human factors that contributed to the debate, and the reasons why this is still an important issue today. It concludes that both positions were based on important theological insights that would need to be taken into account if any resolution were to be found, that a resolution of this debate would benefit the Church in a number of ways, and that Jesuit and Dominican tribalism and polemics have contributed to keeping this issue unresolved.
Effect of Curcumin Against the Transforming Growth Factor β1-Induced Myocardial Fibrosis and Mechanism
Authors: Chen Li-Ping , Wu Zai-Tao
Published: April 2020

This study investigates the mechanism of curcumin in myocardial fibrosis-mediated inhibition of myocardial fibrosis by observing the roles of curcumin in TGF-β1/smads pathway in mouse cardiac fibroblasts. The logarithmic stage cells with good growth status were selected
from in vitro cultured mouse myocardial fibroblasts (CFs). Cells, at were categorized: control, vehicle control (1% DMSO), TGF-β1 (10 ng/ml) group, and low curcumin group (TGF-β1 + 1 ug/ml curcumin), medium curcumin (TGF-β1 + 3 ug/ml curcumin), and
high curcumin group (TGF-β1 + 6 ug/ml curcumin). qRT-PCR was applied to calculated the mRNA level. The protein level was determined by western blot. The regulatory role of TGF-β1 in the expression of collagen I/III, Smad1, Smad2/3, Smad4, TGF-β1, and Smad7
was reversed by curcumin. Curcumin alleviates the cardiomyocytes fibrosis of mouse. The regulatory roles of curcumin in mouse cardiomyocytes and modulating TGF-β1/Smads pathways predicted its potential role in inhibiting pulmonary fibrosis and anti-fibrosis. This may provide a
therapeutic strategy for myocardial fibrosis.
LncRNA Urothelial Carcinoma-Associated 1 (UCA1) Regulates Rat Bone Marrow Mesenchymal Stem Cell Differentiation and Promotes Repair of Bone Defects
Authors: Li Yucheng , Xin Jiang , Sun Wencai
Published: April 2020

Bone marrow mesenchymal stem cells (BMSCs) have characteristics of self-renewal and multidirectional differentiation. LncRNA UCA1 regulates BMSCs differentiation. Whether LncRNA UCA1 plays a role in bone defects remains unclear. BMSCs were randomly divided into control group, radiation
group (6Gy), radiation + UCA1 group followed by analysis of the expression of LncRNA UCA1, RUNX2 and OPN by real time PCR, BMSCs proliferation by MTT assay as well as ALP activity. Healthy Sprague-Dawley rats were randomly divided into control group; bone defect group; UCA1 group, in which
UCA1-transfected BMSCs were infused into bone defect rats followed by analysis of bone mineral density, ALP activity as well as the formation of type II collagen by ELISA. LncRNA UCA1 expression was significantly decreased in BMSCs of irradiated group, with decreased BMSCs proliferation, reduced
expression of RUNX2 and OPN as well as decreased ALP activity (P < 0.05). Transfection of UCA1 significantly up-regulated LncRNA UCA1 expression in BMSCs, promoted BMSCs proliferation, increased the expression of RUNX2 and OPN, and the activity of ALP (P < 0.05). In addition,
UCA1 promoted bone mineral density, increased ALP activity and type II collagen formation in rats with bone defect. LncRNA UCA1 promotes osteogenic differentiation of BMSCs, and targeting it might be a novel approach to promote bone remodeling at the bone defect site.