bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional analgesia for Labour
Authors: Harries Sarah , Collis Rachel
Published: September 2020

Epidural analgesia is the most effective way of managing pain associated with labour. Pharmacological and technological advances, as well as a greater understanding of anatomy and physiology, have contributed to its safety and efficacy, with >25% of women receiving epidural analgesia during labour in the UK today. The pharmacokinetics of drugs administered into the epidural space are explained, and the evidence for using different methods of administration to establish optimum analgesia, i.e. intermittent top-ups vs continuous infusions vs patient controlled epidural analgesia, is discussed. How to accurately assess a block is emphasized. Epidurals that do not work are a source of anxiety and frustration to women and anaesthetists alike. Therefore understanding why an epidural may not behave as expected, and suggestions to trouble-shoot problematic epidurals are described based on authors’ experience.
Post-delivery symptom control
Authors: Keigthley Gemma , Harries Sarah
Published: September 2020

Postpartum analgesia requirements vary considerably between women, however are largely dependent on the mode of delivery. Suggested regimes are outlined, with an emphasis to ensure early mobilization, safe breast-feeding and discharge to home as soon as possible. The common side effects, e.g. nausea and pruritus, associated with regional techniques and opioid medication are described, with suggested treatments.
The fetus
Authors: Conner Christine
Published: September 2020

An understanding of the assessment of fetal well-being in labour and basic interpretation of the cardio-tocograph is important for any obstetric anaesthetist, in order to anticipate transfer to theatre for operative delivery as early as possible. Illustrated normal and abnormal CTG patterns, fetal ST analysis, fetal scalp capillary sampling, and interpretation of umbilical cord blood gases are discussed in detail. Methods of assessment of fetal well-being during pregnancy are discussed: ultrasound biometry, amniotic fluid volume, and umbilical artery Doppler, followed by the management of intra-uterine growth restriction. Finally, the effects of analgesia in labour, regional and general anaesthesia, and other drugs e.g. magnesium sulphate and terbutaline on the fetus are reviewed.
A–Z of conditions in obstetric anaesthesia
Authors: Leslie David , Collis Rachel
Published: September 2020

The final chapter is a comprehensive A–Z index of less familiar medical conditions, which may present to the obstetric anaesthetist during any busy day or night shift. The conditions described are a compilation of referenced case reports or case series from peer-reviewed publications in recent years. The information provided should instantly guide the reader to the known characteristics of the condition, and the key points to consider in the antenatal, peripartum and anaesthetic management planning.
Evolution and observational signatures of the cosmic ray electron spectrum in SN 1006
Authors: Winner Georg , Pfrommer Christoph , Girichidis Philipp , Werhahn Maria , Pais Matteo
Published: September 2020

Supernova remnants (SNRs) are believed to be the source of Galactic cosmic rays (CRs). SNR shocks accelerate CR protons and electrons which reveal key insights into the non-thermal physics by means of their synchrotron and γ-ray emission. The remnant SN 1006 is an ideal particle acceleration laboratory because it is observed across all electromagnetic wavelengths from radio to γ-rays. We perform 3D magnetohydrodynamics (MHD) simulations where we include CR protons and follow the CR electron spectrum. By matching the observed morphology and non-thermal spectrum of SN 1006 in radio, X-rays, and γ-rays, we gain new insight into CR electron acceleration and magnetic field amplification. (1) We show that a mixed leptonic–hadronic model is responsible for the γ-ray radiation: while leptonic inverse-Compton emission and hadronic pion-decay emission contribute equally at GeV energies observed by Fermi, TeV energies observed by imaging air Cherenkov telescopes are hadronically dominated. (2) We show that quasi-parallel acceleration (i.e. when the shock propagates at a narrow angle to the upstream magnetic field) is preferred for CR electrons and that the electron acceleration efficiency of radio-emitting GeV electrons at quasi-perpendicular shocks is suppressed at least by a factor ten. This precludes extrapolation of current 1D plasma particle-in-cell simulations of shock acceleration to realistic SNR conditions. (3) To match the radial emission profiles and the γ-ray spectrum, we require a volume-filling, turbulently amplified magnetic field and that the Bell-amplified magnetic field is damped in the immediate post-shock region. Our work connects microscale plasma physics simulations to the scale of SNRs.
X-ray spectra and light curves of cooling novae and a nova like
Authors: Sun Bangzheng , Orio Marina , Dobrotka Andrej , Luna Gerardo Juan Manuel , Shugarov Sergey , Zemko Polina
Published: September 2020

We present X-ray observations of novae V2491 Cyg and KT Eri about 9 yr post-outburst of the dwarf nova and post-nova candidate EY Cyg, and of a VY Scl variable. The first three objects were observed with XMM–Newton, KT Eri also with the Chandra ACIS-S camera, V794 Aql with the Chandra ACIS-S camera and High Energy Transmission Gratings. The two recent novae, similar in outburst amplitude and light curve, appear very different at quiescence. Assuming half of the gravitational energy is irradiated in X-rays, V2491 Cyg is accreting at $\dot{m}=1.4\times 10^{-9}{\!-\!}10^{-8}\,{\rm M}_\odot \,{\rm yr}^{-1}$, while for KT Eri, $\dot{m}\lt 2\times 10^{-10}{\rm M}_\odot \,{\rm yr}$. V2491 Cyg shows signatures of a magnetized WD, specifically of an intermediate polar. A periodicity of  39 min, detected in outburst, was still measured and is likely due to WD rotation. EY Cyg is accreting at $\dot{m}\sim 1.8\times 10^{-11}{\rm M}_\odot \,{\rm yr}^{-1}$, one magnitude lower than KT Eri, consistently with its U Gem outburst behaviour and its quiescent UV flux. The X-rays are modulated with the orbital period, despite the system’s low inclination, probably due to the X-ray flux of the secondary. A period of  81 min is also detected, suggesting that it may also be an intermediate polar. V794 Aql had low X-ray luminosity during an optically high state, about the same level as in a recent optically low state. Thus, we find no clear correlation between optical and X-ray luminosity: the accretion rate seems unstable and variable. The very hard X-ray spectrum indicates a massive WD.
Function of a viral genome packaging motor from bacteriophage T4 is insensitive to DNA sequence
Authors: Mo Youbin , Keller Nicholas , delToro Damian , Ananthaswamy Neeti , Harvey Stephen C , Rao Venigalla B , Smith Douglas E
Published: September 2020

Many viruses employ ATP-powered motors during assembly to translocate DNA into procapsid shells. Previous reports raise the question if motor function is modulated by substrate DNA sequence: (i) the phage T4 motor exhibits large translocation rate fluctuations and pauses and slips; (ii) evidence suggests that the phage phi29 motor contacts DNA bases during translocation; and (iii) one theoretical model, the ‘B-A scrunchworm’, predicts that ‘A-philic’ sequences that transition more easily to A-form would alter motor function. Here, we use single-molecule optical tweezers measurements to compare translocation of phage, plasmid, and synthetic A-philic, GC rich sequences by the T4 motor. We observed no significant differences in motor velocities, even with A-philic sequences predicted to show higher translocation rate at high applied force. We also observed no significant changes in motor pausing and only modest changes in slipping. To more generally test for sequence dependence, we conducted correlation analyses across pairs of packaging events. No significant correlations in packaging rate, pausing or slipping versus sequence position were detected across repeated measurements with several different DNA sequences. These studies suggest that viral genome packaging is insensitive to DNA sequence and fluctuations in packaging motor velocity, pausing and slipping are primarily stochastic temporal events.
Aging Atlas: a multi-omics database for aging biology
Authors:   Aging Atlas Consortium, Liu Guang-Hui , Bao Yiming , Qu Jing , Zhang Weiqi , Zhang Tao , Kang Wang , Yang Fei , Ji Qianzhao , Jiang Xiaoyu , Ma Yingke , Ma Shuai , Liu Zunpeng , Chen Siyu , Wang Si , Sun Shuhui , Geng Lingling , Yan Kaowen , Yan Pengze , Fan Yanling , Song Moshi , Ren Jie , Wang Qiaoran , Yang Shanshan , Yang Yuanhan , Xiong Muzhao , Liang Chuqiang , Li Lan-Zhu , Cao Tianling , Hu Jianli , Yang Ping , Ping Jiale , Hu Huifang , Zheng Yandong , Sun Guoqiang , Li Jiaming , Liu Lixiao , Zou Zhiran , Ding Yingjie , Li Mingheng , Liu Di , Wang Min , Ji Qianzhao , Sun Xiaoyan , Wang Cui , Bi Shijia , Shan Hezhen , Zhuo Xiao
Published: September 2020

Organismal aging is driven by interconnected molecular changes encompassing internal and extracellular factors. Combinational analysis of high-throughput ‘multi-omics’ datasets (gathering information from genomics, epigenomics, transcriptomics, proteomics, metabolomics and pharmacogenomics), at either populational or single-cell levels, can provide a multi-dimensional, integrated profile of the heterogeneous aging process with unprecedented throughput and detail. These new strategies allow for the exploration of the molecular profile and regulatory status of gene expression during aging, and in turn, facilitate the development of new aging interventions. With a continually growing volume of valuable aging-related data, it is necessary to establish an open and integrated database to support a wide spectrum of aging research. The Aging Atlas database aims to provide a wide range of life science researchers with valuable resources that allow access to a large-scale of gene expression and regulation datasets created by various high-throughput omics technologies. The current implementation includes five modules: transcriptomics (RNA-seq), single-cell transcriptomics (scRNA-seq), epigenomics (ChIP-seq), proteomics (protein–protein interaction), and pharmacogenomics (geroprotective compounds). Aging Atlas provides user-friendly functionalities to explore age-related changes in gene expression, as well as raw data download services. Aging Atlas is freely available at https://bigd.big.ac.cn/aging/index.
Rehabilitation Therapy for Vocal Fold Paralysis Caused by Lung Cancer: A Case Report
Authors: Lu Qing Yi , Zhang Bin , Jin Ke Xin , Jiang Wan Ling , Li Xiang , Gao Chang Yue
Published: September 2020

Objective

Unilateral vocal fold paralysis (UVFP) can be caused by iatrogenic injury or tumor-induced damage to the recurrent laryngeal nerve. Studies of comprehensive rehabilitation therapies for patients suffering from severe UVFP are limited. The purpose of this case report is to describe an improvement in complete aphonia after comprehensive rehabilitation therapies in a patient with severe UVFP due to a lung tumor.

Methods

An 81-year-old woman with a history of bronchial adenoma had complete aphonia due to compression of the left recurrent laryngeal nerve by the tumor. Dynamic fibrolaryngoscope revealed paralysis of the left vocal fold. The patient was treated with interferential current therapy, vocal training, and kinesiology taping. Indicators of voice recovery were scored according to the grade, roughness, breathiness, asthenia, strain scale, and the voice handicap index.

Results

After 10 days of comprehensive rehabilitation treatment, the patient recovered from complete aphonia to normal communication. The hoarseness and breathiness of patient were significantly improved. In addition, the grade, roughness, breathiness, asthenia, strain, and the voice handicap index scores changed from severe to mild or absent.

Conclusion

This case provided a novel comprehensive treatment for a patient with UVFP, which was safe, cost-effective, and easy to implement in clinic.
Whole Genome Sequence and Gene Annotation Resource for Didymella bellidis Associated with Tea Leaf Spot
Authors: Wang Xue , Wu Xian , Jiang Silong , Yin Qiaoxiu , Li Dongxue , Wang Yong , Wang Delu , Chen Zhuo
Published: September 2020

Didymella bellidis is a phytopathogenic fungus that causes leaf spot on tea plants (Camellia sinensis), which negatively affects the productivity and quality of tea leaves in Guizhou Province, China. D. bellidis isolate GZYQYQX2B was sequenced using Pacific Biosciences and Illumina technologies, and assembled into a whole genome of 35.5 Mbp. Transcripts of D. bellidis isolate GZYQYQX2B were predicted from the assembled genome and were further validated by RNA sequence data. In total, 10,731 genes were predicted by integrating three approaches, namely ab initio and homology-based gene prediction, as well as transcriptomics data. The whole-genome sequence of D. bellidis will provide a resource for future research on trait-specific genes of the pathogen and host-pathogen interactions.
Patient-reported outcomes for ambulatory surgery
Authors: Warnakulasuriya Samantha R. , Patel Reshma C. , Singleton Georgina F. , Moonesinghe S. Ramani
Published: September 2020

Purpose of review

To discuss the importance of validated tools that measure patient-reported outcomes and their use in ambulatory surgery.

Recent findings

Sustained increases in ambulatory surgical care reflect advances in surgical techniques and perioperative anaesthetic care. Use of patient-reported outcomes allows identification of minor adverse events that are more common in this population compared with traditional endpoints such as mortality. Variability in reported outcomes restricts research potential and limits the ability to benchmark providers. The standardized endpoints in perioperative medicine initiative's recommendations on patient-reported outcomes and patient comfort measures are relevant to evaluating ambulatory care. Combining validated generic and disease-specific patient-reported outcome measures (PROMs) examines the widest spectrum of outcomes. Technological advances can be used to facilitate outcome measurement in ambulatory surgery with digital integration optimizing accurate real-time data collection. Telephone or web-based applications for reviewing ambulatory patients were found to be acceptable in multiple international settings and should be harnessed to allow remote follow-up.

Use of validated tools to measure patient-reported outcomes allows internal and external quality comparison. Tools can be combined to measure objective outcomes and patient satisfaction. These are both key factors in driving forward improvements in perioperative ambulatory surgical care.
Reducing Severity of Posttraumatic Stress Disorder in Intensive Care Unit Survivors
Authors: Pinkas Jamie , Horowitz Abigail
Published: September 2020

When patients are in the intensive care unit (ICU), they are in their most vulnerable and fragile state. These critically ill patients are often unable to make their needs known, which can produce an overwhelming feeling of helplessness and fear. The environment can seem threatening and foreign, and patients are often subjected to a multitude of disturbances that can be detrimental to their physical and psychological recovery. Loud noises, diagnostic tests performed at all hours, and poor natural lighting contribute to debilitating delirium and disturbed diurnal rhythms. Loss of privacy and basic human dignity, as well as painful procedures, has been associated with traumatic memories and distress in the post-ICU survivor population. All of these factors have contributed to patients developing ICU-related posttraumatic stress disorder after they leave the hospital. Recently, there has been an increase in awareness regarding this phenomenon within the medical community, which has generated more literature on the topic. Evidence suggests that ICU-related posttraumatic stress disorder can be mitigated. This article proposes the implementation of interventions by critical care health care providers that focus on reducing sleep disturbances, delirium, and benzodiazepine use in ICU patients, thereby improving patient comfort and reducing the severity of posttraumatic stress disorder in ICU survivors.
Masson Trichrome and Sulfated Alcian Blue Stains Distinguish Light Chain Deposition Disease From Amyloidosis in the Lung
Authors: Kunnath-Velayudhan Shajo , Larsen Brandon T. , Coley Shana M. , De Michele Simona , Santoriello Dominick , Colby Thomas V. , Bhagat Govind , Saqi Anjali
Published: September 2020

Light chain deposition disease, characterized by nonamyloidogenic deposits of immunoglobulin light chains, is rare in the lung and possibly underdiagnosed due to low clinical suspicion and lack of readily accessible tests. We encountered a case of pulmonary light chain deposition disease (PLCDD) in which light chain deposits appeared crimson red with a Masson trichrome (MT) stain and salmon pink with a sulfated Alcian blue (SAB) stain. This prompted us to characterize a series of PLCDD cases and assess the utility of MT and SAB stains to distinguish them from amyloidosis. From the pathology archives of 2 institutions spanning 10 years, we identified 11 cases of PLCDD, including 7 diagnosed as such and 4 determined retrospectively. The deposits in all cases of PLCDD stained crimson red with MT and salmon pink with SAB, while the cases of pulmonary amyloid (n=10) stained blue-gray and blue-green, respectively. The immunoglobulin light chain nature of the deposits was confirmed in 10 of 11 cases by either immunofluorescence microscopy (n=5) or mass spectrometry (n=5). Transmission electron microscopy revealed osmiophilic, electron-dense deposits in all cases analyzed (n=3). An extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type was diagnosed in 10 cases and 1 represented a plasma cell neoplasm. Our study highlights the importance of considering PLCDD in the differential diagnosis of amyloid-like deposits in the lung and the value of performing MT and SAB stains to distinguish between PLCDD and amyloidosis.
Blood-Pool SPECT/CT in Chronic Ankle Tendinopathy
Authors: Cuvilliers Cécile , Icard Nicolas , Meneret Pierre , Palard-Novello Xavier , Girard Antoine
Published: September 2020

We report 2 cases where blood-pool SPECT/CT had a high added value compared with standard 3-phase bone scintigraphy with only delayed SPECT/CT for the etiological diagnosis of painful ankles. Two men, aged 48 and 62 years, were referred for suspicions of medial and lateral malleoli stress fractures, respectively. Although standard planar blood-pool imaging and delayed SPECT/CT were inconclusive, blood-pool SPECT/CT showed markedly increased uptake along posterior tibial tendon and peroneal tendon, respectively, leading to diagnose tendonitises. These cases illustrate that blood-pool SPECT/CT can extend the diagnostic yield of bone scintigraphy to extraosseous origin, particularly in chronic lower extremities pain.
Superior Vena Cava Syndrome Induced Collateral Circulation on 99mTc–Macroaggregated Albumin Lung Perfusion Scintigraphy
Authors: Kersting David , Guberina Nika , Umutlu Lale , Stuschke Martin , Hautzel Hubertus
Published: September 2020

Perfusion lung scintigraphy using SPECT/CT is one mainstay in diagnosing pulmonary embolism. Although typically almost all tracer will be accumulated in the lung capillaries, occasionally abnormal uptake can be detected. As superior vena cava syndrome leads to aberrant blood flow, tracer injected to an arm vein might partly circumvent the pulmonary capillary bed and accumulate in well-perfused anatomical structures. In this case, next to the commonly described liver enhancement, more prominent pseudo-uptake of various thoracic vertebrae was observable. However, a time-related FDG PET/CT demonstrated only the hepatic pseudo-uptake. Taken together, careful assessment of superior vena cava syndrome patient studies is highly recommended.
A Case of Localized Malignant Peritoneal Mesothelioma Evaluated by 18F-FDG PET/CT
Authors: Xu Tingting , Hu Jiajia , Zhang Xinyi , Cao Jianpeng , Chen Yue
Published: September 2020

Localized malignant mesothelioma is rare. The prognosis is generally more favorable for this condition than for diffuse malignant mesothelioma. An elderly woman recently complained of abdominal pain, fever, and weight loss. She had no history of asbestos exposure. Her serum CEA level was elevated. Plain CT revealed a mass under the left diaphragm, with liquefaction and necrosis. A contrast-enhanced scan showed circular enhancement of the mass. A subsequent biopsy of the mass revealed a poorly differentiated carcinoma. PET/CT showed a significant FDG-avid subphrenic mass without any indications of metastasis. Postoperative pathological and immunohistochemical examination confirmed a case of malignant mesothelioma.
Ectopic Parathyroid Adenoma of the Piriform Sinus on Parathyroid 4D-CT and 99mTc-MIBI SPECT/CT
Authors: Hsieh Meng-Chieh P. , Nemer John S. , Beylergil Volkan , Yeh Randy
Published: September 2020

Ectopic parathyroid adenomas are a common cause of postsurgical persistent primary hyperparathyroidism. Our case highlights a patient with a negative bilateral 4-gland exploration with follow-up parathyroid 4-dimensional CT and 99mTc-MIBI SPECT/CT, yielding focal uptake in the right piriform sinus. Subsequent direct laryngoscopy revealed a mass in the piriform sinus, which was resected with surgical pathology yielding parathyroid adenoma.
Before and After Treatment Characterization of Cerebrospinal Disease in Bing-Neel Syndrome Using 18F FDG PET/MRI
Authors: Riaz Saima , Priftakis Dimitrios , Arulogun Suzanne , Wan Simon , Bomanji Jamshed
Published: September 2020

Bing-Neel syndrome is a rare neurological complication of Waldenström macroglobulinemia. We present the case of a 71-year-old man who underwent prechemotherapy and postchemotherapy FDG PET/MRI scan for the evaluation of cerebrospinal disease. In light of limited literature and lack of consensus guidelines on the role of metabolic imaging, we aim to highlight the utility of FDG PET/MRI in the diagnosis and response assessment in Bing-Neel syndrome.
Incidental Detection of a Small Cell Lung Cancer by 18F-Choline PET/CT Performed for Recurrent Hyperparathyroidism After Parathyroidectomy
Authors: Jacquet-Francillon Nicolas , Granjon Denise , Casteillo François , Prévot Nathalie , Habouzit Vincent
Published: September 2020

We report the case of a 64-year-old woman with musculoskeletal pain and elevated serum parathyroid hormone who had undergone parathyroidectomy for primary hyperparathyroidism 4 years earlier. An 18F-choline PET/CT scan was performed and incidentally showed an intense uptake in a right upper lobe pulmonary nodule and in the right hilar, mediastinal, and cervical lymph nodes. Histopathological analysis confirmed the diagnosis of a small cell lung cancer. Clinical symptoms and recurrent hyperparathyroidism were therefore consistent with a paraneoplastic syndrome. A complete metabolic response was achieved on 18F-FDG PET/CT scan after chemotherapy.
Quality and Safety in Healthcare, Part LXXIX
Authors: Harolds Jay A. , Miller Laura B.
Published: September 2020

Most executives new to a health care organization should have introductory and development programs during their first year, which should include networking opportunities, special projects to improve skills, independent or assigned course work, multiple types of assessments, and periodic discussions regarding expectations about their work and their progress in achieving them. It is preferable for the organization and the new executive to have information from outside sources about how a person in that position can achieve success and the reasons for turnover in the position. This is discussed in this article, using the chief nursing officer as the example.
Even Small Pleural Effusion Could Be Potential Pitfall on Posttherapeutic 131I Scintigraphy
Authors: Peng Dong , Shao Fuqiang
Published: September 2020

Pleural and pericardiac effusion could have radioiodine accumulation and be potential pitfall on posttherapeutic 131I whole-body scintigraphy. However, the volume of the effusion was relatively massive in the previous publications. We report a case of pleural effusion with a very small volume also had radioiodine uptake in a 37-year-old man.
68Ga-PSMA–Avid Small Cell Lung Cancer on PET/CT
Authors: Sharma Punit
Published: September 2020

68Ga–prostate-specific membrane antigen (68Ga-PSMA) PET/CT has shown excellent results in imaging of prostate cancer. Some nonprostatic malignancies can also demonstrate 68Ga-PSMA uptake, including primary lung adenocarcinoma. However, no such data are present for small cell lung cancer. We present the case of a 59-year-old man, where a second primary metastatic small cell lung cancer was discovered on 68Ga-PSMA PET/CT done for suspected recurrence of prostate cancer.
Malignant Peripheral Nerve Sheath Tumor Arising From Transplanted Kidney Assessed by 18F-FDG PET/CT
Authors: Feng Hongyan , Tu Ning , Bu Lihong
Published: September 2020

Malignant peripheral nerve sheath tumor (MPNST) originates from Schwann cells or pluripotent perineural cells, which is an extremely rare tumor that occurs in the kidney. We report a case of MPNST in transplanted kidney that was diagnosed in a 32-year-old man with a history of kidney transplantation. Contrast-enhanced MRI and 18F-FDG PET/CT features of MPNST are described, which can accurately discriminate MPNST from infection and benign tumors. These features could potentially provide valuable information to distinguish it from other renal malignancies. 18F-FDG PET/CT may be a useful tool for the primary diagnosis and the initial staging of MPNST.
Iatrogenic Lung Microembolism Resulted in Extraosseous Uptake of 99mTc-MDP
Authors: Lei Lei , Deng Yan , Ding Haoyuan , Zhang Wei
Published: September 2020

A 61-year-old woman diagnosed with left breast cancer underwent a bone scan for the evaluation of possible bone metastases. Multiple foci of elevated activity were noticed in the spine and pelvis. In addition, a focus of intense activity was observed in the right lung on the SPECT/CT images without corresponding anatomic abnormality.
Solitary Acute Inflammatory Demyelinating Lesion of the Cervical Spinal Cord Mimicking Malignancy on FDG PET/CT
Authors: Liu Qianyun , Liu Mingyuan , Bai Yushu , Dong Aisheng
Published: September 2020

A 43-year-old woman presented with numbness of the left hand and leg for 4 weeks. MRI of the spinal cord revealed an intramedullary lesion with central nodular enhancement at the C3 level. Primary tumor or metastasis of the cervical spinal cord was suspected. FDG PET/CT showed focal hypermetabolism of the spinal cord corresponding to the gadolinium-enhanced nodule. The patient underwent resection of the cervical spinal cord lesion. Histopathological findings of the resected specimens were consistent with acute inflammatory demyelinating lesion.
18F-Fluciclovine Uptake in Thymoma Demonstrated on PET/MRI
Authors: Tsikitas Lucas , Karls Shawn , Kranz Anca-Oana , Friedman Kent P. , Mahajan Sonia
Published: September 2020

A 68-year-old man with a history of prostate cancer post–primary treatment presented with rising prostate-specific antigen levels and was referred for 18F-fluciclovine PET/MRI to localize recurrent disease. PET/MRI revealed a solitary focus of uptake in a soft tissue nodule in the anterior mediastinum, which was resected and found to be a type B2 thymoma. 18F-fluciclovine uptake is mediated by amino acid transporters, primarily alanine-serine-cysteine transporter 2 and l-type amino acid transporter 1, previously demonstrated to be expressed on thymic carcinomas. This case highlights the possibility of overexpression of amino acid transporters in thymomas as well, rarely described before.
Orbital Emphysema Secondary to Frontal Osteoma
Authors: Devaraja K , Pujary Kailesh , Pillai Suresh
Published: September 2020

Repeated bouts of nose blowing can at times lead to orbital emphysema due to stress fracture in the medial or the inferior wall of the orbit. Very rarely, this can result from paranasal sinus osteoma rendering the orbital wall weak. We report only the fifth case of literature to have such an association. Also, we managed our case non-surgically, as against the previous reports treated surgically. In discussion, we highlight the nuances related to principles of management, including the role of computed tomography, and surgical intervention.
Three-Dimensionally-Printed Bioactive Ceramic Scaffolds: Construct Effects on Bone Regeneration
Authors: Fama Christopher , Kaye Gabriel J. , Flores Roberto , Lopez Christopher D. , Bekisz Jonathan M. , Torroni Andrea , Tovar Nick , Coelho Paulo G. , Witek Lukasz
Published: September 2020

Background/Purpose:

The utilization of three-dimensionally (3D)-printed bioceramic scaffolds composed of beta-tricalcium phosphate in conjunction with dipyridamole have shown to be effective in the osteogenesis of critical bone defects in both skeletally immature and mature animals. Furthermore, previous studies have proven the dura and pericranium's osteogenic capacity in the presence of 3D-printed scaffolds; however, the effect galea aponeurotica on osteogenesis in the presence of 3D scaffolds remains unclear.

Method/Description:

Critical-sized (11 mm) bilateral calvarial defects were created in 35-day old rabbits (n = 7). Two different 3D scaffolds were created, with one side of the calvaria being treated with a solid nonporous cap and the other with a fully porous cap. The solid cap feature was designed with the intention of preventing communication of the galea and the ossification site, while the porous cap permitted such communication. The rabbits were euthanized 8 weeks postoperatively. Calvaria were analyzed using microcomputed tomography, 3D reconstruction, and nondecalcified histologic sectioning in order assess differences in bone growth between the two types of scaffolding.

Results:

Scaffolds with the solid (nonporous) cap yielded greater percent bone volume (P = 0.012) as well as a greater percent potential bone (P = 0.001) compared with the scaffolds with a porous cap. The scaffolds with porous caps also exhibited a greater percent volume of soft tissue (P < 0.001) presence. There were no statistically significant differences detected in scaffold volume.

Conclusion:

A physical barrier preventing the interaction of the galea aponeurotica with the scaffold leads to significantly increased calvarial bone regeneration in comparison with the scaffolds allowing for this interaction. The galea's interaction also leads to more soft tissue growth hindering the in growth of bone in the porous-cap scaffolds.
Foamy oysters: vesicular microstructure production in the Gryphaeidae via emulsification
Authors: Checa Antonio G. , Linares Fátima , Maldonado-Valderrama Julia , Harper Elizabeth M.
Published: September 2020

The vesicular microstructure is a very distinctive arrangement of calcite, consisting of hollow cavities (vesicles) of diverse sizes and shapes, usually elongated in the direction of shell thickening. It is uniquely found among living bivalves in a single oyster family, Gryphaeidae. The vesicles are distributed in lenses interleaved with compact foliated layers. We have studied the morphology and distribution of vesicles within the lenses using optical and electron microscopy, and micro-computed tomography. At a small scale, vesicles do not follow a classical von Neumann–Mullins route typical of ideal foams. At a larger scale, the initiation and evolution of a vesicular layer statistically proceed like a foam, with vesicles becoming more numerous, larger and more even in size. In summary, the vesicular material follows a foam-like coarsening to reduce the number of energetically costly interfaces. However, a steady state is never reached because the animal permanently introduces energy in the system by creating new vesicles. The fabrication of the vesicular material is mediated by the production of an emulsion between the extrapallial fluid and the precursor PILP of the calcitic walls within the thin extrapallial space. For this mechanism to proceed, the mantle cells must perform highly sophisticated behaviours of contact recognition and secretion. Accordingly, the vesicular material is under mixed physical–biological control.
Effects of pulsating heat source on interstitial fluid transport in tumour tissues
Authors: Andreozzi A. , Iasiello M. , Netti P. A.
Published: September 2020

Macromolecules and drug delivery to solid tumours is strongly influenced by fluid flow through interstitium, and pressure-induced tissue deformations can have a role in this. Recently, it has been shown that temperature-induced tissue deformation can influence interstitial fluid velocity and pressure fields, too. In this paper, the effect of modulating-heat strategies to influence interstitial fluid transport in tissues is analysed. The whole tumour tissue is modelled as a deformable porous material, where the solid phase is made up of the extracellular matrix and cells, while the fluid phase is the interstitial fluid that moves through the solid matrix driven by the fluid pressure gradient and vascular capillaries that are modelled as a uniformly interspersed fluid point-source. Pulsating-heat generation is modelled with a time-variable cosine function starting from a direct current approach to solve the voltage equation, for different pulsations. From the steady-state solution, a step-variation of vascular pressure included in the model equation as a mass source term via the Starling equation is simulated. Dimensionless 1D radial equations are numerically solved with a finite-element scheme. Results are presented in terms of temperature, volumetric strain, pressure and velocity profiles under different conditions. It is shown that a modulating-heat procedure influences velocity fields, that might have a consequence in terms of mass transport for macromolecules or drug delivery.
Extension of hydrophilicity stability by reactive plasma treatment and wet storage on TiO2nanotube surfaces for biomedical implant applications
Authors: Kunrath Marcel F. , Vargas André L. M. , Sesterheim Patrícia , Teixeira Eduardo R. , Hubler Roberto
Published: September 2020

Micro and nanoscale changes allow the optimization of physico-chemical properties of titanium implant surfaces. Recently UV and plasma treatments have allowed surface hydrophilicity to take increased prominence; however, this beneficial effect is short-lived. The aim of this study is to investigate methodologies post-anodizing treatment to generate and maintain high surface hydrophilicity along with high biocompatibility. Anodized surfaces were characterized regarding physical–chemical properties. Then, surface wettability with nanomorphology was evaluated at different times and with distinct post-treatments: as deposited, with a reactive plasma and UV-light post-treatment, stored in air or deionized (DI) water. Adhesion, alkaline phosphatase (ALP) activity and bone cell viability tests were executed after the incremental treatments. The anodizing process generated a surface with TiO2nanotubes morphology and micro-roughness. Plasma-treated surfaces resulted in the most hydrophilic samples and this property was maintained for a longer period when those were stored in DI water (angle variation of 7° to 12° in 21 days). Furthermore, plasma post-treatment changed the titanium surface crystalline phase from amorphous to anatase. Anodized surfaces modified by reactive plasma and stored in DI water suggest better hydrophilicity stability, biocompatibility, ALP activity and achievement of crystalline phase alteration, indicating future potential use on biomedical implants.
Gramella bathymodioli sp. nov., isolated from a mussel inhabiting a hydrothermal field in the Okinawa Trough
Authors: Liu Lijun , Wang Shuang , Zhou Shun , Sun Wen , Fu Tianyu , Zhang Yulin , Zhang Xiao-Hua , Yu Min
Published: September 2020

A Gram-stain-negative, strictly aerobic, motile by gliding, rod-shaped and non-flagellated marine bacterium strain, designated BOM4T, was isolated from a mussel inhabiting the Tangyin hydrothermal field of the Okinawa Trough. The growth temperature was in the range of 16–40 °C, and the optimum temperature was 37 °C. Optimal growth occurred at pH 7.0 and in the presence of 1 % (w/v) NaCl. The predominant isoprenoid quinone of strain BOM4T was identified as menaquinone-6 (MK-6). The predominant fatty acids (>10 %) were iso-C15 : 0(43.8 %) and iso-C17 : 0 3-OH (17.5 %). The major polar lipids comprised one phosphatidylethanolamine, three unidentified aminolipids and two unidentified lipids. Based on 16S rRNA gene sequence analyses, strain BOM4T was found to be most closely related to

Gramella aestuarii

JCM 17790T (96.7 %), followed by

Gramella flava

JLT2011T (96.1 %),

Gramella sediminilitoris

GHTF-27T (95.6 %) and

Gramella gaetbulicola

RA5-111T (95.5 %) and with lower sequence similarities (93.7- 95.4 %) to other species of the genus

Gramella

. Genome relatedness between strain BOM4T and

G. aestuarii

JCM 17790T was computed using both average nucleotide identity and DNA–DNA hybridization with values of 75.6 and 19.3±2.4 %, respectively. The DNA G+C content of strain BOM4T was 41.4 mol%. On the basis of polyphasic analysis, strain BOM4T was considered to represent a novel species of the genus

Gramella

, for which the name Gramella bathymodioli sp. nov. is proposed. The type strain is BOM4T (=MCCC 1K03735T=JCM 33424T).
New insights underlying the early events of dopaminergic dysfunction in Parkinson’s Disease
Authors: Dela Cruz Hannah L. , Dela Cruz Esther L. , Zurhellen Cody J. , York Herbert T. , Baun Jim A. , Dela Cruz Joshua L. , Dela Cruz Jay S.
Published: September 2020

Alpha melanocyte-stimulating hormone (α-MSH) is an autocrine factor released by activated microglia during neuroinflammation and is elevated in the cerebrospinal fluid of Parkinson’s disease (PD) patients.α-MSH impaired cellular autophagy and induced the accumulation of alpha-synuclein in a melanized human dopaminergic cell model. Increasedα-MSH in the brain of mice resulted in the gradual worsening of abnormal gait. Dopamine replacement with L-dopa/Benserazide or treatment with a dopamine receptor agonist, Pramipexole, temporarily restored normal gait, suggesting dopamine deficiency as the cause of motor deficits in these mice. Notably, end-stage disease pathology such as neuronal cell loss, reduction in tyrosine hydroxylase (TH)+ fiber density in the striatum and pSer129+ alpha-synuclein inclusions were absent. Rather, autophagic dysfunction was observed in the dopaminergic neuronal (DN) cell population within the substantia nigra pars compacta and ventral tegmental area. Moreover, increased expression of TH was observed in the striatum, suggesting a compensatory response to diminished dopamine levels. Our findings provide new insights into the early events that underlie neurodegeneration in PD and suggest that exposure of DNs to elevated levels of microglialα-MSH leads to impairment of autophagy resulting in abnormal accumulation of proteins, dopaminergic dysfunction and motor deficits.

Graphical abstract

Significance statement

We now show that a naturally occurring compound increased in the brain of Parkinson’s disease (PD) patients, calledα-MSH, can trigger abnormal accumulation of alpha-synuclein in a dopaminergic cell model. Increasingα-MSH in the brain of mice resulted in motor symptoms and abnormal gait. Increasing dopamine activity in these mice using Levodopa or Pramipexole restored normal gait, suggesting that the mice were deficient in dopamine, as seen in PD. We now describe a cell and an animal model that can reproduce the early stages of dopaminergic dysfunction in PD. These new pre-clinical research tools will be useful in developing effective drugs that will stop the progression of the disease in patients who suffer from PD.

Abbreviations

PD, Parkinson’s disease; DN, dopaminergic neuron;α-MSH, alpha-melanocyte stimulating hormone; TH, tyrosine hydroxylase; SNpc, substantia nigra pars compacta; VTA, ventral tegmental area; CNS, central nervous system; CSF, cerebrospinal fluid; INS, intranasal; ASIP, agouti-signaling protein; MC1R, melanocortin receptor 1; ROS, reactive-oxygen species; MSA, multiple system atrophy
A steady trickle-down from metro districts and improving epidemic-parameters characterized the increasing COVID-19 cases in India
Authors: Ansumali Santosh , Kumar Aloke , Agrawal Samarth , Shashank H J , Prakash Meher K
Published: September 2020

Background By mid-September of 2020, the number of daily new infections in India crossed 95,000. We aimed to characterize the spatio-temporal shifts in the disease burden as the infections rose during the first wave of COVID-19.

Methods We gathered the publicly available district-level (equivalent of counties) granular data for the 15 April to 31 August 2020 period. We used the epidemiological data from 186 districts with the highest case burden as of August 31, 559,566 active cases and 2,715,656 cumulative infections, and the governing epidemic parameters were estimated by fitting it to a susceptible-asymptomatic-infected-recovered-dead (SAIRD) model. The space-time trends in the case burden and epidemic parameters were analyzed. When the physical proximity of the districts did not explain the spreading patterns, we developed a metric for accessibility of the districts via air and train travel. The districts were categorized as large metro, metro, urban and sub-urban and the spatial shifts in case burden were analyzed.

Results The center of the burden of the current-active infections which on May 15 was in the large metro districts with easy international access shifted continuously and smoothly towards districts which could be accessed by domestic airports and by trains. A linear trend-analysis showed a continuous improvement in the governing epidemic parameters consistently across the four categories of districts. The reproduction numbers improved from 1.77±0.58 on May 15 to 1.07± 0.13 on August 31 in large metro districts (p-Value of trend 0.0001053); and from 1.58±0.39 on May 15 to 0.94±0.11 on August 31 in sub-urban districts (p-Value of trend 0.0067). The recovery rate per infected person per day improved from 0.0581±0.009 on May 15 to 0.091±0.010 on August 31 in large metro districts (p-Value of trend 0.26\times10^-12); and from 0.059±0.011 on May 15 to 0.100±0.010 on August 31 in sub-urban districts (p-Value of trend 0.12\times10^-16). The death rate of symptomatic individuals which includes the case-fatality-rate as well as the time from symptoms to death, consistently decreased from 0.0025±0.0014 on May 15 to 0.0013±0.0003 on August 31 in large metro districts (p-Value of trend 0.0010); and from 0.0018±0.0008 on May 15 to 0.0014±0.0003 on August 31 in sub-urban districts (p-Value of trend 0.2789).

Conclusions As the daily infections continued to rise at a national level, the ``center'' of the pandemic-burden shifted smoothly and predictably towards smaller sized districts in a clear hierarchical fashion of accessibility from an international travel perspective. This observed trend was meant to serve as an alert to re-organize healthcare resources towards remote districts. The geographical spreading patterns continue to be relevant as the second wave of infections began in March 2021 with a center in the mid-range districts.
ASSESSMENT OF PROFESSIONALISM IN NURSING AND FACTORS ASSOCIATED AMONG NURSES WORKING IN ARSI ZONE PUBLIC HOSPITALS, OROMIA, ETHIOPIA, 2018
Authors: Tola Mulugeta Degefa , Tafesa Fikru , Siraneh Yibeltal
Published: September 2020

Background

Professionals are defined in the context of a particular body of knowledge which is obtained through formal education, expanded level of skills, type of certification proving their entry into the profession; a set of behavioral norms called professionalism and attitudes representing high levels of commitment to and identification with a specific profession. Several factor affecting the development of the nursing profession. Recognizing and determining such factors can be the first step to move towards the professionalization of nursing. The objective of this study was to assess professionalism in nursing and factors associated among nurses working in Arsi zone, Public Hospitals, Oromia, Ethiopia 2018.

Methods

This study used an Institutional based cross sectional study design. Self-administered structured questionnaire adapted from RNAO (Registered Nurses’ association of Ontario) guideline, was used to measure the level of professionalism. The sample was 420 nurses from the six Public Hospitals of Arsi Zone, Oromia, Ethiopia. Data was analyzed using SPSS 20.0. Both bivariate and multivariate analysis were carried out to identify associations. Odds ratio was calculated for related factors with 95% confidence interval (CI). A p-value < 0.05 was considered to be statistically significant.

Result

Out of 420 Nurses working in six public Hospitals, 380 responded to the questionnaire, making the response rate of 90.5%. In current study level of professionalism was high among nurses (n=380) with highest percentages on accountability, advocacy, and ethics. Gender (AOR=2.489, 95% CI=1.540-4.023), nursing is indispensable (AOR=1.760, 95% CI=1.104-2.806), job satisfaction (AOR= 1.844, 95% CI = 1.143-2.975) and having up to dated training (AOR= 1.809, 95%CI=1.071-3.055 were significantly associated with overall professionalism level.

Conclusion

Nurses working in public hospitals of Arsi zone have relatively had better professionalism level. Gender, nursing is indispensable, job satisfaction, presence of up-to-dated trainings were found significantly associated with professionalism in nursing. Human resource personnel and CEO’s of respective hospitals should develop various training programs for nurses and provide encouraging environments for obtaining better qualities in attributes of professionalism.
Impact of stopping therapy during the SARS-CoV-2 pandemic in persons with lymphoma
Authors: Yang Shenmiao , Dong Dong , Gu Hongfei , Gale Robert Peter , Ma Jun , Huang Xiaojun
Published: September 2020

Introduction

The severe acute respiratory syndrome-2 (SARS-CoV-2) pandemic disrupted medical care for persons with cancer including those with lymphoma. Many professional societies recommend postponing, decreasing or stopping anti-cancer therapy in selected persons during the pandemic. However, although seemingly sensible these recommendations are not evidence-based and their impact on anxiety and health-relatedquality-of-life(HRQoL) is unknown.

Methods

Surveyed 2532 subjects including 1060 persons with lymphoma, 948 caregivers and 524 normal, uninvolved persons using a purposed-designed questionnaire on a patient organization website. Respondents also completed the Zung Self-Rating Anxiety and patient respondents, the EORTC QLQ-C30 instruments to quantify anxiety and HRQoL. We also evaluated caregiver support and an online education programme of the Chinese Society of Clinical Oncology (CSCO). Data of HRQoL from a 2019 pre-pandemic online survey of 1106 persons with lymphoma was a control.

Results

33% (95% Confidence Interval [CI] 30, 36%) of lymphoma patients and 31% (28, 34%) of caregivers but only 21% (17, 24%) of normal individuals had any level of anxiety (both pair-wiseP< 0.001). Amongst lymphoma respondents physical exercise and better caregiver support were associated with less anxiety whereas female sex, receiving therapy and reduced therapy intensity were associated with more anxiety. Paradoxically, lymphoma respondents during the pandemic had better HRQoL than pre-pandemic controls. Reduced therapy intensity was associated with worse HRQoL whereas respondents who scored caregiver support and the online patient education programme high had better HRQoL.

Conclusions

During the SARS-CoV-2 pandemic lymphoma patients and their caregivers had significantly higher incidence of anxiety compared with normals. Lymphoma respondents reported better HRQoL compared with pre-pandemic controls. Reduced therapy-intensity in patients with cancer may have unanticipated adverse effects on anxiety and HRQoL. Regular and intense support by caregivers and online education programmes alleviate anxiety and improve HRQoL.