bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Larval Nutritional Regimes on Morphometry and Vectorial Capacity of Aedes aegypti for Dengue Transmission
Authors: Gunathilaka Nayana , Upulika Hasini , Udayanga Lahiru , Amarasinghe Deepika
Published: October 2019

Background. Nutritional level in larval diet of mosquito vectors influence on life history traits and vectorial capacity (VC). Therefore, the present study was carried out to assess the effect of larval diet concentration on vector bionomic and VC of Aedes aegypti in Sri Lanka. Method. Three batches of 400 Ae. aegypti larvae (first instar) were reared under different concentrations of larval diet (6%, 8%, and 10%; Volume/Volume), which was prepared by mixing 12.5 g of tuna meal, 9.0 g of bovine liver powder, and 3.5 g of Brewer’s yeast, in 100 ml of distilled water. The effect of larval diet concentration on different morphometric and functional parameters of larvae (length and width of head, abdomen, survival rate, and pupation success), pupae (length and width of cephalothorax, survival rate, and adult emersion), adult (length and width of thorax, abdomen, survival rate, longevity, biting frequency and fecundity of adults) were examined. In addition, VC of Ae. aegypti was evaluated. The General Linear Model (GLM) was used for the statistical analysis. Results. Larval head length, head width, thoracic width, abdominal length, abdominal width, total length, and survival rate significantly increased with higher doses of larval diet (P<0.05). In case of pupae, length, and width of cephalothorax, survival rate and adult emergence rate denoted an increasing trend with the elevated larval diets. However, the variations of survival rate and adult emergence rate were statistically significant (P<0.05). In adults, all morphometric parameters (thoracic length, abdominal length, abdominal width, and wing length) significantly increased with elevating larval diets levels (except for thoracic width) along with the biting frequency, fecundity, and survival rate (P<0.05) of adult females. The VC also denoted significant variations (F4,14 = 24.048; P<0.05) with the larval diet concentration, whereby the highest VC of 196.37 was observed at 10% treatment. Conclusion. Larval food availability has a significant influence on the adult fitness and thus may affect the incidence of dengue due to variations in the VC of Ae. aegypti. Hence, this investigation highlights the requirement in accounting the environmental variation at the larval stages in order to understand transmission dynamics and control of dengue in Sri Lanka.
Current Trends in the Evaluation of Osteochondral Lesion Treatments: Histology, Histomorphometry, and Biomechanics in Preclinical Models
Authors: Maglio M. , Brogini S. , Pagani S. , Giavaresi G. , Tschon M.
Published: October 2019

Osteochondral lesions (OCs) are typically of traumatic origins but are also caused by degenerative conditions, in primis osteoarthritis (OA). On the other side, OC lesions themselves, getting worse over time, can lead to OA, indicating that chondral and OC defects represent a risk factor for the onset of the pathology. Many animal models have been set up for years for the study of OC regeneration, being successfully employed to test different treatment strategies, from biomaterials and cells to physical and biological adjuvant therapies. These studies rely on a plethora of post-explant investigations ranging from histological and histomorphometric analyses to biomechanical ones. The present review aims to analyze the methods employed for the evaluation of OC treatments in each animal model by screening literature data within the last 10 years. According to the selected research criteria performed in two databases, 60 works were included. Data revealed that lapine (50% of studies) and ovine (23% of studies) models are predominant, and knee joints are the most used anatomical locations for creating OC defects. Analyses are mostly conducted on paraffin-embedded samples in order to perform histological/histomorphometric analyses by applying semiquantitative scoring systems and on fresh samples in order to perform biomechanical investigations by indentation tests on articular cartilage. Instead, a great heterogeneity is pointed out in terms of OC defect dimensions and animal’s age. The choice of experimental times is generally adequate for the animal models adopted, although few studies adopt very long experimental times. Improvements in data reporting and in standardization of protocols would be desirable for a better comparison of results and for ethical reasons related to appropriate and successful animal experimentation.
Iron Redox Chemistry and Implications in the Parkinson’s Disease Brain
Authors: Abeyawardhane Dinendra L. , Lucas Heather R.
Published: October 2019

The etiology of Parkinson’s disease (PD) is linked with cellular inclusions in the substantia nigra pars compacta region of the brain that are enriched in the misfolded presynaptic protein α-synuclein (αS) and death of the dopaminergic neurons. Brain iron homeostasis governs both neurotransmission and neurodegeneration; hence, the role of iron in PD progression and neuronal health is apparent. Elevated iron deposits become prevalent in the cerebral region upon aging and even more so in the PD brain. Structural as well as oxidative modifications can result from coordination of αS with redox active iron, which could have functional and/or pathological implications. In this review, we will discuss iron-mediated αS aggregation, alterations in iron metabolism, and the role of the iron-dopamine couple. Moreover, iron interactions with N-terminally acetylated αS, the physiologically relevant form of the human protein, will be addressed to shed light on the current understanding of protein dynamics and the physiological environment in the disease state. Oxidative pathways and biochemical alterations resulting from aberrant iron-induced chemistry are the principal focus of this review in order to highlight the plethora of research that has uncovered this emerging dichotomy of iron playing both functional and disruptive roles in PD pathology.
Evaluation of RealStar® Alpha Herpesvirus PCR Kit for Detection of HSV-1, HSV-2, and VZV in Clinical Specimens
Authors: Yip Cyril C. Y. , Sridhar Siddharth , Leung Kit-Hang , Cheng Andrew K. W. , Chan Kwok-Hung , Chan Jasper F. W. , Cheng Vincent C. C. , Yuen Kwok-Yung
Published: October 2019

Several commercial PCR kits are available for detection of herpes simplex virus (HSV) and varicella zoster virus (VZV), but the test performance of one CE-marked in vitro diagnostic kit—RealStar® alpha Herpesvirus PCR Kit—has not been well studied. This study evaluated the performance of RealStar® alpha Herpesvirus PCR Kit 1.0 on the LightCycler® 480 Instrument II for detection and differentiation of HSV-1, HSV-2, and VZV in human clinical specimens. We evaluated the analytical sensitivity of the RealStar® and in-house multiplex real-time PCR assays using serial dilutions of nucleic acids extracted from clinical specimens. The analytical sensitivity of the RealStar® assay was 10, 32, and 100 copies/reaction for HSV-1, HSV-2, and VZV, respectively, which was slightly higher than that of the in-house multiplex real-time PCR assay. Reproducibility of the cycle threshold (Cp) values for each viral target was satisfactory with the intra- and interassay coefficient of variation values below 5% for both assays. One-hundred and fifty-three clinical specimens and 15 proficiency testing samples were used to evaluate the diagnostic performance of RealStar® alpha Herpesvirus PCR Kit against the in-house multiplex real-time PCR assay. The RealStar® assay showed 100% sensitivity and specificity when compared to the in-house assay. Cp values of the RealStar® and in-house assays showed excellent correlation. RealStar® alpha Herpesvirus PCR is a sensitive, specific, and reliable assay for the detection of HSV-1, HSV-2, and VZV, with less extensive verification requirements compared to a laboratory developed assay.
Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
Authors: Ssemogerere Lameck , Sendagire Cornelius , Mbabazi Ceaser , Namungoma Yvonne , Oketayot Anna Noland , Namuyonga Judith , Mijumbi Cephas , Nkwine Ritah , Othin Moses , Oketcho Michael , Magala John Paul , Lwabi Peter , Kwizera Arthur , Dünser Martin W. , Najjuka Christine Florence
Published: October 2019

Background. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac ICU. Methods. We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts and tables. Results. Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and 14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%), and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Resistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion. Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.
Comparison of the Effect of Tanacethum Parthenium, 5-Hydroxy Tryptophan, and Magnesium (Aurastop) versus Magnesium Alone on Aura Phenomenon and Its Evolution
Authors: Volta Giorgio Dalla , Zavarise Paola , Perego Laura , Savi Lidia , Pezzini Alessandro
Published: October 2019

None of the clinical trials on migraine conducted thus far have focused on the possibility to modulate the phenomenon of aura. Furthermore, whether proper management of aura results in a better control of the headache phase has been poorly investigated. In the setting of a single-center, pilot, clinical trial, we aimed at comparing the effects of Aurastop (a combination of tanacetum parthenium (150 mg extracted at 0.8% = 1.2 mg di of active parthenolide), griffonia simplicifoila (20 mg of 5-hydroxy tryptophan), and magnesium (185 mg of magnesium pidolatum)) with those of magnesium alone (2.25 grams/tablet, corresponding to 184 mg of Mg++) in the treatment of acute attacks of migraine with aura. Between June 2017 and June 2018, 50 consecutive patients (27/23 male/female; mean age, 31 [18–57] years) with at least 3 episodes of aura per year were included (t0). Participants were instructed to keep track of the following 4 episodes of migraine with aura (t1) and invited to assume (1) a tablet of Aurastop at the beginning of the following 2 episodes of aura and (2) a magnesium tablet alone at the occurrence of the third and fourth aura attacks. Forty-eight patients (96.0%) had >50% reduction in aura duration when treated with Aurastop vs. 7 patients (14.0%) when treated with magnesium alone (p<0.001); 48 patients (96.0%) had >50% reduction of aura-related disability when receiving Aurastop vs. 5 patients (10.0%) when treated with magnesium alone (p<0.001); however, patients receiving Aurastop did not need to take pain killers in 35% of aura attacks vs. 3% when assuming magnesium (p<0.001). These results support the hypothesis that Aurastop might be effective in interfering with the phenomenon of aura and provide evidence that the clinical benefit attributable to this combination of molecules might be greater than that obtained with single compounds of proven effect on the biology of migraine.
Relationships between Serum Uric Acid, Malondialdehyde Levels, and Carotid Intima-Media Thickness in the Patients with Metabolic Syndrome
Authors: Wu Shun-Sheng , Kor Chew-Teng , Chen Ting-Yu , Liu Ko-Hung , Shih Kai-Lun , Su Wei-Wen , Wu Hung-Ming
Published: October 2019

Oxidative stress is the major cause of atherosclerosis and cardiovascular diseases. This cross-sectional study is aimed at determining if parallel serum markers of oxidative stress are related to carotid intima-media thickness (IMT). We enrolled 134 participants with varied metabolic syndrome (Met-S) scores (zero, n=21; one, n=19; two, n=27; three, n=26; four, n=25; five, n=16). Biochemical profiles and potential oxidative stress biomarkers malondialdehyde (MDA) and uric acid were measured in fasting plasma. We found that carotid IMT positively correlated with both MDA and uric acid levels. Multivariate analysis revealed that both MDA (p<0.05) and uric acid (p<0.01) levels were significantly associated with carotid IMT in participants whose Met-S scores were ≥1 or ≥2. However, only uric acid (p<0.01) levels were positively associated with carotid IMT in patients with metabolic syndrome. Linear regression model analysis revealed that the prediction accuracies for carotid IMT from MDA combined with uric acid and from a combination of MDA, uric acid, and Met-S score were 0.176 and 0.237, respectively. These were better than the predication accuracies from MDA (r2=0.075) and uric acid (r2=0.148) individually. These results suggest that measuring uric acid levels along with MDA biomarkers and Met-S scores may be a promising step in the development of an effective model for monitoring the severity of carotid IMT and atherosclerosis in the patients with metabolic syndrome.
Neurogenic Pulmonary Edema Following a Seizure: A Case Report and Literature Review
Authors: Suhail Najim Mostafa , Ali Mohammed Hammamy Riyadh , Sasi Sreethish
Published: October 2019

Acute pulmonary edema is one of the frequent causes of dyspnea encountered in everyday practice. It is broadly attributed to be either cardiogenic or noncardiogenic. It is usually treated with diuretics in addition to other medications depending on the underlying pathology. Here, we report a case of a female patient who presented with shortness of breath after developing a seizure. Further investigations excluded cardiogenic etiology and showed critically low phenytoin level. It improved within 48 h of supportive care without giving diuretics favoring the diagnosis of neurogenic pulmonary edema as the primary pathology. The goal of our case report is to keep neurogenic pulmonary edema in mind, and hence provide the appropriate management, when dealing with similar cases.
Effect of the Nonprestressed/Prestressed BFRP Bar on Flexural Performance of the Bamboo Beam
Authors: Lv Qingfang , Ding Yi , Liu Ye
Published: October 2019

Until now, the systematical and comprehensive strengthening techniques have not been formed for the bamboo structure. Under such background, this paper aims to explore the effects of the application of the nonprestressed and prestressed basalt fiber-reinforced polymer (BFRP) bars on the flexural performance of the beams made of the laminated bamboo and reconstituted bamboo materials. Two series of four-point bending tests were thus conducted. In the first series of tests, the pure laminated bamboo beam and the laminated bamboo beam applied with nonprestressed BFRP bar were compared. Test results showed that the ultimate load and deformation capacity of the laminated bamboo beam was improved due to the existence of the BFRP bar. In the second series of tests, the reconstituted bamboo beams applied with nonprestressed and prestressed BFRP bars were compared. It is found that the ultimate load of the reconstituted bamboo beam was not improved by the application of the prestressed force. The further analysis related to the prestress loss demonstrated that the prestress loss before the release of the prestressed BFRP bar could reach up to 31.8–37.3% compared with the design initial prestressed stress. The prestress loss caused by the elastic deformation of the bamboo beam can be neglected. For all tested specimens, the plane section assumption was acceptable and the position of the neutral axis of the beam gradually moved down with the increase of the applied load.
Effects of Pyrene on Human Liver HepG2 Cells: Cytotoxicity, Oxidative Stress, and Transcriptomic Changes in Xenobiotic Metabolizing Enzymes and Inflammatory Markers with Protection Trial Using Lycopene
Authors: Ma Jin-Kui , Saad Eldin Walaa Fathy , El-Ghareeb Waleed Rizk , Elhelaly Abdelazim Elsayed , Khedr Mariam H. E. , Li Xiang , Huang Xiao-Chen
Published: October 2019

Pyrene is one of the major polycyclic aromatic hydrocarbons formed during heat treatment of meat and in car exhausts; however, few studies have investigated pyrene-induced adverse effects on human cell lines. This study aimed at the investigation of pyrene-induced cytotoxicity and oxidative damage in human liver HepG2 cells at environmentally relevant concentrations. Pyrene-induced changes in mRNA expression of xenobiotic metabolizing enzymes (XMEs), xenobiotic transporters, antioxidant enzymes, and inflammatory markers were investigated using real-time PCR. As a protection trial, the ameliorative effects of lycopene, a carotenoid abundantly found in tomato, were investigated. The possible mechanisms behind such effects were examined via studying the co exposure effects of pyrene and lycopene on regulatory elements including the aryl hydrocarbon receptor (Air) and elytroid 2-related factor 2 (RF). The achieved results indicated that pyrene caused significant cytotoxicity at 50 n, with a clear production of reactive oxygen species (ROS) in a dose-dependent manner. Pyrene upregulated mRNA expression of phase I enzymes including CYP1A1, 1A2, and CYP1B1 and inflammatory markers including TNFα and Cox2. However, pyrene significantly downregulated phase II enzymes, xenobiotic transporters, and antioxidant enzymes. Interestingly, lycopene significantly reduced pyrene-induced cytotoxicity and ROS production. Moreover, lycopene upregulated detoxification and antioxidant enzymes, probably via its regulatory effects on Air- and RF-dependent pathways.
Research into Correlation between the Lubrication Mode of Contact Surfaces and Dynamic Parameters of Turbo-Generator Transmissions
Authors: Kočiško Marek , Baron Petr , Telíšková Monika , Török Jozef , Bašistová Anna
Published: October 2019

The paper presents the results of an experimental study aimed at assessing the correlation between the measurement of dynamic parameters (vibration, high-frequency vibration, and acoustic emission) and the analysis of friction mode and the state of lubrication of the contact surfaces of two gearboxes in the turbo-generator assembly (high-speed single-body steam turbine—gearbox—generator) with the transmission power of no more than 50 MW. The analysis confirmed the assumption of a significant correlation of the monitored high-frequency vibration signal with the unsatisfactory engagement of the gear teeth. Through vibration analysis, an increased level of the tooth vibration component and vibration multiples with increased acoustic emission were identified in gearbox operation. The gear oil of one of the gearboxes examined showed a loss of additive elements in the real operation of the contact surfaces of the teeth engagement. The trend analysis confirmed the complexity of the monitored transmission operation in terms of the friction mode and the influence of the oil quality on the state of the tooth flank microgeometry.
Treatment with Molgramostim (Recombinant Human Granulocyte-Macrophage Colony Stimulating Factor, Rhugm-Csf, Mielogen) and Lenograstim (Granulocyte-Colony Stimulating Factor) Improves Experimental Colitis in Rats
Authors: Papalois Apostolos E. , Barbatis Calypso , Chrysikos Dimosthenis , Korontzi Maria , Sideris Michail , Pittaras Theodoros , Triantafyllidi Eleni , Nomikos Alexandros , Triantafillidis John K.
Published: October 2019

Background/Aim. Treatment with growth factors could be beneficial in both inflammatory bowel disease and experimental colitis. The aim of this study was to investigate the effect of Colony Stimulating Factor (CSF), and Recombinant Human (rHu) Granulocyte Stimulating Factor (GSF) in experimental colitis in rats. Methods. Experimental colitis was induced in 62 male Wistar rats, divided into 9 groups, using 2,4,6-trinitrobenzensulfonic acid (TNBS). Group 1: Ten rats with colitis without treatment (control group). Euthanasia after 15 days. Group 2: Ten animals with colitis without treatment (control group). Euthanasia after 30 days. Group 3: Six animals with colitis. Immediate treatment with CSF. Euthanasia after 19 days. Group 4: Six animals with colitis. Treatment started 7 days after the induction of colitis. Animals were kept for 19 days. Group 5: Six animals with colitis. Treatment started 2 weeks after the induction of colitis. Group 6: Six animals with colitis, the same as in group 3. Treatment with GSF. Group 7: Six animals with colitis, the same as in group 4. Treatment with GSF. Group 8. Six animals with colitis, the same as in group 5. Treatment with GSF. Group 9: Six animals with colitis. Immediate treatment with prednisolone. Euthanasia after 15 days. Results. CSF and GSF administration significantly improved the histological score (P<0.05) and reduced malondialdehyde contents (P<0.05), compared to control groups in all animals. CSF was superior to GSF and to prednisolone. Conclusion. Administration of both CSF and GSF could significantly improve the histological score and oxidative stress in experimental colitis in rats.
Effect of Thermal‐Related Fit Clearance between Outer Ring and Pedestal on the Vibration of Full Ceramic Ball Bearing
Authors: Shi Huaitao , Bai Xiaotian , Zhang Ke , Wu Yuhou , Wang Zinan
Published: October 2019

Full ceramic bearing can work under a wide range of temperatures, but the thermal deformation difference between the ceramic outer ring and steel pedestal has a great increase with the rise of temperature and leads to obvious impact and friction. In this paper, the thermal deformation difference is considered and the fit clearance is taken as the boundary condition of the dynamic model. Investigations on the dynamic response of the outer ring are conducted, and the effect of thermal‐related fit clearance is analyzed at different working temperatures and rotation speeds through parametric study and experiments. Results show that the vibration of the outer ring grows with the temperature and shows different changes with rotation speed as the temperature changes. The variation of working temperature brings difference in the interactions between the outer ring and the pedestal, and the trends of vibration with rotation speed also change at different temperatures. Impact and friction make great contributions to the interactions between the outer ring and the pedestal and show different changes with temperature. This study puts forward a method for the calculation of bearing vibration at variable temperatures and provides theoretical basis for the application of the full ceramic bearings.
Wetting Process and Adsorption Mechanism of Surfactant Solutions on Coal Dust Surface
Authors: Wang Xiaonan , Yuan Shujie , Jiang Bingyou
Published: October 2019

To determine the wetting process and wetting mechanism of different surfactant solutions on coal dust surface, four types of surfactants (anionic surfactant 1227, anionic surfactant AOS, amphoteric surfactant CAB-35, and nonionic surfactant CDEA) are selected to measure their surface tension and contact angle. Based on the data, the adhesion work, spreading coefficient, and immersion work of the surfactant solutions on a coal dust surface are calculated and their adsorption mechanism is discussed. The results show that the surface tension and contact angle of AOS and CDEA are lower and smaller, respectively, their calculated spreading coefficients are higher, and their adhesion work and immersion work are less than those of 1227 and CAB-35. This shows that the wettability of the AOS and CDEA solutions for a coal dust surface is more than that of 1227 and CAB-35, whereas their adhesion is lower than that of the latter. The spreading coefficient can be used as an index to determine the wettability. The wetting ability of the AOS and CDEA aqueous solutions for coal dust is stronger than that of 1227 and CAB-35 because of the different adsorption forms of the surfactant molecules on the surface of the coal dust. The tail hydrophobic group of the AOS and CDEA surfactant molecules orient to the surface of the coal dust, whereas the head hydrophilic group directs to the solution, being easier to wet. The results show that anionic and nonionic surfactant solutions can significantly improve the wettability of a coal dust surface, providing a theoretical basis for selecting suitable surfactants as water-spray additives to improve the dust suppression efficiency.
Malondialdehyde and Uric Acid as Predictors of Adverse Outcome in Patients with Chronic Heart Failure
Authors: Romuk Ewa , Wojciechowska Celina , Jacheć Wojciech , Zemła-Woszek Aleksandra , Momot Alina , Buczkowska Marta , Rozentryt Piotr
Published: October 2019

In chronic heart failure (HF), some parameters of oxidative stress are correlated with disease severity. The aim of this study was to evaluate the importance of oxidative stress biomarkers in prognostic risk stratification (death and combined endpoint: heart transplantation or death). In 774 patients, aged 48-59 years, with chronic HF with reduced ejection fraction (median: 24.0 (20-29)%), parameters such as total antioxidant capacity, total oxidant status, oxidative stress index, and concentration of uric acid (UA), bilirubin, protein sulfhydryl groups (PSH), and malondialdehyde (MDA) were measured. The parameters were assessed as predictive biomarkers of mortality and combined endpoint in a 1-year follow-up. The multivariate Cox regression analysis was adjusted for other important clinical and laboratory prognostic markers. Among all the oxidative stress markers examined in multivariate analysis, only MDA and UA were found to be independent predictors of death and combined endpoint. Higher serum MDA concentration increased the risk of death by 103.0% (HR=2.103; 95% CI (1.330-3.325)) and of combined endpoint occurrence by 100% (HR=2.000; 95% CI (1.366-2.928)) per μmol/L. Baseline levels of MDA in the 4th quartile were associated with an increased risk of death with a relative risk (RR) of 3.64 (95% CI (1.917 to 6.926), p<0.001) and RR of 2.71 (95% CI (1.551 to 4.739), p<0.001) for the occurrence of combined endpoint as compared to levels of MDA in the 1st quartile. Higher serum UA concentration increased the risk of death by 2.1% (HR=1.021; 95% CI (1.005-1.038), p<0.001) and increased combined endpoint occurrence by 1.4% (HR=1.014; 95% CI (1.005-1.028), p<0.001), for every 10 μmol/L. Baseline levels of UA in the 4th quartile were associated with an increased risk for death with a RR of 3.21 (95% CI (1.734 to 5.931)) and RR of 2.73 (95% CI (1.560 to 4.766)) for the occurrence of combined endpoint as compared to the levels of UA in the 1st quartile. In patients with chronic HF, increased MDA and UA concentrations were independently related to poor prognosis in a 1-year follow-up.
Solitary Fibrous Tumor Arising in the Buccal Space
Authors: Okui Tatsuo , Ibaragi Soichiro , Kawai Hotaka , Sasaki Akira
Published: October 2019

A 39-year-old Japanese woman presented to the Department of Oral and Maxillofacial Surgery, Okayama University Hospital, with the complaint of a slowly growing buccal mass. The mass was well defined, had rounded margins, and was free from skin and muscles. A color Doppler echographic examination indicated high flow velocity of the blood surrounding the mass. Contrast-enhanced images on CT and contrast-enhanced T1-weighted images on MRI displayed a homogeneous enhanced mass with a well-defined margin. A fine-needle aspiration biopsy and histological examination were performed. On immunohistochemistry, spindle cells were strongly positive for CD34, STAT6, and vimentin and negative for EMA, S100, and α-SMA. The tumor was removed with extracapsular dissection. The tumor was composed of bland spindle cells proliferating in a patternless arrangement with a collagenous background. Most of the tumor mass consisted of hypocellular areas including ectatic blood vessels. A prominent branching vascular pattern was observed. Immunohistochemistry demonstrated that the tumor cells were positive for CD34, STAT6, vimentin, and Bcl-2, and negative for α-SMA, S100, and EMA. Three mitotic cells were observed per 10 high-power fields, and the Ki-67 index was 5.7%. The morphological and immunohistochemical features were consistent with a diagnosis of solitary fibrous tumor.
Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases
Authors: Opoku-Agyeman Jude , Humenansky Kayla , Davis Wellington , Glat Paul
Published: October 2019

Background. The use of Integra Dermal Reconstruction Template has emerged as an option for wound reconstruction, after resection of congenital nevi, especially giant congenital nevi. There have been many reports on Integra use in the literature for this purpose. This systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes. Methods. Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Studies were analyzed if they met the inclusion criteria. Pooled descriptive statistics were performed. Results. Thirteen studies that met the inclusion criteria were included for analysis, yielding 31 procedures in 31 patients. Eleven of the thirteen studies were case reports representing 17 of the 31 patients. One study was retrospective, and the other study was a prospective study. The mean follow-up was 2.67 years (range, 0.2–13 years). The overall wound closure rate was 100%. The overall initial Integra take rate was 90.3% and the skin graft take rate was 100%. The rate of reported complications was 14.8%. The average age of patients was 7.36 years. The average size of the nevus was 6.29% TBSA (range, 0.005%–26%), and the time to definitive skin grafting was 3.28 weeks. Significant heterogeneity was found among the published studies. Conclusion. We conclude that the use of Integra appears to be a safe and viable option for defect reconstruction after the primary or secondary excision of congenital nevi of different sizes and on most parts of the body. Long-term follow-up studies and prospective cohort studies are required in order to fully estimate the incidence of complications. However, the rarity of this condition make these types of studies very difficult.
Tumor Vessel Normalization, Immunostimulatory Reprogramming, and Improved Survival in Glioblastoma with Combined Inhibition of PD-1, Angiopoietin-2, and VEGF
Authors: Di Tacchio Mariangela , Macas Jadranka , Weissenberger Jakob , Sommer Kathleen , Bähr Oliver , Steinbach Joachim P. , Senft Christian , Seifert Volker , Glas Martin , Herrlinger Ulrich , Krex Dietmar , Meinhardt Matthias , Weyerbrock Astrid , Timmer Marco , Goldbrunner Roland , Deckert Martina , Scheel Andreas H. , Büttner Reinhard , Grauer Oliver M. , Schittenhelm Jens , Tabatabai Ghazaleh , Harter Patrick N. , Günther Stefan , Devraj Kavi , Plate Karl H. , Reiss Yvonne
Published: October 2019

Glioblastoma (GBM) is a non-T-cell–inflamed cancer characterized by an immunosuppressive microenvironment that impedes dendritic cell maturation and T-cell cytotoxicity. Proangiogenic cytokines such as VEGF and angiopoietin-2 (Ang-2) have high expression in glioblastoma in a cell-specific manner and not only drive tumor angiogenesis and vascular permeability but also negatively regulate T-lymphocyte and innate immune cell responses. Consequently, the alleviation of immunosuppression might be a prerequisite for successful immune checkpoint therapy in GBM. We here combined antiangiogenic and immune checkpoint therapy and demonstrated improved therapeutic efficacy in syngeneic, orthotopic GBM models. We observed that blockade of VEGF, Ang-2, and programmed cell death protein-1 (PD-1) significantly extended survival compared with vascular targeting alone. In the GBM microenvironment, triple therapy increased the numbers of CTLs, which inversely correlated with myeloid-derived suppressor cells and regulatory T cells. Transcriptome analysis of GBM microvessels indicated a global vascular normalization that was highest after triple therapy. Our results propose a rationale to overcome tumor immunosuppression and the current limitations of VEGF monotherapy by integrating the synergistic effects of VEGF/Ang-2 and PD-1 blockade to reinforce antitumor immunity through a normalized vasculature.
High Expression Levels of Long Noncoding RNA Small Nucleolar RNA Host Gene 18 and Semaphorin 5A Indicate Poor Prognosis in Multiple Myeloma
Authors: Huang Ling-Juan , Shen Ying , Bai Ju , Wang Fang-Xia , Feng Yuan-Dong , Chen Hong-Li , Peng Yue , Zhang Ru , Li Fang-Mei , Zhang Pei-Hua , Lei Xiao-Ru , Xue Feng , Ma Yan-Ping , Hu Jin-Song , He Ai-Li
Published: October 2019

Background: The aim of this study was to detect the expression of long noncoding RNA small nucleolar RNA host gene 18 (SNHG18) andsemaphorin 5A (SEMA5A) genes in multiple myeloma (MM) patients and to explore the correlation of the expression of these genes with the clinical characteristics and prognosis of MM patients. Methods: Forty-seven newly diagnosed MM, 18 complete remission MM, 13 refractory/relapse MM, and 22 iron deficiency anemia (serving as control) samples were extracted at the Department of Hematology, Second Aﬃliated Hospital of Xian Jiaotong University between January 2015 and December 2016. The clinical features of the MM patients are summarized. Real-time quantitative PCR was performed to analyze the relative expression levels of the SNHG18 and SEMA5Agenes. The clinical characteristics and overall survival (OS) of the MM patients were statistically analyzed while measuring different levels of SNHG18 and SEMA5Agene expression. At the same time, the correlation between the expression of SNHG18 and SEMA5A was also analyzed. Results: The analysis confirmed that SNHG18 and its possible target gene SEMA5A were both highly expressed in newly diagnosed MM patients. After analyzing the clinical signiﬁcance of SNHG18 and SEMA5A in MM patients, we found that the expression of SNHG18 and SEMA5A was related to the Durie-Salmon (DS), International Staging System (ISS), and Revised International Staging System (R-ISS) classification systems, and the Mayo Clinic Risk Stratification for Multiple Myeloma (mSMART; p < 0.05). Moreover, we observed a significant difference in OS between the SNHG18/SEMA5A high expression group and the low expression group. We found a positive correlation between SNHG18 and SEMA5A expression (r = 0.709, p < 0.01). Surprisingly, the expected median OS times of both the SNHG18 and SEMA5Ahigh expression groups were significantly decreased, which was in contrast to those of both the SNHG18 and SEMA5Alow expression groups and the single-gene high expression group (p < 0.05). Conclusion: High expression of both SNHG18 and SEMA5A is associated with poor prognosis in patients with MM.
Initial Experience of Superb Microvascular Imaging for Key Cardiac Views in Foetal Assessment before 15 Weeks Gestation
Authors: Jabak  Salma , Vigneswaran Trisha V. , Charakida Marietta , Kasapoglu Taner , de Jesus Cruz Jader , Simpson John M. , Zidere Vita
Published: October 2019

Background: In the first trimester, ultrasound confirmation of normal or abnormal cardiac anatomy is difficult. B-mode and colour flow Doppler (CFD) are used to assess the foetal heart. Superb microvascular imaging (SMI) can visualise blood flow within the heart and vessels in early gestation. Objective: We report an initial experience of SMI for visualisation of normal and abnormal cardiac anatomy in the first trimester. Methods: Transabdominal foetal echocardiography was performed between 11 + 6 and 14 + 3 weeks (Aplio 500 US system, Toshiba Medical Systems, Tokyo, Japan) from January 2017 to December 2017. All scans were performed at a tertiary foetal cardiology unit. To assess the potential utility of the technique for early gestation screening, normal scans were reviewed by foetal medicine trainees with respect to the B-mode, CFD and SMI. Three key views were selected to compare modalities: the 4-chamber view, outflow tracts and the 3-vessel and trachea view (VTV). Visualisation rates of key echocardiographic features of significant cardiac abnormalities by SMI were reviewed. Results: Fifty-five normal echocardiograms and 34 cardiac abnormalities were included. In the normal heart, when B-mode, CFD and SMI were assessed separately, SMI had the highest rate of visualisation of 4-chamber, outflow tracts and 3-VTV (93, 85 and 83%, respectively). Intra-observer reliability was moderate for SMI of the 3 standard views (kappa 1, 0.64 and 0.64); inter-observer for 4-chamber and outflow tract views was moderate (kappa 0.64 and 0.77). In 29/34 abnormal cases, SMI showed key features, enhancing greyscale visualisation. Conclusion: SMI has potential to become a useful, complementary modality for early foetal echocardiography. Further prospective studies are warranted to establish the place of the technique in assessment of the first trimester foetal heart.
Personalised Nutrition Technologies and Innovations: A Cross-National Survey of Registered Dietitians
Authors: Abrahams Mariette , Frewer Lynn J. , Bryant Eleanor , Stewart-Knox Barbara
Published: October 2019

Background: Commercial technology-enabled personalised nutrition is undergoing rapid growth, yet its uptake in dietetics practice remains low. This survey sought the opinions of dietetics practitioners on personalised nutrition and related technologies to understand the facilitators and barriers to its application in practice. Method: A cross-section of registered dietitians were recruited in the USA, UK, Australia, Canada, Israel, Mexico, Portugal, Spain, and South Africa. The questionnaire sought their views on the risks of genetics technology, the ethics of genetic testing, the usefulness of new personalised nutrition technologies, entrepreneurism, and the perceived importance of new technologies to dietetics. Validated scales were included to assess personality (Big Five) and self-efficacy (NGSEI). The survey was available in English, Spanish, and Portuguese. Regression analyses were performed to identify factors associated with the integration of nutrigenetic testing into practice, and to identify factors associated with the perceived importance of bio-information, and mobile technology to dietetics practice. Results: A total of 323 responses (response rate 19.7%) were analysed. Dietetics practitioners who had integrated personalised nutrition technology into practice perceived technologies to be less risky (p = 0.02), biotechnology to be more important (p < 0.01), and professional skills to be less important (p = 0.04) than those who had not. They were also more likely to see themselves as entrepreneurs (p < 0.01) and to perceive lower risks to be associated with technology (p < 0.01). Practitioners of nutrigenetics were lower on neuroticism (p < 0.01) and higher on self-efficacy (p < 0.01), extraversion (p < 0.01), and agreeableness (p < 0.01). A higher perceived importance of biotechnology to dietetics practice was associated with higher perceived usefulness of omics tests (p < 0.01). Perceived importance of information technology was associated with the perceived importance of biotechnology (p < 0.01). Mobile technology was perceived as important by dietitians with the highest level of education (p = 0.02). Conclusions: For dietitians to practice technology-enabled personalised nutrition, training will be required to enhance self-efficacy, address the risks perceived to be associated with new technologies, and instil an entrepreneurial mindset.
Reversible Progressive Multiple Cranial Nerve Paresis in the Isolated Fourth Ventricle following Placement of Fourth Ventricle Shunt: Case Report and Review of the Literature
Authors: Thakker Ravi , Mohanty Aaron
Published: October 2019

Background/Aims: Multiple lower cranial nerve paresis occurring after placement of a fourth ventricle shunt for an isolated fourth ventricle is an uncommon complication in the postoperative period. Of the various etiologies, direct brain stem injury by the catheter and rapid decompression of the fourth ventricle by the shunt causing traction on the cranial nerves have been reported in the literature. Methods: We report the case of a 9-year-old girl with an isolated fourth ventricle who developed bilateral facial and multiple lower cranial nerve paresis with bilateral internuclear ophthalmoplegia a month after placement of a ventriculoperitoneal shunt. The postprocedure MRI showed a well-decompressed fourth ventricle with catheter tip located along the long axis of the fourth ventricle. Results: She was managed non-operatively. She improved gradually in her cranial nerve paresis over the next 3 months and completely recovered at 9 months. Conclusion: We believe the reversible multiple cranial nerve neuropathies resulted from acute decompression of the fourth ventricle following the shunt insertion. A gradual decompression of the dilated fourth ventricle by an aqueductal stent or a high-pressure shunting system could prevent this potential complication.
A Case of Non-Resolving MEK Inhibitor-Associated Retinopathy
Authors: Chancellor John R. , Kilgore David A. , Sallam Ahmed B. , Allen Richard C. , Uwaydat Sami H.
Published: October 2019

The mitogen-activated kinase pathway plays an important role in cell survival, and its dysregulation is associated with cancers such as melanoma. Drugs designed to target this pathway have been associated with serous retinal detachments in a new entity termed MEK inhibitor-associated retinopathy (MEKAR). MEKAR has classically been described as self-limiting, with serous fluid often resolving without discontinuation of the drug. We present a case in which a patient undergoing treatment for metastatic melanoma with lacnotuzumab, a macrophage colony-stimulating factor inhibitor that blocks an upstream component of the mitogen-activated protein kinase pathway, developed serous retinopathy that did not resolve despite drug discontinuation.
Plasma Desmosine and Abdominal Aortic Aneurysm Disease
Authors: Mordi Ify R. , Forsythe Rachael O. , Gellatly Corry , Iskandar Zaid , McBride Olivia M. , Saratzis Athanasios , Chalmers Rod , Chin Calvin , Bown Matthew J. , Newby David E. , Lang Chim C. , Huang Jeffrey T. J. , Choy Anna‐Maria
Published: October 2019

Background

It is recognized that factors beyond aortic size are important in predicting outcome in abdominal aortic aneurysm (AAA) disease. AAA is characterized by the breakdown of elastin within the aortic tunica media, leading to aortic dilatation and rupture. The aim of this study was to investigate the association of plasma desmosine (pDES), an elastin‐specific degradation product, with disease severity and clinical outcome in patients with AAA.

Methods and Results

We measured pDES and serum biomarker concentrations in 507 patients with AAAs (94% men; mean age, 72.4±6.1 years; mean AAA diameter, 48±8 mm) and 162 control subjects (100% men; mean age, 71.5±4.4 years) from 2 observational cohort studies. In the longitudinal cohort study (n=239), we explored the incremental prognostic value of pDES on AAA events. pDES was higher in patients with AAA compared with control subjects (mean±SD: 0.46±0.22 versus 0.33±0.16 ng/mL;
P
<0.001) and had the strongest correlation with AAA diameter (
r
=0.39;
P
<0.0001) of any serum biomarker. After adjustment for baseline AAA diameter, pDES was associated with an AAA event (hazard ratio, 2.03 per SD increase [95% CI, 1.02–4.02];
P
=0.044). In addition to AAA diameter, pDES provided incremental improvement in risk stratification (continuous net reclassification improvement, 34.4% [95% CI, −10.8% to 57.5%;
P
=0.09]; integrated discrimination improvement, 0.04 [95% CI, 0.00–0.15;
P
=0.050]).

Conclusions

pDES concentrations predict disease severity and clinical outcomes in patients with AAA.

Clinical Trial Registration

http://
www.isrctn.com
. Unique identifier: ISRCTN76413758.
Does Chronic Kidney Disease Predict Stroke Risk Independent of Blood Pressure?
Authors: Kelly Dearbhla M. , Rothwell Peter M.
Published: October 2019

Background and Purpose—

Chronic kidney disease is strongly associated with stroke with various purported mechanisms proposed. Low glomerular filtration rate appears to be a risk factor for stroke independent of cardiovascular risk factors in epidemiological studies, but there has been no systematic assessment of the impact of more complete adjustment for blood pressure on the association.

Methods—

We did a systematic review to February 2018 (MEDLINE/EMBASE) for cohort studies or randomized controlled trials that reported stroke incidence in adults according to baseline estimated glomerular filtration rate. Study and participant characteristics and relative risks (RR) were extracted. Estimates were combined using a random-effects model. Heterogeneity was assessed by x
2
statistics and
I
2
and by subgroup strata and meta-regression.

Results—

We identified 168 studies reporting data on 5 611 939 participants with 115 770 stroke outcomes. Eighty-five studies (3 417 098 participants; 72 996 strokes) provided adequate data for meta-analysis of estimated glomerular filtration rate and stroke risk. Incident stroke risk was increased among participants with estimated glomerular filtration rate <60 mL/min per 1.73 m
2
(RR=1.73; 95% CI, 1.57–1.90;
P
<0.001), but there was substantial heterogeneity between studies (
P
<0.0001;
I
2
, 78.5%). Moreover, the association was reduced after adjustment for cardiovascular risk factors, with progressive attenuation on more thorough adjustment for hypertension: single baseline blood pressure measure (RR=1.63; CI, 1.34–1.99;
P
<0.001); history or treated hypertension (RR=1.35; CI, 1.24–1.46;
P
<0.001); multiple blood pressure measurements over months to years (RR=1.10; CI, 1.02–1.18;
P
=0.01).

Conclusions—

The association between chronic kidney disease and stroke appears to be highly dependent on the method of adjustment for hypertension. The apparently independent relationship between chronic kidney disease and stroke may be confounded by their shared association with long-term prior blood pressure.