bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitreous hemorrhage: A rare ophthalmic adverse effect due to imatinib treatment
Authors: Yılmaz Fatma , Albayrak Murat , Tığlıoğlu Pınar , Tığlıoğlu Mesut , Sağlam Buğra , Reis Aras Merih , Maral Senem , Afacan Öztürk Hacer Berna
Published: November 2021

Introduction

Imatinib is generally well tolerated by patients. The most common ophthalmic side effects are eyelid edema and periorbital edema. Other side effects which occur at rates of <1% include blepharitis, blurred vision, conjunctival hemorrhage, conjunctivitis, retinal hemorrhage, etc. An uncommon case is here reported of a 51-year-old male with chronic myeloid leukemia who developed vitreous hemorrhage due to imatinib after 9 months of treatment.

Case report

A 51-year-old male with leukocytosis detected in the blood test examination was referred to the Hematology Department. The bone marrow biopsy result was compatible with chronic myeloid leukemia. Imatinib treatment (400 mg/day) was started. In the ninth month of imatinib treatment, the patient complained of a sudden decrease in vision. Vitreous hemorrhage was detected in the left eye and the patient underwent surgery. Vitreous hemorrhage recurred 1 month after the operation. On the fourth day after the discontinuation of imatinib treatment, the patient's ophthalmic complaints improved significantly. The Naranjo algorithm was applied and a score of 9 was detected. The vitreous hemorrhage of the patient was attributed to imatinib, and so the treatment of the patient was switched to bosutinib.

Discussion

Imatinib is an oral signal inhibitor that targets tyrosine kinase for BCR/ABL, platelet-derived growth factor, stem cell factor, and c-kit (CD117). The conjunctiva and sclera have a large amount of c-kit positive mast cells which are inhibited by imatinib. The inhibition of c-kit positive mast cells by imatinib may be responsible for further exposure of the conjunctival mucosa to injuries.
Does IQ Influence Association Between Working Memory and ADHD Symptoms in Young Adults?
Authors: Soares Pedro San Martin , de Oliveira Paula Duarte , Wehrmeister Fernando César , Menezes Ana Maria Baptista , Rohde Luis Augusto , Gonçalves Helen
Published: November 2021

Objective

This study examined the association between WM and ADHD symptoms in young adults and whether IQ-score influenced this association.

Method

Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed ( N = 2,845). Working memory and ADHD symptoms were collected at 22 years. IQ was examined at age 18. Poisson regression with robust variance was used to assess the associations between working memory and ADHD symptoms. We also evaluated whether IQ modified associations between working memory and ADHD symptoms.

Results

Working memory was negatively associated with Inattention symptoms of ADHD. The association between working memory and hyperactivity-impulsivity symptoms of ADHD varied by IQ.

Conclusions

This study provides new insights to theories about the relationship between WM and ADHD symptoms as well as the development of interventions aimed at improving the performance of WM in ADHD.
Reducing Unhealthy Normative Behavior: The Case of Sports and Energy Drinks
Authors: Hennessy Michael , Bleakley Amy , Ellithorpe Morgan E. , Maloney Erin , Jordan Amy B. , Stevens Robin
Published: November 2021

American adolescents consume more sugar-sweetened beverages (SSBs) than any other age group. Sports and energy drinks consumption among adolescents is higher than other SSBs. For sports drinks, there is uncertainty about their “healthiness” and also beliefs that these drinks may provide health benefits such as hydration, enhanced athletic performance, heightened mental alertness, and rapid recovery after exercise. Confusion about relative healthiness and expectations of health benefits suggest that factors that may encourage youth to avoid drinking sports and energy drinks, such as athletic status, psychological reactance, and SSB media literacy, may necessitate different approaches to promoting avoidance of sports drinks compared with avoidance of energy drinks. Using a nationally representative U.S. probability-based web panel augmented by a volunteer nonprobability-based web panel of 500 adolescent participants aged 14 to 18 years, we used the reasoned action approach to model intention to avoid sports and to avoid energy drinks. The result show there are similarities and differences in the determinants associated with adolescents’ avoidance of sports and energy drinks: attitudes and descriptive normative pressure are both related to increased avoidance for both types of drinks and perceived control over the avoidance behavior is positively associated for with intention to avoid for energy drinks. Sport identification, psychological reactance, and SSB media literacy also play a different role in the sports and energy drink models. Based on our results, the content of prevention messages in interventions to limit sports drinks will need to be quite different from those targeted at reducing energy drink consumption.
Recommendations for the management of diabetic macular oedema with intravitreal dexamethasone implant: A national Delphi consensus study
Authors: Kodjikian Laurent , Baillif Stephanie , Couturier Aude , Creuzot-Garcher Catherine , Delyfer Marie-Noelle , Matonti Frédéric , Weber Michel
Published: November 2021

Purpose

The intravitreal dexamethasone implant (DEX-I) is an alternative to anti-VEGF for the first-line treatment of diabetic macular oedema (DME). However, several questions remain regarding its routine use and its place in certain situations not always specified in current recommendations. A national consensus approach was, therefore, initiated by French retinal experts.

Methods

An iterative Delphi consensus approach was used. A steering committee (SC) of seven experts analysed data from the literature to formulate statements divided into five key areas of treatment. These statements were submitted to the independent and anonymous electronic vote of 87 French retina experts among whom 39 expressed their opinion and therefore constituted the voting panel.

Results

After two rounds of voting, 22 and 7 of 38 statements received a strong consensus and a good consensus, respectively. The consensus level was higher for statements regarding first-line indications and safety of DEX-I compared to those regarding efficacy assessment, reprocessing time or pathophysiological biomarkers. The panellists recommended the preferential use of DEX-I for patients with limited availability for multiple injections, those who needed to undergo cataract surgery or who had a recent cardiovascular history, and as a therapeutic alternative to anti-VEGF in patients with a history of vitrectomy, retinal serous detachment, hyper-reflective points or dry exudates in optical coherence tomography (OCT). However, some statements proposed by SC experts were not validated.

Conclusion

This study provides some key recommendations to clinicians treating diabetic macular oedema, which may be useful when using intravitreal dexamethasone implants in daily practice.
The association of T786C and G894T polymorphisms of eNOS gene with diabetic retinopathy in Greece
Authors: Gouliopoulos Nikolaos , Siasos Gerasimos , Oikonomou Dimitra , Oikonomou Evangelos , Konsola Theodosia , Kollia Christina , Athanasiou Dimitris , Dimitropoulos Stathis , Rouvas Alexandros , Kassi Eva , Tousoulis Dimitrios , Moschos Marilita M.
Published: November 2021

Purpose

To investigate whether eNOS T786C (rs2070744) and G894T (rs1799983) gene polymorphisms are associated with diabetic retinopathy in Greek diabetic patients.

Materials

271 patients with type-2 diabetes mellitus participated in our study; 130 suffered from diabetic retinopathy and 141 not. All the patients underwent a complete ophthalmological examination, while clinical and demographic data were assessed. Furthermore, they were genotyped for rs2070744 and rs1799983 single nucleotide polymorphisms of eNOS gene.

Results

Regarding the clinical and demographic data, no significant differences were detected between the studied groups, except for hemoglobin A1c levels and the frequency of insulin treatment (higher in patients with diabetic retinopathy). The frequency of rs1799983 GT genotype was significantly elevated in patients with diabetic retinopathy (55% vs. 40%, P = 0.011) and was associated with a 2-fold increased risk of developing retinopathy (OR 1.92, 95% CI 1.16–3.17). Furthermore, we demonstrated that the aforementioned genotype was significantly and independently associated with increased odds for retinopathy onset in diabetic subjects (OR 2.23, 95% CI 1.28–3.90, P = 0.005), regardless of the impact of other confounders.

Conclusions

We documented that rs1799983 GT genotype could be recognized as an independent risk factor of retinopathy in Greek patients with type-2 diabetes mellitus, while no role for rs2070744 polymorphism was identified. Further research in different ethnic groups will clarify the exact association of these polymorphisms with the risk for diabetic retinopathy development.
The role of venous pressure variability during hemodialysis in the prediction of impending arteriovenous graft occlusion
Authors: Tseng Yuan-Hsi , Wong Min Yi , Kao Chih-Chen , Lin Chien-Chao , Lu Ming-Shian , Lu Chu-Hsueh , Huang Yao-Kuang
Published: November 2021

Background:

Elevated venous pressure during hemodialysis (VPHD) is associated with arteriovenous graft (AVG) stenosis. This study investigated the role of VPHD variations in the prediction of impending AVG occlusion.

Methods:

Data were retrieved from 118 operations to treat AVG occlusion (occlusion group) and 149 operations to treat significant AVG stenosis (stenosis group). In addition to analyzing the VPHD values for the three hemodialysis (HD) sessions prior to the intervention, VPHD values were normalized to mean blood pressure (MBP), blood flow rate (BFR), BFR × MBP, and BFR2 × MBP to yield ratios for analysis. The coefficient of variation (CV) was used to measure relative variations.

Results:

The within-group comparisons for both groups revealed no significant differences in the VPHD mean and CV values among the three HD sessions prior to intervention. However, the CVs for VPHD/MBP, VPHD/(BFR × MBP), and VPHD/(BFR2 × MBP) exhibited significant elevation in the occlusion group during the last HD session prior to intervention compared with both the penultimate and antepenultimate within-group HD data ( p < 0.05). In the receiver operating characteristic curve analysis, the CV for VPHD/(BFR2 × MBP) was the only parameter able to discriminate between the last and the penultimate HD outcomes ( p < 0.001). According to a multivariate analysis, after controlling for covariates, CV for VPHD/(BFR2 × MBP) >8.76% was associated with a higher risk of AVG thrombosis (odds ratio: 3.17, p < 0.001).

Conclusions:

Increasing the variation in VPHD/(BFR2 × MBP) may increase the probability of AVG occlusion.
Comparison of the Gut Microbiota in Patients with Benign and Malignant Breast Tumors: A Pilot Study
Authors: Yang Peidong , Wang Zhitang , Peng Qingqin , Lian Weibin , Chen Debo
Published: November 2021

The microbiome plays diverse roles in many diseases and can potentially contribute to cancer development. Breast cancer is the most commonly diagnosed cancer in women worldwide. Thus, we investigated whether the gut microbiota differs between patients with breast carcinoma and those with benign tumors. The DNA of the fecal microbiota community was detected by Illumina sequencing and the taxonomy of 16S rRNA genes. The α-diversity and β-diversity analyses were used to determine richness and evenness of the gut microbiota. Gene function prediction of the microbiota in patients with benign and malignant carcinoma was performed using PICRUSt. There was no significant difference in the α-diversity between patients with benign and malignant tumors ( P = 3.15e−1 for the Chao index and P = 3.1e−1 for the ACE index). The microbiota composition was different between the 2 groups, although no statistical difference was observed in β-diversity. Of the 31 different genera compared between the 2 groups, level of only Citrobacter was significantly higher in the malignant tumor group than that in benign tumor group. The metabolic pathways of the gut microbiome in the malignant tumor group were significantly different from those in benign tumor group. Furthermore, the study establishes the distinct richness of the gut microbiome in patients with breast cancer with different clinicopathological factors, including ER, PR, Ki-67 level, Her2 status, and tumor grade. These findings suggest that the gut microbiome may be useful for the diagnosis and treatment of malignant breast carcinoma.
Expansion of telehealth curriculum: National survey of clinical education leaders
Authors: Jortberg Bonnie T , Beck Dallaghan Gary L , Schatte Dawnelle , Christner Jennifer , Ryan Michael S
Published: November 2021

Introduction

In response to the COVID pandemic and the rapid changes in delivery of and education on telehealth services, the Research Committee of the Alliance of Clinical Education (ACE) surveyed its multidisciplinary group of medical educators to determine how telehealth was being taught pre-COVID versus during-COVID.

Methods

An online survey was developed by the ACE Research Committee and sent via email to the ACE delegation. The objective of the survey was to determine changes in telehealth curriculum for medical students due to the rapid transition to telehealth, and the barriers for developing and delivering a telehealth curriculum.

Results

Forty-nine percent of recipients (31/63) responded representing eight different disciplines in addition to institutional curriculum developers. Most programs had no formal didactics and no clinical experiences in telehealth prior to the pandemic. Most respondents added didactics and clinical telehealth encounters during COVID, although few schools required this of all students.

Discussion

Given the barriers of faculty training to pivot to telehealth, and the potential benefits to healthcare cost and patient satisfaction, there is a need for more formal study on best practices for teaching telehealth to prepare our future physicians.
Pediatric Avoidant-Restrictive Food Intake Disorder and gastrointestinal-related Somatic Symptom Disorders: Overlap in clinical presentation
Authors: Boerner Katelynn E , Coelho Jennifer S , Syal Fiza , Bajaj Deepika , Finner Natalie , Dhariwal Amrit K
Published: November 2021

Certain presentations of Avoidant/Restrictive Food Intake Disorder (ARFID) and Somatic Symptom and Related Disorders (SSRDs) have conceptual overlap, namely, distress and impairment related to a physical symptom. This study compared characteristics of pediatric patients diagnosed with ARFID to those with gastrointestinal (GI)-related SSRD. A 5-year retrospective chart review at a tertiary care pediatric hospital comparing assessment data of patients with a diagnosis of ARFID ( n = 62; 69% girls, Mage = 14.08 years) or a GI-related SSRD ( n = 37; 68% girls, Mage = 14.25 years). Patients diagnosed with ARFID had a significantly lower percentage of median BMI than those with GI-related SSRD. Patients diagnosed with ARFID were most often assessed in the Eating Disorders Program, whereas patients diagnosed with an SSRD were most often assessed by Consultation-Liaison Psychiatry. Groups did not differ on demographics, psychiatric diagnoses, illness duration, or pre-assessment services/medications. GI symptoms were common across groups. Patients diagnosed with an SSRD had more co-occurring medical diagnoses. A subset (16%) of patients reported symptoms consistent with both diagnoses. Overlap is observed in the clinical presentation of pediatric patients diagnosed with ARFID or GI-related SSRD. Some group differences emerged, including anthropometric measurements and co-occurring medical conditions. Findings may inform diagnostic classification and treatment approach.
The meaning of loneliness to stroke survivors: A qualitative study in Northeast England
Authors: Yang Keming , Armstrong Nicole , Diamond Clare , Lane Alison R , Dunne Stephen
Published: November 2021

This study explored stroke survivors’ experiences of loneliness. Drawing on interviews with 29 community-dwelling stroke survivors living in the Northeast of England, we found several themes: loneliness as being alone, the season or time, lack of understanding from those without any experience of stroke, reduced autonomy, and deterioration of social relations. It is important that healthcare professionals pay attention to the aspects of life that may increase the chances of a stroke survivor becoming lonely after being discharged from hospital, and to measure loneliness in stroke survivors a more valid scale should include items that touch on the aspects reported here.
Investigation of outdoor air pollutant, PM2.5 affecting the indoor air quality in a high-rise building
Authors: Fu Nuodi , Kim Moon Keun , Chen Bing , Sharples Stephen
Published: November 2021

This study investigated the impact of outdoor air pollutants on indoor air quality in a high-rise building, considering factors related to the seasons and air infiltration. Further, the impact of atmospheric weather conditions on air infiltration has been analysed in a downtown area of Suzhou, China. The influence of the outdoor air pollution rate on indoor air quality in the office building was investigated based on on-site measurements and computer simulations. Results showed that the impact of outdoor air pollutants on indoor air quality was highest in winter, followed by spring, autumn and summer. Furthermore, multiple factors, which affect the indoor air quality in a high-rise building, have been further investigated in this study, including stack effect, wind effect, infiltration rate, outdoor air pollution rate, seasonal change and air filter efficiency. The significant influence of these factors on the indoor air quality level with floor height variations has been verified. Based on the analysis, a high-efficiency filter is recommended to maintain healthy indoor air quality. Meanwhile, a double-filter system is required if a building is exposed to heavily polluted outdoor air considering the most substantial impact of outdoor air pollutants on indoor air quality in winter. Moreover, a numerical model of steady-state indoor PM2.5 concentration was established to determine the suitable air filter efficiency and airtightness.
Experimental and Optimization Study of Compression Behavior of Sandwich Panels with New Symmetric Lattice Cores
Authors: Norouzi Hossein , Mahmoodi Masoud
Published: November 2021

The paper presents a novel core design for sandwich panels and conducts an experiment to determine whether the mechanical strength of symmetric aluminum lattice core sandwich panels can be improved. Both Design of Experiments (DOE) and Response Surface Methodology (Box-Behnken) were used to establish a quantitative relationship between the strength-to-weight ratio and the input parameters. The thickness of the sheet, the height of sandwich panels, and the width of the seat were all considered design variables to achieve the optimal state. The maximum Initial Peak Crushing Forces (IPCF) were then determined using quasi-static axial flatwise compression tests. This study found that the model's predicted values were consistent with the experimental results. As a result, the parameters were optimized using the Design-Expert software to maximize the initial peak force while minimizing the weight. The results were validated using the Genetic Algorithm, NSGA2, and LINGO. The results indicated that the height of the sandwich panel and the thickness of the sheet had the most significant impact on the maximum force and panel weight. To this end, it is concluded that introducing a novel core design for the sandwich panel, utilizing a suitable Snap-Fitting method for attaching lattice parts rather than using a paste, and finally optimizing the core were the primary reasons for achieving this level of strength.
Investigating the success factors of the Nordic entrepreneurial ecosystem – talent transformation as a key process
Authors: Steigertahl Lisa , Mauer René
Published: November 2021

This paper explores talent transformation from a pool of entrepreneurial talent to successful entrepreneurs as a central characteristic of a successful entrepreneurial ecosystem. To this end, we link related literature streams around cluster theory and regional innovation systems and expand them by drawing on the literature of entrepreneurial ecosystems. Starting out, we review literature on contextual factors that drive the success of entrepreneurial ecosystems and employ qualitative expert interviews to uncover nuances of a qualitative entrepreneurial ecosystem. Based on the interviews and by interlinking the factors identified in literature to have a positive influence on entrepreneurial ecosystems, we introduce talent transformation as a potential key process for the flourishing of entrepreneurial ecosystems and find the social and contextual business environment to be the main independent co-factors. By investigating the European best-practice example of the Nordic countries, we develop and introduce a three-phased talent transformation process and make concrete recommendations for entrepreneurial ecosystem development that can be applied in any geographic context.
Toddlers as active, competent story weavers: Lexie’s story
Authors: White Amanda , Gaffney Janet S , Hedges Helen
Published: November 2021

Communication and literacy development of young children is shaped by the nature of social and cultural relationships in everyday situations. Few studies, however, have explored early story experiences encountered by infants and toddlers in naturalistic settings. We argue that personal stories about everyday lived experiences are a vital context for considering how toddlers develop communicative competencies as they participate in these stories within their families and communities. The paper presents selected findings from a qualitative study underpinned by a broad theoretical view of story embedded in a sociocultural, participatory framework. We contend that stories are collaborative, social endeavours in which intersubjectivity is accomplished collectively and multimodally. Evidence is offered of the communicative process enacted by 1-year-old Lexie, her parent, teacher and peers, as they shared meaning together in a personal story about eating lunch. Lexie and her family were participants in a wider study of the story experiences of 1-year-old toddlers, within and across their family home and early childhood settings, in a culturally diverse community of Aotearoa New Zealand. Drawing on multimodal ethnography and video data, findings illustrate how Lexie and her family, teacher and peers actively participated together in the weaving of a shared personal story using verbal, visual and kinaesthetic forms of communication. The study contributes to the field of early childhood literacy by providing unique insights into the potential of everyday personal stories as a valuable context for exploring ways children’s communicative competencies are developed through relationships in family and community settings.
The Relation of Anxiety and Avoidance Dimensions of Attachment to Intimate Partner Violence: A Meta-Analysis About Victims
Authors: Stefania Cataudella , Rogier Guyonne , Beomonte Zobel Sara , Velotti Patrizia
Published: November 2021

Objective: Attachment theory is a useful framework for understanding the phenomenon of intimate partner violence (IPV) victimisation. Many studies have examined the relationship between attachment and IPV victimisation. The need to examine the nature of this relationship through a meta-analytic approach arises from an awareness of the amount of contrasting data surrounding the topic. Method: Searching five databases (PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science and PubMed) and screening 4343 records, resulted in 34 studies comprising 1271 individuals who met the inclusion criteria for this meta-analysis. Results: Results about attachment anxiety showed significant and moderate effect sizes (ranging from .18 for generic violence to .25 for sexual violence). Results about attachment avoidance also showed significant and moderate effect sizes (ranging from .18 for physical violence to .30 for generic violence). Conclusions: The meta-analysis findings highlight that the relationship between the dimensions of anxiety and the avoidance of attachment are significantly related to all forms of IPV victimisation, with moderate and moderate-to-strong effect sizes, respectively. These results are significant in that they confirm the importance of the relationship between attachment and IPV victimisation, suggesting promising new directions in which this field can further develop.
The Effect of Topically Applied Boric Acid on Ephrin-Eph Pathway in Wound Treatment: An Experimental Study
Authors: Büyük Başak , Aydeğer Cemre , Adalı Yasemen , Eroğlu Hüseyin Avni
Published: November 2021

Background: Wound healing has a vital importance for the organism and various agents are used to accelerate wound healing. Although the effect of boron on wound healing is known, its mechanisms are not completely clear yet. In this study, the effect of boron in the Ephrin /Eph pathway will be evaluated. Methods: Forty adult female rats were used in the study. A full-thickness excisional wound model was created in all groups divided as Control, Fito, Boron and Plu groups. After the applications performed twice a day and lasting 7 days, skin tissues obtained and evaluated histopathological (inflammatory cell infiltration, oedema, and fibroblast proliferation density) and immunohistochemical (TNF-α, EphrinA1, EphrinB1, EphrinB2 and EphB4). Results: Inflammatory cell infiltration score was found to be higher in the Fito group compared to Boron group (p = .018). Fibroblast proliferation density was higher in Plu group than Boron group (p = .012). While TNF-α was lower in boron group than Plu (p = .027) and Fito (p = .016) groups, EphrinA1 was higher in Boron group than Plu group (p = .005). EphrinB1 expression was higher in Boron group compared to Plu (p = .015) and Fito (p = .015) groups, and the same difference was also observed in EphrinB2 (p values .000). Similarly, EphB4 immunoreactivity was higher in the Boron group compared to Plu (p = .000) and Fito (p = .002). Conclusion: One of the mechanisms of action of boron in wound healing is to increase EphrinB1, EphrinB2 and EphB4. Low TNF-α and histopathological findings indicate that boron limits extensive wound healing.
Complement factor H deficiency combined with smoking promotes retinal degeneration in a novel mouse model
Authors: Feng Liwen , Nie Kailai , Huang Qing , Fan Wei
Published: November 2021

Age-related macular degeneration is the leading cause of blindness in the elderly. The Y402H polymorphism in complement factor H promotes disease-like pathogenesis, and a Cfh+/− murine model can replicate this phenotype, but only after two years. We reasoned that by combining CFH deficiency with cigarette smoke exposure, we might be able to accelerate disease progression to facilitate preclinical research in this disease. Wild-type and Cfh+/− mice were exposed to nose-only cigarette smoke for three months. Retinal tissue morphology and visual function were evaluated by optical coherence tomography, fundus photography and autofluorescence, and electroretinogram. Retinal pigment epithelial cell phenotype and ultrastructure were evaluated by immunofluorescence staining and transmission electron microscopy. Cfh+/− smoking mice showed a dome-like protruding lesion at the ellipsoid zone (drusen-like deposition), many retinal hyper-autofluorescence spots, and a marked decrease in A- and B-wave amplitudes. Compared with non-smoking mice, wild-type and Cfh+/− smoking mice showed sub-retinal pigment epithelium complement protein 3 deposition, activation of microglia, metabolic waste accumulation, and impairment of tight junctions. Microglia cells migrated into the photoreceptor outer segment layer in Cfh+/− smoking mice showed increased activation. Our results suggest that exposing Cfh+/− mice to smoking leads to earlier onset of age-related macular degeneration than in other animal models, which may facilitate preclinical research into the pathophysiology and treatment of this disease.
Bioinformatics analysis of an animal model of diet-induced nonalcoholic fatty liver disease with rapid progression
Authors: Hong Wei , Zhang Tingting , Yan Junbin , Yu Jianshun , He Beihui , Wu Liyan , Yao Kannan , Mao Wei , Chen Zhiyun
Published: November 2021

Nonalcoholic fatty liver disease (NAFLD) develops rapidly in high-fat diet (HFD) fed Mongolian gerbil ( Meriones unguiculatus). Here, we aim to explore the gene expression characteristics of Mongolian gerbil to better understand the underlying mechanism in this animal model. Mongolian gerbils were fed with normal diet or HFD for different periods. High-throughput sequencing was carried out on the hepatic mRNA and bioinformatics analysis was further performed. Eight hub genes Cd44, App, Cdc42, Cd68, Cxcr4, Csf1r, Adgre1, and Fermt3, which were involved in inflammation, fibrosis, and HCC were obtained. Four significant independent poor prognostic factors for HCC (GPC1, ARPC1B, DAB2, and CFL1) were screened out. qRT-PCR result showed that the above genes expressed high levels in different periods of modeling process. The findings of this study provide useful information for further studies on Mongolian gerbil NAFLD model.
Altered Dynamic Brain Connectivity in Individuals With Sickle Cell Disease and Chronic Pain Secondary to Hip Osteonecrosis
Authors: Santana Jamille Evelyn R. S. , Baptista Abrahão F. , Lucena Rita , Lopes Tiago da S. , do Rosário Raphael S. , Xavier Marjorie R. , Fonseca André , Miranda José Garcia V.
Published: November 2021

Individuals with sickle cell disease (SCD) exhibit changes in static brain connectivity in rest. However, little known as chronic pain associated with hip osteonecrosis affects dynamic brain connectivity during rest and the motor imagery task. The aim of this study was to investigate the characteristics of the dynamic functional brain connectivity of individuals with SCD and chronic pain secondary to hip osteonecrosis. This is a cross-sectional study comparing the dynamic brain connectivity of healthy individuals (n = 18) with the dynamic brain connectivity of individuals with SCD and chronic pain (n = 22). Individuals with SCD and chronic pain were stratified into high- or low-intensity pain groups based on pain intensity at the time of assessment. Dynamic brain connectivity was assessed through electroencephalography in 3 stages, resting state with eyes closed, and during hip (painful for the SCD individuals) and hand (control, nonpainful) motor imagery. Average weight of the edges and full synchronization time (FST)—time required for 95% of the possible edges to appear over time during a given task—were evaluated. Regarding the average weight of the edges, individuals with SCD and high-intensity pain presented higher edge weight during hip motor imagery. The average weight of the edges correlated positively with pain intensity and depression symptoms. Individuals with SCD and chronic pain complete the cerebral network at rest more quickly (lower FST). Individuals with SCD and chronic pain/hip osteonecrosis have impaired dynamic brain network with shorter FST in rest network and more pronounced diffuse connectivity in individuals with high-intensity pain. The dynamic brain network evaluated by time-varying graphs and motif synchronization was able to identify differences between groups.
Diagnostic Yield of Five Minutes Compared to Three Minutes Hyperventilation During Electroencephalography in Children
Authors: Vasudevan Nivetha , Manokaran Ranjith Kumar , James Saji
Published: November 2021

Purpose: To investigate whether hyperventilation (HV) for 5 minutes increases the diagnostic yield of electroencephalography (EEG) compared to 3 minutes HV and to determine whether performing HV for 5 minutes is feasible and safe in children. Methods: Data were evaluated from 579 children aged less than 18 years, referred to EEG for epilepsy evaluation. Occurrence of seizures, HV induced interictal epileptiform discharges precipitation and potentiation and adverse events if any were noted during the first 3 minutes and last 2 minutes of HV separately. Results: 398 children (68.7%) completed 5 minutes HV. Seizures were precipitated during the first 3 minutes of HV in 2 children, and during the last 2 minutes in one more child. Inter-ictal EEG abnormalities were precipitated in the first 3 minutes of HV in 31 children, and during the last 2 min in 4 more children. All 398 children completed HV during the last 2 minutes successfully and no adverse events occurred during the last 2 minutes of HV. Conclusion: 33.33% of seizures and 11.5% of inter-ictal EEG abnormalities triggered by HV occurred during the last 2 min of HV. This finding supports the utility of prolonged hyperventilation for 5 minutes. Prolonged HV for 5 minutes increases the diagnostic yield of EEG in paediatric population and it is safe and feasible.
#MadelungDeformity: Insights Into a Rare Congenital Difference Using Social Media
Authors: Peymani Abbas , Lokhorst Max M. , Chen Austin D. , van der Horst Chantal M.A.M. , Lee Bernard T. , Lin Samuel J. , Strackee Simon D.
Published: November 2021

Background

Madelung deformity is a rare congenital hand difference with little known regarding the patient perspective. In this cross-sectional survey study, we harnessed the global reach of social media to understand the clinical spectrum of Madelung deformity and its impact on physical, mental, and social health.

Methods

A survey was developed based on a previously published protocol and multiple Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. The survey was distributed on several Madelung deformity communities on Facebook and Instagram. T-scores were calculated, interpreted, and compared between patients who underwent surgery and those who did not. Correlations between scores were calculated using the Spearman rank correlation coefficient.

Results

Mean PROMIS scores for adults were as follows: pain intensity, 4.9 ± 2.8; pain interference, 57.6 ± 10.0; upper extremity, 35.2 ± 8.1; depression, 53.8 ± 11.1; anxiety, 55.4 ± 11.4; and ability to participate in social roles and activities, 42.5 ± 7.7. Mean scores for children were as follows: pain intensity, 5.0 ± 2.8; pain interference, 55.7 ± 11.3; upper extremity function, 24.6 ± 10.4; depressive symptoms, 57.7 ± 11.3; anxiety, 57.3 ± 11.9; and peer relationships, 42.2 ± 10.3.

Conclusions

Madelung deformity has significant effects on patients’ physical, mental, and social well-being, even after surgical treatment. Using social media, we were able to compensate for Madelung deformity’s rarity by engaging an international audience, demonstrating the feasibility to conduct research through it, and providing a global perspective of the disease entity.
“Highly Exposed Chinese Herbal Medicine” Combined With Apatinib as Maintenance Treatment Following First-Line or Second-Line Chemotherapy for Extensive-Stage Small-Cell Lung Cancer: A Single-Arm, Prospective Study
Authors: Wang Mingqi , Jiang Haili , Zhang Mei , Chen Yang , Wang Ting , Li Ping
Published: November 2021

This study aimed to evaluate the efficacy and safety of “highly exposed Chinese herbal medicine” combined with apatinib as maintenance treatment following first-line or second-line chemotherapy in patients with ES-SCLC. A total of 23 patients with ES-SCLC were included in this single-arm prospective study (ChiCTR2100045255). “Highly exposed Chinese herbal medicine” combined with apatinib was administered each day after the chemotherapy for maintenance treatment. The primary endpoint of the study was median PFS, while the secondary endpoints included median OS, DCR, ORR, AE, and the association of “highly exposed Chinese herbal medicine” with PFS and OS. Three and 16 patients achieved partial response (PR) and stable disease (SD), respectively, and four patients were with disease progression (PD). The ORR of the patients was 13.0%, DCR was 83.0%, median PFS was 5.0 months, and median OS was 18.0 months. The major AE included secondary hypertension and hand-foot syndrome. Oral intake of Chinese herbal medicine for ≥ 6 months was associated with longer PFS. Hand-foot syndrome was an independent predictive factor for PFS. The statistical analysis suggested no independent influencing factors for OS. “Highly exposed Chinese herbal medicine” combined with apatinib is effective and relatively safe as the maintenance treatment for ES-SCLC patients who undergo first-line or second-line chemotherapy.
Endovascular treatment of anterior inferior cerebellar artery trunk aneurysms
Authors: Hou Kun , Xu Kan , Yu Jinlu
Published: November 2021

Background

The anterior inferior cerebellar artery (AICA) is a very slender and anatomically variable artery that gives off many important perforating arteries that feed the brainstem and nerve-related arteries that feed the inner ear and labyrinth. AICA trunk aneurysms are rare entities that are also difficult to manage. At present, endovascular treatment (EVT) is the preferred choice; however, the understanding of EVT for AICA trunk aneurysms is limited.

Methods

In this article, we present a literature review on EVT for AICA trunk aneurysms. To promote understanding, we would also provide some illustrative educational cases of our institute.

Results

Aneurysms along the AICA trunk can occur alone (isolated AICA aneurysm) or secondary to cerebrovascular shunts (flow-related AICA aneurysm). According to their anatomical location, they can also be divided into proximal and distal types. At present, EVT is the mainstream treatment, mainly including selective coiling with parent artery preservation and parent artery occlusion. Both coils and liquid embolization materials can be used.

Conclusions

For AICA trunk aneurysms, EVT is a reasonable choice and should be based on the specific anatomical location, pathology, and collateral circulation. However, there is still controversy as to the specific type of treatment that should be chosen.
Fatal hemorrhagic complication after coil embolization of a petrosal arteriovenous shunt
Authors: Volders David , Cora Elena Adela , Chaalala Chiraz , Cartier Maxime , Tanaka Michihiro , Farzin Behzad , Berthelet France , Raymond Jean
Published: November 2021

Background

Cerebello-pontine AVMs (CPAVMs) and petrous apex dural arteriovenous fistulae (DAVFs) are rare and sometimes difficult to distinguish. We report a fatal hemorrhagic complication after coil embolization of the petrosal vein draining a trigeminal AVM misdiagnosed as a DAVF.

Case presentation

A 73-year-old woman with a petrous apex arteriovenous shunt with dual dural and pial arterial supply presented with posterior fossa hemorrhage. The draining petrosal vein was catheterized and coiled via the superior petrosal sinus. Two episodes of contrast extravasation occurred during coiling, but the lesion was completely occluded at the end of the procedure. The patient developed a fatal posterior fossa hemorrhage in the recovery room. Microscopic pathology revealed numerous dilated vessels within the trigeminal nerve.

Conclusion

CPAVMs and DAVFs with pial drainage should be distinguished pre-operatively. Occlusion of a pial vein (as opposed to a sinus) in the treatment of an arteriovenous shunt carries hemorrhagic risk if a liquid embolic agent is not used to completely occlude all pathological vessels.
A numerical study of droplet splitting in branched T-shaped microchannel using the two-phase level-set method
Authors: Raad Mohammad , Rezazadeh Sajad , Jalili Habib , Abbasinezhad Fallah Davod
Published: November 2021

Droplet splitting as a significant feature of droplet-based microfluidic systems has been widely employed in biotechnology, biomedical engineering, tissue engineering, and it has been preferred over continuous flow systems. In the present paper, two-dimensional numerical simulations have been done to examine the asymmetrical droplet splitting process. The two-phase level set method (LSM) has been predicted to analyze the mechanism of droplet formation and droplet splitting in immiscible liquid/liquid two-phase flow in the branched T-junction microchannel. Governing equations on flow field have been discretized and solved using finite element-based COMSOL Multiphysics software (version 5.3a). Obtained numerical results were validated by experimental data reported in the literature which show acceptable agreement. The model was developed to simulate the mechanism of droplet splitting at the branched T-junction microchannel. This study provides a passive technique to asymmetrically split up microdroplets at the downstream T-junctions. The results show that outlet branches’ pressure gradient affects the droplet splitting. Specifically, it has been shown that the splitting ratio increases by increasing the length ratio, and equal droplet splitting can be achieved where the ratio is LL/ Lu = 1. We have used two outlet branches having the same width but different lengths to create the required pressure gradient. As the length ratio of the outlet branches increases, the diameter ratio increases as well.
Stability analysis of triple solutions of Casson nanofluid past on a vertical exponentially stretching/shrinking sheet
Authors: Lanjwani Hazoor Bux , Saleem Salman , Chandio Muhammad Saleem , Anwar Muhammad Imran , Abbas Nadeem
Published: November 2021

The MHD two dimensional boundary layer flow of Casson nanofluid on an exponential stretching/shrinking sheet is considered with effects of radiation parameter, nanoparticles volume fractions (i.e. Fe3O4 and Ti6Al4V) and thermal convective boundary condition. The partial differential equations are transformed into ordinary differential equations by means of similarity transformations. The solutions of the transferred equations are achieved numerically with the help of shooting technique in Maple software. At different ranges of involved physical parameters, triple solutions are found. Therefore, stability analysis is performed by bvp4c in MATLAB to find the stable and physically reliable solution. Impacts of the physical parameter are presented through graphs and tables. Mainly, it is found that an increase in Casson and suction parameters decrease the corresponding velocity profiles while increase in Prandtl number, stretching/shrinking, and suction parameter decrease the temperature profiles. Furthermore, an increase in nanoparticles volumetric fraction, radiation and magnetic parameters as well as Biot number increase the temperature profiles and their thermal boundary layer thicknesses.
A three-dimensional thermal analysis for cooling a square Light Emitting Diode by Multiwalled Carbon Nanotube-nanofluid-filled in a rectangular microchannel
Authors: Ben Hamida Mohamed Bechir , Almeshaal Mohammed A. , Hajlaoui Khalil
Published: November 2021

The aim of this paper is to ensure proper thermal management in order to remove and dissipate the heat produced by a square Light Emitting Diode (LED), as well as to ensure stable and safe operation by reducing the junction temperature. For this, we developed a three-dimensional code, time-dependent that solves the systems of equations for the mass, momentum, and energy using Comsol Multiphysics. After validation of this numerical 3D code, the thermal performance of a LED cooling system with three nanofluids such as MWCNT-Water, MWCNT-Ethylene Glycol, and MWCNT-Engine oil is studied numerically into account of aggregation effect. Several parameters such as: the power of the LED lamp, the inlet temperature and velocity of nanofluid, the length of the heat sink, and the length of the microchannel have been varied in order to find an optimal condition allowing a good heat dissipation from the LED chip to the heat sink. It was concluded that the use of MWCNT-Water in the microchannel is the best nanofluid that can cool the heat sink. In addition, the increase of velocity inlet of the coolant in the microchannel, the length of the heat sink, and the microchannel length while the decrease of the inlet temperature of nanofluid in the microchannel are an important factors allowing the decrease of the junction temperature of the square LED lamp.
The use of bilateral transversus abdominis plane blocks with liposomal bupivacaine on postoperative cesarean delivery patients during COVID-19 pandemic is associated with reduced narcotics use and reduced length of stay
Authors: Feierman Dennis E , Kim Jason , Bronstein Aden , Miller Agnes , Dgheim Christein , London Viktoriya , Alter Avram , Tyagaraj Kalpana
Published: November 2021

Background:

The use of transversus abdominis plane blocks has been previously shown in both large-scale studies and our own institution to significantly reduce postoperative pain and opioid use. In addition, the use of bilateral transversus abdominis plane blocks using liposomal bupivacaine in combination with neuraxial morphine significantly reduced post-cesarean-delivery pain and opioid use. During the COVID-19 crisis, our anesthesia department in a collaborative effort with our obstetric colleagues thought that the use of bilateral transversus abdominis plane blocks with liposomal bupivacaine could reduce the use of opioids to treat postoperative pain and might result in decreased length of stay.

Methods:

After institutional review board approval, a retrospective study of 288 patients who underwent cesarean delivery under spinal or epidural (neuraxial) anesthesia at Maimonides Medical Center in Brooklyn, NY was conducted. Historical controls were from 142 consecutive patients from 1 January 2012 through 12 May 2012. An additional set of controls consisted of 30 consecutive patients from 10 March 2020 through 13 April 2020. The primary outcome data analyzed were the use of opioids and length of stay.

Results:

Post cesarean delivery, patients who received both bilateral transversus abdominis plane blocks with liposomal bupivacaine and neuraxial morphine was associated with a significant decrease in the number of patients using post operative opioids, 54%–60% decreased to 18% ( p < 0.001), and a decreased length of stay; 3.1 days was reduced to 2.39 ( p < 0.001).

Conclusion:

Neuraxial opioids combined with liposomal bupivacaine transversus abdominis plane blocks provided significant pain relief for patients post cesarean delivery, required less post operative opioids, and facilitated earlier discharge that may aid in reducing patient exposure and hospital burden secondary to COVID-19.