bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of the fractional flow reserve in the coronary steal phenomenon evaluation caused by the coronary-pulmonary fistulas: case report and review of the literature
Authors: Huang Zhiwei , Liu Zhihong , Ye Shaodong
Published: February 2020

Background

Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral; however, bilateral and multilateral fistulas are relatively rare. The steal phenomenon aroused from bilateral or multilateral CPFs, and was uncertain and seldom reported. We possess a new tool to assess the hemodynamic significance of coronary artery fistulas. This study aimed to describe the clinical presentation, diagnostic modalities, and management of the coincidentally detected congenital bilateral CPFs.

Case presentation

A case of a 52 year-old female with 10 years history of typical palpitations and chest tightness was presented. The selective coronary arteriography showed a right dominant coronary circulation without significant stenosis; however, with anomalous vessels originating from the proximal right and left anterior descending coronary arteries, draining into the pulmonary artery through a plexus of small vessels. We introduced the fractional flow reserve (FFR) to evaluate the hemodynamic significance of CPFs. The patient was successfully treated with coil embolization.

Conclusions

We presented the case of a female with typical palpitations and chest tightness due to the steal phenomenon that aroused from bilateral CPFs. The fistulas were safely and successfully closed by coil embolization. We showed a new tool for the sophisticated evaluation of the hemodynamic significance of CPFs using FFR measurement and temporary occlusion of the fistula with a standard balloon. FFR could be a promising means for the treatment of decision making of the CPFs.
Newborn screening for Morquio disease and other lysosomal storage diseases: results from the 8-plex assay for 70,000 newborns
Authors: Chien Yin-Hsiu , Lee Ni-Chung , Chen Pin-Wen , Yeh Hui-Ying , Gelb Michael H. , Chiu Pao-Chin , Chu Shao-Yin , Lee Chen-Hao , Lee An-Ru , Hwu Wuh-Liang
Published: February 2020

Background

The necessity of early treatment for lysosomal storage diseases (LSDs) has triggered the development of newborn screening for LSDs in recent years. Here we report the first 70,000 newborns screened for Mucopolysaccharidosis (MPS) type 4A (Morquio syndrome) and other LSDs by an 8-plex assay including the original 4-plex LSD screening tandem mass spectrometry (MS/MS) assay for Pompe disease, Fabry disease, Gaucher disease, and MPS I disease.

Methods

The additional reaction for MPS II, MPS 3B, MPS 4A, and MPS 6 enzymes was performed separately from the 4-plex reaction. The two reactions were quenched and extracted, then combined before carrying out a single 2-min UPLC-MS/MS analysis.

Results

From Mar. 2018 to Apr. 2019, 73,743 newborns were screened with the 8-plex LSD screening assay. The 8-plex assay revealed a better analytical precision than the previous 4-plex assay possibly because the 8-plex was carried out using UPLC-MS/MS. Six newborns were found to have low MPS-4A enzyme (N-acetylgalactosamine-6-sulfatase) activity and biallelic GALNS pathogenic mutations in trans; these patients are presumably affected with MPS4A, making an incidence of one in 12,291 (95% confident interval (CI): 5633-26,817). One mutation, c.857C > T (p.T286 M) of the GALNS gene, accounted 5 of the 12 mutated alleles. These newborns had immature vertebral bodies at 1 month of age, and one case was treated with elosulfase alfa 2 mg/kg/week starting from 4 months of age. Among other MPSs screened, one case of MPS I, 3 cases of MPS II, and 3 cases of MPS 3B were detected. One case of mucolipidosis type III was also diagnosed. In conjunction with another 9 patients of Pompe disease, Gaucher disease, and classical Fabry disease, making an incidence of LSDs as one in 3206 newborns (95% CI: 2137 - 4811). The one with infantile-onset Pompe disease and the one with Gaucher disease were treated since the age of 8 days and 41 days respectively.

Conclusions

Routine newborn screening of MPS 4A and other LSDs were made possible by the 8-plex LSD screening assay. However, detailed phenotype prediction and the time to start treatment will need further elucidation.
Acute dacryocystitis with giant lacrimal abscess: a case report
Authors: Di Cicco Maria , Bellino Elisabetta Maria , Marabotti Andrea , Luti Laura , Peroni Diego G. , Baroncelli Giampiero I.
Published: February 2020

Background

We report a case of a 4-year-old girl with acute dacryocystitis complicated with giant lacrimal abscess who underwent open dacryocystectomy as resolutive surgery.

Case presentation

A 4-year-old previously healthy girl presented to the emergency department with a voluminous and erythematous, fluctuant warm mass localized inferiorly to the medial canthus of the right eye. She had a 2-week history of right inferior eyelid oedema and hyperemia, treated firstly with dexamethasone and netilmicin by eye drops, and then with per oral amoxicillin clavulanate. Ultrasound examination showed a well-circumscribed round lesion filled by anechoic fluid with punctate echoes, confirming a diagnosis of acute dacryocystitis complicated by lacrimal abscess. Parents refused a head CT. Systemic antibiotic treatment was started and, on 5th day from admission, open dacryocystectomy was performed with good esthetical result.

Conclusions

Pediatric acute dacryocystitis is a potentially serious condition, which must be treated with intravenous antibiotic therapy followed by surgery tailored to the clinical history. Even if probing and dacryocystorhinostomy are the most used surgery in adults and children, open dacryocystectomy is a safe and successful option, mainly in severe cases where imaging studies are not available.
Analgosedation for diagnostic and interventional procedures: a countrywide survey of pediatric centers in Germany
Authors: Sauer Harald , Lobenhofer Marie , Abdul-Khaliq Hashim
Published: February 2020

Background

As more and more diagnostic and interventional options are becoming available for use in pediatric patients, techniques of procedural sedation analgesia (PSA) are being administered in considerably growing numbers as well.

Aims

The objective of this research effort was to conduct the first countrywide survey on the status quo of sedation analgesia as delivered to children and adolescents in Germany.

Methods

We dispatched letters to all pediatric hospital settings in Germany (n = 305), including a questionnaire that had been developed with existing guidelines taken into account. Its items were designed to elucidate the current practice of PSA throughout these pediatric centers regarding (a) organizational structures and (b) standards of medication and staffing.

Results

A total of 138 centers returned the questionnaire, hence the response rate was 45.2%. Numerous centers had implemented adequate structures and staffing standards. Deficits were nevertheless identified, most notably in terms of on-location equipment and staff provided to deliver sedations. Essential items of equipment were not provided in up to 26.8% of centers. Adequate staffing was not provided in up to 44.2% of centers, depending on the diagnostic or interventional procedures for which the PSA was delivered. The most widely used sedative agents were midazolam, ketamine/esketamine, and propofol.

Conclusions

Adequate care structures for the management of procedural sedation analgesia have been implemented by many pediatric centers in Germany. On the downside, these findings also reveal deficits that will take efforts to be eliminated.
Eco-friendly approach to access of quinoxaline derivatives using nanostructured pyrophosphate Na2PdP2O7 as a new, efficient and reusable heterogeneous catalyst
Authors: Dânoun Karim , Essamlali Younes , Amadine Othmane , Mahi Hassan , Zahouily Mohamed
Published: February 2020

In the present study, we report the synthesis of various quinoxaline derivatives from direct condensation of substituted aromatic 1,2-diamine with 1,2-dicarbonyl catalyzed by nanostructured pyrophosphate Na2PdP2O7 as a new highly efficient bifunctionalheterogeneous catalyst. The quinoxaline synthesis was performed in ethanol as a green and suitable solvent at ambient temperature to afford the desired quinoxalines with good to excellent yields in shorter reaction times. Many Quinoxaline derivatives were successfully synthesized using various 1,2-diketones and 1,2-diamines at room temperature. Catalyst reusability showed that the Na2PdP2O7 catalyst exhibited excellent recyclability without significant loss in its catalytic activity after five consecutive cycles.
Integration of wastewater treatment into process design of lignocellulosic biorefineries for improved economic viability
Authors: Tobin Tyler , Gustafson Rick , Bura Renata , Gough Heidi L.
Published: February 2020

Background

Production and use of bio-based products offer advantages over conventional petrochemicals, yet the relatively high cost of production has restricted their mainstream adoption. Optimization of wastewater treatment processes could reduce capital expenditures, lowering the barrier to market entry for lignocellulosic biorefineries. This paper characterizes wastewater associated with lignocellulosic ethanol production and evaluates potential wastewater treatment operations.

Results

It is found that organic material is intrinsic to bioconversion wastewater, representing up to 260 kg of biological oxygen demand per tonne of feedstock processed. Inorganics in the wastewater largely originate from additions during pretreatment and pH adjustments, which increase the inorganic loading by 44 kg per tonne of feedstock processed. Adjusting the ethanol production process to decrease addition of inorganic material could reduce the demands and therefore cost of waste treatment. Various waste treatment technologies—including those that take advantage of ecosystem services provided by feedstock production—were compared in terms of capital and operating costs, as well as technical feasibility.

Conclusions

It is concluded that wastewater treatment technologies should be better integrated with conversion process design and feedstock production. Efforts to recycle resources throughout the biofuel supply chain through application of ecosystem services provided by adjacent feedstock plantations and recovery of resources from the waste stream to reduce overall capital and operating costs of bioconversion facilities.
Evaluation of short training session for venous limited compression ultrasonography: prospective multicenter study
Authors:   Winfocus-France Study Group, Javaudin François , Seon Julie , Le Bastard Quentin , Cabiot Astrid , Pes Philippe , Arnaudet Idriss , Allain Milena , Le Conte Philippe
Published: February 2020

Background

Venous limited compression ultrasonography (VLCU) is recommended in case of suspicion of deep venous thrombosis (DVT). Current training pathways are rather long and include experiential phase. This aim of this study was to investigate the efficacy of a short training session for VLCU without experiential phase. The training session was applied in residents without previous ultrasound skills. Program included operation of ultrasound device and interpretation of venous images. Included patients were older than 18 years and had a suspicion of DVT. After realization of VLCU using usual technique, residents reported the dynamic compressibility of the femoral and popliteal veins, the presence or not of a visible thrombus, self-reported difficulty and duration. Patients then underwent a whole leg ultrasonography (WLCU) in the local laboratory which was blinded to VLCU results. The main criterion was the negative-predictive value (NPV) of VLCU for the absence of proximal DVT diagnosed with WLCU. Secondary criteria were VLCU diagnostic performances, rate of inability to conclude, difficulty and duration. For a NPV of 95 ± 6%, the needed number of patients was 96. This study was approved by the ethical committee.

Results

102 patients were analyzed. 46 residents were trained. A DVT was diagnosed by WLCU in 18 patients (prevalence of 17.6% [95% CI 11–26%]). VLCU detected 15 DVT (NPV of 96% [95% CI 89–99%]). The positive likelihood ratio was 9.9, the negative likelihood ratio 0.19 and Cohen’s Kappa 0.62 [95% CI 0.52–0.71]. The sensitivity was 83% [CI 95% 60–94%] and specificity 88% [CI 95% 79–93%]. The mean number of VLCU by residents was 2.3 ± 2.1, median 2 (minimum 1, maximum 8). Mean duration was 3.4 min, difficulty was 3.7 ± 2.

Conclusion

The principal objective, NPV 96% [95% CI 89–99%], was achieved. However, this short training session was inadequate to allow ruling-out a DVT with sufficient security. Thus, the experiential phase seems to be essential.
Comprehensive analysis of PM20D1 QTL in Alzheimer’s disease
Authors: Sanchez-Mut Jose Vicente , Glauser Liliane , Monk David , Gräff Johannes
Published: February 2020

Background

Alzheimer’s disease (AD) is a complex disorder caused by a combination of genetic and non-genetic risk factors. In addition, an increasing evidence suggests that epigenetic mechanisms also accompany AD. Genetic and epigenetic factors are not independent, but multiple loci show genetic-epigenetic interactions, the so-called quantitative trait loci (QTLs). Recently, we identified the first QTL association with AD, namely Peptidase M20 Domain Containing 1 (PM20D1). We observed that PM20D1 DNA methylation, RNA expression, and genetic background are correlated and, in turn, associated with AD. We provided mechanistic insights for these correlations and had shown that by genetically increasing and decreasing PM20D1 levels, AD-related pathologies were decreased and accelerated, respectively. However, since the PM20D1 QTL region encompasses also other genes, namely Nuclear Casein Kinase and Cyclin Dependent Kinase Substrate 1 (NUCKS1); RAB7, member RAS oncogene family-like 1 (RAB7L1); and Solute Carrier Family 41 Member 1 (SLC41A1), we investigated whether these genes might also contribute to the described AD association.

Results

Here, we report a comprehensive analysis of these QTL genes using a repertoire of in silico methods as well as in vivo and in vitro experimental approaches. First, we analyzed publicly available databases to pinpoint the major QTL correlations. Then, we validated these correlations using a well-characterized set of samples and locus-specific approaches—i.e., Sanger sequencing for the genotype, cloning/sequencing and pyrosequencing for the DNA methylation, and allele-specific and real-time PCR for the RNA expression. Finally, we defined the functional relevance of the observed alterations in the context of AD in vitro. Using this approach, we show that only PM20D1 DNA methylation and expression are significantly correlated with the AD-risk associated background. We find that the expression of SLC41A1 and PM20D1—but not NUCKS1 and RAB7L1—is increased in mouse models and human samples of AD, respectively. However, SLC41A1 and PM20D1 are differentially regulated by AD-related stressors, with only PM20D1 being upregulated by amyloid-β and reactive oxygen species, and with only PM20D1 being neuroprotective when overexpressed in cell and primary cultures.

Conclusions

Our findings reinforce PM20D1 as the most likely gene responsible of the previously reported PM20D1 QTL association with AD.
3-D printing model used to streamline surgical procedures for an intricate condition of airway compression caused by devastating mediastinal chondrosarcoma: a case report
Authors: Shai Sen-Ei , Lai Yi-Ling , Li Hsin-Ni , Hung Shih-Chieh
Published: February 2020

Background

The condition of mediastinal chondrosarcoma causing severe airway compression has never been reported before, and its complexity makes its surgical management challenging. We implemented two new techniques to overcome this problem. Creative mockup analogy of a distorted trachea and tumor lesion using a 3-D printing module, with reprogramming by computed tomography, streamlined the panorama with intricate correlation.

Case presentation

Our patient was a previously healthy 52-year-old slender yellow man who had no obvious medical history. In the last 3 years, upper respiratory tract infection and productive cough were noted frequently, and the patient’s symptoms were aggravated with shortness of breath when his head was positioned below 90 degrees during squatting and hunching of the body. The patient manifested prone sleep with ashen complexion, and he had lost 3–4 kg of body weight over the 3 weeks before admission to our hospital. Virtual bronchoscopy with computed tomography revealed an 8.3 × 7.5 × 4-cm lobulated right upper mediastinal mass with amorphous calcification and severe, intricate airway compression. A creative mockup analogy module of the distorted trachea and tumor was generated by 3-D printing and reprogrammed by computed tomography to streamline the sophisticated correlation. The patient underwent a two-stage operation comprising stabilization of the airway for innovative T-tube insertion preceded by thoracoscopy-assisted radical removal of the tumor. Postoperative adjuvant radiotherapy was administered. The patient recovered uneventfully and stayed healthy for 2 solid years in follow-up.

Conclusions

An advanced 3-D printing model provides affirmative information related to treatment strategy and is also a prospective tool for better doctor–patient communication regarding the disease.
Rapid generation of purified human RPE from pluripotent stem cells using 2D cultures and lipoprotein uptake-based sorting
Authors: Michelet Fabio , Balasankar Aishwarya , Teo Nickolas , Stanton Lawrence W. , Singhal Shweta
Published: February 2020

Background

Despite increasing demand, current protocols for human pluripotent stem cell (hPSC)-derived retinal pigment epithelium (RPE) remain time, labor, and cost intensive. Additionally, absence of robust methods for selective RPE purification and removal of non-RPE cell impurities prevents upscaling of clinical quality RPE production. We aimed to address these challenges by developing a simplified hPSC-derived RPE production and purification system that yields high-quality RPE monolayers within 90 days.

Methods

Human pluripotent stem cells were differentiated into RPE using an innovative time and cost-effective protocol relying entirely on 2D cultures and minimal use of cytokines. Once RPE identity was obtained, cells were transferred onto permeable membranes to acquire mature RPE morphology. RPE differentiation was verified by electron microscopy, polarized VEGF expression, establishment of high transepithelial electrical resistance and photoreceptor phagocytosis assay. After 4 weeks on permeable membranes, RPE cell cultures were incubated with Dil-AcLDL (DiI-conjugated acetylated low-density lipoproteins) and subjected to fluorescence-activated cell sorting (FACS) for purification and subculture.

Results

Using our 2D cytokine scarce protocol, hPSC-derived functional RPE cells can be obtained within 2 months. Nevertheless, at this stage, most samples contain a percentage of non-RPE/early RPE progenitor cells that make them unsuitable for clinical application. We demonstrate that functional RPE cells express high levels of lipoprotein receptors and that this correlates with their ability to uptake lipoproteins. Combining photoreceptor uptake assay with lipoprotein uptake assay further confirms that only functional RPE cells uptake AcLDL. Incubation of mixed RPE/non-RPE cell cultures with fluorophore conjugated AcLDL and subsequent FACS-based isolation of labeled cells allows selective purification of mature functional RPE. When subcultured, DiI-AcLDL-labeled cells rapidly form pure homogenous high-quality RPE monolayers.

Conclusions

Pure functional RPE monolayers can be derived from hPSC within 90 days using simplified 2D cultures in conjunction with our RPE PLUS protocol (RPE Purification by Lipoprotein Uptake-based Sorting). The simplicity of this protocol makes it scalable, and the rapidity of production and purification allows for high-quality RPE to be produced in a short span of time making them ideally suited for downstream clinical and in vitro applications.
Antiamoebic activity of plant-based natural products and their conjugated silver nanoparticles against Acanthamoeba castellanii (ATCC 50492)
Authors: Anwar Areeba , Ting Elaine Lim Siew , Anwar Ayaz , Ain Noor ul , Faizi Shaheen , Shah Muhammad Raza , Khan Naveed Ahmed , Siddiqui Ruqaiyyah
Published: February 2020

Acanthamoeba spp. are the causative agent of Acanthamoeba keratitis and granulomatous amoebic encephalitis (GAE). The current options to treat Acanthamoeba infections have limited success. Silver nanoparticles show antimicrobial effects and enhance the efficacy of their payload at the specific biological targets. Natural folk plants have been widely used for treating diseases as the phytochemicals from several plants have been shown to exhibit amoebicidal effects. Herein, we used natural products of plant or commercial sources including quercetin (QT), kolavenic acid (PGEA) isolated from plant extracts of Polyalthia longifolia var pendula and crude plant methanolic extract of Caesalpinia pulcherrima (CPFLM) as antiacanthamoebic agents. Furthermore, these plant-based materials were conjugated with silver nanoparticles (AgNPs) to determine the effects of the natural compounds and their nanoconjugates against a clinical isolate of A. castellanii from a keratitis patient (ATCC 50492) belonging to the T4 genotype. The compounds were conjugated with AgNPs and characterized by using ultraviolet visible spectrophotometry and atomic force microscopy. Quercetin coated silver nanoparticles (QT-AgNPs) showed characteristic surface plasmon resonance band at 443 nm and the average size distribution was found to be around 45 nm. The natural compounds alone and their nanoconjugates were tested for the viability of amoebae, encystation and excystation activity against A. castellanii. The natural compounds showed significant growth inhibition of A. castellanii while QT-AgNPs specifically exhibited enhanced antiamoebic effects as well as interrupted the encystation and excystation activity of the amoebae. Interestingly, these compounds and nanoconjugates did not exhibit in vitro cytotoxic effects against human cells. Plant-based compounds and extracts could be an interesting strategy in development of alternative therapeutics against Acanthamoeba infections.
Characteristics of smallholders’ goat production systems and effect of Boer crossbreeding on body measurements of goats in Burundi
Authors: Manirakiza Josiane , Hatungumukama Gilbert , Besbes Badi , Detilleux Johann
Published: February 2020

As part of a national action plan to manage animal genetic resources in Burundi, we characterized smallholders’ goat production systems and assessed the effect of Boer crossbreeding on animal body measures. To that end, 319 farmers were surveyed in the five agro-ecological zones of Burundi and the zootechnical measures of 939 adult goats were taken. Cluster analysis of the goat production systems resulted into two opposed groups and one intermediate. On the one hand, there are the dry lowlands systems characterized by large herds composed mainly of indigenous animals grazing freely, and having high market characteristics. On the other hand, there are the humid highlands systems characterized by small herds composed of indigenous and crossbred animals in stall feeding or herding/tethering systems, and by low market characteristics. Fixed effect linear models were used to evaluate the effect of Boer crossbreeding on body weights and linear body measures, after adjustment for age, sex, grazing systems and agro-ecological zones. Results showed that least square means for body weights of adult Boer crossbreds were 4.74 kg higher than those of indigenous goats, which was lower than expected. Least square means for linear body measures of Boer crossbreds were significantly higher than those of indigenous breeds: differences in chest girth, body length and height at withers were 4.88 cm, 5.59 cm and 4.82 cm, respectively. Goats were heavier and greater in linear measures in lowlands than in highlands. The advantages and issues of a selection programme within indigenous breeds are discussed as an alternative to the crossbreeding programme.
Facial attribute-controlled sketch-to-image translation with generative adversarial networks
Authors: Hu Mingming , Guo Jingtao
Published: February 2020

Due to the rapid development of the generative adversarial networks (GANs) and convolution neural networks (CNN), increasing attention is being paid to face synthesis. In this paper, we address the new and challenging task of facial sketch-to-image synthesis with multiple controllable attributes. To achieve this goal, first, we propose a new attribute classification loss to ensure that the synthesized face image with the facial attributes, which the users desire to have. Second, we employ the reconstruction loss to synthesize the facial texture and structure information. Third, the adversarial loss is used to encourage visual authenticity. By incorporating above losses into a unified framework, our proposed method not only can achieve high-quality sketch-to-image translation, but also allow the users control the facial attributes of synthesized image. Extensive experiments show that user-provided facial attribute information effectively controls the process of facial sketch-to-image translation.
A subgradient extragradient algorithm for solving monotone variational inequalities in Banach spaces
Authors: Ma Fei
Published: February 2020

In this paper, we introduce an algorithm for solving classical variational inequalities problem with Lipschitz continuous and monotone mapping in Banach space. We modify the subgradient extragradient methods with a new and simple iterative step size, the strong convergence of algorithm is established without the knowledge of the Lipschitz constant of the mapping. Finally, a numerical experiment is presented to show the efficiency and advantage of the proposed algorithm. Our results generalize some of the work in Hilbert spaces to Banach spaces.
Stability of a discrete-time general delayed viral model with antibody and cell-mediated immune responses
Authors: Elaiw A. M. , Alshaikh M. A.
Published: February 2020

We propose a discrete-time viral model with antibody and cell-mediated immune responses. Two types of infected cells are incorporated into the model, namely latently infected and actively infected. The incidence rate of infection as well as the production and removal rates of all compartments are modeled by general nonlinear functions. The model contains three types of intracellular time delays. We utilize nonstandard finite difference (NSFD) method to discretize the continuous-time model. We prove that NSFD preserves the positivity and boundedness of the solutions of the model. Based on four threshold parameters, the existence of the five equilibria of the model is established. We perform global stability of all equilibria of the model by using Lyapunov approach. Numerical simulations are carried out to illustrate our theoretical results. The impact of time delay on the viral dynamics is established.
Self-rated health and associated factors among the oldest-old: results from a cross-sectional study in Sweden
Authors: Simonsson Bo , Molarius Anu
Published: February 2020

Background

Very few population-based studies have investigated self-rated health and related factors in the increasing age group 85 years or older. The aim of this study was to examine self-rated health and its association with living conditions, lifestyle factors, physical and mental health problems and functional ability among the oldest-old in the general population in Sweden.

Methods

The study is cross-sectional and based on 1360 persons, 85 years of age or older, who answered a survey questionnaire sent to a random population sample in 2012 (participation rate 47%). Multivariate logistic regression was used as the statistical method.

Results

The prevalence of good self-rated health was 39% in men and 30% in women. Physical inactivity, impaired physical mobility, pain, anxiety/depression and longstanding illness were independently associated with poorer than good self-rated health, while factors such as gender, age, educational level, cash margin, living alone, social support, smoking, alcohol use, obesity, accidents and impaired vision/hearing were not.

Conclusions

While a considerable part of the oldest-old assess their health as good, not being physically active and having common health problems such as pain and depression as well as impaired physical mobility are associated with poorer than good self-rated health. This should be considered when planning how to improve and maintain health in the growing population of persons 85 years and older.
Fecal microbiota transplantation to maintain remission in Crohn’s disease: a pilot randomized controlled study
Authors:   Saint-Antoine IBD Network, Sokol Harry , Landman Cecilia , Seksik Philippe , Berard Laurence , Montil Mélissa , Nion-Larmurier Isabelle , Bourrier Anne , Le Gall Guillaume , Lalande Valérie , De Rougemont Alexis , Kirchgesner Julien , Daguenel Anne , Cachanado Marine , Rousseau Alexandra , Drouet Élodie , Rosenzwajg Michelle , Hagege Hervé , Dray Xavier , Klatzman David , Marteau Philippe , Beaugerie Laurent , Simon Tabassome
Published: February 2020

Background

The role of the gut microbiota in Crohn’s disease (CD) is established and fecal microbiota transplantation (FMT) is an attractive therapeutic strategy. No randomized controlled clinical trial results are available. We performed a randomized, single-blind, sham-controlled pilot trial of FMT in adults with colonic or ileo-colonic CD.

Method

Patients enrolled while in flare received oral corticosteroid. Once in clinical remission, patients were randomized to receive either FMT or sham transplantation during a colonoscopy. Corticosteroids were tapered and a second colonoscopy was performed at week 6. The primary endpoint was the implantation of the donor microbiota at week 6 (Sorensen index > 0.6).

Results

Eight patients received FMT and nine sham transplantation. None of the patients reached the primary endpoint. The steroid-free clinical remission rate at 10 and 24 weeks was 44.4% (4/9) and 33.3% (3/9) in the sham transplantation group and 87.5% (7/8) and 50.0% (4/8; one patient loss of follow-up while in remission at week 12 and considered in flare at week 24) in the FMT group. Crohn’s Disease Endoscopic Index of Severity decreased 6 weeks after FMT (p = 0.03) but not after sham transplantation (p = 0.8). Conversely, the CRP level increased 6 weeks after sham transplantation (p = 0.008) but not after FMT (p = 0.5). Absence of donor microbiota engraftment was associated with flare. No safety signal was identified.

Conclusion

The primary endpoint was not reached for any patient. In this pilot study, higher colonization by donor microbiota was associated with maintenance of remission. These results must be confirmed in larger studies (NCT02097797).
Dispersal and life-history traits in a spider with rapid range expansion
Authors: Wolz Marina , Klockmann Michael , Schmitz Torben , Pekár Stano , Bonte Dries , Uhl Gabriele
Published: February 2020

Background

Dispersal and reproduction are key life-history traits that jointly determine species’ potential to expand their distribution, for instance in light of ongoing climate change. These life-history traits are known to be under selection by changing local environmental conditions, but they may also evolve by spatial sorting. While local natural selection and spatial sorting are mainly studied in model organisms, we do not know the degree to which these processes are relevant in the wild, despite their importance to a comprehensive understanding of species’ resistance and tolerance to climate change.

Methods

The wasp spider Argiope bruennichi has undergone a natural range expansion - from the Mediterranean to Northern Europe during the recent decades. Using reciprocal common garden experiments in the laboratory, we studied differences in crucial traits between replicated core (Southern France) and edge (Baltic States) populations. We tested theoretical predictions of enhanced dispersal (ballooning behaviour) and reproductive performance (fecundity and winter survival) at the expansion front due to spatial sorting and local environmental conditions.

Results

Dispersal rates were not consistently higher at the northern expansion front, but were impacted by the overwintering climatic conditions experienced, such that dispersal was higher when spiderlings had experienced winter conditions as occur in their region. Hatching success and winter survival were lower at the range border. In agreement with theoretical predictions, spiders from the northern leading edge invested more in reproduction for their given body size.

Conclusions

We found no evidence for spatial sorting leading to higher dispersal in northern range edge populations of A. bruennichi. However, reproductive investment and overwintering survival between core and edge populations differed. These life-history traits that directly affect species’ expansion rates seem to have diverged during the recent range expansion of A. bruennichi. We discuss the observed changes with respect to the species’ natural history and the ecological drivers associated with range expansion to northern latitudes.
Inflammation of the choroid plexus in progressive multiple sclerosis: accumulation of granulocytes and T cells
Authors: Rodríguez-Lorenzo Sabela , Konings Julia , van der Pol Susanne , Kamermans Alwin , Amor Sandra , van Horssen Jack , Witte Maarten E. , Kooij Gijs , de Vries Helga E.
Published: February 2020

The choroid plexus (CP) is strategically located between the peripheral blood and the cerebrospinal fluid, and is involved in the regulation of central nervous system (CNS) homeostasis. In multiple sclerosis (MS), demyelination and inflammation occur in the CNS. While experimental animal models of MS pointed to the CP as a key route for immune cell invasion of the CNS, little is known about the distribution of immune cells in the human CP during progressive phases of MS. Here, we use immunohistochemistry and confocal microscopy to explore the main immune cell populations in the CP of progressive MS patients and non-neuroinflammatory controls, in terms of abundance and location within the distinct CP compartments. We show for the first time that the CP stromal density of granulocytes and CD8+ T cells is higher in progressive MS patients compared to controls. In line with previous studies, the CP of both controls and progressive MS patients contains relatively high numbers of macrophages and dendritic cells. Moreover, we found virtually no B cells or plasma cells in the CP. MHCII+ antigen-presenting cells were often found in close proximity to T cells, suggesting constitutive CNS immune monitoring functions of the CP. Together, our data highlights the role of the CP in immune homeostasis and indicates the occurrence of mild inflammatory processes in the CP of progressive MS patients. However, our findings suggest that the CP is only marginally involved in immune cell migration into the CNS in chronic MS.
Inelastic deformation zone in the lower crust for the San-in Shear Zone, Southwest Japan, as observed by a dense GNSS network
Authors: Meneses-Gutierrez Angela , Nishimura Takuya
Published: February 2020

We analyze Global Navigation Satellite System (GNSS) within the San-in Shear Zone (SSZ), Southwest Japan, in order to clarify the width of the inelastic deformation zone in the lower crust beneath it. We assumed multiple discrete fault dislocations distributed below the seismogenic depth in a channel to represent inelastic deformation in the lower crust. Kinematic models at 68% confidence level at three profiles indicate that deformation can be explained by a deep inelastic deformation zone with a width of 0.5–56.0 km, 0.5–79.5 km, and 0.0–58.5 km, for the Eastern, Central and Western profiles, respectively; and a relative moving rate between the two blocks sandwiching the zone of 6.2–8.0 mm/year. In Eastern Tottori, the center of the estimated inelastic zone coincides with the source region of the 1943 Tottori earthquake. In Central and Western Tottori, the channel is in agreement with the source regions of the 2000 Western and the 2016 Central Tottori earthquake. Current GNSS network provides a limited contribution to constraining the width of the deformation in the lower crust.
Metachronous rupture of a residual pancreaticoduodenal aneurysm after release of the median arcuate ligament: a case report
Authors: Kimura Nana , Matsui Koshi , Shibuya Kazuto , Yoshioka Isaku , Naruto Norihito , Hoshino Yui , Mori Kosuke , Hirano Katsuhisa , Watanabe Toru , Hojo Shozo , Sawada Shigeaki , Okumura Tomoyuki , Nagata Takuya , Noguchi Kyo , Fujii Tsutomu
Published: February 2020

Background

Multiple pancreaticoduodenal artery aneurysms in association with median arcuate ligament syndrome (MALS) are relatively rare. A treatment option, such as a median arcuate ligament (MAL) release or embolization of the aneurysms, should be considered in such cases, but the treatment criteria remain unclear.

Case report

A 75-year-old man was transferred to our hospital because of a ruptured pancreaticoduodenal aneurysm. Emergency angiography showed stenosis of the root of the celiac axis (CA), a ruptured aneurysm of the posterior inferior pancreaticoduodenal artery (PIPDA), and an unruptured aneurysm of the anterior inferior pancreaticoduodenal artery (AIPDA). Coil embolization of the PIPDA was performed. Five days after embolization, the gallbladder became necrotic due to decreased blood flow in the CA region, and an emergency operation was performed. We performed a cholecystectomy and released the MAL to normalize the blood flow of the CA region. However, the patient died on postoperative day 8 because of rupture of the untreated aneurysm of the AIPDA.

Conclusions

This is the first report of metachronous ruptures of multiple pancreaticoduodenal aneurysms due to MALS, even after a MAL release. Although rare, a residual aneurysm in the pancreatic head region may need to be embolized quickly.
Ruptured visceral artery aneurysms in a patient of neurofibromatosis type 1 (NF-1) successfully treated by endovascular treatment
Authors: Fukushima Naoko , Aoki Hiroaki , Takenaga Shinsuke , Morikawa Kazuhiko , Ogawa Masaichi , Yanaga Katsuhiko
Published: February 2020

Background

Neurofibromatosis type 1 (NF-1) is an autosomal dominant disease and arteriovenous abnormalities are a well-recognized complication. There are several case reports of ruptured aneurysms; however, among them, reports of superior pancreaticoduodenal artery (PDA) and superior mesenteric artery (SMA) aneurysms are rare. We experienced the case of ruptured PDA and SMA aneurysms in a patient of neurofibromatosis type I successfully treated by endovascular treatment.

Case presentation

A 55-year-old woman with NF-1 came to our hospital with abdominal pain and vomiting. Enhanced abdominal computed tomography revealed a hematoma in the retroperitoneum and an aneurysm in the head of the pancreas. Angiography was performed, and a ruptured aneurysm was suspected the periphery of the PDA, and we embolized it using coils. However, on postoperative day 2, the hemoglobin level decreased, and a branch of the SMA was ruptured. She underwent embolization using coils again and discharged on postoperative day 27 without any further hemorrhage.

Conclusions

To our knowledge, this is the first successfully treated case of ruptured SMA and PDA aneurysms in a patient with NF-1.
Laparoscopic two-stage operation for rectal cancer with refractory obstructive colitis after kidney transplantation: a case report
Authors: Fujinaga Atsuro , Akagi Tomonori , Etoh Tsuyoshi , Tada Kazuhiro , Itai Yusuke , Kono Yohei , Hiratsuka Takahiro , Suzuki Kosuke , Shibata Tomotaka , Ueda Yoshitake , Toujigamori Manabu , Shiroshita Hidefumi , Shiraishi Norio , Inomata Masafumi
Published: February 2020

Background

Although obstructive colitis with colon cancer is not a rare disease, most cases can be improved with conservative therapy. We report a case of a patient who underwent a laparoscopic two-stage operation for rectal cancer with refractory obstructive colitis after kidney transplantation.

Case presentation

The patient was a 71-year-old man taking immunosuppressants who had previously undergone right living kidney transplantation for chronic nephritis. He presented to hospital complaining of abdominal pain and was diagnosed as having rectal cancer with obstructive colitis. Although conservative therapy by fasting was continued for 5 weeks, his obstructive colitis did not improve. Therefore, we decided to perform a two-stage operation. First, we performed a laparoscopic Hartmann’s operation. It took 6 months for his obstructive colitis to improve after this operation, and then we performed a laparoscopic colorectal anastomosis. There were no postoperative complications in either operation.

Conclusion

A laparoscopic two-stage operation could be one of the operative options to reduce postoperative complications in patients with comorbidities such as taking immunosuppressants.
Designing integrated interventions to improve nutrition and WASH behaviors in Kenya
Authors: Jacob Arriola Kimberly R. , Ellis Anna , Webb-Girard Amy , Ogutu Emily Awino , McClintic Emilie , Caruso Bethany , Freeman Matthew C.
Published: February 2020

Background

Child stunting, an indicator of chronic malnutrition, is a global public health problem. Malnutrition during pregnancy and the first 2 years of life undermines the survival, growth, and development of children. Exposure to fecal pathogens vis-à-vis inadequate water, sanitation, and hygiene (WASH) has been implicated in the etiology of child stunting, highlighting the need to integrate WASH with nutrition-sensitive interventions to comprehensively address this complex problem. The aim of this study was to describe a systematic, theoretically informed approach (that drew from the Starr and Fornoff approach to the Theory of Change development and the Behavior Change Wheel approach) to design a multi-component and integrated social and behavior change intervention to improve WASH and nutrition-related behaviors in western Kenya.

Methods

This intervention was developed to be integrated into an existing project that utilized the care group model and aimed to create a culture of care and support for HIV/AIDS-affected children under two and their caregivers and was executed by local partners. We tested the newly created intervention packages in user-testing trials using an adapted Trials of Improved Practices approach to pilot acceptability and feasibility.

Results

Using authentic stakeholder engagement and relevant theories, we conducted an 8-step process: (1) conduct mixed methods formative research, (2) prioritize target behaviors, (3) use causal analysis to create problem trees, (4) develop solution trees and articulate assumptions and rationales for change, (5) link solution trees to intervention functions, (6) develop the intervention plan, (7) create the intervention packages, and (8) test and refine the intervention packages.

Conclusions

This study highlights the need to take a multi-sectorial, integrated approach that integrates contextually relevant behavior change theories with the experiential knowledge gleaned from stakeholders into the design of interventions that seek to reduce child stunting. This process resulted in the creation of intervention packages that grouped behaviors thematically to be most relevant and responsive to the population context. This work has the potential to make important contributions towards achievement of the United Nations’ sustainable development goals.
Blood pressure trajectory modeling in childhood: birth-cohort study
Authors: Lee Jung Won , Kim Nameun , Park Bohyun , Park Hyesook , Kim Hae Soon
Published: February 2020

Background

Systolic blood pressure (SBP) and diastolic blood pressure (DBP) tends to increase with age and increase in proportion to body weight and height. Recent epidemiological and longitudinal cohort studies have found that high BP in children can be progressed into hypertension (HTN) in adulthood. Therefore, the aim of this study is that we monitor and analyze the tendency of the BP trajectory in children from the age of 3 years to the age of 10 years.

Method

A total of 767 subjects were gathered from Ewha Birth and Growth cohort study. We observed and analyzed the data of 65 subjects which were completely repeated measures for 6 times as 3, 5, 7, 8, 9, 10 years old follow-up. We collected retrospective information such as BP and anthropometric data measured for children and constructed the trajectory models of SBP and DBP in early stage of life.

Results

Three distinct trajectories on SBP and DBP from 3 to 10 years old were identified. As a result of SBP, 82.7% (n = 54) of subjects experienced moderate SBP levels maintained stable levels; 13.7% (n = 9) of subjects experienced a rapid increase as the age increase; 3.6% (n = 2) of subjects experienced high SBP levels throughout follow-up as moderate grade. For DBP, 6.7% (n = 4) of subjects started with low levels and experienced generally a gradual grade; 61.7% (n = 41) of subjects started with moderate levels and experienced a steep increase at 7-years-old; 31.6% (n = 20) of subjects experienced a rapid increase on DBP levels.

Conclusion

The result of study shows tendency of increase BP as the age increase. This research inspires that we verify risk group and risk factor in early stage of life with trajectory modeling for the HTN prevention in adulthood.
Perceptual learning in the identification of lung cancer in chest radiographs
Authors: Sha Li Z. , Toh Yi Ni , Remington Roger W. , Jiang Yuhong V.
Published: February 2020

Extensive research has shown that practice yields highly specific perceptual learning of simple visual properties such as orientation and contrast. Does this same learning characterize more complex perceptual skills? Here we investigated perceptual learning of complex medical images. Novices underwent training over four sessions to discriminate which of two chest radiographs contained a tumor and to indicate the location of the tumor. In training, one group received six repetitions of 30 normal/abnormal images, the other three repetitions of 60 normal/abnormal images. Groups were then tested on trained and novel images. To assess the nature of perceptual learning, test items were presented in three formats – the full image, the cutout of the tumor, or the background only. Performance improved across training sessions, and notably, the improvement transferred to the classification of novel images. Training with more repetitions on fewer images yielded comparable transfer to training with fewer repetitions on more images. Little transfer to novel images occurred when tested with just the cutout of the cancer region or just the background, but a larger cutout that included both the cancer region and some surrounding regions yielded good transfer. Perceptual learning contributes to the acquisition of expertise in cancer image perception.