bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal capillary degeneration and blood-retinal barrier disruption in murine models of Alzheimer’s disease
Authors: Shi Haoshen , Koronyo Yosef , Fuchs Dieu-Trang , Sheyn Julia , Wawrowsky Kolja , Lahiri Shouri , Black Keith L. , Koronyo-Hamaoui Maya
Published: November 2020

Extensive effort has been made studying retinal pathology in Alzheimer’s disease (AD) to improve early noninvasive diagnosis and treatment. Particularly relevant are vascular changes, which appear prominent in early brain pathogenesis and could predict cognitive decline. Recently, we identified platelet-derived growth factor receptor beta (PDGFRβ) deficiency and pericyte loss associated with vascular Aβ deposition in the neurosensory retina of mild cognitively impaired (MCI) and AD patients. However, the pathological mechanisms of retinal vascular changes and their possible relationships with vascular amyloidosis, pericyte loss, and blood-retinal barrier (BRB) integrity remain unknown. Here, we evaluated the retinas of transgenic APPSWE/PS1ΔE9 mouse models of AD (ADtg mice) and wild-type mice at different ages for capillary degeneration, PDGFRβ expression, vascular amyloidosis, permeability and inner BRB tight-junction molecules. Using a retinal vascular isolation technique followed by periodic acid-Schiff or immunofluorescent staining, we discovered significant retinal capillary degeneration in ADtg mice compared to age- and sex-matched wild-type mice (P < 0.0001). This small vessel degeneration reached significance in 8-month-old mice (P = 0.0035), with males more susceptible than females. Degeneration of retinal capillaries also progressively increased with age in healthy mice (P = 0.0145); however, the phenomenon was significantly worse during AD-like progression (P = 0.0001). A substantial vascular PDGFRβ deficiency (~ 50% reduction, P = 0.0017) along with prominent vascular Aβ deposition was further detected in the retina of ADtg mice, which inversely correlated with the extent of degenerated capillaries (Pearson’s r = − 0.8, P = 0.0016). Importantly, tight-junction alterations such as claudin-1 downregulation and increased BRB permeability, demonstrated in vivo by retinal fluorescein imaging and ex vivo following injection of FITC-dextran (2000 kD) and Texas Red-dextran (3 kD), were found in ADtg mice. Overall, the identification of age- and Alzheimer’s-dependent retinal capillary degeneration and compromised BRB integrity starting at early disease stages in ADtg mice could contribute to the development of novel targets for AD diagnosis and therapy.
An assessment of the magnitude, parallelism, and asymmetry of micro-implant-assisted rapid maxillary expansion in non-growing patients
Authors: Elkenawy Islam , Fijany Layla , Colak Ozge , Paredes Ney Alberto , Gargoum Ausama , Abedini Sara , Cantarella Daniele , Dominguez-Mompell Ramon , Sfogliano Luca , Moon Won
Published: November 2020

Background and objectives

Micro-implant-assisted expanders have shown significant effects on the mid-face, including a degree of asymmetry. The aim of this study is to quantify the magnitude, parallelism, and asymmetry of this type of expansion in non-growing patients.

Methods

A retrospective study on a sample of 31 non-growing patients with an average age of 20.4 years old, with cone beam computed tomography images taken before and right after expansion using maxillary skeletal expander (MSE) were assessed for skeletal expansion at three landmarks bilaterally.

Results

Average magnitude of total expansion was 4.98 mm at the anterior nasal spine (ANS) and 4.77 mm at the posterior nasal spine (PNS) which showed statistical significance using a paired t test with p < 0.01. Average expansion at the PNS was 95% of that at the ANS. The sample was divided into symmetric (n = 15) and asymmetric (n = 16) based on the difference in expansion at the ANS, with 16 out of 31 patients exhibiting statistically significant asymmetry.

Conclusions

MSE achieves distinctly parallel expansion in the sagittal plane but can exhibit asymmetrical expansion in the transverse plane.
The higher the better? Defining the optimal beta-lactam target for critically ill patients to reach infection resolution and improve outcome
Authors: Scharf Christina , Liebchen Uwe , Paal Michael , Taubert Max , Vogeser Michael , Irlbeck Michael , Zoller Michael , Schroeder Ines
Published: November 2020

Objectives

Beta-lactam antibiotics are often subject to therapeutic drug monitoring, but breakpoints of target attainment are mostly based on expert opinions. Studies that show a correlation between target attainment and infection resolution are missing. This analysis investigated whether there is a difference in infection resolution based on two breakpoints of target attainment.

Methods

An outcome group out of 1392 critically ill patients treated with meropenem or piperacillin-tazobactam was formed due to different selection criteria. Afterwards, three groups were created: group 1=free drug concentration (f) was < 100% of the time (T) above the minimal inhibitory concentration (MIC) (< 100% fT >MIC), group 2=100% fT >MIC<4xMIC, and group 3=100% fT >4xMIC. Parameters for infection control, renal and liver function, and estimated and observed in-hospital mortality were compared between those groups. Statistical analysis was performed with one-way analysis of variance, Tukey post hoc test, U test, and bivariate logistic regression.

Results

The outcome group consisted of 55 patients (groups 1–3, 17, 24, and 14 patients, respectively). Patients allocated to group 2 or 3 had a significantly faster reduction of the C-reactive protein in contrast to patients allocated to group 1 (p = 0.033 and p = 0.026). Patients allocated to group 3 had a worse renal function, a higher Acute Physiology and Chronic Health Evaluation (APACHE II) score, were older, and had a significantly higher in-hospital mortality compared to group 1 (p = 0.017) and group 2 (p = 0.001). The higher mortality was significantly influenced by worse liver function, higher APACHE II, and higher Sequential Organ Failure Assessment (SOFA) score and norepinephrine therapy.

Conclusion

Achieving the target 100% fT >MIC leads to faster infection resolution in the critically ill. However, there was no benefit for patients who reached the highest target of 100% fT >4xMIC, although the mortality rate was higher possibly due to confounding effects. In conclusion, we recommend the target 100% fT >MIC<4xMIC for critically ill patients.

Trial registration

NCT03985605
Prevalence and prognostic value of elevated troponins in patients hospitalised for coronavirus disease 2019: a systematic review and meta-analysis
Authors: Zhao Bing-Cheng , Liu Wei-Feng , Lei Shao-Hui , Zhou Bo-Wei , Yang Xiao , Huang Tong-Yi , Deng Qi-Wen , Xu Miao , Li Cai , Liu Ke-Xuan
Published: November 2020

Background

The clinical significance of cardiac troponin measurement in patients hospitalised for coronavirus disease 2019 (covid-19) is uncertain. We investigated the prevalence of elevated troponins in these patients and its prognostic value for predicting mortality.

Methods

Studies were identified by searching electronic databases and preprint servers. We included studies of hospitalised covid-19 patients that reported the frequency of troponin elevations above the upper reference limit and/or the association between troponins and mortality. Meta-analyses were performed using random-effects models.

Results

Fifty-one studies were included. Elevated troponins were found in 20.8% (95% confidence interval [CI] 16.8–25.0 %) of patients who received troponin test on hospital admission. Elevated troponins on admission were associated with a higher risk of subsequent death (risk ratio 2.68, 95% CI 2.08–3.46) after adjusting for confounders in multivariable analysis. The pooled sensitivity of elevated admission troponins for predicting death was 0.60 (95% CI 0.54–0.65), and the specificity was 0.83 (0.77–0.88). The post-test probability of death was about 42% for patients with elevated admission troponins and was about 9% for those with non-elevated troponins on admission. There was significant heterogeneity in the analyses, and many included studies were at risk of bias due to the lack of systematic troponin measurement and inadequate follow-up.

Conclusion

Elevated troponins were relatively common in patients hospitalised for covid-19. Troponin measurement on admission might help in risk stratification, especially in identifying patients at high risk of death when troponin levels are elevated. High-quality prospective studies are needed to validate these findings.

Systematic review registration

PROSPEROCRD42020176747
Ginsenoside ameliorated ventilator-induced lung injury in rats
Authors: Cho Woo Hyun , Kim Yun Hak , Heo Hye Jin , Kim Dohyung , Kwak Tae Won , Kim Kwang Ho , Yeo Hye Ju
Published: November 2020

Background

Ginsenosides have antioxidant and anti-inflammatory features. This study aimed to evaluate the biologic effects of ginsenoside Rb2 pretreatment on ventilator-induced lung injury (VILI) in rats.

Methods

Rats were divided into four groups with 12 rats per group: control; low tidal volume (TV), TV of 6 mL/kg, VILI, TV of 20 mL/kg, positive end-expiratory pressure of 5 cm H2O, and respiratory rate of 60 breaths per minute for 3 h at an inspiratory oxygen fraction of 0.21; and ginsenosides, treated the same as the VILI group but with 20 mg/kg intraperitoneal ginsenoside pretreatment. Morphology was observed with a microscope to confirm the VILI model. Wet-to-dry weight ratios, protein concentrations, and pro-inflammatory cytokines in the bronchoalveolar lavage fluid were measured. RNA sequencing of the lung tissues was conducted to analyze gene expression.

Results

High TV histologically induced VILI with alveolar edema and infiltration of inflammatory cells. Ginsenosides pretreatment significantly reduced the histologic lung injury score compared to the VILI group. Wet-to-dry weight ratios, malondialdehyde, and TNF-α in bronchoalveolar lavage fluid were significantly higher in the VILI group and ginsenoside pretreatment mitigated these effects. In the immunohistochemistry assay, ginsenoside pretreatment attenuated the TNF-α upregulation induced by VILI. We identified 823 genes differentially presented in the VILI group compared to the control group. Of the 823 genes, only 13 genes (Arrdc2, Cygb, Exnef, Lcn2, Mroh7, Nsf, Rexo2, Srp9, Tead3, Ephb6, Mvd, Sytl4, and Ube2l6) recovered to control levels in the ginsenoside group.

Conclusions

Ginsenosides inhibited the inflammatory and oxidative stress response in VILI. Further studies are required on the 13 genes, including LCN2.
Gamma entrainment frequency affects mood, memory and cognition: an exploratory pilot study
Authors: Sharpe Ryan L. S. , Mahmud Mufti , Kaiser M. Shamim , Chen Jianhui
Published: November 2020

Here we provide evidence with an exploratory pilot study that through the use of a Gamma 40 Hz entrainment frequency, mood, memory and cognition can be improved with respect to a 9-participant cohort. Participants constituted towards three binaural entrainment frequency groups: the 40 Hz, 25 Hz and 100 Hz. Participants attended a total of eight entrainment frequency sessions twice over the duration of a 4-week period. Additionally, participants were assessed based on their cognitive abilities, mood as well as memory, where the cognitive and memory assessments occurred before and after a 5-min binaural beat stimulation. The mood assessment scores were collected from sessions 1, 4 and 8, respectively. With respect to the Gamma 40 Hz entrainment frequency population, we observed a mean improvement in cognitive scores, elevating from 75% average to 85% average upon conclusion of the experimentation at weak statistical significance ($$\alpha$$
α
= 0.10, p = 0.076). Similarly, memory score improvements at a greater significance ($$\alpha$$
α
= 0.05, p = 0.0027) were noted, elevating from an average of 87% to 95%. In pertinence to the mood scores, a negative correlation across all populations were noted, inferring an overall increase in mood due to lower scores correlating with elevated mood. Finally, correlation analysis revealed a stronger R$$^2$$

2

value (0.9838) within the 40 Hz group between sessions as well as mood score when compared across the entire frequency group cohort.
A rare case of meningeal carcinomatosis and internal auditory canal metastasis presenting with the deafness for gastric cancer
Authors: Tanaka Takayuki , Kanetaka Kengo , Ikeda Takahiro , Yamaguchi Shun , Kawakami Syunsuke , Kitajima Tomoo , Iwata Toru , Eguchi Susumu
Published: November 2020

Background

Meningeal carcinomatosis is a very rare metastatic site of gastric cancer and meningeal carcinomatosis without other metastatic sites is much extremely rare. Herein, we report our experience with a very rare case of meningeal carcinomatosis which was difficult to diagnose the recurrence by general systemic examination and was found due to the deafness despite the sustained high tumor markers.

Case presentation

A 68-year-old man consulted a hospital with vomiting and hematemesis. Laboratory tests revealed severe anemia. He was referred to our hospital and underwent an emergency gastroscopy, which revealed Borrman type 3 tumor and oozing of blood. Biopsy specimen showed gastric cancer. After several examinations, total gastrectomy was performed and tegafur-gimeracil-oteracil potassium (S-1) was initiated as adjuvant chemotherapy one month after surgery. Tumor marker levels (CEA and CA19-9) remained high for three months after surgery. S-1 was continued while shortening the imaging study follow-up period. Nine months after surgery, he noticed difficulty in hearing with facial paralysis, dizziness, tinnitus, and appetite loss. He was diagnosed with meningeal carcinomatosis and bilateral internal auditory canal metastasis. He died approximately two months later.

Conclusion

Meningeal carcinomatosis should be considered if bilateral deafness and vestibulopathy develop after gastrectomy, even if no recurrence is apparent in the abdominal cavity.
Heterotopic ossification in a patient with paroxysmal sympathetic hyperactivity following multiple trauma complicated with vitamin D deficiency: a case report
Authors: Sato Takeaki , Watanabe Mayo , Onoda Yoshito , Oyanagi Taku , Kushimoto Shigeki
Published: November 2020

Background

Paroxysmal sympathetic hyperactivity (PSH) may occur in patients with traumatic brain injury. Heterotopic ossification (HO) has frequently been observed in patients with PSH and has been found to impair patients’ recoveries. However, the pathophysiology of HO in patients with PSH remains unelucidated. Vitamin D deficiency is a common abnormality among critically ill patients and may be associated not only with musculoskeletal complications, but also with high morbidity and mortality. The association between vitamin D deficiency and HO in patients with PSH has not yet been evaluated.

Case presentation

A 21-year-old man was in a motorcycle accident. The initial diagnosis was diffused axonal injury, thoracic aortic injury, bilateral lung contusion with hemopneumothorax, liver injury, vertebral injury of T5, along with fractures of the right humerus, left patella, bilateral scapula, and a stable pelvic fracture, with an Injury Severity Score of 50. Two weeks after admission, he was diagnosed with PSH. One month after the injury, decreased joint mobility and progressive pain were evident. Computed tomography (CT) showed HO in his humerus, ulna, radius, scapula, ilium, pubis, ischium, knee joint, patella, and tibia, as well as renal calculus. To evaluate metabolic bone abnormalities, we measured levels of 25-OH vitamin D, parathyroid hormone, calcitonin, procollagen type I N-terminal propeptide (a marker of bone formation), and tartrate-resistant acid phosphatase 5b (a marker of bone resorption). This revealed a vitamin D deficiency. Bisphosphonate agents and vitamin D were administered for 1 month. Thereafter, his symptoms, radiographic findings, and laboratory abnormalities improved, and he was transferred to another facility.

Conclusions

HO in patients with PSH, following severe head injury, may be associated with vitamin D deficiency. Medication for vitamin-D-related metabolism abnormalities may represent a novel intervention for HO with PSH.
Swine inflammation and necrosis syndrome is influenced by husbandry and quality of sow in suckling piglets, weaners and fattening pigs
Authors: Reiner Gerald , Kühling Josef , Lechner Mirjam , Schrade Hansjörg , Saltzmann Janine , Muelling Christoph , Dänicke Sven , Loewenstein Frederik
Published: November 2020

Background

Swine inflammation and necrosis syndrome (SINS) is a newly identified syndrome in swine that can affect different parts of the extremities in suckling piglets. This study investigates the hypotheses that the clinical signs of SINS have histological equivalents, that SINS can also be observed in weaners and fatteners, that improving sow quality and husbandry (here the supply of water and fibre) can reduce the signs, and that coprostasis in sows is significantly associated with SINS in their offspring.

From a cohort of 123 hybrid sows, the twenty sows exhibiting the best conditions and the twenty exhibiting the worst conditions were selected based on detailed scores from coronary bands, soles, heels, claws and teats. Half of the sows in each group, along with their offspring, were kept under conventional conditions, while the environment for the remaining sows in each group was improved with drinking bowls, water disinfection and additional feeding with hay and straw. In total, 115 suckling piglets, 113 weaners and 103 fatteners were scored for the degree of inflammation and necrosis of their tails, ears, teats, coronary bands, soles, heels and claws.

Results

The clinical signs of SINS are associated with inflammatory signs at the histological level. SINS scores in suckling piglets, weaners and fatteners derived from low-quality sows under standard husbandry conditions were high, but they decreased significantly when husbandry was improved (water consumption and additional fibre). Sow quality had significant effects on suckling piglets and weaners under standard husbandry conditions. Coprostasis in sows led to significantly higher SINS scores in their offspring at any age. Improved husbandry conditions were associated with a reduced prevalence of coprostasis (R2 = 0.74). Taking all factors together, husbandry improvements, sow quality and coprostasis explained 57, 67 and 45% of SINS score variance in suckling piglets, weaners and fatteners, respectively.

Conclusion

The present study shows that SINS is not limited to suckling piglets but can also be found in weaners and fatteners. Coprostasis in sows is significantly correlated with SINS in their offspring and adds a good prognostic tool. Water supply and fibre could play a crucial role in combatting the syndrome.
Wound healing potentials of herbal ointment containing Calendula officinalis Linn. on the alteration of immunological markers and biochemical parameters in excision wounded animals
Authors: Gunasekaran Shobana , Nayagam Agnel Arul John , Natarajan Rameshkannan
Published: November 2020

Objective

The present study was designed to investigate the in vivo wound healing activity of herbal ointment prepared fromCalendula officinalisLinn. on excision wounded rats.

Materials and methods

The excision wound model was employed for wound healing activity in albino rats. Healthy albino rats (150–200 g) of either sex were taken for excision wound model. Animals were divided into five groups of six animals in each. Group I served as normal control, Group II served as excision wounded control without treatment and Group III, IV served as excision wounded rats were treated with herbal ointment of two different doses (10% and 20%) applied topically for 14 days and group V served as excision wounded animals treated with reference ointment soframycin. Healing potential was evaluated by the rate of wound contraction, immunological markers like IL-6(Interleukin 6), TNF-alpha (Tumor necrosis factor -α), PDGF (Platelet Derived Growth Factor) and EGF (Epidermal Growth Factor), lipid peroxide (LPO), superoxide dismutase (SOD), and biochemical parameters like hydroxyproline, hesosamine, and tissue protein.

Results

The topical application of herbal ointment treated groups showed increase in the levels of growth factors such as PDGF and EGF hydroxy proline, hesosamine, tissue protein, SOD and wound contraction and the ointment normalized the levels of lipid peroxide, IL-6, TNF-alpha compared than that of excision wounded animals.

Conclusion

From the above results, it was concluded that the topical application of herbal ointment exhibited significant wound healing activity in excision wounded rats as evidenced by increased wound contraction and collagen synthesis.
Self-assembly study of type I collagen extracted from male Wistar Hannover rat tail tendons
Authors: González-Masís Jeimmy , Cubero-Sesin Jorge M. , Guerrero Simón , González-Camacho Sara , Corrales-Ureña Yendry Regina , Redondo-Gómez Carlos , Vega-Baudrit José Roberto , Gonzalez-Paz Rodolfo J.
Published: November 2020

Background

Collagen, the most abundant protein in the animal kingdom, represents a promising biomaterial for regenerative medicine applications due to its structural diversity and self-assembling complexity. Despite collagen’s widely known structural and functional features, the thermodynamics behind its fibrillogenic self-assembling process is still to be fully understood. In this work we report on a series of spectroscopic, mechanical, morphological and thermodynamic characterizations of high purity type I collagen (with a D-pattern of 65 nm) extracted from Wistar Hannover rat tail. Our herein reported results can be of help to elucidate differences in self-assembly states of proteins using ITC to improve the design of energy responsive and dynamic materials for applications in tissue engineering and regenerative medicine.

Methods

Herein we report the systematic study on the self-assembling fibrillogenesis mechanism of type I collagen, we provide morphological and thermodynamic evidence associated to different self-assembly events using ITC titrations. We provide thorough characterization of the effect of pH, effect of salts and protein conformation on self-assembled collagen samples via several complementary biophysical techniques, including circular dichroism (CD), Fourier Transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), atomic force microscopy (AFM), scanning electron microscopy (SEM), dynamic mechanical thermal analysis (DMTA) and thermogravimetric analysis (TGA).

Results

Emphasis was made on the use of isothermal titration calorimetry (ITC) for the thermodynamic monitoring of fibrillogenesis stages of the protein. An overall self-assembly enthalpy value of 3.27 ± 0.85 J/mol was found. Different stages of the self-assembly mechanism were identified, initial stages take place at pH values lower than the protein isoelectric point (pI), however, higher energy release events were recorded at collagen’s pI. Denatured collagen employed as a control exhibited higher energy absorption at its pI, suggesting different energy exchange mechanisms as a consequence of different aggregation routes.

Graphical abstract
Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial
Authors:   on behalf the study group, Coulibaly Abou , Millogo Tieba , Baguiya Adama , Tran Nguyen Toan , Yodi Rachel , Seuc Armando , Cuzin-Kihl Asa , Thieba Blandine , Landoulsi Sihem , Kiarie James , Mashinda Kulimba Désiré , Kouanda Séni
Published: November 2020

Introduction

Women who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.

Methods

We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.

Results

In total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-nine women of the control group used modern methods compared to 279 women of the intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, modern methods’ discontinuation was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8–8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p < 0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.

Conclusion

The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also essential to set up specific actions targeting women’s partners and influential people in the community to counter inhibiting beliefs.

Trial registration

Pan African Clinical Trials Registry (PACTR201609001784334,https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).
Discovering optimal weights in weighted-scoring stock-picking models: a mixture design approach
Authors: Yeh I-Cheng , Liu Yi-Cheng
Published: November 2020

Certain literature that constructs a multifactor stock selection model adopted a weighted-scoring approach despite its three shortcomings. First, it cannot effectively identify the connection between the weights of stock-picking concepts and portfolio performances. Second, it cannot provide stock-picking concepts’ optimal combination of weights. Third, it cannot meet various investor preferences. Thus, this study employs a mixture experimental design to determine the weights of stock-picking concepts, collect portfolio performance data, and construct performance prediction models based on the weights of stock-picking concepts. Furthermore, these performance prediction models and optimization techniques are employed to discover stock-picking concepts’ optimal combination of weights that meet investor preferences. The samples consist of stocks listed on the Taiwan stock market. The modeling and testing periods were 1997–2008 and 2009–2015, respectively. Empirical evidence showed (1) that our methodology is robust in predicting performance accurately, (2) that it can identify significant interactions between stock-picking concepts’ weights, and (3) that which their optimal combination should be. This combination of weights can form stock portfolios with the best performances that can meet investor preferences. Thus, our methodology can fill the three drawbacks of the classical weighted-scoring approach.
Near-infrared reflectance imaging of neovascularization in proliferative diabetic retinopathy
Authors: Vaz-Pereira Sara , Monteiro-Grillo Manuel , Engelbert Michael
Published: November 2020

Background

Blood is one of the main absorbers in the near-infrared spectrum and thus retinal vessels appear dark in near-infrared reflectance (NIR) images. Proliferative diabetic retinopathy (PDR) is characterized by abnormal neovascularization which also absorbs light and appears dark against a lighter fundus background. We analyzed neovascularization in PDR using NIR imaging, by observing changes in the neovascular complexes (NVCs) contrast and reflectivity over time.

Methods

Retrospective case series of 20 eyes of 17 patients with PDR who underwent NIR imaging with optical coherence tomography (OCT) using the Spectralis System. NVCs presence and activity was determined using clinical, tomographic and angiographic criteria. At baseline, all NVCs were qualitatively graded in the NIR image into 3 groups (absent, present and inactive and present and active) and their evolution over time was registered as progression, regression or same status.

Results

Twenty-seven NVCs were imaged, of which, 52% were neovascularization of the disc (NVD) and 48% were elsewhere (NVE). Consecutive NIR images were obtained from baseline to up to 5 time-points with a mean follow-up of 3.2 ± 1.7 years. All eyes underwent laser treatment and 30% had additional intravitreal therapy. Using NIR imaging, NVCs were classified at baseline as absent, present and inactive and present and active, respectively in 11, 4 and 85% of cases. NIR identified active neovascularization as hyporeflective irregular dark vessels originating from the retinal venules in NVE or from the disc in NVD. In all groups during follow-up, progression was identified as the development of new vascular hyporeflective dark fronds while regression was shown by reduced dark perfusion. Five eyes developed a wolf’s jaw configuration with vascular hyporeflective new vessels and hyperreflective tissue from extensive fibrosis. Fibrosis was more apparent in later images, reaching 86%. In 3 cases (11%), the NVC was no longer seen in NIR, although was still identifiable on OCT over the NVC area.

Conclusions

NIR is a non-invasive imaging modality commonly performed alongside OCT and frequently overlooked which can be useful to evaluate NVCs in PDR. Changes in NVC contrast and reflectivity due to blood perfusion can help in the detection and monitoring of diabetic proliferative disease and aid clinicians in daily practice.
How can technology support ageing in place in healthy older adults? A systematic review
Authors: Ollevier Aline , Aguiar Gabriel , Palomino Marco , Simpelaere Ingeborg Sylvia
Published: November 2020

Background

Ageing in place has recently gained visibility in healthcare policies and services. Technology has the potential to facilitate independence at home. The objective of this systematic review is to identify technologies that have been rigorously evaluated for supporting the ageing in place of healthy older adults. As well we explored the methods in engagement with technology in healthy older adults.

Methods

Databases Pubmed, Scopus, PsycInfo and Cinahl were consulted for clinical controlled trials or randomised controlled trials between 2014 and 2019. Studies were included if they contained a technological intervention and focussed on supporting healthy older adults’ independent living. PRISMA guidelines and the risk of bias tool of the Cochrane Collaboration were applied.

Results

The search identified 3662 articles of which only 7 made the final analysis. Through narrative analysis, technologies were categorised into three groups: accessible communication, emergency assistance and physical and mental well-being. Patient-centredness was extensively addressed by exploring how the participants engaged in the development and evaluation of the technology and how they were trained and monitored.

Conclusions

Literature concerning technology to support ageing, based on controlled trials and research performed in authentic home situations, is scarce. Thus, there is a need to investigate the subject in depth. The use of a neurofeedback headband, an accessible computer system, a wristband with pedometer, a biofeedback device and an online video platform can bring added value to ageing in place for healthy older adults. A patient-centred approach for developing, implementing and evaluating technology benefits ageing in place.
Global strategies and effectiveness for COVID-19 prevention through contact tracing, screening, quarantine, and isolation: a systematic review
Authors: Girum Tadele , Lentiro Kifle , Geremew Mulugeta , Migora Biru , Shewamare Sisay
Published: November 2020

Background

COVID-19 is an emerging disease caused by highly contagious virus called SARS-CoV-2. It caused an extensive health and economic burden around the globe. There is no proven effective treatment yet, except certain preventive mechanisms. Some studies assessing the effects of different preventive strategies have been published. However, there is no conclusive evidence. Therefore, this study aimed to review evidences related to COVID-19 prevention strategies achieved through contact tracing, screening, quarantine, and isolation to determine best practices.

Methods

We conducted a systematic review in accordance with the PRISMA and Cochrane guidelines by searching articles from major medical databases such as PubMed/Medline, Global Health Database, Embase, CINAHL, Google Scholar, and clinical trial registries. Non-randomized and modeling articles published to date in areas of COVID prevention with contact tracing, screening, quarantine, and isolation were included. Two experts screened the articles and assessed risk of bias with ROBINS-I tool and certainty of evidence with GRADE approach. The findings were presented narratively and in tabular form.

Results

We included 22 (9 observational and 13 modeling) studies. The studies consistently reported the benefit of quarantine, contact tracing, screening, and isolation in different settings. Model estimates indicated that quarantine of exposed people averted 44 to 81% of incident cases and 31 to 63% of deaths. Quarantine along with others can also halve the reproductive number and reduce the incidence, thus, shortening the epidemic period effectively. Early initiation of quarantine, operating large-scale screenings, strong contact tracing systems, and isolation of cases can effectively reduce the epidemic. However, adhering only to screening and isolation with lower coverage can miss more than 75% of asymptomatic cases; hence, it is not effective.

Conclusion

Quarantine, contact tracing, screening, and isolation are effective measures of COVID-19 prevention, particularly when integrated together. In order to be more effective, quarantine should be implemented early and should cover a larger community.
Content validity of a sleep numerical rating scale and a sleep diary in adults and adolescents with moderate-to-severe atopic dermatitis
Authors: Dias-Barbosa Carla , Matos Rodolfo , Vernon Margaret , Carney Colleen E. , Krystal Andrew , Puelles Jorge
Published: November 2020

Background

The intense itching associated with atopic dermatitis (AD) often causes patients to experience severe sleep disturbance. Here, we describe the results of a two-phase concept elicitation and cognitive interview study to establish the content validity of a sleep disturbance numerical rating scale (SD NRS) and a Consensus Sleep Diary adapted for adults and adolescents with moderate-to-severe AD (CSD-AD©).

Results

In phase I, a concept elicitation conducted in 20 adults and 10 adolescents with moderate-to-severe AD revealed that the following sleep-related issues were important and relevant: nighttime awakening (87%), trouble falling asleep (73%), feeling unrested (53%), daytime fatigue or sleepiness (53%), and feeling as if they did not get enough sleep (33%). The frequency and extent of sleep disturbance varied substantially from day to day due to varying degrees of itching and flares, medication use, and changes in the weather. All participants understood the SD NRS question, with most finding it easy or very easy to understand (100% of adults and 90% of adolescents) and most understanding the anchors as intended (95% of adults, and 100% of adolescents). Most participants (94% of adults, and 90% of adolescents) indicated that they would consider a one- or two-point change meaningful on the SD NRS. The CSD-AD© was revised based on participant feedback, and tested during phase II in a convenience sample of six adults and four adolescents from phase I. The changes made to the CSD-AD© were confirmed to be relevant and understandable. All patients were able to provide an answer to each item in the CSD-AD©, and most were able to estimate the duration of nighttime awakenings, daytime naps, and dozing.

Conclusions

The study supported the content validity of the SD NRS and CSD-AD© in adults and adolescents with moderate-to-severe AD. It also emphasized the importance of using these instruments daily when assessing the benefit of a new treatment on sleep quality in this population.
Prenatal presentation of Walker–Warburg syndrome with a POMT2 mutation: an extended fetal phenotype
Authors: El-Dessouky Sara H. , Hosny Heba , Elarab Ahmed Ezz , Issa Mahmoud Y.
Published: November 2020

Background

Walker–Warburg syndrome (WWS) is a rare, lethal, genetically, and clinically heterogeneous congenital muscular dystrophy resulting from defective glycosylation of α-dystroglycan (α-DG) and is associated with both cranial and ocular malformations. Prenatal detection of posterior fossa anomalies in association with hydrocephalus are nonspecific, however, an additional finding of eye anomalies are typical for WWS. The purpose of this report is to elucidate the pattern of associated malformations in a fetus with WWS born to 3rd degree consanguineously married couple. Additionally, the fetal ultrasonography revealed congenital heart disease, clenched hands, and talipes equinovarus; these findings have not been previously reported and represent an expansion of prenatal spectrum associated with WWS.

Case presentation

We report on a specific sonographic pattern of congenital anomalies including hydrocephalus, agenesis of corpus callosum, and Dandy–Walker malformation. Ocular abnormalities include microphthalmia, cataract, and an echoic structure suggestive of persistent primary vitreous. Other features include congenital heart disease, unilateral multicystic kidney, and previously unreported findings of bilateral clenched hands and talipes equinovarus. The molecular analysis detected a homozygous splicing mutation, c.924-2A>C, in the POMT2 gene; this variant segregated with the phenotype.

Conclusion

WWS syndrome has characteristic prenatal ultrasound findings which can improve the prenatal identification of this condition and help in guiding the molecular diagnosis and counseling. The detection of bilateral clenched hands and talipes equinovarus is a novel finding that further expands the phenotypic spectrum of WWS.
Relationship of serum vitamin D levels with coronary thrombus grade, TIMI flow, and myocardial blush grade in patients with acute ST-segment elevation myocardial infarction
Authors: Abdallah Abdallah Ahmed , Elrhman Mohamed Ahmed Abd , Elshazly Ahmd , Bastawy Islam
Published: November 2020

Background

Vitamin D deficiency is a prevalent condition that is found in about 30–50% of the general population, and it is increasing as a new risk factor for coronary artery disease. Our study aimed to evaluate the relationship of serum vitamin D levels with coronary thrombus burden, Thrombolysis In Myocardial Infarction flow grade, and myocardial blush grade in patients managed by primary percutaneous coronary intervention for their first acute ST-segment elevation myocardial infarction.

Results

Eighty patients were included in the study with their first acute ST-segment elevation myocardial infarction and were managed by primary percutaneous coronary intervention. According to the serum concentrations of vitamin D, the study population was divided into 2 groups: group A with abnormal vitamin D levels less than 30 ng/ml (50 patients) and group B with normal vitamin D levels equal to or more than 30 ng/ml (30 patients). Angiographic data was recorded before and after coronary intervention. On comparing thrombus grade and initial and post-procedural Thrombolysis In Myocardial Infarction flow between both groups of patients, there was no significant difference (p = 0.327, p = 0.692, p = 0.397). However, myocardial blush grade was better in patients with normal vitamin D levels (p = 0.029) without a significant correlation between vitamin D concentration values and myocardial blush grade (r = 0.164, p = 0.146).

Conclusions

Patients with first acute ST-segment elevation myocardial infarction and normal vitamin D levels undergoing primary percutaneous coronary intervention had better myocardial blush grade and more successful microvascular reperfusion in comparison with patients with abnormal vitamin D levels. There was no significant difference between the normal and abnormal vitamin D groups regarding the coronary thrombus grade and Thrombolysis In Myocardial Infarction flow.
Tensile mechanical properties of fly ash concrete at early age for thermal stress analysis
Authors: Mimura Yoichi , Vimonsatit Vanissorn , Horiguchi Itaru , Yoshitake Isamu
Published: November 2020

The present study investigates tensile properties of concrete with and without fly ash at early age, such as tensile Young’s modulus, strength and creep. Some Young’s modulus of fly ash concrete for thermal crack analysis was compared with the tensile Young’s modulus, secant modulus, initial tangent modulus and linear modulus obtained from the direct tension test and compression test. The tensile creep test was also performed to obtain the specific creep behavior considering decrease in elastic strain due to stiffness development at early age during creep test. The results show that the Young’s modulus for crack evaluation can be obtained from the compression test based on the stress range less than the splitting tensile strength, while the compressive secant modulus was smaller than the tensile Young’s modulus. The decrease of the elastic strain at early age contributes more to the evaluation of the tensile creep than the use of the fly ash mixing.
What is better for rotator cuff tendinopathy: dextrose prolotherapy, platelet-rich plasma, or corticosteroid injections? A randomized controlled study
Authors: Sabaah Hala M. Abd Elsabour , Nassif Mary A.
Published: November 2020

Background

Rotator cuff tendinopathy (RCT) is a leading cause of shoulder pain and disability. Management is mainly conservative, but the limited ability of tendons to regenerate is the main cause of unsatisfactory results. So, we conducted our study to compare the efficacy of deep prolotherapy (glucose 25%), platelet-rich plasma (PRP), and betamethasone corticosteroid for treatment of RCT to find the most effective one based on clinical, functional, and radiological assessment.

Results

Regarding visual analog scale (VAS), it was significantly (p < 0.001) improved after injection among group 1 (prolotherapy group) and group 3 (steroid group) patients, while no significant improvement was noted among group 2 (PRP group) (p = 0.212) patients. The Western Ontario Rotator Cuff (WORC) Index significantly improved among the studied groups (p < 0.001, p = 0.049, and p < 0.001, respectively) after injection. Regarding the range of motion (ROM), a significant improvement (p = 0.029) was achieved in group 1 after injection but no significant improvements were noted among group 2 and 3 patients (p = 0.529 and 0.121, respectively). There was a significant improvement among group 1 and 2 patients (p < 0.001 and p = 0.020, respectively) regarding the grade of tendon lesions but no improvement occurred among group 3 patients (p = 0.470).

Conclusion

Prolotherapy injections improve shoulder ROM, VAS, WORC index, and rotator cuff tendon healing while PRP injections improve WORC index and tendon healing but steroid injection has no effect on healing.

Trial registration

PACTR202005610509496. Retrospective registration on May 25, 2020, Pan African Clinical Trial Registry.
Anality in the Colonial Archive
Authors: Ragni Andrew
Published: November 2020

This essay establishes points of contact between Sigmund Freud’s research on the anal-sadistic stage of infantile sexuality in the first decade of the twentieth century and the Irishman Roger Casement’s contemporaneous sexual practices in Peru while he investigated a colonial rubber enterprise for its gruesomely violent punitive practices against colonized peoples. The pairing of Freud and Casement elucidates a theory of colonial archivization evinced in Casement’s notorious Black Diaries and in Freud’s Three Essays on the Theory of Sexuality and “Wolf Man” case history. The author argues for a retooling of psychoanalysis as a hermeneutic for archival work on queer pasts by sidestepping the familiar terrain of melancholic loss in favor of the ambivalent, defiant function of anal sexuality and its peculiar encryption strategy.
Dissecting Hes-centred transcriptional networks in neural stem cell maintenance and tumorigenesis in Drosophila
Authors: Magadi Srivathsa S. , Voutyraki Chrysanthi , Anagnostopoulos Gerasimos , Zacharioudaki Evanthia , Poutakidou Ioanna K. , Efraimoglou Christina , Stapountzi Margarita , Theodorou Vasiliki , Nikolaou Christoforos , Koumbanakis Konstantinos A. , Fullard John F. , Delidakis Christos
Published: November 2020

Neural stem cells divide during embryogenesis and juvenile life to generate the entire complement of neurons and glia in the nervous system of vertebrates and invertebrates. Studies of the mechanisms controlling the fine balance between neural stem cells and more differentiated progenitors have shown that, in every asymmetric cell division, progenitors send a Delta-Notch signal to their sibling stem cells. Here, we show that excessive activation of Notch or overexpression of its direct targets of the Hes family causes stem-cell hyperplasias in the Drosophila larval central nervous system, which can progress to malignant tumours after allografting to adult hosts. We combined transcriptomic data from these hyperplasias with chromatin occupancy data for Dpn, a Hes transcription factor, to identify genes regulated by Hes factors in this process. We show that the Notch/Hes axis represses a cohort of transcription factor genes. These are excluded from the stem cells and promote early differentiation steps, most likely by preventing the reversion of immature progenitors to a stem-cell fate. We describe the impact of two of these ‘anti-stemness’ factors, Zfh1 and Gcm, on Notch/Hes-triggered tumorigenesis.
Temporal patterns of pollen shedding for longleaf pine (Pinus palustris) at the Escambia Experimental Forest in Alabama, USA
Authors: Chen Xiongwen , Brockway Dale G. , Guok Qinfeng
Published: November 2020

Longleaf pine is an important tree species in the southeastern United States and studying the temporal patterns of pollen shedding is crucial to a better understanding of its phenology and seed production. In this study, field observation data on the timing of pollen shedding from 1958 to 2013 were analyzed with reference to local weather conditions. Our results indicated that the time of peak pollen shedding after January 1 (TPPS) ranged from 53 days (about February 22) to 95 days (around April 5). There was no significant trend of decreasing TPPS. The number of days with the maximum air temperature above 0 °C was close to the TPPS. The accumulated maximum daily air temperature for the TPPS approximated an average of 1,342 °C. The TPPS declined with an increase in the average air temperature during winters. The time of 80% accumulated pollen density (TAPD) varied from 5 to 32 days, with an average of 13 days. Taylor’s power-law was evident in the TAPD data, with the time group of 10–15 days having an interval time of 2 years. Winter weather was not correlated with the TAPD. These results provide new information concerning the pollen phenology for longleaf pine trees.