bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal Complication and Glycemic Control in Korean Veterans with Type 2 Diabetes: A 10-Year Retrospective Cohort Study
Authors: Kim Ye An , Lee Young , Seo Je Hyun
Published: June 2020

Objective. Tight glycemic control reduces the risk of diabetes complications, but it may increase the risk of hypoglycemia or mortality in elderly patients. This study is aimed at evaluating the incidence and progression of renal complications and its association with glycemic control in elderly patients with type 2 diabetes. Methods. This retrospective cohort study examined the data of 3099 patients with type 2 diabetes who were followed for at least 10 years at the Korean Veterans Hospital and for whom glycated hemoglobin (HbA1c) was measured in 2008 and 2017. Participants were divided into six groups according to their baseline or dynamic HbA1c levels. Extended Cox models were used to calculate adjusted hazard ratios for the development of chronic kidney disease (CKD) and end-stage renal disease (ESRD) associated with specific HbA1c ranges. Results. During the 10-year follow-up period, 30% of patients developed new CKD, 50% showed progression, and ESRD developed in 1.7%. The risk of CKD was associated with baseline HbA1c from the first year of the study and dynamic HbA1c throughout the study period. The adjusted hazard ratios for CKD were 1.98 and 2.32 for baseline and dynamic HbA1c, respectively, at the level of ≥69 mmol/mol. There was no increased risk for any complications in baseline and dynamic HbA1c below 58 mmol/mol. Conclusions. A higher HbA1c≥58 mmol/mol was associated with an increased risk of diabetes complications. A less stringent glycemic target of HbA1c could be used as the threshold of renal complications.
A Genetic Risk Score to Personalize Prostate Cancer Screening, Applied to Population Data
Authors: Huynh-Le Minh-Phuong , Fan Chun Chieh , Karunamuni Roshan , Walsh Eleanor I. , Turner Emma L. , Lane J. Athene , Martin Richard M. , Neal David E. , Donovan Jenny L. , Hamdy Freddie C. , Parsons J. Kellogg , Eeles Rosalind A. , Easton Douglas F. , Kote-Jarai Zsofia , Amin Al Olama Ali , Benlloch Garcia Sara , Muir Kenneth , Grönberg Henrik , Wiklund Fredrik , Aly Markus , Schleutker Johanna , Sipeky Csilla , Tammela Teuvo LJ , Nordestgaard Børge Grønne , Key Timothy J. , Travis Ruth C. , Pharoah Paul D.P. , Pashayan Nora , Khaw Kay-Tee , Thibodeau Stephen N. , McDonnell Shannon K. , Schaid Daniel J. , Maier Christiane , Vogel Walther , Luedeke Manuel , Herkommer Kathleen , Kibel Adam S. , Cybulski Cezary , Wokolorczyk Dominika , Kluzniak Wojciech , Cannon-Albright Lisa A. , Brenner Hermann , Schöttker Ben , Holleczek Bernd , Park Jong Y. , Sellers Thomas A. , Lin Hui-Yi , Slavov Chavdar Kroumov , Kaneva Radka P. , Mitev Vanio I. , Batra Jyotsna , Clements Judith A. , Spurdle Amanda B. , Teixeira Manuel R. , Paulo Paula , Maia Sofia , Pandha Hardev , Michael Agnieszka , Mills Ian G. , Andreassen Ole A. , Dale Anders M. , Seibert Tyler M.
Published: June 2020

Background:

A polygenic hazard score (PHS), the weighted sum of 54 SNP genotypes, was previously validated for association with clinically significant prostate cancer and for improved prostate cancer screening accuracy. Here, we assess the potential impact of PHS-informed screening.

Methods:

United Kingdom population incidence data (Cancer Research United Kingdom) and data from the Cluster Randomized Trial of PSA Testing for Prostate Cancer were combined to estimate age-specific clinically significant prostate cancer incidence (Gleason score ≥7, stage T3–T4, PSA ≥10, or nodal/distant metastases). Using HRs estimated from the ProtecT prostate cancer trial, age-specific incidence rates were calculated for various PHS risk percentiles. Risk-equivalent age, when someone with a given PHS percentile has prostate cancer risk equivalent to an average 50-year-old man (50-year-standard risk), was derived from PHS and incidence data. Positive predictive value (PPV) of PSA testing for clinically significant prostate cancer was calculated using PHS-adjusted age groups.

Results:

The expected age at diagnosis of clinically significant prostate cancer differs by 19 years between the 1st and 99th PHS percentiles: men with PHS in the 1st and 99th percentiles reach the 50-year-standard risk level at ages 60 and 41, respectively. PPV of PSA was higher for men with higher PHS-adjusted age.

Conclusions:

PHS provides individualized estimates of risk-equivalent age for clinically significant prostate cancer. Screening initiation could be adjusted by a man's PHS.

Impact:

Personalized genetic risk assessments could inform prostate cancer screening decisions.
HIST1H2BB and MAGI2 Methylation and Somatic Mutations as Precision Medicine Biomarkers for Diagnosis and Prognosis of High-grade Serous Ovarian Cancer
Authors: Valle Blanca L. , Rodriguez-Torres Sebastian , Kuhn Elisabetta , Díaz-Montes Teresa , Parrilla-Castellar Edgardo , Lawson Fahcina P. , Folawiyo Oluwasina , Ili-Gangas Carmen , Brebi-Mieville Priscilla , Eshleman James R. , Herman James , Shih Ie-Ming , Sidransky David , Guerrero-Preston Rafael
Published: June 2020

Molecular alterations that contribute to long-term (LT) and short-term (ST) survival in ovarian high-grade serous carcinoma (HGSC) may be used as precision medicine biomarkers. DNA promoter methylation is an early event in tumorigenesis, which can be detected in blood and urine, making it a feasible companion biomarker to somatic mutations for early detection and targeted treatment workflows. We compared the methylation profile in 12 HGSC tissue samples to 30 fallopian tube epithelium samples, using the Infinium Human Methylation 450K Array. We also used 450K methylation arrays to compare methylation among HGSCs long-term survivors (more than 5 years) and short-term survivors (less than 3 years). We verified the array results using bisulfite sequencing and methylation-specific PCR (qMSP). in another cohort of HGSC patient samples (n = 35). Immunoblot and clonogenic assays after pharmacologic unmasking show that HIST1H2BB and MAGI2 promoter methylation downregulates mRNA expression levels in ovarian cancer cells. We then used qMSP in paired tissue, ascites, plasma/serum, vaginal swabs, and urine from a third cohort of patients with HGSC cancer (n = 85) to test the clinical potential of HIST1H2BB and MAGI2 in precision medicine workflows. We also performed next-generation exome sequencing of 50 frequently mutated in human cancer genes, using the Ion AmpliSeqCancer Hotspot Panel, to show that the somatic mutation profile found in tissue and plasma can be quantified in paired urine samples from patients with HGSC. Our results suggest that HIST1H2BB and MAGI2 have growth-suppressing roles and can be used as HGSC precision medicine biomarkers.
In Human Visualization of Ibrutinib-Induced CLL Compartment Shift
Authors: Mayerhoefer Marius E. , Haug Alexander , Jäger Ulrich , Pichler Verena , Pfaff Sarah , Wester Hans-Jürgen , Hacker Marcus , Kazianka Lukas , Staber Philipp B.
Published: June 2020

Bruton tyrosine kinase inhibitor ibrutinib is effective in treating chronic lymphocytic leukemia (CLL). However, after ibrutinib treatment initiation, patients frequently experience an increase of CLL blood cell count. This phenomenon in clinical practice is thought to reflect a “compartment shift” of CLL cells from lymph nodes to the peripheral blood, but the actual shifting has not yet been demonstrated. Using [68Ga]Pentixafor-PET/MRI for in vivo CXCR4 visualization, we here provide images of topical changes of CLL cells upon ibrutinib treatment. Within the first month of ibrutinib treatment, mean standardized [68Ga]Pentixafor uptake decreased in the bone marrow and lymph nodes, whereas [68Ga]Pentixafor uptake increased in the spleen. Leukocytosis rose, as did numbers of CXCR4high (tissue-resident) CLL cells. Volumes of lymph nodes and spleen decreased. Upon longer ibrutinib treatment, leukocytosis decreased, followed by a decrease of [68Ga]Pentixafor uptake in the spleen. These results support the preexisting clinical hypothesis of a “compartment shift” of CLL cells from the lymph nodes to the peripheral blood, but also refine the mechanistic model by describing early clearing of the bone marrow and redistribution of CLL cells to the orthotopic splenic cavernous system in response to ibrutinib treatment.
Pericardial Effusion Associated with Diazoxide Treatment for Congenital Hyperinsulinism
Authors: Hastings Lucy A. , Preddy John , McCready Michael , Neville Kristen , Verge Charles F.
Published: June 2020

Background: Diazoxide is widely used to manage congenital hyperinsulinism and is generally well tolerated. Pericardial effusion is not a recognized side effect of diazoxide, apart from 2 single case reports. Case Description: Three patients with congenital hyperinsulinism developed pericardial effusion at the ages of 7 weeks, 8 months, and 17 years. The duration of diazoxide treatment (10–15 mg/kg/day) was 6.5 weeks, 5 months, and 17 years, respectively. There was no evidence of fluid overload or significant other cardiac anomaly. The 7-week-old patient presented with signs of cardiac failure, was treated with diuretics, and the effusion resolved after cessation of diazoxide. The 8-month-old patient required emergency subxiphoid drainage of the effusion due to hemodynamic compromise. The pericardial fluid had high numbers of polymorphonuclear cells, but did not grow any organisms, and histology showed non-specific chronic reactive changes; the effusion did not recur after cessation of diazoxide. The 17-year-old patient presented with atrial fibrillation, was treated with beta blockade and colchicine, and continues on diazoxide with monitoring of the effusion by ultrasound. Conclusion: Patients on long-term diazoxide treatment may be at risk of pericardial effusion, the timing and significance of which is unpredictable. The duration of diazoxide treatment before presentation of pericardial effusion varied in our patients from weeks to years. We advise serial echocardiography 1–2 months after commencement of diazoxide and annually thereafter.
Oral Iron Therapy-Induced Neutropenia in Patient with Iron Deficiency Anemia
Authors: Kloub Mohammad N. , Yassin Mohamed A.
Published: June 2020

Iron deficiency anemia is common and worldwide distributed, particularly among females; however, it can also occur among males. Iron deficiency anemia is commonly associated with thrombocytosis; little is known about the effect of iron therapy (oral or intravenous) on other hematological parameters. We report a 29-year-old male patient with iron deficiency anemia, who received oral iron replacement therapy and developed neutropenia which recovered spontaneously 1 month later.
Pressure versus Sudden Wean from Nasal Continuous Positive Airway Pressure in Preterm Infants: A Systematic Review and Meta-Analysis
Authors: Lemieux-Bourque Charlotte , Piedboeuf Bruno , Fontela Patricia S. , Bornais Kevin , Beltempo Marc
Published: June 2020

Background: Nasal continuous positive airway pressure (NCPAP) is a well-studied treatment for respiratory problems in preterm infants. However, the best strategy for NCPAP weaning is unknown. Objective: We aimed to compare the success of progressive pressure wean versus sudden wean for discontinuation of NCPAP in preterm infants. Methods: We conducted a systematic review and meta-analysis of publications identified by searching MEDLINE, Embase, ­CINAHL, and CENTRAL. Randomized controlled trials comparing pressure wean to sudden wean for NCPAP in preterm infants were included. Primary outcomes were postmenstrual age (PMA) at successful weaning and weight gain. Secondary outcomes were total duration of ventilation, success of weaning strategy on first attempt, length of stay (LOS), and bronchopulmonary dysplasia (BPD). Results: Two trials (422 infants) were eligible for inclusion. Pressure wean was associated with a higher PMA at weaning (33.9 ± 2.1 vs. 32.1 ± 2.0 weeks, mean difference [MD] 0.88, 95% CI 0.40 to 1.35, low quality evidence). Daily weight gain was only reported in 1 trial. Total duration of ventilation was not reported. Pressure wean was associated with higher probability of successful weaning at first attempt (risk ratio [RR] 1.25, 95% CI 1.03–1.53). However, it was not associated with LOS (MD –2.5 days, 95% CI –7.3 to 2.4) or BPD (RR 0.92, 95% CI 0.52–1.63). Conclusion: Sudden wean of NCPAP was associated with a lower PMA at successful wean compared to pressure wean but also with a lower rate of successful wean at first attempt, most likely because of the developmental stage at which weaning is possible.
Positive Modulation of SK Channel Impedes Neuron-Specific Cytoskeletal Organization and Maturation
Authors: Shrestha Amita , Sultana Razia , Adeniyi Philip A. , Lee Charles C. , Ogundele Olalekan M.
Published: June 2020

N-methyl-D-aspartate receptor (NMDAR) modulates the structural plasticity of dendritic spines by impacting cytoskeletal organization and kinase signaling. In the developing nervous system, activation of NMDAR is pertinent for neuronal migration, neurite differentiation, and cellular organization. Given that small conductance potassium channels (SK2/3) repress NMDAR ionotropic signaling, this study highlights the impact of neonatal SK channel potentiation on adult cortical and hippocampal organization. Neonatal SK channel potentiation was performed by one injection of SK2/3 agonist (CyPPA) into the pallium of mice on postnatal day 2 (P2). When the animals reached adulthood (P55), the hippocampus and cortex were examined to assess neuronal maturation, lamination, and the distribution of synaptic cytoskeletal proteins. Immunodetection of neuronal markers in the brain of P2-treated P55 mice revealed the presence of immature neurons in the upper cortical layers (layers II–IV) and CA1 (hippocampus). Also, layer-dependent cortical-cell density was attenuated due to the ectopic localization of mature (NeuN+) and immature (Doublecortin+ [DCX+]) neurons in cortical layers II–IV. Similarly, the decreased count of NeuN+ neurons in the CA1 is accompanied by an increase in the number of immature DCX+ neurons. Ectopic localization of neurons in the upper cortex and CA1 caused the dramatic expression of neuron-specific cytoskeletal proteins. In line with this, structural deformity of neuronal projections and the loss of postsynaptic densities suggests that postsynaptic integrity is compromised in the SK2/3+ brain. From these results, we deduced that SK channel activity in the developing brain likely impacts neuronal maturation through its effects on cytoskeletal formation.
Lymphatic Capillaries in Aging
Authors: Jakic Bojana , Kerjaschki Dontscho , Wick Georg
Published: June 2020

The lymphatic system is responsible for fluid drainage from almost every organ in the body. It sustains tissue homeostasis and is also a central part of the immune system. With the discovery of cell-specific markers and transgenic mouse models, it has become possible to gain some insight into the developmental and functional roles of lymphatic endothelial cells (LECs). Only recently, a more direct regulatory role has been assigned to LECs in their functions in immunity responses and chronic diseases. Here, we discuss the changes occurring in aged lymphatic system and the role of lymphatic capillaries in some age-related diseases and experimental animal models.
Aeromedical Retrieval for Stroke in Australia
Authors: Gardiner Fergus William , Bishop Lara , Dos Santos Angela , Sharma Pritish , Easton Damien , Quinlan Frank , Churilov Leonid , Schwarz Madeleine , Walter Silke , Fassbender Klaus , Davis Stephen M. , Donnan Geoffrey A.
Published: June 2020

Introduction: Rural, remote, and Indigenous stroke patients have worse stroke outcomes than urban Australians. This may be due to lack of timely access to expert facilities. Objectives: We aimed to describe the characteristics of patients who underwent aeromedical retrieval for stroke, estimate transfer times, and investigate if flight paths corresponded with the locations of stroke units (SUs) throughout Australia. Methods: Prospective review of routinely collected Royal Flying Doctor Service (RFDS) data. Patients who underwent an RFDS aeromedical retrieval for stroke, July 2014–June 2018 (ICD-10 codes: I60–I69), were included. To define the locations of SUs throughout Australia, we accessed data from the 2017 National Stroke Audit. The main outcome measures included determining the characteristics of patients with an in-flight diagnosis of stroke, their subsequent pickup and transfer locations, and corresponding SU and imaging capacity. Results: The RFDS conducted 1,773 stroke aeromedical retrievals, consisting of 1,028 (58%) male and 1,481 (83.5%) non-Indigenous and 292 (16.5%) Indigenous patients. Indigenous patients were a decade younger, 56.0 (interquartile range [IQR] 45.0–64.0), than non-Indigenous patients, 66.0 (IQR 54.0–76.0). The most common diagnosis was “stroke not specified,” reflecting retrieval locations without imaging capability. The estimated median time for aeromedical retrieval was 238 min (95% confidence interval: 231–244). Patients were more likely to be transferred to an area with SU and imaging capability (both p < 0.0001). Conclusion: Stroke patients living in rural areas were younger than those living in major cities (75 years, Stroke Audit Data), with aeromedically retrieved Indigenous patients being a decade younger than non-Indigenous patients. The current transfer times are largely outside the time windows for reperfusion methods. Future research should aim to facilitate more timely diagnosis and treatment of stroke.
Histopathological Findings of Uncomplicated Hair Transplant for Male Androgenetic Alopecia: Can Lichen Planopilaris Features Be Present?
Authors: Alcântara Andressa Silva , Donati Aline , Suárez Maria Victoria , Pereira Ivan José Netto , Valente Neusa Yuriko Sakai , Michalany Nilceo Schwery , Horta de Lima Jr. Cristiano Luiz , Contin Leticia Arsie
Published: June 2020

Introduction: Insufficient hair growth after hair transplant, as well as erythema and perifollicular scaling, may be diagnosed as lichen planopilaris and treated as such based on clinical and histopathological findings. The purpose of this study is to observe graft biopsies of patients after uncomplicated hair transplants and to discuss if histological findings are enough to diagnose lichen planopilaris. Methods and Results: Eight patients diagnosed with androgenetic alopecia who were submitted to hair transplant were enrolled. In each of the participants, a scalp biopsy was performed in the receptor area and in the adjacent area. Biopsies were performed between 6 months and 1 year after surgery. Exams were analyzed by 3 pathologists. The t test was performed for paired observations, comparing the transplanted and the nontransplanted area for lymphocytic infiltrate and fibrosis. The significance level was considered as 5% (p < 0.05). Four of 8 participants had perifollicular lymphocytic infiltrate, from moderate to dense intensity in the recipient area. Fibrosis was seen in 6 patients. These findings were not seen in the control area. Conclusions: It is questioned whether lymphocytic infiltrate and fibrosis may be expected in patients who are submitted to normal hair transplants.
Diagnosis, Background, and Treatment of Hypothalamic Damage in Craniopharyngioma
Authors: Erfurth Eva-Marie
Published: June 2020

Craniopharyngiomas (CP) are rare brain tumors managed primarily with surgery and radiotherapy. There are 2 phenotypes of CP, i.e., one with a rather good outcome without hypothalamic damage and another with hypothalamic damage. With hypothalamic damage, progressive disease with recurrent operations and additional cranial radiotherapy often result in hypothalamic obesity, an affected psychosocial life, and cognitive dysfunction. The morbidity and mortality are increased for particularly cerebrovascular diseases. Preoperative hypothalamic involvement to predict hypothalamic damage is important for decision making for hypothalamus-sparing surgery. Also a postoperative hypothalamic damage evaluation with the use of hypothalamus volume measurement can predict hypothalamic obesity, which is important for early treatment options. The morbidity of CP includes cognitive dysfunction with attention deficits and impaired episodic memory and processing speed. Again patients with hypothalamic damage are more affected. Treatment options of hypothalamic obesity in the chronic phase are scarce and not convincingly successful. The most optimal situation is to try to hinder or stop the evolution of hypothalamic obesity. Prevention of hypothalamic damage is recommended, with special regard to hypothalamus-sparing therapeutic approaches that respect the integrity of essential nuclei located in both the medial and the posterior hypothalamic areas.
КЛІНІЧНИЙ ВИПАДОК ВНУТРІШНЬОУТРОБНОГО МІКСТ-ІНФІКУВАННЯ У НОВОНАРОДЖЕНОЇ ДИТИНИ
Authors: Kretsu N. M. , Koliubakina L. V.
Published: June 2020

Мета – проаналізувати клінічний випадок внутрішньоутробного мікст-інфікування у новонародженої дитини.

В останні роки відзначається зростання частоти та поширеності внутрішньоутробних інфекцій, які є провідними у структурі захворюваності та смертності немовлят. Серед них провідну роль посідає родина герпесвірусів, до яких належить й цитомегаловірус (ЦМВ). Здатність вірусу спричиняти тяжке ураження плода можливе у будь-якому триместрі вагітності, особливо у випадках первинного зараження під час вагітності. У 5-18 % немовлят розвивається маніфестна вроджена цитомегаловірусна інфекція, яка характеризується тяжким ступенем з високою летальністю. Вірус володіє здатністю викликати супресію практично всіх ланок імунітету, а саме: дисфункцію макрофагів, дисбаланс синтезу інтерлейкінів, пригнічувати активність Т-лімфоцитів, спричиняти зниження співвідношення CD4/CD8, синтезу інтерферонів й активності природних кілерів, що створює передумови для нашарування бактерійних генералізованих інфекційно-запальних процесів.

Наведено особливості клініки та перебігу внутрішньоутробного мікст-інфікування у новонародженої дитини.
ФАКТОРИ ПСИХІЧНОЇ ТРАВМАТИЗАЦІЇ У ВНУТРІШНЬО ПЕРЕМІЩЕНИХ ОСІБ: ЇХ СТРУКТУРА ТА ДИНАМІКА У ЧАСІ
Authors: Maruta N. O. , Panko T. V. , Kalenska G. Yu. , Kolyadko S. P. , Yavdak I. O. , Volkova S. O.
Published: June 2020

Сьогодні Україна займає дев’яте місце у світі за кількістю внутрішньо переміщених осіб (ВПО). Масштабні вимушені внутрішні міграції останніх років не могли не відобразитися на стані здоров’я як певної соціальної групи, так і на стані здоров’я населення у цілому.

Мета – вивчення факторів психічної травматизації, їх динаміки у часі та впливу на стан психічного здоров’я, визначення стресостійкості та соціальної адаптації у ВПО.

Матеріал і методи. Методи обстеження включали клініко-психопатологічний з оцінкою факторів психічної травматизації, методику визначення стресостійкості та соціальної адаптації Т. Холмса і Р. Раге для оцінки актуального рівня стресу протягом останнього року, статистичні методи.

Дослідження проведено в ДУ «Інститут неврології, психіатрії та наркології НАМН України» у відділі пограничної психіатрії. Всього було обстежено 213 ВПО. Усі обстежені були поділені на 3 групи: до І групи увійшли 94 ВПО із загальної популяції, у яких не було виявлено психічних розладів (умовно здорові); 68 осіб, у яких були визначені окремі психічні симптоми, що не сягали клінічного рівня, склали ІІ групу (група ризику) та 51 особа, що звернулася за медичною допомогою та мала діагностовані психічні розлади, увійшли до ІІІ групи (обстежені з психічними розладами).

Результати. Всім обстеженим була проведена оцінка стресогенних факторів (СФ), що включали фізіологічні, психоемоційні, соціально-психологічні та інформаційні чинники та відображала їх динаміку в часі. Рівень опірності стресу відрізнявся у здорових, хворих та осіб з групи ризику.

Висновки. Загальна оцінка впливу стресогенних чинників на ВПО свідчить про їх поєднану дію, різний ступінь патогенності та динаміки у часі.
САМООЦІНКА СТАНУ ЗДОРОВ’Я ПАЦІЄНТІВ ТЕРАПЕВТИЧНОГО ПРОФІЛЮ
Authors: Moiseeva Yu. A. , Zhukovska M. M.
Published: June 2020

Показники стану здоров’я населення України вказують на те, що хронічні неінфекційні хвороби є визначальними в структурі захворюваності й смертності населення нашої країни і залежать перш за все від способу життя. Найнебезпечнішими чинниками зниження стану здоров’я в Україні є артеріальний тиск та тютюнокуріння, яке зумовлює захворювання як дихальної, так і серцево-судинної систем.

Мета дослідження – проаналізувати анкетні дані щодо самооцінки здоров’я хворих із патологією дихальної і серцево-судинної систем.

Матеріали і методи. Дослідження проводили за матеріалами опитування 60 хворих із пульмонологічними та кардіологічними патологіями за анкетою, розробленою Київським міжнародним інститутом соціології.

Результати. Встановлено, що серед опитаних ре­спондентів переважали особи з досить низьким рівнем матеріального добробуту (яким вистачає на їжу, проте не вистачає грошей на задоволення іншим потреб). В обох групах пацієнтів зареєстровано найменшу кількість заможних осіб. Результати аналізу самооцінки стану здоров’я пацієнтів терапевтичного профілю показали, що хворі із патологією дихальної системи у 33,3 % випадків вважають своє здоров’я посереднім, а у 23,3 % випадків – поганим, тоді як пацієнти із серцево-судинними захворюваннями однаковою мірою оцінили своє здоров’я як хороше, посереднє, погане і дуже погане. Стан здоров’я є важливою умовою для відчуття щастя: серед тих, хто має легеневі й серцево-судинні захворювання, більшість почувається недостатньо щасливими (швидше ні, ніж так), а найменший відсоток тих, котрі є щасливими. Порівнюючи отримані дані у пацієнтів пульмонологічного і кардіологічного профілів, можна говорити про те, що за умов практично однакового матеріального добробуту, своє здоров’я як «посереднє» оцінили на 13,3 % більше пульмонологічних пацієнтів, тоді як на 16,7 % більше кардіологічних хворих вважають себе нещасливими.

Висновки. У пацієнтів із серцево-судинними та легеневими захворюваннями важливою умовою для відчуття щастя є не тільки стан здоров’я, але й матеріальний добробут та місце проживання.
ОСОБЛИВОСТІ РОБОТИ МЕДИЧНИХ СЕСТЕР У ЗОНІ БОЙОВИХ ДІЙ
Authors: Tzipkalo A. I. , Marushchak M. I. , Krynytska I. Ya.
Published: June 2020

Забезпечення кожному постраждалому належної медичної допомоги збільшує шанси на виживання та відновлення функцій протягом усього процесу надання медичної допомоги, що зумовлює актуальність аналізу складнощів у виконанні покладених на медсестер обов’язків у зоні бойових дій.

Мета дослідження – проаналізувати особливості роботи медичних сестер у зоні ведення бойових дій та на їх основі сформулювати рекомендації щодо удосконалення освітніх навчальних програм для медсестер.

Матеріали і методи. На базі військово-медичної служби ВМС УСБУ в Закарпатській області було про­аналізовано анкетні дані медичних сестер, які проходили військову службу в зоні антитерористичної операції упродовж 2015–2017 рр. Основним запитанням до респондентів було коротко описати складнощі у виконанні покладених на медсестер обов’язків.

Результати. Аналізуючи отримані відповіді медичних сестер, які виконували свої професійні обов’язки в зоні бойових дій, було сформульовано основні складнощі їх роботи в умовах прямої і непрямої загрози: недостатні знання принципів Tactical Combat Casualty Care; розподіл поранених при евакуації в умовах тактичної екстреної медичної допомоги; різна популяція постраждалих, яка включала не тільки військовослужбовців, а й мирне населення, у тому числі педіатричні й геріатричні вікові групи; необхідність психологічної допомоги військово­службовцям і мирному населенню в зоні бойових дій; недостатній досвід тактичної евакуації.

Висновки. Для оптимізації професійних знань медичних сестер у цих напрямках рекомендується включити освітні компоненти «Тактична медицина» і «Екстрена психологічна допомога» в освітні навчальні програми для медсестер.
КЛІНІЧНИЙ ВИПАДОК БОРЕЛІОЗНОЇ ІНФЕКЦІЇ ЯК МОЖЛИВОЇ ПРИЧИНИ УРАЖЕННЯ СЕРЦЯ ТА ВИНИКНЕННЯ СИНКОПАЛЬНИХ СТАНІВ
Authors: Dzyha S. V. , Bakalets O. V. , Behosh N. B. , Maksiv K. Y.
Published: June 2020

Прояви ураження серця при лайм-бореліозі варіюють від безсимптомних чи симптомних електрокардіографічних (ЕКГ) змін та блокад серця, зворотних при лікуванні, до раптової смерті. Синдром слабкості синусового вузла як прояв лайм-кардиту зустрічається рідко.

Мета дослідження – описати випадок виникнення синкопальних станів унаслідок дисфункції синусового вузла в пацієнтки з лайм-бореліозом.

Матеріали і методи. Пацієнтку, яка перебувала на стаціонарному лікуванні у кардіологічному відділенні Тернопільської університетської лікарні, обстежено згідно з протоколом для оцінки стану серцево-судинної системи. Холтерівське моніторування проводили з використанням електрокардіографічного комплексу ECG-pro (ІМЕСК).

Результати. Пацієнтку турбували епізоди втрати свідомості, виражена загальна слабість. За допомогою серодіагностики виявили специфічні антитіла до Borrelia afzelii в кількості, що підверджує наявність інфекції. При добовому моніторуванні ЕКГ зафіксовано наявність синусової паузи тривалістю 16 с, що виникла у ранковий час.

Висновки. Діагностовано симптомну дисфункцію синусового вузла як прояв лайм-кардиту, що потре­бува­ло встановлення постійного кардіостимулятора.
COP9 Signalosome Suppresses RIPK1-RIPK3–Mediated Cardiomyocyte Necroptosis in Mice
Authors: Xiao Peng , Wang Changhua , Li Jie , Su Huabo , Yang Liuqing , Wu Penglong , Lewno Megan T. , Liu Jinbao , Wang Xuejun
Published: June 2020

Background:

Mechanisms governing the induction of heart failure by the impairment of autophagy and the ubiquitin-proteasome system and the molecular pathways to cardiomyocyte necrosis remain incompletely understood. COPS8 is an essential subunit of the COP9 (COnstitutive Photomorphogenesis 9) signalosome, a key regulator of ubiquitination. Mice with cardiomyocyte-restricted knockout of
Cops8
(Cops8-cko) show autophagic and ubiquitin-proteasome system malfunction and massive cardiomyocyte necrosis followed by acute heart failure and premature death, providing an excellent animal model to address the mechanistic gaps specified above. This study was conducted to determine the nature and underlying mechanisms of the cardiomyocyte necrosis in Cops8-cko mice.

Methods and Results:

Compared with littermate control mice, myocardial protein levels of key factors in the necroptotic pathway (RIPK1 [receptor-interacting protein kinase 1], RIPK3, MLKL [mixed lineage kinase-like], the RIPK1-bound RIPK3), protein carbonyls, full-length Casp8 (caspase 8), and BCL2, as well as histochemical staining of superoxide anions were significantly higher but the cleaved Casp8 and the Casp8 activity were significantly lower in Cops8-cko mice. In vivo cardiomyocyte uptake of Evan’s blue dye was used as an indicator of necrosis. Cops8-cko mice treated with a RIPK1 kinase inhibitor (Nec-1 [Necrostatin-1]) showed less Evans blue dye uptake (0.005% versus 0.20%;
P
<0.0001) and longer median lifespan (32.5 versus 27 days;
P
<0.01) than those treated with vehicle control.
RIPK3
haploinsufficiency showed similar rescuing effects on Cops8-cko but Cyclophilin D deficiency did the opposite.

Conclusions:

Cardiac Cops8/COP9 signalosome malfunction causes RIPK1-RIPK3 dependent, but mitochondrial permeability transition pore independent, cardiomyocyte necroptosis in mice and the COP9 signalosome plays an indispensable role in suppressing cardiomyocyte necroptosis.
Prognostic Value of Functional Capacity in Different Exercise Protocols
Authors: Harb Serge C. , Bhat Pavan , Cremer Paul C. , Wu Yuping , Cremer Laura J. , Berger Stephanie , Cho Leslie , Menon Venu , Gulati Martha , Jaber Wael A.
Published: June 2020

Background

Functional capacity is associated with mortality, although the prognostic value of achieved estimated metabolic equivalents (METs) across various exercise protocols is not established. We sought to determine whether achieved METs had different prognostic implications according to the protocol employed.

Methods and Results

From 1991 to 2015, we identified 120 705 consecutive patients from a stress testing registry who underwent the following 7 different standardized exercise protocols: Bruce, modified Bruce, Cornell 0%, Cornell 5%, Cornell 10%, Naughton, and modified Naughton. The primary outcome was all‐cause mortality. There were 74 953 Bruce, 8368 modified Bruce, 2648 Cornell 0%, 9972 Cornell 5%, 20 425 Cornell 10%, 1226 Naughton, and 3113 modified Naughton protocols. During a mean follow‐up of 8.7 years, a total of 8426 deaths (6.9%) occurred. When compared with the Bruce protocol, after multivariable adjustment for clinical risk factors, medications, and functional capacity, test protocol was independently associated with mortality (modified Naughton [hazard ratio (HR), 2.51; 95% CI, 2.26–2.8], Naughton [HR, 1.79; 95% CI, 1.57–2.04], Cornell 0% [HR, 1.79; 95% CI, 1.59–2.01], modified Bruce [HR, 1.62; 95% CI, 1.48–1.76], Cornell 5% [HR, 1.61; 95% CI, 1.47–1.75], and Cornell 10% [HR, 1.32; 95% CI, 1.22–1.42]). Across all protocols, higher estimated METs were associated with lower mortality, although the equivalent METs achieved were associated with a worse prognosis in less‐demanding protocols.

Conclusions

Higher estimated METs are reliably associated with lower mortality in all exercise protocols, although the prognostic value is not transferable across different tests. Consequently, the prognostic value of METs achieved during a stress test should be considered protocol dependent.
Extracorporeal Life Support in Pregnancy: A Systematic Review
Authors: Naoum Emily E. , Chalupka Andrew , Haft Jonathan , MacEachern Mark , Vandeven Cosmas J. M. , Easter Sarah Rae , Maile Michael , Bateman Brian T. , Bauer Melissa E.
Published: June 2020

Background

The use of extracorporeal life support (ECLS) has expanded to include unique populations such as peripartum women. This systematic review aims to (1) quantify the number of cases and indications forECLSin women during the peripartum period reported in the literature and (2) report maternal and fetal complications and outcomes associated with peripartumECLS.

Methods and Results

This review was registered inPROSPERO(CRD42018108142).MEDLINE, Embase, andCINAHLwere searched for case reports, case series, and studies reporting cases ofECLSduring the peripartum period that reported one or more of the following outcomes: maternal survival, maternal complications, fetal survival, and/or fetal complications. Qualitative assessment of 221 publications evaluated the number of cases, clinical details, and maternal and fetal outcomes ofECLSduring the peripartum period. There were 358 women included and 68 reported fetal outcomes in cases where the mother was pregnant at the time of cannulation. The aggregate maternal survival at 30 days was 270 (75.4%) and at 1 year was 266 (74.3%); fetal survival was 44 (64.7%). The most common indications forECLSoverall in pregnancy included acute respiratory distress syndrome 177 (49.4%), cardiac failure 67 (18.7%), and cardiac arrest 57 (15.9%). The most common maternal complications included mild to moderate bleeding 66 (18.4%), severe bleeding requiring surgical intervention 48 (13.4%), and intracranial neurologic morbidity 19 (5.3%). The most commonly reported fetal complications included preterm delivery 33 (48.5%) and neonatal intensive care unit admission 19 (27.9%).

Conclusions

Reported rates of survival inECLSin pregnant and postpartum women are high and major complications relatively low.
Additional Low‐Voltage‐Area Ablation in Patients With Paroxysmal Atrial Fibrillation: Results of the Randomized Controlled VOLCANO Trial
Authors: Masuda Masaharu , Asai Mitsutoshi , Iida Osamu , Okamoto Shin , Ishihara Takayuki , Nanto Kiyonori , Kanda Takashi , Tsujimura Takuya , Matsuda Yasuhiro , Okuno Shota , Hata Yosuke , Mano Toshiaki
Published: June 2020

Background

The efficacy of low‐voltage‐area (
LVA
) ablation has not been well determined. This study aimed to investigate the efficacy of
LVA
ablation in addition to pulmonary vein isolation on rhythm outcomes in patients with paroxysmal atrial fibrillation (
AF
).

Methods and Results

VOLCANO (Catheter Ablation Targeting Low‐Voltage Areas After Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation Patients) trial included paroxysmal AF patients undergoing initial AF ablation. Of 398 patients in whom a left atrial voltage map was obtained after pulmonary vein isolation, 336 (85%) had no
LVA
(group A). The remaining 62 (15%) patients with
LVA
s were randomly allocated to undergo
LVA
ablation (group B, n=30) or not (group C, n=32) in a 1:1 fashion. Primary end point was 1‐year
AF
‐recurrence‐free survival rate. No adverse events related to
LVA
ablation occurred. Procedural (124±40 versus 95±33 minutes,
P
=0.003) and fluoroscopic times (29±11 versus 24±8 minutes,
P
=0.034) were longer in group B than group C. Patients with
LVA
s demonstrated lower
AF
‐recurrence‐free survival rates (88%) than those without
LVA
(B, 57%,
P
<0.0001; C, 53%,
P
<0.0001). However,
LVA
ablation in addition to pulmonary vein isolation did not impact
AF
‐recurrence‐free survival rate (group B versus C,
P
=0.67).

Conclusions

The presence of
LVA
was a strong predictor of
AF
recurrence after pulmonary vein isolation in patients with paroxysmal
AF
. However,
LVA
ablation had no beneficial impact on 1‐year rhythm outcomes.

Registration

URL:
https://www.umin.ac.jp/ctr
; Unique identifier: UMIN000023403.
Airlines, Mayonnaise, and Justice: Reflections on the Theory and Practice of Legal Design and Technology
Authors: Ross Gordon
Published: June 2020

Design theory and practice are increasingly prevalent in legal and justice systems, at times reframing the relationship between the law and the world it seeks to make just. This article presents my professional experiences introducing design theory, methods, and mindsets into legal and government contexts, highlighting challenges and tensions across various legal design projects. Challenges include the justice sector's struggles dealing with complexity, the unfamiliar logics of design and abductive reasoning, and the legacy of positivist and instrumentalist philosophies. As a response, I propose a legal design that incorporates phronesis and re-orients around anticipation, rather than prediction.
Credibility and Testimony in Asylum Procedures with Unaccompanied Refugee Minors
Authors: Guarch-Rubio Marta , Manzanero Antonio L.
Published: June 2020

The present article reviews the credibility analysis procedure proposed by the UNHCR through which asylum applications are resolved, especially for unaccompanied minors. The particularities of these refugee minors and the general character of the credibility analysis procedure are described. Credibility indicators are analyzed together with the psychological barriers related to them. This manuscript provides evidence of the presence of trauma and resilience in the studied minors and how both influence their memories during the asylum interviews. As credibility assessment has a special focus on the evaluation of narratives through memory, memory is considered as a criterion responsible for the accuracy and credibility of underage applicants’ testimony. Finally, this paper contributes with scientific psychological evidence towards the existence of multiple testimonies in asylum seekers.
The Holy See’s Position on Lethal Autonomous Weapons Systems
Authors: Mauri Diego
Published: June 2020

The issue of lethal autonomous weapons systems (laws) goes to the heart of the debate on new warfare technologies: States, international organizations, non-governmental organizations and civil society at large have long been discussing the acceptability of ‘autonomous killing’. The present contribution zooms in on the position held by the Holy See, exploring its content and the main arguments which support the call of a ban on such technology. Both diplomatic statements and doctrinal teachings will be tackled. Importantly, a solid argument for a prohibition of laws is based on the moral unacceptability of autonomous killing, which may assume also a legal standing through the so-called Martens Clause. The history and the actual content of the Clause will be analyzed in order to explore whether – and to what extent – it can be interpreted so as to offer a legal ground for rejecting laws. It will be argued that the Holy See is in a particularly fit position to advocate for a renewed appraisal of the Martens Clause that may help the pro-ban front to structure a more principled debate.
A History of Violence
Authors: Cotter Cédric , Policinski Ellen
Published: June 2020

The International Review of the Red Cross, an academic journal produced by the International Committee of the Red Cross (icrc) and published by Cambridge University Press, traces its origins back more than 150 years. Throughout its existence, the publication has featured international humanitarian law (ihl) prominently. Because of this, it is possible to trace how the icrc was communicating publicly about ihl since 1869, allowing researchers to draw conclusions about how that body of law has evolved. In this article, the authors divide the history of the Review into five time periods, looking at trends over time as ihl was established as a body of law, was expanded to address trends in the ways war was waged, was disseminated and promoted to the international community, and how it is interpreted in light of current conflicts. Based on the way the law has been represented in the Review, the authors draw conclusions about the evolution of the law itself over time, and lessons this may provide for those who seek to influence the future development of the law regulating armed conflict.
­­­­­­­­­Melastomataceae in the Parque Estadual da Serra Dourada, Goiás state, Brazil
Authors: MACHADO ANA ISA MARQUEZ ROCHA , ROMERO ROSANA
Published: June 2020

Melastomataceae is represented in the Parque Estadual da Serra Dourada by 42 taxa in 14 genera. Miconia is the most representative genus, with 18 species, followed by Tibouchina, with five, Microlicia and Pleroma with four species each, and Clidemia with two species. Acisanthera, Cambessedesia, Desmoscelis, Macairea, Pterolepis, Rhynchanthera, Siphanthera, Tococa, and Trembleya have one species each. This study provides a key to the species, descriptions, comments about morphological characters, geographical data, and the flowering and fruiting periods of each species, as well as illustrations of the species that are poorly illustrated in the literature.
New additions to Gomesa from old known names (Orchidaceae)

Authors: MENEGUZZO THIAGO E. C.
Published: June 2020

Five new combinations are made for taxa formerly described or assigned to the genus Oncidium, but currently placed in Gomesa. These all predate formerly widely known and accepted names: Gomesa bicornuta, comb. nov. for Gomesa cruciata; Gomesa florida f. florida, comb. nov. for Gomesa longicornu; Gomesa maculosa f. maculosa, comb. nov. for Gomesa spilotera; Gomesa maculosa f. aurea for Oncidium spilopterum [unranked] aureum; and Gomesa polyodonta, comb. nov. for Gomesa damacenoi. A new infraspecific taxon, Gomesa florida f. concolor, f. nov., is described for an unpublished but already known infraspecies. Two historical names described by J.M.C. Vellozo are herein resolved: Epidendrum floridum and Epidendrum gilvum, respectively as an accepted name for Gomosa longicornu and new synonym of Gomesa pubes. An historical, nomenclatural, and taxonomic review of all related names is presented, as well as 28 nomenclatural types are designated.
Luticola puchalskiana, a new small terrestrial Luticola species (Bacillariophyceae) from the Maritime Antarctic Region

Authors: KOCHMAN-KĘDZIORA NATALIA , ZIDAROVA RALITSA , NOGA TERESA , OLECH MARIA , VIJVER BART VAN DE
Published: June 2020

During a survey of the terrestrial diatom flora of the Maritime Antarctic Region, an unknown Luticola taxon that could not be identified using the currently available literature was observed on two islands of the South Shetland Archipelago. After a detailed morphological analysis and comparison, the unknown taxon is described as Luticola puchalskiana sp. nov. The new species can be separated from other Luticola species based on its valve dimensions, stria density and the shape of both central and terminal raphe endings. Two populations of the new taxon were observed in samples collected from terrestrial habitats. The morphology of Luticola puchalskiana is elaborately described and illustrated using both light and scanning electron microscopy observations. A comparison is made with a large number of other morphologically similar Luticola species from the entire (sub)Antarctic Region.
Two new species of burrowing crayfish in the genus Lacunicambarus (Decapoda: Cambaridae) from Alabama and Mississippi
Authors: GLON MAEL G. , ADAMS SUSAN B. , LOUGHMAN ZACHARY J. , MYERS GREG A. , TAYLOR CHRISTOPHER A. , SCHUSTER GUENTER A.
Published: June 2020

While sampling for the Rusty Gravedigger, Lacunicambarus miltus, Taylor et al. (2011) found one or more potentially undescribed burrowing crayfish species in the genus Lacunicambarus inhabiting the area between the Pascagoula River and Mobile Bay in southern Alabama and Mississippi. Molecular analyses by Glon et al. (2018) confirmed that samples from this area were genetically distinct from other Lacunicambarus crayfishes. These findings prompted a dedicated sampling trip in January 2020. We used morphological and molecular analyses to investigate the specimens we collected and, based on our results, we describe two new crayfish species: the Lonesome Gravedigger, L. mobilensis sp. nov. and the Banded Mudbug, L. freudensteini sp. nov. Lacunicambarus mobilensis sp. nov. is sister to the Rusty Gravedigger, L. miltus, while L. freudensteini sp. nov. is sister to the Painted Devil Crayfish, L. ludovicianus. Both new species are currently known from a small number of sites in southern Alabama and Mississippi and may require conservation attention. In addition, we provide an updated key to Lacunicambarus crayfishes that includes these new species.
Key to species of the genus Andixius Emeljanov & Hayashi (Hemiptera: Fulgoromorpha: Cixiidae) with descriptions of two new species
Authors: WANG XIAOYA , ZHI YAN , CHEN XIANGSHENG
Published: June 2020

Two new species of the genus Andixius Emeljanov & Hayashi, A. cultratus Wang, Zhi & Chen, sp. nov. and A. lingulatus Wang, Zhi & Chen, sp. nov. are described and illustrated from China to provide the genus with six species in total. A key to species of Andixius is presented.
A new species of South Asian Cnemaspis (Squamata: Gekkonidae) from the Eastern Ghats, India
Authors: AGARWAL ISHAN , BAUER AARON M , KHANDEKAR AKSHAY
Published: June 2020

We describe a new species from within the South Asian clade of the polyphyletic gekkonid genus Cnemaspis from the Velikonda Range, in the Eastern Ghats, Andhra Pradesh, India. The new species is the smallest known Indian gekkonid and can be diagnosed from all Indian congeners by its small body size (SVL <29 mm), the absence of spine-like scales on flank, heterogeneous dorsal pholidosis, presence of precloacal pores and no femoral pores in males, tail with enlarged, strongly keeled, conical tubercles forming whorls, median row of sub-caudals smooth and slightly enlarged, and a distinct colour pattern. This is the 12th species of Cnemaspis to be described from outside the Western Ghats and is the first endemic from the Velikonda region of the Eastern Ghats. The new species is only known from its type locality, a lowland riparian habitat (<200 m asl.) in dry evergreen forest at the base of a ~1200 m asl. peak. This discovery extends the range of the genus in peninsular India by ~130–150 kilometres to the northeast and suggests the genus is likely to be even more widely distributed than understood. The new species is clearly allied to C. mysoriensis, C. otai and C. yercaudensis with which it shares superficial colour pattern and similar body size, but is the first species from outside the Western Ghats in which males lack femoral pores.