bluuebunny/crossref_metadata_2025 huggingface dataset:
Discordance between patient and physician global assessment of disease activity in Behçet’s syndrome: a multicenter study cohort
Authors:   the BODI Project collaborators, Floris Alberto , Espinosa Gerard , Serpa Pinto Luisa , Kougkas Nikolaos , Lo Monaco Andrea , Lopalco Giuseppe , Orlando Ida , Bertsias George , Cantarini Luca , Cervera Ricard , Correia João , Govoni Marcello , Iannone Florenzo , Mathieu Alessandro , Neri Piergiorgio , Martins Silva Ana , Vasconcelos Carlos , Muntoni Monica , Cauli Alberto , Piga Matteo
Published: November 2020

Background

To compare the patients’ and physician’s global assessment of disease activity in Behçet’s syndrome (BS) and investigate the frequency, magnitude, and determinants of potential discordance.

Methods

A total of 226 adult BS patients with a median (IQR) age of 46.9 (35.6–55.2) years were enrolled across Italy, Greece, Portugal, and Spain. Demographic, clinical, and therapeutic variables, as well as the patient reported outcomes, were collected at the recruitment visit. The physical (PCS) and mental (MCS) component summary scores of the Short Form Questionnaire 36 (SF-36) and the Behçet’s syndrome Overall Damage Index (BODI) were calculated. Disease activity was assessed by the patients’ (PtGA) and physician’s global assessment (PGA) in a 10-cm visual analog scale, as well as the Behçet Disease Current Activity Form (BDCAF). Discordance (∆) was calculated by subtracting the PGA from the PtGA and defined as positive (PtGA>PGA) and negative (PtGA<PGA) discordance using both a more stringent (∆ = ±2) and a less stringent (∆ = ±1) cutoff. Univariate and multivariate logistic regressions were performed.

Results

Median PtGA and PGA scores were 2.0 (0.3–5.0) and 1.0 (0.0–3.0) cm, respectively. The discordance prevalence varied (from 29.6 to 55.3%) according to the cutoff applied, and the majority (> 80%) of disagreements were due to patients rating higher their disease activity. Higher values of BDCAF were associated to increased rate of positive discordance. When BDCAF = 0, the median (IQR) values of PtGA and PGA were 0.2 (0–2) and 0 (0–1), respectively. PCS (adjusted odds ratio (adjOR) 0.96 per unit, 95% CI 0.93–0.98, p = 0.006) and MCS (adjOR 0.96 per unit, 95% CI 0.93–0.99, p = 0.003) were independently associated with positive discordance using both cutoffs. Active ocular involvement emerged as a potential determinant of negative discordance (adjOR 5.88, 95% CI 1.48–23.30, p = 0.012).

Conclusions

PtGA and PGA should be considered as complementary measures in BS, as patients and physicians may be influenced by different factors when assessing active disease manifestations. Particularly, PtGA may be a useful tool in the assessment of BS disease activity, as it carries a low risk to misclassify an inactive disease, and may allow to capture aspects of the patient’s health that negatively affect his well-being and the treatment.
Optic nerve sheath diameter sonography during the acute stage of intracerebral hemorrhage: a potential role in monitoring neurocritical patients
Authors: Bender M. , Lakicevic S. , Pravdic N. , Schreiber S. , Malojcic B.
Published: November 2020

Background

Optic nerve sheath diameter (ONSD) sonography has been proposed as a reliable bedside tool for the detection of increased intracranial pressure (ICP). ONSD reacts almost simultaneously to oscillations in ICP. The aim of this study was to investigate the ONSD dynamics in the acute stage of intracerebral hemorrhage (ICH) and to compare ONSD dynamics to the clinical outcome.

Methods

We enrolled 35 acute ICH patients and 20 healthy volunteers in this prospective study. At the admission, all patients underwent brain CT scan and ONSD sonography. We repeated the ONSD on the second and the third day in all patients while CT scan was repeated if a patient condition deteriorated. The changes in serial ONSD measurements were termed as stable or unstable ONSD trend. ONSD trend was considered as unstable if variations of average ONSD were above 5%. The outcome of the patient was assessed with the Modified Rankin Scale (mRS) and Glasgow Outcome Scale (GOS).

Results

In healthy volunteers serial ONSD recordings for 3 days revealed a stable trend in 100%. However, in the study group, 23 patients had unstable and 12 had stable ONSD trend during the acute stage of ICH. The patients with unstable ONSD trend were more likely to have worse outcomes (p value 0.003).

Conclusion

In patients with ICH, the acute-phase ONSD dynamics can help in predicting the clinical outcome.
Low prevalence of Moraxella catarrhalis in the patients who suffered from conjunctivitis in the southwest of Iran
Authors: Farajzadeh Sheikh Ahmad , Feghhi Mustafa , Torabipour Maryam , Saki Morteza , Veisi Hojat
Published: November 2020

Objective

Moraxella catarrhalis is a non-motile Gram-negative diplococcus bacterium that contributed to several human infections including conjunctivitis. This study aimed to reveal the prevalence of M. catarrhalis in patients who suffered from conjunctivitis in Ahvaz city, southwest of Iran.

Results

Out of 100 conjunctiva swab specimens, M. catarrhalis was isolated only from one (1%) conjunctivitis cases using the culture method. This strain was isolated from a 34 years old female patient. Also, the results of the polymerase chain reaction (PCR) were in agreement with the culture method, and the specimen that showed positive culture was also positive for specific gene of M. catarrhalis. The remaining 99 specimens did not show positive results with any of the culture and PCR methods.
Differences in the bacterial profiles and physicochemical between natural and inoculated fermentation of vegetables from Shanxi Province
Authors: Chen Zhidi , Kang Jianyi , Zhang Yao , Yi Xinxin , Pang Xiaona , Li-Byarlay Hongmei , Gao Xiuzhi
Published: November 2020

Purpose

Fermented vegetables can be divided into two types, natural fermented and artificially inoculated fermented. By detecting and identifying the changes of bacterial diversity using physical and chemical indicators during natural and inoculation fermentation, we analyzed and determined the dominant bacteria in the fermentation process and revealed the relationship between bacteria and volatile substances.

Methods

We used the Illumina Miseq to sequence the bacteria in fermented vegetable samples at different fermentation periods, and calculated the total number of mesophilic microorganisms and lactic acid bacteria. We used the pH and nitrite to monitor the acidification process. GC-MS was used to determine volatile flavor compounds. Finally, we analyzed the correlation between volatile flavor compounds and bacteria.

Results

Total mesophilic microorganisms and the number of lactic acid bacteria in the inoculated fermentation were higher than the natural fermentation. The bacterial diversity Shannon and Simpson indexes of the natural fermentation, higher than those of inoculated fermentation in 0~7 days, were between 55~71% and 36~45%, respectively. On the 7th day, the proportion ofLactobacillusin the natural fermentation and inoculated fermentation were 53.4% and 90.2%, respectively, which were significantly different.Lactobacilluswas the dominant genus in the fermented vegetables and an important genus to promote the formation of volatile flavors.Lactobacilluswas negatively correlated with two volatile substances (4-[2,2,6-trimethyl-7-oxabicyclo [4.1.0] hept-1-yl]-3-Buten-2-one (K4) and a-Phellandrene (X1)) and played a leading role in the fermentation process.

Conclusions

Results demonstrated that the total number of mesophilic microorganisms and lactic acid bacteria in inoculated fermentation were more than those in natural fermentation. Inoculated fermentation can shorten the fermentation cycle and reduce the content of nitrite. Lactic acid bacteria were the dominant bacteria in fermented vegetables.
The role of regenerative therapy in the treatment of right ventricular failure: a literature review
Authors: Haller Christoph , Friedberg Mark K. , Laflamme Michael A.
Published: November 2020

Right ventricular (RV) failure is a commonly encountered problem in patients with congenital heart disease but can also be a consequence of left ventricular disease, primary pulmonary hypertension, or RV-specific cardiomyopathies. Improved survival of the aforementioned pathologies has led to increasing numbers of patients suffering from RV dysfunction, making it a key contributor to morbidity and mortality in this population. Currently available therapies for heart failure were developed for the left ventricle (LV), and there is clear evidence that LV-specific strategies are insufficient or inadequate for the RV. New therapeutic strategies are needed to address this growing clinical problem, and stem cells show significant promise. However, to properly evaluate the prospects of a potential stem cell-based therapy for RV failure, one needs to understand the unique pathophysiology of RV dysfunction and carefully consider available data from animal models and human clinical trials. In this review, we provide a comprehensive overview of the molecular mechanisms involved in RV failure such as hypertrophy, fibrosis, inflammation, changes in energy metabolism, calcium handling, decreasing RV contractility, and apoptosis. We also summarize the available preclinical and clinical experience with RV-specific stem cell therapies, covering the broad spectrum of stem cell sources used to date. We describe two different scientific rationales for stem cell transplantation, one of which seeks to add contractile units to the failing myocardium, while the other aims to augment endogenous repair mechanisms and/or attenuate harmful remodeling. We emphasize the limitations and challenges of regenerative strategies, but also highlight the characteristics of the failing RV myocardium that make it a promising target for stem cell therapy.
Characterization of carp seminal plasma Wap65-2 and its participation in the testicular immune response and temperature acclimation
Authors: Dietrich Mariola A. , Adamek Mikołaj , Jung-Schroers Verena , Rakus Krzysztof , Chadzińska Magdalena , Hejmej Anna , Hliwa Piotr , Bilińska Barbara , Karol Halina , Ciereszko Andrzej
Published: November 2020

Two functionally distinct isoforms of warm-temperature acclimation related 65-kDa protein (Wap65-1 and Wap65-2) with a role in the immune response are present in fish. To our knowledge, contrary to Wap65-1, Wap65-2 has neither been isolated nor functionally characterized in carp especially in reproductive system. The aim of this study was to characterize Wap65-2 and ascertain its functions in immune response and temperature acclimation within reproductive system. Wap65-2 corresponded to one of the most abundant proteins in carp seminal plasma, with a high immunologic similarity to their counterparts in seminal plasma of other fish species and a wide tissue distribution, with predominant expression in the liver. The immunohistochemical localization of Wap65-2 to spermatogonia, Leydig cells, and the epithelium of blood vessels within the testis suggests its role in iron metabolism during spermatogenesis and maintenance of blood-testis barrier integrity. Wap65-2 secretion by the epithelial cells of the spermatic duct and its presence around spermatozoa suggests its involvement in the protection of spermatozoa against damage caused by heme released from erythrocytes following hemorrhage and inflammation. Our results revealed an isoform-specific response of Wap65 to temperature acclimation andAeromonas salmonicidainfection which alters blood-testis barrier integrity. Wap65-2 seems to be related to the immune response against bacteria, while Wap65-1 seems to be involved in temperature acclimation. This study expands the understanding of the mechanism of carp testicular immunity against bacterial challenge and temperature changes, in which Wap65-2 seems to be involved and highlights their potential usefulness as biomarkers of inflammation and temperature acclimation.
The association between ambient air pollution and pulmonary tuberculosis: a systematic review protocol
Authors: Dimala Christian Akem , Kadia Benjamin Momo , Hansell Anna
Published: November 2020

Background

There is inconclusive evidence on the association between ambient air pollution and pulmonary tuberculosis-related hospital admission and mortality. This review aims to assess if and to what extent, selected air pollutants are associated to pulmonary tuberculosis (PTB) incidence, hospital admissions and mortality.

Methods

This will be a systematic review and meta-analysis of studies published in English between January 1st, 1946 and October 31st, 2020, quantitatively assessing the association between air pollutants and PTB incidence, hospital admissions and mortality. A comprehensive search strategy will be used to search the databases: Medline, Embase, Scopus and The Cochrane Library. Retrieved studies will be screened based on the set eligibility criteria and data will be extracted from eligible studies. Extracted data will be analysed on STATA version 14.0 software. Studies included will be assessed for their quality using the respective Study Quality Assessment Tools of the National Health Institute. The quality of the evidence on the study outcomes will be graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The risk of bias will be assessed using Cochrane’s Risk of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool. Study characteristics, socio-demographic and clinical characteristics across eligible studies will be summarised and presented. Pooled estimates of the measures of association between air pollutants and PTB incidence, hospital admission and mortality will be obtained through random-effect meta-analyses models and the respective I2 test statistics will be reported. Meta-regression analyses will be done in case of significant between-study heterogeneity.
CGG expansion in NOTCH2NLC is associated with oculopharyngodistal myopathy with neurological manifestations
Authors: Ogasawara Masashi , Iida Aritoshi , Kumutpongpanich Theerawat , Ozaki Ayami , Oya Yasushi , Konishi Hirofumi , Nakamura Akinori , Abe Ryuta , Takai Hiroshi , Hanajima Ritsuko , Doi Hiroshi , Tanaka Fumiaki , Nakamura Hisayoshi , Nonaka Ikuya , Wang Zhaoxia , Hayashi Shinichiro , Noguchi Satoru , Nishino Ichizo
Published: November 2020

Oculopharyngodistal myopathy (OPDM) is a rare hereditary muscle disease characterized by progressive distal limb weakness, ptosis, ophthalmoplegia, bulbar muscle weakness and rimmed vacuoles on muscle biopsy. Recently, CGG repeat expansions in the noncoding regions of two genes, LRP12 and GIPC1, have been reported to be causative for OPDM. Furthermore, neuronal intranuclear inclusion disease (NIID) has been recently reported to be caused by CGG repeat expansions in NOTCH2NLC. We aimed to identify and to clinicopathologically characterize patients with OPDM who have CGG repeat expansions in NOTCH2NLC (OPDM_NOTCH2NLC). Note that 211 patients from 201 families, who were clinically or clinicopathologically diagnosed with OPDM or oculopharyngeal muscular dystrophy, were screened for CGG expansions in NOTCH2NLC by repeat primed-PCR. Clinical information and muscle pathology slides of identified patients with OPDM_NOTCH2NLC were re-reviewed. Intra-myonuclear inclusions were evaluated using immunohistochemistry and electron microscopy (EM). Seven Japanese OPDM patients had CGG repeat expansions in NOTCH2NLC. All seven patients clinically demonstrated ptosis, ophthalmoplegia, dysarthria and muscle weakness; they myopathologically had intra-myonuclear inclusions stained with anti-poly-ubiquitinated proteins, anti-SUMO1 and anti-p62 antibodies, which were diagnostic of NIID (typically on skin biopsy), in addition to rimmed vacuoles. The sample for EM was available only from one patient, which demonstrated intranuclear inclusions of 12.6 ± 1.6 nm in diameter. We identified seven patients with OPDM_NOTCH2NLC. Our patients had various additional central and/or peripheral nervous system involvement, although all were clinicopathologically compatible; thus, they were diagnosed as having OPDM and expanding a phenotype of the neuromyodegenerative disease caused by CGG repeat expansions in NOTCH2NLC.
Does substrate colour affect the visual appearance of gilded medieval sculptures? Part II: SEM–EDX observations on gold leaf samples taken from medieval wooden sculptures
Authors: Wu Qing , Döbeli Max , Lombardo Tiziana , Schmidt-Ott Katharina , Watts Benjamin , Nolting Frithjof , Ganz David
Published: November 2020

In the previous paper (Part I), the colorimetry and interferometric microscopy measurements on modern gold leaf models have revealed that the visual appearance of a gilded surface, both burnished and unburnished, depends strongly on the substrate type, surface roughness and texture, but not on the colour of the substrate. In this second part, we investigate the materials compositions and technical specifications of medieval gold leaf through combining literature sources and materials analysis such as scanning electron microscopy coupled with energy dispersive X-ray analysis (SEM–EDX) on samples taken from gilded wooden sculptures. Our study shows that the late medieval gold leaf has a high purity of about 23.7 carat and has an average thickness of 160 nm (with a peak value of 138 nm), purer and thicker than the modern gold leaves studies in Part I. Supportive Rutherford backscattering spectrometry (RBS) measurements on gilded models confirms the accuracy and reliability of the SEM–EDX observations on the medieval gold leaf samples. We additionally present observations of a rarely recorded special variant of medieval gold leaf—“fine reinforced gold leaf”. Combined with the findings from Part I, we conclude that light penetrating the medieval gold leaf and reflected from the gilding substrate could not be a significant, or even perceptible contribution to the visual appearance of the gilding. We argue that the misconception surrounding the correlation between the substrate colour and the gilded surface appearance can be attributed to the historical development of gilding and polychromy technologies.
Flow-controlled ventilation during EVLP improves oxygenation and preserves alveolar recruitment
Authors: Ordies Sofie , Orlitova Michaela , Heigl Tobias , Sacreas Annelore , Van Herck Anke , Kaes Janne , Saez Berta , Vanstapel Arno , Ceulemans Laurens , Vanaudenaerde Bart M. , Vos Robin , Verschakelen Johny , Verleden Geert M. , Verleden Stijn E. , Van Raemdonck Dirk E. , Neyrinck Arne P.
Published: November 2020

Background

Ex vivo lung perfusion (EVLP) is a widespread accepted platform for preservation and evaluation of donor lungs prior to lung transplantation (LTx). Standard lungs are ventilated using volume-controlled ventilation (VCV). We investigated the effects of flow-controlled ventilation (FCV) in a large animal EVLP model.

Fourteen porcine lungs were mounted on EVLP after a warm ischemic interval of 2 h and randomized in two groups (n = 7/group). In VCV, 7 grafts were conventionally ventilated and in FCV, 7 grafts were ventilated by flow-controlled ventilation. EVLP physiologic parameters (compliance, pulmonary vascular resistance and oxygenation) were recorded hourly. After 6 h of EVLP, broncho-alveolar lavage (BAL) was performed and biopsies for wet-to-dry weight (W/D) ratio and histology were taken. The left lung was inflated, frozen in liquid nitrogen vapors and scanned with computed tomography (CT) to assess regional distribution of Hounsfield units (HU).

Results

All lungs endured 6 h of EVLP. Oxygenation was better in FCV compared to VCV (p = 0.01) and the decrease in lung compliance was less in FCV (p = 0.03). W/D ratio, pathology and BAL samples did not differ between both groups (p = 0.16, p = 0.55 and p = 0.62). Overall, CT densities tended to be less pronounced in FCV (p = 0.05). Distribution of CT densities revealed a higher proportion of well-aerated lung parts in FCV compared to VCV (p = 0.01).

Conclusions

FCV in pulmonary grafts mounted on EVLP is feasible and leads to improved oxygenation and alveolar recruitment. This ventilation strategy might prolong EVLP over time, with less risk for volutrauma and atelectrauma.
Degradation of a leather-dye by the combination of depolymerised wood-chip biochar adsorption and solid-state fermentation with Trametes villosa SCS-10
Authors: Ortiz-Monsalve S. , Gutterres M. , Valente P. , Plácido J. , Bustamante-López S. , Kelly D. , Kelly S. L.
Published: November 2020

Adsorption into biochar-derived materials and mycoremediation are promising technologies for removing dyes from solid and liquid matrices. This study presents a combined treatment with adsorption into wood-chip biochar and mycodegradation under solid-state fermentation by Trametes villosa for removing the leather-dye Acid Blue 161. In the first stage, untreated wood-chip biochar, NaOH–depolymerised biochar and KMnO4–depolymerised biochar were assessed for their dye removal efficiency by adsorption. KMnO4–depolymerised biochar exhibited the highest adsorption (85.1 ± 1.9%) after 24 h of contact. KMnO4–depolymerisation modified some physical and chemical properties on the untreated wood-chip biochar, increasing the surface area (50.4 m2 g–1), pore size (1.9 nm), and presence of surface functional groups. Response surface methodology coupled with a Box–Behnken design was used to optimise the AB161 adsorption into the KMnO4–depolymerised biochar. The optimised conditions, pH 3.0, dye concentration 100 mg L–1 and sorbent dosage 2 g L–1, led to a higher dye removal efficiency by adsorption (91.9 ± 1.0%). In a second stage, the wood-chip biochar supplemented with nutrients (1% malt extract and 0.5% peptone) was employed as a solid matrix for growing T. villosa and regenerating the dye-saturated material. After 15 days, T. villosa was able to grow (86.8 ± 0.8%), exhibit laccase activity (621.9 ± 62.3 U L–1), and biodegrade (91.4 ± 1.3%) the dye adsorbed into the KMnO4–depolymerised biochar. Finally, the mycoregenerated biochar was reutilised in a new cycle of adsorption reaching 79.5 ± 2.0% of dye removal efficiency by adsorption. This study revealed the potential of the combined treatment and is an initial assessment for developing commercial alternatives for treating leather industry wastewaters.
Relationship between risk markers for cardiovascular disease and peri-implant diseases
Authors: Ustaoğlu Gülbahar , Erdal Emrah
Published: November 2020

Background

The aim of this paper is to explore the serum biochemical parameters also known as risk markers for cardiovascular system, in individuals who have received dental implant treatment, and to reveal risk factors for peri-implant diseases.

Methods

The study included 58 subjects with peri-implantitis, 49 subjects with peri-implant mucositis, and 49 healthy subjects. All the subjects were assessed in terms of both peri-implant clinical parameters—probing depth (PD), bleeding on probing (BOP), the type of prosthesis, gingival index (GI), keratinized mucosa width (KMW), and plaque index (PI)—and serum biochemical parameters (e.g., LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, vitamin D, uric acid, white blood cell (WBC), neutrophil, hemoglobin (Hb), and platelet counts).

Results

KMW was the lowest in the peri-implantitis group. Compared with the other groups, the peri-implantitis group showed significantly higher levels of triglyceride, uric acid, and WBC. The peri-implantitis group had the lowest level of vitamin D. Triglyceride and uric acid levels had positive correlations with peri-implant clinical parameters.

Conclusion

High levels of triglyceride and uric acid may pose a risk for both peri-implant diseases and cardiovascular diseases. Prior to dental implant surgery, patients’ serum biochemical parameters should be checked.
Extended total gastrectomy after nivolumab for unresectable multivisceral invasive gastric cancer
Authors: Toyota Satoshi , Naito Hiroshi , Motoyoshi Saki , Nakanishi Ryota , Oki Eiji , Orita Hiroyuki , Korenaga Daisuke
Published: November 2020

Background

Chemotherapy has been considered the main treatment for stage IV gastric cancer (GC). However, advances in chemotherapy have provided new clinical approaches, permitting conversion surgery with the aim of R0 resection after resolving unresectability issues.

Case presentation

A 70-year-old man with gastric cancer invading the pancreatic tail and spleen and with periaortic lymph-node enlargement was admitted to our hospital. After 24 courses of nivolumab as third-line chemotherapy, periaortic lymph-node enlargement was resolved, and conversion surgery was planned. Intraoperatively, we found no peritoneal metastasis, but the distal pancreas, splenic hilum, and transverse colon were adhered to the gastric body. Therefore, we performed D2 total gastrectomy with distal pancreatosplenectomy and partial transverse colectomy. The pathological diagnosis was type III moderately differentiated tubular adenocarcinoma (tub2) with signet ring cells, stage ypT1b (SM), ly0, and v0. The pathological proximal and distal tumor margins were negative. One lymph-node metastasis was observed (No. 4d; 1/23). Postoperatively, no recurrence was observed over 7 months, without adjuvant chemotherapy.

Conclusions

Nivolumab may allow R0 resection in patients with unresectable gastric cancer. Conversion surgery should be considered even after third-line nivolumab treatment.
Effect of porcine immature oocyte vitrification on oocyte-cumulus cell gap junctional intercellular communication
Authors: Casillas Fahiel , Ducolomb Yvonne , López Alma , Betancourt Miguel
Published: November 2020

Vitrification may severely affect cumulus cells and oocyte morphology and viability, limiting their maturation and developmental potential. The aim of this study was to evaluate the gap junction intercellular communication (GJIC) integrity after the vitrification of porcine immature cumulus-oocyte complexes (COCs). Fresh COCs were randomly distributed in three groups: untreated (control), toxicity (cryoprotectants exposure), and vitrification, then subjected to in vitro maturation (IVM). Oocyte viability and IVM were measured in all groups. The evaluation of GJIC was expressed as relative fluorescence intensity (RFI). Vitrification significantly decreased oocyte viability and maturation after 44 h of culture compared to control. Also, significantly reduced RFI was observed in vitrified COCs during the first hours of culture (4–8 h) compared to control. This study demonstrates that porcine oocyte viability and maturation after 44 h of culture decreased after vitrification. GJIC was also affected during the first hours of culture after the vitrification of immature oocytes, being one of the possible mechanisms by which oocyte maturation decreased.
Race biology
Authors: Saura Anssi
Published: November 2020

Background

The founders of Hereditas envisioned that race biology would be a major subject that had social applications with utmost importance in the near future. Anthropometrics was in this context understood to be the pure and eugenics the applied science. Sweden had a long tradition in physical anthropometry. Herman Lundborg, member of the advisory board of Hereditas, united the anthropometric and eugenic approaches in a synthesis. He was the first head of the Institute for Race Biology in Sweden. The contents of Hereditas reflect the development of race biology in the Nordic countries.

Conclusions

The initial enthusiasm for applied race biology did not last long. In the 1920’s Hereditas carried papers on both physical anthropology and eugenics. Most paper dealt, however, with human genetics without eugenic content. Two papers, published in 1921 and 1939 show how the intellectual climate had changed from positive to negative. Finally only human genetics prevailed as the legitimate study of the human race or humankind. A belated defense of eugenics published in 1951 did not help; geneticists had abandoned anthropometrics for good around the year 1940 and eugenics about a decade later. In spite of that, eugenic legislation was amended astonishingly late, in the 1970’s. The development was essentially similar in all Nordic countries.
Minimum wage regulation in Switzerland: survey evidence for restaurants in the canton of Neuchâtel
Authors: Berger Marius , Lanz Bruno
Published: November 2020

This paper provides a first set of results on the impact of minimum wage regulation in Switzerland. We study the effects of an unexpected Supreme Court ruling mandating the Swiss canton of Neuchâtel to enforce a minimum hourly wage of around CHF 20 previously accepted via popular ballot. Given policy discontinuity at cantonal borders, we design a two-wave survey of restaurants to measure wages, employment, workers’ characteristics, and prices and administer it in Neuchâtel as well as in geographically proximate districts of neighboring cantons. Our data covers pre- and post-enforcement outcomes for around 100 restaurants, with information for more than 800 employees distributed over two-survey waves. Our data suggest that the proportion of workers paid below minimum wage went down from 19% to 5% after the introduction of the policy. This decline is compensated by a significant increase of the workforce paid just above minimum wage, and our results suggest that restaurants did not use employment as a margin of adjustment. We also find evidence that the policy affected the distribution of hourly wages up to CHF 6 above the minimum wage, with some workers initially paid above minimum wage experiencing a wage increase.
Electrical energy generation in a double-compartment microbial fuel cell using Shewanella spp. strains isolated from Odontesthes regia
Authors: Calderon Sandy L. , Avelino Pilar García , Baena-Moncada Angélica María , Paredes-Doig Ana Lucía , La Rosa-Toro Adolfo
Published: November 2020

This study is focused on electrical energy generation in a double-compartment microbial fuel cell. Carbon felt impregnated with multi-walled carbon nanotubes was used as an anode, which contained gold nanoparticles and Shewanella spp. grown under aerobic conditions was used as a biocatalyst. The electrodes, used before and after biofilm growth, were characterized by scanning electron microscopy and cyclic voltammetry. The results revealed the formation of Shewanella spp. colonies on the electrode surface and electrochemical activity under aerobic and anaerobic conditions. During biofilm growth in Luria Bertani medium, a stabilized average power density of 281 mW m− 2 was recorded. Subsequently, the cell reached a maximum current density of 0.11 mA cm− 2 after 72 h of operation and a coulombic efficiency of 65% under anaerobic conditions.
A case of needle embolism in a drug abuser, a diagnostic and therapeutic challenge
Authors: Scheggi Valentina , Mariani Tiziano , Mazzoni Carlotta , Stefàno Pier Luigi
Published: November 2020

Background

Needle embolism is a rare complication of intravenous habit. Clinical manifestations include recurrent pericarditis, tamponade, cardiac perforation, and infective endocarditis. We describe the case of needle embolization in a young intravenous opiate abuser.

Case presentation

We describe a rare complication of intravenous misuse in a 23-year-old patient. He presented at the emergency department with chest pain and shortness of breath. He complained of remittent fever ensued 6 months before. Echocardiographic and radiologic images revealed pericardial effusion and a needle fragment inside the pericardium. The needle was removed through left-anterior mini-thoracotomy, after CT-guided carbon tracking.

Conclusions

The presence of a foreign body within the heart resulted from the migration of a needle fragment from a peripheral vessel. It caused fever and recurrent pericarditis. In similar cases, surgical extraction is the therapy of choice.
Endoscopic intervention in a case proven latterly to be a COVID-19
Authors: Elkholy Shaimaa , Wifi Mohamed-Naguib , Maurice Karim K. , Youssif Kerolos , Mashhour Karim , Mashhour Shady N. , Nabil Ahmed , Abdellatif Abeer Awad
Published: November 2020

Background

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the newly developed worldwide outbreak of coronavirus disease with a high rate of mortality especially among elderly and multiple co-morbid personnel. Asymptomatic COVID-19-infected patients are a well-known source of transmission of infection. The risk of exposure to respiratory secretions and/or feces is hardly avoidable during the endoscopic procedure; also, the aerosol and droplets take up to an hour disperse, so they remain a risk to staff and other patients after they leave the room; therefore, strict infectious precautions should be taken by all health care workers to limit the virus spread.

Main body

We present an endoscopic trial of duodenal stent insertion in non-operable gastric carcinoma that is proven 2 days later to be a COVID-19-positive case. Fortunately, no one of the health care workers that came in contact with the case becomes infected owing to the proper infection control measures.

Conclusion

We recommended that the endoscopy examination and procedures should be strictly limited to urgent cases to minimize the risk of virus infection among health care workers.
Otology practice during COVID-19 era: a review of current practice
Authors: Dawoud Moustafa M.
Published: November 2020

Background

The novel coronavirus started as an outbreak in Wuhan, China, in December 2019.The outbreak was declared a pandemic by the WHO on 12 March 2020. The virus is called SARS-CoV-2, and the virus-induced disease is called COVID-19. The infection spreads via droplets or direct contact with contaminated surfaces. Airborne transmission occurs during aerosol-generating procedures on patients. Many otologic procedures are considered AGPs and therefore require precautions to protect staff and patients and minimize transmission of the disease.

Main body

Outpatient otology activity has seen changes, including virtual clinics and limitation of face-to-face consultations, to ensure safety. Powered instrumentation should be avoided during surgical procedures unless necessary or replaced with other tools, and if performed, enhanced personal protective equipment (PPE) must be used. Ear, nose, and throat (ENT) examination is recommended for any patient with full PPE in place except for consultations done without examination. Systemic steroid administration for treating conditions such as Bell’s palsy and sudden sensorineural hearing loss should be discussed with both the patient and infectious diseases specialist to weigh risks against benefits. Triaging of patients and prioritization is unavoidable during the pandemic and even after due to the limitations of clinic and theater time. All emergency/urgent cases are considered potentially COVID-19 positive. For the semi-urgent and all elective cases, COVID-19 testing 48 h prior to surgery, strict quarantine awaiting test results, and repeat testing on day of surgery if rapid tests are available are the precautions suggested. Different measures should be in place to minimize staff potential exposure intraoperatively.

Conclusions

Otology practice has been affected by the COVID-19 pandemic. Various measures are in place to ensure the delivery of safe and effective service for patients and health care workers.
Gender equality in academic publishing: action from the BJPsych
Authors: Upthegrove Rachel , de Cates Angharad , Shuttleworth Alice , Tracy Derek K. , Broome Matthew R. , Lingford-Hughes Anne
Published: November 2020

Women in academic publishing and academic psychiatry face many challenges of gender inequality, including significant pay differentials, poor visibility in senior positions and a male-dominated hierarchical system. We discuss this problem and outline how the BJPsych plans to tackle these issues it in its own publishing.
Clinical Outcomes and Complications of Pituitary Blastoma
Authors: Liu Anthony P Y , Kelsey Megan M , Sabbaghian Nelly , Park Sung-Hye , Deal Cheri L , Esbenshade Adam J , Ploner Oswald , Peet Andrew , Traunecker Heidi , Ahmed Yomna H E , Zacharin Margaret , Tiulpakov Anatoly , Lapshina Anastasia M , Walter Andrew W , Dutta Pinaki , Rai Ashutosh , Korbonits Márta , de Kock Leanne , Nichols Kim E , Foulkes William D , Priest John R
Published: November 2020

Context

Pituitary blastoma is a rare, dysontogenetic hypophyseal tumor of infancy first described in 2008, strongly suggestive of DICER1 syndrome.

Objective

This work aims to describe genetic alterations, clinical courses, outcomes, and complications in all known pituitary blastoma cases.

Design and Setting

A multi-institutional case series is presented from tertiary pediatric oncology centers.

Patients

Patients included children with pituitary blastoma.

Interventions

Genetic testing, surgery, oncologic therapy, endocrine support are reported.

Outcome Measures

Outcome measures included survival, long-term morbidities, and germline and tumor DICER1 genotypes.

Results

Seventeen pituitary blastoma cases were studied (10 girls and 7 boys); median age at diagnosis was 11 months (range, 2-24 months). Cushing syndrome was the most frequent presentation (n = 10). Cushingoid stigmata were absent in 7 children (2 with increased adrenocorticotropin [ACTH]; 5 with normal/unmeasured ACTH). Ophthalmoplegia and increased intracranial pressure were also observed. Surgical procedures included gross/near-total resection (n = 7), subtotal resection (n = 9), and biopsy (n = 1). Six children received adjuvant therapy. At a median follow-up of 6.7 years, 9 patients were alive; 8 patients died of the following causes: early medical/surgical complications (n = 3), sepsis (n = 1), catheter-related complication (n = 1), aneurysmal bleeding (n = 1), second brain tumor (n = 1), and progression (n = 1). Surgery was the only intervention for 5 of 9 survivors. Extent of resection, but neither Ki67 labeling index nor adjuvant therapy, was significantly associated with survival. Chronic complications included neuroendocrine (n = 8), visual (n = 4), and neurodevelopmental (n = 3) deficits. Sixteen pituitary blastomas were attributed to DICER1 abnormalities.

Conclusions

Pituitary blastoma is a locally destructive tumor associated with high mortality. Surgical resection alone provides long-term disease control for some patients. Quality survival is possible with long-term neuroendocrine management.
The Hypothalamic-Pituitary-Thyroid Axis in Cushing Syndrome Before and After Curative Surgery
Authors: Shekhar Skand , McGlotten Raven , Auh Sunyoung , Rother Kristina I , Nieman Lynnette K
Published: November 2020

Background

We do not fully understand how hypercortisolism causes central hypothyroidism or what factors influence recovery of the hypothalamic-pituitary-thyroid axis. We evaluated thyroid function during and after cure of Cushing syndrome (CS).

Methods

We performed a retrospective cohort study of adult patients with CS seen from 2005 to 2018 (cohort 1, c1, n = 68) or 1985 to 1994 (cohort 2, c2, n = 55) at a clinical research center. Urine (UFC) and diurnal serum cortisol (F: ~8 am and ~midnight [pm]), morning 3,5,3′-triiodothyronine (T3), free thyroxine (FT4), and thyrotropin (TSH) (c1) or hourly TSH from 1500 to 1900 h (day) and 2400 to 04000 h (night) (c2), were measured before and after curative surgery.

Results

While hypercortisolemic, 53% of c1 had central hypothyroidism (low/low normal FT4 + unelevated TSH). Of those followed long term, 31% and 44% had initially subnormal FT4 and T3, respectively, which normalized 6 to 12 months after cure. Hypogonadism was more frequent in hypothyroid (69%) compared to euthyroid (13%) patients. Duration of symptoms, morning and midnight F, adrenocorticotropin, and UFC were inversely related to TSH, FT4, and/or T3 levels (r = –0.24 to –0.52, P < .001 to 0.02). In c2, the nocturnal surge of TSH (mIU/L) was subnormal before (day 1.00 ± 0.04 vs night 1.08 ± 0.05, P = .3) and normal at a mean of 8 months after cure (day 1.30 ± 0.14 vs night 2.17 ± 0.27, P = .01). UFC greater than or equal to 1000 μg/day was an independent adverse prognostic marker of time to thyroid hormone recovery.

Conclusions

Abnormal thyroid function, likely mediated by subnormal nocturnal TSH, is prevalent in Cushing syndrome and is reversible after cure.
Testicular Testosterone and Estradiol Concentrations and Aromatase Expression in Men with Nonobstructive Azoospermia
Authors: Shiraishi Koji , Oka Shintaro , Matsuyama Hideyasu
Published: November 2020

Context

Spermatogenesis is strictly regulated by the intratesticular hormonal milieu, in which testosterone (T) and estradiol (E2) play pivotal roles. However, the optimal expression of aromatase and intratesticular T (ITT) and E2 (ITE2) levels are unknown.

Objective

To investigate ITT/ITE2 and aromatase expression in men with nonobstructive azoospermia (NOA) and to elucidate the roles of aromatase in spermatogenesis, as determined based on sperm retrieval by microdissection testicular sperm extraction (micro-TESE).

Design and Setting

A retrospective study at a reproductive center using serum, testicular specimens, and intratesticular fluid.

Patients

Seventy-six men with NOA, including 4 men who received 3 months of anastrozole administration prior to micro-TESE, and 18 men with obstructive azoospermia.

Interventions

Testicular aromatase expression was evaluated using immunohistochemistry and quantitative reverse transcription-polymerase chain reaction (RT-PCR). Intratesticular T and ITE2 levels were determined using liquid chromatography-tandem mass spectrometry.

Results

Aromatase was mainly located in Leydig cells, and the levels of its transcript and protein expression levels were increased in men with NOA. No correlation was observed between serum T/E2 and ITT/ITE2 levels, whereas significant associations were observed between decreased ITT and increased ITE2, aromatase expression, and sperm retrieval. Treatment with anastrozole increased the ITT/ITE2 ratio and decreased aromatase expression.

Conclusions

A close association between the expression of aromatase in Leydig cells and ITT/ITE2 was shown. Leydig cell aromatase is a factor that is independently correlated with spermatogenesis, and aromatase inhibitors may open a therapeutic window by increasing ITT/ITE2 in selected patients.
Improved Urinary Cortisol Metabolome in Addison Disease: A Prospective Trial of Dual-Release Hydrocortisone
Authors: Espiard Stéphanie , McQueen Johanna , Sherlock Mark , Ragnarsson Oskar , Bergthorsdottir Ragnhildur , Burman Pia , Dahlqvist Per , Ekman Bertil , Engström Britt Edén , Skrtic Stanko , Wahlberg Jeanette , Stewart Paul M , Johannsson Gudmundur
Published: November 2020

Context

Oral once-daily dual-release hydrocortisone (DR-HC) replacement therapy has demonstrated an improved metabolic profile compared to conventional 3-times-daily (TID-HC) therapy among patients with primary adrenal insufficiency. This effect might be related to a more physiological cortisol profile, but also to a modified pattern of cortisol metabolism.

Objective

This work aimed to study cortisol metabolism during DR-HC and TID-HC.

Design

A randomized, 12-week, crossover study was conducted.

Intervention and Participants

DC-HC and same daily dose of TID-HC were administered to patients with primary adrenal insufficiency (n = 50) vs healthy individuals (n = 124) as controls.

Main Outcome Measures

Urinary corticosteroid metabolites were measured by gas chromatography/mass spectrometry at 24-hour urinary collections.

Results

Total cortisol metabolites decreased during DR-HC compared to TID-HC (P < .001) and reached control values (P = .089). During DR-HC, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity measured by tetrahydrocortisol + 5α-tetrahydrocortisol/tetrahydrocortisone ratio was reduced compared to TID-HC (P < .05), but remained increased vs controls (P < .001). 11β-HSD2 activity measured by urinary free cortisone/free cortisol ratio was decreased with TID-HC vs controls (P < .01) but normalized with DR-HC (P = .358). 5α- and 5β-reduced metabolites were decreased with DR-HC compared to TID-HC. Tetrahydrocortisol/5α-tetrahydrocortisol ratio was increased during both treatments, suggesting increased 5β-reductase activity.

Conclusions

The urinary cortisol metabolome shows striking abnormalities in patients receiving conventional TID-HC replacement therapy, with increased 11β-HSD1 activity that may account for the unfavorable metabolic phenotype in primary adrenal insufficiency. Its change toward normalization with DR-HC may mediate beneficial metabolic effects. The urinary cortisol metabolome may serve as a tool to assess optimal cortisol replacement therapy.
Neurologic Complications in Patients With Cancer
Authors: Lee Eudocia Q.
Published: November 2020

PURPOSE OF REVIEW

Neurologic complications in patients with cancer can significantly impact morbidity and mortality. Although these complications can be seen in patients without cancer as well, the purpose of this review is to highlight how the presentation, etiology, and management of delirium, seizures, cerebrovascular disease, and central nervous system infections may be different in patients with cancer.

RECENT FINDINGS

Some of the newer anticancer therapies are associated with neurologic complications. Delirium and seizures have been described in patients receiving chimeric antigen receptor (CAR) T-cell therapy and other immune effector cell therapies. Angiogenesis inhibitors can increase the risk of bleeding and clotting, including intracranial hemorrhage and stroke. The risk of opportunistic fungal infections, including aspergillosis, is elevated with the Bruton tyrosine kinase inhibitor ibrutinib.

Providers should familiarize themselves with neurologic complications in patients with cancer because early diagnosis and intervention can improve outcomes. The differential diagnosis should be broad, including conventional causes as seen in patients who do not have cancer, with special consideration of etiologies specific to patients with cancer.
Paraneoplastic Disorders of the Nervous System
Authors: Flanagan Eoin P.
Published: November 2020

PURPOSE OF REVIEW

This article reviews paraneoplastic neurologic disorders and includes an overview of the diagnostic approach, the role of autoantibody testing, the pathophysiology of these disorders, and treatment approaches. This article also provides an overview of the emerging clinical scenarios in which paraneoplastic and autoimmune neurologic disorders may occur.

RECENT FINDINGS

The number of autoantibodies associated with paraneoplastic neurologic disorders has rapidly expanded over the past 2 decades. These discoveries have improved our ability to diagnose patients with these disorders and have provided insight into their pathogenesis. It is now recognized that these antibodies can be broadly divided into two major categories based on the location of the target antigen: intracellular and cell surface/synaptic. Antibodies to intracellular antigens are almost always accompanied by cancer, respond less well to immunotherapy, and have an unfavorable outcome. In contrast, antibodies to cell surface or synaptic targets are less often accompanied by cancer, generally respond well to immunotherapy, and have a good prognosis. Paraneoplastic and autoimmune neurologic disorders are now being recognized in novel settings, including their occurrence as an immune-related adverse effect of immune checkpoint inhibitor treatment for cancer.

This article discusses when to suspect a paraneoplastic neurologic syndrome, the diagnostic utility and pitfalls of neural autoantibody testing, how to best detect the underlying tumor, and the treatment approach that involves combinations of antineoplastic treatments, immunosuppressants, and supportive/symptomatic treatments.