bluuebunny/crossref_metadata_2025 huggingface dataset:
Fetal Ultrasonic Evaluation of Bronchial Morphology in Fetuses with Isomerism
Authors: Wang Xin , Chen Song , Tu Peng , Liu Xiaowei , Zhang Xiaohang , Han Jiancheng , Dong Hongmei , Ran Suzhen , He Yihua
Published: September 2021

Objective: The aim of the study was to evaluate whether fetal ultrasound could determine bronchial isomerism and distinguish left isomerism from right isomerism. Methods: We identiﬁed 110 healthy fetuses and 28 fetuses with isomerism. The outer angle between the tracheal midline and the inner margin of the bronchus is measured. The bronchial angles and the ratio of left/right bronchial angle were used to differentiate bronchial morphology and confirm the presence of bronchial isomerism in pathological cases. Results: The normal angles of the left and right bronchi were 146.98° (95% CI, 145.15–147.81°) and 167.37° (95% CI, 166.30–168.44°), separately. The cutoff bronchial angle of 156.5° was used to distinguish left bronchus from right bronchus. The bronchial isomerism could be identified in all pathological cases by autopsy and bronchial-atrial concordance occurred in 27 pathological cases (96.4%). In 21 pathological cases, the bilateral bronchial angle was <156.5 versus >156.5 differentiated left from right isomerism, respectively. The ratio of the left/right bronchial angle of >0.935 identified 92.9% (26/28) of all pathological cases, with a sensitivity of 89.7%. Conclusions: Fetal ultrasound can detect the bronchial morphology and the presence of bronchial isomerism in fetuses with isomerism according to bronchial angles and the ratio of left/right bronchial angle.
A Small Supernumerary Xp Marker Chromosome Including Genes NR0B1 and MAGEB Causing Partial Gonadal Dysgenesis and Gonadoblastoma
Authors: Nishi Mirian Yumie , Faria Júnior José Antônia Diniz , Krepischi Ana Cristina Victorino , de Moraes Daniela Rodrigues , da Costa Silvia Souza , Silva Elinaelma Suelane do Nascimento , Costa Elaine Maria Frade , Mendonca Berenice Bilharinho , Domenice Sorahia
Published: September 2021

Copy number variations of several genes involved in the process of gonadal determination have been identified as a cause of 46,XY differences of sex development. We report a non-syndromic 14-year-old female patient who was referred with primary amenorrhea, absence of breast development, and atypical genitalia. Her karyotype was 47,XY,+mar/46,XY, and FISH analysis revealed the X chromosome origin of the marker chromosome. Array-CGH data identified a pathogenic 2.0-Mb gain of an Xp21.2 segment containing NR0B1/DAX1 and a 1.9-Mb variant of unknown significance from the Xp11.21p11.1 region. This is the first report of a chromosomal microarray analysis to reveal the genetic content of a small supernumerary marker chromosome detected in a 47,XY,+der(X)/46,XY karyotype in a non-syndromic girl with partial gonadal dysgenesis and gonadoblastoma. Our findings indicate that the mosaic presence of the small supernumerary Xp marker, encompassing the NR0B1/DAX1 gene, may have been the main cause of dysgenetic testes development, although the role of MAGEB and other genes mapped to the Xp21 segment could not be completely ruled out.
Applications of Endoscopic Endonasal Surgery in Early Childhood: A Case Series
Authors: McDowell Michael M. , Chiang Michael , Abou-Al-Shaar Hussam , Zenonos Georgios A. , Wang Eric W. , Snyderman Carl H. , Gardner Paul A.
Published: September 2021

Introduction: Endoscopic endonasal surgery (EES) has been slower to gain popularity in early childhood due to anatomical challenges. We sought to describe the safety and efficacy of EES in early childhood. Methods: All patients younger than 7 years who underwent EES at a large Cranial Base Center from 2002 to 2019 were reviewed as a retrospective cohort study. Results: Thirty-six patients underwent EES before the age of 7 years. Four patients had two-stage EES. Two patients required combined transcranial and endonasal approaches. The mean age at the time of initial surgery was 4 years (range: 1–6). Twenty patients were male, and 16 were female. Of 21 tumors intended for resection, 11 patients had gross total resections, and 10 had near total (>95% tumor removed) resections. Nine patients (43%) had recurrences, of which 6 were craniopharyngiomas (p = 0.01). There was no difference in recurrence rates based on the degree of resection (p = 0.67). Three cerebrospinal fluid (CSF) leaks occurred following primary EES (8%). Following an increase in nasoseptal flap usage (31–52%) and CSF diversion (15–39%) in 2008, there was only one CSF leak out of 23 patients (4 vs. 15%; p = 0.54). Postoperatively, 1 patient developed a permanent new cranial neuropathy, and 1 patient developed a permanent visual field cut. Six patients developed permanent postoperative panhypopituitarism, of which all were craniopharyngiomas (p < 0.001). The mean follow-up was 64 months. Conclusions: Early childhood EES is both safe and technically feasible for a variety of pathologies.
Optical Coherence Tomography Biomarkers Predicting Visual Acuity Change after Intravitreal Bevacizumab Injections for Macular Edema Secondary to Branch Retinal Vein Occlusion
Authors: Segal Ori , Yavnieli Roy , Mimouni Michael , Rabina Gilad , Geffen Noa , Moisseiev Elad , Nemet Arie Y.
Published: September 2021

Purpose: This study aimed to identify baseline optical coherence tomography (OCT) factors in branch retinal vein occlusion (BRVO) that predict response to bevacizumab injections. Methods: It is a retrospective case series of consecutive patients that underwent OCT at diagnosis, and the central macular thickness (CMT), extent of disorganized retinal inner layers, and outer retinal layers including external limiting membrane, ellipsoid zone (EZ), and cone outer segment tips (COST) were measured. Patients received 3 consecutive monthly injections of bevacizumab followed by pro re nata treatment. The main outcome measure was improvement in best-corrected visual acuity (BCVA) after 1 year. Results are expressed as mean ± SD, and p value <0.05 was considered statistically significant. Results: Overall, 66 eyes of 66 patients, with an average age of 68.5 ± 11.4 years, were included. The mean BCVA improved significantly from 0.68 logMAR at baseline to 0.50 logMAR at 1 year (p < 0.001). Baseline logMAR BCVA (r = 0.41, p < 0.001) and CMT (r = 0.23, p = 0.04) were associated with improvement while EZ (r = −0.24, p = 0.05) and COST (r = −0.32, p = 0.01) disruption with deterioration in BCVA. Conclusion: In patients with naïve BRVO treated with bevacizumab, BCVA improvement at 1 year can be predicted from baseline BCVA, CMT, extent of COST disruption, and EZ disruption.
Formação de um habitus futebolístico em mulheres no Brasil: um relato a partir das vivências de infância e vida adulta
Authors: Salvini Leila , Marchi Júnior Wanderley
Published: September 2021

O presente escrito tem como objetivo identificar disposições iniciais à prática do futebol e a formação de um habitus futebolístico em mulheres, para tanto, foram realizadas quatro entrevistas semiestruturadas com jogadoras de uma equipe de futebol da cidade de Curitiba/PR que no decorrer de suas carreiras participaram de partidas oficiais defendendo a Seleção Brasileira de Futebol Feminino. Após análise das informações, concluímos que as disposições iniciais para a prática do futebol baseiam-se em seis etapas compartilhadas por todas as entrevistadas, e que as disposições necessárias para elas adentrarem o espaço do futebol não são as mesmas que as mantém nele.
Estresse em árbitros de Ginástica Rítmica
Authors: Debien Paula Barreiros , Bara Maurício Gattás , Reis Cleiton Pereira , Costa Varley Teoldo da
Published: September 2021

O objetivo do estudo foi identificar e classificar o estresse em árbitros brasileiros de ginástica rítmica (GR). Foram entrevistados 10 árbitros brasileiros de GR de nível internacional, com média de idade de 37.6 ±6.6 anos. Realizou-se a transcrição das entrevistas e, posteriormente, uma análise qualitativa foi feita, por meio de miniunidades (MUs). Estas MUs foram classificadas em três categorias: estresse social, biológico e psicológico. Além da dificuldade de conciliar a vida social e a atividade profissional, o relacionamento com outros árbitros, comissão técnica e espectadores são fontes importantes de estresse social para os entrevistados. Quanto ao estresse biológico, os árbitros se queixaram da longa duração das competições. Eles frequentemente apresentam algum tipo de desconforto físico durante a atuação laboral. O estresse psicológico que estes profi ssionais estão submetidos tem relação com o desgaste em atribuir notas à atuação das atletas, além do nível das competições que os árbitros atuam e da necessidade de interpretar o código de pontuação. Conclui-se que diferentes fatores envolvidos na atividade laboral dos árbitros brasileiros de GR se interagem e se relacionam no aparecimento do estresse nestes profissionais.
As baterias motoras MABC-2, TGMD-2 e KTK explicam a função executiva em crianças de 8 a 10 anos?
Authors: Fronza Fernanda Cerveira , Medeiros Pâmella de , Ferrari Elisa Pinheiro , Cordeiro Paola Cidade , Freitas Kamylla Thais Dias de , Cardoso Fernando Luiz
Published: September 2021

Objetivo deste estudo foi verificar se há relação entre o desempenho motor e as funções executivas, bem como, analisar qual bateria motora, MABC-2, KTK, TGMD-2, explica melhor as funções executivas de crianças de 8 a 10 anos com desenvolvimento típico. Fizeram parte da investigação 60 crianças, com idades entre oito e 10 anos (Média=9,09; desvio padrão 0,75). Para avaliação das funções executivas utilizou-se o Teste de Trilhas, já para avaliação do desempenho motor, utilizou-se os testes Movement Assessment Battery for Children Second Edition (MABC -2), Körperkoordination Test fürKinder (KTK) e Test of Gross Development Second Edition (TGMD-2). No que se refere às análises estatísticas, utilizou-se o teste de Correlação de Spearman para verificar a relação entre as funções executivas e o desempenho motor, e a Regressão linear simples foi utilizada para identifi car quais os testes motores melhor explicam as funções executivas. Encontrou-se relação entre o desempenho motor e função executiva apenas para as meninas. Além disso, verificou-se que a bateria MABC-2 é o teste que melhor explica as funções executivas principalmente para o sexo feminino. Esses resultados implicam em uma possível detecção prévia parcial de difi culdades tanto motoras como cognitivas, por meio da bateria MABC-2 para o sexo feminino nesse grupo estudado. Ao mesmo tempo, com esses resultados, presume-se que apenas algumas tarefas motoras estão relacionadas à função executiva, sendo aquelas que envolvem habilidades motoras finas.
Resolução nº 3699 (18-06-1990) Portaria nº 1145 (21-06-1990)
Authors: Lobo e Silva Filho Roberto Leal
Published: September 2021

Parecer de 08-12-1989, do professor Celso de Rui Beisiegel, então diretor da Faculdade de Educação e vice-diretor e de chefe do Departamento de Filosofia da Educação e Ciências da Educação, da Universidade de São Paulo, constante no processo nº 87.1.854.8.3, como favorável à criação do Departamento de Teoria Literária e Literatura Comparada.
Memorial Acadêmico
Authors: Candido Antonio
Published: September 2021

Reprodução do memorial apresentado para o concurso de Professor Titular de Teoria Literária e Literatura Comparada da Faculdade de Filosofia, Letras e Ciências Humanas da Universidade de São Paulo, no ano de 1974. O documento original possui 29 páginas datilografadas.
Os artigos tchecos perdidos de Roman Jakobson sobre fonologia: um caso de como evitar anacronismo em historiografia linguística
Authors: Qu Changliang
Published: September 2021

Embora a teoria dos traços distintivos de Roman Jakobson esteja bem representada em seus trabalhos em inglês após sua imigração para os Estados Unidos, um quadro completo do desenvolvimento dessa teoria ainda está por ser feito, ainda que todos os seus trabalhos iniciais sobre o tópico, escritos em tcheco, francês e alemão já tenham sido bem examinados. Apesar de alguns desses trabalhos já terem sido vertidos para o inglês, pode haver diferenças enganosas entre os originais (escritos em outros idiomas) e essas traduções. Baseado na comparação entre as obras fonológicas de Jakobson publicadas no início dos anos de 1930 (“Z fonologie spisovné slovenštiny” e algumas entradas da enciclopédia Ottův) e suas versões presentes em seus Selected Writings, o presente artigo procura esclarecer alguns detalhes sobre a divisibilidade do fonema, a natureza paradigmática do traço distintivo e a nomenclatura e a classificação dos traços distintivos. Este estudo também procura oferecer um exemplo específico sobre como evitar anacronismos na pesquisa sobre história da linguística.
Sobre a preparação e a proibição da edição russa da obra de Jan Mukařovský, organizada por Iuri Lótman e Oliég Maliévitch
Authors: Pilshchikov Igor , Trunin Mikhail
Published: September 2021

No final dos anos de 1960, Iuri Lótman, um dos fundadores da Escola de Semiótica Tártu-Moscou, preparou, em cooperação com seus colegas, uma edição em dois volumes de escritos de Jan Mukařovský, um dos fundadores do estruturalismo literário tcheco e da estética semiótica. Embora Mukařovský alegasse lealdade ao marxismo já no início dos anos de 1950 e fosse considerado politicamente aceitável na URSS, tanto seu passado estruturalista quanto a bagagem estruturalista de Lótman eram alheios e suspeitos aos marxistas ortodoxos dominantes e às autoridades de censura soviéticas, especialmente depois da “Primavera Tcheca” de 1968. A edição russa de Mukařovský veio a lume só depois do colapaso da União Soviética (e da morte de Lótman). Baseado em vasta documentação de arquivo, este artigo oferece uma reconstrução detalhada da história da edição inicial não publicada.
LARP7 Suppresses Endothelial-to-Mesenchymal Transition by Coupling With TRIM28
Authors: Liang Xiaodong , Wu Shuo , Geng Zilong , Liu Li , Zhang Shasha , Wang Shiyan , Zhang Yan , Huang Yu , Zhang Bing
Published: September 2021

Rationale:

Endothelial-to-mesenchymal transition (EndMT) is a fundamental biological process in which endothelial cells lose their endothelial characteristics and acquire mesenchymal properties. EndMT contributes to physiological organ development such as valvulogenesis and is associated with a number of deleterious pathologies such as organ fibrosis. Several signaling pathways of TGF-β (transforming growth factor β), BMP (bone morphogenetic protein) and inflammation have been shown to regulate EndMT. However, the transcriptional and epigenetic programs governing EndMT remains largely unclarified.

Objective:

To identify the transcriptional or epigenetic mechanisms underlying EndMT and EndMT-associated formation of cardiac valves.

Methods and Results:

We identified the LARP7 (La ribonucleoprotein domain family member 7), a RNAPII (RNA-binding protein regulating RNA polymerase II) pausing, was downregulated in 2 cytokine-induced EndMT models. LARP7 depletion with lentivirus-mediated shRNA transformed endothelial cells to mesenchymal morphology and induced the expression of the EndMT key regulator, SLUG. Specific deletion of LARP7 in the endocardium in inducible CDH5
CreERT2
;LARP7
f/f
mouse enhanced EndMT in the atrioventricular and outflow tract cushion as revealed by lineage tracing approach. ChIP-seq analysis showed LARP7 and TRIM28 (tripartite motif containing 28) which is an epigenetic repressor were colocalized at SLUG promoter. LARP7 directly interacted with TRIM28 and facilitated it loading to SLUG promoter and repressed its transcription through deacetylating the histones. More importantly, inducible knockout of LARP7 or TRIM28 in the endocardium accelerated EndMT, leading to the valvular hyperplasia, which was further aggravated by the double knockout of these 2 genes.

Conclusions:

The present study uncovers an orchestrated transcriptional and epigenetic mechanism by which LARP7 cooperates with TRIM28 to govern the EndMT and valvulogenesis.
A New Growth Rate Measure in Identifying Extended Gompertz Growth Curve and Development of Goodness-of-fit Test
Authors: Yeasmin Farhana , Daw Ranadeep , Chakraborty Bratati , Gupta Arindam , Bhattacharya Sabyasachi , Chakraborty Biman
Published: September 2021

Growth is a fundamental aspect of a living organism. Growth curves play an important role in explaining the complex dynamics of growth trajectories. The development of a large class of growth models provides more choices to explain complex growth dynamics. However, identifying a suitable growth curve from a broad class of growth models becomes a challenging task. Relative Growth Rate (RGR) is the most popular measure in the growth-related study. It serves many purposes in growth curve literature, including constructing any goodness-of-fit index of some growth dynamics. However, the goodness-of-fit test based on RGR is restricted to only simple growth models. This study aims to develop a new growth rate function, instantaneous maturity rate (IMR), which can play an important role in identifying growth models. We have explored that the measure has synergy in mathematical form with IMR. However, unlike the hazard rate, IMR is a random variable when the size/RGR variable is stochastic. We have derived the exact and asymptotic distribution of this measure under the Gaussian setup of both the size and RGR variables. We have constructed a goodness-of-fit test for the extended Gompertz growth model based on the instantaneous maturity rate. We have checked the performance of the test through simulation studies as well as real data.

AMS 2010 subject classifications: 62Mxx, 92Bxx, 62P10
Youth Suicide in India: A Critical Review and Implication for the National Suicide Prevention Policy
Authors: Gupta Snehil , Basera Devendra
Published: September 2021

Youth suicide is a significant public health problem in Low-and middle-income countries (LMIC), including India. It is a distinct phenomenon with various bio-psycho-social determinants. Despite this, comprehensive literature on this topic is lacking from India. Thus, the current paper aimed to review the available literature on youth-suicide from India and other LMIC, discusses the contentious issues, including potential solutions for the possible roadblocks, and provides recommendations for the national suicide-prevention policy and strategy (NSPPS) in the Indian context. We found that the magnitude of youth suicide in India is substantial with the distinct bio-psycho-social determinants. Although, youth-specific suicide prevention and therapeutic intervention do exist; its feasibility and effectivity in the Indian context are yet to be established. The is an urgent need for the NSPPS; experiences from other LMIC should be incorporated while framing such policies. More research is required from India in this area.
Moderating Role of Religiosity and the Determinants to Attitude, Willingness to Donate and Willingness to Communicate Posthumous Organ Donation Decisions among University Students in Pakistan
Authors: Umair Sonia , Ho Jo-Ann , Ng Serene Siew Imm , Basha Norazlyn Kamal
Published: September 2021

Organ transplantation is considered an alternative treatment to save lives or to improve the quality of life and is a successful method for the treatment of patients with end-stage organ diseases. The main objective of the current study was to explore the determinants of the attitudes and willingness to communicate the posthumous organ donation decisions to the families. Questionnaires were used to test the hypothesized relationships. The results confirmed altruism, knowledge, empathy, and self-identity as the antecedents to attitude. We also found perceived behavioral control, moral norms, and attitude as significant antecedents to the willingness to donate organs after death. The results of the study also indicated that those who were willing to sign the donor card were also willing to communicate their decision to their families. Religiosity moderated the relationship between willingness to donate and signing the donor card, and it strengthened the relationship. The findings of this study would provide insight into the factors which can influence posthumous organ donation among university students in Pakistan.
Development and Validation of Iranian Adolescent’s Participation Assessment Tool
Authors: Joveini Ghodsiyeh , Hasani Mehraban Afsoon , Zareiyan Armin , Khalafbeigi Mitra , Lajevardi Laleh
Published: September 2021

Background

Health promotion of children and adolescents through participation in purposeful and meaningful activities is one of the focuses of occupational therapy. In this study, in line with the Iranian culture, a tool for assessment of Iranian adolescents’ participation in daily occupations/activities was developed and validated.

Method

An exploratory sequential mixed method was used to develop and validate the tool. Content and structural validity and reliability of the initial version were estimated.

Results

During the validation process, the items were reduced to 54. Data were collected from 481 adolescents to investigate factor analysis. According to principal component analysis, the Kaiser–Meyer–Olkin index was 0.88, and the analysis yielded seven factors explaining 47.2% of the total variance. The tool showed excellent internal consistency and test–retest reliability.

Conclusion

This newly developed Participation Assessment Tool for Iranian adolescents is a valid and reliable measure for assessing the participation of this group in daily activities.
Doing gender and being gendered through occupation: Transgender and non-binary experiences
Authors: Swenson Rebecca , Alldred Pam , Nicholls Lindsey
Published: September 2021

Background

Transgender people can face discrimination which can be reflected in and encoded by their occupational experiences. There is emerging research regarding those who are transgender but experiences of non-binary people remain under-explored.

Purpose

This study considered the occupational experiences of transgender and non-binary people and how gender expression related to engagement in occupations and space.

Method

Five transgender and non-binary people participated in repeat interviews, including a ‘walking interview’. Analysis was informed by new materialism.

Findings

Occupational engagement can re-enforce binary understandings of gender or facilitate creative expressions of gender identity. Within normative environments, occupational participation can offer assimilation, particularly for non-binary people. Some occupations provided emancipation from binary gender norms through expression such as clothing and creative activities which provided recognition and belonging. Symbolic and personal meanings of occupations shifted when participants were able to express themselves in a way that felt authentic.

Conclusion

‘Occupational assimilation’ can bring safety from scrutiny for those who are transgender and non-binary but curtails authentic expression. Occupational therapists have a role in supporting transgender and non-binary people in accessing occupations which facilitate their authentic gender expression and need to improve critical awareness of the culturally encoded binary nature of many occupations and environments.
Gender Equitable Attitudes, Rape Myth Acceptance, and Perceived Peer Approval of Violence as Correlates of High School Boys’ Intention to Garner Sexual Consent
Authors: Dunn Hailee K. , Orchowski Lindsay M.
Published: September 2021

The current study examines correlates of high school boys’ intentions to garner consent in a future sexual encounter ( N = 816). Bivariate correlation analyses demonstrated that increased intention to garner sexual consent was negatively correlated with rape myth acceptance and perceived peer acceptance of violence, and positively correlated with gender equitable attitudes. In multivariate linear regression analyses, perceived peer acceptance of violence and gender equitable attitudes remained significant in relation to intentions to garner sexual consent. Specifically, boys who reported a greater likelihood of perceiving their peers as accepting of violence and a lower likelihood of holding gender equitable attitudes also reported a lower likelihood to garner sexual consent. These findings highlight the importance of developing sexual assault prevention programs for high school boys that address the complex relationships between perceived peer norms, harmful gender role expectancies, and risk for sexual aggression. Results from this study also add to the existing literature on sexual consent communication in adolescents.
Look Who’s Writing: How Gender Affects News Credibility and Perceptions of News Relevance
Authors: Paul Newly , Sui Mingxiao , Searles Kathleen
Published: September 2021

Women reporters are underrepresented in newsrooms and assigned to gender-stereotypic roles, but to what effect? To better understand the role of gender in news making, this article utilizes three survey experiments to investigate the effects of journalists’ gender on reader perceptions toward reporter credibility, outlet credibility, and the relevance of news to them. We find little evidence that readers doubt the credibility of a reporter or a news outlet based on the gender of a reporter, the gender of the source, or the gendered nature of the issue. Our findings have implications for media credibility and newsroom diversity.
Placental elastography in second trimester preeclampsia prediction: A prospective study
Authors: Meena Rajkumar , Malik Amita , Jain Swarna , Batra Achla
Published: September 2021

Objective

The aim of the study was to evaluate the diagnostic potential of placental shear wave elastography in predicting preeclampsia at 16 to 20 weeks of gestation.

Materials and methods

A total of 230 pregnant women between 16 and 20 weeks of gestation were observed for the study. These women underwent shear wave elastography ElastPQ (Philips Healthcare, Bothell, Washington, USA) of the placenta. The mean value of placental shear modulus was obtained for each participant. These participants were followed up for the development of preeclampsia and were divided into two groups; group A included those who developed preeclampsia and group B included those who remained normotensive until delivery. The elasticity values of the two groups were compared, and the ROC curve was drawn to obtain the best cut-off value that would predict the onset of preeclampsia.

Results

Placental shear modulus varied from 1.03 kPa to 7.4 kPa at 16 to 20 weeks of gestation with an average of 2.74 ± 0.87 kPa. There was a statistically significant difference in the mean value of elasticity between two groups, being 4.61 kPa in group A and 2.51 kPa in group B. Maximum diagnostic accuracy was obtained at 2.9667 kPa with area under the curve 0.970, sensitivity 92%, specificity 91.71%, positive predictive value 57.5% and negative predictive value 98.9%.

Conclusion

Stiffness of placenta, quantitatively measured by SWE at 16 to 20 weeks of gestation, is higher in the women who develop preeclampsia and hence may be used for predicting preeclampsia.
Tetrahydropalmatine exerts analgesic effects by promoting apoptosis and inhibiting the activation of glial cells in rats with inflammatory pain
Authors: Liu Beibei , Luo Man , Meng Danyang , Pan Huan , Shen Hui , Shen Jianfen , Yao Ming , Xu Longsheng
Published: September 2021

Background

Pain is an unpleasant sensory experience that usually plays a protective role. Inflammatory pain is often severe and stubborn, which has a great impact on the quality of life of patients. However, there has been no breakthrough in the treatment strategy and mechanism of inflammatory pain.

Methods

This study investigated the analgesic effect of tetrahydropalmatine (THP) in rats injected with complete Freund's adjuvant (CFA)-induced inflammatory pain. Allodynia and gait analysis of rats were used to evaluate the analgesic effect at different time points before and after operation. THP (2.5, 5, and 10 mg/kg) was administered intraperitoneally once daily for 7 days post Day 3. The expression levels of TNF- α and IL-1 β in the spinal cord were measured by enzyme-linked immunosorbent assay. The activation of astrocytes and microglial cells in the spinal cord was tested by western blot before and after THP treatment. The apoptosis of glial cells was tested by flow cytometry after treatment with THP in the primary cultured glial cell model.

Results

CFA treatment induced significant allodynia and caused abnormal gait in rats. Administration of THP at 10 mg/kg significantly alleviated CFA-induced inflammatory pain behaviors. Moreover, CFA-induced activation of glial cells and the increased levels of TNF- α and IL-1 β were inhibited by THP administration. In addition, THP promotes apoptosis in primary cultured glial cells. This study suggests the possible clinical utility of THP in the treatment of inflammatory pain.

Conclusion

THP plays an analgesic role by inhibiting the activation of glial cells and promoting apoptosis.
Effect of Radiofrequency Neurolysis on the Symptoms of Chronic Rhinitis: A Randomized Controlled Trial
Authors: Stolovitzky J. Pablo , Ow Randall A. , Silvers Stacey L. , Bikhazi Nadim B. , Johnson Curtis D. , Takashima Masayoshi
Published: September 2021

Objective

To determine the safety and efficacy of temperature‐controlled radiofrequency (RF) neurolysis of the posterior nasal nerve (PNN) area for the treatment of chronic rhinitis.

Study Design

A multicenter, prospective, single‐blinded, randomized controlled trial, in which the control arm underwent a sham procedure.

Setting

Sixteen otolaryngology centers.

Methods

Patients with 24‐hour reflective Total Nasal Symptom Score (rTNSS) ≥6, including moderate to severe rhinorrhea and mild to severe congestion, were randomized 2:1 to active treatment of the posterior nasal nerve area with a temperature‐controlled RF device or a sham procedure, with no RF energy delivery. The stylus was applied bilaterally to nonoverlapping areas of the posterior middle meatus and posterior inferior turbinate in each nostril in the region of the PNN. The primary endpoint was responder rate at 3 months, where a response was defined as ≥30% improvement (decrease) in rTNSS from baseline.

Results

Patients had a mean baseline rTNSS of 8.3 (95% CI, 7.9‐8.7) and 8.2 (95% CI, 7.6‐8.8) (P =. 797) in the active treatment (n = 77) and sham control (n = 39) arms, respectively. At 3 months, responder rate was significantly higher in the active treatment arm: 67.5% (95% CI, 55.9%‐77.8%) vs 41.0% (95% CI, 25.6%‐57.9%) (P =. 009). The active treatment arm had a significantly greater decrease in rTNSS (mean, −3.6 [95% CI, −4.2 to −3.0] vs −2.2 [95% CI, −3.2 to −1.3]) (P =. 013). Three adverse events related to the device/procedure were reported, and all resolved.

Conclusion

This randomized controlled trial showed temperature‐controlled neurolysis of the PNN area is free from significant adverse events and superior to a sham procedure in decreasing the symptom burden of chronic rhinitis.
Comparative transcriptome and microbial community sequencing provide insight into yellow-leaf phenotype of Camellia japonica
Authors: Fu Mingyue , Zhou Zhongcheng , Yang Xu , Liu Zhongbing , Zheng Jiarui , Huang Xinru , Wang Ling , Ye Jiabao , Zhang Weiwei , Liao Yongling , Xu Feng
Published: September 2021

Background

Leaf color variation is a common trait in plants and widely distributed in many plants. In this study, a leaf color mutation in Camellia japonica (cultivar named as Maguxianzi, M) was used as material, and the mechanism of leaf color variation was revealed by physiological, cytological, transcriptome and microbiome analyses.

Results

The yellowing C. japonica (M) exhibits lower pigment content than its parent (cultivar named as Huafurong, H), especially chlorophyll (Chl) and carotenoid, and leaves of M have weaker photosynthesis. Subsequently, the results of transmission electron microscopy(TEM) exhibited that M chloroplast was accompanied by broken thylakoid membrane, degraded thylakoid grana, and filled with many vesicles. Furthermore, comparative transcriptome sequencing identified 3,298 differentially expressed genes (DEGs). KEGG annotation analysis results showed that 69 significantly enriched DEGs were involved in Chl biosynthesis, carotenoid biosynthesis, photosynthesis, and plant-pathogen interaction. On this basis, we sequenced the microbial diversity of the H and M leaves. The sequencing results suggested that the abundance of Didymella in the M leaves was significantly higher than that in the H leaves, which meant that M leaves might be infected by Didymella.

Conclusions

Therefore, we speculated that Didymella infected M leaves while reduced Chl and carotenoid content by damaging chloroplast structures, and altered the intensity of photosynthesis, thereby causing the leaf yellowing phenomenon of C. japonica (M). This research will provide new insights into the leaf color variation mechanism and lay a theoretical foundation for plant breeding and molecular markers.
Custom-made fenestrated stent for mycotic aortic aneurysms: a report of two cases
Authors: Li Siting , Chen Mengyin , Zheng Yuehong , Liu Zhili , Zeng Rong
Published: September 2021

Background

Mycotic aortic aneurysm is a rare and potentially life-threatening lesion, and endovascular repair has become increasingly accepted for intervention. Fenestrated endografts are available options to treat aneurysms involving visceral arteries. Here, we first report two patients with mycotic aortic aneurysm involving paraviscereal aorta who were successfully treated with custom-made fenestrated endograft.

Case presentation

Two patients were presented with mycotic aortic aneurysm. Due to their comorbidities and the involvement of the renal arteries, company-manufactured fenestrated stents were designed. Meanwhile, antibiotic therapy was administrated for 2 months before endovascular repair. Patients improved well without complications.

Conclusions

Custom-made fenestrated endovascular stent is an effective and feasible alternative solution to mycotic paravisceral aorta aneurysm.
Takotsubo syndrome as an overlooked and elusive cause of a single episode of dyspnea in young women: a case report
Authors: Lee Sung Eun , Yoon Seung-Hyun , Kang Hyo Jung , Ahn Jung Hwan
Published: September 2021

Background

Dyspnea is a common symptom in patients presenting to the emergency department. It has a variety of causes that range from non-urgent to life-threatening. One episode of dyspnea in a healthy young person is easy to overlook. However, if the symptoms occur after physically or emotionally stressful events, careful evaluation needs to be undertaken because it may be associated with Takotsubo syndrome, which is rarely expected but can be fatal. Herein, we report the case of Takotsubo syndrome in a healthy young woman who arrived at the emergency department after experiencing a short single episode of dyspnea following a minor surgery.

Case presentation

A 23-year old woman with no underlying chronic disease underwent closed reduction surgery for a nasal bone fracture under general anesthesia (with sevoflurane as the anesthetic). Approximately 5 h later, she presented to the emergency department with dyspnea, which improved soon upon arrival at the emergency department. There were no other symptoms. The dyspnea occurred about 5 h after being discharged on observation, with an uneventful postoperative course. Her electrocardiogram and chest X-ray findings were unremarkable. On testing, troponin I and creatine kinase myocardial band levels were elevated at 6.122 ng/mL and 11.2 µg/L (reference ranges: 0.000–0.046 ng/mL and 0.0–5.0 µg/L), respectively. Bedside echocardiography revealed an ejection fraction of 25%, with mid-ventricular and apical akinesia and basal hyperkinesia. The pulmonary and coronary angiographic computed tomographic scans were unremarkable. Hence, apical Takotsubo syndrome was suspected. A follow-up echocardiogram taken 5 days after admission showed full recovery with a normalized ejection fraction (60%) and no regional wall motion abnormality. The patient was discharged on the sixth day with no other complications.

Conclusion

When atypical symptoms, such as transient dyspnea, manifest, it becomes necessary to suspect and diagnose Takotsubo syndrome to ensure timely and appropriate medical management, especially when a preceding stressful event, such as minor surgery has occurred. It might be helpful to perform bedside point-of-care echocardiography to check for regional wall motion abnormalities that are typically associated with Takotsubo syndrome.
Predictive value of qSOFA score for death in emergency department resuscitation room among adult trauma patients:a retrospective study
Authors: Huang Wenjuan , Yang Peng , Xu Feng , Chen Du
Published: September 2021

Background

To explore the predictive value of the quick Sequential Organ Failure Assessment (qSOFA) score for death in the emergency department (ED) resuscitation room among adult trauma patients.

Methods

During the period November 1, 2016 to November 30, 2019, data was retrospectively collected of adult trauma patients triaged to the ED resuscitation room in the First Affiliated Hospital of Soochow University. Death occurring in the ED resuscitation room was the study endpoint. Univariate and multivariate analyses were performed to explore the association between qSOFA score and death. Receiver operating characteristic (ROC) curve analysis was also performed for death.

Results

A total of 1739 trauma victims were admitted, including 1695 survivors and 44 non-survivors. The death proportion raised with qSOFA score: 0.60% for qSOFA = 0, 3.28% for qSOFA = 1, 12.06% for qSOFA = 2, and 15.38% for qSOFA = 3, p < 0.001. Subgroup of qSOFA = 0 was used as a reference. In univariate analysis, crude OR for death with qSOFA = 1 was 5.65 [95% CI 2.25 to 14.24, p < 0.001], qSOFA = 2 was 22.85 [95% CI 8.84 to 59.04, p < 0.001], and qSOFA = 3 was 30.30 [95% CI 5.50 to 167.05, p < 0.001]. In multivariate analysis, with an adjusted OR (aOR) of 2.87 (95% CI 0.84 to 9.87, p = 0.094) for qSOFA = 1, aOR 6.80 (95% CI 1.79 to 25.90, p = 0.005) for qSOFA = 2, and aOR 24.42 (95% CI 3.67 to 162.27, p = 0.001) for qSOFA = 3. The Area Under the Curve (AUC) for predicting death in the ED resuscitation room among trauma patients was 0.78 [95% CI, 0.72–0.85].

Conclusions

The qSOFA score can assess the severity of emergency trauma patients and has good predictive value for death in the ED resuscitation room.
Trauma-informed care in geriatric inpatient units to improve staff skills and reduce patient distress: a co-designed study protocol
Authors: Cations Monica , Laver Kate , Couzner Leah , Flatman Stephen , Bierer Petra , Ames Catherine , Huo Yan , Whitehead Craig
Published: September 2021

Background

Geriatric hospital wards are highly medicalised environments with limited opportunities for choice and control, and can be distressing for older survivors of psychological trauma. While trauma-informed models of care (TIC) are effectively applied across mental health and other settings, the utility of these models in aged care settings has not been assessed. The objective of this study was to examine whether TIC can reduce responsive behaviour, chemical restraint, and improve staff skills and patient experiences in inpatient geriatric settings.

Methods

Four wards participated in this type I hybrid implementation-effectiveness study across southern Adelaide, Australia, including 79 beds. Using a co-design method, the principles of TIC were transformed into an implementation strategy including staff training, establishment of highly trained ‘champions’ on each ward, screening for trauma-related needs, and amending ward policies and procedures. Primary outcomes will be examined using an interrupted time-series design and are monthly incidence of responsive behaviour incidents and use of chemical restraint. Process evaluation will be used to examine secondary, implementation outcomes including the acceptability, feasibility, and fidelity to the implementation strategy.

Discussion

Trauma-informed care has potential to improve the safety and accessibility of hospital wards for older people who have survived psychologically traumatic events and has an extensive evidence base supporting its effectiveness in other settings. Identifying trauma-related needs and amending care to reduce the risk of re-traumatisation and distress may also reduce the incidence of responsive behaviour change, which has a significant impact on the quality of life of hospital patients and staff and is very costly. The inclusion of a process evaluation will allow us to identify and report changes made on each ward and make recommendations for future implementation efforts.
Detection and treatment of cerebral toxoplasmosis in an aplastic pediatric post-allogeneic hematopoietic cell transplant patient: a case report
Authors: Brewer Danielle , MacMillan Margaret L. , Schleiss Mark R. , Ayuthaya Satja Issaranggoon Na , Young Jo-Anne , Ebens Christen L.
Published: September 2021

Background

Cerebral toxoplasmosis infection presents with non-specific neurologic symptoms in immunocompromised patients. With lack of measurable adaptive immune responses and reluctance to sample affected brain tissue, expedient diagnosis to guide directed treatment is often delayed.

Case presentation

We describe the use of cerebrospinal fluid polymerase chain reaction and plasma cell-free DNA technologies to supplement neuroimaging in the diagnosis of cerebral toxoplasmosis in an immunocompromised pediatric patient following allogeneic hematopoietic cell transplantation for idiopathic severe aplastic anemia. Successful cerebral toxoplasmosis treatment included antibiotic therapy for 1 year following restoration of cellular immunity with an allogeneic stem cell boost.

Conclusions

Plasma cell-free DNA technology provides a non-invasive method of rapid diagnosis, improving the likelihood of survival from often lethal opportunistic infection in a high risk, immunocompromised patient population.
I can’t count, but I can beat you playing cards: a case report on autoimmune encephalitis
Authors: Mori Laura , Campanella William , Vestito Lucilla , Marinelli Lucio , Benedetti Luana , Cocito Leonardo , Trompetto Carlo
Published: September 2021

Background

Autoimmune encephalitis (AE) is a rare inflammatory disorder characterized by important psychiatric and neurologic symptoms. The literature documents high rates of neuropsychological dysfunction in N-methyl D-aspartate-receptor (NMDAr) encephalitis but papers don’t consider specifically calculation disturbances between the long-term deficits, although deficits in executive control and episodic memory were less likely to resolve.

Case report

Here we present a severe case of NMDAr encephalitis in a young patient without a relevant past medical history. Upon first examination he presented psycho-motor slowdown, speech disorders, severe cognitive deficits in all areas: concentration, attention, memory, language, dual task functions, increased latency in responses, severe dyscalculia. Upon first evaluation, the young patient underwent a battery of neuropsychological tests and he showed a dysexecutive syndrome with performances significantly low for age and education. Our patient hence underwent 1 month of intensive cognitive rehabilitation. After the rehabilitation treatment, he presented an amelioration in all domains except calculations.

Conclusions

In our patient the calculation disorder has proved to be the most relevant problem and the most difficult to treat. Clinicians should consider a careful approach to determine the prognosis of this syndrome because of the wide range of deficits, the need of prolonged treatment and the rate of long-term sequelae.
Overlapping syndrome mimicking infectious meningoencephalitis in a patient with MOG and GFAP IgG
Authors: Ji Suqiong , Liu Chenchen , Bi Zhuajin , Gao Huajie , Sun Jian , Bu Bitao
Published: September 2021

Background

Central nervous system overlapping autoimmune syndromes are uncommon, especially with the coexistence of MOG-IgG and GFAP-IgG.

Case presentation

A 23-year-old woman presented with transient convulsions, a loss of consciousness, persistent fever, headache, and vomiting. Cerebrospinal fluid (CSF) analysis revealed elevated cellularity, and magnetic resonance imaging (MRI) showed diffuse leptomeningeal enhancement. She had fever and headache with antiviral and antibiotic treatment for 2 weeks, and she had empirical anti-tuberculosis treatment and oral prednisolone therapy. She was followed for 3 months after presentation with improved symptoms and normal CSF analysis. A 3-month follow-up MRI showed asymmetric lesions in the cerebellum, corona radiata, and white matter with enhancement. The anti-tuberculosis treatment was continued, and steroid therapy was discontinued. After she stopped taking prednisolone, an interrupted headache gradually appeared. MRI at 4 months after presentation revealed a partial reduction in lesions but enlarged areas in the left cerebellum and right parietal white matter and a new lesion in the region of the right ependyma with linear enhancement. Her CSF was positive for anti-myelin oligodendrocyte glycoprotein (MOG) and anti-glial fibrillary acidic protein (GFAP) antibodies using a transfected cell-based assay. She was diagnosed with overlapping syndrome of MOG‑IgG‑associated disease and GFAP astrocytopathy. She received steroid pulse therapy (methylprednisolone, 1 g for 5 days), followed by a gradual tapering of oral prednisolone and the addition of an immunosuppressant (tacrolimus, 3 mg per day). Six months after the initial presentation, she had no symptoms. An MRI showed that the lesions had diminished, and no enhancement was found.

Conclusions

We report a case that was positive for double antibodies, which was initially misdiagnosed as infectious meningoencephalitis. This case broadens the clinical and phenotypic presentation of the overlapping syndrome spectrum.
The role of Magnetic Resonance Images (MRIs) in coping for patients with brain tumours and their parents: a qualitative study
Authors: Tyldesley-Marshall Natalie , Greenfield Sheila , Neilson Susan J. , English Martin , Adamski Jenny , Peet Andrew
Published: September 2021

Background

When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs).

Methods

Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method.

Results

Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: ‘Normalising’; ‘Maintaining hope and a sense of the future’; ‘Dealing with an uncertain future’; and ‘Seeking Support’.

Conclusions

Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping.

MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or ‘better’ place than they have been previously.