bluuebunny/crossref_metadata_2025 huggingface dataset:
History and Theory of Knowledge Production
Authors: Gurukkal Rajan
Published: March 2019

This book seeks to provide an introductory outline of the history and theory of knowledge production, notwithstanding the vastness of the subject. It is to try and do a history of intellectual formation or history of ideas. One can see it as a textbook of historical epistemology, which in spatio-temporal terms historicizes knowledge production and contextualizes methodological development. It addresses itself as the historical process of the social constitution of knowledge, that is, the social history of the making of knowledge. Its objective is to make researchers of knowledge knowledgeable about the significant elements that underlie the history of knowledge. These elements constitute contemporary compulsions that make, shape, and regulate knowledge. Understanding what they mean and how they work is essential to prepare researchers as self-consciously realistic about the socio-economic and cultural process of knowledge production. What forces engender knowledge, how certain forms of it acquire precedence over the rest, and why are questions examined. Who decides what knowledge means or what should be recognized as knowledge becomes important here. We confine the discussion of knowledge systems to the broad heads, namely, the non-European, specifically the Indian and the European. Examining the process of the rise of science and new science, the book ends up reviewing speculative thoughts and imagination about the dynamics of subatomic micro-universe as well as the mechanics of the galactic macro-universe.
Introduction
Authors: Gurukkal Rajan
Published: March 2019

It is the introductory chapter that seeks to explain the need to theorize the history of knowledge production through an overview of the compelling features that necessitate theorization. It points out the landmarks in the history of knowledge production during the hoary past. A brief discussion of the methodological preoccupation, the theory of social formation as the central framework, and a chapter-wise outline is given.
Knowledge Production
Authors: Gurukkal Rajan
Published: March 2019

The chapter traces the non-European roots of specialized knowledge production in the ancient times as illustrated by the civilizations of the Indian and the Chinese regions. Examining the archaeology and ethno-archaeology of remains of the civilizations in the valleys of the Indus and Yellow rivers, we try and capture the earliest knowledge in crafts production technology such as architecture, metallurgy, lapidary, and ceramics. Orally transmitted Vedic knowledge, eschatology, metaphysics, grammar, phonetics, astronomy, the post-Vedic systems of thought, Ayurvedic knowledge, architecture, nature of metallurgical texts, the Indian and Chinese textual traditions, and epistemological traces constitute other contents of the chapter. This chapter underscores the early India’s methodologically distinct aphoristic structure of stating truth as astute observations generalized as self-validated principles, the logic of which corresponds to that of mathematical equations or formulas. It discusses the history of mathematical astronomy. A distinct epistemic shift is explicit in India’s astronomy of fourteenth to sixteenth centuries CE. Mādhava of Sangamagrāma (c. 1340–1425 CE) in Kerala marks the beginnings of this shift through his path-breaking mathematical advances in conceptualizing infinite series. The chapter ends with a concise discussion of the Chinese history of knowledge systems across the material cultures
The Rise of Science
Authors: Gurukkal Rajan
Published: March 2019

A review of knowledge production in the Age of Renaissance, impetus of great intellectuals like Roger Bacon, growth of natural philosophy of Copernicus, Galileo, Francis Bacon, Descartes, and Newton on contemporary knowledge production; and the making of the Age of Enlightenment constitute the fifth chapter. How Newton’s theories of objects, position, relations, dynamic, and velocity went into the making of a new field of knowledge called mechanics in Natural Philosophy, explaining the fundamental laws of the motion of bodies under the action of forces, became the hegemonic model for the centuries that succeeded, is the core of the chapter. It shows how the Newtonian inductive theorization of absolute space as independent of objects and of the universal time revolutionized the entire domain of knowledge and became the epochal model.
How Words Make Things Happen
Authors: Bromwich David
Published: March 2019

Sooner or later, our words take on meanings other than we intended. How Words Make Things Happen suggests that the conventional idea of persuasive rhetoric (which assumes a speaker’s control of calculated effects) and the modern idea of literary autonomy (which assumes that “poetry makes nothing happen”) together have produced a misleading account of the relations between words and human action. Words do make things happen. But they cannot be counted on to produce the result they intend. The argument is enriched by examples from speakers and writers of various sorts, with close readings of the quoted passages. Chapter 1 considers the theory of speech acts propounded by J. L. Austin. “Speakers Who Convince Themselves” is the subject of Chapter 2, which interprets two soliloquies by Shakespeare’s characters, two by Milton’s Satan, and a character’s inward meditation in a novel by Henry James. The oratory of Burke and Lincoln comes in for extended treatment in Chapter 3, while Chapter 4 looks at the rival tendencies of moral suasion and aestheticism in the poetry of Yeats and Auden. The final chapter, a cause of controversy when first published in the London Review of Books, supports a policy of unrestricted free speech against contemporary proposals of censorship. Since we cannot know what our own words are going to do, we have no standing to justify the banishment of one set of words in favour of another.
Speakers Who Convince Themselves
Authors: Bromwich David
Published: March 2019

It is a common occurrence, too little remarked on, that speakers (with or without an audience) work with words in order to convince themselves. Characters in fiction may not consciously trace a path of persuasion, but great writers are adroit at doing so. Shakespeare, for example, in the soliloquies by Brutus in Julius Caesar and Angelo in Measure for Measure; Milton in the speeches of Satan in Books I and V of Paradise Lost; and Henry James in the recognition scene in the mind of Isabel Archer in The Portrait of a Lady. The train of thought of a speaker may afford a clue—by means of language that inseparably mixes motives with reasons—to the definiteness and the elusiveness of personal character.
Pledging Emotion for Conviction
Authors: Bromwich David
Published: March 2019

A usual idea of persuasion involves the spread of contagious emotion from speaker to listener. We know that this happens, from introspection and third-person reports. A less obvious feature of persuasion may be the speaker’s identification of himself or herself as the bearer of a conviction adequate to impassioned words. Adam Smith’s Theory of Moral Sentiments offers a definition of judicious sympathy at a distance, appropriate to our social nature, but this ought to be modified in view of Walter Bagehot’s insight regarding “the emotion of conviction.” Examples from Lincoln and Burke show that the repression of emotion in the speaker, dramatically exhibited, may have an effect greater than a deliberate appeal to named emotions such as anger, fear, and grief.
Feminist Dialogues on International Law
Authors: Heathcote Gina
Published: March 2019

Reflecting on recent gender law reform within international law, this book examines the nature of feminist interventions to consider what the next phase of feminist approaches to international law might include. To undertake analysis of existing gender law reform and future gender law reform, the book engages critical legal inquiries on international law on the foundations of international law. At the same time, the text looks beyond mainstream feminist accounts to consider the contributions, and tensions, across a broader range of feminist methodologies than has been adapted and incorporated into gender law reform including transnational and postcolonial feminisms. The text therefore develops dialogues across feminist approaches, beyond dominant Western liberal, radical, and cultural feminisms, to analyse the rise of expertise and the impact of fragmentation on global governance, to study sovereignty and international institutions, and to reflect on the construction of authority within international law. The book concludes that through feminist dialogues that incorporate intersectionality, and thus feminist dialogues with queer, crip, and race theories, that reflect on the politics of listening and which are actively attentive to the conditions of privilege from which dominant feminist approaches are articulated, opportunity for feminist dialogues to shape feminist futures on international law emerge. The book begins this process through analysis of the conditions in which the author speaks and the role histories of colonialism play out to define her own privilege, thus requiring attention to indigenous feminisms and, in the UK, the important interventions of Black British feminisms.
Fragmentation
Authors: Heathcote Gina
Published: March 2019

Chapter 3 examines fragmentation and provides an analysis of the fragmentation of gender law reform: practically, within institutional apparatus, and substantively, through the segregation of diverse currents within feminist and gender theories from the developments that have materialised within international law. This is a departure from the existing feminist critiques of ‘governance feminism’, focusing instead on understanding of the structural limitations of international law as vital to any critique of feminist ‘successes’. Thus, chapter 3 demonstrates the need to appreciate the role fragmentation within international law and the global order plays in constraining the potential for inclusion of diverse feminist approaches in a system which mitigates against the very possibility of structural change at the level required. The chapter concludes by emphasising a diversity of feminist approaches as necessary for feminist dialogues and as leverage for a transformative feminist politics and ethics within international law.
The Qur’an and Scripture
Authors: Neuwirth Angelika
Published: March 2019

This chapter provides a study of the Qur’an’s self-presentation as a revealed and proclaimed text. The concepts of “writing” (kitāb) as well as the various terms used within the Qur’an to refer to revelation and the proclaimer’s delivery of scripture are discussed, and the relevant Qur’anic texts are studied. This leads to a discussion of the somewhat controversial concept of “inlibration,” or the supposed becoming-book of the text. The resulting image of the self-understanding of the Qur’an as text is a complex one, in which the self-conceptions of earlier scriptures are adapted to the pre-Islamic Arabian conceptual area.
Sura Structures and Chronology
Authors: Neuwirth Angelika
Published: March 2019

This chapter lays out the criteria for the chronological arrangement of the suras that will be followed in the rest of the book. It argues critically for upholding the basic chronology first set out by Nöldeke at the end of the nineteenth century, providing detail on the textual and rhetorical qualities used to define the chronological development of the text. It also provides an overview of the structural qualities of the sura as a genre, and of the verbal features characteristics of the successive stages of the text’s development.
Stages of Communal Formation in the Middle and Late Meccan Periods
Authors: Neuwirth Angelika
Published: March 2019

This chapter focuses on the process of communal formation in the middle and late Meccan time and the way the Qur’an reflects this process. This involves the construction of a “text world” whereby the stories of “God’s people” are told in relation to their predecessors among the earlier religious communities of the Jews and the Christians, as well as the emergence of anti-pagan polemic as a major theme in the proclamation. It also involves the alteration of existing mythic narrative paradigms and the emergence of new homiletic instruments, namely, the usage of parables and the distinctive Qur’anic simile or “likeness,” the mathal.
Stages of Communal Formation in Medina
Authors: Neuwirth Angelika
Published: March 2019

This chapter presents the final stage of “communal formation” reflected in the Qur’an, which occurred during the Medinan period. During this period, through processes involving the insertion of texts within existing proclamations from the Meccan period, concepts such as the “discovery of God’s wrath” and the “discovery of ambiguity in the divine scripture” come to the fore. Furthermore, Mecca again becomes the focus of communal ritual, after that focus had strayed toward Jerusalem. Finally, in this chapter the Qur’anic conception of martyrdom is discussed in relation to its monotheistic precedents.
The Rhetorical Qur’an
Authors: Neuwirth Angelika
Published: March 2019

This chapter examines the notion that the Qur’an is a document of an “age of rhetoric,” showing the ways in which the Qur’an uses rhetorical means to present a convincing and novel statement in relation to previous texts and credos. This includes a view to the early reception of the Qur’an in terms of the concept of its “incapacitating” rhetoric, which was highlighted in the early reception history, and also shows the ways in which the rhetorical structures of earlier creeds are incorporated and “overcome” in particular ways in the Qur’an. This shows how the Qur’an and the community around it developed within a Late Antique milieu.
Extracellular vesicles reveal abnormalities in neuronal iron metabolism in restless legs syndrome
Authors: Chawla Sahil , Gulyani Seema , Allen Richard P , Earley Christopher J , Li Xu , Van Zijl Peter , Kapogiannis Dimitrios
Published: March 2019

Study Objectives

Determine abnormalities in levels of iron-management proteins in neuronal origin-enriched extracellular vesicles (nEVs) in restless legs syndrome (RLS).

Methods

We used immunoprecipitation for neuronal marker L1CAM to isolate nEVs from the serum of 20 participants with RLS from a study including magnetic resonance imaging (MRI) determinations of iron deposition in the substantia nigra and hematologic parameters and 28 age- and sex-matched Controls.

Results

RLS compared with Control participants showed higher levels of nEV total ferritin but similar levels of transferrin receptor and ferroportin. Western blot analysis showed that heavy- but not light-chain ferritin was increased in nEVs of RLS compared with Control participants. In RLS but not Control participants, nEV total ferritin was positively correlated with systemic iron parameters; the two groups also differed in the relation of nEV total ferritin to MRI measures of iron deposition in substantia nigra.

Conclusions

Given the neuronal origin and diversity of EV cargo, nEVs provide an important platform for exploring the underlying pathophysiology and possible biomarkers of RLS.
Multisectoral approaches for the control of vector-borne diseases, with particular emphasis on dengue and housing
Authors: Horstick Olaf , Runge-Ranzinger Silvia
Published: March 2019

The Sustainable Development Goals suggest an intersectoral approach for development and health, including for vector-borne diseases. Evidence-based policy recommendations exist for malaria and housing, but not for other, more underfunded, vector-borne diseases. This review aims to stimulate the process for developing policy recommendations for other vector-borne diseases and housing with the process as it was developed for dengue and Aedes control as an example and with suggestions for steps necessary for other vector-borne diseases. For dengue, some basic research on the efficacy of vector control in relation to housing exists, summary evidence highlights the lack of evidence and efficacy and policy recommendations remain difficult. For other vector-borne diseases, few studies have focused on protecting the house, combinations of effective interventions (e.g. intradomiciliary residual spraying, insecticide-treated materials and treatment of larval habitats with biological and chemical methods, which have proven to be effective) have not been studied and summary evidence is non-existent. In order to recommend vector control to protect the house against vector-borne diseases, basic research and summary evidence are needed, with an appropriate combination of the most efficacious interventions and linked to improvement of housing itself. Standards for such studies need to be developed.
Identification of Resistant Cultivars for Sheath Blight and use of AMMI Models to Understand Genotype and Environment Interactions
Authors: Persaud Rajendra , Saravanakumar Duraisamy , Persaud Mahendra
Published: March 2019

One hundred and one rice genotypes were evaluated for response to sheath blight disease under greenhouse and lowland irrigated field conditions in Guyana. The level of resistance varied from highly resistant to resistant in 14 genotypes over five experimental trials. These genotypes were also observed with low area under the disease progress curve values and slow blighting reactions against artificial inoculation of the pathogen. Genotypes GR1568-31-9-1-1-2-1 and cultivar Rustic had susceptible reactions in all experiments. Additive main effect and multiplicative interaction analysis was used to study the genotype and environment interactions. The analysis revealed that 52.98% of the total sum of square was attributed to genotype effect, 7.50% was attributable to environment effect, and 39.52% was attributable to genotype by environment interaction (G × E) effects. The G × E was almost as large as the genotype effect, thus indicating significant differences of genotypes across the testing environments. This revealed that resistance was slightly influenced by the G × E. The genotypes that showed stable resistance in all environments in this study could be used for breeding the sheath blight resistance in rice.
Survivals of the Intraoperative Motor-evoked Potentials Response in Pediatric Patients Undergoing Spinal Deformity Correction Surgery
Authors: Wang Shujie , Li Chaoxiong , Guo Lanjun , Hu Haimei , Jiao Yang , Shen Jianxiong , Tian Ye , Zhang Jianguo
Published: March 2019

Study Design.

This is a retrospective cases study from a prospective patient register.

Objective.

To clarify the clinical implication regard to the survivals of motor-evoked potential (MEP) response.

Summary of Background Data.

Intraoperative neurophysiological monitoring has become an essential component for decreasing the incidence of neurological deficits during spine surgeries. Significant motor-evoked potential (MEP) loss but does not vanish completely is common especially in some high-risk and complicated pediatric spine deformity surgeries.

Methods.

A total of 1820 young patients (mean age = 12.2 years) underwent spinal deformity correction were mainly analyzed. Intraoperative monitoring (somatosensory-evoked potential, MEP, free-run electromyography, free-run electromyography) and postoperative neurologic outcomes were mainly analyzed in this study. All patients with monitoring alerts were divided into two groups: group 1, intraoperative MEP recovery group; and group 2, no obvious MEP recovery group. Moreover, the patients would be followed up strictly if he/she showed IOM alerting. The surviving MEP response was identified as significant monitoring alerts (80%–95% MEP Amp. loss) associated with high-risk surgical maneuvers.

Results.

The results showed that there were 32 pediatric patients (group 1, 21 cases and group 2, 11 cases) presenting significant MEP monitoring alerts (80%–95% loss) relative to baseline. The patients in group 1 presented the partial/entire signal recovery from MEP alerts and they did not show spinal cord deficits postoperation. The patients in group 2 without obvious intraoperative MEP recovery showed different levels of new spinal deficits, no patient showed postoperative complete paraplegia or permanent spinal cord/nerve root deficits.

Conclusion.

When the intraoperative MEP changes significant and persistent but without totally disappeared, the rate of postoperative neural complication is relatively low. The chance of recovery of these neurological deficits is very high. Therefore, this phenomenon may be used to predictive of nonpermanent paraplegia.

Level of Evidence: 3
Health Care Costs and Opioid Use Associated With High-impact Chronic Spinal Pain in the United States
Authors: Herman Patricia M. , Broten Nicholas , Lavelle Tara A. , Sorbero Melony E. , Coulter Ian D.
Published: March 2019

Study Design.

A descriptive analysis of secondary data.

Objective.

The aim of this study was to estimate health care costs and opioid use for those with high-impact chronic spinal (back and neck) pain.

Summary of Background Data.

The US National Pain Strategy introduced a focus on high-impact chronic pain—that is, chronic pain associated with work, social, and self-care restrictions. Chronic neck and low-back pain are common, costly, and associated with long-term opioid use. Although chronic pain is not homogenous, most estimates of its costs are averages that ignore severity (impact).

Methods.

We used 2003 to 2015 Medical Expenditures Panel Survey (MEPS) data to identify individuals with chronic spinal pain, their health care expenditures, and use of opioids. We developed prediction models to identify those with high- versus moderate- and low-impact chronic spinal pain based on the variables available in MEPS.

Results.

We found that overall and spine-related health care costs, and the use and dosage of opioids increased significantly with chronic pain impact levels. Overall and spine-related annual per person health care costs for those with high-impact chronic pain ($14,661 SE: $814; and $5979 SE: $471, respectively) were more than double that of those with low-impact, but still clinically significant, chronic pain ($6371 SE: $557; and $2300 SE: $328). Those with high-impact chronic spinal pain also use spine-related opioids at a rate almost four times that of those with low-impact pain (48.4% vs. 12.4%), and on average use over five times the morphine equivalent daily dose (MEDD) in mg (15.3 SE: 1.4 vs. 2.7 SE: 0.6). Opioid use and dosing increased significantly across years, but the increase in inflation-adjusted health care costs was not statistically significant.

Conclusion.

Although most studies of chronic spinal pain do not differentiate participants by the impact of their chronic pain, these estimates highlight the importance of identifying chronic pain levels and focusing on those with high-impact chronic pain.

Level of Evidence: 3
Health Insurance and Out-of-Pocket Costs in the Last Year of Life Among Decedents Utilizing the ICU
Authors: Khandelwal Nita , White Lindsay , Curtis J. Randall , Coe Norma B.
Published: March 2019

Objectives:

Use of intensive care is increasing in the United States and may be associated with high financial burden on patients and their families near the end of life. Our objective was to estimate out-of-pocket costs in the last year of life for individuals who required intensive care in the months prior to death and examine how these costs vary by insurance coverage.

Design:

Observational cohort study using seven waves of post-death interview data (2002–2014).

Participants:

Decedents (n = 2,909) who spent time in the ICU at some point between their last interview and death.

Interventions:

None.

Measurements and Main Results:

Two-part models were used to estimate out-of-pocket costs for direct medical care and health-related services by type of care and insurance coverage. Decedents with only traditional Medicare fee-for-service coverage have the highest out-of-pocket spending in the last year of life, estimated at $12,668 (95% CI, $9,744–15,592), second to only the uninsured. Medicare Advantage and private insurance provide slightly more comprehensive coverage. Individuals who spend-down to Medicaid coverage have 4× the out-of-pocket spending as those continuously on Medicaid.

Conclusions:

Across all categories of insurance coverage, out-of-pocket spending in the last 12 months of life is high and represents a significant portion of assets for many patients requiring intensive care and their families. Medicare fee-for-service alone does not insulate individuals from the financial burden of high-intensity care, due to lack of an out-of-pocket maximum and a relatively high co-payment for hospitalizations. Medicaid plays an important role in the social safety net, providing the most complete hospital coverage of all the insurance groups, as well as significantly financing long-term care.
Prognostic Value of Glial Fibrillary Acidic Protein in Patients With Moderate and Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis
Authors: Shemilt Michèle , Boutin Amélie , Lauzier François , Zarychanski Ryan , Moore Lynne , McIntyre Lauralyn A. , Nadeau Linda , Fergusson Dean A. , Mercier Eric , Archambault Patrick , Lamontagne François , Perron Caroline , Léger Caroline , Turgeon Alexis F.
Published: March 2019

Objectives:

Biomarkers have been suggested as potential prognostic predictors following a moderate or severe traumatic brain injury but their prognostic accuracy is still uncertain. The objective of this systematic review is to assess the ability of the glial fibrillary acidic protein to predict prognosis in patients with moderate or severe traumatic brain injury.

Data Sources:

MEDLINE, Embase, CENTRAL, and BIOSIS electronic databases and conference abstracts, bibliographies of selected studies, and narrative reviews were searched.

Study Selection:

Pairs of reviewers identified eligible studies. Cohort studies including greater than or equal to four patients with moderate or severe traumatic brain injury and reporting glial fibrillary acidic protein levels according to the outcomes of interest, namely Glasgow Outcome Scale or Extended Glasgow Outcome Scale, and mortality, were eligible.

Data Extraction:

Pairs of reviewers independently extracted data from the selected studies using a standardized case report form. Mean levels were log-transformed, and their differences were pooled with random effect models. Results are presented as geometric mean ratios. Methodologic quality, risk of bias, and applicability concerns of the included studies were assessed.

Data Synthesis:

Seven-thousand seven-hundred sixty-five citations were retrieved of which 15 studies were included in the systematic review (n = 1,070), and nine were included in the meta-analysis (n = 701). We found significant associations between glial fibrillary acidic protein serum levels and Glasgow Outcome Scale score less than or equal to 3 or Extended Glasgow Outcome Scale score less than or equal to 4 (six studies: geometric mean ratio 4.98 [95% CI, 2.19–11.13]; I
2 = 94%) and between mortality (seven studies: geometric mean ratio 8.13 [95% CI, 3.89–17.00]; I
2 = 99%).

Conclusions:

Serum glial fibrillary acidic protein levels were significantly higher in patients with an unfavorable prognosis. Glial fibrillary acidic protein has a potential for clinical bedside use in helping for prognostic assessment. Further research should focus on multimodal approaches including tissue biomarkers for prognostic evaluation in critically ill patients with traumatic brain injury.
The evolving role of diet in prostate cancer risk and progression
Authors: Kaiser Adeel , Haskins Christopher , Siddiqui Mohummad M. , Hussain Arif , D’Adamo Christopher
Published: March 2019

Purpose of review

This overview examines the rationale for dietary interventions for prostate cancer by summarizing the current evidence base and biological mechanisms for the involvement of diet in disease incidence and progression.

Recent findings

Recent data have further solidified the association between insulin resistance and prostate cancer with the homeostatic model assessment of insulin resistance. Data also show that periprostatic adipocytes promote extracapsular extension of prostate cancer through chemokines, thereby providing a mechanistic explanation for the association observed between obesity and high-grade cancer. Regarding therapeutics, hyperinsulinemia may be the cause of resistance to phosphatidylinositol-3 kinase inhibitors in the treatment of prostate cancer, leading to new investigations combining these drugs with ketogenic diets.

Given the recently available data regarding insulin resistance and adipokine influence on prostate cancer, dietary strategies targeting metabolic syndrome, diabetes, and obesity should be further explored. In macronutrient-focused therapies, low carbohydrate/ketogenic diets should be favored in such interventions because of their superior impact on weight loss and metabolic parameters and encouraging clinical data. Micronutrients, including the carotenoid lycopene which is found in highest concentrations in tomatoes, may also play a role in prostate cancer prevention and prognosis through complementary metabolic mechanisms. The interplay between genetics, diet, and prostate cancer is an area of emerging focus that might help optimize therapeutic dietary response in the future through personalization.
Molecular genetics of head and neck squamous cell carcinoma
Authors: Saada-Bouzid Esma , Peyrade Frederic , Guigay Joël
Published: March 2019

Purpose of review

The aim of this review is to summarize the current knowledge on the genomic characterization of squamous cell carcinomas of the head and neck (HNSCC) and discusses how these abnormalities could be incorporated into a therapeutic approach.

Recent findings

Tobacco and HPV infection, the two main risk factors of HNSCC, allow the definition of two groups with distinct anatomoclinical and genetic features. As tobacco and HPV infection are not exclusive, exposure to both risk factors is associated with an intermediate prognostic. HPV-positive, nontobacco-related HNSCCs are associated with a better prognosis, a rather more simple genomic profile, frequent activating mutations of genes involved in pi3kinase pathway, and the very low incidence of mutations of tumor suppressor genes. HPV-negative, tobacco-related HNSCC are genetically more complex. HPV-negative HNSCC are characterized by almost mandatory inactivating mutations/deletions of tumor suppressor genes (especially TP53 and CDKN2A) and the occurrence, though less frequent, of activating mutations or amplifications of some oncogenes that encode for cell cycle proteins or receptors with tyrosine kinase activity. Despite many efforts to improve therapeutic targeting in RM HNSCC, Cetuximab, a monoclonal antibody targeting REGF, remains the sole approved targeted treatment in RM HNSCC.

Despite the increasingly precise genomic characterization of HNSCCs, precision medicine is struggling to find its place in the management of HNSCCs. Inclusion of enriched populations in dedicated trials is likely to help implement precision medicine in the management of HNSCCs.
A case report of the rare fifteen-and-a-half syndrome
Authors: Li Mengmeng , Li Xuan , Liu Lina , Zhu Mingsu , Lu Dandan , Wang Pei
Published: March 2019

Rationale:

The dorsal tegmentum of the caudal pons, including the medial longitudinal fasciculus (MLF), the paramedian pontine reticular formation (PPRF), abducens nucleus, and the adjacent facial nerve is the anatomical basis of the the fifteen and a half syndrome (15½) syndrome. No patients of 15½ Syndrome presenting with bilateral peripheral facial paralysis and one-and-a-half simultaneously at the onset have been reported up to now.

Patient concerns:

A 54-year-old woman complained of diplopia, slurred speech, and slightly distal numbness of the left upper limb for 4 days in our hospital.

Diagnoses:

The diffusion weighted image (DWI) and apparent dispersion coefficient (ADC) of MRI revealed the causative lesion in pons including bilateral pontine tegmentum and a narrow lesion along the midline in the right of the pons. Her clinical manifestations with results of MRI resulted in the diagnosis of the fifteen-and-a-half-syndrome.

Interventions:

The patient received antiplatelet aggregation, plaque stabilization, free radicals elimination, circulation improvement, nerves nourishment, and other symptomatic treatments.

Outcomes:

Two months later, her ocular movement recovered, and the bilateral facial paresis showed some improvement.

Lessons:

First, our patient with 15½ syndrome maybe one of mutants whose bilateral pontine tegmentum is supplied by unilateral pontine paramedian perforator artery. Second, DWI combined with ADC may be applied in the diagnosis of fifteen-and-half syndrome when the lesions of infarction are too small to be revealed by MRI scan.
Surgical treatment of progressive cauda equina compression caused by spontaneous spinal subdural hematoma
Authors: Li Xigong , Yang Ge , Wen Zhiqiang , Lou Xianfeng , Lin Xiangjin
Published: March 2019

Rationale:

Spontaneous spinal subdural hematoma (SSDH) without an underlying pathology is a very rare condition. The treatment protocol for SSDH is early diagnosis and treatment before irreversible damage to neural tissue. However, there is no agreement on the etiopathogenesis, as well as the need for surgery to treat spontaneous SSDH. Here, we report a rare case of spontaneous SSDH with progressive deterioration and symptoms of cauda equina syndrome after ineffective conservative treatment.

Patient's concern:

A 38-year-old male patient presented with sudden lower back and bilateral leg pain.

Diagnosis:

A magnetic resonance imaging (MRI) scan on the third day after the onset of symptoms revealed a subdural hematoma from L1 to S1, presenting as hyperintensities on T1 weighted sequences and hypointensities to isointensities on T2 weighted sequences.

Intervention:

Laminectomy and subdural evacuation were performed immediately.

Outcomes:

An abnormal ligamentum flavum was observed intraoperatively. A histological examination revealed extravasation of blood in the degenerated ligamentum flavum. Postoperatively, the lower limb pain improved immediately. At the 6-month follow-up, the pain and numbness of the lower limb disappeared, and the muscle strength of both legs recovered completely with normal gait.

Lessons:

Spontaneous SSDH with ligamentum flavum hematoma was caused by a sudden increase of intravenous pressure, resulting from a marked surge in the intra-abdominal or intrathoracic pressure. Consecutive MRI scans provided valuable information, leading to a diagnosis of spontaneous SSDH. The treatment protocol for spontaneous SSDH should be determined based on the location and stage of the hematoma, as well as the subject's neurological status.
Next-generation sequencing (NGS) as a molecular diagnostic tool for hypertrophic cardiomyopathy in a Chinese boy due to novel compound heterozygous mutations in the MYBPC3 gene
Authors: Chen Xu , Jiang Jun , Zhu Weiliang , Wu Yuan , Su Maolong
Published: March 2019

Rationale:

Hypertrophic cardiomyopathy (HCM) is mainly caused by mutations in genes encoding sarcomeric proteins. One of the most commonly mutated HCM genes is the MYBPC3 gene. Mutations in this gene lead mainly to truncation of the protein, which gives rise to a relatively severe phenotype. Analyses of gene mutations associated with HCM are valuable for molecular diagnosis, genetic counseling, and management of familial HCM.

Patient concerns:

A 12-year-old boy presented with palpitations and dyspnea after exercise for 1 year. Echocardiography showed myocardial asymmetric hypertrophy of the ventricular septum, the anterior wall, and the lateral wall of the left ventricle. The thickness of the interventricular septum was estimated to be 33 mm. ECG showed left ventricular high voltage and ST-T changes. He had been diagnosed with HCM 3 months previously.

Diagnoses:

Due to his clinical presentation, he was determined to have HCM via a molecular analysis, revealing compound heterozygotes (p.R597W and p.Q1012Sfs∗8) in the MYBPC3 gene.

Interventions:

The patient was prescribed metoprolol to slow the heart rate and increase diastolic filling time.

Outcomes:

The boy was treated with metoprolol 6.75 mg b.i.d. Approximately 3 months later, review of the echocardiography showed that the peak velocity across the LVOT dropped to 2.3 m/seconds and that the pressure gradient dropped to 21 mm Hg.

Lessons:

A custom next-generation sequencing (NGS) technology for the HCM panel allowed us to identify compound heterozygous mutations in the MYBPC3 gene, confirming NGS as a molecular diagnostic tool.
Clinical features and antimicrobial susceptibility profiles of culture-proven neonatal sepsis in a tertiary children's hospital, 2013 to 2017
Authors: Li Xiaoxia , Ding Xiangyu , Shi Peng , Zhu Yiqing , Huang Yidie , Li Qin , Lu Jinmiao , Li Zhiping , Zhu Lin
Published: March 2019

Neonatal sepsis (NS) remains a major cause of morbidity and mortality in neonates, but data on the etiology and antibiotic susceptibility patterns of pathogens are limited. The aim of this study was to analyze the clinical characteristics, risk factors, and the antibiotic susceptibility patterns of pathogenic microbes associated with NS at a tertiary children's hospital in Shanghai, China.

Episodes of blood culture-proven sepsis in the neonatal intensive care unit (NICU) of Children's Hospital of Fudan University from January 2013 to August 2017 were retrospectively reviewed. Collected data included demographics, perinatal risk factors, clinical symptoms, laboratory values, microbiology results and their antimicrobial susceptibility. Data for early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS) were compared.

The 341 of 976 culture-positive cases were selected, including 161 EONS cases (47.21% of 341) and 180 LONS cases (52.79% of 341). 635 incomplete cases were excluded. There was significant difference in risk factors between the EONS group and LONS group including birth weight, gestational age, 1-minute Apgar score, respiratory support, and the use of peripherally insertion central catheter (PICC). Clinical symptoms such as fever, feeding intolerance, abdominal distension, and neonatal jaundice, and laboratory results such as hemoglobin and lymphocyte counts also showed between-group differences. Staphylococcus epidermidis (22.87%), Escherichia coli (9.68%), Alcaligenes xylosoxidans (9.38%) and Klebsiella pneumoniae (9.09%) remain the principal organisms responsible for neonatal sepsis. Most isolates of Gram-positive bacteria were sensitive to vancomycin, linezolid, minocycline and tigecycline, of which more than 90% were resistant to penicillin. Most isolates of Gram-negative bacteria were sensitive to amikacin and imipenem and resistant to ampicillin. Fungus was sensitive to antifungal agents. Better medical decisions, especially early detection and appropriate initial antimicrobial therapy can be made after understanding the different clinical features and pathogens of EONS and LONS.
Lymph node metastasis outside of a tumor-bearing lobe in primary lung cancer and the status of interlobar fissures
Authors: Li Hui , Wang Ruimin , Zhang Dexian , Zhang Yongming , Li Wanhu , Zhang Baijiang , Liu Qi , Du Jiajun
Published: March 2019

The new Tumor Node Metastasis staging system does not recognize fissure status with respect to adjacent lobe invasion (ALI) in lung cancer. Furthermore, no specific surgical strategies have been recommended for lymph node dissections around adjacent nontumor-bearing lobes (NTBLs) according to fissure status. Therefore, this study was undertaken to investigate the necessity of removing additional adjacent lobe lymph nodes in patients with nonsmall cell lung cancer (NSCLC) for lesions limited to in the vicinity of the interlobar fissure.

From August 2013 to March 2015, the records of 332 patients, who underwent systematic mediastinal lymph node dissection, were reviewed in this retrospective study. The bronchial lymph nodes had been subjected to pathological examination, and the status of the fissures was also recorded. A statistical analysis was performed to identify the significant predictors of lymph node metastasis.

The patients were divided into a nonadjacent lobe invasion (NALI) group (n = 295) and an ALI group (n = 37). There was a significant difference in tumors with pN2 disease between the ALI and NALI groups (37.8% vs 8.8%, P = .001). ALI tumors had significantly more frequent pleural involvement than NALI tumors (62.2% vs 43.1%, P = .035). The frequency of N2 involvement among tumors invading across the complete fissure was higher than that of the tumors invading across the incomplete fissure (44.4% vs 14.3%, P = .015). However, the frequency of N1 involvement among tumors invading across the incomplete fissure was not statistically different than that of tumors not invading across incomplete fissure (32.1% vs 24.2%, P = .357). Regarding lymph node metastasis in NTBL, 15 (12.7%) patients had lymph node metastases in NTBLs. Pleural involvement was an independent predictor of lymph node metastasis in an NTBL.

A greater frequency of N2 lymph nodes existed in NSCLC with invading adjacent lobe across complete fissure, extensive lymphatic resection within the hilum, and NTBL in tumors with pleural involvement are justifiable and necessary.
Removal of an infant's gastric duplication cyst through endoscopic submucosal dissection
Authors: Fang Ying , Gao Tianjiao , Yang Hongbin , Ma Shiyang , Li Quanlin , Zhou Ping-Hong
Published: March 2019

Rationale:

Gastric duplication cyst is an anomaly that primarily occurs to children. Apart from the conventional use of surgical resection, few cases using endoscopic treatment have been reported.

Patient concerns:

A 5-month-old female infant was hospitalized with the chief complaint of gastric cyst. No significant abnormalities were identified by physical examination.

Interventions:

Endoscopic submucosal dissection (ESD) was performed successfully for the infant and the duration was less than 20 minutes. The patient showed no postoperative complications.

Outcomes:

At 4 months during the follow-up, upper endoscopy revealed a small scar at the previous site of the lesion and no recurrence.

Lessons:

According to the results of PUBMED review, she was the youngest with gastric duplication cyst removed with ESD. The less invasive ESD should be considered an effective therapeutic option to remove gastric duplication cyst in children.
Cerebral embolism during edoxaban administration for venous thromboembolism in a patient with lung adenocarcinoma
Authors: Nakao Satoshi , Masuda Takeshi , Sakamoto Shinjiro , Yamaguchi Kakuhiro , Horimasu Yasushi , Miyamoto Shintaro , Nakashima Taku , Iwamoto Hiroshi , Fujitaka Kazunori , Hamada Hironobu , Hattori Noboru
Published: March 2019

Rationale:

The efficacy of direct oral anticoagulants (DOACs) in the treatment and prophylaxis of cancer-related venous thromboembolism (VTE) is reportedly similar to that of heparin. However, the effect of DOACs on the prophylaxis of cancer-related arterial thromboembolism (ATE) remains unclear. To our knowledge, we present the 1st case where cerebral ATE was encountered during edoxaban administration for VTE in a patient with lung adenocarcinoma.

Patient concerns:

In March 2017, a 63-year-old female was diagnosed with lung adenocarcinoma (cT2aN3M1b stage IVa) along with having asymptomatic VTE; thus, 60 mg/day edoxaban administration was initiated. In addition, 1st-line chemotherapy generated a partial antitumoral response. However, owing to lung cancer progression, a secondary treatment with pembrolizumab administration was initiated. The patient suddenly experienced aphasia 11 days after pembrolizumab administration.

Diagnosis:

The patient was diagnosed as multiple cerebral ATE using brain magnetic resonance imaging. However, VTE recurrence was not observed. Based on the findings of lung cancer progression and increased coagulation, cerebral ATE was diagnosed as Trousseau syndrome.

Interventions:

DOAC administration was switched to heparin administration.

Outcomes:

Coagulation profile normalized and aphasia improved without any further disease symptoms.

Lessons:

We considered that DOACs are effective for the treatment and prophylaxis of VTE but may be insufficient for ATE prevention. Therefore, DOACs should be replaced with heparin to prevent ATE when cancer and coagulation become uncontrollable with DOAC.
Effect of statins on Parkinson's disease
Authors: Yan Junqiang , Qiao Liang , Tian Jing , Liu Anran , Wu Jiannan , Huang Jiarui , Shen Mengmeng , Lai Xiaoyi
Published: March 2019

Background:

Statins have key lipid-lowering, anti-inflammatory, and anti-oxidative effects. However, it remains unclear whether statins are beneficial to patients with Parkinson's disease (PD). This study aimed to evaluate the relationship between statins and PD through a systematic review.

Methods:

This study adhered to the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Potentially relevant case-control or cohort studies published before March 2018 were identified by searching the MEDLINE (PubMed), EMBASE (OVID), CENTRAL (Cochrane Library), CNKI, WANGANG, VIP, CBM, CMCC, Clinicaltrials.gov, ProQuest, Opengray, and ISI Proceedings databases and conducting a manual search. Summarized relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed effect model. Sensitivity and subgroup analyses were also performed.

Results:

The meta-analysis included 17 studies (3,845,303 patients; 8 case-control and 9 cohort studies), including 5 articles not cited by other studies. We searched the Chinese database, but unfortunately, no Chinese literature can be included in the study. Briefly, statins could decrease the risk of PD, with a summary OR of 0.92 (95% CI: 0.86–0.99). A sensitivity analysis demonstrated the robustness of the results. Subgroup analyses revealed heterogeneity across the studies in terms of subject race, study type, reporting style, quality, statins type, and time for taking statins.

Conclusion:

Our study provides evidence that statins, especially atorvastatin, can reduce the risk of PD. Different time of statins using has different effects on PD. However, additional randomized controlled trials and observational studies are needed to confirm this conclusion.

Registration Id:

PROSPERO CRD: 42018095580