bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered immune phenotype and DNA methylation in panic disorder
Authors: Petersen Curtis L. , Chen Ji-Qing , Salas Lucas A. , Christensen Brock C.
Published: November 2020

Background

Multiple studies have related psychiatric disorders and immune alterations. Panic disorder (PD) has been linked with changes in leukocytes distributions in several small studies using different methods for immune characterization. Additionally, alterations in the methylation of repetitive DNA elements, such as LINE-1, have been associated with mental disorders. Here, we use peripheral blood DNA methylation data from two studies and an updated DNA methylation deconvolution library to investigate the relation of leukocyte proportions and methylation status of repetitive elements in 133 patients with panic disorder compared with 118 controls.

Methods and results

We used DNA methylation data to deconvolute leukocyte cell-type proportions and to infer LINE-1 element methylation comparing PD cases and controls. We also identified differentially methylated CpGs associated with PD using an epigenome-wide association study approach (EWAS), with models adjusting for sex, age, and cell-type proportions. Individuals with PD had a lower proportion of CD8T cells (OR: 0.86, 95% CI: 0.78–0.96,P-adj = 0.030) when adjusting for age, sex, and study compared with controls. Also, PD cases had significantly lower LINE-1 repetitive element methylation than controls (P < 0.001). The EWAS identified 61 differentially methylated CpGs (58 hypo- and 3 hypermethylated) in PD (Bonferroni adjustedP < 1.33 × 10–7).

Conclusions

These results suggest that those with panic disorder have changes to their immune system and dysregulation of repeat elements relative to controls.
Health-related quality of life in people with predementia Alzheimer’s disease, mild cognitive impairment or dementia measured with preference-based instruments: a systematic literature review
Authors:   on behalf of the ROADMAP consortium, Landeiro Filipa , Mughal Seher , Walsh Katie , Nye Elsbeth , Morton Jasmine , Williams Harriet , Ghinai Isaac , Castro Yovanna , Leal José , Roberts Nia , Wace Helena , Handels Ron , Lecomte Pascal , Gustavsson Anders , Roncancio-Diaz Emilse , Belger Mark , Jhuti Gurleen S. , Bouvy Jacoline C. , Potashman Michele H. , Tockhorn-Heidenreich Antje , Gray Alastair M.
Published: November 2020

Background

Obtaining reliable estimates of the health-related quality of life (HR-QoL) of people with predementia Alzheimer’s disease [AD] (preclinical or prodromal AD), mild cognitive impairment (MCI) and dementia is essential for economic evaluations of related health interventions.

Aims

To provide an overview of which quality of life instruments are being used to assess HR-QoL in people with predementia AD, MCI or dementia; and, to summarise their reported HR-QoL levels at each stage of the disease and by type of respondent.

Methods

We systematically searched for and reviewed eligible studies published between January 1990 and the end of April 2017 which reported HR-QoL for people with predementia AD, MCI or dementia. We only included instruments which are preference-based, allowing index scores/utility values to be attached to each health state they describe based on preferences obtained from population surveys. Summary results were presented by respondent type (self or proxy), type of instrument, geographical location and, where possible, stage of disease.

Health state utility values derived using the EuroQoL 5-Dimensions (EQ-5D) were meta-analysed by pooling reported results across all studies by disease severity (MCI, mild, mild to moderate, moderate, severe dementia, not specified) and by respondent (person with dementia, carer, general public, not specified), using a fixed-effects approach.

Results

We identified 61 studies which reported HR-QoL for people with MCI or dementia using preference-based instruments, of which 48 used the EQ-5D. Thirty-six studies reported HR-QoL for mild and/or moderate disease severities, and 12 studies reported utility values for MCI.

We found systematic differences between self-rated and proxy-rated HR-QoL, with proxy-rated utility valued being significantly lower in more severe disease states.

Conclusions

A substantial literature now exists quantifying the impact of dementia on HR-QoL using preference-based measures, giving researchers and modellers a firmer basis on which to select appropriate utility values when estimating the effectiveness and cost-effectiveness of interventions in this area. Further research is required on HR-QoL of people with preclinical and prodromal AD and MCI, possible differences by type of dementia, the effects of comorbidities, study setting and the informal caregiver’s own HR-QoL, including any effect of that on their proxy-ratings.
Solitary extrapleural fibrous tumor with hepatic bilobar metastases: multimodal approach treatment
Authors: Orue-Echebarria Maitane I. , Garciafília Laura , Rodriguez-Bachiller Luis , Díaz-Zorita Benjamín , Velasco Enrique , Ramón Enrique , Agra Carolina , Rodríguez Arturo Colón
Published: November 2020

Background

Solitary fibrous tumor is an unusual fibroblastic mesenchymal neoplasm typically described in the pleura. It may appear anywhere with a varied anatomic distribution and essentially it can develop from any soft tissue or visceral location. Its course is usually indolent and it rarely causes distant metastases, so it has a prolonged survival rate. It sometimes presents itself as a disseminate disease being the liver the most frequently involved location. In these occasions, the management should be discussed in a multidisciplinary tumor committee formed by surgeons, oncologists and radiologists. Surgery remains the gold standard for treatment.

Case representation

We present the case of a woman with a tumor in the left abdominal wall and bilobar massive liver metastases, both locations histologically diagnosed as solitary fibrous tumor. She receives biological treatment for a severe case of Crohn´s disease. Evaluated in a multidisciplinary committee, surgery was recommended for both the primary lesion and the liver metastases. The hepatobiliary surgeons considered a two-stage hepatectomy with portal vein embolization (PVE) as the best strategy. After the first procedure consisting in cleaning the left hepatic lobe followed by PVE the future liver remnant volume (FLRV) was considered inadequate, so the patient was also treated with right transarterial radioembolizacion with yttrium 90 (TARE-Y90) intending a double goal: to treat the tumor and to increased the FLRV. Furthermore, a severe flare of Crohn´s disease forced us to intensify the patient’s treatment with the addition of biological agents (infliximab and adalimumab) until complete remission of the symptoms. The second stage of the liver surgery had to be postponed for more than 6 months and could finally be carried out without complications, achieving an R0 resection. The postoperative course was uneventful and the follow up has showed no recurrence to date.

Conclusion

Solitary fibrous tumours with extensive liver metastases are infrequent but when they appear modern surgical strategies like two stage hepatectomy are the treatment of choice and must be carried out by specialised units. The therapeutic decisions should be guided by a multidisciplinary committee.
Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study
Authors: Schittek Gregor A. , Zoidl Philipp , Eichinger Michael , Orlob Simon , Simonis Holger , Rief Martin , Metnitz Philipp , Fellinger Tobias , Soukup Jens
Published: November 2020

Background

Haemoadsorption has been described as an effective way to control increased pro- and anti-inflammatory mediators (“cytokine storm”) in septic shock patients. No prospective or randomised clinical study has yet confirmed these results. However, no study has yet prospectively specifically investigated patients in severe septic shock with sepsis-associated acute kidney injury (SA-AKI). Therefore, we aimed to examine whether haemoadsorption could influence intensive care unit (ICU) and hospital mortality in these patients. Furthermore, we examined the influence of haemoadsorption on length of stay in the ICU and therapeutic support.

Methods

Retrospective control group and prospective intervention group design in a tertiary hospital in central Europe (Germany). Intervention was the implementation of haemoadsorption for patients in septic shock with SA-AKI. 76 patients were included in this analysis.

Results

Severity of illness as depicted by APACHE II was higher in patients treated with haemoadsorption. Risk-adjusted ICU mortality rates (O/E ratios) did not differ significantly between the groups (0.80 vs. 0.83). We observed in patients treated with haemoadsorption a shorter LOS and shorter therapeutic support such as catecholamine dependency and duration of RRT. However, in multivariate analysis (logistic regression for mortality, competing risk for LOS), we found no significant differences between the two groups.

Conclusions

The implementation of haemoadsorption for patients in septic shock with acute renal failure did not lead to a reduction in ICU or hospital mortality rates. Despite univariate analysis delivering some evidence for a shorter duration of ICU-related treatments in the haemoadsorption group, these results did not remain significant in multivariate analysis.

Trial registration CytoSorb® registry https://clinicaltrials.gov/ct2/show/NCT02312024. December 9, 2014. Database: https://www.cytosorb-registry.org/ (registration for content acquisition is necessary)
Effectiveness of corticosteroids for post-extubation stridor and extubation failure in pediatric patients: a systematic review and meta-analysis
Authors: Kimura Satoshi , Ahn JiYoon B. , Takahashi Mai , Kwon Sohee , Papatheodorou Stefania
Published: November 2020

Background

While the results of previous meta-analyses have shown beneficial effects of corticosteroid therapy on post-extubation stridor and extubation failure in adults, these results might not be generalizable to children because of the differences in anatomy and structure. We aimed to determine the benefits of corticosteroids on those outcomes in pediatric populations.

Methods

We searched PubMed, EMBASE, and reference lists of articles from inception until February 2019. Randomized controlled trials and observational studies on the efficacy of systemic corticosteroid administration given prior to elective extubation in mechanically ventilated pediatrics were eligible. Outcomes included post-extubation stridor indicating laryngeal edema and extubation failures.

Results

A total of ten randomized controlled trials with 591 pediatric patients were included: seven of the ten studies for post-extubation stridor/suspected upper airway obstruction and nine of the ten studies for extubation failure. The estimate of pooled odds ratios (ORs) for post-extubation stridor/suspected upper airway obstruction was 0.40 (95% CI: 0.21–0.79). When analysis was restricted to trials that had explicit data for infants and explicit data for pediatric patients under 5 years old excluding infants, the estimates of pooled ORs were 0.53 (95% CI: 0.20–1.40) and 0.68 (95% CI: 0.38–1.22), respectively. For pediatric patients who received corticosteroids, there was a 0.37-fold lower odds of extubation failure than that in pediatric patients who did not receive corticosteroids (OR, 0.37; 95% CI, 0.22–0.61). While three observational studies were included in this review, their estimates have a potential for bias and we did not perform a meta-analysis.

Conclusions

Despite a relatively small sample size in each randomized controlled trial and wide ranges of ages and steroid administration regimens, our results suggest that the use of corticosteroids for prevention of post-extubation stridor and extubation failure could be considered to be acceptable in pediatric patients.
On integral inequalities related to the weighted and the extended Chebyshev functionals involving different fractional operators
Authors: Çelik Barış , Gürbüz Mustafa Ç. , Özdemir M. Emin , Set Erhan
Published: November 2020

The role of fractional integral operators can be found as one of the best ways to generalize classical inequalities. In this paper, we use different fractional integral operators to produce some inequalities for the weighted and the extended Chebyshev functionals. The results are more general than the available classical results in the literature.
On the existence of solutions for a multi-singular pointwise defined fractional system
Authors: Mansouri Ali , Rezapour Shahram , Shabibi Mehdi
Published: November 2020

One of best ways for increasing our abilities in exact modeling of natural phenomena is working with a singular version of different fractional differential equations. As is well known, multi-singular equations are a modern version of singular equations. In this paper, we investigate the existence of solutions for a multi-singular fractional differential system. We consider some particular boundary value conditions on the system. By using the α-ψ-contractions and locating some control conditions, we prove that the system via infinite singular points has solutions. Finally, we provide an example to illustrate our main result.
Integral inequalities via Raina’s fractional integrals operator with respect to a monotone function
Authors: Chen Shu-Bo , Rashid Saima , Hammouch Zakia , Noor Muhammad Aslam , Ashraf Rehana , Chu Yu-Ming
Published: November 2020

We establish certain new fractional integral inequalities involving the Raina function for monotonicity of functions that are used with some traditional and forthright inequalities. Taking into consideration the generalized fractional integral with respect to a monotone function, we derive the Grüss and certain other associated variants by using well-known integral inequalities such as Young, Lah–Ribarič, and Jensen integral inequalities. In the concluding section, we present several special cases of fractional integral inequalities involving generalized Riemann–Liouville,k-fractional, Hadamard fractional, Katugampola fractional,$(k,s)$(k,s)-fractional, and Riemann–Liouville-type fractional integral operators. Moreover, we also propose their pertinence with other related known outcomes.
Rapid establishment of a national surveillance of COVID-19 hospitalizations in Belgium
Authors: Van Goethem Nina , Vilain Aline , Wyndham-Thomas Chloé , Deblonde Jessika , Bossuyt Nathalie , Lernout Tinne , Rebolledo Gonzalez Javiera , Quoilin Sophie , Melis Vincent , Van Beckhoven Dominique
Published: November 2020

Background

In response to the COVID-19 epidemic, caused by a novel coronavirus, it was of great importance to rapidly collect as much accurate information as possible in order to characterize the public health threat and support the health authorities in its management. Hospital-based surveillance is paramount to monitor the severity of a disease in the population.

Methods

Two separate surveillance systems, a Surge Capacity survey and a Clinical survey, were set up to collect complementary data on COVID-19 from Belgium’s hospitals. The Surge Capacity survey collects aggregated data to monitor the hospital capacity through occupancy rates of beds and medical devices, and to follow a set of key epidemiological indicators over time. Participation is mandatory and the daily data collection includes prevalence and incidence figures on the number of COVID-19 patients in the hospital. The Clinical survey is strongly recommended by health authorities, focusses on specific patient characteristics and relies on individual patient data provided by the hospitals at admission and discharge.

Conclusions

This national double-level hospital surveillance was implemented very rapidly after the first COVID-19 patients were hospitalized and revealed to be crucial to monitor hospital capacity over time and to better understand the disease in terms of risk groups and outcomes. The two approaches are complementary and serve different needs.
Effects of maternal dietary omega-3 polyunsaturated fatty acids and methionine during late gestation on fetal growth, DNA methylation, and mRNA relative expression of genes associated with the inflammatory response, lipid metabolism and DNA methylation in placenta and offspring’s liver in sheep
Authors: Rosa Velazquez Milca , Batistel Fernanda , Pinos Rodriguez Juan Manuel , Relling Alejandro Enrique
Published: November 2020

Background

Omega-3 PUFA or methionine (Met) supply during gestation alters offspring physiology. However, the effect of both nutrients on fetal development has not been explored. Our objective was to determine the effects of supplementation of these two nutrients during late gestation on fetal growth, DNA methylation, and mRNA expression of genes associated with the inflammatory response, and DNA methylation. Ewes (n = 5/treatment) were fed from day 100 to 145 of gestation one of the following treatments: 1) basal diet (NS) without fatty acids (FS) or methionine (MS) supplementation; 2) FS (10 g/kg Ca salts, source omega-3 PUFA); 3) MS (1 g/kg rumen protected methionine); and 4) FS and MS (FS-MS). On day 145, ewes were euthanized, and data from dams and fetus was recorded. Placenta (cotyledon), fetal liver, and blood samples were collected.

Results

A treatments interaction on fetal liver weight, ewe body weight and body condition score (BCS) was observed; FS-MS were heavier (P <  0.01) than FS and MS, and FS-MS ewes had a better (P = 0.02) BCS than NS. Methionine increased (P = 0.03) ewe plasma glucose concentration. Fetal liver global DNA methylation increased (P <  0.01) in FS and MS. Dietary treatments modify the mRNA relative expression on some of the genes evaluated. In the fetal liver, FS increased (P = 0.04) the mRNA relative expression of arachidonate-5-lipoxygenase-activating-protein and tended to decrease (P = 0.06) methionine-adenosyltransferase-1A. Moreover, MS decreased (P = 0.04) DNA-methyltransferase-1 and tended to decrease (P = 0.08) free-fatty-acid-receptor-1 mRNA relative expression. Furthermore, FS-MS decreased mRNA relative expression of tumor-necrosis-factor-alpha (P = 0.05), peroxisome-proliferator-activated-receptor-delta (P = 0.03) and gamma (P = 0.04), tended to decrease (P ≤ 0.09) interleukin-6, fatty-acid-transport-protein-1, and delta-5-desaturase, and increased adenosylhomocysteinase (P = 0.04) mRNA relative expression. In cotyledon, FS tended to decrease fatty acid binding protein 4 (P = 0.09) mRNA relative expression.

Conclusion

Omega-3 PUFA and Met supplementation improves dam’s performance in late gestation, which was positively correlated with an increase in offspring’s liver development. Moreover, FS-MS decreased mRNA relative expression of proinflammatory cytokines, and lipogenic genes, and increased the expression on an enzyme that has an important role in methylation.
Spatial heterogeneity of bacterial colonization across different gut segments following inter-species microbiota transplantation
Authors: Li Na , Zuo Bin , Huang Shimeng , Zeng Benhua , Han Dandan , Li Tiantian , Liu Ting , Wu Zhenhua , Wei Hong , Zhao Jiangchao , Wang Junjun
Published: November 2020

Abstract

Background

The microbiota presents a compartmentalized distribution across different gut segments. Hence, the exogenous microbiota from a particular gut segment might only invade its homologous gut location during microbiota transplantation. Feces as the excreted residue contain most of the large-intestinal microbes but lack small-intestinal microbes. We speculated that whole-intestinal microbiota transplantation (WIMT), comprising jejunal, ileal, cecal, and colonic microbiota, would be more effective for reshaping the entire intestinal microbiota than conventional fecal microbiota transplantation fecal microbiota transplantation (FMT).

Results

We modeled the compartmentalized colonization of the gut microbiota via transplanting the microbiota from jejunum, ileum, cecum, and colon, respectively, into the germ-free mice. Transplanting jejunal or ileal microbiota induced more exogenous microbes’ colonization in the small intestine (SI) of germ-free mice rather than the large intestine (LI), primarily containing Proteobacteria, Lactobacillaceae, and Cyanobacteria. Conversely, more saccharolytic anaerobes from exogenous cecal or colonic microbiota, such as Bacteroidetes, Prevotellaceae, Lachnospiraceae, and Ruminococcaceae, established in the LI of germ-free mice that received corresponding intestinal segmented microbiota transplantation. Consistent compartmentalized colonization patterns of microbial functions in the intestine of germ-free mice were also observed. Genes related to nucleotide metabolism, genetic information processing, and replication and repair were primarily enriched in small-intestinal communities, whereas genes associated with the metabolism of essential nutrients such as carbohydrates, amino acids, cofactors, and vitamins were mainly enriched in large-intestinal communities of germ-free mice. Subsequently, we compared the difference in reshaping the community structure of germ-free mice between FMT and WIMT. FMT mainly transferred LI-derived microorganisms and gene functions into the recipient intestine with sparse SI-derived microbes successfully transplanted. However, WIMT introduced more SI-derived microbes and associated microbial functions to the recipient intestine than FMT. Besides, WIMT also improved intestinal morphological development as well as reduced systematic inflammation responses of recipients compared with FMT.

Conclusions

Segmented exogenous microbiota transplantation proved the spatial heterogeneity of bacterial colonization along the gastrointestinal tract, i.e., the microbiota from one specific location selectively colonizes its homologous gut region. Given the lack of exogenous small-intestinal microbes during FMT, WIMT may be a promising alternative for conventional FMT to reconstitute the microbiota across the entire intestinal tract.
Severe bronchiectasis and inflammatory lung disease in a patient with anorexia nervosa and severe and enduring malnutrition - a case report
Authors: Saran Anna , Oliver Firszt , Łosień Tomasz , Kulig-Kulesza Monika , Myga-Porosiło Jolanta , Kluczewska Ewa , Ziora Dariusz
Published: November 2020

Background

Persistent structural changes of the lungs in anorexia nervosa (AN) patients are rarely described in contemporary medical literature. The objective of our paper is to report a rare case of severe bronchiectasis and inflammatory changes to the lungs resulting from chronic malnutrition in a AN patient.

Case presentation

We describe a patient with severe inflammatory lung disease caused by malnutrition, resulting in persistent bronchiectasis accompanying AN. We performed an analysis of the patient’s medical records including radiological findings and laboratory results. A review of available literature shows very little data available on this topic.

Conclusion

Bronchiectasis and other structural changes of the lungs are rare, but severe complications of severe, chronic malnutrition. As exemplified by our case report, they may require extensive differential diagnosis and pose a significant clinical challenge due to their non-reversible character. A successful treatment relies heavily on the patient’s compliance and may be hard to achieve. Clinicians managing patients with anorexia nervosa should be wary of early respiratory tract dysfunction-related symptoms and always consider malnutrition bronchiectasis as a differential diagnosis option.
Effect of salicylic acid foliar application on growth, glandular hairs and essential oil yield in Salvia officinalis L. grown under zinc stress
Authors: Es-sbihi Fatima Zohra , Hazzoumi Zakaria , Amrani Joutei Khalid
Published: November 2020

Background

Generally, zinc (Zn) is an essential element and acts as a plant nutrient, but at higher concentrations, it is toxic. Higher uptake and translocation of Zn into plant tissues can cause serious physiological and biochemical alterations. However, salicylic acid (SA) is an endogenous regulator of growth and signaling molecule responsible for inducing environmental stress tolerance in plants. Therefore, spray application of SA could provide protection against several types of stresses such as Zn toxicity. In this context, the ameliorative effect of SA (0.5 and 1 mM) on Salvia officinalis L. under Zn stress (40 mM) was studied.

Results

Zn stress decreased growth, chlorophyll content, essential oil yield and peltate glandular trichome density. This toxicity can be linked to a strong accumulation of Zn in the various parts of the plant. In addition, Zn stress disturbed nutrients assimilation (K, P and Ca). However, spray of SA, particularly at 0.5 mM improved all parameters studied under both Zn and normal conditions. The positive effects of SA under Zn stress condition may be due to the decrease of Zn accumulation in different parts of the plant. This decrease was accompanied by an increase in K, P and Ca content. In addition, the histological study of S. officinalis leaves showed the presence of two types of glandular hairs, the peltate and capitate glands. In the leaves of stressed plants, we noticed the presence of glands with deformations in the form of pockets in the number of one or more as well as the glands with an oval form. On the other hand, all these abnormalities glands were not detected in stressed plants that were sprayed with SA. Therefore, the absence of these anomalies under the effect of SA showed the remedial effect of this growth regulator.

Conclusion

The findings of the present work suggest that spraying SA maybe useful for improving the plant growth in Zn-contaminated areas.
The puzzling pathophysiology of frozen shoulders – a scoping review
Authors: Kraal T. , Lübbers J. , van den Bekerom M. P. J. , Alessie J. , van Kooyk Y. , Eygendaal D. , Koorevaar R. C. T.
Published: November 2020

Purpose

The pathophysiology of frozen shoulders is a complex and multifactorial process. The purpose of this review is to scope the currently available knowledge of the pathophysiology of frozen shoulders.

Methods

A systematic search was conducted in Medline, Embase and the Cochrane library. Original articles published between 1994 and October 2020 with a substantial focus on the pathophysiology of frozen shoulders were included.

Results

Out of 827 records, 48 original articles were included for the qualitative synthesis of this review. Glenohumeral capsular biopsies were reported in 30 studies. Fifteen studies investigated were classified as association studies. Three studies investigated the pathophysiology in an animal studies. A state of low grade inflammation, as is associated with diabetes, cardiovascular disease and thyroid disorders, predisposes for the development of frozen shoulder. An early immune response with elevated levels of alarmins and binding to the receptor of advance glycation end products is present at the start of the cascade. Inflammatory cytokines, of which transforming growth factor-β1 has a prominent role, together with mechanical stress stimulates Fibroblast proliferation and differentiation into myofibroblasts. This leads to an imbalance of extracellular matrix turnover resulting in a stiff and thickened glenohumeral capsule with abundance of type III collagen.

Conclusion

This scoping review outlines the complexity of the pathophysiology of frozen shoulder. A comprehensive overview with background information on pathophysiologic mechanisms is given. Leads are provided to progress with research for clinically important prognostic markers and in search for future interventions.

Level of evidence

Level V.
Hydrocortisone decreases lethality and inflammatory cytokine and nitric oxide production in rats challenged with B. anthracis cell wall peptidoglycan
Authors: Li Yan , Cui Xizhong , Shiloach Joseph , Wang Jeffrey , Suffredini Dante A. , Xu Wanying , Liu Wancang , Fitz Yvonne , Sun Junfeng , Eichacker Peter Q.
Published: November 2020

Background

Lethal B. anthracis infection produces high proinflammatory peptidoglycan (PGN) burdens in hosts. We investigated whether the lethality and inflammation anthrax PGN can produce are related.

Methods

At 6 h before and the start of 24 h anthrax PGN infusions, rats (n = 198) were treated with diluent (controls) or one of three IV-doses of either hydrocortisone (125, 12.5 or 1.25 mg/kg) or TNF-soluble receptor (TNFsr; 2000, 1000 or 333 μg/kg), non-selective and selective anti-inflammatory agents, respectively.

Results

Compared to controls, hydrocortisone 125 and 12.5 mg/kg each decreased 7-day lethality (p ≤ 0.004). Hydrocortisone 125 mg/kg decreased IL-1β, IL-6, TNFα, MCP, MIP-1α, MIP-2, RANTES and nitric oxide (NO) blood levels at 4 and 24 h after starting PGN (except MCP at 24 h). Each decrease was significant at 4 h (except MIP-1α that was significant at 24 h) (p ≤ 0.05). Similarly, hydrocortisone 12.5 mg/kg decreased each measure at 4, 24 and 48 h (except TNFα at 24 h and MIP-1α at 24 and 48 h and NO at 48 h). Decreases were significant for IL-6 and NO at 4 h and RANTES at 48 h (p ≤ 0.05). Hydrocortisone 1.25 mg/kg had non-significant effects. Each TNFsr dose decreased lethality but non-significantly. However, when doses were analyzed together, TNFsr decreased lethality in a potential trend (p = 0.16) and IL-6 and NO significantly at 4 h (p = 0.05).

Conclusions

Peptidoglycan-stimulated host inflammation may contribute to B. anthracis lethality.
Laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy for Siewert type II esophagogastric junction cancer with right aortic arch: a case report
Authors: Murakami Motoki , Nakanishi Yasutaka , Hojo Yudai , Nakamura Tatsuro , Kumamoto Tsutomu , Kurahashi Yasunori , Ishida Yoshinori , Shinohara Hisashi
Published: November 2020

Background

Right aortic arch (RAA) is a congenital malformation detected in 0.04% of the population without heterotaxia and makes esophagectomy and mediastinal lymphadenectomy difficult. A left thoracic approach is recommended in patients with RAA, but a minimally invasive procedure has not yet been established.

Case presentation

The case was a 40-year-old man with RAA and Siewert type II adenocarcinoma of the esophagogastric junction with metastases to the adrenal glands and paraaortic lymph nodes. Conversion surgery was performed when radiologic disappearance of metastatic disease was confirmed after first-line treatment consisting of 12 cycles of S-1 plus platinum-based systemic chemotherapy. Minimally invasive laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy was performed in the right semi-lateral decubitus position. The esophagus was easy to see on left thoracoscopy because of the RAA. Esophagectomy with lower mediastinal lymphadenectomy and an intrathoracic esophagogastric anastomosis was performed successfully with laparoscopy and thoracoscopy without a position change. There were no surgical complications, and no residual cancer was detected in the resected specimen on pathological examination. There has been no recurrence during 21 months of follow-up.

Conclusions

Laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy in the right semi-lateral decubitus position is a minimally invasive, anatomically novel procedure for Siewert type II esophagogastric junction cancer in patients with RAA.
Mixed Cryoglobulinemia Syndrome (MCS) due to untreated hepatitis B with uncommon presentation: case report and literature review
Authors: Alfraji Nasam , Upadhyaya Vandan D. , Bekampis Christopher , Kuzyshyn Halyna
Published: November 2020

Background

The mixed cryoglobulinemia (MC) syndrome is a systemic inflammatory syndrome that causes small-to-medium vessel vasculitis due to cryoglobulin-containing immune complexes most commonly caused by chronic hepatitis C virus (HCV), and rarely by chronic hepatitis B virus (HBV). Its clinical presentation is significantly varied, with manifestations ranging from purpura, arthralgia, and myalgia to more severe neurologic and renal involvement. Pulmonary involvement as organizing pneumonia, alveolar hemorrhage, and pulmonary vasculitis have been reported, but appear to be quite rare.

Case presentation

We report an uncommon case of a patient who presented with primary pulmonary syndrome without renal involvement in the setting of MC, due to untreated chronic hepatitis B infection. Early diagnosis and consequent institution of glucocorticoids, B-cell-depleting monoclonal antibody and antiviral therapy led to a favorable outcome and prevented any fatal sequelae.

Conclusion

Pulmonary compromise in MC syndrome is very uncommon and carries a high rate of mortality. Therefore, in patients with HBV presenting with hemoptysis, physicians must carry a high clinical suspicion for alveolar hemorrhage secondary to cryoglobulinemic vasculitis.
A case of Gayet-Wernicke encephalopathy with misleading symptoms
Authors: Hadbi Mohamed , Benalakma Dalila , Fellah Nadia
Published: November 2020

Background

The dramatic evolution of incoercible vomiting in pregnancy is at the origin of a rare and serious neurological complication known as EGW; its symptomatology is polymorphic posing a diagnostic problem. MRI is the test of choice for screening. Early vitamin supplementation is essential to improve the maternal-fetal prognosis.

Case presentation

A 35-year-old parturient, G5P1, without particular pathological history presented incoercible vomiting at 8 weeks, which led to dehydration, undernutrition, and impairment of general condition. Neurological signs: headaches, confused scored at 14 on the Glasgow scale, amnesia, a cerebellar syndrome, sensory-motor deficit. Ophthalmological examination revealed: edema in the eye fundus, a decrease in visual acuity, nystagmus, and ophthalmoplegia. The biological analysis showed moderate hepatic cytolysis.

Given the polymorphic neurological symptomatology presented by our parturient, several differential diagnoses were evoked: intracranial hypertension (headache - vomiting - decrease in visual acuity - papillary edema), brain stroke (sensory-motor deficit, ground “pregnancy”), deficit in vitamin B12 (sensory-motor deficit, confusion, memory impairment), and GWE (nystagmus-confusion-ataxia). Cerebral MRI has allowed us to establish the diagnosis of GWE.

Conclusion

All pregnant with severe hyperemesis gravidarum should be supplemented with thiamine prior to glucose administration to prevent and improve the prognosis of GWE.
Prospective randomized trial comparing efficacy and safety of intravenous and intra-articular tranexamic acid in total knee arthroplasty
Authors: Li Moses Man-Lung , Kwok Jojo Yan-Yan , Chung Kwong-Yin , Cheung Kin-Wing , Chiu Kwok-Hing , Chau Wai-Wang , Ho Kevin Ki-Wai
Published: November 2020

Background

Total knee arthroplasty (TKA) is associated with significant perioperative blood loss and postoperative allogenic blood transfusion. Tranexamic acid (TXA) reversibly blocks lysine binding sites on plasminogen molecules and inhibits plasmin formation. Comparisons of the efficacy and safety of intra-articular and intravenous TXA in primary TKA have not previously been reported.

Methods

A prospective randomized trial was conducted in 150 patients who underwent TKA, and these patients were randomized into three groups. Patients in Group A were injected by intra-articular TXA according to body weight (20 mg/kg). Patients in Group B received a standard dose of intra-articular TXA (2000 mg), and those in Group C were infused with TXA according to body weight (20 mg/kg) before tourniquet deflation and again 3 h later. Baseline characteristics and data collected at blood transfusion were compared. Differences among four time points (baseline, day 0, day 2, and day 5) were carried out using ANOVA.

Results

The hemoglobin levels at postoperative day 5 were 10.6 g/dL for Group A, 10.6 g/dL for Group B, and 10.7 g/dL for Group C. The drain output was 399 ml for Group A, 314 ml for Group B, and 305 ml for Group C (p = 0.03). Group C had significantly less drain output than Group A after post hoc comparisons (p = 0.05), whereas no significant difference was observed between Group A and B (p = 0.09) or between Group B and C.

Conclusion

The weight-adjusted dose of TXA administered intravenously significantly reduced the drain output but not the total blood loss when compared with the weight-adjusted dose of TXA administered intra-articularly. No significant difference was observed in the other parameters among the three groups.

Trial registration

The Joint CUHK-NTEC CREC, CRE-2013.644-T. Registered 1 March 2014.
Otoplasty: a graduated approach
Authors: Ismail Ahmed Soliman
Published: November 2020

Background

Bat ear deformity is a common presentation among the ENT patients (22.5%). Many surgical procedures have been described to manage such a problem. A thorough study of the anatomical anomalies contributing to such deformity is required by any plastic surgeon in handling this anomaly.

Results

Modified anterior scoring (Chong-Chet) was done on 45 bat ear deformities in 31 patients. Good surgical results were obtained in 97.7% of patients, and the surgical time ranged from 60 t0 90 min. Postoperative pain and infection were minimal and effectively managed.

Conclusions

The modified Chong-Chet anterior scoring is a reliable and effective surgical tool for managing bat ear deformity done through one postauricular incision. This technique could be used in young as well as adult patients because it renders the auricular cartilage easier to manipulate.
Correction to: Safeguarding and using global banana diversity: a holistic approach
Authors: Van den Houwe Ines , Chase Rachel , Sardos Julie , Ruas Max , Kempenaers Els , Guignon Valentin , Massart Sebastien , Carpentier Sebastien , Panis Bart , Rouard Mathieu , Roux Nicolas
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
PCSK-9 Inhibitors in a Real-World Setting and a Comparison Between Alirocumab and Evolocumab in Heterozygous FH Patients
Authors: Ceballos-Macías José Juan , Lara-Sánchez Carolina , Flores-Real Jorge , Aguilar-Salinas Carlos Alberto , Ortega-Gutiérrez Guillermo , Vargas-Sánchez Joel , Madriz-Prado Ramón , Derosa Giuseppe , Rodríguez-Benítez Hazel , Baltazar-Romero Ricardo , Lopez-Mezquita Dante José
Published: November 2020

A real-world setting study of familial hypercholesterolemia (FH) patients who received Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in a specialized referral center in Mexico City. Ten patients between the ages of 18 and 70 years, with a diagnosis of FH according to Dutch Lipid Clinic Network (DLCN) criteria, with failure to achieve their Low-density lipoprotein Cholesterol (LDL-C) goals, and with standard therapy between 2016 and 2017 enrolled in a simple randomization in which a group of 5 participants received alirocumab (75 mg every 2 weeks) and the remaining 5 patients received evolocumab (140 mg every 2 weeks). Comparative analysis was made, analyzing the means of LDL at baseline at 4, 6, and 12 weeks. The evolocumab group had an average initial LDL-C of 277 mg/dL, which, after 12 weeks of treatment, was significantly reduced to 116 mg/dL; P = 0.04 (95% confidence interval [CI]: 11.5–310.9). The alirocumab group with a mean initial LDL-C of 229 mg/dL showed a reduction of LDL-C levels at 12 weeks of treatment to 80 mg/dL; P = 0.008 (95% CI: 63.8–233.7). In conclusion, PCSK9 inhibitors are an excellent treatment option in patients with FH who do not reach their LDL-C goals with standard therapy or due to intolerance to the standard therapy. There is no difference in the lipid-lowering effect between both PSCK9 inhibitors.
Mouse models of myocardial infarction: comparing permanent ligation and ischaemia-reperfusion
Authors: De Villiers Carla , Riley Paul R.
Published: November 2020

Myocardial infarction (MI) is a disease of major consequence in the modern world, causing permanent, irreversible damage to the heart. Survivors are at risk for developing further cardiovascular pathologies such as heart failure. Further study of MI injury is crucial to improve the understanding and treatment of the post-MI heart. The most commonly used model for MI in vivo is surgical ligation of the left anterior descending coronary artery (LAD). There are two predominant approaches: permanent ligation (PL), where the LAD is permanently occluded with a suture, or ischaemia-reperfusion (IR), where the LAD is temporarily occluded before removing the suture to restore blood flow and tissue reperfusion. PL results in the majority of the area at risk becoming infarcted, leading to significant apoptotic cell death and a large scar. Conversely, IR salvages some of the area at risk; thus, the scar is smaller and includes reperfusion injury, an additional, albeit smaller, second wave of necrotic damage. PL may be a more appropriate model choice for studies of heart tissue injury and wound healing, owing to the larger, more consistent infarcts, while IR enables the study of reperfusion injury. Both are clinically relevant, and the choice of model depends upon the precise pre-clinical research questions to be addressed.
A causal relationship model of health literacy and health behavior for obesity prevention among primary school students in Bangkok, Thailand
Authors: Thongsong Ladaporn , Neranon Wanida
Published: November 2020

Background: The aim of the study was to develop a research instrument to study the levels of health literacy for obesity prevention (HLFOP), as well as health behavior for obesity prevention (HBFOP). In addition, we investigated the causal relationship model between health literacy and health behavior for obesity prevention among primary school students in Bangkok, Thailand.

Methods: A cross-sectional study among 600 participants who were primary school students (aged 9-13 years) was conducted. The participants were selected from schools in all parts of Bangkok using multi-stage random sampling technique. The research instrument to assess HLFOP and HBFOP, constructed by the researchers, were utilized for data collection. Data were analyzed using descriptive statistics, exploratory and confirmatory factor analyses, and structural equation model through linear structural relationship.

Results: We found that HBFOP was directly influenced by heath literacy in the category of Critical Literacy with an effect size of 0.65 (p < 0.01), and was indirectly influenced in the category of Basic Literacy and Interactive Literacy through Critical Literacy with effect sizes of 0.46 and 0.58 (p<0.01), respectively. The model was consistent with the empirical data, with Chi-Square=13.68, df=7, p=0.05721, RMSEA (root mean square error of approximation)= 0.040,  SRMR (standardized root mean square residual)= 0.017 NFI (normal fit index)=0.99, GFI (goodness of fit index)=0.99, and AGFI (adjusted goodness of fit index)=0.97.

Conclusions: HLFOP was influential on HBFOP in primary school students in the Bangkok Metropolis. The categories that were particularly influential were: 1) Basic Literacy: accessing health information skills; 2) Interactive Literacy: communication skills; and 3) Critical Literacy: media literacy and self-management skills.
Complete mitochondrial genome of the endangered species Brycon nattereri (Characiformes, Characidae)
Authors: Resende Snaydia Viegas , Pasa Rubens , Menegídio Fabiano Bezerra , Heslop-Harrison John Seymour (Pat) , Schwarzacher Trude , Kavalco Karine Frehner
Published: November 2020

Brycon nattereri is a Brazilian fish species of the order Characiformes (Bryconidae). Like others in the genus, B. nattereri is classified as "vulnerable" on the red list of endangered species. For this work, we collected a sample of B. nattereri from the Upper Paraná and São Francisco river basins, identified it and registered in an ichthyology collection. Whole genome sequencing was performed by Illumina. The raw reads were assembled with Novoplasty and the sequence annotated with MitoAnnotator. This is the third complete mitochondrial genome described for the genus and is available on GenBank: MT428073.1 and MT428074.1.
Recent advances in the treatment of Clostridioides difficile infection: the ever-changing guidelines
Authors: Khurana Shruti , Kahl Alyssa , Yu Kevin , DuPont Andrew W
Published: November 2020

Clostridioides difficile infection (CDI), formerly known as Clostridium difficile, continues to be the most common healthcare-associated infection worldwide. With the shifting epidemiology towards higher a incidence of community-acquired CDI and the continued burden on the healthcare system posed by high rates of CDI recurrence, there has been an impetus to advance the diagnostic testing and treatment strategies. Recent advancements over the past decade have led to rapidly changing guidelines issued by the Infectious Diseases Society of America and European Society of Clinical Microbiology and Infectious Diseases. With our comprehensive review, we aim to summarize the latest advances in diagnosing and treating CDI and thus attempt to help readers guide best practices for patient care. This article also focusses on cost-effectiveness of various therapies currently available on the market and provides an analysis of the current evidence on a relatively new monoclonal antibody therapy, Bezlotoxumab, to treat recurrent CDI.
Schrift als Komponente der Bildschirmfläche am Beispiel der deutschen Nachrichtensendungen
Authors: Kapuścińska Anna
Published: November 2020

The article focusses the written components of the screen surface in television news programs. The semiotic perspective represented in this article legitimises the viewpoint that they are not (ordinary) language signs. The main concern of this article is the status of the written text (as a semiotic medium) in the construction patterns of the news programs. It is argued that the written texts appear in the news programs increasingly as graphical elements, so that their visual presence becomes primary to their language meaning. This tendency is discussed in the article on the example of three news programs in the German television between 1996 and 2016.
“I hardly ever practice the real Standard German.” Self-reported language use and language proficiency in South Tyrol (Italy)
Authors: Leonardi Mara Maya Victoria
Published: November 2020

This paper deals with qualitative data on language use and self-assessments on language proficiency in multilingual speakers in South Tyrol (Italy). The first aim is to investigate empirically whether there has been a change in young people’s language use within certain domains (family, friends, and school). The second aim describes whether, after years of segregation between the language groups, a change in pupil’s language proficiency could be observed. Moreover, we also examine which extra-linguistic factors may influence their language competences in German, Italian and English. One way to investigate these aspects is through an empirical study on self-reported language use and language proficiency by the speakers themselves. The current survey was conducted in South Tyrol, an official trilingual province in northern Italy. The qualitative analyses are based on biographical interviews provided by 65 high school graduates (mean age: 19.3 years) attending German-language high schools in South Tyrol.