bluuebunny/crossref_metadata_2025 huggingface dataset:
Before the Mughals: Material Culture of Sultanate North India
Authors: Flood Finbarr Barry
Published: May 2021

This article presents an overview of the current state of knowledge regarding the material culture of north India under the Delhi sultans and the regional sultanates that emerged in Bengal, Gujarat, Jaunpur, and Malwa during the fourteenth and fifteenth centuries. Highlighting lacunae in existing scholarship, it also draws attention to material and textual sources that underline the strong transregional filiations of Sultanate art and architecture. It suggests that negotiations between regional artistic forms and styles and those that reflect transregional connections in Sultanate art and architecture anticipate a feature often seen as characteristic of early Mughal art and architecture.
The Blue-and-White Tiles of the Muradiye in Edirne: Architectural Decoration between Tabriz, Damascus, and Cairo
Authors: Blessing Patricia
Published: May 2021

In the second quarter of the fifteenth century, a new phenomenon appears in Ottoman architecture: tiles with blue-and-white decoration, associated with tile-makers from Tabriz. These tiles appear most prominently in the Muradiye in Edirne, completed in 839/1435-36. They mark the beginning of an aesthetic shift, away from black-line (or cuerda seca) tiles inspired by Timurid and Aqquyunlu models, toward the blue-and-white tiles and vessels of the so-called Baba Naqqaş style of the late fifteenth and early sixteenth centuries. The mihrāb of the Muradiye features both kinds of tiles, thus illustrating this shift at its early stages. Within the parameters of an international Timurid style, the artistic production of this period (tile-work in particular) has been considered an offshoot of Timurid court patronage in eastern Iran and Central Asia. In the larger context of the fifteenth-century Islamic world, however, related tiles and vessels were also produced in Damascus and Cairo. This article examines the tiles of the Muradiye Mosque within the framework of artistic centers, the movements of motifs, objects, and makers, and their impact on architecture in the fifteenth-century Ottoman empire.
Intersections Between the Architect’s Cubit, the Science of Surveying, and Social Practices in CaʿFer Efendi’s Seventeenth-Century Book on Ottoman Architecture
Authors: Kale Gül
Published: May 2021

In 1614 Caʿfer Efendi devoted four chapters of his book on architecture to the science of surveying. Caʿfer’s text is the only extant comprehensive book written by a scholar on the relation between architecture and various forms of knowledge. His sections on surveying have attracted little scholarly attention since they were often viewed as ad hoc chapters in a biography of the chief architect Mehmed Agha. An investigation into the intersection between architecture, as represented by the architect’s cubit, the science of surveying, and jurisprudence sheds significant light on how scholars assessed the legitimacy of early modern Ottoman architecture. In this article, I examine the relationship between architectural practices, mathematical knowledge, and social practices by focusing on Caʿfer Efendi’s elaborations on the architect’s cubit, units of measure, and mensuration of areas. These links need to be understood through the cultural and scientific context in which architects and scholars collaborated. I also explore Caʿfer Efendi’s identity, which gave him the tools to discuss such intrinsic connections. When read along with court decrees, and in conjunction with the use of mathematical sciences for civic affairs, this investigation reveals how Ottoman architecture was embedded in the scientific discourses, social practices, and ethical concerns of the early seventeenth century.
The Heart Case of Abbot Roger de Norton from St. Albans Abbey: An Islamic Object in a Medieval English Context
Authors: Knight Barry
Published: May 2021

The lid of a small wooden box, believed to have contained the heart of Abbot Roger de Norton (d. 1291), was discovered in 1872, during the restoration of St. Albans Abbey. The lid has an Arabic inscription that has not previously been translated. It is now suggested that the inscription reads al-ʿizz al-dāʾim wa ’l-iqbāl lahu, or “Everlasting glory and good fortune for him.”
Effect of backing plate on mechanical and microstructural properties of tungsten inert gas welded AA 6063 butt joints
Authors: Om Prakash S , Karuppuswamy P , Sowrirajan M
Published: May 2021

In the present scenario, ship building industries are frequently associated with welding process to explore the benefits of improved strength over the parent material. Development of new techniques to enhance the processes is of a part of the usual practice in industries. In the present work, as a supportive measure, backing plate was introduced to develop the weldments with enhanced properties. The central composite design array specimens, a widely used aluminum alloy in marine application AA 6063 were prepared by TIG welding process with the help of backing plates of different materials. Effect of backing plate material on the properties such as ultimate tensile strength and microhardness of the weld joints were investigated. A detailed study of microstructure and macrostructure on the weldment was also done. Results exhibit a considerable improvement for the recommendation of using copper backing plates in the welding processes.
Graphene-Based Polarization-Independent Mid-Infrared Electro-Absorption Modulator Integrated in a Chalcogenide Glass Waveguide
Authors: Zhou Yong , Lu Rongguo , Wang Guangbiao , Lyu Jiangbo , Tan Meng , Shen Liming , Lin Rui , Yang Zhonghua , Liu Yong
Published: May 2021

A polarization-insensitive graphene-based mid-infrared optical modulator is presented that comprised SiO2/ Ge23Sb7S70, in which two graphene layers are embedded with a semiellipse layout to support transverse magnetic (TM) and transverse electric (TE) polarizing modes with identical absorption. The key performance index for the polarization independent modulator is polarization-sensitivity loss (PSL). The waveguide of our device just supports basic TE and TM modes, and the PSL between two modes is of < 0.24 dB. The model can offer extinction ratio (ER) more than 16 dB and insertion loss less than 1 dB. The operation spectrum ranges from 2 to 2.4 μm with optical bandwidth of 400 nm. The 3 dB modulation bandwidth is as high as 136 GHz based on theoretical calculation.
Assessing nucleic acid binding activity of four dinoflagellate cold shock domain proteins from Symbiodinium kawagutii and Lingulodinium polyedra
Authors: Zaheri Bahareh , Morse David
Published: May 2021

Background

Dinoflagellates have a generally large number of genes but only a small percentage of these are annotated as transcription factors. Cold shock domain (CSD) containing proteins (CSPs) account for roughly 60% of these. CSDs are not prevalent in other eukaryotic lineages, perhaps suggesting a lineage-specific expansion of this type of transcription factors in dinoflagellates, but there is little experimental data to support a role for dinoflagellate CSPs as transcription factors. Here we evaluate the hypothesis that dinoflagellate CSPs can act as transcription factors by binding double-stranded DNA in a sequence dependent manner.

Results

We find that both electrophoretic mobility shift assay (EMSA) competition experiments and selection and amplification binding (SAAB) assays indicate binding is not sequence specific for four different CSPs from two dinoflagellate species. Competition experiments indicate all four CSPs bind to RNA better than double-stranded DNA.

Conclusion

Dinoflagellate CSPs do not share the nucleic acid binding properties expected for them to function as bone fide transcription factors. We conclude the transcription factor complement of dinoflagellates is even smaller than previously thought suggesting that dinoflagellates have a reduced dependance on transcriptional control compared to other eukaryotes.
The strength of selection is consistent across both domains of the MHC class I peptide-binding groove in birds
Authors: Minias Piotr , He Ke , Dunn Peter O.
Published: May 2021

Background

The Major Histocompatibility Complex (MHC) codes for the key vertebrate immune receptors responsible for pathogen recognition. Foreign antigens are recognized via their compatibility to hyper-variable region of the peptide-binding groove (PBR), which consists of two separate protein domains. Specifically, the PBR of the MHC class I receptors, which recognize intra-cellular pathogens, has two α domains encoded by exon 2 (α1) and exon 3 (α2) of the same gene. Most research on avian MHC class I polymorphism has traditionally focused exclusively on exon 3 and comparisons of selection between the two domains have been hampered by the scarcity of molecular data for exon 2. Thus, it is not clear whether the two domains vary in their specificity towards different antigens and whether they are subject to different selective pressure.

Results

Here, we took advantage of rapidly accumulating genomic resources to test for the differences in selection patterns between both MHC class I domains of the peptide-binding groove in birds. For this purpose, we compiled a dataset of MHC class I exon 2 and 3 sequences for 120 avian species from 46 families. Our phylogenetically-robust approach provided strong evidence for highly consistent levels of selection on the α1 and α2 domains. There were strong correlations in all selection measures (number of positively/negatively selected residues and dN/dS ratios) between both PBR exons. Similar positive associations were found for the level of amino acid polymorphism across the two domains.

Conclusions

We conclude that the strength of selection and the level of polymorphism are highly consistent between both peptide-binding domains (α1 and α2) of the avian MHC class I.
Genome-wide detection of CNV regions and their potential association with growth and fatness traits in Duroc pigs
Authors: Qiu Yibin , Ding Rongrong , Zhuang Zhanwei , Wu Jie , Yang Ming , Zhou Shenping , Ye Yong , Geng Qian , Xu Zheng , Huang Sixiu , Cai Gengyuan , Wu Zhenfang , Yang Jie
Published: May 2021

Background

In the process of pig breeding, the average daily gain (ADG), days to 100 kg (AGE), and backfat thickness (BFT) are directly related to growth rate and fatness. However, the genetic mechanisms involved are not well understood. Copy number variation (CNV), an important source of genetic diversity, can affect a variety of complex traits and diseases and has gradually been thrust into the limelight. In this study, we reported the genome-wide CNVs of Duroc pigs using SNP genotyping data from 6627 animals. We also performed a copy number variation region (CNVR)-based genome-wide association studies (GWAS) for growth and fatness traits in two Duroc populations.

Results

Our study identified 953 nonredundant CNVRs in U.S. and Canadian Duroc pigs, covering 246.89 Mb (~ 10.90%) of the pig autosomal genome. Of these, 802 CNVRs were in U.S. Duroc pigs with 499 CNVRs were in Canadian Duroc pigs, indicating 348 CNVRs were shared by the two populations. Experimentally, 77.8% of nine randomly selected CNVRs were validated through quantitative PCR (qPCR). We also identified 35 CNVRs with significant association with growth and fatness traits using CNVR-based GWAS. Ten of these CNVRs were associated with both ADG and AGE traits in U.S. Duroc pigs. Notably, four CNVRs showed significant associations with ADG, AGE, and BFT, indicating that these CNVRs may play a pleiotropic role in regulating pig growth and fat deposition. In Canadian Duroc pigs, nine CNVRs were significantly associated with both ADG and AGE traits. Further bioinformatic analysis identified a subset of potential candidate genes, including PDGFA, GPER1, PNPLA2 and BSCL2.

Conclusions

The present study provides a necessary supplement to the CNV map of the Duroc genome through large-scale population genotyping. In addition, the CNVR-based GWAS results provide a meaningful way to elucidate the genetic mechanisms underlying complex traits. The identified CNVRs can be used as molecular markers for genetic improvement in the molecular-guided breeding of modern commercial pigs.
Genome-wide association study reveals novel loci associated with feeding behavior in Pekin ducks
Authors: Li Guang-Sheng , Zhu Feng , Zhang Fan , Yang Fang-Xi , Hao Jin-Ping , Hou Zhuo-Cheng
Published: May 2021

Background

Feeding behavior traits are an essential part of livestock production. However, the genetic base of feeding behavior traits remains unclear in Pekin ducks. This study aimed to determine novel loci related to feeding behavior in Pekin ducks.

Results

In this study, the feeding information of 540 Pekin ducks was recorded, and individual genotype was evaluated using genotyping-by-sequencing methods. Genome-wide association analysis (GWAS) was conducted for feeding behavior traits. Overall, thirty significant (P-value < 4.74E-06) SNPs for feeding behavior traits were discovered, and four of them reached the genome-wide significance level (P-value < 2.37E-07). One genome-wide significance locus associated with daily meal times was located in a 122.25 Mb region on chromosome 2, which was within the intron of gene ubiquitin-conjugating enzyme E2 E2 (UBE2E2), and could explain 2.64% of the phenotypic variation. This locus was also significantly associated with meal feed intake, and explained 2.72% of this phenotypic variation.

Conclusions

This study is the first GWAS for feeding behavior traits in ducks. Our results provide a list of candidate genes associated with feeding behavior, and also help to better understand the genetic mechanisms of feeding behavior patterns in ducks.
CardiOvaScular Mechanisms In Covid-19: methodology of a prospective observational multimodality imaging study (COSMIC-19 study)
Authors: Alam Shirjel R. , Shah Anoop S. V. , Ombati Kevin O. , Nganga Edward , Gitau Samuel , Makhdomi Khalid , Chung Michael H. , Vinayak Sudhir
Published: May 2021

Background

8–28% of patients infected with COVID-19 have evidence of cardiac injury, and this is associated with an adverse prognosis. The cardiovascular mechanisms of injury are poorly understood and speculative. We aim to use multimodality cardiac imaging including cardiac magnetic resonance (CMR) imaging, computed tomography coronary angiography (CTCA) and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography (18F-FDG-PET/CT) to identify the cardiac pathophysiological mechanisms related to COVID-19 infections.

Methods

This is a single-centre exploratory observational study aiming to recruit 50 patients with COVID-19 infection who will undergo cardiac biomarker sampling. Of these, 30 patients will undergo combined CTCA and 18F-FDG-PET/CT, followed by CMR. Prevalence of obstructive and non-obstructive atherosclerotic coronary disease will be assessed using CTCA. CMR will be used to identify and characterise myocardial disease including presence of cardiac dysfunction, myocardial fibrosis, myocardial oedema and myocardial infarction. 18F-FDG-PET/CT will identify vascular and cardiac inflammation. Primary endpoint will be the presence of cardiovascular pathology and the association with troponin levels.

Discussion

The results of the study will identify the presence and modality of cardiac injury associated COVID-19 infection, and the utility of multi-modality imaging in diagnosing such injury. This will further inform clinical decision making during the pandemic.

Trial Registration: This study has been retrospectively registered at the ISRCTN registry (ID ISRCTN12154994) on 14th August 2020. Accessible at https://www.isrctn.com/ISRCTN12154994
Anti-IL-4Ralpha monoclonal antibody dupilumab mimics ulcerative colitis: a case report
Authors: Shimodaira Yosuke , Takahashi So , Iijima Katsunori
Published: May 2021

Background

Various molecular-targeted therapeutic agents that inhibit cytokines and immune checkpoints are used in clinical practice. Some of these biologics that control immunity, such as anti-interleukin-17, anti-programmed cell death protein-1, and anti-cytotoxic T-lymphocyte-associated protein antibodies, affect intestinal immune homeostasis and cause intestinal inflammation. Development of enteritis due to dupilumab (an anti-IL-4Ralpha monoclonal antibody) therapy is not yet reported in the literature.

Case presentation

A 17-year-old man was administered an injection of dupilumab and continued to receive it for refractory atopic dermatitis. After 3 months of initiating dupilumab therapy, he developed intermittent abdominal pain, tenesmus, and had diarrhea. Colonoscopy examination showed decreased vascularity, mild friability, and erythema in the cecum, part of the ascending colon, sigmoid colon, and rectum without any pathogenic bacteria. Histological examination revealed moderate mixed inflammatory cell infiltration, cryptitis, destruction of the crypt, decreased goblet cells, mucosal erosions, and edema. He was diagnosed with UC and was prescribed oral mesalazine (4800 mg/day) treatment. Within a month of the treatment, his diarrhea improved and the frequency of defecation decreased.

Conclusions

This is a first report that dupilumab mimicked ulcerative colitis. Careful monitoring for adverse effects with the onset of an intestinal inflammation will be recommended after dupilumab administration.
Smell, taste and trigeminal disorders in a 65‐year‐old population
Authors: Sødal Anne Thea Tveit , Singh Preet Bano , Skudutyte-Rysstad Rasa , Diep My Tien , Hove Lene Hystad
Published: May 2021

Background

Smell, taste and trigeminal disorders likely have a substantial impact on human daily life. However, data regarding the prevalence of these disorders in Norway are scarce. The aim of this study was to investigate the prevalence of smell, taste, trigeminal disorders and associated factors in a 65-year-old population in Oslo, Norway.

Methods

A random sample of 223 individuals (123 men, 100 women) participated in the study. Medical history was obtained, and unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected to determine salivary secretion rates. Sniffin`n Sticks and Taste Strips (Burghart Messtechnik GmbH, Wedel, Germany) were used for quantitative testing of olfactory and gustatory function. In addition, the participants’ self-reported perceptions of smell and taste, and burning mouth sensation were investigated.

Results

The results showed that 34 % of the participants had reduced smell (28 % hyposmia and 6 % anosmia) and 28 % had reduced taste perception (21 % hypogeusia and 7 % ageusia). 13 % of the partcipants had a combination of smell and taste disorders. Dysgeusia was reported by 5 % and burning mouth sensation (syndrome) by 3 % of the participants. Hyposmia, hypogeusia and ageusia were significantly more prevalent among men. Significant associations were found between taste disorders and previous history of cerebral hemorrhage and heart attack, and between burning mouth sensation and gastrointestinal disorders. Disturbances in olfactory, gustatory and trigeminal function were significantly related to medication use. Ageusia and burning mouth sensation were significantly more prevalent among smokers. Except from higher prevalence of ageusia among participants with hyposalivation with respect to SWS, no significant associations were found between salivary secretion rate and chemosensory or trigeminal disorders in the present study.

Conclusions

The present study revealed that one-third of 65-year-old individuals had impaired smell and more than one-fourth had impaired taste function. The prevalence of dysgeusia and burning mouth sensation was very low. Reduced smell and taste perception were more common among men than women. Furthermore, some diseases and medications were associated with chemosensory and trigeminal disorders. Ageusia was associated with SWS hyposalivation.
The accuracy of the Ishii score chart in predicting sarcopenia in the elderly community in Chengdu
Authors: Chen Xiaoyan , Hou Lisha , Zhang Ying , Luo Shuyue , Dong Birong
Published: May 2021

Background

Sarcopenia is a disorder associated with age that reduces the mass of skeletal muscles, the strength of muscles, and/or physical activity. It increases the risk of fall incidence which can result in fractures, hospitalizations, limited movement, and considerably decreased quality of life. Hence, it is needed to explore candidate screening tools to evaluate sarcopenia in the initial phases. The reported studies have been revealed that the sensitivity and specificity of the Ishii score chart are higher. However, the Ishii score chart is principally based on the European Working Group on Sarcopenia in Older People (EWGSOP) consensus. Recently, the Asian Working Group for Sarcopenia (AWGS) 2019 consensus has updated its diagnostic criteria for sarcopenia,which was previously similar to the EWGSOP. Hence, it is necessary to determine whether the Ishii score chart is appropriate for use among the elderly population in China. The current study aimed to validate the precision of the Ishii score chart, within the Chinese old aged community to establish an effective model for the evaluation of sarcopenia.

Methods

The AWGS2019 sarcopenia diagnostic criteria were used as a standard, and among the elderly community, the accuracy of the Ishii score chart was determined by using indicators, including specificity, sensitivity, negative and positive predictive values, negative and positive likelihood ratios, Youden index, and receiver operating characteristic (ROC) curve.

Results

In the elderly Chengdu community, the prevalence rate of sarcopenia was 18.38 %, 19.91 % for males and 16.91 % for females. The Ishii score chart predicts sarcopenia at an AUC value of 0.84 with 95 % confidence interval (CI), ranging between 0.80 and 0.89 for females, and at an AUC value of 0.81 with 95 % CI, ranging between 0.75 and 0.86 for males.According to the original cut-off, which was set at 120 points for females, the corresponding sensitivity was 46.91 % and the specificity was 93.22 %. The 105 cut-off points (original) set for males revealed a corresponding sensitivity of 64.94 % and the specificity of 85.46 %. However, the original cut-off value exhibited low sensitivity, hence, we selected a new cut-off value. With the new cut-off value, the sensitivity, specificity, positive and negative predictive values for sarcopenia were 75.31 %, 79.9 %, 43 %, and 94 % for females, and 70.65 %, 81.35 %, 49 %, and 92 % for males, respectively.

Conclusions

The Ishii score chart was used for the prediction of sarcopenia in the old-age people of the Chengdu community and the obtained results showed a high value of predictability. Hence, more than 95 and 102 points were suggested for males and females, accordingly which can set to be the diagnostic cut-off values for the prediction of sarcopenia.
An examination of three prescribing cascades in a cohort of older adults with dementia
Authors: Trenaman Shanna C. , Bowles Susan K. , Kirkland Susan , Andrew Melissa K.
Published: May 2021

Background

Prescribing cascades are a source of inappropriate prescribing for older adults with dementia. We aimed to study three prescribing cascades in older Nova Scotians with dementia using administrative databases.

Methods

Cohort entry for Nova Scotia Seniors’ Pharmacare Program beneficiaries was the date of dementia diagnosis. Prescription drug dispensing data was extracted for inciting medication and second treatment (cholinesterase inhibitor and bladder anticholinergic, metoclopramide and Parkinson’s disease medication, or calcium channel blocker (CCB) and diuretic) over the six-year period April 1, 2009 to March 31, 2015. In three separate analyses, dispensing an inciting medication signaled a look back of 365 days from the date of first dispensing to confirm that the second treatment was started after the inciting medication. The prescribing cascade was considered when the second treatment was started within 180 days of the inciting treatment. Sex differences in the prescribing cascade were tested using t-tests or chi square tests as appropriate. Both univariate (unadjusted) and multivariate (adjusted) logistic regression (adjusted for age, rurality, and sex) and Cox proportional hazards regression was used to identify risk factors for the prescribing cascade.

Results

From March 1, 2005 to March 31, 2015, 28,953 Nova Scotia Seniors' Pharmacare beneficiaries with dementia (NSSPBD) were identified. There were 60 cases of bladder anticholinergics following cholinesterase inhibitors, 11 cases of Parkinson’s disease medication following metoclopramide, and 289 cases of a diuretic following CCB in the cohort. Regression analysis demonstrated that risk of bladder anticholinergics following cholinesterase inhibitors and diuretics following CCBs were associated with female sex. Cox regression suggested that bladder anticholinergics were less often used by those on cholinesterase inhibitors and did not identify CCB use as leading more frequently to diuretic use.

Conclusions

The combination of diuretics following CCB was the most common prescribing cascade and bladder anticholinergics following cholinesterase inhibitors the second most common. However, exposure to the inciting medications did not increase risk of exposure to the second treatments. Combinations of bladder anticholinergics following cholinesterase inhibitors and diuretics following CCBs were more common for women raising concern that women may be at increased risk of these prescribing cascades.
Intestinal schistosomiasis masquerading as intestinal polyps
Authors: Zhu Xiu Li , Song Ji Zhong , Yu Wen Yong , Hua Li Qun , Zhang Ming Li
Published: May 2021

Background

Schistosomiasis is very common in the southern part of the Yangtze River Basin in China. It is mainly manifested as appendicitis, ulcers, hematomas, and thickening of the intestinal tract. Schistosomiasis of the appendix is rare, mainly manifested as appendicitis, which is easy to be misdiagnosed.

Case presentation

Here we report a rare case of a Chinese female whose intestinal mass manifested as intestinal polyps and was eventually diagnosed pathologically as schistosomiasis infection (appendix schistosomiasis). So far, there are rare relevant cases reported.

Conclusions

Intestinal schistosomiasis is easily misdiagnosed, and appendix schistosomiasis is rare. The final diagnosis requires pathology, especially surgical pathology.
Cytomegalovirus in urinary sediment in patients with acute kidney injury
Authors: Pajenda Sahra , Kapps Sebastian , Gerges Daniela , Hoermann Gregor , Wagner Ludwig , Buchtele Nina , Geist Barbara , Strassl Robert , Schmidt Alice , Winnicki Wolfgang
Published: May 2021

Background

Immunosuppression in solid organ transplantation is associated with frequent infections. Renal allograft recipients are susceptible to opportunistic infections and can acquire human cytomegalovirus (HCMV) infections even within the allograft. There, HCMV can be found in both the glomerulus and tubular cells, but is mostly restricted to specific and circumscribed sites. Therefore, not all organ infections are identifiable by immunohistology for HCMV proteins in fine needle core biopsies. Thus, we performed a urinalysis study to search for HCMV-specific RNA transcripts in the urine sediment of patients with acute kidney injury.

Methods

Urinary sediment of 90 patients with acute kidney injury (AKI), including 48 renal transplant recipients (RTX) and 42 non-transplant recipients (nRTX), was collected from morning urine for RNA extraction and reverse transcription. The copy number of HCMV transcripts was evaluated using a UL132 HCMV-specific probe set and by real-time quantitative polymerase chain reaction (RT-qPCR).

Results

Of the 48 RTX patients, ten showed HCMV copies in their urine sediment cells. Within this group, three recipients had negative HCMV serology and received an allograft from an HCMV-seropositive donor. In addition, all three RTX patients on a belatacept-based immunosuppressive regimen had HCMV transcripts in their urine. Of the 42 nRTX patients, only two had detectable HCMV transcripts in urine sediment cells and both were under immunosuppression.

Conclusions

Ten immunosuppressed renal allograft recipients and two immunosuppressed non-transplant patients with AKI showed HCMV copies in urine sediment. Thus, HCMV positivity in urinary sediment appears to be associated with immunosuppression. This study describes a novel noninvasive method for detection of HCMV in urinary sediment. Whether all HCMV infections can be detected or only those with viral replication warrants further investigation.
Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report
Authors: Yan Zhizhong , Shi Zhonghua , Wang Yuhai , Zhang Chunlei , Liu Huize , Cai Jin , Zhang Xin
Published: May 2021

Background

Abnormal hypoperfusion on the surgical side after carotid artery stenting is rare. Neurological deterioration caused by it is deceptive, which can easily lead to misdiagnosis. The mechanism of hypoperfusion has rarely been demonstrated. We present here a fully studied case with a high probability of intracerebral steal phenomenon.

Case presentation

A 68-year-old male with severe right internal carotid artery stenosis and left internal carotid artery occlusion underwent right stenosis stent implantation. Restlessness and left limb hemiplegia occurred within 24 h after the procedure, which was similar to hyperperfusion syndrome. However, postoperative computerized tomography perfusion (CTP) revealed abnormal hypoperfusion in the right hemisphere. Transcranial Doppler (TCD) also showed decreased flow velocity in the right middle cerebral artery, and increased flow velocity in the right anterior cerebral artery. We considered that intracerebral steal phenomenon might be the cause, then hypervolemic therapy was accepted and the symptoms completely resolved after 3 days.

Conclusions

Ipsilateral hypoperfusion is rarely seen after carotid artery stenting. Intracerebral steal phenomenon may be the underlying mechanism. CTP or TCD is helpful for the early detection of this adverse event.
Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Authors: Wang Wei , Xie Xin , Yuan Ting , Wang Yanyan , Zhao Fei , Zhou Zhangjian , Zhang Hao
Published: May 2021

Background

Relevant studies focusing on epidemiological of profiles hypertensive disorders of pregnancy from global data that report the cause-specific prevalence and trends of hypertensive disorders of pregnancy at global, regional and national levels from 1990 to 2019 by age and sociodemographic index are still limited.

Methods

For hypertensive disorders of pregnancy, point prevalence, annual incidence, and years lived with disability numbers and age standardized rates per 100,000 population were compared at regional and national levels by age and sociodemographic index using data from the global Burden of Disease 2019 Study, covering populations from 204 countries and territories. Estimates are reported with uncertainty intervals to exhibit the changing trends during a specific period.

Results

The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million globally, with a total increase of 10.92 % from 1990 to 2019. The age-standardized incidence rate decreased, with an estimated annual percent change of -0.68 (95 % confidence interval [CI] -0.49 to -0.86). The number of deaths due to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019, representing a 30.05 % decrease from 1990. Based on the incidence and prevalence, the number of deaths and years lived with disability were highest in the group aged 25–29 years, followed by the groups aged 30–34 and 20–24 years, while the lowest estimated incidence rate was observed in the group aged 25–29 years and higher incidence rates were observed in the youngest and oldest groups. Positive associations between incidence rates and the sociodemographic index and human development index were found for all countries and regions in 2019. Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices.

Conclusions

Our study provides a comprehensive overview of the global burden of hypertensive disorders of pregnancy. The death and incidence rates are decreasing in most countries and all regions except for those with low sociodemographic and human development indexes. This difference is mainly due to the increasing attention to prenatal examinations and health education. Further investigations should focus on forecasting the global disease burden of specific hypertensive disorders of pregnancy and modifiable risk factors.
Reconstructive outcome analysis of the impact of neoadjuvant chemotherapy on immediate breast reconstruction: a retrospective cross-sectional study
Authors: Yang Jia-Ruei , Kuo Wen-Ling , Yu Chi-Chang , Chen Shin-Cheh , Huang Jung-Ju
Published: May 2021

Background

Neoadjuvant chemotherapy (NACT) was initially applied to locally advanced breast cancer to convert advanced lesions to an operable status. Currently, its application has been expanded to enhance overall oncological results, especially in patients with triple-negative or HER-2-positive breast cancer. With more NACT being applied, the role and impact of this approach on breast reconstruction needs to be determined. This study aimed to perform a complete reconstructive outcome analysis of patients receiving NACT who underwent immediate breast reconstruction.

Methods

A retrospective review of a single reconstructive surgeon’s immediate breast reconstructions performed from July 2008 to December 2018 was undertaken. The results were stratified by the use of NACT. Patient demographics, delivery of NACT, adjuvant treatment, incidence of surgical complications, and postoperative photographs were analyzed.

Results

A total of 269 patients were included. The mean follow-up was 46.3 months. Forty-six out of 269 patients received NACT and were included in the NACT group. The other patients were included in the non-NACT group. When implant-based reconstruction was planned, the NACT group had a higher rate of two-stage tissue expander-implant reconstruction than direct-to-implant reconstruction (p < 0.001). The requirement for postmastectomy radiotherapy was higher in the NACT group (p < 0.001). The surgical complication rates were similar between groups after adjusting for confounding factors. The objective aesthetic outcomes assessed by 6 plastic surgeons were also similar between groups.

Conclusions

Immediate breast reconstruction is a safe and reliable procedure, with an acceptable reconstructive complication rate and satisfactory aesthetic outcomes, for patients treated with NACT.
Comparison of dose-dense vs. 3-weekly paclitaxel and carboplatin in the first-line treatment of ovarian cancer in a propensity score-matched cohort
Authors: Pirolli Rafaela , de Alencar Viviane Teixeira Loiola , Estati Felipe Leonardo , Ribeiro Adriana Regina Gonçalves , Honda Daniella Yumi Tsuji , de Oliveira Mariana , da Silveira Nogueira Lima Joao Paulo , dos Santos Elizabeth Santana , Guimarães Andrea Paiva Gadelha , Baiocchi Glauco , da Costa Alexandre André Balieiro Anastácio
Published: May 2021

Background

Benefit of carboplatin and dose-dense weekly paclitaxel (ddCT) in first line treatment of ovarian cancer patients has been different in Western and Asian studies. In the present study we compare progression-free survival (PFS) of ddCT to three-weekly carboplatin and paclitaxel (CT) in first-line treatment of ovarian carcinoma in a single institution in a Western population.

Materials and methods

We conducted a retrospective review of medical records from patients with ovarian carcinoma treated in a tertiary cancer center from 2007 to 2018. All patients treated with ddCT or CT in the first-line setting were included. Patients who received first-line bevacizumab were not included. PFS and overall survival (OS) were compared in a propensity score-matched cohort to address selection bias. Patients were matched according to age, ECOG performance status, CA 125, FIGO stage, residual disease, and histological subtype, in a 1:2 ratio.

Results

Five hundred eighty-eight patients were eligible for propensity score matching, the final cohort consisted of 69 patients treated with ddCT and 138 CT group. Baseline characteristics were well-balanced. After a median follow-up of 65.1 months, median PFS was 29.3 vs 20.0 months, favouring ddCT treatment (p = 0.035). In the multivariate cox regression ddCT showed a 18% lower risk of progression (HR 0.82, 95% CI 0.68–0.99, p = 0.04). Overall survival data is immature, but suggested better outcomes for ddCT (not reached versus 78.8 months; p = 0.07).

Conclusion

Our retrospective study has shown superior PFS of ddCT over CT regimen in first-line treatment of ovarian carcinoma in a Western population not treated with bevacizumab.
Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction
Authors: Shin Da Young , Hwang Ho Sik , Kim Hyun Seung , Kim Man Soo , Kim Eun Chul
Published: May 2021

Background

The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D).

Methods

We performed a retrospective chart review for patients with corneal astigmatism > 1.5D who underwent cataract surgery and their target refraction is -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.

Results

The near UCVA of the toric IOL group (0.26 ± 0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48 ± 0.32) (p = 0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). Best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465) did not show significant differences between the toric IOL group and the monofocal IOL group. In the toric IOL group, postoperative refractive astigmatism was − 0.80 ± 0.46D and postoperative corneal astigmatism was − 1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were − 1.65 ± 0.77D and − 1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications.

Conclusions

When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.
Evaluation of health care providers’ use of the ‘Exercise and Depression Toolkit’: a case study
Authors: Glowacki Krista , Zumrawi Daniah , Michalak Erin , Faulkner Guy
Published: May 2021

Background

Exercise is now recommended as a primary treatment for mild-moderate depression in Canada. The ‘Exercise and Depression Toolkit’ was developed to help health care providers (HCP) integrate these treatment guidelines into practice. The purpose of this study was to evaluate acceptability and perceived effectiveness of the toolkit in practice by HCPs working with individuals with depression.

Methods

A case study design was utilized. The toolkit was given to 6 HCPs to use in practice for 4 weeks. Pre- and post-intervention phone interviews were conducted, and weekly logs were provided to track use and satisfaction of interactions with individuals with depression when using the toolkit. The study was conceptually guided by a hybrid theoretical approach using the Diffusion of Innovation Theory and the Theoretical Framework of Acceptability.

Results

All HCPs used the toolkit at least once. Participants viewed their interactions when using the toolkit to be successful (considering individuals’ receptiveness, its usefulness and general satisfaction.) The average success score for all participants was 5.5/7. HCPs found the toolkit to be acceptable. All participants (n = 6) viewed the toolkit as having relative advantage in helping them to discuss exercise with individuals with depression, and as relatively simple and easy to use (not complex) and adaptable to their practice needs (having trialability). Participants liked the toolkit and had mostly positive things to say about it. Participants had mixed feelings about whether changes in the people they worked with (such as mood and activity levels) could be observed (observability) and whether the toolkit changed their belief in their ability to recommend or discuss exercise (self-efficacy). Recommended dissemination strategies were adopted in promoting the toolkit.

Conclusions

Future work should address observability and the ability for health care providers to see other providers using it, as well as effectiveness considering outcomes for people with depression such as mood and activity changes. The results of this initial evaluation seem promising for uptake and future adoption of the toolkit by health care providers working with adults with depression in Canada.
Temporal dynamic in the impact of COVID− 19 outbreak on cause-specific mortality in Guangzhou, China
Authors: Li Li , Hang Dong , Dong Han , Yuan-Yuan Chen , Bo-Heng Liang , Ze-Lin Yan , Zhou Yang , Chun-Quan Ou , Peng-Zhe Qin
Published: May 2021

Background

Studies related to the SARS-CoV-2 spikes in the past few months, while there are limited studies on the entire outbreak-suppressed cycle of COVID-19. We estimate the cause-specific excess mortality during the complete circle of COVID-19 outbreak in Guangzhou, China, stratified by sociodemographic status.

Methods

Guangzhou Center for Disease Control Prevention provided the individual data of deaths in Guangzhou from 1 January 2018 through 30 June 2020. We applied Poisson regression models to daily cause-specific mortality between 1 January 2018 and 20 January 2020, accounting for effects of population size, calendar time, holiday, ambient temperature and PM2.5. Expected mortality was estimated for the period from 21 January through 30 June 2020 assuming that the effects of factors aforementioned remained the same as described in the models. Excess mortality was defined as the difference between the observed mortality and the expected mortality. Subgroup analyses were performed by place of death, age group, sex, marital status and occupation class.

Results

From 21 January (the date on which the first COVID-19 case occurred in Guangzhou) through 30 June 2020, there were three stages of COVID-19: first wave, second wave, and recovery stage, starting on 21 January, 11 March, and 17 May 2020, respectively. Mortality deficits were seen from late February through early April and in most of the time in the recovery stage. Excesses in hypertension deaths occurred immediately after the starting weeks of the two waves. Overall, we estimated a deficit of 1051 (95% eCI: 580, 1558) in all-cause deaths. Particularly, comparing with the expected mortality in the absence of COVID-19 outbreak, the observed deaths from pneumonia and influenza substantially decreased by 49.2%, while deaths due to hypertension and myocardial infarction increased by 14.5 and 8.6%, respectively. In-hospital all-cause deaths dropped by 10.2%. There were discrepancies by age, marital status and occupation class in the excess mortality during the COVID-19 outbreak.

Conclusions

The excess deaths during the COVID-19 outbreak varied by cause of death and changed temporally. Overall, there was a deficit in deaths during the study period. Our findings can inform preparedness measures in different stages of the outbreak.
Clinical implications of bronchoscopy for immune checkpoint inhibitor-related pneumonitis in patients with non-small cell lung cancer
Authors: Nishiyama Osamu , Shimizu Shigeki , Haratani Koji , Isomoto Kosuke , Tanizaki Junko , Hayashi Hidetoshi , Yamazaki Ryo , Oomori Takashi , Nishikawa Yusaku , Sano Akiko , Nakagawa Kazuhiko , Tohda Yuji
Published: May 2021

Background

The utility of bronchoscopy for patients with suspected immune checkpoint inhibitor (ICI)-related pneumonitis is currently debatable. The purpose of this study was to examine the findings of bronchoalveolar lavage (BAL) analysis and transbronchial lung biopsy (TBLB) in non-small cell lung cancer (NSCLC) patients with ICI-related pneumonitis, and to elucidate the clinical significance of bronchoscopy for this health condition.

Patients and methods

Consecutive NSCLC patients treated with ICIs, diagnosed with ICI-related pneumonitis after undergoing bronchoscopy between October 2015 and March 2019 were retrospectively screened. Findings of BAL fluid analysis and/or TBLB specimen histology were reviewed.

Results

Twelve patients underwent bronchoscopy for the diagnosis of ICI-related pneumonitis, ten of whom underwent BAL. An increase in the proportion of lymphocytes higher than 20% was observed in all ten patients. An increase in the proportion of neutrophils (> 10%) and eosinophils (> 10%) was observed in two and one patient, respectively. TBLB specimens were analyzed for eight patients. Major histologic findings included alveolitis in seven (87.5%) and organizing pneumonia (OP) in five (62.5%) patients. Other findings included acute lung injury and fibrosis. All twelve patients demonstrated favorable outcomes.

Conclusion

A major characteristic of BAL analysis in ICI-related pneumonitis with NSCLC was an increased proportion of lymphocytes. The histologic features of lung tissue included alveolitis and/or OP. Acute lung injury and fibrosis were observed. Although the necessity of bronchoscopy should be determined on a case-by-case basis, it is necessary to assess these parameters when proper differential diagnosis is needed.