bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebral embolism due to left atrial myxoma in a patient presenting with chest pain and ST-segment elevation: a case report
Authors: Fontes António , Dias-Ferreira Nuno , Tavares Anabela , Neves Fátima
Published: December 2020

Background

Myocarditis is an uncommon, potentially life-threatening disease that presents with a wide range of symptoms. In acute myocarditis, chest pain (CP) may mimic typical angina and also be associated with electrocardiographic changes, including an elevation of the ST-segment. A large percentage (20–56%) of myxomas are found incidentally.

Case summary

A 62-year-old female presenting with sudden onset CP and infero-lateral ST-elevation in the electrocardiogram. The diagnosis of ST-elevation myocardial infarction was presumed and administered tenecteplase. The patient was immediately transported to a percutaneous coronary intervention centre. She complained of intermittent diplopia during transport and referred constitutional symptoms for the past 2 weeks. Coronary angiography showed normal arteries. The echocardiogram revealed moderate to severe left ventricular systolic dysfunction due to large areas of akinesia sparing most of the basal segments, and a mobile mass inside the left atrium attached to the septum. The cardiac magnetic resonance (CMR) suggested the diagnosis of myocarditis with concomitant left atrial myxoma. The patient underwent resection of the myxoma. Neurological evaluation was performed due to mild vertigo while walking and diplopia in extreme eye movements. The head magnetic resonance imaging identified multiple infracentimetric lesions throughout the cerebral parenchyma compatible with an embolization process caused by fragments of the tumour.

Discussion

Myocarditis can have various presentations may mimic acute myocardial infarction and CMR is critical to establish the diagnosis. Myxoma with embolic complications requires emergent surgery. To the best of our knowledge, this is the first case reported in the applicable literature of a myxoma diagnosed during a myocarditis episode.
Ribosomal RNA 2′O-methylation as a novel layer of inter-tumour heterogeneity in breast cancer
Authors: Marcel Virginie , Kielbassa Janice , Marchand Virginie , Natchiar Kundhavai S , Paraqindes Hermes , Nguyen Van Long Flora , Ayadi Lilia , Bourguignon-Igel Valérie , Lo Monaco Piero , Monchiet Déborah , Scott Véronique , Tonon Laurie , Bray Susan E , Diot Alexandra , Jordan Lee B , Thompson Alastair M , Bourdon Jean-Christophe , Dubois Thierry , André Fabrice , Catez Frédéric , Puisieux Alain , Motorin Yuri , Klaholz Bruno P , Viari Alain , Diaz Jean-Jacques
Published: December 2020

Recent epitranscriptomics studies unravelled that ribosomal RNA (rRNA) 2′O-methylation is an additional layer of gene expression regulation highlighting the ribosome as a novel actor of translation control. However, this major finding lies on evidences coming mainly, if not exclusively, from cellular models. Using the innovative next-generation RiboMeth-seq technology, we established the first rRNA 2′O-methylation landscape in 195 primary human breast tumours. We uncovered the existence of compulsory/stable sites, which show limited inter-patient variability in their 2′O-methylation level, which map on functionally important sites of the human ribosome structure and which are surrounded by variable sites found from the second nucleotide layers. Our data demonstrate that some positions within the rRNA molecules can tolerate absence of 2′O-methylation in tumoral and healthy tissues. We also reveal that rRNA 2′O-methylation exhibits intra- and inter-patient variability in breast tumours. Its level is indeed differentially associated with breast cancer subtype and tumour grade. Altogether, our rRNA 2′O-methylation profiling of a large-scale human sample collection provides the first compelling evidence that ribosome variability occurs in humans and suggests that rRNA 2′O-methylation might represent a relevant element of tumour biology useful in clinic. This novel variability at molecular level offers an additional layer to capture the cancer heterogeneity and associates with specific features of tumour biology thus offering a novel targetable molecular signature in cancer.
Short-term impact of surgically induced menopause on cognitive function and wellbeing in women at high risk for ovarian cancer following risk-reducing bilateral salpingo-oophorectomy
Authors: Chang Heidi , Kamara Daniella , Bresee Catherine , Lester Jenny , Cass Ilana
Published: December 2020

Objective:

Risk-reducing bilateral salpingo-oophorectomy (RRSO) is an effective strategy to prevent pelvic serous carcinoma for women at high risk of developing ovarian cancer; however, it results in premature menopause. Data is lacking to adequately counsel these women about potential effects of premature menopause on cognition and quality of life.

Methods:

A prospective study in premenopausal women at high risk of ovarian cancer to determine changes in cognition over time after RRSO and the impact of hormone therapy (HT) on cognition. Participants were surveyed before and after surgery using the Functional Assessment of Cancer Therapy-Cognitive questionnaire and questions regarding domains of wellbeing at 6, 12 and 18 months. Data was tested for changes across time using mixed model regression and logistic regression.

Results:

Fifty-seven women were included. Sixty-three percent of participants used HT. At 6 months postoperatively, perceived cognitive impairment declined by 5.5 points overall (4.4 in non-HT users and 6 in HT users), P = 0.003. The other domains of cognition assessed did not change significantly over time and the use of HT did not impact scores. Sleep disruption was common in this cohort and was not mitigated by HT. Self-reported depression improved after RRSO (P = 0.004).

Conclusion:

Women at high risk of ovarian cancer who choose RRSO may experience declines in cognition within the first 6 months of surgical menopause. HT may cause small declines in perceived cognitive impairment at 6 months after RRSO. Women can expect more sleep disruption after menopause, which is not mitigated by HT.

Video Summary:
http://links.lww.com/MENO/A697.
Endovascular management of symptomatic stenosis of supra-aortic arteries in patients with Takayasu arteritis
Authors: Chen Shu-Ting , Luo Chao-Bao , Guo Wan-Yuo , Chang Feng-Chi
Published: December 2020

Background:

Endovascular management is used to treat Takayasu arteritis (TA) involving the supra-aortic branches. However, the long-term outcome of this treatment remains unclear. Here, technical safety, outcomes, and restenosis management of supra-aortic arteries in TA patients receiving endovascular treatment were evaluated.

Methods:

TA patients with symptomatic supra-aortic stenosis who underwent percutaneous angioplasty and stenting between 2008 and 2018 at our institute were enrolled in this study. Pre- and post-procedural magnetic resonance imaging (MRI) evaluations, including high-resolution vessel wall imaging (HR-VWI), were performed. Technical efficacy, peri-procedural complications, early post-procedural MRI results, and stent patency were examined.

Results:

All six patients successfully received stent placement or percutaneous transluminal angioplasty in a total of 22 treated arteries without neurologic complications. During follow-up (mean, 56.3 ± 41.1 months), no recurrent stroke occurred, yet significant restenosis developed in 12 of 22 (54.5%) of the treated arteries. Three of the patients underwent HR-VWI before surgery. Concentric wall thickening and enhancement of the left common carotid artery was detected in one patient, indicating acute inflammation. Angioplasty with drug-eluting balloon (DEB) successfully treated a case of refractory restenosis. Among 10 early post-procedure MRI performed, only two asymptomatic new lesions were detected with diffusion-weighted imaging.

Conclusion:

Endovascular treatment of supra-aortic arteries of TA patients was safe and effective, yet was associated with a high restenosis rate. Thus, close follow-up is needed. HR-VWI is helpful for pre-procedural selection of patients for percutaneous angioplasty and stenting and drug-eluting balloon angioplasty appears to be a promising treatment for refractory in-stent restenosis.
A Qualitative Study of the Health-Related Perceptions of Married Iranian Women Who Have Experienced Domestic Violence
Authors: Rezaee Nasrin , Mardani-Hamooleh Marjan
Published: December 2020

Introduction

Violence against women occurs all over the world; it is a phenomenon that is considered an invasion of human rights. The most common form of this phenomenon is domestic violence (DV).

Aim

The purpose of this study was to explore the health-related perceptions of married women in Iran who have experienced DV.

Method

This qualitative study was carried out using conventional content analysis method. In total, a purposive sample of 27 women who had been subjected to violence by their spouses agreed to participate in this study. Individual, in-depth, and semistructured interviews were conducted.

Findings

Three main categories emerged from the data: (a) perceptions related to physical health (including non-sex-organ injuries and sex organ injuries), (b) perceptions related to psychological health (including fear, concern, and the creation of challenges), and (c) perceptions related to sociocultural health (specifically social health and cultural health).

Conclusion

In Iran, DV threatens women's health and is influenced by personal, familial, social, and cultural factors. Nurses should consider various aspects of physical, psychological, and sociocultural health when caring for women who have experienced DV. Social and cultural-based interventions are needed to address negative attitudes, stigma, and false beliefs that sanction DV in Iran.
Increased Radiosurgery Toxicity Associated With Treatment of Vestibular Schwannoma in Multiple Sclerosis
Authors: Wallerius Katherine , Collins Sean , Forsthoefel Matthew , Kim Hung Jeffrey
Published: December 2020

Objective:

Explore the risk of radiation-induced neurotoxicity in patients with multiple sclerosis (MS) treated with stereotactic radiosurgery (SRS) and better understand the pathophysiology of radiation-induced injury in the central nervous system (CNS).

Patients/Intervention:

We present the clinical course and magnetic resonance imaging (MRI) findings of a 52-year-old woman with a history of relapsing remitting MS, who developed radiation-induced neurotoxicity following CyberKnife SRS (25 Gy in five fractions) for a left-sided vestibular schwannoma (VS).

Main Outcome Measure:

Risk of radiation-induced damage following SRS to the CNS, including radiation type and dose, toxicity, and time to symptom onset, in patients with MS.

Results:

Our patient developed increased imbalance (grade 2 toxicity) 3 months following CyberKnife SRS. Brain MRI showed new fluid-attenuated inversion recovery (FLAIR) hyperintensity in the pons and cerebellum. Neurotoxicity from SRS is rare. However, our literature review showed that 19 patients with MS who underwent intracranial radiation therapy sustained radiation-induced toxicity. The potential mechanisms for increased toxicity in MS could be due to a combination of demyelination, inflammatory, and/or vascular changes. Efficacy of treatments including steroids, bevacizumab, and hyperbaric oxygen therapy is currently unknown.

Conclusion:

Treatment options of SRS and surgery for VS should be carefully considered as patients with known MS may be at increased risk for radiation-induced damage following SRS to the CNS. Thoughtful radiosurgical planning and dosing accounting for this inherent risk is essential for managing patients with MS and VS.
Treatment Analysis and Overall Survival Outcomes of Patients With Bilateral Vestibular Schwannoma
Authors: Goshtasbi Khodayar , Abouzari Mehdi , Yasaka Tyler M. , Soltanzadeh-Zarandi Sina , Sarna Brooke , Lin Harrison W. , Djalilian Hamid R.
Published: December 2020

Objectives:

To investigate the clinical presentation, treatment breakdown, and overall survival (OS) outcomes of patients with neurofibromatosis type 2 (NF2)-associated bilateral vestibular schwannoma (NVS).

Methods:

The 2004 to 2016 National Cancer Database was queried for patients with a diagnosis of VS. The “Laterality” code was used to stratify patients into sporadic unilateral vestibular schwannoma (UVS) and NVS.

Results:

Of the 33,839 patients with VS, 155 (0.46%) were coded for NVS with an average age and tumor size of 37.4 ± 20.5 years and 23.5 ± 18.2 mm. Patients underwent observation (45.3%), surgery (29.3%), and radiotherapy (20.0%), and had a 5.8% 5-year mortality rate. Compared with UVS, NVS was negatively associated with receiving surgery (40.2% versus 29.3%, p = 0.02) while watchful observation was more prevalent (30.1% versus 45.3%, p = 0.001). In NVS, undergoing surgery was associated with larger tumor size (34.5 ± 21.2 versus 17.8 ± 13.3 mm, p = 0.001) and shorter diagnosis-to-treatment time (49.1 ± 60.6 versus 87.0 ± 78.5 d, p = 0.02), radiotherapy was associated with older age (44.4 ± 18.9 versus 35.2 ± 20.6 yr, p = 0.02) and longer diagnosis-to-treatment time (85.9 ± 77.9 versus 53.9 ± 65.5 d, p = 0.04), and observation was associated with smaller tumor size (17.8 ± 15.9 versus 28.0 ± 19.2 mm, p = 0.01). Kaplan–Meier log-rank analysis demonstrated similar 10-year OS between NVS and UVS patients (p = 0.58) without factoring the earlier age of presentation. Furthermore, there were no temporal changes in presentation/management of NVS, and OS was not dependent on the received treatment (p = 0.30).

Conclusions:

With younger age, larger tumors, and more conservative management, NVS's OS was not treatment-dependent and was similar to sporadic UVS, though the latter should not be interpreted as similar life expectancies due to the much earlier presentation.
Balloon Dilation for Obstructive Eustachian Tube Dysfunction in Children
Authors: Toivonen Joonas , Kawai Kosuke , Gurberg Joshua , Poe Dennis
Published: December 2020

Objective:

Determine the safety and efficacy of balloon dilation of the Eustachian tube (ET) in pediatric patients.

Study Design:

Retrospective matched cohort study.

Setting:

Tertiary medical center.

Patients:

Pediatric patients (<18 yr) with persistent (>1.5 yr) chronic Eustachian tube dysfunction (ETD) with previous tympanostomy tube (TT) insertion versus matched controls.

Intervention(s):

Balloon dilation of the cartilaginous ET (BDET) was performed using concomitant myringotomy with/without tube placement and adjunctive procedures if indicated versus controls (TT).

Main Outcome Measure(s):

Otitis media with effusion (OME)/retraction with need for additional tube, tympanogram, audiogram, otomicroscopy, ET mucosal inflammation/opening score, and Valsalva maneuver.

Results:

Forty six ETs (26 patients), ages 7 to 17 years (mean 12.5) underwent BDET. Mean follow-up was 2.3 years (standard deviation [SD], 1.1; range, 6 mo–5 yr). Significant improvements were observed for all measures. Tympanic membranes were healthy in 9% preoperatively, 38% at 6 months, 55% at 12 months, and 93% at 36 months postoperatively. Tympanograms improved to type A in 50% at 6 months, 59% at 12 months, and 85% at 36 months. Mean scores of mucosal inflammation declined from 3.2 (±0.6) preoperatively to 2.5 (±0.7) at 6 months and 1.7 (±0.6) at 36 months postoperatively. BDET had lower risk of failure versus TT insertion (adjusted hazard ratio [HR] 0.26; 95% confidence interval [CI]: 0.10, 0.70; p = 0.007). Probability of being failure free at 2 years was 87% (95% CI: 70, 94%) after BDET and 56% (95% CI: 40, 70%) after TT insertions.

Conclusions:

BDET is a safe and possibly effective procedure in selected pediatric patients with chronic ETD.
Hemophilia carriers: quality of life and management at different life stages
Authors: Torres-Ortuño Ana
Published: December 2020

The carrier testing, genetic counseling and prenatal diagnosis have become an integrated part of the comprehensive care for hemophilia, but quality of life and management of carriers frequently remain suboptimal. It is paramount to evaluate the physical and psycho-social impact of them as problematic physical, psychological and social situations are not uncommon. There are to instruct them about their hemorrhagic possible symptoms and condition for offering solutions that meet their needs and help them enjoy a satisfactory quality of life in all life stages.
Quantitative Differentiation of Left Atrial Performance in Hypertrophic Cardiomyopathy
Authors: Ran Hong , Schneider Matthias , Wan Lin-lin , Ren Jun-yi , Ma Xiao-wu , Zhang Ping-yang
Published: December 2020

Objective:

The objective of this study was to describe the different components of left atrial (LA) dysfunction predictors in nonobstructive and occult obstructive hypertrophy cardiomyopathy (HCM) patients especially with preserved left ventricular (LV) ejection fraction, particularly using LA 4-dimensional (D) longitudinal and circumferential strains.

Methods:

Twenty-eight nonobstructive HCM patients and 30 occult obstructive HCM patients according to LV outflow tract gradient at rest and after exercise were prospectively enrolled. 4D echocardiographic evaluation was performed in 58 HCM patients, both nonobstructive and occult obstructive, and 38 control subjects. LA reservoir, conduit, contractile functions were performed by 4D volume-strain with volumes and longitudinal, circumferential strains.

Results:

Optimal correlation coefficients obtained between LV 4D mass (index) and LA 4D longitudinal/circumferential strain (r=−0.860 to 0.518, all P<0.001). Both nonobstructive and occult obstructive HCM patients had increased volumes and significantly decreased longitudinal, circumferential strain values with lower reservoir, conduit, contractile functions than the controls (all P<0.001). Occult obstructive HCM patients presented incremented volumes compared with nonobstructive ones (P<0.001 to 0.003). Lower conduit function and higher contractile function indicated with lower reservoir function revealed by circumferential strain in occult obstructive HCM patients than nonobstructive ones (P<0.001 to 0.017). Interclass correlation coefficients of intraobserver and interobserver in the LV and LA 4D value evaluations were >0.75 and >0.85, respectively.

Conclusions:

LA volumes were significantly increased and LA reservoir, conduit, and contractile functions were significantly impaired in HCM patients. Furthermore, different performances of LA functional analyses in nonobstruction and occult obstruction patients with 4D volume-strain echocardiography may facilitate the recognition of subtle LA dysfunctional differentiation in HCM patients.
Health-Related Quality of Life Among Patients With Inflammatory Bowel Disease
Authors: Kamp Kendra J. , Stommel Manfred
Published: December 2020

The aim of this study is to compare health-related quality of life between inflammatory bowel disease patients and age-/gender-matched controls while taking into account comorbid conditions (such as diabetes and heart disease). Data from the 2015 and 2016 National Health Interview Survey were used. Patients with inflammatory bowel disease (n = 951) were age- and gender-matched to noninflammatory bowel disease patients (n = 3,804). Patients with inflammatory bowel disease were more likely to be diagnosed with an airway disease (p < .000), heart disease (p < .000), or stomach cancer (p < .001) than age- and gender-matched individuals without inflammatory bowel disease. Even after controlling for these comorbidities, sociodemographic characteristics as well as health-related behaviors, patients with inflammatory bowel disease had significantly lower health-related quality of life than individuals of the same age and gender. Inflammatory bowel disease appears to be associated with particularly low levels of health-related quality of life. Alcohol consumption, smoking, physical activity, and body mass index may be risk factors for a decreased health-related quality of life.
Lessons learned from Vietnam’s COVID-19 response: the role of adaptive behavior change and testing in epidemic control
Authors: Pham Quang D. , Stuart Robyn M. , Nguyen Thuong V. , Luong Quang C. , Tran Dai Q. , Pham Thai Q. , Phan Lan T. , Dang Tan Q. , Tran Duong N. , Do Hung T. , Mistry Dina , Klein Daniel J. , Abeysuriya Romesh G. , Oron Assaf P. , Kerr Cliff C.
Published: December 2020

Background

Vietnam has emerged as one of the world’s leading success stories in responding to COVID-19. After prolonged zero-low transmission, a summer outbreak of unknown source at Da Nang caused the country’s first COVID-19 deaths, but was quickly suppressed. Vietnam recently reopened its borders to international travelers. Understanding the attendant risks and how to minimize them is crucial as Vietnam moves into this new phase.

Methods

We create an agent-based model of COVID-19 in Vietnam, using regional testing data and a detailed linelist of the 1,014 COVID-19 cases, including 35 deaths, identified across Vietnam. We investigate the Da Nang outbreak, and quantify the risk of another outbreak under different assumptions about behavioral/policy responses and ongoing testing.

Results

The Da Nang outbreak, although rapidly contained once detected, nevertheless caused significant community transmission before it was detected; higher symptomatic testing could have mitigated this. If testing levels do not increase, the adoption of past policies in response to newly-detected cases may reduce the size of potential outbreaks but will not prevent them. Compared to a baseline symptomatic testing rate of 10%, we estimate half as many infections under a 20% testing rate, and a quarter as many with 40-50% testing rates, over the four months following border reopenings.

Conclusions

Vietnam’s success in controlling COVID-19 is largely attributable to its rapid response to detected outbreaks, but the speed of response could be improved even further with higher levels of symptomatic testing.
Covid-19 Prediction in USA using modified SIR derived model
Authors: desan Jathin
Published: December 2020

The Covid-19 pandemic is rapidly extended into the extraordinary crisis. Based on the SIR model and published datasets the Covid-19 spread is assessed and predicted in USA in terms of susceptible, recovered and infected in the communities is focused on this study. For modelling the USA pandemic prediction several variants have been utilized. The SIR model splits the whole population into three components such as Susceptible (S), Infected (I) and Recovered or Removed (R). A collection of differential equations have been utilized to propagate the model and resolve the disease dynamics. In the proposed study, the prediction of covid-19 based on time is performed using the modified SIR derived model SIR-D with discrete markov chain. This proposed technique analyse and forecasting the covid-19 spread in 19 states of USA. The performance analysis of the proposed Analytical results revealed that though the probable uncertainty of the proposed model provides prediction, it becomes difficult to determine the death cases in future.
Urban governance innovation and COVID‐19
Authors: McGuirk Pauline , Dowling Robyn , Maalsen Sophia , Baker Tom
Published: December 2020

Emergencies such as COVID‐19 trigger calls for innovation and invoke forced experimentation. They can shift what is thinkable and thus licence social and institutional change, opening space wherein new sociopolitical arrangements might emerge. Cities are at the heart of the COVID‐19 emergency, in terms of impact, management, and solutions. This commentary considers the implications of COVID‐19 for urban governance innovation. Incrementally, innovation has become a “new normal” across multiple fields of social, economic, technological, and environmental endeavour as disruptive enhancements are sought to address complex problems: urban governance is no exception. In cities, diverse new ecosystems of innovative urban governance have been emerging with the potential to reshape the politics and parameters of urban decision making, produce new institutional settings, reconstitute cities' multiscalar relations, and invoke new forms of power. This commentary considers urban governance innovation in COVID times. Drawing from Australian and international examples, we reflect on the actors taking centre stage as cities' responses to the pandemic take shape and consider the governing mechanisms being evoked. As these innovations embed more deeply the distributed nature of urban governance, we close with thoughts on the risks and opportunities that COVID‐19 presents for seeking inclusive innovation in the field of urban governance.
KIF4A enhanced cell proliferation and migration via Hippo signaling and predicted a poor prognosis in esophageal squamous cell carcinoma
Authors: Sun Xiaozheng , Chen Pengxiang , Chen Xue , Yang Wenjing , Chen Xuan , Zhou Wei , Huang Di , Cheng Yufeng
Published: December 2020

Background

In this study, we aimed to explore and clarify the function of KIF4A in esophageal squamous cell carcinoma (ESCC).

Methods

The microarray data were extracted from the Gene Expression Omnibus (GEO) database. We then used the database for Annotation, Visualization, and Integrated Discovery (DAVID) to perform the gene ontology function (GO) and KEGG Orthology‐Based Annotation System (KOBAS) to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of differentially expressed genes (DEGs). The six core candidate genes were identified using protein–protein interaction (PPI) network analysis and Cytoscape software. Among them, the expression of KIF4A were validated by UALCAN database from the Cancer Genome Atlas (TCGA) (P < 0.05). Western blotting, qRT‐PCR and IHC were used to detect the expression of KIF4A in tissues. Cell experiments (transwell migration assays, wound healing assay, CCK8 assay, and clone formation experiment) were utilized to verify the roles of KIF4A on the ESCC cells. Western blotting was used to explore the mechanism of KIF4A in ESCC.

Results

The expression level of KIF4A was upregulated in ESCC samples compared to those in paracancerous tissues. Transwell migration and wound healing assay showed overexpression of KIF4A significantly promoted the migration of ESCC cells. CCK8 assay and clone formation experiment analysis showed that overexpression of KIF4A promoted proliferation of ESCC cells. Western blot detection found that KIF4A could affect the phosphorylation level of Hippo signaling pathway related proteins.

Conclusions

In summary, KIF4A promotes ESCC cell proliferation and migration by regulating the biological function of ESCC cells through the Hippo signaling pathway.

Key points

Significant findings of the study

We found that high KIF4A expression was associated with poor overall survival in esophageal squamous cell carcinoma. KIF4A expression also promoted the proliferation and migration of ESCC cells in vitro.

What this study adds

Our experimental results explain the role of KIF4A in ESCC, and provide a new biomolecular target for the treatment of ESCC.
Effects of age and comorbidities on serum levels of inflammatory markers in community‐acquired pneumonia
Authors: Viasus Diego , Simonetti Antonella F. , Estupiñan‐Bohórquez Andrés F. , Carratalà Jordi
Published: December 2020

Introduction

Studies have suggested that an inappropriate inflammatory response is a major cause of treatment failure and mortality in patients with community‐acquired pneumonia (CAP). We aimed to determine the effect of age and comorbidities on serum inflammatory markers in CAP.

Methods

We performed a prospective cohort study of adults hospitalized with CAP. For the purposes of this study, we compared patients according to comorbidities and age. Inflammatory markers were measured at hospital admission, focusing on acute phase proteins, cytokines and monocyte human leucocyte antigen DR (mHLA‐DR) expression.

Results

In patients with chronic pulmonary disease (COPD), serum cytokines had significantly decreased levels of tumour necrosis factor (TNF)‐α, interleukin (IL)‐6 and mHLA‐DR expression, as well as the C‐reactive protein (CRP), compared with patients who had no comorbidities. Similarly, patients with chronic heart disease had a significantly reduced CRP levels and mHLA‐DR expression, whereas patients with chronic kidney disease had significantly higher serum levels of procalcitonin and TNF‐α. Lower procalcitonin, IL‐6 and IL‐10 levels, as well as mHLA‐DR expression, were documented in older patients, but with no significant differences compared to younger patients. Multimorbidity in older patients was associated with significant lower levels of CRP and mHLA‐DR expression.

Conclusions

The circulating inflammatory markers to CAP have profiles that differ with age and underlying comorbidities. Multimorbidity in the elderly is also associated with lower serum levels of some inflammatory markers. Our findings suggest that inflammatory markers in CAP should be interpreted after considering age and comorbid conditions.
Drivers for genetic structure at different geographic scales for Pacific red snapper (Lutjanus peru) and yellow snapper (Lutjanus argentiventris) in the tropical eastern Pacific
Authors: Reguera‐Rouzaud Nicole , Díaz‐Viloria Noé , Pérez‐Enríquez Ricardo , Espino‐Barr Elaine , Rivera‐Lucero Mailin Isabel , Munguía‐Vega Adrián
Published: December 2020

The tropical eastern Pacific (TEP) is a highly dynamic region and a model system to study how habitat discontinuities affect the distribution of shorefishes, particularly for species that display ontogenetic habitat shifts, including snappers (Lutjanidae). To evaluate the genetic structure of the Pacific red snapper (Lutjanus peru) and the yellow snapper (Lutjanus argentiventris) throughout their distribution range along the TEP, 13 and 11 microsatellite loci were analysed, respectively. The genetic diversity of L. peru (N = 446) and L. argentiventris (N = 170) was evaluated in 10 and 5 localities, respectively, showing slightly higher but non‐significant values in the Gulf of California for both species. The genetic structure analysis identified the presence of significant genetic structure in both species, but the locations of the identified barriers for the gene flow differed between species. The principal driver for the genetic structure at large scales >2500 km was isolation by distance. At smaller scales (<250 km), the habitat discontinuity for juveniles and adults and the environmental differences throughout the distribution range represented potential barriers to gene flow between populations for both species.
An international effort and use of social media to save a young girl
Authors: Gammon Richard R. , Tyler Lisa , Alvarez Harold , Benitez Nancy , Nance Sandra , Burton Angela , Delk Alexander , Bright Frieda , Sawh Dave , Forbes Susan
Published: December 2020

Background and objectives

A 2‐year‐old female with neuroblastoma needed In(b−), E− red blood cells (RBCs). No units were available at the blood centre (BC) nor in the rare donor programme member’s inventories. BC’s Immunohematology Reference Laboratory (IRL) and its marketing department concentrated on recruiting and testing those donors more likely to be antigen negative based on ethnicity.

Materials and methods

The BC’s communication plan utilized social and traditional media to assist in the search for In(b–) blood. Media strategies directed donors in the United States (US) and Canada to go to their nearest BC for collection, tagging and testing of units. Two segments from each donation were shipped overnight to the BC’s IRL (associated with the patient) for testing. Diluted anti‐Inb sera was tested by microtechniques to conserve resources. Additionally, the American Rare Donor Program (ARDP) facilitated the international searches and acted as a liaison to the Food and Drug Administration (FDA).

Results

More than 25 000 people responded to the appeal. Seventy‐seven BCs submitted segments from 4197 units. Two donors were In(b–) but E+ and thus not compatible with the patient but were submitted to ARDP for future needs. The prevalence of In(b–) units identified in the search was 0·048%. In total, five known In(b−) donors, two from the US and three from international sources, provided units for this patient.

Conclusion

Social media sparked a viral response to the rare blood need. While a match was not found among the units tested, domestic and international searches were able to meet the patient’s blood needs.
Staphylococcus lugdunensis: a Skin Commensal with Invasive Pathogenic Potential
Authors: Heilbronner Simon , Foster Timothy J.
Published: December 2020

Staphylococcus lugdunensis
is a species of coagulase-negative staphylococcus (CoNS) that causes serious infections in humans akin to those of
S. aureus
. It was often misidentified as
S. aureus
, but this has been rectified by recent routine use of matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) in diagnostic laboratories. It encodes a diverse array of virulence factors for adhesion, cytotoxicity, and innate immune evasion, but these are less diverse than those encoded by
S. aureus
.
Unusual cause of tooth mobility
Authors: Hassona Yazan , Saleh Mohammad Wael , Alkhawaldeh Hamza , Al Abweh Ruba
Published: December 2020

We describe a case of a 71-year-old otherwise healthy man who presented to the dental clinic with the chief complaint of mobility involving his upper left molar teeth. The patient was a febrile, and clinical oral examination revealed localised grade II mobility and absence of gingival swelling, erythema or sinus tract. Orthopantogram revealed a poorly defined radiolucency involving the upper left second and third molar teeth. Surgical exploration of the involved area was performed and revealed the presence of a ‘jelly like’ brown tissue that fragments easily. Pathological examination confirmed the diagnosis of diffuse large B cell lymphoma.
Pseudomonaslaryngeal perichondritis: unexpected diagnosis
Authors: Zainal Abidin Siti Salwa , Kew Thean Yean , Azman Mawaddah , Mat Baki Marina
Published: December 2020

A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months’ duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolatedPseudomonas aeruginosa. The patient made a good recovery following treatment with oral ciprofloxacin.
Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma
Authors: Banerjee Monidipa , Haj Ahmed Eiman , Foster Kathryn , Gangadharan Arundoss
Published: December 2020

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.
Scurvy presenting as lower limb ecchymoses in the setting of metastatic colorectal cancer
Authors: Inglis Joshua M , Tan Jia
Published: December 2020

A 58-year-old woman presented with a 1-week history of lower limb bruising. She had a medical history of recurrent metastatic colon cancer with a sigmoid colectomy and complete pelvic exenteration leading to colostomy and urostomy formation. She had malignant sacral mass encroaching on the spinal cord. This caused a left-sided foot drop for which she used an ankle-foot orthosis. She was on cetuximab and had received radiotherapy to the sacral mass 1 month ago. On examination, there were macular ecchymoses with petechiae on the lower limbs. There was sparing of areas that had been compressed by the ankle-foot orthosis. Bloods showed mild thrombocytopaenia and anaemia with markedly raised inflammatory markers. Coagulation studies consistent with inflammation rather than disseminated intravascular coagulation. She was found to haveKlebsiellabacteraemia secondary to urinary source. Skin biopsy showed dermal haemorrhage without vessel inflammation. Vitamin C levels were low confirming the diagnosis of scurvy.
Isolated contralateral abducens palsy in direct carotid-cavernous fistula
Authors: Jain Chirag , Mehta Aditi , Bhatia Vikas , Gupta Pankaj
Published: December 2020

Post-traumatic direct carotid-cavernous fistulas may develop in patients with a closed head injury. The classical presentation is the Dandy’s triad—chemosis, pulsatile proptosis and orbital bruit. Associated findings may include orbital pain, dilated episcleral corkscrew vessels, vision deficit and cranial nerve palsies. Cranial nerves—oculomotor (III), trochlear (IV), ophthalmic (V1), and maxillary (V2) divisions of trigeminal and the abducens (VI) lie in close association of the cavernous sinus. Abducens nerve (VI) lies close to the intracavernous internal carotid artery, within the substance of the sinus and is hence easily susceptible to vascular insult. The two sinuses connect across the midline and communicate freely with each other. Back pressure changes can present with the same sided or bilateral cranial nerve palsies. We report a rare association of a long-standing left-sided carotid-cavernous fistula with right eye abduction deficit and contralateral abducens palsy.
COVID-19 with dengue shock syndrome in a child: coinfection or cross-reactivity?
Authors: Tiwari Lokesh , Shekhar Shashank , Bansal Anmol , Kumar Pradeep
Published: December 2020

COVID-19, caused by SARS-CoV-2, has spread globally. Coinfection with other endemic viruses is likely to complicate the clinical presentation and outcome. Information on clinical manifestations and management strategies on COVID-19 coinfection with endemic diseases in children is yet to evolve. The risk of dengue infection exists in 129 countries and it is endemic in more than 100 countries. The SARS-CoV-2 pandemic might overlap with the dengue epidemics in tropical countries. We report the first paediatric case to the best of our knowledge of COVID-19 encephalitis with dengue shock syndrome. This clinical syndrome could be attributed to serological cross-reactivity, incidental coinfection or perhaps a warning for dengue-endemic regions to face the unique challenge of differentiating and managing two disease entities together. Enhanced understanding of potential COVID-19 and dengue coinfection warrants immediate attention of researchers and international health policy makers.
Oceans and human health—navigating changes on Canada’s coasts
Authors: Kenny Tiff-Annie , Archambault Philippe , Ayotte Pierre , Batal Malek , Chan Hing Man , Cheung William , Eddy Tyler D. , Little Matthew , Ota Yoshitaka , Pétrin-Desrosiers Claudel , Plante Steve , Poitras Julien , Polanco Fernando , Singh Gerald , Lemire Mélanie
Published: December 2020

Ocean conditions can affect human health in a variety of ways that are often overlooked and unappreciated. Oceans adjacent to Canada are affected by many anthropogenic stressors, with implications for human health and well-being. Climate change further escalates these pressures and can expose coastal populations to unique health hazards and distressing conditions. However, current research efforts, education or training curriculums, and policies in Canada critically lack explicit consideration of these ocean–public health linkages. The objective of this paper is to present multiple disciplinary perspectives from academics and health practitioners to inform the development of future directions for research, capacity development, and policy and practice at the interface of oceans and human health in Canada. We synthesize major ocean and human health linkages in Canada, and identify climate-sensitive drivers of change, drawing attention to unique considerations in Canada. To support effective, sustained, and equitable collaborations at the nexus of oceans and human health, we recommend the need for progress in three critical areas: ( i) holistic worldviews and perspectives, ( ii) capacity development, and ( iii) structural supports. Canada can play a key role in supporting the global community in addressing the health challenges of climate and ocean changes.
(Invited) Axial Silicon-Germanium Nanowires: Properties and Device Applications
Authors: Tsybeskov Leonid , Kamins Theodore I , Wu Xiaohua , Lockwood David J.
Published: December 2020

Dense nanowire films can be considered as quasi-porous structures with a high surface-to-volume ratio. From this perspective, structural, optical and electrical properties of axial Si-Ge nanowire heterojunctions produced by the vapor-liquid-solid growth method using Au nanoclusters as catalysts are analyzed. The lattice mismatch induced strain is partially relieved due to spontaneous SiGe intermixing at the heterointerface and lateral expansion of the Ge segment of the nanowire. The mismatch in Ge and Si coefficients of thermal expansion and low thermal conductivity of Si-Ge nanowire heterojunctions are found to be responsible for the thermally induced stress detected under intense laser radiation in photoluminescence and Raman scattering measurements. In electrical measurements, the observed non-linear current-voltage characteristics, strong flicker noise, and damped current oscillations with frequencies of 20-30 MHz are explained using a proposed Si-Ge nanowire heterojunction energy band diagram that includes energy states associated with structural imperfections at the nanowire surface. It is also shown that the nanowire surface states act as shunt resistors and considerably degrade the Si-Ge nanowire device characteristics.
Recent Progress in Anodic TiO2 Nanotube Layer Synthesis
Authors: Sopha Hanna , Motola Martin , Ng Siowwoon , Alijani Mahnaz , Macak Jan M.
Published: December 2020

Over the past 15 years, self-organized TiO2 nanotube layers have attracted considerable scientific and technological interest due to their wide possible range of applications including (photo-) catalysis, hydrogen generation and biomedical uses [1,2]. The synthesis of the 1D TiO2 nanotube layers is usually carried out by electrochemical anodization of valve Ti metal sheets in various electrolytes.

The advantage of anodic TiO2 nanotube layers compared to TiO2 nanotubes prepared by other methods (e.g. hydrothermal) are the tunability of dimensions, their directionality, ability to absorb significant amount of incident light and the possibility to utilize nanotube interiors and exteriors for decoration-coating of secondary materials [2]. However, by now most publications report on the nanotube layer production on the laboratory scale, i.e. on Ti substrates of a few cm2.

The presentation will focus on the recent progress in the TiO2 nanotube layer synthesis. We will show and discuss a possible upscaling of the nanotube layers towards areas of dozens of cm2 [3], taking into account the control of the anodization parameters. Furthermore, we will discuss the use of bipolar electrochemistry for the preparation of TiO2 nanotube layers on small Ti objects which cannot be connected to the potentiostat [4], as well as the selective etching of anodic TiO2 nanotube layers towards single-wall nanotube layers [5] and single nanotubes [6], where nanotubes are separated from one another into tube powders.

References:

[1] J. M. Macak et al., Curr. Opin. Solid State Mater. Sci.,
2007, 1-2, 3.

[2] K. Lee et al., Chem. Rev., 2014, 114, 9385.

[3] H. Sopha et al., Electrochem. Commun.
2018, 97, 91-95.

[4] H. Sopha et al., Electrochem. Commun.
2020
, 111, 106669.

[5] M. Motola et al., Electrochem. Commun., 2018, 97, 1-5.

[6] D. Beketova et al., ACS Appl. Nano Mater.
2020, 3, 1553−1563.
Corrosion Resistant Feedstock Modification in Additively Manufactured 316L
Authors: Srinivasan Rengaswamy , Sopcisak Joseph , Storck Steven , Montalbano Timothy , Mooers Cavin , He Mo-Rigen , Hemker Kevin , Trelewicz Jason R. , Sprouster David J.
Published: December 2020

Additive manufacturing (AM) is a disruptive technology that has the potential to dramatically improve the US Department of Defense supply chain. The corrosion performance of these AM materials is not well understood and contradicts equivalent conventionally-manufactured materials. AM316L steel frequently has defects and pores that are 25-µm or less, and these are implicated as the cause for localized corrosion including crevice and pitting. The 316L feedstock used in manufacturing AM316L contains up to 0.03% wt carbon, and the depletion of chromium due to sensitization and formation of Cr26C3 is yet another cited reason for localized corrosion. We demonstrate that mixing the feedstock with small amounts of certain ceramic materials could might improve these shortcomings. The surface of this new material - AM316L-MMC (metal matrix composite) - is hydrophobic, in contrast to the hydrophilicity of AM316L, and shows little or no evidence of pitting and crevice corrosion in aqueous solutions of 5%, 30% and 60% FeCl3. It also remains free of pitting and crevice corrosion under anodic polarization in aqueous 3.5% sodium chloride electrolyte.