bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Creeping Attachment Noted after Mandibular Labial Frenuloplasty
Authors: Stylianou P. , Soldatos N. , Edmondson E. K. , Angelov N. , Weltman R.
Published: February 2020

Recession of the mandibular central incisors is frequently associated with high frenum insertion. Often times, this recession is accompanied by a lack of sufficient amount of keratinized tissue and absence of attached gingiva. In this case report, an ASA I patient presented with Cairo Recession Type 2 (RT2) and a minimal amount of keratinized tissue on the mandibular central incisors and underwent frenuloplasty in the anterior mandible with the use of a conventional scalpel technique due to high frenum attachment. The results demonstrated creeping attachment of 1.0 mm as early as 10 days postoperatively resulting in complete root coverage and closure of the interproximal space between teeth #24 and 25. A second soft tissue surgery was avoided due to complete root coverage which remained stable at the 6-month follow-up appointment.
A Cross-Sectional Study on Subjective Fever Assessment in Children by Palpation: Are Fathers as Reliable as Mothers?
Authors: Rosenbloom Ehud , Balis Crysta , Jacobson Dustin , Conway Melanie , Cheng Ji , Kozer Eran
Published: February 2020

Background. Fever is common in pediatric patients. Often, parents rely solely on palpation when assessing their child’s fever. The objective of the current study was to determine the accuracy of parents in detecting their child’s fever by palpation.Methods. A prospective cross-sectional study was conducted at the emergency department (ED) of a tertiary pediatric hospital. Infants and children, 0–4 years of age, presenting to the ED with both parents were included. Parents were separately asked if their child had a fever and, if so, were asked to assess the temperature by palpation. A nurse obtained the rectal temperature. The primary outcome measure was the accuracy of fathers and mothers in detecting fever.Results. A total of 170 children with their parents were enrolled. The mean ages of the children, mothers, and fathers were 18.9 (SD 0.8) months, 31.1 (SD 6.4) years, and 33.7 (SD 6.9) years, respectively. No statistically significant difference was found between mothers and fathers in the ability to assess fever by palpation (OR 0.65, 95% CI 0.39,−1.08). Sensitivities for detecting fever by palpation for mothers and father were 86.4% and 88.2%, respectively (specificity among mothers: 54.2% and specificity among fathers: 43.1%). The overall negative and positive predictive values were 65.9% (95% CI 55%–75.7%) and 75.7% (95% CI 69.9%–80.8%), respectively.Conclusions. Mothers and fathers do not differ in their ability to accurately assess their child’s fever by palpation. The low positive and negative predictive values indicate that if temperature was not measured, physicians cannot rely on parents’ reports.
PCK1 Deficiency Shortens the Replicative Lifespan of Saccharomyces cerevisiae through Upregulation of PFK1
Authors: Yuan Yuan , Lin Jia-ying , Cui Hong-jing , Zhao Wei , Zheng Hui-ling , Jiang Zhi-wen , Xiong Xing-dong , Xu Shun , Liu Xin-guang
Published: February 2020

The cytosolic isozyme of phosphoenolpyruvate carboxykinase (PCK1) was the first rate‐limiting enzyme in the gluconeogenesis pathway, which exerted a critical role in maintaining the blood glucose levels. PCK1 has been established to be involved in various physiological and pathological processes, including glucose metabolism, lipid metabolism, diabetes, and tumorigenesis. Nonetheless, the association of PCK1 with aging process and the detailed underlying mechanisms of PCK1 on aging are still far to be elucidated. Hence, we herein constructed the PCK1‐deficient (pck1Δ) and PCK1 overexpression (PCK1 OE) Saccharomyces cerevisiae. The results unveiled that PCK1 deficiency significantly shortened the replicative lifespan (RLS) in the S. cerevisiae, while overexpression of PCK1 prolonged the RLS. Additionally, we noted that the ROS level was significantly enhanced in PCK1‐deficient strain and decreased in PCK1 OE strain. Then, a high throughput analysis by deep sequencing was performed in the pck1Δ and wild‐type strains, in an attempt to shed light on the effect of PCK1 on the lifespan of aging process. The data showed that the most downregulated mRNAs were enriched in the regulatory pathways of glucose metabolism. Fascinatingly, among the differentially expressed mRNAs, PFK1 was one of the most upregulated genes, which was involved in the glycolysis process and ROS generation. Thus, we further constructed the pfk1Δpck1Δ strain by deletion of PFK1 in the PCK1‐deficient strain. The results unraveled that pfk1Δpck1Δ strain significantly suppressed the ROS level and restored the RLS of pck1Δ strain. Taken together, our data suggested that PCK1 deficiency enhanced the ROS level and shortened the RLS of S. cerevisiae via PFK1.
Vibration Tendency Prediction Approach for Hydropower Generator Fused with Multiscale Dominant Ingredient Chaotic Analysis, Adaptive Mutation Grey Wolf Optimizer, and KELM
Authors: Fu Wenlong , Wang Kai , Tan Jiawen , Shao Kaixuan
Published: February 2020

Accurate vibrational tendency forecasting of hydropower generator unit (HGU) is of great significance to guarantee the safe and economic operation of hydropower station. For this purpose, a novel hybrid approach combined with multiscale dominant ingredient chaotic analysis, kernel extreme learning machine (KELM), and adaptive mutation grey wolf optimizer (AMGWO) is proposed. Among the methods, variational mode decomposition (VMD), phase space reconstruction (PSR), and singular spectrum analysis (SSA) are suitably integrated into the proposed analysis strategy. First of all, VMD is employed to decompose the monitored vibrational signal into several subseries with various frequency scales. Then, SSA is applied to divide each decomposed subseries into dominant and residuary ingredients, after which an additional forecasting component is calculated by integrating the residual of VMD with all the residuary ingredients orderly. Subsequently, the proposed AMGWO is implemented to simultaneously adapt the intrinsic parameters in PSR and KELM for all the forecasting components. Ultimately, the prediction results of the raw vibration signal are obtained by assembling the results of all the predicted prediction components. Furthermore, six relevant contrastive models are adopted to verify the feasibility and availability of the modified strategies employed in the proposed model. The experimental results illustrate that (1) VMD plays a positive role for the prediction accuracy promotion; (2) the proposed dominant ingredient chaotic analysis based on the realization of time-frequency decomposition can further enhance the capability of the forecasting model; and (3) the appropriate parameters for each forecasting component can be optimized by the proposed AMGWO effectively, which can contribute to elevating the forecasting performance distinctly.
Expanding Robotic Arm-Assisted Knee Surgery: The First Attempt to Use the System for Knee Revision Arthroplasty
Authors: Kalavrytinos Dimitrios , Koutserimpas Christos , Kalavrytinos Ioannis , Dretakis Konstantinos
Published: February 2020

Robotic arm-assisted arthroplasty was introduced in 2006 and has expanded its applications into unicompartmental knee, total knee, and total hip replacement. The first case of a revision surgery from conventional unicompartmental to total knee arthroplasty with the utilization of the robotic arm-assisted MAKO system is presented. An 87-year-old female presented with deteriorating left knee pain due to failure of medial unicompartmental knee arthroplasty at the outpatient clinic. The patient was advised to undergo revision surgery. Through medial parapatellar arthrotomy, the joint was exposed. With the use of the MAKO system, the estimated depth of the medial plateau according to CT planning was found to be 10 mm more distal than the lateral. The resection line of the remaining plateau was placed deliberately 2 mm more distal in order to achieve satisfactory replacement of the bony gap of the medial tibial condyle by a 10 mm augment. The patient had an uneventful recovery. A plethora of additional applications in the future, such as total shoulder or reverse total shoulder arthroplasty, megaprosthesis placement in oncological patients, and total hip or knee revision surgeries, may improve patient-related outcomes.
The Epidemiology of Hip Fracture among Subjects with Pyogenic Liver Abscess (PLA): A Nationwide Population‐Based Study
Authors: Hsu Chieh-Cheng , Ko Jih-Yang , Lin Cheng-Li , Hsu Horng-Chaung , Chen Hsien-Te , Lin Che-Chen , Kuo Shu-Jui
Published: February 2020

Pyogenic liver abscess (PLA) is a potentially fatal disease that can stimulate prominent systemic inflammation. Osteoporotic hip fracture is a major complication of systemic inflammation. This study tried to determine the epidemiology of hip fractures among PLA patients. All subjects admitted due to PLA during 1999∼2010 were assessed, excluding the subjects with a history of high energy trauma, malignancy, and previous hip fracture. We matched the control subjects to PLA patients according to age, gender, and the coding of osteoporosis by 1 : 4 ratio. The PLA patients had a 1.17‐fold risk of hip fracture than the controls (aHR = 1.17, 95% CI = 1.07–1.29) after adjusting for gender, age, and comorbidities. Considering death as the competing event of suicide, the PLA patients had 1.10‐fold suicide risk (aHR = 1.10, 95% CI: 1.00–1.21) than the control subjects under the competing risks regression model. The cumulative incidence of hip fracture was higher in the PLA cohort (log‐rank test, p < 0.001). When compared to the controls, the fracture risk was 18.4‐fold (aHR = 18.4, 95% CI = 13.0–26.1) for the PLA patients admitted 2‐3 times per year and 46.0‐fold (aHR = 46.0, 95% CI = 31.2–67.8) for the PLA patients admitted ≧4 times per year. The impact of PLA is more prominent among the subjects aged <45 years (aHR = 2.81, 95% CI = 1.42–5.56). Preventive measures for hip fracture might be warranted for PLA patients.
Determination and Analysis of Trace Elements in Five Kinds of Traditional Chinese Medicine in High Blood Pressure Medicinal Food by ICP-AES
Authors: Yang Li , Yan Qinghua , Zhang Huixuan , Zhang Jianwei
Published: February 2020

Objective. To establish a method for analysis of microelements in five kinds of traditional Chinese medicine in high blood pressure medicinal food, mainly including manganese, cobalt, selenium, iron, magnesium, and other 15 elements. Methods. The samples were digested using a microwave digestion instrument through NHO3-H2O2 solution, and then, the elements were synthesized by inductively coupled plasma atomic emission spectrometry (ICP-AES). Results. The content of cobalt, manganese, zinc, copper, and nickel in the high blood pressure diet foods is higher, the RSD is between 0.005% and 4.82%, and the recovery rate ranges from 93.40% to 106.5%. The precision and recovery of the detection method are higher. Conclusion. The experiment result is better. Medicinal foods curing high blood pressure contain a number of micronutrients that are beneficial to the human body. This experiment provides some meaningful basis for the prevention and treatment of cardiovascular diseases such as hypertension.
A Differential Game of Transboundary Pollution Control and Ecological Compensation in a River Basin
Authors: Yi Yongxi , Wei Zhongjun , Fu Chunyan
Published: February 2020

This paper investigates a Stackelberg differential game between an upstream region and a downstream region for transboundary pollution control and ecological compensation (EC) in a river basin. Among them, the downstream region as the leader chooses its abatement investment level and an ecological compensation rate to encourage upstream investing in water pollution control firstly. After then, the upstream region as the follower determines its abatement investment level to maximize welfare. FFurthermore, we take into consideration the effects of efficiency-improving and cost-reducing learning by doing which are originated from abatement investment activity of both regions simultaneously. The results show the following. (i) There is an optimal ecological compensation rate and under which a Pareto improvement result can be obtained. (ii) Carrying out EC will shift some abatement investment from the downstream region into the upstream region. (iii) The efficiency-improving and cost-reducing learning by doing derived from abatement investment activity of both regions can decrease the optimal ecological compensation rate, increase abatement investment,and improve the social welfare.
Antimalarial Activity of Meriandra dianthera Leaf Extracts in Plasmodium berghei‐Infected Mice
Authors: Hagazy Kalay , Sibhat Gereziher G. , Karim Aman , Tekulu Gebretsadkan H. , Periasamy Gomathi , Hiben Mebrahtom G.
Published: February 2020

Objective. To evaluate the antimalarial effect of aqueous methanolic extract and solvent fractions of Meriandra dianthera leaves against Plasmodium berghei in mice model. Method. M. dianthera leaves were extracted with 80% methanol and dried. The dried crude extract was then defatted and further fractionated with chloroform, ethyl acetate, and butanol. Acute oral toxicity test was performed as per the Organization for Economic Cooperation and Development guideline 425. Peter’s 4‐day suppressive test was used to determine the in vivo antimalarial activity of the extract and fractions. Result. The crude leaf extract of Meriandra dianthera showed parasite inhibition of 42.28% and 45.52% at doses of 400 and 600 mg/kg, respectively, as compared to the negative control. Moreover, the mice which received chloroform and aqueous fractions at the dose of 400 mg/kg/day showed significant (P < 0.001) chemosuppression compared to the negative control. Both the extract and fractions were able to prevent P. berghei induced body weight loss and body temperature reduction and also increased the survival time of the mice as compared to the negative control. The aqueous methanolic leaf extract of M. dianthera showed no gross signs of toxicity or mortality in mice until a single oral dose of 2000 mg/kg. Conclusion. The extracts of M. dianthera leaves showed promising antimalarial activity, with no sign of toxicity and therefore may support its traditional use for the treatment of malaria.
Multiple Myeloma Mimicking a Small Vessel Vasculitis Presentation
Authors: Mejía-Zuluaga Mateo , Lacouture Jorge Andrés , Gaviria Maria Clara , Garcés Maria Adelaida , Mejía Ana María , Herrera Sebastián
Published: February 2020

Multiple myeloma can have different clinical manifestations, and not all patients present with classic CRAB component. We describe a 46-year-old woman admitted to our hospital with a complaint of a bluish-to-black discoloration of the second toe that was rapidly progressive and acute kidney injury. We documented a Kappa light chain monoclonal gammopathy, increased presence of plasmacytes in bone marrow aspiration, and multiple lytic bone lesions, which led to a diagnosis of multiple myeloma. Although multiple myeloma presenting with blue finger syndrome is uncommon, it must always be considered as a differential diagnosis with this clinical finding.
Physicians’ Self‐Assessed Empathy and Patients’ Perceptions of Physicians’ Empathy: Validation of the Greek Jefferson Scale of Patient Perception of Physician Empathy
Authors: Katsari Vasiliki , Tyritidou Athina , Domeyer Philippe-Richard
Published: February 2020

Aims. This study aims to (i) translate, culturally adapt, and validate the Jefferson Scale of Patient Perception of Physician Empathy questionnaire for the Greek population (Gr‐JSPPPE) and (ii) estimate physicians’ self‐assessed empathy and patients’ perceptions of physicians’ empathy, investigate their relationship, and assess their predictors. Methods. A total of 189 patients and 17 physicians from an internal medicine clinic took part in the study. A composite questionnaire was administered to the patients, consisting of (1) sociodemographic items, (2) hospitalization‐related questions, (3) the Zung Self‐Rating Anxiety Scale, (4) the Patient Health Questionnaire (PHQ‐9), (5) the EQ‐5D‐5L Questionnaire, (6) the Gr‐JSPPPE, and (7) the Visual Analog Scale for pain. The physicians’ composite questionnaire comprised (1) sociodemographic items, (2) the EQ‐5D‐5L questionnaire, and (3) the Toronto Composite Empathy Scale (TCES). Exploratory and confirmatory factor analyses were conducted to assess the psychometric properties of the Gr‐JS PPPE. Univariate comparisons were performed between (a) empathy measures and (b) sociodemographic and health‐related measures of both groups; multivariate regression analysis for the Gr‐JSPPPE adjusting for baseline confounders was executed. Results. Statistically significant negative correlations were found between the Gr‐JSPPPE mean score and the TCES personal/cognitive, professional/cognitive, and professional/emotional subscales. Female sex, being married, duration of employment in current post, and physicians’ EQ‐5D index score emerged as important predictors of increased physician empathy. Patients’ EQ‐VAS “thermometer” scale was significantly associated with the Gr‐JSPPPE total score at the multivariate level. Conclusion. The Gr‐JSPPPE is a psychometrically sound tool to assess patient perceptions of physician empathy. Physician empathy assessed by the self‐reported scale is inversely associated with patient perceptions.
Exact Solution of Modified Veselov–Novikov Equation and Some Applications in the Game Theory
Authors: Kurmanbayev Damir
Published: February 2020

A method of finding exact solutions of the modified Veselov–Novikov (mVN) equation is constructed by Moutard transformations, and a geometric interpretation of these transformations is obtained. An exact solution of the mVN equation is found on the example of a higher order Enneper surface, and given transformations are applied in the game theory via Kazakh proverbs in terms of trees.
A Multi-Institutional Cohort of Therapy-Associated Polyposis in Childhood and Young Adulthood Cancer Survivors
Authors: Biller Leah H. , Ukaegbu Chinedu , Dhingra Tara G. , Burke Carol A. , Chertock Yana , Chittenden Anuradha , Church James M. , Koeppe Erika S. , Leach Brandie H. , Levinson Elana , Lim Ramona M. , Lutz Megan , Salo-Mullen Erin , Sheikh Rania , Idos Gregory , Kastrinos Fay , Stoffel Elena , Weiss Jennifer M. , Hall Michael J. , Kalady Matthew F. , Stadler Zsofia K. , Syngal Sapna , Yurgelun Matthew B.
Published: February 2020

Prior small reports have postulated a link between gastrointestinal polyposis and childhood and young adulthood cancer (CYAC) treatment (therapy-associated polyposis; TAP), but this remains a poorly understood phenomenon. The aim of this study was to describe the phenotypic spectrum of TAP in a multi-institutional cohort. TAP cases were identified from eight high-risk cancer centers. Cases were defined as patients with ≥10 gastrointestinal polyps without known causative germline alteration or hereditary colorectal cancer predisposition syndrome who had a history of prior treatment with chemotherapy and/or radiotherapy for CYAC. A total of 34 TAP cases were included (original CYAC: 27 Hodgkin lymphoma, three neuroblastoma, one acute myeloid leukemia, one medulloblastoma, one nephroblastoma, and one non-Hodgkin lymphoma). Gastrointestinal polyposis was first detected at a median of 27 years (interquartile range, 20–33) after CYAC treatment. A total of 12 of 34 (35%) TAP cases had ≥50 colorectal polyps. A total of 32 of 34 (94%) had >1 histologic polyp type. A total of 25 of 34 (74%) had clinical features suggestive of ≥1 colorectal cancer predisposition syndrome [e.g., attenuated familial adenomatous polyposis (FAP), serrated polyposis syndrome, extracolonic manifestations of FAP, mismatch repair–deficient colorectal cancer, or hamartomatous polyposis] including 8 of 34 (24%) with features of multiple such syndromes. TAP is an apparently acquired phenomenon that should be considered in patients who develop significant polyposis without known causative germline alteration but who have had prior treatment for a CYAC. Patients with TAP have features that may mimic various hereditary colorectal cancer syndromes, suggesting multiple concurrent biologic mechanisms, and recognition of this diagnosis may have implications for cancer risk and screening.
Zentrale Schlafapnoe bei Patienten mit Herzinsuffizienz: Physiologische Auswirkungen der periodischen Beatmung
Authors: Herkenrath Simon Dominik
Published: February 2020

Background: The effects of hyperventilation and hyperventilation in the context of periodic breathing (PB) on sympatho-vagal balance (SVB) and hemodynamics in conditions of decreased cardiac output and feedback resetting, such as heart failure (HF) or pulmonary arterial hypertension (PAH), are not completely understood. Objectives: To investigate the effects of voluntary hyperventilation and simulated PB on hemodynamics and SVB in healthy subjects, in patients with systolic HF and reduced or mid-range ejection fraction (HFrEF and HFmrEF) and in patients with PAH. Methods: Study participants (n = 20 per group) underwent non-invasive recording of diastolic blood pressure, heart rate variability (HRV), baroreceptor-reflex sensitivity (BRS), total peripheral resistance index (TPRI) and cardiac index (CI). All measurements were performed at baseline, during voluntary hyperventilation and during simulated PB with different length of the hyperventilation phase. Results: In healthy subjects, voluntary hyperventilation led to a 50% decrease in the mean BRS slope and a 29% increase in CI compared to baseline values (p < 0.01 and p < 0.05). Simulated PB did not alter TPRI or CI and showed heterogeneous effects on BRS, but analysis of dPBV revealed decreased sympathetic drive in healthy volunteers depending on PB cycle length (p < 0.05). In HF patients, hyperventilation did not affect BRS and TPRI but increased the CI by 10% (p < 0.05). In HF patients, simulated PB left all of these parameters unaffected. In PAH patients, voluntary hyperventilation led to a 15% decrease in the high-frequency component of HRV (p < 0.05) and a 5% increase in CI (p < 0.05). Simulated PB exerted neutral effects on both SVB and hemodynamic parameters. Conclusions: Voluntary hyperventilation was associated with sympathetic predominance and CI increase in healthy volunteers, but only with minor hemodynamic and SVB effects in patients with HF and PAH. Simulated PB had positive effects on SVB in healthy volunteers but neutral effects on SVB and hemodynamics in patients with HF or PAH.
Malignes Mesotheliom: Die diagnostische Aussagekraft einer Computertomographie kritisch hinterfragen
Authors: Keymel Stefanie
Published: February 2020

Background: Medical history, thoracentesis, and imaging features are usually the first steps in the investigation of a possible malignant pleural effusion (MPE). Unfortunately, the diagnostic yield of thoracentesis in this situation is suboptimal even if the procedure is repeated, especially in the context of malignant pleural mesothelioma (MPM). The next step for confirming the diagnosis, if clinically appropriate, is thoracoscopy, but not all patients are fit to undergo this procedure, so the diagnosis is then based on the medical history and imaging features only. Objectives: Our objective was to evaluate the diagnostic value of the medical history and imaging features in MPM. Methods: We reviewed the imaging and medical charts of 92 patients with a final diagnosis of MPE included in our prospective medical thoracoscopy database. The clinical characteristics and imaging features of patients with primary MPE were compared with those of patients with secondary MPE. Results: Male sex (82 vs. 59%, p = 0.02), asbestos exposure (58 vs. 10%, p < 0.001), and mediastinal (68 vs. 33%, p = 0.04), diaphragmatic (75 vs. 31%, p = 0.001) and circumferential pleural thickening (55 vs. 19% p = 0.001) were significantly more frequent in MPM patients. In a multivariate linear regression model, only asbestos exposure (OR 11.2; 95% CI 3.4-36.9) and circumferential pleural thickening (OR 4.7; 95% CI 1.6-13.9) were significantly associated with a diagnosis of MPM. Conclusion: In situations where it is impossible to obtain adequate pleural samples to differentiate MPM from a secondary pleural malignancy, the combination of circumferential pleural thickening and a history of asbestos exposure may be sufficient to make a clinical diagnosis.
Primary Mediastinal Seminoma Achieved by Transbronchial Mediastinal Cryobiopsy
Authors: Zhang Jing , Fu Wan-Lei , Huang Zan-Sheng , Guo Jie-Ru , Li Qi , Herth Felix J.F. , Fan Ye
Published: February 2020

Mediastinal biopsy is essential for the clinical diagnosis of mediastinal disease. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established approach for obtaining diagnostic samples from mediastinal masses or enlarged lymph nodes which is proven to be minimally invasive and effective. However, the insufficiency of intact samples acquired might restrict the diagnostic efficacy of EBUS-TBNA for mediastinal lesions such as rare malignancy and granulomatous disorder. We here present an EBUS-guided approach for the cryobiopsy of mediastinal diseases that is capable of providing larger amounts of intact tissue with few observed complications.
Multiple Vitelliform Lesions as a Retinal Manifestation of Alport Syndrome
Authors: Eriksen Kathrine O. , Jørstad Øystein Kalsnes
Published: February 2020

Alport syndrome is associated with various ocular phenotypic features, including several retinal manifestations. The purpose of this case report was to describe a case of multiple vitelliform lesions in Alport syndrome. This particular finding has, to our knowledge, not been reported previously. A 63-year-old man with known Alport syndrome presented with symptomatic, bilateral anterior lenticonus. Fundoscopic examination revealed multiple vitelliform lesions, which were symmetrically distributed at the posterior poles. Additional retinal findings included an irregular foveal contour and central macular thinning in both eyes, as well as a multilayered retinoschisis in the left eye. The underlying pathophysiology of the vitelliform lesions may be a dysfunctional Bruch’s membrane.
СИНДРОМ ПОЛІКІСТОЗНИХ ЯЄЧНИКІВ ЯК ЧИННИК ЕНДОКРИННОГО БЕЗПЛІДДЯ
Authors: Khmil M. S. , Khmil-Doswald A. S. , Khmil S. V.
Published: February 2020

Мета роботи. Проаналізувати літературні дані щодо етіопатогенетичних чинників синдрому полікістосних яєчників у розвитку ендокринного безпліддя.

Матеріали і методи. У дослідженні опрацьовано наукові публікації за останнє десятиліття, які доступні у мережі «Інтернет», ключовими словами були «синдром полікістозних яєчників», «ендокринне безпліддя».

Результати й обговорення. У 80–90 % жінок причиною ановуляторного безпліддя є СПКЯ. Механізм ановуляції при СПКЯ залишається не зрозумілим, але є дані про те, що порушення росту фолікулів, яке характерне для ановуляторних жінок із СПКЯ, відображає ендокринний дисбаланс. Ключова роль у патогенезі СПКЯ належить дефекту ензимних систем. Для жінок із СПКЯ характерна наявність резистентності до інсуліну, центральне ожиріння та дисліпідемія, які також впливають на фертильність.

Висновки. Розуміння патогенезу СПКЯ (спадкових, метаболічних, ендокринних факторів та чинників зовнішнього середовища) дозволяє обґрунтувати тактику лікування ановуляторного безпліддя, спричиненого даним захворюванням.
КЛІНІЧНИЙ ВИПАДОК ГІПЕРПРОЛАКТИНЕМІЇ, ПОЄДНАНОЇ ІЗ ПІДВИЩЕННЯМ ТИРЕОТРОПНОГО ГОРМОНУ
Authors: Mazur L. P. , Marushchak M. I. , Naumova L. V. , Krytskyi T. I. , Danylevych Yu. O.
Published: February 2020

Результати й обговорення. Гіперпролактинемія є стійким підвищенням вмісту пролактину в плазмі крові. Вона буває у вигляді фізіологічної і патологічної форм у жінок і чоловіків, частота якої складає близько 17 випадків на 100 тис. населення. Причинами гіперпролактинемії є пухлини гіпофіза, первинний гіпотиреоз, хронічна ниркова недостатність, цироз печінки, синдром полікістозних яєчників, приймання ряду лікарських засобів. Частота ідіопатичних гіперпролактинемій складає близько 30–40 %. Поєднання гіперпролактинемії із високою концентрацією ТТГ потребує диференціювати змішану аденому гіпофіза з гіперпролактинемією як проявом гіпотиреозу. В статті наведено клінічний випадок гіперпролактинемії, що поєднувалася із високою концентрацією ТТГ у крові. Пацієнтку турбували загальна слабість, втомлюваність, частий головний біль, що пов’язувала зі значною інтенсивністю навчання у школі. Виявлено підвищені рівні тиреотропного гормону в крові, пролактину і тироксину вільного. Вміст соматотропного, лютеїнізуючого, фолікулостимулюючого гормонів та кортизолу крові був у межах норми. В лівій половині аденогіпофіза виявлено вогнище розмірами 4×3 мм (ймовірніше мікроаденома). Проведено динамічне спостереження із визначенням рівнів пролактину, тиреотропного гормону і тироксину вільного, а також магнітно-резонансного дослідження гіпофіза. Лікування з комбінацією каберголіном, лікарським засобом, що містить сухий екстракт плодів прутняка звичайного, а також L-тироксином, дозволило досягти нормопролактинемії без зниження вмісту пролактину менше норми та утримувати рівень тиреотропного гормону та тироксину вільного в межах норми, не спричиняючи при цьому симптомів передозування L-тироксину.
Paradoxical Higher Myocardial Wall Stress and Increased Cardiac Remodeling Despite Lower Mass in Females
Authors: Phua Andrew I. H. , Le Thu‐Thao , Tara Su W. , De Marvao Antonio , Duan Jinming , Toh Desiree‐Faye , Ang Briana , Bryant Jennifer A. , O'Regan Declan P. , Cook Stuart A. , Chin Calvin W. L.
Published: February 2020

Background

Increased left ventricular (
LV
) mass is characterized by increased myocardial wall thickness and/or ventricular dilatation that is associated with worse outcomes. We aim to comprehensively compare sex‐stratified associations between measures of
LV
remodeling and increasing
LV
mass in the general population.

Methods and Results

Participants were prospectively recruited in the National Heart Center Singapore Biobank to examine health and cardiovascular risk factors in the general population. Cardiovascular magnetic resonance was performed in all individuals. Participants with established cardiovascular diseases and abnormal cardiovascular magnetic resonance scan results were excluded. Global and regional measures of
LV
remodeling (geometry, function, interstitial volumes, and wall stress) were performed using conventional image analysis and novel 3‐dimensional machine learning phenotyping. Sex‐stratified analyses were performed in 1005 participants (57% males; 53±13 years). Age and prevalence of cardiovascular risk factors were well‐matched in both sexes (
P
>0.05 for all). Progressive increase in
LV
mass was associated with increased concentricity in either sex, but to a greater extent in females. Compared with males, females had higher wall stress (mean difference: 170 mm Hg,
P
<0.0001) despite smaller
LV
mass (42.4±8.2 versus 55.6±14.2 g/m
2
,
P
<0.0001), lower blood pressures (
P
<0.0001), and higher
LV
ejection fraction (61.9±5.9% versus 58.6±6.4%,
P
<0.0001). The regions of increased concentric remodeling corresponded to regions of increased wall stress. Compared with males, females had increased extracellular volume fraction (27.1±2.4% versus 25.1±2.9%,
P
<0.0001).

Conclusions

Compared with males, females have lower
LV
mass, increased wall stress, and concentric remodeling. These findings provide mechanistic insights that females are susceptible to particular cardiovascular complications.
Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke
Authors: Petersen Nils H. , Silverman Andrew , Strander Sumita M. , Kodali Sreeja , Wang Anson , Sansing Lauren H. , Schindler Joseph L. , Falcone Guido J. , Gilmore Emily J. , Jasne Adam S. , Cord Branden , Hebert Ryan M. , Johnson Michele , Matouk Charles C. , Sheth Kevin N.
Published: February 2020

Background and Purpose—

Loss of cerebral autoregulation in the acute phase of ischemic stroke leaves patients vulnerable to blood pressure (BP) changes. Effective BP management after endovascular thrombectomy may protect the brain from hypoperfusion or hyperperfusion. In this observational study, we compared personalized, autoregulation-based BP targets to static systolic BP thresholds.

Methods—

We prospectively enrolled 90 patients undergoing endovascular thrombectomy for stroke. Autoregulatory function was continuously measured by interrogating changes in near-infrared spectroscopy–derived tissue oxygenation (a cerebral blood flow surrogate) in response to changes in mean arterial pressure. The resulting autoregulatory index was used to trend the BP range at which autoregulation was most preserved. Percent time that mean arterial pressure exceeded the upper limit of autoregulation or decreased below the lower limit of autoregulation was calculated for each patient. Time above fixed systolic BP thresholds was computed in a similar fashion. Functional outcome was measured with the modified Rankin Scale at 90 days.

Results—

Personalized limits of autoregulation were successfully computed in all 90 patients (age 71.6±16.2, 47% female, mean National Institutes of Health Stroke Scale 13.9±5.7, monitoring time 28.0±18.4 hours). Percent time with mean arterial pressure above the upper limit of autoregulation associated with worse 90-day outcomes (odds ratio per 10% 1.84 [95% CI, 1.3–2.7]
P
=0.002), and patients with hemorrhagic transformation spent more time above the upper limit of autoregulation (10.9% versus 16.0%,
P
=0.042). Although there appeared to be a nonsignificant trend towards worse outcome with increasing time above systolic BP thresholds of 140 mm Hg and 160 mm Hg, the effect sizes were smaller compared with the personalized approach.

Conclusions—

Noninvasive determination of personalized BP thresholds for stroke patients is feasible. Deviation from these limits may increase risk of further brain injury and poor functional outcome. This approach may present a better strategy compared with the classical approach of maintaining systolic BP below a predetermined value, though a randomized trial is needed to determine the optimal approach for hemodynamic management.
Temporal Trends in Stroke Incidence Over Time by Sex and Age in the GCNKSS
Authors: Madsen Tracy E. , Khoury Jane C. , Leppert Michelle , Alwell Kathleen , Moomaw Charles J. , Sucharew Heidi , Woo Daniel , Ferioli Simona , Martini Sharyl , Adeoye Opeolu , Khatri Pooja , Flaherty Matthew , De Los Rios La Rosa Felipe , Mackey Jason , Mistry Eva , Demel Stacie L. , Coleman Elisheva , Jasne Adam , Slavin Sabreena J. , Walsh Kyle , Star Michael , Broderick Joseph P. , Kissela Brett M. , Kleindorfer Dawn O.
Published: February 2020

Background and Purpose—

Sex differences in stroke incidence over time were previously reported from the GCNKSS (Greater Cincinnati/Northern Kentucky Stroke Study). We aimed to determine whether these differences continued through 2015 and whether they were driven by particular age groups.

Methods—

Within the GCNKSS population of 1.3 million, incident (first ever) strokes among residents ≥20 years of age were ascertained at all local hospitals during 5 periods: July 1993 to June 1994 and calendar years 1999, 2005, 2010, and 2015. Out-of-hospital cases were sampled. Sex-specific incidence rates per 100 000 were adjusted for age and race and standardized to the 2010 US Census. Trends over time by sex were compared (overall and age stratified). Sex-specific case fatality rates were also reported. Bonferroni corrections were applied for multiple comparisons.

Results—

Over the 5 study periods, there were 9733 incident strokes (56.3% women). For women, there were 229 (95% CI, 215–242) per 100 000 incident strokes in 1993/1994 and 174 (95% CI, 163–185) in 2015 (
P
<0.05), compared with 282 (95% CI, 263–301) in 1993/1994 to 211 (95% CI, 198–225) in 2015 (
P
<0.05) in men. Incidence rates decreased between the first and last study periods in both sexes for IS but not for intracerebral hemorrhage or subarachnoid hemorrhage. Significant decreases in stroke incidence occurred between the first and last study periods for both sexes in the 65- to 84-year age group and men only in the ≥85-year age group; stroke incidence increased for men only in the 20- to 44-year age group.

Conclusions—

Overall stroke incidence decreased from the early 1990s to 2015 for both sexes. Future studies should continue close surveillance of sex differences in the 20- to 44-year and ≥85-year age groups, and future stroke prevention strategies should target strokes in the young- and middle-age groups, as well as intracerebral hemorrhage.
Nano-Optical Image-Making: Morphologies, Devices, Speculations
Authors: Kaminska Aleksandra
Published: February 2020

This article provides a technical overview of nano-optical image-making produced in collaboration between the author, engineering scientists at the Ciber Lab in Vancouver and the artists Christine Davis and Scott Lyall. It situates the work in relation to other optical technologies (such as holographs), to the primary application of nano-optical images as authentication devices and to other artistic practices concerning nanoscale interactions of light and matter. The paper articulates the convergence of visual technologies and designed materials by explaining how the principles of structural color can be used for the production of images. Building a discussion on the shift from device to medium that is anchored around questions of remediation and reproducibility, it concludes with a speculation on informatic matters, or the convergence of mediating functions at the surface of things.
Concretization, Associated Milieus and Aestheticization of Objects in Bio-Art
Authors: Shin Jongcheon , Yoon Joonsung
Published: February 2020

This article explores an ensemble of technical objects and biological objects in bio-art and proposes aesthetic values that the ensemble reveals. French philosopher Gilbert Simondon considered technical objects carefully in the 1950s. In his study, he was alert to an assimilation of technical objects to biological objects. In our time, the development of molecular biology and genetic engineering offers evidence that technical objects are closely linked to biological objects. The process of concretizing technical objects and biological objects is latent in works of bio-art, which therefore can realize aesthetic potentials that technical objects and biological objects imply.
Quantifying the dynamics of topical fluctuations in language
Authors: Karjus Andres , Blythe Richard A. , Kirby Simon , Smith Kenny
Published: February 2020

The availability of large diachronic corpora has provided the impetus for a growing body of quantitative research on language evolution and meaning change. The central quantities in this research are token frequencies of linguistic elements in texts, with changes in frequency taken to reflect the popularity or selective fitness of an element. However, corpus frequencies may change for a wide variety of reasons, including purely random sampling effects, or because corpora are composed of contemporary media and fiction texts within which the underlying topics ebb and flow with cultural and socio-political trends. In this work, we introduce a simple model for controlling for topical fluctuations in corpora—the topical-cultural advection model—and demonstrate how it provides a robust baseline of variability in word frequency changes over time. We validate the model on a diachronic corpus spanning two centuries, and a carefully-controlled artificial language change scenario, and then use it to correct for topical fluctuations in historical time series. Finally, we use the model to show that the emergence of new words typically corresponds with the rise of a trending topic. This suggests that some lexical innovations occur due to growing communicative need in a subspace of the lexicon, and that the topical-cultural advection model can be used to quantify this.
Prehistoric languages and human self-domestication
Authors: Benítez-Burraco Antonio
Published: February 2020

The comparative method has enabled us to trace distant phylogenetic relationships among languages and reconstruct extinct languages from the past. Nonetheless, it has limitations, mostly resulting from the circumstance that languages also change by contact with unrelated languages and in response to external factors, particularly, aspects of human cognition and features of our physical and cultural environments. In this paper, it is argued that the limitations of historical linguistics can be partially alleviated by the consideration of the links between language structure and the biological underpinnings of human language, human cognition, and human behaviour, and specifically, of human self-domestication (that is, the existence in humans of features of domesticated mammals). Overall, we can expect that the languages spoken in remote prehistory exhibited most of the features of the so-called esoteric languages, which are used by present-day, close-knit, small human communities that share a great deal of knowledge about their environment.
Rare liverwort species of Romania from the exsiccatae of K. Loitlesberger

Authors: ȘTEFĂNUȚ SORIN
Published: February 2020

Within the framework of the Synthesys Programme, some European liverwort species held by the Herbarium of the Natural History Museum in Vienna (W) were checked, in particular for their occurrence in Romania. Examination of these liverwort specimens has led to the identification of rare species for Romania, some of which are only present in the Vienna collection. This includes the exsiccatae collections compiled by the bryologist Karl Loitlesberger for Romania, during his field trip in 1897 and held by W. In these exsiccatae, several rare species of liverworts have been identified and confirmed, such as Frullania parvistipula, the holotype of the taxon Marsupella lapponica, the male of Bucegia romanica (=Marchantia romanica), and Scapania crassiretis for Romania. This paper presents for the first time the oldest known drawings of Frullania parvistipula and Bucegia romanica.
The Making of a Metric: Co-Producing Decision-Relevant Climate Science
Authors: Jagannathan Kripa , Jones Andrew D. , Ray Isha
Published: February 2020

Developing decision-relevant science for adaptation requires the identification of climatic parameters that are both actionable for practitioners as well as tractable for modelers. In many sectors, these decision-relevant climatic metrics and the approaches that enable their identification remain largely unknown. “Co-production” of science with scientists and decision-makers is one potential way to identify these metrics, but there is little research describing specific and successful co-production approaches. This paper examines the negotiations and outcomes from Project Hyperion, wherein scientists and water managers jointly developed decision-relevant climatic metrics for adaptive water management. We identify successful co-production strategies by analyzing the project’s numerous back-and-forth engagements and tracing the evolution of the science during these engagements. We found that effective mediation between scientists and managers needed dedicated “boundary spanners” with significant modeling expertise. Translating practitioners’ information needs into tractable climatic metrics required direct and indirect methods of eliciting knowledge. We identified four indirect methods that were particularly salient for extracting tacitly held knowledge and enabling shared learning: developing a hierarchical framework linking management issues with metrics, starting discussions from the planning challenges, collaboratively exploring the planning relevance of new scientific capabilities, and using analogies of other “good” metrics. The decision-relevant metrics we developed provide insights into advancing adaptation-relevant climate science in the water sector. The co-production strategies we identified can be used to design and implement productive scientist–decision-maker interactions. Overall, the approaches and metrics we developed can help climate science to expand in new and more use-inspired directions.
Gravity Wave Excitation during the Coastal Transition of an Extreme Katabatic Flow in Antarctica
Authors: Vignon Étienne , Picard Ghislain , Durán-Alarcón Claudio , Alexander Simon P. , Gallée Hubert , Berne Alexis
Published: February 2020

The offshore extent of Antarctic katabatic winds exerts a strong control on the production of sea ice and the formation of polynyas. In this study, we make use of a combination of ground-based remotely sensed and meteorological measurements at Dumont d’Urville (DDU) station, satellite images, and simulations with the Weather Research and Forecasting Model to analyze a major katabatic wind event in Adélie Land. Once well developed over the slope of the ice sheet, the katabatic flow experiences an abrupt transition near the coastal edge consisting of a sharp increase in the boundary layer depth, a sudden decrease in wind speed, and a decrease in Froude number from 3.5 to 0.3. This so-called katabatic jump manifests as a turbulent “wall” of blowing snow in which updrafts exceed 5 m s−1. The wall reaches heights of 1000 m and its horizontal extent along the coast is more than 400 km. By destabilizing the boundary layer downstream, the jump favors the trapping of a gravity wave train—with a horizontal wavelength of 10.5 km—that develops in a few hours. The trapped gravity waves exert a drag that considerably slows down the low-level outflow. Moreover, atmospheric rotors form below the first wave crests. The wind speed record measured at DDU in 2017 (58.5 m s−1) is due to the vertical advection of momentum by a rotor. A statistical analysis of observations at DDU reveals that katabatic jumps and low-level trapped gravity waves occur frequently over coastal Adélie Land. It emphasizes the important role of such phenomena in the coastal Antarctic dynamics.
An Observational Estimate of the Direct Response of the Cold-Season Atmospheric Circulation to the Arctic Sea Ice Loss
Authors: Simon Amélie , Frankignoul Claude , Gastineau Guillaume , Kwon Young-Oh
Published: February 2020

The direct response of the cold-season atmospheric circulation to the Arctic sea ice loss is estimated from observed sea ice concentration (SIC) and an atmospheric reanalysis, assuming that the atmospheric response to the long-term sea ice loss is the same as that to interannual pan-Arctic SIC fluctuations with identical spatial patterns. No large-scale relationship with previous interannual SIC fluctuations is found in October and November, but a negative North Atlantic Oscillation (NAO)/Arctic Oscillation follows the pan-Arctic SIC fluctuations from December to March. The signal is field significant in the stratosphere in December, and in the troposphere and tropopause thereafter. However, multiple regressions indicate that the stratospheric December signal is largely due to concomitant Siberian snow-cover anomalies. On the other hand, the tropospheric January–March NAO signals can be unambiguously attributed to SIC variability, with an Iceland high approaching 45 m at 500 hPa, a 2°C surface air warming in northeastern Canada, and a modulation of blocking activity in the North Atlantic sector. In March, a 1°C northern Europe cooling is also attributed to SIC. An SIC impact on the warm Arctic–cold Eurasia pattern is only found in February in relation to January SIC. Extrapolating the most robust results suggests that, in the absence of other forcings, the SIC loss between 1979 and 2016 would have induced a 2°–3°C decade−1 winter warming in northeastern North America and a 40–60 m decade−1 increase in the height of the Iceland high, if linearity and perpetual winter conditions could be assumed.