bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma
Authors: Wagner Sabine , Lanfermann Heinrich , Wohlgemuth Walter Alexander , Gufler Hubert
Published: May 2020

Background

To evaluate whether functional and metabolic MRI can detect radiation-induced alterations in the adjacent areas after effective stereotactic radiosurgery (SRS) for brain metastases. If confirmed, these techniques may be suited for monitoring the timely stratification of patients for neuroprotective treatments after irradiation.

Methods

Inclusion criteria were complete response, partial response, or stable disease on routine follow-up MR-scans. Multiparametric 3T-MRI was performed with diffusion-weighted imaging, dynamic susceptibility perfusion-weighted imaging, and two-dimensional proton MR-spectroscopy. Parameters were measured in the SRS-treated target and in the adjacent parenchyma up to both 0.75 cm and 1.5 cm from the target border.

Results

Nineteen lesions in sixteen consecutive patients met the inclusion criteria. The median follow-up time was 39 months (range, 10–142) with 41 multiparametric MR-examinations in total. We found low values of N-acetyl-aspartate up to 1.5 cm from the target borders of SRS (P = 0.043) associated with high values of choline (P = 0.004) at the end of the observation period. Lactate levels in the adjacent tissue declined over time, whereas continuously high apparent-diffusion-coefficient values were noted (P < 0.001).

Conclusion

Multiparametric MRI can depict radiobiological effects and their time course at a distance from the effectively treated site after SRS for brain metastases, even if conventional MRI findings are inconspicuous.
Polaron Diffusion in Pentathienoacene Crystals
Authors: Pereira Marcelo Lopes , Sousa Rafael Timóteo , Giozza William Ferreira , Ribeiro Luiz Antonio
Published: May 2020

Molecular crystals have been used as prototypes for studying the energetic and dynamic properties of charge carriers in organic electronics. The growing interest in oligoacenes and fused-ring oligothiophenes in the last two decades is due, in particular, to the success achieved in conceiving pentacene-based organic photovoltaic devices. In the present work, a one-dimensional Holstein-Peierls model is designed to study the temperature-dependent polaron transport in pentathienoacene (PTA) lattices. The tight-binding Hamiltonian employed here takes into account intra and intermolecular electron-lattice interactions. Results reveal that polarons in PTAs can be stable structures even at high temperatures, about 400 K. During the dynamical process, these charge carriers present a typical 1D random walk diffusive motion with a low activation energy of 13 meV and a room temperature diffusivity constant of 1.07 × 10−3 cm2 s−1. Importantly, these critical values for the polaron diffusion and activation energy are related to the choice of model parameters, which are adopted to describe pristine lattices.
Contactless mass transfer for intra-droplet extraction
Authors: Asano Shusaku , Takahashi Yu , Maki Taisuke , Muranaka Yosuke , Cherkasov Nikolay , Mae Kazuhiro
Published: May 2020

This study demonstrates the possibility of “contactless” mass transfer between two aqueous slugs (droplets) separated by an oil slug in Taylor flow inside milli-channels. Separation of the alternating aqueous slugs at the outlet was performed by switching a couple of solenoid valves at branched outlets according to signals obtained by an optical sensor at the branch. Transfer of bromothymol blue (BTB) from acidic to basic aqueous slugs was performed for demonstration. In some cases, aqueous slugs separated by oil, merged catching on each other due to the velocity difference. Interfacial tension which was affected by the solute concentration was responsible for the velocity difference. Position-specific mass transfer activity at the rear end of the aqueous slugs was found on the course of the experiment. A meandering channel decreased the velocity difference and enhanced mass transfer. Almost complete (93%) transfer of BTB was achieved within a short residence time of several minutes under optimized conditions. The presented system opens a way for advanced separation using minimum amounts of the oil phase and allows concentrating the solute by altering relative lengths of the sender and receiver slugs.
lncRNA AFAP1-AS1 promotes triple negative breast cancer cell proliferation and invasion via targeting miR-145 to regulate MTH1 expression
Authors: Zhang Xiaohui , Zhou Yidong , Mao Feng , Lin Yan , Shen Songjie , Sun Qiang
Published: May 2020

The actin fiber-associated protein 1-antisense RNA1 (AFAP1-AS1) is upregulated in various cancers and associated with cancer proliferation and metastasis. Several cancer-related pathways have been linked to up-expression of this long non-coding (lnc)RNA, but the underlying mechanisms are yet unknown. In triple negative breast cancer (TNBC), AFAP1-AS1 expression is also significantly overexpressed compared to that in other subtypes of breast cancer from the TCGA dataset. In this study, we performed bioinformatic RNAhybrid analyses and identified that miR-145 is a potential target of AFAP1-AS1 and able to reduce MutT homolog-1 (MTH1) expression. Thus, this study investigated the oncogenic activity of AFAP1-AS1 in TNBC cells and the underlying mechanisms that are yet poorly understood. The results showed that miR-145 expression was low, whereas AFAP1-AS1 and MTH1 expression was high in TNBC cells and that miR-145 mimics reduced TNBC cell proliferation and invasion, whereas miR-145 knockdown exerted the opposite activity in TNBC cells. Moreover, knockdown of AFAP1-AS1 reduced tumor cell proliferation and invasion, but miR-145 co-transfection rescued tumor cell viability and colony formation ability. The dual luciferase reporter assay showed that AFAP1-AS1 could directly target miR-145, while miR-145 could directly target MTH1. After knockdown of ATF6, AFAP1-AS1 was reduced along with AFAP1-AS1 promoter activity. This study revealed that AFAP1-AS1 could promote TNBC cell proliferation and invasion via regulation of MTH1 expression through targeting of miR-145.
Detecting cortical circuits resonant to high-frequency oscillations in the human primary motor cortex: a TMS-tACS study
Authors: Guerra Andrea , Ranieri Federico , Falato Emma , Musumeci Gabriella , Di Santo Alessandro , Asci Francesco , Di Pino Giovanni , Suppa Antonio , Berardelli Alfredo , Di Lazzaro Vincenzo
Published: May 2020

Corticospinal volleys evoked by transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) consist of high-frequency bursts (≈667 and ≈333 Hz). However, intracortical circuits producing such corticospinal high-frequency bursts are unknown. We here investigated whether neurons activated by single TMS pulses over M1 are resonant to high-frequency oscillations, using a combined transcranial alternating current stimulation (tACS)-TMS approach. We applied 667, 333 Hz or sham-tACS and, concurrently, we delivered six single-pulse TMS protocols using monophasic or biphasic pulses, different stimulation intensities, muscular states, types and orientations of coils. We recorded motor evoked potentials (MEPs) before, during and after tACS. 333 Hz tACS facilitated MEPs evoked by biphasic TMS through a figure-of-eight coil at active motor threshold (AMT), and by monophasic TMS with anterior-to-posterior-induced current in the brain. 333 Hz tACS also facilitated MEPs evoked by monophasic TMS through a circular coil at AMT, an effect that weakly persisted after the stimulation. 667 Hz tACS had no effects. 333 Hz, but not 667 Hz, tACS may have reinforced the synchronization of specific neurons to high-frequency oscillations enhancing this activity, and facilitating MEPs. Our findings suggest that different bursting modes of corticospinal neurons are produced by separate circuits with different oscillatory properties.
Zero-dimensional ionic antimony halide inorganic–organic hybrid with strong greenish yellow emission
Authors: Lin Fang , Wang Hao , Liu Wei , Li Jing
Published: May 2020

Here, we reported a new zero-dimensional ionic antimony halide inorganic–organic hybrid structure, H3SbBr6(L)6 (L = 2-(3-methyl-1H-imidazol-3-ium-1-yl)acetate).
MiR-377-3p inhibits atherosclerosis-associated vascular smooth muscle cell proliferation and migration via targeting neuropilin2
Authors: Wang Haijun , Wei Zheng , Li Hulun , Guan Yinghui , Han Zhiyang , Wang Hengzhen , Liu Bing
Published: May 2020

Vascular smooth muscle cell (VSMC) proliferation and migration are vital to atherosclerosis (AS) development and plaque rupture. MicroRNA-377-3p (miR-377-3p) has been reported to inhibit AS in apolipoprotein E knockout (ApoE−/−) mice. Herein, the mechanism underlying the effect of miR-377-3p on alleviating AS is explored. In vivo experiments, ApoE−/− mice were fed with high-fat diet (HFD) to induce AS and treated with miR-377-3p agomir or negative control agomir (agomir-NC) on week 0, 2, 4, 6, 8, 10 after HFD feeding. MiR-377-3p was found to restore HFD-induced AS lesions and expressions of matrix metalloproteinase (MMP)-2, MMP-9, α-smooth muscle actin (α-actin) and calponin. In in vitro experiments, human VSMCs were tranfected with miR-377-3p agomir or agomir-NC, followed by treatment with oxidized low-density lipoprotein (ox-LDL). MiR-377-3p was observed to significantly inhibit ox-LDL-induced VSMC proliferation characterized by inhibited cell viability, expressions of proliferating cell nuclear antigen (PCNA), cyclin D1 and cyclin E and cell cycle transition from G1 to S phase accompanied with less 5-Ethynyl-2′-deoxyuridine (EdU)-positive cells. Furthermore, MiR-377-3p significantly inhibited ox-LDL-induced VSMC migration characterized by inhibited wound closure and decreased relative VSMC migration. Besides, neuropilin2 (NRP2) was verified as a target of miR-377-3p. MiR-377-3p was observed to inhibit NRP2 expressions in vivo and in vitro. Moreover, miR-377-3p significantly inhibited MMP-2 and MMP-9 expressions in human VSMCs. Additionally, miR-377-3p-induced inhibition of VSMC proliferation and migration could be attenuated by NRP2 overexpression. These results indicated that miR-377-3p inhibited VSMC proliferation and migration via targeting NRP2. The present study provides an underlying mechanism for miR-377-3p-based AS therapy.
Conifers from the Cenomanian amber of Fouras (Charente-Maritime, western France)
Authors: Moreau Jean-David , Néraudeau Didier , Perrichot Vincent
Published: May 2020

Fossil inclusions of arthropods and microorganisms are abundant in the Cretaceous amber from western France, but plant meso- or macroremains are scarce. Preserved remains are mostly tiny, very fragmented, and indeterminable. Only one amber locality in the Charente department has already provided conifer remains. Here, we report the first plant mesoremains ensnared in Cenomanian amber from Fouras – Bois Vert, in the Charente-Maritime department. They consist of three well-preserved leafy axes and one cone of Cheirolepidiacean conifers. Based on the helical arrangement of rhomboidal, longer than wide, and highly adpressed leaves, leafy axes are ascribed to the genus Pagiophyllum. The ovoid cone bears more than 15 imbricate, helically arranged, scale-like leaves and is ascribed to Classostrobus sp. Although Cretaceous flora is abundant in lignitic clay from the Charentes region, Pagiophyllum is reported for the first time in Albian-Cenomanian deposits from this area. Xerophytic features of Pagiophyllum further support a harsh and instable coastal environment seasonally exposed to hot, dry conditions during the mid-Cretaceous in the Charentes region.
Borehole resistivity and induced polarization tomography at the Canadian Shield for Mineral Exploration in north-western Sudbury
Authors: Ali Mosaad , Sun Shulin , Qian Wei , Bohari Abdou Dodo , Claire Dusabemariya , Faruwa Ajibola Richard , Zhang Yan
Published: May 2020

Mineral exploration in the Canadian shield is a major challenge nowadays. This is because of the thick overburden cover and complex geology. Borehole tomography using resistivity and induced polarization (BHDCIP) method has a big advantage here due to that the data is acquired underneath the cover and data quality, in general, is superior to that acquired at the surface. BHDCIP provides good resistivity and chargeability data, which can identify mineralization easily. In this study, the BHDCIP survey with high-resolution data was carried out to identify mineralization zones in the McCreedy West zone, north-western Sudbury, Ontario, Canada. Two and three-dimensional (2-D and 3-D) inversion results of three boreholes clearly revealed the mineralization zones and that harmonised with previous geological studies in the study area. The BHDCIP method provided insight and developed an informative subsurface map to identify the mineralization zones, thus proving it as a beneficial tool used for mineral exploration in complex geology with a minimal data survey and an irregular geometrical distribution.
Research identify the group for lead – zinc ore type to prepare exploration in Ban Lim area, Caobang province, Vietnam
Authors: Khang Luong Quang , Hung Khuong The , Hung Nguyen Phi , Ton Dang Minh
Published: May 2020

Ban Lim area, Caobang province has proposed high potential of lead-zinc resources, which have occurred in different geological formations. In this paper, based on the collecting, synthetics and processing geological data, especially applied mathematical methods to recognize studied objects of exploration process and quantitative description. The results show that the lead-zinc orebodies in Ban Lim area are mainly occurred in lens-shaped and distributed in layered surfaces of dolomitized limestone of Coc Xo formation. The average lead-zinc content of the orebodies is in a range from 3.27% to 8.33%, its coefficient of variation (Vc) is in a range from 13.71% (evenly) to 137.92% (very unevenly). On the whole, the lead-zinc contents of the orebodies in Ban Lim area mainly comply with the standard normal distribution. The average thicknesses of the orebodies are in a range from 0.92 m to 6.48 m, its coefficient of variation (Vm) is in the range from 8.7% (stable) to 132.95% (very unstable). Quantitative calculation results have shown that Ban Lim lead-zinc deposit belongs to group III of deposits. For the exploration of this type of minerals, it is recommended to use linear grid pattern. Appropriate exploration grid pattern for category 122 reserve is (60-80)×(30-40) m.
Research on the relative productivity of a drum mill type SAG 8.5×5.3
Authors: Minin Ivan
Published: May 2020

The determination of the optimal operational mode of drum mills can be assessed by different criteria. The most important of them can be formulated as follows: “To be specified and established the values of the mill operational parameters regarding to which it is possible to be provided the user’s expected performance at the required quality of the final product and the same to be achieved at minimal energy consumption”. For the fulfillment of this condition, there has to be determined the laws of productivity variation, the final product quality and the energy consumption in function of the adequately chosen representative control parameters of the mill. There are obtained mathematical models, describing the most important technological parameters of the machine and are made conclusions about the factors influencing on them.
Features of process of epoxidation of natural rubber scrap in water – xylene
Authors: Zybailo Serhii , Ved Viktor , Shapovalov Denis
Published: May 2020

The article presents the analysis of the existing methods of producing epoxidized polydiene rubbers in order to obtain new derivative materials with improved physical and mechanical properties. The study proves the use of natural rubber as a raw material for the production of epoxidized polydiene. It has been experimentally demonstrated that conducting epoxidation as a combined-separation process allows producing epoxidized rubber in one reaction volume. It has been also found that the use of a water-xylene environment for the process has a qualitative effect on the degree of epoxidation and significantly reduces power consumption.
Assessment of the stability and loading indicators of two-axle mine cars and rail tracks
Authors: Hovorukha Volodymyr , Zhelyazov Todor
Published: May 2020

The paper presents the research results of the stability and loading of the two-axle mine cars and rail tracks with various design for calculation schemes construction of transport systems of underground rail haulage. The dependences of changes in loading, stability and operation safety of rolling stocks from the parameters of irregularities, curvature radii of the rail track and the movement speed of rolling stocks at various technical solutions of the transport system, have been studied. The research results of the interaction between the two-axle mine cars and rail track with the gauge of 750 mm for underground rail haulage are presented. The parameters have been determined of the rail track irregularities in the horizontal and vertical planes, which cause the highest values of vertical and horizontal loads, acting on the rail track and the two-axle rolling stock. The recommendations are proposed for improving the study of the rail vehicles and regulatory documents development for the construction and operation of the track structure. The results can be applied for the underground rail haulage when creating the new vehicles for mines.
Determining the exciton diffusion length of copper phthalocyanine in operating planar-heterojunction organic solar cells
Authors: Guan Xi , Wang Shiyu , Liu Wenxing , Qin Dashan , Ban Dayan
Published: May 2020

Organic solar cells based on planar copper phthalocyanine (CuPc)/C60 heterojunction have been characterized, in which a 2 nm-thick layer of bathocuproine (BCP) is inserted into the CuPc layer. The thin layer of BCP allows hole current to tunnel it through but blocks the exciton diffusion, thereby altering the steady-state exciton profile in the CuPc zone (zone 1) sandwiched between BCP and C60. The short-circuit current density (JSC) of device is limited by the hole-exciton scattering effect at the BCP/CuPc (zone 1) interface. Based on the variation of JSC with the width of zone 1, the exciton diffusion length of CuPc is deduced to be 12.5–15 nm. The current research provides an easy and helpful method to determine the exciton diffusion lengths of organic electron donors.
Schwannoma of the Greater Superficial Petrosal Nerve: An Unusual Site for a Common Tumor
Authors: Uppar Alok Mohan , Rao Shilpa , Prasad Chandrajit , Arimappamagan Arivazhagan , Santosh Vani
Published: May 2020

Greater superficial petrosal nerve (GSPN) schwannoma is a rare clinical entity. It forms a small subset of the larger group of facial nerve schwannomas. A thorough literature search yielded only 27 such cases reported to date in the English literature. We present one such rare case of GSPN schwannoma and discuss the clinical spectrum and management along with a review of the literature. We demonstrate the surgical steps in an operative video.
Delayed Transfer of the Extensor Carpi Radialis Brevis Branch of the Radial Nerve to the Anterior Interosseous Nerve for Restoration of Thumb and Index Finger Flexion: Case Report
Authors: Salomão Renan , de Oliveira Jairo Porfírio , Junger Carolina Fernandes , Soares Ricardo Luiz Cezar , de Lima Carlos Roberto , Acioly Marcus Andre
Published: May 2020

High median nerve injuries (HMNIs) are rare lesions involving the upper extremities and affect the median nerve from its origin to the emergence of the anterior interosseous nerve (AIN). Proximal reconstruction has long been considered the gold standard in treating HMNI, but thumb and index flexion and pinch and grip weakness are consistently not recovered. We report the surgical results of a patient affected by an HMNI with partial spontaneous recovery after a gunshot wound. AIN function was successfully restored in a delayed fashion by transferring the radial nerve branch to the extensor carpi radialis brevis to the AIN.
Combined Surgical Resection and Laser Interstitial Thermal Therapy for Glioblastoma: Technical Note
Authors: Vega Rafael A. , Traylor Jeffrey I. , Patel Rajan , Muir Matthew , Bastos Dheigo C.A. , Prabhu Sujit S.
Published: May 2020

Background Glioblastoma multiforme (GBM) is an aggressive intracranial malignancy that confers a poor prognosis despite maximum surgical resection and chemoradiotherapy. Survival decreases further with deep-seated lesions. Laser interstitial thermal therapy (LITT) is an emerging minimally invasive technique for tumor ablation shown to reduce tumor burden effectively, particularly in deep-seated locations less amenable to gross total resection. We describe our initial technical experience of using the combination of LITT followed by surgical resection in patients with GBMs that exhibit both an easily accessible and deep-seated component.

Materials and Methods Patients with GBM who received concurrent LITT and surgical resection at our institution were identified. Patient demographic and clinical information was procured from the University of Texas MD Anderson Cancer Center electronic medical record along with preoperative, postoperative, and 1-month follow-up magnetic resonance imaging (MRI).

Results Four patients (n = 2 male, n = 2 female) with IDH-wild type GBM who received combined LITT and surgical resection were identified and analyzed retrospectively. All patients received chemoradiotherapy before presentation. All but one patient (75%) received resection before presentation. Median age was 54 years (range: 44–56 years). Median length of hospital stay was 6.5 days (range: 2–47 days). Median extent of combined ablation/resection was 90.4%. One of the four patients experienced complications in the perioperative or immediate follow-up periods. Local recurrence was observed in one patient during the follow-up period.

Conclusion Malignant gliomas in deep-seated locations or in close proximity to white matter structures are challenging to manage. LITT followed by surgical resection may provide an alternative for tumor debulking that minimizes potential morbidities and extent of residual tumor. Further studies comparing this approach with standard resection techniques are warranted.
Exploring the Benefit of an Integrated Ophthalmology Internship (PGY-1)—Perceived Preparedness and the Recommended Duration of Training
Authors: Hou Andrew , Goyal Nikhil , Darnley-Fisch Deborah , Edwards Paul , Goldman David
Published: May 2020

Objective The effective utilization of intern training for ophthalmology residency is undermined by its variability across postgraduate programs. As residency programs shift toward integrating the first postgraduate year (PGY-1) into the ophthalmology-training curriculum, there are no definitive guidelines to build upon.

Methods This is a retrospective cross-sectional study of new second postgraduate year (PGY-2) ophthalmology residents. Residents were surveyed in their first 2 months of ophthalmology training. Residents were asked to self-assess preparedness for ophthalmology based on their PGY-1 curriculum. A survey was composed and modified from the Accreditation Council for Graduate Medical Education's assessment of resident training. The Wilcoxon's rank-sum test was used to evaluate survey differences between the transitional year (TY) versus preliminary internal medicine (IM) year and compare survey responses between residents who were below versus above optimal cut points for weeks of ophthalmic training.

Results There were 72 PGY-2 residents who responded to blinded surveys collected from July to August of 2017 and 2018. Thirty-nine (54%) residents graduated from a TY, 28 (39%) from preliminary IM, 3 (4%) from preliminary surgery, and 2 (3%) from a categorical ophthalmology year. Both categorical ophthalmology and surgery year were excluded from training year comparison due to low sample size. Using weeks of ophthalmology training as the control variable, there were significant increases in preparedness for addressing the ophthalmic complaint (p = 0.003) with at least 8 weeks of clinical ophthalmology, ability to perform ophthalmic exam (p = 0.018) with at least 12 weeks, ophthalmology medical knowledge (p = 0.005) with at least 10 weeks, and proficiency with hospital electronic health record (p = 0.003) with at least 12 weeks.

Conclusion While our study did not find significant differences in perceived preparedness for ophthalmology residency based on the type of PGY-1 programs completed, there were statistically significant associations for specific ophthalmology tasks. These findings suggested a potential merit of integrating 12 weeks of clinical ophthalmology training as a benchmark for resident preparedness.
Klinik unternehmen: Auf-/Absteiger des Monats
Authors: Schmidt Hartmut
Published: May 2020

Börsenexperte Hartmut Schmidt analysiert für kma die Jahresabschlüsse ausgewählter Kliniken
Pflege 2020: Auf ein Wort
Authors: Heeser Alexandra
Published: May 2020

Für das Jahr 2020 standen einige Neuerungen in der Pflege an. Doch in Zeiten von Corona sind diese zum Teil aus dem Fokus geraten, wie das Aussetzen der Pflegepersonaluntergrenzen zeigt. Vielleicht schafft die Krise ein Umdenken – in der Bevölkerung und in der Politik. Denn eines haben alle aus der Krise gelernt: Die Pflege spielt eine elementare Rolle in unserem Gesundheitssystem.
WLAN im Krankenhaus: Neuverkabelung lohnt sich
Authors: Schutz Thorsten
Published: May 2020

Zuhause ist, wo mein Wlan ist. Der Spruch spiegelt, dass die kabellose Funkverbindung heutzutage nahezu als überlebenswichtig gilt. Überraschenderweise kommen viele Krankenhäuser nach wie vor ohne aus. Es gibt jedoch gute Gründe, Wlan im Krankenhaus zu installieren.
Praxisübernahme durch Klinik-MVZ: Die richtige Kaufpreisverhandlung
Authors: Frielingsdorf Oliver
Published: May 2020

Soll eine Praxis in ein Klinik-MVZ integriert werden, müssen zuvor beide Seiten Einigkeit über den Kaufpreis und das Gehalt erzielen. Kaufpreisverhandlungen mit niedergelassenen Ärzten können jedoch anspruchsvoll sein. Denn es gilt, subjektive Einschätzungen, objektive Gegebenheiten und betriebswirtschaftliche Notwendigkeiten in Einklang zu bringen.
“An equal right to comment”
Authors: Hatzidaki Ourania
Published: May 2020

This paper analyses a snapshot of a conflictive Greek YouTube polylogue dealing with the issue of public online female nudity and the norms pertaining to both the act itself and its verbal critique. The said polylogue contains a markedly high proportion of lay (im)politeness/(in)appropriateness evaluations (Locher and Watts 2005). By quantifying and critically analyzing key lexical impoliteness (Culpeper 2011) and metapragmatic markers contained in the evaluations, I identify the ways in which the norms of online verbal behaviour are discursively negotiated amongst the polylogue participants, focusing especially on the arguments and justifications underlying the suggested norms. It is found that, firstly, the notions of (im)politeness/(in)appropriateness emerge as open to fierce, yet heavily argument-supported discursive dispute; secondly, sexualized slang functions both as an object of critique and as an extremely versatile rhetorical instrument serving metapragmatic argumentation; and, thirdly, online (im)politeness/(in)appropriateness is construed not as a superficial matter of netiquette, but as a deeply ethical and political-ideological controversy, especially regarding speech liberty and political correctness.
A usage-based approach to productive use of inflectional patterns and level of lemma sophistication in adult heritage speakers’ performance
Authors: Karayayla Tuğba
Published: May 2020

Adopting a usage-based perspective, the present study assesses the mental lexicon of Turkish heritage speakers in the UK (HSs,n = 31) regarding the productive use of formulaic inflectional suffix templates and the level of sophistication of the lemmas produced in free speech. We additionally explore input-related predictors of this performance by comparing HS performance to that of a group of previous generation immigrant bilinguals (IBs,n = 61), who are representative input providers, and of a group of monolinguals (n = 44). The results show that overall, both the HSs and IBs diverge from the monolinguals in that they use nominal suffix sequences less productively and rely on less sophisticated nominal lemmas. Their verbal productivity performance, however, remains intact. We argue that altered input results in a performance which diverges from that of the monolinguals but converges on the immigrant variety. The individual variability is partly explained by the amount of L1 passive exposure, indicating that the HSs are not sensitive only to the changes in the input available to them but also to the amount of it. These findings provide new insights into the line of research that describes HSs as incomplete due to their L1-divergent skills in comparison to a monolingual baseline.
Can music inspire translators?
Authors: Naranjo Beatriz
Published: May 2020

This article examines the role of musically-triggered narrative engagement in translation performance. An experimental study was conducted to investigate the potential of music to induce narrative engagement (NE), based on findings that suggest the influence of NE-relevant dimensions such as visualization and emotional involvement in translation. Participants translated two literary texts with opposing emotional content (happy and sad) in two different sound conditions (with and without music). Three hypotheses were formulated predicting a beneficial effect of music for narrative engagement as well as positive correlations between narrative engagement and translation quality and creativity. Results suggest an increase of visualization in the music condition and a correlation between visualization levels and accuracy scores. Retrospective questionnaires indicate a positive appraisal of the experience of translating with music at both the cognitive and emotional level, although further investigations is needed to validate the scale and confirm its reliability.
Invited Commentary: Biomarkers for Mortality Among Individuals With a History of Out-of-Home Care—Implications for Study Design and Conceptualizations of Risk
Authors: Brown Hilary K
Published: May 2020

Out-of-home care in childhood and adolescence has been shown to be associated with elevated risk for all-cause mortality in adulthood, with adverse socioeconomic, psychosocial, and health-related trajectories hypothesized to mediate this relationship. In the research letter by Batty and Hamer (Am J Epidemiol. 2021;190(1):176–178), the authors used data from the 1970 British birth cohort (n = 8,581) to examine risk of biomarkers for mortality in adults with a history of out-of-home care. While markers of inflammation, glucose metabolism, and lipids were less favorable in the exposed versus unexposed, differences between groups were small and were completely attenuated after adjustment. This study raises important issues regarding the design and conceptualization of future studies on the long-term outcomes of out-of-home care recipients. Such studies require more detailed information on duration of care, type of care setting, and reasons for care, all of which could affect outcome risk. Because the duration of follow-up is long, and attrition likely, authors should consider use of novel analytical techniques to account for selection bias, such as inverse probability weighting. Finally, a “chain-of-risk” approach to understanding outcomes might be warranted, given that risk is likely explained by accumulation of and prolonged exposure to adverse socioeconomic, psychosocial, and health risks.
The Silent Spring of Human Rights in Investment Arbitration: Jurisprudence Constante through Case-Law Trajectory
Authors: Joshi Riddhi Dhananjay , Gurpur Shashikala
Published: May 2020

As a niché body of jurisprudence, International Investment Arbitration has paradoxically remained aloof from developments in other related spheres of law. Increasingly, however, Tribunals have been compelled to reflect on matters arising out of a human rights narrative. This article studies the perspectives of certain stakeholders in choosing to employ human rights to further social, economic or environmental interests in an investment arbitration. These stakeholders are: Claimant, Respondent, Third Party Interveners, Tribunal, and Enforcing Jurisdiction. Reliance is placed on awards spanning 28 years from 1989 to 2017 under the ICSID regime as well as in ad hoc arbitrations under the UNCITRAL Rules. An analysis of trends in case law sheds light on the nature of a jurisprudence constante developing in this regard. The article also explores limitations to, and recommendations for, the engagement of human rights within the realms of Investment Arbitration.
A Sensitive and Optimized HPLC-FLD Method for the Simultaneous Quantification of Hydroxychloroquine and Its Two Metabolites in Blood of Systemic Lupus Erythematosus Patients
Authors: Luo Xuemei , Peng Ying , Ge Weihong
Published: May 2020

Quantification of hydroxychloroquine (HCQ) and its two metabolites desethylchloroquine and desethylhydroxychloroquine in human blood can provide insight into the pharmacokinetic/pharmacodynamic characteristics of HCQ for the treatment of systemic lupus erythematosus (SLE), which is crucial for the optimization of the therapy. A simple, sensitive and optimized high performance liquid chromatography with fluorescence detection method has been developed and validated for the simultaneous determination of HCQ and its two metabolites in human blood. After addition of internal standard chloroquine, the blood sample was deproteinized with 2-fold acetonitrile and separated on an YMC-Triart C18 column (250 × 4.6 mm, 5 μm) with a mobile phase of 20 mM sodium phosphate buffer solution containing 0.25% triethylamine (pH 8.0)—acetonitrile (60:40, v/v). The analytes were detected by using fluorescence detection at an excitation and emission wavelength of 337 and 405 nm, respectively. The method was linear over the range of 3–3000 ng/mL for all three analytes and the chromatographic run time was 9 min. The values for intra- and inter-day precisions were ranged from 1.3 to 7.3. This method was successfully applied to quantify the concentrations of HCQ and its two metabolites in blood of 92 SLE patients.
Empagliflozin improves endothelial and cardiomyocyte function in human heart failure with preserved ejection fraction via reduced pro-inflammatory-oxidative pathways and protein kinase Gα oxidation
Authors: Kolijn Detmar , Pabel Steffen , Tian Yanna , Lódi Mária , Herwig Melissa , Carrizzo Albino , Zhazykbayeva Saltanat , Kovács Árpád , Fülöp Gábor Á , Falcão-Pires Inês , Reusch Peter H , Linthout Sophie Van , Papp Zoltán , van Heerebeek Loek , Vecchione Carmine , Maier Lars S , Ciccarelli Michele , Tschöpe Carsten , Mügge Andreas , Bagi Zsolt , Sossalla Samuel , Hamdani Nazha
Published: May 2020

Aims

Sodium-glucose-cotransporter-2 inhibitors showed favourable cardiovascular outcomes, but the underlying mechanisms are still elusive. This study investigated the mechanisms of empagliflozin in human and murine heart failure with preserved ejection fraction (HFpEF).

Methods and results

The acute mechanisms of empagliflozin were investigated in human myocardium from patients with HFpEF and murine ZDF obese rats, which were treated in vivo. As shown with immunoblots and ELISA, empagliflozin significantly suppressed increased levels of ICAM-1, VCAM-1, TNF-α, and IL-6 in human and murine HFpEF myocardium and attenuated pathological oxidative parameters (H2O2, 3-nitrotyrosine, GSH, lipid peroxide) in both cardiomyocyte cytosol and mitochondria in addition to improved endothelial vasorelaxation. In HFpEF, we found higher oxidative stress-dependent activation of eNOS leading to PKGIα oxidation. Interestingly, immunofluorescence imaging and electron microscopy revealed that oxidized PKG1α in HFpEF appeared as dimers/polymers localized to the outer-membrane of the cardiomyocyte. Empagliflozin reduced oxidative stress/eNOS-dependent PKGIα oxidation and polymerization resulting in a higher fraction of PKGIα monomers, which translocated back to the cytosol. Consequently, diminished NO levels, sGC activity, cGMP concentration, and PKGIα activity in HFpEF increased upon empagliflozin leading to improved phosphorylation of myofilament proteins. In skinned HFpEF cardiomyocytes, empagliflozin improved cardiomyocyte stiffness in an anti-oxidative/PKGIα-dependent manner. Monovariate linear regression analysis confirmed the correlation of oxidative stress and PKGIα polymerization with increased cardiomyocyte stiffness and diastolic dysfunction of the HFpEF patients.

Conclusion

Empagliflozin reduces inflammatory and oxidative stress in HFpEF and thereby improves the NO–sGC–cGMP–cascade and PKGIα activity via reduced PKGIα oxidation and polymerization leading to less pathological cardiomyocyte stiffness.
Prognostic value of left ventricular remodelling index in idiopathic dilated cardiomyopathy
Authors: Xu Yuanwei , Lin Jiayi , Liang Yaodan , Wan Ke , Li Weihao , Wang Jie , Zhu Yanjie , Mui David , Wang Lili , Li Yuancheng , Cheng Wei , Sun Jiayu , Zhang Qing , Han Yuchi , Chen Yucheng
Published: May 2020

Aims

To evaluate the prognostic value of left ventricular (LV) remodelling index (RI) in idiopathic dilated cardiomyopathy (DCM) patients.

Methods and results

We prospectively enrolled 412 idiopathic DCM patients and 130 age- and sex-matched healthy volunteers who underwent cardiovascular magnetic resonance imaging between September 2013 and March 2018. RI was defined as the cubic root of the LV end-diastolic volume divided by the mean LV wall thickness on basal short-axis slice. The primary endpoint included all-cause mortality and heart transplantation. The secondary endpoint included the primary endpoint and heart failure (HF) readmission. During the median follow-up of 28.1 months (interquartile range: 19.3–43.0 months), 62 (15.0%) and 143 (34.7%) patients reached the primary and secondary endpoints, respectively. Stepwise multivariate Cox regression showed that RI [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.11–1.30, P < 0.001], late gadolinium enhancement (LGE) presence and log (N-terminal pro-B-type natriuretic peptide) were independent predictors of the primary endpoint, while RI (HR 1.15, 95% CI 1.08–1.23, P < 0.001) and extracellular volume were independent predictors of the secondary endpoint. The addition of RI to LV ejection fraction (EF) and LGE presence showed significantly improved global χ2 for predicting primary and secondary endpoints (both P < 0.001). Furthermore, RI derived from echocardiography also showed independent prognostic value for primary and secondary endpoints with clinical risk factors.

Conclusions

RI is an independent predictor of all-cause mortality, heart transplantation, and HF readmission in DCM patients and provides incremental prognostic value to LVEF and LGE presence.
Balloon atrial septostomy and transition of subcutaneous to intravenous prostacyclin infusion for rescuing advanced right heart failure in idiopathic pulmonary arterial hypertension: a case report
Authors: Liang Kae-Woei , Wang Kuo-Yang
Published: May 2020

Background

Intravenous (IV) prostacyclin analogues infusion and balloon atrial septostomy (BAS) are two important treatment options for managing advanced right heart failure in patients with idiopathic pulmonary arterial hypertension (IPAH). References and protocols are rare for dose titrations and transitions between subcutaneous and IV prostacyclin in functional Class IV IPAH patients. Balloon atrial septostomy is rarely done in very few expert centres.

Case summary

A young female with IPAH who had received maximal medication including subcutaneous prostacyclin analogues injection was admitted due to advanced right heart failure. She received ascites drainage twice. Later, we directly switched the administration route of prostacyclin from subcutaneous to IV at a ratio of 1:1 instantly. Such rapid conversion led her into a state of profound hypotension and drowsy consciousness, which was resolved after escalating IV inotropics and reducing prostacyclin dosage. Five days later, she received BAS under the guidance of intracardiac echocardiography. Her urine output increased and dyspnoea improved gradually. Six months later, clinical worsening happened again with increase of ascites and dyspnoea. She underwent 2nd and 3rd session of graded BAS with relief of symptoms again. She received permanent transition to IV prostacyclin analogues infusions via a peripherally inserted central catheter after three sessions of BAS.

Discussion

Balloon atrial septostomy is effective in stabilizing the critical right heart failure in IPAH patients but should be intended as a bridge to lung transplant procedure. Transition from subcutaneous to IV prostacyclin is helpful but needs to be titrated in proper aliquots and time intervals to avoid abrupt haemodynamic changes.
Haemophagocytic lymphohistiocytosis after heart transplantation: a case report
Authors: Danielsson Christian , Karason Kristjan , Dellgren Göran
Published: May 2020

Background

Haemophagocytic lymphohistiocytosis (HLH) is an uncommon but serious systemic inflammatory response with high mortality rates. It can be triggered by malignancy or infectious agents, often in the context of immunosuppression. Literature covering HLH in heart transplantation (HTx) is scarce.

Case summary

A 25-year-old male with a history of celiac disease underwent HTx at Sahlgrenska Hospital in 2011 due to giant cell myocarditis and was treated with tacrolimus, mycophenolate mofetil (MMF), and prednisolone. He developed several episodes of acute cellular rejections (ACR) during the first 3 post-HTx years, which subsided after addition of everolimus. In May 2017, the patient was admitted to the hospital due to fever without focal symptoms. He had an extensive inflammatory reaction, but screening for infectious agents was negative. Haemophagocytic lymphohistiocytosis was discussed early, but first dismissed since two bone marrow biopsies revealed no signs of haemophagocytosis. Increasing levels of soluble IL-2 were considered confirmative of the diagnosis. Even with intense immunosuppressant treatment, the patient deteriorated and died in progressive multiorgan failure within 2 weeks of the symptom onset.

Discussion

A 25-year-old HTx recipient with an extensive inflammatory response, fulfilled criteria for HLH, but the diagnosis was delayed due to normal bone marrow biopsies. A background with autoimmune reactivity and immunosuppressive therapy may have contributed to HLH, but the actual trigger was not identified. Haemophagocytic lymphohistiocytosis can occur in HTx recipients in the absence of malignancy, identifiable infectious triggers and signs of haemophagocytosis. Early diagnosis and intervention are likely to be of importance for a favourable outcome.
Cardiac tamponade due to primary hypothyroidism: acute management and approach to prevent recurrence—a case report
Authors: Maddali Vikas Reddy , Miryala Srikar , Bellamkonda Yagna Sreekanth , Nagula Praveen
Published: May 2020

Background

Hypothyroidism is a common endocrine disorder resulting from deficiency of thyroid hormone, with iodine deficiency remains the foremost cause. It is more common in women with increasing incidence in the elderly. The manifestations of hypothyroidism results from the hypometabolism in the body at cellular level and affects all organs. Although there can be an incidental diagnosis of the disorder, the presentation with cardiac signs and symptoms is rare. We report a case of primary hypothyroidism with dysmorphic features manifesting as massive pericardial effusion with cardiac tamponade at presentation.

Case summary

A female aged 20 years presented with lethargy, constipation, and dyspnoea of 6 months duration. On examination, she was short-statured and had dysmorphic features with hypotension, raised jugular venous pressure (JVP), muffled heart sounds, and thyroid stimulating hormone >100 uIU/mL. Chest X-ray showed cardiomegaly and 2DEcho confirmed cardiac tamponade for which emergency pericardiocentesis was done.

Discussion

Cardiovascular manifestations in hypothyroidism are dyspnoea and decreased exercise tolerance. Bradycardia, diastolic hypertension, cardiomegaly, and non-pitting or pitting peripheral oedema may be seen on physical examination. Mild pericardial effusion is common and generally asymptomatic. Massive pericardial effusion being manifested at presentation primarily as a sign of hypothyroidism is rare. A few cases have been mentioned in the literature in India and western population. Rarely, hypothyroidism presents with massive pericardial effusion resulting in cardiac tamponade as in our case.
Extensive coil embolization of a giant coronary artery aneurysm in an octogenarian: a case report
Authors: Ahmed Talha , Chahal Diljon , Shkullaku Melsjan , Gupta Anuj
Published: May 2020

Background

Coronary artery aneurysms (CAA) are often diagnosed incidentally on coronary angiography or imaging modalities done for other reasons. ‘Giant’ CAA by definition exceeds 20 mm in diameter or four times the diameter of normal coronary artery. The management of patients with CAAs is challenging due to poorly understood mechanism, variable presentation, and lack of clear-cut societal recommendations. Though conservative management is preferred in asymptomatic patients, massive size or interval growth may make intervention necessary.

Case summary

We describe a case of successful coil embolization of a giant coronary aneurysm in an elderly 84-year-old male. Patient, who presented for a follow-up computed tomography angiography to evaluate a previously repaired abdominal aortic aneurysm 2 years back, was found to have interval growth of right coronary artery aneurysm from 4 cm in diameter to 7 × 8 cm in its greatest dimensions. The rationale for treatment was to prevent sudden death from continued growth and eventual rupture of aneurysm in addition to potential risk of thromboembolism and compression of adjacent structures.

Discussion

This case demonstrates the safe and successful use of extensive coil embolization technique to treat a ‘giant’ CAA in an elderly patient when surgical risks were prohibitive.
Case report: adult-onset manifesting heterozygous glycogen storage disease type IV with dilated cardiomyopathy and absent late gadolinium enhancement on cardiac magnetic resonance imaging
Authors: Lyo Shawn , Miles Jeremy , Meisner Jay , Guelfguat Mark
Published: May 2020

Background

Glycogen storage disease type IV (GSD IV; Andersen’s disease) is a rare autosomal recessive disease caused by mutation in the GBE1 gene. Presentation of GSD IV varies on a continuum of severity and symptomatology ranging from neonatal death to mild adult-onset disease with variable involvement of hepatic, muscular, neurologic, dermatologic, and cardiac systems. Cardiomyopathy seen in GSD IV is also heterogeneous and its appearance on cardiac magnetic resonance imaging (CMR) is rarely described.

Case summary

A 29-year-old man without previous medical history was admitted to our facility multiple times over 2 years for focal sensorimotor deficits, gout arthropathy, chronic hyperlactataemia and hyperuricaemia, and severe decompensated non-ischaemic cardiomyopathy complicated by episodes of thromboembolic organ infarction. Echocardiography and CMR showed severe biventricular failure with the presence of intraventricular thrombi with increased right ventricular trabeculation and absent late gadolinium enhancement. He underwent muscle biopsy which showed prominent glycogen in skeletal muscle followed by genetic testing showing a single heterozygous splicing mutation c.993-1G>T found at the junction of intron 7 and exon 8 of the GBE1 gene which had not previously been reported and was predicted to be pathologic. He was referred to a tertiary care centre with glycogen storage disease specialists but expired prior to establishing care at that facility.

Discussion

Discovery of GSD IV in our patient was unexpected due to a highly variant clinical presentation. Our case stresses the clinical heterogeneity of GSD IV and the importance of genetic sequencing studies in the evaluation of potential glycogen storage disease.