bluuebunny/crossref_metadata_2025 huggingface dataset:
The Only Eye Study (OnES): a qualitative study of surgeon experiences of only eye surgery and recommendations for patient safety
Authors: Jones Lee , Taylor Deanna J , Sii Freda , Masood Imran , Crabb David P , Shah Peter
Published: December 2019

Objective

Performing surgery on patients with only one seeing-eye, where complications may result in catastrophic vision loss, presents unique challenges for the ophthalmic care team. There is currently no evidence regarding how surgeons augment their care when treating only eye patients and no guidelines for how these patients should be managed in hospital eye services. This study aimed to explore ophthalmic surgeons’ experiences of only eye surgery and perceptions of current practice.

Design and participants

Ten ophthalmic surgeons were asked to relate their experiences and views on performing only eye surgery in indepth, semistructured interviews. Interviews were audio-recorded and transcribed. Qualitative data were subjected to thematic analysis to identify key themes.

Setting

Hospital eye service.

Results

Five key themes emerged relating to surgeons’ experiences and perceptions of only eye surgery: (1) differences in approach to consent, (2) strategies for risk reduction, (3) unmet training needs, (4) value of surgical mentor and (5) emotional impact of unsuccessful outcomes. Recommendations for improving the surgical journey for both the patient and the surgeon related primarily to better recognition and understanding of the complexities inherent with only eye surgery.

Conclusions

Outcomes of only eye surgery may be improved through a number of methods, including development of purpose-designed training fellowships, adoption of stress-reducing strategies and enhancement of available support services. The findings identify emerging themes unique to only eye surgery and the need for guidelines on the provision of care for these high-stakes surgical patients.
Association between blood circulating vitamin D and colorectal cancer risk in Asian countries: a systematic review and dose-response meta-analysis
Authors: Zhang Lin , Zou Huachun , Zhao Yang , Hu Chunlei , Atanda Adejare , Qin Xuzhen , Jia Peng , Jiang Yu , Qi Zhihong
Published: December 2019

Objectives

To assess the association between blood circulating vitamin D levels and colorectal cancer risk in the Asian population.

Design

This is a systematic review and dose-response meta-analysis of observational studies that investigated the relationship between blood circulating vitamin D levels and colorectal cancer risk in the Asian population.

Data sources

Relevant studies were identified through a literature search in Medline, Embase and Web of Science from 1st January 1980 to 31st January 2019. Eligibility criteria: original studies published in peer-reviewed journals investigating the association between blood circulating vitamin D levels and the risk of colorectal cancer and/or adenoma in Asian countries.

Data extraction and synthesis

Two authors independently extracted data and assessed the quality of included studies. Study-specific ORs were pooled using a random-effects model. A dose-response meta-analysis was performed with generalised least squares regression. We applied the Newcastle-Ottawa Scale quality assessment to evaluate the quality of the selected studies.

Results

The eight included studies encompassed a total of 2916 cases and 6678 controls. The pooled ORs of colorectal cancer for the highest versus lowest categories of blood circulating vitamin D levels was 0.75 (95% CI 0.58 to 0.97) up to 36.5 ng/mL in the Asian population. There was heterogeneity among the studies (I2=53.9%,Pheterogeneity=0.034). The dose-response meta-analysis indicated a significant linear relationship (Pnon-linearity=0.11). An increment of 16 ng/mL in blood circulating vitamin D level corresponded to an OR of 0.79 (95% CI 0.64 to 0.97).

Conclusions

The results of this meta‐analysis indicate that blood circulating vitamin D level is associated with decreased risk of colorectal cancer in Asian countries. The dose-response meta-analysis shows that the strength of this association among the Asian population is similar to that among the Western population. Our study suggests that the Asian population should improve nutritional status and maintain a higher level of blood circulating vitamin D.
Long-term outcomes in patients with severe depression after in-hospital treatment – study protocol of the depression long-term Augsburg (DELTA) study
Authors: Kirchberger Inge , Maleckar Barbara , Meisinger Christine , Linseisen Jakob , Schmauss Max , Baumgärtner Jessica
Published: December 2019

Introduction

Depressive disorders are very common diseases entailing a great burden on affected people. However, comprehensive information on long-term disease course in patients with severe depression is lacking so far. The objectives of the DELTA study are to examine long-term outcomes and their predicting factors, to assess clinical response of antidepressant pharmacotherapy by applying therapeutic drug monitoring, to identify predictors of therapeutic non-response, to describe the long-term healthcare utilisation and to investigate the role of biomarkers in disease course.

Methods and analysis

A cohort study including all adult hospitalised cases (age range 18 to 75 years) of severe major depression who are admitted to the Bezirkskrankenhaus Augsburg is established. It is planned to include 300 patients. During the hospital stay, information is gathered through personal interview, self-administered questionnaires, cognitive tests and chart review. Furthermore, biomaterials are collected. After hospital discharge, patients are repeatedly re-examined over time (3, 6, 12, 24 and 36 months) to collect information about mortality, relapse, depression severity, health-related quality of life (HRQOL), perceived stigma, cognitive functions, diet, physical activity, treatment and healthcare utilisation. Follow-up blood samples are collected to determine therapeutic drug levels. The primary study aim is to investigate long-term therapeutic response, survival, relapse, HRQOL and cognitive functions. Survival time and time to relapse or re-hospitalisation will be analysed using Cox regression models. Changes of HRQOL, depressive symptoms and cognitive functions over time will be examined using generalised linear regression models for repeated measures or mixed models. Correlates of the disease course will be modelled using suitable generalised linear, mixed, estimating equation and growth curve models.

Ethics and dissemination

The study protocol was approved by the Ethics Committee of the Ludwig-Maximilians-Universität München (date of approval: 23 October 2017, reference number: 17–625). Study results will be presented at scientific conferences and published in peer-reviewed scientific journals.
What are the chances for personalised treatment with antidepressants? Detection of patient-by-treatment interaction with a variance ratio meta-analysis
Authors: Plöderl Martin , Hengartner Michael Pascal
Published: December 2019

Objectives

To investigate if the treatment effect of antidepressants in patients with depression substantially varies in each patient (patient-by-treatment interaction or treatment heterogeneity), a necessary but largely unexplored prerequisite of personalised antidepressant treatment.

Design

Meta-analytic variance comparison of treatment outcome between drug arms and placebo arms of clinical trials, based on the assumption that patient-by-treatment interaction should lead to larger variances in drug arms than placebo arms. To put the results into context, we run simple simulations, assuming different definitions and rates of those who respond especially well to antidepressants.

Data sources

163 randomised, placebo-controlled trials (51 396 patients) with complete results for pre–post differences, selected from a recently published systematic review.

Analysis

Variance ratios (VRs) and coefficients of variance ratios (CVRs) of individual trials were meta-analytically combined. The analysis was repeated for classes of antidepressants and specific antidepressants.

Results

VRs (VR=1.01, CI 0.99 to 1.02) and CVRs (CVR=0.82, CI 0.80 to 0.84) of the antidepressant-treatment arms were comparable or smaller than in placebo arms. Similar results were observed for classes of antidepressants and for specific antidepressants. Our simulation analysis confirmed that equal VRs can only be obtained if they are not more than a few patients who respond slightly above average.

Conclusions

The lack of increased treatment-outcome variance in the antidepressants versus placebo groups in randomised controlled trials indicates that no or only very small subgroups of patients respond particularly well to antidepressants. Thus, the scope for personalised treatment with antidepressants seems to be limited.
Safety and cost analysis of selective histopathological examination following appendicectomy and cholecystectomy (FANCY study): protocol and statistical analysis plan of a prospective observational multicentre study
Authors: Bastiaenen Vivian P , Corten Bartholomeus JGA , de Savornin Lohman Elise AJ , de Jonge Joske , Kraima Anne C , Swank Hilko A , van Vliet Jaap LP , van Acker Gijs JD , van Geloven Anna AW , in 't Hof Klaas H , Koens Lianne , de Reuver Philip R , van Rossem Charles C , Slooter Gerrit D , Tanis Pieter J , Terpstra Valeska , Dijkgraaf Marcel GW , Bemelman Willem A
Published: December 2019

Introduction

Routine histopathological examination following appendicectomy and cholecystectomy has significant financial implications and comprises a substantial portion of the pathologists’ workload, while the incidence of unexpected pathology is low. The aim of the selective histopathological examination Following AppeNdicectomy and CholecystectomY (FANCY) study is to investigate the oncological safety and potential cost savings of selective histopathological examination based on macroscopic assessment performed by the surgeon.

Methods and analysis

This is a Dutch multicentre prospective observational study, in which removed appendices and gallbladders will be systematically assessed by the operating surgeon for macroscopic abnormalities suspicious for malignant neoplasms. After visual inspection and digital palpation of the removed specimen, the operating surgeon will report whether macroscopic abnormalities suspicious for a malignant neoplasm are present, and if he or she believes additional microscopic examination by the pathologist is indicated. Regardless of the surgeon’s assessment, all specimens will be sent for histopathological examination. In this way, routine histopathological examination can be compared with a hypothetical situation in which specimens are routinely examined by surgeons and only sent to the pathologist on indication. The two main outcomes are oncological safety and potential cost savings of a selective policy. Oncological safety of selective histopathological examination will be assessed by calculating the number of patients in whom a histopathological diagnosis of an appendiceal neoplasm or gallbladder cancer with clinical consequences benefitting the patient would have been missed. A cost analysis will be performed to quantify the potential cost savings.

Ethics and dissemination

The study protocol was reviewed by the Institutional Review Board of the Amsterdam UMC, location AMC, which decided that the Dutch Medical Research Involving Human Subjects Act is not applicable. In all participating centres, approval for execution of the FANCY study has been obtained from the local Institutional Review Board before the start of inclusion of patients. The study results will be disseminated through peer-reviewed publications and conference presentations. Guidelines will be revised according to the findings of the study.

Trial registration number

NCT03510923.
Predictive factors for sleep apnoea in patients on opioids for chronic pain
Authors: Chung Frances , Wong Jean , Bellingham Geoff , Lebovic Gerald , Singh Mandeep , Waseem Rida , Peng Philip , George Charles F P , Furlan Andrea , Bhatia Anuj , Clarke Hance , Juurlink David N , Mamdani Muhammad M , Horner Richard , Orser Beverley A , Ryan Clodagh M
Published: December 2019

Background

The risk of death is elevated in patients taking opioids for chronic non-cancer pain. Respiratory depression is the main cause of death due to opioids and sleep apnoea is an important associated risk factor.

Methods

In chronic pain clinics, we assessed the STOP-Bang questionnaire (a screening tool for sleep apnoea;Snoring,Tiredness,Observed apnoea, high bloodPressure,Body mass index, age, neck circumference and male gender), Epworth Sleepiness Scale, thyromental distance, Mallampati classification, daytime oxyhaemoglobin saturation (SpO2) and calculated daily morphine milligram equivalent (MME) approximations for each participant, and performed an inlaboratory polysomnogram. The primary objective was to determine the predictive factors for sleep apnoea in patients on chronic opioid therapy using multivariable logistic regression models.

Results

Of 332 consented participants, 204 underwent polysomnography, and 120 (58.8%) had sleep apnoea (AHI ≥5) (72% obstructive, 20% central and 8% indeterminate sleep apnoea), with a high prevalence of moderate (23.3%) and severe (30.8%) sleep apnoea. The STOP-Bang questionnaire and SpO2are predictive factors for sleep apnoea (AHI ≥15) in patients on opioids for chronic pain. For each one-unit increase in the STOP-Bang score, the odds of moderate-to-severe sleep apnoea (AHI ≥15) increased by 70%, and for each 1% SpO2decrease the odds increased by 33%. For each 10 mg MME increase, the odds of Central Apnoea Index ≥5 increased by 3%, and for each 1% SpO2decrease the odds increased by 45%.

Conclusion

In patients on opioids for chronic pain, the STOP-Bang questionnaire and daytime SpO2are predictive factors for sleep apnoea, and MME and daytime SpO2are predictive factors for Central Apnoea Index ≥5.

Trial registration number

NCT02513836
Methylation Analysis of MIR200 Family in Mexican Patients with Colorectal Cancer
Authors: Alvizo-Rodriguez Carlos Rogelio , de la Luz Ayala-Madrigal Maria , Hernandez-Sandoval Jesus Arturo , Ramirez-Plascencia Helen Haydee Fernanda , Gonzalez-Villaseñor Christian Octavio , Macias-Gomez Nelly Margarita , Peregrina-Sandoval Jorge , Moreno-Ortiz Jose Miguel , Valenzuela-Perez Jesus A , Cruz-Ramos Jose Alfonso , Gutierrez-Angulo Melva
Published: December 2019

The present study aimed to analyze the methylation pattern of the MIR200 family in the colorectal tissues and peripheral blood of colorectal cancer (CRC) patients. Previous informed consent, 102 samples of colorectal tissues (tumor and adjacent normal tissues) and 40 peripheral blood samples were collected from CRC patients. Additionally, we included a reference group of 40 blood samples. DNA extraction was done for colorectal tissues and peripheral blood. For methylation-specific PCR, we used bisulfite-treated DNA and controls for methylated and unmethylated DNA were included to each assay. PCR fragments were separated by 6% polyacrylamide gel electrophoresis. Methylation-positive and methylation-negative results were confirmed by bisulfite genomic sequencing technique. We analyzed 102 colorectal tissues and 40 blood samples from 51 CRC patients. MIR200B/MIR200A/MIR429 methylation analysis discloses no differences among tissues (p>0.05). However, MIR200C/MIR141 methylation showed differences between colorectal tissues and peripheral blood of CRC patients (p<0.0001) and mainly methylated alleles were observed in peripheral blood. These findings suggest a tissue-specific methylation pattern for the MIR200C/MIR141 promoter.
Too Young to Have a Stroke?—a Global Health Crisis
Authors: Vrudhula Amey , Zhao Jing , Liu Renyu
Published: December 2019

This editorial discusses the importance of improving awareness of stroke in young individuals. Stoke can occur in any age group and is not restricted to elderly populations. Today, the average age of the first-time stroke patient continues to decrease. However, the incidence of stroke in seemingly healthy, young adults remains neglected, and stroke awareness among young patients remains poor, even in well-developed countries. Education targeting two common barriers to stroke care, identification and rescue, should be implemented for both medical professionals and the public domain. Only through education can we reduce preventable stroke-related death and damage in young patients moving forward.
Temperature and doping content independence of lifetime in Li2MgSiO4:Eu3+ phosphor
Authors: Tang Huidong , Yang Rong , Xiong Chao , Gao Wei
Published: December 2019

Novel red light-emitting [Formula: see text] ([Formula: see text][Formula: see text]–[Formula: see text][Formula: see text]) phosphors were prepared by solid state reaction. The crystal phase structure and powder morphology were measured by X-ray powder diffraction (XRD) and scanning electron microscope (SEM), respectively. The photoluminescence (PL) properties were investigated. The excitation spectrum shows a wide coverage in the UV-Vis region, and the [Formula: see text] transition with the maximum peak of 613 nm governs the emission spectrum. The lifetime of [Formula: see text] ([Formula: see text][Formula: see text]–[Formula: see text][Formula: see text]) phosphor is temperature-independent as well as the [Formula: see text] doping content because of the existence of defect. In [Formula: see text] lattice, the Eu[Formula: see text] ions substitute for the [Formula: see text] ions, and the charge compensation mechanism could be ascribed to the dipole complex ([Formula: see text]) combined by [Formula: see text] vacancy ([Formula: see text]) and positive charge ([Formula: see text]).
Adolescent–Parent Relationships: Progress, Processes, and Prospects
Authors: Smetana Judith G. , Rote Wendy M.
Published: December 2019

The nature of adolescent–parent relationships has been a topic of enduring concern in developmental science. In this article, we review theory and current research on several central topics. First, we define adolescence as a developmental period and briefly discuss current theoretical and analytical approaches. Then, we consider adolescent–parent relationship quality, including developmental trends and individual differences in negative interactions, positive relationships, and conflict resolution, as well as research that examines relationship quality within different family subsystems. Next, we discuss effects of emotional variability and flexibility on parent–adolescent relationships and review research on adolescents’ and parents’ beliefs about parental authority legitimacy. This is followed by a discussion of current research on parenting effects on adolescent–parent relationships, including approaches that provide greater specificity in defining parental control and its links with relationship quality, as well as research on parental monitoring and adolescent information management. We conclude this article with directions for future research.
Ovariohysterectomy and Partial Vaginectomy for Treatment of Cervicovaginitis in a Dog
Authors: Folk Christian A. , Lux Cassie N. , DeGroot Whitney
Published: December 2019

A 1-year-old sexually intact female Labrador Retriever was evaluated for malodorous vaginal discharge, lethargy, and vomiting. A diagnosis of pyometra was suspected based on signalment, clinical signs, and abdominal ultrasonography. The dog underwent an exploratory celiotomy revealing a palpably enlarged cervix and edematous, fluid-filled vagina with an otherwise normal uterus. The ovaries, uterus, cervix, and cranial vagina were surgically resected. Histopathology revealed mild to moderate regionally extensive subacute neutrophilic cervicovaginitis due to an unknown underlying etiology. The dog did not exhibit any postoperative complications or recurrence of clinical signs in 6 months. This case represents an unusual disease condition, which presented in a manner typical for pyometra, yet required more extensive surgical resection.
Altered Brain Structure and Functional Connectivity Associated with Pubertal Hormones in Girls with Precocious Puberty
Authors: Chen Tao , Lu Yi , Wang Yu , Guo Anna , Xie Xiaoling , Fu Yuchuan , Shen Bangli , Lin Wenxiao , Yang Di , Zhou Lu , Liu Xiaozheng , Liu Peining , Yan Zhihan
Published: December 2019

Pubertal hormones play an important role in brain and psychosocial development. However, the role of abnormal HPG axis states in altering brain function and structure remains unclear. The present study is aimed at determining whether there were significant differences in gray matter volume (GMV) and resting state (RS) functional connectivity (FC) patterns in girls with idiopathic central precocious puberty (CPP) and peripheral precocious puberty (PPP). We further explored the correlation between these differences and serum pubertal hormone levels. To assess this, we recruited 29 idiopathic CPP girls and 38 age-matched PPP girls. A gonadotropin-releasing hormone (GnRH) stimulation test was performed, and pubertal hormone levels (including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), prolactin, and cortisol) were assessed. All subjects underwent multimodal magnetic resonance imaging of brain structure and function. Voxel-based morphometry (VBM) analysis was paired with seed-to-voxel whole-brain RS-FC analysis to calculate the GMV and RS-FC in idiopathic CPP and PPP girls. Correlation analyses were used to assess the effects of pubertal hormones on brain regions with structural and functional differences between the groups. We found that girls with CPP exhibited decreased GMV in the left insula and left fusiform gyrus, while connectivity between the left and right insula and the right middle frontal gyrus (MFG), as well as the left fusiform gyrus and right amygdala, was reduced in girls with CPP. Furthermore, the GMV of the left insula and peak FSH levels were negatively correlated while higher basal and peak E2 levels were associated with increased bilateral insula RS-FC. These findings suggest that premature activation of the HPG axis and pubertal hormone fluctuations alter brain structure and function involved in the cognitive and emotional process in early childhood. These findings provide vital insights into the early pathophysiology of idiopathic CPP.
Transmission Opportunities: A New Approach to Improve Quality in V2V Networks
Authors: Guerber Carlos Rafael , Gomes Eduardo Luis , Pereira Fonseca Mauro Sérgio , Munaretto Anelise , Silva Thiago Henrique
Published: December 2019

In vehicular ad hoc networks (VANETs), vehicle-to-vehicle (V2V) communication occurs opportunistically due to frequent node mobility and intermittent contact time. In this scenario, the performance evaluation of forwarding protocols by the use of the existing resources in the network is an open challenge, given the different strategies that the routing protocols adopt for choosing the next hop. Through the data analysis of three real taxis’ mobility traces and varying the radio signal range from 50 meters to 1.000 meters, we could contribute to the analysis of the existence of single-radio transmission opportunities and their quantification and classification considering either serial or parallel. Additionally, the inventory analysis of communication resources is done by evaluating the data transmission rate and the beacon overhead impact and by the proposal of a new metric (TOppMi) for the performance evaluation of forwarding protocols. We discuss the impact on forwarding protocols by the appropriate use of this metric, and we show that this metric can be used either for performance evaluation of forwarding protocols or to improve the quality over the consumption of resources in vehicular ad hoc networks. Our metric can obtain the maximum theoretical resource usage independent of the scenario. Either for Rome or San Francisco or Shanghai, as the radio’s signal range increases, the maximum theoretical amount of resources also increases. We could also show that, for the three scenarios, the beacon overhead has an insignificant impact over the total theoretical data inventory available. Furthermore, we classify the vehicles according to the contact time between them.
Design of Digital Control System for DC/DC Converter of On-Board Charger
Authors: Tao Haijun , Zhang Guopeng , Zheng Zheng , Du Changshun
Published: December 2019

Vehicle charging power supply is widely used because of its small size and portability. Aiming at the problems of slow dynamic response, subharmonic, oscillation and limited soft-switching range of phase-shifted full-bridge DC/DC converter, the paper proposed a modified PSFB converter by introducing clamp diodes at the primary side of the transformer to suppress voltage oscillation of the transformer’s secondary side. Also, digital peak current phase-shifting control and slope compensation are introduced to avoid subharmonic oscillation. Dynamic dead-time control technology introduced adjust the dead-time in different load ranges through the dead-time adjustment subroutine. Finally, an experimental platform of on-board charging phase-shifted full-bridge DC/DC converter is established. The experimental results show that the power supply eliminates subharmonic oscillation, achieves a wide range of soft-switching, improves the dynamic performance and antiinterference ability of the system, and optimizes the power efficiency.
Pulse Dye Laser Therapy Successful for Elastosis Perforans Serpiginosa
Authors: Rinaldi Giulia , Chacko Alisha , Syed Samira Batul
Published: December 2019

Background. We describe a case of elastosis perforans serpiginosa and its successful management with PDL laser. Case Presentation. A 15-year-old male presented with a history of itchy, raised, red and unsightly lesions on the back of his neck. He was diagnosed with Elastosis Perforans Serpiginosa on tissue biopsy and underwent pulse dye laser therapy over four years with excellent results. Conclusions. Our results show that pulse dye laser therapy is a safe and effective treatment for elastosis perforans serpiginosa.
Impulse Elimination and Fault‐Tolerant Preview Controller Design for a Class of Descriptor Systems
Authors: Jia Chen , Liao Fucheng , Deng Jiamei
Published: December 2019

In this paper, a fault‐tolerant preview controller is designed for a class of impulse controllable continuous time descriptor systems with sensor faults. Firstly, the impulse is eliminated by introducing state prefeedback; then an algebraic equation and a normal control system are obtained by restricted equivalent transformation for the descriptor system after impulse elimination. Next, the model following problem in fault‐tolerant control is transformed into the optimal regulation problem of the augmented system which is constructed by a general method. And the final augmented system and its corresponding performance index function are obtained by state feedback for the augmented system constructed above. The controller with preview effect for the final augmented system is attained based on the existing conclusions of optimal preview control; then, the fault‐tolerant preview controller for the original system is obtained through integral and backstepping. The relationships between the stabilisability and detectability of the final augmented system and the corresponding characteristics of the original descriptor system are also strictly discussed. The effectiveness of the proposed method is verified by numerical simulation.
Two 2-D DOA Estimation Methods with Full and Partial Generalized Virtual Aperture Extension Technology
Authors: Wu Riheng , Dong Yangyang , Zhang Zhenhai , Xu Le
Published: December 2019

We address the two-dimensional direction-of-arrival (2-D DOA) estimation problem for L-shaped uniform linear array (ULA) using two kinds of approaches represented by the subspace-like method and the sparse reconstruction method. Particular interest emphasizes on exploiting the generalized conjugate symmetry property of L-shaped ULA to maximize the virtual array aperture for two kinds of approaches. The subspace-like method develops the rotational invariance property of the full virtual received data model by introducing two azimuths and two elevation selection matrices. As a consequence, the problem to estimate azimuths represented by an eigenvalue matrix can be first solved by applying the eigenvalue decomposition (EVD) to a known nonsingular matrix, and the angles pairing is automatically implemented via the associate eigenvector. For the sparse reconstruction method, first, we give a lemma to verify that the received data model is equivalent to its dictionary-based sparse representation under certain mild conditions, and the uniqueness of solutions is guaranteed by assuming azimuth and elevation indices to lie on different rows and columns of sparse signal cross-correlation matrix; we then derive two kinds of data models to reconstruct sparse 2-D DOA via M-FOCUSS with and without compressive sensing (CS) involvements; finally, the numerical simulations validate the proposed approaches outperform the existing methods at a low or moderate complexity cost.
A Case of Vaginal Birth after Cesarean Delivery in a Patient with Uterine Didelphys
Authors: Wong Jennifer W. H.
Published: December 2019

Background. The American College of Obstetricians and Gynecologists (ACOG) recommends that most women with one prior low-transverse cesarean delivery should be offered a trial of labor after cesarean (TOLAC). However, very little is known about TOLAC in women with uterine anomalies. Case. A 32-year-old gravida-2 para-1 female with a history of uterine didelphys and one prior low-transverse cesarean section in the left uterine horn presented with a subsequent pregnancy in the left uterine horn. After extensive counseling on TOLAC versus repeat cesarean delivery, the patient decided to proceed with TOLAC and had a spontaneous vaginal delivery of a healthy infant at 38 3/7 weeks of gestation. Conclusion. TOLAC can be considered in women with uterine anomalies using ACOG’s standard TOLAC guidelines with informed consent and shared decision-making between the patient and obstetrician.
Changes of NADH Fluorescence from the Skin of Patients with Systemic Lupus Erythematosus
Authors: Bogaczewicz Jaroslaw , Tokarska Kamila , Wozniacka Anna
Published: December 2019

Introduction. The blood circulation of the skin is an accessible and representative vascular bed for examining the mechanisms of microcirculatory function. Endothelial function is impaired in systemic lupus erythematosus (SLE), which implies disorders in cell metabolism dependent on blood circulation; however, noninvasive monitoring of metabolism at the tissue and cell level is absent in daily clinical practice.Objective. The aim of the study was to examine changes of NADH fluorescence from the epidermis of a forearm measured with the flow mediated skin fluorescence (FMSF) technique in patients with SLE and to investigate whether they are associated with clinical manifestation of the disease.Materials and Methods. The study enrolled 36 patients with SLE and 34 healthy individuals. Changes of NADH fluorescence were measured using FMSF on the forearm in response to blocking and releasing of blood flow. The results were represented as ischemic (IR max and IR auc) and hyperemic response maximum and area under the curve (HR max and HR auc).Results. IR max, IR auc, HR max, and HR auc were all lower in patients with SLE (p<0.05) compared with controls. All four parameters were negatively correlated (p<0.05) with patient age. No difference was found in NADH fluorescence between SLE patients with malar rash, discoid rash, photosensitivity, oral ulcers, nonerosive arthritis, renal disorder, hematologic disorder, or immunologic disorder and those without. No correlation was revealed between the SLEDAI score and NADH fluorescence.Conclusion. Changes of NADH fluorescence indicate the reduction in NADH restoration, observed especially during reperfusion, and suggest the occurrence of disorders in the microcirculation of the skin and/or at the mitochondrial level. Such changes of NADH during reperfusion in patients with SLE could be associated with their possible lower sensitivity to hypoxia and possibly with endothelial dysfunction.
Uncovering Synergistic Mechanism of Chinese Herbal Medicine in the Treatment of Atrial Fibrillation with Obstructive Sleep Apnea Hypopnea Syndrome by Network Pharmacology
Authors: Mao Ting , Zhang Jingchun , Qiao Yu , Liu Bei , Zhang Shan
Published: December 2019

Paroxysmal atrial fibrillation (AF) combined with obstructive sleep apnea hypopnea syndrome (OSAHS) is very common in clinical practice. Traditional Chinese medicine (TCM) rule of regulating the liver based on psycho-cardiology shows satisfactory effectiveness in the treatment of paroxysmal AF combined with OSAHS. However, its underlying pharmacological mechanism has not yet been elucidated. This study applied network pharmacology to identify 94 active components in the six TCM liver-regulating herbs and 182 corresponding targets from several databases and comprehensive literature studies, as well as retrieved AF combined with OSAHS-related targets. Cytoscape software was adopted to construct the component-component target network and component-putative target-AF combined with OSAHS target network. Then, we obtained 38 putative therapeutic targets against AF combined with OSAHS. After the production of a putative therapeutic target interaction network, topological analysis was adopted to determine the core targets of TCM liver-regulating herbs in the treatment of paroxysmal AF combined with OSAHS. For all putative therapeutic targets, biological process analysis and pathway enrichment analysis were utilized to investigate the possible mechanism of TCM liver-regulating herbs in the treatment of paroxysmal AF combined with OSAHS. Mechanistically, it included positive regulation of nitric oxide biosynthetic process, aging, response to hypoxia, TNF signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway, neuroactive ligand-receptor interaction, and calcium signaling pathway. Especially, six core targets of TCM liver-regulating herbs, namely, TNF, STAT3, AKT1, IL-6, TP53, and INS, were significant in the regulation of the above biological processes and pathways. This study demonstrates the multicomponent, multitarget, and multipathway feature of TCM liver-regulating herbs, provides an extensional foundation for further research, and facilitates the reasonable application of TCM liver-regulating herbs in treating paroxysmal AF combined with OSAHS.
Congenital Aplasia of the Common Carotid Artery: A Comprehensive Review
Authors: Vasović L. , Trandafilović M. , Vlajković S.
Published: December 2019

In an attempt to describe the morphofunctional consequences of uni- and bilateral aplasia of the common carotid artery (CCA), which is usually a vascular source of the external carotid (ECA) and internal carotid (ICA) arteries, we investigated online databases of anatomical and clinical papers published from the 18th century to the present day. We found 87 recorded cases of uni- and bilateral CCA aplasia in subjects from the first hours to the eighth decade of life, which had been discovered in 14 (known) countries. Four crucial parameters were described: the embryology of the carotid arteries, morphophysiology of the carotid arteries, CCA aplasia, and unilateral versus bilateral CCA aplasia, including history, general data, diagnosing, vascular sources, caliber, course of the separated ECA and ICA, associated vascular variants, and pathological disorders. To complete the knowledge of the morphofunctional consequences of the absence of some artery of the carotid system, and risking the possibility of repeating some words, as “carotid artery”, or “carotid aplasia” and the headings from our previous article about bilateral ICA absence, this review is the first in the literature that recorded all cases of the CCA aplasia published and/or cited for the past 233 years. Main characteristic of the CCA absence is its association with 21 different diseases, among which the aneurysms were in 13.69% of cases, and 17.80% of cases were without pathology.
The Deubiquitinase USP38 Promotes NHEJ Repair through Regulation of HDAC1 Activity and Regulates Cancer Cell Response to Genotoxic Insults
Authors: Yang Yongfeng , Yang Chuanzhen , Li Tingting , Yu Shuyu , Gan Tingting , Hu Jiazhi , Cui Jun , Zheng Xiaofeng
Published: December 2019

The DNA damage response (DDR) is essential for maintaining genome integrity. Mounting evidence reveals that protein modifications play vital roles in the DDR. Here, we show that USP38 is involved in the DDR by regulating the activity of HDAC1. In response to DNA damage, USP38 interacted with HDAC1 and specifically removed the K63-linked ubiquitin chain promoting the deacetylase activity of HDAC1. As a result, HDAC1 was able to deacetylate H3K56. USP38 deletion resulted in persistent focal accumulation of nonhomologous end joining (NHEJ) factors at DNA damage sites and impaired NHEJ efficiency, causing genome instability and sensitizing cancer cells to genotoxic insults. Knockout of USP38 rendered mice hypersensitive to irradiation and shortened survival. In addition, USP38 was expressed at low levels in certain types of cancers including renal cell carcinoma, indicating dysregulation of USP38 expression contributes to genomic instability and may lead to tumorigenesis. In summary, this study identifies a critical role of USP38 in modulating genome integrity and cancer cell resistance to genotoxic insults by deubiquitinating HDAC1 and regulating its deacetylation activity.

Significance:

This study demonstrates that USP38 regulates genome stability and mediates cancer cell resistance to DNA-damaging therapy, providing insight into tumorigenesis and implicating USP38 as a potential target for cancer diagnosis.
A “Caixa de Pandora”
Authors: Athila Adriana
Published: December 2019

Este artigo analisa o modo pelo qual os Rikbaktsa falam sobre e produzem suas “diferenças”, incluindo aquelas de gênero, sexo e outras modalidades de relação, com destaque para as práticas homoeróticas femininas. Centrado nas biotecnologias nativas e investigando sobre seus “dados bio-lógicos de base”, ele destaca a maestria exercida pelas mulheres sobre a produção de “pessoas” e de suas relações, em uma sociedade patrilinear e com ideias patricentradas sobre concepção, praticante da paternidade múltipla. A etnografia rikbaktsa sugere a reconsideração dos modelos hegemônicos para explicar os regimes de socialidade ameríndios e as sexualidades de povos indígenas brasileiros, diante do ressurgimento contemporâneo do tema. Por fim, o artigo explora alguns dilemas do fazer etnográfico e da representação na teoria antropológica.
Aztec Monoliths as Time-Shaping Devices
Authors: Linares Federico Navarrete
Published: December 2019

This article presents a new interpretation of the most famous artistic monuments manufactured by the Aztecs, or Mexica, of Ancient Mesoamerica in the 15th and 16th centuries. Going beyond traditional artistic and iconographic interpretations, it strives to understand this huge works as beings endowed with “agency” that organized and controlled the flow of time and space, the “chronotopes” constructed by the Mexica. The analysis shows the magnitude of the networks mobilized by the Mexica to build these monuments, and also the effects they strived to achieve through them, all within the frame of their “ritual” actions to keep the cosmos working.
Conhecimentos para a política
Authors: Oliveira Alessandro Roberto
Published: December 2019

Experiências de representação de conhecimentos e práticas tradicionais estão cada vez mais presentes nas estratégias indígenas de comunicação intercultural. Este artigo aborda a experiência de produção de um livro-documento que conectou diversos atores em uma rede de apoiadores, técnicos e um grupo de Agentes Territoriais e Ambientais Indígenas (ATAIs) que vivem na região Serra da Lua, no Estado de Roraima. Através da contextualização do processo de pesquisas colaborativas realizadas por estes agentes visando à confecção desse produto, meu interesse é inscrever o fluxo dessa produção para identificar alguns aspectos epistemológicos e efeitos sociopolíticos desta movimentação “dentro” e “fora” das comunidades participantes. O objetivo, de um lado, é reafirmar as diferenças entre os modos indígenas de conhecer e formas de representação destes saberes. De outro, considerar a dimensão política das relações que são criadas para a geração destes materiais e por meio destes.
Estreitando alianças, criando crentes moçambicanos
Authors: Santos Lívia Reis
Published: December 2019

A partir do trabalho de campo realizado entre jovens crentes da Igreja Universal do Reino de Deus em Maputo, capital de Moçambique, este artigo analisa os elementos que articulam a igreja, os fiéis e o partido governante, a Frelimo, em torno de uma comunidade de pertencimento chamada Família Universal Moçambique. Como ponto de partida, o texto realiza uma “análise de situação social” (Gluckman, 2010) da primeira visita oficial de um Presidente da República à sede nacional da IURD, um evento público que reuniu fiéis, não fiéis, lideranças religiosas e políticas durante a campanha eleitoral de 2014. Além deste evento, apresenta dados sobre a religião vivida (Hall, 1997; Orsi, 2010) cotidianamente pelos crentes e o posicionamento institucional da IURD no contexto moçambicano, ora incorporando, ora demonizando determinados aspectos da cultura local. Ao final, demonstra como a identidade iurdiana era acionada na construção de uma noção específica de ser moçambicano, quais moralidades estavam sendo disputadas como legítimas e o ideal de sociedade que se reivindicava discursiva e ativamente a partir do pertencimento religioso.
Autecology of the lizard Colobosauroides cearensis (Squamata: Gymnophthalmidae) from Brazilian semiarid Caatinga
Authors: Silva Neta Aldenir Ferreira da , Matias Cicera Silvilene Leite , Ávila Robson Waldemar
Published: December 2019

Autecology of the lizard Colobosauroides cearensis (Squamata: Gymnophthalmidae) from Brazilian semiarid Caatinga. Colobosauroides cearensis is a diurnal lizard with a relictual distribution associated with forested habitats in the Brazilian Caatinga Domain. Knowledge of the natural history of this secretive lizard is scarce. Herein, the diet, reproduction, sexual dimorphism, microhabitat use, and thermal ecology of C. cearensis are described based on feldwork in 2015–2017 in the state of Ceará, Brazil. The diet of the lizards is composed exclusively of arthropods, with Formicidae being the most important prey category. Numerical and volumetric niche breadths are 5.52 and 9.2 respectively, and trophic niche overlap between females and males is 0.3. Males are distinguished from females by the larger size of the males and the presence of femoral pores. Colobosauroides cearensis is cryptozoic, inhabiting the leaf litter and having no direct contact with the soil or solar radiation. The average body temperature of the lizards is 30.4 ± 3.3°C, which is positively correlated with the air temperature. Gravid females with fxed clutch size of two eggs are found in early rainy season. Oviposition occurs between April and May (when the highest number of juveniles are observed). Sexual maturity occurs early in males and testicular volume is signifcantly correlated with body size.
Avaliação do alinhamento de joelhos e retropés em mulheres com e sem dor patelofemoral durante o exercício de agachamento
Authors: Quadros Letícia Ruebenich de , Sehnem Eduardo , Tiggemann Carlos Leandro
Published: December 2019

O agachamento, considerado um movimento biomecânico complexo em função de exigir alinhamento dinâmico, é um exercício frequentemente praticado. Se executado de forma errada, pode tornar-se fator de risco para lesões osteomioarticulares, como a dor patelofemoral. Objetivo: Avaliar o alinhamento dos joelhos e do retropé durante o exercício de agachamento em mulheres com e sem dor patelofemoral. Método: Foram selecionadas 25 mulheres, com idade entre 19 e 37 anos, praticantes de musculação há no mínimo seis meses, que referissem dor no joelho durante atividades funcionais. A amostra foi recrutada em quatro academias do Vale do Taquari. Após a aplicação de um Questionário, que abordou intensidade e comportamento da dor patelofemoral, as voluntárias foram divididas em dois grupos: 14 com dor patelofemoral e 11 sem dor patelofemoral. Foi filmada a execução do exercício de agachamento e do Step Down Test, para avaliar o alinhamento dos joelhos e retropé nestas atividades funcionais. Resultados: Os dados foram analisados por meio de estatística descritiva, teste t Student e Correlação de Pearson, com um nível de significância de p < 0,05. Não houve diferença entre as variáveis, comparando-se o grupo com e sem dor patelofemoral. As participantes com maiores valores angulares de valgismo estático tendem a apresentar a mesma característica durante o teste Step Down. Conclusão: É necessária uma abordagem avaliativa individualizada, com a divisão em subgrupos, de acordo com a etiologia da dor. Questiona-se a classificação das alterações biomecânicas como causa ou efeito da dor patelofemoral e das compensações realizadas.
Avaliação termográfica e adaptação à prótese de amputados de membros inferiores
Authors: Luz Soraia Cristina Tonon da , Silva Amanda Reinert , Honório Gesilani Júlia da Silva , Santos Kadine Priscila Bender dos , Branco Ruy Luiz Lorenzetti , Ruy Tayla Siqueira
Published: December 2019

Objetivo: Avaliar qualitativamente características do mapa termográfico do coto membro inferior íntegro e adaptação à prótese de pacientes amputados de membros inferiores. Método: Pesquisa qualitativa, do tipo descritiva e exploratória. Amostra foi composta por cinco indivíduos amputados de membros inferiores, de ambos os sexos, com os níveis transtibial e transfemural, idade entre 18 e 65 anos, alfabetizados e protetizados pelo Sistema Único de Saúde (SUS). Foi realizada anamnese e avaliação termográfica analisando qualitativamente o membro íntegro e coto aplicado o questionário Prothesis Evaluation Questionnaire (PEQ). Resultados: As imagens termográficas dos indivíduos transfemurais apresentaram no membro residual aumento da temperatura em região inguinal, podendo ser devido à fricção do encaixe superior da prótese. Em toda amostra percebeu-se diminuição da temperatura na extremidade inferior do coto, apontando uma possível redução de vascularização desta região. No PEQ o domínio fortemente mais citado como desfavorável para os participantes foi o de mobilidade, principalmente nas questões de subida e descida de escadas, subida e descida de morros íngremes e andar sobre lugares escorregadios. A transpiração dentro do encaixe e o inchaço do membro residual também foram queixas bem citadas pelos participantes. Conclusão: As questões de maior impacto à adaptação da prótese foram a mobilidade, transferência caraterísticas relacionadas ao edema, sensação de peso e desconforto térmico do membro residual na região do encaixe protético. A termografia evidenciou maiores valores de temperatura do membro íntegro, assim como aumento de temperatura na região do encaixe da prótese e redução de temperatura na extremidade do coto.