bluuebunny/crossref_metadata_2025 huggingface dataset:
Carnitine palmitoyltransferase 2 knockout potentiates palmitate-induced insulin resistance in C2C12myotubes
Authors: Blackburn Michael L. , Ono-Moore Kikumi D. , Sobhi Hany F. , Adams Sean H.
Published: May 2020

Saturated fatty acids (SFAs) are implicated in muscle inflammation/cell stress and insulin resistance, but the catalog of factors involved is incomplete. SFA derivatives that accumulate with mismatched FA availability and FA oxidation (FAO) are likely involved, and evidence has emerged that select acylcarnitines should be considered. To understand if excessive long-chain acylcarnitine accumulation and limited FAO associate with lipotoxicity, carnitine palmitoyltransferase 2 knockout C2C12 cells were generated (CPT2 KO). CPT2 KO was confirmed by Western blot, increased palmitoylcarnitine accumulation, and loss of FAO capacity. There was no effect of CPT2 KO on palmitic acid (PA) concentration-dependent increases in media IL-6 or adenylate kinase. PA at 200 and 500 µM did not trigger cell stress responses (phospho-Erk, -JNK, or -p38) above that of vehicle in WT or CPT2 KO cells. In contrast, loss of CPT2 exacerbated PA-induced insulin resistance (acute phospho-Akt; 10 or 100 nM insulin) by as much as ~50–96% compared with WT. Growing cells in carnitine-free media abolished differences between WT and CPT2 KO, but this did not fully rescue PA-induced insulin resistance. The results suggest that PA-induced insulin resistance stems in part from palmitoylcarnitine accumulation, further supporting the hypothesis that select acylcarnitines participate in cell signaling and, when in excess, can compromise cell function. Since carnitine-free conditions could not fully rescue insulin signaling, and CPT2 KO did not alter cell stress responses, the majority of PA-induced “lipotoxicity” in C2C12 myotubes cannot be attributed to palmitoylcarnitine alone.
Branching points of primary afferent fibers are vital for the modulation of fiber excitability by epidural DC polarization and by GABA in the rat spinal cord
Authors: Li Yaqing , Hari Krishnapriya , Lucas-Osma Ana M. , Fenrich Keith K. , Bennett David J. , Hammar Ingela , Jankowska Elzbieta
Published: May 2020

Polarization of sensory fibers traversing dorsal columns of the spinal cord may considerably increase the excitability of these fibers. We show that this involves the effects of current at branching points of afferent fibers and depends on extrasynaptic of GABA. These results contribute to our understanding of the mechanism underlying plasticity of activation of nerve fibers and may be used to increase the effectiveness of epidural stimulation in humans and recovery of spinal functions.
An Integrated Fecal Microbiome and Metabolomics in T2DM Rats Reveal Antidiabetes Effects from Host-Microbial Metabolic Axis of EtOAc Extract from Sophora flavescens
Authors: Shao Jing , Liu Yi , Wang Huan , Luo Yun , Chen Lei
Published: May 2020

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease. Sophora flavescens (S. flavescens), also named Kushen, is a famous Chinese herbal medicine that has been used to prevent and cure T2DM both in folk medicine and in medical institution. However, its mechanism of action remains unclear. In this study, the pharmacodynamic effects of S. flavescens EtOAc extract (SFE) on high-fat diet and low-dose streptozotocin-induced T2DM rats were examined. Fecal metabolomics analysis and 16S rRNA gene sequencing were applied to determine the influence of T2DM and SFE treatment on gut microbiota and host metabolism. Based on the consistency of the results of metabolic pathways in metabolomics analysis and phylogenetic investigation of communities by reconstruction of unobserved state (PICRUSt) analysis of 16S rRNA gene sequencing, the level of metabolites and the operational taxonomic units of gut bacteria were combined, and Spearman’s analysis was implemented. Our data showed that SFE significantly decreased fasted blood glucose levels and improved lipid profile, glycosylated serum protein, glycosylated hemoglobin index, and pancreas damage. Metabolomics and 16S rRNA gene sequencing analysis indicated gut bacteria disorder, disturbed lipid metabolism, carbohydrate metabolism, and especially amino acid metabolism in T2DM and that SFE can regulated these metabolic pathways through the influence on gut bacteria. Spearman’s analysis indicated that the amino acid metabolism that included tryptophan, branched chain amino acid, aromatic amino acid, beta-alanine, and glycine, serine and threonine metabolism, lipid metabolism, including lysophosphatidylcholines and lysophosphatidylethanolamines, primary bile acid and linoleic acid metabolism, carbohydrate metabolism, and nucleotide metabolism positively correlated with Faecalibacterium, Flexispira, Phascolarctobacterium, Prevotella, Roseburia, and [Prevotella]. In addition, arginine and proline metabolism, steroid hormone, steroid biosynthesis, and sphingolipid metabolism positively correlated with Lactobacillus, Oscillospira, Parabacteroides, Ruminococcus, and Streptococcus. Taken together, we speculated that SFE may have an effect on T2DM by mediating host-microbial metabolic axis. Exploration of SFE treatment for T2DM by multiomics is expected to provide a reference for clinical treatment.
miR193b Promotes Apoptosis of Gastric Cancer Cells via Directly Mediating the Akt Pathway
Authors: Tian Ruyue , Jiang Hailun , Shao Linlin , Yu Yang , Guo Qingdong , Cao Bangwei , Guo Shuilong
Published: May 2020

Gastric cancer (GC) is one of the most common and fatal malignancies worldwide. MicroRNAs (miRNAs) play a critical role in tumor initiation, proliferation, and metastasis of gastric cancer. miR193b has been identified as a tumor suppressor in a variety of tumor types; however, its role in gastric cancer is yet to be determined. Here, we found a significant downregulation of miR193b expression in both human gastric cancer tissues (p < 0.05) and human gastric cancer cell lines (p < 0.01). Furthermore, the expression level of miR193b correlated with the tumor type, tumor size, and clinical stage (p < 0.05). In vitro, miR193b overexpression inhibited cell survival and induced apoptosis in GC cell lines, indicating that miR193b plays a role in the development of gastric cancer. KRAS was verified as the target of miR193b, and KRAS overexpression attenuated miR193b‐induced apoptosis (p < 0.05). Moreover, we found that the Akt pathway negatively regulated miR193b, also affecting apoptosis. Further analyses indicated that PIK3CA mutation and KRAS amplification are two mutually exclusive pathways (p < 0.01), and we hypothesize that both two pathways could result in the carcinogenic overactivation of KRAS. Thus, our results suggest that the Akt‐miR193b‐KRAS axis may act as a mechanism affecting apoptosis in gastric cancer cells.
Knowledge of Neonatal Danger Signs and Its Associated Factors among Mothers Attending Child Vaccination Centers at Sheko District in Southwest Ethiopia
Authors: Yosef Tewodros , Nigussie Tadesse , Asefa Adane
Published: May 2020

Background. Even though a great improvement in the last twenty years, the problem of newborn deaths is still remaining. In 2017 alone, an estimated 2.5 million neonatal deaths occurred worldwide, around 39 percent of all deaths in sub-Saharan Africa. Early detection of neonatal illness is an important step towards improving newborn survival. If mothers know the appropriate manifestations of the causes of death in newborns (neonatal danger signs), it is possible to avert related mortality, because of the health-seeking behavior of mothers highly relies on their knowledge of neonatal danger signs. Objective. To assess knowledge of neonatal danger signs and its associated factors among mothers attending child vaccination centers at Sheko District in Southwest Ethiopia. Methods. A facility-based cross-sectional study was conducted among 351 mothers who attended health centers for child vaccination in Sheko District from March 17 to April 30, 2018. A consecutive sampling method was used to select study participants. Data were collected by using structured questionnaires through face-to-face interviews. Data were entered using EPI-DATA version 3.1 and analysed using SPSS version 21. Results. Of the 351 mothers interviewed, 39% (137) had good knowledge of neonatal danger signs. The study also found that mothers aged 29-40 years (AOR=2.37, 95% CI [1.35-4.17], P=0.003), educational status of primary and above (AOR=2.68, 95% CI [1.48-4.88], P=0.001), attending ≥ 4 antenatal care visits during pregnancy (AOR=3.57, 95% CI [2.10-6.06], P<0.001), and history of postnatal attendance after birth (AOR=2.33, 95% CI [1.16-4.65], P=0.017) were significantly associated with good knowledge of neonatal danger signs. Conclusion. The proportion of mothers with good knowledge of neonatal danger signs was remarkably low. Since the problem is a public health importance in developing countries, particularly in Ethiopia, which determines future generations. Great efforts are needed to create awareness for mothers on the importance of the early identifying neonatal danger signs plus to avert the high magnitude of neonatal mortality.
The Risk of Acute Kidney Injury in Hepatitis B Virus‐Related Acute on Chronic Liver Failure with Tenofovir Treatment
Authors: Zhang Kai , Lin Su , Wang Mingfang , Huang Jiaofeng , Zhu Yueyong
Published: May 2020

Aims. Tenofovir (TDF) is an antiviral drug with potential risk of kidney injury. The study is aimed at comparing the incidence of acute kidney injury (AKI) between TDF and entecavir (ETV) treatment in hepatitis B virus‐ (HBV‐) related acute on chronic liver failure (ACLF). Methods. Treatment‐naive patients with HBV‐related ACLF were included. Propensity score matching was used to balance the baseline characteristics between ETV and TDF groups. The risk of AKI and the efficacy of TDF and ETV were compared. Results. A total of 95 cases with HBV‐related ACLF were included in this study, with 74.74% of male and a mean age of 47.01 ± 14.71 years. The antiviral therapy was initiated within 2 days after admission, with 39 cases on the TDF group and 56 on the ETV group. Patients in the TDF group had higher AST, hemoglobin, and serum sodium levels and lower MELD‐Na score. After propensity matching, 39 cases of TDF and 39 of ETV were included in the final analysis. No difference was found in the changes of creatinine and cystatin C from baseline to 4 weeks after treatment between ETV and TDF groups. AKI was developed in 1 (2.56%) patient in the ETV group and 2 (5.13%) in the TDF group within one month (P = 0.556). Survival analysis revealed no significant difference in the 6‐month mortality between the two groups (P = 0.813). Cox analysis showed that the type of antiviral drug or the development of AKI was not an independent risk factor for the outcomes. Conclusions. Compared to ETV, TDF did not increase the risk of AKI nor the mortality in patients with HBV‐related ACLF in the short time.
Repeated Galvanic Vestibular Stimulation Modified the Neuronal Potential in the Vestibular Nucleus
Authors: Kim Gyutae , Lee Sangmin , Kim Kyu-Sung
Published: May 2020

Vestibular nucleus (VN) and cerebellar flocculus are known as the core candidates for the neuroplasticity of vestibular system. However, it has been still elusive how to induce the artificial neuroplasticity, especially caused by an electrical stimulation, and assess the neuronal information related with the plasticity. To understand the electrically induced neuroplasticity, the neuronal potentials in VN responding to the repeated electrical stimuli were examined. Galvanic vestibular stimulation (GVS) was applied to excite the neurons in VN, and their activities were measured by an extracellular neural recording technique. Thirty-eight neuronal responses (17 for the regular and 21 for irregular neurons) were recorded and examined the potentials before and after stimulation. Two-third of the population (63.2%, 24/38) modified the potentials under the GVS repetition before stimulation (p=0.037), and more than half of the population (21/38, 55.3%) changed the potentials after stimulation (p=0.209). On the other hand, the plasticity-related neuronal modulation was hardly observed in the temporal responses of the neurons. The modification of the active glutamate receptors was also investigated to see if the repeated stimulation changed the number of both types of glutamate receptors, and the results showed that AMPA and NMDA receptors decreased after the repeated stimuli by 28.32 and 16.09%, respectively, implying the modification in the neuronal amplitudes.
The Therapeutic Evaluation of Spinal Canal Decompression by Using the TBEIS Technique in the Treatment of Lumbar Spinal Stenosis
Authors: You Kemin , Li Bo , Chang Hongze , Zhang Yan , Cai Feng , Liu Liang , Liu Xiaodong
Published: May 2020

Objective. To evaluate the clinical efficacy of the percutaneous endoscopic Transforaminal Broad Easy Immediate Surgery (TBEIS) technology in elderly patients with lumbar spinal stenosis (LSS). Methods. From February 2016 to May 2018, 35 elderly patients with LSS were treated with the TBEIS technique. There were 23 males and 12 females, aged from 53 to 72 years with a median age of 63.1 years. Preoperative, 1 day, and 1 and 12 months postoperative visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) were statistically analyzed. The modified MacNab criterion was used to assess the clinical effects. The radiological outcomes were evaluated by X‐ray and computed tomography (CT). Results. All of the operations were successful. The operative time ranged from 120 to 170 min with a median time of 148 min. All of the patients were followed up for 12 to 38 months with a median follow‐up of 18 months. Preoperative, 1 day, and 1 and 12 months postoperative VAS leg scores were 6.91 ± 0.98, 1.69 ± 0.68, 1.23 ± 0.59, and 0.91 ± 0.61, respectively, and the VAS back scores improved from 4.51 ± 0.82 to 0.66 ± 0.68. The ODI scores were 63.82 ± 7.59, 38.79 ± 6.36, 24.79 ± 3.90, and 11.33 ± 3.92, respectively. Postoperative scores of VAS and ODI were obviously improved (P < 0.01). According to the modified MacNab criteria used to evaluate the clinical effects, 11 cases achieved excellent results, 18 cases achieved good results, 4 cases achieved fair results, and 2 cases achieved poor results. There were no neurovascular injury and other complications. Conclusions. Treatment of LSS in the elderly patients by the TBEIS technology has good clinical efficacy, and the technique is safe and minimally invasive.
In relation to NO-System, Stable Pentadecapeptide BPC 157 Counteracts Lidocaine-Induced Adverse Effects in Rats and Depolarisation In Vitro
Authors: Lozic Marin , Stambolija Vasilije , Krezic Ivan , Dugandzic Aleksandra , Zivanovic-Posilovic Gordana , Gojkovic Slaven , Kovacevic Josip , Vrdoljak Luka , Mirkovic Ivan , Kokot Antonio , Petrovic Andreja , Pavlov Katarina Horvat , Drmic Domagoj , Suran Jelena , Blagaic Alenka Boban , Seiwerth Sven , Sikiric Predrag
Published: May 2020

Recently, the pentadecapeptide BPC 157-induced counteraction of bupivacaine cardiotoxicity has been reported. Medication includes (i) lidocaine-induced local anesthesia via intraplantar application and axillary and spinal (L4-L5) intrathecal block, (ii) lidocaine-induced arrhythmias, (iii) convulsions, and (iv) lidocaine-induced HEK293 cell depolarisation. BPC 157 applications (intraplantar, intraperitoneal, and intragastric) were given (i) immediately after lidocaine, (ii) 10 min after, or (iii) 5 min before. The BPC 157/NO-system relationship was verified with NO-agents, the NOS-blocker L-NAME and the NOS-substrate L-arginine, given alone and/or together, in axillary and spinal intrathecal blocks. BPC 157 applied immediately after lidocaine or 5 min before the application of lidocaine considerably ameliorated plantar presentation. BPC 157 medication considerably counteracted lidocaine-induced limb function failure; L-NAME was counteracted; L-arginine exhibited counteraction when given immediately after lidocaine, but prolongation was seen when given later. Given together, prophylactically or therapeutically, L-NAME and L-arginine (L-NAME + L-arginine) counteracted the other’s response. BPC 157 maintained its original response when given together with L-NAME or L-arginine. When BPC 157 was given together with L-NAME and L-arginine, its original response reappeared. BPC 157 antagonised the lidocaine-induced bradycardia and eliminated tonic-clonic convulsions. Also, BPC 157 counteracted the lidocaine-induced depolarisation of HEK293 cells. Thus, BPC 157 has antidote activity in its own right against lidocaine and local anesthetics.
Does Open Reduction in Intramedullary Nailing of Femur Shaft Fractures Adversely Affect the Outcome? A Retrospective Study
Authors: Ghouri Syed Imran , Alhammoud Abduljabbar , Alkhayarin Mohammed Mubarak
Published: May 2020

Aim. This study aims to assess the results of open versus closed reduction in intramedullary nailing for femoral fractures and whether it delays union, predisposes to nonunion, or increases the rate of infection.Materials and Methods. A retrospective review of all adult patients with isolated femoral shaft fractures treated by intramedullary nailing was done. The primary outcome is union rate, and the secondary outcomes are operation time and the infection rate.Results. 110 isolated femoral shaft fractures, with 73 (66.4%) in the closed reduction group and 37 (33.6%) in the open reduction group, 90.4% males and 9.6% females, and the average age was 32.6 years. RTA is the most common cause of these injuries followed by the fall from height. The delayed union rate was 20% (22/110) with no difference between the two groups,pvalue 0.480, and the nonunion rate was 5.5% (6/110), and no statistical difference was observed between the two groups. The operation time was shorter in the closed groups, and no difference in the time to union was observed between two groups. No infection was found in the two groups.Conclusions. There is no statistical difference between the healing rates in closed and open reduction in femoral shaft fractures. In cases where closed reduction is difficult, it is better to open reduce the fracture if closed reduction cannot be achieved in 15 minutes, especially in polytrauma.
Effects of Exenatide and Humalog Mix25 on Fat Distribution, Insulin Sensitivity, and β-Cell Function in Normal BMI Patients with Type 2 Diabetes and Visceral Adiposity
Authors: Wang Xinlei , Zhao Xiaoqin , Gu Yunjuan , Zhu Xiaohui , Yin Tong , Tang Zhuqi , Yuan Jin , Chen Wei , OuYang Rong , Yao Lili , Zhang Rongping , Yuan Jie , Zhou Ranran , Sun Yi , Cui Shiwei
Published: May 2020

In China, most normal BMI (body mass index of ≥18.5 to <25 kg/m2) adults with type 2 diabetes (T2DM) exhibit visceral adiposity. This study compared the effects of exenatide and humalog Mix25 on normal BMI patients with T2DM and visceral adiposity. A total of 95 patients were randomized to receive either exenatide or humalog Mix25 treatment for 24 weeks. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were quantified by magnetic resonance imaging (MRI) and liver fat content (LFC) by liver proton magnetic resonance spectroscopy (1H MRS). Each patient’s weight, waist circumference, BMI, blood glucose, insulin sensitivity, pancreatic β-cell function, and fibroblast growth factor 21 (FGF-21) levels were measured. Data from 81 patients who completed the study (40 and 41 in the exenatide and humalog Mix25 groups, respectively) were analysed. The change in 2 h plasma blood glucose was greater in the exenatide group (P=0.039). HOMA-IR and MBCI improved significantly after exenatide therapy (P<0.01, P=0.045). VAT and LFC decreased in both groups (P<0.01 for all) but to a greater extent in the exenatide group, while SAT only decreased with exenatide therapy (P<0.01). FGF-21 levels declined more in the exenatide group (P<0.01), but were positively correlated with VAT in the entire cohort before (r=0.244, P=0.043) and after (r=0.290, P=0.016) the intervention. The effects of exenatide on glycaemic metabolism, insulin resistance, pancreatic β-cell function, and fat deposition support its administration to normal BMI patients with T2DM and visceral adiposity.
Adjuvant Chemotherapy for Low-Clinical-Risk Breast Cancer Defined by Modified Version of Adjuvant! Online: A Propensity Score Matched SEER Analysis
Authors: Huang Jiefeng , Wu Zhiyong , Zhang Zechun , Li Jie , Li Yunhai , Ren Guosheng
Published: May 2020

Background: The purpose of this research was to investigate whether the modified version of Adjuvant! Online was able to omit chemotherapy (CT) for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, and axillary node-negative breast cancer, who are defined as low clinical risk. Methods: From 2010 to 2014, HR-positive, HER2-negative, and node-negative breast cancer patients aged 50 years and older were retrieved from the Surveillance, Epidemiology, and End Results (SEER) 18 database. The propensity score matching method was applied between the no-CT and CT groups. Overall survival (OS) was evaluated using Kaplan-Meier analysis and compared across groups using a log-rank test. Results: A total of 48,857 patients were enrolled. After propensity score matching, the numbers of patients in the no-CT and CT groups were both 3,102. The median follow-up period was 37 months. The 5-year OS rates in the no-CT and CT groups were 92 and 91%, respectively (p = 0.066). In the subgroup with a tumor score (tumor size added to tumor grade) of 2–3, OS was significantly higher in the no-CT group than in the CT group (93 vs. 90%, p < 0.001). In the subgroup with a tumor score of 4, OS was not different between these 2 groups (92 vs. 93%, p = 0.47). Conclusion: This retrospective study provides evidence that CT may not be beneficial to patients 50 years of age or older with HR-positive, HER2-negative, axillary node-negative breast cancer and additionally defined as low clinical risk by a modified version of Adjuvant! Online.
Neuropathic Pain Causes a Decrease in the Dendritic Tree Complexity of Hippocampal CA3 Pyramidal Neurons
Authors: Tyrtyshnaia Anna A. , Manzhulo Igor V. , Konovalova Sophia P. , Zagliadkina Anna A.
Published: May 2020

The International Pain Association defines neuropathic pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” Recent studies show that chronic neuropathic pain causes both morphological and functional changes within brain structures. Due to the impact of supraspinal centers on pain signal processing, patients with chronic pain often suffer from depression, anxiety, memory impairment, and learning disabilities. Changes in hippocampal neuronal and glial plasticity can play a substantial role in the development of these symptoms. Given the special role of the CA3 hippocampal area in chronic stress reactions, we suggested that this region may undergo significant morphological changes as a result of persistent pain. Since the CA3 area is involved in the implementation of hippocampus-dependent memory, changes in the neuronal morphology can cause cognitive impairment observed in chronic neuropathic pain. This study aimed to elucidate the structural and plastic changes within the hippocampus associated with dendritic tree atrophy of CA3 pyramidal neurons in mice with chronic sciatic nerve constriction. Behavioral testing revealed impaired working and long-term memory in mice with a chronic constriction injury. Using the Golgi-Cox method, we revealed a decrease in the number of branches and dendritic length of CA3 pyramidal neurons. The dendritic spine number was decreased, predominantly due to a reduction in mushroom spines. An ­immunohistochemical study showed changes in astro- and microglial activity, which could affect the morphology of neurons both directly and indirectly via the regulation of neurotrophic factor synthesis. Using ELISA, we found a decrease in brain-derived neurotrophic factor production and an increase in neurotrophin-3 production. Morphological and biochemical changes in the CA3 area are accompanied by impaired working and long-term memory of animals. Thus, we can conclude that morphological and biochemical changes within the CA3 hippocampal area may underlie the cognitive impairment in neuropathic pain.
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review
Authors: Vieira Silva Sara , Freire Elga , Pessegueiro Miranda Helena
Published: May 2020

Introduction: End-stage liver disease (ESLD) is the advanced phase of most liver diseases. The cure is liver transplantation (LT), only available for a minority of patients. This review summarizes the evidence regarding palliative care (PC) in ESLD patients awaiting LT. Methods: Review of the literature available in Medline, Scopus and Web of Knowledge, with keywords ESLD and PC. Results: Fifteen of the 230 articles reviewed met the inclusion criteria. Ten main themes were addressed: symptom burden; perspectives of life-sustaining treatment and comfort for patients, families and health professionals; goals of care discussions; patient and family needs; quality of life; PC and survival; referral to PC, barriers and opportunities; integration of PC; outpatient care and cost-effectiveness analysis. The referral of patients to PC was only evaluated in a few studies, all of which reported low referral rates. Better knowledge of how PC professionals can support other professionals was considered important, and also better ways to integrate PC were considered essential. Conclusion: ESLD patients awaiting LT have a significant need for PC and, despite the insufficient response, were reported to benefit from this type of care. Future research is essential to determine the means to overcome barriers and better integrate PC for ESLD patients awaiting LT.
Sex Differences in Adults with Insect Venom Allergy regarding Psychological Distress, Attitudes toward the Emergency Medication, and Factual Knowledge about the Disease
Authors: Schoeben Lisa-Sophie , Bubak Corinna , Schaarschmidt Marthe-Lisa , Schmieder Astrid
Published: May 2020

Background: Hymenoptera venom allergy (HVA) has a prevalence of 3% in adults. Although patients have no ongoing symptoms, they often suffer from an impairment of their psychological well-being and quality of life. Objective: The aim of this study was to analyze sex-specific differences regarding the psychological burden caused by this allergy and handling of the emergency medication. Method: Study participants filled out a questionnaire including sociodemographic and disease-specific characteristics, the Hospital Anxiety and Depression Score (HADS), and theoretical knowledge about the emergency medication set (EMS). Additionally, an objective structured clinical examination was used to assess practical knowledge and handling of the EMS. Results: Fifty-six patients were included (55.4% females). Female patients showed higher subjective anxiety levels due to HVA compared to men (mean 7.2 vs. 4.6, p = 0.0003). Furthermore, the HADS revealed that women had a significant higher anxiety level, especially after Mueller grade I–II anaphylactic reactions (mean 6.3 vs. 2.8, p = 0.0134). This was associated with a higher theoretical but not practical knowledge about their disease. On the other hand, males were less inclined to carry the emergency medication “always” or “almost always” (56 vs. 87.1%, p = 0.0015) but showed higher self-assurance in using it (mean 7.3 vs. 6.1, p = 0.0446). Conclusions: This clinical study provides evidence for sex differences in coping with HVA. The results suggest that females should be monitored more closely for allergy-associated anxiety symptoms, while men need more encouragement to carry the emergency medication.
Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma
Authors: Jazbinšek Sončka , Kolenc Danijela , Bošnjak Roman , Faganel Kotnik Barbara , Zadravec Zaletel Lorna , Jenko Bizjan Barbara , Vipotnik Vesnaver Tina , Battelino Tadej , Janež Andrej , Jensterle Mojca , Kotnik Primož
Published: May 2020

Objective: The major part of craniopharyngioma (CP) morbidity is the tumor and/or treatment-related damage, which results in impaired function of the hypothalamic-pituitary axes and metabolic derangements. The aim of the study was to analyze the prevalence of long-term endocrine and metabolic comorbidities in a national cohort of CP patients based on the age at diagnosis and histology criteria. Design: A retrospective-prospective longitudinal cohort analysis. Methods: Forty-six patients with CP treated from 1979 onwards (19 with childhood-onset disease) in a single university institution were included in our study. Median follow-up from presentation was 12.8 years (interquartile range: 8.3–22.2 years) and comparable between age-at-diagnosis and histological subtype groups. Data on tumor histology were extracted from patients’ records and re-evaluated if tissue samples were available (n = 32). Results: Childhood-onset patients presented more frequently with headache, and adult-onset with visual impairment. Prevalence of at least one pituitary axis affected increased from 54% at presentation to 100% at follow-up in childhood-onset and from 41 to 93% in adult-onset CP. Growth hormone deficiency, central diabetes insipidus, and panhypopituitarism were more prevalent in childhood-onset adamantinomatous CP (aCP) and least prevalent in adult-onset papillary CP (pCP). At follow-up, metabolic syndrome (MetS) was diagnosed in 80% of childhood-onset and 68% of adult-onset patients (p = 0.411). In the latter group, it tended to be more frequent in the aCP than pCP subtype (80 vs. 50%, p = 0.110). Conclusions: Long-term endocrine and metabolic complications are very frequent in childhood- and adult-onset CP patients of both histological subtypes. The prevalence of MetS was higher compared to the largest cohort previously reported.
Hemoglobin S/OArab: Retinal Manifestations of a Rare Hemoglobinopathy
Authors: Sanders Riley , Ly Victoria , Ahmad Kinza , Swift Jesse , Sallam Ahmed , Uwaydat Sami
Published: May 2020

Hemoglobin S/OArab (Hgb S/OArab) disease is a rare hemoglobinopathy which presents similarly to sickle cell retinopathy, with only three prior reports that describe associated retinal findings. In this report, we present ophthalmic examination findings in 2 patients with Hgb S/OArab. One patient exhibited peripheral ischemia and sunburst lesions without neovascular disease, and the other patient developed proliferative retinopathy of both eyes and multiple posterior-pole branch retinal artery occlusions in one eye. To our knowledge, this is the first case of retinal arterial occlusive disease in Hgb S/OArab, and the first report of fundus autofluorescence and OCT angiography in Hgb/OArab retinopathy.
A Conservative Surgical Approach to the Treatment of Optic Disc Pit Maculopathy: Four Case Reports
Authors: Rapizzi Emilio , Gallon Paola , Ponzin Diego , Ferrari Stefano , Zemella Nicola
Published: May 2020

The purpose of this report is to present the outcomes of surgical interventions in 4 patients with maculopathy associated with optic disc pit (ODP). We report 4 cases of patients affected by ODP maculopathy and treated by core vitrectomy with induction of posterior vitreous detachment and peeling of the internal limiting membrane restricted to the interpapillary macular zone without laser treatment and gas tamponade. The patients had rapid resolution of the multilayer inner retinoschisis-like separation and progressive slow reabsorption of the macular intraretinal and subretinal fluid up to complete retinal reattachment. Currently, there are still no widely accepted guidelines related to the best technique in the management of the maculopathy associated with ODP. We used a conservative approach, without the adoption of intravitreal gas injection or laser.
Paisagem e estratégias na patrimonialização da cultura material e da natureza na Serra da Capivara-PI
Authors: Figueiredo Diva Maria Freire , Lopes Myriam Bahia
Published: May 2020

Este artigo percorre os campos do patrimônio cultural, proteção do meio ambiente e arqueologia para tratar a paisagem e os sítios arqueológicos e compreender suas concepções e práticas, tendo como estudo de caso a patrimonialização da Serra da Capivara. Em uma abordagem mais ampla, destacamos os significados atribuídos à paisagem nas narrativas patrimoniais brasileiras desde a instituição da preservação do patrimônio. Em uma abordagem restrita ao tema, estudamos as narrativas usadas na proteção e na gestão da Serra da Capivara. Revisão bibliográfica e análise das narrativas patrimoniais em documentos públicos, ancoradas em noção polissêmica de paisagem, permitem observar uma tensão entre duas perspectivas de argumentos que a justificam. Por um lado, a perspectiva que considera o homem integrado à natureza, como elemento interativo e, de outro, a perspectiva que considera o homem separado da natureza.
Temporal Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting: Insights From the Washington Cardiac Care Outcomes Assessment Program
Authors: Kataruka Akash , Maynard Charles C. , Kearney Kathleen E. , Mahmoud Ahmed , Bell Sean , Doll Jacob A. , McCabe James M. , Bryson Chistopher , Gurm Hitinder S. , Jneid Hani , Virani Salim S. , Lehr Eric , Ring Michael E. , Hira Ravi S.
Published: May 2020

Background

Patient selection and outcomes for percutaneous coronary intervention (
PCI
) and coronary artery bypass grafting (
CABG
) have changed over the past decade. However, there is limited information on outcomes for both revascularization strategies in the same population. The study evaluated temporal changes in risk profile, procedural characteristics, and clinical outcomes for
PCI‐
and
CABG
‐treated patients.

Methods and Results

We analyzed all
PCI
and isolated
CABG
between 2005 and 2017 in nonfederal hospitals in Washington State. Descriptive analysis was performed to evaluate temporal changes in risk profile and, risk‐adjusted in‐hospital mortality. Over the study period, 178 474
PCI
and 36 592
CABG
procedures were performed.
PCI
and
CABG
volume decreased by 2.9% and 22.6%, respectively. Compared with 2005–2009, patients receiving either form of revascularization between 2014 and 2017 had a higher prevalence of comorbidities including diabetes mellitus and hypertension and dialysis. Presentation with ST‐segment–elevation myocardial infarction (17% versus 20%) and cardiogenic shock (2.4% versus 3.4%) increased for patients with
PCI
compared with CABG. Conversely, clinical acuity decreased for patients receiving
CABG
over the study period. From 2005 to 2017, mean National Cardiovascular Data Registry Cath
PCI
mortality score increased for patients treated with
PCI
(20.1 versus 22.4,
P
<0.0001) and decreased for patients treated with
CABG
(18.8 versus 17.8,
P
<0.0001). Adjusted observed/expected in‐hospital mortality ratio increased for
PCI
(0.98 versus 1.19,
P
<0.0001) but decreased for
CABG
(1.21 versus 0.74,
P
<0.0001) over the study period.

Conclusions

Clinical acuity increased for patients treated with
PCI
rather than
CABG
. This resulted in an increase in adjusted observed/expected mortality ratio for patients undergoing
PCI
and a decrease for
CABG
. These shifts may reflect an increased use of
PCI
instead of
CABG
for patients considered to be at high surgical risk.
Mitral Valve Surgical Volume and Transcatheter Mitral Valve Repair Outcomes: Impact of a Proposed Volume Requirement on Geographic Access
Authors: Vemulapalli Sreekanth , Prillinger Julie , Thourani Vinod , Yeh Robert W.
Published: May 2020

Background

There is an open Centers for Medicare and Medicaid Services National Coverage Decision for Transcatheter Mitral Valve Repair (
TMV
r) and a recent multisociety consensus document suggesting that
TMV
r centers should achieve prespecified mitral valve replacement or repair (
MVR
r). Yet, little is known about the
MVR
r volume–
TMV
r outcome relationship.

Methods and Results

Using Centers for Medicare and Medicaid Services administrative claims from January 1, 2016 to December 31, 2018, we computed the Pearson correlation coefficient and performed multivariable hierarchical modeling to estimate the
MVR
r volume to
TMV
r outcome relationship for mortality and heart failure hospitalization. Additionally, we assessed the impact of the consensus recommendations on geographic access to care by hospital referral region. Total annualized
MVR
r volume was <11 to 1552 (median 96, interquartile range 53, 167). One‐year survival, 1‐year heart failure hospitalization after
TMV
r were not correlated with
MVR
r volume. After patient risk‐adjustment for age, sex, and significant Elixhauser Comorbidities, there remained no significant correlation between institutional
MVR
r volume and 1‐year mortality (estimate −0.010, SE 0.047,
P
=0.834) or heart failure hospitalization (estimate −0.011, SE 0.045,
P
=0.808) after
TMV
r. Raising the restriction on
TMV
r from 20 to 40
MVR
r/y results in ≈30 million individuals having to travel outside of their hospital referral region to undergo
TMV
r, with a disproportionate impact in the Midwest and Southeast.

Conclusions

There is no relationship between
MVR
r volumes and
TMV
r outcomes. Additionally, adoption of an annual
MVR
r volume ≥40 for performance of
TMV
r disproportionately impacts geographic access in the Midwest and Southeast and their large black and Hispanic populations.
N8‐Acetylspermidine: A Polyamine Biomarker in Ischemic Cardiomyopathy With Reduced Ejection Fraction
Authors: Nayak Aditi , Liu Chang , Mehta Anurag , Ko Yi‐An , Tahhan Ayman S. , Dhindsa Devinder S. , Uppal Karan , Jones Dean P. , Butler Javed , Morris Alanna A. , Quyyumi Arshed A.
Published: May 2020

Background

Patients with ischemic cardiomyopathy (
ICM
) have worse outcomes than those with coronary artery disease alone and those with non‐ICM. N8‐acetylspermidine (N8
AS
) is a polyamine that regulates ischemic cardiac apoptosis and resultant cardiac dysfunction. We hypothesized that N8
AS
is a mechanistic biomarker of adverse outcomes in patients with
ICM
.

Methods and Results

High‐resolution plasma metabolomics profiling and mass spectrometry were used to quantitate N8
AS
levels in a discovery cohort of 474 patients with coronary artery disease (age: 68±11 years, 12% black, 26% women): 154 with
ICM
, and 320 without
ICM
; and in an external validation cohort of 85 patients with ICM (age: 60±12 years, 37% black, 19% women). Patients without heart failure (
HF)
at baseline were followed for incident
HF
. The association between N8
AS
(log
2
‐transformed, standardized) and outcomes of all‐cause mortality and incident
HF
were examined using Cox regression. N8
AS
was higher (10.39 [interquartile range, 7.21–17.75] versus 8.29
nmol/L
[interquartile range, 5.91–11.42];
P
<0.001) in patients with ICM compared with patients who had coronary artery disease without
ICM
. Higher N8
AS
levels were associated with higher mortality in patients with ICM (hazard ratio [HR], 1.48; 95%
CI
, 1.19–1.85 per
SD
increase [
P
=0.001]), independent of B‐type natriuretic peptide, high‐sensitivity troponin I, and high‐sensitivity
C‐reactive protein
. Findings were validated in the independent cohort. Moreover, higher N8
AS
level was associated with incident
HF
in patients without
HF
at baseline (HR, 4.16; 95%
CI
, 1.41–12.25 per
SD
increase [
P
=0.01]).

Conclusions

Independent of traditional
HF
measures, higher N8
AS
levels are associated with higher mortality in patients with
ICM
and incident
HF
in those who have coronary artery disease without
HF
. N8
AS
is a novel mechanistic biomarker in
ICM
.
Retrospective Analysis of Clinical Genetic Testing in Pediatric Primary Dilated Cardiomyopathy: Testing Outcomes and the Effects of Variant Reclassification
Authors: Quiat Daniel , Witkowski Leora , Zouk Hana , Daly Kevin P. , Roberts Amy E.
Published: May 2020

Background

Genetic testing in pediatric primary dilated cardiomyopathy (DCM) patients has identified numerous disease‐causing variants, but few studies have evaluated genetic testing outcomes in this population in the context of patient and familial clinical data or assessed the clinical implications of temporal changes in genetic testing results.

Methods and Results

We performed a retrospective analysis of all patients with primary DCM who presented to our institution between 2008 and 2018. Variants identified by genetic testing were reevaluated for pathogenicity on the basis of current guidelines for variant classification. A total of 73 patients with primary DCM presented to our institution and 63 (86%) were probands that underwent cardiomyopathy‐specific gene testing. A disease‐causing variant was identified in 19 of 63 (30%) of cases, with at least 9/19 (47%) variants occurring de novo. Positive family history was not associated with identification of a causal variant. Reclassification of variants resulted in the downgrading of a large proportion of variants of uncertain significance and did not identify any new disease‐causing variants.

Conclusions

Clinical genetic testing identifies a causal variant in one third of pediatric patients with primary DCM. Variant reevaluation significantly decreased the number of variants of uncertain significance, but a large burden of variants of uncertain significance remain. These results highlight the need for periodic reanalysis of genetic testing results, additional investigation of genotype‐phenotype correlations in DCM through large, multicenter genetic studies, and development of improved tools for functional characterization of variants of uncertain significance.
Religion and the Creation of Normal Appearance
Authors: Trinidad Jose Eos
Published: May 2020

Religions in prison often help individuals with their internal coping with prison life and with external benefits from participation in religious groups. However, less is known about religion’s role that extend beyond the individual and affect the whole of prison society. Through in-depth interviews in a Philippine prison, the research finds that religious groups have both a normative and a normalizing function. In a sense, these Christian groups help inmates create expectations with each other and provide a semblance of normal life in a constrained prison. The article suggests that the appearance of normality, rather than the fact of normality, happens as Christian groups provide inmates with forms of self-determination and continuance of their life from outside.
Ties and Identities
Authors: Saracino Doriano
Published: May 2020

Immigration from the Global South is a recent phenomenon in Italy, which is turning from a prevalently homogenous Catholic country into a multi-faith one. This transformation is evident too in prisons, where people from different religious traditions share space. The long road from religious diversity to social acceptance of differences is difficult. The public debate concerns essentially Muslim inmates, and the arguments swing from ‘securitarian’ views to an inclusive approach as an alternative way to prevent radicalisation. The lack of meaningful relationships between inmates of different faiths and their religious communities can be a serious obstacle to social reinsertion. An analysis of the Italian prison system with statistical data and qualitative research enables us to outline a model of the evolution of the penitentiary systems.
Typification of Adelia resinosa, the basionym of Mallotus resinosus (Euphorbiaceae), and its three new synonyms from India

Authors: CHAKRABARTY TAPAS , KRISHNA GOPAL
Published: May 2020

The species Mallotus aureopunctatus, M. beddomei and M. lawii are merged under the variable and widespread M. resinosus. A second-step neotype is designated for the name Adelia resinosa while lectotypes are designated for M. beddomei and Rottlera aureopunctata.
Corybas circinatus (Orchidaceae), a new species from Palawan, the Philippines

Authors: TANDANG DANILO N. , BUSTAMANTE RENE ALFRED ANTON , FERRERAS ULYSSES , HADSALL ANNALEE S. , PYM-LYON STEPHANIE , ROBINSON ALASTAIR S.
Published: May 2020

Corybas circinatus, a new species of helmet orchid endemic to ultramafic habitats on the island of Palawan, Philippines, is hereby described and illustrated. This species is distinct in bearing a small glandular protuberance at the front of its pedicel, a 4-lobed entire labellum, and a distinctive strongly incurved dorsal sepal. The general colouration of the floral and vegetative parts is also highly characteristic, and the general lowland to mid-montane ecology of the species is unique amongst the known Philippines Corybas.
Recovery Over Time and Prognostic Factors in Treated Patients with Post-Infectious Olfactory Dysfunction: A Retrospective Study
Authors: Ogawa Takao , Nakamura Keigo , Yamamoto Sayuri , Tojima Ichiro , Shimizu Takeshi
Published: May 2020

Objectives:

The aims of the present study were to clarify the time-course of olfactory recovery and the prognostic factors in PIOD patients treated with Toki-shakuyaku-san (TSS).

Methods:

A retrospective cohort study of patients with PIOD was conducted by reviewing patients’ medical records. This study included patients who received TSS or a combination of TSS and zinc sulfate. Olfactory function was examined by T&T olfactometer at each 3-monthly follow-up visit. Patients with normal and mild olfactory dysfunction were excluded. Gender, age, treatment, duration of disease until the first visit and olfactory function scores of the T&T olfactometer at the first visit were analyzed as candidate clinical predictors of recovery.

Results:

A total of 82 PIOD patients with ages ranging from 16 to 79 years were included. The mean duration of follow-up was 14.5 months (range 3-45 months). The number of patients with olfactory recovery increased for 24 months and the cumulative recovery rate was 77.3%. In about 60% of patients, olfactory recovery occurred within 6 months. Multivariate analysis showed that younger age (<65 years) and residual olfactory function were significantly associated with good olfactory recovery.

Conclusions:

We revealed recovery rates over time in patients with PIOD. The recovery of olfactory function often occurred during the early period (≤6 months). However, the number of patients with olfactory recovery increased for a long-term of 24 months after the first visit. Residual olfactory function and younger age were prognostic factors exactly. TSS may be a useful therapeutic agent for patients with PIOD. We believe that these results provide important information that is useful for counseling patients with PIOD.