bluuebunny/crossref_metadata_2025 huggingface dataset:
Sildenafil (Viagra) Aggravates the Development of Experimental Abdominal Aortic Aneurysm
Authors: Zhang Chongyang , Mohan Amy , Shi Hangchuan , Yan Chen
Published: January 2022

Background

cGMP‐hydrolyzing phosphodiesterase type 5 (PDE5) regulates vascular smooth muscle cell (SMC) contraction by antagonizing cGMP‐dependent protein kinase I (PKGI)–dependent SMC relaxation. SMC contractile dysfunction is implicated in the pathogenesis of aortic aneurysm. PDE5 inhibitors have been used for treating erectile dysfunction, such as drug Viagra (sildenafil). However, a few clinical cases have reported the association of Viagra usage with aortic dissection, and reduced PDE5A expression was found in human aortic aneurysm tissues. Therefore, we aimed to investigate the effect of sildenafil on experimental abdominal aortic aneurysm (AAA), the most common form of aortic aneurysm in elderly men.

Methods and Results

AAA was induced in C57BL/6J male mice by periaortic elastase in combination with blocking elastin/collagen formation via 3‐aminopropionitrile fumarate salt for 35 days. PDE5A protein levels detected by immunostaining were significantly reduced in mouse AAA. Sildenafil application in drinking water significantly aggravated aortic wall dilation and elastin degradation with pre‐existing moderate AAA. The phosphorylation level of myosin light chain 2 at Ser19, a biochemical marker of SMC contraction, was significantly reduced by sildenafil in AAA. Proximity ligation assay further revealed that the interaction between cGMP and PKGI was significantly increased by sildenafil in AAA, suggesting an elevation of PKGI activation in AAA.

Conclusions

Sildenafil treatment aggravated the degradation of elastin fibers and progression of experimental AAA by dysregulating cGMP and contractile signaling in SMCs. Our findings may raise the caution of clinical usage of Viagra in aneurysmal patients.
Sex Difference and Rupture Rate of Intracranial Aneurysms: An Individual Patient Data Meta-Analysis
Authors: Zuurbier Charlotte C.M. , Molenberg Rob , Mensing Liselore A. , Wermer Marieke J.H. , Juvela Seppo , Lindgren Antti E. , Jääskeläinen Juha E. , Koivisto Timo , Yamazaki Tomosato , Uyttenboogaart Maarten , van Dijk J. Marc C. , Aalbers Marlien W. , Morita Akio , Tominari Shinjiro , Arai Hajime , Nozaki Kazuhiko , Murayama Yuichi , Ishibashi Toshihiro , Takao Hiroyuki , Gondar Renato , Bijlenga Philippe , Rinkel Gabriel J.E. , Greving Jacoba P. , Ruigrok Ynte M.
Published: January 2022

Background and Purpose:

In previous studies, women had a higher risk of rupture of intracranial aneurysms than men, but female sex was not an independent risk factor. This may be explained by a higher prevalence of patient- or aneurysm-related risk factors for rupture in women than in men or by insufficient power of previous studies. We assessed sex differences in rupture rate taking into account other patient- and aneurysm-related risk factors for aneurysmal rupture.

Methods:

We searched Embase and Pubmed for articles published until December 1, 2020. Cohorts with available individual patient data were included in our meta-analysis. We compared rupture rates of women versus men using a Cox proportional hazard regression model adjusted for the PHASES score (Population, Hypertension, Age, Size of Aneurysm, Earlier Subarachnoid Hemorrhage From Another Aneurysm, Site of Aneurysm), smoking, and a positive family history of aneurysmal subarachnoid hemorrhage.

Results:

We pooled individual patient data from 9 cohorts totaling 9940 patients (6555 women, 66%) with 12 193 unruptured intracranial aneurysms, and 24 357 person-years follow-up. Rupture occurred in 163 women (rupture rate 1.04%/person-years [95% CI, 0.89–1.21]) and 63 men (rupture rate 0.74%/person-years [95% CI, 0.58–0.94]). Women were older (61.9 versus 59.5 years), were less often smokers (20% versus 44%), more often had internal carotid artery aneurysms (24% versus 17%), and larger sized aneurysms (≥7 mm, 24% versus 23%) than men. The unadjusted women-to-men hazard ratio was 1.43 (95% CI, 1.07–1.93) and the adjusted women/men ratio was 1.39 (95% CI, 1.02–1.90).

Conclusions:

Women have a higher risk of aneurysmal rupture than men and this sex difference is not explained by differences in patient- and aneurysm-related risk factors for aneurysmal rupture. Future studies should focus on the factors explaining the higher risk of aneurysmal rupture in women.
Carotid Interventions for Women: The Hazards and Benefits
Authors: Rockman Caron , Caso Valeria , Schneider Peter A.
Published: January 2022

The goal of the current review is to examine the hazards and benefits of carotid interventions in women and to provide recommendations for the indications for carotid intervention in female patients. Stroke and cerebrovascular disease are prevalent in women. There are inherent biological and other differences in men and women, which affect the manifestations and outcome of stroke, with women experiencing worse disability and higher mortality following ischemic stroke than men. Due to the underrepresentation of female patients in most clinical trials, the ability to make firm but alternative recommendations for women specifically on the management of carotid stenosis is challenging. Although some data suggest that women might have worse periprocedural outcomes as compared to men following all carotid revascularization procedures, there is also an abundance of data to support a similar risk for carotid procedures in men and women, especially with carotid endarterectomy and transcarotid artery revascularization. Therefore, the indications for carotid revascularization are the same in women as they are in men. The choice of a carotid revascularization procedure in women is based upon the same factors as in men and requires careful evaluation of a particular patient’s risk profile, anatomic criteria, plaque morphology, and medical comorbidities that might favor one technique over the other. When performing carotid revascularization procedures in women, tailored techniques and procedures to address the small diameter of the female artery are warranted.
Infertility, Miscarriage, Stillbirth, and the Risk of Stroke Among Women: A Systematic Review and Meta-Analysis
Authors: Liang Chen , Chung Hsin-Fang , Dobson Annette J. , Mishra Gita D.
Published: January 2022

Background and Purpose:

Stroke is one of the leading causes of mortality, and women are impacted more from stroke than men in terms of their absolute number and in having worse outcomes. A growing number of studies have explored the association between pregnancy complications, pregnancy outcomes, and stroke. Limited studies, however, have investigated links involving infertility, miscarriage, and stillbirth, which could plausibly be associated via a background of endocrine conditions, endothelial dysfunction, and chronic systematic inflammation. This review aims to summarize current evidence and provide up-to-date information on the associations of infertility, miscarriage, and stillbirth, with stroke incidence.

Methods:

A comprehensive literature search was conducted for cohort and case-control studies on associations between infertility, miscarriage, stillbirth, and stroke up to September 26, 2020. Seven databases were searched: PubMed, Embase, Cochrane, CINIHL, PsyclNFO, Wanfang, and CNKI. Random-effects models were used to estimate the pooled hazard ratios (HRs) and 95% CIs.

Results:

Sixteen cohort studies and 2 case-control studies enrolling 7 808 521 women were included in this meta-analysis. Women who had experienced miscarriage or stillbirth were at higher risk of stroke (miscarriage: HR, 1.07 [95% CI, 1.00–1.14]; stillbirth: HR, 1.38 [95% CI, 1.11–1.71]) than other women. The HRs of stroke for each additional miscarriage and stillbirth were 1.13 (95% CI, 0.96–1.33) and 1.25 (95% CI, 1.06–1.49), respectively. In subgroup analysis, increased risk of stroke was associated with repeated miscarriages and stillbirths (miscarriage ≥3: HR, 1.42 [95% CI, 1.05–1.90]; stillbirth ≥2: HR, 1.14 [95% CI, 1.04–1.26]). Associations between infertility and stroke were inconsistent and inconclusive (HR, 1.07 [95% CI, 0.87–1.32]).

Conclusions:

Miscarriage and stillbirth are associated with increased risk of stroke among women, which could be used as a contributing risk factor to help identify women at higher risk of stroke.
Erratum: Measuring and Improving Consistency in Pretrained Language
Models
Authors: Elazar Yanai , Kassner Nora , Ravfogel Shauli , Ravichander Abhilasha , Hovy Eduard , Schütze Hinrich , Goldberg Yoav
Published: January 2022

During production of this paper, an error was introduced to the formula on the bottom of the right column of page 1020. In the last two terms of the formula, the n and m subscripts were swapped. The correct formula is:Lc=∑n=1k∑m=n+1kDKL(Qnri∥Qmri)+DKL(Qmri∥Qnri)The paper has been updated.
The Survey of Use and Ownership Rights in Finnmark – A Change of Direction?
Authors: Ravna Øyvind
Published: January 2022

In 2008, the Finnmark Act initiated a process of surveying land rights the Sámi and others may have in Finnmark, the core Sámi area of Norway. The Finnmark Commission, which was established to conduct the survey has completed six investigations. The assessments and conclusions in the first five reports are so similar in terms of collective rights appears as cut from the same cloth. In December 2019, the Commission presented its sixth report, which covers the municipality of Karasjok, a community with a Sámi majority. This report marks a significant change from the previous ones, as the Commission for the first time concludes that the people in an investigation field own their outlying areas. This article examines how the Commission arrived at that result, pointing out that it is more an outcome of a different approach to the legal history and international law, than substantive differences in factual circumstances.
The Jewish Reception of Aristotle’s Poetics in Thirteenth- and Fourteenth-century Provence: A Survey of the Arabic Sources
Authors: Gorgoni Francesca
Published: January 2022

The last few years have seen a renewed interest in Aristotle’s logic in the Jewish tradition, giving a decisive impulse to the research on the Greek-into-Hebrew philosophical transmission in medieval and early modern times. The present article aims to contribute to the studies on Aristotelian logic in Hebrew by focusing on a less explored aspect, namely the reception of Aristotle’s Poetics in Jewish culture.
A new species of Amphimallon Latreille, 1825 (Coleoptera: Scarabaeidae: Melolonthinae) from continental Greece
Authors: ULIANA MARCO , MONTREUIL OLIVIER
Published: January 2022

Amphimallon alexandri Uliana & Montreuil, new species, is described from continental Greece, near Volos. The species has diurnal activity and is close to A. arianae (Fairmaire, 1879), A. krali Montreuil, 2002, and A. spartanum (Brenske, 1884), but is well characterized and easily distinguished from all of them by several morphological characters. Detailed comparative illustrations of the main diagnostic traits of the new species and the most similar one (A. krali) are provided. After reviewing the available information, Amphimallon atrum is removed from the Greek fauna.
Spatiotemporal Modeling of the Wind Field over an Urban Lake Subject to Wind Sheltering
Authors: Ashrafi Mohammad , Chua Lloyd H. C. , Irvine K. N. , Yang Peipei
Published: January 2022

The wind field over an urban lake may exhibit considerable variability resulting from wind-shielding effects from surrounding structures. Field measurements at an urban reservoir in Singapore were augmented by computational fluid dynamics (CFD) model results to develop a wind model over the reservoir surface via a data assimilation approach. The field measurements identified, depending on structure alignment with the prevailing wind direction, wind shielding that impacted wind direction and velocity over the reservoir surface. The wind model integrated the temporal response of the measurements and spatial distribution produced by the CFD modeling. The wind model was used to predict the spatiotemporal pattern of the wind field over the reservoir surface for a full year. The modeling results showed good agreement with measured wind data at three measurement locations on the reservoir surface. The wind model has been incorporated with a hydrodynamics and water quality model to provide the spatiotemporal wind forcing over the reservoir surface.
Observed and Modeled Mountain Waves from the Surface to the Mesosphere near the Drake Passage
Authors: Kruse Christopher G. , Alexander M. Joan , Hoffmann Lars , van Niekerk Annelize , Polichtchouk Inna , Bacmeister Julio T. , Holt Laura , Plougonven Riwal , Šácha Petr , Wright Corwin , Sato Kaoru , Shibuya Ryosuke , Gisinger Sonja , Ern Manfred , Meyer Catrin I. , Stein Olaf
Published: January 2022

Four state-of-the-science numerical weather prediction (NWP) models were used to perform mountain wave (MW)-resolving hindcasts over the Drake Passage of a 10-day period in 2010 with numerous observed MW cases. The Integrated Forecast System (IFS) and the Icosahedral Nonhydrostatic (ICON) model were run at Δx ≈ 9 and 13 km globally. The Weather Research and Forecasting (WRF) Model and the Met Office Unified Model (UM) were both configured with a Δx = 3-km regional domain. All domains had tops near 1 Pa (z ≈ 80 km). These deep domains allowed quantitative validation against Atmospheric Infrared Sounder (AIRS) observations, accounting for observation time, viewing geometry, and radiative transfer. All models reproduced observed middle-atmosphere MWs with remarkable skill. Increased horizontal resolution improved validations. Still, all models underrepresented observed MW amplitudes, even after accounting for model effective resolution and instrument noise, suggesting even at Δx ≈ 3-km resolution, small-scale MWs are underresolved and/or overdiffused. MW drag parameterizations are still necessary in NWP models at current operational resolutions of Δx ≈ 10 km. Upper GW sponge layers in the operationally configured models significantly, artificially reduced MW amplitudes in the upper stratosphere and mesosphere. In the IFS, parameterized GW drags partly compensated this deficiency, but still, total drags were ≈6 times smaller than that resolved at Δx ≈ 3 km. Meridionally propagating MWs significantly enhance zonal drag over the Drake Passage. Interestingly, drag associated with meridional fluxes of zonal momentum (i.e.,
) were important; not accounting for these terms results in a drag in the wrong direction at and below the polar night jet.

Significance Statement

This study had three purposes: to quantitatively evaluate how well four state-of-the-science weather models could reproduce observed mountain waves (MWs) in the middle atmosphere, to compare the simulated MWs within the models, and to quantitatively evaluate two MW parameterizations in a widely used climate model. These models reproduced observed MWs with remarkable skill. Still, MW parameterizations are necessary in current Δx ≈ 10-km resolution global weather models. Even Δx ≈ 3-km resolution does not appear to be high enough to represent all momentum-fluxing MW scales. Meridionally propagating MWs can significantly influence zonal winds over the Drake Passage. Parameterizations that handle horizontal propagation may need to consider horizontal fluxes of horizontal momentum in order to get the direction of their forcing correct.
Operation Devon, Termoli 1943: ‘A catalogue of errors’?
Authors: Muschamp Amy
Published: January 2022

The little-known World War II battle for Termoli, code named Operation Devon, took place in early October 1943 and began with the only Allied amphibious landing on Italy’s Adriatic coast. It was a joint operation between newly formed elite groups and regular units of the Allied armed forces. A brigade made up of two units of commandos and the 1st Special Air Service, known during this operation as the Special Raiding Squadron, was given the task of making the first landing. Despite the initial success of the operation, a drawn out and fierce battle ensued. With the help of archival material from the Imperial War Museum, London, and The National Archives, Kew, this article reconstructs the key elements of a battle that has received little scholarly attention, particularly in relation to the role of conventional forces in the fighting. In doing so, it provides an overview of the battle, analysing the main factors that led to a chaotic handover between special and regular infantry forces and what made the action ultimately successful. Finally, it reveals how the operation was part of an evolutionary process for special forces and helped to cement their role in UK military doctrine.
Clinicopathological Features Related to the Efficacy of CDK4/6 Inhibitor-Based Treatments in Metastatic Breast Cancer
Authors: Shikanai Ayana , Horimoto Yoshiya , Ishizuka Yumiko , Uomori Toshitaka , Nakai Katsuya , Arakawa Atsushi , Saito Mitsue
Published: January 2022

Background:

Resistance to endocrine therapy has been a major obstacle in the management of hormone receptor (HR)-positive metastatic breast cancer (MBC). Meanwhile, a number of treatments are available to such patients, and physicians often encounter difficulties in choosing the most appropriate treatments for individual patients. The combination of CDK 4/6 inhibitors (CDKi) and endocrine therapy has now become a standard treatment for HR-positive and human epidermal growth factor receptor 2 (HER2)-negative MBC. However, no predictive markers for CDKi-based treatments have been established. Considering their side effects and the financial burden on patients, identifying such markers is crucial.

Methods:

Clinicopathological features of 107 patients with HR-positive HER2-negative MBC, who received CDKi-based treatments at our institution were retrospectively investigated. HR status in distant metastatic lesions and immunocompetent cells in peripheral blood were also studied.

Results:

Progression-free survival (PFS) was significantly shorter in patients whose primary tumour was high grade ( P = 0.016) or high neutrophil-to-lymphocyte ratio (NLR) at baseline ( P = 0.017). Meanwhile, there were no differences in other factors, such as expression levels of hormone receptors. Patients whose metastatic lesions were of low tumour grade or high Ki67 labelling index had longer PFS, and such trends were more obvious than primary lesions.

Conclusion:

Our data indicate that tumour grade in primary lesion and NLR are potential predictive factors for CDKi-based treatments. Moreover, pathological assessment of metastatic lesions might also be useful.
Youth Activism for Climate on and Beyond Social media: Insights from FridaysForFuture-Rome
Authors: Belotti Francesca , Donato Stellamarina , Bussoletti Arianna , Comunello Francesca
Published: January 2022

The FridaysForFuture movement (FFF), launched by Greta Thumberg's school strikes in 2018, has led a new wave of climate activism worldwide. Young people are at the forefront, with social media serving both as mobilizing tools and expressive spaces. Drawing upon literature on youth and digital activism with a generational, situated approach, we account for how both the climate struggle and social media are appropriated by FFF-activists as part of their own youth grassroots politics. Moreover, we explore the activities they mix and the strategies they adopt when moving across online and offline environments. From July 2020 to January 2021, we carried out 6 months of ethnographic work with(in) the FFF-Rome group by blending participant observation of assemblies and protests with digital ethnography on the homonym WhatsApp group. Results’ thematic analysis shows that FFF-activists believe climate activism to be their own fight and social media their own battlefield. A generational understanding of digital climate activism emerges at the intersection of the appropriation of the dispute (climate change) and the digital environments (social media). Findings also account for broader logics and strategies adopted by FFF-activists, on and beyond social media. They move seamlessly between online and offline, spanning across and negotiating with different platforms according to political goals and target audiences. These results contribute to overcoming reductive or marginalizing approaches to youth activism, to legitimizing and situating young activists’ social media usage practices within an array of grassroots political practices, and to understanding how generational belonging affects such practices in the Italian context.
Saying Her Name: Gendered Narratives in News Coverage of Breonna Taylor's Death
Authors: Cecil Dawn K.
Published: January 2022

In 2020, Breonna Taylor was killed in her apartment as police officers served a no-knock warrant. Unlike most cases of police violence against a woman of color, Taylor’s death was eventually deemed newsworthy. Given that people’s perceptions of justice-related issues are often informed by media representations, the way the her death was covered can send critical messages about police violence against women of color. This research note presents the findings of a qualitative media analysis of newspaper coverage of Taylor’s case for the six months following her death. Drawing from research on media depictions of police use of force and women as victims, it explored how gender shaped the media coverage of her case. Findings indicate that while there are similarities to other news coverage of deadly use of force incidents that gender and its intersection with race shaped the narratives in three main ways—by characterizing Taylor through a patriarchal lens suggesting that she is an ideal victim; by shifting blame onto Taylor by focusing on relationships with men; and by addressing media coverage while reporting on her death.
A CD45-targeted antibody-drug conjugate successfully conditions for allogeneic hematopoietic stem cell transplantation in mice
Authors: Saha Asim , Hyzy Sharon , Lamothe Tahirih , Hammond Katelyn , Clark Nicholas , Lanieri Leanne , Bhattarai Prashant , Palchaudhuri Rahul , Gillard Geoffrey O. , Proctor Jennifer , Riddle Megan J. , Panoskaltsis-Mortari Angela , MacMillan Margaret L. , Wagner John E. , Kiem Hans-Peter , Olson Lisa M. , Blazar Bruce R.
Published: January 2022

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment of patients with nonmalignant or malignant blood disorders. Its success has been limited by graft-versus-host disease (GVHD). Current systemic nontargeted conditioning regimens mediate tissue injury and potentially incite and amplify GVHD, limiting the use of this potentially curative treatment beyond malignant disorders. Minimizing systemic nontargeted conditioning while achieving alloengraftment without global immune suppression is highly desirable. Antibody-drug-conjugates (ADCs) targeting hematopoietic cells can specifically deplete host stem and immune cells and enable alloengraftment. We report an anti-mouse CD45-targeted-ADC (CD45-ADC) that facilitates stable murine multilineage donor cell engraftment. Conditioning with CD45-ADC (3 mg/kg) was effective as a single agent in both congenic and minor-mismatch transplant models resulting in full donor chimerism comparable to lethal total body irradiation (TBI). In an MHC-disparate allo-HSCT model, pretransplant CD45-ADC (3 mg/kg) combined with low-dose TBI (150 cGy) and a short course of costimulatory blockade with anti-CD40 ligand antibody enabled 89% of recipients to achieve stable alloengraftment (mean value: 72%). When CD45-ADC was combined with pretransplant TBI (50 cGy) and posttransplant rapamycin, cyclophosphamide (Cytoxan), or a JAK inhibitor, 90% to 100% of recipients achieved stable chimerism (mean: 77%, 59%, 78%, respectively). At a higher dose (5 mg/kg), CD45-ADC as a single agent was sufficient for rapid, high-level multilineage chimerism sustained through the 22 weeks observation period. Therefore, CD45-ADC has the potential utility to confer the benefit of fully myeloablative conditioning but with substantially reduced toxicity when given as a single agent or at lower doses in conjunction with reduced-intensity conditioning.
3D AGSE-VNet: an automatic brain tumor MRI data segmentation framework
Authors: Guan Xi , Yang Guang , Ye Jianming , Yang Weiji , Xu Xiaomei , Jiang Weiwei , Lai Xiaobo
Published: January 2022

Background

Glioma is the most common brain malignant tumor, with a high morbidity rate and a mortality rate of more than three percent, which seriously endangers human health. The main method of acquiring brain tumors in the clinic is MRI. Segmentation of brain tumor regions from multi-modal MRI scan images is helpful for treatment inspection, post-diagnosis monitoring, and effect evaluation of patients. However, the common operation in clinical brain tumor segmentation is still manual segmentation, lead to its time-consuming and large performance difference between different operators, a consistent and accurate automatic segmentation method is urgently needed. With the continuous development of deep learning, researchers have designed many automatic segmentation algorithms; however, there are still some problems: (1) The research of segmentation algorithm mostly stays on the 2D plane, this will reduce the accuracy of 3D image feature extraction to a certain extent. (2) MRI images have gray-scale offset fields that make it difficult to divide the contours accurately.

Methods

To meet the above challenges, we propose an automatic brain tumor MRI data segmentation framework which is called AGSE-VNet. In our study, the Squeeze and Excite (SE) module is added to each encoder, the Attention Guide Filter (AG) module is added to each decoder, using the channel relationship to automatically enhance the useful information in the channel to suppress the useless information, and use the attention mechanism to guide the edge information and remove the influence of irrelevant information such as noise.

Results

We used the BraTS2020 challenge online verification tool to evaluate our approach. The focus of verification is that the Dice scores of the whole tumor, tumor core and enhanced tumor are 0.68, 0.85 and 0.70, respectively.

Conclusion

Although MRI images have different intensities, AGSE-VNet is not affected by the size of the tumor, and can more accurately extract the features of the three regions, it has achieved impressive results and made outstanding contributions to the clinical diagnosis and treatment of brain tumor patients.
A mixed-ethnicity myoclonus-dystonia patient with a novel SGCE nonsense mutation: a case report
Authors: de Leon Meliza Angelica J. , Rosales Raymond L. , Klein Christine , Westenberger Ana
Published: January 2022

Background

Myoclonus-dystonia is a rare movement disorder with an autosomal dominant inheritance pattern characterized by a combination of myoclonic jerks and dystonia that may have psychiatric manifestations. Our aim is to present neurologic and psychiatric phenotypic characteristics in the first Filipino bi-ethnic myoclonus-dystonia patient and her father.

Case presentation

We investigated a Filipino myoclonus-dystonia patient with a positive family history. This 21-year-old woman of mixed Filipino-Greek ethnicity presented with involuntary jerking movements of her upper extremities, head, and trunk. Her symptoms affected her activities of daily living which led her to develop moderate depression, mild to moderate anxiety, and mild obsessive-compulsive disorder (OCD). Her 49-year-old Greek father suffered from adolescence-onset myoclonus-dystonia.

Conclusion

Genetic testing revealed a novel epsilon-sarcoglycan (SGCE) gene nonsense mutation c.821C > A; p.Ser274* that confirmed our clinical diagnosis. For co-morbid anxiety, depression, and OCD, this patient was given duloxetine, in addition to clonazepam for the myoclonus and dystonia.
Leukoencephalopathy with brain calcifications and cysts (Labrune syndrome) case report: diagnosis and management of a rare neurological disease
Authors: Paff Michelle , Samuel Nardin , Alsafwani Noor , Paul Darcia , Diamandis Phedias , Climans Seth A. , Kucharczyk Walter , Ding Mandy Yi Rong , Gao Andrew F. , Lozano Andres M.
Published: January 2022

Background

Leukoencephalopathy with brain calcifications and cysts (LCC; also known as Labrune syndrome) is a rare genetic microangiopathy caused by biallelic mutations in SNORD118. The mechanisms by which loss-of-function mutations in SNORD118 lead to the phenotype of leukoencephalopathy, calcifications and intracranial cysts is unknown.

Case presentation

We present the histopathology of a 36-year-old woman with ataxia and neuroimaging findings of diffuse white matter abnormalities, cerebral calcifications, and parenchymal cysts, in whom the diagnosis of LCC was confirmed with genetic testing. Biopsy of frontal white matter revealed microangiopathy with small vessel occlusion and sclerosis associated with axonal loss within the white matter.

Conclusions

These findings support that the white matter changes seen in LCC arise as a consequence of ischemia rather than demyelination.
Acquired nasolacrimal duct obstruction: clinical and histological findings of 275 cases
Authors: Makselis Almantas , Petroska Donatas , Kadziauskiene Aiste , Jaruseviciene Ruta , Ruzgys Andrius , Cimbalas Andrius , Besusparis Justinas , Asoklis Rimvydas S.
Published: January 2022

Background

Acquired nasolacrimal duct obstruction is a blockage of the lacrimal outflow system usually caused by local nonspecific inflammation of the lacrimal sac and the nasolacrimal duct. However, cases exist where the primary nasolacrimal system obstruction is caused by malignancies.

Our aim was to investigate lacrimal sac pathologies in patients with acquired nasolacrimal duct obstruction and compare their clinical manifestations.

Methods

This retrospective clinical study included 275 patients with acquired nasolacrimal duct obstruction who underwent external dacryocystorhinostomy and lacrimal sac biopsy. Cases were classified into tumor or nonspecific pathology groups and subdivided according to the level of inflammation. Histological and clinical data were analyzed.

Results

Three tumors (1.1%) (an adenoid cystic carcinoma, an eccrine spiradenoma and small B cell lymphoma) were diagnosed. Chronic nongranulomatous inflammation was the most common histological finding, corresponding to 194 cases (70.5%). The other 81 (29.5%) were subacute, acute forms of nongranulomatous inflammation, tumors and fibrosis cases. Epiphora with continuous purulent discharge was the most common clinical sign reported by 144 (52.4%) patients, and two (0.7%) patients had a palpable mass near the medial canthal tendon, which was identified as an eccrine spiradenoma and small B cell lymphoma. There was no significant difference in the clinical symptoms, duration or case history between the nonspecific pathology and tumor groups (p = 0.292).

Conclusions

Chronic nongranulomatous inflammation of the lacrimal sac was the most common finding among acquired nasolacrimal duct obstruction cases. There were no associations between the histological findings and clinical presentation. The authors recommend a lacrimal sac biopsy only in cases when a tumor is clinically suspected.
Use of latent profile analysis and k-means clustering to identify student anxiety profiles
Authors: Liu Fang , Yang Dan , Liu Yueguang , Zhang Qin , Chen Shiyu , Li Wanxia , Ren Jidong , Tian Xiaobin , Wang Xin
Published: January 2022

Background

Anxiety disorders are often the first presentation of psychopathology in youth and are considered the most common psychiatric disorders in children and adolescents. This study aimed to identify distinct student anxiety profiles to develop targeted interventions.

Methods

A cross-sectional study was conducted with 9738 students in Yingshan County. Background characteristics were collected and Mental Health Test (MHT) were completed. Latent profile analysis (LPA) was applied to define student anxiety profiles, and then the analysis was repeated using k-means clustering.

Results

LPA yielded 3 profiles: the low-risk, mild-risk and high-risk groups, which comprised 29.5, 38.1 and 32.4% of the sample, respectively. Repeating the analysis using k-means clustering resulted in similar groupings. Most students in a particular k-means cluster were primarily in a single LPA-derived student profile. The multinomial ordinal logistic regression results showed that the high-risk group was more likely to be female, junior, and introverted, to live in a town, to have lower or average academic performance, to have heavy or average academic pressure, and to be in schools that have never or occasionally have organized mental health education activities.

Conclusions

The findings suggest that students with anxiety symptoms may be categorized into distinct profiles that are amenable to varying strategies for coordinated interventions.
Medicines and vaccines supply chains challenges in Nigeria: a scoping review
Authors: Olutuase Victory O. , Iwu-Jaja Chinwe J. , Akuoko Cynthia P. , Adewuyi Emmanuel O. , Khanal Vishnu
Published: January 2022

Background

Medicines and vaccines supply chains represent critical systems for realising one of the major targets of the United Nations’ third Sustainable Development Goals (SDGs)—access to safe, effective, quality, and affordable essential medicines and vaccines, for all. However, evidence suggests the system is confronted with several challenges in many low-medium income countries, including Nigeria. This scoping review aims to summarize the available evidence on the challenges of medicines and vaccines supply chain system in Nigeria.

Results

We searched relevant databases including Scopus and Web of Science for studies published between January 2005 and August 2020 on the challenges associated with medicines and vaccines supply chain systems in Nigeria. Our findings implicate several factors including difficulty with medicines or vaccines selection, procurement, distribution, and inventory management. Others included poor storage infrastructure, financial constraints, insecurity, transportation challenges, inadequate human resources, weak, or poorly implemented policies. These challenges mostly resulted in stock-outs of essential medicines which notably got worsened during the current COVID-19 pandemic.

Conclusion

Our study is a wake-up call on the need to prioritise the critical sector of the supply chain systems for medicines and vaccines in Nigeria. Effective implementation of existing policies, improved security, strengthening of the health system through adequate budgetary allocations, and provision of infrastructure including regular availability of electricity are keys to surmounting the challenges and improving access to medicines or vaccines in Nigeria.
Economic impact of switching from partially combined vaccine “Pentaxim® and hepatitis B” to fully combined vaccine “Hexaxim®” in the Malaysian National Immunization Program
Authors: Aljunid Syed Mohamed , Al Bashir Lama , Ismail Aniza Binti , Aizuddin Azimatun Noor , Rashid S. A. Zafirah Abdul , Nur Amrizal Muhammad
Published: January 2022

Background

The decision to implement new vaccines should be supported by public health and economic evaluations. Therefore, this study was primarily designed to evaluate the economic impact of switching from partially combined vaccine (Pentaxim® plus hepatitis B) to fully combined vaccine (Hexaxim®) in the Malaysian National Immunization Program (NIP) and to investigate healthcare professionals (HCPs)’ and parents’/caregivers’ perceptions.

Methods

In this economic evaluation study, 22 primary healthcare centers were randomly selected in Malaysia between December 2019 and July 2020. The baseline immunization schedule includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses), whereas the alternative scheme includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses) and hepatitis B (one dose) administered at birth. Direct medical costs were extracted using a costing questionnaire and an observational time and motion chart. Direct non-medical (cost for transportation) and indirect costs (loss of productivity) were derived from parents’/caregivers’ questionnaire. Also, HCPs’ and parent’s/caregivers’ perceptions were investigated using structured questionnaires.

Results

The cost per dose of Pentaxim® plus hepatitis B vs. Hexaxim® for the baseline scheme was Malaysian ringgit (RM) 31.90 (7.7 United States dollar [USD]) vs. 17.10 (4.1 USD) for direct medical cost, RM 54.40 (13.1 USD) vs. RM 27.20 (6.6 USD) for direct non-medical cost, RM 221.33 (53.3 USD) vs. RM 110.66 (26.7 USD) for indirect cost, and RM 307.63 (74.2 USD) vs. RM 155.00 (37.4 USD) for societal (total) cost. A similar trend was observed for the alternative scheme. Compared with Pentaxim® plus hepatitis B, total cost savings per dose of Hexaxim® were RM 137.20 (33.1 USD) and RM 104.70 (25.2 USD) in the baseline and alternative scheme, respectively. Eighty-four percent of physicians and 95% of nurses supported the use of Hexaxim® in the NIP. The majority of parents/caregivers had a positive perception regarding Hexaxim® vaccine in various aspects.

Conclusions

Incorporation of Hexaxim® within Malaysian NIP is highly recommended because the use of Hexaxim® has demonstrated substantial direct and indirect cost savings for healthcare providers and parents/caregivers with a high percentage of positive perceptions, compared with Pentaxim® plus hepatitis B.

Trial registration

Not applicable.
Promoting organizational vision integration among hospital employees
Authors: Slåtten Terje , Lien Gudbrand , Mutonyi Barbara Rebecca
Published: January 2022

Background

The concept of organizational vision has been little explored in the health-care services research literature. To address this knowledge gap in the literature, the present study examines the factors that may promote organizational vision integration (OVI), which refers to the employees’ use of organizational vision as a guiding framework in their work. The roles of organizational commitment (OC), leadership autonomy support (LAS), and organizational culture in relation to hospital employees’ OVI are examined.

Methods

Hospital employees were surveyed. Partial least-squares structural equation modeling was performed using SmartPLS 3 software to test the proposed hypotheses statistically. A bootstrapping test was used to identify the mediating effects.

Results

The main findings show that: (i) OC is the most powerful factor in promoting employees’ OVI (β = 0.26), while organizational culture (represented by the concept of internal market-oriented culture) and LAS showed significantly less and almost equal impact (β = 0.16 and β = 0.15, respectively). In total, OC, organizational culture and LAS explain 25% of the variance in the concept of OVI. (ii) LAS and organizational culture both significantly contribute to employees’ OC (β = 0.35 and β = 0.29, respectively) and in total explain nearly 40% (R2 = 0.38) of the variance in the concept of OC. (iii) The relationships between organizational culture, LAS, and OVI are mediated through OC, and (iv) LAS mediates the relationship between organizational culture and OVI, and that between organizational culture and OC.

Conclusions

To promote hospital employees’ OVI effectively, hospital managers should focus particularly on their employees’ OC. Specifically, they should strengthen their employees’ OC through building a strong employee-focused organizational culture and ensuring that leaders practice LAS. This contributes to promoting hospital employees’ OVI.
Forest malaria and prospects for anti-malarial chemoprophylaxis among forest goers: findings from a qualitative study in Lao PDR
Authors: Jongdeepaisal Monnaphat , Inthasone Soulixay , Khonputsa Panarasri , Malaphone Vilayvone , Pongsoipetch Kulchada , Pongvongsa Tiengkham , Mayxay Mayfong , Chindavongsa Keobouphaphone , Pell Christopher , Maude Richard J.
Published: January 2022

Background

Despite significant decline in malarial incidence and mortality in countries across the Greater Mekong Subregion, the disease remains a public health challenge in the region; transmission continues mainly among people who visit forests in remote areas, often along international borders, where access to primary healthcare is limited. In the absence of effective vector-control measures and limited exposure periods, malaria chemoprophylaxis has been proposed as a strategy to protect forest goers. As a rarely used approach for indigenous populations, questions remain about its feasibility and acceptability. Drawing on in-depth interviews with forest goers and stakeholders, this article examines opportunities and challenges for implementation of anti-malarial chemoprophylaxis for forest goers in Lao PDR.

Methods

In-depth interviews were conducted with 16 forest goers and 15 stakeholders in Savannakhet province, Lao PDR. Interview topics included experience of malaria prevention and health services, and perceptions of prophylaxis as a potential component of malaria elimination strategy. The interviews were transcribed and coded using inductive and deductive approaches for qualitative thematic analysis.

Results

In ethnically and geographically diverse villages, awareness of malaria risk prompts forest goers to protect themselves, albeit sub-optimally using available preventive measures. Stakeholders highlighted challenges for targeting at-risk populations and approaches to address forest malaria in southern Lao PDR. Among policymakers, choice and cost of anti-malarials, particularly their efficacy and source of funding, were key considerations for the feasibility of malaria prophylaxis. Acceptability of prophylaxis among forest goers was also influenced by the complexity of the regimen, including the number of tablets and timing of doses. Implementation of prophylaxis may be affected by a lack of transportation and communication barriers in remote communities.

Conclusion

Adding prophylaxis to existing malaria control activities requires strengthening the capacity of local health workers in Lao PDR. Ideally, this would be part of an integrated approach that includes strategies to address the other febrile illnesses that forest goers describe as priority health concerns. The prophylactic regimen also requires careful consideration in terms of effectiveness and simplicity of dosing.
Liposuction in cancer-related lower extremity lymphedema: an investigative study on clinical applications
Authors: Xin Jianfeng , Sun Yuguang , Xia Song , Chang Kun , Dong Chao , Liu Zhong , Dong Jian , Shen Wenbin
Published: January 2022

Background

Lymphedema is a progressive, noncurable condition consisting of increases in subcutaneous fat and interstitial fluid in the limbs and fibrosis during later stages. The disease most commonly affects the limbs following injury to or removal of the lymph nodes. The aim of this study was to investigate the therapeutic outcomes of liposuction for cancer-related lower extremity lymphedema.

Methods

Sixty-two patients with cancer-related lymphedema in the unilateral lower extremity were recruited for this study, and all patients underwent liposuction. The volume of hemorrhage and lipids, the operation time, and the volume changes of the affected extremity were compared by applying thettests, and the subjective feelings of patients were compared with the chi-square tests.

Results

The total lipid volume was 2539 ± 1253.5 ml, and the hemorrhage volume was 828 ± 311.8 ml. For the comparison of objective indices, (1) the percent volume differences (PVDs) before surgery, intraoperatively, and at the 3-month follow-up were 5.5 ± 12.2 vs. 11.6 ± 18.4 vs. 43.2 ± 23.7,P< 0.05, respectively; (2) greater lipid volumes and higher liposuction rates were observed for female patients, as was a smaller volume of hemorrhage; (3) greater hemorrhage volumes were observed in patients with a history of recurrent erysipelas; and (4) greater lipid volumes and liposuction rates (LRs) and smaller hemorrhage volumes were observed for stage II than for stage III patients.

Conclusions

Liposuction is an effective therapy for cancer-related lower extremity lymphedema. Sex, stage, and recurrent erysipelas history influence the course and effect of liposuction.
Digital research data: from analysis of existing standards to a scientific foundation for a modular metadata schema in nanosafety
Authors: Elberskirch Linda , Binder Kunigunde , Riefler Norbert , Sofranko Adriana , Liebing Julia , Minella Christian Bonatto , Mädler Lutz , Razum Matthias , van Thriel Christoph , Unfried Klaus , Schins Roel P. F. , Kraegeloh Annette
Published: January 2022

Background

Assessing the safety of engineered nanomaterials (ENMs) is an interdisciplinary and complex process producing huge amounts of information and data. To make such data and metadata reusable for researchers, manufacturers, and regulatory authorities, there is an urgent need to record and provide this information in a structured, harmonized, and digitized way.

Results

This study aimed to identify appropriate description standards and quality criteria for the special use in nanosafety. There are many existing standards and guidelines designed for collecting data and metadata, ranging from regulatory guidelines to specific databases. Most of them are incomplete or not specifically designed for ENM research. However, by merging the content of several existing standards and guidelines, a basic catalogue of descriptive information and quality criteria was generated. In an iterative process, our interdisciplinary team identified deficits and added missing information into a comprehensive schema. Subsequently, this overview was externally evaluated by a panel of experts during a workshop. This whole process resulted in a minimum information table (MIT), specifying necessary minimum information to be provided along with experimental results on effects of ENMs in the biological context in a flexible and modular manner. The MIT is divided into six modules: general information, material information, biological model information, exposure information, endpoint read out information and analysis and statistics. These modules are further partitioned into module subdivisions serving to include more detailed information. A comparison with existing ontologies, which also aim to electronically collect data and metadata on nanosafety studies, showed that the newly developed MIT exhibits a higher level of detail compared to those existing schemas, making it more usable to prevent gaps in the communication of information.

Conclusion

Implementing the requirements of the MIT into e.g., electronic lab notebooks (ELNs) would make the collection of all necessary data and metadata a daily routine and thereby would improve the reproducibility and reusability of experiments. Furthermore, this approach is particularly beneficial regarding the rapidly expanding developments and applications of novel non-animal alternative testing methods.