bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility of a new notation to visualize flow cytometry analysis results: first preliminary comparison with immunohistochemistry to detect CD30 expression on T-cell lymphoma cells
Authors: Fujishima Fumiyoshi , Fukuhara Noriko , Katsushima Hiroki , Nakamura Yasuhiro , Harigae Hideo , Sasano Hironobu , Ichinohasama Ryo
Published: December 2021

Background

It is important to confirm CD30 expression in T-cell lymphoma cases, but immunohistochemical staining for CD30 is not commonly performed and no comparison has been done between the results of flow cytometry (FCM) and immunohistochemical staining for CD30. Therefore, we devised a notation that we termed proportion of immunoreactivity/expression for FCM (PRIME-F notation), based on the cellular proportion showing different antigen-antibody reactivity.

Methods

We retrospectively compiled 211 cases of T-cell lymphoma, assessed via FCM, from major hospitals in Miyagi Prefecture from January 2012 to January 2019, and compared 52 of these cases with the immunohistochemical immunoreactive (IR) pattern of CD30 (PRIME-I notation). The PRIME-F notation was divided into five levels: notations starting with “-” followed by 3, 2, and 1 “>” correspond to level-I, level-II, or level-III; notations starting with “(dim)+” correspond to level-IV; and those starting with “+” or “(bright)+” correspond to level-V.

Results

The 52 cases of PRIME-F notation with “+” included 16 cases of peripheral T-cell lymphoma (PTCL/NOS), 3 of follicular T-cell lymphoma (FTL), 3 of angioimmunoblastic T-cell lymphoma (AITL), 6 of extranodal NK/T-cell lymphoma/nasal type (ENKL), 18 of adult T-cell lymphoma (ATL), and 6 cases of anaplastic large cell lymphoma (ALCL). Eight of the 52 cases were immunohistochemically CD30-negative. In the PRIME-F level-I to III group (excluding false-positive cases), 21.7% (5 out of 23 cases) were < 10% positive for CD30 upon immunohistochemistry (IHC). Contrarily, in the level-IV & -V group, no CD30 positivity rate of < 10% upon IHC was found (0%) (p = 0.0497). In level-IV, 42.9% of cases presented a CD30 negative rate > 1/3 upon IHC, while in level-V, only 7.1% (one out of 14 cases) did. The CD30 negative rate tended to be low (p = 0.0877) in level-V.

Conclusions

To our knowledge, this is the first report describing the correspondence between FCM and immunohistochemistry findings for CD30 through newly proposed notations. The PRIME-F and PRIME-I notations for CD30 showed a minor positive correlation. The PRIME notation is considered universally applicable to antibodies, and notations of both FCM and IHC show great potential for big data.
Development of an optimal relief method for the palatal plate by stress analysis
Authors: Mukai Tomoko , Sato Yuji , Shimodaira Osamu , Furuya Junichi , Isobe Akio , Omori Tomoka
Published: December 2021

Background

Plate dentures cannot be easily modified after fabrication; therefore, the sites and magnitude of relief must be effectively assessed at the time of fabrication. However, a considerable variation exists in the magnitude of optimal relief and relief range, and there are no guidelines that present these clearly, leading the dentists to decide subjectively. Thus, this study aims to develop an optimal relief method to improve the stress bearing capacity of the palatal mucosa.

Methods

The objective of this study, namely, the borderline, was set in steps. A three-dimensional finite element model for the pseudopalatal plate was created and used to evaluate the changes in stress distribution in the palatal mucosa due to the selective relief of stresses above the borderline. The resulting data were used to develop the optimal relief method.

Results

In the relief model with a borderline of 0.04 MPa or higher, the distribution volume at which a high stress of 0.20 MPa or higher is generated was approximately 800% of that with the no-relief model, and in the relief model with a borderline of 0.06 MPa or higher, the respective ratio was approximately 280%. On the other hand, the relief models with a borderline of 0.14 MPa or higher were approximately 60%. In the mid-palatal relief model, the distribution volume at which a stress of 0.20 MPa or higher was generated was 180% of that in the relief model.

Conclusions

The supportive strength of plates can be increased by selectively applying optimal relief rather than standard relief, allowing for easier and more effective plate-denture treatment.
Limitation of life-sustaining treatment and patient involvement in decision-making: a retrospective study of a Danish COVID-19 patient cohort
Authors: Jensen Hanne Irene , Ozden Sevim , Kristensen Gitte Schultz , Azizi Mihnaz , Smedemark Siri Aas , Mogensen Christian Backer
Published: December 2021

Background

The coronavirus (COVID-19) pandemic and the risk of an extensive overload of the healthcare systems have elucidated the need to make decisions on the level of life-sustaining treatment for patients requiring hospitalisation. The purpose of the study was to investigate the proportion and characteristics of COVID-19 patients with limitation of life-sustaining treatment decisions and the degree of patient involvement in the decisions.

Methods

A retrospective observational descriptive study was conducted in three Danish regional hospitals, looking at all patients ≥ 18 years of age admitted in 2020 with COVID-19 as the primary diagnosis. Lists of hospitalised patients admitted due to COVID-19 were extracted. The data registration included age, gender, comorbidities, including mental state, body mass index, frailty, recent hospital admissions, COVID-19 life-sustaining treatment, ICU admission, decisions on limitations of life-sustaining treatment before and during current hospitalisation, hospital length of stay, and hospital mortality.

Results

A total of 476 patients were included. For 7% (33/476), a decision about limitation of life-sustaining treatment had been made prior to hospital admission. At the time of admission, one or more limitations of life-sustaining treatment were registered for 16% (75/476) of patients. During the admission, limitation decisions were made for an additional 11 patients, totaling 18% (86/476). For 40% (34/86), the decisions were either made by or discussed with the patient. The decisions not made by patients were made by physicians. For 36% (31/86), no information was disclosed about patient involvement.

Conclusions

Life-sustaining treatment limitation decisions were made for 18% of a COVID-19 patient cohort. Hereof, more than a third of the decisions had been made before hospital admission. Many records lacked information on patient involvement in the decisions.
Prognostic role of computed tomography-based, artificial intelligence-driven waist skeletal muscle volume in uterine endometrial carcinoma
Authors: Kim Se Ik , Chung Joo Yeon , Paik Haerin , Seol Aeran , Yoon Soon Ho , Kim Taek Min , Kim Hee Seung , Chung Hyun Hoon , Cho Jeong Yeon , Kim Jae-Weon , Lee Maria
Published: December 2021

Objectives

To investigate the impact of computed tomography (CT)-based, artificial intelligence-driven waist skeletal muscle volume on survival outcomes in patients with endometrial cancer.

Methods

We retrospectively identified endometrial cancer patients who received primary surgical treatment between 2014 and 2018 and whose pre-treatment CT scans were available (n = 385). Using an artificial intelligence-based tool, the skeletal muscle area (cm2) at the third lumbar vertebra (L3) and the skeletal muscle volume (cm3) at the waist level were measured. These values were converted to the L3 skeletal muscle index (SMI) and volumetric SMI by normalisation with body height. The relationships between L3, volumetric SMIs, and survival outcomes were evaluated.

Results

Setting 39.0 cm2/m2 of L3 SMI as cut-off value for sarcopenia, sarcopenia (< 39.0 cm2/m2, n = 177) and non-sarcopenia (≥ 39.0 cm2/m2, n = 208) groups showed similar progression-free survival (PFS; p = 0.335) and overall survival (OS; p = 0.241). Using the median value, the low-volumetric SMI group (< 206.0 cm3/m3, n = 192) showed significantly worse PFS (3-year survival rate, 77.3% vs. 88.8%; p = 0.004) and OS (3-year survival rate, 92.8% vs. 99.4%; p = 0.003) than the high-volumetric SMI group (≥ 206.0 cm3/m3, n = 193). In multivariate analyses adjusted for baseline body mass index and other factors, low-volumetric SMI was identified as an independent poor prognostic factor for PFS (adjusted HR, 1.762; 95% CI, 1.051–2.953; p = 0.032) and OS (adjusted HR, 5.964; 95% CI, 1.296–27.448; p = 0.022).

Conclusions

Waist skeletal muscle volume might be a novel prognostic biomarker in patients with endometrial cancer. Assessing body composition before treatment can provide important prognostic information for such patients.
Renal replacement therapy-requiring acute kidney injury due to tubulointerstitial nephritis and uveitis syndrome: case report
Authors: Marahrens B. , Amann K. , Asmus K. , Erfurt S. , Patschan D.
Published: December 2021

Background

Acute kidney injury is a major challenge for today’s healthcare systems around the globe. Renal replacement therapy has been shown to be beneficial in acute kidney injury, but treatment highly depends on the cause of the acute kidney injury. One less common cause is tubulointerstitial nephritis, which comes in different entities. A very rare type of tubulointerstitial nephritis is tubulointerstitial nephritis and uveitis syndrome, in which the patient presents with additional uveitis.

Case presentation

A 19-year-old caucasian male presented with mild dyspnea, lack of appetite, weight loss, and moderate itchiness. Lab results showed an acute kidney injury with marked increase of serum creatinine. The patient was started on prednisolone immediately after admission. As the patient in this case showed symptoms of uremia on admission, we decided to establish renal replacement therapy, which is unusual in tubulointerstitial nephritis and uveitis syndrome. During his course of dialysis, the patient developed symptoms of sepsis probably due to a catheter-related infection requiring intensive care and antibiotic treatment, which had to be terminated early as the patient developed a rash. Intensified immunosuppression, combined with antibiotics, significantly resolved excretory kidney dysfunction.

Conclusions

Since both the primary inflammatory process and the secondary infectious complication significantly impaired excretory kidney function, kidney function of younger individuals with new-onset anterior uveitis should be monitored over time and during follow-up.
The impact of the Pliensbachian–Toarcian crisis on belemnite assemblages and size distribution
Authors: De Baets Kenneth , Nätscher Paulina S. , Rita Patricia , Fara Emmanuel , Neige Pascal , Bardin Jérémie , Dera Guillaume , Duarte Luís Vítor , Hughes Zoe , Laschinger Peter , García-Ramos José Carlos , Piñuela Laura , Übelacker Christof , Weis Robert
Published: December 2021

The second-order Pliensbachian–Toarcian crisis affected major groups of marine organisms. While its impact has been intensively studied for ammonites, the response of belemnites is only currently emerging through quantitative studies. Novel overall and regional diversity analyses suggest that belemnite richness in the NW-Tethys drops at the Pliensbachian–Toarcian boundary, while overall diversity slightly increases in NW-Tethys assemblages during the Toarcian Oceanic Anoxic event (T-OAE), mostly driven by NW European assemblages (e.g., Yorkshire). The T-OAE coincides with marked taxonomic turnover within individual basins, which is associated with an increase in median rostrum size of specimens in taxa at most localities. The changes in median body size across the Pliensbachian–Toarcian boundary are less consistent and driven by changes in body size within individual lineages crossing the boundary. However, our analyses also illustrate differences in sampling across the Pliensbachian–Toarcian crisis, which needs to be considered in further studies.
Evacuation solutions for individuals with functional limitations in the built environment: a scoping review protocol
Authors: Roberts Brad W. R. , Al Bochi Abdulrahman , Weiler Mark , Sharma Yashoda , Marquez-Chin Cesar , Pong Steven , Babineau Jessica , Sajid Waqas , Dutta Tilak , Vette Albert H.
Published: December 2021

Background

Whether due to aging, disability, injury, or other circumstances, an increasing number of Canadians experience functional limitations that reduce their ability to participate in activities of daily life. While the built environment has become increasingly accessible, existing Canadian evacuation guidelines lack comprehensive strategies for evacuating individuals with functional limitations from buildings during emergencies. To inform guideline revisions, a map of existing solutions for evacuating such individuals is required. Therefore, this scoping review aims to provide an account of solutions that have been reported to safely evacuate individuals with functional limitations from the built environment.

Methods

We will conduct a scoping review using the Arksey and O’Malley methodological framework. To identify potentially relevant studies, comprehensive searches (from January 2002 onwards) of the CINAHL, Ei Compendex, Inspec, Embase, MEDLINE, KCI, RSCI, SciELO CI, Web of Science Collection, and Scopus databases will be performed. Using a set of inclusion and exclusion criteria, two reviewers will independently (1) classify identified studies as relevant, irrelevant, or maybe relevant by evaluating their titles and abstracts and (2) classify the relevant and maybe relevant studies as included or excluded by evaluating their full-text. From each included study, data on publication information, study purpose, methodological details, evacuation information, and outcomes will be extracted using a set of data extraction items. We will present a numerical summary of the key characteristics of the included studies. For each evacuation activity, reported evacuation solutions will be summarized, and citations provided for functional limitations that are targeted by a given evacuation solution. To inform Canadian evacuation guideline revisions, we will tabulate evacuation activities common to different types of buildings and emergencies.

Discussion

To our knowledge, this will be the first scoping review to identify the state and use of solutions for evacuating individuals with functional limitations from the built environment. Identifying solutions that enable all individuals to safely evacuate from different types of buildings will allow us to inform recommendations for the revision of evacuation guidelines in Canada and other jurisdictions. The findings of this scoping review will be published in a peer-reviewed journal, presented at relevant conferences, and made publicly available on the internet.

Systematic review registration

Open Science Framework: osf.io/jefgy
The Metaproteomics Initiative: a coordinated approach for propelling the functional characterization of microbiomes
Authors: Van Den Bossche Tim , Arntzen Magnus Ø. , Becher Dörte , Benndorf Dirk , Eijsink Vincent G. H. , Henry Céline , Jagtap Pratik D. , Jehmlich Nico , Juste Catherine , Kunath Benoit J. , Mesuere Bart , Muth Thilo , Pope Phillip B. , Seifert Jana , Tanca Alessandro , Uzzau Sergio , Wilmes Paul , Hettich Robert L. , Armengaud Jean
Published: December 2021

Through connecting genomic and metabolic information, metaproteomics is an essential approach for understanding how microbiomes function in space and time. The international metaproteomics community is delighted to announce the launch of the Metaproteomics Initiative (www.metaproteomics.org), the goal of which is to promote dissemination of metaproteomics fundamentals, advancements, and applications through collaborative networking in microbiome research. The Initiative aims to be the central information hub and open meeting place where newcomers and experts interact to communicate, standardize, and accelerate experimental and bioinformatic methodologies in this field. We invite the entire microbiome community to join and discuss potential synergies at the interfaces with other disciplines, and to collectively promote innovative approaches to gain deeper insights into microbiome functions and dynamics.
Predation of archival tagged Dolly Varden, Salvelinus malma, reveals predator avoidance behaviour and tracks feeding events by presumed beluga whale, Delphinapterus leucas, in the Beaufort Sea
Authors: Gallagher Colin P. , Storrie Luke , Courtney Michael B. , Howland Kimberly L. , Lea Ellen V. , MacPhee Shannon , Loseto Lisa
Published: December 2021

Background

We report compelling evidence suggesting a predation event of a pop-up satellite archival tagged anadromous Dolly Varden (Salvelinus malma) by a marine mammal during summer in the Beaufort Sea based on abrupt changes in temperature and vertical movements. This observation provides insight on predator avoidance behaviour by Dolly Varden and the predator’s feeding frequency while the tag was ingested. Based on published distribution and ecology information, we presumed the predator was a beluga whale (Delphinapterus leucas). Supplemental satellite telemetry data from previously tagged Dolly Varden and beluga whales were used to determine the extent of spatial and vertical overlap between species in the area where predation occurred.

Results

Prior to the predation event, depths and temperatures occupied by the tagged Dolly Varden averaged 1.1 m and 3.1 °C, respectively. On July 7, 2020, depths remained shallow apart from a sudden dive to 12.5 m (16:45 UTC) followed by a precipitous increase in temperature from 4.4 to 27.1 °C (16:52 UTC) suggesting predation by an endotherm. Subsequent readings indicated the endotherm had a resting stomach temperature of 36.1 °C. Including the predation event, eight separate feeding events were inferred during the 20-h period the tag was ingested (before presumed regurgitation) based on subsequent declines in stomach temperatures (mean decline to 31.1 °C) that took an average of 24.1 min to return to resting temperature. The predator occupied mainly shallow depths (mean = 2.3 m), overlapping with tagged belugas that spent 76.9% of their time occupying waters ≤ 2.5 m when frequenting the area occupied by tagged Dolly Varden in the Canadian Beaufort Sea in July. Back-calculation based on tag drift and mean displacement by tagged belugas indicated the predation likely occurred west of the Mackenzie Delta.

Conclusion

Our findings provide new information on both anti-predator behaviour by, and marine predators of, Dolly Varden in the Beaufort Sea. We provide the first estimate of feeding frequency and stomach temperature recovery in a presumed wild beluga, and evidence for shallow foraging behaviour by belugas. Elucidating the likely predator and exploring the extent of overlap between Dolly Varden and beluga whales contributes towards knowledge on the trophic interactions in the Beaufort Sea.
How deep is your thought? The relations between intolerance of uncertainty, worry and weight and shape concerns in adolescent girls with anorexia nervosa
Authors: Bijsterbosch Jojanneke M. , Keizer Anouk , Boelen Paul A. , van den Brink Femke , Danner Unna N. , Sternheim Lot C.
Published: December 2021

Background

Inherent to anorexia nervosa are repetitive thoughts about weight and shape. Growing research suggests the relevance of intolerance of uncertainty and worry in maintaining these types of repetitive thoughts. The relation between these cognitive processes and weight and shape concerns in adolescent girls with anorexia nervosa is understudied. This study investigated associations between prospective (desire for predictability) and inhibitory (uncertainty paralysis) intolerance of uncertainty, and weight and shape concerns and the mediating role of worry in these associations.

Methods

In a cross-sectional study, 93 adolescent girls with anorexia nervosa completed questionnaires measuring the variables of interest. A mediation model with worry as a mediator between inhibitory and prospective intolerance of uncertainty and weight and shape concerns was tested.

Results

A total and direct effect of inhibitory intolerance of uncertainty on weight and shape concerns was found. Worry did not mediate this relation.

Conclusions

These results confirm the importance of inhibitory intolerance of uncertainty in adolescent girls with anorexia nervosa, more specifically to weight and shape concerns. This group may benefit from intervention strategies targeting intolerance of uncertainty. General worry seems less relevant to weight and shape concerns in adolescent girls with anorexia nervosa.

Plain English summary

Adolescent girls with anorexia nervosa often experience repetitive thoughts about weight and shape. Growing research suggests the relevance of intolerance of uncertainty and worry in maintaining these types of repetitive thoughts. Intolerance of uncertainty is defined as the incapacity to tolerate uncertainty and is often divided into two components; prospective intolerance of uncertainty (desire for predictability) and inhibitory intolerance of uncertainty (uncertainty paralysis). The relation between intolerance of uncertainty, worry and weight and shape concerns in adolescent girls with anorexia nervosa is understudied. This study aims to investigate study relations between prospective and inhibitory intolerance of uncertainty, worry, and weight and shape concerns. A total of 93 adolescent girls with anorexia nervosa completed three questionnaires, measuring prospective and inhibitory intolerance of uncertainty worry, and weight and shape concerns, respectively. The results of this study confirmed the importance of inhibitory intolerance of uncertainty in adolescent girls with anorexia nervosa, more specifically to weight and shape concerns. This group may benefit from intervention strategies targeting intolerance of uncertainty. General worry seems less relevant to weight and shape concerns in adolescent girls.
A comparison of endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in reversing endolymphatic hydrops in Meniere's disease
Authors: Peng Anquan , Hu Junjiao , Wang Qin , Pan Xueying , Zhang Zhiwen , Jiang Wenqi , Chen Yichao , Huang Chao
Published: December 2021

Background

To explore the differences between endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in the reversal of endolymphatic hydrops (EH) in patients with intractable Meniere's disease (MD).

Methods

A total of 27 MD patients receiving endolymphatic duct blockage surgery (n = 10), endolymphatic sac drainage surgery (n = 9) and endolymphatic sac decompression surgery (n = 8) underwent gadolinium-enhanced inner ear magnetic resonance imaging (MRI) scans prior to, 2 weeks after and at > 12 months following surgery.

Results

In the group with endolymphatic duct blockage, the second MRI revealed no changes in EH, whereas the third MRI revealed a reversal of vestibular EH in 3 patients and a downgrading of cochlear hydrops in 2 of these 3 patients, who presented with an improvement in their hearing and complete control of vertigo. In the group with endolymphatic sac drainage, the second MRI showed a reversal of EH in 4 patients, and no changes in EH in the remaining 5 patients, whereas the third MRI showed that those 4 patients who presented with a reversal of EH at the second MRI stage remained unchanged except a recurrence of vestibular hydrops in 1 patient. All 4 patients exhibited a complete control of vertigo, but hearing improved in 1, worsened in 1 and remained unchanged in 2. In the group with endolymphatic sac decompression, both the second and third MRI examination revealed no reversal of EH.

Conclusions

The present study has shown that both endolymphatic duct blockage surgery and endolymphatic sac drainage surgery have the potential to reduce EH in certain MD patients, but none of the patients receiving endolymphatic sac decompression surgery showed reversal of their EH.

Graphical Abstract
Motor vehicle crashes on tribal reservations: mapping and statistics
Authors: Vandjelovic Jordan M. , Merchant Darcy
Published: December 2021

Background

Motor vehicle crashes (MVC’s) in the American Indian/Alaska Native (AI/AN) communities account for 43% of unintentional injury deaths. This article introduces MVC data and geographic information system (GIS) mapping for tribal reservations.

Methods

Utilizing a sample of Montana Department of Transportation (DOT) data for the Flathead reservations to calculate frequencies and proportions of crash types (i.e., property damage or no-injury, injury, fatality or unknown), while also mapping these data to provide a cross-sectional snapshot of MVC’s.

Results

Overall, 515 MVC’s occurred for years 2016 through 2018, with no-injury, injury, and fatality accounting for 72.2%, 24.9% and 1.8% of all crashes, respectively, with the number of MVC’s ranging up to 30 per square mile.

Conclusion

Examining DOT data and utilizing it for visual representation of MVC’s can be used as an additional source in uncovering patterns and trends on Tribal reservations and supporting MVC prevention efforts.
Laparoscopic distal pancreatectomy for metastatic melanoma originating from the choroidal membrane: a case report
Authors: Baba Shigeaki , Akiyama Yuji , Endo Fumitaka , Nikai Haruka , Sugimoto Ryo , Umemura Akira , Katagiri Hirokatsu , Hasegawa Yasushi , Iwaya Takeshi , Nitta Hiroyuki , Koeda Keisuke , Sugai Tamotsu , Sasaki Akira
Published: December 2021

Background

Metastatic melanoma originating from the choroidal membrane is extremely rare. Here, we report a case of laparoscopic distal pancreatectomy for malignant melanoma that developed after heavy-particle therapy for malignant choroidal melanoma.

Case presentation

A 43-year-old Japanese woman underwent 70 Gy heavy-particle radiotherapy for a right choroidal malignant melanoma. Positron emission tomography-computed tomography examination was performed 4 years after treatment, when contrast accumulation was observed on the posterior wall of the stomach. Endoscopic ultrasonography and computed tomography showed a mass with contrast enhancement in contact with the stomach wall. Based on the imaging findings, a gastrointestinal stromal tumor of the posterior wall of the lower gastric corpus with extramural growth was suspected. Laparoscopic surgery was performed under general anesthesia. A black-pigmented tumor originating from the pancreas was discovered. Following an intraoperative diagnosis of metastasis of malignant melanoma, a laparoscopic distal pancreatectomy was performed. The pathological diagnosis was pancreatic metastasis of malignant melanoma. The patient was treated with adjuvant immune checkpoint inhibitors and chemotherapy after surgery, which led to long-term survival.

Conclusions

Including this case, only eight case reports on pancreatic resection for metastatic ocular malignant melanoma have been reported. The ocular malignant melanoma with distant metastasis has a poor prognosis. Therefore, in our case, careful follow-up is required. A single pancreatic metastasis from a malignant melanoma of the choroid can be successfully managed by laparoscopic radical resection of the pancreas, and molecularly targeted adjuvant chemotherapy.
Meckel’s diverticulum with intraperitoneal hemorrhage in a child detected with screening laparoscopy: a case report
Authors: Wakizaka Kazuki , Khor Lee Wee , Annen Kazuya , Fukushima Tsuyoshi , Furuya Mitsuko , Taketomi Akinobu
Published: December 2021

Background

The most common presentation of symptomatic Meckel’s diverticulum (MD) are intestinal obstruction, gastrointestinal hemorrhage, and inflammation of the MD with or without perforation. Intraperitoneal hemorrhage because of MD is extremely rare. We report a case of MD with intraperitoneal hemorrhage in a child detected with screening laparoscopy.

Case presentation

An 11-year-old girl presented to another hospital with lower abdominal pain and vomiting that lasted for 2 days. Acute appendicitis was suspected, and she was referred to our department. Abdominal enhanced computed tomography showed an abscess in the lower abdomen with ascites in the pelvis. She was diagnosed with a localized intra-abdominal abscess and the decision was made to treat with antibiotics. However, her abdominal pain worsened, with abdominal distension, tenderness and guarding. She was diagnosed with panperitonitis and the decision was made for surgery 5 h after admission. During surgery, laparoscopic observation from the umbilical region revealed 200 ml of fresh blood throughout the peritoneal cavity, originating from the mesentery of the ileum. MD was observed with bleeding from the surrounding mesentery. Small bowel resection was performed, and the patient was discharged on the 5th postoperative day. Pathological findings revealed an MD containing ectopic gastric mucosa and small intestinal ulcer perforation at the base of the MD.

Conclusions

We report an extremely rare case of an MD with intraperitoneal hemorrhage in a child. In pediatric cases, it is possible that perforation with ectopic gastric mucosa may cause massive bleeding because of rupture of the surrounding mesenteric blood vessels.
Usage of pedestrian overpass in Akure, Nigeria
Authors: Olorunfemi Samuel Oluwaseyi , Adeniran Adetayo Olaniyi , Akinsehinwa Feyisola Olajire
Published: December 2021

Background

This study addressed the safety challenge, motivation, and utilization factors regarding the usage of the pedestrian overpass by different people of dissimilar ages alongside Oba Adeshida road at Oja-Oba (Oba market) in Akure, Ondo State, Nigeria. It addressed the following objectives: determined the value of the pedestrian overpass as used by people of different ages; examined the reasons for using the pedestrian overpass in Akure; and examined the performance level of a pedestrian overpass in Akure.

Methods

In total, 384 users (who used the bridge) were purposively sampled for questionnaire administration, but 324 users participated in the questionnaire, which included multiple-choice and open-ended questions. Also, personal observation was employed for queue analysis. The “Semantic Differential Scale” and single-server queue system for the single queue were employed for data analysis.

Conclusions

In Akure, there was low or no usage of the pedestrian overpass when the road median was made use of metal and low concrete; but when the road median was made use of high concrete barrier, there was high usage of the pedestrian overpass. It also revealed that the engineering design of the pedestrian overpass is low compared to the contemporary design solutions in addressing the urban societal needs. The pedestrian overpass was used frequently and every day because it provides access to the car park, market, and central mosque. The performance of the pedestrian overpass in Akure is 105% which indicates that the pedestrian overpass is over-utilized by a pedestrian. It is recommended that there is a need to construct another pedestrian overpass to enhance the efficiency of the structure. The existing and future pedestrian overpass should be redesigned to constitute interesting aesthetics and architectural solutions that could harmonize with the environment and enhance flow of the disabled persons.
The cellular biology of atherosclerosis with atherosclerotic lesion classification and biomarkers
Authors: Melaku Leta , Dabi Addisu
Published: December 2021

Background

Atherosclerosis is a chronic lipid-driven inflammatory disease with infiltration of low-density lipoprotein and is considered as the pivotal step in plaque formation. The aim of the review is to get into the fine details of pathophysiologic mechanisms responsible for atherosclerosis with atherosclerotic lesion classification. It also provides a summary of current biomarkers other than the traditional risk factors so that new treatment modalities can emerge and reduce the morbidity and mortality associated with atherosclerosis.

Main body

In the classification of atherosclerosis made by American Heart Association (AHA), AHA Type I lesion is the earliest vascular change described microscopically. AHA Type II lesion is primarily composed of abundant macrophages. AHA Type III lesion is the earliest of progressive lesions, while AHA Type IV lesion consists of an acellular necrotic core. Various biomarkers are implicated in different stages of the pathophysiological mechanism of plaque formation and evolution. C Reactive Protein plays a direct role in promoting the inflammatory component of atherosclerosis. Fibrinogen was demonstrated to be elevated among patients with acute thrombosis. Higher leukocyte count is associated with a greater cardiovascular risk. Cytokines have been implicated in atheroma formation and complications. High rates of protease activated receptor expression are also induced by interleukin-6 secretion in atherosclerotic lesions and areas of vascular tissue injury. Cluster of differentiation 40 receptor and its ligand have been also detected in atherosclerotic plaques. Osteopontin, acidic phosphoprotein, and osteoprotegerin have emerged as novel markers of atherosclerotic plaque composition. There are also overproductions of matrix metalloproteinases in the rupture-prone regions and promote lipid-necrotic core formation in the atherosclerotic plaque. Myeloperoxidase has been proposed as a marker of plaque instability. Oxidized low-density lipoprotein receptor 1 provides a route of entry for oxidized low-density lipoprotein into the endothelium. A human atherosclerotic lesion also expresses lipoprotein-associated phospholipase A2.

Short conclusion

Atherosclerotic plaques are the battlefield between an unbalanced immune response and lipid accumulation in the intima of arteries. Most of the biomarkers associated with atherosclerosis are indicators of inflammatory response and will also be used for medical purposes.
In silico assessment of chronic toxicity of a combination drug namely ‘Olmesartan medoxomil and Hydrochlorothiazide’, marketed in Bangladesh
Authors: Roy Matrika Saha , Tanjin Rehnuma , Debnath Tanmoy , Sarkar Bidduth Kumar , Modak Prema , Mondal Milon , Sarkar Arghya Prosun , Islam Md Ariful , Kundu Sukalyan Kumar
Published: December 2021

Background

Nowadays combination therapy has become more popular due to their additional effect, synergistic effect and antagonistic effect. Any of these can influence the treatment profile. Combination therapy is used to treat some chronic diseases like diabetes, hypertension, cancer etc. But recently India has banned some fixed dose drug combinations due to their increased chances of adverse drug effects and drug interactions. So it is the time to take a look on the present drug combinations available in Bangladesh. An in silico study may provide important information about their probable toxicities. Drugs available in the combination may deposit slowly in the body and may lead to toxicities. Here an antihypertensive drug combination ‘Olmesartan medoxomil and Hydrochlorothiazide’ had been studied.

Results

Olmesartan medoxomil and Hydrochlorothiazide have not been found to comply any similar protein to interact with each other, thus no possible chance of additional toxicity of the combination in case of long term use.

Conclusions

At first, using PubChem the ligand was searched for a canonical SMILE. By inputting the canonical SMILE in Protox, a basic information about toxicities was predicted. From Swiss Target Prediction, target proteins responsible for both efficacy and toxicity were identified. These protein structures were downloaded from Protein Data Bank and edited with Flare. Undesired amino acid, ligand–ligand complex, fatty acid, and water molecules were removed by PyMOL. Structurally modified proteins and ligands were inputted in Swiss PDB viewer for energy minimization. Energy minimization is a very important step because unfavorable bond length, bond strength and torsion angle between protein and ligand may interfere with docking procedure. Then docking between Olmesartan medoxomil (ligand) and the proteins responsible for efficacy and toxicity was performed by PyRx. Vina binding affinity provided the value of binding strength between the ligand and the proteins, which determines how strong the bond is. The more negative the vina binding affinity, the stronger the bond. Discovery studio software was used to visualize the docking complexes. Same steps were followed for Hydrochlorothiazide to identify proteins responsible for desired and undesired effects, but no toxic effect was found from protox.
Assessment of physical function, quality of life, and medication adherence in elderly patients with rheumatic diseases
Authors: Erdem Sultanoğlu Tuba , Ataoğlu Safinaz , Avşar Burcu , Merkür Ömer Faruk
Published: December 2021

Background

The proportion of older people in the total population has increased in Turkey as well as worldwide. As life expectancy rises, the increasing prevalence of rheumatic diseases poses major problems in the elderly. Comorbid diseases and the aging-induced changes in the endogenous immune response and the pharmacokinetic properties of therapeutic agents may complicate the decision to use a particular drug and result in a different clinical picture and treatment response. We, therefore, aimed to investigate the characteristics of chronic inflammatory diseases, their impact on physical function and quality of life, the prevalence of comorbid diseases that may complicate treatment planning, and treatment adherence in patients aged 65 years or older.

Results

One hundred seventy-four patients were included and divided into two age groups: 18–64 years (group 1, n = 85) and 65 years or older (group 2, n = 89). The mean age of all recruited patients was 57.55 ± 16.98 years. Of 174, 99 (56.9%) were female and 75 (43.1%) were male. The mean duration of rheumatic disease was 7 ± 4.8 years and age at onset was 51.46 ± 14.78 years. Gender distribution differed significantly by age group (P = 0.024). The percentage of females in group 1 was 48.2% and 65.2% in group 2. The occupational status also differed significantly by age group (P < 0.001). 48.2% of group 1 were employed and 57.3% of group 2 were housewives. Marital status varied significantly by age (P < 0.001). The percentage of married was 74.1% in group 1 and the percentage of separated/divorced/widowed in group 2 was 28.1%. There was no difference between groups 1 and 2 in terms of place of residence (P = 0.459). The prevalence of comorbid diseases and the rate of use of medications for comorbid diseases (non-rheumatic treatments) were higher in elderly patients. The rate of use of disease-modifying anti-rheumatic drugs (DMARDs) was 30.3% and biological agents 61.8% in the elderly group (≥ 65 years) (group 2) (P < 0.001). There were positive correlations between, Health Assessment Questionnaire (HAQ), Bath Ankylosing Spondylitis Functional Index (BASFI) and Nottingham Health Profile (NHP) domains in both groups. There was also a significant negative correlation between Medication Adherence Rating Scale (MARS) and all dimensions.

Conclusions

Elderly and younger patients with rheumatic diseases have different demographic and clinical characteristics. Physical function and quality of life are more affected by rheumatic diseases and treatment adherence is poorer in the elderly. Our study found a positive correlation between physical function and quality of life in both age groups. The treatment adherence rating scale showed a negative correlation with physical function and quality of life scores, with individuals with poor treatment adherence having worse physical function and quality of life.
Iron homeostasis pathway DNA methylation trajectories reveal a role for STEAP3 metalloreductase in patient outcomes after aneurysmal subarachnoid hemorrhage
Authors: Heinsberg Lacey W. , Weeks Daniel E. , Alexander Sheila A. , Minster Ryan L. , Sherwood Paula R. , Poloyac Samuel M. , Deslouches Sandra , Crago Elizabeth A. , Conley Yvette P.
Published: December 2021

Background

Following aneurysmal subarachnoid hemorrhage (aSAH), the brain is susceptible to ferroptosis, a type of iron-dependent cell death. Therapeutic intervention targeting the iron homeostasis pathway shows promise for mitigating ferroptosis and improving recovery in animal models, but little work has been conducted in humans. DNA methylation (DNAm) plays a key role in gene expression and brain function, plasticity, and injury recovery, making it a potentially useful biomarker of outcomes or therapeutic target for intervention. Therefore, in this longitudinal, observational study, we examined the relationships between trajectories of DNAm in candidate genes related to iron homeostasis and acute (cerebral vasospasm and delayed cerebral ischemia) and long-term (Glasgow Outcome Scale [GOS, unfavorable = 1–3] and death) patient outcomes after aSAH.

Results

Longitudinal, genome-wide DNAm data were generated from DNA extracted from post-aSAH cerebrospinal fluid (n= 260 participants). DNAm trajectories of 637 CpG sites in 36 candidate genes related to iron homeostasis were characterized over 13 days post-aSAH using group-based trajectory analysis, an unsupervised clustering method. Significant associations were identified between inferred DNAm trajectory groups at several CpG sites and acute and long-term outcomes. Among our results, cg25713625 in the STEAP3 metalloreductase gene (STEAP3) stood out. Specifically, in comparing the highest cg25713625 DNAm trajectory group with the lowest, we observed significant associations (i.e., based onp-values less than an empirical significance threshold) with unfavorable GOS at 3 and 12 months (OR= 11.7,p= 0.0006 andOR= 15.6,p= 0.0018, respectively) and death at 3 and 12 months (OR= 19.1,p= 0.0093 andOR= 12.8,p= 0.0041, respectively). These results were replicated in an independent sample (n= 100 participants) observing significant associations with GOS at 3 and 12 months (OR= 8.2,p= 0.001 andOR= 6.3,p= 0.0.0047, respectively) and death at 3 months (OR= 2.3,p= 0.008) and a suggestive association (i.e.,p-value < 0.05 not meeting an empirical significance threshold) with death at 12 months (OR= 2.0,p= 0.0272). In both samples, an additive effect of the DNAm trajectory group was observed as the percentage of participants with unfavorable long-term outcomes increased substantially with higher DNAm trajectory groups.

Conclusion

Our results support a role for DNAm of cg25713625/STEAP3in recovery following aSAH. Additional research is needed to further explore the role of DNAm of cg25713625/STEAP3as a biomarker of unfavorable outcomes, or therapeutic target to improve outcomes, to translate these findings clinically.
Long-term aspirin use and epigenetic mitotic clocks for cancer risk prediction: findings in healthy colon mucosa and recommendations for future epigenetic aging studies
Authors: Nwanaji-Enwerem Jamaji C. , Nze Chijioke , Cardenas Andres
Published: December 2021

Background

Despite the known role of mitosis in colorectal cancer, previous associations of long-term aspirin use with suppressed cancer-related epigenetic aging did not involve epigenetic mitotic clocks. We investigated these relationships using three epigenetic mitotic clocks developed for cancer risk prediction: EpiTOC, EpiTOC2, and MiAge. We utilized publicly available HumanMethylationEPIC BeadChip data from 112 healthy colon (proximal and distal) mucosal samples taken at baseline (T1) and at 10-years follow-up (T2) from a screening cohort of 28 Polish women (11 non-users and 17 long-term [≥ 2 years] aspirin users). Mitotic clock values were divided by chronological age at each timepoint to obtain intrinsic rates (IRs). We evaluated differences in residuals of the mitotic clock IRs taken from linear mixed effects models adjusted for BMI, polyp status, and DNA methylation batch.

Findings

EpiTOC, EpiTOC2, and MiAge were significantly correlated with chronological age (P < 0.05) with correlations ranging from 0.41 to 0.63. The EpiTOC, EpiTOC2, and MiAge clocks were strongly correlated with each other in proximal and distal samples (r > 0.79, P < 0.0001). We observed proximal within group median clock IR deceleration for EpiTOC (-0.0004 DNAm, P = 0.008), EpiTOC2 (− 16 cell divisions, P = 0.009), and MiAge (− 3 cell divisions, P = 0.002) for long-term aspirin users from T1 to T2 but not for non-users. In distal samples, only the long-term user MiAge IR was significantly deaccelerated (− 3 cell divisions, P = 0.009).

Conclusions

Our observed findings support previously reported longitudinal associations of aspirin use with deceleration of other epigenetic age measures in the proximal colon. Our mitotic clock results suggest that cell proliferation could play a role in some aspirin relationships with epigenetic aging. Furthermore, the findings provide added impetus for establishing gold standards for epigenetic aging and consensus guidelines for more comprehensive reporting in future epigenetic aging cancer studies.
Treatment-resistant depression: therapeutic options when first-line treatments fail
Authors: Wigg Chloe , Costi Sara
Published: December 2021

The Cochrane review by Davies et al aimed to address the lack of clarity on the risks and benefits of switching and augmentation strategies in the pharmacological treatment of treatment-resistant depression in adults who did not respond (or partially responded) to at least 4 weeks of antidepressant treatment at a recommended dose. This commentary assesses their review and their conclusion that augmenting the current antidepressant with mianserin or with an antipsychotic improves depressive symptoms over the short-term (8 to 12 weeks). Their results need to be treated with caution owing to the small body of evidence and individual comparisons supported by one, two or three studies, the limited evidence on long-term effects and the significant gaps in the literature (e.g. a lack of studies assessing dose increases).
A clinical approach to nightmares and bad dreams in cognitive–behavioural therapy
Authors: Carona Carlos , Fonseca Ana
Published: December 2021

Clinicians trained in cognitive–behavioural therapy (CBT) are frequently not trained to work with dreams. Given the high prevalence and impact of nightmares and bad dreams, empowering CBT therapists to effectively work with these sleep phenomena is crucial to improve therapeutic outcomes. This article briefly outlines a cognitive–behavioural model of dreams and reviews some clinical guidelines for directly and indirectly addressing nightmares and bad dreams in CBT practice.