bluuebunny/crossref_metadata_2025 huggingface dataset:
A Mathematical Overview of the Monogamous Marriage in a Multiregion Framework: Modelling and Control
Authors: Lhous Mustapha , Zakary Omar , Rachik Mostafa
Published: August 2020

The main objective of this paper is to develop a new mathematical model to study, analyze, and control the family status in several regions and to discuss the impact of the connectivity of regions and the mobility of residents on the marital status of the family, by adopting a multiregion discrete-time model. The modelling and the control process of the system that describes the case of monogamous marriages in a multiregion framework are considered. Two combined control strategies are proposed, which allow reducing the virgin and divorced individuals and increasing the number of married individuals in a specific region. The first control is considered as the impact of public awareness campaigns to educate virgin men and women about the benefits of marriage for the individual and the society; the second control characterizes the legal procedures, administrative complications, and the heavy financial and social consequences of divorces. The optimal control theory is applied to characterize such optimal strategies and determined numerically using a progressive-regressive discrete scheme to discuss the obtained results.
La diversidad es una fuente de riqueza, humana y económica
Authors: Siri Frites Aldo
Published: August 2020

Las relaciones laborales de una organización comienzan con los procesos de reclutamiento y selección es decir, mucho antes de la contratación e inducción formales, pues las empresas dan a conocer sus valores, estrategias y filosofía organizacionales desde el mismo instante en que llaman a postular, buscan candidatos, toman contacto con ellos y los evalúan. Continuar leyendo...
Is Metabolic Acidosis a Novel Risk Factor for a Long-Term Graft Survival in Patients after Kidney Transplantation?
Authors: Gojowy Damian , Skiba Katarzyna , Bartmanska Magdalena , Kolonko Aureliusz , Wiecek Andrzej , Adamczak Marcin
Published: August 2020

Background: Results of both experimental and clinical studies suggest that metabolic acidosis (MA) contributes to the progression of chronic kidney disease (CKD) and mortality in CKD patients. It is unknown whether the same relationship exists in kidney transplantation (KTx) patients. The aim of this observational study was to examine this relationship between MA and both mortality and renal outcomes in patients after KTx. Methods: Four hundred eighty-six (290 male; 196 female) patients aged 48 ± 12 years, at least 1 year after KTx, were analyzed. Blood HCO3– was measured, and patients were then observed over 3 years. MA was defined as the blood HCO3– concentration <22 mmol/L. The end points of survival analysis were death and initiation of dialysis therapy. In patients who did not reach the above-mentioned end points, the difference between final (after 3 years of follow-up) and initial estimated glomerular filtration rate (eGFR) was calculated. Results: MA was initially diagnosed in 57 (12%) patients after KTx. Three-year patient survival was 89.5% in the MA group and 97.4% in the non-MA group (p = 0.001). Three-year graft survival was 73.7% for patients with MA and 93.0% for patients without MA (p < 0.001). In patients with MA who did not reach study end points, blood bicarbonate concentration at baseline correlated positively with a change in eGFR (R = 0.48, p = 0.002, n = 36). Such a correlation was not found in patients without MA (n = 388). Conclusions: (1) MA significantly increases the risk of mortality in patients after KTx. (2) The intensity of MA may be associated with progression of transplanted kidney dysfunction in KTx patients.
Primary Cutaneous Cryptococcosis: An Unusual Injection Site Infection
Authors: Shalom Guy , Horev Amir
Published: August 2020

Primary cutaneous cryptococcosis (PCC) is an uncommonly reported entity. We describe an unusual case of PCC in an injection site of an immunocompromised patient. The specific case demonstrates a challenging treating dilemma with different alternative treatment choices. In the presented clinical setting, each choice concealed its risks and benefits. We highlight the importance of patient education for taking the appropriate measures for the disinfection of subcutaneous injection sites.
The Efficacy and Therapeutic Outcome of Bipolar Radiofrequency Ablation for the Treatment for Hepatocellular Carcinoma in the Real-World Setting, Compared with Monopolar Radiofrequency Ablation Conducted during the Same Period
Authors: Tanaka Takashi , Takata Kazuhide , Kunimoto Hideo , Fukuda Hiromi , Yamauchi Ryo , Tsuchiya Naoaki , Inomata Shinjiro , Yokoyama Keiji , Morihara Daisuke , Takeyama Yasuaki , Shakado Satoshi , Sakisaka Shotaro , Hirai Fumihito
Published: August 2020

Background: Several reports have suggested that the bipolar radiofrequency ablation (RFA) system is useful for the treatment of hepatocellular carcinoma (HCC). We evaluated the efficacy and safety of the bipolar RFA system for HCC treatment in the real-world setting. Methods: A total of 155 patients with 224 HCC tumors were enrolled. First, we examined the characteristics and outcomes of two RFA systems, monopolar and bipolar. Second, we identified the factors associated with local tumor progression in 72 patients with 104 HCC tumors, who could be followed up for at least 3 months after treatment and had been treated with the bipolar RFA system. Results: Of the baseline characteristics, tumor size and location were associated with the selection of the bipolar RFA system. A sufficient ablative zone margin (≥5 mm) was obtained by bipolar RFA in 81 of 94 (86.1%). The 1- and 2-year local tumor progression rates were 15.6 and 26.3%, respectively. An alpha-fetoprotein-L3 (AFP-L3) ratio >10% (HR: 7.64; 95% CI: 1.7–39.8, p = 0.007) and an insufficient ablative zone margin (<5 mm) (HR: 4.53; 95% CI: 1.02–20.3, p = 0.047) were related to local tumor progression in Cox regression analysis. Although severe adverse events were not observed in most cases, severe hepatic infarction occurred in 1 patient. Conclusions: The bipolar RFA system is safe and effective for HCC treatment. Tumor localization within the liver is an important factor associated with bipolar RFA. Careful follow-up or reconsideration of treatment is necessary for cases with AFP-L3 ratio >10% or insufficient ablative zone margin (<5 mm), which were associated with local tumor progression.
A Case of Hyperintense Liver Metastases of Breast Cancer in the Hepatobiliary Phase on Gadoxetic Acid-Enhanced Magnetic Resonance Imaging
Authors: Yamaguchi Tomoyuki , Oura Shoji , Honda Mariko , Makimoto Shinichiro
Published: August 2020

A 64-year-old woman complaining of left arm and breast edema was referred to our hospital. Mammography and ultrasound could not initially show any masses, but magnetic resonance imaging (MRI) showed ill-defined small masses in her left breast. Histological examination showed the tumor to be triple-negative breast cancer. After neoadjuvant chemotherapy, the patient underwent operation. Postoperative histological examination showed massive cancer remnants in the lymph nodes and lymphatics. Enhanced CT taken at the onset of abdominal pain showed multiple liver masses with ring enhancement 17 months after the operation. Gadoxetic acid-enhanced MRI showed hyperintense masses and presumed broad cancer cell permeation to the liver in the hepatobiliary phase. Due to the histologically proven high lymphatic permeability, metastatic sites, and gadoxetic acid-enhanced MRI findings, we judged the liver metastases as lymphatic liver metastases. Due to the marked liver dysfunction at the onset of abdominal pain, the patient received best supportive care and died in 4 months.
Ileocecal Burkitt’s Lymphoma Presenting as Acute Abdominal Pain
Authors: Abdelmaksoud Mostafa Mosbeh , Alshareef Maram Kheder , Jamjoom Alaa Osama , Hafez Mohamed Tarek
Published: August 2020

Primary gastrointestinal non-Hodgkin’s lymphomas are rare tumors which account for about 0.9% of all gastrointestinal tract tumors. They are usually associated with inflammatory bowel disease, previous radiotherapy, and renal transplantation. We report a case of non-Hodgkin’s lymphoma involving the ileocecal region in a 46-year-old gentleman who presented with acute abdominal pain that mandated emergency laparotomy.
Nail Unit Schwannoma: An Important Consideration in the Differential Diagnosis of Soft Tissue Tumors Affecting the Nail Apparatus
Authors: Dany Mohammed , Fischer Andrew S. , Pei Susan , Ogunleye Temitayo , Elenitsas Rosalie , Rubin Adam I.
Published: August 2020

Schwannoma is a tumor of schwann cell proliferation which presents as a solitary, soft, skin-colored dermal or subcutaneous papulo-nodule most commonly on the flexor part of extremities and head and neck areas. Here, we report a case of nail unit schwannoma, which is a rare tumor of the nail apparatus with only 4 other prior reports in the literature. This case illustrates the importance of including subungual schwannoma in the clinical differential diagnosis of subungual soft tissue tumors. We include a literature review which catalogs and summarizes the current knowledge regarding this unusual nail unit neoplasm.
Male Breast Carcinoma after Irradiation and Long-Term Phenothiazine Exposure: A Case Report
Authors: Hultborn Ragnar , Parris Toshima Z. , Helou Khalil , Borg Åke , De Lara Shahin , Kovács Anikó
Published: August 2020

We present a young male patient with breast cancer having several risk factors likely acting in consort: irradiation of the breast for gynecomastia in adolescence and a life-long administration of phenothiazine for schizophrenia from the age of 16 years, with elevated serum prolactin level resulting in breast cancer development 24 years after irradiation.
IgA Nephropathy Associated with Trifluridine/Tipiracil: A Case Report
Authors: Desbuissons Geoffroy , Ngango Liliane , Brochériou Isabelle , Fournier Philippe
Published: August 2020

Kidney diseases during chemotherapy treatment are variable, with different manifestations depending on the drugs used. Trifluridine/tipiracil is a treatment used in refractory metastatic digestive cancers. Its renal toxicity is poorly described. We report here the onset of a severe IgA nephropathy requiring hemodialysis which occurred several weeks after trifluridine/tipiracil treatment.
Radiotherapy-Induced Fatigue in Breast Cancer Patients
Authors: Kowalczyk Lidia , Deutschmann Christine , Crevenna Richard , Konrad Stefan , Singer Christian F. , Farr Alex
Published: August 2020

Background: A large proportionof breast cancer patients who undergo adjuvant radiotherapy suffer from radiotherapy-induced fatigue. The possible causative factors of this specific side effect are diverse. Summary: Prevalence, duration, and severity of radiotherapy-induced fatigue are dependent on the type of radiotherapy, as well as on the irradiated volume, dose scheme, on the number of radiation fields, the combination with other treatments, diurnal rhythm, smoking, and time-to-hospitalization. Recommended treatments include non-pharmacologic interventions, such as physical and psychosocial interventions. Pharmacologic therapies include treatment with methylphenidate and modafinil. In addition to its early detection with standardized instruments, adequate education to breast cancer patients about risks and predisposing factors of radiotherapy-induced fatigue is essential. Multidimensional strategies help to maintain the patients’ quality of life and therefore guarantee treatment adherence and efficacy. Key Messages: Radiotherapy-induced fatigue is an underreported, underdiagnosed, and undertreated side effect. This review provides an overview of radiotherapy-induced fatigue in breast cancer patients receiving adjuvant radiotherapy.
Diverse Receptor Tyrosine Kinase Phosphorylation in Urine-Derived Tubular Epithelial Cells from Autosomal Dominant Polycystic Kidney Disease Patients
Authors: Ikeda Kisho , Kusaba Tetsuro , Tomita Aya , Watanabe-Uehara Noriko , Ida Tomoharu , Kitani Takashi , Yamashita Noriyuki , Uehara Masahiro , Matoba Satoaki , Yamada Tadaaki , Tamagaki Keiichi
Published: August 2020

Backgrounds: The clinical features of autosomal dominant polycystic kidney disease (ADPKD) differ among patients even if they have the same gene mutation in PKD1 or PKD2. This suggests that there is diversity in the expression of other modifier genes or in the underlying molecular mechanisms of ADPKD, but these are not well understood. Methods: We primarily cultured solute carrier family 12 member 3 (SLC12A3)-positive urine-derived distal tubular epithelial cells from 6 ADPKD patients and 4 healthy volunteers and established immortalized cell lines. The diversity in receptor tyrosine kinase (RTK) phosphorylation by phospho-RTK array in immortalized tubular epithelial cells was analyzed. Results: We noted diversity in the activation of several molecules, including Met, a receptor of hepatocyte growth factor (HGF). Administration of golvatinib, a selective Met inhibitor, or transfection of small interfering RNA for Met suppressed cell proliferation and downstream signaling only in the cell lines in which hyperphosphorylation of Met was observed. In three-dimensional culture of Madin-Darby canine kidney (MDCK) cells as a cyst formation model of ADPKD, HGF activated Met, resulting in an increased total cyst number and total cyst volume. Administration of golvatinib inhibited these phenotypes in MDCK cells. Conclusion: Analysis of urine-derived tubular epithelial cells demonstrated diverse RTK phosphorylation in ADPKD, and Met phosphorylation was noted in some patients. Considering the difference in the effects of golvatinib on immortalized tubular epithelial cells among patients, this analysis may aid in selecting suitable drugs for individual ADPKD patients.
Malignancies in Inflammatory Bowel Disease
Authors: Greuter Thomas , Vavricka Stephan , König Alexander O. , Beaugerie Laurent , Scharl Michael ,   on behalf of Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology
Published: August 2020

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, primarily of, but not restricted to, the gut. Association between IBD and cancer has been clearly established and is uniformly accepted. Summary: IBD patients are at particular risk for intestinal and extraintestinal cancers. There are 2 underlying mechanisms: (1) IBD-related inflammation triggers initiation and progression of tumor formation. This particularly results in the development of colorectal cancer, small bowel adenocarcinoma, intestinal lymphoma, anal cancer, and cholangiocarcinoma. (2) Immunosuppressive drugs exhibit carcinogenic properties such as shown for azathioprine and anti-TNF promoting lymphoproliferative malignancies and melanoma and nonmelanoma skin cancer. However, within the last years, IBD-related cancer incidence and prevalence have been decreasing, which might be attributed to better treatment options and surveillance strategies. Moreover, novel biological drugs have been introduced in clinical practice and have dramatically changed long-term IBD management. Therefore, we sought to summarize up-to-date knowledge about (1) overall cancer risk; (2) risk and protective factors for cancer development; and (3) inflammation- and immunosuppression-related malignancies in the current anti-TNF era of IBD. Key Messages: Recent studies and meta-analyses questioned the excess rates of cancer in IBD patients. However, IBD still is associated with cancer development due to ongoing intestinal inflammation and the use of potential carcinogenic drugs. Patients should be educated about the increased risk of cancer with IBD and IBD drugs. However, they should also be informed that most malignancy subtypes are possibly preventable by controlling intestinal inflammation and by using adequate screening strategies.
A Bayesian Approach to Diagnose Growth Hormone Deficiency in Children: Insulin-Like Growth Factor Type 1 Is Valuable for Screening and IGF-Binding Protein Type 3 for Confirmation
Authors: Inoue-Lima Thais H. , Vasques Gabriela A. , Nakaguma Marilena , Brito Luciana Pinto , Mendonça Berenice B. , Arnhold Ivo J.P. , Jorge Alexander A.L.
Published: August 2020

Background: The utility of insulin-like growth factor type 1 (IGF-1) is well established in the diagnosis of growth hormone deficiency (GHD), whereas IGF-binding protein type 3 (IGFBP-3) has a more controversial role. Most studies evaluated the value of these peptides by assessing their sensitivity and specificity but not considering the low prevalence of GHD among short children (<2%). Objective: To evaluate the utility of basal IGF-1 and IGFBP-3 values in the GHD diagnosis process with a Bayesian approach, based on pre- and post-test probability. Methods: We determined ROC curves, sensitivity, specificity, and positive and negative predictive values for IGF-1 and IGFBP-3 obtained from patients with GHD (n = 48) and GH-sufficient children (n = 175). The data were also analyzed by classifying the children into early childhood and late childhood (girls and boys younger and older than 8 and 9 years, respectively). Results: The area under the curve (AUC) of the receiver operating characteristic curve of IGF-1-SDS (standard deviation score) was greater than that of IGFBP-3-SDS (AUC 0.886 and 0.786, respectively, p = 0.001). In early childhood, the AUC of IGFBP-3-SDS was significantly improved (0.866) and similar to IGF-1-SDS (0.898). IGF-1-SDS, in comparison to IGFBP-3-SDS, had a greater sensitivity (92 vs. 45.8%, respectively), lower specificity (69 vs. 93.8%, respectively), and lower positive predictive value (5.7 vs. 13.1%, respectively), with similar negative predictive values. Conclusion: IGF-1-SDS is a useful screening tool in the diagnosis of GHD. Although IGFBP-3-SDS lacks sensitivity, its high specificity supports the role to confirm GHD in short children, especially in early childhood. This strategy could simplify and reduce the necessity of a second laborious and expensive GH stimulation test to confirm the diagnosis of GHD.
Periokuläre Talgdrüsenkarzinome: Wann auf Muir-Torre-Syndrom testen?
Authors: Bertelmann Eckart
Published: August 2020

Over a period of 1 year, a 74-year-old man slowly developed a painless left upper eyelid intratarsal mass. The skin was movable over the lesion. At surgery, a well-circumscribed, yellow-white, partially cystic tumor was encountered. Histopathologically it was composed of a random mixture of basaloid and sebaceous cells arranged in interconnecting cords. Immunohistochemical evaluation disclosed epithelial membrane antigen, adipophilin, and cytokeratin 14 positivity. These findings led to the diagnosis of a sebaceoma. The tumor cells abnormally failed to express mismatch repair proteins for MLH1 and PMS2. The patient did not have a personal history of any visceral malignancy, but his father had died at the age of 46 years and a daughter at the age of 33 years from colonic carcinomas. The implications of this periocular sebaceoma for the Muir-Torre syndrome are explored.
Allostatic Load and Its Impact on Health: A Systematic Review
Authors: Guidi Jenny , Lucente Marcella , Sonino Nicoletta , Fava Giovanni A.
Published: August 2020

Introduction: Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. Objective: To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. Methods: PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. Results: A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. Conclusions: The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
Avaliação da relação Triglicerídeo/HDL-C e da razão Neutrófilos/Linfócitos em idosos com e sem dislipidemia
Authors: Lima Leticia De , Bortoli Stella , Maciel Margarete Aparecida Salina , Borato Danielle Cristyane Kalva
Published: August 2020

Introdução: As doenças cardiovasculares (DCV) estão entre as principais causas de mortalidade entre idosos, sendo a dislipidemia um importante fator de risco. Além disso, a relação Triglicerídeo/HDL-C e a razão Neutrófilos/Linfócitos apresentam estreita relação com os fatores de riscos para DCV. Objetivo: Comparar as relações Triglicerídeo/HDL-C e Neutrófilos/Linfócitos na população idosa sem e com dislipidemia. Métodos: Estudo documental, transversal, retrospectivo, com abordagem quantitativa e comparativa. A amostra foi de conveniência e incluiu os 110 idosos residentes em uma Instituição de Longa Permanência de Idosos. Foram coletados dados do perfil lipídico, hemograma, idade e sexo. Os idosos foram divididos em dois grupos: Com Dislipidemia e Sem Dislipidemia. As relações Triglicerídeo/HDL-C e Neutrófilos/Linfócitos foram calculadas e comparadas. Os resultados foram apresentados como mediana e intervalo interquartil e analisados pelo teste de Mann-Whitney. As variáveis categóricas foram representadas como frequência absoluta (n) e relativa (%) e avaliadas pelo teste Qui-Quadrado (χ2). Utilizou-se o programa estatístico SPSS 20.0® e nível de significância < 0,05. Resultados: Foram selecionados 84 idosos com resultados do perfil lipídico e hemograma, sendo 56 (67%) idosos do sexo feminino e 28 (33%) do sexo masculino, com idade mediana de 75 (69-81) anos. O grupo Com Dislipidemia apresentou valores superiores para Triglicerídeo/HDL-C e para a relação Neutrófilos/Linfócitos não houve diferença estatística. Conclusão: A relação Triglicerídeo/HDL-C pode ser utilizada como uma medida preventiva de doenças cardiovasculares nos idosos participantes do estudo. Porém, a relação Neutrófilos/Linfócitos deve ser interpretada com cautela nos idosos que apresentam características particulares quanto ao desenvolvimento das DCV.
Atividade física na prevenção de doenças crônicas não transmissíveis em homens
Authors: Aragão Francisca Bruna Arruda , Oliveira Elaynne Silva De , Souza Sérgio Augusto Rosa De , Carvalho Wellington Roberto Gomes De , Bezerra Sonny Állan Silva , Santos Denilson de Menezes , Reis Andréa Dias , Salvador Emanuel Péricles
Published: August 2020

Introdução: A promoção da atividade física (AF) é uma das prioridades das políticas públicas de atenção básica à saúde, especialmente para o público masculino. Objetivo: Avaliar a associação da prática de atividade física com o estilo de vida e presença doenças crônicas não transmissíveis (DCNTs) em usuários do sexo masculino de Unidade Básica de Saúde (UBS). Métodos: Participaram do estudo 119 homens na faixa etária de 20 a 59 anos. A associação entre a prática de atividade física com variáveis sociodemográficas, etilismo, tabagismo, uso de medicamento, presença de doenças crônicas não transmissíveis e conhecimento da política de saúde do homem foi realizada por Regressão Logística com um α=5%. Resultados: A prevalência de atividade física foi de 58,8%, entretanto 36,7% dos participantes faziam uso de medicações diariamente e 70,6% não conhecem a Política Nacional de Atenção Integral à Saúde do Homem. Além disso, fazer atividade física demonstrou como um fator de proteção contra as doenças crônicas não transmissíveis (OR = 2,97; IC 95% 1,03 – 8,55; p = 0,043). Conclusão: A prática de atividade física em homens, independentemente da idade, tabagismo e etilismo foi associada à prevenção de doenças crônicas não transmissíveis.
Edições digitais nas Clássicas: elementos de gênero na produção e leitura da língua grega e do latim
Authors: Ferreira Anise , Blackwell Christopher , Palladino Chiara
Published: August 2020

As edições digitais na área de clássicas têm surgido como aliadas no rompimento de barreiras e no enfrentamento de desafios no ensino das línguas e culturas clássicas. O objetivo deste artigo é destacar algumas características específicas de edições digitais das Letras Clássicas, como possíveis elementos de gênero na sua produção e sua leitura digitais, supondo serem uma forma de contribuir para a mobilização da aprendizagem das línguas clássicas e a formação docente na área. Descrevemos, de um lado, os componentes essenciais no processo de uma edição digital nova do texto grego do Édipo Rei, de Sófocles, preparado na Universidade Furman, para um curso de graduação. De outro, apontamos de que modo as anotações de edições digitais, em alinhamentos, treebanking e geoanotações, na qualidade de experiências de aprendizagem, são potenciais instrumentos de desenvolvimento.
O ensino da apresentação oral em francês e sua contribuição para o letramento acadêmico e para o plurilinguismo na ciência
Authors: Lousada Eliane Gouvea , Silva Emily Caroline , Dias Ana Paula Silva
Published: August 2020

No contexto da internacionalização das pesquisas nas universidades, este artigo apresenta parte dos resultados de um curso sobre o ensino de gêneros textuais da esfera acadêmica em francês. Com base nos pressupostos teóricos do Interacionismo Sociodiscursivo, nos aportes sobre o Letramento Acadêmico e em considerações sobre o plurilinguismo na ciência, o estudo analisou o material didático proposto e as apresentações orais dos alunos através de uma abordagem comparativa entre produção intermediária e produção final. Os resultados revelam um desenvolvimento das capacidades de linguagem dos estudantes e uma consequente contribuição para o Letramento Acadêmico em francês, visando a construir uma ciência plurilíngue.
Long-Term Follow-Up Study on the Uptake of Genetic Counseling and Predictive DNA Testing in Inherited Cardiac Conditions
Authors: van den Heuvel Lieke M. , van Teijlingen Maxiem O. , van der Roest Wilma , van Langen Irene M. , Smets Ellen M.A. , van Tintelen J. Peter , Christiaans Imke
Published: August 2020

Background:

Inherited cardiac conditions present with a wide range of symptoms and may even result in sudden cardiac death. Relatives of probands with a confirmed pathogenic genetic variant are advised predictive DNA testing to enable prevention and treatment. In 2 previous cohort studies of 115 probands with a pathogenic variant, family uptake of genetic counseling was assessed in the first year(s) after test result disclosure to the proband. This study assesses uptake in these cohorts in the 14 to 23 years following disclosure.

Methods:

Uptake was determined retrospectively using patient records. First-degree relatives, and second-degree relatives of a deceased first-degree relative suspected of having an inherited cardiac condition, were considered eligible.

Results:

Of 717 eligible relatives (598 first-degree and 119 second-degree relatives), 60% attended genetic counseling. Most of them (68.6%) attended genetic counseling in the first year. A total of 98.4% of counseled relatives pursued predictive DNA testing. A total of 49.2% was identified as carrier. Median time between disclosure to the proband and counseling of relatives was 6 months (range: 0–187 months). Attending genetic counseling was observed more frequently in first-degree relatives, female relatives, primary arrhythmia syndromes, relatives with manifest inherited cardiac condition, relatives without children and families with sudden cardiac death in first-degree relatives <40 years.

Conclusions:

During median follow-up of 16 years, 60.0% of relatives attended genetic counseling, with 41.0% in the first year. Our results may suggest that some relatives are not or inadequately informed or that barriers against genetic counseling are present. Further research is needed into interventions facilitating family communication, increasing awareness among families and healthcare professionals, and lowering thresholds for genetic counseling.
Disentangling the Links Between Psychosocial Stress and Cardiovascular Disease
Authors: Osborne Michael T. , Shin Lisa M. , Mehta Nehal N. , Pitman Roger K. , Fayad Zahi A. , Tawakol Ahmed
Published: August 2020

Stress is a pervasive component of the human experience. While often considered an adversity to be ignored, chronic stress has important pathological consequences, including cardiovascular disease (CVD). Stress also increases the prevalence and severity of several CVD risk factors, including hypertension, diabetes mellitus, and obesity. Yet even after adjustment, stress’ attributable CVD risk is similar to those risk factors, suggesting it is a particularly potent contributor. Nevertheless, there has been insufficient study of mechanisms linking stress to CVD or of methods to attenuate stress’ pathological impact. This review covers the current concepts of how stress impacts CVD and emerging approaches to mitigate stress-attributable CVD risk.
ST-Segment–Elevation Myocardial Infarction During COVID-19 Pandemic
Authors: Gramegna Mario , Baldetti Luca , Beneduce Alessandro , Pannone Luigi , Falasconi Giulio , Calvo Francesco , Pazzanese Vittorio , Sacchi Stefania , Pagnesi Matteo , Moroni Francesco , Ajello Silvia , Melisurgo Giulio , Agricola Eustachio , Camici Paolo G. , Scandroglio Anna Mara , Landoni Giovanni , Ciceri Fabio , Zangrillo Alberto , Cappelletti Alberto Maria
Published: August 2020

Background:

Coronavirus disease 2019 (COVID-19) pandemic has led to a fast and radical transformation in social, economic, and healthcare networks. COVID-19 outbreak may thus have profound indirect consequences on clinical presentation and management of patients with ST-segment–elevation myocardial infarction (STEMI). Aim of this study was to assess clinical features of patients with STEMI during COVID-19 pandemic.

Methods:

This single-center, prospective study from a regional public service healthcare hub in Milan included all consecutive patients with STEMI admitted to our institute from February 21 to April 1, 2020 (during COVID-19 pandemic). These patients were compared with a historical cohort of patients admitted for STEMI during the analogous time period (February 21 to April 1) in 2018 and 2019, in terms of time from symptoms onset to hospital admission, clinical characteristics, and in-hospital outcomes.

Results:

A total of 26 patients were admitted for STEMI during the study period, and 7 (26.9%) of these patients tested positive for severe acute respiratory syndrome coronavirus 2. On admission, medical therapy, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers use, was similar between cohorts. Median (interquartile range) time from symptoms onset to hospital admission was significantly longer in 2020 as compared to the historical cohort (15.0 [2.0–48.0] versus 2.0 [1.0–3.0] hours;
P
<0.01). A higher proportion of patients presenting with late presentation STEMI was observed in 2020 compared with the historical cohort (50.0% versus 4.8%;
P
<0.01). Primary percutaneous coronary intervention resulted indicated in 80.8% of patients in 2020 compared with 100% in the historical cohort (
P
=0.06). In-hospital death, thromboembolism, mechanical ventilation, or hemodynamic decompensation needing inotropic or mechanical support were similar between years.

Conclusions:

These preliminary results from a cardiovascular regional public service healthcare hub demonstrate a significantly longer time from symptoms onset to hospital admission among patients with STEMI during COVID-19 pandemic compared with the same time period in the previous 2 years.
No Evidence for Erythro-Myeloid Progenitor-Derived Vascular Endothelial Cells in Multiple Organs
Authors: Feng Teng , Gao Zibei , Kou Shan , Huang Xinyan , Jiang Zhen , Lu Zhengkai , Meng Jufeng , Lin Chao-Po , Zhang Hui
Published: August 2020

Rationale:

Endothelial cells are thought to emerge de novo from the mesoderm to form the entire circulatory system. Recently, erythro-myeloid progenitors (EMPs) have been proposed to be another remarkable developmental origin for blood vessels in multiple organs, including the hindbrain, liver, lung, and heart, as demonstrated by lineage tracing studies using different genetic tools. These observations challenge the current consensus that intraembryonic vessels are thought to expand solely by the proliferation of preexisting endothelial cells. Resolution of this controversy over the developmental origin of endothelial cells is crucial for developing future therapeutics for vessel-dependent organ repair and regeneration.

Objective:

To examine the contribution of EMPs to intraembryonic endothelial cells.

Methods and Results:

We first used a transgenic mouse expressing a tamoxifen-inducible Mer-iCre fusion protein driven by the Csf1r (colony stimulating factor 1 receptor) promoter. Genetic lineage tracing based on Csf1r-Mer-iCre-Mer showed no contribution of EMPs to brain endothelial cells identified by several markers. We also generated a knock-in mouse line by inserting an internal ribosome entry site-iCre cassette into the 3′ untranslated region of
Csf1r
gene to further investigate the cellular fates of EMPs. Similarly, we did not find any Csf1r-ires-iCre traced endothelial cells in brain, liver, lung, or heart in development either. Additionally, we found that Kit (KIT proto-oncogene receptor tyrosine kinase) was expressed not only in EMPs but also in embryonic hindbrain endothelial cells. Therefore, Kit promoter–driven recombinase, such as Kit-CreER, is a flawed tool for lineage tracing when examining the contribution of EMPs to hindbrain endothelial cells. We also traced CD45 (protein tyrosine phosphatase receptor type C; Ptprc)
+
circulating EMPs and did not find any CD45 lineage-derived endothelial cells during development.

Conclusions:

Our study suggested that EMPs are not the origin of intraembryonic endothelial cells.
Taxonomic revision of the genus Panca Evans, 1955 (Hesperiidae: Hesperiinae: Hesperiini: Moncina) with the description of two new species
Authors: DE MEDEIROS ADALBERTO DANTAS , DOLIBAINA DIEGO RODRIGO , CARNEIRO EDUARDO , MIELKE OLAF HERMANN HENDRIK , CASAGRANDE MIRNA MARTINS
Published: August 2020

The South American genus Panca Evans, 1955 and its respective species are revised. Previous to this study, the genus included solely its type species, Lerodea subpunctuli Hayward, 1934, until Panca moseri Dolibaina, Carneiro & O. Mielke, 2017 was described recently. However, as a result of a broader morphological study including closely related genera, we here propose that Panca assembles 12 species, most of which inhabit open environments such as the Cerrado biome and the natural grasslands of the Atlantic Forest biome. Eight species formerly included among other genera of Moncina are here combined with Panca: Panca satyr (Evans, 1955) comb. nov., Panca tobiasi (Mielke, 1992) comb. nov., Panca trogon (Evans, 1955) comb. nov., Panca steinhauseri (Dolibaina & A. Warren, 2015) comb. nov., Panca acroleuca (Plötz, 1884) comb. nov., and Panca mirnae (O. Mielke, Dolibaina, Carneiro & A. Warren, 2015) comb. nov. (all formerly in Artines Godman, 1901), Panca paulo (Bell, 1932) comb. nov. (formerly in Eutocus Godman, 1901), and Panca mictra (Evans, 1955) comb. nov. (formerly in Vidius Evans, 1955). Additionally, two new species are described from Brazil: Panca puri Medeiros, O. Mielke & Casagrande sp. nov. (from Pará, Pernambuco, Minas Gerais, Rio de Janeiro and Paraná) and Panca xavante Medeiros, O. Mielke & Dolibaina sp. nov. (from Mato Grosso, Goiás, Distrito Federal and Minas Gerais). A neotype for Apaustus acroleuca Plötz, 1884 is designated. Illustrations of the male and female genitalia and distribution maps are presented for all the species of Panca and an identification key is provided for both sexes.
The trouble with Adineta vaga (Davis, 1873): a common rotifer that cannot be identified (Rotifera: Bdelloidea: Adinetidae)
Authors: ÖRSTAN AYDIN
Published: August 2020

My purpose here is to highlight three long-standing problems in the taxonomy of Adineta vaga (Davis, 1873) and its subspecies: 1. The lack of unique morphological criteria to identify the morphological variant (morphovariant) Davis described; 2. The lack of an evolutionarily meaningful subspecies definition applicable to parthenogenetic bdelloid rotifers; 3. The lack of compliance with the applicable articles of the International Code of Zoological Nomenclature (ICZN; https://tinyurl.com/y8f242an) when subspecies are assigned to A. vaga.
Seasonal Modulation of Trapped Gravity Waves and Their Imprints on Trade Wind Clouds
Authors: Stephan Claudia Christine
Published: August 2020

Shallow convection over the oceans is responsible for the largest uncertainties in climate projections. Idealized simulations have shown decades ago that shallow clouds generate internal gravity waves, which under certain atmospheric background conditions become trapped inside the troposphere and influence the development of clouds. These feedbacks, which occur at horizontal scales of up to several tens of kilometers. are neither resolved nor parameterized in traditional global climate models (GCMs), while the newest generation of GCMs (grid spacings < 5 km) is starting to resolve them. The interactions between the convective boundary layer and trapped waves have almost exclusively been studied in highly idealized frameworks and it remains unclear to what degree this coupling affects the organization of clouds in the real atmosphere or in the new generation of GCMs. Here, the coupling between clouds and trapped waves is examined in 2.5-km simulations that span the entirety of the tropical Atlantic and are initialized and forced with meteorological analyses. The coupling between clouds and trapped waves is sufficiently strong to be detected in these simulations of full complexity. Stronger upper-tropospheric westerly winds are associated with a stronger cloud–wave coupling. In the simulations this results in a highly organized scattered cloud field with cloud spacings of about 19 km, matching the dominant trapped wavelength. Based on the large-scale atmospheric state, wave theory can reliably predict the regions and times where cloud–wave feedbacks become relevant to convective organization. Theory, the simulations, and satellite imagery imply a seasonal cycle in the trapping of gravity waves.
Sensitivity of MCS Low-Frequency Gravity Waves to Microphysical Variations
Authors: Adams-Selin Rebecca D.
Published: August 2020

The sensitivity of low-frequency gravity waves generated during the development and mature stages of an MCS to variations in the characteristics of the rimed ice parameterization were tested through idealized numerical simulations over a range of environment shears and instabilities. Latent cooling in the simulations with less dense, graupel-like rimed ice was more concentrated aloft near the melting level, while cooling in simulations with denser, hail-like rimed ice extended from the melting level to the surface. However, the cooling profiles still had significant internal variability across different environments and over each simulation’s duration. Initial wave production during the MCS developing stage was fairly similar in the hail and graupel simulations. During the mature stages, graupel simulations showed stronger perturbations in CAPE due to the cooling and associated wave vertical motion being farther aloft; hail simulations showed stronger perturbations in LFC due to cooling and wave vertical motion being concentrated at lower levels. The differences in the cooling profiles were not uniform enough to produce consistently different higher-order wave modes. However, the initiation of discrete cells ahead of the convective line was found to be highly sensitive to the nature of the prior destabilizing wave. Individual events of discrete propagation were suppressed in some of the graupel simulations due to the higher location of both peak cooling and vertical wave motion. Such results underscore the need to fully characterize MCS microphysical heating profiles and their low-frequency gravity waves to understand their structure and development.
Long-Term Statistics of Riming in Nonconvective Clouds Derived from Ground-Based Doppler Cloud Radar Observations
Authors: Kneifel Stefan , Moisseev Dmitri
Published: August 2020

Riming is an efficient process of converting liquid cloud water into ice and plays an important role in the formation of precipitation in cold clouds. Due to the rapid increase in ice particle mass, riming enhances the particle’s terminal velocity, which can be detected by ground-based vertically pointing cloud radars if the effect of vertical air motions can be sufficiently mitigated. In our study, we first revisit a previously published approach to relate the radar mean Doppler velocity (MDV) to rime mass fraction (FR) using a large ground-based in situ dataset. This relation is then applied to multiyear datasets of cloud radar observations collected at four European sites covering polluted central European, clean maritime, and Arctic climatic conditions. We find that riming occurs in 1%–8% of the nonconvective ice containing clouds with median FR between 0.5 and 0.6. Both the frequency of riming and FR reveal relatively small variations for different seasons. In contrast to previous studies, which suggested enhanced riming for clean environments, our statistics indicate the opposite; however, the differences between the locations are overall small. We find a very strong relation between the frequency of riming and temperature. While riming is rare at temperatures lower than −12°C, it strongly increases toward 0°C. Previous studies found a very similar temperature dependence for the amount and droplet size of supercooled liquid water, which might be closely connected to the riming signature found in this study. In contrast to riming frequency, we find almost no temperature dependence for FR.
Decadal Variability of the Anticyclone in the Western North Pacific
Authors: Xie Mingmei , Wang Chunzai
Published: August 2020

The western North Pacific anomalous anticyclone (WNPAC) significantly affects East Asian climate. Previous studies have elucidated interannual variability of the WNPAC associated with El Niño, but decadal variability of the WNPAC remains unknown. The present paper investigates the dominant modes of decadal variability of the WNPAC by using observational data. The first decadal mode, characterized by an anomalous anticyclone centered over the western North Pacific, is associated with the Pacific decadal oscillation (PDO). The relationship between the first mode and the PDO shifted from in phase to out of phase around 1966. From 1900 to 1966 when the PDO and the first mode are in phase, the anticyclone is maintained by the effects of both the strengthened Aleutian low through meridional atmospheric forcing and Indian Ocean warming through enhanced zonal Walker circulation. From 1967 to 2012, the anticyclone is induced by cold SST anomalies over the central equatorial Pacific when the PDO and the first mode are out of phase. The second decadal mode is characterized by an anomalous anticyclone extending from southeastern China to the Philippine Sea and is associated with the Maritime Continent (MC). This anticyclone resides in the sinking branch of the local Hadley circulation, triggered by enhanced convection associated with the MC warming from 1900 to 2012. The finding of the decadal WNPAC in this paper may provide a new way to explain East Asian climate on a decadal time scale.
How Does the Quasi-Biennial Oscillation Affect the Boreal Winter Tropospheric Circulation in CMIP5/6 Models?
Authors: Rao Jian , Garfinkel Chaim I. , White Ian P.
Published: August 2020

Using 17 CMIP5 and CMIP6 models with a spontaneously generated quasi-biennial oscillation (QBO)-like phenomenon, this study explores and evaluates three dynamical pathways for impacts of the QBO on the troposphere: 1) the Holtan–Tan (HT) effect on the stratospheric polar vortex and the northern annular mode (NAM), 2) the subtropical zonal wind downward arching over the Pacific, and 3) changes in local convection over the Maritime Continent and Indo-Pacific Ocean. More than half of the models can reproduce at least one of the three pathways, but few models can reproduce all of the three routes. First, seven models are able to simulate a weakened polar vortex during easterly QBO (EQBO) winters, in agreement with the HT effect in the reanalysis. However, the weakened polar vortex response during EQBO winters is underestimated or not present at all in other models, and hence the chain for QBO, vortex, and tropospheric NAM/AO is not simulated. For the second pathway associated with the downward arching of the QBO winds, 10 models simulate an inconsistent extratropical easterly anomaly center over 20°–40°N in the Pacific sector during EQBO, and hence the negative relative vorticity anomalies poleward of the easterly center is not present in those models, leading to no consensus on the height response over the North Pacific between those models and the reanalysis. However, the other seven models do capture this effect. The third pathway is only observed in the Indo-Pacific Ocean, where the strong climatological deep convection and the warm pool are situated. Seven models can simulate the convection anomalies associated with the QBO over the Maritime Continent, which is likely caused by the near-tropopause low buoyancy frequency anomalies. No robust relationship between the QBO and El Niño–Southern Oscillation (ENSO) events can be established using the JRA55 reanalysis, and 10 models consistently confirm little modulation of the ocean basinwide Walker circulation and ENSO events by the QBO.
Rapid Local Urbanization around Most Meteorological Stations Explains the Observed Daily Asymmetric Warming Rates across China from 1985 to 2017
Authors: Jiang Shaojing , Wang Kaicun , Mao Yuna
Published: August 2020

The increasing rate of the observed daily minimum temperatureTminhas been much higher than that of the observed daily maximum temperatureTmaxduring the past six decades across China. In this study, the local urbanization impact on these observed asymmetric warming rates was investigated. The latest released land-cover data with a 30-m spatial resolution and annual temporal resolution from 1985 to 2017 were used to quantify the urbanization ratios around weather stations. Although urbanized areas occupied only 2.25% of the landmass in China, the percentage of stations with an urbanization ratio over 20% increased from 22.1% to 68.2% during the period 1985–2017. Significant asymmetric warming rates at urban stations were identified, which were approximately 3 times larger compared to the average asymmetry observed at all 2454 stations in China. However, this asymmetry disappeared at rural stations. These differences are mainly due to the rapid local urbanization around most meteorological stations in China since 1985, which affected the spatial representation of observations and led to the observed asymmetry warming rates. The results reported here indicate that the observed asymmetric warming rate over China from 1985 to 2017 is an observational bias due to local urbanization around most stations rather than large-scale climate change. The results also explain the phenomenon that the observed warming rate ofTminremains higher than that ofTmaxafter 1990 when the surface solar radiation stops decreasing in China.