bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between Blood Cell Profiles and Primary Open-Angle Glaucoma: A Retrospective Case-Control Study
Authors: Tang Binghua , Li Shengjie , Han Jianping , Cao Wenjun , Sun Xinghuai
Published: February 2020

Purpose: We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune inflammation index (SII) were associated with primary open-angle glaucoma (POAG). Materials and Methods: This retrospective case-control study included 240 patients with POAG and 300 age- and sex-matched control subjects. Complete ophthalmological examination and blood count measurements were performed for all subjects. Results: The values of NLR, PLR, and SII in the POAG group were significantly increased compared with the control group (p < 0.001; p = 0.012; p < 0.001). However, the LMR value was lower in the POAG patients than in the control group (p < 0.001). When we divided the subjects into different age and gender subgroups, the NLR and SII values in the POAG patients were always higher than those in the control group. In the comparison of laboratory parameters in POAG subjects stratified according to severity, we also found that NLR and SII increased with the severity. The receiver operating characteristic (ROC) analysis revealed that the areas under the ROC curve of NLR, PLR, LMR, and SII to predict patients with POAG were found to be 0.627, 0.569, 0.382, and 0.986, respectively. The best cutoff point of NLR was 1.998 with a sensitivity of 59.8% and a specificity of 63.0%, and the SII was 947.365 with a sensitivity of 95.4% and a specificity of 95.7%. Multivariable logistic regression analysis showed that NLR was positively associated with mean deviation; moreover, NLR and SII were independent indicators correlated with POAG (OR 1.502; 95% CI 1.227–1.839; p < 0.001; OR 1.02; 95% CI 1.009–1.021; p < 0.001). Conclusion: We speculated that elevated NLR and SII might serve as readily available inflammatory predictors in POAG patients.
Glomerular, Mesangial, and Tubular Cytoplasmic Fibrillary Inclusions in a Patient with Light-Chain Proximal Tubulopathy
Authors: Chung Edmund Y.M. , McIlroy Kirsten , Fung Caroline , Seshan Surya V. , Moran Steven , Coleman Patrick L.
Published: February 2020

Monoclonal immunoglobulin or free light chains, produced in the setting of plasma cell dyscrasias, are a common cause of kidney injury with a wide variety of disease patterns. Light-chain proximal tubulopathy is a rare form of this disease that is often difficult to diagnose due to its relatively indolent presentation, subtle light microscopic findings, and often negative immunofluorescence using routine laboratory techniques. We report a case of light-chain proximal tubulopathy with cytoplasmic fibrillary inclusions in tubular cells, glomerular endothelial cells, and mesangial cells, which were positive for κ light chains on immunostaining after pronase digestion. Cytoplasmic fibrillary inclusions, composed of monoclonal protein, are strongly suggestive of underlying plasma cell dyscrasias, and such cases warrant further hematological investigations.
Symptomatic Pneumocephalus after Deep Brain Stimulation Surgery: Report of 2 Cases
Authors: Albano Luigi , Rohatgi Pratik , Kashanian Alon , Bari Ausaf , Pouratian Nader
Published: February 2020

Background: Symptomatic pneumocephalus is an uncommon complication of cranial surgery. Reports of symptomatic pneumocephalus in deep brain stimulation (DBS) surgery are lacking, due to the rarity of this condition. The ­authors describe 2 patients who experienced clinically significant intraparenchymal pneumocephalus as a consequence of DBS surgery and report their clinical presentations, treatments, and outcomes. Cases Descriptions: The first patient was a 69-year-old woman with Parkinson disease and the second was a 73-year-old woman with medically refractory essential tremor. Both patients underwent DBS implantation and developed focal neurological deficits in the days after surgery. In each case, immediate postoperative head computed tomography scans showed extra-axial pneumocephalus which redistributed on subsequent imaging along the dorsal length of the lead. For each patient, a second surgery was carried out to evacuate the pneumocephalus without lead removal. Clinical symptoms and radiological signs of intracranial air were resolved on the last follow-up. Conclusion: Symptomatic intraparenchymal pneumocephalus is a rare complication of DBS surgery which can be treated with surgical evacuation.
Sustained Stable Disease with Capecitabine plus Bevacizumab in Metastatic Appendiceal Adenocarcinoma: A Case Report
Authors: Arias Ron David , Labandeira Carmen M. , Cameselle García Soledad , García Mata Jesús , Salgado Fernández Mercedes
Published: February 2020

In a patient who had been diagnosed in 2006 with appendiceal adenocarcinoma with peritoneal metastases after an incomplete surgery, palliative chemotherapy was administered. First-line treatment with 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX) and second-line treatment including 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) plus panitumumab showed inefficiency in controlling disease progression. Third-line chemotherapy combining capecitabine plus bevacizumab was started, achieving good control of the tumour growth and a minor response in the second computed tomography scan. We decided to maintain the treatment, although forced bevacizumab “breaks” were necessary due to unexpected adverse events, with the patient suffering disease progression every time bevacizumab was stopped and reaching minor response again once the antiangiogenic treatment was reintroduced. During more than 10 years after starting third-line treatment, the patient maintained good performance status and disease stability with this “up and down” management until January 2019, when a neurological adverse event during bevacizumab infusion drove us to abandon it definitely.
Multiple Fixed Drug Eruption Mimicking Parapsoriasis en Plaque in a Patient with Hepatitis C Virus Infection
Authors: Katsuta Michie , Asahina Akihiko , Shiohara Tetsuo
Published: February 2020

Although hepatitis C virus (HCV) infection is often associated with extrahepatic cutaneous manifestations such as lichen planus, it is unclear whether HCV per se or HCV-specific immune responses play a pathophysiological role in the development of HCV-related cutaneous diseases. We recently treated a patient who developed parapsoriasis en plaque-like lesions after ingestion of various drugs. She showed hypersensitivity to multiple drugs after interferon therapy. Her clinical course was complicated by flares of parapsoriasis-like lesions which returned at precisely the same sites. The flares had begun within hours of ingesting nicardipine hydrochloride, amlodipine besilate, candesartan cilexetil and atenolol for the first time despite showing a low level of HCV RNA. Interestingly, the flares gradually subsided during continued treatment with these drugs while her HCV RNA level paradoxically increased: thus, there was an inverse correlation between flares and HCV RNA level. The eruptions were eventually diagnosed as fixed drug eruption, although the clinical manifestations mimicked parapsoriasis en plaque. Our results suggest that multiple drug hypersensitivity could be induced by antiviral immune responses that are cross-reactive to multiple drugs, but not by HCV per se.
Rheumatic Mitral Stenosis: Long-Term Follow-Up of Adult Patients with Nonsevere Initial Disease
Authors: Bitan Amram , Mazor-Dray Efrat , Weinstein Jean Marc , Carmel Sarah , Ilia Reuben
Published: February 2020

Introduction: There is no consensus regarding the natural history of rheumatic mitral stenosis (MS) among adults presenting with nonsevere disease. This study aims to describe the progression of stenosis among adult rheumatic MS patients, to identify predictive factors for progression, and to assess the incidence of complications. Methods: A retrospective cohort analysis was performed among patients with rheumatic MS treated at a single center. Eighty-five patients were included with mild to moderate MS, ≥30 years old on initial echocardiography. Demographics, medical history, echocardiographic reports over at least 10 years, and related complications were obtained from a computerized database. Results: Over a period of 13.1 ± 2.38 years, 75 patients (88%) had no significant progression in stenosis severity. The final echocardiographic assessment demonstrated 2 groups with a significant difference between them regarding the mitral valve area (1.58 ± 0.44 vs. 1.1 ± 0.26 cm2, p = 0.001) and mean valvular pressure gradient (6.27 ± 2.52 vs. 8.5 ± 2.69 mm Hg, p = 0.01). Patients with indolent MS (group A) were compared to patients with progressive disease (group B), and a higher percent of Bedouin patients were found in group B (OR 8.036, p = 0.015). No significant differences were found in other parameters. Complications including atrial fibrillation, cerebral ischemic events, and impaired right ventricle function, although frequent, were not statistically different between the groups. Conclusions: An indolent natural progression of rheumatic MS was observed in our study. Despite this finding, it still has potentially deleterious effects. Bedouin patients have a higher risk for progressive disease.
A Rare Case of Severe Copper Deficiency in an Infant with Exclusive Breast Feeding Mimicking Myelodysplastic Syndrome
Authors: Kohla Samah , Ali Elrazi , Amer Aliaa , Yousif Tayseer , Yassin Mohamed A.
Published: February 2020

An 11-month-old full-term female infant was referred to the hematology clinic due to marked anemia and neutropenia. She was almost exclusively breastfed and rejecting all trials for supplementary food including artificial formulas. Bone marrow aspirate revealed cytoplasmic vacuolization in precursors of the myeloid and erythroid series with significant dysgranulopoiesis and dyserythropoiesis and ringed sideroblasts. Flow cytometry analysis revealed increased hematogones with aberrant loss/downregulation of CD33 on granulocytes and monocytes (sign of dysmyelopoiesis). Laboratory investigation revealed low serum copper and ceruloplasmin. Administration of a multivitamin including a high concentration of copper for only 1 week improved her hemoglobin and absolute neutrophil count up to 1.9 × 103/µL, then dropped to 0.3 103/µL after she stopped taking the copper multivitamin. Her blood counts improved till total normalization and up to the time this report is issued. The probable role of unrecognized copper deficiency in causing anemia in infants more than 6 months of age is discussed, and the importance of serum copper examination in refractory anemia and neutropenia is emphasized. This case shows that copper deficiency should be an integral part of the differential diagnosis of refractory anemia including sideroblastic anemia and dysplasia. To the best of our knowledge, no such case has previously been described in the literature.
Verification of the Deep Brain Stimulation Electrode Position Using Intraoperative Electromagnetic Localization
Authors: Burchiel Kim J. , Kinsman Michael , Mansfield Kevin , Mitchell Ann
Published: February 2020

Background: Electromagnetic (EM) localization has typically been used to direct shunt catheters into the ventricle. The objective of this study was to determine if this method of EM tracking could be used in a deep brain stimulation (DBS) electrode cannula to accurately predict the eventual location of the electrode contacts. Methods: The Medtronic AxiEMTM system was used to generate the cannula tip location directed to the planned target site. Prior to clinical testing, a series of phantom modelling observations were made. Results: Phantom trials (n = 23) demonstrated that the cannula tip could be accurately located at the target site with an error of between 0.331 ± 0.144 and 0.6 ± 0.245 mm, depending on the orientation of the delivery system to the axis of the phantom head. Intraoperative EM localization of the DBS cannula was performed in 84 trajectories in 48 patients. The average difference between the planned target and the EM stylet location at the cannula tip was 1.036 ± 0.543 mm. The average error between the planned target coordinates and the actual target electrode location (by CT) was 1.431 ± 0.607 and 1.145 ± 0.636 mm for the EM stylet location in the cannula (p = 0.00312), indicating that EM localization reflected the position of the target electrode more accurately than the planned target. Conclusions: EM localization can be used to verify the position of DBS electrodes intraoperatively with a high accuracy.
Analysis of Sensitization Profiles in Central European Allergy Patients Focused on Animal Allergen Molecules
Authors: Vachová Martina , Panzner Petr , Vlas Tomáš , Vítovcová Petra
Published: February 2020

Introduction: Frequently observed multiple sensitizations to several animals highlights the importance of a molecular diagnosis, distinguishing between sensitizations specific to single species and sensitizations due to cross-reactivity. Objective: The aim of our study was to assess the usefulness of a molecular diagnosis in the description of sensitization profiles in allergy patients living in Central Europe, with a particular focus on animal-derived molecules. Methods: The molecular diagnosis was performed using the ImmunoCAP ISAC microarray. Results of 1,255 allergy patients were subjected to statistical analysis. Results: The highest sensitization rates were observed for uteroglobin Fel d 1 (31.8%) and kallikrein Can f 5 (16.4%), followed by animal lipocalins Can f 1 (13.9%), Equ c 1 (6.2%), Fel d 4 (5.3%), Can f 2 (4.2%), and Mus m 1 (4.1%). Sensitization rates to serum albumins Fel d 2, Can f 3, Equ c 3, and Bos d 6 were very low, with the highest being 3.2% to Fel d 2. Detailed subanalysis confirmed the dominant role of Fel d 1 or Can f 5 and/or Can f 1 in cat- or dog-sensitized patients, respectively. Further analysis focused on lipocalins and albumins confirmed a high rate of cosensitizations within both groups. Conclusion: The sensitization to animal allergen molecules is very frequent in Central Europe. The most common is sensitization to species-specific cat uteroglobin Fel d 1 and dog kallikrein Can f 5, followed by sensitizations to animal lipocalins. Our data suggest that commonly observed multiple sensitizations detected by extract approach can be explained not only by true cosensitization, but also by cross-reactivity, mainly in the frame of lipocalins. Cross-reactive serum albumins are minor sensitizers and are probably not important from this point of view.
Korean Red Ginseng Inhibits Amyloid-β-Induced Apoptosis and Nucling Expression in Human Neuronal Cells
Authors: Choi Suyun , Lim Joo Weon , Kim Hyeyoung
Published: February 2020

Introduction: The accumulation of amyloid-β (Aβ) plaque in the brain is a characteristic feature of Alzheimer’s disease (AD) and the cause of fatal oxidative damage to neuronal cells. Korean red ginseng (RG) is used extensively in traditional medicine and is known to have anti-oxidative and anti-inflammatory properties. Objective: This study aims to investigate whether Korean RG extract inhibits Aβ-induced neuronal apoptosis. Methods: Human neuronal cells (SH-SY5Y cells) were stimulated with Aβ (5 μmol/L) and treated with RG dissolved in phosphate-buffered saline (0.2, 2, 20 μg/mL). Results: RG suppressed the reduction of cell viability and the increase in apoptotic factors (Bax/Bcl-2 ratio and caspase-3 activity) in Aβ-treated cells. RG suppressed Aβ-induced increases in intracellular and mitochondrial reactive oxygen species (ROS) levels and mitochondrial dysfunction (determined by low mitochondrial membrane potential and oxygen consumption rate) in a dose-dependent manner. RG inhibited nuclear factor kappa-light-chain-enhancer of activated B cells (NF-ĸB) activation and expression of the pro-apoptotic gene Nucling in Aβ-treated cells. Conclusion: RG confers protection against neuronal apoptosis by reducing ROS levels and suppressing mitochondrial dysfunction and NF-κB activation, which results in suppression of NF-κB-mediated activation of Nucling expression in Aβ-treated cells. Supplementation with RG may be beneficial for preventing Aβ-induced neuronal cell death associated with AD.
Dementia Research Fit for the Planet: Reflections on Population Studies of Dementia for Researchers and Policy Makers Alike
Authors: Brayne Carol E. , Barnes Linda E. , Breteler Monique M.B. , Brooks Rachael L. , Dufouil Carole , Fox Chris , Fratiglioni Laura , Ikram M. Arfan , Kenny Rose A. , Kivipelto Miia , Lobo Antonio , Musicco Massimo , Qiu Chengxuan , Richard Edo , Riedel-Heller Steffi G. , Ritchie Craig , Skoog Ingmar , Stephan Blossom C.M. , Venneri Annalena , Matthews Fiona E.
Published: February 2020

In recent years, a rapidly increasing collection of investigative methods in addition to changes in diagnostic criteria for dementia have followed “high-tech” trends in medicine, with the aim to better define the dementia syndrome and its biological substrates, mainly in order to predict risk prior to clinical expression. These approaches are not without challenge. A set of guidelines have been developed by a group of European experts in population-based cohort research through a series of workshops, funded by the Joint Program for Neurodegenerative Disorders (JPND). The aims of the guidelines are to assist policy makers and researchers to understand (1) What population studies for ageing populations should encompass and (2) How to interpret the findings from population studies. Such studies are essential to provide evidence relevant to the understanding of healthy and frail brain ageing, including the dementia syndrome for contemporary and future societies by drawing on the past.
Early Repolarization Pattern and Left Ventricular Mass in Hypertrophic Cardiomyopathy
Authors: Azevedo Pedro Miguel Oliveira  , Guerreiro Cláudio , Ladeiras-Lopes Ricardo , Ferreira Nuno , Faria Rita , Barbosa Raquel , Primo João , Braga José 
Published: February 2020

Background: J-point elevation in the inferior and/or lateral leads is associated with an increased incidence of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM), although the exact underlying mechanism is not known. As severe left ventricular hypertrophy and late gadolinium enhancement (LGE) are important risk factors for SCD in this population, we aimed to assess whether there was an association between an early repolarization pattern (ERP) and greater left ventricular mass (LVM) and LGE extent among patients with HCM. Methods: This was a retrospective cohort study of 85 consecutive patients with HCM who underwent cardiac magnetic resonance (CMR) and had an electrocardiogram without confounders (intraventricular conduction delay, complete left or right bundle branch block, or ventricular paced rhythm). Baseline characteristics and MRI-derived LVM and LGE extent were compared between patients with and without ERP. Results: ERP was present in 9 out of 85 patients (10.6%). Patients with ERP had greater indexed LVM compared to those without (112.5 ± 26.3 vs. 87.8 ± 24.6 g/m2, p = 0.006). Logistic regression analysis revealed a 4.2-fold increase in the odds of prevalent ERP per standard deviation increase in body surface area-indexed LVM (odds ratio 4.2; 95% CI 1.54–11.4, p = 0.005). There were no statistically significant differences regarding LGE extent between groups. Conclusion: ERP is associated with greater CMR-derived LVM among patients with HCM. This finding could partially explain the association between J waves and a higher risk of SCD in this population. There were no differences in LGE extent. Further studies are needed to confirm this association and evaluate the importance of ERP as a marker of increased risk of SCD in HCM.
Blood Platelet Count at Hospital Admission Impacts Long-Term Mortality in Patients with Acute Coronary Syndrome
Authors: Małyszczak Artur , Łukawska Agata , Dyląg Izabela , Lis Weronika , Mysiak Andrzej , Kuliczkowski Wiktor
Published: February 2020

Introduction: Platelets play a fundamental role in the pathogenesis of acute coronary syndrome (ACS). The platelet count (PC) at hospital admission is easy to obtain, but whether thrombocytopenia or/and thrombocytosis impact long-term mortality (LTM) after ACS is unclear. Objective: To evaluate the effect of PC at hospital admission on LTM in patients with ACS. Methods: This retrospective cohort study included patients with the ICD-10 codes for unstable angina (I.20) and acute myocardial infarction (I.21, I.22). Thrombocytopenia was defined as a blood PC <150 G/L and thrombocytosis as a PC >450 G/L. Additional platelet indices which were tested included plateletcrit (PCT), the mean platelet volume (MPV), the platelet distribution width (PDW), and the platelet larger cell ratio (P-LCR). Data on all-cause death were obtained from the National Health Fund database. Results: The study included 3,162 patients with a median follow-up of 27.2 months (interquartile range 12.5–46.8 months; max 68.7 months). Patients with thrombocytopenia and thrombocytosis yielded a higher maximal analyzed 5-year mortality rate in comparison with normal PC patients (45.8 and 47.7 vs. 24.2%, respectively; p < 0.00001) which was mainly driven by higher deaths at 1–2 years after ACS. The 5-year LTM was also significantly higher in patients with abnormal PCT and MPV levels in comparison with patients with PCT and MPV within the normal range. Other platelet indices (PDW, P-LCR) were not associated with a worse outcome. The Cox proportional hazards model revealed that thrombocytopenia at admission was independently associated with higher LTM after ACS (RR 1.83; 95% CI 1.1–3.0; p = 0.01). Conclusions: Both thrombocytopenia and thrombocytosis at hospital admission in post-ACS patients are associated with a significant almost two times higher 5-year mortality rate.
Bullous Pemphigoid in Which Eruption Developed Exclusively on Preexisting Eruption of Vitiligo Vulgaris
Authors: Oka Masahiro , Fukumoto Takeshi
Published: February 2020

Coexistence of bullous pemphigoid (BP) and vitiligo vulgaris (VV) is very rare. We present a unique case of BP associated with VV in a 76-year-old Japanese man, in which BP eruption developed exclusively on preexisting VV regions. The patient was referred to us with a 3-month history of blistering eruption with severe pruritis on the right forearm and left lower limb. In addition, he had been suffering from a widespread depigmented eruption on the trunk and extremities for at least 20 years. Curiously, the blistering eruption developed exclusively on preexisting depigmented eruption. Histopathological and laboratory examinations identified the blistering eruption as BP. The depigmented eruption was diagnosed as VV. BP eruption responded quickly to oral prednisolone therapy, improving within 1 week, and the prednisolone dose was gradually tapered. Within 1 month, BP lesions almost completely resolved. In the present case, BP not only coexisted with VV, but also developed exclusively on preexisting vitiliginous regions. The present case strongly suggests that BP and VV are partly caused by common pathological mechanisms.
Reduced Plasma NT-proBNP Levels Months after Myocardial Infarction Postconditioned with Lactate-Enriched Blood
Authors: Koyama Takashi , Munakata Masahito , Akima Takashi , Kanki Hideaki
Published: February 2020

Background: We recently reported a new approach, namely postconditioning with lactate-enriched blood (PCLeB), for cardioprotection in patients with ST-segment elevation myocardial infarction (STEMI). Objectives: We examined the effects of PCLeB on plasma NT-proBNP levels months after myocardial infarction (MI). Methods: The study included consecutive patients (n = 31) undergoing percutaneous coronary intervention (PCI) for anterior STEMI within 12 h of symptom onset in our hospital between March 2014 and August 2018. We retrospectively compared plasma NT-proBNP levels several months after MI in these patients with those in historical control patients (n = 32). The control patients included consecutive patients who underwent successful PCI without PCLeB for anterior STEMI within 12 h of symptom onset in our hospital between March 2009 and February 2014. We compared the highest plasma NT-proBNP values 6–10 months after MI in the postconditioned patients with the lowest plasma NT-proBNP values 6–10 months after MI in the control patients. In the PCLeB protocol, the duration of each brief reperfusion was increased stepwise from 10 to 60 s. Lactated Ringer’s solution (30 mL) was injected directly in the culprit coronary artery at the end of each brief reperfusion. Each ischemic episode lasted 60 s. Results: Plasma NT-proBNP levels in the postconditioned patients months after MI (211 ± 207 pg/mL) were significantly lower than those in the control patients (516 ± 598 pg/mL; p < 0.0001). Conclusion: PCLeB was associated with reduced plasma NT-proBNP levels months after MI.
Factors Associated with Elective Withdrawal of Maintenance Hemodialysis: A Case-Control Analysis
Authors: Wetmore James B. , Yan Heng , Gilbertson David T. , Liu Jiannong
Published: February 2020

Background: Associations of demographic factors with elective dialysis withdrawal and setting of death, patterns of illness trajectories preceding death, and how illness trajectories, particularly worsening putative disability, are associated with elective withdrawal are poorly understood. Methods: Using United States Renal Data System data, we performed a case-control analysis of hemodialysis patients who died in 2010–2015. A disability proxy score characterized disability; logistic regression identified characteristics associated with death from withdrawal and with death setting; and group-based trajectory models characterized the trajectory of disability in the months preceding death. Results: We identified 14,571 (9.2%) patients who withdrew and 144,305 (90.8%) who died of a non-withdrawal cause. Women were more likely than men to withdraw (OR 1.19, 95% CI 1.15–1.24). The most rural patients were more likely to withdraw than the most urban (OR 1.37, 95% CI 1.25–1.50). Medicaid coverage (a marker for impoverishment) was associated with less withdrawal (OR 0.90, 95% CI 0.86–0.94). Disability proxy score was strongly related to withdrawal: the OR for patients in the highest score category was 31.16 (95% CI 28.40–34.20) versus those with a score of 0. Women and whites (vs. blacks) were overrepresented in the worst, versus better, proxy disability score trajectory. In-hospital death and death in the intensive care unit were more common in women and minorities than in men and whites, but less common in the most rural patients. Conclusions: Important differences separate patients who electively withdraw from those who die of non-withdrawal causes. Worsening disability, in particular, may be a marker for withdrawal.
A Novel Variant Rearrangement of the Rare Aberration dic(17;20)(p11.2;q11.2) Characterized by Array-CGH as an Insertion in a Patient with Myelodysplastic Syndrome of Multilineage Dysplasia (MDS-MLD)
Authors: Vazmitsel Maryna A. , Grammatopoulou Vasiliki , Yao Jianhui , Batanian Jacqueline R.
Published: February 2020

We report on a novel variant of the dicentric chromosome 17;20 (dic (17;20)(p11.2;q11.2) in a patient with de novo myelodysplastic syndrome (MDS). Based on FISH and array-CGH, the variant turns out to be an insertion of chromosome 17 (17p11.2-telomere 17) into chromosome 20 with breakpoints at 20q11.22 and 20q13.33. Based on conventional chromosome analysis and G-banding patterns, the region 17p11.2-17q25 was directly inserted between 20q11.22 and 20q13.33. The breakpoint junctions occurred within KCNJ12 (17p11.2), UQCC1 (20q11.2), and CDH4 (20q13.3), leading to 5′ deletions of all the genes and positioning the 3′ of UQCC1 next to KCNJ12 at 17p11.2 and CDH4 next to an unknown gene at 17q25-20q13.3. In addition, the centromere of chromosome 17 was not active, transforming the primary constriction to a flat band. Therefore, the novel insertion variant is a pseudo dicentric derivative chromosome with one functional centromere: 45,XX,der(17;20)del(20)(q11.22q13.33)ins(20;17)(q11.2;p11.2q25). A review of the literature of all dic(17;20) cases is presented. For the first time, we report an array-CGH characterization of such rare variant that revealed to be an insertion.
Immunodeficiency in a Patient with 22q11.2 Distal Deletion Syndrome and a p.Ala7dup Variant in the MAPK1 Gene
Authors: Sánchez Ana I. , García-Acero Mary A. , Paredes Angela , Quero Rossi , Ortega Rita I. , Rojas Jorge A. , Herrera Daniel , Parra Miguel , Prieto Karol , Ángel Juana , Rodríguez Luz-Stella , Prieto Juan C. , Franco Manuel
Published: February 2020

The genetic basis for sporadic immunodeficiency in patients with 22q11.2 distal deletion syndrome is unknown. We report an adult with a type 1 (D-F) 22q11.2 distal deletion syndrome and recurrent severe infections due to herpes zoster virus, presenting mild T cell lymphopenia and diminished frequency of naive CD4+ T cells, but increased frequencies of central, effector, and terminally differentiated memory T cells. Antigen-specific CD4+ and CD8+ T cells to influenza, rotavirus, and SEB were conserved in the patient, but responses to tetanus toxoid were temporarily undetectable. Exomic sequencing identified the c.20_22dupCGG (NM_002745.4) variant in the remaining MAPK1 gene of the patient, which adds 1 alanine to the polyalanine amino-terminal tract of the protein (p.Ala7dup). The mother, unlike the father, was heterozygote for the variant. Western blot analysis with the patient's activated PBMCs showed a 91% reduction in the MAPK1 protein. Further studies will be necessary to determine whether or not the variant present in the remaining MAPK1 gene of the patient is pathogenic.
Neural Mechanisms of Strategic Adaptation in Attentional Flexibility
Authors: Sali Anthony W. , Jiang Jiefeng , Egner Tobias
Published: February 2020

Individuals are able to adjust their readiness to shift spatial attention, referred to as “attentional flexibility,” according to the changing demands of the environment, but the neural mechanisms underlying learned adjustments in flexibility are unknown. In the current study, we used fMRI to identify the brain structures responsible for learning shift likelihood. Participants were cued to covertly hold or shift attention among continuous streams of alphanumeric characters and to indicate the parity of target stimuli. Unbeknown to the participants, the stream locations were predictive of the likelihood of having to shift (or hold) attention. Participants adapted their attentional flexibility according to contextual demands, such that the RT cost associated with shifting attention was smallest when shift cues were most likely. Learning model-derived shift prediction error scaled positively with activity within dorsal and ventral frontoparietal regions, documenting that these regions track and update shift likelihood. A complementary inverted encoding model analysis revealed that the pretrial difference in attentional selection strength between to-be-attended and to-be-ignored locations did not change with increasing shift likelihood. The behavioral improvement associated with learned flexibility may primarily arise from a speeding of the shift process rather than from preparatory broadening of attentional selection.
Descending into the Indeterminate State between the Determinate
Authors: Yama Megumi
Published: February 2020

When Jung received the manuscript of the Taoist-alchemical treatise entitled The Secret of the Golden Flower from Richard Wilhelm he realized what his drawings of mandalas meant and received confirmation of his theories about the Self. At the same time, Jung realized that he had encountered ‘the East’ within, as he was digging into the depths of his own psyche. Today, thanks to the publication of The Red Book (RB) and Memories, Dreams, Reflections (MDR), we can understand that through that process, Jung held dialogues with the dead. This is considered to mean that he had contact with the world of death to reach another culture—the East. Yama argues that the indeterminate state between the determinate culture and another is chaotic and uncertain, a space which may possibly lead to the world of death. Nowadays, amongst rapid globalization, many people from diverse backgrounds have opportunities to encounter different cultures for various reasons, sometimes out of interest and sometimes out of necessity. In some cases, but not all, individuals simply step across into the other culture without the experience of ‘descending into the depth,’ as Jung had. Yama explores Jung’s inner journey and his childhood memories from the view of what was taking place while he was moving symbolically from the West to the East. For further exploration of the life of someone who is destined to live between different cultures, Yama introduces a Japanese old folk tale and presents clinical material, as well as her personal experience as one who spent her adolescence outside of her native culture.
Rūmī’s Verse at the Crossroads of Language and Music
Authors: Sedaghat Amir Artaban
Published: February 2020

This article demonstrates how Rūmī has made use of the Iranian musical system and Persian classical prosody, two separate semiotic systems with overlapping forms and aesthetic principles, in order to create a hybrid semiotic system in his poetry. His poetic feat can be observed through a comparative analysis of the linguistic and musical components of his poems in the Divān-e Shams-e Tabrizi, used extensively in the sacred tradition of samāʿ as well as in Iranian musical performances. This essay shows how the systematic use of rhythm and music in versification reaches new heights in Rumi’s ghazals, where the combination of language and music gives birth to a transcendental mode of expression devised with the aim of expressing the ineffable Ultimate Truth. Rumi employed this unique sign system to communicate a mystical message that cannot be conveyed using ordinary language. His unparalleled means of expression, in direct relation with the mystic experience of wajd, is used to incarnate what Sufis call maʿnā (the archetypal meaning). These archetypal ideas cannot be understood through dialectic means of the intellect but can only be taken in by the heart of the mystic in a state of ecstasy.
A new species of Miconia (Melastomataceae) endemic to western Jalisco, Mexico

Authors: ZABALGOITIA ALEJANDRO , FIGUEROA DANTE S. , MUÑIZ-CASTRO MIGUEL Á.
Published: February 2020

Miconia vallartensis is a new species endemic to the western mountains of Jalisco, south of Puerto Vallarta, Mexico. Here we describe, illustrate and provide a key to Miconia vallartensis and morphologically similar species based on vegetative and reproductive characters. This species is easily differentiated from other species by its compact inflorescences, long trichomes and glabrescent pink to dark red flowering hypanthia with reflexed calyx teeth.
The larva of Rhyacophila hartigi Malicky 1971, including a discriminatory matrix to the Italian Rhyacophila larvae with tufted multifilament gills (Rhyacophilidae, Trichoptera)
Authors: WARINGER JOHANN , MALICKY HANS
Published: February 2020

The collection of adults and larvae sampled at the same site on Sicily and the absence of confusing species at the sampling location enabled a description of the hitherto unknown larva of Rhyacophila hartigi Malicky 1971 (Trichoptera: Rhyacophilidae). We present information on the morphology of the larva and illustrate the most important diagnostic features. This dataset is included in a discriminatory matrix of the ten other Rhyacophila larvae with tufted multifilament gills of Italy described so far. Species can be separated by coloration patterns of head and pronotum, and by anal claw morphology; however, separation of the R. dorsalis-palmeni-simulatrix-vulgaris species quartet is not yet possible. Rhyacophila hartigi is restricted to the southern Apennine Peninsula and the island of Sicily (Cianficconi et al. 2008).
Inflammatory and Hematological Indices as Simple, Practical Severity Predictors of Microdysfunction Following Coronary Intervention: A Systematic Review and Meta-Analysis
Authors: Zhang Enyuan , Gao Mingdong , Gao Jing , Xiao Jianyong , Li Xiaowei , Zhao Haiwang , Wang Jixiang , Zhang Nan , Wang Shufeng , Liu Yin
Published: February 2020

C-reactive protein (CRP) and high-sensitivity CRP (hsCRP), along with a series of hematological indices, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and red blood cell distribution width (RDW), are regarded to be related to the incidence of no-reflow or slow flow. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE, Google Scholar, Clinical Trials, and science direct from their inception to August 24, 2019. A total of 21 studies involving 7403 patients were included in the meta-analysis. Pooled analysis results revealed patients with higher hsCRP (odds ratio [OR] = 1.03, 95% confidence interval [CI], 1.01-1.05, P = .006), hsCRP (OR = 1.04, 95% CI: 1.0-1.08, P = .012), NLR (OR = 1.23, 95% CI: 1.11-1.37, P < .0001), PLR (OR = 1.13, 95% CI: 1.07-1.20, P < .0001), and MPV (OR = 2.13, 95% CI: 1.57-2.90, P < .0001) all exhibited significantly higher no-reflow incidence, but there was no significant association between no-reflow risk and RDW or PDW. Patients with higher CRP/hsCRP also performed higher rate of slow flow (OR = 1.06, 95% CI: 1.01-1.11, P = .018). Preangiographic CRP/hsCRP could independently predict no-reflow and slow flow. Moreover, some hematological indices are associated with no-flow.
The Relationship Between Serum Bilirubin Levels and Peripheral Arterial Disease and Gender Difference in Patients With Hypertension: BEST Study
Authors: Lan Yang , Liu Huan , Liu Jinbo , Zhao Hongwei , Wang Hongyu
Published: February 2020

We evaluated the relationship between serum bilirubin levels and ankle-brachial index (ABI) to determine whether gender affected the relationship between bilirubin levels and peripheral arterial disease (PAD) in patients with hypertension. A total of 543 patients were included in our studies (78 patients with PAD and 465 without PAD). Peripheral arterial disease was defined as ABI <0.90 for either and/or both sides. Serum bilirubin levels were measured with a vanadate oxidation method by using fasting venous blood samples. Serum total bilirubin (TBiL) and direct bilirubin (DBiL) levels were higher in males compared with females (both P < .05). Total bilirubin and DBiL were significantly lower in the PAD group. After adjustment for cardiovascular risk factors, PAD was independently negatively related to TBiL and DBiL, with odds ratios (OR) 0.914 (95% confidence interval [CI]: 0.845-0.990) and 0.748 (95% CI: 0.572-0.977). In addition, there was a relationship between PAD and bilirubin levels (TBiL—OR = 0.884, 95% CI: 0.792-0.985; DBiL—OR = 0.621; 95% CI: 0.424-0.909) only in males but not in females. Future studies should further evaluate whether interventions that increase serum bilirubin levels will have a particular role in PAD prevention in males.
Child Development Outcomes of DIR/Floortime TM-based Programs: A Systematic Review
Authors: Boshoff Kobie , Bowen Henry , Paton Hazel , Cameron-Smith Sally , Graetz Sean , Young Alexander , Lane Katelyn
Published: February 2020

Background.

Occupational therapy is often part of the multi-disciplinary approach within the Developmental, Individual-differences, Relationship-based (DIR) FloortimeTM Model. The model addresses the emotional development of children, which is considered to be critical for the other child developmental areas.

Purpose.

This review serves to inform practitioner decision-making about the use of this model, as no systematic reviews exist on child development outcomes.

Methods.

The systematic search included Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Cochrane. For critical appraisal, the McMaster Critical Review was utilized.

Findings.

Nine studies were identified with varying quality levels. Outcomes were mostly reported for increased socio-emotional development.

Implications.

The evidence base for this model is emerging from a published research perspective. It is recommended that the use of this model be supported by sound clinical reasoning processes, intervention fidelity, use of valid outcome measures, and regular monitoring. Higher quality research is urgently needed to progress the research base for this intervention.
China and the Frustrated Region: Central and Eastern Europe’s Repeating Troubles with Great Powers
Authors: Turcsányi Richard Q.
Published: February 2020

Central and Eastern Europe (CEE) had few historical opportunities to interact with China, but with the Belt and Road Initiative (BRI) and the 16+1 platform, that changed dramatically in recent years. The article discusses recent development in the China-CEE relations with the aim of explaining why the CEE countries became excited about China initially, but also why this excitement led prevailingly to disappointment. It will be argued that the frustration with the EU in the aftermath of the 2008 crisis created an environment in which China was, for a moment, perceived as a promising alternative. A few years into the new diplomatic initiatives, however, most of the CEE countries started to be unsatisfied with the lack of economic results. Eventually, the article will assess the implications of the new era of China-CEE relations for the EU affairs and broader Chinese relations with the developing world. The CEE region is in a specific position vis-à-vis China, for it is structurally in between the developed and the developing world. Moreover, the EU membership adds some critical features which make the Chinese offer less applicable and appealing.
Effects of Two Passive Back-Support Exoskeletons on Muscle Activity, Energy Expenditure, and Subjective Assessments During Repetitive Lifting
Authors: Alemi Mohammad Mehdi , Madinei Saman , Kim Sunwook , Srinivasan Divya , Nussbaum Maury A.
Published: February 2020

Objective

The aim of this study was to explore the efficacy of two different passive back-support exoskeleton (BSE) designs during repetitive lifting in different postures.

Background

Although BSEs have been proposed as a potential intervention for reducing physical demands, limited information is available about the impacts of different exoskeleton designs in diverse work scenarios.

Method

Eighteen participants (gender-balanced) performed lab-based simulations of repetitive lifting tasks. These tasks were performed in 12 different conditions, involving two BSEs and a control condition, two levels of lifting symmetry (symmetric and asymmetric), and two postures (standing and kneeling). Outcome measures described muscle activity and energy expenditure, along with perceived discomfort, balance, and usability.

Results

Using both BSEs significantly reduced peak activity of the trunk extensor muscles (by ~10%–28%) and energy expenditure (by ~4%–13%) in all conditions tested. Such reductions, though, were task dependent and differed between the two BSEs. In most of the tested conditions, using BSEs positively affected subjective responses regarding perceived exertion and usability.

Conclusion

Our results suggest that the beneficial effects of a BSE are task specific and depend on the specific BSE design approach. More work is needed, though, to better characterize this task specificity and to determine the generalizability of BSE effects on objective and subjective outcomes for a wider range of conditions and users.

Application

Our results provide new evidence to guide the selection and application of passive BSE designs in diverse lifting tasks.
The Liber Theoreumacie (1214) and the Early History of the Quadrans Vetus
Authors: E. Nothaft C. Philipp
Published: February 2020

The Liber theoreumacie is a neglected work of practical geometry, written in Strasbourg in 1214, which sheds valuable light on the study and practice of astronomy in early thirteenth-century Europe. In this article, I focus on the first two chapters of Book IV, which both deal with the construction of horary instruments. The first of these chapters contains the earliest known account of the type of universal horary quadrant known as quadrans vetus, which is here given a biblical pedigree by labelling it the “sundial of Ahaz.” The second chapter describes a graphical method of inscribing hour markings on the surface of an astrolabe’s alidade, which appears to have been introduced into Latin Europe by the twelfth-century translator John of Seville. A critical edition and translation of the relevant passages will conclude the article.
Temporary Measures: Women Computers at the Royal Observatory, Greenwich, 1890–1895
Authors: Mullen Kane
Published: February 2020

Between 1890 and 1895, five women “computers” were hired to work at the Royal Observatory, Greenwich, one of the world’s leading observatories at the time. Caroline Herschel notwithstanding, these women were the very first in Britain to be paid for astronomical observation. They were hired as supernumerary computers – normally a temporary position reserved for young schoolboys. Instead of adhering to the usual strict regimen of astronomical calculations, the women at Greenwich functioned much more as astronomers. They observed with telescopes, engaged in original research, and even published their findings. This paper examines how exactly this occurred at a time when women remained excluded from professional observation elsewhere. It engages original archival research in combination with the Greenwich published literature to shed light on a little-known story that reveals how women in Britain first came to be paid as professional astronomers.
Limitations of methods used for monitoring of various cellulose degradation mechanisms
Authors: Drábková Klára , Ďurovič Michal , Škrdlantová Markéta
Published: February 2020

Study of the degradation of cellulosic fibers can be based on measurement of their optical, mechanical and chemical properties. Instrumental spectroscopic methods and mechanical properties measurement are preferred. Other methods, such as viscometric and gel permeation chromatography determination of the average degree of polymerization are even more reliable. Selection of the methods for cellulose degradation monitoring must be based on the knowledge of their limits in relation to the various degradation mechanisms. This work is concerned with determining these limits of selected methods of characterizing cellulose textiles in relation to damage in acidic and alkaline conditions and to oxidation at various pH values of the oxidation bath. Model samples of cotton textiles damaged to various degrees in various media were characterized using viscometric determination of the average degree of polymerization of the cellulose, the thread tensile strength, Fourier-transform infrared spectroscopy and ultraviolet/visible spectroscopy.
Power Dynamics in Field-Level Events: A Narrative Approach
Authors: Gross Tamar , Zilber Tammar B.
Published: February 2020

Drawing upon an in-depth analysis of two bio-tech annual conferences in Israel, we explicate the exertion of power in convening. Event organization involves three narrative mechanisms: (1) telling stories which construct the field, and enacting them through different genres that channel participants to perform these stories in the unfolding of the event; (2) setting the stage and a space of possibilities for certain stories to be told in certain ways, and limiting others; and (3) grounding the stories in meta-narratives that confer plausibility on some of them over others. Our contribution lies in explicating how diverse narrative mechanisms allow organizers to exert various faces of power in organizing an event, how organizers use power to construct their own and others’ resources, and how power is used not only through words, but also through space and embodiment. Taken together, self-serving constructions of the field are turned into a taken-for-granted reality, while constraining participants’ ability to negotiate or refute it.