bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual and gynecological health in women with a history of sexual violence: the role of the gynecologist
Authors: Escura Sílvia , Anglès-Acedo Sònia , Ribera-Torres Laura , Castelo-Branco Camil
Published: March 2022

Objectives: Sexual violence is defined as any sexual act, attempt to commit a sexual act or unwanted sexual comment or action which, by means of force or coercion, is directed against a person’s sexuality, regardless of the relationship with the victim. The global prevalence of sexual violence all over the world is 35.6%; 30% partner-related and 7.2% non-partner sexual violence, being the prevalence of sufferers from both types of sexual violence 1.6%. Sexual violence against girls and women is a global public health problem of epidemic proportions. As a violence free life constitutes a basic human right, actions to prevent sexual violence and to treat and follow-up its victims have to be undertaken. Mechanism: A multidisciplinary approach on these cases should be mandatory to help women in all the potential short-, mid- and long-term consequences, which need to be evaluated. Finding in brief: Consequences after sexual violence can be both physical and psychological, including a potential impact on gynecological, reproductive, obstetric and sexual issues of the individual. For this reason, gynecologists should play an important role in the follow-up of girls and women who have suffered sexual violence. Conclusions: Gynecologists have to participate in both the immediate attention and the follow-up of patients who have suffered sexual violence. Gynecologists have the gold opportunity to introduce sexual health care in their clinical practice and their visits should be the place where the discussion of sexual concerns is permitted and also where the identification, support and treatment of women with sexual violence is provided.
Paracervical block in laparoscopic hysterectomy for postoperative pain control: a randomized, multi-center, double-blind, placebo-controlled trial
Authors: Lee San-Hui , Kim Tae-Joong , Lee Nae Hyun , Jeong Soo Young , Lee Jimin , Song Taejong
Published: March 2022

Background: To determine the effect of a paracervical block in laparoscopic hysterectomy on postoperative pain relief. Method: A total of 86 patients scheduled for total laparoscopic hysterectomy for benign gynecologic diseases were randomly assigned to the experimental group (n = 43) and the control group (n = 43). Patients were received a paracervical injection that was either 10 mL of 0.5% bupivacaine with 1 : 200,000 epinephrine or 10 mL of normal saline. The primary outcome was the postoperative pain score which was assessed using a visual analog scale at 2, 4, 6, 8, and 12 hours after surgery. The secondary outcome was the postoperative rescue analgesic requirement within 12 hours after surgery. Results: Baseline characteristics were similar in both groups. Postoperative pain scores did not significantly differ between groups. Rescue analgesia requirements were also statistically similar in both groups. Conclusion: Adding a paracervical block with preemptive local analgesia in patients undergoing laparoscopic hysterectomy did not reduce postoperative pain and postoperative rescue analgesia requirements.
Correlation of ovarian volume and clinical and laboratory parameters of PCOS in Korean patients
Authors: Lee Seul Yi , Yu Eun Hee , Lee Hyun Joo , Joo Jong Kil
Published: March 2022

Background: The aim of this study is to analyze the correlation of ovarian volume and clinical and laboratory parameters of polycystic ovary syndrome (PCOS) in Korean women. Methods: Two hundred and thirty-three patients aged between 20 and 40 years with PCOS diagnosis between January 2014 and June 2020 at Pusan National University Hospital, Busan, Republic of Korea, were included to this retrospective observational study using previously recorded patient medical charts. PCOS was diagnosed according to the revised 2003 Rotterdam criteria. Laboratory tests including anti-mullerian hormone (AMH), prolactin, thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, free and total testosterone, dehydroepiandrosterone-sulfate (DHEA-S), 17-alpha-hydroxyprogesterone (17-OHP), HbA1C and insulin were conducted. Results: The correlation analysis showed that free testosterone (p = 0.006, r = 0.215), total testosterone (p < 0.001, r = 0.305), 17-OHP (p = 0.008, r = 0.203) and height (p = 0.008, r = 0.173) were statistically correlated with the total ovarian volume in overall PCOS patients. In these patients, serum AMH level was positively correlated with LH but negatively with body weight and body mass index (BMI). Conclusions: According to the results, the ovarian volume, quantified by ultrasonographic measurements, was significantly related to the increasing serum levels of free testosterone, total testosterone and 17-OHP in Korean PCOS patients.
Fallopian tube patency diagnosed by laparoscopic chromopertubation in women with polycystic ovarian syndrome and non-subfertile controls: a retrospective case-control study
Authors: Mayrhofer Daniel , Parry John Preston , Hager Marlene , Marculescu Rodrig , Ott Johannes
Published: March 2022

Background: Hyperandrogenism has been associated with tubal dysfunction. Previous studies have not used non-subfertile controls when assessing hyperandrogenic women through laparoscopic chromopertubation (LC), the gold standard for tubal patency testing. Methods: The objective of this retrospective study was to compare the results of LC between women with medication-resistant anovulatory polycystic ovary syndrome (PCOS, n = 202) and non-subfertile women with ovarian cysts (controls, n = 48). Results: There were no statistically significant differences between PCOS women and controls for the prevalence of bilateral tubal occlusion (2.5% versus 4.2%, respectively; p = 1.000) or overall rates for occlusion (7.4% of tubes assessed versus 6.3%, respectively; p = 0.828). More PCOS patients needed high pressure chromopertubation to demonstrate bilateral tubal patency than controls (12.4% versus 2.1%; p = 0.036). In the PCOS group, patients needing higher pressure to achieve patency demonstrated higher testosterone levels than women requiring typical pressure (0.66 ± 0.17 versus 0.47 ± 0.24 ng/mL; p = 0.001). Conclusions: For women with ovarian cysts and without subfertility, six percent of all Fallopian tubes are occluded. PCOS patients have similar rates of tubal occlusion, making these women a reasonable but more available control group for LC studies. Higher total testosterone levels were associated with higher LC pressures to demonstrate bilateral patency.
Detection of pentylenetetrazol-induced seizure activity in the 19–21 Hz beta range using a magnetic coil induction method
Authors: Lu Hsiang-Chin , Chang Wei-Jen , Wei Huang Andrew Chih , Shyu Bai Chuang
Published: March 2022

Introduction: A force transducer or automatic scoring system is not sufficient to detect small or fine seizure activity. To improve previous assessments of epileptic behavior, a novel coil method was developed to detect an early behavioral marker for epileptic seizures. Methods: The present study used the γ-aminobutyric acid (GABA) receptor antagonist pentylenetetrazol (PTZ) to induce seizure activity and epileptic behavior in mice. A coil method was used to detect motor seizures consisting of small amplitude 19–21 Hz muscle contractions. Results: Seizure activity in the 19–21 Hz range detected by the coil method was positively correlated with generalized clonic seizures with a kangaroo posture after PTZ administration. GABA receptor agonist valproic acid and ethosuximide decreased PTZ-induced 19–21 Hz seizure activity. The pattern of the amplitude ratio (%) of 19–21 Hz seizure activity after administration of the GABAA/C receptor antagonist picrotoxin was similar to the group that was treated with PTZ but different from the group that was treated with the nonselective muscarinic receptor agonist pilocarpine. The coil method detected 19–21 Hz seizure activity after PTZ administration. However, the force transducer method did not detect 19–21 Hz seizure activity. Conclusions: The coil method was more sensitive than the force transducer method for detecting epileptic behaviors. The findings may indicate a novel behavioral marker that can be detected by the coil method to reveal epileptic seizures, thus improving our understanding of the brain mechanisms of action and specific brain waves that are associated with PTZ-induced 19–21 Hz seizure activity.
Biomarkers of intrahepatic cholangiocarcinoma: diagnosis and response to therapy
Authors: Brown Zachary J. , Hewitt D. Brock , Pawlik Timothy M.
Published: March 2022

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer behind hepatocellular carcinoma (HCC) and carries a dismal prognosis. Improved genetic analysis has paved the way for a better understanding of the distinct somatic genomic landscapes of ICC. The use of next generation sequencing has paved the way for more personalized medicine through identifying unique mutations which may prove to be therapeutic targets. The ability to identify biomarkers specific to ICC will assist in establishing a diagnosis, monitoring response to therapy, as well as assist in identifying novel therapies and personalized medicine. Herein, we discuss potential biomarkers for ICC and how these markers can assist in diagnosis, monitor response to therapy, and potentially identify novel interventions for the treatment of ICC.
Mesenchymal stem cell derived exosomes-based immunological signature in a rat model of corneal allograft rejection therapy
Authors: Jia Zhe , Lv Ying , Zhang Wanjun , Zhang Xiaomin , Li Fei , Lu Xiaoxiao , Zhao Shaozhen
Published: March 2022

Background: Mesenchymal stem cells (MSCs) are promising candidates for immunomodulatory therapy that are currently being tested in corneal allograft rejection. In this study, we tested the effects of Mesenchymal stem cells derived exosomes in the corneal allograft rejection model. Methods: Mesenchymal stem cells derived exosomes (MSC-exo) were collected and characterized. Wistar-Lewis rat corneal allograft rejection models were established. PKH26 labeled exosomes were used for track experiment. Models were randomly separated into four groups and treated with graded doses of exosomes or same volumn of PBS. Corneal grafts were assessed for rejection degree using slit-lamp biomicroscopy. Grafts were examined histologically using hematoxylin-eosin (H-E) staining and immunohistochemically using antibodies against CD4, CD8 and CD25. A comprehensive graft mRNA gene expression array analysis was conducted and checked by real-time polymerase chain reaction (PCR). Results: The nanovesicles obtained were expressing exosome specific protein markers CD9, CD63, CD81. The labeled exosomes could be detected in both cornea and anterior chamber two hours after injection.The 10 μg exosomes subconjunctival injection can effectively prolong graft survival time (MST 16.3 ± 2.5 days). 10 μg exosomes-treated group can inhibit the infiltration of CD4+ and CD25+ T cells. IFN-γ and CXCL11 levels were significantly decreased in grafts obtained from postoperative exosomes-treated rats when compared with controls. Conclusions: MSC-exo can cross biological barrier and play better role directly towards target tissue. MSC-exo can effectively prolong grafts survival time. Th1 signaling pathway was significantly inhibited in the exosomes treated group.
Immunohistochemical Assessment of the P53 Protein as a Predictor of Non-Small Cell Lung Cancer Response to Immunotherapy
Authors: Olivares-Hernández Alejandro , del Barco Morillo Edel , Miramontes-González José Pablo , Figuero-Pérez Luis , Pérez-Belmonte Luis , Martín-Vallejo Javier , Martín-Gómez Teresa , Escala-Cornejo Roberto , Vidal-Tocino Rosario , Hernández Lorena Bellido , Sarmiento Rogelio González , Ludeña de la Cruz María Dolores , Cruz-Hernández Juan Jesús , Pérez Carmen Parra
Published: March 2022

Background: Determining predictive biomarkers for immune checkpoint inhibitors (ICIs) is a current challenge in oncology. Previous studies on non-small cell lung cancer (NSCLC) have shown how TP53 gene mutations are correlated with different responses to ICIs. Strong and diffuse immuno-expression of p53 by immunohistochemistry (IHC) is interpreted as a likely indicator of a TP53 gene mutation. We aimed to assess the p53 protein expression via IHC in NSCLC as a predictive biomarker of the response to ICIs. Methods: This was a retrospective hospital-based study of patients with NSCLC treated with Nivolumab in the University Hospital of Salamanca. All diagnostic biopsies were studied via IHC (measuring p53 protein expression, peroxidase anti-peroxidase immunohistochemistry technique using Leica BOND Polymer development kits). Survival analysis was performed by subgroups of expression of p53 and other factors using the Kaplan-Meier estimator and Cox proportional-hazards model. Results: Seventy-three patients were included (59 men and 14 women). The median age was 68 (44–84) years. Thirty-six biopsies were adenocarcinoma, 34 were squamous, and three were undifferentiated. In 41 biopsies (56.2%), the cellular expression of p53 was <5% (Group A), and in 32 biopsies (43.8%), the expression was ≥5% (Group B). In the general analysis, no differences were observed in overall survival (OS) (A: 12 months vs B: 20 months; p = 0.070) or progression-free survival (PFS) (A: 4 m vs B: 7 m; p = 0.064). Significant differences were observed in adenocarcinomas for both OS (A: 8 m vs B: median not reached; p = 0.002) and PFS (A: 3 m vs 8 m; p = 0.013). No differences in PFS and OS were observed in squamous cell carcinoma. Significant differences were observed in OS in the PD-L1 negative group (0% expression) (A: 13 m vs B: 39 m; p = 0.024), but not in PFS (A: 3 m vs B: 7 m; p = 0.70). No differences were observed in the PD-L1 positive group. Conclusions: A trend toward a greater response to ICIs was observed in the PFS and OS of patients with high expression of p53 by IHC (TP53 mutation), especially in the PD-L1 negative adenocarcinoma subgroup. These results will make it possible to make future modifications to the clinical guidelines of NSCLC according to the expression of p53.
Prediction of the Potential Mechanism of Triptolide in Improving Diabetic Nephropathy by Utilizing A Network Pharmacology and Molecular Docking Approach
Authors: An Xiaofei , Fan Decai , Yin Zi , Zhang Junhan , Zhou Yuexin , Tian Ruina , Yan Ming
Published: March 2022

Background: Triptolide (TP) is a major active component of colquhounia root tablet, which has been long been used in China to treat diabetic nephropathy (DN) due to its marked anti‑inflammatory, antiproteinuric, and podocyte‑protective effects. Methods: This study investigated the anti-proteinuria activity and related signaling cascade of TP in DN by utilizing a network pharmacology and molecular docking approach. Results: From the GeneCard, DisGeNET, and National Center for Biotechnology Information Gene databases, 1458 DN targets were obtained and input together with 303 TP targets into Venny2.1.0 for mapping and comparing. In total, 113 common targets of TP and DN were obtained, of which 7 targets were found to play an important role through theoretical inhibitory constant analysis. The common targets were further analyzed by Kyoto Encyclopedia of Genes and Genomes to identify the pathways related to the therapeutic effect of TP on DN. Among them, the seven targets were found to play key roles in six signaling pathways. The molecular docking results also showed TP had good binding ability to the seven targets. Conclusions: Analysis of the common targets and key pathways showed that TP can improve DN via its anti-nephritis, anti-renal fibrosis, antioxidant, and podocyte-protective effects, which might elucidate the mechanism by which TP improves renal function and reduces proteinuria in DN.
The chaperone system in glioblastoma multiforme and derived cell lines: diagnostic and mechanistic implications
Authors: Alberti Giusi , Campanella Claudia , Paladino Letizia , Porcasi Rossana , Bavisotto Celeste Caruso , Pitruzzella Alessandro , Graziano Francesca , Florena Ada Maria , Argo Antonina , de Macario Everly Conway , Macario Alberto JL , Cappello Francesco , Bucchieri Fabio , Barone Rosario , Rappa Francesca
Published: March 2022

Background: Glioblastoma multiforme (GBM) is the most common and malignant primary brain tumor in adults. Novel treatments are needed to counteract the molecular mechanisms of GBM growth and drug resistance. The chaperone system (CS) members are typically cytoprotective but some, termed Hsp, can become pathogenic and participate in carcinogenesis, along with the vascular endothelial growth factor (VEGF), and we investigated them in GBM biopsies and derived cell lines. The objectives were to identify diagnostic-prognostic biomarkers and gather information for developing chaperonotherapy. Methods: Cell lines from GBMs were established, characterized (morphology, growth characteristics, and specific markers), and stored. Chaperones and angiogenic factors [Hsp10, Hsp27, Hsp60, Hsp70, Hsp90, FLT-1 (VEGFR-1), FLK1 (KDR, VEGFR-2), and FLT-4 (VEGFR-3)] were observed in cells by immunofluorescence while the chaperones were measured in tumor tissue by immunohistochemistry. Results: Four cell lines were derived from four different GBMs; the cells were spindle shaped or polygonal and grew at high rates as adherent monolayers or clusters without evidence of contact inhibition. The astrocyte-specific glial fibrillary acidic protein (GFAP); and the neuronal NSE, malignancy VIM, and proliferation PCNA, markers were determined. The cells expressed GFAP but no NSE, indicating that they were primary glioblastoma cell lines, with high levels of Hsp10, Hsp27, Hsp60, Hsp90, and Flk1; and low levels of Hsp70, Flt1, and Flt4. Conclusions: Four cell lines were established derived from four out of ten GBM tumors studied. The cell lines showed intense positivity for chaperones studied and factors connected to malignancy and the tumors showed increased levels of chaperones, making them potential diagnostic-prognostic biomarkers and targets for anti-cancer compounds.
Peruranolides A–D, four new withanolides with potential antibacterial and cytotoxic activity from Physalis peruviana L.
Authors: Li Qian-Ran , Liang Hui-Jun , Li Bai-Lin , Yuan Jie , Ao Zhuo-Yi , Fan Yu-Wen , Zhang Wei-Jie , Lian Xin , Chen Jia-Yan , Wang Jian-Zhong , Wu Jie-Wei
Published: March 2022

Background: Many drugs for anti-tumour have been developed, nevertheless, seeking new anticancer drug is the focus of ongoing investigation. Withanolides have been reported to possess potent antiproliferative activity. Literature findings revealed that a diversity of withanolides were obtained from Physalis peruviana, however, the antitumor activity of these bioactive compounds is still unclear. Methods: The EtOAc fraction of P. peruviana were decolorized on Middle Chromatogram Isolated (MCI) Gel column, repeatedly subjected to column chromatography (CC) over sephadex LH-20, preparative High Performance Liquid Chromatography (HPLC) and silica gel to afford compounds. Their chemical structures of the new isolates were elucidated through analyzing spectroscopic and HRESIMS data. All these obtained metabolites were appraised for their potential antiproliferative activity against the human breast cancer cell line MCF-7 by MTT assay, and in vitro antibacterial activity of the isolated compounds (1–7) were evaluated against E. coli, B. cereus and S. aureus. Results: Four new withanolides, including one withaphysalin-type withanolide (peruranolide A, 1), two 13,14-seco-withaphysalins (peruranolides B–C, 2–3), as well as one normal withanolide (peruranolide D, 4), were purified and separated from P. peruviana L.. Compound 5 was discovered to exhibit potent cytotoxic effect with an IC50 value of 3.51 μM. In vitro antibacterial activities, compounds 1–7 had no obvious inhibitory activity against E. coli, but had moderate inhibitory activities against B. cereus and S. aureus. Conclusions: Our findings might offer valuable clues for the utilization of withanolides as lead compounds for antineoplastic or antibacterial drug development.
Deep learning quantification of vascular pharmacokinetic parameters in mouse brain tumor models
Authors: Arledge Chad A. , Sankepalle Deeksha M. , Crowe William N. , Liu Yang , Wang Lulu , Zhao Dawen
Published: March 2022

Background: Dynamic contrast-enhanced (DCE) MRI is widely used to assess vascular perfusion and permeability in cancer. In small animal applications, conventional modeling of pharmacokinetic (PK) parameters from DCE MRI images is complex and time consuming. This study is aimed at developing a deep learning approach to fully automate the generation of kinetic parameter maps, Ktrans (volume transfer coefficient) and Vp (blood plasma volume ratio), as a potential surrogate to conventional PK modeling in mouse brain tumor models based on DCE MRI. Methods: Using a 7T MRI, DCE MRI was conducted in U87 glioma xenografts growing orthotopically in nude mice. Vascular permeability Ktrans and Vp maps were generated using the classical Tofts model as well as the extended-Tofts model. These vascular permeability maps were then processed as target images to a twenty-four layer convolutional neural network (CNN). The CNN was trained on T1-weighted DCE images as source images and designed with parallel dual pathways to capture multiscale features. Furthermore, we performed a transfer study of this glioma trained CNN on a breast cancer brain metastasis (BCBM) mouse model to assess the potential of the network for alternative brain tumors. Results: Our data showed a good match for both Ktrans and Vp maps generated between the target PK parameter maps and the respective CNN maps for gliomas. Pixel-by-pixel analysis revealed intratumoral heterogeneous permeability, which was consistent between the CNN and PK models. The utility of the deep learning approach was further demonstrated in the transfer study of BCBM. Conclusions: Because of its rapid and accurate estimation of vascular PK parameters directly from the DCE dynamic images without complex mathematical modeling, the deep learning approach can serve as an efficient tool to assess tumor vascular permeability to facilitate small animal brain tumor research.
Alterations in the fecal microbiota and serum metabolome in unstable angina pectoris patients
Authors: Liu Langsha , Luo Fanyan
Published: March 2022

Background: Unstable angina pectoris (UAP) is a type of Coronary artery disease (CAD) characterized by a series of angina symptoms. Insulin-like growth factor 1 (IGF-1) system may be related to CAD. However, the correlation between the IGF-1 system, metabolism, and gut microbiota has not been studied. In the present study, we investigated the alterations of serum IGF-1 system, metabolomics, and gut microbiota in patients with UAP. Methods: Serum and stool samples from healthy volunteers and UAP patients were collected. Serum metabolomics, PAPP-A, IGF-1, IGFBP-4, STC2, hs-CRP, TNF-α, and IL-6 were detected in serum samples by LC-MS, and commercial ELISA kits, respectively. Fecal short-chain fatty acids (SCFAs) were measured by gas chromatography. 16S rDNA was used to measure the changes of the gut microbiota. The correlation of the above indicators was analyzed. Results: There were 24 upregulated and 31 downregulated metabolites in the serum of UAP patients compared to those in the controls. Pathway analysis showed that these metabolites were enriched in pathways including linoleic acid metabolism, amino acid metabolism, starch metabolism, sucrose metabolism, and citrate cycle (TCA cycle), etc. Additionally, the UAP patients had lower fecal levels of 2-hydroxyisobutyric acid and succinic acid. 16S rDNA sequencing results showed that the relative abundances of Bacteroidetes, Synergistetes, Lactobacillaceae, Burkholderiaceae, Synergistaceae, and Subdoligranulum were significantly higher in the UAP patients than the healthy subjects. Moreover, the UAP patients had lower serum IGF-1, IGFBP-4, and STC2 and higher serum inflammatory cytokines (hs-CRP, TNF-α, and IL-6) levels than the healthy controls. Furthermore, there was a strong correlation between serum amino acids and IL-6, which played an important role in the development of UAP. Conclusions: These results indicated that the UAP patients had decreased serum IGF-1 level and imbalanced amino acids metabolism, which may be caused by the altered gut microbiota. It may provide a new therapeutic strategy for unstable angina pectoris.
Individualized right ventricular outflow tract reconstruction using autologous pulmonary tissue in situ for the treatment of pulmonary atresia with ventricular septum defect
Authors: Wu Ming , Fan Chengming , Liu Jian , Iroegbu Chukwuemeka Daniel , Chen Wangping , Huang Peng , Tang Mi , Wu Xun , Wang Chunle , Xiang Kun , Zhou Wenwu , Yang Jinfu
Published: March 2022

Objective: The study aims to evaluate the feasibility and effectiveness of an individualized procedure for right ventricular outflow tract (RVOT) reconstruction in pulmonary atresia with ventricular septal defect (PA-VSD). Methods: RVOT was reconstructed using autologous pulmonary artery tissue preserved in situ as the posterior wall and a bovine jugular vein patch (BJVP) as the anterior wall in patients with PA-VSD (observation group). The size of the BJVP made from a bovine jugular vein conduit (BJVC) was individually calculated using a formula based on the child’s weight and the size of the autologous pulmonary artery (the diameter of BJVC DB⁢J⁢V⁢C = Dt⁢h⁢e⁢o⁢r⁢e⁢t⁢i⁢c⁢a⁢l-W⁢z^-4π). Its effect was then compared with the conventional modified Rastelli procedure based on the BJVC (control group). Results: A total of 22 patients that underwent the new procedure were simultaneously compared with the 25 patients in the control group. No deaths occurred in both groups. Notably, there were no significant differences in mechanical ventilation, ICU and postoperative residence, cardiopulmonary bypass, and aortic cross-clamp time. In the follow-up, which spanned for 8–12 years (mean 9.2 years), only four cases with moderate regurgitation were noted in the observation group without obstruction. In the control group, two patients had a conduit replacement. Three patients suffered from anastomotic stenosis, which was corrected by balloon dilatation. Conclusion: Individualized RVOT reconstruction with autologous pulmonary tissue preserved in situ as the posterior wall is adequate for treating PA-VSD.
Rest contrast echocardiography unmasks hidden wall motion abnormalities in patients with chest pain. A case series and review of pertinent literature
Authors: Suma Sergio , Tuttolomondo Domenico , Gaibazzi Nicola
Published: March 2022

We present a case series of three patients that underwent myocardial contrast echocardiography (MCE) in the setting of recent chest pain, as paradigmatic examples of the usefulness of contrast-echocardiography with very-low mechanical index imaging in the context of rest wall motion assessment. Moreover, we analysed the pertinent literature about the use of rest MCE in the context of chest pain of unknown origin, showing its diagnostic and prognostic impact. We think that MCE could play a key role in detecting chest pain subtended by previously unknown coronary artery disease (CAD). For example, in pts without significant electrocardiogram (ECG) modifications or in whom high sensitivity troponins show only borderline increase (still below the upper limit) or have no clearly significant delta. In such cases the more sensitive evaluation of wall motion (WM) powered by MCE could add diagnostic information, above all in pts with severe CAD but apparently normal WM at standard echocardiography.
Cardiovascular events after liver transplantation: MACE hurts
Authors: Altieri Mario H. , Liu Hongqun , Lee Samuel S.
Published: March 2022

The curative therapy for patients with end-stage liver disease is liver transplantation. However, liver transplantation challenges the cardiovascular system, and is associated with major adverse cardiovascular events (MACE). Immediately after implantation of the liver graft, changes in cardiac preload and afterload increase the cardiac workload. Longer-term postoperatively, a more sedentary lifestyle and enhanced appetite increase obesity and body mass index. Immunosuppressants may also affect the cardiovascular system. All these factors that liver recipients encounter impact the function of the cardiovascular system. Cardiac events are the third-leading cause of death in liver recipients. This review describes the pertinent factors that predispose to development of MACE after liver transplantation, and how to predict these cardiovascular events in the post-transplant period. We review the roles of metabolic syndrome, renal dysfunction, non-alcoholic fatty liver disease, diagnostic tests such as imaging and biomarkers, and parameters such as systolic and diastolic dysfunction, and QT interval prolongation in cardiovascular events. We summarize the current literature on scoring systems to predict cardiovascular events.
Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
Authors: Rodriguez-Granillo Gaston A. , Cirio Juan J. , Ciardi Celina , Caballero Maria L. , Fontana Lucia A. , Buezas Mariano D. , Diluca Pablo , Lylyk Pedro
Published: March 2022

Background: Hyperacute cardiac imaging of patients with acute ischemic stroke (AIS), though desirable, is impractical. Using delayed-enhancement, low-dose, non-gated, chest spectral computed tomography scans (DESCT), we explored the prevalence and patterns of incidental myocardial late iodine enhancement (LIE) and embolic sources, and their relationship with stroke etiology. Methods: Since July 2020, DESCT was performed after cerebrovascular CT angiography (CTA) among patients with suspected AIS undergoing CT using a dual-layer spectral scanner, without additional contrast administration. Images were analyzed using monoenergetic reconstructions and iodine density maps, and the myocardial extracellular volume fraction (ECV, %) was calculated. Results: Eighty patients with AIS were included. DESCT identified a cardiac thrombi in 6 patients (7.5%), and a complex aortic plaque in 4 (5%) cases; reclassifying 5 embolic strokes of uncertain source (28% of ESUS) to cardioembolic (CE, n = 3) and non-CE (n = 2) etiologies. LIE was identified in 38 (48%) patients, most commonly (82%) of ischemic pattern. We did not identify significant relationships between AIS etiology and the presence, pattern, and extent of LIE (p > 0.05); ECV (p = 0.56), severe aortic (p = 0.25) or valvular (p = 0.26) disease, or the extent of coronary calcification (p = 0.39). Patients with evidence of major cardiovascular DESCT findings had higher rates of all-cause death at 90 days (42% vs. 19%, p = 0.037). Conclusions: In this study, hyperacute cardiac imaging of AIS with DESCT identified a high prevalence of incidental cardiac disease predominantly involving LIE of ischemic etiology and mostly not related to the stroke etiology.
Interleukin Receptor Associated Kinase 1 Signaling and Its Association with Cardiovascular Diseases
Authors: Zheng Youjing , He Jia-Qiang
Published: March 2022

Toll-like receptors (TLRs) and interleukin-1 receptor (IL-1R) directly interact with intracellular interleukin receptor associated kinase (IRAK) family members to initialize innate immune and inflammatory responses following activation by pathogen-associated or host-derived elements. Although four IRAK family members [IRAK1, 2, 3 (i.e., IRAK-M), and 4] are involved in TLR and IL-1R signaling pathways, IL-1R > IRAK1 signaling appears to be the most studied pathway, with sufficient evidence to support its central role linking the innate immune response to the pathogenesis of various diseases, including cancers, metabolic disorders, and non-infectious immune disorders. However, IRAK1’s involvement in cardiovascular diseases was only recently revealed and the detailed mechanism underling the pathogenesis of cardiovascular diseases, such as atherosclerosis, myocardial infarction, and heart failure (all non-infectious disorders), remains largely unknown with very limited publications to date. This review aims to summarize the overall roles of the IRAK family, especially IRAK1, in mediating the development of cardiovascular diseases.
Hypertensive status is associated with renoprotection by remote ischemic conditioning for acute myocardial infarction—a meta-regression and trial sequential analysis of randomized clinical trials
Authors: Li Yuehua , Lou Ying , Zhou Chenghui , Pei Hanjun
Published: March 2022

The potential modifiable factors for remote ischemic conditioning (RIC) in reducing contrast-associated acute kidney injury (CA-AKI) in patients with acute myocardial infarction (AMI) have not been investigated. The aim of this meta-regression was to address these issues.We searched Pubmed, Embase and the Cochrane Library database for published randomized controlled trials (RCTs) with registration number CRD42020155532. Nine RCTs comprising of 1540 subjects were included in our meta-analysis. Compared with control group, RIC was associated with reduced incidence of CA-AKI [(9 studies, 1540 subjects, relative risk (RR) 0.51, 95% confidence intervals (CI) 0.35 to 0.76, p = 0.000, I2 = 52%, p for heterogeneity 0.04)] and major adverse cardiovascular events (MACE) (5 studies, 1078 subjects, RR 0.52, 95% CI 0.38 to 0.73, p = 0.000, I2 = 9%, p for heterogeneity 0.36) for AMI. In addition, both meta-regression and subgroup analyses have shown that RIC was more effective in the hypertensive patients in reducing CA-AKI for AMI (regression coefficient = –0.05, p = 0.021; for subgroup with more hypertensive patients: RR 0.36, 95% CI 0.25 to 0.52 vs the one with less hypertensive patients: RR 0.72, 95% CI (0.40 to 1.30, p for subgroup difference 0.008). Subsequent trial sequential analysis confirmed the effect of RIC in both CA-AKI and MACE. RIC is an effective strategy in reducing CA-AKI and MACE in patients with AMI, especially for patients with hypertension.
Modern mapping and ablation of idiopathic outflow tract ventricular arrhythmias
Authors: Dragasis Stylianos , Vlachos Konstantinos , Frontera Antonio , Mililis Panagiotis , Saplaouras Athanasios , Zygouri Andromahi , Zymatoura Maria Erato , Kontonika Marianthi , Kafkas Nikolaos , Efremidis Michael , Letsas Konstantinos P.
Published: March 2022

Outflow tract (OT) premature ventricular complexes (PVCs) are being recognized as a common and often troubling, clinical electrocardiographic finding. The OT areas consist of the Right Ventricular Outflow Tract (RVOT), the Left Ventricular Outflow Tract (LVOT), the Aortomitral Continuity (AMC), the aortic cusps and the Left Ventricular (LV) summit. By definition, all OT PVCs will exhibit an inferior QRS axis, defined as positive net forces in leads II, III and aVF. Activation mapping using the contemporary 3D mapping systems followed by pace mapping is the cornerstone strategy of every ablation procedure in these patients. In this mini review we discuss in brief all the modern mapping and ablation modalities for successful elimination of OT PVCs, along with the potential advantages and disadvantages of each ablation technique.
Endovascular therapeutic hypothermia adjunctive to percutaneous coronary intervention in acute myocardial infarction: realistic simulation as a game changer
Authors: Dallan Luis Augusto Palma , Dae Michael , Giannetti Natali Schiavo , Polastri Tathiane Facholi , Lima Marian Keiko Frossard , Rochitte Carlos Eduardo , Hajjar Ludhmila Abrahao , San Martin Claudia Yanet Bernoche , Lima Felipe Gallego , Nicolau Jose Carlos , de Oliveira Mucio Tavares , Dallan Luis Alberto Oliveira , Ribeiro da Silva Expedito Eustaquio , Kalil Filho Roberto , Abizaid Alexandre , Lemos Neto Pedro Alves , Timerman Sergio
Published: March 2022

Background: Endovascular therapeutic hypothermia (ETH) reduces the damage by ischemia/reperfusion cell syndrome in cardiac arrest and has been studied as an adjuvant therapy to percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). New available advanced technology allows cooling much faster, but there is paucity of resources for training to avoid delays in door-to-balloon time (DTB) due to ETH and subsequently coronary reperfusion, which would derail the procedure. The aim of the study was to describe the process for the development of a simulation, training & educational protocol for the multidisciplinary team to perform optimized ETH as an adjunctive therapy for STEMI. Methods and results: We developed an optimized simulation protocol using modern mannequins in different realistic scenarios for the treatment of patients undergoing ETH adjunctive to PCI for STEMIs starting from the emergency room, through the CathLab, and to the intensive care unit (ICU) using the Proteus® Endovascular System (Zoll Circulation Inc™, San Jose, CA, USA). The primary endpoint was door-to-balloon (DTB) time. We successfully trained 361 multidisciplinary professionals in realistic simulation using modern mannequins and sham situations in divisions of the hospital where real patients would be treated. The focus of simulation and training was logistical optimization and educational debriefing with strategies to reduce waste of time in patient’s transportation from different departments, and avoiding excessive rewarming during transfer. Afterwards, the EHT protocol was successfully validated in a trial randomizing 50 patients for 18 minutes cooling before coronary recanalization at the target temperature of 32 ± 1.0 ∘C or PCI-only. A total of 35 patients underwent ETH (85.7% [30/35] in 90 ± 15 minutes), without delays in the mean door-to-balloon time for primary PCI when compared to 15 control group patients (92.1 minutes versus 87 minutes, respectively; p = 0.509). Conclusions: Realistic simulation, intensive training and educational debriefing for the multidisciplinary team propitiated feasible endovascular therapeutic hypothermia as an adjuvant therapy to primary PCI in STEMI. ClinicalTrials.gov: NCT02664194.
Bridging the future of cardiac stimulation: physiologic or leadless pacing?
Authors: Piemontese Giuseppe Pio , Toniolo Sebastiano , Biffi Mauro , Capobianco Claudio , Bartoli Lorenzo , Sorrentino Sergio , Minguzzi Alessandro , Angeletti Andrea , Statuto Giovanni , Ziacchi Matteo , Martignani Cristian , Massaro Giulia , Diemberger Igor , Spadotto Alberto
Published: March 2022

Cardiac simulation has moved from early life-saving pacemakers meant only to prevent asystole to current devices capable of physiologic stimulation for the treatment of heart rhythm and heart failure, that are also intended for remote patient and disease-progression monitoring. The actual vision of contemporary pacing aims to correct the electrophysiologic roots of mechanical inefficiency regardless of underlying structural heart diseases. The awareness of the residual cardiac dyssynchrony related to customary cardiac pacing has changed the concept of what truly represents “physiologic pacing”. On a different perspective, leadless stimulation to abolish CIED surgery and prevent lead-related complications is becoming a priority both for young device recipients and for frail, elderly patients. Careful clinical evaluation attempts to bridge decision-making to patient-tailored therapy.
Macrophage-Related Genes Biomarkers in Left Ventricular Remodeling Induced by Heart Failure
Authors: Zheng Yue , Lang Yuheng , Qi Zhenchang , Qi Bingcai , Gao Wenqing , Hu Xiaomin , Li Tong
Published: March 2022

Background: Elevated left ventricular mass index contributes to morbidity and mortality induced by heart failure and M2 macrophages play a critical role in left ventricular remodeling. Here, our aim was to investigate the roles of M2 macrophage-related genes in heart failure. Methods: GSE10161 was downloaded and the abundance of immune cells were estimated utilizing the CIBERSORT algorithm. Using the limma test and correlation analysis, differentially expressed plasm B cells and M2 macrophages-related genes (DEBRGs and DEMRGs) were documented. Functional pathways and the protein-protein interaction network were analyzed and the hub DEMRGs were obtained. The hub DEMRGs and their interactions were analyzed using NetworkAnalyst 3.0 and for validation, the hub DEMRGs expressions were analyzed using the GSE135055, GSE116250 and GSE74144 datasets. Results: 103 differentially expressed genes were correlated with the abundance of M2 Macrophages and were identified as DEMRGs (PCC >0.4), which were mainly enriched in extracellular matrix organization, cell adhesion molecule binding and postsynaptic membrane. After screening out, 5 hub DEMRGs were obtained, including FN1 (degree = 21), COL3A1 (degree = 13), COL1A2 (degree = 13), FBN1 (degree = 12), and MMP2 (degree = 11). However, no hub DEBRGs were obtained in the network. The expression patterns of the screened DEMRGs were further validated in the patients with heart failure, dilated cardiomyopathy, ischemic cardiomyopathy or hypertension. Conclusions: The results can improve our understanding of the macrophages-associated molecular mechanisms in heart failure induced by dilated cardiomyopathy, ischemic cardiomyopathy or hypertension and 5 hub DEMRGs may help prevent the adverse left ventricular remodeling to decrease mortality and morbidity.
Sadownik, S.A. (2022). Monitoring and Assessing Student Thinking in Google Math Classroom Environments.pdf
Authors: Sadownik Stephanie
Published: March 2022

Monitoring and assessing student thinking, facilitating mathematical
processes and increasing student engagement are key issues for
practicing elementary mathematics teachers. Awareness of student
thinking allows teachers to plan lessons according to zones of proximal
development and pace teaching, and group members accordingly. Awareness
also allows teachers to catch misconceptions early. This article
examines the use of Google Classroom to facilitate the mathematical
processes of communication, representation, reasoning and justification
or proof, allowing arguments to be built on prior knowledge that is
accessible and readily available and noting the particular benefit for
students of age 10-12 who benefit from shared awareness and subsequent
student calibration when sharing their thinking at this age.
Sadownik, S.A. (2022). Emotional language-Pedagogy of the Oppressed.pdf
Authors: Sadownik Stephanie
Published: March 2022

Paulo Freire popularized the Portuguese term conscientização, in
his work Pedagogy of the Oppressed (1970). His book noted students as
oppressed by an education system by singling out the teacher-student
relationship and offered insight into policy changes and approaches to
teaching that considered student-centered education and the development
of student discourse. Fifty years later, this paper presents a critical
investigation of the impact of technology devices used in education
among vulnerable and marginalized populations as a highly significant
and needed focus, given the rapidly increasing reliance on
internet-based technologies across the increasingly diverse communities
comprising our public educational system. Current school technology
agreements and poorly worded surveillance policies may silence
vulnerable and marginalized populations voice or agency for students
challenged by past trauma, lived experiences, emotion dysregulation or
specifically a Disruptive Mood Dysregulation Disorder (DMDD). Teachers,
administrators, technology staff and school board members were asked
questions related to their understanding of policies related to
technology and surveillance of devices such as laptops, cell phones,
iPads and school sponsored BYOD programs. The information collected
served as an indicator for which to measure the content knowledge and
experience of the participants as well as the individual perceived goals
or intentions of the participants school in relation to surveillance of
staff and students. Data collected during the study indicated
surveillance is attributed to five themes: well-being, assessment,
policy, security, punitive. Key findings included: an assumption that
school technology agreements included the use of personal devices and
schools may not uniquely identify inappropriate behaviour. Additionally,
assumptions informed the personal use of technology during school hours
with administrators and IT staff referencing general larger district
acceptable use policies assumed to be accepted as applicable to all
technology equipment and general use. Assumptions regarding the
enforcement of the technology agreement applications to personally owned
cell phones at school, were enforced during tests; and considered
generally accepted privacy concerns by students and staff related to the
inappropriate recording of others through taking pictures; video; but
extending to accessing social media. Finally, IT staff and
administration shared parental concerns of the surveillance of students
on Google and phones.
Gestalt Research on Problem-Solving and Today’s Gestalt
Authors: Mungan Esra
Published: March 2022

This article will focus on two pioneering scientific works in problem-solving, or per Gestalt theory, “productive thinking”. One of them is Köhler’s research on goal-directed tool use and overcoming obstacles in chimpanzees, the other is Duncker’s studies on problem-solving using a “think aloud” technique. In both Köhler’s and Duncker’s work, productive thinking is linked to a restructuring behavior, such as tearing off a thin, long branch from a tree to serve as a stick or removing various objects in a matchbox to transform it from a container to a base on which to mount a candle. In the final section, I will look at how today’s research trends might and should connect to Gestalt theory. In conclusion, just as in memory, the main tenets of Gestalt theory of figure-ground segregation and grouping play a critical role also in thinking. Thus, Gestalt theory seems to be able to come up with a common way of understanding perception, memory, as well as thinking. To my knowledge there is no other single theory within cognitive psychology that has such broad an explanatory power. This in itself is one more reason why Gestalt theory deserves crucial attention across all of cognition, even all of psychology and possibly even beyond.
The Composite Face Effect is Modulated by an Individual’s Preferred Fixation Position on Faces
Authors: Chakravarthula Puneeth N , Eckstein Miguel P.
Published: March 2022

Humans consistently land their first saccade to a face at a preferred fixation location (PFL). Humans also typically process faces as wholes, as evidenced by perceptual effects such as the Composite Face Effect (CFE). However, not known is whether an individual’s tendency to process faces as wholes varies with the PFL. Here, we investigated the variation of the CFE with the PFL. We compared the strength of the CFE for two groups of observers that were screened to have their PFLs either higher up closer to the eyes or lower on the face closer to the tip of the nose. We found that the PFL modulates the magnitude of the CFE. Observers with a PFL higher on the face had a stronger CFE than those with a lower PFL. Our findings suggest that holistic face processing is modulated by learned representations arising from an observer’s long-term eye movements to faces.