bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular adaptation to exercise and sport: (according to type of sport, gender, and ethnicity)
Authors: Papadakis Michael , Sharma Sanjay
Published: July 2019

‘Athlete’s heart’ is associated with several structural and electrophysiological adaptations, which are reflected on the 12-lead electrocardiogram (ECG) and imaging studies. Most studies investigating cardiac remodelling in athletes are based on cohorts of white, adult, male athletes competing in the most popular sports. Evidence suggests, however, that sporting discipline and the athlete’s gender and ethnicity are important determinants of cardiovascular adaptation to exercise. Athletes competing in endurance sports demonstrate more pronounced adaptations in comparison to athletes performing static or resistance training. The ECG of endurance athletes is more likely to demonstrate repolarization anomalies in the anterior leads and ventricular dilatation on imaging studies, causing considerable overlap with arrhythmogenic right ventricular cardiomyopathy and dilated cardiomyopathy. Female athletes exhibit less pronounced adaptations compared to males, in terms of the prevalence of ECG changes and absolute cardiac dimensions. Importantly, female endurance athletes are more likely to demonstrate eccentric hypertrophy compared to males, suggesting that concentric remodelling or hypertrophy in female endurance athletes is unlikely to be the consequence of physiological adaptation to training. The most pronounced paradigm of ethnically distinct cardiovascular adaptation to exercise stems from black athletes, who exhibit a significantly higher prevalence of repolarization anomalies and left ventricular hypertrophy compared to white athletes, making the differentiation between athlete’s heart and hypertrophic cardiomyopathy challenging in this ethnic group.
Successful reversal of ovarian hyperstimulation syndrome in a mouse model by rapamycin, an mTOR pathway inhibitor
Authors: Liu Wenwen , Zhang Chi , Wang Lu , Huang Xuan , Zhang Jing , He Yuanlin , Chen Li , Li Jing
Published: July 2019

Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening, iatrogenic complication of ovarian stimulation in assisted reproduction technology. This complex syndrome is characterised by enlarged ovaries with multiple corpora luteum, elevated sex steroid hormones in serum and increased capillary permeability. Until now, the pathogenesis of OHSS remains obscure, and no absolute strategy can fully prevent OHSS without any side effect on ovulation and clinical pregnancy. Using cultured human or mouse granulosa cells, our study revealed the time-dependent activation of the mTOR signaling pathway after human chorionic gonadotropin (hCG) treatment. The involvement of the mTOR signaling pathway was also observed in the development of OHSS in a mouse model. Selectively inhibiting mTOR signals by only two injections of rapamycin (2 mg/kg body weight), before or just after hCG treatment, significantly reduced vascular leakage and the severity of OHSS symptoms. Although ovarian angiogenesis was significantly inhibited, rapamycin could not decrease the elevated levels of vascular endothelial growth factor, IL-6 and IL-11 in OHSS ovaries. Further study showed the functional roles of the mTOR signaling pathway in the hyperstimulation-induced ovarian extracellular matrix remodeling as the expression of α2M, a broad proteolytic inhibitor in both ovary and serum, was dramatically decreased after rapamycin treatment. Since a single injection of rapamycin during superovulation had no side effects on ovulation and early embryonic development, we propose rapamycin may be a good candidate to lower and prevent the risk of OHSS in the future.
Synthetic lethality between BRCA1 deficiency and poly(ADP-ribose) polymerase inhibition is modulated by processing of endogenous oxidative DNA damage
Authors: Giovannini Sara , Weller Marie-Christine , Repmann Simone , Moch Holger , Jiricny Josef
Published: July 2019

Poly(ADP-ribose) polymerases (PARPs) facilitate the repair of DNA single-strand breaks (SSBs). When PARPs are inhibited, unrepaired SSBs colliding with replication forks give rise to cytotoxic double-strand breaks. These are normally rescued by homologous recombination (HR), but, in cells with suboptimal HR, PARP inhibition leads to genomic instability and cell death, a phenomenon currently exploited in the therapy of ovarian cancers in BRCA1/2 mutation carriers. In spite of their promise, resistance to PARP inhibitors (PARPis) has already emerged. In order to identify the possible underlying causes of the resistance, we set out to identify the endogenous source of DNA damage that activates PARPs. We argued that if the toxicity of PARPis is indeed caused by unrepaired SSBs, these breaks must arise spontaneously, because PARPis are used as single agents. We now show that a significant contributor to PARPi toxicity is oxygen metabolism. While BRCA1-depleted or -mutated cells were hypersensitive to the clinically approved PARPi olaparib, its toxicity was significantly attenuated by depletion of OGG1 or MYH DNA glycosylases, as well as by treatment with reactive oxygen species scavengers, growth under hypoxic conditions or chemical OGG1 inhibition. Thus, clinical resistance to PARPi therapy may emerge simply through reduced efficiency of oxidative damage repair.
Practice Patterns of Pneumocystis Pneumonia Prophylaxis in Connective Tissue Diseases: A Survey of Infectious Disease Physicians
Authors: Wolfe Rachel M , Beekmann Susan E , Polgreen Philip M , Winthrop Kevin L , Peacock James E
Published: July 2019

Background

Immunosuppressive therapy for connective tissue diseases (CTDs) increases risk for opportunistic infections including Pneumocystis pneumonia (PCP). High mortality rates are reported in CTD patients with PCP, which suggests a potential need for prophylaxis, but indications remain poorly defined. Wide variations in the use of PCP prophylaxis among rheumatologists have been documented. This study evaluated PCP prophylaxis patterns for CTD patients among infectious disease (ID) physicians.

Methods

An electronic survey was emailed to 1264 adult ID physicians who are members of the Infectious Diseases Society of America Emerging Infections Network.

Results

Six hundred thirty-one physicians responded to the survey. Respondents to the survey were more likely to work in academics (P = .02) and be early (<5 years) or late (≥25 years) in their careers (P = .0002). Forty-three percent (n = 269) made no recommendations for PCP prophylaxis in non-HIV patients. Of the 362 respondents who did make such recommendations, the greatest consensus for disease-based prophylaxis was for granulomatosis with polyangiitis (53%). For therapy-based prophylaxis, corticosteroids ≥20 mg/d was the most frequently cited indication (87%). Surrogate laboratory markers to aid in decisions about prophylaxis were not routinely used (21%). Although the majority recommended discontinuation of PCP prophylaxis with tapering of corticosteroids (65%), there was variability in the specific dose. Eighty-nine percent of respondents felt that guidelines about PCP prophylaxis would be helpful.

Conclusions

There is little consensus about PCP prophylaxis in CTDs among ID physicians. Guidelines for PCP prophylaxis would be helpful when caring for these complex patients.
Risk Factors for Asymptomatic Enteric Pathogen Detection Among Men Who Have Sex With Men
Authors: Williamson Deborah A , Chow Eric P F , Lee Darren , Maddaford Kate , Sait Michelle , Easton Marion , Ingle Danielle , Wigan Rebecca , De Petra Vesna , Howden Benjamin P , Fairley Christopher K , Chen Marcus Y
Published: July 2019

Improved knowledge of factors that promote outbreaks of enteric pathogens among men who have sex with men (MSM) could enable targeted public health interventions. We detected enteric pathogens in 57 of 519 (11%) asymptomatic MSM, and we found that enteric pathogen detection was associated with both oroanal sex (rimming) and group sex.
Sickle cell disease in anaemic children in a Sierra Leonean district hospital: a case series
Authors: Italia Maria B , Kirolos Sandy
Published: July 2019

Sickle cell disease (SCD) is the most common inherited haemoglobinopathy wordwide, with the highest prevalence in sub-Saharan Africa. Due to the lack of national strategies and scarcity of diagnostic tools in resource-limited settings, the disease may be significantly underdiagnosed. We carried out a 6-month retrospective review of paediatric admissions in a district hospital in northern Sierra Leone. Our aim was to identify patients with severe anaemia, defined as Hb < 7 g/dl, and further analyse the records of those tested for SCD. Of the 273 patients identified, only 24.5% had had an Emmel test, among which 34.3% were positive. Furthermore, only 17% of patients with a positive Emmel test were discharged on prophylactic antibiotics. Our study shows that increased awareness of SCD symptoms is required in high-burden areas without established screening programmes. In addition, the creation or strengthening of follow-up programmes for SCD patients is essential for disease control.
Microsurgical Resection of Lung Carcinoma Spinal Cord Metastasis: 2-Dimensional Operative Video
Authors: Pojskić Mirza , Arnautović Kenan I
Published: July 2019

This video demonstrates microsurgical resection of intramedullary spinal cord metastasis of lung adenocarcinoma. Lung cancer is the predominant cause of rare metastatic intramedullary involvement of the spinal cord.
1-4
Because of severe disabilities, these tumors should be considered for treatment with the goal of complete removal to preserve neurological functioning.
5-9

 Surgical resection improves symptoms, preserves ambulatory status, and increases survival time twice that of nonsurgical treatments.
3,8,10
Surgery can be effective in arresting neurological decline.
11,12
To our knowledge, this is the first video report of an intramedullary spinal cord metastasis resection.

 A 69-yr-old male with history of lung cancer presented with acute onset left arm abduction, forearm flexion, and hand weakness (3/5) and gait disturbance. Cervical spine MRI revealed C4/C5 nonhomogenously enhancing intramedullary tumor measuring 22 × 10 × 7 mm. Sagittal T2-weighted image demonstrated extensive cord edema.

 The C4 and C5 laminectomies were performed. Microsurgical techniques were employed.
13-15

Metastasis involved the left lateral aspect of the cord with invasion of 2 left dorsal sensory nerve roots, which were resected. Further transection of the dentate ligament relaxed the spinal cord, enabling safer tumor resection. Pial dissection using bipolar forceps, microscissors, and microdissector enabled tumor delivery. Following resection, dural closure was reinforced with previously harvested fat tissue graft to prevent CSF leak.
16

 Postoperative MRI revealed complete macroscopic resection with improvement of spinal cord swelling. Patient improved his gate and his left arm motor strength was stable. Subsequently, patient received focal adjuvant radiotherapy.

Written consent was obtained directly from the patient.
Effects of increasing copper from either copper sulfate or combinations of copper sulfate and a copper–amino acid complex on finishing pig growth performance and carcass characteristics1,2
Authors: Carpenter Corey B , Woodworth Jason C , Derouchey Joel M , Tokach Mike D , Goodband Robert D , Dritz Steve S , Wu Fangzhou , Rambo Zachary J
Published: July 2019

A total of 1,089 pigs (PIC 280 × 1050; initially 37.3 ± 2.8 kg) were used to determine the effects of increasing Cu provided from either CuSO4 alone or a 50:50 blend of CuSO4 and a Copper–amino acid complex (Cu-AA) on growth performance and carcass characteristics of finishing pigs. Pens of pigs were blocked by body weight; within blocks, pens were randomly allotted to one of six dietary treatments. The six dietary treatments consisted of a control diet which contained 17 mg/kg Cu from CuSO4 from the trace mineral premix, or the control diet with either added CuSO4 to provide 70 and 130 mg/kg total Cu or a 50:50 blend of Cu from CuSO4 and Cu-AA (CuSO4/Cu-AA blend) to provide 70, 100, and 130 mg/kg total Cu. Experimental diets were corn–soybean meal-dried distillers grains with solubles-based and fed in meal form in five phases (approximately 37 to 46, 46 to 63, 63 to 77, 77 to 103, and 103 to 129 kg body weight). From d 0 to 43, neither Cu source nor level influenced growth performance. From d 43 to 105, average daily feed intake (ADFI) decreased (P = 0.037) for pigs fed the CuSO4/Cu-AA blend compared to those fed added Cu from CuSO4 alone. Gain:feed ratio (G:F) tended to be improved (linear, P = 0.056) as Cu concentration increased. Overall, d 0 to 105, neither Cu level nor source influenced average daily gain (ADG). Pigs fed 70 or 130 mg/kg total added Cu from the CuSO4/Cu-AA blend had lower (P = 0.045) ADFI but G:F tended to be improved (P = 0.051) compared with those fed the same amount of total Cu from only CuSO4. Owing to the decreased ADFI and improved G:F of pigs fed the CuSO4/Cu-AA blend, carcass G:F also improved (P = 0.033) compared with those fed added Cu from CuSO4 alone. In conclusion, providing a 50:50 blend of CuSO4 and Cu-AA improved G:F on both a live and carcass weight basis compared to CuSO4 alone with no differences in ADG or carcass ADG observed.
Determining the influence of chromium propionate and Yucca schidigera on growth performance and carcass composition of pigs housed in a commercial environment1
Authors: Gebhardt Jordan T , Woodworth Jason C , Tokach Mike D , Derouchey Joel M , Goodband Robert D , Loughmiller Joe A , de Souza Ana L P , Rincker Mike J , Dritz Steve S
Published: July 2019

Two experiments were conducted to determine the effects of feeding chromium propionate (Cr; Kemin Industries, Inc., Des Moines, IA) and a Yucca schidigera-based extract (YS; Distributors Processing, Inc., Porterville, CA) on growth performance of finishing pigs housed in commercial conditions. In experiment 1, a total of 1,188 pigs (PIC 337 × 1050; initially 27.3 ± 0.48 kg body weight [BW]) with 27 pigs per pen and 11 pens per treatment were split by sex upon arrival at the facility and were randomly allotted to groups of four pens blocked by BW. Diets were corn–soybean meal-dried distillers grains with solubles-based and were fed in five phases. Treatments were arranged as a 2 × 2 factorial with main effects of Cr (0 vs. 200 µg/kg) or YS (0 vs. 62.5 mg/kg YS-based feed grade concentrate). Overall, adding Cr alone increased (P = 0.049) average daily feed intake (ADFI), and inclusion of YS resulted in a marginally significant increase (P = 0.077) in ADFI. Backfat depth was increased (P = 0.043) and lean percentage was decreased (P = 0.011) with added Cr. In experiment 2, a total of 2,430 pigs (PIC 359 × 1050; initially 29.3 ± 0.43 kg BW) were placed in balanced mixed-sex pens with 27 pigs per pen, blocked by average pen BW, and randomly assigned to one of six dietary treatments with 14 pens per treatment. Diets were corn–soybean meal-based and were formulated in five dietary phases. Treatments were arranged in a 2 × 3 factorial with main effects of Cr (0 vs. 200 µg/kg added Cr), and YS extract (0, 62.5, or 125 mg/kg YS-based feed grade concentrate). Overall, a marginally significant (linear, P = 0.072) Cr × YS interaction was observed for average daily gain (ADG) where there was insufficient evidence of a difference with increasing YS in diets not including added Cr (P ≥ 0.109); however, ADG increased (quadratic, P = 0.026) with YS addition in treatments fed 200 µg/kg added Cr. For overall ADFI, a marginally significant (linear, P = 0.071) Cr × YS interaction was observed where YS increased ADFI with 200 µg/kg added Cr (linear, P = 0.031), however, did not when diets contained no added Cr (P = 0.700). A marginally significant reduction in gain:feed ratio was observed when 62.5 mg/kg YS was included (quadratic, P = 0.053), and final BW and hot carcass weight were lowest with 62.5 mg/kg YS (quadratic, P = 0.012). In summary, adding Cr propionate along with YS led to modest changes in performance with the greatest benefit observed with 200 µg/kg Cr and 125 mg/kg YS-based feed grade concentrate.
13Poetics
Authors: Grace Stephen
Published: July 2019

This review is divided into three sections. The first, ‘Poet-Critics and Criticizing Poets’, considers the accounts of poetry traced in Robert Hass’s A Little Book on Form: An Exploration of the Formal Imagination of Poetry and Don Paterson’s The Poem: Lyric, Sign, Metre. The second section, ‘(Dis)embodied Sound’, examines the different ways that Peter Robinson and Angela Leighton (themselves both prominent critics and poets) approach sound in poetry in The Sound-Sense of Poetry and Hearing Things: The Work of Sound in Literature, while the third section, ‘Hybrids and Remnants’, explores the eccentric, hybrid forms of prose poetry and ecopoetics, as described in Jane Monson’s essay collection British Prose Poetry: The Poems Without Lines and Margaret Ronda’s monograph Remainders: American Poetry at Nature’s End.
A Predictive Risk Model Analysis of the Potato Cyst Nematode Globodera pallida in Idaho
Authors: Contina J. B. , Dandurand L. M. , Knudsen G. R.
Published: July 2019

Globodera pallida is a major nematode pest of potato (Solanum tuberosum) and is of great economic importance for the potato industry. Assessing potato yield loss caused by the Idaho G. pallida population under field conditions was not performed due to its quarantine status in Idaho, where it is prohibited by regulatory statutes to grow potato in any infested fields. The experimental data came from three trials that were conducted under greenhouse conditions. A predictive risk model analysis was performed to: (i) determine the effect of the Idaho population of G. pallida on potato yield; (ii) estimate reproduction rate from different initial nematode densities; and (iii) simulate potato yield losses in Idaho field conditions by integrating the coefficients of potato yield into the SUBSTOR-DSSAT crop simulation model. Experiments were conducted under greenhouse conditions using five initial G. pallida soil infestation levels (0, 10, 20, 40, and 80 eggs/g soil). The coefficients of potato yield achieved under each initial nematode density were integrated into the SUBSTOR-DSSAT potato growth simulation model. The model showed that tuber weight reached a maximum yield of 96 ton/ha in noninfested soil. Based on the greenhouse trials, the model predicted a minimum yield of 12 and 58 ton/ha in trial 1 and trial 2/3 respectively, when initial nematode density was 80 eggs/g soil. In trial 1, tuber weight was significantly reduced by 44% at 40 eggs/g soil and by 87% at 80 eggs/g soil, and 20% at 40 eggs/g soil and by 39% at 80 eggs/g soil in trial 2/3. The outputs of this study should facilitate common understanding between regulators, policymakers, and potato growers on the challenges and opportunities for controlling this economically important pest in Idaho.
Chondrosarcomas in adolescents: are they different?
Authors: Puri Ajay , Gulia Ashish , Kurisunkal Vineet John , Sukumar Vivek , Rekhi Bharat
Published: July 2019

The objective of this study was to evaluate the characteristics and oncologic outcomes of a single institution series of chondrosarcoma of pelvis and extremities in patients who were 21 years or younger. Between January 2006 and December 2016, we operated on 249 chondrosarcomas of the pelvis and extremities. Eleven (4%) of these were 21 years or younger. The mean age was 18 years (range 14–21 years). There were eight males and three females. Four occurred in the pelvis. The other sites were humerus (three) and one each in the scapula, clavicle, metatarsal and proximal femur. There were five primary chondrosarcomas and 6 (55%) secondary chondrosarcomas. After appropriate surgical excision, we had nine free margins and two margins were microscopically involved. None of the 11 patients received adjuvant chemotherapy or radiotherapy. One patient never followed up after surgery and another was lost to follow-up after 32 months. Eight were alive and one had died. All survivors had minimum follow-up of 2 years (range 26–106 months). There was one local recurrence. The overall and disease-free survival at 5 years for all patients was 89 %. There was no statistically significant difference in survival for primary chondrosarcomas compared to secondary chondrosarcomas (P = 0.061), or pelvic chondrosarcomas compared to other sites (P = 0.264). Chondrosarcomas in children and adolescents constitute <5% of all chondrosarcomas. Secondary chondrosarcomas constituted more than half the cases. Overall, outcomes in the young were no different from those in adults.
Is the incidence of paediatric stress fractures on the rise? Trends in New York State from 2000 to 2015
Authors: Patel Neeraj M. , Mai David H. , Ramme Austin J. , Karamitopoulos Mara S. , Castañeda Pablo , Chu Alice
Published: July 2019

The purpose of this study is to analyze trends in the epidemiology of paediatric stress fractures. The New York Statewide Planning and Research Cooperative System database was queried for stress fractures in children between the ages of 6 and 18 years. After checking for monotonicity of the data, Spearman’s correlation coefficient was calculated. Multivariate regressions were used to test for associations between demographic variables and risk of stress fracture. Analysis of 11 475 386 outpatient visits between 2000 and 2015 showed that the annual incidence of paediatric stress fractures increased from 1.37 cases per 100 000 outpatient visits in 2006 to 5.32 per 100 000 visits in 2015 (ρ = 0.876, P < 0.01). The mean age at the time of injury was 14.4 ± 2.8 years. Children younger than 14 years accounted for 33.6% of the cohort. Age, male sex, white ethnicity, and private insurance were statistically significant predictors of stress fractures in a multivariate model. This study is the first to document an increase in the annual incidence of paediatric stress fractures.
Declining Mortality of Cirrhotic Variceal Bleeding Requiring Admission to Intensive Care: A Binational Cohort Study*
Authors: Majeed Ammar , Majumdar Avik , Bailey Michael , Kemp William , Bellomo Rinaldo , Pilcher David , Roberts Stuart K.
Published: July 2019

Objectives:

We aimed to describe changes over time in admissions and outcomes, including length of stay, discharge destinations, and mortality of cirrhotic patients admitted to the ICU for variceal bleeding, and to compare it to the outcomes of those with other causes of ICU admissions.

Design:

Retrospective analysis of data captured prospectively in the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database.

Settings:

One hundred eighty-three ICUs in Australia and New Zealand.

Patients:

Consecutive admissions to these ICUs for upper gastrointestinal bleeding related to varices in patients with cirrhosis between January 1, 2005, and December 31, 2016.

Interventions:

None.

Measurements and Main Results:

ICU admissions for variceal bleeding in cirrhotic patients accounted for 4,003 (0.6%) of all 720,425 nonelective ICU admissions. The proportion of ICU admissions for variceal bleeding fell significantly from 0.8% (83/42,567) in 2005 to 0.4% (53/80,388) in 2016 (p < 0.001). Hospital mortality rate was significantly higher within admissions for variceal bleeding compared with nonelective ICU admissions (20.0% vs 15.7%; p < 0.0001), but decreased significantly over time, from 24.6% in 2005 to 15.8% in 2016 (annual decline odds ratio, 0.93; 95% CI, 0.90–0.96). There was no difference in the reduction in mortality from variceal bleeding over time between liver transplant and nontransplant centers (p = 0.26).

Conclusions:

Admission rate to ICU and mortality of cirrhotic patients with variceal bleeding has declined significantly over time compared with other causes of ICU admissions with the outcomes comparable between liver transplant and nontransplant centers.
Current role of poly(ADP-ribose) polymerase inhibitors: which poly(ADP-ribose) polymerase inhibitor and when?
Authors: Vanacker Hélène , Romeo Clémence , Ray-Coquard Isabelle
Published: July 2019

Purpose of review

In the past few years, the advent of PARP inhibitors has been a revolution in the management of ovarian cancer. Patients harboring somatic or germ line BRCA1/2 mutations exhibit different clinical and treatment response behavior. The BRCA gene is involved in repairing DNA repair via homologous recombination, and mutation of this gene leads to homologous recombination deficiency (HRD).

Recent findings

HRD constitutes a therapeutic opportunity for these patients, thanks to the development of poly(ADP-ribose) polymerase inhibitors (PARPi) in the late 2000s. Indeed, using PARPi in patients with HRD simultaneously compromises two mechanisms of DNA repair, resulting in synthetic lethality.

This breakthrough in clinical practice has raised remaining questions: which population will most benefit from PARPi? Are all ovarian cancers susceptible to synthetic lethal strategy? At which stage of ovarian cancer should PARPi be used? Is earlier always better? Are PARPi all equivalent? Which strategies are reasonable to overcome PARPi resistance? Which combination strategies should be efficient?
Selective oestrogen receptor degraders in breast cancer: a review and perspectives
Authors: Gombos Andrea
Published: July 2019

Purpose of review

Estrogen receptor-positive breast cancer accounts for 70% of all breast cancers. Sequential endocrine treatment in monotherapy or in combination with CDK 4/6 or m-TOR inhibitors is the mainstay of recommended treatment options in the management of metastatic breast cancer even in the presence of visceral metastasis. There is an emerging need to address endocrine resistance, which despite highly efficacious treatment combinations still can develop.

Recent findings

One of the mechanisms of endocrine resistance is molecular alteration of the oestrogen receptor itself, such as ESR1 mutations affecting the ligand-binding domain. These mutations emerge under the selective pressure of aromatase inhibitors. The efficacy of selective oestrogen receptor degraders (SERDs) might not be affected by the presence of molecular alterations of oestrogen receptor. Fulvestrant is the only SERD used in current clinical practice. Numerous novel, nonsteroidal orally available SERDs are currently in clinical development. Efficacious oestrogen receptor target engagement and promising clinical activity was shown in early phase clinical trials.

Therefore, a new class of orally available nonsteroidal SERDs gains high interest in tackling endocrine resistance in oestrogen receptor-positive (ER+) advanced breast cancer. Clinical efficacy needs to be confirmed in larger patient populations.
Seronegative West Nile Virus in a Patient With Stage 4 Follicular Cell Lymphoma
Authors: Sterrett Yamini , Katikineni Veena , Nayak Rahul , Piechowiak Mary , Delman Mark
Published: July 2019

West Nile virus (WNV) is an arbovirus, which is transmitted by mosquitoes. Transmission peaks in the late summer and early fall. In 2018, Virginia had 47 total cases of WNV, 37 of which were neuroinvasive with 7 reported deaths. Risk factors for neuroinvasive WNV include advanced age, history of organ transplantation, and hematologic malignancy especially those actively undergoing chemotherapy. Here we discuss a case of a patient with stage 4 follicular cell lymphoma with recent chemotherapy and radiation therapy, who was found to have severe neuroinvasive seronegative WNV encephalitis with flaccid paralysis.
Characteristics and Outcomes of Pediatric Vestibular Schwannomas
Authors: Janz Tyler A. , Camilon Philip Ryan , Cheung Anthony Y. , Nguyen Shaun A. , Meyer Ted A. , McRackan Theodore R. , Lambert Paul R.
Published: July 2019

Objective:

To review the demographics, treatment modalities, and survival of children with vestibular schwannomas.

Study Design:

Analysis using the Surveillance, Epidemiology, and End Results (SEER) database.

Subjects and Methods:

Pediatric patients from birth to 18 years in the SEER database were included from 2004 to 2014 based on a diagnosis of vestibular schwannoma using the primary site International Classification of Diseases (ICD) O-3 code of C72.4: acoustic nerve and the ICD O-3 histology codes of 9540/1: neurofibromatosis, Not Otherwise Specified (NOS); 9560/0: neurilemoma, NOS; or 9570/0: neuroma, NOS.

Results:

One hundred forty-eight pediatric vestibular schwannomas (VSs) cases were identified. The mean age at diagnosis was 13.9 years (range, 4.0–18.0). Eighty-five (57.4%) patients were women. Seventy-seven (52.0%) patients had isolated unilateral VSs while 71 (48.0%) patients had either bilateral VSs or unilateral VSs with other brain, spinal cord, or cranial nerve tumors. Eighty two (55.4%) patients received surgical resection only, 45 (30.4%) received no treatment, 6 (4.1%) received radiation only, and 12 (8.1%) received surgery and radiation. The median tumor size for patients who received no treatment was 9.5 mm (interquartile range [IQR]: 8.0) compared with 33.5 mm (IQR: 23.0) for patients who received surgical care and 41.0 mm (IQR: 1.5) for patients who received both surgery and radiation (p < 0.001). The 5-year overall survival rate was 97%.

Conclusion:

Pediatric VSs tend to be diagnosed in adolescence. No men or women predominance was appreciated. Treatment varied according to tumor size. Survival rates for children with vestibular schwannomas are excellent. These data may assist healthcare providers when counseling children with vestibular schwannomas and their families.
A comparison of the effects of electroacupuncture vs transcutaneous electrical nerve stimulation for pain control in knee osteoarthritis
Authors: Shi Xiaowei , Yu Wenjing , Wang Tong , Shu Qi , Wang Chunjiu , Yang Xue , Liu Changxin , Guo Changqing
Published: July 2019

Background:

Knee osteoarthritis (KOA), the most common type of osteoarthritis, is a chronic degenerative joint disease accompanied by pain and functional limitation for the elderly. The 2 nonpharmacologic approaches, electroacupuncture (EA) and transcutaneous electrical nerve stimulation (TENS), are considered beneficial in relieving KOA pain, however, the current conclusions are controversial. Furthermore, no direct or indirect meta-analyses between EA and TENS have been reported for the pain relief of KOA patients.

Methods:

PubMed, EMBASE, Cochrane library, Web of Science, CNKI, VIP, Wan Fang will be systematically searched their inception to May 2018. Randomized controlled trials that compared the effect of EA and TENS on pain control in knee osteoarthritis will be included. The primary outcome was the knee pain levels, and secondary outcome was the comprehensive indicators. Risk of bias assessment of the included studies will be performed according to the Cochrane risk of bias tool. The pairwise and network meta-analysis will be performed by STATA 14.0 software.

Results:

This study is ongoing and will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study will provide comprehensive evidence on the effects of EA and TENS for pain control in knee osteoarthritis.

PROSPERO registration number:

CRD42018091826.
Obesity in psoriatic arthritis
Authors: Queiro Rubén , Lorenzo Andrés , Tejón Patricia , Coto Pablo , Pardo Estefanía
Published: July 2019

Obesity is a common cardiovascular risk factor in psoriatic disease. Although the prevalence of obesity is high, the factors associated with it in patients with psoriatic arthritis (PsA) are poorly understood. We aimed to analyze the frequency and obesity-associated factors in a cohort of PsA.

This retrospective cross-sectional study included 290 consecutive patients with PsA according to CASPAR criteria. Three-hundred ten psoriatic patients without arthritis and 600 outpatients without inflammatory conditions were used as comparison populations. The factors associated with obesity were analyzed first using conditional logistic regression. The significant factors in this first model were introduced in a multivariate model using a backward step approach.

This series included 159 men (54.8%) and 131 women (45.2%), with an average age of 54 ± 12 years. Obesity was more common both in psoriasis (36.5% vs 22%, OR 2.1 [95%CI: 1.5–2.8), P < .01]) and PsA (27.6% vs 22%, OR 1.4 [95%CI: 1.0–1.9], P < .05) than in the non-inflammatory population. Obesity was more frequent in psoriasis (36.5%) than in PsA (27.6%), OR 1.5 95% CI: 1.1 to 2.1, P < .05. After correcting for age, sex, disease duration, and other confounders, independent associations with obesity (P < .05) were: PsA family history (OR 3.6, 95%CI: 1.1–12.4), evolution as axial disease (OR 4.4, 95%CI: 1.0–15.4), and dyslipidemia (OR 3.5, 95%CI: 1.5–8.6).

Obesity is common in psoriatic disease, but much more frequent among patients with cutaneous than joint disease. Patients who present with spondylitis during evolution are more prone to this comorbidity, and therefore, should be closely monitored to correct this eventuality in a timely manner.
Fruits and vegetables consumption and the risk of gallstone diasease
Authors: Zhang Jun-Wei , Xiong Jian-Ping , Xu Wei-Yu , Sang Xin-Ting , Huang Han-Chun , Bian Jin , Xu Yi-Yao , Lu Xin , Zhao Hai-tao
Published: July 2019

Background:

The role of fruit and vegetables (FVs) consumption in decreasing gallstone disease risk remains contradictory. We performed a meta-analysis to analyze this potential correlation, followed by investigation of dose-response relationship of FVs consumption with gallstone disease.

Materials and methods:

PubMed, Embase, as well as Web of Science were searched to determine all published researches about the connection of FVs consumption with gallstone disease before March 2018. Relative risks (RRs) or odds ratios (ORs) along with corresponding 95% confidence intervals (CIs) was pooled utilizing random effect models, aiming at examining the correlation of FVs consumption with gallstone disease risk.

Results:

One cross-sectional study, our case-control studies as well as nine cohort studies were enrolled, covering approximately 33,983 patients with gallstone disease and 1,53,3752 participants. In a pooled analysis, vegetables consumption was significantly related to a decreased gallstone disease risk, (RR = 0.83, 95% CI, 0.74–0.94, I
2 = 91.1%), and for fruits consumption, RR was similar (RR = 0.88, 95%CI, 0.83–0.92, I
2 = 0.01%). This inverse correlation of FVs consumption with gallstone disease risk was solid in most subgroup analysis. The nonlinear dose-response correlation indicated that gallstone risk was reduced by 4% (RR = 0.96, 95%CI, 0.93–0.98) and 3% (RR = 0.97, 95%CI, 0.96–0.98) for every 200 g per day increment in vegetables consumption (P = .001) and fruits consumption (P = .001), respectively.

Conclusion:

This study suggests vegetables and fruits consumption is correlated with a significantly reduced risk of gallstone disease.
Significant association of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) rs3846662 and sirtuin 1 (SIRT1) rs7895833 and apolipoprotein E (APOE) hypermethylation with mild cognitive impairment (MCI)
Authors: Zou Ting , Duan Yali , Zhou Xiaohui , Chen Wei , Ying Xiuru , Liu Guili , Zhao Yongjie , Zhu Meisheng , Pari Abuliz , Alimu Kader , Miao Haijun , Kabinur Keyim , Zhang Lei , Wang Qinwen , Duan Shiwei
Published: July 2019

Our study investigated the association of five genes with MCI in the Xinjiang Uygur population in China. In addition, we also analyzed the association between APOE methylation and MCI.

Forty-three MCI and 125 controls were included in the present study. Genotyping was done by Sanger sequencing. DNA methylation assay was done using quantitative methylation-specific polymerase chain reaction (qMSP).

The distribution of HMGCR rs3846662 allele frequencies was significantly different between the MCI group and the control group (P = .04), especially in women (P = .032). Subgroup analysis showed that there was a statistically significant association of HMGCR rs3846662 with MCI in the non-APOE ε4 group (P = .024), especially in the females with non-APOE ε4. Similarly, HMGCR rs3846662 genotype and allele frequency in the ApoE E2 protein group were significantly different in the MCI group and the control group (genotype P = .021; allele P = .007). In addition, SIRT1 rs7895833 genotype frequency in the APOE ε4 group was found to be significantly different between the MCI and the control group (P = .005). We also observed a significant association of SIRT1 rs7895833 with MCI in the ApoE E4 protein subgroup (P = .005). In addition, APOE methylation levels were significantly different between the MCI group and the control group (P = .021), especially in men (P = .006). Subgroup analysis showed that APOE methylation levels were significantly associated with MCI in the non-APOE ε4 group (P = .009), especially in men (P = .015).

This study found a significant association of HMGCR rs3846662 with MCI in females independent of APOE ε4. In contrast, we revealed that the association of SIRT1 rs7895833 with MCI was dependent on with APOE ε4. We also showed that hypermethylation of APOE in MCI was independent of APOE ε4.
Tobacco smoke exposure and the risk of childhood acute lymphoblastic leukemia and acute myeloid leukemia
Authors: Chunxia Dong , Meifang Wang , Jianhua Zhang , Ruijuan Zhang , Xiue Liu , Zhuanzhen Zheng , Linhua Yang
Published: July 2019

Objective:

Tobacco smoke contains carcinogens known to damage somatic and germ cells. In this study, we investigated the effect of tobacco smoking on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML).

Methods:

Information about tobacco smoking exposures of the mother before, during, and after pregnancy was collected via PubMed, Embase, and Web of Science databases through November 5, 2018. We performed to evaluate the association between smoking exposure and the risk of childhood ALL and AML. Study selection, data abstraction, and quality assessment were performed by 2 independent reviewers. Random effects models were used to obtain summary odds ratios (ORs) and 95% confidence intervals (CIs).

Results:

Nineteen case–control studies of childhood leukemia (age < 15 years) conducted in 9 countries from 1974 to 2018. Maternal smoking exposures did not a significant association with childhood ALL (OR = 1.004, 95% CI 0.953–1.058, P = .881) and AML (OR = 0.92, 95% CI 0.815–1.038, P = .177) during exposure time windows. However, there was an association with paternal smoking and ALL (OR = 1.15, 95% CI 1.038–1.275, P = .007). Paternal smoking in AML showed there was no association with smoking exposures and childhood AML (OR = 1.133, 95% CI 0.943–1.362, P = .181). Next, maternal daily cigarettes consumption showed no associations with ALL (OR = 1.08, 95% CI 1.000–1.168, P = .051) during pregnancy. No association with maternal daily smoking and AML (OR = 0.909, 95% CI 0.682–1.211, P = .514). Paternal daily cigarettes consumption was associated with increased risks of childhood ALL (OR = 1.200, 95% CI 1.112–1.302, P = .000). The higher consumption of paternal smoking (more than 10 per day) was significantly related to childhood ALL. Paternal daily smoking consumption also was related to AML (OR = 1.242, 95% CI 1.031–1.496, P = .022).

Conclusion:

Maternal smoking before, during, or after pregnancy was not associated with childhood ALL or AML. However, paternal smoking was related to a significantly elevated risk of childhood ALL during pregnancy, but not for AML. Maternal daily smoking consumption was not associated with ALL or AML during pregnancy. The higher consumption of paternal smoking were, the higher the risk of childhood ALL or AML.
Colon Perforation by Compressed Air
Authors: Das Siddhartha , Hanuman Srinivas Bheemanathi , Toi Pampa Ch , Subramania Deepak Barathi , Yanamadala Siva Pradeep
Published: July 2019

Barotrauma-associated perforation of the colon is not common and usually occurs due to the passage of compressed air through the anus. Most of the cases are accidental and done for fun often at the victim's workplace. Therefore, it is necessary that the workers should be made aware of the dangers of the equipment they regularly use at their workplace. Here, we describe one such case where a rice mill worker died when compressed air through an air pump pipe entered his rectum. His chief complaint was abdominal pain and breathing difficulty. Computed tomography scan of the abdomen and thorax showed pneumoperitoneum, pneumomediastinum, and soft tissue emphysema. There was a complete tear in the rectosigmoid junction of the colon. The mucosa was deeply hemorrhagic and congested. Histopathology of this segment showed hemorrhagic necrosis of the mucosa.
Expanding the Phenotypic Spectrum of Mesenchymal Tumors Harboring the EWSR1-CREM Fusion
Authors: Yoshida Akihiko , Wakai Susumu , Ryo Eijitsu , Miyata Kazuyuki , Miyazawa Masahisa , Yoshida Ken-ichi , Motoi Toru , Ogawa Chitose , Iwata Shintaro , Kobayashi Eisuke , Watanabe Shun-ichi , Kawai Akira , Mori Taisuke
Published: July 2019

ATF1, CREB1, and CREM constitute the CREB family of transcription factors. The genes encoding these factors are involved in gene fusion events in human tumors. EWSR1-ATF1 and EWSR1-CREB1 are the 2 most characterized fusions, whereas EWSR1-CREM has been less studied. To better understand the phenotypic spectrum of mesenchymal tumors associated with the EWSR1-CREM fusion, we investigated archival cases using fluorescence in situ hybridization and/or RNA sequencing. Among 33 clear cell sarcomas of soft tissue tested, we found 1 specimen, a hand tumor bearing the rearrangements of EWSR1 and CREM, with classic histology and immunophenotype. None of 6 clear cell sarcoma-like tumors of the gastrointestinal tract tested harbored the EWSR1-CREM fusion. Among 11 angiomatoid fibrous histiocytomas, we found that 3 tumors of myxoid variant harbored the rearrangements of EWSR1 and CREM. All 3 tumors occurred in middle-aged men and involved the distal extremities (N=2) and the lung (N=1). Prominent lymphoid cuff, fibrous pseudocapsule, and amianthoid fiber were present in 3, 2, and 2 tumors, respectively, whereas none showed pseudoangiomatoid spaces. All 3 tumors were immunohistochemically positive for epithelial membrane antigen and desmin. These cases suggested a closer relationship between angiomatoid fibrous histiocytoma and a recently proposed novel group of myxoid tumors with CREB family fusions. Our cohort also included 2 unclassifiable sarcomas positive for EWSR1-CREM. One of these was an aggressive pediatric tumor of the abdominal cavity characterized by proliferation of swirling spindle cells immunopositive for cytokeratin and CD34. The other tumor derived from the chest wall of an adult and exhibited a MUC4-positive sclerosing epithelioid fibrosarcoma-like histology. Our study demonstrates that a wider phenotypic spectrum is associated with the EWSR1-CREM fusion than previously reported.
Current and new rotavirus vaccines
Authors: Burke Rachel M. , Tate Jacqueline E. , Kirkwood Carl D. , Steele A. Duncan , Parashar Umesh D.
Published: July 2019

Purpose of review

As of 2019, four rotavirus vaccines have been prequalified by the WHO for use worldwide. This review highlights current knowledge regarding rotavirus vaccines available, and provides a brief summary of the rotavirus vaccine pipeline.

Recent findings

Data generated from use of currently available products supports their effectiveness and impact in diverse settings. Rotavirus vaccines have a favorable risk–benefit profile, but previous associations of rotavirus vaccination with intussusception necessitate continued monitoring for this rare but serious adverse event. Implementation of rotavirus vaccines was jeopardized in late 2018 and 2019 by a shortage of vaccine supply. Fortunately, with the prequalification of two additional vaccines in 2018, countries have increased choice in products with different characteristics, pricing, and implementation strategies. Other vaccines currently in development may open up further immunization strategies, such as neonatal vaccination schedules or parenteral administration.

Rotavirus vaccines have demonstrated impact in reducing diarrheal morbidity and mortality worldwide. As countries begin to introduce the newly prequalified vaccines, additional data will become available on the safety and effectiveness of those products. Products in the pipeline have distinct profiles and could be an essential part of the expansion of rotavirus vaccine use worldwide.
Association of TDP-43 Pathology With Domain-specific Literacy in Older Persons
Authors: Kapasi Alifiya , Yu Lei , Stewart Christopher C. , Schneider Julie A. , Bennett David A. , Boyle Patricia A.
Published: July 2019

Background:

Low health and financial literacy may be an early behavioral manifestation of cognitive impairment, dementia, and accumulating Alzheimer pathology. However, there are limited studies investigating the behavioral features associated with hyperphosphorylated transactive response DNA-binding protein-43 (TDP-43), a common age-related pathology, and even fewer studies investigating the neurobiological basis underlying low literacy in aging.

Objective:

To test the hypothesis that TDP-43 pathology is associated with lower literacy.

Materials and Methods:

Data came from 293 community-based older persons who were enrolled in 2 ongoing studies of aging. Participants completed literacy and cognitive assessments, consented to brain donation, and underwent detailed neuropathologic evaluation for Alzheimer disease (AD) and TDP-43. Linear regression models assessed the association of TDP-43 with literacy after adjusting for demographics, and AD pathology. Posthoc pairwise comparisons examined whether the level of literacy differed by TDP-43 stage.

Results:

TDP-43 pathology was associated with lower literacy (estimate=−3.16; SE=0.86; P<0.001), above and beyond demographics and AD pathology, and this association persisted even after additionally adjusting for global cognition (estimate=−1.53; SE=0.74; P=0.038). Further, literacy was lower among persons with neocortical TDP-43 pathology compared with those without TDP-43 pathology.

Conclusions:

TDP-43 pathology is associated with lower health and financial literacy in old age, above and beyond AD pathology.