bluuebunny/crossref_metadata_2025 huggingface dataset:
Transnational media consumption dissonance and ambivalent sexism: How American and Korean television drama consumption shapes Chinese audiences’ gender-role values
Authors: Zhang Xiao , Su Chris Chao
Published: July 2021

Driven by globalization, modernity and the development of media technology, transnational media consumption is increasingly prevalent. Together with domestic media consumption, transnational media consumption constitutes the fragmentation and diversification of individuals’ media consumption behaviors. Yet research concerning the hybrid media effects generated by domestic and transnational media consumption is still underdeveloped. Using a sample of 556 Chinese Internet users, this study proposes a concept of transnational media consumption dissonance to compare the effects of hybrid media consumption on sexism and gender-role norms in marriage (GRIM). The findings suggest that individuals’ perceptions of gender-role norms are not only affected by domestic media usage but also altered through transnational media usage. We illustrate how transnational media consumption dissonance can affect Chinese audiences’ perception of GRIM through the mediating roles of perceived sexism in American and Korean dramas and their general sexism values.
Stratification of Microvascular Disease Severity in the Foot Using Spatial Frequency Domain Imaging
Authors: Jett Samuel , Thompson Mallory R. , Awasthi Shubhangi , Cuccia David J. , Tan Tze-Woei , Armstrong David G. , Mazhar Amaan , Weinkauf Craig C.
Published: July 2021

Background:

Microvascular disease (MVD) describes systemic changes in the small vessels (~100 um diameter) that impair tissue oxygenation and perfusion. MVD is a common but poorly monitored complication of diabetes. Recent studies have demonstrated that MVD: (i) is an independent risk factor for ulceration and amputation and (ii) increases risk of adverse limb outcomes synergistically with PAD. Despite the clinical relevance of MVD, microvascular evaluation is not standard in a vascular assessment.

Methods:

We evaluated 299 limbs from 153 patients seen clinically for possible lower extremity PAD. The patients were assessed by ankle brachial index (ABI), toe brachial index (TBI), and spatial frequency domain imaging (SFDI). These measurements were evaluated and compared to patient MVD status, defined by clinical diagnoses of (in ascending order of severity) no diabetes; diabetes; diabetes + neuropathy; diabetes + neuropathy + retinopathy.

Results:

SFDI-derived parameters HbT1 and StO2 were significantly different across the MVD groups ( P < .001). A logistic regression model based on HbT1 and StO2 differentiated limbs with severe MVD (diabetes+neuropathy+retinopathy) from the larger group of limbs from patients with only diabetes ( P = .001, area under the curve = 0.844). Neither ABI nor TBI significantly differentiated these populations.

Conclusions:

Standard assessment of PAD using ABI and TBI are inadequate for detecting MVD in at-risk populations. SFDI-defined HbT1 and StO2 are promising tools for evaluating MVD. Prospective studies with wound-based outcomes would be useful to further evaluate the role MVD assessment could play in routine clinical evaluation of patients at risk for lower extremity complications.
Who Should Make Medical Decisions When a Patient Lacks an Advance Directive?
Authors: Dygert Levi , Lewis Ariane
Published: July 2021

Patients admitted to the hospital with neurological problems are sometimes incapacitated and unable to make end-of-life decisions. In these instances, without an advanced directive from the patient, clinicians and family members must make critical medical decisions without input from the patient. This paper looks at two cases - one child and one adult – in which neuroprognosis was uncertain, and physician and family members’ beliefs on end-of-life care clash. We provide insight into these disagreements and reflect on how best to manage them. We argue that when considering withdrawing treatment, respecting autonomy is of paramount importance, while decision-making about continuing life-sustaining treatment requires clinicians to ensure surrogates are adequately educated about the principle of beneficence.
Fatty Acid–Binding Protein 4 (FABP4) Is Associated with Cartilage Thickness in End-Stage Knee Osteoarthritis
Authors: Schadler Paul , Lohberger Birgit , Thauerer Bettina , Faschingbauer Martin , Kullich Werner , Stradner Martin Helmut , Husic Rusmir , Leithner Andreas , Steinecker-Frohnwieser Bibiane
Published: July 2021

Background

There is no single blood biomarker for the staging of knee osteoarthritis (KOA). The purpose of this study was to assess the relationship of obesity, serum biomarkers, the hip-knee-ankle angle (HKAA) with sonographic cartilage thickness.

Methods

We conducted a cross-sectional study of n = 33 patients undergoing knee arthroplasty. Body mass index (BMI) was recorded, and patients were grouped based on BMI. Serum blood samples were collected, and the following biomarkers were measured using the ELISA technique (subgroup of n = 23): oxidized low-density lipoprotein (oxLDL), soluble receptor for advanced glycation end-products (sRAGE), fatty acid–binding protein 4 (FABP4), membrane-bound phospholipase A2 (PLA2G2A). The HKAA was analyzed on full-length limb standing x-ray images. Cartilage thickness was assessed on ultrasound images. Multivariable regression analysis was performed to account for confounding.

Results

After adjusting for age, gender, and HKAA, obese patients had thicker medial femoral cartilage (β = 0.165, P = 0.041). Furthermore, lateral cartilage thickness was negatively correlated with FABP4 level after adjusting for of age, gender, BMI, and HKAA (β = −0.006, P = 0.001). Confirming previous studies, after adjustment, FABP4 level was associated with a higher BMI group (β = 42.99, P < 0.001). None of the other markers (oxLDL, PLA2G2A, and sRAGE) was associated with BMI or cartilage thickness.

Discussion

Our results indicate that BMI has a weak, positive association with cartilage thickness in end-stage KOA patients. FABP4 levels were negatively associated with cartilage thickness. While our study is limited by a small sample size, these results further highlight the role of FABP4 as promising biomarkers of burden of disease in KOA.
The Chicken and Egg of Pride and Social Rank
Authors: Witkower Zachary , Mercadante Eric , Tracy Jessica L.
Published: July 2021

Prior research has found an association between pride experiences and social rank outcomes. However, the causal direction of this relationship remains unclear. The current research used a longitudinal design ( N = 1,653) to investigate whether pride experiences are likely to be a cause, consequence, or both, of social rank outcomes, by tracking changes in individuals’ pride and social rank over time. Prior research also has uncovered distinct correlational relationships between the two facets of pride, authentic and hubristic, and two forms of social rank, prestige and dominance, respectively. We therefore separately examined longitudinal relationships between each pride facet and each form of social rank. Results reveal distinct bidirectional relationships between authentic pride and prestige and hubristic pride and dominance, suggesting that specific kinds of pride experiences and specific forms of social rank are both an antecedent and a consequence of one another.
A review of neuroradiological abnormalities in patients with coronavirus disease 2019 (COVID-19)
Authors: Bahranifard Bahar , Mehdizadeh Somayeh , Hamidi Ali , Khosravi Alireza , Emami Ramin , Mirzaei Kamran , Nemati Reza , Nemati Fatemeh , Assadi Majid , Gholamrezanezhad Ali
Published: July 2021

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to various neurological manifestations. There is an urgent need for a summary of neuroimaging findings to accelerate diagnosis and treatment plans. We reviewed prospective and retrospective studies to classify neurological abnormalities observed in patients with the SARS-CoV-2 infection.

Methods

The relevant studies published in Scopus, PubMed and Clarivate Analytics databases were analysed. The search was performed for full-text articles published from 23 January 2020 to 23 February 2021.

Results

In 23 studies the number of patients with SARS-CoV-2 infection was 20,850 and the number of patients with neurological manifestations was 1996 (9.5%). The total number of patients with neuroradiological abnormalities was 602 (2.8%). SARS-CoV-2 has led to various neuroimaging abnormalities which can be categorised by neuroanatomical localisation of lesions and their main probable underlying pathogenesis. Cranial nerve and spinal root abnormalities were cranial neuritis and polyradiculitis. Parenchymal abnormalities fell into four groups of: (a) thrombosis disorders, namely ischaemic stroke and sinus venous thrombosis; (b) endothelial dysfunction and damage disorders manifested as various types of intracranial haemorrhage and posterior reversible encephalopathy syndrome; (c) hypoxia/hypoperfusion disorders of leukoencephalopathy and watershed infarction; and (d) inflammatory disorders encompassing demyelinating disorders, encephalitis, vasculitis-like disorders, vasculopathy and cytotoxic lesions of the corpus callosum. Leptomeninges disorders included meningitis. Ischaemic stroke was the most frequent abnormality in these studies.

Conclusion

The review study suggests that an anatomical approach to the classification of heterogeneous neuroimaging findings in patients with SARS-CoV-2 and neurological manifestations would lend itself well for use by practitioners in diagnosis and treatment planning.
Normalized intraplaque hemorrhage signal on MP-RAGE as a marker for acute ischemic neurological events
Authors: Larson Anthony S , Brinjikji Waleed , Kroll Neil J , Savastano Luis , Huston John , Benson John C
Published: July 2021

Purpose

This study sought to validate whether the signal intensity ratio (SIR) of carotid intraplaque hemorrhage (IPH) was associated with acute ischemic neurologic events.

Methods

A retrospective review was completed of consecutive patients that underwent neck magnetic resonance angiography using magnetization prepared-rapid gradient echo (MP-RAGE) and T1-CUBE sequences between 2017 and 2020. Patients with magnetic resonance evidence of IPH were included. SIRs were measured by comparing the maximum IPH signal with the mean intramuscular signal from the adjacent sternocleidomastoid. Patients were stratified into ischemic or non-ischemic groups based on the presence of acute ipsilateral ischemic events (stroke, retinal artery occlusion). Logistic regression analysis was performed to determine if increasing IPH SIR was associated with an increased risk of ipsilateral ischemic events.

Results

Of 85 included patients (85 arteries), 66 were male (77.6%). Mean age was 71.0 (SD ± 11.1). There were 70 arteries with IPH that were ipsilateral to an ischemic event, and 15 that belonged to patients without an ischemic event. No association was found between increasing IPH SIR seen on MP-RAGE (odds ratio (OR): 0.82; 95% confidence interval (CI): 0.58–1.4; P = 0.43) or T1-CUBE sequences (OR: 0.85; 95% CI: 0.53–1.5; P = 0.56).

Conclusions

There was no association between the SIR of IPH and acute ischemia on either MP-RAGE or T1-CUBE sequences. Further investigation is required prior to widespread acceptance of SIR as a predictive imaging marker of symptomatic carotid plaque.
Polio Supplementary Immunization Activities During COVID-19 Pandemic: Experience from Penampang District, Sabah, Malaysia
Authors: Jiee Sam Froze , Bondi Melvin Ebin , Emiral Muhammad Ezmeer , Jantim Anisah
Published: July 2021

Background:

Polio Supplementary Immunization Activities (SIAs) were carried out in the State of Sabah in response to the Vaccine Derived Poliovirus outbreak declared in December 2019. Prior to this, Malaysia had been polio-free over the past 27 years. This paper reported on the successful implementation of SIAs in the district of Penampang, Sabah, adapting (vaccine administration) to the COVID-19 pandemic.

Methods:

A series of meticulous planning, healthcare staff training, advocacy, and community engagement activities were conducted by the Penampang District Health Office. Bivalent Oral Polio Vaccine (bOPV) and monovalent Oral Polio Vaccine were administered over the period of 1 year via these methods: house to house, drive-through, static, and mobile posts. The targeted group was 22 096 children aged 13 years and below.

Results:

Polio SIAs in Penampang managed to achieve more than 90% coverage for both bOPV and mOPV. The overall vaccine wastage was reported to be 1.63%. No major adverse reaction was reported.

Conclusion:

High vaccine uptake during Polio SIAs in Penampang was attributed to good inter-agency collaboration, community engagement, intensified health promotion activities, and drive-through vaccination campaign.
Automatic Diagnosis of Spinal Disorders on Radiographic Images: Leveraging Existing Unstructured Datasets With Natural Language Processing
Authors: Galbusera Fabio , Cina Andrea , Bassani Tito , Panico Matteo , Sconfienza Luca Maria
Published: July 2021

Study Design:

Retrospective study.

Objectives:

Huge amounts of images and medical reports are being generated in radiology departments. While these datasets can potentially be employed to train artificial intelligence tools to detect findings on radiological images, the unstructured nature of the reports limits the accessibility of information. In this study, we tested if natural language processing (NLP) can be useful to generate training data for deep learning models analyzing planar radiographs of the lumbar spine.

Methods:

NLP classifiers based on the Bidirectional Encoder Representations from Transformers (BERT) model able to extract structured information from radiological reports were developed and used to generate annotations for a large set of radiographic images of the lumbar spine (N = 10 287). Deep learning (ResNet-18) models aimed at detecting radiological findings directly from the images were then trained and tested on a set of 204 human-annotated images.

Results:

The NLP models had accuracies between 0.88 and 0.98 and specificities between 0.84 and 0.99; 7 out of 12 radiological findings had sensitivity >0.90. The ResNet-18 models showed performances dependent on the specific radiological findings with sensitivities and specificities between 0.53 and 0.93.

Conclusions:

NLP generates valuable data to train deep learning models able to detect radiological findings in spine images. Despite the noisy nature of reports and NLP predictions, this approach effectively mitigates the difficulties associated with the manual annotation of large quantities of data and opens the way to the era of big data for artificial intelligence in musculoskeletal radiology.
Clinical and Radiological Analysis of Arch Bars Over-Retained for 14 years Post Maxillo-Mandibular Fixation
Authors: Brooker Jack E. , Bruce Madeleine K. , Chen Wendy , Hashemi Robert , Losee Joseph E. , Goldstein Jesse A. , Schuster Lindsay A.
Published: July 2021

Maxillo-mandibular fixation (MMF) is common technique used in mandibular fractures to stabilize the fragments and maintain the patient in normal dental occlusion during the healing process. Arch bars with elastics are one of the most frequently used methods of MMF and are temporary, and designed to be removed after the healing process is completed. There is controversy as to what impact the hardware has on dental hygiene and oral health. No reports of long-term retention of the hardware exist. This report details the case of arch bars retained for 14 years. The patient underwent MMF and internal fixation at age 16 for a complex mandibular fracture and failed to follow-up for timely removal of the arch bars due to loss of insurance. He presented at age 30 with dental pain and returned to the treating center for removal. He was in normal occlusion, but general indices of dental and periodontal health were extremely poor with multiple non-restorable teeth despite reporting good oral hygiene in the intervening period. A decline in overall dental health was evident at 1 year following removal of arch bars. Due to the presence of smooth surface dental caries, it was concluded that the presence of the arch-bars had exacerbated already poor oral hygiene and contributed to the extensive dental pathology seen. This case highlights the need for timely follow-up and hardware removal. Understanding each patient’s individual social and financial circumstances is essential to this process and a formalized office recall process may have prevented this complication.
The Epidemiology of Facial Trauma Presentations during and after the Implementation of COVID-19 Social Distancing Measures—The Coventry-Warwickshire (UK) Experience
Authors: McEwen Ellie C. , Hoffman Gary R. , Qiu Michael M. , Pandya Rishi , Walton Gary M.
Published: July 2021

Purpose: The COVID-19 pandemic resulted in the institution of strict public health measures aimed at reducing virus transmission. This coincided with a well-documented alteration to the frequency and characteristics of maxillofacial trauma presentations. The aim was to examine the incidence and characteristics of maxillofacial trauma at a large tertiary hospital in the United Kingdom to determine whether these previously reported changes persisted after the relaxation of COVID-19 “lockdown” legislation. Method: This was a retrospective cohort study of patients who sustained a facial injury during the 8-week period of 16th March 2020 to 11th May 2020 (strict COVID lockdown) compared to the 11th May 2020 to 6th July 2020 (relaxation of COVID lockdown). Cohorts were compared on the incidence and characteristics of facial injury. Results: Compared to the peak of COVID-19 lockdown, the subsequent period during which these laws were eased saw an increase in the frequency of maxillofacial trauma presentations (n = 78 vs n = 37). Despite this absolute increase, the incidence remained statistically below seasonal expectation. Operative management remained persistently low (45% in 2020 vs 67% in 2019). Conclusion: This is the first study to report the characteristics of facial trauma after the easing of COVID-19 lockdown legislation. Compared to previously published reports from Australia, there has not yet been a clear return to baseline epidemiology in the UK, perhaps reflecting the severity of the pandemic in that region.
Variations in Facial Anthropometric Measurements among Major Ethnic Groups in Nigeria: A 3-Dimentional Stereophotogrammetry Analysis
Authors: Adekunle Adegbayi Adeola , Olowo Abiodun Yusuff , Adetona Moses , James Olutayo , Adamson Olawale Olatubosun , Agbogidi Failat Olushola , Oladega Afisu , Ogunlewe Mobolanle , Adeyemo Wasiu Lanre , Busch Tamara , Mossey Peter A. , Marazita Mary L. , Butali Azeez
Published: July 2021

Objectives: The aim of the study is to highlight variations in facial anthropometric measurements among the major ethnic groups in Nigeria using 3D photogrammetry. Materials and Methods: This study was conducted in Lagos, Nigeria. Acquisition of 3D facial photographs was done using a Vectra H1 portable 3D photogrammetry imaging system. Descriptive analysis of collected data was done and a test of associations performed using independent samples t-test. The level of significance was set at <.05. Results: The total number of participants in this study was 503. The study population was made up of 302 (60%) males and 201 (40%) females. Mean upper facial height among Yoruba, Igbo, Hausa, and other ethnic groups were 68.93 ± 5.85, 70.18 ± 5.99, 63.79 ± 4.80, and 69.29 ± 5.95 mm respectively, while mean interpupillary distances were 66.99 ± 3.70, 67.34 ± 3.56, 66.73 ± 3.80, and 67.09 ± 3.72 mm respectively. A Tukey posthoc test revealed significant pairwise differences for upper facial height between the Yoruba and Hausa population with a mean difference of 5.15 mm ( P < .001, 95% CI 2.94-7.35) ( P < .001, 95% CI 2.94-7.35), and Hausa and Igbo population with a mean difference of 6.39 mm ( P < .001, 95% CI 3.75-9.03). Multivariate regression analysis confirmed the presence of significant inter-ethnic differences between Hausa ethnic group and the Yoruba ethnic group for midfacial height ( P < .001), upper lip height ( P = .004), lower lip height ( P = .003), total face height ( P = .010), and orbital fissure width ( P < .001). Conclusion: The result of this study shows that distinct difference does exist in the facial anthropological measurements between the ethnicities included in this study especially in vertical facial measurements.
Enhanced thermal stability and adsorption performance of MIL-53(Fe)@montmorillonite
Authors: Dai Fengli , Guo Junhui , He Yufeng , Song Pengfei , Wang Rongmin
Published: July 2021

Montmorillonite (Mnt), a clay mineral with a nanolayered structure, was combined with an Fe-based metal–organic framework (MOF; MIL-53(Fe)) using an in situ growth technique that yielded a novel eco-friendly clay-based adsorbent (MIL-53(Fe)@Mnt). The adsorbent was characterized by scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, thermogravimetric analysis and N2 gas adsorption. The MIL-53(Fe) particles grew on the surface of the nanolayered Mnt and the MIL-53(Fe) particle size became smaller. The adsorption performance of MIL-53(Fe)@Mnt was investigated by removing methylene blue (MB), and optimization experiments were carried out to study the effects of contact time, pH, initial dye concentration and adsorbent mass on the adsorption processes. The MIL-53(Fe)@Mnt exhibited excellent adsorption capacity for MB, namely 313.7 mg g−1, which was 3.02 times and 3.54 times greater than that of pure Mnt and MIL-53(Fe), respectively. Adsorption was fitted with the Langmuir isotherm model and followed a pseudo-second order kinetic model. The MIL-53(Fe)@Mnt obtained is a low-cost and eco-friendly adsorbing material and might be a candidate for removing dyes during water treatment.
Zvěstovite-(Zn), Ag6(Ag4Zn2)As4S13, a new tetrahedrite-group mineral from Zvěstov, Czech Republic
Authors: Sejkora Jiří , Biagioni Cristian , Vrtiška Luboš , Moëlo Yves
Published: July 2021

The new mineral, zvěstovite-(Zn), ideally Ag6(Ag4Zn2)As4S13, was found in quartz–baryte gangue at the mine dump of the abandoned small deposit of Zvěstov, central Bohemia, Czech Republic. Zvěstovite-(Zn) is associated with tennantite-(Zn), tetrahedrite-(Zn), argentotennantite-(Zn), acanthite and supergene azurite and malachite. The new mineral occurs as rare relic anhedral grains rimmed by acanthite, up to 100 μm in size. Zvěstovite-(Zn) is grey, Mohs hardness is ca. 3½–4, in agreement with other members of the tetrahedrite group; the calculated density is 5.16 g.cm–3. In reflected light, zvěstovite-(Zn) is grey with a greenish tint, without bireflectance, pleochroism or anisotropy. Deep red internal reflections are ubiquitous. Reflectance values of zvěstovite-(Zn) in air (R%) are: 28.5 at 470 nm, 26.9 at 546 nm, 25.5 at 589 nm and 23.8 at 650 nm. The empirical formula for zvěstovite-(Zn), based on electron-microprobe analyses (n = 4), is Ag6.27[(Ag3.90Cu0.38)Σ4.28(Zn1.60Fe0.09Cd0.03)Σ1.72]Σ6.00(As2.26Sb1.48)Σ3.74S12.50. The ideal formula is Ag6(Ag4Zn2)As4S13, which requires (in wt.%) Ag 56.01, Zn 6.79, As 15.56 and S 21.64, total 100.00. Zvěstovite-(Zn) is cubic, I$\bar{4}$3m, with unit-cell parameters: a = 10.850(2) Å, V = 1277.3(8) Å3 and Z = 2. The strongest reflections of the calculated powder X-ray diffraction pattern [d, Å (I) (hkl)] are: 3.1321(100) (222), 2.7125(21) (400), 1.9809(11) (521), 1.9180(31) (440) and 1.6357(15) (622). According to the single-crystal X-ray diffraction data (Robs = 0.051), the crystal structure of zvěstovite-(Zn) agrees with the general features of the members of the tetrahedrite group. Zvěstovite-(Zn) is named after its type locality, Zvěstov; the suffix indicates the dominant divalent C-constituent, according to the approved nomenclature of the tetrahedrite group. It is the As-isotype of rozhdestvenskayaite-(Zn). The mineral and its name have been approved by the Commission on New Minerals, Nomenclature and Classification of the International Mineralogical Association (IMA2020-061).
Factors affectıng recurrence after trımodal treatment ın ınvasıve bladder cancer
Authors: Solakhan Mehmet , Benlier Necla , Yıldırım Zeliha , Seran Ali Ihsan , Kaya Vildan , Yıldırım Mustafa
Published: July 2021

Background

In this study, we aimed to determine which patients will benefit most from TMT treatment, and to evaluate the factors affecting relapse, survival and response to treatment separately.

Methods

For the study, patients who presented to our hospital’s outpatient clinic between 2010 and 2020 and were diagnosed with locally advanced (T2-G3) invasive urothelial bladder cancer and treated with gemcitabine concomitantly with radiotherapy following complete TUR were identified. A total of 112 patients with transitional cell bladder cancer invading the muscle were enrolled in the study including 88 (78.6%) males and 24 (21.4%) females.

Results

Tumor location was significantly associated with tumor recurrence (p = 0.003). Recurrence at follow-up was significantly associated with the number of tumor foci (p = 0.008). Median duration of follow-up and median progression-free survival were 41.50 months and 65 ± 4.21 (95% CI, 56.74-73.25) months, respectively. Progression-free survival was not statistically significantly associated with neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) or BMI (p = 0.32, p = 0.47, p = 0.39, respectively), but muscle invasion during follow-up was significantly associated with progression-free survival (p = 0.009).

Conclusions

Tumor location, the number of tumor foci, history of multiple transurethral resection surgeries and a NLR ≥ 2.56 were significantly associated with recurrence following Trimodal therapy (TMT). A lower rate of recurrence was observed among patients undergoing early TMT after initial diagnosis. None of the patients treated with trimodal therapy experienced severe adverse effects. Therefore, trimodal therapy is a safe, effective and tolerable therapeutic option with a low rate of recurrence in selected eligible patients.
Reactivation of Vogt-Koyanagi-Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination
Authors: Papasavvas Ioannis , Herbort Carl P.
Published: July 2021

Background/purpose

Vogt-Koyanagi-Harada (VKH) disease is a primary stromal choroiditis with bilateral granulomatous panuveitis. If initial-onset VKH is treated early and relentlessly the disease can be controlled and even “cured” in a substantial number of cases. We are reporting on a patient treated early and in a sustained fashion who was inflammation free for seven years but who presented a reactivation 6 weeks after the second dose of anti-SARS-CoV-2 vaccination.

Case report

A 43-year-old woman presented with severe initial-onset VKH disease which was brought under control using steroidal and non-steroidal Immunosuppression (mycophenolic acid and cyclosporine) with additional infliximab infusions because of the persistence of subclinical choroiditis identified on ICGA. Under infliximab alone disease had been inflammation free with no subclinical disease and absence of sunset glow fundus for 6 years. However, following anti-SARS-CoV-2 vaccination, severe resurgence of the disease occurred with exudative retinal detachments. Disease was rapidly brought again under control with oral prednisone (1 mg/kg) therapy and a new loading scheme of infliximab therapy.

Conclusion

VKH disease results from an autoimmune process directed against melanocyte associated antigens which can be controlled when early and sustained immunosuppressive treatment is introduced. It seems that anti-SARS-CoV-2 vaccination can be at the origin of reactivation of long-time controlled disease.
Dentition and feeding in Placodontia: tooth replacement in Henodus chelyops
Authors: Pommery Yannick , Scheyer Torsten M. , Neenan James M. , Reich Tobias , Fernandez Vincent , Voeten Dennis F. A. E. , Losko Adrian S. , Werneburg Ingmar
Published: July 2021

Background

Placodontia is a Triassic sauropterygian reptile group characterized by flat and enlarged crushing teeth adapted to a durophagous diet. The enigmatic placodont Henodus chelyops has numerous autapomorphic character states, including extreme tooth count reduction to only a single pair of palatine and dentary crushing teeth. This renders the species unusual among placodonts and challenges identification of its phylogenetic position.

Results

The skulls of two Henodus chelyops specimens were visualized with synchrotron tomography to investigate the complete anatomy of their functional and replacement crushing dentition in 3D. All teeth of both specimens were segmented, measured, and statistically compared to reveal that H. chelyops teeth are much smaller than the posterior palatine teeth of other cyamodontoid placodonts with the exception of Parahenodus atancensis from the Iberian Peninsula. The replacement teeth of this species are quite similar in size and morphology to the functional teeth.

Conclusion

As other placodonts, Henodus chelyops exhibits vertical tooth replacement. This suggests that vertical tooth replacement arose relatively early in placodont phylogeny. Analysis of dental morphology in H. chelyops revealed a concave shape of the occlusal surface and the notable absence of a central cusp. This dental morphology could have reduced dental wear and protected against failure. Hence, the concave teeth of H. chelyops appear to be adapted to process small invertebrate items, such as branchiopod crustaceans. Small gastropods were encountered in the matrix close to both studied skulls.
GA3 is superior to GA4 in promoting bud endodormancy release in tree peony (Paeonia suffruticosa) and their potential working mechanism
Authors: Yuxi Zhang , Yanchao Yuan , Zejun Liu , Tao Zhang , Feng Li , Chunying Liu , Shupeng Gai
Published: July 2021

Background

Sufficient low temperature accumulation is the key strategy to break bud dormancy and promote subsequent flowering in tree peony anti-season culturing production. Exogenous gibberellins (GAs) could partially replace chilling to accelerate dormancy release, and different kinds of GAs showed inconsistent effects in various plants. To understand the effects of exogenous GA3 and GA4 on dormancy release and subsequent growth, the morphological changes were observed after exogenous GAs applications, the differentially expressed genes (DEGs) were identified, and the contents of endogenous phytohormones, starch and sugar were measured, respectively.

Results

Morphological observation and photosynthesis measurements indicated that both GA3 and GA4 applications accelerated bud dormancy release, but GA3 feeding induced faster bud burst, higher shoot and more flowers per plant. Full-length transcriptome of dormant bud was used as the reference genome. Totally 124 110 459, 124 015 148 and 126 239 836 reads by illumina transcriptome sequencing were obtained in mock, GA3 and GA4 groups, respectively. Compared with the mock, there were 879 DEGs and 2 595 DEGs in GA3 and GA4 group, 1 179 DEGs in GA3 vs GA4, and 849 DEGs were common in these comparison groups. The significant enrichment KEGG pathways of 849 DEGs highlighted plant hormone signal transduction, starch and sucrose metabolism, cell cycle, DNA replication, etc. Interestingly, the contents of endogenous GA1, GA3, GA4, GA7 and IAA significantly increased, ABA decreased after GA3 and GA4 treatments by LC–MS/MS. Additionally, the soluble glucose, fructose and trehalose increased after exogenous GAs applications. Compared to GA4 treatment, GA3 induced higher GA1, GA3 and IAA level, more starch degradation to generate more monosaccharide for use, and promoted cell cycle and photosynthesis. Higher expression levels of dormancy-related genes, TFL, FT, EBB1, EBB3 and CYCD, and lower of SVP by GA3 treatment implied more efficiency of GA3.

Conclusions

Exogenous GA3 and GA4 significantly accelerated bud dormancy release and subsequent growth by increasing the contents of endogenous bioactive GAs, IAA, and soluble glucose such as fructose and trehalose, and accelerated cell cycle process, accompanied by decreasing ABA contents. GA3 was superior to GA4 in tree peony forcing culture, which might because tree peony was more sensitive to GA3 than GA4, and GA3 had a more effective ability to induce cell division and starch hydrolysis. These results provided the value data for understanding the mechanism of dormancy release in tree peony.
Management of enterococcal central line-associated bloodstream infections in patients with cancer
Authors: Awadh Hesham , Chaftari Anne-Marie , Khalil Melissa , Fares Johny , Jiang Ying , Deeba Rita , Ali Shahnoor , Hachem Ray , Raad Issam I.
Published: July 2021

Objective

Enterococcus species are the third most common organisms causing central line-associated bloodstream infections (CLABSIs). The management of enterococcal CLABSI, including the need for and timing of catheter removal, is not well defined. We therefore conducted this study to determine the optimal management of enterococcal CLABSI in cancer patients.

Methods

We reviewed data for 542 patients diagnosed with Enterococcus bacteremia between September 2011 to December 2018. After excluding patients without an indwelling central venous catheter (CVC), polymicrobial bacteremia or with CVC placement less than 48 h from bacteremia onset we classified the remaining 397 patients into 3 groups: Group 1 (G1) consisted of patients with CLABSI with mucosal barrier injury (MBI), Group 2 (G2) included patients with either catheter-related bloodstream infection (CRBSI) as defined in 2009 Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection by the Infectious Diseases Society of America (IDSA) or CLABSI without MBI, and Group 3 (G3) consisted of patients who did not meet the CDC criteria for CLABSI. The impact of early (< 3 days after bacteremia onset) and late (3–7 days) CVC removal was compared. The composite primary outcome included absence of microbiologic recurrence, 90-day infection-related mortality, and 90-day infection-related complications.

Results

Among patients in G2, CVC removal within 3 days of bacteremia onset was associated with a trend towards a better overall outcome than those whose CVCs were removed later between days 3 to 7 (success rate 88% vs 63%). However, those who had CVCs retained beyond 7 days had a similar successful outcome than those who had CVC removal < 3 days (92% vs. 88%). In G1, catheter retention (removal > 7 days) was associated with a better success rates than catheter removal between 3 and 7 days (93% vs. 67%, p = 0.003). In non-CLABSI cases (G3), CVC retention (withdrawal > 7 days) was significantly associated with a higher success rates compared to early CVC removal (< 3 days) (90% vs. 64%, p = 0.006).

Conclusion

Catheter management in patients with enterococcal bacteremia is challenging. When CVC removal is clinically indicated in patients with enterococcal CLABSI, earlier removal in less than 3 days may be associated with better outcomes.

Based on our data, we cannot make firm conclusions about whether earlier removal (< 3 days) could be associated with better outcomes in patients with Enterococcal CLABSI whose CVC withdrawal is clinically indicated. In contrast, it seemed that catheter retention was associated to higher success outcome rates. Therefore, future studies are needed to clearly assess this aspect.
Steroid responsive cavernous sinus syndrome due to Rosai-Dorfman disease: beyond Tolosa-Hunt syndrome – a case report
Authors: Nóbrega Paulo Ribeiro , Rodrigues Pedro Gustavo Barros , de Sousa Pereira Isabelle , de Figueiredo Santos Carolina , Gerson Gunter , de Arruda José Arnaldo Motta , Júnior José Wagner Leonel Tavares , de Araújo Coimbra Pablo Picasso , Braga-Neto Pedro
Published: July 2021

Background

The term “Tolosa-Hunt syndrome” (THS) has been used to refer to painful ophthalmoplegia associated with nonspecific inflammation of the cavernous sinus and many processes can result in a similar clinical picture, including infectious, inflammatory and neoplastic diseases. Rosai-Dorfman disease (RDD) is a lymphoproliferative disorder that rarely affects the central nervous system. We report a case of isolated CNS Rosai-Dorfman disease involving the cavernous sinus and presenting as “Tolosa-Hunt syndrome”.

Case presentation

Our patient presented with horizontal diplopia due to impairment of cranial nerves III, IV and VI and a stabbing/throbbing headache predominantly in the left temporal and periorbitary regions. There was a nonspecific enlargement of the left cavernous sinus on MRI and the patient had a dramatic response to steroids. Biopsy of a frontal meningeal lesion was compatible with RDD.

Conclusions

We highlight the importance of including Rosai-Dorfman disease as a differential diagnosis in cavernous sinus syndrome and demonstrate a satisfactory long-term response to steroid treatment in this disease.
Sex and age differences in isolated traumatic brain injury: a retrospective observational study
Authors: Hosomi Sanae , Kitamura Tetsuhisa , Sobue Tomotaka , Ogura Hiroshi , Shimazu Takeshi
Published: July 2021

Background

Among the many factors that may influence traumatic brain injury (TBI) progression, sex is one of the most controversial. The objective of this study was to investigate sex differences in TBI-associated morbidity and mortality using data from the largest trauma registry in Japan.

Methods

This retrospective, population-based observational study included patients with isolated TBI, who were registered in a nationwide database between 2004 and 2018. We excluded patients with extracranial injury (Abbreviated Injury Scale score ≥ 3) and removed potential confounding factors, such as non-neurological causes of mortality. Patients were stratified by age and mortality and post-injury complications were compared between males and females.

Results

A total of 51,726 patients with isolated TBI were included (16,901 females and 34,825 males). Mortality across all ages was documented in 12.01% (2030/16901) and 12.76% (4445/34825) of males and females, respectively. The adjusted odds ratio (OR) of TBI mortality for males compared to females was 1.32 (95% confidence interval [CI], 1.22–1.42]. Males aged 10–19 years and ≥ 60 years had a significantly higher mortality than females in the same age groups (10–19 years: adjusted OR, 1.97 [95% CI, 1.08–3.61]; 60–69 years: adjusted OR, 1.24 [95% CI, 1.02–1.50]; 70–79 years: adjusted OR, 1.20 [95% CI, 1.03–1.40]; 80–89 years: adjusted OR, 1.50 [95% CI, 1.31–1.73], and 90–99 years: adjusted OR, 1.72 [95% CI, 1.28–2.32]). In terms of the incidence of post-TBI neurologic and non-neurologic complications, the crude ORs were 1.29 (95% CI, 1.19–1.39) and 1.14 (95% CI, 1.07–1.22), respectively, for males versus females. This difference was especially evident among elderly patients (neurologic complications: OR, 1.27 [95% CI, 1.14–1.41]; non-neurologic complications: OR, 1.29 [95% CI, 1.19–1.39]).

Conclusions

In a nationwide sample of patients with TBI in Japan, males had a higher mortality than females. This disparity was particularly evident among younger and older generations. Furthermore, elderly males experienced more TBI complications than females of the same age.
A computational multi-targeting approach for drug repositioning for psoriasis treatment
Authors: Ibezim Akachukwu , Onah Emmanuel , Dim Ebubechukwu N. , Ntie-Kang Fidele
Published: July 2021

Background

Psoriasis is an autoimmune inflammatory skin disease that affects 0.5–3% of the world’s population and current treatment options are posed with limitations. The reduced risk of failure in clinical trials for repositioned drug candidates and the time and cost-effectiveness has popularized drug reposition and computational methods in the drug research community.

Results

The current study attempts to reposition approved drugs for the treatment of psoriasis by docking about 2000 approved drug molecules against fifteen selected and validated anti-psoriatic targets. The docking results showed that a good number of the dataset interacted favorably with the targets as most of them had − 11.00 to − 10.00 kcal/mol binding free energies across the targets. The percentage of the dataset with binding affinity higher than the co-crystallized ligands ranged from 34.76% (JAK-3) to 0.73% (Rac-1). It was observed that 12 out of the 0.73% outperformed all the co-crystallized ligands across the 15 studied proteins. All the 12 drugs identified are currently indicated as either antiviral or anticancer drugs and are of purine and pyrimidine nuclei. This is not surprising given that there is similarity in the mechanism of the mentioned diseases.

Conclusion

This study, therefore, suggests that; antiviral and anticancer drugs could have anti-psoriatic effects, and molecules with purine and pyrimidine structural architecture are likely templates to consider in developing anti-psoriatic agents.
Ruyiping formula inhibits metastasis via the microRNA-134-SLUG axis in breast cancer
Authors: Jiang Ziwei , Pei Lixia , Xie Ying , Ye Qun , Liang Xiaoqiang , Ye Yiyi , Liu Sheng
Published: July 2021

Background

Metastasis is the leading cause of death among breast cancer patients. MicroRNA-134 has been reported to have a tumor-suppressive role in breast cancer. Ruyiping (RYP), a traditional Chinese formula, has been shown with the ability to reduce breast cancer metastasis in pre-clinical studies. This present study was designed to examine whether miR-134 was involved in RYP-inhibited breast cancer metastasis.

Methods

The expression of SLUG, E-Cadherin, N-Cadherin and miR-134 in MDA-MB-231 and 4 T1 cells treated with RYP or vehicle control were determined by quantitative realtime-PCR and western blot. Invasiveness determined by transwell assay as well as SLUG gene expression determined by qPCR were detected in cells transfected with chemically synthesized miR-134 mimics or inhibitors. BALB/c mice were injected with 4 T1 cells orthotopically and fed with RYP through gavage. Breast tumor growth, metastasis and tumor expression of EMT markers were detected.

Results

Compared with the control, Ruyiping formula significantly inhibited SLUG-regulated breast cancer cells invasion. MiR-134 was induced by RYP in vitro and in vivo and was able to suppress SLUG by targeting its 3’UTR. RYP suppressed SLUG expression and cell invasion through miR-134. In 4 T1 tumor-bearing mice, RYP significantly inhibited 4 T1 tumor growth and lung metastasis, increased the levels of miR-134 and epithelial marker while decreased the levels of SLUG and mesenchymal marker.

Conclusion

Our data uncovered that Ruyiping formula exerts an anti-metastatic activity against breast cancer cells by regulating SLUG through miR-134. MiR-134-SLUG axis might be a promising strategy in breast cancer therapy.
Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol
Authors: Fernández-Rodríguez Eduardo José , González-Sánchez Jesús , Puente-González Ana Silvia , Recio-Rodríguez José Ignacio , Sánchez-Gómez Celia , Méndez-Sánchez Roberto , Cruz-Hernández Juan Jesús , Rihuete-Galve María Isabel
Published: July 2021

Background

Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea.

Methods

This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale).

Discussion

The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life.

Trial registration

ClinicalTrials.gov; ID: NCT04766593. (February 23, 2021).