bluuebunny/crossref_metadata_2025 huggingface dataset:
C5. Acute limb ischemia in COVID-19 patient: a case report
Authors: Kristianti S , Lizarda A
Published: April 2022

Background

Spread of coronavirus has led to the coronavirus disease (COVID-19) pandemic and resulting in new challenges. COVID-19 can cause thrombotic complications such as acute limb ischemia (ALI). This complication may increase the risk of morbidity and mortality in COVID-19 patient. A high index of suspicion should be maintained for ALI in COVID-19 patient, which is a vascular emergency.

Case Description

A-53 year old male presented to the emergency department with acute left leg pain and shortness of breath since two days before admission. Physical examination revealed heart rate of 120x/min, blood pressure 130/100 mmHg, and oxygen saturation 96%. The patient had bilateral crackles on lung auscultation and absent left dorsalis pedis pulse. His left foot was discoloured, cold to the touch, and mottled in appearance. He had elevated D-dimer. Chest x-ray showed bilateral hazy infiltrates. COVID-19 was diagnosed on the basis of RT-PCR testing. He received antibiotic, antiviral, and enoxaparin. Unfortunately, he underwent amputation procedure.

Discussion

COVID-19 has been associated with systemic effects resulting in cardiovascular, hematologic, neurologic, immunologic, and renal complications. Arterial thrombosis is an important consideration in COVID-19 patient associated with systemic inflammatory response, hypercoagulable states, and endothelial injury. ALI can occur during in-hospital evolution of COVID-19 infection or they can be admitted to the hospital for this vascular condition with mild or no respiratory symptoms. Some patients are able to achieve revascularization with observation or medical and/or surgical intervention, but other patients succumb to either amputation or death.
C30. Clinical Decision Making in Intermediate Coronary Stenosis: Role of Fractional Flow Reserve
Authors: Kusnadi S , Nugraha M T
Published: April 2022

Background

Coronary stenosis can be managed by percutaneous coronary intervention (PCI). However, it has limitation by producing only 2D images of the actual 3D vascular lumen. It is necessary to assess the functional significance of stenosis with fractional flow reserve (FFR).

Case Summary

There are two patients in this case. The first patient was a 52-year-old man with typical chest pain, with a history of PCI in LAD 2 years earlier. Echocardiography revealed regional wall motion abnormality (RWMA) with reduced left ventricular ejection fraction (LVEF) of 30-40%. PCI with FFR guidance was performed. Previous stent in osteal-distal LAD was patent. In the distal LAD, a stenosis of 60-70% was obtained with FFR of 0.81. In distal LCX, 50-60% stenosis was also obtained with FFR of 0.91. No stent was implanted then. The second patient was a 59-year-old man with typical chest pain. The patient had been stented in proximal-mid LAD and LCX-OM a year earlier. Echocardiography showed RWMA with LVEF of 51-54%. LAD and LCX stents were patent. A 70-80% stenosis was found in both mid and distal RCA. FFR was done in the mid-RCA with result of 0.57, so stent was placed in the mid RCA. FFR at distal RCA was 0.31 so that the stent was also placed in the distal RCA. Both showed good results.

Discussion

Physiologic assessment is important before deciding to revascularize. FFR-guided PCI is expected to better guide us in managing intermediate coronary stenosis.
C38. Diagnosis and Management of Atrial Septal Defects (ASD) and Pulmonary Hypertension (PH) in Pregnancy
Authors: Sari Anna P , Krevani C K , Karani Y , Kino
Published: April 2022

Background

Atrial Septal Defect (ASD) is a congenital heart disease that is often found in adulthood, including women in pregnancy. Women with ASD are at greater risk for cardiovascular complications during pregnancy especially with Pulmonary Hypertension (PH), so comprehensive management is essential for this case.

Case Summary

A 31-year-old woman with gravida 32-33 weeks complaint of shortness of breath increasing since 3 days before entering the hospital with central cyanosis, clubbing finger, peripheral oxygen saturation 74%, from auscultation showed hardened P2 sound, indistinct wide fixed split, grade 3/6 systolic murmur. Echocardiography showed ASD with High Probability PH (Pulmonary Hypertension). The patient treated with furosemide 2x20 mg, sildenafil 3x12.5 mg, 3x20 mcg berraprost. The pregnancy was electively terminated with cesarean delivery and also got tubectomy. After 18 days of treatment in hospital, patient was discharged with stable and good condition. The patient was planned for right heart catheterization from outpatient clinic.

Discussion

Based on Guidline ESC on the management of Cardiovascular disease during Pregnancy in 2011, patients with ASD-PH are included in class IV WHO classification, where are contraindicated for pregnancy. If the pregnancy continues, recommended for patients to control regularly to the cardiologists and obstetricians during pregnancy, delivery and the puerperium.

From literature, cesarean delivery is recommended for pregnant women with Pulmonary Hypertension (including Eisenmenger's Syndrome). Special attention and comprehensive management are required for pregnant patients with ASD-PH. The choice of intervention method and some medical therapy in this patient must also be considered.
C49. Hybrid Procedure in A Patient with Multiple Aortic Dissections and Marfan Syndrome: A Case Report
Authors: Taofan T , Gill R S D , Wartono D A , Adiarto S
Published: April 2022

Background

Aortic dissection is a tear in the inner layer of the aortic wall, which allows blood to enter into the wall of the aorta, creating a new passage for blood, known as the false lumen. The indications for surgical approach in aortic dissections Stanford A and DeBakey I and II are widely recognised and accepted, but little is known that in certain cases of Stanford A, DeBakey type I or type II aortic dissection patients who meet the eligibility criteria, endovascular repair can be performed.

Case Illustration

A 36-year-old woman came with a chief complaint of acute stabbed pain, she was known to have Concomitant DeBakey type II and IIIb aortic dissection, severe aortic regurgitation, and Marfan Syndrome. Because of her condition, we decided to conduct an open surgical repair with Bentall Procedure that was planned to be followed by an elective thoracic endovascular aortic repair (TEVAR). The Bentall procedure was a success and the patient’s clinical condition improved each day.

Conclusion

In concomitant DeBakey type II and IIIb aortic dissection cases, especially in those who have an underlying condition such as Marfan Syndrome, the Bentall procedure is the treatment of choice. In conditions when surgical procedure cannot be done, a hybrid approach of open surgery and TEVAR may provide a valuable alternative for patients.
C55. Intramyocardial dissecting hematoma, a rare complication after myocardial infarction : a case report
Authors: Kaputrin N , Rahimah A F , Rizal A
Published: April 2022

Background

Intramyocardial dissecting hematoma (IDH) is a rare complication of myocardial infarction (MI) that contribute to high morbidity and mortality rate. There is scarce information in literature and hence management uncertainties. Additionally, coronary reperfusion results on the occurrence of IDH is still poorly understood.

Case Summary

A 49-year-old man with a previous anterior wall MI 3 months before without revascularization, presented with a recent onset of New York Heart Association (NYHA) functional class IV heart failure. Echocardiographic diagnosis of IDH was based on the presence of a neocavity with an endomyocardial border extending from the LV mid inferoseptal wall to the apical segments, corroborated with cardiac magnetic resonance (CMR). Coronary angiography showed severe three-vessel disease. The patient underwent staged complete revascularization and kept on optimal medical management. With non-surgical treatment, the patient remained clinically stable and showed a gradual improvement. Repeated echocardiography up to one year after the initial diagnosis demonstrated regression of the haematoma.

Discussion

An unusual form of myocardial rupture that can complicate acute myocardial infarction is IDH. The diagnosis can be missed in some cases. Transthoracic echocardiography may allow diagnosing and evaluating IDH at the bedside. Controversy exists regarding whether surgical repair or conservative treatment is the best option for this condition. The appropriate management should be individualized. Conservative treatment in clinically stable patients suffering from IDH following MI and coronary intervention can be a feasible option.
C60. Management of Symptomatic Wolff-Parkinson-White (WPW) Syndrome: A Case Report
Authors: Lestari Puspa , Rizal Ardian , A Yudi Putra , Fadlan M R , Ardhi R A Lukitasari Ayu Galuh
Published: April 2022

Background

Atrioventricular reentrant tachycardia (AVRT) could be the reentrant tachyarrhythmia that occurs in Wolff-Parkinson-White (WPW) syndrome. In AVRT, the existence of normal AV node and accessory pathway (AP) along with the atria and ventricles establish the electrical circuit that permits impulse re-entry. The incidence of multiple accessory pathways (MAP) is reported 3-15% and incidence of sudden cardiac death (SCD) in WPW syndrome is about 0.25% per year or 3% to 4% over a lifetime.

Case Description

We presented a case of Wolff-Parkinson-White Syndrome. A 28-year old man was admitted for evaluation of frequent episodes of palpitation. The diagnosis of WPW syndrome was established based on the 12 lead surface electrocardiogram (ECG). Echocardiography showed normal resting echocardiography then we performed electrophysiology study (EPS). We conducted the radiofrequency ablation (RFA) to the accessory pathway (AP). The challenging point of this case was multiple accessory pathways (APs) located at right posteroseptal and left lateral.

Discussion

Ablation of multiple accessory pathways (MAP) had a longer fluoroscopic time and large number of unsuccessful attempts than those with a single accessory pathway. We performed RFA at right posteroseptal and left lateral accessory pathway. The radiofrequency ablation has successfully eliminated both accessory pathways. In summary, we conclude that anatomical consideration, EP study, and the ablation strategy was important to improve the safety and success rate of RFA procedure.
C66. Paraaortic abscess complicating an Aerococcus Viridans Endocarditis: A Case Report
Authors: Farissa I P , Goma M S , Permitasari D A , Nugroho M A
Published: April 2022

Background

Infective Endocarditis (IE) associated with high mortality and complication despite improvement in its management. Paravalvular abscess known as feared complication of IE because its association with increased mortality. We describe a case of man with paravalvular abscess complicating IE undergone Aortic Valve Replacement.

Case Summary

A 42 years old man presented with exertional dyspneu since 2 weeks prior to admission, exaggerated with mild activities, accompanied with nausea, vomiting, swollen legs, and subfebrile for weeks. He was conscious and moderately ill with pressure 100/50 mmHg, regular pulse of 70, respiratory rate 25 times/minute, temperature was 37˚C, oxygen saturation was 94% on room air with end diastolic murmur grade II/4 in right upper sternal border. The laboratory result was leucocytosis (12.900/cu mm). The echocardiography revealed calcified in RCC and NCC aortic valve, RCC prolapse, severe aortic insufficiency, hyperechoic in paravalvular area. MSCT Cardiac revealed fistula originating from aortic root to a sac led to left ventricle. Sensitivity cultured revealed Aerococcus viridans. We gave antibiotics for 3 weeks before he undergone Aortic Valve Replacement. 1 month follow up, he had no more symptoms, and the prosthetic valve was normal.

Discussion

The diagnostic of IE remains challenging. It may present as an acute, rapidly progressive infection, but also as a subacute or chronic disease. Its complications need to be monitored vigilantly because it worsens the outcome. Antibiotics use for microbial eradication contributed by removing infected material surgically, might improve successful treatment for IE.
C68. Patient with Zero Coronary Calcium Score and Significant Stenosis in Left Anterior Descending Coronary Artery: a case report
Authors: Dylan R , Suratna K S K , Rampengan S H , Pangemanan J A
Published: April 2022

Background

Coronary heart disease is pathological process characterized by the accumulation of atherosclerotic plaque in the epicardial artery, either obstructive or non-obstructive. Coronary calcium score (CCS) detects and calculates coronary artery calcification (CAC) and CT coronary angiography (CTCA) allows evaluation of the coronary arteries anatomy for luminal stenosis due to atherosclerotic plaque with or without calcification.

Case Description

A 70 years-old man, admitted to the emergency department with a chief complain of chest pain. Physical examination was within normal limits. His treadmill stress testing was positive ischemic response one month prior. Then patient undergoing CTCA, the result was zero calcium score with 90-99% stenosis at proximal left anterior descending (LAD) due to soft plaque. Invasive coronary angiography (ICA) confirmed the CT findings and showed total occlusion with grade V thrombus in osteal LAD.

Discussion

A study showed that 1-2% of symptomatic patients with zero CAC potentially had obstructive CAD. It is supported with this report that the patient had typical chest pain with zero calcium score. CCTA has high sensitivity and negative predictive value for the detection of CAD but has a relatively low positive predictive value, especially for moderate severity coronary. In this report CTCA showed 90% -99% stenosis at the proximal LAD and correlate with ICA findings.
C76. Primary Cardiac Tumors : Benign or Malignant ? The Importance of Clinicopathologic Confirmation : a case series
Authors: Andryan D P , Lestiadi I D , Siswanto B B
Published: April 2022

Background

Cardiac tumor is a rare condition of space-occupying lesion mass in cardiac chamber. The incidence of clinically diagnosed Primary Cardiac Tumors is approximately 1,380/100 million individuals. Majority of cases are benign, with nearly half of them are cardiac myxoma. Although early clinical symptom of benign and malignant cardiac tumor are similar, the management and prognosis are much different.

Objective

To present serial cases of benign and malignant primary cardiac tumor.

Case Description

Mrs. RH, a 60-year-old woman referred to heart failure clinic National Cardiovascular Center Harapan Kita with chief complaint of short of breath on exercise. Echocardiography confirmed a huge mass obstructed her left atrium. She was hospitalized urgently with giant Left Atrial Myxoma with normal coronary artery, then underwent surgery of LA myxoma extirpation, Mitral Valve repair and Tricuspid Valve repair. Histopathological analysis confirmed of LA myxoma.

Mr. RBM, a 42-years-old man came to emergency unit at National Cardiovascular Center Harapan Kita with chief complaint shortness of breath and palpitation in about 1 month. A history of a cardiac tumor extirpation and mitral valve replacement was done in Penang Adventist hospital 10 months before. Transthoracal and transesophageal echocardiography found solid mass obstructing mechanical valve. Histopathology analysis showed undifferentiated cardiac sarcoma and against LA myxoma.

Discussion

Clinical course and management of cardiac tumor depends on early detection and histopathologic analysis. Although surgery is the cornerstone for cardiac tumor management, but confirmation of histopathologic findings is important.
C81. Pulse Dose Corticosteroid Improves Clinical Outcome in Pulmonary Hypertension Patient: A Potential of Immense Affordability and Availability Medication in Suburban Area
Authors: Sudirman A R , Sitompul S I
Published: April 2022

Background

Pulmonary hypertension (PH) in adolescence is a devastating diagnosis with significant morbidity and mortality. Despite limited literature exists on treating PH with anti-inflammatory medications in humans, hereby we present the case of prednisolone induced clinical outcomes improvement in PH patient.

Case Summary

A 20-year-old woman presented with exertional dyspnea. Her past-two-years medical history was remarkable for tricuspid regurgitation with multiple readmission. Upon arrival, her saturation-75% and BP-110/60. She was in respiratory distress with JVP increased and high-pitched-holosystolic murmur. Laboratory studies was unremarkable. The x-ray revealed cardiomegaly and ECG showing RVH-RAE. Initial echocardiography demonstrated TR-Vmax 4.55m/s and PR-Vmax 3.62m/s. The RVSP estimated around 107mmHg, which was highly suggestive for PH. Due to the aggressive nature of the disease, her condition deteriorated despite management with IV-furosemide-(40mg/d), beta-blocker-(2.5mg/d), and sodium beraprost-(60µg/d). Following days, a 5-days pulse-dose-steroid (methylprednisolone) at 2mg/kg/day was administered. Her condition improved with saturation from 50% to 90% and significant reduced in dyspnea. The steroid was tapering down for another 7 days and she was discharged for further referral.

Discussion

Inflammation plays unequivocal role in the pathogenesis of PH, which was involved in the development of pulmonary vascular remodeling. The possible mechanism of prednisolone were related with the inhibition of platelet-derived growth factor (PDGF)-induced accelerated proliferation and migration of pulmonary artery smooth muscle cell, and prevented the activation of NF-κB, key transcription factor that controls inflammation, cell-proliferation, and apoptosis. Thus, given the ready availability and features of this medication compared with other PH-medication, we decided to utilize steroid in this patient.
C93. Temporary Pacemaker Lead Insertion with Echocardiography Guided Technique in Emergency Setting: a Case Report
Authors: Kristanto H , Rizal A
Published: April 2022

Background

The implantation of the temporary pacemaker (TPM) must be done in symptomatic bradycardia to provide adequate heart rate and stabilize hemodynamic. Transvenous TPM is inserted under the fluoroscopy guidance. However, in an extraordinary situation, such as the unavailability of the catheterization laboratory, transvenous TPM insertion can be performed with echocardiography guiding.

Case Summary

A 27 years old male came to our ER with symtomatic bradicardia. Emergency procedure like medical treatment and transcutaneous pacing were done, but failed to increase heart rate. We planned transvenous pacing with fluoroscopy but the catheterization laboratory was not immediately available. Echocardiography guided temporary pacemaker were done in ER successfully and the patient was strabilized.

Discussion

Emergency transvenous pacemaker implantation with echocardiography guiding can be accomplished successfully in our case without complication. There are several techical aspect that we should consider in temporary pacemaker insertion without fluoroscopy. We use femoral access and with echocardiography guided in our case. The confirmation of the lead placement using fluoroscopy was needed to ensure that the tip of the electrode was in the proper position. Future research that focuses on the safety and effectiveness of the technique across the range of operator skill levels is needed.
Long-Term Effects of Crop Tree Release on Growth and Quality in White-Oak (Quercus alba L.)-Dominated Stands
Authors: Vogel Philip J , Lhotka John M , Stringer Jeffrey W
Published: April 2022

Crop tree release (CTR) can be an effective intermediate silvicultural treatment for culturing high-value stems in mixed hardwood stands. The lengthy rotation of hardwoods requires long-term evaluations if silvicultural treatment effectiveness is to be fully evaluated. Our study provides a 35-year evaluation of individual-tree and stand response to CTR imposed in small sawtimber-sized white-oak (Quercus alba L.)-dominated stands. The focus on white oak is justified based on the significant biologic and economic values of the species, and this study furthers our ability to optimize use of CTR as management tool for sustaining our oak resources. The replicated experiment included three treatment levels: 20 crop trees ac−1, 34 crop trees ac−1, and a control. Using a repeated-measures framework, we analyzed (1) how CTR affects growth and stem quality of white oak crop trees and (2) stand-level effects of CTR on basal area, stocking, and ingrowth. CTR increased crop tree diameter growth and proportion of crop trees reaching their maximum potential grade. However, crop tree diameter growth and proportion achieving maximum potential grade did not differ between the 20 and 34 crop trees ac−1 treatments. Finally, CTR stimulated stand-wide growth without altering the patterns of ingrowth density or species distributions.
Effects of edible whole citrus fruits on endogenous antioxidant enzymes of HepG2 cells
Authors: Sun Yujing , Liu Miaomiao , Tao Wenyang , Ye Xingqian , Sun Peilong
Published: April 2022

The effects of eating fresh citrus fruits including two varieties of mandarins, one of sweet oranges, one of grapefruit, two of pomelo, and one of kumquat cultivated in China on endogenous antioxidant enzymes were investigated by in vitro digestion and HepG2 cells. The correlations between enzyme activity and cell uptake of phytochemicals and cellular antioxidant capacities were analyzed. The results showed that most fresh citrus fruits increased the endogenous antioxidant activity. Bairoumiyou, Hongroumiyou, Ponkan, and Jinju after digestion significantly increased the activity of catalase (P<0.05). Hongroumiyou, Bairoumiyou, Ponkan navel orange, and Jinju after digestion significantly increased glutathione peroxidases (GPxs) activity (P<0.05), while Huyou and satsuma could not increase the activity of GPxs after digestion. Thioredoxin oxidoreductase activity was improved significantly by most of the digested whole citrus fruits except Ponkan (P<0.05) and thioredoxin oxidoreductase added whole citrus fruits had a higher increase than added citrus fruits extracts. The results indicated that edible whole citrus fruits had similar effects as extracts on enzymes.
A Gelfand-Type Duality for Coarse Metric Spaces With Property A
Authors: Braga Bruno M , Vignati Alessandro
Published: April 2022

We prove the following two results for a given uniformly locally finite metric space with Yu’s property A: 1. The group of outer automorphisms of its uniform Roe algebra is isomorphic to its group of bijective coarse equivalences modulo closeness. 2. The group of outer automorphisms of its Roe algebra is isomorphic to its group of coarse equivalences modulo closeness. The main difficulty lies in the latter. To prove that, we obtain several uniform approximability results for maps between Roe algebras and use them to obtain a theorem about the “uniqueness” of Cartan masas of Roe algebras. We finish the paper with several applications of the results above to concrete metric spaces.
Connecting plant phenotyping and modelling communities: lessons from science mapping and operational perspectives
Authors: Saint Cast Clément , Lobet Guillaume , Cabrera-Bosquet Llorenç , Couvreur Valentin , Pradal Christophe , Tardieu François , Draye Xavier
Published: April 2022

Plant phenotyping platforms generate large amounts of high-dimensional data at different scales of plant organization. The possibility to use this information as inputs of models is an opportunity to develop models that integrate new processes and genetic inputs. We assessed to what extent the phenomics and modelling communities can address the issues of interoperability and data exchange, using a science mapping approach (i.e. visualization and analysis of a broad range of scientific and technological activities as a whole). In this paper, we (i) evaluate connections, (ii) identify compatible and connectable research topics and (iii) propose strategies to facilitate connection across communities. We applied a science mapping approach based on reference and term analyses to a set of 4332 scientific papers published by the plant phenomics and modelling communities from 1980 to 2019, retrieved using the Elsevier’s Scopus database and the quantitative-plant.org website. The number of papers on phenotyping and modelling dramatically increased during the past decade, boosted by progress in phenotyping technologies and by key developments at hardware and software levels. The science mapping approach indicated a large diversity of research topics studied in each community. Despite compatibilities of research topics, the level of connection between the phenomics and modelling communities was low. Although phenomics and modelling crucially need to exchange data, the two communities appeared to be weakly connected. We encourage these communities to work on ontologies, harmonized formats, translators and connectors to facilitate transparent data exchange.
Effects of ferulic acid on the growth performance, antioxidant capacity, and intestinal development of piglets with intrauterine growth retardation
Authors: Wan Jin , Yu Qiong , Luo Junqiu , Zhang Li , Ruan Zheng
Published: April 2022

Neonates with intrauterine growth retardation (IUGR) are prone to suffer from delayed postnatal growth and development during the early stages of life. Ferulic acid (FA) is a phenolic compound that is abundantly present in fruits and vegetables and has various health benefits. Hence, we explored whether FA supplementation could favorably affect the growth performance, antioxidant capacity, and intestinal development of piglets with IUGR. In total, eight normal-birth-weight (NBW) piglets and 16 piglets with IUGR (age, 7 d) were assigned to be fed either basic formula milk (NBW and IUGR groups, respectively) or basic formula milk supplemented with 100 mg/kg FA (IUGR + FA group) for 21 d. At necropsy, the serum and intestinal tissues were collected. FA supplementation increased (P < 0.05) the feed conversion ratio and serum total superoxide dismutase and catalase activities in piglets with IUGR. Moreover, FA supplementation elevated (P < 0.05) the duodenal lactase and maltase activities, jejunal villus height and jejunal maltase activity but reduced (P < 0.05) the duodenal crypt depth and duodenal and jejunal cell apoptosis, cleaved cysteinyl aspartic acid protease-3 (caspase-3) content and cleaved caspase-9 content in piglets with IUGR. In summary, FA supplementation could elevate antioxidant capacity and facilitate intestinal development, thus resulting in increased feed efficiency in piglets with IUGR.
Analysis of fourth-grade fluid model over a stretchable surface with Riga plate subject to permeable medium
Authors: Hua Bian , Shah Faisal , Khan M Ijaz , El-Zahar Essam Roshdy , Farooq Shahid , Khan Sami Ullah , Guedri Kamel , Wu Wen-jing
Published: April 2022

The current investigation is concerned with the rheological impact of fourth-grade confined by Riga surface. The flow behaviour is analysed over a Riga plate in the presence of stagnation point and porous medium. The relevant similarity variables and corresponding boundary conditions are adopted to model the current problem. The highly non-linear coupled differential system is via optimal homotopy scheme. The outcomes of relevant dimensionless parameters on the velocity profile have been visualized with physical exploration. It is observed from the obtained outcomes that the fluid velocity declines against rising estimations of modified magnetic variable and inverse Darcy number. The increasing velocity change is noted for boosting values of third-grade fluid parameter. Moreover, the velocity pattern for fourth-grade material is comparatively higher than viscous, second-grade, and third-grade materials. The comparative analysis against obtained simulations is also listed.
Current trend of radiotherapy for glioblastoma in the elderly: a survey study by the brain tumor Committee of the Korean Radiation Oncology Group (KROG 21–05)
Authors: Wee Chan Woo , In Yoon Hong , Lee Sea-Won , Lim Do Hoon
Published: April 2022

Background

To investigate the current variability in radiotherapy practice for elderly glioblastoma patients.

Methods

A questionnaire comprising general information on elderly glioblastoma, treatment selection, radiotherapy and 16 clinical case-scenario-based questions (based on age, performance, extent of resection and MGMT promoter methylation) was sent to brain tumor radiation oncologists.

Results

Twenty-one responses were recorded. Most (71.4%) stated that 70 years is an adequate cut-off for ‘elderly’ individuals. The most preferred hypofractionated short-course radiotherapy schedule was 40–45 Gy over 3 weeks (81.3%). The median margin for high-dose target volume was 5 mm (range, 0–20 mm) from the T1-enhancement for short-course radiotherapy. The case-scenario-based questions revealed a near-perfect consensus on 6-week standard radiotherapy plus concurrent/adjuvant temozolomide as the most appropriate adjuvant treatment in good performing patients aged 65–70 years, regardless of surgery and MGMT promoter methylation. Notably, in 75-year-old patients with good performance, the most preferred treatment was 6-week radiotherapy (81.0–90.5%) plus concurrent/adjuvant temozolomide (71.4–95.2%) rather than short-course radiotherapy or radiotherapy alone. Although the use of 3-week short-course radiotherapy increased with age and decreased performance status (all P < 0.05), 6-week radiotherapy was adopted in a significant proportion of responders (14.3–23.8%) even for wheelchair-bound, 75-year-old patients. Temozolomide use was affected by age, performance and MGMT promoter (all P < 0.05).

Conclusions

A high level of consensus was observed in treating elderly glioblastoma patients with good performance status. However, the variability increased, especially for older patients and those with poor performance. This study serves as a basis for designing future clinical trials in elderly glioblastoma.
Older Refugees and Internally Displaced People in African Countries: Findings from a Scoping Review of Literature
Authors: Böcker Anita , Hunter Alistair
Published: April 2022

By and large, the attention and resources of governments, NGOs, and humanitarian actors have been directed at children and working-age displaced people, ignoring the needs and perspectives of displaced elders. Africa is the continent with the largest number of displaced people aged 60 and over. To help achieve equity and better representation for this latter group, it appears essential to delineate and clarify the evidence base on displaced elders in Africa. We systematically searched bibliographic databases in the social and health sciences. One hundred forty-one papers met our inclusion criteria globally, of which 16 were based on data collected in African countries. The scoping review establishes that the main focus has been the specific vulnerabilities faced by older African displaced people, particularly with regard to physical health and the erosion of social support systems. Contrary to research on older displaced populations elsewhere, studies on the mental health of displaced elders in Africa are lacking. Similarly, more priority should be given to phenomenological and life course approaches to better understand the lived experience of displaced African elders.
The cell wall of hornworts and liverworts: innovations in early land plant evolution?
Authors: Pfeifer Lukas , Mueller Kim-Kristine , Classen Birgit
Published: April 2022

An important step for plant diversification was the transition from freshwater to terrestrial habitats. The bryophytes and all vascular plants share a common ancestor that was probably the first to adapt to life on land. A polysaccharide-rich cell wall was necessary to cope with newly faced environmental conditions. Therefore, some pre-requisites for terrestrial life have to be shared in the lineages of modern bryophytes and vascular plants. This review focuses on hornwort and liverwort cell walls and aims to provide an overview on shared and divergent polysaccharide features between these two groups of bryophytes and vascular plants. Analytical, immunocytochemical, and bioinformatic data were analysed. The major classes of polysaccharides—cellulose, hemicelluloses, and pectins—seem to be present but have diversified structurally during evolution. Some polysaccharide groups show structural characteristics which separate hornworts from the other bryophytes or are too poorly studied in detail to be able to draw absolute conclusions. Hydroxyproline-rich glycoprotein backbones are found in hornworts and liverworts, and show differences in, for example, the occurrence of glycosylphosphatidylinositol (GPI)-anchored arabinogalactan-proteins, while glycosylation is practically unstudied. Overall, the data are an appeal to researchers in the field to gain more knowledge on cell wall structures in order to understand the changes with regard to bryophyte evolution.
Identification and characterization of the WYL BrxR protein and its gene as separable regulatory elements of a BREX phage restriction system
Authors: Luyten Yvette A , Hausman Deanna E , Young Juliana C , Doyle Lindsey A , Higashi Kerilyn M , Ubilla-Rodriguez Natalia C , Lambert Abigail R , Arroyo Corina S , Forsberg Kevin J , Morgan Richard D , Stoddard Barry L , Kaiser Brett K
Published: April 2022

Bacteriophage exclusion (‘BREX’) phage restriction systems are found in a wide range of bacteria. Various BREX systems encode unique combinations of proteins that usually include a site-specific methyltransferase; none appear to contain a nuclease. Here we describe the identification and characterization of a Type I BREX system from Acinetobacter and the effect of deleting each BREX ORF on growth, methylation, and restriction. We identified a previously uncharacterized gene in the BREX operon that is dispensable for methylation but involved in restriction. Biochemical and crystallographic analyses of this factor, which we term BrxR (‘BREX Regulator’), demonstrate that it forms a homodimer and specifically binds a DNA target site upstream of its transcription start site. Deletion of the BrxR gene causes cell toxicity, reduces restriction, and significantly increases the expression of BrxC. In contrast, the introduction of a premature stop codon into the BrxR gene, or a point mutation blocking its DNA binding ability, has little effect on restriction, implying that the BrxR coding sequence and BrxR protein play independent functional roles. We speculate that elements within the BrxR coding sequence are involved in cis regulation of anti-phage activity, while the BrxR protein itself plays an additional regulatory role, perhaps during horizontal transfer.
Tracking N-terminal protein processing from the Golgi to the chromatophore of a rhizarian amoeba
Authors: Meinnel Thierry
Published: April 2022

Mass spectrometry analysis of protein processing in a photosynthetic rhizarian amoeba, Paulinella chromatophora, suggests a major trafficking route from the cytosol to the chromatophore via the Golgi.
Unsupervised classification reveals consistency and degeneracy in neural network patterns of emotion
Authors: Doyle Cameron M , Lane Stephanie T , Brooks Jeffrey A , Wilkins Robin W , Gates Kathleen M , Lindquist Kristen A
Published: April 2022

In the present study, we used an unsupervised classification algorithm to reveal both consistency and degeneracy in neural network connectivity during anger and anxiety. Degeneracy refers to the ability of different biological pathways to produce the same outcomes. Previous research is suggestive of degeneracy in emotion, but little research has explicitly examined whether degenerate functional connectivity patterns exist for emotion categories such as anger and anxiety. Twenty-four subjects underwent functional magnetic resonance imaging (fMRI) while listening to unpleasant music and self-generating experiences of anger and anxiety. A data-driven model building algorithm with unsupervised classification (subgrouping Group Iterative Multiple Model Estimation) identified patterns of connectivity among 11 intrinsic networks that were associated with anger vs anxiety. As predicted, degenerate functional connectivity patterns existed within these overarching consistent patterns. Degenerate patterns were not attributable to differences in emotional experience or other individual-level factors. These findings are consistent with the constructionist account that emotions emerge from flexible functional neuronal assemblies and that emotion categories such as anger and anxiety each describe populations of highly variable instances.
Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse
Authors: Pechtel Pia , Harris Jennifer , Karl Anke , Clunies-Ross Caroline , Bower Susie , Moberly Nicholas J , Pizzagalli Diego A , Watkins Edward R
Published: April 2022

Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA +  major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.
The validation of the existence of the entero-mammary pathway and the assessment of the differences of the pathway between first and third parity sows
Authors: Greiner Laura L , Humphrey Dalton C , Holland Shayla N , Anderson C J , Schmitz-Esser Stephan
Published: April 2022

Forty sows (PIC Camborough 1050) from a single farm were randomly selected at 112 days of gestation to evaluate if gut bacteria transverse the blood system of the sow to deposit gut microbiota into the colostrum for piglet gut inoculation via the entero-mammary pathway. Fourteen first-parity gilts and 20 third-parity sows were used for the study. At the time of farrowing, colostrum, fecal samples, and blood samples were collected to evaluate the presence of bacteria in each sample. Colostrum and blood samples were processed via centrifugation to separate the immune cell fraction. Total DNA was extracted from fecal, colostrum, and white blood cell fractions. 16S ribosomal RNA gene amplicon sequencing was conducted at the Iowa State University DNA Facility (Ames, IA) to further characterize the bacterial and archaeal taxa present within each sample. Data were analyzed using Mothur and using R v4.0.3 (R Core Team, 2020). The experimental unit was the sow. Tables were generated to demonstrate the relative abundances of bacteria and archaea present in each type of sample and also identify organisms differentially abundant between sample types. Firmicutes were the most abundant phylum in colostrum and fecal samples and Tenericutes had the greatest abundance in blood comparative to other phyla. Further evaluation of the classification of bacteria present demonstrated that a few genera of bacteria are present in all three samples. Clostridum_sensu_stricto 1 was present in high relative abundance in colostrum and moderate abundance in the feces while also being present within the blood. Other genera present in all three sample types include Ruminococcus and Mycoplasma. In conclusion, the data suggest that there are bacteria present in all three locations of the sow at the time of farrowing and that first parity sows have different microbial populations than third parity sows.
A New Oomycete Metabarcoding Method Using the rps10 Gene
Authors: Foster Zachary S. L. , Albornoz Felipe E. , Fieland Valerie J. , Larsen Meredith M. , Jones F. Andrew , Tyler Brett M. , Nguyen Hai D. T. , Burgess Treena I. , Riddell Carolyn , Voglmayr Hermann , Martin Frank N. , Grünwald Niklaus J.
Published: April 2022

Oomycetes are a group of eukaryotes related to brown algae and diatoms, many of which cause plant and animal diseases. Improved methods are needed for rapid and accurate characterization of oomycete communities using DNA metabarcoding. We have evaluated the mitochondrial 40S ribosomal protein S10 ( rps10) gene as a locus for oomycete metabarcoding and provide primers predicted to amplify this region from all oomycetes based on a wide range of available reference sequences. We evaluated its utility relative to the internal transcribed spacer 1 (ITS1), by sequencing environmental samples and a mock community using Illumina MiSeq. Amplified sequence variants (ASVs) and operational taxonomic units (OTUs) were identified per community. Observed sequences and predicted taxonomy of ASVs and OTUs were compared with the known composition of the mock community. Both rps10 and ITS yielded ASVs with sequences matching 21 of the 24 species in the mock community and matching all 24 when allowing for a 1-bp difference. Taxonomic classifications of ASVs included 23 members of the mock community for rps10 and 17 for ITS1. Sequencing results for the environmental samples suggest that the rps10 locus results in substantially less amplification of nontarget organisms than the ITS1 method. The amplified rps10 region also has higher taxonomic resolution than ITS1, allowing for greater discrimination of closely related species. We present a new website with a searchable rps10 reference database for species identification and all protocols needed for oomycete metabarcoding. The rps10 barcode and methods described herein provide an effective tool for metabarcoding oomycetes using short-read sequencing.
Acquisition and Transmission of the Lethal Bronzing Phytoplasma byHaplaxius crudusUsing Infected Palm Spear Leaves and Artificial Feeding Media
Authors: Mou De-Fen , Di Lella Brandon , Halbert Susan E. , Bextine Blake , Helmick Ericka E. , Bahder Brian W.
Published: April 2022

Lethal bronzing (LB) is a fatal palm disease caused by the phytoplasma ‘ Candidatus Phytoplasma aculeata’. This disease causes significant economic losses in palm industries and landscapes. The American palm cixiid, Haplaxius crudus, recently was identified as the vector of the phytoplasma. However, knowledge about LB phytoplasma transmission is limited due to the lack of a method to generate phytoplasma-infected insects in the laboratory. In this study, the acquisition and transmission of the LB phytoplasma by H. crudus were investigated. Successful acquisitions of the phytoplasma by H. crudus were observed at 2 days acquisition access period on LB-infected palm spear leaves. Analyses revealed increased phytoplasma infection rates of H. crudus with longer acquisition access periods and latent periods. A significantly higher phytoplasma infection rate was shown after various acquisition access periods and latent periods than the infection rate of the field-collected H. crudus population. Transmission of the phytoplasma from LB-infected spear leaves to sucrose media by H. crudus also was observed using digital PCR assays. These results further support the vector status of H. crudus and offer valuable information to understand LB phytoplasma transmission. Additionally, these results generate a critical baseline for future LB phytoplasma−vector research by providing a way to generate vectors with high phytoplasma infection rates in the laboratory setting.
Harboyan Syndrome: A Novel SLC4A11 Variant With Unique Genotype–Phenotype Correlation
Authors: Magan Tejal , Hammersmith Kristin M. , Viaene Angela N. , Kumar Priyanka , Eagle Ralph C. , Milman Tatyana
Published: April 2022

Purpose:

The purpose of this study was to describe the genotypic and phenotypic characteristics of an infant with a SLC4A11 mutation associated with bilateral corneal edema, hearing loss, and hydronephrosis present since birth.

Methods:

This was a case report. Ophthalmic and systemic examination of the proband, histopathologic and ultrastructural characteristics of bilateral corneal discs, and molecular genetic evaluation by whole-exome sequencing are described.

Results:

A male infant was born with bilateral corneal opacities, sensorineural hearing loss, and hydronephrosis to healthy parents after an uneventful pregnancy. Penetrating keratoplasty of the left eye at age 10 months demonstrated minimal corneal edema with normal thickness Descemet membrane and cellular endothelium with intracytoplasmic vacuoles and degenerative changes in rare cells. Penetrating keratoplasty of the right eye 6 months later disclosed prominent corneal edema with a thickened posterior banded layer of Descemet membrane and severe endothelial atrophy. Whole-exome sequencing of the proband and parents' blood demonstrated a homozygous mutation in SLC4A11 gene (c.1735_1737delCTC,p.Leu579del). The combined clinical, histopathologic, and molecular genetic findings raised consideration of an unusual phenotype of Harboyan syndrome manifesting as congenital hereditary endothelial dystrophy with a prelingual rather than, as previously described, postlingual hearing loss.

Conclusions:

We report a novel homozygous SLC4A11 variant with a previously undocumented phenotype of CHED in association with prelingual sensorineural hearing loss and hydronephrosis, thus broadening our understanding of the spectrum of genotypic and phenotypic findings of Harboyan syndrome.
Case for Epithelium-Off Corneal Cross-linking
Authors: Dupps William J.
Published: April 2022

The question of whether the epithelium should be removed in corneal cross-linking (CXL) in the treatment of keratoconus and other corneal ectatic disorders remains controversial. The motivation for epithelium-on CXL methods, which are not yet FDA approved and vary greatly in methodology, is to reduce the risk of vision-threatening complications related to debridement. However, as discussed in this counterpoint piece, most high-level evidence suggests that removal of the epithelium facilitates greater crosslinking effectiveness as measured by primary clinical outcome metrics such as topographic flattening and stabilization of disease. Furthermore, quality evidence is still lacking for a significant reduction in rates of infectious keratitis or loss of vision that can be attributed to debridement-related complications. In the absence of comparative effectiveness trials or long-term follow-up studies that show otherwise, the FDA-approved epi-off protocol is still the standard-bearer for safe and effective stabilization of corneal ectatic disease.