bluuebunny/crossref_metadata_2025 huggingface dataset:
Travel-associated neurological disease terminated in a postmortem diagnosed atypical HSV-1 encephalitis after high-dose steroid therapy – a case report
Authors: Osterman Andreas , Ruf Viktoria C. , Domingo Cristina , Nitsche Andreas , Eichhorn Peter , Zimmermann Hanna , Seelos Klaus , Zange Sabine , Dimitriadis Konstantinos , Pfister Hans-Walter , Thye Thorsten , Giese Armin , Tappe Dennis , Böhm Stephan
Published: February 2020

Background

Human encephalitis can originate from a variety of different aetiologies, of which infection is the most common one. The diagnostic work-up is specifically challenging in patients with travel history since a broader spectrum of unfamiliar additional infectious agents, e. g. tropical disease pathogens, needs to be considered. Here we present a case of encephalitis of unclear aetiology in a female traveller returning from Africa, who in addition developed an atypical herpes simplex virus (HSV) encephalitis in close temporal relation with high-dose steroid treatment.

Case presentation

A previously healthy 48-year-old female presented with confusion syndrome and impaired vigilance which had developed during a six-day trip to The Gambia. The condition rapidly worsened to a comatose state. Extensive search for infectious agents including a variety of tropical disease pathogens was unsuccessful. As encephalitic signs persisted despite of calculated antimicrobial and antiviral therapy, high-dose corticosteroids were applied intravenously based on the working diagnosis of an autoimmune encephalitis. The treatment did, however, not improve the patient’s condition. Four days later, bihemispheric signal amplification in the insular and frontobasal cortex was observed on magnetic resonance imaging (MRI). The intracranial pressure rapidly increased and could not be controlled by conservative treatment. The patient died due to tonsillar herniation 21 days after onset of symptoms. Histological examination of postmortem brain tissue demonstrated a generalized lymphocytic meningoencephalitis. Immunohistochemical reactions against HSV-1/2 indicated an atypical manifestation of herpesviral encephalitis in brain tissue. Moreover, HSV-1 DNA was detected by a next-generation sequencing (NGS) metagenomics approach. Retrospective analysis of cerebrospinal fluid (CSF) and serum samples revealed HSV-1 DNA only in specimens one day ante mortem.

Conclusions

This case shows that standard high-dose steroid therapy can contribute to or possibly even trigger fulminant cerebral HSV reactivation in a critically ill patient. Thus, even if extensive laboratory diagnostics including wide-ranging search for infectious pathogens has been performed before and remained without results, continuous re-evaluation of potential differential diagnoses especially regarding opportunistic infections or reactivation of latent infections is of utmost importance, particularly if new symptoms occur.
Semi-constrained posterior stabilized total knee arthroplasty reproduces natural deep knee bending kinematics
Authors: Sumino Takanobu , Tomita Tetsuya , Sugamoto Kazuomi , Yamazaki Takaharu , Okazaki Ken
Published: February 2020

Background

The Flexible Nichidai Knee Posterior Stabilized (FNK-PS) system was designed to provide relatively high varus-valgus stabilities without the stem extensions to patients with severe knee joint disorders. This is a combination of a large tibial post and high femoral cam adapted to a PS system. The aim of our study was to analyze the in vivo two-dimensional/three-dimensional registration kinematics of the FNK PS-total knee arthroplasty (TKA) system during deep knee bending.

Methods

Nineteen knees from 15 total knee arthroplasty (TKA) patients who were able to squat with enough knee flexion were selected. During deep knee bending under weight bearing (WB) and non-weight bearing (NWB) conditions, we quantified range of motion, axial rotation, femoral anteroposterior translation, and post-cam engagement angle.

Results

The maximum-flexion was significantly different between the two conditions. The mean axial femoral external rotation was 4.8° and 6.2° under WB and NWB conditions, respectively, at 120° flexion. Anteroposterior translation based on bicondylar posterior roll-back patterns was noted with increasing knee flexion. Both the medial and lateral femoral aspects were significantly more posterior during early to mid-flexion. Initial post-cam engagement occurred significantly earlier during flexion under NWB than under WB conditions. Under WB, the timing of the post-cam engagement correlated with the maximum flexion .

Conclusions

The kinematics of the semi-constrained PS system reproducibly exhibited a mild external rotation with smooth posterior roll-back. This was assisted by the engagement of the large tibial post and high femoral cam during the early phase of flexion.
Measuring resilience prospectively as the speed of affect recovery in daily life: a complex systems perspective on mental health
Authors: Kuranova Anna , Booij Sanne H. , Menne-Lothmann Claudia , Decoster Jeroen , van Winkel Ruud , Delespaul Philippe , De Hert Marc , Derom Catherine , Thiery Evert , Rutten Bart P. F. , Jacobs Nele , van Os Jim , Wigman Johanna T. W. , Wichers Marieke
Published: February 2020

Introduction

There is growing evidence that mental disorders behave like complex dynamic systems. Complex dynamic systems theory states that a slower recovery from small perturbations indicates a loss of resilience of a system. This study is the first to test whether the speed of recovery of affect states from small daily life perturbations predicts changes in psychopathological symptoms over 1 year in a group of adolescents at increased risk for mental disorders.

Methods

We used data from 157 adolescents from the TWINSSCAN study. Course of psychopathology was operationalized as the 1-year change in the Symptom Checklist-90 sum score. Two groups were defined: one with stable and one with increasing symptom levels. Time-series data on momentary daily affect and daily unpleasant events were collected 10 times a day for 6 days at baseline.

We modeled the time-lagged effect of daily unpleasant events on negative and positive affect after each unpleasant event experienced, to examine at which time point the impact of the events is no longer detectable.

Results

There was a significant difference between groups in the effect of unpleasant events on negative affect 90 min after the events were reported. Stratified by group, in the Increase group, the effect of unpleasant events on both negative (B = 0.05, p < 0.01) and positive affect (B = − 0. 08, p < 0.01) was still detectable 90 min after the events, whereas in the Stable group this was not the case.

Conclusion

Findings cautiously suggest that adolescents who develop more symptoms in the following year may display a slower affect recovery from daily perturbations at baseline. This supports the notion that mental health may behave according to the laws of a complex dynamic system. Future research needs to examine whether these dynamic indicators of system resilience may prove valuable for personalized risk assessment in this field.
Circular RNA-CDR1as acts as the sponge of microRNA-641 to promote osteoarthritis progression
Authors: Zhang Wei , Zhang Chi , Hu Chengfang , Luo Congfeng , Zhong Biao , Yu Xiaowei
Published: February 2020

Background

The antisense cerebellar degenerative-related protein-1 (CDR1as) has been identified as a sponge for several microRNAs. MiR-641 has been shown to be downregulated in osteoarthritic human chondrocytes, but its regulation and function in osteoarthritis (OA) has not been reported.

Methods

OA cartilage samples were obtained from the knee joints of 12 patients (8 males and 4 females at age of 57–73 years old) who underwent total knee arthroplasty. Normal articular cartilage samples were obtained from the knee joints of 10 trauma patients at age of 29–65 years old (6 males and 4 females). The levels of circRNA-CDR1as mRNA and miR-641 were examined by qRT-PCR and the contents of type II collagen (Col II), IL-6, MMP13 and GAPDH in chondrocytes were examined by Western blot.

Results

In this study, we found that circRNA-CDR1as level was significantly upregulated in OA chondrocytes, and negatively related with that of miR-641. RNA pull down assay confirmed that circRNA-CDR1as directly targets to miR-641. Furthermore, downregulation of circRNA-CDR1as increased type II collagen level but reduced MMP13 and IL-6 contents, while these effects were partly reversed by down-regulation of miR-641.

Conclusion

Overall, our results indicate that circRNA-CDR1as plays a crucial role in regulating OA progression via modulating extracellular matrix metabolism and inflammation via sponging miR-641 and provide a novel regulatory role of circRNA-CDR1as in OA.
Governance of health research funding institutions: an integrated conceptual framework and actionable functions of governance
Authors: Smits Pernelle , Champagne François
Published: February 2020

Background

Health research has scientific, social and political impacts. To achieve such impacts, several institutions need to participate; however, health research funding institutions are seldom nominated in the literature as essential players. The attention they have received has so far focused mainly on their role in knowledge translation, informing policy-making and the need to organise health research systems. In this article, we will focus solely on the governance of national health research funding institutions. Our objectives are to identify the main functions of governance for such institutions and actionable governance functions. This research should be useful in several ways, including in highlighting, tracking and measuring the governance trends in a given funding institution, and to forestall low-level governance.

Methods

First, we reviewed existing frameworks in the grey literature, selecting seven relevant documents. Second, we developed an integrated framework for health research funding institution governance and management.

Third, we extracted actionable information for governance by selecting a mix of North American, European and Asian institutions that had documentation available in English (e.g. annual report, legal status, strategy).

Results

The framework contains 13 functions – 5 dedicated to governance (intelligence acquisition, resourcing and instrumentation, relationships management, accountability and performance, and strategy formulation), 3 dedicated to management (priority-setting, financing and knowledge transfer), and 5 dedicated to transversal logics that apply to both governance and management (ethics, transparency, capacity reinforcement, monitoring and evaluation, and public engagement).

Conclusions

Herein, we provide a conceptual contribution for scholars in the field of governance and health research as well as a practical contribution, with actionable functions for high-level managers in charge of the governance of health research funding institutions.
Is patient-centred care for women a priority for policy-makers? Content analysis of government policies
Authors: Gagliardi Anna R. , Dunn Sheila , Foster Angel M. , Grace Sherry L. , Khanlou Nazilla , Stewart Donna E. , Straus Sharon E.
Published: February 2020

Background

Considerable research shows that women experience gendered disparities in healthcare access and quality. Patient-centred care (PCC) could reduce inequities by addressing the patient’s clinical and personal needs. Healthcare policies can influence service delivery to optimise patient outcomes. This study assessed whether and how government policies recognise and promote PCC for women (PCCW).

Methods

We analysed the content of English-language policies published in Canada from 2010 to 2018 on depression and cardiac rehabilitation – conditions featuring known gendered inequities – that were identified on government websites. We extracted data and used summary statistics to enumerate mentions of PCC and women’s health.

Results

We included 30 policies (20 depression, 10 cardiac rehabilitation). Of those, 20 (66.7%) included any content related to PCC (median 1.0, range 0.0 to 5.0), most often exchanging information (14, 46.7%) and making decisions (13, 43.3%). Less frequent domains were enabling self-management (8, 26.7%), addressing emotions (6, 20.0%) and fostering the relationship (4, 13.3%). No policies included content for the domain of managing uncertainty. A higher proportion of cardiac rehabilitation guidelines included PCC content. Among the 30 policies, 7 (23.3%) included content related to at least one women’s health domain (median 0.0, range 0.0 to 3.0). Most frequently included were social determinants of health (4, 13.3%). Fewer policies mentioned any issues to consider for women (2, 28.6%), issues specific to subgroups of women (2, 28.6%) or distinguished care for women from men (2, 28.6%). No policies included mention of abuse or violence, or discrimination or stigma. The policies largely pertained to depression. Despite mention of PCC or women’s health, policies offered brief, vague guidance on how to achieve PCCW; for example, “Patients value being involved in decision-making” and “Women want care that is collaborative, woman- and family-centered, and culturally sensitive.”

Conclusions

Despite considerable evidence of need and international recommendations, most policies failed to recognise gendered disparities or promote PCC as a mitigating strategy. These identified gaps represent opportunities by which government policies could be developed or strengthened to support PCCW. Future research should investigate complementary strategies such as equipping policy-makers with the evidence and tools required to develop PCCW-informed policies.
Comprehensive pharmacogenomic characterization of gastric cancer
Authors: Sa Jason K. , Hong Jung Yong , Lee In-Kyoung , Kim Ju-sun , Sim Moon-Hee , Kim Ha Jung , An Ji Yeong , Sohn Tae Sung , Lee Joon Ho , Bae Jae Moon , Kim Sung , Kim Kyoung-Mee , Kim Seung Tae , Park Se Hoon , Park Joon Oh , Lim Ho Yeong , Kang Won Ki , Her Nam-Gu , Lee Yeri , Cho Hee Jin , Shin Yong Jae , Kim Misuk , Koo Harim , Kim Mirinae , Seo Yun Jee , Kim Ja Yeon , Choi Min-Gew , Nam Do-Hyun , Lee Jeeyun
Published: February 2020

Background

Gastric cancer is among the most lethal human malignancies. Previous studies have identified molecular aberrations that constitute dynamic biological networks and genomic complexities of gastric tumors. However, the clinical translation of molecular-guided targeted therapy is hampered by challenges. Notably, solid tumors often harbor multiple genetic alterations, complicating the development of effective treatments.

Methods

To address such challenges, we established a comprehensive dataset of molecularly annotated patient derivatives coupled with pharmacological profiles for 60 targeted agents to explore dynamic pharmacogenomic interactions in gastric cancers.

Results

We identified lineage-specific drug sensitivities based on histopathological and molecular subclassification, including substantial sensitivities toward VEGFR and EGFR inhibition therapies in diffuse- and signet ring-type gastric tumors, respectively. We identified potential therapeutic opportunities for WNT pathway inhibitors inALK-mutant tumors, a significant association betweenPIK3CA-E542K mutation and AZD5363 response, and transcriptome expression ofRNF11as a potential predictor of response to gefitinib.

Conclusions

Collectively, our results demonstrate the feasibility of drug screening combined with tumor molecular characterization to facilitate personalized therapeutic regimens for gastric tumors.
CHD4/NuRD complex regulates complement gene expression and correlates with CD8 T cell infiltration in human hepatocellular carcinoma
Authors: Shao Simin , Cao Haowei , Wang Zhongkun , Zhou Dongmei , Wu Chaoshen , Wang Shu , Xia Dian , Zhang Daoyong
Published: February 2020

Backgrounds

The NuRD (Nucleosome Remodeling and Deacetylation) complex is a repressive complex in gene transcription by modulating chromatin accessibility of target genes to transcription factors and RNA polymerase II. Although individual subunits of the complex have been implicated in many other cancer types, the complex’s role in human hepatocellular carcinoma (HCC) is not fully understood. More importantly, the NuRD complex has not yet been investigated as a whole in cancers.

Methods

We analyzed the expression of the NuRD complex in HCC and evaluated the prognostic value of NuRD complex expression in HCC using the RNA-seq data obtained from the TCGA project. We examined the effect of CHD4 knockdown on HCC cell proliferation, apoptosis, migration, invasion, epithelial-mesenchymal transition, colony-forming ability, and on complement gene expression. We also performed bioinformatic analyses to investigate the correlation between the NuRD complex expression and immune infiltration.

Results

We found that nine subunits, out of 14 subunits of the NuRD complex examined, were significantly overexpressed in HCC, and their expression levels were positively correlated with cancer progression. More importantly, our data also demonstrated that these subunits tended to be overexpressed as a whole in HCC. Subsequent studies demonstrated that knockdown of CHD4 in HCC cells inhibits cell proliferation, migration, invasion, and colony-forming ability and promotes apoptosis of HCC cells, indicating that the CHD4/NuRD complex plays oncogenic roles in HCC. Further analysis revealed that the CHD4/NuRD complex regulates complement gene expression in HCC. Intriguingly, we found that the CHD4/NuRD complex expression was inversely correlated with CD8 T cell infiltration in HCC.

Conclusions

Our data demonstrate that the CHD4/NuRD complex plays an oncogenic role in human HCC and regulates complement gene expression in HCC cells. The results of inverse correlation between the CHD4/NuRD complex and CD8 T cell and DC cell infiltration in HCC suggest that the CHD4/NuRD complex not only plays direct regulatory roles in HCC cells, but also has an impact on the immune microenvironment of HCC.
Age-, tumor-, and metastatic tissue-associated DNA hypermethylation of a T-box brain 1 locus in human kidney tissue
Authors: Serth Jürgen , Peters Inga , Dubrowinskaja Natalia , Reese Christel , Albrecht Knut , Klintschar Michael , Lafos Marcel , Grote Alexander , Becker Albert , Hennenlotter Jörg , Stenzl Arnulf , Tezval Hossein , Kuczyk Markus A.
Published: February 2020

Background

While a considerable number of tumor-specific hypermethylated loci have been identified in renal cell cancer (RCC), DNA methylation of loci showing successive increases in normal, tumoral, and metastatic tissues could point to genes with high relevance both for the process of tumor development and progression. Here, we report that DNA methylation of a locus in a genomic region corresponding to the 3′UTR of the transcription factor T-box brain 1 (TBR1) mRNA accumulates in normal renal tissues with age and possibly increased body mass index. Moreover, a further tissue-specific increase of methylation was observed for tumor and metastatic tissue samples.

Results

Biometric analyses of the TCGA KIRC methylation data revealed candidate loci for age-dependent and tumor-specific DNA methylation within the last exon and in a genomic region corresponding to the 3′UTR TBR1 mRNA. To evaluate whether methylation of TBR1 shows association with RCC carcinogenesis, we measured 15 tumor cell lines and 907 renal tissue samples including 355 normal tissues, 175 tissue pairs of normal tumor adjacent and corresponding tumor tissue as well 202 metastatic tissues samples of lung, bone, and brain metastases by the use of pyrosequencing. Statistical evaluation demonstrated age-dependent methylation in normal tissue (R = 0.72, p < 2 × 10−16), association with adiposity (P = 0.019) and tumor-specific hypermethylation (P = 6.1 × 10−19) for RCC tissues. Comparison of tumor and metastatic tissues revealed higher methylation in renal cancer metastases (P = 2.65 × 10−6).

Conclusions

Our analyses provide statistical evidence of association between methylation of TBR1 and RCC development and disease progression.
Conditioned medium derived from FGF-2-modified GMSCs enhances migration and angiogenesis of human umbilical vein endothelial cells
Authors: Jin Shanshan , Yang Chengzhe , Huang Jiahui , Liu Lianlian , Zhang Yu , Li Shutong , Zhang Liguo , Sun Qinfeng , Yang Pishan
Published: February 2020

Background

Angiogenesis plays an important role in tissue repair and regeneration, and conditioned medium (CM) derived from mesenchymal stem cells (MSC-CM) possesses pro-angiogenesis. Nevertheless, the profile and concentration of growth factors in MSC-CM remain to be optimized. Fibroblast growth factor-2 (FGF-2) has been proven to be an effective angiogenic factor. Thus, the aim of this study was to verify whether FGF-2 gene overexpression optimized CM from human gingival mesenchymal stem cells (hGMSCs) and whether such optimized CM possessed more favorable pro-angiogenesis effect.

Methods

First, FGF-2 gene-modified hGMSCs were constructed using lentiviral transfection technology (LV-FGF-2+-hGMSCs) and the concentration of angiogenesis-related factors in LV-FGF-2+-hGMSC-CM was determined by ELISA. Then, human umbilical vein endothelial cells (HUVECs) were co-cultured for 3 days with LV-FGF-2+-hGMSC-CM, and the expression level of placenta growth factor (PLGF), stem cell factor (SCF), vascular endothelial growth factor receptor 2 (VEGFR2) in HUVECs were determined by qRT-PCR, western blot, and cellular immunofluorescence techniques. The migration assay using transwell and in vitro tube formation experiments on matrigel matrix was conducted to determine the chemotaxis and angiogenesis enhanced by LV-FGF-2+-hGMSC-CM. Finally, NOD-SCID mice were injected with matrigel mixed LV-FGF-2+-hGMSC-CM, and the plug sections were analyzed by immunohistochemistry staining with anti-human CD31 antibody.

Results

LV-FGF-2+-hGMSC-CM contained significantly more FGF-2, vascular endothelial growth factor A (VEGF-A), and transforming growth factor β (TGF-β) than hGMSC-CM. HUVECs pretreated with LV-FGF-2+-hGMSC-CM expressed significantly more PLGF, SCF, and VEGFR2 at gene and protein level than hGMSC-CM pretreated HUVECs. Compared with hGMSC-CM, LV-FGF-2+-hGMSC-CM presented significantly stronger chemotaxis to HUVECs and significantly strengthened HUVECs mediated in vitro tube formation ability. In vivo, LV-FGF-2+-hGMSC-CM also possessed stronger promoting angiogenesis ability than hGMSC-CM.

Conclusions

Overexpression of FGF-2 gene promotes hGMSCs paracrine of angiogenesis-related growth factors, thereby obtaining an optimized conditioned medium for angiogenesis promotion.
A safety type of genetically engineered bacterium that degrades chemical pesticides
Authors: Li Qin , Li Jing , Kang Ke-Lai , Wu Yi-Jun
Published: February 2020

Chemical pesticides are used widely and their residues are found in the environment. Pesticide pollution has become a global problem. To find an economical, effective and safety way to degrade residues of pesticides in environment, we constructed a genetically engineered bacterium (GEB) having the ability to degrade pesticides, emit green fluorescence and has a containment system by using a dual plasmid expression system. One plasmid contains the genes of enhanced green fluorescent protein (EGFP) and carboxylesterase B1 (CarE B1), which were cloned downstream of lambda PL promoter and expressed constitutively. The gene of CarE B1 encodes an insect-detoxifying enzyme possessing the degradability to organochloride pesticides, organophosphorus pesticides, carbamates, and pyrethoid insecticides. The other is the conditional suicide plasmid for containment system, in which the lethal gene used was the nuclease gene of Serratia marcescens without the leader-coding sequence and was placed downstream of T7 promoter. The GEB has wide prospects of application on cleanup of pesticide residues with its degradability to several pesticides and containment system.
Trends in extreme temperature and rainfall indices in the semi-arid areas of Western Tigray, Ethiopia
Authors: Berhane Abadi , Hadgu Gebre , Worku Walelign , Abrha Berhanu
Published: February 2020

Background

Africa is the most vulnerable continent in the world; which recurrent droughts, extreme temperature and rainfall affects agriculture and food security. The aim of this study was to analyze the trends in extreme temperature and rainfall in major sesame producing areas in western Tigray using RClimDex software. We selected eight temperature and nine rainfall indices from 27 extreme temperature and rainfall indices, which are recommended by joint CCL/CLIVAR/JCOMM Expert Team on Climate Change Detection and Indices (ETCCDI). A non-parametric Mann–Kendall test and Sen’s slope estimates were used to test the statistical significance and trend of each of the extreme temperature and rainfall indices, respectively.

Results

Number of heavy rainy days, number of very heavy rainy days, very wet days, extremely wet days, and maximum 5 days precipitation showed a negative trend, with significant (p < 0.05) decrease throughout the study area. Monthly maximum value of maximum and minimum value of maximum temperature, monthly maximum and minimum value of minimum temperature, hot days and hot nights revealed positive trend throughout the study areas. Total rainfall was decreasing significantly (p < 0.05) by 13.34 mm, 13.8 mm, 14.65 mm, 10.9 mm and 8.4 mm/year at Humera and Dansha, Adiremets, Maygaba, Maytsebri and Sheraro, and Adigoshu, respectively. Spatial analysis on extreme temperature also indicated there was relatively lower variability on minimum temperature in Humera, Dansha, Adiremets, and Adigoshu. On average, the western part of Tigray experienced a reduction in total rainfall ranging 8.45 to 14.7 mm/year; and increase in average maximum temperature of 0.04 to 0.051 °C/year since 1983 to 2016. The results also revealed an increase in warm nights and warm days ranging from 0.31 to 0.62 days, and 0.38 to 0.71 days/year, respectively.

Conclusions

Increase in temperature and decrease in amount of rainfall may have a negative impact on crop transpiration, photosynthetic rate and soil water balance; exacerbating distribution and infestation of malaria and leishmaniasis. The results in this study could have an important role in identifying possible present and future production strategies on sesame, cotton, and sorghum crops, which are essential cash crops produced by farmers and investors.
The impact of production shocks on maize markets in Ethiopia: implications for regional trade and food security
Authors: Yami Mesay , Meyer Ferdi , Hassan Rashid
Published: February 2020

In this article, we demonstrated the dynamic impact of a bumper harvest and drought shocks on the maize market and on the trade regime in Ethiopia. Regional market integration of Ethiopia’s white maize market with the South Sudan and Kenyan maize markets was also examined using cointegration analysis. Despite the renewed conflict in South Sudan, Addis Ababa maize market is cointegrated with Juba’s maize market. The simulation analysis indicated that a 20% increase in maize yield could reduce the maize price by 81%. This implies a decrease in the maize price level of 70% (110 USD/t) below the export parity price. This makes maize exports profitable and shifts the trade regime from autarky to an export parity regime. On the other hand, the effect of a drought could increase maize prices by 61% in the short run (within the year). At the current market price, the domestic maize price is wandering between the border prices and it is unprofitable to export maize. Therefore, lifting the export ban, even during normal harvest seasons, would not do any harm to the domestic maize price.
Estimation of the source process and forward simulation of long-period ground motion of the 2018 Hokkaido Eastern Iburi, Japan, earthquake
Authors: Kubo Hisahiko , Iwaki Asako , Suzuki Wataru , Aoi Shin , Sekiguchi Haruko
Published: February 2020

In this study, we investigate the source rupture process of the 2018 Hokkaido Eastern Iburi earthquake in Japan (MJMA6.7) and how the ground motion can be reproduced using available source and velocity models. First, we conduct a multiple-time-window kinematic waveform inversion using strong motion waveforms, which indicates that a large slip area located at a depth of 25–30 km in the up-dip direction from the hypocenter was caused by a rupture propagating upward 6–12 s after its initiation. Moreover, the high-seismicity area of aftershocks did not overlap with the large-slip area. Subsequently, using the obtained source model and a three-dimensional velocity structure model, we conduct a forward long-period (< 0.5 Hz) ground-motion simulation. The simulation was able to reproduce the overall ground-motion characteristics in the sedimentary layers of the Ishikari Lowland.
Studies on the cold tolerance of ratoon ‘Chaling’ common wild rice
Authors: Xu Mengliang , Li Xiangzhen , Mo Xiang , Tu Siyu , Cui Yanchun , Yang Daichang
Published: February 2020

Background

Rice is the staple food of many people around the world. However, most rice varieties, especially widely grown indica varieties and hybrids, are sensitive to cold stress. In order to provide a basis for the utilization of a common wild rice (CWR, Oryza rufipogon Griff.) named ‘Chaling’ CWR in cold-tolerant rice breeding and deepen the understanding of rice cold tolerance, the cold tolerance of ratoon ‘Chaling’ CWR was studied under the stress of the natural low temperature in winter in Changsha, Hunan province, China, especially under the stress of abnormal natural low temperature in Changsha in 2008, taking other ratoon CWR accessions and ratoon cultivated rice phenotypes as control.

Results

The results showed that ratoon ‘Chaling’ CWR can safely overwinter under the natural conditions in Changsha (28° 22′ N), Hunan province, China, which is a further and colder northern place than its habitat, even if it suffers a long-term low temperature stress with ice and snow. In 2008, an extremely cold winter appeared in Changsha, i.e., the average daily mean temperature of 22 consecutive days from January 13 to February 3 was − 1.0 °C, and the extreme low temperature was − 4.7 °C. After subjected to this long-term cold stress, the overwinter survival rate of ratoon ‘Chaling’ CWR was 100%, equals to that of ratoon ‘Dongxiang’ CWR which is northernmost distribution in the word among wild rice populations, higher than those of ratoon ‘Fusui’ CWR, ratoon ‘Jiangyong’ CWR, and ratoon ‘Liujiang’ CWR (63.55–83.5%) as well as those of ratoon ‘Hainan’ CWR, ratoon ‘Hepu’ CWR, and all the ratoon cultivated rice phenotypes including 3 japonica ones, 3 javanica ones, and 5 indica ones (0.0%).

Conclusions

The results indicate that ratoon ‘Chaling’ CWR possesses strong cold tolerance and certain freezing tolerance.
Intratumoral pseudoaneurysm within a liver metastasis of gastric cancer: a case report
Authors: Ohara Hiroki , Ishibashi Yuji , Yoshimura Shuntaro , Yamazaki Ryoto , Hatao Fumihiko , Koshiishi Takeshi , Morita Yasuhiro , Imamura Kazuhiro
Published: February 2020

Background

Intrahepatic artery pseudoaneurysms are mostly iatrogenic and result from hepatobiliary interventions. The incidence of intrahepatic artery pseudoaneurysms within liver tumors without prior intervention is extremely rare. We presented herein the first report of a case of an intratumoral pseudoaneurysm within a liver metastasis of gastric cancer without any prior intervention during chemotherapy.

Case presentation

A 59-year-old male patient underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer. He was treated in the emergency room for right abdominal pain following the 4th cycle of nivolumab administration as second-line chemotherapy after adjuvant chemotherapy with S-1 and first-line chemotherapy for a liver metastasis of gastric cancer with ramucirumab plus paclitaxel. CT showed a 72-mm metastatic liver tumor containing a 9-mm pseudoaneurysm and fluid collection around the hepatic edge. Intrahepatic artery pseudoaneurysm within the metastatic liver tumor was diagnosed, with the surrounding fluid indicating potential, active bleeding. An emergency angiography confirmed the presence of a pseudoaneurysm in the intrahepatic artery, which was embolized using microcoils. The contributory causes of the intratumoral pseudoaneurysm were assumed to be the following: (1) tumor necrosis leading to encasement, erosion of the vessel wall, and subsequent arterial wall weakening; and (2) inhibition of vascular endothelial growth by ramucirumab resulting in a vessel wall breach and pseudoaneurysm formation.

Conclusion

It is necessary to recognize that pseudoaneurysms can arise within a metastatic liver tumor during chemotherapy.
Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study
Authors: Ravid Noga L. , Zamora Kayla , Rehm Roberta , Okumura Megumi , Takayama John , Kaiser Sunitha
Published: February 2020

Background

The hospital to home transition for children with medical complexity (CMC) poses many challenges, including suboptimal communication between the hospital and medical home. Our objective was to evaluate the implementation of a discharge videoconference incorporating the patient, caregiver, primary care provider (PCP), hospitalist physician, and case manager.

Methods

We evaluated implementation of this pilot intervention at a freestanding tertiary care children’s hospital using mixed methods. A discharge videoconference was conducted for hospitalized children (< 18 years old) meeting complex chronic disease (C-CD) criteria. We collected field notes and conducted surveys and semi-structured interviews. Outcomes included adoption, cost, acceptability, feasibility, and appropriateness. Adoption, cost, and acceptability were analyzed using descriptive statistics. Acceptability, feasibility, and appropriateness were summarized using thematic content analysis.

Results

Adoption: A total of 4 CMC (9% of the 44 eligible children) had discharge videoconferences conducted. Cost (in provider time): On average, videoconferences took 5 min to schedule and lasted 21.5 min. Acceptability: All hospitalists involved (n = 4) were very likely to participate again. Interviews with caregivers (n = 4) and PCPs (n = 5) demonstrated that for those participating, videoconferences were acceptable and appropriate due to benefits including development of a shared understanding, remote physical assessment by the PCP, transparency, and humanization of the care handoff, and increased PCP comfort with care of CMC. Feasibility: Barriers included internet connection quality and scheduling constraints.

Conclusions

This novel, visual approach to discharge communication for CMC had low adoption, possibly related to recruitment strategy. The videoconference posed low time burdens, and participating physicians and caregivers found them acceptable due to a variety of benefits. We identified several feasibility barriers that could be targeted in future implementation efforts.
Imaging properties of 3D printed breast phantoms for lesion localization and Core needle biopsy training
Authors: Ali Arafat , Wahab Rifat , Huynh Jimmy , Wake Nicole , Mahoney Mary
Published: February 2020

Background

Breast cancer is the most commonly diagnosed malignancy in females and frequently requires core needle biopsy (CNB) to guide management. Adequate training resources for CNB suffer tremendous limitations in reusability, accurate simulation of breast tissue, and cost. The relatively recent advent of 3D printing offers an alternative for the development of breast phantoms for training purposes. However, the feasibility of this technology for the purpose of ultrasound (US) guided breast intervention has not been thoroughly studied.

Methods

We designed three breast phantom models that were printed in multiple resins available through Stratasys, including VeroClear, TangoPlus and Tissue Matrix. We also constructed several traditional breast phantoms using chicken breast and Knox gelatin for comparison. These phantoms were compared side-by-side for ultrasound penetrance, simulation of breast tissue integrity, anatomic accuracy, reusability, and cost.

Results

3D printed breast phantoms were more anatomically accurate models than traditional breast phantoms. The chicken breast phantom provided acceptable US beam penetration and material hardness for simulation of human breast tissue integrity. Sonographic image quality of the chicken breast phantom was the most accurate overall. The gelatin-based phantom also had acceptable US beam penetration and image quality; however, this material was too soft and poorly simulated breast tissue integrity. 3D printed phantoms were not visible under US.

Conclusions

There is a large unmet need for a printable material that is truly compatible with multimodality imaging for breast and other soft tissue intervention. Further research is warranted to create a realistic, reusable and affordable material to 3D print phantoms for US-guided intervention training.
Terlipressin infusion for prevention of vasoplegic syndrome in patients treated with angiotensin II receptor antagonist undergoing coronary artery bypass graft surgery: a randomized controlled study
Authors: Saleh Mohamed , Kodeira Sherine Kamal Zaki , Aboulseoud Abdelkhalek Abdelmoneim
Published: February 2020

Background and objectives

Preoperative use of renin angiotensin system antagonists has been considered an independent risk factor for development of vasoplegic syndrome. The aim of this study was to demonstrate efficacy of prophylactic terlipressin infusion for prevention of vasoplegic syndrome in patients treated with angiotensin receptor blocker undergoing coronary artery bypass graft surgery.

Patients and methods

One hundred patients on angiotensin II receptor antagonist [losartan] scheduled for coronary artery bypass surgery were enrolled into this prospective randomized controlled study. Anesthetic technique, surgical technique, and cardiopulmonary bypass management were standardized for all patients. With the start of rewarming, patients were randomized to receive either terlipressin infusion 1.3 μg.kg−1.hour−1, or normal saline infusion. Incidence of vasoplegic syndrome score was used as primary outcome. Hemodynamic parameters, inotropic score, and vasopressor dependency index were used as secondary outcome.

Results

Incidence of vasoplegic syndrome was significantly lower in terlipressin group compared to placebo group. Norepinephrine was required in 2 patients of terlipressin versus 15 patients of placebo group. Mean arterial blood pressure was significantly higher in terlipressin group compared to placebo group (81.7 ± 18.5 versus 69.3 ± 20.2 at 60 min after weaning from CBP). Cardiac index was significantly lower in terlipressin group compared to placebo group (2.52 ± 1.48 versus 3.2 ± 1.55). Systemic vascular resistance was significantly higher in terlipressin group compared to placebo group (2438.09 ± 735.13 versus 1575.05 ± 753.54). Inotropic score and vasopressor dependency index were significantly lower in terlipressin group compared to placebo group.

Conclusion

Prophylactic terlipressin infusion could prevent development of vasoplegic syndrome in patients treated with angiotensin II receptor antagonist undergoing coronary artery bypass graft surgery.

Trial registration

PACTR, PACTR201804003249274, Registered 25/03/2018—retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3249.
Perinatal mental health around the world: priorities for research and service development in China
Authors: Schwank Simone Eliane , Zhou Qiongjie , He Yanling , Acharya Ganesh
Published: February 2020

China's healthcare is improving together with rapid economic growth. Yet, mental healthcare is lagging behind. Prevalence of perinatal depression is high among women of the one-child generation, but access to qualified care is limited. Chinese healthcare professionals, policy makers and patients alike express concerns about insufficient knowledge among the public as well as healthcare providers regarding mental disorders. There appears to be a general lack of help-seeking behaviour for mental disorders owing to perceived risk of social stigmatisation. Social support through family and friends, use of online resources and community healthcare services are preferred, rather than seeking help from mental health specialists.
Depression and Suicidal Ideation Among Patients With Cancer in the United States: A Population-Based Study
Authors: Abdel-Rahman Omar
Published: February 2020

PURPOSE:

To evaluate the association between cancer diagnosis and depression and suicidal ideation in a population-based cohort in the United States.

METHODS:

This was a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) conducted for the years 2005 to 2016. Depression was assessed using a validated tool (Patient Health Questionnaire-9, and suicidal ideation was assessed by item number 9 of this tool. Propensity score matching was conducted to match survey respondents with cancer versus those without cancer. Multivariable logistic regression analysis was then conducted to evaluate factors associated with higher probability of depression and suicide among the whole postpropensity cohort.

RESULTS:

A total of 32,178 survey respondents were eligible and included in the study. These included 3,043 respondents with cancer and 29,675 respondents without cancer. Within the postpropensity cohort, a cancer diagnosis was not associated with a higher probability of depressive disorders (odds ratio, 0.937; 95% CI, 0.819 to 1.073), whereas it was associated with a higher probability of suicidal ideation (for respondents without cancer v those with cancer: odds ratio, 0.695; 95% CI, 0.517 to 0.935).

CONCLUSION:

Cancer diagnosis is associated with a higher probability of suicidal ideation. Screening for suicidal ideation should be part of the assessment of patients with cancer.
Features of Multiple Endocrine Neoplasia Type 1 and 2A in a Patient with Both RET and MEN1 Germline Mutations
Authors: Brown Spandana J , Riconda Daniel L , Zheng Feibi , Jackson Gilchrist L , Suo Liye , Robbins Richard J
Published: February 2020

The coexistence of multiple endocrine neoplasia type 1 (MEN1) and type 2A (MEN2A) is a rare occurrence and has been reported only twice in the literature. We present a patient with primary hyperparathyroidism and medullary thyroid cancer with strong family history of both MEN1- and MEN2A-associated conditions. Genetic testing showed the patient had a novel MEN1 loss-of-function mutation, c0.525_526insTT (p.Ala176Leufs*10), and an uncommon Cys630Tyr RET mutation. This case highlights the importance of obtaining a detailed family history when heritable endocrine disorders are suspected.
Risk factors, presentation and outcome of meningomyelocele repair
Authors: Rehman Lal , Sheikh Munwar , Afzal Ali , Rizvi Raza
Published: February 2020

Objective: To determine the risk factors, presentation and outcome of meningomyelocele repair

Methods: We reviewed 150 cases operated for meningomyelocele (MMC) at Jinnah Postgraduate Medical Centre Karachi between May 2015 and May 2018. Data of infants operated for MMC repair was extracted including socioeconomic status, maternal folate intake during pregnancy, head circumference, location and width of the defect, accompanying bladder and limb anomalies and treatments administered. Patients were followed up for a mean period of six months.

Results: A total of 150 children were evaluated, out of which there were 83(55.3%) males and 67(44.7%) females. All belonged to low socio economic group and prenatal maternal folate intake as risk factor was positive in 103(68.7%) cases. Mean head circumference was 37.4 cm (range, 30.7 to 50 cm). Based on their location, 83(55%) of the defects were lumbosacral, 38(25.4%) were lumbar, 16(10.7%) were thoraco lumbar, 10(6.7%) were thoracic and three (2%) were cervical. Mean size of the meningomyelocele sac was 4.3 cm×5.6 cm (range, 1cm×2cm to 11cm×8.4cm) and 21(14%) of the babies had a skin defect requiring flap. According to accompanying anomalies, 98(65.3%) of the babies had hydrocephalus, 13(9%) had club foot, four (2.7%) had diastematomyelia and three (2%) had tethered cord. Eighty seven (58%) patients had neurological deficit pre operatively and eight (5.4%) patients with normal power deteriorated after surgery out of which five (3.3%) developed paraplegia and three (2%) developed paraparesis. CSF leak was the major complication encountered in 16(11%) followed by meningitis in seven (5%), while the overall mortality was four (2.6%).

Conclusion: The practice of periconceptional folic acid supplementation is essential to reduce the prevalence of neural tube defects (NTDs) in the developing world. Improved maternal nutrition with access to quality antenatal care is vital to decrease the prevalence and health burden.

doi: https://doi.org/10.12669/pjms.36.3.1237

How to cite this:Rehman L, Shiekh M, Afzal A, Rizvi R. Risk factors, presentation and outcome of meningomyelocele repair. Pak J Med Sci. 2020;36(3):422-425. doi: https://doi.org/10.12669/pjms.36.3.1237

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case Report: Upper airway obstruction due to rheumatoid arthritis
Authors: Rudrappa Mohan , Kokatnur Laxmi , Shah Sanket
Published: February 2020

Rheumatoid arthritis (RA) is a common autoimmune disease characterized by inflammation of small joints. Small synovial joints in the larynx can also become affected, and laryngeal involvement is seen in more than half of patients with RA. As most patients have subtle symptoms and indolent course, they are either misdiagnosed or undiagnosed. The acute worsening of cricoarytenoid arthritis can cause sudden upper airway obstruction and may require emergency intubation or tracheostomy. This life-threatening condition is described in only a handful of cases in the medical literature. Physicians should be aware of this rare but life-threatening consequence of RA. We present a case of sudden and severe upper airway obstruction secondary to laryngeal involvement in a patient with long-standing RA.
Mitteformaalõppe tähenduse konstrueerimine poliitikadokumentides
Authors: Karu Katrin , Jõgi Larissa , Rannala Ilona-Evelyn , Roosalu Triin , Teder Lianne , Põlda Halliki
Published: February 2020

Artikkel tugineb uuringule, mille fookuses on mitteformaalõppe tähendus ja diskursuse muutus Eesti arengut suunavates poliitikadokumentides. Selline rõhuasetus on tingitud asjaolust, et mitteformaalõppe tähendus on sotsiaalselt konstrueeritud, paradigma- ja kontekstispetsiifiline ning sõltub ideoloogiast, hariduspoliitilisest korraldusest, traditsioonidest ja väljakujunenud tavadest. Uurimuses kombineeritakse kriitilist diskursuseanalüüsi poliitikaradade meetodiga ning esitatakse mitteformaalõppe diskursuse ajalise ja valdkondliku kasutuse analüüs. Analüüsi tulemusena eristus kuus valdkondlikku poliitikadokumentide rada, kümme mitteformaalõppe aladiskursust ja viis diskursust: keskkonna-, eristumis-, kaasamis-, süsteemi- ja tunnustamisdiskursus. Mitteformaalõppe tunnustamise diskursus eristus diskursusteülesena ning selles ilmnevad võimalikud edasised muutused mitteformaalõppe sisu ja vormi sotsiaalsel konstrueerimisel poliitikadokumentides.

 Summary