bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Race, Ethnicity, and Socioeconomic Status over Time on the Long-term Survival of Adolescent and Young Adult Hodgkin Lymphoma Survivors
Authors: Berkman Amy M. , Andersen Clark R. , Puthenpura Vidya , Livingston J. Andrew , Ahmed Sairah , Cuglievan Branko , Hildebrandt Michelle A.T. , Roth Michael E.
Published: July 2021

Background:

Although there are growing numbers of adolescent and young adult (AYA) Hodgkin lymphoma (HL) survivors, long-term overall survival (OS) patterns and disparities in this population are underreported. The aim of the current study was to assess the impact of race/ethnicity, socioeconomic status (SES), rurality, diagnosis age, sex, and HL stage over time on long-term survival in AYA HL survivors.

Methods:

The authors used the Surveillance, Epidemiology, and End Results (SEER) registry to identify survivors of HL diagnosed as AYAs (ages 15–39 years) between the years 1980 and 2009 and who were alive 5 years after diagnosis. An accelerated failure time model was used to estimate survival over time and compare survival between groups.

Results:

There were 15,899 5-year survivors of AYA HL identified, with a median follow-up of 14.4 years and range up to 33.9 years from diagnosis. Non-Hispanic black survivors had inferior survival compared with non-Hispanic white survivors [survival time ratio (STR): 0.71, P = 0.002]. Male survivors, older age at diagnosis, those diagnosed at higher stages, and those living in areas of higher SES deprivation had unfavorable long-term survival. There was no evidence of racial or sex-based survival disparities changing over time.

Conclusions:

Racial, SES, and sex-based disparities persist well into survivorship among AYA HL survivors.

Impact:

Disparities in long-term survival among AYA HL survivors show no evidence of improving over time. Studies investigating specific factors associated with survival disparities are needed to identify opportunities for intervention.
Incidence and Mortality of Cancers of the Biliary Tract, Gallbladder, and Liver by Sex, Age, Race/Ethnicity, and Stage at Diagnosis: United States, 2013 to 2017
Authors: Ellington Taylor D. , Momin Behnoosh , Wilson Reda J. , Henley S. Jane , Wu Manxia , Ryerson A. Blythe
Published: July 2021

Background:

Few population-based studies have examined incidence and mortality of cancers of the biliary tract, including intrahepatic bile duct, extrahepatic bile duct, ampulla of Vater, and overlapping or other lesions of the biliary tract in one study.

Methods:

To further the understanding of recent rates of biliary tract cancers, we used population-based data, to examine incidence and mortality during 2013 to 2017. We examined how rates varied by sex, age, race/ethnicity, U.S. census region, and stage at diagnosis.

Results:

Intrahepatic bile duct was the most common biliary tract cancer, with an incidence rate of 1.49 per 100,000 persons. Cancer incidence rates per 100,000 persons were 0.96 for extrahepatic bile duct, 0.45 for ampulla of Vater, and 0.24 for overlapping or other lesions of the biliary tract. Cancer death rates per 100,000 persons were 1.66 for intrahepatic bile duct and 0.45 for other biliary tract. Intrahepatic bile duct incidence and death rates were higher among males than females, higher among Hispanic and Asian and Pacific Islander persons compared with non-Hispanic Whites, and higher in the Northeast and in urban counties.

Conclusions:

This report provides national estimates of these rare biliary tract cancers.

Impact:

Key interventions targeted to high-risk populations may help reduce incidence and mortality of cancers of the biliary tract by improving primary prevention through strategies to reduce tobacco and alcohol use, control overweight and obesity, and promote hepatitis B vaccination and use of syringe service programs meant to curb the transmission of infectious diseases such as viral hepatitis.
Obvious Reduction of the Tumor Size in Dedifferentiated Liposarcoma in a Lung Metastasis Patient Receiving Individualized Treatment
Authors: Wang Xin-Li , Gong Jia-Yao , Xue Yan
Published: July 2021

Abdominal metastasis is relatively rare in dedifferentiated liposarcoma of the shoulder and back. Surgery is the best treatment option, whether it is radical or palliative surgery. Chemotherapy is the standard systemic treatment for advanced unresectable/metastatic patients, but the therapeutic effect is limited. Here, we treat advanced abdominal dedifferentiated liposarcoma through a comprehensive treatment method of targeting, surgery, and chemotherapy, which improves the quality of life of the patient, and shrinks the tumor significantly.
Nephrostomy Tube Misplaced into the Right Atrium: An Extremely Rare Case and Review of the Literature
Authors: Li Tao , Jiang Yiting , Chen Jie , Luo Guangheng , Sun Fa
Published: July 2021

Although percutaneous nephrolithotomy is generally safe, it has various complications. We present an extremely rare case in which the nephrostomy tube pierced renal parenchyma, proceeded through the right renal vein and inferior vena cava, finally reaching the right atrium. Such a tube misplaced to atrium level was firstly reported, which was safely withdrawn using a 2-step process under fluoroscopic monitoring. We also recommend the tube be marked with different color lines to maintain awareness of the tube length that has passed the peel-away sheath. Such information might help to avoid such complication.
Improving Drinking and Micturition Habits in Preschool Children: An Educational Project
Authors: Erl Anna , Hauenstein Katja , Huber Johanna , Leyh Herbert , Weingärtner Karl , Ebert Anne-Karoline , Waidelich Raphaela , Necknig Ulrike
Published: July 2021

Introduction: Children worldwide often do not drink enough. However, sufficient fluids are essential for physical and cognitive health. A regular and adequate supply of fluids also supports bladder maturation in the context of acquiring urinary continence. We investigated whether training preschool children and their caretakers improves drinking and micturition habits. Methods: This field study in a pre-post design was conducted in 6 kindergartens in the district of Garmisch-Partenkirchen from October 2018 to February 2019. An intervention group (IG) received a 3-day training on drinking and micturition habits and was compared to a control group (CG) without any training. Caretakers (IG + CG) were instructed about drinking and voiding management, too. Behavioral changes were identified by questionnaires. To analyze the long-term effect, group interviews were performed with the IG 3 months after training. The training was evaluated on different levels. Results: After training, the estimated total daily fluid intake in the IG (1,160 mL) significantly exceeded that of CG (830 mL) (p = 0.015). In the IG, fluid intake until 12:00 a.m. increased (p = 0.001), children took more time for voiding (p = 0.029), and urgency decreased (p = 0.008). Children (IG + CG) used leg support to enable pelvic floor relaxation more often both at home (p = 0.026) and in kindergarten (p = 0.047). Nocturnal enuresis was reduced by approximately 46% in the IG (p = 0.485). Group interviews in the IG showed a considerable learning effect. Conclusion: The present study could demonstrate an increased intake of fluids and significant changes in micturition behavior in the IG. So far, this is the first educational project in Germany addressing drinking and voiding management. Our results suggest that a training of preschool children and their caretakers is feasible and effective. Further nationwide research will be needed to confirm our results and assess the need for prevention in these areas.
Association between Psychiatric Disorders and Glomerular Disease
Authors: Desmond Hailey E. , Lindner Clare , Troost Jonathan P. , Held Zack , Callaway Andrea , Oh Gia J. , Lafayette Richard , O’Shaughnessy Michelle , Elliott Matthew , Adler Sharon G. , Kamil Elaine S. , Pesenson Anne , Selewski David T. , Gipson Patrick E. , Carlozzi Noelle E. , Gipson Debbie S. , Massengill Susan F.
Published: July 2021

Introduction: Patients with chronic health conditions, particularly chronic kidney disease, are at heightened risk for psychiatric disorders; yet, there are limited data on those with primary glomerular disease. Methods: This study included patients with glomerular disease enrolled in the kidney research network multisite patient registry. Registry data include encounter, diagnoses, medication, laboratory, and vital signs data extracted from participants’ electronic health records. ICD-9/10 diagnosis codes were used to identify a subset of psychiatric disorders focused on anxiety, mood, and behavioral disorders. Time-varying Cox proportional hazard models were used to analyze time from the onset of kidney disease to diagnosis of psychiatric disorder. Adjusted models retained significant covariates from the full list of potential confounders, including age, sex, race, ethnicity, time-varying treatment, the estimated glomerular filtration rate, and proteinuria (urine protein-to-creatinine ratio [UPCR]). Analogous models examined diagnosis of psychiatric disorder as a predictor of time to end-stage kidney disease (ESKD). Results: Data were available for 950 participants, with a median of 58 months of follow-up. 110 (12%) participants were diagnosed with psychiatric disorder during the follow-up. The estimated rate of psychiatric diagnosis after kidney disease was 14.7 cases per 1,000 person-years and was highest among those of adolescent age at the time of kidney disease diagnosis. Adjusted analyses found adolescent age (vs. adult, hazard ratio [HR] = 3.11, 95% confidence interval [CI] 1.87–5.17) and Asian race (vs. white, HR = 0.34, 95% CI 0.16–0.71) were associated with psychiatric diagnosis. A higher UPCR per 1 log unit (HR 1.13, 95% CI 1.01–1.27) and a higher total number of oral medications were associated with psychiatric disorder (p < 0.001). Psychiatric diagnosis was also associated with progression to ESKD (HR = 2.45, 95% CI 1.53–3.92) in adjusted models. Discussion/Conclusion: Psychiatric disorders were documented in approximately one-eighth of patients with glomerular disease and correlated with clinical disease characteristics such as age, race, proteinuria, and oral medication burden. These findings suggest mental health screening is warranted in patients of all ages with glomerular disease.
Are Incidental Minute Pulmonary Nodules Ultimately Determined to Be Metastatic Nodules in Esophageal Cancer Patients?
Authors: Matsuura Norihiro , Tanaka Koji , Yamasaki Makoto , Yamashita Kotaro , Makino Tomoki , Saito Takuro , Yamamoto Kazuyoshi , Takahashi Tsuyoshi , Kurokawa Yukinori , Motoori Masaaki , Kimura Yutaka , Nakajima Kiyokazu , Eguchi Hidetoshi , Doki Yuichiro
Published: July 2021

Purpose: Esophageal cancer patients may simultaneously have resectable esophageal cancer and undiagnosable incidental minute solid pulmonary nodules. While the latter is rarely metastatic, only a few studies have reported on the outcomes of such nodules after surgery. In this retrospective study, we assessed the incidence of such nodules, the probability that they are ultimately metastatic nodules, and the prognosis of patients after esophagectomy according to the metastatic status of the nodules. Methods: Data of 398 patients who underwent esophagectomy for resectable esophageal cancer between January 2012 and December 2016 were collected. We reviewed computed tomography (CT) images from the first visit and searched for incidental minute pulmonary nodules <10 mm in size. We followed the outcomes of these nodules and compared the characteristics of metastatic and nonmetastatic nodules. We also assessed the prognosis of patients whose minute pulmonary nodules were metastatic. Results: Among the patients who underwent esophagectomy, 149 (37.4%) had one or more minute pulmonary nodules, with a total of 285 nodules. Thirteen (4.6%) of these nodules in 12 (8.1%) patients were ultimately diagnosed as being metastatic. Thirteen (8.7%) patients experienced recurrence at a different location from where the nodules were originally identified. Characteristics of the metastatic nodules were not unique in terms of size, SUVmax, or location in the lungs. Two-year and 5-year overall survival rates of patients whose nodules were metastatic were 64.2 and 32.1%, respectively. Conclusion: The rate of minute pulmonary nodules which were ultimately metastatic was 4.6%. Our findings suggest that esophagectomy followed by the identification of minute pulmonary nodules is an acceptable strategy even if the nodules cannot be diagnosed as being metastatic on the first visit CT due to their small size.
Whole-Exome Sequencing in Critically Ill Neonates and Infants: Diagnostic Yield and Predictability of Monogenic Diagnosis
Authors: Scholz Tasja , Blohm Martin Ernst , Kortüm Fanny , Bierhals Tatjana , Lessel Davor , van der Ven Amelie T. , Lisfeld Jasmin , Herget Theresia , Kloth Katja , Singer Dominique , Perez Anna , Obi Nadia , Johannsen Jessika , Denecke Jonas , Santer René , Kubisch Christian , Deindl Philipp , Hempel Maja
Published: July 2021

Introduction: Monogenic diseases play an important role in critically ill neonates and infants treated in the intensive care unit. This study aimed to determine the diagnostic yield of whole-exome sequencing (WES) for monogenic diseases and identify phenotypes more likely associated with a genetic etiology. Methods: From March 2017 to 2020, a comprehensive diagnostic workup including WES in a single academic center was performed in 61 unrelated, critically ill neonates and infants with an unknown underlying disease within the first year of life. We conducted 59 trio-WES, 1 duo-WES, and 1 single-WES analyses. Symptoms were classified according to the Human Phenotype Ontology. Results: The overall molecular genetic diagnostic rate within our cohort was 46% (28/61) and 50% (15/30) in the subgroup of preterm neonates. Identifying the genetic cause of disease facilitates individualized management in the majority of patients. A positive or negative predictive power of specific clinical features for a genetic diagnosis could not be observed. Conclusion: WES is a powerful noninvasive diagnostic tool in critically ill neonates and infants with a high diagnostic rate. We recommend initiating WES as early as possible due to the impact on management and family counseling. Recommendations regarding the clinical utility of WES in critically ill neonates and infants should not be based on the phenotype alone. Here, we present a clinical workflow for the application of WES for critically ill neonates and infants in an interdisciplinary setting.
Residual Dizziness in Elderly Patients after Benign Paroxysmal Positional Vertigo
Authors: Çetin Yaser Said , Çağaç Aydın , Düzenli Ufuk , Bozan Nazım , Elasan Sadi
Published: July 2021

Introduction: The aim of this study was to compare the effects of Brandt-Daroff (BD) exercise and shopping exercise (SE) on the resolution of residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) following a successful modified Epley canalith repositioning maneuver (CRP). Methods: This single-blind, randomized clinical trial included patients with posterior semicircular canal type of BPPV. Following the modified Epley maneuver, patients that experienced RD were randomly assigned to 3 groups: (i) BD, (ii) SE, and (iii) control groups. Primary outcomes were quantified using the Dizziness Handicap Inventory (DHI). Results: Following CRP, 240 (63%) participants experienced RD. All these patients were followed up weekly for RD. After the resolution of RD, patients were followed up monthly for recurrence. Mean time to recovery was 16.4 ± 10 (range, 5–49) days in the BD group, 11.5 ± 4.6 (range, 6–32) days in the SE group, and 23.4 ± 16.8 (range, 6–89) days in the control group. The SE group recovered significantly faster than the BD and control groups (p < 0.001). Baseline emotional DHI (E-DHI) scores were significantly correlated with the duration of pre-CRP symptoms (p < 0.001). Correlation analysis indicated that patients with obesity and diabetes mellitus (DM) recovered later than patients without these comorbidities. Conclusion: We found that RD improved significantly in the SE group compared to the BD and control groups. Additionally, a significant relationship was established between RD and high anxiety levels and DM, and obesity had a negative impact on the resolution of RD.
Deep Neck Infections: Demographic and Clinical Factors Associated with Poor Outcomes
Authors: Treviño-Gonzalez José Luis , Maldonado-Chapa Félix , González-Larios Amalia , Morales-Del Angel Josefina Alejandra , Soto-Galindo Germán Armando , Zafiro García-Villanueva Jennifer Mística
Published: July 2021

Introduction: Deep neck infections (DNIs) are abscesses located in the profound spaces of the neck and constitute one of the most common otolaryngological life-threatening emergencies. The aim of this study is to review the clinical and demographic data of patients with DNI and identify factors associated with prolonged hospitalization, reoperation, and mortality. Methods: Retrospective review and analysis of 75 patients with DNI admitted from January 2015 to December 2019 in a tertiary referral hospital. Results: Of 75 patients, 50 (66.6%) were males and 25 (33.3%) females. Age ranged from 18 to 91 years with a mean of 41.79 (±15.48). DNIs were odontogenic in 49 patients (65.3%). History of diabetes mellitus (DM) was positive in 26 patients (34.6%). The submandibular space was involved in 57 patients (76%). Streptococcus spp. were isolated in 35 patients (46%). Intubation for airway preservation was needed in 21 patients (28%) and tracheostomy in 6 (8%). Mediastinitis presented in 8 patients (10.67%), with a mortality rate of 62.5% (n = 5). Mean hospital stay was 9.13 days (±7.2). DM (p = 0.016), age (p = 0.001), BMI classification 3, 4, and 6 (p = 0.041), and intensive care unit (ICU) admission (p = 0.009) were associated with a longer stay. Surgical drainage was performed after 1.71 days (±1.65). Surgical reintervention was needed in 6 cases (8%) and was associated with temporal (p = 0.001) and masticator (p = 0.002) space involvement and DM (p = 0.009). Overall mortality was 8% and decreased to 1.5% when mediastinitis was excluded. Mediastinitis (p = 0.001), ICU admission (p < 0.0001), Streptococcus spp. (p = 0.019), and low hemoglobin levels (p = 0.004) were associated with mortality. Discussion/Conclusion: DNIs are entities associated with high morbimortality. Mediastinitis and airway obstruction are life-threatening possible complications and should be promptly evaluated. Low HB could be used as a predicting factor for mortality.
Secondary Oxalate Nephropathy: Causes and Clinicopathological Characteristics of a Case Series
Authors: Liang Shaoshan , Li Lijuan , Chen Dacheng , Liang Dandan , Xu Feng , Cheng Zhen , Abuduwupuer Zulihumaer , Zhang Changming , Zhang Mingchao , Zeng Caihong
Published: July 2021

Introduction: Secondary oxalate nephropathy (OxN) is associated with a variety of causes and has not been well characterized in Chinese population. To investigate the etiology, clinicopathological features, and outcomes of secondary OxN, we report a case series from a single center in China. Methods: A retrospective analysis of 68 patients diagnosed with secondary OxN by renal biopsy from January 2013 to February 2019 in Jinling Hospital was performed. Results: Secondary OxN accounted for 0.23% of the renal biopsies and 2.31% of patients who received renal biopsies due to acute kidney injury (AKI). A total of 49 men and 19 women with an average age of 51.6 ± 11.8 years were enrolled. The most common cause was iatrogenic medication, followed by oxalate-rich diet and industry exposure. Stage 1, 2, and 3 AKI and AKI on chronic kidney disease (ACKD) were found in 4.4, 8.8, 69.1, and 17.6% of the patients, respectively. The peak serum creatinine during hospitalization was 8.62 ± 4.67 mg/dL. The median urinary oxalate excretion was 51.5 (23.2–147.1) mg/24 h. Kidney biopsy showed extensive calcium oxalate crystal deposits with acute tubulointerstitial nephritis. Thirty-four patients (50.0%) required renal replacement therapy. At the end of a follow-up that lasted 8.7 (0.1–72.1) months, 81.0% of patients achieved renal function recovery in 50 (14–432) days. Patients with renal function recovery had a lower rate of ACKD, a higher level of hemoglobin, a lower level of urine lysozyme, and a lower degree of interstitial fibrosis/tubular atrophy, interstitial inflammation, and global glomerulosclerosis than those in the nonrecovery group. Conclusions: In this case series of secondary OxN, the most common cause was iatrogenic medication, and it presented with AKI or ACKD. Half of the patients required renal replacement therapy, and in most of them, the renal function was reversible. Renal biopsy played an important role in diagnosis and prognosis evaluation.
Multiple Strokes in a Latin American Patient
Authors: Halaseh Ramez , Shehadeh Malik , Marcus Rachel
Published: July 2021

We present a case of a recent immigrant from El Salvador without past medical history who presented to our hospital with symptoms concerning for acute stroke. Brain magnetic resonance imaging (MRI) with gadolinium confirmed an acute stroke along with multiple prior infarcts involving different vascular beds. Head magnetic resonance arteriogram did not reveal any occlusions/stenosis or aneurysmal changes. His subsequent extensive evaluation included an electrocardiogram (ECG) that revealed bifascicular block and echocardiography that suggested an apical aneurysm, but images were limited to assess. To further assess the likelihood of cardiac embolism, he underwent cardiac MRI with gadolinium, which confirmed the apical aneurysm. Because of his country of origin and classic ECG and echo findings, Chagas disease was suspected, and both commercial ELISA and confirmatory ELISA and TESA blots were positive. This is both a classic presentation of Chagas cardiomyopathy and an important reminder that Chagas disease should be considered in the differential diagnosis of cardioembolic stroke in Latin American immigrants from an endemic country.
Alpha-Tocopherol Protects Human Dermal Fibroblasts by Modulating Nitric Oxide Release, Mitochondrial Function, Redox Status, and Inflammation
Authors: Camillo Lara , Grossini Elena , Farruggio Serena , Marotta Patrizia , Gironi Laura Cristina , Zavattaro Elisa , Savoia Paola
Published: July 2021

Background: The altered balance between oxidants/antioxidants and inflammation, changes in nitric oxide (NO) release, and mitochondrial function have a role in skin aging through fibroblast modulation. Tocopherol is promising in counteracting the abovementioned events, but the effective mechanism of action needs to be clarified. Objective: The aim of this study was to examine the effects of α-tocopherol on cell viability/proliferation, NO release, mitochondrial function, oxidants/antioxidants, and inflammation in human dermal fibroblasts (HDF) subjected to oxidative stress. Methods: HDF were treated with H2O2 in the presence or absence of 1–10 μM α-tocopherol. Cell viability, reactive oxygen species (ROS), NO release, and mitochondrial membrane potential were measured; glutathione (GSH), superoxide dismutase (SOD)-1 and -2, glutathione peroxidase-1 (GPX-1), inducible NO synthase (iNOS), and Ki-67 were evaluated by RT-PCR and immunofluorescence; cell cycle was analyzed using FACS. Pro- and anti-inflammatory cytokine gene expression was analyzed through qRT-PCR. Results: α-Tocopherol counteracts H2O2, although it remains unclear whether this effect is dose dependent. Improvement of cell viability, mitochondrial membrane potential, Ki-67 expression, and G0/G1 and G2/M phases of the cell cycle was observed. These effects were accompanied by the increase of GSH content and the reduction of SOD-1 and -2, GPX-1, and ROS release. Also, iNOS expression and NO release were inhibited, and pro-inflammatory cytokine gene expression was decreased, confirming the putative role of α-tocopherol against inflammation. Conclusion: α-Tocopherol exerts protective effects in HDF which underwent oxidative stress by modulating the redox status, inflammation, iNOS-dependent NO release, and mitochondrial function. These observations have a potential role in the prevention and treatment of photoaging-related skin cancers.
Endovascular Treatment of an Arteriovenous Malformation Associated with a Double Origin of the Posterior Inferior Cerebellar Artery
Authors: Rodriguez-Calienes Aaron , Saal-Zapata Giancarlo , De la Cruz Joselyn
Published: July 2021

Introduction: A double origin of the posterior inferior cerebellar artery (DOPICA) is a rare anatomical variant. Posterior fossa arteriovenous malformations (AVMs), especially cerebellar AVMs, are also not common. Consequently, the association of a DOPICA with a cerebellar AVM is even rare. Case Presentation: We present a rare case of a pediatric cerebellar AVM supplied by a branch of a DOPICA which was treated endovascularly with NBCA. Total obliteration was achieved in the immediate controls and at 1-year follow-up. Conclusion: Navigation through tortuous and long branches from a DOPICA is technically feasible. Although NBCA cure rates are relatively low, when the microcatheter can no longer navigate through the feeding artery, a correct dilution of NBCA with lipiodol can provide adequate penetration of this embolic agent, to obliterate the AVM nidus completely.
The Impact of Languages and Cultural Backgrounds on Voice Quality Analyses
Authors: Englert Marina , v. Latoszek Ben Barsties , Behlau Mara
Published: July 2021

Objective: The aim of this study was to verify the influence of different cultural backgrounds and languages on the perception of voice quality. Another aim was to evaluate the correlation between clinical auditory-perceptual judgments with acoustic measurements, such as the acoustic voice quality index (AVQI) and the acoustic breathiness index (ABI), i.e., their effect on the concurrent validity. Methods: Brazilian and European participants rated 2 culturally and linguistically different datasets (i.e., 150 Brazilian Portuguese and 218 German voice sample sets), with each dataset containing concatenated voice samples of continuous speech and sustained phonation. The raters evaluated the vocal quality in terms of the overall voice quality and breathiness. Intra- and interrater reliabilities were also tested. The psychometric qualities of the AVQI and the ABI (concurrent validity and diagnostic accuracy) were analyzed, considering the perceptual ratings of Brazilian and European participants for each dataset. Results: Rater reliability decreased for nonnative participants when evaluating the nonnative dataset. Brazilian raters perceived the German voices as more severe, whereas German raters considered the overall voice quality of Brazilian voices as less severe than native raters. The concurrent validity of the AVQI and the ABI, i.e., the agreement with the auditory-perceptual evaluations, was high irrespectively of the group of participants. The diagnostic accuracy, which refers to the ability to identify a deviated voice, was higher, considering the perceptual evaluations of native listeners. Conclusions: Brazilian raters classified voice quality as more deviated, and the Brazilian voice samples were measured to be less severe (a possible language characteristic). Further studies are necessary to verify whether there was a task or sample consequence or if adjustments to the AVQI and ABI equations are required for Brazilian Portuguese.
Regulation of Alternative Splicing during Epithelial-Mesenchymal Transition
Authors: Lyu Jingyi , Cheng Chonghui
Published: July 2021

Alternative splicing is an essential mechanism of gene regulation, giving rise to remarkable protein diversity in higher eukaryotes. Epithelial-mesenchymal transition (EMT) is a developmental process that plays an essential role in metazoan embryogenesis. Recent studies have revealed that alternative splicing serves as a fundamental layer of regulation that governs cells to undergo EMT. In this review, we summarize recent findings on the functional impact of alternative splicing in EMT and EMT-associated activities. We then discuss the regulatory mechanisms that control alternative splicing changes during EMT.
Genome-Wide Association Study Identifies a Functional
SIDT2
Variant Associated With HDL-C (High-Density Lipoprotein Cholesterol) Levels and Premature Coronary Artery Disease
Authors: León-Mimila Paola , Villamil-Ramírez Hugo , Macías-Kauffer Luis R. , Jacobo-Albavera Leonor , López-Contreras Blanca E. , Posadas-Sánchez Rosalinda , Posadas-Romero Carlos , Romero-Hidalgo Sandra , Morán-Ramos Sofía , Domínguez-Pérez Mayra , Olivares-Arevalo Marisol , López-Montoya Priscilla , Nieto-Guerra Roberto , Acuña-Alonzo Víctor , Macín-Pérez Gastón , Barquera-Lozano Rodrigo , Del-Río-Navarro Blanca E. , González-González Israel , Campos-Pérez Francisco , Gómez-Pérez Francisco , Valdés Victor J. , Sampieri Alicia , Reyes-García Juan G. , Carrasco-Portugal Miriam del C. , Flores-Murrieta Francisco J. , Aguilar-Salinas Carlos A. , Vargas-Alarcón Gilberto , Shih Diana , Meikle Peter J. , Calkin Anna C. , Drew Brian G. , Vaca Luis , Lusis Aldons J. , Huertas-Vazquez Adriana , Villarreal-Molina Teresa , Canizales-Quinteros Samuel
Published: July 2021

Objective:

Low HDL-C (high-density lipoprotein cholesterol) is the most frequent dyslipidemia in Mexicans, but few studies have examined the underlying genetic basis. Our purpose was to identify genetic variants associated with HDL-C levels and cardiovascular risk in the Mexican population.

Approach and Results:

A genome-wide association studies for HDL-C levels in 2335 Mexicans, identified four loci associated with genome-wide significance:
CETP
,
ABCA1
,
LIPC
, and
SIDT2
. The
SIDT2
missense Val636Ile variant was associated with HDL-C levels and was replicated in 3 independent cohorts (
P
=5.9×10
−18
in the conjoint analysis). The
SIDT2
/Val636Ile variant is more frequent in Native American and derived populations than in other ethnic groups. This variant was also associated with increased ApoA1 and glycerophospholipid serum levels, decreased LDL-C (low-density lipoprotein cholesterol) and ApoB levels, and a lower risk of premature CAD. Because SIDT2 was previously identified as a protein involved in sterol transport, we tested whether the SIDT2/Ile636 protein affected this function using an in vitro site-directed mutagenesis approach. The SIDT2/Ile636 protein showed increased uptake of the cholesterol analog dehydroergosterol, suggesting this variant affects function. Finally, liver transcriptome data from humans and the Hybrid Mouse Diversity Panel are consistent with the involvement of
SIDT2
in lipid and lipoprotein metabolism.

Conclusions:

This is the first genome-wide association study for HDL-C levels seeking associations with coronary artery disease in the Mexican population. Our findings provide new insight into the genetic architecture of HDL-C and highlight
SIDT2
as a new player in cholesterol and lipoprotein metabolism in humans.
Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association
Authors: Streed Carl G. , Beach Lauren B. , Caceres Billy A. , Dowshen Nadia L. , Moreau Kerrie L. , Mukherjee Monica , Poteat Tonia , Radix Asa , Reisner Sari L. , Singh Vineeta ,   on behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Hypertension; and Stroke Council
Published: July 2021

There is growing evidence that people who are transgender and gender diverse (TGD) are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Prior literature has characterized disparities in cardiovascular morbidity and mortality as a result of a higher prevalence of health risk behaviors. Mounting research has revealed that cardiovascular risk factors at the individual level likely do not fully account for increased risk in cardiovascular health disparities among people who are TGD. Excess cardiovascular morbidity and mortality is hypothesized to be driven in part by psychosocial stressors across the lifespan at multiple levels, including structural violence (eg, discrimination, affordable housing, access to health care). This American Heart Association scientific statement reviews the existing literature on the cardiovascular health of people who are TGD. When applicable, the effects of gender-affirming hormone use on individual cardiovascular risk factors are also reviewed. Informed by a conceptual model building on minority stress theory, this statement identifies research gaps and provides suggestions for improving cardiovascular research and clinical care for people who are TGD, including the role of resilience-promoting factors. Advancing the cardiovascular health of people who are TGD requires a multifaceted approach that integrates best practices into research, health promotion, and cardiovascular care for this understudied population.
Glucose Derivative Induced Vasculopathy in Children on Chronic Peritoneal Dialysis
Authors: Bartosova Maria , Zhang Conghui , Schaefer Betti , Herzog Rebecca , Ridinger David , Damgov Ivan , Levai Eszter , Marinovic Iva , Eckert Christoph , Romero Philipp , Sallay Peter , Ujszaszi Akos , Unterwurzacher Markus , Wagner Anja , Hildenbrand Georg , Warady Bradley A. , Schaefer Franz , Zarogiannis Sotirios G. , Kratochwill Klaus , Schmitt Claus Peter
Published: July 2021

Rationale:

Patients with chronic kidney disease (CKD) have an exceedingly high cardiovascular risk; which further increases in patients on peritoneal dialysis (PD). The pathophysiological role of reactive metabolites accumulating in CKD such as glucose degradation products (GDP) is uncertain.

Objective:

Delineating the impact of GDP present in PD fluids in accelerated vasculopathy development in patients with CKD.

Methods and Results:

Omental and parietal peritoneal tissues were obtained from 107 children with CKD before dialysis and 90 children on chronic PD with PD fluids containing very low or high concentrations of GDP. Omental arterioles, protected from local PD fluid exposure by surrounding fat, were microdissected for multiomics analyses. High-GDP exposed omental arterioles exhibited 3-fold higher advanced glycation endproduct concentrations and upregulated genes involved in cell death/apoptosis and suppressed genes related to cell viability/survival, cytoskeleton organization, and immune response biofunctions. Vasculopathy-associated canonical pathways concordantly regulated on gene and protein level with high-GDP exposure included cell death/proliferation, apoptosis, cytoskeleton organization, metabolism and detoxification, cell junction signaling, and immune response. Parietal peritoneal arterioles of patients exposed to high-GDP fluids exhibited lumen narrowing compared to patients with CKD stage 5 (end-stage kidney disease) and patients on low-GDP PD, intima thickness was increased. Protein quantification verified increased proapoptotic activity and cytoskeleton disintegration, single-molecule-localization microscopy demonstrated arteriolar endothelial ZO-1 (zonula occludens-1) disruption. Absolute and per endoluminal surface length, arteriolar endothelial cell counts inversely correlated with GDP exposure, caspase-3, TGF (transforming growth factor)-β–induced pSMAD2/3 (phosphorylated SMAD2/3), interleukin-6, ZO-1 abundance, and lumen narrowing. In vitro, 3,4-dideoxyglucosone-3-ene reduced lamin-A/C and membrane ZO-1 assembly, increased pSMAD2/3, and ionic and 4 and 10 kDa permeability of arterial endothelial cells.

Conclusions:

Our findings indicate a fundamental role of GDP in PD-associated vasculopathy, exerted by endothelial cell junction and cytoskeleton disruption, and induction of apoptosis. They should redirect the focus of research and intervention on targeting reactive metabolite overload in CKD and PD.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01893710.
Economic Impact of Poststroke Delirium and Associated Risk Factors
Authors: Zipser Carl Moritz , Deuel Jeremy Werner , Held Jeremia Philipp Oskar , Ernst Jutta , Schubert Maria , Weller Michael , Luft Andreas Rüdiger , von Känel Roland , Boettger Soenke
Published: July 2021

Background and Purpose:

Delirium is a common severe complication of stroke. We aimed to determine the cost-of-illness and risk factors of poststroke delirium (PSD).

Methods:

This prospective single-center study included n=567 patients with acute stroke from a hospital-wide delirium cohort study and the Swiss Stroke Registry in 2014. Delirium was determined by Delirium Observation Screening Scale or Intensive Care Delirium Screening Checklist 3 times daily during the first 3 days of admission. Costs reflected the case-mix index and diagnosis-related groups from 2014 and were divided into nursing, physician, and total costs. Factors associated with PSD were assessed with multiple regression analysis. Partial correlations and quantile regression were performed to assess costs and other factors associated with PSD.

Results:

The incidence of PSD was 39.0% (221/567). Patients with delirium were older than non-PSD (median 76 versus 70 years;
P
<0.001), 52% male (115/221) versus 62% non-PSD (214/346) and hospitalized longer (mean 11.5 versus 9.3 days;
P
<0.001). Dementia was the most relevant predisposing factor for PSD (odds ratio, 16.02 [2.83–90.69],
P
=0.002). Moderate to severe stroke (National Institutes of Health Stroke Scale score 16–20) was the most relevant precipitating factor (odds ratio, 36.10 [8.15–159.79],
P
<0.001). PSD was a strong predictor for 3-month mortality (odds ratio, 15.11 [3.33–68.53],
P
<0.001). Nursing and total costs were nearly twice as high in PSD (
P
<0.001). There was a positive correlation between total costs and admission National Institutes of Health Stroke Scale (correlation coefficient, 0.491;
P
<0.001) and length of stay (correlation coefficient, 0.787;
P
<0.001) in all patients. Quantile regression revealed rising nursing and total costs associated with PSD, higher National Institutes of Health Stroke Scale, and longer hospital stay (all
P
<0.05).

Conclusions:

PSD was associated with greater stroke severity, prolonged hospitalization, and increased nursing and total costs. In patients with severe stroke, dementia, or seizures, PSD is anticipated, and additional costs are associated with hospitalization.
Blood Pressure Control and Recurrent Stroke After Intracerebral Hemorrhage in 2002 to 2018 Versus 1981 to 1986
Authors: Li Linxin , Zuurbier Susanna M. , Kuker Wilhelm , Warlow Charles P. , Rothwell Peter M.
Published: July 2021

Background and Purpose:

The PROGRESS trial (Perindopril Protection Against Recurrent Stroke Study) conducted in the early 1990s showed that blood pressure (BP) lowering therapy reduced the risks of recurrent stroke by about 50% after spontaneous intracerebral hemorrhage (ICH). However, the ICH subgroup was a minority, and trial cohorts are invariably selective. Therefore, it is unclear whether the impact of BP control on risk of recurrent stroke in ICH observed in PROGRESS would be as great in real-world practice.

Methods:

We compared BP control (mean BP during study follow-up) and risks of recurrent stroke after first-ever primary ICH in 2 colocated population-based studies before and after the PROGRESS trial (1995–2001) in Oxfordshire: Oxfordshire Community Stroke Project (OCSP; 1981–1986) and OXVASC (Oxford Vascular Study; 2002–2018).

Results:

Two hundred seventy-seven patients (753 patient-years of follow-up) with first-ever primary ICH were ascertained in OXVASC and OCSP. Baseline systolic BP was comparable between the 2 studies (mean/SD=183.8/36.5 in OXVASC versus 178.1/38.2 in OCSP,
P
=0.30) but among one hundred thirty-seven 90-day survivors, mean BP during follow-up was substantially lower in OXVASC versus OCSP (135.2/16.4 versus 157.3/17.8,
P
<0.0001). Risks of recurrent stroke (per 100 patient-years) decreased from 10.3 (95% CI, 4.7–19.5) in OCSP to 3.1 (1.8–4.8) in OXVASC (
P
=0.006), predominantly driven by a reduction at younger ages (5-year risk at age <75 years: 35.4% versus 6.9%,
P
=0.001; hazard ratio, 0.14 [0.04–0.54]).

Conclusions:

Risks of recurrent stroke after primary ICH have fallen significantly in Oxfordshire over the past 4 decades, coinciding with substantial improvements in BP control during follow-up.
Anoectochilus medogensis (Goodyerinae, Cranichideae, Orchidaceae), a new species from Tibet, China
Authors: JIN YUE , SUN MEI , JIANG HONG , KUMAR PANKAJ , LIU ZHEN , SCHUITEMAN ANDRE , WU JIANYONG , TIAN HUAIZHEN
Published: July 2021

Based on field observations and examination of preserved specimens, Anoectochilus medogensis is described as a new species from Tibet, China. Phylogenetic evidence using combined plastid regions (matK, trnL-F and rbcL) further supports the systematic status of A. medogensis. A detailed morphological description, photographic plates and line drawings, as well as conservation assessment are also provided for this new species.
Begonia xuansonensis, a new orange-flowered species of Begoniaceae from northern Vietnam
Authors: DO TRUONG VAN , SHUI YU-MIN , LE PHUC VAN , HUYNH HUE THU THI , KUZNETSOV ANDREY N. , KUZNETSOVA SVETLANA P. , NURALIEV MAXIM S.
Published: July 2021

Begonia xuansonensis, a new species from northern Vietnam, is described and illustrated. The new species is characterized by reddish-orange to orange tepals, which is a rare type of flower coloration in Asian species of the genus. Begonia xuansonensis is most similar to B. lowiana, but differs from the latter by stipules 4–6 × 1.5–2 mm, orange tepals and ovary, and abaxially densely red setose inner tepals of staminate and pistillate flowers. The new species also shows similarity with B. cathayana, differing in stipules 4–6 mm long, uniformly dark green adaxial side of leaf blade, abaxially densely red setose inner tepals of a staminate flower and three styles in a pistillate flower. Begonia xuansonensis is tentatively assigned to B. sect. Platycentrum on the basis of actinomorphic androecium, apically rounded anthers and fruit with three unequal wings. Morphological description and detailed photographs of the new species are provided, accompanied by information on its ecology, provisional conservation status, and a taxonomic comparison with similar species.
Review of the subgenus Lophotyna Hampson of the genus Polymixis Hübner (Lepidoptera: Noctuidae: Noctuinae), with descriptions of two new species from Myanmar
Authors: BENEDEK BALÁZS , VOLYNKIN ANTON V. , BABICS JÁNOS , SALDAITIS AIDAS
Published: July 2021

The noctuid genus Lophotyna Hampson, 1910 is downgraded to a subgenus of the genus Polymixis Hübner, [1820] and reviewed. Two new species are described from Myanmar: Polymixis (Lophotyna) pateikkaya sp. nov. and Polymixis (Lophotyna) aungi sp. nov. The Polymixis crinomima (Wiltshire, 1946) species-group is associated with the subgenus Lophotyna. Polymixis crinomima diluta (L. Ronkay, Varga & Hreblay, 1998) syn.nov. is synonymized with P. crinomima crinomima (Wiltshire, 1946). Polymixis jabaliya (Wiltshire, 1987) is downgraded to a subspecies of P. crinomima: Polymixis crinomima jabaliya (Wiltshire, 1987), stat. nov. Four new combinations are established: Polymixis (Lophotyna) albosignata (Moore, 1881), comb. nov., Polymixis (Lophotyna) hoenei (Boursin, 1956), comb. nov., Polymixis (Lophotyna) albirena (Moore, 1867), comb. nov. and Polymixis (Lophotyna) khumbuensis (Owada, 1981), comb. nov. A replacement name, Polymixis (s. l.) boursinella nom. nov. is introduced for Polymixis (s. l.) albirena (Boursin, 1944), homonym nov. A lectotype for Mamestra albirena Moore, 1867 is designated.
Origin and Composition of Nanoparticles Induced in a Complex Plastic-Brittle Transition Process of Xiaomei Shear Zone, Hainan Island, China
Authors: Zhou Yang , Shen Bao-Yun , Liu Hai-Ling , Yan Yi
Published: July 2021

Micro and nano structures of quartz schist, plagioclase granite, and granitic gneiss in the Xiaomei Shear Zone located in southeastern Hainan Island, China are observed using Scanning Electron Microscope (SEM). Ultramicroscopic analyses indicate that three types of nanoparticles were
found in the samples, including spherical nanoparticles, agglomerated nanoparticles and nanofibers. These nanoparticles are mainly developed in the fracture zones. The more fractures there are, the more nanoparticles are developed. Energy dispersive spectrometer (EDS) and X-ray diffraction
(XRD) are used to ascertain the composition of the nanoparticles. The results suggest that the nanoparticles are mainly composed of silicate, dolomite and calcite, rich in O, Si, Al, Ca. Based on our results, we suggest that nanoparticle formation is a complex, plastic-brittle transition process.
Thermal decomposition driven by steady shearing possibly forms well-organized nanoparticles, while fast-moving dislocations by shock-like stress release possibly forms radial nanofibers.
A Review on Green Synthesis and Applications of Iron Oxide Nanoparticles
Authors: Yadwade Rachana , Kirtiwar Saili , Ankamwar Balaprasad
Published: July 2021

Bio-fabrication of iron oxide nanoparticles by using different sources of plants, plant parts and microbial cells have become a great topic of interest nowadays due to its eco-friendly nature. The stabilizing and capping agents in biological sources are biocompatible, stable and non-toxic
which make its use beneficial for various biomedical applications. The bacteria are able to utilize metal ions and convert them into their respective nanoparticles by secreting different biomolecules. The plants and plant parts contain different types of phytochemicals which play a key role
in synthesis and bio-fabrication of nanoparticles. Iron oxide nanoparticles are known to have various applications in the fields of medicine, environment etc. This review summarizes the applications of iron oxide nanoparticles as antimicrobial agent, drug delivery agent, material for removal
of heavy metals and dyes from aqueous system etc. Due to these wide applications of iron oxide nanoparticles its demand in various fields is increasing considerably. This review describes different approaches which are used for biosynthesis of iron oxide nanoparticles and their applications.
The review also summarizes about the surface modification strategies of iron oxide nanoparticles by using different polymers, polyelectrolytes which can be used for in-vivo applications.
Aqueous Mg-Ion Supercapacitor and Bi-Functional Electrocatalyst Based on MgTiO3 Nanoparticles
Authors: Maitra S. , Mitra R. , Nath T. K.
Published: July 2021

Supercapacitor and hydrogen-based fuel cells are cheap and environmental-friendly next-generation energy storage devices that are intended to replace Lithium-ion batteries. Metal oxide nanostructures having perovskite crystal structure have been found to exhibit unique electrochemical
properties owing to its unique electronic band structure and multiple redox-active ions. Herein, MgTiO3 nanoparticles (MTO-1) were synthesized by wet-chemical sol–gel technique with an average particle size of 50–55 nm, which exhibited superior supercapacitor performance
of capacitance (C) = 25 F/g (at 0.25 A/g), energy density (ED) = 17 Wh/kg, power density (PD) = 275 W/kg and 82.41% capacitance retention (after 1000 cycles). Aqueous 1 M Mg(ClO4)2 solution was used as the electrolyte. MTO-1
revealed an overpotential (η) = 1.329 V and Tafel slope (b) = 374 mV/dec towards Oxygen Evolution Reaction (OER) electrocatalyst and exhibited η = 0.914 V and b = 301.4 mV/dec towards Hydrogen Evolution Reaction (HER) electrocatalyst, both in presence of
alkaline 1 M KOH solution, making these MgTiO3 nanoparticles very promising for potential use in various technologically important electrochemical applications.