bluuebunny/crossref_metadata_2025 huggingface dataset:
More on the infrared renormalon in SU (N) QCD(adj.) on $\mathbb{R}^3\times S^1$
Authors: Ashie Masahiro , Morikawa Okuto , Suzuki Hiroshi , Takaura Hiromasa
Published: June 2020

We present additional observations to previous studies on the infrared (IR) renormalon in $SU(N)$ QCD(adj.), the $SU(N)$ gauge theory with $n_W$-flavor adjoint Weyl fermions on $\mathbb{R}^3\times S^1$ with the $\mathbb{Z}_N$ twisted boundary condition. First, we show that, for arbitrary finite $N$, a logarithmic factor in the vacuum polarization of the “photon” (the gauge boson associated with the Cartan generators of $SU(N)$) disappears under the $S^1$ compactification. Since the IR renormalon is attributed to the presence of this logarithmic factor, it is concluded that there is no IR renormalon in this system with finite $N$. This result generalizes the observation made by Anber and Sulejmanpasic [J. High Energy Phys. 1501, 139 (2015)] for $N=2$ and $3$ to arbitrary finite $N$. Next, we point out that, although renormalon ambiguities do not appear through the Borel procedure in this system, an ambiguity appears in an alternative resummation procedure in which a resummed quantity is given by a momentum integration where the inverse of the vacuum polarization is included as the integrand. Such an ambiguity is caused by a simple zero at non-zero momentum of the vacuum polarization. Under the decompactification $R\to\infty$, where $R$ is the radius of the $S^1$, this ambiguity in the momentum integration smoothly reduces to the IR renormalon ambiguity in $\mathbb{R}^4$. We term this ambiguity in the momentum integration “renormalon precursor”. The emergence of the IR renormalon ambiguity in $\mathbb{R}^4$ under the decompactification can be naturally understood with this notion.
Factors Associated With the Outcome of a First-Line Intervention for Patients With Hip or Knee Osteoarthritis or Both: Data From the BOA Register
Authors: Dell’Isola Andrea , Jönsson Therese , Nero Håkan , Eek Frida , Dahlberg Leif
Published: June 2020

Objective

This study explored the association of patients’ demographics, health status, symptom severity, previous osteoarthritis (OA) care, and psychological status with the change in pain severity following a first-line intervention including education and exercise for OA provided nationwide in Swedish primary care.

Methods

This register-based cohort study included 23,309 people with knee or hip OA from the Better Management of Patients with OA register. Linear regression models were used to assess the association of independent variables with the change in pain from baseline to 3 and 12 months. All the analyses were stratified based on the affected joint (hip vs knee).

Results

In people with hip and people with knee OA, high levels of baseline pain were associated with decreased pain at both follow-ups (3 months: knee B = −.67; hip B = −.64; 12 months: knee B = −.70; hip B = −.66), whereas being older, overweight, or female had a weak or no association. Finally, at both follow-ups, bilateral OA was associated with increased pain only in people with knee OA, whereas comorbidities and the willingness to undergo surgery were associated with increased pain regardless of the affected joint.

Conclusions

Baseline pain showed the strongest association among the analyzed variables, whereas sex, age, and body mass index appear to be weakly associated with the pain change after a first-line intervention. Comorbidities and willingness to undergo surgery showed a potentially important association and may have a negative impact on the pain change following a first-line intervention.

Impact

In people with hip or knee OA, age, sex, body mass index, and previous surgery are only weakly associated with the change in pain after a first-line intervention supporting the evidence recommending exercise and education as a foundation for all OA therapy. Having comorbidities and being willing to undergo surgery is associated with a worse outcome from a first-line intervention, including exercise and education. Individualized treatments addressing the disease perception and the specific comorbidity profile may improve the outcomes.
Threatening increase in alcohol consumption in physicians quarantined due to coronavirus outbreak in Poland: the ALCOVID survey
Authors: Silczuk Andrzej
Published: June 2020

Background

The potential risks of increased alcohol use and of the development of alcohol dependence during COVID-19 pandemic were identified. So far there have been no studies concerning pandemic influence on alcohol consumption in medical professionals in quarantine or isolation.

Methods

The 12 point ‘online’ ALCOVID survey with a cover letter was designed and addressed to physicians, recruited online via accessible networks, who underwent isolation or quarantine during recent pandemic. The AUDIT-3 scale was included.

Results

A representative trial of 113 physicians participated in the study. Over 53% of screened doctors revealed that the amounts of the consumed alcohol have escalated; almost 20% of subjects binged over seven standard drinks for one occasion. Close to every second used six or more drinks on one occasion. Over 40% used alcohol more than four times per week. Female used alcohol more often and more standard drinks per occasion. Male binged more. Anxiety and hopelessness were the most common motives to drink.

Conclusions

Alcohol consumption in physicians in quarantine has threateningly increased. It is important to identify the group of people at the risk of problem drinking and dependence development, especially when it concerns key professional branches in the fight against the current crisis.
Total Positivity in Springer Fibres
Authors: Lusztig G
Published: June 2020

Let u be a unipotent element in the totally positive part of a complex reductive group. We consider the intersection of the Springer fibre at u with the totally positive part of the flag manifold. We show that this intersection has a natural cell decomposition which is part of the cell decomposition (Rietsch) of the totally positive flag manifold.
ASSESSMENT OF OCCUPATIONAL EXPOSURE OF RADIATION WORKERS AT A TERTIARY HOSPITAL IN ANHUI PROVINCE, CHINA, DURING 2013–18
Authors: Zhang Guoliang , Shen Jianmin , Bao Pin , Yao Ziqin , Yuan Yuan , Fang Shiyuan
Published: June 2020

Data on occupational radiation exposure of radiation workers at a tertiary hospital in China during 2013–18 were analyzed to provide decision-making advice for hospitals and health administrative departments. A total of 1255 exposure records of radiation workers were collected. The average annual effective doses of radiation workers during 2013–18 was 0.4977 mSv, with 1150 (91.63%) records ranging between 0 and 1 mSv, 91 (7.25%) between 1 and 2 mSv, 10 (0.80%) between 2 and 5 mSv and 4 (0.32%) records exceeding 5 mSv. There was a significant difference in the average annual effective dose of radiation workers among different occupational categories except in 2015 indicating that hospitals and administrative authorities should pay more attention to the radiation workers in the nuclear medicine and intervention department. The average annual effective doses did not show significant differences between male and female workers except in 2017; in that year the average individual dose of female workers was higher than male workers’. There were no significant differences in the average annual effective doses among doctors, nurses and radiologic technologists except in 2016 and 2017; during that period the individual dose of nurses was higher than doctors’ and radiologic technologists’.
Reduced Hippocampal Volume and Its Relationship With Verbal Memory and Negative Symptoms in Treatment-Naive First-Episode Adolescent-Onset Schizophrenia
Authors: Duan Xujun , He Changchun , Ou Jianjun , Wang Runshi , Xiao Jinming , Li Lei , Wu Renrong , Zhang Yan , Zhao Jingping , Chen Huafu
Published: June 2020

Accumulating neuroimaging evidence has shown remarkable volume reductions in the hippocampi of patients with schizophrenia. However, the relationship among hippocampal morphometry, clinical symptoms, and cognitive impairments in schizophrenia is still unclear. In this study, high-resolution structural magnetic resonance imaging data were acquired in 36 patients with adolescent-onset schizophrenia (AOS, age range: 13–18 years) and 30 age-, gender-, and education-matched typically developing controls (TDCs). Hippocampal volume was assessed automatically through volumetric segmentation and measurement. After adjusting for total intracranial volume, we found reduced hippocampal volume in individuals with AOS compared with TDCs, and the hippocampal volume was positively correlated with verbal memory and negatively correlated with negative symptoms in AOS. In addition, mediation analysis revealed the indirect effect of hippocampal volume on negative symptoms via verbal memory impairment. When the negative symptoms were represented by 2 dimensions of deficits in emotional expression (EXP) and deficits in motivation and pleasure (MAP), the indirect effect was significant for EXP but not for MAP. Our findings provide further evidence of hippocampal volume reduction in AOS and highlight verbal memory impairment as a mediator to influence the relationship between hippocampal morphometry and negative symptoms, especially the EXP dimension of negative symptoms, in individuals with AOS.
When Do Unions Matter to Social Policy? Organized Labor and Leave Legislation in US States
Authors: Engeman Cassandra
Published: June 2020

Trade union institutions are historically and comparatively weak in the United States, and union membership has been in steady decline over several decades. Scholars thus question the contemporary relevance of organized labor to social policy. Yet, there is considerable state-level variation in social policy and union institutional strength that remains underexamined. Focusing on variability across US states, this paper uses mixed-methods analysis to examine relationships between organized labor and parental and family leave legislation under varying political conditions. Event history analysis of state-level leave policy adoption from 1983 to 2016 shows that union institutional strength, particularly in the public sector, is positively associated with the timing of leave policy adoption. These findings are robust to the inclusion of other factors, including Democratic control of state houses, which is also shown to facilitate leave policy adoption. Comparative case studies support event history findings and illustrate how state house partisanship informs the level of government that leave advocates target for policy change. The paper concludes by suggesting further attention to subnational policies and investigation into the social movement practice of target-shifting and its effects. Ultimately, the paper demonstrates the operation of power resources at the subnational level within a liberal market national context.
The Townscape Movement and the Politics of Post-War Urbanism
Authors: Subramanian Divya
Published: June 2020

This article examines the political and aesthetic significance of the Townscape movement, an architectural and planning movement that emerged in the 1940s and advocated for urban density, individuality, and vibrant street life. Townscape’s vernacular, human-scale vision of urban life was a significant strand in post-war planning culture, one that existed alongside the archetypal forms of social democratic planning, from new towns to tower blocks. By examining the writings of key Townscape figures associated with the Architectural Review, this article argues that Townscape engaged with the tensions at the heart of the post-war social democratic project—individualism versus community, debates over expertise and authority, and responses to the culture of affluence. In doing so, it contributes to a broader urban historiography on the post-war ‘return to the city’, showing how post-war urbanism, usually depicted as an American phenomenon centred around the figure of Jane Jacobs, had its counterpart in a uniquely British planning movement.
How does varying water supply affect oxygen isotope variations in needles and tree rings of Scots pine?
Authors: Timofeeva Galina , Treydte Kerstin , Bugmann Harald , Salmon Yann , Rigling Andreas , Schaub Marcus , Vollenweider Pierre , Siegwolf Rolf , Saurer Matthias
Published: June 2020

In many regions, drought is suspected to be a cause of Scots pine decline and mortality, but the underlying physiological mechanisms remain unclear. Because of their relationship to ecohydrological processes, δ18O values in tree rings are potentially useful for deciphering long-term physiological responses and tree adaptation to increasing drought. We therefore analyzed both needle- and stem-level isotope fractionations in mature trees exposed to varying water supply. In a first experiment, we investigated seasonal δ18O variations in soil and needle water of Scots pine in a dry inner Alpine valley in Switzerland, comparing drought-stressed trees with trees that were irrigated for more than 10 years. In a second experiment, we analyzed twentieth-century δ18O variations in tree rings of the same forest, including a group of trees that had recently died. We observed less 18O enrichment in needle water of drought-stressed compared with irrigated trees. We applied different isotope fractionation models to explain these results, including the Péclet and the two-pool correction, which considers the ratio of unenriched xylem water in the needles to total needle water. Based on anatomical measurements, we found this ratio to be unchanged in drought-stressed needles, although they were shorter. The observed lower 18O enrichment in needles of stressed trees was therefore likely caused by increased effective path length for water movement within the leaf lamina. In the tree-ring study, we observed lower δ18O values in tree rings of dead trees compared with survivors during several decades prior to their death. These lower values in declining trees are consistent with the lower needle water 18O enrichment observed for drought-stressed compared with irrigated trees, suggesting that this needle-level signal is reflected in the tree rings, although changes in rooting depth could also play a role. Our study demonstrates that long-term effects of drought are reflected in the tree-ring δ18O values, which helps to provide a better understanding of past tree physiological changes of Scots pine.
Possible Impact of COVID-19 on Children in Africa, Reflections from Italy and Burkina Faso
Authors: Ouedraogo Paul , Schumacher Richard Fabian
Published: June 2020

Africa is the World Health Organization-region least affected by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. Here, we compare the situation in severely hit Italy with that in less hit Burkina Faso, focussing on the differences in epidemiological, geographical, demographical, cultural and medical conditions to highlight how a full-blown war on the pandemic can impact on other, equally important aspects of global child health.
Conservation genetics of native and European-introduced Chinese water deer (Hydropotes inermis)
Authors: Putman Rory , Dunn Nicholas , Zhang Endi , Chen Min , Miquel Christian , Savolainen Vincent
Published: June 2020

Sufficient genetic variation is vital for the long-term survival of a population. The adaptive potential and reproductive fitness of a population is generally enhanced by greater levels of genetic diversity, while loss of genetic variation in small populations may increase extinction risk due to disease susceptibility and decreased reproductive fitness. Determining levels of genetic diversity in threatened species can, therefore, help inform conservation strategies. The Chinese water deer (Hydropotes inermis) is classified as Vulnerable in its native range on the IUCN Red List, and populations in Korea and mainland China have declined drastically in recent years. However, the species was introduced to Europe about a century ago and populations there now make up over 40% of global numbers. To infer the population genetic structure and genetic diversity of Chinese water deer both in their native China and in populations introduced to the UK and France, variation in mitochondrial DNA was investigated for over 100 individuals (92 cytochrome b and 106 control region sequences). Our results reveal lower levels of genetic diversity in the British populations, differentiation between native and introduced populations, and that the source population of British deer is likely to be extinct. Recommendations are made for the conservation of populations.
Mobility of Oxathiapiprolin and Mefenoxam in Citrus Seedlings After Root Application and Implications for Managing Phytophthora Root Rot
Authors: Gray Morgan A. , Nguyen Kevin A. , Hao Wei , Belisle Rodger J. , Förster Helga , Adaskaveg James E.
Published: June 2020

Oxathiapiprolin is highly effective in the management of Phytophthora root rot of citrus; however, its uptake into plants after soil application is not known. This was investigated and compared with mefenoxam using potted citrus seedlings sampled 7, 10, 13, and 16 days after soil treatments. Bioassays and high-performance liquid chromatography tandem mass spectroscopy (HPLC-MS/MS) were used to quantify fungicide amounts in plant extracts. Distinct inhibition zones of mycelial growth of Phytophthora citrophthora were observed in bioassays when root, stem, or leaf extracts were added to filter paper disks on agar plates. Based on the two quantification methods, concentrations of both fungicides in the three tissue types and at all sampling times were above the mean effective concentration that provides 50% growth reduction values of the baseline sensitivities. Relative concentrations at the four sampling times sometimes varied between the two methods but, for both methods, concentrations of oxathiapiprolin were significantly higher in roots and leaves as compared with stems 10 days after treatment and statistically similar in the three tissues after 7 days. For mefenoxam, concentrations significantly increased in roots between 7 and 16 days after treatment and were significantly the highest in roots as compared with stems or leaves 16 days after treatment. Regressions of oxathiapiprolin and mefenoxam concentrations using HPLC-MS/MS on those calculated from bioassay standard curves indicated that the bioassays overestimated fungicide amounts in the extracts. The bioassay, however, can be considered an alternative option comparable with costly residue analyses in fungicide mobility studies in plants. Uptake of oxathiapiprolin at sufficient but low concentrations into plant roots provides an explanation for its long-lasting high activity in the management of Phytophthora root rot.
When to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysis
Authors: Leonardi Mathew , Gibbons Tatjana , Armour Mike , Wang Rui , Glanville Elizabeth , Hodgson Ruth , Cave Adele E. , Ong Jozarino , Tong Yui Yee Felice , Jacobson Tal Z. , Mol Ben W. , Johnson Neil P. , Condous George
Published: June 2020

(Abstracted from J Minim Invasive Gynecol 2020;27:390–407)

Endometriosis is an inflammatory disease characterized by endometrium-like lesions outside the uterus. Pelvic pain and infertility are hallmarks of the disorder.
The Effects of Propofol on Neural Responses in the Mouse Primary Auditory Cortex
Authors: Du Fang , Xu Ninglong , Wang Kai , Liang Chao , Miao Changhong
Published: June 2020

Objective:

Two-photon laser-scanning microscopy allows for the monitoring of all brain neurons with single-cell and single-action potential accuracy. This study aimed to investigate the neural responses of the primary auditory cortex to sound stimuli in awake and propofol-anesthetized mice using 2-photon laser-scanning microscopy.

Methods:

Twelve healthy adult male C57BL/6 mice were used in the present study. In each mouse, the scalp was removed over the entire dorsal skull, and the right primary auditory cortex (A1) located. The test stimulus, used in the awake and propofol-induced anesthetic state, was a group of tones with a random combination of 3 sound intensities and 8 sound frequencies. The calcium indicator GCaMP6s was virally expressed in cortical neurons and neuronal activity was recorded using 2-photon imaging.

Results:

Calcium responses to sound stimuli in two thirds of the neuronal population of the A1 layer were significantly inhibited by propofol anesthesia. In a single neuron, the calcium responses were also inhibited by propofol anesthesia. In the waking state, △F/F (where F is the time series of fluorescence intensity) of all single neurons was significantly higher than that in the propofol-induced anesthetic state (n=669, P<0.001). Finally, in one example session and averaged across different fields of views (n=6 sessions), the response events to sound stimuli were also inhibited by propofol anesthesia.

Conclusion:

Anesthetic doses of propofol inhibited calcium transients and neuronal activity in the primary auditory cortex of mice.
Second Place Award: Long-term patient-reported outcomes after intramedullary Kirschner-wire fixation for displaced subcapital fractures of the fifth metacarpal bone: A retrospective cohort study
Authors: van Bussel Erik M. , Houwert R. Marijn , Kootstra Tom J.M. , van Heijl Mark , Van der Velde Detlef , Wittich Philip , Keizer Jort
Published: June 2020

Background:

The objective of this study was to analyze complications and patient-reported functional outcome after antegrade intramedullary Kirschner-wire fixation of displaced subcapital fractures of the fifth metacarpal bone.

Methods:

All consecutive patients treated from January 2010 to December 2015 were retrospectively identified using patient logs and radiographic images. Indications for operative fixation were angulation greater than 40 degrees, shortening less than 2 mm, or rotational deficit. Complications were registered from the patient logs. Functional outcome was assessed with the Patient-Rated Wrist/Hand Evaluation (PRWHE) and Disabilities of the Arm, Shoulder and Hand Score (DASH) questionnaires, both ranging from 1-100.

Results:

Fifty-one patients could be included, with two patients lost to follow-up. The mean outpatient follow-up was 9 wk, and the interval for functional assessment was 34 mo with 40 patients (78%) having responded to the questionnaires. Forty-seven patients (92%) proceeded to fracture union, while the recovery of two patients was complicated by migration of the Kirschner wires through the distal cortex into the metacarpophalangeal joint respectively 5 and 6 wk after primary surgery. Eight minor complications were registered, including a superficial skin infection, mild local dysesthesia or a 10- to 20-degree extension lag at the end of outpatient follow-up. Overall, in 41 patients (80%) the Kirschner wires were removed. Long-term functional outcome was excellent with mean PRWHE and DASH scores of, respectively, 3 and 6 points.

Conclusions:

If surgical treatment is considered, we recommend temporary antegrade intramedullary Kirschner wire fixation as a reliable therapeutic method with a low complication rate and excellent long-term functional outcome.

Level of Evidence:

Level III.
Third Place Award: Reconstruction of metastatic bone loss of the proximal femur and acetabulum: A literature review
Authors: Mayassi Hani A. , Zeitlinger Lauren N. , Aboulafia Albert J. , Wallace Matthew T.
Published: June 2020

Background:

Improved rates of long-term survival in cancer patients has led to an increasing prevalence of metastatic disease, notably to osseous structures. The proximal femur and acetabulum are vital weight-bearing surfaces of the lower extremity and common regions of metastatic spread. There are many reconstructive options that depend on several factors including the location of the lesion, type of lesion, and the prognosis of the patient.

Methods:

An extensive literature review was conducted searching Pubmed.gov with the key words metastatic, proximal femur, acetabulum, reconstruction, and fixation. This identified pathologic characteristics for various metastatic processes, anatomic considerations for the proximal femur, and periacetabular metastatic lesions. This also identified treatment-sensitive tumors compared to treatment-resistant conditions. Reconstruction was usually recommended specifically considering renal, lung, and gastrointestinal carcinomas as well as previously irradiated bone where healing was unlikely. In addition, this study provides a technique guide for implementation of a proximal femoral prosthetic replacement (PFR).

Results:

The management of femoral head or neck lesions are frequently managed by hemiarthroplasty with overall reasonable outcomes. In intertrochanteric or subtrochanteric regions, there have been high failure rates of intramedullary fixation, and 2-year reoperation rate of up to 35% was reported with conversion to endoprosthesis. In comparison to an 85% implant survival in intramedullary constructions, there was a 100% 5-year survival in endoprosthesis reconstruction. Periacetabular lesions that do not impact structural stability can be managed with palliative measures. Those patients experiencing significant pain with contained defects may be managed with cement augmentation. Support of the columns may be required with fixation into the ilium, and those with extensive disease may require en bloc internal hemipelvectomy.

Conclusions:

Management of lesions of the proximal femur and acetabulum can be managed with a variety of treatment constructions. The utilization of PFR is increasingly more common especially in the setting of destructive metastatic lesions in the proximal femur as soft-tissue repairs improve ambulatory function. Additionally, the survivorship of endoprosthesis is greater than intramedullary fixation and is recommended for reconstruction for individuals with an expected survivorship greater than 7 mo. Lesions within the periacetabular region that are refractory to nonoperative management may benefit anywhere on the spectrum from intralesional cementation to en bloc hemipelvectomy depending the primary tumor type and degree of osseous involvement.

Level of Evidence:

Level IV.
Comparison of Radiation Treatment Volumes for Borderline Resectable Pancreatic Cancer in Contemporary Clinical Trials
Authors: Bluemel Trevor S. , Kharofa Jordan
Published: June 2020

Objectives:

Optimal radiation target volumes for neoadjuvant therapy in patients with borderline resectable pancreatic cancer (BRPCa) are undefined. Most local recurrences are near the celiac axis and superior mesenteric artery. Methods for generating radiation target volumes include symmetric expansion around the tumor or a customized vascular based approach. We investigated 3 current prospective trials’ coverage of vascular regions at increased risk of recurrence by comparing them to 2 reference standards.

Materials and Methods:

Fourteen computed tomography simulation scans from an institutional prospective trial on BRPCa were used to replicate distinct volumes corresponding to each of 3 contemporary BRPCa trials. Trial volumes were compared with 2 reference volumes (vascular planning target volume and Hopkins planning target volume), which were both based on vascular regions at increased risk of recurrence. Boolean operators and DICE analyses were performed to evaluate trial volume coverage of reference standards.

Results:

A total of 42 target volumes and 28 reference volumes were created using the 14-patient data set. DICE coefficients were highly variable ranging from 0.11 to 0.99. Mean % coverage of reference volumes ranged from 5.8% to 98.6%.

Conclusions:

The wide range of DICE coefficients and coverage indicate heterogeneity in high risk vascular target coverage using symmetric Boolean expansions from the primary tumor. This approach may inadequately cover regions at high risk of local recurrence in BRPCa. A customized clinical target volume that specifically includes the superior mesenteric artery and celiac axis will improve coverage to this region and will account for individual and tumor variability.
Neonatal Autoimmune Subepidermal IgG/IgA Blistering Disease With Severe Laryngeal and Esophageal Involvement: A Report of a Case and Review of the Literature
Authors: Raiber Sofia , Sezin Tanya , Sadik Christian D. , Bergman Reuven , Avitan-Hersh Emily
Published: June 2020

Neonatal autoimmune subepidermal blistering disease is rare. Mucosal involvement is more common in neonatal linear immunoglobulin A (IgA) bullous dermatosis. We describe a neonate with subepidermal cutaneous blistering disease with severe laryngeal and esophageal involvement leading to acute respiratory distress. Histopathology demonstrated a subepidermal blister with neutrophils and eosinophils at the dermal base. Collagen IV was detected at the dermal floor, and direct immunofluorescence showed linear IgG, IgA, and C3 deposits at the basement membrane zone. The patient demonstrated markedly increased serum levels of anti-BP180 NC16A and anti-BP230 IgG antibodies (Abs) but failed to show anti-LAD-1 IgA Abs. His healthy mother showed serum anti-LAD-1 IgA Abs but did not show anti-BP180 and anti-BP230 Abs. The neonate responded promptly to systemic corticosteroid therapy. A review of the literature detected 11 cases of neonatal subepidermal blistering disease with linear IgA deposits. Nine of these cases demonstrated coexisting linear IgG deposits, often with C3. Respiratory compromise was present in most of the cases. Neutrophils and eosinophils were commonly present in the inflammatory cell infiltrates. Besides our case, 2 cases of neonatal IgG/IgA subepidermal blistering disease with esophageal involvement were previously described. IgA Abs were present in the sera of both cases. Anti-LAD-1 IgA Abs were detected in the mother's serum of our case alone, but IgA Abs do not cross the placenta. Our case was consistent with neonatal IgG/IgA pemphigoid. Neonatal IgG/IgA subepidermal blistering disease may be associated with severe laryngeal and esophageal involvement leading to respiratory compromise. Expedited diagnosis and prompt treatment are warranted.
Indeterminate Dendritic Cell Tumor as Cutaneous Involvement of Chronic Myelomonocytic Leukemia Successfully Treated With Phototherapy
Authors: Santos-Briz Angel , Medina-Miguelañez Mario , Moyano-Bueno David , Viñolas-Cuadros Alex , Martínez Teresa G. , Izquierdo Marta M. , García-Sánchez Maria S.
Published: June 2020

Indeterminate dendritic cell tumor (IDCT) is a rare disease composed of so-called indeterminate cells, a dendritic cell subset displaying histological and some ultrastructural and immunophenotypic features of Langerhans cells, but lacking Birbeck granules. We report a case of cutaneous IDCT occurring in a patient with chronic myelomonocytic leukemia (CMML) successfully treated with UV-A phototherapy. Next-generation sequencing studies of the CMML demonstrated mutations in TET2, ASXL1, and ZRS2 genes, also detected in the IDCT, demonstrating a clonal relationship between both tumors and confirming IDCT as a specific subtype in the spectrum of CMML-related cutaneous lesions.
Dihydroartemisinin Attenuates Pulmonary Hypertension Through Inhibition of Pulmonary Vascular Remodeling in Rats
Authors: Tang Ming , Wang Ruiyu , Feng Panpan , Dong Qian , Chen Wanshi , Zhao Yongpeng , Li Ailing , Li Haibin , Chen Jiwang , Huang Wei
Published: June 2020

Pulmonary arterial hypertension (PAH) is a malignant disease characterized by pulmonary arterial remodeling because of the abnormal proliferation and migration of pulmonary arterial smooth muscle cells. Dihydroartemisinin (DHA), an artemisinin derivative used to treat malaria, is able to inhibit fibrosis, neovascularization, and tumor proliferation. In this study, we hypothesized that DHA can be beneficial in treating PAH. To test this hypothesis, a rat model of pulmonary hypertension induced with monocrotaline (MCT) was used. Compared with MCT treatment alone, treatment with 50 or 100 mg/kg DHA significantly reduced the mean pulmonary arterial pressure (30.11 ± 2.48 mm Hg vs. 21.35 ± 3.04 mm Hg and 19.18 ± 1.98 mm Hg, respectively, both P < 0.01), right ventricular transverse diameter (4.36 ± 0.41 mm vs. 3.72 ± 0.24 mm and 3.67 ± 0.27 mm, respectively, both P < 0.01), pulmonary artery medial wall thickness (57.93 ± 11.14% vs. 34.45 ± 4.39% and 25.01 ± 6.66%, respectively, both P < 0.01), and increased tricuspid annular plane systolic excursion (1.34 ± 0.17 mm vs. 1.62 ± 0.3 mm and 1.62 ± 0.16 mm, respectively, both P < 0.05). We also found that DHA inhibited platelet-derived growth factor-BB-mediated pulmonary arterial smooth muscle cells proliferation and migration in a dose-dependent manner. Moreover, DHA downregulated β-catenin levels while upregulating the levels of axis inhibition protein 2 (Axin2) and glycogen synthase kinase 3β (GSK-3β). Our findings suggest that DHA, which may be a potential candidate for PAH therapy, attenuates experimental pulmonary hypertension possibly by inhibiting pulmonary vascular remodeling.
CEACAM1 Inhibited IκB-α/NF-κB Signal Pathway Via Targeting MMP-9/TIMP-1 Axis in Diabetic Atherosclerosis
Authors: Yu Jie , Sun Guihu , Chen Yu , Li Lin , Wang Huawei , Tu Dong , Li Longjun , Meng Zhaohui , Wang Yan
Published: June 2020

Atherosclerosis (AS) is the most common and serious complication in type 2 diabetes mellitus (T2DM). Recent studies have emphasized that inflammation is the main cause of atherosclerosis. Studies have shown that carcinoembryonic antigen-related cellular adhesion molecule 1 (CEACAM1) regulates the expression of matrix metallopeptidase 9 (MMP-9) after ischemic stroke to reduce inflammation. The aim of this study was to elucidate potential molecular mechanism of CEACAM1 on the inflammatory response in atherosclerosis. The serum levels of CEACAM1, MMP-9, and tissue inhibitors of metalloproteinase 1 (TIMP-1) in T2DM patients and healthy control was detected. The results showed that the levels of CEACAM1 and TIMP-1 were significantly decreased, and the levels of MMP-9 were significantly higher than those in the control group. Moreover, we also observed the effect of CEACAM1 on atherosclerosis in T2DM rats. Hematoxylin & eosin (HE) staining and oil red staining showed that CEACAM1 recombinant protein reduced intima-media thickness and the area of atherosclerotic plaques. To further explore the molecular mechanism of CEACAM1 regulating MMP-9/TIMP-1, we conducted experiments in rat aorta vascular endothelial cells and rat aorta smooth muscle cells. The result showed that CEACAM1 inhibits inflammatory response via MMP-9/TIMP-1 axis. Taken together, CEACAM1 attenuates diabetic atherosclerosis by inhibition of IκB/NF-κB signal pathway via MMP-9/TIMP-1 axis, which indicate that CEACAM1 is potentially amenable to therapeutic manipulation for clinical application in atherosclerosis in T2DM.
ABUNDANCE AND MULTIMODAL VISIBILITY OF SOFT DRUSEN IN EARLY AGE-RELATED MACULAR DEGENERATION
Authors: Chen Ling , Messinger Jeffrey D. , Sloan Kenneth R. , Wong Jessica , Roorda Austin , Duncan Jacque L. , Curcio Christine A.
Published: June 2020

Purpose:

To determine the abundance and multimodal visibility of drusen and basal linear deposit (BLinD) in early age-related macular degeneration.

Methods:

A 69-year-old white man was imaged by color fundus photography and red free photography, fundus autofluorescence, and optical coherence tomography. From en face images, we determined the drusen field, drusen area, and equivalent diameters of individual drusen. From high-resolution light-microscopic histology (6 months after the last clinic visit), we determined the area of drusen, BLinD, and pre-BLinD in a subretinal pigment epithelium-basal lamina lipid field.

Results:

In right and left eyes, respectively, BLinD covered 40% and 46% of the lipid field, versus 21% and 14% covered by drusen. The lipid field was covered 60% to 61% by Drusen + BLinD and 65% to 72% by BLinD + pre-BLinD. In the left eye, the drusen area on color fundus photography (0.18 mm2) and red free (0.28 mm2) was smaller than the drusen area on histology (1.16 mm2). Among drusen confirmed by optical coherence tomography, 55.1% and 56.6% were observed on red free and fundus autofluorescence, respectively.

Conclusion:

Basal linear deposit covered 1.9 and 3.4-fold more fundus area than soft drusen, silently increasing progression risk. Improved visualization of BLinD and readouts of the retinal pigment epithelium health over lipid will assist population surveillance, early detection, and trial outcome measures.
Corneal Elevation, Power, and Astigmatism to Assess Toric Orthokeratology Lenses in Moderate-to-High Astigmats
Authors: Tomiyama Erin S. , Logan Anna-Kaye , Richdale Kathryn
Published: June 2020

Objectives:

Fitting philosophies for toric orthokeratology are based on elevation or corneal astigmatism, but it is unclear which is more effective. The purpose of this analysis was to further understand corneal shape and the relationship between peripheral elevation and central astigmatism in moderate-to-high astigmats.

Methods:

Corneal tomography was measured three times on the right eyes of 25 moderate-to-high refractive myopic astigmatic adults. Corneal astigmatism and elevation were calculated at 4-, 6-, and 8-mm chords. Subjects were fitted with toric orthokeratology lenses following the manufacturer's guidelines based on elevation. Twenty subjects completed 10 days of wear. A masked examiner assessed movement and centration via slitlamp videos and quantified treatment zone and decentration from tangential power difference tomography maps. Correlations between variables were assessed.

Results:

Average corneal astigmatism was 2.20±0.70 DC and peripheral elevation was 50.88±18.92 μm and they were strongly correlated (4 mm R2=0.96, 6 mm R2=0.92, 8 mm R2=0.86, all P<0.001). Each diopter of astigmatism equated to 25 μm of elevation at an 8-mm chord. Via slitlamp, average treatment zone area was 12.73±4.62 mm2 and 13 lenses decentered. From tomography, average treatment zone area was 7.16±2.56 mm2 and 17 were decentered. Tomography treatment zone area was negatively correlated with central corneal astigmatism (R2=0.60) and elevation at an 8-mm chord (R2=0.64, both P<0.001).

Conclusions:

For tomography images, central corneal astigmatism was highly correlated with peripheral elevation and may be a more expedient measure for clinical use. Treatment area decreased as corneal astigmatism and elevation increased.
Review of Gamma-Irradiated Sterile Cornea: Properties, Indications, and New Directions
Authors: Kuo Irene C.
Published: June 2020

Gamma-irradiated sterile cornea (GISC) is a relatively new graft tissue that follows the 30-year success of irradiation to other tissues (bone and sclera) to lessen antigenic load and infection transmission. It can serve as a graft to cover glaucoma drainage devices, as graft tissue for frank or impending corneal perforations in tectonic keratoplasty, as graft tissue in lamellar keratoplasty, and as carrier tissue for keratoprosthesis. With the limited availability of fresh corneal tissue in less developed countries, GISC may fill a need for corneal tissue worldwide. It can be used in situations where corneal endothelium is not needed and with a greatly reduced risk of rejection and infection because of the effect of irradiation on corneal tissue.
Laser Iridoplasty to Treat Iris-occluded XEN Gel Stent
Authors: Tadrosse Abanoob F. , Khouri Albert S.
Published: June 2020

Purpose:

To provide the first report on argon laser peripheral iridoplasty (ALPI) to restore XEN-45 Gel stent patency after iris occlusion.

Methods:

Case description, laser technique, and relevant clinical imaging.

Results:

A 53-year-old African American male patient presented with progressive advanced stage primary open-angle glaucoma. Initial intraocular pressure (IOP) was 40 mm Hg, which continued to be elevated despite maximal medical therapy and selective laser trabeculoplasty. The patient underwent an uncomplicated XEN-45 Gel stent implantation and presented with an IOP of 4 mm Hg 5 days postoperatively with a functioning bleb. On postoperative day 10, the XEN lumen was found to be occluded by the iris with an IOP spike of 39 mm Hg. Anti-glaucoma treatment to induce miosis and liberate the stent was unsuccessful. ALPI was attempted to relieve the obstruction. IOP dropped to 26 mm Hg immediately post-ALPI and continued to be well-controlled 6 months later (11 mm Hg).

Conclusions:

ALPI can effectively restore XEN Gel stent patency if occluded by the iris and should be considered before attempting more invasive surgical revisions.
Twelve-month outcomes of an ab interno gelatin stent combined with cataract surgery or as a standalone procedure in pseudophakic eyes with open-angle glaucoma
Authors: Rather Peyton A. , Vold Steven , McFarland Michael
Published: June 2020

Purpose:

To provide safety and effectiveness outcomes at 12 months postsurgery for an ab interno transscleral gelatin stent in patients with advanced refractory glaucoma or intolerant of medical therapy.

Setting:

Multisubspecialty ophthalmology practice and surgery center.

Design:

Retrospective, single-arm, cohort study.

Methods:

All patients implanted with the gelatin stent either combined with cataract surgery or as a solo procedure between February 2017 and April 2018 and meeting eligibility criteria were included. Outcome measures included proportion of patients achieving a 20% reduction in intraocular pressure (IOP), proportions at or below 12 mm Hg, 15 mm Hg, and 18 mm Hg, IOP, medication usage, needling rate, and adverse events.

Results:

The study included 92 eyes of 69 patients. Mean preoperative IOP and medications were 16.6 mm Hg on 2.1 medications. Average visual field mean deviation was −13.7 dB. Half (48%) of the patients achieved the primary endpoint of 20% reduction while medication use decreased by −1.7 medications. Most patients at 12 months had IOP of 18 mm Hg or less on zero medications (74%), whereas 34% were medication free and had IOP of 12 mm Hg or less. Bleb needling was required for only 14% of patients. There were few adverse events (13% of eyes), the most common being corrected distance visual acuity loss and hyphema.

Conclusions:

Eyes with advanced glaucoma despite maximum tolerated medical therapy achieved lower target IOP on fewer medications after implantation with the gelatin microstent.
Microglial annexin A3 downregulation alleviates bone cancer-induced pain through inhibiting the Hif-1α/vascular endothelial growth factor signaling pathway
Authors: Zhang Zengli , Deng Meiling , Huang Jiangju , Wu Jing , Li Zhengyiqi , Xing Manyu , Wang Jian , Guo Qulian , Zou Wangyuan
Published: June 2020

Bone cancer-induced pain (BCP) is a challenging clinical problem because traditional therapies are often only partially effective. Annexin A3 (ANXA3) is highly expressed in microglia in the spinal cord, and its expression is upregulated during BCP. However, the roles of microglial ANXA3 in the development and maintenance of BCP and the underlying molecular mechanisms remain unclear. This study was performed on male mice using a metastatic lung BCP model. Adeno-associated virus shANXA3 (AAV-shANXA3) was injected intrathecally 14 days before and 7 days after bone cancer induction, and relevant pain behaviors were assessed by measuring the paw withdrawal mechanical threshold, paw withdrawal thermal latency, and spontaneous hind limb lifting. ANXA3 protein expression was downregulated in microglial N9 cells by lentiviral transfection (LV-shANXA3). ANXA3, hypoxia-inducible factor-1α (Hif-1α), vascular endothelial growth factor (VEGF) expression levels, and Hif-1α transactivation activity regulated by ANXA3 were measured. As a result, ANXA3 was expressed in microglia, and its expression significantly increased during BCP. ANXA3 knockdown reversed pain behaviors but did not prevent pain development. Moreover, ANXA3 knockdown significantly reduced Hif-1α and VEGF expression levels in vitro and in vivo. And overexpression of Hif-1α or VEGF blocked the effects of AAV-shANXA3 on BCP. ANXA3 knockdown in N9 cells significantly decreased the p-PKC protein expression in the cocultured neurons. Finally, ANXA3 overexpression significantly increased Hif-1α transactivation activity in 293T cells. Therefore, microglial ANXA3 downregulation alleviates BCP by inhibiting the Hif-1α/VEGF signaling pathway, which indicates that ANXA3 may be a potential target for the treatment of BCP.
Acute orofacial pain leads to prolonged changes in behavioral and affective pain components
Authors: Araya Erika Ivanna , Baggio Darciane Favero , Koren Laura de Oliveira , Andreatini Roberto , Schwarting Rainer K. W. , Zamponi Gerald W. , Chichorro Juliana Geremias
Published: June 2020

Acute pain that persists for a few days is associated with a reduction in patients' quality of life. Orofacial persistent pain promotes psychological disorders such as anxiety, impairs daily essential activities such as eating, and results in decreased social interaction. Here, we investigated whether rats subjected to orofacial formalin injection or intraoral incision surgery display persistent facial heat hyperalgesia, ongoing pain, anxiety-like behavior, and changes in ultrasonic vocalization. Orofacial formalin injection or intraoral incision caused facial heat hyperalgesia for 3 days compared with saline-injected and sham animals. In addition, both experimental groups showed a reduction in the number of entries and in the time spent in the open arms in the elevated plus maze test on day 3, suggesting that anxiety-like behavior developed as a consequence of persistent pain. At this time point, both groups also displayed a reduction in the number of 50-kHz calls, specifically in the flat subtype, which suggests a decrease in social communication. Moreover, on day 3 after surgery, systemic morphine produced robust conditioned place preference in rats subjected to intraoral incision compared with sham, and the former group also presented increased spontaneous facial grooming, revealing the presence of ongoing pain. Finally, Western blot and immunohistochemistry analysis showed a reduction in tyrosine hydroxylase expression in the nucleus accumbens, which may reflect a decrease in mesolimbic dopaminergic activity. Altogether, the results demonstrate that acute orofacial pain causes prolonged changes in behavioral and affective pain components, which may be related to dopaminergic changes in the nucleus accumbens.
Pharmacological development of the potential adjuvant therapeutic agents against coronavirus disease 2019
Authors: Chen Kuan-Hsuan , Wang Sheng-Fan , Wang Szu-Yu , Yang Yi-Ping , Wang Mong-Lien , Chiou Sih-Hwa , Chang Yuh-Lih
Published: June 2020

As the coronavirus disease 2019 (COVID-19, also called severe acute respiratory syndrome coronavirus-2) outbreak accelerates, vigorous and diverse efforts were made in developing treatment strategies. In addition to direct acting agents, increasing evidence showed some potential adjuvant therapies with promising efficacy against COVID-19. These therapies include immunomodulators (i.e. intravenous immunoglobulin, thymosin α-1, interleukin [IL]-6, tocilizumab, cyclosporine, thalidomide, fingolimod), Chinese medicines (i.e. glycyrrhizin, baicalin, Xuebijing), anti–vascular endothelial growth factors (bevacizumab), estrogen modulating drugs, statins, and nutritional supplements (i.e. vitamins A, B, C, D, E and zinc). This article reviewed the pharmacological development of potential adjuvants for COVID-19 treatment.