bluuebunny/crossref_metadata_2025 huggingface dataset:
Kidney Transplantation for Erdheim-Chester Disease
Authors: Yoo Jongwon , Gunsteen Cynthia , Patel Sima , Clevy-Schneller Ted , Nand Sucha , Jain Divya , Garcia-Roca Raquel , Desai Amishi , Akkina Sanjeev
Published: July 2020

Erdheim-Chester disease is a rare inflammatory disease that infiltrates skeletal and extra-skeletal tissue. Chronic kidney disease (CKD) in Erdheim-Chester disease is usually attributed to retroperitoneal lesions that lead to urologic obstruction and hydronephrosis. In this report, we describe a patient diagnosed with Erdheim-Chester disease who eventually developed end-stage kidney disease (ESKD). After complete remission of Erdheim-Chester disease by vemurafenib therapy and 2 years of hemodialysis, the patient underwent a deceased donor kidney transplantation with basiliximab induction and tacrolimus/mycophenolic acid maintenance. After conversion of mycophenolic acid to azathioprine due to cost, acute cellular rejection had occurred, and he was treated with steroid therapy. The patient remained in complete remission from Erdheim-Chester disease and dialysis-free 16 months after transplant. Kidney transplantation is another treatment option for those patients with Erdheim-Chester disease who suffer from renal failure in the setting of complete remission.
Estimation of Continuous Joint Angles of Upper Limb Based on sEMG by Using GA-Elman Neural Network
Authors: Wang Junhong , Hao Qiqi , Xi Xugang , Cao Jiuwen , Xue Anke , Wang Huijiao
Published: July 2020

The estimation of continuous and simultaneous multijoint angle based on surface electromyography (sEMG) signal is of considerable significance in rehabilitation practice. However, there are few studies on the continuous joint angle of multiple joints at present. In this paper, the wavelet packet energy entropy (WPEE) of the special subspace was investigated as a feature of the sEMG signal. An Elman neural network optimized by genetic algorithm (GA) was established to estimate the joint angle of shoulder and elbow. First, the accuracy of the method is verified by estimating the angle of the shoulder joint. Then, this method was used to simultaneously and continuously estimate the shoulder and elbow joint angle. Six subjects flexed and extended the upper limbs according to the intended movements of the experiment. The results show that this method can obtain a decent performance with a RMSE of 3.4717 and R2 of 0.8283 in shoulder movement and with a RMSE of 4.1582 and R2 of 0.8114 in continuous synchronous movement of the shoulder and elbow.
A Comprehensive Review on Bast Fibre Retting Process for Optimal Performance in Fibre‐Reinforced Polymer Composites
Authors: Lee C. H. , Khalina A. , Lee S. H. , Liu Ming
Published: July 2020

Natural fibres are a gift from nature that we still underutilise. They can be classified into several groups, and bast natural fibre reinforcement in polymer composites has the most promising performance, among others. However, numerous factors have reported influences on mechanical properties of the fibre‐reinforced composite, including natural fibre retting processes. In this review, bast fibre retting process and the effect of enzymatic retting on the fibre and fibre‐reinforced polymer composites have been discussed and reviewed for the latest research studies. All retting methods except chemical and mechanical retting processes are involving secretion of enzymes by bacteria or fungi under controlled (enzymatic retting) or random conditions (water and dew retting). Besides, enzymatic retting is claimed to have more environmentally friendly wastewater products, shorter retting period, and controllable fibre biochemical components under mild incubation conditions. This review comprehensively assesses the enzymatic retting process for producing high‐quality bast fibre and will become a reference for future development on bast fibre‐reinforced polymer composites.
Total Oxidation of Isopropanol in the Liquid Phase, under Atmospheric Pressure and Low Temperature, on Transition Metal Oxides Catalysts Cr2O3 and Fe2O3
Authors: Dehmani Younes , Abouarnadasse Sadik
Published: July 2020

Isopropanol oxidation in the liquid phase under atmospheric pressure and low temperature has been studied in the presence of transition metal oxides (Cr2O3 and Fe2O3) prepared by the precipitation method. These solids characterized by structural analyses (FTIR and XRD) and textural analysis (BET) have led to results in line with those reported in the literature. Chromium oxide has a much more developed texture, with a specific surface area and pore volume 5 times larger than iron oxide. Both of the solids show a good specific activity and led to acetone and carbon dioxide to be formed as the only oxidation products of isopropanol. However, chromium oxide is more active. The initial catalytic activity for the latter is varying between 4.87 ∗ 10−6 and 5.79 ∗ 10−6 mol·g−1·s−1 with temperature range from 40 to 80°C. Kinetic study shows that the reaction follows a successive scheme: isopropanol ⟶ acetone ⟶ CO2 involving a redox mechanism. The low value of the activation apparent energy (Ea.(Cr2O3) = 2.87 kJ·mol−1 < Ea. (Fe2O3) = 5.37 kJ·mol−1) justifies the relatively higher activity observed for chromium oxide.
Attention with Long-Term Interval-Based Deep Sequential Learning for Recommendation
Authors: Li Zhao , Zhang Long , Lei Chenyi , Chen Xia , Gao Jianliang , Gao Jun
Published: July 2020

Modeling user behaviors as sequential learning provides key advantages in predicting future user actions, such as predicting the next product to purchase or the next song to listen to, for the purpose of personalized search and recommendation. Traditional methods for modeling sequential user behaviors usually depend on the premise of Markov processes, while recently recurrent neural networks (RNNs) have been adopted to leverage their power in modeling sequences. In this paper, we propose integrating attention mechanism into RNNs for better modeling sequential user behaviors. Specifically, we design a network featuring Attention with Long-term Interval-based Gated Recurrent Units (ALI-GRU) to model temporal sequences of user actions. Compared to previous works, our network can exploit the information of temporal dimension extracted by time interval-based GRU in addition to normal GRU to encoding user actions and has a specially designed matrix-form attention function to characterize both long-term preferences and short-term intents of users, while the attention-weighted features are finally decoded to predict the next user action. We have performed experiments on two well-known public datasets as well as a huge dataset built from real-world data of one of the largest online shopping websites. Experimental results show that the proposed ALI-GRU achieves significant improvement compared to state-of-the-art RNN-based methods. ALI-GRU is also adopted in a real-world application and results of the online A/B test further demonstrate its practical value.
Performance Analysis of Single-Well Enhanced Geothermal System for Building Heating
Authors: Liang Haijun , Guo Xiaofeng , Gao Tao , Wang Lingbao , Bu Xianbiao
Published: July 2020

Deep borehole heat exchanger (DBHE) technology does not depend on the existence of hot water reservoir and can be used in various regions. However, the heat extraction from DBHE can hardly be improved due to poor thermal conductivity of rocks. Here, a single-well enhanced geothermal system (SWEGS) is proposed, which has a larger heat-exchange area of artificial reservoir created by fracturing hydrothermal technology. We find that, due to heat convection between rocks and fluid, the extracted thermal output for SWEGS is 4772.73 kW, which is 10.64 times of that of DBHE. By changing the injection water temperature, volume flow rate, and artificial reservoir volume, it is easy to adjust the extracted thermal output to meet the requirement of building thermal loads varying with outdoor air temperature. Understanding these will enable us to better apply SWEGS technology and solve the fog and haze problem easily and efficiently.
A Case of Sclerosing Mesenteritis during Etanercept Therapy for Psoriatic Arthritis
Authors: Bukiej Aleksandra
Published: July 2020

Sclerosing mesenteritis (SM) is a chronic nonspecific mesenteric inflammation. I report a case of a 72-year-old male treated with etanercept for psoriatic arthritis for 7 years who developed abdominal discomfort, urinary retention, acute kidney injury, and bilateral ureteric obstruction. CT abdomen revealed retroperitoneal mass. Biopsy showed sclerosing mesenteritis. One year later, after discontinuation of etanercept, CT abdomen showed regression of the mass. To my knowledge, this is first case report of reversible sclerosing mesenteritis associated with etanercept therapy.
Improvement and Application of Generative Adversarial Networks Algorithm Based on Transfer Learning
Authors: Bi Fangming , Man Zijian , Xia Yang , Liu Wei , Yang Wenjia , Fu Xuanyi , Gao Lei
Published: July 2020

Generative adversarial networks are currently used to solve various problems and are one of the most popular models. Generator and discriminator are characteristics of continuous game process in training. While improving the quality of generated pictures, it will also make it difficult for the loss function to be stable, and the training speed will be extremely slow compared with other methods. In addition, since the generative adversarial networks directly learns the data distribution of samples, the model will become uncontrollable and the freedom of the model will become too large when the original data distribution is constantly approximated. A new transfer learning training idea for the unsupervised generation model is proposed based on the generation network. The decoder of trained variational autoencoders is used as the network architecture and parameters to generative adversarial network generator. In addition, the standard normal distribution is obtained by sampling and then input into the model to control the degree of freedom of the model. Finally, we evaluated our method on using the MNIST, CIFAR10, and LSUN datasets. The experiment shows that our proposed method can make the loss function converge as quickly as possible and increase the model accuracy.
Glucose-6-Phosphate Dehydrogenase Is Not Essential for K-Ras–Driven Tumor Growth or Metastasis
Authors: Ghergurovich Jonathan M. , Esposito Mark , Chen Zihong , Wang Joshua Z. , Bhatt Vrushank , Lan Taijin , White Eileen , Kang Yibin , Guo Jessie Yanxiang , Rabinowitz Joshua D.
Published: July 2020

The enzyme glucose-6-phosphate dehydrogenase (G6PD) is a major contributor to NADPH production and redox homeostasis and its expression is upregulated and correlated with negative patient outcomes in multiple human cancer types. Despite these associations, whether G6PD is essential for tumor initiation, growth, or metastasis remains unclear. Here, we employ modern genetic tools to evaluate the role of G6PD in lung, breast, and colon cancer driven by oncogenic K-Ras. Human HCT116 colorectal cancer cells lacking G6PD exhibited metabolic indicators of oxidative stress, but developed into subcutaneous xenografts with growth comparable with that of wild-type controls. In a genetically engineered mouse model of non–small cell lung cancer driven by K-Ras G12D and p53 deficiency, G6PD knockout did not block formation or proliferation of primary lung tumors. In MDA-MB-231–derived human triple-negative breast cancer cells implanted as orthotopic xenografts, loss of G6PD modestly decreased primary site growth without ablating spontaneous metastasis to the lung and moderately impaired the ability of breast cancer cells to colonize the lung when delivered via tail vein injection. Thus, in the studied K-Ras tumor models, G6PD was not strictly essential for tumorigenesis and at most modestly promoted disease progression.

Significance:

K-Ras–driven tumors can grow and metastasize even in the absence of the oxidative pentose pathway, a main NADPH production route.
Multi-omics Analysis Reveals Adipose–tumor Crosstalk in Patients with Colorectal Cancer
Authors: Holowatyj Andreana N. , Haffa Mariam , Lin Tengda , Scherer Dominique , Gigic Biljana , Ose Jennifer , Warby Christy A. , Himbert Caroline , Abbenhardt-Martin Clare , Achaintre David , Boehm Juergen , Boucher Kenneth M. , Gicquiau Audrey , Gsur Andrea , Habermann Nina , Herpel Esther , Kauczor Hans-Ulrich , Keski-Rahkonen Pekka , Kloor Matthias , von Knebel-Doeberitz Magnus , Kok Dieuwertje E. , Nattenmüller Johanna , Schirmacher Peter , Schneider Martin , Schrotz-King Petra , Simon Thomas , Ueland Per M. , Viskochil Richard , Weijenberg Matty P. , Scalbert Augustin , Ulrich Alexis , Bowers Laura W. , Hursting Stephen D. , Ulrich Cornelia M.
Published: July 2020

Obesity and obesity-driven cancer rates are continuing to rise worldwide. We hypothesize that adipocyte–colonocyte interactions are a key driver of obesity-associated cancers. To understand the clinical relevance of visceral adipose tissue in advancing tumor growth, we analyzed paired tumor-adjacent visceral adipose, normal mucosa, and colorectal tumor tissues as well as presurgery blood samples from patients with sporadic colorectal cancer. We report that high peroxisome proliferator-activated receptor gamma (PPARG) visceral adipose tissue expression is associated with glycoprotein VI (GPVI) signaling—the major signaling receptor for collagen—as well as fibrosis and adipogenesis pathway signaling in colorectal tumors. These associations were supported by correlations between PPARG visceral adipose tissue expression and circulating levels of plasma 4-hydroxyproline and serum intercellular adhesion molecule 1 (ICAM1), as well as gene set enrichment analysis and joint gene-metabolite pathway results integration that yielded significant enrichment of genes defining epithelial-to-mesenchymal transition—as in fibrosis and metastasis—and genes involved in glycolytic metabolism, confirmed this association. We also reveal that elevated prostaglandin-endoperoxide synthase 2 (PTGS2) colorectal tumor expression is associated with a fibrotic signature in adipose–tumor crosstalk via GPVI signaling and dendritic cell maturation in visceral adipose tissue. Systemic metabolite and biomarker profiling confirmed that high PTGS2 expression in colorectal tumors is significantly associated with higher concentrations of serum amyloid A and glycine, and lower concentrations of sphingomyelin, in patients with colorectal cancer. This multi-omics study suggests that adipose–tumor crosstalk in patients with colorectal cancer is a critical microenvironment interaction that could be therapeutically targeted.

See related spotlight by Colacino et al., p. 803
Mitotic Spindle Apparatus Abnormalities in Chronic Obstructive Pulmonary Disease Cells: A Potential Pathway to Lung Cancer
Authors: Thaiparambil Jose , Dong Lingyun , Jasso Diana , Huang Jian-An , El-Zein Randa A.
Published: July 2020

Chronic obstructive pulmonary disease (COPD) is a long-term lung disease characterized by irreversible lung damage resulting in airflow limitation, abnormal permanent air-space enlargement, and emphysema. Cigarette smoking is the major cause of COPD with 15% to 30% of smokers developing either disease. About 50% to 80% of patients with lung cancer have preexisting COPD and smokers who have COPD are at an increased risk for developing lung cancer. Therefore, COPD is considered an independent risk for lung cancer, even after adjusting for smoking. A crucial early event in carcinogenesis is the induction of the genomic instability through alterations in the mitotic spindle apparatus. To date, the underlying mechanism by which COPD contributes to lung cancer risk is unclear. We hypothesized that tobacco smoke carcinogens induce mitotic spindle apparatus abnormalities and alter expression of crucial genes leading to increased genomic instability and ultimately tumorigenesis. To test our hypothesis, we assessed the genotoxic effects of a potent tobacco-smoke carcinogen [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, (NNK)] on bronchial epithelial cells from patients with COPD and normal bronchial epithelial cells and identified genes associated with mitotic spindle defects and chromosome missegregation that also overlap with lung cancer. Our results indicate that exposure to NNK leads to a significantly altered spindle orientation, centrosome amplification, and chromosome misalignment in COPD cells as compared with normal epithelial cells. In addition, we identified several genes (such as AURKA, AURKB, and MAD2L2) that were upregulated and overlap with lung cancer suggesting a potential common pathway in the transition from COPD to lung cancer.
Prevention of Tobacco Carcinogen-Induced Lung Tumor Development by a Novel STAT3 Decoy Inhibitor
Authors: Njatcha Christian , Farooqui Mariya , Almotlak Abdulaziz A. , Siegfried Jill M.
Published: July 2020

The STAT3 pathway is frequently overactive in non–small cell lung cancer (NSCLC), an often fatal disease with known risk factors including tobacco and chemical exposures. Whether STAT3 can be downmodulated to delay or prevent development of lung cancer resulting from an environmental exposure has not been previously tested. A circular oligonucleotide STAT3 decoy (CS3D) was used to treat mice previously exposed to the tobacco carcinogen nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone. CS3D contains a double-stranded STAT3 DNA response element sequence and interrupts STAT3 signaling by binding to STAT3 dimers, rendering them unable to initiate transcription at native STAT3 DNA binding sites. An intermittent course of CS3D decreased the development of airway preneoplasias by 42% at 1 week posttreatment, reduced the progression of preneoplasia to adenomas by 54% at 8 weeks posttreatment, and reduced the size and number of resulting lung tumors by 49.7% and 29.5%, respectively, at 20 weeks posttreatment. No toxicity was detected. A mutant cyclic oligonucleotide with no STAT3 binding ability was used as a control. Chemopreventive effects were independent of the KRAS mutational status of the tumors. In lungs harvested during and after the treatment course with CS3D, airway preneoplasias had reduced STAT3 signaling. Chemopreventive effects were accompanied by decreased VEGFA expression, ablated IL6, COX-2, and p-NF-κB, and decreased pulmonary M2 macrophages and myeloid-derived suppressor cells. Thus, downmodulation of STAT3 activity using a decoy molecule both reduced oncogenic signaling in the airway epithelium and favored a lung microenvironment with reduced immunosuppression.
A Pooled Analysis to Compare the Clinical Characteristics of Human Papillomavirus–positive and -Negative Cervical Precancers
Authors: Castle Philip E. , Pierz Amanda J. , Adcock Rachael , Aslam Shagufta , Basu Partha S. , Belinson Jerome L. , Cuzick Jack , El-Zein Mariam , Ferreccio Catterina , Firnhaber Cynthia , Franco Eduardo L. , Gravitt Patti E. , Isidean Sandra D. , Lin John , Mahmud Salaheddin M. , Monsonego Joseph , Muwonge Richard , Ratnam Samuel , Safaeian Mahboobeh , Schiffman Mark , Smith Jennifer S. , Swarts Avril , Wright Thomas C. , Van De Wyngard Vanessa , Xi Long Fu
Published: July 2020

Given that high-risk human papillomavirus (HPV) is the necessary cause of virtually all cervical cancer, the clinical meaning of HPV-negative cervical precancer is unknown. We, therefore, conducted a literature search in Ovid MEDLINE, PubMed Central, and Google Scholar to identify English-language studies in which (i) HPV-negative and -positive, histologically confirmed cervical intraepithelial neoplasia grade 2 or more severe diagnoses (CIN2+) were detected and (ii) summarized statistics or deidentified individual data were available to summarize proportions of biomarkers indicating risk of cancer. Nineteen studies including 3,089 (91.0%) HPV-positive and 307 (9.0%) HPV-negative CIN2+ were analyzed. HPV-positive CIN2+ (vs. HPV-negative CIN2+) was more likely to test positive for biomarkers linked to cancer risk: a study diagnosis of CIN3+ (vs. CIN2; 18 studies; 0.56 vs. 0.24; P < 0.001) preceding high-grade squamous intraepithelial lesion cytology (15 studies; 0.54 vs. 0.10; P < 0.001); and high-grade colposcopic impression (13 studies; 0.30 vs. 0.18; P = 0.03). HPV-negative CIN2+ was more likely to test positive for low-risk HPV genotypes than HPV-positive CIN2+ (P < 0.001). HPV-negative CIN2+ appears to have lower cancer risk than HPV-positive CIN2+. Clinical studies of human high-risk HPV testing for screening to prevent cervical cancer may refer samples of HPV test–negative women for disease ascertainment to correct verification bias in the estimates of clinical performance. However, verification bias adjustment of the clinical performance of HPV testing may overcorrect/underestimate its clinical performance to detect truly precancerous abnormalities.
Inflammatory and Insulinemic Dietary Patterns: Influence on Circulating Biomarkers and Prostate Cancer Risk
Authors: Aroke Desmond , Folefac Edmund , Shi Ni , Jin Qi , Clinton Steven K. , Tabung Fred K.
Published: July 2020

Prostate cancer is common in countries with affluent dietary patterns and represents a heterogeneous collection of subtypes with varying behavior. Reductionist strategies focusing on individual nutrients or foods have not clearly defined risk factors. We have developed mechanisms-based dietary patterns focusing upon inflammation and chronic insulin hypersecretion, processes that are hypothesized to impact prostate carcinogenesis. In the Prostate, Lung, Colorectal, and Ovarian cancer cohort, we calculated the empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores from food frequency questionnaire data among 3,517 men and women who provided a blood sample at enrollment. We used these scores in multivariable-adjusted linear regression to validate EDIH and EDIP against relevant circulating biomarkers. In a separate sample of 49,317 men, we used multivariable-adjusted Cox regression to evaluate associations of EDIH and EDIP with prostate cancer (total and subtypes) risk. Participants consuming the most hyperinsulinemic diets (EDIH quintile 5) had significantly higher concentrations of C-peptide, insulin, c-reactive protein, TNFα-R2, and lower adiponectin, than those in quintile 1. Similarly, participants consuming the most proinflammatory diets had significantly higher concentrations of IL6, TNFα-R2, C-peptide, insulin, and lower adiponectin. Men consuming hyperinsulinemic diets were at higher total prostate cancer risk: HRquintile5vs1, 1.11; 95% confidence interval (CI), 1.01–1.23; P trend = 0.03, especially high-grade cancer: HRquintile5vs1, 1.18; 95% CI, 1.02–1.37; P trend = 0.06. The EDIP was not associated with prostate cancer risk. In summary, EDIH and EDIP predicted concentrations of known insulinemic and inflammatory biomarkers, and EDIH further predicted risk of future prostate cancer. Interventions to reduce the adverse role of hyperinsulinemic diets may be a means of prostate cancer prevention.
The Effect of Ostrich Oil as a Complementary Medicine on the Severity of Pruritus and Quality of Life in Hemodialysis Patients
Authors: Sadeghnejad Zahra , Karampourian Arezou , Borzou Seyed Reza , Gholyaf Mahmoud , Mohammadi Younes , Hadadi Rasoul
Published: July 2020

Introduction: Pruritus is one of the most common problems in a uremic syndrome that reduces the quality of life due to the constant unpleasant feeling. The purpose of this study was to investigate the effect of ostrich oil massage on the severity of pruritus and quality of life in hemodialysis patients. Methods: In this study, 68 hemodialysis patients with pruritus were selected based on the available sampling method. The intervention group used 1 mL ostrich oil on the pruritus area for 10 min each night for 1 month. The control group received a placebo massage. Pruritus severity questionnaire-based itch severity scale and quality of life questionnaire were completed, respectively, at the end of each week and at the end of the period. Statistical analysis was done using SPSS software version 23 and applying on independent t test, paired t test, and analysis of covariance. Results: During the first and second weeks after the treatment, there was no statistical difference between the mean scores of pruritus severity in both groups (p > 0.05); however, in the third and fourth weeks after the treatment, the mean severity level of pruritus in the ostrich oil group was lower than in the placebo group, and these differences were statistically significant between the two groups (p < 0.05). There was no significant difference in quality of life between two groups of ostrich and placebo. Conclusion: The use of ostrich oil was effective in reducing pruritus in hemodialysis patients. This method can be proposed as a complementary method for relieving pruritus in hemodialysis patients.
Two Cases of STAT6-Positive, Primary Conjunctival Giant Cell-Rich Solitary Fibrous Tumour (Giant Cell Angiofibroma) with Some Unusual Histological Features
Authors: Mudhar Hardeep Singh , Pavel Madalina , Chung Andrew K.K. , Jackson Thomas Elliott
Published: July 2020

An 84-year-old male presented with a history of a slowly growing lesion beneath the right lower lid. Examination showed a right-sided mass in the inferior bulbar conjunctiva, measuring approximately 10 × 6 mm. The lesion was excised and showed a giant cell-rich solitary fibrous tumour (GCR-SFT) with pseudo-vascular spaces with benign cytology, with STAT6, expressed in the spindle, ovoid, and tumour giant cells. A second case, a 26-year-old white female, presented with a 12-month history of a gradually expanding lesion in left inferior bulbar conjunctiva. Examination showed a well-defined, dome-shaped pink fleshy mass of 10 × 7 × 2 mm, on the inferior bulbar conjunctiva and abutting the inferior fornix. Excision followed by histology showed a similar appearance to the first case except that the multinucleate giant cells closely resembled Touton giant cells and did not show the rather hyperchromatic crowded nuclei of the giant cells observed in the first case. No pseudo-vascular spaces were identified. The tumour cells, including the Touton-like multinucleate giant cells, displayed nuclear positivity for STAT6. An unexpected feature was the presence of a Melan A- and Sox10-positive population amongst the GCR-SFT, postulated to be a subepithelial melanocytic nevus colliding with the GCR-SFT.
Intraoperative Imaging Techniques to Visualize Hepatic (Micro)Perfusion: An Overview
Authors: Uz Zühre , Shen Lucinda , Milstein Dan M.J. , van Lienden Krijn P. , Swijnenburg Rutger-Jan , Ince Can , van Gulik Thomas M.
Published: July 2020

The microcirculation plays a crucial role in the distribution of perfusion to organs. Studies have shown that microcirculatory dysfunction is an independent predictor of morbidity and mortality. Hence, assessment of liver perfusion offers valuable information on the (patho)physiological state of the liver. The current review explores techniques in perfusion imaging that can be used intraoperatively. Available modalities include dynamic contrast-enhanced ultrasound, handheld vital microscopes, indocyanine green fluorescence angiography, and laser contrast speckle imaging. Dynamic contrast-enhanced ultrasound relays information on deep tissue perfusion and is a commonly used technique to assess tumor perfusion. Handheld vital microscopes provide direct visualization of the sinusoidal architectural structure of the liver, which is a unique feature of this technique. Intraoperative fluorescence imaging uses indocyanine green, a dye that is administered intravenously to visualize microvascular perfusion when excited using near-infrared light. Laser speckle contrast imaging produces non-contact large surface-based tissue perfusion imaging free from movement- or pressure-related artefacts. In this review, we discuss the intrinsic advantages and disadvantages of these techniques and their clinical and/or scientific applications.
Duodenal Duplication Cysts in Children: Clinical Features and Current Treatment Choices
Authors: Dipasquale Valeria , Barraco Paolo , Faraci Simona , Balassone Valerio , De Angelis Paola , Di Matteo Francesco Maria , Dall'Oglio Luigi , Romano Claudio
Published: July 2020

Background: Duodenal duplication cysts are rare gastrointestinal tract malformations. Most patients experience symptom onset in the first decade of life. This review aims to examine clinical presentation, management strategies and outcomes of duodenal duplication cysts in childhood. Methods: A Pubmed/Medline (http://www.ncbi.nlm.nih.gov/pubmed/) search in October 2019 for articles published since 1999 using the keywords “duodenal duplication cyst,” “child” and “newborn” was carried out. Clinical symptoms, complications, diagnostic examinations, treatment options and outcomes were analyzed and tabulated. Results: There were 41 citations in the literature providing adequate descriptions of 45 cases of duodenal duplication cysts. The age of presentation ranged from newborn to 18 years. The median interval between initial presentation and definitive diagnosis and treatment was 17 months (range: 2 months to 12 years). Overall, 67% of cases presented with abdominal pain, and 43% were complicated with pancreatitis. Different surgical and endoscopic therapeutic strategies were reported. Conclusions: Duodenal duplication cysts may be associated with life-threatening complications and/or recurrent symptoms, impairing quality of life. Early recognition of patients who demonstrate suggestive signs and symptoms is important to ensure success of treatment. This review may be useful to highlight the main diagnostic aspects and limit the risk of a delayed diagnosis.
Spatiotemporal Analysis of Breast Cancer Hospitalizations in Portugal in 2002–2016
Authors: Afonso Gomes Inês , Moita Bruno , Nunes Carla
Published: July 2020

Introduction: Breast cancer (BC) is the most common cancer among Portuguese women and it is associated with high hospitalization rates. Therefore, this study aims to characterize the BC hospital admission rate (HAR) in women in the period of 2002–2016, with an additional focus on spatiotemporal patterns of hospitalizations by BC (main code). Methods: After a descriptive analysis of all BC hospitalizations, the main BC code HAR was studied using mapping techniques, analysis of spatiotemporal clusters, and analysis of spatial variations in temporal trends. Results: The BC-HAR was 118.72/105 women, showing a growth of 3.109% per year in this period. The median length of stay (LOS) in these patients was 5 days, and most cases were programmed surgical admissions. Several spatiotemporal clusters and spatial variations in temporal trends were detected. The seaside area of the country showed 4 high HAR clusters in the spatiotemporal analysis. Additionally, the seaside north of the country and 2 isolated counties presented significantly different temporal trends in BC-HAR versus the rest of the country. These clusters suggest regional asymmetries, as they showed differences in terms of: demographic characteristics (age at admission and rurality of county of residence), the type of admission, LOS, and outcomes of hospitalization. Conclusion: This study identified key areas of high BC-HAR and increasing trends for female HAR, providing evidence of spatial heterogeneities in this health indicator.
Cardiac Complications during Pregnancy Related to Parity in Women with Congenital Heart Disease
Authors: Furenäs Eva , Eriksson Peter , Wennerholm Ulla-Britt , Dellborg Mikael
Published: July 2020

Objective: To describe the frequency of cardiac complications during pregnancy related to parity in women with congenital heart defects. Methods: A retrospective tertiary single-center study at the Adult Congenital Heart Disease Centre that followed 307 women with congenital heart disease during the years 1997–2015 in Gothenburg, Sweden. Ma­ternal cardiac complications were noted for each pregnancy using medical and obstetric records. The CARPREG I and modified WHO (mWHO) risk classifications were used. Twin pregnancies, miscarriages before gestational week 13, and pregnancy terminations were excluded. Results: Five hundred seventy-one deliveries and 9 late miscarriages were analyzed. The mean parity was 1.74 per woman (range 1–8). Eighty-four (14.6%) maternal cardiac complications were experienced; arrhythmia (5.7%) and heart failure (4.4%) being the most prevalent, and there was 1 maternal death. Heart failure occurred during the first pregnancy in 12 women (3.9%), in the second pregnancy in 8 women (4.3%), and in the third pregnancy in 4 women (7.7%). CARPREG I and mWHO scores were associated with an increased risk of having a cardiac complication, while parity per se was not associated. The OR for having a maternally uneventful second pregnancy if the first pregnancy was without cardiac complications was 5.47 (95% CI 1.76–16.94) after controlling for CARPREG I and mWHO scores. Conclusion: The risk of severe maternal cardiac complications during pregnancy in women with congenital heart disease is low. In this largest analysis to date with a focus on parity in 307 women, the risk classification predicts the maternal outcome more than parity per se. If the first pregnancy is uneventful, the OR is 5.5 for an uneventful second pregnancy if CARPREG I and mWHO scores remain unchanged.
Efficacy of Thalidomide in Discoid Lupus Erythematosus: Insights into the Molecular Mechanisms
Authors: Domingo Sandra , Solé Cristina , Moliné Teresa , Ferrer Berta , Ordi-Ros Josep , Cortés-Hernández Josefina
Published: July 2020

Background: Thalidomide has been used successfully in a variety of chronic refractory inflammatory dermatological conditions with underlying autoimmune or infectious pathogenesis. It was first used for refractory discoid lupus erythematosus (DLE) in 1983 and has steadily grown since then. Method: In this review, we describe the therapeutic benefits of thalidomide for DLE treatment and its biological properties. We explain how new discoveries in DLE pathogenesis are relevant to understand thalidomide’s mechanism of action and the need to find an alternative safe drug with similar therapeutic effects. Summary: Thalidomide’s efficacy in DLE patients is significant, with 80–90% reaching clinical remission according to different studies. However, thalidomide’s use is still limited by serious adverse effects such as teratogenicity, neurotoxicity, and thrombosis. In addition, there is a frequent rate of relapse and many patients require a long-term low dose of thalidomide as maintenance. The achievement of clinical response within weeks is key to avoid irreversible DLE fibrotic sequelae, making it critical to introduce thalidomide earlier in the DLE treatment algorithm. Recently, microarray and miRNA screenings demonstrated a significant CD4+ T enrichment and T-helper 1 response predom­inance with a dysregulation of regulatory T cell (Treg) expression in DLE lesions that induced high levels of proinflammatory, chemotaxis, and apoptotic proteins that induce the chronic inflammation response. Thalidomide’s anti-inflammatory, antiangiogenic, and T-cell co-stimulatory effects may be beneficial for DLE since it promotes cytokine inhibition, inhibits macrophage activation, regulates Treg responses, inhibits angiogenesis, modulates T cells, and promotes NK cell-mediated cytotoxicity.
Association of Testosterone Levels and Steroid 5-Alpha-Reductase 2 Polymorphisms with Opioid Craving
Authors: Janke Eva , Groh Adrian , Mühle Christiane , Dürsteler-MacFarland Kenneth M. , Wiesbeck Gerhard A. , Kornhuber Johannes , Jahn Kirsten , Groeschl Michael , Lichtinghagen Ralf , Frieling Helge , Bleich Stefan , Hillemacher Thomas , Lenz Bernd , Heberlein Annemarie
Published: July 2020

Background/Aims: Opioid dependence is a severe disease which is associated with a high risk of relapse, even in cases of successful withdrawal therapy. Studies have shown alterations of the hypothalamic-pituitary-gonadal axis in opioid-dependent patients, such as decreased testosterone serum levels in affected males. Sex hormones and the steroid 5-alpha-reductase 2 (SRD5A2) V89L polymorphism are associated with craving during alcohol withdrawal, but little is known about their impact on symptomatology of opioid dependence. Methods: In this study, we analyzed 2 independent male cohorts of opioid-dependent patients for possible alterations in testosterone serum levels compared to non-opioid-dependent controls. In one of the cohorts, we additionally investigated associations of testosterone serum levels and 3 SRD5A2 polymorphisms with symptoms of opioid dependence, measured by the Heroin Craving Questionnaire (HCQ). Results: In the patient groups, we found significantly decreased testosterone serum levels compared to the control groups. Furthermore, we found significant associations of both the testosterone serum levels and the SRD5A2 V89L polymorphism with opioid craving assessed by the HCQ. Conclusion: Our data show a possible role of testosterone metabolism in opioid dependence, which may be relevant for the establishment of future treatment strategies.
Ocular Myasthenia Gravis with Severe Blepharitis and Ocular Surface Disease: A Case Report
Authors: Arnon Roee , Yahalomi Tal , Rozen-Knisbacher Irit , Pikkel Joseph , Mostovoy Dina
Published: July 2020

Ocular myasthenia gravis (OMG) is an autoimmune disease of the neuromuscular junction and commonly associated with other immune diseases. We describe a 16-year-old female who presented to our clinic with 1-month complaints of diplopia and strabismus, visual acuity deterioration, and ocular irritation. Her examination showed crossed diplopia and alternating exotropia of 25 prism diopters, severe blepharitis, conjunctival hyperemia, corneal pannus, epithelial irregularities, and subepithelial opacities. Workup included pediatric neurologic examination, laboratory tests, imaging, and electrophysiological tests. Diagnoses of OMG and blepharitis with ocular surface disease were made. Topical treatment included eyelid hygiene, tea tree oil scrubbing, topical steroids, and tacrolimus ointment. Systemic treatment included corticosteroids, pyridostigmine, azathioprine, intravenous immunoglobulins, amitriptyline, and doxycycline. Both diseases were refractory to intensive immunosuppressive treatment and had simultaneous relapses and an intertwined course. Our hypothesis is that a shared immune mechanism may be the cause of both OMG and ocular surface disease in our patient.
Once Weekly Application of Urea 40% and Bifonazole 1% Leads to Earlier Nail Removal in Onychomycosis
Authors: Shemer Avner , Eshel Yossi , Gupta Aditya K. , Farhi Renata , Haneke Eckart , Daniel Carlton Ralph , Foley Kelly , Quinlan Emma M.
Published: July 2020

Introduction: Onychomycosis is a chronic nail fungal infection resulting in nail damage and a decreased quality of life. Chemical avulsion of the nail with urea and bifonazole ­removes fungally infected debris, increasing antifungal treatment efficacy and penetration. Previous clinical ob­servations describe patients who applied their urea and ­bifonazole ointment less frequently, achieving earlier nail removal. In this study, we analyzed the relationship between duration of urea and bifonazole application and time to nail avulsion. Methods: χ2 tests, multiple regression analysis, and ANOVA were performed to analyze the similarities between treatment regimens (daily, every 3 days, or once a week), association of regimens or patient characteristics to nail removal, and compare time to nail removal between each regimen, respectively. Results: Daily application of ointment and sealing resulted in an average length of time (±SD) to nail removal of 18.7 days (±6.8 days); once every 3 days resulted in nail removal at 12.7 days (±6.2 days) and once per week at 11 days (±4.46 days) (p < 0.001). Age was the only patient factor that affected duration to nail removal. Conclusion: Once weekly application of ointment with sealing for a 1-week duration is associated with a decrease in time to complete chemical avulsion of the nail by approximately 1 week.
Effects of Substance Misuse and Family History of Substance Use Disorder on Delay Discounting in Adolescents and Young Adults with Attention-Deficit/Hyperactivity Disorder
Authors: Paraskevopoulou Maria , van Rooij Daan , Schene Aart H. , Scheres Anouk P.J. , Buitelaar Jan K. , Schellekens Arnt F. A.
Published: July 2020

Background: Attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-occur. Both disorders are characterized by impulsive choice. However, little is known about the effects of substance misuse (SM) and family history of SUD (FH) on impulsive choice in ADHD-SUD comorbidity. Impulsive choice is also linked to callous-unemotional (CU) traits, which are suggested to play a role in ADHD-SUD comorbidity. Our aim was to examine the effects of (1) FH and (2) SM on impulsive choice, while exploring the role of CU traits. Methods: Impulsive choice was assessed with the delay discounting (DD) task. We compared task performance across (1) ADHD patients and controls with or without FH of SUD (ADHD FH+: n = 86; ADHD FH−: n = 63; control FH+: n = 49; control FH−: n = 72; mean age of the whole sample [n = 270]: 16.39, SD: 3.43) and (2) family history-matched ADHD groups with and without SM and controls (ADHD + SM: n = 62; ADHD-only: n = 62; controls: n = 62; mean age of the whole sample [n = 186]: 18.01, SD: 2.71). Effects of CU traits were explored by adding this as a covariate in all analyses. Results: (1) There was no main effect of FH on DD. (2) We found increased DD in ADHD + SM compared to ADHD-only and no difference between ADHD-only and controls. Finally, increased DD was associated with increased callous traits only in ADHD FH+ and control FH+. Conclusions: In adolescents and young adults with ADHD, high impulsive choice might only be present in those with comorbid SM and in an FH+ subgroup with high callous traits. This suggests that impulsive choice in ADHD might result from (1) effects of SM and (2) a combined effect of SUD vulnerability and high callousness. Future studies should investigate efficacy of early interventions, targeting CU traits.
Variabilidade da frequência cardíaca na recuperação pós-exercício máximo em jovens sobrepesos
Authors: Tricot Gabriel Kolesny , Araújo Jaqueline Alves de , Arsa Gisele , Cambri Lucieli Teresa
Published: July 2020

O objetivo deste estudo foi analisar a variabilidade da frequência cardíaca (VFC) na recuperação ativa em jovens com diferentes índices de massa corporal (IMC) e associar as variáveis em repouso e recuperação. Dezoito jovens, eutróficos – E (22,36 ± 1,92 kg.m-2) e sobrepesos – S (29,71 ± 2,97 kg.m-2), foram avaliados. A frequência cardíaca (FC) e os índices de VFC (RMSSD e SDNN) em repouso, exercício e na recuperação após exercício máximo durante 5 minutos, assim como, as áreas sob a curva da VFC, foram analisadas. O consumo máximo de oxigênio – VO2máx – foi menor (p<0,05) nos jovens sobrepesos. Os índices LnRMSSD30s e LnSDNN30s ao final do exercício (E: 0,46 ± 0,11 e 0,75 ± 0,12; S: 0,58 ± 1,15 e 0,73 ± 0,12 ms) estão reduzidos em relação ao repouso (E: 1,56 ± 0,11 e 1,72 ± 0,13; S: 1,42 ± 0,11 e 1,65 ± 0,23 ms), e permaneceram inferiores (p<0,05) ao final da recuperação (E: 0,54 ± 0,23 e 0,67 ± 0,24; S: 0,47 ± 0,23 e 0,67 ± 0,23 ms) sem diferença entre os grupos. Além disso, as variáveis morfológicas associam-se (p<0,05) à aptidão aeróbia (r= -0,71 a -0,76), e a FC aos índices da VFC nos diferentes momentos fisiológicos. Em conclusão, não há reativação vagal após 5 minutos de recuperação ativa de um exercício máximo em jovens, com comportamento similar entre eutróficos e sobrepesos. Igualmente, as variáveis morfológicas associam-se inversamente à aptidão aeróbia, e a FC aos índices de VFC nos diferentes momentos fisiológicos.
Práticas de prescrição e controle de treino no remo
Authors: Vaz Marcelo Dos Santos , Miarka Bianca , Costa Oguener José Tissot da , Del Vecchio Fabrício Boscolo
Published: July 2020

Atualmente, não existem referenciais publicados no Brasil sobre o contexto real de treinamento para futuras prescrições e conduções de pesquisas com intervenções no remo. Por isso, o presente estudo objetivou mostrar a prescrição e o controle do treino de equipes de diferentes países participantes da 2014 World Rowing Coaches Conference. Para isso, dezoito sujeitos (oito brasileiros, dois australianos, dois suecos, um húngaro, um neozelandês, um italiano, um chinês, um peruano e um dinamarquês), responderam um questionário aplicado. Em água, as prescrições mostram prevalência de 56% até 67% de treinos contínuos em baixa/moderada intensidade (≤4mmol.L-1), sem diferença estatística entre as nacionalidades (χ2=0,57 p=0,44). As prescrições de treinamento com pesos mostraram uma frequência semanal de três sessões em 95% dos casos, com mais de 60 min de duração. Dentre os exercícios considerados mais importantes nas prescrições, destacam-se: i) agachamento, ii) remada em decúbito ventral, iii) levantamentos olímpicos, iv) supino e vi) levantamento terra. Esses dados fornecem importantes referenciais para futuras pesquisas e para aplicações práticas na prescrição de treinos contextualizados e específicos para o remo.
Saúde e lazer
Authors: Silva Cinthia Lopes da , Robinson Tomeka , Libardi Natalia , Sordi Lucas Roberto Alves Ribeiro de , Origuela Milena Avelaneda , Ferreira Rosana De Almeida e , Valdez Danny , Clemens Cody M. , Hendershot Vicent
Published: July 2020

O objetivo deste trabalho foi identificar e analisar os significados que graduandos em Educação Física e cursos afins atribuem à atuação profissional no campo da saúde e sua compreensão sobre lazer. Tradicionalmente, a área da Educação Física e cursos afins tem recebido forte influência das Ciências Naturais, e essa tradição tem influenciado a atuação do profissional no campo da saúde. O problema desta orientação, muitas vezes exclusivamente biomédica, é que os profissionais se deparam com um fazer profissional centrado na prescrição de exercícios e não entendem como lidar com a saúde das pessoas considerando aspectos como a subjetividade, a questão cultural, o cuidado à saúde. Como procedimentos metodológicos utilizamos revisão bibliográfica e pesquisa de campo, a partir de entrevistas semiestruturadas com estudantes de graduação em Educação Física e cursos afins brasileiros e americanos, caracterizando este estudo como qualitativo. Os resultados deste estudo indicam que os graduandos em Educação Física e cursos afins compreendem a finalidade de sua atuação relacionada à qualidade de vida, bem-estar, saúde e ausência de doença. Além disso, a maioria dos entrevistados compreende o lazer somente a partir do descanso, desconsiderando as possibilidades de diversão e desenvolvimento pessoal e social. Concluímos, portanto, que a visão dos participantes da pesquisa com relação a saúde e lazer mostrou-se ainda inicial, sendo fundamental para que tenham uma atuação profissional futura efetiva o acesso ao referencial tanto das ciências biológicas como das humanidades.
A construção da identidade na socialização profissional de treinadores
Authors: Rodrigues Heitor De Andrade , Paes Roberto Rodrigues , Souza Neto Samuel De
Published: July 2020

O presente estudo teve como objetivo analisar o processo de constituição da identidade profissional em treinadores de jovens atletas de basquetebol. Optou-se pela metodologia qualitativa, na perspectiva etnossociológica, baseada nos pressupostos da narrativa de vida de 13 treinadores de basquetebol, utilizando a entrevista narrativa como técnica para coleta de dados. Os resultados revelaram que o processo de constituição da identidade profissional dos treinadores é fruto de socializações sucessivas no curso de suas vidas pessoais e profissionais. A identidade dos treinadores emergiu da interação entre trajetórias biográficas e relacionais, confirmando a relevância da experiência no campo profissional adquirida por meio da imersão na cultura do esporte. Esta, por um lado, é fortemente marcada por uma educação artesanal, “escola de ofício”, em que o aprendiz aprende com um mestre e, por outro lado, é questionada pelos mecanismos de formação dos cursos de Educação Física. Por fim, à guisa de conclusão, identificou-se a emergência de dois perfis identitários entre os treinadores pesquisados, quais sejam: a identidade de ofício e a identidade em mobilidade.