bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyponatremia and Renal Venous Congestion in Heart Failure Patients
Authors: Caraba Alexandru , Iurciuc Stela , Munteanu Andreea , Iurciuc Mircea
Published: August 2021

Objective. The interrelationship between the heart and kidneys has a great importance in the homeostasis of the cardiovascular system. Heart failure patients present intrarenal arterial hypoperfusion and intrarenal venous congestion due to reduced left ventricle ejection fraction, which triggers numerous neurohormonal factors. The aim of this study was to investigate intrarenal vascularization (arterial and venous), as well as the links between it and systemic congestion and, on the other side, with the mortality in patients with heart failure. Material and Methods. This cross-sectional study was performed on a group of 44 patients with heart failure in different stages of evolution and 44 healthy subjects, matched for age and gender, as controls. Serum natremia, NT-proBNP, and creatinine analyses were performed in all patients and controls. Renal and cardiac ultrasonography was done in all patients and controls, recording intrarenal arterial resistive index (RRI), intrarenal venous flow (IRVF) pattern, renal venous stasis index (RVSI), and left ventricular ejection fraction (LVEF). Data are recorded and presented as

mean
±
standard
 
deviation

. Statistical analyses were performed using the Student

t

-test, ANOVA test, and the Pearson correlation. Differences were considered statistically significant at the value of

p
<
0.05

. Results. Hyponatremia was identified in 47.72% of the HF patients. This study revealed correlations between serum natremia and LVEF, NT-proBNP, serum creatinine, interlobar venous RVSI (

p
<
0.00001

), and interlobar artery RRI (

p
≤
0.002

). Hyponatremia and renal venous congestion represent negative prognostic factors in HF patients. Conclusion. In HF patients, hyponatremia was correlated with cardiac dysfunction and intrarenal venous congestion. Hyponatremia and renal venous congestion represented negative prognostic factors in HF patients.
Effect of Crack Propagation on Mining-Induced Delayer Water Inrush Hazard of Hidden Fault
Authors: Du Yanhui , Liu Weitao , Meng Xiangxi , Pang Lifu , Han Mengke
Published: August 2021

Hidden faults in deep coal seam floor threaten the exploitation of coal resources. Under the influence of mining and water confined in the floor, the cemented filler in the hidden fault will be eroded by water flow, in order to investigate the fracture characteristics and water inrush risk of hidden faults in floors above confined aquifer. Using the 27305 working face as geological background, the influence of the seepage scouring filler on the mechanism of water inrush from hidden faults was assessed by developing a stress-seepage coupling model and employing the finite difference method to simulate the seepage process of hidden faults under the combined action of high ground stress and high confined water. The evolution of seepage, shear stress, and plastic zone was also assessed. The influence of the hydraulic pressure of the aquifer and the thickness of a waterproof rock floor on the formation of the water inrush pathway was analyzed. Results indicate that (1) under the influence of mining, the hidden fault experienced the change process of stress stability, stress concentration, and stress release. The shear stress increases first and then decreases. The compressive stress decreases gradually due to stress release. (2) Water inrush disaster will not occur immediately when the working face is above the hidden fault. The delayed water inrush occurs in the mined-out area when the working face advances to 160 m, the floor failure zone is connected with the hidden fault failure zone, and the delayed water inrush channel is formed. (3) With the mining advances, the water pressure of aquifer is the same. The larger-angle fault leads to the thinner thickness of floor aquifer. The greater the influence of hidden fault on coal seam mining, the higher the danger of water inrush.
Practice on Metered Dose Inhaler Techniques and Its Associated Factors among Asthmatic Patients at Debre Markos Comprehensive Specialized Hospital, East Gojjam, Ethiopia: A Prospective Study
Authors: Asmare Tadele , Belayneh Anteneh , Dessie Bekalu
Published: August 2021

Background. Asthma stands 16th among the leading causes of years lived with disability and 28th among the leading causes of disease in the world. A metered-dose inhaler remains the principal route for drug administration, and it has greater advantages over systemic treatment. In routine use, however, a majority of patients make inhalation errors. Suboptimal inhaler technique worsens health outcomes, with poor disease control, and increases the risk of hospitalization. This study aimed to assess practice metered-dose inhalation techniques and associated factors among asthmatic patients at Debre Markos Comprehensive Specialized Hospital, East Gojjam, Amhara region, Ethiopia. Methods. Prospective cross-sectional study was conducted from July 15 to August 30, 2020. Data were collected through a semistructured questionnaire. The data were analyzed using SPSS version 25. Associations between dependent and independent variables were assessed by using binary and multiple logistic regressions.

P

values less than 0.05 were considered to be statistically significant in all cases. Results are presented in tables, figures, numbers, and percentages. Result. A total of 166 patients had involved in the study, of which 52.4% were females. One hundred and eleven (66.9%) participants had good knowledge of asthma and inhalational techniques, while the rest of them had poor knowledge. One hundred and eight (65.1%) patients had effective practice on metered-dose inhaler use techniques. Participant's knowledge regarding asthma and meter dose inhaler and marital status has a significant association with their practice of metered-dose inhaler techniques with

P

value 0.001 and 0.006, respectively. Conclusion. In this study, most participants are suffering from asthma for a long duration and they have repeated exacerbation. Around two-thirds of patients had good knowledge regarding asthma and metered-dose inhaler and practice on metered-dose inhaler techniques. Participants with poor knowledge had poor practice on metered-dose inhaler techniques, and single patients were less likely to have poor practice on metered-dose inhaler techniques. Health education and counseling services should be consistently provided to the clients regarding the proper steps of inhalers use.
Angiopoietin-Like Proteins 2 and 3 in Children and Adolescents with Obesity and Their Relationship with Hypertension and Metabolic Syndrome
Authors: Arab Sadeghabadi Zahra , Nourbakhsh Mitra , Alaee Mohammad , Nourbakhsh Mona , Ghorbanhosseini Seyedeh Sara , Sharifi Roya , Razzaghy-Azar Maryam
Published: August 2021

Background. Angiopoietin-like protein 2 (ANGPTL2) is one of the adipocyte-derived inflammatory factors which connects obesity to insulin resistance. ANGPTL3 has a direct role in regulation of lipid metabolism. The objective of this study was to evaluate ANGPTL2 and ANGPTL3 in childhood obesity and their relationship with metabolic syndrome. Methods. 70 children and adolescents, 35 obese and 35 normal-weight subjects, were enrolled in this research after complete clinical examination and anthropometric evaluations. Serum ANGPTL2 and ANGPTL3 and insulin were measured by enzyme-linked immunosorbent assay (ELISA). Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated and used to estimate insulin resistance (IR). Colorimetric methods were used for the assessment of fasting plasma glucose (FPG), LDL-C, HDL-C, total cholesterol (TC), and triglyceride (TG). Results. The levels of ANGPTL2 and ANGPTL3 were significantly higher in obese subjects than those in controls, but they did not differ significantly in subjects with or without IR. ANGPTL3 was found to be significantly elevated in obese children with metabolic syndrome (MetS) in comparison with those without MetS. Both of the studied ANGPTLs were positively correlated with BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), TC, and LDL-C. The correlation between ANGPTL3 and either TC or LDL-C remained significant after adjusting for BMI. Conclusion. Serum ANGPTL2 and ANGPTL3 were elevated in obesity and associated with blood pressure and indices of metabolic syndrome, suggesting that they might be involved in the advancement of obesity-related hypertension and metabolic syndrome.
Environment Effect on the Rutting Resistance of Nano‐SiO2‐Modified Asphalt Concrete: Temperature and Water
Authors: Chen Luchuan , Gu Wenjun , Zhang Xuanyu
Published: August 2021

Nanoparticles have been widely adopted to improve the high‐temperature performance of asphalt binder. However, the influence of moisture on high‐temperature performance is not clear. Hence, the water absorption performance of the nano‐SiO2‐modified asphalt concrete is investigated. Based on this, to further analyze the pavement performance of the nano‐SiO2‐modified asphalt concrete, the coupled effects of high‐temperature, moisture content, and nanoparticles content on the rutting resistance of the nano‐SiO2‐modified asphalt concrete are tested and revealed in this study. Results show that temperature has the most significant influence on the water absorption performance of the nano‐SiO2‐modified asphalt concrete. The rutting resistance of the nano‐SiO2‐modified asphalt concrete decreases as temperature and moisture content increase, especially for the temperature. The dynamic stability at the same temperature condition decreases approximately linearly as moisture content increases. The effect of the nano‐SiO2 content is the most nonobvious.
Management of Groin Pain Using an Iliohypogastric Nerve Block in a Patient with Inguinal Hernia due to Persistent Müllerian Duct Syndrome
Authors: Sekito Takanori , Sadahira Takuya , Sugihara Masahiro , Edamura Kohei , Araki Motoo , Nasu Yasutomo
Published: August 2021

Persistent Müllerian duct syndrome can cause an inguinal hernia, although this is a rare occurrence; recurrent inguinal hernias can, in turn, cause ongoing groin pain. Management of groin pain plays an important role in patients’ quality of life. We present our experience with a 43-year-old man who had a 2-week history of left-sided groin pain. The patient underwent laparoscopic surgery for a left inguinal hernia via the transabdominal preperitoneal approach. Right-sided cryptorchidism was noted during surgery, with a solid structure—thought to be a uterus—extending into the left inguinal canal. The diagnosis was persistent Müllerian duct syndrome, and the groin pain was relieved after a laparoscopic right orchiectomy with a bilateral preperitoneal hernia repair using a mesh. Four years later, magnetic resonance imaging performed for new-onset left groin pain showed a left inguinal hernia caused by the uterine structure. We diagnosed the recurrent hernia as the cause of his pain. Prior to performing any invasive surgical procedures, an iliohypogastric nerve block was performed using 1% lidocaine. Short-term analgesia was provided by the block, improving his quality of life. He has been followed since then and has declined surgical neurectomy. An iliohypogastric nerve block can be an effective method of controlling groin pain caused by an inguinal hernia resulting from persistent Müllerian duct syndrome; the effectiveness of the nerve block will help determine whether surgical neurectomy is indicated for permanent pain control.
Clinical Value of Body Mass Index and Waist-Hip Ratio in Clinicopathological Characteristics and Prognosis of Uterine Leiomyomata
Authors: Pan Hanyi , Qin Feiyong , Deng Fengyun
Published: August 2021

Objective. To explore the relationship between body mass index (BMI) and waist-to-hip ratio (WHR) and clinicopathological characteristics and prognosis of uterine leiomyomata (UL). Methods. A retrospective analysis of the clinical data of 133 patients with UL admitted to our hospital from September 2018 to August 2019. According to the BMI standard, the patients were divided into the normal group (n = 32), the super-recombination group (n = 45), and the obesity group (n = 56). According to WHR, the patients were divided into the normal body group (n = 32) and the obesity body group (n = 101). The prognosis of all patients with UL at 3 months postoperatively was evaluated. The relationship between BMI patients and clinical characteristics in different groups was compared, and univariate analysis and multivariate logistic regression model were used to analyze the factors affecting the prognosis of UL patients. Results. The proportion of UL patients in the overweight/obese group was higher than that of the normal group, the proportion of the obese body group was higher than that of the normal body group, and the proportion of the good prognosis group was higher than that of the poor prognosis group (

P
<
0.05

). The difference between the overweight/obese group and the normal group and the obese body group and the normal body group was irregular vaginal bleeding, the number of tumors, and the diameter of the lesion (

P
<
0.05

), and the differences between the degenerations in the obese body group and the normal body group were statistically significant (

P
<
0.05

). Multivariate analysis showed that BMI, WHR, surgical method, and tumor location were all independent risk factors that affected the prognosis of the surgery (

P
<
0.05

). Conclusion. Elevated BMI and WHR can be accompanied by an increased risk of UL. Obesity is a risk factor for UL. Overweight/obese women are more clinically pathological than normal patients, and overweight/obese patients have worse surgical prognosis than normal patients. In order to reduce the prevalence of UL and improve the clinicopathological characteristics and prognosis of patients, clinically obese women should be instructed to use reasonable diet and exercise to control weight.
Time‐Frequency Analysis of EEG Signals and GLCM Features for Depth of Anesthesia Monitoring
Authors: Mousavi Seyed Mortaza , Asgharzadeh-Bonab Akbar , Ranjbarzadeh Ramin
Published: August 2021

One of the important tasks in the operating room is monitoring the depth of anesthesia (DoA) during surgery, and noninvasive techniques are very popular. Hence, we propose a new scheme for DoA monitoring considering the time‐frequency analysis of electroencephalography (EEG) signals and GLCM features extracted from them. To this end, at first, the time‐frequency map (TFM) of each channel of each EEG is computed by smoothed pseudo‐Wigner–Ville distribution (SPWVD), where the EEG signal used in this paper is recorded in 15 channels. After that, we consider the gray‐level co‐occurrence matrix (GLCM) to obtain the content of TFM, and after that, four features such as homogeneity, correlation, energy, and contrast are obtained for each GLCM. Finally, after the selection of efficient features using the minimum redundancy maximum relevance (MRMR) method, the K‐nearest neighbor (KNN) classifier is utilized to determine the DoA. Here, we consider the three states, namely, deep hypnotic, surgical anesthesia, and sedation and awake states according to bispectral index (BIS), and each EEG epoch is classified to these states. We also employ data augmentation to enhance the training phase and increase accuracy. We obtain the accuracy and confusion matrix of the proposed method. We also analyze the effects of a number of gray levels of GLCM, distance measure in KNN classifier, and parameters of data augmentation on the performance of the proposed method. Results indicate the efficiency of the proposed method to determine the DoA during surgery.
Characteristics of Raindrop Size Distribution in Typhoon Nida (2016) before and after Landfall in Southern China from 2D Video Disdrometer Data
Authors: Feng Lu , Liu Xiantong , Xiao Hui , Xiao Liusi , Xia Feng , Hao Xiao , Lu Haiqi , Zhang Chenxian
Published: August 2021

During the passage of Typhoon Nida, the raindrop size distribution parameters, the raindrop spectra, the shape and slope (μ–Λ) relationship, the radar reflectivity factor, and rain rate (Z–R) relationship were investigated based on a two-dimensional (2D) video disdrometer in Guangdong, China, from August 1 to 2, 2016. Due to the underlying surface difference between the ocean and land, this process was divided into two distinct periods (before landfall and after landfall). The characteristics of raindrop size distribution between the period before landfall and the period after landfall were quite distinct. The period after landfall exhibited higher concentrations of each size bin (particularly small drops) and wider raindrop spectral width than the period before landfall. Compared with the period before landfall, the period after landfall had a higher average mass-weighted mean diameter Dm that was smaller than those of other TCs from the same ocean (the Pacific). The μ–Λ relationship and Z–R relationship in this study were also compared with other TCs from the same ocean (the Pacific). This investigation of the microphysical characteristics of Typhoon Nida before landfall and after landfall may improve radar quantitative precipitation estimation (QPE) products and microphysical schemes by providing useful information.
The Reciprocal Influence Criterion: An Upgrade of the Information Quality Ratio
Authors: Rossi Riccardo , Gelfusa Michela , De Masi Filippo , Ossidi Matteo , Murari Andrea
Published: August 2021

Understanding and quantifying the mutual influence between systems remain crucial but challenging tasks in any scientific enterprise. The Pearson correlation coefficient, the mutual information, and the information quality ratio are the most widely used indicators, only the last two being valid for nonlinear interactions. Given their limitations, a new criterion is proposed, the reciprocal influence criterion, which is very simple conceptually and does not make any assumption about the statistics of the stochastic variables involved. In addition to being normalised as the information quality ratio, it provides a much better resilience to noise and much higher stability to the issues related to the determination of the involved probability distribution functions. A conditional version, to counteract the effects of confounding variables, has also been developed, showing the same advantages compared to the more traditional indicators. A series of systematic tests with numerical examples is reported, to compare the properties of the new indicator with the more traditional ones, proving its clear superiority in practically all respects.
Numerical Simulation of Coupled Thermal-Hydrological-Mechanical-Chemical Processes in the Spontaneous Combustion of Underground Coal Seams
Authors: Liang Yuntao , Zhou Rui
Published: August 2021

In this study, we develop a fully coupled thermal-hydrological-mechanical-chemical (THMC) model to analyze the spontaneous combustion process of underground coal seams, focusing on investigating the influences of the pressure difference between oxygen and coal, the rate of coal-oxygen reaction heat, and the activation energy. The simulation results show that as oxygen propagates into the coal seams, the coal-oxygen reaction causes the spontaneous combustion of coal to heat. The consumption of oxygen leads to an increase in oxygen consumption along the way and a decrease in gas pressure. The permeability near the right boundary increases while significantly reducing the area far away from the right boundary as the predominant effect of spontaneous combustion. Additionally, a sensitivity study shows that a more considerable pressure difference and coal-oxygen reaction heat contribute to promoting the coal temperature, while the activation energy has a slight effect. Moreover, an increase in coal-oxygen reaction heat and activation energy accelerates the oxygen consumption rate and thus causes a lower oxygen concentration. Overall, the results provide a basis for the prediction and prevention of coal seam spontaneous combustion.
Complete Heart Block as a Clinical Feature in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients: A Case Series of Three Cases
Authors: Ahmad Farook , Gandre Priti , Nguekam Julien , Wall Alanna , Ong ShiYu , Karuppamakkantakath Abdul N. , Tasopoulos Konstantinos , Sadiq Muhammad Athar , Kasim Sazzli , Cuesta Jeronimo M.
Published: August 2021

Background. Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. However, there have been very few reports on complete heart block (CHB) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of critically ill COVID-19 patients complicated by CHB. Case Summary. We present three cases of new-onset CHB in critically ill COVID-19 patients. Patient 1 is a 41-year-old male with well-documented history of Familial Mediterranean Fever (FMF) who required mechanical ventilator support for acute hypoxic respiratory failure from severe COVID-19 pneumonia. He developed new-onset CHB without a hemodynamic derangement but subsequently had acute coronary syndrome complicated by cardiogenic shock. Patient 2 is a 77-year-old male with no past medical history who required intubation for severe COVID-19 pneumonia acute hypoxic respiratory failure. He developed CHB with sinus pause requiring temporary pacing but subsequently developed multiorgan failure. Patient 3 is 36-year-old lady 38 + 2 weeks pregnant, gravida 2 para 1 with no other medical history, who had an emergency Lower Section Caesarean Section (LSCS) as she required intubation for acute hypoxic respiratory failure. She exhibited new-onset CHB without hemodynamic compromise. The CHB resolved spontaneously after 24 hours. Discussion. COVID-19-associated CHB is a very rare clinical manifestation. The potential mechanisms for CHB in patients with COVID-19 include myocardial inflammation or direct viral infiltration as well as other causes such as metabolic derangements or use of sedatives. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and hemodynamic instability.
lncRNA MSTRG.29039.1 Promotes Proliferation by Sponging hsa‐miR‐12119 via JAK2/STAT3 Pathway in Multiple Myeloma
Authors: Liu Zhaoyun , Han Mei , Meng Nanhao , Luo Jingyi , Fu Rong
Published: August 2021

Noncoding RNA (ncRNA) is involved in the occurrence, development, metastasis, and drug resistance of tumors and involves a variety of biological functions. In addition, miRNA can regulate proliferation and migration and even regulate epigenetics to promote the development of multiple myeloma (MM). However, the mechanism of ncRNA involved in MM is still unclear, and there are many unknown ncRNAs to be explored. This research is aimed at discovering the unknown lncRNA in MM through high‐throughput sequencing and to study the mechanism and role of competitive endogenous RNA (ceRNA) involved in the pathogenesis of MM for the development of novel molecular markers and potential new targeted drugs. We screened out 262 new lncRNAs with statistical differences by RNA sequencing and selected the lncRNA MSTRG.29039.1 according to the expression and function of lncRNAs and their target genes in MM. We verified that MSTRG.29039.1 and its target gene OSMR were highly expressed in MM. After knockdown of MSTRG.29039.1 in MM cell lines, the expression of OSMR was decreased, and the expression of hsa‐miR‐12119 was upregulated which can also promote cell apoptosis and inhibit proliferation. Then, we knocked down hsa‐miR‐12119 and MSTRG.29039.1, we found that apoptosis of MM cells was reduced, and cell proliferation was increased compared with just knocking down hsa‐miR‐12119. We further verified the direct binding relationship between MSTRG.29039.1 and OSMR by the dual‐luciferase reporter assay system. Thus, MSTRG.29039.1 can competitively bind with miRNA to counteract the inhibitory effect of miRNA on OSMR, which regulates cell proliferation and apoptosis through the JAK2/STAT3 pathway. In a conclusion, lncRNA MSTRG.29039.1 could promote proliferation by sponging hsa‐miR‐12119 via the JAK2/STAT3 pathway in multiple myeloma. This may be a molecular marker and a potential therapeutic target for MM.
Changes in Pharyngeal Airway Space and Craniocervical Angle after Anterior Bimaxillary Subapical Osteotomy
Authors: Cheng Jung-Hsuan , Chen Chun-Feng , Chen Ping-Ho , Hsu Kun-Jung , Chen Han-Sheng , Chen Chun-Ming
Published: August 2021

Purpose. This study explored the effects of genioplasty (Gep) and anterior subapical osteotomy of the maxilla and mandible (ASOMx+ASOMd) on the pharyngeal airway dimensions of patients with bimaxillary protrusion (BiP). Method. Thirty‐two patients were divided into 2 groups. Group 1 received ASOMx+ASOMd, and group 2 received ASOMx+ASOMd+Gep. The cephalograms of the patients were collected before surgery and 2 months after surgery. Changes in the landmarks, related cephalometric angles (gonial, SN‐GoGn, Y‐axis, and SN‐C2C4 angles), and 2 pharyngeal airway dimensions (uvulo‐pharyngeal airway [UOP] and tongue–pharyngeal airway [TOP]) were analyzed. Results. Before surgery, the parameters (incisor superius, incisor inferius, menton, most superior and anterior point of the hyoid bone, tip of the uvula, inferoanterior point on the second cervical vertebra, and inferoanterior point on the fourth cervical vertebra) and measured angles (SNA, SNB, ANB, gonial, SN‐GoGn, Y‐axis, and C4C2‐SN) of both groups showed no significant differences. Following ASOMx, the patients in groups 1 and 2 exhibited a setback by 7.0 and 6.6 mm, respectively. After ASOMd, groups 1 and 2 exhibited 4.9 and 5.3 mm setbacks, respectively. No significant difference in the amount of setback was observed between groups 1 and 2. The postoperative horizontal and vertical positions of Me in group 2 were significantly forward by 6.1 mm and upward by 1.5 mm, respectively. Regarding pharyngeal airway dimensions, TOP was decreased in group 1 (1.7 mm) and group 2 (1.3 mm). In the postoperative Pearson correlation coefficient test, the horizontal and vertical positions of Me showed no significant correlation with TOP in both groups. Therefore, Gep did not prevent the reduction of TOP in group 2. Conclusion. After bimaxillary anterior subapical osteotomy, the TOP of patients with BiP was decreased, and this situation was unavoidable, regardless of whether Gep was performed.
Therapeutic Applications of Nanozymes in Chronic Inflammatory Diseases
Authors: Wang Haojue , Cui Zichen , Wang Xuan , Sun Shui , Zhang Dongsheng , Fu Chuanyun
Published: August 2021

Since the discovery of horseradish peroxidase‐like activity of magnetite nanoparticles in 2007, many researchers have investigated different types of nanoparticles that show enzyme‐like activities, namely, nanozymes. Nanozymes possess high efficiency, stability, and low production costs compared to natural enzymes. Thus, nanozymes have already been widely studied in various domains including medical science, food industry, chemical engineering, and agriculture. This review presents the utilization of nanozymes in medicine and focuses particularly on their therapeutic applications in chronic inflammatory diseases because of their antioxidant‐like activity. Furthermore, the treatment of chronic inflammatory diseases with nanozymes of different materials was introduced emphatically.
LIBRO RESÚMENES IX ENCUENTRO DE INVESTIGACIÓN ODONTOLOGÍA UC
Authors: MEDICA ARS
Published: August 2021

Los días viernes 7 y sábado 8 de mayo se realizó por primera vez en formato virtual a través de la plataforma ZOOM, el IX Encuentro de Investigación de Odontología UC. Este evento fue organizado por la Comisión de Investigación de la Escuela, junto a la Comisión Científica de Estudiantes (CCEO UC). En este encuentro, fueron presentadas 2 conferencias, 5 presentaciones de profesores de la Escuela de Odontología, 5 trabajos de investigación, 9 casos clínicos y 36 revisiones narrativas o sistemáticas en los que participaron estudiantes de pregrado de nuestra Escuela y de varias Facultades de Odontología de nuestro país, de Brasil y Colombia.
Spatially Distinct Reprogramming of the Tumor Microenvironment Based On Tumor Invasion in Diffuse-Type Gastric Cancers
Authors: Jeong Hye Young , Ham In-Hye , Lee Sung Hak , Ryu Daeun , Son Sang-Yong , Han Sang-Uk , Kim Tae-Min , Hur Hoon
Published: August 2021

Purpose:

Histologic features of diffuse-type gastric cancer indicate that the tumor microenvironment (TME) may substantially impact tumor invasiveness. However, cellular components and molecular features associated with cancer invasiveness in the TME of diffuse-type gastric cancers are poorly understood.

Experimental Design:

We performed single-cell RNA-sequencing (scRNA-seq) using tissue samples from superficial and deep invasive layers of cancerous and paired normal tissues freshly harvested from five patients with diffuse-type gastric cancer. The scRNA-seq results were validated by immunohistochemistry (IHC) and duplex in situ hybridization (ISH) in formalin-fixed paraffin-embedded tissues.

Results:

Seven major cell types were identified. Fibroblasts, endothelial cells, and myeloid cells were categorized as being enriched in the deep layers. Cell type–specific clustering further revealed that the superficial-to-deep layer transition is associated with enrichment in inflammatory endothelial cells and fibroblasts with upregulated CCL2 transcripts. IHC and duplex ISH revealed the distribution of the major cell types and CCL2-expressing endothelial cells and fibroblasts, indicating tumor invasion. Elevation of CCL2 levels along the superficial-to-deep layer axis revealed the immunosuppressive immune cell subtypes that may contribute to tumor cell aggressiveness in the deep invasive layers of diffuse-type gastric cancer. The analyses of public datasets revealed the high-level coexpression of stromal cell–specific genes and that CCL2 correlated with poor survival outcomes in patients with gastric cancer.

Conclusions:

This study reveals the spatial reprogramming of the TME that may underlie invasive tumor potential in diffuse-type gastric cancer. This TME profiling across tumor layers suggests new targets, such as CCL2, that can modify the TME to inhibit tumor progression in diffuse-type gastric cancer.

See related commentary by Huang and Brekken, p. 6284
Diuretic Resistance Treated with Low-Dose Hydralazine: A Case Report and Review of the Literature
Authors: Alshehri Mohammed , Wilcox Christopher
Published: August 2021

We present a case of severe diuretic resistance and edema from acute cardiorenal syndrome complicating heart failure with preserved ejection fraction (HFpEF) and mild alcoholic liver disease. High doses of intravenous (iv) furosemide plus iv doses of chlorothiazide failed to increase the daily urine output (UV) above 1,500 mL or the fractional excretion of sodium (FENa) above 2%. The addition of a relatively low dose of hydralazine (10 mg thrice daily PO) during 5 days of constant iv infusion of furosemide plus iv bolus chlorothiazide doubled the UV and FENa while reducing the serum creatinine concentration from 3.3 to 2.0 mg/dL. Hydralazine may have restored a response to the diuretics by increasing the renal blood flow and thereby the renal diuretic delivery, or by reducing the filtration fraction or reducing the renal congestion and thereby reducing the proximal reabsorption during blockade of distal reabsorption with diuretics. Further mechanistic studies of low-dose hydralazine for diuretic resistance are warranted.
Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors
Authors: Schmutzler Rita K. , Schmitz-Luhn Björn , Borisch Bettina , Devilee Peter , Eccles Diana , Hall Per , Balmaña Judith , Boccia Stefania , Dabrock Peter , Emons Günter , Gaissmaier Wolfgang , Gronwald Jacek , Houwaart Stefanie , Huster Stefan , Kast Karin , Katalinic Alexander , Linn Sabine C. , Moorthie Sowmiya , Pharoah Paul , Rhiem Kerstin , Spranger Tade , Stoppa-Lyonnet Dominique , van Delden Johannes Jozef Marten , van den Bulcke Marc , Woopen Christiane
Published: August 2021

Background: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action. Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept.
Combined Selective Dorsal Rhizotomy and Single-Event Multilevel Surgery in a Child with Spastic Diplegic Cerebral Palsy: A Case Report
Authors: Gimarc Kayli , Yandow Suzanne , Browd Samuel , Leibow Connie , Pham Kelly
Published: August 2021

Introduction: Children with spastic diplegic cerebral palsy (CP) often have functional and gait impairments related to spasticity and loss of range of motion (ROM). Selective dorsal rhizotomy (SDR) and single-event multilevel surgery (SEMLS) are surgical interventions that are used to manage spasticity and functional gait impairments, respectively. This is the first known case report of a child with spastic diplegic CP who underwent combined SDR and SEMLS. Case Report: Our patient is a 7-year-old girl with spastic diplegic CP, functioning at the Gross Motor Function Classification System (GMFCS) level II, who presented with spasticity and contractures in bilateral lower extremities leading to functional gait impairments, despite conservative management. Combined SDR/SEMLS was offered with the goal of simultaneously managing spasticity and contractures while reducing the need for multiple procedures. Postoperatively, the patient’s functional mobility, ROM, spasticity, and strength were assessed at various follow-up intervals. The patient had increased lower extremity weakness and functional decline postoperatively. Persistent genu recurvatum and knee instability required prolonged rehabilitation services, and she demonstrated functional gains with these interventions. At follow-ups, spasticity was resolved and ROM improved. By the 12-month follow-up, the Gross Motor Function Measure-66 was improved to 68.9 (55th percentile) from the preoperative level of 62.1 (35th percentile). By the 30-month follow-up, she was able to participate in novel recreational activities. Discussion/Conclusion: Multidisciplinary teams may consider combined SDR/SEMLS for management of spasticity, gait impairment, and contracture in carefully selected patients with spastic CP.
Measuring the Change in Health-Related Quality of Life in Patients Using Marijuana for Pain Relief
Authors: Peterson Andrew M. , Le Christine , Dautrich Tyler
Published: August 2021

Introduction: Current evidence suggests that cannabinoids are safe with minimal side effects and are effective in managing chronic pain. Data also show that medical marijuana (MM) may improve quality of life (QoL) among patients. However, there are little data showing the health-related QoL (HRQoL) benefit in MM patients using it for pain. The purpose of this study was to determine if there is a relationship between HRQol and MM use in patients using it to relieve pain. Methods: All pain patients aged 18 years or older enrolled in the Pennsylvania MM program were eligible for inclusion. Recruited subjects completed 4 surveys – at enrollment (baseline) then 2, 4, and 8 weeks post-enrollment. We used the EQ-5D survey tool for measuring HRQoL. The primary outcome measure was the change in the EQ-5D Index Score from survey 2 to survey 4 (6 week difference). Secondary outcomes included self-reported pain and health scores. Data were analyzed using a paired t test and repeated-measures multivariable analysis to control for both gender and length of time between surveys. Results: 1,762 people responded to the screening request, and 1,393 (79%) met screening criteria. Of those, 353 (25.3%) agreed to participate and 51% completed all 4 surveys, for a final sample of 181 with 85 male and 95 female and one nonbinary subject. The average age was 41.21 (SD = 12.9) years, with no difference between genders. The adjusted HRQoL score improved from 0.722 to 0.747 (p = 0.011) from survey 2 to survey 4, as did the self-reported pain and health scores. The EQ-5D subscales revealed no change in mobility or usual activities, significant improvement in anxiety and pain, and a significant worsening in self-care. Conclusion: The results show a significant improvement in HRQoL among patients using MM for pain. The EQ-5D subscales validated the pain improvement and also showed an improvement in anxiety. However, the decline in the self-care subscale may have tempered the overall improvement in HRQoL, and further research into which aspects of self-care are impacted by MM use in this population is warranted. Overall, there is a positive relationship between MM use and HRQoL in patients using it for pain.
Guideline-Based Quality Indicators for Kidney and Bladder Cancer in Germany: Development and Implementation
Authors: Rückher Johannes , Lobitz Jessica , Follmann Markus , Derenz Steffi , Schmidt Stefanie , Mensah Jumana , Wesselmann Simone
Published: August 2021

Introduction: As part of the development of the evidence-based (S3) clinical practice guidelines for kidney and bladder cancer by the German Guideline Program in Oncology, quality indicators (QIs) were defined to measure the quality of care. Based on these guidelines and QIs, the German Cancer Society (DKG) developed two new certification systems. The aim of this article is to show the process of development and implementation of QIs in certified cancer centres. Methods: Based on strong recommendations of each guideline and an additional systematic literature review for national and international QIs, two sets of QIs were derived in a multistep standardized approach. These QIs were implemented in the centres in certification data sheets to measure their outcomes. First results of treatment years 2018 and 2019 are available. Results: The final sets include 9 QIs for kidney cancer and 12 QIs for bladder cancer. Two-thirds of the QIs were transferred to the data sheets. In 2018 and 2019, the results of all but one QI are within the plausibility limits. From 2020 on, they are replaced by stricter target values that will challenge centres to improve their outcomes. Conclusions: Guideline-derived QIs make relevant aspects of patient care measurable and consequently improvable. The first QI results are encouraging. However, the DKG certification system and the methods of measuring quality are under ongoing development. Systematic QI implementation and evaluation may help to generate broader databases and thus expand knowledge.
Hyperoncotic Albumin Solution in Continuous Renal Replacement Therapy Patients
Authors: O’Brien Zachary , Finnis Mark , Gallagher Martin , Bellomo Rinaldo ,   on behalf of the RENAL Study Investigators and the Australian and New Zealand Intensive Care Clinical Trials Group
Published: August 2021

Aim: The aim of this study was to investigate the association of hyperoncotic (20%) human albumin solution (HAS) with outcomes among critically ill patients receiving continuous renal replacement therapy (RRT). Methods: Analysis of the Randomized Evaluation of Normal versus Augmented Level (RENAL) RRT trial data. Results: Of 1,508 patients, 771 (51%) received albumin. Of these, 345 (45%) received 4% HAS only, 155 (20%) received 20% HAS only, and 271 (35%) received both. Patients who received combined 4% and 20% HAS were more severely ill, received more days of RENAL trial therapy and required mechanical ventilation for longer. Mean daily fluid balance was −288 mL (−904 to 261) with 20% HAS only versus 245 mL (−248 to 1,050) with 4% HAS only (p < 0.001). On Cox proportional hazards regression, 20% HAS exposure was not associated with greater 90-day mortality (odds ratio 1.12, 95% confidence interval [CI]: 0.77–1.62; p = 0.55) or longer recovery to RRT independence (sub-hazard ratio 1.04, 95% CI: 0.84–1.30; p = 0.70) compared to those who received 4% HAS only. Conclusions: RENAL trial patients commonly received albumin in varying concentrations. The administration of 20% HAS was associated with a more negative fluid balance but was not independently associated with increased mortality or RRT dependence when compared to 4% HAS only.
Das Verstärkermodell der Suizidalität: Chronische Suizidalität bei der Borderline-Persönlichkeitsstörung verstehen und behandeln
Authors: Hennings Johannes M.
Published: August 2021

Trotz großer Fortschritte in der evidenzbasierten Psychotherapie wird unser Versorgungssystem durch chronisch suizidale Patienten mit einer Borderline-Persönlichkeitsstörung (BPS) weiterhin stark herausgefordert. Die BPS ist mit einem hohen Suizidrisiko von 5–10% sowie einem hohen Selbstverletzungsrisiko von bis zu 80% behaftet. Therapeuten wie Angehörige fühlen sich oft überfordert und hilflos, wenn sie mit der Suizidalität der Patienten konfrontiert sind. Immer wieder kommt es so zu Therapieabbrüchen, Vorstellungen in Notaufnahmen oder akut-psychiatrischen Einweisungen. Bei der nichtsuizidalen Selbstverletzung (NSSV) – einem Verhaltensmuster, das gehäuft zusammen mit chronischer Suizidalität bei BPS auftritt – tragen Verstärkermechanismen (z.B. Nachlassen von Anspannung) dazu bei, dass sich Borderline-Patienten trotz längerfristig unangenehmen Folgen immer wieder selbst verletzen. Die Motive für NSSV und suizidales Verhalten können sehr unterschiedlich sein. Es spricht jedoch einiges dafür, dass die zugrunde liegenden Mechanismen ähnlich sind und sich hieraus wichtige therapeutische Interventionsmöglichkeiten ableiten lassen. In dieser Übersichtsarbeit werden die Hintergründe und Unterschiede von NSSV, Suizidideationen sowie Suizidversuchen bei chronisch suizidalen Borderline-Patienten dargestellt. Neuere Erkenntnisse der modernen Neuro- und Verhaltenswissenschaft werden in ein Verstärkermodell der Suizidalität integriert, von dem verhaltenstherapeutische Interventionen abgeleitet werden, die Therapeuten in ihrer Arbeit mit chronisch suizidalen Patienten unterstützen können.
Endothelial Hyaluronan Synthase 3 Augments Postischemic Arteriogenesis Through CD44/eNOS Signaling
Authors: Schneckmann Rebekka , Suvorava Tatsiana , Hundhausen Christian , Schuler Dominik , Lorenz Christin , Freudenberger Till , Kelm Malte , Fischer Jens W. , Flögel Ulrich , Grandoch Maria
Published: August 2021

Objective:

The dominant driver of arteriogenesis is elevated shear stress sensed by the endothelial glycocalyx thereby promoting arterial outward remodeling. Hyaluronan, a critical component of the endothelial glycocalyx, is synthesized by 3 HAS isoenzymes (hyaluronan synthases 1-3) at the plasma membrane. Considering further the importance of HAS3 for smooth muscle cell and immune cell functions we aimed to evaluate its role in collateral artery growth.

Approach and Results:

Male
Has3
-deficient (
Has3
-KO) mice were subjected to hindlimb ischemia. Blood perfusion was monitored by laser Doppler perfusion imaging and endothelial function was assessed by measurement of flow-mediated dilation in vivo. Collateral remodeling was monitored by high resolution magnetic resonance angiography. A neutralizing antibody against CD44 (clone KM201) was injected intraperitoneally to analyze hyaluronan signaling in vivo. After hindlimb ischemia,
Has3
-KO mice showed a reduced arteriogenic response with decreased collateral remodeling and impaired perfusion recovery. While postischemic leukocyte infiltration was unaffected, a diminished flow-mediated dilation pointed towards an impaired endothelial cell function. Indeed, endothelial AKT (protein kinase B)-dependent eNOS (endothelial nitric oxide synthase) phosphorylation at Ser1177 was substantially reduced in
Has3
-KO thigh muscles. Endothelial-specific
Has3
-KO mice mimicked the hindlimb ischemia-induced phenotype of impaired perfusion recovery as observed in global
Has3
-deficiency. Mechanistically, blocking selectively the hyaluronan binding site of CD44 reduced flow-mediated dilation, thereby suggesting hyaluronan signaling through CD44 as the underlying signaling pathway.

Conclusions:

In summary, HAS3 contributes to arteriogenesis in hindlimb ischemia by hyaluronan/CD44-mediated stimulation of eNOS phosphorylation at Ser1177. Thus, strategies augmenting endothelial HAS3 or CD44 could be envisioned to enhance vascularization under pathological conditions.
High Free Cholesterol Bioavailability Drives the Tissue Pathologies in Scarb1
−/−
Mice
Authors: Liu Jing , Gillard Baiba K. , Yelamanchili Dedipya , Gotto Antonio M. , Rosales Corina , Pownall Henry J.
Published: August 2021

Objective:

Overall and atherosclerosis-associated mortality is elevated in humans with very high HDL (high-density lipoprotein) cholesterol concentrations. Mice with a deficiency of the HDL receptor, Scarb1 (scavenger receptor class B type 1), are a robust model of this phenotype and exhibit several additional pathologies. We hypothesized that the previously reported high plasma concentration of free cholesterol (FC)–rich HDL in Scarb1
−/
−
mice produces a state of high HDL-FC bioavailability that increases whole-body FC and dysfunction in multiple tissue sites.

Approach and Results:

The higher mol% FC in Scarb1
−/−
versus WT (wild type) HDL (41.1 versus 16.0 mol%) affords greater FC bioavailability for transfer to multiple sites. Plasma clearance of autologous HDL-FC mass was faster in WT versus Scarb1
−/−
mice. FC influx from Scarb1
−/−
HDL to LDL (low-density lipoprotein) and J774 macrophages was greater (≈4×) than that from WT HDL, whereas FC efflux capacity was similar. The higher mol% FC of ovaries, erythrocytes, heart, and macrophages of Scarb1
−/−
versus WT mice is associated with previously reported female infertility, impaired cell maturation, cardiac dysfunction, and atherosclerosis. The FC contents of other tissues were similar in the two genotypes, and these tissues were not associated with any overt pathology. In addition to the differences between WT versus Scarb1
−/−
mice, there were many sex-dependent differences in tissue-lipid composition and plasma FC clearance rates.

Conclusions:

Higher HDL-FC bioavailability among Scarb1
−/−
versus WT mice drives increased FC content of multiple cell sites and is a potential biomarker that is mechanistically linked to multiple pathologies.