bluuebunny/crossref_metadata_2025 huggingface dataset:
Prolonged Myelosuppression due to Progressive Bone Marrow Fibrosis in a Patient with Acute Promyelocytic Leukemia
Authors: Inagawa Yuta , Komeno Yukiko , Saito Satoshi , Maenohara Yuji , Yamagishi Tetsuro , Kawashima Hiroyuki , Saito Taku , Abe Keiko , Iihara Kuniko , Hatada Yasumasa , Ryu Tomiko
Published: November 2019

A 34-year-old woman was diagnosed with acute promyelocytic leukemia. Chemotherapy was administered following the JALSG APL204 protocol. Induction therapy with all-trans retinoic acid resulted in complete remission on day 49. She developed coccygeal pain from day 18, which spread to the spine and cheekbones and lasted 5 weeks. She had similar bone pain on days 7–10 of the first consolidation therapy and on days 4–12 of the second consolidation therapy. Oral loxoprofen was prescribed for pain relief. On day 33 of the third consolidation, white blood cell and neutrophil counts were 320/μL and 20/μL, respectively. After she developed epigastralgia and hematemesis, she developed septic shock. Gastroendoscopy revealed markedly thickened folds and diffusely damaged mucosa with blood oozing. Computed tomography revealed thickened walls of the antrum and the pylorus. Despite emergency treatments, she died. Bacterial culture of the gastric fluid yielded Enterobacter cloacae and enterococci growth. Collectively, she was diagnosed with phlegmonous gastritis. Retrospective examination of serial bone marrow biopsy specimens demonstrated progressive bone marrow fibrosis, which may have caused prolonged myelosuppression. Thus, evaluation of bone marrow fibrosis by bone marrow biopsy after each treatment cycle might serve as a predictor of persistent myelosuppression induced by chemotherapy.
Effect of Moxibustion on HIF-1α and VEGF Levels in Patients with Rheumatoid Arthritis
Authors: Gong Yuanyuan , Yu Zeyun , Wang Yingni , Xiong Yan , Zhou Yumei , Liao Chen-xi , Li Yuan , Luo Yun , Bai Yu , Chen Bailu , Tang Yuzhi , Wu Ping
Published: November 2019

Background. Moxibustion has a therapeutic effect of reducing swelling and relieving pain in patients with rheumatoid arthritis (RA) but its mechanism is uncertain. Objective. To evaluate the effect of moxibustion on serum levels of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in patients with RA and to explore the possible mechanism of moxibustion. Methods. This study involved 46 RA patients who had fulfilled the inclusion criteria and were randomly assigned to a treatment group and a control group in an equal ratio. The control group was treated with methotrexate or leflunomide, while the treatment group received methotrexate or leflunomide and moxibustion at ST 36 (Zusanli), BL 23 (Shenshu), and Ashi points. Patients’ clinical symptoms, RA-associated serum markers, and serum levels of TNF-α, IL-1β, HIF-1α, and VEGF were compared in the two groups before and after intervention. Statistical analysis was performed using SPSS 21.0 statistical software. Results. 37 of 46 RA patients eventually completed the whole treatment course. Compared with the control group, the treatment group significantly improved the clinical symptoms (P<0.05) but with no significant differences in RA-associated serum markers (P>0.05). There were significant differences in TNF-α and IL-1β among the groups after 8 weeks of treatment (P<0.05). HIF-1α and VEGF were decreased in the treatment group after therapy (P<0.05). VEGF was reduced in the control group (P<0.05), while HIF-1α was not significantly improved (P>0.05). The reductions of HIF-1α and VEGF in the treatment group were superior to the control group (P<0.05). Conclusions. Moxibustion enhanced the anti-inflammatory and analgesic effects of conventional medicine and can enhance the effect of conventional medicine, downregulating HIF-1α/VEGF contents to inhibit angiogenesis.
IgG4-Producing MALT Lymphoma in the Renal Hilum
Authors: Shimokihara Kota , Kawahara Takashi , Kasahara Ryo , Kasuga Jun , Sugiura Shinpei , Tajiri Ryosuke , Uemura Hiroji , Chiba Kimio
Published: November 2019

IgG4-related disease is diagnosed when both the elevation of the serum IgG4 level and invasion of IgG4-positive interstitial cells and sclerosis to a tumor are noted. Some cases have demonstrated malignant disease. In the head and neck lesion in particular, IgG4-producing mucosa-associated lymphoid tissue (MALT) lymphoma has arisen during the treatment of IgG4-related disease. We herein report the first case of IgG4-producing MALT lymphoma during the treatment of IgG4-related disease in the renal hilum. A 79-year-old man was being followed for autoimmune pancreatitis and IgG4-related sclerosing cholangitis. During follow-up, magnetic resonance cholangiopancreatography detected a mass in the renal hilum, so he was referred to our department for a further examination. Positron emission tomography-computed tomography detected a standard uptake of 9.7, and the tumor size was gradually increasing. Due to these findings, laparoscopic nephro-ureterectomy was performed. A pathological examination revealed IgG4-producing marginal zone B cell lymphoma. We herein report a rare case of IgG4-producing B cell lymphoma in the renal hilum.
Gender in Biblical Studies: a Brief Overview
Authors: Edwards Katie , Stiebert Johanna
Published: November 2019

This article provides background and context for the ensuing contributions in this special journal edition, the focus of which is gender studies and the Dead Sea Scrolls. While the discovery and study of the Scrolls has certainly revolutionized Biblical Studies, the study of the Scrolls is nevertheless often perceived and treated as a subsidiary, even marginalized, field of Biblical Studies, rather than as either an integral part thereof, or as a discipline in its own right. This article aims to highlight how gender has been studied with reference to the Bible. Subsequent contributions demonstrate how gender is shaping interpretations of the Scrolls.
“Du Selbst Bist dir die Welt”. Die Reise Nach Utopia als Fahrt zum Stoisch Verfaßten Ich.
Authors: Schmidt Jochen
Published: November 2019

Auf dem Hintergrund der stoischen Kritik am Reisen wird Flemings großes Reise-Gedicht als eine dennoch ganz stoisch fundierte Konzeption erstmals genau analysiert. Der Nachweis der Subtexte, vor allem aus Senecas philosophischen Schriften, führt zur Bestimmung eines als utopisch inszenierten Identitätsentwurfs, der sich im prozessualen Duktus des kunstvoll durchkomponierten Textes entfaltet.
Das Autonome Subjekt in der Auseinandersetzung mit Fatum uno Fortuna
Authors: Neymeyr Barbara
Published: November 2019

Flemings Sonett “An sich” ist durch das tradierte stoische Verfahren der Selbstemahnung geprägt und zielt in seiner Argumentation auf das Ideal des autonomen und souveränen Weisen. Außer Fortuna erhält auch das bisher von der Forschung vernachlässigte Fatum als Leitvorstellung eine konstitutive Bedeutung für das Gedicht. Erstmals wird in der vorliegenden Abhandlung nachgewiesen, wie exakt Fleming auf die stoischen Grundtexte zurückgreift und daß er die Konzepte Senecas und Ciceros zugleich mit Positionen des Neustoizismus von Montaigne bis Justus Lipsius vemittelt.
Ritter Galmy vß Schottenland und Jörg Wickram aus Colmar
Authors: Kartschoke Dieter
Published: November 2019

Seit Karl Goedeke (1859) und Erich Schmidt (1879) gilt Jörg Wickram als Autor des anonym erschienenen Romans Ritter Galmy. Eine Überprtifung der Indizien und Argumente für diese Zuschreibung läßt erhebliche Zweifel an ihrer Tragfähigkeit aufkommen.
Zahlenkomposition und Prophetisches Selbstverständnis
Authors: Schuff Karin
Published: November 2019

Jakob Böhme gilt gemeinhin als inspirierter, aber unmethodischer Theosoph. Hingegen ist zu zeigen, dass er mit den Mitteln seiner Epoche systematisch arbeitete. In der Vorrede seiner Aurora, oder Morgen-Roete im Aufgangk entwickelt er aus der Figur des biblischen Lebens- und Erkenntnisbaumes ein universales Ordnungsschema und verweist auf allegorische und symbolische Deutungen des Baumes und seiner einzelnen Glieder. Dabei ordnet er mittels eines kryptographischen Systems der Zahlenkomposition, vergleichbar dem für Dantes Divina Commedia nachgewiesenen, die Aurora in die Tradition christlich-prophetischer Schriften ein.
Reassessment of taxonomic characters for the plant bug genus Hypseloecus Reuter, with descriptions of new species of Hypseloecus and the related genus Lasiolabops Poppius (Heteroptera: Miridae: Phylinae)
Authors: Yasunaga Tomohide , Duwal Ram Keshari
Published: November 2019

The Old World plant bug genus Hypseloecus Reuter of the tribe Pilophorini is reviewed on the basis of detailed observation of the morphological characters, with an updated checklist of Asian congeners. “Pleural glands” are herein suggested as a novel diagnostic character and currently considered as an additional autapomorphy for the genus. Two Asian new species, Hypseloecus nakagawai sp. n. (from Honshu, Japan) and H. aaroni sp. n. (Bagmati Zone, Nepal), are diagnosed and described. The host association and habitat of H. nakagawai are also documented. An Old World pilophorine genus, Lasiolabops Poppius, assumed to be a potential sister taxon of Hypseloecus, is diagnosed and discussed; further, two new species, L. cirratus sp. n. (from Japanese Ryukyus) and L. remicornis sp. n. (from Central Thailand), are described, based on their distinctive vestiture pattern.
شكاوى موظفي الدولة الأشورية الحديثة إلى الملك أو لولي العهد (قبل الميلاد ٦١٢ – ٧٢١)
Authors: علي ياسين الجبوري
Published: November 2019

Justice is one of the Assyrian Kings’ titles during the Sargon II Dynasty, 721–612 BCE. They used to say that they loved justice. Despite the existence of courts and judges, high-ranking officials and astrologers prefer to complain to the King directly using their association with the King to state their problem, sometimes between lines or at the end of the report. Most of the cases are concerned with either estate or other affairs.

This paper focused on those cases; unfortunately in most cases we do not know the King’s orders except in some cases when the officials were not satisfied with the judge’s verdict, therefore they complain again and mention the King’s order as an indirect speech in the same letter.
نقش كتابي بصهريج يعقوب شاه المهمندار بالقاهرة، يسجل مآثر السلطان قايتباي المعمارية والحربية م) ١٤٩٦-١٤٩٥ /ھ ٩۰۱)
Authors: فرج الحسيني
Published: November 2019

This is an extensive study about the inscription of the cistern of Yacqūb Shāh al- Mihmandār in Cairo (901 AH/1495–1496 CE). This Cistern is a small building existing at the foot of the Citadel; however, it is a very important building, not only for its function but also for the content of its inscriptions. Despite that there are previous studies of the inscription, they are brief studies. Therefore, it should be restudied in a comprehensive manner.

The inscription showed that the building at the time of construction was a dual cistern with double domes, established by Yacqūb Shāh al-Mihmandār (one of Amirs during the reign of the Sultan Qāyt Bāy, and is one of the loyal friends of this Sultan). Although the inscription is a construction text, it is considered a documentary and ceremonial text. It recorded the religious and knighthood achievements of Sultan Qāyt Bāy, which made him surpass his peers of kings and sultans, and recorded the military and architectural accomplishments of the same Sultan. For example, in Makkah, Sultan Qāyt Bāy reconstructed Masjid al-Khayf (Al-Khayef) in the south of Mina (873/1467), and also restarted the flow of the aqueduct of Arafa (Ain Zubaidah). In Medina, he reconstructed the Prophet’s Mosque. In Jerusalem, he restarted the flow of the aqueduct of el-Sabīl. Afterwards, the inscription is completed by an epic report about the victory of the Mamluk Army versus the Ottoman Army in the Battle of Adana (891 AH/1486 CE), and the capture of the commander of the Ottoman Army, Hersekzāde Ahmed, bringing him to Cairo in a humiliating manner.
Effects of nutrition education on cardio-metabolic outcomes: A randomised clinical trial
Authors: Dos Santos Hildemar , Beeson W Lawrence , Segovia-Siapco Gina , Koranda Brenda , Jehi Tony
Published: November 2019

Objective:

The aim of this study was to assess the effect of Full Plate Diet (FPD) on the primary prevention of cardio-metabolic risk factors.

Design:

Randomised clinical trial.

Setting:

Drayson Center, Loma Linda University, CA, USA.

Methods:

Forty individuals were randomly assigned to either an intervention group receiving the FPD health education for 10 weeks or to a control group not receiving this intervention. Comprehensive evaluations of clinical and anthropometric outcomes were conducted at baseline and at the end of intervention. To assess within-group changes and between-group differences, a general linear model was used.

Results:

Significant reductions in weight (−1.54 kg, 95% confidence interval [CI] −2.5, −.54) and total cholesterol (TC) (−11.7 mg/dL; 95% CI −21.4, −2) and non-significant reductions in means for low-density lipoprotein cholesterol (LDL-C) (−7.3 mg/dL, 95% CI −16, 1.5) and triglycerides (−18.7 mg/dL, 95% CI −46, 8.5) were observed in the intervention group after 10 weeks compared with baseline. These reductions were non-significantly higher in the intervention compared with the control group. There were no significant mean changes in systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C) and haemoglobin A1c (A1c) in the intervention group after 10 weeks.

Conclusion:

A multi-component programme comprising 10 weeks of health education that emphasised the high intake of fibre failed to significantly reduce cardio-metabolic risk factors. It did show a downward trend in triglycerides, TC and body weight that may be of clinical importance suggesting that a future investigation with a longer intervention duration is needed.
Determination of voriconazole in human plasma by liquid chromatography-tandem mass spectrometry and its application in therapeutic drug monitoring in Chinese patients
Authors: Mei Hekun , Hu Xing , Wang Jin , Wang Rui , Cai Yun
Published: November 2019

Objective

To develop a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of voriconazole in human plasma, and to evaluate its application in clinical therapeutic drug monitoring.

Method

Plasma samples were obtained from Chinese patients receiving voriconazole, precipitated with methanol (using fluconazole as an internal standard), and then subjected to LC-MS/MS using an SB C18 column with a methanol and water mobile phase at a flow rate of 0.4 mL/minute. Quantification was performed by multiple-reaction monitoring using the precursor and product ion pair m/z 350–280.9 for voriconazole and m/z 307–219.9 for fluconazole.

Results

The calibration curve was linear over a range of 0.1–10.0 µg/mL (R2 = 0.9995). The inter-day and intra-day relative standard deviations were <7.68% and <8.97%, respectively. Extraction recovery, matrix effect, and stability were also validated. Sixty-eight plasma samples from 42 patients were analyzed, and the voriconazole concentrations in 25 samples (36.8%) were outside the optimal range of 1.5–4.5 µg/mL.

Conclusions

We developed a simple and accurate method of drug monitoring, which could improve the efficacy and prevent adverse reactions of voriconazole.
Different Contexts of Sexual Abuse With a Special Focus on the Context of Christian Institutions: Results From the General Population in Germany
Authors: Witt Andreas , Brähler Elmar , Plener Paul L. , Fegert Jörg M.
Published: November 2019

Recent revelations of the extent of sexual abuse in the Roman Catholic Church in Germany and the United States have once more triggered the debate about sexual abuse. Those inquiries identify cases that are known to authorities or have been recorded in these institutions. However, to assess the full magnitude of the problem, data beyond recorded or known cases are needed, as it can be assumed that a vast number of cases are not reported and are hence not included in such file reviews. Therefore, representative surveys are needed. The aim of the present study was to examine the prevalence of sexual abuse by priests and in different contexts in the German population based on a representative sample. A total of 2,510 participants (54.3% female, M = 48 years) were retrospectively asked about different experiences, offenders, contexts, and so on, of child sexual abuse using questions that were used to assess child sexual abuse in prior surveys and the Childhood Trauma Questionnaire (CTQ). In sum, 0.21% ( n = 7) of the participants reported child sexual abuse by a priest or pastor. 0.16% reported child sexual abuse in an institution of the Roman Catholic Church. Results also indicated that victims of sexual abuse by priests and pastors reported rather severe types of sexual abuse based on the CTQ in comparison with other contexts, such as schools. Extrapolating the data for the population, it can be assumed that the estimated number of victims is much higher than those identified by research based on recorded cases.
Force modeling to develop a novel method for fabrication of hollow channels inside a gel structure
Authors: Barua Ranjit , Giria Himanshu , Datta Sudipto , Roy Chowdhury Amit , Datta Pallab
Published: November 2019

Fabrication of hollow channels with user-defined dimensions and patterns inside viscoelastic, gel-type materials is required for several applications, especially in biomedical engineering domain. These include objectives of obtaining vascularized tissues and enclosed or subsurface microfluidic devices. However, presently there is no suitable manufacturing technology that can create such channels and networks in a gel structure. The advent of three-dimensional bioprinting has opened new possibilities for fabricating structures with complex geometries. However, application of this technique to fabricate internal hollow channels in viscoelastic material has not been yet explored to a great extent. In this article, we present the theoretical modeling/background of a proposed manufacturing paradigm through which hollow channels can be conveniently fabricated inside a gel structure. We propose that a tip connected to a robotic arm can be moved in X-, Y-, and Z-axis as per the desired design. The tip can be moved by a magnet or mechanical force. If the tip is further trailed with porous tube and moved inside the viscoelastic material, corresponding internal channels can be fabricated. To achieve this, however, force modeling to understand the forces that will be required to move the tip inside viscoelastic material should be known and understood. Therefore, in our first attempt, we developed the computational force modeling of the tip movement inside gels with different viscoelastic properties to create the channels.
The cardiotoxic effects of acute and chronic grayanotoxin-III in rats
Authors: Doǧanyiǧit Z , Kaymak E , Silici S
Published: November 2019

The purpose of this study is to histologically and immunohistochemically determine the changes created by grayanotoxin-III (GTX-III), which is a sodium channel neurotoxin, on heart tissues in different dosages. Rats were randomly divided into 10 groups to determine the acute and chronic effects of GTX-III. While the rats in groups 1 and 6 were control rats, the rats in groups 2–5 (1, 2, 4, and 8 μg/kg bw GTX-III) received a single dose of intraperitoneal GTX-III, and the rats in groups 7–10 received GTX-III every day for 3 weeks. As a result of the trial, in the heart tissues, histopathological changes were determined by hematoxylin–eosin staining, interleukin-1 (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and brain natriuretic peptide (BNP) were determined by the avidin–biotin peroxidase method, and apoptosis was examined by immunohistochemistry (IHC) analysis and the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining method. In the immunohistochemistry sense, while the BNP level in the AGTX-III groups did not vary significantly, an increase in dosage significantly increased the IL-6, IL-1β, and TNF-α levels in comparison to the control groups. In their comparison to the control groups, the BNP levels increase and the IL-6 and IL-1β levels decreased in the CGTX-III groups. TUNEL analysis revealed that apoptosis increased in both the acute and chronic groups.
“A Pap smear saved my life”: Personal experiences of cervical abnormalities shape attitudes to cervical screening renewal
Authors: Obermair Helena M , McCaffery Kirsten J , Dodd Rachael H
Published: November 2019

Objective

In 2017, the Australian National Cervical Screening Program changed from two-yearly Pap smears between ages 18 and 69, to five-yearly human papillomavirus screening between ages 25 and 74 (the “Renewal”). This study investigated attitudes towards the changes, among individuals previously affected by cervical abnormalities/cervical cancer, personally or through a friend/relative.

Methods

We conducted a thematic analysis of comments expressing personal history or a family/friend history of cervical abnormalities/cervical cancer as a reason for opposing changes to the cervical screening program. The comments were taken from a 20% random sample of 19,633 comments posted on the “Change.org” petition “Stop May 1st Changes to Pap Smears – Save Women's Lives” in February–March 2017.

Results

There were 831 (20.8%) commenters who reported that they were concerned about a change in screening due to: feelings of increased personal vulnerability to cervical cancer due to their own personal history of cervical abnormalities; comparison of extended screening intervals and later age of first screening to their own experiences; and a perception of increased personal risk due to family history.

Conclusion

Women previously affected by cervical abnormalities or cervical cancer, personally or through a friend/relative, expressed concern about changes to cervical screening due to perceived increased risk and feeling vulnerable due to personal history.
Effective School Practices in Title I Schools Exceeding Educational Expectations (E3)
Authors: Padilla George , Guerra Federico , Zamora Roberto
Published: November 2019

A research study was designed and conducted to identify effective school characteristics and strategies of high-performing, high-poverty schools. Four High-Performing Reward schools in South Texas that demonstrated longitudinal academic success were selected to study. We developed an 11 effective school characteristics model including school processes from the effective school research literature as the framework for the study. A mixed-research study was designed to collect data from professional school staff, and principals related to the 11 effective characteristics, their processes, and strategies used by the schools. An area of improvement identified among these already high-performing schools was parental engagement.
The Blurred Line between Physical Ageing and Mental Health in Older Adults: Implications for the Measurement of Depression
Authors: Hazell Cassie M , Smith Helen E , Jones Christina J
Published: November 2019

Objectives:

Depression in older adults is assessed using measures validated in the general adult population. However, such measures may be inappropriate in the elderly due to the similarities between ageing and the symptoms of depression. This article discusses whether these measures are fit for the purpose and the implications of using inappropriate tools.

Methods:

A commentary on measuring depression in older adults.

Results:

Depression symptoms may be mistaken for signs of ageing. Several measures of depression include items that may have a physical cause and thus generate measurement error. Those studies that have assessed the psychometric properties of depression measures in older adults have failed to conduct appropriate assessments of discriminant validity.

Discussion:

Research is needed to determine whether the conceptual similarity between some symptoms of depression and the effects of ageing translate to factorial similarity. If so, there may be a need for a specific depression measure for older adults that prioritises psychological symptoms.
Asset-building and social inclusion: A qualitative analysis of families’ perspectives
Authors: Feldman Guy
Published: November 2019

Social inclusion has historically been one of the key goals of the welfare state. Over the past two decades, an increasing number of policies have aimed to promote inclusion by connecting low-income families to mainstream financial services and enabling them to save and acquire assets. Building on the concept of the “paradox of inclusion,” this article examines whether and how policies that aim to include low-income families in asset accumulation do so in ways that risk reinforcing their exclusion. The article focuses on a case study of a matched savings program in the heart of a major American city, gathering evidence through in-depth interviews with 24 clients in the program and ethnographic observations at the agency implementing the program.

Findings

Findings show that the program enhances families’ feelings of social inclusion, but it also creates the possibility for social exclusion in two distinctive ways: teaching families to save even under challenging circumstances and encouraging them to pursue the risky venture of homeownership.

Application

This research suggests that addressing the structural sources of poverty and training social workers to be more sensitive to low-income families’ distinctive circumstances are necessary to ensure that they are included as full members of society.
Period Hacks: Menstruating in the Big Data Paradigm
Authors: Kressbach Mikki
Published: November 2019

Menstrual tracking and fertility apps have gained popularity in recent years, often sold as tools for self-empowerment through self-knowledge. While critics tend to focus on the gendered design of these apps, this article examines the self-tracking and analytic features of the popular apps, Flo and Clue, to argue that menstrual tracking and fertility apps reinforce discourses of menstrual concealment and bodily alienation. Beginning with an analysis of the daily log interface, the author situates the humorous icons in discourses of menstrual jokes and euphemisms to show how these apps participate in the suppression of menstruation. The author then turns to the analytics features to demonstrate how these apps encourage users to understand their lives through their menstrual cycle. The article ends with a call for collaborations between humanists, scientists, and designers to revise and mobilize these apps to explore under-explored issues of sexual and reproductive health.
Defending the media from itself: Reforming media regulations to minimise the impact of misinformation
Authors: Nurvala Juha-Pekka , Buckell Amelia
Published: November 2019

This article argues that media regulations on correcting incorrect articles are in dire need of reform due to technological and behavioural changes. By using case studies from the UK, the authors demonstrate the huge difference between the number of people who were reached by the original article before the Independent Press Standards Organisation (the regulator in the UK) ruled it incorrect and the number reached by the correction or corrected article. The authors argue that media regulations must be reformed to ensure that corrections reach the same people as the original incorrect article to avoid misinformation impacting peoples’ decision-making, and that reforms must include social media platforms and search engines.
Long Head Biceps Tendon as Superior Capsular Reconstruction (LHBT-SCR) augmentation for Massive rotator cuff repair: “The Chinese Way
Authors: Chen Shiyi , Lihong  , Shang Xiliang
Published: November 2019

Massive or irreparable rotator cuff tears remain a challenging with a high failure rates of the tendon re-tear after surgical treatment in sports medicine practice. Superior capsular reconstruction with either fascia lata autograft or a dermal allograft patch has been described to prevent superior humeral head migration and restore the shoulder muscle force couples to achieve the promising results. A modified and simplified surgical procedure using long head biceps tendon (LHBT) autograft as superior capsular reconstruction (LHBT-SCR) to facilitate the massive rotator cuff repair has been descripted as ”Chinese Way” by a team of French surgeons and Chinese surgeons. The surgical technic has been used in China more than 300 cases. The procedure of this LHBT-SCR has been approved with the advantage of least technical demands, simplifies the original demanding, short the surgical time, satisfy the results and patient acceptance. A multi-center prospective studies with large cohort populations and long-term follow-up has been established in China for its effectiveness. The present will introduce the technic in detail.
Technical standards for respiratory oscillometry
Authors: King Gregory G. , Bates Jason , Berger Kenneth I. , Calverley Peter , de Melo Pedro L. , Dellacà Raffaele L. , Farré Ramon , Hall Graham L. , Ioan Iulia , Irvin Charles G. , Kaczka David W. , Kaminsky David A. , Kurosawa Hajime , Lombardi Enrico , Maksym Geoffrey N. , Marchal François , Oppenheimer Beno W. , Simpson Shannon J. , Thamrin Cindy , van den Berge Maarten , Oostveen Ellie
Published: November 2019

Oscillometry (also known as the forced oscillation technique) measures the mechanical properties of the respiratory system (upper and intrathoracic airways, lung tissue and chest wall) during quiet tidal breathing, by the application of an oscillating pressure signal (input or forcing signal), most commonly at the mouth. With increased clinical and research use, it is critical that all technical details of the hardware design, signal processing and analyses, and testing protocols are transparent and clearly reported to allow standardisation, comparison and replication of clinical and research studies. Because of this need, an update of the 2003 European Respiratory Society (ERS) technical standards document was produced by an ERS task force of experts who are active in clinical oscillometry research.

The aim of the task force was to provide technical recommendations regarding oscillometry measurement including hardware, software, testing protocols and quality control.

The main changes in this update, compared with the 2003 ERS task force document are 1) new quality control procedures which reflect use of “within-breath” analysis, and methods of handling artefacts; 2) recommendation to disclose signal processing, quality control, artefact handling and breathing protocols (e.g.number and duration of acquisitions) in reports and publications to allow comparability and replication between devices and laboratories; 3) a summary review of new data to support threshold values for bronchodilator and bronchial challenge tests; and 4) updated list of predicted impedance values in adults and children.
Effect of asthma exacerbation during pregnancy in women with asthma: a population-based cohort study
Authors: Abdullah Kawsari , Zhu Jingqin , Gershon Andrea , Dell Sharon , To Teresa
Published: November 2019

The association between asthma exacerbation during pregnancy and adverse maternal and child health outcomes have not been investigated appropriately. Our objective was to determine the short- and long-term intergenerational effect of asthma exacerbation in pregnant women with asthma.

A population cohort study was conducted using data from the Ontario asthma surveillance system and population-level health administrative data. Asthma exacerbation in pregnant women with asthma was defined as at least one of the following criteria: at least five physician visits, or one emergency department visit or one hospital admission for asthma during pregnancy. Pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders were identified using International Classification of Disease codes (9th and 10th revisions).

The cohort consisted of 103 424 singleton pregnancies in women with asthma. Asthma exacerbation in pregnant women with asthma was associated with higher odds of pre-eclampsia (OR 1.30, 95% CI 1.12–1.51) and pregnancy-induced hypertension (OR 1.17, 95% CI 1.02–1.33); babies had higher odds of low birthweight (OR 1.14, 95% CI 1.00–1.31), preterm birth (OR 1.14, 95% CI 1.01–1.29) and congenital malformations (OR 1.21, 95% CI 1.05–1.39). Children born to women with asthma exacerbation during pregnancy had elevated risk of asthma (OR 1.23, 95% CI 1.13–1.33) and pneumonia (OR 1.12, 95% CI 1.03–1.22) during the first 5 years of life.

Asthma exacerbation during pregnancy in women with asthma showed increased risk of pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders in their children, indicating that appropriate asthma management may reduce the risk of adverse health outcomes.
Noninvasive evaluation of pulmonary artery pressure during exercise: the importance of right atrial hypertension
Authors: Obokata Masaru , Kane Garvan C. , Sorimachi Hidemi , Reddy Yogesh N.V. , Olson Thomas P. , Egbe Alexander C. , Melenovsky Vojtech , Borlaug Barry A.
Published: November 2019

Introduction

Identification of elevated pulmonary artery pressures during exercise has important diagnostic, prognostic and therapeutic implications. Stress echocardiography is frequently used to estimate pulmonary artery pressures during exercise testing, but data supporting this practice are limited. This study examined the accuracy of Doppler echocardiography for the estimation of pulmonary artery pressures at rest and during exercise.

Methods

Simultaneous cardiac catheterisation-echocardiographic studies were performed at rest and during exercise in 97 subjects with dyspnoea. Echocardiography-estimated pulmonary artery systolic pressure (ePASP) was calculated from the right ventricular (RV) to right atrial (RA) pressure gradient and estimated RA pressure (eRAP), and then compared with directly measured PASP and RAP.

Results

Estimated PASP was obtainable in 57% of subjects at rest, but feasibility decreased to 15–16% during exercise, due mainly to an inability to obtain eRAP during stress. Estimated PASP correlated well with direct PASP at rest (r=0.76, p<0.0001; bias −1 mmHg) and during exercise (r=0.76, p=0.001; bias +3 mmHg). When assuming eRAP of 10 mmHg, ePASP correlated with direct PASP (r=0.70, p<0.0001), but substantially underestimated true values (bias +9 mmHg), with the greatest underestimation among patients with severe exercise-induced pulmonary hypertension (EIPH). Estimation of eRAP during exercise from resting eRAP improved discrimination of patients with or without EIPH (area under the curve 0.81), with minimal bias (5 mmHg), but wide limits of agreement (−14–25 mmHg).

Conclusions

The RV–RA pressure gradient can be estimated with reasonable accuracy during exercise when measurable. However, RA hypertension frequently develops in patients with EIPH, and the inability to noninvasively account for this leads to substantial underestimation of exercise pulmonary artery pressures.
Intensity and quality of exertional dyspnoea in patients with stable pulmonary hypertension
Authors: Boucly Athénaïs , Morélot-Panzini Capucine , Garcia Gilles , Weatherald Jason , Jaïs Xavier , Savale Laurent , Montani David , Humbert Marc , Similowski Thomas , Sitbon Olivier , Laveneziana Pierantonio
Published: November 2019

Dynamic hyperinflation is observed during exercise in 60% of patients with clinically stable pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), intensifying exertional dyspnoea. The impact of dynamic changes in respiratory mechanics during exercise on qualitative dimensions of dyspnoea in these patients has not been evaluated.

26 patients (PAH n=17; CTEPH n=9) performed an incremental symptom-limited cycle exercise test. Minute ventilation (V′E), breathing pattern, operating lung volumes and dyspnoea intensity were assessed throughout exercise. Dyspnoea quality was serially assessed during exercise using a three-item questionnaire (dyspnoea descriptors). The inflection point of tidal volume (VT) relative toV′Ewas determined for each incremental test. Changes in inspiratory capacity during exercise defined two groups of patients: hyperinflators (65%) and non-hyperinflators (35%). Multidimensional characterisation of dyspnoea was performed after exercise using the Multidimensional Dyspnea Profile.

In hyperinflators, inspiratory capacity decreased progressively throughout exercise by 0.36 L, while remaining stable in non-hyperinflators. The “work/effort” descriptor was most frequently selected throughout exercise in both types of patients (65% of all responses). At theVT/V′Einflection, work/effort plateaued while “unsatisfied inspiration” descriptors became selected predominantly only in hyperinflators (77% of all responses). In the affective domain, the emotion most frequently associated with dyspnoea was anxiety.

In pulmonary hypertension patients who develop hyperinflation during exercise, dyspnoea descriptors referring to unsatisfied inspiration become predominant following theVT/V′Einflection. As these descriptors are generally associated with more negative emotional experiences, delaying or preventing theVT/V′Einflection may have important implications for symptom management in patients with pulmonary hypertension.
Detection of 8-oxoguanine and apurinic/apyrimidinic sites using a fluorophore-labeled probe with cell-penetrating ability
Authors: Kang Dong Min , Shin Jong-Il , Kim Ji Beom , Lee Kyungho , Chung Ji Hyung , Yang Hye-Won , Kim Kil-Nam , Han Ye Sun
Published: November 2019

Background

Reactive oxygen species (ROS) produce different lesions in DNA by ROS-induced DNA damage. Detection and quantification of 8-oxo-7,8-dihydroguanine (8-oxoG) within cells are important for study. Human ribosomal protein S3 (hRpS3) has a high binding affinity to 8-oxoG. In this study, we developed an imaging probe to detect 8-oxoG using a specific peptide from hRpS3. Transactivator (TAT) proteins are known to have cell-penetrating properties. Therefore, we developed a TAT-S3 probe by attaching a TAT peptide to our imaging probe.

Results

A DNA binding assay was conducted to confirm that our probe bound to 8-oxoG and apurinic/apyrimidinic (AP) sites. We confirmed that the TAT-S3 probe localized in the mitochondria, without permeabilization, and fluoresced in H2O2-treated HeLa cells and zebrafish embryos. Treatment with Mitoquinone (MitoQ), a mitochondria-targeted antioxidant, reduced TAT-S3 probe fluorescence. Additionally, treatment with O8, an inhibitor of OGG1, increased probe fluorescence. A competition assay was conducted with an aldehyde reaction probe (ARP) and methoxyamine (MX) to confirm binding of TAT-S3 to the AP sites. The TAT-S3 probe showed competitive binding to AP sites with ARP and MX.

Conclusions

These results revealed that the TAT-S3 probe successfully detected the presence of 8-oxoG and AP sites in damaged cells. The TAT-S3 probe may have applications for the detection of diseases caused by reactive oxygen species.
Analysing detection of chronic diseases with prolonged sub-clinical periods: modelling and application to hypertension in the U.S.
Authors: Brinks Ralph , Kaufmann Sophie , Hoyer Annika , Gregg Edward W , Saal Jürgen
Published: November 2019

Background

We recently introduced a system of partial differential equations (PDEs) to model the prevalence of chronic diseases with a possibly prolonged state of asymptomatic, undiagnosed disease preceding a diagnosis. Common examples for such diseases include coronary heart disease, type 2 diabetes or cancer. Widespread application of the new method depends upon mathematical treatment of the system of PDEs.

Methods

In this article, we study the existence and the uniqueness of the solution of the system of PDEs. To demonstrate the usefulness and importance of the system, we model the age-specific prevalence of hypertension in the US 1999–2010.

Results

The examinations of mathematical properties provide a way to solve the systems of PDEs by the method of characteristics. In the application to hypertension, we obtain a good agreement between modeled and surveyed age-specific prevalences.

Conclusions

The described system of PDEs provides a practical way to examine the epidemiology of chronic diseases with a state of undiagnosed disease preceding a diagnosis.
Accumulation of damaged mitochondria in alveolar macrophages with reduced OXPHOS related gene expression in IPF
Authors: Tsitoura Eliza , Vasarmidi Eirini , Bibaki Eleni , Trachalaki Athina , Koutoulaki Chara , Papastratigakis George , Papadogiorgaki Sevasti , Chalepakis George , Tzanakis Nikos , Antoniou Katerina M.
Published: November 2019

Background

Impaired mitochondria homeostasis and function are established hallmarks of aging and increasing evidence suggests a link with lung fibrosis. Mitochondria homeostasis may be also affected in alveolar macrophages (AMs) in idiopathic pulmonary fibrosis (IPF). In this study, we used bronchoalveolar lavage (BAL), a tool for both clinical and research purposes, and a rich source of AMs.

Methods

BAL samples were examined from 52 patients with IPF and 19 healthy individuals. Measurements of mitochondria reactive oxygen species (mtROS), mitochondria morphology and related gene expression were performed. Additionally, autophagy and mitophagy levels were analysed.

Results

Mitochondria in AMs from IPF patients had prominent morphological defects and impaired transcription paralleled to a significant reduction of mitochondria homeostasis regulators PINK1, PARK2 and NRF1. mtROS, was significantly higher in IPF and associated with reduced expression of mitochondria-encoded oxidative phosphorylation (OXPHOS) genes. Age and decline in lung function correlated with higher mtROS levels. Augmentation of damaged, oxidised mitochondria in IPF AMs however was not coupled to increased macroautophagy and mitophagy, central processes in the maintenance of healthy mitochondria levels.

Conclusion

Our results suggest a perturbation of mitochondria homeostasis in alveolar macrophages in IPF.
Recurrent mitral regurgitation after mitral valve repair for bileaflet lesions in the modern era
Authors: Kaneyuki Daisuke , Nakajima Hiroyuki , Asakura Toshihisa , Yoshitake Akihiro , Tokunaga Chiho , Tochii Masato , Hayashi Jun , Takazawa Akitoshi , Izumida Hiroaki , Iguchi Atsushi
Published: November 2019

Background

Good mid-term durability of mitral valve repair of bileaflet lesions has been reported; however, patients may develop failure during follow-up. This study assessed late outcomes and mechanisms of failure associated with mitral valve repair of bileaflet lesions.

Methods

Fifty-six patients (mean age 67 ± 12 years) underwent mitral valve repair of bileaflet lesions due to degenerative disease in 2011–2018. Mitral annuloplasty was added to all procedures except for 1 patient with annular calcification. Mitral valve lesions were identified by surgical inspection. Mean clinical and echocardiography follow-up occurred at 2.7 ± 2.1 and 2.5 ± 1.9 years, respectively.

Results

Additional mitral valve repair techniques involved triangular resection (n = 15 patients), quadrangular resection with sliding plasty (n = 12), neochordoplasty (n = 52), and commissural plication (n = 26). Prolapse of ≥2 anterior and posterior leaflet scallops occurred in 22 (39%) and 30 (54%) patients, respectively. During follow-up, 10 (17.8%) patients developed moderate or severe mitral regurgitation. Whereas prolapse or tethering was observed early after neochordoplasty or quadrangular resection, recurrent regurgitation occurred late after commissural repair. Five-year freedom from recurrent moderate or severe mitral regurgitation rates was 71.1 ± 11.0%.

Conclusions

Seventeen percent of patients developed recurrent mitral regurgitation during follow-up. Repair failure in the early phase occurred owing to aggressive resection of the posterior mitral leaflet or maladjustment of the artificial neochordae. Recurrent mitral regurgitation might occur in the late phase even after acceptable commissural repair. A sequential approach may be useful to improve the quality of mitral valve repair in bileaflet lesions.
Study partner types and prediction of cognitive performance: implications to preclinical Alzheimer’s trials
Authors:   for the Alzheimer’s Disease Cooperative Study, Nuño Michelle M. , Gillen Daniel L. , Grill Joshua D.
Published: November 2019

Background

Alzheimer’s disease (AD) clinical trials require enrollment of a participant and a study partner, whose role includes assessing participant cognitive and functional performance. AD trials now investigate early stages of the disease, when participants are not cognitively impaired. This gives rise to the question of whether study partners or participants provide more information in these trials.

Methods

We used data from the AD Cooperative Study Prevention Instrument Project (ADCS-PI) to compare participant and study partner predictions of the participant’s current and future cognitive state. We used the Cognitive Function Instrument (CFI) as a measure of evaluation of the participant’s cognitive status and the modified ADCS Preclinical Alzheimer’s Cognitive Composite (mADCS-PACC) as an objective measure of cognition. Stratifying by cognitive status and study partner type and adjusting for other predictors of the participant’s cognitive state, we used random forests along with estimated mean variable importance (eMVI) to assess how well each member of the dyad can predict cognitive state at current and later visits. We also fit linear regression models at each time point and for each scenario.

Results

Participants were better at predicting future cognitive status compared to their study partners regardless of study partner type, though the difference between participants and partners was greatest for non-spousal dyads in the lowest-performing quartile. Cross-sectional assessments differed substantially by dyad type. Within the lowest cognitive performance quartile, participants having a non-spousal study partner outperformed their partners in assessing cognition at later times. Spousal partners, in contrast, outperformed participants later in the study in predicting current cognitive performance.

Conclusions

These results indicate that participants tend to be better at predicting future cognition compared to their study partners regardless of the study partner type. When assessing current cognition, however, spousal study partners perform better at later time points and non-spousal study partners do not provide as much information regarding participant cognitive state.