bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Brain Stimulation Targeting the Globus Pallidus Interna for Dystonic Tremor in the Setting of Generalized Dystonia
Authors: Zhang Qiang , Thomsen Teri R.
Published: June 2020

Intractable generalized dystonia can be treated by deep brain stimulation (DBS) targeting the globus pallidus interna (GPi). The GPi DBS parameters used for generalized dystonia are frequently different from those used for Parkinson disease, with low-frequency, high–pulse width stimulation being common. This chapter presents a patient with generalized dystonia and debilitating dystonic tremor involving the bilateral hands. He could not tolerate higher pulse width than 60 µsec, but high-frequency (130-Hz) stimulation achieved good control of the dystonic tremor as well as of the generalized dystonia. DBS therapy improved his qualify of life. For generalized dystonia and coexisting dystonic tremor, the tremor may in some cases respond to high-frequency GPi DBS.
Tardive Dystonia and Dyskinesia Responsive to Deep Brain Stimulation
Authors: Chiu Shannon Y. , Malaty Irene A.
Published: June 2020

Tardive disorders encompass phenomenologically diverse delayed-onset persistent involuntary motor symptoms associated with exposure to dopamine receptor blocking agents. Two common tardive disorders encountered in the clinical setting include tardive dyskinesia and tardive dystonia. This chapter presents a patient with severe refractory tardive dyskinesia and also tardive dystonia, manifesting as frequent and disabling retropulsion. He initially underwent bilateral globus pallidus interna (GPi) deep brain stimulation (DBS) but was found to have lead migration secondary to his severe hyperkinetic movements. He had persistent symptoms despite lead revision and ultimately required bilateral subthalamic nucleus (STN) rescue DBS implantation. The rescue procedure was synergistic with the initial GPi DBS and markedly improved his symptoms. Severe tardive dyskinesia and dystonia may respond to bilateral GPi DBS, and if necessary, rescue STN DBS can be added.
A Puzzle about Belief-about
Authors: Rausch Alex
Published: June 2020

I present a puzzle for the standard, propositional semantic account of belief reports by considering novel inferences which it incorrectly predicts to be invalid under assumptions that are plausible by its advocates’ own lights. In response, I propose a conservative departure from the standard view on which certain ‘that’-clauses designate novel devices of semantic type  that I call open propositions. After outlining some desiderata for a theory of open propositions, I provide some reasons for advocates of the standard view to treat them as properties of a certain kind. Then I give a bridge principle between the core notions of belief and belief-about before showing how the resulting view can be implemented in accordance with formal theories of syntax and semantics. I bring out some of the consequences this investigation has beyond our semantic theorizing and conclude, more generally, that any response to the puzzle requires paying some surprising cost or another.
Forecast constraints on anisotropic stress in dark energy using gravitational waves
Authors: Yang Weiqiang , Pan Supriya , Mota David F , Du Minghui
Published: June 2020

It is always interesting to investigate how well can a future experiment perform with respect to others (present or future ones). Cosmology is really an exciting field where a lot of puzzles are still unknown. In this paper, we consider a generalized dark energy (DE) scenario where anisotropic stress is present. We constrain this generalized cosmic scenario with an aim to investigate how gravitational waves standard sirens (GWSS) may constrain the anisotropic stress, which, according to the standard cosmological probes, remains unconstrained. In order to do this, we generate the luminosity distance measurements from $\mathcal {O} (10^3)$ mock GW events that match the expected sensitivity of the Einstein Telescope. Our analyses report that, first of all, GWSS can give better constraints on various cosmological parameters compared to the usual cosmological probes, but the viscous sound speed appearing due to the DE anisotropic stress is totally unconstrained even after the inclusion of GWSS.
Galaxy cold gas contents in modern cosmological hydrodynamic simulations
Authors: Davé Romeel , Crain Robert A , Stevens Adam R H , Narayanan Desika , Saintonge Amelie , Catinella Barbara , Cortese Luca
Published: June 2020

We present a comparison of galaxy atomic and molecular gas properties in three recent cosmological hydrodynamic simulations, namely SIMBA, EAGLE, and IllustrisTNG, versus observations from z ∼ 0 to 2. These simulations all rely on similar subresolution prescriptions to model cold interstellar gas that they cannot represent directly, and qualitatively reproduce the observed z ≈ 0 H i and H2 mass functions (HIMFs and H2MFs, respectively), CO(1–0) luminosity functions (COLFs), and gas scaling relations versus stellar mass, specific star formation rate, and stellar surface density μ*, with some quantitative differences. To compare to the COLF, we apply an H2-to-CO conversion factor to the simulated galaxies based on their average molecular surface density and metallicity, yielding substantial variations in αCO and significant differences between models. Using this, predicted z = 0 COLFs agree better with data than predicted H2MFs. Out to z ∼ 2, EAGLE’s and SIMBA’s HIMFs and COLFs strongly increase, while IllustrisTNG’s HIMF declines and COLF evolves slowly. EAGLE and simba reproduce high-LCO(1–0) galaxies at z ∼ 1–2 as observed, owing partly to a median αCO(z = 2) ∼ 1 versus αCO(z = 0) ∼ 3. Examining H i, H2, and CO scaling relations, their trends with M* are broadly reproduced in all models, but EAGLE yields too little H i in green valley galaxies, IllustrisTNG and SIMBA overproduce cold gas in massive galaxies, and SIMBA overproduces molecular gas in small systems. Using SIMBA variants that exclude individual active galactic nucleus (AGN) feedback modules, we find that SIMBA’s AGN jet feedback is primarily responsible by lowering cold gas contents from z ∼ 1 → 0 by suppressing cold gas in $M_*\gtrsim 10^{10}{\rm \,M}_\odot$ galaxies, while X-ray feedback suppresses the formation of high-μ* systems.
Vitrification-induced activation of lysosomal cathepsin B perturbs spindle assembly checkpoint function in mouse oocytes
Authors: Balboula Ahmed Z , Schindler Karen , Kotani Tomoya , Kawahara Manabu , Takahashi Masashi
Published: June 2020

As the age of child-bearing increases and correlates with infertility, cryopreservation of female gametes is becoming common-place in ART. However, the developmental competence of vitrified oocytes has remained low. The underlying mechanisms responsible for reduced oocyte quality post-vitrification are largely unknown. Mouse cumulus–oocyte complexes were vitrified using a cryoloop technique and a mixture of dimethylsulphoxide, ethylene glycol and trehalose as cryoprotectants. Fresh and vitrified/thawed oocytes were compared for chromosome alignment, spindle morphology, kinetochore-microtubule attachments, spindle assembly checkpoint (SAC) and aneuploidy. Although the majority of vitrified oocytes extruded the first polar body (PB), they had a significant increase of chromosome misalignment, abnormal spindle formation and aneuploidy at metaphase II. In contrast to controls, vitrified oocytes extruded the first PB in the presence of nocodazole and etoposide, which should induce metaphase I arrest in a SAC-dependent manner. The fluorescence intensity of mitotic arrest deficient 2 (MAD2), an essential SAC protein, at kinetochores was reduced in vitrified oocytes, indicating that the SAC is weakened after vitrification/thawing. Furthermore, we found that vitrification-associated stress disrupted lysosomal function and stimulated cathepsin B activity, with a subsequent activation of caspase 3. MAD2 localization and SAC function in vitrified oocytes were restored upon treatment with a cathepsin B or a caspase 3 inhibitor. This study was conducted using mouse oocytes, therefore confirming these results in human oocytes is a prerequisite before applying these findings in IVF clinics. Here, we uncovered underlying molecular pathways that contribute to an understanding of how vitrification compromises oocyte quality. Regulating these pathways will be a step toward improving oocyte quality post vitrification and potentially increasing the efficiency of the vitrification program.
Proteome dynamics analysis identifies functional roles of SDE2 and hypoxia in DNA damage response in prostate cancer cells
Authors: Luo Ang , Gong Yao , Kim Hyungjin , Chen Yue
Published: June 2020

Mechanistic understanding of hypoxia-responsive signaling pathways provides important insights into oxygen- and metabolism-dependent cellular phenotypes in diseases. Using SILAC-based quantitative proteomics, we provided a quantitative map identifying over 6300 protein groups in response to hypoxia in prostate cancer cells and identified both canonical and novel cellular networks dynamically regulated under hypoxia. Particularly, we identified SDE2, a DNA stress response modulator, that was significantly downregulated by hypoxia, independent of HIF (hypoxia-inducible factor) transcriptional activity. Mechanistically, hypoxia treatment promoted SDE2 polyubiquitination and degradation. Such regulation is independent of previously identified Arg/N-end rule proteolysis or the ubiquitin E3 ligase, CDT2. Depletion of SDE2 increased cellular sensitivity to DNA damage and inhibited cell proliferation. Interestingly, either SDE2 depletion or hypoxia treatment potentiated DNA damage-induced PCNA (proliferating cell nuclear antigen) monoubiquitination, a key step for translesion DNA synthesis. Furthermore, knockdown of SDE2 desensitized, while overexpression of SDE2 protected the hypoxia-mediated regulation of PCNA monoubiquitination upon DNA damage. Taken together, our quantitative proteomics and biochemical study revealed diverse hypoxia-responsive pathways that strongly associated with prostate cancer tumorigenesis and identified the functional roles of SDE2 and hypoxia in regulating DNA damage-induced PCNA monoubiquitination, suggesting a possible link between hypoxic microenvironment and the activation of error-prone DNA repair pathway in tumor cells.
Observations of V404 Cygni during the 2015 outburst by the Nasu telescope array at 1.4 GHz
Authors: Asuma Kuniyuki , Niinuma Kotaro , Takefuji Kazuhiro , Aoki Takahiro , Kida Sumiko , Nakajima Hirochika , Tsubono Kimio , Daishido Tsuneaki
Published: June 2020

Waseda University Nasu telescope array is a spatial fast Fourier transform interferometer consisting of eight linearly aligned antennas with 20 m spherical dishes. This type of interferometer was developed to survey transient radio sources with an angular resolution as high as that of a 160 m dish and a field of view as wide as that of a 20 m dish. We have been performing drift-scan-mode observations, in which the telescope scans the sky around a selected declination as the Earth rotates. The black hole X-ray binary V404 Cygni underwent a new outburst in 2015 June after a quiescent period of 26 yr. Because of the interest in black hole binaries, a considerable amount of data on this outburst at all wavelengths was accumulated. Using the above telescope, we had been monitoring V404 Cygni daily from one month before the X-ray outburst, and two radio flares at 1.4 GHz were detected on 2015 June 21.73 and June 26.71. The flux density and timescale of the flares were 313 ± 30 mJy and 1.50 ± 0.49 d, 364 ± 30 mJy and 1.70 ± 0.16 d, respectively. We also confirmed the extreme variation of the radio spectra within a short period by collecting other radio data observed with several radio telescopes. Such spectral behavior is considered to reflect the change in the opacity of the ejected blobs associated with these extreme activities in radio and X-ray. Our 1.4 GHz radio data are expected to be helpful for studying the physics of the accretion and ejection phenomena around black holes.
A Pathology of Sacral Kingship: Putrefaction in the Body of Charles Xi of Sweden
Authors: Sennefelt Karin
Published: June 2020

This article uses the ailing body of King Charles XI of Sweden (1655–97) to explore how the king’s physicality was intimately connected not only with the nature of his kingship, its sacredness and legitimacy, but also with his personal faith. It shows that, while Charles’s body was exceptional in that it was the body of the king, at the same time it was reacting to illness and sin like any other Lutheran body. It also projected the body’s capabilities on a larger scale. In particular, the lethal putrefaction inside his belly came to play an important part in interpreting his kingship. These ideas had an impact that extended from his own stomach pains, via the anxiety of his suffering people, to the ending of absolute rule. By following the analogies that contemporaries drew from the king’s autopsy and his physicians’ notes, from sermons, official proclamations, diaries, weather reports, poetry, correspondence and prophecies, this article uncovers the powerful resemblances that connected Charles’s body with nature, his people, the realm and the divine. In the end it was the gathering of the cosmos into Charles’s body that paved the way for direct criticism of absolutism itself.
Factors determining different death rates because of the COVID-19 outbreak among countries
Authors: Fountoulakis Konstantinos N , Fountoulakis Nikolaos K , Koupidis Sotirios A , Prezerakos Panagiotis E
Published: June 2020

Background

During the coronavirus disease 2019 (COVID-19) pandemic, all European countries were hit, but mortality rates were heterogenous. The aim of the current paper was to identify factors responsible for this heterogeneity.

Methods

Data concerning 40 countries were gathered, concerning demographics, vulnerability factors and characteristics of the national response. These variables were tested against the rate of deaths per million in each country. The statistical analysis included Person correlation coefficient and Forward Stepwise Linear Regression Analysis (FSLRA).

Results

The FSLRA results suggested that ‘days since first national death for the implementation of ban of all public events’ was the only variable significantly contributing to the final model, explaining 44% of observed variability.

Discussion

The current study suggests that the crucial factor for the different death rates because of COVID-19 outbreak was the fast implementation of public events ban. This does not necessarily mean that the other measures were useless, especially since most countries implemented all of them as a ‘package’. However, it does imply that this is a possibility and focused research is needed to clarify it, and is in accord with a model of spreading where only a few superspreaders infect large numbers through prolonged exposure.
The Schizotypal Personality Questionnaire for Children (SPQ-C): Factor Structure, Child Abuse, and Family History of Schizotypy
Authors: Raine Adrian , Wong Keri Ka-Yee , Liu Jianghong
Published: June 2020

There is a relative dearth of research on features of schizotypal personality in children, in part due to lack of instrumentation. This study tests 5 competing models of the factor structure of the self-report Schizotypal Personality Questionnaire for Children (SPQ-C) and examines its relationship with a family history of schizotypal personality disorder (SPD), child abuse, and stability over time. Hypotheses were tested on 454 11- to 12-year-old schoolchildren and their caregivers. Confirmatory factor analyses supported a 3-factor structure of the SPQ-C (cognitive-perceptual, interpersonal, and disorganized). Test-retest stability was relatively robust over 3 months (r = .67), 6 months (r = .64), and 12 months (r = .55), with acceptable internal reliabilities (r = .84 to .91). Regarding construct validity, children with a biological family history of SPD had higher scores on all 3 factors (d =.51). Abused children had higher schizotypy scores (d = .55). A genetic × environment interaction was observed, with schizotypy highest in those with both a family history of schizotypy and also child abuse. Findings are the first in the child schizotypy field to document a gene × environment interaction and the independence of child abuse from confounding genetic influences. Results support the utility of the SPQ-C in future family and clinical studies of schizotypal personality and provide an avenue for much-needed and neglected research into the early antecedents of child schizotypal personality.
Effect of calcium oxide and soybean hull addition to feedlot diets containing dried distillers grains and corn stover on steer performance, carcass characteristics, and digestibility
Authors: Lancaster Nicholas A , Muegge Chris R , Carvalho Jose R R , Lopes Rodrigo C , Narumiya Rafael S , Pinese Fabio , Baird Aubrey Nickie , Schoonmaker Jon P
Published: June 2020

The objective of this study was to determine the effect of soybean hulls (SBH) and/or calcium oxide (CaO) on rumen pH, digestibility, and performance of steers fed diets containing dried distillers grains with solubles (DDGS). In experiment 1, Angus × Simmental steers (n = 112, body weight [BW] = 364 ± 7.8 kg) were allotted to 1 of 4 diets arranged as a 2 × 2 factorial and placed in 16 pens (7 steers/pen, 4 pens/treatment, and 28 steers/treatment). Factors were SBH (0% or 30% of diet dry matter [DM]) and CaO (0% or 1%) inclusion. Basal diets contained 20% corn stover, 30% DDGS, and 4% supplement. Diets with SBH contained 14.1% or 15.0% corn and diets without SBH contained 43.9% or 44.8% corn. In experiment two, four steers (BW = 510 ± 9.8 kg) were allotted to a 4 × 4 Latin square (21 d periods) to determine the effects of CaO and SBH on ruminal pH, volatile fatty acid (VFA), nutrient digestibility, and digestion kinetics. Statistical analyses were conducted using the MIXED procedure of SAS. In experiment 1, BW did not differ among treatments (P ≥ 0.46). Overall carcass-adjusted gain did not differ due to SBH or CaO inclusion (P ≥ 0.13); however, there was an interaction (P = 0.01) where CaO improved gain in steers fed no SBH, but not in steers fed SBH. Steers fed SBH consumed more DM than steers not fed SBH (P = 0.02) and an interaction tended to occur (P = 0.06) where CaO increased dry matter intake in steers fed no SBH, but not in steers fed SBH. Calcium oxide increased hot carcass weight and yield grade (interaction; P ≤ 0.04) and tended to increase fat thickness (interaction; P = 0.08) in steers fed no SBH, but not in steers fed SBH. Dressing percentage, longissimus muscle area, % kidney, pelvic, heart fat, and marbling score did not differ among treatments (P ≥ 0.14). Total VFA concentrations were greater with SBH inclusion and with CaO addition (P < 0.01). Digestibility of DM, neutral detergent fiber (NDF), and acid detergent fiber (ADF) was greater with CaO addition (P ≤ 0.04) and NDF and ADF digestibility were greater with SBH inclusion (P < 0.001). Inclusion of SBH did not affect (P ≥ 0.26) rate of digestion (kd) or passage (kp). Addition of CaO tended to increase mean retention time (P = 0.09). An interaction between SBH inclusion and CaO addition occurred for kd (P = 0.01), where CaO increased kd in steers fed SBH, but decreased kd when steers were fed no SBH. Total N excretion tended to be lower with SBH inclusion and CaO addition (P = 0.07). In conclusion, CaO enhances performance of cattle fed corn, DDGS, and corn stover diets, but not when corn is partially replaced by a fiber-based energy feed.
Association Between Provider Engagement, Staff Engagement, and Culture of Safety
Authors: Zallman Leah , Finnegan Karen E. , Todaro Martina , Dallinga Bree , Curtis Joy , Lidman Marcy , Allen Paul , Peterson Denise , Schoonmaker Karen , Sayah Assaad
Published: June 2020

As healthcare organizations seek to improve patient experience, quality, and safety, employee engagement and perceptions of patient safety (POPS) have increasingly become foci of attention. Yet, the relationship between these constructs is poorly understood. We examined the correlation between provider and staff engagement (collectively, “employee engagement”), and between employee engagement and POPS in ambulatory and hospital environments. We found significant correlations between staff engagement and POPS, and between provider engagement and POPS in ambulatory and hospital environments. We also found significant correlation between provider and staff engagement. Although all correlations were weak (correlation coefficients of 0.17–0.47), there were significant increases in POPS with increases in employee engagement (in both ambulatory and hospital environments) and increases in provider engagement with increases in staff engagement. These increases range from 4% to 11% for every 17% increase in staff engagement. These findings suggest that healthcare systems seeking to improve provider engagement, staff engagement, and POPS may find synergistic effects between these efforts in ambulatory and hospital settings.
Comparison of the recurrence rate of 3 treatment modalities for Bowen disease in an aging city
Authors: Mo Young Woong , Lee Dong Lark
Published: June 2020

A wide range of therapeutic options are available for the treatment of Bowen disease. However, few studies have been conducted on wide excision using various resurfacing methods. The objectives of this study were:

One hundred forty-eight lesions were studied. All lesions were histopathologically confirmed as Bowen disease. Lesions were classified by anatomical site and treatment modality and their dimensions were measured. Punch biopsy was reperformed when a treated lesion was considered to have possibly recurred. Recurrence rates were then compared. Preoperative and intraoperative photos and follow-up images were also taken.

The most common site of Bowen disease was the head and neck region. Wide excision was found to provide good outcomes with minimal tumor recurrence. Recurrence after cryotherapy occurred relatively quickly (mean 0.2 years, median 0.2 years) while recurrence after wide excision occurred at a mean 2.5 years. Treatment modality was significantly associated with recurrence (P < .05).

The optimal treatment for Bowen disease has not been determined. Wide excision provided lower recurrence than other treatment modalities. Providers should be aware of the multiple treatment options available and select the method most appropriate for each patient. The limitations of our study are that it was retrospectively designed and conducted at a single institution.
Lumbar decompression and lumbar interbody fusion in the treatment of lumbar spinal stenosis
Authors: Yang Li-Hui , Liu Wei , Li Jian , Zhu Wen-Yi , An Li-Kun , Yuan Shuo , Ke Han , Zang Lei
Published: June 2020

Background:

The goal of this study was to review relevant randomized controlled trials in order to determine the efficacy of decompression and lumbar interbody fusion in the treatment of lumbar spinal stenosis.

Method:

Using appropriate keywords, we identified relevant studies in PubMed, the Cochrane library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through July 2019 were considered for inclusion. For each study, we assessed odds ratios, mean difference, and 95% confidence interval to assess and synthesize outcomes.

Result:

Twenty-one randomized controlled trials were eligible for this meta-analysis with a total of 3636 patients. Compared with decompression, decompression and fusion significantly increased length of hospital stay, operative time and estimated blood loss. Compared with fusion, decompression significantly decreased operative time, estimated blood loss and overall visual analogue scale (VAS) scores. Compared with endoscopic decompression, microscopic decompression significantly increased length of hospital stay, and operative time. Compared with traditional surgery, endoscopic discectomy significantly decreased length of hospital stay, operative time, estimated blood loss, and overall VAS scores and increased Japanese Orthopeadic Association score. Compared with TLIF, MIS-TLIF significantly decreased length of hospital stay, and increased operative time and SF-36 physical component summary score. Compared with multi-level decompression and single level fusion, multi-level decompression and multi-level fusion significantly increased operative time, estimated blood loss and SF-36 mental component summary score and decreased Oswestry disability index score. Compared with decompression, decompression with interlaminar stabilization significantly decreased operative time and the score of Zurich claudication questionnaire symptom severity, and increased VAS score.

Conclusion:

Considering the limited number of included studies, we still need larger-sample, high-quality, long-term studies to explore the optimal therapy for lumbar spinal stenosis.
Risk factors of stone recurrence after endoscopic retrograde cholangiopancreatography for common bile duct stones
Authors: Lujian Peng , Xianneng Cheng , Lei Zhang
Published: June 2020

To explore the risk factors related to the recurrence of common bile duct stones (CBDS) after endoscopic retrograde cholangiopancreatography (ERCP), so as to provide reference for reducing the recurrence of CBDS after ERCP.

The clinical data of 385 patients with CBDS treated by ERCP from March 2012 to May 2016 were collected. According to the diagnostic criteria of recurrence of CBDS, the patients were divided into recurrence group and control group. The general information of the patients, personal history, past history, and surgical-related information were collected. Univariate analysis and multivariate logistic regression analysis were performed on the collected data to identify risk factors for recurrence of CBDS after ERCP.

A total of 262 patients were included in the study, of which 51 had recurrence of CBDS, with a recurrence rate of 19.46%. Multivariate Logistic analysis (Table 2) showed greasy diet (P = .436), history of cholecystectomy (P = .639) and gallstone size (P = .809) were not independent risk factor for recurrence of stones after ERCP in CBDS. But age ≥65 (P = .013), history of common bile duct incision (P = .001), periampullary diverticulum (P = .001), common bile duct diameter ≥1.5 cm (P = .024), ERCP ≥2 (P = .003), the number of stones ≥2 (P = .015), the common bile duct angle ≤120° (P = .002) and the placement of bile duct stent (P = .004) are important independent risk factor for recurrence of stones after ERCP in CBDS.

This study confirmed that ag ≥65, history of choledochotomy, periampullary diverticulum, diameter of common bile duct (≥15 mm), multiple ERCP, the number of stones ≥2, stent placement and angle of common bile duct < 120° were independent risk factors for recurrence of CBDS after ERCP.
The evaluation of the treatment for old osteoporotic vertebral compression fracture pain by percutaneous vertebroplasty
Authors: Zhao Peng , Guo Aifeng , Tan Zhongjiang , Li Tianqiang , Zhao Fei , Li Jie , Yan Wenliang
Published: June 2020

The aim of the present study was to evaluate the clinical effect of percutaneous vertebroplasty (PVP) in the treatment of old osteoporotic vertebral compression fracture (OVCF) pain.

A retrospective study was conducted on the clinical and imaging data of 31 patients with old OVCF treated by PVP from June 2010 to September 2011. Clinical efficacy was evaluated by the visual analog scale (VAS) scores, the oswestry disability index (ODI), the Cobb angle, and vertebral kyphotic angle at pre-operation and post-operation 3 days, 3 months, and 12 months.

The VAS scores and ODI scores of 3 day, 3 month, and 12 month after PVP were significantly improved compared with those before operation (P < .05), but the Cobb angle and vertebral kyphosis angle were not significantly improved compared with those before operation (P > .05).

PVP can effectively relieve the pain caused by old OVCF, and the motor ability of the patients is improved obviously. However, the recovery of Cobb angle and vertebral kyphosis angle was not obvious.
The current status of stroke-related smartphone applications available to adopt in China
Authors: Zhang Huixia , Wang Tao , Zhang Zhenxiang , Lin Beilei , Mei Yongxia , Zhang Yongchao , Chen Gang
Published: June 2020

Introduction:

Stroke-related smartphone applications (apps) present enormous potential for stroke management as apps become increasingly prevalent in China. However, there is no comprehensive study reported about the currents status of stroke-related apps available to adopt in Chinese app market. The aim of this study is to assess the current status of stroke-related apps available to adopt in China.

Materials and Methods:

Using Stroke-related keywords written in either Chinese or English, the top 6 most prevalent apps online stores in China were searched from June to August 2018, including android market, 360 app market, wan dou jia, baidu mobile app, ying yong bao, apple app store. The basic features of selected apps were analyzed based on operating system, cost, target people, engagement, online interaction, release date, size, popularity, and usefulness. The information accountability of selected apps was evaluated with the Silberg scale. The functionality of selected apps targeting stroke patients at home were reviewed by researchers.

Results:

Our study showed that the downloads of stroke-related apps from android platform and the engagement of health professionals in apps development were critically insufficient. And most apps didn’t offer a platform to facilitate online interaction with health professional. The information accountability of apps also presented a huge room for improvement. The average Silberg score of 127 apps was 3.5 (out of 9) with most apps not disclosing sponsorship, authors’ affiliations, credentials, and sources or references of information. Few apps were modified in the past months. What's more, although the apps targeting stroke patients at home have covered 9 functionalities, most apps had only a simple functionality.

Conclusion:

This study identified areas for improvement concerning information accountability of stroke-related apps available for adoption in China and reviewed functionality of apps targeting stroke patients at home. The findings might guide the development for stroke-related apps in China in the future.
Acupuncture for breathlessness in COVID-19
Authors: Zhang Baozhen , Zhang Kai , Tang Qilin , Sun Kaihang , Han Zhenzhen
Published: June 2020

Background:

At present, accumulative attention has been paid to coronavirus disease 2019 (COVID-19) due to its global prevalence. Acupuncture may play a beneficial role in patients with breathlessness in COVID-19. This study is designed to determine the efficacy and safety of acupuncture for breathlessness in COVID-19.

Methods:

Randomized controlled trials (RCT) will be searched from 7 electronic databases, with the last search update being 30 June 2020. Studies by registers of clinical trials will be additionally searched. Two investigators will independently select studies, extract data and evaluate study quality. Finally, a meta-analysis will be used to evaluate the pooled intervention effect if possible.

Results:

Our present findings will indicate the application of acupuncture as an adjunctive treatment for dyspnea in COVID-19, which will be published in a peer-reviewed journal.

Conclusion:

Our study will provide a reference foundation for clinical optimization of treatment.

Prospero registration number:

CRD42020182323.
Effectiveness of backward walking for people affected by stroke
Authors: Chen Ze-Hua , Ye Xiang-Ling , Chen Wei-Jian , Chen Guo-Qian , Wu Jia-Tao , Wu Huai , Xu Xue-Meng
Published: June 2020

Background:

Backward walking (BW) training is increasingly used in rehabilitation for stroke, but relevant evidence remains unclear.

Objective:

To determine the effect of BW training on patients with stroke.

Methods:

A keyword search was conducted in PubMed, EMBASE, CINAHL, and China National Knowledge Infrastructure database for articles published until November, 2019. Two investigators screened the articles and extract data from each included study. Meta-analysis was performed to estimate the effect of BW on stroke. In addition, the quality of evidence was evaluated by GRADE (grading of recommendations, assessment, development, and evaluation; version:3.6) approach.

Results:

A total of ten studies were included according to the inclusion and exclusion criteria in the review. All included studies described some positive influences of BW on stroke relative to the control group (forward walking or conventional treatment). Compared to control group, there is a statistically significant improvement for BW group in gait velocity (mean difference [MD] = 6.87, 95%CI: [1.40, 12.33], P = .01, I
2 = 3%), Berg balance score (MD =3.82, 95%CI: [2.12, 5.52], P < .0001, I
2 = 0%), and walk test (MD =0.11, 95%CI: [0.02, 0.20], P = .02, I
2 = 36%).

Conclusions:

For patients with stroke, BW training, as an adjunct an adjunct to conventional treatment, can improve Berg balance score (moderate evidence), walk test performance (very low evidence), gait velocity (very low evidence). More large-scale and high-quality studies are warranted.
Binasal congruous hemianopia secondary to functional visual loss
Authors: Tsokolas Georgios , Khan Hina , Tyradellis Straton , George Jithin , Lawden Mark
Published: June 2020

Introduction:

To describe an unusual case of binasal congruous hemianopia secondary to functional visual loss (FVL).

Patient concerns:

A 24 year-old male was referred originally by his optician at the Emergency Eye Department of the Leicester Royal Infirmary in October 2018 with visual field changes affecting the nasal field of vision in both eyes on routine eye examination. The patient reported ongoing headaches over the last 6 weeks to 8 weeks associated with simultaneous peripheral visual field changes. He also reported rapid loss of weight over the same period of time.

Diagnosis:

Binasal congruous hemianopia secondary to FVL.

Interventions:

Full past medical and ocular history was obtained. The patient underwent full ophthalmic examination including dilated fundoscopy. Visual acuity was recorded with Snellen Chart. Color vision was assessed with Ishihara plates. Peripheral vision was assessed with both Humphrey visual fields and Goldmann visual fields. Optical coherence tomography of the macula and discs was also performed. Neuroimaging investigations included Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) of the Brain. Electrophysiology investigations included Electroretinogram and visual evoked potentials. Patient was also tested for syphilis.

Outcomes:

Humphrey visual fields and Goldmann visual fields confirmed the presence of complete binasal field defects. Optical coherence tomography, electroretinogram, visual evoked potentials, CT, MRI were all unremarkable. Ocular examination was normal. Finally, syphilis serology was negative. After 1 year of follow-up, the visual field changes have remained the same.

Conclusion:

To the best of our knowledge, this is the fourth case described in the literature with complete congruous binasal hemianopia due to FVL. We advocate thorough investigations with multimodal imaging of the fundus, neuroimaging and syphilis serology to exclude serious organic causes for binasal field defects prior to labeling such a field defect functional. Such patients may benefit from neuropsychological input to understand the psychological factors that may be contributing to the symptoms.
Screening and identification of key gene in sepsis development
Authors: Fu Qinghui , Yu Wenqiao , Fu Shuiqiao , Chen Enjiang , Zhang Shaoyang , Liang Ting-bo
Published: June 2020

Sepsis is one of the leading causes of mortality in intensive care units (ICU). The growing incidence rate of sepsis and its high mortality rate result are very important sociosanitary problems. Sepsis is a result of infection which can cause systemic inflammatory and organ failure. But the pathogenesis and the molecular mechanisms of sepsis is still not well understood. The aim of the present study was to identify the candidate key genes in the progression of sepsis.

Microarray datasets GSE28750, GSE64457, and GSE95233 were downloaded from Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) were identified, and function enrichment analyses were performed. The protein–protein interaction network (PPI) was constructed and the module analysis was performed using STRING and Cytoscape. Furthermore, to verify the results of the bioinformatics analyses, the expression levels of selected DEGs were quantified by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) in libobolysaccharide (LPS)-induced Human Umbilical Vein Endothelial Cells (HUVECs) to support the result of bioinformatics analysis.

Thirteen hub genes were identified and biological process analysis revealed that these genes were mainly enriched in apoptotic process, inflammatory response, innate immune response. Hub genes with high degrees, including MAPK14, SLC2A3, STOM, and MMP8, were demonstrated to have an association with sepsis. Furthermore, RT-PCR results showed that SLC2A3 and MAPK14 were significantly upregulated in the HUVECs induced by LPS compared with controls.

In conclusion, DEGs and hub genes identified in the present study help us understand the molecular mechanisms of sepsis, and provide candidate targets for diagnosis and treatment of sepsis.
Efficacy and safety of remimazolam in procedural sedation and analgesia
Authors: Wang Feng , Zhou Qian , Shen Minhuan , Quan Jing , Chen Jiejuan , Shi Jing , Zou Xiaohua
Published: June 2020

Background:

Remimazolam is a newly developed benzodiazepine as an alternative of conventional sedatives in the procedure of anesthesia. For the purpose of evaluating the efficacy and safety of remimazolam sedation during an endoscopy, we will perform a systematic review and meta-analysis of randomized controlled trials that compared remimazolam with midazolam and/or placebo.

Methods:

We will search PubMed, Embase, Web of Science, and the Cochrane Controlled Register of Trials (CENTRAL) from inception to December 2019 for randomized controlled trials that investigated efficacy and safety of remimazolam during an endoscopy. The job will be performed without language restriction. Experimental groups will include the interventions of remimazolam, while control groups will involve midazolam, placebo, or no controls. The primary outcome will be the onset time, followed by the secondary outcomes of the recovery time, the incidence of hypotension, the incidence of hypoxia and the incidence of bradycardia. Relative ratio or standardized mean difference will be used to measure the effect size of remimazolam. We will use I
2 statistics to assess the between-study heterogeneity in each meta-analysis, Eager's test to detect publication bias.

Results:

The results of this study will be published in a peer-reviewed journal.

Ethics and dissemination:

There is no need for ethical approval because all data used in this meta-analysis have been published. In addition, all data will be analyzed anonymously during the review process.

Protocol registration number:

CRD42020170745.
Therapeutic effect of percutaneous vertebroplasty and nonoperative treatment on osteoporotic vertebral compression fracture
Authors: Wang Dongliang , Cang Dingwei , Wu Ya , Wang Siqing
Published: June 2020

Background:

Osteoporosis and related complications have been increasing with the aging population. Osteoporotic vertebral compression fractures (OVCFs) are the most common among all osteoporotic fractures. The purpose of this study was performed to compare the efficiency and safety of vertebroplasty versus conservative treatment for acute OVCFs.

Methods:

The conduct of this study followed the Declaration of Helsinki principles and the reporting of this study adhered to the Consolidated Standards of Reporting Trials guidelines for randomized controlled trials. Written informed consent was obtained from every participant. Participants were randomly assigned (1:1) to receive either vertebroplasty or control group. The primary outcome was pain relief at 1 month and 1 year, measured with a Visual Analogue Scale score. The secondary outcomes were Roland-Morris Disability Questionnaire, short form score, European Quality of Life-5 Dimensions, and postoperative complications.

Results:

We hypothesize that vertebroplasty will provide a rapid decrease of pain and an early return to daily life activities compared with the control group.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5624).
Traditional Chinese medicine on treating dilated cardiomyopathy
Authors: Tan Yuqing , Chen Hengwen , Li Jun , Wu Qingjuan , Wu Xiaobo , Zhao Wei
Published: June 2020

Background:

Dilated cardiomyopathy (DCM) is a type of complex cardiomyopathy characterized by enlargement and contractile dysfunction of the left ventricle, right ventricle, or double ventricle. Modern studies have shown that the pathogenesis of DCM is closely related to factors such as heredity, gene mutation, autoimmunity, and viral infection. The etiology is complex and the mortality rate is high. Many clinical trials have proved that traditional Chinese medicine has a great therapeutic effect on DCM. In this systematic review, we aim to evaluate the effectiveness and safety of traditional Chinese medicine for DCM.

Methods:

The databases of Pubmed, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WANFANG Data), Weipu Information Chinese Periodical Service Platform (VIP), and China Biomedical Literature Service System (SinoMed) will be searched online to collect randomized controlled trials related to the treatment of DCM with Traditional Chinese medicine The time is limited from the construction of the library to December 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata 13.0 software so as to systematically review the effectiveness of Traditional Chinese medicine for DCM.

Ethics and dissemination:

This systematic review will evaluate the efficacy and safety of traditional Chinese medicine for DCM. Because all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. In addition, all data will be analyzed anonymously during the review process.

Trial registration number:

PROSPERO CRD42020163332.
Atypical polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes syndrome without polyneuropathy
Authors: Li Qiang , Xu Fang , Duan Jing-Feng , Tang Yu-Feng
Published: June 2020

Introduction:

Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome is a rare paraneoplastic syndrome that occurs secondary to an underlying plasma cell disorder. The diagnosis of POEMS syndrome is 2 of the mandatory major criteria (polyneuropathy and monoclonal plasma cell disorder), 1 of the other major criteria (Castleman's disease, sclerotic bone lesions, or vascular endothelial growth factor elevation), and at least 1 of the minor criteria (organomegaly, extravascular volume overload, endocrinopathy, skin changes, papilledema, thrombocytosis, or polycythemia). However, some cases do not fully meet the diagnostic criteria, such cases are referred to as incomplete or atypical POEMS syndrome.

Patient concerns:

A 58-year-old Chinese female was admitted to our department of neurology with weakness of both arms and legs. In addition,it's found that she had skin manifestations, lymphadenopathies, pedal edema, immunoglobin - A-λ restricted paraproteinemia, and elevated vascular endothelial growth factor and other features, but without polyneuropathy.

Diagnoses:

we made a diagnosis of atypical POEMS syndrome without polyneuropathy.

Interventions:

Two drug regimens were recommended: VAD (Vincristine, Adriamycin, Dexamethasone) and bortezomib. Finally, the VAD strategy was performed.

Outcomes:

The patient's limb strength and pain improved and enzyme parameters decreased gradually after 4 weeks. However, the treatment was still not perfect. Conclusion: We reported a rare case of POEMS syndrome without polyneuropathy. We hope similar cases will be reported in the future.
Endoscopic removal of a large foreign body retained in the duodenum
Authors: Guo Ya-nan , Li Fang , Huang Fu , Yu Tao
Published: June 2020

Introduction:

This study aimed to present the case of a patient in whom a chopstick, which had been in the duodenum for 10 years, was finally removed by endoscopy. This case was reported because of the long-time retention and noninvasive removal by endoscopy without sedation or complication.

Patient concerns:

A 30-year-old male patient with intermittent upper abdominal pain.

Diagnoses:

During upper-gastrointestinal (GI) endoscopy, a long-strip foreign body (Fb) was seen in the descending part of the duodenum. An upper-GI barium examination was performed, which revealed a linear Fb in the duodenum cavity. The Fb was >10-cm long. Combined with his history (the patient admitted swallowing a chopstick 10 years ago in a bet), the diagnosis of Fb in the duodenum was confirmed.

Interventions:

The Fb was removed from the duodenum cavity by upper-GI endoscopy successfully.

Outcomes:

The patient was discharged after the removal of the Fb.

Conclusion:

Endoscopic removal and nonoperative management might be feasible in carefully selected patients with a long and old Fb in the duodenum without the need for anesthesia or surgery as well as no occurrence of complications and laceration.
Retrospective analysis of prognostic value of the neutrophil-to-lymphocyte ratio in early miscarriages
Authors: Kim Youngsun
Published: June 2020

This study aims to identify prognostic value of neutrophil-to-lymphocyte ratio (NLR) in early miscarriages. A total of 260 pregnant women with vaginal spotting were recruited from the Department of Obstetrics and Gynecology of the Kyung Hee Medical Center from January 1, 2011, and December 31, 2018. Venous samples were obtained from the women for measurements of platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and NLR. All the patients were in < 14 gestational weeks of their pregnancy. Eighty-four patients were excluded because of incomplete data, loss of follow-up, and serious medical diseases. We enrolled 176 women for analysis and divided them into two groups. Group 1 included 104 women with threatened abortion; and group 2, 72 women with missed abortion. A significant difference in NLR was found between the groups (p = 0.001; P < .01). The multivariate analysis also revealed that NLR was the only prognostic factor of early miscarriage (odd ratio [OR], 0.732; 95% confidence interval [CI], 0.612–0.881, P = .001). The area under the Receiver-operating characteristic of NLR for distinguishing between the missed and threatened abortion groups was 0.792, and the best cutoff value was 5.72 (P < .05).