bluuebunny/crossref_metadata_2025 huggingface dataset:
Coenzyme Q10 Sunscreen Prevents Progression of Ultraviolet‐Induced Skin Damage in Mice
Authors: Wu Haiyou , Zhong Zhangfeng , Lin Sien , Qiu Chuqun , Xie Peitao , Lv Simin , Cui Liao , Wu Tie
Published: August 2020

The level of sun ultraviolet ray reaching the surface of the earth is increasing severely due to the rapid development of the society and environmental destruction. Excessive exposure to ultraviolet radiation causes skin damage and photoaging. Therefore, it is emerged to develop effective sunscreen to prevent ultraviolet‐induced skin damage. This study was aimed at investigating the effects of Coenzyme Q10 (CoQ10) sunscreen on the prevention of ultraviolet B radiation‐ (UVB‐) induced mouse skin damage. Three‐month‐old female mice were used, and they were randomly divided into four groups: control, model, CoQ10, and titanium dioxide (TiO2; positive control) groups. Our results showed that body weight, superoxide dismutase (SOD) and glutathione peroxidase (GSH‐Px) activities, and DNA (cytosine‐5)‐methyltransferase 1 (DNMT1) protein expression were significantly decreased, while malondialdehyde (MDA) activity and metalloproteinase‐1 (MMP‐1) level were increased in UVB‐treated mice. Besides, the stratum corneum was shed from the skin surface in the model group compared with the control group. In contrast, CoQ10 sunscreen prevented from UVB‐induced skin damage, as well as reversing SOD, GSH‐Px, and MDA activities, and MMP‐1 and DNMT1 levels. Taken together, the current study provided further evidence on the prevention of UVB‐induced skin damage by CoQ10 and its underlying mechanisms.
Construction of a MicroRNA‐mRNA Network Underlying Decidualized Endometriotic Cyst Stromal Cells Using Bioinformatics Analysis
Authors: Li Junzui , Zhao Bin , Yang Cui , Chen Qionghua
Published: August 2020

Background. Decidualization of ectopic endometrium often leads to the extensive proliferation of local tissue and is easily misdiagnosed as malignant tumors. The study is aimed at constructing a microRNA‐ (miRNA‐) mRNA network underlying decidualized endometriotic cyst stromal cells (ECSCs). Methods. All data were collected from the Gene Expression Omnibus (GEO) database. Firstly, the differentially expressed genes (DEGs, adj. P‐Val < 0.05, | log FC | ≥1) and miRNAs (DEMs, P‐Val < 0.05, ∣log FC | ≥1) were analyzed by the limma package. Secondly, we predicted the target genes (TGs) of these DEMs through the TargetScan, miRDB, and miRTarBase databases. The overlapping genes between DEGs and TGs were screened out. Thirdly, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) enrichment analyses of the overlapping genes were performed for integrated discovery, visualization, and annotation. Then, the protein‐protein interaction (PPI) network of the overlapping genes was conducted by the STRING database. Finally, we combined the PPI network and the miRNA‐mRNA pairs to build a miRNA‐mRNA network. Results. There are 29 DEMs and 523 DEGs. Fourteen overlapping genes were screened out, and these genes were significantly enriched in metabolism and immunity. What is more, a miRNA‐mRNA network, including 14 mRNAs and 9 miRNAs, was successfully constructed. Conclusions. Taken together, the miRNA‐mRNA regulatory networks described in this study may provide new insights in the decidualization of ECSCs, suggesting further investigations in novel pathogenic mechanisms.
Antioxidant Capacity-Related Preventive Effects of Shoumei (Slightly Fermented Camellia sinensis) Polyphenols against Hepatic Injury
Authors: Yi Ruokun , Wei Yuxuan , Tan Fang , Mu Jianfei , Long Xingyao , Pan Yanni , Liu Weiwei , Zhao Xin
Published: August 2020

Shoumei is a kind of white tea (slightly fermented Camellia sinensis) that is rich in polyphenols. In this study, polyphenols were extracted from Shoumei. High-performance liquid chromatography (HPLC) showed that the polyphenols included mainly gallic acid, catechin, hyperoside, and sulfuretin. In an in vitro experiment, H2O2 was used to induce oxidative damage in human normal hepatic L-02 cells. In an animal experiment, CCl4 was used to induce liver injury. The in vitro results showed that Shoumei polyphenols inhibited oxidative damage in normal hepatic L-02 cells, and the in vivo results showed that the polyphenols effectively reduced liver index values in mice with liver injury. The polyphenols also decreased aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), triglyceride (TG), total cholesterol (TC), blood urea nitrogen (BUN), nitric oxide (NO), malondialdehyde (MDA), interleukin 6 (IL-6), interleukin 12 (IL-12), tumour necrosis factor alpha (TNF-α), and interferon gamma (IFN-γ) levels and increased albumin (ALB), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) levels in the serum of mice with liver injury. Furthermore, pathological observation showed that the Shoumei polyphenols reduced CCl4-induced hepatocyte damage. qRT-PCR and Western blotting showed that the polyphenols upregulated the mRNA and protein expression of neuronal nitric oxide synthase (nNOS), endothelial nitric oxide synthase (eNOS), manganese- (Mn-) SOD, copper/zinc- (Cu/Zn-) SOD, CAT, and inhibitor of nuclear factor kappa B (NF-κB) alpha (IκB-α) and downregulated the expression of inducible nitric oxide synthase (iNOS) and NF-κB p65. The Shoumei polyphenols had a preventive effect against CCl4-induced mouse liver injury equivalent to that of silymarin. The four polyphenols identified as the key substances responsible for this effect mediated the effect through their antioxidant capacity. These results suggest that Shoumei polyphenols are high-quality natural products with liver-protective effects.
Revisiting Tumors and the Cardiovascular System: Mechanistic Intersections and Divergences in Ferroptosis
Authors: Wang Yani , Peng Xiang , Zhang Maomao , Jia Ying , Yu Bo , Tian Jinwei
Published: August 2020

Ferroptosis was recently identified as an iron-dependent regulatory necrosis process mediated by polyunsaturated fatty acid (PUFA) peroxidation. The pivotal events related to oxidative stress in ferroptosis include direct or indirect glutathione peroxidase 4 (GPX4) inhibition, ferrous iron overload, and lipid peroxidation. The links between ferroptosis and multiple pathological processes including tumor and cardiovascular system disease have become increasingly apparent, and the mechanisms and compounds involved in ferroptosis, such as reduction of coenzyme Q10(ubiquinone/CoQ10), are gradually emerging. Current reports have revealed crossroads between ferroptosis and other multiple responses. This overview of the current research illuminates the mechanisms involving ferroptosis-related compounds and emphasizes the crosstalk between ferroptosis and other responses, including mitochondrial damage, endoplasmic reticulum stress (ER stress), autophagy, and the release of damage-associated molecular patterns (DAMPs), to reveal the intersections of regulatory mechanisms. This review also outlines the discovery, characterization, and pathological relevance of ferroptosis and notes controversial elements in ferroptosis-related mechanisms, such as nuclear factor E2-related factor 2 (Nrf2), sequestosome 1 (p62/SQSTM1), and heat shock protein family A member 5 (HSPA5). We hope our inferences will supply a partial reference for disorder prevention and treatment.
KRAS Controls Pancreatic Cancer Cell Lipid Metabolism and Invasive Potential through the Lipase HSL
Authors: Rozeveld Cody N. , Johnson Katherine M. , Zhang Lizhi , Razidlo Gina L.
Published: August 2020

Oncogene-induced metabolic reprogramming is a hallmark of pancreatic cancer (PDAC), yet the metabolic drivers of metastasis are unclear. In PDAC, obesity and excess fatty acids accelerate tumor growth and increase metastasis. Here, we report that excess lipids, stored in organelles called lipid droplets (LD), are a key resource to fuel the energy-intensive process of metastasis. The oncogene KRAS controlled the storage and utilization of LD through regulation of hormone-sensitive lipase (HSL), which was downregulated in human PDAC. Disruption of the KRAS–HSL axis reduced lipid storage, reprogrammed tumor cell metabolism, and inhibited invasive migration in vitro and metastasis in vivo. Finally, microscopy-based metabolic analysis revealed that migratory cells selectively utilize oxidative metabolism during the process of migration to metabolize stored lipids and fuel invasive migration. Taken together, these results reveal a mechanism that can be targeted to attenuate PDAC metastasis.

Significance:

KRAS-dependent regulation of HSL biases cells towards lipid storage for subsequent utilization during invasion of pancreatic cancer cells, representing a potential target for therapeutic intervention.

See related commentary by Man et al., p. 4886
U.S. Food and Drug Administration: Initial Experience with the Real-Time Oncology Review Program
Authors: de Claro R. Angelo , Gao Jennifer J. , Kim Tamy , Kluetz Paul G. , Theoret Marc R. , Beaver Julia A. , Pazdur Richard
Published: August 2020

The FDA Oncology Center of Excellence commenced the Real-Time Oncology Review (RTOR) pilot project in February 2018 to facilitate earlier submission of topline results and datasets to support an earlier start to the FDA application review. RTOR was initially begun to support supplemental drug applications to add new indications, dosing regimens, or other clinical information to the prescribing information, but was later expanded to include original new drug applications and biological license applications for new molecular entities (NME). From February 2018 to April 2020, RTOR was used to support the submission and review of drug approvals for 20 oncology applications (11 for solid tumor and nine for hematologic malignancy indications). Two were NME drug approvals and 18 were supplemental approvals. All of the applications received priority review and nine (45%) applications had received breakthrough therapy designation status. FDA received the RTOR submissions a median of 5.7 weeks (range 1.7–16.2 weeks) prior to the full application submission. The median time from application submission to FDA approval was 3.3 months (range 0.4–5.9 months). RTOR was also integrated with other review programs including the Assessment Aid and Project Orbis programs. Innovative regulatory processes are critical to expedite the rigorous review of impactful products across the FDA.
Transcatheter Closure of Atrial Septal Defects with Cardiac Computed Tomography Sizing: Eight-Year Single-Center Practice
Authors: Zhang Xin , Huang Yangyang , Wang Lihong , Ye Lifang , Tang Jun
Published: August 2020

Introduction: An accurate evaluation of atrial septal defect (ASD) is important for the success of interventional treatment. Cardiac computed tomography (CT) has unique advantages for ASD assessment, although transesophageal echocardiography (TEE) remains the accepted method. Objective: This study aimed to evaluate the safety and feasibility of transcatheter closure of ASD with cardiac CT sizing but without TEE measurement. Methods: Among 134 patients undergoing transcatheter closure, 13 underwent TEE in addition to a cardiac CT examination, and 121 underwent only cardiac CT. Propensity score matching was used to analyze the outcomes of the groups treated with (group 1) or without (group 2) TEE examinations. The success rate and complications among the 121 ASD patients with only cardiac CT sizing were recorded and analyzed. The maximal diameters of the defects remeasured on CT images were compared to the echocardiography results and correlated with the device size by Student t test and Pearson’s linear regression analysis, respectively. Results: No significant differences (p > 0.05) were found between groups 1 and 2 in the success rate, complications, or ratio of the device size to the maximum diameter of the defect measured by cardiac CT. In group 1, the maximum diameters of the ASD derived from cardiac CT and TEE were comparable (22.08 ± 9.68 vs. 21.50 ± 10.24; p = 0.351). The success rate among the 121 patients who underwent transcatheter closure with only cardiac CT sizing was 99.2%; however, within 1 month of follow-up, 2 patients had arrhythmia, 1 patient had residual shunting, 1 patient had an infection, and 1 patient had a hematoma, but all patients recovered within a short time. Conclusions: Cardiac CT seems to be comparable to TEE in the assessment of ASD, and transcatheter closure of ASD based on CT sizing alone is safe and feasible.
Short-Term Intravenous Infusion of Cyclophosphamide in the Treatment of Refractory Pemphigus Vulgaris: A Retrospective Study
Authors: Zhang Wenjing , Wei Shanshan , Peng Xuebiao , Xie Shuangde , Zhang Zhiwen , Zeng Kang , Lai Kuan
Published: August 2020

Background: Pemphigus is an autoimmune disease of the skin and mucous membranes. Glucocorticoids have been the most effective drug for the treatment of pemphigus; however, some patients are insensitive to glucocorticoid therapy. Cyclophosphamide has been extensively used in the treatment of pemphigus. Objectives: To observe and evaluate the efficacy and safety of high-dose glucocorticoid with weekly intravenous cyclophosphamide in the treatment of refractory pemphigus vulgaris insensitive to glucocorticoids. Methods: Clinical data of 19 patients with refractory pemphigus vulgaris (insensitive to glucocorticoid) who were treated with high-dose glucocorticoids(1.5 mg/kg/day prednisone) and weekly intravenous infusion of cyclophosphamide, and 24 patients who were sensitive to glucocorticoid therapy received a medium dose of glucocorticoid alone (1 mg/kg/day prednisone) were retrospectively analyzed. Results: By the time the disease was brought under control, the average total dose of cyclophosphamide was 2.02 g. Comparison between the glucocorticoid-insensitive and glucocorticoid-sensitive groups showed that the average time to disease control was 2.68 vs. 2 weeks, and the average daily dosage of steroid was 1.33 ± 0.53 vs. 0.90 ± 0.28 mg/kg. At the 12- and 18-month follow-ups, the recurrence rate of the glucocorticoid-insensitive group was significantly lower than that of the sensitive group (5.3 vs. 37.5%, 15.8 vs. 45.8%). No serious adverse reactions were observed. Conclusion: High-dose glucocorticoid plus weekly intravenous infusion of cyclophosphamide safely, effectively, and rapidly controlled the conditions of the patients with refractory pemphigus who were insensitive to glucocorticoids, shortened the duration of hospitalization, avoided the risk of complications that could be caused by further increasing the dose of glucocorticoids (>1.5 mg/kg/day), and lowered the recurrence rate within 18 months.
Increased Use of Therapeutic Hypothermia in Infants with Milder Neonatal Encephalopathy due to Presumed Perinatal Asphyxia
Authors: Parmentier Corline E.J. , de Vries Linda S. , Toet Mona C. , van Haastert Ingrid C. , Koopman Corine , Weeke Lauren C. , Groenendaal Floris
Published: August 2020

Introduction: Adverse outcomes have been reported in infants with mild neonatal encephalopathy (NE). Increasing clinical experience with the application of therapeutic hypothermia (TH) may have resulted in the treatment of newborns with milder NE during recent years. Objective: To determine whether infants treated with TH in the initial years following implementation had a higher degree of NE than infants treated during subsequent years. Methods: Infants with NE treated with TH from February 2008 until July 2017 were included. Thompson and Sarnat scores, amplitude-integrated electroencephalography (aEEG) background patterns before the start of TH, and neurodevelopmental outcome at 2 years were compared between infants treated from February 2008 until October 2012 (period 1) and infants treated from November 2012 until July 2017 (period 2). Results: 211 newborns with NE were treated with TH (period 1: n = 109, period 2: n = 102). Sarnat scores in period 1 and 2 were mild in 7.3 vs. 28.4%, moderate in 66.1 vs. 44.1%, and severe in 26.6 vs. 22.5%, respectively (p = 0.008). Thompson scores were lower in period 2 (median = 9, IQR 7–12) than in period 1 (median = 10, IQR 8.5–13.5, p = 0.018). The aEEGs and neurodevelopmental outcomes were comparable between the periods. Conclusions: Based on Thompson and Sarnat scores, but not aEEG background patterns, infants treated during the second period had milder NE than infants treated during the first years following implementation of TH. There was no difference in 2 years neurodevelopmental outcome. Further research is necessary to evaluate the value of TH for infants with clinically mild NE.
Multinational Survey of Treatment Practices of Clinicians Managing Subclinical Hypothyroidism in Older People in 2019
Authors: Razvi Salman , Arnott Bronia , Teare Dawn , Hiu Shaun , O’Brien Nicki , Pearce Simon H.
Published: August 2020

Background: International societies have recommended that levothyroxine should not routinely be prescribed in older individuals for the management of mild subclinical hypothyroidism (SCH). However, it is unknown whether clinicians managing people with SCH are either aware of or adhere to these guidelines. Methods: A web-based survey of members of several international thyroid associations and general practitioners in North-East England was conducted. Respondents were presented with a vignette of an 80-year-old gentleman with mild persistent SCH experiencing tiredness. Multivariable logistic regression analyses were performed to evaluate predictors of awareness of guidelines and responses to treatment. Results: The survey response rate was 21.9% (565/2,583). Only 7.6% of clinicians were unaware of guidelines regarding management of SCH in older people. Twenty percent of clinicians stated that they would treat the older patient with mild SCH, whereas 13% were unsure. Clinicians from North America were more likely to treat the older person with mild SCH than clinicians from elsewhere (OR 2.24 [1.25–3.98]). Likewise, non-endocrinologists were also more likely than endocrinologists to treat the older person with mild SCH (OR 3.26 [1.45–6.47]). Conclusion: The majority of clinicians are aware of guidelines regarding management of SCH in older individuals. However, a considerable proportion of clinicians would still treat an older person with non-specific symptoms and mild SCH. These guidelines need to be disseminated more widely and more research is required to understand barriers to adherence to international recommendations.
Manifestation of Pleomorphic Undifferentiated Aortic Sarcoma with Splenic Infarction: A Case Report
Authors: Kaushal Varun , Amoozgar Behzad , Barua Nabonita , Chhetri Shankar , Garsondiya Bhaveshkumar
Published: August 2020

Aortic spindle cell sarcoma is a rare neoplasm with poor prognosis that is often found incidentally due to its adverse effects. CT and MRI with contrast are useful imaging modalities, but a tissue biopsy is the gold standard for diagnosis. Tumor resection is the ultimate treatment followed by chemotherapy. Our case was an adult female who presented mainly for shortness of breath, and further imaging workup demonstrated a soft tumor juxtaposed to a major vein with compressive effect. The patient’s tumor was resected, and the pathology result confirmed undifferentiated aortic sarcoma. The patient’s condition improved and she was discharged with outpatient oncology follow-up and possible treatment.
Probability of Major Depression Classification Based on the SCID, CIDI, and MINI Diagnostic Interviews: A Synthesis of Three Individual Participant Data Meta-Analyses
Authors: Wu Yin , Levis Brooke , Ioannidis John P.A. , Benedetti Andrea , Thombs Brett D. ,   DEPRESsion Screening Data (DEPRESSD) Collaboration
Published: August 2020

Introduction: Three previous individual participant data meta-analyses (IPDMAs) reported that, compared to the Structured Clinical Interview for the DSM (SCID), alternative reference standards, primarily the Composite International Diagnostic Interview (CIDI) and the Mini International Neuropsychiatric Interview (MINI), tended to misclassify major depression status, when controlling for depression symptom severity. However, there was an important lack of precision in the results. Objective: To compare the odds of the major depression classification based on the SCID, CIDI, and MINI. Methods: We included and standardized data from 3 IPDMA databases. For each IPDMA, separately, we fitted binomial generalized linear mixed models to compare the adjusted odds ratios (aORs) of major depression classification, controlling for symptom severity and characteristics of participants, and the interaction between interview and symptom severity. Next, we synthesized results using a DerSimonian-Laird random-effects meta-analysis. Results: In total, 69,405 participants (7,574 [11%] with major depression) from 212 studies were included. Controlling for symptom severity and participant characteristics, the MINI (74 studies; 25,749 participants) classified major depression more often than the SCID (108 studies; 21,953 participants; aOR 1.46; 95% confidence interval [CI] 1.11–1.92]). Classification odds for the CIDI (30 studies; 21,703 participants) and the SCID did not differ overall (aOR 1.19; 95% CI 0.79–1.75); however, as screening scores increased, the aOR increased less for the CIDI than the SCID (interaction aOR 0.64; 95% CI 0.52–0.80). Conclusions: Compared to the SCID, the MINI classified major depression more often. The odds of the depression classification with the CIDI increased less as symptom levels increased. Interpretation of research that uses diagnostic interviews to classify depression should consider the interview characteristics.
The Protective Role of Klotho in CKD-Associated Cardiovascular Disease
Authors: Bi Xianjin , Yang Ke , Zhang Bo , Zhao Jinghong
Published: August 2020

Background: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality in advanced CKD. The major pathological changes of CKD-associated CVD are severe vascular media calcification, aberrant cardiac remodeling such as hypertrophy and fibrosis, as well as accelerated atherosclerosis. α-Klotho is proposed as an anti-aging gene, which is primarily expressed in the kidney. Recent studies reveal that α-Klotho deficiency is associated with profound cardiovascular dysfunction. Of note, CKD represents extremely declined α-Klotho levels, hinting that α-Klotho deficiency may be implicated in the pathogenesis of CKD-associated CVD. Summary: Based on the pathogenic mechanism of α-Klotho deficiency and decreased Klotho levels in the circulation even early in stage 1 of CKD, α-Klotho serves as a sensitive biomarker for renal insufficiency and also a novel predictor of risk of overall mortality of CVD events in CKD. Meanwhile, loss of Klotho resulted from kidney dysfunction markedly contributes to the progressive development of CKD and CVD. By contrast, prevention of Klotho decline using exogenous supplementation or genetically activated ways by several mechanisms can dramatically mitigate cardiac dysfunction, prevent vascular calcification, and retard the progression of CKD-accelerated atherosclerosis. Key Messages: Klotho deficiency is proposed as a novel predictive biomarker as well as a pathogenic contributor to CVD events in CKD. In the future, Klotho may be a crucial potential therapeutic strategy to decrease the burden of CVD comorbidity with CKD in clinics.
Intraoperative Only versus Extended Duration Use of Antimicrobial Prophylaxis for Infectious Complications in Radical Cystectomy with Intestinal Urinary Diversion
Authors: Numao Noboru , Fujiwara Ryo , Uehara Sho , Yasuoka Shotaro , Fujiwara Motohiro , Komai Yoshinobu , Yuasa Takeshi , Yamamoto Shinya , Fukui Iwao , Yonese Junji
Published: August 2020

Introduction: In spite of the high incidence of infectious complications (ICs), appropriate duration of antimicrobial prophylaxis (AMP) for radical cystectomy (RC) with intestinal urinary diversion (IUD) has not been established. We compared the incidence of ICs after RC with IUD in patients using only intraoperative AMP or extended duration AMP. Risk factors for ICs were also investigated. Patients and Methods: One hundred twenty-three consecutive patients who underwent RC with IUD were divided into 2 groups based on the AMP duration (intraoperative only vs. extended duration for a median of 3 days). Between the groups, the incidence of ICs was compared. Risk factors for ICs were investigated in multivariate analysis. Results: The IC rate was 44%. No significant difference was found in the rate of ICs between the groups. The IC rate was significantly higher in patients with lower estimated glomerular filtration rate (eGFR). Rates of ICs were 60 and 38% in patients with eGFR of less than 60 and equal or more than 60 mL/min/1.73 m2, respectively. Conclusions: Our result indicates that AMP that is administered more than intraoperatively may be excessive in RC with IUD. Patients with a lower eGFR should be particularly cared for postoperative ICs.
Ferroptosis Is Regulated by Mitochondria in Neurodegenerative Diseases
Authors: Zhou Juepu , Jin Yao , Lei Yuhong , Liu Tianyi , Wan Zheng , Meng Hao , Wang Honglei
Published: August 2020

Background: Neurodegenerative diseases are characterized by a gradual decline in motor and/or cognitive function caused by the selective degeneration and loss of neurons in the central nervous system, but their pathological mechanism is still unclear. Previous research has revealed that many forms of cell death, such as apoptosis and necrosis, occur in neurodegenerative diseases. Research in recent years has noticed that there is a new type of cell death in neurodegenerative diseases: ferroptosis. An increasing body of literature provides evidence for an involvement of ferroptosis in neurodegenerative diseases. Summary: In this article, we review a new form of cell death in neurodegenerative diseases: ferroptosis. Ferroptosis is defined as an iron-dependent form of regulated cell death, which occurs through the lethal accumulation of lipid-based reactive oxygen species when glutathione-dependent lipid peroxide repair systems are compromised. Several salient and established features of neurodegenerative diseases (including lipid peroxidation and iron dyshomeostasis) are consistent with ferroptosis, which means that ferroptosis may be involved in the progression of neurodegenerative diseases. In addition, as the center of energy metabolism in cells, mitochondria are also closely related to the regulation of iron homeostasis in the nervous system. At the same time, neurodegenerative diseases are often accompanied by degeneration of mitochondrial activity. Mitochondrial damage has been found to be involved in lipid peroxidation and iron dyshomeostasis in neurodegenerative diseases. Key Messages: Based on the summary of the related mechanisms of ferroptosis, we conclude that mitochondrial damage may affect neurodegenerative diseases by regulating many aspects of ferroptosis, including cell metabolism, iron dyshomeostasis, and lipid peroxidation.
Cannabinoids and COVID-19
Authors: El Biali Myriam , Broers Barbara , Besson Marie , Demeules Jules
Published: August 2020

Since the endocannabinoid system is involved in immune function, the effect of cannabinoid intake on infectious conditions is questioned for several years and is of particular interest in the COVID 19 pandemia. Some data suggest that the immunomodulatory effect of cannabinoids may affect the course and severity of SARS-CoV-2 infection. Given the large number of cannabinoids consumers in the community, this commentary presents the current knowledge on the potential impact of cannabinoids and endocannabinoids on bacterial and viral infection courses namely SARS-CoV-2 disease. Practical recommendations, which can be drawn from the literature, are given.
Transcatheter Aortic Valve Replacement in Low-Population Density Areas
Authors: Damluji Abdulla A. , Fabbro Michael , Epstein Richard H. , Rayer Stefan , Wang Ying , Moscucci Mauro , Cohen Mauricio G. , Carroll John D. , Messenger John C. , Resar Jon R. , Cohen David J. , Sherwood Matthew W. , O’Connor Christopher M. , Batchelor Wayne
Published: August 2020

Background:

Restricting transcatheter aortic valve replacement (TAVR) to centers based on volume thresholds alone can potentially create unintended disparities in healthcare access. We aimed to compare the influence of population density in state of Florida in regard to access to TAVR, TAVR utilization rates, and in-hospital mortality.

Methods and Results:

From 2011 to 2016, we used data from the Agency for Health Care Administration to calculate travel time and distance for each TAVR patient by comparing their home address to their TAVR facility ZIP code. Travel time and distance, TAVR rates, and mortality were compared across categories of low to high population density (population per square miles of land). Of the 6531 patients included, the mean (SD) age was 82 (9) years, 43% were female and 91% were White. Patients residing in the lowest category (<50/square miles) were younger, more likely to be men, and less likely to be a racial minority. Those residing in the lowest category density faced a longer unadjusted driving distances and times to their TAVR center (mean extra distance [miles]=43.5 [95% CI, 35.6–51.4];
P
<0.001; mean extra time (minutes)=45.6 [95% CI, 38.3–52.9],
P
<0.001). This association persisted regardless of the methods used to determine population density. Excluding uninhabitable land, there was a 7-fold difference in TAVR utilization rates in the lowest versus highest population density regions (7 versus 45 per 100 000,
P
-for-pairwise-comparisons <0.001) and increase in TAVR in-hospital mortality (adjusted OR, 6.13 [95% CI, 1.97–19.1];
P
<0.001).

Conclusions:

Older patients living in rural counties in Florida face (1) significantly longer travel distances and times for TAVR, (2) lower TAVR utilization rates, and (3) higher adjusted TAVR mortality. These findings suggest that there are trade-offs between access to TAVR, its rate of utilization, and procedural mortality, all of which are important considerations when defining institutional and operator requirements for TAVR across the country.
Corticosteroids Added to Initial Intravenous Immunoglobulin Treatment for the Prevention of Coronary Artery Abnormalities in High‐Risk Patients With Kawasaki Disease
Authors: Ae Ryusuke , Abrams Joseph Y. , Maddox Ryan A. , Schonberger Lawrence B. , Nakamura Yosikazu , Kuwabara Masanari , Makino Nobuko , Matsubara Yuri , Kosami Koki , Sasahara Teppei , Belay Ermias D.
Published: August 2020

BACKGROUND

Randomized controlled trials previously provided different conclusions about the superiority of adding corticosteroids to initial intravenous immunoglobulin treatment for the prevention of coronary artery abnormalities in patients with Kawasaki disease (KD). To further assess this issue, we analyzed large‐scale data from nationwide KD surveys in Japan, where combination treatment (corticosteroids added to initial standard intravenous immunoglobulin treatment) has become commonly used for patients at high risk for KD.

METHODS AND RESULTS

Standard intravenous immunoglobulin treatment and combination treatment were compared using data from time periods with and without combination treatment. Outcome measures were coronary artery abnormalities and initial intravenous immunoglobulin treatment failure. Hospitals where ≥20% of patients received combination treatment were identified, and treatment and control groups were selected via matching by age, sex, illness day at initial treatment, and KD recurrence. Matched group selection and subsequent analyses were conducted 1000 times to minimize sampling bias and potential confounders (bootstrapping). From 115 hospitals, 1593 patients with KD in the treatment group and 1593 controls were selected for each of the 1000 sample iterations. The median proportion of patients who developed coronary artery abnormalities among the treatment group and controls were 4.6% (95% CI, 3.8%–5.8%) and 8.8% (95% CI, 7.5%–10.0%), respectively: an estimated risk ratio of 0.53 (0.41–0.67). A median of 14.1% (95% CI, 12.4%–15.9%) of the patients in the treatment group and 21.7% (95% CI, 19.8%–23.4%) in the controls had treatment failure: an estimated risk ratio of 0.65 (0.56―0.75).

CONCLUSIONS

Combination treatment reduced coronary artery abnormality risk by an estimated 47% and treatment failure by 35%. Multiple‐dose corticosteroids may provide benefit in selected patients at high risk for KD.
Causality in Cognitive Neuroscience: Concepts, Challenges, and Distributional Robustness
Authors: Weichwald Sebastian , Peters Jonas
Published: August 2020

Whereas probabilistic models describe the dependence structure between observed variables, causal models go one step further: They predict, for example, how cognitive functions are affected by external interventions that perturb neuronal activity. In this review and perspective article, we introduce the concept of causality in the context of cognitive neuroscience and review existing methods for inferring causal relationships from data. Causal inference is an ambitious task that is particularly challenging in cognitive neuroscience. We discuss two difficulties in more detail: the scarcity of interventional data and the challenge of finding the right variables. We argue for distributional robustness as a guiding principle to tackle these problems. Robustness (or invariance) is a fundamental principle underlying causal methodology. A (correctly specified) causal model of a target variable generalizes across environments or subjects as long as these environments leave the causal mechanisms of the target intact. Consequently, if a candidate model does not generalize, then either it does not consist of the target variable's causes or the underlying variables do not represent the correct granularity of the problem. In this sense, assessing generalizability may be useful when defining relevant variables and can be used to partially compensate for the lack of interventional data.
First record of the non-native flowering plant Dichondra argentea (Convolvulaceae) in southern Europe and Italy: floristic, distributive and ecological notes

Authors: CESCHIN SIMONA , RAIMONDI DARIO , MARIANI FLAMINIA , SALERNO GIOVANNI
Published: August 2020

Dichondra Forster & Forster (1776: 39) is one of the oldest genera included in the Convolvulaceae family and is estimated to include 15 species that are native to the tropical and warm temperate regions of Americas, New Zealand and Australia (Tharp & Johnston 1961, Staples et al. 2017, Delgado et al. 2018).
All genera of the infraorder Gryllidea of the world: a full list and biodiversity information on the April 2020 release of the Orthoptera Species File (OSF)
Authors: GAO SI-JIA , XU FEI , LIU HAO-YU
Published: August 2020

According to the Orthoptera species file, there are 765 genera of the infraorder Gryllidea in the world, belonging to 2 superfamilies, 8 families, 37 subfamilies and 6159 species or subspecies in total. A complete list of all genera in the world is provided, including type species, synonyms and species richness. Through statistical analysis, there are 26 extant subfamilies, accounting for 70.27%, 692 extant genera, accounting for 90.46%, 6010 extant species or subspecies, accounting for 97.58%. At the same time, the composition characteristics of the extant genera and species or subspecies in all subfamilies: subfamily Gryllinae has the largest number of genera and species or subspecies, reaching 125 genera and 1221 species or subspecies, with the proportion of 16.34% and 20.34%, followed by subfamily Podoscrtinae, with the number of 99 genera, 770 species or subspecies, with the proportion of 12.94% and 12.83%; subfamily Gryllomiminae with the least number, the number and ratio is 1 genus, 2 species and 0.13%, 0.03%. Among all fossil genera, subfamily †Cearagryllinae is the largest, with 7 genera, 15 species. There are 21 free genera in infraorder Gryllidea, accounting for 2.75%, and 268 monotypic genera (only 1 species), accounting for 35.03%. The largest genus is Hapithus Uhler, 1864, with 209 species or subspecies.
Revision of the Chinese Macropelopia (Diptera: Chironomidae: Tanypodinae), with description of a new species
Authors: TANG HONGQU , NIITSUMA HIROMI
Published: August 2020

The Chinese species of Macropelopia Thienemann are reviewed. A new species belonging to the subgenus Macropelopia, M. (M.) pergrandis sp. n., is described based on the adult male and pupa. Macropelopia grandivolsella Wang, Cheng et Wang and M. rotunda Wang, Cheng et Wang are synonymized with M. (M.) paranebulosa Fittkau and M. (M.) kibunensis (Tokunaga) respectively, based on reexamination of the type materials. Macropelopia galbina Wang, Cheng et Wang is transferred to the genus Brundiniella, and the male holotype is redescribed.
First fossil Eriocottidae discovered in Eocene Baltic amber (Insecta: Lepidoptera)
Authors: NGÔ-MULLER VALERIE , ENGEL MICHAEL S. , NEL ANDRE , NEL JACQUES
Published: August 2020

Eocompsoctena macroptera gen. et sp. nov., the first fossil eriocottid moth, is described from Baltic amber and attributed to the Compsocteninae. Comparisons are provided with the related families Dryadaulidae, Meessiidae, Psychidae, and Tineidae. The new species confirms the antiquity of ‘Tineoidea’ grade diversification. The putative Gondwanan origin of Eriocottidae is discussed.
Observational Evidence that Radiative Heating Modifies the Life Cycle of Tropical Anvil Clouds
Authors: Wall Casey J. , Norris Joel R. , Gasparini Blaž , Smith William L. , Thieman Mandana M. , Sourdeval Odran
Published: August 2020

A variety of satellite and ground-based observations are used to study how diurnal variations of cloud radiative heating affect the life cycle of anvil clouds over the tropical western Pacific Ocean. High clouds thicker than 2 km experience longwave heating at cloud base, longwave cooling at cloud top, and shortwave heating at cloud top. The shortwave and longwave effects have similar magnitudes during midday, but only the longwave effect is present at night, so high clouds experience a substantial diurnal cycle of radiative heating. Furthermore, anvil clouds are more persistent or laterally expansive during daytime. This cannot be explained by variations of convective intensity or geographic patterns of convection, suggesting that shortwave heating causes anvil clouds to persist longer or spread over a larger area. It is then investigated if shortwave heating modifies anvil development by altering turbulence in the cloud. According to one theory, radiative heating drives turbulent overturning within anvil clouds that can be sufficiently vigorous to cause ice nucleation in the updrafts, thereby extending the cloud lifetime. High-frequency air motion and ice-crystal number concentration are shown to be inversely related near cloud top, however. This suggests that turbulence depletes or disperses ice crystals at a faster rate than it nucleates them, so another mechanism must cause the diurnal variation of anvil clouds. It is hypothesized that radiative heating affects anvil development primarily by inducing a mesoscale circulation that offsets gravitational settling of cloud particles.
Cooperation and Conflict at the Horn of Africa: A New Regional Bloc Between Ethiopia, Eritrea, and Somalia and Its Consequences for Eastern Africa
Authors: Henneberg Ingo , Stapel Sören
Published: August 2020

In January 2020, Eritrea, Ethiopia, and Somalia proposed to form a new regional bloc, occasionally referred to as the Horn of Africa Cooperation (HoAC). This article assesses which factors have contributed to making this proposal and contemplates potential effects for the complex security challenges, political tensions among the neighbours, and existing institutional environment in the region. Drawing on the scholarship on comparative regionalism and overlapping regionalism, we show that a genuine interest to independently address security challenges in the Horn of Africa, as well as domestic concerns, are core motivations for the leaders in all three states. However, the HoAC proposal bears the risk of further alienating partners in the region and undermning security efforts of other regional organisations, most importantly the Intergovernmental Authority on Development, the African Union, and the Eastern Africa Standby Force. Thus, the promises and pitfalls of this new bloc could shape the regional architecture and cause new political challenges in the region.
24 Hours or Less Stay After Laparoscopic Minor Hepatectomy
Authors: Philip Justus , Miller Nic , Cocieru Andrei
Published: August 2020

Background

Laparoscopic liver resections can result in decreased length of stay. We looked at our hospital experience with 24 hours or less stay after minor laparoscopic liver resections.

Methods

Patients who underwent laparoscopic minor hepatectomy (less than 3 hepatic segments resection) and stayed 24 hours or less in the hospital were selected from prospectively kept hepatobiliary surgery database. All were managed according to the established enhanced recovery after surgery protocol.

Results

14 cases were identified and included 3 bisegmentectomies and 11 segmental resections. Length of surgery was between 29 and 210 minutes (median 80.5 minutes), and median blood loss was 50 cc (range 20-400 cc). 4 patients were discharged home the same day with 10 staying overnight.

Conclusions

Selected group of patients undergoing minor laparoscopic hepatectomy can be discharged home the same day or less than 24 hours after surgery.
An Early Case of Fat Embolism Syndrome Occurring Following Polytrauma
Authors: Millen Janelle-Cheri A. , Watson Carrie , Cain John M. , Hagan Joshua , Richards Winston T. , Taylor Dana , Ang Darwin , Clark Jason M.
Published: August 2020

Fat embolism syndrome (FES) is a clinical entity occurring due to the presence of fat particles in the microcirculation, typically manifesting 12-72 hours after long bone trauma with respiratory distress, altered mental status, and petechial rash. Our case is that of a 17-year-old girl who suffered multiple orthopedic injuries without intracranial trauma after being a pedestrian struck by a vehicle. Despite presenting with a normal Glasgow Coma Score (GCS), within 4 hours of presentation, she was noted to have an acute mental status change to a GCS 7 with a normal computed tomography brain. Magnetic resonance imaging of the brain was suggestive of FES which, in this patient, had a rapidly progressing course with the development of severe cerebral edema and intracranial hypertension refractory to maximal medical therapy. Our patient required bilateral craniectomies for intracranial decompression and progressed over a 2-month hospital course to have subsequent cranioplasty and functional neurologic improvement. FES requires a high index of clinical suspicion in the presence of long bone fracture with unexplained altered mental status. The clinical course can be rapidly progressing with the development of intracranial hypertension which may benefit from surgical decompression with optimistic prognosis.
Recurrent Postoperative Toxic Shock Syndrome in a Living Kidney Transplant Recipient
Authors: Aslam Sadaf , Buggs Jacentha , Rogers Ebonie , Bowers Victor
Published: August 2020

Recurrent toxic shock syndrome (TSS) is uncommon. A certain level of clinical suspicion is indicated with a complex sepsis presentation in the postoperative kidney transplant patient. We present a case of presumed recurrent postoperative TSS in a living kidney transplant recipient. The patient was a 19-year-old Caucasian female with a 4-year prior single episode of toxin-mediated sepsis and chronic kidney disease (CKD) secondary to autosomal recessive Alport’s syndrome (confirmed via renal biopsy and genetic testing). She received a human leukocyte antigen (HLA) 2A 2B 1DR MM, CMV -D/-R kidney from her 21-year-old friend. The patient received Campath and IV steroid induction after total cold ischemic time of 170 minutes with 40 minutes of revascularization. On postoperative day (POD) 5, she required re-exploration with reimplantation and stenting of the transplanted ureter. The patient subsequently spiked a fever of 101.6° with a generalized rash prompting collection of blood cultures which demonstrated no growth. Infectious Disease was consulted due to persistent fevers despite IV antibiotics. On POD 12, the patient returned to the operating room (OR) for evacuation of hematoma after decline in Hgb to 5.8 and CT confirmed perinephric hematomas. Kidney biopsy showed no rejection and donor specific antibodies (DSAs) were unremarkable. The patient underwent 1 treatment of empiric plasmapheresis for possible non-HLA antibodies followed by initiation of clindamycin. The patient’s condition improved, and she was discharged home with a normal creatinine. Recurrent TSS is rare but should be added to the differential diagnoses of immuno-compromised patients undergoing kidney transplantation with a history of prior toxin-mediated sepsis.
Functionally Silent, Giant Pheochromocytoma Presenting With Varicocele
Authors: Curfman Karleigh R. , Di Como Joseph A. , Chung Timothy R. , Dumire Russell D.
Published: August 2020

Adrenal incidentalomas are a known entity that have been increasing in commonality with the advent of improved diagnostic and imaging techniques. There are a vast variety of causative pathologies to which this diagnosis can be attributed. Some of these pathologies are more common than others, while many remain extremely rare. One of the distinct entities that is a unique cause of incidentalomas is the diagnosis presented herein: pheochromocytoma. Pheochromocytomas are often an exceptional subset of incidentalomas that can certainly play a major role in treatment and management plans. However, the exclusivity of a pheochromocytoma diagnosis alone is not where the uniqueness of this case rests. The uniqueness in this patient is paramount to report due to 2 additional significant factors. The first was that the patient was entirely asymptomatic aside from complaints related to scrotal swelling due to a varicocele, for which this presentation of pheochromocytoma has been scarcely reported in the literature. Second, the patient had a pathology proven diagnosis of pheochromocytoma, while lacking both symptoms and biochemical findings to support the diagnosis, making it truly a silent pheochromocytoma.
The Role of Diabetes Mellitus as an Effect Modifier of the Association Between Smoking Cessation and Its Clinical Prognoses: An Observational Cohort Study
Authors: Wang Yang , Tse Lap Ah , Li Guangwei , Yin Lu , Chen Tao , Zhao Yanyan , Xu Bo , Xian Ying , Li Wei
Published: August 2020

The smoker’s paradox refers to an increased risk of adverse clinical outcomes after smoking cessation in patients with coronary artery disease. The mechanisms involved are controversial. The present study evaluated the effect of delay in smoking cessation on clinical outcomes among patients after percutaneous coronary intervention (PCI) stratified by diabetes mellitus (DM). Patients included in this study came from an established Fu Wai hospital PCI cohort. Smoking behavior was recorded; clinical end points included all-cause mortality and repeat revascularization. The analyses were based on 8489 smokers who underwent PCI. Patients with and without DM were examined separately. Multivariable model analysis suggested that smoking cessation was associated with significant lower all-cause mortality both for non-DM and DM patients. The smoking paradox was observed for revascularization. However, the increased risk of repeat revascularization correlated with quitting time among non-DM patients only, especially if they stopped smoking late (>90 days) after their index procedure (adjusted hazard ratio, 3.40; 95% CI: 2.45-4.72). In conclusion, smoking cessation is associated with a lower mortality rate for PCI patients. However, the relative benefit on repeated revascularization was only observed among non-DM patients if they quit smoking early.