bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urban tree pests and natural enemies respond to habitat at different spatial scales
Authors: Parsons Sarah E , Frank Steven D 
Published: August 2019

AbstractTrees provide many ecosystem services in our urban environments. However, city trees are often stressed by pests that are typically higher than those in nearby natural areas. Our research highlights a potential mismatch in scale between the habitat elements that affect the densities of pests and their natural enemies on city trees. We tested a well-known ecological concept, the enemies hypothesis, in the city, where relationships of pests and their enemies have not been thoroughly studied. To test our hypothesis that natural enemies and aphid predation services on urban trees increase with more local structural complexity around trees, we collected data on crape myrtle trees on NC State University’s campus from 2016 to 2017. We measured local structural complexity of vegetation around study trees, quantified impervious cover among other urban habitat elements, collected crape myrtle aphids (Tinocallis kahawaluokalani) and their natural enemies on trees, and performed predation experiments. We found that aphid abundance was positively correlated with more impervious cover within 100 m of crape myrtle trees. Alternatively, greater local structural complexity within the 10 × 10 m area around crape myrtles correlated with a higher abundance of natural enemies. Aphid predation was mostly predicted by local structural complexity and impervious cover within 20 m of crape myrtle trees. Together, these findings suggest that although the impervious nature of our cities may mean higher densities of some pests, local landscapes around trees can play an important role in maintaining natural enemies and predation services that help regulate pest populations.
Changes on the viral capsid surface during the evolution of porcine circovirus type 2 (PCV2) from 2009 till 2018 may lead to a better receptor binding
Authors: Wei Ruifang , Xie Jiexiong , Theuns Sebastiaan , Nauwynck Hans J 
Published: August 2019

AbstractPorcine circovirus type 2 (PCV2) is the primary causative agent of porcine circovirus-associated diseases (PCVAD). Three major PCV2 genotypes (PCV2a, PCV2b, and PCV2d) have been identified globally. Despite their worldwide distribution, the prevalence and genetic evolution of PCV2 in Belgium has not previously been determined. In this study, 319 samples from animals suffering from diseases likely to be associated with PCV2 were collected from 2009 to 2018 and analysed by virus titration. The overall prevalence of PCV2 in PCVAD-suspected cases was 15.7 per cent (50/319). The phylogenetic analysis demonstrated that at least three genotypes (PCV2a, PCV2b, and PCV2d) circulated in Belgium from 2009 till 2018, and that PCV2 evolved from PCV2a to PCV2b and from PCV2d-1 to PCV2d-2. Sequence comparison among the forty-three PCV2 isolates showed that they had 89.7–100 per cent nucleotide-sequence and 88.5–100 per cent amino-acid-sequence identities. Three amino acid sites were under positive selection. Three-dimensional analysis of genotype-specific amino acids revealed that most of the mutations were on the outside of the cap protein with a few conserved mutations present on the inner side. Mutations toward more basic amino acids were found on the upper and tail parts of two connecting capsid proteins which form one big contact region, most probably involved in receptor binding. The lower part was relatively conserved. This polarity change together with the formation of an extruding part drive the virus to a more efficient GAG receptor binding. Taken together, these results showed a genotype shift from PCV2a to PCV2b and later on from PCV2d-1 to PCV2d-2, and a PCV2 evolution toward a better receptor binding capacity.
The synonymous 903C>G mutation in the alpha 1,4-galactosyltransferase gene in a Chinese woman with habitual abortion
Authors: Lv Xiaoying , Chen Yongquan , Luo Yuanyuan , Li Lingbo , Wang Houzhao 
Published: August 2019

Abstract

Rationale:
Habitual abortion is caused by complex and diverse factors, such as genetic factors, immune factors, endocrine factors, viruses, bacterial infections, and so on. Allogeneic antibodies, generated due to blood-group incompatibilities between a female and her fetus, are sometimes important for habitual abortion.

Patient concerns:
A 26-year-old woman had undergone abortions 3 times in July 2015 (17 weeks pregnant), March 2017 (15 weeks of gestation) and February 2018 (16 weeks pregnant) before she came to the Reproductive Medicine Center of our hospital for prenatal examinations without pregnancy.

Diagnoses:
Unexplained habitual abortion.

Interventions:
A series of serological tests and nucleotide sequence of 1,4-galactosyltransferase (A4GALT) gene were performed.

Outcomes:
The patient was the rare p phenotype in P1Pk blood system and the patient's habitual abortion was caused by anti-PP1Pk antibody which was generated naturally in persons with p phenotype. There was a mutation (903C>G, CCC>CCG) in the 3rd exon of A4GALT gene, which is likely a significant contributor to p phenotype.

Lessons:
This is the first case of habitual abortion caused by p phenotype due to independent 903C>G homozygous mutation with no similar record reported before, which indicates that it is a new class of mutation that leads to p phenotype.
Laparoscopic spleen-preserving pancreatic resection for intrapancreatic accessory spleen
Authors: Li Le , Liu Xiaohua , Chen Jinming , Liu Zhonghua , Li Qiang , Shi Ying 
Published: August 2019

Abstract

Introduction:
Intrapancreatic accessory spleen (IPAS) has been rarely noted radiologically because the spatial resolution of conventional images was low. The infrequent presence of the accessory spleen in the pancreatic tissue could lead to inappropriate diagnosis, thereby necessitating a therapeutic approach. The present study reported such cases and summarized the available imaging findings to reduce unnecessary invasive surgeries.

Patient concerns:
The patient's complaint was “a pancreatic mass was found for half a month.”

Diagnosis:
IPAS was eventually diagnosed by pathology.

Interventions:
Laparoscopic spleen-preserving pancreatic resection.

Outcomes:
Postoperative course was uneventful and the patient was discharged from our hospital after 10 days.

Conclusions:
When an asymptomatic pancreatic mass is detected, the diagnosis of IPAS should not be excluded, especially if the lesion has the same imaging features as the spleen. As a definite diagnosis of IPAS is difficult by a single examination, multiple techniques might be essential.
Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain
Authors: Gao Kun , Zhang Jiliang , Lai Jinquan , Liu Weidong , Lyu Hanqing , Wu Yihong , Lin Zhanpeng , Cao Yafei 
Published: August 2019

Abstract
Abnormal cervical curvature and cervical disc herniation are closely related to neck pain and should be taken into account before any treatment. However, studies have rarely reported on the correlation between cervical lordosis and cervical disc herniation in patients with neck pain. Therefore, in this study, we collect young neck pain patients with abnormal cervical curvature to evaluate the relationship between cervical lordosis and cervical disc herniation.
Three hundred patients below 40 years old with neck pain were enrolled. Patient sex, age, apical vertebra, segment of intervertebral disc protrusionl, sagittal diameter of spinal duramater, saggital diameter of spinal canal, height of disc space were recorded, and the cervical curvature, and degree of cervical spinal cord compression (G/F ratio) were calculated. The change of degree of disc herniation and degree of cervical spinal cord compression were analyzed in different cervical curvature groups. Further more, collected these patients who had improved cervical curvature over a period of time, to compare the changes of degree of disc herniation, G/F ratio, and height of disc space.
The median age of patients with kyphosis was lower than those with lordosis and straight cervical spine. The degree of disc herniation was higher in the straight and kyphosis groups compared to the lordosis group. Cervical lordosis was inversely correlated with the degree of disc herniation and positively with G/F ratio. Cervical curvature was significantly affected by sex, age, and the degree of disc herniation. With the improvement of cervical lordotic curvature, the degree of disc herniation decreased and height of disc space increased.
The degree of disc herniation and cervical spinal cord compression are inversely correlated to cervical lordosis in young neck pain patients, and the degree of disc herniation and height of disc space can recover with the recovery of cervical lordotic curvature. These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications.
Multi-organ embolism caused by oscillating aortic valve vegetation
Authors: Huang Guang , Tang Yu , Xiong Rong , Xu Ainan 
Published: August 2019

AbstractIntroduction:Valvular vegetation is often due to rheumatic heart disease and infective endocarditis. However, multi-arterial embolism can happen in older patients with no history of infection, fever, and cardiac symptoms. We describe a case of multi-organ embolism caused by oscillating aortal valve vegetation.Patient concerns:An 80-year-old woman without a history of infection, fever, and heart symptoms showed sudden loss of consciousness and symptoms of a multi-vessel embolism. Magnetic resonance imaging revealed multiple patchy ischemic foci in both cerebral hemispheres in the same time-phase, and echocardiography showed regurgitation in the aortic valve due to an abnormally hypo-hyperechoic mass measuring about 7.7 × 17.2 mm and oscillating aortic valve vegetation, which was induced by cardiac contraction.Diagnosis:Multiple organ cardiac embolisms caused by oscillating aortic valve vegetation.Interventions:Anti-platelet, fluid-supplement, and vascular-dilating therapies as well as intravenous diazepam were given to the patient.Outcome:The patient died of epileptic attack secondary to the cerebral embolism.Conclusions:The patient's whole-body multi-vessel ischemic events in nearly the same time-phase should have encouraged us to consider the possibility of cardiogenic embolism and thus early examination and treatment, although she was old with a relatively poor response due to early infection and physical discomfort. Clinicians should be aware that aortic valve vegetation induces generalized multi-organ embolism in the setting of infective endocarditis in order to ensure prompt recognition and treatment of this fatal complication.
Hamartoma of mature cardiomyocytes in right atrium
Authors: Zhou Xinqi , Zhou Yangzhao , Zhaoshun Yuan , Zeng Mu , Zhou Xinmin , Liao Xiaobo , Zhang Zhiyuan 
Published: August 2019

Abstract

Rationale:
Tumors in the heart are rare. Myxomas, rhabdomyomas, and fibromas are the most common benign cardiac tumors. Hamartoma of mature cardiomyocytes (HMCM) is another benign cardiac tumor, are very rare and have only been reported in a few literatures.

Patient concerns:
We report a case of 41-year-old male who suffered short of breath for 3 years, and lower limbs edema for 2 years.

Diagnoses:
Transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) showed a large amount of pericardial effusion and confirmed a mass of 18 × 14 mm on the superior vena cava near the outer edge of right atrium. The patient was first diagnosed as pleural mesothelioma. Surgery was performed to relieve the symptoms and confirm diagnoses. However, during surgery, we found the right atrium is apparently thicken with rough and uneven surface. Histology of right atrium mass indicated it as hamartoma of mature cardiomyocytes.

Intervention:
We resected the thicken atrial wall completely, reconstructed right atrium with bovine pericardial patch, and resected the pericardium.

Outcomes:
Patient was discharged 9 days after surgery, and remained asymptomatic during 9 months follow up.

Lessons:
Hamartoma of mature cardomyocytes is a rare benign cardiac tumor. There were 26 cases reported until now. The conclusive diagnosis depends on pathological sections. For patients with symptoms, surgery is an effective treatment for HMCM.
Deep vein thrombosis secondary to abdominal aortic aneurysm
Authors: Goh Zhong Ning Leonard , Seak Joanna Chen-Yeen , Seak Chen-Ken , Wu Chen-Te , Seak Chen-June 
Published: August 2019

Abstract

Rationale:
Abdominal aortic aneurysm is an extremely rare cause of deep vein thrombosis. Here we report an elderly gentleman who presented with deep vein thrombosis and was found to have concomitant abdominal aortic aneurysm upon ultrasonographic screening. It illustrates the possibility of such an aetiology, and the importance of screening for such aneurysms in a select patient population before heparinization.

Patient concerns:
A 73-year-old Asian gentleman with underlying hypertension, hyperlipidaemia, chronic renal failure, and history of chronic smoking presented to the emergency department with acute left lower limb swelling of 1 day. On examination, the patient was tachycardic (110 beats/minute) and hypertensive (168/84 millimeters mercury (mmHg)). The entire left lower limb was swollen with notable pitting oedema, tenderness, and warmth; left calf swelling was measured to be 4 centimeters (cm).

Diagnoses:
The patient's Wells score of 4 placed him in the high-risk group for deep vein thrombosis. Serum D-dimer was subsequently found to be elevated at 926 nanograms/milliliter (ng/ml). Compression ultrasonography revealed a thrombus in the left deep femoral vein, confirming the diagnosis of deep vein thrombosis. The ultrasonographic evaluation was extended to the abdominal aorta due to the patient's high risk of abdominal aortic aneurysm, and a 7-cm aneurysm was indeed found. Further computed tomography and magnetic resonance imaging localized it to the infrarenal region, with left common iliac vein compression resulting in stagnant venous return.

Interventions:
Emergency endovascular repair was performed with insertion of an inferior vena cava filter.

Outcomes:
The patient was subsequently monitored in the intensive care unit and uneventfully discharged after 2 weeks.

Lessons:
Such clinical presentations of deep vein thrombosis are rare, but physicians are reminded to consider screening for abdominal aneurysms and other anatomical causes before heparinization in patients who seemingly do not have thromboembolic risk factors. This is especially so for the high risk group of male deep vein thrombosis patients aged 65–75 years with a history of smoking who have yet to be screened for abdominal aortic aneurysms, in line with United States Preventive Services Task Force recommendations.
Survival after cardiac arrest secondary to high-risk pulmonary embolism without reperfusion therapies
Authors: Xu Cai-Yun , Song Jia-Fu , Yao Li-Hong , Xu Hui-Ling , Liu Ke-Xi 
Published: August 2019

Abstract

Introduction:
High-risk pulmonary embolism (PE) needs reperfusion therapies. However, it is difficult to make medical decisions when thrombolysis is contraindicated, though pulmonary embolectomy and percutaneous catheter-directed treatment (CTD) are recommended for these patients.

Patient concerns:
We reported here a case of high-risk PE patient with cardiac arrest (CA), vertebral compression fracture, as well as scalp and frontal hematoma.

Diagnosis:
The diagnosis of PE was based on computed tomography pulmonary angiography (CTPA) which demonstrated filling defects in the right and left pulmonary arteries.

Interventions:
Cardiopulmonary resuscitation was performed until the patient returned to idioventricular rhythm 3 minutes after admitted. She suffered another half-hour of hemodynamic disturbance after her shock improved 3 days later. The diagnosis of PE was confirmed by CTPA at that time. The patient did not receive any reperfusion therapies because hemoglobin decreased significantly. Moreover, anticoagulation was postponed for 2 weeks when bleeding appeared to be stopped. She received overlapping treatment with low molecular weight heparin and warfarin for 5 days then warfarin alone and discharged.

Outcomes:
She was discharged with normal vital signs and neurologically intact. She received anticoagulant therapy with warfarin and international normalized ratio regularly monitored after she was discharged, moreover, the pulmonary artery pressure turned normal, as determined by transthoracic echocardiography 1 month later. The warfarin treatment was discontinued after 12 months and no evidence of recurrence was seen until recently.

Conclusions:
This is the first case report of PE combined with CA that did not receive reperfusion therapy. We hypothesized that there was a spontaneous resolution in pulmonary emboli.
Endoscopic full-thickness resection for a gastrointestinal stromal tumor in a liver transplant recipient
Authors: Xie Man , Rao Wei , Zhang Peng , Zhao Qingxi , Tian Zibin 
Published: August 2019

Abstract

Rationale:
With the development of endoscopic technique and the improvement of available accessories, endoscopic therapy became to play an important role in the management of gastrointestinal submucosal tumors (SMTs).

Patients concerns:
A gastric SMT which was suspected to be gastrointestinal stroma tumor (GIST) was diagnosed in a liver transplant recipient who received transplanted operation 11 months ago.

Diagnosis:
gastric SMT, post-liver transplantation

Interventions:
Endoscopic full-thickness resection (EFR) was preformed to remove the tumor. The operation time was 50 minutes and oral immunosuppressant drug was not interrupted in the postoperative period.

Outcomes:
The clinical course was uneventful and slightly elevated liver enzyme was observed on the fourth day after operation. The pathological diagnosis was GIST with complete capsule.

Lessons:
Our successful experience showed that EFR is a feasible, safe and efficacious treatment for small (<2 cm) gastric GIST in liver transplant recipients, providing the advantages of little damage, short operative time, stable graft function, without compromising postoperative outcomes.
A statistical analysis plan for a randomized clinical trial to evaluate the efficacy and safety of ethosuximide in patients with treatment-resistant depression
Authors: Jiang Jiajun , Wang Zheng , Dong YiYan , Yang Yan , Ng Chee H. , Ma Shuangshuang , Xu Yi , Hu Hailan , Hu Shaohua 
Published: August 2019

Abstract

Background and objective:
A recent striking advance in the treatment of depression has been the finding of rapid antidepressant effects in over 70% of patients with treatment-resistant depression (TRD) using ketamine. However, the potential risk of addiction may limit its clinical use. Recent research revealed that blockade of N-methyl-D-aspartate receptor (NMDAR) dependent bursting activity in the lateral habenula (LHb) could mediate the fast antidepressant effects of ketamine. Further, LHb bursting plays an important role in the pathophysiology of depression that requires both NMDARs and low-voltage-sensitive T-type calcium channels (T-VSCCs). Ethosuximide, which is used to treat absence seizures, is a T-VSCCs inhibitor, may be a novel drug candidate for depression. The objective of this clinical trial is to investigate the efficacy and safety of ethosuximide in patients with TRD.

Design:
The study is a single center, randomized, double-blind, placebo-controlled, parallel-group, two-stage clinical trial. Forty patients with TRD will be randomly assigned to Group A (treatment group) or Group B (control group). In the first stage ethosuximide or placebo will be given for 2 weeks. In the second stage, escitalopram (or another antidepressant if escitalopram has been used before) will be given for the next 4 weeks for all trial patients to ensure effective treatment. The primary outcome measure is the Montgomery–Åsberg Depression Rating Scale (MADRS) scores. Secondary outcome measures include the Quick Inventory of Depressive Symptomatology—Self Report score, Hamilton Anxiety Rating Scale scores, individual scores of MADRS, and Young Mania Rating Scale scores. All these scales are measured at baseline and at each treatment visit. Two-way repeated measures analysis of variance is used to analyze the study outcomes.

Discussion:
A statistical analysis plan is employed to enhance the transparency of the clinical trial and reduce the risks of outcome reporting bias and data-driven results.
The consequence of endotracheal intubation in a 95-years old man for 839 days
Authors: Feng Yan-mei , Wan Dong , Guo Rui 
Published: August 2019

Abstract

Rationale:
The benefits of prolonged endotracheal intubation (ETI) in comparison to early tracheotomy is still over the controversy. Little information is available in concern to prolonged ETI more than years. We report the consequence of oral ETI in a 95-year old man for 839 days.

Patient concerns:
This patient was transferred to the intensive care unit due to sputum asphyxia and respiratory arrest. Timely ETI was performed. However, as a neurological insult, extubation had a high risk of failure due to the insufficient ability of sputum clearance. In addition, his family members refused further surgical interventions including tracheotomy.

Diagnoses:
Prolonged ETI occurred in this patient. On day 240 and 329 after ETI, 3D airway image did not reveal laryngeal stenosis or laryngeal lesions. On day 459 and 662, ET tube (ETT) exchanged was performed and the balloon became stiff and inelasticity.

Interventions:
Although a possible tracheoesophageal fistula was suspected by imaging findings on day 547, the gastroscopy did not reveal the fistula on the esophagus. Enteral nutrition was delivered through the gastric tube, while the mediastinal infection was not observed during subsequent follow-up of computed tomography.

Outcomes:
He received tracheostomy due to acute sputum obstruction within ETT and abrupt oxygen desaturation on day 839.

Lessons:
During prolonged ETI, more attention should focus on airway humidification, proper cuff pressure and optimal time for tube exchange in order to avoid severe complications.