bluuebunny/crossref_metadata_2025 huggingface dataset:
Personalizing Medical Treatment Decisions: Integrating Meta-analytic Treatment Comparisons with Patient-Specific Risks and Preferences
Authors: Weyant Christopher , Brandeau Margaret L. , Basu Sanjay
Published: November 2019

Background. Network meta-analyses (NMAs) that compare treatments for a given condition allow physicians to identify which treatments have higher or lower probabilities of reducing the risks of disease complications or increasing the risks of treatment side effects. Translating these data into personalized treatment plans requires integration of NMA data with patient-specific pretreatment risk estimates and preferences regarding treatment objectives and acceptable risks. Methods. We introduce a modeling framework to integrate data probabilistically from NMAs with data on individualized patient risk estimates for disease outcomes, treatment preferences (such as willingness to incur greater side effects for increased life expectancy), and risk preferences. We illustrate the modeling framework by creating personalized plans for antipsychotic drug treatment and evaluating their effectiveness and cost-effectiveness. Results. Compared with treating all patients with the drug that yields the greatest quality-adjusted life-years (QALYs) on average (amisulpride), personalizing the selection of antipsychotic drugs for schizophrenia patients over the next 5 years would be expected to yield 0.33 QALYs (95% credible interval [crI]: 0.30–0.37) per patient at an incremental cost of $4849/QALY gained (95% crI: dominant–$12,357), versus 0.29 and 0.04 QALYs per patient when accounting for only risks or preferences, respectively, but not both. Limitations. The analysis uses a linear, additive utility function to reflect patient treatment preferences and does not consider potential variations in patient time discounting. Conclusions. Our modeling framework rigorously computes what physicians normally have to do mentally. By integrating 3 key components of personalized medicine—evidence on efficacy, patient risks, and patient preferences—the modeling framework can provide personalized treatment decisions to improve patient health outcomes.
Prosocial Motivation of Private Sector IT Professionals Joining Government
Authors: Mergel Ines , Bellé Nicola , Nasi Greta
Published: November 2019

Attracting highly skilled IT talent has become a priority and an immense burden for government organizations—especially when they have other—higher paying—employment opportunities. We set out to explore why IT professionals choose a government job to make an impact on society. We aim at disentangling the effects of different types of motives, such as extrinsic, intrinsic, and other-oriented motivational forces on the decision to accept a challenging government IT job. We use self-determination theory (SDT) to analyze publicly available statements of former private sector IT professionals reporting their reason for joining 18F. Our study is one of the first attempts to use SDT as a comprehensive framework for conducting qualitative research into work motivation in the public sector. We shed light on the conceptual and empirical distinctiveness of motives, behaviors, and perceptions of prosocial impact, which are often lumped together in the public service motivation (PSM) literature. We contribute novel empirical evidence to a nascent stream of research that uses SDT to disentangle the intrinsic, prosocial, and purely extrinsic motives that drive individuals’ decisions to join public-sector organizations.
Numerical study on the combustion characteristics in a porous-free flame burner for lean mixtures
Authors: Ghorashi Seyed Amin , Hashemi Seyed Mohammad , Hashemi Seyed Abdolmehdi , Mollamahdi Mahdi
Published: November 2019

The present work implements a numerical simulation to investigate the combustion process in a porous-free flame burner. The non-equilibrium thermal condition is performed, and discretization and solving of the governing equations are conducted in a two-dimensional axisymmetric model. In order to simulate the combustion process, a reduced chemical kinetic mechanism of GRI 3.0, which includes 16 species and 41 reactions, is used. In order to prove the precision of the numerical method, some experimental tests are carried out and the numerical results are in a good agreement with the experimental measurements. The numerical results demonstrate that the porous-free flame burner has a higher flame stability compared to the conventional porous burner and the radiative efficiency of the porous-free flame burner is less than the porous burner. In addition, an increase in thermal conduction of the porous medium leads to an extension in the flame stability. In addition, the results show that with decreasing the pore density of porous medium, the flame stability is extended.
Congratulations, You Got a Revise and Resubmit! Now What? The Impetus Behind and Lessons Learned from a Successful Years-long PDW Focused on the Peer Review Revision Process
Authors: Vogelgesang Lester Gretchen
Published: November 2019

For all the experiences researchers have with the publication process, questions continue to arise about how to best navigate the revise and resubmit gauntlet. This dialog captures insight from six years of Academy of Management professional development workshops, an action editor’s perspective on the process, and a qualitative exploration of revision derailers—topics focused on understanding and improving the predictability of the revise and resubmit process. In doing so, this dialog serves as a resource for new and accomplished scholars, reviewers, and editors to refocus the revision process on creating and disseminating knowledge throughout business-related fields. The three articles in this dialog first summarize the planning and execution of six professional development workshops (PDWs), the process from the perspective of an action editor, and a content analysis of rejections after an R&R, in order to highlight best practices authors can take to increase success throughout this process
High Yield of Screening for ADHD in the Epilepsy Monitoring Unit
Authors: Dunbar Corrinne , Lee Maxwell , Maheshwari Atul
Published: November 2019

Objective: ADHD is common in patients with epilepsy, but adult patients with possible epilepsy are not routinely screened for ADHD. We aimed to characterize the results of two validated screening tools in the setting of an Epilepsy Monitoring Unit (EMU). Method: This study utilized the validated Adult ADHD Self-Report Scale version 1.1 (ASRS) and Conners Continuous Performance Test, third edition (CPT-III) to screen patients who were admitted to the EMU at a Level 4 epilepsy center. Patients with epileptic seizures (ES) were compared with patients with psychogenic nonepileptic seizures (PNES). Results: In all, 40.6% of patients screened positive using the ASRS. A significantly greater proportion of patients with PNES (63.6%) screened positive compared with patients with ES (27.8%, Fisher’s exact test, p = .005). Positive ASRS screens showed no significant association with positive CPT screens (chi-square test, p = .146). Conclusion: Adult patients admitted to the EMU are at a high risk of comorbid attention deficits.
Do Changes in Blood Nutrient Levels Mediate Treatment Response in Children and Adults With ADHD Consuming a Vitamin–Mineral Supplement?
Authors: Rucklidge Julia J. , Eggleston Matthew J. F. , Boggis Anna , Darling Kathryn , Gorman Brigette , Frampton Christopher M.
Published: November 2019

Objective: We investigated whether changes in serum nutrient levels mediate clinical response to a micronutrient intervention for ADHD. Method: Data were compiled from two ADHD trials (8-10 weeks), one in adults ( n = 53) and one in children ( n = 38). Seven outcomes included change in ADHD symptoms, mood, overall functioning (all clinician-rated) as well as response status. Change in serum/plasma nutrient levels (vitamins B12 and D, folate, ferritin, iron, zinc, and copper) were considered putative mediators. Results: A decrease in ferritin and an increase in copper were weakly associated with greater likelihood of being identified as an ADHD responder; none of the other nutrient biomarkers served as mediators. Conclusion: Further research looking at nutrients more broadly from other tissues are required to confirm these initial observations of the limited value of nutrient levels in deciphering mechanism of action. Monitoring these biomarkers on their own is unlikely helpful in understanding clinical response to a broad-spectrum micronutrient approach.
Rethinking Social Inquiry in the Wake of Science Studies: Transdisciplinary Pursuits in Times of Climate Change, Information Flows, and Fading Democracies
Authors: de Freitas Elizabeth , Weaver John A.
Published: November 2019

Our aim for this special issue of Cultural Studies—Critical Methodologies is to engage with current influential texts in Science Studies, addressing the urgent need to rethink the role of the sciences in transdisciplinary possibilities for social inquiry. In this introductory essay, we underscore the political stakes of this kind of work, and we focus on a few key themes that run across the collected articles, situated as they are within what scientists call the Anthropocene.
Understanding Lung Cancer Resources and Barriers Among Worksites With Mostly Male Employees in Eight Rural Kentucky Counties: A Focus Group Discussion
Authors: Knight Jennifer Redmond , Williamson Lucy Hollingsworth , Armstrong Debra K. , Westbrook Elizabeth A.
Published: November 2019

Kentucky has the highest cancer incidence and mortality rates in the United States, and lung cancer is Kentucky’s leading cause of cancer deaths. Males in Kentucky have higher lung incidence and mortality rates than females. Through support from the SelfMade Health Network, Kentucky developed a Regional Resource Lead Organization that collaboratively developed a multi-component worksite intervention on lung cancer among male populations. The intervention targets eight Kentucky counties. The first component and focus of this manuscript included focus group meetings with organizational representatives in each county that provide health, educational, and social services to men and worksites. The focus groups discussed four distinct areas: (a) lung cancer-related resources and services in each county; (b) perceived ways men in worksites learn about and access health-related services; (c) identification of potential challenges and barriers to reaching men in worksites; and (d) creation of linkages and potential partnerships between community organizations and worksites. Forty-five organizational representatives participated in the eight focus groups. Most resources and services discussed were related to tobacco treatment. Employers were the most commonly perceived way men learn about and access health-related services, while attitudes and behaviors were the most commonly perceived barriers preventing men from accessing services. The most common potential linkages and partnerships across all areas were community organizations and groups, employers, health-care providers, and mass media. Partnering with employers may provide an opportunity to reach males with lung cancer prevention and control resources and services.
Shooting efficiency and structure of shooting in 3 × 3 basketball compared to 5v5 basketball
Authors: Erčulj Frane , Vidic Matic , Leskošek Bojan
Published: November 2019

This article presents and analyses certain playing characteristics of men's and women's 3 × 3 basketball in relation to shooting at the basket. Our intention was to compare this young and developing basketball discipline with the more established and traditional 5v5 basketball. For this purpose, over 400 matches were analysed in the U18 age category during the men’s and women’s European Championship (5v5 Basketball) and the Youth Olympic Games (3 × 3 Basketball). The research confirms some differences in the efficiency and structure of shooting. It can generally be said that male and female 3 × 3 basketball players take more long-distance shots (behind the 6.75 m line) and take fewer free throws than their counterparts in 5v5 basketball. When shooting from behind the 6.75 m line, both male and female 3 × 3 basketball players are less efficient than their 5v5 basketball counterparts, and similar applies to free throws. The reasons for these differences may entail many factors, including differences in the game rules, the playing conditions on outdoor courts, different technical and tactical requirements and the characteristics (style) of playing as well as the quality and performance level of basketball players.
Near-Infrared Optical Nanosensors for Continuous Detection of Glucose
Authors: Le Long V. , Chendke Gauree S. , Gamsey Soya , Wisniewski Natalie , Desai Tejal A.
Published: November 2019

Background:

Continuous glucose monitors (CGMs) enable people with diabetes to proactively manage their blood glucose and reduce the risk of hypoglycemia. Commercially available CGMs utilize percutaneous electrodes that, after days to weeks of implantation, are subjected to the foreign body response that severely reduces sensor accuracy. The previous work demonstrated the use of hydrogels containing a glucose-responsive viologen that quenches a nearby fluorophore. Here, we investigate the immobilization of this sensing motif onto a nanoparticle surface and optimize local surface concentrations for optical glucose sensing.

Methods:

A viologen quencher-fluorescent dye system was incorporated into poly(2-hydroethyl methacrylate) hydrogels in varying quantities to assess the effect of quencher-fluorophore concentration on glucose responsiveness. The sensing motif was then immobilized onto silica nanoparticles by carbodiimide chemistry. Nanosensors with a range of dye and quencher concentrations were challenged for glucose responsiveness to determine the optimal sensor formulation.

Results:

When incorporated into a hydrogel, high concentrations of viologen quencher and fluorophore were required to permit electron transfer between the two components and yield a detectable glucose response. Immobilization of this glucose-responsive system onto a silica nanoparticle facilitated this electron transfer to yield detectable responses at even low concentrations. Increasing quencher concentration on the nanoparticle, relative to the fluorophore, resulted in the greatest apparent glucose response.

Conclusion:

The nanoparticle sensors demonstrated excellent glucose response in the physiological range and are a promising tool for real-time glucose tracking.
The Cost-Effectiveness of Vancomycin Powder in Lumbar Laminectomy
Authors: Kerbel Yehuda E. , Kirchner Gregory J. , Sunkerneni Anisha Reddy , Lieber Alexander M. , Moretti Vincent M. , Khalsa Amrit S. , Levine Marc J.
Published: November 2019

Study Design:

Break-even cost analysis.

Objective:

The goal of this study is to examine the cost-effectiveness of vancomycin powder for preventing infection following lumbar laminectomy.

Methods:

The product cost of vancomycin powder was obtained from our institution’s purchasing records. Infection rates and revision costs for lumbar laminectomy and lumbar laminectomy with fusion were obtained from the literature. A break-even analysis was then performed to determine the absolute risk reduction (ARR) in infection rate to make prophylactic application of vancomycin powder cost-effective. Analysis of lumbar laminectomy with fusion was performed for comparison.

Results:

Costing $3.06 per gram at our institution, vancomycin powder was determined to be cost-effective in lumbar laminectomy if the infection rate of 4.2% decreased by an ARR of 0.015%. Laminectomy with fusion was also determined to be cost-effective at the same cost of vancomycin powder if the infection rate of 8.5% decreased by an ARR of 0.0034%. The current highest cost reported in the literature, $44.00 per gram of vancomycin powder, remained cost-effective with ARRs of 0.21% and 0.048% for laminectomy and laminectomy with fusion, respectively. Varying the baseline infection rate did not influence the ARR for either procedure when the analysis was performed using the product cost of vancomycin at our institution.

Conclusions:

This break-even analysis demonstrates that prophylactic vancomycin powder can be highly cost-effective for lumbar laminectomy. At our institution, vancomycin powder is economically justified if it prevents at least one infection out of 6700 lumbar laminectomy surgeries.
OsProT1 and OsProT3 Function to Mediate Proline- and γ-aminobutyric acid-specific Transport in Yeast and are Differentially Expressed in Rice (Oryza sativa L.)
Authors: Lin Jin-Hong , Xu Zhi-Jun , Peng Jia-Shi , Zhao Jing , Zhang Guo-Bin , Xie Jun , Yi Zhen-Xie , Zhang Jian-Hua , Gong Ji-Ming , Ye Neng-Hui , Meng Shuan
Published: November 2019

Background

Proline (Pro) and γ-aminobutyric acid (GABA) play important roles in plant development and stress tolerance. However, the molecular components responsible for the transport of these molecules in rice remain largely unknown.

Results

Here we identified OsProT1 and OsProT3 as functional transporters for Pro and GABA. Transient expression of eGFP-OsProTs in plant protoplasts revealed that both OsProT1 and OsProT3 are localized to the plasma membrane. Ectopic expression in a yeast mutant demonstrated that both OsProT1 and OsProT3 specifically mediate transport of Pro and GABA with affinity for Pro in the low affinity range. qRT-PCR analyses suggested that OsProT1 was preferentially expressed in leaf sheathes during vegetative growth, while OsProT3 exhibited relatively high expression levels in several tissues, including nodes, panicles and roots. Interestingly, both OsProT1 and OsProT3 were induced by cadmium stress in rice shoots.

Conclusions

Our results suggested that plasma membrane-localized OsProT1 and OsProT3 efficiently transport Pro and GABA when ectopically expressed in yeast and appear to be involved in various physiological processes, including adaption to cadmium stress in rice plants.
Hypo- or hyperactivity of zebrafish embryos provoked by neuroactive substances: a review on how experimental parameters impact the predictability of behavior changes
Authors: Ogungbemi Afolarin , Leuthold David , Scholz Stefan , Küster Eberhard
Published: November 2019

Tests with zebrafish embryos have gained wide acceptance as an alternative test model for drug development and toxicity testing. In particular, the behavioral response of the zebrafish embryo is currently seen as a useful endpoint to diagnose neuroactive substances. Consequently, several behavioral test methods have been developed addressing various behavioral endpoints such as spontaneous tail coiling (STC), photomotor response (PMR), locomotor response (LMR) and alternating light/dark-induced locomotor response (LMR-L/D). Although these methods are distinct in their application, most of their protocols differ quite strongly in the use of experimental parameters and this is usually driven by different research questions. However, if a single mode of action is to be diagnosed, then varying experimental parameters may cause incoherent behavioral responses (hypo- or hyperactivity) of zebrafish during toxicity assessment. This could lead to inconclusiveness of behavioral test results for use within a prospective and diagnostic risk assessment framework. To investigate the influence of these parameters, we conducted a review of existing behavioral assays to address the following two questions: (1) To what extent do varying experimental parameters influence observed effects in published behavioral test methods? (2) Is the observed behavior change (hypo- or hyperactivity) of zebrafish embryos consistent with the expected mode of action of a chemical? We compiled a set of 18 substances which are anticipated to be neuroactive. We found that behavioral changes are not only affected by chemicals but also variation in the use of experimental parameters across studies seems to have a high impact on the outcome and thus comparability between studies. Four parameters, i.e., exposure concentration, exposure duration, endpoint parameter and developmental stage were the most influential parameters. Varying combinations of these parameters caused a non-reproducible outcome for the hyperactivity expected for the organophosphates; chlorpyrifos and diazinon. We highlighted that the STC test shows a higher capacity to predict the hyperactivity of organophosphates, while PMR and LMR-L/D were more suitable to predict the hypoactivity expected for anticonvulsants. We provide a list of recommendations which, when implemented, may help to exclude the risk of bias due to experimental parameters if similar goals are desired.
Prevalence of Viremic hepatitis C, hepatitis B, and HIV infection, and vaccination status among prisoners in Stockholm County
Authors: Gahrton Caroline , Westman Gabriel , Lindahl Karin , Öhrn Fredrik , Dalgard Olav , Lidman Christer , Nilsson Lars-Håkan , Said Karouk , Duberg Ann-Sofi , Aleman Soo
Published: November 2019

Background

Identification and knowledge of settings with high prevalence of hepatitis C virus (HCV) infection is important when aiming for elimination of HCV. The primary aim of this study was to estimate the prevalence of viremic HCV infection among Swedish prisoners. Secondary aims were to estimate the prevalence of hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV), and the proportion who have received hepatitis B virus (HBV) vaccination.

Methods

A cross-sectional study of all incarcerated persons (n = 667) at all prisons (n = 9) in Stockholm County was conducted. All prisoners are routinely offered opt-in screening for HCV antibodies (anti-HCV), HCV RNA, HBsAg, anti-HBs, anti-HBc and HIV Ag/Ab at prison in Sweden. Data on the results of these tests and the number of received HBV vaccine doses were collected from the prison medical records. The parameters of HCV RNA, anti-HCV, and occurrence of testing for HCV were analysed in multiple logistic regression models in relation to age, sex and prison security class.

Results

The median age was 35 (IQR 26–44) years, and 93.4% were men. Seventy-one percent (n = 471) had been tested for anti-HCV, 70% (n = 465) for HBsAg and 71% (n = 471) for HIV. The prevalence of anti-HCV, HCV RNA, HBsAg and HIV Ag/Ab was 17.0, 11.5, 1.9, and 0.2%, respectively among tested persons. The proportion of prisoners who had received full HBV vaccination was 40.6% (n = 271) among all study subjects.

Conclusions

The prevalence of viremic HCV infection among Swedish prisoners in Stockholm County was 11.5%, which is high in comparison to the general population. Therefore, when aiming for the WHO goal of HCV elimination, prisons could suit as a platform for identification and treatment of HCV infection. There is a need to increase testing for blood-borne viruses and to improve vaccination coverage against HBV in Swedish prisons.
Simultaneous intrathyroidal parathyroid adenomas and multifocal papillary thyroid carcinoma in a patient with kidney transplantation: a case report
Authors: Yang Jun , Zhang Jun , Bi Jian-li , Weng Wan-wen , Dong Meng-jie
Published: November 2019

Background

Persistent hyperparathyroidism after kidney transplantation has been associated with adverse outcomes. Parathyroidectomy is the definitive treatment approach, but the success of parathyroidectomy relies on the accurate preoperative localization of the culprit parathyroid lesions. Simultaneous intrathyroidal parathyroid adenomas and multifocal papillary thyroid carcinoma present important diagnostic challenges. Here, we describe a patient with kidney transplantation who underwent successful surgery after being evaluated with functional and structural imaging.

Case presentation

A 53-year-old man presented with potentially malignant multifocal thyroid nodules by ultrasonography 2 years after kidney transplantation. The patient had hypercalcaemia and persistent hyperparathyroidism. Thyroid papillary carcinoma was confirmed in the left thyroid nodules by fine-needle aspiration biopsy. The right superior thyroid hypoechoic nodule was 1.2 cm in size and showed marked uptake of the tracer 99mTcO4-sestamibi during single-photon emission computed tomography/computed tomography (SPECT/CT); additionally, a cystic parathyroid lesion without tracer uptake was present behind the left superior pole of the thyroid. The histological examination demonstrated the coexistence of right intrathyroidal parathyroid adenomas, left cystic parathyroid nodular hyperplasia and multifocal papillary thyroid carcinoma. At the 6-month follow-up, the serum calcium levels were within the normal range, and the patient’s kidney function remained stable.

Conclusions

Simultaneous intrathyroidal parathyroid adenomas and multifocal papillary thyroid carcinoma in a patient with kidney transplantation is a rare clinical scenario. Physicians must be aware that the combination of functional (SPECT/CT) and structural (ultrasonography) imaging is highly successful in diagnosing patients with coexistent intrathyroidal parathyroid adenomas and papillary thyroid carcinoma.
Dual oxidase 1 and NADPH oxidase 2 exert favorable effects in cervical cancer patients by activating immune response
Authors: Cho Sang Yeon , Kim Sungha , Son Mi-Ju , Kim Gwanghun , Singh Parul , Kim Ha Neul , Choi Hei-Gwon , Yoo Heon Jong , Ko Young Bok , Lee Byung Seok , Eun Hyuk Soo
Published: November 2019

Background

Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-derived reactive oxygen species (ROS) not only can promote cancer progression, but also they have recently emerged as mediators of the mucosal immune system. However, the roles and clinical relevance of the collective or individual NADPH oxidase (NOX) family genes in cervical cancer have not been studied.

Methods

We investigated the clinical significance of the NOX family genes using data from 307 patients with cervical cancer obtained from The Cancer Genome Atlas. Bioinformatics and experimental analyses were performed to examine NOX family genes in cervical cancer patients.

Results

Dual Oxidase1 (DUOX1) and Dual Oxidase 2 (DUOX2) mRNA levels were upregulated 57.9- and 67.5-fold, respectively, in cervical cancer patients. The protein expression of DUOX1, DUOX2, and NOX2 also identified in cervical squamous cell carcinoma tissues. Especially, DUOX1 and DUOX2 mRNA levels were significantly increased in patients infected with human papillomavirus (HPV) 16. Moreover, high DUOX1 mRNA levels were significantly associated with both favorable overall survival and disease-free survival in cervical cancer patients. High NOX2 mRNA levels was significantly associated with favorable overall survival. Gene set enrichment analyses revealed that high DUOX1 and NOX2 expression was significantly correlated with the enrichment of immune pathways related to interferon (IFN)-alpha, IFN-gamma, and natural killer (NK) cell signaling. Cell-type identification by estimating relative subsets of known RNA transcript analyses indicated that the fraction of innate immune cells, including NK cells, monocytes, dendritic cells, and mast cells, was elevated in patients with high DUOX1 expression.

Conclusions

DUOX1 and NOX2 expression are associated with mucosal immunity activated in cervical squamous cell carcinoma and predicts a favorable prognosis in cervical cancer patients.
BAP1 tumor predisposition syndrome case report: pathological and clinical aspects of BAP1-inactivated melanocytic tumors (BIMTs), including dermoscopy and confocal microscopy
Authors: Soares de Sá Bianca Costa , de Macedo Mariana Petaccia , Torrezan Giovana Tardin , Braga Juliana Casagrande Tavoloni , Fidalgo Felipe , Moredo Luciana Facure , Lellis Rute , Duprat João Pereira , Carraro Dirce Maria
Published: November 2019

Background

BRCA1 associated-protein 1 (BAP1) tumor predisposition syndrome is associated with an increased risk for malignant mesotheliomas, uveal and cutaneous melanomas, renal cell carcinomas, and singular cutaneous lesions. The latter are referred to as BAP1-inactivated melanocytic tumors (BIMTs). When multiple BIMTs manifest, they are considered potential markers of germline BAP1 mutations.

Case presentation

Here, we report a novel pathogenic BAP1 germline variant in a family with a history of BIMTs, cutaneous melanomas, and mesotheliomas. We also describe singular pathological aspects of the patient’s BIMT lesions and their correlation with dermoscopic and reflectance confocal microscopy findings.

Conclusions

This knowledge is crucial for the recognition of BIMTs by dermatologists and pathologists, allowing the determination of appropriate management for high-risk patients, such as genetic investigations and screening for potentially aggressive tumors.
Predictors of early life milestones: Results from the Copenhagen Perinatal Cohort
Authors: Flensborg-Madsen Trine , Grønkjær Marie , Mortensen Erik Lykke
Published: November 2019

Background

Pre- and postnatal factors have been found to be predictors of age at attaining milestones in infancy; however, the degree to which such factors are predictors of milestones in the subsequent years is less investigated. The aim was to conduct a systematic evaluation of a broad range of possible predictors of milestone attainment during the second and third years to identify factors that explain significant inter-individual variance.

Methods

Mothers of 4009 children from the Copenhagen Perinatal Cohort (1959–61) were interviewed by a physician about 20 developmental milestones at a three-year examination. Milestones were related to: Language, Walking, Eating, Dressing, Social interaction, and Toilet training. Information on possible predictors was collected during pregnancy and at a 1- and 3-year follow-up.

Results

Several pre- and postnatal factors were significantly associated with the timing of milestone attainment; especially parental social status, paternal age, sex, gestational age, birth weight, birth length, weight increase in the first year of life, and motor development during the first year of life. The significant predictors explained 16.2% of the variance in the Overall mean of milestones and 20.3% of the variance in milestones related to Walking. The most influential individual factor for the timing of milestone attainment was previous motor development during the first year of life. Additionally, sex was an important factor as girls were generally faster at attaining milestones. Parental social status was a consistent, but relatively week predictor.

Conclusion

A notable amount of variance in the timing of milestones during the first three years of life can be explained by perinatal and early postnatal factors. The study provides evidence of developmental continuity as the main predictor of milestones in the second and third years was the speed of development during the first year.
The relation between behavioral problems and social competence: A correlational Meta-analysis
Authors: Hukkelberg Silje , Keles Serap , Ogden Terje , Hammerstrøm Karianne
Published: November 2019

Background

Previous studies have shown that children who display behavioral problems also tend to display low social competence. The relation does however vary according to type of behavior being measured, as well as demographic characteristics of the respondent. The present meta-analysis examined the correlation between different types of behavioral problems and social competence among children aged 3–13, and investigated possible moderators in this relation.

Methods

A systematic literature search was conducted for English language studies from January 2008 to January 2018 that reported correlations between three types of behavioral problems (i.e., externalizing behaviors, conduct problems, or aggression) and two types of social competence (i.e., social competence or social skills). The studies included reports from parents and teachers, or both as a dyad. The review included data from 54 independent studies and a total of 46,828 participants. Effect sizes were estimated using a random effects approach and moderator analyses between subsets of categorical variables were tested by the significant Q test.

Results

Results showed an overall correlation between behavioral problems and social competence of medium effect size (r = −.42, p < .01). Moderation analyses indicated no significant differences for different types of behavioral problems or social competence. However, a significant difference was found with regard to type of respondent; the correlation was significantly higher when both measures were reported by the same respondent (teacher or parent) compared to when measures were reported by parent-teacher as a dyad.

Conclusions

Findings summarized and quantified a robust negative correlation between behavioral problems and social competence. The results indicate that intervention programs targeting problem behaviors in children would benefit from reducing behavioral problems and in concert, increase social competence to help children with emerging or present problem behaviors.
Quantitative lung morphology: semi-automated measurement of mean linear intercept
Authors: Crowley George , Kwon Sophia , Caraher Erin J. , Haider Syed Hissam , Lam Rachel , Batra Prag , Melles Daniel , Liu Mengling , Nolan Anna
Published: November 2019

Background

Quantifying morphologic changes is critical to our understanding of the pathophysiology of the lung. Mean linear intercept (MLI) measures are important in the assessment of clinically relevant pathology, such as emphysema. However, qualitative measures are prone to error and bias, while quantitative methods such as mean linear intercept (MLI) are manually time consuming. Furthermore, a fully automated, reliable method of assessment is nontrivial and resource-intensive.

Methods

We propose a semi-automated method to quantify MLI that does not require specialized computer knowledge and uses a free, open-source image-processor (Fiji). We tested the method with a computer-generated, idealized dataset, derived an MLI usage guide, and successfully applied this method to a murine model of particulate matter (PM) exposure. Fields of randomly placed, uniform-radius circles were analyzed. Optimal numbers of chords to assess based on MLI were found via receiver-operator-characteristic (ROC)-area under the curve (AUC) analysis. Intraclass correlation coefficient (ICC) measured reliability.

Results

We demonstrate high accuracy (AUCROC > 0.8 for MLIactual > 63.83 pixels) and excellent reliability (ICC = 0.9998, p < 0.0001). We provide a guide to optimize the number of chords to sample based on MLI. Processing time was 0.03 s/image. We showed elevated MLI in PM-exposed mice compared to PBS-exposed controls. We have also provided the macros that were used and have made an ImageJ plugin available free for academic research use at https://med.nyu.edu/nolanlab.

Conclusions

Our semi-automated method is reliable, equally fast as fully automated methods, and uses free, open-source software. Additionally, we quantified the optimal number of chords that should be measured per lung field.
Novel implant-free loop Tenodesis vs. simple Tenotomy of the long biceps tendon - a biomechanical investigation
Authors: Kerschbaum Maximilian , Voss Andreas , Pfeifer Christian , Weiss Isabella , Mayr Agnes , Alt Volker , Greiner Stefan , Grechenig Stephan
Published: November 2019

Background

Simple tenotomy and anchor tenodesis are commonly used in treatment of long biceps tendon (LHB) pathologies. The tenotomy can result in biceps distalization or cosmetic deformities. A novel loop Tenodesis Technique (LTD) could prevent a distalization of the biceps muscle without the risk of implant associated complications. The purpose of this study was to investigate the biomechanical aspects of the novel LTD compared to a standard tenotomy of the LHB. It has been hypothesized that the novel technique will show biomechanical superiority in terms of resistance and distalization.

Methods

Seven paired adult human cadaveric shoulder joints were assigned to one of the two study groups: Loop tenodesis (LTD); simple tenotomy (STT). In both groups load-to-failure testing was performed. The load-displacement curve was used to determine the maximum load (N), the degree of distalization of the LHB (mm) and the stiffness (N/mm). Additionally, the mode of failure was registered.

Results

The LTD group achieved a significantly higher ultimate load to failure (LTD: 50.5 ± 12.5 N vs. STT: 6.6 ± 3.9 N; p = 0.001). Significantly less distalization of the tendon could be detected for the LTD group (LTD: 8 ± 2.3 mm vs. STT: 22.4 ± 2.4 mm; p = 0.001). Stiffness was 7.4 ± 3.9 N/mm for the LTD group and 0.23 ± 0.16 N/mm for the STT group (p = 0.001). In all specimens of the LTD group a tendon rupture was found as mode of failure, while the STT group failed because of pulling out the LHB through the bicipital groove.

Conclusion

The novel loop Tenodesis Technique shows biomechanically higher stability as well as less distalization compared to a simple tenotomy of the long biceps tendon.
Duodenal descending part-jejunum intussusception and upper gastrointestinal bleeding caused by duodenal fibrolipoma: a case report
Authors: Zhao Bangbo , Zhou Xingtong , Wang Weibin
Published: November 2019

Background

Duodenal fibrolipoma and duodenum-jejunum intussusception are both rare occasions in clinical practice. The diagnosis of duodenal fibrolipoma mainly depends on endoscopy examination, supplemented by CT and MRI. As the tumor grows, some severe symptoms need surgical intervention. As the development of endoscopic techniques, the operation plan should be made individually.

Case presentation

A 47-year-old female with the complaint of upper abdominal pain and melena was reported. Abdominal examination revealed upper abdomen lightly tender and blood test showed severe anemia. Image and endoscopy examination exhibited “a giant mass” in the descending (D2) part of duodenum, dragged by the tumor into the distal intestinal canal and causing intussusception. Intermittent blood transfusion treatment, enteral and parenteral nutrition were adopted to adjust her general state. Two weeks later, the mass was resected together with the basement intestinal wall via the jejunum incision and then the intussuscepted D2 part was restored. The paraffin pathological diagnosis correlated with the preoperative judgment of fibrolipoma and the patient was discharged healthy on POD 14.

Conclusions

Duodenal fibrolipoma is a rare disease, infrequently causing intussusception and severe upper GIB. Duodenoscopy and endoscopic ultrasound contribute to making an appropriate diagnosis, and for patients with severe symptoms needed surgical intervention, operation plan should be individualized depending on the size and location of the lesion.
Adjuvant chemotherapy after surgery for pancreatic ductal adenocarcinoma: retrospective real-life data
Authors: Chikhladze Sophia , Lederer Ann-Kathrin , Kousoulas Lampros , Reinmuth Marilena , Sick Olivia , Fichtner-Feigl Stefan , Wittel Uwe A.
Published: November 2019

Background

The recommendation for postoperative chemotherapy in pancreatic ductal adenocarcinoma (PDAC) is based on prospective randomized trials. However, patients included in clinical trials do not often reflect the overall patient population treated in clinical practice.

Materials and methods

A retrospective review of all patients undergoing pancreas resection for PDAC between 2001 and 2013 was performed. Follow-up data from oncologists, general practitioners, or hospital patient files were available for 92% of patients.

Results

A total of 251 patients were included in our analysis. Chemotherapy was recommended for 223 patients, but 86 patients did not follow the recommendation. The application of the recommended chemotherapy, consisting of 6 cycles of gemcitabine, was only applied to 45 patients. Forty patients received the recommended number of cycles with dose reduction or prolonged intervals between cycles, and adjuvant chemotherapy was terminated prior to the intended completion of all 6 cycles in 54 patients. Survival of patients after adjuvant chemotherapy was increased compared to that of patients without chemotherapy (with recurrence 25.6 vs. 14.3 months, p = 0.001, and without recurrence 27.4 vs. 14.3 months, p <  0.001). Terminating chemotherapy prior to completion (p = 0.009) as well as a lower number of chemotherapy cycles (p = 0.026) was associated with a decreased survival.

Conclusion

Adjuvant chemotherapy improves overall and disease-free survival after curative pancreatic resection, but only a small fraction of patients completes the recommended 6 cycles of adjuvant chemotherapy. Our data indicates that performance status of patients after pancreas resections for PDAC requires not only highly biologically active but also well-tolerated adjuvant chemotherapy regimens.
Oxidized low density lipoprotein receptor 1 promotes lung metastases of osteosarcomas through regulating the epithelial-mesenchymal transition
Authors: Jiang Long , Jiang Shanshan , Zhou Wenjie , Huang Jia , Lin Yongbin , Long Hao , Luo Qingquan
Published: November 2019

Background

Oxidized low density lipoprotein receptor 1 (OLR1), a type II membrane protein, has been identified as receptor for oxidized low-density lipoprotein. The current study firstly provided evidence that OLR1 regulated EMT and thus promoted lung metastases in osteosarcoma (OS).

Method

All relevant experiments were conducted according to the manufacturer’s protocols. In vivo tumor xenograft experiments were carried out in 6- to 16-week-old mice, then maintained in our animal facility under pathogen-free conditions in accordance with the Institutional Guidelines and approval by local authorities. For the use of the clinical materials for research purposes, prior patient’s consent and approval from the Institute Research Ethics Committee were obtained. All statistical analyses were performed using IBM SPSS Statistics 22.0 for Windows.

Result

Microarrays were adopted to explore the underlying epigenetic mechanisms related to metastasis. 11 genes were identified among total 26,890 differentially expressed genes. After validated in paired primary and metastatic tissues, OLR1 was selected in the current study. The expression levels of OLR1 were tested in 4 widely used cell lines. Cell proliferation, migration and invasion could be enhanced when OLR1 was overexpressed. OLR1 overexpression also triggered G1 to S + G2 phases of cell cycle. Accordingly, cell proliferations, migration and invasion would be reduced when OLR1 was silenced. OLR1-silencing blocked G1 to S + G2 phases of cell cycle. Also, OLR1 silencing effectively suppressed local tumor carcinogenesis and lung metastases in vivo. Moreover, silencing OLR1 repressed the expression of mesenchymal markers (Snail, Twist, and N-cadherin), but induced an epithelial marker (E-cadherin).

Conclusion

This study indicated a novel molecular mechanism involving the role of OLR1 in lung metastases of osteosarcoma, strengthened the correlation between OLR1 and lung metastases.
Autologous adipose-derived stromal cell treatment for patients with refractory angina (MyStromalCell Trial): 3-years follow-up results
Authors: Qayyum Abbas Ali , Mathiasen Anders Bruun , Helqvist Steffen , Jørgensen Erik , Haack-Sørensen Mandana , Ekblond Annette , Kastrup Jens
Published: November 2019

Background

Stem cell therapy is investigated as a treatment option for patients with ischemic heart disease. In this study, long-term safety and efficacy of autologous intra-myocardial injections of adipose-derived stromal cells (ASCs) was studied in patients with refractory angina.

Methods

Sixty patients with coronary artery stenosis and preserved left ventricular ejection fraction were 2:1 randomised to intramyocardial injections of ASCs or saline and followed for 3 years.

Results

For patients in the ASC group, the bicycle exercise time and the exercise performance in watt were un-changed (383 ± 30 s to 370 ± 44 s, P = 0.052 and 81 ± 6 to 78 ± 10, P = 0.123, respectively), but the performance in METs was reduced significantly (4.2 ± 0.3 to 4.0 ± 0.4, P = 0.027) during the follow-up period. However, in the same period, there was in the placebo group a significant decline in bicycle exercise time (437 ± 53 s to 383 ± 58 s, P = 0.001), the exercise performance measured in watt (87 ± 12 W to 80 ± 12 W, P = 0.019) and in METs (4.5 ± 0.4 to 4.1 ± 0.4, P = 0.002). Moreover, angina measured as CCS class was significantly reduced in the ASC group but not in the placebo group (2.5 ± 0.9 to 1.8 ± 1.2, P = 0.002 and 2.5 ± 0.8 to 2.1 ± 1.3, P = 0.186, respectively). However, no significant change was observed between the two groups.

Conclusions

Patients receiving ASCs had improved cardiac symptoms and unchanged exercise capacity, in opposition to deterioration in the placebo group.

Trial registration ClinicalTrials.gov Identifier: NCT01449032. Registered 7 October 2011—Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT01449032?term=jens+kastrup&rank=7
Establishment and validation of a nomogram model for aseptic loosening after tumor prosthetic replacement around the knee: a retrospective analysis
Authors: Zhang Hao-ran , Wang Feng , Yang Xiong-gang , Xu Ming-you , Qiao Rui-qi , Li Ji-kai , Zhao Yun-long , Pang Cheng-gang , Yu Xiu-chun , Hu Yong-cheng
Published: November 2019

Background

Aseptic loosening has become the main cause of prosthetic failure in medium- to long-term follow-up. The objective of this study was to establish and validate a nomogram model for aseptic loosening after tumor prosthetic replacement around knee.

Methods

We collected data on patients who underwent tumor prosthetic replacements. The following risk factors were analyzed: tumor site, stem length, resection length, prosthetic motion mode, sex, age, extra-cortical grafting, custom or modular, stem diameter, stem material, tumor type, activity intensity, and BMI. We used univariate and multivariate Cox regression for analysis. Finally, the significant risk factors were used to establish the nomogram model.

Results

The stem length, resection length, tumor site, and prosthetic motion mode showed a tendency to be related to aseptic loosening, according to the univariate analysis. Multivariate analysis showed that the tumor site, stem length, and prosthetic motion mode were independent risk factors. The internal validation indicated that the nomogram model had acceptable predictive accuracy.

Conclusions

A nomogram model was developed for predicting the prosthetic survival rate without aseptic loosening. Patients with distal femoral tumors and those who are applied with fixed hinge and short-stem prostheses are more likely to be exposed to aseptic loosening.