bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive radiotherapy in locally advanced esophageal cancer with atelectasis: a case report
Authors: Sakanaka Katsuyuki , Fujii Kota , Mizowaki Takashi
Published: January 2020

Background

To the best of our knowledge, no study has reported mediastinal shift accompanied with obstructive atelectasis due to bulky primary esophageal tumor components treated with adaptive radiotherapy and concurrent chemotherapy.

Case presentation

Here we report the case of a 65-year-old male patient diagnosed with locally advanced thoracic esophageal squamous cell cancer, clinical T4bN1M0, stage IVA. Bronchoscopy and computed tomography (CT) revealed an almost complete obstruction of the lumen of the left bronchus due to compression by bulky primary esophageal tumor components. On admission, the patient presented with dyspnea and decreased arterial oxygen saturation. Chest radiography and CT on admission revealed mediastinal shift with left atelectasis, as opposed to findings from the chest radiography performed 26 days before admission. Because of the patient’s overall good condition, we recommended definitive chemoradiotherapy instead of palliative bronchial stent placement. After obtaining the patient’s consent, chemoradiotherapy was initiated on the following day and it comprised three-dimensional conformal radiotherapy with 60 Gy in 30 fractions with concurrent administration of cisplatin and 5-fluorouracil. During chemoradiotherapy, tumor location was monitored with cone-beam CT and chest radiography. Chemoradiotherapy on day 8 revealed no evidence of the mediastinal shift. CT simulation was reperformed to adjust the radiotherapy fields to account for geometrical changes induced by the absence of the mediastinal shift. Subsequently, the mediastinal shift and bronchial obstruction did not recur during the course of chemoradiotherapy. The patient completed the planned radiotherapy with concurrent and adjuvant chemotherapy, and no non-hematological grade ≥ 3 adverse events were observed. Complete response was confirmed 7 months after initiating chemoradiotherapy. Currently, no disease recurrence, dysphagia, or respiratory symptoms have been reported at 13 months after initiating chemoradiotherapy.

Conclusions

In this study, a bulky primary esophageal tumor caused mediastinal shift due to ipsilateral bronchial obstruction. The close follow-up for monitoring resolution of the mediastinal shift during the course of chemoradiotherapy enabled adequate dose delivery to targets, thus reflecting the geometrical changes induced by the absence of the mediastinal shift. Adaptive radiotherapy technique was crucial for favorable patient outcomes in this challenging clinical situation.
Neutrophil priming as a risk factor for surgical site infection in patients with colon cancer treated by laparoscopic surgery
Authors: Toiyama Yuji , Okugawa Yoshinaga , Shimura Tadanobu , Ide Shozo , Yasuda Hiromi , Fujikawa Hiroyuki , Okita Yoshiki , Yokoe Takeshi , Hiro Junichiro , Ohi Masaki , Kusunoki Masato
Published: January 2020

Background

The purpose of this study is to identify perioperative marker predicting postoperative surgical site infection (SSI) including with anastomotic leakage (AL) in curative colon cancer patients, laparoscopically.

Methods

In total, 135 colon cancer patients (stage I–III) undergoing curative laparoscopic surgery between January 2004 and December 2013 were enrolled in this study. We collected data on clinicopathological factors, laboratory data on pre and postoperative day 3 (POD3) and tumor markers levels to assess the relation to surgical site infection (SSI) including with anastomotic leakage (AL).

Results

SSI and AL occurred in 16 cases (5.6%) and 4 cases (3%), respectively. SSI and AL were not association with clinicopathological factors. Within laboratory data and tumor markers preoperatively, high neutrophil counts were significantly associated with SSI (P < 0.05) and AL (P < 0.01), respectively. Area under curves (AUC) of SSI and AL were 0.656 and 0.854, respectively. In addition, high neutrophil counts on POD3 also were significantly associated with SSI (P < 0.01) and AL (P < 0.01), respectively. Area under curves (AUC) of SSI and AL were 0.747 and 0.832, respectively.

Conclusion

Neutrophil count on pre and POD3 are potentially valuable indicators of SSI including with AL in colon cancer patients undergoing curative surgery laparoscopically.
PCOS without hyperandrogenism is associated with higher plasma Trimethylamine N-oxide levels
Authors: Huang Jiayu , Liu Lin , Chen Chunyan , Gao Ying
Published: January 2020

Background

Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disorder, and its pathogenesis is still under debate. Trimethylamine-N-oxide (TMAO) is a small, organic compound generated by the gut microbiome with a hypothesized relation to insulin resistance (IR) and low-grade inflammation in PCOS. By comparing plasma TMAO levels in non-PCOS participants and PCOS patients without hyperandrogenism (HA), we aimed to determine whether plasma TMAO levels correlate with PCOS without HA and to analyze their relationship with low-grade inflammation and IR.

Methods

A total of 27 PCOS patients without HA and 23 non-PCOS participants were enrolled in this study and subdivided into “nonobese” and “obese” arms for each group. Levels of plasma TMAO were quantified, and basic clinical characteristics and plasma biomarkers of inflammation were assessed.

Results

First, plasma TMAO levels, insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were higher in PCOS patients without HA, especially in the obese subgroup. Second, the levels of the inflammatory factors interleukin (IL)-17A, IL-18 and interferon gamma (IFN-γ) were significantly increased in obese PCOS patients without HA. Third, plasma TMAO levels were associated with body mass index (BMI) in the normal-weight groups, and the obese groups had higher fasting plasma insulin (FINS) and HOMA-IR values. Finally, logistic regression showed that the plasma levels of TMAO and luteinizing hormone/follicle-stimulating hormone (LH/FSH) were independent predictors of PCOS and indicated an increased risk of PCOS.

Conclusions

Elevated plasma TMAO levels may be associated with the pathogenesis of PCOS without HA and correlated with increased systemic inflammation. Further studies are needed to determine the suitability of TMAO as a predictive biomarker and to identify possible therapies for PCOS.
Glycosylation deficiency of lipopolysaccharide-binding protein and corticosteroid-binding globulin associated with activity and response to treatment for rheumatoid arthritis
Authors: Ciregia Federica , Baiwir Dominique , Cobraiville Gaël , Dewael Thibaut , Mazzucchelli Gabriel , Badot Valérie , Di Romana Silvana , Sidiras Paschalis , Sokolova Tatiana , Durez Patrick , Malaise Michel G. , de Seny Dominique
Published: January 2020

Background

Serum protein glycosylation is an area of investigation in inflammatory arthritic disorders such as rheumatoid arthritis (RA). Indeed, some studies highlighted abnormalities of protein glycosylation in RA. Considering the numerous types of enzymes, monosaccharides and glycosidic linkages, glycosylation is one of the most complex post translational modifications. By this work, we started with a preliminary screening of glycoproteins in serum from RA patients and controls.

Methods

In order to isolate glycoproteins from serum, lectin wheat germ agglutinin was used and quantitative differences between patients and controls were investigated by LC–MS/MS. Consequently, we focused our attention on two glycoproteins found in this explorative phase: corticosteroid-binding globulin (CBG) and lipopolysaccharide-binding protein (LBP). The subsequent validation with immunoassays was widened to a larger number of early RA (ERA) patients (n = 90) and well-matched healthy controls (n = 90).

Results

We observed a significant reduction of CBG and LBP glycosylation in ERA patients compared with healthy controls. Further, after 12 months of treatment, glycosylated CBG and LBP levels increased both to values comparable to those of controls. In addition, these changes were correlated with clinical parameters.

Conclusions

This study enables to observe that glycosylation changes of CBG and LBP are related to RA disease activity and its response to treatment.
Three-year experience with immediate extubation in pediatric patients after congenital cardiac surgery
Authors: Tirotta Christopher F. , Alcos Stephen , Lagueruela Richard G. , Salyakina Daria , Wang Weize , Hughes Jessica , Irizarry Marysory , Burke Redmond P.
Published: January 2020

Background

In pediatric cardiac anesthesiology, there is increased focus on minimizing morbidity, ensuring optimal functional status, and using health care resources sparingly. One aspect of care that has potential to affect all of the above is postoperative mechanical ventilation. Historically, postoperative ventilation was considered a must for maintaining patient stability. Ironically, it is recognized that mechanical ventilation may increase risk of adverse outcomes in the postoperative period. Hence, many institutions have advocated for immediate extubation or early extubation after many congenital heart surgeries which was first reported decades ago.

Methods

637 consecutive patient charts were reviewed for pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. Patients were placed into three groups. Those that were extubated in the operating room (OR) at the conclusion of surgery (Immediate Extubation or IE), those that were extubated within six hours of admission to the ICU (Early Extubation or EE) and those that were extubated sometime after six hours (Delayed Extubation or DE). Multiple variables were then recorded to see which factors correlated with successful Immediate or Early Extubation.

Results

Overall, 338 patients (53.1%) had IE), 273 (42.8%) had DE while only 26 patients (4.1%) had EE. The median age was 1174 days for the IE patients, 39 days for the DE patients, whereas 194 days for EE patients (p < 0.001). Weight and length were also significantly different in at least one extubation group from the other two (p < 0.001). The median ICU LOS was 3 and 4 days for IE and EE patients respectively, whereas it was 9.5 days for DE patients (p < 0.001). DE group had a significant longer median anesthesia time and cardiopulmonary bypass time than the other two extubation groups (p > 63,826.88 < 0.001). Regional low flow perfusion, deep hypothermia, deep hypothermic circulatory arrest, redo sternotomy, use of other sedatives, furosemide, epinephrine, vasopressin, open chest, cardiopulmonary support, pulmonary edema, syndrome, as well as difficult intubation were significantly associated with delayed extubation (IE, EE or DE).

Conclusions

Immediate and early extubation was significantly associated with several factors, including patient age and size, duration of CPB, use of certain anesthetic drugs, and the amount of blood loss and blood replacement. IE can be successfully accomplished in a majority of pediatric patients undergoing surgery for congenital heart disease, including in a minority of infants.
Promoting tau secretion and propagation by hyperactive p300/CBP via autophagy-lysosomal pathway in tauopathy
Authors: Chen Xu , Li Yaqiao , Wang Chao , Tang Yinyan , Mok Sue-Ann , Tsai Richard M. , Rojas Julio C. , Karydas Anna , Miller Bruce L. , Boxer Adam L. , Gestwicki Jason E. , Arkin Michelle , Cuervo Ana Maria , Gan Li
Published: January 2020

Background

The trans-neuronal propagation of tau has been implicated in the progression of tau-mediated neurodegeneration. There is critical knowledge gap in understanding how tau is released and transmitted, and how that is dysregulated in diseases. Previously, we reported that lysine acetyltransferase p300/CBP acetylates tau and regulates its degradation and toxicity. However, whether p300/CBP is involved in regulation of tau secretion and propagation is unknown.

Method

We investigated the relationship between p300/CBP activity, the autophagy-lysosomal pathway (ALP) and tau secretion in mouse models of tauopathy and in cultured rodent and human neurons. Through a high-through-put compound screen, we identified a new p300 inhibitor that promotes autophagic flux and reduces tau secretion. Using fibril-induced tau spreading models in vitro and in vivo, we examined how p300/CBP regulates tau propagation.

Results

Increased p300/CBP activity was associated with aberrant accumulation of ALP markers in a tau transgenic mouse model. p300/CBP hyperactivation blocked autophagic flux and increased tau secretion in neurons. Conversely, inhibiting p300/CBP promoted autophagic flux, reduced tau secretion, and reduced tau propagation in fibril-induced tau spreading models in vitro and in vivo.

Conclusions

We report that p300/CBP, a lysine acetyltransferase aberrantly activated in tauopathies, causes impairment in ALP, leading to excess tau secretion. This effect, together with increased intracellular tau accumulation, contributes to enhanced spreading of tau. Our findings suggest that inhibition of p300/CBP as a novel approach to correct ALP dysfunction and block disease progression in tauopathy.
RETRACTED ARTICLE: Metformin-repressed miR-381-YAP-snail axis activity disrupts NSCLC growth and metastasis
Authors: Jin Dan , Guo Jiwei , Wu Yan , Chen Weiwei , Du Jing , Yang Lijuan , Wang Xiaohong , Gong Kaikai , Dai Juanjuan , Miao Shuang , Li Xuelin , Su Guoming
Published: January 2020

Background

Recent evidence indicates that metformin inhibits mammalian cancer growth and metastasis through the regulation of microRNAs. Metformin regulates miR-381 stability, which plays a vital role in tumor progression. Moreover, increased YAP expression and activity induce non-small cell lung cancer (NSCLC) tumor growth and metastasis. However, the molecular mechanism underpinning how metformin-induced upregulation of miR-381 directly targets YAP or its interactions with the epithelial-mesenchymal transition (EMT) marker protein Snail in NSCLC is still unknown.

Methods

Levels of RNA and protein were analyzed using qPCR, western blotting and immunofluorescence staining. Cellular proliferation was detected using a CCK8 assay. Cell migration and invasion were analyzed using wound healing and transwell assays. Promoter activity and transcription were investigated using the luciferase reporter assay. Chromatin immunoprecipitation was used to detect the binding of YAP to the promoter of Snail. The interaction between miR-381 and the 3′UTR of YAP mRNA was analyzed using the MS2 expression system and co-immunoprecipitation with biotin.

Results

We observed that miR-381 expression is negatively correlated with YAP expression and plays an opposite role to YAP in the regulation of cellular proliferation, invasion, migration, and EMT of NSCLC cells. The miR-381 function as a tumor suppressor was significantly downregulated in lung cancer tissue specimens and cell lines, which decreased the expression of its direct target YAP. In addition, metformin decreased cell growth, migration, invasion, and EMT via up-regulation of miR-381. Moreover, YAP, which functions as a co-transcription factor, enhanced NSCLC progression and metastasis by upregulation of Snail. Snail knockdown downregulated the mesenchymal marker vimentin and upregulated the epithelial marker E-cadherin in lung cancer cells. Furthermore, miR-381, YAP, and Snail constitute the miR-381-YAP-Snail signal axis, which is repressed by metformin, and enhances cancer cell invasiveness by directly regulating EMT.

Conclusions

Metformin-induced repression of miR-381-YAP-Snail axis activity disrupts NSCLC growth and metastasis. Thus, we believe that the miR-381-YAP-Snail signal axis may be a suitable diagnostic marker and a potential therapeutic target for lung cancer.
Metta-based group meditation and individual cognitive behavioral therapy (MeCBT) for chronic depression: study protocol for a randomized controlled trial
Authors: Frick Artjom , Thinnes Isabel , Stangier Ulrich
Published: January 2020

Background

Depression is a widespread disorder with severe impacts for individuals and society, especially in its chronic form. Current treatment approaches for persistent depression have focused primarily on reducing negative affect and have paid little attention to promoting positive affect. Previous studies have shown that metta meditation increases positive affect in chronically depressed patients. Results from previous trials provide evidence for the efficacy of a stand-alone metta meditation group treatment in combination with mindfulness-based approaches. Further research is needed to better understand the implementation of meditation practice into everyday life. Therefore, mindfulness and metta meditation in a group setting are combined with individual cognitive behavioral therapy (CBT) into a new, low-intensity, cost-effective treatment (“MeCBT”) for chronic depression.

Methods/design

In this single-center, randomized, observer-blinded, parallel-group clinical trial we will test the efficacy of MeCBT in reducing depression compared to a wait-list control condition. Forty-eight participants in a balanced design will be allocated randomly to a treatment group or a wait-list control group. Metta-based group meditation will be offered in eight weekly sessions and one additional half-day retreat. Subsequent individual CBT will be conducted in eight fortnightly sessions. Outcome measures will be assessed at four time points: before intervention (T0); after group meditation (T1); after individual CBT (T2); and, in the treated group only, at 6-month follow-up (T3). Changes in depressive symptoms (clinician rating), assessed with the Quick Inventory of Depressive Symptoms (QIDS-C) are the primary outcome. We expect a significant decline of depressive symptoms at T2 compared to the wait-list control group. Secondary outcome measures include self-rated depression, mindfulness, benevolence, rumination, emotion regulation, social connectedness, social functioning, as well as behavioral and cognitive avoidance. We will explore changes at T1 and T2 in all these secondary outcome variables.

Discussion

To our knowledge this is the first study to combine a group program focusing on Metta meditation with state-of-the art individual CBT specifically tailored to chronic depression. Implications for further refinement and examination of the treatment program are discussed.

Trial registration

ISRCTN, ISRCTN97264476. Registered 29 March 2018 (applied on 14 December 2017)—retrospectively registered.
A call for consensus in defining efficacy in clinical trials for opioid addiction: combined results from a systematic review and qualitative study in patients receiving pharmacological assisted therapy for opioid use disorder
Authors: Dennis Brittany B. , Sanger Nitika , Bawor Monica , Naji Leen , Plater Carolyn , Worster Andrew , Woo Julia , Bhalerao Anuja , Baptist-Mohseni Natasha , Hillmer Alannah , Rice Danielle , Corace Kim , Hutton Brian , Tugwell Peter , Thabane Lehana , Samaan Zainab
Published: January 2020

Background

Given the complex nature of opioid addiction treatment and the rising number of available opioid substitution and antagonist therapies (OSAT), there is no ‘gold standard’ measure of treatment effectiveness, and each successive trial measures a different set of outcomes which reflect success in arbitrary or opportune terms. We sought to describe the variation in current outcomes employed across clinical trials for opioid addiction, as well as determine whether a discrepancy exists between the treatment targets that patients consider important and how treatment effectiveness is measured in the literature.

Methods

We searched nine commonly used databases (e.g., EMBASE, MEDLINE) from inception to August 1, 2015. Outcomes used across trials were extracted and categorized according to previously established domains. To evaluate patient-reported goals of treatment, semi-structured interviews were conducted with 18 adults undergoing methadone treatment.

Results

We identified 60 trials eligible for inclusion. Once outcomes were categorized into eight broad domains (e.g., abstinence/substance abuse), we identified 21 specific outcomes with furthermore 53 subdomains and 118 measurements. Continued opioid use and treatment retention were the most commonly reported measures (46%, n = 28). The majority of patients agreed that abstinence from opioids was a primary goal in their treatment, although they also stressed goals under-reported in clinical trials.

Conclusions

There is inconsistency in the measures used to evaluate the effectiveness of OSATs. Individual and population level decision making is being guided by a standard of effect considered useful to researchers yet in direct conflict with what patients deem important.

Trial registration

PROSPERO, CRD42013006507.
A comparative study of autistic and non-autistic women’s experience of motherhood
Authors: Pohl A. L. , Crockford S. K. , Blakemore M. , Allison C. , Baron-Cohen S.
Published: January 2020

Background

Autism is a lifelong neurodevelopmental difference and disability, yet there is limited research examining parenting in autistic mothers.

Objective

To explore autistic mothers’ experience of the perinatal period and parenthood. This includes pregnancy, childbirth, the postpartum period, self-perception of parenting strengths and weaknesses, communication with professionals in relation to one’s child, mental health difficulties and the social experience of motherhood. It also includes disclosing one’s diagnosis of autism in parenting contexts.

Methods

We used a community-based participatory research model, and recruited an advisory panel, with whom we co-developed an anonymous, online survey for autistic mothers. The online survey was completed by autistic and non-autistic mothers, and we compared their responses using Chi-squared analysis.

Sample

Autistic mothers (n = 355), and non-autistic mothers (n = 132), each of whom had at least one autistic child, were included in our final analysis.

Results

There were differences in education, gender identity and age of mother at birth of first child. Autistic mothers were more likely to have experienced additional psychiatric conditions, including pre- or post-partum depression, and reported greater difficulties in areas such as multi-tasking, coping with domestic responsibilities and creating social opportunities for their child. They were also more likely to report feeling misunderstood by professionals, and reported greater anxiety, higher rates of selective mutism, and not knowing which details were appropriate to share with professionals. They were also more likely to find motherhood an isolating experience, to worry about others judging their parenting, or feel unable to turn to others for support in parenting. However, despite these challenges, autistic mothers were able to act in the best interest of their child, putting their child’s needs first.

Conclusions

Autistic mothers face unique challenges and the stigma associated with autism may further exacerbate communication difficulties. Greater understanding and acceptance amongst individuals who interact with autistic mothers is needed, and autistic mothers would benefit from additional and better-tailored support.
Interactions of clinical relevance associated with concurrent administration of prescription drug and food or medicinal plants: a systematic review protocol
Authors: Orellana-Paucar Adriana , Vintimilla-Rojas Daniela
Published: January 2020

Background

An inadequate combination of prescription drugs with food or medicinal plants could cause adverse effects in patients or produce negative therapeutic results. Therefore, this generic systematic review protocol aims to identify and synthesize the literature on clinical characteristics and safety issues of these types of pharmacological interactions occurring in children, adolescents, adults, pregnant/lactating women, and older adults.

Methods/design

This generic protocol follows the stated guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. A literature search will be performed in PubMed, Scopus, and Virtual Health Library (VHL) electronic databases from 1960 till present for studies reporting clinical characteristics and safety issues associated with pharmacological interactions occurring between prescription drugs and food or medicinal plants in participants from birth-age to ≥ 65-year-old, including pregnant/lactating women. Lateral searching will be carried out in PubMed via related citation. Two reviewers will carry out an independent evaluation of eligible studies as well as the corresponding data extraction of the selected ones. Subsequently, the methodological quality evaluation of the selected articles will be completed using the corresponding Joanna Briggs Institute Checklists. Moreover, the quality of evidence will be graded according to the criteria of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group. Quantitative research in humans comprising clinical trials and clinical, comparative and, observational studies will be included. The main outcomes of this protocol involve reported potential food-drug and herb-drug interactions, associated safety issues, and adverse reactions along with the generic name of the prescribed drug and the scientific name of the food and medicinal plants involved in these types of pharmacological interactions. Finally, findings extracted from the selected studies will be summarized in a narrative synthesis.

Discussion

This generic systematic review protocol seeks to synthesize and critically evaluate current knowledge besides to identify any comprehension gaps in the concurrent administration of prescription drugs with food and herbs. By achieving a better understanding of this topic, this information will allow healthcare professionals to develop useful strategies to recognize, manage, and prevent these types of pharmacological interactions at different age stages, including pregnant/lactating women.

Systematic review registration

PROSPERO CRD42018117308
Determinants of biogas technology adoption in southern Ethiopia
Authors: Shallo Lemma , Ayele Mitiku , Sime Getachew
Published: January 2020

Background

Renewable energies such as biogas are considered as clean sources of energy that minimize environmental impacts and are sustainable with regard to current and future economic and social needs. Biogas offers an attractive option for replacing the unsustainable usage of traditional energy sources such as firewood, cow dung, and charcoal in developing countries. In Ethiopia, these energy sources have been in decline. To address these challenges, mainly in rural areas, biogas technology has been domesticated since 2009, as seen in the National Program. The purpose of this study is thus to examine factors that influence households' decisions of adopting biogas technology in rural areas in southern Ethiopia.

Methods

A sample of 268 households with 134 biogas adopters and 134 non-adopters were surveyed using simple random and purposive sampling techniques, respectively. The data were collected through individual interviews of households using a semistructured questionnaire. Descriptive statistics and a binary logistic regression model were used for the data analysis. The binary logistic regression model was applied to identify determinant factors affecting the adoption of biogas technology.

Results

The results of the study indicated that biogas adopter and non-adopter households had significant mean differences in education level, cattle size, household income, farmland size, number of planted trees as well as the distance to water sources, market places, and firewood sources. Level of education, level of income, access to credit, distance to firewood sources, and access to electronic media had a significantly positive influence on the adoption of biogas technology. Conversely, distance to water sources and access to electricity had a significantly negative influence on the adoption of biogas technology.

Conclusions

Biogas technology mostly appears in privileged households having a better socioeconomic status and other resource endowments. The beneficiaries are thus households that can afford the higher initial investment costs for bio-digester installation, maintenance services and purchasing bio-digester spare parts; as well as households that have access to credit facilities, water sources for adequate water supply, markets for purchasing spare parts and electronic media for information, and also households residing far away from firewood sources.
Bipolar depression: a major unsolved challenge
Authors: Baldessarini Ross J. , Vázquez Gustavo H. , Tondo Leonardo
Published: January 2020

Depression in bipolar disorder (BD) patients presents major clinical challenges. As the predominant psychopathology even in treated BD, depression is associated not only with excess morbidity, but also mortality from co-occurring general-medical disorders and high suicide risk. In BD, risks for medical disorders including diabetes or metabolic syndrome, and cardiovascular disorders, and associated mortality rates are several-times above those for the general population or with other psychiatric disorders. The SMR for suicide with BD reaches 20-times above general-population rates, and exceeds rates with other major psychiatric disorders. In BD, suicide is strongly associated with mixed (agitated-dysphoric) and depressive phases, time depressed, and hospitalization. Lithium may reduce suicide risk in BD; clozapine and ketamine require further testing. Treatment of bipolar depression is far less well investigated than unipolar depression, particularly for long-term prophylaxis. Short-term efficacy of antidepressants for bipolar depression remains controversial and they risk clinical worsening, especially in mixed states and with rapid-cycling. Evidence of efficacy of lithium and anticonvulsants for bipolar depression is very limited; lamotrigine has long-term benefit, but valproate and carbamazepine are inadequately tested and carry high teratogenic risks. Evidence is emerging of short-term efficacy of several modern antipsychotics (including cariprazine, lurasidone, olanzapine-fluoxetine, and quetiapine) for bipolar depression, including with mixed features, though they risk adverse metabolic and neurological effects.
Prevalence and severity of apical root resorption during orthodontic treatment with clear aligners and fixed appliances: a cone beam computed tomography study
Authors: Li Yuan , Deng Shiyong , Mei Li , Li Zhengzheng , Zhang Xinyun , Yang Chao , Li Yu
Published: January 2020

Background

Fixed appliances have been the mainstream for orthodontic treatment, while clear aligners, such as Invisalign system, have become increasingly popular. The prevalence of apical root resorption (ARR) in patients with clear aligners is still controversial. The aim of this study was to investigate and compare the prevalence and severity of ARR in patients treated with clear aligners and fixed appliances using cone beam computed tomography (CBCT).

Materials and methods

A total of 373 roots from 70 subjects, with similar baseline characteristics and the ABO discrepancy index scores (i.e., treatment difficulty), were included into two groups: the clear aligners group (Invisalign, Align Technology, California, USA) and fixed appliances group (Victory Series; 3 M Unitek, California, USA). Root length of each anterior tooth was measured on the CBCT images by two blinded investigators. The ARR on each tooth was calculated as the difference of root length before and after orthodontic treatment. Chi-square test and paired t test was used to compare the ARR between the two groups as well as before and after orthodontic treatments.

Results

Prevalence of ARR in the clear aligners group (56.30%) was significantly lower than that in the fixed appliances group (82.11%) (P < 0.001). The severity of ARR in the clear aligners group (0.13 ± 0.47 mm) was significantly less than that in the fixed appliances group (1.12 ± 1.34 mm) (P < 0.001). The most severe ARR was found on the maxillary canine (1.53 ± 1.92 mm) and lateral incisor (1.31 ± 1.33 mm) in the fixed appliances group; the least ARR was found on the mandibular canine (− 0.06 ± 0.47 mm) and lateral incisor (0.04 ± 0.48 mm) in the clear aligners group (P < 0.001).

Conclusions

The prevalence and severity of ARR measured on CBCT in patients with clear aligners were less than those in patients with fixed appliances.
Toward multi-label sentiment analysis: a transfer learning based approach
Authors: Tao Jie , Fang Xing
Published: January 2020

Sentiment analysis is recognized as one of the most important sub-areas in Natural Language Processing (NLP) research, where understanding implicit or explicit sentiments expressed in social media contents is valuable to customers, business owners, and other stakeholders. Researchers have recognized that the generic sentiments extracted from the textual contents are inadequate, thus, Aspect Based Sentiment Analysis (ABSA) was coined to capture aspect sentiments expressed toward specific review aspects. Existing ABSA methods not only treat the analytical problem as single-label classification that requires a fairly large amount of labelled data for model training purposes, but also underestimate the entity aspects that are independent of certain sentiments. In this study, we propose a transfer learning based approach tackling the aforementioned shortcomings of existing ABSA methods. Firstly, the proposed approach extends the ABSA methods with multi-label classification capabilities. Secondly, we propose an advanced sentiment analysis method, namely Aspect Enhanced Sentiment Analysis (AESA) to classify text into sentiment classes with consideration of the entity aspects. Thirdly, we extend two state-of-the-art transfer learning models as the analytical vehicles of multi-label ABSA and AESA tasks. We design an experiment that includes data from different domains to extensively evaluate the proposed approach. The empirical results undoubtedly exhibit that the proposed approach outperform all the baseline approaches.
Trends in alcohol and marijuana detected in homicide victims in 9 US states: 2004–2016
Authors: Nazarov Oybek , Li Guohua
Published: January 2020

Background

Use of alcohol and other drugs is a major risk factor for assaultive injuries and violent deaths. The purpose of this study was to examine the time trends in the prevalence of alcohol and marijuana detected in homicide victims.

Methods

We analyzed toxicological testing data for homicide victims (n = 12,638) from the 2004–2016 National Violent Death Reporting System in 9 US states (Colorado, Georgia, Massachusetts, New Jersey, Oregon, Rhode Island, South Carolina, Virginia, and Wisconsin). We used the Cochran-Armitage test for trend to assess the statistical significance of changes in the prevalence of alcohol and marijuana detected in these homicide victims during the study period.

Results

Overall, 37.5% of the homicide victims tested positive for alcohol, 31.0% positive for marijuana, and 11.4% positive for both substances. During the study period, the prevalence of marijuana increased from 22.3% (95% confidence interval [CI] = 19.6, 25.0) in 2004 to 42.1% (95% CI = 39.2, 44.9) in 2016 (Z = -15.7; P < .001) while the prevalence of alcohol declined slightly (Z = 1.5; P = 0.143). Marked increases in the prevalence of marijuana were observed in both sexes and across age and racial groups.

Conclusions

Marijuana is increasingly detected in homicide victims irrespective of demographic characteristics. Further research is needed to assess the causal role of marijuana use and concurrent use of marijuana and alcohol in homicide victimization.
Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report
Authors: Ueda Takeshi , Tanaka Tetsuya , Yokoyama Takashi , Sadamitsu Tomomi , Harada Suzuka , Yoshimura Atsushi
Published: January 2020

Background

Pneumoperitoneum commonly occurs as a result of a viscus perforation and usually presents with peritoneal signs requiring emergent laparotomy. Spontaneous pneumoperitoneum is a rare condition characterized by intraperitoneal gas with no clear etiology.

Case presentation

We herein report a case in which conservative treatment was achieved for an 83-year-old male patient with spontaneous pneumoperitoneum that probably occurred due to duodenal diverticulosis. He had stable vital signs and slight epigastric discomfort without any other signs of peritonitis. A chest radiograph and computed tomography showed that a large amount of free gas extended into the upper abdominal cavity. Esophagogastroduodenoscopy showed duodenal diverticulosis but no perforation of the upper gastrointestinal tract. He was diagnosed with spontaneous pneumoperitoneum, and conservative treatment was selected. His medical course was uneventful, and pneumoperitoneum disappeared after 6 months.

Conclusion

In the management of spontaneous pneumoperitoneum, recognition of this rare condition and an accurate diagnosis based on symptoms and clinical imaging might contribute to reducing the performance of unnecessary laparotomy. However, in uncertain cases with peritoneal signs, spontaneous pneumoperitoneum is difficult to differentiate from free air resulting from gastrointestinal perforation and emergency exploratory laparotomy should be considered for these patients.
RETRACTED ARTICLE: Multi-objective energy management in microgrids with hybrid energy sources and battery energy storage systems
Authors: Murty V. V. S. N. , Kumar Ashwani
Published: January 2020

Microgrid with hybrid renewable energy sources is a promising solution where the distribution network expansion is unfeasible or not economical. Integration of renewable energy sources provides energy security, substantial cost savings and reduction in greenhouse gas emissions, enabling nation to meet emission targets. Microgrid energy management is a challenging task for microgrid operator (MGO) for optimal energy utilization in microgrid with penetration of renewable energy sources, energy storage devices and demand response. In this paper, optimal energy dispatch strategy is established for grid connected and standalone microgrids integrated with photovoltaic (PV), wind turbine (WT), fuel cell (FC), micro turbine (MT), diesel generator (DG) and battery energy storage system (ESS). Techno-economic benefits are demonstrated for the hybrid power system. So far, microgrid energy management problem has been addressed with the aim of minimizing operating cost only. However, the issues of power losses and environment i.e., emission-related objectives need to be addressed for effective energy management of microgrid system. In this paper, microgrid energy management (MGEM) is formulated as mixed-integer linear programming and a new multi-objective solution is proposed for MGEM along with demand response program. Demand response is included in the optimization problem to demonstrate it’s impact on optimal energy dispatch and techno-commercial benefits. Fuzzy interface has been developed for optimal scheduling of ESS. Simulation results are obtained for the optimal capacity of PV, WT, DG, MT, FC, converter, BES, charging/discharging scheduling, state of charge of battery, power exchange with grid, annual net present cost, cost of energy, initial cost, operational cost, fuel cost and penalty of greenhouse gases emissions. The results show that CO2 emissions in standalone hybrid microgrid system is reduced by 51.60% compared to traditional system with grid only. Simulation results obtained with the proposed method is compared with various evolutionary algorithms to verify it’s effectiveness.
Assessment of plasminogen activator inhibitor-1 in obese Egyptian children
Authors: Mira Marwa Farouk , Anwar Ghada Mohammad , Sarry EL-Din Azza Mohamed , Megahed Safinaz Mohammed
Published: January 2020

Background

Plasminogen activator inhibitor-1 (PAI-1) is mainly produced in the liver and in the adipose tissue. Normal fibrin clearance mechanisms were found to be affected by high plasma PAI-1 levels and thus increases risk of thrombosis. The aim of the current study was to expound the childhood obesity effect on circulating PAI-1 and interpret the relation of PAI-1 to metabolic syndrome. This cross-sectional study was conducted on 43 obese children following in the Children Hospital and compared to 44 healthy sex- and age-matched controls. All recruited cohort are subjected to anthropometric measurements: weight, height, BMI, waist circumference, hip circumference, and skin fold thickness (biceps, triceps, and subscapular), and laboratory investigations in the form of lipid profile, fasting blood sugar, fasting insulin, insulin resistance estimated by HOMA-IR, and plasminogen activator inhibitor-1.

Results

The level of plasminogen activator inhibitor-1 in the obese group was significantly higher than that in the control group (47.98 ± 17.42 vs. 28.00 ± 11.35 respectively). PAI-1 showed positive significant correlation to anthropometric measurements: BMI (p = 0.000), weight (p = 0.000), biceps skin fold thickness (p = 0.04), triceps skin fold thickness (p = 0.4), and subscapular skin fold thickness (p = 0.04). Also, a significant positive correlation was found between PAI-1 and systolic (p = 0.000) and diastolic blood pressure (p = 0.04). Positive correlations were found between PAI-1 and cholesterol (p = 0.000), triglycerides (p = 0.02), LDL-c (p = 0.000), insulin (p = 0.000), and HOMA-IR (r = 0.5, p = 0.02).

Conclusion

Fat mass accumulation is related to high PAI-1 levels, which might in turn contribute to cardiovascular risk. Plasminogen Activator Inhibitor-1 is a good predictive test for metabolic syndrome in obese children.
What kind of in-patient psychiatry for Africa? Report from Zimbabwe
Authors: Summerfield Derek
Published: January 2020

The expanding global mental health field has paid little attention to evaluating the culture of psychiatry prevailing in in-patient settings across Africa. For example, in Zimbabwe in-patient psychiatry has been heavily pathologising, with over-reliance on the diagnosis of schizophrenia and on antipsychotic polypharmacy. It is not helpful that the next generation of African doctors are learning unmediated Western psychiatry, with little credence given to background cultural factors and mentalities shaping presentations. Some of the psychiatric and social consequences of this for patients in Zimbabwe are discussed.
Neural Determinants of Pulsatile Luteinizing Hormone Secretion in Male Mice
Authors: Han Su Young , Cheong Isaiah , McLennan Tim , Herbison Allan E
Published: January 2020

The gonadotrophin-releasing hormone (GnRH) pulse generator drives pulsatile luteinizing hormone (LH) secretion essential for fertility. However, the constraints within which the pulse generator operates to drive efficient LH pulsatility remain unclear. We used optogenetic activation of the arcuate nucleus kisspeptin neurons, recently identified as the GnRH pulse generator, to assess the efficiency of different pulse generator frequencies in driving pulsatile LH secretion in intact freely behaving male mice. Activating the pulse generator at 45-minute intervals generated LH pulses similar to those observed in intact male mice while 9-minute interval stimulation generated LH profiles indistinguishable from gonadectomized (GDX) male mice. However, more frequent activation of the pulse generator resulted in disordered LH secretion. Optogenetic experiments directly activating the distal projections of the GnRH neuron gave the exact same results, indicating the pituitary to be the locus of the high frequency decoding. To evaluate the state-dependent behavior of the pulse generator, the effects of high-frequency activation of the arcuate kisspeptin neurons were compared in GDX and intact mice. The same stimulus resulted in an overall inhibition of LH release in GDX mice but stimulation in intact males. These studies demonstrate that the GnRH pulse generator is the primary determinant of LH pulse profile and that a nonlinear relationship exists between pulse generator frequency and LH pulse frequency. This may underlie the ability of stimulatory inputs to the pulse generator to have opposite effects on LH secretion in intact and GDX animals.
CUBES: A practical toolkit to measure enablers and barriers to behavior for effective intervention design
Authors: Engl Elisabeth , Sgaier Sema K.
Published: January 2020

A pressing goal in global development and other sectors is often to understand what drives people’s behaviors, and how to influence them. Yet designing behavior change interventions is often an unsystematic process, hobbled by insufficient understanding of contextual and perceptual behavioral drivers and a narrow focus on limited research methods to assess them. We propose a toolkit (CUBES) of two solutions to help programs arrive at more effective interventions. First, we introduce a novel framework of behavior, which is a practical tool for programs to structure potential drivers and match corresponding interventions. This evidence-based framework was developed through extensive cross-sectoral literature research and refined through application in large-scale global development programs. Second, we propose a set of descriptive, experimental, and simulation approaches that can enhance and expand the methods commonly used in global development. Since not all methods are equally suited to capture the different types of drivers of behavior, we present a decision aid for method selection. We recommend that existing commonly used methods, such as observations and surveys, use CUBES as a scaffold and incorporate validated measures of specific types of drivers in order to comprehensively test all the potential components of a target behavior. We also recommend under-used methods from sectors such as market research, experimental psychology, and decision science, which programs can use to extend their toolkit and test the importance and impact of key enablers and barriers. The CUBES toolkit enables programs across sectors to streamline the process of conceptualizing, designing, and optimizing interventions, and ultimately to change behaviors and achieve targeted outcomes.
A Structural Model of Correlated Learning and Late-Mover Advantages: The Case of Statins
Authors: Ching Andrew T. , Lim Hyunwoo
Published: January 2020

We propose a structural model of correlated learning with indirect inference to explain late-mover advantages. Our model focuses on a class of products with the following two features: (i) products that build on a common fundamental technology (e.g., computer processor, car, smartphone, etc.) and (ii) that consumers can observe some product attributes of a product (e.g., CPU clock speed, horsepower of a car engine, screen size of a smartphone, etc.), but when making their purchase decisions, consumers are not sure how efficiently the product can translate its observed attributes to performing tasks that they care about. For products that base on a similar technology, it is plausible that consumers use the information signals of one product’s technological efficiency to help them update their belief about another product’s technological efficiency within the same product category. As a result, a late entrant could benefit from the information spillover generated by an early entrant. We apply our framework to the statin market in Canada, where drugs rely on a similar mechanism to reduce the cholesterol level. In our model, patients/doctors can observe a statin’s efficacy in reducing the cholesterol level, but they are uncertain about how effectively it can convert its cholesterol-reducing ability to reducing heart disease risks. Our estimation results show that the combination of correlated learning and informative and persuasive detailing explain the success of the two late entrants in the statin market: Lipitor and Crestor.

This paper was accepted by Matthew Shum, marketing.