bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptoms and Experience of Depression Among Chinese Communities in the West: A Scoping Review
Authors: Ahmad Farah , Maule Catherine , Wang Jamie , Fung Wai Lun Alan
Published: November 2018

Despite the increasing presence of Chinese communities in the West, their experiences of depression and the variations in symptoms or presentation are not well understood. Using Arksey and O’Malley’s methodical framework, we conducted a scoping review of the published literature, using electronic databases MEDLINE and PsycINFO, and searched for articles published since 1999. Out of 1177 articles identified, 21 met the inclusion criteria. Thematic synthesis revealed valuable scholarly work on (1) depression rates, migration, and contextual determinants, (2) causation beliefs and help seeking, (3) acculturation and symptoms, (4) presenting symptoms and somatization, and (5) culturally sensitive assessment and care. Overall, this review has identified the importance of contextual determinants in the development of depression, low rates of seeking of professional help, subtle variations in somatization, and knowledge gaps in culturally sensitive care. The findings suggest that, rather than treating migration as a cause of mental distress, the accompanying conditions and events need to be further examined and addressed as potential risk or protective factors. Subtle variations in somatization are also evident, and future scholarly work should examine the notion of cultural scripts—namely, that people attend and react to particular experiences in culturally based ways. For this reason (among others), practice models need to develop strategies for culturally sensitive care, such as co-construction of illness narratives and finding common ground. Given the stigma of mental illness and the low level of seeking professional help, the role of primary care should be expanded. Further studies investigating mental health issues beyond depression are also warranted in the studied community.
A Potential Role for the Noncoding Transcriptome in Psychiatric Disorders
Authors: Klengel Torsten
Published: November 2018

Understanding the complexity and regular function of the human brain is an unresolved challenge that hampers the identification of disease-contributing components and mechanisms of psychiatric disorders. It is accepted that the majority of psychiatric disorders result from a complex interaction of environmental and heritable factors, and efforts to determine, for example, genetic variants contributing to the pathophysiology of these diseases are becoming increasingly successful. We also continue to discover new molecules with unknown functions that might play a role in brain physiology. One such class of polymeric molecules is noncoding RNAs; though discovered years ago, they have only recently started to receive careful attention. Furthermore, recent technological advances in the field of molecular genetics and high-throughput sequencing have facilitated the discovery of a broad spectrum of RNAs that show no obvious coding potential but may provide additional layers of complexity and regulation to the molecular mechanisms underlying psychiatric disorders. Their exquisite enrichment and expression profiles in the brain may point to important functions of these RNAs in health and disease. This review will therefore aim to provide insight into the expression of noncoding RNAs in the brain, their function, and potential role in psychiatric disorders.
Impact of a Leadership Thread on Doctor of Physical Therapist Education
Authors: Eigsti Heidi J. , Davis Alice M.
Published: November 2018

Background and Purpose.

Health care systems worldwide are investing considerable resources in leadership development programs.
1–4
Yet there is limited evidence as to the effectiveness of leadership training in graduate health care education. The purpose of this study was to investigate the impact of a leadership curricular thread on an entry-level doctor of physical therapist (DPT) program.

Design.

This study was a prospective repeated measure design.

Methods.

Participants were 210 students (women (60%), mean age = 25.33 years (3.71) from the graduating classes of 2015, 2016, and 2017. All participants took the online Leadership Practices Inventory Self
5
in their fourth semester and last semester of an 8-semester DPT program.

Results.

There was a significant improvement in all five of Kouzes and Posner's exemplary leadership practices over time; Model the Way (mean difference = 5.24 [6.80], P = .0001), Inspire a Shared Vision (mean difference = 7.15[8.82], P = .0001), Challenge the Process (mean difference = 6.86 [8.38], P = .0001), Enable Others to Act (mean difference = 3.83[5.36], P = .0001), and Encourage the Heart (mean difference = 3.83 [8.51], P = .0001).

Conclusions.

The findings support that a focused leadership thread integrated into a 3-year DPT program can have a positive impact on student leadership behaviors.
Anti-PD-1 pembrolizumab induced autoimmune diabetes in Chinese patient
Authors: Li Sicheng , Zhang Yi , Sun Zhichun , Hu Ji , Fang Chen
Published: November 2018

Rationale:

Programmed cell death-1 protein (PD-1) antibody is an immune-checkpoint inhibitor that triggers anti-tumor response by enhancing immune response. Although PD-1 antibody has been reported effective in some malignant tumor, it can also induce significant immune-related adverse events (irAEs) such as autoimmune diabetes.

Patient concerns:

A 67-year-old male patient with non-small cell lung cancer (NSCLS) presented with polydipsia, polyuria, weakness, and weight loss after use of anti-programmed cell death-1 antibody therapy. Hyperglycemia, high serum ketone, low bicarbonate and high anion gap were compatible with the criteria of diabetic ketoacidosis (DKA).

Diagnoses:

Autoimmune diabetes and diabetic ketoacidosis (DKA). The presence of low serum titers of c-peptide, high blood glucose together with diabetic ketoacidosis (DKA) that occurs shortly after the use of pembrolizumab strongly supported the diagnosis of anti-PD-1 induced autoimmune diabetes.

Interventions:

The patient stopped using pembrolizumab while continuous subcutaneous insulin infusion (CSII) was started at the same time. The insulin infusion was switched to multiple daily injection (MDI) after he was discharged from hospital.

Outcomes:

The patient is now a well-controlled insulin-dependent patient with palliative care of NSCLS.

Lessons:

Autoimmune diabetes induced by anti-programmed cell death-1 (PD-1)/programmed cell death 1 ligand 1 (PD-L1) therapy is a rare, but life threatening immune-related side effect. Physicians should closely monitor diabetes-related indexes of patients who have been undergoing the treatment of anti-PD-1/PD-L1 therapy.
New methods for specialized subjective and high-precision objective evaluation of constricted ears
Authors: Wang Di , Pan Bo , Lin Lin , Yang Qinghua , He Leren , Song Yupeng , Zhou Jiayu , Jiang Haiyue
Published: November 2018

The effects of therapy on constricted ears are evaluated subjectively and objectively. However, previous methods are not specific, comprehensive, precise, or effective in diagnosing and predicting surgical outcomes. This study aimed to present a personalized, subjective evaluation scale and new objective indices utilizing a digital method for the accurate evaluation of constricted ears.

Nine consecutive patients with constricted ears were selected. To perform subjective evaluations, the patients’ parents were contacted by telephone within 3 to 6 months after surgery and asked to answer questions using a scale. To perform objective evaluations, the constricted and normal ears of each patient were scanned using a 3-dimensional scanner before and 14 days after surgery. The vertical height of the auricle (VHA), transverse diameter of the auricle, minimum length of the helix (MLH), length of the inner auricle (LIA), and transverse diameter of the inner auricle were calculated using Mimics software. The Wilcoxon matched pairs signed-rank test was used for data analysis.

High satisfaction scores were reported. The folds of the ear and helix had the highest median scores, whereas the crus of the antihelix had the lowest. The difference in LIA and postoperative MLH was greater than that in VHA and preoperative MLH. The mean values of the 5 indices of the normal ear were greater than those of the indices of the preoperative constricted ear (P < .05).

The specialized subjective scale reported in this study allows comprehensive and personalized assessment of constricted ears. The new objective indices are more effective than existing methods and the digital measurement method is precise and reliable. These methods will allow the treatment of constricted ears to be better evaluated, leading to improvements in patient management and treatment selection.
Efficacy and safety of Xiaofeng powder (xiao feng san) in treating urticaria
Authors: Chen Guoming , Zhao Jinlong , Chen Tengyu , Zhang Zhaoping , Huang Chuyao , Xu Zhirui , Xu Hua
Published: November 2018

Background:

Urticaria is a common skin disease that has a high impact on a patient's daily life. Xiaofeng powder (XFP) is one of the most commonly used Chinese herbal formula in China for urticaria. However, due to the lack of systematic evaluations, its clinical efficacy remains controversial. This meta-analysis was performed to evaluate the effect and safety of XFP for urticaria.

Methods:

Seven databases, including Cochrane Central Register of Controlled Trials, PubMed, Embase, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (VIP), the Chinese Biomedical Literature Database (CBM), and the Wanfang Database. The period will be from their inception to September 2018. Randomized controlled trials of XFS used separately against conventional Western medicine therapy in patients with urticarial were included. After the methodologic quality was assessed and the valid data were extracted, RevMan 5.3 software was used for the final meta-analysis.

Results:

The results will provide evidence regarding the efficacy and safety of XFP in treating urticaria.

Conclusion:

The conclusion of our systematic review will provide evidence to judge whether XFP is an effective intervention for patient with urticaria. This systematic review will be disseminated in peer-reviewed publications. The results of the study will provide evidence concerning the efficacy and safety of Xiaofeng Powder (xiao feng san) in treating urticaria.

PROSPERO registration number:

PROSPERO CRD 42018087260.
Clinical efficacy and safety of traditional Chinese patent medicine for hyperthyroid heart disease: study protocol for a systematic review and meta-analysis
Authors: Wang Qing , Li Chun , Di Sha , Han Lin , Zhao Linhua , Tong Xiaolin
Published: November 2018

Background:

Hyperthyroid heart disease (HHD), one of the most common complications of hyperthyroidism, is a serious public health problem due to the direct toxic or indirect effects of excessive thyroid hormone on the heart, resulting in high mortality and increasing health care costs. Traditional Chinese patent medicines (TCPMs), developed by combining modernized pharmaceutical technologies with ancient TCM theories, have been widely used in the treatment of HHD. However, the safety and efficacy of TCPMs used in patients with HHD has been uncertain and there has been no standard clinical trial published to confirm this. Thus, we conduct a study to evaluate the safety and efficacy of TCPMs for HHD.

Methods:

The reference lists of randomized controlled trials and 8 electronic databases will be independently and systematically searched by 2 review authors in August 2018. Four English databases [EMBASE, PubMed, National Guideline Clearinghouse (NGC), and Cochrane Central Register of Controlled Trials (CENTRAL)] and 4 Chinese databases [Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure [CNKI], Wanfang Database, and VIP Database] will be included. The primary outcomes will be assessed according to the effective rate of treatment, electrocardiogram, and thyroid hormone levels. Data synthesis will be precisely computed using the RevManV5.3 software when a data-analysis is allowed. Methodological quality will be assessed according to Cochrane Handbook.

Results:

This study will provide a high-quality synthesis of current evidence of TCPMs for HHD from different aspects, including the clinical symptoms, thyroid hormone levels, and ECG changes.

Conclusion:

The conclusion of this systematic review will provide evidence to prove whether TCPMs are effective therapeutic intervention for patient with HHD.
Rhabdomyolysis during myelosuppression in a patient with central nervous system leukemia
Authors: Le Ying , Li Huiqun , Wan Chengyao , Long Yuan , Liu Zhenfang
Published: November 2018

Rationale

Rhabdomyolysis is a potentially life-threatening syndrome and is a rare complication in patients with acute leukemia.

Patient's concerns

A 20-year-old male was admitted to our hospital due to skin ecchymosis in his trunk and lower limbs for 10 days.

Diagnoses

Based on the precise diagnosis of leukemia, namely cell morphology, immunology, cytogenetics, and molecular biological typing (MICM), the patient was diagnosed with acute T-lymphocytic leukemia (T-ALL).

Interventions

The patient received hyper-Cyclophosphamide, Vincristine,Adriamycin, Dexamethasone (hyper-CVAD) regimen chemotherapy (methotrexate, pirarubicin, vincristine and dexamethasone alternating with methotrexate and cytarabine) for 3 courses of chemotherapy. After 3 months of treatment, the patient developed intermittent pain, blurred vision, and inarticulate speech. Therefore, the patient was considered as central nervous system leukemia (CNSL) and immediately received 2 courses of chemotherapy with hyper-CVAD-B combined with polyethylene glycol conjugated asparaginase (PEG-ASP).

Outcomes

On the seventh day after the completion of chemotherapy, the patient was diagnosed with rhabdomyolysis because he complained of perianal pain and hematuria, and his creatine kinase (CK) increased suddenly to 3136 U/L. Finally, the patient died despite all kinds of active rescue.

Lessons

Rhabdomyolysis may occur after chemotherapy of leukemia. When patients developed hematuria, muscle weakness, or even asymptomatic elevation of CK levels, physicians should pay attention to the occurrence of rhabdomyolysis and take active hydration treatment.
Clinical, cytogenetic, and molecular findings in a fetus with ultrasonic multiple malformations, 4q duplication, and 7q deletion
Authors: Yue Fagui , Jiang Yuting , Yu Yang , Yang Xiao , Zhang Hongguo , Liu Ruizhi , Wang Ruixue
Published: November 2018

Rationale:

Chromosome deletion/duplication has been reported to be associated with mental disability and dysmorphism according to the accumulated research evidence.

Patient concerns:

A 25-year-old woman underwent amniocentesis for cytogenetic and single-nucleotide polymorphism (SNP) array analysis at 18 weeks of gestation due to the increased Down syndrome risk of 1/13.

Diagnoses:

The fetal chromosomal analysis revealed a seemingly “normal” chromosomal karyotype, but the SNP array results showed a partial duplication of chromosome 4q34.1q35.2 and a deletion of chromosome 7q34q36.3fluorescence in situ hybridization (FISH) analysis showed that the couple had normal chromosome 4 and 7, whereas there was a partial signal fragment of chromosome 4 attached on the long arm of chromosome 7 for the fetus.

Interventions:

The couple finally chose to terminate the pregnancy based on the ultrasonic multiple malformations and the abnormal SNP array results.

Outcomes:

The duplicated/deleted segments of the fetus were de novo. Meanwhile, we consider SHH and XRCC2 as good candidate genes, which may, in part, explain the observed abnormalities for the fetus.

Lessons:

The combination of SNP array and FISH analysis can give a molecular chromosomal diagnosis, which will offer more clear cytogenetic diagnosis and genetic counseling.
Focal therapy versus robot-assisted partial nephrectomy in the management of clinical T1 renal masses
Authors: Yoon Young Eun , Lee Hyung Ho , Kim Ki Hong , Park Sung Yul , Moon Hong Sang , Lee Seung Ryeol , Hong Young Kwon , Park Dong Soo , Kim Dae Keun
Published: November 2018

Background:

Robot-assisted partial nephrectomy (RPN) and focal therapy (FT) have both been successfully employed in the management of small renal masses. However, despite this being the era of minimally invasive surgery, few comparative studies exist on RPN and FT. The aim of our study is to review perioperative, renal functional and oncologic outcomes of FT and RPN in cT1 renal masses.

Methods:

Literature published in Medline, EMBASE, and Cochrane Library databases up to April 22, 2018, was systematically searched. We included literature comparing outcomes of FT (radiofrequency ablation, cryoablation, microwave ablation, and irreversible electroporation) and RPN. Studies that reported only on laparoscopic partial nephrectomy or open partial nephrectomy, and review articles, editorials, letters, or cost analyses were excluded. In total, data from 1166 patients were included.

Results:

From 858 total articles, 7 nonrandomized, observational studies were included. Compared with RPN, FT was associated with a significantly lower decrease of estimated glomerular filtration rate (weighted mean difference [WMD] −8.06 mL/min/1.73 m2; confidence interval [CI] −15.85 to −0.26; P = .04), and lower estimated blood loss (WMD −49.61 mL; CI −60.78 to −38.45; P < .001). However, patients who underwent FT had a significantly increased risk of local recurrence (risk ratio [RR] 9.89; CI 4.24–23.04; P < .001) and distant metastasis (RR 6.42; CI 1.70–24.33; P = .006). However, operative times, lengths of stay, and complication rates were revealed to be similar between FT and RPN.

Conclusion:

RPN has a substantial advantage in preventing cancer recurrence. However, in the era of minimally invasive surgery, FT has advantages in renal function preservation and less bleeding. Long-term follow-up for survival rates and comparative analysis of microwave ablation and irreversible electroporation are needed to extend FT for patients with significant morbidities and for those who need sufficient renal function preservation with minimal bleeding.
Response of germline BRCA2-mutated advanced pancreatic acinar cell carcinoma to olaparib
Authors: Li Mao , Mou Yu , Hou Shengzhong , Cao Dan , Li Ang
Published: November 2018

Rationale:

Pancreatic acinar cell carcinoma (PACC) is a relatively rare malignancy of the exocrine pancreas. BRCA2, a cancer susceptibility gene, has been widely studied in breast and ovarian carcinomas as mutation carriers for this gene are at a high risk for cancer development. Olaparib, an oral poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor, has been approved for the treatment of ovarian cancer with any BRCA 1/2 mutations. Herein, we report the first case of a germline BRCA2-mutated unresectable advanced PACC patient who responded well to olaparib treatment.

Patient concerns:

A 59-year-old male with a family history of cancer presented with a persistent epigastric dull pain for 3 months.

Diagnosis:

The patient was diagnosed with advanced PACC based on computed tomography (CT) scan, laparotomy, and pathology.

Interventions:

Exploratory laparotomy, intratumoral brachytherapy by radioiodine-125 seeds, modified FOLFIRINOX chemotherapy, and targeted therapy with olaparib were administered.

Outcomes:

The patient responded well to olaparib until the occurrence of severe adverse drug reactions, he died as a result of multiple organ failure with an overall survival period of 12 months.

Lessons:

As a PARP inhibitor, olaparib has remarkable curative effect not only on breast and ovarian cancers, but also on other malignancies with BRCA mutations. Patients with advanced cancer could benefit from active targeted therapy with improvement in overall survival and quality of life.
TA pharmacopuncture as a primary and independent treatment for frequent sprains occurring over 9 months in a patient with needle sickness
Authors: Hwang Ji Hye , Jung Hyo Won
Published: November 2018

Rationale:

Sprains, stretching or tearing of ligaments are common injuries. Clinicians should try to prevent acupuncture-associated vasovagal responses (AAVR) when treating patients with such injuries. In this study, we report the treatment of frequent sprains of various body parts in a patient with a history of AAVR using only TA (a 7-herb extract consisting of Scutellaria baicalensis, Phellodendron amurense, Pulsatilla koreana, Sophora tonkinensis, Aucklandia lappa, Aquilaria agallocha, and Carthamus tinctorius L.) pharmacopuncture.

Patient concerns:

The patient was a 47-year-old woman who was injured 23 times in 9 months. The injuries occurred in the knees, thumb, wrist, ankle, and low back region due to overextension during physical activity or frequent exercise. This patient had great fear of acupuncture after fainting due to her experience with a previous fire needling on an ankle sprain 18 years ago. Therefore, she did not want to undergo conventional acupuncture, including needle retention.

Diagnoses:

With the exception of the bruising and sprain of a knee occurring over 1 week after onset at the initial visit, the injuries were diagnosed as acute sprains of grade 1 with pain without range of movement limitation in various parts of the knee, ankle, thumb, and lower back. Time to onset of these injuries was within 3 days.

Interventions:

The patients received only TA pharmacopuncture at 4 to 6 ouch points (ashi points). The patient returned to work immediately after the conclusion of treatment without any posttreatment such as infrared and hot pack which can help absorbing the extract and calming the injection site.

Outcome:

The treatment was usually completed within 4 sessions, and led to a reduction in pain (visual analog scale [VAS] score of 1). In the absence of mild swelling and warmth or when there was mild pain (VAS score <3) in the affected area, the patient reported reduced pain and smoother joint movement immediately after 1 to 2 sessions.

Lessons:

Although our report is a single case study, our results indicate that TA pharmacopuncture can be effective in treating various acute sprains and is a potential acupuncture method for the treatment of patients with AAVR.
Novel homozygous inactivating mutation of the calcium-sensing receptor gene in neonatal severe hyperparathyroidism responding to cinacalcet therapy
Authors: Sun Xiaomei , Huang Liang , Wu Jin , Tao Yuhong , Yang Fan
Published: November 2018

Rationale:

Calcium-sensing receptor (CaSR) mutations can cause life-threatening neonatal severe hyperparathyroidism (NSHPT). The medical management of NSHPT is often challenging and complex. Here, we present a case of NSHPT caused by a novel homozygous CaSR mutation.

Patient concerns:

A Chinese female infant presented with poor feeding, constipation, severe hypotonia, and periodic bradycardia. Biochemistry tests revealed markedly elevated serum levels of Ca2+ and parathyroid hormone (PTH).

Diagnoses:

Genetic sequencing revealed a previously undescribed CaSR mutation in exon 3 (c.242T>A; p.I81K). A diagnosis of NSHPT secondary to homozygously inherited familial hypocalciuric hypercalcemia syndrome was established.

Interventions:

Cinacalcet was administered after the common treatments (low-calcium intake, hydration, and furosemide), calcitonin, and pamidronate therapy all failed.

Outcomes:

Serum Ca2+ decreased and stabilized with cinacalcet therapy. During a 10-month follow-up, total calcium was maintained within the high-normal range and PTH was normalized.

Lessons:

A trial of cinacalcet therapy might be undertaken in cases of NSHPT while definitive results of the genetic analysis are awaited.
Lack of antiretroviral therapy is associated with higher risk of neurosyphilis among HIV-infected patients who remain serofast after therapy for early syphilis
Authors: Pastuszczak Maciej , Sitko Marek , Bociaga-Jasik Monika , Kucharz Jakub , Wojas-Pelc Anna
Published: November 2018

Resolution of clinical symptoms and at least 4-fold decline in nontreponemal antibody titers after treatment of syphilis is regarded as “proof of cure.” However, a substantial proportion of patients demonstrates <4-fold reduction of titers after recommended therapy (serofast state). It remains unclear whether the serofast state is indicative of persistence of bacteria or only a residual immune response.

The aim of the present study was to determine the association between the serofast state and the risk of neurosyphilis in human immunodeficiency virus (HIV)-infected individuals and to identify potential predictors of neurosyphilis.

Thirty-three patients with early syphilis and HIV co-infection were included. One year after the recommended treatment of syphilis, all patients who did not achieve proper serologic response underwent lumbar puncture and cerebrospinal fluid (CSF) examination.

Twelve months after completing therapy for syphilis, the proportion of patients with serofast state after syphilis therapy was 36.4% (n = 12). Among them, 5 (41.7%) had neurosyphilis. Individuals who remained serofast and had neurosyphilis (n = 5) when compared to those without neurosyphilis (n = 7) were characterized by significantly lower CD4+ cell count and higher HIV RNA levels (P < .05). Moreover, a significantly higher proportion of patients with neurosyphilis was not receiving antiretroviral therapy (ART). The nonreceipt of ART independently increased the risk of neurosyphilis in the analyzed group of serofast HIV-infected patients (odds ratio = 4.5; 95% confidence interval 1.5–13.59, P = .003).

Patients co-infected with HIV require careful serologic and clinical follow-up after therapy for syphilis. In all of the patients who do not respond serologically after treatment for syphilis, especially in those who are not receiving ART, lumbar puncture and CSF examination should be considered.
Human papillomavirus prevalence and behavioral risk factors among HIV-infected and HIV-uninfected men who have sex with men in Taiwan
Authors: Lin Chia-Chun , Hsieh Ming-Chang , Hung Hung-Chang , Tsao Shih-Ming , Chen Shiuan-Chih , Yang Hao-Jan , Lee Yuan-Ti
Published: November 2018

Human papillomavirus (HPV) infection is associated with cancer and can be prevented through vaccination. Few studies from Taiwan have reported on HPV infection among human immunodeficiency virus (HIV)-infected subjects. The aim of this study was to examine the prevalence of HPV infection among men who have sex with men (MSM) with and without HIV infection in Taiwan, and explore the behavioral risk factors thereof.

We conducted a cross-sectional study in Taiwan during 2013 to 2016 to collect data on MSM aged 20 years or older. We used a questionnaire in a face-to-face interview, and subsequently collected oral, anal, and genital specimens from HIV-infected and HIV-uninfected subjects. Multivariate analysis was performed to predict factors associated with high-risk HPV (HR-HPV) positivity.

Overall, 279 subjects, including 166 (59.5%) HIV-uninfected and 113 (40.5%) HIV-infected men were enrolled. Compared to HPV-negative subjects, HPV-positive subjects had significantly higher rates of receptive anal sex (91.3% vs 75.6%), substance use (22.6% vs 11%), history of sexually transmitted infections (75.7% vs 38.4%), anogenital or oral warts (39.1% vs 6.72%), syphilis (32.2% vs 11.6%), and HIV infection (69.6% vs 20.1%). We detected 489 HPV deoxyribonucleic acid (DNA) types (through 379 viable specimens), of which 43.6%, 5.7%, 56.4%, and 10.4% were HR-HPV type, HPV type 16, low-risk HPV types, and HPV type 6, respectively. In multivariate analysis, HIV-infected subjects had a significantly higher prevalence of HR-HPV infection (adjusted odds ratio, 5.80; 95% confidence interval, 2.57–13.11), compared to HIV-uninfected subjects.

These results suggest that the prevalence of HPV infection was high among HIV-infected MSM. Additionally, anal HPV infection was observed to be common among both HIV-infected and HIV-uninfected MSM in Taiwan. The prevalence of oral and genital HPV infection, HR-HPV DNA types, and multiple HPV types was higher in HIV-infected subjects than in HIV-uninfected subjects. As only 35% of subjects practiced safe sex, we recommend routine HPV vaccination with 4-valent HPV or 9-valent HPV vaccines for both MSM, and HIV-infected subjects.
Analysis of cervical human papillomavirus infection in 2300 women in Urumqi, China
Authors: Yao Lili , Yuan Min , Yuan Jianlin , Zhou Ping , Mei Lipa , Cheng Jingxin
Published: November 2018

This study is to investigate the cervical human papillomavirus (HPV) infection rate in women of Urumqi, China.

The epidemiological questionnaire survey was used to study 2300 women in Urumqi with a prospective research method. The second-generation hybrid capture assay, cervical liquid-based cytology test, colposcopy, and cervical biopsy were used to screen CC.

In 2300 cases, HPV was detected in 385 cases with infection rate of 16.74%. The infection rates of Uygur and Han women were 20.08% and 13.39%, respectively, with significant differences (P <.05). Among all age groups, the infection rate was highest in the age group of 20 to 25 years (with infection rate of 22.22%), followed by the age group of 45 to 49 years (with infection rate of 18.78%). In 8 districts, the highest positive rate was in Saybagh District with infection rate of 24.79%, followed by Urumqi County with infection rate of 19.05%, and the lowest was in Toutunhe District with infection rate of 10.86%. There was no significant difference in HPV infection among all age groups or among 8 districts of Urumqi. HPV infection rates were 10.48%, 84.52%, 92.94%, 100% in chronic cervicitis, low grade and high-grade intraepithelial neoplasia and CC group, respectively. The difference was statistically significant (P <.05).

The HPV infection rate of Uygur is higher than that in Han ethnic in Urumqi. The infection rate of HPV increases with the severity of cervical lesions.
Differences in Perceptions of Incivility Among Disciplines in Higher Education
Authors: Wagner Becka , Holland Cindra , Mainous Rosalie , Matcham William , Li Gengxin , Luiken Jessica
Published: November 2018

Background

Incivility occurs in various forms in higher education and negatively affects teaching and learning outcomes. It has not been determined if incivility is more prevalent in one discipline than another.

Purpose

The purpose of this study was to compare faculty and student perceptions of incivility across disciplines at a large public university.

Methods

In this descriptive comparative study, a convenience sample of 156 faculty and 421 students completed the Incivility in Higher Education–Revised survey electronically.

Results

The total sample was 577. Nursing reported the highest level of perceived incivility, with all other disciplines also reporting some level of incivility. Faculty perceived more incivility than students.

Conclusions

With a national awareness of incivility in nursing education, this study shows that incivility also exists in other disciplines and is a starting point for addressing its impact on higher education.
Medical Disimpaction for Children With Organic Esophageal Foreign Body in the Era of Eosinophilic Esophagitis
Authors: Lee Wei Hao , Grover Zubin , Borland Meredith , Thacker Kunal
Published: November 2018

Objective

Esophageal foreign body impaction (EFBI) is a common presentation in pediatric emergency medicine. Interventions (medical or endoscopic) are often required because of the severity of symptoms and risk of complications. Use of medical disimpaction (MD) such as glucagon injections and effervescent agents (eg, carbonated beverages) has been well described in adults; however, there are limited data in the pediatric literature. Eosinophilic esophagitis (EoE) is a relatively “new” clinicopathological entity that may present with EFBI mostly due to food with histological findings of EoE. Our study aim was to determine the efficacy of MD for organic EFBI in the pediatric population especially in children with EoE.

Methods

A retrospective chart review was performed using the International Classification of Diseases codes and the emergency department database of patients presenting with EFBI from January 2010 to December 2014. Response to MD was defined as symptomatic relief of obstruction. Age, object ingested, medical agent used, EoE status, complications, and outcome were recorded.

Results

A total of 317 presentations of EFBI were identified during the study period, of which organic EFBI accounted for 101 impactions (31.9%). Medical disimpaction was attempted for 42 (41.6%) with organic EFBI, resulting in resolution of symptoms for 16 (38.1%). One child with EoE responded to MD compared with 15 without EoE (4.8% vs 71.4%, P < 0.0001).

Conclusions

Medical disimpaction was ineffective in children with EoE but may be of help with symptom resolution in approximately 70% of children without EoE.
The current status of clinical trials in emergency gastrointestinal surgery: A systematic analysis of contemporary clinical trials
Authors: Milton Amelia , Drake Thomas M. , Lee Matthew J.
Published: November 2018

BACKGROUND

Emergency gastrointestinal surgery (EGS) conditions represent a significant healthcare burden globally requiring emergency operations that are associated with mortality rates as high as 80%. EGS is currently focused on quality improvement and internal audits, which occurs at a national or local level. An appreciation of what EGS trials are being conducted is important to reduce research wastage and develop coordinated research strategies in surgery. The primary aim of this study was to identify and quantify recent and active trials in EGS. The secondary aim was to identify conditions of interest and which aspects of care were being modified.

METHODS

A systematic search of WHO, UK, US, Australian, and Canadian trials databases was undertaken using broad terms to identify studies addressing emergency abdominal surgery and specific high-risk diagnoses. Studies registered between 2013 and 2018 were eligible for inclusion. Data on study topic, design, and funding body were collected. Interventions were classified into “perioperative”, “procedural”, “postoperative”, “non-surgical”, and “other” categories.

RESULTS

Searches identified 5603 registered trials. After removal of duplicates, 4492 studies remained and 42 were eligible for inclusion. Almost 50% of trials were located in Europe and 17% (n = 7) in the United States. The most common condition addressed was acute appendicitis (n = 11), with the most common intervention being procedure based (n = 23). Hospital-based funding was the most common funder (n = 30).

CONCLUSION

There is large disparity in the number of surgical trials in emergency surgery, which are primarily focused on high-volume conditions. More research is needed into high-mortality conditions.

LEVEL OF EVIDENCE

Systematic review, level III.
A simple Dot Blot Assay for population scale screening of DNA methylation
Authors: Luviano Nelia , Diaz-Palma Sayuri , Cosseau Céline , Grunau Christoph
Published: November 2018

The study of epigenetic changes in natural and experimental populations has increased the need to find a cost-effective and high throughput method to analyze multiple samples to effectuate a population-wide screening to study epigenetic changes triggered by biotic or abiotic stress. One of the most studied epigenetic marks is global DNA methylation, its measurement is used as a first step to differentiate methylation between individuals. There is a wide range of methods designed to detect genome-wide 5 methyl-cytosine (5mC) that differ in sensitivity, price, level of expertise required, but as a general rule, require large amounts of DNA and are relatively expensive. This is a limit for the analysis of 5mC in a large number of individuals as a prerequisite to population-wide testing of methylation markers. In this work, we evaluated a method based on antibody recognition of 5mC to measure the DNA methylation level of individuals of the species Biomphalaria glabrata, the intermediate host of schistosomiases, a neglected tropical disease. We validated the method to complete a large screening in the genome of B. glabrata snails treated with a chemical inhibitor of DNA methylation; however, the method can be applied to any species containing 5mC. The dot blot assay is a suitable method to perform a large-scale screening of global DNA methylation to compare 5mC levels between individuals from different natural or experimental populations. The dot blot method compares favorably with methods with an equivalent sensitivity such as the Enzyme Linked Immunosorbent Assay (ELISA) kit since it requires a smaller amount of DNA (30 ng) is less expensive and allows many more samples to be analyzed.
The cell wall regulates dynamics and size of plasma-membrane nanodomains in Arabidopsis
Authors: McKenna JF , Rolfe DJ , Webb SED , Tolmie AF , Botchway SW , Martin-Fernandez ML , Hawes C , Runions J
Published: November 2018

Plant plasma-membrane (PM) proteins are involved in several vital processes, such as detection of pathogens, solute transport and cellular signalling. Recent models suggest that for these proteins to function effectively there needs to be structure within the PM allowing, for example, proteins in the same signalling cascade to be spatially organized. Here we demonstrate that several proteins with divergent functions are located in clusters of differing size in the membrane using sub-diffraction-limited Airyscan confocal microscopy. In addition, single particle tracking reveals that these proteins move at different rates within the membrane. We show that the actin and microtubule cytoskeletons appear to significantly regulate the mobility of one of these proteins (the pathogen receptor FLS2) and we further demonstrate that the cell wall is critical for the regulation of cluster size by affecting single particle dynamics of two proteins with key roles in morphogenesis (PIN3) and pathogen perception (FLS2). We propose a model in which the cell wall and cytoskeleton are pivotal for differentially regulating protein cluster size and dynamics thereby contributing to the formation and functionality of membrane nanodomains.

One sentence summary

Size and mobility of protein nanodomains in the plant plasma-membrane are regulated by interaction with the cell wall extracellular matrix.

Significance statement

The plant plasma membrane acts as the front line for cellular perception of the environment. As such, a large number of signalling and transport proteins which perceive or transport environmental signals, developmental cues and nutrients are located within it. Recently, a number of studies have revealed that proteins located within the plasma membrane do not simply freely diffuse within its plane. Rather, proteins are localized in nanometer sized structures called nanodomains. In addition to the plasma-membrane, plant cells also have an extracellular matrix, the cell wall. Here we have shown that the cell wall has a role in regulating the dynamics and size of plasma membrane nanodomains for proteins involved in morphogenesis (PIN3) and pathogen perception (FLS2).
Ectopic expression induces abnormal somatodendritic distribution of tau in the mouse brain
Authors: Kubo Atsuko , Ueda Shouyou , Yamane Ayaka , Wada-Kakuda Satoko , Matsuyama Makoto , Nomori Akane , Takashima Akihiko , Goto Motohito , Ito Mamoru , Tomiyama Takami , Mori Hiroshi , Ihara Yasuo , Misonou Hiroaki , Miyasaka Tomohiro
Published: November 2018

Tau is a microtubule-associated protein that is localized to the axon. In Alzheimer’s disease, the distribution of tau undergoes a remarkable alteration, leading to the formation of tau inclusions in the somatodendritic compartment. To investigate how this mis-localization occurs, we recently developed immunohistochemical techniques that can separately detect endogenous mouse and exogenous human tau with high sensitivity, which allows us to visualize not only the pathological but pre-aggregated tau in mouse brain tissues of both sex. In tau transgenic mouse brains, exogenous human tau was abundant in dendrites and somata even in the presymptomatic period, whereas the axonal localization of endogenous mouse tau was unaffected. In stark contrast, exogenous tau was properly localized to the axon in human tau knock-in mice. We tracked this difference to the temporal expression patterns of tau. Tau mRNA was continuously expressed in the transgenic mice, whereas endogenous tau and exogenous tau in the knock-in mice exhibited high expression levels during the neonatal period and strong suppression into the adulthood. These results indicated the uncontrolled expression of exogenous tau beyond the developmental period as a cause of mis-localization in the transgenic mice. Super-resolution microscopic and biochemical analyses also indicated that the interaction between microtubules and exogenous tau was indeed impaired in the tau transgenic mice. Thus, the ectopic expression of tau may be critical for its somatodendritic mis-localization, a key step of the tauopathy.

Significance Statement

Somatodendritic localization of tau may be an early step leading to the neuronal degeneration in tauopathies. However, the mechanisms of the normal axonal distribution of tau and the mis-localization of pathological tau remain obscure. Our immunohistochemical and biochemical analyses demonstrated that the endogenous mouse tau is transiently expressed in neonatal brains, that exogenous human tau expressed corresponding to such tau expression profile can distribute into the axon, and that the constitutive expression of tau into adulthood (ex. human tau in Tg mice) results in abnormal somatodendritic localization. Thus, the expression profile of tau is tightly associated with the localization of tau, and the ectopic expression of tau in matured neurons may be involved in the pathogenesis of tauopathy.
Limited differential expression of miRNAs and other small RNAs in LPS-stimulated human monocytes
Authors: Lu Daniel , Yamawaki Tracy , Zhou Hong , Chou Wen-Yu , Chhoa Mark , lamas Edwin , Escobar Sabine S. , Arnett Heather A. , Ge Huanying , Wang Songli , Li Chi-Ming
Published: November 2018

Monocytes are a distinct subset of myeloid cells with diverse functions in early inflammatory immune modulation. While previous studies have surveyed the role of microRNA regulation on different myeloid cell lines and primary cultures, the time-dependent kinetics of inflammatory stimulation on miRNA expression and the relationship between miRNA-to-target-RNA expression have not been comprehensively profiled in monocytes. In this study, we use next-generation sequencing and RT-PCR assays to analyze the non-coding small RNA transcriptome of unstimulated and lipopolysaccharide (LPS)-stimulated monocytes at 6 and 24 hours. We identified a miRNA signature consisting of five mature miRNAs (hsa-mir-146a,hsa-mir-155,hsa-mir-9,hsa-mir-147b, andhsa-mir-193a) upregulated by LPS-stimulated monocytes after 6 hours and found that most miRNAs were also upregulated after 24 hours of stimulation. Only one miRNA gene was down-regulated and no other small RNAs were found dysregulated in monocytes after LPS treatment. In addition, novel tRNA-derived fragments were also discovered in monocytes, although none showed significant changes upon LPS stimulation. Interrogation of validated miRNA targets by transcriptomic analysis revealed that the majority of differential mRNA expression was maintained in LPS-stimulated monocytes although few of miRNA targets seemed to obtain heterogeneous expression pattern along the treatment. Our findings reveal a potential role by which selective miRNA upregulation and stable expression of other small RNAs enable monocytes to develop finely tuned cellular responses during acute inflammation.
Human papillomavirus 16 E2 regulates keratinocyte gene expression relevant to cancer and the viral life cycle
Authors: Evans Michael R , James Claire D , Bristol Molly L , Nulton Tara J , Wang Xu , Kaur Namsimar , White Elizabeth A , Windle Brad , Morgan Iain M
Published: November 2018

Human papillomaviruses (HPV) are causative agents in ano-genital and oropharyngeal cancers. The virus must reprogram host gene expression to promote infection, and E6 and E7 contribute to this via targeting of cellular transcription factors including p53 and pRb, respectively. The HPV16 E2 protein regulates host gene expression in U2OS cells and in this study we extend these observations into TERT immortalized oral keratinocytes (NOKs) that are capable of supporting late stages of the HPV16 life cycle. We observed repression of innate immune genes by E2 that are also repressed by the intact HPV16 genome in NOKs. RNA-seq data identified 167 up and 395 downregulated genes by E2; there was a highly significant overlap of the E2 regulated genes with those regulated by the intact HPV16 genome in the same cell type. siRNA targeting of E2 reversed repression of E2 targeted genes. The ability of E2 to repress innate immune genes was confirmed in an ano-genital immortalized keratinocyte cell line, N/Tert-1. We present analysis of data from The Cancer Genome Atlas (TCGA) for HPV16 positive and negative head and neck cancers (HNC) suggesting that E2 plays a role in regulation of the host genome in cancers. Patients with HPV16 positive HNC with a loss of E2 expression exhibit a worse clinical outcome and we discuss how this could, at least partially, be related to the loss of E2 host gene regulation.

Importance

HPV16 positive tumors that retain expression of E2 have a better clinical outcome than those that have lost E2 expression. It has been suggested that this is due to a loss of E2 repression of E6 and E7 expression but this is not supported by data from tumors where there is not more E6 and E7 expression in the absence of E2. Here we report that E2 regulates host gene expression and place this regulation in context of the HPV16 life cycle and HPV16 positive head and neck cancers (the majority of which retain E2 expression). We propose that this E2 function may play an important part in the increased response of HPV16 positive cancers to radiation therapy. Therefore, host gene regulation by E2 may be important for promotion of the HPV16 life cycle, and also for the response of HPV16 positive tumors to radiation therapy.
Molecular basis of Cul3 ubiquitin ligase subversion by vaccinia virus protein A55
Authors: Gao Chen , Pallett Mitchell A. , Croll Tristan I. , Smith Geoffrey L. , Graham Stephen C.
Published: November 2018

BTB-Kelch proteins are substrate-specific adaptors for cullin-3 (Cul3) RING-box based E3 ubiquitin ligases, which mediate protein ubiquitylation leading to proteasomal degradation. Vaccinia virus encodes three BTB-Kelch proteins, namely A55, C2 and F3. Viruses lacking A55 or C2 demonstrate altered cytopathic effect in cultured cells and altered pathology in vivo. Previous studies show that the ectromelia virus orthologue of A55, EVM150, interacts with Cul3 in cells. We show that A55 binds directly to Cul3 via its N-terminal BTB-BACK domain, and together they form a 2:2 complex in solution. The crystal structure of the A55/Cul3 complex was solved to 2.8 Å resolution. The overall conformation and binding interfaces resemble those of the cellular BTB-BACK/Cul3 complex structures, despite low sequence similarity of A55 to cellular BTB-BACK proteins. Surprisingly, despite this structural similarity the affinity of Cul3 for A55 is significantly higher than for reported cellular BTB-BACK proteins. Detailed analysis of the binding interface suggests that I48 from A55 at the BTB/Cul3 interface is important for this high-affinity interaction and mutation at this site reduced the affinity by several orders of magnitude. I48 is conserved only in close orthologues of A55 from poxviruses, but not in C2, F3, or other poxvirus or cellular BTB-Kelch proteins. The high affinity interaction between A55 and Cul3 suggests that, in addition to directing the Cul3-RING E3 ligase complex to degrade cellular/viral target proteins that are normally unaffected, A55 may also sequester Cul3 from cellular adaptor proteins and thus protect substrates of these cellular adaptors from ubiquitination and degradation.