bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncovering PD‐L1 and CD8+ TILS Expression and Clinical Implication in Cervical Squamous Cell Carcinoma
Authors: Chen Jingjing , Gu Ping , Wu Haibo
Published: August 2020

Objective. To investigate the association between programmed death‐ligand 1 (PD‐L1) coupled with CD8+ tumor‐infiltrating lymphocytes (TILS) and the clinicopathological features, along with prognosis of cervical squamous cell carcinoma (CSCC). Methods. 95 patients of CSCC received tumor resection at the Department of Pathology of the First Affiliated Hospital of University of Science and Technology of China (USTC) from 2015 to 2020. Full‐automatic immunohistochemistry was applied to measure PD‐L1 expression and CD8+ TILS density. Our literature deeply assessed the links between PD‐L1 expression, clinicopathological features, and the influences of combination of PD‐L1 and CD8+ TILS (PD‐L1+/CD8+ TILS) on the prognosis of CSCC. Results. 64.21% of CSCC patients (61/95) expressed PD‐L1, and PD‐L1 expression was related to the Federation of Gynecology and Obstetrics (FIGO) stage, tumor size, invasion depth, differentiation degree, metastasis of lymph node, and vascular invasion (P < 0.05). Dramatic correlation between PD‐L1 expression and CD8+ TILS density was illustrated in CSCC patients (r = −0.461, P < 0.001). Obvious differences in differentiation degree, FIGO stage, infiltration depth, and lymph node metastasis were shown between patients with PD‐L1 coupled with high‐density of CD8+ TILS and those with PD‐L1 coupled with low‐density of CD8+ TILS (P < 0.05). Patients with PD‐L1 negative expression exhibited better prognosis compared with those with PD‐L1 positive expression (P < 0.05). Patients with PD‐L1 coupled with high‐density of CD8+ TILS showed better prognostic status, while those with PD‐L1 coupled with low‐density of CD8+ TILS had worse prognostic condition (P < 0.05). Differentiation, metastasis of lymph node, and FIGO stage were substantive impact elements of a CSCC patient’s overall survival (OS) by Cox multivariate analysis. Conclusions. CD8+ TILS density is related to PD‐L1 expression in carcinoma. PD‐L1/CD8+ TILS density can be regarded as evaluation for the prognosis of patients with CSCC, providing a new therapeutic target in clinical application.
Triggering Mechanism of an Extreme Rainstorm Process near the Tianshan Mountains in Xinjiang, an Arid Region in China, Based on a Numerical Simulation
Authors: Zeng Yong , Yang Lianmei
Published: August 2020

The current study investigated the triggering mechanism of a record-breaking heavy rain process in the area near the Tianshan Mountains in Xinjiang, an arid region in China, from July 31 to August 1, 2016, based on the simulation using the Weather Research and Forecasting (WRF) model. The results illustrated that the rainstorm system was generated in the middle atmosphere of the western Aksu region near the Tianshan Mountains and gradually evolved into a multicell linear echo during system evolution. The cold air transported from the Tianshan Mountains partly reached the low altitudes during the downhill process, and the warm southwest air from Aksu was lifted, forming oblique updraft airflow. The other part of the cold air converged with the southeastern warm air in the middle atmosphere, and the transportation and convergence of the water vapor related to the southwestern, southeastern, and oblique updraft airflows provided good water vapor conditions for the storm system. Meanwhile, the inclined upward air transported cloud water and ice-phase particles to high altitudes, mixing the two and generating a large amount of supercooled cloud water, which was very beneficial for the development and maintenance of the storm system. These conditions were favorable for power, heat, water vapor, and water condensate particles, which enabled the development and maintenance of the rainstorm system on the convergence line, thus triggering this rare rainstorm process during the movement to the northeast.
The Properties of a Coal Body and Prediction of Compound Coal-Rock Dynamic Disasters
Authors: Dong Guowei , Liang Xuanming , Wang Zhen
Published: August 2020

Since the precise identification and prediction and early warning of compound coal-rock dynamic disaster remain difficult, a new coal characterisation and prediction method for compound coal-rock dynamic disasters was described based on theoretical analysis, laboratory experiment, field sampling, mathematical treatment, and industrial testing. The results implied that the physicomechanical properties of coal in a compound coal-rock dynamic disaster are between those pertinent to a typical rock burst and a coal-gas outburst, i.e., with high crustal stress surrounding pressure, high gas pressure, low permeability, bump proneness, and outburst risk. The predicted drilling data indicate moderate gas desorption indices. The gas desorption velocity and permeability of compound coal-rock dynamic disaster coal decrease with the increase in crustal stress, while increase and decrease with the increase in gas pressure, respectively, at the same time, and they change little with increasing temperature. Gas extraction leads to the increase in coal mass brittleness and bump proneness. Based on the unique physical-mechanical properties of compound coal-rock dynamic disaster coal, a reasonably sensitive predictive index and critical value for Donglin Coal Mine were determined.
Evaluation of the COVID-19 Pandemic Intervention Strategies with Hesitant F-AHP
Authors: Samanlioglu Funda , Kaya Burak Erkan
Published: August 2020

In this study, a hesitant fuzzy AHP method is presented to help decision makers (DMs), especially policymakers, governors, and physicians, evaluate the importance of intervention strategy alternatives applied by various countries for the COVID-19 pandemic. In this research, a hesitant fuzzy multicriteria decision making (MCDM) method, hesitant fuzzy Analytic Hierarchy Process (hesitant F-AHP), is implemented to make pairwise comparison of COVID-19 country-level intervention strategies applied by various countries and determine relative importance scores. An illustrative study is presented where fifteen intervention strategies applied by various countries in the world during the COVID-19 pandemic are evaluated by seven physicians (a professor of infectious diseases and clinical microbiology, an infectious disease physician, a clinical microbiology physician, two internal medicine physicians, an anesthesiology and reanimation physician, and a family physician) in Turkey who act as DMs in the process.
Page Kidney in a Child with Severe Pelviureteric Junction Obstruction
Authors: Kamaraj Senthil G. , Kochunny Ashita , Kathirvelu Gopinathan , Singh Praachi , Samnakay Naeem
Published: August 2020

There are various causes of Reno Vascular Hypertension in children reported in the literature. Amongst these, Page kidney gets a rare mention. This phenomenon is a result of the accumulation of blood or urine in the perinephric or subcapsular space, resulting in compression of renal parenchyma, microvascular ischemia, alteration in the renin-angiotensin apparatus, and high renin hypertension. It has been well documented and studied in adults. Only a few cases are reported in the paediatric population. We report a rare presentation of Page kidney in a 5 year 8 months old girl. She initially presented with Dietl’s crisis secondary to left Pelviureteric Junction obstruction (PUJO) causing massive hydronephrosis. She developed Page kidney phenomenon after spontaneous rupture of the pelvicalyceal system formed a tight compressive urinoma. She was managed successfully with internal JJ stenting and ultrasound-guided aspiration of the urinoma followed by elective delayed Pyeloplasty. To our knowledge, this is the first documented case of Page kidney in a child with severe PUJO.
Determination of Physicochemical Parameters and Levels of Heavy Metals in Food Waste Water with Environmental Effects
Authors: Ma Jingxi , Wu Shuqing , Shekhar N. V. Ravi , Biswas Supriya , Sahu Anoop Kumar
Published: August 2020

Bioinorganic chemistry is found as a sizzling field in today’s era. It deals with chemistry amongst the heavy metals with natural resources, i.e., air, soil, water, plant byproducts (foods), and environmental essences. The aim of this research is to determine the concentration of heavy metals present in the food waste water sample and to study the environmental effects of metal ion concentration. To conduct the research work, the physicochemical parameters and levels of five heavy metals of food waste water samples were collected from five sampling points of renowned hotels, restaurants, canteens, and confectionaries of a state of India and assessed using the standard analytical procedure. Sampling was carried out from January 2017 up to December 2017. The physicochemical parameters were determined such as pH, temperature, turbidity, conductivity, total dissolved solids, total suspended solids, total alkalinity, biological oxygen demand, chemical oxygen demand, dissolved oxygen, total organic carbon, sulphate, nitrate, and phosphate. The heavy metal concentration was determined by using the UV-spectrophotometer, and the results were compared with the standards prescribed by the WHO, BIS, ICMR, and municipal authorities. The results obtained in the physicochemical analysis revealed that a few parameters were found beyond limits, and the metal ion concentration (iron and zinc) results were found above the permissible limits set by the CPCB (Central Pollution Control Board), ICMR, BIS, and World Health Organization (WHO), most especially, effluent from point P1. It was concluded that all the effluents required further treatment before releasing them into the water body or land to prevent pollution. The obtained results reveal that waste water used for irrigation and farming of nearby areas and water drained from restaurant kitchens were considerably polluted and not suitable for aquatic organisms, irrigation, and agricultural purposes.
Minimizing Drying Shrinkage and Enhancing Impermeability of Foam Concrete Modified with Epoxy Resin
Authors: Gong Jianqing , Li Ke
Published: August 2020

Relatively high drying shrinkage and permeability were two of the major challenges associated with foam concrete (FC), primarily due to its high porosity nature. This study was aimed at reducing the drying shrinkage and improving the impermeability of FC by blending and modifying it with epoxy resin (EP). Extensive laboratory testing yielded an optimum content of 4.0% EP, corresponding to a minimum drying shrinkage rate of 1.47 mm/m, which was 48% lower than that of the unmodified FC. At this optimum dosage of 4.0% EP, the permeability pressure was at a maximum level of 1.4 MPa, whereas the permeability coefficient was at its lowest value of 0.75 × 10−9  mm/h. Internal pore structure and EP distribution were characterized using the scanning electron microscopy and indicated that a microgrid structure of the FC was formed internally, featuring an increase in the number of pores, a reduction in the average pore size, and a uniform pore size distribution. Similarly, surface energy measurements using the tensiometry method yielded maximum surface energy values at 4.0% EP content, which could be used to explain the reduced drying shrinkage and the enhanced impermeability characteristics of the modified FC.
The Impact of Modern Therapeutic Methods on the Oxidant-Antioxidant Equilibrium and Activities of Selected Lysosomal Enzymes and Serine Protease Inhibitor in Amateur Athletes
Authors: Sielski Łukasz , Sutkowy Paweł , Pawlak-Osińska Katarzyna , Woźniak Alina , Skopowska Agnieszka , Woźniak Bartosz , Czuczejko Jolanta
Published: August 2020

Deep electromagnetic stimulation (DEMS) and low-frequency ultrasound (US) are new physical therapy methods used in the rehabilitation of the musculoskeletal system and wound healing. They are applied locally to treat the injured tissues. The beneficial effects of these methods in supportive care have been documented, but accurate biochemical effects are not known. The goal was to assess the effect of single DEMS and US sessions on the oxidant-antioxidant equilibrium, as well as the activities of lysosomal hydrolases andα1-antitrypsin (AAT) in peripheral blood of juvenile injured amateur athletes. In the athletes with low back pain (DEMS treated,N=16) and pain in the shoulder or ankle joint (US treated,N=14), as well as in healthy control amateur athletes (DEMS treated,N=14; US treated,N=17), before the sessions and 30 minutes and 24 hours after them, the levels of the following parameters were determined: thiobarbituric acid reactive substances (TBARS) in erythrocytes and plasma, superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) in erythrocytes, as well as acid phosphatase (AcP), arylsulfatase (ASA), cathepsin D (CTS D), andα1-antitrypsin (AAT) in serum. After both procedures, the levels of parameters changed in a negligible manner, excluding the cathepsin D activity, which was statistically significantly lower 30 min and 24 h after US in the control athletes compared to the baseline activity determined directly before the procedure (47.5% and 55.7% differences, respectively). Similar tendency was observed after DEMS (p>0.05). The procedures, especially low-frequency US, decrease lysosomal proteolytic activity and do not significantly disrupt the oxidant-antioxidant and lysosomal equilibriums in the peripheral blood both of healthy and injured athletes. No systemic acute-phase response of AAT was also detected in the athletes after both procedures. This trial is registered withCTRI/2018/01/011344.
Using Latent Class Modeling to Jointly Characterize Economic Stress and Multipollutant Exposure
Authors: Larsen Alexandra , Kolpacoff Viktoria , McCormack Kara , Seewaldt Victoria , Hyslop Terry
Published: August 2020

Background:

Work is needed to better understand how joint exposure to environmental and economic factors influence cancer. We hypothesize that environmental exposures vary with socioeconomic status (SES) and urban/rural locations, and areas with minority populations coincide with high economic disadvantage and pollution.

Methods:

To model joint exposure to pollution and SES, we develop a latent class mixture model (LCMM) with three latent variables (SES Advantage, SES Disadvantage, and Air Pollution) and compare the LCMM fit with K-means clustering. We ran an ANOVA to test for high exposure levels in non-Hispanic black populations. The analysis is at the census tract level for the state of North Carolina.

Results:

The LCMM was a better and more nuanced fit to the data than K-means clustering. Our LCMM had two sublevels (low, high) within each latent class. The worst levels of exposure (high SES disadvantage, low SES advantage, high pollution) are found in 22% of census tracts, while the best levels (low SES disadvantage, high SES advantage, low pollution) are found in 5.7%. Overall, 34.1% of the census tracts exhibit high disadvantage, 66.3% have low advantage, and 59.2% have high mixtures of toxic pollutants. Areas with higher SES disadvantage had significantly higher non-Hispanic black population density (NHBPD; P < 0.001), and NHBPD was higher in areas with higher pollution (P < 0.001).

Conclusions:

Joint exposure to air toxins and SES varies with rural/urban location and coincides with minority populations.

Impact:

Our model can be extended to provide a holistic modeling framework for estimating disparities in cancer survival.

See all articles in this CEBP Focus section, “Environmental Carcinogenesis: Pathways to Prevention.”
Risks of Second Primary Gynecologic Cancers following Ovarian Cancer Treatment in Asian Ethnic Subgroups in the United States, 2000–2016
Authors: Mukand Nita H. , Zolekar Ashwini , Ko Naomi Y. , Calip Gregory S.
Published: August 2020

Background:

The differential occurrence of second primary cancers by race following ovarian cancer is poorly understood. Our objective was to determine the incidence of second primary gynecologic cancers (SPGC) following definitive therapy for ovarian cancer. Specifically, we aimed to determine differences in SPGC incidence by Asian ethnic subgroups.

Methods:

We identified 27,602 women ages 20 years and older and diagnosed with first primary epithelial ovarian cancer between 2000 and 2016 who received surgery and chemotherapy in 18 population-based Surveillance, Epidemiology and End Results Program registries. We compared the incidence of SPGC with expected incidence rates in the general population of women using estimated standardized incidence ratios (SIR) and 95% confidence intervals (CI).

Results:

The incidence of SPGC was lower among White women (SIR = 0.73; 95% CI, 0.59–0.89), and higher among Black (SIR = 1.80; 95% CI, 0.96–3.08) and Asian/Pacific Islander (API) women (SIR = 1.83; 95% CI, 1.07–2.93). Increased risk of vaginal cancers was observed among all women, although risk estimates were highest among API women (SIR = 26.76; 95% CI, 5.52–78.2) and were also significant for risk of uterine cancers (SIR = 2.53; 95% CI, 1.35–4.33). Among API women, only Filipinas had significantly increased incidence of SPGC overall including both uterine and vaginal cancers.

Conclusions:

Risk of SPGC following treatment of ovarian cancer differs by race and ethnicity, with Filipina women having the highest rates of second gynecologic cancers among Asian women.

Impact:

Ensuring access and adherence to surveillance may mitigate ethnic differences in the early detection and incidence of second gynecologic cancers.
Disparities in the Occurrence of Late Effects following Treatment among Adolescent and Young Adult Melanoma Survivors
Authors: Gingrich Alicia A. , Sauder Candice A.M. , Goldfarb Melanie , Li Qian , Wun Ted , Keegan Theresa H.M.
Published: August 2020

Background:

Melanoma is the third most common cancer in the adolescent and young adult (AYA) population; however, no studies have addressed the occurrence of adverse health conditions following melanoma treatment in these survivors.

Methods:

Data for patients ages 15 to 39 years diagnosed with cutaneous melanoma from 1996 to 2012 and surviving ≥2 years were obtained from the California Cancer Registry and linked to statewide hospitalization data. The influence of age at diagnosis, sex, race/ethnicity, neighborhood socioeconomic status (SES), health insurance, and surgery on the development of adverse health conditions was evaluated using Cox proportional hazards regression models.

Results:

Of 8,259 patients, 35.3% were male, 83.3% were non-Hispanic White, 82.4% had private health insurance, and 60.5% were considered high SES. In Cox regression models, males had an increased risk of developing adverse health conditions across all systems, including cardiac [HR, 1.73, 95% confidence interval (CI), 1.47–2.03], lymphedema (HR, 1.56; 95% CI, 1.37–1.77), hematologic disorders (HR, 1.17; 95% CI, 1.03–1.33), major infection/sepsis (HR, 1.59; 95% CI, 1.39–1.82), and second cancers (HR, 1.51; 95% CI, 1.31–1.74). Patients with public/no insurance (vs. private) had a greater risk of developing all studied adverse health conditions, including subsequent cancers (HR, 2.34; 95% CI, 1.94–2.82). AYA patients residing in low SES neighborhoods had similar increased risk of developing adverse health conditions.

Conclusions:

Of AYA melanoma survivors, males, those with public/no health insurance, and those living in low SES neighborhoods had a greater likelihood of developing adverse health conditions.

Impact:

Strategies to improve surveillance and secondary prevention of these adverse health conditions are needed among AYA melanoma survivors, specifically for the at-risk populations identified.
Long-term Outcomes for Extraskeletal Myxoid Chondrosarcoma: A SEER Database Analysis
Authors: Wagner Michael J. , Chau Bonny , Loggers Elizabeth T. , Pollack Seth M. , Kim Teresa S. , Kim Edward Y. , Thompson Matthew J. , Harwood Jared L. , Cranmer Lee D.
Published: August 2020

Background:

Extraskeletal myxoid chondrosarcoma (EMCS) is a rare tumor that typically has an indolent course but high rate of recurrence. We queried the Surveillance, Epidemiology, and End Results (SEER) database to assess factors associated with metastasis, treatment, and survival.

Methods:

We queried the SEER 1973–2016 database for patients with myxoid chondrosarcoma (ICD-O-3: 9231/3). Kaplan–Meier analyses and Cox proportional hazard models assessed effects on overall survival (OS) of demographics and clinical characteristics. Logistic regression assessed associations between tumor location and distant disease. Primary analysis was a complete case analysis; multiple imputation (MI) was used in a sensitivity analysis.

Results:

Locoregional disease (LRD) was found in 373 (85%) of patients. In univariate analysis with LRD, surgery correlated with superior OS [HR = 0.27; 95% confidence interval (CI), 0.16–0.47]; chemotherapy and radiotherapy associated with inferior OS (HR = 1.90; 95% CI, 1.11–3.27 and HR = 1.45; 95% CI, 1.03–2.06, respectively). No treatment modality associated with OS in the adjusted, complete case model. In the adjusted sensitivity analysis, surgery associated with superior outcomes (HR = 0.36; 95% CI, 0.19–0.69). There was no OS difference by primary tumor site. 10-year OS with distant disease was 10% (95% CI, 2%–25%).

Conclusions:

Surgery in LRD associated with improved OS in univariate analysis and adjusted models correcting for missing data. There was no OS benefit with chemotherapy or radiotherapy.

Impact:

This represents the largest report of EMCS with long-term follow-up. Despite the reputedly indolent nature of EMCS, outcomes with metastatic disease are poor. We provide OS benchmarks and guidance for stratification in future prospective trials.
Early-Life Cardiorespiratory Fitness and Long-term Risk of Prostate Cancer
Authors: Crump Casey , Stattin Pär , Brooks James D. , Stocks Tanja , Sundquist Jan , Sieh Weiva , Sundquist Kristina
Published: August 2020

Background:

Adolescence is a period of rapid prostatic growth, yet is understudied for susceptibility for future risk of prostate cancer. We examined cardiorespiratory fitness (CRF) in late adolescence in relation to long-term prostate cancer risk.

Methods:

A population-based cohort study was conducted of all 699,125 Swedish military conscripts during 1972–1985 (97%–98% of 18-year-old men) in relation to risk of prostate cancer overall, aggressive prostate cancer, and prostate cancer mortality during 1998–2017 (ages 50–65 years). CRF was measured by maximal aerobic workload, and prostate cancer was ascertained using the National Prostate Cancer Register. Muscle strength was examined as a secondary predictor.

Results:

In 38.8 million person-years of follow-up, 10,782 (1.5%) men were diagnosed with prostate cancer. Adjusting for sociodemographic factors, height, weight, and family history of prostate cancer, high CRF was associated with a slightly increased risk of any prostate cancer [highest vs. lowest quintile: incidence rate ratio (IRR), 1.10; 95% CI, 1.03–1.19; P = 0.008], but was neither significantly associated with aggressive prostate cancer (1.01; 0.85–1.21; P = 0.90) nor prostate cancer mortality (1.24; 0.73–2.13; P = 0.42). High muscle strength also was associated with a modestly increased risk of any prostate cancer (highest vs. lowest quintile: IRR, 1.14; 95% CI, 1.07–1.23; P < 0.001), but neither with aggressive prostate cancer (0.88; 0.74–1.04; P = 0.14) nor prostate cancer mortality (0.81; 0.48–1.37; P = 0.43).

Conclusions:

High CRF or muscle strength in late adolescence was associated with slightly increased future risk of prostate cancer, possibly related to increased screening, but neither with risk of aggressive prostate cancer nor prostate cancer mortality.

Impact:

These findings illustrate the importance of distinguishing aggressive from indolent prostate cancer and assessing for potential detection bias.
Associations of Novel Dietary and Lifestyle Inflammation Scores with Incident, Sporadic Colorectal Adenoma
Authors: Byrd Doratha A. , Judd Suzanne , Flanders W. Dana , Hartman Terryl J. , Fedirko Veronika , Bostick Roberd M.
Published: August 2020

Background:

Colorectal carcinogenesis is mechanistically linked to inflammation and is highly associated with diet and lifestyle factors that may affect chronic inflammation. We previously developed dietary (DIS) and lifestyle (LIS) inflammation scores, comprising inflammation biomarker–weighted components, to characterize the collective contributions of 19 food groups and four lifestyle exposures to systemic inflammation. Both scores were more strongly directly associated with circulating inflammation biomarkers in three validation populations, including a subset of the study population described below, than were the previously reported dietary inflammatory index and empirical dietary inflammatory pattern.

Methods:

We calculated the DIS and LIS in three pooled case–control studies of incident, sporadic colorectal adenoma (N = 765 cases and 1,986 controls) with extensive dietary and lifestyle data, and investigated their associations with adenoma using multivariable unconditional logistic regression.

Results:

For those in the highest (more proinflammatory) relative to the lowest (more anti-inflammatory) quintiles of the DIS and LIS, the multivariable-adjusted ORs were 1.31 [95% confidence interval (CI), 0.98–1.75; Ptrend = 0.09] and 1.98 (95% CI, 1.48–2.66; Ptrend < 0.001), respectively. These associations were strongest for adenomas with high-risk characteristics and among men. Those in the highest relative to the lowest joint DIS/LIS quintile had a 2.65-fold higher odds (95% CI, 1.77–3.95) of colorectal adenoma.

Conclusions:

These results support that diets and lifestyles with higher balances of pro- to anti-inflammatory exposures may be associated with higher risk for incident, sporadic colorectal adenoma.

Impact:

Our findings support further investigation of the DIS and LIS in relation to colorectal neoplasms.
Asian Race and Risk of Prostate Cancer: Results from the REDUCE Study
Authors: Vidal Adriana C. , Oyekunle Taofik , Feng Tom , Freedland Alexis R. , Moreira Daniel , Castro-Santamaria Ramiro , Andriole Gerald L. , Freedland Stephen J. , Allott Emma H.
Published: August 2020

Background:

Global prostate cancer incidence rates are lower in Asian men than Caucasian men. Whether this is the result of less screening in Asian men remains to be determined. We examined whether Asian race was associated with prostate cancer diagnosis in the Reduction by Dutasteride of Cancer Events (REDUCE) study.

Methods:

REDUCE was a 4-year, multicenter, randomized trial of dutasteride versus placebo for prostate cancer prevention among men who underwent prostate-specific antigen (PSA)-independent biopsies at 2 and 4 years. Eligible men were ages 50 to 75 years, had PSA between 2.5 and 10 ng/mL, and a negative prestudy prostate biopsy. We tested the association between Asian and Caucasian race and prostate cancer diagnosis using logistic regression.

Results:

Of 8,122 men in REDUCE, 5,755 (71%) were Caucasian and 105 (1.8%) were Asian. Asians had lower body mass index (24.8 vs. 26.9 kg/m2, P < 0.001), had smaller prostate volume (35.0 vs. 43.5 cc, P < 0.001), and were less likely to have abnormal digital rectal exams (P = 0.048), but were similar in baseline age, PSA, family history of prostate cancer, and smoking status compared with Caucasian men (all P ≥ 0.164). Asian men were equally likely to receive any on-study biopsy compared with Caucasian men (P = 0.634). After adjusting for potential confounders, Asian men were less likely to be diagnosed with prostate cancer during the 4-year study (OR = 0.49; 95% confidence interval, 0.28–0.88; P = 0.016), compared with Caucasian men.

Conclusions:

In REDUCE, where all men underwent biopsies largely independent of PSA, Asian race was associated with lower prostate cancer diagnosis.

Impact:

These findings suggest that lower prostate cancer risk in Asian men may be due to biological, genetic, and/or lifestyle factors.
Spatial and Temporal Heterogeneity of PD-L1 Expression and Tumor Mutational Burden in Gastroesophageal Adenocarcinoma at Baseline Diagnosis and after Chemotherapy
Authors: Zhou Katherine I. , Peterson Bryan , Serritella Anthony , Thomas Joseph , Reizine Natalie , Moya Stephanie , Tan Carol , Wang Yan , Catenacci Daniel V.T.
Published: August 2020

Purpose:

Intrapatient heterogeneity of programmed death ligand 1 (PD-L1) expression and tumor mutational burden (TMB) in gastroesophageal adenocarcinoma (GEA) could influence their roles as predictive biomarkers for response to immune checkpoint inhibitors (ICI). In this retrospective analysis, we evaluated the spatiotemporal heterogeneity and prognostic relevance of PD-L1 expression and TMB in GEA.

Experimental Design:

A cohort of 211 patients with stage II–IV GEA was retrospectively reviewed for a total of 407 tumor samples with PD-L1 expression data and 319 tumor samples with TMB data. PD-L1 status was defined as positive if combined positive score (CPS) ≥1 using the 22C3 pharmDx assay. TMB levels were categorized as low, intermediate, or high (≤5, 5–15, or >15 mutations/Mb), or using a single threshold (<10 or ≥10 mutation/Mb), determined by next-generation sequencing using a targeted gene panel.

Results:

Of 407 tumors, 56% were PD-L1 negative and 44% PD-L1 positive. Of 319 tumors, 50% were TMB-low, 45% TMB-intermediate, and 5% TMB-high; 86% had <10 and 14% ≥10 mutations/Mb. TMB level was significantly associated with MSI-status. PD-L1 expression and TMB exhibited marked spatial heterogeneity between baseline primary and metastatic tumors (61% and 69% concordance), and temporal heterogeneity between tumors before and after chemotherapy (57%–63% and 73%–75% concordance). PD-L1 expression and TMB were not significantly associated with overall survival.

Conclusions:

PD-L1 expression and TMB exhibit marked spatial and temporal heterogeneity in GEA. This heterogeneity should be considered when obtaining tumor samples for molecular testing and when deciding whether ICI therapy is appropriate.

See related commentary by Klempner et al., p. 6401
Hyperglycemia Enhances Cancer Immune Evasion by Inducing Alternative Macrophage Polarization through Increased O-GlcNAcylation
Authors: Rodrigues Mantuano Natália , Stanczak Michal A. , Oliveira Isadora de Araújo , Kirchhammer Nicole , Filardy Alessandra A. , Monaco Gianni , Santos Ronan Christian , Fonseca Agatha Carlos , Fontes Miguel , Bastos César de Souza , Dias Wagner B. , Zippelius Alfred , Todeschini Adriane R. , Läubli Heinz
Published: August 2020

Diabetes mellitus (DM) significantly increases the risk for cancer and cancer progression. Hyperglycemia is the defining characteristic of DM and tightly correlates with a poor prognosis in patients with cancer. The hexosamine biosynthetic pathway (HBP) is emerging as a pivotal cascade linking high glucose, tumor progression, and impaired immune function. Here we show that enhanced glucose flow through the HBP drives cancer progression and immune evasion by increasing O-GlcNAcylation in tumor-associated macrophages (TAM). Increased O-GlcNAc skewed macrophage polarization to a M2-like phenotype supporting tumor progression. Finally, we found an upregulation of M2 markers on TAMs in DM2 patients with colorectal cancer compared with nondiabetic normoglycemic patients. Our results provide evidence for a new and targetable mechanism of cancer immune evasion in patients with hyperglycemia, advocating for strict control of hyperglycemia in patients with cancer.
Febrile Neutropenia in Patients with Solid Tumors Undergoing Intravenous Chemotherapy
Authors: Moreira-Pinto João , Leão Inês , Palmela Carolina , Branco Francisco , Godinho João , Simões Pedro , Leal-Costa Luisa , Lopes Fabio , Faria Ana , Casa-Nova Mafalda , Escária Ana , Costa Filipa , Galvão Isabel , Teixeira José , Passos-Coelho José Luís 
Published: August 2020

Introduction: Febrile neutropenia (FN) is a potentially life-threatening complication of systemic chemotherapy (CT) that often requires hospital admission. Delay in diagnosis and treatment are associated with higher morbidity and mortality. Objective: We aimed to determine the factors that influence FN episodes outcomes in the emergency room (ER). Methods: This was a retrospective study of all FN episodes (with a collected blood culture [BC]) that occurred between 2012 and 2016 at our institution. FN was defined as a temperature ≥38°C and an absolute neutrophil count (ANC) <1,000/μL, expected to decrease to <500/μL in the following week. Results: Between 2012 and 2016, there were 173 FN episodes in 153/1,947 patients treated with intravenous CT. Most of these episodes (n = 121, 70%) were diagnosed in the ER, 29 in the outpatient clinic, and 23 as inpatients. In the ER, the median time was 36 min from hospital nurse triage to medical observation, and 52 min from medical observation to complete blood count specimen collection. There was a positive BC in 33 FN episodes, 72% with Gram-negative bacteria. A total of 160 FN episodes led to hospital admission and 13 were treated as outpatients. Mortality associated with the FN episode was 15% and an ANC <100/μL was predictive of increased mortality. Conclusion: This study confirms that FN is a serious and common complication of IV CT which must be diagnosed and treated promptly. Profound neutropenia was the only predictive factor of mortality.
Hepcidin Status at 2 Months in Infants Fed Breast Milk Compared with Formula
Authors: Verhaeghe Rebecca , George Kandie , Westerman Mark , Olbina Gordana , McCann Diane , Parrow Nermi , Pincus Elisa , Havranek Tomas , Fleming Robert E.
Published: August 2020

Introduction: The basis for the superior absorption of iron from breast milk compared with infant formulas is unclear. The hormone hepcidin downregulates dietary iron absorption. Hepcidin production increases with increased body iron status (reflected in serum ferritin levels). We hypothesized that serum hepcidin levels are suppressed relative to iron status in infants fed breast milk compared with formula. Methods: Subjects were healthy infants presenting for routine 2-month clinic visit and strictly fed either breast milk or standard infant formula. Urinary hepcidin and ferritin levels (reflective of serum levels) were analyzed and compared across the breast milk- and formula-fed groups. The relationship between urinary hepcidin and ferritin levels within each group was analyzed by linear regression. Results: Twenty-four subjects were enrolled in each group. The median urinary hepcidin level in the group fed breast milk was lower than in formula (130 vs. 359 ng hepcidin/mg creatinine, p < 0.05). However, the median ferritin levels were similar (2.1 vs. 1.9 ng/mL). Within each group, urinary hepcidin correlated with urinary ferritin (r = 0.5, p < 0.05 for each group); however, the slope of the regression line was lower in the group fed breast milk compared with formula (p < 0.005). Conclusion: Despite similar urinary ferritin levels, urinary hepcidin levels are lower at 2 months in infants fed breast milk compared with infants fed formula. Hepcidin levels correlate with iron status in each group; however, this relationship is relatively dampened in infants fed breast milk. We speculate that relatively lower infant hepcidin contributes to the superior efficiency of iron absorption from breast milk.
GRUPUGE Perspective: Endoscopic Ultrasound-Guided Drainage of Peripancreatic Collections
Authors: Pereira Flávio , Caldeira Ana , Leite Sílvia , Marques Susana , Moreira Teresa , Moutinho-Ribeiro Pedro , Nunes Nuno , Bispo Miguel
Published: August 2020

Pancreatic and peripancreatic collections (PPC) are a known complication of acute pancreatitis. They are categorized into four types of collection: (1) acute peripancreatic fluid collection, (2) pseudocyst, (3) acute necrotic collection and (4) walled-off necrosis. Most PPC resolve spontaneously or are persistent but asymptomatic. Intervention is needed in a minority of patients with infected or symptomatic collection. Endoscopic ultrasound-guided transmural drainage is currently the first-line treatment option for PPC management. It has shown great technical and clinical success, similar to percutaneous or surgical approaches, but with lower morbidity and costs and better quality of life. In this review article, the GRUPUGE presents an updated perspective on the potential role of endoscopic ultrasound-guided drainage of peripancreatic collections, addressing the selection criteria and the technical issues of different techniques and analysing emerging data on their efficacy and safety.
Effectiveness and Safety of the European Society of Cardiology 0-/1-h Troponin Rule-Out Protocol: The Design of the ESC-TROP Multicenter Implementation Study
Authors: Mokhtari Arash , Khoshnood Ardavan , Lundager Forberg Jakob , Hård af Segerstad Caroline , Ekström Ulf , Schyman Tommy , Akbarzadeh Mahin , Lindahl Bertil , Ekelund Ulf
Published: August 2020

Chest pain is one of the most common complaints at the emergency department (ED), and it is commonly the perceived likelihood of acute coronary syndrome (ACS) that drives management. Guidelines from the European Society of Cardiology (ESC) recommend the use of a 0-/1-h high-sensitivity cardiac troponin T (hs-cTnT) protocol to rule out or in ACS, but this is mostly based on observational studies. The aim of the ESC-TROP trial is to determine the safety and effectiveness of the ESC 0-/1-h hs-cTnT protocol when implemented in routine care. Adult chest pain patients at 5 EDs in the Skåne Region, Sweden, are included in the trial. The 0-/1-h hs-cTnT ESC protocol supplemented with clinical assessment and electrocardiography (ECG) is implemented at 3 EDs, and the other 2 EDs act as concurrent controls. Outcomes will be evaluated during the 10 months after the implementation and the corresponding 10 months of the previous year. The 2 co-primary outcomes are (a) acute myocardial infarction (AMI) and all-cause death within 30 days in patients discharged from the ED, and (b) ED length of stay of the same patients. Secondary outcomes include the proportion of chest pain patients discharged from the ED and the number of ruled-out patients undergoing objective testing within 30 days. The ESC-TROP trial will determine the performance and applicability of the 0-/1-h hs-cTnT ESC protocol supplemented with clinical assessment and ECG when implemented in routine ED care. It will provide evidence whether 0-/1-h hs-cTnT testing is safe, effective, and feasible, and whether widespread implementation as recommended by ESC guidelines should be supported.
O documentário Megalópolis como veículo de memória
Authors: Souza Gustavo , Camargo Fábio Dummer
Published: August 2020

O documentário Megalópolis (Leon Hirszman, 1973) aborda o período em que se iniciou uma acelerada modernização em metrópoles brasileiras, especialmente em São Paulo e no Rio de Janeiro no início dos anos 1970. Com características didáticas e expositivas, o filme revela como deveria se dar o crescimento metropolitano no país atrelado ao modelo estadunidense. Tendo por norte a discussão sobre o documentário como um veículo de memória (Waterson, 2007), buscamos revelar o potencial de Megalópolis como documento e fonte historiográfica por meio de três aspectos que nele se sobressaem: americanização, nacionalismo e consumo. Para tanto, discutimos como a acelerada modernização e a urbanização irracional impostas pelo regime militar são retratadas num documentário dirigido por um cineasta de convicções marxistas, o que revela o potencial de ampliação das discussões em torno deste documentário.
Alegorias do Arbítrio
Authors: Eduardo Andre Gustavo de Paula , Abramovictz Felipe
Published: August 2020

Este artigo tem como objeto de estudo o curta-metragem O Pedestre (1966), de Otoniel Santos Pereira, trazendo à luz sua situação e importância dentro do cinema brasileiro, e sua relevância especial enquanto um dos filmes que atuam como reação ao Golpe Civil-Militar de 1964. É fundamental destacar seu papel enquanto alegoria, recurso bastante presente no cinema brasileiro em tempos autoritários. Também se pretende colocá-lo, por assim dizer, em diálogo (e comparação) com Manhã Cinzenta (1969), de Olney São Paulo – este, por sua vez, filme-síntese do contexto do Ato Institucional nº 5. Os dois curtas atuariam como um conjunto de alegorias do arbítrio, trazendo elementos essenciais em comum, entre os quais a ambiência da distopia e emblemas da ficção científica.
The challenge of the BRICS countries
Authors: Nordenstreng Kaarle
Published: August 2020

The challenge of the BRICS countries is an overview of an international project. First, the history and rationale of the project is shortly reviewed. Secondly, main points of the research plan submitted to the Academy of Finland in 2011 are presented with selected references of literature. Thirdly, the implementation and results are summarized with links to respective pages of the project website and with main publications.
Avaliação eletrocardiográgica e da pressão arterial em cães obesos
Authors: Silva M. B. F. , Carnicelli C. , Rezende A. C. , Burgese L. F. , Jericó M. M.
Published: August 2020

O artigo não apresenta resumo.
Ureterotomia como tratamento de obstrução ureteral em dois cães
Authors: Castro P. F. , Matera J. M. , Rosner S. A. , Galeazzi V. S. , Froes T. R.
Published: August 2020

O artigo não apresenta resumo.
Ixodidoses em cervídeos brasileiros
Authors: Calheiros D. F. , Maldonado A. L. L. , Medeiros L. C.
Published: August 2020

O artigo não apresenta resumo.
Uso de Propofol intracelomatico em tigres do mississipi (Trachemys scripta elegans)
Authors: Mouriño J. M. P. , Vasconcelos A. S.
Published: August 2020

O artigo não apresenta resumo.
Caracterização clínica e histopatológica da adenite sebácea em diferentes fases
Authors: Mariano C. S. , Málaga S. K. , Meneguello J. L. , Sá L. R. M. , Silva P. T. D.
Published: August 2020

O artigo não apresenta resumo.
Otite externa associada a Demodex cati e Otodectys cynotis em felino
Authors: Lustoza A. C. , Silva S. B.
Published: August 2020

O artigo não apresenta resumo.
Pênfigo foliáceo em canino jovem. Relato de caso
Authors: Castro R. C. C. , Marcondes Santos M. , Gussoni F. R. A. , Fragata F. S.
Published: August 2020

O artigo não apresenta resumo.
Aspectos ultra-sonográficas modo B, Doppler colorido e Power doppler no carcinoma de células transicionais da bexiga de cães. Estudo de casos
Authors: Froes T. R. , Iwasaki M. , Campos A. G. , Torres L. N. , Unhur S. M. , Dagli M. L. Z. , Matera J. M.
Published: August 2020

O artigo não apresenta resumo.
Avaliação radiográfica da silhueta cardíaca através do método de mensuração (VHS) em 20 cães da raça Dachshund clinicamente normais
Authors: Fonseca Pinto A. C. B. C. , Iwasaki M. , Corrêa T. P. , Langrafe C. , Sterman F. A. , Barbusci L. O. D. , Pereira G. G.
Published: August 2020

O artigo não apresenta resumo.
Estudo radiográfico das lesões ósseas agressivas na espécie canina
Authors: Burgese L. F. , Oliveira S. M.
Published: August 2020

O artigo não apresenta resumo.
Estudo dos aspectos radiográficos observados aos exames simples e contrastados de cães com compressão extra dural
Authors: Fonseca Pinto A. C. B. C. , Clemente E. A. , Caldas G. M. M. , Sterman F. A. , Cortopassi S. R. G.
Published: August 2020

O artigo não apresenta resumo.
Freqüência e intensidade parasitária de helmintos gastrintestinais em cães sem dono em Araçatuba-SP
Authors: Montano T. R. P. , Ishizaki M. N. , Kaneto C. N. , Bresciani K. D. S. , Vasconcelos R. O. , Nascimento A. A. , Perri S. H. V.
Published: August 2020

O artigo não apresenta resumo.
Caracterização clínica dos cães diabéticos atendidos no Hovet Unisa
Authors: Cury C. M. , Jericó M. M.
Published: August 2020

O artigo não apresenta resumo.
Utilização de Azatioprina no tratamento de Trombocitopenia imunomediada em cão
Authors: Gonzalez R. , Nishiya A. T. , Moreira M. A. B. , Eimantas G. , Jericó M. M. , Bottazzo R. , Silveira E. C.
Published: August 2020

O artigo não apresenta resumo.
Diagnóstico das paralisias flácidas. Relato de três casos
Authors: Ushikoshi W. S. , Gonçalves S. , Ferreira C. B. , Bars R. , Calvo D. B.
Published: August 2020

O artigo não apresenta resumo.
Mesotelioma abdominal em cão. Relato de caso
Authors: Gimenes L. U. , Prestes N. C. , Moya C. F. , Porto C. D. , Rocha N. S.
Published: August 2020

O artigo não apresenta resumo.
Metástase ocular de tumor venéreo transmissível em cão. Relato de um caso
Authors: Carvalho T. P. A. , Cascardi A. F. , Murolo F. P. , D'Oliveira K. S.
Published: August 2020

O artigo não apresenta resumo.
Múltiplos sarcomas atípicos recidivantes em um felino. Relato de caso
Authors: Martin E. C. , Merlo A. , Silva P. T. D. , Marcondes Santos M. , Chierichetti A. L. , Ubukata R. , Fragata F. S.
Published: August 2020

O artigo não apresenta resumo.
Rabdomiossarcoma de vesícula urinária em cão da Serra da Estrela adulto jovem. Relato de caso
Authors: Horta P. V. P. , Silva P. T. D. , Berl C. A. , Chalita M. C. C. , Maia F. B. N. , Kanayama L. M.
Published: August 2020

O artigo não apresenta resumo.
Terapia fotodinâmica para tratamento de tumores em cães e gatos
Authors: Oliveira S. A. , Almeida A. G. , Bagnato V. S. , Marcassa L. G.
Published: August 2020

O artigo não apresenta resumo.
Ocorrência simultânea de adenocarcinoma das glândulas ceruminosas e otite externa em um cão
Authors: Headley S. A. , Saito T. B. , Bettini C. M. , Tomita A. L.
Published: August 2020

O artigo não apresenta resumo.
Effect of Optimized Versus Guidelines‐Based Automated External Defibrillator Placement on Out‐of‐Hospital Cardiac Arrest Coverage: An In Silico Trial
Authors: Sun Christopher L. F. , Karlsson Lena , Morrison Laurie J. , Brooks Steven C. , Folke Fredrik , Chan Timothy C. Y.
Published: August 2020

Background

Mathematical optimization of automated external defibrillator (AED) placement may improve AED accessibility and out‐of‐hospital cardiac arrest (OHCA) outcomes compared with American Heart Association (AHA) and European Resuscitation Council (ERC) placement guidelines. We conducted an in silico trial (simulated prospective cohort study) comparing mathematically optimized placements with placements derived from current AHA and ERC guidelines, which recommend placement in locations where OHCAs are usually witnessed.

Methods and Results

We identified all public OHCAs of presumed cardiac cause from 2008 to 2016 in Copenhagen, Denmark. For the control, we computationally simulated placing 24/7‐accessible AEDs at every unique, public, witnessed OHCA location at monthly intervals over the study period. The intervention consisted of an equal number of simulated AEDs placements, deployed monthly, at mathematically optimized locations, using a model that analyzed historical OHCAs before that month. For each approach, we calculated the number of OHCAs in the study period that occurred within a 100‐m route distance based on Copenhagen’s road network of an available AED after it was placed (“OHCA coverage”). Estimated impact on bystander defibrillation and 30‐day survival was calculated by multivariate logistic regression. The control scenario involved 393 AEDs at historical, public, witnessed OHCA locations, covering 15.8% of the 653 public OHCAs from 2008 to 2016. The optimized locations provided significantly higher coverage (24.2%;
P
<0.001). Estimated bystander defibrillation and 30‐day survival rates increased from 15.6% to 18.2% (
P
<0.05) and from 32.6% to 34.0% (
P
<0.05), respectively. As a baseline, the 1573 real AEDs in Copenhagen covered 14.4% of the OHCAs.

Conclusions

Mathematical optimization can significantly improve OHCA coverage and estimated clinical outcomes compared with a guidelines‐based approach to AED placement.