bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID‐19 in third trimester may not be as scary as you think, it can be innocent: Evaluating vertical transmission from a COVID‐19 positive asymptomatic pregnant woman with early membrane rupture
Authors: Palalioglu Rabia M. , Mahammadaliyeva Aytakin , Erbiyik Halil I. , Muhcu Murat
Published: December 2020

In the literature, many cases of coronavirus disease 2019 (COVID‐19) positive pregnancies have been observed, mostly with mild findings, but there is limited evidence about perinatal transition and early COVID‐19 positive newborns. In this case, severe acute respiratory syndrome coronavirus 2 reverse transcription–polymerase chain reaction results were studied from samples obtained from the placenta, amniotic fluid, cord blood and postoperative breast milk – that were obtained while avoiding contamination and preserved appropriately – of a cesarean section performed under anesthesia on a woman with previous cesarean section and gestational diabetes mellitus history. This patient who presented to our emergency gynecology clinic with membrane rupture was infected with severe acute respiratory syndrome coronavirus 2 two weeks before delivery but was not treated as the disease was asymptomatic. In addition, literature data in line with this topic were evaluated to demonstrate that there was generally no perinatal transmission over 34 weeks of gestation.
Gender in authorship and editorship in medical education journals: A bibliometric review
Authors: Madden Caoimhe , O’Malley Róisín , O’Connor Paul , O’Dowd Emily , Byrne Dara , Lydon Sinéad
Published: December 2020

Context

Gender bias has been observed in the authorship and editorship of academic literature in varied medical specialties. This is important as peer‐reviewed publications, and participation on editorial boards, are closely related to academic productivity and advancement. The aim of this paper was to examine whether gender‐based disparities in authorship and editorship exist in leading medical education journals.

Methods

A retrospective bibliometric review was conducted of articles published at eight different time‐points across a 49‐year time period (specifically: 1970, 1980, 1990, 2000, 2005, 2010, 2015 and 2019) in four leading medical education journals (Academic Medicine, BMC Medical Education, Medical Education and Medical Teacher). First and last (as a proxy for senior) author gender was determined for each article, along with the gender of the 2019 editorial board members of each journal. Chi‐square tests for trend were conducted to examine variations in author gender distributions over time, and binomial tests of proportions were conducted to examine gender distributions in authorship and editorship in 2019. Logistic regression analyses were carried out to determine factors that predicted the odds of authorship by women.

Results

A total of 5749 articles were included. A significant trend of increased women as first and last authors was observed across all journals. The percentage of women first authors increased from 6.6% in 1970 to 53.7% in 2019 (P < .001), and women last authors increased from 9.5% in 1970 to 46% in 2019 (P < .001). Overall, the distributions of women first authors, last authors and editorial board members in 2019 indicated greater gender parity than many other fields of medicine.

Conclusions

Positive progress towards gender parity has been made in medical education scholarship. However, future research and efforts are needed to ensure the continued participation, and highlighting, of women in medical education scholarship and to address other factors which may hinder academic advancement for women in this field.
Evidence of no horizontal or vertical transmission of tomato severe rugose virus by Bemisia tabaci MEAM1
Authors: Favara Gabriel M. , Bello Vinicius H. , Rezende Jorge A. M.
Published: December 2020

Bemisia tabaci is important in agriculture worldwide, mainly because it is a vector of numerous plant viruses, probably the most important of which are members of the genus Begomovirus. Dozens of begomoviruses have been reported to infect tomato plants in Brazil, although tomato severe rugose virus (ToSRV) predominates in tomato crops. ToSRV, found so far only in Brazil, is efficiently transmitted by B. tabaci MEAM1. However, no studies have assessed the occurrence of vertical and horizontal transmission of the virus in the insect, which may have epidemiological consequences affecting disease management. This study evaluated the possibility of transmission of ToSRV between whiteflies during copulation and transovarial transmission from viruliferous females of B. tabaci MEAM1 to their progeny. Transmission of ToSRV did not occur during mating between males and females of B. tabaci MEAM1. Aviruliferous males and females confined with viruliferous insects of the opposite sex were also unable to transmit the virus to tomato plants. ToSRV was detected, by PCR, in the ovaries of viruliferous females of B. tabaci MEAM1 but not in eggs, nymphs, or adults of the progeny of viruliferous females. Adult progeny of viruliferous females also did not transmit ToSRV to tomato plants. Together, the results indicate that vertical and horizontal transmission of ToSRV by B. tabaci MEAM1 is unlikely. Sustainable management of the tomato golden mosaic disease caused by ToSRV should continue to focus on using resistant varieties, managing sources of inoculum around tomato fields, and rational chemical control of the vector.
People exposed to suicide attempts: Frequency, impact, and the support received
Authors: Hvidkjær Karine Larving , Ranning Anne , Madsen Trine , Fleischer Elene , Eckardt Jens Peter , Hjorthøj Carsten , Cerel Julie , Nordentoft Merete , Erlangsen Annette
Published: December 2020

Objective

Little is known about people who have been exposed to a suicide attempt by someone they know. The purpose of this study was to examine how many people have been exposed to a suicide attempt by someone they knew and whether the exposure was associated with general well‐being and suicidal ideation.

Method

A population‐based online survey was conducted during 2019 in Denmark (n = 6,191). The associations between exposures to suicide attempt and general well‐being (WHO‐5) and suicidal ideation (Suicidal Ideation Attributes Scale) were examined using linear regression analyses.

Results

Overall, 24.6% reported having experienced a suicide attempt by someone they knew. Of those, 46.5% had experienced a suicide attempt of a close relation and this group reported having been more affected by the event. Those exposed scored lower on general well‐being (b: −3.0; 95% CI: −4.2 to −1.8; p > 0.001) and higher on suicidal ideation (b: 1.6; 95% CI: 1.3 – 1.9; p = 0.001) than those not exposed. Half of the exposed reported not having received sufficient support after the event.

Conclusion

Suicide attempt affects a substantial share of the population, and it might be relevant to ensure that support is available for those exposed perceived to be in need of support.
Hepatitis C‐positive donor to negative recipient kidney transplantation: A real‐world experience
Authors: Jandovitz Nicholas , Nair Vinay , Grodstein Elliot , Molmenti Ernesto , Fahmy Ahmed , Abate Mersema , Bhaskaran Madhu , Teperman Lewis
Published: December 2020

Background

Several studies have shown that transplanting a hepatitis C virus (HCV)‐negative recipients with a HCV‐positive donor is feasible in a research setting. In February 2018, we began transplanting HCV‐negative recipients with HCV‐positive donors as standard of care.

Methods

All patients, except those with previously cured HCV and those with cirrhosis, were consented for HCV NAT‐positive donor kidneys. After transplantation, patients were tested for HCV RNA until viremic. A direct‐acting antiviral (DAA) agent was prescribed based on genotype and insurance approval. Sustained virologic response (SVR) at weeks 4 and 12 was recorded. Renal function and death censored graft survival at 1 year were evaluated and compared to recipients of HCV NAT‐negative kidneys.

Results

A total of 25 HCV NAT‐positive donor kidney transplants from February to October 2018 were performed. All patients received basiliximab and maintained with tacrolimus, mycophenolate mofetil, and prednisone. Median time from viremia to start of DAA was 13 (8‐22) days. The most common genotype was 1a (60%), followed by 3a (28%). The most commonly prescribed DAA was ledipasvir/sofosbuvir (56%), followed by velpatasvir/sofosbuvir (32%), and then glecaprevir/pibrentasvir (12%). All patients achieved initial SVR12, except one. One patient had a mixed‐genotype infection requiring retreatment to achieve SVR12. Death censored graft survival was 96%. Recipients of HCV NAT‐positive organs compared to HCV NAT‐negative organs received younger donors (mean 35 ± 8.9 vs 45.1 ± 15.7 years; P < .01) and spent less time on the waitlist (median 479 (93‐582) vs 1808 (567‐2263) days; P = .02).

Conclusion

HCV NAT‐negative recipients can be safely and successfully transplanted with HCV NAT‐positive donor kidneys outside of a research protocol. Access to DAA and timely administration of therapy is important and an insurance approval process within the transplant center can be beneficial to patients. A case of mixed‐genotype infection was presented, and although not as common, can be successfully treated. HCV organs can expand the organ pool and should no longer be considered experimental. The use of these organs in HCV‐negative recipient's decreases waiting time, have excellent outcomes, and should be considered standard of care.
Chromoplast differentiation in bell pepper (Capsicum annuum) fruits
Authors: Rödiger Anja , Agne Birgit , Dobritzsch Dirk , Helm Stefan , Müller Fränze , Pötzsch Nina , Baginsky Sacha
Published: December 2020

We report here a detailed analysis of the proteome adjustments that accompany chromoplast differentiation from chloroplasts during bell pepper (Capsicum annuum) fruit ripening. While the two photosystems are disassembled and their constituents degraded, the cytochrome b6f complex, the ATPase complex, and Calvin cycle enzymes are maintained at high levels up to fully mature chromoplasts. This is also true for ferredoxin (Fd) and Fd‐dependent NADP reductase, suggesting that ferredoxin retains a central role in the chromoplasts’ redox metabolism. There is a significant increase in the amount of enzymes of the typical metabolism of heterotrophic plastids, such as the oxidative pentose phosphate pathway (OPPP) and amino acid and fatty acid biosynthesis. Enzymes of chlorophyll catabolism and carotenoid biosynthesis increase in abundance, supporting the pigment reorganization that goes together with chromoplast differentiation. The majority of plastid encoded proteins decline but constituents of the plastid ribosome and AccD increase in abundance. Furthermore, the amount of plastid terminal oxidase (PTOX) remains unchanged despite a significant increase in phytoene desaturase (PDS) levels, suggesting that the electrons from phytoene desaturation are consumed by another oxidase. This may be a particularity of non‐climacteric fruits such as bell pepper that lack a respiratory burst at the onset of fruit ripening.
Validation of a Community-Acquired Pneumonia Score To Improve Empiric Antibiotic Selection at an Academic Medical Center
Authors: Oliver Meredith B. , Fong Karen , Certain Laura , Spivak Emily S. , Timbrook Tristan T.
Published: December 2020

The 2019 American Thoracic Society and the Infectious Diseases Society of America community-acquired pneumonia (CAP) guidelines recommend that drug-resistant pathogens (DRP) be empirically covered if locally validated risk factors are present. This retrospective case-control validation study evaluated the performance of the drug resistance in pneumonia (DRIP) clinical prediction score.
In Vivo
Efficacy and Metabolism of the Antimalarial Cycleanine and Improved
In Vitro
Antiplasmodial Activity of Semisynthetic Analogues
Authors: Uche Fidelia Ijeoma , Guo Xiaozhen , Okokon Jude , Ullah Imran , Horrocks Paul , Boateng Joshua , Huang Chenggang , Li Wen-Wu
Published: December 2020

Bisbenzylisoquinoline (BBIQ) alkaloids are a diverse group of natural products that demonstrate a range of biological activities. In this study, the
in vitro
antiplasmodial activity of three BBIQ alkaloids (cycleanine [compound 1], isochondodendrine [compound 2], and 2′-norcocsuline [compound 3]) isolated from the
Triclisia subcordata
Oliv. medicinal plant traditionally used for the treatment of malaria in Nigeria are studied alongside two semisynthetic analogues (compounds 4 and 5) of cycleanine.
Evaluation of the Dynamiker Cryptococcal Antigen Lateral Flow Assay for the Diagnosis of HIV-Associated Cryptococcosis
Authors: Kwizera Richard , Omali Denis , Tadeo Kiiza , Kasibante John , Rutakingirwa Morris K. , Kagimu Enock , Ssebambulidde Kenneth , Williams Darlisha A. , Rhein Joshua , Boulware David , Meya David B.
Published: December 2020

Cryptococcal meningitis is a leading cause of meningitis in sub-Saharan Africa. Given the need for rapid point-of-care testing, we evaluated the diagnostic performance of the Dynamiker cryptococcal antigen (CrAg) lateral flow assay (LFA).
The Fiber Knob Protein of Human Adenovirus Type 49 Mediates Highly Efficient and Promiscuous Infection of Cancer Cell Lines Using a Novel Cell Entry Mechanism
Authors: Baker Alexander T. , Davies James A. , Bates Emily A. , Moses Elise , Mundy Rosie M. , Marlow Gareth , Cole David K. , Bliss Carly M. , Rizkallah Pierre J. , Parker Alan L.
Published: December 2020

Adenoviruses are powerful tools experimentally and clinically. To maximize efficacy, the development of serotypes with low preexisting levels of immunity in the population is desirable.
Production of Noncapped Genomic RNAs Is Critical to Sindbis Virus Disease and Pathogenicity
Authors: LaPointe Autumn T. , Landers V Douglas , Westcott Claire E. , Sokoloski Kevin J.
Published: December 2020

Mosquito-transmitted alphaviruses have been the cause of widespread outbreaks of disease that can range from mild illness to lethal encephalitis or severe polyarthritis. There are currently no safe and effective vaccines or therapeutics with which to prevent or treat alphaviral disease, highlighting the need to better understand alphaviral pathogenesis to develop novel antiviral strategies. This report reveals production of noncapped genomic RNAs (ncgRNAs) to be a novel determinant of alphaviral virulence and offers insight into the importance of inflammation to pathogenesis. Taken together, the findings reported here suggest that the ncgRNAs contribute to alphaviral pathogenesis through the sensing of the ncgRNAs during alphaviral infection and are necessary for the development of severe disease.
Association between Antibody Responses to Epstein-Barr Virus Glycoproteins, Neutralization of Infectivity, and the Risk of Nasopharyngeal Carcinoma
Authors: Zhu Qian-Ying , Kong Xiang-Wei , Sun Cong , Xie Shang-Hang , Hildesheim Allan , Cao Su-Mei , Zeng Mu-Sheng
Published: December 2020

Epstein-Barr virus (EBV) is a human oncogenic gammaherpesvirus that infects over 90% of humans in the world and is causally associated with a spectrum of epithelial and B-cell malignancies such as nasopharyngeal carcinoma (NPC). A prophylactic vaccine against EBV is called for, but no approved vaccine is available yet.
Factors associated with the utilisation of primary care services: a cross-sectional study in public and private facilities in Albania
Authors: Gabrani Jonila , Schindler Christian , Wyss Kaspar
Published: December 2020

Objectives

To identify key factors influencing the utilisation of governmental and private primary healthcare services in Albania.

Design

A cross-sectional health facility survey using a 4-point Likert scale questionnaire to rank the importance of factors driving services utilisation.

Setting

Exit interviews with patients who consulted one of 23 primary care providers (18 public and 5 private) in Fier district of Albania from the period of July–August 2018.

Participants

Representative sample of 629 adults ≥18 years of age.

Main outcomes measures

(1) Factors influencing the decision to visit a governmental or private primary care provider and (2) the association of sociodemographic characteristics and patients’ decision to attend a given provider. Data were analysed using mixed logistic regression models.

Results

Nearly half of the participants in this study were older than 60 years (45%). The majority (63%) reported to suffer from a chronic condition. Prevailing determinants for choosing a provider were ‘quality of care’ and ‘healthcare professionals’ attitudes. Solely looking at patients using a public provider, ‘geographical proximity’ was the most important factor guiding the decision (85% vs 11%, p<0.001). For private provider’s patients, the ‘availability of diagnostic devices’ was the most important factor (69% vs 9%, p<0.001). The odds of using public facilities were significantly higher among the patients who perceived their health as poor (OR 5.59; 95% CI 2.62 to 11.92), suffered from chronic conditions (OR 3.13; 95% CI 1.36 to 7.24) or were benefiting from a socioeconomic aid scheme (OR 3.52; 95% CI 1.64 to 7.56).

Conclusion

The use of primary healthcare is strongly influenced by geographical and financial access for public facility users and availability of equipment for private users. This study found that aspects of acceptability and adequacy of services are equally valued. Additional commitment to further develop primary care through engagement of local decision-makers and professional associations is needed.
Orodispersible and transmucosal alternative medications for symptom control in adults
Authors: Sutherland Anna Elizabeth , Presland Melinda , Harrop Emily , Carey Matthew , Miller Mary , Wong Ian Chi Kei CK
Published: December 2020

Background

Paediatric palliative care makes frequent use of orodispersible and transmucosal drug delivery routes. The limited published experience of this practice suggests that it enables the delivery of needle-free symptom relief, with the potential to train family carers to administer anticipatory medications without reliance on trained health professionals.

Aims

To identify orodispersible and potential transmucosal alternatives that may be used in adults in the event of a patient having no oral or intravenous route and no access to subcutaneous injections.

Methods

The author panel identified medications through review of multiple drug formularies, review of the published evidence and their experience. Where possible, licensed alternatives were identified and any ‘off label’ or unlicensed medications clearly highlighted.

Results

A list of 27 medications is provided, which could be used either via the orodispersible or transmucosal alternative route for healthcare professionals delivering end of life care to consider when the licensed alternative routes are unavailable. All users of this guide are encouraged to use their professional judgement whenever selecting a medication for a patient, recognising that this review is neither a guideline nor a systematic review, and taking account of licensing considerations, adverse effects, potential unpredictability of time to effect and contraindications.

Conclusion

Should it be necessary to use these orodispersible or transmucosal alternatives then any experience gained should be reported in the literature. Combined with further research, this experience offers the possibility of reducing injection frequency and inherent delays in medication administration, particularly in the community setting during the COVID-19 pandemic.
Ideals and Bosbach States on Residuated Lattices
Authors: Woumfo Francis , Njionou Blaise B. Koguep , Alomo Etienne R. Temgoua , Lele Celestin
Published: December 2020

In random experiments, the fact that the sets of events has a structure of a Boolean algebra, i.e. it follows the rules of classical logic, is the main hypothesis of classical probability theory. Bosbach states have been introduced on commutative and non-commutative algebras of fuzzy logics as a way of probabilistically evaluating the formulas. In this paper, we focus on the relationship between some properties of ideals and Bosbach states in the framework of commutative residuated lattices. In particular, we introduce the concept of co-kernel of a Bosbach state which is an ideal and we establish the relationship between the notion of co-kernel and the kernel. Moreover, we define and characterize maximal ideals and maximal MV-ideals in residuated lattices.
M-Fuzzifying Approximation Spaces, M-Fuzzifying Pretopological Spaces and M-Fuzzifying Closure Spaces
Authors: Singh Anand P. , Perfilieva I.
Published: December 2020

In category theory, Galois connection plays a significant role in developing the connections among different structures. The objective of this work is to investigate the essential connections among several categories with a weaker structure than that of [Formula: see text]-fuzzifying topology, viz. category of [Formula: see text]-fuzzifying approximation spaces based on reflexive [Formula: see text]-fuzzy relations, category of [Formula: see text]-fuzzifying pretopological spaces and the category of [Formula: see text]-fuzzifying interior (closure) spaces. The interrelations among these structures are shown via the functorial diagram.
Continental Drift with Deep Cratonic Roots
Authors: Yoshida Masaki , Yoshizawa Kazunori
Published: December 2020

The influence of the continental lithosphere and its root (or keel) on the continental drift of Earth is a key element in the history of plate tectonics. Previous geodynamic studies of mantle flow suggested that the cratonic root is moderately mechanically coupled with the underlying mantle, and stable continental drift on Earth's timescales occurs when the effective viscosity contrast between the continental lithosphere and the underlying mantle is approximately 103. Both geodynamics and seismological studies indicate that mechanically weak mobile belts (i.e., orogenic or suture zones) that surround cratons may play a role in the longevity of the cratonic lithosphere over geologically long timescales (i.e., over 1,000 million years) because they act as a buffer region against the high-viscosity cratons. Low-viscosity asthenosphere, characterized by slow seismic velocities, reduces the basal drag force acting on the cratonic root, which may also contribute to the longevity of the cratonic lithosphere. ▪  The role of the continental lithosphere and its root on the continental drift is reviewed from recent geodynamic and seismological studies. ▪  The cratonic root is moderately mechanically coupled with the underlying mantle and deformed by mantle flow over geological timescales. ▪  Orogenic belts or suture zones that surround cratons act as a buffer to protect cratons and are essential for their longevity. ▪  Low-viscosity asthenosphere may reduce the basal drag acting on the cratonic root and also contribute to its stability and longevity.
Party and Ideology in American Local Government: An Appraisal
Authors: Anzia Sarah F.
Published: December 2020

For decades, research on US local politics emphasized the distinctiveness of local government, but that has begun to change. In recent years, new data on partisanship and ideology have transformed the study of local politics. Much of the ensuing scholarship has concluded that local politics resembles politics in state and national governments: partisan and ideological. I argue that such a conclusion is premature. So far, this newer literature has been insufficiently attentive to the policies US local governments make—and to the fact that they are mostly different from the issues that dominate national politics. Going forward, scholars should prioritize measurement of preferences on these local government issues, develop theories of when and why local political divisions will mirror national partisanship and ideology, and investigate why there are links between some local policies and national partisanship and ideology—and whether those links also exist for core local government issues.
The Predictive Value of 2D Myocardial Strain for Epirubicin-Induced Cardiotoxicity
Authors: Ben Abdallah Ichrak , Ben Nasr Sonia , Chourabi Chadia , Boukhris Marouane , Ben Abdallah Israa , Zribi Aref , Fendri Sana , Balti Mehdi , Fehri Wafa , Chraiet Nesrine , Haddaoui Abderrazek
Published: December 2020

Introduction. Although epirubicin has significantly improved outcome in breast cancer (BC) patients, it is responsible for myocardial dysfunction that affects patients’ quality of life. The use of 2D global longitudinal strain (GLS) has been reported to detect early myocardial dysfunction. The aim of this study was to evaluate how GLS changes can predict cardiotoxicity. Methods. We conducted a prospective study from March 2018 to March 2020 on 66 patients with no cardiovascular risk factors, who presented with BC and received epirubicin. We measured left ventricular ejection fraction (LVEF) and GLS before chemotherapy, at three months (T3), and at 12 months (T12) from the last epirubicin infusion. Chemotherapy-Related-Cardiac-Dysfunction (CTRCD) was defined as a decrease of 10% in LVEF to a value below 53% according to ASE and EACI 2014 expert consensus. Results. The mean age at diagnosis was 47 ± 9 years old. At baseline, median LVEF was 70% and median GLS was −21%. Shortly after chemotherapy completion, two patients presented with symptomatic heart failure while asymptomatic CTRCD was revealed in three other patients at T12. Three months after the last epirubicin infusion, median LVEF was 65%, median GLS was −19%, and median GLS variation was 5%. However, in patients who presented with subsequent CTRCD, median GLS at T3 was −16% and median GLS variation was 19% (

p
=
0.002

and

p
<
0.001

, respectively, when compared to patients who did not develop cardiotoxicity). Persistent GLS decrease at T3 was an independent predictor of CTRCD at T12. Age and left-sided thoracic irradiation did not increase the risk of cardiotoxicity in our study while the cumulative dose of epirubicin significantly affected cardiologic findings (

p
=
0.001

). Conclusion. This was the first North African study that assesses the value of measuring GLS to early detect cardiotoxicity. Patients whose GLS remained decreased after 3 months from anthracyclines-base chemotherapy had an increased risk for developing subsequent CTRCD. Further studies with larger sample size are warranted to identify the best cardioprotective molecules to be initiated in these patients before LVEF declines.
Smart City Landscape Design Based on Improved Particle Swarm Optimization Algorithm
Authors: Yao Wenting , Ding Yongjun
Published: December 2020

Aiming at the shortcomings of standard particle swarm optimization (PSO) algorithms that easily fall into local optimum, this paper proposes an optimization algorithm (LTQPSO) that improves quantum behavioral particle swarms. Aiming at the problem of premature convergence of the particle swarm algorithm, the evolution speed of individual particles and the population dispersion are used to dynamically adjust the inertia weights to make them adaptive and controllable, thereby avoiding premature convergence. At the same time, the natural selection method is introduced into the traditional position update formula to maintain the diversity of the population, strengthen the global search ability of the LTQPSO algorithm, and accelerate the convergence speed of the algorithm. The improved LTQPSO algorithm is applied to landscape trail path planning, and the research results prove the effectiveness and feasibility of the algorithm.
15-lncRNA-Based Classifier-Clinicopathologic Nomogram Improves the Prediction of Recurrence in Patients with Hepatocellular Carcinoma
Authors: Zhang Qiong , Ning Gang , Jiang Hongye , Huang Yanlin , Piao Jinsong , Chen Zhen , Tan Xiaojun , Zhang Jiangyu , Liu Genglong
Published: December 2020

Background. Our study aims to develop a lncRNA-based classifier and a nomogram incorporating the genomic signature and clinicopathologic factors to help to improve the accuracy of recurrence prediction for hepatocellular carcinoma (HCC) patients. Methods. The lncRNA profiling data of 374 HCC patients and 50 normal healthy controls were downloaded from The Cancer Genome Atlas (TCGA). Using univariable Cox regression and least absolute shrinkage and selection operator (LASSO) analysis, we developed a 15-lncRNA-based classifier and compared our classifier to the existing six-lncRNA signature. Besides, a nomogram incorporating the genomic classifier and clinicopathologic factors was also developed. The predictive accuracy and discriminative ability of the genomic-clinicopathologic nomogram were determined by a concordance index (C-index) and calibration curve and were compared with the TNM staging system by the C-index and receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was performed to estimate the clinical value of our nomogram. Results. Fifteen relapse-free survival (RFS-) related lncRNAs were identified, and the classifier, consisting of the identified 15 lncRNAs, could effectively classify patients into the high-risk and low-risk subgroups. The prediction accuracy of the 15-lncRNA-based classifier for predicting 2-year and 5-year RFS was 0.791 and 0.834 in the training set and 0.684 and 0.747 in the validation set, respectively, which was better than the existing six-lncRNA signature. Moreover, the AUC of genomic-clinicopathologic nomogram in predicting RFS were 0.837 in the training set and 0.753 in the validation set, and the C-index of the genomic-clinicopathologic nomogram was 0.78 (0.72-0.83) in the training set and 0.71 (0.65-0.76) in the validation set, which was better than the traditional TNM stage and 15-lncRNA-based classifier. The decision curve analysis further demonstrated that our nomogram had a larger net benefit than the TNM stage and 15-lncRNA-based classifier. The results were confirmed externally. Conclusion. Compared to the TNM stage, the 15-lncRNAs-based classifier-clinicopathologic nomogram is a more effective and valuable tool to identify HCC recurrence and may aid in clinical decision-making.
Omega-3 Eicosapentaenoic Acid Reduces Prostate Tumor Vascularity
Authors: Gevariya Nikunj , Lachance Gabriel , Robitaille Karine , Joly Beauparlant Charles , Beaudoin Lisanne , Fournier Éric , Fradet Yves , Droit Arnaud , Julien Pierre , Marette André , Bergeron Alain , Fradet Vincent
Published: December 2020

The impact of omega (ω)-3 fatty acids on prostate cancer is controversial in epidemiological studies but experimental studies suggest a protective effect. However, little is known about the mechanism of action. Here, we studied the effects of purified fatty acid molecules on prostate tumor progression using the TRAMP-C2 syngeneic immunocompetent mouse model. Compared with ω-6 or ω-9–supplemented animals, we observed that late-stage prostate tumor growth was reduced with a monoacylglyceride (MAG)-conjugated form of eicosapentaenoic acid (EPA) supplementation, whereas docosahexanenoic acid (DHA) caused an early reduction. MAG–EPA significantly decreased tumor blood vessel diameter (P < 0.001). RNA sequencing analysis revealed that MAG–EPA downregulated angiogenesis- and vascular-related pathways in tumors. We also observed this tissue vascular phenotype in a clinical trial testing MAG–EPA versus a high oleic sunflower oil placebo. Using anti-CD31 IHC, we observed that MAG–EPA reduced blood vessel diameter in prostate tumor tissue (P = 0.03) but not in normal adjacent tissue. Finally, testing autocrine and paracrine effects in an avascular tumor spheroid growth assay, both exogenous MAG–EPA and endogenous ω3 reduced VEGF secretion and in vitro endothelial cell tube formation and blocked tumor spheroid growth, suggesting that ω3 molecules can directly hinder prostate cancer cell growth. Altogether, our results suggest that fatty acids regulate prostate cancer growth and that a tumor-specific microenvironment is required for the anti-vascular effect of MAG–EPA in patients with prostate cancer.

Implications:

Increasing the amount of ingested EPA omega-3 subtype for patients with prostate cancer might help to reduce prostate tumor progression by reducing tumor vascularization.
A Sweet Approach to Heat Up Cancer Response to Immunotherapy
Authors: Pearce Oliver M.T. , Läubli Heinz
Published: December 2020

Song and colleagues describe how N-glycans stabilize expression of checkpoint molecule B7-H4 that suppresses T-cell function. Inhibiting N-glycan stabilization of B7-H4 generates an immune hot cancer that is more responsive to combination therapies.

See related article by Song et al., p. 1872.
Natural Course of the American Thyroid Association Response to Therapy Statuses (Dynamic Risk Stratification) in Differentiated Thyroid Cancer
Authors: Mukhtar Noha , Aljamei Hadeel , Aljomaiah Abeer , Moria Yosra , Alzahrani Ali S.
Published: December 2020

The concept of response to therapy in differentiated thyroid cancer (DTC) was introduced as a dynamic risk stratification used to assess the status of the disease at the time of the evaluation during the follow-up and the risk of recurrence in the future. Our aim in this study was to evaluate the natural course over time of different response to therapy statuses. Methods: We studied 501 nonselected DTC patients (102 males and 399 females) with a median age of 37 years (interquartile range [IQR] 29–48). All patients underwent near-total or total thyroidectomy followed by I-131 ablation (initial management). Results: Of the 501 patients, 387 patients (77.2%) did not have any additional therapuetic interventions after the initial management. In this group, the response to therapy status at the time of the first evaluation after I-131 (median 17 months, IQR 14–22) was an excellent response in 258 (66.7%), an indeterminate response in 101 (26.1%), biochemically incomplete in 17 (4.4%), and structurally incomplete in 11 patients (2.8%). The status changed spontaneously without any intervention in many of them. At the last follow-up visit (median duration 101 months, IQR 71–126), 357 patients (92.2%) achieved an excellent response, 4 (1%) an indeterminate response, 8 (2.1%) a biochemically incomplete status, 16 (4.1%) a structurally incomplete status, and 2 (0.5%) died secondary to DTC with a structurally incomplete status. The response to therapy in the other 114 patients who underwent additional interventions changed from before intervention to the last evaluation as follows: excellent response, 0 to 60 patients (52.6%), indeterminate response, 20 (17.5%) to 1 patient (0.9%), biochemically incomplete 25 (21.9%) to 10 patients (9%), and structurally incomplete 69 (60.5%) to 43 patients (37.7%). Overall, at the last evaluation, 417 (83.2%) were in an excellent response, 5 (1%) in an indeterminate response, 18 (3.6%) in a biochemically incomplete status, 50 (10.2%) in a structurally incomplete status, and 11 (2.2%) died secondary to DTC with a structurally incomplete status. Conclusions: The response to therapy at the initial evaluation is predictive of the long-term outcome. Most patients with the indeterminate response and some in the biochemically incomplete statuses spontaneously regress to an excellent status. Mortality and progression of DTC occur mostly in the structurally incomplete status.
First Report of a Late Lethal Pulmonary Biliary Embolism following Hepatic Microwave Ablation
Authors: Jusufi Maximilian Stanley , Makridis Georgios , Feyerabend Bernd , Oldhafer Karl Jürgen
Published: December 2020

Microwave ablation (MWA) is an established tool in modern therapy of hepatic malignomas. Although it is generally a safe procedure, severe complications related to MWA have been reported in the literature. We report on the first case of a fatal pulmonary biliary embolism following hepatic MWA. The development of pulmonary biliary embolisms is possible and should be considered particularly in the case of by extensive ablation near liver veins.
Pre-Stroke Glycemic Variability Estimated by Glycated Albumin Is Associated with Early Neurological Deterioration and Poor Functional Outcome in Prediabetic Patients with Acute Ischemic Stroke
Authors: Lee Sang-Hwa , Kim Yerim , Park So Young , Kim Chulho , Kim Yeo Jin , Sohn Jong-Hee
Published: December 2020

Introduction: Whether glycemic variability prior to stroke increases the risk of stroke outcomes in prediabetic patients presenting with acute ischemic stroke is still unclear. We evaluated whether pre-stroke glycemic variability, estimated by glycated albumin (GA), increased early neurological deterioration (END) and functional outcomes in prediabetic patients with acute ischemic stroke. Methods: A total of 215 acute ischemic stroke patients with prediabetes were evaluated. The primary outcome was END, defined as an incremental increase in the National Institutes of Health Stroke Scale score by ≥1 point in motor power or ≥2 points in the total score within the 7 days after admission. The secondary outcome was poor functional status defined by a modified Rankin Scale at 3 months. Higher GA (≥16.0%) was determined to reflect glycemic fluctuation prior to ischemic stroke. Results: Of the 215 prediabetic patients, 77 (35.8%) were in the higher GA group. In prediabetic patients, END occurrence and poor functional status were higher in the higher GA group than in the lower GA group. The multivariate analysis showed that a higher GA was associated with an increased risk of END occurrence and poor functional outcomes at 3 months (adjusted odds ratio [95% confidence interval], 4.58 [1.64–12.81], p = 0.004 and 2.50 [1.19–5.25], p = 0.02, respectively). Conclusion: Pre-stroke glycemic variability estimated by GA was associated with END occurrence and poor functional outcome after ischemic stroke in patients with prediabetes.
A Novel Hybrid Stent with Endoscopic Vacuum Therapy for Treating Leaks of the Upper Gastrointestinal Tract
Authors: Chon Seung-Hun , Töx Ulrich , Lorenz Florian , Rieck Isabel , Wagner Britta Janina , Kleinert Robert , Fuchs Hans Friedrich , Goeser Tobias , Quaas Alexander , Bruns Christiane J.
Published: December 2020

Introduction: Self-expanding metal stents (SEMS) are an established option for treating leaks in the upper gastrointestinal tract, and endoscopic vacuum therapy (EVT) has become a promising alternative. A novel approach is the use of an esophageal hybrid SEMS (VACStent®), which can maintain esophageal passage during EVT. We present the first study demonstrating successful use of the VACStent® for treating leaks of the upper gastrointestinal tract. Method: We performed a retrospective, single-center study of all patients who underwent endoscopic stenting with the VACStent® of leaks in the upper gastrointestinal tract. Results: Indications for treatment with the VACStent® were: iatrogenic esophageal perforation (n = 1), spontaneous perforation (n = 2), esophageal fistula (n = 2), and anastomotic leak after upper gastrointestinal surgery (n = 5). Successful application of the VACStent® was achieved in all patients (n = 10; 100%) with a total of 15 interventions. VACStent® therapy was used as a first-line treatment in 5 patient (success rate 80%; 4 out 5 patients) and as a second-line treatment after failed previous endoscopic therapy in 5 patients (success rate 60%; 3 out of 5 patients). Overall, VACStent® treatment was successful in 70% of the patients (7 out of 10). No severe VACStent® treatment-related adverse events occurred. Conclusion: The initial experience has been that the technical application of the VACStent® is safe and technically feasible. However, due to the small number of patients this study could not show the clear advantages of this novel hybrid stent. More studies are necessary to show significant advantages.
Irnerius and the imperial legislator, between Justinian and Henry V
Authors: Loschiavo Luca
Published: December 2020

Nowadays both the figure of Irnerius and his role in the revival of legal studies in the Middle Ages are being questioned under different profiles. Returning to examine the manuscript tradition, the author aims in this essay to show how fondamental was the Irnerius’ contribution in giving the subsequent school of Bologna a very specific direction. Philology was only a tool he used to demonstrate to his contemporaries the authority and ‘positive’ validity of the whole imperial legislation against the early medieval use of selecting only what was immediately useful for practice.
The Felix Meritis Concert Programs Database, 1832–1888: From Archival Ephemera to Searchable Performance Data
Authors: van Nieuwkerk Mascha , Nijboer Harm , Kisjes Ivan
Published: December 2020

The Felix Meritis Concert Programs Database 1832–1888 (fmcp Database) provides a full digitisation of the concert programs collection of the most long-standing Dutch concert hall in the nineteenth century: Felix Meritis. Formerly hidden in boxes with archival ephemera, the content of this collection is now unlocked by manually entering the program details into a searchable dataset. The programs give an extremely rich account of a local concert practice, the performed repertoire, and the musicians involved. However, archiving concert programs at item-level presents a challenge: due to inconsistencies in and incompleteness of work descriptions it is often hard to identify and categorize the musical works performed. For the fmcp database, the authors have developed a possible solution to this problem; a strategy for structuring and categorizing concert programming data that aims to include incomplete work descriptions and reflect genre categorizations used in local concert practice. In this paper, the authors will present this categorization method and discuss the attributes and the basic structure of the fmcp database.
The Bolzano Tracer Experiment (BTEX)
Authors: Zardi Dino , Falocchi Marco , Giovannini Lorenzo , Tirler Werner , Tomasi Elena , Antonacci Gianluca , Ferrero Enrico , Alessandrini Stefano , Jimenez Pedro A. , Kosovic Branko , Delle Monache Luca
Published: December 2020

The paper describes the observational and modeling efforts performed under the Bolzano Tracer Experiment (BTEX). BTEX focused on the basin surrounding the city of Bolzano, at the junction of three tributary valleys on the southern side of the Alps, to characterize the ground-level impact of pollutants emitted by a waste incinerator close to the city, and atmospheric factors controlling dispersion processes in the whole basin, under different winter weather situations. As part of the experiment, two controlled releases of a passive gas tracer (sulfur hexafluoride, SF6) were performed through the stack of the incinerator on 14 February 2017 at two different times, starting respectively at 0700 and 1245 LST, representative of distinct phases of the daily cycle. Samples of ambient air were collected at target sites, and later analyzed using a mass spectrometer, allowing a detectability limit down to 30 ppt. Meanwhile, meteorological conditions were continuously monitored by means of a high-resolution, nonconventional network of ground-based instruments, including 15 weather stations, one temperature profiler, one sodar, and one Doppler wind lidar. Data from the above measurements represent one of the rare examples of integrated datasets available to the community for the characterization of dispersion processes in a typical mountainous environment. In particular, they offered a reference benchmark for testing and calibrating a series of combined numerical modeling suites for weather prediction and pollutant dispersion simulation in such a complex terrain, as shown in the paper.
Numerical Simulations of Melt-Driven Double-Diffusive Fluxes in a Turbulent Boundary Layer beneath an Ice Shelf
Authors: Middleton Leo , Vreugdenhil Catherine A. , Holland Paul R. , Taylor John R.
Published: December 2020

The transport of heat and salt through turbulent ice shelf–ocean boundary layers is a large source of uncertainty within ocean models of ice shelf cavities. This study uses small-scale, high-resolution, 3D numerical simulations to model an idealized boundary layer beneath a melting ice shelf to investigate the influence of ambient turbulence on double-diffusive convection (i.e., convection driven by the difference in diffusivities between salinity and temperature). Isotropic turbulence is forced throughout the simulations and the temperature and salinity are initialized with homogeneous values similar to observations. The initial temperature and the strength of forced turbulence are varied as controlling parameters within an oceanographically relevant parameter space. Two contrasting regimes are identified. In one regime double-diffusive convection dominates, and in the other convection is inhibited by the forced turbulence. The convective regime occurs for high temperatures and low turbulence levels, where it is long lived and affects the flow, melt rate, and melt pattern. A criterion for identifying convection in terms of the temperature and salinity profiles, and the turbulent dissipation rate, is proposed. This criterion may be applied to observations and theoretical models to quantify the effect of double-diffusive convection on ice shelf melt rates.
Management of pregnancy in women with cirrhosis
Authors: Rahim Mussarat N. , Pirani Tasneem , Williamson Catherine , Heneghan Michael A.
Published: December 2020

Although pregnancy is rare in women with cirrhosis, it is increasingly prevalent in an era of modern assisted conception techniques and improved awareness, monitoring and management of underlying liver disease. After overcoming the difficulties of subfertility and becoming pregnant, women undergo a ‘high‐risk’ pregnancy which can be complicated by variceal haemorrhage (≤50%) and hepatic decompensation (≤25%). Management of these complications are similar to non‐pregnant individuals. However, there are a few caveats to consider. These pregnancies are associated with adverse maternal and foetal outcomes, such as mortality (0%–8%) and prematurity (19%–67%) in the newborn, and mortality (0%–14%), pregnancy‐induced hypertension (5%–22%) and post‐partum haemorrhage (5%–45%) in the mother. Pre‐pregnancy counselling, use of predictive scores and appropriate variceal screening during pregnancy can stratify patients and improve outcomes. This review focusses on the complications that can occur during pregnancy in women with cirrhosis.
Supportive medication in cancer during pregnancy
Authors: Zagouri Flora , Dedes Nikolaos , Papatheodoridi Alkistis , Liontos Michael , Dimopoulos Meletios Athanasios
Published: December 2020

While pregnancy-related malignancies are quite rare, their incidence is increasing and thus affecting more and more women nowadays. Their management, however, with both chemotherapy and supportive agents remains quite challenging and it seems crucial to define the optimal treatment for this special population. Concerning supportive medication, it is clinically significant to determine whether commonly used agents, including Granulocyte Colony-Stimulating Factors, Erythropoiesis-stimulating agents, Bisphosphonates, Anticoagulation agents, Antiemetics and Glucocorticoids are indeed effective in ameliorating chemotherapy side effects. Meanwhile, it is of great importance that the administration of any of these agents is safe for both mother and fetus. This review aims to provide a précis of the current literature regarding both safety and efficacy of all categories of supportive medication during pregnancy.