bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical outcomes of hysterectomy for endometriosis: Benefits of a minimally invasive approach
Authors: Mutter Olga , Ackroyd Sarah , Taylor George A , Diaz Juan
Published: January 2021

Introduction:

We aimed to evaluate surgical outcomes of hysterectomy for endometriosis performed by general obstetricians and gynecologists (OB/GYNs) based on surgical approach.

Methods:

Using the 2016–2018 National Surgical Quality Improvement Program (NSQIP) database, we examined surgical outcomes including 30-day complication rates based on surgical approach in patients who underwent a hysterectomy for endometriosis by OB/GYNs.

Results:

From 2016 to 2018, 3641 hysterectomies were performed by OB/GYNs for endometriosis. 86.0% were performed via a minimally invasive (MIS) approach, with 2882 (79.2%) via a laparoscopic and 247 (6.8%) via a vaginal approach. Compared to MIS hysterectomies, those who underwent an abdominal hysterectomy included a higher proportion of African American and a lower proportion of non-Hispanic white patients, had heavier uteri, lower parity, and were more likely obese (all p < 0.05). There were no differences in age, American Society of Anesthesiologists class, comorbidities other than obesity, or a history of prior abdominal or pelvic surgery (all p > 0.05). Women undergoing hysterectomy for endometriosis experienced an overall 9.8% complication rate. Compared to abdominal approaches, MIS had a lower rate of overall complications (8.5% vs 17.8%) including wound (2.7% vs 7.2%) and major (4.4% vs 8.8%) complications (all p < 0.001). MIS had shorter operative time (129.2 ± 60.9 vs 143.8 ± 71.9), shorter length of stay (0.9 ± 1.6 vs 2.4 ± 1.8), and fewer readmissions (2.8% vs 5.5%) (all p < 0.001).

Conclusion:

While hysterectomy for endometriosis is a challenging procedure to perform, OB/GYNs are performing this procedure predominantly via a minimally invasive approach with fewer complications and more favorable surgical outcomes than an abdominal approach.
Mapping of the Inferior Glenohumeral Ligament for Suture Pullout Strength: A Biomechanical Analysis
Authors: Raniga Sumit , Cadman Joseph , Dabirrahmani Danè , Bui David , Appleyard Richard , Bokor Desmond
Published: January 2021

Background:

Suture pullout during rehabilitation may result in loss of tension in the inferior glenohumeral ligament (IGHL) and contribute to recurrent instability after capsular plication, performed with or without labral repair. To date, the suture pullout strength in the IGHL is not well-documented. This may contribute to recurrent instability.

Purpose/Hypothesis:

A cadaveric biomechanical study was designed to investigate the suture pullout strength of sutures in the IGHL. We hypothesized that there would be no significant variability of suture pullout strength between specimens and zones. Additionally, we sought to determine the impact of early mobilization on sutures in the IGHL at time zero. We hypothesized that capsular plication sutures would fail under low load.

Study Design:

Descriptive laboratory study.

Methods:

Seven fresh-frozen cadaveric shoulders were dissected to isolate the IGHL complex, which was then divided into 18 zones. Sutures in these zones were attached to a linear actuator, and the resistance to suture pullout was recorded. A suture pullout strength map of the IGHL was constructed. These loads were used to calculate the load applied at the hand that would initiate suture pullout in the IGHL.

Results:

Mean suture pullout strength for all specimens was 61.6 ± 26.1 N. The maximum load found to cause suture pullout through tissue was found to be low, regardless of zone of the IGHL. Calculations suggest that an external rotation force applied to the hand of only 9.6 N may be sufficient to tear capsular sutures at time zero.

Conclusion:

This study did not provide clear evidence of desirable locations for fixation in the IGHL. However, given the low magnitude of failure loads, the results suggest the timetable for initiation of range-of-motion exercises should be reconsidered to prevent suture pullout through the IGHL.

Clinical Relevance:

From this biomechanical study, the magnitude of force required to cause suture pullout through the IGHL is met or surpassed by normal postoperative early range-of-motion protocols.
On Track or Derailed? Race, Advanced Math, and the Transition to High School
Authors: Irizarry Yasmiyn
Published: January 2021

Recent scholarship has examined how accelerated math trajectories leading to calculus take shape during middle school. The focus of this study is on advanced math course taking during the critical yet understudied period that follows: the transition to high school. Data from the High School Longitudinal Study of 2009 are used to examine advanced math course taking in ninth grade, including both track persistence among students who took advanced math in middle school and upward mobility among students who took standard math in middle school. Results reveal sizable racial gaps in the likelihood of staying on (and getting on) the accelerated math track, neither of which are fully explained by prior academic performance factors. Interactions with parents and teachers positively predict advanced math course taking. In some cases, interactions with teachers may also reduce inequality in track persistence, whereas interactions with counselors increase such inequality. Implications for research and policy are discussed.
Reading Remarks on the Foundations of Mathematics in Times of COVID-19: Remarks on the Relationship Between Mathematics and Society
Authors: Malviya Saumya
Published: January 2021

The crisis, following the spread of the COVID-19 pandemic across the globe, has been unprecedented in terms of the extent to which it has been mathematised, such that both our understanding of it and responses to it have been largely guided by mathematical or epidemiological models. Mathematical certainties seem to have provided a reliable guide for action and anticipation in the midst of looming uncertainties unleashed by the spread of the virus. States, too, have mostly relied on mathematical projection to dole out policies for precaution and control, as the strange ‘fix’ between prevailing uncertainties and mathematical certainties, has provided the rationale for acting urgently and, literally, imposingly. Instead of attending to the fragility and diversity of human worlds mathematics of the pandemic has produced sweeping, but, ‘critical sounding’ generalisations and governments, world-over, have been too ready to act on their behest, often to the great detriment of the working poor and marginalised sections of society. This article offers a critical evaluation of this ‘fix’ and more generally of the mathematics of the pandemic with the help of Ludwig Wittgenstein’s Remarks on the Foundations of Mathematics. The argument is that in the absence of a proper appreciation of the sociality of mathematics we create certain pictures of the mathematical, with very concrete consequences at the level of policy and implementation, which demean and dehumanise instead of helping us out in times of need and despair. A case is made for a mathematics which is more sensitive to our vulnerabilities, desires and capabilities, as an alternative to solutionism which has come to dominate our life with and in crisis.
A case of recalcitrant linear morphea responding to subcutaneous abatacept
Authors: Talia Jordan , Bitar Carole , Wang Yue , Whitfield Michael L , Khanna Dinesh
Published: January 2021

Introduction:

Linear morphea is an inflammatory condition that is often treated with systemic glucocorticoids and methotrexate, with mycophenolate mofetil being used as an alternative agent. However, there are few published reports on beneficial effect of abatacept for refractory disease. We present a case of a woman in her 30s who presented with linear morphea on her scalp, with a notable response following the addition of subcutaneous abatacept.

Methods:

Computational analysis was performed comparing the immune cell scores of skin biopsies from five morphea skin biopsies from three additional unique patients and 15 healthy control skin biopsies. Value of p < 0.05 was considered statistically significant.

Results:

Immune cell scores demonstrated a statistically significant enrichment of activated CD4 memory T cells, M1 macrophages, monocytes, and memory B cells comparing skin biopsies of morphea versus healthy controls (p < 0.05 for all).

Discussion:

Abatacept may be considered for recalcitrant cases of morphea. Our computational analysis supports a well-designed study is needed to assess abatacept as first-line therapy.
Re-evaluating inclusion criteria for autologous hematopoietic stem cell transplantation in advanced systemic sclerosis: Three successful cases and review of the literature
Authors: Shah Ankoor , Spierings J , van Laar JM , Sullivan Keith M
Published: January 2021

Systemic sclerosis is a chronic autoimmune disease with a poor prognosis, particularly when a patient has rapidly progressive skin or pulmonary involvement. Autologous hematopoietic stem cell transplant is an emerging treatment for this condition, that has been demonstrated to be more effective than immunosuppressants. Careful selection of patients has reduced the transplant-related mortality and maximized the likelihood of benefit. In this report, we present three cases of successful autologous hematopoietic stem cell transplant in patients who would not have met inclusion criteria for entrance into the completed hematopoietic stem cell transplant. After >18 months of follow-up, three patients had clinically significant benefit in terms of skin tightening and pulmonary function tests. Future studies of hematopoietic stem cell transplant in systemic sclerosis may aim to carefully liberalize inclusion criteria to include patients who may not have otherwise been treated while still maintaining an acceptable safety profile.
Spatial sensitivity analysis for urban hotspots using cell phone traces
Authors: Wu Jiahui , Frias-Martinez Enrique , Frias-Martinez Vanessa
Published: January 2021

Urban hotspots can be used to model the structure of urban environments and to study or predict various aspects of urban life. An increasing interest in the analysis of urban hotspots has been triggered by the emergence of pervasive technologies that produce massive amounts of spatio-temporal data including cell phone traces (or Call Detail Records). Although hotspot analyses using cell phone traces are extensive, there is no consensus among researchers about the process followed to compute them in terms of four important methodological choices: city boundaries, spatial units, interpolation methods, and hotspot variables. Using a large-scale CDR dataset from Mexico, we provide an interpretable systematic spatial sensitivity analysis of the impact that these methodological choices might have on the stability of the hotspot variables in both static and dynamic settings.
Cross‐reactivity in Skin Prick Test Results of Members Within Pooideae Subfamily
Authors: Harding Brette C. , Kinealy Brian P. , Franzese Christine B.
Published: January 2021

Objective

Molecular similarities of grass pollen antigens have led to the view that cross‐reactivity exists within members of the Pooideae subfamily of grasses. This has resulted in testing for only the most antigenically representative member of Pooideae, Timothy grass (Phleum pratense), despite little literature to support the claim that Phleum is the most representative member or that in vitro cross‐reactivity correlates with in vivo cross‐reactivity. The aim of the study was to determine if patients with allergic rhinitis symptoms and positive skin prick test results to meadow fescue (Festuca pratensis) also have positive results to Timothy grass.

Study Design

Retrospective cross‐sectional study.

Setting

Tertiary care center in middle Missouri.

Methods

A retrospective chart review identified patients ≥12 years old with a diagnosis of allergic rhinitis who underwent skin prick testing between March 2016 and July 2018, by using a search with CPT code 95004 (Current Procedural Terminology). Positive skin prick test results were based on wheal produced ≥3 mm than the negative control.

Results

After review of 2182 charts, 1587 patients met criteria to test for Phleum and Festuca. In total, 1239 patients had a positive result for Phleum or Festuca. Of these, 479 (38.6%) tested positive for Festuca alone, while 342 (27.6%) and 418 (33.7%) tested positive for Phleum alone and Phleum+Festuca, respectively.

Conclusion

Clinical cross‐reactivity among Pooideae members may not be as complete as traditionally thought. P pratense may not be the most antigenically representative subfamily member, and other grasses may need to be included in skin prick testing.
Four-year outcomes of intravitreal aflibercept treatment for neovascular age-related macular degeneration using a treat-and-extend regimen in Japanese patients
Authors: Ishibashi Koki , Haruta Masatoshi , Ishibashi Yumi , Noda Rie , Dake Shotaro , Yoshida Shigeo
Published: January 2021

Objective:

The purpose of our study was to determine the 4-year visual and anatomic outcomes of intravitreal aflibercept treatment for neovascular age-related macular degeneration (AMD) using a treat-and-extend (TAE) regimen.

Methods:

We retrospectively reviewed the medical records of 39 patients with neovascular AMD who were treated continuously with intravitreal aflibercept injections using the TAE regimen for at least 4 years. The outcome measures were the best-corrected visual acuity (BCVA) and central macular thickness (CMT) on spectral-domain optical coherence tomography. The BCVAs were measured as decimal values and converted to the corresponding Early Treatment Diabetic Retinopathy Study (ETDRS) letter scores for statistical analysis. The Wilcoxon signed-rank test was used to compare the differences in BCVAs and CMTs.

Results:

The mean ETDRS letter scores improved significantly from 63.9 at baseline to 70.4, 67.8, 67.2, and 67.3 at 1, 2, 3, and 4 years, respectively. The mean baseline CMT was 380 µm, which decreased significantly to 229, 231, 221, and 210 µm at 1, 2, 3, and 4 years, respectively. The mean numbers of injections were 7.9, 6.0, 5.5, and 5.4 at 1, 2, 3, and 4 years, respectively. The percentages of patients with a treatment interval of 12 weeks or more were 46.2%, 46.2%, 43.6%, and 46.2% at 1, 2, 3, and 4 years, respectively. At year 4, 30.8% of the patients had a treatment interval of 7 weeks or less, whereas 25.6% had 16 weeks or more.

Conclusion:

Intravitreal aflibercept TAE treatment may be an effective and efficient method for treating patients with neovascular AMD up to 4 years of follow-up. The TAE regimen is a potential tool to optimize appropriate treatment intervals, avoiding both undertreatment and overtreatment of neovascular AMD.
Rocking response of liquid-filled cylindrical tanks
Authors: Mir Faizan Ul Haq , Yu Ching-Ching , Whittaker Andrew S.
Published: January 2021

The hydrodynamic response of liquid-filled storage tanks subjected to translational earthquake shaking has been the focus of studies for more than 75 years. In service, tanks experience six components of seismic input, with rocking due to support flexibility and/or rotational components of ground motion. Published theory for predicting hydrodynamic responses in rigid cylindrical tanks due to rotational seismic input is examined. Analytical solutions for pressure in the fluid and on the tank wall, and base moment are modified to account for the effects of angular displacements at the base. A finite element model of a water-filled cylindrical tank using the Arbitrary Lagrangian and Eulerian (ALE) solver in LS-DYNA is used to demonstrate the efficacy of the proposed expressions for three base rocking motions. Results from the modified analytical solutions and the finite element model are in excellent agreement.
Tumor interferon signaling and suppressive myeloid cells are associated with CAR T-cell failure in large B-cell lymphoma
Authors: Jain Michael D. , Zhao Hua , Wang Xuefeng , Atkins Reginald , Menges Meghan , Reid Kayla , Spitler Kristen , Faramand Rawan , Bachmeier Christina , Dean Erin A. , Cao Biwei , Chavez Julio C. , Shah Bijal , Lazaryan Aleksandr , Nishihori Taiga , Hussaini Mohammed , Gonzalez Ricardo J. , Mullinax John E. , Rodriguez Paulo C. , Conejo-Garcia Jose R. , Anasetti Claudio , Davila Marco L. , Locke Frederick L.
Published: January 2021

Axicabtagene ciloleucel (axi-cel) is a chimeric antigen receptor (CAR) T-cell therapy for relapsed or refractory large B-cell lymphoma (LBCL). This study evaluated whether immune dysregulation, present before CAR T-cell therapy, was associated with treatment failure. Tumor expression of interferon (IFN) signaling, high blood levels of monocytic myeloid-derived suppressor cells (M-MDSCs), and high blood interleukin-6 and ferritin levels were each associated with a lack of durable response. Similar to other cancers, we found that in LBCL tumors, IFN signaling is associated with the expression of multiple checkpoint ligands, including programmed cell death–ligand 1, and these were higher in patients who lacked durable responses to CAR-T therapy. Moreover, tumor IFN signaling and blood M-MDSCs associated with decreased axi-cel expansion. Finally, patients with high tumor burden had higher immune dysregulation with increased serum inflammatory markers and tumor IFN signaling. These data support that immune dysregulation in LBCL promotes axi-cel resistance via multiple mechanistic programs: insufficient axi-cel expansion associated with both circulating M-MDSC and tumor IFN signaling, which also gives rise to expression of immune checkpoint ligands.
Accucopy: accurate and fast inference of allele-specific copy number alterations from low-coverage low-purity tumor sequencing data
Authors: Fan Xinping , Luo Guanghao , Huang Yu S.
Published: January 2021

Background

Copy number alterations (CNAs), due to their large impact on the genome, have been an important contributing factor to oncogenesis and metastasis. Detecting genomic alterations from the shallow-sequencing data of a low-purity tumor sample remains a challenging task.

Results

We introduce Accucopy, a method to infer total copy numbers (TCNs) and allele-specific copy numbers (ASCNs) from challenging low-purity and low-coverage tumor samples. Accucopy adopts many robust statistical techniques such as kernel smoothing of coverage differentiation information to discern signals from noise and combines ideas from time-series analysis and the signal-processing field to derive a range of estimates for the period in a histogram of coverage differentiation information. Statistical learning models such as the tiered Gaussian mixture model, the expectation–maximization algorithm, and sparse Bayesian learning were customized and built into the model. Accucopy is implemented in C++ /Rust, packaged in a docker image, and supports non-human samples, more at http://www.yfish.org/software/.

Conclusions

We describe Accucopy, a method that can predict both TCNs and ASCNs from low-coverage low-purity tumor sequencing data. Through comparative analyses in both simulated and real-sequencing samples, we demonstrate that Accucopy is more accurate than Sclust, ABSOLUTE, and Sequenza.
Multi-trait GWAS using imputed high-density genotypes from whole-genome sequencing identifies genes associated with body traits in Nile tilapia
Authors: Yoshida Grazyella M. , Yáñez José M.
Published: January 2021

Background

Body traits are generally controlled by several genes in vertebrates (i.e. polygenes), which in turn make them difficult to identify through association mapping. Increasing the power of association studies by combining approaches such as genotype imputation and multi-trait analysis improves the ability to detect quantitative trait loci associated with polygenic traits, such as body traits.

Results

A multi-trait genome-wide association study (mtGWAS) was performed to identify quantitative trait loci (QTL) and genes associated with body traits in Nile tilapia (Oreochromis niloticus) using genotypes imputed to whole-genome sequences (WGS). To increase the statistical power of mtGWAS for the detection of genetic associations, summary statistics from single-trait genome-wide association studies (stGWAS) for eight different body traits recorded in 1309 animals were used. The mtGWAS increased the statistical power from the original sample size from 13 to 44%, depending on the trait analyzed. The better resolution of the WGS data, combined with the increased power of the mtGWAS approach, allowed the detection of significant markers which were not previously found in the stGWAS. Some of the lead single nucleotide polymorphisms (SNPs) were found within important functional candidate genes previously associated with growth-related traits in other terrestrial species. For instance, we identified SNP within the α1,6-fucosyltransferase (FUT8), solute carrier family 4 member 2 (SLC4A2), A disintegrin and metalloproteinase with thrombospondin motifs 9 (ADAMTS9) and heart development protein with EGF like domains 1 (HEG1) genes, which have been associated with average daily gain in sheep, osteopetrosis in cattle, chest size in goats, and growth and meat quality in sheep, respectively.

Conclusions

The high-resolution mtGWAS presented here allowed the identification of significant SNPs, linked to strong functional candidate genes, associated with body traits in Nile tilapia. These results provide further insights about the genetic variants and genes underlying body trait variation in cichlid fish with high accuracy and strong statistical support.
Post-status epilepticus treatment with the Fyn inhibitor, saracatinib, improves cognitive function in mice
Authors: Luo Xin-Ming , Zhao Jing , Wu Wen-Yue , Fu Jie , Li Zheng-Yu , Zhang Ming , Lu Jie
Published: January 2021

Background

Status epilepticus (SE) is a life-threatening neurological disorder. The hippocampus, as an important area of the brain that regulates cognitive function, is usually damaged after SE, and cognitive deficits often result from hippocampal neurons lost after SE. Fyn, a non-receptor Src family of tyrosine kinases, is potentially associated with the onset of seizure. Saracatinib, a Fyn inhibitor, suppresses epileptogenesis and reduces epileptiform spikes. However, whether saracatinib inhibits cognitive deficits after SE is still unknown.

Methods

In the present study, a pilocarpine-induced SE mouse model was used to answer this question by using the Morris water maze and normal object recognition behavioral tests.

Results

We found that saracatinib inhibited the loss in cognitive function following SE. Furthermore, we found that the number of hippocampal neurons in the saracatinib treatment group was increased, when compared to the SE group.

Conclusions

These results showed that saracatinib can improve cognitive functions by reducing the loss of hippocampal neurons after SE, suggesting that Fyn dysfunction is involved in cognitive deficits after SE, and that the inhibition of Fyn is a possible treatment to improve cognitive function in SE patients.
Effect of chlorophyll biosynthesis-related genes on the leaf color in Hosta (Hosta plantaginea Aschers) and tobacco (Nicotiana tabacum L.)
Authors: Zhang Jingying , Sui Changhai , Liu Huimin , Chen Jinjiao , Han Zhilin , Yan Qian , Liu Shuying , Liu Hongzhang
Published: January 2021

Background

‘Regal Splendour’ (Hosta variety) is famous for its multi-color leaves, which are useful resources for exploring chloroplast development and color changes. The expressions of chlorophyll biosynthesis-related genes (HrHEMA, HrPOR and HrCAO) in Hosta have been demonstrated to be associated with leaf color. Herein, we isolated, sequenced, and analyzed HrHEMA, HrPOR and HrCAO genes. Subcellular localization was also performed to determine the location of the corresponding enzymes. After plasmid construction, virus-induced gene silencing (VIGS) was carried out to reduce the expressions of those genes. In addition, HrHEMA-, HrPOR- and HrCAO-overexpressing tobacco plants were made to verify the genes function. Changes of transgenic tobacco were recorded under 2000 lx, 6000 lx and 10,000 lx light intensity. Additionally, the contents of enzyme 5-aminolevulinic acid (5-ALA), porphobilinogen (PBG), chlorophyll a and b (Chla and Chlb), carotenoid (Cxc), superoxide dismutase (SOD), peroxidase (POD), malondialdehyde (MDA), proline (Pro) and catalase (CAT) under different light intensities were evaluated.

Results

The silencing of HrHEMA, HrPOR and HrCAO genes can induce leaf yellowing and chloroplast structure changes in Hosta. Specifically, leaves of Hosta with HrCAO silencing were the most affected, while those with HrPOR silencing were the least affected. Moreover, all three genes in tobacco were highly expressed, whereas no expression was detected in wild-type (WT). However, the sensitivities of the three genes to different light intensities were different. The highest expression level of HrHEMA and HrPOR was detected under 10,000 lx of illumination, while HrCAO showed the highest expression level under 6000 lx. Lastly, the 5-ALA, Chla, Cxc, SOD, POD, MDA, Pro and CAT contents in different transgenic tobaccos changed significantly under different light intensities.

Conclusion

The overexpression of these three genes in tobacco enhanced photosynthesis by accumulating chlorophyll content, but the influential level varied under different light intensities. Furthermore, HrHEMA-, HrPOR- and HrCAO- overexpressing in tobacco can enhance the antioxidant capacity of plants to cope with stress under higher light intensity. However, under lower light intensity, the antioxidant capacity was declined in HrHEMA-, HrPOR- and HrCAO- overexpressing tobaccos.
Pregnant women’s well-being and worry during the COVID-19 pandemic: a cross-sectional study
Authors: Mortazavi Forough , Mehrabadi Maryam , KiaeeTabar Roya
Published: January 2021

Background

COVID-19 caused some worries among pregnant women. Worries during pregnancy can affect women’s well-being. We investigated worry and well-being and associated factors among pregnant women during the COVID-19 pandemic.

Methods

This descriptive cross-sectional study was conducted on 484 pregnant women using an online questionnaire. Sampling was performed in a period between May 5 and Aug 5, 2020. Inclusion criteria were having a single healthy fetus and having no significant psychological disorder. We collected the data using the Persian versions of the World Health Organization’s Well-Being Index (WHO-5 Well-Being Index) and the Cambridge Worry Scale. We used univariate and multivariate logistic regression analyses to identify predictors of women’s worry and well-being.

Results

The mean total scores of the WHO-5 Well-Being Index and the percentage of WHO-5 score < 50 were 64.9 ± 29.0 and 24.4%, respectively. Predictors of women’s worry are the increased level of fear of COVID-19 (OR = 6.40, p <  0.001), a low family income (OR = 3.41, p <  0.001), employment status (OR = 1.86, p = 0.019), nulliparity (OR = 1.68, p = 0.024), having a COVID-19 infected person among relatives (OR = 2.45, p = 0.036), having a history of abortion (OR = 1.86, p = 0.012), having participated in the study after the first wave of COVID-19 outbreak (OR = 2.328, p = 0.003), and women’s age < 30 year (OR = 2.11, p = 0.002). Predictors of low level of well-being in pregnant women are worry about their own health and relationships (OR = 1.789, p = .017), worry about fetus health (OR = 1.946, p = 0.009), and having at least one infected person with COVID-19 among relatives (OR = 2.135, p = 0.036).

Conclusions

The percentage of women experiencing a low well-being state was relatively high. This result is worthy of attention by health care providers and policy makers. Providing care and support to pregnant women should have high priority during the COVID-19 pandemic.
Risk factors of breast cancer among patients in a tertiary care hospitals in Afghanistan: a case control study
Authors: Baset Zekrullah , Abdul-Ghafar Jamshid , Parpio Yasmin Nadeem , Haidary Ahmed Maseh
Published: January 2021

Background

Breast cancer is the second most common causes of women’s death, worldwide. Data on risk factors associated with female breast cancer in the Afghan population is very limited. The aim of our study was to identifying risk factor associated with female breast cancer in Afghanistan.

Methods

A retrospective case-control study was conducted with inclusion of 201 cases and 201 controls. Patient information was collected by interviewing the patient through a structured questionnaire. Histopathological information was collected from the hospital integrated laboratory management system. The data was analyzed by using logistic regression with univariate and multivariable analyses to determine the association between breast cancer and predictors.

Results

The results of the current study showed that factors such as: age (OR = 1.02; 95%CI: 0.99–1.04; p-0.148); age at menarche (OR = 0.83; 95%CI: 0.72–0.92; p-0.008); age at first baby (OR = 1.14; 95%CI: 1.07–1.20; p- < 0.001); illiteracy (OR = 1.93; 95%CI: 1.16–3.22; p-0.011); smoking (OR = 2.01; 95%CI: 1.01–3.99; p-0.04) and family history of cancer (OR = 1.98; 95%CI: 1.18–3.32; p-0.009) were significantly associated with breast cancer. However, our study did not demonstrate any statistically significant correlation between breast cancer and some of the predictors that were previously highlighted in literature, such as: marital status, Body Mass Index (BMI), use of hormonal contraceptive, breastfeeding and exercise.

Conclusion

Our study demonstrated that age at menarche, and age at first baby birth, illiteracy, smoking and family history of cancer were significant risk factors associated with development of breast cancer among women in Afghanistan. Health education of women regarding aforementioned predisposing factors are therefore, expected to be valuable in decreasing the burden of breast cancer with reduction of its burden on the healthcare system in Afghanistan.
Lasting effects of residential mobility during childhood on psychopathology among Chinese University students
Authors: Zhang Yingzhe , Coid Jeremy , Liu Xiang , Zhang Yamin , Sun Huan , Li Xiaojing , Tang Wanjie , Wang Qiang , Deng Wei , Zhao Liansheng , Ma Xiaohong , Meng Yajing , Li Mingli , Wang Huiyao , Chen Ting , Lv Qiuyue , Guo Wanjun , Li Tao
Published: January 2021

Background

Residential mobility during childhood increases risk of psychopathology in adulthood and is a common experience among Chinese children. This study investigated associations between number and age of first move, etiological risk factors for psychopathology, and common mental disorders in adolescence and early adulthood.

Methods

The sample included 39,531 undergraduates (84.5% completion rate) age 15–34 years in their first year at a Chinese comprehensive university in annual cross-sectional surveys during 2014–2018. Common mental disorders measured using standardised self-report instruments. Data analysed using logistic regression models and interaction analysis.

Results

Half of all students experienced one or more moves of residence before age 15 years. Outcomes of Depression, Somatisation, Obsessive-compulsive disorder, Hallucinations and Delusions, and Suicide attempts showed dose-response relationships with increasing number of moves. Other etiological risk factors, including childhood disadvantage and maltreatment, showed similar dose response relationships but did not confound associations with mobility. We found interactions between reporting any move and being a left-behind child on depression and somatisation; number of moves and younger age at first move on depression, somatisation, suicide attempts and hallucinations and delusions.

Conclusions

Residential mobility in childhood is associated with psychopathology in adulthood and this association increases with increasing number of moves. Mobility is also associated with childhood disadvantage and maltreatment but associations with psychopathology are independent of these factors. Multiplicative effects were shown for multiple moves starting at a younger age and if the participant had been a left-behind child.
Assessment of surveillance core and support functions regarding neglected tropical diseases in Kenya
Authors: Ng’etich Arthur K. S. , Voyi Kuku , Mutero Clifford M.
Published: January 2021

Background

Effective surveillance and response systems are vital to achievement of disease control and elimination goals. Kenya adopted the revised guidelines of the integrated disease surveillance and response system in 2012. Previous assessments of surveillance system core and support functions in Africa are limited to notifiable diseases with minimal attention given to neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). The study aimed to assess surveillance system core and support functions relating to PC-NTDs in Kenya.

Methods

A mixed method cross-sectional survey was adapted involving 192 health facility workers, 50 community-level health workers and 44 sub-national level health personnel. Data was collected using modified World Health Organization generic questionnaires, observation checklists and interview schedules. Descriptive summaries, tests of associations using Pearson’s Chi-square or Fisher’s exact tests and mixed effects regression models were used to analyse quantitative data. Qualitative data derived from interviews with study participants were coded and analysed thematically.

Results

Surveillance core and support functions in relation to PC-NTDs were assessed in comparison to an indicator performance target of 80%. Optimal performance reported on specimen handling (84%; 100%), reports submission (100%; 100%) and data analysis (84%; 80%) at the sub-county and county levels respectively. Facilities achieved the threshold on reports submission (84%), reporting deadlines (88%) and feedback (80%). However, low performance reported on case definitions availability (60%), case registers (19%), functional laboratories (52%) and data analysis (58%). Having well-equipped laboratories (3.07, 95% CI: 1.36, 6.94), PC-NTDs provision in reporting forms (3.20, 95% CI: 1.44, 7.10) and surveillance training (4.15, 95% CI: 2.30, 7.48) were associated with higher odds of functional surveillance systems. Challenges facing surveillance activities implementation revealed through qualitative data were in relation to surveillance guidelines and reporting tools, data analysis, feedback, supervisory activities, training and resource provision.

Conclusion

There was evidence of low-performing surveillance functions regarding PC-NTDs especially at the peripheral surveillance levels. Case detection, registration and confirmation, reporting, data analysis and feedback performed sub-optimally at the facility and community levels. Additionally, support functions including standards and guidelines, supervision, training and resources were particularly weak at the sub-national level. Improved PC-NTDs surveillance performance sub-nationally requires strengthened capacities.
Peer victimisation during adolescence and its impact on wellbeing in adulthood: a prospective cohort study
Authors: Armitage Jessica M. , Wang R. Adele H. , Davis Oliver S. P. , Bowes Lucy , Haworth Claire M. A.
Published: January 2021

Background

Peer victimisation is a common occurrence and has well-established links with a range of psychiatric problems in adulthood. Significantly less is known however, about how victimisation influences positive aspects of mental health such as wellbeing. The purpose of this study was therefore to assess for the first time, whether peer victimisation in adolescence is associated with adult wellbeing. We aimed to understand whether individuals who avoid a diagnosis of depression after victimisation, maintain good wellbeing in later life, and therefore display resilience.

Methods

Longitudinal data was taken from the Avon Longitudinal Study of Parents and Children, a prospective cohort study based in the UK. Peer victimisation was assessed at 13 years using a modified version of the bullying and friendship interview schedule, and wellbeing at age 23 using the Warwick-Edinburgh Mental Well-Being Scale. The presence or absence of depression was diagnosed using the Clinical Interview Schedule–Revised at 18 years. A series of logistic and linear regression analyses were used to explore relationships between peer victimisation, depression, and wellbeing, adjusting for potentially confounding individual and family factors.

Results

Just over 15% of victims of frequent bullying had a diagnosis of depression at age 18. Victimisation also had a significant impact on wellbeing, with a one-point increase in frequent victimisation associated with a 2.71-point (SE = 0.46, p < 0.001) decrease in wellbeing scores aged 23. This finding remained after adjustment for the mediating and moderating effects of depression, suggesting that the burden of victimisation extends beyond depression to impact wellbeing. Results therefore show that individuals who remain partially resilient by avoiding a diagnosis of depression after victimisation have significantly poorer wellbeing than their non-victimised counterparts.

Conclusion

Overall, our study demonstrates for the first time that victimisation during adolescence is a significant risk factor for not only the onset of depression, but also poor wellbeing in adulthood. Such findings highlight the importance of investigating both dimensions of mental health to understand the true burden of victimisation and subsequent resilience. In addition to the need for interventions that reduce the likelihood of depression following adolescent victimisation, efforts should also be made to promote good wellbeing.
Reflective practice and transcultural psychiatry peer e-learning between Somaliland and the UK: a qualitative evaluation
Authors: Prosser Mia , Stephenson Thomas , Mathur Jai , Enayati Hanieh , Kadie Abdirasak , Abdi Manal Mohamed , Handuleh Jibril I. M. , Keynejad Roxanne C.
Published: January 2021

Background

Reflective practice is a key skill for healthcare professionals. E-learning programmes have the potential to develop reflective practice in remote settings and low- and middle-income countries (LMICs), where access to in-person reflective groups may be reduced. ‘Aqoon’ is a global mental health peer-to-peer e-learning programme between Somaliland and UK medical students. We aimed to explore participants’ experiences of participating in the Aqoon programme, including their experiences of reflective practice.

Methods

Thirty-three medical students (22 Somaliland, 11 UK) enrolled in Aqoon. We matched volunteer learners in trios, to meet online to discuss anonymised clinical cases relevant to chapters of the World Health Organization’s mental health gap action programme (mhGAP) intervention guide. We conducted thematic analysis of learners’ reflective writing and post-programme focus group transcripts.

Results

Twenty-four students (73%) attended at least three online discussions (14 Somaliland, 10 UK). Somaliland and UK students described improved reflective skills and greater recognition of stigma towards mental ill-health. Themes included gaining memorable insights from peer discussions which would impact their medical education. UK students emphasised improved cultural understanding of common psychiatric presentations whilst Somaliland students reflected on increased clinical confidence.

Discussion

Integrating reflective practice into Aqoon showed the potential for low-cost e-learning interventions to develop cross-cultural reflective practice among medical students in diverse settings.
Targeting AURKA in Cancer: molecular mechanisms and opportunities for Cancer therapy
Authors: Du Ruijuan , Huang Chuntian , Liu Kangdong , Li Xiang , Dong Zigang
Published: January 2021

Aurora kinase A (AURKA) belongs to the family of serine/threonine kinases, whose activation is necessary for cell division processes via regulation of mitosis. AURKA shows significantly higher expression in cancer tissues than in normal control tissues for multiple tumor types according to the TCGA database. Activation of AURKA has been demonstrated to play an important role in a wide range of cancers, and numerous AURKA substrates have been identified. AURKA-mediated phosphorylation can regulate the functions of AURKA substrates, some of which are mitosis regulators, tumor suppressors or oncogenes. In addition, enrichment of AURKA-interacting proteins with KEGG pathway and GO analysis have demonstrated that these proteins are involved in classic oncogenic pathways. All of this evidence favors the idea of AURKA as a target for cancer therapy, and some small molecules targeting AURKA have been discovered. These AURKA inhibitors (AKIs) have been tested in preclinical studies, and some of them have been subjected to clinical trials as monotherapies or in combination with classic chemotherapy or other targeted therapies.
Procalcitonin expression in patients with large cell neuroendocrine carcinoma of the lung
Authors: Itoga Masamichi , Tanaka Hisashi , Taima Kageaki , Ishioka Yoshiko , Sakamoto Hiroaki , Takanashi Shingo , Kurose Akira , Tasaka Sadatomo
Published: January 2021

Objective

Procalcitonin (PCT) has received much attention as a serum marker for bacterial infection. Elevated serum PCT is occasionally seen in severe trauma, heatstroke, and neoplastic diseases, including lung cancer with neuroendocrine component.

Results

In the present study, we evaluated PCT expression in the specimen of pulmonary neuroendocrine tumors, comparing large cell neuroendocrine carcinoma (LCNEC), carcinoid, and small cell lung carcinoma (SCLC). Pathological specimens of 10 LCNEC, 4 carcinoid, and 7 SCLC cases were evaluated with immunochemical staining of PCT. Clinical characteristics and serum levels of PCT and C-reactive protein were also evaluated. We observed positive PCT expression in 5 (50%) LCNEC and 2 (50%) carcinoid specimens that were surgically resected. Whereas serum PCT levels were not elevated in patients with PCT-positive carcinoid, two out of three LCNEC patients with high PCT expression in the tumor had elevated serum PCT levels that reflected disease progression. In patients with SCLC, PCT was not detected in the tumor or serum. This is the first immunohistochemical study of the PCT expression in the lung tumor specimens. We concluded that, in patients with LCNEC, high serum PCT levels may be indicative of disease activity and serve as a biomarker.
Steganographic visual story with mutual-perceived joint attention
Authors: Guo Yanyang , Wu Hanzhou , Zhang Xinpeng
Published: January 2021

Social media plays an increasingly important role in providing information and social support to users. Due to the easy dissemination of content, as well as difficulty to track on the social network, we are motivated to study the way of concealing sensitive messages in this channel with high confidentiality. In this paper, we design a steganographic visual stories generation model that enables users to automatically post stego status on social media without any direct user intervention and use the mutual-perceived joint attention (MPJA) to maintain the imperceptibility of stego text. We demonstrate our approach on the visual storytelling (VIST) dataset and show that it yields high-quality steganographic texts. Since the proposed work realizes steganography by auto-generating visual story using deep learning, it enables us to move steganography to the real-world online social networks with intelligent steganographic bots.
Eprenetapopt (APR-246) and Azacitidine in TP53-Mutant Myelodysplastic Syndromes
Authors: Sallman David A. , DeZern Amy E. , Garcia-Manero Guillermo , Steensma David P. , Roboz Gail J. , Sekeres Mikkael A. , Cluzeau Thomas , Sweet Kendra L. , McLemore Amy , McGraw Kathy L. , Puskas John , Zhang Ling , Yao Jiqiang , Mo Qianxing , Nardelli Lisa , Al Ali Najla H. , Padron Eric , Korbel Greg , Attar Eyal C. , Kantarjian Hagop M. , Lancet Jeffrey E. , Fenaux Pierre , List Alan F. , Komrokji Rami S.
Published: January 2021

PURPOSE

Approximately 20% of patients with TP53-mutant myelodysplastic syndromes (MDS) achieve complete remission (CR) with hypomethylating agents. Eprenetapopt (APR-246) is a novel, first-in-class, small molecule that restores wild-type p53 functions in TP53-mutant cells.

METHODS

This was a phase Ib/II study to determine the safety, recommended phase II dose, and efficacy of eprenetapopt administered in combination with azacitidine in patients with TP53-mutant MDS or acute myeloid leukemia (AML) with 20%-30% marrow blasts (ClinicalTrials.gov identifier: NCT03072043 ).

RESULTS

Fifty-five patients (40 MDS, 11 AML, and four MDS/myeloproliferative neoplasms) with at least one TP53 mutation were treated. The overall response rate was 71% with 44% achieving CR. Of patients with MDS, 73% (n = 29) responded with 50% (n = 20) achieving CR and 58% (23/40) a cytogenetic response. The overall response rate and CR rate for patients with AML was 64% (n = 7) and 36% (n = 4), respectively. Patients with only TP53 mutations by next-generation sequencing had higher rates of CR (69% v 25%; P = .006). Responding patients had significant reductions in TP53 variant allele frequency and p53 expression by immunohistochemistry, with 21 (38%) achieving complete molecular remission (variant allele frequency < 5%). Median overall survival was 10.8 months with significant improvement in responding versus nonresponding patients by landmark analysis (14.6 v 7.5 months; P = .0005). Overall, 19/55 (35%) patients underwent allogeneic hematopoietic stem-cell transplant, with a median overall survival of 14.7 months. Adverse events were similar to those reported for azacitidine or eprenetapopt monotherapy, with the most common grade ≥ 3 adverse events being febrile neutropenia (33%), leukopenia (29%), and neutropenia (29%).

CONCLUSION

Combination treatment with eprenetapopt and azacitidine is well-tolerated yielding high rates of clinical response and molecular remissions in patients with TP53-mutant MDS and oligoblastic AML.