bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of CXCL10 in prognosis of patients with colon cancer and tumor microenvironment remodeling
Authors: Song Weiwei , Yin Hongli , Han Chenguang , Mao Qiantai , Tang Jing , Ji Zhaoshuai , Yan Xu , Wang Lan , Liu Shengnan , Ai Chao
Published: September 2021

Backgroung:

Tumor microenvironment (TME) has gradually emerged as an important research topic in the fight against cancer. The immune system is a major contributing factor in TME, and investigations have revealed that tumors are partially infiltrated with numerous immune cell subsets.

Method:

We obtained transcriptome RNA-seq data from the the Cancer Genome Atlas databases for 521 patients with colon adenocarcinoma (COAD). ESTIMATE algorithms are then used to estimate the fraction of stromal and immune cells in COAD samples.

Result:

A total of 1109 stromal-immune score-related differentially expressed genes were identified and used to generate a high-confidence protein–protein interaction network and univariate COX regression analysis. C-X-C motif chemokine 10 (CXCL10) was identified as the core gene by intersection analysis of data from protein–protein interaction network and univariate COX regression analysis. Then, for CXCL10, we performed gene set enrichment analysis, survival analysis and clinical analysis, and we used CIBERSORT algorithms to estimate the proportion of tumor-infiltrating immune cells in COAD samples.

Conclusion:

We discovered that CXCL10 levels could be effective for predicting the prognosis of COAD patients as well as a clue that the status of TME is transitioning from immunological to metabolic activity, which provided additional information for COAD therapies.
Polymorphisms of matrix metalloproteinases affect the susceptibility of esophageal cancer
Authors: Chen Hai , Xu Xianquan , Hua Congshu , Zhang Heng , Jian Junling , Ge Tengfei , Xie Jianfeng , Yu Zaicheng
Published: September 2021

Background:

The results of how matrix metalloproteinases (MMPs) polymorphisms affect esophageal cancer (EC) risk are not consistent, especially for MMP1,2,7 and 9. A meta-analysis focused on the impact of MMPs to digestive cancers, but not a precise analysis to EC, therefore, we designed the current study to make a clear understanding of the association between MMPs polymorphisms and EC.

Methods:

Up to March 2020, we searched several databases to find case-control cohorts concerned about the risk of MMPs polymorphisms to EC risk. Odds ratios with 95% confidence intervals under five genetic models to generate the risk predicted value. The Q test and I
2 statistics are used to estimate heterogeneity. Sensitivity analysis, Egger test, and Begg's funnel plot were employed to assess the results. In-silico analysis was performed to study the association between the polymorphism and mRNA expression.

Results:

19 case-control studies were enrolled, including 8371 EC patients and 12041 health controls. We observed the increased risk in BA vs. AA and BB + BA vs. AA models of MMP1-rs1799750 polymorphism. The protective effectiveness of EC was found in the MMP2 rs243865 polymorphism in B vs. A, BA vs. AA, and BB + BA vs. AA models. Meanwhile, the risk effect was also observed in the MMP7 rs11568818 polymorphism in most genetic models. In the furthermore bioinformatics analysis, we found that MMP1, MMP3, MMP7, MMP9, MMP12, MMP13 all increased in the tumor tissues, and the genetic alteration in the polymorphisms could impact the mRNA expression of the above MMPs.

Conclusion:

MMP1 rs1799705 and MMP7 rs1156818 polymorphisms will take part in the tumorigenesis of EC, while MMP2 rs243865 acts as a protective role to decrease the risk of EC.
Top 100 cited articles on hemodialysis
Authors: Lee Yoo Jin , Heo Chang Min , Park Sihyung , Kim Yang Wook , Park Jin Han , Kim Il Hwan , Ko Junghae , Park Bong Soo
Published: September 2021

Introduction:

This study was conducted to better understand hemodialysis by reviewing the most-cited articles related to it.

Methods:

We searched articles on the Web of Science and selected the 100 most frequently cited articles. Subsequently, we reviewed these articles and identified their characteristics.

Results:

The 100 most frequently cited articles were published in 21 journals. The majority of these papers were published in the following journals: Kidney International (26 articles), New England Journal of Medicine (18 articles), Journal of the American Society of Nephrology (14 articles), and the American Journal of Kidney Disease (13 articles). The 100 most-cited articles were published in 25 countries. The United States of America was the country with the highest number of publications (65 articles). The University of Michigan was the institution with the highest number of articles (14 articles). FK Port was the author with the largest number of publications (13 articles).

Conclusions:

This is the first study in the field of nephrology that provides a list of the 100 most-cited articles on hemodialysis. Through this study, clinicians will be able to recognize major academic interests and research trends in hemodialysis.
Influence of gastric morphology on gastroesophageal reflux in adults
Authors: Cheng She-Meng , Hung Kun-Long , Wang Yu-Jen , Ng Suk-Ping , Chiang Hsin-Fan
Published: September 2021

The study's aim was to determine if there was an association between gastric morphology and gastroesophageal reflux (GER). Few published studies have investigated the relationship between gastric morphology and the risk of GER.

A total of 777 patients were randomly selected from 3000 to 3300 patients who presented at a medical center in Taipei for annual health checkups from early 2008 through to late 2010 and underwent a series of radiographs of the upper gastrointestinal tract (UGI). GER was recorded during the real-time fluoroscopic study. Thirty-nine participants had a follow-up endoscopy, and another 164 participants were followed up by a second UGI series 12 +/ −1.5 months later, from late 2008 through to early 2022. All participants completed a lifestyle and symptom questionnaire. The variables included current smoking and alcohol consumption. Participants who had heartburn and dysphagia were included in the study. Additionally, all participants underwent a limited physical examination which recorded age, sex, body mass index, and total cholesterol and triglyceride levels.

All participants were classified into types 1 to 6 based on the gastric morphology determined from the first UGI. Cascade stomach is recognized by characteristic findings on UGI. Gastric types 2 and 3 tend to appear as cascade stomachs and were significantly associated with GER (P < .05) compared with the other groups. Morphologic type 5 appeared as an elongated sac extending downward into the pelvic cavity and was less likely to develop GER (P < .001). The results of follow-up studies by UGI and endoscopy were similar to those of the first UGI. Gastric morphologic type 2 was significantly associated, and type 5 was usually not associated, with GER and erosive esophagitis (P < .05) compared with the other groups, by both UGI and endoscopy.

Gastric morphologic types 2 and 3, with cascade stomach, might provide a relatively easy method for the development of the GER phenomenon. Gastric morphologic type 5 appeared as an elongated sac that might reduce the incidence of the GER phenomenon. The study suggested that gastric morphologic type could influence the occurrence of GER.
Using a mobile device for margin assessment of specimen mammography in breast-conserving surgery
Authors: Yun Bo La , Jang Mijung , Ahn Hye Shin , Kim Mi Young , Kim Bohyoung , Kim Sun Mi
Published: September 2021

To compare the performance of margin assessment of specimen mammography (SM) in patients with breast-conserving surgery (BCS) on mobile devices and 5-megapixel (5M) thin film transistor liquid crystal display (TFT-LCD) monitors based on the safety margin for pathologic results.

This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. A total of 105 consecutive breast cancer SM samples from 104 women who underwent BCS were included in the study. The SM were independently reviewed by two radiologists using mobile devices and by two additional radiologists using 5M TFT-LCD monitor. Each reader was asked to measure the shortest distance between the lesion and the lesion margin. The interpretation time was recorded. The sensitivity, specificity, and interobserver agreement were analyzed.

In total, 19% (20/105) breast specimens had a positive surgical margin (<1 mm). The mean absolute difference from the pathologic margin was 0.60 ± 0.57 cm and 0.54 ± 0.47 cm using the 5 M TFT-LCD monitor and the mobile device, respectively (without any statistical significance, P = .273). The mean interpretation time was 49.5 and 47.6 s for the 5M TFT-LCD monitor and the mobile device, respectively (P = .012). The pooled sensitivity and specificity were 60% and 74% for 5M TFT-LCD monitor, and 60% and 69% for the mobile device (P = 1.00 and P = .190, respectively). The kappa coefficient indicated moderate agreement for both the displays.

The diagnostic performance for margin assessment of SM in BCS patients on mobile devices and 5M TFT-LCD monitors are showed not statistically difference. The findings of the study provide evidence of the benefit of the mobile device for SM interpretation in patients who underwent BCS. However, a large sample size study is warranted before using a mobile device for margin evaluation on SM.

The mobile device showed comparable diagnostic performance with 5M TFT-LCD monitor in the evaluation of SM margin in patients with BCS and could be used as a display tool for immediate assessment when a dedicated LCD monitor is unavailable.
Predictive value of the monocyte-to-lymphocyte ratio in the diagnosis of prostate cancer
Authors: Xu Zhanping , Zhang Jing , Zhong Yuxiang , Mai Yuan , Huang Danxuan , Wei Wei , Huang Jianhua , Zhao Pengpeng , Lin Fuxiang , Jin Jingmiao
Published: September 2021

It has been reported that inflammation and immune system are related to prostate cancer. The neutrophil-to-lymphocyte ratio (NLR), as well as the platelet-to-lymphocyte ratio (PLR), have already been proposed as new indices to help diagnose prostate cancer (PCa). However, the monocyte-to-lymphocyte ratio (MLR) with regard to PCa has rarely been mentioned.

To investigate the capability of the MLR to predict PCa.

Patients who were pathologically diagnosed with PCa in our hospital and healthy control subjects who conformed to the inclusion criteria were enrolled. Patient data were recorded, including age, complete blood counts, blood biochemistry, and serum prostate-specific antigen (PSA) levels. The differences in these data between the groups were analyzed and the diagnostic value of the MLR was compared with PSA.

Our study included a total of 100 patients with PCa and 103 healthy control subjects. Patients with PCa presented with a significantly higher NLR, MLR, and PLR compared to control subjects. However, the hemoglobin and lymphocyte levels were lower (P < .05) in PCa patients. The area under the curve (AUC) of PSA and ratio of free/total serum prostate-specific antigen were 0.899 (95% confidence interval [CI]: 0.857–0.942) and 0.872 (95% CI: 0.818–0.926), respectively, while the AUC of the MLR was 0.852 (95% CI: 0.798–0.906), which was higher than that of the NLR, PLR, and any other blood parameters. Additionally, the optimal cut-off value of the MLR for PCa was 0.264, with a specificity of 87.4% and a sensitivity of 72.0%. An evaluation of the diagnostic value of MLR + PSA gave an AUC of 0.936 (95% CI: 0.902–0.970). However, the AUC of MLR + PSA + f/tPSA was 0.996 (95% CI: 0.991–1.000). The diagnostic value of MLR + NLR + PSA gave an AUC of 0.945 (95% CI: 0.913–0.977), and the specificity is 0.971.

PSA remains the most important diagnostic indicator. MLR combined with PSA and f/tPSA has the higher predictive value than PSA. It suggests that MLR may be another good predictive indicator of PCa. It can help reduce the clinical false positive rate.
Efficacy and safety of Zhen Wu Decoction against chronic heart failure
Authors: Liang Jian , Tao Xianming , Hu Dabi , Cao Yi
Published: September 2021

Introduction:

Chronic heart failure (CHF) is the end stage of several cardiac diseases. 50% of patients with severe CHF would survive less than 1 year, which has seriously affected patients’ survival and quality of life. The current modern therapy could improve survival and quality of life. However, a larger number of patients still suffer from repeated hospitalization, unsatisfactory efficacy, and many side effects. In China, Zhen Wu Decoction (ZWD), a classic prescription recorded in Treatise on Febrile Diseases, was widely used for CHF. In this study, we try to conduct a prospective, double-blinded, randomized, controlled study to evaluate the efficacy and safety of ZWD in the treatment of CHF patients in China.

Methods:

Patients will be randomly divided into treatment group and control group in 1:1 ratio. Guideline directed medical therapies and ZWD will be provided for patients in treatment group, while guideline directed medical therapies and ZWD-granules simulations for control group. Left ventricular ejection fraction, left ventricular end diastolic diameter, left ventricular end systolic diameter, b-type natriuretic peptide, NT-proBNP, peak VO2, VO2 maximum, exercise time, and walking distance will be recorded. The data will be analyzed by SPSS 22.0.

Conclusions:

The results will evaluate the efficacy and safety of ZWD in the treatment of CHF patients.

Trial registration:

OSF registration number: DOI 10.17605/OSF.IO/G3QNU.
Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation
Authors: Pilichowska-Paszkiet Ewa , Baran Jakub , Kułakowski Piotr , Zaborska Beata
Published: September 2021

Proper selection for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. Echocardiographic assessment of left atrium (LA) is complex and challenging. Speckle tracking echocardiography (STE) with recent standardized LA deformation analysis allows for the quantitative assessment of various LA function parameters. We aimed to assess the value of detailed evaluations of LA function using STE in patients with non-valvular AF without structural heart disease to predict the outcomes after CA for AF. Secondary aim was to analyze the prediction of CA efficacy in patients with normal LA dimension in baseline echocardiography.

We studied with transthoracic and transesophageal echocardiography 82 patients (58% males, mean age 57.3 ± 9.5 years) with non-valvular paroxysmal AF without structural heart disease scheduled for CA. Peak longitudinal LA strain (LAS) and strain rate (LASR) during the reservoir (r), conduit (cd) and contraction (ct) phases were measured by STE before the procedure. Patients were followed for 1 year using serial 4 to 7 day Holter ECG monitoring.

Complete freedom from any AF recurrence was achieved in 44 (54%) patients. All patients had normal left ventricular systolic and diastolic function and 53 (65%) of them had not enlarged LA. In the multivariable logistic regression analysis, global left atrial reservoir strain (LASr) was identified as an independent predictor of CA efficacy (OR [95% CI]: 1.35 [1.17–1.55], P < .0001). The opportunity of CA success was 135 fold higher for each 1% increase in global LASr.

The receiver operating characteristic (ROC) analysis identified global LASr and left atrial conduit strain (LAScd) as the most powerful parameters for predicting of CA outcome with an area under the curve of 0.896 and 0.860, respectively, in the whole study group, and 0.922 and 0.938, respectively, in patients with not enlarged LA.

In patients with paroxysmal AF and normal standard echocardiographic assessment, parameters reflecting LA compliance - reservoir and conduit strain, are independent and strong predictors of CA outcome.
Comparison of accuracy and safety between robot-assisted and conventional fluoroscope assisted placement of pedicle screws in thoracolumbar spine
Authors: Li Chuntao , Li Wenyi , Gao Shangju , Cao Can , Li Changren , He Liang , Ma Xu , Li Meng
Published: September 2021

Objective:

The purpose of this systematic review and meta-analysis is to explore the screw positioning accuracy, complications related to pedicle screw implantation, revision rate and radiation exposure between robot screw placement and traditional fluoroscopic screw placement.

Methods:

We searched several databases, including CNKI, Wanfang database, cqvip datebase, PubMed, Cochrane library and EMBASE, to identify articles that might meet the criteria. Meta-analysis was performed using Revman 5.3 software.

Results:

A total of 13 randomized controlled trial were included. The results showed that the pedicle screw accuracy of the robot assisted group was significantly better than that of the conventional freehand (FH) group (OR = 3.5, 95% confidence interval [CI] [2.75,4.45], P < .0001). There was no significant difference in the complications caused by pedicle screw implantation between the robot-assisted group and the conventional FH group [OR = 0.39, 95%CI (0.10,1.48), P = .17]. The rate of facet joint invasion in the robot-assisted group was significantly lower than that in the conventional FH group (OR = 0.06, 95%CI [0.01,0.29], P = .0006). The revision rate in the robot-assisted group was significantly lower than that in the conventional FH group (OR = 0.19, 95%CI [0.05,0.71], P = 0.0.01). There was no significant difference in the average radiation of pedicle screws implantation between the robot-assisted group and the conventional FH (mean difference = -7.94, 95%CI [-20.18,4.30], P = .20).

Conclusion:

The robot-assisted group was significantly better than the conventional FH in the accuracy of pedicle screw placement and facet joint invasion rate and revision rate. There was no significant difference in the complication and fluoroscopy time between the two groups.
Subcutaneous golimumab induced and maintained clinical response in a child with a biological-experienced steroid-refractory flare of ulcerative colitis
Authors: Alhalabi Marouf , Eddin Kamal Alaa , Cheha Khaled , Abbas Ahmad
Published: September 2021

Introduction:

Golimumab is a fully human antitumor necrosis monoclonal antibody that can be administered by either subcutaneous injection or intravenous infusion. Golimumab is approved for the treatment of the adults with rheumatic diseases, and ulcerative colitis, Whereas in children, golimumab is indicated only for the treatment of active polyarticular juvenile idiopathic arthritis. We have written on the off-label use of subcutaneous golimumab, which helped to induce and maintain remission on a low-weight biologically experienced child with steroid-refractory ulcerative colitis flare.

Patient concerns:

A 13-year-old pancolitis Syrian boy presented with abdominal pain and six to seven times bloody diarrhea. The child had treated with mesalamine 80 mg/kg/day, azathioprine 2.5 mg/kg/day, infliximab with an induction dose of 5 mg/kg at weeks 0, 2, and 6 followed by 5 mg/kg every 8 weeks. Infliximab did not maintain remission as the patient suffered from two flares that required hospital admission, intravenous corticosteroids, and infliximab escalation. Initial tests disclosed leukocytosis, anemia, hypoalbuminemia, an elevation in C-reactive protein and fecal calprotectin. All Stool studies were negative including routine stool cultures, Clostridium difficile toxin, Escherichia coli O157:H7, Cryptosporidium, and microscopy for ova and parasites. A sigmoidoscopy revealed multiple large ulcerations and spontaneous bleeding, colon biopsies were negative for Clostridium difficile and Cytomegalovirus. Cyclosporine, tacrolimus, and adalimumab were unavailable in Syria. Child's parents opposed colectomy as a treatment option.

Diagnosis:

Ulcerative colitis flare.

Interventions:

A subcutaneous golimumab with a loading dose of 200 mg at week 0, followed by 100 mg at week 2, then 50 mg every 4 weeks.

Outcomes:

The patient achieved clinical remission by week sixth and maintained the remission for the next 90 weeks. At the time of last evaluation, tests, including C-reactive protein and fecal calprotectin, were within normal limits, complete colonoscopy revealed erythema, edema, mucosal friability, loss of vascular patterns, and pseudo-polyps. The Pediatric Ulcerative Colitis Activity Index and Mayo scores were 5 and 2 points, respectively. No adverse events were documented.

Conclusion:

Golimumab has shown potential efficacy and safety in the treatment of ulcerative colitis in children which may indicate a significant future role for subcutaneous golimumab in pediatrics ulcerative colitis.
Radiotherapy for a rare phosphaturic mesenchymal tumor in the middle ear presenting with oncogenic osteomalacia
Authors: Takaoka Taiki , Tomita Natsuo , Shido Yoji , Baba Satoshi , Fukushima Mayu , Sugie Chikao , Shibamoto Yuta
Published: September 2021

Rationale:

Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm causing oncogenic osteomalacia. Surgery remains the definitive treatment for PMT, and radiotherapy is seldom employed. However, surgery for PMT involving the head and neck is often difficult due to the local invasion and complicated anatomy. We report the first case of PMT, which was successfully treated with the combination of radiotherapy and supplementation of activated vitamin D.

Patient concerns:

A 55-year-old woman suffered from pain in the hip and bilateral femur. Serum phosphate and calcium decreased to abnormal levels. Serum alkaline phosphatase and fibroblast growth factor 23 increased to abnormal levels. The hearing loss of the right ear had continued and a middle ear tumor was revealed.

Diagnoses:

Subsequent biopsy provided the diagnosis of PMT that caused oncogenic osteomalacia. These clinical and pathological characteristics were consistent with and provided the final diagnosis of benign PMT.

Interventions:

Surgery of the PMT was difficult and the patient underwent radiotherapy. The prescribed dose was 36 Gy in 10 fractions. Simultaneously, the patient started supplementation of 1,25-dihydroxyvitamin D3 (1–2 μg/day) and continued for 2 years.

Outcomes:

Near-complete resolution of the symptoms was achieved and abnormal laboratory values recovered. At 5 years of follow-up, the irradiated tumor showed no regrowth. Severe hearing loss of the right ear was not observed.

Lessons:

Radiotherapy was effective for the PMT and could be an important treatment option for inoperable cases.
Gastric microbiota in patients with Helicobacter pylori-negative gastric MALT lymphoma
Authors: Tanaka Takahide , Matsuno Yuichi , Torisu Takehiro , Shibata Hiroki , Hirano Atsushi , Umeno Junji , Kawasaki Keisuke , Fujioka Shin , Fuyuno Yuta , Moriyama Tomohiko , Esaki Motohiro , Kitazono Takanari
Published: September 2021

To investigate the mucosal microbiota in the stomach of patients with Helicobacter pylori-negative mucosa-associated lymphoid tissue (MALT) lymphoma by means of metagenomic analysis.

Although some gastric MALT lymphomas are associated with the presence of H. pylori, other gastric MALT lymphomas occur independently of H. pylori infection. The pathogenesis of H. pylori-negative MALT lymphoma remains unclear.

Mucosal biopsy specimens were collected from the gastric body from 33 MALT lymphoma patients with gastric lesions, including both H. pylori-infection naïve patients and posteradication patients, as well as 27 control participants without H. pylori infection or cancer. Subsequently, the samples were subjected to 16S rRNA gene sequencing. Quantitative insights into microbial ecology, linear discriminant analysis effect size, and phylogenetic investigation of communities by reconstruction of unobserved states softwares were used to analyze the participants’ microbiota.

H. pylori-negative MALT lymphoma patients had significantly lower alpha diversity (P = .04), compared with control participants. Significant differences were evident in the microbial composition (P = .04), as determined by comparison of beta diversity between the 2 groups. Taxonomic composition analysis indicated that the genera Burkholderia and Sphingomonas were significantly more abundant in MALT lymphoma patients, while the genera Prevotella and Veillonella were less abundant. Functional microbiota prediction showed that the predicted gene pathways “replication and repair,” “translation,” and “nucleotide metabolism” were downregulated in MALT lymphoma patients.

H. pylori-negative MALT lymphoma patients exhibited altered gastric mucosal microbial compositions, suggesting that altered microbiota might be involved in the pathogenesis of H. pylori-negative MALT lymphoma.
Factors associated with severe maternal outcomes in patients with eclampsia in an obstetric intensive care unit
Authors: De Barros Joanna Francyne Silva , Amorim Melania Maria , De Lemos Costa Duana Gabrielle , Katz Leila
Published: September 2021

To describe the clinical profile, management, maternal outcomes and factors associated with severe maternal outcome (SMO) in patients admitted for eclampsia.

A retrospective cohort study was carried out. All women admitted to the Obstetric Intensive Care Unit (ICU) at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Northeast of Brazil, from April 2012 to December 2019 were considered for inclusion and patients with the diagnosis of eclampsia were selected. Patients who, after reviewing their medical records, did not present a diagnosis of eclampsia were excluded from the study. Severe maternal outcome (SMO) was defined as all cases of near miss maternal mortality (MNM) plus all maternal deaths during the study period. The Risk Ratio (RR) and its 95% confidence interval (95% CI) were calculated as a measure of the relative risk. Multiple logistic regression analysis was performed to control confounding variables. The institute's internal review board and the board waived the need of the informed consent.

Among 284 patients with eclampsia admitted during the study period, 67 were classified as SMO (23.6%), 63 of whom had MNM (22.2%) and 5 died (1.8%). In the bivariate analysis, the following factors were associated with SMO: age 19 years or less (RR = 0.57 95% CI 0.37–0.89, P = .012), age 35 years or more (RR = 199 95% CI 1.18–3.34, P = .019), the presence of associated complications such as acute kidney injury (RR = 3.85 95% CI 2.69–5.51, P < .001), HELLP syndrome (RR = 1.81 95% CI 1.20–2.75, P = .005), puerperal hemorrhage (PPH) (RR = 2.15 95% CI 1.36–3.40, P = .003) and acute pulmonary edema (RR = 2.78 95% CI 1.55–4.96, P = .008). After hierarchical multiple logistic regression analysis, the factors that persisted associated with SMO were age less than or equal to 19 years (ORa = 0.46) and having had PPH (ORa = 3.33).

Younger age was a protective factor for developing SMO, while those with PPH are more likely to have SMO.
Efficacy and safety of traditional Chinese medicine injections in the treatment of chronic obstructive pulmonary disease
Authors: Sun Zhongli , Zhao Wei , Yang Kun , Li Xingying , Yu Penglong
Published: September 2021

Background:

Chronic obstructive pulmonary disease (COPD) is a widespread, heterogeneous disease characterized by chronic inflammation of the airway and the gradual blockage of air flow due to bronchial obstruction. At present, a large number of traditional Chinese medicine injections (TCMIs) has been applied in the clinical treatment of COPD. However, there is insufficient evidence of evidence-based medicine of the interaction between them. Therefore, the purpose of this study is through the network meta-analysis to evaluate the efficacy and safety of the different TCMIs treatment of COPD, offering reference and evidence for clinical application.

Methods:

We will search 7 databases for randomized controlled trials of TCMI for the COPD, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and Wan-fang databases, from the date of the establishment of each database to October 31, 2021. The network meta-analysis will be implemented through Aggregate Data Drug Information System 1.16.8 and Stata 13.0 software. Pulmonary function included forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC will be the primary outcomes, FEV1 as a percentage of the estimated value (FEV1%pred), maximal voluntary ventilation (MVV), MVV as a percentage of the estimated value (MVV%pred), 6 minutes walking distance, The St. George's Respiratory Questionnaire score, and safety/adverse event will be evaluated as secondary outcomes. Mean differences or odds ratios will be used for statistical analysis. We will ensure the reliability of the results through node-split model and heterogeneity analysis. In addition, methodological quality will be evaluated based on the Cochrane Collaboration's tool, and the quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation system.

Results:

This study will provide reliable evidence for the clinical selection of TCMI in the treatment of COPD.

Conclusion:

The results of this study will evaluate the efficacy and safety of TCMI in the treatment of COPD, and provide decision-making references for future clinical and scientific research.
Androgen abuse and the brain
Authors: Scarth Morgan , Bjørnebekk Astrid
Published: September 2021

Purpose of review

The purpose of this review is to examine the recent evidence regarding the effects of exogenous androgens on the brain. Understanding these effects is of high importance, as the consequences of androgens on the reproductive and endocrine system are well documented, while fewer studies have focused on the neural and cerebral consequences of androgen use.

Recent findings

Supraphysiological doses of androgens have been shown to contribute to neurodegeneration, decreased brain-derived neurotrophic factor, increased inflammation and decreased neuronal density in animal studies, which may correspond to changes in mood, cognition and aggression. Findings from human studies suggest that similar behavioural and cognitive deficits may occur as a result of prolonged use of androgens. Additional evidence suggests that androgen use, particularly in high doses, may contribute to brain ageing and cerebrovascular problems.

Findings from recent human and animal studies indicate that androgen use likely contributes to brain alterations, which may cause the frequently observed deficits in cognitive and emotional functioning. Although exogenous testosterone in appropriate doses for therapeutic purposes likely have some neurobiological benefits for certain populations, supraphysiological doses may cause multiple mental and physical health problems, indicating a need for additional large-scale studies in humans.
Nonprescribed androgen use among women and trans men
Authors: Havnes Ingrid Amalia , Muller Ashley Elizabeth
Published: September 2021

Purpose of review

To summarize the most recent evidence regarding nonprescribed androgen use among women and trans men.

Recent findings

Fourteen heterogeneous studies met inclusion criteria. Three provided lifetime prevalence estimates among particular subgroups (from 0.5 to 8%), whereas one longitudinal study found adverse childhood experiences predicted later nonprescribed androgen use. Mental health and substance problems appear to correlate with severity of use, but evidence is mixed as to whether female users had lower or equal mental health burdens compared to male users. Studies that discuss motivation highlighted the dynamic risk management that underlies decisions to continue use; benefits have to outweigh undesired effects, whereas some sexual side effects are re-framed to be positive. Finally, a theme among qualitative studies is the gendered experiences of nonprescribed androgen use, and the search for knowledge and communities created by women.

Prevalence, side effects, and trajectories of use appear to be different for women than men. Women users need gender-specific information, although some are able to navigate male-dominated knowledge sources and are creating a female ethnopharmacology that privileges women's experiences. Health research, including epidemiology, gravely needs a gender perspective when examining nonprescribed androgen use, and one that is inclusive of transgender people.
The real-world applications of the symptom tracking functionality available to menstrual health tracking apps
Authors: Adnan Tatheer , Coull Brent A. , Jukic Anne Marie , Mahalingaiah Shruthi
Published: September 2021

Purpose of review

The goal of this review was to evaluate whether the fields available in iOS mobile phone apps for recording menstrual cycle symptoms are able to be harmonized across platforms for potential use in research, such as aggregated data analysis.

Recent findings

Symptom tracking capabilities are a common feature among menstrual health apps but have been the subject of limited investigations. Apps differ with respect to which symptoms are included and the rationale for these differences is unclear. Epidemiologic studies are poised to incorporate these data; however, a thorough exploration of symptom tracking functionality across apps is required.

Our review finds that the language used to describe symptoms and the specificity with which symptoms are collected varies greatly across the most used iOS tracking apps. Although some apps allow numerical and qualitative description of symptoms, such as sleep and mood, most simply record the presence or absence of a symptom. Collaborative efforts between clinicians and researchers to guide what and how data is collected may allow tracking apps to realize their potential diagnostic applicability. Regardless, with the increasing use of menstrual health tracking apps, it is imperative that data retrieved from such apps can realize its potential in the research and clinical ecosystems.
Impact of reconstruction parameters on spatial resolution and its comparison between cadmium-zinc-telluride SPECT/CT and conventional SPECT/CT
Authors: Wang Miao , Dong Sheng , Zhang Ruyi , Sun Danyang , Wang Shen , Shen Yiming , Li Ning , Wang Peng , Tan Jian , Meng Zhaowei , Jia Qiang
Published: September 2021

Objective

To evaluate the impact of reconstruction parameters on the spatial resolution of the tomographic image in single photon emission computed tomography (SPECT)/computed tomography (CT), and compare spatial resolution between a new polyvalent whole-body Cadmium-Zinc-Telluride camera (CZT-SPECT/CT) and a conventional dual-head Anger camera (conventional SPECT/CT).

Methods

Spatial resolution was evaluated with four-line sources filled with 99mTc in tomographic images reconstructed by varying reconstruction parameters. Ordered-subset expectation maximization (OSEM) algorithm was performed with varying iterations (1–20), the number of subsets was fixed at 10. Butterworth filter, Gauss filter and no-filter were selected, respectively. Computed tomography-based attenuation correction (CTAC), scatter correction, resolution recovery and no correction (NC) were adopted for image correction. Filtered back projection (FBP) with Butterworth filter and CTAC was performed in image reconstruction. Spatial resolution was expressed by the full width at half-maximum (FWHM) value.

Results

The impact of reconstruction parameters on the spatial resolution was identical in both cameras: FWHM values decreased with the increase of iterations and converged uniformly when the number of iterations was over 4. FWHM values decreased with the increase of cutoff frequency of the Butterworth filter and increased with the increase of the Gauss filter. scatter correction and resolution recovery improved spatial resolution, whereas CTAC had a negligible effect on spatial resolution when reconstructed by OSEM. FWHM was generally lower with OSEM reconstruction than FBP reconstruction. On the whole, under the same reconstruction conditions, CZT-SPECT/CT had a lower FWHM value than conventional SPECT/CT.

Conclusion

The spatial resolution was improved with the increase of iterations. Increasing the cutoff frequency of the Butterworth filter and decreasing the Gauss filter enhanced spatial resolution. The spatial resolution was better reconstructed by OSEM associated with attenuation correction, scatter correction and resolution recovery than FBP. CZT-SPECT/CT had better spatial resolution than conventional SPECT/CT.
Consumer Intravenous Vitamin Therapy
Authors: Dayal Sahil , Kolasa Kathryn M.
Published: September 2021

Intravenous vitamin therapy (IVVT) has become increasingly popular in recent years promising to cure or improve a variety of health problems or infuse “wellness.” Patients and consumers have intravenous vitamins or other nutrients and fluids infused into their arms outside the hospital setting in medical spas, hydration rooms, integrative medicine, and concierge primary care practices. The IVVT “menu” options include but are not limited to mixes containing vitamins C and B12, glutathione, electrolytes, and saline. In the United States, the intravenous administration of nutrients is considered drug or parenteral nutrition. In this article, we describe what we learned while trying to answer a question of a patient contemplating an IVVT treatment at a retail store. Discussion of the regulatory issues and pharmacokinetics associated with IVVT is complex and beyond the scope of this article. There is insufficient evidence to conclude there is benefit from these expensive services provided often without the knowledge of the person's primary care physician but there is a possibility of harm.
Revisiting “Twilight of the Gatekeepers”
Authors: Rowe Sylvia , Alexander Nick
Published: September 2021

In recent years, nutrition, health, and other science communicators have noted a dramatic change among the disseminators, the purveyors of the information that is their stock in trade. Evolution of the information landscape has been dramatic as it morphs from traditional media—peer-reviewed print journals and science articles in newspapers, broadcast television, and radio—to more technologically modern media. The present authors have documented the passing of the “old guard” of health and science communication “gatekeepers,” as newer digitally based information increases—exponentially. However, although the traditional curation of information may have experienced a significant decrease, the authors argue that new gatekeepers have emerged to take on the task. The present article analyzes the transition of journal and other print editors, as well as academic and other traditionally educated scientists, to the new cyber curators of health and science news. The resulting implications for today's communicators are also explored.
Developing State Health Improvement Plans: Exploring States' Use of Healthy People
Authors: Fromknecht Catharine Q. , Hallman Victoria A. , Heffernan Megan
Published: September 2021

Background:

While Healthy People outlines a national framework for improving the health of the nation, many states develop State Health Improvement Plans (SHIPs) to set priorities to improve the health of their residents. The purpose of this study was to understand the processes that states use to develop their SHIPs, how states align their SHIPs with Healthy People, and challenges that states face using Healthy People.

Methods:

NORC conducted semistructured interviews with 9 state health department representatives who were responsible for SHIPs. The responses were analyzed using qualitative thematic analysis.

Results:

State health departments used similar approaches to develop their SHIPs. Generally, states began the SHIP development process by performing community health assessments and then assembling diverse stakeholders to recommend key priority areas that should be addressed in the SHIP. States used a similar framework for their SHIPs, outlining priority areas, indicators, and targets. All respondents reported that they referenced Healthy People during the development of their SHIPs. Some states reported aligning their state plans with the Healthy People Framework, while others focused more on the specific Healthy People objectives or target setting guidance.

Conclusions:

Both the federal government and state public health agencies rely on input from stakeholders and cross-sector collaboration to ensure their initiatives reflect the diverse needs of their population. Stakeholder engagement is increasingly important as public health professionals are shifting toward a health equity approach that considers social determinants outside of the health care sector. Healthy People continues to strengthen this perspective by outlining national priorities on well-being while incorporating language around health equity issues. Reinforcing relationships between the federal government and state public health can help states better understand the role of Healthy People as well as encourage further dissemination of creative strategies and best practices.
A uniform benchmark for testing ssrA-derived degrons in the Escherichia coli ClpXP pathway
Authors: Klimecka Maria Magdalena , Antosiewicz Anna , Izert Matylda Anna , Szybowska Patrycja Emanuela , Twardowski Piotr Krzysztof , Delaunay Clara , Górna Maria Wiktoria
Published: September 2021

The ssrA degron is commonly used in fusion proteins to control protein stability in bacteria or as an interaction module. These applications often rely on the modular activities of the ssrA tag in binding to the SspB adaptor and in engaging the ClpXP protease. However, a comparison of these activities for a substantial standard set of degron variants has not been conducted previously, which may hinder developments of new variants optimized exclusively for one application. Here, we strive to establish a benchmark that will facilitate the comparison of ssrA variants under uniform conditions. In our workflow, we included methods for expression and purification of ClpX, ClpP, SspB and eGFP-degrons, assays of ClpX ATPase activity, of eGFP-degron binding to SspB and for measuring eGFP-degron degradation in vitro and in vivo. Using uniform, precise and sensitive methods under the same conditions on a range of eGFP-degrons allowed us to determine subtle differences in their properties that can affect their potential applications. Our findings can serve as a reference and a resource for developing targeted protein degradation approaches.

This work lays standards for assays used to compare engagement of SspB and ClpXP by a set of ssrA-derived degrons that can be used to fine-tune tools for protein stability control.
Association of Initial Clinical Characteristics with the Need for the Intensive Care Unit and Hospitalization in Patients Presenting to the Emergency Department with Acute Symptomatic COVID-19
Authors: Zollinger Benjamin , Newton Sophia , Freeman Jincong Q. , Moran Seamus , Montano Vargas Nataly , Ma Yan , Meltzer Andrew C.
Published: September 2021

Objective

To evaluate the association of initial clinical symptoms with need for hospitalization, intensive care, or death in ED patients within 30 days after presenting with acute symptomatic COVID-19.

Methods

This study is a retrospective case-series of patients presenting to a single ED with acute symptomatic COVID-19 from March 7–August 9, 2020. Symptomatic patients with laboratory-confirmed SARS-CoV-2 infection were eligible for this study. Patients who tested positive for COVID-19 due to screening tests but had no reasonably associated symptoms were excluded. Participants were analyzed by three categories representative of clinical severity: intensive care unit (ICU) care/death, general ward admission, and ED discharge/convalescence at home. Outcomes were ascertained 30 days after initial presentation to account for escalation in severity after the ED visit. We conducted univariate and multivariable logistic regression analyses to report odds ratios (OR) with 95% confidence intervals (CI) between hospital or ICU care/death versus convalescence at home and between ICU care/death versus general ward admission.

Results

In total, 994 patients were included in the study, of which, 551 (55.4%) patients convalesced at home, 314 (31.6%) patients required general ward admission, and 129 (13.0%) required ICU care or died. In the multivariable models, ED patients requiring hospital admission were more likely to be aged ≥ 65 years (adjusted OR [aOR] 7.4, 95% CI: 5.0, 10.8), Black/African American (aOR 3.0, 95% CI: 1.6, 5.8) or Asian/American Indian/Alaska Native/Other (aOR 2.2, 95% CI: 1.1, 4.3), and experience dyspnea (aOR 2.7, 95% CI: 2.0, 3.7) or diarrhea (aOR 1.6, 95% CI: 1.1, 2.2). However, they were less likely to experience sore throat (aOR 0.4, 95% CI: 0.2, 0.6), myalgia (aOR 0.5, 95% CI: 0.4, 0.7), headache (aOR 0.5, 95% CI: 0.4, 0.8), or olfactory/taste disturbance (aOR 0.5, 95% CI: 0.3, 0.8). ED patients who required ICU care or died were more likely to experience altered mental status (aOR 3.8, 95% CI: 2.1, 6.6), but were less likely to report history of fever (0.5, 95% CI: 0.3, 0.8).

Conclusions

COVID-19 presents with a multitude of clinical symptoms and an understanding of the association of symptoms with clinical severity may be useful for predicting ultimate patient outcomes.
The impact of armed conflict on the prevalence and transmission dynamics of HIV Infection in Libya
Authors: Daw Mohamed Ali , El-Bouzedi Abdallah Hussean , Ahmed Mohamed Omar
Published: September 2021

The interrelationships between HIV/AIDS and armed conflict are a complex phenomenon and studies are rarely devoted to this area of research. Libya is the second-largest country in Africa that has been evoked with war since NATO intervention in 2011. The country has also experienced one of the largest HIV outbreaks associated with the Bulgarian Nurses saga. The effect of the armed conflict on the dynamic spread of HIV is not well known. The objectives of this study were to determine the impact of armed conflict on the epidemiological situation of HIV infection in Libya and analyze the transmission dynamics of HIV strains during the conflict. We investigated the movement of HIV-infected people during the Libyan armed conflict and analyzed the HIV subtypes reported from 2011 to 2020 and followed up the infected cases all over the country. The patterns of HIV spread within the Libyan regions were traced and risk factors were determined during the conflict period. A total of 4539 HIV/AIDS patients were studied from the four regions during the Libyan conflict. Our data analysis indicated that Benghazi the biggest city in the Eastern region was the significant exporter of the virus to the rest of the country. Viral dissemination changes were observed within the country particularly after 2015. A major virus-flow from the Eastern region during the armed conflict associated with internally displaced people. This resulted in a dissemination of new HIV strains and accumulations of HIV cases in Western and Meddle regions. Although, there were no significant changes in the national prevalence of HIV/AIDS. Our data highlights the factors that complicated the spread and dissemination of HIV during the armed conflict which provides a better understanding of the interaction between them. This could be used to plan for effective preventive measures in tackling the spread of HIV in conflict and post-conflict settings.