bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-dimensional mechanics of the rugby tackle, does the ball carrier alter their movement into contact in response to the tackler’s position?
Authors: Edwards Suzi , Tahu Timana , Buchanan Matthew , Tucker Ross , Fuller Gordon , Gardner Andrew J.
Published: June 2021

In rugby league and rugby union, the ball carrier is vulnerable to injury during a tackle. The height of the tackle has been associated with injury risk. The extent to which a ball carrier may alter their approach entering a tackle in response the tackler’s body height is unknown. This exploratory study aimed to identify if, when and how, the ball carrier modified their motion when being tackled in response to tackling instructions given to the tackler. Three-dimensional analysis was completed on 15 adult male rugby union/league players performing a front-on, one-on-one tackle at differing tackle heights. Repeated measure factorial analyses of variance were used to test for differences (P < 0.05). The ball carrier used two movement strategies: (1) increasing their stability by flexing their trunk, knee, and hips more when entering mid/high torso tackles; (2) offloading the ball or performing an evasive movement strategy by positioning themselves in a more upright body position when being tackled at a lower torso tackle height. This preliminary evidence suggests it may be beneficial for a coach to provide different instructions to the ball carrier to modify their movement strategies when being tackled in response to the height of the tackler to improve their performance and decrease their potential injury risk.
Impact of body mass index on 90-day warfarin requirements: a retrospective chart review
Authors: Soyombo Bolanle M. , Taylor Ashley , Gillard Christopher , Wilson Candice , Bailey Wheeler Janel
Published: June 2021

Background:

Rates of obesity continue to rise worldwide as evidenced in the 2017 Centers for Disease Control and Prevention (CDC) report that indicated over 35% of United States (US) citizens are obese, with Louisiana ranked as the fifth most obese state in America. Since large clinical trials tend to exclude obese patients, health care providers are faced with concerns of under- or overdosing these patients on warfarin.

Methods:

This retrospective chart review evaluated patients who reported to a community anticoagulation clinic for warfarin management between 1 June 2017 and 30 September 2017. Along with baseline demographics, chronic use of drugs that have clinically significant interactions with warfarin, social activity such as tobacco use and alcohol consumption, were collected. Body mass indexes (BMI) were collected and categorized according to the World Health Organization definitions as follows: Normal (BMI 18–24.9 kg/m2), Overweight (25–29.9 kg/m2), Obesity Class I (30–34.9 kg/m2), Obesity Class II (35–39.9 kg/m2), Obesity Class III (⩾40 kg/m2). The primary outcome was the mean 90-day warfarin dose required to maintain “intermediate control” or “good control” of international normalized ratio (INR), stratified by BMI classifications. The secondary outcome was the time in therapeutic range (TTR) stratified by BMI classifications.

Results:

A total of 433 patient encounters were included in this study. There was a total of 43 encounters in the Normal BMI category, 111 Overweight encounters, 135 Obesity Class I encounters, 45 Obesity Class II encounters, and 99 Obesity Class III encounters. Approximately 63% of the study population were male, and over 90% the patients were African American. The Obesity Class I and Obesity Class II class required an average of 11.47 mg and 17.10 mg more warfarin, respectively, to maintain a therapeutic INR when compared with the Normal BMI category. These findings were statistically significant with p values of 0.007 and <0.001, respectively. Additionally, upon comparing the Overweight BMI category with the Obesity Class II category, there was a mean warfarin dose difference of 11.22 mg ( p = 0.010) more in Obesity Class II encounters to maintain a therapeutic INR. In the secondary analysis of TTR, Overweight category encounters had the highest TTR, whereas encounters in the Normal BMI category had the lowest TTR.

Conclusion:

As BMI increases, there is an increased chronic warfarin requirement to maintain “intermediate control” or “good control” of INR between 2 and 3 in an ambulatory care setting.
The contribution of Industry 4.0 technologies to facility management
Authors: Nota G , Peluso D , Lazo A Toro
Published: June 2021

Facility management is an evolving discipline that has received attention from both professionals and researchers in recent years. Modern facility management considers various interests related to material resources, and among others, social and environmental interests. An important opportunity for the improvement of this discipline derives from the introduction of Industry 4.0 technologies for the management of material resources. In this paper, we shall study the problem of industrial facility management, an area with important economic implications. Starting from a facility management model for the maintenance of industrial assets, we develop a general approach to maintenance based on the Internet of Things and Cyber-Physical Systems, which allows us to reason about the implementation of an effective Organisational Facility Management Unit. The objective is the continuous improvement of maintenance activities, from which also derives the improvement of the production process performance.
Inconsistencies in Overdose Suicide Death Investigation Practice and Potential Remedies Using Technology: A Centers for Disease Control and Prevention Consultation Meeting Summary
Authors: Mercado Melissa C. , Stone Deborah M. , Kokubun Caroline W. , Trudeau Aimée-Rika T. , Gaylor Elizabeth , Holland Kristin M. , Bartholow Brad N.
Published: June 2021

Introduction:

It is widely accepted that suicides—which account for more than 47 500 deaths per year in the United States—are undercounted by 10% to 30%, partially due to incomplete death scene investigations (DSI) and varying burden-of-proof standards across jurisdictions. This may result in the misclassification of overdose-related suicides as accidents or undetermined intent.

Methods:

Virtual and in-person meetings were held with suicidologists and DSI experts from five states (Spring-Summer 2017) to explore how features of a hypothetical electronic DSI tool may help address these challenges.

Results:

Participants envisioned a mobile DSI application for cell phones, tablets, or laptop computers. Features for systematic information collection, scene description, and guiding key informant interviews were perceived as useful for less-experienced investigators.

Discussion:

Wide adoption may be challenging due to differences in DSI standards, practices, costs, data privacy and security, and system integration needs. However, technological tools that support consistent and complete DSIs could strengthen the information needed to accurately identify overdose suicides.
Application of [18F]FLT‐PET in pulmonary arterial hypertension: a clinical study in pulmonary arterial hypertension patients and unaffected bone morphogenetic protein receptor type 2 mutation carriers
Authors: Botros Liza , Jansen Samara M.A. , Ashek Ali , Spruijt Onno A. , Tramper Jelco , Noordegraaf Anton V. , Aman Jurjan , Harms Hans , de Man Frances S. , Huisman Marc C. , Zhao Lan , Bogaard Harm J.
Published: June 2021

Pulmonary arterial hypertension is a heterogeneous group of diseases characterized by vascular cell proliferation leading to pulmonary vascular remodelling and ultimately right heart failure. Previous data indicated that 3′‐deoxy‐3′‐[18F]‐fluorothymidine (18FLT) positron emission tomography (PET) scanning was increased in pulmonary arterial hypertension patients, hence providing a possible biomarker for pulmonary arterial hypertension as it reflects vascular cell hyperproliferation in the lung. This study sought to validate 18FLT‐PET in an expanded cohort of pulmonary arterial hypertension patients in comparison to matched healthy controls and unaffected bone morphogenetic protein receptor type 2 mutation carriers. 18FLT‐PET scanning was performed in 21 pulmonary arterial hypertension patients (15 hereditary pulmonary arterial hypertension and 6 idiopathic pulmonary arterial hypertension), 11 unaffected mutation carriers and 9 healthy control subjects. In‐depth kinetic analysis indicated that there were no differences in lung 18FLT k3 phosphorylation among pulmonary arterial hypertension patients, unaffected bone morphogenetic protein receptor type 2 mutation carriers and healthy controls. Lung 18FLT uptake did not correlate with haemodynamic or clinical parameters in pulmonary arterial hypertension patients. Sequential 18FLT‐PET scanning in three patients demonstrated uneven regional distribution in 18FLT uptake by 3D parametric mapping of the lung, although this did not follow the clinical course of the patient. We did not detect significantly increased lung 18FLT uptake in pulmonary arterial hypertension patients, nor in the unaffected bone morphogenetic protein receptor type 2 mutation carriers, as compared to healthy subjects. The conflicting results with our preliminary human 18FLT report may be explained by a small sample size previously and we observed large variation of lung 18FLT signals between patients, challenging the application of 18FLT‐PET as a biomarker in the pulmonary arterial hypertension clinic.
Acupuncture (superficial dry-needling) as a treatment for chronic postherpetic neuralgia – a randomized clinical trial
Authors: Sollie Martin , Pind Robert , Madsen Christoffer Bing , Sørensen Jens Ahm
Published: June 2021

Background:

Postherpetic neuralgia is a painful condition where finding sufficient treatment poses a great challenge. Acupuncture is often used as an alternative treatment for these pains, yet no randomized trials, using a sham-placebo have been performed to confirm its effect. Our objective was to investigate the efficacy of acupuncture compared to sham-acupuncture when treating chronic postherpetic dermal pain.

Methods:

We performed a sham-controlled double-blinded randomized clinical trial (RCT) with two arms. The intervention group received superficial dry-needling, and the control group received sham acupuncture using blunted needles. Twenty-six patients received two treatments. They filled out questionnaires at baseline and 1 month after treatment: (1) average and maximum pain (Numeric Rating Scale), (2) neuropathic pain (Neuropathic Pain Scale Inventory) and (3) Quality of Life (QoL) (Short-form 36).

Results:

Thirteen patients were allocated to the intervention group and 15 to the control group. We did not detect any significant changes in levels of pain and neuropathic pain. One QoL parameter, regarding emotional problems, reached a level of statistical significance. The sham-blinding was successful. This is the first RCT on the effect of acupuncture (superficial dry-needling) on postherpetic neuralgia (PHN), using a sham procedure as control. We observed no significant changes or tendencies in the measured levels of pain. One QoL parameter had significant improvement in the intervention group compared to the control group.

Conclusion:

In conclusion, acupuncture was not superior to treatment with sham acupuncture. Though individual patients may experience some pain relief from acupuncture, our results do not support the routine use of this type of acupuncture to treat PHN.
Satisfaction with dental condition and oral health–related quality of life of school-age children with dental pain in Ibadan, Nigeria
Authors: Lawal Folake Barakat , Oke Gbemisola Aderemi
Published: June 2021

Objectives:

The aim of the study was to determine the association between oral health–related quality-of-life domains and satisfaction with dental condition of school-age children with dental pain in Ibadan, Nigeria.

Methods:

This cross-sectional study was conducted among 1006 pupils aged 9–12 years who attended 18 randomly selected primary schools in Ibadan, Nigeria. An interviewer-administered questionnaire, Child Oral Impact on Daily Performances inventory in addition to oral examination was used to obtain data. Analysis was done with SPSS 23 and STATA 14 and p-value set at <0.05.

Results:

The prevalence of self-reported dental pain was 10.2%. The mean Child Oral Impact on Daily Performances inventory score was 2.6(±7.2) overall and 9.8(±12.4) for pupils with pain. There was a greater impact on oral health–related quality of life of respondents who reported dental pain than in others (mean rank = 749.54 vs 475.4, U = 21,162, p < 0.001) compared to those with clinically assessed pain (mean rank = 541.21 vs 502.97, U = 6416, p = 0.489). Those who reported dental pain were more dissatisfied with their dental condition (odds ratio = 7.7, 95% confidence interval = 5.0–12.0, p < 0.001) compared to those with clinically assessed dental pain (odds ratio = 1.3, 95% confidence interval = 0.4–4.9, p = 0.687). The direct effect of pain on satisfaction with dental condition and Child Oral Impact on Daily Performances inventory was β = 0.74 (standard error = 0.12, 95% confidence interval = 0.50–0.97, p < 0.001) and β = 0.53 (standard error = 0.05, 95% confidence interval = 0.44–0.63, p < 0.001), respectively. The indirect effect was β = 0.12 (standard error = 0.039, 95% confidence interval = 0.05–0.20, p = 0.001) and the total effect was β = 0.86 (standard error = 0.11, 95% confidence interval = 0.64–1.08, p < 0.001); R2 = 0.21.

Conclusion:

Self-reported dental pain significantly impacted the quality of life of the pupils to cause dissatisfaction with dental condition when compared to clinically assessed pain.
Efficacy and safety of non-vitamin K antagonist oral anticoagulants for venous thromboembolism: a meta-analysis
Authors: Zhuang Yan , Dai Lin-feng , Chen Ming-qi
Published: June 2021

Objective

Several trials had compared the efficacy and safety between non-vitamin K antagonist oral anticoagulants and warfarin for acute venous thromboembolism, but the results were incomplete. This updated review comprehensively assessed the efficacy and safety of non-vitamin K antagonist oral anticoagulants for venous thromboembolism.

Design

Meta-analysis of randomised control trials. Six databases were searched from January 2000 to December 2018.

Setting

Adult patients had got non-vitamin K antagonist oral anticoagulants or warfarin for venous thromboembolism.

Participants

Randomised control trials that compared the efficacy and safety between non-vitamin K antagonist oral anticoagulants and warfarin.

Main outcome measures

The efficacy and safety of non-vitamin K antagonist oral anticoagulants .

Results

Seven studies involving 29,879 cases were included, among which 14,943 cases were assigned to non-vitamin K antagonist oral anticoagulants group and 14,936 cases to warfarin group. Meta-analysis showed that compared with warfarin, recurrent venous thromboembolism (odds ratio 0.94 [95% confidence interval 0.81 to 1.11]), death related to venous thromboembolism or fatal pulmonary embolism (odds ratio 1.00 [95% confidence interval 0.63 to 1.60]), symptomatic deep-vein thrombosis (odds ratio 0.88 [95% confidence interval 0.72 to 1.09]), symptomatic nonfatal pulmonary embolism (odds ratio 1.03 [(95% confidence interval 0.82 to 1.30]) and all deaths (odds ratio 0.92 [95% confidence interval 0.76 to 1.12]) are similar in non-vitamin K antagonist oral anticoagulants group, but major bleeding event (odds ratio 0.61 [95% confidence interval 0.50 to 0.75]) and clinically relevant non-major bleeding event (odds ratio [95% confidence interval 0.53 to 0.85]) are less in non-vitamin K antagonist oral anticoagulants group. 

Conclusions

For the treatment of venous thromboembolism, non-vitamin K antagonist oral anticoagulants is as effective as warfarin, and has a better safety profile than warfarin.
Understanding Home Hemodialysis Patient Attrition: A Cohort Study
Authors: Paterson Bailey , Fox Danielle E. , Lee Chel Hee , Riehl-Tonn Victoria , Qirzaji Elena , Quinn Rob , Ward David , MacRae Jennifer M.
Published: June 2021

Background:

Home hemodialysis (HHD) offers a flexible, patient-centered modality for patients with kidney failure. Growth in HHD is achieved by increasing the number of patients starting HHD and reducing attrition with strategies to prevent the modifiable reasons for loss.

Objective:

Our primary objective was to describe a Canadian HHD population in terms of technique failure and time to exit from HHD in order to understand reasons for exit. Our secondary objectives include the following: (1) determining reasons for training failure, (2) reasons for early exit from HHD, and (3) timing of program exit.

Design:

A retrospective cohort study of incident adult HHD patients between January 1, 2013—June 30, 2020.

Setting:

Alberta Kidney Care South, AKC-S HHD program.

Participants:

Patients who started training for HHD in AKC-S.

Methods:

A retrospective, cohort study of incident adult HHD patients with primary outcome time on home hemodialysis, secondary outcomes include reason for train failure, time to and reasons for technique failure. Cox-proportional hazard model to determine associations between patient characteristics and technique failure. The cumulative probability of technique failure over time was reported using a competing risks model.

Results:

A total of 167 patients entered HHD. Training failure occurred in 20 (12%), at 3.1 [2.0, 5.5] weeks; these patients were older ( P < .001) and had 2 or more comorbidities ( P < .001). Reasons for HHD exit after training included transplant (35; 21%), death (8; 4.8%), and technique failure (24; 14.4%). Overall, the median time to HHD exit, was 23 months [11, 41] and the median time of technique failure was 17 months [8.9, 36]. Reasons for technique failure included: psychosocial reasons (37%) at a median time 8.9 months [7.7, 13], safety (12.5%) at 19 months [19, 36], and medical (37.5%) at 26 months [11, 50].

Limitations:

Small patient population with quality of data limited by the electronic-based medical record and non-standardized definitions of reasons for exit.

Conclusions:

Training failure is a particularly important source of patient loss. Reasons for exit differ according to duration on HHD. Early interventions aimed at reducing train failure and increasing psychosocial supports may help program growth.
Fostering spatial thinking skills for future citizens to support sustainable development
Authors: Kolvoord Robert A
Published: June 2021

The United Nations Sustainable Development Goals (UNSDGs) represent the consensus of the global community on the most important issues facing our planet. A major challenge is embedding the UNSDGs in primary and secondary education and providing the tools needed for students to explore and analyse data relevant to the UNSDGs. The Geospatial Semester is a secondary school class in the United States that is focused on mastering geospatial technologies and using them to examine key problems of student interest, including the UNSDGs. Research studies show that the extended use of geographic information systems augments student problem solving and spatial thinking skills, particularly for females. Spatial thinking skills are a key gateway to science, technology, engineering and mathematics careers and an avenue to addressing the UNSDGs.
Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations
Authors: Pera Megan F. , Cain Mary M. , Emerick Ashleigh , Katz Stephanie , Hirsch Nicole A. , Sherman Bruce W. , Bravata Dena M.
Published: June 2021

Objectives:

To evaluate the prevalence of social determinants of health (SDoH) factors in a large commercially-insured population and to characterize the prevalence of common conditions (eg, diabetes, behavioral health issues) and addressable health services utilization concerns (eg, lack of preventive care) for which employers offer no- and low-cost benefit programs.

Methods:

We identified groups with SDoH challenges within a commercially-insured population of 5.1 M through administrative data and self-report. Using medical claims and health assessment data, we identified populations with SDoH needs who had common conditions for which employers often provide no- or low-cost benefit programs (ie, diabetes, behavioral health conditions, high-risk pregnancy, overweight/obesity). Additionally, we sought populations with common addressable health services utilization concerns such as avoidable emergency room visits, lack of preventive care services, or non-adherence to medications. We used univariate analyses to describe the prevalence of SDoH risks in the population of interest.

Results:

Twenty-seven percent of this commercially-insured population live in a zip code where the median income is at or below 200% of the Federal Poverty Line. Respondents identified cost (55%) and family, school, or work responsibilities (26%) as key barriers to care. ER overutilization rates are higher in lower income zip codes than wealthier zip codes (34% vs 9%) as is the prevalence of diabetes, overweight/obesity, and behavioral issues, and decreased use of preventive services. Fifteen percent of the study population live in a low-access food area. There is considerable variability in access to employer-sponsored resources to address these needs (70% of employers provide behavioral health programs; 63% provide telehealth programs, but only 1% offer healthy food programs and less than 0.5% offer either child care or transportation support programs).

Conclusions:

Commercially insured populations could benefit from employer-sponsored programs or benefits that address key SDoH barriers such as financial support, healthy food programs, child-care, and transportation.
In Vivo biomechanical evaluations of suture anchors for repairing grade 3 superficial medial collateral ligament injury in a porcine model
Authors: Takahashi Tsuneari , Takeshita Katsushi
Published: June 2021

Purpose:

To clarify the biomechanical and radiological outcomes of superficial medial collateral ligament (sMCL) repair using suture anchors in a large animal model.

Methods:

The right sMCLs of nine male castrated pigs was completely detached at the femoral attachment. sMCL repair surgery was performed using two suture anchors. The same skin incision, sMCL exposure, and immediate wound closure were made at the left knee as a sham surgery. Magnetic resonance imaging was performed preoperatively and 4 weeks after surgery. The structural properties (upper yield load, maximum load, linear stiffness, and elongation at failure) of the femur-sMCL-tibia complex were determined.

Results:

During tensile testing, all the repaired sMCLs avulsed from the femoral attachment. There were no significant differences in the upper yield load, maximum load, linear stiffness, or elongation at failure between the groups 4 weeks after surgery or in the MRI-derived signal-to-noise quotients (SNQs) at the mid and tibial sMCL. The SNQs differed significantly at the femoral (2.7 ± 1.2 vs 0.3 ± 0.7; P = 0.00064) portions between groups.

Conclusion:

The injured sMCLs biomechanically recovered after surgery using suture anchors even though the SNQs were higher than those with native contralateral sMCLs. For clinical relevance, sMCL repair of grade 3 sMCL injuries using suture anchors was both safe and successful with less tissue dissection.
An Inquiry into the Persistence of Holiday Effect on Stock Markets in India: Insights and Perspectives on a Seasonal Anomaly
Authors: Tadepalli Meher Shiva , Jain Ravi Kumar , Metri Bhimaraya
Published: June 2021

Asset pricing is a key area of literature in analysing and evaluating the stock market efficiency.

Though various pricing models made efforts to explain the behaviour of the stocks, the existence of seasonal anomalies in the stock markets creates an opportunity for the investors to generate abnormal returns. The present article emphasizes one of such market anomalies namely, the holiday effect using indices belonging to Indian stock exchanges. Thorough research is performed by including all the prime market-capital and sectoral indices of the National Stock Exchange and the Bombay Stock Exchange. The ARIMAX methodology is adopted to observe the anomaly by considering exogenous variables representing the trading days before the exchange-mandated holidays. Further, the strength of the anomaly is analysed with the incorporation of various stock market reforms and observed to be significantly persistent among most of the Indian market indices (including both the sectoral and the market-capital based indices).
Isolated Right Ventricular Noncompaction Cardiomyopathy Causing Pulmonary Embolism
Authors: Seecheran Rajeev Virender , Ramdin Ryan , Singh Sonia , Seecheran Valmiki Krishna , Persad Sangeeta Anjali , Peram Lakshmipathi , Raza Sadi , Seecheran Naveen Anand
Published: June 2021

Ventricular noncompaction is a rare, heterogeneous cardiomyopathy characterized by marked trabeculations and deep intertrabecular spaces with clinical sequelae of heart failure, arrhythmias, and cardioembolic events. In this article, we describe a patient with isolated right ventricular noncompaction who presented with submassive pulmonary embolism, which was managed with long-term direct oral anticoagulation.
Characterizing the complex influence of the urban built environment on the dynamic population distribution of Shenzhen, China, using geographically and temporally weighted regression
Authors: Liu Xiaoqian , Huang Bo , Li Rongrong , Wang Jionghua
Published: June 2021

Big data can provide new insights for smart city planning. This study exploits mobile-phone locating-request (MPLR) data as a proxy for real-time intra-urban population distribution. It models the relationship between the dynamic population distribution and the urban built environment using geographically and temporally weighted regression (GTWR), which can account for spatial and temporal non-stationarity simultaneously. A case study is undertaken based on MPLR records in Shenzhen, China and points of interest-based urban environment data aggregated to grid zones. Compared with previous models, GTWR yields a better result. Furthermore, the spatiotemporal coefficients are analyzed and compared. The results suggest that the patterns of urban population distribution are more complex during weekends than during weekdays. The coefficients of the company density variable are significantly higher during weekdays than weekends, while the coefficients associated with residential buildings are lower during weekday afternoons. Hence, the urban built environment plays an important role in the dynamic distribution of the population at different times. The findings show that the GTWR model in combination with MPLR and points of interest-based urban environment data can assist urban planners in gaining a better understanding of the spatiotemporal dynamics of the population distribution, thereby providing potential inputs to the rational allocation of public resources over space and time.
Simultaneous improvement of microgeometry and surface quality of spur and straight bevel gears by abrasive flow finishing process
Authors: Petare Anand , Jain Neelesh Kumar , Palani I. A.
Published: June 2021

This article reports on influence of extrusion pressure, abrasive particle size and volumetric concentration on simultaneous reduction of surface roughness and microgeometry errors of spur and straight bevel gear by abrasive flow finishing (AFF) process. A vertical configured experimental apparatus was developed for two-way AFF and developed fixtures for finishing gears. Experimental investigations were conducted to identify optimum parametric combination, using response surface methodology, based on Box–Behnken design approach. Results revealed that higher values of abrasive particle size and volumetric concentration yield more percentage decrease in surface roughness and microgeometry error. Roughness profile, bearing area curve, microhardness, surface morphology, and wear resistance of the gear having best quality finishing were studied. Surface morphology analysis of the flank regions of the best finished spur and straight bevel gears found them to be smooth and free from cracks and burrs. Reciprocating wear test results revealed higher wear resistance of the AFF finished gears as compared to the unfinished gears. AFF also enhanced microhardness of the finished gears, which would enhance their operating performance and service life. This study shows that AFF is a flexible, economical, productive, easy to operate, and sustainable nontraditional process for precision finishing of gear that can simultaneously improve microgeometry, surface finish, microhardness, surface morphology, wear resistance, and residual stresses of the finished gears. Gear manufacturers and users will be benefited by the outcome of this study.

JEL codes: C00, C20
Tumor suppressor function of Gata2 in acute promyelocytic leukemia
Authors: Katerndahl Casey D. S. , Rogers Olivia R. S. , Day Ryan B. , Cai Michelle A. , Rooney Timothy P. , Helton Nichole M. , Hoock Mieke , Ramakrishnan Sai Mukund , Nonavinkere Srivatsan Sridhar , Wartman Lukas D. , Miller Christopher A. , Ley Timothy J.
Published: June 2021

Most patients with acute promyelocytic leukemia (APL) can be cured with combined all-trans retinoic acid (ATRA) and arsenic trioxide therapy, which induces the destruction of PML-RARA, the initiating fusion protein for this disease. However, the underlying mechanisms by which PML-RARA initiates and maintains APL cells are still not clear. Therefore, we identified genes that are dysregulated by PML-RARA in mouse and human APL cells and prioritized GATA2 for functional studies because it is highly expressed in preleukemic cells expressing PML-RARA, its high expression persists in transformed APL cells, and spontaneous somatic mutations of GATA2 occur during APL progression in mice and humans. These and other findings suggested that GATA2 may be upregulated to thwart the proliferative signal generated by PML-RARA and that its inactivation by mutation (and/or epigenetic silencing) may accelerate disease progression in APL and other forms of acute myeloid leukemia (AML). Indeed, biallelic knockout of Gata2 with CRISPR/Cas9-mediated gene editing increased the serial replating efficiency of PML-RARA–expressing myeloid progenitors (as well as progenitors expressing RUNX1-RUNX1T1, or deficient for Cebpa), increased mouse APL penetrance, and decreased latency. Restoration of Gata2 expression suppressed PML-RARA–driven aberrant self-renewal and leukemogenesis. Conversely, addback of a mutant GATA2R362G protein associated with APL and AML minimally suppressed PML-RARA–induced aberrant self-renewal, suggesting that it is a loss-of-function mutation. These studies reveal a potential role for Gata2 as a tumor suppressor in AML and suggest that restoration of its function (when inactivated) may provide benefit for AML patients.
Laparoscopic uterosacral ligament suspension versus sacrospinous ligament fixation for apical prolapse: perioperative outcomes
Authors: Gabra Martina G. , Winget Veronica , Torabi Mohammad T. , Addis Ilana , Hatch Kenneth , Heusinkveld John
Published: June 2021

Background

Pelvic organ prolapse can be repaired vaginally or laparoscopically. Studies comparing vaginal repair with sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (V-USLS) have found no difference in functional or adverse outcomes. Laparoscopic USLS (L-USLS) is becoming a popular treatment for pelvic organ prolapse because it has a low rate of ureteral compromise. To date, no studies have compared perioperative outcomes between L-USLS and SSLF. The objective of this study is to compare the rates of perioperative complications between these two methods.

Methods

This was a retrospective chart review of 243 consecutive patients who underwent L-USLS or SSLF at one institution between March 2017 and August 2019 for apical pelvic organ prolapse. Descriptive data was analyzed as appropriate with Student’s t tests and chi-square. Univariable logistic regression analysis was performed to assess predictors of perioperative complications.

Results

Preoperative Pelvic Organ Prolapse Quantification Stage (POP-Q) was similar between the two cohorts (p = 0.23). After adjusting for confounding factors, L-USLS was associated with a longer operative time (118 vs 142 min, p < 0.01) and shorter length of hospitalization (0.68 vs 1.06 days, p < 0.01). The estimated blood loss between the procedures was not statistically significant after adjusting for confounding factors. There was no difference in perioperative complication rates between L-USLS and SSLF (5% vs 7%, p = 0.55). No clinical risk factors were significantly associated with perioperative complications.

Conclusion

We did not find a difference in complications between L-USLS and SSLF.
Identification of genomic regions affecting production traits in pigs divergently selected for feed efficiency
Authors: Delpuech Emilie , Aliakbari Amir , Labrune Yann , Fève Katia , Billon Yvon , Gilbert Hélène , Riquet Juliette
Published: June 2021

Background

Feed efficiency is a major driver of the sustainability of pig production systems. Understanding the biological mechanisms that underlie these agronomic traits is an important issue for environment questions and farms' economy. This study aimed at identifying genomic regions that affect residual feed intake (RFI) and other production traits in two pig lines divergently selected for RFI during nine generations (LRFI, low RFI; HRFI, high RFI).

Results

We built a whole dataset of 570,447 single nucleotide polymorphisms (SNPs) in 2426 pigs with records for 24 production traits after both imputation and prediction of genotypes using pedigree information. Genome-wide association studies (GWAS) were performed including both lines (global-GWAS) or each line independently (LRFI-GWAS and HRFI-GWAS). Forty-five chromosomal regions were detected in the global-GWAS, whereas 28 and 42 regions were detected in the HRFI-GWAS and LRFI-GWAS, respectively. Among these 45 regions, only 13 were shared between at least two analyses, and only one was common between the three GWAS but it affects different traits. Among the five quantitative trait loci (QTL) detected for RFI, two were close to QTL for meat quality traits and two pinpointed novel genomic regions that harbor candidate genes involved in cell proliferation and differentiation processes of gastrointestinal tissues or in lipid metabolism-related signaling pathways. In most cases, different QTL regions were detected between the three designs, which suggests a strong impact of the dataset structure on the detection power and could be due to the changes in allelic frequencies during the establishment of lines.

Conclusions

In addition to efficiently detecting known and new QTL regions for feed efficiency, the combination of GWAS carried out per line or simultaneously using all individuals highlighted chromosomal regions that affect production traits and presented significant changes in allelic frequencies across generations. Further analyses are needed to estimate whether these regions correspond to traces of selection or result from genetic drift.
Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study
Authors: Zhu Bin , Feng Xiaokai , Jiang Chunguo , Mi Song , Yang Liya , Zhao Zhigang , Zhang Yong , Zhang Liming
Published: June 2021

Background

Coronavirus disease-19 (COVID-19) has become a world health threaten. Its risk factors with death were still not known. White blood cells (WBC) count as a reflection of inflammation has played a vital role in COVID-19, however its level with death is not yet investigated.

Methods

In this retrospective, single-center study, all confirmed patients with COVID-19 at West Branch of Union Hospital from Jan 29 to Feb 28, 2020 were collected and analyzed. Demographic and clinical data including laboratory examinations were analyzed and compared between recovery and death patients.

Results

A total of 163 patients including 33 death cases were included in this study. Significant association was found between WBC count and death (HR = 1.14, 95%CI: 1.09–1.20, p < 0.001). The regression analysis results showed there was a significant association between WBC count and death (HR = 5.72, 95%CI: 2.21–14.82, p < 0.001) when use the second quartile as a cutoff value (> 6.16 × 10^9/L). The difference was still exist after adjusting for confounding factors (HR = 6.26, 95%CI: 1.72–22.77, p = 0.005). In addition, Kaplan-meier survival analysis showed that there was a significant decline of the cumulative survival rate (p < 0.001) in those with WBC count ≥6.16 × 10^9/L.

Conclusion

WBC count at admission is significantly corelated with death in COVID-19 patients. Higher level of WBC count should be given more attention in the treatment of COVID-19.
AFP and eGFR are related to early and late recurrence of HCC following antiviral therapy
Authors: Watanabe Takao , Tokumoto Yoshio , Joko Kouji , Michitaka Kojiro , Horiike Norio , Tanaka Yoshinori , Tada Fujimasa , Kisaka Yoshiyasu , Nakanishi Seiji , Yamauchi Kazuhiko , Ochi Hironori , Hiraoka Atsushi , Yagi Sen , Yukimoto Atsushi , Hirooka Masashi , Abe Masanori , Hiasa Yoichi
Published: June 2021

Background

An unexpected recurrence of hepatocellular carcinoma (HCC) sometimes occurs in patients with hepatitis C virus (HCV) after treatment with direct-acting antivirals (DAAs). However, the characteristics of patients with HCC recurrence may differ depending on time after DAA treatment. We aimed to identify risk factors related to HCC recurrence according to time after DAA treatment.

Methods

Of 1663 patients with HCV treated with a DAA, 199 patients had a previous history of HCC. We defined HCC recurrence within 1 year after DAA treatment as ‘early recurrence’, and recurrence more than 1 year after as ‘late recurrence’. The different risk factors between the early and late phases of HCC recurrence after the end of DAA therapy were investigated.

Results

Ninety-seven patients experienced HCC recurrence during the study period. Incidences of recurrence were 29.8, 41.0, and 53.4% at 1, 2, and 3 years, respectively, after the end of DAA therapy. Multivariate analysis identified post-treatment α-fetoprotein (AFP) as an independent factor contributing to HCC recurrence in the early phase (hazard ratio, 1.056; 95% confidence interval, 1.026–1.087, p < 0.001) and post-treatment estimated glomerular filtration rate (eGFR) (hazard ratio, 0.98; 95% confidence interval, 0.96–0.99, p = 0.032) as a predictor of HCC recurrence in the late phase.

Conclusion

Patients with higher post-treatment AFP in the early phase and those with lower post-treatment eGFR in the late phase had a high risk of HCC recurrence. The risk factors associated with HCC recurrence after DAA treatment were different between the early and late phases.
Pretreatment systemic inflammation response index is predictive of pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy
Authors: Dong Jie , Sun Qingqing , Pan Yueyin , Lu Nannan , Han Xinghua , Zhou Qiong
Published: June 2021

Background

Inflammation plays an important role in tumor proliferation, metastasis, and resistance to chemotherapy. The systemic inflammation response index (SIRI), has been reported to be closely related to prognosis in many tumors, such as breast and gastric cancers. However, the predictive value of pretreatment SIRI on pathological complete response (pCR) rates in patients with breast cancer treated with neoadjuvant chemotherapy (NAC) is unknown. This study examined the correlation between SIRI and pCR in patients with breast cancer receiving NAC and identified convenient and accurate predictive indicators for pCR.

Methods

We retrospectively analyzed the clinicopathological parameters and pretreatment peripheral blood characteristics of the 241 patients with breast cancer who received NAC between June 2015 and June 2020. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff of SIRI. ROC curves were also plotted to verify the accuracy of inflammatory markers for pCR prediction. The chi-squared test was used to explore the relationships of SIRI with pCR and other clinicopathological parameters. Multivariate analyses were performed using a logistic regression model.

Results

Among the 241 patients, 48 (19.92%) achieved pCR. pCR was significantly related to SIRI, the neutrophil-lymphocyte ratio (NLR), the lymphocyte-monocyte ratio (LMR), molecular subtypes and other clinicopathological parameters, such as BMI, clinical T and N staging, and histological grade. Multivariate analyses indicated that the clinical T and N staging, SIRI, and NLR were independent prognostic factors for pCR in patients with breast cancer. The area under the ROC curve for SIRI was larger than that for NLR. Compared to patients with SIRI ≥0.72, patients with SIRI < 0.72 had a nearly 5-fold higher chance of obtaining pCR (odds ratio = 4.999, 95% confidence interval = 1.510–16.551, p = 0.000).

Conclusions

Pretreatment SIRI is predictive of pCR in patients with breast cancer receiving NAC, and the index can assist physicians in formulating personalized treatment strategies.
Evaluation of patients admitted with musculoskeletal tuberculosis: sixteen years’ experience from a single center in Turkey
Authors: Ozdemir Mikail , Ozdemir H. Gulnihal
Published: June 2021

Background

The aim of our study was to describe musculoskeletal system tuberculosis (TB) as a single-center experience.

Methods

This is a retrospective observational study conducted at a TB Dispensary in the east Mediterranean part of Turkey between 2004 and 2020. The clinical and demographic characteristics including age, gender, involvement location and duration of illness, presenting complaint, local examination findings, treatment outcome were retrieved and analyzed from the case files. Statistical analyses were performed using SPSS Statistics version 17.0 (IBM). The normality of data analysed by using Kolmogorov-Smirnov. The descriptive statistics were reported as mean ± standard deviation, medians, and ranges (min-max).

Results

Overall, 31 patients (3.2 % of all TB cases) with a mean age of 44.2 ± 16.7 years had musculoskeletal tuberculosis. The mean duration of treatment was 12.9 ± 5.5 months. Of the 31 patients, six (19.4 %) had concomitant pulmonary TB. One of the patients was in the pediatrics age group, and two of them were in the geriatric group. The most affected area was the vertebra. The most common complaint of the patients was back pain and seen in 22 patients (70.9 %).

Conclusions

The physicians should be suspicious about the diagnosis of musculoskeletal TB disease. If the diagnosis and treatment are delayed, spinal damage and other consequences might be incurable.
The engineered expression of secreted HSPB5-Fc in CHO cells exhibits cytoprotection in vitro
Authors: Li Jing , Yu Jingjing , Xue Wenxian , Huang Huili , Yan Longjun , Sang Fan , An Shuangshuang , Zhang Jing , Wang Mingli , Zhang Jun , Li Hui , Cui Xiukun , He Jiang , Hu Yanzhong
Published: June 2021

Background

HSPB5 is an ATP-independent molecular chaperone that is induced by heat shock or other proteotoxic stresses. HSPB5 is cytoprotective against stress both intracellularly and extracellularly. It acts as a potential therapeutic candidate in ischemia-reperfusion and neurodegenerative diseases.

Results

In this paper, we constructed a recombinant plasmid that expresses and extracellularly secrets a HSPB5-Fc fusion protein (sHSPB5-Fc) at 0.42 μg/ml in CHO-K1 cells. This sHSPB5-Fc protein contains a Fc-tag at the C-terminal extension of HSPB5, facilitating protein-affinity purification. Our study shows that sHSPB5-Fc inhibits heat-induced aggregation of citrate synthase in a time and dose dependent manner in vitro. Administration of sHSPB5-Fc protects lens epithelial cells against cisplatin- or UVB-induced cell apoptosis. It also decreases GFP-Httex1-Q74 insolubility, and reduces the size and cytotoxicity of GFP-Httex1-Q74 aggregates in PC-12 cells.

Conclusion

This recombinant sHSPB5-Fc exhibits chaperone activity to protect cells against proteotoxicity.
A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences
Authors: Tominaga Yoshiko , Morisky Donald E. , Mochizuki Mayumi
Published: June 2021

Background

Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing with those who continued (Cont group) in terms of the related factors to glycemic control.

Methods

A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received retrospectively from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group.

Results

In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70 % of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians and half of them perceived their situations inappropriately.

Conclusions

Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better interventions.