bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of a Multicomponent Lower Extremity Training Technique on Physical Function in Healthy Older Adults: A Randomized Controlled Trial
Authors: Jung Hungu , Miki Yumiko , Tanaka Ryo , Yamasaki Masahiro
Published: June 2020

Objective: We aimed to examine the outcomes of our novel multicomponent lower extremity training (MLT) technique on physical function in older adults. Methods: Participants were randomly divided into a training group (TG) or a control group (CG). The TG (4 men, 14 women) received MLT for 24 weeks, once per week. MLT contains strength, balance, and flexibility components. The CG (5 men, 10 women) did not receive any training for 24 weeks. Nine lower extremity range of motions (ROMs; hip flexion, hip abduction, hip adduction, hip extension, internal and external hip rotations, knee flexion, ankle dorsiflexion, and ankle plantar flexion) and two muscle strength assessments (knee extension and flexion) were collected. Physical performance tests were also performed, including the functional reach test, timed up and go test (TUGT), and five times sit-to-stand test (FTSST). Results: After 24 weeks, significant increases were observed in the TG in all ROMs (with the exception of knee flexion), knee extension strength, and performance in the TUGT and FTSST. Conclusions: MLT significantly improved ROM, muscle strength, and physical performance in healthy older adults. We suggest that it is an efficacious intervention in the maintenance and improvement of mobility and functional independence in healthy older adults.

Trial registration: UMIN CTR, UMIN000037463. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041955
Nursing Skills Video Selfies: An Innovative Teaching and Learning Strategy for Undergraduate Nursing Students to Master Psychomotor Skills
Authors: Sterling-Fox Cynthia , Smith Julius P. , Gariando Ophalyn , Charles Pamela
Published: June 2020

Introduction

The quality of care for patients is linked to the performance and competence of nurses. Nurse educators are challenged to prepare graduates to deliver safe, competent, patient-centered care. Nursing skills video “selfie” is an innovative teaching and learning strategy in which nursing students use technology to create videos of themselves (video selfie) performing psychomotor skills.

Method

The instructional exercise of creating the video selfie was administered to a group of nursing students in a medical–surgical class. The laboratory instructors identified three psychomotor nursing skills. In the skills lab, the instructors showed videos to demonstrate how the skills were performed. The students returned demonstration in the lab and were asked to return to the lab independently to practice the skills and to create a video selfie.

Results

The exercise encouraged students to increase the quality and length of practice and master the skill. Students demonstrated confidence to perform the skills and to accurately list each step required to perform the skills. The video selfie was used as a peer evaluation tool and as a faculty assessment tool to guide individual students’ instruction, learning, and remediation.

Conclusion

The exercise had some shortcomings. Future quantitative research using survey instruments to collect data from a larger group of nursing students is needed to validate the utility of this innovative teaching and learning strategy in nursing programs.
Coping profiles and health outcomes among individuals with systemic sclerosis: A latent profile analysis approach
Authors: Condon Shelley E , Roesch Scott C , Clements Philip J , Furst Daniel E , Weisman Michael H , Malcarne Vanessa L
Published: June 2020

Background:

Systemic sclerosis has negative implications for quality of life, and coping is a mechanism by which individuals can adapt more successfully to illness. This study (1) identified coping profiles in patients with systemic sclerosis and (2) examined distress and disability correlates of the profiles.

Methods:

A sample of 93 patients with confirmed diagnoses of systemic sclerosis received clinical examinations and reported on coping, psychological distress, and health-related disability. Latent profile analysis was used to identify coping-based profile groups. The profile groups were then compared on psychological distress and health-related disability, controlling for disease severity.

Results:

A two-profile solution was supported: Active Copers emphasized problem-focused, social support, counting blessings, and religious approaches to coping with systemic sclerosis. Passive Copers emphasized blaming self and others, avoidance, and wishful thinking approaches to coping. Active Copers reported significantly less psychological distress than Passive Copers, but no significant differences were found for health-related disability.

Discussion:

The findings identify multidimensional patterns of coping that are differentially related to psychological distress in systemic sclerosis patients. These findings can inform coping-based interventions for patients with systemic sclerosis.
Green transformation is a boundary object: An analysis of conceptualisation of transformation in Norwegian primary industries
Authors: Amundsen Helene , Hermansen Erlend AT
Published: June 2020

The concept of green transformation is burgeoning in the academic literature and policy discourses, yet few empirical studies investigate what the concept actually means to diverse actors, and how it manifests in practices. This paper contributes to filling that gap. Through an analysis of policy documents and interviews, we investigate how central policy actors and interest organisations in Norwegian farming, fisheries and aquaculture conceptualise and enact transformation. The analysis of the policy documents shows that the concept ‘transformation’ is mentioned more frequently, and a rhetoric with close connotations to green growth is increasingly applied, which may leave the impression that there is consensus concerning what the concept means and entails. The interviews however leave a more nuanced picture. Among most of the actors, transformation is interpreted in terms of green growth, while a minority of the actors argue for a deeper sustainability, pointing to planetary limits. Clearly, what transformation is and what it entails is embedded in interpretive flexibility. The concept ‘transformation’ is plastic enough to be applied in several different, and partly conflicting, policy discourses and arenas. We argue that transformation can be understood as a boundary object, and different actors perform different sorts of boundary work to adapt the boundary object of ‘transformation’ to fit their agendas. Thus, it makes more sense to think of transformation in plural – transformations – instead of a single, consensual discourse. We find that the very practices of most of the actors are not transformative in the theoretical understanding of the concept and that inadequate attention is given to potential negative sides of transformation. Consequently, both scholarly and practical discussions on how to achieve transformation should take into account that different and (partly) conflicting interpretations will continue to exist and contribute to distinguish between different degrees of sustainability and related pathways.
Association of aberrantASNSimprinting with asparaginase sensitivity and chromosomal abnormality in childhood BCP-ALL
Authors: Watanabe Atsushi , Miyake Kunio , Nordlund Jessica , Syvänen Ann-Christine , van der Weyden Louise , Honda Hiroaki , Yamasaki Norimasa , Nagamachi Akiko , Inaba Toshiya , Ikawa Tomokatsu , Urayama Kevin Y. , Kiyokawa Nobutaka , Ohara Akira , Kimura Shunsuke , Kubota Yasuo , Takita Junko , Goto Hiroaki , Sakaguchi Kimiyoshi , Minegishi Masayoshi , Iwamoto Shotaro , Shinohara Tamao , Kagami Keiko , Abe Masako , Akahane Koshi , Goi Kumiko , Sugita Kanji , Inukai Takeshi
Published: June 2020

Karyotype is an important prognostic factor in childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL), but the underlying pharmacogenomics remain unknown. Asparaginase is an integral component in current chemotherapy for childhood BCP-ALL. Asparaginase therapy depletes serum asparagine. Normal hematopoietic cells can produce asparagine by asparagine synthetase (ASNS) activity, but ALL cells are unable to synthesize adequate amounts of asparagine. The ASNS gene has a typical CpG island in its promoter. Thus, methylation of the ASNS CpG island could be one of the epigenetic mechanisms for ASNS gene silencing in BCP-ALL. To gain deep insights into the pharmacogenomics of asparaginase therapy, we investigated the association of ASNS methylation status with asparaginase sensitivity. The ASNS CpG island is largely unmethylated in normal hematopoietic cells, but it is allele-specifically methylated in BCP-ALL cells. The ASNS gene is located at 7q21, an evolutionally conserved imprinted gene cluster. ASNS methylation in childhood BCP-ALL is associated with an aberrant methylation of the imprinted gene cluster at 7q21. Aberrant methylation of mouse Asns and a syntenic imprinted gene cluster is also confirmed in leukemic spleen samples from ETV6-RUNX1 knockin mice. In 3 childhood BCP-ALL cohorts, ASNS is highly methylated in BCP-ALL patients with favorable karyotypes but is mostly unmethylated in BCP-ALL patients with poor prognostic karyotypes. Higher ASNS methylation is associated with higher L-asparaginase sensitivity in BCP-ALL through lower ASNS gene and protein expression levels. These observations demonstrate that silencing of the ASNS gene as a result of aberrant imprinting is a pharmacogenetic mechanism for the leukemia-specific activity of asparaginase therapy in BCP-ALL.
Hematopoietic stem cells acquire survival advantage by loss of RUNX1 methylation identified in familial leukemia
Authors: Matsumura Takayoshi , Nakamura-Ishizu Ayako , Muddineni Siva Sai Naga Anurag , Tan Darren Qiancheng , Wang Chelsia Qiuxia , Tokunaga Kenji , Tirado-Magallanes Roberto , Sian Stephanie , Benoukraf Touati , Okuda Tsukasa , Asou Norio , Matsuoka Masao , Osato Motomi , Suda Toshio
Published: June 2020

RUNX1 is among the most frequently mutated genes in human leukemia, and the loss or dominant-negative suppression of RUNX1 function is found in myelodysplastic syndrome and acute myeloid leukemia (AML). How posttranslational modifications (PTMs) of RUNX1 affect its in vivo function, however, and whether PTM dysregulation of RUNX1 can cause leukemia are largely unknown. We performed targeted deep sequencing on a family with 3 occurrences of AML and identified a novel RUNX1 mutation, R237K. The mutated R237 residue is a methylation site by protein arginine methyltransferase 1, and loss of methylation reportedly impairs the transcriptional activity of RUNX1 in vitro. To explore the biologic significance of RUNX1 methylation in vivo, we used RUNX1 R233K/R237K double-mutant mice, in which 2 arginine-to-lysine mutations precluded RUNX1 methylation. Genetic ablation of RUNX1 methylation led to loss of quiescence and expansion of hematopoietic stem cells (HSCs), and it changed the genomic and epigenomic signatures of phenotypic HSCs to a poised progenitor state. Furthermore, loss of RUNX1 R233/R237 methylation suppressed endoplasmic reticulum stress–induced unfolded protein response genes, including Atf4, Ddit3, and Gadd34; the radiation-induced p53 downstream genes Bbc3, Pmaip1, and Cdkn1a; and subsequent apoptosis in HSCs. Mechanistically, activating transcription factor 4 was identified as a direct transcriptional target of RUNX1. Collectively, defects in RUNX1 methylation in HSCs confer resistance to apoptosis and survival advantage under stress conditions, a hallmark of a preleukemic clone that may predispose affected individuals to leukemia. Our study will lead to a better understanding of how dysregulation of PTMs can contribute to leukemogenesis.
Mutational and phenotypic characterization of hereditary hemorrhagic telangiectasia
Authors: Shovlin Claire L. , Simeoni Ilenia , Downes Kate , Frazer Zoe C. , Megy Karyn , Bernabeu-Herrero Maria E. , Shurr Abigail , Brimley Jennifer , Patel Dilipkumar , Kell Loren , Stephens Jonathan , Turbin Isobel G. , Aldred Micheala A. , Penkett Christopher J. , Ouwehand Willem H. , Jovine Luca , Turro Ernest
Published: June 2020

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia. Care delivery for HHT patients is impeded by the need for laborious, repeated phenotyping and gaps in knowledge regarding the relationships between causal DNA variants in ENG, ACVRL1, SMAD4 and GDF2, and clinical manifestations. To address this, we analyzed DNA samples from 183 previously uncharacterized, unrelated HHT and suspected HHT cases using the ThromboGenomics high-throughput sequencing platform. We identified 127 rare variants across 168 heterozygous genotypes. Applying modified American College of Medical Genetics and Genomics Guidelines, 106 variants were classified as pathogenic/likely pathogenic and 21 as nonpathogenic (variant of uncertain significance/benign). Unlike the protein products of ACVRL1 and SMAD4, the extracellular ENG amino acids are not strongly conserved. Our inferences of the functional consequences of causal variants in ENG were therefore informed by the crystal structure of endoglin. We then compared the accuracy of predictions of the causal gene blinded to the genetic data using 2 approaches: subjective clinical predictions and statistical predictions based on 8 Human Phenotype Ontology terms. Both approaches had some predictive power, but they were insufficiently accurate to be used clinically, without genetic testing. The distributions of red cell indices differed by causal gene but not sufficiently for clinical use in isolation from genetic data. We conclude that parallel sequencing of the 4 known HHT genes, multidisciplinary team review of variant calls in the context of detailed clinical information, and statistical and structural modeling improve the prognostication and treatment of HHT.
PAR4 activation involves extracellular loop 3 and transmembrane residue Thr153
Authors: Han Xu , Hofmann Lukas , de la Fuente Maria , Alexander Nathan , Palczewski Krzysztof ,   the INVENT Consortium, Nieman Marvin T.
Published: June 2020

Protease-activated receptor 4 (PAR4) mediates sustained thrombin signaling in platelets and is required for a stable thrombus. PAR4 is activated by proteolysis of the N terminus to expose a tethered ligand. The structural basis for PAR4 activation and the location of its ligand binding site (LBS) are unknown. Using hydrogen/deuterium exchange (H/D exchange), computational modeling, and signaling studies, we determined the molecular mechanism for tethered ligand–mediated PAR4 activation. H/D exchange identified that the LBS is composed of transmembrane 3 (TM3) domain and TM7. Unbiased computational modeling further predicted an interaction between Gly48 from the tethered ligand and Thr153 from the LBS. Mutating Thr153 significantly decreased PAR4 signaling. H/D exchange and modeling also showed that extracellular loop 3 (ECL3) serves as a gatekeeper for the interaction between the tethered ligand and LBS. A naturally occurring sequence variant (P310L, rs2227376) and 2 experimental mutations (S311A and P312L) determined that the rigidity conferred by prolines in ECL3 are essential for PAR4 activation. Finally, we examined the role of the polymorphism at position 310 in venous thromboembolism (VTE) using the International Network Against Venous Thrombosis (INVENT) consortium multi-ancestry genome-wide association study (GWAS) meta-analysis. Individuals with the PAR4 Leu310 allele had a 15% reduction in relative risk for VTE (odds ratio, 0.85; 95% confidence interval, 0.77-0.94) compared with the Pro310 allele. These data are consistent with our H/D exchange, molecular modeling, and signaling studies. In conclusion, we have uncovered the structural basis for PAR4 activation and identified a previously unrecognized role for PAR4 in VTE.
Monoclonal immunoglobulins promote bone loss in multiple myeloma
Authors: Westhrin Marita , Kovcic Vlado , Zhang Zejian , Moen Siv H. , Nedal Tonje Marie Vikene , Bondt Albert , Holst Stephanie , Misund Kristine , Buene Glenn , Sundan Anders , Waage Anders , Slørdahl Tobias S. , Wuhrer Manfred , Standal Therese
Published: June 2020

Most patients with multiple myeloma develop a severe osteolytic bone disease. The myeloma cells secrete immunoglobulins, and the presence of monoclonal immunoglobulins in the patient’s sera is an important diagnostic criterion. Here, we show that immunoglobulins isolated from myeloma patients with bone disease promote osteoclast differentiation when added to human preosteoclasts in vitro, whereas immunoglobulins from patients without bone disease do not. This effect was primarily mediated by immune complexes or aggregates. The function and aggregation behavior of immunoglobulins are partly determined by differential glycosylation of the immunoglobulin-Fc part. Glycosylation analyses revealed that patients with bone disease had significantly less galactose on immunoglobulin G (IgG) compared with patients without bone disease and also less sialic acid on IgG compared with healthy persons. Importantly, we also observed a significant reduction of IgG sialylation in serum of patients upon onset of bone disease. In the 5TGM1 mouse myeloma model, we found decreased numbers of lesions and decreased CTX-1 levels, a marker for osteoclast activity, in mice treated with a sialic acid precursor, N-acetylmannosamine (ManNAc). ManNAc treatment increased IgG-Fc sialylation in the mice. Our data support that deglycosylated immunoglobulins promote bone loss in multiple myeloma and that altering IgG glycosylation may be a therapeutic strategy to reduce bone loss.
Identification of pathogens from native urine samples by MALDI-TOF/TOF tandem mass spectrometry
Authors: Oros Damir , Ceprnja Marina , Zucko Jurica , Cindric Mario , Hozic Amela , Skrlin Jasenka , Barisic Karmela , Melvan Ena , Uroic Ksenija , Kos Blazenka , Starcevic Antonio
Published: June 2020

Background

Reliable high-throughput microbial pathogen identification in human urine samples is crucial for patients with cystitis symptoms. Currently employed methods are time-consuming and could lead to unnecessary or inadequate antibiotic treatment. Purpose of this study was to assess the potential of mass spectrometry for uropathogen identification from a native urine sample.

Methods

In total, 16 urine samples having more than 105 CFU/mL were collected from clinical outpatients. These samples were analysed using standard urine culture methods, followed by 16S rRNA gene sequencing serving as control and here described culture-independent MALDI-TOF/TOF MS method being tested.

Results

Here we present advantages and disadvantages of bottom-up proteomics, using MALDI-TOF/TOF tandem mass spectrometry, for culture-independent identification of uropathogens (e.g. directly from urine samples). The direct approach provided reliable identification of bacteria at the genus level in monobacterial samples. Taxonomic identifications obtained by proteomics were compared both to standard urine culture test used in clinics and genomic test based on 16S rRNA sequencing.

Conclusions

Our findings indicate that mass spectrometry has great potential as a reliable high-throughput tool for microbial pathogen identification in human urine samples. In this case, the MALDI-TOF/TOF, was used as an analytical tool for the determination of bacteria in urine samples, and the results obtained emphasize high importance of storage conditions and sample preparation method impacting reliability of MS2 data analysis. The proposed method is simple enough to be utilized in existing clinical settings and is highly suitable for suspected single organism infectious etiologies. Further research is required in order to identify pathogens in polymicrobial urine samples.
Impact of sub-setting the data of the main Limousin beef cattle population on the estimates of across-country genetic correlations
Authors: Bonifazi Renzo , Vandenplas Jeremie , Napel Jan ten , Matilainen Kaarina , Veerkamp Roel F. , Calus Mario P. L.
Published: June 2020

Background

Cattle international genetic evaluations allow the comparison of estimated breeding values (EBV) across different environments, i.e. countries. For international evaluations, across-country genetic correlations (rg) need to be estimated. However, lack of convergence of the estimated parameters and high standard errors of thergare often experienced for beef cattle populations due to limited across-country genetic connections. Furthermore, using all available genetic connections to estimatergis prohibitive due to computational constraints, thus sub-setting the data is necessary. Our objective was to investigate and compare the impact of strategies of data sub-setting on estimated across-countryrgand their computational requirements.

Methods

Phenotype and pedigree information for age-adjusted weaning weight was available for ten European countries and 3,128,338 Limousin beef cattle males and females. Using a Monte Carlo based expectation–maximization restricted maximum likelihood (MC EM REML) methodology, we estimated across-countryrgby using a multi-trait animal model where countries are modelled as different correlated traits. Values ofrgwere estimated using the full data and four different sub-setting strategies that aimed at selecting the most connected herds from the largest population.

Results

Using all available data, direct and maternalrg(standard errors in parentheses) were on average equal to 0.79 (0.14) and 0.71 (0.19), respectively. Direct-maternal within-country and between-countryrgwere on average equal to − 0.12 (0.09) and 0.00 (0.14), respectively. Data sub-setting scenarios gave similar results: on average, estimatedrgwere smaller compared to using all data for direct (0.02) and maternal (0.05) genetic effects. The largest differences were obtained for the direct-maternal within-country and between-countryrg, which were, on average 0.13 and 0.12 smaller compared to values obtained by using all data. Standard errors always increased when reducing the data, by 0.02 to 0.06, on average. The proposed sub-setting strategies reduced the required computing time up to 22% compared to using all data.

Conclusions

Estimating all 120 across-countryrgthat are required for beef cattle international evaluations, using a multi-trait MC EM REML approach, is feasible but involves long computing time. We propose four strategies to reduce computational requirements while keeping a multi-trait estimation approach. In all scenarios with data sub-setting, the estimatedrgwere consistently smaller (mainly for direct-maternalrg) and had larger standard errors.
Association of functional limitations and disability with elder abuse in India: a cross-sectional study
Authors: Sathya T. , Premkumar Ramaswamy
Published: June 2020

Background

Globally, elder abuse is a common form of violence against the elderly. This study examines the association of disability and functional ability measures with elder abuse in India.

Methods

Cross-sectional data from the UNFPA’s ‘Building Knowledge Base on Population Ageing in India’ (BKPAI 2011) have been analysed. Bivariate and multivariate logistic regression analyses have been used to examine the association of measures of disability and functional ability with elder abuse/mistreatment.

Results

The overall prevalence of elder abuse in the study population is 11.4%. The prevalence of elder abuse experienced by study participants in the month before the survey is 6%. The prevalence of disability/functional ability increases the likelihood of elder abuse. Furthermore, the association between functional ability and abuse is stronger and consistent among the elderly who experienced abuse in the month preceding the survey. In addition, the association between disability and elder abuse is stronger in urban areas. Another observation is that gender introduces considerable disparities in the association of disability and functional ability measures with elder abuse. While elderly men with more than two disabilities are 1.85 times (95% CI: 1.23, 2.77,p < 0.003) more likely to experience abuse/mistreatment, women are 3.16 times (CI: 2.22, 4.49,p < .001) more exposed to it.

Conclusions

The results of this study suggest a significant association of disability and functional ability with elder abuse. The association differs considerably by place of residence and gender. Measures to improve the functional health of the elderly population and measures to protect the elderly with disability and functional limitations are important in preventing abuse/mistreatment in old age.
Risk factors for disease progression in COVID-19 patients
Authors: Chang Min Cheol , Park Yu-Kyung , Kim Bong-Ok , Park Donghwi
Published: June 2020

Background

Coronavirus disease (COVID-19) is rapidly spreading worldwide. Although 10–20% of patients with COVID-19 have severe symptoms, little is known about the risk factors related to the aggravation of COVID-19 symptoms from asymptomatic or mild to severe disease states.

Methods

This retrospective study included 211 patients who were asymptomatic or with mild presentations of COVID-19. We evaluated the differences in demographic and clinical data between the cured (discharged to home) and transferred (aggravated to severe-stage COVID-19) groups.

Results

A multivariate logistic analysis showed that body temperature, chills, initial chest X-ray findings, and the presence of diabetes were significantly associated with predicting the progression to severe stage of COVID-19 (p < 0.05). The odds ratio of transfer in patients with COVID-19 increased by 12.7-fold for abnormal findings such as haziness or consolidation in initial chest X-ray, 6.32-fold for initial symptom of chills, and 64.1-fold for diabetes.

Conclusions

Even if patients are asymptomatic or have mild symptoms, clinicians should closely observe patients with COVID-19 presenting with chills, body temperature > 37.5 °C, findings of pneumonia in chest X-ray, or diabetes.
Multilevel ordinal model for CD4 count trends in seroconversion among South Africa women
Authors: Dessie Zelalem G. , Zewotir Temesgen , Mwambi Henry , North Delia
Published: June 2020

Background

Ordinal health longitudinal response variables have distributions that make them unsuitable for many popular statistical models that assume normality. We present a multilevel growth model that may be more suitable for medical ordinal longitudinal outcomes than are statistical models that assume normality and continuous measurements.

Methods

The data is from an ongoing prospective cohort study conducted amongst adult women who are HIV-infected patients in Kwazulu-Natal, South Africa. Participants were enrolled into the acute infection, then into early infection subsequently into established infection and afterward on cART. Generalized linear multilevel models were applied.

Results

Multilevel ordinal non-proportional and proportional-odds growth models were presented and compared. We observed that the effects of covariates can’t be assumed identical across the three cumulative logits. Our analyses also revealed that the rate of change of immune recovery of patients increased as the follow-up time increases. Patients with stable sexual partners, middle-aged, cART initiation, and higher educational levels were more likely to have better immunological stages with time. Similarly, patients having high electrolytes component scores, higher red blood cell indices scores, higher physical health scores, higher psychological well-being scores, a higher level of independence scores, and lower viral load more likely to have better immunological stages through the follow-up time.

Conclusion

It can be concluded that the multilevel non-proportional-odds method provides a flexible modeling alternative when the proportional-odds assumption of equal effects of the predictor variables at every stage of the response variable is violated. Having higher clinical parameter scores, higher QoL scores, higher educational levels, and stable sexual partners were found to be the significant factors for trends of CD4 count recovery.
CT findings of patients infected with SARS-CoV-2
Authors: Wang Xiaoyang , Liu Chenbin , Hong Liang , Yuan Cuiyun , Ding Jiguang , Jia Qing , Sun Gangqiang , Peng Wenxian , Sun Qingfeng
Published: June 2020

Background

We aimed to describe the chest CT findings in sixty-seven patients infected by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

We retrospectively reviewed 67 patients hospitalized in Ruian People’s Hospital. All the patients received the positive diagnosis of SARS-CoV-2 infection. The CT and clinical data were collected between January 23rd, 2020 and February 10th, 2020. The CT images were analyzed by the senior radiologists.

Results

There are 54 patients with positive CT findings and 13 patients with negative CT findings. The typical CT findings in hospitalized patients with SARS-CoV-2 infection were ground glass opacities (42/54), lesions located in the peripheral area (50/54), multiple lesions (46/54), and lesions located in the lower lobes (42/54). There were less typical CT findings, including air bronchogram (18/54), pleural thickening or pleural effusion (14/54), consolidation (12/54), lesions in the upper lobes (12/54), interlobular septal thickening (11/54), reversed halo sign (9/54), single lesion (8/54), air cavities (4/54), bronchial wall thickening (3/54), and intrathoracic lymph node enlargement (2/54).

Conclusions

CT features can play an important role in the early diagnosis and follow-up of COVID-19 patients.
Treatment of recurrent renal transplant lithiasis: analysis of our experience and review of the relevant literature
Authors: Li Xiaohang , Li Baifeng , Meng Yiman , Yang Lei , Wu Gang , Jing Hongwei , Bi Jianbin , Zhang Jialin
Published: June 2020

Background

Renal transplant lithiasis is a rather unusual disease, and the recurrence of lithiasis presents a challenging situation.

Methods

We retrospectively analyzed the medical history of one patient who suffered renal transplant lithiasis twice, reviewed the relevant literature, and summarized the characteristics of this disease.

Results

We retrieved 29 relevant studies with an incidence of 0.34 to 3.26% for renal transplant lithiasis. The summarized incidence was 0.52%, and the recurrence rate was 0.082%. The mean interval after transplantation was 33.43 ± 56.70 mo. Most of the patients (28.90%) were asymptomatic. The management included percutaneous nephrolithotripsy (PCNL, 22.10%), ureteroscope (URS, 22.65%), extracorporeal shockwave lithotripsy (ESWL, 18.60%) and conservative treatment (17.13%). In our case, the patient suffered from renal transplant lithiasis at 6 years posttransplantation, and the lithiasis recurred 16 months later. He presented oliguria, infection or acute renal failure (ARF) during the two attacks but without pain. PCNL along with URS and holmium laser lithotripsy were performed. The patient recovered well after surgery, except for a 3 mm residual stone in the calyx after the second surgery. He had normal renal function without any symptoms and was discharged with oral anticalculus drugs and strict follow-up at the clinic. Fortunately, the calculus passed spontaneously about 1 month later.

Conclusions

Due to the lack of specific symptoms in the early stage, patients with renal transplant lithiasis may have delayed diagnosis and present ARF. Minimally invasive treatment is optimal, and the combined usage of two or more procedures is beneficial for patients. After surgery, taking anticalculus drugs, correcting metabolic disorders and avoiding UIT are key measures to prevent the recurrence of lithiasis.
Ex vivo modelling of drug efficacy in a rare metastatic urachal carcinoma
Authors: Mäkelä Rami , Arjonen Antti , Härmä Ville , Rintanen Nina , Paasonen Lauri , Paprotka Tobias , Rönsch Kerstin , Kuopio Teijo , Kononen Juha , Rantala Juha K.
Published: June 2020

Background

Ex vivo drug screening refers to the out-of-body assessment of drug efficacy in patient derived vital tumor cells. The purpose of these methods is to enable functional testing of patient specific efficacy of anti-cancer therapeutics and personalized treatment strategies. Such approaches could prove powerful especially in context of rare cancers for which demonstration of novel therapies is difficult due to the low numbers of patients. Here, we report comparison of different ex vivo drug screening methods in a metastatic urachal adenocarcinoma, a rare and aggressive non-urothelial bladder malignancy that arises from the remnant embryologic urachus in adults.

Methods

To compare the feasibility and results obtained with alternative ex vivo drug screening techniques, we used three different approaches; enzymatic cell viability assay of 2D cell cultures and image-based cytometry of 2D and 3D cell cultures in parallel. Vital tumor cells isolated from a biopsy obtained in context of a surgical debulking procedure were used for screening of 1160 drugs with the aim to evaluate patterns of efficacy in the urachal cancer cells.

Results

Dose response data from the enzymatic cell viability assay and the image-based assay of 2D cell cultures showed the best consistency. With 3D cell culture conditions, the proliferation rate of the tumor cells was slower and potency of several drugs was reduced even following growth rate normalization of the responses. MEK, mTOR, and MET inhibitors were identified as the most cytotoxic targeted drugs. Secondary validation analyses confirmed the efficacy of these drugs also with the new human urachal adenocarcinoma cell line (MISB18) established from the patient’s tumor.

Conclusions

All the tested ex vivo drug screening methods captured the patient’s tumor cells’ sensitivity to drugs that could be associated with the oncogenic KRASG12V mutation found in the patient’s tumor cells. Specific drug classes however resulted in differential dose response profiles dependent on the used cell culture method indicating that the choice of assay could bias results from ex vivo drug screening assays for selected drug classes.
Retraction Note: Comparison of 0.05% cyclosporine and 3% diquafosol solution for dry eye patients: a randomized, blinded, multicenter clinical trial
Authors: Park Chang Hyun , Lee Hyung Keun , Kim Mee Kum , Kim Eun Chul , Kim Jae Yong , Kim Tae-im , Kim Hong Kyun , Song Jong Suk , Yoon Kyung Chul , Lee Do Hyung , Chung Tae-Young , Choi Chul Young , Kim Hyun Seung
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Utilization of machine learning to test the impact of cognitive processing and emotion recognition on the development of PTSD following trauma exposure
Authors: Augsburger Mareike , Galatzer-Levy Isaac R.
Published: June 2020

Background

Though lifetime exposure to traumatic events is significant, only a minority of individuals develops symptoms of posttraumatic stress disorder (PTSD). Post-trauma alterations in neurocognitive and affective functioning are likely to reflect changes in underlying brain networks that are predictive of PTSD. These constructs are assumed to interact in a highly complex way. The aim of this exploratory study was to apply machine learning models to investigate the contribution of these interactions on PTSD symptom development and identify measures indicative of circuit related dysfunction.

Methods

N = 94 participants admitted to the emergency room of an inner-city hospital after trauma exposure completed a battery of neurocognitive and emotional tests 1 month after the incident. Different machine learning algorithms were applied to predict PTSD symptom severity and clusters after 3 months based.

Results

Overall, model accuracy did not differ between PTSD clusters, though the importance of cognitive and emotional domains demonstrated both key differences and overlap. Alterations in higher-order executive functioning, speed of information processing, and processing of emotionally incongruent cues were the most important predictors.

Conclusions

Data-driven approaches are a powerful tool to investigate complex interactions and can enhance the mechanistic understanding of PTSD. The study identifies important relationships between cognitive processing and emotion recognition that may be valuable to predict and understand mechanisms of risk and resilience responses to trauma prospectively.
Low uptake of continuous subcutaneous insulin infusion therapy in people with type 1 diabetes in Ireland: a retrospective cross-sectional study
Authors: Gajewska Katarzyna Anna , Bennett Kathleen , Biesma Regien , Sreenan Seamus
Published: June 2020

Background

The uptake of continuous subcutaneous insulin infusion (CSII) therapy in those with type 1 diabetes varies internationally and is mainly determined by the national healthcare reimbursement systems. The aim of this study is to estimate national and regional uptake of CSII therapy in children, adolescents and adults with type 1 diabetes in Ireland.

Methods

A retrospective cross-sectional study was conducted utilizing the national pharmacy claims database in 2016. Individuals using CSII were identified by dispensing of infusion sets. The uptake of CSII was calculated as the percentage of people with type 1 diabetes claiming CSII sets in 2016, both in children and adolescent (age < 18 years) and adult populations (≥ 18 years). Descriptive statistics including percentages with 95% confidence intervals (CIs) are presented, stratified by age-groups and geographical regions, and chi-square tests used for comparisons.

Results

Of 20,081 people with type 1 diabetes, 2111 (10.5, 95% CI: 10.1–10.9%) were using CSII in 2016. Uptake was five-fold higher in children and adolescents at 34.7% (95% CI: 32.9–36.5%) than in adults at 6.8% (95% CI: 6.4–7.2%). Significant geographical heterogeneity in CSII uptake was found, from 12.6 to 53.7% in children and adolescents (p < 0.001), and 2 to 9.6% in adults (p < 0.001).

Conclusions

Uptake of CSII in people with type 1 diabetes is low in Ireland, particularly in those ≥18 years. Identification of barriers to uptake, particularly in this group, is required.
A rare long-term undetected pheochromocytoma leading to Takotsubo syndrome in an older male patient: a case report
Authors: Chen Min , Zhao Tong , Chen Guoping , Hu Shenjiang
Published: June 2020

Background

Takotsubo syndrome is an uncommon, acute, and reversible cardiomyopathy that occurs primarily in postmenopausal females. The clinical presentation of the syndrome resembles acute coronary syndrome, but coronary angiography reveals no obstructive coronary artery disease. Rarely, a catecholamine surge due to pheochromocytoma may induce Takotsubo syndrome. The clinical features of pheochromocytoma include paroxysmal hypertension, headache, palpitations, and profuse sweating. However, owing to the episodic, rather than continued, symptoms and signs of pheochromocytoma, its timely diagnosis poses a challenge for clinicians. Here, we report a rare case of long-term undetected pheochromocytoma leading to Takotsubo syndrome in an older male patient.

Case presentation

A 70-year-old man presented with paroxysmal chest distress and chest pain. Examinations revealed acute coronary syndrome with normal coronary arteries, heart failure, reversible left ventricular regional wall motion abnormalities, labile blood pressure, a giant left adrenal mass, and extremely high levels of metanephrine and normetanephrine. Clinical manifestations, laboratory reports, and imaging findings suggested a diagnosis of Takotsubo syndrome caused by pheochromocytoma. Supportive therapy, administration of alpha- adrenergic receptor blockers, and left adrenal mass resection resolved the patient’s symptoms. A histological examination confirmed the presence of pheochromocytoma. We reviewed his history of midbrain hemorrhage 6 years prior and found a mass in the left adrenal region by reviewing the computed tomography images of the lung that were also taken 6 years prior, on which the pheochromocytoma was evident.

Conclusions

Our case illustrates the importance of understanding the link between pheochromocytoma and Takotsubo syndrome. A diagnosis of pheochromocytoma-induced Takotsubo syndrome should be considered during the differential diagnosis of acute coronary syndrome, especially in patients with labile blood pressure and normal coronary angiography findings; meanwhile, assessments of catecholamines and its metabolites and abdominal computed tomography scan should be performed at the right time. Clinicians should also be alert to potential pheochromocytoma in patients with unexplained cerebral hemorrhage, even in the absence of symptoms of catecholamine excess.
Health- and social care in the last year of life among older adults in Sweden
Authors: Hallgren Jenny , Johansson Linda , Lannering Christina , Ernsth Bravell Marie , Gillsjö Catharina
Published: June 2020

Background

In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of life among persons living in ordinary housing or in assisted living facilities.

Methods

A retrospective study examining health- and social care utilization during their last year of life, using a subsample from the Swedish twin registries individually linked to several Swedish national quality registries (NQR). Persons that died during 2008–2009 and 2011–2012 (n = 1518) were selected.

Results

Mean age at death was 85.9 ± 7.3 (range 65.1–109.0). Among the 1518 participants (women n = 888, 58.5%), of which 741 (49%) were living in assisted living facilities and 1061 (69.9%) had at least one hospitalization during last year of life. The most common causes of death were cardiovascular disease (43.8%) and tumors (15.3%). A multivariable logistic regression revealed that living in ordinary housing, younger age and higher numbers of NQR’s increased the likelihood of hospitalization.

Conclusions

Persons in their last year of life consumed high amount of health- and social care although 12% did not receive any home care. Married persons received less home care than never married. Persons living in ordinary housing had higher numbers of hospitalizations compared to participants in assisted living facilities. Older persons and persons registered in fewer NQR’s were less hospitalized.
RETRACTED ARTICLE: Ginkgolide B inhibits lung cancer cells promotion via beclin-1-dependent autophagy
Authors: Wang Xuan , Shao Qi-Hui , Zhou Hao , Wu Jun-Lu , Quan Wen-Qiang , Ji Ping , Yao Yi-Wen , Li Dong , Sun Zu-Jun
Published: June 2020

Background

Ginkgolide B (GKB) is a major active component of the extracts of Ginkgo biloba leaves, and it has been used as an anti-cancer agent. However, it is unknown whether GKB has the therapeutic effects on lung cancer. Here, we studied the effects of GKB on lung cancer cells.

Methods

The effects of GKB on lung cancer cell proliferation and invasion were analyzed by cell counting kit (CCK-8) and cell invasion assays, respectively. Apoptosis was detected by flow cytometry. Western blot analysis was used to confirm the expression of autophagy-associated proteins in GKB-treated cells. Immunofluorescence analysis was used to analyze the level of light chain 3B (LC3B).

Results

Treatment with GKB time-dependently inhibited the proliferation and decreased the invasive capacity of A549 and H1975 cells. GKB induced apoptosis of these cells, but there was no significant effect on apoptosis compared to the control treatment. GKB-induced inhibition of cell proliferation and GKB-induced cell death were due to autophagy rather than apoptosis. GKB-induced autophagy of lung cancer cells was dependent on beclin-1, and autophagy-induced inhibition of the NLRP3 inflammasome contributed to the anti-tumor effect of GKB.

Conclusions

GKB-mediated autophagy of lung cancer cells is beclin-1-dependent and results in inhibition of the NLRP3 inflammasome. Therefore, GKB might be a potential therapeutic candidate for the treatment of lung cancer.
Medical, nursing, and physician assistant student knowledge and attitudes toward climate change, pollution, and resource conservation in health care
Authors: Ryan Emma C. , Dubrow Robert , Sherman Jodi D.
Published: June 2020

Background

Climate change and pollution generated by the health care sector impose significant public health burdens. This study aimed to assess medical, nursing and physician assistant student knowledge and attitudes regarding climate change, pollution from the health care sector, and responsibility for resource conservation within professional practice.

Methods

In February–March, 2018, medical, nursing, and physician assistant students at Yale University (1011 potential respondents) were sent a 17-question online Qualtrics survey. Data analysis included descriptive statistics, as well as Fisher’s exact test and logistic regression to assess associations between variables of interest and the personal characteristics of gender, age, geographic place of origin, school, and year in school (among medical students).

Results

The response rate was 28% (280 respondents). 90% felt that physicians, nurses, and physician assistants have a responsibility to conserve resources and prevent pollution within their professional practice. 63% agreed or strongly agreed that the relationship between pollution, climate change, and health should be covered in the classroom and should be reinforced in the clinical setting. 57% preferred or strongly preferred reusable devices. 91% felt lack of time and production pressure, and 85% believed that lack of education on disease burden stemming from health care pollution, were barriers to taking responsibility for resource conservation and pollution prevention. Women and physician assistant students exhibited a greater commitment than men and medical students, respectively, to address pollution, climate change, and resource conservation in patient care and professional practice.

Conclusion

We found that health professional students are engaged with the concept of environmental stewardship in clinical practice and would like to see pollution, climate change, and health covered in their curriculum. In order for this education to be most impactful, more research and industry transparency regarding the environmental footprint of health care materials and specific clinician resource consumption patterns will be required.