bluuebunny/crossref_metadata_2025 huggingface dataset:
Wise Reasoning About the Future Is Associated With Adaptive Interpersonal Feelings After Relational Challenges
Authors: Peetz Johanna , Grossmann Igor
Published: June 2020

Two prospective studies examine how wise reasoning about an anticipated conflict interaction—intellectual humility, recognition of uncertainty and change, consideration and integration of different perspectives—is associated with interpersonal feelings and closeness to the interaction partner after the challenging interaction. In Study 1 ( N = 243) and preregistered replication Study 2 ( N = 234), participants who reasoned more wisely before an anticipated conflict interaction felt more positively toward and closer to the person involved in the conflict afterward. We explored three avenues accompanying effects of wise reasoning about the future for interpersonal outcomes: conflict outcome, perception of the interaction as fair and satisfying, and sense of meaning in the conflict experience. Path models indicated that sense of meaning was a consistent factor accounting for the positive effect of prospective wise reasoning for relational well-being. We discuss implications for research on prospection, wisdom, and well-being.
Interacting for Peace: Rethinking Peace Through Interactive Digital Platforms
Authors: Katz Yuval
Published: June 2020

Peace is often studied as a lull in war or as a way to make war inconceivable. In this study, I explore the ability of digital culture to promote a new understanding of peace as a communication concept. Specifically, I analyze small digital platforms devoted to making people care about peace by encouraging them to play, explore, listen, or participate in a variety of activities. Since war is centered around the occupation of spaces and places, I use time and temporality as a theoretical framework for understanding how these interactive digital platforms construct peace in a way that is meaningful to people. In this investigation of a popular meaning of peace, I argue that the epistemology of peace offers a promise for a better future while its ethics is a commitment to remembering the past. The ontology of peace is a lived experience found in daily practices in the present.
Walls and Cows: Social Media, Vigilante Vantage, and Political Discourse
Authors: Ward Megan
Published: June 2020

Vigilante groups in the United States and India have used social media to distribute their content and publicize violent spectacles for political purposes. This essay will tackle the spectacle of vigilante lynchings, abduction, and threats as images of vigilante violence are spread online in support of specific candidates, state violences, and election discourse. It is important to understand the impact of not only these vigilante groups, but understand the communicative spectacle of their content. Using Leo R. Chavez’s understanding of early 2000s vigilante action as spectacle in service of social movements, this essay extends the analysis to modern vigilante violence online content used as dramatic political rhetoric in support of sitting administrations. Two case studies on modern vigilante violence provide insight into this phenomenon are as follows: (1) Vigilante nativist militia groups across the United States in support of border militarization have kidnapped migrants in the Southwest desert, documenting these incidents to show support for the Trump Administration and building of a border wall and (2) vigilante mobs in India have circulated videos and media documenting lynchings of so-called “cow killers”; these attacks target Muslims in the light of growing Hindu Nationalist sentiment and political movement in the country. Localized disinformation and personal video allow vigilante content to spread across social media to recruit members for militias, as well as incite quick acts of mob violence. Furthermore, these case studies display how the social media livestreams and video allow representations of violence to become attention-arresting visual acts of political discourse.
Carpometacarpal Joint Dislocations: Management and Long-Term Outcomes at a Specialized Hand Surgery Center in Latin America
Authors: Telich-Tarriba Jose E. , Guevara-Valmaña Osvaldo I. , Navarro-Barquín David F. , Victor-Baldin Andre
Published: June 2020

Carpometacarpal joint dislocations are uncommon hand injuries. These dislocations are usually misdiagnosed due to their non-specific clinical signs and tend to be difficult to identify in simple X-rays. We report our experience in the management of carpometacarpal bone dislocations at a specialized hand surgery center. Patients with carpometacarpal dislocations seen at the emergency department between 2013 and 2017 were included. All patients were treated with either closed reduction and percutaneous pinning (CRPP) or open reduction and internal fixation (ORIF). Postoperative functional assessment was performed at 6 and 18 months using the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Eleven patients were included, 8 (72%) were managed with CRPP and the rest required ORIF (28%). For the functional outcome, we found an average DASH score of 27.9 at the 6 months threshold and of 1.5 at the 18 months threshold. Carpometacarpal dislocations are uncommon and easy to misdiagnose; the hand surgeon should have a high clinical suspicion in patients who sustained high-energy trauma, and imaging studies should be thoroughly evaluated. Closed reduction and percutaneous pinning is a safe and effective treatment option, with long-term good functional results.
After Less Than 2 Months, the Simulations That Drove the World to Strict Lockdown Appear to be Wrong, the Same of the Policies They Generated
Authors: Boretti Alberto
Published: June 2020

Here, we review modeling predictions for Covid-19 mortality based on recent data. The Imperial College model trusted by the British Government predicted peak mortalities above 170 deaths per million in the United States, and above 215 deaths per million in Great Britain, after more than 2 months from the outbreak, and a length for the outbreak well above 4 months. These predictions drove the world to adopt harsh distancing measures and forget the concept of herd immunity. China had peak mortalities of less than 0.1 deaths per million after 40 days since first deaths, and an 80-day-long outbreak. Italy, Belgium, the Netherlands, Sweden, or Great Britain flattened the curve at 13.6, 28.6, 9.0, 10.6, and 13.9 deaths per million after 40, 39, 33, 44, and 39 days from first deaths, or 31, 29, 24, 38, and 29 days since the daily confirmed deaths reached 0.1 per million people, respectively. The declining curve is much slower for Italy, the Netherlands, or Great Britain than Belgium or Sweden. Opposite to Great Britain, Italy, or Belgium that enforced a complete lockdown, the Netherlands only adopted an “intelligent” lockdown, and Sweden did not adopt any lockdown. However, they achieved better results. Coupled to new evidence for minimal impact of Covid-19 on the healthy population, with the most part not infected even if challenged, or only mild or asymptomatic if infected, there are many good reasons to question the validity of the specific epidemiological model simulations and the policies they produced. Fewer restrictions on the healthy while better protecting the vulnerable would have been a much better option, permitting more sustainable protection of countries otherwise at risk of second waves as soon as the strict measures are lifted.
The implication of ROS production on triflumuron-induced oxidative stress and genotoxicity in human colon carcinoma (HCT-116) cells
Authors: Timoumi Rim , Amara Ines , Salem Intidhar Ben , Buratti Matia Franca , Testai Emanuella , Abid-Essefi Salwa
Published: June 2020

The aim of this study is to evaluate the cytotoxic and the genotoxic effects of triflumuron (TFM) on human colon carcinoma cells (HCT-116). Indeed, TFM is used to protect vegetables, fruits, and domestic animals against a large spectrum of parasites causing animal and human disorders. However, studies revealing its toxicity and its mode of action in mammalian systems remain very limited. We monitored our work with the cytotoxicity assay starting with the cell viability test, the ROS generation, the malondialdehyde (MDA) production, the DNA fragmentation, and the measurement of some antioxidant enzymes activities such as catalase, superoxide dismutase, and the glutathione S-transferase. Also, we measured the mitochondrial transmembrane potential. We showed that TFM induced a dose-dependent cell death. This decrease in cell viability was accompanied by a significant reduction in the mitochondrial membrane potential. We also have shown that TFM induced oxidative stress as revealed by the generation of reactive oxygen species, the increase of the MDA levels, and the activation of the antioxidant enzymes. Moreover, our results indicated that TFM induced DNA damage in HCT-116 cells as monitored by the comet assay. We demonstrate, for the first time, the cytotoxic and the genotoxic potentials of TFM on human cultured cells.
Use of Sexually Explicit Materials as Sex Education Tools to Reduce the Number of Recurrences of Urinary Tract Infection in Sexually Active Women
Authors: Bhat Gajanan Shripad , Shastry Anuradha
Published: June 2020

Context: As sexual intercourse is a known risk factor for recurrent urinary tract infection (UTI) in women, we decided to evaluate a novel method of sex education using sexually explicit materials (SEM) to reduce the number of recurrences of UTI in sexually active women, when the other preventive measures fail to reduce the number of recurrences of UTI in these women.

Methods: After obtaining written informed consent and ethical committee approval, sexually active women with a single sexual partner, who presented for recurrent symptomatic UTI following sexual intercourse, were included in this study. The absence of recurrence for 6 months, successful postcoital drug prophylaxis, the presence of comorbidities, anatomical abnormalities of the genitourinary tract (GUT), history of instrumentation of GUT, and use of contraception were exclusion criteria. Their demographic profile, socioeconomic status, imaging studies, pre- and post-intervention urine culture profile and pre- and post-intervention sexual practices were recorded. During every visit, all these women along with their male partners were given sex education sessions about healthy sexual practices using SEM. Data is analyzed.

Results: Study period was January 2012 to June 2018. A total of 107 women with the mean age of 30.11 years were included in the study. A total of 82% of UTI were due to Escherichia coli, whereas the other cases were attributable to Klebsiella, Proteus, and Staphylococcus saprophyticus. Their preintervention yearly incidence of documented UTI was 4.04 episodes which reduced to 1.91 episodes post intervention.

Conclusions: Sex education with SEM can be an option to treat recurrent UTI in sexually active women.
Correcting β-thalassemia by combined therapies that restrict iron and modulate erythropoietin activity
Authors: Casu Carla , Pettinato Mariateresa , Liu Alison , Aghajan Mariam , Lo Presti Vania , Lidonnici Maria Rosa , Munoz Kevin A. , O’Hara Emir , Olivari Violante , Di Modica Simona Maria , Booten Sheri , Guo Shuling , Neil Garry , Miari Reem , Shapir Nir , Zafir-Lavie Inbal , Domev Hagit , Ferrari Giuliana , Sitara Despina , Nai Antonella , Rivella Stefano
Published: June 2020

β-Thalassemia intermedia is a disorder characterized by ineffective erythropoiesis (IE), anemia, splenomegaly, and systemic iron overload. Novel approaches are being explored based on the modulation of pathways that reduce iron absorption (ie, using hepcidin activators like Tmprss6-antisense oligonucleotides [ASOs]) or increase erythropoiesis (by erythropoietin [EPO] administration or modulating the ability of transferrin receptor 2 [Tfr2] to control red blood cell [RBC] synthesis). Targeting Tmprss6 messenger RNA by Tmprss6-ASO was proven to be effective in improving IE and splenomegaly by inducing iron restriction. However, we postulated that combinatorial strategies might be superior to single therapies. Here, we combined Tmprss6-ASO with EPO administration or removal of a single Tfr2 allele in the bone marrow of animals affected by β-thalassemia intermedia (Hbbth3/+). EPO administration alone or removal of a single Tfr2 allele increased hemoglobin levels and RBCs. However, EPO or Tfr2 single-allele deletion alone, respectively, exacerbated or did not improve splenomegaly in β-thalassemic mice. To overcome this issue, we postulated that some level of iron restriction (by targeting Tmprss6) would improve splenomegaly while preserving the beneficial effects on RBC production mediated by EPO or Tfr2 deletion. While administration of Tmprss6-ASO alone improved the anemia, the combination of Tmprss6-ASO + EPO or Tmprss6-ASO + Tfr2 single-allele deletion produced significantly higher hemoglobin levels and reduced splenomegaly. In conclusion, our results clearly indicate that these combinatorial approaches are superior to single treatments in ameliorating IE and anemia in β-thalassemia and could provide guidance to translate some of these approaches into viable therapies.
KEYNOTE-013 4-year follow-up of pembrolizumab in classical Hodgkin lymphoma after brentuximab vedotin failure
Authors: Armand Philippe , Kuruvilla John , Michot Jean-Marie , Ribrag Vincent , Zinzani Pier Luigi , Zhu Ying , Marinello Patricia , Nahar Akash , Moskowitz Craig H.
Published: June 2020

The KEYNOTE-013 study was conducted to evaluate pembrolizumab monotherapy in hematologic malignancies; classical Hodgkin lymphoma (cHL) was an independent expansion cohort. We present long-term results based on >4 years of median follow-up for the cHL cohort. The trial enrolled cHL patients who experienced relapse after, were ineligible for, or declined autologous stem cell transplantation and experienced progression with or did not respond to brentuximab vedotin. Patients received IV pembrolizumab 10 mg/kg every 2 weeks for up to 2 years or until confirmed progression or unacceptable toxicity. Primary end points were safety and complete response (CR) rate by central review. Enrolled patients (N = 31) had received a median of 5 therapies (range, 2 to 15). After a median follow-up of 52.8 months (range, 7.0 to 57.6 months), CR rate was 19%, and median duration of response (DOR) was not reached; 24-month and 36-month DOR rates were both 50% by the Kaplan-Meier method. Median overall survival was not reached; 36-month overall survival was 81%. Six patients (19%) experienced grade 3 treatment-related adverse events (AEs); there were no grade 4 or 5 treatment-related AEs. With long-term follow-up among a heavily pretreated cohort, pembrolizumab had a favorable safety profile; some patients maintained long-term response with pembrolizumab years after end of treatment. This trial was registered at www.clinicaltrials.gov as #NCT01953692.
Artificial thymic organoids represent a reliable tool to study T-cell differentiation in patients with severe T-cell lymphopenia
Authors: Bosticardo Marita , Pala Francesca , Calzoni Enrica , Delmonte Ottavia M. , Dobbs Kerry , Gardner Cameron L. , Sacchetti Nicolo’ , Kawai Tomoki , Garabedian Elizabeth K. , Draper Debbie , Bergerson Jenna R. E. , DeRavin Suk See , Freeman Alexandra F. , Güngör Tayfun , Hartog Nicholas , Holland Steven M. , Kohn Donald B. , Malech Harry L. , Markert Mary Louise , Weinacht Katja G. , Villa Anna , Seet Christopher S. , Montel-Hagen Amelie , Crooks Gay M. , Notarangelo Luigi D.
Published: June 2020

The study of early T-cell development in humans is challenging because of limited availability of thymic samples and the limitations of in vitro T-cell differentiation assays. We used an artificial thymic organoid (ATO) platform generated by aggregating a DLL4-expressing stromal cell line (MS5-hDLL4) with CD34+ cells isolated from bone marrow or mobilized peripheral blood to study T-cell development from CD34+ cells of patients carrying hematopoietic intrinsic or thymic defects that cause T-cell lymphopenia. We found that AK2 deficiency is associated with decreased cell viability and an early block in T-cell development. We observed a similar defect in a patient carrying a null IL2RG mutation. In contrast, CD34+ cells from a patient carrying a missense IL2RG mutation reached full T-cell maturation, although cell numbers were significantly lower than in controls. CD34+ cells from patients carrying RAG mutations were able to differentiate to CD4+CD8+ cells, but not to CD3+TCRαβ+ cells. Finally, normal T-cell differentiation was observed in a patient with complete DiGeorge syndrome, consistent with the extra-hematopoietic nature of the defect. The ATO system may help determine whether T-cell deficiency reflects hematopoietic or thymic intrinsic abnormalities and define the exact stage at which T-cell differentiation is blocked.
Bronchoscopic intratumoural therapies for non-small cell lung cancer
Authors: DeMaio Andrew , Sterman Daniel
Published: June 2020

The past decade has brought remarkable improvements in the treatment of non-small cell lung cancer (NSCLC) with novel therapies, such as immune checkpoint inhibitors, although response rates remain suboptimal. Direct intratumoural injection of therapeutic agentsviabronchoscopic approaches poses the unique ability to directly target the tumour microenvironment and offers several theoretical advantages over systemic delivery including decreased toxicity. Increases in understanding of the tumour microenvironment and cancer immunology have identified many potential options for intratumoural therapy, especially combination immunotherapies. Herein, we review advances in the development of novel bronchoscopic treatments for NSCLC over the past decade with a focus on the potential of intratumoural immunotherapy alone or in combination with systemic treatments.
The significance of m6A RNA methylation regulators in predicting the prognosis and clinical course of HBV-related hepatocellular carcinoma
Authors: Fang Qiongxuan , Chen Hongsong
Published: June 2020

Background

Hepatocarcinogenesis is reportedly correlated with abnormal m6A modifications; however, it is unknown whether m6A RNA methylation regulators facilitate the occurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Thus, we constructed an m6A-related model that may enhance HBV-related HCC prognosis.

Methods

Gene signatures of HNRNPA2B1 and RBM15 were generated by univariate and Lasso Cox regression analyses using the gene set and clinical information from The Cancer Genome Atlas (TCGA) database. High-risk and low-risk groups were confirmed based on the gene signature model. Furthermore, we validated the predictive roles of the two genes for overall survival (OS) in the GSE14520 dataset. The relative expression of 22 paired mRNAs was measured using quantitative real-time polymerase chain reaction (qRT-PCR) analysis to determine whether the two genes had a predictive role in our Guilin cohort.

Results

The differences in OS between the high-risk and low-risk groups were statistically significant in the TCGA (p = 0.003) and GSE14520 (p = 0.045) datasets, but not in the Guilin cohort, owing to differences in clinical information among the three cohorts (mainly the TNM stage and survival state). Stratified analysis of TNM stages showed that the two-gene signature acted as a prognostic indicator of HBV-related HCC patients in the early TNM stage; both TCGA and GSE14520 cohorts showed statistical significance. Moreover, multivariate Cox regression analysis indicated that the two-gene signature was an independent factor for predicting prognosis (HR = 1.087, 95% CI: 1.007–1.172). Correlation analysis between the gene signature and clinical features revealed that the risk stratification was significantly correlated with grade and survival state. Finally, Gene Set Enrichment Analysis (GSEA) revealed that the KEGG pathways associated with the cell cycle, DNA replication, the spliceosome, repair, and metabolism-related processes were all significantly enriched in the high-risk group. Among the enriched genes, the expression levels of the replication protein RPA1 and the pre-mRNA splicing factor SF3B1 were significantly upregulated in the high-risk group. These results might help in elucidating the underlying molecular mechanisms of HBV-related HCC.

Conclusions

Our data may provide new predictive signatures and potential therapeutic targets to identify and treat HBV-related HCC patients in the early disease stage.
A qualitative study of workplace violence among healthcare providers in emergency departments in India
Authors: Davey Kevin , Ravishankar Veda , Mehta Nikita , Ahluwalia Tania , Blanchard Janice , Smith Jeffrey , Douglass Katherine
Published: June 2020

Background

Emergency department (ED) workplace violence is increasingly recognized as an important issue for ED providers. Most studies have occurred in developed countries with established laws and repercussions for violence against healthcare providers. There is a paucity of data on workplace violence against ED providers in less developed countries. The aim of this study was to learn more about workplace violence among healthcare providers in EDs in India.

Results

Semi-structured interviews were conducted in-person with physicians, nurses, and paramedics in Indian EDs. Interviews were coded independently using the NVivo qualitative research software. A hybrid thematic analysis approach was used to determine dominant themes. Sixty-three interviews were conducted at 7 sites across India. Interview participants include attending physicians (11), resident physicians (36), nurses (10), and paramedics (5). Events were most often described as involving accompanying persons to the patient, not the patient themselves. Most events involved verbal abuse, although a significant percentage of responses described some kind of physical violence. ED factors such as busy times with high patient volumes or periods of waiting are associated with increased violence, as well as incidents with unanticipated outcomes such as patients with severe illness or death. Decreased levels of health literacy among patients often contribute as the financial stressors of paying for medical care. Providers reported negative consequences of workplace violence on quality of care for patients and their own motivation to work in the ED. Communication strategies were frequently proposed as interventions to mitigate violence in the future including both provider communication as well as public awareness campaigns.

Conclusion

Workplace violence is a frequent reality for this sample of Indian ED healthcare providers. Alarming levels of verbal and physical abuse and their impact on patient care are described. This qualitative study identified unique challenges to Indian ED providers that differ from those in more developed settings, including financial stressors, inadequate enforcement of rules governing behavior in the hospital, and an overwhelming frequency of violence emanating from patient family members and attendants rather than the patients themselves. Further investigation into preventive strategies is needed.
The Rice BZ1 Locus Is Required for Glycosylation of Arabinogalactan Proteins and Galactolipid and Plays a Role in both Mechanical Strength and Leaf Color
Authors: Liu Sitong , Tang Yijun , Ruan Nan , Dang Zhengjun , Huang Yuwei , Miao Wei , Xu Zhengjin , Li Fengcheng
Published: June 2020

Background

The cell wall and chloroplast are two fundamental structures determining plant mechanical strength and grain yield. Therefore, understanding mechanisms that improve plants’ ability to develop a robust cell wall and well-developed chloroplast is of utmost importance for agricultural activities.

Results

In this study, we report the functional characterization of a novel rice mutant, brittle stem and zebra leaf (bz1), which displays altered cell wall composition and collapsed chloroplast membrane. Molecular and biochemical analysis revealed that BZ1 encodes a functional UDP-galactose/glucose epimerase (UGE) and is ubiquitously expressed with higher expression in stem and leaf tissues. Multiple techniques analyses, including immunoblots, immuno-gold, and cryogenic scanning electron microscopy, demonstrated a significantly impaired glycosylation of arabinogalactan proteins (AGPs) and disordered cellulose microfibril deposition in bz1. Lipid profiling assay showed that the amount of monogalactosyldiacylglycerols (MGDG), a major chloroplast membrane glycolipid, was significantly decreased in bz1. Taken together, these results strongly demonstrate that BZ1 participates in UDP-galactose supply for the sugar chains biosynthesis of AGPs and MGDG, which thereby, respectively, results in altered cell wall and abnormal chloroplast development. Due to inferior mechanical strength and reduced photosynthesis, bz1 plants displayed detrimental agronomic traits, whereas BZ1 overexpressing lines showed enhanced plant growth. Transcriptome analysis of stems and leaves further showed that numerous key genes involved in AGPs biosynthesis and photosynthesis metabolism were substantially suppressed in bz1.

Conclusions

Our finding identifies BZ1 as a dual-targeting UGE protein for glycosylation of AGPs and MGDG and suggests a strategy for breeding robust elite crops.
Comparative analyses of DNA repeats and identification of a novel Fesreba centromeric element in fescues and ryegrasses
Authors: Zwyrtková Jana , Němečková Alžběta , Čížková Jana , Holušová Kateřina , Kapustová Veronika , Svačina Radim , Kopecký David , Till Bradley John , Doležel Jaroslav , Hřibová Eva
Published: June 2020

Background

Cultivated grasses are an important source of food for domestic animals worldwide. Increased knowledge of their genomes can speed up the development of new cultivars with better quality and greater resistance to biotic and abiotic stresses. The most widely grown grasses are tetraploid ryegrass species (Lolium) and diploid and hexaploid fescue species (Festuca). In this work, we characterized repetitive DNA sequences and their contribution to genome size in five fescue and two ryegrass species as well as one fescue and two ryegrass cultivars.

Results

Partial genome sequences produced by Illumina sequencing technology were used for genome-wide comparative analyses with the RepeatExplorer pipeline. Retrotransposons were the most abundant repeat type in all seven grass species. The Athila element of the Ty3/gypsy family showed the most striking differences in copy number between fescues and ryegrasses. The sequence data enabled the assembly of the long terminal repeat (LTR) element Fesreba, which is highly enriched in centromeric and (peri)centromeric regions in all species. A combination of fluorescence in situ hybridization (FISH) with a probe specific to the Fesreba element and immunostaining with centromeric histone H3 (CENH3) antibody showed their co-localization and indicated a possible role of Fesreba in centromere function.

Conclusions

Comparative repeatome analyses in a set of fescues and ryegrasses provided new insights into their genome organization and divergence, including the assembly of the LTR element Fesreba. A new LTR element Fesreba was identified and found in abundance in centromeric regions of the fescues and ryegrasses. It may play a role in the function of their centromeres.
Leptomeningeal metastasis in a marginal zone lymphoma, presenting as a delirium: case report
Authors: Dreessen Lisa , Maréchal Nicolas , Verheyden Michel , De Becker Ann , Jochmans Kristin , Vanderhasselt Tim , Bravenboer Bert , Beyer Ingo
Published: June 2020

Background

Hematologic malignancies can spread to the central nervous system (CNS), either as focal lesions or as leptomeningeal disease. Marginal zone lymphoma (MZL) is a low-grade non-Hodgkin lymphoma and generally presents as an indolent disease. This case report illustrates an unexpected diagnosis of leptomeningeal metastasis in an MZL, presenting as a delirium without B symptoms, pronounced hematologic progression or abnormalities on cerebral imaging.

Case presentation

An 80-year-old patient with a medical history of monoclonal B-cell lymphocytosis (MBL) with a clone indicative for an MZL, presented to the emergency and the geriatric departments with a recent cognitive deterioration and behavioral changes. MMSE score was 18/30. After excluding the most common etiologies through classical work-up including a normal head magnetic resonance imaging, a lumbar puncture was performed. In the cerebrospinal fluid an elevated protein level and increased lymphocyte count were identified, whereas beta-amyloid and tau protein levels were normal. Immunophenotyping of the lymphocytes confirmed CNS invasion by the MZL clone. Staging revealed mild splenomegaly. Prednisolone, intrathecal and systemic chemotherapy were initiated, leading to quick cognitive improvement with a final MMSE score of 28/30.

Conclusions

To the best of our knowledge a delirium in an older patient due to leptomeningeal disease in MZL has never been described. To date, rare reports of CNS invasion by MZL describe focal intracranial lesions. After exclusion of common etiologies, physicians should remain vigilant when confronted with a patient with history of MBL presenting neurological symptoms. This case illustrates the importance of low threshold for lumbar punctures in this population, also for those patients with normal imaging studies.
The tumour microenvironment of the upper and lower gastrointestinal tract differentially influences dendritic cell maturation
Authors: Morrissey Maria E. , Byrne Róisín , Nulty Celina , McCabe Niamh H. , Lynam-Lennon Niamh , Butler Clare T. , Kennedy Susan , O’Toole Dermot , Larkin John , McCormick Paul , Mehigan Brian , Cathcart Mary-Clare , Lysaght Joanne , Reynolds John V. , Ryan Elizabeth J. , Dunne Margaret R. , O’Sullivan Jacintha
Published: June 2020

Background

Only 10–30% of oesophageal and rectal adenocarcinoma patients treated with neoadjuvant chemoradiotherapy have a complete pathological response. Inflammatory and angiogenic mediators in the tumour microenvironment (TME) may enable evasion of anti-tumour immune responses.

Methods

The TME influence on infiltrating dendritic cells (DCs) was modelled by treating immature monocyte-derived DCs with Tumour Conditioned Media (TCM) from distinct gastrointestinal sites, prior to LPS-induced maturation.

Results

Cell line conditioned media from gastrointestinal cell lines inhibited LPS-induced DC markers and TNF-α secretion. TCM generated from human tumour biopsies from oesophageal, rectal and colonic adenocarcinoma induced different effects on LPS-induced DC markers - CD54, CD80, HLA-DR, CD86 and CD83 were enhanced by oesophageal cancer; CD80, CD86 and CD83 were enhanced by rectal cancer, whereas CD54, HLA-DR, CD86, CD83 and PD-L1 were inhibited by colonic cancer. Notably, TCM from all GI cancer types inhibited TNF-α secretion. Additionally, TCM from irradiated biopsies inhibited DC markers. Profiling the TCM showed that IL-2 levels positively correlated with maturation marker CD54, while Ang-2 and bFGF levels negatively correlated with CD54.

Conclusion

This study identifies that there are differences in DC maturational capacity induced by the TME of distinct gastrointestinal cancers. This could potentially have implications for anti-tumour immunity and response to radiotherapy.
A comparative study of long interspersed element-1 protein immunoreactivity in cutaneous malignancies
Authors: Zolfaghari Mohammad Ali , Karimi Abbas , Kalantari Elham , Korourian Alireza , Ghanadan Alireza , Kamyab Kambiz , Esmaili Nafiseh , Emami Razavi Amir Nader , Madjd Zahra
Published: June 2020

Background

Skin cancer is the most common cancer worldwide and commonly classified into malignant melanoma (MM) and Nonmelanoma skin cancers (NMSCs), which mainly include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The extent to which Long Interspersed Element-1 (LINE-1, L1) ORF1p is expressed in cutaneous malignancies remains to be evaluated. This study aimed to assess LINE-1 ORF1p immunoreactivity in various skin cancer subtypes.

Method

The expression level of LINE-1 ORF1p was evaluated in 95 skin cancer specimens comprising 36 (37.9%) BCC, 28 (29.5%) SCC, and 31 (32.6%) melanoma using the tissue microarray (TMA) technique. Then the association between expression of LINE-1 encoded protein and clinicopathological parameters was analyzed.

Results

We showed that LINE-1 ORF1p expression level was substantially higher in BCC and SCC patients compared with melanoma samples (p < 0.001). BCC cases had a higher LINE-1 histochemical score (H-score) compared with SCC cases (p = 0.004). In SCC samples, a lower level of LINE-1 ORF1p expression was associated with age younger than the mean (p = 0.041). At the same time, no significant correlation was found between LINE-1 ORF1p expression and other clinicopathological parameters (all p > 0.05).

Conclusions

According to our observation, LINE-1 ORF1p immunoreactivity in various skin tumor subtypes extends previous studies of LINE-1 expression in different cancers. LINE-1ORF1p overexpression in NMSCs compared with MM can be considered with caution as a tumor-specific antigen for NMSCs.
Cervical cancer screening in rural Ethiopia: a cross- sectional knowledge, attitude and practice study
Authors: Ruddies Friederike , Gizaw Muluken , Teka Brhanu , Thies Sarah , Wienke Andreas , Kaufmann Andreas M. , Abebe Tamrat , Addissie Adamu , Kantelhardt Eva Johanna
Published: June 2020

Background

Cervical cancer is the fourth most common cancer among women worldwide. Sub- Saharan Africa has a high incidence, prevalence and mortality due to shortage and underutilization of screening facilities. This study aims to assess knowledge and attitude towards cervical cancer and its prevention, as well as practice of cervical cancer screening.

Methods

This cross-sectional community- based study was conducted in Butajira, Ethiopia in February 2018. Systematic cluster randomized sampling was used to select households from which women in the targeted age group of 30–49 years were invited to participate. Data was collected using a quantitative door to door approach. The questionnaire included socio-demographic data, obstetric history, general knowledge, risk factors, attitude and practice. Logistic regression was used to assess factors associated with knowledge, attitude and practice after dichotomizing the scores using the median as cut off point.

Results

Three hundred forty-two out of 354 women completed the interviewer administered questionnaire making the response rate 96.3%. 125 women (36%) were aware of cervical cancer and 14 (4.7%) knew symptoms. None of the women named HPV as a risk factor. 61% thought it was a deadly disease, 13.5% felt at risk of developing cervical cancer and 60.7% said cervical cancer is treatable. Eight women (2.3%) had previously been screened. 48.1% had a source of information concerning cervical cancer, of which 66.5% named nurses. Better knowledge was associated with 1–8 years of education (OR = 2.4; CI: 2.4–1.3), having a source of information (OR = 9.1, CI:4.0–20.6), use of contraceptives (OR = 2.3, CI: 1.3–4.0) and a higher income (OR = 1.009, CI: 1.00–1.01). Naming nurses (OR:5.0, CI:2.4–10.3), another source of information (OR = 3.3, CI:1.2–9.0), use of contraceptives (OR = 2.2, CI:1.2–3.8) and living in an urban area (OR = 3.3, CI:1.2–9.0) were associated with a positive attitude. Naming nurses (OR = 21,0, CI:10.4–42.3) and another source of information (OR = 5.8, CI:2.4–13.5) were associated with participating in cervical cancer screening.

Conclusion

Most women were unaware of cervical cancer, HPV-infection as a risk factor and did not feel susceptible to cervical cancer. As Health workers were the most commonly mentioned source of information, focus should be put on their further education.
Iron deficiency anaemia among 6-to-36-month children from northern Angola
Authors: Fançony Cláudia , Soares Ânia , Lavinha João , Barros Henrique , Brito Miguel
Published: June 2020

Background

Angola is one of the southern African countries with the highest prevalence of anaemia. Identifying anaemia determinants is an important step for the design of evidence-based control strategies. In this study, we aim at documenting the factors associated with Iron Deficiency Anaemia (IDA) in 948 children recruited at the Health Research Center of Angola study area during 2015.

Methods

Data on demographic, socio-economic and parental practices regarding water, sanitation, hygiene, malaria infection and infant and young child feeding were collected, as well as parasitological, biochemical and molecular data. Total and age-stratified multivariate multinomial regression models were fitted to estimate the magnitude of associations between anaemia and its determinants.

Results

Anaemia was found in 44.4% of children, of which 46.0% had IDA. Overall, regression models associated IDA with age, gender and inflammation and non-IDA with age, zinc deficiency and overload, P. falciparum infection, sickle cell trait/anaemia. Among 6-to-23-month-old children IDA was associated with continued breastfeeding and among 24-to-36-month-old children IDA was associated with stunting. Furthermore, zinc deficiency was associated with non-IDA among both age groups children. Inflammation was associated with IDA and non-IDA in either 6-to-23 and 24-to-36 months old children.

Conclusion

The main variables associated with IDA and non-IDA within this geographic setting were commonly reported in Africa, but not specifically associated with anaemia. Additionally, the associations of anaemia with inflammation, zinc deficiency and infections could be suggesting the occurrence of nutritional immunity and should be further investigated. In age groups, zinc overload was observed to protect under 6 months children from Non-IDA, while continued breastfeeding was associated with increased IDA prevalence in 6-to-23 months children, and stunting was suggested to increase the odds of IDA in 24-to-36 month children. This site-specific aetiology profile provides an essential first set of evidences able to inform the planification of preventive and corrective actions/programs. Nevertheless, regional and country representative data is needed.
Prognostic factors for overall survival in patients with spinal metastasis secondary to prostate cancer: a systematic review and meta-analysis
Authors: Gao Zhong-yu , Zhang Tao , Zhang Hui , Pang Cheng-gang , Jiang Wen-xue
Published: June 2020

Background

To guide the selection of treatments for spinal metastases, the expected survival time is one of the most important determinants. Few scoring systems are fully applicable for spinal metastasis secondary to prostate cancer (PCa). This study aimed to identify the independent factors to predict the overall survival (OS) of patients with spinal metastases from PCa.

Methods

The PubMed, Embase and CENTRAL were retrieved by two reviewers independently, to identify studies analyzed the prognostic effect of different factors in spinal metastasis from PCa. A systematic review and quantitative meta-analysis was conducted with hazard ratio (HR) and 95% confidence interval (95%CI) as the effect size.

Results

A total of 12 retrospective cohort studies (1566 patients) were eligible for qualitative synthesis and 10 for quantitative meta-analyses. The OS was significantly influenced by performance status, visceral metastasis, ambulatory status and time from PCa diagnosis in more than half of the available studies. The meta-analyses demonstrated that OS was significantly influenced by visceral metastasis (HR = 2.24, 95%CI:1.53–3.27, p < 0.001), pre-treatment ambulatory status (HR = 2.64, 95%CI:1.82–3.83, p < 0.001), KPS (HR = 4.45, 95%CI:2.01–9.85, p < 0.001), ECOG (HR = 2.96, 95%CI:2.02–4.35, p < 0.001), extraspinal bone metastasis (HR = 2.04, 95%CI:1.13–3.68, p = 0.018), time developing motor deficit (HR = 1.57, 95%CI:1.30–1.88, p < 0.001) and time from PCa diagnosis (HR = 1.37, 95%CI:1.17–1.59, p < 0.001).

Conclusions

Visceral metastasis, ambulatory status, extraspinal bone metastasis, performance status, time developing motor deficit and time interval from primary tumor diagnosis were significantly associated with the OS for spinal metastasis from PCa. When selecting the treatment modality, clinicians should fully consider the patients’ systematic status based on all potential prognostic factors.

Level of evidence

I Meta-analysis.
Lower bile duct metastasis from rectal cancer after surgery for liver metastasis and intrahepatic bile duct metastasis: a case report
Authors: Nakagawa Yoichi , Maeda Atsuyuki , Seita Kazuaki , Kaneoka Yuji
Published: June 2020

Background

Biliary metastasis of colorectal cancer is a manifestation of metastatic liver carcinoma, and is often difficult to differentiate from cholangiocarcinoma. Further, lower bile duct metastasis of colorectal cancer is rare. We report the case of a 74-year-old woman who underwent pylorus-preserving pancreatoduodenectomy for lower bile duct metastasis of rectal cancer.

Case presentation

The patient had undergone laparoscopic low anterior resection for rectal cancer (pT3N0M0 stage IIA) 6 years ago, laparoscopic anterior liver resection for liver metastasis (Couinaud segment V) 3 years ago, and left and caudal lobectomy with extrahepatic bile duct resection for left intrahepatic bile duct metastasis 6 months ago. A follow-up examination showed a 15 mm mass in the common bile duct, for which she underwent pylorus-preserving pancreatoduodenectomy. Histological and immunohistological examination of the specimens revealed similar cytokeratin (CK) expression patterns, which were negative for CK7 and positive for CK20. Therefore, the definitive diagnosis was metastasis from rectal cancer.

Conclusions

In summary, we encountered a case of lower bile duct metastasis from rectal cancer, which is often difficult to differentiate from cholangiocarcinoma. In such patients, CK7 and CK20 expression patterns are important in differentiating the two. The mechanism of metastasis in this case was considered to be through cancer cell implantation from lymphatic spread, or through distant metastasis of the primary cancer.
Health and intention to leave the profession of nursing - which individual, social and organisational resources buffer the impact of quantitative demands? A cross-sectional study
Authors: Diehl Elisabeth , Rieger Sandra , Letzel Stephan , Schablon Anja , Nienhaus Albert , Escobar Pinzon Luis Carlos , Dietz Pavel
Published: June 2020

Background

The aim of this study was to analyse the buffering effect of individual, social and organisational resources on health and intention to leave the profession in the context of burden due to quantitative job demands.

Methods

In 2017, a cross-sectional survey was carried out anonymously among nurses in palliative care in Germany. One thousand three hundred sixteen nurses responded to the questionnaire (response rate 38.7%), which contained, amongst others, questions from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ). Moderator analyses were conducted to investigate the buffering effect of different resources on health (‘self-rated health’ and ‘burnout’) and ‘intention to leave’ in the context of quantitative demands.

Results

‘Self-rated health’ was significantly buffered by the resources ‘recognition through salary’ (p = 0.001) and ‘good working team’ (p = 0.004). Additionally, buffering effects of the resources ‘workplace commitment’ and ‘good working team’ on ‘burnout’ (p = 0.001 and p = 0.006, respectively) as well as of the resources ‘degree of freedom’, ‘meeting relatives after death of patients’, ‘recognition from supervisor’ and ‘possibilities for development’ on ‘intention to leave’ (p = 0.014, p = 0.012, p = 0.007 and p = 0.036, respectively) were observed.

Conclusions

The results of our study can be used to develop and implement job (re) design interventions with the goal of reducing the risk of burnout and enhancing job satisfaction among nurses in palliative care. This includes for example adequate payment, communication training and team activities or team events to strengthen the team as well as the implementation of some rituals (such as meeting relatives after the death of patients). As our study was exploratory, the results should be confirmed in further studies.
Preclinical anticancer studies on the ethyl acetate leaf extracts of Datura stramonium and Datura inoxia
Authors: Nasir Bakht , Baig Muhammad Waleed , Majid Muhammad , Ali Syeda Masooma , Khan Muhammad Zafar Irshad , Kazmi Syeda Tayyaba Batool , Haq Ihsan-ul
Published: June 2020

Background

Cancer is a horrific disease relentlessly affecting human population round the globe. Genus Datura encompasses numerous species with reported medicinal uses. However, its potential as a source of natural anticancer agents is yet to be determined. Datura stramonium (DS) and Datura inoxia (DI) are the two species chosen for this study.

Methods

Total phenolic and flavonoid content (TPC and TFC) as well as antioxidant activity were assessed through colorimetric method. Polyphenolic quantification was done by RP-HPLC. Following extract standardization ethyl acetate leaf extracts of both species (DSL-EA and DIL-EA) were chosen for anticancer studies. In vitro cytotoxicity using various models including cancer cell lines was monitored. Following toxicity studies, benzene (0.2 ml) was used to induce leukemia in Sprague-Dawley rats. Extracts were orally administered to preventive (100 and 200 mg/kg) and treatment (200 mg/kg only) groups. The antileukemic potential of extracts was assessed through haematological, biochemical, endogenous antioxidants and histological parameters.

Results

Significant TPC and TFC were estimated in DSL-EA and DIL-EA. RP-HPLC quantified (μg/mg extract) rutin (0.89 ± 0.03), gallic acid (0.35 ± 0.07), catechin (0.24 ± 0.02) and apigenin (0.29 ± 0.09) in DSL-EA while rutin (0.036 ± 0.004) and caffeic acid (0.27 ± 0.03) in DIL-EA. Both extracts exhibited significant brine shrimp cytotoxicity (LC50 < 12.5 μg/ml). DIL-EA exhibited greater cytotoxicity against PC-3, MDA-MB 231 and MCF-7 cell lines (IC50 < 3 μg/ml in each case) as well as higher protein kinase inhibitory action (MIC: 25 μg/disc) compared to DSL-EA. Leukemia induced in rats was affirmed by elevated serum levels of WBCs (7.78 ± 0.012 (× 103) /μl), bilirubin (7.56 ± 0.97 mg/dl), Thiobarbituric acid reactive substances (TBARs) (133.75 ± 2.61 nM/min/mg protein), decreased RBCs (4.33 ± 0.065 (× 106)/μl), platelets (344 ± 3.19 (× 103)/μl), total proteins (2.14 ± 0.11 g/dl), Glutathione S-transferases (GST) (81.01 ± 0.44 nM/min/ml), endogenous antioxidant enzymes levels and abnormal liver and kidney functionality in disease control rats. Both species revealed almost identical and significant (p < 0.05) alleviative effects in benzene induced leukemia.

Conclusion

Comprehensive screening divulged the tremendous potential of selected species as potent source of natural anticancer agents in a variety of cancers particularly leukemia. Present study might provide useful finger prints in cancer research and mechanistic studies are prerequisite in logical hunt of this goal.