bluuebunny/crossref_metadata_2025 huggingface dataset:
The Prognosis and Clinicopathological Features of Different Distant Metastases Pattern in Renal Cell Carcinoma: Analysis Based on SEER Database
Authors: Wei Haibin , Miao Jia , Cui Jianxin , Zheng Wei , Chen Xinpeng , Zhang Qi , Liu Feng , Mao Zujie , Qiu Songlin , Zhang Dahong
Published: December 2020

Background: Existing data on the prognosis and clinicopathological features of patients with metastatic renal cell carcinoma (mRCC) are limited. This study aims to investigate the prognostic value and clinicopathological features of different metastatic sites in patients with mRCC. Methods: A dataset from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 18 Registries (1973–2015) was selected for a retrospective mRCC cohort study. There was information on distribution of metastatic lesions in lung, bone, liver, and brain in the SEER database. Kaplan-Meier analysis and nomogram analyses were applied to compare the survival distribution of cases. Univariate and multivariate cox regression models were used to analyze survival outcomes and risk factors. Results: From the SEER database, a total of 10410 patients with primary mRCC from 2010 to 2015 were enrolled in this cohort study. Based on the initial metastatic sites, 54.9%, 37.7%, 19.5%, and 10.4 % of patients were found to have lung, bone, liver, and brain metastasis, respectively. Patients who had a single site of distant metastases accounted for 50.6% (5268/10410). Sarcomatoid RCC had significantly higher risk to develop liver metastasis than clear cell RCC, and liver metastasis had the worst prognosis in all the patients. The median survival for patients with lung, bone, liver, and brain metastasis was 7 months, 7 months, 4 months and 5 months, respectively. The nomogram model was constructed to visually present the 1-, 3- and 5-year survival rates of patients.Conclusion: In conclusion, different metastatic sites possess various clinicopathological features and prognostic values. Understanding these differences may contribute to designing targeted pre-treatment assessment of primary mRCC and creating a personalized curative intervention.
Assessment of Standardization Circumferential Resection Margin Status Influence Survival following Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma
Authors: Liu Jinheng , Wang Yanting , Liu Xubao , Ke Nengwen
Published: December 2020

Background: Not only to assess the prognostic influence on standardization circumferential resection margin R0 and R1 Status but also to research the prognostic influence on adjuvant chemotherapy to PV/SMV, SMA resection margins﹤1mm. The SMV and SMA resection margins had an important prognostic influence to PDAC patients, and the survival prognosis of R1 status(resection margin﹤1mm) was poor. Methods: A total of 228 patients performed PD between 2015 and 2019 were included, which was assessment of standardization circumferential resection margin status and survival prognosis. There were cancer cells within 1mm clearance of PV/SMV and SMA resection margins named R1 PV/SMV, SMA, and no cancer cells named R0 PV/SMV, SMA.Results: The resection margin 1mm clearance of PV/SMV, SMA (P=0.010) and postoperative adjuvant chemotherapy (P=0.001) were prognostic independent predictors. The median survival time was 22 months of 166 R0 PV/SMV, SMA patients (73%) compared to 15 months of 62 R1 PV/SMV, SMA patients (27%) (P=0.005). There was the statistical significance of survival time between the adjuvant chemotherapy group and the none-adjuvant chemotherapy group (P=0.000). In the R1 PV/SMV, SMA group, there was no statistical significance of survival time between the adjuvant chemotherapy patients and the none-adjuvant chemotherapy patients (P=0.208).Conclusions: Patients undergoing PD for PDAC, postoperative adjuvant chemotherapy could not improve the poor survival prognosis of R1 PV/SMV, SMA resection patients. The resection margins of PV/SMV, SMA had a greater prognostic influence on survival than postoperative adjuvant chemotherapy.Trial registration: Clinicaltrials.gov/ct2/show/NCT02928081
Enhanced Electrochemical Stability by Alkyldiammonium in Dion-Jacobson Perovskite Towards Ultrastable Light-Emitting Diodes
Authors: Ngai Kwanho , Wei Qi , Chen Zefeng , Guo Xinlu , Qin Minchao , Chan Christopher C. S. , Xing Guichuan , Lu Xinhui , Xie Fangyan , Chen Jian , Xu Jian-Bin , Wong Kam Sing , Long Mingzhu
Published: December 2020

The electroluminescence efficiency of perovskite light-emitting diodes (PeLEDs) has gained notable achievements, but the poor stability under electric stress severely impedes future practical use. Here, an alkyldiammonium 1,4-butanediamine (BDA) is incorporated into perovskite emitting layer, which substantially optimizes electrochemical stability and minimizes interfacial deep traps under large external bias. The BDA-PeLED shows a record operational half-lifetime T50 of 189.4 h at a high current density of 100 mA cm−2 and 589 hours under 50 mA cm−2. Additionally, the device maintains its original performance upon 2500 cycles of voltage scan and withstands 10000 times of ON-OFF under a pulsed voltage of 2.5 V. Further degradation mechanism study reveals that the main origins of the instability property of PeLEDs without BDA are the generation of deep traps at the interfaces and the infiltration of anions into adjacent layers. The significantly enhanced electrochemical stability suggests that alkyldiammonium cation incorporation provides a direction to solve the instability issue.
Specific Dietary Practices in Female Athletes and their Association with Positive Screening for Disordered Eating
Authors: de Borja Celina , Holtzman Bryan , McCall Lauren , Moretti Laura , Farnsworth Nicole , Ackerman Kathryn
Published: December 2020

BACKGROUND: To determine if following specific diets was associated with responding positively to eating disorder/disordered eating (ED/DE) screening tools compared to non-diet-adherent athletes. We hypothesized that athletes adhering to specific diets were more likely to respond positively on ED/DE screening tools than those not following a diet. METHODS: 1000 female athletes (15-30 y) completed a comprehensive survey about athletic health and wellness. Athletes were asked to specify their diet and completed 3 ED/DE screening tools: the Brief Eating Disorder in Athletes Questionnaire, the Eating Disorder Screen for Primary Care, and self-reported current or past history of ED/DE. Descriptive statistics were calculated for all study measures and chi-squared tests assessed relationships between athletes’ dietary practices and their responses to ED/DE screening tools. Statistical significance was defined as p<0.05. RESULTS: 234 of 1000 female athletes reported adherence to specific diets. 69 of the 234 diet-adhering athletes (29.5%) were excluded due to medically-indicated dietary practices or vague dietary descriptions. Of the 165 diet-adherent athletes, 122 (67.9%) responded positively to ≥1 of the 3 ED/DE screening tools. Athletes practicing vegetarian, vegan, low-carbohydrate, low-dairy, or ≥2 diets were more likely to respond positively to ≥1 ED/DE screening tool vs. athletes without dietary restrictions (70.0%, 77.8%, 79.5%, 60.0%, and 65.6%, respectively vs. 41.8%; p≤0.048). CONCLUSION: Specific diet adherence in female athletes is associated with positive responses to ED/DE screening tools. Health practitioners should consider further ED/DE questioning of athletes reporting specific diet adherence in order to enhance nutritional knowledge and help treat and prevent ED/DE.
RETRACTED: Dodecanoic acid induces oxidative stress-mediated apoptotic death in liver cancer cells through mitochondrial pathway
Authors: chen xiaoguang , Guo Liwei , Liu Yumei , Zhu Xuemin , Lv Qiongxia
Published: December 2020

The authors have requested that this preprint be removed from Research Square.
Identification of Polycistronic Transcriptional Units and Non-canonical Introns in Green Algal Chloroplasts Based on Long-read RNA Sequencing Data
Authors: Zou Xiaoxiao , Verbruggen Heroen , Li Tianjingwei , Zhu Jun , Chen Zuo , He Henqi , Bao Shixiang , Sun Jinhua
Published: December 2020

Background: Chloroplasts are important semi-autonomous organelles in plants and algae. Unlike higher plants, the chloroplast genomes of green algal linage have distinct features both in organization and expression. Despite the architecture of chloroplast genome have been extensively studied in higher plants and several model species of algae, little is known about transcriptional features in green algal lineages. Results: Based on full-length cDNA (Iso-Seq) sequencing, we identified widely co-transcribed polycistronic transcriptional units (PTUs) in the green alga Caulerpa lentillifera. In addition to clusters of genes from the same pathway, we identified a series of PTUs of up to nine genes whose function in the plastid is not understood. The RNA data further allowed us to confirm widespread expression of fragmented genes and conserved open reading frames, which are both important features in green algal chloroplast genomes. In addition, a newly fragmented gene specific to C. lentillifera was discovered, which may represent a recent gene fragmentation event in chloroplast genome.Taking the accurate exon-intron boundary information, gene structural annotation was greatly improved across the siphonous green algae lineages. Our data also revealed a type of non-canonical Group II introns, with a deviant secondary structure and intronic ORFs lacking known splicing or mobility domains. These widespread introns have conserved positions in their genes and are excised precisely despite lacking clear consensus intron boundaries.Conclusion: Our study fills important knowledge gaps in chloroplast genome organization and transcription in green algae, and providing new insights into expression of polycistronic transcripts, freestanding ORFs and fragmented genes in algal chloroplast genomes. Moreover, we revealed an unusual type of Group II intron with distinct features and conserved positions in Bryopsidales. Our data represents interesting additions to knowledge of chloroplast intron structure and highlights clusters of uncharacterized genes that probably play important roles in plastid.
Fiscal Decentralization, Institutional Quality, and Government Size: An Asymmetry Analysis for Asian Economies
Authors: Sohail Sidra , Ullah Sana , Ozturk Ilhan , Javid Attiya Yasmin
Published: December 2020

The aim of this study is to examine the asymmetric effects of fiscal decentralization and institutional quality on government size by employing asymmetric autoregressive-distributed lag (ARDL) methodology by using the time series data of Asain economies from 1984 to 2017. The results show that positive shocks in expenditures decentralization (ED) enhance government size in Japan, Kazakhstan, Thailand, Turkey, and reduces it in Korea, Rep. in long run. While negative shock in ED reduces government size in Pakistan, Thailand, Turkey and increases it in Kazakhstan and Mongolia in long run. Whereas asymmetric results in the long show that a positive shock in revenue decentralization (RD) increase government size in Pakistan, Japan, Kazakhstan, Thailand, and Turkey, and a negative shock in RD is also decreased government size in Pakistan, Mongolia, Thailand, and Turkey. The results also disclosed that positive shock in institutional quality (IQ) increases government size in Azerbaijan, Japan, Thailand and negative shock in IQ also increases government size in Pakistan, Azerbaijan, Japan, Kazakhstan, Thailand, in the long run. While short-run asymmetric results of fiscal decentralization and institutional quality on government size have robust in the public sector. Based on the empirical outcomes, some economic policy implications are proposed for the provincial and federal governments of Asain economies.
JAK-2 Positive Polycythemia Vera with Paroxysmal Nocturnal Hemoglobinuria and Splanchic Thromboses: A Case Report and Review of the Literature.
Authors: Chatzidavid Sevastianos , Giannakopoulou Nefeli , Diamantopoulos Panagiotis Theodorou , Gavriilaki Eleni , Katsiampoura Panagiota , Viniou Nora-Athina , Dryllis Georgios
Published: December 2020

Background: Polycythemia vera (PV) is usually characterized by red cell mass expansion in the peripheral blood and can be complicated with thrombosis, bleeding, evolution to acute myeloid leukemia (AML) or a fibrotic phase. Paroxysmal nocturnal hemoglobinuria (PNH) in an acquired clonal haematopoietic stem cell disorder associated with chronic intravascular hemolysis, venous thrombosis, defective hematopoiesis, frequent episodes of infection and, rarely, leukemic transformation. Herein, we report an interesting case of a patient with co-existence of PNH clones and a JAK2V617F positive polycythemia vera, with unusual thromboses and not overt hemolysis.Case presentation: the case is a 51-year-old woman presented with increased levels of hematocrit and multiple liver, spleen, and left kidney infarctions with ascites; further investigation revealed a JAK2-positive polycythemia vera and a significant PNH population. Interestingly, our patient has experienced severe thrombotic events without reporting signs or symptoms of overt hemolysis.Conclusions: This case raises questions over uncharted aspects of the PNH etiopathogenesis, its potential association with myeloproliferative neoplasms (MPN) and highlights the difficulty of dealing with patients with more than one pro-thrombotic states, especially with established and severe thromboses.
Acquired Radioresistance in Cancer Associated Fibroblasts is Concomitant with Enhanced Antioxidant Potential and DNA Repair Capacity
Authors: Domogauer Jason D. , de Toledo Sonia M. , Howell Roger W. , Azzam Edouard I.
Published: December 2020

Background: Cancer-associated fibroblasts (CAFs) are a major component of the cancer stroma, and their response to therapeutic treatments likely impacts the outcome. We tested the hypothesis that CAFs develop unique characteristics that enhance their resistance to ionizing radiation. Methods: CAFs were generated through intimate coculture of normal human fibroblasts of skin or lung origin with various human cancer cell types using permeable microporous membrane inserts. Fibroblasts and cancer cells are grown intimately, yet separately, on either side of the insert’s membrane for extended times to generate activated fibroblast populations highly enriched in CAFs. Results: The generated CAFs exhibited a decrease in Caveolin-1 protein expression levels, a CAF biomarker, which was further enhanced when the coculture was maintained under in-vivo -like oxygen tension conditions. The level of p21 Waf1 was also attenuated, a characteristic also associated with accelerated tumor growth. Furthermore, the generated CAFs experienced perturbations in their redox environment as demonstrated by increases in protein carbonylation, mitochondrial superoxide anion levels, and modulation of the activity of the antioxidants, manganese superoxide dismutase and catalase. Propagation of the isolated CAFs for 25 population doublings was associated with enhanced genomic instability and a decrease in expression of the senescence markers β-galactosidase and p16 INK4a . With relevance to radiotherapeutic treatments, CAFs in coculture with cancer cells of diverse origins (breast, brain, lung, and prostate) were resistant to the clastogenic effects of 137 Cs γ rays compared to naïve fibroblasts. Addition of repair inhibitors of single- or double-stranded DNA breaks attenuated the resistance of CAFs to the clastogenic effects of g rays, supporting a role for increased ability to repair DNA damage in CAF radioresistance. Conclusions : This study reveals that CAFs are radioresistant and experience significant changes in indices of oxidative metabolism. The CAFs that survive radiation treatment likely modulate the fate of the associated cancer cells. Identifying them together with their mode of communication with cancer cells, and eradicating them, particularly when they may exist at the margin of the radiotherapy planning treatment volume (PTV), may improve the efficacy of cancer treatments.
The relation between dietary phytochemical index and metabolic syndrome and its components in a large sample of Iranian adults: A population-based study
Authors: Vasmehjani Azam Ahmadi , Darabi Zahra , Nadjarzadeh Azadeh , Mirzaei Masoud , Hosseinzadeh Mahdieh
Published: December 2020

Background: There is growing agreement that plant foods-based phytochemicals have a protective role against chronic diseases. Current study was to appraise Dietary Phytochemical Index (DPI) with the risk of metabolic syndrome (MetS) and its components.Methods: A cross sectional study of 1097 men , 1220 women and aged 20-70 years assessed dietary intake using a validated and reliable food frequency questionnaire. DPI is calculated based on dietary energy derived from phytochemical-rich food sources (kcal)/ total daily energy intake (kcal). Results: After adjustment for all potential confounders, the risk of MetS (OR=0.63, 95% CI=0.41-0.96, P=0.03) and elevated blood pressure (OR=0.62, 95% CI=0.40-0.96, P=0.03) in second category of DPI compared to the first significantly decreased. After full adjustment for confounders, women in the highest quartile of DPI compared with the lowest, had 59% lower risk of MetS (OR=0.41, 95% CI=0.22-0.76, P=0.005). In second quartiles of DPI, the risk of MetS decreased by 62% (OR=0.38, 95% CI=0.16-0.90, P=0.02) in participants with normal BMI and 29% in subjects with high BMI (OR=0.71, 95% CI=0.52-0.99, P=0.04), and also 57% in men (OR=0.43, 95%CI=0.23-0.83, P=0.01). Independent of variables including age, sex and total energy intake, subjects in second and fourth quartiles of DPI had 30% and 25% lower risk of abdominal obesity, respectively.Conclusions: Greater adherence to phytochemical-rich diet could reduce odds of MetS and some components especially in women. Further studies with intervention approaches are warranted.
Public Health Practitioner Perspectives on Dealing with Measles Outbreaks in Areas with high Anti-vaccination Sentiment
Authors: Robinson Penelope , Wiley Kerrie , Degeling Chris
Published: December 2020

BackgroundCommunities with low vaccination rates are at greater risk during outbreaks of vaccine preventable diseases. Most Australian parents support vaccines, but some refuse and are often judged harshly by their community, especially during an outbreak. We sought the perspectives of Australian public health experts on the key issues faced when managing a measles outbreak in an area with high anti-vaccination sentiment.MethodsA measles outbreak scenario formed the basis of a 3-round modified Delphi process to identify key practitioner concerns in relation to parents/carers who don’t follow the recommended vaccination schedule. We surveyed a range of professionals in the field: policymakers, infectious disease experts, immunisation program staff, and others involved in delivering childhood vaccinations, to identify key priorities when responding to an outbreak in a community with low vaccination coverage.ResultsFindings indicate that responses to measles outbreaks in communities with high anti-vaccination sentiment are motivated by concerns about the potential for a much larger outbreak event. The highest operational priority is to isolate infected children. The two most highly ranked practical issues are mistrust from non-vaccinating members of the local region and combatting misinformation about vaccines. Trying to change minds of such individuals is not a priority during an outbreak, nor is vaccinating their children. Using media and social media to provide information about the outbreak and measures the public can take to limit the spread of the disease was a focus.ConclusionsOur findings provide a deeper understanding of the challenges faced during an outbreak and priorities for communicating with communities where there is a high level of anti-vaccination sentiment. In the context of a global pandemic, the results of this study also have implications for managing public health responses to community transmission of SARS-CoV-2, if and when a safe and effective vaccine becomes widely available.
Colorectal Resection in Endometriosis Patients: Correlation Between Histopathological Findings and Postoperative Outcome.
Authors: Tschann Peter , Vitlarow Nikola , Hufschmidt Martin , Lechner Daniel , Girotti Paolo , Offner Felix , Abendstein Burghard , Königsrainer Ingmar
Published: December 2020

IntroductionEndometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis is associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis. Methods25 Patients who underwent colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome. ResultsAverage follow-up time was 38.68 months (±19.92). Preoperative VAS-score was 8.32 (±1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%), anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (±2.54). ConclusionOur data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary in order to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.
Spontaneous Regression of an Arteriovenous Fistula Between Paravertebral Venous Plexus and the Vertebral Artery: A Rare Case Report
Authors: Yu Zhiqiang , Zhang Guangxu , Bai Xingcheng , Zhao Jinbing , Ma Jun
Published: December 2020

Background: Spontaneous regression of huge vertebral arteriovenous fistula (AV fistulas) due to acupuncture procedure is a rare phenomenon. The clinical presentations, management, prognosis of this type arteriovenous fistula has been rarely reported. In addition, we exclusively analyzed the possible reasons for its spontaneous regression.Case presentation: A 57-year-old Chinese woman presented with a 2-month history of progressively worsening headache and high-pitched tinnitus after acupuncture and massage in the neck and the left mastoid region. Later Digital Subtraction Angiography (DSA) confirmed the presence of arteriovenous fistulas at cervical 2-3 (C2-3) level, lying between the paravertebral venous plexus and the left vertebral artery. The patient had a background of hypertension, hypothyroidism and hysterectomy. The arteriovenous fistulas disappeared mysteriously, possibly because of the motion of the left vertebral artery and the compression of guide wire against the blood vessel wall. The patient recovered well following conservative treatment of taking atorvastatin calcium tablets (20mg/day), despite delayed recognition and invasive investigation.Conclusion: Adequate evaluation and standardized procedures with Doppler may minimize the associated risks while performing acupuncture. Early application of vascular examination should be considered in patients with typical high-pitched tinnitus and medical history associated with acupuncture treatment. Statins are effective in repairing the lining of blood vessels.
C-Reactive Protein Knock Out Attenuate Temporomandibular Joint Inflammation in Rats
Authors: He Yao , Zhou Mengjiao , Jian Zixiang , Fang Lingli , Huang Lan , Song Jinlin
Published: December 2020

Background: C-reactive protein (CRP), as the biomarker for inflammation, high expresses in osteoarthritis (OA) related diseases with exact role been clouded. In this study, we evaluated the biological effect of CRP in temporomandibular joint osteoarthritis (TMJ-OA).Methods: Freund’s complete adjuvant (CFA) was used for TMJ inflammation induction in CRP knock out (CRP -/-) and control rats. And TMJ degenerative changes, such as the synovitis performance, TMJ disc morphological changes and cartilage degeneration were compared to elucidate the role of CRP played in TMJ-OA. Results: Compared to control group, CFA induced TMJ inflammation caused systemic and local CRP expression increased. Based on this, CRP -/- rat performed less severe inflammation symptoms. Lower degree of pro-inflammatory cytokines (interleukins IL-1β and IL-6) expression and up-expression of anti-inflammatory cytokine IL-10 were detected in CRP -/- rat, which with less macrophage and activation and osteoclast differentiation.Conclusion: These results indicated that control high elevated CRP level during inflammation should be benefit for TMJ-OA prevention and treatment.
Assessment of in vivo Bone Microarchitecture Changes in a Psoriatic Arthritic Patient Resulting from an Anti-TNFα Treatment
Authors: Soldati Enrico , Escoffier Lucas , Gabriel Sophie , Mattei Jean Pierre , Cammilleri Serge , Bendahan David , Guis Sandrine
Published: December 2020

Objective: Psoriatic arthritis (PA) is an inflammatory rheumatism, mediated in part by TNFα and associated with bone loss. Anti-TNFα treatment should inhibit this phenomenon and reduce the systemic bone loss. Ultra-high field MRI (UHF MRI) may be used to quantify bone microarchitecture (BM) in-vivo. In this study, we quantified BM using UHF MRI in a PA patient and followed up the changes related to anti-TNFα treatment.Patients and methods: A non-treated PA patient with knee arthritis and 7 gender-matched controls were scanned using a gradient re-echo sequence at UHF MRI. After a year of Adalimumab treatment, the patient underwent a second UHF MRI. A PET-FNa imaging was performed before and after treatment to identify and localize the abnormal metabolic areas. BM was characterized using typical morphological parameters quantified in 32 regions of interest (ROIs) located in the patella, proximal tibia, and distal femur. Statistical analysis was assessed performing Student T-tests.Results: Before treatment, the BM parameters were statistically different from controls in 24/32 ROIs with differences reaching up to 38%. After treatment, BM parameters were normalized for 15 out of 24 ROIs. The hypermetabolic areas disclosed by PET-FNa before the treatment partly resumed after the treatment.Conclusion: Thanks to UHF MRI, we quantified in-vivo BM anomalies in a PA patient and we illustrated a major reversion after one year of treatment. Moreover, BM results highlighted that the abnormalities were not only localized in hypermetabolic regions identified by PET-FNa, suggesting that the bone loss was global and not related to inflammation.
Comparison of Waist-to-height Ratio, Hypertriglyceridemic Waist Phenotype, Triglycerides to HDL-C Ratio and Fasting Plasma Glucose With the Matsuda Index for the Prediction of Insulin Resistance/hyperinsulinemia
Authors: Lechner Katharina , Lechner Benjamin , Crispin Alexander , Schwarz Peter , Bibra Helene Von
Published: December 2020

BackgroundCurrent screening algorithms for type 2 diabetes (T2D) rely on fasting plasma glucose (FPG) and/or HbA1c. This fails to identify a sizeable subgroup of individuals in early stages of metabolic derangement who are at high risk for developing diabetes or cardiovascular disease. The Matsuda index, a combination of parameters derived from a fasting and postprandial insulin assay, is an early biomarker for metabolic dysfunction (i.e. insulin resistance/compensatory hyperinsulinemia). We compared four widely available anthropometric and biochemical markers indicative of this condition (waist-to-height ratio (WHtR), hypertriglyceridemic waist phenotype (HTW), triglycerides to HDL-C ratio (TG/HDL-C) and FPG) to the Matsuda index.MethodsThis cross-sectional analysis included 2231 individuals with normal fasting glucose (NFG, n=1333), impaired fasting glucose (IFG, n = 599) and T2D (n=299) from an outpatient diabetes clinic in Germany and thus extended a prior analysis from our group done on the first two subgroups. We analyzed correlations of the Matsuda index with WHtR, HTW, TG/HDL-C and FPG and their predictive accuracies by correlation and logistic regression analyses and receiver operating characteristics.ResultsIn the entire group and in NFG, IFG and T2D, the best associations were observed between the Matsuda index and the WHtR (r=-0,458), followed by HTW phenotype (r=-0,438). As for prediction accuracy, WHtR was superior to HTW, TG/HDL-C and FPG in the entire group (area under the curve 0,801) and NFG, IFG and T2D. A multivariable risk score for the prediction of insulin resistance was tested and demonstrated an area under the ROC curve of 0.765 for WHtR and its interaction with sex as predictor controlled by age and sex. The predictive power increased to 0.845 when FPG and TG/HDL-C were included.ConclusionsUsing as a comparator the Matsuda index, WHtR, compared to HTW, TG/HDL-C and FPG, showed the best predictive value for detecting metabolic dysregulation. We conclude that WHtR, a widely available anthropometric index, could refine phenotypic screening for insulin resistance/hyperinsulinemia. This may ameliorate early identification of individuals who are candidates for appropriate therapeutic interventions aimed at addressing the twin epidemic of metabolic and cardiovascular disease in settings where more extended testing such as insulin assays are not feasible.
The Effect of Off-center Placement of Twisted Tape on Flow and Heat Transfer Characteristics in a Circular Tube
Authors: Wang Li , Ni Peiyong , Xi Guannan
Published: December 2020

This study is conducted to investigate the effect of off-center placement of twisted tape on flow distribution and heat transfer in a circular tube. The effect of tape width of 20, 18, 16, 14 and 12 mm on the heat transfer performance is discussed under the same twist ratio of 2.0. The numerical analysis of the flow field, average Nusselt number, friction factor and thermo-hydraulic performance parameter of the tube are discussed with Reynolds number ranged from 2600 to 8760. The results indicate that the Nusselt number of the tube fitted with center-placed twisted tapes at various width is 7~51% higher than the plain tube, and performance in low Reynolds region was found more effective than that in high Reynolds region. The heat transfer for circular tube with twisted tape attached to the wall shows better performance than that for the tube with center-placed twisted tape. With a smaller tape width, a higher increasing ratio of Nu-wall/Nu-center is obtained. The increasing ratio for Nusselt number ranged from 3 to 18%. However, the use of twisted tape inserts is not beneficial for energy saving. The thermo-hydraulic performance parameters for convective heat transfer of helium gas flowing in a circular tube are below unity for the calculated Reynolds region.
Characterization of microbial antifreeze protein with intermediate activity suggests that a bound-water network is essential for hyperactivity
Authors: Khan N. M.-Mofiz , Arai Tatsuya , Tsuda Sakae , Kondo Hidemasa
Published: December 2020

Antifreeze proteins (AFPs) inhibit ice growth by adsorbing onto a specific ice plane. Microbial AFPs show diverse antifreeze activity and ice plane specificity, while sharing a common molecular scaffold. To probe the molecular mechanisms responsible for AFP activity, we here characterized the antifreeze activity and crystal structure of TisAFP7 from the snow mold fungus Typhula ishikariensis. TisAFP7 exhibited intermediate activity, with the ability to bind ice basal plane, compared with a hyperactive isoform TisAFP8 and a moderately active isoform TisAFP6. Analysis of the TisAFP7 crystal structure revealed a bound-water network arranged in a zigzag pattern on the surface of the protein’s ice-binding site (IBS). While the three AFP isoforms shared the water network pattern, the network on TisAFP7 IBS was not extensive, which was likely related to its intermediate activity. Analysis of the TisAFP7 crystal structure also revealed the presence of additional water molecules that form a ring-like network surrounding the hydrophobic side chain of a crucial IBS phenylalanine, which might be responsible for the increased adsorption of AFP molecule onto the basal plane. Based on these observations, we propose that the extended water network and hydrophobic hydration at IBS together determine the TisAFP activity.
Sick Leave and Costs in Active Workers With Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study
Authors: Sicras-Mainar Antoni , Tornero Juan Carlos , Vargas F , Lizarraga I , Sicras A , Rejas J
Published: December 2020

ObjectiveTo evaluate sick leave and its costs in active workers who initiate opioid treatment for moderate/severe chronic osteoarthritis (OA) pain.MethodsSecondary analysis of the longitudinal, retrospective OPIOIDS study using electronic medical records (EMR) of patients aged ≥ 18 years who started opioid treatment for chronic OA pain between 2010 and 2015 after treatment failure with usual analgesics. The follow-up period was 36 months from the index date, and the days of sick leave and their cost were analyzed.ResultsA total of 5,089 EMRs of OA chronic pain patients aged 56.8 years (SD: 4.6), 56.6% male, were analyzed: 73.3% of patients started treatment with a weak opioid and 26.7% a strong opioid. At 36 months, adherence was 21% (strong opioids 15.4%, weak opioids: 23%; p<0.001), and 77% of patients had at least one sick leave related with OA chronic pain, with a mean total days off work of 93 days in all actively working patients (120.5 days in patients with sick leaves). In 16.9% it lasted ≥ 6 months. Pain reduction was modest (-1.2 points; -4.0%, p<0.001). The cost of sick leave was € 2,594 patient/year and was associated (p<0.05) with age (β-0.043), female sex (β-0.035), comorbidity (β-0.034) and strong opioid use (β-0.037).ConclusionsActive workers who started opioid treatment for chronic osteoarthritis pain showed an increased frequency of sick leave and cost to society, with modest pain reduction. Age, female sex, comorbidity, and strong opioids were factors associated with the cost of sick leave.
Development and Feasibility of the Early Rehabilitation Program on Postoperative Enhanced Recovery Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial
Authors: Yang Funa , Li Lijuan , Mi Yanzhi , Zou Limin , Chu Xiaofei , Sun Aiying , Sun Haibo , Liu Xianben , Xu Xiaoxia
Published: December 2020

Background: Perioperative rehabilitation management is essential to enhanced recovery after surgery. Few reports, however, focused on quantitative, detailed early activity plans for patients after esophagectomy. Aim: The purpose of this research was to estimate the effect of the Early Rehabilitation Program (ERP) on the recovery of bowel function and physical function for patients undergoing esophagectomy. Method: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selected from June 2019 to February 2020 and assigned to the intervention group (IG) or the control group(CG) randomly. The participants in IG received an ERP strategy during the perioperative period, and the CG received routine care. The recovery of bowel and physical function, readiness for hospital discharge (RHD) and postoperative hospital stay were evaluated on the day of discharge. Results: 215 cases were enrolled and randomized to the CG (n=108) or IG (n=107). There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the ERP intervention, the IG group presented a significantly shorter time to first flatus (P<0.001) and to first bowel movement postoperative (P=0.024), and a better physical function recovery (P＜0.001), compared with the CG group. The analysis also showed that participants in the IG have higher scores of RHD and shorter length of postoperative stay than the CG (P＜0.05). Conclusion: The findings suggest that the ERP can improve bowel and physical function recovery, ameliorate patients' RHD, and shorten postoperative hospital stay for patients undergoing MIE.Trial registration：ClinicalTrials.gov Identifier: NCT01998230
The Primary Tumor Surgery Prolongs the Medium Cancer Specific Survival in Metastatic Colorectal Cancer Patients with Initial Isolated Unresectable Lung Metastasis: A SEER-based Retrospective Study
Authors: Gao Yu , Xia Ling , Liu Qi , Dai Jing , Zhou Fuxiang , Liang Chen
Published: December 2020

Background: The efficiency of primary tumor surgery (PTS) to patients who are diagnosed as colorectal cancer (CRC) with initial isolated unresectable lung metastasis (URLM) is still on debates.Methods: 1580 patients are involved in this study eventually, data from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Chi-square (Χ2) test examines the categorical variables. Hazard ratio (HR) and 95% confidence interval (95% CI) are used as the estimation of risk for mortality in univariate and multivariate Cox regression. Propensity score match (PSM) simulates the random progress. Kaplan-Meier method outputs the medium cancer specific survival (mCSS) and delineates the survival curve.Results: After PSM, PTS prolongs the mCSS time in surgery group compared to no-surgery group (40 months vs. 14 months, HR=0.396, P<0.001), and raises the 3-year CSS rate (37% vs. 12%, P<0.001). Radiotherapy has further survival benefits in surgery group (49 months vs. 32 months, HR=0.434, P=0.001). Chemotherapy, radiotherapy, and no peritoneum metastasis have better mCSS (31 months, 33 months, 30months respectively). Multivariate Cox regression turns out that patients older than 75 (HR=1.869, P<0.001), with poor differentiation or undifferentiation pathological grade (HR=1.796, P<0.001), with peritoneum metastasis (HR=1.650, P<0.001) have higher risks of death, and PTS (HR=0.396, P<0.001), chemotherapy (HR=0.330, P<0.001) are favor prognostic factors in mCRC with URLM.Conclusion: This study affirms the effectiveness of primary tumor surgery in the colorectal cancer patients with initial isolated unresectable lung metastasis. More random clinical trials or real-world researches need to be implemented.
Different Patterns of Pneumothorax in Patients With Soft Tissue Tumors Treated With Pazopanib
Authors: Aiba Hisaki , Kimura Hiroaki , Yamada Satoshi , Okamoto Hideki , Hayashi Katsuhiro , Miwa Shinji , Kawaguchi Yohei , Saito Shiro , Sakai Takao , Tatematsu Tsutomu , Nakanisi Ryoichi , Murakami Hideki
Published: December 2020

Background: To investigate the patterns of pneumothorax in pazopanib treatment, focusing on the positional relationship between the visceral pleura and metastatic lung tumor. Methods: We examined 20 patients with advanced soft tissue tumor who developed lung metastases before pazopanib treatment during 2012–2019. Pneumothorax was classified into two types based on the location of the metastatic lesion around the visceral pleural area before pazopanib treatment: subpleural type, within 5 mm from the pleura; central type, > 5 mm from the pleura. We investigated the rates of pneumothorax and the risk factors. Results: Overall, 5 patients experienced pneumothorax (3 subpleural and 2 central type). Cavitation preceded pneumothorax in 80% of the patients and led to connection of the cavitated cyst of the metastatic lesion to the chest cavity in a shorter term in those with the subpleural type. Conversely, a more gradual increase in cavity and sudden cyst rupture were observed in the central type. The risk factors for pneumothorax were cavitation after the initiation of pazopanib and previous intervention before pazopanib including ablation or surgery. The locations of metastatic lesion were not risk factor for the occurrence of pneumothorax.Conclusion: Pneumothorax is an adverse event of pazopanib treatment. Therefore, attention must be paid to the predisposing factors such as the formation of cavitation after pazopanib initiation and previous interventions on the lungs. Moreover, as the subpleural pneumothorax tends to occur earlier than the central type, the different time course can be anticipated based on the positional relationships of the metastatic lesions to the visceral pleura.
Prognostic Factors in Patients with Advanced HER2-Positive Gastric Cancer Treated with Trastuzumab-Based Chemotherapy: A Cohort study
Authors: Marshall Shoko , Wakatsuki Takeru , Takahari Daisuke , Matsushima Tomohiro , Ishizuka Naoki , Nakayama Izuma , Osumi Hiroki , Ogura Mariko , Ichimura Takashi , Shinozaki Eiji , Chin Keisho , Yamaguchi Kensei
Published: December 2020

Background: Prognostic factors for the survival of patients with advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy remain controversial. The aim of this study was to reveal the clinical factors that predict prognosis in this patient population.Methods: We retrospectively reviewed the medical records of HER2-positive gastric cancer patients treated with trastuzumab-based chemotherapy in our institution. Clinical features and laboratory test results considered prognostic factors were re-examined. Overall survival (OS) was estimated using the Kaplan-Meier method, univariate analysis was performed with the log-rank test, and multivariate analysis using Cox’s proportional hazard regression model.Results: A total of 133 patients with advanced HER2-positive gastric cancer were enrolled. The median OS in this cohort was 18.7 months. Four prognostic factors: visceral metastasis (lung or liver), and levels of haemoglobin (Hb) (< 11.6 g/dL), lactate dehydrogenase (LDH) (> 222 mg/dL), and C-reactive protein (CRP) (> 0.14 mg/dl) were identified as independent prognostic factors. After classifying the patients in three groups according to their number of prognostic factors, namely low (0,1), moderate (2,3), and high (4) risk, OS curves were separated into three categories with median OS of 32.0, 18.7, and 10.1 months, respectively (p=0.00025). Compared to the low-risk group, hazard ratios for the moderate- and high-risk groups were 1.75 (95% CI: 1.05–2.93) and 3.49 (95% CI: 1.81–6.71), respectively.Conclusion: Visceral metastasis and abnormal Hb, LDH, and CRP test results were associated with unfavourable OS. These findings are helpful for the management of advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy.
One Year of Procarbazine Lomustine and Vincristine is Poorly Tolerated in Low Grade Glioma: A Real World Experience in a National Neuro-Oncology Centre
Authors: Keogh Rachel , Aslam Razia , Hennessy Maeve , Coyne Zac , Hennessy Bryan , Breathnach Oscar , Grogan Liam , Morris Patrick
Published: December 2020

BackgroundFollowing optimal local therapy, adjuvant Procarbazine, Lomustine and Vincristine (PCV) improves overall survival (OS) in low-grade glioma (LGG). However, one year of PCV is associated with significant toxicities. In the pivotal RTOG 9802 randomised control trial, approximately half of the patients discontinued treatment after six months. As patients on clinical trials may be fitter, we aimed to further explore the tolerability of PCV chemotherapy in routine clinical practice. MethodsWe conducted a retrospective study between 2014 and 2018 at a National Neuro-Oncology centre. Patients who had received PCV during this time period were included. The primary objective was to assess tolerability of treatment. Secondary objectives included evaluation of treatment delays, dose modifications and toxicities. ResultsOverall, 41 patients were included, 24 (58%) were male and 21 (51%) aged ≥ 40 years. Overall, 38 (93%) underwent surgical resection and all patients received adjuvant radiotherapy prior to chemotherapy. The median number of cycles completed was 3,2,4 for procarbazine, lomustine and vincristine respectively. Only 4 (10%) completed all six cycles of PCV without dose modifications. There was a universal decline in dose intensity as cycles of chemotherapy progressed. Dose intensity for cycle 1 versus cycle 6 respectively: procarbazine (98% versus 46%), lomustine (94% versus 48%) and vincristine (93% versus 50%). Haematological toxicities were common. Six (14%) patients experienced Grade III-IV thrombocytopaenia and 13 (31%) experienced Grade III-IV neutropaenia. Conclusion﻿Toxicities are frequently observed with the PCV regimen in clinical practice. It might be preferable to adjust doses from the start of chemotherapy to improve tolerability or consider alternative chemotherapy, particularly in older patients with LGG.
Research Priorities and Indicators for Lifestyle Programs to Address Cardiometabolic Conditions
Authors: Brauer Paula , Desroches Sophie , Dhaliwal Rupinder , Li Airu , Wang Yiran , Conklin Annalijn , Klein Doug , Drouin-Chartier Jean-Philippe , Robitaille Julie , Horne Justine , Ponta Monia , Burns Rachel , Harding Scott , Hosseini Zeinab
Published: December 2020

Background: Cardiometabolic conditions are a major and growing health burden in many countries. At least one-third of middle-aged adults with overweight and obesity develop various combinations of type 2 diabetes, hypertension, dyslipidemia, and other cardiometabolic conditions. Currently, all relevant clinical and community guidelines recommend lifestyle (e.g. diet and physical activity) interventions, yet current evidence suggests limited and variable uptake by either primary care or public health services. New implementation research in lifestyle interventions is needed in multiple jurisdictions. As part of this effort, some agreement within the research community on priorities and core measures and indicators across studies would improve comparability and drive progress. Members of a new volunteer network undertook a first Delphi process to determine initial consensus.Methods: Network members were invited by email to participate and completed two rounds of a modified Delphi process delivered through online questionnaire and teleconferences. Results were sent back to participants at the end of each round of the survey. High priority with consensus was defined as the median and 25-75%ile range within the 7 to 9 range on a 9-point scale. Results: Fifty-three people were invited and provided with a link to the first questionnaire. Twenty-five (47%) and 18 (34%) participants completed the round 1 and round 2 surveys, respectively. Of 22 possible research priorities, four were rated high priority with consensus, including: evaluating the efficacy and effectiveness of interventions in place, improving existing interventions for sustainability, and clinical and public health research to advance existing knowledge to develop new capacities. Of the 93 measures and indicators proposed, 15 achieved consensus with an additional nine measures having high medians, but greater variance.Conclusions: This first effort suggests a wide range of research priorities within the group, but also broad agreement on a few core implementation research priorities. There is currently limited agreement on core indicators/measures for implementation studies and additional work is needed. The results provide a starting point for further development of common measures for implementation research in lifestyle interventions for cardiometabolic conditions.