bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical end‐of‐life decisions for people with intellectual disabilities in Switzerland: Third survey
Authors: Wicki Monika T.
Published: April 2020

Background

There is a generally high incidence of medical end‐of‐life decisions in Switzerland. International research has described a number of potential problems that complicate end‐of‐life decisions for people with intellectual disabilities (IDs).

Specific Aims

The aim of this study was to explore the prevalence and nature of end‐of‐life decisions for people with IDs in Swiss residential homes and to assess, whether, and with whom the end‐of‐life decision was discussed and whether the person had decision‐making capacity or not.

Method

A cross‐sectional survey in residential homes for adults with disabilities was conducted in six cantons in Switzerland. Responses were provided by 64.4% of the residential homes. The survey delivered detailed information on 161 persons (101 men, 60 women) who had died between 2015 and 2017 in 77 residential homes for people with disabilities.

Findings

In 86% of all nonsudden deaths, at least one end‐of‐life decision was reported. There were no differences in the frequency of medical end‐of‐life decisions for people with IDs and for people with other disabilities. In 63.6% of the cases, the decisions were discussed with the person with a disability. Not all persons with a disability were considered to have decision‐making capacity. For people with disability, health and care staff are important persons to initiate such discussions.

Discussion

Changes made in 2013 in Swiss law on adult protection as well as training courses on palliative care and end‐of‐life decisions in residential homes have had an impact on medical end‐of‐life decision‐making for people with IDs. Still, further efforts to motivate physicians to include patients with IDs in end‐of‐life decision‐making will be useful.
Screen‐detected gallstone disease and risk of liver and pancreatic cancer: The Kailuan Cohort Study
Authors: Zhao Xinyu , Wang Na , Sun Yuanyuan , Zhu Guoling , Wang Yanhong , Wang Zhenyu , Zhang Yanmin , Cheng Kailiang , Wang Guodong , Wu Shouling , Wang Li
Published: April 2020

Background

Few studies have examined the risk of gastrointestinal cancers in screen‐detected gallstone disease. This study aimed to investigate the association between screen‐detected gallstone disease and gastrointestinal cancers using the Kailuan cohort, a population‐based prospective cohort initiated in 2006.

Methods

A total of 79 809 men who underwent gallbladder ultrasonography, were free of cancers in 2006 and did not have gastrointestinal cancers within one year were enrolled. A Cox proportional hazards model with age as the timescale was used to evaluate the association between screen‐detected gallstone disease and gastrointestinal cancers.

Results

We identified 1264 cases with gastrointestinal cancers, including 303 cases with liver cancer and 94 cases with pancreatic cancer. Screen‐detected gallstone disease increased the risk of liver cancer, with an HR of 2.28 [95% confidence interval (CI): 1.20‐4.33, P = .012]. The association was modified by the hepatitis B surface antigen status. A non‐significant positive association was observed between pancreatic cancer and gallstone disease (HR 2.19, 95% CI: 0.95‐5.05, P = .065). However, the HR became significant after those individuals with diabetes were excluded (HR 2.60, 95% CI: 1.12‐6.01, P = .026).

Conclusion

Screen‐detected gallstone disease may predict the risk for liver and pancreatic cancer.
Limits of post‐secularism in Turkey: Comparing the attitudes of the Justice and Development Party towards the headscarf and Alevi issues
Authors: Konuralp Emrah
Published: April 2020

The debate on post‐secularism indicates both the inclusion of religious voices into the public sphere and the rising importance of religion in international politics as well as in domestic politics of Western nation‐states. The term “post‐secular” firstly emerged to describe the Western societies where pluralism has been a vital concern for liberal democracy. Nonetheless, the very same concern is prevalent across non‐Western societies. In this respect, the Turkish case having a secular state in a predominantly Muslim society provides a vibrant example for the analysis of post‐secularism as Islamic‐oriented Justice and Development Party (Adalet ve Kalkınma Partisi, AKP) has been ruling Turkey since November 2002. In this article, the success or failure of the AKP in representing a post‐secular moment in Turkish politics is analysed with reference to and in comparison of two issues. The first one is the Sunni‐Islamic demands on the visibility in the public sphere symbolised with the headscarf issue. The second issue is the demands of Alevis living in Turkey as they force the boundaries of the “secular” public sphere which has been dominated by the Sunni‐Turkish socio‐cultural identity.
Whole-Genome Comparisons of
Staphylococcus agnetis
Isolates from Cattle and Chickens
Authors: Shwani Abdulkarim , Adkins Pamela R. F. , Ekesi Nnamdi S. , Alrubaye Adnan , Calcutt Michael J. , Middleton John R. , Rhoads Douglas D.
Published: April 2020

Staphylococcus agnetis
has been recently recognized as associated with disease in dairy cattle and meat-type chickens. The infections appear to be limited in cattle and systemic in broilers. This report details the molecular relationships between cattle and chicken isolates in order to understand how this recently recognized species infects different hosts with different disease manifestations. The data show that the chicken and cattle isolates are very closely related, but the chicken isolates all cluster together, suggesting a single jump from cattle to chickens.
Cell therapy for the preterm infant: promise and practicalities
Authors: Baker Elizabeth K , Jacobs Susan E , Lim Rebecca , Wallace Euan M , Davis Peter G
Published: April 2020

Recent decades have seen the rapid progress of neonatal intensive care, and the survival rates of the most preterm infants are improving. This improvement is associated with changing patterns of morbidity and new phenotypes of bronchopulmonary dysplasia and preterm brain injury are recognised. Inflammation and immaturity are known contributors to their pathogenesis. However, a new phenomenon, the exhaustion of progenitor cells is emerging as an important factor. Current therapeutic approaches do not adequately address these new mechanisms of injury. Cell therapy, that is the use of stem and stem-like cells, with its potential to both repair and prevent injury, offers a new approach to these challenging conditions. This review will examine the rationale for cell therapy in the extremely preterm infant, the preclinical and early clinical evidence to support its use in bronchopulmonary dysplasia and preterm brain injury. Finally, it will address the challenges in translating cell therapy from the laboratory to early clinical trials.
LPIAT1/MBOAT7 depletion increases triglyceride synthesis fueled by high phosphatidylinositol turnover
Authors: Tanaka Yuki , Shimanaka Yuta , Caddeo Andrea , Kubo Takuya , Mao Yanli , Kubota Tetsuya , Kubota Naoto , Yamauchi Toshimasa , Mancina Rosellina Margherita , Baselli Guido , Luukkonen Panu , Pihlajamäki Jussi , Yki-Järvinen Hannele , Valenti Luca , Arai Hiroyuki , Romeo Stefano , Kono Nozomu
Published: April 2020

Objective

Non-alcoholic fatty liver disease (NAFLD) is a common prelude to cirrhosis and hepatocellular carcinoma. The geneticrs641738 C>Tvariant in the lysophosphatidylinositol acyltransferase 1 (LPIAT1)/membrane bound O-acyltransferase domain-containing 7, which incorporates arachidonic acid into phosphatidylinositol (PI), is associated with the entire spectrum of NAFLD. In this study, we investigated the mechanism underlying this association in mice and cultured human hepatocytes.

Design

We generated the hepatocyte-specificLpiat1knockout mice to investigate the function of Lpiat1 in vivo. We also depletedLPIAT1in cultured human hepatic cells using CRISPR-Cas9 systems or siRNA. The effect of LPIAT1-depletion on liver fibrosis was examined in mice fed high fat diet and in liver spheroids. Lipid species were measured using liquid chromatography-electrospray ionisation mass spectrometry. Lipid metabolism was analysed using radiolabeled glycerol or fatty acids.

Results

The hepatocyte-specificLpiat1knockout mice developed hepatic steatosis spontaneously, and hepatic fibrosis on high fat diet feeding. Depletion ofLPIAT1in cultured hepatic cells and in spheroids caused triglyceride accumulation and collagen deposition. The increase in hepatocyte fat content was due to a higher triglyceride synthesis fueled by a non-canonical pathway. Indeed, reduction in the PI acyl chain remodelling caused a high PI turnover, by stimulating at the same time PI synthesis and breakdown. The degradation of PI was mediated by a phospholipase C, which produces diacylglycerol, a precursor of triglyceride.

Conclusion

We found a novel pathway fueling triglyceride synthesis in hepatocytes, by a direct metabolic flow of PI into triglycerides. Our findings provide an insight into the pathogenesis and therapeutics of NAFLD.
Genome‐Wide Characterization and Analysis of bHLH Transcription Factors Related to Crocin Biosynthesis in Gardenia jasminoides Ellis (Rubiaceae)
Authors: Tian Ya , Pu Xiangdong , Yu Haoying , Ji Aijia , Gao Ranran , Hu Yating , Xu Zhichao , Wang Hualei
Published: April 2020

Crocins, enriched in Gardenia jasminoides fruits, have a pharmacological activity against central nervous system diseases, cardiovascular diseases, and cancer cell growth. The biosynthesis of crocins has been widely explored, but its regulatory mechanism remains unknown. Here, the basic helix‐loop‐helix (bHLH) transcription factors related to crocin biosynthesis were systematically identified on the basis of the genome of G. jasminoides. A total of 95 GjbHLH transcription factor genes were identified, and their phylogenetic analysis indicated that they could be classified into 23 subfamilies. The combination of gene‐specific bHLH expression patterns, the coexpression analysis of biosynthesis genes, and the analysis of promoter sequences in crocin biosynthesis pathways suggested that nine bHLHs in G. jasminoides might negatively regulate crocin biosynthesis. This study laid a foundation for understanding the regulatory mechanism of crocin biosynthesis and the improvement and breeding of G. jasminoides varieties.
Combined Cohesin–RUNX1 Deficiency Synergistically Perturbs Chromatin Looping and Causes Myelodysplastic Syndromes
Authors: Ochi Yotaro , Kon Ayana , Sakata Toyonori , Nakagawa Masahiro M , Nakazawa Naotaka , Kakuta Masanori , Kataoka Keisuke , Koseki Haruhiko , Nakayama Manabu , Morishita Daisuke , Tsuruyama Tatsuaki , Saiki Ryunosuke , Yoda Akinori , Okuda Rurika , Yoshizato Tetsuichi , Yoshida Kenichi , Shiozawa Yusuke , Nannya Yasuhito , Kotani Shinichi , Kogure Yasunori , Kakiuchi Nobuyuki , Nishimura Tomomi , Makishima Hideki , Malcovati Luca , Yokoyama Akihiko , Takeuchi Kengo , Sugihara Eiji , Sato Taka-Aki , Sanada Masashi , Takaori-Kondo Akifumi , Cazzola Mario , Kengaku Mineko , Miyano Satoru , Shirahige Katsuhiko , Suzuki Hiroshi I. , Ogawa Seishi
Published: April 2020

STAG2 encodes a cohesin component and is frequently mutated in myeloid neoplasms, showing highly significant comutation patterns with other drivers, including RUNX1. However, the molecular basis of cohesin-mutated leukemogenesis remains poorly understood. Here we show a critical role of an interplay between STAG2 and RUNX1 in the regulation of enhancer–promoter looping and transcription in hematopoiesis. Combined loss of STAG2 and RUNX1, which colocalize at enhancer-rich, CTCF-deficient sites, synergistically attenuates enhancer–promoter loops, particularly at sites enriched for RNA polymerase II and Mediator, and deregulates gene expression, leading to myeloid-skewed expansion of hematopoietic stem/progenitor cells (HSPC) and myelodysplastic syndromes (MDS) in mice. Attenuated enhancer–promoter loops in STAG2/RUNX1–deficient cells are associated with downregulation of genes with high basal transcriptional pausing, which are important for regulation of HSPCs. Downregulation of high-pausing genes is also confirmed in STAG2–cohesin-mutated primary leukemia samples. Our results highlight a unique STAG2–RUNX1 interplay in gene regulation and provide insights into cohesin-mutated leukemogenesis.

Significance:

We demonstrate a critical role of an interplay between STAG2 and a master transcription factor of hematopoiesis, RUNX1, in MDS development, and further reveal their contribution to regulation of high-order chromatin structures, particularly enhancer–promoter looping, and the link between transcriptional pausing and selective gene dysregulation caused by cohesin deficiency.

This article is highlighted in the In This Issue feature, p. 747
Collateral Recruitment Is Impaired by Cerebral Small Vessel Disease
Authors: Lin Michelle P. , Brott Thomas G. , Liebeskind David S. , Meschia James F. , Sam Kevin , Gottesman Rebecca F.
Published: April 2020

Background and Purpose—

Cerebral small vessel disease (SVD) is associated with increased stroke risk and poor stroke outcomes. We aimed to evaluate whether chronic SVD burden is associated with poor recruitment of collaterals in large-vessel occlusive stroke.

Methods—

Consecutive patients with middle cerebral artery or internal carotid artery occlusion presenting within 6 hours after stroke symptom onset who underwent thrombectomy from 2012 to 2017 were included. The prespecified primary outcome was poor collateral flow, which was assessed on baseline computed tomographic angiography (poor, ≤50% filling; good, >50% filling). Markers of chronic SVD on brain magnetic resonance imaging were rated for the extent of white matter hyperintensities, enlarged perivascular spaces, chronic lacunar infarctions and cerebral microbleeds using the Standards for Reporting Vascular Changes on Neuroimaging criteria. Severity of SVD was quantified by adding the presence of each SVD feature, with a total possible score of 0 to 4; each SVD type was also evaluated separately. Multivariable logistic regression analyses were performed to evaluate the relationships between SVD and poor collaterals, with adjustment for potential confounders.

Results—

Of the 100 eligible patients, the mean age was 65±16 years, median National Institutes of Health Stroke Scale score was 15, and 68% had any SVD. Poor collaterals were observed in 46%, and those with SVD were more likely to have poor collaterals than patients without SVD (aOR, 1.9 [95% CI, 1.1–3.2]). Of the SVD types, poor collaterals were significantly associated with white matter hyperintensities (aOR, 2.9 per Fazekas increment [95% CI, 1.6–5.3]) but not with enlarged perivascular spaces (adjusted odds ratio [aOR], 1.3 [95% CI, 0.4–4.0]), lacunae (aOR, 2.1 [95% CI, 0.6–7.1]), or cerebral microbleeds (aOR, 2.1 [95% CI, 0.6–7.8]). Having a greater number of different SVD markers was associated with a higher odds of poor collaterals (crude trend
P
<0.001; adjusted
P
=0.056). There was a dose-dependent relationship between white matter hyperintensity burden and poor collaterals: adjusted odds of poor collaterals were 1.5, 3.0, and 9.7 across Fazekas scores of 1 to 3 (
P
trend=0.015). No patient with an SVD score of 4 had good collaterals.

Conclusions—

Chronic cerebral SVD is associated with poor recruitment of collaterals in large vessel occlusive stroke. A prospective study to elucidate the potential mechanism of how SVD may impair the recruitment of collaterals is ongoing.
Plasma 25-hydroxyvitamin D level and the risk of frailty among Chinese community-based oldest-old: evidence from the CLHLS study
Authors: Xiao Qi , Wu Meiliyang , Cui Jinrui , Yuan Mengmei , Chen Ye , Zeng Tieying
Published: April 2020

Background

Vitamin D deficiency has been linked to the risk of frailty. However, there are limited methods for evaluations of the potential association of vitamin D with frailty in a longevous (80+) population. The aim of this study was to examine the association between plasma 25-hydroxyvitamin D [25(OH)D] levels and the risk of frailty among the Chinese community based oldest-old.

Methods

Secondary analysis of data compiled in the 2011 wave of the Chinese Longitudinal Healthy Longevity Survey (n = 1324) was performed. Frailty was assessed by the Study of Osteoporotic Fractures (SOF) index. Multivariate logistic regression and spline smoothing with threshold effect analysis were performed to investigate the association between 25(OH) D level and the risk of frailty after adjusting for socio-demographic variables, health characteristics and confounding biomarkers.

Results

The mean age was 92.89 ± 7.92 years, and 844 (63.7%) participants were women. In all, data from 426 (33.2, 95% confidence interval, CI: 29.66–34.69) frail participants were recorded. After adjustment for confounding covariates, the level of 25(OH) D was significantly related to frailty. By spline smoothing with threshold effect analysis, a monotonically negative association between 25(OH) D and frailty was identified. Subgroup analyses revealed that the association did not differ by sex or age.

Conclusions

The 25(OH) D level was inversely associated with the risk of frailty among the Chinese community-based oldest-old.
Plasmodium yoelii 17XL infection modified maturation and function of dendritic cells by skewing Tregs and amplificating Th17
Authors: Chen Guang , Du Ji-wei , Nie Qing , Du Yun-ting , Liu Shuang-chun , Liu De-hui , Zhang Hui-ming , Wang Fang-fang
Published: April 2020

Background

Emerging data has suggested that Tregs, Th17, Th1 and Th2 are correlated with early immune mechanisms by controlling Plasmodium infection. Plasmodium infection appeared to impair the antigen presentation and maturation of DCs, leading to attenuation of specific cellular immune response ultimately. Hence, in this study, we aim to evaluate the relevance between DCs and Tregs/Th17 populations in the process and outcomes of infection with Plasmodium yoelii 17XL (P.y17XL).

Methods

DCs detection/analysis dynamically was performed by Tregs depletion or Th17 neutralization in P.y17XL infected BALB/c mice via flow cytometry. Then the levels of cytokines production were detected using enzyme-linked mmunosorbent assay (ELISA).

Results

Our results indicated that Tregs depletion or Th17 neutralization in BALB/c mice infected with P.y17XL significantly up-regulated the percentages of mDC and pDC, increased the expressions of major histocompatibility complex (MHC) class II, CD80, CD86 on DCs and the levels of IL-10/IL-12 secreted by DCs, indicating that abnormal amplification of Tregs or Th17 may damage the maturation and function of DCs during the early stage of malaria infection. Interestingly, we also found that the abnormal amplification of Th17, as well as Tregs, could inhibit the maturation of DCs.

Conclusions

Tregs skewing or Th17 amplification during the early stage of malaria infection may inhibit the maturation and function of DCs by modifying the subsets of DCs, expressions of surface molecules on DCs and secretion mode of cytokines.
Risk scores for predicting incident chronic kidney disease among rural Chinese people: a village-based cohort study
Authors: Wen Jiangping , Hao Jie , Zhang Ye , Cao Kai , Zhang Xiaohong , Li Jiang , Lu Xinxin , Wang Ningli
Published: April 2020

Background

Few chronic kidney disease (CKD) risk prediction models have been investigated in low- and middle-income areas worldwide. We developed new risk scores for predicting incident CKD in low- and middle-income rural Chinese populations.

Methods

Data from the Handan Eye Study, which was a village-based cohort study and conducted from 2006 to 2013, were utilized as part of this analysis. The present study utilized data generated from 3266 participants who were ≥ 30 years of age. Two risk models for predicting incident CKD were derived using two-thirds of the sample cohort (selected randomly) using stepwise logistic regression, and were subsequently validated using data from the final third of the sample cohort. In addition, two simple point systems for incident CKD were generated according to the procedures described in the Framingham Study. CKD was defined as reduced renal function (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2) or the presence of albuminuria (urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g).

Results

The Simple Risk Score included waist circumference, systolic blood pressure (SBP), diabetes, sex, and education. The Best-fit Risk Score included urinary albumin-to-creatinine ratio, SBP, C-reactive protein, triglyceride, sex, education, and diabetes. In the validation sample, the areas under the receiver operating curve of the Simple Risk Score and Best-fit Risk Score were 0.717 (95% CI, 0.689–0.744) and 0.721 (95% CI, 0.693–0.748), respectively; the discrimination difference between the score systems was not significant (P = 0.455). The Simple Risk Score had a higher Youden index, sensitivity, and negative predictive value, with an optimal cutoff value of 14.

Conclusions

Our Simple Risk Score for predicting incident CKD in a low- and middle-income rural Chinese population will help identify individuals at risk for developing incident CKD.
The contribution of iron deficiency to the risk of peripartum transfusion: a retrospective case control study
Authors: VanderMeulen H. , Strauss R. , Lin Y. , McLeod A. , Barrett J. , Sholzberg M. , Callum J.
Published: April 2020

Background

Iron deficiency in pregnancy is associated with inferior maternal and fetal outcomes. Postpartum depression, prematurity, intrauterine growth restriction, impaired childhood cognition and transfusion are all sequelae of maternal iron deficiency anemia. Transfusion to women of childbearing age has important consequences including increasing the risk of hemolytic disease of the fetus and newborn with future pregnancies. The relative contribution of iron deficiency to transfusion rates in the peripartum period is unknown. This study aimed to identify the prevalence of iron deficiency and anemia in pregnant women that received peripartum transfusions relative to age-matched non-transfused controls.

Methods

We performed a retrospective case-control study of all women that were transfused in the peripartum period from January, 2014 to July, 2018. Cases were compared to the next age matched control to deliver at our institution. The primary objective was to determine the proportion of patients with iron deficiency in pregnancy or anemia in pregnancy in cases and controls. Charts were reviewed for predisposing risk factors for iron deficiency, laboratory measures of iron deficiency and anemia, iron supplementation history and maternal and fetal outcomes. Factors associated with peripartum transfusion were analyzed using a multivariate logistic regression.

Results

169 of 18, 294 (0.9%) women were transfused in the peripartum period and 64 (44%) of those transfused received 1 unit. Iron deficiency or anemia were present in 103 (71%) transfused women and 74 (51%) control women in pregnancy (OR 2.34, 95% CI: 3.7–18.0). Multivariate analysis identified social work involvement (adjusted OR 4.1, 95% CI: 1.8–10.1), intravenous iron supplementation in pregnancy (adjusted OR 3.8, 95% CI: 1.2–17.4) and delivery by unscheduled cesarean section (adjusted OR 2.8, 95% CI: 1.3–6.2) as significant predictors of peripartum transfusion.

Conclusions

Pregnant women being followed by a social worker, receiving intravenous iron supplementation in pregnancy or who deliver by unscheduled cesarean section are more likely to receive a red blood cell transfusion. Women with iron deficiency or anemia in pregnancy are at increased risk of peripartum blood transfusions and warrant early and rigorous iron supplementation.
CD45dimCD34+CD38−CD133+ cells have the potential as leukemic stem cells in acute myeloid leukemia
Authors: Heo Sook-Kyoung , Noh Eui-Kyu , Ju Lan Jeong , Sung Jun Young , Jeong Yoo Kyung , Cheon Jaekyung , Koh Su Jin , Min Young Joo , Choi Yunsuk , Jo Jae-Cheol
Published: April 2020

Background

Leukemia stem cells (LSCs) in play an important role in the initiation, relapse, and progression of acute myeloid leukemia (AML), and in the development of chemotherapeutic drug resistance in AML. Studies regarding the detection of LSCs and the development of novel therapies for targeting them are extensive. The identification of LSCs and targeting therapies for them has been continuously under investigation.

Methods

We examined the levels of CD45dimCD34+CD38−CD133+ cells in bone marrow samples from patients with hematological malignancies and healthy controls, using four-color flow cytometry.

Results

Interestingly, the CD45dimCD34+CD38−CD133+ cells were highly expressed in the bone marrow of patients with AML compared to that in healthy controls (HC). Moreover, the proportions of CD45dimCD34+CD38−CD133+ cells were also examined in diverse hematological malignancies, including AML, CML, DLBCL, MM, MDS, HL, ALL, and CLL. LSCs were prominently detected in the BMCs isolated from patients with AML and CML, but rarely in BMCs isolated from patients with DLBCL, MM, MDS, ALL, CLL, and HL. Additionally, the high CD45dimCD34+CD38−CD133+ cell counts in AML patients served as a significantly poor risk factor for overall and event free survival.

Conclusions

Therefore, our results suggest that CD45dimCD34+CD38−CD133+ cells in AML might potentially serve as LSCs. In addition, this cell population might represent a novel therapeutic target in AML.
Dietary factors and risk of mortality among patients with esophageal cancer: a systematic review
Authors: Sun Li-Ping , Yan Lu-Bin , Liu Zhen-Zhen , Zhao Wen-Jing , Zhang Cai-Xia , Chen Yu-Min , Lao Xiang Qian , Liu Xudong
Published: April 2020

Background

The effects of dietary factors on prognosis of esophageal cancer remain unclear. This systematic review and meta-analysis aimed to assess the association between dietary intake and the risk of mortality among patients with esophageal cancer.

Methods

Six electronic databases (PubMed, Web of Science, OVID, ProQuest, CNKI and Wanfang) were searched for studies published up to Oct. 2019 that examined the association between dietary intake and all-cause mortality, esophageal cancer-specific mortality and esophageal cancer recurrence. The pooled hazard ratio (HR) with 95% confidence interval (CI) were derived by comparing the highest with the lowest categories of each dietary item and by using random effect models.

Results

A total of 15 cohort studies were included in this study and all reported pre-diagnosis dietary exposure; two focused on dietary folate, 12 on alcohol consumption and three on other dietary components (sugary beverages, phytochemicals and preserved vegetables). When comparing the highest with the lowest categories, dietary folate intake was associated with a reduced risk of esophageal cancer-specific mortality in patients with esophageal squamous cell carcinoma (HR: 0.41, 95% CI: 0.25–0.69), with low heterogeneity (I2 = 0%, P = 0.788). When comparing the highest with the lowest categories of alcohol consumption, alcohol consumption was associated with an increased risk of all-cause mortality in patients with esophageal squamous cell carcinoma (HR: 1.29, 95% CI: 1.07–1.55; heterogeneity: I2 = 53%, P = 0.030), but this increased risk was not significant in patients with esophageal adenocarcinoma (HR = 1.05, 95% CI: 0.84–1.32).

Conclusions

This review with pre-diagnostic dietary exposure showed that dietary folate intake was associated with a reduced risk of mortality of esophageal squamous cell carcinoma, whereas alcohol consumption was associated with an increased risk. More studies are needed to investigate effect of dietary factors, especially post-diagnosis dietary consumption, on esophageal cancer prognosis.
Overexpression of SLC6A1 associates with drug resistance and poor prognosis in prostate cancer
Authors: Chen Chaojiang , Cai Zhiduan , Zhuo Yangjia , Xi Ming , Lin Zhuoyuan , Jiang Funeng , Liu Zezhen , Wan Yueping , Zheng Yu , Li Jianxin , Zhou Xing , Zhu Jianguo , Zhong Weide
Published: April 2020

Background

Solute Carrier Family 6 Member 1 (SLC6A1) has been identified as a cancer-promoting gene in various human cancers, such as clear cell renal cell carcinoma and ovarian cancer. However, its roles in prostate cancer (PCa) has not been fully elucidated. The aim of this study was to investigate the expression and clinical significance of SLC6A1 in PCa tissues and its effect on drug resistance to docetaxel in PCa.

Methods

Expression patterns of SLC6A1 protein in PCa tissues were examined by immunohistochemistry based on Tissue microarray. Associations of SLC6A1 protein expression with various clinicopathological features and patients’ prognosis of PCa were also statistically evaluated based on TCGA data. Roles of SLC6A1 deregulation in prostate carcinogenesis and drug resistance was further determined in vitro and in vivo experiments.

Results

Based on TCGA Dataset, SLC6A1 expression was markedly higher in patients with high Gleason score, advanced clinical stage and positive biochemical recurrence than those with control features (all P < 0.05). Both unvariate and multivariate analyses demonstrated that SLC6A1 expression was significantly associated with biochemical recurrence-free survival in PCa patients. In addition, enforced expression of SLC6A1 effectively promoted cell proliferation, migration and invasion of PCa cells in vitro. Moreover, the inhibition of SLC6A1 suppressed the tumor growth in vivo. Additionally, immunohistochemical notches of PCNA and MMP-9 in the low-expression cluster were pointedly lower compared to those of NC group. Finally, the cell viability revealed that the overexpression of SLC6A1 obviously promoted the PCa cell resistant to docetaxel (DTX), and the transplanted tumor in the overexpression group had no significant reduction compared with the untreated group.

Conclusions

Our data suggest that SLC6A1 overexpression may be associated with aggressive progression and short biochemical recurrence-free survival of PCa, and may be related to the resistance to docetaxel therapy.
Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial
Authors: Bi Nan , Liu Lipin , Liang Jun , Wu Shixiu , Chen Ming , Lv Changxing , Zhao Lujun , Shi Anhui , Jiang Wei , Xu Yaping , Zhou Zongmei , Wang Jingbo , Wang Wenqing , Chen Dongfu , Hui Zhouguang , Lv Jima , Zhang Hongxing , Feng Qinfu , Xiao Zefen , Wang Xin , Zhang Tao , Yin Weibo , Li Junling , He Jie , Wang Luhua
Published: April 2020

Background

There is no consensus on the therapeutic approach to ECOG 2 patients with locally advanced non-small-cell lung cancer (LA-NSCLC), despite the sizable percentage of these patients in clinical practice. This study focused on the efficacy, toxicity and the optimal chemotherapy regimen of CCRT in ECOG 2 patients in a phase III trial.

Methods

Patients capable of all self-care with bed rest for less than 50% of daytime were classified as ECOG 2 subgroup. A subgroup analysis was performed for ECOG 2 patients recruited in the phase III trial receiving concurrent EP (etoposide + cisplatin)/PC (paclitaxel + carboplatin) chemotherapy with intensity-modulated radiation therapy (IMRT) or three-dimensional conformal external beam radiation therapy (3D-CRT).

Results

A total of 71 ECOG 2 patients were enrolled into the study. Forty-six (64.8%) patients were treated with IMRT technique. The median overall survival (OS) and progression free survival (PFS) for ECOG 2 patients were 16.4 months and 9 months, respectively. No difference was observed in treatment compliance and toxicities between ECOG 2 patients and ECOG 0–1 patients. Within the ECOG 2 group (31 in the EP arm and 40 in the PC arm), median OS and 3-year OS were 15.7 months and 37.5% for the EP arm, and 16.8 months and 7.5% for the PC arm, respectively (p = 0.243). The incidence of grade ≥ 3 radiation pneumonitis was higher in the PC arm (17.5% vs. 0.0%, p = 0.014) with 5 radiation pneumonitis related deaths, while the incidence of grade 3 esophagitis was numerically higher in the EP arm (25.8% vs. 10.0%, p = 0.078).

Conclusions

CCRT provided ECOG 2 patients promising outcome with acceptable toxicities. EP might be superior to PC in terms of safety profile in the setting of CCRT for ECOG 2 patients. Prospective randomized studies based on IMRT technique are warranted to validate our findings.

Trial registration

ClinicalTrials.gov registration number: NCT01494558. (Registered 19 December 2011).
Patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma after first-line treatment with surgery and/or intensity-modulated radiotherapy
Authors: Wang Dongqing , Yu Shui , Zhai Limin , Xu Jin , Li Baosheng
Published: April 2020

Background

To identify the spatial patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma (SCC) after first-line treatment with surgery and/or intensity-modulated radiotherapy (IMRT).

Methods

We retrospectively obtained the clinicopathological characters of 123 hypopharyngeal SCC patients, and investigated the patterns of regional lymph node failure. Univariate and multivariate logistic regression were used to determine the risk factors of regional lymph node failure.

Results

Forty patients (32.5% of total patients) were suffered regional lymph node failure. In these patients, the ipsilateral neck level II nodal failure account for 55.0% (22/40) followed by level III 30.0% (12/40), level VIb 15.0% (6/40), level VII 15.0% (6/40), and level IV 5.0% (2/40). In addition, 17.5% (7/40) patients suffered contralateral neck level II nodal failure and 7.5% (3/40) patients suffered level III nodal failure. The common failure levels were the II (7/46, 15.2%), III (4/46, 8.7%), VIb (4/46, 8.7%), and VII (5/46, 10.9%) for treatment by surgery. The lymph node recurrence and persistent disease at levels II (19/77, 24.7%) and III (10/77, 13.0%) remained the major cause of failure following curative intent of IMRT. The postoperative radiation significantly decreased the risk of regional lymph node failure (OR = 0.082, 95% CI: 0.007–1.000,P = 0.049); and the radiologic extranodal extension significantly increased the risk of regional lymph node failure (OR = 11.07, 95% CI: 2.870–42.69,P < 0.001).

Conclusions

Whatever the treatment modality, the lymph node failure at level II and III was the most popular pattern for hypopharyngeal SCC. Moreover, for patients who underwent surgery, the nodal failure at level VIb and VII was frequent. Thus, postoperative radiation of level VIb and VII may give rise to benefit to locally advanced hypopharyngeal SCC patients.
A case of bilateral endogenous endophthalmitis misdiagnosed as Purtscher’s retinopathy
Authors: Huang Yanming , Yuan Rongdi
Published: April 2020

Background

Purtscher’s retinopathy characterized by the appearance of cotton-wool spots and intraretinal hemorrhage at the posterior pole that commonly occurs after severe head and chest trauma. We report a patient who presented with multiple white retinal patches and retinal hemorrhage forty-two days after a severe thoracoabdominal trauma, which was misdiagnosed as Purtscher’s retinopathy.

Case presentation

A middle-aged woman presented to the eye clinic complaining of decreased vision and distortion in the right eye forty-two days after thoracoabdominal trauma. Upon first glance at her fundal appearances with multiple white retinal patches and retinal hemorrhage, we considered it to be bilateral Purtscher’s retinopathy. No specific treatment was given to her. Ten days later, the four white retinal patches in the right eye joined together with star-shaped hard exudates and radial folds in the macula. This was not consistent with the characteristics of Purtscher’s retinopathy. In retrospect, we found that the onset time, shape, and location of the white retinal patches were not cotton-wool spots. A detailed history revealed that she had Staphylococcus aureus septicaemia due to abdominal incision infection, and she underwent intravenous antibiotic therapy. Fundus fluorescein angiography (FFA) revealed hyperpermeable vasculature and extensive fluorescence leakage in the middle and late stages. Optical coherence tomography (OCT) revealed highly reflective exudates in the neuroepithelium and macular edema in the right eye. Taking her history and the FFA and OCT results into consideration, she was diagnosed with bilateral endogenous endophthalmitis.

Conclusion

In the present case, multiple white patches and intraretinal hemorrhage at the posterior pole forty-two days after the trauma were not Purtscher’s retinopathy. It was bilateral endogenous endophthalmitis. The subretinal abcesses that developed secondary to Staphylococcus aureus infection involved the macula causing decreased vision and distortion in the right eye. We concluded that in the case of multiple white retinal patches at the posterior pole in patients after trauma, especially in patients with infectious disease, Purtscher’s retinopathy is not the only possible diagnosis. Correct diagnosis depends on reevaluation of the lesions by FFA and OCT, laboratory investigation and detailed history.
Retinal vascular abnormalities and their associations with cardiovascular and cerebrovascular diseases: a Study in rural southwestern Harbin, China
Authors: Wang Junwei , Leng Fei , Li Zhijian , Tang Xianling , Qian Hua , Li Xiaoguang , Zhang Yi , Chen Xuedong , Du Haitao , Liu Ping
Published: April 2020

Background

Limited data is available on retinal vessel morphology in the north China. The study aimed to evaluate the prevalence of retinal vascular abnormalities (RVAs) and investigate their associations with the self-reported diagnosis of cardiovascular and cerebrovascsular diseases (CCVds) in a rural adult population of northeast China.

Methods

A population-based, cross-sectional study was conducted, using the cluster random sampling method. One eye of each participant was photographed with a non-mydriatic fundus camera. RVAs including focal and general arteriolar narrowing (FAN and GAN), arteriovenous nicking (AVN), arteriolar sheathing (AS), and retinopathy were evaluated. Data on self-reported diagnosis of cardiovascular and cerebrovascular diseases and status of smoking and alcohol drinking were obtained from questionnaires.

Results

Among the 6267 participants with an age ≥ 50 years, photographs were obtained of 99.2%, with quality sufficient to perform retinal evaluations in 82.5%. The prevalence of FAN, AVN, AS, retinopathy and GAN were 9.1, 8.9, 5.0, 6.6 and 6.2%, respectively. All the retinal lesions were associated with hypertension (all P < 0.01). After adjusting for age, gender, and left/right eyes, hypertension, hyperlipidaemia, diabetes mellitus, habits of past or current smoking and alcohol consumption, AVN was strongly associated with the self-reported diagnosis histories of coronary heart diseases(CHD) (OR, 1.44; 95% CI, 1.09, 1.89) and retinopathy was significantly associated with a self-reported diagnosis of stroke (OR, 2.05; 95% CI, 1.18, 3.57).

Conclusions

The overall prevalence of retinal microvascular abnormalities in this population was relatively higher than that reported in other regions of the world. Retinopathy is associated with the self-reported diagnosis of stroke while AVN was associated with the self-reported diagnosis of CHD, but the remaining retinal lesions were not consistently associated with CCVds. Thus, an examination of retinal microvascular characteristics may offer clues to CCVds and could be a potentially novel biomarkers for CCVds risk.
Core conflictual relationship theme: the reliability of a simplified scoring procedure
Authors: Tallberg Peter , Ulberg Randi , Johnsen Dahl Hanne-Sofie , Høglend Per Andreas
Published: April 2020

Background

Creating a case formulation is an important and basic skill in psychotherapy meant to guide treatment. A patient’s interpersonal pattern is an essential part of a case formulation. Core Conflictual Relationship Theme (CCRT) is a well-known structured method to describe interpersonal patterns.

The CCRT method is based on the assumption that humans display a central relationship theme, which is shown in most relationships as well as in the patient-therapist relation. The CCRT scoring is based on how the patient describes interactions with others, in therapy sessions or in a specific interview. These descriptions are transcribed. Raters then score the identified relational episodes by choosing elements from the clustered categories of Wishes, Response from Others and Response from Self. The method has shown high validity and reliability. Inter rater reliability is generally good: Cohen’s kappa ranging from 0.55 to 0.70.

To decide CCRT pattern from transcribed material is time consuming and labour intensive This study investigates a labour- and timesaving version of the method.

Methods

This study aimed to investigate rater agreement in a simplified method of scoring the CCRT, based directly on live semi-structured dynamic interviews without transcribing the material.

Fifty-two patients referred for psychotherapy in a clinical trial, were scored for CCRT pattern. Based on information that came forth during the two-hour interview, raters scored the patients choosing elements from the clustered categories of Wishes, Response from Others and Response from Self. More than one category in each component could be chosen without ranking. Five raters compared two by two were investigated. Inter rater reliability was measured by Cohen’s kappa.

Results

Mean kappa for Wishes, Response from Others and Response from Self was .33, .41 and .45 respectively. Mean kappa for CCRT in total was .41 among 5 raters.

Conclusion

In this simplified method to score the CCRT based on oral dynamic interviews, fair to moderate IRR was obtained.

Trial registration

First Experimental Study of Transference-interpretations (FEST307/95).

Registration number: ClinicalTrials.gov Identifier: NCT00423462.
The impact of gun violence restraining order laws in the U.S. and firearm suicide among older adults: a longitudinal state-level analysis, 2012–2016
Authors: Saadi Altaf , Choi Kristen R. , Takada Sae , Zimmerman Fred J.
Published: April 2020

Background

Older adults complete suicide at a disproportionately higher rate compared to the general population, with firearms the most common means of suicide. State gun laws may be a policy remedy. Less is known about Gun Violence Restricting Order (GVRO) laws, which allow for removal of firearms from people deemed to be a danger to themselves or others, and their effects on suicide rates among older adults. The purpose of this study was to examine the association of state firearm laws with the incidence of firearm, non-firearm-related, and total suicide among older adults, with a focus on GVRO laws.

Methods

This is a longitudinal study of US states using data from 2012 to 2016. The outcome variables were firearm, non-firearm and total suicide rates among older adults. Predictor variables were [1] total number of gun laws to assess for impact of overall firearm legislation at the state level, and [2] GVRO laws.

Results

The total number of firearm laws, as well as GVRO laws, were negatively associated with firearm-related suicide rate among older adults ages 55–64 and > 65 years-old (p < 0.001). There was a small but significant positive association of total number of firearm laws to non-firearm-related suicide rates and a negative association with total suicide rate. GVRO laws were not significantly associated with non-firearm-related suicide and were negatively associated with total suicide rate.

Conclusion

Stricter firearm legislation, as well as GVRO laws, are protective against firearm-relate suicides among older adults.
Impact of front-of-pack nutrition labels on consumer purchasing intentions: a randomized experiment in low- and middle-income Mexican adults
Authors: Jáuregui Alejandra , Vargas-Meza Jorge , Nieto Claudia , Contreras-Manzano Alejandra , Alejandro Nelson Zacarías , Tolentino-Mayo Lizbeth , Hall Marissa G. , Barquera Simón
Published: April 2020

Background

Front-of-pack (FOP) nutrition labeling is a cost-effective strategy to help consumers make informed and healthier food choices. We aimed to investigate the effect of the FOP labels used in the Latin American region on consumers’ shopping intentions when prompted to make their choices with specific nutrients-to-limit in mind among low- and middle-income Mexican adults (> 18 y).

Methods

In this experimental study of an online simulated shopping situation participants (n = 2194) were randomly assigned to one of three labeling conditions: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), or red Warning Labels (WL). Participants were required to view a video explaining how to correctly interpret the assigned label. Primary outcomes were the overall nutritional quality (estimated using the Nutrient Profiling Scoring Criterion [NPSC] and NPSC baseline score) and mean energy and nutrient content of purchases. Secondary outcomes included shopping time variables. We also evaluated the impact of the labels across food categories (ready-made foods, dairy beverages, non-dairy beverages, salty snacks, and breakfast cereals) and sociodemographic subgroups.

Results

The MTL and the WL led to a better overall nutritional quality of the shopping cart compared to the GDA (p < 0.05). According to the NPSC score, the WL led to a better nutritional quality across breakfast cereals and salty snacks compared to the GDA (p < 0.05); a similar effect was observed for the MTL among non-dairy beverages (p < 0.05). The MTL and the WL required shorter shopping times compared to GDA (p < 0.05). Across all labeling conditions, the nutritional quality of the shopping cart tended to be lower among those with low income, education and nutrition knowledge levels.

Conclusion

WL and MTL may foster healthier food choices in a faster way among low- and middle-income groups in Mexico. To produce an equitable impact among consumers of all socioeconomic strata, efforts beyond simply the inclusion of a communication campaign on how to use and interpret FOP labels will be required.

Trial registration

clinicaltrials.gov.NCT04308408Retrospectively registered March 16, 2020.