bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal Hemorrhages During Examination for Retinopathy of Prematurity: A Form of Ocular Decompression Retinopathy
Authors: Matei Vlad M. , He Yu-Guang
Published: August 2020

Purpose:

Posterior segment hemorrhage occurring during or shortly after examination (PSHE) for retinopathy of prematurity (ROP) is a very rare complication. We present a case of and review the literature on PSHE during ROP examination to better characterize this complication.

Methods:

A case report is presented, followed by a review of similar cases in the literature.

Results:

An infant undergoing laser photocoagulation for ROP rapidly developed diffuse intraretinal hemorrhages in his right eye during the laser and after a Valsalva event while he was intubated under general anesthesia. The hemorrhages resolved within 1 week. This presentation was similar to those in previously reported cases.

Conclusions:

PSHE in ROP usually consists of multiple, diffuse, intraretinal hemorrhages that occur within minutes of ROP examination and resolve within a few weeks without any other ocular findings or sequelae. PSHE seems to represent a form of ocular decompression retinopathy.
Vitrectomy With Sequential Internal Limiting Membrane Peeling and Flap Formation in Closure of a Large, Traumatic Macular Hole
Authors: Brown Jeffrey A. , Chang Jonathan S.
Published: August 2020

Purpose:

We report the use of sequential vitrectomy with internal limiting membrane (ILM) flaps in closure of a chronic, large, traumatic macular hole (MH) in a 32-year-old male patient.

Methods:

The patient underwent vitrectomy using a sequential ILM flap technique.

Results:

This sequential ILM flap technique resulted in complete closure of the MH and improvement in visual acuity. In this case, a second ILM flap procedure allowed for successful closure of a traumatic MH.

Conclusions:

This case suggests that the MH's closure may have been facilitated by both relief of tangential traction on the retina as well as glial tissue proliferation from presence of the ILM flap.
Dendritic Spines in the Spinal Cord: Live Action Pain
Authors: Benson Curtis A , Reimer Marike L , Tan Andrew M
Published: August 2020

Dendritic spines are microscopic protrusions on neurons that house the postsynaptic machinery necessary for neurotransmission between neurons. As such, dendritic spine structure is intimately linked with synaptic function. In pathology, dendritic spine behavior and its contribution to disease are not firmly understood. It is well known that dendritic spines are highly dynamic in vivo. In our recent publication, we used an intravital imaging approach, which permitted us to repeatedly visualize the same neurons located in lamina II, a nociceptive processing region of the spinal cord. Using this imaging platform, we analyzed the intravital dynamics of dendritic spine structure before and after nerve injury–induced pain. This effort revealed a time-dependent relationship between the progressive increase in pain outcome, and a switch in the steady-state fluctuations of dendritic spine structure. Collectively, our in vivo study demonstrates how injury that leads to abnormal pain may also contribute to synapse-associated structural remodeling in nociceptive regions of the spinal cord dorsal horn. By combining our live-imaging approach with measures of neuronal activity, such as with the use of calcium or other voltage-sensitive dyes, we expect to gain a more complete picture of the relationship between dendritic spine structure and nociceptive physiology.
Short telomere length predicts nonrelapse mortality after stem cell transplantation for myelodysplastic syndrome
Authors: Myllymäki Mikko , Redd Robert , Reilly Christopher R. , Saber Wael , Spellman Stephen R. , Gibson Christopher J. , Hu Zhen-Huan , Wang Tao , Orr Esther H. , Grenier Jaclyn G. , Chen Maxine M. , Steensma David P. , Cutler Corey , De Vivo Immaculata , Antin Joseph H. , Neuberg Donna , Agarwal Suneet , Lindsley R. Coleman
Published: August 2020

Allogeneic hematopoietic stem cell transplantation is the only potentially curative treatment for patients with myelodysplastic syndrome (MDS), but long-term survival is limited by the risk of transplant-related complications. Short telomere length, mediated by inherited or acquired factors, impairs cellular response to genotoxic and replicative stress and could identify patients at higher risk for toxicity after transplantation. We measured relative telomere length in pretransplant recipient blood samples in 1514 MDS patients and evaluated the association of telomere length with MDS disease characteristics and transplantation outcomes. Shorter telomere length was significantly associated with older age, male sex, somatic mutations that impair the DNA damage response, and more severe pretransplant cytopenias, but not with bone marrow blast count, MDS treatment history, or history of prior cancer therapy. Among 1267 patients ≥40 years old, telomere length in the shortest quartile was associated with inferior survival (P < .001) because of a high risk of nonrelapse mortality (NRM; P = .001) after adjusting for significant clinical and genetic variables. The adverse impact of shorter telomeres on NRM was independent of recipient comorbidities and was observed selectively among patients receiving more intensive conditioning, including myeloablative regimens and higher dose melphalan-based reduced-intensity regimens. The effect of shorter telomeres on NRM was prominent among patients who developed severe acute graft-versus-host disease, suggesting that short telomere length may limit regenerative potential of mucosal tissues after acute injury. MDS patients with shorter telomere length, who have inferior survival driven by excess toxicity, could be considered for strategies focused on minimizing toxic effects of transplantation.
Fetal hemoglobin in sickle cell anemia
Authors: Steinberg Martin H.
Published: August 2020

Fetal hemoglobin (HbF) can blunt the pathophysiology, temper the clinical course, and offer prospects for curative therapy of sickle cell disease. This review focuses on (1) HbF quantitative trait loci and the geography of β-globin gene haplotypes, especially those found in the Middle East; (2) how HbF might differentially impact the pathophysiology and many subphenotypes of sickle cell disease; (3) clinical implications of person-to-person variation in the distribution of HbF among HbF-containing erythrocytes; and (4) reactivation of HbF gene expression using both pharmacologic and cell-based therapeutic approaches. A confluence of detailed understanding of the molecular basis of HbF gene expression, coupled with the ability to precisely target by genomic editing most areas of the genome, is producing important preliminary therapeutic results that could provide new options for cell-based therapeutics with curative intent.
Management of solitary fibrous tumours of the pleura: a systematic review and meta-analysis
Authors: Mercer Rachel M. , Wigston Charlotte , Banka Radhika , Cardillo Giuseppe , Benamore Rachel , Nicholson Andrew G. , Asciak Rachelle , Hassan Maged , Hallifax Robert J. , Wing Louise , Bedawi Eihab O. , Maskell Nick A. , Harriss Elinor K. , Miller Robert F. , Rahman Najib M.
Published: August 2020

Background

Solitary fibrous tumours of the pleura (SFTP), or pleural fibromas, are rare tumours that generally, but not universally, follow a benign course. Surgical resection is the standard treatment, but there are no evidence-based guidelines regarding the management of these tumours.

Methods

Five databases were searched from inception to April 1, 2019 for studies reporting on SFTP management.

Results

Twenty-seven studies met the inclusion criteria (1542 patients, all non-comparative case series); 98% of these patients underwent resection and all SFTP included were pathologically diagnosed. 394 out of 1299 cases (30.5%, 95% CI 27.8–32.8%) were malignant with recurrence rates of between 0% and 42.9%. A pleural effusion was always associated with a negative outcome, but no other features were consistently reported to have negative associations. Preoperative biopsies incorrectly reported malignant histology in two studies. Over 25% of cases of recurrence occurred when a complete (R0) resection had been achieved. The first recurrence occurred >5 years after the initial resection in at least 23% of cases.

Conclusions

There is strong evidence to support long-term surveillance after surgical resection of SFTP, even where a complete (R0) resection has been achieved; however, there is no clear evidence to inform clinicians regarding the selection of patients who should undergo resection. The rates of malignant SFTP and SFTP recurrence are higher than previously reported. Only those that were pathologically diagnosed or resected were included, which may bias the data towards more aggressive tumours. Data collection on radiologically diagnosed SFTP is required to draw conclusions regarding the timing and need for intervention.
Risk factors for intensive care admission in children with severe acute asthma in the Netherlands: a prospective multicentre study
Authors: Boeschoten Shelley A. , Boehmer Annemie L. , Merkus Peter J. , van Rosmalen Joost , de Jongste Johan C. , Fraaij Pieter L.A. , Molenkamp Richard , Heisterkamp Sabien G. , van Woensel Job B. , Kapitein Berber , Haarman Eric G. , Wösten-van Asperen Roelie M. , Kneyber Martin C. , Lemson Joris , Hartman Stan , van Waardenburg Dick A. , Bunker-Wiersma Heleen E. , Brouwer Carole N. , van Ewijk Bart E. , Landstra Anneke M. , Verwaal Mariel , Vaessen-Verberne Anja A. , Hammer Sanne , Buysse Corinne M. , de Hoog Matthijs
Published: August 2020

Rationale

Severe acute asthma (SAA) can be fatal, but is often preventable. We previously observed in a retrospective cohort study, a three-fold increase in SAA paediatric intensive care (PICU) admissions between 2003 and 2013 in the Netherlands, with a significant increase during those years of numbers of children without treatment of inhaled corticosteroids (ICS).

Objectives

To determine whether steroid-naïve children are at higher risk of PICU admission among those hospitalised for SAA. Furthermore, we included the secondary risk factors tobacco smoke exposure, allergic sensitisation, previous admissions and viral infections.

Methods

A prospective, nationwide multicentre study of children with SAA (2–18 years) admitted to all Dutch PICUs and four general wards between 2016 and 2018. Potential risk factors for PICU admission were assessed using logistic regression analyses.

Measurements and main results

110 PICU and 111 general ward patients were included. The proportion of steroid-naïve children did not differ significantly between PICU and ward patients. PICU children were significantly older and more exposed to tobacco smoke, with symptoms >1 week prior to admission. Viral susceptibility was not a significant risk factor for PICU admission.

Conclusions

Children with SAA admitted to a PICU were comparable to those admitted to a general ward with respect to ICS treatment prior to admission. Preventable risk factors for PICU admission were >7 days of symptoms without adjustment of therapy and exposure to tobacco smoke. Physicians who treat children with asthma must be aware of these risk factors.
Electrical and Optical Properties of Nb-doped SrSnO3 Epitaxial Films Deposited by Pulsed Laser Deposition
Authors: Li Kaifeng , Gao Qiang , Zhao Li , Liu Qinzhuang
Published: August 2020

Nb-doped SrSnO3 (SSNO) thin films were epitaxially grown on LaAlO3(001) single-crystal substrates using pulsed laser deposition under various oxygen pressures and substrate temperatures. The crystalline structure, electrical, and optical properties of the films were investigated in detail. X-ray diffraction results show that the cell volume of the films reduces gradually with increasing oxygen pressure while preserving the epitaxial characteristic. X-ray photoelectron spectroscopy analysis confirms the Nb5+ oxidation state in the SSNO films. Hall-effect measurements were performed and the film prepared at 0.2 Pa with the 780 °C substrate temperature exhibits the lowest room-temperature resistivity of 31.3 mΩcm and Hall mobility of 3.31 cm2/Vs with a carrier concentration at 6.03 × 1019/cm3. Temperature-dependent resistivity of this sample displays metal-semiconductor transition and is explained mainly by electron-electron effects. Optical transparency of the films is more than 70% in the wavelength range from 600 to 1800 nm. The band gaps increase from 4.35 to 4.90 eV for the indirect gap and 4.82 to 5.29 eV for the direct by lowering oxygen pressure from 20 to 1 × 10−3 Pa, which can be interpreted by Burstein-Moss effect and oxygen vacancies generated in the high vacuum.
Comparative analysis of diet-associated responses in two rice planthopper species
Authors: Huang Hai-Jian , Cui Jia-Rong , Hong Xiao-Yue
Published: August 2020

Background

Host adaptation is the primary determinant of insect diversification. However, knowledge of different host ranges in closely related species remains scarce. The brown planthopper (Nilaparvata lugens, BPH) and the small brown planthopper (Laodelphax striatellus, SBPH) are the most destructive insect pests within the family Delphacidae. These two species differ in their host range (SBPH can well colonize rice and wheat plants, whereas BPH survives on only rice plants), but the underlying mechanism of this difference remains unknown. High-throughput sequencing provides a powerful approach for analyzing the association between changes in gene expression and the physiological responses of insects. Therefore, gut transcriptomes were performed to elucidate the genes associated with host adaptation in planthoppers. The comparative analysis of planthopper responses to different diets will improve our knowledge of host adaptation regarding herbivorous insects.

Results

In the present study, we analyzed the change in gene expression of SBPHs that were transferred from rice plants to wheat plants over the short term (rSBPH vs tSBPH) or were colonized on wheat plants over the long term (rSBPH vs wSBPH). The results showed that the majority of differentially expressed genes in SBPH showed similar changes in expression for short-term transfer and long-term colonization. Based on a comparative analysis of BPH and SBPH after transfer, the genes associated with sugar transporters and heat-shock proteins showed similar variation. However, most of the genes were differentially regulated between the two species. The detoxification-related genes were upregulated in SBPH after transfer from the rice plants to the wheat plants, but these genes were downregulated in BPH under the same conditions. In contrast, ribosomal-related genes were downregulated in SBPH after transfer, but these genes were upregulated in BPH under the same conditions.

Conclusions

The results of this study provide evidence that host plants played a dominant role in shaping gene expression and that the low fitness of BPH on wheat plants might be determined within 24 h after transfer. This study deepens our understanding of different host ranges for the two planthopper species, which may provide a potential strategy for pest management.
The gut mycobiota of rural and urban individuals is shaped by geography
Authors: Kabwe Mubanga Hellen , Vikram Surendra , Mulaudzi Khodani , Jansson Janet K. , Makhalanyane Thulani P.
Published: August 2020

Background

Understanding the structure and drivers of gut microbiota remains a major ecological endeavour. Recent studies have shown that several factors including diet, lifestyle and geography may substantially shape the human gut microbiota. However, most of these studies have focused on the more abundant bacterial component and comparatively less is known regarding fungi in the human gut. This knowledge deficit is especially true for rural and urban African populations. Therefore, we assessed the structure and drivers of rural and urban gut mycobiota.

Results

Our participants (n = 100) were balanced by geography and sex. The mycobiota of these geographically separated cohorts was characterized using amplicon analysis of the Internal Transcribed Spacer (ITS) gene. We further assessed biomarker species specific to rural and urban cohorts. In addition to phyla which have been shown to be ubiquitous constituents of gut microbiota,Pichiawere key constituents of the mycobiota. We found that geographic location was a major driver of gut mycobiota. Other factors such as smoking where also determined gut mycobiota albeit to a lower extent, as explained by the small proportion of total variation. Linear discriminant and the linear discriminant analysis effect size analysis revealed several distinct urban and rural biomarkers.

Conclusions

Together, our analysis reveals distinct community structure in urban and rural South African individuals. Geography was shown to be a key driver of rural and urban gut mycobiota.
Targeting the honey bee gut parasite Nosema ceranae with siRNA positively affects gut bacteria
Authors: Huang Qiang , Evans Jay D.
Published: August 2020

Background

Gut microbial communities can contribute positively and negatively to host health. So far, eight core bacterial taxonomic clusters have been reported in honey bees. These bacteria are involved in host metabolism and defenses. Nosema ceranae is a gut intracellular parasite of honey bees which destroys epithelial cells and gut tissue integrity. Studies have shown protective impacts of honey bee gut microbiota towards N. ceranae infection. However, the impacts of N. ceranae on the relative abundance of honey bee gut microbiota remains unclear, and has been confounded during prior infection assays which resulted in the co-inoculation of bacteria during Nosema challenges. We used a novel method, the suppression of N. ceranae with specific siRNAs, to measure the impacts of Nosema on the gut microbiome.

Results

Suppressing N. ceranae led to significant positive effects on microbial abundance. Nevertheless, 15 bacterial taxa, including three core taxa, were negatively correlated with N. ceranae levels. In particular, one co-regulated group of 7 bacteria was significantly negatively correlated with N. ceranae levels.

Conclusions

N. ceranae are negatively correlated with the abundance of 15 identified bacteria. Our results provide insights into interactions between gut microbes and N. ceranae during infection.
Median nerve conduction studies in rabbits
Authors: Mansiz-Kaplan Basak , Pervane-Vural Secil , Gursoy Koray , Nacir Baris
Published: August 2020

Background

When planning nerve conduction studies using animal models, the sciatic nerve is often used and the upper extremity nerves are not preferred due to the size of laboratory animals. This study aimed to present the method and mean values of median nerve conduction studies in laboratory rabbits. Fifty-five six-month-old male New Zealand white rabbits weighing 2 to 2.5 kg were included in nerve conduction studies performed under anesthesia. The compound muscle action potential amplitude and distal latency values were recorded for the median motor nerve with the electrodes placed on the flexor digitorum superficialis muscle and tendon.

Results

A total of 110 median nerves were evaluated. The mean amplitude of the median nerve was 30.6 ± 6.8, mV the median nerve distal latency was 1.3 ± 0.2 ms, and the mean intensity of stimulation inducing a response was 2.5 ± 1 mA.

Conclusions

The mean values obtained by the median motor nerve conduction method in this study can act as a guide for future nerve interventions undertaken in the upper extremities.
Genetic diversity and fingerprinting of 33 standard flue-cured tobacco varieties for use in distinctness, uniformity, and stability testing
Authors: He Binbin , Geng Ruimei , Cheng Lirui , Yang Xianbin , Ge Hongmei , Ren Min
Published: August 2020

Background

At present, the distinctness, uniformity, and stability (DUS) testing of flue-cured tobacco (Nicotiana tabacumL.) depends on field morphological identification, which is problematic in that it is labor intensive, time-consuming, and susceptible to environmental impacts. In order to improve the efficiency and accuracy of tobacco DUS testing, the development of a molecular marker-based method for genetic diversity identification is urgently needed.

Results

In total, 91 simple sequence repeats (SSR) markers with clear and polymorphic amplification bands were obtained with polymorphism information content, Nei index, and Shannon information index values of 0.3603, 0.4040, and 0.7228, respectively. Clustering analysis showed that the 33 study varieties, which are standard varieties for flue-cured tobacco DUS testing, could all be distinguished from one another. Further analysis showed that a minimum of 25 markers were required to identify the genetic diversity of these varieties. Following the principle of two markers per linkage group, 48 pairs of SSR markers were selected. Correlation analysis showed that the genetic relationships revealed by the 48 SSR markers were consistent with those found using the 91 SSR markers.

Conclusions

The genetic fingerprints of the 33 standard varieties of flue-cured tobacco were constructed using 48 SSR markers, and an SSR marker-based identification technique for new tobacco varieties was developed. This study provides a reliable technological approach for determining the novelty of new tobacco varieties and offers a solid technical basis for the accreditation and protection of new tobacco varieties.
Ketorolac tromethamine pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial
Authors: Tian Zhen , Hu Bei , Miao Min , Zhang Lulu , Wang Lin , Chen Bin
Published: August 2020

Background

To observe the effect of pretreatment with ketorolac tromethamine on sufentanil-induced cough in general anesthesia patients.

Methods

A total of 102 patients were screened, and 90 patients were scheduled for elective surgery under general anesthesia. The 90 patients were randomly divided into two groups: the control group (C group) and the observation group (KT group). Five minutes before anesthesia induction, the observation group was given ketorolac tromethamine 0.5 mg/kg intravenously within 3 s, while the control group was given the same amount of normal saline intravenously. All patients were given a sufentanil bolus of 0.5 μg/kg (within 3 s) intravenously. One minute later, propofol 2.5 mg/kg and vecuronium 0.15 mg/kg were injected intravenously, and endotracheal intubation was guided by laryngoscopy. The number of coughs that occurred within 1 min after sufentanil injection was recorded. The mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) were recorded at T0 (immediately before pretreatment), T1 (5 min after pretreatment), T2 (before intubation), T3 (1 min after intubation) and T4 (5 min after intubation). The incidence of adverse reactions, including nausea and vomiting, dizziness, drowsiness, delay of recovery, restlessness in the recovery period, respiratory depression and postoperative incision pain, was analyzed.

Results

Within 1 min after sufentanil injection, the incidence and severity of cough in the KT group was significantly lower than that in the C group (P <  0.05). At T0, T1, T2, T3 and T4, there were no significant differences in MAP, HR and SpO2 between the two groups (P >  0.05). There was no significant difference in the dosage of sufentanil, propofol, remifentanil and vecuronium, the incidence of nausea and vomiting, the delay of recovery, dizziness, drowsiness or respiratory depression between the two groups (P >  0.05). However, the incidence of restlessness and the number of patients with VAS scores > 3 in the KT group were significantly lower than those in the C group (P <  0.05).

Conclusion

Pretreatment with intravenous ketorolac tromethamine can significantly reduce the incidence of sufentanil-induced cough during induction of general anesthesia, which can also significantly reduce postoperative incision pain and restlessness during the recovery period.

Trial registration

Chinese Clinical Trial Registry (registration number# ChiCTR2000030287; date of registration: 27/02/2020).
Appropriate use of anti-thrombotic therapy in patients with atrial fibrillation at single-center experience, Northwest Ethiopia
Authors: Endewunet Ermiyas , Tadesse Abilo , Adane Aynishet , Abdulkadir Mohamed
Published: August 2020

Background

Atrial fibrillation (AF) is the commonest clinically significant ECG-evidenced sustained cardiac arrhythmia in clinical practice. Disability and mortality attributed to AF is high in low-income regions like sub-Saharan Africa. The risk of stroke/TIA in patients with AF can be significantly reduced with anti-thrombotic therapy. Despite the existing evidence of its benefit, significant percentages of AF patients eligible for anti-thrombotic therapy are undertreated in the region.

Methods

A hospital-based cross-sectional study was conducted to determine the appropriate use of anti-thrombotic therapy in patients with AF between December 1, 2018 and September 30, 2019 at Cardiac Clinic, University of Gondar hospital, Northwest Ethiopia. Consecutive sampling method was used to recruit 210 study subjects. Patients were interviewed to obtain socio-demographic data. Relevant medical history and laboratory parameters were obtained from patients’ records. Diagnosis of atrial fibrillation was based on detection of irregular arterial pulse and presence of ‘f’ waves on 12-lead ECG tracing. Clinical evaluation, echocardiography, chest X-ray and blood chemistry were used to diagnose underlying causes of AF. Data was entered into EPI Info version 4.4.1 and analyzed using SPSS version 20. Bi-variate and multi-variate logistic regression analyses were used to identify associated factors with appropriate use of anti-thrombotic therapy in patients with atrial fibrillation. P-values < 0.05 were used to declare significant association.

Results

A total of 210 patients were included in the study. The mean age of patients was 51.29 ± 17.2 years. Two-thirds (145/210) of participants were females. Seventy-four (35%) had valvular AF, while 136/210 (65%) had non-valvular AF. Sixty-six percent (139/210) of study subjects were appropriately treated with anti-thrombotic therapy. Appropriately treated subjects in valvular AF group and non-valvular AF group were 58/74 (78%) and 81/136 (60%) respectively. On multi-variate analysis, ‘can afford for regular INR monitoring’ (AOR = 2.60 95% CI: 1.10–6.10, P = 0.001) was significantly associated with appropriate use of anti-thrombotic therapy.

Conclusion

Sixty-six percent of AF patients eligible for anti-thrombotic therapy were appropriately treated. Intervention program to access ‘regular INR monitoring’ should be practiced to escalate utilization rate of anti-thrombotic therapy (warfarin) in eligible AF patients.
Identification of an autophagy-related gene signature that can improve prognosis of hepatocellular carcinoma patients
Authors: Huo Xingxing , Qi Jian , Huang Kaiquan , Bu Su , Yao Wei , Chen Ying , Nie Jinfu
Published: August 2020

Background

Autophagy is a programmed cell degradation mechanism that has been associated with several physiological and pathophysiological processes, including malignancy. Improper induction of autophagy has been proposed to play a pivotal role in the progression of hepatocellular carcinoma (HCC).

Methods

Univariate Cox regression analysis of overall survival (OS) was performed to identify risk-associated autophagy-related genes (ARGs) in HCC data set from The Cancer Genome Atlas (TCGA). Multivariate cox regression was then performed to develop a risk prediction model for the prognosis of 370 HCC patients. The multi-target receiver operating characteristic (ROC) curve was used to determine the model’s accuracy. Besides, the relationship between drug sensitivity and ARGs expression was also examined.

Results

A total of 62 differentially expressed ARGs were identified in HCC patients. Univariate and multivariate regression identified five risk-associated ARGs (HDAC1, RHEB, ATIC, SPNS1 and SQSTM1) that were correlated with OS in HCC patients. Of importance, the risk-associated ARGs were independent risk factors in the multivariate risk model including clinical parameters such as malignant stage (HR = 1.433, 95% CI = 1.293–1.589, P < 0.001). In addition, the area under curve for the prognostic risk model was 0.747, which indicates the high accuracy of the model in prediction of HCC outcomes. Interestingly, the risk-associated ARGs were also correlated with drug sensitivity in HCC cell lines.

Conclusion

We developed a novel prognostic risk model by integrating the molecular signature and clinical parameters of HCC, which can effectively predict the outcomes of HCC patients.
An integrative pan-cancer investigation reveals common genetic and transcriptional alterations of AMPK pathway genes as important predictors of clinical outcomes across major cancer types
Authors: Chang Wai Hoong , Lai Alvina G.
Published: August 2020

Background

The AMP-activated protein kinase (AMPK) is an evolutionarily conserved regulator of cellular energy homeostasis. As a nexus for transducing metabolic signals, AMPK cooperates with other energy-sensing pathways to modulate cellular responses to metabolic stressors. With metabolic reprogramming being a hallmark of cancer, the utility of agents targeting AMPK has received continued scrutiny and results have demonstrated conflicting effects of AMPK activation in tumorigenesis. Harnessing multi-omics datasets from human tumors, we seek to evaluate the seemingly pleiotropic, tissue-specific dependencies of AMPK signaling dysregulation.

Methods

We interrogated copy number variation and differential transcript expression of 92 AMPK pathway genes across 21 diverse cancers involving over 18,000 patients. Cox proportional hazards regression and receiver operating characteristic analyses were used to evaluate the prognostic significance of AMPK dysregulation on patient outcomes.

Results

A total of 24 and seven AMPK pathway genes were identified as having loss- or gain-of-function features. These genes exhibited tissue-type dependencies, where survival outcomes in glioma patients were most influenced by AMPK inactivation. Cox regression and log-rank tests revealed that the 24-AMPK-gene set could successfully stratify patients into high- and low-risk groups in glioma, sarcoma, breast and stomach cancers. The 24-AMPK-gene set could not only discriminate tumor from non-tumor samples, as confirmed by multidimensional scaling analyses, but is also independent of tumor, node and metastasis staging. AMPK inactivation is accompanied by the activation of multiple oncogenic pathways associated with cell adhesion, calcium signaling and extracellular matrix organization. Anomalous AMPK signaling converged on similar groups of transcriptional targets where a common set of transcription factors were identified to regulate these targets. We also demonstrated crosstalk between pro-catabolic AMPK signaling and two pro-anabolic pathways, mammalian target of rapamycin and peroxisome proliferator-activated receptors, where they act synergistically to influence tumor progression significantly.

Conclusion

Genetic and transcriptional aberrations in AMPK signaling have tissue-dependent pro- or anti-tumor impacts. Pan-cancer investigations on molecular changes of this pathway could uncover novel therapeutic targets and support risk stratification of patients in prospective trials.
Cross-cultural adaptation and validation of the Global Physical Activity Questionnaire among healthy Hungarian adults
Authors: Ács Pongrác , Betlehem József , Oláh András , Bergier Barbara , Morvay-Sey Kata , Makai Alexandra , Prémusz Viktória
Published: August 2020

Background

Physical activity (PA) is an important factor among the determinants of health due to it’s protective factor and preventive role. Self-reported measures such as questionnaires are most commonly used in public health studies, but may over- or underestimate actual patterns of PA. Therefore, accelerometers are widely used to assess concurrent validity. The aim of the present study was to adapt and validate the self-administered GPAQ - Hungarian version (GPAQ-H) against accelerometer data and IPAQ-Hungarian long version (IPAQ-HL) in Hungarian healthy young adults.

Methods

A cross-sectional comparative study was conducted to examine the last 7 days PA by GPAQ-H, comparing with IPAQ-HL and Actigraph GT3X accelerometer to measure concurrent validity and reliability. A convenient sample of 300 young adults was recruited in January – July 2018 at the University of Pécs, in South-Hungary, 120 participants (age 21.53 ± 1.75 years, 46.66% male) were included in the validity and reliability study.

Results

Significant differences between the three instruments were found (p < 0.001) in all scores, except PAQs vigorous activities (p = 0.332) and GPAQ-H and accelerometer MVPA score (p = 0.424). A moderate KMO measure was found (0.538) with a significant Barlett’s test of Sphericity (279.51; p < 0.001). The total variance was explained as 81.10%. The reliability of the GPAQ-H instrument with all domain’s scores was 0.521 (CI 0.371–0.644). We found in all intensity scores and sitting time good reliability scores (R = 0.899–987, p < 0.001) between the baseline and follow-up (N = 33 random subsample). The Bland-Altman plots were showed that GPAQ-H overestimates vigorous activities by 212.75 min/week (331.82–757.42) and MVPA by 104.93 min/week (− 1016.98–807.11). A high difference, 6336.79 min/week (CI 3638.18–9035.40) was revealed regarding sitting, as GPAQ-H largely underestimated the time spent sedentary.

Conclusions

The Hungarian GPAQ self-administered form showed fair to moderate validity with correlation coefficients similar to other European studies. Based on our study’s results it could be claimed that the GPAQ-H measurement tool is a valid and reliable questionnaire to measure the healthy Hungarian population’s physical activity patterns. However, our results also proved that GPAQ-H alone is not a valid and reliable questionnaire to measure sitting time.
Comparative analysis of the economic burdens of physical inactivity in Hungary between 2005 and 2017
Authors: Ács Pongrác , Kovács Antal , Paár Dávid , Hoffbauer Márk , Szabó Péter , Szabó Tünde , Stocker Miklós
Published: August 2020

Background

National economies are increasingly facing the challenge of having to finance the prevention and treatment of human diseases, and of having to compensate for the resulting loss of economic production. Physical inactivity is demonstrably closely related to the risk of developing certain disease group. Physical inactivity results in direct and indirect burdens that the present study intends to quantify in Hungary for the period between 2005 and 2017.

Methods

Based on the data of the Hungarian public finances, this study determines the direct and indirect costs incurred by Hungary due to illnesses, and, through the PAR method, it quantifies the financial burden of physical inactivity incurred by the Hungarian Treasury.

Results

The total financial burden of illnesses in Hungary showed a decreasing tendency from 2005 to 2017, even though the year 2017 saw an increase in costs compared to 2014. Similarly, while total public expenditure on illnesses associated with physical inactivity increased by 2017 when compared to 2009, the total amount attributable to medical conditions stemming from physical inactivity still showed a decrease of 2 billion HUF in the overall period. The biggest economic burden is posed by cardiovascular diseases, hypertension and type 2 diabetes.

Conclusions

The increase in the economic burden associated with physical inactivity can be attributed to the combined effect of two factors: changes in total expenditure on specific disease groups (which showed an increase in the period under review) and changes in the physical activity levels of the Hungarian population (which showed an improvement over the period under review). Initiatives in Hungary aimed at encouraging an active lifestyle from childhood onwards should be continued since – beyond the initial impact that has already been felt to some extent in recent years - these initiatives will come to their full fruition in the coming decades.
Measurement of public health benefits of physical activity: validity and reliability study of the international physical activity questionnaire in Hungary
Authors: Ács Pongrác , Betlehem József , Oláh András , Bergier Józef , Melczer Csaba , Prémusz Viktória , Makai Alexandra
Published: August 2020

Background

To ensure accurate measurement of the health benefits of habitual physical activity in large sample epidemiological studies, physical activity questionnaires (PAQs) are the most feasible methods. Therefore, the purpose of this study was the validation and cultural adaptation to the Hungarian population of the International Physical Activity Questionnaire (IPAQ-HL).

Methods

A cross-sectional study among Hungarian healthy adults (age 21.375 ± 1.940 years, n = 120) was performed comparing measures of last 7 days IPAQ-HL self- administered questionnaire and obtained accelerometer (Actigraph GT3X) data for concurrent validity, reassessed by a random subsample (n = 33) to measure reliability.

Results

Our results indicate acceptable criterion validity for total physical activity, moderate to vigorous physical activity (R = 0.387, p < 0.001; R = 0.331 p < 0.001 respectively) and moderate physical activity (R = 0.193, p = 0.034). The ICC scores revealed moderate to good correlations (ICC = 0.744–0.942, p < 0.001). Moderate Kaiser–Meyer–Olkin measure (0.531, p < 0.001) and good reproducibility for vigorous, moderate to vigorous and moderate activities was found for IPAQ-HL in the studied population. Nevertheless, like analogous self-reports in other languages, it overestimates the time spent on physical activity.

Conclusions

IPAQ-HL proved to be a reasonably valid measure for population prevalence epidemiological studies and is suggested for use to develop public health policy recommendations or to optimize public health interventions. However, the results on vigorous activity should be interpreted with caution, the questionnaire showed moderate validity for this particular intensity.
The effect of a community-based e-health program to promote the role of physical activity among healthy adults in Hungary
Authors: Makai Alexandra , Füge Kata , Breitenbach Zita , Betlehem József , Ács Pongrác , Lampek Kinga , Figler Mária
Published: August 2020

Background

Physically active lifestyle can prolong the years spent without chronic diseases and is strongly associated with good mental and physical health. The goal of the study was to examine the physical activity patterns of the healthy adults and the effectiveness of a community-based e-health program.

Methods

The study sample comprised of 633 participants. Analyses were based on the E-Harmony health program that was conducted in Hungary in 2014–2015. The longitudinal study measured the physical activity patterns of the healthy adult population, and a 12-month community-based internet and media program was evaluated for the target group to improve the physical activity level and related knowledge. We examined the effectiveness of the program by the International Physical Activity Questionnaire – Hungarian validated long version adjusting for socio-demographic parameters, also across multivariate linear regression analysis using SPSS 24.0 software. Confidence interval of 95% was used and the level of significance wasp < 0.05.

Results

The total physical activity of the study sample was 5129.9 (SD = 4488.1) MET min/week. Male participants scored higher in total activity but the results showed no statistical significance. Our participants were sitting 2211.6 (SD = 1592.8) min /week on average (daily average was 315.9 (SD = 227.6) minutes); the results showed no statistically significant difference by gender. We found weak but significant relationship between the active lifestyle and anthropometric data, especially according to leisure time activities and sedentary behaviour (p < 0.001). Based on the multivariate linear regression models the socio-demographic parameters significantly affected the physical activity level of participants. After the 12-month community-based e-health program, 10.34% changes occurred in the total physical activity level (p < 0.001).

Conclusions

To our knowledge, ours was the first community-based e-health program in Hungary to improve the physical activity level of the healthy adult population. Based on our results this web-based e-health program can be an adequate tool to promote healthy lifestyle. The study could provide appropriate information for the further health interventions and policy making. Further research is necessary to determine the special risk groups and to develop an applicable e-health program for such specific subgroups.
Health literacy among participants from neighbourhoods with different socio-economic statuses in the southern region of Hungary: a pilot study
Authors: Bánfai-Csonka Henrietta , Bánfai Bálint , Jeges Sára , Gyebnár Brigitta , Betlehem József
Published: August 2020

Background

Health literacy (HL) has a deep impact on people’s decisions about their health and health care system. Measurement and improvement of HL level is essential to develop an appropriate health care system. The aim of the study was to (1) conduct a pilot study among the population of Baranya County in Hungary with different socio-economic statuses, (2) evaluate the HL level and (3) found the correlations between socio-economic data, emergency departments’ visits, medical history and HL.

Methods

In a cross-sectional study conducted in 2019 with 186 participants, socio-economic status, health status, HL level and knowledge about the triage system were measured. The questionnaire included questions on socio-economic status, previous chronic diseases, and satisfaction with the emergency care system as well as the standardised European Health Literacy Survey Questionnaire (HLS-EU-Q47). Descriptive statistical analysis (mean, SD, mode) and mathematical statistical analysis (ANOVA, chi2 test, Pearson Correlations, Two sample t-test) were applied. SPSS 24.0 statistical software was used to analyse the data. Relationships were considered significant at the p < 0.05 level.

Results

One hundred and eighty-six people were involved in the research, but 45 of them were excluded (N = 141). The participation rate was 75.8%. There were significant differences in HL levels by gender and educational level (p = 0.017), health education (p = 0.032) and presence of children in the household (p = 0.049). Educational level (p = 0.002) and type of settlement (p = 0.01) had strong impacts on economic status. We found that 46.1% of the participants had limited comprehensive HL (cHL) level. This proportion was slightly lower for the disease prevention sub-index (33.3%). The average cHL index score was 34.8 ± 8.7 points, the average health care sub-index score was 34.6 ± 9.7 points, the average disease prevention sub-index score was 35.8 ± 9.9 points, and the average health promotion sub-index score was 34.2 ± 9.4 points. 46.1% of the examined population in Hungary had limited HL level.

Conclusions

Socio-economic status has a strong influence on HL level. It is not enough to improve awareness but we need to improve knowledge and cooperation with the doctors and health care system.
Space-time analysis of ovarian cancer mortality rates by age groups in spanish provinces (1989–2015)
Authors: Trandafir Paula Camelia , Adin Aritz , Ugarte María Dolores
Published: August 2020

Background

Ovarian cancer is a silent and largely asymptomatic cancer, leading to late diagnosis and worse prognosis. The late-stage detection and low survival rates, makes the study of the space-time evolution of ovarian cancer particularly relevant. In addition, research of this cancer in small areas (like provinces or counties) is still scarce.

Methods

The study presented here covers all ovarian cancer deaths for women over 50 years of age in the provinces of Spain during the period 1989-2015. Spatio-temporal models have been fitted to smooth ovarian cancer mortality rates in age groups [50,60), [60,70), [70,80), and [80,+), borrowing information from spatial and temporal neighbours. Model fitting and inference has been carried out using the Integrated Nested Laplace Approximation (INLA) technique.

Results

Large differences in ovarian cancer mortality among the age groups have been found, with higher mortality rates in the older age groups. Striking differences are observed between northern and southern Spain. The global temporal trends (by age group) reveal that the evolution of ovarian cancer over the whole of Spain has remained nearly constant since the early 2000s.

Conclusion

Differences in ovarian cancer mortality exist among the Spanish provinces, years, and age groups. As the exact causes of ovarian cancer remain unknown, spatio-temporal analyses by age groups are essential to discover inequalities in ovarian cancer mortality. Women over 60 years of age should be the focus of follow-up studies as the mortality rates remain constant since 2002. High-mortality provinces should also be monitored to look for specific risk factors.
Risk factors affecting treatment outcomes for pulmonary tuberculosis in Finland 2007–2014: a national cohort study
Authors: Korhonen Virve , Lyytikäinen Outi , Ollgren Jukka , Soini Hanna , Vasankari Tuula , Ruutu Petri
Published: August 2020

Background

Major transition in tuberculosis (TB) epidemiology is taking place in many European countries including Finland. Monitoring treatment outcome of TB cases is important for identifying gaps in the national TB control program, in order to strengthen the system. The aim of the study was to identify potential risk factors for non-successful TB treatment outcomes, with a particular focus on the impact of comorbidities. We also evaluated the treatment outcome monitoring system.

Methods

All notified microbiologically confirmed pulmonary TB cases in Finland in 2007–2014 were included, except multi-drug resistant (MDR) cases. Nationwide register data were retrieved from: Infectious Diseases Register, Population Register, Cause of Death Register and Hospital Discharge Register. Non-successful outcomes were divided into three groups: death, unsatisfactory outcomes and non-defined outcomes. Logistic regression analyses were used to identify risk factors for non-successful outcomes.

Results

Treatment outcomes were notified for 98.6% of study cases (n = 1396/1416). Treatment success rate was 75%. The main reason for non-successful outcome was death (16%), whereas outcomes failed and lost to follow-up were rare (1% together). In a multivariable model, risk factors for death as outcome were increasing age, male gender and Charlson comorbidity index ≥1, for unsatisfactory outcomes non-MDR drug resistance and TB registered in the first study period, and for non-defined outcomes non-MDR drug resistance. Among 50 cases with unsatisfactory outcomes, we observed false outcome allocations in eight (16%), and > 2% of the cases transferred to another country or disappeared before or during treatment.

Conclusions

With a high proportion of older population among tuberculosis cases, death is a common treatment outcome in Finland. Comorbidity is an important factor to be incorporated when interpreting and comparing outcome rates. There was a considerable inconsistency in outcome allocation in the monitoring system, which implies that there is need to review the guidelines and provide further training for outcome assessment.