bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of a physical internet based supply chain using reinforcement learning
Authors: Puskás Eszter , Budai Ádám , Bohács Gábor
Published: July 2020

Physical Internet based supply chains create open, global logistics systems that enable new types of collaboration among participants. The open system allows the logistical examination of vehicle technology innovations such as the platooning concept. This article explores the multiple platoon collaboration. For the reconfiguration of two platoons a heuristic and a reinforcement learning (RL) based models have been developed. To our knowledge, this work is the first attempt to apply an RL-based decision model to solve the problem of controlling platoon cooperation. Vehicle exchange between platoons is provided by a virtual hub. Depending on the various input parameters, the efficiency of the model was examined through numerical examples in terms of the target function based on the transportation cost. Models using platoon reconfiguration are also compared to the cases where no vehicle exchange is implemented. We have found that a reinforcement learning based model provides a more efficient solution for high incoming vehicle numbers and low dispatch interval, although for low vehicle numbers heuristics model performs better.
Understanding the child-doctor relationship in research participation: a qualitative study
Authors: Luchtenberg Malou L. , Maeckelberghe Els L. M. , Locock Louise , Verhagen A. A. Eduard
Published: July 2020

Background

Children have reported that one reason for participating in research is to help their doctor. This is potentially harmful if associated with coercive consent but might be beneficial for recruitment. We aimed to explore children’s perceptions of the child-doctor relationship in research.

Methods

This is a multicenter qualitative study with semi structured interviews performed between 2010 and 2011 (United Kingdom) and 2017–2019 (the Netherlands). Interviews took place nationwide at children’s homes. We performed a secondary analysis of the two datasets, combining an amplified analysis aimed to enlarge our dataset, and a supplementary analysis, which is a more in-depth investigation of emergent themes that were not fully addressed in the original studies. All participants had been involved in decisions about research participation, either as healthy volunteers, or as patients. Recruitment was aimed for a purposive maximum variation sample, and continued until data saturation occurred. We have studied how children perceived the child-doctor relationship in research. Interviews were audiotaped or videotaped, transcribed verbatim, and thematically analyzed using Atlas.ti software.

Results

In total, 52 children were recruited aged 9 to 18, 29 in the United Kingdom and 23 in the Netherlands. Children’s decision-making depended strongly on support by research professionals, both in giving consent and during participation. Often, their treating physician was involved in the research process. Familiarity and trust were important and related to the extent to which children thought doctors understood their situation, were medically competent, showed support and care, and gave priority to the individual child’s safety. A trusting relationship led to a feeling of mutuality and enhanced children’s confidence. This resulted in improving their experiences throughout the entire research process. None of the participants reported that they felt compelled to participate in the research.

Conclusions

The child-doctor relationship in pediatric research should be characterized by familiarity and trust. This does not compromise children’s voluntary decision but enhances children’s confidence and might result in a feeling of mutuality. By addressing the participation of children as an iterative process during which treatment and research go hand in hand, the recruitment and participation of children in research can be improved.
Triglyceride–glucose index (TyG index) is a predictor of incident colorectal cancer: a population-based longitudinal study
Authors: Okamura Takuro , Hashimoto Yoshitaka , Hamaguchi Masahide , Obora Akihiro , Kojima Takao , Fukui Michiaki
Published: July 2020

Background

Colorectal cancer (CRC), which is related with insulin resistance, is a one of the most common cancers. Triglyceride-glucose index (TyG index) was made for a marker of insulin resistance. We conducted the investigation of association between TyG index and incident CRC.

Methods

We examined the affect of TyG index on incident CRC in this historical cohort study of 27,944 (16,454 men and 11,490 women) participants. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. The impact of TyG index on incident CRC was investigated using Cox proportional hazard models, adjusting for sex, age, body mass index, smoking status, alcohol consumption, exercise, systolic blood pressure and creatinine. The covariate-adjusted receiver operating characteristic (ROC) curve calculated the area under the curve (AUC) and cut-off value of TyG index for the incidence of CRC.

Results

During the median 4.4-year follow-up, 116 participants were diagnosed as CRC. The cumulative incidence rate of CRC were 0.4%. In Cox proportional hazard model, the HRs of TyG index were 1.38 (95% Confidence interval (CI), 1.00–1.91, p = 0.049) after adjusting for covariates. In the covariate-adjusted ROC curve analysis, the cut-off value of TyG index for incident CRC was 8.272 (AUC 0.687 (95%CI, 0.637–737, sensitivity = 0.620, specificity = 0.668, p < 0.001)).

Conclusions

TyG index can predict the onset of CRC. For early detection of CRC, we should encourage people with high TyG index to undergo screening for CRC.
Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial
Authors: Johar Hamimatunnisa , Hoffmann Julia , Günther Julia , Atasoy Seryan , Stecher Lynne , Spies Monika , Hauner Hans , Ladwig Karl-Heinz
Published: July 2020

Background

Maternal weight variables are important predictors of postpartum depression (PPD). While preliminary evidence points to an association between pre-pregnancy obesity and PPD, the role of excessive gestational weight gain (GWG) on PPD is less studied. In this secondary cohort analysis of the German ‘healthy living in pregnancy’ (GeliS) trial, we aimed to investigate associations between weight-related variables and PPD and to assess the influence of GWG on the risk for PPD.

Methods

We included women with normal weight, overweight, and obesity (BMI 18.5–40.0 kg/m2). Symptoms of PPD were assessed 6–8 weeks postpartum using the Edinburgh Postnatal Depression Scale. Pre-pregnancy BMI was self-reported. During the course of pregnancy, weight was measured at gynaecological practices within regular check-ups. GWG was defined as the difference between the last measured weight before delivery and the first measured weight at the time of recruitment (≤ 12th week of gestation). Excessive GWG was classified according to the Institute of Medicine. Multiple logistic regression analyses were used to estimate the odds of PPD in relation to pre-pregnancy BMI, GWG, and excessive GWG adjusting for important confounders.

Results

Of the total 1583 participants, 45.6% (n = 722) showed excessive GWG and 7.9% (n = 138) experienced PPD. Pre-pregnancy BMI (per 5-unit increase; OR = 1.23, 95% CI 1.08–1.41, p = 0.002) and pre-pregnancy overweight or obesity were significantly positively associated with the odds of developing PPD, particularly among women with an antenatal history of anxiety or depressive symptoms (overweight: OR = 1.93, 95% CI = 1.15–3.22, p = 0.01; obesity: OR = 2.11, 95% CI = 1.13–3.96, p = 0.02). Sociodemographic or lifestyle factors did not additively influence the odds of having PPD. In fully adjusted models, there was no significant evidence that GWG or the occurrence of excessive GWG increased the odds of experiencing PPD (excessive vs. non-excessive: OR = 3.48, 95% CI 0.35–34.94; GWG per 1 kg increase: OR = 1.16, 95% CI 0.94–1.44).

Conclusion

Pre-pregnancy overweight or obesity is associated with PPD independent of concurrent risk factors. History of anxiety or depressive symptoms suggests a stress-induced link between pre-pregnancy weight and PPD.

Trial registration

NCT01958307, ClinicalTrials.gov, retrospectively registered on 9 October 2013.
Clinical trials to assess adjuvant therapeutics for severe malaria
Authors: Varo Rosauro , Erice Clara , Johnson Sydney , Bassat Quique , Kain Kevin C.
Published: July 2020

Despite potent anti-malarial treatment, mortality rates associated with severe falciparum malaria remain high. To attempt to improve outcome, several trials have assessed a variety of potential adjunctive therapeutics, however none to date has been shown to be beneficial. This may be due, at least partly, to the therapeutics chosen and clinical trial design used. Here, we highlight three themes that could facilitate the choice and evaluation of putative adjuvant interventions for severe malaria, paving the way for their assessment in randomized controlled trials. Most clinical trials of adjunctive therapeutics to date have been underpowered due to the large number of participants required to reach mortality endpoints, rendering these study designs challenging and expensive to conduct. These limitations may be mitigated by the use of risk-stratification of participants and application of surrogate endpoints. Appropriate surrogate endpoints include direct measures of pathways causally involved in the pathobiology of severe and fatal malaria, including markers of host immune and endothelial activation and microcirculatory dysfunction. We propose using circulating markers of these pathways to identify high-risk participants that would be most likely to benefit from adjunctive therapy, and further by adopting these biomarkers as surrogate endpoints; moreover, choosing interventions that target deleterious host immune responses that directly contribute to microcirculatory dysfunction, multi-organ dysfunction and death; and, finally, prioritizing where possible, drugs that act on these pathways that are already approved by the FDA, or other regulators, for other indications, and are known to be safe in target populations, including children. An emerging understanding of the critical role of the host response in severe malaria pathogenesis may facilitate both clinical trial design and the search of effective adjunctive therapeutics.
“Bayis Ilh Tus – a strong breath” a community-based research project to estimate the prevalence of chronic obstructive pulmonary disease in remote and rural first nations communities in Canada: research protocol
Authors: Turner Justin , Holyk Travis , Bartlett Karen , Rathburn Benna , Karlen Barbara , Ervin Francis , Wilson Jennifer , Camp Pat G.
Published: July 2020

Background

Respiratory health conditions appear to be more common among First Nations people versus non-First Nations people in Canada. However, the prevalence of chronic obstructive pulmonary disease (COPD) and its associated risk factors in First Nations communities are unknown. This project aims to estimate the prevalence of COPD in several First Nations communities in British Columbia, Canada and to characterize respiratory symptoms, COPD risk factors, and healthcare utilization.

Methods

This project is approved by both the University of British Columbia and Carrier Sekani Family Services Research Ethics Boards. We will randomly sample 220 adults, 30 years and older, from 11 participating First Nations. Each participant will complete pre- and post-bronchodilator spirometry tests and the adapted American Thoracic Society Epidemiological Questionnaire with items about smoking history, respiratory symptoms, co-morbidities, and exposures, in order to identify the presence of COPD and its associated individual, occupational, and community risk factors. Homes will be assessed for air quality measures including particulate matter, carbon monoxide and carbon dioxide, and humidity. Health care utilization will be abstracted from the electronic medical record.

Discussion

This is the first project in Canada to estimate the prevalence of COPD in First Nations communities using a random-sampling approach to recruitment. Additionally, although this study will collect detailed information on smoking history, we will also characterize past and current risk factors beyond cigarette smoking. Finally, our methodology ensures that the benefits to the communities are realized during the study period. Individual results will be shared with individuals and health providers to facilitate care. Air quality results will be sent to each Nation’s governing council to facilitate remediation where necessary.

Trial registration

The study has been retrospectively registered at clinicaltrials.gov (NCT04105088).
miR-541 serves as a prognostic biomarker of osteosarcoma and its regulatory effect on tumor cell proliferation, migration and invasion by targeting TGIF2
Authors: Liu Chunlei , Yi Xiuling
Published: July 2020

Background

Several studies reported the dysregulation of miR-541 in the progression of some human malignancies. Osteosarcoma (OS) is one of the most common primary malignant bone tumors. This study aimed to assess the expression and clinical significance of miR-541 in OS patients and explore the biological function of miR-541 in tumor progression.

Methods

Expression of miR-541 was detected by quantitative real-time PCR, and its prognostic value was evaluated using Kaplan-Meier survival analysis. The biological function of miR-541 was examined by analyzing its effects on OS cell proliferation, migration and invasion. Additionally, the underlying potential target of miR-541 was predicated and analyzed.

Results

The expression of miR-541 was significantly decreased in OS tissues and cell lines. The deregulated expression of miR-541 in tumor tissues was associated with the overall survival of OS patients and was a potential independent prognostic indicator. In OS cells, the overexpression of miR-541 could inhibit cell proliferation, migration and invasion. The luciferase activity results indicated that TGIF2 was a potential target of miR-541.

Conclusion

The results of this study revealed that the decreased miR-541 expression in OS patients may serve as a prognostic biomarker, and that the overexpression of miR-541 in OS cells results in inhibited cell proliferation, migration and invasion, indicating the potential of miR-541 as a therapeutic target in OS treatment.
Malakoplakia of the gastrointestinal tract: clinicopathologic analysis of 23 cases
Authors: Lee Michael , Ko Huaibin Mabel , Rubino Anthony , Lee Hwajeong , Gill Ryan , Lagana Stephen M.
Published: July 2020

Background

Malakoplakia is an uncommon, tumor-like inflammatory disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria. The genitourinary tract is the most common site of involvement, however, cases have also been described in the gastrointestinal tract, suggesting that it is the second most common site of involvement. This study investigates the clinical and histologic features of malakoplakia in the gastrointestinal tract.

Case presentation

For 23 gastrointestinal specimens (biopsies and resections) from patients with a pathologic diagnosis of malakoplakia, we recorded the gender, age, location, primary diagnosis, endoscopic or surgical indication, endoscopic/gross impression and immune status (immunocompromised vs. immunocompetent).

Conclusion

Malakoplakia occurred throughout the length of the gastrointestinal tract with most of the cases located in the sigmoid colon and rectum (n = 10); other sites included the transverse and descending colon (n = 4), stomach/gastroesophageal junction (n = 4), appendix (n = 2), cecum (n = 1), small bowel (n = 1), and the peri-anal area (n = 1). Endoscopically, these lesions most commonly appeared as polyps (n = 10) or masses (n = 5), other clinical endoscopic impressions varied from a thickened area/fibrosis to mucosal erythema. Most patients were immunocompromised due to a disease state (e.g. organ transplantation, cancer diagnosis, autoimmune condition) and/or medication effect. Eight patients with malakoplakia were on immunosuppressive medications (8/23, 35%). Common immunosuppressed disease states included cancer (n = 9), autoimmune disease (n = 5), status post organ transplantation (n = 4), diabetes (n = 5), infection/sepsis (n = 3), and HIV/AIDS (n = 1). Some patients had multiple co-morbidities (i.e. diabetes and organ transplant). Twenty-one patients with malakoplakia were in an immunosuppressive state (21/23, 91%).
Distribution of hygiene kits during a cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo: a process evaluation
Authors: D’Mello-Guyett Lauren , Greenland Katie , Bonneville Sharla , D’hondt Rob , Mashako Maria , Gorski Alexandre , Verheyen Dorien , Van den Bergh Rafael , Maes Peter , Checchi Francesco , Cumming Oliver
Published: July 2020

Background

Cholera remains a leading cause of infectious disease outbreaks globally, and a major public health threat in complex emergencies. Hygiene kits distributed to cholera case-households have previously shown an effect in reducing cholera incidence and are recommended by Médecins Sans Frontières (MSF) for distribution to admitted patients and accompanying household members upon admission to health care facilities (HCFs).

Methods

This process evaluation documented the implementation, participant response and context of hygiene kit distribution by MSF during a 2018 cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo (DRC). The study population comprised key informant interviews with seven MSF staff, 17 staff from other organisations and a random sample of 27 hygiene kit recipients. Structured observations were conducted of hygiene kit demonstrations and health promotion, and programme reports were analysed to triangulate data.

Results and conclusions

Between Week (W) 28–48 of the 2018 cholera outbreak in Kasaï-Oriental, there were 667 suspected cholera cases with a 5% case fatality rate (CFR). Across seven HCFs supported by MSF, 196 patients were admitted with suspected cholera between W43-W47 and hygiene kit were provided to patients upon admission and health promotion at the HCF was conducted to accompanying household contacts 5–6 times per day. Distribution of hygiene kits was limited and only 52% of admitted suspected cholera cases received a hygiene kit. The delay of the overall response, delayed supply and insufficient quantities of hygiene kits available limited the coverage and utility of the hygiene kits, and may have diminished the effectiveness of the intervention. The integration of a WASH intervention for cholera control at the point of patient admission is a growing trend and promising intervention for case-targeted cholera responses. However, the barriers identified in this study warrant consideration in subsequent cholera responses and further research is required to identify ways to improve implementation and delivery of this intervention.
Correction to: The design and development of covalent protein-protein interaction inhibitors for cancer treatment
Authors: Cheng Sha-Sha , Yang Guan-Jun , Wang Wanhe , Leung Chung-Hang , Ma Dik-Lung
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Professional identity formation within Longitudinal Integrated Clerkships: a scoping review protocol
Authors: Brown Megan El , Whybrow Paul , Kirwan Gavin , Finn Gabrielle M.
Published: July 2020

Background

Professional identity development is an area of contemporary interest within medical education. It can be defined as ‘the foundational process one experiences during the transformation from lay person to physician’. In order for this transformation to occur, medical values and principles are internalised. A robust professional identity is key to confident practice as a medical professional. As such, research regarding what works to encourage identity development is popular. New models of educational delivery, such as the increasingly popular Longitudinal Integrated Clerkship model (LICs), present an interesting opportunity to investigate impact on identity. As no previous literature reviews focus on identity development within LICs, it is unclear what is already known about their impact. Therefore, a scoping review synthesising current knowledge and mapping areas for future research is necessary.

Methods

Arksey and O’Malley’s scoping review steps will be used as a methodological framework. MEDLINE, EMBASE, PubMed, Web of Knowledge, ERIC, PsychINFO, Google Scholar, JSTOR, Scopus, and Web of science will be searched (from inception onwards). We will include single studies of any design (e.g. quantitative and qualitative) and reviews examining professional identity within Longitudinal Integrated Clerkships involving health profession students. Two reviewers will complete all screening and data abstraction independently. Deductive coding will be presented as a quantitative textual meta-analysis. Inductive coding will be presented in narrative format.

Discussion

This scoping review will explore professional identity formation within LICs, evaluating any known impact of the educational model and mapping the ways in which identity within LICs has been researched. Mapping of current knowledge should highlight whether LICs as an educational model can influence professional identity development and outline gaps in what is known about their impact to date. Theory used in LIC-based identity research will also be mapped, in order to summarise the main theoretical orientations of research to date. It is anticipated that through such evidence synthesis, directions for future research will become clear.

Systematic review registration

Open Science Framework: osf.io/hk83p
Replacing conventional brittleness indices determination with new attributes using true hydrofracturing mechanism
Authors: Sharma Ritesh Kumar , Chopra Satinder , Lines Larry R.
Published: July 2020

Shale resource plays are associated with low permeability; hence, hydraulic fracturing is required for their stimulation and production. Even though considerable nonuniqueness exists in identifying favorable zones for hydraulic fracturing, geophysicists seem to be avid followers of low-Poisson’s ratio and high-Young’s modulus brittleness criteria, proposed a decade ago. We highlight the misinterpretation that one may run into in following such a criterion for any shale play and develop a new attribute that makes use of strain energy density and fracture toughness. Although the former controls fracture initiation, the propagation of fractures is governed by the latter. Because hydraulic fracturing comprises both these properties, it is firmly believed that the new proposed attribute could be used to highlight the favorable intervals for fracturing. Core data, well log curves, along with mud logs have been used to authenticate the proposed attribute. Finally, computation of the new attributes is implemented on the seismic data with encouraging results.
Cancer and Leukemia Group B 90203 (Alliance): Radical Prostatectomy With or Without Neoadjuvant Chemohormonal Therapy in Localized, High-Risk Prostate Cancer
Authors: Eastham James A. , Heller Glenn , Halabi Susan , Monk J. Paul , Beltran Himisha , Gleave Martin , Evans Christopher P. , Clinton Steven K. , Szmulewitz Russell Z. , Coleman Jonathan , Hillman David W. , Watt Colleen R. , George Saby , Sanda Martin G. , Hahn Olwen M. , Taplin Mary-Ellen , Parsons J. Kellogg , Mohler James L. , Small Eric J. , Morris Michael J.
Published: July 2020

PURPOSE

Radical prostatectomy (RP) alone is often inadequate in curing men with clinically localized, high-risk prostate cancer (PC). We hypothesized that chemohormonal therapy (CHT) with androgen-deprivation therapy plus docetaxel before RP would improve biochemical progression–free survival (BPFS) over RP alone.

PATIENTS AND METHODS

Men with clinically localized, high-risk PC were assigned to RP alone or neoadjuvant CHT with androgen deprivation plus docetaxel (75 mg/m2body surface area every 3 weeks for 6 cycles) and RP. The primary end point was 3-year BPFS. Biochemical failure was defined as a serum prostate-specific antigen level > 0.2 ng/mL that increased on 2 consecutive occasions that were at least 3 months apart. Secondary end points included 5-year BPFS, overall BPFS, local recurrence, metastasis-free survival (MFS), PC-specific mortality, and overall survival (OS).

RESULTS

In total, 788 men were randomly assigned. Median follow-up time was 6.1 years. The overall rates of grade 3 and 4 adverse events during chemotherapy were 26% and 19%, respectively. No difference was seen in 3-year BPFS between neoadjuvant CHT plus RP and RP alone (0.89 v 0.84, respectively; 95% CI for the difference, −0.01 to 0.11; P = .11). Neoadjuvant CHT was associated with improved overall BPFS (hazard ratio [HR], 0.69; 95% CI, 0.48 to 0.99), improved MFS (HR, 0.70; 95% CI, 0.51 to 0.95), and improved OS (HR, 0.61; 95% CI, 0.40 to 0.94) compared with RP alone.

CONCLUSION

The primary study end point, 3-year BPFS, was not met. Although some improvement was seen in secondary end points, any potential benefit must be weighed against toxicity. Our data do not support the routine use of neoadjuvant CHT and RP in patients with clinically localized, high-risk PC at this time.
Pituitary Gangliocytoma Producing TSH and TRH: A Review of “Gangliocytomas of the Sellar Region”
Authors: Sakata Kiyohiko , Fujimori Kana , Komaki Satoru , Furuta Takuya , Sugita Yasuo , Ashida Kenji , Nomura Masatoshi , Morioka Motohiro
Published: July 2020

Purpose

Pituitary gangliocytomas (GCs) are rare neuronal tumors that present with endocrinological disorders, such as acromegaly, amenorrhea-galactorrhea syndrome, and Cushing’s disease. Most pituitary GCs coexist with pituitary adenomas pathologically and are diagnosed as mixed gangliocytoma-adenomas. Herein, we report a case of 45-year-old man who presented with the syndrome of inappropriate secretion of thyroid-stimulating hormone (SITSH) and discuss the pathogenesis of pituitary GCs.

Methods

Pituitary magnetic resonance imaging showed an 8-mm homogeneous and poorly enhanced mass inside the pituitary gland. Endoscopic transsphenoidal surgery was performed under a preoperative diagnosis of thyrotroph adenoma. However, the tumor was finally diagnosed as gangliocytoma without an adenomatous component. The tumor was further analyzed via immunohistochemistry and electron microscopy. Additionally, we searched MEDLINE and PubMed for previously published cases of isolated pituitary GCs and analyzed the reported clinicopathological findings.

Results

The patient showed complete clinical and endocrinological recovery after an operation. The tumor was positive for thyrotropin (TSH), TSH-releasing hormone (TRH), Pit-1, GATA-2, and most neuronal markers. Electron microscopy demonstrated the presence of intracytoplasmic secretory granules and neuronal processes. Co-secreting hypothalamic and pituitary hormone inside the tumor indicated autocrine/paracrine endocrinological stimulation.

Conclusion

Herein, we report a case of SITSH caused by an isolated pituitary gangliocytoma, expressing both TSH and TRH, which, to our best knowledge, is the first reported case of such a condition. The multidirectional differentiation and multihormonal endocrine characteristics of these tumors indicate that they are a member of neuroendocrine neoplasms, further supporting that they are derived from neural crest cells.
IL-6 Response to Psychosocial Stress Predicts 12-month Changes in Cardiometabolic Biomarkers in Perimenopausal Women
Authors: Zannas Anthony S , Gordon Jennifer L , Hinderliter Alan L , Girdler Susan S , Rubinow David R
Published: July 2020

Objective

Cardiometabolic diseases are the number one cause of mortality, accounting for over one third of all deaths in the United States. Cardiometabolic risk further increases with psychosocial stress exposure and during menopausal transition in women. Because disease risk and stress burden are associated with aberrant immune signaling, we hypothesized that responses of interleukin-6 (IL-6) to psychosocial stress may predict longitudinal cardiometabolic outcomes in perimenopausal women.

Methods

We conducted post hoc analyses in 151 perimenopausal or early postmenopausal women participants in a previously completed study. At study onset, participants underwent the Trier Social Stress Test (TSST), and plasma IL-6 was measured repeatedly before and during the 1 hour post-TSST. Subsequently, participants were randomly assigned to either hormonal treatment (HT) or placebo and followed for 12 months to determine longitudinal changes in cardiometabolic biomarkers.

Results

Greater IL-6 reactivity to stress, measured with baseline-adjusted area under the curve, predicted 12-month decrease in flow-mediated dilatation of the brachial artery (P = 0.0005), a measure of endothelial-dependent vascular function, but not in endothelial-independent function measured with nitroglycerin-mediated dilatation (P = 0.17). Greater baseline IL-6 levels predicted 12-month increase in insulin resistance based on the homeostatic model assessment of insulin resistance score (P = 0.0045) and in the number of criteria met for metabolic syndrome (P = 0.0008). These predictions were not moderated by HT.

Conclusions

Greater baseline IL-6 levels as well as its reactivity to stress may predict worsening in distinct cardiometabolic biomarkers as women transition to menopause. Interleukin-6 reactivity predicts decline in endothelial-dependent vascular function, whereas baseline IL-6 presages accumulation of metabolic risk.
Response to GH Treatment After Radiation Therapy Depends on Location of Irradiation
Authors: Rose Susan R , Carlsson Martin , Grimberg Adda , Aydin Ferah , Albanese Assunta , Hokken-Koelega Anita C S , Camacho-Hubner Cecilia
Published: July 2020

Objectives

Cancer survivors with GH deficiency (GHD) receive GH therapy (GHT) after 1+ year observation to ensure stable tumor status/resolution.

Hypothesis

Radiation therapy (RT) to brain, spine, or extremities alters growth response to GHT.

Aim

Identify differences in growth response to GHT according to type/location of RT.

Methods

The Pfizer International Growth Database was searched for cancer survivors on GHT for ≥5 years. Patient data, grouped by tumor type, were analyzed for therapy (surgery, chemotherapy, RT of the focal central nervous system, cranial, craniospinal, or total body irradiation [TBI] as part of bone marrow transplantation), sex, peak stimulated GH, age at GHT start, and duration from RT to GHT start. Kruskal-Wallis test and quantile regression modeling were performed.

Results

Of 1149 GHD survivors on GHT for ≥5 years (male 733; median age 8.4 years; GH peak 2.8 ng/mL), 431 had craniopharyngioma (251, cranial RT), 224 medulloblastoma (craniospinal RT), 134 leukemia (72 TBI), and 360 other tumors. Median age differed by tumor group (P < 0.001). Five-year delta height SD score (SDS) (5-year ∆HtSDS; median [10th-90th percentile]) was greatest for craniopharyngioma, 1.6 (0.3-3.0); for medulloblastoma, 5-year ∆HtSDS 0.9 (0.0-1.9); for leukemia 5-year ∆HtSDS, after TBI (0.3, 0-0.7) versus without RT (0.5, 0-0.9), direct comparison P < 0.001. Adverse events included 40 treatment-related, but none unexpected.

Conclusions

TBI for leukemia had significant impact on growth response to GHT. Medulloblastoma survivors had intermediate GHT response, whereas craniopharyngioma cranial RT did not alter GHT response. Both craniospinal and epiphyseal irradiation negatively affect growth response to GH therapy compared with only cranial RT or no RT.
Hypernatremia—A Manifestation of COVID-19: A Case Series
Authors: Zimmer Milena A. , Zink Anne K. , Weißer Christian W. , Vogt Ulrike , Michelsen Andrea , Priebe Hans-Joachim , Mols Georg
Published: July 2020

We report for the first time therapy-resistant hypernatremia (plasma sodium concentration ≥150 mmol per liter) developing in 6 of 12 critically ill coronavirus disease 2019 (COVID-19) patients age 57–84 years requiring mechanical ventilation. There was no correlation between plasma sodium concentrations and sodium input. Plasma concentrations of chloride were elevated, those of potassium decreased. These findings are consistent with abnormally increased renal sodium reabsorption, possibly caused by increased angiotensin II activity secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–induced downregulation of angiotensin-converting enzyme 2 (ACE2) receptors. As hypernatremia was associated with increased length of intensive care unit stay, special attention should be paid to the electrolyte status of COVID-19 patients.
Comparative interactomics analysis reveals potential regulators of α6β4 distribution in keratinocytes
Authors: Molder Lisa te , Hoekman Liesbeth , Kreft Maaike , Bleijerveld Onno , Sonnenberg Arnoud
Published: July 2020

The integrin α6β4 and cytoskeletal adaptor plectin are essential components of type I and type II hemidesmosomes (HDs). We recently identified an alternative type II HD adhesion complex that also contains CD151 and the integrin α3β1. Here, we have taken a BioID proximity labeling approach to define the proximity protein environment for α6β4 in keratinocytes. We identified 37 proteins that interacted with both α6 and β4, while 20 and 78 proteins specifically interacted with the α6 and β4 subunits, respectively. Many of the proximity interactors of α6β4 are components of focal adhesions (FAs) and the cortical microtubule stabilizing complex (CMSC). Though the close association of CMSCs with α6β4 in HDs was confirmed by immunofluorescence analysis, CMSCs have no role in the assembly of HDs. Analysis of the β4 interactome in the presence or absence of CD151 revealed that they are strikingly similar; only 11 different interactors were identified. One of these was the integrin α3β1, which interacted with α6β4 more strongly in the presence of CD151 than in its absence. These findings indicate that CD151 does not significantly contribute to the interactome of α6β4, but suggest a role of CD151 in linking α3β1 and α6β4 together in tetraspanin adhesion structures.
Cell death in animal development
Authors: Ghose Piya , Shaham Shai
Published: July 2020

Cell death is an important facet of animal development. In some developing tissues, death is the ultimate fate of over 80% of generated cells. Although recent studies have delineated a bewildering number of cell death mechanisms, most have only been observed in pathological contexts, and only a small number drive normal development. This Primer outlines the important roles, different types and molecular players regulating developmental cell death, and discusses recent findings with which the field currently grapples. We also clarify terminology, to distinguish between developmental cell death mechanisms, for which there is evidence for evolutionary selection, and cell death that follows genetic, chemical or physical injury. Finally, we suggest how advances in understanding developmental cell death may provide insights into the molecular basis of developmental abnormalities and pathological cell death in disease.
Walking on chains: the morphology and mechanics behind the fin ray derived limbs of sea-robins
Authors: Petersen Jarrod C. , Ramsay Jason B.
Published: July 2020

Fish fin rays (lepidotrichia) are typically composed of paired and segmented flexible structures (hemitrichia) that help support and change the shape of the fins to affect water flow. Yet, marine ray-finned fish that are members of the family Priontinae (sea-robins) have specialized pectoral fin rays that are separated from the fin and used as limbs to walk along the seafloor. While previous kinematic studies have demonstrated the use of these specialized fin rays as walking appendages, there is little information on how the morphology of the “walking-rays” and associated musculature facilitate underwater walking. Here, we examine the musculoskeletal anatomy of the walking and pectoral fin rays in striped sea-robin, Prionotus evolans and compare the mechanical properties of the rays with those of the smaller northern sea-robin, Prionotus carolinus. We aimed to determine what structural modifications in the walking-rays allow them to function as a supportive limb. We found enlarged processes for muscle attachment, bone extensions that brace the hemitrich articulations, and reduced flexibility and increased second moment of area along the rostro-caudal bending axis in the rays used for walking. This novel limb design may have promoted the benthic foraging behavior exhibited by these species by uncoupling locomotion and feeding.
Prediction models for clear cell renal cell carcinoma ISUP/WHO grade: comparison between CT radiomics and conventional contrast-enhanced CT
Authors: Han Dong , Yu Yong , Yu Nan , Dang Shan , Wu Hongpei , Jialiang Ren , He Taiping
Published: July 2020

Objective:

Comparing the prediction models for the ISUP/WHO grade of clear cell renal cell carcinoma (ccRCC) based on CT radiomics and conventional contrast-enhanced CT (CECT).

Methods:

The corticomedullary phase images of 119 cases of low-grade (I and II) and high-grade (III and IV) ccRCC based on 2016 ISUP/WHO pathological grading criteria were analyzed retrospectively. The patients were randomly divided into training and validation set by stratified sampling according to 7:3 ratio. Prediction models of ccRCC differentiation were constructed using CT radiomics and conventional CECT findings in the training setandwere validated using validation set. The discrimination, calibration, net reclassification index (NRI) and integrated discrimination improvement index (IDI) of the two prediction models were further compared. The decision curve was used to analyze the net benefit of patients under different probability thresholds of the two models.

Results:

In the training set, the C-statistics of radiomics prediction model was statistically higher than that of CECT (p < 0.05), with NRI of 9.52% and IDI of 21.6%, both with statistical significance (p < 0.01).In the validation set, the C-statistics of radiomics prediction model was also higher but did not show statistical significance (p = 0.07). The NRI and IDI was 14.29 and 33.7%, respectively, both statistically significant (p < 0.01). Validation set decision curve analysis showed the net benefit improvement of CT radiomics prediction model in the range of 3–81% over CECT.

Conclusion:

The prediction model using CT radiomics in corticomedullary phase is more effective for ccRCC ISUP/WHO grade than conventional CECT.

Advances in knowledge:

As a non-invasive analysis method, radiomics can predict the ISUP/WHO grade of ccRCC more effectively than traditional enhanced CT.
Normal pulmonary venous anatomy and non-anomalous variations demonstrated on CT angiography: what the radiologist needs to know?
Authors: Pandey Niraj Nirmal , Taxak Avichala , Kumar Sanjeev
Published: July 2020

Variations in pulmonary venous anatomy (in the absence of any anomalous pulmonary venous connections) is not uncommon. Commonly occurring variations include presence of conjoined pulmonary veins (PV), supernumerary PVs and ostial PVs. Variant PV anatomy is often asymptomatic; however, it may assume importance in the pre-procedural planning prior to cardiothoracic surgeries and radiofrequency catheter-directed ablation for PV isolation. It is therefore important that the radiologist is aware of the conventional normal and variant PV anatomy in addition to obvious abnormalities like anomalous PV drainage or PV stenosis/ occlusion. Multidetector CT (MDCT) is often used as the first-line imaging modality for pre-procedural PV mapping as it provides high quality images with short acquisition times and availability of numerous post-processing tools.This pictorial review focusses on the MDCT-based PV imaging describing the reporting nomenclature, the conventional normal as well as non-anomalous variant PV anatomy along with their clinical significance.
COMO APRENDEM OS ESTUDANTES E PROFESSORES DE UMA INSTITUIÇÃO DE ENSINO SUPERIOR: APLICAÇÃO DO INVENTÁRIO DE ESTILOS DE APRENDIZAGEM DE KOLB (1984)
Authors: Abreu José Adailton de , Mendes Josiete Da Silva , Oliveira Maria Edilene de , Cruz Tatyane Veras de Queiroz Ferreira da , Brandão Wanderberg Alves
Published: July 2020

Aprender e ensinar faz parte da vida do ser humano, constituindo essas ações como um complexo sistema de interação entre professor e estudante dentro do processo de ensino e aprendizagem. Com base nisso, este trabalho analisou como aprendem os membros de uma comunidade acadêmica baseado na teoria de Kolb por meio de uma pesquisa quantitativa descritiva transversal, processando os dados obtidos com o uso de técnicas estatísticas descritivas. Os dados apontaram que os discentes e docentes possuem, como estilo de aprendizagem predominante, o assimilador, estando mais envolvidos com modelos teóricos do que com a vivência prática. Acredita-se que a compreensão dos estilos de aprendizagem enriquece a prática acadêmica, viabilizando o aprendizado, de forma mais significativa, de acordo com o perfil dos estudantes. Ademais, considera-se que a sintonia entre os estilos de aprendizagem dos discentes e docentes parecem contribuir para o bom desempenho desses estudantes.
PERÍODO ACADÊMICO, NÍVEL DE CONSUMO, PLANEJAMENTO FINANCEIRO: COMO ESTÁ A EDUCAÇÃO FINANCEIRA DOS ALUNOS DE GRADUAÇÃO NA UNIVERSIDADE DE SÃO JOÃO DEL-REI?
Authors: Silveira Ana Flávia , Ferreira Roberto Do Nascimento , Almeida Mário Sérgio de
Published: July 2020

Educação financeira é um tema objeto de estudos no meio acadêmico, representando, também, iniciativas de instituições dos mercados financeiros e de capitais. Pesquisas têm demonstrado que a falta de conhecimento ou preocupação com a educação financeira atinge, também, os alunos universitários. Esta pesquisa teve como objetivo analisar o conhecimento dos graduandos de Administração e Ciências Contábeis da UFSJ sobre Educação Financeira. A metodologia utilizada constou da aplicação de questionário estruturado aos alunos dos dois cursos (noturno e integral). Os dados foram analisados por meio de planilhas eletrônicas do Microsoft Excel®. Os resultados indicaram que a maioria dos alunos (52,6%) considera ter algum conhecimento sobre Educação Financeira. Para 16,3%, a fonte de conhecimento sobre o tema é a experiência prática. Concluiu-se que os discentes têm algum conhecimento sobre Educação Financeira, mas não de forma aprofundada. Observou-se uma preocupação com os gastos imediatos, sem, no entanto, realizar um planejamento.
O CONSUMO COLABORATIVO E A GERAÇÃO Y
Authors: Ferreira Sara Raquel de Melo , Ferreira Érika De Araújo , Oliveira Maria Gleiciene Rodrigues
Published: July 2020

O consumo colaborativo surge com a proposta de acesso a bens e serviços sem, necessariamente, a aquisição do produto ou a troca monetária para seu uso. Atualmente, existem vários modelos de negócios que estão ancorados nesse conceito, como compartilhamento de bicicletas e carros, hospedagem, sistema de caronas, espaços de trabalho etc. O presente estudo visa analisar como a geração y se relaciona com o consumo colaborativo, mediante uma pesquisa quantitativa e questionário aplicado por meio da ferramenta google forms. Os dados foram analisados pelo software SPSS, utilizando as técnicas estatísticas média, desvio padrão e análise fatorial. Como resultado, constatou-se que existe uma predominância do gênero feminino, solteiros, com ensino superior incompleto/cursando, e que possuem conhecimento sobre o conceito de consumo colaborativo. Os fatores que mais influenciam no comportamento de consumo desses serviços são o financeiro e o socialmente responsável.
Comparative response of Desmopressin versus Combination Therapy (Desmopressin + Oxybutynin) in Children with Nocturnal Enuresis
Authors: Kazi Asiya , Moorani Kemchand N , Zehra Shabih , Zaidi Ijaz Hussain
Published: July 2020

Objective: To assess the safety as well as efficacy of desmopressin monotherapy alone and in combination (desmopressin + oxybutynin) in treating nocturnal urinary incontinence among children with 7 to 13 years.

Methods: This randomized controlled trial has been carried out in National Institute of Child Health from September 2018 to March 2019 with the utilization of convenient sampling technique. Data has been collected after taking ethical approval and informed consent of the Parents with complete confidentiality. The sample size was 84 and equal number of patients was divided in two groups. Group-I was given desmopressin at monotherapy at a dose of 0.2 mg and Group-II was given desmopressin and oxybutynin at the dose of 0.2 mg desmopressin and 5 mg oxybutynin patients were diagnosed on the basis of history. Routine lab investigation included Urine DR and ultrasound abdomen.

Results: In this study significant differences between two groups were found with respect to socio economic status, lack of education of parents (P Less than 0.05). The frequency, urgency and incontinence of this ailment was significantly controlled by combination therapy (desmopressin + oxybutynin) as compared to desmopressin as monotherapy (P Less than 0.05) as patient was followed after one, two and three monthly basis.

Conclusion: Desmopressin combination with oxybutynin is more effective as compared to monotherapy treatment. The affectivity of the combination therapy was very high with least side effects and all the children recovered from the condition at third month of treatment. Furthermore, headache was observed to be common with monotherapy and loss of appetite was observed with combination therapy.

doi: https://doi.org/10.12669/pjms.36.6.1957

How to cite this:Kazi A, Moorani KN, Zehra S, Zaidi IH. Comparative response of Desmopressin versus Combination Therapy (Desmopressin + Oxybutynin) in Children with Nocturnal Enuresis. Pak J Med Sci. 2020;36(6):1263-1269.   doi: https://doi.org/10.12669/pjms.36.6.1957

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