bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Strategy Based on Radiological 3D Reconstruction in a Giant Metastatic Neuroendocrine Tumor of the Pancreas: A Case Report of an Interdisciplinary Approach
Authors: Hess Gabriel Fridolin , Soysal Savas Deniz , Nicolas Guillaume , Bolli Martin , Zech Christoph Johannes , Tzankov Alexandar , Christ Emanuel , Montemurro Michael , Kollmar Otto
Published: January 2021

Background. Neuroendocrine tumors (NETs) are a rare entity and are most commonly found in the gastroenteropancreatic tract. The clinical outcome depends on the potential resectability, grade, and stage. Here, we report a case of a tumor debulking in a metastatic NET of the pancreas. A 25-year-old woman with stable metastatic NET of the pancreas G2 T4N1M1 (hepatic, extrahepatic) already underwent several therapies. Case Presentation. A 25-year-old woman with stable metastatic NET of the pancreas G2 T4N1M1 (hepatic, extrahepatic) already underwent several pharmaceutical therapies. Due to the young age, the G2 characteristic, and the stable liver disease, the decision for debulking was made. Based on a 3D CT scan, an embolization was successfully performed directly prior to a pylorus-preserving pancreatic head resection, advanced interaortocaval lymph node dissection, and an atypical liver resection within segment VI. Histological workup revealed a stage pT3, G2, pN1 (29/34), pM1c (hepatic and extrahepatic), L1, V0, Pn0 with complete surgical resection of the primary tumor (180 mm). The excision of the liver segment V showed a completely resected metastasis. Conclusions. In this patient, extensive surgery of a pancreatic NET with the aim of a prolonged progression-free survival was performed. Close cooperation between different disciplines is absolutely mandatory. Modern imaging allowed a precise therapy plan to be worked out.
Sarcoma of the Breast: Clinical Characteristics and Outcomes of 991 Patients from the National Cancer Database
Authors: Lee Jin Sun , Yoon Kevin , Onyshchenko Mykola
Published: January 2021

Background. Sarcoma of the breast is a rare malignancy with heterogeneous histology. Angiosarcoma, including secondary angiosarcoma from previous radiation, is the most common type of sarcoma of the breast. Other types of sarcomas of the breast have limited clinical and survival information. Methods. We obtained clinicopathological data and survival outcomes from the patients with sarcoma of the breast, excluding angiosarcoma, that were registered in the National Cancer Database (NCDB) from 2004 to 2016. The treatment patterns and prognostic factors were analyzed. Results. A total of 991 patients had sarcoma of the breast other than angiosarcoma. The most common histology was spindle cell sarcoma (13.4%), followed by leiomyosarcoma (11.7%) and giant cell sarcoma (10.1%). Surgical resection was performed in 894 out of 991 patients (90.2%), including R0 resection achieved in 781 (87.4%). The patients who received surgery showed better survival than the patients without surgery regardless of radiation therapy. When radiation was added to the surgical management, the OS (overall survival) benefit was marginally significant (hazard ratio 1.30 (CI 1.01–1.67),

p
=
0.044

). Adding chemotherapy did not improve OS. Conclusions. Surgical resection seems to be the most important treatment modality in sarcoma of the breast from the analysis of a large database. Radiation therapy added a minor survival benefit to the patients who received surgical resection. Systemic chemotherapy did not play a clear role in sarcoma of the breast.
A Comparative Study on the Effect of Different Methods of Recycling Orthodontic Brackets on Shear Bond Strength
Authors: Khanal Purna Prasad , Shrestha Basanta Kumar , Yadav Rajiv , Prasad Gupta Sanjay
Published: January 2021

Aim. The aim of this study was to evaluate and compare the effect of different methods of recycling stainless steel orthodontic brackets on shear bond strength. Methods. One hundred twenty human premolars extracted for orthodontic purpose were randomly divided into four groups. Standard MBT (0.022″) brackets were bonded on the buccal surface of all samples with light cured adhesive primers using an LED curing unit for 10 seconds. Group I was assigned as control, and the brackets of Group II, Group III, and Group IV were subjected to recycling by flaming, flaming with sandblasting, and flaming with ultrasonic cleaning, respectively. The recycled brackets were rebonded, and final debonding of all brackets was performed using a universal testing machine at a crosshead speed of 0.5 mm/min and shear bond strength was determined. Data were analyzed with descriptive statistics, ANOVA, and post hoc tests. The adhesive remnant index was evaluated using a stereomicroscope at 10X magnification. Results. The highest shear bond strength was obtained with Group I (10.35 ± 0.46 MPa), followed by Group III (9.36 ± 0.55 MPa) and Group IV (5.97 ± 0.66 MPa), and the least value was obtained with Group II (4.30 ± 0.55 Mpa). Significant differences among the groups were detected by analysis of variance. Tukey’s post hoc multiple comparison test showed that the shear bond strength of each group was significantly different from one another (

p
<
0.001

). Conclusions. Shear bond strength of new brackets was significantly higher than that of the recycled brackets. Among recycled brackets, flaming with sandblasting provided adequate shear bond strength, flaming with ultrasonic cleaning provided a borderline value for clinical use, and flaming alone led to a significantly lower value.
Adoption of Mobile Government Cloud from the Perspective of Public Sector
Authors: Liang Yikai , Wang Weijie , Dong Kunxiang , Zhang Guijie , Qi Guijie
Published: January 2021

Mobile cloud computing (MCC) has been widely used in every aspect of our society, bringing both advantages and challenges. However, the adoption of MCC technology is still at an early stage of implementation in the governments. To promote the adoption and diffusion of MCC in the government area, exploring the determinants and influence mechanisms of mobile cloud computing-based government (m-Gov cloud) adoption has become the focus in academic and industry. Based on the technology-organization-environment framework and trust theory at the organizational level, an integrated model including the determinants on the adoption of m-Gov cloud is proposed, and 93 survey samples from China are used to analyzed by partial least squares structural equation modeling (PLS-SEM). The results show that provider competence, organizational readiness, external pressure, and trust of m-Gov cloud have significant effects on m-Gov cloud adoption. Perceived benefit, perceived risk, and provider competence have significant effects on m-Gov cloud trust. The m-Gov cloud trust plays an indirect-only (full) mediation and a complementary (partial) mediation effect between perceived benefit, provider competence, and m-Gov cloud adoption, respectively, while perceived risk has no significant direct and indirect effect on m-Gov cloud adoption. The findings provide a new research perspective and practice insights to promote the implementation of solutions based on the idea of mobile cloud computing.
Endoscopic Retroperitoneal Necrosectomy for Infected Pancreatic Necrosis Using a Self-Expandable Metal Stent
Authors: Patil Gaurav , Maydeo Amit , Dalal Ankit , Iyer Arun , More Rajdeep , Thakare Shivaji
Published: January 2021

Infected walled-off pancreatic necrosis (WOPN) is a severe complication of acute pancreatitis. Surgery in these critically ill patients can be associated with increased morbidity and mortality. Hence, minimally invasive therapies have emerged as an alternative to surgery. Herein, we report a case of severe acute pancreatitis with WOPN which was treated percutaneously with a flexible endoscope through an esophageal self-expanding metal stent using a total retroperitoneal approach. Percutaneous direct endoscopic necrosectomy (p-DEN) using the retroperitoneal route improved the patient’s parameters dramatically with resolution of sepsis without the need for surgery. p-DEN using a flexible endoscope passed through a large bore metal stent shows promise in selected patients with WOPN and can be used in patients who are not ideal candidates for transmural or surgical drainage.
MS St. Petersburg RNL Yevr. II A 640: A Possible Remnant of Another Copy of Saadya Gaon’s Tafsīr by Samuel ben Jacob
Authors: Zewi Tamar
Published: January 2021

The article discusses one Genizah fragment from the Russian National Library in St. Petersburg, MS St. Petersburg RNL Yevr. II A 640, which contains a remnant of Saadya Gaon’s translation of the Pentateuch possibly copied by Samuel ben Jacob in the first quarter of the 11th century.
Tightening the Bonds between Edom and Israel (Gen 33:1–17*): On the Further Development of Edom’s Role within the Fortschreibung of the Jacob Cycle in the Exilic and Early Persian Periods
Authors: Hensel Benedikt
Published: January 2021

The article re-evaluates the role of Edom within the Jacob narrative and its formation processes. The bulk of the narrative stems from the pre-exilic period, supposedly the 8th century BCE. This article’s distinctive thesis is that Edom’s role undergoes certain developments during its Fortschreibung in the exilic and early Persian periods. The article will venture from the reconciliation scene in Gen 33:1–17*—the original ending of the earliest Jacob narrative—and describe the development of Edom’s role at different stages of its literary growth (e.g., the earliest Patriarchal narrative, the Abraham narrative, or within P). It will be observed that the strong and positive bond between Israel and Edom becomes even tightened within this process, which is remarkable because their relationship arguably worsened to a certain degree in the events accompanying the destruction of the Judahite kingdom. The article will investigate the historical realities behind this development.
Heretical Geometry
Authors: Jakušić Dino
Published: January 2021

This paper presents Christian Wolff’s claim that philosophy, undertaken on the basis of a proper method, cannot contradict revealed religion. The paper first provides a context of Wolff’s banishment from Halle for holding views in conflict with religious doctrines. Next, it proceeds, on the basis of Wolff’s Discursus præliminaris de philosophia in genere prefixed to his 1728 Latin Logic, to explain the principles of Wolff’s method, and to show how his conception of method enables him to disallow the possibility of a genuine conflict between philosophical and religious dogmas. For Wolff, doctrinal conflicts between philosophy and revealed religion can only occur as a result of terminological disagreements, disagreements between dogmas and hypotheses, or disagreements between dogmas and theological misinterpretations. The actual conflict of dogmas, understood as religious or philosophical truths, Wolff holds to be impossible.
Caspar Langenhert on Free Choice, Causation, and the Rejection of Calvinism
Authors: Jaworzyn Michael
Published: January 2021

This article provides an account of how Caspar Langenhert (1661–c. 1730) attempted to reconcile teaching a controversial “egoist” metaphysics in Paris with his reasons for rejecting Calvinism, leaving the Netherlands, and joining the Catholic Church. Langenhert had renounced Calvinism especially because he took the Calvinist account of free will to be philosophically, morally, and scripturally dubious. He preferred the notion of indifference in explaining freedom. That did not seem to accord well with his later work, the Novus Philosophus (1701–1702), whose supposedly “egoist” metaphysics appears to deny such freedom to creatures. Langenhert’s own defence would have been that there was no conflict here, because of the unusually strong distinction he drew between the domains of metaphysics and theology, but his attempts to sidestep his apparent unorthodoxy seem to have been unconvincing to the Parisian authorities, and Langenhert was required to cease teaching.
4. Mrs. Jennings
Authors: Bartlett Nora
Published: January 2021

This chapter focuses on Mrs. Jennings. Noted is the importance of the Austen family to Jane Austen's writing, as well as the expectations on her after her first novel was published. Bartlett examines the continuity between Austen's juvenilia and her later writing, particularly Sense and Sensibility. The first section is titled, "Books within Books", partly referring to Austen's juvenile writings—and how many of these very short “novels” were drawn together to achieve a long narrative such as Sense and Sensibility. Bartlett comments on how characters' stories in the novel are given ample space (another reference to “books within books”), particularly Mrs. Jennings. The next section is titled "Two Vulgar Women", where Bartlett examines the complexity with which Mrs. Jennings' character is depicted and developed—and contrasts her to Pride and Prejudice's Mrs. Bennet (and the style Austen uses to represent her). Bartlett explores Austen's writing: the capacity to retain a sympathetic sense of the existence of other people when not immediately confronted with them is of the highest importance to her. The final section is titled "The Vulgar Woman and the Lady: Two Matchmakers": a comparison between Mrs. Jennings and Emma, the vulgar woman and the born lady, both matchmakers. Bartlett explores how Mrs Jennings’ matchmaking is very different from Emma Woodhouse’s because it is founded in a realism about women’s aspirations, their opportunities and expectations. That is contrasted with Emma's selfish, ignorant, and unrealistic matchmaking. Finally, Bartlett comments on the end of Sense and Sensibility as it relates to Mrs. Jennings' matchmaking.
The Covid-19 lockdown in the United Kingdom and subjective well-being: Have the self-employed suffered more due to hours and income reductions?
Authors: Yue Wei , Cowling Marc
Published: January 2021

It is well documented that the self-employed experience higher levels of happiness than waged employees even when their incomes are lower. Given the UK government’s asymmetric treatment of waged workers and the self-employed, we use a unique Covid-19 period data set which covers the months leading up to the March lockdown and the months just after to assess three aspects of the Covid-19 crisis on the self-employed: hours of work reductions, the associated income reductions and the effects of both on subjective well-being. Our findings show the large and disproportionate reductions in hours and income for the self-employed directly contributed to a deterioration in their levels of subjective well-being compared to waged workers. It appears that their resilience was broken when faced with the reality of dealing with rare events, particularly when the UK welfare support response was asymmetric and favouring waged employees.
Using Analytics to Gain Insights on U.S. Prescription Drug Prices: An Inductive Analysis
Authors: Iacocca Kathleen , Vallen Beth
Published: January 2021

Using data scraping techniques to gather data from a variety of previously disjointed sources—some proprietary and some publicly available—this research applies the analytical techniques of data visualization and machine learning to (1) gain exploratory insights into the drivers of prescription drug list prices and (2) test how well these variables impact prices directly and interact to predict pricing. Specifically, this inductive analysis considers characteristics related to the brand (i.e., manufacturer, brand/generic classification), product attributes (i.e., dosing levels, amount of active ingredient), the condition for which the drug is recommended (i.e., therapeutic class, subclass, and pricing tier), and market factors (i.e., number of drugs in class and approval year). Through these analytic analyses, the authors seek to cut through some of the opacity of pharmaceutical drug list prices to consider the drivers of drug prices, evaluate how these insights might drive marketplace and policy solutions, and spark future research inquiries in this area.
Textures of Transaction: Exploring the Heterogeneity in Primary Teachers’ Engagements with Mathematics Textbooks in Delhi
Authors: Chowdhuri Meghna Nag
Published: January 2021

For more than a decade, government primary-school teachers in many parts of India have been using mathematics textbooks based on National Curriculum Framework 2005 (NCF 2005). While curriculum and textbook development is often debated, teachers’ use of textbooks does not receive enough attention in policy and research. This article, drawing from a multiple-case study of 10 teachers, using classroom observations and teacher interviews, explores different ways in which teachers use the Math-Magic mathematics textbook in Delhi’s government primary schools. The findings demonstrate heterogeneity in the ways in which teachers use textbooks, which are the dominant teaching resource in these schools. Teachers use different degrees of agency in textbook use—from avoiding the textbooks to designing their lessons. These are influenced by their views about the textbooks, as well as their institutional realities. Finally, this heterogeneity offers a useful approach to understanding textbooks, and their relevance to teaching beyond being viewed as teaching scripts.
Treatment considerations for foreign-born victims of human trafficking: Practical applications of an ecological framework
Authors: Salami’ Temilola , Gordon Mollie , Babu Jeeva , Coverdale John , Nguyen Phuong T.
Published: January 2021

Foreign-born individuals immigrating to or residing in the United States are especially vulnerable to exploitation by traffickers. Being trafficked elevates the risk for a variety of physical and mental health problems; thus, victims will often come into contact with health professionals. Because there is a dearth of literature concerning the treatment of human trafficking victims, and especially foreign-born victims, we set out to describe the practical applications of a model that we use for the mental health treatment of victimization in this population. As has been suggested by leaders in the anti-human trafficking community, we employed a culturally sensitive version of Bronfrenbrenner’s Ecological Systems Model to provide recommendations and educational resources for treatment at the individual, interpersonal, community, and societal levels. Our recommendations should serve to inform and improve the provision of care for foreign-born victims of human trafficking.
Five-Year Surveillance of Vitamin D Levels in NCAA Division I Football Players: Risk Factors for Failed Supplementation
Authors: Weber Alexander E. , Bolia Ioanna K. , Korber Shane , Mayfield Cory K. , Lindsay Adam , Rosen Jared , McMannes Sean , Romano Russ , Tibone James E. , Gamradt Seth C.
Published: January 2021

Background:

Monitoring vitamin D levels in athletes and determining their response to supplementation in cases of deficiency is thought to be necessary to modulate the risks associated with vitamin D deficiency.

Hypothesis/Purpose:

To report the results of a 5-year-long surveillance program of vitamin D in the serum of football players on a National Collegiate Athletic Association (NCAA) Division I team and to examine whether factors including age, body mass index (BMI), race, position played, and supplement type would affect the response to 12-month oral vitamin D replacement therapy in athletes with deficiency. We hypothesized that yearly measurements would decrease the proportion of athletes with vitamin D insufficiency over the years and that the aforementioned factors would affect the response to the supplementation therapy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We measured serum 25(OH)D levels (25-hydroxyvitamin D) in 272 NCAA Division I football players from our institution annually between 2012 and 2017. Athletes with insufficient vitamin D levels (<32 ng/mL) received supplementation with vitamin D3 alone or combined vitamin D3/D2. The percentage of insufficient cases between the first 2 years and last 2 years of the program was compared, and yearly team averages of vitamin D levels were calculated. Associations between player parameters (age, BMI, race, team position, supplement type) and failed supplementation were evaluated.

Results:

The prevalence of vitamin D insufficiency decreased significantly during the study period, from 55.5% in 2012-2013 to 30.7% in 2016-2017 ( P = .033). The mean 25(OH)D level in 2012 was 36.3 ng/mL, and this increased to 40.5 ng/mL in 2017 ( P < .001); however, this increase was not steady over the study period. Non-Hispanic athletes and quarterbacks had the highest average 25(OH)D levels, and Black players and running backs had the lowest overall levels. There were no significant differences in age, BMI, race, or playing position between athletes with and without failed vitamin D supplementation. Athletes receiving vitamin D3 alone had a more successful rate of conversion (48.15%) than those receiving combined vitamin D3/D2 (22.22%; P = .034).

Conclusion:

To decrease the prevalence of vitamin D deficiency in football players, serum vitamin D measurements should be performed at least once a year, and oral supplementation therapy should be provided in cases of deficiency. Black players might be at increased risk of vitamin D insufficiency. Oral vitamin D3 may be more effective in restoring vitamin D levels than combined vitamin D3/D2 therapy.
Comparing the hippocampal miRNA expression profiles of wild and domesticated Chinese tree shrews (Tupaia belangeri chinensis)
Authors: Lu Caixia , Li Mingxue , Sun Xiaomei , Li Na , Wang Wenguang , Tong Pinfen , Dai Jiejie
Published: January 2021

Background

The domestication of tree shrews represents an important advance in the development of standardized laboratory animals. Little is known regarding the miRNA changes that accompany the transformation of wild tree shrews into domestic tree shrews.

Results

By performing miRNA-seq analysis on wild and domestic tree shrews, we identified 2410 miRNAs and 30 differentially expressed miRNAs in the hippocampus during tree shrew domestication. A KEGG analysis of the differentially expressed genes showed that the differentially expressed miRNAs were associated with ECM-receptor interaction, the phosphatidylinositol signaling system, protein digestion and absorption, inositol phosphate metabolism, lysine degradation, fatty acid degradation and focal adhesion. Most of these pathways could be classified under environmental information processing, organismal systems and metabolism. The miRNAs exclusively expressed in wild and tame tree shrews GO enriched in terms of divergent functions. The miRNA-mRNA networks suggested that novel-m1388-5p and novel-m0746-5p might play regulatory roles in domestication of tree shrews. Real–time RT-PCR analysis was employed to verify the presence of these miRNAs.

Conclusion

We identified a number of candidate miRNA-regulated domestication genes that may represent targets for selection during the domestication of tree shrews.
Correction to: You don’t have the guts: a diverse set of fungi survive passage through Macrotermes bellicosus termite guts
Authors: Bos Nick , Guimaraes Leandro , Palenzuela Romen , Renelies-Hamilton Justinn , Maccario Lorrie , Silue Simon Kolotchèlèma , Koné N.’golo Abdoulaye , Poulsen Michael
Published: January 2021

An amendment to this paper has been published and can be accessed via the original article.
Cost-effectiveness of out-of-hospital continuous positive airway pressure for acute respiratory failure: decision analytic modelling using data from a feasibility trial
Authors: Thokala Praveen , Fuller Gordon W. , Goodacre Steve , Keating Samuel , Herbert Esther , Perkins Gavin D. , Rosser Andy , Gunson Imogen , Miller Joshua , Ward Matthew , Bradburn Mike , Harris Tim , Marsh Maggie , Ren Kate , Cooper Cindy
Published: January 2021

Background

Standard prehospital management for Acute respiratory failure (ARF) involves controlled oxygen therapy. Continuous positive airway pressure (CPAP) is a potentially beneficial alternative treatment, however, it is uncertain whether this could improve outcomes and provide value for money. This study aimed to evaluate the cost-effectiveness of prehospital CPAP in ARF.

Methods

A cost-utility economic evaluation was performed using a probabilistic decision tree model synthesising available evidence. The model consisted of a hypothetical cohort of patients in a representative ambulance service with undifferentiated ARF, receiving standard oxygen therapy or prehospital CPAP. Costs and quality adjusted life years (QALYs) were estimated using methods recommended by NICE.

Results

In the base case analysis, using CPAP effectiveness estimates form the ACUTE trial, the mean expected costs of standard care and prehospital CPAP were £15,201 and £14,850 respectively and the corresponding mean expected QALYs were 1.190 and 1.128, respectively. The mean ICER estimated as standard oxygen therapy compared to prehospital CPAP was £5685 per QALY which indicated that standard oxygen therapy strategy was likely to be cost-effective at a threshold of £20,000 per QALY (67% probability). The scenario analysis, using effectiveness estimates from an updated meta-analysis, suggested that prehospital CPAP was more effective (mean incremental QALYs of 0.157), but also more expensive (mean incremental costs of £1522), than standard care. The mean ICER, estimated as prehospital CPAP compared to standard care, was £9712 per QALY. At the £20,000 per QALY prehospital CPAP was highly likely to be the most cost-effective strategy (94%).

Conclusions

Cost-effectiveness of prehospital CPAP depends upon the estimate of effectiveness. When based on a small pragmatic feasibility trial, standard oxygen therapy is cost-effective. When based on meta-analysis of heterogeneous trials, CPAP is cost-effective. Value of information analyses support commissioning of a large pragmatic effectiveness trial, providing feasibility and plausibility conditions are met.
Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography
Authors: Lu Chunyu , Tang Shaoshan , Zhang Xiaoyue , Wang Yang , Wang Kaiming , Shen Peng
Published: January 2021

Background

To summarize the characteristics of solitary necrotic nodules (SNN) in the liver observed under contrast-enhanced ultrasonography (CEUS).

Methods

Conventional ultrasonography (US) and CEUS were performed in 24 patients who were confirmed to have SNN by pathological assessment. The US data and dynamic enhancement patterns of CEUS were recorded and retrospectively analyzed.

Results

Ten of 24 patients underwent surgical resection, while the other 14 patients underwent a puncture biopsy to be confirmed as SNN. Among the 24 patients, 13 patients had a single lesion and 11 patients had multiple lesions. The largest lesion was selected for CEUS examination for patients with multiple lesions. Eleven patients presented no enhancement in all three phases, while the other 13 patients presented with a peripheral thin rim-like enhancement in the arterial phase, an iso-enhancement in the portal phase and delayed phase. However, no enhancement in the interior of the lesions was detected during three phases of CEUS.

Conclusions

SNN has characteristic findings on the CEUS, which play an important role in the differential diagnoses of liver focal lesions.
Prediction model study of overweight and obesity in preschool children with allergic diseases from an ecological perspective
Authors: Han Jeong-Won , Kim Da-Jung
Published: January 2021

Background

Allergic diseases have a high incidence in childhood and a high chance to be carried over into adulthood unless appropriately treated during childhood, it is important that healthcare providers actively manage these diseases. This study was to identify multidimensional factors that affect weight gain in preschool children with allergic diseases.

Methods

The overweight and obesity prediction model for children with allergic diseases was analyzed using multiple logistic regression analysis and a decision tree model and the present study was a secondary data analysis study that used data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education.

Results

The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases, which found that children (gender, sitting time during weekdays, sleeping hours during weekends,), parent (education level, mother’s job, quality of the home environment), local community (convenience of local community facilities, satisfaction level with local community facilities, quality of childcare in the local community) characteristics affected overweight and obesity at multidimensional levels as risk factors.

Conclusions

The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases using the data of the Panel Study on Korean Children, which found that children, parent, local community characteristics affected overweight and obesity at multidimensional levels as risk factors.
Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar – a qualitative investigation
Authors: Lakin Daniel P. , Win Kyaw Soe , Aung Htin , Soe Khin Nyein Chan , Kyi Bo , Marcell Arik V. , Tol Wietse A. , Bass Judith K.
Published: January 2021

Background

Men living in low- and middle-income countries are unlikely to seek mental health care, where poor healthcare infrastructure, differences in illness conceptualization, and stigma can impact treatment seeking. Vulnerable groups, such as former political prisoners, are more likely than others to experience potentially traumatic events that may lead to negative mental health outcomes. To improve the likelihood of successful engagement of vulnerable men in psychotherapy, it is necessary to identify factors that influence treatment adherence, and to better understand men’s attitudes surrounding decisions to seek and initiate care. The purpose of this investigation was to explore themes of masculinity, treatment seeking, and differences between male former political prisoners who accepted and declined therapy in an urban low-income context.

Methods

We conducted a qualitative, interview-based investigation with 30 former political prisoners in Yangon, Myanmar who were eligible to receive mental health counseling provided by the non-governmental organization (NGO), Assistance Association for Political Prisoners. Men were initially screened using a composite questionnaire with items related to depression, anxiety, and posttraumatic stress symptom severity. After screening, if potential clients were identified as having probable mental health problems, they were asked if they would like to participate in a multi-session cognitive behavioral therapy program. Semi-structured, open-ended interviews were conducted with 15 participants who accepted and 15 participants who declined therapy. Interviews were transcribed and translated by local partners and thematically coded by the authors. We used thematic analysis to identify and explore differences in treatment-seeking attitudes between men who accepted and men who declined the intervention.

Results

Men described that being a community leader, self-reliance, morality, and honesty were defining characteristics of masculinity. A focus on self-correction often led to declining psychotherapy. A general lack of familiarity with psychological therapy and how it differed from locally available treatments (e.g. astrologists) was connected to stigma regarding mental health treatment.

Conclusions

Masculinity was described in similar terms by both groups of participants. The interpretation of masculine qualities within the context of help-seeking (e.g. self-reliance as refusing help from others versus listening to others and applying that guidance) was a driving factor behind men’s decision to enter psychotherapy.
One‐level mini‐open pedicle subtraction osteotomy for treating spinal kyphosis in patients with ankylosing spondylitis
Authors: Wang Yu , Li Chunde , Liu Long , Qi Longtao
Published: January 2021

Background

To report a mini-open pedicle subtraction osteotomy (PSO) technique, to summarize the 2-year follow-up results of 25 patients, and to describe a modified operating table which allows the osteotomy to be closed in a more controllable manner.

Methods

We retrospectively reviewed the records of patients with AS who received one-level mini-open PSO between July 2015 and January 2018. The 25 patients with complete medical records and 2-year radiographic follow-up were included in the analysis. Estimated blood loss, operation time, incision length, complications, bed rest period, and length of hospitalization were extracted from the medical records and recorded.

Results

The mean age of the 25 patients (22 males and 3 females) was 39.5 years. The average global kyphosis(GK) decreased from 70.2° before surgery to 22.3° after surgery; the average C7- sagittal vertical axis (C7-SVA) decreased from 15.5 cm before surgery to 5.1 cm after surgery; the average pelvic incidence(PT) decreased from 37.8° before surgery to 22.5° after surgery. The average length of the incision was 10.2 cm. The average surgical time was 263.0 min, the average estimated blood loss was 840.0 ml, and the average time to mobilization was 4.1 days.

Conclusions

The current report shows that one-level PSO can be performed through an incision of about 10 cm. The one-level mini-open PSO could be superior to traditional PSO surgery with respect to cosmetic outcomes. Further comparative studies are necessary to evaluate the current and conventional techniques.
A network pharmacology perspective for deciphering potential mechanisms of action of Solanum nigrum L. in bladder cancer
Authors: Dong Yang , Hao Lin , Fang Kun , Han Xiao-xiao , Yu Hui , Zhang Jian-jun , Cai Long-jun , Fan Tao , Zhang Wen-da , Pang Kun , Ma Wei-ming , Wang Xi-tao , Han Cong-hui
Published: January 2021

Background

Solanum nigrum L. decoction has been used as a folklore medicine in China to prevent the postoperative recurrence of bladder cancer (BC). However, there are no previous pharmacological studies on the protective mechanisms of this activity of the plant. Thus, this study aimed to perform a systematic analysis and to predict the potential action mechanisms underlying S. nigrum activity in BC based on network pharmacology.

Methods

Based on network pharmacology, the active ingredients of S. nigrum and the corresponding targets were identified using the Traditional Chinese Medicines for Systems Pharmacology Database and Analysis Platform database, and BC-related genes were screened using GeneCards and the Online Mendelian Inheritance in Man database. In addition, ingredient-target (I–T) and protein–protein interaction (PPI) networks were constructed using STRING and Cytoscape, Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted, and then the pathways directly related to BC were integrated manually to reveal the pharmacological mechanism underlying S. nigrum-medicated therapeutic effects in BC.

Results

Seven active herbal ingredients from 39 components of S. nigrum were identified, which shared 77 common target genes related to BC. I-T network analysis revealed that quercetin was associated with all targets and that NCOA2 was targeted by four ingredients. Besides, interleukin 6 had the highest degree value in the PPI network, indicating a hub role. A subsequent gene enrichment analysis yielded 86 significant GO terms and 89 significant pathways, implying that S. nigrum had therapeutic benefits in BC through multi-pathway effects, including the HIF-1, TNF, P53, MAPK, PI3K/Akt, apoptosis and bladder cancer pathway.

Conclusions

S. nigrum may mediate pharmacological effects in BC through multi-target and various signaling pathways. Further validation is required experimentally. Network pharmacology approach provides a predicative novel strategy to reveal the holistic mechanism of action of herbs.
Fetal birthweight prediction with measured data by a temporal machine learning method
Authors: Tao Jing , Yuan Zhenming , Sun Li , Yu Kai , Zhang Zhifen
Published: January 2021

Background

Birthweight is an important indicator during the fetal development process to protect the maternal and infant safety. However, birthweight is difficult to be directly measured, and is usually roughly estimated by the empirical formulas according to the experience of the doctors in clinical practice.

Methods

This study attempts to combine multiple electronic medical records with the B-ultrasonic examination of pregnant women to construct a hybrid birth weight predicting classifier based on long short-term memory (LSTM) networks. The clinical data were collected from 5,759 Chinese pregnant women who have given birth, with more than 57,000 obstetric electronic medical records. We evaluated the prediction by the mean relative error (MRE) and the accuracy rate of different machine learning classifiers at different predicting periods for first delivery and multiple deliveries. Additionally, we evaluated the classification accuracies of different classifiers respectively for the Small-for-Gestational-age (SGA), Large-for-Gestational-Age (LGA) and Appropriate-for-Gestational-Age (AGA) groups.

Results

The results show that the accuracy rate of the prediction model using Convolutional Neuron Networks (CNN), Random Forest (RF), Linear-Regression, Support Vector Regression (SVR), Back Propagation Neural Network(BPNN), and the proposed hybrid-LSTM at the 40th pregnancy week for first delivery were 0.498, 0.662, 0.670, 0.680, 0.705 and 0.793, respectively. Among the groups of less than 39th pregnancy week, the 39th pregnancy week and more than 40th week, the hybrid-LSTM model obtained the best accuracy and almost the least MRE compared with those of machine learning models. Not surprisingly, all the machine learning models performed better than the empirical formula. In the SGA, LGA and AGA group experiments, the average accuracy by the empirical formula, logistic regression (LR), BPNN, CNN, RF and Hybrid-LSTM were 0.780, 0.855, 0.890, 0.906, 0.916 and 0.933, respectively.

Conclusions

The results of this study are helpful for the birthweight prediction and development of guidelines for clinical delivery treatments. It is also useful for the implementation of a decision support system using the temporal machine learning prediction model, as it can assist the clinicians to make correct decisions during the obstetric examinations and remind pregnant women to manage their weight.
C3 glomerulonephritis along with light chain proximal tubulopathy without crystal deposits in multiple myeloma: a case report
Authors: Xu Junhui , Yu Xiaojuan , Wang Suxia , Yan Miao , Wang Mangju , Ou Jinping , Wang Lihong , Liu Huihui , Cen Xinan
Published: January 2021

Background

Multiple myeloma causes different types of renal injury. C3 glomerulonephritis (C3GN) is characterised by an abnormal deposition of complement C3 in the glomeruli due to abnormal activation of the alternative pathway of the complement system. While the association between C3GN and multiple myeloma has been well established, mild renal injury by C3GN in multiple myeloma patients with high levels of light chain has not been reported.

Case presentation

A 55-year-old Chinese man presented with proteinuria. Combined with immunofixation electrophoresis, bone marrow biopsy, and renal biopsy, he was diagnosed with IgA-type multiple myeloma accompanied by C3GN and light chain proximal tubulopathy without crystal deposits. Although he had a higher level of lambda serum-free light chain, the renal injury in this patient was mild. After treatment with four courses of BD, one course of PAD, and autologous stem cell transplantation, he achieved a very good partial hematologic response with stable renal function.

Conclusions

In multiple myeloma, the light chain reaches a certain level and persists, resulting in C3GN renal impairment. Early diagnosis and early intensive treatment are critical for the prognosis of such patients.
Efficacy and safety of berberine for dyslipidemia: study protocol for a randomized double-blind placebo-controlled trial
Authors: Zhao Ying , Yang Yuan-Yuan , Yang Bao-Lin , Du Ya-Wei , Ren Da-Wei , Zhou Hong-Mei , Wang Jing , Yang Hui-Min , Wang Yao-Xian , Zhang Ying-Ying , Wu Sheng-Xian
Published: January 2021

Background

Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease and a leading cause of death worldwide. The clinical utility of commonly used lipid-lowering drugs such as statins and fibrates is sometimes limited by the occurrence of various adverse reactions. Recently, berberine (BBR) has received increasing attention as a safer and more cost-effective option to manage dyslipidemia. Thus, a high-quality randomized controlled trial to evaluate the efficacy and safety of BBR in the treatment of dyslipidemia is deemed necessary.

Methods/design

This is a randomized, double-blind, and placebo-controlled clinical trial. A total of 118 patients with dyslipidemia will be enrolled in this study and randomized into two groups at a ratio of 1:1. BBR or placebo will be taken orally for 12 weeks. The primary outcome is the percentage of low-density lipoprotein cholesterol reduction at week 12. Other outcome measures include changes in other lipid profiles, high sensitivity C-reactive protein, blood pressure, body weight, Bristol Stool Chart, traditional Chinese medicine symptom form, adipokine profiles, and metagenomics of intestinal microbiota. Safety assessment includes general physical examination, blood and urine routine test, liver and kidney function test, and adverse events.

Discussion

This trial may provide high-quality evidence on the efficacy and safety of BBR for dyslipidemia. Importantly, the findings of this trial will help to identify patient and disease characteristics that may predict favorable outcomes of treatment with BBR and optimize its indication for clinical use.

Trial registration

Chinese Clinical Trial Registry ChiCTR1900021361. Registered on 17 February 2019.
Volatile concentrate from the neotropical moss Neckeropsis undulata (Hedw.) Reichardt, existing in the brazilian Amazon
Authors: Miranda Thyago G. , Alves Raynon Joel M. , de Souza Ronilson F. , Maia José Guilherme S. , Figueiredo Pablo Luis B. , Tavares-Martins Ana Cláudia C.
Published: January 2021

Background

Many natural compounds have been identified and synthesized by the advancement of bryophytes phytochemistry studies. This work aimed to report the composition of Neckeropsis undulata (Hedw.) Reichardt moss volatiles, sampled in the Combú Island, Belém city, Pará state, Brazil. The volatile concentrate of N. undulata was obtained by a simultaneous distillation-extraction micro-system, analyzed by GC and GC-MS, and reported for the first time.

Results

Ten compounds were identified in the volatile concentrate, corresponding to 91.6% of the total, being 1-octen-3-ol (35.7%), α-muurolol (21.4%), naphthalene (11.3%), and n-hexanal (10.0 %) the main constituents. Most of the constituents of the N. undulata volatile concentrate have been previously identified in other mosses, and liverworts spread wide in the world.

Conclusions

1-Octen-3-ol, n-hexanal, 2-ethylhexanol, isoamyl propionate, and octan-3-one are already known metabolic products obtained from enzymatic oxidation of polyunsaturated fatty acids, belonging to the large family of minor oxygenated compounds known as oxylipins. The knowledge of the composition of volatiles from moss N. undulata could contribute to the Neckeraceae species’ chemotaxonomy.
CAMK2N1/RUNX3 methylation is an independent prognostic biomarker for progression-free and overall survival of platinum-sensitive epithelial ovarian cancer patients
Authors: Heinze Karolin , Rengsberger Matthias , Gajda Mieczyslaw , Jansen Lars , Osmers Linea , Oliveira-Ferrer Leticia , Schmalfeldt Barbara , Dürst Matthias , Häfner Norman , Runnebaum Ingo B.
Published: January 2021

Background

To date, no predictive or prognostic molecular biomarkers except BRCA mutations are clinically established for epithelial ovarian cancer (EOC) despite being the deadliest gynecological malignancy. Aim of this biomarker study was the analysis of DNA methylation biomarkers for their prognostic value independent from clinical variables in a heterogeneous cohort of 203 EOC patients from two university medical centers.

Results

The marker combination CAMK2N1/RUNX3 exhibited a significant prognostic value for progression-free (PFS) and overall survival (OS) of sporadic platinum-sensitive EOC (n = 188) both in univariate Kaplan–Meier (LogRank p < 0.05) and multivariate Cox regression analysis (p < 0.05; hazard ratio HR = 1.587). KRT86 methylation showed a prognostic value only in univariate analysis because of an association with FIGO staging (Fisher’s exact test p < 0.01). Thus, it may represent a marker for EOC staging. Dichotomous prognostic values were observed for KATNAL2 methylation depending on BRCA aberrations. KATNAL2 methylation exhibited a negative prognostic value for PFS in sporadic EOC patients without BRCA1 methylation (HR 1.591, p = 0.012) but positive prognostic value in sporadic EOC with BRCA1 methylation (HR 0.332, p = 0.04) or BRCA-mutated EOC (HR 0.620, n.s.).

Conclusion

The retrospective analysis of 188 sporadic platinum-sensitive EOC proved an independent prognostic value of the methylation marker combination CAMK2N1/RUNX3 for PFS and OS. If validated prospectively this combination may identify EOC patients with worse prognosis after standard therapy potentially benefiting from intensive follow-up, maintenance therapies or inclusion in therapeutic studies. The dichotomous prognostic value of KATNAL2 should be validated in larger sample sets of EOC.
CAR T cells in solid tumors: challenges and opportunities
Authors: Marofi Faroogh , Motavalli Roza , Safonov Vladimir A. , Thangavelu Lakshmi , Yumashev Alexei Valerievich , Alexander Markov , Shomali Navid , Chartrand Max Stanley , Pathak Yashwant , Jarahian Mostafa , Izadi Sepideh , Hassanzadeh Ali , Shirafkan Naghmeh , Tahmasebi Safa , Khiavi Farhad Motavalli
Published: January 2021

Background

CARs are simulated receptors containing an extracellular single-chain variable fragment (scFv), a transmembrane domain, as well as an intracellular region of immunoreceptor tyrosine-based activation motifs (ITAMs) in association with a co-stimulatory signal.

Main body

Chimeric antigen receptor (CAR) T cells are genetically engineered T cells to express a receptor for the recognition of the particular surface marker that has given rise to advances in the treatment of blood disorders. The CAR T cells obtain supra-physiological properties and conduct as “living drugs” presenting both immediate and steady effects after expression in T cells surface. But, their efficacy in solid tumor treatment has not yet been supported. The pivotal challenges in the field of solid tumor CAR T cell therapy can be summarized in three major parts: recognition, trafficking, and surviving in the tumor. On the other hand, the immunosuppressive tumor microenvironment (TME) interferes with T cell activity in terms of differentiation and exhaustion, and as a result of the combined use of CARs and checkpoint blockade, as well as the suppression of other inhibitor factors in the microenvironment, very promising results were obtained from the reduction of T cell exhaustion.

Conclusion

Nowadays, identifying and defeating the mechanisms associated with CAR T cell dysfunction is crucial to establish CAR T cells that can proliferate and lyse tumor cells severely. In this review, we discuss the CAR signaling and efficacy T in solid tumors and evaluate the most significant barriers in this process and describe the most novel therapeutic methods aiming to the acquirement of the promising therapeutic outcome in non-hematologic malignancies.