bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach
Authors: Zhao Chen , Luo Lei , Liu Liehua , Li Pei , Liang Lichuan , Gao Yongjian , Luo Fei , Xu Jianzhong , Zhou Qiang
Published: August 2020

Purpose

To compare the efficacy, safety, and technical characteristics of anterior-only and posterior-only approach surgeries for the treatment of consecutive multisegment thoracic and lumbar tuberculosis.

Methods

Thirty-five patients who developed consecutive multisegment thoracic and lumbar tuberculosis from September 2012 to May 2016 were retrospectively analyzed. Group A was the posterior-only surgery group, and group B was the anterior-only surgery group. The data on the surgery, deformity correction, functional scores, and complications were compared between the two groups.

Results

There was no significant difference in the operation time or blood loss between groups A and B (P > 0.05). The preoperative average Cobb angle of kyphosis in groups A and B were 36.2 ± 15.2° and 27.9 ± 7.7°, respectively, which significantly decreased to 4.9 ± 11.8° and 10.4 ± 5.6° after the operation, respectively (P < 0.05). At the final follow-up, the angles were 7.1 ± 10.5° and 14.6 ± 8.0°. The correction angle and correction rate in group A (31.3 ± 16.6°, 88.6 ± 43.6%) were greater than those in group B (17.5 ± 4.4°, 64.9 ± 14.0%) (P < 0.05). There was no significant difference in the loss angle between groups A and B (P > 0.05), but the loss rate in group B (24.0 ± 27.8%) was higher than that in group A (9.6 ± 10.2%) (P < 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05).

Conclusion

The posterior-only and anterior-only approaches can lead to satisfactory clinical results in the treatment of patients with consecutive multisegment thoracic and lumbar tuberculosis. With posterior-only surgery, kyphosis can be better corrected, and the correction can be better maintained than with anterior-only surgery.
An evaluation of a mental health literacy course for Arabic speaking religious and community leaders in Australia: effects on posttraumatic stress disorder related knowledge, attitudes and help-seeking
Authors: Slewa-Younan Shameran , Guajardo Maria Gabriela Uribe , Mohammad Yaser , Lim Henry , Martinez Gabriela , Saleh Randa , Sapucci Michele
Published: August 2020

Background

Australia is an ethnically diverse nation with one of the largest refugee resettlement programs worldwide, including high numbers of refugees with an Arabic speaking background. Evidence suggests that refugees can demonstrate high levels of psychological distress and are at a higher risk of developing mental illness such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Notwithstanding, research has also shown Arabic speaking refugees have lower levels of professional help-seeking behaviours, postulated to be related to mental health literacy levels.

Methods

A culturally sensitive mental health literacy (MHL) training program was developed and delivered in Arabic to Arabic speaking religious and community leaders using a 1-day training workshop format. An uncontrolled pre-, and post study design was used to provide a preliminary evaluation of improvement in PTSD-related knowledge, attitudes and help-seeking measures.

Results

A total of 54 adults were trained, with 52 completing the pre- and post-intervention questionnaire. Significant differences were found post-training in measures such as the ability to recognise mental health problems (p = 0.035) and an increased recognition of the role that medication can play in the treatment of PTSD (p = 0.00). Further, an improvement in negative attitudes such as a desire for social distance (p = 0.042) was noted and participants reported more helpful strategies in line with promoting professional help-seeking following training (p = 0.032).

Conclusion

Our findings indicated the training led to an improvement of some measures of MHL. To the best of our knowledge, this is the first time that the MHL program has been tailored for Arabic speaking religious and community leaders; who assist refugees with an Arabic background. By equipping community leaders with the knowledge to better respond to mental health problems, the overall goal of improving the mental health outcomes of Arabic speaking refugee communities is closer to being realised.
Prehospital management of burns requiring specialized burn centre evaluation: a single physician-based emergency medical service experience
Authors: Maudet Ludovic , Pasquier Mathieu , Pantet Olivier , Albrecht Roland , Carron Pierre-Nicolas
Published: August 2020

Background

Emergency medical services regularly encounter severe burns. As standards of care are relatively well-established regarding their hospital management, prehospital care is comparatively poorly defined. The aim of this study was to describe burned patients taken care of by our physician-staffed emergency medical service (PEMS).

Methods

All patients directly transported by our PEMS to our burn centre between January 2008 and December 2017 were retrospectively enrolled. We specifically addressed three “burn-related” variables: prehospital and hospital burn size estimations, type and volume of infusion and pain assessment and management. We divided patients into two groups for comparison: TBSA < 20% and ≥ 20%. We a priori defined clinically acceptable limits of agreement in the small and large burn group to be ±5% and ± 10%, respectively.

Results

We included 86 patients whose median age was 26 years (IQR 12–51). The median prehospital TBSA was 10% (IQR 6–25). The difference between the prehospital and hospital TBSA estimations was outside the limits of agreement at 6.2%. The limits of agreement found in the small and large burn groups were − 5.3, 4.4 and − 10.1, 11, respectively. Crystalloid infusion was reported at a median volume of 0.8 ml/kg/TBSA (IQR 0.3–1.4) during the prehospital phase, which extrapolated over the first 8 h would equal to a median volume of 10.5 ml/kg/TBSA. The median verbal numeric rating scale on scene was 6 (IQR 3–8) and 3 (IQR 2–5) at the hospital (p < 0.001). Systemic analgesia was provided to 61 (71%) patients, predominantly with fentanyl (n = 59; 69%), followed by ketamine (n = 7; 8.1%). The median doses of fentanyl and ketamine were 1.7 mcg/kg (IQR 1–2.6) and 2.1 mg/kg (IQR 0.3–3.2), respectively.

Conclusions

We found good agreement in burn size estimations. The quantity of crystalloid infused was higher than the recommended amount, suggesting a potential risk for fluid overload. Most patients benefited from a correct systemic analgesia. These results emphasized the need for dedicated guidelines and decision support aids for the prehospital management of burned patients.
Incidence and outcomes of acute respiratory distress syndrome in intensive care units of mainland China: a multicentre prospective longitudinal study
Authors: Huang Xu , Zhang Ruoyang , Fan Guohui , Wu Dawei , Lu Haining , Wang Daoxin , Deng Wang , Sun Tongwen , Xing Lihua , Liu Shaohua , Wang Shilei , Cai Ying , Tian Ye , Zhang Yi , Xia Jingen , Zhan Qingyuan ,   the CHARDSnet group, Xie Lixin , Wang Ying , Weng Li , Zhu Guangfa , Liu Yan , Song Man , Zhao Yanming , Chen Jing , Zhao Hongwen , Hou Haijia , Yang Jingping , Wu Rina , Xu Xiyuan , Yan Xixin , Xu Haibo , Wu Dawei , Lu Haining , Sun Gengyun , Zhang Dan , Zhao Beilei , Pan Binhai , Liu Jialin , Tan Ruoming , Pan Pinhua , Lu Rongli , Luo Hong , Zhang Han , Wang Daoxin , Deng Wang , Chen Yusheng , Lu Fengfeng , Xu Sicheng , Luo Xia , Teng Hong , Chen Lijuan , Xing Lihua , Wang Shilei , Sun Tongwen , Liu Shaohua , Han Bing , Li Yunlu
Published: August 2020

Objectives

To evaluate the incidence and mortality of acute respiratory distress syndrome (ARDS) in medical/respiratory intensive care units (MICUs/RICUs) to assess ventilation management and the use of adjunct therapy in routine clinical practice for patients fulfilling the Berlin definition of ARDS in mainland China.

Methods

This was a multicentre prospective longitudinal study. Patients who met the Berlin definition of ARDS were included. Baseline data and data on ventilator management and the use of adjunct therapy were collected.

Results

Of the 18,793 patients admitted to participating ICUs during the study timeframe, 672 patients fulfilled the Berlin ARDS criteria and 527 patients were included in the analysis. The most common predisposing factor for ARDS in 402 (77.0) patients was pneumonia. The prevalence rates were 9.7% (51/527) for mild ARDS, 47.4% (250/527) for moderate ARDS, and 42.9% (226/527) for severe ARDS. In total, 400 (75.9%) patients were managed with invasive mechanical ventilation during their ICU stays. All ARDS patients received a tidal volume of 6.8 (5.8–7.9) mL/kg of their predicted body weight and a positive end-expository pressure (PEEP) of 8 (6–12) cmH2O. Recruitment manoeuvres (RMs) and prone positioning were used in 61 (15.3%) and 85 (16.1%) ventilated patients, respectively. Life-sustaining care was withdrawn from 92 (17.5%) patients. When these patients were included in the mortality analysis, 244 (46.3%) ARDS patients (16 (31.4%) with mild ARDS, 101 (40.4%) with moderate ARDS, and 127 (56.2%) with severe ARDS) died in the hospital.

Conclusions

Among the 18 ICUs in mainland China, the incidence of ARDS was low. The rates of mortality and withdrawal of life-sustaining care were high. The recommended lung protective strategy was followed with a high degree of compliance, but the implementation of adjunct treatment was lacking. These findings indicate the potential for improvement in the management of patients with ARDS in China.

Trial registration

Clinicaltrials.gov NCT02975908. Registered on 29 November 2016—retrospectively registered.
Effect of albumin administration on outcomes in hypoalbuminemic patients hospitalized with community-acquired pneumonia (ALBUCAP): a prospective, randomized, phase III clinical controlled trial—a trial protocol
Authors: Rombauts Alexander , Abelenda-Alonso Gabriela , Simonetti Antonella Francesca , Verdejo Guillermo , Meije Yolanda , Ortega Lucia , Clemente Mercedes , Niubó Jordi , Ruiz Yolanda , Gudiol Carlota , Tebé Cristian , Videla Sebastian , Carratalà Jordi
Published: August 2020

Background

Community-acquired pneumonia (CAP) remains a leading cause of death worldwide, and hypoalbuminemia is associated with worse outcomes. However, it remains uncertain whether albumin administration could have any beneficial effects. We aim to assess whether the administration of albumin in hypoalbuminemic patients with CAP increases the proportion of clinically stable patients at day 5 compared with the standard of care alone.

Methods

This is a trial protocol for a superiority, non-blinded, multicenter, randomized, phase 3, interventional controlled clinical trial. The primary endpoint will be the proportion of clinical stable patients at day 5 (intention to treat), defined as those with stable vital signs for at least 24 h. The secondary endpoints will be time to clinical stability, duration of intravenous and total antibiotic treatment, length of hospital stay, intensive care unit admission, duration of mechanical ventilation and vasopressor treatment, adverse events, readmission within 30 days, and all-cause mortality. The trial has been approved by the Spanish Medicines and Healthcare Products Regulatory Agency. The investigators commit to publish the data in peer-reviewed journals within a year of the study completion date. Subjects will be recruited from three Spanish hospitals over a planned enrolment period of 2 years. A follow-up visit will be performed 1 month after discharge. We have estimated the need for a sample size of 360 patients at a two-sided 5% alpha-level with a power of 80% based on intention to treat. Eligible participants must be hospitalized, hypoalbuminemic (≤ 30 g/L), non-immunosuppressed, adults, and diagnosed with CAP. They will be randomly assigned (1:1) to receive standard care plus albumin (20 g in 100 mL) every 12 h for 4 days or standard care alone.

Discussion

If this randomized trial confirms the hypothesis, it should lead to a change in current clinical practice for the management of hypoalbuminemic patients with CAP.

Trial registration

European Clinical Trials Database (EudraCT) 2018-003117-18. Registered on 12 April 2019. ClinicalTrials.gov NCT04071041. Registered on 27 August 2019
The effect of ear acupressure (auriculotherapy) on sexual function of lactating women: protocol of a randomized sham controlled trial
Authors: Barghamadi Sanaz , Alimoardi Zainab , Oleson Terry , Bahrami Nasim
Published: August 2020

Background

Lactation has a negative effect on female sexual function. Hormonal changes during lactation cause changes which might lead to dyspareunia, lack of libido, and anorgasmia. There are various pharmacological and non-pharmacological approaches to treat sexual dysfunction. While pharmacological treatment has multiple unwanted side effects, non-pharmacological therapies such as complementary medicine are a potential safer alternative. The aim of this study is to evaluate the effect of ear acupressure on sexual function of lactating women.

Methods/design

This is a randomized clinical trial with a parallel sham control group. In this study, 76 lactating women between 6 months and 1 year after childbirth were referred to health care centers in Qazvin City and would be invited to participate. Participants will be divided into intervention (n = 38) and control (n = 38) groups using simple block randomization. Both intervention and sham control groups will be visited over 10 sessions within a 4-day interval. At each visit, the adhesives containing Vaccaria seed will be adhered for the intervention group, while non-latex-based adhesives with no Vaccaria seeds will be placed on the same ear acupoints for the sham control group. Selected ear acupoints include genitalia (two ear points), pelvic point, master shoulder, and posterior pituitary gland. The women will be asked to hold the seeds on their ears for 3 days and press each ear point three times a day for 20 s. After 3 days, they will be asked to remove the seeds from their ears and rest for 1 day. Sexual function as primary outcome in both groups will be assessed using the Female Sexual Function Index before and immediately after 1 and 2 months after the intervention. Also, Sexual Quality of Life as secondary outcome will be assessed using Sexual Quality of Life-Female (SQOL-F) before and 2 months after intervention. Data will be analyzed using repeated measure ANOVA at the significant level of 0.05.

Discussion

This study is expected to support the impact of ear channel ear acupressure on sexual function in lactating women.

Trial registration

Iranian Clinical Trial Registration Center IRCT20190626044028N1. Registered on 16 August 2019
Circulating histone signature of human lean metabolic-associated fatty liver disease (MAFLD)
Authors: Buzova Diana , Maugeri Andrea , Liguori Antonio , Napodano Cecilia , Lo Re Oriana , Oben Jude , Alisi Anna , Gasbarrini Antonio , Grieco Antonio , Cerveny Jan , Miele Luca , Vinciguerra Manlio
Published: August 2020

Background

Although metabolic associate fatty liver disease (MAFLD) is associated with obesity, it can also occur in lean patients. MAFLD is more aggressive in lean patients compared to obese patients, with a higher risk of mortality. Specific biomarkers to diagnose differentially lean or overweight MAFLD are missing. Histones and nucleosomes are released in the bloodstream upon cell death. Here, we propose a new, fast, imaging and epigenetics based approach to investigate the severity of steatosis in lean MAFLD patients.

Results

A total of 53 non-obese patients with histologically confirmed diagnosis of MAFLD were recruited. Twenty patients displayed steatosis grade 1 (0–33%), 24 patients with steatosis grade 2 (34–66%) and 9 patients with steatosis grade 3 (67–100%). The levels of circulating nucleosomes were assayed using enzyme-linked immunosorbent assay, while individual histones or histone dimers were assayed in serum samples by means of a new advanced flow cytometry ImageStream(X)-adapted method. Circulating nucleosome levels associated poorly with MAFLD in the absence of obesity. We implemented successfully a multi-channel flow methodology on ImageStream(X), to image single histone staining (H2A, H2B, H3, H4, macroH2A1.1 and macroH2A1.2). We report here a significant depletion of the levels of histone variants macroH2A1.1 and macroH2A1.2 in the serum of lean MAFLD patients, either individually or in complex with H2B.

Conclusions

In summary, we identified a new circulating histone signature able to discriminate the severity of steatosis in individuals with lean MAFLD, using a rapid and non-invasive ImageStream(X)-based imaging technology.
The diagnostic quandary of magnetic resonance imaging-negative Hirayama disease: a case report
Authors: Ojha Rajeev , Shahi Sumit , Nepal Gaurav , Shakya Arjana , Gajurel Bikram Prasad , Karn Ragesh , Rajbhandari Reema , Gautam Niraj
Published: August 2020

Background

Magnetic resonance imaging (MRI) features are typical findings in Hirayama disease (HD) and are useful diagnostic entities but may not be present in all patients.

Case presentation

We present the case of a 22-year-old Nepalese man who presented with insidious onset of weakness of his right upper limb of more than 5 years duration. His weakness was progressive for the first 3 years, and then remained static. On examination, weakness of the interossei, thenar, hypothenar, flexor, and extensor muscles were present in his right upper limb, power was normal in his left upper and bilateral lower limbs. Minipolymyoclonus was present in both upper limbs, less prominent on the left side. Electrophysiological findings showed motor axonal neuropathy in his right upper limb, neurogenic discharges and fibrillations, and fasciculations in both upper limbs. Contrast magnetic resonance imaging (MRI) of his cervical spine in flexion was normal. Our patient was diagnosed with HD based on clinical and electrophysiological findings. Our patient was advised to use a cervical collar and regular physiotherapy and was found to have subjective benefit.

Conclusion

A normal cervical MRI does not rule out HD and the diagnosis can also be made based on clinical and electrophysiological studies. Progressive distal upper limb weakness or tremor in young patients should be evaluated for HD, because early diagnosis and intervention might halt the progression.
Generation of a recombinant chickenized monoclonal antibody against the neuraminidase of H9N2 avian influenza virus
Authors: Wang Fei , Wang Yajuan , Wan Zhimin , Shao Hongxia , Qian Kun , Ye Jianqiang , Qin Aijian
Published: August 2020

We previously reported a monoclonal antibody (mAb), 1G8, against the neuraminidase (NA) of H9N2 avian influenza virus (AIV) with significant NA inhibitory activity. To generate a recombinant chickenized mAb (RCmAb) against the NA of H9N2 AIV for passive immunization in poultry, the gene of the fragment of antigen binding (Fab) of mAb 1G8 was cloned and fused with the fragment crystallizable (Fc) gene of chicken IgY. The RCmAb 1G8 was expressed in COS-1 cells and could be detected in cell culture supernatant. The results of NA inhibitory activity tests of the RCmAb 1G8 in an enzyme-linked lectin assay (ELLA) and a microneutralization (MN) assay showed that the RCmAb 1G8 maintained significant NA inhibitory activity and neutralizing ability. This is the first chickenized antibody against AIV, which would be a good candidate for passive immunization in poultry.
The inhibitory effects of metabolites from Bacillus pumilus on potato virus Y and the induction of early response genes in Nicotiana tabacum
Authors: Shen Shuo , Li Wei
Published: August 2020

To develop a new antiviral preparation from a microbial source, the halophilic bacterium Bacillus pumilus E303035 was isolated from a soil sample collected at Qarhan Salt Lake in Qinghai, China. The inhibitory activity of an ethyl acetate extract of its fermentation broth was higher than that of an n-butanol extract. After isolation and purification, 9 compounds were obtained: cyclo(L-Leu-L-Pro) (1), cyclo(L-Pro-L-Tyr) (2), Brevianamide F (3), 2-(3-Indolyl) ethanol (4), N-[2-(1H-indol-3-yl) ethyl] acetamide (5), 3, 3-di(1H-indol-3-yl)propane-1,2-diol (6), Lincomycin B (7), dibutylphthalate (8), and p-hydroxyphenethyl alcohol (9). Compounds 1, 5, and 9 showed inhibitory activities against potato virus Y (PVY). Compounds 1, 4, and 9 had significant inhibitory activity against genes HC-pro, P3, and Nib, compound 5 against gene P3, and compounds 1 and 4 against NIa. Compounds 1, 4, 5, and 9 had significant inhibitory activity against genes VPg and 6K1. Active compounds 1, 5, and 9 had various effects on the expression of viral genes related to pathogenesis. Expression of genes cullin and XTH was up-regulated and CP was down-regulated, compared to the positive control. In conclusion, compounds 1, 5, and 9 might be considered as potential antiviral agents for future development.
Existence of solutions of non-autonomous fractional differential equations with integral impulse condition
Authors: Kumar Ashish , Chauhan Harsh Vardhan Singh , Ravichandran Chokkalingam , Nisar Kottakkaran Sooppy , Baleanu Dumitru
Published: August 2020

In this paper, we investigate the existence of solution of non-autonomous fractional differential equations with integral impulse condition by the measure of non-compactness (MNC), fixed point theorems, and k-set contraction. The obtained results are verified via a supporting example.
Strong convergence of an inertial algorithm for maximal monotone inclusions with applications
Authors: Chidume C. E. , Adamu A. , Nnakwe M. O.
Published: August 2020

An inertial iterative algorithm is proposed for approximating a solution of a maximal monotone inclusion in a uniformly convex and uniformly smooth real Banach space. The sequence generated by the algorithm is proved to converge strongly to a solution of the inclusion. Moreover, the theorem proved is applied to approximate a solution of a convex optimization problem and a solution of a Hammerstein equation. Furthermore, numerical experiments are given to compare, in terms of CPU time and number of iterations, the performance of the sequence generated by our algorithm with the performance of the sequences generated by three recent inertial type algorithms for approximating zeros of maximal monotone operators. In addition, the performance of the sequence generated by our algorithm is compared with the performance of a sequence generated by another recent algorithm for approximating a solution of a Hammerstein equation. Finally, a numerical example is given to illustrate the implementability of our algorithm for approximating a solution of a convex optimization problem.
The rhythms of life in the Himalaya: seasonality and sociality among the Gurung people of the Nhāson Valley
Authors: Poudel Jiban Mani
Published: August 2020

The paper explores the linkage between ecological and social systems of the Gurung people in the Nhāson Valley of Nepal, accounting for the interconnectedness of social life and seasons. The main themes of the paper are the local people’s understanding and experience of seasons, and the ways in which their social life moves according to those seasons. The paper is based on 9 months of ethnographic fieldwork undertaken from 2012 to 2018 in Nhāson, a small mountain valley located in the central Himalayan region of Nepal. Informal interaction and conversation with the local people were the key sources of understanding the seasonality and sociality. The findings reveal that a single cultural group has multiple frameworks for marking and counting the year which are contextual and culturally specific. Likewise, seasons and social life in the mountain region are closely interlinked to each other. Local people see that the transformation of seasons from one to the next is related to socio-cultural changes that reflect the rhythm of life. The social and ecological systems in this Himalayan region of Nepal are gradually being affected by climate change.
Individual Patient Data Meta-Analysis of FOLFOXIRI Plus Bevacizumab Versus Doublets Plus Bevacizumab as Initial Therapy of Unresectable Metastatic Colorectal Cancer
Authors: Cremolini Chiara , Antoniotti Carlotta , Stein Alexander , Bendell Johanna , Gruenberger Thomas , Rossini Daniele , Masi Gianluca , Ongaro Elena , Hurwitz Herbert , Falcone Alfredo , Schmoll Hans-Joachim , Di Maio Massimo
Published: August 2020

PURPOSE

A proper estimation of the magnitude of the overall survival (OS) benefit from infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus bevacizumab versus doublets + bevacizumab is lacking because all trials that have investigated this regimen had primary end points other than OS. To test OS with higher power and to explore the interaction of treatment effect with main patient and disease characteristics, we performed an individual patient data (IPD) meta-analysis.

PATIENTS AND METHODS

IPD from 5 eligible trials were collected: CHARTA (ClinicalTrials.gov identifier: NCT01321957 ), OLIVIA (ClinicalTrials.gov identifier: NCT00778102 ), STEAM (ClinicalTrials.gov identifier: NCT01765582 ), TRIBE (ClinicalTrials.gov identifier: NCT00719797 ), and TRIBE2 (ClinicalTrials.gov identifier: NCT02339116 ). The primary end point was OS. Secondary end points were progression-free survival (PFS), objective response rate (ORR), R0 resection rate, grade 3/4 adverse events, and subgroup analyses according to clinical and molecular characteristics.

RESULTS

A total of 1,697 patients were randomly assigned to FOLFOXIRI + bevacizumab (n = 846) or doublets + bevacizumab (n = 851). Most (78%) had an Eastern Cooperative Oncology Group performance status of 0, and the median age was 61 years. After a median follow-up of 39.9 months, patients assigned to FOLFOXIRI + bevacizumab had significantly longer OS than those assigned to doublets + bevacizumab (median, 28.9 v 24.5 months; hazard ratio [HR], 0.81; 95% CI, 0.72 to 0.91; P < .001), with no significant heterogeneity among trials ( P = .39; I2 = 2%). No significant interaction effect between treatment arm and investigated characteristics was demonstrated. Patients assigned to FOLFOXIRI + bevacizumab had longer PFS (median, 12.2 v 9.9 months; HR, 0.74; 95% CI, 0.67 to 0.82; P < .001), higher ORR (64.5% v 53.6%; P < .001), higher R0 resection rate (16.4% v 11.8%; P = .007), and higher rates of grade 3/4 neutropenia (45.8% v 21.5%; P < .001), febrile neutropenia (6.3% v 3.7%; P = .019), and diarrhea (17.8% v 8.4%; P < .001).

CONCLUSION

FOLFOXIRI + bevacizumab significantly and meaningfully improves survival of patients with metastatic colorectal cancer compared with doublets + bevacizumab and provides advantage in PFS, ORR, and R0 resection rate at the price of a moderate increase in toxicity. No increased benefit is observed among patients with BRAF-mutant tumors.
Human Corticotropin-Releasing Hormone Tests: 10 Years of Real-Life Experience in Pituitary and Adrenal Disease
Authors: Ceccato Filippo , Tizianel Irene , Vedolin Carlotta Keiko , Boscaro Marco , Barbot Mattia , Scaroni Carla
Published: August 2020

Context

The human corticotropin-releasing hormone (CRH) test (hCRHtest) is used to differentiate Cushing disease (CD) from ectopic adrenocorticotropin (ACTH) secretion (EAS), to assess autonomous cortisol secretion by the adrenal glands, and to characterize pseudo-Cushing syndrome (CS) or adrenal insufficiency (AI).

Main Outcome Measure

The main outcome measure of this study was to assess the diagnostic accuracy of the hCRHtest.

Methods

We measured ACTH and cortisol levels; collected the peak values (peakACTH and peakcortisol), and calculated the percentage increases (∆%ACTH and ∆%cortisol) after an intravenous bolus of 100 μg hCRH.

Design and Setting

This cross-sectional study of hCRH tests from 2010 to 2019 took place in a referral university hospital center.

Patients

We enrolled 200 patients: 86 CD, 15 EAS, 18 adrenal CS, 25 mild adrenal autonomous cortisol secretion, 31 pseudo-CS, and 25 suspected AI.

Results

The hCRHtest was performed mainly for the differential diagnosis of ACTH-dependent CS or adrenal lesions (P = .048). PeakACTH and peakcortisol were higher in CD, and ∆%ACTH and ∆%cortisol were able to differentiate CD from EAS with a sensitivity and specificity greater than 80%. In patients with low (< 10 pg/mL) or indeterminate (10-20 pg/mL) basalACTH levels, an absent or reduced peakACTH response was able to differentiate adrenal from ACTH-dependent forms. PeakACTH and peakcortisol after hCRHtest were lower in pseudo-CS than in CD, but ∆%ACTH and ∆%cortisol were similar. The role of hCRHtest in patients with AI was limited.

Conclusions

The hCRHtest test is the mainstay of the differential diagnosis of ACTH-dependent CS. It is also useful for pointing to a diagnosis of CD in the event of bilateral adrenal masses, and in patients with low basalACTH.
Loss of the seipin gene perturbs eggshell formation inC. elegans
Authors: Bai Xiaofei , Huang Leng-Jie , Chen Sheng-Wen , Nebenfuhr Benjamin , Wysolmerski Brian , Wu Jui-Ching , Olson Sara K. , Golden Andy , Wang Chao-Wen
Published: August 2020

SEIPIN, an evolutionary conserved protein, plays pivotal roles during lipid droplet (LD) biogenesis and is associated with various human diseases with unclear mechanisms. Here, we analyzed C. elegans mutants deleted of the sole SEIPIN gene, seip-1. Homozygous seip-1 mutants displayed penetrant embryonic lethality, which is caused by the disruption of the lipid-rich permeability barrier, the innermost layer of the C. elegans embryonic eggshell. In C. elegans oocytes and embryos, SEIP-1 is associated with LDs and crucial for controlling LD size and lipid homeostasis. The seip-1 deletion mutants reduced the ratio of polyunsaturated fatty acids (PUFAs) in their embryonic fatty acid pool. Interestingly, dietary supplementation of selected n-6 PUFAs rescued the embryonic lethality and defective permeability barrier. Accordingly, we propose that SEIP-1 may maternally regulate LD biogenesis and lipid homeostasis to orchestrate the formation of the permeability barrier for eggshell synthesis during embryogenesis. A lipodystrophy allele of seip-1 resulted in embryonic lethality as well and could be rescued by PUFA supplementation; these experiments support a great potential of using C. elegans to model SEIPIN-associated human diseases.
Feeling the heat: source–sink mismatch as a mechanism underlying the failure of thermal tolerance
Authors: Vornanen Matti
Published: August 2020

A mechanistic explanation for the tolerance limits of animals at high temperatures is still missing, but one potential target for thermal failure is the electrical signaling off cells and tissues. With this in mind, here I review the effects of high temperature on the electrical excitability of heart, muscle and nerves, and refine a hypothesis regarding high temperature-induced failure of electrical excitation and signal transfer [the temperature-dependent deterioration of electrical excitability (TDEE) hypothesis]. A central tenet of the hypothesis is temperature-dependent mismatch between the depolarizing ion current (i.e. source) of the signaling cell and the repolarizing ion current (i.e. sink) of the receiving cell, which prevents the generation of action potentials (APs) in the latter. A source–sink mismatch can develop in heart, muscles and nerves at high temperatures owing to opposite effects of temperature on source and sink currents. AP propagation is more likely to fail at the sites of structural discontinuities, including electrically coupled cells, synapses and branching points of nerves and muscle, which impose an increased demand of inward current. At these sites, temperature-induced source–sink mismatch can reduce AP frequency, resulting in low-pass filtering or a complete block of signal transmission. In principle, this hypothesis can explain a number of heat-induced effects, including reduced heart rate, reduced synaptic transmission between neurons and reduced impulse transfer from neurons to muscles. The hypothesis is equally valid for ectothermic and endothermic animals, and for both aquatic and terrestrial species. Importantly, the hypothesis is strictly mechanistic and lends itself to experimental falsification.
Raman imaging of protein in a model cheese system
Authors: Nickless Elizabeth , Holroyd Stephen
Published: August 2020

Raman confocal microscopy is an increasingly useful technique when applied to food samples; it has the unique ability to interrogate the chemical structure, aligned with the same confocality capability that is available when using standard confocal microscopy. In this research, we investigated the potential of Raman confocal microscopy to investigate the components in a model cheese system. We showed an ability to distinguish whey protein particles within the casein protein matrix using several different image analysis approaches. The results illustrate the potential of Raman confocal microscopy and imaging to understand the chemical and microstructural features of cheese systems via the analysis of the distribution of the protein types in complex dairy matrices.
Phosphodiester modifications in mRNA poly(A) tail prevent deadenylation without compromising protein expression
Authors: Strzelecka Dominika , Smietanski Miroslaw , Sikorski Pawel J. , Warminski Marcin , Kowalska Joanna , Jemielity Jacek
Published: August 2020

Chemical modifications enable preparation of mRNAs with augmented stability and translational activity. In this study, we explored how chemical modifications of 5′,3′-phosphodiester bonds in the mRNA body and poly(A) tail influence the biological properties of eukaryotic mRNA. To obtain modified and unmodified in vitro transcribed mRNAs, we used ATP and ATP analogs modified at the α-phosphate (containing either O-to-S or O-to-BH3substitutions) and three different RNA polymerases—SP6, T7, and poly(A) polymerase. To verify the efficiency of incorporation of ATP analogs in the presence of ATP, we developed a liquid chromatography–tandem mass spectrometry (LC–MS/MS) method for quantitative assessment of modification frequency based on exhaustive degradation of the transcripts to 5′-mononucleotides. The method also estimated the average poly(A) tail lengths, thereby providing a versatile tool for establishing a structure-biological property relationship for mRNA. We found that mRNAs containing phosphorothioate groups within the poly(A) tail were substantially less susceptible to degradation by 3′-deadenylase than unmodified mRNA and were efficiently expressed in cultured cells, which makes them useful research tools and potential candidates for future development of mRNA-based therapeutics.
Repair of non-traumatic femoral head necrosis by marrow core decompression with bone grafting and porous tantalum rod implantation
Authors: Peng Keyun , Wang Yu , Zhu Jifeng , Li Chengling , Wang Zimin
Published: August 2020

Objective: To compare the clinical effects of marrow core decompression with bone grafting and marrow core decompression with porous tantalum rod implantation in treating avascular necrosis of non-traumatic femoral head.

Methods: This prospective study selected 60 patients (74 hips) with avascular necrosis of femoral head admitted to Daping Hospital from January 2018 to March 2019. According to treatment methods, the 60 patients were randomly divided into two groups, i.e. 30 patients in one group were treated by marrow core decompression with bone grafting, and the other 30 patients in the other group were treated with marrow core decompression and porous tantalum rod implantation.

Results: All implantation treatments were successful. No significant difference was found in surgical duration, hemorrhage volume and duration of hospitalization stay between the two groups during follow-up. All Harris scores were significantly improved (P<0.05) following treatment compared to those before treatment. The Harris score of patients treated with porous tantalum rod implantation was higher than that of patients treated with bone grafting (P<0.05) after 12 months following treatment and such a difference was significant.

Conclusion: The combination of marrow core decompression and porous tantalum rod implantation can better improve the functions of hip joints with early femoral head necrosis than marrow core decompression with bone grafting, and can also prevent articular cartilage from collapsing gradually.

doi: https://doi.org/10.12669/pjms.36.6.2176

How to cite this:Peng K, Wang Y, Zhu J, Li C, Wang Z. Repair of non-traumatic femoral head necrosis by marrow core decompression with bone grafting and porous tantalum rod implantation. Pak J Med Sci. 2020;36(6):1392-1396. doi: https://doi.org/10.12669/pjms.36.6.2176

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019
Authors: Zhu Jin , Chen Cheng , Shi Rongshu , Li Bangguo
Published: August 2020

Objectives: To study the correlations of CT scan with high-sensitivity C-reactive protein (hs-CRP) and D-dimer in patients with coronavirus disease 2019 (COVID-2019).

Methods: From January to March 2020, COVID-19 patients were divided into two groups according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial version 7), with mild and ordinary cases as Group-1 and critical and severe cases as Group-2. The chest CT scan results, hs-CRP, D-dimmer levels of the two groups from admission to discharge were compared by the c2 test or Fisher’s exact test. The quantitative data were represented as mean ± standard deviation (±s). Intergroup comparisons were performed by the independent samples t test, and the ineligible data were subjected to the nonparametric rank sum test. Binary logistic regression model was used for multivariate correlation analysis, using independent variables that were significant in univariate analysis. The correlations between the above indices were analyzed.

Results: In Group-1, there were two cases of normal chest CT scan results, one case of fibrosis, and 25 cases of abnormalities during the first diagnosis, mainly manifested as single or scattered ground-glass shadows. After treatment, the CT scan results became normal. The chest CT scan of Group-2 showed abnormalities, including 21 cases of multiple ground-glass shadows, and six cases of multiple consolidations accompanied by ground-glass shadows, who were critically ill and died. In addition, there were 16 cases of multiple ground glass shadows with partial consolidation, and the CRP and D-dimer levels of Group-2 were significantly higher than those of Group-1. Chest CT scan results were significantly positively correlated with CRP and D-dimer levels (P<0.05).

Conclusion: The chest CT scan results of COVID-19 patients are characteristic, being correlated with CRP and D-dimer levels. D-dimer and CRP levels significantly increase in most severe and critical patients, which are closely related to their prognosis. The indices may play predictive roles in clinical treatment and prognosis evaluation.

doi: https://doi.org/10.12669/pjms.36.6.2961

How to cite this:Zhu J, Chen C, Shi R, Li B. Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019. Pak J Med Sci. 2020;36(6):1397-1401. doi: https://doi.org/10.12669/pjms.36.6.2961

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Διερεύνηση των αντιλήψεων νηπιαγωγών και δασκάλων της Α’ τάξης του δημοτικού σχολείου αναφορικά με τις προσδοκίες γονέων για τον γραμματισμό των παιδιών τους και τη μεταξύ τους συνεργασία
Authors: Αποστόλου (Apostolou) Ζωή (Zoi) Ταξιάρχης , Στελλάκης (Stellakis) Νεκτάριος (Nektarios)
Published: August 2020

Η παρούσα εργασία αφορά τη διερεύνηση των αντιλήψεων νηπιαγωγών και δασκάλων της Α’ τάξης του δημοτικού σχολείου που υπηρετούν σε δημόσια ελληνικά σχολεία για τις προσδοκίες των γονέων των μαθητών τους για την κατάκτηση του γραμματισμού και τη γλωσσική ανάπτυξη των παιδιών τους. Ειδικότερα, μελετώνται οι αντιλήψεις των εκπαιδευτικών για την επιρροή που ασκείται πάνω τους από τις προσδοκίες των γονέων για τον γραμματισμό των παιδιών τους, καθώς και τον τρόπο διαχείρισής τους. Διερευνώνται ακόμη οι πρακτικές που υιοθετούν οι εκπαιδευτικοί στη συνεργασία τους με τους γονείς για τη διαχείριση των προσδοκιών, αλλά και για τη συνέχεια της ενίσχυσης του γραμματισμού, όπως αυτός λαμβάνει χώρα στο σπίτι, στο νηπιαγωγείο και στο δημοτικό σχολείο, ως ένα συνεχές. Η διερεύνηση αποτελεί μέρος ευρύτερης μελέτης (διδακτορικής διατριβής) των σχέσεων φυσικού/πρώτου και συμβατικού/σχολικού γραμματισμού, των αντιλήψεων των εκπαιδευτικών σχετικά με το θέμα ύπαρξης ή μη σύνδεσης των προγραμμάτων γραμματισμού, αλλά και των πρακτικών που απορρέουν από αυτές. Η συλλογή των δεδομένων έγινε με τη χορήγηση ερωτηματολογίου (ποσοτική έρευνα) σε δείγμα 326 νηπιαγωγών και 306 δασκάλων που διδάσκουν τη χρονιά διεξαγωγής της διαδικασίας στην Α’ τάξη ελληνικών δημοτικών σχολείων των νομών Αχαΐας και Ηλείας, καθώς και με τη διεξαγωγή ημιδομημένων συνεντεύξεων (ποιοτική έρευνα) σε 32 εκπαιδευτικούς, 16 νηπιαγωγούς και 16 δασκάλους, από αυτούς που έλαβαν μέρος στη συμπλήρωση του ερωτηματολογίου. Από τα αποτελέσματα φάνηκε ότι οι νηπιαγωγοί πιστεύουν σε μεγαλύτερο βαθμό από τους δασκάλους στην επιρροή των προσδοκιών των γονέων για τη γλωσσική αγωγή από τις απαιτήσεις της συστηματικής διδασκαλίας του δημοτικού σχολείου. Αυτό ερμηνεύεται, καθώς οι νηπιαγωγοί γίνονται καθημερινά «δέκτες» αυτών των προσδοκιών των γονέων και καλούνται να τις διαχειριστούν με πολλούς τρόπους. Νηπιαγωγοί και δάσκαλοι, ωστόσο, φάνηκε να μην επηρεάζονται καθόλου από τις προσδοκίες των γονέων. Θεωρούν σημαντική τη συνεργασία με τους γονείς και την επιδιώκουν σε μεγάλο βαθμό, εισπράττοντας όμως συχνά από μέρους τους μια αδιαφορία και λανθασμένες εκδηλώσεις προσδοκιών και ανησυχιών. Οι δάσκαλοι, σε μεγαλύτερο βαθμό από τις νηπιαγωγούς, προσπαθούν να συνεργάζονται στενά με τους γονείς, όσον αφορά τις πρακτικές του γραμματισμού που λαμβάνουν χώρα στο σχολείο ως συνέχεια του οικογενειακού γραμματισμού. Οι νηπιαγωγοί δηλώνουν ότι συνεργάζονται με τους γονείς με γνώμονα την πρόοδο των παιδιών γενικότερα και διαχειρίζονται το πλαίσιο της συνεργασίας με τέτοιο τρόπο, ώστε να μπορούν να ελέγχουν και να περιορίζουν οποιαδήποτε διάθεση επιρροής και άσκησης πίεσης από μέρους των γονέων.
Η Πολυπλοκότητα της Αντιύλης
Authors: Οικονομίδης Μιχαήλ-Ευάγγελος , Μένης Απόστολος , Μπάρτσας Αχιλλέας , Μαυρής Ιωάννης , Νιφόρος Ιωάννης
Published: August 2020

Στο άρθρο αυτό επιχειρούμε να αναλύσουμε το επιστημονικό υπόβαθρο της αντι-ύλης. Θα εξηγήσουμε πως πρωτοδημιουργήθηκε η αντι-ύλη και θα αναφέρουμε τις πρώτες θεωρίες που αναπτύχθηκαν στις αρχές του 20ου αιώνα, αναλύοντας τα βασικά στοιχεία και τα αντι-στοιχεία τους καθώς επίσης και τις διαφορές τους. Είναι σημαντικό να παρατηρηθεί η σημασία που δίνεται στην αντίδραση ύλης-αντιύλης και σε όλα τα παρεπόμενα αποτελέσματα, καθώς είναι ένα από τα πιο ενδιαφέροντα γεγονότα στο σύμπαν. Επικεντρωθήκαμε λοιπόν στο εξής πρόβλημα, πως γίνεται η αντι-ύλη να βρίσκεται σε τόσο μικρότερες ποσότητες από την κανονική ύλη. Αυτό αποκαλείται ασυμμετρία ύλης-αντιύλης (Τα βαρυόνια είναι υποατομικά σωματίδια τα οποία δημιουργούνται με συνδυασμούς τριών κουάρκ. Μαζί με τα μεσόνια απαρτίζουν την οικογένεια των αδρονίων, δηλαδή σωματίδια που κατασκευάζονται από κουάρκ.). Στο άρθρο αυτό θα αναλύσουμε επίσης τον τρόπο παραγωγής και αποθήκευσης της αντιύλης,καθώς και το επιστημονικό της υπόβαθρο.
Recent advances in preventing recurrent stroke
Authors: Spence J David
Published: August 2020

Since a 2017 update, there have been important advances in stroke prevention. These include new evidence about nutrition, antiplatelet therapy, anticoagulation, lipid-lowering therapy, hypertension control, pioglitazone, and carotid endarterectomy and stenting. Evidence regarding toxic metabolites produced by the intestinal microbiome from egg yolk and red meat has important dietary implications, particularly for patients with impaired renal function, including the elderly. They should avoid egg yolk and red meat and limit the intake of animal flesh. Higher doses of folic acid may be needed for patients with the T allele of MTHFR, so it may not be sufficient to give vitamin B12 (methylcobalamin) alone, even in countries with folate fortification. There is now good evidence that lipid-lowering therapy is even more beneficial in the elderly than in younger patients; we should be using lipid-lowering therapy more intensively, often/usually combining statins with ezetimibe. There is new evidence that lower systolic blood pressure targets are better for most patients, but a subgroup with stiff arteries, a wide pulse pressure, and a diastolic pressure of <60 would be more likely to be harmed than helped by aiming for a systolic target of <120 mmHg. There is a better understanding of how the pharmacological properties of direct-acting oral anticoagulants and the metabolism of antiplatelet agents should inform decisions about the use of these agents. Pioglitazone markedly reduces the risk of stroke, both in diabetics and prediabetics; it should be used more widely. It is now clear that carotid endarterectomy is safer than stenting and that the difference is strongly affected by age. Most patients, and in particular older patients, would be better served by endarterectomy than stenting.
Appearance and management of COVID-19 laryngo-tracheitis: two case reports
Authors: Oliver Charles Matthew , Campbell Marta , Dulan Oma , Hamilton Nick , Birchall Martin
Published: August 2020

We present two cases of coronavirus disease 2019 (COVID-19)-related laryngotracheitis in good-prognosis, ventilated patients who had failed extubation. As the pandemic continues to unfold across the globe and better management of those with respiratory failure develops, this may be an increasingly common scenario. Close ENT-intensivist liaison, meticulous team preparation, early consideration of rigid endoscopy and prospective data collection and case sharing are recommended.