bluuebunny/crossref_metadata_2025 huggingface dataset:
A phase 2 study of venetoclax plus R-CHOP as first-line treatment for patients with diffuse large B-cell lymphoma
Authors: Morschhauser Franck , Feugier Pierre , Flinn Ian W. , Gasiorowski Robin , Greil Richard , Illés Árpád , Johnson Nathalie A. , Larouche Jean-François , Lugtenburg Pieternella J. , Patti Caterina , Salles Gilles A. , Trněný Marek , de Vos Sven , Mir Farheen , Samineni Divya , Kim Su Y. , Jiang Yanwen , Punnoose Elizabeth , Sinha Arijit , Clark Emma , Spielewoy Nathalie , Humphrey Kathryn , Bazeos Alexandra , Zelenetz Andrew D.
Published: September 2020

The phase 2 CAVALLI (NCT02055820) study assessed efficacy and safety of venetoclax, a selective B-cell lymphoma-2 (Bcl-2) inhibitor, with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in first-line (1L) diffuse large B-cell lymphoma (DLBCL), including patients demonstrating Bcl-2 protein overexpression by immunohistochemistry (Bcl-2 IHC+). Eligible patients were ≥18 years of age and had previously untreated DLBCL, Eastern Cooperative Oncology Group performance status ≤2, and International Prognostic Index 2 to 5. Venetoclax 800 mg (days 4-10, cycle 1; days 1-10, cycles 2-8) was administered with rituximab (8 cycles) and cyclophosphamide, doxorubicin, vincristine, and prednisone (6-8 cycles) in 21-day cycles. Primary end points were safety, tolerability, and complete response (CR) at end of treatment (EOT). Secondary end points were progression-free survival (PFS) and overall survival. Comparative analyses used covariate-adjusted R-CHOP controls from the GOYA/BO21005 study, an appropriate contemporary benchmark for safety and efficacy. Safety and efficacy analyses included 206 patients. CR rate at EOT was 69% in the overall population and was maintained across Bcl-2 IHC+ subgroups. With a median follow-up of 32.2 months, trends were observed for improved investigator-assessed PFS for venetoclax plus R-CHOP in the overall population (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.43-0.87) and Bcl-2 IHC+ subgroups (HR, 0.55; 95% CI, 0.34-0.89) vs R-CHOP. Despite a higher incidence of grade 3/4 hematologic adverse events (86%), related mortality was not increased (2%). Chemotherapy dose intensity was similar in CAVALLI vs GOYA. The addition of venetoclax to R-CHOP in 1L DLBCL demonstrates increased, but manageable, myelosuppression and the potential of improved efficacy, particularly in high-risk Bcl-2 IHC+ patient subgroups.
Why drivers are frustrated: results from a diary study and focus groups
Authors: Bosch Esther , Ihme Klas , Drewitz Uwe , Jipp Meike , Oehl Michael
Published: September 2020

Introduction

Designing emotion-aware systems has become a manageable aim through recent developments in computer vision and machine learning. In the context of driver behaviour, especially negative emotions like frustration have shifted into the focus of major car manufacturers. Recognition and mitigation of the same could lead to safer roads in manual and more comfort in automated driving. While frustration recognition and also general mitigation methods have been previously researched, the knowledge of reasons for frustration is necessary to offer targeted solutions for frustration mitigation. However, up to the present day, systematic investigations about reasons for frustration behind the wheel are lacking.

Methods

Therefore, in this work a combination of diary study and user focus groups was employed to shed light on reasons why humans become frustrated during driving. In addition, participants of the focus groups were asked for their usual coping methods with frustrating situations.

Results

It was revealed that the main reasons for frustration in driving are related to traffic, in-car reasons, self-inflicted causes, and weather. Coping strategies that drivers use in everyday life include cursing, distraction by media and thinking about something else, amongst others. This knowledge will help to design a frustration-aware system that monitors the driver’s environment according to the spectrum of frustration causes found in the research presented here.
Bioinformatic screening for candidate biomarkers and their prognostic values in endometrial cancer
Authors: Li Yaowei , Li Li
Published: September 2020

Background

Endometrial cancer is a common gynecological cancer with annually increasing incidence worldwide. However, the biomarkers that provide prognosis and progression for this disease remain elusive.

Results

Two eligible human endometrial cancer datasets (GSE17025 and GSE25405) were selected for the study. A total of 520 differentially expressed mRNAs and 30 differentially expressed miRNAs were identified. These mRNAs were mainly enriched in cell cycle, skeletal system development, vasculature development, oocyte maturation, and oocyte meiosis signalling pathways. A total of 160 pairs of differentially expressed miRNAs and mRNAs, including 22 differentially expressed miRNAs and 71 overlapping differentially expressed mRNAs, were validated in endometrial cancer samples using starBase v2.0 project. The prognosis analysis revealed that Cyclin E1 (CCNE1, one of the 82 hub genes, which correlated with hsa-miR-195 and hsa-miR-424) was significantly linked to a worse overall survival in endometrial cancer patients.

Conclusions

The hub genes and differentially expressed miRNAs identified in this study might be used as prognostic biomarkers for endometrial cancer and molecular targets for its treatment.
Hair follicle regional specificity in different parts of bay Mongolian horse by histology and transcriptional profiling
Authors: Zhao Ruoyang , Yihan Wu , Zhao Yiping , Li Bei , Han Haige , Mongke Togtokh , Bao Tugeqin , Wang Wenxing , Dugarjaviin Manglai , Bai Dongyi
Published: September 2020

Background

Different morphological structures of hairs having properties like defense and camouflage help animals survive in the wild environment. Horse is one of the rare kinds of animals with complex hair phenotypes in one individual; however, knowledge of horse hair follicle is limited in literature and their molecular basis remains unclear. Therefore, the investigation of horse hair follicle morphogenesis and pigmentogenesis attracts considerable interest.

Result

Histological studies revealed the morphology and pigment synthesis of hair follicles are different in between four different parts (mane, dorsal part, tail, and fetlock) of the bay Mongolian horse. Hair follicle size, density, and cycle are strongly associated with the activity of alkaline phosphatase (ALP). We observed a great difference in gene expression between the mane, tail, and fetlock, which had a greater different gene expression pattern compared with the dorsal part through transcriptomics. The development of the hair follicle in all four parts was related to angiogenesis, stem cells, Wnt, and IGF signaling pathways. Pigmentogenesis-related pathways were involved in their hair follicle pigment synthesis.

Conclusions

Hair follicle morphology and the activity of ALP differ among four body parts in bay Mongolian horse. Hair follicles of the different body parts of the are not synchronized in their cycle stages. GO terms show a regional specificity pattern between different skin parts of the bay Mongolian horse. These results provide an insight into the understanding of the biological mechanism of the hair follicle in other mammals.
The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis
Authors: Chen Chun-Wei , Kuo Chia-Jung , Chiu Cheng-Tang , Su Ming-Yao , Lin Chun-Jung , Le Puo-Hsien , Lim Siew-Na , Yeh Chau-Ting , Alison Malcolm R. , Lin Wey-Ran
Published: September 2020

Background

Delayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB.

Methods

Patients with polyps sized 6 to 20 mm underwent snare polypectomy from 2015 to 2017 were retrospectively reviewed. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group.

The incidence of delayed PPB and time to bleeding were compared between the groups. Multivariate analysis was used to identify the risk factors of delayed PPB. Propensity score matching was used to minimize potential bias.

Results

After propensity score matching, 612 patients with 806 polyps were in the clipping group, and 576 patients with 806 polyps were in the non-clipping group. There were no significant differences in the incidence of delayed PPB and days to bleeding between two groups (0.8% vs 1.3%, p = 0.4; 3.4 ± 1.94 days vs 4.13 ± 3.39 days, p = 0.94). In the multivariate analysis, the polyp size [Odds ratio (OR):1.16, 95% confidence interval (CI):1.01–1.16, p = 0.03), multiple polypectomies (OR: 4.64, 95% CI:1.24–17.44, p = 0.02) and a history of anticoagulant use (OR:37.52, 95% CI:6.49–216.8, p < 0.001) were associated with delayed PPB.

Conclusions

In polyps sized 6 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Patients without risk factors including multiple polypectomies and anticoagulant use are no need to performing prophylactic hemoclipping.
Can in-hospital or post discharge caregiver involvement increase functional performance of older patients? A systematic review
Authors: van Dijk Margaretha , Vreven Jasmien , Deschodt Mieke , Verheyden Geert , Tournoy Jos , Flamaing Johan
Published: September 2020

Background

Regaining pre-hospitalization activity levels is only achieved in 30–50% of older patients. Extra physiotherapy time has been proven to improve functional outcome and shorten length of stay, but is costly. Considering their key role in caring for older people, involving informal caregivers in rehabilitation might further improve functional performance.

Aim

To determine if in-hospital or post discharge caregiver involvement can increase functional performance in older adults. The secondary aim was to determine if caregiver involvement can influence, quality of life of patient and caregiver, medical costs, readmission rate, discharge location, and mortality.

Design

Systematic review with narrative synthesis.

Methods

The electronic bibliographic databases MEDLINE, Embase, CINAHL, Cochrane and Web of Science were searched for (quasi) experimental and observational studies, with the following inclusion criteria; caregiver involvement regarding functional performance, mean age over 65 years, admitted to a hospital unit and subsequently discharged to their home setting. Risk of bias was assessed with the Rob 2 (randomized trials) and the ROBINS-1 tool (non-randomized studies).

Results

Eight studies of an initial 4683 were included: four randomized controlled trials, one prospective cohort study, one non-randomized controlled trial, one subgroup analysis of an RCT and one prospective pre-post study. All but one study included patients with stroke. Three types of caregiver interventions could be distinguished: a care pathway (inclusion of caregivers in the process of care), education on stroke and teaching of bed-side handling-skills, and caregiver-mediated exercises. The one study evaluating the care pathway reported 24.9% more returns home in the intervention group. Studies evaluating the effect of education and bed-side handling-skills reported higher effect sizes for several outcomes with increasing session frequency. All studies with caregiver-mediated exercises showed beneficial effects on functional performance, immediately after the intervention and within 3 months follow-up.

Conclusion

The findings of this review suggest that involvement of caregivers in the rehabilitation of older adults leads to better functional performance up to 3 months after initiation. However, evidence is low and mainly focusing on stroke.
Unplanned return presentations of older patients to the emergency department: a root cause analysis
Authors: Driesen Babiche E. J. M. , Merten Hanneke , Wagner Cordula , Bonjer H. Jaap , Nanayakkara Prabath W. B.
Published: September 2020

Background

In line with demographic changes, there is an increase in ED presentations and unplanned return presentations by older patients (≥70 years). It is important to know why these patients return to the ED shortly after their initial presentation. Therefore, the aim of this study was to provide insight into the root causes and potential preventability of unplanned return presentations (URP) to the ED within 30 days for older patients.

Methods

A prospective observational study was conducted from February 2018 to November 2018 in an academic hospital in Amsterdam. We included 83 patients, aged 70 years and older, with an URP to the ED within 30 days of the initial ED presentation. Patients, GPs and doctors at the ED were interviewed by trained interviewers and basic administrative data were collected in order to conduct a root cause analysis using the PRISMA-method.

Results

One hundred fifty-one root causes were identified and almost half (49%) of them were disease-related. Fifty-two percent of the patients returned to the ED within 7 days after the initial presentation. In 77% of the patients the URP was related to the initial presentation. Patients judged 17% of the URPs as potentially preventable, while doctors at the ED judged 25% and GPs 23% of the URPs as potentially preventable. In none of the cases, there was an overall agreement from all three perspectives on the judgement that an URP was potentially preventable.

Conclusion

Disease-related factors were most often identified for an URP and half of the patients returned to the ED within 7 days. The majority of the URPs was judged as not preventable. However, an URP should trigger healthcare workers to focus on the patient’s process of care and their needs and to anticipate on potential progression of disease. Future research should assess whether this may prevent that patients have to return to the ED.
Psychometric properties of the Iranian version of self-care ability scale for the elderly
Authors: Amir-Behghadami Mehrdad , Tabrizi Jafar Sadegh , Saadati Mohammad , Gholizadeh Masoumeh
Published: September 2020

Background

Measuring self-care ability in elderly people needs specific instruments. The Self-care Ability Scale for Elderly (SASE) is one of the common instruments used for assessing self-care ability. The aim of this study was to assess the psychometric properties of the SASE among Iranian elderly population.

Methods

This cross-cultural adaptation study was carried out at Shahid Chamran and Shadpour Health Complex in Tabriz, Iran. The forward-backward procedure was applied to translate the SASE from English into Persian. Then, it was completed to 220 elderly people. A systematic random sampling method was used for sampling. Content validity was calculated through modified Kappa coefficient (modified CVI) based on clarity and relevance criteria. Reliability was measured by internal consistency and test-retest analysis. The construct validity also was assessed using Exploratory Factor Analysis (EFA). All the statistical analyses were performed using SPSS 21 statistical software package.

Results

The mean of self-care ability was 61.14 ± 21.08. The CVI and modified kappa were 0.91 and 0.92 for relevance and clarity, respectively. The Cronbach’s alpha coefficient was 0.73 and Intra-class correlation coefficient was 0.97. The results of EFA revealed a three-factor solution (‘ability to take care of personal responsibility’, ‘ability to take care for the goals’, and ‘ability to take care of the health’) that jointly explained for 64.61% of the total variance.

Conclusion

Results of the study showed that the Iranian version of the SASE has good psychometric properties and can be used in assessing the self-care ability of elderly people.
The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults
Authors: Bello-Chavolla Omar Yaxmehen , Aguilar-Salinas Carlos Alberto , Avila-Funes José Alberto
Published: September 2020

Background

The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D.

Methods

We included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac’s set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz’ and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles.

Results

Mean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures.

Conclusion

The DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.
COVID-19 confirmed patients with negative antibodies results
Authors: Wang Jian , Chen Chong , Li Qilin , Cai Pengcheng , Wang Zheng , Wang Lin
Published: September 2020

Background

A new coronavirus disease 2019 (COVID-19) has escalated to a pandemic since its first outbreak in Wuhan, China. A small proportion of patients may have difficulty in generating IgM or IgG antibodies against SARS-CoV-2, and little attention has been paid to them.

Case presentations

We present two cases of confirmed COVID-19 patients and characterize their initial symptoms, chest CT results, medication, and laboratory test results in detail (including RT-PCR, IgM/ IgG, cytokine and blood cell counts).

Conclusion

Both of patients with confirmed COVID-19 pneumonia failed to produce either IgM or IgG even 40 to 50 days after their symptoms onset. This work provides evidence demonstrating that at least a small proportion of patients may have difficulty in rapidly gaining immunity against SARS-CoV-2.
Altered respiratory microbiota composition and functionality associated with asthma early in life
Authors: AL Bataineh Mohammad T. , Hamoudi Rifat A. , Dash Nihar R. , Ramakrishnan Rakhee K. , Almasalmeh Mohamad A. , Sharif Hanan A. , Al-Hajjaj Mohamed S. , Hamid Qutayba
Published: September 2020

Background

The microbiota of the respiratory tract has an important role in maintaining respiratory health. However, little is known on the respiratory microbiota in asthmatic patients among Middle Eastern populations. This study investigated the respiratory microbiota composition and functionality associated with asthma in Emirati subjects.

Methods

We performed 16S rRNA and ITS2-gene based microbial profiling of 40 expectorated sputum samples from adult and pediatric Emirati individuals averaging 52 and 7 years of age, respectively with or without asthma.

Results

We report bacterial difference belonging to Bacteroidetes, Firmicutes, Fusobacteria and Proteobacteria phyla between asthmatic and non-asthmatic controls. Similarly, fungal difference belonging to Ascomycota, Basidiomycota phyla and other unclassified fungi. Differential abundance testing among asthmatic individuals with relation to Asthma Control Test show a significant depletion of Penicillium aethiopicum and Alternaria spp., among poorly controlled asthmatics. Moreover, data suggest a significant expansion of Malassezia spp. and other unclassified fungi in the airways of those receiving steroids and leukotriene receptor antagonists’ combination therapy, in contrast to those receiving steroids alone. Functional profiling from 16S data showed marked differences between pediatric asthmatic and non-asthmatic controls, with pediatric asthmatic patients showing an increase in amino acid (p-value < 5.03 × 10− 7), carbohydrate (p-value < 4.76 × 10− 7), and fatty acid degradation (p-value < 6.65 × 10− 7) pathways, whereas non-asthmatic controls are associated with increase in amino acid (p-value < 8.34 × 10− 7), carbohydrate (p-value < 3.65 × 10− 7), and fatty acid (p-value < 2.18 × 10− 6) biosynthesis pathways in concordance with enterotype composition.

Conclusions

These differences provide an insight into respiratory microbiota composition in Emirati population and its possible role in the development of asthma early in life. This study provides important information that may eventually lead to the development of screening biomarkers to predict early asthma development and novel therapeutic approaches.
Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018
Authors: Onukwugha Franklin I. , Magadi Monica A. , Sarki Ahmed M. , Smith Lesley
Published: September 2020

Background

Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15–24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15–24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among 15–24 year-old women in Nigeria.

Methods

We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis and are reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results

Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for 15–24 year-old women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for reproductive health service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7).

Conclusion

Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.
Maternal autonomy and high-risk pregnancy in Bangladesh: the mediating influences of childbearing practices and antenatal care
Authors: Abedin Sumaiya , Arunachalam Dharma
Published: September 2020

Background

Maternal, infant and neonatal mortality rates are high in Bangladesh. Certain childbearing practices and poor utilisation of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy and adverse pregnancy outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This study investigates the severity of health complications during pregnancy in relation to women’s autonomy, and how childbearing practices and utilisation of antenatal care mediate this relationship.

Methods

Data from the most recent Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial regression models (MLRM) are employed to examine the relationship between the outcome variable - high risk pregnancy, and explanatory variables - women’s autonomy, childbearing practices and use of antenatal care.

Results

In Bangladesh, about 41.5% of women experienced high-risk pregnancies involving multiple health complications. Findings showed that women’s autonomy in decision-making, freedom of movement and economic autonomy were significantly associated with high-risk pregnancies. However, women’s autonomy in physical mobility in particular did so only through the mediating factors of maternal childbearing practices and antenatal care. Specifically, both early and delayed childbearing and shorter birth interval increased the likelihood of high-risk (multiple complications) pregnancies by about 30% and 31% respectively, high parity increased the risk by 23% and use of antenatal care decreased it by 46%.

Conclusions

The Women’s decision-making autonomy, freedom of movement and economic autonomy had significant effects on high-risk pregnancies. However, the effects were mediated by both maternal childbearing practices and use of antenatal care in a limited way. Policies and programmes aimed at improving pregnancy outcomes need to focus on all three sets of factors: women’s autonomy, childbearing practices and use of antenatal care.
Identification of an alternative splicing signature as an independent factor in colon cancer
Authors: Chen Haitao , Luo Jun , Guo Jianchun
Published: September 2020

Background

Colon cancer is a common malignant tumor with a poor prognosis. Abnormal alternative splicing (AS) events played a part in the occurrence and metastasis of the tumor. We aimed to develop a survival-associated AS signature in colon cancer.

Methods

The Percent Spliced In values of AS events were available in The Cancer Genome Atlas (TCGA) SpliceSeq database. Univariate Cox analysis was carried out to detect the prognosis-related AS events. We created a predictive model on account of the survival-associated AS events, which was further validated with a training-testing group design. Kaplan-Meier analysis was applied to assess patient survival. The area under curve (AUC) of receiver operating characteristic (ROC) was performed to evaluate the predictive values of this model. Meanwhile, the clinical relevance of the signature and its regulatory relationship with splicing factors (SFs) were also evaluated.

Results

In total, 2132 survival-related AS events were identified from colon cancer samples. We developed an eleven-AS signature, in which the 5-year AUC value was 0.911. Meanwhile, the AUC values at five years were 0.782 and 0.855 in the testing and entire cohort, respectively. Multivariate Cox regression displayed that the T category and the risk score of the signature were independent risk factors of colon cancer survival. Also, we constructed an SFs-AS network based on 11 SFs and 48 AS events.

Conclusions

We identified an eleven-AS signature of colon cancer. This signature could be treated as an independent prognostic factor.
Ocular findings in patients with transfusion-dependent β-thalassemia in southern Iran
Authors: Haghpanah Sezaneh , Zekavat Omid Reza , Bordbar Mohammadreza , Karimi Mehran , Zareifar Soheila , Safaei Sanaz , Ramzi Mani , Ashraf Hossein
Published: September 2020

Background

Ocular involvement may occur via several mechanisms in patients with transfusion-dependent β-thalassemia (TDT) mainly chronic anemia, iron overload and iron chelator toxicity. We aimed to evaluate the frequency of abnormal ocular findings and their relationship with hematologic parameters in TDT patients.

Methods

In this cross-sectional study from January 2018 to January 2019, a total of 79 patients with TDT over the age of 18 who were on iron-chelation therapy (ICT) were consecutively investigated. All patients were registered at the Thalassemia Comprehensive Center affiliated with Shiraz University of Medical Sciences, Shiraz, Southern Iran. Complete ophthalmic examination was performed by an expert ophthalmologist. Clinical and hematologic parameters were collected from the patients´ medical records.

Results

The mean age ± standard deviation (SD) of the patients was 28.4 ± 5.6 years (range: 18–43). Twenty-four patients (30.4%) were male and 29 (36.7%) were splenectomized. The mean ± SD of the best-corrected visual acuity (VA) was 0.960 ± 0.086 decimal, (range: 0.6–1), 0.016 ± 0.046 logMar, (range: 0–0.2). The frequency of patients with VA > 0.1 logMar was 3 (3.8%). The mean intraocular pressure (IOP) was 14.88 ± 3.34 (6–25) mmHg. Fundus abnormalities were observed in 8 patients (10.1%), consisting of increased cup-disk ratio (3.8%), vessel tortuosity (2.5%), retinal pigment epithelium degeneration (2.5%), myelinated nerve fiber layer (1.3%), and internal limiting membrane wrinkling (1.3%). No significant association was observed between fundus abnormalities, VA, or IOP with hematologic parameters (P > 0.05). TDT patients with diabetes mellitus had significantly higher IOP (P = 0.010) but similar frequency of fundus abnormalities with non-diabetic patients (P > 0.05).

Conclusions

The frequency of ocular abnormalities in our patients was lower than the previous reports. The frequency of fundus abnormalities were similar in diabetic and non-diabetic thalassemia patients indicating close monitoring and proper management of the disease and comorbidities in these patients.
Parents’ knowledge, attitude and practice towards children’s vaccination in Lebanon: role of the parent-physician communication
Authors: Matta Perla , El Mouallem Rayane , Akel Marwan , Hallit Souheil , Fadous Khalife Marie-Claude
Published: September 2020

Background

One of the most effective public health interventions in the world is immunization. However, some parents doubt its usefulness and safety. Many factors influence their decision to vaccinate, including their sociodemographic characteristics, their trust in the public health system, the parent-physician relationship, their level of knowledge and their attitudes towards vaccination. Our objective was to determine the factors, especially the parent-physician communication, associated with parental knowledge, attitudes and practices of their children’s vaccination.

Methods

Three thousand five hundred parents (father, mother or both) of children aged between 1 month and 15 years were approached by a trained personnel who performed the data collection through personal interviews (February–April 2019).

Results

The response rate was 79.5%. The results of the multivariable analysis showed that a better patient-physician communication was significantly associated with higher knowledge, better attitude and practice. Better knowledge was significantly associated with better attitude, whereas better knowledge and attitude were significantly associated with better practice.

Conclusion

Our study shows the importance of good physician-patient communication in improving knowledge, attitude and practice of parents towards their children’s vaccination.
Association between neighborhood disadvantage and fulfillment of desired postpartum sterilization
Authors: Arora Kavita Shah , Ascha Mustafa , Wilkinson Barbara , Verbus Emily , Montague Mary , Morris Jane , Einstadter Douglas
Published: September 2020

Background

Adequacy of prenatal care is associated with fulfillment of postpartum sterilization requests, though it is unclear whether this relationship is indicative of broader social and structural determinants of health or reflects the mandatory Medicaid waiting period required before sterilization can occur. We evaluated the relationship between neighborhood disadvantage (operationalized by the Area Deprivation Index; ADI) and the likelihood of undergoing postpartum sterilization.

Methods

Secondary analysis of a single-center retrospective cohort study examining 8654 postpartum patients from 2012 to 2014, of whom 1332 (15.4%) desired postpartum sterilization (as abstracted from the medical record at time of delivery hospitalization discharge) and for whom ADI could be calculated via geocoding their home address. We determined the association between ADI and sterilization completion, postpartum visit attendance, and subsequent pregnancy within 365 days of delivery via logistic regression and time to sterilization via Cox proportional hazards regression.

Results

Of the 1332 patients included in the analysis, patients living in more disadvantaged neighborhoods were more likely to be younger, more parous, delivered vaginally, Black, unmarried, not college educated, and insured via Medicaid. Compared to patients living in less disadvantaged areas, patients living in more disadvantaged areas were less likely to obtain sterilization (44.8% vs. 53.5%, OR 0.84, 95% CI 0.75–0.93), experienced greater delays in the time to sterilization (HR 1.23, 95% CI 1.06–1.44), were less likely to attend postpartum care (58.9% vs 68.9%, OR 0.86, CI 0.79–0.93), and were more likely to have a subsequent pregnancy within a year of delivery (15.1% vs 10.4%, OR 1.56, 95% CI 1.10–1.94). In insurance-stratified analysis, for patients with Medicaid, but not private insurance, as neighborhood disadvantage increased, the rate of postpartum sterilization decreased. The rate of subsequent pregnancy was positively associated with neighborhood disadvantage for both Medicaid as well as privately insured patients.

Conclusion

Living in an area with increased neighborhood disadvantage is associated with worse outcomes in terms of desired postpartum sterilization, especially for patients with Medicaid insurance. While revising the Medicaid sterilization policy is important, addressing social determinants of health may also play a powerful role in reducing inequities in fulfillment of postpartum sterilization.
Correction to: Water-pipe smoke condensate increases the internalization of Mycobacterium Bovis of type II alveolar epithelial cells (A549)
Authors: Mortaz Esmaeil , Alipoor Shamila D. , Movassaghi Masoud , Varahram Mohammad , Ghorbani Jahangir , Folkerts Gert , Garssen Johan , Adcock Ian M.
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
Selective Glenohumeral external rotation deficit – sequelae of post-ORIF deltoid adhesions after treatment of the proximal humerus fracture
Authors: Waszczykowski Michał , Fabiś Jarosław
Published: September 2020

Background

The deltopectoral approach is commonly used for plate stabilization of proximal humerus fracture. Although adhesions between the deltoid, plate, and humerus are common sequelae of plate ORIF, little is known about their effect on the range of movement and a function of the shoulder. To confirm their impact, the preoperative and intraoperative evaluation of the range of motion (ROM) was measured during the sequential arthroscopic release of adhesions, with special regard to external rotation. Postoperative ROM and subjective shoulder function were also evaluated.

Methods

Eighteen patients treated with ORIF of the proximal humerus were scheduled to the unified arthroscopic procedures comprising sequential limited subacromial bursectomy, removal of the adhesions between the deltoid, plate, and humerus, as well as the plate removal. The ROM of the operated and opposite shoulders were assessed before surgery, intraoperatively and after a minimum two-year follow-up, with special regard to external rotation in adduction (AddER) and abduction (AbdER). Besides, the Constant-Murley score and Subjective Shoulder Value (SSV) were evaluated before a plate removal and after a minimum two-year follow-up after the surgery.

Results

Deltoid adhesion release correlated with considerable and statistically significant improvement of AddER (p < 0.0002) but not with the intraoperative range of AbdER. Significant improvement of AddER, but also of AbdER and other range of motion was noted at the follow-up. The improvement of the affected shoulder function following arthroscopic plate removal was considerable and statistically significant according to the modified Constant-Murley score (p < 0,01) and SSV (p < 0.0000) after a minimum of two-year follow-up.

Conclusions

Our findings are the first to highlight the influence of deltoid muscle, plate, and humerus adhesions on limiting external rotation in adduction after ORIF treatment of proximal humerus fractures. These observations allow the identification of a new shoulder evaluation symptom: Selective Glenohumeral External Rotation Deficit (SGERD) as well as functional deltohumeral space.
Effect of Qinbai Qingfei Concentrated Pellets on substance P and neutral endopeptidase of rats with post-infectious cough
Authors: Jia Weigang , Wang Wei , Li Rui , Zhou Quanyu , Qu Ying , Jia Yumei , Zhang Zhiheng , Wan Chengwei , Zhang Wanwan
Published: September 2020

Background

In recent years, it has been reported that Qinbai Qingfei Concentrated Pellet (QQCP) has the effect of relieving cough and reducing sputum. However, the therapeutic potentials of QQCP on post-infectious cough (PIC) rat models has not been elucidated. So the current study was aimed to scientifically validate the efficacy of QQCP in post infectious cough.

Methods

All rats were exposed to sawdust and cigarette smokes for 10 days, and intratracheal lipopolysaccharide (LPS) and capsaicin aerosols. Rats were treated with QQCP at dose of 80, 160, 320 mg/kg. Cough frequency was monitored twice a day for 10 days after drug administration. Inflammatory cell infiltration was determined by ELISA. Meanwhile, the histopathology of lung tissue and bronchus in rats were evaluated by hematoxylin-eosin staining (H&E). Neurogenetic inflammation were measured by ELISA and qRT-PCR.

Results

QQCP dose-dependently decreased the cough frequency and the release of pro-inflammatory cytokines TNF-α, IL-1β, IL-6 and IL-8, but exerted the opposite effects on the secretion of anti-inflammatory cytokines IL-10 and IL-13 in BALF and serum of PIC rats. The oxidative burden was effectively ameliorated in QQCP-treated PIC rats as there were declines in Malondialdehyde (MDA) content and increases in Superoxide dismutase (SOD) activity in the serum and lung tissue. In addition, QQCP blocked inflammatory cell infiltration into the lung as evidenced by the reduced number of total leukocytes and the portion of neutrophils in the broncho - alveolar lavage fluid (BALF) as well as the alleviated lung damage. Furthermore, QQCP considerable reversed the neurogenetic inflammation caused by PIC through elevating neutral endopeptidase (NEP) activity and reducing Substance P (SP) and Calcitonin gene related peptide (CGRP) expression in BALF, serum and lung tissue.

Conclusions

Our study indicated that QQCP demonstrated a protective role of PIC and may be a potential therapeutic target of PIC.
Iterative sure independent ranking and screening for drug response prediction
Authors: An Biao , Zhang Qianwen , Fang Yun , Chen Ming , Qin Yufang
Published: September 2020

Background

Prediction of drug response based on multi-omics data is a crucial task in the research of personalized cancer therapy.

Results

We proposed an iterative sure independent ranking and screening (ISIRS) scheme to select drug response-associated features and applied it to the Cancer Cell Line Encyclopedia (CCLE) dataset. For each drug in CCLE, we incorporated multi-omics data including copy number alterations, mutation and gene expression and selected up to 50 features using ISIRS. Then a linear regression model based on the selected features was exploited to predict the drug response. Cross validation test shows that our prediction accuracies are higher than existing methods for most drugs.

Conclusions

Our study indicates that the features selected by the marginal utility measure, which measures the conditional probability of drug responses given the feature, are helpful for drug response prediction.
A data-driven approach to a chemotherapy recommendation model based on deep learning for patients with colorectal cancer in Korea
Authors: Park Jin-Hyeok , Baek Jeong-Heum , Sym Sun Jin , Lee Kang Yoon , Lee Youngho
Published: September 2020

Background

Clinical Decision Support Systems (CDSSs) have recently attracted attention as a method for minimizing medical errors. Existing CDSSs are limited in that they do not reflect actual data. To overcome this limitation, we propose a CDSS based on deep learning.

Methods

We propose the Colorectal Cancer Chemotherapy Recommender (C3R), which is a deep learning-based chemotherapy recommendation model. Our model improves on existing CDSSs in which data-based decision making is not well supported. C3R is configured to study the clinical data collected at the Gachon Gil Medical Center and to recommend appropriate chemotherapy based on the data. To validate the model, we compared the treatment concordance rate with the National Comprehensive Cancer Network (NCCN) Guidelines, a representative set of cancer treatment guidelines, and with the results of the Gachon Gil Medical Center’s Colorectal Cancer Treatment Protocol (GCCTP).

Results

For the C3R model, the treatment concordance rates with the NCCN guidelines were 70.5% for Top-1 Accuracy and 84% for Top-2 Accuracy. The treatment concordance rates with the GCCTP were 57.9% for Top-1 Accuracy and 77.8% for Top-2 Accuracy.

Conclusions

This model is significant, i.e., it is the first colon cancer treatment clinical decision support system in Korea that reflects actual data. In the future, if sufficient data can be secured through cooperation among multiple organizations, more reliable results can be obtained.
Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study
Authors:   for the Relationship between Cardiovascular disease and Brachial-ankle Pulse Wave Velocity (baPWV) in Patients with Type 2 Diabetes (REBOUND) Study Group, Kim Jeong Mi , Kim Sang Soo , Kim In Joo , Kim Jong Ho , Kim Bo Hyun , Kim Mi Kyung , Lee Soon Hee , Lee Chang Won , Kim Min Chul , Ahn Jun Hyeob , Kim Jinmi
Published: September 2020

Background

This study aimed to evaluate the benefit of brachial-ankle pulse wave velocity (baPWV) as a noninvasive marker of arterial stiffness for the prediction of all-cause and cause-specific mortality in patients with type 2 diabetes.

Methods

This multicenter prospective observational study analyzed 2308 patients with type 2 diabetes between 2008 and 2018. The patients were categorized according to the quartiles of baPWV. Cause of mortality was determined using death certificates and patient clinical records. We estimated proportional mortality rates from all causes, cardiovascular, cancer, and other causes among adults with diabetic status according to their baPWV. Cox regression models were used to estimate hazard ratios (HRs).

Results

There were 199 deaths (8.6%) in the study population during a median follow-up duration of 8.6 years. When baPWV was assessed as quartiles, a significantly higher risk of all-cause mortality (HR = 5.39, P < 0.001), cardiovascular-mortality (HR = 14.89, P < 0.001), cancer-mortality (HR = 5.42, P < 0.001), and other-cause mortality (HR = 4.12, P < 0.001) was found in quartile 4 (Q4, ≥ 1830 cm/s) than in quartiles 1–3 (Q1–3). Adding baPWV to baseline model containing conventional risk factors such as age, sex, diabetes duration, body mass index, glycated hemoglobin, systolic blood pressure, glomerular filtration rate, smoking, and insulin improved the risk prediction for all-cause (net reclassification index (NRI) = 49%, P < 0.001) and cause-specific (cardiovascular NRI = 28%, P = 0.030; cancer NRI = 55%, P < 0.001; other-cause NRI 51%, P < 0.001) mortality.

Conclusion

This long-term, large-scale, multicenter prospective observational cohort study provide evidence that increased arterial stiffness, as measured by baPWV, predicts the risk of all-cause and cause-specific mortality in type 2 diabetes, supporting the prognostic utility of baPWV.

Trial registration Clinical Research Information Service (CRIS), KCT 0005010. Retrospectively Registered May 12, 2020. https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=16677
LINC02418 promotes colon cancer progression by suppressing apoptosis via interaction with miR-34b-5p/BCL2 axis
Authors: Tian Jun , Cui Peng , Li Yifei , Yao Xuequan , Wu Xiaoyu , Wang Zhirong , Li Chunsheng
Published: September 2020

Background

LncRNAs act as functional regulators in tumor progression through interacting with various signaling pathways in multiple types of cancer. However, the effect of LINC02418 on colorectal cancer (CRC) progression and the underling mechanisms remain unclear.

Methods

LncRNA expression profile in CRC tissues was investigated by the TCGA database. The expressional level of LINC02418 in CRC patients was determined by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Kaplan–Meier analyses was used to investigate the correlation between LINC02418 and overall survival (OS) of CRC patients. Cell proliferative, migratory and invasive abilities were detected by CCK-8 assays, colony formation assays and trans-well assays in HCT116 and LoVo cells which were stably transduced with sh-LINC02418 or sh-NC. The binding between LINC02418 and miR-34b-5p, and the interaction between miR-34b-5p and BCL2 were determined by dual-luciferase assays. Western blot experiments were conducted to further explore the effect of miR-34b-5p on BCL2 signaling pathway. Rescue experiments were performed to uncover the role of LINC02418/miR-34b-5p/BCL2 axis in CRC progression.

Results

LINC02418 was upregulated in human colon cancer samples when compared with adjacent tissue, and its high expressional level correlated with poor prognosis of CRC patients. LINC02418 promoted cancer progression by enhancing tumor growth, cell mobility and invasiveness of colon cancer cells. Additionally, LINC02418 could physically bind to miR-34b-5p and subsequently affect BCL2 signaling pathway. Down-regulation of LINC02418 reduced cell proliferation, while transfection of miR-34b-5p inhibitor or BCL2 into LINC02418-silenced CRC cells significantly promoted CRC cells growth.

Conclusions

LINC02418 was upregulated in human CRC samples and could be used as the indicator for prediction of prognosis. LINC02418 acted as a tumor driver by negatively regulating cell apoptosis through LINC02418/miR-34b-5p/BCL2 axis in CRC.