bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality Diet Index and Risk of Pancreatic Cancer: Findings from the Singapore Chinese Health Study
Authors: Luu Hung N. , Paragomi Pedram , Jin Aizhen , Wang Renwei , Neelakantan Nithya , van Dam Rob M. , Brand Randall E. , Koh Woon-Puay , Yuan Jian-Min
Published: August 2021

Background:

Limited research has been conducted on the effect of quality diet index (QDI), which represents a comprehensive assessment of healthy diet quality and quantity, on pancreatic cancer risk in Asian populations.

Methods:

Using data from the Singapore Chinese Health Study, a prospective cohort of 63,257 middle-aged or older Chinese men and women, four QDI scores: the Alternative Health Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH), and the Heathy Diet Indicator (HDI), at baseline were calculated. After 25 years of follow-up, 311 cohort participants developed pancreatic cancer. Cox proportional hazard regression method was used to estimate HR and 95% confidence interval (CI) for pancreatic cancer associated with higher QDI scores.

Results:

Higher scores of AHEI-2010, aMED, and DASH were significantly associated with lower pancreatic cancer risk (all Ptrend < 0.05). Compared with the lowest quartile, HRs (95% CIs) of pancreatic cancer for the highest quartiles of AHEI-2010, aMED, and DASH scores were 0.65 (0.46–0.90), 0.57 (0.38–0.85), and 0.66 (0.46–0.95), respectively. These associations were more apparent among men. Overall, there was no statistically significant difference in the QDI–pancreatic cancer risk association between subgroups stratified by levels of body mass index, history of diabetes, and smoking status.

Conclusions:

Higher QDI scores were significantly associated with reduced risk of pancreatic cancer.

Impact:

The consistent results across multiple QDIs shows that adherence to a healthy diet may lower pancreatic cancer risk, suggesting that dietary modification may be a promising approach for primary prevention of pancreatic cancer.
Long-term Lung Cancer Risk Associated with Sputum Atypia: A 27-Year Follow-up Study of an Occupational Lung Screening Cohort in Yunnan, China
Authors: Fan Yaguang , Su Zheng , Wei Mengna , Liang Hao , Jiang Yong , Li Xuebing , Meng Zhaowei , Wang Ying , Pan Hongli , Song Jinzhao , Qiao Youlin , Zhou Qinghua
Published: August 2021

Background:

Sputum cytologic atypia is associated with increased lung cancer risk. However, little is known about the long-term magnitude and temporal trend of this risk.

Methods:

An extended follow-up was conducted in a prospective screening cohort among occupational tin miners in Yunnan, China. Sputum samples were collected prospectively at baseline and 7 annual screenings since enrollment. The associations between sputum cytologic results from baseline screening, the first 4 consecutive rounds of sputum screening, and lung cancer risk were analyzed by time-varying covariate Cox regression model.

Results:

A moderate or worse cytologic result was associated with a significantly increased lung cancer risk. This relative hazard significantly decreased over time. Compared with negative screening results, the adjusted hazard ratios of baseline-moderate or worse atypia, at least one moderate or worse atypia in the first 4 consecutive screening rounds during the first 10 years of follow-up were 3.11 [95% confidence interval (CI): 2.37–4.07], 3.25 (95% CI: 2.33–4.54) respectively. This association was stronger for persistent atypia (adjusted hazard ratio = 17.55, 95% CI: 8.32–37.03); atypia identified in the recent screening rounds (adjusted HR = 4.14, 95% CI: 2.70–6.35), and those were old in age, had higher level of smoking, occupational radon, and arsenic exposure. In terms of histology, this increased risk was significant for squamous cell carcinoma and small cell lung cancer.

Conclusions:

Although decreasing over time, an increased lung cancer risk concerning moderate or worse sputum atypia can continue at least for 10 years.

Impact:

Sputum atypia might be helpful for identifying high-risk individuals for screening, surveillance, or chemoprevention of lung cancer.
Applying the Strategic Planning Process to a Large Research Consortium: The Example of the National Cancer Institute Cohort Consortium
Authors: Harvey Chinonye E. , Gapstur Susan M. , Pottinger Camille A. , Elena Joanne W. , Helzlsouer Kathy J.
Published: August 2021

Strategic planning is conducted by many organizations to systematically evaluate and assess their current state, establish or update their mission and/or goals, and identify strategies and activities to achieve the goals. The National Cancer Institute (NCI) Cohort Consortium is a collaborative network of 62 prospective cohort studies and their affiliated investigators that focus on cancer etiology and outcome research. The organization's membership grew markedly from 10 cohort studies at its inception in 2001 to 59 cohort studies at the time of the launch of the Consortium's strategic planning in 2017. This paper describes the strategic planning process that was conducted to establish organizational goals and to develop strategies and activities consistent with the Consortium's mission. The process involved a 2-year iterative approach combining surveys and in-person meetings. The resulting goals focus on communication, career development, research facilitation, scientific gaps, and common scientific challenges. The NCI Cohort Consortium's strategic plan and evaluation of its progress will advance new initiatives in cancer etiology and survivorship research.
Obesity, Height, and Serum Androgen Metabolism among Postmenopausal Women in the Women's Health Initiative Observational Study
Authors: Oh Hannah , Wild Robert A. , Manson JoAnn E. , Bea Jennifer W. , Shadyab Aladdin H. , Pfeiffer Ruth M. , Saquib Nazmus , Underland Lisa , Anderson Garnet L. , Xu Xia , Trabert Britton
Published: August 2021

Background:

Anthropometric measures, including obesity, are important risk factors for breast and endometrial cancers in postmenopausal women. It is unknown whether these risk factors are associated with androgen metabolism, another risk factor for these cancers.

Methods:

Using baseline data from 1,765 postmenopausal women in the Women's Health Initiative Observational Study, we conducted a cross-sectional analysis examining associations between anthropometric measures [current body mass index (BMI), waist-to-hip ratio (WHR), height, and recalled BMI at age 18) and serum androgen metabolites. Twelve androgens/androgen metabolites were quantified using LC-MS/MS. Geometric means of androgen/androgen metabolite concentrations were estimated using linear regression, adjusting for potential confounders and stratified by hormone therapy (HT) use.

Results:

Regardless of HT use, higher current BMI (≥30 vs. <25 kg/m2) was associated with higher serum concentrations of dehydroepiandrosterone sulfate (DHEAS), 5α-reduced glucuronide metabolites [androsterone-glucuronide (ADT-G), 5α-androstane-3α,17β diol-3-glucuronide (3α-diol-3G), 3α-diol-17-glucuronide (3α-diol-17G)], and DHEAS:DHEA ratio (all P trend ≤ 0.02). BMI was also positively associated with unconjugated estrone:androstenedione and unconjugated estradiol:testosterone ratios among never/former HT users (all P trend < 0.001) but not among current users (P-int < 0.001). WHR was positively associated with adrenal androgens and 5α-reduced glucuronide metabolites in obese women only (BMI ≥ 30 kg/m2; all P-trend ≤ 0.01). BMI at age 18 was inversely associated with adrenal androgens (DHEA, DHEAS, androstenedione, testosterone) and 5α-reduced glucuronide metabolites in never/former HT users (all P trend < 0.06). Height was not associated with androgen metabolites.

Conclusions:

Current BMI is associated with androgen metabolism among postmenopausal women.

Impact:

This study contributes to our understanding of the link between obesity and cancer risk in postmenopausal women.
The Effectiveness of Cannabis and Cannabis Derivatives in Treating Lower Back Pain in the Aged Population: A Systematic Review
Authors: Senderovich Helen , Wagman Hayley , Zhang Dennis , Vinoraj Danusha , Waicus Sarah
Published: August 2021

Background/Aims: Cannabis is increasingly used in the management of pain, though minimal research exists to support its use since approval. Reduction in stigma has led to a growing interest in pharmaceutical cannabinoids as a possible treatment for lower back pain (LBP). The objective of this review was to assess the role and efficacy of cannabis and its derivatives in the management of LBP and compile global data related to the role of cannabis in the management of LBP in an aging population. Methods: A systematic review was conducted using predetermined keywords by 3 independent researchers. Predetermined inclusion and exclusion criteria were applied, and 23 articles were selected for further analysis. Results: Studies identified both significant and insignificant impacts of cannabis on LBP. Contradicting evidence was noted on the role of cannabis in the management of anxiety and insomnia, 2 common comorbidities with LBP. The existing literature suggests that cannabis may be used in the management of LBP and comorbid symptoms. Conclusions: Further research is needed to consider cannabis as an independent management option. There is a lack of evidence pertaining to the benefits of cannabis in an aged population, and thus, additional research is warranted to support its use in the aged population.
On the impact of earthquake-induced landslides on Red Panda Ailurus fulgens (Mammalia: Carnivora: Ailuridae) habitat in Langtang National Park, Nepal
Authors: Rana Magar Yogesh , Dhamala Man Kumar , Mathema Ajay , Chauhan Raju , Bhatta Sijar
Published: August 2021

In addition to the threats of human encroachment, infrastructure development, tourism activities, habitat fragmentation, and human-wildlife interactions, natural disasters also pose a threat to the habitat of endangered species such as the Red Panda. This study aims to assess the impact of the 2015 Gorkha earthquake-induced landslides on the Red Panda’s habitat in Langtang National Park (LNP), central Nepal Himalaya. Remote sensing and geographical information system were applied to estimate the potential and core habitats of the Red Panda, and collect information on earthquake-induced landslides. Field sampling and verification of remotely collected data were done within a year of the earthquake. Considering preferred vegetation types, elevation range, aspects, distance from water sources, and Red Panda presence points, an area of 214.34 km2 was estimated as the potential habitat of Red Panda in the Park. Thirty-nine landslides were identified in LNP triggered by the Gorkha earthquake, 14 of which occurred in the core Red Panda habitat. As a result of the earthquake-induced landslides, a significant decrease in tree density was observed in the areas affected by the landslides. Similarly, the bamboo cover was observed to be significantly lower in the areas affected by landslides compared to the unaffected adjacent areas. The average size of the landslide, causing damage to the Red Panda habitat was 0.8 ha. The potential habitat damaged by the earthquake-induced landslide was estimated to be 11.20 ha which is equivalent to the habitat required by one Red Panda. The findings could be useful in initiating restoration of the damaged Red Panda habitat in LNP.
White-bellied Heron Ardea insignis in Hkakabo Razi Landscape, northern Myanmar
Authors: Kyaw Myint , Bates Paul J. J. , Suarez-Rubio Marcela , Shaung Bran , Zaw Han Nyi , Aung Thein , Oo Sai Sein Lin , Renner Swen C.
Published: August 2021

White-bellied Heron Ardea insignis is a critically endangered species. The population is in decline and the range significnatly shrinking. Here we report some recent sightings/photo proof of the species form one of the last refuges of the species in the Hkakabo Razi Landscape since 2016.
Rediscovery of the Bhutan Primrose Primula jigmediana W.W. Smith (Angiosperms: Primulaceae) after 87 years in Bumdeling Wildlife Sanctuary, Bhutan
Authors: Ghalley Tez Bdr. , Dendup Tshering , Sangay Karma , Shacha Namgay
Published: August 2021

Primula jigmediana W.W. Smith named in honour of His Majesty the 2nd King of Bhutan was confined to Bumdeling Wildlife Sanctuary, Bhutan until recent record from Arunachal Pradesh, India. Primula jigmediana has been rediscovered from same region after the lapse of 87 years in Bhutan. The paper shows the morphological descriptions and distributional records of the species in Bumdeling Wildlife Sanctuary. The species was found growing along the humid sides of streams and lakes at narrower elevation of 4,300–4,600 m in isolated patches. Yaks and Ophiocordyceps sinensis collectors were observed as the prime anthropogenic threat to the species. Hence, instant conservation measures to protect this rare species is deemed necessary.
First record of interspecies grooming between Raffles’ Banded Langur and Long-tailed Macaque
Authors: Lee Zan Hui , Ang Andie , Ruppert Nadine
Published: August 2021

In primates, observations of interspecies grooming are not uncommon, especially between species of the same genus. However, little is reported about grooming between different genera and less is discussed about its ecological significance. Here, we report the first sighting of Long-tailed Macaques grooming the Critically Endangered and rare Raffles’ Banded Langur during two independent events at Gunung Lambak Recreational Forest in Kluang, Malaysia.
Anemone pindariensis sp. nov., a new species from Pindari valley of the Western Himalaya, India
Authors: SINGH HARSH , BARIK S.K.
Published: August 2021

A new species Anemone pindariensis discovered from the valley near Pindari Glacier of Western Himalaya, India is described and illustrated. This new species is closely related to A. rivularis, but differs from the latter in the sepal and stamen characters. A. pindariensis has densely hairy (vs. glabrous in A. rivularis), rounded to elliptic to oblong (vs. ovate to obovate), 4–5 (vs. 5–8) sepals, greenish-yellow sepals (vs. white-blue sepals of A. rivularis), circinnately arranged staminodes around the stamens (vs. absence of staminodes), densely hairy filaments (vs. glabrous) and oblong (vs. ellipsoid or ovoid) anthers.
Design of High Performance Low-Noise Amplifier Circuit Based on Complementary Metal Oxide Semiconductor Technology
Authors: Huang Chao , Yin Wan-Jun
Published: August 2021

This paper designs a body-biased (BB) differential cascode low-noise amplifier (LNA) with current bias (CR) and capacitor cross-coupling (CCC) technology that meets the bandwidth requirements of 5 GHz wireless applications. In the design, the CCC technology in the differential cascode
topology is used to effectively suppress the common mode noise, thereby improving the noise figure. The series resonant network eliminates parasitic capacitance at the input and output ends, thereby improving the power transmission efficiency. The CR technology formed by the intermediate capacitor
shares the DC current input to the output device, thereby increasing the gain. This paper uses BB technology in the design to lower the threshold of the cascode device and improve the transconductance, which further improves the gain and reduces the power consumption. The CCC technology used
in the paper improves linearity by eliminating the non-linear components present in the input device, which will not interfere with the transconductance of the output stage. This article has obtained excellent performance parameters including gain, noise figure (NF) and linearity without affecting
the power consumption, integration and cost of the proposed design.
Design, Fabrication, and Verification of Blue-Extended Single-Photon Avalanche Diode with Low Dark Count Rate and High Photon Detection Efficiency
Authors: Zeng Mei-Ling , Wang Yang , Jin Xiang-Liang , Peng Yan , Luo Jun
Published: August 2021

Single-photon avalanche diodes (SPADs) can detect extremely weak optical signals and are mostly used in single-photon imaging, quantum communication, medical detection, and other fields. In this paper, a low dark count rate (DCR) single-photon avalanche diode device is designed based
on the 180 nm standard BCD process. The device has a good response in the 450~750 nm spectral range. The active area of the device adopts a P+/N-Well structure with a diameter of 20 µm. The low-doped N-Well increases the thickness of the depletion region and can effectively improve
the detection sensitivity; the P-Well acts as a guard ring to prevent premature breakdown of the PN junction edge; the isolation effect of the deep N-Well reduces the noise coupling of the substrate. Use the TCAD simulation tool to verify the SPAD’s basic principles. The experimental
test results show that the avalanche breakdown voltage of the device is 11.7 V. The dark count rate is only 123 Hz when the over-bias voltage is 1 V, and the peak photon detection efficiency (PDE) reaches 37.5% at the wavelength of 500 nm under the 0.5 V over-bias voltage. PDE exceeds 30%
in the range of 460~640 nm spectral range, which has a good response in the blue band. The SPAD device provides certain design ideas for the research of fluorescence detectors.
Influence of the Power Generation Capacity of the Structural Parameters of a Piezoelectric Unimorph
Authors: Tian Xiao-Chao , Wang Hai-Gang , Wang Hu , Wang Zhi-Cong , Zhang Si-Da , Yang Zhi-Gang , Zhao Jian
Published: August 2021

To explore the influence of the structural parameters of unimorph piezoelectric vibrators on the power generation capacity, a power generation model of cantilever rectangular unimorph piezoelectric vibrators was established. The power generation expressions of the unimorph piezoelectric
vibrator were obtained, and the parameters influencing the power generation effect were determined. The influence relationship curve of the system output voltage and structural parameters was obtained through MATLAB simulations; the effecting laws of the output voltage, excitation amplitude,
thickness ratio, width-length ratio were experimentally acquired. The test results are consistent with the theoretical results, and the accuracy of theoretical analyses was verified. The piezoelectric vibrator exhibited the optimum power generation effect and provided a theoretical basis and
technical reference for applying piezoelectric ceramic materials to power generation at the thickness ratio, Young’s modulus, and aspect ratio of 0.5, 0.35, and 1, respectively.
Recombinant protein production provoked accumulation of ATP, fructose-1,6-bisphosphate and pyruvate in E. coli K12 strain TG1
Authors: Weber Jan , Li Zhaopeng , Rinas Ursula
Published: August 2021

Background

Recently it was shown that production of recombinant proteins in E. coli BL21(DE3) using pET based expression vectors leads to metabolic stress comparable to a carbon overfeeding response. Opposite to original expectations generation of energy as well as catabolic provision of precursor metabolites were excluded as limiting factors for growth and protein production. On the contrary, accumulation of ATP and precursor metabolites revealed their ample formation but insufficient withdrawal as a result of protein production mediated constraints in anabolic pathways. Thus, not limitation but excess of energy and precursor metabolites were identified as being connected to the protein production associated metabolic burden.

Results

Here we show that the protein production associated accumulation of energy and catabolic precursor metabolites is not unique to E. coli BL21(DE3) but also occurs in E. coli K12. Most notably, it was demonstrated that the IPTG-induced production of hFGF-2 using a tac-promoter based expression vector in the E. coli K12 strain TG1 was leading to persistent accumulation of key regulatory molecules such as ATP, fructose-1,6-bisphosphate and pyruvate.

Conclusions

Excessive energy generation, respectively, accumulation of ATP during recombinant protein production is not unique to the BL21(DE3)/T7 promoter based expression system but also observed in the E. coli K12 strain TG1 using another promoter/vector combination. These findings confirm that energy is not a limiting factor for recombinant protein production. Moreover, the data also show that an accelerated glycolytic pathway flux aggravates the protein production associated “metabolic burden”. Under conditions of compromised anabolic capacities cells are not able to reorganize their metabolic enzyme repertoire as required for reduced carbon processing.
The current issues and future perspective of artificial intelligence for developing new treatment strategy in non-small cell lung cancer: harmonization of molecular cancer biology and artificial intelligence
Authors: Tanaka Ichidai , Furukawa Taiki , Morise Masahiro
Published: August 2021

Comprehensive analysis of omics data, such as genome, transcriptome, proteome, metabolome, and interactome, is a crucial technique for elucidating the complex mechanism of cancer onset and progression. Recently, a variety of new findings have been reported based on multi-omics analysis in combination with various clinical information. However, integrated analysis of multi-omics data is extremely labor intensive, making the development of new analysis technology indispensable. Artificial intelligence (AI), which has been under development in recent years, is quickly becoming an effective approach to reduce the labor involved in analyzing large amounts of complex data and to obtain valuable information that is often overlooked in manual analysis and experiments. The use of AI, such as machine learning approaches and deep learning systems, allows for the efficient analysis of massive omics data combined with accurate clinical information and can lead to comprehensive predictive models that will be desirable for further developing individual treatment strategies of immunotherapy and molecular target therapy. Here, we aim to review the potential of AI in the integrated analysis of omics data and clinical information with a special focus on recent advances in the discovery of new biomarkers and the future direction of personalized medicine in non-small lung cancer.
Family doctor contract services and health-related quality of life among patients with chronic diseases in rural China: what is the role of socioeconomic status?
Authors: Li Zhixian , Li Jie , Fu Peipei , Chen Yan , Jing Zhengyue , Yuan Yemin , Yang Shijun , Yan Chen , Li Wenjuan , Li Jie , Gui Zhen , Zhou Chengchao
Published: August 2021

Purpose

Few studies explored the relationship between the family doctor contract services (FDCS) and health-related quality of life (HRQOL) among patients with chronic diseases in rural China. This study aims to explore the relationship between the status of signing on FDCS and HRQOL among patients with chronic diseases and examine whether there are differences in the relationship between different socioeconomic status (SES).

Methods

A total of 1,210 respondents were included in this study. HRQOL was measured by EQ-5D-3L. The contracting status was divided into uncontracted and contracted. Tobit regression and Logistic regression were employed to explore the association between contracting status and HRQOL. The interaction terms were included to explore the differences in the association among different SES.

Results

Contracting with family doctors was associated with HRQOL (coefficient = 0.042; 95%CI 0.008 to 0.075). The association was different among different socioeconomic levels that the contracting status was only associated with HRQOL in sub-high-income (P < 0.01) and highly educated patients (P < 0.05). Compared with uncontracted patients, contracted patients reported higher ED-5D-3L utility value in the sub-high-income group (coefficient = 0.078; 95%CI 0.017 to 0.140) and high educational attainment (coefficient = 0.266; 95%CI 0.119 to 0.413).

Conclusions

This study found a significant association between FDCS and HRQOL among chronic patients in rural Shandong, China. This relationship varied by income levels and educational attainment. The government should take efforts to formulate a variety of measures to encourage chronic patients to contract with family doctors, with special attention to people with low SES.
Sirtuin3 rs28365927 functional variant confers to the high risk of non-alcoholic fatty liver disease in Chinese Han population
Authors: Chen Li-jie , Guo Jing , Zhang Song-xia , Xu Ying , Zhao Qing , Zhang Wei , Xiao Jian , Chen Yao
Published: August 2021

Background

Non-alcoholic fatty liver disease (NAFLD) is a multifactorial condition associated with aging, insulin resistance, metabolic syndrome, genetic factors and more. Although genetic traits are among the most important risks factors for NAFLD, the understanding of their influence is still quite limited. The present study aimed at identifying novel single nucleotide polymorphisms (SNPs) that may confer a risk for NAFLD in the Han Chinese population.

Methods

Based on the “two-hit hypothesis”, candidate SNPs, including Sirtuin3 rs28365927, were genotyped by MassARRAY in B-type ultrasonography-proven NAFLD patients (n = 292) and healthy controls (n = 387).

Results

In a model analysis of individuals matched based on gender and age that compared 223 NAFLD and 223 non-NAFLD patients, the rs28365927 GA + AA genotype was a significant risk factor for the development of NAFLD in a dominant model. Rs28365927 was significantly associated with a higher NAFLD risk in both an additive model (A vs G) and genotypic model (GA vs GG). Among the NAFLD patients, serum levels of total bilirubin (TBIL), DBIL direct bilirubin (DBIL) and glutamic-pyruvic transaminase (ALT) in rs28365927 A allele carriers (GA + AA) were 11.1, 14.7 and 41.5% higher, respectively, than in non-carriers (GG). Furthermore, among the NAFLD patients, the carriers of Rs28365927 allele A were positively correlated with higher ALT levels.

Conclusion

Sirtuin3 rs28365927 functional variant confers to the high risk of non-alcoholic fatty liver disease in Chinese Han population. The rs28365927 A allele significantly increased the ALT levels of NAFLD patients.
Biological consequences of cancer radiotherapy in the context of oral squamous cell carcinoma
Authors: Feller G. , Khammissa R. A. G. , Nemutandani M. S. , Feller L.
Published: August 2021

Approximately 50% of subjects with cancer have been treated with ionizing radiation (IR) either as a curative, adjuvant, neoadjuvant or as a palliative agent, at some point during the clinical course of their disease. IR kills cancer cells directly by injuring their DNA, and indirectly by inducing immunogenic cell killing mediated by cytotoxic T cells; but it can also induce harmful biological responses to non-irradiated neighbouring cells (bystander effect) and to more distant cells (abscopal effect) outside the primary tumour field of irradiation.

Although IR can upregulate anti-tumour immune reactions, it can also promote an immunosuppressive tumour microenvironment. Consequently, radiotherapy by itself is seldom sufficient to generate an effective long lasting immune response that is capable to control growth of metastasis, recurrence of primary tumours and development of second primary cancers. Therefore, combining radiotherapy with the use of immunoadjuvants such as immune checkpoint inhibitors, can potentiate IR-mediated anti-tumour immune reactions, bringing about a synergic immunogenic cell killing effect.

The purpose of this narrative review is to discuss some aspects of IR-induced biological responses, including factors that contributes to tumour radiosensitivity/radioresistance, immunogenic cell killing, and the abscopal effect.
The effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: a prospective cohort study
Authors: Addila Alemu Earsido , Azale Telake , Gete Yigzaw Kebede , Yitayal Mezgebu
Published: August 2021

Background

The teratogenic effect of fetal alcohol exposure may lead to actual and potential problems, instantly after birth, at infancy; or even later, and mental impairment in life. This study aimed to investigate the effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes at Gondar town public health facilities, Northwest Ethiopia.

Methods

A facility-based prospective cohort study was performed among 1778 pregnant women who were booked for antenatal care in selected public health facilities from 29 October 2019 to 7 May 2020 in Gondar town. We used a two-stage random sampling technique to recruit and include participants in the cohort. Data were collected using the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) standardized and pre-tested questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and interested adverse birth outcomes using log-binomial regression modeling. The burden of outcomes was reported using the adjusted risk ratio and population-attributable risk (PAR).

Results

A total of 1686 pregnant women were included in the analysis, which revealed that the incidences of low birth weight, preterm, and stillbirth were 12.63% (95% CI: 11.12, 14.31), 6.05% (95% CI: 5.00, 7.29) and 4.27% (95% CI: 3.4, 5.35), respectively. Non-hazardous and hazardous alcohol consumption during pregnancy was significantly associated with low birth weight (ARR = 1.50; 95% CI: 1.31, 1.98) and (ARR = 2.34; 95% CI: 1.66, 3.30), respectively. Hazardous alcohol consumption during pregnancy was also significantly associated with preterm birth (ARR = 2.06; 95% CI: 1.21, 3.52). The adjusted PAR of low birth weight related to non-hazardous and hazardous alcohol drinking during pregnancy was 11.72 and 8.44%, respectively. The adjusted PAR of hazardous alcohol consumption was 6.80% for preterm.

Conclusions

Our findings suggest that there is an increasing risk of adverse birth outcomes, particularly preterm delivery and low birth weight, with increasing levels of alcohol intake. This result showed that the prevention of maternal alcohol use during pregnancy has the potential to reduce low birth weight and preterm birth. Hence, screening women for alcohol use during antenatal care visits and providing advice with rigorous follow-up of women who used alcohol may save the fetus from the potential risks of adverse birth outcomes.
Video assisted, transaortic removal of left ventricular thrombus during concurrent cardiac surgery: a case report
Authors: Eranki Aditya , Villanueva Claudia , Collins Nicholas , Seah Peng
Published: August 2021

Introduction

Left ventricular (LV) thrombus is a complication of acute myocardial infarction and is associated with systemic thromboembolism. We describe a trans-aortic endoscopic approach to the removal of an LV thrombus in a patient undergoing concurrent coronary artery bypass grafting and aortic valve replacement.

Case presentation

A 47 year old male presented following an embolic middle cerebral artery stroke and underwent transthoracic echocardiography demonstrating a mobile LV thrombus. Additional investigation revealed a moderately stenosed bicispid aortic valve, two vessel coronary artery disease and ischemic cardiomyopathy. The patient underwent early surgery to reduce the risk of further embolic episodes. A trans-aortic approach was utilized with videoscopy and single shafted instrumentation to aide in removal of the thrombus. The patient then underwent aortic valve replacement and coronary artery bypass grafting.

Conclusion

We report an alternative technique for the removal of a left ventricular thrombus in a patient undergoing concurrent coronary and aortic valve surgery. The transaortic video-assisted approach provided excellent visualisation of the apex and near complete removal of the thrombus without damaging the surrounding trabeculae. The main benefit of this technique is sparing of LV tissue, thereby preserving left ventricular function.
A novel multidimensional strategy to evaluate Belamcanda chinensis (L) DC and Iris tectorum Maxim based on plant metabolomics, digital reference standard analyzer and biological activities evaluation
Authors: Zhou Hongxu , Zhang Yi , Liang Hui , Song Huijie , Zhao Jiaming , Liu Li , Zeng Jun , Sun Lei , Ma Shuangcheng , Meng Dali
Published: August 2021

Background

Belamcanda chinensis(L.) DC. (BC) belongs to the family ofIridaceaeand is widely cultivated and used in many Chinese patent medicine and Chinese medicinal formulae. However, due to the high similarities in appearance such as color and shape toIris tectorumMaxim (ITM), another plant from the same family, BC is often confused or even misused with ITM.

Methods

Therefore, in order to distinguish the chemical constituents, qualities and biological activities of BC and ITM, multiple technologies including plant metabolomics, digital reference standard (DRS) analyzer and biological activities assay were employed to provide a sufficient basis for their practical applications.

Results

In plant metabolomics, the PCA and OPLS-DA score plot indicated the obvious differences in chemical profiling between BC and ITM and 6 compounds were successfully identified to contribute to the differences. In DRS study, the fingerprints of 10 and 8 compounds in BC and ITM were developed based on DRS analyzer, respectively, involving relative retention time (RRT) method and linear calibration using two reference substances (LCTRS) technique. The DRS analyzer also accurately identified 10 and 8 compounds from BC and ITM, respectively, by using only two reference standards. In biological activities assay, BC had a better anticancer effect than ITM due to the high abundance of irigenin, while ITM showed stronger hepatoprotective activity than BC because of the high abundance of tectoridin.

Conclusions

Therefore, due to the significant differences ofB. chinensisandI. dichotomain chemical composition and biological activities, the current studies strongly proved that these two medicinal plants could not be mixed in industrial production and clinical medication.
Complications after intramedullary nail fixation of pathological versus non-pathological femoral shaft fractures: a retrospective cohort study in 233 patients
Authors: Anusitviwat Chirathit , Iamthanaporn Khanin , Tuntarattanapong Pakjai , Tangtrakulwanich Boonsin , Liabsuetrakul Tippawan
Published: August 2021

Background

Postoperative adverse events after intramedullary nailing have been reported in patients with metastatic pathological and non-pathological femoral fractures. Other consequences to be considered are readmission and reoperation. Few studies have compared the risks of postoperative adverse events, reoperation, and readmission after intramedullary nailing of pathological and non-pathological femur fractures. This study was designed to test the hypothesis that patients with pathological femoral fractures had more adverse events, readmission, and reoperation following surgical fixation than non-pathological femoral fractures.

Methods

This was a retrospective observational cohort study, conducted at an academic medical center in Thailand. The data from patients with femoral shaft fractures undergoing long intramedullary nailing, from June 1, 2006, to June 30, 2020, were included. Patients who had a pathological fracture from a primary bone tumor, metabolic bone disease, or inadequate/missing information were excluded. Patients with pathological fractures from metastatic bone disease were assigned to be the pathological group whereas those with traumatic fractures were assigned to be the non-pathological group. The primary outcome was the risk of inpatient adverse events as compared between the two groups. The secondary outcome was the risk of consequences after discharge as compared between the two groups. Outcomes were analyzed by using multivariate logistic regression analysis.

Results

The total number of patients was 48 in the pathological fracture group and 185 in the non-pathological group. There were significantly higher rates of surgical and medical adverse events in patients with pathological fractures compared to patients with non-pathological fractures. After adjusting for potential confounding factors in multivariate regression analysis, patients with pathological fractures had higher odds of both adverse surgical (adjusted OR 2.43, 95 % CI 1.15–5.13) and medical adverse events (adjusted OR 2.81, 95 % CI 1.13–7.03).

Conclusions

Patients with metastatic pathological femoral shaft fractures undergoing intramedullary nailing were more likely to experience postoperative adverse events than patients with non-pathological fractures.
Making large-scale surgical trials possible: collaboration and the role of surgical trainees
Authors: Jepson Marcus , Lazaroo Michelle , Pathak Samir , Blencowe Natalie , Collingwood Jane , Clout Madeleine , Toogood Giles , Blazeby Jane ,   on behalf of the Sunflower Study Executive Group
Published: August 2021

Background

Recruitment to surgical randomised controlled trials (RCTs) can be challenging. The Sunflower study is a large-scale multi-centre RCT that seeks to establish the clinical and cost effectiveness of pre-operative imaging versus expectant management in patients with symptomatic gallstones undergoing laparoscopic cholecystectomy at low or moderate risk of common bile duct stones. Trials such as Sunflower, with a large recruitment target, rely on teamworking. Recruitment can be optimised by embedding a QuinteT Recruitment Intervention (QRI). Additionally, engaging surgical trainees can contribute to successful recruitment, and the NIHR Associate Principal Investigator (API) scheme provides a framework to acknowledge their contributions.

Methods

This was a mixed-methods study that formed a component part of an embedded QRI for the Sunflower RCT. The aim of this study was to understand factors that supported and hindered the participation of surgical trainees in a large-scale RCT and their participation in the API scheme. It comprised semi-structured telephone interviews with consultant surgeons and surgical trainees involved in screening and recruitment of patients, and descriptive analysis of screening and recruitment data. Interviews were analysed thematically to explore the perspectives of—and roles undertaken by—surgical trainees.

Results

Interviews were undertaken with 34 clinicians (17 consultant surgeons, 17 surgical trainees) from 22 UK hospital trusts. Surgical trainees contributed to patient screening, approaches and randomisation, with a major contribution to the randomisation of patients from acute admissions. They were often encouraged to participate in the study by their centre principal investigator, and career development was a typical motivating factor for their participation in the study. The study was registered with the API scheme, and a majority of the trainees interviewed (n = 14) were participating in the scheme.

Conclusion

Surgical trainees can contribute substantial activity to a large-scale multi-centre RCT. Benefits of trainee engagement were identified for trainees themselves, for local sites and for the study as a whole. The API scheme provided a formal framework to acknowledge engagement. Ensuring that training and support for trainees are provided by the trial team is key to optimise success for all stakeholders.
Randomized phase II study of gemcitabine and S-1 combination therapy versus gemcitabine and nanoparticle albumin-bound paclitaxel combination therapy as neoadjuvant chemotherapy for resectable/borderline resectable pancreatic ductal adenocarcinoma (PDAC-GS/GA-rP2, CSGO-HBP-015)
Authors: Yamada Daisaku , Kobayashi Shogo , Takahashi Hidenori , Akita Hirofumi , Yamada Terumasa , Asaoka Tadafumi , Shimizu Junzo , Takeda Yutaka , Yokoyama Shigekazu , Tsujie Masanori , Tomokuni Akira , Tanemura Masahiro , Morimoto Osakuni , Murakami Masahiro , Kim Yongkook , Nakahira Shin , Hama Naoki , Sugimoto Keishi , Hashimoto Kazuhiko , Doki Yuichiro , Eguchi Hidetoshi
Published: August 2021

Background

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease, and multimodal strategies, such as surgery plus neoadjuvant chemotherapy (NAC)/adjuvant chemotherapy, have been attempted to improve survival in patients with localized PDAC. To date, there is one prospective study providing evidence for the superiority of a neoadjuvant strategy over upfront surgery for localized PDAC. However, which NAC regimen is optimal remains unclear.

Methods

A randomized, exploratory trial is performed to examine the clinical benefits of two chemotherapy regimens, gemcitabine plus S-1 (GS) and gemcitabine plus nab-paclitaxel (GA), as NAC for patients with planned PDAC resection. Patients are enrolled after the diagnosis of resectable or borderline resectable PDAC. They are randomly assigned to either NAC regimen. Adjuvant chemotherapy after curative resection is highly recommended for 6 months in both arms. The primary endpoint is tumor progression-free survival time, and secondary endpoints include the rate of curative resection, the completion rate of protocol therapy, the recurrence type, the overall survival time, and safety. The target sample size is set as at least 100.

Discussion

This study is the first randomized phase II study comparing GS combination therapy with GA combination therapy as NAC for localized pancreatic cancer.

Trial registration

UMIN Clinical Trials RegistryUMIN000021484. This trial began in April 2016.
Reforming solitary confinement: the development, implementation, and processes of a restrictive housing step down reentry program in Oregon
Authors: Labrecque Ryan M. , Tostlebe Jennifer J. , Useem Bert , Pyrooz David C.
Published: August 2021

Background

Over the past decade there have been numerous and impassioned calls to reform the practice of solitary confinement in U.S. prisons. This article examines the development, implementation, and processes of a restrictive housing reentry program in the Oregon Department of Corrections. It draws on data from official documents, site observations, and interviews with 12 prison officials and 38 prisoners. The Step Up Program (SUP) seeks to improve the living conditions in restrictive housing over business-as-usual, alleviate physiological and psychological harms of solitary confinement, and use rehabilitative programming to increase success upon returning to the general prison population or community.

Results

The impetus to change the culture and structure of restrictive housing was primarily the result of internal administrative reform. Prisoners assigned at random to housing assignments offered accounts of their daily activities suggesting that the SUP provides more time out-of-cell and greater access to other services and activities. Program participants preferred the living conditions in the SUP because they had more opportunities for social interaction and incentives for compliant behavior. However, views on the value of programming among respondents were mixed.

Conclusions

The launch of the SUP occurred in early 2020, which was soon followed by the COVID-19 pandemic. As a result, the program was never fully implemented as intended. As Oregon returns to more normal operations, it is possible that the SUP will be able to include even more out-of-cell time, greater socialization opportunities, and increased access to programming and other beneficial activities. As we await the opportunity to conduct prospective psychological and behavioral analyses, this study provides tentative support for the use of step down reentry programs in restrictive housing units.

Trial registration

Open Science Framework,Preparing adults in custody for successful reentry: An experimental study of a restrictive housing exit program in Oregon. Registered 4 October 2019,https://osf.io/t6qpx/
Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: results from a multicenter randomized controlled trial
Authors: Kratzer André , Luttenberger Katharina , Karg-Hefner Nina , Weiss Maren , Dorscht Lisa
Published: August 2021

Background

Recent studies have suggested that therapeutic climbing/bouldering may have positive effects on perceived self-efficacy. Nevertheless, there is still an urgent need for high-quality studies, as many existing studies have suffered from methodological problems. Therefore, the current work was aimed at investigating the effect of a manualized bouldering psychotherapy (BPT) on perceived self-efficacy in people with depression, compared with a home-based physical exercise program (EP) and state-of-the-art cognitive behavioral group therapy (CBT).

Methods

In a prospective, multicenter, randomized controlled trial, 233 people with depression were randomly assigned to one group (BPT, EP, or CBT). Perceived self-efficacy was assessed at baseline (t0) and directly after the 10-week intervention period (t1) with the GSE. In addition, depression was assessed with the PHQ-9 and the MADRS.We computedttests, analyses of variance (ANOVAs), confounder-adjusted hierarchical regression analyses, mediation analyses, and several sensitivity analyses.

Results

BPT participants showed a significantly larger increase in perceived self-efficacy on the GSE compared with the EP (an increase of 3.04 vs. 1.26 points,p = .016, Cohen’s d = 0.39). In the confounder-adjusted hierarchical multiple regression analysis, group allocation (BPT vs. EP) was found to be the only significant predictor of the postintervention GSE score (β = .16,p = .014) besides the baseline GSE score (β = .69,p < .001). No differences were found between BPT and CBT participants regarding the effect on perceived self-efficacy. Only in the CBT group, the relationship between depression at baseline and postintervention was partially mediated (23%) by perceived self-efficacy.

Conclusions

Participation in the manualized BPT in a group setting leads to a clinically relevant enhancement of perceived self-efficacy in people with depression. This effect is superior to that of physical exercise alone. The results provide also initial indications that BPT is comparable to CBT in enhancing perceived self-efficacy, suggesting a strong case for a broader use of BPT as a supplement to existing health services. Future studies should focus on the modes of action of BPT and its effect on perceived self-efficacy in people with other mental or physical disorders.

Trial registrationISRCTN12457760, registered partly retrospectively, 26 July 2017.