bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of red and blue light on leaf anatomy, CO2 assimilation and the photosynthetic electron transport capacity of sweet pepper (Capsicum annuum L.) seedlings
Authors: Li Yan , Xin Guofeng , Liu Chang , Shi Qinghua , Yang Fengjuan , Wei Min
Published: July 2020

Background

The red (R) and blue (B) light wavelengths are known to influence many plant physiological processes during growth and development, particularly photosynthesis. To understand how R and B light influences plant photomorphogenesis and photosynthesis, we investigated changes in leaf anatomy, chlorophyll fluorescence and photosynthetic parameters, and ribulose-1, 5-bisphosphate carboxylase/oxygenase (Rubisco) and Calvin cycle-related enzymes expression and their activities in sweet pepper (Capsicum annuum L.) seedlings exposed to four light qualities: monochromatic white (W, control), R, B and mixed R and B (RB) light with the same photosynthetic photon flux density (PPFD) of 300 μmol/m2·s.

Results

The results revealed that seedlings grown under R light had lower biomass accumulation, CO2 assimilation and photosystem II (PSII) electron transportation compared to plants grown under other treatments. These changes are probably due to inactivation of the photosystem (PS). Biomass accumulation and CO2 assimilation were significantly enriched in B- and RB-grown plants, especially the latter treatment. Their leaves were also thicker, and photosynthetic electron transport capacity, as well as the photosynthetic rate were enhanced. The up-regulation of the expression and activities of Rubisco, fructose-1, 6-bisphosphatase (FBPase) and glyceraldehyde-phosphate dehydrogenase (GAPDH), which involved in the Calvin cycle and are probably the main enzymatic factors contributing to RuBP (ribulose-1, 5-bisphosphate) synthesis, were also increased.

Conclusions

Mixed R and B light altered plant photomorphogenesis and photosynthesis, mainly through its effects on leaf anatomy, photosynthetic electron transportation and the expression and activities of key Calvin cycle enzymes.
Inhibition of multiple defense responsive pathways by CaWRKY70 transcription factor promotes susceptibility in chickpea under Fusarium oxysporum stress condition
Authors: Chakraborty Joydeep , Sen Senjuti , Ghosh Prithwi , Jain Akansha , Das Sampa
Published: July 2020

Background

Suppression and activation of plant defense genes is comprehensively regulated by WRKY family transcription factors. Chickpea, the non-model crop legume suffers from wilt caused by Fusarium oxysporum f. sp. ciceri Race1 (Foc1), defense response mechanisms of which are poorly understood. Here, we attempted to show interaction between WRKY70 and several downstream signaling components involved in susceptibility/resistance response in chickpea upon challenge with Foc1.

Results

In the present study, we found Cicer arietinum L. WRKY70 (CaWRKY70) negatively governs multiple defense responsive pathways, including Systemic Acquired Resistance (SAR) activation in chickpea upon Foc1 infection. CaWRKY70 is found to be significantly accumulated at shoot tissues of susceptible (JG62) chickpea under Foc1 stress and salicylic acid (SA) application. CaWRKY70 overexpression promotes susceptibility in resistant chickpea (WR315) plants to Foc1 infection. Transgenic plants upon Foc1 inoculation demonstrated suppression of not only endogenous SA concentrations but expression of genes involved in SA signaling. CaWRKY70 overexpressing chickpea roots exhibited higher ion-leakage and Foc1 biomass accumulation compared to control transgenic (VC) plants. CaWRKY70 overexpression suppresses H2O2 production and resultant reactive oxygen species (ROS) induced cell death in Foc1 infected chickpea roots, stem and leaves. Being the nuclear targeted protein, CaWRKY70 suppresses CaMPK9-CaWRKY40 signaling in chickpea through its direct and indirect negative regulatory activities. Protein-protein interaction study revealed CaWRKY70 and CaRPP2-like CC-NB-ARC-LRR protein suppresses hyper-immune signaling in chickpea. Together, our study provides novel insights into mechanisms of suppression of the multiple defense signaling components in chickpea by CaWRKY70 under Foc1 stress.

Conclusion

CaWRKY70 mediated defense suppression unveils networking between several immune signaling events negatively affecting downstream resistance mechanisms in chickpea under Foc1 stress.
Physical activity and the risk of sudden cardiac death: a systematic review and meta-analysis of prospective studies
Authors: Aune Dagfinn , Schlesinger Sabrina , Hamer Mark , Norat Teresa , Riboli Elio
Published: July 2020

Background

Physical activity has been associated with a significant reduction in risk of sudden cardiac death in epidemiological studies, however, the strength of the association needs clarification. We conducted a systematic review and meta-analysis to summarize the available data from population-based prospective studies.

Methods

PubMed and Embase databases were searched for studies of physical activity and sudden cardiac death from inception to March 26th 2019. Prospective studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) of sudden cardiac death associated with physical activity were included. A random effects model was used to estimate summary RRs (95% CIs).

Results

Thirteen prospective studies were included in the systematic review. Eight prospective studies with 1193 sudden cardiac deaths among 136,298 participants were included in the meta-analysis of physical activity and sudden cardiac death and the summary RR for highest vs. lowest level of physical activity was 0.52 (95% CI: 0.45–0.60, I2 = 0%, pheterogeneity = 0.72). The association was similar in men and women and among American and European studies. In the dose-response analysis the summary RR was 0.68 (95% CI: 0.55–0.86, I2 = 44%, n = 3) per 20 MET-hours/week. Although the test for nonlinearity was not significant, pnonlinearity = 0.18, there was no further reduction in risk beyond 20–25 MET-hours/week. The summary RR was 0.58 (95% CI: 0.41–0.81, I2 = 0%, pheterogeneity = 0.65, n = 2) for the highest vs. the lowest level of cardiorespiratory fitness.

Conclusion

This meta-analysis suggest that a high compared to a low level of physical activity may reduce the risk of sudden cardiac death in the general population. Further studies are needed to clarify the dose-response relationship between specific subtypes and intensities of physical activity in relation to sudden cardiac death.
Identification of candidate genes in ischemic cardiomyopathy by gene expression omnibus database
Authors: Dang Haiming , Ye Yicong , Zhao Xiliang , Zeng Yong
Published: July 2020

Background

Ischemic cardiomyopathy (ICM) is one of the most usual causes of death worldwide. This study aimed to find the candidate gene for ICM.

Methods

We studied differentially expressed genes (DEGs) in ICM compared to healthy control. According to these DEGs, we carried out the functional annotation, protein-protein interaction (PPI) network and transcriptional regulatory network constructions. The expression of selected candidate genes were confirmed using a published dataset and Quantitative real time polymerase chain reaction (qRT-PCR).

Results

From three Gene Expression Omnibus (GEO) datasets, we acquired 1081 DEGs (578 up-regulated and 503 down-regulated genes) between ICM and healthy control. The functional annotation analysis revealed that cardiac muscle contraction, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and dilated cardiomyopathy were significantly enriched pathways in ICM. SNRPB, BLM, RRS1, CDK2, BCL6, BCL2L1, FKBP5, IPO7, TUBB4B and ATP1A1 were considered the hub proteins. PALLD, THBS4, ATP1A1, NFASC, FKBP5, ECM2 and BCL2L1 were top six transcription factors (TFs) with the most downstream genes. The expression of 6 DEGs (MYH6, THBS4, BCL6, BLM, IPO7 and SERPINA3) were consistent with our integration analysis and GSE116250 validation results.

Conclusions

The candidate DEGs and TFs may be related to the ICM process. This study provided novel perspective for understanding mechanism and exploiting new therapeutic means for ICM.
Multi-state analysis of hypertension and mortality: application of semi-Markov model in a longitudinal cohort study
Authors: Ramezankhani Azra , Blaha Michael J. , Mirbolouk Mohammad hassan , Azizi Fereidoun , Hadaegh Farzad
Published: July 2020

Background

Most previous research has studied the association of hypertension with cardiovascular disease (CVD) and all-cause mortality by focusing on the transition from the initial state to a single outcome. We investigated the impact of hypertension, defined according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) (new) and the Seventh Report of the Joint National Committee (JNC7) (old), on CVD death and all-cause mortality considering non-fatal CVD as an intermediate event between two CVD-free and mortality states.

Methods

A total of 3002 Iranian population (47.4% men), aged ≥50 years were followed from 1999 to 2014. Two multi-state semi-Markov models with three transitions were defined for CVD death and all-cause mortality as two outcomes. The multivariable Cox model was used to estimate the effect of hypertension on transition hazards. The mean of 15-year life expectancy of participants in each transition was estimated using the restricted mean survival time.

Results

The ACC/AHA guideline increased the prevalence of hypertension from 43.3 to 68.6%. Among CVD-free individuals, hypertension was significantly associated with increased risk of non-fatal CVD [Hazard Ratio, 1.52 (1.28–1.81) and 1.48 (1.21–1.80)], CVD death [2.96 (2.06–4.25) and 1.98 (1.30–3.04)] and all-cause mortality [1.64 (1.32–2.05) and 1.31 (1.01–1.69)] according the old and new guidelines, respectively. However, after incident non-fatal CVD, the association between hypertension and mortality events was not significant according to both definitions. Hypertensive participants experienced a first non-fatal CVD about 0.9 and 0.6 years earlier than normotensive population according to JNC7 and the 2017 ACC/AHA guidelines, respectively.

Conclusion

Hypertension, according to JNC7 and the ACC/AHA guidelines, significantly increased the risk of mortality events among CVD-free population although the risk was attenuated using ACC/AHA guideline. Hypertension also decreased the number of years lived without CVD and early onset of CVD, and consequently, an increase in the time spent with these diseases. After non-fatal CVD, hypertension had no significant impact on mortality risk according to both guidelines.
Quasi-linear Cox proportional hazards model with cross- L1 penalty
Authors: Omae Katsuhiro , Eguchi Shinto
Published: July 2020

Background

To accurately predict the response to treatment, we need a stable and effective risk score that can be calculated from patient characteristics. When we evaluate such risks from time-to-event data with right-censoring, Cox’s proportional hazards model is the most popular for estimating the linear risk score. However, the intrinsic heterogeneity of patients may prevent us from obtaining a valid score. It is therefore insufficient to consider the regression problem with a single linear predictor.

Methods

we propose the model with a quasi-linear predictor that combines several linear predictors. This provides a natural extension of Cox model that leads to a mixture hazards model. We investigate the property of the maximum likelihood estimator for the proposed model. Moreover, we propose two strategies for getting the interpretable estimates. The first is to restrict the model structure in advance, based on unsupervised learning or prior information, and the second is to obtain as parsimonious an expression as possible in the parameter estimation strategy with cross- L1penalty. The performance of the proposed method are evaluated by simulation and application studies.

Results

We showed that the maximum likelihood estimator has consistency and asymptotic normality, and the cross- L1-regularized estimator has root-nconsistency. Simulation studies show these properties empirically, and application studies show that the proposed model improves predictive ability relative to Cox model.

Conclusions

It is essential to capture the intrinsic heterogeneity of patients for getting more stable and effective risk score. The proposed hazard model can capture such heterogeneity and achieve better performance than the ordinary linear Cox proportional hazards model.
Using CT texture analysis to differentiate between peripheral lung cancer and pulmonary inflammatory pseudotumor
Authors: Liu Chenlu , Ma Changsheng , Duan Jinghao , Qiu Qingtao , Guo Yanluan , Zhang Zhenhua , Yin Yong
Published: July 2020

Background

This study is to distinguish peripheral lung cancer and pulmonary inflammatory pseudotumor using CT-radiomics features extracted from PET/CT images.

Methods

In this study, the standard 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18 F-FDG PET/CT) images of 21 patients with pulmonary inflammatory pseudotumor (PIPT) and 21 patients with peripheral lung cancer were retrospectively collected. The dataset was used to extract CT-radiomics features from regions of interest (ROI), The intra-class correlation coefficient (ICC) was used to screen the robust feature from all the radiomic features. Using, then, statistical methods to screen CT-radiomics features, which could distinguish peripheral lung cancer and PIPT. And the ability of radiomics features distinguished peripheral lung cancer and PIPT was estimated by receiver operating characteristic (ROC) curve and compared by the Delong test.

Results

A total of 435 radiomics features were extracted, of which 361 features showed relatively good repeatability (ICC ≥ 0.6). 20 features showed the ability to distinguish peripheral lung cancer from PIPT. these features were seen in 14 of 330 Gray-Level Co-occurrence Matrix features, 1 of 49 Intensity Histogram features, 5 of 18 Shape features. The area under the curves (AUC) of these features were 0.731 ± 0.075, 0.717, 0.748 ± 0.038, respectively. ThePvalues of statistical differences among ROC were 0.0499 (F9, F20), 0.0472 (F10, F11) and 0.0145 (F11, Mean4). The discrimination ability of forming new features (Parent Features) after averaging the features extracted at different angles and distances was moderate compared to the previous features (Child features).

Conclusion

Radiomics features extracted from non-contrast CT based on PET/CT images can help distinguish peripheral lung cancer and PIPT.
Whole-exome sequencing identifies a de novo PDE3A variant causing autosomal dominant hypertension with brachydactyly type E syndrome: a case report
Authors: Li Xianqing , Li Zongzhe , Chen Peng , Wang Yan , Wang Dao Wen , Wang Dao Wu
Published: July 2020

Background

Autosomal dominant hypertension with brachydactyly type E syndrome caused by pathogenic variants in the PDE3A gene was first reported in 2015. To date, there are only a few reports of this kind of syndrome. Other patients still lack a genetic diagnosis.

Case presentation

Whole-exome sequencing was performed in an 18-year-old female proband with a clinical diagnosis of hypertension with brachydactyly syndrome. Quantitative real-time PCR was used to identify pathogenic copy number variations (CNVs). After bioinformatics analysis and healthy control database filtering, we revealed a heterozygous missense PDE3A variant (c.1346G > A, p.Gly449Asp). The variant was absent in the ExAC database and located in a highly evolutionarily conserved cluster of reported PDE3A pathogenic variants. Importantly, this variant was predicted to affect protein function by both SIFT (score = 0) and PolyPhen-2 (score = 1). After Sanger sequencing, the variant was determined to be absent in the healthy parents of the proband as well as 800 ethnically and geographically matched healthy controls.

Conclusion

We present a report linking a de novo PDE3A variant to autosomal dominant hypertension with brachydactyly type E syndrome.
Markers of potassium homeostasis in salt losing tubulopathies- associations with hyperaldosteronism and hypomagnesemia
Authors: Eder Michael , Darmann Elisabeth , Haller Maria C. , Bojic Marija , Peck-Radosavljevic Markus , Huditz Rainer , Bond Gregor , Vychytil Andreas , Reindl-Schwaighofer Roman , Kikić Željko
Published: July 2020

Background

Renal loss of potassium (K+) and magnesium (Mg2+) in salt losing tubulopathies (SLT) leads to significantly reduced Quality of Life (QoL) and higher risks of cardiac arrhythmia. The normalization of K+ is currently the most widely accepted treatment target, however in even excellently designed RCTs the increase of K+ was only mild and rarely normalized. These findings question the role of K+ as the ideal marker of potassium homeostasis in SLT. Aim of this hypothesis-generating study was to define surrogate endpoints for future treatment trials in SLT in terms of their usefulness to determine QoL and important clinical outcomes.

Methods

Within this prospective cross-sectional study including 11 patients with SLTs we assessed the biochemical, clinical and cardiological parameters and their relationship with QoL (RAND SF-36). The primary hypothesis was that QoL would be more dependent of higher aldosterone concentration, assessed by the transtubular-potassium-gradient (TTKG). Correlations were evaluated using Pearson’s correlation coefficient.

Results

Included patients were mainly female (82%, mean age 34 ± 12 years). Serum K+ and Mg2+ was 3.3 ± 0.6 mmol/l and 0.7 ± 0.1 mmol/l (mean ± SD). TTKG was 9.5/3.4–20.2 (median/range). While dimensions of mental health mostly correlated with serum Mg2+ (r = 0.68, p = 0.04) and K+ (r = 0.55, p = 0.08), better physical health was associated with lower aldosterone levels (r = -0.61, p = 0.06). TTKG was neither associated with aldosterone levels nor with QoL parameters. No relevant abnormalities were observed in neither 24 h-ECG nor echocardiography.

Conclusions

Hyperaldosteronism, K+ and Mg2+ were the most important parameters of QoL. TTKG was no suitable marker for hyperaldosteronism or QoL. Future confirmatory studies in SLT should assess QoL as well as aldosterone, K+ and Mg2+.
Association of urinary non-albumin protein with the different urinary marker for glomerular and tubular damage in patients with type 2 diabetes
Authors: Siddiqui Khalid , Joy Salini Scaria , Nawaz Shaik Sarfaraz , Alnaqeb Dhekra , Mujammami Muhammad , Al-Rubeaan Khalid
Published: July 2020

Background/aim

In recent years, the diagnostic utility of urinary protein levels has been demonstrated for the early detection and progression of kidney disease. This study aimed to evaluate the associations of the non-albumin protein (NAP) with different urinary marker for tubular and glomerular damage in patients with type 2 diabetes (T2D).

Methods

In this observational cross-sectional study, 424 patients with T2D duration > 10 years were classified into two groups according to estimated glomerular filtration rate (eGFR). The ratios of different urinary markers (albumin, NAP, total protein, transferrin, retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL) to creatinine were analyzed.

Results

The levels of urinary biomarkers increased significantly with decrease in eGFR levels. In the group with moderately decreased eGFR, the albumin to-creatinine ratio (ACR), non-albumin protein-to-creatinine ratio (NAPCR), and total protein-to-creatinine ratio (PCR) were independently associated with all urinary markers after being adjusted for risk factors. The area under the receiver operating characteristics (ROC) curve for ACR and PCR had a better diagnostic value than other urinary biomarkers. Comparing ROC curve of NAPCR with other urinary biomarkers, it was significantly better than NGAL/Cr (p = 0.033).

Conclusions

The findings of the present study confirm that ACR and PCR are diagnostic biomarkers in T2D patients with decreased eGFR. NAPCR in these patients diagnostically only outperformed NGAL/Cr.
Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications
Authors: Sun Yin , Shen Zhongzhou , Zhan Yongle , Wang Yawen , Ma Shuai , Zhang Suhan , Liu Juntao , Wu Sansan , Feng Yahui , Chen Yunli , Cai Shuya , Shi Yingjie , Ma Liangkun , Jiang Yu
Published: July 2020

Background

The potential effects of pre-pregnancy body mass (BMI) and gestational weight gain (GWG) on pregnancy outcomes remain unclear. Thus, we investigated socio-demographic characteristics that affect pre-pregnancy BMIs and GWG and the effects of pre-pregnancy BMI and GWG on Chinese maternal and infant complications.

Methods

3172 women were enrolled in the Chinese Pregnant Women Cohort Study-Peking Union Medical College from July 25, 2017 to July 24, 2018, whose babies were delivered before December 31, 2018. Regression analysis was employed to evaluate the socio-demographic characteristics affecting pre-pregnancy BMI and GWG values and their effects on adverse maternal and infant complications.

Results

Multivariate logistic regression analysis revealed that age groups < 20 years (OR: 1.97), 25–30 years (OR: 1.66), 30–35 years (OR: 2.24), 35–40 years (OR: 3.90) and ≥ 40 years (OR: 3.33) as well as elementary school or education below (OR: 3.53), middle school (OR: 1.53), high school (OR: 1.40), and living in the north (OR: 1.37) were risk factors in maintaining a normal pre-pregnancy BMI. An age range of 30–35 years (OR: 0.76), living in the north (OR: 1.32) and race of ethnic minorities (OR: 1.51) were factors affecting GWG. Overweight (OR: 2.01) and inadequate GWG (OR: 1.60) were risk factors for gestational diabetes mellitus (GDM). Overweight (OR: 2.80) and obesity (OR: 5.42) were risk factors for gestational hypertension (GHp). Overweight (OR: 1.92), obesity (OR: 2.48) and excessive GWG (OR: 1.95) were risk factors for macrosomia. Overweight and excessive GWG were risk factors for a large gestational age (LGA) and inadequate GWG was a risk factor for low birth weights.

Conclusions

Overweight and obesity before pregnancy and an excessive GWG are associated with a greater risk of developing GDM, GHp, macrosomia and LGA. The control of body weight before and during the course of pregnancy is recommended to decrease adverse pregnancy outcomes, especially in pregnant women aged < 20 or > 25 years old educated below university and college levels, for ethnic minorities and those women who live in the north of China.

Trial registration

Registered at Clinical Trials (NCT03403543), September 29, 2017.
Starvation stress attenuates the miRNA-target interaction in suppressing breast cancer cell proliferation
Authors: Lü Jinhui , Zhang Chuyi , Han Junyi , Xu Zhen , Li Yuan , Zhen Lixiao , Zhao Qian , Guo Yuefan , Wang Zhaohui , Bischof Evelyne , Yu Zuoren
Published: July 2020

Background

Emerging evidence has demonstrated the limited access to metabolic substrates as an effective approach to block cancer cell growth. The mechanisms remain unclear. Our previous work has revealed that miR-221/222 plays important role in regulating breast cancer development and progression through interaction with target gene p27.

Results

Herein, we determined the miRNA-mRNA interaction in breast cancer cells under induced stress status of starvation. Starvation stimulation attenuated the miR-221/222-p27 interaction in MDA-MB-231 cells, thereby increased p27 expression and suppressed cell proliferation. Through overexpression or knockdown of miR-221/222, we found that starvation-induced stress attenuated the negative regulation of p27 expression by miR-221/222. Similar patterns for miRNA-target mRNA interaction were observed between miR-17-5p and CyclinD1, and between mR-155 and Socs1. Expression of Ago2, one of the key components of RNA-induced silencing complex (RISC), was decreased under starvation-induced stress status, which took responsibility for the impaired miRNA-target interaction since addition of exogenous Ago2 into MDA-MB-231 cells restored the miR-221/222-p27 interaction in starvation condition.

Conclusions

We demonstrated the attenuated interaction between miR-221/222 and p27 by starvation-induced stress in MDA-MB-231 breast cancer cells. The findings add a new page to the general knowledge of negative regulation of gene expression by miRNAs, also demonstrate a novel mechanism through which limited access to nutrients suppresses cancer cell proliferation. These insights provide a basis for development of novel therapeutic options for breast cancer.
Oncolytic vaccinia virus GLV-1h68 exhibits profound antitumoral activities in cell lines originating from neuroendocrine neoplasms
Authors: Kloker Linus D. , Berchtold Susanne , Smirnow Irina , Beil Julia , Krieg Andreas , Sipos Bence , Lauer Ulrich M.
Published: July 2020

Background

Oncolytic virotherapy is an upcoming treatment option for many tumor entities. But so far, a first oncolytic virus only was approved for advanced stages of malignant melanomas. Neuroendocrine tumors (NETs) constitute a heterogenous group of tumors arising from the neuroendocrine system at diverse anatomic sites. Due to often slow growth rates and (in most cases) endocrine non-functionality, NETs are often detected only in a progressed metastatic situation, where therapy options are still severely limited. So far, immunotherapies and especially immunovirotherapies are not established as novel treatment modalities for NETs.

Methods

In this immunovirotherapy study, pancreatic NET (BON-1, QGP-1), lung NET (H727, UMC-11), as well as neuroendocrine carcinoma (NEC) cell lines (HROC-57, NEC-DUE1) were employed. The well characterized genetically engineered vaccinia virus GLV-1 h68, which has already been investigated in various clinical trials, was chosen as virotherapeutical treatment modality.

Results

Profound oncolytic efficiencies were found for NET/NEC tumor cells. Besides, NET/NEC tumor cell bound expression of GLV-1 h68-encoded marker genes was observed also. Furthermore, a highly efficient production of viral progenies was detected by sequential virus quantifications. Moreover, the mTOR inhibitor everolimus, licensed for treatment of metastatic NETs, was not found to interfere with GLV-1 h68 replication, making a combinatorial treatment of both feasible.

Conclusions

In summary, the oncolytic vaccinia virus GLV-1 h68 was found to exhibit promising antitumoral activities, replication capacities and a potential for future combinatorial approaches in cell lines originating from neuroendocrine neoplasms. Based on these preliminary findings, virotherapeutic effects now have to be further evaluated in animal models for treatment of Neuroendocrine neoplasms (NENs).
Multiple recurrent myxofibrosarcoma of the orbit: case report and review of the literature
Authors: Du Baixue , He Xin , Wang Yujiao , He Weimin
Published: July 2020

Background

Although myxofibrosarcoma (MFS) is the most common mesenchymal tumor, occurrence in the orbit is extremely rare. A characteristic clinical feature of MFS is its propensity for local recurrence (LR). Still, none of published literature has described the entire clinical course of multiple recurrences of MFS in the orbit. Here we present an unusual case in which a patient with multiple recurrences of MFS in the orbit followed-up for 5 years. We describe its clinical-pathological correlation, treatment, and prognosis.

Case presentation

A 70-year-old woman sought treatment for a year history of right upper eyelid swelling in May 2014. Since then, she underwent three surgical procedures in the right orbit in the same region (in 2014, 2016, and 2017). The pathology analysis of the three surgical tissue samples was consistent with myxofibrosarcoma, characterized by spindle-shaped cells and variably myxoid stroma. In the 2 years follow-up after the third surgery, there was no evidence of tumor recurrence.

Conclusion

Myxofibrosarcoma of the orbit is extremely rare. Since few reports are available in the literature, the diagnosis and management of the orbit myxofibrosarcoma is still a challenge to ophthalmologists. Histopathology is highly valuable in the diagnosis. As a clinical characteristic, the lesions have a high risk of local recurrence; therefore, aggressive resection and careful postoperative follow-up are paramount.
Metacognitive Training for Obsessive-Compulsive Disorder: a study protocol for a randomized controlled trial
Authors: Miegel Franziska , Demiralay Cüneyt , Moritz Steffen , Wirtz Janina , Hottenrott Birgit , Jelinek Lena
Published: July 2020

Background

A high number of patients with obsessive-compulsive disorder (OCD) do not receive cognitive-behavioral therapy with exposure and response prevention, which is the most effective treatment for OCD. Therefore, Metacognitive Training for OCD (MCT-OCD) was developed, which is a structured group therapy aiming at the modification of dysfunctional (meta-)cognitive biases, beliefs and coping styles. It can be administered by less trained personnel, thus may reach a higher number of patients.

An uncontrolled pilot study (MCT-OCD pilot version) provided first evidence that the training is highly accepted by patients; OC symptoms decreased with a high effect size (η2partial = 0.50). The aim of the present study is to address the shortcomings of the pilot study (e.g., no control group) and to assess the efficacy of the revised version of the MCT-OCD in the framework of a randomized controlled trial.

Methods

Eighty patients with OCD will be recruited. After a blinded assessment at baseline (−t1), patients will be randomly assigned either to the intervention group (MCT-OCD;n = 40) or to a care as usual control group (n = 40). The MCT-OCD aims to enhance patients’ metacognitive competence in eight modules by addressing dysfunctional (meta-)cognitive biases and beliefs associated with OCD (e.g., intolerance of uncertainty). After 8 weeks, patients will be invited to a post assessment (t1), and then they will receive a follow-up online questionnaire 3 months following t1 (t2). The primary outcome is the Y-BOCS total score, and the secondary outcomes include the HDRS, OCI-R, OBQ-44, MCQ-30, WHOQOL-BREF, BDI-II, and subjective appraisal ratings of the MCT-OCD. We expect that OC symptoms will decrease more in the intervention group compared with the care as usual control group from –t1 to t1 and that treatment gains will be maintained until t2.

Discussion

The planned study is the first to investigate the MCT-OCD, a promising new treatment, in a randomized controlled trial. The MCT-OCD may help to overcome existing treatment barriers for patients with OCD.

Trial registration

German Registry for Clinical Studies (DRKS00013539), 22.02.2018.
The Characteristics and Social Functioning of Pathological Social Withdrawal, “Hikikomori,” in a Secondary Care Setting: a One-Year Cohort Study
Authors: Imai Hissei , Takamatsu Toko , Mitsuya Hideaki , Yoshizawa Hajime , Mitsuya Hidehiko , Furukawa Toshi A.
Published: July 2020

Background

Pathological social withdrawal, named “Hikikomori,” is a Japanese culture-bound syndrome and a serious social problem in Japan. The number of Hikikomori cases in Japan was estimated at about 563,000 in 2016 according to governmental surveys. However, no studies have reported how many people with Hikikomori have access to community-based psychiatry clinics, and how different they are from non-Hikikomori patients regarding their baseline characteristics and outcomes. The aim of the present study is to evaluate the baseline characteristics, clinical attendance, and social functioning of community psychiatric clinic patients treated for social withdrawal at one-year follow-up.

Method

Participants (n = 304) were all patients (aged under 65) of a psychiatric clinic in a one-year period. Baseline patient characteristics were compared among “current” Hikikomori patients, “past” Hikikomori,” and “other” patients. Logistic regression analysis of clinic attendance status and social functioning at one-year follow-up was used to assess patient outcomes. Independent variables were age, gender, Hikikomori status, and support from clinical staff.

Results

Numbers of “current”, “past” Hikikomori, and “other” patients were 60 (19.7%), 81 (26.6%), and 163 (53.6%), respectively. The percentage of “current” Hikikomori who attended in person (56.7%) was significantly smaller than for “past” (92.6%) and “other” (92.6) (p < .001). The age distribution of “current” Hikikomori patients was bimodal, peaking at 20 and 40–45 years. The “current” state predicted significantly fewer regular visits (OR = 0.43; 95% CI = 0.22–0.83; p = .012); support from psychiatric social workers increased visits (OR = 2.35; 95% CI = 1.14–4.86; p = .021). Among the “current” Hikikomori patients, first visit attendance in person predicted regular attendance; no factor consistently predicted working/schooling status.

Conclusion

A sizable percentage of community clinic patients experienced Hikikomori. The “current” Hikikomori state corresponded with low clinic attendance and social function; “support from clinical staff” may increase visit regularity; no factors consistently improved social functioning. Further multi-site study is warranted to examine the generalizability of the findings from the current single-center study.
Smoking, heavy drinking, physical inactivity, and obesity among middle-aged and older adults in China: cross-sectional findings from the baseline survey of CHARLS 2011–2012
Authors: Ding Lijie , Liang Yajun , Tan Edwin C. K. , Hu Yin , Zhang Chi , Liu Yanxun , Xue Fuzhong , Wang Rui
Published: July 2020

Background

Prevention and control of cardiometabolic conditions and cardiovascular disease (CVD) in China may contribute to sustainable CVD reduction globally, given the fact that one-fifth of the worldwide population is in China. Knowing the distribution of behavioral risk factors (e.g., smoking and physical inactivity), especially at a national level in China, would be extremely relevant to the field of public health and CVD prevention. The objectives of this study were to investigate the nationwide prevalence of obesity, smoking, heavy drinking, and physical inactivity in Chinese adults, and further explore whether cardiometabolic conditions would modify the distribution of behavioral risk factors.

Methods

This population-based study is based on the China Health and Retirement Longitudinal Study (2011–2012), including 17,302 adults (≥45 years, mean age 59.67 years, female 51.66%) from 25 provinces in China. Data on demographics, lifestyle factors, health status and history of diseases were collected via structured interviews and laboratory tests. Smoking, heavy drinking, obesity, and physical inactivity were defined following standard guidelines. We performed descriptive analysis and logistic regressions in this study.

Results

The overall prevalence of heavy drinking, obesity, current smoking, and physical inactivity among middle-aged and older adults was 7.23% (95% confidence interval 6.53—7.29%), 11.53% (10.43—12.62%), 27.46% (26.30—28.62%), and 44.06% (41.19—46.92%), respectively. The prevalence varied between rural and urban areas as well as among geographic areas, with higher prevalence in the Northern and Northeastern regions. Heavy drinking and obesity were significantly associated with incident hypertension, diabetes, and high cholesterol; while current smoking was significantly associated with incident hypertension. Compared with healthy individuals, participants who self-reported a diagnosis of hypertension, high cholesterol, or diabetes were less likely to smoke currently and drink alcohol heavily, but more likely to be physically inactive and obese.

Conclusions

Among Chinese middle-aged and older adults, the prevalence of behavioral risk factors varies by geographic region. Further effort is required to improve physical activity and fitness for Chinese adults, especially those with cardiometabolic conditions.
Patterns of fish and whale consumption in relation to methylmercury in hair among residents of Western Canadian Arctic communities
Authors: Walker Emily V. , Yuan Yan , Girgis Safwat , Goodman Karen J.
Published: July 2020

Background

Methylmercury contamination of the environment represents a substantial environmental health concern. Human exposure to methylmercury occurs primarily through consumption of fish and marine mammals. Heavily exposed subgroups include sport or subsistence fishers residing in Arctic communities. We aimed to estimate the association of fish/whale consumption patterns of Canadian Arctic subsistence fishers with the internal dose of methylmercury as measured in hair.

Methods

This research was conducted within ongoing community projects led by the CANHelp Working Group in Aklavik and Fort McPherson, Northwest Territories and Old Crow, Yukon. We interviewed each participant using a fish-focused food-frequency questionnaire during September–November 2016 and collected hair samples concurrently. Methylmercury was measured in the full-length of each hair sample using gas chromatography inductively-coupled plasma-mass spectrometry. Multivariable linear regression estimated beta-coefficients and 95% confidence intervals (CIs) for the effect of fish/whale consumption on hair-methylmercury concentrations.

Results

Among 101 participants who provided hair samples and diet data, the mean number of fish/whale species eaten was 3.5 (SD:1.9). The mean hair-methylmercury concentration was 0.60 μg/g (SD:0.47). Fish/whale consumption was positively associated with hair-methylmercury concentration, after adjusting for sex, hair length and use of permanent hair treatments. Hair-methylmercury concentrations among participants who consumed the most fish/whale in each season ranged from 0.30–0.50 μg/g higher than those who consumed < 1 meal/week.

Conclusions

In this population of Canadian Arctic subsistence fishers, hair-methylmercury concentration increased with fish/whale consumption, but the maximum concentrations were below Health Canada’s 6.0 μg/g threshold for safe exposure.
The impact of HIV knowledge and attitudes on HIV testing acceptance among patients in an emergency department in the Eastern Cape, South Africa
Authors: Ryan Sofia , Hahn Elizabeth , Rao Aditi , Mwinnyaa George , Black John , Maharaj Roshen , Mvandaba Nomzamo , Nyanisa Yandisa , Quinn Thomas C. , Hansoti Bhakti
Published: July 2020

Background

Transmission of HIV in South Africa continues to be high due to a large proportion of individuals living with undiagnosed HIV. Uptake of HIV testing is influenced by a multitude of factors including the patient’s knowledge and beliefs about HIV.

Methods

This study sought to quantify the impact of knowledge and attitudes on HIV testing acceptance in an emergency department by co-administering a validated HIV knowledge and attitudes survey to patients who were subsequently offered HIV testing.

Results

During the study period 223 patients were interviewed and offered HIV testing. Individuals reporting more negative overall attitudes (p = 0.006), higher levels of stigma to HIV testing (p < 0.001), and individuals who believed their test was confidential (p < 0.001) were more likely to accept an HIV test.

Conclusions

Interventions focused on improving patient perceptions around testing confidentiality will likely have the greatest impact on testing acceptance in the emergency department.
Cross-sectional study of prevalence and determinants of uncontrolled hypertension among South African adult residents of Mkhondo municipality
Authors: Masilela Charity , Pearce Brendon , Ongole Joven Jebio , Adeniyi Oladele Vincent , Benjeddou Mongi
Published: July 2020

Background

Achieving the blood pressure treatment target in individuals with hypertension is a serious global health challenge. Furthermore, the actual burden of uncontrolled hypertension is poorly understood, especially in the developing countries. Therefore, this study comprehensively examined the prevalence and factors associated with uncontrolled hypertension in individuals receiving care at the primary healthcare facilities in the rural areas of Mkhondo Municipality in the Mpumalanga Province, South Africa.

Methods

In this cross-sectional study, 329 individuals attending care for hypertension were recruited from January 2019 to June 2019 at three primary healthcare centres, namely, Piet Retief hospital, Mkhondo town clinic and Thandukukhanya community health centre. Uncontrolled hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg in accordance with the South African Hypertension Society guideline (2014). Multiple logistic regression (Forward LR method) analysis was used to identify the significant determinants of uncontrolled hypertension.

Results

The majority of the participants were 55 years old and above (69.0%), Zulus (81.2%), non-smokers (84.19%) and had been diagnosed with hypertension for more than a year prior to the study (72.64%). The overall prevalence of uncontrolled hypertension was 56.83% (n = 187) with no significant difference between sexes, 57.38% male versus 56.88% female, respectively. In the multiple logistic regression model analysis after adjusting for confounding variables, obesity (AOR = 2.90; 95% CI 1.66–5.05), physical activity (AOR = 4.79; 95% CI 2.15–10.65) and HDL-C (AOR = 5.66; 95% CI 3.33–9.60) were the significant and independent determinants of uncontrolled hypertension in the cohort.

Conclusion

The high prevalence of uncontrolled hypertension in the study setting can be largely attributed to obesity, physical activity and dyslipidaemia. Treatment will require the collaborative efforts of individuals, clinicians and health authorities. All these determinants should be addressed decisively so as to achieve the treatment blood pressure targets in the study population.
Association of complete uncinate process removal on 2-year assessment of radiologic outcomes: subsidence and sagittal balance in patients receiving one-level anterior cervical discectomy and fusion
Authors: Noh Sung Hyun , Park Jeong Yoon , Kuh Sung Uk , Chin Dong Kyu , Kim Keun Su , Cho Yong Eun , Kim Kyung Hyun
Published: July 2020

Background

Many patients with cervical radiculopathy experience stenosis of the neural foramens due to cumulative osteophyte or uncovertebral joint hypertrophy. For cervical foraminal stenosis, complete uncinate process resection (UPR) is often conducted concurrently with anterior discectomy and fusion (ACDF). The aim of this study was to assess the clinical and radiological outcomes of ACDF with complete UPR versus ACDF without UPR.

Methods

In total, 105 patients who performed one-level ACDF with a cage-and-plate construct between 2011 and 2015 were retrospectively reviewed. Among them, 37 patients had ACDF with complete UPR, and 68 patients had ACDF without UPR. Radiologic outcomes of disc height, C2–C7 lordosis, T1 slope, C2–C7 sagittal vertical axis (SVA), center of the sella turcica–C7 SVA (St-SVA), spino-cranial angle (SCA), and fusion rate were evaluated on plain X-ray at pre-operation, immediately post-operation, and at 2-year follow-up. For statistically matched pairs analysis, ACDF with UPR group (24 patients) and ACDF without UPR (24 patients) were compared.

Results

All of the clinical parameters improved at the 2-year follow up (P < 0.0001). Improvement in visual analogue scale (VAS) scores for arm pain was significantly improved in the ACDF with complete UPR group immediately post-operation. All cervical sagittal parameters, including cervical lordosis, segmental angle, disc height, C2-C7 SVA, St-SVA, T1 slope, and SCA, except for preoperative St-SVA, SCA, and disc height of 2 years follow-up, were similar between the ACDF with complete UPR and ACDF without UPR groups. Differences in disc height, C2-C7 SVA, and SCA at 2-year follow up after preoperative examination, however, were statistically significant (p < 0.05). Subsidence occurred in 9 patients (ACDF with complete UPR: 8 cases [33%] versus ACDF without UPR: 1 cases [4%]; p < 0.05).

Conclusions

Cervical sagittal alignment after ACDF with complete UPR is not significantly different from that achieved with ACDF without UPR. However, subsidence appears to occur more often after ACDF with complete UPR than after ACDF without UPR, although with little to no clinical impact. More precise and careful selection of patients is needed when deciding on additional complete UPR.
Chronic pain after groin hernia repair: pain characteristics and impact on quality of life
Authors: Bande David , Moltó Luis , Pereira Jose Antonio , Montes Antonio
Published: July 2020

Background

Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study.

Methods

Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair. Patients with pain were identified by telephone at 1 and 3 months and referred to the hospital 4 months after surgery for a physical examination to confirm CPSP. Three validated tools were used: the Brief Pain Inventory (BPI) for severity, analgesic use, and interference with activities; the SF-12 questionnaire for QoL (validated Spanish version), and the Douleur Neuropathique 4 (DN4). Patients with CPSP were called again at 1 and 2 years.

Results

In 1761 patients who underwent hernia repair and were eligible for physical examination for CPSP, the incidence of confirmed pain at 4 months was 13.6% (patient-reported pain, 6.2% at 1 year and 4.0% at 2 years). Neuropathic pain was diagnosed in 38.5% of the CPSP patients at 4 months. The incidences of neuropathic CPSP in patients with mesh or non-mesh repairs were similar (38.6 and 33.3%, respectively). SF-12 physical component scores changed little in all patients, whether or not they developed CPSP. The SF-12 mental component decreased significantly in all patients, but the decrease was clinically significant only in CPSP patients. CPSP interfered with activities (18%), work (15.6%), walking (15%) and mood (10.2%). At 2 years 52.1% of CPSP patients had moderate/intense pain and 28.2% took analgesics.

Conclusion

CPSP affects QoL-related activities, and although it diminishes over the course of 2 years after surgery, many patients continue to have moderate/intense pain and take analgesics. CPSP and neuropathic pain rates seem to be similar after mesh and non-mesh repair. BPI and SF-12 mental component scores detect effects on QoL.

Trial registration

ClinicalTrials.gov NCT01510496.