bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric Evaluation of the Making it CLEAR Questionnaire: A Resilience Measure for Older Adults
Authors: Whitehall Lucy , Górska Sylwia , Rush Robert , Singh Roy Anusua , Irvine Fitzpatrick Linda , Forsyth Kirsty
Published: August 2021

Background and Objectives

Previous efforts to develop a resilience measure for older adults have largely failed to consider the environmental influences on their resilience, and have primarily concentrated on the resilience of community-dwelling older adults. Our objective was to validate a new multidimensional measure of resilience, the Making it CLEAR (MiC) questionnaire, for use with older adults at the point of discharge from hospital.

Research Design and Methods

This study tested the structure, validity, and reliability of the MiC questionnaire. The questionnaire consists of 34 items, which assess the “individual determinants of resilience” (IDoR) and the “environmental determinants of resilience” (EDoR) across 2 subscales. 416 adults aged 66–102 years participated. Exploratory factor analysis, item analysis, and linear regression were undertaken.

Results

The IDoR subscale contained six factors which were labeled “Self-efficacy,” “Values,” “Interpersonal skills,” “Life orientation,” “Self-care ability,” and “Process skills.” The EDoR subscale contained five factors related to “Person–environment fit,” “Friends,” “Material assets,” “Habits,” and “Family.” Both subscales demonstrated acceptable convergent validity and internal consistency, while individual items showed acceptable levels of discrimination and difficulty.

Discussion and Implications

The study provides evidence supporting the validity and quality of the MiC questionnaire. The results suggest that the MiC questionnaire could be used to identify the resilience needs of older adults at the point of hospital discharge. However, future research should identify which items of the MiC questionnaire are associated with hospital readmission, in order to develop an easily applicable screening tool for clinical practice.
Flame propagation and CO/CO2 generation characteristics of lignite dust explosion in horizontal pipeline
Authors: Liu Tianqi , Wang Ning , Sun Ruicheng , Cai Zhixin , Tian Weiye , Jia Ruiheng
Published: August 2021

To reveal the flame propagation and CO/CO2 generation characteristics of coal dust explosion, lignite dust cloud is studied through experiment and numerical simulation in a horizontal pipeline apparatus. The result indicated that within 0.5 s after explosion, the flame propagation distance rapidly increases until the explosion reaction is sufficient. FLUENT is used to simulate the flame propagation and CO/CO2 generation characteristics. It is found that the simulation error is acceptable and the simulation result is consistent with the experimental result. The explosion space is divided into five zones by simulating the flame temperature. It also revealed that z = 0.3 ~ 0.6 m in the pipeline generates more CO because it is closed to the ignition zone. As the explosion spreads through the pipeline, the generated CO accumulates to the bottom of the pipeline, and the generated CO2 accumulates more in the upper part of the pipeline.
Robust portfolio choice under the 4/2 stochastic volatility model
Authors: Cheng Yuyang , Escobar-Anel Marcos
Published: August 2021

This paper provides the first optimal portfolio analysis for a constant relative risk-averse and ambiguity-averse investor under the state-of-the-art 4/2 stochastic volatility model in a complete market setting. We determine the robust optimal strategy and the worst case measure by allowing separate levels of uncertainty for variance and stock drivers. Technical conditions for well-defined solutions are detailed together with a verification result. The robust optimal investment exposure displays a dependence on current volatility levels similar to the non-robust case further impacted by the ambiguity-aversion level. Using real-world parameters, the numerical analysis finds that wealth-equivalent losses (WELs) from ignoring uncertainty or market completeness are moderate. On the other hand, WELs for investors who follow simpler but popular strategies, such as Heston (1/2 model) and Merton (geometric Brownian motion [GBM] model), could be quite substantial, of up to 24 and 51%, respectively. This latest analysis comes from new non-affine representations for the suboptimal value function of the 1/2 and GBM strategies.
Target unbiased meta-learning for graph classification
Authors: Li Ming , Zhu Shuo , Li Chunxu , Zhao Wencang
Published: August 2021

Even though numerous works focus on the few-shot learning issue by combining meta-learning, there are still limits to traditional graph classification problems. The antecedent algorithms directly extract features from the samples, and do not take into account the preference of the trained model to the previously “seen” targets. In order to overcome the aforementioned issues, an effective strategy with training an unbiased meta-learning algorithm was developed in this paper, which sorted out problems of target preference and few-shot under the meta-learning paradigm. First, the interactive attention extraction module as a supplement to feature extraction was employed, which improved the separability of feature vectors, reduced the preference of the model for a certain target, and remarkably improved the generalization ability of the model on the new task. Second, the graph neural network was used to fully mine the relationship between samples to constitute graph structures and complete image classification tasks at a node level, which greatly enhanced the accuracy of classification. A series of experimental studies were conducted to validate the proposed methodology, where the few-shot and semisupervised learning problem has been effectively solved. It also proved that our model has better accuracy than traditional classification methods on real-world datasets.
A new species of South America marsh rat (Holochilus, Cricetidae) from northeastern Brazil
Authors: Prado Joyce R , Knowles L Lacey , Percequillo Alexandre R
Published: August 2021

Marsh rats of the genus Holochilus are broadly distributed and inhabit several distinct environments throughout South America. As an enigmatic group with a somewhat uncertain taxonomy, the composition and names of taxa have shifted throughout history, including the boundaries of Holochilus sciureus, a species formerly distributed in the lowlands of the Guianas, Peru, Bolivia, and northern, central, and northeastern of Brazil. Based on a combination of morphological and morphometric traits, and genomic sequences, we redefined species boundaries and split this wide concept of H. sciureus into three separated species, including a redefined H. sciureus, the newly erected from synonymy H. nanus, and an unnamed taxon. We describe this unnamed species, and provide emended diagnoses for the two redefined species. The newly named taxon inhabits the northeastern part of Brazil and differs from the other congeners by a unique combination of phenotypic and genomic characters.
Intra- and inter-physician variability in target volume delineation in radiation therapy
Authors: Das Indra J , Compton Julia J , Bajaj Amishi , Johnstone Peter A
Published: August 2021

Reduction in setup errors is advocated through daily imaging and adaptive therapy, where the target volume is drawn daily. Previous studies suggest that inter-physician volume variation is significant (1.5 cm standard deviation [SD]); however, there are limited data for intra-physician consistency in daily target volume delineation, which is investigated in this study. Seven patients with lung cancer were chosen based on the perceived difficulty of contouring their disease, varying from simple parenchymal lung nodules to lesions with extensive adjacent atelectasis. Four physicians delineated the gross tumor volume (GTV) for each patient on 10 separate days to see the intra- and inter-physician contouring. Isocenter coordinates (x, y and z), target volume (cm3), and largest dimensions on anterior–posterior (AP) and lateral views were recorded for each GTV. Our results show that the variability among the physicians was reflected by target volumes ranging from +109% to −86% from the mean while isocenter coordinate changes were minimal; 3.8, 1.7 and 1.9 mm for x, y and z coordinates, respectively. The orthogonal image (AP and lateral) change varied 16.3 mm and 15.0 mm respectively among days and physicians.

We conclude than when performing daily imaging, random variability in contouring resulted in isocenter changes up to ±3.8 mm in our study. The shape of the target varied within ±16 mm. This study suggests that when using daily imaging to track isocenter, target volume, or treatment parameters, physicians should be aware of personal variability when considering margins added to the target volume in daily decision making especially for difficult cases.
Pararectal hernia: literature review and surgical repair techniques in the era of robotic surgery
Authors: Glanzer Rebecca , O’Neil Breanna , Turaihi Hassan
Published: August 2021

A pelvic hernia is the protrusion of intraperitoneal or extraperitoneal contents into the perineum through a defect in the pelvic floor. Pelvic hernias are rare with no gold standard method for repair. After abdominoperineal resection, a commonly cited incidence of perineal hernia is 1%. Here, we describe a robotic repair of a pararectal hernia in a post-menopausal women presenting with rectal herniation through a pelvic floor defect causing issues with fecal urgency and incontinence.
Diagnostic laparoscopy and oophorectomy for ovarian vein thrombosis in a patient with COVID-19: a surgical case report and literature review
Authors: Glanzer Rebecca , Rogers Nicole , Patrick Ryan J , Hassebroek-Johnson Jeanne
Published: August 2021

Ovarian vein thrombosis (OVT) is a rare condition most frequently associated with pelvic inflammatory disease (PID), malignancy or the immediate postpartum period. This case study reports on a 56-year-old woman who developed OVT 11 days after a positive COVID-19 diagnosis. Imaging including abdominal/pelvic computed tomography, transvaginal Doppler ultrasound and transabdominal pelvic ultrasound failed to definitively diagnose the thrombotic etiology of the patient’s presentation. Ultimately, laparoscopic visualization and subsequent oophorectomy were necessary for diagnostic and therapeutic purposes. The patient did not have underlying malignancy, recent surgical history, history of PID or any history of previous thromboembolic events. Therefore, this report contributes further evidence to the growing knowledge of systemic manifestations associated with COVID-19 that may require surgical intervention.
Dual roles of jasmonate in adventitious rooting
Authors: Pan Xuan , Yang Zhengfei , Xu Lin
Published: August 2021

This article comments on:

Dob A, Lakehal A, Novak O, Bellini C. 2021. Jasmonate inhibits adventitious root initiation through repression of CKX1 and activation of RAP2.6L transcription factor in Arabidopsis. Journal of Experimental Botany 72, 7107–7118.
Gas Chromatography Mass Spectrometry Aided Diagnosis of Glutathione Synthetase Deficiency
Authors: Kaur Parminder , Chaudhry Chakshu , Panigrahi Inusha , Srivastava Priyanka , Kaur Anupriya
Published: August 2021

Glutathione synthetase (GSS) deficiency is a rare disorder, occurring with a frequency of less than 1 in 100,000 individuals worldwide. The clinical presentation may vary from mild to severe, and manifestations include hemolytic anemia, hyperbilirubinemia, metabolic acidosis, neurological problems, and sepsis. Herein, we present a case of a newborn boy with the most severe phenotype of GSS deficiency, diagnosed based on clinical features and increased urinary 5-oxoproline levels determined via gas chromatography mass spectrometry (GCMS) testing.
Tailoring polymer acceptors by electron linkers for achieving efficient and stable all-polymer solar cells
Authors: Wu Qiang , Wang Wei , Wu Yao , Sun Rui , Guo Jing , Shi Mumin , Min Jie
Published: August 2021

The trade-off between efficiency and stability is a bit vague, and it can be tricky to precisely control the bulk morphology to simultaneously improve device efficiency and stability. Herein, three fused-ring conducted polymer acceptors containing furan, thiophene and selenophene as the electron linkers in their conjugated backbones, namely PY-O, PY-S and PY-Se, were designed and synthesized. The electron linker engineering affects the intermolecular interactions of relative polymer acceptors and their charge transport properties. Furthermore, excellent material compatibility was achieved when PY-Se was blended with polymer donor PBDB-T, resulting in nanoscale domains with favorable phase separation. The optimized PBDB-T : PY-Se blend not only exhibits maximum performance with a power conversion efficiency of 15.48%, which is much higher than those of PBDB-T : PY-O (9.80%) and PBDB-T : PY-S (14.16%) devices, but also shows better storage and operational stabilities, and mechanical robustness. This work demonstrates that precise modification of electron linkers can be a practical way to simultaneously actualize molecular crystallinity and phase miscibility for improving the performance of all-polymer solar cells, showing practical significance.
AtPGAP1 functions as a GPI inositol-deacylase required for efficient transport of GPI-anchored proteins
Authors: Bernat-Silvestre César , Sánchez-Simarro Judit , Ma Yingxuan , Montero-Pau Javier , Johnson Kim , Aniento Fernando , Marcote María Jesús
Published: August 2021

Glycosylphosphatidylinositol (GPI)-anchored proteins (GPI-APs) play an important role in a variety of plant biological processes including growth, stress response, morphogenesis, signaling, and cell wall biosynthesis. The GPI anchor contains a lipid-linked glycan backbone that is synthesized in the endoplasmic reticulum (ER) where it is subsequently transferred to the C-terminus of proteins containing a GPI signal peptide by a GPI transamidase. Once the GPI anchor is attached to the protein, the glycan and lipid moieties are remodeled. In mammals and yeast, this remodeling is required for GPI-APs to be included in Coat Protein II-coated vesicles for their ER export and subsequent transport to the cell surface. The first reaction of lipid remodeling is the removal of the acyl chain from the inositol group by Bst1p (yeast) and Post-GPI Attachment to Proteins Inositol Deacylase 1 (PGAP1, mammals). In this work, we have used a loss-of-function approach to study the role of PGAP1/Bst1 like genes in plants. We have found that Arabidopsis (Arabidopsis thaliana) PGAP1 localizes to the ER and likely functions as the GPI inositol-deacylase that cleaves the acyl chain from the inositol ring of the GPI anchor. In addition, we show that PGAP1 function is required for efficient ER export and transport to the cell surface of GPI-APs.
‘It’s just a great muddle when it comes to food’: a qualitative exploration of patient decision-making around diet and gout
Authors: Liddle Jennifer , Richardson Jane C , Hider Samantha L , Mallen Christian D , Watson Lorraine , Chandratre Priyanka , Roddy Edward
Published: August 2021

Objective

Our aim was to understand whether, why and how patients choose to modify their diets after developing gout.

Methods

We conducted an inductive thematic secondary analysis of qualitative data from 43 interviews and four focus groups with UK participants with gout (n = 61).

Results

Participants commonly initiated dietary changes as part of a self-management strategy for gout. Reasons for making such dietary changes included: desperation; a desire for control; and belief that it would be possible to achieve successful management through diet alone; but not weight loss. Participants who did not make changes or who reverted to previous dietary patterns did so because: they believed urate-lowering therapy was successfully managing their gout; medication allowed normal eating; they did not find ‘proof’ that diet would be an effective treatment; or the dietary advice they found was unrealistic, unmanageable or irrelevant. Dietary modification was patient led, but patients would have preferred the support of a health-care professional. Beliefs that diet could potentially explain and modify the timing of flares gave patients a sense of control over the condition. However, the belief that gout could be controlled through dietary modification appeared to be a barrier to acceptance of management with urate-lowering therapy.

Conclusions

Perceptions about gout and diet play a large role in the way patients make decisions about how to manage gout in their everyday lives. Addressing the reasons why patients explore dietary solutions, promoting the value of urate-lowering therapy and weight loss and drawing on strong evidence to communicate clearly will be crucial in improving long-term clinical management and patient experience.
The idea of a transparent world full of equality and common property—a way to disaster
Authors: Prince Michael of Liechtenstein H S H
Published: August 2021

The idea of an overly idealized “sharing economy”, in which private property becomes a common good, is gaining power. The proponents seem to forget, that private property and clearly defined property rights are essential factors for the prospering development of society. This article illustrates how the world has got so far and why the idea of a transparent world full of equality and common property is a misleading effort.
Screening of Existing and New Boxwood Cultivars for Disease Resistance and In Vitro Fungicide Screening to Manage Boxwood Dieback Caused by Colletotrichum theobromicola
Authors: Kaur Harleen , De Souza Monique , Singh Raghuwinder
Published: August 2021

Boxwood (Buxus spp. L.) is one of the most common and widely planted perennial ornamentals in both home gardens and commercial landscapes. Although considered robust, boxwood is susceptible to several plant pathogens. Boxwood dieback, a recently reported fungal disease caused by Colletotrichum theobromicola, has been spreading rapidly within the United States. Symptoms of boxwood dieback are difficult to distinguish visually in affected plants due to the symptom resemblance to other known biotic and abiotic diseases of boxwood. Previous studies have shown that it may take 2 to 3 months for the symptoms to appear under greenhouse conditions. Although a molecular method has been designed for early, rapid, and accurate pathogen detection, boxwood breeders, nursery growers, and landscape professionals are concerned about the lack of effective management practices. Therefore, the primary objectives of this study were to devise effective disease management strategies by screening cultivars to determine their susceptibility to boxwood dieback and screening various fungicides to determine their effectiveness in managing the disease. Host range studies were conducted by screening a wide variety of boxwood cultivars under greenhouse conditions. The boxwood cultivar ‘Little Missy’ showed much-delayed symptom expression compared with the rest of the cultivars. None of the 11 cultivars were found to be resistant to boxwood dieback. In vitro screening of nine fungicide treatments was conducted to determine inhibition of mycelial growth and spore germination for eight isolates of C. theobromicola collected from eight states in the United States. Of the nine fungicide treatments, difenoconazole + pydiflumetofen showed maximum inhibition of mycelial growth and spore germination at 1 ppm active ingredient, followed by fluxapyroxad + pyraclostrobin, and pyraclostrobin + boscalid at 5 ppm active ingredient. Azoxystrobin + benzovindiflupyr significantly inhibited mycelial growth at 1 ppm but reduced spore germination only at 10 ppm active ingredient. This study provides boxwood industry professionals with critical information pertaining to host susceptibility and fungicide efficacy that may be applied to effectively mitigate boxwood dieback and reduce its further spread.
Traumatic Arthrotomies: Do They All Need the Operating Room?
Authors: McKnight Richard. Randall , Ruffolo Michael , Wally Meghan K. , Seymour Rachel B. , Jeray Kyle , E. Matuszewski Paul , Weinlein John , Hsu Joseph R. ,   on behalf of the Southeast Fracture Consortium
Published: August 2021

Objectives:

To compare complications and cost of care in patients with traumatic arthrotomies (TAs) treated with surgical debridement, irrigation, and closure to those treated with nonoperative treatment and local wound care.

Design:

This is a prospective observational multicenter study.

Setting:

This study was conducted at multiple Level I trauma centers.

Patients:

Patients with TAs.

Intervention:

Patients were treated with operative versus nonoperative management decided by the attending surgeon. Nonoperative treatment of TAs included bedside irrigation, primary closure, antibiotics, and discharge from the emergency department with close follow-up unless admission was otherwise indicated.

Main Outcome Measurements:

Primary outcomes included adverse outcomes and cost. VR-12 was captured at the time of injury and 3 months postinjury.

Results:

Of 189 major joint TAs, 64 arthrotomies were treated nonoperatively and 125 operatively. Seventy percent of the arthrotomies in the nonoperative group were small (less than 50 mm in size) and 95% had minimal/no gross contamination, whereas the operative group (OG) had significantly more arthrotomies greater than 50 mm in size and with moderate/severe gross contamination. There was one septic joint in the nonoperative group (1.5%) and 7 in the OG (5.6%). Nonoperative treatment was associated with significantly lower total charges when compared with the OG.

Conclusions:

Although further study may still be needed, this study suggests that small, minimally contaminated TAs with no associated fracture have a low risk of adverse complications, can safely be treated nonoperatively, and are associated with a significantly decreased cost of care.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Marijuana Use Results in Increased Time to Union in Surgically Treated Pediatric Fracture Patients
Authors: Heath David , Ghali Abdullah , Momtaz David , Lee Lynda , Hogue Grant
Published: August 2021

Objective:

To identify the impact of marijuana use on fracture healing in surgically treated pediatric patients.

Design:

Retrospective review.

Setting:

Level 1 trauma center, single-center study.

Patients/Participants:

Surgically treated pediatric patients 10–18 years with extremity fractures from 2010 to 2020. Conservatively treated patients and patients with nonunions were excluded from the study. Three hundred thirty-nine patients were included in the study, 21 of which were confirmed marijuana users by toxicology screening.

Intervention:

Surgical treatment of extremity fractures by any type of fixation.

Main Outcome Measurements:

Time to union was the primary outcome and was defined as radiographic evidence of bridging callus on all sides of the fracture and absence of the previous fracture line. Analysis of covariance, logistic regression analysis, and Fisher exact tests were used to establish the relationship between all collected variables and time to radiographic union.

Results:

The average time to union for marijuana users (159.1 ± 69.5 days, 95% confidence interval) was significantly longer than for nonusers (80.3 ± 7.8 days), P < 0.001. The odds of having a time to union of greater than 4 months and greater than 6 months were 4.17 (P = 0.00192) and 6.19 (P = 0.000159), respectively, for marijuana users compared with nonusers.

Conclusion:

Marijuana users demonstrated longer time to union in surgically treated pediatric fracture patients.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Functional and Clinical Outcomes of Combined Simultaneous Bilateral Anterior Distal Femoral Plate Hemiepiphysiodesis and Hamstrings Release in Management of Knee Flexion Contractures in Children With Neuromuscular Disorders
Authors: Zaghloul Ahmed , Manoukian Dimitrios , Barrett Matthew C. , Geronta Ilektra , Maizen Claudia
Published: August 2021

Background:

We examined the clinical and functional outcomes of the simultaneous anterior distal femoral 8-plate hemiepiphysiodesis (ADF8PH) and hamstring release, for fixed knee flexion deformity in children with neuromuscular disease. To our knowledge, no published evidence is available that reports the outcomes of this combined techniques.

Methods:

Electronic medical records were retrospectively reviewed for 19 consecutive children who underwent bilateral ADF8PH and concomitant hamstrings release in our institution from 2012 to 2019. Relevant demographics, Gross Motor Functional Classification Score and preoperative and postoperative knee flexion contractures and popliteal angles were documented.

Results:

The average age at the time of operation was 12±2.1 years. There were 15 males and 4 females. Diagnoses included cerebral palsy (n=16), Cornelia de Lange syndrome (n=1), hereditary spastic paraplegia type 56 (n=1) and fructose-1,6 bisphosphonate aldose B deficiency (n=1). Mean length of follow-up was 3.8 years (range: 1.5 to 7 y). Mean fixed knee flexion deformity improved from 28.9 to 13.4 degrees (P<0.001) at an average correction rate of 0.94 degrees per month. Mean popliteal angle improved from 81.8 to 44.4 degrees (P<0.001) in the early postoperative phase and to 51.8 degrees (P<0.001) in latest clinic review. Mean time to correction was 18.9 months. The agreed treatment goals of maintaining or promoting the use of standing frame and spinal/postural symmetry was attained in 18 patients (94.7%). Postoperative knee pain was reported in 2 cases (10.5%). We report 2 complications; 1 case of neurapraxia and 1 case of sepsis because of respiratory infection.

Conclusion:

Simultaneous bilateral ADF8PH with hamstrings release is a promising effective technique for correction of knee flexion contractures in skeletally immature individuals with neuromuscular disabilities. Our findings demonstrate improvement in clinical outcomes and maintaining functional outcomes, indicating the validity of this approach as a satisfactory, less invasive alternative in the management of this deformity.

Level of Evidence:

Level IV—therapeutic study.
Dihydroartemisinin induces cell apoptosis through repression of UHRF1 in prostate cancer cells
Authors: Xia Tong , Liu Sihao , Xu Ge , Zhou Siji , Luo Ziguo
Published: August 2021

Prostate cancer (PCa) seriously jeopardizes men’s health worldwide. Dihydroartemisinin, which is an effective antimalarial agent, has shown potential anticancer effects in various human cancer cell lines, including PCa cells. However, the mechanisms underlying the anticancer activity of dihydroartemisinin are not fully understood. Ubiquitin-like with plant homeodomain and ring finger domain 1 (UHRF1) is highly expressed in a variety of tumors and is negatively correlated with the prognosis of various tumors. We reported previously that UHRF1 is downregulated during apoptosis induced by dihydroartemisinin in PC-3 PCa cells. In this study, we transfected PC-3 cells with lentiviruses containing UHRF1 or shRNA-UHRF1. Then, the cells were treated with dihydroartemisinin at different concentrations. Our data showed that overexpression of UHRF1 promoted cell proliferation and migration in PC-3 cells, inhibited cell apoptosis, increased cell proportion in G2 phase, increased DNA methyltransferase 1 and decreased p16INK4A expression at mRNA and protein levels. Downregulation of UHRF1 produces the opposite results. Moreover, the phenomena caused by overexpression of UHRF1 were inhibited after dihydroartemisinin treatment. Compared with control cells, cells overexpressing UHRF1 can resist the proapoptotic and antiproliferative effects of dihydroartemisinin to a certain extent. The effects of UHRF1 knockdown were further aggravated by dihydroartemisinin treatment, but no statistically significant effect was observed with increasing drug concentration. Our results suggested that dihydroartemisinin decreases proliferation and migration but enhances apoptosis of PCa cells, likely by downregulating UHRF1 and upregulating p16INK4A.
Circ_KIAA1199 inhibits MSI1 degradation by targeting miR-34c-5p to drive the malignant cell behaviors and tumor growth of colorectal cancer
Authors: Zhang Yanbo , Yu Hailong , Guo Zhen
Published: August 2021

Circular RNAs (circRNAs) are important regulators that drive or inhibit cancer initiation and development. Here, we identified the expression and function of a circRNA, circ_KIAA1199, in colorectal cancer (CRC). The expression levels of circ_KIAA1199, microRNA-34c-5p (miR-34c-5p) and Musashi RNA-binding protein 1 (MSI1) mRNA were detected by quantitative real-time PCR. Cell proliferative capacity was assessed by colony formation assay, EdU assay and MTT assay. Cell apoptosis was determined by flow cytometry assay. Cell migration and cell invasion were investigated by transwell assay. The expression of MSI1 protein and proliferation, migration-related markers was detected by western blot. The relationship between miR-34c-5p and circ_KIAA1199 or MSI1 was verified by dual-luciferase reporter assay. Animal models were constructed to ascertain the role of circ_KIAA1199 in vivo. The expression of circ_KIAA1199 was elevated in CRC. Circ_KIAA1199 downregulation suppressed CRC cell proliferation, survival, migration and invasion. MiR-34c-5p was a target of circ_KIAA1199. The effects of circ_KIAA1199 downregulation were reversed by miR-34c-5p deficiency. In addition, MSI1 was a target of circ_KIAA1199, and the inhibitory effects of miR-34c-5p restoration on CRC cell proliferation, survival, migration and invasion were reversed by MSI1 overexpression. Circ_KIAA1199 positively regulated MSI1 expression by targeting miR-34c-5p. Moreover, circ_KIAA1199 knockdown blocked tumor growth in animal models. Circ_KIAA1199 functioned as an oncogene to drive the malignant development of CRC by activating MSI1 via competitively targeting miR-34c-5p.
Anti-androgen for myoepithelial tumor: a potent therapy yet a potential misleader
Authors: Hijab Adham , Taha Tarek , Charas Tomer , Bar-Sela Gil , Stein Polina , Agbarya Abed
Published: August 2021

Myoepithelial tumor is a rare form of cancer, mainly arising from the salivary glands and extremities. Due to its rarity, no formal treatment guidelines exist. Here we report a case of a male patient diagnosed with metastatic myoepithelial tumor which was successfully treated with an androgen-receptor (AR) antagonist (bicalutamide), based on the results of molecular testing. Six years after the initiation of bicalutamide, patient was diagnosed with metastatic prostate cancer. To our knowledge, this is the first case described in literature that demonstrate the effectiveness of anti-androgens in treating myoepithelial tumor. Vigilance should be maintained when screening these patients for prostate cancer as their ‘true’ prostate specific antigen levels might be masked by the ongoing endocrine therapy.
Successful treatment of refractory retroperitoneal Epstein-Barr virus-positive diffuse large B-cell lymphoma with secondary hemophagocytic syndrome by sequential combination regimen of PD-1 blockade and chimeric antigen receptor T cells: a case report
Authors: Yu Min , Zhang Qian , Xu Shan , Yin Ting , Li Fei
Published: August 2021

Epstein-Barr virus (EBV) is convincingly contributed to the development of several types of lymphomas such as NK/T cell lymphoma, Burkitt lymphoma, plasmablastic lymphoma, and diffuse large B cell lymphoma (DLBCL). Herein, we reported an atypical case of EBV-positive DLBCL in an immunocompetent young male patient who presented with epistaxis due to hypergammaglobulinemia. 2-Deoxy-2-[fluorine-8] fluoro-d-glucose PET/computed tomography showed multiple highly metabolic retroperitoneal tissue masses with the involvement of bilateral adrenal gland. Ultrasonography-guided biopsy revealed a significant number of lymphocytes and plasma-like cells that are immunopositive for plasma-cell markers and partly positive for pan-B cell markers. The Ki-67 proliferation index was 20%. The extensive distribution of EBV-encoded small RNAs was confirmed by in-situ hybridization. Due to atypical/overlapping pathological characteristics, it was initially misdiagnosed as extramedullary plasmacytoma and treated with two cycles of bortezomib, lenalidomide, and dexamethasone. Disease progression occurred and pathology consultation for the retroperitoneal biopsies modified the diagnosis to EBV-positive DLBCL with plasma cell differentiation. The treatment was adjusted to etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab, and lenalidomide (R2-EPOCH), but no response was observed after three cycles of treatment and he developed hemophagocytic syndrome during treatment. A monotherapy of anti-programmed cell death-1 (PD-1) treatment with tiririzumab was administered, successfully controlling hemophagocytic syndrome and EBV infection. The response assessment was partial for EBV-positive DLBCL, subsequent anti-CD19 chimeric antigen receptor-T (CAR-T) cell therapy resulted in complete remission including lumps, immunoglobulins, and negative EBV-DNA 1.5 months later. The present case study proved the possibility of PD-1 blockade in controlling EBV infection and associated hemophagocytic syndrome and offered an example of the combination of CAR-T therapy and PD-1 blockade for refractory EBV-positive DLBCL in clinic.
CircCUL2 suppresses retinoblastoma cells by regulating miR-214-5p/E2F2 Axis
Authors: Zhang Hui , Qiu XinWen , Song ZhiJie , Lan LiXia , Ren Xuan , Ye Bo
Published: August 2021

The aim of this study was to investigate the effect of circCUL2 on the proliferation, invasion and migration of retinoblastoma cells by regulating the miR-214-5p/E2F2 axis. qRT-PCR and western blot were performed to detect the expressions of circCUL2, miR-214-5p and E2F2 in tumor tissues and adjacent normal tissues from retinoblastoma patients, and in normal human retinal epithelial cells ARPE-19 and human retinoblastoma cells Y79 and SO-Rb50. qRT-PCR and western blot were performed for the detection of RNA levels of circCUL2 and miR-214-5p and the mRNA and protein levels of E2F2, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay for cell proliferation ability, Transwell assay for cell invasion ability, and scratch assay for cell migration ability. Luciferase dual reporter assay was used to detect the targeting relationship between circCUL2 and miR-214-5p, and between miR-214-5p and E2F2. CircCUL2 and E2F2 were lowly expressed, while miR-214-5p was highly expressed in retinoblastoma tumor tissues and cells. Transfection with pcDNA3.1-CUL2 or miR-214-5p inhibitor inhibited the proliferation, invasion and migration of Y79 and SO-Rb50 cells compared with the negative control; while transfection with sh-CUL2 or miR-214-5p mimics promoted the proliferation, invasion and migration of Y79 and SO-Rb50 cells. CircCUL2 negatively regulated miR-214-5p, while miR-214-5p negatively regulated E2F2. Overexpression of miR-214-5p or silencing of E2F2 in SO-Rb50 cells partially reversed the inhibitory effect of circCUL2 on the proliferation, invasion and migration of retinoblastoma cells. CircCUL2 inhibited the proliferation, invasion and migration of retinoblastoma cells by regulating the miR-214-5p/E2F2 axis.
CEBPB knockdown sensitizes nasopharyngeal carcinoma cells to cisplatin by promoting the expression of serine protease inhibitor Kazal-type 5
Authors: Liu Hong , Huang Qingli , Lv Yunxia , Dong Youwei , Song Daoliang
Published: August 2021

Serine protease inhibitor Kazal-type 5 (SPINK5) has been indicated to act as a prognostic predictor for patients with head and neck squamous cell carcinoma. However, its specific role in nasopharyngeal carcinoma (NPC), a malignancy that has a high propensity for chemoresistance, remains largely obscure. We, thus, sought to investigate the importance of SPINK5 expression in regulating chemoresistance in NPC. Differentially expressed genes in NPC were screened using the cancer genome atlas-head and neck squamous cell carcinoma database and microarray analysis. SPINK5 was downregulated in NPC tissues and cells. After SPINK5 upregulation, the cells treated with cisplatin showed reduced cell survival and the ability to migrate, invade and metastasize. Mechanistically, the transcription factors regulating SPINK5 were queried through the JASPAR website, followed by dual-luciferase and Chromatin immunoprecipitation assay validation. CCAAT enhancer-binding protein (CEBP) beta (CEBPB) bound to the SPINK5 promoter region in NPC cells. The silencing of CEBPB enhanced the expression of SPINK5. CEBPB overexpression reversed the inhibitory effects of cisplatin on NPC cell malignant phenotype in the presence of SPINK5 overexpression. In conclusion, CEBPB silencing promoted chemoresistance of NPC cells via activating SPINK5, signifying that targeting CEBPB was a new approach to enhance the chemotherapy efficacy in NPC.
Molar Sodium Lactate Attenuates the Severity of Postcardiac Arrest Syndrome: A Preclinical Study
Authors: Stevic Neven , Argaud Laurent , Loufouat Joseph , Kreitmann Louis , Desmurs Laurent , Ovize Michel , Bidaux Gabriel , Cour Martin
Published: August 2021

OBJECTIVES:

To determine whether continuous IV infusion of molar sodium lactate would limit cardiac arrest–induced neurologic injury and cardiovascular failure.

DESIGN:

Randomized blinded study (animal model).

SETTING:

University animal research facility.

SUBJECTS:

Twenty-four adult male “New Zealand White” rabbits.

INTERVENTIONS:

Anesthetized rabbits underwent 12.5 minutes of asphyxial cardiac arrest and were randomized to receive either normal saline (control group, n = 12) or molar sodium lactate (molar sodium lactate group, n = 12) at a rate of 5 mL/kg/hr during the whole 120-minute reperfusion period.

MEASUREMENTS AND MAIN RESULTS:

Pupillary reactivity (primary outcome), levels of S100β protein, in vitro brain mitochondria functions, cardiovascular function, and fluid balance were assessed. Molar sodium lactate reduced brain injury, with a higher proportion of animals exhibiting pupillary reactivity to light (83% vs 25% in the CTRL group, p = 0.01) and lower S100β protein levels (189 ± 42 vs 412 ± 63 pg/mL, p < 0.01) at the end of the protocol. Molar sodium lactate significantly prevented cardiac arrest–induced decrease in oxidative phosphorylation and mitochondrial calcium–retention capacity compared with controls. At 120 minutes of reperfusion, survival did not significantly differ between the groups (10/12, 83% in the molar sodium lactate group vs nine of 12, 75% in the control group; p > 0.99), but hemodynamics were significantly improved in the molar sodium lactate group compared with the control group (higher mean arterial pressure [49 ± 2 vs 29 ± 3 mm Hg; p < 0.05], higher cardiac output [108 ± 4 vs 58 ± 9 mL/min; p < 0.05], higher left ventricle surface shortening fraction [38% ± 3% vs 19% ± 3%; p < 0.05], and lower left ventricular end-diastolic pressure [3 ± 1 vs 8 ± 2 mm Hg; p < 0.01]). While fluid intake was similar in both groups, fluid balance was higher in control animals (11 ± 1 mL/kg) than that in molar sodium lactate-treated rabbits (1 ± 3 mL/kg; p < 0.01) due to lower diuresis.

CONCLUSIONS:

Molar sodium lactate was effective in limiting the severity of the postcardiac arrest syndrome. This preclinical study opens up new perspectives for the treatment of cardiac arrest.
High prevalence of extrarenal artery involvement in children with fibromuscular dysplasia – a single-center experience
Authors: Obrycki Łukasz , Sarnecki Jędrzej , Sobczyk Katarzyna , Feber Janusz , Brzezińska-Rajszys Grażyna , Litwin Mieczysław
Published: August 2021

Background:

Although the clinical presentation of fibromuscular dysplasia (FMD) and its generalized character has been previously described in adults, data on FMD in children are limited.

Method:

In this study, we aimed to assess visceral artery involvement in pediatric FMD patients with documented renal artery stenosis (RAS) and renovascular hypertension (RVH) in comparison with healthy individuals. We retrospectively analyzed the results of angiographic studies of 16 patients with a median age of 13.9 years (10 girls) in comparison with 16 age- and sex-matched healthy controls.

Results:

Out of the 16 FMD patients, 10 (63%) had stenotic lesions identifiable only in renal arteries, whereas six (37%) had additional stenoses in other vascular beds – in the celiac trunk (four patients), superior mesenteric artery (four patients), inferior mesenteric artery (one patient), splenic artery (one patient), common hepatic artery (three patients), and abdominal aorta (one patient). The comparison of ostial diameters of vessels, in which no periostial narrowing, stents, or occlusions were found, revealed that patients with FMD had a significantly smaller diameter of the celiac trunk (P = 0.017), splenic arteries (P = 0.007), and common hepatic artery (P = 0.026) than their age- and sex-matched healthy peers.

Conclusion:

We found that 69% of children with RVH caused by FMD had clinically silent stenoses or tortuosity of visceral arteries. The results of our study suggest that pediatric FMD is a generalized arterial condition, and the patients may need screening for both renal as well as nonrenal manifestations of the disease.
Exercise blood pressure and cardiovascular disease risk: a systematic review and meta-analysis of cross-sectional studies
Authors: Moore Myles N. , Climie Rachel E. , Otahal Petr , Schultz Martin G.
Published: August 2021

Background:

A hypertensive response to exercise (HRE) is associated with cardiovascular disease and high blood pressure (BP). A poor cardiovascular risk factor profile may underlie these associations, although this has not been systematically elucidated. Via systematic review and meta-analysis, we aimed to assess the relationship between exercise BP and cardiovascular risk factors, and determine if cardiovascular risk is higher in those with an HRE vs. no-HRE across different study populations (including those with/without high BP at rest).

Methods:

Three online databases were searched for cross-sectional studies reporting data on exercise BP, an HRE and cardiovascular risk factors (including arterial structure, lipid, metabolic, inflammatory and kidney function markers). Random-effects meta-analyses and meta-regression were used to calculate pooled correlations between exercise BP and each risk factor and pooled mean differences between those with/without an HRE.

Results:

Thirty-eight studies (38 295 participants, aged 50 ± 3years; 78% male) were included. Exercise SBP was associated with arterial, lipid and kidney function risk markers (P < 0.05). Those with an HRE had greater aortic stiffness (+0.80 ± 0.35 m/s), total (+0.14 ± 0.03 mmol/l) and low-density lipoprotein (+0.12 ± 0.03 mmol/l) cholesterol, triglycerides (+0.24 ± 0.04 mmol/l), glucose (+0.15 ± 0.05 mmol/l), white blood cell count (+0.49 ± 0.16 mmol/l) and albumin-to-creatinine ratio (standardized mean difference: +0.97 ± 0.34), and lower flow-mediated dilation (−4.13 ± 1.02%) and high-density lipoprotein cholesterol (−0.04 ± 0.01 mmol/l) vs. those with no-HRE (P < 0.05 all). Results were broadly similar across study populations.

Conclusion:

Exercise SBP is associated with multiple cardiovascular risk factors, which appear worse in those with an HRE vs. no-HRE. As results were similar across population groups, an HRE should be considered an important indicator of cardiovascular risk.
The association between the Moyamoya disease susceptible gene RNF213 variant and incident cardiovascular disease in a general population: the Nagahama study
Authors: Tabara Yasuharu , Yamada Hitomi , Setoh Kazuya , Matsukawa Manami , Takahashi Meiko , Kawaguchi Takahisa , Nakayama Takeo , Matsuda Fumihiko , Kosugi Shinji
Published: August 2021

Objective:

An association between the Moyamoya disease susceptible gene ring finger protein 213 (RNF213) variant and ischemic stroke and coronary artery disease has been suggested in case-control studies. We aimed to investigate the possible association between the RNF213 variant and the incidence of cardiovascular disease in a general population.

Methods:

The study participants consisted of 9153 Japanese community residents without history of cardiovascular disease. The clinical parameters employed in this analysis were observed at baseline between 2008 and 2010. The RNF213 p.R4859K variant was determined by TaqMan probe assay and then confirmed by Sanger sequencing.

Results:

During 8.52 years follow-up period, we observed 214 incident cases of cardiovascular diseases (99 total stroke cases, 119 major adverse cardiac event cases, including 4 cases of both). The incidence rate was higher for the variant allele carriers (120 cases; incidence rate, 71.0 per 10 000 person-years) than for the homozygotes of the wild-type allele (26.9), and the group differences achieved statistical significance (P = 0.009). Although the RNF213 variant was also associated with systolic blood pressure (dominant model: coefficient of 8.19 mmHg; P < 0.001), the Cox regression analysis adjusted for major covariates including systolic blood pressure identified the RNF213 variant as an independent determinant for cardiovascular disease (hazard ratio of 3.41, P = 0.002) and major adverse cardiac event (hazard ratio of 3.80, P = 0.010) but not with total stroke (P = 0.102).

Conclusion:

The Moyamoya disease susceptible RNF213 variant was associated with blood pressure and the incidence of cardiovascular disease in a Japanese general population.
Nurses' Perspectives of the Need for Physical Therapy Services During an Acute Postpartum Stay: A Focus Group
Authors: Divine Kate , Duvall Paige , Weicht Lenzie , Abraham Karen
Published: August 2021

Hypothesis/Purpose:

Complications in the postpartum period can include pain, urinary incontinence, diastasis recti abdominis, and pelvic floor injury. Physical therapists are in a unique position to address these concerns during the acute postpartum stay. However, there is a lack of consensus regarding the role of physical therapy (PT) in this patient population. Mother-Baby (MB) nurses work closely with postpartum mothers; therefore, the purpose of this study was to gain nurses' perspectives of their knowledge of and need for PT in the acute postpartum setting.

Subjects:

Nine MB nurses and 1 newly graduated nurse with MB experience from 2 hospitals near Winchester, Virginia, participated.

Materials/Methods:

Contact was made with nurse managers to arrange a time for the focus group. A demographic questionnaire was distributed prior to the session. A student moderator led the semistructured interview with preselected open-ended questions. The focus groups were audio/video recorded and transcribed. Transcriptions were used for theme coding and concept map development.

Results:

Five participants were present for each focus group. Four main themes and 1 subtheme emerged. These included lack of understanding of PT scope of practice with a subtheme of special circumstances, limited time, role overlap, and appropriate timing of PT. Lack of understanding of PT scope of practice was the overarching theme.

Conclusion:

MB nurses demonstrated a limited understanding of the PT scope of practice and their potential role postpartum. Further education and interdisciplinary collaboration may be beneficial to enhance postpartum care in the United States.