bluuebunny/crossref_metadata_2025 huggingface dataset:
SARS-CoV-2 Among Military and Civilian Patients, Metro Manila, Philippines
Authors: Velasco John Mark , Navarro Fatima Claire , Diones Paula Corazon , Villa Vicente , Valderama Maria Theresa , Tabinas Henry , Chua Domingo , Rosa Romulo Dela , Turao-Agoncillo Melissa Monica , Timbol John Carlo , Leonardia Susie , Timbol Maria Leanor , Klungthong Chonticha , Chinnawirotpisan Piyawan , Joonlasak Khajohn , Manasatienkij Wudtichai , Huang Angkana , Jones Anthony , Fernandez Stefan
Published: December 2020

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belonging to the family Coronaviridae and genus Betacoronavirus is the causative agent of COVID-19 disease and was first identified in Wuhan, China. SARS-CoV-2 spread globally with >28 million cases and 911,000 deaths recorded worldwide as of September 12, 2020. The Philippines reported the first case of community transmission on March 5, 2020, and despite the government imposing one of the longest and strictest lockdowns in Southeast Asia, the number of confirmed COVID-19 cases still surged with >250,000 cases and 4,000 deaths reported as of September 12, 2020. It is important to estimate the burden and impact of SARS-CoV-2 on the military population since this can affect the military readiness.

Materials and Methods

Nasopharyngeal and oropharyngeal swabs were collected and SARS-CoV-2 real-time RT-PCR testing was performed on the samples. Phylogenetic analysis was performed using sequences from 23 SARS-CoV-2-positive specimens from this study and sequences retrieved from GenBank and GISAID databases.

Results

From April 14 to August 15, 2020, a total of 12,432 specimens were tested with 763 (6%) unique individuals testing positive for SARS-CoV-2 by rRT-PCR. In the military population, majority of the patients who were tested (80%) and those who tested positive for SARS-CoV-2 (86%) were male. Military and civilian status was available for 7,672 patients with 515/5,042 (10%) positive among military patients and 248/2,630 (9%) positive among civilian patients. Both military and civilian populations had the highest case counts of SARS-CoV-2-positive cases in the 21- to 30- and 31- to 40-year-old age groups, while the 71- to 80-year-old age group had the highest proportion (18%) of SARS-CoV-2-positive cases. Sequencing analysis showed 19 different variants in the 23 genomes. Twenty of the 23 genomes were classified under clade GR/B1.1, 2 genomes were classified under clade GR/B1.1.28, and 1 genome was classified under Clade O/B.6. Twenty-two of the 23 sequences collected after June 25, 2020, contained the D614G mutation.

Conclusion

We describe here the results of SARS-CoV-2 testing for military and civilian patients and personnel. The 21- to 30- and 31- to 40-year-old age groups had the highest case counts of SARS-CoV-2-positive cases. Sequencing results showed the presence of the D614G mutation in the spike protein in a majority of specimens collected from the end of June to July 2020.
Solo dwarfs – III. Exploring the orbital origins of isolated Local Group galaxies with Gaia Data Release 2
Authors: McConnachie Alan W , Higgs Clare R , Thomas Guillaume F , Venn Kim A , Côté Patrick , Battaglia Giuseppina , Lewis Geraint F
Published: December 2020

We measure systemic proper motions for distant dwarf galaxies in the Local Group and investigate if these isolated galaxies have ever had an interaction with the Milky Way or M31. We cross-match photometry of isolated, star-forming, dwarf galaxies in the Local Group, taken as part of the Solo survey, with astrometric measurements from Gaia Data Release 2. We find that NGC 6822, Leo A, IC 1613, and WLM have sufficient supergiants with reliable astrometry to derive proper motions. An additional three galaxies (Leo T, Eridanus 2, and Phoenix) are close enough that their proper motions have already been derived using red giant branch stars. Systematic errors in Gaia DR2 are significant for NGC 6822, IC 1613, and WLM. We explore the orbits for these galaxies, and conclude that Phoenix, Leo A, and WLM are unlikely to have interacted with the Milky Way or M31, unless these large galaxies are very massive (${\gtrsim}1.6 \times 10^{12}\, \mathrm{M}_\odot$). We rule out a past interaction of NGC 6822 with M31 at ${\sim}99.99{{\ \rm per\ cent}}$ confidence, and find there is a <10 per cent chance that NGC 6822 has had an interaction with the Milky Way. We examine the likely origins of NGC 6822 in the periphery of the young Local Group, and note that a future interaction of NGC 6822 with the Milky Way or M31 in the next 4 Gyr is essentially ruled out. Our measurements indicate that future Gaia data releases will provide good constraints on the interaction history for the majority of these galaxies.
RoboPol: AGN polarimetric monitoring data
Authors: Blinov D , Kiehlmann S , Pavlidou V , Panopoulou G V , Skalidis R , Angelakis E , Casadio C , Einoder E N , Hovatta T , Kokolakis K , Kougentakis A , Kus A , Kylafis N , Kyritsis E , Lalakos A , Liodakis I , Maharana S , Makrydopoulou E , Mandarakas N , Maragkakis G M , Myserlis I , Papadakis I , Paterakis G , Pearson T J , Ramaprakash A N , Readhead A C S , Reig P , Słowikowska A , Tassis K , Xexakis K , Żejmo M , Zensus J A
Published: December 2020

We present uniformly reprocessed and re-calibrated data from the RoboPol programme of optopolarimetric monitoring of active galactic nuclei (AGNs), covering observations between 2013, when the instrument was commissioned, and 2017. In total, the data set presented in this paper includes 5068 observations of 222 AGN with Dec. > −25○. We describe the current version of the RoboPol pipeline that was used to process and calibrate the entire data set, and we make the data publicly available for use by the astronomical community. Average quantities summarizing optopolarimetric behaviour (average degree of polarization, polarization variability index) are also provided for each source we have observed and for the time interval we have followed it.
Playing With Chaos: Broadening Possibilities for How Music Therapist’s Consider Chaos in Group Work With Young People
Authors: Oosthuizen Helen , McFerran Katrina
Published: December 2020

Many music therapists have alluded to challenges in their work with groups of young people. However, chaos, incorporating experiences of disintegration and destruction, is a construct often overlooked in music therapy literature. Some music therapy authors have related experiences of chaos to the struggles faced by young people referred for therapy. These experiences require management, modification, or resolution. The authors of this article synthesized broader understandings and approaches towards chaos described in literature from fields including music therapy group work, drama therapy, the arts, psychoanalysis, organizational studies, and philosophy. Chaos is positioned as an inherent and necessary aspect of music therapy groups with young people, situated within a mutually potentiating relationship with more ordered features of a group process. From this paradoxical perspective, therapeutic transformation is enabled through creativity that holds the tension between order and the destructiveness of chaos. When chaos is welcomed in music therapy groups and framed within appropriate boundaries, the authors argue that experiences of chaos can be harnessed to support engagement with the paradoxes of creativity and destructiveness. The provision of a space to play with chaos supports young people who are required to flourish within adverse, chaotic life circumstances. The significance of this position for a group of young people who have committed offences in the South African context is highlighted.
Ultrashort Echo Time Magnetic Resonance Angiography in Follow-up of Intracranial Aneurysms Treated With Endovascular Coiling: Comparison of Time-of-Flight, Pointwise Encoding Time Reduction With Radial Acquisition, and Contrast-Enhanced Magnetic Resonance Angiography
Authors: You Sung-Hye , Kim Byungjun , Yang Kyung-Sook , Kim Bo Kyu , Ryu Jaeil
Published: December 2020

BACKGROUND

The optimal magnetic resonance angiography (MRA) sequence for assessing the aneurysm occlusion state or in-stent flow after endovascular coiling is not well established.

OBJECTIVE

To evaluate the diagnostic performance of pointwise encoding time reduction with radial acquisition (PETRA)-MRA in patients who underwent endovascular coiling relative to that of time-of-flight (TOF)-MRA and contrast-enhanced (CE)-MRA.

METHODS

We evaluated the aneurysm occlusion state using digital subtraction angiography (DSA) and MRA. In patients who underwent stent-assisted coiling, we estimated the visibility of in-stent flow.

RESULTS

We enrolled 189 patients with assessable TOF, PETRA, and CE-MRAs after coiling. In patients who underwent simple coiling (128 patients), PETRA showed a higher sensitivity in the detection of residual flow than TOF and CE (PETRA, 100%; CE, 83%; TOF, 80%). There were no significant differences in the height of residual flow between DSA (0.68 ± 1.45 mm) and PETRA (0.70 ± 1.50 mm; P = 1.000). In patients who underwent stent-assisted coiling (61 patients), PETRA showed the highest sensitivity (88%) in detecting residual flow (CE, 56%; TOF, 31%). Regarding in-stent flow, PETRA, CE, and TOF showed visual scores of ≥3 with frequencies of 96.7%, 85.2%, and 37.7%, respectively. Relative signal-to-noise ratio of PETRA (0.62 ± 0.18) was significantly higher than that of CE (0.56 ± 0.12) and TOF (0.39 ± 0.12; P < .001 for both).

CONCLUSION

PETRA-MRA showed excellent diagnostic performance in terms of residual flow detection and in-stent flow assessment. PETRA could be a versatile alternative sequence for following up patients with coiled aneurysm.
Presentation of spinal cord and column tumors
Authors: Fridley Jared S , Syed Sohail , Niu Tianyi , Leary Owen P , Gokaslan Ziya L
Published: December 2020

Metastatic spine disease occurs in more than 10% of all cancer patients. Advances in systemic treatment for cancer has led to improved overall survival for many types of cancer, which has increased the overall incidence of spinal metastases. The most common presenting complaint of patients with spinal metastases is pain. Pain originating from spinal metastases can be oncological, mechanical, and/or neurological in nature. Early recognition of these symptoms is helpful to guide treatment and accurately gauge patient prognosis. Unfortunately, the prevalence of degenerative back pain in the general population can complicate early clinical recognition of patients with metastatic spine disease. Therefore, back pain in any patient with a history of malignancy should prompt clinicians to perform an expedited workup for metastatic disease of the spine. Diagnostic imaging and laboratory studies are part of the initial work up. Obtaining pathology via biopsy to establish tumor histology is essential to determine the appropriate treatment.
Tobacco Smoking and Associated Factors Among People Living With HIV in Uganda
Authors: Mdege Noreen Dadirai , Makumbi Fredrick Edward , Ssenyonga Ronald , Thirlway Frances , Matovu Joseph K B , Ratschen Elena , Siddiqi Kamran , Nyamurungi Namusisi Kellen
Published: December 2020

Introduction

The prevalence of smoking among people living with HIV (PLWH) in Uganda is high.

Aims and Methods

We assessed the smoking patterns, behaviors, and associated factors among PLWH in Uganda through a cross-sectional survey. Descriptive statistics were used to describe smoking patterns and behaviors. Logistic regression was used to identify factors associated with current smoking status.

Results

We recruited 777 participants between October and November 2019: 387 (49.8%) current smokers and 390 (50.2%) nonsmokers. 60.9% were males, and the mean age was 40.5 (SD 10.7) years. In multivariate logistic regression, the following increased the odds of being a current smoker: being male (odds ratio [OR] 6.60 [95% confidence interval, CI = 4.34–10.04]), having at least two smokers among five closest friends (OR 3.97 [95% CI = 2.08–7.59]), living in smoking-permitted households (OR 5.83 [95% CI = 3.32–10.23]), alcohol use (OR 3.96 [95% CI = 2.34–6.71]), a higher perceived stress score (OR 2.23 [95% CI = 1.50–3.34]), and higher health-related quality of life (OR 5.25 [95% CI = 1.18–23.35]). Among smokers, the mean Fagerström Test for Nicotine Dependence score was 3.0 (SD 1.9), and 52.5% were making plans to quit. Self-efficacy to resist smoking and knowledge of the impact of smoking on PLWH’s health were low.

Conclusions

Being male, having at least two smokers among five closest friends, living in smoking-permitted households, alcohol use, higher perceived stress scores, and higher health-related quality of life were associated with being a current smoker. Smokers had low to moderate nicotine dependence, high willingness to quit, and low self-efficacy.

Implications

Future behavioral smoking cessation interventions for PLWH should address co-consumption with alcohol and comorbid mental health conditions that are common among PLWH such as stress. In addition, they should take into account the lack of knowledge among this population of the impact of smoking on their health, and low self-efficacy. Given the relatively low levels of nicotine dependency and high levels of willingness to quit in our sample, smoking cessation interventions, if offered, are likely to support this population in achieving long-term smoking abstinence.
Multi-Approach Analysis Reveals Local Adaptation in a Widespread Forest Tree of Reunion Island
Authors: Garot Edith , Dussert Stephane , Domergue Fr�d�ric , Jo�t Thierry , Fock-Bastide Isabelle , Combes Marie-Christine , Lashermes Philippe
Published: December 2020

Detecting processes of local adaptation in forest trees and identifying environmental selective drivers are of primary importance for forest management and conservation. Transplant experiments, functional genomics and population genomics are complementary tools to efficiently characterize heritable phenotypic traits and to decipher the genetic bases of adaptive traits. Using an integrative approach combining phenotypic assessment in common garden, transcriptomics and landscape genomics, we investigated leaf adaptive traits in Coffea mauritiana, a forest tree endemic to Reunion Island. Eight populations of C. mauritiana originating from sites with contrasted environmental conditions were sampled in common garden to assess several leaf morphological traits, to analyze the leaf transcriptome and leaf cuticular wax composition. The relative alkane content of cuticular waxes was significantly correlated with major climatic gradients, paving the way for further transcriptome-based analyses. The expression pattern of cuticle biosynthetic genes was consistent with a modulation of alkane accumulation across the population studied, supporting the hypothesis that the composition of cuticular wax is involved in the local adaptation of C. mauritiana. Association tests in landscape genomics performed using RNA-seq-derived single-nucleotide polymorphisms revealed that genes associated with cell wall remodeling also likely play an adaptive role. By combining these different approaches, this study efficiently identified local adaptation processes in a non-model species. Our results provide the first evidence for local adaptation in trees endemic to Reunion Island and highlight the importance of cuticle composition for the adaptation of trees to the high evaporative demand in warm climates.
Nuclear-Encoded Maturase Protein 3 Is Required for the Splicing of Various Group II Introns in Mitochondria during Maize (Zea maysL.) Seed Development
Authors: Chen Weiwei , Cui Yu , Wang Zheyuan , Chen Rongrong , He Cheng , Liu Yan , Du Xuemei , Liu Yunjun , Fu Junjie , Wang Guoying , Wang Jianhua , Gu Riliang
Published: December 2020

Splicing of plant organellar group II introns from precursor-RNA transcripts requires the assistance of nuclear-encoded splicing factors. Maturase (nMAT) is one such factor, as its three homologs (nMAT1, 2 and 4) have been identified as being required for the splicing of various mitochondrial introns in Arabidopsis. However, the function of nMAT in maize (Zea mays L.) is unknown. In this study, we identified a seed development mutant, empty pericarp 2441 (emp2441) from maize, which showed severely arrested embryogenesis and endosperm development. Positional cloning and transgenic complementation assays revealed that Emp2441 encodes a maturase-related protein, ZmnMAT3. ZmnMAT3 is highly expressed during seed development and its protein locates to the mitochondria. The loss of function of ZmnMAT3 resulted in the reduced splicing efficiency of various mitochondrial group II introns, particularly of the trans-splicing of nad1 introns 1, 3 and 4, which consequently abolished the transcript of nad1 and severely impaired the assembly and activity of mitochondrial complex I. Moreover, the Zmnmat3 mutant showed defective mitochondrial structure and exhibited expression and activity of alternative oxidases. These results indicate that ZmnMAT3 is essential for mitochondrial complex I assembly during kernel development in maize.
Autophagy Contributes to the Quality Control of Leaf Mitochondria
Authors: Nakamura Sakuya , Hagihara Shinya , Otomo Kohei , Ishida Hiroyuki , Hidema Jun , Nemoto Tomomi , Izumi Masanori
Published: December 2020

In autophagy, cytoplasmic components of eukaryotic cells are transported to lysosomes or the vacuole for degradation. Autophagy is involved in plant tolerance to the photooxidative stress caused by ultraviolet B (UVB) radiation, but its roles in plant adaptation to UVB damage have not been fully elucidated. Here, we characterized organellar behavior in UVB-damaged Arabidopsis (Arabidopsis thaliana) leaves and observed the occurrence of autophagic elimination of dysfunctional mitochondria, a process termed mitophagy. Notably, Arabidopsis plants blocked in autophagy displayed increased leaf chlorosis after a 1-h UVB exposure compared to wild-type plants. We visualized autophagosomes by labeling with a fluorescent protein-tagged autophagosome marker, AUTOPHAGY8 (ATG8), and found that a 1-h UVB treatment led to increased formation of autophagosomes and the active transport of mitochondria into the central vacuole. In atg mutant plants, the mitochondrial population increased in UVB-damaged leaves due to the cytoplasmic accumulation of fragmented, depolarized mitochondria. Furthermore, we observed that autophagy was involved in the removal of depolarized mitochondria when mitochondrial function was disrupted by mutation of the FRIENDLY gene, which is required for proper mitochondrial distribution. Therefore, autophagy of mitochondria functions in response to mitochondrion-specific dysfunction as well as UVB damage. Together, these results indicate that autophagy is centrally involved in mitochondrial quality control in Arabidopsis leaves.
On Reflection
Authors: Horsten Leon
Published: December 2020

This article gives an epistemological analysis of the reflection process by means of which you can come to know the consistency of a mathematical theory that you already accept. It is argued that this process can result in warranted belief in new mathematical principles without justifying them.
What’s new in ocular and oral aspects of Sjögren’s syndrome and do new treatments work?
Authors: Sutcliffe Nurhan , Recchioni Alberto , Hilmi Shireen , Rauz Saaeha , Tappuni Anwar R
Published: December 2020

Primary SS (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands leading to glandular dysfunction, resulting in dryness of the eyes, mouth and other mucosal surfaces. Systemic manifestations also occur in the majority of patients. There has been increasing interest in recent years, with a number of publications regarding the classification criteria, diagnostic tools, disease activity, damage, impact and potential treatments. This article reviews recent advances in the diagnosis and treatment of ocular and oral involvement in pSS. Recent stand-out developments include measurement of tear osmolarity as a marker in dry eye disease diagnosis, new devices measuring tear constituents and meibomian gland structure and treatment of its dysfunction. Lip biopsy is still valuable despite emerging evidence of non-invasive diagnostic techniques, notably salivary gland ultrasound.
Stronger Top-Down and Weaker Bottom-Up Frontotemporal Connections During Sensory Learning Are Associated With Severity of Psychotic Phenomena
Authors: Dzafic Ilvana , Larsen Kit M , Darke Hayley , Pertile Holly , Carter Olivia , Sundram Suresh , Garrido Marta I
Published: December 2020

Recent theories in computational psychiatry propose that unusual perceptual experiences and delusional beliefs may emerge as a consequence of aberrant inference and disruptions in sensory learning. The current study investigates these theories and examines the alterations that are specific to schizophrenia spectrum disorders vs those that occur as psychotic phenomena intensify, regardless of diagnosis. We recruited 66 participants: 22 schizophrenia spectrum inpatients, 22 nonpsychotic inpatients, and 22 nonclinical controls. Participants completed the reversal oddball task with volatility manipulated. We recorded neural responses with electroencephalography and measured behavioral errors to inferences on sound probabilities. Furthermore, we explored neural dynamics using dynamic causal modeling (DCM). Attenuated prediction errors (PEs) were specifically observed in the schizophrenia spectrum, with reductions in mismatch negativity in stable, and P300 in volatile, contexts. Conversely, aberrations in connectivity were observed across all participants as psychotic phenomena increased. DCM revealed that impaired sensory learning behavior was associated with decreased intrinsic connectivity in the left primary auditory cortex and right inferior frontal gyrus (IFG); connectivity in the latter was also reduced with greater severity of psychotic experiences. Moreover, people who experienced more hallucinations and psychotic-like symptoms had decreased bottom-up and increased top-down frontotemporal connectivity, respectively. The findings provide evidence that reduced PEs are specific to the schizophrenia spectrum, but deficits in brain connectivity are aligned on the psychosis continuum. Along the continuum, psychotic experiences were related to an aberrant interplay between top-down, bottom-up, and intrinsic connectivity in the IFG during sensory uncertainty. These findings provide novel insights into psychosis neurocomputational pathophysiology.
Epithelial-to-mesenchymal transition in neutrophilic chronic rhinosinusitis
Authors: Ryu Gwanghui , Mo Ji-Hun , Shin Hyun-Woo
Published: December 2020

Purpose of review

Barrier dysfunction, tissue fibrosis, and remodeling are essential processes of the pathophysiology of chronic rhinosinusitis (CRS). The role of epithelial-to-mesenchymal transition (EMT) has been assessed in various studies in CRS. In this review, we summarized the pathophysiologic mechanisms of EMT related to CRS, particularly neutrophilic CRS.

Recent findings

Loss of epithelial characteristics due to EMT makes leaky epithelium, and transformed mesenchymal cells cause fibrosis and remodeling. Hypoxia, allergens (house dust mites), infections, and air pollutants were related to the pathogenesis of neutrophilic CRS, and these factors are known to induce barrier dysfunction and EMT in sinonasal epithelia. Some molecular pathways related to EMT have been recognized in CRS, including interferon-γ/p38/extracellular signal-regulated kinase, high-mobility group box 1/receptor of advanced glycosylation end-products, TGF-β1/SMAD, and Wnt/β-catenin-signaling pathways. Apart from, several microRNAs (miR-21, miR-761, and miR-30a-5p) have been identified to regulate EMT in CRS.

EMT is considered to be an important pathogenesis mechanism for CRS. The factors cause EMT in CRS, and the associated molecular mechanisms are related to neutrophilic inflammation. Further studies on CRS endotype and/or phenotype are needed to clarify the implication of EMT on CRS pathogenesis.
Cleaners and airway diseases
Authors: Dumas Orianne
Published: December 2020

Purpose of review

Evidence for adverse respiratory effects of occupational exposure to disinfectants and cleaning products (DCPs) has grown in the last two decades. The relationship between DCPs and asthma is well documented but questions remain regarding specific causal agents. Beyond asthma, associations between DCPs and COPD or chronic rhinitis are plausible and have been examined recently. The purpose of this review is to summarize recent advances on the effect of occupational exposure to DCP and chronic airway diseases.

Recent findings

Recent epidemiological studies have often focused on healthcare workers and are characterized by efforts to improve assessment of exposure to specific DCPs. Despite increasing knowledge on the effect of DCPs on asthma, the burden of work-related asthma caused by DCPs has not decreased in the past decade, emphasizing the need to strengthen prevention efforts. Novel data suggest an association between occupational exposure to DCPs and other chronic airway diseases, such as rhinitis, COPD, and poor lung function.

Epidemiological and experimental data showed that many chemicals contained in DCPs are likely to cause airway damage, indicating that prevention strategies should target multiple products. Further research is needed to evaluate the impact of DCP exposure on occupational airway diseases beyond asthma.
Alpha1-antitrypsin deficiency and asthma
Authors: Pini Laura , Paoletti Giovanni , Heffler Enrico , Tantucci Claudio , Puggioni Francesca
Published: December 2020

Purpose of review

The aim of the article is to highlight the association between α1-antitrypsin deficiency (AATD) and asthma.

Recent findings

AATD is one of the most common and underrecognized autosomal disorders associated with an increased risk of developing liver and lung diseases. An association between α1-antitrypsin and asthma has been suggested, especially with severe forms of this disease. Many studies have shown an increased prevalence of asthma in the α1-antitrypsin-deficient population overtime (4–38%). The biological mechanism underlying these two conditions and able to bind them has not yet been well investigated. As α1-antitrypsin is the main inhibitor of the serine proteinase and it is an important anti-inflammatory protein with pronounced immunomodulatory activities, it can be hypothesized that the link between AATD and asthma might be represented by the elastase/antielastase imbalance and the proinflammatory effect that occurs because of the reduction of this protein.

There is a strong need for further researches to better understand the molecular mechanisms binding AATD and asthma. It is also recommendable to screen for AATD, late-onset asthma patients, and/or those with not fully reversible airways obstruction.
Prediction of malignancy for solitary pulmonary nodules based on imaging, clinical characteristics and tumor marker levels
Authors: Hou Hongjun , Yu Shui , Xu Zushan , Zhang Hongsheng , Liu Jie , Zhang Wenjun
Published: December 2020

Objective

To establish a prediction model of malignancy for solitary pulmonary nodules (SPNs) on the basis of imaging, clinical characteristics and tumor marker levels.

Methods

Totally, 341 cases of SPNs were enrolled in this retrospective study, in which 70% were selected as the training group (n = 238) and the rest 30% as the verification group (n = 103). The imaging, clinical characteristics and tumor marker levels of patients with benign and malignant SPNs were compared. Influencing factors were identified using multivariate logistic regression analysis. The model was assessed by the area under the curve (AUC) of the receiver operating characteristic curve.

Results

Differences were evident between patients with benign and malignant SPNs in age, gender, smoking history, carcinoembryonic antigen (CEA), neuron-specific enolase, nodule location, edge smoothing, spiculation, lobulation, vascular convergence sign, air bronchogram, ground-glass opacity, vacuole sign and calcification (all P < 0.05). Influencing factors for malignancy included age, gender, nodule location, spiculation, vacuole sign and CEA (all P < 0.05). The established model was as follows: Y = −5.368 + 0.055 × age + 1.012 × gender (female = 1, male = 0) + 1.302 × nodule location (right upper lobe = 1, others = 0) + 1.208 × spiculation (yes = 1, no = 0) + 2.164 × vacuole sign (yes = 1, no = 0) −0.054 × CEA. The AUC of the model with CEA was 0.818 (95% confidence interval, 0.763–0.865), with a sensitivity of 64.80% and a specificity of 84.96%, and the stability was better through internal verification.

Conclusions

The prediction model established in our study exhibits better accuracy and internal stability in predicting the probability of malignancy for SPNs.
Re-examination of MAGE-A3 as a T-cell Therapeutic Target
Authors: Martin Aaron D. , Wang Xueyin , Sandberg Mark L. , Negri Kathleen R. , Wu Ming L. , Toledo Warshaviak Dora , Gabrelow Grant B. , McElvain Michele E. , Lee Bella , Daris Mark E. , Xu Han , Kamb Alexander
Published: December 2020

In 2013, an innovative MAGE-A3-directed cancer therapeutic of great potential value was terminated in the clinic because of neurotoxicity. The safety problems were hypothesized to originate from off-target T-cell receptor activity against a closely related MAGE-A12 peptide. A combination of published and new data led us to test this hypothesis with current technology. Our results call into question MAGE-A12 as the source of the neurotoxicity. Rather, the data imply that an alternative related peptide from EPS8L2 may be responsible. Given the qualities of MAGE-A3 as an onco-testis antigen widely expressed in tumors and largely absent from normal adult tissues, these findings suggest that MAGE-A3 may deserve further consideration as a cancer target. As a step in this direction, the authors isolated 2 MAGE-A3 peptide-major histocompatibility complex-directed chimeric antigen receptors, 1 targeting the same peptide as the clinical T-cell receptor. Both chimeric antigen receptors have improved selectivity over the EPS8L2 peptide that represents a significant risk for MAGE-A3-targeted therapeutics, showing that there may be other options for MAGE-A3 cell therapy.
Journey to Diversity in a University Radiation Oncology Residency Program
Authors: Amdur Robert J. , Mendenhall Nancy P. , Mendenhall William M. , Dagan Roi , Yeung Anamaria R. , Okunieff Paul G.
Published: December 2020

Objectives:

Increasing diversity in radiation oncology with respect to sex, under-represented minorities (URMs), and people of color is a major objective of our profession. The purpose of this project is to plot diversity percentages in our residency program over the past 52 years and explain major causes for change when identified.

Materials and Methods:

Plots of the percent of residents in our program each year between 1967 and 2020 in the following categories: White male, female, URM, and people of color.

Results:

Between 1967 and 1992 diversity percentage in our program changed little with ∼90% of residents representing White males. Between 1992 and 1995, overall diversity increased by 40 percentage points, a change maintained from 1995 to 2020. Approximate annual percentages over the past 25 years were: female, 35%; URM, 10%; and people of color, 25%.

The main reason for increased diversity starting in 1992 was new leadership seeking to promote diversity. Tools that helped promote diversity were measuring our diversity profile and setting target goals.

Conclusions:

Our experience provides a model to measure diversity and track performance over time in residency programs, departments, or practice groups. The priority to place on diversity, and specific performance goals, vary by group. For those seeking to increase diversity, our experience shows it is possible to achieve substantial diversity in all categories, but change requires leadership making diversity a priority.
Factors Affecting Quality of Life Among the Elderly in Long-Term Care Hospitals
Authors: CHANG Hee-Kyung , GIL Cho-Rong , KIM Hye-Jin , BEA Han-Ju
Published: December 2020

Background

There are challenges in sustaining person-centered care in aged care settings. Key related issues of concern such as quality of life among the older people in long-term care hospitals and interactions with nursing staff have been described previously.

Purpose

This study was designed to explore the factors affecting quality of life among older people living in long-term care hospitals in South Korea.

Methods

Older adult patients (N = 202) in three long-term care hospitals completed measures of cognitive functions, depression, care dependency, and interactions between nurse and patient and a quality-of-life assessment tool. Univariate analyses were used to examine the relationships among these variables, and a multiple linear regression analysis was used to explore the extent to which these variables predicted quality of life in these patients.

Results

The significant factors associated with quality of life were found to be cognitive functions (r = .373, p < .001), care dependency (r = .350, p < .001), and depression (r = −.504, p < .001). The regression model with depression and care dependency as predictor variables accounted for 25.7% of the variance in quality of life.

Conclusions/Implications for Practice

The correlation found in this study between quality of life and depression and care dependency provides additional evidentiary support for developing and applying nursing interventions that reduce depression and care dependency in older adult populations.
Utility of Equivalence and Cognition Models in Enhancing Validity of Translated Questionnaires: A Methodological Example Using the Heart Quality-of-Life Questionnaire
Authors: LEE Wan Ling , LIM ABDULLAH Khatijah , CHINNA Karuthan , ABIDIN Imran Z.
Published: December 2020

Background

The cross-cultural adaptation of questionnaires has tenuous theoretical underpinnings that limit the rigor of data collection and the meaningful analysis of cognitive interview data. An adaptation of existing models of equivalence and cognition provides structure to the comprehensive investigation of various equivalence types in enhancing the validity of translated questionnaires.

Purpose

In this study, a framework comprising equivalence and cognition models was used to assess and finalize the Heart Quality-of-Life (HeartQoL)-Bahasa Malaysia (BM) questionnaire, which was derived from both forward–backward (FB) and dual-panel (DP) translation methods.

Methods

Investigation and finalization of two initial versions of the questionnaire were conducted based on findings from an expert assessment (n = 3 sociolinguists blinded to translation methods) and cognitive interviews with purposively sampled patients (FB: n = 11; DP: n = 11). The equivalence model of Herdman et al. and the question-and-answer model of Collins were adapted to form a “cognition-and-equivalence” model to guide data collection and analysis through modified cognitive interviews. The final HeartQoL-BM was completed by 373 patients with ischemic heart disease from two medical centers, and the data were analyzed using confirmatory factor analysis to assess the evidence of equivalence.

Results

Findings from the expert assessment and cognitive interview showed the existence of semantic and item equivalence on almost all of the FB and DP items, identified some subtle potential equivalence gaps, and guided the process of item finalization. Confirmatory factor analysis, including tests of factorial invariance on the final two-factor model of HeartQoL-BM, confirmed conceptual, item, measurement, and operational equivalence, which supports functional equivalence.

Conclusions

The potential use of the cognition-and-equivalence model for modified cognitive interviewing and the application of the six equivalence types of Herdman et al. were supported by the HeartQoL-BM showing functional equivalence with its source. HeartQoL-BM is a potentially valid measure of health-related quality of life for patients with ischemic heart disease independent of conditions such as angina, myocardial infarction, and heart failure.
Does the Association Between Fatigue and Fatigue Self-management Preference Vary by Breast Cancer Stage?
Authors: Jang Min Kyeong , Park Chang , Lee Keon Suk , Lee KyungHi , Hwang Eun Kyung , Joh Hye Jin , Lim Kyung Hee , Ko Yun Hee , Kim Dong Mi , Han Jeehee , Kim Sue
Published: December 2020

Background

Cancer-related fatigue (CRF) is a major issue facing breast cancer survivors (BCS) that can negatively impact their symptoms and quality of life.

Objectives

The aims of this study were to examine levels of fatigue, identify preferred types of fatigue self-management, and explore the relationship between fatigue levels and management choices by cancer stage.

Methods

This cross-sectional descriptive study included 229 BCS recruited from 5 hospitals in Korea. The study inclusion criteria were limited to BCS between 20 and 69 years old in stages 1, 2, or 3 who were undergoing or had completed active therapy. The Revised Piper Fatigue Scale and a questionnaire developed for fatigue management were used for data collection.

Results

The stage 2 group experienced more fatigue (mean, 5.31) than the other cancer stage groups, and significant differences in fatigue were found between stages 1 and 2 (P < .001). Fatigue self-management choices showed different correlations with fatigue levels in each stage. Physical activity control was most frequently used in stage 1, whereas exercise was most frequently used in stages 2 and 3. Multivariate regression analysis showed that exercise consistently and effectively decreased all fatigue dimensions.

Conclusion

Stage 2 BCS experienced the greatest level of CRF, and fatigue levels and management choices differed in BCS by cancer stage.

Implications for Practice

Recognizing how CRF and patients' preferences for fatigue self-management may differ by cancer stage can alert clinicians in assessing CRF and tailoring effective fatigue management for BCS.
Mesonephric (Wolffian-derived) Adenocarcinoma of the Female Urethra
Authors: Paner Gladell P. , Lopez-Beltran Antonio , Amin Mahul B.
Published: December 2020

The current World Health Organization (WHO) classification of adenocarcinoma of the urinary tract including the urethra includes uncommon Müllerian-derived carcinomas such as clear cell and endometrioid adenocarcinomas. The concept of primary mesonephric (Wolffian-derived) adenocarcinoma (MA) in the urethra (and urinary tract in general) is currently regarded as controversial as the term “mesonephric” had been also inaccurately applied in the past to label Müllerian-derived carcinomas, particularly clear cell adenocarcinoma. Further, pathologically well-documented or bona fide urethral MAs have not yet to be reported. Herein, we describe 2 examples of MA in elderly females that primarily presented in the urethra and manifested clinically with obstructive lower urinary tract symptoms. Both tumors exhibited histology similar to those in MAs of the female genital tract including the distinctive tubular proliferations with luminal eosinophilic materials. The first case, in addition, showed a variety of patterns including ductal (glandular), solid, fused/sieve-like tubules, dilated tubules, and spindled cells. The second case also showed a transition to the more irregular and poorly formed tubular proliferation of cells with greater nuclear atypia and with a desmoplastic response. Both tumors showed positivity for PAX8, GATA3, and luminal CD10, and 1 tumor analyzed harbored KRAS and ARID1A mutations. One patient received neoadjuvant chemotherapy and underwent resection but had local tumor recurrence and metastasis to the lungs and lumbar spine 12 months after presentation. In conclusion, MA, similar to those occurring in the female genital tract and distinct from the recognized Müllerian-derived carcinomas, may present primarily as urethral tumors. MA in the urethra probably shares a common pathogenesis with vaginal MA as both may originate from the same caudal loci of mesonephric remnants along the closely apposed anterior vaginal and posterior urethral walls. MA should be considered in future classifications for urethral tumors and we recommend that the confusing term “mesonephroid adenocarcinoma” should no longer be used.
S100 and Pan-Trk Staining to Report NTRK Fusion-Positive Uterine Sarcoma: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual Meeting
Authors: Chiang Sarah
Published: December 2020

NTRK fusion-positive uterine sarcoma is a recently recognized mesenchymal tumor that is defined by its morphologic resemblance to soft tissue fibrosarcoma, NTRK gene rearrangements, and potential response to Trk inhibition. Reported lesions affect premenopausal women with a median age of 32 yr, and most arise in the uterine cervix. Haphazard, storiform, or herringbone patterns of spindle cells with mild to moderate nuclear atypia are characteristic. SMA, CD34, and S100 are variably positive, but tumors are negative for desmin, ER, PR, and SOX10 and retain H3K27me3 expression. While pan-Trk immunohistochemistry is positive in these tumors, it has decreased sensitivity and specificity in the evaluation of sarcomas in general and the detection of NTRK3 rearrangements. A variety of molecular methods such as fluorescence in situ hybridization and next-generation sequencing may be useful in confirming NTRK fusion in fibrosarcoma-like uterine sarcomas.
POLE, MMR, and MSI Testing in Endometrial Cancer: Proceedings of the ISGyP Companion Society Session at the USCAP 2020 Annual Meeting
Authors: Casey Laura , Singh Naveena
Published: December 2020

Subclassification of endometrial carcinoma (EC) based on morphologic features alone has been shown to have suboptimal reproducibility, both in regard to biopsy versus hysterectomy findings, as well as interobserver agreement. This restricts the role of morphologic classification of EC as a tool for risk prediction and therefore treatment planning. A diagnostic algorithm based on The Cancer Genome Atlas (TCGA) classification of EC holds promise for improving accuracy in risk prediction. This classifies EC into 4 groups: those harbouring mutations in the exonuclease domain of DNA polymerase epsilon, POLE (POLEmut), those showing a mismatch repair defect, those showing mutations in TP53 (p53abn) and a heterogenous group showing none of these 3 abnormalities (currently termed no specific molecular profile). These groups can be accurately and reproducibly diagnosed on biopsy samples using a limited panel of tests, namely immunohistochemistry for mismatch repair proteins and p53, and testing for POLE exonuclease domain pathogenic variants. In this article we briefly review the biology, testing and interpretation of POLE and mismatch repair defects in EC.
How I Treat Non–Small Cell Lung Cancer Refractory to Immunotherapy
Authors: Wong Selina K. , Horn Leora
Published: December 2020

Lung cancer is a leading cause of cancer-related mortality despite continued advances in diagnostic and therapeutic strategies. Although the development of immune checkpoint inhibitors has revolutionized the treatment landscape for advanced non–small cell lung cancer, many patients either have primary resistance to these agents or eventually develop secondary resistance necessitating a change to an alternate therapy. Understanding novel patterns of response to immunotherapy is crucial in determining appropriate selection and sequencing of treatment. Chemotherapy remains the standard of care in immunotherapy-refractory disease, but multiple trials are ongoing to explore the role of combination radioimmunotherapy and rechallenging with immunotherapy either alone or in combination with other antineoplastic agents.
Gastric Motor Functions in Patients With Mood Disorders and Functional Gastroduodenal Symptoms
Authors: Maselli Daniel B. , Park Seon-Young , Camilleri Michael
Published: December 2020

Objective

Functional gastroduodenal symptoms (FGDSs) may result from perturbations in gastric emptying (GE) and gastric accommodation (GA), which are variably affected by acute stress. This study aimed to examine whether individuals who have both mood disorder and FGDS exhibit differences in GE and GA using standardized, validated, and reproducible noninvasive methods.

Methods

Using a data retrieval program, 1554 individuals at a single center were identified after having undergone measurements of GE by scintigraphy of a 99mTc-radiolabeled egg (320 kcal, 30% fat meal) and GA by single-photon emission computed tomography to assess the underlying pathophysiology in FGDS. An extensive medical record review identified 267 of these individuals as having diagnoses of depression, anxiety, or comorbid anxiety/depression (CAD). Differences in GE and GA as related to the presence of anxiety or depressive disorders were analyzed using one-way analysis of variance on ranks and Mann-Whitney tests for the two-group comparisons.

Results

Sixty-three patients with anxiety, 134 with depression, and 70 with CAD were identified. GE at 1 hour was slower (p = .04) and GE at 2 hours numerically decreased (p = .07) for depression compared with anxiety. GA was diminished for CAD compared with anxiety (p = .04) and depression (p = .009). There were no differences in fasting gastric volume or GE at 4 hours.

Conclusions

In this study examining GE and GA in anxiety and depressive disorders among patients with FGDS, the combined presence of anxiety and depression was associated with impaired GA compared with patients with depression or anxiety alone, and early GE seemed to be slower in those with depression compared with patients with anxiety.
Preoperative Ultrasound-guided Wire Localization of Soft Tissue Masses Within the Musculoskeletal System
Authors: Burke Christopher John , Walter William R. , Gao Yiming , Hoda Syed T. , Adler Ronald S.
Published: December 2020

Ultrasound-guided hookwire localization was initially introduced to facilitate the excision of nonpalpable breast lesions by guiding surgical exploration, thereby reducing operative time and morbidity. The same technique has since found utility in a range of other applications outside breast and can be useful within the musculoskeletal system. Despite this, there remains limited literature with respect to its technical aspects and practical utility. We describe our technique and a series of preoperative ultrasound-guided wire localizations in the musculoskeletal system to assist surgical excision of 4 soft tissue masses.