bluuebunny/crossref_metadata_2025 huggingface dataset:
Stopping renin-angiotensin system blockers after acute kidney injury and risk of adverse outcomes: parallel population-based cohort studies in English and Swedish routine care
Authors: Bidulka Patrick , Fu Edouard L. , Leyrat Clémence , Kalogirou Fotini , McAllister Katherine S. L. , Kingdon Edward J. , Mansfield Kathryn E. , Iwagami Masao , Smeeth Liam , Clase Catherine M. , Bhaskaran Krishnan , van Diepen Merel , Carrero Juan-Jesus , Nitsch Dorothea , Tomlinson Laurie A.
Published: July 2020

Background

The safety of restarting angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) after acute kidney injury (AKI) is unclear. There is concern that previous users do not restart ACEI/ARB despite ongoing indications. We sought to determine the risk of adverse events after an episode of AKI, comparing prior ACEI/ARB users who stop treatment to those who continue.

Methods

We conducted two parallel cohort studies in English and Swedish primary and secondary care, 2006–2016. We used multivariable Cox regression to estimate hazard ratios (HR) for hospital admission with heart failure (primary analysis), AKI, stroke, or death within 2 years after hospital discharge following a first AKI episode. We compared risks of admission between people who stopped ACEI/ARB treatment to those who were prescribed ACEI/ARB within 30 days of AKI discharge. We undertook sensitivity analyses, including propensity score-matched samples, to explore the robustness of our results.

Results

In England, we included 7303 people with AKI hospitalisation following recent ACEI/ARB therapy for the primary analysis. Four thousand three (55%) were classified as stopping ACEI/ARB based on no prescription within 30 days of discharge. In Sweden, we included 1790 people, of whom 1235 (69%) stopped treatment. In England, no differences were seen in subsequent risk of heart failure (HR 1.10; 95% confidence intervals (CI) 0.93–1.30), AKI (HR 0.90; 95% CI 0.77–1.05), or stroke (HR 0.99; 95% CI 0.71–1.38), but there was an increased risk of death (HR 1.27; 95% CI 1.15–1.41) in those who stopped ACEI/ARB compared to those who continued. Results were similar in Sweden: no differences were seen in risk of heart failure (HR 0.91; 95% CI 0.73–1.13) or AKI (HR 0.81; 95% CI 0.54–1.21). However, no increased risk of death was seen (HR 0.94; 95% CI 0.78–1.13) and stroke was less common in people who stopped ACEI/ARB (HR 0.56; 95% CI 0.34–0.93). Results were similar across all sensitivity analyses.

Conclusions

Previous ACEI/ARB users who continued treatment after an episode of AKI did not have an increased risk of heart failure or subsequent AKI compared to those who stopped the drugs.
Integration analysis of long non-coding RNA (lncRNA) role in tumorigenesis of colon adenocarcinoma
Authors: Poursheikhani Arash , Abbaszadegan Mohammad Reza , Nokhandani Negin , Kerachian Mohammad Amin
Published: July 2020

Background

Colon adenocarcinoma (COAD) is one of the most common gastrointestinal cancers globally. Molecular aberrations of tumor suppressors and/or oncogenes are the main contributors to tumorigenesis. However, the exact underlying mechanisms of COAD pathogenesis are clearly not known yet. In this regard, there is an urgent need to indicate promising potential diagnostic and prognostic biomarkers in COAD patients.

Methods

In the current study, level 3 RNA-Seq and miR-Seq data and corresponding clinical data of colon adenocarcinoma (COAD) were retrieved from the TCGA database. The “limma” package in R software was utilized to indicate the differentially expressed genes. For in silico functional analysis, GO and KEGG signaling pathways were conducted. PPI network was constructed based on the STRING online database by Cytoscape 3.7.2. A ceRNA network was also constructed by “GDCRNATools” package in R software. Kaplan-Meier survival analysis (log-rank test) and ROC curve analysis were used to indicate the diagnostic and prognostic values of the biomarkers.

Results

The differential expression data demonstrated that 2995 mRNAs, 205 lncRNAs, and 345 miRNAs were differentially expressed in COAD. The GO and KEGG pathway analysis indicated that the differentially expressed mRNAs were primarily enriched in canonical processes in cancer. The PPI network showed that the CDKN2A, CCND1, MYC, E2F, CDK4, BRCA2, CDC25B, and CDKN1A proteins were the critical hubs. In addition, the Kaplan-Meier analysis revealed that 215 mRNAs, 14 lncRNAs, and 39 miRNAs were associated with overall survival time in the patients. Also, the ceRNA network data demonstrated that three lncRNAs including MIR17HG, H19, SNHG1, KCNQ1OT1, MALAT1, GAS5, SNHG20, OR2A1-AS1, and MAGI2-AS3 genes were involved in the development of COAD.

Conclusions

Our data suggested several promising lncRNAs in the diagnosis and prognosis of patients with COAD.
DNA methylation data-based molecular subtype classification and prediction in patients with gastric cancer
Authors: Lian Qixin , Wang Bo , Fan Lijun , Sun Junqiang , Wang Guilai , Zhang Jidong
Published: July 2020

Background

Genetic and epigenetic alterations have been indicated to be closely correlated with the carcinogenesis, DNA methylation is one of most frequently occurring molecular behavior that take place early during this complicated process in gastric cancer (GC).

Methods

In this study, 398 samples were collected from the cancer genome atlas (TCGA) database and were analyzed, so as to mine the specific DNA methylation sites that affected the prognosis for GC patients. Moreover, the 23,588 selected CpGs that were markedly correlated with patient prognosis were used for consistent clustering of the samples into 6 subgroups, and samples in each subgroup varied in terms of M, Stage, Grade, and Age. In addition, the levels of methylation sites in each subgroup were calculated, and 347 methylation sites (corresponding to 271 genes) were screened as the intrasubgroup specific methylation sites. Meanwhile, genes in the corresponding promoter regions that the above specific methylation sites were located were performed signaling pathway enrichment analysis.

Results

The specific genes were enriched to the biological pathways that were reported to be closely correlated with GC; moreover, the subsequent transcription factor enrichment analysis discovered that, these genes were mainly enriched into the cell response to transcription factor B, regulation of MAPK signaling pathways, and regulation of cell proliferation and metastasis. Eventually, the prognosis prediction model for GC patients was constructed using the Random Forest Classifier model, and the training set and test set data were carried out independent verification and test.

Conclusions

Such specific classification based on specific DNA methylation sites can well reflect the heterogeneity of GC tissues, which contributes to developing the individualized treatment and accurately predicting patient prognosis.
Reshaping the role of m6A modification in cancer transcriptome: a review
Authors: Yang Guanqun , Sun Zhigang , Zhang Nan
Published: July 2020

N6-methyl-adenosine(m6A) modification emerges as an abundant and dynamic regulation throughout the Eukaryotic transcriptome. Dysregulation of the m6A regulators has increasingly been found in many neoplasms. It is reasonable to believe that m6A changes the fate of cancer cells and subsequently affected all aspects of cancer progression. In view of the context-dependent role of m6A modification, we emphasize a dual effect of m6A in a particular tumor model, that is, m6A plays a promoting role or a suppressing role in different stages of cancer. This novel sight is compared to the older view that a particular m6A regulator acts as a consistent role in cancer progression.
Comparing the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners and the urban population in Zimbabwe using the EuroQol (EQ-5D-3L+C) questionnaire: a cross-sectional study
Authors: Becker Jana , Bose-O’Reilly Stephan , Shoko Dennis , Singo Josephine , Steckling-Muschack Nadine
Published: July 2020

Background

The role of artisanal and small-scale gold mining (ASGM) as a source of income is rapidly gaining importance in the economically difficult times in Zimbabwe. Besides limited epidemiological data, no data about the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners exist. The aim of the project was to access HRQoL of ASGM workers to improve the data base and compare the data to the urban Zimbabwean population.

Methods

Data from 83 artisanal and small-scale gold miners in Kadoma, Zimbabwe was analysed. The HRQoL was assessed using the EuroQol dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) accompanied by the cognition add-on questionnaire (EQ-5D-3L+C) and associated visual analogue scale (VAS). We described the EQ-5D dimensions and VAS values and computed health utility (HU) values using the Zimbabwean tariff. The proportions of miners reporting no problem in each EQ-5D dimension were compared with corresponding proportions reporting any problem (moderate or severe), and mean HU and VAS values were analysed across subgroups of the sample. To test differences between subgroups, Fisher’s exact test was used and between urban and mining population, Student’s t-test was used.

Results

The reported health states of miners were homogenous, with a large amount (42%) reporting ‘full health’. Mean (SD) VAS and HU values were 81.0 (17.5) and 0.896 (0.13), respectively. Subgroup analysis showed that miners with a lower education reported significantly more problems in the dimension of daily activities and miners with mercury contact had more problems in the dimensions of pain/discomfort and cognition. Comparison between mining and urban population showed that in the oldest age group, self-rated VAS values of miners were significantly higher than of their urban counterparts.

Conclusions

There were no significant differences in the HRQoL of mining and urban populations. However, the reason might be adverse health effects faced by the urban population that do not apply to rural mining areas. A higher education level of miners can improve the HRQoL, which is especially impaired by problems in the cognition dimension.
SARS-CoV-2: characteristics and current advances in research
Authors: Yang Yicheng , Xiao Zhiqiang , Ye Kaiyan , He Xiaoen , Sun Bo , Qin Zhiran , Yu Jianghai , Yao Jinxiu , Wu Qinghua , Bao Zhang , Zhao Wei
Published: July 2020

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection has spread rapidly across the world and become an international public health emergency. Both SARS-CoV-2 and SARS-CoV belong to subfamilyCoronavirinaein the familyCoronaviridaeof the orderNidoviralesand they are classified as the SARS-like species while belong to different cluster. Besides, viral structure, epidemiology characteristics and pathological characteristics are also different. We present a comprehensive survey of the latest coronavirus—SARS-CoV-2—from investigating its origin and evolution alongside SARS-CoV. Meanwhile, pathogenesis, cardiovascular disease in COVID-19 patients, myocardial injury and venous thromboembolism induced by SARS-CoV-2 as well as the treatment methods are summarized in this review.
Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): study protocol for a cluster-randomized comparative effectiveness trial
Authors: Kazak Anne E. , Deatrick Janet A. , Scialla Michele A. , Sandler Eric , Madden Rebecca E. , Barakat Lamia P.
Published: July 2020

Background

Childhood cancer affects and is affected by multiple levels of the social ecology, including social and relational determinants of health (e.g., economic stability, housing, childcare, healthcare access, child and family problems). The 2015 Standards of Psychosocial Care in Pediatric Cancer outline optimal psychosocial care sensitive to these ecological factors, starting with assessment of psychosocial healthcare needs to promote medical and psychosocial outcomes across all children with cancer. To address the first standard of family psychosocial assessment, the Psychosocial Assessment Tool (PAT) is a validated screener ready for broad implementation.

Method

The PAT will be implemented across a national sample of 18 pediatric cancer programs ranging in size (annual new patients) in a mixed methods, comparative effectiveness study, guided by the Interactive Systems Framework for Dissemination and Implementation, comparing two implementation strategies. It is hypothesized that implementation will be more successful at the patient/family, provider, and institutional level when training (strategy I) is combined with implementation expanded resources (strategy II). There are three aims: (1) Refine the two implementation strategies using semi-structured qualitative interviews with 19 stakeholders including parent advocates, providers, pediatric oncology organization representatives, healthcare industry leaders; (2) Compare the two theoretically based and empirically informed strategies to implement the PAT in English and Spanish using a cluster-randomized controlled trial across 18 sites. Stratified by size, sites will be randomized to cohort (3) and strategy (2). Outcomes include adoption and penetration of screening (patient/family), staff job satisfaction/burnout (provider), and cost-effective use of resources consistent with family risk (institution); (3) Based on the results of the trial and feedback from the first and second aim, we will develop and disseminate a web-based PAT Implementation Toolkit.

Discussion

Use of the PAT across children’s cancer programs nationally can achieve the assessment standard and inform equitable delivery of psychosocial care matched to family need for all patients.

Trial Registration

ClinicalTrials.gov, NCT04446728, registered 23 June 2020
RETRACTED ARTICLE: Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis
Authors: Zhou Yong-Qiang , Tu Hong-Liang , Duan Yan-Ji , Chen Xiao
Published: July 2020

Background

Bone morphogenetic proteins (BMPs) have strong bone induction properties and can promote healing of fractures and other defects. However, BMP treatment efficacy for long bone nonunion remains controversial. The aim of this meta-analysis was to synthetically evaluate the advantages and disadvantages of BMP plus bone grafting (observation group) versus autologous bone grafting (control group) for limb long bone nonunion.

Methods

PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Weipu Journal, Chinese Biomedical Literature, and WanFang were searched for randomized and non-randomized controlled trials published before November 2019. A meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 12.0.

Results

Five randomized and four non-randomized controlled trials involving 30–124 cases were included, with a total of 655 nonunion cases. There were no significant group differences in postoperative healing rate, infection, and secondary operation rates (P > 0.05), but the study group demonstrated significantly shorter mean healing time (WMD = − 1.27, 95%CI − 1.67 to − 0.88, P < 0.00001), a greater frequency of excellent/good post-treatment limb function (RR = 1.18, 95%CI 1.01–1.39, P = 0.04), and lower intraoperative blood loss (P < 0.05). Alternatively, the hospitalization cost was significantly higher in the study group (P < 0.01).

Conclusions

Bone morphogenetic protein is a viable alternative to autologous bone grafting, with potential advantages of accelerated fracture healing and improved postoperative function.
Surgical treatment of bilateral vanishing lung syndrome: a case report
Authors: Giller Dmitry Borisovich , Scherbakova Galina Vladimirovna , Giller Boris Dmitrievich , Khanin Arkadyi Leybovich , Nikolenko Vladimir Nikolayeich , Sinelnikov Mikhail Yegorovich
Published: July 2020

Background

Volume reduction surgery is a routine treatment method for lung emphysema in chronic obstructive pulmonary disease (COPD) patients. The formation of giant bullous emphysema is an indication for surgical bullectomy. Bilateral giant bullae severely compromise lung function and complicate surgical treatment.

Case presentation

We present the algorithm for surgical treatment and correction of complications in a 38-year-old male with bilateral giant bullae (vanishing lung syndrome), severe COPD. Primarily the patient was admitted with a mild cough, mucopurulent sputum and dyspnea. A CT scan revealed bilateral giant bullae, displacing up to 50% of lung volume. A two-stage surgical bullectomy was planned, yet postoperative complications due to secondary bullae rupture prompted urgent revision with contralateral bullae resection. After complete bullectomy, severely reduced lung volume was successfully managed throughout a long postoperative rehabilitation period. At 5 year follow-up, spirometry indicators and radiological examination show significantly improved and stable lung function.

Conclusion

This clinical case demonstrates the technical difficulties and possible complications of extended bilateral lung resections in patients with severe vanishing lung syndrome. Single-stage treatment of bilateral giant bullous emphysema is recommended to minimize postoperative complications and reduce risk of bullae rupture. Positive long-term outcome outweighs possible complications of surgical treatment.
Bilateral lung nodules resection by image-guided video-assisted thoracoscopic surgery: a case series
Authors: Liang Chu-Chun , Liao Chi-Hao , Cheng Ya-Fu , Hung Wei-Heng , Chen Heng-Chung , Huang Chang-Lun , Wang Bing-Yen
Published: July 2020

Background

We demonstrated the safety and feasibility of image-guided video-assisted thoracoscopic surgery (iVATS) of bilateral lung lesions in a hybrid operating room.

Methods

This study was a retrospective analysis of a case series. A total of 7 patients with 15 small lung nodules underwent bilateral iVATS between July 2018 and May 2019. All procedures were completed within a single anesthesia procedure and performed in a hybrid operating room that had a cone-beam computed tomography (CT) apparatus equipped with a laser navigation system. The lesion characteristics, operation methods, and peri-operative clinical outcomes were summarized.

Results

A total of 7 patients with 15 resected lung nodules were analyzed. The most common pathological result of our bilateral iVATS was metastasis. The median length of hospital stay was 5 days (range from 3 to 10 days). The median right chest tube duration was 2 days (range from 1 to 8 days), and the median left chest tube duration was 3 days (range from 2 to 5 days). Only one patient had a complication during his hospitalization period. There was no surgery-related mortality observed.

Conclusions

For bilateral pulmonary nodules, the iVATS procedure seems to be a feasible and cost-effective approach.
HIV and development of epithelial cell abnormalities in women with prior normal cervical cytology in Nigeria
Authors: Musa Jonah , Mehta Supriya D. , Achenbach Chad J. , Evans Charlesnika T. , Jordan Neil , Magaji Francis A. , Pam Victor C. , Daru Patrick H. , Silas Olugbenga A. , Sagay Atiene S. , Anorlu Rose , Zheng Yinan , Maiga Mamoudou , Adewole Isaac F. , Murphy Robert L. , Hou Lifang , Simon Melissa A.
Published: July 2020

Background

HIV-associated cellular immune dysfunction has been linked to higher risk of cervical dysplasia and cancer in HIV infected women. We sought to understand the relationship between HIV and development of epithelial cell abnormalities (ECA) at follow-up in women with prior normal cervical cytology (NCC).

Methods

Retrospective cohort analysis of women who received a Pap test at the Operation Stop Cervical Cancer Unit in Jos, Nigeria over a 10-year period (2006–2016). We analyzed the data of women with NCC at first Pap who had at least one follow-up cytology result for time-to-detection of ECA. We determined follow-up time in years from date of first NCC to date of first ECA report or date of last NCC follow up report with censoring at last follow-up date or December 31st, 2016 whichever came first. The primary outcome was development of any ECA as defined by the Bethesda 2001 reporting system. We identified demographic and clinical factors associated with incident ECA using multivariable Cox regression.

Results

A total of 1599 women were eligible for this analysis. Overall, 3.7% (57/1556) of women reported being HIV infected. The median age at first Pap was 39 years (IQR; 33–45). The HIV infected women were younger (36.3 ± 8.1) compared to those uninfected (39.3 ± 6.6), p = 0.005. After an accrued follow-up time of 3809 person-years (PYs), 243 women (15%) had an ECA with an event rate of 6.38 per 100 PYs. Women ≥35 years at first Pap were more likely to have an ECA compared to those < 35 years (7.5 per 100 PYs vs 3.8 per 100 PYs, HR = 1.96; 95% CI: 1.4, 2.8). HIV status was not significantly associated with developing ECA in either unadjusted (7.4 per 100 PYs vs 6.4 per 100 PYs, HR = 1.17; 95% CI: 0.53, 2.3) or adjusted analyses (aHR = 1.78; 95% CI: 0.87, 3.65).

Conclusion

Women living with HIV and on successful antiretroviral treatment may not have a differential hazard in the development of ECA during follow up after a prior normal Pap. Offering a repeat CCS to women who are 35 years or older irrespective of HIV status is likely an effective strategy in resource limited settings.
Intermittent theta burst stimulation (iTBS) combined with working memory training to improve cognitive function in schizophrenia: study protocol for a randomized controlled trial
Authors: Song Jiaqi , Liu Dan , Zhang Meng , Wang Huiqiu , Tan Shuping
Published: July 2020

Background

Working memory deficit is one of the most critical complex cognitive impairments in schizophrenia. Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant therapy, but not still unsatisfactory. Intermittent theta burst stimulation (iTBS), which has recently been used in clinical practice, may have faster and stronger effects comparing the traditional model (10-Hz high-frequency rTMS). A large number of studies have showed that rTMS, especially iTBS, can enhance the neural plasticity of the brain, and cognitive training can improve the cognitive function of schizophrenia. Is there any facilitation effect of iTBS add on cognitive training (such as working memory training, WMT) on cognitive function enhancement in schizophrenia is still unknown.

Methods/design

The proposed study is designed of a double-center, double-blinded, randomized controlled trial that will include 200 schizophrenia patients between 18 and 45 years of age. The patients will be randomized to four groups, i.e., the study group (iTBS+WMT), WMS control group (iTBS+ Simple Response Training (SRT)), iTBS control group (sham iTBS+WMT), and placebo control (sham iTBS+SRT). The patients will receive 3 min 20 s of real or sham stimulation, followed by a short 1–2-min rest and 40 min of WMT training or SRT immediately. Neuropsychological and clinical symptom assessments, with functional and structural MRI, will be performed on baseline, post-treatment, and 3- and 6-month follow-up periods. The primary outcome is cognitive function measured by the MATRICS Consensus Cognitive Battery (MCCB). The secondary outcomes are changes in neuroplasticity, as measured by MRI and other behavioral assessments.

Discussion

The aim of our study is to explore the facilitation effects of iTBS added on WMT in improving cognitive function of schizophrenia. That means, patients with schizophrenia will benefit more in cognitive function improvement from the combination training mode of “preheating (iTBS stimulation changes the neural activity of working memory-related brain regions) and ironning (working memory training).” And the long-term effects of this combined training model will be assessed at a 6-month follow-up period. In case of a significant improvement of working memory with a prolonged effect, the iTBS combined with WMT protocol could be considered as a first-line clinical protocol in schizophrenia treatment. More broadly, the potential for increased universality and efficiency of rTMS with the iTBS model to enhance the neural plasticity of the brain should have a more positive effect on cognitive function in schizophrenia.

Trial registration

chictr.org.cn ChiCTR1900023405. Registered on 25 May 2019
Comparative study of physiologic characteristics between the newly compiled Bafa Wubu of tai chi and 24 form simplified tai chi
Authors: Lyu Shaojun , Zhang Jianwei , Nie Jianquan , Li Cuihan , Gao Tianming , Yuan Wen , Chen Zaihao , Ma Jing
Published: July 2020

Background

The newly compiled Bafa Wubu of Tai Chi (Eight Methods and Five Footworks) is a fitness routine that has been developed in accordance with the appeal of the General Administration of Sport of China and promoted both in China and abroad. This paper aims to compare the differences in energy consumption and related parameters between the two types of Tai Chi.

Methods

A total of 60 healthy participants were recruited; 37 males (aged 37.4 ± 10.4 years) and 23 females (aged 31.9 ± 12.8 years). The maximal exercise capacity of participants was measured at baseline. Then, they received Tai Chi training for 12-week and their energy metabolism was measured dynamically.

Results

A set of the Bafa Wubu of Tai Chi requires approximately 3 min, while a set of 24 form simplified Tai Chi approximately 5 min and 40 s. The average oxygen uptake/kg (VO2/kg, 10.8 ± 2.52 ml/kg/min vs. 12.9 ± 2.59 ml/kg/min, P = 0.000), the highest VO2/kg (19.3 ± 6.03 ml/kg/min vs. 24.1 ± 7.50 ml/kg/min, p = 0.000, the average metabolic equivalent (METs,2.3 ± 0.16 METs vs. 3.2 ± 0.14 METs, p = 0.000), the highest oxygen pulse (VO2/HR, 11.1 ± 0.99 ml vs. 13.9 ± 0.93 ml, p = 0.000) and rate of perceived exertion (RPE, 10.7 ± 0.70 vs. 1.3 ± 0.62, p = 0.000) gained immediately after Bafa Wubu of Tai Chi exercise were significantly lower than those in 24 form simplified Tai Chi; heart rate recovery (HRR,1.5 ± 0.41 vs. 1.3 ± 0.45, p = 0.008) at 1 min after the practice was significantly higher than after the 24 form simplified Tai Chi. Meanwhile, the average heart rate (HR, 104.1 ± 11.41 bpm vs. 105.7 ± 9.68 bpm, p = 0.696) and the highest respiratory quotient (RQ, 1.0 ± 0.06 vs. 0.9 ± 0.09, p = 0.643) were not significantly different. The intensity of Tai Chi was described as the highest oxygen uptake of the participants when they performed the Tai Chi divided by their individual maximal oxygen uptake. Tai Chi intensity during Bafa Wubu of Tai Chi (50% ± 11.7% vs. 64% ± 12.5%) was significantly lower than during 24 form simplified Tai Chi.

Conclusion

The newly compiled Bafa Wubu of Tai Chi is characterized by lower energy consumption than 24 form simplified Tai Chi.

Trial registration

Ethics Committee of Sports Science Experiment, Beijing Sport University- 2018010H. Registered 19 June 2018
Baseline factors identified for the prediction of good responders in patients with end-stage diffuse coronary artery disease undergoing intracoronary CD34+ cell therapy
Authors: Sung Pei-Hsun , Chiang Hsin-Ju , Li Yi-Chen , Chiang John Y. , Chu Chi-Hsiang , Shao Pei-Lin , Lee Fan-Yen , Lee Mel S. , Yip Hon-Kan
Published: July 2020

Background

Treating patients with end-stage diffuse coronary artery disease (EnD-CAD) unsuitable for coronary intervention remains a clinical challenge. They usually express refractory angina and have a high risk of mortality. Although growing data have indicated cell therapy is an alternative solution to medical or invasive therapy, there are still lacking useful markers to predict whether heart function will improve in the EnD-CAD patients who underwent circulatory-derived CD34+ cell therapy. By utilizing the baseline variables and results from our previous phase I/II clinical trials, the aim of this study tried to elucidate the variables predictive of the “good response” to CD34+ cell therapy.

Methods

This retrospective study included 38 patients in phase I clinical trial (2011–2014), and 30 patients in phase II clinical trial (2013–2017). These patients were categorized into “good responders” and “non-responders” according to their 1-year improvement of LVEF ≥ 7.0% or < 7.0% after intracoronary CD34+ cell therapy. Univariate and multivariate logistic regression models were performed to identify potential independent predictors of a good responder to cell therapy, followed by Hosmer–Lemeshow (H-L) test for goodness of fit and prediction power.

Results

Among baseline data, multivariate analysis demonstrated that the history of a former smoker was independently predictive of good responders (p = 0.006). On the other hand, male gender, the baseline Canadian Cardiovascular Society angina score ≥ 3, and grades of LV diastolic dysfunction ≥ 2 were significantly negative predictors of good responders (all p < 0.01). After administration of subcutaneous granulocyte-colony stimulating factor (G-CSF), a higher post-G-CSF neutrophil count in addition to the above four baseline variables also played crucial roles in early prediction of good response to CD34+ cell therapy for EnD-CAD (all p < 0.03). The H-L test displayed a good prediction power with sensitivity 83.3%, specificity 85.3%, and accuracy 84.4%.

Conclusions

Using the results of our phase I/II clinical trials, previous smoking habit, female sex, lower grades of angina score, and diastolic dysfunction were identified to be independently predictive of “good response” to CD34+ cell therapy in the patients with EnD-CAD.

Trial registration

This is a retrospective analysis based on phase I (ISRCTN72853206) and II (ISRCTN26002902) clinical trials.
Roles for androgens in mediating the sex differences of neuroendocrine and behavioral stress responses
Authors: Zuloaga Damian G. , Heck Ashley L. , De Guzman Rose M. , Handa Robert J.
Published: July 2020

Estradiol and testosterone are powerful steroid hormones that impact brain function in numerous ways. During development, these hormones can act to program the adult brain in a male or female direction. During adulthood, gonadal steroid hormones can activate or inhibit brain regions to modulate adult functions. Sex differences in behavioral and neuroendocrine (i.e., hypothalamic pituitary adrenal (HPA) axis) responses to stress arise as a result of these organizational and activational actions. The sex differences that are present in the HPA and behavioral responses to stress are particularly important considering their role in maintaining homeostasis. Furthermore, dysregulation of these systems can underlie the sex biases in risk for complex, stress-related diseases that are found in humans. Although many studies have explored the role of estrogen and estrogen receptors in mediating sex differences in stress-related behaviors and HPA function, much less consideration has been given to the role of androgens. While circulating androgens can act by binding and activating androgen receptors, they can also act by metabolism to estrogenic molecules to impact estrogen signaling in the brain and periphery. This review focuses on androgens as an important hormone for modulating the HPA axis and behaviors throughout life and for setting up sex differences in key stress regulatory systems that could impact risk for disease in adulthood. In particular, impacts of androgens on neuropeptide systems known to play key roles in HPA and behavioral responses to stress (corticotropin-releasing factor, vasopressin, and oxytocin) are discussed. A greater knowledge of androgen action in the brain is key to understanding the neurobiology of stress in both sexes.
Scalable, efficient, and secure RFID with elliptic curve cryptosystem for Internet of Things in healthcare environment
Authors: Noori Davood , Shakeri Hassan , Niazi Torshiz Masood
Published: July 2020

The rapid development of IoT technology has led to the usage of various devices in our daily life. Along with the ever-increasing rise of the Internet of Things, the use of appropriate methods for establishing secure communications in health care systems is vital. The adoption of high-security optimal mechanisms for this purpose has been more effective regarding the efficiency of medical information systems; hence, many studies are being conducted in this field today. One of the most important components is the RFID cards that can be used for communication between entities in the environment. In healthcare systems, patient information is critical and nobody should have access to this information. Thus, providing security for these networks is essential. Recently, good researches have been done in the area of authentication for medical information systems, using RFID technology, which has a low computational cost. In this paper, we propose a novel method based on elliptic curve cryptography for vital and efficient and scalable authentication between RFID cards, card readers, and servers. This proposed method maintains security and has less computational cost and low elliptic curve point multiplication running time compared to similar recent methods.
The existence and boundedness of linear and multilinear Marcinkiewicz integrals on central Campanato spaces
Authors: Ma Jiao , Wei Mingquan , Yan Dunyan
Published: July 2020

In this paper, we obtain the existence and boundedness of Marcinkiewicz integrals with homogeneous kernels on central Campanato spaces. Moreover, the existence and boundedness of multilinear Marcinkiewicz integrals on central Campanato spaces are also deduced. We extend various previous results to central Campanato spaces which can be seen as the local version of Campanato spaces.
A fuzzy inference system (FIS) to evaluate the security readiness of cloud service providers
Authors: Rizvi Syed , Mitchell John , Razaque Abdul , Rizvi Mohammad R. , Williams Iyonna
Published: July 2020

Cloud computing is a model for on-demand delivery of IT resources (e.g., servers, storage, databases, etc.) over the Internet with pay-as-you-go pricing. Although it provides numerous benefits to cloud service users (CSUs) such as flexibility, elasticity, scalability, and economies of scale, there is a large trust deficit between CSUs and cloud service providers (CSPs) that prevents the widespread adoption of this computing paradigm. While some businesses have slowly started adopting cloud computing with careful considerations, others are still reluctant to migrate toward it due to several data security and privacy issues. Therefore, the creation of a trust model that can evolve to reflect the true assessment of CSPs in terms of either a positive or a negative reputation as well as quantify trust level is of utmost importance to establish trust between CSUs and CSPs. In this paper, we propose a fuzzy-logic based approach that allows the CSUs to determine the most trustworthy CSPs. Specifically, we develop inference rules that will be applied in the fuzzy inference system (FIS) to provide a quantitative security index to the CSUs. One of the main advantages of the FIS is that it considers the uncertainties and ambiguities associated with measuring trust. Moreover, our proposed fuzzy-logic based trust model is not limited to the CSUs as it can be used by the CSPs to promote their services through self-evaluation. To demonstrate the effectiveness of our proposed fuzzy-based trust model, we present case studies where several CSPs are evaluated and ranked based on the security index.
Understanding the client characteristics of Aboriginal residential alcohol and other drug rehabilitation services in New South Wales, Australia
Authors: James Douglas B. , Lee KS Kylie , Patrao Tania , Courtney Ryan J. , Conigrave Katherine M. , Shakeshaft Anthony
Published: July 2020

Background

Aboriginal alcohol and other drug residential rehabilitation (residential rehabilitation) services have been providing treatment in Australia of over 50 years. However, there are no studies in Australia or internationally that document characteristics of clients attending Indigenous residential rehabilitation services worldwide. This is the first multi-site paper to describe key client characteristics of six Indigenous (hereafter Aboriginal Australians as the term recommended by the Aboriginal Health and Medical Research Council of New South Wales) residential rehabilitation services in Australia.

Methods

All recorded client admissions between 1 January 2011 to 31 December 2016 were considered from six operating services in the Australian state of New South Wales. Data collected were classified into categories based on demographics, treatment utilisation, substance use, mental health and quality of life characteristics. Means, median and percentages were calculated (where appropriate).

Results

There were 2645 admissions across the six services in the study period, with an average of 440 admissions per year across all services. Participants were aged between 26 to 35 years, with fewest participants aged 46 +. Program length ranged from 12 to 52 weeks (mean of 12 weeks). The completion rates and length of stay for each service ranged from less than two to more than 12 weeks. The principal drug of choice was alcohol and amphetamines in half of the services. Not all services used them, but a range of tools were used to measure treatment, substance use and mental health or quality of life outcomes.

Conclusion

This study is the first internationally to describe the key features of multiple Aboriginal residential rehabilitation services. The variation in tools used to collect client data made it difficult to compare client characteristics across services. Future research could explore predictors of treatment completion, identify opportunities for standardisation in client assessments and validate cultural approaches of care. These efforts would need to be guided by Aboriginal leadership in each service.
Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial
Authors: Edelman E. Jennifer , Maisto Stephen A. , Hansen Nathan B. , Cutter Christopher J. , Dziura James , Deng Yanhong , Fiellin Lynn E. , O’Connor Patrick G. , Bedimo Roger , Gibert Cynthia L. , Marconi Vincent C. , Rimland David , Rodriguez-Barradas Maria C. , Simberkoff Michael S. , Tate Janet P. , Justice Amy C. , Bryant Kendall J. , Fiellin David A.
Published: July 2020

Background

At-risk levels of alcohol use threaten the health of patients with HIV (PWH), yet evidence-based strategies to decrease alcohol use and improve HIV-related outcomes in this population are lacking. We examined the effectiveness of integrated stepped alcohol treatment (ISAT) on alcohol use and HIV outcomes among PWH and at-risk alcohol use.

Methods

In this multi-site, randomized trial conducted between January 28, 2013 through July 14, 2017, we enrolled PWH and at-risk alcohol use [defined as alcohol consumption of ≥ 14 drinks per week or ≥ 4 drinks per occasion in men ≤ 65 years old or ≥ 7 drinks per week or ≥ 3 drinks per occasion in women or men > 65 years old]. ISAT (n = 46) involved: Step 1- Brief Negotiated Interview with telephone booster, Step 2- Motivational Enhancement Therapy, and Step 3- Addiction Physician Management. Treatment as usual (TAU) (n = 47) involved receipt of a health handout plus routine care. Analyses were conducted based on intention to treat principles.

Results

Despite a multi-pronged approach, we only recruited 37% of the target population (n = 93/254). Among ISAT participants, 50% advanced to Step 2, among whom 57% advanced to Step 3. Participants randomized to ISAT and TAU had no observed difference in drinks per week over the past 30 days at week 24 (primary outcome) [least square means (Ls mean) (95% CI) = 8.8 vs. 10.6; adjusted mean difference (AMD) (95% CI) =  − 0.4 (− 3.9, 3.0)].

Conclusion

An insufficient number of patients were interested in participating in the trial. Efforts to enhance motivation of PWH with at-risk alcohol use to engage in alcohol-related research and build upon ISAT are needed.

Trial registration Clinicaltrials.gov: NCT01410123, First posted August 4, 2011
What constitutes “behavioral health”? Perceptions of substance-related problems and their treatment in primary care
Authors: Chen Ida Q. , Chokron Garneau Helene , Seay-Morrison Timothy , Mahoney Megan R. , Filipowicz Heather , McGovern Mark P.
Published: July 2020

Background

Integrating behavioral health in primary care is a widespread endeavor. Yet rampant variation exists in models and approaches. One significant question is whether frontline providers perceive that behavioral health includes substance use. The current study examined front line providers’: 1. definition of behavioral health, and 2. levels of comfort treating patients who use alcohol and other drugs. Frontline providers at two primary care clinics were surveyed using a 28-item instrument designed to assess their comfort and knowledge of behavioral health, including substance use. Two questions from the Integrated Behavioral Health Staff Perceptions Survey pertaining to confidence in clinics’ ability to care for patients’ behavioral health needs and comfort dealing with patients with behavioral health needs were used for the purposes of this report. Participants also self-reported their clinic role. Responses to these two items were assessed and then compared across roles. Chi square estimates and analysis of variance tests were used to examine relationships between clinic roles and comfort of substance use care delivery.

Results

Physicians, nurses/nurse practitioners, medical assistants, and other staff (N = 59) participated. Forty-nine participants included substance use in their definition of behavioral health. Participants reported the least comfort caring for patients who use substances (M = 3.5, SD = 1.0) compared to those with mental health concerns (M = 4.1, SD = 0.7), chronic medical conditions (M = 4.2, SD = 0.7), and general health concerns (M = 4.2, SD = 0.7) (p < 0.001). Physicians (M = 3.0, SD = 0.7) reported significantly lower levels of comfort than medical assistants (M = 4.2, SD = 0.9) (p < 0.001) caring for patients who use substances.

Conclusions

In a small sample of key stakeholders from two primary care clinics who participated in this survey, most considered substance use part of the broad umbrella of behavioral health. Compared to other conditions, primary care providers reported being less comfortable addressing patients’ substance use. Level of comfort varied by role, where physicians were least comfortable, and medical assistants most comfortable.
Outcomes of wildlife translocations in protected areas: what is the type and extent of existing evidence? A systematic map protocol
Authors: Langridge Joseph , Sordello Romain , Reyjol Yorick
Published: July 2020

Background

Conversion, fragmentation, and loss of natural habitats are among the main causes of declining species’ populations worldwide. Protected areas are therefore crucial for biodiversity as they provide refuge and ensure key ecological processes. Wildlife translocations, defined as “the deliberate movement of organisms from one site for release in another”, have been used in conjunction as a conservation tool for a number of decades as wild populations become increasingly fragmented and endangered. Not only are translocations used to bolster the viability of imperiled species but are also recommended for improving population resilience and adapting species’ ranges in response to climate change. Despite translocation being a recognised conservation tool, it remains complex with variable results due to the different factors that can determine its success. Accordingly, the Map will investigate the existing evidence on the links between different types of wildlife translocation interventions and factors that may be important to consider for planning. This will provide an overview of relevant studies for possible future syntheses, and may help to inform management decisions.

Method

We will perform a thorough search of peer-reviewed journal articles and grey literature sources documenting the occurrence of translocations in the context of protected areas. Two databases will be used: Web of science core collection and Scopus, with a supplementary search in Google Scholar. Multiple key specialized websites will also be used. All bibliographic data will be extracted, managed, and screened in Microsoft excel. Three screening stages will be undertaken (title, then abstract, then full texts) against predefined inclusion criteria. The retained relevant literature will be subjected to coding and meta-data extraction. No formal validity appraisal will be undertaken. The Map will particularly highlight translocation operations in terms of origin and destination (i.e. translocating from one protected area to another, within the same area, and from and to non-protected areas) by taxonomic group, among other important factors (e.g. number of individuals, age class, release strategy, distance between capture and release sites etc.). Finally, a database will be provided along with a Map narratively describing the evidence with summary figures and tables of pertinent study characteristics.
Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among undocumented migrants and uninsured legal residents in Amsterdam, the Netherlands: a cross-sectional study
Authors: van Dulm E. , Klok S. , Boyd A. , Joore I. K. , Prins M. , van Dam A. P. , Tramper-Stranders G. A. , van Duijnhoven Y. T. H. P.
Published: July 2020

Background

Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with an increased risk of infection. Colonization with MRSA is observed in < 1% of the general Dutch population. Increased risk for MRSA carriage is known to occur in several key groups, one of which is asylum seekers. However, little is known about MRSA carriage among undocumented migrants and uninsured legal residents. This study aimed to determine the prevalence of nasal MRSA carriage among these groups in Amsterdam, the Netherlands.

Methods

In this cross-sectional study, between October 2018 and October 2019, undocumented migrants and uninsured legal residents aged 18 years or older who were able to understand one of the study languages were recruited at an NGO health care facility in Amsterdam, the Netherlands, for general practitioner (GP) consultations. Participants were asked questions on demographics, migration history, antibiotic use and other possible risk factors for MRSA carriage and were screened for nasal MRSA carriage by selective culturing e-swabs. Characteristics of MRSA-negative and MRSA-positive participants were compared using univariable logistic regression analysis with Firth’s correction.

Results

Of the 3822 eligible patients, 760 were screened for nasal MRSA carriage (19.9%). Of the 760 participants, over half were male (58%; 442/760) and originated mainly from Africa (35%; 267/760), Asia (30%; 229/760) and North or South America (30%; 227/760). In total, 705/760 participants (93%) were undocumented migrants and 55/760 (7%) were uninsured legal residents of Amsterdam. The overall prevalence of nasal MRSA carriage was 2.0% (15/760) (95%CI 1.1 to 3.2%), with no difference between undocumented migrants (14/705) (2.0, 95%CI 1.1 to 3.3%) and uninsured legal residents (1/55) (1.8, 95%CI 0.1 to 9.7%). Genotyping showed no clustering of the 15 isolates. MRSA carriage was not associated with sociodemographic, migration history or other possible risk factors. Nevertheless, this study had limited power to detect significant determinants. Three participants (3/15; 20%) harbored Panton-Valentine leukocidin (PVL)-positive isolates.

Conclusion

Even though our study population of undocumented migrants and uninsured legal residents had a higher prevalence of nasal MRSA carriage compared to the general Dutch population, the prevalence was relatively low compared to acknowledged other high-risk groups.