bluuebunny/crossref_metadata_2025 huggingface dataset:
The apelin-13 peptide protects the heart against apoptosis through the ERK/MAPK and PI3K/AKT signaling pathways.
Authors: Wang Xuejun , Zhang Li , Feng Mengwen , Zhang Hao , Xu Jia , Cheng Zijie , Qian Lingmei
Published: July 2020

Background: It has been acknowledged that endocrine activity is associated with the function of multiple systems in vivo. The apelin-13 peptide has been demonstrated to play a crucial role in various physiological and pathological processes. However, whether apelin-13 peptide function in DOX induced cardiotoxicity is unknown. Methods: We explored the function and mechanism of the apelin-13 peptide in apoptosis and oxidative stress by CCK-8, trypan blue staining, TUNEL, LDH, JC-1 and western blot in vitro. Then we verified the effect of apelin-13 in vivo by serum CKMB and LDH, echocardiography, sirius red staining and HE staining assay.Results: Treatment with the apelin-13 peptide significantly enhanced cell viability, mitochondrial membrane potential, and reduced LDH release, rate of apoptosis and activation of caspase-3 in vitro. In mice, the apelin-13 peptide alleviated the heart failure induced by DOX treatment. ML-221 inhibited the activation of ERK, PI3K and AKT proteins phosphorylation by apelin-13.Conclusion: The apelin-13 and APJ interaction on the cell membrane inhibits apoptosis though the ERK/MAPK and PI3K/AKT signaling pathways. The application of apelin-13 may be a novel therapeutic strategy in oxidative stress-induced heart failure therapy.
Acoustic emission response characteristics of anthracitic coal under uniaxial compression
Authors: Du Feng , Wang Kai , Zhang Guojun , Wang Gongda , Zhang Qian , Ma Ji
Published: July 2020

The damage evolution of coal is accompanied by the generation of acoustic emission (AE) signal. Through the analysis and research of AE response characteristics of coal deformation and failure, it is helpful to reveal the initiation, propagation and fracture evolution of micro cracks in coal. In this work, taking the anthracite coal as research object, the basic mechanical parameters of coal samples were obtained by ultrasonic tests and uniaxial compression experiments. Meanwhile, the AE response characteristics of coal samples during uniaxial compression were obtained through AE experiments. The results show that when the density is low, the wave velocity of coal sample decreases with the increase of density. When the density is higher than a certain value, the wave velocity of coal sample increases with the increase of density. Through the measurement of ultrasonic wave velocity, it is found that there are some non-uniformity and anisotropy in raw coal samples. The distribution of ring count, energy count and AE events with time in uniaxial compression process is approximately normal distribution. The AE events are concentrated in the elastic stage and yield stage, and the energy amplitude of AE events is higher in the plastic stage. Compared with the ring count and energy count, the AE events have good positioning function, which can better reflect the evolution of internal cracks in coal samples during uniaxial compression.
Chloremia and Fluid Therapy – A Systematic Review
Authors: Astapenko David , Navratil Pavel , Pouska Jiri , Cerny Vladimir
Published: July 2020

Background: Crystalloid solutions are one of the most widely used remedies in the field. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates. Current balanced solutions are safer in this respect and are designed to have a composition close to that of blood plasma.Methods: Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The key words searched for included hyperchloremia, hypochloremia and compound words containing the word “chloride”, infusion therapy, metabolic acidosis, renal failure, and review.Results: A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed.Conclusions: According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) is a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chlorine homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chlorine content on chloremia and organ function.
Association of PICK1 and BDNF Variations with Increased Risk of Methamphetamine Dependence Among Iranian population; A Case-Control Study
Authors: Tajbakhsh Amir , Alimardani Maliheh , Asghari Mahla , Abedini Soheila , Khadem Sohrab Saghafi , Bajestani Abolfazl Nesaei , Alipoor Forough , Alidoust Maryam , Savardashtaki Amir , Hashemian Peyman , Pasdar Alireza
Published: July 2020

Background: Genetic factors play an important role in susceptibility to methamphetamine. In this line, protein that interact with C-kinase-1 (PICK1) and brain-derived neurotrophic factor (BDNF) genes are linked to methamphetamine dependence (substance use disorder). Thus, in a case-control study, we investigated the association between polymorphisms of PICK1 and BDNF genes and methamphetamine dependence in an Iranian population from 2015 to 2018.Methods: Total of 235 cases and 204 controls were recruited. The PICK1-rs713729, -rs2076369 and BDNF-rs6265 genotypes were determined via ARMS-PCR assay. Statistical analysis was performed, using SPSS 20.0, PHASE 2.1.1 program as well as SNP Analyzer 2.0.Results: In the present study, two polymorphisms including PICK1-rs713729 (OR: 1.38 (CI: 1.08-1.52; P-value: 0.004) in multiplicative and dominant models, and PICK1-rs2076369 (OR: 1.31 (CI: 1.10-1.56; P-value: 0.002) in multiplicative, dominant and co-dominant models were associated with the risk of methamphetamine abuse. Moreover, haplotype analysis methods showed a significant association between haplotype AG (OR: 2.50 (CI: 1.50-4.16; P-value: 0.0002) in dominant, recessive and co-dominant models, and haplotype TT (OR: 0.67 (CI: 0.50-0.91; P-value: 0.009) in dominant model and co-dominant model with the risk of methamphetamine abuse. None of the polymorphisms in this study had a high level of linkage disequilibrium. Conclusion: Our findings indicate that the PICK1 gene might be linked to methamphetamine dependence. Therefore, it can be stated that PICK1 might play a significant role in the pathophysiology of methamphetamine dependence in an Iranian population.
Depression, Anxiety, Stress, and Resiliency in Iranian Families with Autistic Children
Authors: Hosseini Maryam alsadat , Shirzad Fatemeh , Ahmadzad-Asl Masoud , Hadi Fatemeh
Published: July 2020

Background

Autism is a chronic, debilitating condition that begins in childhood and is associated with burnout and sometimes even depression and anxiety in families. The main objective of this study was to investigate the relationship between resilience and anxiety-depression-stress among families of children with autism in 2018.
Materials and Methods

In this cross-sectional study, after the Ethics Committee approval, according to the calculated sample size, 137 members of the families of children with autism were selected randomly. They were self-questioned themselves by family resilience scale, and also DASS-21 questionnaires, along with the checklist of variables such as number of family members, marital status, educational level, income, background of physical and mental disorders, age and sex. After data collection, they were entered into and analyzed by MS Excel and SPSS V.24 software.
Results

The mean age of the subjects was 40.67 years (± 9.12) with the range of 42 years. 80 persons (58.4%) were female and 57 (41.6%) were male, most of who had a bachelor's degree (51.7%), and generally were married (78.8%) (Living with family). They often had a history of chronic physical (84.7%) or mental illness (95.6%). The mean of the family resilience scores was 193 (± 25) and its range was 124. There was no significant correlation between age/gender and resilience, but depression, anxiety and stress were related to the level of resiliency. Regarding the rate of depression, 51.8% were normal, 10.2% had mild depression, 22.6% had moderate depression, 10.2% had severe depression and 5.1% had very severe depression; income and history of mental illness were significantly associated with depression. In addition, the level of anxiety was 46% normal, 8% mild, 17.5% moderate, 11.7% severe and 16.8% very severe. The number of family members, educational level, income, and history of mental illness had a significant effect on people's anxiety. Also, the stress status of the studied samples were 43.8%, 12.4%, 26.3%, 10.9% and 6.6% normal, mild, moderate, severe and very severe, respectively. The level of education, income, history of mental illness and gender were statistically significant with the level of stress among individuals.
Conclusion

Based on the results of this study, it is concluded that family resilience is a factor that directly correlates with the level of depression, anxiety and stress among the family members of the autistic children. It is therefore advisable to increase this ability of individuals in various ways, such as training, counseling, support groups, and etc.
Impact of Long-Term Air Pollution on the Case Fatality Rate of COVID-19
Authors: Hou Chang-kai , Qin Ya-fei , Liu Quan-lei , Yang Xin-yu , Wang Hao
Published: July 2020

Background There is preliminary evidence of the long-term exposure to air pollution will affect the outcome of patients with COVID-19. More information is needed about relationship between long-term exposure to air pollution and case fatality rate (CFR) of patients with COVID-19.Methods In this study, we have collected the data of Air Quality Index (AQI), PM2.5, PM10, SO2, NO2 and O3 from 14 representative cities in China in the past 5 years, and calculated the case fatality rate of COVID-19 in the corresponding city. First, we explored correlation relationship between CFR and long-term air quality indicators. Then, we try to point out the air pollutants that affect the level of CFR and evaluated their predictive value.Results We have observed a positive correlation between the CFR and AQI (1-year, 3-year, 5-year), PM2.5 (1-year, 3-year, 5-year), and PM10 (1-year, 3-year, 5-year). Meanwhile, AQI (3-year, 5-year) and PM2.5 (1-year, 3-year, 5-year) were significantly higher in the high CFR group. Moderate predictive value of air pollution indicator to CFR such as AQI (1-year, 3-year, 5-year), PM2.5 (1-year, 3-year, 5-year) have been found.Conclusions Our results indicate that long-term exposure to the environment with severe air pollution is associated with CFR of COVID-19. Air pollutants such as PM2.5 may have potential ability to predict the CFR of COVID-19.
Changes in Substance Use Pattern in Men with Opioid Use Disorders treated with Methadone during the first year after the Earthquake in the west of Iran: A Cohort Study
Authors: Mirmoeini Seyed Mahmood , Shakeri Jalal , Farnia Vahid , Davarinejad Omran , Radmehr Farnaz , Alikhani Mostafa , Salemi Safora , Hookari Sara
Published: July 2020

Background

Experiencing earthquake can lead to an increase in substance use disorders (SUDs) and changes in substance use (SU) patterns in the survivors, therefore, the present study aimed to investigate changes in SU pattern in men with opioid use disorders (OUDs) treated with methadone who referred to Methadone Maintenance Treatment centers in Sarpole Zahab in the first year after the earthquake in the west of Iran in 2017–2018.
Methods

In this prospective cohort study, 180 male patients treated with methadone were enrolled in a census over three periods of four, eight, and twelve months after the earthquake.
Results

93 (51.7%) immediately and 87 people (48.3%) between 1–15 days after the earthquake had access to methadone, 18 of them (10.0%) reported the relapse in the meantime, and in all these cases, the person continued the use in the following months. An increase in the daily dose of methadone in patients was observed in the first evaluation after the earthquake compared to the time before the earthquake, the daily dose was reported in the second and third evaluations with a significant decrease. 18 people (10.0%) had a history of relapse before the earthquake, which in the first post-earthquake assessment reached 32 people (17.8%). In the second and third assessments, 26 (14.4%) and 24 people (13.3%) reported relapse of using the previous drugs without a tendency to new substances.
Conclusion

Due to the changes in the pattern of SU in men treated with methadone, preventive interventions are important for this group after the earthquake.
Feasibility of Anticoagulation using Low Molecular‑weight Heparin during Catheter-directed Thrombolysis for Lower Extremity Deep Venous Thrombosis
Authors: Li Yonghui , Wang Junwei , He Rongzhou , Zheng Junmeng , Chen Zhibo , Yao Chen , Huang Kai
Published: July 2020

Background: The optimal anticoagulant scheme during catheter-directed thrombolysis (CDT) for deep venous thrombosis (DVT) remains unknown. The present study is performed to evaluate the effectiveness and safety of anticoagulation therapy using low molecular‑weight heparin (LMWH) during CDT for DVT.Methods: The clinical data of DVT patients underwent CDT during the past 6 years were retrospectively collected and reviewed. According to LMWH dose, patients were divided into therapeutic-dose anticoagulation (TPDA) group and sub therapeutic-dose anticoagulation (sub-TPDA) group.Results: A total of 61 patients involving 61 limbs were comprised. Acute and subacute DVT were identified in 39 (63.9%) and 22 (36.1%) patients, respectively. Thrombosis involving iliac vein was identified in 34 (55.7%) patients. Inferior vena cava filter placement was performed in 38 (62.3%) patients. Intraoperatively, adjunctive balloon, stent and thrombectomy were provided for 9 (14.8%), 4 (6.6%) and 1 (1.6%) patients, respectively. Twenty (32.8%) patients accepted TPDA therapy, while 41 (67.2%) patients were administrated with sub-TPDA therapy. Median urokinase infusion rates was 2.5 (0.83 to 5) x 104 U/h. Median infusion duration time was 4 (2 to 14) days, and median urokinase dose infused was 240 (60 to 1080) x 104 U. During CDT, 5 (8.2%) cases of minor bleeding were observed, and blood transfusion was not required. No major bleeding, symptomatic pulmonary embolism or death occurred. Complete (>90%) and partial thrombolysis (50~90%) were achieved in 56 (91.8%) patients. In comparison with sub-TPDA group, TPDA group exhibited no significant difference in baseline characteristics, clinical improvement, thrombolysis results and complications.Conclusions: Anticoagulation therapy using low molecular‑weight heparin during CDT for DVT is effective and safe. In comparison with sub-therapeutic-dose anticoagulation, therapeutic-dose did not improve the thrombolytic effect or increase the rate of complication.
Risk Factors for Early Wheezing in Preterm Infants: A Retrospective Cohort Study
Authors: Chen Xun , Yang Minjing , Huang Shengzhu , Qin Xiaolian , Pan Zhijian , Zhu Maoling , Zeng Dingyuan , Huang Yifeng , Liang Tao , Liang Chunmei , Nong Guangmin
Published: July 2020

Background: The related factors that cause recurrent wheezing in children are complex, and premature delivery may be one of the reasons. Little is known about early wheezing in preterm infants. Methods: Data sourced from 1616 children born between 2007 and 2013 from 8 hospitals of Guangxi in China. All children were followed by telephone or questionnaire through the sixth year of life. Children were grouped by characters of age: Group A: gestational age (GA) ≤ 32 weeks, Group B: 32 weeks < GA < 37 weeks, Group C: 37 weeks ≤ GA < 42 weeks. Results: The incidence and the risk factors of early wheezing in preterm infants were analyzed. The incidence of early wheezing: Group A > Group B > Group C. In Group A, the proportion of small-for-gestational-age (SGA) infant was higher in early wheezing group than in normal group (P = 0.005). Male (95% CI: 1.611 to 4.601) and family history of allergy (95% CI: 1.222 to 3.411) were the risk factors for early wheezing in Group B. Conclusions: Newborns with younger GA had a higher risk of early wheezing. SGA was a possible factor influencing early wheezing in preterm infants with GA≤ 32 weeks. Male and family history of allergy were the risk factors for early wheezing in preterm infants with 32 weeks < GA < 37 weeks.
WITHDRAWN: Employees’ Occupational Health and Safety Awareness in Riyadh, Saudi Arabia
Authors: Alghalyini Baraa , Elgazzar Tasnim , Bajaber Abubakr , Wahed Muaz , Ambia Ayesha , Binsaeedu Abdullah , Khan Museera , Adem Fatima , Azouz Rand , Elkhair Sana , Mohamed Fatma , Alsaeed Raghad , AlMakoshi Amel
Published: July 2020

Background: Occupational hazards are extremely pervasive and preventive community-related incidents occurring in occupations all over the world. In fact, the majority of developed countries impose national policies to provide their employees with Occupational Health and Safety (OHAS) guidelines and recommendations to avoid these hazards. Maintaining and monitoring employee health through following (OHAS) laws in turn has a positive impact on the economic status of the country. Our study was conducted in Riyadh, KSA to fill a research gap on OHAS in the country, and to collect evidence-based OHAS recommendations by focusing on three main occupational health domains: stress, musculoskeletal and respiratory symptoms.Methods: A validated structured questionnaire was administered on a cross-section of 319 randomly selected employees aged 18 - 64 years in Riyadh for two weeks in Oct 2018. The survey was conducted on site of 11 locations for different occupations. Information was sought on their socio-demographic characteristics, first aid training and their awareness of major occupational illnesses; stress, respiratory and musculoskeletal disorders. Factors such as underlying diseases and confounding factors such as smoking were also taken into consideration.Results: A total of 319 employees were surveyed from eleven occupational backgrounds. Among all the involved workplaces only 51.3% of them offered First Aid training for the employees. The prevalence of musculoskeletal disorders was 24.1% for weakness followed by 16% for pain. Around 70% of respondents denied suffering from stress at work, neither experiencing stress- related symptoms such as headache, sleeplessness or anxiety attacks as a result of their work.Conclusion: This student-led community engaging study aimed to evaluate employees’ awareness of illnesses related to their occupations and their practices to prevent them. Under the supervision of College of Medicine faculty members at Alfaisal University,1st and 3rd year medical students visited different worksites including schools, dental clinics, car shops, airport terminals, and others to present a brief presentation to promote occupational health and safety proceeded by the distribution of a brief survey. Although musculoskeletal, respiratory and mental illnesses are commonly observed occupation- related complaints, yet this wasn’t evident in our study. This could be explained by employees’ lack of awareness or fear of reporting their health concerns. This observed gap in our study will help in recommending national guidelines to promote occupational health and safety across different occupations.
Is Dietary Pattern Associated with Gastric Cancer Risk? A Case-control Study in Iran
Authors: Nikniaz Zeinab , Somi Mohammad Hossein , Jafarabadi Mohammad Asghari , Naghashi Shahnaz , Faramarzi Elnaz
Published: July 2020

Objective

Diet is considered an important contributor to cancers and one of the best approaches for assessing the combined effect of nutrients and food is the dietary pattern approach. In the present study, the association of dietary patterns identified by factor analysis with gastric cancer risk was studied.
Results

Four major dietary patterns with a 55.48% prediction rate, namely “tubers and spices”, “cereals and dairies”, “healthy” and “Western-style”, were identified. Tubers and spices (males: 11.42 (4.17, 26.75); females: 6.94 (2.24, 21.56)) and “Western-style” dietary patterns (males: 1.16 (1.00-4.35); females: 2.25 (1.10, 6.49) significantly increased the odds of gastric cancer risk in both sex. However, “healthy” dietary pattern and “cereals and dairies” dietary pattern were not associated with gastric cancer risk (P > 0.05).
Prevalence of Antibiotic-Resistant Bacteria in the Environment of Poultry Farms
Authors: Veloo Yuvaneswary , Thahir Syahidiah Syed Abu , Shaharudin Rafiza , Rajendiran Sakshaleni , Hock Lim Kuang , Muthu Vickneshwaran , Ahmad Norazah
Published: July 2020

Background

The occurrence and spread of antibiotic-resistant bacteria (ARB) due to the high demand in poultry industries are of great public health concern. Indiscriminate and abusive use of various antibiotics on a large scale causes antibiotic resistance (AMR) in animal-associated bacteria that may be pathogenic to humans. These bacteria are widely disseminated in the environment via animal waste. This study was therefore designed to assess the prevalence of multiple antibiotic resistance (MAR) among the environmental bacteria in poultry farms and to determine the risk contamination category of poultry by calculating the multiple antibiotic resistance index (MARI).
Results

More than half (58.2%) of the 511 total bacteria had MAR, and a number of bacteria were resistant to cefazolin (86.8%), fusidic acid (84.6%), ampicillin (79.3%), clindamycin (65.5%) and erythromycin (63.7%). These antibiotics are listed under the WHO’s criteria of critically and highly important antibiotics in human medicine. In this study, 39.53% of the MARI values, which indicate the contamination level in the environment, indicated a high risk, while 14.48% were ambiguous.
Conclusion

These results therefore have shown that MAR is present not only among humans and animals but also in environmental bacteria. The high prevalence of MAR and the MARI values, together with the resistance patterns of each bacterium, indicate various effects, including possible occupational risks among workers. This study provides an introduction to the AMR of bacteria in the environment. Further studies are needed to observe the horizontal transfer of the resistance gene and the overall mobile genetic elements in environmental bacteria.
Skin Microbiota Dynamics Following B. subtilis formulation Challenge
Authors: Moskovicz Veronica , Ben-El Rina , Horev Guy , Mizrahi Boaz
Published: July 2020

Background
Modulating the microbiota is a leading-edge strategy for the restoration and maintenance of a healthy, balanced environment. The use of health-promoting bacteria is emerging as an alternative for skin microbiota intervention, showing promising results. Bacillus subtilis, with its non-pathogenic and antibacterial properties, has great potential as a microbiota-manipulating agent. Here, we investigate the experimental manipulation of the skin microbiota using B. subtilis incorporated into a supportive Pluronic F-127 hydrogel formulation. Indeed, the formulation is of prime importance for dermal bacterial delivery, determining the ability of live bacteria to become established at the desired action site.
Results
The B. subtilis challenge induced a shift in the composition and abundance of the skin microbiota. Containment of B. subtilis in the Pluronic F-127 hydrogel accelerated bacterial modulation compared with free B. subtilis. The abundance of both Staphylococcus and Corynebacterium spp. was altered as a result of the live bacterial intervention: the abundance of Corynebacterium increased while that of Staphylococcus decreased. Four days after last application of the B. subtilis formulation, B. subtilis counts returned to its initial level.
Conclusions
B. subtilis intervention can induce a shift in the skin microbiota, with an increased presence of commensal, benefit-associated bacteria and a reduced abundance of pathogen-containing bacterial genera. Containment of B. subtilis in Pluronic hydrogel accelerates the microbial alteration, probably by facilitating bacterial attachment and supporting continuous growth. Our results reveal the ability of B. subtilis in Pluronic to modulate the skin microbiota composition, suggesting that the formulation holds therapeutic potential for skin disease treatment.
Clinical Outcomes of Chemotherapy in Patients with Undifferentiated Carcinoma of the Pancreas: A Retrospective Multicenter Cohort Study
Authors: Imaoka Hiroshi , Ikeda Masafumi , Maehara Kosuke , Umemoto Kumiko , Ozaka Masato , Kobayashi Satoshi , Terashima Takeshi , Inoue Hiroto , Sakaguchi Chihiro , Tsuji Kunihiro , Shioji Kazuhiko , Okamura Keiya , Kawamoto Yasuyuki , Suzuki Rei , Shirakawa Hirofumi , Nagano Hiroaki , Ueno Makoto , Morizane Chigusa , Furuse Junji
Published: July 2020

Background: Undifferentiated carcinoma (UC) of the pancreas is a rare subtype of pancreatic cancer. Although UC has been considered a highly aggressive malignancy, no clinical studies have addressed the efficacy of chemotherapy for unresectable UC. Therefore, we performed multicenter retrospective study to investigate the efficacy of chemotherapy in patients with UC of the pancreas.Methods: This multicenter retrospective cohort study was conducted at 17 institutions in Japan between January 2007 and December 2017. A total of 50 patients treated with chemotherapy were analyzed.Results: The median overall survival (OS) in UC patients treated with chemotherapy was 4.08 months. The details of chemotherapy in first-line treatment were as follows: gemcitabine (n=24), S-1 (n=12), gemcitabine plus nab-paclitaxel (n=6), and other treatment (n=8). The median progression-free survival (PFS) was 1.61 months in the gemcitabine group, 2.96 months in the S-1 group, and 4.60 months in the gemcitabine plus nab-paclitaxel group. Gemcitabine plus nab-paclitaxel significantly improved PFS compared with gemcitabine (p=0.014). The objective response rate (ORR) was 4.2% in the gemcitabine group, 0.0% in the S-1 group, and 33.3% in the gemcitabine plus nab-paclitaxel group. Gemcitabine plus nab-paclitaxel also showed a significantly higher ORR compared with both gemcitabine and S-1 (gemcitabine plus nab-paclitaxel vs. gemcitabine: p=0.033; gemcitabine plus nab-paclitaxel vs. S-1: p=0.034). A paclitaxel-containing first-line regimen significantly improved OS compared with a non-paclitaxel-containing regimen (6.94 months vs. 3.75 months, respectively; p=0.041). After adjustment, use of a paclitaxel-containing regimen in any line was still an independent predictor of OS (hazard ratio for OS, 0.221; 95% confidence interval, 0.076 – 0.647; p=0.006) in multiple imputation by chained equation.Conclusions: The results of the present study indicate that paclitaxel-containing regimen would offer relatively longer survival, and it is considered a reasonable option for treating patients with unresectable UC.
Survival After Combined Hepatic Metastasectomy and Chemotherapy in Patients with Concurrent Hepatic and Extrahepatic Colorectal Metastases: A SEER Database Analysis.
Authors: Uthman Inas , Fouad Ahmed M , Khaled Islam , Ahmed Ihab S. , Faisal Mohammed
Published: July 2020

Purpose: Colorectal cancer is the second leading cause of death among all cancers worldwide. Hepatic metastases exist in about 50% of colorectal cancer patients. The purpose of this study was to assess the effect of combined hepatic metastasectomy and chemotherapy on the overall survival in patients with concurrent hepatic and extra-hepatic disease.Methods: 2533 patients from the US Surveillance, Epidemiology, and End Results (SEER) database with concurrent colorectal liver metastasis (CRLM) and extra-hepatic disease (EHD) between January 1, 2010, and December 31, 2014, were retrieved. Survival analysis with Kaplan-Meier and Cox-regression was performed to assess the effect of combined hepatic metastasectomy and chemotherapy on 5-year survival. Results: Two-hundred and fourteen (8.4%) patients underwent combined hepatic metastasectomy and chemotherapy. The median survival time among patients underwent combined hepatic metastasectomy, and chemotherapy was significantly higher than chemotherapy alone (24 vs. 21 months; p < 0.0001). Furthermore, older age at diagnosis (≥ 60 years), American Indian/Alaska Native race, primary sites at the recto-sigmoid colon, sigmoid colon, and descending colon, grade III, and the presence of bone metastases were all significantly associated with higher 5-year mortality. Patients who underwent combined hepatic metastasectomy and chemotherapy were significantly associated with 22.2% less 5-year mortality compared to patients who received chemotherapy alone. Conclusion: Combined hepatic metastasectomy with chemotherapy in CRLM patients with EHD yields better survival than chemotherapy only.
Resection Of A Retroperitoneal Cancer Of Unknown Primary Site After Chemoradiation Therapy: A Case Report
Authors: Suetsugu Tomonari , Matsuhashi Nobuhisa , Tsuchiya Hiroshi , Takahashi Takao , Fukada Masahiro , Tanaka Hideharu , Iwata Yoshinori , Yasufuku Itaru , Sato Yuta , Imai Takeharu , Imai Hisashi , Tanaka Yoshihiro , Okumura Naoki , Yamaguchi Kazuya , Yoshida Kazuhiro
Published: July 2020

Background: Complete recovery from retroperitoneal squamous cell carcinoma of unknown primary site treated by multidisciplinary therapy is extremely rare.Case presentation: A 78-year-old man was referred to our hospital due to a mass measuring 8 cm in size in the left pelvic retroperitoneal area, which was diagnosed as a cancer of unknown primary site. The pathological type was squamous cell carcinoma. The left iliac artery/vein and ureter were involved in the tumor, and the tumor caused severe left leg pain. Although inflammation and symptoms were severe, palliative radiotherapy was considered. After that, biweekly combined therapy with docetaxel, cisplatin, and fluorouracil was planned. After 5 courses of chemotherapy, the tumor diameter reduced from 11.6 cm to 4 cm in size. In addition, the border between the iliac vessels, urinary tract and tumor became apparent. The patient underwent radical resection of the tumor 8 months after the treatment started. The left ureter and the external/internal iliac artery were preserved, but the external iliac vein was sacrificed because of the possibility of tumor invasion. The postoperative course was free of complications, and the patient was discharged 10 days after the operation. The histopathological findings showed no residual viable tumor cells or foreign body-type giant cells with necrosis. The pathological effect of chemotherapy was defined as Grade 3 (pathological complete response). The patient has experienced no recurrence or distant metastasis for 4 years.Conclusions: Multidisciplinary therapy succeeded in treating a retroperitoneal squamous cell carcinoma of unknown primary site with preservation of organ function.
Anastomosis Technique For Pancreatojejunostomy And Early Removal Of Drainage Tubes May Reduce Postoperative Pancreatic Fistula
Authors: Kawaida Hiromichi , Kono Hiroshi , Amemiya Hidetake , Hosomura Naohiro , Watanabe Mitsuaki , Saito Ryo , Nakata Yuuki , Shoda Katsutoshi , Shimizu Hiroki , Furuya Shinji , Akaike Hidenori , Kawaguchi Yoshihiko , Sudo Makoto , Matsuda Masanori , Itakura Jun , Fujii Hideki , Ichikawa Daisuke
Published: July 2020

Background: Postoperative pancreatic fistula (POPF) is one of the most serious complications after pancreaticoduodenectomy (PD). Various factors have been reported as POPF risks, but the most serious of these is soft pancreas. To reduce POPF occurrences, many changes to the PD process have been proposed. This study evaluates short-term results of anastomosis technique for PD.Methods: In total, 120 patients with soft pancreases who had undergone PD at Yamanashi University between January 2012 and December 2019 were retrospectively analyzed. We divided these patients into two groups depending on the time PD was performed: a conventional group (n=67) and a modified group (n = 53).Results: The rate of clinically relevant POPF was significantly lower in the modified group than that in the conventional group (1.9% vs 22.4%, p < 0.001), with there being only one case of POPF in the modified group. There were no cases of POPF-related hemorrhaging in the modified group. On the third day after the operation, the amylase levels in the drainage fluid for the modified group had reduced to one third of those in the conventional group (1696 vs 643 U/L). Multivariate analysis showed that the modified method was the independent predictors to prevent clinical POPF (p = 0.004).Conclusions: Our novel anastomosis technique for pancreatojejunostomy reduced POPF in PD, especially in cases where the patient had a soft pancreas.
How to Choose the Best Procedure Type for Duodenal Neuroendocrine Tumors With a Maximum Diameter of 1 to 2 Cm a Propensity Score Matching Analysis Based on the SEER Database
Authors: Tang Huanyu , xie jiebin , Pang Yueshan , Hua Xia , Li xun
Published: July 2020

Background: The treatment plan for duodenal neuroendocrine tumors (d-NETs) with a diameter between 1 and 2 cm is still controversy. Aim: To compare the effects of local endoscopic resection and radical resection on the prognosis of d-NETs with a maximum diameter of 1-2 cm. Methods: 286 eligible patients were identified from the SEER database. Propensity score matching (PSM) was done to match patients 1:1 on clinicopathological characteristics. Kaplan-Meier analysis was used to analyze the factors affecting the prognosis.Results: Before PSM, there was no significant difference in the cancer-specific survival (CSS) between the two groups (P = 0.595), but the tumor size, T stage, N stage, and M stage were significantly different between the two groups (all P < 0.05). After 1:1 PSM, the differences in clinicopathological characteristics between the two groups were significantly reduced (all P > 0.05). Survival analysis showed that only the tumor grade was correlated with the prognosis (P = 0); surgical method and other clinicopathological characteristics were not correlated with the prognosis (all P > 0.05). Conclusion: The surgical approach had no significant effect on the prognosis of d-NET patients with a maximum diameter of 1-2 cm and without lymph node metastasis.
Prognosis and Risk Factors for Malignant Peripheral Nerve Sheath Tumor: A Systematic Review and Meta-analysis
Authors: Cai Zhenyu , Tang Xiaodong , Liang Haijie , Yang Rongli , Yan Taiqiang , guo wei
Published: July 2020

Background: No available meta-analysis was printed to systematically introduce the MPNST clinic outcome and risk factors based on largely pooled data. This systematic review and meta-analysis aimed to investigate 5-year OS rate, 5-year EFS rate and LR rate for MPNST, and to assess potential risk factors for prognosis.Methods: Electronic articles published between January 1, 1966 and February 29, 2020, were searched and critically evaluated. The authors independently reviewed the abstracts and extracted data for 5-year OS rate, 5-year EFS rate, LR rate, and potential risk factors for prognosis.Results: Twenty-eight literatures were finally included for meta-analysis. The pooled 5-year OS rate, 5-year EFS rate, and LR rate were 49%, 37%, and 37%, respectively. The significant prognostic factors for survival were NF-1 status, tumor size, depth, location, malignant grade, margin status, chemotherapy, and radiotherapy. Age and sex were not associated with survival.Conclusion: Survival and local recurrence of MPNST are poor. Worse prognosis is mainly associated with NF 1 mutation, large size, deep to fascia, high grade, metastases and location (trunk and head & neck). Complete resection with adequate surgical margins is the mainstay protective factor of MPNST patients, following necessary adjuvant therapies.
Knockdown of Long Non-coding RNA UCA1 Represses Gallbladder Cancer Advancement by Regulating SPOCK1 Expression via Sponging miR-613
Authors: Zhang Tao , Chen Lijian , Xu Xundi , Shen Chao
Published: July 2020

OBJECTIVE : Patients with advanced gallbladder cancer (GBC) have a lower 5-year survival rate. Long non-coding RNA urothelial carcinoma associated 1 (UCA1) and miR-613 are involved in the progression of various cancers. This study was to explore the regulatory mechanism between UCA1 and miR-613 in GBC. METHODS: The expression levels of UCA1, miR-613, and SPOCK1 mRNA were detected using qRT-PCR. Cell proliferation, migration, invasion, and apoptosis were determined with MTT, transwell, or flow cytometry assays. The levels of SPOCK1 protein, Bax, cleaved-casp-3, and Bcl-2 were determined by western blot analysis. The relationship between miR-613 and UCA1 or SPOCK1 was verified via dual-luciferase reporter and/or RNA immunoprecipitation (RIP) assays. The role of UCA1 in vivo was confirmed by xenograft assay. RESULTS: UCA1 and SPOCK1 were upregulated while miR-613 was downregulated in GBC tissues and cells. UCA1 silencing blocked tumor growth in vivo, impeded cell proliferation, migration, invasion, and induced cell apoptosis in GBC cells in vitro. Notably, UCA1 acted as a sponge for miR-613, which targeted SPOCK1 in GBC cells. Moreover, miR-613 repressed cell proliferation, migration, invasion, and accelerated cell apoptosis in GBC cells. UCA1 enhancement reversed miR-613 mimic-mediated influence on proliferation, migration, invasion, and apoptosis of GBC cells. UCA1 regulated SPOCK1 expression through miR-613. Furthermore, SPOCK1 elevation overturned UCA1 silencing-mediated the malignant behaviors of GBC cells. CONCLUSION: UCA1 knockdown suppressed GBC progression via downregulating SPOCK1 via sponging miR-613, providing an evidence for UCA1 as a target for GBC treatment.
Cultural Adaptation of the PTSD Checklist- Military version (PCL-M) among Army Personnel in Ghana
Authors: Agah Nathanael Nartey
Published: July 2020

Background: The type of deployment duties performed by military personnel differs across the world, as some perform combat related deployment, others are sent on peacekeeping duties. Due to the difference in events experienced when performing any of the deployment duties as combat veterans are more likely to encounter traumatic events than peacekeeping duties personnel, the occurrence of PTSD symptoms might differ. The study aims to construct a PTSD Checklist – Military version that is relevant to peacekeeping duty army personnel in Ghana (PCL-M-G), on the basis of the original scale by Weathers and colleagues.Methods: A cross-sectional study was undertaken with a purposive and convenient sample of 189 army personnel of the Ghana Armed Forces who have returned from peacekeeping duties within the last year as at the time of data collection. The original scale containing 17 items was administered for data collection. Principal Component Analysis (PCA) with Varimax rotation was used in the extraction of factor structures. Cronbach’s Alpha was used to determine the internal consistency of the scale. Bivariate correlation was used to examine the external validity of the scale. Results: 12 items with three factors, namely, Hyperarousal (Cronbach alpha= .92), Re-experience (Cronbach alpha= .92) and Avoidance (Cronbach alpha= .79) was identified. The three factors altogether explained 77.21% of the total variance. The scale had a significant positive correlation with post deployment transition experience over at most a year (r = .33), as this shows evidence of construct and discriminatory validity. Even though the factors identified in this study are similar to the original scale, there are some differences, indicating the significations of cultural diversity.Conclusion: The current study of PCL=M among Ghanaian army personnel identified difference with regards to item factor loadings and dimension. It is suggested that the scale would be validated locally before it is used. The PCL-M-G is reliable and valid, therefore, researchers, clinicians as well as other health workers can cautiously use this scale when assessing PTSD symptoms among Ghanaian military personnel.
Total Body Water (TBW) Percentage and 3rd Space Water Were Risk Factors for Recruit Injuries in Lower Limbs: A Case-Control Study
Authors: Ouyang Junjie , Yang Jing , Jiang Wanling , Li Bing , Jin Kexing , Chen Liang , Luo Xiaoqing , Chang Jinhong , Tan Qiaoyan , Kuang Liang , Xie Yangli , Liu Mi , He Mei , Chen Hangang , Meng Tao , Hu Yan , Chen Lin , Ni Zhenhong , Du Xiaolan
Published: July 2020

Background: Recruit training injuries have caused serious problems for troop training and medical support. The lower limbs is the site where recruit injuries occur the most. Bio-impedance (BIA) measures body composition quickly and accurately. Our aim was to identify the risk factors for lower limbs training injuries to recruits due to body composition.Methods: A total of 282 recruits were included. Before training, use BodyStat QuadScan 4000 multifrequency BIA system to measure the body composition of recruits. After training, they were divided into two groups according to the occurrence of lower limb training injuries. The basic characteristics of the two recruits were compared by Wilcoxon rank sum test. Receiver operator characteristic (ROC) curves was performed on the indicators with statistical difference between the two groups to find the cutoff point. Finally, multivariate logistic regression analysis was used to find the risk factors of lower limb training injuries.Results: Compared with the lower limb uninjured group, the lean mass percentage (P = 0.003), TBW percentage (P = 0.010), extracellular water (ECW) percentage (P = 0.023), intracellular water(ICW) percentage (P = 0.027), 3rd space water (P = 0.021) and basal metabolic rate(BMR)/total weight (P = 0.014) of the lower limb injury group was higher. On the contrary, the body fat percentage (P = 0.003) and body fat mass index (BFMI) (P = 0.005) of the lower limb injury group was lower. The results of multivariate logistic regression analysis showed that TBW percentage > 65.350% (P = 0.050, OR=2.085) and 3rd space water >0.950 (P = 0.045, OR=2.342) were independent risk factors for lower limb injuries.Conclusions: TBW percentage> 65.35% and 3rd space water >0.950 were independent risk of lower limb training injuries. These recruits need to be paid more attention during training.
Dactylitis in psoriatic arthritis – prevalence and reliability of ultrasound lesions in a clinical setting
Authors: Felbo Sara Helena Kamp , Østergaard Mikkel , Sørensen Inge J. , Terslev Lene
Published: July 2020

Objectives. To investigate the prevalence of ultrasound elementary lesions in dactylitis in psoriatic arthritis (PsA), and the reliability of scoring these lesions in a clinical setting.Methods. In 31 patients with PsA and clinical dactylitis, ultrasound assessment of the affected digit was performed using grey-scale and color Doppler mode. One examiner scanned all patients and a 2nd examiner scanned 10 patients for inter-reader reliability. The following lesions were evaluated: subcutaneous edema; soft tissue thickening; synovitis of the digital joints; tenosynovitis of the flexor tendon; enthesitis at the deep flexor tendon and the extensor tendon entheses; and paratenonitis of the extensor tendon. A dactylitis sum-score was calculated. Findings in clinically tender and non-tender digits were compared.Results. The most frequent lesions were soft tissue thickening (81%) and subcutaneous edema (74%) followed by synovitis (56–68%) and flexor tenosynovitis (52%). Color Doppler was most frequently found subcutaneously (55%) and around the flexor tendons (45%). All lesions were typically found in combinations, most commonly subcutaneous edema and synovitis (71%), subcutaneous edema and flexor tenosynovitis (52%), and all three in combination (52%). Tender digits had a higher dactylitis sum-score and numerically higher prevalence of most lesions than non-tender digits. Intra- and inter-reader agreements were moderate to excellent, though lower for few components of digital enthesitis, especially hypoechogenicity.Conclusion. Dactylitis in PsA appears to encompass several pathologies, most often subcutaneous changes combined with synovitis and/or flexor tenosynovitis. Reliability of scoring established ultrasound lesions of dactylitis in a clinical setting is moderate-excellent.
Unravelling Wolbachia global exchange: a contribution from the Bicyclus and Mylothris butterflies in the Afrotropics
Authors: Duplouy Anne , Pranter Robin , Warren-Gash Haydon , Tropek Robert , Wahlberg Niklas
Published: July 2020

Background
Phylogenetically closely related strains of maternally inherited endosymbiotic bacteria are often found in phylogenetically divergent, and geographically distant insect host species. The interspecies transfer of the symbiont Wolbachia has been thought to have occurred repeatedly, facilitating its observed global pandemic. Few ecological interactions have been proposed as potential routes for the horizontal transfer of Wolbachia within natural insect communities. These routes are however likely to act only at the local scale, but how they may support the global distribution of some Wolbachia strains remains unclear.
Results
Here, we characterize the Wolbachia diversity in butterflies from the tropical forest regions of central Africa to discuss transfer at both local and global scales. We show that numerous species from both the Mylothris (family Pieridae) and Bicyclus (family Nymphalidae) butterfly genera are infected with similar Wolbachia strains, this despite only minor interclade contacts across the life cycles of the species within their partially overlapping ecological niches. The phylogenetic distance and differences in resource use between these genera rule out the role of ancestry, hybridization, and shared host-plants in the interspecies transfer of the symbiont. Furthermore, we could not identify any shared ecological factors to explain the presence of the strains in other arthropod species from other habitats, or even ecoregions.
Conclusion
Only the systematic surveys of the Wolbachia strains from entire species communities may offer the material currently lacking for understanding how Wolbachia may transfer between highly different and unrelated hosts, as well as across environmental scales.