bluuebunny/crossref_metadata_2025 huggingface dataset:
Specificity of the Multi-Target Stool DNA Test for Colorectal Cancer Screening in Average-Risk 45–49 Year-Olds: A Cross-Sectional Study
Authors: Imperiale Thomas F. , Kisiel John B. , Itzkowitz Steven H. , Scheu Bradley , Duimstra Emma Kate , Statz Sandra , Berger Barry M. , Limburg Paul J.
Published: January 2021

High-specificity colorectal cancer screening is desirable to triage patients <50 years for colonoscopy; however, most endorsed colorectal cancer screening tests have not been rigorously evaluated in younger populations. This prospective cross-sectional study determined the specificity of the multitarget stool DNA (mt-sDNA) test in an average-risk screening population of 45 to 49 year-olds. Specificity was the primary outcome and was measured in participants without colorectal cancer or advanced precancerous lesions [APL– advanced adenomas (AA), and sessile serrated lesions ≥10 mm], and in the subgroup of participants with negative colonoscopic findings. APL sensitivity was a secondary outcome. The evaluable cohort included those who completed the study without protocol deviations and had a usable mt-sDNA test. Of 983 enrolled participants, 816 formed the evaluable cohort, with a mean age of 47.8 (SD, 1.5) years; 47.7% were women. No participants had colorectal cancer, 49 had APL, 253 had nonadvanced adenomas (NAA), and 514 had negative colonoscopic findings. mt-sDNA test specificity was 95.2% (95% CI, 93.4–96.6) in participants with NAA or negative findings [96.3% (confidence interval (CI), 94.3%–97.8%)] in those with negative findings, and did not differ by sex (P = 0.75) or race (P = 0.36) in participants with NAA or negative findings. Sensitivity for APL was 32.7% (CI, 19.9–47.5%), with most APL (83.7%) measuring 10–19 mm and none having high-grade dysplasia. The area under the ROC curve for discriminating between APL and lesser findings was 0.72 (CI, 0.64–0.81). mt-sDNA's high specificity would help minimize risk from unnecessary diagnostic procedures in this age group. This study shows that mt-sDNA has high specificity among average-risk 45 to 49-year olds, supporting its use as a noninvasive option for colorectal cancer screening.

Prevention Relevance:

This study shows that mt-sDNA has high specificity among average-risk 45–49 year olds, supporting its use as a non-invasive option for colorectal cancer screening.
Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates
Authors: Kandi Salam Chettian , Khan Hayat Ahmad
Published: January 2021

Introduction: Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of <6/18 to 3/60 or having visual field loss to <20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of <3/60 or corresponding visual field of <10°. Purpose: To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. Methods: An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. Results: 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (n = 340) had impaired vision with 20.9% (n = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. Conclusion: A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, n = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (n = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.
Women and Pregnancy in Thromboangiitis Obliterans
Authors: Le Joncour Alexandre , Espitia Olivier , Soudet Simon , Cacoub Patrice , Lambert Marc , Saadoun David
Published: January 2021

Data regarding women and thromboangiitis obliterans (TAO) are conflicted, and a few cases of pregnancy have been described. We aimed to describe the interplay between TAO and pregnancies. Among 224 TAO patients, 22.8% were women. Demographic data, clinical manifestations, and outcomes were similar between men and women. Twenty-one (41.2%) women had 48 pregnancies. Thirty-six (75%) pregnancies with on term and complication free delivery occurred. None of the patients experienced a disease flare of TAO during pregnancy. TAO does not seem to affect pregnancy complications, and pregnancy does not seem to interfere with the course of TAO.
desconexão da práxis na produção contemporânea de edifícios residenciais multifamiliares no Brasil: o concurso Weefor Arq sob a ótica do conforto ambiental
Authors: Fontenelle Marilia Ramalho , Esteves Ingrid Machado , Mendes Ana Beatriz Pinheiro , Gomes Ágatha Machado
Published: January 2021

Este artigo evidencia a desconexão entre o debate e a produção contemporânea de edifícios residenciais multifamiliares no Brasil, investigando a aplicação do conforto ambiental nos três projetos vencedores do concurso Weefor Arq. Partindo-se de uma análise crítica dos documentos do concurso, avalia-se a adequação das propostas às condicionantes climáticas de Curitiba (ZB1). São realizadas simulações computacionais com os plug-ins Ladybug e Butterfly para analisar a radiação solar na envoltória, o sombreamento das sacadas e a ventilação natural externa aos edifícios. Avaliou-se ainda o atendimento às NBRs 15220 e 15575 quanto ao desempenho térmico da envoltória e ao percentual de área de abertura. Os resultados apontam que, embora o concurso expresse clara preocupação com o bem-estar do usuário, na prática, as limitações impostas pelas dimensões do terreno, legislação urbana, número de unidades solicitadas e o despreparo dos arquitetos quanto aos aspectos de conforto ambiental comprometem a aplicação das estratégias bioclimáticas nos projetos. O artigo denuncia os prejuízos gerados aos usuários quando os arquitetos são excluídos da etapa de planejamento do empreendimento.
Systematic Approach to High Implantation of SAPIEN-3 Valve Achieves a Lower Rate of Conduction Abnormalities Including Pacemaker Implantation
Authors: Sammour Yasser , Banerjee Kinjal , Kumar Arnav , Lak Hassan , Chawla Sanchit , Incognito Cameron , Patel Jay , Kaur Manpreet , Abdelfattah Omar , Svensson Lars G. , Tuzcu E. Murat , Reed Grant W. , Puri Rishi , Yun James , Krishnaswamy Amar , Kapadia Samir
Published: January 2021

Background:

The conventional method of implanting balloon-expandable SAPIEN-3 (S3) valve results in a final 70:30 or 80:20 ratio of the valve in the aorta:left ventricular outflow tract with published rates of permanent pacemaker around 10%. We sought to evaluate whether higher implantation of S3 reduces conduction abnormalities including the need for permanent pacemaker.

Methods:

We included consecutive patients who underwent transfemoral transcatheter aortic valve replacement using S3 between April 2015 and December 2018 and compared outcomes with typical valve deployment strategy to our more contemporary high deployment technique (HDT). We excluded patients with nontransfemoral access or valve-in-valve.

Results:

Among 1028 patients, HDT was performed in 406 patients (39.5%). Mean implantation depth under the noncoronary cusp was significantly smaller with HDT compared with conventional technique (1.5±1.6 versus 3.2±1.9 mm;
P
<0.001). Successful implantation was achieved in 100% of the patients in both groups with no cases of conversion to open heart surgery, second valve implantation within the first transcatheter aortic valve replacement, or coronary occlusion during transcatheter aortic valve replacement. One patient (0.2%) had valve embolization with HDT (
P
=0.216). Thirty-day permanent pacemaker rates were lower with HDT (5.5% versus 13.1%;
P
<0.001), as were rates of complete heart block (3.5% versus 11.2%;
P
<0.001) and new-onset left bundle branch block (5.3% versus 12.2%;
P
<0.001). There were no differences in mild (16.5% versus 15.9%;
P
=0.804), or moderate-to-severe aortic regurgitation (1% versus 2.7%;
P
=0.081) at 1 year. HDT was associated with slightly higher 1-year mean gradients (13.1±6.2 versus 11.8±4.9 mm Hg;
P
=0.042) and peak gradients (25±11.9 versus 22.5±9 mm Hg;
P
=0.026). However, Doppler velocity index was similar (0.47±0.15 versus 0.48±0.13;
P
=0.772).

Conclusions:

Our novel technique for balloon-expandable S3 valve positioning consistently achieves higher implantation resulting in substantial reduction in conduction abnormalities and permanent pacemaker requirement after transcatheter aortic valve replacement without compromising procedural safety or valve hemodynamics. Operators should consider this as an important technique to improve patient outcomes.
Microrandomized Trial Design for Evaluating Just-in-Time Adaptive Interventions Through Mobile Health Technologies for Cardiovascular Disease
Authors: Golbus Jessica R. , Dempsey Walter , Jackson Elizabeth A. , Nallamothu Brahmajee K. , Klasnja Predrag
Published: January 2021

Smartphone and wearable device use is rising broadly and can be leveraged for chronic disease management. Just-in-time adaptive interventions promise to deliver personalized, dynamic interventions directly to patients through use of push notifications from mobile devices. Although just-in-time adaptive interventions are a powerful tool for shaping health behavior, their application to cardiovascular disease management has been limited as they can be challenging to design. Herein, we provide a general overview and conceptual framework for microrandomized trials, a novel experimental study design that can be used to optimize just-in-time adaptive interventions. Microrandomized trials leverage mobile devices to sequentially randomize participants to types or levels of an intervention to determine the effectiveness of an intervention and time-varying moderators of those effects. Microrandomized trials are an efficient study design that can be used to determine which intervention components to include in just-in-time adaptive interventions and to optimize their decision rules while maintaining the strength of causal inference associated with traditional randomized controlled trials.
Charney Problem with a Generic Stratosphere
Authors: Mak Mankin , Zhao Siyu , Deng Yi
Published: January 2021

This paper reports a comprehensive instability analysis of a 3D Charney-like model with an observationally compatible generic stratosphere. It is found that the values of a single nondimensional parameter (detailed definition in text), in conjunction with representative values of four other nondimensional parameters, would dictate the existence of multiple branches of unstable modes as a function of the zonal wavenumber. Prototype Charney mode, Green mode, and two additional structurally distinct modes (Charney+ mode and tropopause mode) are identified. The latter result from the additional strong influence of the tropopause. The dynamical nature of all modes is delineated in terms of their meridional fluxes of heat and potential vorticity. The three-dimensional structure of the ageostrophic velocity field in each mode is presented to identify its potential of inducing frontogenesis. Optimal-mode analyses are also performed to ascertain how a disturbance with a predisposed structure would explosively develop toward each type of normal mode. In view of the pivotal role of Γ in baroclinic instability and for historical reason, we name it the Charney number. It is most instructive to think of Γ as a ratio of the meridional gradient of PV associated with the basic flow in the troposphere, , to that associated with Earth’s rotation, β.
Assimilation of Vegetation Conditions Improves the Representation of Drought over Agricultural Areas
Authors: Mocko David M. , Kumar Sujay V. , Peters-Lidard Christa D. , Wang Shugong
Published: January 2021

This study presents an evaluation of the impact of vegetation conditions on a land surface model (LSM) simulation of agricultural drought. The Noah-MP LSM is used to simulate water and energy fluxes and states, which are transformed into drought categories using percentiles over the continental United States from 1979 to 2017. Leaf area index (LAI) observations are assimilated into the dynamic vegetation scheme of Noah-MP. A weekly operational drought monitor (the U.S. Drought Monitor) is used for the evaluation. The results show that LAI assimilation into Noah-MP’s dynamic vegetation scheme improves the model’s ability to represent drought, particularly over cropland areas. LAI assimilation improves the simulation of the drought category, detection of drought conditions, and reduces the instances of drought false alarms. The assimilation of LAI in these locations not only corrects model errors in the simulation of vegetation, but also can help to represent unmodeled physical processes such as irrigation toward improved simulation of agricultural drought.
Deep Eastern Boundary Currents: Idealized Models and Dynamics
Authors: Yang Xiaoting , Tziperman Eli , Speer Kevin
Published: January 2021

Concentrated poleward flows along eastern boundaries between 2- and 4-km depth in the southeast Pacific, Atlantic, and Indian Oceans have been observed, and appear in data assimilation products and regional model simulations at sufficiently high horizontal resolution, but their dynamics are still not well understood. We study the local dynamics of these deep eastern boundary currents (DEBCs) using idealized GCM simulations, and we use a conceptual vorticity model for the DEBCs to gain additional insights into the dynamics. Over most of the zonal width of the DEBCs, the vorticity balance is between meridional advection of planetary vorticity and vortex stretching, which is an interior-like vorticity balance. Over a thinner layer very close to the eastern boundary, a balance between vorticity tendencies due to friction and stretching that rapidly decay away from the boundary is found. Over the part of the DEBC that is governed by an interior-like vorticity balance, vertical stretching is driven by both the topography and temperature diffusion, while in the thinner boundary layer, it is driven instead by parameterized horizontal temperature mixing. The topographic driving acts via a cross-isobath flow that leads to stretching and thus to vorticity forcing for the concentrated DEBCs.
Evaluation of a multi-component, non-pharmacological intervention to prevent and reduce sleep disturbances in people with dementia living in nursing homes (MoNoPol-sleep): study protocol for a cluster-randomized exploratory trial
Authors: Dichter Martin N. , Berg Almuth , Hylla Jonas , Eggers Daniela , Wilfling Denise , Möhler Ralph , Haastert Burkhard , Meyer Gabriele , Halek Margareta , Köpke Sascha
Published: January 2021

Background

Sleep problems are highly prevalent in people with dementia. Nevertheless, there is no “gold standard” intervention to prevent or reduce sleep problems in people with dementia. Existing interventions are characterized by a pronounced heterogeneity as well as insufficient knowledge about the possibilities and challenges of implementation. The aim of this study is to pilot and evaluate the effectiveness of a newly developed complex intervention to prevent and reduce sleep problems in people with dementia living in nursing homes.

Methods

This study is a parallel group cluster-randomized controlled trial. The intervention consists of six components: (1) the assessment of established sleep-promoting interventions and an appropriate environment in the participating nursing homes, (2) the implementation of two “sleep nurses” as change agents per nursing home, (3) a basic education course for nursing staff: “Sleep problems in dementia”, (4) an advanced education course for nursing staff: “Tailored problem-solving” (two workshops), (5) workshops: “Development of an institutional sleep-promoting concept” (two workshops with nursing management and sleep nurses) and (6) written information and education material (e.g. brochure and “One Minute Wonder” poster). The intervention will be performed over a period of 16 weeks and compared with usual care in the control group.

Overall, 24 nursing homes in North, East and West Germany will be included and randomized in a 1:1 ratio. The primary outcome is the prevalence of sleep problems in people with dementia living in nursing homes. Secondary outcomes are quality of life, quality of sleep, daytime sleepiness and agitated behavior of people with dementia, as well as safety parameters like psychotropic medication, falls and physical restraints. The outcomes will be assessed using a mix of instruments based on self- and proxy-rating. A cost analysis and a process evaluation will be performed in conjunction with the study.

Conclusions

It is expected that the intervention will reduce the prevalence of sleep problems in people with dementia, thus not only improving the quality of life for people with dementia, but also relieving the burden on nursing staff caused by sleep problems.

Trial registration

Current controlled trials:ISRCTN36015309. Date of registration: 06/11/2020.
Enriched Music-supported Therapy for chronic stroke patients: a study protocol of a randomised controlled trial
Authors: Grau-Sánchez Jennifer , Segura Emma , Sanchez-Pinsach David , Raghavan Preeti , Münte Thomas F. , Palumbo Anna Marie , Turry Alan , Duarte Esther , Särkämö Teppo , Cerquides Jesus , Arcos Josep Lluis , Rodríguez-Fornells Antoni
Published: January 2021

Background

Residual motor deficits of the upper limb in patients with chronic stroke are common and have a negative impact on autonomy, participation and quality of life. Music-Supported Therapy (MST) is an effective intervention to enhance motor and cognitive function, emotional well-being and quality of life in chronic stroke patients. We have adapted the original MST training protocol to a home-based intervention, which incorporates increased training intensity and variability, group sessions, and optimisation of learning to promote autonomy and motivation.

Methods

A randomised controlled trial will be conducted to test the effectiveness of this enriched MST (eMST) protocol in improving motor functions, cognition, emotional well-being and quality of life of chronic stroke patients when compared to a program of home-based exercises utilizing the Graded Repetitive Arm Supplementary Program (GRASP). Sixty stroke patients will be recruited and randomly allocated to an eMST group (n = 30) or a control GRASP intervention group (n = 30). Patients will be evaluated before and after a 10-week intervention, as well as at 3-month follow-up. The primary outcome of the study is the functionality of the paretic upper limb measured with the Action Research Arm Test. Secondary outcomes include other motor and cognitive functions, emotional well-being and quality of life measures as well as self-regulation and self-efficacy outcomes.

Discussion

We hypothesize that patients treated with eMST will show larger improvements in their motor and cognitive functions, emotional well-being and quality of life than patients treated with a home-based GRASP intervention.

Trial registration

The trial has been registered atClinicalTrials.govand identified asNCT04507542on 8 August 2020.
Correction to: Comprehensive analysis of prognostic gene signatures based on immune infiltration of ovarian cancer
Authors: Yan Shibai , Fang Juntao , Chen Yongcai , Xie Yong , Zhang Siyou , Zhu Xiaohui , Fang Feng
Published: January 2021

An amendment to this paper has been published and can be accessed via the original article.
Adjuvant albumin-bound paclitaxel combined with S-1 vs. oxaliplatin combined with capecitabine after D2 gastrectomy in patients with stage III gastric adenocarcinoma: a phase III multicenter, open-label, randomized controlled clinical trial protocol
Authors: Cheng Xiangdong , Wu Dan , Xu Nong , Chen Luchuan , Yan Zhilong , Chen Ping , Zhou Lei , Yu Jianfa , Cui Jiuwei , Li Wei , Wang Chang , Feng Wenming , Wei Yunhai , Yu Pengfei , Du Yian , Ying Jieer , Xu Zhiyuan , Yang Litao , Zhang Yunli
Published: January 2021

Background

Surgery is the only treatment option for operable gastric cancer. The CLASSIC and ACTS-GC studies showed that the 5-year overall survival (OS) of patients with stage III gastric cancer undergoing D2 gastrectomy is still very low. Whether adjuvant nanoparticle albumin-bound paclitaxel (nab-paclitaxel) combined chemotherapy is more effective than the XELOX standard adjuvant chemotherapy in patients with stage III gastric cancer has not been confirmed.

Methods

This is a multicenter, open-label, phase III clinical study. In this trial, 616 patients with locally advanced stage III gastric cancer that underwent curative D2 radical surgery and achieved R0 are planned to be included. Patients will be randomized 1:1 to nab-paclitaxel combined with S-1 (AS) vs. oxaliplatin combined with capecitabine (XELOX). XELOX group: Patients assigned to the XELOX group received eight 3-week cycles of oral capecitabine (1000 mg/m2) twice daily on days 1–14 of each cycle plus intravenous oxaliplatin 130 mg/m2 on day 1 of each cycle. AS group: AS group received eight 3-week cycles of oral S-1 (80–120 mg) (< 1.25 m2, 40 mg; 1.25 to < 1.5 m2, 50 mg; and > 1.5 m2, 60 mg) twice daily on days 1–14 plus intravenous nab-paclitaxel 120 mg/m2 on days 1 and 8 of each cycle. The primary endpoint was the 3-year disease-free survival (3-year-DFS) defined as the time from randomisation to the time of recurrence of the original gastric cancer, development of a new gastric cancer, or death from any cause. The secondary endpoints were the overall survival, (defined as the time from the date of randomisation to date of death from any cause) and safety (any adverse event).

Discussion

Compared with previous studies, this study includes nab-paclitaxel based on S-1 adjuvant chemotherapy, which is expected to achieve better efficacy and lower toxicity than the standard treatment. This study is the first clinical study to evaluate the safety and efficacy of nab-paclitaxel combined with S-1 in patients with stage III gastric cancer after D2 radical resection.

Trial registration

This clinical trial has been registered with ClinicalTrials.gov, registration number: NCT04135781, on October 20th, 2019.
Linking political exposures to child and maternal health outcomes: a realist review
Authors: Barnish Maxwell S. , Tan Si Ying , Taeihagh Araz , Tørnes Michelle , Nelson-Horne Rebecca V. H. , Melendez-Torres G. J.
Published: January 2021

Background

Conceptual and theoretical links between politics and public health are longstanding. Internationally comparative systematic review evidence has shown links between four key political exposures – the welfare state, political tradition, democracy and globalisation – on population health outcomes. However, the pathways through which these influences may operate have not been systematically appraised. Therefore, focusing on child and maternal health outcomes, we present a realist re-analysis of the dataset from a recent systematic review.

Methods

The database from a recent systematic review on the political determinants of health was used as the data source for this realist review. Included studies from the systematic review were re-evaluated and those relating to child and/or maternal health outcomes were included in the realist synthesis. Initial programme theories were generated through realist engagement with the prior systematic review. These programme theories were adjudicated and refined through detailed engagement with the evidence base using a realist re-synthesis involving two independent reviewers. The revised theories that best corresponded to the evidence base formed the final programme theories.

Results

Out of the 176 included studies from the systematic review, a total of 67 included child and/or maternal health outcomes and were included in the realist re-analysis. Sixty-three of these studies were ecological and data were collected between 1950 and 2014. Six initial programme theories were generated. Following theory adjudication, three theories in revised form were supported and formed the final programme theories. These related to a more generous welfare state leading to better child and maternal health especially in developed countries through progressive social welfare policies, left-of-centre political tradition leading to lower child mortality and low birth weight especially in developed countries through greater focus on welfare measures, and increased globalisation leading to greater child and infant mortality and youth smoking rates in LMECs through greater influence of multinational corporations and neoliberal trade organisations.

Conclusion

We present a realist re-analysis of a large systematically identified body of evidence on how four key political exposures – the welfare state, democracy, political tradition and globalisation – relate to child and maternal health outcomes. Three final programme theories were supported.
LncRNA HOTTIP leads to osteoarthritis progression via regulating miR-663a/ Fyn-related kinase axis
Authors: He Xianwei , Gao Kun , Lu Shuaihua , Wu Rongbo
Published: January 2021

Background

Long non-coding RNA (lncRNA) has been implicated in the progression of osteoarthritis (OA). This study was aimed to explore the role and molecular mechanism of lncRNA HOXA terminal transcriptional RNA (HOTTIP) in the development of OA.

Methods

The expression of HOTTIP, miR-663a and Fyn-related kinase (FRK) in the OA articular cartilage and OA chondrocyte model induced by IL-1β was determined by qRT-PCR. CCK-8, colony formation and flow cytometry were used to determine the cell proliferation and apoptosis of OA chondrocytes. The specific molecular mechanism of HOTTIP in OA chondrocytes was determined by dual luciferase reporter assay, qRT-PCR, western blotting and RNA pull-down.

Results

The expression of HOTTIP and FRK were up-regulated, while miR-663a was down-regulated in OA cartilage tissues. Knockdown of HOTTIP decreased the proliferation and induced the apoptosis of OA cartilage model cells, while overexpression of HOTTIP increased the proliferation and reduced the apoptosis of OA cartilage model cells. Moreover, HOTTIP could bind to miR-663a as competitive endogenous RNA. Inhibition of miR-663a expression could alleviate the effect of HOTTIP knockdown on the proliferation and apoptosis of OA cartilage model cells. Furthermore, FRK was found to be a direct target of miR-663a, which could markedly down-regulate the expression of FRK in OA chondrocytes, while HOTTIP could remarkably up-regulate the expression of FRK. In addition, miR-663a inhibition increased the proliferation and reduced the apoptosis of OA cells, while FRK knockdown reversed the effect of miR-663a inhibition on the proliferation and apoptosis of OA cells. Meanwhile, overexpression of miR-663a decreased the proliferation and induced the apoptosis of OA cells, while overexpression of FRK reversed the effect of miR-663a overexpression on the proliferation and apoptosis of OA cells.

Conclusion

HOTTIP was involved in the proliferation and apoptosis of OA chondrocytes via miR-663a/ FRK axis, and HOTTIP/miR-663a/FRK might be a potential target for the treatment of OA.
Evaluation of efficacy and safety of percutaneous transforaminal endoscopic surgery (PTES) for surgical treatment of calcified lumbar disc herniation: a retrospective cohort study of 101 patients
Authors: Wang Hao , Zhou Tianyao , Gu Yutong , Yan Zuoqin
Published: January 2021

Background

Percutaneous transforaminal endoscopy has been widely used to treat lumbar disc herniation (LDH), but the steep learning curve and difficulties in removing the calcified disc hinders the application of conventional endoscopy in treating calcified lumbar disc herniation (CLDH). In 2017, we first reported Percutaneous Transforaminal Endoscopic Surgery (PTES) as an easy-to-learn posterolateral transforaminal endoscopic technique to decompress the nerve root for LDH. We used our PTES technique to remove the calcified LDH and the purpose of this study is to evaluate the safety and efficacy of this technique.

Methods

Forty-six patients with CLDH and fifty-five patients with uncalcified lumbar disc herniation (ULDH) underwent PTES to decompress the nerve root. Visual analogue scale was collected before the surgery, immediately, one week, one month, two months, three months, six months, 12 months and 24 months after surgery. The outcomes of MacNab classification were collected 24 months after surgery. Intra- and Post-operative complications were also recorded.

Results

For CLDH patients, the VAS score was 9 (5–10) before operation, and then dropped to 2 (1–4) after surgery. VAS score continually decreased to 0 (0–3) at 24 months after surgery. 95.65% of CLDH patients showed excellent or good outcomes. ULDH group showed similar MacNab classification (94.55%) and VAS changing curve. The therapeutic effect of PTES in treating CLDH was as good as that in treating uncalcified patients.

Conclusions

PTES is an effective and safe method to treat calcified lumbar disc herniation.
Successful pregnancy after operation in an infertile woman caused by luteinizing hormone-secreting pituitary adenoma: case report and literature review
Authors: Zhang Yi , Chen Cheng , Lin Min , Deng Kan , Zhu Huijuan , Ma Wenbin , Pan Hui , Wang Renzhi , Yao Yong
Published: January 2021

Background

Functional gonadotroph adenomas (FGAs) are rare adenomas that most commonly secrete FSH. However, solitary LH-secreting pituitary adenomas are unusual.

Case presentation

A 30-year-old woman with elevated LH and normal FSH presented with inability to conceive. An MRI revealed an enlarged sella turcica and an intrasellar mass. Treatment with transsphenoidal resection led to normalization of LH and estradiol, as well as successful pregnancy. And we reviewed 6 cases of LH-secreting pituitary adenomas from 1981 to 2020.

Conclusions

Our case is unique because of the LH-secreting pituitary adenoma without FSH hypersecretion. This case indicates that pituitary adenoma should be considered when other diseases causing infertility have been excluded.
Challenges for palliative care day services: a focus group study
Authors: Hasson Felicity , Jordan Joanne , McKibben Laurie , Graham-Wisener Lisa , Finucane Anne , Armour Kathy , Zafar Shazia , Hewison Alistair , Brazil Kevin , Kernohan W. George
Published: January 2021

Background

Palliative care day services provide a safe environment for people with palliative care needs, enabling them to access a range of services while acting as a respite services for family caregivers. Viewed as marginal services, they are often under resourced and under researched. The aim of this study was to understand how palliative day care services contribute to client care from the perspective of management and hospice multidisciplinary teams.

Methods

A descriptive qualitative study, using six focus groups conducted with staff at three United Kingdom hospices in England, Scotland and Northern Ireland. Thirty-five participants were recruited, including management and staff. Discussions were transcribed and analysed thematically.

Results

Four key themes emerged: (1) variations of care, beyond heterogeneity of patients; (2) unclear referrals and inconsistent patient population; (3) recognising strengths and challenges and (4) an uncertain future. A major focus of group discussions was the model of care and the benefits of the service, however the importance of demonstrating services’ effectiveness and value for money was highlighted.

Conclusions

Management and hospice staff believed day-services to be a helpful introduction to palliative care, providing both social and medical support. Economic pressures and patient demand were influencing them to move from a social model to a hybrid model. Further research is needed to understand the effectiveness of the service.
Empathy in nurse-patient interaction: a conversation analysis
Authors: Wu Yijin
Published: January 2021

Background

Considerable attention has been drawn to empathy in nursing and the concept of empathy has firmly been embedded in nursing discourse. However, little has been known about the details of how nurses express empathy to their patients. In this study, we aim to conduct a qualitative study of actual nurse-patient conversations through which empathy was achieved.

Methods

The data in this study was based on audio-recording of sessions of conversations between participating nurses and patients in two Chinese hospitals. The participants in this study involved 6 female nurses and 14 patients. Based on Bachelor’s (1988) categorization of empathy, this study described and analyzed the actual empathic sequences in nursing conversations in an attempt to demonstrate how nursing empathy was interactionally achieved using the method of conversation analysis. Conversation analysis (CA), focusing on the study of talk in interaction, is a useful method for the qualitative analysis of empathic talk in nursing.

Results

By drawing on prior theoretical work as well as on empathic sequence in nursing, this study described and analyzed some of the conversational resources nurses and patients used in achieving empathy. It has been shown that empathy can be interactionally and sequentially achieved in actual sequences of talk. Specifically, nursing empathy is a collaboratively constructed action instead of the nurse’s own committed action, which is produced in specific interactional contexts.

Conclusion

Conversation analysis is a very useful method for describing and analyzing the nurse-patient interaction, especially for studying empathy in nursing care. The sequences in this study present example of exemplary empathic interaction between nurses and patients, which might shed some light on how nurses express empathy to their patients. Also, this study could help to increase the understanding of the mirco-process of empathy in nursing and contribute to improving nursing communicative skills.
Reduction in cardiovascular mortality following severe hypoglycemia in individuals with type 2 diabetes: the role of a pragmatic and structured intervention
Authors: Pearson Sam M. , Whittam Beverley , Kulavarasalingam Kavita , Mitchell-Gears Amelia , James Cathyrn , Ajjan Ramzi A.
Published: January 2021

Background

Mortality in individuals with diabetes with severe hypoglycemia requiring ambulance services intervention is high and it is unclear whether this is modifiable. Our aim was to characterise this high-risk group and assess the impact of nurse-led intervention on mortality.

Methods

In this single centre study, patients with diabetes and hypoglycemia requiring ambulance call out were randomized to nurse led support (intensive arm) or managed using existing pathways (standard arm). A third group agreed to have their data collected longitudinally (observational arm). The primary outcome was all-cause mortality comparing intensive with combined standard and observational arms as well as standard arm alone.

Results

Of 828 individuals identified, 323 agreed to participate with 132 assigned to intensive, 130 to standard and 61 to observational arms. Mean follow up period was 42.6 ± 15.6 months. Mortality in type 1 diabetes (n = 158) was similar across study arms but in type 2 diabetes (n = 160) this was reduced to 33% in the intensive arm compared with 51% in the combined arm (p = 0.025) and 50% in the standard arm (p = 0.06). Cardiovascular deaths, the leading cause of mortality, was lower in the intensive arm compared with combined and standard study arms (p < 0.01).

Conclusions

Medium-term mortality following severe hypoglycemia requiring the assistance of emergency services is high in those with type 2 diabetes. In individuals with type 2 diabetes, nurse-led individualized intervention reduces cardiovascular mortality compared with standard care. Large-scale multicentre studies are warranted to further investigate this approach.

Trial registration The trial was retrospectively registered on http://www.clinicaltrials.gov with reference NCT04422145
Triglyceride–glucose index is associated with the risk of myocardial infarction: an 11-year prospective study in the Kailuan cohort
Authors: Tian Xue , Zuo Yingting , Chen Shuohua , Liu Qian , Tao Boni , Wu Shouling , Wang Anxin
Published: January 2021

Background

The triglyceride–glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI.

Methods

A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models.

Results

During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77–2.45) and 1.58 (1.18–2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63–2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (Pinteraction = 0.0411).

Conclusions

Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.
Molecular, structural and biochemical characterization of a novel recombinant chlorophyllase from cyanobacterium Oscillatoria acuminata PCC 6304
Authors: Gu Sitian , Dai Xiaojun , Xu Zhengjun , Niu Qiwen , Jiang Jiang , Liu Yuanfa
Published: January 2021

Background

Chlorophyllase catalyzes the hydrolysis of chlorophyll and produces chlorophyllide and phytol. Cyanobacterial chlorophyllases are likely to be more highly heterologously expressed than plant chlorophyllases. A novel recombinant chlorophyllase from the cyanobacterium Oscillatoria acuminata PCC 6304 was successfully expressed in Escherichia coli BL21(DE3).

Results

The putative N-terminal 28-amino-acid signal peptide sequence of O. acuminata chlorophyllase (OaCLH) is essential for its activity, but may confer poor solubility on OaCLH. The C-terminal fusion of a 6 × His tag caused a partial loss of activity in recombinant OaCLH, but an N-terminal 6 × His tag did not destroy its activity. The optimal pH and temperature for recombinant OaCLH activity are 7.0 and 40 °C, respectively. Recombinant OaCLH has hydrolysis activities against chlorophyll a, chlorophyll b, bacteriochlorophyll a, and pheophytin a, but prefers chlorophyll b and chlorophyll a as substrates. The results of site-directed mutagenesis experiments indicated that the catalytic triad of OaCLH consists of Ser159, Asp226, and His258.

Conclusions

The high-level expression and broad substrate specificity of recombinant OaCLH make it suitable for genetically engineering and a promising biocatalyst for industrial production, with applications in vegetable oil refining and laundry detergents.
CDCA4 suppresses epithelial–mesenchymal transtion (EMT) and metastasis in Non-small cell lung cancer through modulating autophagy
Authors: Xu Chenxin , Cao Haixia , Sui Ying , Zhang Hui , Shi Chen , Wu Jianzhong , Ma Rong , Feng Jifeng
Published: January 2021

Background

Cell division cycle associated 4 (CDCA4) has been reported to be engaged into the progression of several cancers. The function of CDCA4 in Non-small cell lung cancer (NSCLC) was unknown. We aimed to explore the critical role of CDCA4 in NSCLC.

Methods

CDCA4 stably knocking down and overexpression cell lines were established and Western blotting assay was applied to measure relevant protein expression of Epithelial-Mesenchymal Transtion (EMT) and cell autophagy. Staining of acidic vacuoles, transmission electron microscopy and immunofluorescence staining were employed to detect autophagy. The ability of cells to migrate and invade were detected by Transwell migration and invasion assays. The interaction of CDCA4 with CARM1 was identified by immunoprecipitation and Western blotting analysis.

Results

In the present study, it was found that inhibition of CDCA4 induced EMT, migration and invasion of NSCLC cells while inhibiting autophagy of NSCLC cells. Meanwhile, overexpression of CDCA4 in NSCLC cells showed the opposite function. More importantly, the inhibition of autophagy could promote the EMT, migration and invasion of NSCLC cells, which should be impaired via the activation of autophagy. In addition, CDCA4-inhibited EMT, migration and invasion could be partially aggravated by autophagy activator, rapamycin, and reversed by autophagy inhibitor, 3-MA. Correspondingly, the application of rapamycin or 3-MA to CDCA4 knockdown cells showed the opposite effects. Further investigation suggested that CDCA4 could interact with coactivator associated arginine methyltransferase 1 (CARM1). Autophagy was induced while cell migration and invasion were inhibited in CARM1 knockdown cells. CDCA4 could suppress the protein expression CARM1 and knocking down of CARM1 could alter cell autophagy, migratory and invasive abilities regulated by CDCA4.

Conclusion

All data indicated that CDCA4 inhibited the EMT, migration and invasion of NSCLC via interacting with CARM1 to modulate autophagy.
Prognosis analysis of patients with pancreatic neuroendocrine tumors after surgical resection and the application of enucleation
Authors: Chen Junzhang , Yang Yongyu , Liu Yuanhua , Kan Heping
Published: January 2021

Objective

To investigate the prognostic factors of patients with pancreatic neuroendocrine tumor (pNETs) after surgical resection, and to analyze the value of enucleation for pNETs without distant metastasis that are well-differentiated (G1) and have a diameter ≤ 4 cm.

Methods

Data from pNET patients undergoing surgical resection between 2004 and 2017 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan–Meier analysis and log-rank testing were used for the survival comparisons. Adjusted HRs with 95% CIs were calculated using univariate and multivariate Cox regression models to estimate the prognostic factors. P < 0.05 was regarded as statistically significant.

Results

This study found that female, cases diagnosed after 2010, and pancreatic body/tail tumors were protective factors for good survival, while histological grade G3, a larger tumor size, distant metastasis, AJCC 8th stage III-IV and age over 60 were independent prognostic factors for a worse OS/CSS. For the pNETs that were well-differentiated (G1) and had a tumor diameter ≤ 4 cm, the type of surgery was an independent factor for the long-term prognosis of this group. Compared with pancreaticoduodenectomy and total pancreatectomy, patients who were accepted enucleation had better OS/CSS.

Conclusion

For pNETs patients undergoing surgical resection, sex, year of diagnosis, tumor location, pathological grade, tumor size, distant metastasis, race, and age were independent prognostic factors associated with the OS/CSS of patients. For pNETs patients with G1 and a tumor diameter less than 4 cm, if the tumor was located over 3 mm from the pancreatic duct, enucleation may be a wise choice.
Nodal histiocytic sarcoma with prominent eosinophilic infiltration: expression of eotaxin-2 on tumor cells
Authors: Ohe Rintaro , Kabasawa Takanobu , Utsunomiya Aya , Urano Yuka , Kitaoka Takumi , Suzuki Kazushi , Aung Naing Ye , Kawamura Ichiro , Tajima Katsushi , Ishiyama Tomoharu , Yamakawa Mitsunori
Published: January 2021

Background

Histiocytic sarcoma (HS) is a rare neoplasm showing morphological and immunophenotypic features of mature tissue histiocytes. We report a patient with nodal HS exhibiting prominent reactive eosinophilic infiltration.

Case presentation

A 68-year-old man presented with intermittent left lower abdominal pain and weight loss over 3 months. A computed tomography scan revealed multiple abdominal nodules. Open biopsy of the mesenteric tumors was performed for definitive diagnosis. Histologically, the tumor was comprised of a diffuse noncohesive proliferation of pleomorphic large cells, including multinucleated cells. Neoplastic cells were positive for histiocytic markers (CD68, CD163, and LIGHT) and PD-L1 but lacked markers of Langerhans cells, follicular dendritic cells, and epithelial cells. Frequent reactive inflammatory cells were intermingled in the background. Interestingly, prominent eosinophilic infiltration was also noted. Spindle neoplastic cells were prone to be present around areas with little to no eosinophilic infiltration and exhibiting fibrosis and lymphatic vessel proliferation. Conversely, polygonal neoplastic cells were prone to be present around areas with relatively large amounts of eosinophilic infiltration without fibrosis or lymphatic vessel proliferation. Immunohistochemically, the tumor cells and reactive eosinophils expressed eotaxin-2 and eotaxin-3, respectively.

Conclusion

We revealed that eotaxins induced the selective migration of eosinophils into tissues in this case. These eosinophils may affect the tumor remodeling and tumor biology characteristics of HS, such as fibrosis and lymphatic vessel proliferation.