bluuebunny/crossref_metadata_2025 huggingface dataset:
Amniotic fluid embolism: A rare cause of maternal collapse—A case report
Authors: Sitaula Sarita , Das Dipti , Sitaula Subhas , Chhetry Manisha
Published: October 2020

High index of suspicion of amniotic fluid embolism should be considered in any intrapartum or postpartum collapse where the obvious cause of collapse is not identified.
Two cycles of adjuvant carboplatin for clinical stage 1 testicular seminoma in New Zealand centres: A retrospective analysis of efficacy and long‐term events
Authors: Chandran Elias A. , Chindewere Aaron , North Richard , Jameson Michael B.
Published: October 2020

Background

Adjuvant carboplatin reduces relapse risk in clinical stage 1 (CS1) seminoma, though there is a paucity of long‐term safety data.

Aim

Our objective was to report long‐term outcomes of two cycles of adjuvant carboplatin dosed at area under the time–concentration curve (AUC) of 7.

Methods and results

We performed a retrospective analysis on treatment and outcomes of patients with CS1 seminoma who received adjuvant carboplatin from 2000 to 2016 at our centres in the Midland Region, New Zealand. Of 159 patients, median age 39 years, 153 received two cycles of carboplatin: 147 dosed at AUC7 and 6 at AUC6. Six patients had one cycle of carboplatin AUC7. One patient relapsed at 22 months and died of bleomycin pneumonitis 2 months after achieving a complete response with BEP chemotherapy. Neither RTI (present in 21.3%) nor tumor size >4 cm (in 43.3%) was predictive of relapse. Median follow‐up was 106 months. At 15 years, outcomes were: relapse‐free survival 99.4%, overall survival 91.4%, disease‐specific survival 100%, subsequent malignant neoplasm rate 7.6%, and second testicular germ cell tumor rate 3.85%. One patient had persistent grade 1 thrombocytopenia at 46 months.

Conclusions

These data add to the body of evidence that two cycles of carboplatin AUC7 is safe and effective adjuvant treatment for CS1 seminoma.
The circuitry of the tumor microenvironment in adult and pediatric Hodgkin lymphoma: cellular composition, cytokine profile, EBV, and exosomes
Authors: Nagpal Poonam , Descalzi‐Montoya Dante B. , Lodhi Niraj
Published: October 2020

Background: Classical Hodgkin lymphoma (cHL) is a unique lymphoid malignancy with a tumor microenvironment (TME) consisting of a small number of neoplastic—Hodgkin and Reed‐Sternberg (H‐RS) cells (<1%), surrounded by a large number of nonneoplastic infiltrating immune cells (>90%). The TME of cHL critically depends on immune cells to support tumor growth as H‐RS cells cannot survive and proliferate in isolation.

Recent Findings: Programmed cell death protein 1 (PD‐1) ligand expressed on H‐RS cells inhibits the clearance of tumor by causing T‐cell exhaustion. Nivolumab and pembrolizumab, PD‐1 inhibitors, have been proven to be effective in treating adult and pediatric patients with R/R cHL. Tumor‐associated macrophages (TAMs) are a central component of TME and are known to cause poor prognosis in adult HL. However, the prognostic impact of CD68+ TAMs in pediatric HL remains ambiguous. EBV modulates the tumor milieu of HL and plays a strategic role in immune escape by enrichment of the TME with Treg cells and associated immunosuppressive cytokines in adult HL. In contrast, EBV+ pediatric patients have increased infiltration of CD8+ T‐cells and show a better therapeutic response suggesting viral‐related TME is distinct in childhood HL. The role of CASP3 in apoptosis of H‐RS cells and its correlation with response prediction in adult and pediatric HL suggest it may serve as a potential biomarker. In cHL, CD30, EBV, and NF‐κB signaling employ exosomes for cell–cell communication that triggers the migration capacity of fibroblasts, stimulate to produce proinflammatory cytokines, and help to create a tumor‐supportive microenvironment.

Conclusion: The cHL microenvironment is distinct in adult and pediatric HL. Future studies are required to understand the role of interplay between H‐RS cells and EBV‐associated microenvironment and their clinical outcome. They may present novel therapeutic targets for the development of antilymphoma therapy.
Cytotoxicity evaluation of dental and orthodontic light‐cured composite resins
Authors: Bationo Raoul , Rouamba Ablassé , Diarra Abdoulaziz , Beugré‐Kouassi Monique Lydie Ahia , Beugré Jean‐Bertin , Jordana Fabienne
Published: October 2020

Introduction

The aim of this study was to determine the cytotoxicity of light‐cured composite resins (Clearfil ES‐2, Clearfil ES Flow, Filtek Supreme XTE, Grengloo, Blugloo, Transbond XT, and Transbond LR) then to assess leachable components in contact with human gingival fibroblasts (GFs) and to quantity detected bisphenol A (BPA).

Methods

Light‐cured composite resin discs were immersed for 24 hours in gingival fibroblastic medium (n = 3 for each product) and in control medium (n = 2 for each product) contained in plate. Cytotoxicity of the products (n = 95) was determined by the measure of cell viability using MTT assay after reading the optical densities of the plates. The analysis of leachable components was done by gas phase chromatography and mass spectrometry (GC–MS) and detected BPA was quantified. The limit of quantification was 0.01 μg/mL. Statistical analyses were performed by using IBM SPSS Statistics 20 and Kruskal–Wallis and Mann–Whitney U‐tests were applied.

Results

Cell viabilities were between 85 and 90%. Many chemical compounds including triethylene glycol dimethacrylate (TEGDMA) and BPA were identified. The average concentrations were 0.67 μg/mL ± 0.84 in the control medium and 0.73 μg/mL ± 1.05 in the fibroblastic medium. Filtek Supreme XTE presented the highest concentration of BPA with 2.16 μg/mL ± 0.65 and Clearfil ES Flow presented the lowest with 0.25 μg/mL ± 0.35. No BPA was detected with Transbond XT and Transbond LR. Clearfil ES Flow, Filtek Supreme XTE, Grengloo and Transbond LR presented residual TEGDMA.

Conclusions

Light‐cured composite resins are slightly cytotoxic opposite GFs and release many components including BPA and TEGDMA. Clinical precautions should be taken to decrease the release of these monomers.
Ambidexterity in the context ofSMEalliances: Does sustainability have a role?
Authors: Russo Angeloantonio , Schena Rosamartina
Published: October 2020

Small and medium‐sized enterprises (SMEs) deal with many challenges that threaten their survival every day. To successfully overcome these challenges, SMEs rely on strategic alliances. Drawing on the innovative concept of ambidexterity, this study focuses on how SME alliances can handle the dilemma of exploration and exploitation to achieve an advantage in terms of financial performance. A sample of 9,673 Italian SMEs aggregated in 1,854 alliances in the period 2010–2015 was used to test the hypotheses, referring to the moderating effect of corporate sustainability on the relationship between ambidextrous strategies and alliance performance. The results show that, in general, SME alliances that do not set sustainability goals prefer a focused alliance to achieve economic benefits; otherwise, if sustainability objectives are considered at the bases of the alliance formation, the greatest economic benefits are linked to an ambidextrous alliance.
Mergers require overcommunication and participative planning
Authors: Hodges Dawn Z.
Published: October 2020

As was true during the recession of 2007–09, the COVID‐19 pandemic of 2020 has turned the college and university conversation to mergers. While not all of higher education's revenue is tuition‐driven, a huge portion of the budget is built around tuition income.
An efficient algorithm for weakly compressible flows in spherical geometries
Authors: Frolov Roman , Minev Peter , Takhirov Aziz
Published: October 2020

In this article, we present a direction splitting method, combined with a nonlinear iteration, for the compressible Navier‐Stokes equations in spherical coordinates. The method is aimed at solving the equations on the sphere, and can be used for a regional geophysical simulations as well as simulations on the entire sphere. The aim of this work was to develop a method that would work efficiently in the limit of very small to vanishing Mach numbers, and we demonstrate here, using a numerical example, that the method shows good convergence and stability at Mach numbers in the range [10−2, 10−6]. We also demonstrate the effect of some of the parameters of the model on the solution, on a common geophysical test case of a rising thermal bubble. The algorithm is particularly suitable for a massive parallel implementation, and we show below some results demonstrating its excellent weak scalability.
Behavioral Change in Determinants of the Choice of Fuels amongst Rural Households after the Introduction of Clean Fuel Program: A District‐Level Case Study
Authors: Jaiswal Vaishali Bhole , Meshram Pravin U.
Published: October 2020

Consumption of energy is a determinant of the socioeconomic status of many citizens across the globe. The majority of rural households in India are dependent on biomass fuels. Existing data on the factors affecting fuel switching in rural India are insufficient to analyze a behavioral change among families. This paper evaluates the influence of four variables income, education, cost of fuel, and clean fuel supply on fuel adoption decisions. To understand the study population's behavioral change, a Household Survey is conducted in 20 villages (in India's rural district). Along with field observation, data are also collected on energy usage at the household level using a formal questionnaire. Binary logistic regression is applied to establish a link between the variables. Both biomass fuels and Liquefied Petroleum Gas are used mostly for cooking. The prevalence of energy stacking behavior is observed even among middle and upper‐income families. Modest evidence for the “energy ladder” hypothesis is seen, however, a “switch over” to cleaner fuels is not.
Glial endozepines and energy balance: Old peptides with new tricks
Authors: Lebrun Bruno , Barbot Manon , Tonon Marie‐Christine , Prévot Vincent , Leprince Jérôme , Troadec Jean‐Denis
Published: October 2020

The contribution of neuroglial interactions to the regulation of energy balance has gained increasing acceptance in recent years. In this context, endozepines, endogenous analogs of benzodiazepine derived from diazepam‐binding inhibitor, are now emerging as major players. Produced by glial cells (astrocytes and tanycytes), endozepines have been known for two decades to exert potent anorexigenic effects by acting at the hypothalamic level. However, it is only recently that their modes of action, including the mechanisms by which they modulate energy metabolism, have begun to be elucidated. The data available today are abundant, significant, and sometimes contradictory, revealing a much more complex regulation than initially expected. Several mechanisms of action of endozepines seem to coexist at the central level, particularly in the hypothalamus. The brainstem has also recently emerged as a potential site of action for endozepines. In addition to their central anorexigenic effects, endozepines may also display peripheral effects promoting orexigenic actions, adding to their complexity and raising yet more questions. In this review, we attempt to provide an overview of our current knowledge in this rapidly evolving field and to pinpoint questions that remain unanswered.
Impact of early oral hydration on pharyngocutaneous fistula following total laryngectomy
Authors: Edafe Ovie
Published: October 2020

see page 718–718.
Need for long‐term follow‐up in sinonasal inverted papilloma: A Single‐institution experience
Authors: Binz Gregori H. A. , Soyka Michael B. , Holzmann David , Meerwein Christian M.
Published: October 2020

Background

Most studies on sinonasal inverted papillomas (SNIPs) regarding risk factors for recurrence, recurrence rates (RRs) and malignant transformation are biased by a significant proportion of revision cases.

Methods

Retrospective study on patients with consecutive, treatment‐naïve SNIPs at a tertiary referral center between 1999 and 2019.

Results

Overall, RR was 9.8% (10 of 102 patients), with 2 of 10 recurrences (20%) occurring after more than 5 years. Histopathological workup revealed synchronous malignancy in 2 of 102 patients (2%). Subgroup analysis revealed a significantly higher RR for SNIPs involving the frontal sinus (26.3% vs 6.0%, P = .02). No SNIPs primarily originating from the frontal sinus were observed.

Conclusion

Overall, RR of treatment‐naïve SNIPs is comparably low; however, long‐term follow‐up is mandatory due to late recurrences. Secondary involvement of the frontal sinus was identified as risk factor for recurrence. No SNIPs primarily originating from frontal sinus were observed.
A phase II trial of bendamustine in combination with ofatumumab in patients with relapsed or refractory marginal zone B‐cell lymphomas
Authors: Vannata Barbara , Vanazzi Anna , Negri Mara , Liptrott Sarah Jayne , Bartosek Anna Amalia , Miani Monica , Di Sanzo Alessandro , Cavalli Franco , Zucca Emanuele , Stathis Anastasios
Published: October 2020

Marginal zone lymphomas (MZLs) are indolent yet incurable lymphomas with frequent relapses following therapy. For patients with relapsed/refractory disease, no standard therapies exist. Here we report results of an exploratory phase II study aimed at assessing the efficacy and safety of the alkylator agent bendamustine in combination with the second‐generation anti‐CD20 monoclonal antibody, ofatumumab, in patients with relapsed or refractory MZL. Patients with MZL and previously treated with at least one line of systemic therapy were eligible. Treatment consisted in bendamustine (90 mg/m2 on days 1 and 2) and ofatumumab (1000 mg on day 1) in 28‐day cycles for up to six cycles. Sixteen patients were included in the trial. In one patient, the diagnosis was revised after two cycles of treatment and was excluded from the efficacy analysis. Among 15 patients with MZL, 14 were evaluable for response: the overall and complete response rates were 92.9% and 57.1%, respectively. The median duration of response was 30.4 months (95% confidence interval [CI], 15.5 –not estimable) and 2‐years progression‐free survival 77% (95% CI, 43%–92%). Fifteen patients (94%) experienced grade 3–4 adverse events. Toxicity was mostly hematological. Neutropenia grade ≥3 was recorded in 27% of patients, lymphocytopenia in 93%, and infections and febrile neutropenia each in 13%. One patient discontinued treatment due to myocardial infarction; no treatment‐related deaths occurred. The combination of bendamustine with ofatumumab was active with an acceptable toxicity profile in this small phase II trial and can be considered for further investigation in relapsed/refractory MZL patients.
The influence of the learning health system to address the COVID‐19 pandemic: An examination of early literature
Authors: Douthit Brian J.
Published: October 2020

Introduction

The COVID‐19 pandemic has demanded immediate response from healthcare systems around the world. The learning health system (LHS) was created with rapid uptake of the newest evidence in mind, making it essential in the face of a pandemic. The goal of this review is to gain knowledge on the initial impact of the LHS on addressing the COVID‐19 pandemic.

Methods

PubMed, Scopus and the Duke University library search tool were used to identify current literature regarding the intersection of the LHS and the COIVD‐19 pandemic. Articles were reviewed for their purpose, findings and relation to each component of the LHS.

Results

Twelve articles were included in the review. All stages of the LHS were addressed from this sample. Most articles addressed some component of interoperability. Articles that interpreted data unique to COVID‐19 and demonstrated specific tools and interventions were least common.

Conclusions

Gaps in interoperability are well known and unlikely to be solved in the coming months. Collaboration between health systems, researchers, governments and professional societies is needed to support a robust LHS which grants the ability to rapidly adapt to global emergencies.
Mothers' and children's depression is linked through children's perceptions of attachment security
Authors: Hughes Jeffrey L. , Morrow Kayley E. , Spears Shantel K. , Gentzler Amy L.
Published: October 2020

This study investigated how mothers' depressive symptoms were related to their children's depressive symptoms through children's perceived attachment security to their mother. Ninety‐six mothers reported on their depressive symptoms. Children reported on their depressive symptoms and their attachment security with their mothers. The results indicated that children's perception of security with their mothers indirectly linked mothers' depressive symptoms to their children's depressive symptoms. Furthermore, this indirect association was moderated by child's sex because only girls, whose mothers reported higher depressive symptoms, reported lower perceived attachment security. This study advances the literature on mechanisms explaining how mothers' depressive symptoms are related to their children's depressive symptoms, which have critical implications for the prevention and intervention of child and adolescent depression.

Highlights

Mothers' depressive symptoms were related to children's depressive symptoms through children's perceptions of mother–child attachment security

One path in the indirect relation was moderated by child's sex such that maternal depression was associated with a less secure perceived attachment relationship for female youth but not male youth

Child depression interventions may be improved by targeting attachment relationships, with particular attention for daughters of depressed mothers
Lymphocyte‐activation gene 3 expression associates with poor prognosis and immunoevasive contexture in Epstein‐Barr virus‐positive and MLH1‐defective gastric cancer patients
Authors: Lv Kunpeng , Li Ruochen , Cao Yifan , Gu Yun , Liu Xin , He Xudong , Jin Kaifeng , Fang Hanji , Fei Yuchao , Shi Mingsu , Liu Hao , Li He , He Hongyong , Lin Chao , Zhang Heng , Xu Jiejie
Published: October 2020

Lymphocyte activation gene 3 (LAG‐3) is a transmembrane immune checkpoint that facilitates immune escape via suppressing T‐cell‐mediated anti‐tumor immunity. The role of LAG‐3 in gastric cancer is little known. Consequently, we assessed the clinical significance of LAG‐3 in gastric cancer. In our study, patients with gastric cancer from Zhongshan Hospital (n = 464) and data from the Asian Cancer Research Group (n = 300) were analyzed. LAG‐3+ cell infiltration and other immune contexture in gastric cancer were detected by immunohistochemistry. Kaplan‐Meier curves and log‐rank test were used for survival analyses. Intratumoral LAG‐3+ cells mainly accumulated in Epstein‐Barr virus (EBV)‐positive (EBV subtype) and MLH1‐defective (dMLH1 subtype) gastric cancer. Furthermore, LAG‐3+ cell infiltration was strongly associated with inferior clinical outcomes in patients with these two subtypes of gastric cancer. Moreover, we found intratumoral LAG‐3+ cell high infiltration was associated with an immunoevasive contexture featured by decreased IFN‐γ+ cells and perforin‐1+ cells, but increased regulatory T cells and M2‐like macrophages in EBV/dMLH1 subtype of gastric cancer. LAG‐3 was a poor prognostic factor and might be a potential immunotherapeutic target in EBV‐positive and MLH1‐defective gastric cancer.
A case of the world’s largest renal cell carcinoma
Authors: Takeda Kotaro , Murray Gina , Vohra Nasreen , Fallon John T
Published: October 2020

Introduction

Renal cell carcinoma is often discovered at an early stage due to the increased use of imaging studies in the current era; therefore, its presentation as a gigantic renal cell carcinoma is rarely encountered.

Case presentation

A 59‐year‐old male presented to our hospital due to dizziness, fatigue, and increasing abdominal distension. A computed tomography scan showed an extremely large mass occupying most of the abdomen and pelvis. Surgical resection of the mass was performed. The largely cavitary mass with fibrous capsule was 43 cm and 13.0 kg, and contained a large amount of necrotic tissue. A portion of the left kidney was identified at the periphery of the mass, indicating that the tumor was arising from the left kidney. The final pathologic diagnosis was type 1 papillary renal cell carcinoma.

Conclusion

To the best of our knowledge, this tumor is the world’s largest malignant renal tumor.
Effects of short‐duration treatment of cartilage with punicalagin and genipin and the implications for treatment of osteoarthritis
Authors: Elder Steven H. , Mosher Mark L. , Jarquin Paulino , Smith Preston , Chironis Andrea
Published: October 2020

Punicalagin (PA) not only binds type II collagen, but also blocks its MMP‐13‐mediated degradation, and genipin (GNP) is a collagen cross‐linking agent. We hypothesized that these drugs could mitigate the loss of cartilage if administered in the early phase of osteoarthritis, and experiments were designed to provide proof‐of‐concept. Porcine cartilage was exposed to both drugs in a manner designed to simulate intra‐articular (IA) injection. Based on penetration of PA into cartilage, the rate of drug diffusion was conservatively estimated at 2 μm per minute. GNP caused a measurable degree of cross‐linking, increased compressive resistance and coefficient of friction, and substantially inhibited degradation by collagenase, but not by hyaluronidase. Pre‐incubation of GNP with collagenase had no effect on enzymatic activity. PA did not cross‐link collagen nor affect the mechanical properties of cartilage. It did, however, increase resistance to degradation by collagenase and hyaluronidase. Furthermore, it reacted with collagenase in solution and inhibited its subsequent enzymatic activity. Effects of PA and GNP were not additive. The chondroprotective effect of semi‐weekly IA injections was investigated in the monoiodoacetate‐induced model of OA in rats. Quantitative histology suggested that injection of PA decreased the amount of cartilage lost compared to saline‐injected controls, and the addition of GNP made no difference. This study supports the notion that IA delivery of PA could mitigate OA‐induced cartilage erosion.
Solubilization of sodium 3‐amino‐2‐hydroxyanthraquinone‐1‐sulphonate in sodium dodecyl sulfate micelles explains its permeation in A549 human lung cancer cell
Authors: Banerjee Somenath , Roy Sanjay , Datta Arup , Mondal Palash , Mishra Monali , Perumalsamy Balaji , Thirumurugan Ramasamy , Dharumadurai Dhanasekaran , Das Saurabh , Guin Partha Sarathi
Published: October 2020

Abstract

Sodium 3‐amino‐2‐hydroxyanthraquinone‐1‐sulphonate (AQS) is an analogue of the anthracycline based chemotherapeutic drugs that was prepared as a part of the reported study. As the surfactant micelles mimics the biological membrane the present study comprises the interaction of AQS with an anionic surfactant, sodium dodecyl sulfate (SDS) in aqueous media at pH 7.4 which was monitored by using UV–Visible spectroscopy. The aim of the study is to see whether the present molecule penetrates a biological membrane. Different binding parameters like binding constant, partition coefficient, and corresponding Gibbs free energies of the interaction of AQS and its distribution between aqueous media and SDS micelles were measured. The study revealed that hydrophobic interactions play the most important role in binding of AQS to SDS micelles. To see whether AQS really permeates a biological membrane and induces apoptosis, it was allowed to interact with A549 human lung cancer cells. This study established the fact that AQS results apoptosis by means of nucleation into this cell.
Parametric Approaches in Population Pharmacokinetics
Authors: Guidi Monia , Csajka Chantal , Buclin Thierry
Published: October 2020

Population pharmacokinetic (popPK) approaches have spread widely throughout clinical pharmacology research, and every clinician should have some understanding of them. After a general introduction on the fundamentals and fields of application of these approaches, this review focuses on parametric popPK methods to provide the clinicians with the conceptual tools to interpret appropriately the results of parametric popPK analyses and to understand their clinical utility. The emphasis is put on the clinical questions that popPK methods are best suited to address. The basic principles of the methodology are introduced first, and then the main algorithms and reference software programs used in such analyses are presented. The description of data analysis and clinical applications of the parametric popPK approach (ie, use in simulations and therapeutic drug monitoring) are illustrated with the example of the antiretroviral drug efavirenz.
Pollen morphology of some species of the genus Cephalaria Schrad. (Caprifoliaceae) and its significance for taxonomy
Authors: Tsymbalyuk Zoya M. , Celenk Sevcan , Mosyakin Sergei L. , Nitsenko Lyudmila M.
Published: October 2020

Palynology gives the evidence for identification and elimination of taxonomically complex genera. Pollen morphology of nine species (three subg., three sect.) of the genus Cephalaria Schrad. was studied using light microscopy and scanning electron microscopy. Pollen grains of all investigated species are triporate, suboblate to subprolate (P/E = 0.75–1.28), and large‐sized (P = 58.52 μm–114.38, E = 63.84–119.70 μm). The outline of pollen grains in equatorial view is circular or elliptic, in polar view circular, circular‐triangular, or triangular. Pores are distinct, lolongate, elliptic, or circular, with an annulus, operculum, and distinct or indistinct, wide halo surrounding the aperture. Exine sculpture is echinate‐microechinate or echinate‐microechinate‐nanoechinate. Additional diagnostic characters at the species level in Cephalaria Schrad. that can be used for the purposes of taxonomy are size of pollen grains and pores, the shape of pores, the width of the annulus, structure of the exine, dimension of echini and microechini, location of microechini, and presence/absence of nanoechini. Palynomorphological data are compared with the taxonomical classification system of investigated taxa. It is shown that pollen grains morphology of the genus Cephalaria Schrad. is similar to the pollen morphology of the genus Dipsacus L., which confirms their inclusion in the Dipsaceae tribe.
The impact of genetic counseling on women's grief and coping following termination of pregnancy for fetal anomaly
Authors: Smith Cayleen , Hashmi Syed S. , Czerwinski Jennifer , Wagner Victoria F. , Promecene Pamela , Milentijevic Irena , Ramdaney Aarti
Published: October 2020

Pregnancy termination for fetal anomaly (TFA) is a unique experience that can cause women to develop long‐term complicated grief. Although a woman's experience with her healthcare providers has been previously identified as an important factor in coping, studies have shown that many women report their health care as lacking to some extent. Given the overlap in women's needs and the practice scope of a genetic counselor (GC), this study aimed to examine how genetic counseling may impact coping and explore women's expectations of GCs pre‐ and post‐TFA. An online survey, which included the brief COPE and the short version of the Perinatal Grief Scale, was distributed among private online support groups. Appropriate statistical analysis tools, such as the Wilcoxon rank‐sum and t test, were utilized for quantitative analysis of the 124 responses, and inductive content analysis was utilized for qualitative analysis. Of those who underwent TFA within the last two years, women who saw a GC utilized active coping, planning, and positive reframing significantly more than women who did not see a GC (p = 0.001, p = 0.031, p = 0.027, respectively). GCs were perceived to have a positive impact on coping when providing information, objective care, emotional support, support resources, and follow‐up care; these practices encouraged confidence in their personal decision‐making and gave women hope for the future. This study not only identified key counseling roles for GCs prior to a TFA, but also demonstrated that genetic counseling prior to TFA may be beneficial to coping. Further studies are warranted to explore the needs of a more diverse population and to identify appropriate genetic counseling training methods to support women pursuing TFA.
Surgical mask use by healthcare personnel to prevent COVID‐19 spread in a long‐term care facility
Authors: Abe Toshikazu , Tokuda Yasuharu , Iriyama Hiroki , Iwagami Masao , Komori Akira , Sugiyama Takehiro , Tamiya Nanako
Published: October 2020

Long‐term care facilities are a recognized high‐risk setting for severe outcomes during the coronavirus disease 2019 (COVID‐19) outbreak. This study describes a COVID‐19 outbreak in a long‐term care facility in Japan. The index case was a nurse who wore a surgical mask and used standard precautions. Of the 17 confirmed cases of COVID‐19, 14 (14/93, 15.1%) were residents and three (3/69, 4.3%) were healthcare personnel (HCP); no visitors tested positive 0 (0/22, 0.0%). Mask utilization by HCP was not much effective in preventing COVID‐19 transmission, even when interaction was not considered as being in close contact.
At the Bench: Pre-clinical evidence for multiple functions of CXCR4 in cancer
Authors: Luker Gary D , Yang Jinming , Richmond Ann , Scala Stefania , Festuccia Claudio , Schottelius Margret , Wester Hans-Jürgen , Zimmermann Johann
Published: October 2020

Signaling through chemokine receptor, C-X-C chemokine receptor type 4 (CXCR4) regulates essential processes in normal physiology, including embryogenesis, tissue repair, angiogenesis, and trafficking of immune cells. Tumors co-opt many of these fundamental processes to directly stimulate proliferation, invasion, and metastasis of cancer cells. CXCR4 signaling contributes to critical functions of stromal cells in cancer, including angiogenesis and multiple cell types in the tumor immune environment. Studies in animal models of several different types of cancers consistently demonstrate essential functions of CXCR4 in tumor initiation, local invasion, and metastasis to lymph nodes and distant organs. Data from animal models support clinical observations showing that integrated effects of CXCR4 on cancer and stromal cells correlate with metastasis and overall poor prognosis in >20 different human malignancies. Small molecules, Abs, and peptidic agents have shown anticancer efficacy in animal models, sparking ongoing efforts at clinical translation for cancer therapy. Investigators also are developing companion CXCR4-targeted imaging agents with potential to stratify patients for CXCR4-targeted therapy and monitor treatment efficacy. Here, pre-clinical studies demonstrating functions of CXCR4 in cancer are reviewed.
Evolutionary and functional substitution of extrinsic musculature in Solifugae (Arachnida)
Authors: Runge Jens , Wirkner Christian S.
Published: October 2020

The locomotory system of Solifugae is distinct from that of other Arachnida in several ways. Only three pairs of legs are involved in locomotion, while the first pair function as sensory appendages. Morphologically, the proximal region of the locomotory system in Solifugae is characterized by fused coxae. Within the prosoma of Solifugae, an endosternite is missing: in other Arachnida, this endosternite serves as the proximal attachment site for a portion of the extrinsic musculature. How then do these skeletal modifications influence the muscular anatomy in the proximal region of the locomotory system? To answer this question, we studied the skeletomuscular anatomy of Galeodes granti at the interface between the prosoma and legs, reinvestigating the complex muscular anatomy of this body region for the first time in over 80 years and—for the first time—using detailed micro‐computed tomography scans to analyze the skeletomuscular morphology. Specimens of three further species were checked for comparison. The analysis revealed differences in the number and composition of coxa‐trochanter muscles in each of the four pairs of legs. These are compared in the light of serial homology. The comparison between the proximal locomotory system of Solifugae and that of other Arachnida unveils a series of analogies. Primarily, the coxa‐trochanter joint is the most proximal joint to move the leg relative to the prosoma. Therefore, we argue that from a morpho‐functional point of view, the coxa‐trochanter muscles in Solifugae should be considered secondary extrinsic musculature. Thus, the legs gain a stable, articulated joint in the most proximal region of the leg to the prosoma, which might be advantageous for agile locomotion.
Increased occurrence of pathological mitochondria in astrocytic perivascular endfoot processes and neurons of idiopathic intracranial hypertension
Authors: Eide Per Kristian , Hasan‐Olive Md Mahdi , Hansson Hans‐Arne , Enger Rune
Published: October 2020

Idiopathic intracranial hypertension (IIH) primarily affects fertile, overweight women, and presents with the symptoms of raised intracranial pressure. The etiology is unknown but has been thought to relate to cerebrospinal fluid disturbance or cerebral venous stenosis. We have previously found evidence that IIH is also a disease of the brain parenchyma, evidenced by alterations at the neurogliovascular interface, including astrogliosis, pathological changes in the basement membrane and pericytes, and alterations of perivascular aquaporin‐4. The aim of this present electron microscopic study was to examine whether mitochondria phenotype was changed in IIH, particularly focusing on perivascular astrocytic endfeet and neurons (soma and pre‐ and postsynaptic terminals). Cortical brain biopsies of nine reference individuals and eight IIH patients were analyzed for subcellular distribution and phenotypical features of mitochondria using transmission electron microscopy. We found significantly increased prevalence of pathological mitochondria and reduced number of normal mitochondria in astrocytic endfeet of IIH patients. The degree of astrogliosis correlated negatively with the number of normal mitochondria in astrocytic endfoot processes. Moreover, we found significantly increased number of pathological mitochondria in pre‐ and postsynaptic neuronal terminals, as well as significantly shortened distance between mitochondria and endoplasmic reticulum contacts. Finally, the length of postsynaptic density, a marker of synaptic strength, was on average reduced in IIH. The present data provide evidence of pathological mitochondria in perivascular astrocytes endfeet and neurons of IIH patients, highlighting that impaired metabolism at the neurogliovascular interface may be a facet of IIH.
Expanded practice in rural community pharmacy in Australia: pharmacists’ perspectives
Authors: Taylor Selina , Cairns Alice , Glass Beverley
Published: October 2020

Background

Pharmacists internationally have successfully expanded their role to provide service delivery to remote rural communities.

Aim

This study evaluated Australian rural community pharmacists’ perspectives of expanded services, to identify priorities, areas of concern, enablers and barriers to their implementation.

Method

A self‐administered questionnaire was distributed to rural and remote Australian (all states and territories) pharmacists between September and December 2019; respondents were asked to rank health issues and the expanded pharmacy services that could potentially address these issues in their communities. Questions were also included to evaluate health service accessibility, skills/knowledge, workspace limitations, time and support for the implementation of these services. Potential associations between demographic factors and responses were also assessed.

Results

Of the 92 returned responses analysed, the top three heath concerns were: Mental health, Cardiovascular disease and Diabetes. Depression screening/referral, diabetes management and vaccinations were the top three areas rated for expanded services. There was agreement (90%; 83/92) that pharmacists had the skills and knowledge for implementation, while time and space were reported as barriers for 50% (46/92) and 25% (23/92) of pharmacists, respectively. The majority of the pharmacists (80%; 74/92) felt services were not easily accessible, and all (92/92, 100%) agreed that service provision would improve community health outcomes.

Conclusion

Rural pharmacists were supportive of the delivery of expanded pharmacy services, describing improved health outcomes and increased access to health services as potential benefits. Successful implementation of these expanded services would require both an understanding of pharmacist resources available and local community health needs.
Optimising health outcomes via pharmacist delivered telehealth medicines management: a systematic review
Authors: Lowry Samuel J. , Kay Charlotte N. , Marsom Erica N. , Park Joon Soo , Poole Susan , Page Amy T.
Published: October 2020

Background

Pharmacist‐led telehealth is an innovative service delivery model that may provide an alternative mode of care. It remains unclear how surrogate markers of health conditions differ when pharmacist services are delivered via telehealth compared to usual care.

Aims

To assess if pharmacist‐led telehealth interventions alter surrogate markers of health conditions.

Methods

Pharmacist‐led telehealth interventions compared to another active intervention for people using one or more regular medicines were included that reported surrogate markers of health conditions. Scopus, Embase, Medline and CINAHL were searched from inception to May 2020 to identify randomised controlled trials. Researchers screened articles to identify eligible studies, then data were extracted using a standardised data collection sheet. Quality assessment was undertaken using the Cochrane risk of bias tool. Data were reported as risk ratio and mean difference with corresponding 95% confidence intervals.

Results

Of 1896 titles identified, 11 studies met the inclusion criteria. Telehealth interventions by pharmacists consisted of multifaceted interventions with contact over differing time durations. Some blood pressure and oral anticoagulation clinical outcomes were improved in the pharmacist‐led telehealth group compared to the control group. However, the majority of outcomes were similar in both groups.

Conclusion

This study identified that pharmacist‐led telehealth interventions for a select range of chronic health conditions provides an acceptable adjunct to usual care and results in similar health outcomes for surrogate markers when compared to usual care.
Neoadjuvant therapy versus upfront surgery for early‐stage left‐sided pancreatic adenocarcinoma: A propensity‐matched analysis from a national cohort of distal pancreatectomies
Authors: Nassour Ibrahim , Adam Mohamed A. , Kowalsky Stacy , Al Masri Samer , Bahary Nathan , Singhi Aatur D. , Lee Kenneth , Zureikat Amer , Paniccia Alessandro
Published: October 2020

Background

There are limited data on the efficacy of neoadjuvant therapy (NAT) for early‐stage distal pancreas adenocarcinoma (PDAC). Previous studies focused on adenocarcinoma of the head of the pancreas or dealt with borderline and locally advanced tumors of the body and tail.

Methods

This is a retrospective study of the National Cancer Database between 2006 and 2015. A propensity‐matched analysis was performed to compare overall survival estimates between NAT and upfront resection (UR) groups.

Results

A total of 5003 distal pancreatectomies for PDAC were identified, of whom 408 (9%) received NAT. After 1:1 matching, 353 NAT patients were compared with 353 UR patients. NAT was associated with lower 90‐day mortality. There were no differences in the number of lymph nodes retrieved, or length of stay. With matching, the NAT group had higher median overall survival compared with UR (33.0 vs. 27.0 months; p = 0.009) and adjusted overall survival (hazard ratio = 0.63, 95% confidence interval = 0.51‐0.77; p < 0.001).

Conclusion

The receipt of NAT followed by distal pancreatectomy for early‐stage distal PDAC is associated with improved overall survival compared with UR. This study supports the use of NAT in the multimodal therapy paradigm of early‐stage adenocarcinoma of the body and tail of the pancreas.
Bond additivity corrections for CBS‐QB3 calculated standard enthalpies of formation of H, C, O, N, and S containing species
Authors: Pappijn Cato A.R. , Vermeire Florence H. , Van de Vijver Ruben , Reyniers Marie‐Françoise , Marin Guy B. , Van Geem Kevin M.
Published: October 2020

A prerequisite for the generation of detailed fundamental kinetic models is the availability of accurate thermodynamic properties. To address the scarcity of accurate experimental data, theoretical calculations can be used. The accuracy of these quantum chemistry methods for determination of thermodynamic properties can be improved by making use of empirical correction methods, such as the isodesmic bond additivity correction (BAC) method. In this work, ab initio calculations for a set of 371 molecules have been performed to determine a new set of BACs for the CBS‐QB3 level of theory. For each of these molecules also accurate experimental data, that is with an experimental uncertainty less than 3 kJ mol−1, is available. This broad dataset of hydrocarbons and heteroatomic compounds contains (non)cyclic molecules with a wide range of functional groups consisting of hydrogen, carbon, oxygen, nitrogen, and sulfur. The new set of 26 BAC parameters is obtained via linear regression analysis, minimizing the differences between experimental and corrected CBS‐QB3 values. The CBS‐QB3 method combined with BACs succeeds in approximating the experimental standard enthalpy of formation at 298 K with an accuracy of 4 kJ mol−1 for almost all species. The BACs reduce the mean absolute deviation for the complete dataset from 5.65 to 2.37 kJ mol−1, corresponding to a decrease of the root mean square deviation from 6.95 to 3.00 kJ mol−1.
Adherence to Subspecialty Guidelines in the Emergency Department
Authors: Taufique Zahrah , Timen Micah , Swartz Jordan L. , Friedmann David R.
Published: October 2020

Objectives/Hypothesis

The American Academy of Otolaryngology‐Head and Neck Surgery has published clinical practice guidelines (CPGs) to guide management of common otolaryngologic (ENT) conditions. While these CPGs have been disseminated within specialty journals, many patients' first presentation of certain ENT complaints is to primary and acute care settings, including the emergency department (ED). It is less clear whether practice in these settings is concordant with specialty CPGs.

Study Design

Retrospective cohort study.

Methods

A retrospective review of medical records was performed at an academic tertiary care center with ED diagnoses of 1) Bell's palsy/facial weakness (BP) or 2) acute otitis externa (AOE) from May 2014–June 2018. Individual chart abstraction was performed for all encounters with these diagnoses for the purpose of assessing providers' adherence to CPGs.

Results

During the study period, 224 patients were diagnosed with BP and 465 patients were diagnosed with AOE. Of the patients diagnosed with BP, 94% (n = 211/224) were prescribed oral steroids, concordant with guidelines, while 36% of these patients received head computed tomography (CT) scans and 43% received laboratory tests, counter to the guidelines. For those with a diagnosis of AOE, 28.6% received topical antibiotics only as primary treatment (n = 133/465) in accordance with guidelines while systemic antibiotics were prescribed in 42.2% (n = 196/465) discordant with the guidelines and 29.2% received both topical and systemic antibiotics (n = 136/465).

Conclusions

CPGs developed by subspecialty societies provide evidence‐based recommendations for the care of patients with particular conditions, but may not be disseminated broadly outside of the specialty. Further research is required to understand the reasons behind divergent management of such conditions.

Level of Evidence

3 Laryngoscope, 131:1266–1270, 2021
Is Ethmoidal Air Cell Count Relevant in Chronic Rhinosinusitis?
Authors: Meier Eva C. , Terryn Stefanie L. , Binz Gregori H. A. , Meerwein Christian M. , Soyka Michael B.
Published: October 2020

Objectives/Hypothesis

Studies analyzing the association between the total number of ethmoid cells (EC) and chronic rhinosinusitis (CRS) are missing. Our aim was to analyze the total number of EC in patients with and without CRS.

Study Design

Retrospective case‐control study.

Methods

A total of 50 computed tomography (CT) scans of patients with CRS, 14 CT scans of patients with odontogenic CRS, and 50 CT scans of healthy controls were retrospectively analyzed. The number of EC has been determined for each side separately.

Results

In total 228 sides have been analyzed. The bilateral total EC count in both planes was more than 2 cells higher, when comparing CRS patients to healthy controls or odontogenic CRS patients (P < .01). No difference was observed, when comparing healthy and odontogenic CRS patients.

Conclusion

The number of EC on CT of CRS patients is significantly higher than in both, the healthy and the odontogenic CRS control group. Cell count could contribute to the pathogenesis of CRS.

Level of Evidence

4 Laryngoscope, 131:1212–1216, 2021
Shift in the larval phenology of a marine ectotherm due to ocean warming with consequences for larval transport
Authors: McGeady Ryan , Lordan Colm , Power Anne Marie
Published: October 2020

Because environmental temperature has an important influence on developmental rate and physiology, marine ectotherms are vulnerable to phenology changes due to ocean warming. Identifying changes to phenology, the timing of biological events, and understanding their effect on recruitment and abundance is of critical importance to establish potential population effects. We examined the larval phenology of the commercially important Norway lobster (Nephrops norvegicus) and used a larval transport model to examine its effect on simulated transport patterns. Using a model to estimate annual larval release dates based on temperature‐dependent embryo incubation, an earlier shift of 17.2 d occurred between 1982–1995 and 2000–2010 in the Irish Sea, similar to an observed empirical shift in phenology of 19.1 d using historical zooplankton data sets. Despite this earlier phenology, temperature‐dependent pelagic larval durations were unchanged because the water column to which larvae were released earlier had also warmed. Larval transport simulations in the western Irish Sea indicated that the phenology shift had minimal effects on larval retention and advection distance overall, because major variations were observed only at very early or late stages of the larval season, that is, times when lower proportions of larvae were present. As the western Irish Sea grounds exports small but consistent quantities of larvae to nearby populations, especially off Scotland, it may act as an important source of larvae, especially when retention of native larvae is low. Overall, larval transport tools may indicate grounds that are periodically vulnerable to recruitment failures and offer potentially valuable information in fishery management.