bluuebunny/crossref_metadata_2025 huggingface dataset:
Quarantines: Between Precaution and Necessity. A Look at COVID-19
Authors: Raposo Vera Lúcia
Published: December 2020

The events surrounding COVID-19, combined with the mandatory quarantines widely imposed in Asia and Europe since the virus outbreak, have reignited discussion of the balance between individual rights and liberties and public health during epidemics and pandemics. This article analyses this issue from the perspectives of precaution and necessity. There is a difficult relationship between these two seemingly opposite principles, both of which are frequently invoked in this domain. Although the precautionary principle (PP) encourages the use of quarantines, including mandatory quarantines, and associated restrictive measures, the principle of necessity (PN) puts a break on such measures. The COVID-19 pandemic reveals once again the different interrelations between these two principles. However, the alleged conflict between the PN and the PP is based on a superficial analysis. The relation between these two principles is far more complex, as this article will demonstrate.
Pain Induced Changes in Brain Oxyhemoglobin: A Systematic Review and Meta-Analysis of Functional NIRS Studies
Authors: Hall MacGregor , Kidgell Dawson , Perraton Luke , Morrissey Jack , Jaberzadeh Shapour
Published: December 2020

Background

Neuroimaging studies show that nociceptive stimuli elicit responses in an extensive cortical network. Functional near-infrared spectroscopy (fNIRS) allows for functional assessment of changes in oxyhemoglobin (HbO), an indirect index for cortical activity. Unlike functional magnetic resonance imaging (fMRI), fNIRS is portable, relatively inexpensive, and allows subjects greater function. No systematic review or meta-analysis has drawn together the data from existing literature of fNIRS studies on the effects of experimental pain on oxyhemoglobin changes in the superficial areas of the brain.

Objectives

To investigate the effects of experimental pain on brain fNIRS measures in the prefrontal-cortex and the sensory-motor-area; to determine whether there is a difference in oxyhemodynamics between the prefrontal-cortex and sensory-motor-area during pain processing; to determine if there are differences in HbO between patients with centralized persistent pain and healthy controls.

Methods

Studies that used fNIRS to record changes in oxyhemodynamics in prefrontal-cortex or sensory-motor-cortex in noxious and innoxious conditions were included. In total, 13 studies were included in the meta-analysis.

Results

Pain has a significantly greater effect on pre-frontal-cortex and sensory-motor areas than nonpainful stimulation on oxyhemodynamics. The effect of pain on sensory-motor areas was greater than the effect of pain on the prefrontal-cortex. There was an effect of centralized pain in the CPP group on oxyhemodynamics from a noxious stimulus compared to control’s response to pain.

Conclusions

Pain affects the prefrontal and sensory-motor cortices of the brain and can be measured using fNIRS. Implications of this study may lead to a simple and readily accessible objective measure of pain.
PEDIATRIC REGIONAL DRL ASSESSMENT IN COMMON CT EXAMINATIONS FOR MEDICAL EXPOSURE OPTIMIZATION IN TEHRAN, IRAN
Authors: Tahmasebzadeh Atefeh , Paydar Reza , Soltani kermanshahi Mojtaba , Maziar Asghar , Rezaei Mehdi , Reiazi Reza
Published: December 2020

The main purpose of this pilot study was to assess the regional diagnostic reference level (RDRL) of computed tomography (CT) examinations to optimise medical exposure in five pediatric medical imaging centers in Tehran, Iran where the most frequent CT examinations were investigated. For each patient, CT volume dose indexes (CTDIvol) and dose length product (DLP) in each group were recorded and their third quartile was calculated and set as RDRL. Pediatrics were divided into four age groups (<1; 1–5; 5–10 and 10–15 years). Then, the third quartile values for head, chest and abdomen-pelvic CTs were, respectively, calculated for each group in terms of CTDIvol: 21.3, 24.4, 24.2 and 36.3 mGy; 2.9, 3.2, 3.7 and 5.7 mGy; 3.7, 5.7, 6.3 and 6.8 mGy; and in terms of DLP: 322.2, 390.1, 424.9 and 694.1 mGy.cm; 53.1, 115.2, 145.3 and 167.6 mGy.cm and 128.7, 317.7, 460.2 and 813.8 mGy.cm. Finally, RDRLs were compared with other countries and preceding data in Iran. As a result, CTDIVOL values were lower than other national and international studies except for chest and abdomen-pelvic values obtained in Europe. Moreover, this matter applied to DLP so that other formerly reported values were higher than the present study but European values for chest and abdomen-pelvic scans and also Tehran studies conducted in 2012. Variation of scan parameters (tube voltage (kVp), tube current (mAs) and scan length), CTDIvol and DLP of different procedures among different age groups were statistically significant (P-value < 0.05). The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimization of examinations relative to which this study provides helpful data.
Phylogenomic Analysis of Ultraconserved Elements Resolves the Evolutionary and Biogeographic History of Segmented Trapdoor Spiders
Authors: Xu Xin , Su Yong-Chao , Ho Simon Y W , Kuntner Matjaž , Ono Hirotsugu , Liu Fengxiang , Chang Chia-Chen , Warrit Natapot , Sivayyapram Varat , Aung Khin Pyae Pyae , Pham Dinh Sac , Norma-Rashid Y , Li Daiqin
Published: December 2020

The segmented trapdoor spiders (Liphistiidae) are the sole surviving family of the suborder Mesothelae, which forms the sister lineage to all other living spiders. Liphistiids have retained a number of plesiomorphic traits and their present-day distribution is limited to East and Southeast Asia. Studying this group has the potential to shed light on the deep evolutionary history of spiders, but the phylogeny and divergence times of the family have not been resolved with confidence. We performed phylogenomic and molecular dating analyses of 2765 ultraconserved element loci from 185 liphistiid taxa. Our analyses show that the crown group of Liphistiidae appeared in the mid-Cretaceous at 102 Ma (95% credibility interval 92–113 Ma), but it was not until the Neogene that much of the diversification within the family occurred in mainland Southeast and East Asia. This diversification was coincident with tectonic events such as the extension of the East Asian continental margin, as well as geological upheavals in Indochina induced by the collision between India and Asia. Our study highlights the important role of major tectonic events in shaping the evolutionary history, present-day diversity, and geographical distribution of mesothele and liphistiid spiders. [biogeography; concatenation; Liphistiidae; molecular dating; summary coalescent; UCEs.]
A target safety assessment of the potential toxicological risks of targeting plasmepsin IX/X for the treatment of malaria
Authors: Barber Jane , Sikakana Phumzile , Sadler Claire , Baud Delphine , Valentin Jean-Pierre , Roberts Ruth
Published: December 2020

The aspartic proteases plasmepsin IX/X are important antimalarial drug targets due to their specificity to the malaria parasite and their vital role as mediators of disease progression. Focusing on parasite-specific targets where no human homologue exists reduces the possibility of on-target drug toxicity. However, there is a risk of toxicity driven by inadequate selectivity for plasmepsins IX/X in Plasmodium over related mammalian aspartic proteases. Of these, CatD/E may be of most toxicological relevance as CatD is a ubiquitous lysosomal enzyme present in most cell types and CatE is found in the gut and in erythrocytes, the clinically significant site of malarial infection. Based on mammalian aspartic protease physiology and adverse drug reactions (ADRs) to FDA-approved human immunodeficiency virus (HIV) aspartic protease inhibitors, we predicted several potential toxicities including β-cell and congenital abnormalities, hypotension, hypopigmentation, hyperlipidaemia, increased infection risk and respiratory, renal, gastrointestinal, dermatological, and other epithelial tissue toxicities. These ADRs to the HIV treatments are likely to be a result of host aspartic protease inhibition due a lack of specificity for the HIV protease; plasmepsins are much more closely related to human CatD than to HIV proteinase. Plasmepsin IX/X inhibition presents an opportunity to specifically target Plasmodium as an effective antimalarial treatment, providing adequate selectivity can be obtained. Potential plasmepsin IX/X inhibitors should be assayed for inhibitory activity against the main human aspartic proteases and particularly CatD/E. An investigative rodent study conducted early in drug discovery would serve as an initial risk assessment of the potential hazards identified.
Effects of chlorpyrifos exposure on liver inflammation and intestinal flora structure in mice
Authors: Zhang Yecui , Jia Qiang , Hu Chenyang , Han Mingming , Guo Qiming , Li Shumin , Bo Cunxiang , Zhang Yu , Qi Xuejie , Sai Linlin , Peng Cheng
Published: December 2020

Chlorpyrifos (CPF) is an organophosphate insecticide commonly used to treat fruit and vegetable crops. CPF can cause severe adverse effects on body organs including the liver and central nervous system. This study investigated the CPF-induced inflammation in mice and explored the role of intestinal flora changes in liver inflammation. Adult C57BL/6 male mice were exposed to a CPF of 0.01-, 0.1-, 1- and 10-mg/kg bodyweight for 12 weeks. The mice in experimental group given CPF solution dissolved in corn oil vehicle by gavage, was administered by intraoral gavage for 5 days per week for 12 weeks. Histopathological examination and inflammatory factor detection were performed on mice liver tissue. Faeces were used for 16S ribosomal RNA high-throughput sequencing to explore the impact of CPF on intestinal flora structure and diversity. The results showed that 1- and 10-mg/kg CPF caused different degrees of liver focal inflammation. The structure of intestinal flora changed significantly in mice including the decreased beneficial bacteria (Akkermansia, Prevotella and Butyricimonas) and increased pathogenic bacteria (Helicobacter and Desulfovibrio). Meanwhile, the results of Q-RT-PCR showed that there was more total bacterial DNA in the liver tissue of the mice treated with 10-mg/kg groups. In conclusion, the imbalance of intestinal flora, the decreased abundance of beneficial bacteria and the increased abundance of pathogenic bacteria, as well as the increase of total bacterial DNA in the liver tissues, maybe associated with the liver focal inflammation induced by CPF.
Field Production, Germinability, and Survival of Puccinia striiformis f. sp. tritici Teliospores in China
Authors: Chen Wen , Zhang Zedong , Chen Xianming , Meng Yan , Huang Lili , Kang Zhensheng , Zhao Jie
Published: December 2020

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici, has been recently demonstrated to be heteroecious and macrocyclic. The pathogen depends on wheat as the primary (telial) host and barberry as the main alternative (aecial) host to complete the complete life cycle. Viable teliospores are essential for the initiation of sexual reproduction of P. striiformis f. sp. tritici. However, no exact source of viable teliospores has been discovered to produce basidiospores to initiate infection on susceptible barberry. In the present study, we investigated the telial production and teliospore germinability of P. striiformis f. sp. tritici in wheat fields in Gansu and Qinghai provinces and wheat straw stacks in Qinghai in 2018 and 2019. Field production of P. striiformis f. sp. tritici teliospores was observed commonly at all growth stages of winter and spring wheat plants. The percentage of leaves bearing viable teliospores and germination rate of P. striiformis f. sp. tritici teliospores were 78.5 and 5.1% at tillering stage, 83.2 and 9.4% at early jointing stage, and 91.8 and 4.9% after booting stage in 2018 and 2019, respectively. Among wheat straw samples bearing telia collected from Qinghai province, samples with germinable teliospores ranged from 23.9% in January to 4.4% in June in 2018 and from 10.3% in January to 6.0% in May in 2019, with an overall mean germinability of 5.9%. This study showed that teliospores are produced at all growth stages of wheat under field conditions, and teliospores harbored in wheat straw stacks after wheat harvest are able to survive through winter for potential infection of barberry to the next spring.
Choice of biologics in asthma endotypes
Authors: Wangberg Hannah , Woessner Katharine
Published: December 2020

Purpose of review

The aim of this study was to highlight the phenotypes and endotypes of asthma as a tool for selection of the Food and Drug Administration approved biologic therapies.

Recent findings

An evolving concept of asthma has led to the identification of distinct phenotypes and endotypes in this disease. Asthma endotypes are defined as the biological mechanism and are often categorized as T2-high and T2-low based on the influence of T helper type 2 (T2) cells and type 2 cytokines, including interleukin (IL)-4, IL-5, IL-9 and IL-13. Biomarkers such as peripheral blood absolute eosinophil count, total IgE, specific IgE and fractional exhaled nitric oxide may be used as indicators of asthma endotypes and help predict response to biologic therapies. There are currently five biologic therapies approved as a treatment option for T2-high asthma: omalizumab, benralizumab, mepolizumab, reslizumab and dupilumab.

Here, we explore the current understandings of asthma endotypes and review their associated phenotypes. We provide practical and evidence-based guidance for clinicians considering a biologic for asthma add-on maintenance therapy.
Low- and Middle-Income Country Host Perceptions of Short-Term Experiences in Global Health: A Systematic Review
Authors: Lu Paul M. , Mansour Rania , Qiu Maylene K. , Biraro Irene A. , Rabin Tracy L.
Published: December 2020

Purpose

Stakeholders have expressed concerns regarding the impact of visiting trainees and physicians from high-income countries (HICs) providing education and/or short-term clinical care in low- and middle-income countries (LMICs). This systematic review aimed to summarize LMIC host perceptions of visiting trainees and physicians from HICs during short-term experiences in global health (STEGH).

Method

In September 2018 then again in August 2020, the authors searched 7 databases (PubMed, Embase, Scopus, Web of Science, ERIC, Cochrane Library, Global Index Medicus) for peer-reviewed studies that described LMIC host perceptions of STEGH. They extracted information pertaining to study design, participant demographics, participant perceptions, representation of LMICs and HICs, and HIC visitors’ roles and used thematic synthesis to code the text, develop descriptive themes, and generate analytical themes.

Results

Of the 4,020 studies identified, 17 met the inclusion criteria. In total, the studies included 448 participants, of which 395 (88%) represented LMICs. The authors identified and organized 42 codes under 8 descriptive themes. They further organized these descriptive themes into 4 analytical themes related to STEGH: (1) sociocultural and contextual differences, (2) institutional and programmatic components, (3) impact on host institutions and individuals, and (4) visitor characteristics and conduct.

Conclusions

STEGH can have both beneficial and detrimental effects on LMIC host institutions and individuals. The authors translated these findings into a set of evidence-based best practices for STEGH that provide specific guidance for LMIC and HIC stakeholders. Moving forward, LMIC and HIC institutions must work together to focus on the quality of their relationships and create conditions in which all stakeholders feel empowered to openly communicate to ensure equity and mutual benefit for all parties.
Unique Variant of Cerebrotendinous Xanthomatosis Presenting With Eyelid Involvement Due to Heterozygous CYP7A1 and SLC10A1 Gene Mutations
Authors: Krbanjevic Aleksandar , Lekakh Olga , Kadkol Shrihari , Mohapatra Gayatry , Gushchin Anna
Published: December 2020

We report a case of a novel phenotypic variant of cerebrotendinous xanthomatosis (CTX) with an adult onset, caused by 2 coexisting mutations involving the CYP7A1 and SLC10A1 genes. A 49-year-old male patient presented with eyelid xanthomatosis associated with dermatochalasis, nystagmus, right-sided paresis with hyperreflexia and atypical parkinsonism. Bilateral xanthomatous plaques involving both Achilles tendons were subsequently detected. Histopathology of the eyelids demonstrated marked diffuse stromal infiltrates of prominent foamy histiocytes. His lipid profile showed only a slightly elevated non-high density lipoprotein cholesterol level but with normal cholesterol and cholestanol levels. By contrast, classic CTX characteristically demonstrates a markedly elevated cholestanol and a mutation involving the CYP27A1 gene for enzyme cholesterol 27-hydroxylase. Unexpectedly, molecular studies on this patient revealed a heterozygous mutation involving 2 different genes, namely, CYP7A1 and SLC10A1 genes. The CYP7A1 gene encodes for the enzyme cholesterol 7α-hydroxylase, which is a rate-limiting enzyme in the cholesterol degradation. The SLC10A1 Na+/taurocholate cotransporter gene is involved in the enterohepatic circulation of bile acids and for the hepatocyte uptake of cholesterol. We are the first to report an unusual case of an adult-onset CTX manifesting with eyelid xanthomas associated with an uncharacteristic lipid profile and a detection of novel heterozygous mutations of CYP7A1 and SLC10A1 genes in this neurocutaneous syndrome.
Information tools for care coordination in patient handover: Is an electronic medical record enough to support nurses?
Authors: Ghosh Kaushik , Dohan Michael S. , Curl Eileen , Goodwin Mary , Morrell Patricia , Guidroz Paul
Published: December 2020

Background

Effectiveness of end-of-shift patient handover between nurses may be impacted by poor communication. This can be improved with the use of information tools, either electronic or paper-based. Few studies have investigated the activities that support patient handover, and fewer have explored how several of these tools used together affects the handover process.

Purpose

The aim of this study was to understand coordination challenges in end-of-shift patient handover between nurses and the influence of multiple information tools used in that context.

Methodology

A qualitative methodology to investigate phenomena in an acute care hospital in the United States was used in this study. Semistructured interviews were used to elicit insights from 16 nurses. Data were analyzed by coding three types of task dependencies (prerequisite, simultaneous, and shared) and three information tools (electronic medical records [EMRs], Kardex, and printouts of EMR data).

Results

In preparation for a handover, nurses were burdened by ensuring that information in the EMR was correct and complete. A one-sheet Kardex was the tool nurses in the study preferred, because the essential information was at hand and it provided structure to the communication. Printouts of EMR data were often physically cumbersome and not useful in their current form, although they may be useful for communicating anomalous data.

Conclusion

This study provides insights regarding the challenges of care coordination in end-of-shift patient handover between nurses and the usages of a variety of information tools in preparation for handover, as well as the actual handover process.

Practice Implications

Multiple interrelated information tools may be used to support patient handover. Health leaders should focus efforts on further advancing protocols for end-of-shift nurse handovers. Health system designers should design information tools to align them with their defined purpose in the handover process. Future work should consider both the information needs of nurses and the goal of improving nurse workflows.
The Effect of Reflexology on Low Back Pain in Operating Room Nurses
Authors: Kandemir Didem , Abdullayev Ayşegül , Seyhan Ak Ezgi , Altun Uğraş Gülay , Kanan Nevin
Published: December 2020

Operating room nurses often face acute or chronic back and low back pains, shoulder and neck injuries. In recent years, the use of complementary and alternative treatment methods has been increasing due to the fact that pharmacological treatment cannot control the pain in general, and its various side effects and cost. The aim of this study was to investigate the effect of foot reflexology on low back pain of operating room nurses. This quasiexperimental study was conducted with 38 operating room nurses. The nurses in the experimental group were given a 30-minute reflexology protocol once a week for 4 weeks and their pain levels were assessed again at week 5. The control group nurses did not receive any intervention. Data were collected using a demographic information form and a visual analog scale (VAS). The low back pain of the nurses in the reflexology group decreased significantly at week 5 compared with week 1, whereas the severity of low back pain of the nurses in the control group did not change between weeks 1 and 5. There were no statistically significant differences between the groups in terms of the mean VAS pain score at week 1. However, the nurses in the reflexology group had significantly lower VAS pain mean scores at week 5 than the control group. In this study, reflexology significantly reduced the pain of nurses who had low back pain. Therefore, reflexology might be useful in controlling low back pain of operating room nurses.
Extending the Limbus-to-Cannula Distance to 6.0 mm During Pars Plana Vitrectomy in Highly Myopic Eyes
Authors: Iwama Yasuaki , Ikeda Toshihide , Nakashima Hiroshi , Matsumoto Eri , Inoue Ryo , Emi Kazuyuki
Published: December 2020

Purpose:

To evaluate the utility of extending the limbus-to-cannula distance to 6.0 mm during pars plana vitrectomy for highly myopic eyes.

Methods:

Four eyes with axial lengths exceeding 31.0 mm, that underwent 25-gauge pars plana vitrectomy were retrospectively evaluated. Assuming that cannulas were inserted 3.5 mm and 6.0 mm from the corneal limbus, the distance from the cannula to the fovea (CF distance) was preoperatively evaluated using anterior segmental optical coherence tomography. Surgical complications were also investigated.

Results:

The CF distance was shortened by 1.22 ± 0.05 mm and 1.22 ± 0.09 mm on the temporal and nasal sides, respectively, by inserting the cannula at 3.5 mm to 6.0 mm from the corneal limbus. As per the preoperatively measured CF distance, one of the cannulas was inserted 6.0 mm from the corneal limbus in three eyes. Their cannulas were confirmed to be inserted at the pars plana, and no surgical complications associated with this technique were observed.

Conclusion:

Extending the limbus-to-cannula distance to 6.0 mm during pars plana vitrectomy could be one of the options to reach the posterior pole in highly myopic eyes. A preoperatively measured CF distance can be a clinical criterion in determining the cannula position.
PROGRESSION OF PARTIAL POSTERIOR VITREOUS DETACHMENT OVER TIME
Authors: Koller Elizabeth C. , Kraker Jessica A. , Hwang Eileen S.
Published: December 2020

Purpose:

We investigated interindividual differences in the rate of change of posterior vitreous detachment (PVD) stage and vitreomacular adhesion area (VMAA). Crosssectional studies demonstrated increasing PVD stage and decreasing VMAA with age, but population-level means may mask interindividual variation in the rate of change.

Methods:

We retrospectively evaluated PVD stage and VMAA in asymptomatic eyes of subjects who underwent repeated optical coherence tomography screening for high-risk medication use or isolated retinal disease in the fellow eye. A Turnbull estimator modeled changes in the PVD stage, and linear mixed models evaluated VMAA change.

Results:

We evaluated 101 eyes of 101 subjects. Seventy-six eyes remained in the same stage. Twenty-three eyes progressed to a higher stage. Modeling of longitudinal data predicts that at age 30, time to convert to Stage 4 is 26 years; at age 40, it is 16 years; at age 50, it is 9 years; and at age 60, it is 8 years. In 37 eyes with Stage 1 partial PVD, VMAA decreased at a similar rate. The average population level decline in VMAA was 0.13 mm2/year.

Conclusion:

Individuals vary in age at which they progress to complete PVD. In early partial PVD, VMAA decreases at a similar rate across individuals.
Factors Affecting the Intent to Use HIV Testing Services of Filipino Men Who Have Sex With Men: A Structural Equation Model
Authors: Calaguas Noriel P.
Published: December 2020

In recent years, the Philippines has seen significant increases in the uptake of HIV testing services (HTSs) but considerably lags in achieving the 2030 goal of achieving 90% of the people knowing their HIV status. The purpose of this study was to determine the utility of the Health Belief Model, using partial least squares structural equation modeling (PLS-SEM), in identifying factors that affect the intentions of Filipino men who have sex with men to seek and get tested for HIV. A sample of 471 Filipino men who have sex with men completed the web-based survey. The mean age of the participants was 25.93 years (SD = 6.02), with a majority reporting having been tested at least once (n = 349; 74.10%) and planning to follow-up with HTS providers in 3 months (73.4%; n = 386). The final model was identified that predicted HTS utilization (R
2 = 0.08); self-efficacy, perceived susceptibility, and benefits were most predictive of HTS utilization. The model produced may be useful in identifying gaps in HTS program planning and implementation.
Employers' and Employees' Perspectives of HIV Self-Testing at Male-Dominated Work Sites and Linkage to Posttest Services in Uganda
Authors: Muwanguzi Patience A. , Nasuuna Esther M. , Osingada Charles Peter , Seruwagi Gloria K. , Nuwagira Edwin , Kiwanuka Noah , Nelson LaRon E. , Sewankambo Nelson K.
Published: December 2020

This study explored men's views of workplace-based HIV self-testing and the barriers and facilitators of linkage to posttest services. Six focus group discussions and individual in-depth interviews were held with employers and employees in private security companies in Uganda (N = 70). Using content analysis, five categories emerged. The first category was the mitigation of potential harm, including reduction of stigma and discrimination, and the need for posttest support. The second category was a perceived need for on-site services where the men proposed on-site prevention services and HIV treatment and care. In the third category, which was strengthening linkage mechanisms, participants proposed expanded clinic hours, improved health facility efficiency, and provision of referral documentation. The fourth and fifth categories were organizational support and social support, respectively. There is need for employers and employees to work together for the success of workplace-based HIV initiatives.
My Whole World Changed: A Qualitative Exploration of the Coping Experiences of Transgender Women After an HIV Diagnosis
Authors: Hines Dana D. , Draucker Claire Burke , Habermann Barbara
Published: December 2020

The aim of this study was to generate a theoretical stage model that describes transgender women's coping strategies and responses after a new HIV diagnosis. The sample included 18 transgender women living with HIV in a large metropolitan city in central Indiana. Semi-structured interviews were conducted, digitally recorded, transcribed verbatim, and analyzed using grounded theory methods. Participants commonly described the experience of being newly diagnosed with HIV as, having the world change. Four stages through which attempts at coping occurred were identified: having the world come crashing down; shutting out the world; living in a dark world; and reconstructing the world. This model advances our understanding of the social and behavioral factors that influence how transgender women cope with a new HIV diagnosis and how their coping responses influence entry and engagement in the HIV care continuum.
Utility of the Frontal Lobe Epilepsy Parasomnia Scale in Evaluation of Children With Nocturnal Events
Authors: Maytum Jennifer , Garcia John , Leighty Denise , Belew John
Published: December 2020

BACKGROUND: Sleep-related hypermotor epilepsy (SHE) and nocturnal non–rapid eye movement parasomnias are difficult to differentiate. Neurologists and sleep medicine clinicians largely rely on clinical history when evaluating nocturnal spells. When the diagnosis is in question, referral for video electroencephalogram monitoring is the standard. However, there are no guidelines as to when this evaluation is needed. The Frontal Lobe Epilepsy Parasomnia (FLEP) scale was developed to assist clinicians in differentiating the two among adults. The aim of this study was to provide a preliminary evaluation of the FLEP for use with children. METHODS: This was a retrospective pilot instrument validation study with a convenience sample of 17 children seen in neurology or sleep medicine clinics. To determine concurrent validity, FLEP scores were compared with clinical diagnoses by neurology providers confirmed by electroencephalography. RESULTS: With a cutoff score of 2, the modified FLEP distinguished between children with and without SHE. The FLEP tool had a specificity of 0.58, implying that 7 of the 12 children without SHE would have been accurately recommended to follow up for parasomnia management rather than more urgent evaluation of potential frontal lobe epilepsy. CONCLUSIONS: With some minor adaptations for children, the FLEP satisfactorily distinguished between SHE and non-SHE patients.
Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients
Authors: Jang Soobin , Ko Youme , Sasaki Yui , Park Sunju , Jo Junyoung , Kang Na-Hoon , Yoo Eun-Sil , Park Nam-Chun , Cho Seong hee , Jang Heejea , Jang Bo-Hyoung , Hwang Deok-Sang , Ko Seong-Gyu
Published: December 2020

Background:

Although randomized controlled trials have revealed the considerable effectiveness of acupuncture in breast cancer patients, there have been no studies exploring current acupuncture research trends for treatment induced various symptoms in breast cancer patients. This review evaluated the effectiveness of acupuncture for treatment-induced symptoms in breast cancer patients.

Methods:

We performed a systematic review and meta-analysis of the literature regarding acupuncture to treat symptoms associated with breast cancer therapies. The following databases were searched for relevant RCTs published before June 2018: MEDLINE, EMBASE, the Cochrane Library, AMED, CINAHL, OASIS, CNKI, and CiNii.

Results:

Among the 19,483 records identified, 835 articles remained after screening titles and abstracts. A total of 19 RCTs were included in this qualitative synthesis. Among the studies, 8 explored climacteric symptoms, 4 explored pain, 2 explored lymphedemas, 2 explored nausea and vomiting and 3 investigated miscellaneous symptoms.

explored miscellaneous symptoms due to cancer treatments. Most of the studies reported that acupuncture can alleviate various symptoms of breast cancer treatment. However, there is a lack of evidence as to whether accupuncture can alleviate chemotherapy associated side effects

Conclusions:

Acupuncture may alleviate the treatment-related symptoms of breast cancer; however, further studies are necessary to obtain conclusive evidence of the effectiveness of acupuncture in treating breast cancer.

Registration number:

CRD42018087813
Single-arm, open-label pilot intervention study to investigate an effect of oral 5-aminolevulinic acid plus sodium ferrous citrate on glucocorticoid reduction in patients with adult-onset Still disease
Authors: Sumiyoshi Remi , Koga Tomohiro , Shimizu Toshimasa , Sato Shuntaro , Tashiro Shigeki , Hosogaya Naoki , Yamamoto Hiroshi , Kawakami Atsushi
Published: December 2020

Background:

Glucocorticoids are an important class of medication for patients with adult-onset Still disease (AOSD), however, relapse following glucocorticoid reduction and adverse events due to long-term effects of glucocorticoid are still problematic. It is of course essential to minimize the risk of treatment. Immunosuppressive therapies such as methotrexate and biologics including tocilizumab are used in glucocorticoid-dependent patients with AOSD, but no second-line treatments for patients with glucocorticoid dependence have been established yet. Given that these drugs also have the potential to cause adverse events, alternative treatments are sought. Recently, elevated heme oxygenase-1 (HO-1) has been reported in the serum of patients with AOSD, suggesting that HO-1 activity contributes to AOSD pathogenesis and may represent a new therapeutic target for the treatment of AOSD. The amino acid 5-aminolevulinic acid (5-ALA) is a non-proteinogenic δ amino acid in human body. An addition of ferrous iron to 5-ALA enhances heme biosynthesis. The increase in heme in vivo induces HO-1 production, a heme-degrading enzyme. Elevated HO-1 has been suggested to contribute to the pathogenesis of AOSD, and administration of 5-ALA and ferrous iron may be a potential treatment for AOSD.

Methods/design:

This study is a single-arm, open-label pilot intervention study using clinical endpoints to investigate the effects of oral 5-ALA with sodium ferrous citrate on glucocorticoid reduction in patients with AOSD receiving glucocorticoid therapy.

Discussion:

This pilot intervention study will provide evidence regarding the effectiveness and safety of 5-ALA/sodium ferrous citrate as a potential new therapeutic agent for glucocorticoid-dependent patients with AOSD.

Trial registration:

This study was registered in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp) on January 14, 2020 as jRCTs071190042.
Association between Helicobacter pylori infection and irritable bowel syndrome
Authors: Li Chenyu , Shuai Yujun , Zhou Xiaodong , Chen Hongxia
Published: December 2020

Background:

In recent years, the incidence of IBS has gradually increased, and it is considered as one of the most common functional gastrointestinal diseases. However, the etiology of IBS is still unclear, and expectations are rising for more targeted treatments. Many clinical trials have explored the link between Helicobacter pylori (H pylori) and IBS, with different conclusions. Therefore, we conducted a meta-analysis to explore whether there is an association between H pylori and IBS, which is of great significance for targeted treatment of IBS.

Methods:

We performed a systematic review and meta-analysis of the association between H pylori and IBS. We searched PubMed, EMBASE, Medline and the Cochrane Library to collect related studies. OR was used to describe the ratio of the probability of the H pylori infection occurring in IBS patients versus the controls. Heterogeneity was assessed by subgroup and meta-regression analysis.

Results:

Eight studies, including 1861 patients, assessed the association between H pylori infection and IBS. The OR of H pylori in IBS patients compared to controls was 1.32 (95% CI: 0.94–1.87; P = 0.11). Subgroup analyses showed a difference between IBS patients diagnosed with Roman III criteria and those diagnosed with non-Roman III criteria.

Conclusions:

Our study suggests that H pylori may have a positive effect on the development of IBS. Although the differences were not statistically significant, there were significant differences among subgroups of patients. Considering the limitations and heterogeneity, high quality studies are needed to further explore the effect of H pylori on the development of IBS.
Coexistence of craniopharyngioma and meningioma
Authors: Liu Guofang , Su Linxi , Xiang Yan , Liu Yun , Zhang Shushu
Published: December 2020

Most of the craniopharyngioma is considered to derive from residual epithelial cells during the craniopharyngeal canal degeneration. Meningioma accounting for the primary intracranial neoplasm is considered to be mainly derived from cells of arachnoid granulations. Nevertheless, rare cases show coexistence of craniopharyngioma and meningioma.

Case 1: A 43-year-old male patient referred to the hospital due to paroxysmal headache combined with blurred vision for 1 month. On physical examination, the visual acuity of left eye was poorer than that of the right eye. The visual acuity of the right eye near the nasal part showed defect.

MRI and pathological examination were performed. The patient received intracranial tumor resection. After surgery, the patient showed hormone disorder, followed by corresponding treatment. However, the patient was lost in the 6-month follow-up.

Case 2: The 64-year-old male patient presented to our department due to decline of visual acuity within 1 year combined with polydipsia (5,000 ml per day), polyuria and fatigue for 6 months. On physical examination, the bilateral visual acuity showed decline, especially the temporal part which was nearly hemiscotosis. MRI was performed. The adamantinomatous craniopharyngioma was diagnosed with the HE staining findings. The patient received intracranial resection. After surgery, the patient was in a deep coma condition, and was lost in the follow-up.

In this case study, we presented 2 patients with coexistence of craniopharyngioma and meningioma. In addition, a complete literature review was carried out to illustrate the studies on coexistence of craniopharyngioma and meningioma. Meanwhile, we tried to explain the possible mechanisms for such condition.
Long-term efficacy and advantages of minimally invasive hepatectomy for hepatolithiasis
Authors: Liu Jianyang , Xu Jinchai , Luo Dengpan , Zhao Yujun , Shen Hongbo , Rao Jianzhong
Published: December 2020

Background:

Hepatolithiasis commonly occurs in the bile duct proximal to the confluence of the right and left hepatic ducts, regardless of the coexistence of gallstones in gallbladder or the common bile duct. Clinical research proves that minimally invasive surgery is effective in the treatment of hepatolithiasis. Although previous meta-analysis also shows that it could reduce intraoperative bleeding and blood transfusion, and shorten hospital stay time, there are few meta-analyses on its long-term efficacy. We conducted the meta-analysis and systematic review to systematically evaluate the long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis.

Methods:

Articles of randomized controlled trials will be searched in the PubMed, Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, Chinese Biological and Medical database, and Wanfang database until September, 2020. Literature extraction and risk of bias assessment will be completed by 2 reviewers independently. Statistical analysis will be conducted in RevMan 5.3.

Results:

This study will summarize the present evidence by exploring the long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis

Conclusions:

The findings of the study will help to determine potential long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/H6WRV.
The clinical profiles, management, and prognostic factors of biliary mixed neuroendocrine nonneuroendocrine neoplasms
Authors: Wen Li-Jia , Chen Jun-Hong , Xu Hong-Ji , Yu Qiong , Deng Yu , Liu Kai
Published: December 2020

Background:

Mixed neuroendocrine nonneuroendocrine neoplasms (MiNENs) originating from the biliary system (gallbladder, biliary tract, or ampulla of Vater) are extremely rare and have not been discussed in detail or systematically. We aimed to present the demographics, clinicopathological characteristics, management, and prognostic factors of biliary MiNENs.

Methods:

A systematic search of electronic biomedical databases (Web of Science, PUBMED, and Embase) was performed to identify eligible studies. Survival was analyzed with the Kaplan–Meier method. Log-rank tests were used to evaluate the differences between groups, and the effects of various clinical and histopathological features on prognosis were analyzed by univariate and multivariate Cox regression.

Results:

Fifty-three publications (patients, n = 67) were included. The median overall survival time was 21.0 months. Fifty-one patients (76.1%) underwent radical surgery and median survival for 41 months (P < .001). Twenty-two patients who received adjuvant radiochemotherapy treatment after radical surgery had a median survival for 43 months (P = .076). Radical resection (P < .001), Ki-67 index (P = .011), tumor stage (P < .001), neuroendocrine (NEC) grade (P = .011), and non-NEC grade (P = .017) were independent statistically significant prognostic factors according to univariate analysis; radical resection (P = .010) and small morphological subtype (P = .036) were independent statistically significant prognostic factors associated with higher overall survival according to multivariate analysis, and radical resection (P = .005) and age < 65 years (P = .026) were associated with higher recurrence free survival time.

Conclusion:

Radical resection is essential for long-term survival. Aggressive multimodality therapy with adjuvant radiochemotherapy and biotherapy may improve survival of biliary MiNENs. Further randomized controlled trials are needed to determine the standard treatment.
Minnesota multiphasic personality inventory of school sandplay group therapy with maladjustment behavior in Korean adolescent
Authors: Ahn Un Kyoung , Kwak Hyeon Jeong , Lim Myung Ho
Published: December 2020

School sandplay group therapy is a useful clinical treatment method for adolescents who cannot adapt to school due to various emotional and behavioral problems. In this study, we conducted 10 weeks of group therapy in 70 adolescents referred to as maladjustment behavior problem in the school. The purpose of this study was to evaluate the clinical effects of sandplay therapy on the emotions and behaviors objectively through minnesota multiphasic personality test -2. There was a statistically significant difference in clinical scales such as depression, masculinity- femininity, social introversion, anger, subjective depression, need for affection, somatic complaint, and internal/external alienation after school sandplay group therapy. Sandplay therapy is estimated to have clinical effects not only on the emotional problems of maladapted high school students but also on physical problems.
Association between CYP2A13 polymorphisms and lung cancer
Authors: Ma Long , Jin Gang , Yang Yi , Pang Yao , Wang Wenhao , Zhang Hongyi , Liu Jiawei , Wu Peng , Wang Zequan , Wang Kui , Chang Ruitong , Li Jialong , Zhu Zijiang
Published: December 2020

Background:

Recently, lung cancer has become the most common cause of cancer-related death, several studies indicate that the cytochrome P450 2A13 (CYP2A13) polymorphisms may be correlated with lung cancer susceptibility, but the results have been inconsistent and inconclusive. Therefore, the aim of this meta-analysis is to provide a precise conclusion on the potential association between CYP2A13 polymorphisms and the risk of lung cancer based on case-control studies.

Methods:

The PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases will be searched for case-control studies published up to September 2020. Odds ratio (OR) and 95% confidence interval (95% CI) were used to determine the effects of the CYP2A13 polymorphism on lung cancer risk, respectively.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This meta-analysis will summarize the association between CYP2A13 polymorphisms and the risk of lung cancer.

INPLASY registration number:

INPLASY202090102
Computational study on natural compounds inhibitor of c-Myc
Authors: Ren Junan , Huangfu Yuhao , Ge Junliang , Wu Bo , Li Weihang , Wang Xinhui , Zhao Liyan
Published: December 2020

To screen and identify ideal leading compounds from a drug library (ZINC15 database) with potential inhibition effect against c-Myc to contribute to medication design and development.

A series of computer-aided virtual screening techniques were performed to identify potential inhibitors of c-Myc. LibDock from the software Discovery Studio was used to do a structure-based screening after ADME (absorption, distribution, metabolism, excretion) and toxicity prediction. Molecular docking was utilized to show the binding affinity and potential mechanism between ligands and c-Myc. Stability of the ligand-receptor complex was analyzed by molecular dynamic simulation at the end of the research.

Compounds with more interactive energy which are confirmed to be the potential inhibitors for c-Myc were identified from the ZINC15 databases. Additionally, those compounds are also anticipated with fewer ames mutagenicity, rodent carcinogenicity, nondevelopmental toxic potential, and tolerant with cytochrome p450 2D6(CYP2D6). Dynamic simulation analysis also revealed that the very compounds had more favorable potential energy compared with 10058-F4(ZINC12406714). Furthermore, we prove that those compounds are stable and can exist in natural conditions.

This study demonstrates that the compounds are potential therapeutic inhibitors for c-Myc. These compounds are safe and stable for drug candidates and may play a critical role in c-Myc inhibitor development.
Xpert Carba-R assay for detection of carbapenemase-producing organisms in patients admitted to emergency rooms
Authors: Jin Sol , Lee Jin Young , Park Ji Young , Jeon Min Ji
Published: December 2020

Carbapenemase-producing organisms (CPO) have been identified as an urgent healthcare threat. Various methods have been used for the detection of CPO using rectal swabs. Recently, an on-demand polymerase chain reaction (PCR) assay, namely, the Xpert Carba-R assay, that requires less than an hour of turnaround time, had been developed for CPO detection in clinical samples. This study focused on the use of this assay to determine the intestinal colonization rate of CPO in patients admitted to emergency rooms (ERs).

A retrospective review of medical records was conducted at a tertiary hospital between July 2017 and June 2018. CPO screening using rectal swabs was performed for patients transferred from other hospitals or for those who tested positive in CPO culture tests in the previous three months. The Xpert Carba-R assay and culture tests were used as the CPO screening methods, and the results of both tests were compared.

Medical records of 705 patients admitted to our hospital during the study period were reviewed. Of these, 31 (4.4%) showed positive results for CPO using the Xpert Carba-R assay, and these patients were then transferred from the ERs to isolation rooms. Fifteen of the Xpert Carba-R assay-positive patients were also positive for the culture test; hence, early detection enabled the rapid isolation of CPO-infected patients and prevented the spread of the CPO.

The Xpert Carba-R assay is a rapid test to identify and guide infection control programs to contain the spread of the rectal colonization of CPO within a hospital.