bluuebunny/crossref_metadata_2025 huggingface dataset:
MERGHERS pilot: MeerKAT discovery of diffuse emission in nine massive Sunyaev–Zel’dovich-selected galaxy clusters from ACT
Authors: Knowles K , Pillay D S , Amodeo S , Baker A J , Basu K , Crichton D , de Gasperin F , Devlin M , Ferrari C , Hilton M , Huffenberger K M , Hughes J P , Koopman B J , Moodley K , Mroczkowski T , Naess S , Nati F , Newburgh L B , Oozeer N , Page L , Partridge B , Pfrommer C , Salatino M , Schillaci A , Sifón C , Smirnov O , Sikhosana S P , Wollack E J , Xu Z
Published: March 2021

The MeerKAT Exploration of Relics, Giant Halos, and Extragalactic Radio Sources (MERGHERS) survey is a planned project to study a large statistical sample of galaxy clusters with the MeerKAT observatory. Here we present the results of a 16-h pilot project, observed in response to the 2019 MeerKAT Shared Risk proposal call, to test the feasibility of using MeerKAT for a large cluster study using short (0.2–2.1 h) integration times. The pilot focuses on 1.28-GHz observations of 13 massive, low-to-intermediate redshift (0.22 < z < 0.65) clusters from the Sunyaev–Zel’dovich-selected Atacama Cosmology Telescope (ACT) DR5 catalogue that show multiwavelength indications of dynamical disturbance. With a 70 per cent detection rate (9/13 clusters), this pilot study validates our proposed MERGHERS observing strategy and provides twelve detections of diffuse emission, eleven of them new, indicating the strength of MeerKAT for such types of studies. The detections (signal-to-noise ratio ≳ 6) are summarized as follows: two systems host both relic(s) and a giant radio halo, five systems host radio haloes, and two have candidate radio haloes. Power values, k-corrected to 1.4 GHz, assuming a fiducial spectral index of α = −1.3 ± 0.4, are consistent with known radio halo and relic scaling relations.
The radial supernova remnant distribution in the Galaxy
Authors: Verberne Sill , Vink Jacco
Published: March 2021

Supernovae (SNe) are the dominant source of chemical enrichment of galaxies, and they are an important source of energy to heat the interstellar medium and accelerate cosmic rays. Our knowledge of SNe in the Milky Way is based mostly on the study of Galactic supernova remnants (SNRs), providing an (incomplete) record to SN activity over the last ∼100 000 yr. Here, we report on an investigation of the spatial distribution of Galactic SNRs. Given the limited number of SNRs, it is common to assume a functional form for the Galactocentric distribution of SNRs. However, several functional forms have been used in the past, without much justification for the radial distribution. For example, one often used functional form implies that no SN activity is present in the Galactic Centre region. However, the presence of a magnetar and an SNR near the Galactic Centre suggests that a spatial distribution with zero SNRs at the Galactic Centre is not realistic. In light of these concerns, we re-evaluate the Galactic SNR distribution. We provide a brief outline of the main detection biases in finding SNRs and we investigate whether or not the use of the most common functional form is justified and how it compares to other models for the SNR distribution. We do this by analysing the longitudinal distribution of SNRs. We find that a simple exponential distribution is the most consistent and simplest model for describing the radial SNR distribution in the Galaxy and draw comparisons with the massive star formation and metallicity distributions.
Gravitational waves from Population III binary black holes are consistent with LIGO/Virgo O3a data for the chirp mass larger than ∼20 M⊙
Authors: Kinugawa Tomoya , Nakamura Takashi , Nakano Hiroyuki
Published: March 2021

The probability number distribution function of binary black hole mergers observed by LIGO/Virgo O3a has double peaks as a function of chirp mass Mchirp, total mass Mtotal, primary black hole mass M1, and secondary one M2, respectively. The larger chirp mass peak is at Mchirp≅ 30 M⊙. The distribution of M2 versus M1 follows the relation of M2≅ 0.7M1. For initial mass functions of Population III stars in the form of f(M) ∝ M−α, population synthesis numerical simulations with 0 ≤ α ≤ 1.5 are consistent with O3a data for Mchirp ≳ 20 M⊙. The distribution of M2 versus M1 for simulation data also agrees with M2 ≅ 0.7M1 relation of O3a data.
Metal-organic frameworks enable broad strategies for lithium-sulfur batteries
Authors: Zhou Cheng , Li Zhaohuai , Xu Xu , Mai Liqiang
Published: March 2021

The lithium-sulfur (Li-S) battery is considered to be a potential next-generation power battery system, however, it is urgent that suitable materials are found in order to solve a series of challenges, such as the shuttle effect and lithium dendrite growth. As a multifunctional porous material, metal-organic frameworks (MOFs) can be used in different parts of Li-S batteries. In recent years, the application of MOFs in Li-S batteries has been developed rapidly. This review summarizes the milestone works and recent advances of MOFs in various aspects of Li-S batteries, including cathode, separator and electrolyte. The factors affecting the performance of MOFs and the working mechanisms of MOFs in these different parts are also discussed in detail. Finally, the opportunities and challenges for the application of MOFs in Li-S batteries are proposed. We also put forward feasible solutions to related problems. This review will provide better guidance for the rational design of novel MOF-based materials for Li-S batteries.
Heated Tobacco Product Awareness, Use, and Perceptions in a Sample of Young Adults in the United States
Authors: Berg Carla J , Romm Katelyn F , Patterson Brooke , Wysota Christina N
Published: March 2021

Introduction

The emergence of heated tobacco products (HTPs) in the US marks a critical time for identifying those most likely to use, particularly among young adults.

Aims and Methods

We analyzed Fall 2019 data from a longitudinal study of young adults (ages 18–34; n = 2375, Mage=24.66±4.68) in 6 US cities, 24.1% of whom used cigarettes and 32.7% e-cigarettes. We assessed HTP awareness, use, and sources, as well as perceived risk, social acceptability, and the likelihood of future use.

Results

In this sample, 9.7% (n = 230) heard of HTPs, 3.5% (n = 84) ever used them, and 2.4% (n = 56) reported past-year purchases (tobacco shops, 66.1%; traditional retailers, 60.7%; online, 39.3%; IQOS specialty stores, 35.7%). In multivariable analyses, having heard of HTPs correlated with being an older, male, and current cigarette and e-cigarette users; among those ever hearing of them, using HTPs correlated with being non-Hispanic and current cigarette and e-cigarette users. Greater likelihood of future use correlated with being older, male, sexual minority, non-Hispanic, and current cigarette and e-cigarette users. Among past-month users (n = 78), the average number of days used was 5.48 (SD = 5.54). Past-month cigarette and e-cigarette users, respectively, who tried HTPs were more likely to report consistent or more frequent use of their respective products than a year ago (p < .001). HTPs were perceived as less addictive than cigarettes, smokeless tobacco, and e-cigarettes, and less harmful and more socially acceptable than other tobacco products except for e-cigarettes and hookah.

Conclusions

The relatively positive perceptions of HTPs and access via various channels underscores the potential penetration of HTPs among US young adults.

Implications

In Fall 2019, as IQOS was launching in the US, there were relatively low rates of awareness, use, and use intentions in this sample of young adults with high proportions of other tobacco use. However, this sample reported relatively positive perceptions of HTPs with regard to potential addiction and harm, as well as social acceptability. They also reported accessing HTPs via various channels, underscoring how pervasive the availability to HTPs already has become and may increasingly become. Moreover, certain subgroups (ie, other tobacco users, men) are particularly likely to use HTPs.
“Act[ing] Riotously”: Theatre and Performance in Early Nineteenth-Century Jamaica
Authors: Valladares Susan
Published: March 2021

Theatrical culture in early nineteenth-century Jamaica attests to tense relationships between tradition and innovation, acceptance and resistance. The early nineteenth century has not, however, received much in-depth treatment by historians of the Jamaican stage, who have tended to focus, instead, on the establishment of formal theatre in the eighteenth century or its revival in the post-emancipation years. In its attempts to recover the bustling auditoria that distinguished Jamaica’s most popular playhouses in the 1810s, this essay details who attended the theatre, and what kind of rules regulated their behaviour. It examines how theatregoing practices reflected the inequalities that characterized Jamaican society; assesses efforts to enforce segregation within the island’s playhouses; and investigates the entertainments that existed beyond them, especially those associated with the members of society least represented or altogether excluded from the island’s theatre auditoria—Jamaica’s free black and the majority of enslaved men and women.
Effectiveness and tolerability of oral vs subcutaneous methotrexate in patients with rheumatoid arthritis
Authors: Heuvelmans Janne , den Broeder Nathan , van den Elsen Geke A H , den Broeder Alfons A , van den Bemt Bart J F
Published: March 2021

Objectives

The aim of this study was to compare the effectiveness and tolerability between oral MTX and s.c. MTX in a large group of RA patients in a real-life setting.

Methods

In this retrospective cohort study, adult patients with clinical diagnosis of RA who started MTX treatment (monotherapy or combined with HCQ) started with either oral or s.c. MTX. The primary outcome was superiority testing of between group difference in change in DAS28CRP between baseline and 3–6 months, and subsequent non-inferiority (non-inferiority margin 0.6) testing analyses in case of non-superiority. Secondary outcomes included MTX dose, side effects, laboratory abnormalities and use of comedication.

Results

Six hundred and forty RA patients were included: 259 started with oral MTX and 381 with s.c. MTX. There was no significant difference in ΔDAS28CRP [after adjusting for confounding, 0.13 (95% CI: –0.14, 0.40)], and oral MTX strategy was non-inferior to s.c. The mean MTX dose was slightly lower for the oral strategy [18.0 (6.9) vs 19.9 (8.2), P = 0.002], which was accompanied by a lower cumulative incidence of adverse events (41% vs 52%, P = 0.005). No differences were seen in use of other comedication.

Conclusion

Starting with oral MTX in RA in a real-life setting is non-inferior to a s.c. MTX treatment with regard to disease activity control, at least when used in dosages up to 25 mg and on a background of HCQ co-treatment and a treat-to-target approach. In addition, tolerability was better. This supports the strategy of starting with oral MTX.
Apremilast inhibits inflammatory osteoclastogenesis
Authors: Degboé Yannick , Sunzini Flavia , Sood Shatakshi , Bozec Aline , Sokolova Maria V , Zekovic Ana , McInnes Iain B , Schett Georg , Goodyear Carl S
Published: March 2021

Objectives

Psoriatic arthritis (PsA) is associated with bone erosion and inflammation-induced bone loss, which are mediated by osteoclasts (OC) and modulated by inflammatory cytokines. Apremilast (APR) (a selective phosphodiesterase 4 inhibitor) is efficacious in PsA and acts by inhibiting cytokine production. However, there are no direct data informing whether and how APR affects osteoclast formation in humans.

Methods

Osteoclastogenic cytokine production by activated human peripheral blood mononuclear cells (PBMCs) was measured in the presence and absence of APR. Effects of APR on osteoclast differentiation were tested (i) in co-cultures of activated PBMCs and human CD14+ blood monocytes as well as (ii) in CD14+ blood monocytes stimulated with activated-PBMCs supernatant, TNF or IL-17A. Bone resorption was measured on OsteoAssay plates. Effects of APR on ex vivo osteoclast differentiation were compared in PsA, pre-PsA and psoriasis patients, as well as in healthy controls.

Results

APR significantly impaired the expression of key osteoclastogenic cytokines in activated PBMCs. Furthermore, APR dose-dependently and significantly inhibited activated PBMC-driven osteoclast differentiation and ex vivo osteoclast differentiation of PBMCs derived from PsA and pre-PsA patients, but not from psoriasis patients or healthy controls. TNF and IL-17A-enhanced osteoclastogenesis and osteolytic activity of CD14+ blood monocytes from PsA patients was also significantly inhibited by APR. Finally, APR inhibited expression of the key osteoclast fusion protein dendritic cell-specific transmembrane protein.

Conclusion

Phosphodiesterase 4 targeting by APR not only inhibits osteoclastogenic cytokine production, but also directly suppresses inflammation-driven osteoclastogenesis. These data provide initial evidence that APR has the potential to provide a direct bone protective effect in PsA.
Potentiators of Disease During Barley Infection byPyrenophora teresf.teresin a Susceptible Interaction
Authors: Moolhuijzen Paula , Lawrence Julie A. , Ellwood Simon R.
Published: March 2021

Pyrenophora teres f. teres is a necrotrophic fungal pathogen and causal agent of net form net blotch (NFNB), a significant disease of barley. RNA-seq data encompassing asymptomatic and subsequent necrotrophic phases of the pathogen was obtained for P. teres f. teres isolate W1-1 in NFNB-sensitive cultivar Baudin. Host genes notably regulated during infection included concerted induction of over half the repertoire of disease resistance genes, together with genes involved in oxidation-reduction processes, characteristic of a hypersensitive response. Several systemic acquired resistance response genes were suppressed and there was a complete absence of defense-related thionin gene expression. In P. teres f. teres, genes involved in hydrolase activities and cell-wall catabolic processes were induced during infection, while nitrate assimilation and response to oxidative stress processes were suppressed. Timecourse data allowed a number of predicted P. teres f. teres effector genes with differing expression profiles to be identified that may underlie barley sensitivity to NFNB. Candidate genes involved in the host-pathogen interaction provide a basis for functional characterization and control strategies based on fungicide or mutation targets, which will facilitate further research aimed at controlling NFNB disease.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Genetic Diversity, Identification, and Utilization of Novel Genetic Resources for Resistance to Meloidogyne incognita in Mulberry (Morus spp.)
Authors: Arunakumar Gondi S. , Gnanesh Belaghihalli N. , Manojkumar Haniyambadi B. , Doss S. Gandhi , Mogili T. , Sivaprasad Vankadara , Tewary Pankaj
Published: March 2021

Mulberry (Morus spp.) is an important crop in the sericulture industry, as the leaves constitute the primary feed for the silkworm. The availability of diverse genetic sources of resistance to root-knot nematode (RKN; Meloidogyne spp.) are very scanty. To address this need, a set of 415 varied exotic and indigenous germplasm accessions were screened under glasshouse conditions. Twenty-one accessions were identified as highly resistant and 48 were resistant, with the highest numbers of highly resistant/resistant accessions being found in Morus alba. Further, 30 accessions based on rooting ability were evaluated for field resistance at four different locations with infested soil. Finally, eight germplasm accessions (BR-8, Karanjtoli-1, Hosur-C8, Nagalur Estate, Tippu, Calabresa, Thai Pecah, and SRDC-3) were identified as potential genetic sources in RKN-resistance breeding programs or as resistant rootstock for the establishment of mulberry gardens. Sixteen simple sequence repeat markers analyzed among the 77 resistant and susceptible accessions generated 55 alleles, ranging from two to five, with an average of 3.43 alleles per locus. Principal coordinates analysis grouped the accessions on the basis of susceptibility and resistance to RKN infestation. The RKN-susceptible accessions exhibited higher variability as compared with resistant accessions, and they were more dispersed. Analysis of molecular variance showed maximum molecular variance was 78% within the population, and 22% between populations. Results of this study indicate that simple sequence repeat markers are reliable for assessing genetic variability among the RKN-resistant and RKN-susceptible mulberry accessions.
Long-term Exposure to PM2.5 and Mortality for the Older Population: Effect Modification by Residential Greenness
Authors: Son Ji-Young , Sabath M. Benjamin , Lane Kevin J. , Miranda Marie Lynn , Dominici Francesca , Di Qian , Schwartz Joel , Bell Michelle L.
Published: March 2021

Background:

Although many studies demonstrated reduced mortality risk with higher greenness, few studies examined the modifying effect of greenness on air pollution–health associations. We evaluated residential greenness as an effect modifier of the association between long-term exposure to fine particles (PM2.5) and mortality.

Methods:

We used data from all Medicare beneficiaries in North Carolina (NC) and Michigan (MI) (2001–2016). We estimated annual PM2.5 averages using ensemble prediction models. We estimated mortality risk per 1 μg/m3 increase using Cox proportional hazards modeling, controlling for demographics, Medicaid eligibility, and area-level covariates. We investigated health disparities by greenness using the Normalized Difference Vegetation Index with measures of urbanicity and socioeconomic status.

Results:

PM2.5 was positively associated with mortality risk. Hazard ratios (HRs) were 1.12 (95% confidence interval (CI) = 1.12 to 1.13) for NC and 1.01 (95% CI = 1.00 to 1.01) for MI. HRs were higher for rural than urban areas. Within each category of urbanicity, HRs were generally higher in less green areas. For combined disparities, HRs were higher in low greenness or low SES areas, regardless of the other factor. HRs were lowest in high-greenness and high-SES areas for both states.

Conclusions:

In our study, those in low SES and high-greenness areas had lower associations between PM2.5 and mortality than those in low SES and low greenness areas. Multiple aspects of disparity factors and their interactions may affect health disparities from air pollution exposures. Findings should be considered in light of uncertainties, such as our use of modeled PM2.5 data, and warrant further investigation.
Children's Hospital Ambulatory Response to the 2019 Novel Coronavirus Disease (COVID-19) Pandemic
Authors: Harahsheh Ashraf S. , Selekman Rachel E. , Simpson Joelle N. , Cronin Ileen , Cady Rebecca F. , Martin Benjamin D. , Mbwana Juma , Biddle Cara L. , Kalloo Naida , Sharma Hemant , Ricks Jeanne R. , Helmandollar Carole , DiFazio Marc , Corriveau Christiane , Melwani Anjna , Saleh Ayman , Schultz John , Lindquist Terry L. , Hamburger Ellen K.
Published: March 2021

The 2019 novel coronavirus disease (COVID-19) pandemic produced an abrupt and near shutdown of nonemergent patient care. Children's National Hospital (CNH) mounted a multidisciplinary, coordinated ambulatory response that included supply chain management, human resources, risk management, infection control, and information technology. To ensure patient access, CNH expanded telemedicine and instituted operational innovations for outpatient procedures. While monthly in-person ambulatory subspecialty visits decreased from 25 889 pre-COVID-19 to 4484 at nadir of the COVID-19 pandemic, telemedicine visits increased from 70 to 13 539. Further studies are needed to assess the impact of innovations in health care delivery and operations that the crisis prompted.
Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failure
Authors: Brown Georgia , Moynihan Katie M. , Deatrick Kristopher B. , Hoskote Aparna , Sandhu Hitesh S. , Aganga Devon , Deshpande Shriprasad R. , Menon Anuradha P. , Rozen Thomas , Raman Lakshmi , Alexander Peta M.A.
Published: March 2021

These guidelines are applicable to neonates and children with cardiac failure as indication for extracorporeal life support. These guidelines address patient selection, management during extracorporeal membrane oxygenation, and pathways for weaning support or bridging to other therapies. Equally important issues, such as personnel, training, credentialing, resources, follow-up, reporting, and quality assurance, are addressed in other Extracorporeal Life Support Organization documents or are center-specific.
Cytokine-induced killer cells/dendritic cells and cytokine-induced killer cells immunotherapy for the treatment of esophageal cancer
Authors: Yuan Xin , Zhang An Zhi , Ren Yi Lin , Wang Xue Li , Jiang Chen Hao , Yang Lan , Liu Chun Xia , Liang Wei Hua , Pang Li Juan , Gu Wen Yi , Li Feng , Hu Jian Ming
Published: March 2021

Objectives:

This meta-analysis was designed to systematically evaluate whether autologous cytokine-induced killer cells (CIK) or dendritic cells and cytokine-induced killer cells (DC-CIK) immunotherapy combined with chemotherapy can improve the therapeutic effect and safety of chemotherapy in esophageal cancer (EC).

Materials and methods:

Randomized controlled trials (RCTs) were electronically searched databases including CNKI, WanFang, WeiPu, CBMDisc, PubMed, Web of Science, EMbase, the Cochrane Library, and Clinical Trials. The databases were searched for articles published until June 2019. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included literature. Meta-analysis was performed using RevMan5.3.

Results:

Seventeen studies (1416 participants) were included. The differences between CIK/DC-CIK combination chemotherapy and chemotherapy alone were significant. The results displayed that the number of CD3+, CD4+, CD4+/CD8+, and NK cells was significantly increased after 1 to 2 weeks of treatment with CIK/DC-CIK cells in the treatment group (all P < .05). In addition, the results shown that 1-year overall survival was significantly prolonged (P < .0001) and quality of life was improved (P = .001) in EC chemotherapy combined with immunotherapy groups compared with conventional treatment. Furthermore, cytokine expression levels of interleukin 2 (IL-2), tumor necrosis factor α (TNF-α), and interleukin 12 (IL-12) were significantly increased (P = .0003) as well as the levels of immunoglobulins were elevated (P < .00001). Serum levels of tumor marker molecules, carcinoembryonic antigen (CEA), carbohydrate antigen (CA)-199, and CA-125 were lower in treatment groups than that of control groups (P < .00001). No fatal adverse reactions were noted (P = .04).

Conclusions:

It is safe and effective for patients to use chemotherapy combined with CIK/DC-CIK immunotherapy. Immunotherapy can simultaneously improve the antitumor immune response. Specifically, DC-CIK cells can increase T lymphocyte subsets, CIK cells, NK cells, and immunoglobulins in peripheral blood to enhance antitumor immunity. Therefore, combination therapy enhances the immune function and improves the therapeutic efficacy of patients with EC.
Acute promyelocytic leukemia with myelofibrosis
Authors: Xiao Mengyu , Qin Ling , Niu Xiaona , Zhou Pan , Niu Junwei , Wei Shengjie , Li Dan , Dou Liurui , Zhang Wanjun , Zhang Lei , Sun Kai , Bai Yanliang
Published: March 2021

Rationale:

Acute promyelocytic leukemia (APL) with myelofibrosis (MF) is rare, and only 14 cases have been reported in the literature to date.

Patient concerns:

A 42-year-old woman was admitted to the hospital with easy bruising and excessive bleeding. With the remission of the primary disease during treatment, the degree of fibrosis did not decrease, but worsened progressively.

Diagnosis:

The woman was diagnosed with acute promyelocytic leukemia with secondary myelofibrosis.

Interventions:

All-trans retinoic acid (ATRA) was discontinued after 6 months of complete remission of APL. Arsenic trioxide (ATO) was discontinued because of supraventricular tachycardia 9 months after complete remission of APL.

Outcomes:

After withdrawal of ATRA for 2 months, the degree of fibrosis was significantly alleviated, and after withdrawal of ATRA for 8 months and ATO for 5 months, bone marrow biopsy showed no reticular fiber deposition.

Lessons:

In this case report and review of an additional 14 cases of APL with MF, we highlighted the importance of the degree of MF to be evaluated by bone marrow biopsy at the time of bone marrow aspiration when APL is suspected. If MF is present, the type of MF should be determined in a timely manner, and appropriate intervention measures should be taken accordingly.
Efficacy and safety of ulinastatin on cognitive dysfunction after general anesthesia in elderly patients
Authors: Liang Zhi , Xu Xue , Qi Xiang , Zhang Fuzhen
Published: March 2021

Background:

With the aging of society, the incidence of diseases increases. And along with the increase of surgery rate, the number of elderly patients with postoperative cognitive dysfunction (POCD) is also increasing. POCD seriously affects the mental state and quality of life of patients and their families. Clinical studies have shown that POCD is closely related to inflammatory reaction, and Ulinastatin can inhibit the inflammatory reaction and reduce the incidence of POCD in elderly patients under general anesthesia. However. the effect of Ulinastatin on POCD in elderly patients under general anesthesia has not been systematically evaluated.

Objective:

Meta analysis will be used to evaluate the efficacy and safety of Ulinastatin in elderly patients with general anesthesia POCD during perioperative period.

Methods:

We will search China Science and Technology Journal Database Chinese database, China National Knowledge Infrastructure, Wanfang, China biomedical database, PubMed, EMBASE, Cochrane Library and web of science for randomized controlled trials of the effect of Ulinastatin on POCD of elderly patients with general anesthesia from the establishment of the database to November 2020. The 2 researchers will independently screen the literature and conducted quality assessment and data extraction for the included studies, Revman5.3 software will be used for risk assessment and meta analysis.

Results:

In this study, the efficacy and safety of Ulinastatin in elderly patients with general anesthesia POCD will be evaluated by the incidence of postoperative cognitive impairment, mini mental state examination (Mini-Mental State Examination [MMSE]), visual regeneration, associative memory score, S100 β protein, tumor necrosis factor α (TNF- α), interleukin 6 (IL-6), IL- 10 inflammatory factors and the incidence of adverse reactions.

Conclusion:

The use of Ulinastatin in perioperative period can significantly reduce the inflammatory level of elderly patients after general anesthesia, effectively prevent the occurrence of POCD and reduce its incidence.

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/GY3V7
Clinicopathological analysis of ovarian sertoli-leydig cell tumor with postmenopausal vaginal bleeding as the first symptom
Authors: Huang Li-juan , Shi Liang-yan , Duan Jie
Published: March 2021

Rational:

Ovarian sertoli-leydig cell tumor (OSLCT) is extremely rare. We reported a OSLCT case in whom postmenopausal vaginal bleeding was the first symptom.

Patient concerns:

The patient came to our hospital due to postmenopausal vaginal bleeding.

Diagnoses:

Serum tumor markers and color Doppler ultrasound for her pelvic cavity were negative. The patient was finally diagnosed with left OSLCT by pathology. It was difficult to make a definite diagnosis before operation, the diagnosis of OSLCT required postoperative pathology in the patients.

Interventions:

the patient underwent laparoscopic hysterectomy+bilateral adnexectomy+lysis of pelvic adhesions.

Outcomes:

Postoperative laboratory examinations were normal. The patient was discharged from our hospital on the seventh day after operation and came to our hospital for follow-up check in April 2020. Physical and laboratory examinations were normal.

Lessons:

OSLCT can show different endocrine abnormalities, which are related to the various types of tumor tissues. Missed diagnosis and misdiagnosis are likely to occur in the patients who only have elevated serum testosterone. For the menopausal women with elevated serum testosterone, ovarian tumor shoule be highly suspected after excluding adrenal gland-related diseases.
Systemic inflammatory response to non-surgical treatment in hypertensive patients with periodontal infection
Authors: Escobar Arregocés Francina Maria , Del Hierro Rada Mariella , Sáenz Martinez María José , Hernández Meza Federico José , Roa Nelly S. , Velosa-Porras Juliana , Latorre Uriza Catalina
Published: March 2021

Hypertension is associated with chronic inflammation in the tissues and organs that are involved in the regulation of arterial pressure, such as kidneys and blood vessels. Periodontal disease affects systemic inflammatory markers, leading to endothelial dysfunction, atherosclerotic plaque instability, dyslipidaemia, and insulin resistance. These conditions can also cause an increase in the blood pressure. Nonsurgical periodontal therapies, such as scaling and root planning, can affect systemic markers of inflammation. We evaluated the effect of scaling and root planning on serum levels of inflammation biomarkers in hypertensive patients. The sample consisted of 19 hypertensive patients with Periodontitis. The patients underwent laboratory tests that included glycaemia, cholesterol, triglycerides and blood count. Blood pressure was measured before periodontal therapy, and the second blood pressure recording was obtained at the re-evaluation appointment. Quantification of peripheral blood cytokines was performed using the Milliplex Inflammation Human Cytokine kit (Interleukin 1-β, Interleukin-4, Interleukin-6, Interleukin-8, Interleukin-10, Interleukin-12 P70, Interleukin-17A, vascular endothelial growth factor and tumor necrosis factor-alpha). All cytokine levels decreased from the initial examination to reassessment. Cytokines that reflected a statistically significant difference included Interleukin-1β and endothelial vascular growth factor (P = .04 and P = .004). Hypertensive patients with periodontitis undergoing non-surgical periodontal treatment exhibited a decrease in proinflammatory cytokine levels. Non-surgical periodontal treatment decreases the levels of systemic proinflammatory cytokines in controlled hypertensive patients.
Primary splenic epithelioid hemangioendothelioma with diffuse metastases revealed by FDG PET/CT imaging
Authors: Li Xian , Ma Xiaowei , Hao Jingwen , Dong Chuning , Wang Yunhua
Published: March 2021

Rationale:

Epithelioid hemangioendothelioma (EHE) is a rare low-to-intermediate grade malignant vascular neoplasm. We report a primary splenic EHE with diffused metastasis who underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Our case emphasizes that EHE should be considered a differential diagnose of 18F-FDG-avid splenic malignancies.

Patient concerns:

A 39-year-old man presented with abdominal distension and chest distress for 20 days and lumbago for 2 days. Transthoracic echocardiography suggested a large amount of pericardial effusion. Contrast-enhanced CT imaging showed splenomegaly with multiple low-density nodules with ring enhancement. A large irregular mass was also found in the right superior mediastinum with heterogeneous density and enhancement. 18F-FDG PET/CT imaging revealed splenomegaly, filled with intense hypermetabolic nodules and masses. And multiple regions of increased 18F-FDG uptake were observed in the mediastinum, left pleura, and bones.

Diagnosis:

EHE of the spleen.

Interventions:

Half a month after the diagnosis was confirmed, the patient then underwent chemotherapy, Docetaxel combined with carboplatin, and Endu were administrated every 3 weeks.

Outcomes:

During the 6-month follow-up period, the patient has finished 4 cycles of chemotherapy combined with 2 months of targeted drug. Efficacy assessment is partial remission through CT imaging, and clinical symptoms of patient improved significantly.

Lessons:

Primary splenic EHE is extremely rare, especially with diffuse systemic metastasis. Our report suggested that EHE should be considered a differential diagnosis of 18F-FDG-avid splenic malignancies. Furthermore, 18F-FDG PET/CT plays critical role in staging and accessing disease extent of EHE.
Ectopic insulinoma diagnosed by 68Ga-Exendin-4 PET/CT
Authors: Zhang Xiaona , Jia Hongwei , Li Fengao , Fang Chunyun , Zhen Jinyang , He Qing , Liu Ming
Published: March 2021

Rationale:

Ectopic insulinomas are extremely rare and challenging to diagnose for clinicians. Precise preoperative localization is essential to successful treatment.

Patient concerns:

A 23-year-old man presented with a 1-year history of recurrent hypoglycemia.

Diagnosis:

Examinations in the local hospital did not reveal any pancreatic lesion. After admission, a fasting test and a 5-hour oral glucose tolerance test (OGTT) suggested a diagnosis of endogenous hyperinsulinemic hypoglycemia. Enhanced volume perfusion computed tomography (VPCT) revealed 2 nodules in the tail of the pancreas, a nodule in the gastric antrum, and a nodule in the hilum of the spleen. To differentiate which nodule was responsible for hypoglycemia, we performed 68Ga-Exendin-4 PET/CT and 68Ga-DOTATATE PET/CT which helped to make a conclusive diagnosis that the lesion in the gastric antrum was an ectopic insulinoma.

Interventions:

The patient was cured with minimally invasive laparoscopic resection of the tumor.

Outcomes:

The symptoms were relieved and the blood glucose level remained normal after surgery.

Conclusions:

This case shows that 68Gallium-exendin-4 PET/CT is useful for precise localization and thereby successful treatment of insulinoma, especially for occult insulinomas and those derived from an ectopic pancreas.
A retrospective study of orthodontic treatment on anterior tooth displacement caused by periodontal disease
Authors: Huang Yi-zhi , Zhu Yan-ru , Yan Ying
Published: March 2021

This retrospective study aimed to explore the effect of orthodontic treatment (ODT) on anterior tooth displacement (ATD) caused by periodontal disease (PD).

A total of 72 patients were selected and were divided into a control group (n = 36) and an experimental group (n = 36). Patients in both groups received conventional periodontal treatment. In addition, patients in the experimental group also received ODT. Outcomes include probing depth, percentage of bleeding sites, clinical attachment loss, clinical crown length, tooth root length, and periodontal tissue of the affected tooth (alveolar bone height, periodontal pocket depth, bleeding index).

After treatment, the patients in the experimental group achieved more improvements in probing depth (P < .01), percentage of bleeding sites (P < .01), clinical attachment loss (P < .01), clinical crown length (P = .04), and periodontal tissue of the affected tooth (periodontal pocket depth (P < .01), and bleeding index (P < .01)), than those of patients in the control group.

This study suggests that ODT is beneficial for ATD caused by PD. Future studies are still needed to verify the findings of this study.
Risk factors of febrile urinary tract infections following retrograde intrarenal surgery for renal stones
Authors: Kim Dong Soo , Yoo Koo Han , Jeon Seung Hyun , Lee Sang Hyub
Published: March 2021

We aimed to evaluate the risk factors of febrile urinary tract infection (UTI) following retrograde intrarenal surgery (RIRS) for treating renal stones.

We retrospectively reviewed the data of patients with 10 – 30 mm kidney stones who underwent RIRS from January 2014 to July 2017. Evaluation included age, gender, body mass index, stone size, stone location, and operative time. All surgeries were performed by a single surgeon and ureteral stenting was not done prior surgery. The risk factors of febrile UTI after RIRS were assessed by univariate and multivariate logistic regression analysis.

A total of 150 patients were included in the present study, and 17 patients (11.3%) had febrile UTI after RIRS. Mean patient age was 56.64 ± 13.91 years, and both genders were evenly distributed. Mean stone size was 14.16 ± 5.89 mm. and mean operation time was 74.50 ± 42.56 minutes. According to univariate analysis, preoperative pyuria was associated with postoperative febrile UTI. Multivariate logistic regression analysis showed that preoperative pyuria was the only independent risk factor of infectious complications after RIRS (odds ratios 8.311, 95% confidence intervals 1.759 – 39.275, P = .008). Age, gender, body mass index, comorbidity, preoperative bacteriuria, presence of hydronephrosis, renal stone characteristics, and operative time were not associated with febrile UTI after RIRS.

Preoperative pyuria was the only risk factor of infectious complications following RIRS. Therefore, careful management after RIRS is necessary especially when preoperative urinalysis shows pyuria.
Effectiveness and persistence of golimumab as a second biological drug in patients with spondyloarthritis
Authors: Alegre-Sancho Juan J. , Juanola Xavier , Rodríguez-Heredia José M. , Manero Javier , Villa-Blanco Ignacio , Laiz Ana , Arteaga María J. , Cea-Calvo Luis , González Carlos M.
Published: March 2021

This observational, longitudinal retrospective, noncomparative study was designed to assess the persistence and effectiveness of golimumab as a second anti-tumor necrosis factor (TNF) drug in patients with spondyloarthritis requiring discontinuation from a first anti-TNF drug.

Data were collected retrospectively for all patients with axial spondyloarthritis or psoriatic arthritis from 20 rheumatology clinics in Spain who started golimumab as a second anti-TNF drug between January 2013 and December 2015. Golimumab persistence was assessed with Kaplan-Meier survival analysis, and associated factors were assessed with Cox regression analysis.

210 patients started golimumab as a second anti-TNF drug: 131 with axial spondyloarthritis and 79 with psoriatic arthritis. In axial spondyloarthritis patients, the mean (standard deviation) Bath Ankylosing Spondylitis Disease Activity Index score at baseline was 5.5 (2.1), decreasing to 3.9 (2.0) at month 3 and 3.5 (2.0) at year 1, and remaining stable thereafter. In psoriatic arthritis patients, mean (standard deviation) baseline Disease Activity Score was 4.0 (1.3), reducing to 2.5 (1.2) at month 3 and to 2.2 (1.3) at year 1. Corresponding improvements were recorded from baseline in C-reactive protein levels and erythrocyte sedimentation rates. The probability of persistence of treatment with golimumab was 80% at year 1, 70% at year 2 and 65% at years 3 and year 4, and was similar in those who had stopped the first anti-TNF due to loss of efficacy or other reasons. Cox regression analysis showed that the probability of survival with golimumab was higher in patients with higher erythrocyte sedimentation rate, in patients with axial spondyloarthritis than with psoriatic arthritis, and in those who had discontinued adalimumab as first anti-TNF. Seventy-two patients (34.3%) discontinued golimumab during follow-up, 50 of them due to lack of efficacy.

In patients with spondyloarthritis requiring discontinuation from a first anti-TNF drug, treatment with golimumab was effective and showed a high probability of persistence up to 4 years of treatment.
Accumulated genetic mutations leading to accelerated initiation and progression of colorectal cancer in a patient with Gardner syndrome
Authors: Gu Xiaoqiang , Li Xin , Xu Jiahua , Yang Jinzu , Li Hongwei , Wu Qing , Qian Jianxin
Published: March 2021

Rationale:

Gardner syndrome is a rare autosomal dominant disorder with a high degree of penetrance, which is characterized by intestinal polyposis, osteomas, and dental abnormalities. Majority of patients with Gardner syndrome will develop colorectal cancer by the age of 40 to 50 years. Mutations in the adenomatous polyposis coli gene are supposed to be responsible for the initiation of Gardner syndrome.

Patient concerns:

A 22-year-old Chinese female was admitted to our hospital due to abdominal pain and bloody stool.

Diagnosis:

The patient presented with multiple intestinal polyposis, desmoid tumors, and dental abnormalities was diagnosed as Gardner syndrome and further examination revealed a colon tumor.

Interventions and outcomes:

Patients were implanted with stents to alleviate bowel obstruction, and were treated with oxaliplatin combined with 5-Fu for 4 cycles, but the efficacy was not good. We performed next generation sequencing of 390 genes for the tumor specimens. We detected adenomatous polyposis coli E1538Ifs∗5, KRAS G12D, NF1 R652C, loss of SMAD4, TP53 R175H, IRF2 p.R82S, TCF7L2 p.A418Tfs∗14, and SMAD4 p.L43F in this patient.

Lessons:

We reported serial mutations in key genes responsible for initiation and progression of colorectal cancer from a patient with Gardner syndrome.
Development of safety and usability guideline for clinical information system
Authors: Lee Yura , Bahn Sangwoo , Shin Gee Won , Jung Min-Young , Park Taezoon , Cho Insook , Lee Jae-Ho
Published: March 2021

Clinical information systems (CISs) that do not consider usability and safety could lead to harmful events. Therefore, we aimed to develop a safety and usability guideline of CISs that is comprehensive for both users and developers. And the guideline was categorized to apply actual clinical workflow and work environment.

The guideline components were extracted through a systematic review of the articles published between 2000 and 2015, and existing CIS safety and/or usability design guidelines. The guideline components were categorized according to clinical workflow and types of user interface (UI). The contents of the guideline were evaluated and validated by experts with 3 specialties: medical informatics, patient safety, and human engineering.

Total 1276 guideline components were extracted through article and guideline review. Of these, 464 guideline components were categorized according to 5 divisions of the clinical workflow: “Data identification and selection,” “Document entry,” “Order entry,” “Clinical decision support and alert,” and “Management”. While 521 guideline components were categorized according to 4 divisions of UI: UIs related to information process steps, “Perception,” “Recognition,” “Control,” and “Feedback”. We developed a guideline draft with 219 detailed guidance for clinical task and 70 for UI. Overall appropriateness and comprehensiveness were proven to achieve more than 90% in experts’ survey. However, there were significant differences among the groups of specialties in the judgment of appropriateness (P < .001) and comprehensiveness (P = .038).

We developed and verified a safety and usability guideline for CIS that qualifies the requirements of both clinical workflows and usability issues. The developed guideline can be a practical tool to enhance the usability and safety of CISs. Further validation is required by applying the guideline for designing the actual CIS.
The impact of dusk phenomenon on total glucose exposure in Chinese people with type 2 diabetes
Authors: Huang Yuxin , Xu Yuanyuan , Qiu Jieyuzhen , Jiang Cuiping , Tan Wen , Tao Xiaoming , Gu Qin , Sun Jiao
Published: March 2021

This study was aimed at assessing the impact of the dusk phenomenon on the total glucose exposure in Chinese people with type 2 diabetes.

A total of 380 type 2 diabetes who received a retrospective continuous glucose monitoring system (CGMs) for 72 hours were enrolled in our study, 32 of them failed in CGMs. The patients were first divided into 2 groups: dusk phenomenon (n = 95) and non dusk phenomenon group (n = 253). The magnitude of the dusk phenomenon (δDusk) was quantified by pre-dinner glucose minus post-lunch 2 hours glucose. A persistent δDusk ≥ 0 or a once only δDusk < 0 can be diagnosed with the dusk phenomenon. The participants were secondarily matched for the post-lunch 2 hours glucose to assess the impact of the dusk phenomenon on the overall glucose exposure. The impact of the dusk phenomenon was assessed on high-performance liquid chromatography assay (HbA1c) and 24-hour mean glucose.

There were 95 of 348 (27.3%) participants with the dusk phenomenon in the overall population, and the median of δDusk level was –0.8 (–1.8, 0.2) mmol/L. The median of glucose differences between the 2 paired groups were 0.4 (–0.4, 1.0)% for HbA1c, 0.9 (0.2, 1.4) mmol/L for 24 hours mean glucose. The correlation analysis showed no relationship between the magnitude of dawn phenomenon and the dusk phenomenon (r = 0.052, P = .472).

The incidence of dusk phenomenon is about 27.3% in people with type 2 diabetes. The impacts of dusk phenomenon on HbA1c and 24-hour mean glucose were about 0.4% and 0.9 mmol/L and the dusk phenomenon was not related with the dawn phenomenon.
Short- and long-term outcomes of 486 consecutive laparoscopic splenectomy in a single institution
Authors: Fu Xiaowei , Yang Zhengjiang , Tu Shuju , Xin Wanpeng , Chen Haiming , Li Xueming , Li Yong , Xiao Weidong
Published: March 2021

Since its introduction in 1991, laparoscopic splenectomy (LS) has become the gold standard in elective spleen surgery in many centres. However, there still lack the report of long-term outcomes of LS with the large-scale cases. The aim of the present study was to analyze the short- and long-term outcomes of LS in a single institution over 16 years, and to compare the perioperative outcomes of totally laparoscopic splenectomy (TLS) and hand-assisted laparoscopic splenectomy (HALS) for splenomegaly.

Between November 2002 and December 2018, 486 consecutive patients undergoing elective LS were enrolled in this study, including 222 TLS and 264 HALS. The intraoperative, postoperative, and follow-up data were retrospectively analyzed.

The 5 most common indications were hypersplenism (71.0%), immune thrombocytopenia (14.8%), splenic benign tumor (4.5%), splenic cyst (2.9%), and splenic malignant tumor (2.9%). The mean operative time, intraoperative blood loss, and length of stay were 149.4 ± 63.3 minutes, 230.1 ± 225.1 mL, and 6.7 ± 3.2 days, respectively. The morbidity, mortality, reoperation, and conversion rate were 23.0%, 0, 0.4%, and 1.9%, respectively. Portal vein system thrombosis (PVST) was the most frequent complication with an incidence of 19.8%. The incidence of PVST in HALS was higher than that in TLS (23.9% vs 14.9%, P = .013). Compared with TLS, HALS had a shorter operative time (P = .000), lower intraoperative blood loss (P = .000), comparable conversion rate (P = .271), and morbidity (P = .922) for splenomegaly > 17.0 cm. During the follow-up period, the overall respond rate for immune thrombocytopenia was 77.8%, and the esophagogastric variceal bleeding rate was 6.9% in 320 patients with hypersplenism secondary to hepatic cirrhosis.

LS is a safe, feasible, and effective procedure with satisfactory short- and long-term outcomes. HALS is a reasonable technique in patients with massive spleens.