bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring the evolution of posttraumatic symptomatology, depression and anxiety during the COVID-19 pandemic in Brazilians (COVIDPsiq)
Authors: Calegaro Vitor Crestani , Negretto Bianca Lorenzi , Weber Leopoldo Pompeo , Kerber Natalia , Zoratto Gustavo , Rodrigues Leonardo , Braun Luiza Elizabete , Kochler Julia , Girardi Fernando Leite , Picinin Vitor Daniel , Maciel Luísa , Labre Gabriel Salomão , Costa Fernanda Coloniese Dala
Published: August 2020

In view of the evolution of the pandemic by COVID-19 in Brazil, and the adoption of social restriction measures, an increase in cases of posttraumatic stress disorder (PTSD), anxiety disorder and depression is expected. In epidemic situations, mental health services can become overloaded; however, the evolution of these disorders over time is not known. This study aims to monitor the evolution of PTSD symptoms, anxiety and depression during the COVID-19 pandemic in Brazilians, and to investigate sociodemographic risk factors related to psychiatric history and contagion, as well as maladaptive personality traits and posttraumatic growth. It will be a longitudinal study, conducted through online questionnaires, with a sample of non-probabilistic convenience. The inclusion criteria are: being brazilian born or living in Brazilian territory; be over 18 years old; have access to digital devices; and be literate. A sample of at least 2000 people is expected. The instruments applied are a research questionnaire, the Posttraumatic Checklist 5 (PCL-5), the Depression, Anxiety and Stress Scale (DASS-21), the Personality Inventory for the DSM-5 – brief form (PID-5-BF), and the PostTraumatic Growth Inventory (PTGI). The study will be carried out in four stages: entry, one month, three months, and six months after the entry. The study relies on voluntary participation, with the agreement through the Free and Informed Consent Form. Data collection will be conducted in 2020, and the study will be completed in 2021. It will be financed with its own resources, and encouragement will be sought through research funding agencies.
Degenerative central lumbar spinal stenosis: Is endoscopic decompression through bilateral transforaminal approach sufficient?
Authors: Zhang Bin , Kong Qingquan , Yan Yuqing , Feng Pin
Published: August 2020

Background: At present, few percutaneous endoscopic transforaminal decompression surgery has been reported to solve central lumbar spinal stenosis (CLSS). Whether endoscopic decompression through lateral transforaminal approach decompression is sufficient for degenerative CLSS.Methods: This retrospective study included 47 cases of CLSS patients who underwent percutaneous endoscopic decompression through a bilateral transforaminal approach. Clinical outcomes such as ODI, back and leg VAS, the Macnab criteria were evaluated. Surgical results including operative time, postoperative hospital stay, recurrence, and surgical complications were also studied. Radiologically, lumbar stability was assessed and lumbar dural sac dimension was compared preoperatively and postoperatively.Results：All 47 patients were followed up. The average follow-up period was 24.5 months. The average operation time was 116 minutes. The mean VAS of leg and back pain, and the mean ODI improved from 7.81, 2.53, and 77.03% at baseline to a final 1.94 (P=0.00), 2.47 (P=0.71), and 19.40 % (P=0.00), respectively. According to the Macnab criteria, 97.9% of patients achieved excellent and good results. There were 2 cases of dura tear and 3 cases of transient postoperative dysthesia. The cross sectional area of the dural sac was significantly enlargement at the last fellow up (74.28±13.08 mm2 vs.104.91±12.40 mm2, P=0.00).Conclusions: Except for the main pathogenic factors on the dorsal side of the dural sac, percutaneous endoscopic decompression through a bilateral transforaminal approach is sufficient for CLSS. It is a feasible, safe, and clinically effective minimally invasive procedure.
Weight maintenance interventions for people with type 2 diabetes mellitus: A systematic review protocol
Authors: Sauchelli Sarah , Bradley Julia , Cox Jennifer , England Clare , Perry Rachel
Published: August 2020

Background: Weight loss maintenance is a challenge for people with Type 2 Diabetes Mellitus (T2DM), which attenuates the long-term benefits of weight loss for diabetes management. Medication, specific dietary requirements, and the psychosocial burden of T2DM signify that weight loss maintenance designed for obesity may not suit people with T2DM. The primary objective of this review is to comprehensively evaluate existing weight maintenance interventions for people with or at high risk of T2DM.Methods: We registered a protocol for the systematic review and meta-analysis of randomised and non-randomised weight maintenance interventions for T2DM. Studies included will have been carried out in adults with clinical diagnosis of T2DM or pre-diabetes. All intervention types will be accepted (e.g. behavioural/lifestyle change and pharmacological). The primary outcomes will be weight control, glycaemic control, and adverse effects. Secondary outcomes will include cardiovascular risk factors (e.g. total cholesterol, LDL-cholesterol, blood pressure control), psychological wellbeing (including health-related quality of life), change in glucose medication and waist circumference. Multiple electronic databases will be searched such as MEDLINE, EMBASE, Web of Science, PsychINFO and international registers (e.g. Cochrane Central Register of Controlled Trials, WHO ICTRP). OpenGrey will be searched for grey literature. Two researchers will screen all citations and abstracts. This process will also be conducted by an additional researcher using a semi-automated tool to reduce human error. Full-text articles will be further examined by the researchers to select a final set for further analysis, and a narrative synthesis of the evidence will be presented. Potential sources of heterogeneity will be assessed, and a meta-analysis will be conducted if feasible. Risk of bias will be evaluated using the Cochrane risk of bias tool and the certainty of evidence using the GRADE (grading of recommendations, assessment, development, and evaluation) approach.Discussion: This review will critically appraise existing weight maintenance interventions targeting T2DM. Findings will inform future intervention development to support people with T2DM delay weight regain and prolong successful diabetes management.Systematic Review Registration: PROSPERO CRD42020168032
Teladorsagia circumcincta beta tubulin: the presence of the E198L polymorphism on its own is associated with benzimidazole resistance
Authors: Valladares Maria Martinez , Valderas-García Elora , Gandasegui Javier , Skuce Philip , Morrison Alison , de Agüero Verónica Castilla Gómez , Cambra-Pellejà Maria , Balaña-Fouce Rafael , Vázquez Francisco A. Rojo
Published: August 2020

Background: Benzimidazole resistance is associated with isotype-1 β-tubulin gene F200Y, E198A and F167Y SNPs. In this study, the recently described polymorphism E198L was reported and analysed in Teladorsagia circumcincta.Methods: The benzimidazole phenotypic resistance was measured by the faecal egg count reduction test (FECRT) and the egg hatch test (EHT) using a discriminating dose (DD) in 39 sheep flocks. Around 1000 larvae collected before and after treatment were used for DNA extraction. The resistant species identified in all flocks was T. circumcincta. The resistance alleles frequencies were measured for F200Y and E198A. A 371-bp fragment of the isotype-1 β-tubulin gene was analysed, including the three codons of interest, and a new pyrosequencing assay was designed for testing E198L.Results: The percentage of resistant flocks was 35% by FECRT or 26% by EHT; however, F200Y and E198A SNPs were absent in T. circumcincta. The amplification of a 371-bp fragment confirmed the absence of F167Y and F200Y in 6 resistant flocks. Regarding codon 198, all samples after treatment carried a leucine (CTA). A pyrosequencing assay analysed the allele frequencies for the first two bases at codon 198 independently, G/C and A/T. The correlation between C and T frequencies was almost 1 (r = 0.929, P < 0.0001) and the mean value of both was calculated to measure the leucine frequency; this value ranged between 10.4–80.7% before treatment, and 82.3–92.8% after treatment. High and similar correlations were reported between the genotypic variables (C frequency, T frequency or mean of both frequencies) and phenotypic resistance (r > 0.720, P < 0.0001), although negatively associated with the FECRT and positively with the EHT. According to multivariate linear regression analysis, the T frequency was the most significant variable influencing the phenotypic resistance (FECRT or EHT; P < 0.0001). In the EHT, 67.1% of the phenotypic variability is associated with the T frequency but in the FECRT only 33.4%; therefore, the EHT using a DD seems to detect the genotypic resistance more accurately than the FECRT.Conclusions: The E198L polymorphism can confer BZ resistance on its own in T. circumcincta.
The miR-187 Induced Bone Reconstruction and Healing in a Mouse Model of Osteoporosis, and Accelerated Osteoblastic Differentiation of Human Multipotent Stromal Cells by Targeting BARX2
Authors: Zhang Jun , Pan Feng , Tang Benseng , Li Jing , Zha Zhengang
Published: August 2020

Background: Multiple microRNAs (miRNAs) have been proven to regulate osteogenic differentiation by affecting the Runx2 signaling pathway. The intervention of miRNA can delay the progress of osteoporosis (OP) and induce fracture repair by affecting bone regeneration. However, the function and mechanism of miR-187 in osteoporotic fractures are still unknown. Methods: We first established the OP mouse model. Next, the BMD value was certified by iDXA. The miR-187 level in the OP mice and serum of OP patients was identified through qRT-PCR. Bone repair and bone healing were assessed through toluidine blue staining and X-ray, and BARX2 expression was also confirmed. Osteogenesis-related proteins, ALP activity, and the matrix mineralization state were evaluated by western blot, ALP staining, and Alizarin Red staining in hMSCs after transfection with miR-187 mimics, miR-187 inhibitor, or human BarH-like homeobox 2 (BARX2) siRNA. Moreover, the interplay between miR-187 and BARX2 was identified through the dual-luciferase reporter.Results: The BMD value was notably reduced in the OP mice, and miR-187 was markedly downregulated in the OP mice and serum of OP patients. Meanwhile, we proved that miR-187 induced bone reconstruction and healing, and downregulated BARX2 in the OP mouse model. We also proved that BARX2 was a direct target of miR-187, and could be significantly downregulated by miR-187. Furthermore, miR-187 induced osteogenic differentiation of hMSCs by targeting BARX2.Conclusions: The miR-187 might have a significant therapeutic effect in osteoporotic fractures. miR-187 accelerated osteogenic differentiation of hMSCs by directly regulating BARX2.
Viral shedding and immunological features of children COVID-19 patients
Authors: Yang Yang , Zheng Haixia , Peng Ling , Wei Jinli , Wang Yanrong , Li Hexiao , Peng Bo , Fang Shisong , Zhang Mingxia , Li Yanjie , Liu Hui , Feng Kai , Xing Li , Wang Jun , Cao Mengli , Wang Fuxiang , Liu Lei , Liu Yingxia , Yuan Jing
Published: August 2020

Background SARS-CoV-2 could infect people at all ages, and the viral shedding and immunological features of children COVID-19 patients were analyzed.Methods Epidemiological information and clinical data were collected from 35 children patients. Viral RNAs in respiratory and fecal samples were detected. Plasma of 11 patients were collected and measured for 48 cytokines.Results 40% (14/35) of the children COVID-19 patients showed asymptomatic infections, while pneumonia shown by CT scan occurred in most of the cases (32/35, 91.43%). Elevated LDH, AST, CRP, neutropenia, leukopenia, lymphopenia and thrombocytopenia occurred in some cases, and CD4 and CD8 counts were normal. A total of 22 cytokines were significantly higher than the healthy control, and IP-10, IFN-α2 of them in children were significantly lower than the adult patients. Meanwhile, MCP-3, HGF, MIP-1α, and IL-1ra were similar or lower than healthy control, while significantly lower than adult patients. Viral RNAs were detected as early as the first day after illness onset (d.a.o) in both the respiratory and fecal samples. Viral RNAs decreased as the disease progression and mostly became negative in respiratory samples within 18 d.a.o, while maintained relatively stable during the disease progression and still detectable in some cases during 36~42 d.a.o. Conclusion COVID-19 in children was mild, and asymptomatic infection was common. Immune responses were relatively normal in children COVID-19 patients. Cytokine storm also occurred in children patients, while much weaker than adult patients. Positive rate of viral RNAs in fecal samples was high, and profile of viral shedding were different between respiratory and gastrointestinal tract.
Reef Foraminifera As Bioindicator Of Coral Reef Health in Pulau Tioman, Pahang, Malaysia
Authors: A’ziz Aishah Norashikin Abdul , Minhat Fatin Izzati , Hui-Juan Pan , Shaari Hasrizal , Saelan Wan Nurzalia Wan , Azmi Nazihah , Manaf Omar Abdul Rahman Abdul , Ismail Md Nizam
Published: August 2020

Pulau Tioman is one of the famous tourism islands in Peninsular Malaysia due to the beautiful terrestrial and coral reefs ecosystem. This study aims to assess and monitor the health of coral reef sites surrounding Pulau Tioman based on the application of Foraminifera in Reef Assessment and Monitoring (FORAM) Index. A total of ten selected sampling sites from west and east side of Pulau Tioman were setup in front of the major beach areas around Pulau Tioman. At each site, 100 m transect was laid out from shore towards the reef slope and surface sediment samples were collected at 50 m intervals. Eight orders, 41 families, 80 genera and 161 species of benthic foraminifera were identified around Pulau Tioman. Amphistegina lessonii found to be the most dominant species and the least dominant species (< 4%) are Bolivina vadescens, Elphidium neosimplex, Heterolepa dutemplei, Heterolepa subhaidingerii, Mikrobelodontos bradyi, Milliolinella suborbicularis, Operculina discoidalis, Parahourinoides fragillissimus, Quinqueloculina incisa, Quinqueloculina sulcate, Triloculinella bertheliniana and Triloculinella parisa. The highest and lowest numbers of species was recorded at station J3 and station F3. The agglutinated type of foraminifera contributed between 2–8% of the total assemblages. Meanwhile, calcareous hyaline and porcelaneous group represent 79% and 19% of total assemblages respectively. Based on the functional groups, symbiont-bearing taxa were the most common foraminiferal found in most of the stations. The present study indicates that majority of sampling sites around Pulau Tioman are conducive for coral reef growth and could recover from any future bleaching events or temporary damage in the ecosystem. However, several areas with higher coastal development and tourism activities has reduced water quality (FI < 4) and chances of better reef recovery. Thus, the number of visitors and tourists should be revised in order to produce a better condition for coral reefs to grow. This assumption is based on the established results of the FORAM index. Thus, we suppose that FORAM index could be used together with coral reef health index in other reef ecosystems around Malaysia to determine the condition and status of coral reef area.
Artificial Intelligence-based Personalized and Risk-adapted Surveillance Management for Urologic Cancer: A SEER-based Study
Authors: Eminaga Okyaz , Breil Bernhard , Semjonow Axel , Boegemann Martin , Xing Lei , Tinay Ilker , Liao Joseph
Published: August 2020

Identification of prognosis changing events is essential during cancer surveillance. Current clinical practice is limited by “one-size-fits-all” time management or subjective assessment that is not necessarily appropriate for individual patients’ risk profiles. A risk-adapted follow-up is more efficient and optimal from the clinical perspective. Herein we introduce an artificial intelligence-based data-driven solution for risk-adapted follow-up schedule that devises the number of follow-up visits per year and assesses the cancer-specific risk profile over a long interval depending on the age at diagnosis. We utilized Surveillance, Epidemiology, and End Results (SEER), a cancer registry database and a resource for cancer-specific survival estimation in the United States that includes more than 2 million patients diagnosed with urologic cancers. We tested different machine learning algorithms on their definition for the feature importance and selected clinically relevant parameters regularly used in clinical routine to develop a survival modeling. As a result, the underlying recurrent neural network algorithm for follow-up modeling was fitted on the unseen test set with an overall concordance index score of 0.80. A controlled access to the online tool is available for physicians.
α-Tomatine Inhibits Proliferation, Metastasis, Drug Resistance and Immune Infiltration Through the PI3K-AKT-MAPK Axis in Gastric Cancer
Authors: Zhang Di , Yuan Hao , Mo Si-Si , Mo Xian-Wei , Tang Wei-Zhong , Yan Lin-Hai
Published: August 2020

Background: α-Tomatine, a naturally existing steroidal glycoalkaloid in immature green tomatoes, had anticarcinogenic performances in various types of cancer cells. Within this study, we aimed to investigate the efficacy and potential molecular mechanism of α-tomatine in gastric cancer (GC) and the association with immune infiltration and prognosis.Methods: We used human GC cells MGC803, BGC823, SGC7901 and SGC7901/DDP to evaluate the cell functions of α-tomatine, and the molecular mechanisms of α-tomatine were investigated by qRT-PCR and western blotting analysis. Timer database was used to analyzed the correlation of targets repressed by α-tomatine, immune infiltration and prognosis. Results: Results showed that α-tomatine strongly inhibited PI3K-AKT and MAPK signaling pathways, thereby repressing the proliferation and metastasis of GC cells with different differentiations and cisplatin resistance. The inhibitory effect of α-tomatine on TWIST, Slug and PARP in SGC7901/DDP cells also suggested α-tomatine provided a feasible approach for confronting metastasis of clinical cisplatin resistant cases. Immunologically, α-tomatine could partially modulate the process and consequences of immune infiltration based on the correlation between 65 genes corresponding to interacting proteins and immune cell infiltration. α-Tomatine could improve prognosis of GC patients by inhibiting AKT3, VIM, FN1 and SNAI2, and at least partially counteract immune dysfunction triggered by macrophage infiltration. Conclusion: Strategies for treating GC should not be restricted to single, repetitive drug use, they should be predisposed to emerging, multi-target drugs. GC was highly susceptible to α-tomatine suggesting that α-tomatine could be used as an emerging and promising approach to confront GC.
EEF1A Acts as A Promising Novel Bio-Marker in the Prognosis of Patients With Cholangiocarcinoma
Authors: Wang Ning , Li Yanni , Zheng Yanfang , Chen Huoming , Wen Xiaolong , Li Zhaoxia
Published: August 2020

Background: The morbidity and mortality of cholangiocarcinoma (CCA) is increasing in recent years. EEF1A2 could regulate multiple biological and pathological processes. Our study was designed to investigate the clinical significance of eEF1A2 for prognosis evaluation in CCA.Methods: The quantitative analysis for eEF1A2 in CCA specimens was performed using quantitative real-time polymerase chain reaction (qRT-PCR). The influences of eEF1A2 expression on disease progression and survival of CCA patients were analyzed by Chi-square test and Kaplan-Meier method, respectively. Additionally, cox regression analyses were adopted to identify the potential predictive biomarker for prognosis of CCA.Results: eEF1A2 expression showed increased tendency in CCA tissues (P<0.05). The expression profile of eEF1A2 was positively correlated with TNM stage (P=0.004), lymph node metastasis (P=0.001) and distant metastasis (P=0.001). In addition, high eEF1A2 expression predicted dismal survival among CCA cases (P<0.05). EEF1A2 might be independently correlated with prognosis of CCA (HR=2.724, 95%CI=1.303-5.964, P=0.008).Conclusions: eEF1A2 may act as a predictive biomarker for clinical outcomes of CCA.
25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons
Authors: Pencak Martin , Veith Miroslav , Stranak Zbynek , Dite Jakub , Vranova Jana , Studeny Pavel
Published: August 2020

Introduction: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (25g PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Materials and Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25g PPV with gas tamponade. Patients were divided into 2 groups: In Group 1 (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in Group 2 (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. The mean best-corrected visual acuity (BCVA) improved from 0.38 decimal to 0.73 decimal. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The mean BCVA improved from 0.33 decimal to 0.74 decimal. The differences between groups were not statistically significant. There was no difference in complication rates between groups.Conclusions: A 25g PPV with gas tamponade for treatment of RRD yields excellent anatomical results and improvement in BCVA. With good technique and use of modern vitrectomy machines and instruments, even inexperienced surgeons can achieve high single operation success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.
The study of the impact factors of behaviors of nursing intern students: PRECEDE-based structural equation modeling analysis
Authors: Zhang Li , Luo Yetao , Chen Yanhan
Published: August 2020

BackgroundTobacco hazard is known as one of the most critical public health problems. Nurses could and should help patients to quit smoking. However, the lack of tobacco cessation education of nurses at medical school leads to the absence of behaviors helping smokers to quit. The analysis of the factors that influencing the nursing interns to help smokers to quit provide evidence for nursing school to administer tobacco cessation education to facilitate more behaviors of smoking cessation in future nurses.ObjectTo explore the interaction and the effect coefficient among the influencing factors of the 5As behaviors of nursing interns in helping smokers to quit provide and to provide evidences for the tobacco cessation education. Method: Based on the PRECEDE theory, a questionnaire was developed with consideration of predisposing factor, enabling factor and reinforcing factor. Random Cluster Sampling was used to conduct a survey in 13 teaching hospitals selected from 29 in Chongqing to assess the 5As behaviors of all nursing interns. A structural equation model was established to test the path and effect coefficient of their 5As behaviors.ResultsThe survey investigated 1358 nurses, and the model fitted well with the data. The tobacco cessation education, one of the enabling factors, imposed max effect on the 5As of nursing interns directly（β=0.542，p<0.001） and indirectly（β=0.38，p<0.001）through self-efficacy. The reinforcing factors ( smoking cessation environment) imposed direct effect（β=0.305，p<0.001）and indirect effect on the 5As of nursing interns through attitude changes. Predisposing factors including self-efficacy influenced the 5As directly, while attitude（β=0.001，p<0.05）and knowledge（β=0.008，p<0.05）of tobacco cessation implied indirect influence on the 5As through self-efficacy change. ConclusionTobacco cessation education was the major factor that influenced the nursing interns’ behaviors of helping patients to quit smoking. Enhanced responsibility of smoking cessation education and skills training of clinical teachers can prompt them to actively help patients to quit smoking, actively instruct students the knowledge and skills of smoking quit to increase students' behavior of helping smokers to quit.
Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer
Authors: Watanabe Shunsuke , Miyoshi Jun , Toki Masao , Kambayashi Komei , Kitada Shuichi , Nosaka Takeshi , Goto Tomoyuki , Ota Hirotaka , Ochiai Kazushige , Gondo Koichi , Ikeuchi Nobuhito , Tsuji Shujiro , Nakamura Kenji , Shibahara Junji , Hisamatsu Tadakazu
Published: August 2020

Background: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is a standard method for pathological diagnosis of pancreatic solid lesions. The EchoTip ProCore 20G® (PC20), a 20-gauge biopsy needle with a forward-bevel core trap, has been available in Japan since 2015.Methods: We compared the efficacy of the PC20 with that of the EchoTip ProCore 22G® (PC22) and Acquire 22G® (AC22) in EUS-FNA/B for diagnosing pancreatic cancer. This retrospective study included 191 patients with pancreatic cancer who underwent EUS-FNA/B using the PC20, PC22, or AC22 at our facility from April 2013 to October 2019. We investigated the patients’ clinical characteristics and the diagnostic accuracy and safety of each needle.Results: A sufficient stroke length of puncture was secured in all patients. The maximum length under EUS was shorter with the AC22 (22.1±2.2 mm) than PC20 (30.6±0.7 mm, p<0.01) and PC22 (30.3±0.8 mm, p<0.01). The histological accuracy was 96.4% with the PC20 but only 58.8% with the PC22 (adjusted p (p-adj)<0.0001) and 75.0% with the AC22 (p-adj=0.06). The diagnostic accuracy of the combination of histology and cytology was 96.4% with the PC20, while it was 72.1% with the PC22 (p-adj<0.0001) and 91.7% with the AC22 (p-adj>0.99). One patient (0.9%) in the PC20 group developed mild pancreatitis, but no adverse events occurred with the other needles. Conclusions: The PC20 showed better diagnostic capability than the PC22. The diagnostic efficacy was similar between the PC20 and AC22. The high histological accuracy of the PC20 could be advantageous for lesions in which histological assessment is critical.
Nucleotide Excision Repair Proteins and Risk of Head and Neck Squamous Cell Carcinomas in a Chinese Population
Authors: Ren Pengyu , Niu Xiaorong , Zhao Ruimin , Chen Zichen , Dai Hao , Zhang Ling , Kou Bo , Xu Chongwen , Yao Xiaobao , Li Baiya , Shao Yuan , Zhang Shaoqiang , Liang Yiqian , Han Peng
Published: August 2020

Background Nucleotide excision repair (NER) is pivotal in the development of smoking-related malignancies. We hypothesize that expression levels of NER proteins are associated with risk of the head and neck squamous cell carcinomas (HNSCCs) in a Chinese population. Methods To test this hypothesis, we conducted a case-control study of 337 HNSCC patients and 285 cancer-free controls by measuring the expression levels of nine core NER proteins in cultured peripheral lymphocytes. Results Compared with the controls, cases had statistically significantly lower expression levels of XPA (P=0.001). After dividing the subjects by controls’ medians of expression levels, we found an association between an increased risk of HNSCCs and low XPA expression levels [adjusted ORs and 95% CIs:1.42 and 1.03-1.96; Ptrend=0.031]. We identified a multiplicative interaction between smoking as well as drinking status and XPA expression levels (P = 0.005 and 0.044, respectively). Finally, the sensitivity of the expanded model with protein expression levels, in addition to demographic variables, on HNSCCs risk was significantly improved, especially among ever smokers and ever drinkers. Conclusions Reduced XPA expression levels were associated with an increased risk of HNSCCs in a Chinese population.
Clinical course, biomarkers, management and outcomes of patients hospitalised due to COVID-19 in Colombia
Authors: Yomayusa Nancy , Acevedo Kelly Rocío Chacón , Reina Adriana Janeth Avila , Rincón Karen Lorena , Toloza Carlos Hernando , Gomez Olga Gomez , Padilla Eduardo Low , Vallejo Juan Felipe Combariza , Rodriguez Johana Vargas , Molina Emilio Herrera , Marin Sandra Yadira Moreno , Moreno Carlos Arturo Álvarez
Published: August 2020

Background: Coronavirus disease (COVID-19) represents an unprecedented challenge for both people and health systems. Latin America is the current epicentre of the pandemic; however, there is little published clinical information on the clinical characteristics and outcomes.Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions.Methods: In the present retrospective observational study, information was acquired from consecutive hospitalized patients with a diagnosis of COVID-19 confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) from March 01 to May 30, 2020 in Colombia.Results: A total of 44 patients were included. The median age was 62 years, and 65.9% of the patients were male. A total of 69.8% of the patients were overweight or obese, and 13.6% of the patients had high blood pressure and diabetes. The presence of systemic symptoms and cough were the most common. Ground-glass opacity was frequent finding upon chest imaging. The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome (critical care requirement, mechanical ventilation and death) occurred in 36.4% of the patients. The biomarkers associated with mortality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Cardiovascular complications, acute respiratory distress syndrome (ARDS) and acute kidney injury were the most frequent comorbidities in patients with severe pneumonia.Conclusion: The clinical course of SARS-CoV-2 infection diagnosis confirmed by RT-PCR in Colombian patients admitted to a high-complexity hospital was similar to that reported in the literature; however, the population was characterised by a more advanced stage of the infection.
Case report: BRAF-MAD1L1 and BRAF-ZC3H7A: novel gene fusion in Rhabdomyosarcoma and Lung adenocarcinoma
Authors: Jiang Da , Jin Hui , Zhou Xinliang , Fan Shaoshuang , Lei Mengping , Xu Mian , Chen Xiaoyan
Published: August 2020

BackgroundRhabdomyosarcoma (RMS) and lung adenocarcinoma (LADC) epitomizes the success of cancer prevention by the development of conventional therapy, but huge challenges remain in the therapy of advanced diseases. Case presentationWe reported two cases of novel BRAF gene fusion. The first case was a 34-year-old female with RMS harboring a BRAF-MAD1L1 fusion. She suffered tumor resection, recurrence and rapid progression. The second case was a 72-year-old female with LADC harboring a BRAF-ZC3H7A fusion, and she gained rapid progression after receiving a first-line course of chemotherapy. ConclusionsThese two BRAF fusions retain the intact BRAF kinase domain (exon 11-18) and showed poor prognosis in RMS and LADC.
Accumulation of the Delivered Dose Based on Cone-Beam CT and Deformable Image Registration for Non-small Cell Lung Cancer Treated With Hypofractionated Radiotherapy
Authors: Wang Bin , Wang DaQuan , Lin MaoSheng , Lu ShiPei , Zhang Jun , Chen Li , Li QiWen , Cheng ZhangKai , Liu FangJie , Guo JinYu , Liu Hui , Qiu Bo
Published: August 2020

Background: This study aimed to quantify the dosimetric differences between the planned and delivered dose to tumor and normal organs in locally advanced non-small cell lung cancer (LANSCLC) treated with hypofractionated radiotherapy (HRT), and to explore the necessity and identify optimal candidates for adaptive radiotherapy (ART).Methods: Twenty-seven patients with stage III NSCLC were enrolled. Planned radiation dose was 51Gy in 17 fractions with cone-beam CT (CBCT) acquired at each fraction. Virtual CT was generated by deformable image registration (DIR) of the planning CT to CBCT for dose calculation and accumulation. Dosimetric parameters were compared between original and accumulated plans using Wilcoxon signed rank test. Correlations between dosimetric differences and clinical variables were analyzed using Mann-Whitney U test or Chi-square test.Results: Patients had varied gross tumor volume (GTV) reduction by HRT (median reduction rate 11.1% , range -2.9%-44.0%). The V51 of PTV-GTV was similar between original and accumulated plans (mean, 88.2% vs. 87.6%, p=0.452). Only 11.1% of patients had above 5% relative decrease in V51 of PTV-GTV in accumulated plans. Compared to the original plan, limited increase (median relative increase <5%) was observed in doses of total lung (mean dose, V20 and V30), esophagus (mean dose, maximum dose) and heart (mean dose, V30 and V40) in accumulated plans. Less than 30% of patients had above 5% relative increase of lung or heart doses. Patients with quick tumor regression or baseline obstructive pneumonitis showed more notable increase in doses to normal structures. Patients with baseline obstructive atelectasis showed notable decrease (10.3%) in dose coverage of PTV-GTV.Conclusions: LANSCLC patients treated with HRT had sufficient tumor dose coverage and acceptable normal tissue dose deviation. ART should be applied in patients with quick tumor regression and baseline obstructive pneumonitis/atelectasis to spare more normal structures.
What is the Impact of the Rashomon Approach in Primary Care Education?: An Educational Care Report of Implementing Dialogue and Improvisation Into Medical Education
Authors: Takamura Akiteru , Imafuku Rintaro
Published: August 2020

Background:The excessive sub-divided or concrete pre-determined objectives found in the technological approach in contemporary medical education curricula may hinder the students’ spontaneous learning about diverse needs and values in care. However, medical professionals must learn the diversity for care or a variety of social factors of the patients influencing decision making in daily practice.Methods:We introduced a new method of curriculum development called the Rashomon approach. For testing the Rashomon approach, educational activities to teach the diversity in primary care were developed in four modules: 1) explication of the competency without specifying sub-objectives; 2) dialogue among multiple professional students; 3) visits and interviews of the patients; 4) dialogue with teachers' improvisation. The students’ outcomes and responses were quantitatively and qualitatively analyzed.Results:A total of 135 medical students joined this study in 2017. The descriptive data suggested that the key concepts of diversity in primary care were fully recognized and that the pre-determined general goals were achieved. Scores on the understanding of social factors in medicine, respect for other professionals, professional identity, and satisfaction with the course were very high.Conclusion:Instead of the technological approach, the Rashomon approach, in which only a general goal guides educational activities was used in this research. Improvisation and dialogue fit the approach and were potentially effective activities to learn the multifaceted practice of medicine. In an era of competency-based education, the Rashomon approach could be a very useful framework in primary care education.
Quantifying Carbon Monoxide Emissions on the Scale of Large Wildfires
Authors: Volkamer Rainer , Bela Megan , Kille Natalie , McKeen Stuart , Ahmadov Ravan , James Eric , Pereira Gabriel , Schmidt Chris , Pierce R , O'Neill Susan , Zhang Xiaoyang , Kondragunta Shobha , Wiedinmyer Christine
Published: August 2020

Anthropogenic factors, such as ignitions, climate, and land use changes, are the primary reason why the wildfire season today is three times longer than only twenty years ago, with fires now burning year-round in the continental United States1. The quantities of fuel that go up as smoke in the form of trace gases and aerosols affect public health2,3,4 and ecosystems5, but are highly uncertain6,7,8,9 due to a lack of measurement techniques to directly quantify wildfire emissions. Uncertain emissions contribute to errors in air quality models10,11 used to forecast smoke impacts on public health in affected communities, and to inform firefighting efforts. Here we show that destructive fires in northern California during October 2017 emitted 2040 ± 316 tonnes hr-1 carbon monoxide (CO), which is more than ten times larger than the emissions from all other anthropogenic CO pollution sources in the entire state of California combined. An assessment of satellite-based emission inventories reveals that the uncertainty in predicting pyrogenic CO emissions spans a factor of 83. Air quality impacts in the form of ozone and fine particulate matter range from insignificant to very severe (vary by two orders of magnitude), and scale with uncertain emissions caused primarily by the different ecosystem classification among emission inventories. This uncertainty is reduced to a factor of ~2 by our first CO mass flux measurements on the scale of actual wildfires. We derive the conversion factor of satellite fire radiative energy to CO emissions (α = 73 ± 11 to 149 ± 23 g CO MJ-1) for savannah and extratropical forest fuels of these fires, which is higher (+30 to +230%) than tabulated for these fuel types. Our results help to improve future model predictions, and suggest an additional organic soil contribution to emissions from wildfires in northern California.
HER-3 Expression and MEK Activation in Non-small Cell Lung Cancer
Authors: Manickavasagar Thubeena , Yuan Wei , Carreira Suzanne , Gurel Bora , Miranda Susana , Ferreira Ana , Crespo Mateus , Riisnaes Ruth , Baker Chloe , O’Brien Mary , Bhosle Jaishree , Popat Sanjay , Banerji Udai , Lopez Juanita , Bono Johann de , Minchom Anna
Published: August 2020

BackgroundHER-3 has a role in pathogenesis and development of resistance to targeted therapies in non-small cell lung cancer (NSCLC). MethodsWe analysed tumour samples from 45 patients with adenocarcinoma of the lung. HER-3 and HER-2 expression was identified using immunohistochemistry as well as bioinformatic interrogation of The Cancer Genome Atlas (TGCA). ResultsHER-3 was highly expressed in 42.2% of cases and observed more frequently than HER-2 overexpression. ERBB3 copy number alone did not account for HER-3 overexpression. Bioinformatic analysis of TCGA demonstrated that MEK activity score (a score of downstream pathway activity and surrogate of functional HER-3 signalling) did not correlate with HER-3 ligands. EGFR pathway signalling was predominant with a significantly positive correlation of EGFR and AREG expression with MEK activity score. In the ERBB3 expressed group, ERBB3 RNA expression levels were significantly correlated with MEK activity score. ERBB3 expression level remained highly positively correlated with MEK activity after adjusting for EGFR expression. ConclusionHER-3 expression is common and it is not associated with gene amplification nor is it ligand dependent. HER-3 is an alternative pathway to EGFR activating MEK. HER-3 is a potential therapeutic target in NSCLC by virtue of frequent overexpression and functional downstream signalling.
Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus Using Proton Pump Inhibitors: A Systematic Review With Meta-Analysis and Trial Sequential Analysis
Authors: Li Lunan , Gao Huiqin , Zhang Chenjing , Geng Xiaoge , Wang Jingya , Pan Wensheng , Jing Jiyong
Published: August 2020

Background: Proton pump inhibitors (PPIs) have been used to treat Barrett's esophagus (BE), but there seems to be insufficient evidence that PPIs can prevent esophageal adenocarcinoma (EAC) and high grade dysplasia (HGD). This study aimed to evaluate the effects of PPIs in BE patients. Methods: PubMed and EMBASE were systematically searched. Stata13 and trial sequential analysis (TSA) software were used to carried out related statistics. Pooled odds ratio (OR) with 95% confidence intervals (CIs) were calculated. Results: Using PPIs to reduce the incidence of EAC and HGD has not been confirmed (OR, 0.61; 95% CI, 0.29–1.26). The pooled results of three cohort studies reported that PPIs use was protective (OR 0.48; 95% CI 0.33 to 0.70). But the pooled results of five case-control study indicating PPIs use does not prove this protective effect (OR 0.73; 95% CI 0.21 to 2.48). On pooled analysis of 4 US studies 2 Netherlands, protective effect on development of EAC and HGD was noted (OR, 0.59; 95% CI, 0.43–0.80) and (OR, 0.16; 95% CI, 0.03–0.75). Conclusion: According to the Meta analysis and TSA of existing studies, the protective effect of PPIs on the progression of BE patients to OAC and / or HGD has not been confirmed. TSA shows that more patients are needed before a clear conclusion can be reached.
An Autophagy-Related Gene Signature Predicts Prognosis of Early Stage Colorectal Cancer
Authors: Zou Yi-feng , Wu Qiu-ning , Qin Si , Chen Xi Xi , Cai Jia-wei , Tan Ying-xin , Weng Jing-rong , Rong Yu-ming , Lin Xutao
Published: August 2020

Background and aimsA certain number of early-stage colorectal cancer (CRC) patients suffer tumor recurrence after initial curative resection. In this context, an effective prognostic biomarker model is constantly in need. Autophagy exhibits a dual role in tumorigenesis. Our study aims to develop an autophagy-related gene (ATG) signature based on high-throughput data analysis for disease-free survival (DFS) prognosis of patients with stage I/II CRC.MethodsGene expression profiles and clinical information of CRC patients extracted from four public datasets were divided into training cohort (GSE39582, n=566), validation cohort (TCGA CRC, n=624), and meta-validation cohort (GSE37892 and GSE14333, n=420). Autophagy genes significantly associated with prognosis were identified.ResultsAmong 655 autophagy-related genes, a 10 gene ATG signature, which was significantly associated with DFS in the training cohort (HR, 2.76[1.56–4.82]; P=2.06×10-4), was constructed. The ATG signature, stratifying patients into high and low autophagy risk groups, was validated in the validation (HR, 2.29[1.15–4.55]; P=1.5×10-2) and the meta-validation cohorts (HR, 2.5[1.03–6.06]; P=3.63×10-2), and proved to be prognostic in a multivariate analysis. Functional analysis revealed enrichment of several immune/ inflammatory processes in the high autophagy risk group, where significantly higher infiltration of T regulatory cells (Tregs) was observed.ConclusionsOur study established a prognostic ATG signature that effectively predicted DFS for early-stage CRC patients. Meanwhile, the study also revealed the possible correlation between autophagy and immune/ inflammatory processes and tumorigenesis.
Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort study
Authors: Scolari Fernando , Schneider Daniel , Fogazzi Débora Vacaro , Gus Miguel , Rover Marciane Maria , Bonatto Marcely Gimenes , de Araújo Gustavo Neves , Zimerman André , Sganzerla Daniel , Goldraich Lívia Adams , Teixeira Cassiano , Friedman Gilberto , Polanczyk Carisi Anne , Rohde Luis Eduardo , Rosa Regis Goulart , Wainstein Rodrigo Vugman
Published: August 2020

Background: To evaluate the prognostic value of peak serum lactate and lactate clearance at several time points in cardiogenic shock treated with temporary mechanical circulatory support (MCS) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP®.Methods: Serum lactate and clearance were measured before MCS and at 1h, 6h, 12h, and 24h post-MCS in 43 patients at four tertiary-care centers in Southern Brazil. Prognostic value was assessed by univariable and multivariable analysis and receiver operating characteristic (ROC) curves for 30-day mortality.Results: VA-ECMO was the most common MCS modality (58%). Serum lactate levels at all time points and lactate clearance after 6h were associated with mortality on unadjusted and adjusted analyses. Lactate levels were higher in non-survivors at 6h, 12h, and 24h after MCS. Serum lactate > 1.55 mmol/L at 24h was the best single prognostic marker of 30-day mortality [area under the ROC curve = 0.81 (0.67-0.94); positive predictive value = 86%). Failure to improve serum lactate after 24h was associated with 100% mortality.Conclusions: Serum lactate was an important prognostic biomarker in cardiogenic shock treated with temporary MCS. Serum lactate and lactate clearance at 24h were the strongest independent predictors of short-term survival.
Chemical and Morphological Characterization of Crinis Carbonisatus
Authors: Bhandari Tika Ram , Lamsal Bidit , Panta Prasamsha , Pradhan Nilam Shrestha , Liebscher Marco , Katuwal Tika Bahadur , Adhikari Rameshwar
Published: August 2020

BackgroundCrinis Carbonisatus, prepared by pyrolysis of human hair, is traditional Chinese medicine used for increasing blood clotting and wound healing. Its use is explored in literature but no detailed structural study is reported.ObjectiveThis work is aimed at studying the chemical and morphological variation of Crinis Carbonisatus under given heating condition.Materials and methodsCrinis Carbonisatus was obtained after pyrolysis of human hair at 300 °C in sealed ceramic pot. The obtained samples were characterized in terms of its physicochemical properties by scanning electron microscopy (SEM), Fourier Transform Infrared (FTIR) spectroscopy and X-ray Diffraction (XRD). ResultsDistinct morphology with nano-particulate structure was observed on SEM micrographs. FTIR spectroscopy of the samples revealed the presence of functional groups like –OH, -COO-­, -NH as well as methyl (-CH3) and methylene (-CH2­-) groups. Graphite interlayer spacing peak appeared in XRD pattern only after 24 h of pyrolysis.ConclusionPyrolysis converts the micron sized particles into the nanometric entities. Amorphous behavior of the materials decreases with the increase in pyrolysis time.