bluuebunny/crossref_metadata_2025 huggingface dataset:
Foam sclerotherapy compared with liquid sclerotherapy for the treatment of lower extremity varicose veins
Authors: Bi Minglei , Li Danyi , Chen Zhenyu , Wang Yanjin , Ren Jizhen , Zhang Weina
Published: May 2020

Background:

There is a continued discussion on which is the best sclerosant to treat lower extremity varicose veins. Therefore, we did this meta-analysis to determine that foam sclerotherapy versus liquid sclerotherapy, which could perform better in the treatment of lower extremity varicose veins.

Materials and methods:

We independently searched 5 databases from inception to February 1, 2019, for randomized controlled trials and prospective controlled trials for comparing foam sclerotherapy and liquid sclerotherapy for the treatment of lower extremity varicose veins. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies. The primary outcome and secondary outcomes were analyzed using stata 15.0. This meta-analysis was performed according to Cochrane Handbook.

Results:

There were significant differences in effective rate (P < .001, odd ratios = 5.64, 95% confidence interval = 3.93–8.10) and incidence rate of pain (P = .030, odd ratios = 1.52, 95% confidence interval = 1.04–2.21) between foam sclerotherapy and liquid sclerotherapy. And there were no significant differences among local inflammation (P = .896, rate difference = 0.00, 95% confidence interval = –0.03 to 0.03), thrombophlebitis (P = .90, rate difference = 0.00, 95% confidence interval = −0.02 to 0.02) and hyperpigmentation (P = .336, rate difference = 0.05, 95% confidence interval = −0.05 to 0.14).

Conclusions:

Although foam sclerotherapy has a higher incidence rate of complications, it could achieve a more stable clinical efficacy in the treatment of lower extremity varicose veins than liquid sclerotherapy.
The effectiveness of acupoint catgut embedding in hyperlipidemia with obesity
Authors: Hong Peipei , Gao Yang , Wang Qiuyue , Qiu Xianliang , Chen Qiu
Published: May 2020

Background:

Hyperlipidemia is a common disease characterized as blood lipid metabolism disorders, which is always companied with obesity. Hyperlipidemia is the leading cause of the cardiovascular disease (CVD) closely associated with mortality, and the risk can further elevate in the obese population. Additionally, it induces stroke and acute pancreatitis. Studies demonstrated that acupoint catgut embedding is an effective therapy for hyperlipidemia with obesity. Whereas, there is no systematic review and meta-analysis to support the point. Thus, we intend to conduct a systematic review and meta-analysis to testify its effectiveness in hyperlipidemia with obesity.

Methods:

We will include articles by searching the following database: PubMed, Embase, Web of Science, Cochrane Controlled Trials Register (CENTRAL), China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Chinese Science Journal Database (VIP), and Wanfang database. Whats more, the manual search can be executed as the complement of database searching. Endnote X8 and RevMan V.5.3 will be used to complete the process of study selection, data analysis, as well as date management.

Result:

The primary outcomes contain the reduction of TC, TG, LDL-C, HDL-C, and BMI, body weight (WB), waist circumference(WC), body fat percent (F%) from baseline to the end of studies. The second outcome is the number of adverse events during the total trial.

Conclusion:

We will summarize sufficient evidence to confirm the therapeutic effect and safety of acupoint catgut embedding in hyperlipidemia with obesity.

INPLASY registration number:

INPLASY202040036.
Efficacy of repair and reconstruction therapy for the treatment of lateral ankle ligament injury
Authors: Wang Zheng-gang , Wu Chao
Published: May 2020

Background:

In this study, we will explore the efficacy and safety of repair and reconstruction therapy (RRT) for patients with lateral ankle ligament injury (LALI).

Methods:

Searches will be carried out in the Medline, EMBASE, Web of Science, Cochrane Library, PsycINFO, China National Knowledge Infrastructure, along with a comprehensive search of grey literature. All databases will be searched from inception to the March 1, 2020 with no restrictions to language and publication status. Two investigators will independently conduct selection of study, information collection, and risk of bias assessment, respectively. A third investigator will help to solve any different opinions between 2 investigators. RevMan 5.3 software will be utilized for statistical analysis.

Results:

This study will assess the efficacy and safety of RRT for patients with LALI through assessing pain intensity, ankle function after ligament injury, time to return to work, time to return to sports, Tegner activity level, quality of life, and adverse events.

Conclusion:

This study summarizes latest evidence of RRT for patients with LALI and may provide guidance for clinical practice.

Study registration number: INPLASY202040082.
Correlation between peripheral blood inflammatory indicators and pathologic complete response to neoadjuvant chemotherapy in locally advanced breast cancer patients
Authors: Eren Tulay , Karacin Cengiz , Ucar Gokhan , Ergun Yakup , Yazici Ozan , İmamoglu Goksen İnanc , Ozdemir Nuriye
Published: May 2020

The immune system plays a fundamental role in the response to neoadjuvant chemotherapy (NAC) of locally advanced breast cancer (LABC) patients. Patients with pathological complete response (pCR) after NAC have a higher survival rate. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are peripheral blood indicators of inflammatory response. This investigates the correlation between NLR, PLR, LMR, and other clinicopathological features of breast cancer patients before receiving NAC and pCR.

Data of LABC patients who underwent NAC between 2009 and 2018 were retrospectively reviewed. Each patient's peripheral complete blood count was recorded before starting NAC. The cut-off values for neutrophils, lymphocytes, monocytes, and platelets in the peripheral blood and NLR, PLR, and LMR were determined by receiver operating characteristic curve analyses.

The records of 131 patients were analyzed and divided into two groups, pCR (+ve) and pCR (−ve), and their clinicopathological features and laboratory findings were compared. pCR was achieved in 23.6% of patients. The cut-off values of neutrophils, lymphocytes, monocytes, and platelets at the time of diagnosis and NLR, PLR, and LMR were, respectively, 4150 μL, 2000 μL, 635 μL, 271 × 103 μL, 1.95, 119, and 3.35. The pCR rate was higher in patients with low neutrophil count, low NLR, and high lymphocyte count (P = .002, <.001, and .040, respectively).

As per the findings of multivariate logistic regression analysis, the independent predictive factors of pCR were clinical tumor size T1 and T2, grade 3, ER negativity, and low NLR (P = .015, .001, .020, .022, and .001, respectively).

While NLR was found to be an independent predictive factor of pCR in LABC patients receiving NAC, a similar result was not observed for PLR and LMR. NLR can be a useful biomarker for predicting the response of patients receiving NAC.
Nasal nebulization inhalation of budesonide for chronic rhinosinusitis with nasal polyps
Authors: Zheng Peng-ju , Zhang Yi-ying , Zhang Shu-hua , Liu Gui-fang , Wang Jin-sheng
Published: May 2020

Background:

Chronic rhinosinusitis and nasal polyps (CRNP) is a common public health concern for general population, and is thought to negatively impact their quality of life. Although previous studies have reported that nasal nebulization inhalation of budesonide (NNIB) can benefit patients with such condition, its conclusions are still inconsistent. Thus, this study will assess the efficacy and safety of NNIB for the treatment of CRNP.

Methods:

To identify any associated studies, we will comprehensively and systematically search Cochrane Library, PubMed, EMBASE, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will search all electronic databases from inception to the present with no limitations of language and publication status. Two independent reviewers will undertake selection of study, data collection, and study quality evaluation, respectively. Another reviewer will help to settle down any different opinions between both of them. Study quality will be checked using Cochrane risk of bias tool, and statistical analysis will be performed using RevMan 5.3 software.

Results:

This study will assess the efficacy and safety of NNIB for the treatment of CRNP through assessing primary outcomes of nasal symptoms and polyp sizes, and secondary outcomes of serum cortisol levels, health-related quality of life, and any expected and unexpected adverse events.

Conclusion:

The results of this study will summarize the up-to-date evidence on assessing the efficacy and safety of NNIB for the treatment of CRNP.

Study registration number:

INPLASY202040108.
Endoscopic papillectomy of benign papillary tumors
Authors: Lü Shunli , Jiang Mengni , Liu Feng , Tang Hailing , Yang Yuan , Zhang Wei , Zhang Minmin , Jin Zhendong , Li Zhaoshen
Published: May 2020

Endoscopic treatment of duodenal papillary tumors is well described. This study aims to provide new evidence for the treatment of benign papillary tumors through comparisons between endoscopic snare papillectomy (ESP) and endoscopic mucosal resection (EMR).

Between May 2010 and December 2017, 72 patients were enrolled. Diagnosis and treatment procedures were ESP and EMR. Endoscopic follow-up evaluation was done periodically as a surveillance measurement for recurrence.

Seventy-two patients with ampullary tumors were enrolled, of which 66 had adenomas including 9 high-grade intraepithelial neoplasias and 2 carcinomas in adenoma. Complete resections with tumor-free lateral and basal margins were achieved in all patients. Postoperative complications were bleeding (9.5% in EMR vs 10% in ESP) and pancreatitis (2.4% in EMR and 3.3% in ESP), with no occurrence of perforation, cholangitis or papillary stenosis. Adenoma recurrence was found in 7 patients (14.3% in EMR vs 3.3% in ESP) at 1 year.

The ESP procedure is safe and effective for benign ampullary adenoma, high-grade intraepithelial neoplasias, and noninvasive cancer without intraductal tumor growth, which has a shorter procedural duration, as well as lower complication, recurrence rates and hospitalization costs.
Long-term efficacy and feasibility of levonorgestrel-releasing intrauterine device use in patients with adenomyosis
Authors: Song Soo Youn , Lee Sun Yeul , Kim Hye Yun , Park Dan Bit , Kim Da Eun , Lee Ki Hwan , Lee Siyeo , Yang Jung Bo , Yoo Heon Jong
Published: May 2020

To evaluate the efficacy and feasibility of levonorgestrel-releasing intrauterine device (LNG-IUD) use longer than 5 years in women with adenomyosis.

Data were retrospectively collected from patients who were treated with LNG-IUD longer than 5 years at the Chungnam National University hospital for adenomyosis diagnosed with ultrasonography from January 2006 to November 2013.

A total of 131 patients who were diagnosed with adenomyosis had treated with LNG-IUD longer than 5 years. The mean duration of keeping 1 device without replacement was 58.35 ± 15.98 months, and total duration of LNG-IUD treatment was 83.86 ± 23.88 months. A total of 51 patients stopped using LNG-IUD after 5 years and the mean age at the time of LNG-IUD removal was 52.46 ± 6.9. LNG-IUD treatment had a significant effect on both menorrhagia and dysmenorrhea starting from the first month of insertion (P < .01), which persisted until 6 years when the effect started to plateau. The decrease in uterine volume was not consistent during the treatment period. The uterine volume decreased significantly only in the first and second year of LNG-IUD treatment and then from eighth to tenth year of LNG-IUD treatment (P < .05). Adverse events after insertion of LNG-IUD decreased significantly after 5 years.

LNG-IUD treatment longer than 5 years is an effective and feasible method for patients diagnosed with adenomyosis.
Precision therapeutic opioid dosing implications from genetic biomarkers and craving score
Authors: Chang Hsin-Wen , Ho Wen-Chao , Huang Chieh-Liang , Wang Ruey-Yun
Published: May 2020

Determining the clinically optimal dose in methadone maintenance therapy (MMT) is a time-consuming procedure, which considers clinical signs and symptoms.

To perform a quantitative trait locus association for identifying genetic variants for MMT dosage that underlie heroin addiction and methadone metabolism and then integrate several genotypic and phenotypic factors are potential predictors for clinically optimal MMT dose for personalized prescription.

In total, 316 heroin-dependent patients undergoing MMT were recruited at the Addiction Center of the China Medical University Hospital. A multinomial logistic regression model was used to assess associations between genetic polymorphisms and MMT dosing. The data were randomly separated into training and testing sets. In order to enhance the prediction accuracy and the reliability of the prediction model, we used areas under the receiver operating characteristic curves to evaluate optimal MMT dose in both training and testing sets.

Four single nucleotide polymorphisms, namely rs806368 in CNR1, s1386493 in TPH2, s16974799 in CYP2B6, and rs2229205 in OPRL1, were significantly associated with the maximum MMT dose (P < .05). The genetic risk score (GRS) was associated with maximum MMT dose, and after adjustments for age, sex, and body mass index, the GRS remained independently associated with the maximum MMT dose. The area under the receiver operating characteristic curve of the combined GRS and craving score was 0.77 for maximum MMT dose, with 75% sensitivity and 60% specificity.

Integrating the GRS and craving scores may be useful in the evaluation of individual MMT dose requirements at treatment initiation. Optimal dose prediction allows clinicians to tailor MMT to each patient's needs.
Hyaluronic acid predicts poor prognosis in breast cancer patients
Authors: Wu Weiping , Chen Lifen , Wang Yanzhong , Jin Jing , Xie Xinyou , Zhang Jun
Published: May 2020

Background:

Hyaluronic acid (HA) may be a novel prognostic biomarker of breast cancer. However, the available evidence is controversial. Therefore, we performed a meta-analysis to determine the prognostic role of HA in breast cancer.

Methods:

The data were extracted from seven articles by searching the databases of PubMed, EMBASE, Web of Science, the Chinese National Knowledge Infrastructure and Wanfang data for the prognostic role of HA in breast cancer. In reference to survival outcomes, the pooled hazard ratios (HRs) of HA were calculated given a 95% confidence interval (CI).

Results:

A total of seven articles were included in our study involving 2664 cases. The result of meta-analysis showed that a high HA level predicts poor overall survival (OS) (HR = 1.86, 95% CI: 1.28–2.71, P = .001) and shortened disease-free or recurrence-free survival or progression free survival (DFS/RFS/PFS) (HR = 1.63, 95% CI: 1.14–2.33, P = .007) in breast cancer patients. Moreover, a high HA level in stroma (HR = 1.63, 95% CI: 1.06–2.51, P = .025) and plasma (HR = 3.26, 95% CI: 2.25–4.73, P < .001) significantly predicted poor OS. Besides, a tendency shows that HA was significantly correlated with lymph node metastasis (HR = 1.55, 95% CI: 0.96–2.49, P = .070) and tumor grade (HR = 2.10, 95% CI: 0.89–4.96, P = .089) on the clinical characteristics of patients.

Conclusion:

These results suggested that HA has a potential to be prognostic biomarker in breast cancer patients, especially location in stroma and plasma.
Effectiveness of acupuncture in polycystic ovary syndrome
Authors: Wu Jielei , Chen Di , Liu Nenghui
Published: May 2020

Objective:

To evaluate the effectiveness of acupuncture in reproductive-age females with polycystic ovary syndrome (PCOS).

Methods:

We searched the Pubmed, Web of Science, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chongqing VIP databases for the relevant literature. The meta-analysis was performed with a random-effects model with RevMan 5.3. The primary outcomes of interest included the rate of live birth, pregnancy and ovulation, and the secondary outcomes included the recovery of menstrual period and hormone levels. Results were expressed as the relative risk (RR) for the discrete data and the mean difference (MD) for the continuous outcomes with a 95% confidence interval (CI).

Results:

Twenty two studies with 2315 participants were included in this systematic review and meta-analysis. A pooled analysis showed a recovery of the menstrual period (5 trials; 364 participants; SMD, −0.52; 95% CI [−0.89, −0.14]; I
2 = 67%; P = .0007; low certainty) in the acupuncture group. Furthermore, there were significant decreases in the luteinizing hormone (LH) (13 trials; 917 participants; MD, −0.92; 95% CI [−1.43, −0.41]; I
2 = 60%; P = .0004; very low certainty) and testosterone (13 trials; 923 participants; SMD, −0.46; 95% CI [−0.73, −0.20]; I
2 = 75%; P = .0006; very low certainty) in the acupuncture group. No significant differences were observed in the rates of live birth, pregnancy, and ovulation, and no significant differences were observed in the LH/follicle-stimulating hormone (FSH) ratio.

Conclusions:

There was insufficient evidence to support that acupuncture could promote live birth, pregnancy, and ovulation. However, acupuncture could promote the recovery of menstrual cycles as well as downregulate the levels of LH and testosterone in patients with PCOS.

Study registration: PROSPERO CRD42019128574.
Impact of transcranial Doppler sonography for detecting ischemic stroke
Authors: Liu Wen-Juan , Zhang Ya-Juan
Published: May 2020

Background:

This study aims to explore the impact of transcranial Doppler sonography (TDS) for detecting ischemic stroke (IS).

Methods:

PUBMED, EMBASE, Cochrane Library, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge In-frastructure will be utilized to examine case-controlled studies that used TDS for detecting IS. All electronic databases will be searched from inception to March 20, 2020. All study selection, data extraction, and study quality assessment will be carried out by 2 independent reviewers. All study quality will be assessed by Quality Assessment of Diagnostic Accuracy Studies tool, and statistical analysis will be performed by RevMan V.5.3 software and Stata V.12.0 software.

Results:

This study will explore the impact of TDS for detecting IS through sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio.

Conclusion

: This study expects to find out whether TDS can be utilized for IS detection.

Systematic review registration: INPLASY202040155.
Nivolumab-induced IgA nephropathy in a patient with advanced gastric cancer
Authors: Tanabe Katsuyuki , Kanzaki Hiromitsu , Wada Takahira , Nakashima Yuri , Sugiyama Hitoshi , Okada Hiroyuki , Wada Jun
Published: May 2020

Introduction:

Immune checkpoint inhibitors including nivolumab, an antibody against programmed death-1, have been increasingly introduced in various cancer treatment regimens, and are reported to be associated with immune-related adverse events. Nivolumab-induced renal injury is generally caused by acute interstitial nephritis and is managed by drug discontinuation and steroid therapy. Although this agent can infrequently induce glomerulonephritis, the pathogenesis and therapeutic strategy remain undetermined.

Patient concerns:

A 78-year-old man was diagnosed with advanced gastric cancer with portal thrombosis. First- and second-line chemotherapies were ineffective; thus, nivolumab monotherapy was initiated. Although it effectively prevented tumor growth, proteinuria and microhematuria appeared 2 months later. Despite drug discontinuation, serum creatinine progressively increased from 0.72 to 1.45 mg/dL. Renal biopsy revealed mesangial IgA and C3 deposition in immunofluorescence analysis and mesangial proliferation with crescent formation in light microscopy.

Diagnosis:

The patient was diagnosed with IgA nephropathy. Based on the temporal relationship between the nivolumab therapy and abnormal urinalysis, IgA nephropathy was considered to have been induced by nivolumab.

Interventions:

A moderate dose (0.6 mg/kg/day) of prednisolone was orally administrated, with tapering biweekly.

Outcomes:

Steroid therapy stabilized his serum creatinine levels and markedly reduced proteinuria. However, bacterial pneumonia substantially impaired his performance status; thus, nivolumab could not be restarted despite tumor regrowth.

Lessons:

IgA nephropathy should be recognized as an uncommon renal adverse event during nivolumab therapy. After drug discontinuation, nivolumab-induced IgA nephropathy is likely to respond to moderate doses of steroid therapy with early tapering. However, more evidence is needed to determine whether nivolumab can be safely restarted during or after steroid therapy.
Assessment of lamivudine, zidovudine, lopinavir, and ritonavir plasma levels in HIV-positive pregnant women
Authors: Hernández-Pineda Jessica , Jung-Cook Helgi Helene , Katende-Kyenda Norah Lucky , Galindo-Sevilla Norma , Domínguez-Castro Mauricio , Romo-Yañéz José , Ramírez-Ramírez Alicia , Irles Claudine , Figueroa-Damián Ricardo
Published: May 2020

Simultaneous therapeutic drug monitoring (TDM) of combination antiretroviral therapy (cART) is critical during pregnancy in order to improve clinical follow-up, monitor viral load, and patient adherence to treatment.

A modified simple and fast ultra-high performance liquid chromatography coupled with tandem mass spectrometry and electrospray ionization (UPLC-ESI-MS/MS) method was developed and validated according to national and international guidelines for the simultaneous determination of lamivudine (LMV), zidovudine (ZDV), lopinavir (LPV), and ritonavir (RTV) concentrations in 100-μL plasma sample of Human Immunodeficiency Virus (HIV)-positive pregnant women. Protein precipitation using 0.1% formic acid in cold acetonitrile was used for sample preparation. The chromatographic separation was achieved with a run-time of 3.0 minutes and 3-μL injection on an ethylene bridged hybrid C18 column (2.1 μm × 50 mm, 1.7 μm), under gradient conditions using acetonitrile and formic acid (0.1%).

The chromatographic method was used to analyze 10 plasma samples from 8 HIV pregnant women as a clinical patient routinely follow-up by applying TDM criteria.

The protonated precursor/product ion transitions for LMV (230.18/112.08), ZDV (268.22/127.10), LPV (629.55/447.35), and RTV (721.50/296.20) were recorded in multiple-reaction-monitoring (MRM) mode. The calibration curve was linear in the range of 50–3,000, 75–4,500, 250–15,000, and 25–1,500-ng/mL for LMV, ZDV, LPV, and RTV, respectively. The range of accuracy was 97.2% to 100.1% and precision 3.4% to 12.7%. The method showed specificity and matrix effect values of < 15%. Minimum absolute recovery percentages (%CV) were 90.5 (5.4), 90.8 (5.0), 95.4 (3.5), and 93.7 (6.9), for LMV, ZDV, LPV, and RTV, respectively. Drug concentrations in patient samples had high inter-individual variability with %CV of 91.98%, 77.54%, 53.80%, and 92.16% for ZDV, LMV, LPV, and RTV, respectively. Two of the 8 patients showed no adherence due to the absence of Protease Inhibitors (PIs) levels in plasma.

This technique demonstrated to be effective in therapeutic drug monitoring and is intended to be used in population pharmacokinetics specifically for HIV-positive pregnant women.
Long-term outcomes of endoscopic submucosal dissection versus surgery for treating early gastric cancer of undifferentiated-type
Authors: Guo Anbing , Du Chao , Tian Shuni , Sun Liangxu , Guo Mingxiao , Lu Lin , Peng Lijun
Published: May 2020

Application of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancers (EGCs) remains controversial. Therefore, we aimed to compare long-term outcomes of ESD with those of surgery for patients with undifferentiated-type EGCs by a retrospective study.

We retrospectively reviewed data of patients who underwent curative ESD or gastrectomy for undifferentiated-type EGCs between 2010 and 2017. Gastric cancers were undifferentiated-type adenocarcinoma without ulceration confined to the mucosal layer and 2 cm or smaller in size. Demographics, complications, recurrence cancer rates, and survival data were collected and compared.

Forty patients who underwent curative ESD and 52 patients who underwent surgery were included. The median follow-up duration was 74.6 months. There was no significant difference of metachronous gastric cancer rate (5.0% vs 3.8%, P = .75) or total cancer recurrence rate (10.0% vs 3.8%, P = .33) between the 2 groups. The 5-year overall survival, disease-free survival, recurrence-free survival rates did not significantly differ between the 2 groups (P = .72, .26, .27 respectively). There were no gastric cancer-related deaths in either group.

Long-term outcomes after curative ESD for undifferentiated-type EGCs that met the expanded indication were comparable to that achieved with surgery. ESD without additional surgery is an acceptable choice to treat undifferentiated-type EGCs that meet the curative criteria.
The utility of electrodiagnostic inching study and conservative treatment in supracondylar process syndrome
Authors: Chun Se-Woong , Lim Seung-Kyu
Published: May 2020

Rationale:

Supracondylar process is a rare bony anomaly that can cause neurovascular symptoms. Previous reports on supracondylar process syndrome mostly suspect the condition by physical examination and simple radiograph with little assistance of electrodiagnostic methods and report efficiency of surgical treatment.

Patients concerns:

A 45-year-old woman working at an assembly line packing boxes presented with tingling pain at her middle and ring fingers that started 2 months ago. She had positive Tinel sign at the medial side of the distal arm.

Diagnosis:

Electrodiagnostic inching study on median nerve was conducted and the conduction velocity at the segment between 3 cm to 5 cm proximal to the elbow crease was decreased to 27m/s. Following imaging studies revealed supracondylar process at 4.2 cm proximal to the medial epicondyle. She was successfully treated with conservative treatment.

Interventions:

Oral medications including Non-steroidal anti-inflammatory drug and pregabalin were prescribed along with superficial and deep heat modalities. The extent of manual labor was modified. Additionally, self-massage and stretching/nerve-gliding exercises were delivered.

Outcomes:

The symptoms substantially improved and she could sleep without trouble, however, complete resolution was not achieved. After a year, she was nearly symptom-free after changing occupations with only occasional tingling after manual labor of unusual intensity.

Lessons:

This case report enlightens the versatility of electrodiagnostic inching study in localizing median neuropathy at the distal arm and the effectiveness of conservative treatment in supracondylar process syndrome.
Clinical significance of circulating tumor cells detection in renal cell carcinoma with thrombus
Authors: Ge Liyuan , Song Yimeng , Yang Feilong , Zhao Guojiang , Lu Min , Zhang Shudong , Ma Lulin
Published: May 2020

The aim of the study was to evaluate the potential role of circulating tumor cell (CTC) detection in the surgical assessment of renal cell carcinoma (RCC) patients with thrombi.

Nine patients diagnosed with renal mass and thrombi were enrolled from June 2018 to January 2019. Blood samples were collected for CTC detection using SE-iFISH assay. CD45, DAPI, programmed death ligand 1, and fluorescence in situ hybridization with the centromere of chromosome 8 (CEP8) were immune-stained for analysis. Patient demographics, clinical features, pathological characteristics, and CTC detection results were extracted for analysis.

Seven of 9 patients (77.8%) had 12 detectable CTCs, 5 of which were with CEP8-positive signal ≥5 and the others were CEP8-positive signal = 3. All 3 patients (100%) with IVC invasion had detectable CTCs, whereas CTCs were detected in 4 of 6 patients (66.7%) without IVC invasion. CEP8 analysis revealed that CTCs in IVC invasion patients were all of CEP8-positive signal ≥5 status, whereas only half of the CTCs in patients without IVC invasion were of CEP8-positive signal ≥5 pattern.

In conclusion, both CTC subtype and total CTC number may serve as a marker for predicting inferior vena cava invasion in RCC patients.
The role of intrasphincteric botulinum toxin injection in the management of functional biliary pain: a systematic review and meta-analysis
Authors: Menon Shyam , Kurien Reuben , Mathew Ray
Published: May 2020

Background

The management of postcholecystectomy functional biliary pain or Type III sphincter of Oddi dysfunction is challenging. The Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction study has demonstrated the lack of efficacy of endoscopic sphincterotomy in the management of Type III sphincter of Oddi dysfunction.

Objective and methods

Botulinum toxin injection to the sphincter of Oddi has been reported as being effective in uncontrolled studies. We sought to understand its pooled efficacy in controlling pancreaticobiliary pain in a systematic review and meta-analysis.

Results

Our literature review yielded 10 studies (416 patients) and on random effects meta-analysis, the pooled efficacy of intrasphincteric botulinum toxin injection in alleviating symptoms of pancreaticobiliary was 49% (complete response) and 64% (partial response). One patient developed mild pancreatitis postprocedure and five patients needed postprocedure hospital admission for pain management. The effect of botulinum toxin injection was transient and in the majority of studies, and a positive response to botulinum toxin injection was followed by an endoscopic sphincterotomy. In one study, relapse of pain was managed by repeat botulinum toxin injections with success.

Conclusion

Intermittent botulinum toxin injection could be a potential option in the overall management strategy of patients with Type III sphincter of Oddi dysfunction, in conjunction with medical management with neuromodulatory medication.
Impact of Recipient Age in Combined Liver-Kidney Transplantation: Caution Is Needed for Patients ≥70 Years
Authors: Ekser Burcin , Goggins William C. , Fridell Jonathan A. , Mihaylov Plamen , Mangus Richard S. , Lutz Andrew J. , Soma Daiki , Ghabril Marwan S. , Lacerda Marco A. , Powelson John A. , Kubal Chandrashekhar A.
Published: May 2020

Background.

Elderly recipients (≥70 y) account for 2.6% of all liver transplants (LTs) in the United States and have similar outcomes as younger recipients. Although the rate of elderly recipients in combined liver-kidney transplant (CLKT) is similar, limited data are available on how elderly recipients perform after CLKT.

Methods.

We have previously shown excellent outcomes in CLKT using delayed kidney transplant (Indiana) Approach (mean kidney cold ischemia time = 53 ± 14 h). Between 2007 and 2018, 98 CLKTs were performed using the Indiana Approach at Indiana University (IU) and the data were retrospectively analyzed. Recipients were subgrouped based on their age: 18–45 (n = 16), 46–59 (n = 34), 60–69 (n = 40), and ≥70 years (n = 8).

Results.

Overall, more elderly patients received LT at IU (5.2%) when compared nationally (2.6%). The rate of elderly recipients in CLKT at IU was 8.2% (versus 2% Scientific Registry of Transplant Recipient). Recipient and donor characteristics were comparable between all age groups except recipient age and duration of dialysis. Patient survival at 1 and 3 years was similar among younger age groups, whereas patient survival was significantly lower in elderly recipients at 1 (60%) and 3 years (40%) (P = 0.0077). Control analyses (replicating Scientific Registry of Transplant Recipient’s survival stratification: 18–45, 46–64, ≥65 y) showed similar patient survival in all age groups.

Conclusions.

Although LT can be safely performed in elderly recipients, extreme caution is needed in CLKT due to the magnitude of operation.
Stroop N450 reflects both stimulus conflict and response conflict
Authors: Huang Bingfang , Chen Caiqi
Published: May 2020

N450 is described as a valid event-related potential indicator of Stroop interference, but the true specific psychological meaning of the Stroop N450 remains obscure. In the present research, we first used a Chinese character incongruent-eligible task and manipulated different types of conflict to investigate whether Stroop N450 reflects stimulus conflict, response conflict or both. The results showed that, only the N450 in the incongruent-eligible condition was more negative than that of the incongruent-ineligible and neutral conditions in the frontal-central area; simultaneously, there was a left parietal-occipital N450 that successively weakened in the incongruent-eligible, incongruent-ineligible and neutral conditions. These results indicate that Stroop N450 reflects both stimulus conflict and response conflict.
ROBUST COVID-19-RELATED CONDITION CLASSIFICATION NETWORK
Authors: Lucius Maximiliano , Belvisi Martin , Galmarini Carlos Maria
Published: May 2020

COVID-19 can exponentially precipitate life-threatening emergencies as witnessed during the recent spreading of a novel coronavirus infection which can rapidly evolve into lung collapse and respiratory distress (among other various severe clinical conditions). Our study evaluates the performance of a tailor-designed deep convolutional network on the tasks of early detection and localization of radiological signs associated to COVID-19 on frontal chest X-rays. We also asses the frameworks capacity in differentiating the above-mentioned signs, which are usually confused with the more usual common bacterial and viral pneumonias. Open-source chest X-ray images categorized as Normal, Non-COVID-19 and COVID-19 pneumonias were downloaded from the NIH (n=2,259), RSNA (n=600) and HM Hospitales (n=2,307). Our algorithmic framework was able to precisely detect the images with COVID19- related radiological findings (mean Accuracy: 90.5%; Sensitivity: 80.6%; Specificity: 98.0%), whilst correctly categorizing images deemed as Non-COVID-19 pneumonias (mean Accuracy: 88.4%; Sensitivity: 93.3%; Specificity: 92.0%) and normal chest X- rays (mean Accuracy 92.1%; Sensitivity: 91.8%; Specificity: 94.3%). The associated results show that our AI framework is able to classify COVID-19 accurately, making of it a potential tool to improve the diagnostic performance across primary-care centres and, to grant priority to a subset of algorithmic selected images for urgent follow-on expert review. This would sensibly accelerate diagnosis in remote locations, reduce the bottleneck on specialized centres, and/or help to alleviate the needs on situations of scarcity in the availability of molecular tests.
Controlling wireframe DNA origami nuclease degradation with minor groove binders
Authors: Wamhoff Eike-Christian , Huang Hellen , Read Benjamin J. , Ginsburg Eric , Schief William R. , Farrell Nicholas , Irvine Darrell J. , Bathe Mark
Published: May 2020

Virus-like DNA nanoparticles have emerged as promising vaccine and gene delivery platforms due to their programmable nature that offers independent control over size, shape, and functionalization. However, as biodegradable materials, their utility for specific therapeutic indications depends on their structural integrity during biodistribution to efficiently target cells, tissues, or organs. Here, we explore reversible minor groove binders to control the degradation half-lives of wireframe DNA origami. Bare, two-helix DNA nanoparticles were found to be stable under typical cell culture conditions in presence of bovine serum, yet they remain susceptible to endonucleases, specifically DNAse I. Moreover, they degrade rapidly in mouse serum, suggesting species-specific degradation. Blocking minor groove accessibility with diamidines resulted in substantial protection against endonucleases, specifically DNAse-I. This strategy was found to be compatible with both varying wireframe DNA origami architectures and functionalization with protein antigens. Our stabilization strategy offers distinct physicochemical properties compared with established cationic polymer-based methods, with synergistic therapeutic potential for minor groove binder delivery for infectious diseases and cancer.
3D chromatin organization changes modulate adipogenesis and osteogenesis
Authors: Hao Ruo-Han , Guo Yan , Guo Jing , Rong Yu , Yao Shi , Chen Yi-Xiao , Dong Shan-Shan , Zhu Dong-Li , Chen Hao , Yang Tie-Lin
Published: May 2020

Human mesenchymal stem cells (hMSCs) can be differentiated into adipocytes and osteoblasts. While the transcriptomic and epigenomic changes during adipogenesis and osteogenesis have been characterized, what happens to the chromatin loops is hardly known. Here we induced hMSCs to adipogenic and osteogenic differentiation, and performed 2 kb resolution Hi-C experiments for loop detection and generated RNA-seq, histone modification ChIP-seq and ATAC-seq data for integrative analysis before and after differentiation. We quantitatively identified differential contact loops and unique loops. After integrating with multi-omics data, we demonstrate that strengthened loops after differentiation are associated with gene expression activation. Specially, unique loops are linked with cell fate determination. We also proposed loop-mediated regulatory networks and identifiedIRS2andRUNX2as being activated by cell-specific loops to facilitate adipocytes and osteoblasts commitment, respectively. These results are expected to help better understand the long-range regulation in controlling hMSC differentiation, and provide novel targets for studying adipocytes and osteoblasts determination.
Status and prospects of marine NIS detection and monitoring through (e)DNA metabarcoding
Authors: Duarte Sofia , Vieira Pedro E. , Lavrador Ana S. , Costa Filipe O.
Published: May 2020

In coastal ecosystems, non-indigenous species (NIS) are recognized as a major threat to biodiversity, ecosystem functioning and socio-economic activities. Here we present a systematic review on the use of metabarcoding for NIS surveillance in marine and coastal ecosystems, through the analysis of 42 publications. Metabarcoding has been mainly applied to environmental DNA (eDNA) from water samples, but also to DNA extracted from bulk organismal samples. DNA extraction kits have been widely used and the 18S rRNA and the COI genes the most employed markers, but less than half of the studies targeted more than one marker loci. The Illumina MiSeq platform has been used in >50% of the publications. Current weaknesses include potential occurrence of false negatives due to the primer-biased or faulty DNA amplification and the incompleteness of reference libraries. This is particularly concerning in the case of NIS surveillance, where proficiency in species level detection is critical. Until these weaknesses are resolved, ideally NIS metabarcoding should be supported by complementary approaches, such as morphological analysis or more targeted molecular approaches (e.g. qPCR, ddPCR). Even so, metabarcoding has already proved to be a highly sensitive tool to detect small organisms or undifferentiated life stages across a wide taxonomic range. In addition, it also seems to be very effective in ballast water management and to improve the spatial and temporal sampling frequency of NIS surveillance in marine and coastal ecosystems. Although specific protocols may be required for species-specific NIS detection, for general monitoring it would be vital to settle on a standard protocol able to generate comparable results among surveillance campaigns and regions of the globe, seeking the best approach for detecting the broadest range of species, while minimizing the chances of a false positive or negative detection.
Lysosomal dysfunction impairs mitochondrial quality control and predicts neurodegeneration in TBCKE
Authors: Tintos-Hernandez Jesus A , Keller Kierstin N. , Santana Adrian , Ortiz-Gonzalez Xilma R
Published: May 2020

Biallelic variants in TBC1-domain containing kinase (TBCK) cause intellectual disability in children. It remains unclear how variants inTBCKlead to a neurodevelopmental disorder and what biological factors modulate the variability of clinical severity. Previous studies showed increased autophagosomes in patients sharing the truncating (p.R126X) Boricua homozygousTBCKvariant, who exhibit a severe and progressive neurodegenerative phenotype. Since defects in mitophagy are linked to neurodegenerative disorders, we tested whether mitophagy and mitochondrial function are altered inTBCK-/-fibroblasts. Our data shows significant accumulation of mitophagosomes, reduced mitochondrial respiratory capacity, and mtDNA depletion. Furthermore, mitochondrial dysfunction correlates with the severity of the neurological phenotype. Since effective mitophagy and degradation of mitophagosomes ultimately depends on successful lysosomal degradation, we also tested lysosomal function. Our data shows that lysosomal proteolytic function is significantly reduced inTBCK-/-fibroblasts. Moreover, acidifying lysosomal nanoparticles rescue the mitochondrial respiratory defects, suggesting that impaired mitochondrial quality control secondary to lysosomal dysfunction, may play an important role in the pathogenicity of this rare neurodevelopmental disorder and predict the degree of disease progression and neurodegeneration.
Development of genetic markers for sexingCannabis sativaseedlings
Authors: Prentout Djivan , Razumova Olga , Henri Hélène , Divashuk Mikhail , Karlov Gennady , Marais Gabriel AB
Published: May 2020

Cannabis sativais a dioecious plant with a XY system. Only females produce cannabinoids in large amount. Efficient male removal is an important issue for the cannabis industry. We have recently identified the sex chromosomes ofC. sativa, which opens opportunities for developing universal genetic markers for early sexing ofC. sativaplants. Here we selected six Y-linked markers and designed PCR primers, which were tested on five hemp cultivars both dioecious and monoecious. We obtained promising results, which need to be extended using a larger number of individuals and a more diverse set of cultivars, including THC producing ones.
Distinguishing within- from between-individual effects: How to use the within-individual centering method for quadratic patterns
Authors: Fay Rémi , Martin Julien , Plard Floriane
Published: May 2020

Any average pattern observed at the population level may confound two different types of processes: some processes that occur among individuals and others that occur within individuals. Separating within- from among-individual processes is critical for our understanding of ecological and evolutionary dynamics.

The within-individual centering method allows distinguishing within- from among-individual processes and this method has been largely used in ecology to investigate both linear and quadratic patterns. Here we show that two alternative equations could be used for the investigation of quadratic within-individual patterns. We explain under which hypotheses each is valid. Reviewing the literature, we found that mainly one of these two equations has been used by the studies investigating quadratic patterns. Yet this equation could be inappropriate in many cases.

We show that these two alternative equations make different assumptions about the shape of the within-individual pattern. The choice of using one equation instead of the other should depend upon the biological process investigated. One equation assumes that all individuals show the same quadratic pattern over the whole range of the explanatory variable whereas the other assumes that the quadratic patterns depend on the average explanatory variable of each individual. We give examples of biological processes corresponding to each equation.

Using simulations, we showed that a mismatch between the assumptions made by the equation used to analyze the data and the biological process investigated led to flawed inference affecting both output of model selection and accuracy of estimates. We stress that the equation used should be chosen carefully to ensure that the assumption made about the shape of the within-individual pattern matches the biological process investigated. We hope that this manuscript will encourage the use of the within-individual centering method, promoting its correct application for non-linear relationships.
Biosynthesis of cittilins, unusual ribosomally synthesized and post-translationally modified peptides fromMyxococcus xanthus
Authors: Hug Joachim J. , Dastbaz Jan , Adam Sebastian , Revermann Ole , Koehnke Jesko , Krug Daniel , Müller Rolf
Published: May 2020

Cittilins are secondary metabolites from myxobacteria comprised of three L-tyrosines and one L-isoleucine forming a bicyclic tetrapeptide scaffold with biaryl and aryl-oxygen-aryl ether bonds. Here we reveal that cittilins belong to the ribosomally synthesized and post-translationally modified peptide (RiPP) family of natural products, for which only the crocagins have been reported from myxobacteria. A 27 amino acid precursor peptide harbors aC-terminal four amino acid core peptide, which is enzymatically modified and finally exported to yield cittilins. The small biosynthetic gene cluster responsible for cittilin biosynthesis also encodes a cytochrome P450 enzyme and a methyltransferase, whereas a gene encoding a prolyl endopeptidase for the cleavage of the precursor peptide is located outside of the cittilin biosynthetic gene cluster. We confirm the roles of the biosynthetic genes responsible for the formation of cittilins using targeted gene inactivation and heterologous expression inStreptomyces. We also report first steps towards the biochemical characterization of the proposed biosynthetic pathwayin vitro. An investigation of the cellular uptake properties of cittilin A connected it to a potential biological function as an inhibitor of the prokaryotic carbon storage regulator A (CsrA).

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