bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgery for small cell lung cancer
Authors: Xu Long , Zhang Guanzhong , Song Shuxi , Zheng Zhendong
Published: October 2019

The role of surgery in small cell lung cancer (SCLC) is controversial. This study explored whether surgery offered a survival benefits for patients with SCLC.

Patients diagnosed with SCLC between 2010 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. The tumor, node, and metastasis (TNM) stage of SCLC in these patients was reclassified according to the 8th edition of the TNM classification for lung cancer. Overall survival (OS) was separately compared according to TNM stage between patients who underwent surgery and those who did not using Kaplan–Meier method. A Cox regression model was used to identify relevant variables affecting survival. Additional Kaplan–Meier curves were created to compare different types of surgery. Cox regression models and Forest plots were used to identify the predictors of survival in the surgery cohort.

A total of 26,659 patients with SCLC were included, among which 627 (2.4%) patients underwent surgery. Surgery was associated with longer survival in patients with stage IA (45.0 vs 20.0 months, P < .001), stage IB (47.0 vs 19.0 months, P = .001), stage IIA (16.0 m vs NR, P = .007), stage III (18.0 vs 12.0 months, P < .001), and stage IV (9.0 vs 5.0 months, P < .001) disease, although the difference was not statistically significant for patients with stage IIB disease. Multivariate analysis identified surgery as an independent predictor of improved survival for all cohorts divided by stages except for stage IIB. Lobectomy was the most commonly performed procedure. Multivariate analysis in patients who underwent surgery identified lobectomy (hazard ratio [HR], 0.544; 95% confidence interval [CI], 0.341–0.869; P = .011) and chemotherapy (HR, 0.634; 95% CI, 0.487–0.827; P < .001) as independent predictors of improved survival in the surgery cohort.

In a national analysis, surgery was performed in some patients for both early and advanced-stage SCLC. Surgery for SCLC was associated with improved survival except for patients with stage IIB disease. These results support an increased role of surgery in multimodal therapy for SCLC.
Unusual form of the distal bone defect of ulna with neurofibromatosis type 1
Authors: Shen Yiguo , Chen Fangfang
Published: October 2019

Rationale:

Bone malformation occurs in 10% to 25% neurofibromatosis type 1 (NF-1) patients, and the manifestations are scoliosis, congenital arch and pseudo-joint formation, bone cyst, and pathologic fracture. However, a large segmental defect without obvious signs of bone destruction has rarely been reported.

Patient concerns:

A 4.5-year-old male presented with a 4-year history of shortening of the right upper limb and radial head dislocation. The X-ray indicated a lack of the distal part of the right ulna and radial head dislocation.

Diagnosis:

The X-ray showed obvious bone resorption at the right ulna distal, proximal stubble, and distal part of the epiphyseal residue, which was 4.3 mm shorter after 14 months. The patient was finally diagnosed with NF-1 according to the pathologic examination.

Interventions:

The treatment included tumor resection, ulnar osteotomy, and fixation by an Ilizarov frame.

Outcomes:

The Ilizarov frame was removed after 2.7 months of surgery. The radial head was successfully repositioned, and the elbow joint function was significantly improved. No recurrence of the deformity was noted until now.

Lessons:

Osteolysis (defect without bone destruction) is an extremely rare symptom in patients with NF1. Therefore, it is essential to make the right diagnosis by comprehensive and careful physical examination.
Chlamydia-induced reactive arthritis diagnosed during gout flares
Authors: Sumiyoshi Remi , Koga Tomohiro , Tsuji Sosuke , Endo Yushiro , Takatani Ayuko , Shimizu Toshimasa , Igawa Takashi , Umeda Masataka , Fukui Shoichi , Nishino Ayako , Kawashiri Shin-ya , Iwamoto Naoki , Ichinose Kunihiro , Tamai Mami , Nakamura Hideki , Origuchi Tomoki , Kawakami Atsushi
Published: October 2019

Rationale:

The pathology of gouty arthritis and reactive arthritis (ReA) partially overlaps, and both diseases are characterized by the production of inflammatory cytokines associated with the activation of monocytes and macrophages. However, the precise cytokine profile of cases with a coexistence of both diseases is unknown, and there are few reports on the course of treatment in patients with both gouty arthritis and ReA.

Patient concerns:

A 39-year-old man with a recurrent episode of gouty arthritis presented prednisolone-resistant polyarthritis with high level of C-reactive protein (CRP). He had the features of gouty arthritis such as active synovitis of the first manifestation of metatarsophalangeal (MTP) joints and the presence of monosodium urate (MSU) crystals from synovial fluid. But he also had the features of ReA such as the presence of tenosynovitis in the upper limb, the positivity of human leukocyte antigen (HLA)-B27, a history of sexual contact and positive findings of anti-Chlamydia trachomatis-specific IgA and IgG serum antibodies.

Diagnoses:

He was diagnosed with HLA-B27 associated Chlamydia-induced ReA accompanied by gout flares.

Interventions:

He was treated with 180 mg/day of loxoprofen, 1 mg/day of colchicine, and 10 mg/day of prednisolone for gout flares. However, his polyarthritis worsened with an increased level of CRP (23.16 mg/dL). Accordingly, we added 500 mg/day of salazosulfapyridine followed by adalimumab (ADA) 40 mg once every 2 weeks.

Outcomes:

After starting ADA, the patient's symptoms and laboratory findings showed rapid improvement and he achieved clinical remission 1 month after initiation of ADA treatment. As of this writing, the patient's clinical remission has been maintained for >1 year.

Lessons:

This case suggests that with exacerbation of arthritis during gouty arthritis, coexistence with other pathologies such as peripheral spondyloarthritis should be considered, and early intensive treatment including tumor necrosis factor inhibitors may be necessary.
Prognostic value of lymphovascular space invasion in patients with early stage cervical cancer in Jilin, China
Authors: Yan Wenxing , Qiu Shuang , Ding Yaming , Zhang Qi , Si Lihui , Lv Sha , Liu Linlin
Published: October 2019

The metastasis of cervical carcinoma is associated with the lymphovascular spread. The primary objective of the present study was to determine the prognostic value of lymphovascular space invasion (LVSI) in patients with early-stage cervical cancer in Jilin, China.

In this retrospective cohort study, patients with early-stage cervical cancer (stage IB-IIA) at the Second Hospital of Jilin University from February 2014 to December 2016 were included in the analysis. All included participants underwent radical hysterectomy with pelvic lymphadenectomy. LVSI was identified by hematoxylin and eosin (H&E) staining. The primary outcomes are overall survival (OS) and progression-free survival (PFS). Kaplan–Meier curves were used to calculate the patient's survival. Survival was compared using the log-rank test, while risk factors for the prognosis were assessed by Cox regression analysis.

The incidence of LVSI was positively associated with the depth of stromal invasion (P = .009) and lymph node metastasis (LNM, P < .001). LVSI is an independent factor that affects OS (P = .009) and PFS (P = .006) in patients with early stage cervical cancer. LNM status is an independent factor that affects postoperative OS (P = .005).

The incidence of lymphatic vessel infiltration is positively associated with the depth of stromal invasion and LNM. LVSI is an independent risk factor for the prognosis of early cervical cancer. The results suggest that further large-scale studies are needed to improve the treatment for patients with LVSI.
Identification of a novel X-linked arginine-vasopressin receptor 2 mutation in nephrogenic diabetes insipidus
Authors: Peng Danxia , Dai Ying , Xu Xuan
Published: October 2019

Introduction:

The clinical and genetic characteristics of nephrogenic diabetes insipidus (NDI) were described via assessing 2 cases of NDI patients from a Chinese family.

Patient concerns:

Two patients who manifest polyuria and polydipsia were admitted to hospital for definite diagnosis.

Diagnosis:

Water deprivation-vasopressin tests showed that the patients may possess renal-origin diabetes insipidus. All the levels of thyroid-stimulating hormone, luteinizing hormone, follicle stimulation hormone, adrenocorticotropic hormone, prolactin, and growth hormone in both patients were normal. These results were certified that both patients possess a nephropathy-type diabetes insipidus. B-mode ultrasonography and urinalysis test demonstrated that the patient's diabetes insipidus is unlikely to originate from renal organic disease. Remarkably, by nucleotide sequencing, we found a novel mutation c.414_418del in arginine-vasopressin receptor 2 (AVPR2) was related to the disease of NDI.

Interventions:

Two patients were treated with oral hydrochlorothiazide and indomethacin. In addition, low salt diet and potassium supplementation throughout the patients’ treatment.

Outcomes:

The clinical symptoms of 2 patients were significantly reduced after targeted therapy.

Conclusion:

A mutation in AVPR2 was discovered to be associated with NID. It provides a new target for molecular diagnosis of NDI, enabling families to undergo genetic counseling and obtain prenatal diagnoses.
Antihypertensive drugs use over a 5-year period among children and adolescents in Beijing, China
Authors: Wu Yao , Cao Yaying , Song Jing , Tian Yaohua , Wang Mengying , Li Man , Wang Xiaowen , Huang Zhe , Li Lin , Zhao Yaling , Qin Xueying , Hu Yonghua
Published: October 2019

Evidence on the prescription patterns of antihypertensive drug use in children and adolescents in China is scarce. A descriptive analysis of the Beijing Medical Claim Data, which covered over 95% of the urban residents, was conducted to investigate antihypertensive prescribing patterns and trends in children and adolescents aged under 18 from 2009 to 2014 in Beijing, China. An additional meta-analysis of trends in hypertension prevalence was conducted to compare trends with antihypertensive medications.

A total of 11,882 patients received at least 1 prescription for antihypertensive drugs from 2009 to 2014. The number of annual antihypertensive users increased from 2009 to 2012, then declined steadily until 2014, which was consistent with the trend of the hypertension prevalence estimated from the meta-analysis. β-receptor blockers, thiazide diuretics, and angiotensin-converting enzyme inhibitors were the 3 most commonly prescribed antihypertensive drugs. More boys took the antihypertensive drugs than girls. For users aged under 3 years, thiazide diuretics, α-receptor blockers, and angiotensin-converting enzyme inhibitors were the most prescribed drugs, while β-receptor blockers, thiazide diuretics were the most used drugs for users above 3 years.

In conclusion, antihypertensive drug prescribing for children and adolescents increased from 2009 to 2014, with different characteristics in different subgroups.
The association of two common polymorphisms in miRNAs with diabetes mellitus
Authors: Li Guixin , Liu Beibei , Jiang Qianqian , Zhang Junli , Xin Shengliang , Xu Keshu
Published: October 2019

Background:

MicroRNAs (miRNAs) are small noncoding single-stranded RNAs with a length of ∼21 nucleotides. Single nucleotide polymorphisms (SNPs) may affect the function of miRNAs, resulting in a variety of disorders in vivo. Recently, diabetes mellitus (DM) has become a global healthcare problem, and several studies have reported that 2 common polymorphisms (miRNA 146a rs2910164 and miRNA 27a rs895819) are related to susceptibility to diabetes. Given that no consensus had been reached regarding the association of the 2 polymorphisms with diabetes, we conducted this meta-analysis.

Methods:

Four databases (PubMed, EMBASE, Cochrane, and Web of Science) were searched up to January 9, 2019. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the association strength. Subgroup and sensitivity analyses were also performed.

Results:

Six studies involving 2585 cases and 2435 controls for miR146a rs2910164 and 5 studies involving 2922 cases and 2781 controls for miR27a rs895819 were ultimately analyzed in our meta-analysis. Based on pooled results, no statistical significance in association between rs2910164 and diabetes in Caucasians, Asians, or type 2 diabetes was observed in any genetic models. Nevertheless, we found a significant correlation between miRNA27a rs895819 and diabetes in the homozygote model (CC vs TT: OR = 0.58, 95%CI [0.35,0.98]) and recessive model (CC vs CT + TT: OR = 0.59, 95%CI [0.36,0.97]). By performing subgroup analysis, we also observed that C allele conveyed a significant protective effect against diabetes development in Caucasians (C vs T: OR = 0.67, 95%CI [0.52,0.85]).

Conclusion:

In conclusion, this meta-analysis indicated that miRNA27a rs895819 might play a protective role in diabetes, and miRNA146a rs2910164 likely had no association with diabetes.
HIV incidence and cohort retention among men who have sex with men in Hangzhou, China
Authors: Li Qingchun , Li Xiting , Luo Yan , Fang Dai , Chen Junfang , Zhang Xingliang , Lv Xin , Jin Jie , Xu Ke , Luo Wenjie , Qian Han-Zhu
Published: October 2019

Prospective cohort studies have been conducted to estimate HIV incidence among men who have sex with men (MSM) in first-line megacities cities (>10 million residents) in China, but few in the second-line large- or middle-size cities. This study was to investigate HIV incidence and cohort retention among MSM in a second-line city Hangzhou in eastern China.

A total of 523 HIV-seronegative MSM were recruited during September 2014 to September 2015, and were followed up prospectively at 3, 6, 9, and 12 months. Questionnaire interviews were conducted, and laboratory tests were performed to evaluate baseline syphilis infection and HIV seroconversions. Chi-square test and logistic regression model were used to identify factors associated with cohort retention rate and syphilis prevalence.

Of 523 participants, 137 (26.2%) completed 6-month follow-up, and use of Internet for recruiting study participants (vs other recruitments: adjusted odds ratio [AOR] = 0.5; 95% confidence interval [CI]: 0.3–0.8) and being homosexual (vs heterosexual or bisexual: AOR = 0.6; 95% CI: 0.4–0.9) were associated with lower cohort retention. The overall HIV incidence during 12 months of follow-up was 6.6 per 100 person-years (95% CI: 3.4–9.8/100 PY). The prevalence of syphilis at baseline was 6.5% (95% CI: 4.4%–8.6%), and disclosing sexual orientation (AOR = 0.4, 95% CI: 0.2–0.9) was associated with lower risk of syphilis infection.

HIV is spreading rapidly among MSM in the second-line Chinese city. Effective interventions are needed to target this population in both first-line megacities and second-line large and middle-size cities.
Regional citrate anticoagulation with a substitute containing calcium for continuous hemofiltration in children
Authors: Bai Ke , Liu Chengjun , Zhou Fang , Xu Feng , Dang Hongxing
Published: October 2019

Regional citrate anticoagulation (RCA) was recommended as the first treatment option for adults by the Kidney Disease Improving Global Outcomes Kidney Foundation in 2012, for the characteristic of sufficient anticoagulation in vitro, but almost no anticoagulation in vivo. Traditionally, the substitute for RCA is calcium-free. This study investigated a simplified protocol of RCA for continuous hemofiltration (CHF) in children using a commercially available substitute containing calcium.

An analytical, observational, retrospective study assessed 59 pediatric patients with 106 sessions and 3580 hours of CHF. Values before and after treatment were compared, including Na+, ionic calcium (iCa2+) and HCO3
− concentrations, pH, and the ratio of total calcium to iCa2+ (T/iCa2+). In addition, in vivo and in vitro iCa2+, treatment time, sessions with continuous transmembrane pressure >200 mm Hg, and sessions with clotting and bleeding were recorded.

The average treatment time was 33.8 ± 10.1 hours. In vitro, 88.5% of iCa2+ achieved the target (0.25–0.35 mmol/L), and in vivo, 95.4% of iCa2+ achieved the target (1.0–1.35 mmol/L). There were 8 sessions with a transmembrane pressure >200 mm Hg and 3 sessions with filters clotted. After treatment, there were 2, 1, and 2 sessions with T/iCa2+ > 2.5 (implying citrate accumulation), iCa2+ < 0.9 mmol/L, and iCa2+ > 1.35 mmol/L. No sodium disorders were recorded. There were fewer cases of acidemia and more cases of alkalemia after treatment compared to before.

RCA-CHF with a substitute containing calcium and close monitoring could be a safe and effective treatment for children. In addition, the calcium test site in vitro and the adjustment of citrate should be given strict attention.
Endobronchial foreign body removal using fiberoptic bronchoscope together with gastroscope biopsy forceps
Authors: Hao Guangshan , Tang Lina , Ji Zhengang , Zhu Jianxin , Yao Lusu
Published: October 2019

Rationale:

There are many difficult cases in the clinic because of the diversity of foreign bodies. The removal of a syringe cap is not so easy because there is always no hole at the closed end.

Patient concerns:

A 54-year-old man suddenly developed dyspnea during his treatment in the hospital.

Diagnoses:

Foreign body in the left main bronchus.

Interventions:

The foreign body was removed using fiberoptic bronchoscope together with gastroscope biopsy forceps.

Outcomes:

A repeat CT showed well inflation of left lung.

Lessons:

The combined use of gastroscope biopsy forceps in trachea is more conducive to remove a foreign body similar to a syringe cap.
The risk of herpes zoster virus infection in patients with depression
Authors: Choi Hyo Geun , Kim Eui-Joong , Lee Young Kyung , Kim Miyoung
Published: October 2019

The features of herpes zoster share some commonalities with depression, including decreased cellular immunity, a close correlation with nutritional status, and a higher prevalence in the elderly population. We aimed to assess the association between herpes zoster infection and depression in the Korean population.

We performed a longitudinal follow-up study of a nationwide sample cohort derived from the Korean National Health Insurance Service database. Individuals diagnosed with depression between 2002 and 2013 (n = 58,278) as well as matched controls (n = 233,112), with both groups comprising 34.3% male and 65.7% female subjects, were extracted and analyzed for the presence of herpes zoster infection. Depression was diagnosed based on the International Classification of Diseases tenth revision (ICD-10) codes F31–F39, while herpes zoster was diagnosed as ICD-10 B02.

The rate of herpes zoster infection was higher in the depressed group (6.8% [3967/58,278]) than in the control group (6.3% [14,689/233,122], P < .001). The adjusted hazard ratio (HR) for herpes zoster infection was 1.09 (95% CI: 1.05–1.13) in the depressed group (P < .001). Subgroup analyses revealed that the adjusted HRs for herpes zoster infection were higher only in women younger than 60 years among participants with depression. These HRs were 1.13 (95% CI: 1.02–1.25; P = .016) in women younger than 40 years and 1.11 (95% CI: 1.04–1.17; P < .001) in women aged 40–59 years.

Depression is a predictor of herpes zoster infection in Korean women younger than 60 years.
Carbapenems vs tigecycline for the treatment of complicated intra-abdominal infections
Authors: Chen Lingyuan , Liang Xueyan , Jiang Junsong , Li Xianshu , Li Yan
Published: October 2019

Background:

Complicated intra-abdominal infections (cIAIs) are common in clinical practice, caused by a mixture of aerobic and anaerobic bacteria, increase the risk of mortality. Carbapenems and tigecycline (TGC) are recommended for antimicrobial therapies for cIAIs.

Objective:

To compare the effectiveness and safety of different carbapenems vs TGC for the treatment of cIAIs.

Methods:

PubMed, Embase, Medline (via Ovid SP) and Cochrane library databases were systematically searched. We included randomized controlled trials (RCTs) comparing different carbapenems vs TGC for the treatment of cIAIs. The pooled odds ratio (OR) with 95% credible interval (CrI) was calculated by Markov chain Monte Carlo methods. We estimated summary ORs using pairwise and network meta-analysis with random effects.

Results:

Fifteen studies involving 6745 participants were included in the analysis. Five different carbapenems and TGC were ultimately evaluated in this study. Although, the efficacy of carbapenems and TGC by ORs with corresponding 95% CrIs had not yet reached statistical differences, the cumulative rank probability indicated that clinical treatment success from best to worst was doripenem (DOPM), meropenem (MEPM), imipenem/cilastatin (IC), biapenem (BAPM), TGC and imipenem/cilastatin/relebactam (ICRB); microbiological treatment success from best to worst was DOPM, MEPM, IC, BAPM, ICRB and TGC. As for the risk of adverse events (AEs), TGC showed higher risk of AEs compared with IC (OR = 1.53, 95% CrI = 1.02–2.41), the remain antibiotic agents from lower to higher was MEPM, IC, BAPM, DOPM, ICRB and TGC. The risk of mortality from lower to higher was BAPM, DOPM, MEPM, IC, TGC and ICRB.

Conclusion:

No differences in clinical and microbiological outcomes were observed between different carbapenems and TGC. Balancing the evidence for drug efficacy and side effects, DOPM appears to be the best available treatment for cIAIs. Therefore, it is reasonable to consider that DOPM is one of the best carbapenem monotherapy for cIAIs. MEPM and IC was also associated with higher rates of clinical and microbiological treatment success following DOPM. Empiric antimicrobial treatment of patients with cIAIs should be selected in light of the local bacterial epidemiology and patterns of resistance.
A case report of a dramatic response to olaparib in a patient with metastatic pancreatic cancer harboring a germline BRCA2 mutation
Authors: Wang Huan , Mao Chenyu , Li Ning , Sun Liping , Zheng Yulong , Xu Nong
Published: October 2019

Rationale:

Pancreatic cancer (PC) is considered as one of the deadliest cancers all over the world. Germline and somatic BRCA1/2 mutations have been widely studied in breast and ovarian carcinomas as they have been found to enhance the risk for disease progression. Olaparib, an oral poly(adenosine diphosphate-ribose)polymerase (PARP) inhibitor, has been approved for the treatment strategy of ovarian cancer with any BRCA1/2 mutations. There is a lack of studies which focus on the treatment of other cancer with BRCA-Mutation.

Patient concerns:

This report describes a patient whose presenting complaints were “Physical examination showed that the pancreas was occupied for one month.” He initially was diagnosed with stage IV PC based on conventional imaging and pathologic assessment. He had a known germline BRCA 2 mutation, which exhibited a good response to PARP inhibitor therapy.

Diagnosis:

Through the biopsy histopathological examination, imaging examination, and genetic testing, the patient was diagnosed as metastatic PC with BRCA2 mutation.

Interventions:

He received gemcitabine and albumin-bound paclitaxel chemotherapy from March 15, 2017 to June 30, 2017, and Nivolumab immunotherapy as the maintenance therapy. After serum CA-199 level increased, Olaparib was orally administered from August 17, 2017 to March. After tumor relapsed, he received multiple lines of chemotherapy, including Trametinib Oxaliplatin, S-1, bevacizumab, and irinotecan liposome injection till July 17, 2018.

Outcomes:

We observed the patient had a good progression-free survival (7.4 months); the lesion of the pancreas was classified as partial disease through Olaparib treatment, which indicated significant shrinkage. But it is difficult to conclude whether such therapy could help prolong the overall survival for such patients.

Lessons:

The targeted therapy Olaparib showed early signs of potential in treating PC in patients with mutations of the BRCA genes. With emerging therapeutic modalities and next-generation sequencing development, it is increasingly relevant to consider mutation screenings of patients with PC.
Factors associated with false negative and false positive results of prostate-specific antigen (PSA) and the impact on patient health
Authors: Bernal-Soriano Mari Carmen , Parker Lucy A. , López-Garrigos Maite , Hernández-Aguado Ildefonso , Caballero-Romeu Juan P. , Gómez-Pérez Luis , Alfayate-Guerra Rocío , Pastor-Valero María , García Nuria , Lumbreras Blanca
Published: October 2019

Introduction:

Prostate-specific antigen (PSA) is the main tool for early detection, risk stratification and monitoring of prostate cancer (PCa). However, there are controversies about the use of PSA as a population screening test because of the high potential for overdiagnosis and overtreatment associated. The net benefit of screening is unclear and according to the available recommendations, it should be offered to well-informed men with an adequate health status and a life-expectancy of at least 10 years or to men at elevated risk of having PCa. In addition, the factors that influence test results are unclear, as is impact of false positive or negative results on patient health.

Our objective is to assess the clinical and analytical factors associated with the presence of false positive and false negative results and the diagnostic/therapeutic process followed by these patients.

Methods and analysis:

A prospective observational cohort study will be carried out. We will include a cohort of patients with a positive PSA result (1.081 patients) and a sample of patients with negative results (572 patients); both will be followed for 2 years by reviewing medical records to assess the variables associated with these results, as well as characteristics of patient management after a positive PSA value. We will include those patients with a PSA determination from 2 hospitals in the Valencian Community. Patients who have been previously diagnosed with prostate cancer or who are being followed for previous high PSA values will be excluded.

Discussion:

The study will estimate the frequency of false positive and false negative PSA results in routine clinical practice, and allow us to quantify the potential harm caused.

Study registration:

Clinicaltrials.gov (https://clinicaltrials.gov/): NCT03978299, June 7, 2019.
Rational emotive intervention for stress management among english education undergraduates
Authors: Igbokwe Uche Lebechi , Onyechi Kay C.N. , Ogbonna Chimaobi Samuel , Eseadi Chiedu , Onwuegbuchulam Adaobi C. , Nwajiuba Chinyere Augusta , Ugodulunwa Christiana C. , Eze Angela , Omaeze Kenneth , Patrick Chioma Patience , Ekechukwu Leona Eucharia , Egbe Cajetan I. , Nnachi Robert Azu , Anyaegbunam Emenike N.
Published: October 2019

Background/objective:

Different studies have shown the prevalence of high level of stress among undergraduate students. The objective of the present study was to investigate the effect of rational emotive behavioral therapy (REBT) as a stress management intervention among English Education undergraduates in Universities in Southeastern Nigeria.

Method:

The study adopted a group randomized trial design. One hundred sixteen samples of English education undergraduates (with a high level of perceived stress) took part in the study. These students were randomly assigned to groups – intervention group(n = 58) and no-intervention control group (n = 58). The Perceived Stress Scale (PSS-14) was used for data collection. The collected data were analyzed using 2-way mixed repeated measure ANOVA and independent sample t test at 0.05 probability level.

Result:

Results showed that an REBT program significantly reduced the stress among English education undergraduates in the intervention group compared to the students in the control group as measured by PSS-14. Also, the English education undergraduates who benefited from the REBT program maintained the reduction in stress after 3 months when the researchers conducted a follow-up.

Conclusion:

REBT program can be used to equip undergraduate students with the necessary skills to manage stress. The implications for curriculum innovation were highlighted.
Successful application of modified keystone flaps following skin tumor ablation
Authors: Huang Jiuzuo , Kim Chan Woo , Wang Xiaojun , Zhao Yumo , Yu Nanze , Zhao Ru , Bai Ming , Long Xiao , Park Tae Hwan
Published: October 2019

Skin cancer and precancerous skin lesions cause significant soft-tissue defects following tumor ablation. Recently, keystone flaps have gained popularity due to their simplicity, versatility, and reliability.

We evaluated the efficacy of modified keystone flaps for soft-tissue reconstruction following skin tumor ablation in 2 medical centers.

We reviewed the medical records of patients who received modified keystone flaps following the removal of skin tumors from January 2017 to December 2017. The diagnosis, site, flap size, and complications were recorded.

Forty-one modified keystone flaps were evaluated, and the wound dimensions ranged from 1 cm × 1 cm to 18 cm × 9.5 cm, with an average size of 9.8 cm × 6.4 cm. With our selection strategy, specific modified keystone flaps were designed for the soft-tissue defects. The flap dimensions ranged from 2.2 cm × 1 cm to 26 cm × 10 cm, with an average size of 14.3 cm × 7.5 cm. Two patients developed minor wound dehiscence (4.9%), and 1 patient developed partial flap loss (2.4%), but all of these patients healed after local wound care without the need for surgical intervention.

Our selection strategy for modified keystone flaps is a feasible and reliable option for reconstruction following skin tumor excision.
Surgical management of urachal remnants in children: open versus laparoscopic approach
Authors: Tanaka Keiichiro , Misawa Takeyuki , Baba Yuji , Ohashi Shinsuke , Suwa Katsuhito , Ashizuka Shuichi , Yoshizawa Jyoji , Ohki Takao
Published: October 2019

Urachal remnants (UR) represent a failure in the obliteration of the allantois, which connects the bladder to the umbilicus, at birth. Surgical management of UR in children is controversial. The traditional surgical approach involves a semicircular intraumbilical incision or a lower midline laparotomy. Recently, many reports have supported the laparoscopic approach (LA) for removing UR. However, there is a paucity of data comparing the benefits of LA those of the open approach (OA).

We retrospectively reviewed all children (aged ≤16 years) with UR who underwent surgical procedures. Age at surgery, sex, operative time, intraoperative or postoperative complications, total wound length, and length of hospital stay length after operation were analyzed.

Overall, 30 children aged between 9 months and 16 years (mean 9.0 years) underwent surgical procedures: 15 were treated by OA and 15 were treated by LA. The only statistically significant variable was the operative time. Furthermore, we reanalyzed the age distributions of the older children (aged ≥10 years). In this group, no significant difference in the operative time between OA and LA was observed; however, there was a statistically significant difference in the total wound length.

Our review indicated that LA required longer operative time than OA without any cosmetic advantage. However, in older children (aged ≥10 years), the difference in the operative time was not significant; moreover, LA provided greater cosmetic advantage. LA is recommended for older children (aged ≥10 years) because of its cosmetic advantage.
The 2019 guidelines from the American Society for Apheresis: what's new?
Authors: Connelly-Smith Laura , Dunbar Nancy M.
Published: October 2019

Purpose of review

For over 30 years, the American Society for Apheresis (ASFA) has published practice guidelines on the use of therapeutic apheresis in the Journal of Clinical Apheresis (JCA) Special Issue. These guidelines are periodically reviewed with the addition of new indications, retirement of some former indications and the provision of updated recommendations for current indications based on new published literature. During the last 12 years, updated guidelines have been published every 3 years to provide a reflection of current evidence-based apheresis practice. Recently, the eighth special issue was published. Significant updates and changes to the last edition are discussed in this review.

Recent findings

This review provides a description of the development of the eighth special issue with the evolution of the ASFA guidelines since introduced in 1986. There are no new indications for therapeutic apheresis listed in the 2019 edition, however, several recommended category changes to existing indications have been made. There are also several organizational changes with the renaming of some fact sheets.

ASFA has recently published its latest guidelines for therapeutic apheresis in the Journal of Clinical Apheresis ‘Eighth Special Edition’. This review describes the evolution of the ASFA guidelines and highlights significant changes to the prior edition.
Adaptive features of innate immune cells and their relevance to graft rejection
Authors: Wang Guangchuan , Kong Gangcheng , Li Xian C.
Published: October 2019

Purpose of review

Allograft rejection involves both innate and adaptive immune cells, and the adaptive immune cells have dominated transplant studies for decades. Recent studies have identified surprising new features for the innate immune cells, including memory recall responses, which may have significant implications in further improvement of transplant outcomes.

Recent findings

Transplant survival is excellent in the short-term, but the long-term graft outcomes are not so, and most grafts are continuously lost to chronic rejection in the clinic. In both animal models and clinical settings, graft loss to chronic rejection is often dominated by innate immune cells, especially macrophages and natural killer (NK) cells in the grafts. Recent studies suggest that innate immune cells can acquire features of adaptive cells in that they either directly sense allogeneic nonself or become ‘trained’ in the allogeneic milieu, where they show features of memory recall responses. In certain models, targeting the adaptive features of such innate immune cells can promote long-term allograft survival. These findings may open new therapeutic opportunities in promoting transplant survival in the clinic.

The discovery of donor specificity and memory recall responses of certain innate immune cells, which are prominently featured in chronic allograft rejection, may open novel therapeutic opportunities in transplantation, as well as in treatment of cancers and autoimmune diseases.
Increasing Fat Graft Retention in Irradiated Tissue after Preconditioning with External Volume Expansion
Authors: Lujan-Hernandez Jorge , Chin Michael S. , Perry Dylan J. , Chappell Ava , Lancerotto Luca , Yu Nanze , Slamin Robert P. , Bannon Elizabeth , Fitzgerald Thomas J. , Lalikos Janice F.
Published: October 2019

Background:

Fat grafting is an adjuvant that may improve the quality of radiation-damaged tissue. However, fat grafting for volume restoration in irradiated sites may be less effective because of a poorly vascularized fibrotic recipient bed. External volume expansion has emerged as a potential technique to prepare the recipient sites for improved survival of grafted fat. The authors previously demonstrated increased vasculature with external volume expansion stimulation of irradiated tissues. The authors now hypothesize that external volume expansion’s improvements in recipient-site vascularity will increase the volume retention and quality of fat grafts in fibrotic irradiated sites.

Methods:

Athymic mice were irradiated until development of chronic radiation injury. Then, the irradiated site was stimulated by external volume expansion (external volume expansion group), followed by subcutaneous fat grafting. Grafts in an irradiated site without external volume expansion stimulation (irradiated control group) and grafts in a healthy nonirradiated (nonirradiated control group) site were used as controls. All grafts were monitored for 8 weeks and evaluated both histologically and by micro–computed tomography for analysis of volume retention.

Results:

Hyperspectral imaging confirmed a 25 percent decrease in vascularity of irradiated tissue (irradiated control group) compared with nonirradiated tissue (nonirradiated control group). Grafts in the irradiated control group retained 11 percent less volume than grafts in the nonirradiated control group. The experimental external volume expansion group achieved a 20 percent (p = 0.01) increase in retained graft volume compared with the irradiated control group.

Conclusions:

External volume expansion stimulation can mitigate the effects of irradiation at the recipient site and in turn help preserve fat graft volume retention. Possible mechanisms include increased vascularity, adipogenic conversion, and increased compliance of a fibrotic recipient site.
Efficacy of Extracorporeal Shockwaves Therapy on Peripheral Nerve Regeneration
Authors: Sağir Dilek , Bereket Cihan , Onger Mehmet Emin , Bakhit Nagi , Keskin Metehan , Ozkan Enes
Published: October 2019

Purpose:

This study was conducted to determine the effects of different doses and methods of extracorporeal shock wave treatment (ESWT) on the sciatic nerve regeneration of rat model using unbiased quantitative stereological techniques and to know which method and dose were effective.

Methods:

Twenty-five Wistar albino rats were used in the experiment. All animals were randomly divided into 5 groups. To the first group (control, n = 5) ESWT and surgery were not applied. To 2nd group (E300∗2, n = 5), twice doses of 300 impulses uESWs (unfocused) were applied. To 3rd group (E500∗2, n = 5), twice doses of 500 impulses uESWs (unfocused) were applied. To 4th group (E300∗2, n = 5), twice doses of 300 impulses of fESWs (focused) were applied. To 5th group (E500∗2, n = 5), twice doses of 500 impulses of fESWs (focused) were applied. Rats were sacrificed and nerve samples analyzed on the 22nd day following the operation.

Results:

There is a variable increase in the axon numbers among the shockwave treated groups in compare to the control group. The focused groups showed better improvement and the 300-focused group has shown the highest regeneration rate.

Conclusion:

The authors found that ESWT promotes nerve regeneration, increases the thickness of the myelin sheath and that the most effective result is in the 300 shock wave.
Role of angiocrine signals in bone development, homeostasis and disease
Authors: Sivan Unnikrishnan , De Angelis Jessica , Kusumbe Anjali P.
Published: October 2019

Skeletal vasculature plays a central role in the maintenance of microenvironments for osteogenesis and haematopoiesis. In addition to supplying oxygen and nutrients, vasculature provides a number of inductive factors termed as angiocrine signals. Blood vessels drive recruitment of osteoblast precursors and bone formation during development. Angiogenesis is indispensable for bone repair and regeneration. Dysregulation of the angiocrine crosstalk is a hallmark of ageing and pathobiological conditions in the skeletal system. The skeletal vascular bed is complex, heterogeneous and characterized by distinct capillary subtypes (type H and type L), which exhibit differential expression of angiocrine factors. Furthermore, distinct blood vessel subtypes with differential angiocrine profiles differentially regulate osteogenesis and haematopoiesis, and drive disease states in the skeletal system. This review provides an overview of the role of angiocrine signals in bone during homeostasis and disease.
Influence of gas migration on permeability of soft coalbed methane reservoirs under true triaxial stress conditions
Authors: Wang Gang , Liu Zhiyuan , Hu Yanwei , Fan Cheng , Wang Wenrui , Li Jinzhou
Published: October 2019

The permeability of the coal body is the key parameter restricting the efficient extraction of coalbed methane, and scholars have analysed it from two angles of the change of stress state and porosity of the coal body. However, there is still a lack of study on the mechanism of gas migration and movement in soft coalbed methane reservoir under the coupling between the true triaxial stress field (maximum principal stress
σ
1
> intermediate principal stress
σ
2
> minimum principal stress
σ
3
) and the gas pressure field. In this paper, the coal gas adsorption and seepage experiments are conducted through the self-developed true triaxial ‘gas–solid’ coupled coal mass seepage system with gas as the adsorption and seepage medium and coal briquette taking the place of soft coalbed methane reservoirs. Furthermore, the coal gas adsorption deformation model and the permeability evolution model taking gas adsorption into account are developed. Through analysis of both experimental and theoretic results, the main conclusions are drawn as follows: (i) With the increase in gas pressure, the adsorption deformation variation of coal mass is divided into a slow growth zone, a stable growth zone and a rapid growth zone. (ii) The gas adsorption deformation model developed can predict the variation trend of coal mass adsorption volumetric strains for different types of soft coalbeds, and the fitting variance of experimental and theoretical volumetric strains is above 98%. (iii) With the increase in maximum principal stress difference, the coal permeability variation curve shows two obvious turning points, which can be divided into a slow reduction zone, a rapid reduction zone and a steady reduction zone. (iv) The permeability model of coal mass considering the gas adsorption effect can reflect the variation characteristics of permeability in the rapid reduction zone, and the overall fitting variance of experimental and theoretical permeabilities is above 91%. The above results could provide a reliable experimental and theoretical basis for improving coalbed methane extraction rates.
Irradiation-catalysed degradation of methyl orange using BaF
2
–TiO
2
nanocomposite catalysts prepared by a sol–gel method
Authors: Ling Yongsheng , Wang Guang , Chen Ting , Fei Xionghui , Hu Song , Shan Qing , Hei Daqian , Feng Huajun , Jia Wenbao
Published: October 2019

BaF
2
–TiO
2
nanocomposite material (hereinafter called the composite) was prepared by a sol–gel method. The composite surface area, morphology and structure were characterized by Brunauer–Emmett–Teller method, X-ray diffraction analysis and a scanning electron microscopy. The results showed that BaF
2
and TiO
2
form a PN-like structure on the surface of the composite. Composites were used to catalyse the degradation of methyl orange by irradiation with ultraviolet light, γ-rays and an electron beam (EB). It was demonstrated that the composite is found to be more efficient than the prepared TiO
2
and commercial P25 in the degradation of methyl orange under γ-irradiation. Increasing the composite catalyst concentration within a certain range can effectively improve the decolorization rate of the methyl orange solution. However, when the composite material is used to catalyse the degradation of organic matter in the presence of ultraviolet light or 10 MeV EB irradiation, the catalytic effect is poor or substantially ineffective. In addition, a hybrid mechanism is proposed; BaF
2
absorbs γ-rays to generate radioluminescence and further excites TiO
2
to generate photo-charges. Due to the heterojunction effect, the resulting photo-charge will produce more active particles. This seems to be a possible mechanism to explain γ-irradiation's catalytic behaviour.
Cilia drive developmental plasticity and are essential for efficient prey detection in predatory nematodes
Authors: Moreno Eduardo , Lightfoot James W. , Lenuzzi Maša , Sommer Ralf J.
Published: October 2019

Cilia are complex organelles involved in a broad array of functions in eukaryotic organisms. Nematodes employ cilia for environmental sensing, which shapes developmental decisions and influences morphologically plastic traits and adaptive behaviours. Here, we assess the role of cilia in the nematodePristionchus pacificus,and determine their importance in regulating the developmentally plastic mouth-form decision in addition to predatory feeding and self-recognition behaviours, all of which are not present inCaenorhabditis elegans. An analysis of a multitude of cilia-related mutants including representatives of the six protein subcomplexes required in intraflagellar transport (IFT) plus the regulatory factor X transcription factordaf-19revealed that cilia are essential for processing the external cues influencing the mouth-form decision and for the efficient detection of prey. Surprisingly, we observed that loss-of-function mutations in the different IFT components resulted in contrasting mouth-form phenotypes and different degrees of predation deficiencies. This observation supports the idea that perturbing different IFT subcomplexes has different effects on signalling downstream of the cilium. Finally, self-recognition was maintained in the cilia deficient mutants tested, indicating that the mechanisms triggering self-recognition inP. pacificusmay not require the presence of fully functional cilia.
Theory predicts plants grow roots to compete with only their closest neighbours
Authors: Farrior Caroline E.
Published: October 2019

The combination of individual-based selection with shared access to resources drives individuals to invest more than necessary in taking up their share of resources due to the threat of other individuals doing the same (competitive overinvestments). This evolutionary escalation of investment is common, from deer antlers and peacock feathers to tree height and plant roots. Because plant roots seem to be well intermingled belowground, the simplifying assumption that belowground resources are perfectly well mixed is often made in models—a condition that favours maximal fine-root overinvestments. Here, I develop simple models to investigate the role of space in determining the overlap among individuals belowground and resulting fine-root biomass. Without costs of growing roots through space, evolutionary optimization leads individuals to intermingle their fine roots perfectly and to invest just as much in these roots, whether there are two individuals competing or many. However, if there are any costs of sending roots through soil, investment in fine roots is constrained in amount and spatial extent. Dominant individuals are those that keep their roots in the soil closest to their own stem and the stems of their closest neighbours. These results highlight the importance of space in determining individual strategies as well as competitive networks.
No evidence of positive assortative mating for genetic quality in fruit flies
Authors: Sharp Nathaniel P. , Whitlock Michael C.
Published: October 2019

In sexual populations, the effectiveness of selection will depend on how gametes combine with respect to genetic quality. If gametes with deleterious alleles are likely to combine with one another, deleterious genetic variation can be more easily purged by selection. Assortative mating, where there is a positive correlation between parents in a phenotype of interest such as body size, is often observed in nature, but does not necessarily reveal how gametes ultimately combine with respect to genetic quality itself. We manipulated genetic quality in fruit fly populations using an inbreeding scheme designed to provide an unbiased measure of mating patterns. While inbred flies had substantially reduced reproductive success, their gametes did not combine with those of other inbred flies more often than expected by chance, indicating a lack of positive assortative mating. Instead, we detected a negative correlation in genetic quality between parents, i.e. disassortative mating, which diminished with age. This pattern is expected to reduce the genetic variance for fitness, diminishing the effectiveness of selection. We discuss how mechanisms of sexual selection could produce a pattern of disassortative mating. Our study highlights that sexual selection has the potential to either increase or decrease genetic load.