bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a library of laminin-mimetic peptide hydrogels for control of nucleus pulposus cell behaviors
Authors: Speer Julie E , Barcellona Marcos N , Lu Michael Y , Zha Zizhen , Jing Liufang , Gupta Munish C , Buchowski Jacob M , Kelly Michael P , Setton Lori A
Published: June 2021

The nucleus pulposus (NP) of the intervertebral disc plays a critical role in distributing mechanical loads to the axial skeleton. Alterations in NP cells and, consequently, NP matrix are some of the earliest changes in the development of disc degeneration. Previous studies demonstrated a role for laminin-presenting biomaterials in promoting a healthy phenotype for human NP cells from degenerated tissue. Here we investigate the use of laminin-mimetic peptides presented individually or in combination on a poly(ethylene) glycol hydrogel as a platform to modulate the behaviors of degenerative human NP cells. Data confirm that NP cells attach to select laminin-mimetic peptides that results in cell signaling downstream of integrin and syndecan binding. Furthermore, the peptide-functionalized hydrogels demonstrate an ability to promote cell behaviors that mimic that of full-length laminins. These results identify a set of peptides that can be used to regulate NP cell behaviors toward a regenerative engineering strategy.
Individual, socio-cultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia: A mixed method study
Authors: Hailemariam Shewangizaw , Abayneh Mengistu , Genetu Amare
Published: June 2021

Introduction:

Traditionally, men are not supposed to take part in maternal health issues in many cultures. Nevertheless, pregnancy care and childbirth are the most crucial matters of reproductive health influenced by men. Hence, the aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia.

Objectives:

The aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia.

Methods:

A community-based cross-sectional study accompanied with a qualitative method was carried out from 1 July to 30 August 2019. A multistage cluster sampling technique was employed to recruit study participants. Descriptive statistics, frequencies, proportions, and mean were calculated, and the results of the analysis were presented in text, tables, and graphs. A multivariate logistic regression model was fitted to investigate the independent effect of each explanatory variable on the likelihood of men’s involvement in facility-based childbirth. Qualitative data were analyzed thematically using OpenCode 4.0 software.

Results:

Out of 800 men, only 36.5% (95% confidence interval: 33.3%–39.6%) were found to have involved in facility-based childbirth. Several factors were associated with men’s involvement in facility-based childbirth of this, being in the age group of 40–49 (adjusted odds ratio 5.04, 95% confidence interval: 2.49–10.20), attaining secondary education and above (adjusted odds ratio 2.14, 95% confidence interval: 1.53–5.60), and having sufficient knowledge of danger signs during pregnancy (adjusted odds ratio 5.65, 95% confidence interval: 3.25–7.46) associated with men’s involvement in facility-based childbirth.

Conclusion:

Relevant entities had better design-specific educational programs targeting younger age groups, those with lower schooling, and had previous bad obstetrics outcomes. Involving elders and religious leaders in the reproductive health program could also help in overcoming the existing cultural barriers. Moreover, creating a men-friendly facility environment and extensively engaging medias are suggested to improve men’s involvement in the study area.
A cohort analysis of patients receiving neoadjuvant androgen deprivation therapy prior to robot-assisted laparoscopic prostatectomy during the Covid-19 pandemic
Authors: Bennett Sahan S , Leung Hing Y , Ahmad Imran
Published: June 2021

Objectives:

The purpose of this study was to investigate localised prostate cancer treated with or without neoadjuvant androgen deprivation therapy prior to robot-assisted laparoscopic prostatectomy, and the impact of Covid-19 treatment disruption, on clinico-pathologic outcomes.

Patients and methods:

Data was retrospectively collected from 124 consecutive patients treated with robot-assisted laparoscopic prostatectomy between November 2019–September 2020. Sixty-two patients were treated before 13 March 2020 (historic cohort) and 62 afterwards (covid cohort). Thirty-seven patients in the covid cohort additionally received neoadjuvant androgen deprivation therapy (mean duration of 3 months) consisting of bicalutamide 150 mg once a day for 4 weeks, with leuprolide 3.75 mg monthly injections commencing after week 1, up until the date of surgery.

Results:

Statistical analysis found no difference in peri-operative measures and length of stay for patients treated with or without neoadjuvant androgen deprivation therapy. Patients with delayed surgical treatment offered neoadjuvant androgen deprivation therapy showed a trend towards a reduction in positive surgical margins ( p=0.134), N1 disease ( p=0.424) and pathological down-staging (50% patients with pT2 disease). Patients within the covid cohort experienced significantly increased detectable prostate-specific antigen levels ( p<0.007).

Conclusion:

Our study demonstrated that a three-month duration of neoadjuvant androgen deprivation therapy prior to robot-assisted laparoscopic prostatectomy may improve pathological outcomes but this time-frame is inadequate to influence detectable prostate-specific antigen levels. Covid-19-related treatment delays led to significantly increased detectable prostate-specific antigen levels.

Level of evidence:

2b
A Novel Surgical Method for Treating Symptomatic Incomplete Atypical Femoral Fracture using Percutaneous Elastic Intramedullary Nailing
Authors: Park Joon Hong , Cho Yoon Je , Chun Young-Soo , Rhyu Kee Hyung
Published: June 2021

Purpose:

To introduce the principles and procedure of percutaneous elastic intramedullary nailing (PEIN) as a treatment for symptomatic incomplete atypical femoral fracture (SIAFF).

Methods:

From October 2014 to April 2019, 6 cases of SIAFF were treated with PEIN. Two pre-bent 4-mm stainless-steel nails were used to apply compressive force to the fracture site. The antegrade method was used for proximal fractures and the retrograde method for middle and distal femoral fractures. The femoral bowing angle in the coronal and sagittal planes, and the time required for callus formation and union, were evaluated on plain radiographs in both planes. Thigh pain, tenderness, and complications were also assessed.

Results:

The mean operating time was 65.00 ± 22.64 min. No case progressed to complete atypical fracture. In one case, fracture occurred around the point of nail entry after the patient fell from a chair on postoperative day 7. The incomplete fracture lines were united in 5 cases, after excluding one case with a complication. The time taken to confirm endocortical callus formation, fracture line disappearance, and clinical union was 2.11 ± 0.53, 6.45 ± 4.10, and 6.45 ± 3.65 months, respectively.

Conclusions:

PEIN is a quick, simple but effective treatment for SIAFF that considers the fracture mechanism and is applicable to cases with severe femoral bowing.

Level of evidence:

Level IV, case series.
Correlation of medial longitudinal arch morphology with body characteristics and locomotive function in community-dwelling older women: A cross-sectional study
Authors: Nakao Hidetoshi , Imaoka Masakazu , Hida Mitsumasa , Imai Ryota , Tazaki Fumie , Morifuji Takeshi , Hashimoto Masashi , Nakamura Misa
Published: June 2021

Purpose:

This cross-sectional study aimed to investigate the effects of foot arch deformities on physical characteristics, muscular strength, and motor function in older women depending on the presence or absence of pain.

Methods:

Overall, 145 community-dwelling women aged 65 to 90 years were included in this study. We measured the foot arch height ratio (AHR, dorsal height/truncated foot length) and classified participants with AHR values above, below, or within 1.5 standard deviations into the high-arched group (HAG), Low-Arched Group (LAG), or normal-arched group (NAG), respectively. We also compared body characteristics (age, height, weight, body mass index (BMI), and skeletal mass index), muscle strength (handgrip strength and intrinsic foot strength (IFS)), and locomotive function (two-step value and gait speed) among the three groups.

Results:

Locomotive examination and muscle strength showed significant differences among the three groups only in the presence of pain; in the two-step test, HAG, NAG, and LAG values were 0.98 cm/cm, 1.19 cm/cm, and 1.18 cm/cm, respectively. The IFS measured 19.2 N, 24.2 N, 31.0 N, respectively, in the HAG, NAG, and LAG.

Conclusion:

This study suggests that decreased IFS affects the mobility function of high-arched feet in older women. Although there was no significant difference in the evaluation of pain, HAG showed the highest average value, which is considered to contribute to the decreased two-step value. It has been suggested that a high-arched foot in the presence of pain is associated with IFS weakness and may affect the decline of mobility function in older women.
Outcomes After Deepening Trochleoplasty and Concomitant Realignment in Patients With Severe Trochlear Dysplasia With Chronic Patellofemoral Pain: Results at 2-Year Follow-up
Authors: Zimmermann Felix , Milinkovic Danko Dan , Balcarek Peter
Published: June 2021

Background:

Abnormal patellofemoral joint stress appears to have major relevance in a subgroup of patients with patellofemoral pain (PFP).

Purpose:

To evaluate whether patients with chronic PFP and trochlear dysplasia–induced patellofemoral joint malalignment benefit from a deepening trochleoplasty procedure with the aim of improving patellotrochlear congruence.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included were 15 patients (male/female, 1/14; mean age, 30.3 years [range, 19-51 years]) with 8.8 years (range, 1-20 years) of chronic PFP and severe trochlear dysplasia. All patients underwent correction of patellotrochlear malalignment with deepening trochleoplasty and concomitant realignment procedures. The Kujala score and a numerical analog scale (0-10) for intensity of pain were used to assess symptoms preoperatively and at 12 and 24 months postoperatively. Pre- and postoperative magnetic resonance imaging (MRI) scans from the patients were compared with the MRI scans of age- and sex-matched controls regarding the patellotrochlear contact area and contact ratio, patellar tilt, patellotrochlear index, and lateral trochlear inclination (LTI) angle.

Results:

The Kujala score increased from a mean of 55 (range, 15-81) preoperatively to 82.5 (range, 53-98) after 12 months (95% CI, –42.56 to –12.37; P < .001) and to 84.2 (range, 59-99) after 24 months (95% CI, –44.29 to –14.11; P < .001). The intensity of PFP decreased from 5.7 (range, 3-10) preoperatively to 1.4 (range, 0-4) after 12 months (95% CI, 2.57 to 5.96; P < .001) and had a mean of 1.6 (range, 0-6) after 24 months (95% CI, 2.44 to 5.75; P < .001). Preoperatively, parameters in the study group indicated significant patellotrochlear malalignment, which improved and normalized (except for the LTI angle) postoperatively compared with the values of the control group ( P > .05).

Conclusion:

In a subgroup of patients with chronic PFP due to severe trochlear dysplasia, deepening trochleoplasty and concomitant realignment procedures significantly reduced pain and improved knee joint function while normalizing patellotrochlear congruence.
Diversity of Skin Images in Medical Texts: Recommendations for Student Advocacy in Medical Education
Authors: Kaundinya Trisha , Kundu Roopal V
Published: June 2021

Foundational academic medical texts facilitate foundational understanding of disease recognition in medical students. Significant underrepresentation of darker skin tones and overrepresentation of lighter skin tones in dermatologic texts, general medical texts, and scientific literature is observed. This compromises the clinical tools of trainees when it comes to darker skin tones. Text publishers and editors are steadily beginning to address these disparities, but bottom-up change from trainees is necessary to comprehensively address this issue. In this article the authors propose institutional review panels as a framework for building awareness of underrepresentation of darker skin tones and ensuring that faculty intentionally share diverse presentations in didactics. They also propose trainee engagement in building diverse medical image libraries and including texts on skin of color in institutional libraries. Empowering trainees to be advocates and call out any implicit or explicit biases in image selection can engender change in this area of medical education.
Reviving a Heritage in Peril: India’s Endangered Traditions of Cotton and Wool
Authors: Iyengar Sushma
Published: June 2021

This article traces the journey of two indigenous textile fibres—Kala cotton and Desi Oon—and the efforts of farmers, pastoralists, craft artisans and Khamir, to conserve, sustain and promote the natural and cultural heritage that have nourished these fibres. It recreates the revival of these fibres in Kutch, a semi-arid region of India, and unfolds the technical, cultural and creative challenges that have accompanied this process—from land to the loom.

Large-scale shifts in Indian agriculture have marked a significant breakdown of the value loops and deep interdependent economies between farmers, spinners, weavers, dyers and tailors. First, in the nineteenth century, when the cultivation of short staple indigenous varieties of cotton shifted to long staple cotton, which could feed the mills of Britain; and then in the late twentieth century when a global push towards hybrid, genetically modified varieties of cotton strode over the farming of more resilient local cotton varieties.

Similarly, across India, vast genetic resource of sheep, yak and camels, in particular, have, for centuries, been conserved and bred by the nomadic pastoral communities of these regions. Even two and a half decade ago, the animal’s fibre was used extensively by the pastoralists themselves and fetched them a market price for the wool that was almost equal to that of meat. However, with India becoming a major sheep meat producing country, accompanied by the relaxation of tariffs on wool imports in the early nineties, the Indian wool market has moved completely to softer, longer staple wool from New Zealand, Australia and the Middle East. Today, this is the only natural fibre in which India is deficient despite having the third largest number of sheep in the world!

The process of conserving indigenous cotton seeds, sheep breeds, their fibres and a range of associated textile crafts, challenge all the essential premises on which the political economy of contemporary textiles rest. However hope comes in many forms—the intense climatic variabilities and growing vulnerabilities to climate change, is compelling farmers and pastoralists to revisit the choices they have been compelled to adopt by a globalized market economy. Their growing understanding and need to revive their local cotton seeds and animal breeds, which are more adaptable and resilient to climatic variabilities, hold out a tremendous opportunity to transform the landscape of indigenous textile fibres. Through her experiences, the author stitches together a story of localization wherein Khamir attempts to restore a lost heritage and the bonds between farmers, pastoralists, spinners, weavers and dyers.
A near-real-time model for estimating probability of road obstruction due to earthquake-triggered landslides
Authors: Wilson Bradley , Allstadt Kate E , Thompson Eric M
Published: June 2021

Coseismic landslides are a major source of transportation disruption in mountainous areas, but few approaches exist for rapidly estimating impacts to road networks. We develop a model that links the U.S. Geological Survey (USGS) near-real-time earthquake-triggered landslide hazard model with Open Street Map (OSM) road network data to rapidly estimate segment-level obstruction risk following major earthquake activity worldwide. To train and validate the model, we process OSM data for 15 historical earthquakes and calculate the average segment-level landslide hazard from the USGS model for each event. We then fit a multivariate adaptive regression spline model for the probability of road obstruction as a function of road segment length and landslide hazard, using a training and validation dataset derived from the intersections of road networks with earthquake-triggered landslide inventories. The resulting probabilistic model is well calibrated across a range of earthquake events, with estimated obstruction probabilities matching the relative frequency of potential road obstructions. The model runs quickly and is capable of producing road segment-level obstruction estimates within minutes to hours of a major earthquake. However, in near-real-time application, the accuracy of the obstruction estimates will be dependent on the quality of the ShakeMap shaking estimates, which often improves with time as more information becomes available after the earthquake. By providing a rapid first-order translation of landslide hazard into potential infrastructure impacts, this model helps provide emergency responders with tangible information on initial areas of concern.
Integrated genomic analyses of cutaneous T-cell lymphomas reveal the molecular bases for disease heterogeneity
Authors: Park Joonhee , Daniels Jay , Wartewig Tim , Ringbloom Kimberly G. , Martinez-Escala Maria Estela , Choi Sara , Thomas Jane J. , Doukas Peter G. , Yang Jingyi , Snowden Caroline , Law Calvin , Lee Yujin , Lee Katie , Zhang Yancong , Conran Carly , Tegtmeyer Kyle , Mo Samuel H. , Pease David R. , Jothishankar Balaji , Kwok Pui-Yan , Abdulla Farah R. , Pro Barbara , Louissaint Abner , Boggon Titus J. , Sosman Jeffrey , Guitart Joan , Rao Deepak , Ruland Jürgen , Choi Jaehyuk
Published: June 2021

Cutaneous T-cell lymphomas (CTCLs) are a clinically heterogeneous collection of lymphomas of the skin-homing T cell. To identify molecular drivers of disease phenotypes, we assembled representative samples of CTCLs from patients with diverse disease subtypes and stages. Via DNA/RNA-sequencing, immunophenotyping, and ex vivo functional assays, we identified the landscape of putative driver genes, elucidated genetic relationships between CTCLs across disease stages, and inferred molecular subtypes in patients with stage-matched leukemic disease. Collectively, our analysis identified 86 putative driver genes, including 19 genes not previously implicated in this disease. Two mutations have never been described in any cancer. Functionally, multiple mutations augment T-cell receptor–dependent proliferation, highlighting the importance of this pathway in lymphomagenesis. To identify putative genetic causes of disease heterogeneity, we examined the distribution of driver genes across clinical cohorts. There are broad similarities across disease stages. Many driver genes are shared by mycosis fungoides (MF) and Sezary syndrome (SS). However, there are significantly more structural variants in leukemic disease, leading to highly recurrent deletions of putative tumor suppressors that are uncommon in early-stage skin-centered MF. For example, TP53 is deleted in 7% and 87% of MF and SS, respectively. In both human and mouse samples, PD1 mutations drive aggressive behavior. PD1 wild-type lymphomas show features of T-cell exhaustion. PD1 deletions are sufficient to reverse the exhaustion phenotype, promote a FOXM1-driven transcriptional signature, and predict significantly worse survival. Collectively, our findings clarify CTCL genetics and provide novel insights into pathways that drive diverse disease phenotypes.
Cereblon enhancer methylation and IMiD resistance in multiple myeloma
Authors: Haertle Larissa , Barrio Santiago , Munawar Umair , Han Seungbin , Zhou Xiang , Vogt Cornelia , Fernández Rafael Alonso , Bittrich Max , Ruiz-Heredia Yanira , Da Viá Matteo , Zovko Josip , Garitano-Trojaola Andoni , Bolli Niccolò , Ruckdeschel Anna , Stühmer Thorsten , Chatterjee Manik , Kull Miriam , Krönke Jan , Agirre Xabier , Martin-Subero Jose I. , Raab Peter , Einsele Hermann , Rasche Leo , Martinez-Lopez Joaquin , Haaf Thomas , Kortüm K. Martin
Published: June 2021

Cereblon is the direct binding target of the immunomodulatory drugs (IMiDs) that are commonly used to treat multiple myeloma (MM), the second most frequent hematologic malignancy. Patients respond well to initial treatment with IMiDs, but virtually all patients develop drug resistance over time, and the underlying mechanisms are poorly understood. We identified an as yet undescribed DNA hypermethylation in an active intronic CRBN enhancer. Differential hypermethylation in this region was found to be increased in healthy plasma cells, but was more pronounced in IMiD-refractory MM. Methylation significantly correlated with decreased CRBN expression levels. DNA methyltransferase inhibitor (DNTMi) in vitro experiments induced CRBN enhancer demethylation, and sensitizing effects on lenalidomide treatment were observed in 2 MM cell lines. Thus, we provide first evidence that aberrant CRBN DNA methylation is a novel mechanism of IMiD resistance in MM and may predict IMiD response prior to treatment.
Infrared thermography for assessment of thoracic paravertebral block: a prospective observational study
Authors: Zhang Shuang , Liu Yong , Liu Xiaohu , Liu Tianzhu , Li Pengcheng , Mei Wei
Published: June 2021

Background

There was no “gold standard” to assess the success or failure of thoracic paravertebral block (TPVB). Measurement of skin temperature with infrared thermography (IT) would be a reliable method to evaluate the effectiveness of regional blocks. This study aimed to explore the feasibility of using skin temperature difference (Td) determined by IT between the blocked and unblocked side to predict the spread of TPVB.

Methods

Sixty-one patients undergoing elective unilateral breast or thoracoscopic surgery were enrolled in this prospective observational study. TPVB was performed at T4 and T5 under real-time ultrasound guidance with 10 mL of 0.4% ropivacaine for each patient, respectively. Td between the blocked and unblocked side were measured with IT from T2 to T10 at the anterior chest wall before TPVB and 5 min, 10 min, 15 min and 20 min after TPVB. Pinprick test was performed at 20 min after TPVB. Successful TPVB was defined as no sensation to pinprick in 3 or more adjacent dermatomes corresponding to the site of injection at 20 min after TPVB. Td was compared to pinprick test for evaluating its effectiveness in predicting the success of TPVB. The sensitivity, specificity, and cut-off value of Td for predicting successful TPVB were determined by receiver operator characteristic (ROC) curve analysis.

Results

Compared with the baseline value before block, Td from T2 to T10 were significantly increased at each time point in successful blocks. In failed blocks, Td was not increased in any dermatome. The increase of Td at T4-T7 was more than 1 °C 20 min after successful TPVB. Fifteen minutes after block, Td increase at T4 had the greatest potential to predict block success. The area under the ROC curve was 0.960 at a cut-off value of 0.63 °C with a sensitivity of 83.3% and a specificity of 100.0%.

Conclusions

This study suggested that the increase of Td at T4 dermatome determined by IT between the blocked and unblocked side is an early, quantitative, and reliable predictor of successful TPVB.

Trial registration

Clinical trial registration: NCT04078347.
Prevalence and risk factors of atrioventricular block among 15 million Chinese health examination participants in 2018: a nation-wide cross-sectional study
Authors: Shan Ruiqi , Ning Yi , Ma Yuan , Liu Siliang , Wu Jing , Fan Xiaohan , Lv Jun , Wang Bo , Li Shijun , Li Liming
Published: June 2021

Background

Nationwide data on the prevalence of atrioventricular (AV) block are currently unavailable in China. Thus, we aimed to assess the prevalence and risk factors of AV block among Chinese health examination adults.

Methods

A total of 15,181,402 participants aged ≥ 18 years (mean age 41.5 ± 13.4 years, 53.2% men) who underwent an electrocardiogram as a part of routine health examination in 2018 were analyzed. AV block was diagnosed by physicians using 12-lead electrocardiogram. Overall and stratified prevalence (by age, sex, and city size) of all, first-, second- and third-degree AV block were calculated. Multivariable logistic regression analyses were performed to explore risk factors associated with AV block.

Results

AV block was observed in 88,842 participants, including 86,153 with first-degree, 2249 with second-degree and 440 with third-degree AV block. The age- and sex-standardized prevalence rate [95% confidence interval (CI)] of all, first-, second- and third-degree AV block were 7.06‰ (7.01–7.11), 6.84‰ (6.79–6.89), 0.18‰ (0.17–0.18) and 0.04‰ (0.03–0.04) respectively. After multivariable adjustment, the risk of AV block was positively associated with older age, being male, lower heart rate, higher body mass index, hypertension, diabetes and low high-density lipoprotein cholesterol. High total cholesterol was associated with a lower risk of AV block.

Conclusion

First-degree AV block is relatively common while severe AV block is rare in health examination adults. Besides, AV block was highly prevalent among the elderly. The risk of AV block was associated with older age, being male and metabolic factors.
Bacteraemia variation during the COVID-19 pandemic; a multi-centre UK secondary care ecological analysis
Authors: Denny Sarah , Rawson Timothy M. , Hart Peter , Satta Giovanni , Abdulaal Ahmed , Hughes Stephen , Gilchrist Mark , Mughal Nabeela , Moore Luke S. P.
Published: June 2021

Background

We investigated for change in blood stream infections (BSI) with Enterobacterales, coagulase negative staphylococci (CoNS), Streptococcus pneumoniae, and Staphylococcus aureus during the first UK wave of SARS-CoV-2 across five London hospitals.

Methods

A retrospective multicentre ecological analysis was undertaken evaluating all blood cultures taken from adults from 01 April 2017 to 30 April 2020 across five acute hospitals in London. Linear trend analysis and ARIMA models allowing for seasonality were used to look for significant variation.

Results

One hundred nineteen thousand five hundred eighty-four blood cultures were included. At the height of the UK SARS-CoV-2 first wave in April 2020, Enterobacterales bacteraemias were at an historic low across two London trusts (63/3814, 1.65%), whilst all CoNS BSI were at an historic high (173/3814, 4.25%). This differed significantly for both Enterobacterales (p = 0.013), CoNS central line associated BSIs (CLABSI) (p < 0.01) and CoNS non-CLABSI (p < 0.01), when compared with prior periods, even allowing for seasonal variation. S. pneumoniae (p = 0.631) and S. aureus (p = 0.617) BSI did not vary significant throughout the study period.

Conclusions

Significantly fewer than expected Enterobacterales BSI occurred during the UK peak of the COVID-19 pandemic; identifying potential causes, including potential unintended consequences of national self-isolation public health messaging, is essential. High rates of CoNS BSI, with evidence of increased CLABSI, but also likely contamination associated with increased use of personal protective equipment, may result in inappropriate antimicrobial use and indicates a clear area for intervention during further waves.
SNX10 and PTGDS are associated with the progression and prognosis of cervical squamous cell carcinoma
Authors: Jiang Pinping , Cao Ying , Gao Feng , Sun Wei , Liu Jinhui , Ma Ziyan , Xie Manxin , Fu Shilong
Published: June 2021

Background

Cervical cancer (CC) is the primary cause of death in women. This study sought to investigate the potential mechanism and prognostic genes of CC.

Methods

We downloaded four gene expression profiles from GEO. The RRA method was used to integrate and screen differentially expressed genes (DEGs) between CC and normal samples. Functional analysis was performed by clusterprofiler. We built PPI network by Search Tool for the Retrieval of Interacting Genes Database (STRING) and selected hub modules via Molecular COmplex Detection (MCODE). CMap database was used to find molecules with therapeutic potential for CC. The hub genes were validated in GEO datasets, Gene Expession Profiling Interactive Analysis (GEPIA), immunohistochemistry, Cox regression analysis, TCGA methylation analysis and ONCOMINE were carried out. ROC curve analysis and GSEA were also performed to describe the prognostic significance of hub genes.

Results

Functional analysis revealed that 147 DEGs were significantly enriched in binding, cell proliferation, transcriptional activity and cell cycle regulation. PPI network screened 30 hub genes, with CDK1 having the strongest connectivity with CC. Cmap showed that apigenin, thioguanine and trichostatin A might be used to treat CC(P < 0.05). Eight genes (APOD, CXCL8, MMP1, MMP3, PLOD2, PTGDS, SNX10 and SPP1) were screened out through GEPIA. Of them, only PTGDS and SNX10 had not appeared in previous studies about CC. The validation in GEO showed that PTGDS showed low expression while SNX10 presented high expression in tumor tissues. Their expression profiles were consistent with the results in immunohistochemistry. ROC curve analysis indicated that the model had a good diagnostic efficiency (AUC = 0.738). GSEA analysis demonstrated that the two genes were correlated with the chemokine signaling pathway (P < 0.05). TCGA methylation analysis showed that patients with lowly-expressed and highly-methylated PTGDS had a worse prognosis than those with highly-expressed and lowly-methylated PTGDS (p = 0.037). Cox regression analysis showed that SNX10 and PTGDS were independent prognostic indicators for OS among CC patients (P = 0.007 and 0.003).

Conclusions

PTGDS and SNX10 showed abnormal expression and methylation in CC. Both genes might have high prognostic value of CC patients.
Low intensity pulsed ultrasound (LIPUS) use for the management of instrumented, infected, and fragility non-unions: a systematic review and meta-analysis of healing proportions
Authors: Leighton Ross , Phillips Mark , Bhandari Mohit , Zura Robert
Published: June 2021

Background

Non-union occurs in approximately 5 to 10% of fracture patients, with certain bones at greater risk of failing to heal. Non-unions have a significant impact on socioeconomic costs and the patients short and long-term quality of life. Low intensity pulsed ultrasound (LIPUS) is a non-invasive therapy for non-union treatment that can improve the long-term outcome. The purpose of this study is to summarize the available literature assessing LIPUS potential to improve the union rate in instrumented, infected, and fragility non-unions.

Methods

A literature search was conducted in the MEDLINE, EMBASE, and CINAHL databases for all relevant literature on the healing rates of LIPUS utilized in instrumented, infected, and fragility non-unions. Study characteristics were summarized for each of the included studies. The percentage of healed patients (healing rate), for instrumented, infected, and fragility fracture non-union patients were pooled from each included study.

Results

The literature search identified a total of 326 articles, while searching reference lists and grey literature identified an additional 3 articles. There was a total of 29 articles included in this review, with 20 articles included within the quantitative synthesis of healing rates. The most common design of included studies was case series (17 articles), followed by case reports (9 articles). Studies were primarily retrospective (18 studies), with an additional 10 prospective studies. Non-union healing rates were 82% (95% CI: 76 to 87%) in instrumented, 82% (95% CI: 70 to 95%) in infected, and 91% (95% CI: 87 to 95%) in fragility fracture patients with non-unions.

Conclusion

This study has provided a thorough overview of the current literature on LIPUS treatment for instrumented, infected, and fragility fracture non-unions. The healing rates for non-unions in these subgroups were comparable to healing rates observed with LIPUS use in general non-union literature. LIPUS treatment should be considered as a conservative non-surgical treatment option to potentially reduce the socioeconomic impact and improve the quality of life of these unfortunate patients.

Level of evidence

4 (systematic review of primarily case series data)
Post Procedural Peak Left Atrial Contraction Strain Predicts Recurrence of Arrhythmia after Catheter Ablation of Atrial Fibrillation
Authors: Wen Songnan , Indrabhinduwat Manasawee , Brady Peter A. , Pislaru Cristina , Miller Fletcher A. , Ammash Naser M. , Nkomo Vuyisile T. , Padang Ratnasari , Pislaru Sorin V. , Lin Grace
Published: June 2021

Background

Left atrial (LA) function can be impaired by the atrial fibrillation (AF) ablation and might be associated with the risk of recurrence. We sought to determine whether the post-procedural changes in LA function impact the risk of recurrence following AF ablation.

Methods

We retrospectively reviewed patients who underwent AF ablation between 2009 and 2011 and underwent transthoracic echocardiography before ablation, 1-day and 3-month after ablation. Peak left atrial contraction strain (PACS) and left atrial emptying fraction (LAEF) were evaluated during sinus rhythm and compared across the three time points. The primary endpoint was atrial tachyarrhythmia recurrence after ablation.

Results

A total of 144 patients were enrolled (mean age 61 ± 11 years, 77% male, 46% persistent AF). PACS and LAEF initially decreased 1-day following ablation but partially recovered within 3 months in PAF patients, with a similar trend in the PerAF patients. After median 24 months follow-up, 68 (47%) patients had recurrence. Patients with recurrence had higher PACS1-day than that in non-recurrence subjects (-10.9 ± 5.0% vs. -13.4 ± 4.7%, p = 0.003). PACS1-day -12% distinguished recurrence cases with a sensitivity of 67.7% and specificity of 60.5%. The Kaplan–Meier curves showed significant difference in 5-year cumulative probability of recurrence between those with PACS ≥ -12% and PACS < -12% (log rank p < 0.0001). Multivariate regression showed that PACS1-day was an independent risk factor of arrhythmia recurrence.

Conclusions

Left atrial function deteriorates immediately following AF ablation and partially recovers in 3 months but remains abnormal in the majority of patients. PACS1-day post procedure predicts arrhythmia recurrence at long-term follow-up.
Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation
Authors: An Zhongcheng , Chen Chen , Wang Junjie , Zhu Yuchen , Dong Liqiang , Wei Hao , Wu Lianguo
Published: June 2021

Objective

To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA.

Methods

A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA.

Results

A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337).

Conclusions

The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.
Suprascapular nerve block is a clinically attractive alternative to interscalene nerve block during arthroscopic shoulder surgery: a meta-analysis of randomized controlled trials
Authors: Sun Changjiao , Ji Xiaolin , Zhang Xiaofei , Ma Qi , Yu Peng , Cai Xu , Yang Huadong
Published: June 2021

Background

The interscalene brachial plexus block (ISB) is a commonly used nerve block technique for postoperative analgesia in patients undergoing shoulder arthroscopy surgery; however, it is associated with potentially serious complications. The use of suprascapular nerve block (SSNB) has been described as an alternative strategy with fewer reported side effects for shoulder arthroscopy. This review aimed to compare the impact of SSNB and ISB during shoulder arthroscopy surgery.

Methods

A meta-analysis was conducted to identify relevant randomized controlled trials involving SSNB and ISB during shoulder arthroscopy surgery. Web of Science, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CNKI, and Wanfang database were searched from 2010 through March 2021.

Results

We identified 1255 patients assessed in 17 randomized controlled trials. Compared with the ISB group, the SSNB group had higher VAS at rest in PACU (P = 0.003), 1 h after operation (P = 0.005), similar pain score 2 h (P = 0.39), 3-4 h (P = 0.32), 6-8 h after operation (P = 0.05), then lower VAS 12 h after operation (P = 0.00006), and again similar VAS 1 day (P = 0.62) and 2 days after operation (P = 0.70). As for the VAS with movement, the SSNB group had higher pain score in PACU (P = 0.03), similar VAS 4-6 h after operation (P = 0.25), then lower pain score 8-12 h after operation (P = 0.01) and again similar VAS 1 day after operation (P = 0.3) compared with the ISB group. No significant difference was found for oral morphine equivalents use at 24 h (P = 0.35), duration of PACU stay (P = 0.65), the rate of patient satisfaction (P = 0.14) as well as the rate of vomiting (P = 0.56), and local tenderness (P = 0.87). However, the SSNB group had lower rate of block-related complications such as Horner syndrome (P < 0.0001), numb (P = 0.002), dyspnea (P = 0.04), and hoarseness (P = 0.04).

Conclusion

Our high-level evidence established SSNB as an effective and safe analgesic technique and a clinically attractive alternative to interscalene block with the SSNB’S advantage of similar pain control, morphine use, and less nerve block-related complications during arthroscopic shoulder surgery, especially for severe chronic obstructive pulmonary disease, obstructive sleep apnea, and morbid obesity. Given our meta-analysis’s relevant possible biases, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.
Effects of the association between APOE rs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in southern China
Authors: He Haoyu , Lu Huaxiang , Liu Shuzhen , Cai Jiansheng , Tang Xu , Mo Chunbao , Xu Xia , Chen Quanhui , Xu Min , Nong Chuntao , Liu Qiumei , Zhang Junling , Qin Jian , Zhang Zhiyong
Published: June 2021

Background

Hand grip strength is a complex phenotype. The current study aimed to identify the effects of the association betweenAPOErs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in Gongcheng, southern China.

Methods

APOErs405509 polymorphisms in 1724 participants (695 men and 1029 women, aged 45–97 years old) were genotyped using the Sequenom MassARRAY platform. Statistical analysis was conducted using SPSS 21.0 and Plink 1.90.

Results

TheAPOErs405509 G allele was associated with lower hand grip strength in all participants (β = −1.04,Pvalue <0.001), and the correlation seemed to be even stronger among women. A significant gene-environment interaction was observed betweenAPOErs405509 and smoking, especially in men. The hand grip strength of male smokers carrying the GG genotype was significantly higher than that of nonsmokers (Pvalue = 0.004).

Conclusions

APOErs405509 polymorphisms might be genetic factors that affect hand grip strength in a rural population in Gongcheng, southern China. TheAPOErs405509-smoking interaction has an impact on hand grip strength.
Performance of bidimensional location quotients for constructing input–output tables
Authors: Pereira-López Xesús , Sánchez-Chóez Napoleón Guillermo , Fernández-Fernández Melchor
Published: June 2021

This article seeks to verify the extent to which the formulation of two-dimensional location quotients (2D-LQ) entails a methodological advance in building or generating economic accounts related to sub-territories drawing from basic information. The input–output tables of the Euro Area 19 for 2010 and 2015 are references for analysis. We have used five statistics to measure similarity between true domestic coefficient matrices for ten countries (Austria, Belgium, Estonia, France, Germany, Italy, Latvia, Slovakia, Slovenia, and Spain) and the matrices they generate using nonsurvey techniques (CILQ, FLQ, AFLQ, and 2D-LQ). The focus substantially centers on ranking methodological efficiency by comparing the results of the four techniques mentioned above. The scope of the work employs standard parameters (associated with 2D-LQ) as guidance to ascertain the optimum parameters.
The value of apprentices in the care sector: the effect of apprenticeship costs on the mobility of graduates from apprenticeship training
Authors: Schuss Eric
Published: June 2021

This paper provides evidence on the effect of apprenticeship costs on the decision whether care facilities employ apprenticeship graduates after completing apprenticeship training. To account for the endogeneity in apprenticeship costs, we exploit an exogenous reduction in the apprenticeship costs of care facilities by exploiting the fact that the underlying apprenticeship levy was introduced across the German federal states at different points in time. We find that the redistribution of apprenticeship costs increases the probability of leaving the training facility after completing apprenticeship training by 10 percentage points. Furthermore, we use this quasi-experimental setting to estimate the effect of mobility of graduates on their wages, which hints at a negative relationship in the upper quartile of the wage distribution.
Cervical Cancer-Associated Suffering: Estimating the Palliative Care Needs of a Highly Vulnerable Population
Authors: Krakauer Eric L. , Kwete Xiaoxiao , Kane Khadidjatou , Afshan Gauhar , Bazzett-Matabele Lisa , Bien-Aimé Danta Dona Ruthnie , Byrne-Martelli Sarah , Connor Stephen , Correa Raimundo , Devi C. R. Beena , Diop Mamadou , Gafer Nahla , Goodman Annekathryn , Grover Surbhi , Hasenburg Annette , Irwin Kelly , Thanh Khanh Quach , Kumar Suresh , Nevzorova Diana , Truong Quynh Xuan Nguyen , Rajagopal M. R. , Randall Tom , Rassouli Maryam , Sessa Cristiana , Spence Dingle , Torode Julie S. , Trimble Ted , Varghese Cherian , Fidarova Elena
Published: June 2021

PURPOSE

To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.

METHODS

We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying the suffering prevalence and duration estimates to the number of decedents, nondecedents, and family caregivers in 2017, we were able to estimate their palliative care needs and the intensity of palliative care needed to respond adequately to this suffering.

RESULTS

There is a high prevalence among decedents of moderate or severe pain (84%), vaginal discharge (66%), vaginal bleeding (61%), and loss of faith (31%). Among both decedents and nondecedents, there is a high prevalence of clinically significant anxiety (63% and 50%, respectively), depressed mood (52% and 38%, respectively), and sexual dysfunction (87% and 83%, respectively). Moderate or severe financial distress is prevalent among decedents, nondecedents, and family caregivers (84%, 74%, and 66%, respectively). More than 40% of decedents and nondecedents are abandoned by their intimate partners. Most patients experience some combination of moderate or severe physical, psychological, social, and spiritual suffering. In total, 258,649 decedents and 2,558,857 nondecedents needed palliative care in 2017, approximately 85% of whom were in low- and middle-income countries where palliative care is rarely accessible.

CONCLUSION

Among women with advanced cervical cancer, suffering is highly prevalent and often severe and multifaceted.