bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association of Low Hemoglobin Levels with IgA Nephropathy Progression: A Two-Center Cohort Study of 1,828 Cases
Authors: Zhu Bin , Liu Wen-hua , Yu Dong-rong , Lin Yi , Li Qiang , Tong Meng-li , Li Ya-yu , Yang Ru-chun , Du Yuan-yuan , Tang Xuan-li , Jiang Fei , Fei Dan , Wei Xin-yi , Zhang Fei-fei , Yin Jia-zhen , Wang Wen-rong , Li Xian-fa , Sun Yue , Zhong Yong-zhong , Zhang Mei-juan , Cheng Xiao-Xia , Zhu Cai-feng , Chen Hong-yu
Published: July 2020

Aim: To investigate the relationship between hemoglobin levels and the progression of IgA nephropathy (IgAN). Methods: In a two-center cohort of 1,828 cases with biopsy-proven IgAN, we examined the association of hemoglobin levels with the primary outcome of a composite of all-cause mortality or kidney failure defined as a 40% decline in eGFR, or ESKD (defined as eGFR <15 mL/min/1.73 m2 or need for kidney replacement therapy including hemodialysis, peritoneal dialysis, or kidney transplantation), or the outcome of kidney failure, assessed using Cox and logistic regression models, respectively, with adjustment for confounders. Results: At baseline, mean age, eGFR, and hemoglobin levels were 33.75 ± 11.03 years, 99.70 ± 30.40 mL/min/1.73 m2, and 123.47 ± 18.36 g/L, respectively. During a median of approximately 7-year follow-up, 183 cases reached the composite outcome. After adjustment for demographic and IgAN-specific covariates and treatments, a lower quartile of hemoglobin was nonlinearly associated with an increased risk of the primary outcome or kidney failure in the Cox proportional hazards models (primary outcome: HR for quartile 3 vs. 4, 1.37; 95% CI, 0.83–2.25; HR for quartile 2 vs. 4, 1.18; 95% CI, 0.68–2.07; HR for quartile 1 vs. 4, 1.91; 95% CI, 1.15–3.17; kidney failure: HR for quartile 3 vs. 4, 1.39; 95% CI, 0.84–2.31; HR for quartile 2 vs. 4, 1.20; 95% CI, 0.68–2.11; HR for quartile 1 vs. 4, 1.83; 95% CI, 1.09–3.07) in the fully adjusted model. Then, hemoglobin levels were transformed to a binary variable for fitting the model according to the criteria for anemia of 110 g/L in the women and 120 g/L in men in China. The participants in the anemia group had an increased risk of developing outcomes compared with the nonanemia group in both genders (primary outcome: male: HR, 1.64; 95% CI, 1.01–2.68; female: HR, 1.68; 95% CI, 1.02–2.76; kidney failure: male: HR, 1.60; 95% CI, 0.97–2.64; female: HR, 1.58; 95% CI, 0.95–2.61) in the fully adjusted model. Conclusions: A low level of hemoglobin was nonlinearly associated with IgAN progression. The anemic IgAN patients presented a higher risk of developing poor outcomes compared with the nonanemic patients.
Psychopathological Networks in Cognitive-Behavioral Treatments for Binge-Eating Disorder
Authors: Hilbert Anja , Herpertz Stephan , Zipfel Stephan , Tuschen-Caffier Brunna , Friederich Hans-Christoph , Mayr Andreas , de Zwaan Martina
Published: July 2020

Introduction: Network approaches to psychopathology posit that mental disorders emerge from interrelated symptoms, and thus connectivity among symptoms are assumed to negatively predict the treatment response and decrease with efficacious treatment. Objective: This study uniquely sought to elucidate the network structure, its change, and its predictive value in cognitive-behavioral therapy (CBT) for binge-eating disorder (BED). Methods: In a multicenter randomized trial of face-to-face and Internet-based guided self-help CBT, 178 individuals with full syndrome and subsyndromal BED, eating disorder and general psychopathology, and body mass index (BMI) were subjected to Gaussian Graphical Network and Exploratory Graph Analyses before and after treatment and at 6-month follow-up. Results: At pretreatment, 3 network communities of: eating disorder psychopathology; general psychopathology; and restraint and BMI were identified, with the latter community included in the first thereafter. Eating disorder-related impairment and self-esteem were the most central symptoms, while BMI and binge eating had the lowest centrality. Network connectivity significantly increased from pre- to posttreatment, with the greatest increases in strength centrality found in binge eating and shape concern, but it did not predict remission from binge eating. Conclusions: With decreasing symptom severity, CBT resulted in a greater integration and connectivity of the psychopathology network in BED, suggesting an increased patient understanding of relations between binge eating and other symptoms. Network connectivity was not a negative prognostic indicator of treatment outcome. These results indicate a need for further research on the predictive value of network variables in the explanation of therapeutic change for patients with BED.
Promise in Preaching and Pop Culture: in Search of a Sermon for Latin American Vulnerable Life
Authors: Adam Júlio Cézar
Published: July 2020

This article aims to reflect on homiletics and Christian preaching as a voice of promise in the Brazilian and Latin American context. Initially it will reflect upon three characteristic types of relationship between preaching and promise: the eschatological and transcendentalist preaching that locates the promise in an afterlife or the end of times; the humanistic and liberating preaching that places the promise in the dimension of the socio-political struggle for transformation in the present; and, thirdly, the individualistic and prosperity-oriented preaching that projects promise as material achievement and hedonistic satisfaction. Finally, faced with this reality, we seek ways in literature (Two Words, by Isabel Allende) and in popular culture (Central do Brasil, a movie by Walter Salles) to help us in creating a sermon that announces the promise amid the daily and vulnerable life in order to contribute not merely to individual, ecclesial or ideological satisfaction, but to point to human and cultural transformations.
Franz Magnis-Suseno, Dialogue Ethics and Public Reasoning of Religions
Authors: Hardiman Fransisco Budi
Published: July 2020

The return of religion in politics is an important issue in a contemporary democracy. Franz Magnis-Suseno, a Jesuit, ethician and interfaith figure in Indonesia, provides a raft of interesting insights for interreligious dialogues in a pluralistic democracy. Through his publications, he seeks to assist Muslims and Christians to build an ethics of citizenship in a pluralistic democracy with the second Vatican theology of religions as his intellectual foundation. In this article, the author attempts to reconstruct the important points of Magnis-Suseno’s thoughts on dialogue ethics and identifies their relationships to the public reasoning of religions in a political public sphere. He comments that Magnis-Suseno demands more of religions than do Rawls and Habermas in terms of moderating their doctrinal positions vis-à-vis other religions.
Public Theology and the Anthropocene: Exploring Human-Animal Relations
Authors: van Urk Eva
Published: July 2020

Given that the current ecological crises are largely human-caused, it is an issue of public concern to promote views which appreciate non-human animals (and creation at large) as inherently and independently valuable, and which stimulate efforts to reverse trends towards mass extinction. This article examines how theologians may critically explore the Bible’s relevance in the Anthropocene. It will show that theology can both critically incorporate new attitudes towards non-human animals, as well as dig into its own reservoirs, like biblical stories for the sake of an appropriate response. Such ‘digging’ needs to consist of a willingness both to discover and actualize a biblical ecological wisdom and to unmask possible anthropocentric tendencies. It is assumed that theology will continue to prove itself to be an indispensable conversation partner in public spheres.
A Second-Order Closure Turbulence Model: New Heat Flux Equations and No Critical Richardson Number
Authors: Cheng Y. , Canuto V. M. , Howard A. M. , Ackerman A. S. , Kelley M. , Fridlind A. M. , Schmidt G. A. , Yao M. S. , Del Genio A. , Elsaesser G. S.
Published: July 2020

We formulate a new second-order closure turbulence model by employing a recent closure for the pressure–temperature correlation at the equation level. As a result, we obtain new heat flux equations that avoid the long-standing issue of a finite critical Richardson number. The new, structurally simpler model improves on the Mellor–Yamada and Galperin et al. models; a key feature includes enhanced mixing under stable conditions facilitating agreement with observational, experimental, and high-resolution numerical datasets. The model predicts a planetary boundary layer height deeper than predicted by models with low critical Richardson numbers, as demonstrated in single-column model runs of the GISS ModelE general circulation model.
Predicting Rainy Season Onset in the Ethiopian Highlands for Agricultural Planning
Authors: Lala Jonathan , Tilahun Seifu , Block Paul
Published: July 2020

The Kiremt rainy season is the foundation of agriculture in the Ethiopian Highlands and a key driver of economic development as well as the instigator of famines that have plagued the country’s history. Despite the importance of these rains, relatively little research exists on predicting the season’s onset; even less research evaluates statistical modeling approaches, in spite of their demonstrated utility for decision-making at local scales. To explore these methods, predictions are generated conditioned on three definitions of onset, at three lead times, using partial least squares (PLS) regression and random forest classification. Results illustrate moderate prediction skill and an ability to avoid false onsets, which may guide planting decisions; however, they are highly sensitive to how onset is defined, suggesting that future prediction approaches should additionally consider local agricultural definitions of onset.
Reflections on the Value of Participation in Simulation as Young Faculty
Authors: Brinkmeier Jennifer V.
Published: July 2020

As simulation becomes more widely adopted among otolaryngology graduate medical education, faculty have much to contribute and gain from participation in courses. Young faculty in particular are well poised to develop new didactic strategies, as they can bridge recent medical education with real‐life specialty experiences. Additionally, participation as faculty leadership in course development is a particularly rich opportunity for professional development.
Pilocytic Astrocytoma: A Review of General, Clinical, and Molecular Characteristics
Authors: Salles Débora , Laviola Gabriela , Malinverni Andréa Cristina de Moraes , Stávale João Norberto
Published: July 2020

Pilocytic astrocytomas are the primary tumors most frequently found in children and adolescents, accounting for approximately 15.6% of all brain tumors and 5.4% of all gliomas. They are mostly found in infratentorial structures such as the cerebellum and in midline cerebral structures such as the optic nerve, hypothalamus, and brain stem. The present study aimed to list the main characteristics about this tumor, to better understand the diagnosis and treatment of these patients, and was conducted on search of the published studies available in NCBI, PubMed, MEDLINE, Scielo, and Google Scholar. It was possible to define the main histologic findings observed in these cases, such as mitoses, necrosis, and Rosenthal fibers. We described the locations usually most affected by tumor development, and this was associated with the most frequent clinical features. The comparison between the molecular diagnostic methods showed great use of fluorescent in situ hybridization, polymerase chain reaction (PCR), and reverse transcriptase–PCR, important techniques for the detection of BRAF V600E mutation and BRAF-KIAA1549 fusion, characteristic molecular alterations in pilocytic astrocytomas.
The Feminist Ethic of Care: Mothering Among Sex Workers in Mumbai
Authors: McCloskey Rebecca J. , Karandikar Sharvari , Reno Rebecca , España Megan
Published: July 2020

The majority of sex workers are mothers. Although participation in sex work is primarily driven by the prioritization of their children’s needs over their own, mothers are stigmatized, subject to poorer health, and lack access to quality health care and social services. Interviews with 25 mothers in Mumbai, India, were analyzed using theory-driven coding to reexamine participation in sex work in context of Gilligan’s three-stage ethic of care, a feminist theory of moral reasoning. Stage 1 (decision making focused on self) themes were (a) sex work served as a means to survival and (b) exploitative and unfulfilling relationships required a focus on self. The transition from Stage 1 to 2 theme was language of selfishness versus responsibility. Stage 2 (selflessness is goodness) themes characterizing the majority of narratives were (a) sex work is justified, (b) duty to prioritize care of others, and (c) self-sacrifice to achieve aspirations for children. The transition from Stage 2 to 3 had one theme: consideration of self. While Stage 3 represents women taking holistic care of themselves and others, the data did not reflect this. Reframing mothers’ participation in sex work using the ethic of care framework may support destigmatization, decriminalization, and security of human rights.
An Update to “Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement”
Authors: Kumar Priyanka R. , Nash David B.
Published: July 2020

The aim of this article is to summarize and interpret the current literature on patient quality and safety measures in the ambulatory setting. The authors reviewed the MEDLINE database from 2016 to the present for articles on patient quality and safety measures in the ambulatory setting. The search was guided by the use of specific keywords and medical subject heading terms, including patient safety, ambulatory care, quality, measurements, medical errors, medication safety and electronic prescribing, safety culture, diagnostic error, team training, continuity, care coordination, simulation exercises, and patient-centered. Studying ambulatory quality and safety remains challenging because of the heterogeneity and complexity of the outpatient environment. This review shows that since 2016, very modest progress has been made in this critical area. Effective change in ambulatory quality and safety will require a prioritization and redoubling of efforts.
Telehealth Therapy for Therapists: Barriers and Benefits
Authors: Botaitis Nicole , Southern Stephen
Published: July 2020

Personal therapy for therapists is described as a means for advancing personal and professional growth. Therapist problems contribute to boundary disturbance, ethical violation, and incompetence. Benefits of therapy include enhanced counselor reflection and therapeutic alliance. Telehealth therapy overcomes barriers and represents an innovation in self-care and career development.
Eligibility for PCSK9 inhibitors based on the 2019 ESC/EAS and 2018 ACC/AHA guidelines
Authors: Koskinas Konstantinos C , Gencer Baris , Nanchen David , Branca Mattia , Carballo David , Klingenberg Roland , Blum Manuel R , Carballo Sebastian , Muller Olivier , Matter Christian M , Lüscher Thomas F , Rodondi Nicolas , Heg Dik , Wilhelm Matthias , Räber Lorenz , Mach François , Windecker Stephan
Published: July 2020

Aims

The 2018 American College of Cardiology (ACC)/American Heart Association (AHA) and 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) lipid guidelines recently updated their recommendations regarding proprotein convertase subtilisin/kexin-9 inhibitors (PCSK9i). We assessed the potential eligibility for PCSK9i according to the new guidelines in patients with acute coronary syndromes.

Methods and results

We analysed a contemporary, prospective Swiss cohort of patients hospitalised for acute coronary syndromes. We modelled a statin intensification effect and an incremental ezetimibe effect on low-density lipoprotein-cholesterol levels among patients who were not on high-intensity statins or ezetimibe. One year after the index acute coronary syndrome event, treatment eligibility for PCSK9i was defined as low-density lipoprotein-cholesterol of 1.4 mmol/l or greater according to ESC/EAS guidelines. For ACC/AHA guidelines, treatment eligibility was defined as low-density lipoprotein-cholesterol of 1.8 mmol/l or greater in the presence of very high-risk atherosclerotic cardiovascular disease, defined by multiple major atherosclerotic cardiovascular disease events and/or high-risk conditions. Of 2521 patients, 93.2% were treated with statins (53% high-intensity statins) and 7.3% with ezetimibe at 1 year, and 54.9% had very high-risk atherosclerotic cardiovascular disease. Low-density lipoprotein-cholesterol levels less than 1.8 mmol/l and less than 1.4 mmol/l at 1 year were observed in 37.5% and 15.7% of patients, respectively. After modelling the statin intensification and ezetimibe effects, these numbers increased to 76.1% and 49%, respectively. The proportion of patients eligible for PCSK9i was 51% according to ESC/EAS criteria versus 14% according to ACC/AHA criteria.

Conclusions

In this analysis, the 2019 ESC/EAS guidelines rendered half of all post-acute coronary syndrome patients potentially eligible for PCSK9i treatment, as compared to a three-fold lower eligibility rate based on the 2018 ACC/AHA guidelines.
Novel manifestations of immune dysregulation and granule defects in gray platelet syndrome
Authors: Sims Matthew C. , Mayer Louisa , Collins Janine H. , Bariana Tadbir K. , Megy Karyn , Lavenu-Bombled Cecile , Seyres Denis , Kollipara Laxmikanth , Burden Frances S. , Greene Daniel , Lee Dave , Rodriguez-Romera Antonio , Alessi Marie-Christine , Astle William J. , Bahou Wadie F. , Bury Loredana , Chalmers Elizabeth , Da Silva Rachael , De Candia Erica , Deevi Sri V. V. , Farrow Samantha , Gomez Keith , Grassi Luigi , Greinacher Andreas , Gresele Paolo , Hart Dan , Hurtaud Marie-Françoise , Kelly Anne M. , Kerr Ron , Le Quellec Sandra , Leblanc Thierry , Leinøe Eva B. , Mapeta Rutendo , McKinney Harriet , Michelson Alan D. , Morais Sara , Nugent Diane , Papadia Sofia , Park Soo J. , Pasi John , Podda Gian Marco , Poon Man-Chiu , Reed Rachel , Sekhar Mallika , Shalev Hanna , Sivapalaratnam Suthesh , Steinberg-Shemer Orna , Stephens Jonathan C. , Tait Robert C. , Turro Ernest , Wu John K. M. , Zieger Barbara ,   NIHR BioResource, Kuijpers Taco W. , Whetton Anthony D. , Sickmann Albert , Freson Kathleen , Downes Kate , Erber Wendy N. , Frontini Mattia , Nurden Paquita , Ouwehand Willem H. , Favier Remi , Guerrero Jose A.
Published: July 2020

Gray platelet syndrome (GPS) is a rare recessive disorder caused by biallelic variants in NBEAL2 and characterized by bleeding symptoms, the absence of platelet α-granules, splenomegaly, and bone marrow (BM) fibrosis. Due to the rarity of GPS, it has been difficult to fully understand the pathogenic processes that lead to these clinical sequelae. To discern the spectrum of pathologic features, we performed a detailed clinical genotypic and phenotypic study of 47 patients with GPS and identified 32 new etiologic variants in NBEAL2. The GPS patient cohort exhibited known phenotypes, including macrothrombocytopenia, BM fibrosis, megakaryocyte emperipolesis of neutrophils, splenomegaly, and elevated serum vitamin B12 levels. Novel clinical phenotypes were also observed, including reduced leukocyte counts and increased presence of autoimmune disease and positive autoantibodies. There were widespread differences in the transcriptome and proteome of GPS platelets, neutrophils, monocytes, and CD4 lymphocytes. Proteins less abundant in these cells were enriched for constituents of granules, supporting a role for Nbeal2 in the function of these organelles across a wide range of blood cells. Proteomic analysis of GPS plasma showed increased levels of proteins associated with inflammation and immune response. One-quarter of plasma proteins increased in GPS are known to be synthesized outside of hematopoietic cells, predominantly in the liver. In summary, our data show that, in addition to the well-described platelet defects in GPS, there are immune defects. The abnormal immune cells may be the drivers of systemic abnormalities such as autoimmune disease.
Molecular basis of ETV6-mediated predisposition to childhood acute lymphoblastic leukemia
Authors: Nishii Rina , Baskin-Doerfler Rebekah , Yang Wentao , Oak Ninad , Zhao Xujie , Yang Wenjian , Hoshitsuki Keito , Bloom Mackenzie , Verbist Katherine , Burns Melissa , Li Zhenhua , Lin Ting-Nien , Qian Maoxiang , Moriyama Takaya , Gastier-Foster Julie M. , Rabin Karen R. , Raetz Elizabeth , Mullighan Charles , Pui Ching-Hon , Yeoh Allen Eng-Juh , Zhang Jinghui , Metzger Monika L. , Klco Jeffery M. , Hunger Stephen P. , Newman Scott , Wu Gang , Loh Mignon L. , Nichols Kim E. , Yang Jun J.
Published: July 2020

There is growing evidence supporting an inherited basis for susceptibility to acute lymphoblastic leukemia (ALL) in children. In particular, we and others reported recurrent germline ETV6 variants linked to ALL risk, which collectively represent a novel leukemia predisposition syndrome. To understand the influence of ETV6 variation on ALL pathogenesis, we comprehensively characterized a cohort of 32 childhood leukemia cases arising from this rare syndrome. Of 34 nonsynonymous germline ETV6 variants in ALL, we identified 22 variants with impaired transcription repressor activity, loss of DNA binding, and altered nuclear localization. Missense variants retained dimerization with wild-type ETV6 with potentially dominant-negative effects. Whole-transcriptome and whole-genome sequencing of this cohort of leukemia cases revealed a profound influence of germline ETV6 variants on leukemia transcriptional landscape, with distinct ALL subsets invoking unique patterns of somatic cooperating mutations. 70% of ALL cases with damaging germline ETV6 variants exhibited hyperdiploid karyotype with characteristic recurrent mutations in NRAS, KRAS, and PTPN11. In contrast, the remaining 30% cases had a diploid leukemia genome and an exceedingly high frequency of somatic copy-number loss of PAX5 and ETV6, with a gene expression pattern that strikingly mirrored that of ALL with somatic ETV6-RUNX1 fusion. Two ETV6 germline variants gave rise to both acute myeloid leukemia and ALL, with lineage-specific genetic lesions in the leukemia genomes. ETV6 variants compromise its tumor suppressor activity in vitro with specific molecular targets identified by assay for transposase-accessible chromatin sequencing profiling. ETV6-mediated ALL predisposition exemplifies the intricate interactions between inherited and acquired genomic variations in leukemia pathogenesis.
Phase 2 study of pembrolizumab for measurable residual disease in adults with acute lymphoblastic leukemia
Authors: Cassaday Ryan D. , Garcia Kelsey-Leigh A. , Fromm Jonathan R. , Percival Mary-Elizabeth M. , Turtle Cameron J. , Nghiem Paul T. , Stevenson Phillip A. , Estey Elihu H.
Published: July 2020

The presence of measurable residual disease (MRD) in acute lymphoblastic leukemia (ALL) confers a poor prognosis. CD19-targeted immunotherapy is effective against MRD but is logistically challenging, potentially toxic, and not applicable to T-cell ALL. We thus hypothesized that inhibition of PD-1 with pembrolizumab could also be effective for MRD, but without lineage restriction. The primary objective of this phase 2 study was to evaluate the efficacy of pembrolizumab in patients with ALL and MRD. Key eligibility criteria included adults with B- or T-cell ALL and MRD detectable by multiparameter flow cytometry or quantitative polymerase chain reaction from bone marrow aspirate (BMA) despite chemotherapy (plus ABL kinase inhibitor if Philadelphia chromosome positive). Pembrolizumab 200 mg IV was given every 3 weeks. Response was assessed by BMA using methods that previously detected MRD. The primary end point was complete MRD response rate. We stopped enrollment early; only 1 of 12 (8%) experienced a complete MRD response, which lasted 3 weeks. Interestingly, this patient had previously received hematopoietic cell transplantation and CD19-targeted chimeric antigen receptor–modified T-cell therapy and was the only patient to experience an immune-related adverse event from pembrolizumab (grade 3 Stevens-Johnson syndrome). Median overall survival from enrollment was 12.7 months. In summary, pembrolizumab had minimal activity against MRD but was generally well tolerated. These data can be compared with ongoing anti-PD-1 combination studies in ALL, and they further establish the role of trials specifically for patients with MRD. This trial was registered at www.clinicaltrials.gov as #NCT02767934.
Seed characterization and early nitrogen metabolism performance of seedlings from Altiplano and coastal ecotypes of Quinoa
Authors: Pinto-Irish Katherine , Coba de la Peña Teodoro , Ostria-Gallardo Enrique , Ibáñez Cristian , Briones Vilbett , Vergara Alexander , Alvarez Rodrigo , Castro Catalina , Sanhueza Carolina , Castro Patricio A. , Bascuñán-Godoy Luisa
Published: July 2020

Background

Early seed germination and a functional root system development during establishment are crucial attributes contributing to nutrient competence under marginal nutrient soil conditions. Chenopodium quinoa Willd (Chenopodiaceae) is a rustic crop, able to grow in marginal areas. Altiplano and Coastal/Lowlands are two representative zones of quinoa cultivation in South America with contrasting soil fertility and edaphoclimatic conditions.

In the present work, we hypothesize that the ecotypes of Quinoa from Altiplano (landrace Socaire) and from Coastal/Lowland (landrace Faro) have developed differential adaptive responses in order to survive under conditions of low availability of N in their respective climatic zones of Altiplano and Lowlands. In order to understand intrinsic differences for N competence between landraces, seed metabolite profile and germinative capacity were studied. Additionally, in order to elucidate the mechanisms of N uptake and assimilation at limiting N conditions during establishment, germinated seeds of both landraces were grown at either sufficient nitrate (HN) or low nitrate (LN) supply. We studied the photosynthetic performance, protein storage, root morphometrical parameters, activity and expression of N-assimilating enzymes, and the expression of nitrate transporters of roots in plants submitted to the different treatments.

Results

Seeds from Socaire landrace presented higher content of free N-related metabolites and faster seed germination rate compared to Faro landrace. Seedlings of both ecotypes presented similar physiological performance at HN supply, but at LN supply their differences were exalted. At LN, Socaire plants showed an increased root biomass (including a higher number and total length of lateral roots), a differential regulation of a nitrate transporter (a NPF6.3-like homologue) belonging to the Low Affinity Transport System (LATS), and an upregulation of a nitrate transporter (a NRT2.1-like homologue) belonging to the High Affinity nitrate Transport System (HATS) compared to Faro. These responses as a whole could be linked to a higher amount of stored proteins in leaves, associated to an enhanced photochemical performance in Altiplano plants, in comparison to Lowland quinoa plants.

Conclusions

These differential characteristics of Socaire over Faro plants could involve an adaptation to enhanced nitrate uptake under the brutal unfavorable climate conditions of Altiplano.
How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey
Authors: Li YiJun , Coppieters Michel W. , Setchell Jenny , Hodges Paul W. , Scholten-Peeters Gwendolyne G. M.
Published: July 2020

Background

Low back pain (LBP) is the second highest cause of health burden in China. Delayed recovery, poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. Chinese philosophies are nested into the daily life of people in China, which is likely to influence pain beliefs. However, there is lack of knowledge about people’s discourses regarding their LBP in China. The primary aim of this study was to explore the discourses underlying the beliefs of people in China about what causes their persistent or recurrent LBP. The secondary aim was to investigate the sources of these pain beliefs.

Methods

People (n = 152) from South Central, East and North Mainland China with LBP completed an online survey about what they believed caused their persistent or recurrent LBP and where these understandings came from. Potential causes of persistent or recurrent LBP were explored qualitatively using discourse analysis. The sources of these discourses were assessed by descriptive statistics with conventional content analysis.

Results

Five discourses were identified to underpin participants’ beliefs about what caused their persistent or recurrent LBP, namely: (1) biomedical problems (66.4%), (2) unbalanced lifestyle (48.7%), (3) menstruation and ‘kidney’ status (9.2%), (4) the ‘Five Elements’ imbalance (7.9%), and (5) energy status (5.9%). Most participants responded that their pain beliefs were based on information derived from healthcare professionals (59.2%), followed by the internet (24.3%) and family (23.0%).

Conclusions

People from moderately and well-developed parts of Mainland China think predominantly in line with a Western biomedical viewpoint about their LBP. Traditional Chinese medicine related pain beliefs mainly to the concept of ‘balance’ were evident on contemporary Chinese society’s understandings of LBP. These cultural beliefs could be relevant to consider in LBP management and involve healthcare professionals, family and patient in this process.
A feasibility study of individual 3D-printed navigation template for the deep external fixator pin position on the iliac crest
Authors: Liang Bin , Chen Qiang , Liu Shuai , Chen Shuo , Yao Qingqiang , Wei Bo , Xu Yan , Tang Cheng , Wang Liming
Published: July 2020

Background

The aim of this study was to investigate the feasibility of an individual navigation template for the deep pin position on the iliac crest, based on digital design and 3D printing technology.

Methods

The preoperative CT images of 8 patients with pelvic fractures were collected. The data were reconstructed using a 3D imaging reconstruction workstation. An individual navigation template for the deep pin position on the iliac crest was designed on a virtual 3D model. The individual drill template and the solid pelvic model were produced using the 3D printing technology. The individual drill template was used for intraoperative deep pin position on the iliac crest after the preoperative simulation was completed.

Results

Thirty-two external fixator pins were inserted using the individual drill template. The average depth of pins was 84.82 mm. The trajectories were appropriate based on the postoperative X-ray and CT scan. No significant difference in the entry point, convergence angle, and caudal angle of the pins were noted before and after the operation (allP > 0.05). Finite element analysis indicated that the deep external fixator pin position could more reasonably distribute the stress in the cortical and spongy bones in the pelvis. All patients could perform partial weight-bearing activity 6 weeks postoperatively. No loosening and rupture of the pin, infection, and no damage of blood vessels and nervous tissue were found during the entire follow-up period.

Conclusions

The individual drill template technique is an improvement of the traditional technique, which could increase precision and the depth of pin position. In addition, good mechanical stability and low risk of pin-related complications occurred due to the individual drill template, which makes the external fixation technique a potential alternative.
Fixing tacks induced bladder erosion and recurrent stones following laparoscopic inguinal hernia repair: a case report
Authors: Liu Wan-Zhang , Qian Jun-Hai , Shen Zhi-Jiu , Yang Bin-Bin , Cheng Yue
Published: July 2020

Background

Hernia mesh erosion into the urinary bladder is a rare complication of hernioplasty, and mesh immigration is the most probable pathophysiology. There is no report describing mesh erosion induced by fixing tacks in inguinal hernia repair.

Case presentation

A 37-year-old man was admitted to our hospital with frequency, urgency and odynuria for 3 months. He received open right inguinal hernia repair in September 2014, and right laparoscopic hernioplasty for recurrence of the inguinal hernia in May 2015. In February 2019, he underwent a day-case transurethral cystoscopic operation for urethral and bladder stones. Cystoscopy revealed the existence of bladder stones and part of the eroded mesh on the right anterior wall, for which an open partial cystectomy was performed. The patient was followed up for 3 months postoperatively, during which no further mesh erosion or stone recurrence was detected by cystoscopy.

Conclusion

This is the first case report describing mesh erosion into the urinary bladder by fixing tacks following laparoscopic inguinal hernia repair. In such a case, the eroded mesh and tacks need to be removed completely, but the effectiveness of a single transurethral procedure needs to be verified in more cases.
LandmarkNet: a 2D digital radiograph landmark estimator for registration
Authors: Wang Zhen , Liu Cong , Ma Longhua
Published: July 2020

Background

Radiation therapy requires precision to target and escalate the doses to affected regions while reducing the adjacent normal tissue exposed to high radiotherapy doses. Image guidance has become the start of the art in the treating process. Registering the digital radiographs megavoltage x ray (MV-DRs) and the kilovoltage digital reconstructed radiographs (KV-DRRs) is difficult because of the poor quality of MV-DRs. We simplify the problem by registering between landmarks instead of entire image information, thence we propose a model to estimate the landmark accurately.

Methods

After doctors’ analysis, it is proved that it is effective to register through several physiological features such as spinous process, tracheal bifurcation, Louis angle. We propose the LandmarkNet, a novel keypoint estimation architecture, can automatically detect keypoints in blurred medical images. The method applies the idea of Feature Pyramid Network (FPN) twice to merge the cross-scale and cross-layer features for feature extraction and landmark estimation successively. Intermediate supervision is used at the end of the first FPN to ensure that the underlying parameters are updated normally. The network finally produces heatmap to display the approximate location of landmarks and we obtain accurate position estimation after non-maximum suppression (NMS) processing.

Results

Our method could obtain accurate landmark estimation in the dataset provided by several cancer hospitals and labeled by ourselves. The standard percentage of correct keypoints (PCK) within 8 pixels of estimation for the spinous process, tracheal bifurcation and Louis angle is 81.24%, 98.95% and 85.61% respectively. For the above three landmarks, the mean deviation between the predicted location of each landmark and corresponding ground truth is 2.38, 0.98 and 2.64 pixels respectively.

Conclusion

Landmark estimation based on LandmarkNet has high accuracy for different kinds of landmarks. Our model estimates the location of tracheal bifurcation especially accurately because of its obvious features. For the spinous process, our model performs well in quantity estimation as well as in position estimation. The wide application of our method assists doctors in image-guided radiotherapy (IGRT) and provides the possibility of precise treatment in the true sense.
Privately computing set-maximal matches in genomic data
Authors: Sotiraki Katerina , Ghosh Esha , Chen Hao
Published: July 2020

Background

Finding long matches in deoxyribonucleic acid (DNA) sequences in large aligned genetic sequences is a problem of great interest. A paradigmatic application is the identification of distant relatives via large common subsequences in DNA data. However, because of the sensitive nature of genomic data such computations without security consideration might compromise the privacy of the individuals involved.

Methods

The secret sharing technique enables the computation of matches while respecting the privacy of the inputs of the parties involved. This method requires interaction that depends on the circuit depth needed for the computation.

Results

We design a new depth-optimized algorithm for computing set-maximal matches between a database of aligned genetic sequences and the DNA of an individual while respecting the privacy of both the database owner and the individual. We then implement and evaluate our protocol.

Conclusions

Using modern cryptographic techniques, difficult genomic computations are performed in a privacy-preserving way. We enrich this research area by proposing a privacy-preserving protocol for set-maximal matches.
Genomic landscape in acute myeloid leukemia and its implications in risk classification and targeted therapies
Authors: Hou Hsin-An , Tien Hwei-Fang
Published: July 2020

Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy in terms of clinical features, underlying pathogenesis and treatment outcomes. Recent advances in genomic techniques have unraveled the molecular complexity of AML leukemogenesis, which in turn have led to refinement of risk stratification and personalized therapeutic strategies for patients with AML. Incorporation of prognostic and druggable genetic biomarkers into clinical practice to guide patient-specific treatment is going to be the mainstay in AML therapeutics. Since 2017 there has been an explosion of novel treatment options to tailor personalized therapy for AML patients. In the past 3 years, the U.S. Food and Drug Administration approved a total of eight drugs for the treatment of AML; most specifically target certain gene mutations, biological pathways, or surface antigen. These novel agents are especially beneficial for older patients or those with comorbidities, in whom the treatment choice is limited and the clinical outcome is very poor. How to balance efficacy and toxicity to further improve patient outcome is clinically relevant. In this review article, we give an overview of the most relevant genetic markers in AML with special focus on the therapeutic implications of these aberrations.
Effect of pericardial incision on left ventricular morphology and systolic function in patients during coronary artery bypass grafting
Authors: Zhao Lan-Ting , Liu Lu , Meng Ping-Ping , Wang Yong-Huai , Li Meng , Yang Jun , Gu Tian-Xiang , Ma Chun-Yan
Published: July 2020

Background

Accurate assessment of left ventricular (LV) systolic function is important after coronary artery bypass grafting (CABG). LV ejection fraction (LVEF) is conventionally used to evaluate LV systolic function; deformation parameters can be used to detect subtle LV systolic dysfunction. It is unclear whether an incised pericardium without sutures during CABG could affect LV morphology and function. We investigated the effect of pericardial incision on LV morphology and systolic function during CABG.

Methods

Intraoperative transesophageal echocardiography was performed in 27 patients during elective off-pump beating heart CABG 5 min before and after pericardial incision. LV longitudinal and mid-cavity transversal diameters, sphericity index, volumes, and LVEF were measured. LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and twist obtained by two-dimensional speckle tracking echocardiography were measured simultaneously.

Results

LV mid-cavity transversal diameter increased, while the LV sphericity index decreased (P < 0.001) immediately after pericardial incision. The GLS, GCS, and twist significantly decreased, while the GRS notably increased (P < 0.001). The LV volumes and LVEF remained unchanged.

Conclusions

Pericardial incision immediately transformed LV morphology from an ellipsoid to sphere, with decreased longitudinal and circumferential strain and twist, and increased radial strain, while LVEF remained unchanged. This should be considered when evaluating LV systolic function in patients after CABG.
Prompt and consistent improvement of coronary flow velocity reserve following successful recanalization of the coronary chronic total occlusion in patients with viable myocardium
Authors: Dobric Milan , Beleslin Branko , Tesic Milorad , Djordjevic Dikic Ana , Stojkovic Sinisa , Giga Vojislav , Tomasevic Miloje , Jovanovic Ivana , Petrovic Olga , Rakocevic Jelena , Boskovic Nikola , Sobic Saranovic Dragana , Stankovic Goran , Vukcevic Vladan , Orlic Dejan , Simic Dragan , Nedeljkovic Milan A. , Aleksandric Srdjan , Juricic Stefan , Ostojic Miodrag
Published: July 2020

Background

Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO.

Methods

Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO.

Results

Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45,p = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS).

Conclusions

In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months.

Trial registration

ClinicalTrials.gov (NumberNCT04060615).
Conversion surgery for stage IV gastric cancer with a complete pathological response to nivolumab: a case report
Authors: Matsumoto Ryu , Arigami Takaaki , Matsushita Daisuke , Okubo Keishi , Tanaka Takako , Yanagita Shigehiro , Sasaki Ken , Noda Masahiro , Kita Yoshiaki , Mori Shinichiro , Kurahara Hiroshi , Ohtsuka Takao
Published: July 2020

Background

Patients with stage IV gastric cancer have a poor prognosis despite the recent development of multidisciplinary treatments that include chemotherapy. However, conversion surgery has emerged as a promising strategy to improve the prognosis in responders with unresectable gastric cancer after chemotherapy. Moreover, nivolumab is currently recommended as a third-line treatment in patients with unresectable advanced gastric cancer. However, there are few reports of conversion surgery after nivolumab in patients with stage IV gastric cancer.

Case presentation

A 68-year-old woman complaining of nausea was diagnosed with stage I gastric cancer (T2N0M0). Although we planned gastrectomy with lymphadenectomy, multiple liver metastases were detected during the surgery. After staging laparoscopy, we diagnosed this patient as having stage IV unresectable gastric cancer, and we administered chemotherapy and immunotherapy for 39 months (first-line regimen: 6 courses of S-1 plus oxaliplatin; second-line regimen: 6 courses of ramucirumab plus paclitaxel; and third-line regimen: 20 courses of nivolumab). Although the liver metastases completely disappeared after the second-line chemotherapy, lung metastases and a rapid enlargement of the primary tumor were confirmed. Consequently, the patient received nivolumab at a dose of 3 mg/kg intravenously every 2 weeks, then a dose of 240 mg/kg intravenously every 2 weeks from September 2018. After 20 courses of nivolumab, the primary tumor dramatically shrank and the lung metastases disappeared. The patient had a partial primary tumor response to nivolumab. Therefore, the patient underwent laparoscopic distal gastrectomy with D2 lymph node dissection. The macroscopic examination of the resected specimen showed an ulcer scar in the primary tumor site. The pathological examination demonstrated no residual tumors and no lymph node metastases, and the histological response of the primary tumor was categorized as grade 3. The postoperative course was uneventful, and the patient is receiving nivolumab to control potential liver and lung metastases.

Conclusions

Conversion surgery might help control tumor progression in responders after chemotherapy and immunotherapy.
Direct comparison of magnetic resonance imaging and pathological shrinkage patterns of triple-negative breast cancer after neoadjuvant chemotherapy
Authors: Yoshikawa Katsuhiro , Ishida Mitsuaki , Kan Naoki , Yanai Hirotsugu , Tsuta Koji , Sekimoto Mitsugu , Sugie Tomoharu
Published: July 2020

Background

We aimed to investigate the usefulness of magnetic resonance imaging (MRI) and histopathological shrinkage patterns to formulate a predictive equation for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC) patients.

Methods

We enrolled 34 TNBC patients who underwent MRI before and after NAC. The MRI and histopathological shrinkage patterns were analyzed and classified into five categories—types I and II (concentric shrinkage without or with surrounding lesions, respectively), type III (shrinkage with residual multinodular lesions), type IV (diffuse contrast enhancement in the entire quadrant), and non-visualization. The residual tumor sizes following MRI and histopathological examination were also compared.

Results

The most common MRI and histopathological shrinkage pattern was type I (41.2% and 38.2%, respectively), followed by non-visualization (26.5% and 32.4%, respectively); the concordance rate between MRI and histopathological shrinkage patterns was 41.2%. There was a strong correlation between MRI tumor size and pathological tumor size (r = 0.89). Based on these findings, a predictive equation for pathological tumor size was formulated as follows: pathological tumor size (mm) = 1.1502 × (MRI tumor size [mm]) + 8.4277.

Conclusions

Our equation may aid accurate preoperative assessment. Further studies are needed to determine its predictive value and applicability.