bluuebunny/crossref_metadata_2025 huggingface dataset:
The Natural History of BK Polyomavirus and the Host Immune Response After Stem Cell Transplantation
Authors: Laskin Benjamin L , Denburg Michelle R , Furth Susan L , Moatz Taylor , Altrich Michelle , Kleiboeker Steve , Lutzko Carolyn , Zhu Xiang , Blackard Jason T , Jodele Sonata , Lane Adam , Wallace Gregory , Dandoy Christopher E , Lake Kelly , Duell Alexandra , Litts Bridget , Seif Alix E , Olson Timothy , Bunin Nancy , Davies Stella M
Published: December 2019

Background

BK polyomavirus (BKPyV) is associated with symptomatic hemorrhagic cystitis after hematopoietic cell transplantation (HCT). Little is known about the host immune response, effectiveness of antiviral treatment, or impact of asymptomatic replication on long-term kidney function.

Methods

In children and young adults undergoing allogeneic HCT, we quantified BKPyV viruria and viremia (pre-HCT and at Months 1–4, 8, 12, and 24 post-HCT) and tested associations of peak viremia ≥10 000 or viruria ≥109 copies/mL with estimated kidney function (glomerular filtration rate, eGFR) and overall survival at 2 years posttransplant. We examined the factors associated with viral clearance by Month 4, including BKPyV-specific T cells by enzyme-linked immune absorbent spot at Month 3 and cidofovir use.

Results

We prospectively enrolled 193 participants (median age 10 years) and found that 18% had viremia ≥10 000 copies/mL and 45% had viruria ≥109 copies/mL in the first 3 months post-HCT. Among the 147 participants without cystitis (asymptomatic), 58 (40%) had any viremia. In the entire cohort and asymptomatic subset, having viremia ≥10 000 copies/mL was associated with a lower creatinine/cystatin C eGFR at 2 years post-HCT. Viremia ≥10 000 copies/mL was associated with a higher risk of death (adjusted hazard ratio, 2.2; 95% confidence interval, 1.1–4.2). Clearing viremia was associated with detectable BKPyV-specific T cells and having viremia <10 000 copies/mL, but not cidofovir exposure.

Conclusions

Screening for BKPyV viremia after HCT identifies asymptomatic patients at risk for kidney disease and reduced survival. These data suggest potential changes to clinical practice, including prospective monitoring for BKPyV viremia to test virus-specific T cells to prevent or treat BKPyV replication.
From Correspondence to Computers: A Theory of Mediated Presence in History
Authors: Bourdon Jérôme
Published: December 2019

This article proposes a theory of mediated presence, defined as the sense of presence— despite physical absence—made possible by technology. Pushing the boundaries of media, the theory integrates various notions of presence at a distance: telepresence in telecommunications and computer-mediated communication, liveness in broadcasting and on the Internet, and the epistolary presence of antiquity. Theoretically, it adopts a social constructivist approach to long-term communication history, with an emphasis on technological breakdowns. The core discussion addresses three criteria for a historical, comparative analysis of mediated presence: dissemination versus dialogue, transmission-reception time lags, and levels of disembodiment. Refuting axiological and technology-centered views of history, the article concludes that increased technological options for presence at a distance have remained essentially ambivalent for users who vacillate between the need for distance and the search for connection.
Microbial indicators are better predictors of wheat yield and quality than N fertilization
Authors: Yergeau Étienne , Quiza Liliana , Tremblay Julien
Published: December 2019

In view of their key roles in many soil- and plant-related processes, we hypothesized that soil microorganisms could play a larger role in determining wheat baking quality than nitrogen fertilization. A field experiment was conducted under bread wheat production conditions, where different fertilization treatments, ranging from 0–120 kg/ha NH4NO3, were applied. Soil samples were taken in May, June and July. Functional genes in the nitrogen cycle were quantified and amplicons of the 16S rRNA gene and the ITS region were sequenced. Wheat yields were measured, and the grain baking quality was analysed for each plot. Fertilisation did not significantly influence the yields and the grain quality. Many bacterial and fungal Amplicon Sequence Variants showed significant positive or negative correlations with yield and grain baking quality parameters. Among the functional gene quantified, the archaeal amoA showed strong negative correlations with the wheat yields and many grain and flour quality parameters. Regression models were able to explain up to 81% of the variability in grain quality based on the microbial data from the May sampling. A better understanding of the microbiology of wheat fields could lead to an optimized management of the N fertilization to maximize yields and grain quality.
Castelnuovo–Mumford Regularity up to Symmetry
Authors: Le Dinh Van , Nagel Uwe , Nguyen Hop D , Römer Tim
Published: December 2019

We study the asymptotic behavior of the Castelnuovo–Mumford regularity along chains of graded ideals in increasingly larger polynomial rings that are invariant under the action of symmetric groups. A linear upper bound for the regularity of such ideals is established. We conjecture that their regularity grows eventually precisely linearly. We establish this conjecture in several cases, most notably when the ideals are Artinian or squarefree monomial.
Genetic influence of ABCG2, UGT1A1 and NR1I2 on dolutegravir plasma pharmacokinetics
Authors: Elliot Emilie R , Neary Megan , Else Laura , Khoo Saye , Moyle Graeme , Carr Daniel F , Wang Xinzhu , Mcclure Myra , Boffito Marta , Owen Andrew
Published: December 2019

Objectives

Dolutegravir has replaced efavirenz as first-line treatment in universal HIV guidelines. We sought to ascertain the contributory effect of SNPs in four key genes linked to dolutegravir disposition (UGT1A1, ABCG2, CYP3A and NR1I2) on plasma dolutegravir pharmacokinetics.

Methods

Paired pharmacogenetic/pharmacokinetic data from 93 subjects were analysed for association using multivariate linear regression.

Results

Co-occurring UGT1*28 and NR1I2 c.63396C>T homozygosity was associated with a 79% increase in AUC0–24 (P = 0.001; 27% if analysed individually), whilst combined ABCG2 c.421C>A and NR1I2 c.63396C>T variants were associated with a 43% increase in Cmax (P = 0.002) and a 39% increase in AUC0–24 (P = 0.002). When analysed individually, homozygosity for the NR1I2 c.63396C>T variant alleles was associated with a 28% increase in Cmax (P = 0.033) and homozygosity for the ABCG2 c.421C>A variant alleles was associated with a 28% increase in Cmax (P = 0.047). The UGT1A1*28 (rs8175347) poor metabolizer status (*28/*28; *28/*37; *37/*37) was individually associated with a 27% increase in AUC0–24 (P = 0.020). The combination of UGT1A1*28 poor metabolizer and UGT1A1*6 intermediate metabolizer statuses correlated with a 43% increase in AUC0–24 (P = 0.023).

Conclusions

This study showed a pharmacogenetic association between dolutegravir pharmacokinetics and variants in the ABCG2, UGT1A1 and NR1I2 genes, particularly when combined. Further research is warranted to confirm these associations in population-specific studies and to investigate their putative relationship with dolutegravir pharmacodynamics.
Developing and Sustaining an Effective and Resilient Oncology Careforce: Opportunities for Action
Authors: Takvorian Samuel U , Balogh Erin , Nass Sharyl , Valentin Virginia L , Hoffman-Hogg Lori , Oyer Randall A , Carlson Robert W , Meropol Neal J , Sheldon Lisa Kennedy , Shulman Lawrence N
Published: December 2019

Advances in cancer care have led to improved survival, which, coupled with demographic trends, have contributed to rapid growth in the number of patients needing cancer care services. However, with increasing caseload, care complexity, and administrative burden, the current workforce is ill equipped to meet these burgeoning new demands. These trends have contributed to clinician burnout, compounding a widening workforce shortage. Moreover, family caregivers, who have unique knowledge of patient preferences, symptoms, and goals of care, are infrequently appreciated and supported as integral members of the oncology “careforce.” A crisis is looming, which will hinder access to timely, high-quality cancer care if left unchecked. Stemming from the proceedings of a 2019 workshop convened by the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine, this commentary characterizes the factors contributing to an increasingly strained oncology careforce and presents multilevel strategies to improve its efficiency, effectiveness, and resilience. Together, these will enable today’s oncology careforce to provide high-quality care to more patients while improving the patient, caregiver, and clinician experience.
Toward an Aggregate, Implicit, and Dynamic Model of Norm Formation: Capturing Large-Scale Media Representations of Dynamic Descriptive Norms Through Automated and Crowdsourced Content Analysis
Authors: Liu Jiaying , Siegel Leeann , Gibson Laura A , Kim Yoonsang , Binns Steven , Emery Sherry , Hornik Robert C
Published: December 2019

Media content can shape people’s descriptive norm perceptions by presenting either population-level prevalence information or descriptions of individuals’ behaviors. Supervised machine learning and crowdsourcing can be combined to answer new, theoretical questions about the ways in which normative perceptions form and evolve through repeated, incidental exposure to normative mentions emanating from the media environment. Applying these methods, this study describes tobacco and e-cigarette norm prevalence and trends over 37 months through an examination of a census of 135,764 long-form media texts, 12,262 popular YouTube videos, and 75,322,911 tweets. Long-form texts mentioned tobacco population norms (4–5%) proportionately less often than e-cigarette population norms (20%). Individual use norms were common across sources, particularly YouTube (tobacco long-form: 34%; Twitter: 33%; YouTube: 88%; e-cigarette long form: 17%; Twitter: 16%; YouTube: 96%). The capacity to capture aggregated prevalence and temporal dynamics of normative media content permits asking population-level media effects questions that would otherwise be infeasible to address.
Military Realism and Doctrinal Innovation in Kennedy's Army: A New Perspective on Military Innovation
Authors: Campbell Peter
Published: December 2019

This article introduces a new theory of military innovation, military realism, which argues that senior military leaders spearhead major changes in military doctrine when existing doctrinal mission priorities and theories of victory do not address the most dangerous threats. What I call the military realist perspective drives this doctrinal innovation. Through a case study of change and continuity in US Army doctrine under President Kennedy, this article challenges bureaucratic, military cultural, and civilian realist theories of military innovation. Military realism provides a powerful explanation of a hard case, while the other theories struggle with what should be an easy case.
Risky Business: Foreign Direct Investment and the Economic Consequences of Electoral Violence
Authors: Doctor Austin C , Bagwell Stephen
Published: December 2019

While the social and political consequences of electoral violence are widely discussed in the literature, less is known about the economic repercussions of electoral violence. Our study investigates this dynamic, asking how episodes of electoral violence affect existing levels of foreign direct investment. We argue that, when managing their investments in foreign markets, multinational firms weigh the expected gains of the investment with the probability that the host country experiences significant lapses in political stability. Electoral violence signals a greater risk of this undesirable outcome and, thus, increases the probability that firms divest in favor of more favorable investment environments. Using firm-level data, we investigate the investment behavior of seventy-seven multinational firms in twenty-five Sub-Saharan African countries from 1995 to 2008 with a series of logistic regression models. Directly modeling the choices that firms make with respect to yearly changes in investment, we demonstrate that firms are more likely to divest following events of electoral violence in a host country. This study carries important implications for our understanding of how electoral violence may undermine the economic stability of emerging economies.
Identification of altered biological processes in heterogeneous RNA-sequencing data by discretization of expression profiles
Authors: Lauria Andrea , Peirone Serena , Giudice Marco Del , Priante Francesca , Rajan Prabhakar , Caselle Michele , Oliviero Salvatore , Cereda Matteo
Published: December 2019

Heterogeneity is a fundamental feature of complex phenotypes. So far, genomic screenings have profiled thousands of samples providing insights into the transcriptome of the cell. However, disentangling the heterogeneity of these transcriptomic Big Data to identify defective biological processes remains challenging. Here we present GSECA, a method exploiting the bimodal behavior of RNA-sequencing gene expression profiles to identify altered gene sets in heterogeneous patient cohorts. Using simulated and experimental RNA-sequencing data sets, we show that GSECA provides higher performances than other available algorithms in detecting truly altered biological processes in large cohorts. Applied to 5941 samples from 14 different cancer types, GSECA correctly identified the alteration of the PI3K/AKT signaling pathway driven by the somatic loss of PTEN and verified the emerging role of PTEN in modulating immune-related processes. In particular, we showed that, in prostate cancer, PTEN loss appears to establish an immunosuppressive tumor microenvironment through the activation of STAT3, and low PTEN expression levels have a detrimental impact on patient disease-free survival. GSECA is available at https://github.com/matteocereda/GSECA.
Molecular subgrouping of atypical teratoid/rhabdoid tumors—a reinvestigation and current consensus
Authors: Ho Ben , Johann Pascal D , Grabovska Yura , De Dieu Andrianteranagna Mamy Jean , Yao Fupan , Frühwald Michael , Hasselblatt Martin , Bourdeaut Franck , Williamson Daniel , Huang Annie , Kool Marcel
Published: December 2019

Background

Atypical teratoid/rhabdoid tumors (ATRTs) are known to exhibit molecular and clinical heterogeneity even though SMARCB1 inactivation is the sole recurrent genetic event present in nearly all cases. Indeed, recent studies demonstrated 3 molecular subgroups of ATRTs that are genetically, epigenetically, and clinically distinct. As these studies included different numbers of tumors, various subgrouping techniques, and naming, an international working group sought to align previous findings and to reach a consensus on nomenclature and clinicopathological significance of ATRT subgroups.

Methods

We integrated various methods to perform a meta-analysis on published and unpublished DNA methylation and gene expression datasets of ATRTs and associated clinicopathological data.

Results

In concordance with previous studies, the analyses identified 3 main molecular subgroups of ATRTs, for which a consensus was reached to name them ATRT-TYR, ATRT-SHH, and ATRT-MYC. The ATRT-SHH subgroup exhibited further heterogeneity, segregating further into 2 subtypes associated with a predominant supratentorial (ATRT-SHH-1) or infratentorial (ATRT-SHH-2) location. For each ATRT subgroup we provide an overview of its main molecular and clinical characteristics, including SMARCB1 alterations and pathway activation.

Conclusions

The introduction of a common classification, characterization, and nomenclature of ATRT subgroups will facilitate future research and serve as a common ground for subgrouping patient samples and ATRT models, which will aid in refining subgroup-based therapies for ATRT patients.
Emergence and Evolution of High-Level Cephalosporin-Resistant Salmonella Goldcoast in Northern Taiwan
Authors: Feng Ye , Chang Yi-Jung , Fang Szu-Hsuan , Su Lin-Hui , Li Hsin-Chieh , Yang Hsin-Ping , Yu Min-Jia , Chiu Cheng-Hsun
Published: December 2019

Background

Nontyphoidal Salmonella (NTS) is an important foodborne pathogen worldwide. We investigated a 2018 outbreak of highly antimicrobial-resistant Salmonella enterica serotype Goldcoast in northern Taiwan.

Methods

We collected 30 clinical isolates and 2 meat isolates from this outbreak in New Taipei and Taoyuan, Taiwan in 2018. The clinical manifestations and the treatment of the patients were reviewed. To trace the source, we examined NTS isolated from food samples collected from the markets in northern Taiwan. All of the isolates along with an additional human isolate from China were sequenced and compared with the sequences of Salmonella Goldcoast reported by other countries.

Results

The outbreak involved 14 pediatric patients (<5 years old) and 16 adults (36 to 83 years old). Nine patients with invasive or severe disease required carbapenem treatment. The MIC90 of ceftriaxone and ciprofloxacin for the outbreak isolates was >256 μg/mL and 1 μg/mL, respectively, and a conjugative 278-kilobase plasmid harboring blaCTX-M-55 and qnrS1 contributed towards the resistance. Whole-genome sequencing revealed a clonal relationship among the outbreak isolates and the 2 collected from the retail meats. The outbreak clone was phylogenetically close to that of Salmonella Goldcoast reported in the United Kingdom, Poland, and China, whereas similar resistance plasmids were found in China and Cambodia.

Conclusions

The clinical spectrum of the high-level cephalosporin-resistant Salmonella Goldcoast is similar to that of other NTS serotypes, but severe cases required carbapenem treatment. The study confirmed the emergence of a highly antimicrobial-resistant clone of Salmonella Goldcoast, highlighting the importance of surveillance for food safety.
Geographic Lead-Lag Effects
Authors: Parsons Christopher A , Sabbatucci Riccardo , Titman Sheridan
Published: December 2019

We document lead-lag effects on returns between coheadquartered firms in different sectors. Geographic lead-lags yield risk-adjusted returns of 5%–6% annually, half that observed for industry lead-lag effects. Whereas industry lead-lag effects are strongest among small, thinly traded stocks with low analyst coverage, geographic lead-lags are unrelated to these proxies for investor scrutiny. We propose an explanation linked to the structure of the investment analyst business, which is organized by sector, not by geographic region. Our findings suggest that in lead-lag relationships, analysts common to both leading and lagging firms are important, regardless of the number of analysts covering each individually.
Efficacy of rituximab in slowing down progression of rheumatoid arthritis–related interstitial lung disease: data from the NEREA Registry
Authors: Vadillo Cristina , Nieto Maria Asuncion , Romero-Bueno Fredeswinda , Leon Leticia , Sanchez-Pernaute Olga , Rodriguez-Nieto Maria Jesus , Freites Dalifer , Jover Juan Angel , Álvarez-Sala Jose Luis , Abasolo Lydia
Published: December 2019

Objectives

To asses the clinical course in RA-related interstitial lung disease (RA-ILD) patients with and without rituximab (RTX). The influence of other variables was also evaluated.

Methods

A longitudinal multicentre study was conducted in RA diagnosed with ILD from 2007 until 2018 in Madrid. Patients were included in a registry [pNEumology RhEumatology Autoinmune diseases (NEREA)] from the time of ILD diagnosis. The main endpoint was functional respiratory impairment (FI), when there was a decline ≥5% in the predicted forced vital capacity compared with the previous one. Pulmonary function was measured at baseline and in follow-up visits every 6–12 months. The independent variable was therapy with RTX. Covariables included sociodemographic, clinical, radiological and other therapies. Survival techniques were used to estimate the incidence rate (IR) and 95% CI of functional impairment, expressed per 100 patient-semesters. Cox multivariate regression models were run to examine the influence of RTX and other covariates on FI. Results were expressed as the hazard ratio (HR) and CI.

Results

A total of 68 patients were included. FI occurred in 42 patients [IR 23.5 (95% CI 19, 29.1)] and 50% of them had FI within 1.75 years of an ILD diagnosis. A multivariate analysis showed that RTX exposure resulted in a lower risk of FI compared with non-exposure [HR 0.51 (95% CI 0.31, 0.85)]. Interstitial pneumonia, glucocorticoids, disease activity and duration also influenced FI.

Conclusion

RA-ILD patients deteriorate over time, with the median time free of impairment being <2 years. Patients exposed to RTX had a higher probability of remaining free of FI compared with other therapies. Other factors have also been identified.
Effect of a High-Fat Diet and Occupational Exposure in Different Rat Strains on Lung and Systemic Responses: Examination of the Exposome in an Animal Model
Authors: Antonini James M , Kodali Vamsi , Shoeb Mohammad , Kashon Michael , Roach Katherine A , Boyce Gregory , Meighan Terence , Stone Samuel , McKinney Walter , Boots Theresa , Roberts Jenny R , Zeidler-Erdely Patti C , Erdely Aaron
Published: December 2019

The exposome is the measure of all exposures of an individual in a lifetime and how those exposures relate to health. The goal was to examine an experimental model integrating multiple aspects of the exposome by collecting biological samples during critical life stages of an exposed animal that are applicable to worker populations. Genetic contributions were assessed using strains of male rats with different genetic backgrounds (Fischer-344, Sprague Dawley, and Brown-Norway) maintained on a regular or high-fat diet for 24 weeks. At week 7 during diet maintenance, groups of rats from each strain were exposed to stainless steel welding fume (WF; 20 mg/m3 × 3 h/d × 4 days/week × 5 weeks) or air until week 12, at which time some animals were euthanized. A separate set of rats from each strain were allowed to recover from WF exposure until the end of the 24-week period. Bronchoalveolar lavage fluid and serum were collected at 7, 12, and 24 weeks to assess general health indices. Depending on animal strain, WF exposure and high-fat diet together worsened kidney toxicity as well as altered different serum enzymes and proteins. Diet had minimal interaction with WF exposure for pulmonary toxicity endpoints. Experimental factors of diet, exposure, and strain were all important, depending on the health outcome measured. Exposure had the most significant influence related to pulmonary responses. Strain was the most significant contributor regarding the other health indices examined, indicating that genetic differences possibly drive the exposome effect in each strain.
Statistics for the Practicing Spine Surgeon
Authors: Goyal Dhruv K.C. , Grandhi Nikhil , Lee Thomas J. , Stolz Katharine , Thomas Alexander , Galetta Matthew S. , Divi Srikanth N. , Fang Taolin , Schroeder Gregory D. , Kepler Christopher K. , Vaccaro Alexander R.
Published: December 2019

With the rapid rise of clinical spine surgery literature in the last few decades, there is a greater need for practicing spine surgeons to confidently analyze and critique published literature within the field. The conclusions drawn from published studies are often integrated into a physician’s clinical decision-making. A strong knowledge in the fundamental statistical measurements used most frequently in spine surgery literature can enhance the ability to properly interpret the meaning of a study’s results. However, medical education often lacks the incorporation of clinically relevant statistical analysis. The purpose of this review is to provide an overview of some of the most commonly used statistical measurements in spine surgery, specifically intraclass correlation coefficient, diagnostic testing analyses, Kaplan-Meier curves, hazard ratios, distribution, and variance.
Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in the General Elderly Population
Authors: Uehara Masashi , Takahashi Jun , Ikegami Shota , Tokida Ryosuke , Nishimura Hikaru , Sakai Noriko , Kato Hiroyuki
Published: December 2019

Study Design:

This is a Japanese resident cohort study based on a municipal registry.

Objectives:

In this study of an aged Japanese population, we used random sampling from the basic resident registry of a rural town for subject selection to investigate the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) and effect of subject-related factors.

Summary of Background:

DISH is a condition characterized by the calcification and ossification of soft tissues. Interest is mounting on DISH as the elderly rate increases, but its pathogenetic mechanism remains unknown.

Data:

A total of 413 aged people randomly sampled from the resident registry of Obuse town.

Materials and Methods:

We established 8 groups on the basis of age (50s, 60s, 70s, and 80s) and sex after random sampling from the resident registry of Obuse town. A total of 411 participants (202 male and 209 female) were enrolled and underwent a single whole-spine lateral radiographic examination. We assessed for the existence of DISH and analyzed the effects of clinical factors using multivariate analysis.

Results:

A total of 72 (17.5%) participants were identified to have DISH in our population cohort. The prevalence of DISH tended to increase with age, being 3.1% in subjects in their 50s, 14.0% in their 60s, 24.3% in their 70s, and 29.0% in their 80s. According to multivariate analysis, hypertension (HT), male, bone mineral density (BMD), and aging were independent factors associated with DISH. The odds ratios of HT, male, and BMD were 1.93, 2.88, and 19.1, respectively.

Conclusions:

This is the first study examining DISH in detail according to age and sex groups on a general population basis. Multivariate analysis revealed HT, male, BMD, and aging to be independent factors associated with DISH in the healthy community-dwelling elderly.
Hyperprogressive disease in advanced cancer patients treated with nivolumab: a case series study
Authors: Petrioli Roberto , Mazzei Maria Antonietta , Giorgi Silvano , Cesqui Eleonora , Gentili Francesco , Francini Guido , Volterrani Luca , Francini Edoardo
Published: December 2019

The aim of this retrospective study was to detail the main clinicopathological characteristics of advanced cancer patients exhibiting hyperprogressive disease (HPD) during immune checkpoint inhibitor (ICI) nivolumab as second- or third-line treatment. A cohort of patients starting second or third-line nivolumab for advanced cancer from 2016 to 2018 was identified from our institution IRB approved and prospectively collected registry. HPD was defined as at least two-fold increase in the tumor growth rate (TGR) during immunotherapy compared to TGR during the preimmunotherapy period. Overall, 47 patients were eligible for this analysis. HPD was observed in three patients (6%) with metastatic lung adenocarcinoma, metastatic urothelial transitional carcinoma, and metastatic hepatocellular carcinoma, respectively. These three patients showed a rapid clinical deterioration and survived less than 3.5 months from immunotherapy onset. Their chief preimmunotherapy characteristics were: age < 75 years, ≥2 metastatic sites, programmed death-ligand 1 < 50%, neutrophil-to-lymphocyte ratio > 3, and elevated lactate dehydrogenase. The results of the current study seem to reinforce the hypothesis that in some cases immunotherapy promotes a dramatic increase of TGR and may suggest possible clinical predictors of HPD during nivolumab.
High- Versus Low-Density Fractional Laser in the Treatment of Hypertrophic Postburn Scars: A Randomized Clinical Trial
Authors: Tawfic Shereen , Sayed Safinaz , Nada Ahmed , Manaa Doha , Shalaby Suzan
Published: December 2019

BACKGROUND

Fractional CO2 laser has been shown effective in improving pigmentation, pruritus, and tightness of hypertrophic burn scars. However, there is no consensus on the optimal treatment parameters.

OBJECTIVE

To compare effectiveness of different densities of fractional CO2 laser in the treatment of mature hypertrophic burn scars.

MATERIALS AND METHODS

The study included 25 patients, each with 3 or more mature hypertrophic burn scars. Scars were randomly assigned to treatment with low-, medium-, and high-density fractional CO2 laser. Each scar received 3 sessions of laser at 1-month interval. The degree of improvement was assessed clinically using Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) scores, and histologically through evaluation of collagen (Masson's Trichrome stain) before and 1 month after end of therapy.

RESULTS

High-density parameters showed significant higher improvement in VSS and POSAS assessment scores (p-value < .001). Pliability and relief are the most improved parameters. Histopathological evaluation revealed a significant drop in the mean area percent of collagen in the 3 used parameters, with highest improvement with high-density laser treatment (p-value < .001).

CONCLUSION

High-density fractional CO2 laser treatment provides more improvement in burn scars both clinically and histopathologically.
Tissue Extraction in Gynecologic Surgery: Past, Present, and Future
Authors: FOLEY CHRISTINE , DONNELLAN NICOLE , HARRIS JOHN
Published: December 2019

Fibroid tissue extraction during hysterectomy and myomectomy has become increasingly controversial. A wave of research has tried to clarify difficult questions around the prevalence of occult malignancies, the effect of morcellation on cancer outcomes, proper informed consent, and surgical options for tissue extraction. This review examines the history of these controversies and discusses tissue extraction techniques and continued areas of debate in the field.
Tocolysis and the risk of nonreassuring fetal status among pregnant women in labor
Authors: Wang I-Te , Tsai Meng-Ting , Erickson Steven R. , Wu Chung-Hsuen
Published: December 2019

The purpose of this study was to evaluate the association between tocolysis for preterm uterine contraction and the risk of nonreassuring fetal status.

This was a retrospective cohort study using data from the Taiwan National Health Insurance Research Database. Pregnant women were enrolled if they delivered a baby during January 1, 2003 to December 31, 2011. The occurrence of the nonreassuring fetal status was compared between pregnant women with and without tocolytic treatment for preterm uterine contraction. Multivariable logistic regression models with adjusted cofounders were used to evaluate the association between tocolysis and the risk of nonreassuring fetal status.

Of 24,133 pregnant women, 1115 (4.6%) received tocolytic treatment during pregnancy. After adjusting for covariates, pregnant women receiving tocolysis more than one time during pregnancy were found to have significantly higher risk of the nonreassuring fetal status when compared with pregnant women who did not receive tocolysis for uterine contraction (Odds Ratio = 2.70, 95% Confidence Interval: 1.13–6.49).

Pregnant women with more frequent tocolysis for preterm uterine contraction during pregnancy had an increased risk of nonreassuring fetal status. Close evaluation of dose and duration of tocolytic treatment is necessary for pregnant women with preterm uterine contraction.
Factors predicting clinical pregnancy rate of in vitro fertilization-embryo transfer (a STROBE-compliant article)
Authors: Zhang Yi-Le , Wang Fu-Zhen , Huang Kai , Hu Lin-Li , Bu Zhi-Qin , Sun Jing , Su Ying-Chun , Guo Yi-Hong
Published: December 2019

The aim of this study was to investigate the factors predicting clinical pregnancy rate of in vitro fertilization-embryo transfer (IVF-ET).

The data of 9960 patients receiving IVF-ET fresh cycle at our Reproductive Center from January 2009 to December 2017 were first divided into pregnant group and non-pregnant group to find the clinical pregnancy rate-related factors. According to the serum HCG levels at 36 hours and 12 hours after HCG trigger, all patients were divided into 4 groups including <50 mIU/ml, ≥50 and <100 mIU/ml, ≥100 and <200 mIU/ml, and ≥200 mIU/ml groups to know whether the HCG levels at 36 hours and 12 hours affect the pregnancy rate. According to the serum HCG ratio at 36 hours to 12 hours (36 h/12 h) after HCG trigger, all patients were divided into three groups including <0.88, 0.88–1.06 and >1.06 groups to observe whether the serum HCG ratio (36 h/12 h) affects the clinical pregnancy rate. According to different assisted pregnancy modes, all patients were divided into 3 groups including IVF, ICSI, and IVF/ICSI groups to observe whether the assisted pregnancy mode affects the clinical pregnancy rate. The correlation of the clinical pregnancy rate with pregnancy rate-related factors obtained above was analyzed using logistic regression analysis model.

The clinical pregnancy rate significantly increased (P < .01) in the HCG ratio (36 h/12 h) >1.06 group as compared with the HCG ratio (36 h/12 h) < 0.88 and 0.88–1.06 groups. The serum estrogen (E2) level at 36 hours was significantly lower and the number of retrieved oocytes was significantly higher in the HCG ratio (36 h/12 h) >1.06 group than in the HCG ratio (36 h/12 h) <0.88 and 0.88–1.06 groups (P = .000).

The serum HCG ratio (36 h/12 h) may be used as a predictor of IVF-ET clinical pregnancy rate. High clinical pregnancy rate is probably associated with E2 down-regulation in the HCG ratio (36 h/12 h) >1.06 group.
Acute arterial thrombosis during adjuvant Adriamycin-cyclophosphamide chemotherapy in a patient with early breast cancer
Authors: Jang Lee Chan , Choi Young Jin
Published: December 2019

Rationale:

Cancer and chemotherapy individually confer hypercoagulability and increased risks of thrombosis. Most thromboembolic complication after breast cancer chemotherapy was venous thrombosis after multiagent chemotherapy. Arterial thrombosis is extremely rare in early breast cancer patients receiving adjuvant chemotherapy.

Presenting concerns:

A 55-year-old woman with right breast cancer presented to the emergency department with sudden pain, numbness, and swelling in her left hand. She underwent breast conserving surgery and sentinel lymph node biopsy 2 months before the visit. She received the second cycle of adjuvant Adriamycin-cyclophosphamide chemotherapy 5 days before.

Interventions:

Computed tomography angiography revealed acute arterial thrombosis in the left brachial, radial, and ulnar arteries. Unfractionated heparin was initiated immediately, followed by brachial and radial-ulnar thrombectomy, restoring perfusion to the extremity. The postoperative course was uncomplicated; she was discharged on warfarin at a daily dose of 4 mg.

Outcomes:

Chemotherapy was discontinued. Anticoagulation with warfarin was continued. She subsequently received adjuvant endocrine therapy with an aromatase inhibitor and adjuvant radiotherapy.

Main lessons:

Despite the low risks of arterial thrombosis in breast cancer, it is a devastating complication with significant morbidity and mortality. Thromboprophylaxis should be considered in those at risk. Immediate anticoagulant therapy and surgical intervention should be considered in affected cases.
Compound kushen injection for multiple myeloma
Authors: Yang Xinwei , Zhao Xiyun , Wang Xiaoxia
Published: December 2019

Background:

Compound kushen injection is increasingly used to treat various cancers. However, its role in the management of multiple myeloma (MM) is still controversial and requires further clarification. The aim of this study is to evaluate efficacy and safety of compound kushen injection for MM through systematic review and meta-analysis.

Methods:

We are going to search the 6 electronic databases: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wangfang and Chinese Biomedical Literature Database. General characteristics and Specific trial characteristics will be collected from the included studies. The outcomes included overall response rate, complete response rate, 3-year progression—free survival rate, 3-year overall survival rate, and different types of treatment-related adverse events. We calculated the risk ratios as well as their 95% confidence intervals of these outcomes and pooled the results through RevMan 5.2 software.

Discussion:

The results of the study will be submitted to a peer-reviewed journal for publication.

Ethics and dissemination:

This study is not a clinical study, ethical approval is not required.
Mycobacterium tuberculosis and Pseudoramibacter alactolyticus coinfection in brain after dental extraction
Authors: Liao Yixin , Wu Fan , Dai Fahui , Huang Qin , Feng Yanling , Ling Yun , Lu Hongzhou
Published: December 2019

Introduction:

More than 1200 different types of microbes were found in the human mouth, only some of these microorganisms were associated with intracranial bacterial infection. However, there are limited data available about the Pseudoramibacter alactolyticus (P alactolyticus) or Mycobacterium tuberculosis (MTB) intracranial infections oral origin.

Patient concerns:

Here, we reported a rarely case with P alactolyticus and MTB coinfection in central nervous after dental extraction. The 44-year-old man presented with progressive headache over the last 2 weeks and a sustained fever >39°C, with a dental extraction performed 2 days before the onset of headache.

Diagnosis:

P alactolyticus and MTB were confirmed by real-time polymerase chain reaction targeting the16S ribosomal RNA gene. The presence of MTB was also demonstrated by positive acid-fast staining of the purulent discharge.

Interventions:

The patient was treated by metronidazole and anti-TB treatment

Outcomes:

The patient fully recovered without sequela.

Conclusion:

In conclusion there should be awareness of the possibility of P alactolyticus or MTB intracranial infections following tooth extraction.
Odds ratio of programmed cell death-1 or ligand 1 inhibitor-related endocrine dysfunction in patients with lung cancer
Authors: Xie Jian , Zhang Zewen , Zhang Shuisheng , Lv Yajuan , Mao Yantao , Liu Rujun , Tian Yuan
Published: December 2019

Purpose:

We designed the study to investigate the incidence risk of Programmed Cell Death-1 (PD-1) or Ligand 1 (PD-L1) inhibitor-related endocrine dysfunction in patients with lung cancer.

Method:

All the data were collected by 1 primary reviewer and then independently reviewed by 2 secondary reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM) guidelines. Incidence risk of all-grade and grade 3–5 PD-1/PD-L1 inhibitors related endocrine dysfunction in patients with lung cancer were taken into account.

Results:

Overall, 12 clinical trials comprising 6108 patients were identified in this systematic review and meta-analysis. The incidence risk of hypothyroidism, hyperthyroidism and adrenal insufficiency was higher in NSCLC patients receiving combination treatments. The incidence rate of all-grade of hypothyroidism was lower in PD-1/PD-L1 inhibitor subgroup compared to chemotherapy (OR = 22.62, 95%CI:9.79–52.25), while the similar result was seen in another treatment regimen (PD-1 + platinum-based chemotherapy vs platinum-based chemotherapy) (OR = 2.93, 95%CI: [2.08, 4.11). The different result can be seen in the group related to the other treatment regimen (1PD-1/PD-L1 inhibitor vs 2 PD-1/PD-L1 inhibitors) (OR = 0.40, 95%CI:0.21–0.76). All the results of the above analysis were considered to be statistical significant. Similar result could also be seen in meta-analysis related to hyperthyroidism and adrenal insufficiency.

Conclusion:

The incidence risk of endocrine dysfunctions, including hypothyroidism, hyperthyroidism and adrenal insufficiency, were higher for PD-1/PD-L1 inhibitors group.
Tuina for children with myopia
Authors: Rong Jiao , Feng Huichao , Li Jing , Wang Mengmeng , Lu Tianjiao , Zhang Xinghe , Zhuang Qian , Jing Fujie
Published: December 2019

Background:

The study aims to evaluate the effectiveness and safety of Tuina for children with myopia.

Methods:

The following electronic databases will be searched from establishment to July 2019: Cochrane Library, MEDLINE, EMBASE, Web of Science, Springer, World Health Organization International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure (CNKI), Wan-fang database, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Databases (CBM), and other databases. All published randomized controlled trials (RCTs) about this topic will be included. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on the included data conditions.

Results:

High-quality synthesis and/or descriptive analysis of current evidence will be provided from improvement of distant vision, improvement of myopic diopter, and side effects.

Conclusion:

This study will provide the evidence of whether Tuina is an effective and safe intervention for children with myopia.

PROSPERO registration number:

CRD42019142283.
The relationship between exposure to particulate matter and breast cancer incidence and mortality
Authors: Zhang Zhe , Yan Wenting , Chen Qing , Zhou Niya , Xu Yan
Published: December 2019

Background:

Particulate matter (PM) acts as an environment pollutant and thus plays a vital role in the development of human lung cancer. Whether PM is a risk factor for breast cancer (BC) morbidity and mortality, however, is not clear. Recently, several studies have reported inconsistent results for the association between PM and BC risk. This meta-analysis examines the indefinite relationship between exposure to PM and BC morbidity and mortality.

Methods:

Based on a search of Pubmed, Embase, Web of Science and Cochrane Library, the hazard ratio (HR) and 95% confidence interval (CI) were extracted and analyzed by Review Manager 5.3 and Stata14.0 to estimate the association between PM and BC morbidity and mortality. The heterogeneity for the included studies was evaluated using a Chi-square test and the I
2 statistic. Forest plot was used to illustrate the pooled HR and mean difference. A Funnel plot, Begg test, and Egger test were performed to explore the publication bias between the included studies.

All analyses were based on previous published studies, thus, no ethical approval and patient consent are required.

Results:

A total of 14 of 284 publications with 1,004,128 BC cases were gathered. The analysis showed each 10 μg/m3 of PM2.5 (diameter ≤2.5 μm) was associated with 1.17 (95% CI: 1.05–1.30, P = .004) fold risk BC mortality, and each 10 μg/m3 of PM10 (diameter ≤10 μm) was associated with 1.11 (95% CI: 1.02–1.21, P = .021) fold risk BC mortality. However, neither PM10 nor PM2.5 was found to be significantly associated with BC morbidity. Publication bias was detected in studies on PM2.5 and BC mortality.

Conclusions:

Our study suggests that PM exposure may raise the mortality but not the morbidity of BC. Still, further studies may be necessary to confirm this finding.
Selection of patients with ovarian cancer who may show survival benefit from hyperthermic intraperitoneal chemotherapy
Authors: Kim Se Ik , Cho Jaehyun , Lee Eun Ji , Park Sunwoo , Park Soo Jin , Seol Aeran , Lee Nara , Yim Ga Won , Lee Maria , Lim Whasun , Song Gwonhwa , Chang Suk Joon , Kim Jae Won , Kim Hee Seung
Published: December 2019

Background:

The use of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery has been extensively studied in patients with peritoneal carcinomatosis from various malignancies. However, the effectiveness of HIPEC for ovarian cancer is still controversial. Therefore, we performed this meta-analysis to identify patients with ovarian cancer who can obtain survival benefit from HIPEC.

Methods:

Articles regarding HIPEC in the MEDLINE, EMBASE, and Cochrane Library were searched till December 2018. In total, 13 case-control studies and two randomized controlled trials were included in this meta-analysis. We investigated the effect of HIPEC on disease-free survival (DFS) and overall survival (OS), and performed subgroup analyses based on the study design, adjustment of confounding variables, and quality of the study.

Results:

HIPEC improved both DFS (hazard ratio [HR], 0.603; 95% confidence interval [CI], 0.513–0.709) and OS (HR, 0.640; 95% CI, 0.519–0.789). In cases of primary disease, HIPEC improved DFS (HR, 0.580; 95% CI, 0.476–0.706) and OS (HR, 0.611; 95% CI, 0.376–0.992). Subgroup analyses revealed that HIPEC did not improve OS but improved DFS of patients with residual tumors ≤1 cm or no visible tumors. In cases of recurrent disease, HIPEC was associated with better OS (HR, 0.566; 95% CI, 0.379–0.844) but not with DFS. Subgroup analyses also revealed similar tendencies. However, HIPEC improved DFS of patients with residual tumors ≤1 cm or no visible tumors, while it improved OS of only those with residual tumors ≤1 cm.

Conclusions:

HIPEC may improve DFS of patients with ovarian cancer when residual tumors were ≤1 cm or not visible. It may also improve OS of only patients with recurrent disease whose residual tumors were ≤1 cm.
Erroneous bronchial transection after video assisted thoracoscopic surgery (VATS) pulmonary resection diagnosed with bronchoscopy
Authors: Borah Amit , Cocciardi Steven , Boujaoude Ziad , Abouzgheib Wissam
Published: December 2019

Introduction:

Early recognition of VATS-related complications is crucial for early interventions, treatments and better outcomes

Patient concerns:

Patient presented with post-obstructive pneumonia like symptoms 1 week after VATS pulmonary resection.

Diagnosis:

CT scan chest showed evidence of complete consolidation of the lobe where the pulmonary segmentectomy resection took place.

Interventions:

Diagnostic bronchoscopy confirmed the erroneous transection of the Superior Segment (SS) of Right Lower Lobe (RLL). Patient was then taken back for completion lobectomy and found with necrotic SS of RLL. This finding potentially could have caused significant complication if not recognized and treated early

Outcomes:

Patient recovered well after completion lobectomy and was discharged home several days later

Conclusion:

Erroneous bronchial transection should be suspected early in patients presenting with post-obstructive pneumonia after VATS pulmonary resection. CT scan chest and diagnostic bronchoscopy are the 2 main diagnostic tests