bluuebunny/crossref_metadata_2025 huggingface dataset:
Cumulated and most recent job control and risk of disability pension in the Danish Work Life Course Cohort (DaWCo)
Authors: Framke Elisabeth , Svane-Petersen Annemette Coop , Holm Anders , Burr Hermann , Melchior Maria , Sivertsen Børge , Stansfeld Stephen , Sørensen Jeppe Karl , Virtanen Marianna , Rugulies Reiner , Madsen Ida E H
Published: May 2020

Background

Previous studies have found low job control to be associated with a higher risk of disability pension (DP). Most studies have measured job control only at one time-point, and there is a lack of knowledge regarding the role of exposure duration. This study examines the prospective association between job control and DP measuring exposure both cumulated throughout work life and most recent.

Methods

We included 712 519 individuals (about 4.5 million person-years) from The Danish Work Life Course Cohort which follows young employees in Denmark from their entry into the labour market. Job control was assessed with a job exposure matrix and DP with register data on public transfer payments. We adjusted for several potential life course confounders, including physical demands at work and parental socioeconomic position and psychiatric and somatic diagnoses.

Results

Employees in occupations with low job control had a higher risk of DP. There were effects of both cumulated and most recent job control when mutually adjusted. Fully adjusted hazard ratios (HRs) were 1.14 [95% confidence intervals (CIs) 1.11–1.17] and 1.15 (95% CI 1.02–1.29) for cumulated and most recent job control, respectively. Without mutual adjustment, estimates were 1.15 (95% CI 1.13–1.18) and 1.55 (95% CI 1.39–1.72) for cumulated and most recent low job control, respectively.

Conclusions

Low job control predicts a higher risk of DP, even after adjustment for physical demands at work. The results indicate both gradual and short-term effects of low job control on DP risk.
In Search for a Jurisprudential Justification for the Recognition of a Right of Publicity in Kenya
Authors: Muchiri Moses
Published: May 2020

Publicity rights fall in the intersection between classic intellectual property rights law, unfair trade practices law and privacy rights law. This is an area that has recently witnessed notable judicial decisions in Kenya which have not gained ample exposure and is therefore worth looking into as an area for potential emerging jurisprudence. A look at the existing practices across different jurisdictions in the world reveals various positions and approaches with respect to publicity rights. On one hand, there are jurisdictions in which publicity rights are categorized within the broad spectrum of personality rights, while in other jurisdictions these rights are treated as proprietary rights. Some jurisdictions also take a hybrid approach that amalgamates both proprietary and personality rights approaches. Publicity rights cut across four broad legal areas: tort, property, privacy and unfair trade practice law. These rights also have common similarities with copyright and trademark rights, although they are not synonymous. A significant number of countries which recognize a right of publicity have a mixture of elements of these areas, either as a form of common law approach based on the tort of passing off, or specific statutory enactments on publicity rights. Legal practice and development in each jurisdiction must be considered in the knowledge that each country has developed specific publicity rights mechanisms in response to the socio-economic needs and realities existing in its particular jurisdiction. This study surveys the legal landscape with respect to development of personality rights in Kenya. It also takes a brief look at several other select jurisdictions in an attempt to answer the question whether there is a jurisprudential justification for the recognition of a publicity right in Kenya.
Remembering 1807: Lessons from the Archives
Authors: Oldfield John , Wills Mary
Published: May 2020

This article offers new perspectives on the commemorative events organized around the UK in 2007 to mark the bicentenary of the Abolition of the Slave Trade Act (1807). Drawing from the resources contained in Remembering 1807, a digital archive of information about nearly 350 events and exhibitions held in 2007, it offers a closer look at the variety, diversity and creativity of projects organized by heritage organizations and community groups from all parts of the UK. While agreeing that much of the national narrative focused on the celebratory aspects of Britain’s role in abolition, we argue that many other projects gave voice to a wide range of concerns relating to transatlantic slavery, challenging participants to rethink the boundaries of slavery and abolition in Britain’s public history. This included highlighting the role of transatlantic slavery in hitherto unexplored areas of British history, in local stories and in broader narratives of Britain’s commercial, military, and imperial expansion. Other projects drew attention to the lasting legacies of slavery, emphasized stories of resistance or celebrated the Black presence in Britain. Recognizing these other perspectives within the commemorative impulse in 2007 can help us to (re)orientate future memory work around Britain’s role in transatlantic slavery.
Synovial Pit of the femoral neck: a rare disease with rare presentations
Authors: Amjad Ali , Hafez Ahmed Tarek , Nawab Ditta Adeel , Jan Waqar
Published: May 2020

Herniation pits are small benign oval lesions that were reported to be always lying within the super-lateral femoral neck, and were first described in 1982 by Michael J. Pitt. They are usually a unilateral incidental finding along with asymptomatic course. It was widely believed that herniation pits are a result of invagination of the overlying synovium into small cortical defects in the femoral neck. In our case; the mentioned lesions were found atypically bilaterally at the inferomedial aspect of the neck of femur of a 7-year old child. Radiological scans were efficient to obtain an adequate diagnosis whereas conservative management proved to be sufficient dealing with the lesions. Synovial pits may have atypical clinical and radiological course, and this can raise concerns especially with symptomatic hip that may encourage surgical interventions. However, due to benign course of these lesions, we do not recommend any surgical intervention for such lesions.
X-ray irradiation and evaporation of the four young planets around V1298 Tau
Authors: Poppenhaeger K , Ketzer L , Mallonn M
Published: May 2020

Planets around young stars are thought to undergo atmospheric evaporation due to the high magnetic activity of the host stars. Here we report on X-ray observations of V1298 Tau, a young star with four transiting exoplanets. We use X-ray observations of the host star with Chandra and ROSAT to measure the current high-energy irradiation level of the planets and employ a model for the stellar activity evolution together with exoplanetary mass-loss to estimate the possible evolution of the planets. We find that V1298 Tau is X-ray bright with log LX [erg s−1] = 30.1 and has a mean coronal temperature of ≈9 MK. This places the star amongst the more X-ray luminous ones at this stellar age. We estimate the radiation-driven mass-loss of the exoplanets and find that it depends sensitively on the possible evolutionary spin-down tracks of the star as well as on the current planetary densities. Assuming the planets are of low density due to their youth, we find that the innermost two planets can lose significant parts of their gaseous envelopes and could be evaporated down to their rocky cores depending on the stellar spin evolution. However, if the planets are heavier and follow the mass–radius relation of older planets, then even in the highest XUV irradiation scenario none of the planets is expected to cross the radius gap into the rocky regime until the system reaches an age of 5 Gyr.
Internal kinematics of giant H ii regions in M101 with the Keck Cosmic Web Imager
Authors: Bresolin Fabio , Rizzi Luca , Ho I-Ting , Terlevich Roberto , Terlevich Elena , Telles Eduardo , Chávez Ricardo , Basilakos Spyros , Plionis Manolis
Published: May 2020

We study the kinematics of the giant H ii regions NGC 5455 and NGC 5471 located in the galaxy M101, using integral field observations that include the H β and [O iii]$\, \lambda$ 5007 emission lines, obtained with the Keck Cosmic Web Imager. We analyse the line profiles using both single and multiple Gaussian curves, gathering evidence for the presence of several expanding shells and moving filaments. The line decomposition shows that a broad (σ ≃ 30–50 km s−1) underlying component is ubiquitous, extending across hundreds of pc, while a large fraction of the narrow components have subsonic line widths. The supersonic turbulence inferred from the global line profiles is consistent with the velocity dispersion of the individual narrow components, i.e. the global profiles likely arise from the combined contribution of discrete gas clouds. We confirm the presence of very extended (400–1200 km s−1) low-intensity line components in three bright star-forming cores in NGC 5471, possibly representing kinematic signatures of supernova remnants. For one of these, the known supernova remnant host NGC 5471 B, we find a significantly reduced [O iii]/H β line ratio relative to the surrounding photoionized gas, due to the presence of a radiative shock at low metallicity. We explore the systematic width discrepancy between H i and [O iii] lines, present in both global and individual spaxel spectra. We argue that the resolution of this long-standing problem lies in the physics of the line-emitting gas rather than in the smearing effects induced by the different thermal widths.
Measuring the local dark matter density with LAMOST DR5 and Gaia DR2
Authors: Guo Rui , Liu Chao , Mao Shude , Xue Xiang-Xiang , Long R J , Zhang Lan
Published: May 2020

We apply the vertical Jeans equation to the kinematics of Milky Way stars in the solar neighbourhood to measure the local dark matter density. More than 90 000 G- and K-type dwarf stars are selected from the cross-matched sample of LAMOST (Large Sky Area Multi-Object Fibre Spectroscopic Telescope) fifth data release and Gaia second data release for our analyses. The mass models applied consist of a single exponential stellar disc, a razor thin gas disc, and a constant dark matter density. We first consider the simplified vertical Jeans equation that ignores the tilt term and assumes a flat rotation curve. Under a Gaussian prior on the total stellar surface density, the local dark matter density inferred from Markov chain Monte Carlo simulations is $0.0133_{-0.0022}^{+0.0024}\ {\rm M}_{\odot }\, {\rm pc}^{-3}$. The local dark matter densities for subsamples in an azimuthal angle range of −10° < ϕ < 5° are consistent within their 1σ errors. However, the northern and southern subsamples show a large discrepancy due to plateaux in the northern and southern vertical velocity dispersion profiles. These plateaux may be the cause of the different estimates of the dark matter density between the north and south. Taking the tilt term into account has little effect on the parameter estimations and does not explain the north and south asymmetry. Taking half of the difference of σz profiles as unknown systematic errors, we then obtain consistent measurements for the northern and southern subsamples. We discuss the influence of the vertical data range, the scale height of the tracer population, the vertical distribution of stars, and the sample size on the uncertainty of the determination of the local dark matter density.
Astrometry and infrared observations of the Mira variable stars AP Lyncis, V837 Herculis, and BX Camelopardalis: Implications for the period–luminosity relation of the Milky Way
Authors: Chibueze James O , Urago Riku , Omodaka Toshihiro , Morikawa Yuto , Fujimoto Masayuki Y , Nakagawa Akiharu , Nagayama Takahiro , Nagayama Takumi , Hirano Ken
Published: May 2020

AP Lyn and V837 Her are long-period Mira variable stars in the Milky Way. We performed VLBI Exploration of Radio Astrometry (VERA) phase-referenced observations towards H2O masers associated with AP Lyn and V837 Her. The annual parallaxes of AP Lyn and V837 Her were obtained to be 2.008 ± 0.038 mas and 1.090 ± 0.014 mas, corresponding to distances of 498 ± 10 pc and 917 ± 12 pc, respectively. From our multi-epoch infrared observations using the Kagoshima University 1 m telescope, we derived the mean J-, H-, and K′-band magnitudes of AP Lyn, V837 Her, and an additional long-period Mira variable BX Cam, whose parallax is known. We derived their pulsation periods to be 433 ± 1 d, 520 ± 1 d, and 458 ± 1 d, respectively, using the K′-band light curves. The MK–log P relation of long-period Mira variables seem to be violated by Mira variable stars with larger-than-expected MK values (like OZ Gem) in the Milky Way because of circumstellar extinction leading to an observed dimming effect. AP Lyn, V837 Her, and BX Cam (like OZ Gem) are dimming from the trend to O-rich stars in the Large Magellanic Cloud. This implies that the high metallicity of the Milky Way galaxy increases the opacity of the Mira-type variable stars and strengthens mass loss.
‘The Empire of England’: Enoch Powell, Sovereignty, and the Constitution of the Nation
Authors: Aqui Lindsay , Kenny Michael , Pearce Nick
Published: May 2020

The 50th anniversary of Enoch Powell’s ‘Rivers of Blood’ speech brought back into public debate one of the most controversial figures in modern British political history. Powell remains indelibly linked to the stances he took on race and immigration in the 1960s and 1970s, but in recent years there has been a widening of the lens through which his politics and public arguments are viewed. This article contributes to this reappraisal, arguing that central aspects of his thinking were shaped by his highly distinctive reflections on sovereignty, representation, and the nation state in the early 1950s. It demonstrates that Powell’s positions on both the internal configuration of the nation state and its external relations were intertwined, and were applied by him on a fairly consistent basis throughout his career, informing the stances he took on the contentious issues of Europe and Ulster in the 1970s, as well as immigration. Our account of his thinking challenges both the tendency of his interpreters to treat his views on international relations and the internal politics of the United Kingdom as thematically distinct, and the accusation of political opportunism that has been a central motif in commentary on his political career.
Hippocampal Resting-State Functional Connectivity Patterns are More Closely Associated with Severity of Subjective Memory Decline than Whole Hippocampal and Subfield Volumes
Authors: Zajac Lauren , Koo Bang-Bon , Tripodis Yorghos , Mian Asim , Steinberg Eric , Mez Jesse , Alosco Michael L , Cervantes-Arslanian Anna , Stern Robert , Killiany Ronald
Published: May 2020

The goal of this study was to examine whether hippocampal volume or resting-state functional connectivity (rsFC) patterns are associated with subjective memory decline (SMD) in cognitively normal aged adults. Magnetic resonance imaging data from 53 participants (mean age: 71.9 years) of the Boston University Alzheimer’s Disease Center registry were used in this cross-sectional study. Separate analyses treating SMD as a binary and continuous variable were performed. Subfield volumes were generated using FreeSurfer v6.0, and rsFC strength between the head and body of the hippocampus and the rest of the brain was calculated. Decreased left whole hippocampal volume and weaker rsFC strength between the right body of the hippocampus and the default mode network (DMN) were found in SMD+. Cognitive Change Index score was not correlated with volumetric measures but was inversely correlated with rsFC strength between the right body of the hippocampus and 6 brain networks, including the DMN, task control, and attentional networks. These findings suggest that hippocampal rsFC patterns reflect the current state of SMD in cognitively normal adults and may reflect subtle memory changes that standard neuropsychological tests are unable to capture.
Regulation and Dynamics of Gene Expression During the Life Cycle of Fusarium graminearum
Authors: Brauer Elizabeth K. , Subramaniam Rajagopal , Harris Linda J.
Published: May 2020

Fungal pathogens survive harsh environments and overcome physical, temporal, and chemical barriers to colonize their hosts and reproduce. Fusarium graminearum was one of the first fungal plant pathogens for which transcriptomic tools were developed, making analysis of gene expression a cornerstone approach in studying its biology. The analysis of gene expression in diverse in vitro conditions and during infection of different cereal crops has revealed subsets of both unique and shared transcriptionally regulated genes. Together with genetic studies, these approaches have enhanced our understanding of the development and infection cycle of this economically important pathogen. Here, we will outline recent advances in transcriptional profiling during sporogenesis, spore germination, vegetative growth, and host infection. Several transcriptional regulators have been identified as essential components in these responses and the role of select transcription factors will be highlighted. Finally, we describe some of the gaps in our understanding of F. graminearum biology and how expression analysis could help to address these gaps.
LtEPG1, a Secretory Endopolygalacturonase Protein, Regulates the Virulence of Lasiodiplodia theobromae in Vitis vinifera and Is Recognized as a Microbe-Associated Molecular Patterns
Authors: Thilini Chethana K. W. , Peng Junbo , Li Xinghong , Xing Qikai , Liu Mei , Zhang Wei , Hyde Kevin D. , Zhao Wensheng , Yan Jiye
Published: May 2020

The Lasiodiplodia theobromae genome encodes numerous glycoside hydrolases involved in organic matter degradation and conducive to pathogen infection, whereas their molecular mechanisms are still largely unknown. Here, we identified the glycoside hydrolase family 28 endopolygalacturonase LtEPG1 in L. theobromae and characterized its function in detail. LtEPG1 acts as a virulence factor during L. theobromae infection. Overexpression and silencing of LtEPG1 in L. theobromae led to significantly increased and decreased lesion areas, respectively. Further, the high transcript level of LtEPG1 during the infection process supported its virulence function. Polygalacturonase activity of LtEPG1 was substantiated by detecting its ability to degrade pectin. Furthermore, LtEPG1 functioned as microbe-associated molecular patterns during the infection process. Both transient expression of LtEPG1 in planta and infiltration of purified LtEPG1 triggered cell death in Nicotiana benthamiana. Site-directed mutation of LtEPG1 indicated that the enzymatic activity of LtEPG1 is independent from its elicitor activity. A protein kinase, KINβ1, was shown to interact in the yeast two‐hybrid system with LtEPG1. This interaction was further confirmed in vitro using a pull-down assay. Our data indicate that LtEPG1 functions as a polygalacturonase and also serves as an elicitor with two independent mechanisms. Moreover, LtEPG1 may be able to manipulate host immune responses by regulating the KINβ1-mediated signal pathway and consequently promote its own successful infection and symptom development.
Nitrosamine Impurities in Angiotensin Receptor Blockers
Authors: Shephard Emily A. , Nawarskas James J.
Published: May 2020

Nitrosamines are known carcinogens which have been recently discovered in several angiotensin receptor blockers (ARBs). This led to the recall of valsartan in the United States in 2018, and afterward, the recall of other ARBs as well as unrelated medications (e.g., ranitidine). The presence of nitrosamine in ARBs was likely a result of changes in the manufacturing process, although nitrosamine contamination is believed to occur by different mechanisms with other medications. The United States Food and Drug Administration has since taken steps to identify products affected by nitrosamine contamination and mitigate this concern going forward. Despite the contamination of some drug products, studies estimate that the overall risk to patients is low enough to not necessitate changes in prescribing patterns at this time.
Evaluating the Outcomes of an Organizational Initiative to Expand End-of-Life Resources in Intensive Care Units With Palliative Support Tools and Floating Hospice
Authors: McAndrew Natalie S. , McCracken Colleen , Szabo Aniko , Narayanan Balaji , Peltier Wendy , Leske Jane
Published: May 2020

Background

There is evidence that palliative care and floating (inpatient) hospice can improve end-of-life experiences for patients and their families in the intensive care unit (ICU). However, both palliative care and hospice remain underutilized in the ICU setting.

Objectives

This study examined palliative consultations and floating hospice referrals for ICU patients during a phased launch of floating hospice, 2 palliative order sets, and general education to support implementation of palliative care guidelines.

Methods

This descriptive, retrospective study was conducted at a level I trauma and academic medical center. Electronic medical records of 400 ICU patients who died in the hospital were randomly selected. These electronic medical records were reviewed to determine if patients received a palliative consult and/or a floating hospice referral, as well as whether the new palliative support tools were used during the course of care. The numbers of floating hospice referrals and palliative consults were measured over time.

Results

Although not significant, palliative consults increased over time (P = .055). After the initial introduction of floating hospice, 27% of the patients received referrals; however, referrals did not significantly increase over time (P = .807). Of the 68 patients who received a floating hospice referral (24%), only 38 were discharged to floating hospice. There was a trend toward earlier palliative care consults, although this was not statistically significant (P = .285).

Conclusion

This study provided the organization with vital information about their initiative to expand end-of-life resources. Utilization and timing of palliative consults and floating hospice referrals were lower and later than expected, highlighting the importance of developing purposeful strategies beyond education to address ICU cultural and structural barriers.
ALK7 Promotes Vascular Smooth Muscle Cells Phenotypic Modulation by Negative Regulating PPARγ Expression
Authors: Gong Fu-Han , Cheng Wen-Lin , Zhang Quan , Chen Xi-Lu , Cao Jian-Lei , Yang Ting , Song Wen-Hao , Zhao Fang
Published: May 2020

As a receptor for transforming growth factor-β, nodal and activin, activin receptor–like kinase 7 (ALK7) previously acts as a suppressor of tumorigenesis and metastasis, which has emerged to play a key role in cardiovascular diseases. However, the potential effect and molecular mechanism of ALK7 on vascular smooth muscle cells’ (VSMCs) phenotypic modulation have not been investigated. Using cultured mouse VSMCs with platelet-derived growth factor-BB administration, we observed that ALK7 showed a significantly increased expression in VSMCs accompanied by decreased VSMCs differentiation marker genes. Loss-of-function study demonstrated that ALK7 knockdown inhibited platelet-derived growth factor-BB–induced VSMCs phenotypic modulation characterized by increased VSMCs differentiation markers, reduced proliferation, and migration of VSMCs. Such above effects were reversed by ALK7 overexpression. Notably, we noticed that ALK7 silencing dramatically enhanced PPARγ expression, which was required for the attenuated effect of ALK7 knockdown on VSMCs phenotypic modulation. Collected, we identified that ALK7 acted as a novel and positive regulator for VSMCs phenotypic modulation partially through inactivation of PPARγ, which suggested that neutralization of ALK7 might act as a promising therapeutic strategy of intimal hyperplasia.
Orchiepididymitis in a Boy With COVID-19
Authors: Gagliardi Luigi , Bertacca Carlo , Centenari Chiara , Merusi Ilaria , Parolo Eva , Ragazzo Vincenzo , Tarabella Vittorio
Published: May 2020

Coronavirus disease 2019 (COVID-19) symptoms in children are incompletely described. We present the first case of orchiepididymitis associated with COVID-19 in a boy and discuss pathways of testicular involvement by SARS-CoV2 virus. This case underlines the need for further study of the clinical presentation of pediatric COVID-19 and the potential association with nonrespiratory symptoms.
Primary malignant melanoma of the esophagus with multiple lymph node metastases
Authors: Iwasaki Kenichi , Ota Yoshihiro , Yamada Erika , Takahashi Kosuke , Watanabe Takafumi , Makuuchi Yosuke , Suda Takeshi , Osaka Yoshiaki , Seshimo Akiyoshi , Katsumata Kenji , Tsuchida Akihiko
Published: May 2020

Rationale:

Primary malignant melanoma of the esophagus (PMME) is a very rare malignancy accounting for only 0.1% to 0.2% of all malignant esophageal lesions. Presently, there are no standard strategies or clear guidelines for PMME treatment.

Patient concerns:

Herein, we report a patient who had PMME with multiple lymph node metastases (LNMs) who was treated successfully by esophagectomy. In March 2018, a 74-year-old man with symptoms of continuous dysphagia was referred to our hospital.

Diagnosis:

Upper gastrointestinal endoscopic examination revealed melanin pigmentation in the middle thoracic esophagus and a pigmented polypoid mass in the lower esophagus. Histopathological examination of the endoscopic biopsy specimen revealed malignant melanoma. Contrast-enhanced computed tomography showed a 3 cm tumor lesion with several enlarged lymph nodes without distant metastasis. The preoperative diagnosis based on the TNM classification was cT2N2M0 stage III.

Interventions:

The patient underwent esophagectomy with lymph node dissection.

Outcomes:

Histopathological examination showed that the tumor extended to the submucosal layer of the esophageal wall, with multiple LNMs. Although multiple LNMs were detected, computed tomography scan 15 months after surgery showed no recurrence. Additionally, we analyzed the relationship between the overall survival and the clinicopathological factors including LNMs in 48 previously reported cases of PMME that were surgically treated.

Lessons:

To our knowledge, this is the first report on the effect of LNMs on the prognosis of PMME patients. The analysis revealed the prognostic value of the TNM stage. Early tumor detection and esophagectomy with lymph node dissection may play as key factors for achieving a better overall survival of PMME patients.
Effect of statins on cardiovascular complications in chronic kidney disease patients
Authors: Hwang Seun Deuk , Kim Kipyo , Kim Yoon Ji , Lee Seoung Woo , Lee Jin Ho , Song Joon Ho
Published: May 2020

Background:

The rates of cardiovascular mortality and morbidity are increased in advanced chronic kidney disease (CKD). Mild to moderate CKD is associated with an increase in cardiovascular events. This study aims to investigate the effects of statins on patient mortality and cardiac events.

Study appraisal and synthesis methods:

Studies on statins (atorvastatin, rosuvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, and simvastatin + ezetimibe) in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded databases from 1970 to February 2019 were analyzed. Inclusion criteria were randomized control trials and adult patients (>18 years old). Reviews, observational studies, and clinical trials that did not clearly define outcomes or that did not have thrombosis as an outcome were excluded. We performed direct and indirect network meta-analysis using Bayesian models and ranked different statins using generation mixed treatment comparison (GeMTC) and Stata version 13. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) of network meta-analysis approach specified 4 levels of certainty for a given result: high, moderate, low, and very low. The outcomes were cardiac events, cardiac mortality, and all-cause mortality.

Results:

Nineteen studies (45,863 patients) were included. Compared with placebos, pravastatin 40 mg group showed a significantly lower patient mortality (odds ratio 0.66 [95% credible interval, 0.46–0.91]).

Atorvastatin 80 mg, fluvastatin 40 mg, lovastatin 20 mg, pravastatin 40 mg, and simvastatin 40 mg showed significant results in reducing cardiac events.

In rank probability, pravastatin showed the best effect at all-cause mortality rate. Lovastatin, fluvastatin, and pravastatin showed good effects in the 1st, 2nd, and 3rd ranks in cardiac events.

Conclusions and implications of key findings:

Pravastatin 40 mg demonstrated the best effect on all-cause mortality, and was observed to be effective with high ranking in cardiac events. We anticipate that the data of this study will assist physicians in making informed decisions when selecting statins, such as pravastatin, as a treatment option for CKD patients.
Comparison of adherence measurement tools used in a pre-exposure prophylaxis demonstration study among female sex workers in Benin
Authors: Mboup Aminata , Béhanzin Luc , Guédou Fernand , Giguère Katia , Geraldo Nassirou , Zannou Djimon Marcel , Kêkê René K. , Bachabi Moussa , Gangbo Flore , Affolabi Dissou , Marzinke Mark A. , Hendrix Craig , Diabaté Souleymane , Alary Michel
Published: May 2020

Background:

Measuring adherence to PrEP (pre-exposure prophylaxis) remains challenging. Biological adherence measurements are reported to be more accurate than self-reports and pill counts but can be expensive and not suitable on a daily basis in resource-limited countries. Using data from a demonstration project on PrEP among female sex workers in Benin, we aimed to measure adherence to PrEP and compare self-report and pill count adherence to tenofovir (TFV) disoproxil fumarate (TDF) concentration in plasma to determine if these 2 measures are reliable and correlate well with biological adherence measurements.

Methods:

Plasma TFV concentrations were analyzed in samples collected at day 14 follow-up visit and months 6, 12, 18, and 24 (or at last visit when follow-up was shorter). Self-reported adherence was captured at day 14 follow-up visit and then quarterly by asking participants to report the number of missed pills within the last week. For pill count, medications were refilled monthly and participants were asked to bring in their medication bottles at each follow-up visit. Using generalized estimating equations adherence measured by self-report and pill count was compared to plasma drug concentrations.

Results:

Of 255 participants, 47.1% completed follow-up. Weighted optimal adherence combining data from all visits was 26.8% for TFV concentration, 56.0% by self-report and 18.9% by pill count. Adherence measured by both TFV concentrations and self-report decreased over time (P = .009 and P = .019, respectively), while the decreasing trend in adherence by pill count was not significant (P = .087). The decrease in adherence was greater using TFV concentrations than the other 2 adherence measures.

Conclusion:

With high levels of misreporting of adherence using self-report and pill count, the objective biomedical assessment of adherence via laboratory testing is optimal and more accurately reflects PrEP uptake and persistence. Alternative inexpensive and accurate approaches to monitor PrEP adherence should be investigated.
Management of cognitive decline in Alzheimer's disease using a non-pharmacological intervention program
Authors: Quail Zara , Carter Mark Mclean , Wei Angelina , Li Xinlei
Published: May 2020

Introduction:

In China, the over 60 population is estimated to grow from 12% in 2010 to 33% of the overall population by 2050. The escalation in the aging population is projected to result in an Alzheimer's disease prevalence of 27.7 million people in China by 2050 causing substantial health and economic burden. While there are some published studies on multicomponent, non-pharmacological interventions for people with dementia, we have found no published community-based approach to care that encompasses personalized selection of non-pharmacological interventions, active social participation, and dementia education.

Patient concerns:

An elderly female living at home alone in urban Beijing presented with significant short-term memory impairment, episodes of confusion, difficulty with language skills, and episodes of wandering. She had become reclusive and disengaged from her previous social networks, and no longer attended any community activities or events. The patient had no significant past medical or psychiatric history.

Diagnosis:

The patient was diagnosed with Alzheimer's disease by a local physician based on clinical features of impaired communication, disorientation, confusion, poor judgement, behavioral changes, and difficulty speaking. Depression was considered a differential diagnosis but is also both a risk factor and symptom of dementia.

Interventions:

A novel, community-based, multicomponent social care program for dementia was used to facilitate implementation of non-pharmacological interventions, gradual socialization and provide supportive carer and community education. Non-pharmacological interventions included a combination of validation therapy, music therapy, art therapy, reminiscence therapy, talking therapy, reality orientation, cognitive training, smell therapy, food therapy, sensory stimulation, garden therapy, and physiotherapy.

Outcomes:

Improvements in the patient's Geriatric Depression Scale and Mini Mental State Examination scores were noted in association with increased social participation in the community.

Conclusion:

The community-based, multicomponent dementia social care program described in this case report has enabled a socially isolated patient with Alzheimer's disease to reduce her social isolation with an associated improvement in her mood and prevention of cognitive decline. Educating the community was an essential part of re-integrating the patient into the social setting. Reducing social isolation and increasing community engagement were essential to maintaining the patient's independence in her own home.
The status and trends of coronavirus research
Authors: Mao Xingjia , Guo Lu , Fu Panfeng , Xiang Chuan
Published: May 2020

Objectives:

The infectious pneumonia caused by the Coronavirus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China, from December 2019 and spread the whole country and even other 24 countries. Coronavirus research is of significance to overcome the epidemic. Our study aims to investigate the global status and trends of coronavirus research.

Method:

Publications related to the studies of coronavirus research from January 1, 2003 to February 6, 2020 were retrieved from the Science Citation Index-Expanded (SCI-E) of the Web of Science database. A total of 9294 publications were included. The data source was studied and indexed by bibliometric methodology. For visualized study, bibliographic coupling analysis, co-authorship analysis, co-citation analysis, co-occurrence analysis and the analysis of publication trends in coronavirus research were conducted by VOS (visualization of similarities) viewer and GraphPadPrism 6 software.

Results:

The number of publications about coronavirus research increased sharply in 2004 for SARS outbreak and increased again in 2012 for MERS outbreak. The USA made the highest contributions to the global research with the most total number of publications, total citation frequency, and the highest H-index, while Netherlands had the highest average citation per item. Journal of Virology had the largest publication numbers. The University of Hong Kong is the most contributive institution with the most publications. The main research orientation and funding agency were virology and United States Department of Health Human Services. Keywords of all related studies could be divided into 4 clusters: “Pathological research,” “Epidemiology research,” “Clinical research,” and “Mechanism research.”

Conclusions:

The outbreak of the epidemic could promote coronavirus research, meanwhile, coronavirus research contributes to overcoming the epidemic. Attention should be drawn to the latest popular research, including “Spike protein,” “Receptor binding domain,” and “Vaccine.” Therefore, more and more efforts will be put into mechanism research and vaccine research and development, which can be helpful to deal with the epidemic.
A nomogram to predict metastasis of soft tissue sarcoma of the extremities
Authors: Li Ruo-He , Zhou Qiang , Li A-Bing , Zhang Hong-Zhen , Lin Zhong-Qin
Published: May 2020

Soft tissue sarcoma (STS) of the extremities are a rare tumor. Metastases develop in about 40%-50% of patients, most of whom die from their disease. We sought to identify potential risk factors associated with metastatic diseases upon presentation for patients with STS and established a reliable nomogram model to predict distant metastasis of STS at presentation. The current study retrospectively analyzed 3884 STS of the extremities or trunk patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Based on patient registration, all patients were randomly allocated to training sets and validation sets (2:1). Then, univariate and binary logistic regression analysis was used to determine the significantly correlated predictors of metastasis. Finally, the nomogram model was established, using these predictors and validated it. 311 (8.21%) of the cases experienced distant metastatic disease was present at the time of presentation. The nomogram was developed from age, histology subtype, primary site, tumor size, grade and depth. Encouragingly, the nomogram showed favorable calibration with C-index 0.790 in the training set and 0.801 in validation set. The DCA showed that the novel model was clinically useful. This nomogram model had a high precision to predict the metastasis of soft tissue sarcoma of the extremities. We expect this model could be used in different clinical consultation and established risk assessment.
Radial neuropathy caused by intraneural leiomyoma
Authors: Lee Byung Chan , Kim Hyun Jin , Choi Yoon La , Jeon Byung Joon , Sung Duk Hyun
Published: May 2020

Introduction:

Leiomyoma of peripheral nerve is a rare condition characterized by neuropathy of affected nerve. We herein report a rare presentation of leiomyoma of radial nerve which presented with wrist drop.

Patient concerns:

A 37-year-old man visited our clinic with a history of sudden onset weakness of the wrist dorsiflexion/finger extension of the right side.

Diagnosis:

T2-weighted with fat saturation image of MRI demonstrated a well-defined, intra-neural, round mass of about 0.8 cm × 0.5 cm within the radial nerve. Excision of mass established the pathological diagnosis of intra-neural leiomyoma.

Interventions:

The patient underwent excision of mass and attached nerve tissue, followed his medial antebrachial nerve graft for repair of the defected radial nerve.

Outcomes:

As of the 1-year follow-up, no symptoms of recurrence have been observed. Also, the strength of wrist dorsiflexion improved to grade 4/5

Conclusion:

This rare case demonstrates the importance of MR imaging to differentiate intra-neural leiomyomas from other benign peripheral nerve sheath tumors. Surgical treatment plays an important role in the treatment of patient with intraneural leiomyoma with neurologic deficits.
A controlled study on the efficacy and quality of life of laparoscopic intersphincteric resection (ISR) and extralevator abdominoperineal resection (ELAPE) in the treatment of extremely low rectal cancer
Authors: Yang Wenming , Huang Libin , Chen Peng , Yang Yun , Liu Xueting , Wang Cun , Yu Yongyang , Yang Lie , Wang Ziqiang , Zhou Zongguang
Published: May 2020

Background:

The aim of this study is to compare the postoperative quality of life (QoL) and survival outcomes in lower rectal cancer (LRC) patients who undergo either laparoscopic- intersphincteric resection or extralevator abdominoperineal excision (L-ELAPE) after long-course neoadjuvant chemoradiation therapy (nCRT).

Methods:

This prospective, single-center, non-randomized, controlled, non-blinded, phase I/II clinical trial is designed to enroll 159 eligible LRC patients who achieved favorable response to long-course nCRT (2 × 25 Gy). After informed consent, the patients will be assigned into the laparoscopic intersphincteric resection group or L-ELAPE group according to their own will. Standard radical laparoscopic surgeries will be performed for every participant. Then every participant will be followed up for 3 years. The primary outcomes are scores of QoL questionnaire-core 30, QoL questionnaire-colorectum 29, Wexner incontinence score, International Prostate Symptom Score (for male), International Index of Erectile Function-5 (for male) and Female Sexual Function Index (for female). The secondary outcomes consist of incomplete circumferential resection margin rate, 3-year local recurrence, 3-year disease-free survival, 3-year overall survival and other surgical outcomes.

Discussion:

This is the first prospective clinical controlled trial to assess postoperative QoL and efficacy for LRC patients after favorable long-course nCRT. The result is expected to provide new evidence for a more detailed individualized treatment guideline for LRC.

Trial registration:

This trial was registered at Chinese Clinical Trial Registry (ChiCTR1800017512; ChiCTR.org) on August 2, 2018.
Prevalence and risk factors of prehypertension in university students in Sabah, Borneo Island of East Malaysia
Authors: Qaiser Shazia , Daud Mohd Nazri Mohd , Ibrahim Mohd Yusof , Gan Siew Hua , Rahman Md Shamsur , Sani Mohd Hijaz Mohd , Nazeer Nazia , Guad Rhanye Mac
Published: May 2020

Unhealthy lifestyle contributes mainly to an increased prevalence of non-communicable diseases including hypertension and cardiovascular diseases tend to increase in Malaysia. These diseases lead to an increased risk of end organ damage and cardiovascular complications. In this study, the prevalence of prehypertension and its associated risk factors among a cohort of university students in Sabah was determined.

This is a prospective, cross-sectional study conducted among 365 undergraduate students irrespective of faculties at Universiti Malaysia Sabah (UMS). Standardized and validated World Health Organization (WHO) STEPS questionnaires were used to collect sociodemographic data. Additionally, clinical and anthropometric data were measured and recorded by a trained staff, followed by descriptive and logistic regression analyses.

A total of 365 UMS undergraduate students aged 18 years and above participated in the study. The prevalence of prehypertension among university students was high (31%) (95% CI [29.1%, 34.3%]). Well-known risk factors for hypertension including family history of hypertension, reduced sleep duration, reduced physical activity, smoking, being overweight or obese were significantly associated with the risk of developing prehypertension (P < .05) among UMS students. However, no association was observed between ethnicity, age, and gender with prehypertension.

A worryingly high percentage of UMS students are prehypertensive, indicating the need of early preventive strategies aimed at increasing awareness, early screening, and lifestyle modification to reduce the rising burden of the disease and the associated complications in this age group.
Computed tomography versus lower endoscopy as initial diagnostic method for evaluating patients with hematochezia at emergency room
Authors: Lee Hee Sung , Kang Sun Hyung , Rou Woo Sun , Eun Hyuk Soo , Joo Jong Seok , Kim Ju Seok , Lee Eaum Seok , Moon Hee Seok , Kim Seok Hyun , Sung Jae Kyu , Lee Byung Seok , Jeong Hyun Yong
Published: May 2020

For acute lower gastrointestinal bleeding (LGIB), lower gastrointestinal endoscopy is the preferred initial diagnostic test. However, it is difficult to perform urgently. Computed tomography (CT) is a convenient alternative.

This study aimed to determine the diagnostic performance of CT compared to lower endoscopy as an initial test for evaluating acute LGIB.

The medical records of 382 patients who visited our emergency department with hematochezia between January 2012 and January 2017 were retrospectively analyzed. Of them, 112 underwent CT, 65 underwent colonoscopy, and 205 underwent sigmoidoscopy as an initial test. For each method, sensitivity, specificity, positive predictive value, and negative predictive value were calculated upon active bleeding site detection and LGIB etiology diagnosis.

The sensitivity, specificity, positive predictive value, and negative predictive value of CT for active bleeding site detection were 85.7%, 100%, 100%, and 96.9%, respectively, while those for identifying the etiology of LGIB were 87.4%, 40.0%, 83.5, and 47.6%, respectively.

CT was not inferior to lower endoscopy for active bleeding site detection. Early localization and the exclusion of active bleeding were possible with CT. Etiology was diagnosed with high sensitivity and PPV by CT. Thus, CT can be an alternative initial diagnostic tool for evaluating acute LGIB.
Study on intelligent syndrome differentiation neural network model of stomachache in traditional Chinese medicine based on the real world
Authors: Ye Hua , Gao Yuan , Zhang Ye , Cao Yue , Zhao Liang , Wen Li , Wen Chuanbiao
Published: May 2020

Stomachache is not only disease name of Traditional Chinese medicine (TCM) but also the clinical symptom. It is a common and multiple diseases. TCM has its particular advantage in clinical treatment of stomachache. Syndrome differentiation is an important concept in TCM practice. The therapeutic process is virtually a nonlinear mapping process from clinical symptom to syndrome diagnosis with processing and seeking rules from mass data. Artificial neutral network has strong learning ability for nonlinear relationship. Artificial neutral network has been widely used to TCM area where the multiple factors, multilevel, nonlinear problem accompanied by a large number of optimization exist.

We present an original experimental method to apply the improved third-order convergence LM algorithm to intelligent syndrome differentiation for the first time, and compare the predicted ability of Levenberg-Marquardt (LM) algorithm and the improved third-order convergence LM algorithm in syndrome differentiation.

In this study, 2436 cases of stomachache electronic medical data from hospital information system, and then the real world data were normalized and standardized. Afterwards, LM algorithm and the improved third-order convergence LM algorithm were used to build the Back Propagation (BP) neural network model for intelligent syndrome differentiation of stomachache on Matlab, respectively. Finally, the differentiation performance of the 2 models was tested and analyzed.

The testing results showed that the improved third-order convergence LM algorithm model has better average prediction and diagnosis accuracy, especially in predicting “liver-stomach disharmony” and “stomach yang deficiency”, is above 95%.

By effectively using the self-learning and auto-update ability of the BP neural network, the intelligent syndrome differentiation model of TCM can fully approach the real side of syndrome differentiation, and shows excellent predicted ability of syndrome differentiation.