bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple daily insulin injections ameliorate QT interval by lowering blood glucose levels in patients with type 2 diabetes
Authors: Kobayashi Shunsuke , Nagao Mototsugu , Fukuda Izumi , Oikawa Shinichi , Sugihara Hitoshi
Published: April 2021

Background:

A prolonged QT interval plays a causal role in fatal arrhythmia and is known to be a risk factor for sudden cardiac death. Although diabetic patients with microvascular complications tend to have a longer QT interval, the therapeutic effect of diabetes on the QT interval remains unclear. Here, we assessed the changes in QT interval in patients with type 2 diabetes (T2D) who received multiple daily insulin injections.

Materials and methods:

Patients with T2D ( n = 34) who were admitted to our hospital and initiated multiple daily insulin injections for glycemic control were enrolled in this study. Clinical measurements, including electrocardiogram, were taken on admission and discharge. The QT interval was measured manually in lead II on the electrocardiogram, and corrected QT interval (QTc) was calculated using Bazett’s formula. The change in QTc (ΔQTc) during hospitalization (median, 15 days) and clinical parameters affecting ΔQTc were investigated.

Results:

QTc was shortened from 439 ± 24 to 427 ± 26 ms during hospitalization ( p < 0.0001). ΔQTc was positively correlated with the changes in fasting plasma glucose (ΔFPG, r = 0.55, p = 0.0008) and glycated albumin ( r = 0.38, p = 0.026) following insulin therapy, but not with the final dose of insulin ( r = −0.20, p = 0.26). The multiple regression analyses revealed that ΔFPG was independently associated with ΔQTc.

Conclusions:

Multiple daily insulin injections can ameliorate QT interval by lowering the blood glucose levels in T2D, suggesting that glycemic control is important for preventing patients with T2D from sudden cardiac death.
What’s driving dermatology? Contribution title analysis of the largest German Dermatology Congress 2019
Authors: Kaczmarczyk Robert , King Felix , Biedermann Tilo , Zink Alexander
Published: April 2021

Background

Every two years, German-speaking dermatologic specialist groups gather in Berlin to share the latest developments at Germanýs largest dermatologic conference, the Annual Meeting of the Germany Society of Dermatology (DDG). Because this conference has a lasting effect on dermatologic practice and research, understanding what is moving the specialist groups means understanding what is driving dermatology in Germany.

Methods

We used word network analysis to compile and visualize the information embedded in the contribution titles to the DDG Annual Meeting in 2019. We extracted words, contributing cities and inter-connections. The data was standardized, visualized using network graphs and analyzed using common network analysis parameters.

Results

A total of 5509 words were extracted from 1150 contribution titles. The most frequently used words were “therapy”, “patients”, and “psoriasis”. The highest number of contributions came from Hamburg, Berlin and Munich. High diversity in research topics was found, as well as a well-connected research network.

Conclusions

Focus of the well-connected German-speaking dermatology community meeting 2019 was patient and therapy centered and lies especially on the diseases psoriasis and melanoma. Network graph analysis can provide helpful insights and help planning future congresses. It can facilitate the choice which contributors to include as imbalances become apparent. Moreover, it can help distributing the topics more evenly across the whole dermatologic spectrum.
Smartphone photography and its socio-economic life in China: An ethnographic analysis
Authors: Yang Yunchang
Published: April 2021

The smartphone is perhaps one of the few items that can define our time in terms of its ubiquity and mobility. The photographic feature of various types of smartphones has also drawn the attention of consumers and manufacturers in recent years, with the consecutive upgrades of built-in cameras, photo-editing and sharing apps. From the taking, retouching, to publishing a photograph, smartphone photography, coupled with social media, has become important in understanding the relationships between digital image and sociality, aesthetics and identity. This article examines several new developments such as the rise of ‘professional amateurs’ and the selfie within the Chinese context. It then attempts to develop theories of smartphone photography that incorporate these developments. Using ethnographic analysis and interviews, this article aims to theorize smartphone photography as a series of practices that reveal local and individual specifications that traverse technicity, sociality and aesthetics. It shows how this has had a significant impact on Chinese people’s economic and social life.
“No CAP”: Reflections on the Intersectionality, Positionality and the Experiences of Navigating Race as a Black Male Criminologist
Authors: Richardson Joseph
Published: April 2021

The arrest of respected Black professor and scholar Henry Louis Gates, Jr., by the Cambridge Police Department in 2009 for allegedly breaking into his own home proverbially “set the table” for this discussion. Following his arrest, Gates noted: “There are one million black men in jail in this country and last Thursday I was one of them. This is outrageous and this is how poor black men across the country are treated every day in the criminal justice system. It’s one thing to write about it, but altogether another to experience it.” Regardless of social class or occupational prestige, Black professors at predominately White institutions are subjected to hyper-surveillance and racially bias policing in public spaces on campus. Using intersectionality and positionality as conceptual frameworks, this paper describes the lived experiences of a Black professor and criminologist at a predominately White institution and his encounters with the university’s police department and the carceral state. Using Armour’s (2020) N*gga Theory, which is framed by Critical Race Theory, I analyze the relationship between race, class, unequal justice, and the politics of respectability. I use Armour’s N*gga Theory (2020) to show solidarity between those vilified as a “crime prone” Black underclass, and the less “crime prone” Black bourgeoisie. Although, the Black bourgeoisie in the academy may embrace the politics of respectability, according to N*gga Theory there is no moral or political distinction between the those considered good Negroes and those considered bad.
Reliability of a Novel Scoring System for MRI Assessment of Severity in Gluteal Tendinopathy: The Melbourne Hip MRI Score
Authors: Tso Chi Kin Nathan , O’Sullivan Richard , Khan Hussain , Fitzpatrick Jane
Published: April 2021

Background:

Gluteal tendinopathy is commonly reported in the literature, but there is a need for a validated magnetic resonance imaging (MRI)-based scoring system to grade the severity of the tendinopathy.

Purpose:

To use intra- and interobserver reliability to validate a new scoring system, the Melbourne Hip MRI (MHIP) score, for assessing the severity of gluteal tendinopathy.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

The MHIP score assesses gluteal tendinopathy according to each 1 of 5 categories: (1) extent of tendon pathology (maximum 5 points); (2) muscle atrophy (maximum 4 points); (3) trochanteric bursitis (maximum 4 points); (4) cortical irregularity (maximum 3 points); and (5) bone marrow edema (maximum 1 point), with an overall range of 0 to 17 (most severe). A total of 41 deidentified MRI scans from 40 patients diagnosed with gluteal tendinopathy (mean baseline age, 57.44 ± 25.26 years; 4 male, 36 female) were read and graded according to MHIP criteria by 2 experienced musculoskeletal radiologists. The radiologists were blinded to previous reports, and the scans were read twice within a 2-month period. Statistical analysis using the intraclass correlation coefficient (ICC) was used to determine intra- and interobserver reliability and mean/range for the MHIP scores.

Results:

Of a total of 123 readings, the mean MHIP score (±SD) was 3.93 ± 2.24 (range, 0-17 points). The MHIP score demonstrated excellent reliability for determining the severity of gluteal tendinopathy on MRI. The ICC for intra- and interobserver reliability was 0.81 (95% CI, 0.67-0.89) and 0.78 (95% CI, 0.62-0.87), respectively.

Conclusion:

The MHIP score had excellent intra- and interobserver reliability in scoring gluteal tendinopathy. This score allows gluteal tendon pathology to be graded prior to treatment and to be used for standardized comparisons between results in future research undertaking radiological review of gluteal tendinopathy.
Psychologists Should Use Brunner-Munzel’s Instead of Mann-Whitney’s U Test as the Default Nonparametric Procedure
Authors: Karch Julian D.
Published: April 2021

To investigate whether a variable tends to be larger in one population than in another, the t test is the standard procedure. In some situations, the parametric t test is inappropriate, and a nonparametric procedure should be used instead. The default nonparametric procedure is Mann-Whitney’s U test. Despite being a nonparametric test, Mann-Whitney’s test is associated with a strong assumption, known as exchangeability. I demonstrate that if exchangeability is violated, Mann-Whitney’s test can lead to wrong statistical inferences even for large samples. In addition, I argue that in psychology, exchangeability is typically not met. As a remedy, I introduce Brunner-Munzel’s test and demonstrate that it provides good Type I error rate control even if exchangeability is not met and that it has similar power as Mann-Whitney’s test. Consequently, I recommend using Brunner-Munzel’s test by default. To facilitate this, I provide advice on how to perform and report on Brunner-Munzel’s test.
Effects of Triphala on Lipid and Glucose Profiles and Anthropometric Parameters: A Systematic Review
Authors: Phimarn Wiraphol , Sungthong Bunleu , Itabe Hiroyuki
Published: April 2021

Aim.

The efficacy of triphala on lipid profile, blood glucose and anthropometric parameters and its safety were assessed.

Methods.

Databases such as PubMed, ScienceDirect, Web of Science, and Thai Library Integrated System (ThaiLIS) were systematically searched to review current evidence of randomized controlled trials (RCT) on triphala. RCTs investigating the safety and efficacy of triphala on lipid profile, blood glucose and anthropometric parameters were included. Study selection, data extraction, and quality assessment were performed independently by 2 authors.

Results.

Twelve studies on a total of 749 patients were included. The triphala-treated groups showed significantly reduced low-density lipoprotein-cholesterol, total cholesterol and triglyceride in 6 studies. Five RCTs demonstrated triphala-treated groups led to statistically significant decrease in body weight, body mass index and waist circumference of obese patients. Moreover, triphala significantly decreased fasting blood glucose level in diabetic patients but not in people without diabetes. No serious adverse event associated with triphala was reported during treatment.

Conclusions.

This review summarized a current evidence to show triphala might improve the lipid profile, blood glucose, the body weight, body mass index and waist circumference under certain conditions. However, large well-designed RCTs are required to confirm this conclusion.
Prognostic factors affecting macular hole closure types
Authors: Gümüş Gülşah , Demir Gökhan , Tülü Aygün Beril , Demircan Ali , Alkın Zeynep , Öztornacı Onur
Published: April 2021

Purpose:

In this study, we aimed to evaluate the relationship between macular hole closure types assessed by optical coherence tomography (OCT) and the preoperative prognostic factors.

Materials and methods:

In total, 183 patients who underwent pars plana vitrectomy and internal limiting membrane peeling for idiopathic macular hole between August 2014 and August 2019 were reviewed retrospectively. The preoperative measurements of the macular hole including minimum linear diameter (MLD), basal hole diameter (BHD) and hole height (HH) were measured on OCT images. The patients were divided into two closure types on the basis of postoperative OCT findings (type 1 closure: retinal edges were flat and there was no defect of the neurosensory retina on the fovea; type 2 closure: retinal edges were flat and there was a defect of the neurosensory retina on the fovea). The difference of prognostic factors such as age; duration of symptoms; preoperative best-corrected visual acuity (BCVA); preoperative macular hole measurements, including MLD, BHD and HH; and rate of reopening between two types were statistically analysed.

Results:

The mean age of patients was 66.33 ± 8.09 years (range: 48–88 years). According to OCT imaging, 117 eyes (63.9%) were classified into the type 1 closure group, and 66 eyes (36.1%) were classified into the type 2 closure group. There were no significant differences between two groups in age, duration of symptoms and preoperative BCVA ( p = 0.694, p = 0.092 and p = 0.15). MLD and BHD were significantly larger, and reopening was significantly more common in type 2 group ( p < 0.05, p = 0.04 and p < 0.005); however, there was no significant difference in HH between two groups ( p = 0.239).

Conclusion:

Preoperative horizontal measurements of macular hole may help to determine postoperative visual expectations and anatomical success, and predict the possibility of reopening.
Confronting the Monolith: Insider Accounts of the Nature and Techniques of Corruption in Nigeria
Authors: Zakari Musa Bala , Button Mark
Published: April 2021

This paper draws upon insider accounts of the nature and techniques of corruption in Nigeria. It draws upon unique access to interview 20 senior officials employed in key public agencies in the fight against corruption in Nigeria and access to 20 case files of prosecutions by the Independent Corrupt Practices and other related offences Commission (ICPC). The paper illustrates their perception of the monolith of corruption faced and shows some of the most common types of corruption confronted such as embezzlement, theft and fraud; procurement fraud; favoritism, nepotism and related acts; extortion and bribery. The paper also illustrates the connection between the private and public sector in corruption and some of the differences that emerge in grand and petty corruption.
Staying alive: A 21st century agenda for mental health, child protection and forensic services
Authors: Crittenden Patricia M , Landini Andrea , Spieker Susan J
Published: April 2021

Mental health treatment, child protection and forensic services for criminality need major reorganisation in conceptualisation and service provision. This need results from the failure of current diagnostic methods, administrative organisations and treatment approaches to reduce the prevalence of mental illness, child maltreatment or criminal behaviour. We propose that defining these problems as individual deficits and responding to them by category of harm (to self, progeny and others, respectively) stands in the way of effective prevention and treatment. We address four topics: (1) the common basis of all of these problems in unprotected and uncomforted exposure to danger, (2) the developmental process of psychological maladaptation that occurs interpersonally in endangered families, (3) the behavioural expression of psychological development as protective strategies that can be adaptive or maladaptive, depending upon the context in which they are used, and (4) proposals for systemic change that could improve prevention and treatment. These proposals include using functional formulations to guide treatment planning, single portal entry to assessment and services, integrated universal transdisciplinary training followed by specialisation for all mental health professionals, delivering customised treatment through transitional attachment relationships and consolidating disparate disciplines in ‘departments of human adaptation’.
A Practical Approach to Screening and Surveillance of Barrett’s Esophagus
Authors: Komanduri Srinadh , Farina Domenico A.
Published: April 2021

Barrett’s esophagus (BE) can progress to Esophageal Adenocarcinoma (EAC), which has associated high morbidity and mortality. As such, societal guidelines suggest endoscopic screening in select individuals with multiple BE risk factors. However, cheaper and less invasive new technologies may allow for more widespread BE screening practices in the future. In patients with established BE, endoscopic surveillance is recommended with intervals based primarily on histology and to a lesser degree, BE segment length. Similar to BE screening, endoscopic surveillance can further be optimized with improved techniques, innovative technology, and further understanding of risk stratification for EAC.
Radiation-induced bystander effects impair transplanted human hematopoietic stem cells via oxidative DNA damage
Authors: Hu Linping , Yin Xiuxiu , Zhang Yawen , Pang Aiming , Xie Xiaowei , Yang Shangda , Zhu Caiying , Li Yapu , Zhang Biao , Huang Yaojin , Tian Yunhong , Wang Mei , Cao Wenbin , Chen Shulian , Zheng Yawei , Ma Shihui , Dong Fang , Hao Sha , Feng Sizhou , Ru Yongxin , Cheng Hui , Jiang Erlie , Cheng Tao
Published: April 2021

Total body irradiation (TBI) is commonly used in host conditioning regimens for human hematopoietic stem cell (HSC) transplantation to treat various hematological disorders. Exposure to TBI not only induces acute myelosuppression and immunosuppression, but also injures the various components of the HSC niche in recipients. Our previous study demonstrated that radiation-induced bystander effects (RIBE) of irradiated recipients decreased the long-term repopulating ability of transplanted mouse HSCs. However, RIBE on transplanted human HSCs have not been studied. Here, we report that RIBE impaired the long-term hematopoietic reconstitution of human HSCs as well as the colony-forming ability of human hematopoietic progenitor cells (HPCs). Our further analyses revealed that the RIBE-affected human hematopoietic cells showed enhanced DNA damage responses, cell-cycle arrest, and p53-dependent apoptosis, mainly because of oxidative stress. Moreover, multiple antioxidants could mitigate these bystander effects, though at different efficacies in vitro and in vivo. Taken together, these findings suggest that RIBE impair human HSCs and HPCs by oxidative DNA damage. This study provides definitive evidence for RIBE on transplanted human HSCs and further justifies the necessity of conducting clinical trials to evaluate different antioxidants to improve the efficacy of HSC transplantation for the patients with hematological or nonhematological disorders.
Upregulation of interleukin-19 in severe asthma: a potential saliva biomarker for asthma severity
Authors: Saheb Sharif-Askari Fatemeh , Saheb Sharif-Askari Narjes , Goel Swati , Mahboub Bassam , Ansari Abdul Wahid , Temsah Mohamad-Hani , Zakri Adel M. , Ratemi Elaref , Hamoudi Rifat , Hamid Qutayba , Halwani Rabih
Published: April 2021

Interleukin (IL)-19, a designated IL-20 subfamily cytokine, has been implicated in inflammatory disorders including rheumatoid arthritis, psoriasis and, lately, asthma. Here, through the analysis of transcriptomic datasets of lung tissue of large asthma cohorts, we report that IL-19 expression is upregulated in asthma and correlates with disease severity. The gene expression of IL-19 was significantly higher in lung tissue from patients with severe and mild/moderate asthma compared to healthy controls. IL-19 protein level, however, was significantly higher in the blood and saliva of patients with severe asthma compared to mild/moderate subgroups as measured by ELISA assay. IL-19 protein level was not affected by corticosteroid treatment in plasma. Our data provide insights into the potential use of IL-19 as a saliva marker for asthma severity and a potential therapeutic target.
Transcriptome analysis of early stages of sorghum grain mold disease reveals defense regulators and metabolic pathways associated with resistance
Authors: Nida Habte , Lee Sanghun , Li Ying , Mengiste Tesfaye
Published: April 2021

Background

Sorghum grain mold is the most important disease of the crop. The disease results from simultaneous infection of the grain by multiple fungal species. Host responses to these fungi and the underlying molecular and cellular processes are poorly understood. To understand the genetic, molecular and biochemical components of grain mold resistance, transcriptome profiles of the developing grain of resistant and susceptible sorghum genotypes were studied.

Results

The developing kernels of grain mold resistant RTx2911 and susceptible RTx430 sorghum genotypes were inoculated with a mixture of fungal pathogens mimicking the species complexity of the disease under natural infestation. Global transcriptome changes corresponding to multiple molecular and cellular processes, and biological functions including defense, secondary metabolism, and flavonoid biosynthesis were observed with differential regulation in the two genotypes. Genes encoding pattern recognition receptors (PRRs), regulators of growth and defense homeostasis, antimicrobial peptides, pathogenesis-related proteins, zein seed storage proteins, and phytoalexins showed increased expression correlating with resistance. Notably, SbLYK5 gene encoding an orthologue of chitin PRR, defensin genes SbDFN7.1 and SbDFN7.2 exhibited higher expression in the resistant genotype. The SbDFN7.1 and SbDFN7.2 genes are tightly linked and transcribed in opposite orientation with a likely common bidirectional promoter. Interestingly, increased expression of JAZ and other transcriptional repressors were observed that suggested the tight regulation of plant defense and growth. The data suggest a pathogen inducible defense system in the developing grain of sorghum that involves the chitin PRR, MAPKs, key transcription factors, downstream components regulating immune gene expression and accumulation of defense molecules. We propose a model through which the biosynthesis of 3-deoxyanthocynidin phytoalexins, defensins, PR proteins, other antimicrobial peptides, and defense suppressing proteins are regulated by a pathogen inducible defense system in the developing grain.

Conclusions

The transcriptome data from a rarely studied tissue shed light into genetic, molecular, and biochemical components of disease resistance and suggested that the developing grain shares conserved immune response mechanisms but also components uniquely enriched in the grain. Resistance was associated with increased expression of genes encoding regulatory factors, novel grain specific antimicrobial peptides including defensins and storage proteins that are potential targets for crop improvement.
The death risk factors of patients undergoing re-exploration for bleeding or tamponade after isolated off-pump coronary artery bypass grafting: a case–control study
Authors: Luan Tongxiao , Zhuang Yingzhu , Nie Weihong , Yang Sumin , Wu Yuhui , Wang Rongmei , Dai Yunyan , Zhang Hong
Published: April 2021

Background

The purpose of the study is to identify off-pump patients who are at higher risk of mortality after re-exploration for bleeding or tamponade.

Methods

We analyzed the data of 3256 consecutive patients undergoing isolated off-pump coronary artery bypass grafting (OPCABG) in our heart center from 2013 through 2020. Fifty-eight patients underwent re-exploration after OPCABG. The 58 patients were divided into death group and survival group according to their discharge status. Propensity score matching (PSM) was performed to analysis the risk factors of death. 15 pairs of cases of two groups were matched well.

Results

The mortality rate of patients underwent re-exploration after OPCABG for bleeding or tamponade was 27.59% (16/58). In the raw data, we found the patients in death group had higher body mass index (BMI) (P = 0.030), higher cardiac troponin T (cTnT) (P = 0.028) and higher incidence of heart failure before OPCABG (P = 0.003). After PSM, the levels of lactic acid before and after re-exploration (P = 0.028 and P < 0.001) were higher in death group. And the levels of creatinine (P = 0.002) and cTnT (P = 0.017) were higher in the death group after re-exploration. The death group had longer reoperation time (P = 0.010). In addition, the perioperative utilization rate of intra-aortic ballon pump (IABP) (P = 0.027), continuous renal replacement therapy (CRRT) (P < 0.001) and platelet transfusion (P = 0.017) were higher than survival group.

Conclusions

The mortality rate of patients undergoing re-exploration for bleeding or tamponade after isolated OPCABG is high. More attention should be paid to patients with above risk factors and appropriate measures should be taken in time.
Olaparib-mediated enhancement of 5-fluorouracil cytotoxicity in mismatch repair deficient colorectal cancer cells
Authors: de Castro e Gloria Helena , Jesuíno Nogueira Laura , Bencke Grudzinski Patrícia , da Costa Ghignatti Paola Victória , Guecheva Temenouga Nikolova , Motta Leguisamo Natalia , Saffi Jenifer
Published: April 2021

Background

The advances in colorectal cancer (CRC) treatment include the identification of deficiencies in Mismatch Repair (MMR) pathway to predict the benefit of adjuvant 5-fluorouracil (5-FU) and oxaliplatin for stage II CRC and immunotherapy. Defective MMR contributes to chemoresistance in CRC. A growing body of evidence supports the role of Poly-(ADP-ribose) polymerase (PARP) inhibitors, such as Olaparib, in the treatment of different subsets of cancer beyond the tumors with homologous recombination deficiencies. In this work we evaluated the effect of Olaparib on 5-FU cytotoxicity in MMR-deficient and proficient CRC cells and the mechanisms involved.

Methods

Human colon cancer cell lines, proficient (HT29) and deficient (HCT116) in MMR, were treated with 5-FU and Olaparib. Cytotoxicity was assessed by MTT and clonogenic assays, apoptosis induction and cell cycle progression by flow cytometry, DNA damage by comet assay. Adhesion and transwell migration assays were also performed.

Results

Our results showed enhancement of the 5-FU citotoxicity by Olaparib in MMR-deficient HCT116 colon cancer cells. Moreover, the combined treatment with Olaparib and 5-FU induced G2/M arrest, apoptosis and polyploidy in these cells. In MMR proficient HT29 cells, the Olaparib alone reduced clonogenic survival, induced DNA damage accumulation and decreased the adhesion and migration capacities.

Conclusion

Our results suggest benefits of Olaparib inclusion in CRC treatment, as combination with 5-FU for MMR deficient CRC and as monotherapy for MMR proficient CRC. Thus, combined therapy with Olaparib could be a strategy to overcome 5-FU chemotherapeutic resistance in MMR-deficient CRC.
Vocal-cord Only vs. Complete Laryngeal radiation (VOCAL): a randomized multicentric Bayesian phase II trial
Authors: Bahig Houda , Rosenthal David I. , Nguyen-Tan Félix-Phuc , Fuller David C. , Yuan Ying , Hutcheson Katherine A. , Christopoulos Apostolos , Nichols Anthony C. , Fung Kevin , Ballivy Olivier , Filion Edith , Ng Sweet Ping , Lambert Louise , Dorth Jennifer , Hu Kenneth S. , Palma David
Published: April 2021

Background

Radiotherapy, along with laser surgery, is considered a standard treatment option for patients with early glottic squamous cell cancer (SCC). Historically, patients have received complete larynx radiotherapy (CL-RT) due to fear of swallowing and respiratory laryngeal motion and this remains the standard approach in many academic institutions. Local control (LC) rates with CL-RT have been excellent, however this treatment can carry significant toxicities include adverse voice and swallowing outcomes, along with increased long-term risk of cerebrovascular morbidity. A recent retrospective study reported improved voice quality and similar local control outcomes with focused vocal cord radiotherapy (VC-RT) compared to CL-RT. There is currently no prospective evidence on the safety of VC-RT. The primary objective of this Bayesian Phase II trial is to compare the LC of VC-RT to that of CL-RT in patients with T1N0 glottic SCC.

Methods

One hundred and fifty-five patients with T1a-b N0 SCC of the true vocal cords that are n ot candidate or declined laser surgery, will be randomized in a 1:3 ratio the control arm (CL-RT) and the experimental arm (VC-RT). Randomisation will be stratified by tumor stage (T1a/T1b) and by site (each site will be allowed to select one preferred radiation dose regimen, to be used in both arms). CL-RT volumes will correspond to the conventional RT volumes, with the planning target volume extending from the top of thyroid cartilage lamina superiorly to the bottom of the cricoid inferiorly. VC-RT volumes will include the involved vocal cord(s) and a margin accounting for respiration and set-up uncertainty. The primary endpoint will be LC at 2-years, while secondary endpoints will include patient-reported outcomes (voice impairment, dysphagia and symptom burden), acute and late toxicity radiation-induced toxicity, overall survival, progression free survival, as well as an optional component of acoustic and objective measures of voice analysis using the Consensus Auditory-Perceptual Evaluation of Voice.

Discussion

This study would constitute the first prospective evidence on the efficacy and safety of VC-RT in early glottic cancer. If positive, this study would result in the adoption of VC-RT as standard approach in early glottic cancer.

Trial registration

ClinicalTrials.gov Identifier:NCT03759431

Registration date: November 30, 2018
Incidence and management of retrobulbar hemorrhage after blowout fracture repair
Authors: Park Jae Hwi , Kim Inhye , Son Jun Hyuk
Published: April 2021

Background

Retrobulbar hemorrhage (RBH) is a rare complication after orbital surgery but associated with ocular complications including blindness. The aim of this study was to identify clinical characteristics of patients with RBH requiring emergent orbital decompression after blowout fracture repair.

Method

A retrospective review of 426 blowout fracture patients at a tertiary oculoplastic clinic provided data regarding demographics, physical examination findings, and computed tomography (CT) images. Extraocular motility had been recorded in patient charts on a scale from 0 to − 4. Patients requiring emergent orbital decompression due to RBH after surgery (RBH group) were compared with those who did not (Control group), using the Mann-Whitney U-test. Incidences of RBH according to primary or secondary surgery were also investigated, using Fisher’s exact test.

Result

Five (1.2%) of the 426 patients who underwent blowout fracture repair developed RBH requiring emergent intervention. All RBH patients fully recovered after the decompression procedure or conservative treatment. Number of days to surgery was significantly longer in the RBH group (97.0 ± 80.1) than in the Control group (29.0 ± 253.0) (p = 0.05). Preoperative enophthalmos was also significantly greater in the RBH group (RBH vs. Control group, 3.6 ± 1.7 mm versus 1.2 ± 1.3 mm (p = 0.003)). The incidence of RBH was significantly higher in patients that underwent secondary surgery (odds ratio = 92.9 [95% confidence interval, 11.16–773.23], p = 0.001).

Conclusions

Surgeons should pay more attention to hemostasis and postoperative care in patients with a large preoperative enophthalmic eye, when time from injury to surgery is long and in revision cases. When RBH occurs, time to intervention and surgical decompression is critical for visual recovery and preventing blindness.

Trial registration

The institutional review board of the Yeungnam University Medical Center approved this study (YUMC 2018-11-010), which was conducted in accord with the Declaration of Helsinki.
Simple action for depression detection: using kinect-recorded human kinematic skeletal data
Authors: Li Wentao , Wang Qingxiang , Liu Xin , Yu Yanhong
Published: April 2021

Background

Depression, a common worldwide mental disorder, which brings huge challenges to family and social burden around the world is different from fluctuant emotion and psychological pressure in their daily life. Although body signs have been shown to present manifestations of depression in general, few researches focus on whole body kinematic cues with the help of machine learning methods to aid depression recognition. Using the Kinect V2 device to record participants’ simple kinematic skeleton data of the participant’s body joints, the presented spatial features and low-level features is directly extracted from the record original Kinect-3D coordinates. This research aimed to constructed machine learning model with the preprocessed data importing, which could be used for depression automatic classification.

Methods

Considering some patients’ conditions and current status and refer to psychiatrists’ advices, simple and significant designed stimulus task will lead human skeleton data collection job. With original Kinect skeleton data extracting and preprocessing, the proposed experiment demonstrated four strong machine learning tools: Support Vector Machine, Logistic Regression, Random Forest and Gradient Boosting. Using the precision, recall, sensitivity, specificity, roc-curve, confusion matrix et.al, indicators were calculated as the measurement of methods, which were commonly used to evaluate classification methodologies.

Results

Across screened 64 pairs with age and gender totally matching in depression and control group, and Gradient Boosting achieved the best performance with the prediction accuracy of 76.92%. Sorted by female (54.69%) and male for the gender-based depression recognition, we applied best performance classifier Gradient Boosting got prediction accuracy of 66.67% in the male group, and 71.73% in the female group. Utilizing the best model Gradient Boosting for age-based classification, prediction accuracy got 76.92% in the older group (age >40, 50% of total) and 53.85% accuracy in the younger group (age <= 40).

Conclusion

The depression and non-depression individuals can be well classified by computational models using Kinect captured skeletal data. The Gradient Boosting, an excellent machine learning tool, get the performance in the four methods we demonstrated. Meanwhile, in the gender-based depression classification also gets reasonable accuracy. In particular, the recognition results of the old group are significantly better than that of the young group. All these findings suggest that kinematic skeletal data based depression recognition can be applied as an effective tool for assisting in depression analysis.
Burden and future projection of revision Total hip Arthroplasty in South Korea
Authors: Park Jung-Wee , Won Seok-Hyung , Moon Sun-Young , Lee Young-Kyun , Ha Yong-Chan , Koo Kyung-Hoi
Published: April 2021

Background

The annual number of hip arthroplasties is increasing combined with the aging population worldwide. In accordance with the increasing number of primary hip arthroplasties, the number of revision total hip arthroplasties (THAs) is expected to increase. The incidence and burden of revision THAs in the United States and have been reported by registry studies. To identify potential differences according to ethnics and regional practice, it is important to obtain data from East Asia. Nevertheless, there has been a lack of studies on the burden and future projection of revision THA based on a large-scale database in East Asia. The purpose of this study was to evaluate annual incidence and burden of revision THAs and to project the future burden in South Korea.

Methods

We identified primary THAs, primary hemiarthroplasties (HAs) and revision THAs, which were performed from 2010 to 2018, using database of Health Insurance and Review and Assessment (HIRA); nation-wide medical claim system of South Korea. The annual incidence rates (per 100,000) of primary THA, primary HA and revision THA, and the annual burden of revision THA; the number of revision THAs divided by the sum of primary hip arthroplasties and revision THAs, were calculated. The future burden of revision THAs were projected through 2030 using generalized linear model with Quasi-poisson regression.

Results

During the 9-year period, the annual incidences of primary THA, primary HA and revision THA increased by 47, 29 and 3%, respectively, while the revision burden decreased from 0.13 to 0.10. Compared to 2018, the annual incidences of primary THA, HA, and revision THA were projected to increase by 7.2, 2.3 and 1.1% per year, respectively, whereas the burden of revision THA was projected to decrease to 0.07 in 2030.

Conclusion

Trends of revision THA in South Korea were similar with those of national registry studies from the United States. The annual incidence of revision THA has steadily increased, whereas its burden has decreased. Findings of our study could be used for epidemiological comparison between Western countries and East Asia as well as for the establishment of medical policies of revision THA in East Asian countries.
Alisol A 24-acetate stimulates lipolysis in 3 T3-L1 adipocytes
Authors: Lou Hai-xia , Fu Wen-cheng , Chen Jia-xiang , Li Tian-tian , Jiang Ying-ying , Liu Chun-hui , Zhang Wen
Published: April 2021

Background

Alisol A 24-acetate (AA-24-a), one of the main active triterpenes isolated from the well-known medicinal plantAlisma orientale(Sam.) Juz., exhibits multiple biological activities including hypolipidemic activity. However, its effect on lipid metabolism in adipocytes remains unclear. The present study aimed to clarify the effect of AA-24-a on adipocyte lipolysis and to determine its potential mechanism of action using 3 T3-L1 cells.

Methods

We assayed the release of glycerol into culture medium of 3 T3-L1 cells under treatment with AA-24-a. Protein and mRNA expression and phosphorylation levels of the main lipases and kinases involved in lipolysis regulation were determined by quantitative polymerase chain reaction and western blotting. Specific inhibitors of protein kinase A (PKA; H89) and extracellular signal-regulated kinase (ERK; PD98059), which are key enzymes in relevant signaling pathways, were used to examine their roles in AA-24-a-stimulated lipolysis.

Results

AA-24-a significantly stimulated neutral lipolysis in fully differentiated adipocytes. To determine the underlying mechanism, we assessed the changes in mRNA and protein levels of key lipolysis-related genes in the presence or absence of H89 and PD98059. Both inhibitors reduced AA-24-a-induced lipolysis. Moreover, pretreatment with H89 attenuated AA-24-a-induced phosphorylation of hormone-sensitive lipase at Ser660, while pretreatment with PD98059 attenuated AA-24-a-induced downregulation of peroxisome proliferator-activated receptor-γ and perilipin A.

Conclusions

Our results indicate that AA-24-a promoted neutral lipolysis in 3 T3-L1 adipocytes by activating PKA-mediated phosphorylation of hormone-sensitive lipase and ERK- mediated downregulation of expression of perilipin A.
The beneficial effects of the composite probiotics from camel milk on glucose and lipid metabolism, liver and renal function and gut microbiota in db/db mice
Authors: Manaer Tabusi , Yu Lan , Nabi Xin-Hua , Dilidaxi Dinareer , Liu Lu , Sailike Jialehasibieke
Published: April 2021

Background

Probiotics may have beneficial effects on patients with type 2 diabetes mellitus (T2DM). We separated 4 lactobacillus and 1 saccharomycetes from traditional fermented cheese whey (TFCW) and prepared composite probiotics from camel milk (CPCM) and investigated their effects on glucose and lipid metabolism, liver and renal function and gut microbiota in db/db mice.

Methods

CPCM was prepared in the laboratory and 40 db/db mice were randomly divided into 4 groups as metformin, low-dose and high-dose group and model group, and treated for 6 weeks. In addition, 10 C57BL/Ks mice as normal control group were used for comparison. Fasting blood glucose (FBG), body weight (BW), oral glucose tolerance test (OGTT), glycated hemoglobin (HbAlc), C-peptide (CP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), 24 h urinary microalbumin (24 h malb), urine ketone, urine sugar, pancreas and liver tissue and intestinal flora were tested.

Results

Compared to diabetic group, high dose CPCM significantly decreased FBG, OGTT, HbAlc and IRI, plasma TC, TG, LDL-C, 24 h malb, urine ketone and urine sugar, increased CP, HDL-C levels, improved the liver and kidney function, protected the function of islets, also increased intestinal tract lactic acid bacteria and Bifidobacterium, decreased Escherichia in db/db mice.

Conclusion

CPCM decreased FBG, OGTT and HbAlc, increased CP, modulated lipid metabolism and improved liver and kidney protected injury in db/db mice, which may be related to various probiotics acting through protecting the function of islets and regulating intestinal flora disturbance.
Applications of brain organoids in neurodevelopment and neurological diseases
Authors: Sun Nan , Meng Xiangqi , Liu Yuxiang , Song Dan , Jiang Chuanlu , Cai Jinquan
Published: April 2021

A brain organoid is a self-organizing three-dimensional tissue derived from human embryonic stem cells or pluripotent stem cells and is able to simulate the architecture and functionality of the human brain. Brain organoid generation methods are abundant and continue to improve, and now, an in vivo vascularized brain organoid has been encouragingly reported. The combination of brain organoids with immune-staining and single-cell sequencing technology facilitates our understanding of brain organoids, including the structural organization and the diversity of cell types. Recent publications have reported that brain organoids can mimic the dynamic spatiotemporal process of early brain development, model various human brain disorders, and serve as an effective preclinical platform to test and guide personalized treatment. In this review, we introduce the current state of brain organoid differentiation strategies, summarize current progress and applications in the medical domain, and discuss the challenges and prospects of this promising technology.
Latent class analysis to predict intensive care outcomes in Acute Respiratory Distress Syndrome: a proposal of two pulmonary phenotypes
Authors: Wendel Garcia Pedro D. , Caccioppola Alessio , Coppola Silvia , Pozzi Tommaso , Ciabattoni Arianna , Cenci Stefano , Chiumello Davide
Published: April 2021

Background

Acute respiratory distress syndrome remains a heterogeneous syndrome for clinicians and researchers difficulting successful tailoring of interventions and trials. To this moment, phenotyping of this syndrome has been approached by means of inflammatory laboratory panels. Nevertheless, the systemic and inflammatory expression of acute respiratory distress syndrome might not reflect its respiratory mechanics and gas exchange.

Methods

Retrospective analysis of a prospective cohort of two hundred thirty-eight patients consecutively admitted patients under mechanical ventilation presenting with acute respiratory distress syndrome. All patients received standardized monitoring of clinical variables, respiratory mechanics and computed tomography scans at predefined PEEP levels. Employing latent class analysis, an unsupervised structural equation modelling method, on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes at a PEEP level of 5cmH2O, distinct pulmonary phenotypes of acute respiratory distress syndrome were identified.

Results

Latent class analysis was applied to 54 respiratory mechanics, gas-exchange and CT-derived gas- and tissue-volume variables, and a two-class model identified as best fitting. Phenotype 1 (non-recruitable) presented lower respiratory system elastance, alveolar dead space and amount of potentially recruitable lung volume than phenotype 2 (recruitable). Phenotype 2 (recruitable) responded with an increase in ventilated lung tissue, compliance and PaO2/FiO2 ratio (p < 0.001), in addition to a decrease in alveolar dead space (p < 0.001), to a standardized recruitment manoeuvre. Patients belonging to phenotype 2 (recruitable) presented a higher intensive care mortality (hazard ratio 2.9, 95% confidence interval 1.7–2.7, p = 0.001).

Conclusions

The present study identifies two ARDS phenotypes based on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes. These phenotypes are characterized by distinctly diverse responses to a standardized recruitment manoeuvre and by a diverging mortality. Given multicentre validation, the simple and rapid identification of these pulmonary phenotypes could facilitate enrichment of future prospective clinical trials addressing mechanical ventilation strategies in ARDS.
Performance of the UCLA Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 instrument as a clinical decision aid in the routine clinical care of patients with systemic sclerosis
Authors: Zampatti Norina , Garaiman Alexandru , Jordan Suzana , Dobrota Rucsandra , Becker Mike Oliver , Maurer Britta , Distler Oliver , Mihai Carina
Published: April 2021

Background and objectives

The University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument 2.0 (UCLA GIT 2.0) is validated to capture gastrointestinal (GI) tract morbidity in patients with systemic sclerosis (SSc). The aims of this study were to determine in a large SSc cohort if the UCLA GIT 2.0 is able to discriminate patients for whom a rheumatologist with experience in SSc would recommend an esophago-gastro-duodenoscopy (EGD), and if it could identify patients with endoscopically proven esophagitis or with any pathologic finding on EGD.

Methods

We selected patients fulfilling the ACR/EULAR 2013 criteria for SSc from our EUSTAR center having completed at least once the UCLA GIT 2.0 questionnaire, and we collected data on gastrointestinal symptoms and EGD from their medical charts. We analyzed by general linear mixed effect models several parameters, including UCLA GIT 2.0, considered as potentially associated with the indication of EGD, as well as with endoscopic esophagitis and any pathologic finding on EGD.

Results

We identified 346 patients (82.7% female, median age 63 years, median disease duration 10 years, 23% diffuse cutaneous SSc) satisfying the inclusion criteria, who completed UCLA GIT 2.0 questionnaires at 940 visits. EGD was recommended at 169 visits. In multivariable analysis, UCLA GIT 2.0 and some of its subscales (reflux, distention/bloating, social functioning) were associated with the indication of EGD. In 177 EGD performed in 145 patients, neither the total ULCA GIT 2.0 score nor any of its subscales were associated with endoscopic esophagitis, nor with any pathologic EGD findings.

Conclusions

In a real-life setting, the UCLA GIT 2.0 and its reflux subscale were able to discriminate patients with SSc who had an indication for EGD, but did not correlate with findings in EGD. We conclude that, while using the UCLA GIT 2.0 in the routine care of patients with SSc may help the rheumatologist to better understand the burden of GI symptoms in the individual patient, it should not be used as a stand-alone instrument to identify an indication of EGD.