bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperoxalemia Leads to Oxidative Stress in Endothelial Cells and Mice with Chronic Kidney Disease
Authors: Sun Ke , Tang Xiaojing , Song Shuwei , Gao Yuan , Yu Hongjing , Sun Ningyun , Wen Bin , Mei Changlin
Published: May 2021

Introduction: Cardiovascular disease is the most common cause of morbidity and mortality in patients with ESRD. In addition to phosphate overload, oxalate, a common uremic toxin, is also involved in vascular calcification in patients with ESRD. The present study investigated the role and mechanism of hyperoxalemia in vascular calcification in mice with uremia. Methods: A uremic atherosclerosis (UA) model was established by left renal excision and right renal electrocoagulation in apoE−/− mice to investigate the relationship between oxalate loading and vascular calcification. After 12 weeks, serum and vascular levels of oxalate, vascular calcification, inflammatory factors (TNF-α and IL-6), oxidative stress markers (malondialdehyde [MDA], and advanced oxidation protein products [AOPP]) were assessed in UA mice. The oral oxalate-degrading microbe Oxalobacter formigenes (O. formigenes) was used to evaluate the effect of a reduction in oxalate levels on vascular calcification. The mechanism underlying the effect of oxalate loading on vascular calcification was assessed in cultured human aortic endothelial cells (HAECs) and human aortic smooth muscle cells (HASMCs). Results: Serum oxalate levels were significantly increased in UA mice. Compared to the control mice, UA mice developed more areas of aortic calcification and showed significant increases in aortic oxalate levels and serum levels of oxidative stress markers and inflammatory factors. The correlation analysis showed that serum oxalate levels were positively correlated with the vascular oxalate levels and serum MDA, AOPP, and TNF-α levels, and negatively correlated with superoxide dismutase activity. The O. formigenes intervention decreased serum and vascular oxalate levels, while did not improve vascular calcification significantly. In addition, systemic inflammation and oxidative stress were also improved in the O. formigenes group. In vitro, high concentrations of oxalate dose-dependently increased oxidative stress and inflammatory factor expression in HAECs, but not in HASMCs. Conclusions: Our results indicated that hyperoxalemia led to the systemic inflammation and the activation of oxidative stress. The reduction in oxalate levels by O. formigenes might be a promising treatment for the prevention of oxalate deposition in calcified areas of patients with ESRD.
The Value of the Surprise Question to Predict One-Year Mortality in Idiopathic Pulmonary Fibrosis: A Prospective Cohort Study
Authors: Moor Catharina C. , Tak van Jaarsveld Nelleke C. , Owusuaa Catherine , Miedema Jelle R. , Baart Sara , van der Rijt Carin C.D. , Wijsenbeek Marlies S.
Published: May 2021

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive fatal disease with a heterogeneous disease course. Timely initiation of palliative care is often lacking. The surprise question “Would you be surprised if this patient died within the next year?” is increasingly used as a clinical prognostic tool in chronic diseases but has never been evaluated in IPF. Objective: We aimed to evaluate the predictive value of the surprise question for 1-year mortality in IPF. Methods: In this prospective cohort study, clinicians answered the surprise question for each included patient. Clinical parameters and mortality data were collected. The sensitivity, specificity, accuracy, negative, and positive predictive value of the surprise question with regard to 1-year mortality were calculated. Multivariable logistic regression analysis was performed to evaluate which factors were associated with mortality. In addition, discriminative performance of the surprise question was assessed using the C-statistic. Results: In total, 140 patients were included. One-year all-cause mortality was 20% (n = 28). Clinicians identified patients with a survival of <1 year with a sensitivity of 68%, a specificity of 82%, an accuracy of 79%, a positive predictive value of 49%, and a negative predictive value of 91%. The surprise question significantly predicted 1-year mortality in a multivariable model (OR 3.69; 95% CI 1.24–11.02; p = 0.019). The C-statistic of the surprise question to predict mortality was 0.75 (95% CI 0.66–0.85). Conclusions: The answer on the surprise question can accurately predict 1-year mortality in IPF. Hence, this simple tool may enable timely focus on palliative care for patients with IPF.
Less computational approach to detect QRS complexes in ECG rhythms
Authors: Younes Tariq M. , Alkhedher Mohammad , Al Khawaldeh Mohamad , Nawash Jalal , Al-Abbas Ibrahim
Published: May 2021

Electrocardiogram (ECG) signals are normally affected by artifacts that require manual assessment or use of other reference signals. Currently, Cardiographs are used to achieve basic necessary heart rate monitoring in real conditions. This work aims to study and identify main ECG features, QRS complexes, as one of the steps of a comprehensive ECG signal analysis. The proposed algorithm suggested an automatic recognition of QRS complexes in ECG rhythm. This method is designed based on several filter structure composes low pass, difference and summation filters. The filtered signal is fed to an adaptive threshold function to detect QRS complexes. The algorithm was validated and results were checked with experimental data based on sensitivity test.
Increased Risk of Stroke in Patients With Obsessive-Compulsive Disorder: A Nationwide Longitudinal Study
Authors: Chen Mu-Hong , Tsai Shih-Jen , Su Tung-Ping , Li Cheng-Ta , Lin Wei-Chen , Chen Tzeng-Ji , Pan Tai-Long , Bai Ya-Mei
Published: May 2021

Background and Purpose:

Patients with obsessive-compulsive disorder (OCD) tend to be comorbid with stroke-related risk factors, including obesity, hypertension, and diabetes. However, the temporal association between OCD and subsequent stroke risk is unclear.

Methods:

Using data collected between 2001 and 2010 by Taiwan’s National Health Insurance Research Database, 28 064 adult patients with OCD (International Classification of Diseases, Ninth Revision, Clinical Modification [
ICD-9-CM
] code: 300.3) and 28 064 age-, sex-, and comorbidity-matched controls were included in this study. Patients who developed ischemic (
ICD-9-CM
codes: 433, 434, and 435) and hemorrhagic (
ICD-9-CM
codes: 430, 431, and 432) stroke during follow-up (from enrollment to end of 2011) were identified. Moreover, medications used for treating OCD were assessed.

Results:

Patients with OCD (hazard ratio [HR], 3.02 [95% CI, 1.91–4.77]), especially middle-aged (HR, 2.66 [95% CI, 1.34–5.29]) and elderly adults (HR, 3.46 [95% CI, 1.70–7.05]), had an elevated risk of developing ischemic stroke during the follow-up period compared with non-OCD controls. The cumulative HR of hemorrhagic stroke did not differ (HR, 0.87 [95% CI, 0.42–1.80]) between the OCD and non-OCD groups. In patients with OCD, both short- (HR, 1.69 [95% CI, 0.74–3.88]; HR, 0.31 [95% CI, 0.05–1.95]) and long-term use (HR, 1.37 [95% CI, 0.60–3.16]; HR, 0.90 [95% CI, 0.22–3.76]) of OCD medications were not correlated with ischemic and hemorrhagic stroke compared with nonuse.

Conclusions:

Clinicians should closely monitor cerebrovascular disease and related risks in patients with OCD. The pathomechanism of OCD with an increased risk of ischemic stroke warrants further investigation.
Predictive Performance of a Polygenic Risk Score for Incident Ischemic Stroke in a Healthy Older Population
Authors: Neumann Johannes T. , Riaz Moeen , Bakshi Andrew , Polekhina Galina , Thao Le T.P. , Nelson Mark R. , Woods Robyn L. , Abraham Gad , Inouye Michael , Reid Christopher M. , Tonkin Andrew M. , Williamson Jeff D. , Donnan Geoffrey A. , Brodtmann Amy , Cloud Geoffrey C. , McNeil John J. , Lacaze Paul
Published: May 2021

Background and Purpose:

Polygenic risk scores (PRSs) can be used to predict ischemic stroke (IS). However, further validation of PRS performance is required in independent populations, particularly older adults in whom the majority of strokes occur.

Methods:

We predicted risk of incident IS events in a population of 12 792 healthy older individuals enrolled in the ASPREE trial (Aspirin in Reducing Events in the Elderly). The PRS was calculated using 3.6 million genetic variants. Participants had no previous history of cardiovascular events, dementia, or persistent physical disability at enrollment. The primary outcome was IS over 5 years, with stroke subtypes as secondary outcomes. A multivariable model including conventional risk factors was applied and reevaluated after adding PRS. Area under the curve and net reclassification were evaluated.

Results:

At baseline, mean population age was 75 years. In total, 173 incident IS events occurred over a median follow-up of 4.7 years. When PRS was added to the multivariable model as a continuous variable, it was independently associated with IS (hazard ratio, 1.41 [95% CI, 1.20–1.65] per SD of the PRS;
P
<0.001). The PRS alone was a better discriminator for IS events than most conventional risk factors. PRS as a categorical variable was a significant predictor in the highest tertile (hazard ratio, 1.74;
P
=0.004) compared with the lowest. The area under the curve of the conventional model was 66.6% (95% CI, 62.2–71.1) and after inclusion of the PRS, improved to 68.5 ([95% CI, 64.0–73.0]
P
=0.095). In subgroup analysis, the continuous PRS remained an independent predictor for large vessel and cardioembolic stroke subtypes but not for small vessel stroke. Reclassification was improved, as the continuous net reclassification index after adding PRS to the conventional model was 0.25 (95% CI, 0.17–0.43).

Conclusions:

PRS predicts incident IS in a healthy older population but only moderately improves prediction over conventional risk factors.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01038583.
Size-assortative mating in explosive breeders: a case study of adaptive male mate choice in anurans
Authors: Swierk Lindsey , Langkilde Tracy
Published: May 2021

Exploration of size-assortative mating (SAM) in animals has led to a near consensus that it arises through constraints in choice, such as preference for large females combined with a large male advantage during intrasexual competition. Although such ‘apparent’ SAM is well explored, whether SAM arises because of specific preferences for size-matched mates has been less thoroughly considered. We tested for ‘preference-based’ SAM in an explosively breeding frog (Rana sylvatica), quantifying how male and female sizes affected fertilization and if males preferred size-matched females. We found that size mismatch severely reduced fertilization. Furthermore, males preferred size-matched, not larger, females in mate choice trials. Because males that mated with much larger females fertilized fewer eggs overall than they would have with size-matched females, male preference for size-matched females may be adaptive. Our results expand understanding of the mechanisms underlying SAM, suggesting that multiple mechanisms may simultaneously cause size-assortative mating patterns to emerge.
When a Global War Befell a Global City: Recent Historiography on Wartime Shanghai
Authors: Yang Taoyu , Han Hongquan
Published: May 2021

Shanghai was the first Chinese city to bear the full brunt of Japanese aggression during the Second Sino-Japanese War (1937–1945). This historiographical article reviews the development of the study of wartime Shanghai in Chinese- and English-language academia in the past two decades. In the People’s Republic of China, Shanghai’s history during World War II has long been a favorite topic for academic historians. In the English-speaking world, however, the history of Shanghai’s wartime experience has only recently become a popular research topic. This article introduces many significant works related to wartime Shanghai, lays out important areas of inquiry, and identifies key historiographical trends. Its conclusion offers some suggestions on how the study of wartime Shanghai can be further advanced in the future.
An expanded concept of Madisonia including miscellaneous species of Pleurothallidinae (Orchidaceae): evidence from molecular analysis

Authors: SMIDT ERIC DE CAMARGO , TOSCANO DE BRITO A. L. V. , MAUAD ANNA VICTORIA SILVÉRIO R. , GUTIÉRREZ MORALES NICOLÁS
Published: May 2021

Prior taxonomic studies in subtribe Pleurothallidinae have suggested a close relationship between miscellaneous species featuring long-repent, segmented rhizomes, abbreviated ramicauls, few-flowered inflorescences, and flowers with partially connate sepals and trilobed lip. The lack of phylogenetic information for most species has prevented further conclusions or changes in their taxonomy; and as a result, they are currently assigned to several unrelated genera: Anathallis, Madisonia, Pabstiella, Pleurothallis, Sansonia and Specklinia. We performed phylogenetic analyses using nuclear (nrITS) and five plastid (matK, psbD-trnT, rps16-trnQ, trnH-psbA and trnS-trnG) markers and demonstrated that these species form an isolated clade which requires generic recognition. The name Madisonia, previously a monotypic genus endemic of the Amazon basin, is re-circumscribed and expanded to include nine species distributed in the Atlantic Rainforest and the Caribbean. Eight new nomenclatural combinations are proposed.
Copepods (Cyclopoida) associated with ascidian hosts: Ascidicolidae, Buproridae, Botryllophilidae, and Enteropsidae, with descriptions of 84 new species
Authors: KIM IL-HOI , BOXSHALL GEOFF A.
Published: May 2021

The Monniot collection of copepods associated with ascidian hosts was built up over several decades of field collecting and taxonomic research on ascidians by Drs Claude & Françoise Monniot (MNHN, Paris). This paper describes a total of 84 new species of copepods collected from ascidian hosts and five new genera are established. Prior to this study the family Ascidicolidae comprised two genera accommodating five valid species; here we add two new genera, Hamistyelicola gen. nov. and Bathycopola gen. nov., and eight new species in total. The family Buproridae comprised a single genus consisting of three species; here we add a new monotypic genus, Buprorides gen. nov. The family Botryllophilidae comprised 68 valid species in seven genera and here we add 45 new species; 13 of Botryllophilus Hesse, 1864, nine of Schizoproctus Aurivillius, 1885, three of Haplostomides Chatton & Harant, 1924, 12 of Haplostoma Chatton & Harant, 1924, seven of Haplostomella Chatton & Harant, 1924 and a single new species of Haplosaccus Chatton & Harant, 1924. The Enteropsidae comprised 42 species in five genera and here we add two new genera, Monnioticopa gen. nov. and Periboia gen. nov., plus a total of 30 new species; 15 of Enterocola van Beneden, 1860, two of Enterocolides Chatton & Harant, 1922, five of Enteropsis C.W.S. Aurivillius, 1885, five of Monnioticopa gen. nov., two of Mychophilus Hesse, 1865, plus the type species of Periboia gen. nov. Generic diagnoses are provided for all genera represented in the collection. A further 13 known species are also reported and brief supplementary descriptive notes or full redescriptions are provided, as appropriate.
The Association between Well-being Behaviors and Resilience in Health Care Workers
Authors: Rink Lesley C. , Silva Susan G. , Adair Kathryn C. , Oyesanya Tolu O. , Humphreys Janice C. , Sexton J. Bryan
Published: May 2021

Engaging in well-being behaviors may promote resilience, which can protect against burnout. This descriptive, correlational analysis utilized baseline data from health care workers enrolled in the Web-based Implementation of the Science for Enhancing Resilience longitudinal study ( N = 2,383). The study aimed to describe the association of (a) types of well-being behaviors (regular exercise, yoga, meditation, spent time with a close friend, vacation) and (b) total number of well-being behaviors with resilience (emotional thriving and emotional recovery), covarying for sociodemographic and professional characteristics. General linear model findings indicated that each well-being behavior was significantly associated with greater emotional thriving, while only exercise and spending time with friends were significantly related to greater emotional recovery. Emotional thriving and emotional recovery were also significantly higher among health care workers reporting more well-being behaviors. Engaging in well-being behaviors may be one part of the solution toward increasing resilience in health care workers that warrants further investigation.
Protecting the Public’s Health Through Successful Reentry for Sex Offender After Incarceration
Authors: Simmons Molly , Kim Bo , Hyde Justeen , Lemon Tiffany L. , Scharer Kirsten E. , McInnes D. Keith
Published: May 2021

This paper describes the post-incarceration reintegration experiences of military veterans convicted of sex offenses and identify potential interventions to ease reintegration for this population. Participants were a convenience sample of 14 veterans who were on sex offender (SO) registries and 21 community stakeholders involved in supporting persons during re-entry. Subjects were identified purposively and through snowball sampling, in Massachusetts. We employed semi-structured qualitative interviews of participants, followed by analysis including process mapping to identify barrier and facilitation points. We used both a grounded thematic approach and a priori codes, guided by the Behavioral Model for Vulnerable Populations. We found re-entry barriers include older age, stigma, lack of social support, inadequate information about sexual offense levels, limited housing options and access to mental health treatment to reduce sexual impulses, and re-entry information tailored to SOs. Re-entry facilitators include access to SO treatment, knowledge about services, self-efficacy, ability to self-advocate, and social support. Interventions to aid successful re-entry include pre-release counseling and classes tailored to SO needs, re-entry planning including housing resources, sexual deviance treatment, and referral to legal counseling to assist with altering assigned SO level. Specific needs and resources unique to veterans should be integrated into reentry plans. Convicted SOs often lack information and assistance to prepare for life after release, putting them at increased risk of homelessness, emotional difficulties, and financial hardship. Failure to recognize the unique needs of this population, and to leverage resources, creates a public health risk as it increases the likelihood that SOs will recidivate. Veterans who are SOs have unique resources available to them through the Veterans Administration such as SO treatment and peer-support specialists. Nevertheless there are additional steps that could be beneficial, such as timely provision of information, creating more opportunities for treatment, and providing more housing options.
Reading, Writing, Responding: Educators’ Perceptions of Safety, Preparedness, and Lockdown Drills
Authors: Schildkraut Jaclyn , Nickerson Amanda B. , Klingaman Kirsten R.
Published: May 2021

Lockdown drills are routinely conducted in schools across the U.S., yet little is known about the impact of such practices on participants—particularly for the faculty, staff, and administrators charged with student safety. The present study considers the effects of lockdown drills and associated emergency response training on perceived safety and preparedness at school for a sample of 3,000 school-based personnel in a large urban school district. After participating in drills and training, significant gains were made in perceived emergency preparedness, particularly among faculty and staff members, while perceived school safety—which already was particularly high—remained unaffected compared to ratings at baseline. Additionally, significant differences were found based upon respondent demographics, highlighting the importance in assessing subgroups’ needs during planning and implementation. Implications for school administration and relevant policymakers related to lockdown drills and training are considered within the context of creating a culture of preparedness.
Trajectory-following of a 4WID-4WIS vehicle via feedforward–backstepping sliding-mode control
Authors: Lei Yu-long , Wen Guanzheng , Fu Yao , Li Xingzhong , Hou Boning , Geng Xiaohu
Published: May 2021

Realisation of high-precision trajectory tracking is the key technology to achieve unmanned driving, which has an important impact on vehicle handling stability, safety and comfort. However, many confounding factors seriously restrict tracking performance and pose a great challenge to the design of the controller for tracking the desired trajectory. A comprehensive method that combines feedforward and backstepping sliding mode control is proposed for a four-wheel independent driving–four-wheel independent steering (4WID-4WIS) vehicle, which has the advantages of over-coupling, multiple degrees of freedom and flexible operation. The desired value is the target for the feedforward output of the controller, and the backstepping sliding mode control is used to overcome all kinds of disturbances. A mature and reliable Luenberger observer is designed to achieve good trajectory tracking performance for reducing some sensors. The proposed method is verified via MATLAB/Simulink simulation, which proved that the method has an excellent trajectory tracking performance.
Appointment Adherence to a City-Wide Cardiovascular Disease Prevention Program: Its Predictors and Outcomes
Authors: Choo Jina , Yang Hwa-Mi , Park Sooyeon , Park MiSuk , Park Yoo Mi , Lim Do-Sun
Published: May 2021

This study identified predictors of appointment adherence and examined its impacts on improvements in metabolic risk factors in a free city-wide cardiovascular disease prevention program in Seoul, South Korea. Data of 8251 citizens with metabolic syndrome were used. Appointment adherers were defined as having 70% or higher adherence rates, that is, 3 or more visits. Of the 8251 citizens, 17.6% were appointment adherers. Appointment adherers were significantly more likely to be older, low-income earners, nonsmokers, and nonobese than appointment nonadherers. Moreover, appointment adherers, compared with nonadherers, showed significant improvements in waist circumference, systolic blood pressure, and high-density lipoprotein cholesterol, but not in fasting glucose and triglycerides. Designing strategies for increasing appointment adherence to a free city-wide cardiovascular disease prevention program is essential to improve health outcomes, especially targeting population groups with young age, high-income, current smoking, or obesity.
The British Labour Party and the antisemitism crisis: Jeremy Corbyn and image repair theory
Authors: Heppell Timothy
Published: May 2021

This article utilises the work of William Benoit on image repair theory as a framework for examining the crisis communication of Jeremy Corbyn in relation to antisemitism within the Labour Party. By examining the self-defence rhetoric of Corbyn on the antisemitism allegations, the article identifies the following. Of the five strategies for crisis communication, Corbyn was overly reliant on denial, evading responsibility and reducing offensiveness; struggled to explain his attempts at corrective action; and reverted to accepting responsibility – that is, apologies – reluctantly and belatedly. Utilising existing perspectives on the most effective strategies for image repair – which emphasise the importance of effective corrective action and accepting responsibility at the expense of denial, evading responsibility and reducing effectiveness – the article argues that Corbyn undermined his own attempts at image repair in the crisis that defined his leadership.
Social workers’ constructions of parents to children in foster care
Authors: Wissö Therése , Melke Anna , Josephson Irene
Published: May 2021

Parents of children in out-of-home care receive little support from social services. Drawing on qualitative data collected in the project ‘Parent at a distance’, in which social services in seven municipalities in Sweden aimed to improve support to parents whose children are placed in foster care, this paper explores social workers’ discourses about parents to children in care. The analysis is based on focus group data in which a total of 52 social workers reflected on parents to children in care and how they can be supported by social services. The concept of interpretive repertoires was used to analyse how social workers in interaction construct parents and their support needs. The identified repertoires of change, acceptance, permanency, biology and non-biology may contribute to the understanding of why so few parents receive support, even though legislation stipulates that placements should be temporary. The paper concluded that discourses may shape support practices and thus it is crucial that social workers reflect on and develop their awareness about their constructions of parents and their role for children in out-of-home care.
Preventive screening for intracranial aneurysms
Authors: Rinkel Gabriel JE , Ruigrok Ynte M
Published: May 2021

Background

Subarachnoid hemorrhage from rupture of an intracranial aneurysm (aneurysmal subarachnoid hemorrhage) is a devastating subset of stroke. Since brain damage from the initial hemorrhage is a major cause for the poor outcome after aneurysmal subarachnoid hemorrhage, prevention of aneurysmal subarachnoid hemorrhage has the highest potential to prevent poor outcome from aneurysmal subarachnoid hemorrhage.

Aim

In this review, we describe the groups at high risk of aneurysmal subarachnoid hemorrhage who may benefit from preventive screening for unruptured intracranial aneurysms followed by preventive treatment of unruptured intracranial aneurysms found. Furthermore, we describe the advantages and disadvantages of screening and advise how to perform counseling on screening.

Summary of review

Modeling studies show that persons with two or more affected first-degree relatives with aneurysmal subarachnoid hemorrhage and patients with autosomal dominant polycystic kidney disease (ADPKD) are candidates for screening for unruptured intracranial aneurysms. One modeling study also suggests that persons with only one affected first-degree relative with aneurysmal subarachnoid hemorrhage are also likely candidates for screening. Another group who may benefit from screening are persons ≥35 years who smoke(d) and are hypertensive, given their high lifetime risk of aneurysmal subarachnoid hemorrhage of up to 7%, but the prevalence of unruptured intracranial aneurysms in such persons and the efficiency and cost-effectiveness of screening in this group are not yet known. The ultimate goal of screening is to increase the number of quality years of life of the screening candidates, and therefore the benefits but also many downsides of screening –such as risk of incidental findings, very small unruptured intracranial aneurysms that require regular follow-up, preventive treatment with inherent risk of complications and anxiety – should be discussed with the candidate so that an informed decision can be made before intracranial vessels are imaged.

Conclusions

Several groups of persons who may benefit from screening have been identified, but since these constitute only a minority of all aneurysmal subarachnoid hemorrhage patients, additional high-risk groups still need to be identified. Further research is also needed to identify persons at low or high risk of aneurysmal development and rupture within the groups identified thus far to improve the efficiency of screening. Moreover, if new medical treatment strategies that can reduce the risk of rupture of unruptured intracranial aneurysm become available, the groups of persons who may benefit from screening could increase considerably.
Comparison of raloxifene effect on the growth and angiogenesis of human endometrium of healthy and endometriosis subjects: An in vitro three-dimensional tissue culture model
Authors: Ranjbarvan Parviz , Khazaei Fatemeh , Chobsaz Farzaneh , Khazaei Mozafar
Published: May 2021

Introduction:

Raloxifene (Ral) is the oldest SERM (selective oestrogen receptor modulators) for treatment of breast cancer and osteoporosis. Its oestrogen-modulating effects have been shown in breast and uterus. Since there is little available data on direct Ral effect on the human endometrium, the aim of present study was to investigate the Ral effect on the growth and angiogenesis of the human endometrium of healthy and endometriosis subjects in an in vitro three-dimensional (3D) tissue culture model.

Material and methods:

Endometrial biopsies from healthy ( n = 9) and endometriosis ( n = 7) patients (endometriotic) were taken and were cut into 1 × 1 mm fragments and implanted between two layers of fibrin jell made by fibrinogen solution (3 mg/ml in medium 199+thrombin). Tissue cultures were performed in 24-wel culture plates. Each biopsy was divided into control wells which received M199 supplemented with FBS (5%) and experimental wells which received same media containing one of raloxifene doses (0.1, 1 and 10 μM). Endometrial tissues were photographed at the beginning and the end of the study period (21 days). Tissue growth and angiogenesis were determined by a scoring system.

Results:

In control (0), 0.1, 1 and 10 μM Ral, the growth score of normal human endometrial tissues were 1.99, 1.72, 1.53 and 1.12 ( p = 0.02) and angiogenesis percent were 29.6%, 31.28%, 33% and 11.5%. The Growth scores of the endometriotic endometrium were 1.92, 1.82, 1.92 and 1.1 ( p = 0.008) and angiogenesis percent were 36.6%, 16.6%, 44% and 12.5% respectively.

Conclusion:

Raloxifene showed a different dose dependent effect on endometrial and endometriotic tissue.
Aluminium release and fluid warming: provocational setting and devices at risk
Authors: Perl Thorsten , Kunze-Szikszay N. , Bräuer A. , Quintel M. , Roy T. , Kerpen K. , Telgheder U.
Published: May 2021

Background

Fluid warming, recommended for fluid rates of > 500 ml h-1, is an integral part of patient temperature management strategies. Fluid warming devices using an uncoated aluminium containing heating element have been reported to liberate aluminium resulting in critical aluminium concentrations in heated fluids. We investigated saline solution (0.9%), artificially spiked with organic acids to determine the influence of fluid composition on aluminium release using the uncoated enFlow® device. Additionally, the Level1® as a high volume fluid warming device and the ThermoSens® device were investigated with artificial spiked fluid at high risk for aluminum release and a clinically used crystalloid solution.

Results

Saline solution spiked with lactate more than acetate, especially at a non neutral pH, led to high aluminium release. Next to the enFlow® device, aluminium release was observed for the Level1® device, but not for the coated ThermoSens®-device.

Conclusion

Uncoated aluminium containing fluid warming devices lead to potentially toxic levels of aluminium in heated fluids, especially in fluids with non-neutral pH containing organic acids and their salts like balanced electrolyte solutions.
Prognostic Nomogram for patients undergoing radical Pancreaticoduodenectomy for adenocarcinoma of the pancreatic head
Authors: Wu Chao , Hou Sheng Zhong , Wu Zuowei , Huang Xing , Wang Zihe , Tian Bole
Published: May 2021

Background

Radical pancreaticoduodenectomy is the most common treatment strategy for patients diagnosed with adenocarcinoma of the pancreatic head. Few studies have reported the clinical characteristics and treatment efficacies of patients undergoing radical pancreaticoduodenectomy for adenocarcinoma of the pancreatic head.

Methods

A total of 177 pancreatic head cancer patients who underwent radical pancreaticoduodenectomy and were pathologically confirmed as having pancreatic ductal adenocarcinoma were screened in the West China Hospital of Sichuan University. The multivariate analysis results were implemented to construct a nomogram. The concordance index (c-index), the area under the curve (AUC) and calibration were utilized to evaluate the predictive performance of the nomogram.

Results

The prognostic nutritional index (PNI), the lymph node ratio (LNR) and the American Joint Committee on Cancer (AJCC) staging served as independent prognostic factors and were used to construct the nomogram. The c-indexes of the nomogram were 0.799 (confidence interval (CI), 0.741–0.858) and 0.732 (0.657–0.807) in the primary set and validation set, respectively. The AUCs of the nomogram at 1 and 3 years were 0.832 and 0.783, which were superior to the AJCC staging values of 0.759 and 0.705, respectively.

Conclusions

The nomogram may be used to predict the prognosis of radical resection for adenocarcinoma of the pancreatic head. These findings may represent an effective model for the developing an optimal therapeutic schedule for malnourished patients who need early effective nutritional intervention and may promote the treatment efficacy of resectable adenocarcinoma of the pancreatic head.
Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence
Authors: Granieri Stefano , Sessa Francesco , Bonomi Alessandro , Paleino Sissi , Bruno Federica , Chierici Andrea , Sciannamea Ivano Massimiliano , Germini Alessandro , Campi Riccardo , Talso Michele , Facciorusso Antonio , Deiana Gianfranco , Serni Sergio , Cotsoglou Christian
Published: May 2021

Background

Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients.

Methods

A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity.

Results

Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively.

Conclusions

Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).
Healthcare planning across healthcare sectors in Baden-Wuerttemberg, Germany: a stakeholder online survey to identify indicators
Authors: Wronski Pamela , Koetsenruijter Jan , Ose Dominik , Paulus Jan , Szecsenyi Joachim , Wensing Michel
Published: May 2021

Background

Stakeholders in the German state of Baden-Wuerttemberg agreed upon the central aims for healthcare planning. These include a focus on geographical districts; a comprehensive, cross-sectoral perspective on healthcare needs and services; and use of regional data for healthcare planning. Therefore, healthcare data at district level is needed. Nevertheless, decision makers face the challenge to make a selection from numerous indicators and frameworks, which all have limitations or do not well apply to the targeted setting. The aim of this study was to identify district level indicators to be used in Baden-Wuerttemberg for the purpose of cross-sectoral and needs-based healthcare planning involving stakeholders of the health system.

Methods

A conceptual framework for indicators was developed. A structured search for indicators identified 374 potential indicators in indicator sets of German and international institutions and agencies (n = 211), clinical practice guidelines (n = 50), data bases (n = 35), indicator databases (n = 25), published literature (n = 35), and other sources (n = 18). These indicators were categorised according to the developed framework dimensions. In an online survey, institutions of various stakeholders were invited to assess the relevance of these indicators from December 2016 until January 2017. Indicators were selected in terms of a median value of the assessed relevance.

Results

22 institutions selected 212 indicators for the five dimensions non-medical determinants of health (20 indicators), health status (25), utilisation of the health system (34), health system performance (87), and healthcare provision (46).

Conclusions

Stakeholders assessed a large number of indicators as relevant for use in healthcare planning on district level.

Trial registration

Not applicable.
miR-1250-5p is a novel tumor suppressive intronic miRNA hypermethylated in non-Hodgkin’s lymphoma: novel targets with impact on ERK signaling and cell migration
Authors: Zhang Min Yue , Wang Lu Qian , Chim Chor Sang
Published: May 2021

Background

miR-1250 is localised to the second intron of AATK at chromosome 17q25. As a CpG island is present at the putative promoter region of its host gene, AATK, we postulated that the intronic miR-1250-5p is a tumor suppressor miRNA co-regulated with its host gene, AATK, by promoter DNA methylation in non-Hodgkin’s lymphoma (NHL).

Methods

AATK/miR-1250 methylation was studied in healthy controls, including ten normal peripheral blood buffy coats and eleven normal tonsils, ten lymphoma cell lines, and 120 primary lymphoma samples by methylation-specific PCR (MSP). The expression of miR-1250-5p and AATK was investigated by quantitative real-time PCR. Tumor suppressor properties of miR-1250-5p were demonstrated by over-expression of precursor miR-1250-5p in lymphoma cells. The target of miR-1250-5p was verified by luciferase reporter assay.

Results

AATK/miR-1250 methylation was absent in healthy peripheral blood and tonsils, but detected in five (50%) NHL cell lines. AATK/miR-1250 methylation correlated with repression of miR-1250-5p and AATK in NHL cell lines. In completely methylated SU-DHL-6 and SUP-T1 cells, treatment with 5-AzadC led to promoter demethylation and re-expression of both miR-1250-5p and AATK. In primary lymphoma samples, AATK/miR-1250 was frequently methylated in B-cell lymphoma (n = 41, 44.09%) and T-cell lymphoma (n = 9, 33.33%) with a comparable frequency (P = 0.318). In SU-DHL-6 and SU-DHL-1 cells, restoration of miR-1250-5p resulted in decreased cellular proliferation by MTS assay, increased cell death by trypan blue staining and enhanced apoptosis by annexin V-PI assay. Moreover, MAPK1 and WDR1 were verified as direct targets of miR-1250-5p by luciferase assay. In 39 primary NHLs, miR-1250-5p expression was shown to be inversely correlated with each of MAPK1 (P = 0.05) and WDR1 (P = 0.031) by qRT-PCR. Finally, in SU-DHL-1 cells, overexpression of miR-1250-5p led to repression of MAPK1 and WDR1 at both transcript and protein levels, with downregulation of phospho-ERK2 by Western-blotting and inhibition of SDF-1-dependent cell migration by transwell assay.

Conclusions

miR-1250-5p is a novel tumor suppressive intronic miRNA co-regulated and silenced by promoter DNA methylation of its host gene AATK in NHL. MAPK1 and WDR1 are novel miR-1250-5p direct targets rendering inhibition of MAPK/ERK signaling and SDF-1-dependent cell migration, hence implicated in survival and dissemination of lymphoma.
Ethnic and minority group differences in engagement with COVID-19 vaccination programmes – at Pandemic Pace; when vaccine confidence in mass rollout meets local vaccine hesitancy
Authors: Reid John A. , Mabhala Mzwandile A.
Published: May 2021

Israel, the UK, the USA, and some other wealthier countries lead in the implementation of COVID-19 vaccine mass vaccination programmes. Evidence from these countries indicates that their ethnic minorities could be as disproportionately disadvantaged in COVID-19 vaccines roll-out as they were affected by COVID-19-related serious illnesses. Their disadvantage is linked to their lower social status and fewer social goods compared with dominant population groups.

Albeit limited by methodology, early studies attribute lower uptake of COVID-19 amongst ethnic minorities to the wider determinants of vaccine uptake, hesitancy or lack of vaccine confidence, including lower levels of trust and greater concerns about vaccine safety. Early sentinel studies are needed in all early adopter countries.

One emerging theme among those of reproductive age in minority communities concerns a worry regarding COVID-19 vaccine’s potential adverse effect on fertility. Respected professional groups reassure this is not a credible rationale. Drug and vaccine regulators use understandable, cautious and conditional language in emergency licencing of new gene-based vaccines. Technical assessments on whether there is any potential genotoxicity or reproductive toxicity should be more emphatic.

From a public health perspective, sentinel studies should identify such community concerns and act early to produce convincing explanations and evidence. Local public health workforces need to be diverse, multiskilled, and able to engage well with minorities and vulnerable groups. The local Directors of Public Health in the UK are based in each local government area and have a remit and opportunity to stimulate speedy action to increase vaccine uptake.

During the rapid Pandemic Pace of the vaccines roll-out, extra efforts to minimise uptake variations are likely to achieve improvements in the next year or two. We expect variations will not disappear however, given that underlying inequalities persist in less inclusive social systems.
Detecting web attacks using random undersampling and ensemble learners
Authors: Zuech Richard , Hancock John , Khoshgoftaar Taghi M.
Published: May 2021

Class imbalance is an important consideration for cybersecurity and machine learning. We explore classification performance in detecting web attacks in the recent CSE-CIC-IDS2018 dataset. This study considers a total of eight random undersampling (RUS) ratios: no sampling, 999:1, 99:1, 95:5, 9:1, 3:1, 65:35, and 1:1. Additionally, seven different classifiers are employed: Decision Tree (DT), Random Forest (RF), CatBoost (CB), LightGBM (LGB), XGBoost (XGB), Naive Bayes (NB), and Logistic Regression (LR). For classification performance metrics, Area Under the Receiver Operating Characteristic Curve (AUC) and Area Under the Precision-Recall Curve (AUPRC) are both utilized to answer the following three research questions. The first question asks: “Are various random undersampling ratios statistically different from each other in detecting web attacks?” The second question asks: “Are different classifiers statistically different from each other in detecting web attacks?” And, our third question asks: “Is the interaction between different classifiers and random undersampling ratios significant for detecting web attacks?” Based on our experiments, the answers to all three research questions is “Yes”. To the best of our knowledge, we are the first to apply random undersampling techniques to web attacks from the CSE-CIC-IDS2018 dataset while exploring various sampling ratios.
Integrative taxonomy resolves species identities within the Macrobiotus pallarii complex (Eutardigrada: Macrobiotidae)
Authors: Stec Daniel , Vecchi Matteo , Dudziak Magdalena , Bartels Paul J. , Calhim Sara , Michalczyk Łukasz
Published: May 2021

The taxonomy of many groups of meiofauna is challenging due to their low number of diagnostic morphological characters and their small body size. Therefore, with the advent of molecular techniques that provide a new source of traits, many cryptic species have started to be discovered. Tardigrades are not an exception, and many once thought to be cosmopolitan taxa are being found to be complexes of phenotypically similar species.Macrobiotus pallariiMaucci, 1954 was originally described in South Italy and has been subsequently recorded in Europe, America, and Asia. This allegedly wide geographic range suggests that multiple species may be hidden under this name. Moreover, recently, genetic evidence to support this was put forward, and theMacrobiotus pallariicomplex has been proposed to accommodate putative species related toM. pallarii. Here, we describe three new pseudocryptic species based on populations that would have been all classified asMacrobiotus pallariiif molecular methods were not employed. Using an integrative taxonomy approach, we analyzed animals and eggs from the topotypic population ofMacrobiotus pallarii, together with four other populations of the complex. We recovered four distinct phylogenetic lineages that, despite the overlap of morphometric traits, can be separated phenotypically by subtle but discrete morphological characters. One lineage corresponds toMacrobiotus pallarii, whereas the other three are newly described asMacrobiotus margoaeStec, Vecchi & Bartels,sp. nov. from the USA,Macrobiotus ripperiStec, Vecchi & Michalczyk,sp. nov. from Poland and Finland, andMacrobiotus pseudopallariiStec, Vecchi & Michalczyk,sp. nov. from Montenegro. To facilitate species identification, we provide a dichotomous key for species of theM. pallariicomplex. Delimitation of these pseudocryptic taxa highlights the need for an integrative approach to uncover the phylum’s diversity in full.
Neoadjuvant Capecitabine and Oxaliplatin Before Concurrent Capecitabine and Radiation in Locally Advanced Rectal Cancers: Experience of a Cancer Hospital in Pakistan
Authors: Mansha Muhammad Atif , Waheed Asmara , Sadaf Tabinda , Rashid Asma , Irfan Nabia , Chaudry Samreen Javed
Published: May 2021

PURPOSE

To report the toxicity and pathologic response rates after adding neoadjuvant capecitabine and oxaliplatin (CAPOX) followed by concurrent radiation and capecitabine (CAPRT) and surgery in patients with locally advanced rectal cancer.

MATERIALS AND METHODS

We retrospectively analyzed medical records of 301 patients between January 2007 and December 2014. Patients were treated with four cycles of neoadjuvant chemotherapy comprising CAPOX, followed by radiotherapy at doses of 45-54 Gy in 25-30 fractions with concurrent capecitabine. A response assessment scan was performed at 4-6 weeks postradiation followed by surgical evaluation at 6-8 weeks. Pathologic tumor and nodal response rates as well as circumferential resection margin were assessed on surgical specimens.

RESULTS

The median age of the patients was 43 years (range, 16-78). Overall, 227 (75.4%) patients were able to complete four cycles of CAPOX. Neoadjuvant chemotherapy was well-tolerated with no serious adverse effects. The most common toxicity was diarrhea (grade 2, n = 108; 35.8%; grade 3, n = 57; 18.9%; grade 4, n = 25; 8.3%) followed by neuropathy (grade 2, n = 132; 43.8%; grade 3, n = 54; 17.9%) and oral mucositis (grade 2, n = 108; 35.8%; grade 3, n = 47; 15.6%; grade 4, n = 9; 2.99%). A total of 229 (76.1%) patients underwent surgery. Pathologic complete response was seen in 52 (22.7%; 95% CI, 13 to 28), whereas 200 (87.3%; 95% CI, 82 to 99) patients had a negative circumferential resection margin on pathology.

CONCLUSION

Neoadjuvant chemotherapy with CAPOX before CAPRT and planned total mesorectal excision surgery result in good tumor regression and substantial pathologic complete response rates with acceptable toxicity. With growing interest in organ preservation in rectal cancer, the strategy of completing all chemotherapy and chemoradiotherapy before planned surgery offers a favorable paradigm. However, further randomized clinical trials are needed to support this evidence.