bluuebunny/crossref_metadata_2025 huggingface dataset:
Cutaneous JAK Expression in Vitiligo
Authors: Abdel Motaleb Amira A. , Tawfik Yasmin M. , El-Mokhtar Mohamed A. , Elkady Sherouk , El-Gazzar Amira F. , ElSayed Suzan Kamel- , Awad Sara M.
Published: November 2020

Background

The Janus kinase–signal transducer and activator of transcription signaling pathway has been suggested as a promising therapeutic target in vitiligo. However, limited data is available on the cutaneous expression of JAK in vitiligo.

Aim

This study is designed to analyze the cutaneous expression patterns of JAK1, 2, and 3 in vitiligo and investigate their relation to the disease clinical parameters.

Methods

This case–control study recruited 24 patients having active vitiligo and 20 age, sex, and skin type-matched healthy volunteers. Skin biopsies were obtained from patients (lesional, perilesional and nonlesional) and controls for assessment of JAK1, 2, and 3 expression using RT-PCR.

Results

JAK1 and JAK3 were overexpressed in patients’ skin compared to control skin and showed a stepwise pattern of upregulation from control to nonlesional, perilesional and lesional skin. However, JAK3 showed much stronger expression. In contrast JAK2 expression showed no significant difference in any of lesional, perilesional or nonlesional skin compared to control skin. JAK1 and JAK3 expression levels showed no correlation with neither the disease activity nor severity.

Conclusion

JAK1 and more prominently JAK3 are upregulated in vitiliginous skin and possibly contribute to the pathogenesis of the disease. Accordingly, selective JAK3/1 inhibition may provide a favorable therapeutic opportunity for vitiligo patients. This study is registered on the ClinicalTrials.gov Identifier: NCT03185312
Race-Specific Prevalence of Hidradenitis Suppurativa
Authors: Sachdeva Muskaan , Shah Monica , Alavi Afsaneh
Published: November 2020

Hidradenitis suppurativa (HS) is a chronic, inflammatory disease affecting approximately 1% of the global population. While age- and sex-specific prevalence of HS is well documented in literature, few studies have explored trends in racial predilections for HS. The objective of this study is to investigate the race-specific prevalence of HS. MEDLINE and EMBASE searches were conducted in the OVID database. Keywords included variations of “race,” “ethnicity,” “country,” “prevalence,” and “Hidradenitis suppurativa.” Studies were included if they were written in English or French, conducted on human participants, and had data on HS and race-specific prevalence. Meta-analyses, systematic and literature reviews, and irrelevant articles were excluded. Thirty-nine out of 184 articles met the inclusion criteria after abstract and full-text screening. Population distribution was scaled according to country-specific demographics reports. These demographic reports were extracted from each country’s national statistics report. The average HS prevalence rates were highest in African American populations (1.3%), lowest in Hispanics/Latinos (0.07%), and intermediate amongst Caucasian populations (0.75%). Total prevalence in all other ethnic groups (0.17%) was minor in comparison to African American and Caucasian populations. Since the highest rates of HS were found among African American population, literature has highlighted the possibility of a genetic etiology in HS development. However, further literature examining race-specific prevalence of HS internationally is required to accurately assess the frequency and underlying etiology of HS among varying racial populations.
Long Noncoding RNA PTPRG Antisense RNA 1 Reduces Radiosensitivity of Nonsmall Cell Lung Cancer Cells Via Regulating MiR-200c-3p/TCF4
Authors: Ma Qiang , Niu Rungui , Huang Wei , Da Liangshan , Tang Yanlei , Jiang Daowen , Xi Yanfeng , Zhang Congjun
Published: November 2020

Background:

PTPRG antisense RNA 1 has been well-documented to exert an oncogenic role in diverse neoplasms. However, the precise role of PTPRG antisense RNA 1 in regulating radiosensitivity of nonsmall cell lung cancer cells remains largely elusive.

Methods:

Expression levels of PTPRG antisense RNA 1 and miR-200c-3p in nonsmall cell lung cancer tissues and cells were detected by quantitative real-time polymerase chain reaction, while transcription factor 4 expression was examined by immunohistochemistry and Western blot. After nonsmall cell lung cancer cells were exposed to X-ray with different doses in vitro, Cell Counting Kit -8 assay and colony formation assay were conducted to determine the influence of PTPRG antisense RNA 1 on cell viability. Interaction between miR-200c-3p and PTPRG antisense RNA 1 as well as transcription factor 4 was investigated by dual luciferase reporter assay.

Result:

In nonsmall cell lung cancer tissues, the expressions of PTPRG antisense RNA 1 and transcription factor 4 were significantly upregulated, whereas the expression of miR-200c-3p was downregulated. It was also proved that PTPRG antisense RNA 1 and 3′-untranslated region of transcription factor 4 can bind to miR-200c-3p. Under X-ray irradiation, overexpressed PTPRG antisense RNA 1 could promote the viability and enhance the radioresistance of nonsmall cell lung cancer cells, and this effect was partially weakened by miR-200c-3p mimics. Transcription factor 4 was identified as a target gene of miR-200c-3p, which could be positively regulated by PTPRG antisense RNA 1.

Conclusion:

PTPRG antisense RNA 1 reduces the radiosensitivity of nonsmall cell lung cancer cells via modulating miR-200c-3p/TCF4 axis.
A Comparison of the Short-Term Clinical Effects Between Totally Laparoscopic Radical Gastrectomy With Modified Roux-en-Y Anastomosis and Laparoscopic-Assisted Radical Gastrectomy With Roux-en-Y Anastomosis
Authors: Zhu Guangsheng , Hu Junjie , Lu Li , Wei Shaozhong , Xiong Zhiguo
Published: November 2020

Objective:

To compare the short-term clinical effects between totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis, and laparoscopic-assisted radical gastrectomy with Roux-en-Y anastomosis; to explore the safety, feasibility and short-term effect of totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis.

Methods:

Data of 75 patients who underwent totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis, and 95 patients who underwent laparoscopic-assisted radical gastrectomy with Roux-en-Y anastomosis by the same surgical team were analyzed. During the modified Roux-en-Y anastomosis, the stomach separation and regional lymph node dissection were completed under a laparoscope; the specimen was placed in a bag; gastrojejunostomy was completed; the subumbilicus hole was enlarged to 3 cm; the specimen was taken out; then, the proximal and distal ends of the small intestine were moved outside of the abdominal wall to complete the small intestine-small intestine end-to-side anastomosis.

Results:

All 170 operations were successful. The differences in the time of anastomosis and the number of dissected lymph nodes between the 2 groups were not statistically significant (P > 0.05), but in the totally-MA group the amount of bleeding and the length of incision significantly decreased (P < 0.05). The recovery time as measured by breathing unassisted, drinking fluids and getting out of bed was significantly shorter than those in the laparoscopic-assisted group (P < 0.05), and the pain score 1 day after surgery was significantly lower than that of the laparoscopic-assisted group (P < 0.05). One case of duodenal stump leakage and 1 case of esophagojejunostomy leakage were found in the laparoscopic-assisted group. In the totally-MA group, there were no complications such as anastomotic leakage, anastomotic stenosis or anastomotic bleeding, but 2 patients with double primary carcinoma underwent joint radical resection.

Conclusion:

Compared with laparoscopic-assisted surgery, totally laparoscopic radical gastrectomy with modified Roux-en-Y anastomosis has the advantages of being safer and less traumatic, with associated reductions in bleeding and pain.
Identification of potential lipid biomarkers for active pulmonary tuberculosis using ultra-high-performance liquid chromatography-tandem mass spectrometry
Authors: Han Yu-Shuai , Chen Jia-Xi , Li Zhi-Bin , Chen Jing , Yi Wen-Jing , Huang Huai , Wei Li-Liang , Jiang Ting-Ting , Li Ji-Cheng
Published: November 2020

Early diagnosis of active pulmonary tuberculosis (TB) is the key to controlling the disease. Host lipids are nutrient sources for the metabolism of Mycobacterium tuberculosis. In this research work, we used ultra-high-performance liquid chromatography-tandem mass spectrometry to screen plasma lipids in TB patients, lung cancer patients, community-acquired pneumonia patients, and normal healthy controls. Principal component analysis, orthogonal partial least squares discriminant analysis, and K-means clustering algorithm analysis were used to identify lipids with differential abundance. A total of 22 differential lipids were filtered out among all subjects. The plasma phospholipid levels were decreased, while the cholesterol ester levels were increased in patients with TB. We speculate that the infection of M. tuberculosis may regulate the lipid metabolism of TB patients and may promote host-assisted bacterial degradation of phospholipids and accumulation of cholesterol esters. This may be related to the formation of lung cavities with caseous necrosis. The results of receiver operating characteristic curve analysis revealed four lipids such as phosphatidylcholine (PC, 12:0/22:2), PC (16:0/18:2), cholesteryl ester (20:3), and sphingomyelin (d18:0/18:1) as potential biomarkers for early diagnosis of TB. The diagnostic model was fitted by using logistic regression analysis and combining the above four lipids with a sensitivity of 92.9%, a specificity of 82.4%, and the area under the curve (AUC) value of 0.934 (95% CI 0.873 – 0.971). The machine learning method (10-fold cross-validation) demonstrated that the model had good accuracy (0.908 AUC, 85.3% sensitivity, and 85.9% specificity). The lipids identified in this study may serve as novel biomarkers in TB diagnosis. Our research may pave the foundation for understanding the pathogenesis of TB.
The use of DNA methylation clock in aging research
Authors: He Xi , Liu Jiaojiao , Liu Bo , Shi Jingshan
Published: November 2020

One of the key characteristics of aging is a progressive loss of physiological integrity, which weakens bodily functions and increases the risk of death. A robust biomarker is important for the assessment of biological age, the rate of aging, and a person's health status. DNA methylation clocks, novel biomarkers of aging, are composed of a group of cytosine-phosphate-guanine dinucleotides, the DNA methylation status of which can be used to accurately measure subjective age. These clocks are considered accurate biomarkers of chronological age for humans and other vertebrates. Numerous studies have demonstrated these clocks to quantify the rate of biological aging and the effects of longevity and anti-aging interventions. In this review, we describe the purpose and use of DNA methylation clocks in aging research.
Bleomycin for orbital and peri-orbital veno-lymphatic malformations – A systematic review
Authors: Faiz Khunsa , Finitsis Stephanos , Linton Janice , Shankar Jai Jai Shiva
Published: November 2020

Background

Orbital and peri-orbital venolymphatic malformations (VLM) are low flow vascular malformations. Intralesional bleomycin is now commonly being used to treat such malformations.

Objective

The purpose of this systematic review is to synthesize evidence on the safety and efficacy of bleomycin/pingyangmycin sclerotherapy for the treatment of orbital and peri-orbital VLM.

Methods

We searched Medline, Embase, Scopus and Cochrane database for studies reporting outcomes of bleomycin/pingyangmycin sclerotherapy for orbital and peri-orbital VLM between 1974 to April 5th, 2019. Nine retrospective cohort studies enrolling 132 patients were included. Two reviewers independently screened and extracted data and assessed the risk of bias. Predefined outcome measures were subjective and objective reduction of the lesion and associated complications.

Results

Subjective reduction of the lesions was seen in 96.2% of the studies. Objective reduction of the lesion and symptomatic improvement were reported in 91.6 and 95% of the studies respectively. Non responders were 9.0%. Minor adverse events were reported in 18.1% of the studies. Major complications like pulmonary toxicity or pulmonary fibrosis was not encountered in any of the included studies. Quality of evidence was generally low.

Conclusion

Bleomycin/pingyangmycin sclerotherapy is very effective and relatively safe for the treatment of orbital and periorbital VLM and is not associated with any major side effects including pulmonary fibrosis. Limitations: The systematic review is limited mainly due to low quality of the included studies with retrospective design.
Randomized controlled study on the effects of triple therapy including vonoprazan or rabeprazole for the second-line treatment of Helicobacter pylori infection
Authors: Hojo Mariko , Asaoka Daisuke , Takeda Tsutomu , Shimada Yuji , Matsumoto Kenshi , Matsumoto Kohei , Yatagai Noboru , Akazawa Yoichi , Ueda Kumiko , Ueyama Hiroya , Nagahara Akihito
Published: November 2020

Background and Aim:

Inhibition of gastric acid secretion is important for eradicating Helicobacter pylori. Vonoprazan (VPZ) is a strong, long-lasting inhibitor of gastric acid secretion. Studies that examined the effectiveness of VPZ-based triple therapy in second-line treatment have been performed. However, there have been no randomized controlled studies to compare the effect between VPZ-based triple therapy and proton pump inhibitor (PPI)-based triple therapy in second-line treatment, and it is not known which is more effective between VPZ-based and PPI-based therapies. This study aimed to compare the effectiveness of second-line triple therapies including VPZ or rabeprazole (RPZ) as the PPI.

Methods:

Eligible patients with H. pylori infection who failed first-line triple therapy were assigned randomly to the VPZ [VPZ40 mg/day, amoxicillin (AMPC) 1500 mg/day, metronidazole (MNZ) 500 mg/day] or RPZ (RPZ20 mg/day, AMPC1500 mg/day, MNZ500 mg/day) group. A 13C-urea breath test result of less than 2.5% was considered as successful eradication.

Results:

In total, 46 and 41 patients were analyzed as intention to treat (ITT) and per protocol (PP), respectively. Eradication rates in the VPZ and RPZ groups were 73.9% [95% confidence interval (CI) 51.6–89.8%] and 82.6% (95% CI 61.2–95.0%) based on ITT analysis, respectively ( p = 0.72). Based on PP analysis, the eradication rates in the VPZ and RPZ groups were 89.5% (95% CI 66.9–98.7%) and 86.4% (95% CI 65.1–97.1%), respectively ( p = 1.00). Two patients in the VPZ group and one in the RPZ group discontinued treatment due to side effects ( p = 1.00).

Conclusion:

There were no significant differences in efficacy and safety between second-line therapies including VPZ or RPZ.
Nursing students’ experiences of peer learning in a dedicated educational unit in municipal home healthcare: A phenomenological study
Authors: Sandvik Ann-Helén , Karlsson Pernilla , Zetterman Agnes , Eskilsson Camilla
Published: November 2020

The shift from hospital-based nursing care to municipal home healthcare has led to the provision of more diverse, complex and advanced nursing care in this context. This poses challenges for undergraduate nursing students’ clinical education. The aim of this study was to describe nursing students’ experiences of learning nursing care through peer learning in a dedicated educational unit in municipal home healthcare. Data were collected through interviews with seven nursing students. The analysis was based on a reflective lifeworld research approach. The study followed the COREQ checklist. Strong cooperation and feelings of safety were found to boost learning and encourage the students to challenge themselves. Alternating between an observational and an active role during independent home visits was beneficial for intertwining caring and learning. Further, being trusted to work independently increased their ethical orientation, knowledge, self-esteem and self-confidence.
ATC Mw7.1 Puebla–Morelos earthquake reconnaissance observations: Seismological, geotechnical, ground motions, site effects, and GIS mapping
Authors: Diaz-Fanas Guillermo , Garini Evangelia , Ktenidou Olga-Joan , Gazetas George , Vaxevanis Themis , Lan Yun Jennifer , Heintz Jon , Ma Xin , Korre Evangelia , Valles-Mattox Rodolfo , Stavridis Andreas , Kim Insung , Hernandez-Bassal Laura , Anzola Esteban , Berkowitz Russell , Hussain Saif , Jalalian Afshar , Carrion Homero , Dominguez Maldonado Virgilio , Gama Contreras Andres , Almanza Camacho Sergio R , Bojorquez Hernandez Rene F , Ruiz Medina Victor A , Vallejo Martinez Fernando , Hortacsu Ayse , Gilsanz Ramón , Nikolaou Sissy
Published: November 2020

This article presents the Applied Technology Council (ATC) team’s observations following the 2017 Mw7.1 Puebla–Morelos, Mexico earthquake. The team was deployed in Mexico City to collect seismological, geotechnical, structural, and overall performance information. The focus was on non-ductile concrete structures, to support implementation of recently published FEMA P-2018 procedures and to identify study buildings for incorporation into NIST-funded ATC-134 ongoing project. This article presents seismological data with 71 strong-motion records processed and ready for use in engineering analysis, geotechnical observations, and characterization of sites visited. Analyses of the response of representative soil profiles are presented in the form of acceleration response spectra and seismic amplification at the ground surface. A comparison of the same analysis using records from the 1985 Michoacán Ms8.1 (approximately Mw8.0) earthquake is also discussed. The ATC team composed GIS maps with structural and geotechnical characteristics of the inspected sites, including color-coded damage of inspected buildings and estimated soil fundamental period to correlate observed behavior with potential soil–structure interaction resonance effects. Recommendations on further detailed studies based on this comprehensive set of case histories are proposed.
AEO-7 surfactant is “super toxic” and induces severe cardiac, liver and locomotion damage in zebrafish embryos
Authors: Al-Asmakh Maha , Majdalawieh Amin F. , Abdullah Aboubakr M. , Younes Nadin , Da’as Sahar I. , Radwan A. Bahgat , Sliem Mostafa H. , Ech-Cherif Houria , Pintus Gianfranco , Nasrallah Gheyath K.
Published: November 2020

Background

Fatty alcohol polyoxyethylene ether-7 (AEO-7), a non-ionic surfactant, has recently been receiving extensive attention from the ocean pipeline industry for its ability to inhibit corrosion. However, the present lack of information concerning the potential environmental toxicity of AEO-7, especially towards aquatic organisms, is a major impediment to its wider application. Here, we assess potential adverse effects of AEO-7 on zebrafish embryos employing a variety of assays, including (i) a mortality/survival assay which allowed the median lethal concentration (LC50) to be calculated; (ii) a teratogenicity assay on the basis of which the no observed effect concentration (NOEC) was determined; and (iii) specific assays of cardiotoxicity, neurotoxicity (based on locomotion), hematopoietic toxicity (the level of hemoglobin as revealed byo-dianisidine staining) and hepatotoxicity (liver steatosis and yolk retention examined by staining with Oil Red O).

Results

AEO-7 caused mortality with a calculated LC50of 15.35 μg/L, which, according to the U.S. Fish and Wildlife Service (USFWS) Acute Toxicity Rating scale, should be considered “super toxic”. Although at its NOEC (0.8 μg/L), there were no signs of significant teratogenicity, cardiotoxicity, or hemopoiesis toxicity, 3.2 µg/L AEO-7 exerted dramatic detrimental effects on organ development.

Conclusion

On the basis of these findings, we recommend that the industrial usage and environmental impact of AEO-7 be re-evaluated and strictly monitored by environmental and public health organizations.
Clinical study of systemic chemotherapy combined with bronchoscopic interventional cryotherapy in the treatment of lung cancer
Authors: Xu Feng , Song Jian , Xu Beizheng , Wang Jiang , Mao Jianjun , Liu Haiyan , Li Xuanmei , Deng Aibing
Published: November 2020

Background

This study is designed to investigate the clinical value of systemic chemotherapy combined with bronchoscopic interventional cryotherapy in the treatment of lung cancer.

Methods

A total of 412 lung cancer patients admitted to Cangzhou People’s Hospital from March 2018 to March 2020 were collected and divided into test group and control group based on their treatment schedules. The test group received systemic chemotherapy combined with bronchoscopic interventional cryotherapy, while the control group received systemic chemotherapy alone. Tumor objective response rate (ORR), disease control rate (DCR), serum tumor marker levels, serum matrix metalloproteinase (MMP) content, T cell subset level, survival time and adverse reactions of the two groups were observed.

Results

The ORR and DCR of the test group were better than those of the control group, while those of the non-small cell lung cancer (NSCLC) patients in the test group were better than patients with small-cell lung cancer (SCLC) (P <  0.05). There was no significant difference in serum tumor marker levels, MMP content and T cell subset level between the two groups before treatment. After treatment, the serum tumor marker levels along with serum MMP-2, MMP-9 and CD8+ levels in the test group decreased more remarkably, while CD4+ and CD4+/CD8+ levels increased more significantly than those in the control group (P <  0.05). The serum MMP-2 and MMP-9 of NSCLC patients in the test group decreased more remarkably than those of SCLC patients, while there was no significant difference in CD8+, CD4+ and CD4+/CD8+. The progression-free survival and overall survival of the test group were obviously longer than those of the control group. The same trend was observed in NSCLC patients compared with SCLC patients in the test group (P <  0.05).

Conclusions

Systemic chemotherapy combined with bronchoscopic interventional cryotherapy for lung cancer has good clinical efficacy and safety, and can be widely used in clinical practice.
Effects and feasibility of hyperthermic baths in comparison to exercise as add-on treatment to usual care in depression: a randomised, controlled pilot study
Authors: Naumann Johannes , Kruza Iris , Denkel Luisa , Kienle Gunver , Huber Roman
Published: November 2020

Background

Limitations of current therapy of depression highlight the need for an immediately available, easily implementable add-on treatment option with high acceptance from patients. Hyperthermic baths (HTB) are a form of balneotherapy with head-out-of-water-immersion in a hot pool or tub at 40 °C for 15–20 min. A prior study suggests that HTB added to usual depression care can have antidepressant effects.

Method

Single-site, open-label randomised controlled 8-week parallel-group pilot study at a university outpatient clinic. 45 medically stable outpatients with moderate depression as determined by the 17-item Hamilton Depression Rating Scale (HAM-D) score ≥ 18 and a score ≥ 2 on item 1 (Depressed Mood) were recruited. They were randomised to twice weekly HTB (n = 22) or a physical exercise program (PEP) of moderate intensity (n = 23). Primary outcome measure was the change in HAM-D total score from baseline (T0) to the 2-week time point (T1). Linear regression analyses, adjusted for baseline values, were performed to estimate intervention effects on an intention-to-treat (ITT) and per-protocol (PP) principle.

Results

Forty-five patients (HTBn = 22; PEPn = 23) were analyzed according to ITT (mean age = 48.4 years, SD = 11.3, mean HAM-D score = 21.7, SD = 3.2). Baseline-adjusted mean difference after 2 weeks was 4.3 points in the HAM-D score in favor of HTB (p < 0.001). Compliance with the intervention and follow-up was far better in the HTB group (2 vs 13 dropouts). Per protocol analysis only showed superiority of HTB as a trend (p = 0.068). There were no treatment-related serious adverse events. Main limitation: the number of dropouts in the PEP group (13 of 23) was higher than in other trials investigating exercise in depression. Due to the high number of dropouts the effect in the ITT-analysis may be overestimated.

Conclusions

HTB added to usual care may be a fast-acting, safe and easy accessible method leading to clinically relevant improvement in depression severity after 2 weeks; it is also suitable for persons who have problems performing exercise training.

Trial registration

German Clinical Trials Register (DRKS) with the registration numberDRKS00011013(registration date 2016-09-19) before onset of the study.
Differences in medical student performance on examinations: exploring score variance between Kolb's Learning Style Inventory classifications
Authors: Reynolds Quentin J. , Gilliland Kurt O. , Smith Katie , Walker Joshua A. , Beck Dallaghan Gary L.
Published: November 2020

Background

Kolb’s Cycle of Learning Theory acts as a foundational framework for the evolution of knowledge gained by learners throughout their education. Through Kolb’s cycle of experiential learning, one’s preferred way of learning could impact academic achievement in the pre-clinical years of medical education.

Methods

The medical student classes of 2020 and 2021 at a public university in the southeastern U.S. were invited to complete Kolb’s Learning Style Inventory (LSI). For those participants completing the LSI, examination results for their pre-clinical blocks were obtained and matched to the LSI results. Examination scores (locally-developed examinations and customized National Board of Medical Examiners (NBME) final examinations) were compared by LSI classification for each examination using Kruskal-Wallis Test.

Results

Out of 360 possible participants, 314 (87.2%) completed the Learning Style Inventory. Convergers and Assimilators made up 84.1% [Convergers (n = 177, 56.4%), Assimilators (n = 87, 27.7%)]. Accommodators (n = 25, 7.9%) and Divergers (n = 25, 7.9%) made up the remaining sample. Accomodators’ scores were significantly lower on locally-developed examinations in Principles of Medicine, Hematology, and Gastrointestinal System. The only NBME examination that demonstrated a significant difference across learning styles was from the Cardiovascular block.

Conclusions

Upon reviewing Kolb’s LSI, our study indicated that performance on the customized NBME examinations minimized the variance in performance compared to locally-developed examinations. The lack of variance across learning styles for all but one NBME final examination appears to provide a more equitable assessment strategy.
Von Willebrand factor:antigen and ADAMTS-13 level, but not soluble P-selectin, are risk factors for the first asymptomatic deep vein thrombosis in cancer patients undergoing chemotherapy
Authors: Setiawan Budi , Permatadewi Cecilia Oktaria , de Samakto Baringin , Bugis Ashar , Naibaho Ridho M. , Pangarsa Eko Adhi , Santosa Damai , Suharti Catharina
Published: November 2020

Background

There is a high incidence of deep vein thrombosis (DVT) among cancer patients undergoing chemotherapy. Chemotherapy-induced vascular endothelial cell activation (VECA) is characterized by increased plasma levels of von Willebrand factor (vWF) and soluble P-selectin (sP-selectin), leading to the activation of endothelial cells and signaling cascades. The biological role of a disintegrin-like and metalloproteinase with thrombospondin type 1 motif, member 13 (ADAMTS-13) is to control the activity of vWF and consequently the risk of thrombosis. The objective of this study was to investigate the roles of sP-selectin, vWF, and ADAMTS-13 as risk factors for the first episode of DVT in cancer patients undergoing chemotherapy.

Methods

This prospective cohort study was conducted at Dr. Kariadi Hospital, Indonesia, on 40 cancer patients. Prechemotherapy (baseline) and postchemotherapy sP-selectin, vWF antigen (vWF:Ag), and ADAMTS-13 plasma levels were determined with ELISAs before and 3 months after chemotherapy. The clinical characteristics of the patients, cancer type, cancer stage, chemotherapy regimen, ABO blood type, D-dimer level and Khorana risk score were also analyzed using logistic regression. Patients were observed for the possibility of developing DVT during chemotherapy.

Results

DVT was confirmed in 5 patients (12.5%) after a period of 3 months. In patients with DVT, sP-selectin and vWF were significantly higher while ADAMTS-13 was lower than in their counterparts. The levels of baseline vWF:Ag and ADAMTS-13, with cut-off points ≥ 2.35 IU/mL and ≤ 1.03 IU/mL, respectively, were found to independently predict the incidence of DVT. In the multivariate logistic regression analysis, the relative risk (RR) for DVT in patients with high vWF:Ag was 3.80 (95% CI 1.15–12.48, p = 0.028), and that for patients with low ADAMTS-13 was 2.67 (95% CI 1.22–23.82, p = 0.005). The vWF:Ag/ADAMTS-13 ratio and both vWF:Ag and ADAMTS-13 dynamics during treatment were also able to differentiate those with prospective DVT. However, sP-selectin and other covariates showed no statistical significance.

Conclusion

We found that prechemotherapy plasma levels of vWF:Ag ≥ 2.35 IU/mL and ADAMTS-13 ≤ 1.03 IU/mL are independent risk factors for DVT incidence among cancer patients.
Sex difference in cerebrospinal fluid/blood albumin quotients in patients with schizophreniform and affective psychosis
Authors: Meixensberger Sophie , Bechter Karl , Dersch Rick , Feige Bernd , Maier Simon , Schiele Miriam A. , Runge Kimon , Denzel Dominik , Nickel Kathrin , Spieler Derek , Urbach Horst , Prüss Harald , Domschke Katharina , Tebartz van Elst Ludger , Endres Dominique
Published: November 2020

Background

The importance of cerebrospinal fluid (CSF) diagnostics for psychiatry is growing. The CSF/blood albumin quotient (QAlb) is considered to be a measure of the blood–CSF barrier function. Recently, systematically higher QAlb in males than in females was described in neurological patients. The aim of this study was to investigate whether a sex difference could also be detected in a well-characterized psychiatric cohort.

Methods

The patient cohort comprised 989 patients, including 545 females and 444 males with schizophreniform and affective syndromes who underwent CSF diagnostics, including QAlb measurement. The basic CSF findings and antineuronal autoantibody data of this cohort have already been published. This re-analysis employed analysis of covariance with age correction for QAlb mean values and chi2-testing for the number of increased age-corrected QAlb levels to investigate sex differences in QAlb.

Results

The QAlb levels were elevated above reference levels by 18% across all patients, and a comparison between male and female patients revealed a statistically significant sex difference, with increased values in 26% of male patients and a corresponding rate of only 10% in female patients (chi2 = 42.625, p < 0.001). The mean QAlb values were also significantly higher in males (6.52 ± 3.69 × 10–3) than in females (5.23 ± 2.56 × 10–3; F = 52.837, p < 0.001).

Discussion

The main finding of this study was a significantly higher QAlb level in male compared to female patients with psychiatric disorders, complementing previously described sex differences in neurological patient cohorts. This result indicates bias from some general factors associated with sex and could be partly explained by sex differences in body height, which is associated with spine length and thus a longer distance for CSF flow within the subarachnoid space down the spine from the occipital area to the lumbar puncture site in males compared to females. Hormonal influences caused by different estrogen levels and other sex-specific factors could also play a relevant role. The significance of the study is limited by its retrospective design, absence of a healthy control group, and unavailability of exact measures of spine length.
KPNA2 expression is a potential marker for differential diagnosis between osteosarcomas and other malignant bone tumor mimics
Authors: Jiang Lucen , Liu Jianghuan , Wei Qingzhu , Wang Yiyang
Published: November 2020

Background

Karyopherin α2 (KPNA2), a member of the karyopherin α family, has been studied in several cancers but has not yet been substantially investigated in malignant bone tumors. The purpose of the current study was to evaluate the KPNA2 expression level and its utility as a novel diagnostic biomarker in osteosarcomas and malignant bone tumor mimics, such as chondrosarcomas and Ewing sarcomas (ESs).

Method

We investigated the expression of KPNA2 protein by immunohistochemistry on paraffin-embedded surgical specimens from 223 patients with malignant and benign bone tumors, including 81 osteosarcomas, 42 chondrosarcomas, 15 ESs, 28 osteoid osteomas, 20 osteochondromas and 37 chondroblastomas. Immunoreactivity was scored semiquantitatively based on staining extent and intensity.

Results

Sixty-seven of 81 (82.7%) osteosarcoma, zero of 42 (0%) chondrosarcoma and one of 15 (6.7%) ES samples showed immunoreactivity for KPNA2. Negative KPNA2 expression was observed in all benign bone tumors. The expression of KPNA2 in osteosarcoma samples was much higher than that in chondrosarcoma and ES samples (P < 0.001). The sensitivity and specificity of KPNA2 immunoexpression for detecting osteosarcoma were 82.7 and 100%, respectively. Several subtypes of osteosarcoma were analyzed, and immunostaining of KPNA2 was frequent in osteoblastic samples (90.9%), with 39 samples (70.9%) showing strong-intensity staining. KPNA2 positivity was observed in ten of 13 (76.9%) chondroblastic, two of 6 (33.3%) fibroblastic, three of 4 (75%) telangiectatic and two of 3 (66.7%) giant cell-rich osteosarcoma samples. The strongest intensity staining was observed in osteoblastic osteosarcoma.

Conclusion

KPNA2 is frequently expressed in osteosarcomas, particularly in osteoblastic and chondroblastic tumors, but is rarely positive in chondrosarcomas and ESs. This feature may aid in distinguishing between osteosarcoma and other bone sarcoma mimics. This report supports KPNA2 as a novel marker for the diagnosis of osteosarcoma.
Applied anatomical study on suprascapular nerve protection in reverse total shoulder arthroplasty
Authors: Li Jianfeng , Zhou Junlin , Wang Dong , Li Dacun , Zhang Wentong
Published: November 2020

Background

This study aimed to investigate the three-dimensional (3D) anatomical relationship between the suprascapular nerve and scapula, and the method of protecting the suprascapular nerve in reverse total shoulder arthroplasty (RTSA)

Methods

In the present study, 12 fresh adult cadaver shoulder specimens were dissected. X-ray and computed tomography (CT) were used to investigate the 3D scapular and suprascapular nerve images.

Results

The results revealed that the best fitting baseplate diameter was 24.73 ± 1.56 mm. Furthermore, the baseplate diameter correlated with the glenoid cavity width. After the osteotomy, a simulated screw placement on the baseplate was performed. The dangerous area for the posterior screw placement was at the angle between the upper edge and transverse axis exceeding 38° and between the lower edge and transverse axis exceeding 76°. The distance between the nearest point of the nerve and osteotomy plane was 15.38 ± 2.02 mm, and the angle between the projection point of the nearest point and transverse axis was 27.33 ± 7.96°, which was the dangerous area for retractor placement. The suitable angle between the superior screw and longitudinal axis was 21.67 ± 13.27°, and the suitable superior screw length was 34.66 ± 2.41 mm.

Conclusion

In RTSA, the baseplate size correlates with the glenoid cavity width. The relationship between the screw and suprascapular nerve and retractor placement position should be carefully considered to avoid damaging the suprascapular nerve.
Clinical effects of staged joint replacement in patients with septic arthritic knee
Authors: Ni Ming , Fu Jun , Deng Tao , Niu Erlong , Xu Chi , Li Xiang , Chai Wei , Zhang Guoqiang , Chen Jiying
Published: November 2020

Objective

To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer.

Methods

Twenty-three patients (24 knee joints) treated with a staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first stage, thorough debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer were performed. After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, the second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement.

Results

All patients finished follow-up, and the mean follow-up time was 27.3 months (12–54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved postoperation (p < 0.05). And there was no significant difference in the post-surgery ROM (p = 0.153) and the HSS score (p = 0.054) between the two groups.

Conclusion

Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.
Screening for aneurysms of the abdominal aorta using a simple screening device
Authors: Brakel J. W. , Berendsen T. A. , Callenbach P. M. C. , van der Burgh J. , Hissink R. J. , van den Berg M.
Published: November 2020

Introduction

Several countries advocate screening for aneurysms of the abdominal aorta (AAA) in selected patients. In the Netherlands, routine screening is currently under review by the National Health Council. In any screening programme, cost-efficiency and accuracy are key. In this study, we evaluate the Aorta Scan (Verathon, Amsterdam, Netherlands), a cost-effective and easy-to-use screening device based on bladder scan technology, which enables untrained personnel to screen for AAA.

Methods

We subjected 117 patients to an Aorta Scan and compared the results to the gold standard (abdominal ultrasound). We used statistical analysis to determine sensitivity and specificity of the Aorta Scan, as well as the positive and negative predictive values, accuracy, and inter-test agreement (Kappa).

Results

Sensitivity and specificity were 0.86 and 0.98, respectively. Positive predictive value was 0.98 and negative predictive value was 0.88. Accuracy was determined at 0.92 and the Kappa value was 0.85. When waist–hip circumferences (WHC) of > 115 cm were excluded, sensitivity raised to 0.96, specificity stayed 0.98, positive and negative predictive value were 0.98 and 0.96, respectively, accuracy to 0.97, and Kappa to 0.94.

Conclusion

Herein, we show that the Aorta Scan is a cost-effective and very accurate screening tool, especially in patients with WHC below 115 cm, which makes it a suitable candidate for implementation into clinical practice, specifically in the setting of screening selected populations for the presence of AAA.
Review of icatibant use in the Winnipeg Regional Health Authority
Authors: Cai George , Barber Colin , Kalicinsky Chrystyna
Published: November 2020

Background

This is a retrospective review of the Winnipeg Regional Health Authority’s (WRHA) angioedema patients who were dispensed icatibant in hospital. Icatibant is a bradykinin B2 receptor antagonist indicated for Hereditary Angioedema (HAE) types I and II and is used off-label for HAE with normal C1INH (HAE-nC1INH) and ACE-inhibitor induced angioedema (ACEIIAE). The WRHA’s use of icatibant is regulated by the Allergist on call. We characterized icatibant's use and the timeline from patient presentation, compared the real-world experience with the FAST-3 trial and hypothesized the factors which may affect response to icatibant.

Methods

Background data were collected on patients. Angioedema attack-related data included administered medications, performed investigations and the timeline to endpoints such as onset of symptom relief. Data was analyzed in R with the package “survival.” Time-to-event data was analyzed using the Peto–Peto Prentice method or Mann–Whitney U-test. Data was also compared with published clinical trial data using the Sign Test. Fisher’s Exact Test was used to produce descriptive statistics.

Results

Overall, 21 patients accounted for 23 angioedema attacks treated with icatibant. Approximately half the patients had a diagnosis of HAE-nC1IHN and half of ACEIIAE. Of those presenting with angioedema, 65% were first treated with conventional medication. Patients without a prior angioedema diagnosis were evaluated only 40–50% of the time for C4 levels or C1INH function or level. The median time from patients’ arrival to the emergency department until the Allergy consultant’s response was 1.77 h. Patients with HAE-nC1IHN had median times to onset of symptom relief and final clinical outcome (1.13 h, p = 0.34; 3.50 h, p = 0.11) similar to those reported in FAST-3 for HAE I/II. Patients with ACEIIAE had longer median times to onset of symptom relief (4.86 h, p = 0.01) than predicted.

Conclusions

HAE-nC1INH may be an appropriate indication for treatment with icatibant. Conversely, the results of this study do not support the use of icatibant for the treatment of ACEIIAE, concordant with a growing body of literature. Patients should be stratified into groups of more- or less-likely icatibant-responders through history and laboratory investigations in order to prevent potential delays.
Hypersensitivity reactions after femtosecond laser small incision lenticule extraction: a case report of corneal infiltrates
Authors: Ma Jiaonan , Zhang Lin , Li Mengdi , Wang Yan
Published: November 2020

Background

Femtosecond laser corneal refractive surgery is generally considered safe and effective; however, this procedure is rarely associated with severe allergic reactions. We reported a rare case of hypersensitivity reactions which caused bilateral peripheral corneal infiltrates after femtosecond laser small incision lenticule (SMILE) surgery in a man with a history of fruits allergy.

Case presentation

Here we report the case of a young man who developed white, ring-shaped bilateral peripheral infiltrates that appeared 1 day after an uneventful SMILE surgery. The overlying corneal epithelium was intact; the infiltrate was negative for bacterial culture, but high titers of immunoglobulin E was demonstrated in the blood. Symptomatically, a clinical diagnosis of sterile corneal infiltrates was made, and the patient was treated with topical and systemic steroids. The infiltrates were immunogenic in origin, which may be caused by the contact lenses used for suction duration in surgery. It resolved without corneal scarring in the subsequent months following steroid treatment. The patient’s visual acuity improved.

Conclusions

When patients with a history of allergy who aim to perform corneal refractive surgery, surgeons must consider possible hypersensitivity reactions after treatment. More studies are needed to clarify the relationship between contact glass used in femtosecond laser corneal refractive surgery and IgE mediated hypersensitivity reactions.
Multilineage differentiation potential of hematoendothelial progenitors derived from human induced pluripotent stem cells
Authors: Netsrithong Ratchapong , Suwanpitak Siriwal , Boonkaew Bootsakorn , Trakarnsanga Kongtana , Chang Lung-Ji , Tipgomut Chartsiam , Vatanashevanopakorn Chinnavuth , Pattanapanyasat Kovit , Wattanapanitch Methichit
Published: November 2020

Background

Human induced pluripotent stem cells (hiPSCs) offer a renewable source of cells for the generation of hematopoietic cells for cell-based therapy, disease modeling, and drug screening. However, current serum/feeder-free differentiation protocols rely on the use of various cytokines, which makes the process very costly or the generation of embryoid bodies (EBs), which are labor-intensive and can cause heterogeneity during differentiation. Here, we report a simple feeder and serum-free monolayer protocol for efficient generation of iPSC-derived multipotent hematoendothelial progenitors (HEPs), which can further differentiate into endothelial and hematopoietic cells including erythroid and T lineages.

Methods

Formation of HEPs from iPSCs was initiated by inhibition of GSK3 signaling for 2 days followed by the addition of VEGF and FGF2 for 3 days. The HEPs were further induced toward mature endothelial cells (ECs) in an angiogenic condition and toward T cells by co-culturing with OP9-DL1 feeder cells. Endothelial-to-hematopoietic transition (EHT) of the HEPs was further promoted by supplementation with the TGF-β signaling inhibitor. Erythroid differentiation was performed by culturing the hematopoietic stem/progenitor cells (HSPCs) in a three-stage erythroid liquid culture system.

Results

Our protocol significantly enhanced the number of KDR+ CD34+ CD31+ HEPs on day 5 of differentiation. Further culture of HEPs in angiogenic conditions promoted the formation of mature ECs, which expressed CD34, CD31, CD144, vWF, and ICAM-1, and could exhibit the formation of vascular-like network and acetylated low-density lipoprotein (Ac-LDL) uptake. In addition, the HEPs were differentiated into CD8+ T lymphocytes, which could be expanded up to 34-fold upon TCR stimulation. Inhibition of TGF-β signaling at the HEP stage promoted EHT and yielded a large number of HSPCs expressing CD34 and CD43. Upon erythroid differentiation, these HSPCs were expanded up to 40-fold and displayed morphological changes following stages of erythroid development.

Conclusion

This protocol offers an efficient and simple approach for the generation of multipotent HEPs and could be adapted to generate desired blood cells in large numbers for applications in basic research including developmental study, disease modeling, and drug screening as well as in regenerative medicine.
Learning attention for object tracking with adversarial learning network
Authors: Cheng Xu , Song Chen , Gu Yongxiang , Chen Beijing
Published: November 2020

Artificial intelligence has been widely studied on solving intelligent surveillance analysis and security problems in recent years. Although many multimedia security approaches have been proposed by using deep learning network model, there are still some challenges on their performances which deserve in-depth research. On the one hand, high computational complexity of current deep learning methods makes it hard to be applied to real-time scenario. On the other hand, it is difficult to obtain the specific features of a video by fine-tuning the network online with the object state of the first frame, which fails to capture rich appearance variations of the object. To solve above two issues, in this paper, an effective object tracking method with learning attention is proposed to achieve the object localization and reduce the training time in adversarial learning framework. First, a prediction network is designed to track the object in video sequences. The object positions of the first ten frames are employed to fine-tune prediction network, which can fully mine a specific features of an object. Second, the prediction network is integrated into the generative adversarial network framework, which randomly generates masks to capture object appearance variations via adaptively dropout input features. Third, we present a spatial attention mechanism to improve the tracking performance. The proposed network can identify the mask that maintains the most robust features of the objects over a long temporal span. Extensive experiments on two large-scale benchmarks demonstrate that the proposed algorithm performs favorably against state-of-the-art methods.