bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients
Authors: Whitmire Paula , Rickertsen Cassandra R. , Hawkins-Daarud Andrea , Carrasco Eduardo , Lorence Julia , De Leon Gustavo , Curtin Lee , Bayless Spencer , Clark-Swanson Kamala , Peeri Noah C. , Corpuz Christina , Lewis-de los Angeles Christine Paula , Bendok Bernard R. , Gonzalez-Cuyar Luis , Vora Sujay , Mrugala Maciej M. , Hu Leland S. , Wang Lei , Porter Alyx , Kumthekar Priya , Johnston Sandra K. , Egan Kathleen M. , Gatenby Robert , Canoll Peter , Rubin Joshua B. , Swanson Kristin R.
Published: May 2020

Background

Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences.

Methods

Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females).

Results

Among males, tumor (T1Gd) radius was a predictor of overall survival (HR = 1.027, p = 0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR = 1.011, p < 0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p = 0.010 t-test), but tumor size was not correlated with female overall survival (p = 0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p = 0.004, F p = 0.001, t-test).

Conclusion

Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.
Functionally validated imaging endpoints in the Alabama study on early age-related macular degeneration 2 (ALSTAR2): design and methods
Authors: Curcio Christine A. , McGwin Gerald , Sadda Srinivas R. , Hu Zhihong , Clark Mark E. , Sloan Kenneth R. , Swain Thomas , Crosson Jason N. , Owsley Cynthia
Published: May 2020

Background

Age-related macular degeneration (AMD), a leading cause of irreversible vision impairment in the United States and globally, is a disease of the photoreceptor support system involving the retinal pigment epithelium (RPE), Bruch’s membrane, and the choriocapillaris in the setting of characteristic extracellular deposits between outer retinal cells and their blood supply. Research has clearly documented the selective vulnerability of rod photoreceptors and rod-mediated (scotopic) vision in early AMD, including delayed rod-mediated dark adaptation (RMDA) and impaired rod-mediated light and pattern sensitivity. The unifying hypothesis of the Alabama Study on Early Macular Degeneration (ALSTAR2) is that early AMD is a disease of micronutrient deficiency and vascular insufficiency, due to detectable structural changes in the retinoid re-supply route from the choriocapillaris to the photoreceptors. Functionally this is manifest as delayed rod-mediated dark adaptation and eventually as rod-mediated visual dysfunction in general.

Methods

A cohort of 480 older adults either in normal macular health or with early AMD will be enrolled and followed for 3 years to examine cross-sectional and longitudinal associations between structural and functional characteristics of AMD. Using spectral domain optical coherence tomography, the association between (1) subretinal drusenoid deposits and drusen, (2) RPE cell bodies, and (3) the choriocapillaris’ vascular density and rod- and cone-mediated vision will be examined. An accurate map and timeline of structure-function relationships in aging and early AMD gained from ALSTAR2, especially the critical transition from aging to disease, will identify major characteristics relevant to future treatments and preventative measures.

Discussion

A major barrier to developing treatments and prevention strategies for early AMD is a limited understanding of the temporal interrelationships among structural and functional characteristics while transitioning from aging to early AMD. ALSTAR2 will enable the development of functionally valid, structural biomarkers for early AMD, suitable for use in forthcoming clinical trials as endpoint/outcome measures. The comprehensive dataset will also allow hypothesis-testing for mechanisms that underlie the transition from aging to AMD, one of which is a newly developed Center-Surround model of cone resilience and rod vulnerability.

Trial registration

ClinicalTrials.gov Identifier NCT04112667, October 7, 2019.
Psychometric properties of the Arabic version of the cardiac depression scale tested on Jordanian patients with cardiovascular diseases
Authors: Al-Zaru Ibtisam M. , Hayajneh Audai A. , Al-Dwaikat Tariq
Published: May 2020

Background

The Cardiac Depression Scale (CDS) is an instrument to screen for depression, specifically in patients with cardiovascular diseases (CVD). The purpose of this study was to evaluate the psychometric properties of the Arabic version of the CDS in the Jordanian population.

Method

A cross-sectional design was used for 304 participants diagnosed with CVD. An exploratory factor analysis (EFA) was performed to explore the underlying structure of the new Arabic version of the CDS tool.

Results

Cronbach’s alpha for the total scale was 0.87. An EFA suggested a two-factor solution. The first factor has 18 items, measuring “My tolerance” of CVD, and the second factor has seven items, measuring “My activities” in the context of CVD. Based on the EFA simple structure, one item was removed due to its low factor loading (< 0.3). A confirmatory factor analysis (CFA) supported a two-factor model with the root mean square error of approximation (RMSEA = 0.06), comparative fit index (CFI = 0.856), and Tucker-Lewis index (TLI = 0.83) indicating acceptable fit. The Cronbach’s alpha values for the first and second factors were 0.86 and 0.84, respectively.

Conclusion

The Arabic version of the CDS is a reliable and valid instrument to screen for depression among Jordanian patients with CVD.
Prevalence and factors associated with depressive and anxiety symptoms among Palestinian medical students
Authors: Shawahna Ramzi , Hattab Suhaib , Al-Shafei Rami , Tab’ouni Mahmoud
Published: May 2020

Background

Co-existence of depression and anxiety can be associated with severe detrimental consequences to the physical, mental and social wellbeing of the affected populations. This study was conducted to determine prevalence of depressive and anxiety symptoms among Palestinian medical students and to investigate associations between sociodemographic factors of the students with depressive and anxiety symptoms.

Methods

This study was conducted in a cross-sectional observational design using a questionnaire in the period between September 2018 and April 2019 in a major university in the West Bank of Palestine. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and anxiety symptoms were assessed using the Beck Anxiety Inventory (BAI). The questionnaire also collected the sociodemographic characteristics of the students. Reliability of the questionnaire was tested using the test re-test method. A total of 425 medical students were invited to participate in the study.

Results

Of those invited, 286 students completed the questionnaire, giving a response rate of 67.3%. More than half (56.6%) of the students had minimal depression, 20.3% had mild depression, 14.0% had moderate depression, 9.1% had severe depression, 23.4% had no anxiety, 29.7% had mild to moderate anxiety, 25.5% had moderate to severe anxiety, and 21.3% had severe anxiety. Multiple linear regression analysis showed that academic stage (p-value < 0.01), Grade Point Average (p-value < 0.01), mental health status (p-value < 0.001), ever attempted suicide (p-value < 0.05), and religious commitment (p-value < 0.01) were predictors of BDI-II scores. Multiple linear regression analysis showed that academic stage (p-value < 0.05) and mental health status (p-value < 0.001) were predictors of BAI scores.

Conclusions

Depressive and anxiety symptoms were prevalent among Palestinian medical students in a major university in the West Bank of Palestine. Interventions might be designed to improve self-rated mental health of medical students in their academic years, ameliorate study conditions, and provision of counseling services to improve spirituality might be effective in reducing symptoms of depression and anxiety among medical students in Palestine. Future studies are still needed to investigate if these interventions could be useful in reducing depressive and anxiety symptoms among Palestinian medical students.
The association between physical activity and body fat percentage with adjustment for body mass index among middle-aged adults: China health and nutrition survey in 2015
Authors: Zou Qinpei , Su Chang , Du Wenwen , Ouyang Yifei , Wang Huijun , Wang Zhihong , Ding Gangqiang , Zhang Bing
Published: May 2020

Background

The inverse association between physical activity and body fat percentage (%) varies among different populations. We aim to examine whether the significant association between them was uniform across the subpopulations after taking into account body mass index (BMI).

Methods

Our study relied on data from China Health and Nutrition Surveys in 2015, including 5763 participants aged 40–64 years from 15 regions. Physical activity was calculated as metabolic equivalent task hours per day (MET·h/d). Body fat% was measured by bioelectrical impedance analysis. Body mass index < 24 kg/m2 was defined as normal weight and BMI ≥ 24 kg/m2 was overweight/obese. The effects of physical activity on body fat% were estimated using the Kruskal-Wallis test among sex, age, BMI groups, education, income, region and urbanization. Quantile regression analyses were utilized to describe the relationship between physical activity and body fat% distribution.

Results

Older adults, overweight/obese, higher education, higher income, residents of central China and those living in areas of higher urbanization had the lower physical activity. Participants who engaged in the highest level of physical activity had 2.0 and 1.5% lower body fat% than the lowest level of physical activity group (23.4, 34.8%) for men and women, respectively. There were 10.4 and 8.8% of normal weight males and females called normal weight obese. Overall, 1 h extra 4.5 MET•h/d was significantly associated with 0.079 and 0.110% less total body fat% at the 75th and 90th percentiles in normal weight males, with 0.071% less at the 25th percentiles in overweight/obese males, with 0.046–0.098% less at the 25th to 90th percentiles in normal weight females, and with 0.035–0.037% less from the 50th to 90th percentiles in overweight/obese females. The inverse association between physical activity and total body fat% was stronger in normal weight obese participants than other subgroups.

Conclusions

In middle-aged Chinese adults, the inverse association between physical activity and body fat% was only in particular subpopulations rather than the entire population. We should pay much attention to normal weight obese and give a suitable physical activity guideline taking into account people with different body fat%.
Interventions to prevent or treat childhood obesity in Māori & Pacific Islanders: a systematic review
Authors: Littlewood Robyn , Canfell Oliver J. , Walker Jacqueline L.
Published: May 2020

Background

Māori and Pacific Islander people are a priority population originating from Australasia. Māori and Pacific Islander children exhibit greater risk of obesity and associated morbidities compared to children of other descent, secondary to unique cultural practices and socioeconomic disadvantage. Despite these known risk factors, there is limited synthesised evidence for preventing and treating childhood obesity in this unique population. The objective of this systematic review was to identify and evaluate global prevention or treatment interventions for overweight or obesity that targeted Māori and Pacific Islander children and adolescents (aged 2–17 years).

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The databases PubMed, EMBASE, Scopus, Web of Science and CINAHL were searched from inception to August 2018. Study quality and risk of bias was assessed using a modified Downs and Black Quality Checklist for Health Care Intervention Studies. Studies were included if RCT/intervention/case control/ or prevention study designs. The study group was defined under the search term ‘Oceanic Ancestry Group’.

Results

Of the initial 94 articles identified, six were included describing two prevention and three treatment interventions. Interventions were heterogenous in setting, design, length and outcomes. Four interventions were implemented in New Zealand. Most studies were of ‘fair’ quality. One study recruited an exclusive population of Māori and Pacific Islander participants. In the five studies that recruited mixed populations, one performed sub-group analysis on Māori and Pacific Islander participants. No study reported an improvement in anthropometric outcomes post-intervention in complete or sub-group analysis. Improvements in cardiometabolic or psychological secondary outcomes were inconsistent across all studies.

Conclusions

There is a lack of evidence to recommend specific intervention characteristics to optimise obesity prevention or treatment outcomes for Māori and Pacific Islander children. Future research requires greater consideration of cultural values and beliefs, community engagement, exclusive targeting of Māori and Pacific Islander children and families, and sub-group analyses for mixed-population studies. Incorporating co-design principles during study design and implementation can maximise the cultural specificity of interventions and may contribute to improved health and weight-related outcomes for this at-risk, priority population.

Trial registration

PROSPERO CRD42019121790 (26 March 2019).
Exploration of self-medication practice in Pokhara valley of Nepal
Authors: Paudel Sabita , Aryal Bijay
Published: May 2020

Background

Self-medication (SM) is the practice of consuming medication without the consultation of physician. The drugs most commonly self-medicated are paracetamol, analgesics, ranitidine, oral rehydration solution and antibiotics. The objective of the study was to assess the SM status and its causes in Pokhara valley of Nepal.

Method

The study was conducted among the people residing in Pokhara metropolitan city. The study duration was of 4 months from April to July, 2018. The study population were patients attending health general and oral health screening programs at Baidam, Birauta, Hemja and Pame areas of Pokhara. Structured questionnaire was used to collect demographics of the patients and the details of the usage of self-medication.

Result

Out of 201 patients, 38.2% patients were found to be self-medicating. The most common illness sought for SM was ache (headache, body ache) in 50% subjects followed by cough and cold in 31% and gastritis in 23%. Paracetamol was the drug consumed by 16 subjects followed by nimesulide by 11. Lack of knowledge about the disadvantages of SM led to self-medication in 65% of respondents. The personnel most commonly consulted for medication were pharmacists (60%).

Conclusion

The trend of SM is high in Pokhara valley. The comedics were consulted most often for SM due to lack of knowledge of consultation to physicians. The public should be made aware about SM.
The concept of virginity from the perspective of Iranian adolescents: a qualitative study
Authors: Mehrolhassani Mohammad Hossein , Yazdi-Feyzabadi Vahid , Mirzaei Saeid , Zolala Farzaneh , Haghdoost Ali-Akbar , Oroomiei Nadia
Published: May 2020

Background

Premarital sex can increase the risk of sexually transmitted diseases (STDs) in adolescents, and lack of premarital sex can be considered as a reliable policy for STD prevention, which is used by some countries such as Iran. Since the success of this policy is related to the concept of virginity, the present study was conducted to determine the concept of virginity from the perspective of Iranian adolescents.

Methods

In this qualitative study with phenomenological approach, the research team visited public places, including parks and coffee shops, and interviewed a number of 15–19-year-old adolescents. The data were collected using in-depth interviews with semi-structured questions and analysed using thematic analysis method.

Results

Several themes, including virginity as the lack of emotional relationship with the opposite sex, lack of physical contact, nonpenetrative relationship, virginity as a myth, virginity as a commitment, having an intact hymen, and not knowing the meaning of virginity, were extracted from the data.

Conclusion

The most reliable policy on STD prevention is the lack of premarital sex. The success of this policy is related to the concept of virginity. The findings of this study showed that the participants did not consider physical contact as the breach of virginity. This may indicate that the policy of not having sex before marriage or lack of premarital sex is not enough and Iranian adolescents are at risk of STDs. Therefore, policymakers must take steps towards modifying the concept of virginity in the adolescents’ value system and provide and implement educational programs on sexual health for adolescents.
Multivariate joint modeling to identify markers of growth and lung function decline that predict cystic fibrosis pulmonary exacerbation onset
Authors: Andrinopoulou E. R. , Clancy J. P. , Szczesniak R. D.
Published: May 2020

Background

Attenuated decreases in lung function can signal the onset of acute respiratory events known as pulmonary exacerbations (PEs) in children and adolescents with cystic fibrosis (CF). Univariate joint modeling facilitates dynamic risk prediction of PE onset and accounts for measurement error of the lung function marker. However, CF is a multi-system disease and the extent to which simultaneously modeling growth and nutrition markers improves PE predictive accuracy is unknown. Furthermore, it is unclear which routinely collected clinical indicators of growth and nutrition in early life predict PE onset in CF.

Methods

Using a longitudinal cohort of 17,100 patients aged 6–20 years (US Cystic Fibrosis Foundation Patient Registry; 2003–2015), we fit a univariate joint model of lung-function decline and PE onset and contrasted its predictive performance with a class of multivariate joint models that included combinations of growth markers as additional submodels. Outcomes were longitudinal lung function (forced expiratory volume in 1 s of % predicted), percentiles of body mass index, weight-for-age and height-for-age and PE onset. Relevant demographic/clinical covariates were included in submodels. We implemented a univariate joint model of lung function and time-to-PE and four multivariate joint models including growth outcomes.

Results

All five joint models showed that declining lung function corresponded to slightly increased risk of PE onset (hazard ratio from univariate joint model: 0.97, P < 0.0001), and all had reasonable predictive accuracy (cross-validated area under the receiver-operator characteristic curve > 0.70). None of the growth markers alongside lung function as outcomes in multivariate joint modeling appeared to have an association with hazard of PE. Jointly modeling only lung function and PE onset yielded the most accurate (area under the receiver-operator characteristic curve = 0.75) and precise (narrowest interquartile range) predictions. Dynamic predictions were accurate across forecast horizons (0.5, 1 and 2 years) and precision improved with age.

Conclusions

Including growth markers via multivariate joint models did not yield gains in prediction performance, compared to a univariate joint model with lung function. Individualized dynamic predictions from joint modeling could enhance physician monitoring of CF disease progression by providing PE risk assessment over a patient’s clinical course.
Intracorporeal esophagojejunostomy using a linear stapler in laparoscopic total gastrectomy: comparison with circular stapling technique
Authors: Lee Sejin , Lee Harim , Song Jeong Ho , Choi Seohee , Cho Minah , Son Taeil , Kim Hyoung-Il , Hyung Woo Jin
Published: May 2020

Background

Laparoscopic total gastrectomy for gastric cancer is feasible but less commonly performed compared to laparoscopic distal gastrectomy due to technical difficulties such as reconstruction. There is no standard esophagojejunal anastomosis technique in laparoscopic total gastrectomy due to a lack of evidence.

Methods

We retrospectively analyzed data from 213 patients with gastric cancer who underwent laparoscopic total gastrectomy from October 2012 to December 2016. Of these, 109 and 104 patients underwent esophagojejunostomy with linear and circular stapling, respectively. We compared short-term postoperative outcomes, including surgical complications and anastomosis costs between both groups.

Results

The mean operation time in the linear stapler group was longer than the circular stapler group (Linear stapler, 235.3 ± 57.9 vs. Circular stapler, 217.1 ± 55.8 min; P = 0.021); however, D2 lymph node dissection was performed more in the linear stapler group (Linear stapler, 36.7% vs. Circular stapler, 23.1%; P = 0.030). There were two anastomosis leakages in each group (Linear stapler, 1.8% vs. Circular stapler, 1.9%; P > 0.999). Anastomosis stenosis only occurred in the circular stapler group (Linear stapler, 0% vs. Circular stapler, 7.7%; P = 0.003). Although the linear stapling technique used more stapler cartridges (Linear stapler, 7.6 ± 1.1 vs. Circular stapler, 4.8 ± 0.9; P < 0.001), costs related to anastomosis were lower in the linear stapler group (Linear stapler, 1,904,679 ± 342,116 vs. Circular stapler, 2,246,150 ± 427,136KRW; P < 0.001).

Conclusions

Esophagojejunostomy with the linear stapling technique reduces anastomosis stenosis in laparoscopic total gastrectomy. It can be recommended as a safe and more cost-effective method for esophagojejunal anastomosis.
“When my mother called me to say that the time of cutting had arrived, I just escaped to Belgium with my daughter”: identifying turning points in the change of attitudes towards the practice of female genital mutilation among migrant women in Belgium
Authors: Agboli Afi A. , Richard Fabienne , Aujoulat Isabelle
Published: May 2020

Background

Female Genital Mutilation (FGM) is a public health concern with negative consequences on women’s health. It is a harmful practice which is recognized in international discourses on public health as a form of gender-based violence. Women are not only victims of this, but also perpetrators. The practice of FGM remains a social norm which is difficult to change because it is deeply rooted in tradition and is embedded in the patriarchal system. However, some women have managed to change their attitudes towards it and have spoken out against it. This study identifies and describes turning points that have been defined as significant and critical events in the lives of the women, and that have engendered changes in their attitudes towards the practice of FGM.

Methods

We have conducted an inductive qualitative study based on the life story approach, where we interviewed 15 women who have undergone FGM. During the interviews, we discussed and identified the turning points that gave the research participants the courage to change their position regarding FGM. The analysis drew on lifeline constructions and thematic analysis.

Results

Six common turning points relating to a change in attitude towards FGM were identified: turning points related to (i) encounters with health professionals, (ii) education, (iii) social interactions with other cultures and their own culture, (iv) experiences of motherhood, (v) repeated pain during sexual or reproductive activity, and (vi) witnessing the effects of some harmful consequences of FGM on loved ones.

Conclusions

The turning points identified challenged the understanding of what it means to be a ‘member’ of the community in a patriarchal system; a ‘normal woman’ according to the community; and what it means to be a ‘good mother’. Moreover, the turning points manifested in conjunction with issues centered on emotional responses and coming to terms with conflicts of loyalty, which we see as possible triggers behind the shift experienced by the women in our sample.
NetConfer: a web application for comparative analysis of multiple biological networks
Authors: Nagpal Sunil , Baksi Krishanu Das , Kuntal Bhusan K. , Mande Sharmila S.
Published: May 2020

Background

Most biological experiments are inherently designed to compare changes or transitions of state between conditions of interest. The advancements in data intensive research have in particular elevated the need for resources and tools enabling comparative analysis of biological data. The complexity of biological systems and the interactions of their various components, such as genes, proteins, taxa, and metabolites, have been inferred, represented, and visualized via graph theory-based networks. Comparisons of multiple networks can help in identifying variations across different biological systems, thereby providing additional insights. However, while a number of online and stand-alone tools exist for generating, analyzing, and visualizing individual biological networks, the utility to batch process and comprehensively compare multiple networks is limited.

Results

Here, we present a graphical user interface (GUI)-based web application which implements multiple network comparison methodologies and presents them in the form of organized analysis workflows. Dedicated comparative visualization modules are provided to the end-users for obtaining easy to comprehend, insightful, and meaningful comparisons of various biological networks. We demonstrate the utility and power of our tool using publicly available microbial and gene expression data.

Conclusion

NetConfer tool is developed keeping in mind the requirements of researchers working in the field of biological data analysis with limited programming expertise. It is also expected to be useful for advanced users from biological as well as other domains (working with association networks), benefiting from provided ready-made workflows, as they allow to focus directly on the results without worrying about the implementation. While the web version allows using this application without installation and dependency requirements, a stand-alone version has also been supplemented to accommodate the offline requirement of processing large networks.
Age-dependent involvement of gut mast cells and histamine in post-stroke inflammation
Authors: Blasco Maria Pilar , Chauhan Anjali , Honarpisheh Pedram , Ahnstedt Hilda , d’Aigle John , Ganesan Arunkumar , Ayyaswamy Sriram , Blixt Frank , Venable Susan , Major Angela , Durgan David , Haag Anthony , Kofler Julia , Bryan Robert , McCullough Louise D. , Ganesh Bhanu Priya
Published: May 2020

Background

Risk of stroke-related morbidity and mortality increases significantly with age. Aging is associated with chronic, low-grade inflammation, which is thought to contribute to the poorer outcomes after stroke seen in the elderly. Histamine (HA) is a major molecular mediator of inflammation, and mast cells residing in the gut are a primary source of histamine.

Methods

Stroke was induced in male C57BL/6 J mice at 3 months (young) and 20 months (aged) of age. Role of histamine after stroke was examined using young (Yg) and aged (Ag) mice; mice underwent MCAO surgery and were euthanized at 6 h, 24 h, and 7 days post-ischemia; sham mice received the same surgery but no MCAO. In this work, we evaluated whether worsened outcomes after experimental stroke in aged mice were associated with age-related changes in mast cells, histamine levels, and histamine receptor expression in the gut, brain, and plasma.

Results

We found increased numbers of mast cells in the gut and the brain with aging. Using the middle cerebral artery occlusion (MCAO) model of ischemic stroke, we demonstrate that stroke leads to increased numbers of gut mast cells and gut histamine receptor expression levels. These gut-centric changes are associated with elevated levels of HA and other pro-inflammatory cytokines including IL-6, G-CSF, TNF-α, and IFN-γ in the peripheral circulation. Our data also shows that post-stroke gut inflammation led to a significant reduction of mucin-producing goblet cells and a loss of gut barrier integrity. Lastly, gut inflammation after stroke is associated with changes in the composition of the gut microbiota as early as 24-h post-stroke.

Conclusion

An important theme emerging from our results is that acute inflammatory events following ischemic insults in the brain persist longer in the aged mice when compared to younger animals. Taken together, our findings implicate mast cell activation and histamine signaling as a part of peripheral inflammatory response after ischemic stroke, which are profound in aged animals. Interfering with histamine signaling orally might provide translational value to improve stroke outcome.
Analysis of lung biopsies using the 2015 WHO criteria and detection of sensitizing mutations——a single-institution experience of 5032 cases
Authors: Zeng Yupeng , Zhu Yunxiang , Ding Ying , Xu Liuyang , Zhai Boya , Zhang Xiang , Ge Qiaoyun , Li Jiao , Song Qiyuan , Li Xiao , Zhang Zhihong
Published: May 2020

Background

A specialized classification for small biopsies was added to the 2015 WHO classification of lung tumors. The purpose of this study is to explore and summarize the experience of applying the newly proposed classifications and criteria to clinical practice.

Methods

We used the 2015 WHO criteria to sort out 5032 small lung biopsies from a group of Chinese patients, and demonstrated their clinicopathological features, mutational status and the relationship between these factors.

Results

The most common diagnosis was primary lung carcinoma (3130, 62.2%), among which adenocarcinoma (1421, 28.2%) was the most frequent histological type. The mutational assays using ARMS-PCR technology demonstrated that EGFR was positive in 56.1% cases(499/889, from adenocarcinoma and NSCC, favor adenocarcinoma), ALK in 5.7% cases(12/211, from NSCC, which comprised all the primary lung carcinomas except small cell carcinomas), and ROS1 in 0.9% cases(2/211, from NSCC). Another 898 NSCC specimens went through an immunohistochemical (IHC) examination for ALK (D5F3) and 38 of them were positive (4.2%). The overall mutation rate of ALK was 4.5% (50/1119). There was no significant difference between ARMS-PCR and immunohistochemistry in the positive rate of ALK mutation detection (P = 0.359). EGFR mutations (P = 0.02) and ALK mutations (P < 0.001) both decreased with an increasing patient age. Furthermore, the amount of EGFR mutations was higher in adenocarcinoma (64.1% vs 34.1%, P < 0.001) than in NSCC, favor adenocarcinoma. In contrast, ALK mutations were more common in NSCC, favor adenocarcinoma (4.2% vs 8.4%, P = 0.021).

Conclusions

This single-center study exhibited a large subset of small lung biopsies from a Chinese institution and demonstrated that applying the 2015 WHO classification for small lung biopsies can help predict the mutational status of primary lung carcinomas.
Wild plants and fungi sold in the markets of Yerevan (Armenia)
Authors: Nanagulyan Siranush , Zakaryan Narine , Kartashyan Nune , Piwowarczyk Renata , Łuczaj Łukasz
Published: May 2020

Background

The aim of the study was to record wild plants and fungi sold in the capital of Armenia. This is the first large market survey in the Caucasus region. The area of the Caucasus is characterised by a very high diversity of climates, flora and languages which results in very rich traditions of plant use.

Methods

Interviews were conducted and photos and voucher specimens were taken during multiple visits made over 4 years. We studied 37 locations and 136 people were interviewed.

Results

As many as 163 plant species, belonging to 44 families and 110 genera, were recorded on Yerevan markets. This included 148 wild food species, 136 medicinal species, 45 species sold for decoration, 15 species of wood and 9 species of insect repellents. Also 14 wild species of fungi were sold, including 12 food species.

Conclusions

The list of plants sold in the markets of Yerevan is very extensive and diverse, and includes many species of wild fruits, vegetables and medicinal plants, some of them never listed in ethnobotanical directories before. A characteristic feature of this market is a large representation of lacto-fermented products. Some of the species sold in Yerevan have never been reported as human food either in wild edible plant word lists or in ethnobotanical publications, e.g. Angelica tatianae, Ferulago setifolia and Heracleum chorodanum. Fungi are also well represented.
Optimising and profiling pre-implementation contexts to create and implement a public health network intervention for tackling loneliness
Authors: Ellis J. , Band R. , Kinsella K. , Cheetham-Blake T. , James E. , Ewings S. , Rogers A.
Published: May 2020

Background

The implementation of complex interventions experiences challenges that affect the extent to which they become embedded and scaled-up. Implementation at scale in complex environments like community settings defies universal replication. Planning for implementation in such environments requires knowledge of organisational capacity and structure. Pre-implementation work is an important element of the early phase of preparing the setting for the introduction of an intervention, and the factors contributing towards the creation of an optimal pre-implementation community context are under-acknowledged.

Methods

To explore the factors contributing towards the creation of an optimal pre-implementation context, a quasi-ethnographic approach was taken. The implementation of a social network intervention designed to tackle loneliness in a community setting acts as the case in example. Observations (of meetings), interviews (with community partners) and documentary analysis (national and local policy documents and intervention resources) were conducted. Layder’s adaptive theory approach was taken to data analysis, with the Consolidated Framework for Implementation Research (CFIR) and a typology of third-sector organisations used to interpret the findings.

Results

Community settings were found to sit along a continuum with three broad categories defined as Fully Professionalised Organisations; Aspirational Community, Voluntary and Social Enterprises; and Non-Professionalised Community-Based Groups. The nature of an optimal pre-implementation context varied across these settings. Using the CFIR, the results illustrate that some settings were more influenced by political landscape (Fully professional and Aspirational setting) and others more influenced by their founding values and ethos (Non-Professionalised Community-Based settings). Readiness was achieved at different speeds across the categories with those settings with more resource availability more able to achieve readiness (Fully Professional settings), and others requiring flexibility in the intervention to help overcome limited resource availability (Aspirational and Non-Professionalised Community-Based settings).

Conclusions

The CFIR is useful in highlighting the multiple facets at play in creating the optimal pre-implementation context, and where flex is required to achieve this. The CFIR illuminates the similarities and differences between and across settings, highlighting the complexity of open system settings and the important need for pre-implementation work.

Trial registration

ISRCTN19193075
Radiotherapy for nonagenarians: the value of biological versus chronological age
Authors: Sprave Tanja , Rühle Alexander , Stoian Raluca , Weber Alina , Zamboglou Constantinos , Nieder Carsten , Grosu Anca-Ligia , Nicolay Nils H.
Published: May 2020

Background

The number of nonagenarian cancer patients (≥ 90 years) is continuously increasing, and radiotherapy is performed in a relevant proportion of patients, as surgery and chemotherapy are often not feasible for these patients. However, the evidence regarding the feasibility and treatment outcomes after radiotherapy for this patient group is very limited.

Methods

All nonagenarian patients receiving (chemo) radiotherapy between 2009 and 2019 at the University of Freiburg - Medical Center were analyzed for patterns of care, overall survival (OS) and therapy-associated toxicities according to the Common Terminology Criteria for Adverse Events. Uni- and multivariate Cox regression analyses were conducted to assess the influence of patient- and treatment-related factors on patient outcomes.

Results

One hundred nineteen patients with a total of 137 irradiated lesions were included in this analysis. After a median follow-up of 27 months, median OS was 10 months with a 3-year OS amounting to 11.1%. Univariate analyses demonstrated that a reduced performance status (HR = 1.56, 95% CI 1.00–2.45, p < 0.05), a higher burden of comorbidities (HR = 2.00, 95% CI 1.00–4.10, p < 0.05) and higher UICC tumor stages (HR = 2.21, 95% CI 1.14–4.26, p < 0.05) were associated with impaired survival rates. Split-course treatments (HR = 2.05, 95% CI 1.07–3.94, p < 0.05), non-completion of radiotherapy (HR = 7.17, 95% CI 3.88–13.26, p < 0.001) and palliative treatments (HR = 2.84, 95% CI 1.68–4.81, p < 0.05) were found to result in significantly reduced OS. In the multivariate analysis, split-course concepts (HR = 2.21, 95% CI 1.10–4.37, p < 0.05) and palliative treatments (HR = 3.19, 95% CI 1.77–5.75, p < 0.001) significantly deteriorated outcomes, while impaired ECOG status (HR = 1.49, 95% CI 0.91–2.43, p = 0.11) did not. The vast majority of patients reported either no (n = 40; 33.6%) or grade 1–2 acute toxicities (n = 66; 55.5%), and only very few higher-grade toxicities were observed in our study.

Conclusion

Radiotherapy for nonagenarian patients is generally feasible and associated with a low toxicity profile. Given the relatively poor OS rates and the importance of the quality of life for this patient group, individualized treatment regimens including hypofractionation concepts should be considered.
Reduction of pedestrian death rates: a missed global target
Authors: Yasin Yasin J. , Grivna Michal , Abu-Zidan Fikri M.
Published: May 2020

Background

The UN Decade of Action for Road Safety aimed to reduce road traffic deaths by half by year 2020. We aimed to study risk factors affecting global pedestrian death rates overtime, and whether the defined target of its reduction by WHO has been achieved.

Methods

The studied variables were retrieved from the WHO Global Status Reports on Road Safety published over 2010–2018. These covered years 2007–2016 and included the estimated road traffic death rates per 100,000 population, policies to promote walking and cycling, enforcement levels of national speed limits, the gross national income per capita and the vehicle/person ratio in each country. A mixed linear model was performed to define the factors affecting the change of pedestrian death rates overtime.

Results

Global pedestrian mortality decreased by 28% over 10 years. This was significant between years 2007 and 2010 (p = 0.034), between years 2013 and 2016 (p = 0.002) but not between 2010 and 2013 (p = 0.06). Factors that reduced pedestrian death rates included time (p < 0.0001), GNI (p < 0.0001), and vehicle/person ratio (p < 0.0001). There was a significant drop overtime in both the middle-income, and high-income countries (p < 0.0001, Friedman test), but not in the low-income countries (p = 0.35, Friedman test).

Conclusions

Global pedestrian mortality has dropped by 28% over a recent decade, which is less than the 50% targeted reduction. This was mainly driven by improved GNI and using more vehicles. The economical gap between poor and rich countries has a major impact on pedestrian death rates.
Mental health in adolescents displaced by the armed conflict: findings from the Colombian national mental health survey
Authors: Marroquín Rivera Arturo , Rincón Rodríguez Carlos Javier , Padilla-Muñoz Andrea , Gómez-Restrepo Carlos
Published: May 2020

Background

Colombia has one of the largest populations of internally displaced individuals by an armed conflict. However, there is no data demonstrating its effect on health, particularly in adolescents.

Purpose

To describe the prevalence and associations of mental illness in the adolescent population displaced by violence in Colombia.

Methods

We conducted a secondary analysis of the 2015 National Mental Health Survey (NMHS), which provides data of mental health issues (SRQ), mental health disorders (CIDI-CAPI) and sociodemographic characteristics.

Results

Of the 1754 adolescents interviewed 5.3% (95% CI 4.1 to 6.9) mentioned a change in residence due to violence. Among them 38.5% lived in poverty compared to 23.6% of those non-displaced by the conflict. Suicidal thoughts and suicide attempt were present in 19.8% and 9.1% of displaced adolescents respectively, compared to 5.8% and 2.1% of non-displaced adolescents. The prevalence of post-traumatic stress disorder (PTSD) and any mental health disorder (measured with the CIDI-CAPI) was higher in the displaced population 12.3%, 11% respectively, in contrast to 2.1% and 7% of those non-displaced. Finally, anxiety and depressive disorders were more common among displaced adolescents.

Conclusion

A higher prevalence of mental health conditions and disorders is observed among displaced adolescents.
High-throughput screening of clinically approved drugs that prime nonviral gene delivery to human Mesenchymal stem cells
Authors: Kozisek Tyler , Hamann Andrew , Nguyen Albert , Miller Michael , Plautz Sarah , Pannier Angela K.
Published: May 2020

Background

Human mesenchymal stem cells (hMSCs) are intensely researched for applications in cell therapeutics due to their unique properties, however, intrinsic therapeutic properties of hMSCs could be enhanced by genetic modification. Viral transduction is efficient, but suffers from safety issues. Conversely, nonviral gene delivery, while safer compared to viral, suffers from inefficiency and cytotoxicity, especially in hMSCs. To address the shortcomings of nonviral gene delivery to hMSCs, our lab has previously demonstrated that pharmacological ‘priming’ of hMSCs with the glucocorticoid dexamethasone can significantly increase transfection in hMSCs by modulating transfection-induced cytotoxicity. This work seeks to establish a library of transfection priming compounds for hMSCs by screening 707 FDA-approved drugs, belonging to diverse drug classes, from the NIH Clinical Collection at four concentrations for their ability to modulate nonviral gene delivery to adipose-derived hMSCs from two human donors.

Results

Microscope images of cells transfected with a fluorescent transgene were analyzed in order to identify compounds that significantly affected hMSC transfection without significant toxicity. Compound classes that increased transfection across both donors included glucocorticoids, antibiotics, and antihypertensives. Notably, clobetasol propionate, a glucocorticoid, increased transgene production 18-fold over unprimed transfection. Furthermore, compound classes that decreased transfection across both donors included flavonoids, antibiotics, and antihypertensives, with the flavonoid epigallocatechin gallate decreasing transgene production − 41-fold compared to unprimed transfection.

Conclusions

Our screen of the NCC is the first high-throughput and drug-repurposing approach to identify nonviral gene delivery priming compounds in two donors of hMSCs. Priming compounds and classes identified in this screen suggest that modulation of proliferation, mitochondrial function, and apoptosis is vital for enhancing nonviral gene delivery to hMSCs.
Correction to: Expectations and psychological issues before genetic counseling: analysis of distress determinant factors
Authors: Ballatore Zelmira , Bracci Raffaella , Maccaroni Elena , Svarca Lucia , Bianchi Francesca , Belvederesi Laura , Brugiati Cristiana , Pagliaretta Silvia , Murrone Alberto , Bini Federica , Pistelli Mirco , Ricci Giulia , Berardi Rossana
Published: May 2020

An amendment to this paper has been published and can be accessed via the original article.
Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka
Authors: Gunathilaka Nayana , Semege Saveen , Pathirana Nishantha , Manamperi Nuwani , Udayanga Lahiru , Wijesinghe Harshima , Premaratne Prasad , Fernando Deepika
Published: May 2020

Background

The 30-year-old armed conflict in Sri Lanka resulted in a general breakdown of civil administration in the Northern and Eastern provinces, leading to mobilisation of many armed forces personnel to assist with reconstruction and resettlement. This occupational group has been identified as a priority risk group for leishmaniasis.

Methods

Individuals enlisted at all military establishments in Mullaitivu and Kilinochchi districts, Northern Province of Sri Lanka were included. Five thousand individuals were screened for skin lesions between September 2018 and August 2019. Persons with lesions suspected as cutaneous leishmaniasis (CL) were further investigated. Information on sociodemographic/other potential risk factors was obtained through an interviewer-administered structured questionnaire. The diagnosis was confirmed by microscopic visualization of parasitic stages from different samples obtained (skin scraping, lesion aspirate and tissue impression smears), histopathology and polymerase chain reaction DNA amplification.

Results

Among 5000 individuals screened, 74 individuals were suspected of having CL. Of these, 67.6% (n = 50) patients were confirmed for CL by microscopy. Around two third of both males (67.6%; n = 48) and females (66.6%; n = 2) were positive for Leishmania. The soldiers belonging to 26–35-year age group reported the highest susceptibility (83.3%; OR: 4.83, 95% CI: 3.49–6.20%). Of the sociodemographic factors, age, wearing short-sleeved upper body clothing as the uniform and non-use of insect repellents were identified as significant risk factors. Most of the CL patients had a single lesion (86.0%; n = 43) of an ulcerative type (34.0%; n = 17), mostly on their upper limb (67.9%; n = 34). Lesions were mostly 5–10 mm diameter (59.9%; n = 30) in size with poorly defined margins (72.0%; n = 36). Amongst the diagnostic techniques, microscopic examination of slit skin smear and tissue impression smear were able to discriminate the majority of patients (92.1%; n = 46) for CL.

Conclusions

In order to highlight the true burden of leishmaniasis in the military personnel, cases of leishmaniasis from military institutes should be recognized as a different entity per say and be included in the national figures so as to depict the real magnitude of the disease burden amongst this high-risk group.