bluuebunny/crossref_metadata_2025 huggingface dataset:
Ivermectin compared with placebo in the clinical course in Mexican patients with asymptomatic and mild COVID-19: a randomized clinical trial
Authors: de la Rocha Carmen , Cid-López Marco A. , Venegas-López Blanca I. , Gómez-Méndez Sandra C. , Sánchez-Ortiz Adriana , Pérez-Ríos Alma M. , Llamas-Velázquez Ricardo A. , Meza-Acuña Aidé I. , Vargas-Íñiguez Bárbara , Rosales-Galván Daniela , Tavares-Váldez Alejandra , Luna-Gudiño Nizdali , Hernández-Puente Cinthia V. , Milenkovic Jovana , Iglesias-Palomares Cecilia , Méndez-del Villar Miriam , Gutiérrez-Dieck Gerardo A. , Valderrábano-Roldán Carlos G. , Mercado-Cerda Jennefer , Robles-Bojórquez Jocelyn G. , Mercado-Sesma Arieh R.
Published: December 2022

Background

Despite the development and application of vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) around the world, the scientific community is still trying to find some therapies to avoid or ameliorate the fatal evolution of the Coronavirus disease 2019 (COVID-19). Since the publication of the potential use of ivermectin as a treatment against the disease, a pleiad of information about it has been published. However, the evidence is not strong or weak enough to conclude its usefulness in the clinical evolution of patients infected with SARS-CoV-2. We evaluate the efficacy and safety of ivermectin in the treatment of Mexican patients with asymptomatic and mild COVID-19 in a three-day administration in comparison to placebo.

Methods

A randomized, double-blind, placebo-controlled trial was carried out in 66 adults with asymptomatic and mild COVID-19. Patients were randomly assigned 1:1 ratio to ivermectin plus acetaminophen or placebo plus acetaminophen. The primary endpoint was the proportion of subjects without a disease progression to severity according to COVID-19 guidelines by the National Institutes of Health (NIH) since randomization to 14 days.

Results

None of the participants presented progression to a severe state in either group. Viral load was measured on Days 1, 5, and 14. No significant differences were observed in baseline or 14-day between groups (p = 0.720 and 0.362, respectively). However, on Day 5, a significant difference in viral load was observed between groups (p = 0.039). The frequency of symptoms was similar between groups, and no significant differences were observed. The most frequent symptom was cough. One severe adverse event associated with SARS-CoV-2 infection was observed in the ivermectin group.

Conclusions

At standard doses, ivermectin is not effective to prevent progression to a severe state or reducing symptoms in adults with asymptomatic and mild COVID-19.

Trial registration The study was registered with ClinicalTrial.gov (NCT04407507) on May 29, 2020.
Insulin resistance in women with recurrent miscarriage: a systematic review and meta-analysis
Authors: Cai Wang-Yu , Luo Xi , Lv Hou-Yi , Fu Kai-You , Xu Jian
Published: December 2022

Purpose

This review aimed to investigate the association of insulin resistance (IR) in women with recurrent pregnancy loss compared to women with normal pregnancy history.

Methods

PubMed, EMBASE, the Web of Science and Google Scholar databases were accessed to collect published observational studies that compared IR of recurrent pregnancy loss women with healthy women until the 6thof October 2022. Outcomes assessed in this review and meta-analysis included fasting blood glucose, fasting plasma insulin, homeostasis model assessment for IR, glucose to insulin ratio. Mean differences, odds ratios with 95% confidence interval were pooled using the fixed or random effect models. Sensitivity analyses were performed to validate the robustness of the results. Review Manager version 5.4.1 and Stata version 8.0 were used.

Results

A total of nineteen studies involving 4453 individuals were included. Recurrent pregnancy loss patients presented significantly higher fasting blood glucose, fasting plasma insulin, homeostasis model assessment for IR, and lower glucose to insulin ratios. Additionally, recurrent pregnancy loss patients had higher rates of IR as defined by abnormal fasting plasma insulin, homeostasis model assessment for IR, and glucose to insulin ratio. Sensitivity analyses validated the robustness of the results.

Conclusion

In the current review, we show that recurrent pregnancy loss is associated with a higher degree of IR and highlight the importance of screening and treatment of IR.
Simplification of dosimetry in 90Y-radioembolization therapy by dual planar images
Authors: Abuqbeitah Mohammad , Akdağ Özgür Taylan , Demir Mustafa , Asa Sertaç , Sönmezoğlu Kerim
Published: December 2022

Aim

The purpose was to provide a practical and effective method for performing reliable 90Y dosimetry based on 99mTc-MAA and SPEC/CT. The impact of scatter correction (SC) and attenuation correction (AC) on the injected 90Y activity, lung shunt fraction (LSF) and the delivered dose to lung and liver compartments was investigated within the scope of the study.

Material and methods

Eighteen eligible patients (F: 3, M: 15) were subjected to 90Y therapy. 99mTc-MAA (111-222 MBq) was injected into the targeted liver, followed by whole-body scan (WBS) with peak-window at 140 keV (15% width) and one down-scatter window. SPECT/CT scan was subsequently acquired encompassing lung and liver regions. The LSFs were fashioned from standard WBS LSFwb (St), scatter corrected WBS LSFwb (Sc), only scatter corrected SPECT LSFspect (NoAC-SC) and SPECT/CT with attenuation and scatter correction LSFspect (AC-SC). The absorbed doses that would be delivered to tumor and injected healthy liver were estimated using different calculation modes involving AC-SC (SPECT/CT), NoAC-SC (SPECT), NoAC-NoSC+LSFwb (SC), AC-SC + LSFwb (St), and NoAC-NoSC+LSFwb (St).

Results

The average deviations (range) in LSF values between standard LSFwb (St) and those from SPECT/CT (AC-SC), SPECT (NoAC-SC), and LSFwb (SC) were − 50% (− 29/− 71), − 32% (− 8/− 67), and − 45% (− 13/80), respectively. The suggested 90Y activity (GBq/Gy) was decreased within a range of 2-11%, 1-9%, and 2-7% by using LSFspect (AC-SC), LSFspect (NoAC-SC), and LSFwb (SC), respectively. Overall, two-sample t-test yielded no statistically significant difference (p < 0.05) in the absorbed doses to tumor and injected healthy liver between AC-SC (SPECT) and the rest of approaches with/and without AC and SC. However, a statistically significant difference (p < 0.05) was demonstrated in the lung shunt fractions and lung doses due to AC and SC. The LSFs from scatter corrected planar images LSFwb (SC) exhibited well agreement (R2 = 0.92) with SPECT/CT (AC-SC) and there was no statistically significant difference (Pvalue > 0.05) between both methods.

Conclusion

It was deduced that SPECT/CT with attenuation and scatter correction plays a crucial role in the measurements of lung shunt fraction and dose as well as the total number of 90Y treatments. However, the absorbed dose to tumors and injected healthy liver was minimally affected by AC and SC. Besides, a good agreement was observed between LSF datasets from SPECT/CT versus scatter corrected WBS that can be alternatively and effectively used in 90Y dosimetry.
Factors associated with allergy traits around the 2nd year of life: a brazilian cohort study
Authors: Muniz Alessandra Karla Oliveira Amorim , Ribeiro Cecilia Claudia Costa , Vianna Elcio Oliveira , Serra Hellen Cristina Oliveira Amorim , Nascimento Joelma Ximenes Prado Teixeira , Cardoso Viviane Cunha , Barbieri Marco Antonio , da Silva Antonio Augusto Moura , Bettiol Heloisa
Published: December 2022

Background

Allergic status has been strongly influenced by early exposures; however, allergic diseases are hard to measure in early life. Thus, this study proposed a latent variable allergy traits around the second year of life and analyzed pre- and perinatal factors associated with this phenomenon.

Methods

The study used data from the BRISA birth cohort, Ribeirão Preto, Brazil (n = 3644). The theoretical model included: family allergy (history of allergic rhinitis, atopic dermatitis, and asthma); gestational period variables (socioeconomic status, mother’s skin color, pregestational body mass index – BMI, smoking, gestational diabetes, and hypertension); birth variables (gestational age, 5-minute Apgar score, birth weight, type of delivery), and early life factor (exclusive breast feeding). The outcome was allergy traits around the 2nd year of life, a latent variable deduced from the shared variance among medical diagnosis of allergic rhinitis, atopic dermatitis, and food allergy. The model was analyzed by structural equation modeling.

Results

Higher socioeconomic status (SC = 0.256; p < 0.001) and higher family allergy values (SC = 1.224; p < 0.001) were associated with higher allergy trait values. Hypertension during pregnancy was associated with higher values (SC = 0.170; p = 0.022) and exclusive breast feeding (SC = -0.192; p < 0.001) with low allergy trait values.

Conclusion

Although socioeconomic and environmental factors were associated with allergy traits around the 2nd year of life, the family component of allergy was the exposure that best explained this outcome.
Counseling parents about child feeding: a qualitative evaluation of French doctors and health/childcare professionals’ experiences and perception of a brochure containing new recommendations
Authors: De Rosso Sofia , Riera-Navarro Camille , Ducrot Pauline , Schwartz Camille , Nicklaus Sophie
Published: December 2022

Background

Parents are crucial in establishing their children’s eating habits, and doctors and health/childcare professionals (HCCPs) can provide meaningful and trusted guidance on feeding, especially in the 0-3-year-old period. With the upcoming release of the official brochure containing the new child feeding recommendations in France, this study aims to: (1) assess professionals’ practices and perceptions regarding their communication with parents on child feeding and (2) evaluate their perception of the draft of the new brochure.

Methods

A 15-page draft brochure (without pictures) containing updated child feeding recommendations for children 0–3 years old was developed by Santé publique France (the French public health agency). Online semi-structured interviews were conducted with professionals (n = 21), including 13 pediatricians and general practitioners (doctors) and eight healthcare or childcare professionals (HCCPs) two weeks after they were provided with this draft brochure to read. The interview guide was developed and piloted with other professionals (n = 3) prior to these interviews. Interview data were transcribed verbatim and analyzed thematically using an inductive approach.

Results

While doctors and HCCPs mostly communicate orally with parents, both acknowledged that the brochure might be a helpful supplement, especially for HCCPs to legitimize their advice to parents. For doctors, giving the brochure to parents may help provide systematic advice and save time during consultations. Professionals serving parents of lower socioeconomic status would prefer a supplement with less text and more illustrations. In general, the messages were perceived to be easily understandable but providing detachable cards to distribute according to the child’s age would facilitate information dissemination and might be more useful to parents. Professionals reported that lack of training, the circulation of contradictory information, and language barriers were common challenges.

Conclusion

French professionals welcomed the new official brochure as a means to spread updated child feeding recommendations. However, this brochure could be modified and specific tools developed to better adapt to professionals’ needs of communication with parents and to facilitate the relay of information. Providing updated and consistent information to parents should be considered a priority for public health stakeholders toward increased adherence to new recommendations.
A systematic review of the global prevalence and incidence of shoulder pain
Authors: Lucas J. , van Doorn P. , Hegedus E. , Lewis J. , van der Windt D.
Published: December 2022

Background and objectives

Studies reporting on the population burden of people living with shoulder pain show wide heterogeneity in terms of case definition, study samples, and occurrence. This systematic review aims to summarize evidence pertaining to the prevalence and incidence of shoulder pain, including variability based on sex and geography. We also explored the potential influence of methodological limitations and important sources of heterogeneity (case definition and reference period) on reported estimates of shoulder pain prevalence.

Databases and data treatment

The study protocol was registered on Prospero under CRD42021243140. We searched EMBASE, CINAHL, Web of Science and Medline from inception to March 2021. Study selection, data extraction and risk of bias assessment was conducted by a team of three researchers. We performed a narrative synthesis of the data, using forest plots to summarize study findings, and stratified data presentation to explore the potential association of risk of bias, case definition, and reference period with estimates of prevalence and incidence of shoulder pain.

Results

We obtained data from 61 studies reporting data from high-, middle- and low-income countries. The overall risk of bias was low, with most rated as “low-risk” and no studies rated as “high-risk”. The community prevalence of shoulder pain varied widely across the countries included in our review, with a median of 16% (range 0.67 to 55.2%). Longer reference periods were typically associated with higher prevalence estimates. Primary care prevalence ranged from 1.01 to 4.84% (median 2.36%). Estimates were generally higher for women than men and were higher in high-income nations. The incidence of shoulder pain ranged from 7.7 to 62 per 1000 persons per year (median 37.8 per 1000 persons per year). Risk of bias did not clearly explain variability in study findings, but there was considerable variation in study samples, methods used, and a relative absence of data from low-income countries.

Conclusions

Our review demonstrates that a significant proportion of the population across the world will experience shoulder pain daily, yearly, and throughout a lifetime. Regional gaps in evidence and methodological inconsistencies must be addressed in order to establish a more definitive global burden.
Laparoscopic extralevator abdominoperineal excision in distal rectal cancer patients: a retrospective comparative study
Authors: Wang Zhiqiang , Liang Rui , Yalikun Dilimulati , Yang Jun , Li Wenliang , Kou Zhiyong
Published: December 2022

Background

At present, abdominoperineal excision with neoadjuvant chemoradiotherapy (nCRT) is one of the treatment modalities of distal rectal cancer. Our study analyzed the effects of laparoscopic extralevator abdominoperineal resection (ELAPE) compared with laparoscopic conventional abdominoperineal resection(cAPR) in the treatment of distal rectal cancer.

Methods

Retrospective analysis was conducted on the clinicopathological data of 177 distal rectal cancer patients treated with a laparoscopic abdominoperineal resection between 2011 and 2018. The patients were divided into four groups as follows: ELAPE without nCRT (group A), cAPR without nCRT (group B), ELAPE with long-course nCRT (group C) and cAPR with long-course nCRT (group D).

Results

Positive circumferential resection margin (CRM), local recurrence rate, 3-year disease-free survival (DFS) and 3-year overall survival (OS) did not differ between group A and group B. The rate of positive CRM in group C was lower than group D (4.4% vs. 11.9%, respectively), although the difference was not significant (P = 0.377). The 3-year local recurrence rate in group C was lower compared with group D (6.6% vs. 16.7%, respectively), although the difference was not significant (P = 0.135). Three-year DFS and 3-year OS were not different between groups C and D.

Conclusions

This study showed that the effect of laparoscopic ELAPE in patients with low-risk rectal cancer is similar to laparoscopic cAPR, revealing that laparoscopic cAPR can be routinely selected for patients with low-risk rectal cancer. Furthermore, laparoscopic ELAPE has a tendency to reduce the rate of positive CRM and local recurrence in patients with high-risk rectal cancer. Laparoscopic ELAPE can be routinely considered for patients with high-risk rectal cancer.
Comparison of surgical smoke between two approaches for endoscopic thyroidectomy and open thyroidectomy
Authors: Zhang Zhe , Jin Gongsheng , Liu Xianfu
Published: December 2022

Background

Surgical smoke has been recognized as a potential health risk by an increasing number of researchers. Moreover, the counts of surgical smoke produced during different surgical approaches are different. This study aimed to measure and compare the particulate matter (PM) of surgical smoke generated during open thyroidectomy and two endoscopic approaches for thyroidectomy to provide guidance for safe clinical practices.

Methods

Forty-eight patients with thyroid cancer admitted to our hospital from June 2020 to December 2021 and treated with different surgical approaches were enrolled in this study. The total and peak counts of PM, dynamic changes, and other characteristics of surgical smoke produced during surgery were recorded. PM was classified as PM2.5 (size ≤ 2.5 μm) and PM10 (size ≤ 10 μm).

Results

In a single cut, both the peak and total counts of PM2.5 and PM10 of surgical smoke in the open thyroidectomy group (n = 15) were significantly higher than those in the breast approach endoscopic thyroidectomy with CO2 insufflation group (n = 15) and the gasless transaxillary endoscopic thyroidectomy group (n = 18) (p < 0.001). Moreover, the latter two groups showed no significant differences in the peak and total counts of PM2.5 and PM10 (p > 0.05).

Conclusion

In thyroid surgery, more surgical smoke is produced during open thyroidectomy than during endoscopic thyroidectomy, while different endoscopic approaches showed no significant difference in surgical smoke production. Thus, endoscopic approaches outperform the open thyroidectomy approach with regard to surgical smoke production.
Predictors of microalbuminuria and its relationship with glycemic control among Type 2 diabetic patients of Jazan Armed Forces Hospital, southwestern Saudi Arabia
Authors: Abdelwahid Hassan Ali , Dahlan Hesham Mohamed , Mojemamy Gassem Maoudhah , Darraj Gasem Hussein
Published: December 2022

Background and purpose

Diabetic kidney disease (DKD) is highly prevalent among patients with diabetes mellitus. It affects approximately 20% of diabetic patients, who are believed to be more than 400 million individuals. The objectives of the present work were to assess patterns of albuminuria and determine microalbuminuria predictors among patients living with type 2 diabetes (T2D) who attended the family medicine department of Jazan Armed Forces Hospital.

Methods

A case–control design was used and included two groups (n, 202/group), one with microalbuminuria and the other with a normal urine albumin/creatinine ratio (ACR). Data regarding patient history, glycosylated hemoglobin (HbA1c), lipid profile, renal function tests, ACR, ASCVD (atherosclerotic cardiovascular disease) risk, etc., were collected.

Results

The prevalence rates of microalbuminuria and macroalbuminuria were 26.4% and 3.9%, respectively. HbA1c was significantly higher in patients with microalbuminuria (9.3 ± 2.2; P˂0.001) and macroalbuminuria (10.5 ± 2.3; P˂0.001) than in those with normal ACR (8.3 ± 1.9%). The predictors of microalbuminuria were poor glycemic control with HbA1c ≥ 7% {OR, 2.5 (95% C. I, 1.5–4.2)}; hypertension {(OR, 1.8 (95% C. I, 1.2–2.8)}; estimated glomerular filtration rate (eGFR) of ˂90 mL/min/1.73 m2 {OR, 2.2 (95% C. I, 1.4–3.6}; smoking {OR, 1.3 (95% C. I, 0.7–2.6}; and body mass index {OR, 1.05 (95% C. I, 1.01–1.09}.

Conclusion

Microalbuminuria is highly prevalent among patients with type 2 diabetes and is associated with poor glycemic control and hypertension, necessitating aggressive and timely screening and treatment.
Providers’ perspectives on the reproductive decision-making of BRCA-positive women
Authors: Dason E. S. , Drost L. , Greenblatt E. M. , Scheer A. S. , Han J. , Sobel M. , Allen L. , Jacobson M. , Doshi T. , Wolff E. , McMahon E. , Jones C. A.
Published: December 2022

Background

Reproductive decision-making is difficult for BRCA-positive women. Our objective was to assess the complexities of decision-making and identify decisional supports for patients and providers when discussing reproductive options prior to risk-reducing salpingo-oophorectomy (RRSO).

Methods

This study was of qualitive design, using data collection via semi-structured interviews conducted from November 2018 to October 2020. Individuals were included if they were identified to provide care to BRCA-positive women. In total, 19 providers were approached and 15 consented to participate. Providers were recruited from three clinics in Toronto, Ontario located at academic centers: [1] A familial ovarian cancer clinic, [2] A familial breast cancer clinic and [3] A fertility clinic, all of which treat carriers of the BRCA1/BRCA2 genetic mutation. The interview guide was developed according to the Ottawa Decision Support Framework and included questions regarding reproductive options available to patients, factors that impact the decision-making process and the role of decisional support. Interviews were transcribed and transcripts were analyzed thematically using NVIVO 12.

Results

Providers identified three major decisions that reproductive-aged women face when a BRCA mutation is discovered: [1] “Do I want children?”; [2] “Do I want to take the chance of passing on this the mutation?”; and [3] “Do I want to carry a child?” Inherent decision challenges that are faced by both providers and patients included difficult decision type, competing options, scientifically uncertain outcomes, and challenging decision timing. Modifiable decisional needs included: inadequate knowledge, unrealistic expectations, unclear values and inadequate support or resources. Identified clinical gaps included counselling time constraints, lack of reliable sources of background information for patients or providers and need for time-sensitive, geographically accessible, and centralized care.

Conclusion

Our study identified a need for a patient information resource that can be immediately provided to patients who carry a BRCA genetic mutation. Other suggestions for clinical practice include more time during consultation appointments, adequate follow-up, value-centric counseling, access to psychosocial support, and a specialized decisional coach.
Luteolin: a flavonoid with a multifaceted anticancer potential
Authors: Prasher Parteek , Sharma Mousmee , Singh Sachin Kumar , Gulati Monica , Chellappan Dinesh Kumar , Zacconi Flavia , De Rubis Gabriele , Gupta Gaurav , Sharifi-Rad Javad , Cho William C. , Dua Kamal
Published: December 2022

Therapeutic effect of phytochemicals has been emphasized in the traditional medicine owing to the presence of bioactive molecules, such as polyphenols. Luteolin is a flavone belonging to the flavonoid class of polyphenolic phytochemicals with healing effect on hypertension, inflammatory disorders, and cancer due to its action as pro-oxidants and antioxidants. The anticancer profile of luteolin is of interest due to the toxic effect of contemporary chemotherapy paradigm, leading to the pressing need for the development and identification of physiologically benevolent anticancer agents and molecules. Luteolin exerts anticancer activity by downregulation of key regulatory pathways associated with oncogenesis, in addition to the induction of oxidative stress, cell cycle arrest, upregulation of apoptotic genes, and inhibition of cell proliferation and angiogenesis in cancer cells. In this review, we discuss about the anticancer profile of luteolin.
Characteristics of low acuity prehospital emergency patients with 48-h mortality, an observational cohort study
Authors: Petersen Jesper A. Dyhring , Blomberg Stig Nikolaj , Lippert Freddy , Christensen Helle Collatz
Published: December 2022

Background

Every year an emergency medical technician or paramedic treats and transports up to several hundred patients. Only some patients are acutely seriously ill, and a few of these show only discrete signs and symptoms of their condition. This study aims to describe patients who died within 48 h of being admitted non-emergently to hospital by ambulance, examine the extent to which critically ill patients are recognized prehospitally, and identify clinical warning signs that might be frequently overlooked.

Method

Registry based follow-up study on patients receiving an ambulance from the Copenhagen EMS in 2018. Data was included regarding the dispatch of the ambulance from the emergency services disposition system, ICD-10 hospital admission diagnoses from the National Patient Register, 48-h mortality from the Central Person Register and assessment and treatment in the ambulance by reviewing the electronic pre-hospital patient record.

Results

In 2018 2279 patients died within 48 h after contact with the EMS, 435 cases met inclusion criteria. The patients’ median age was 83 years (IQR 75–90), and 374 (86.0%) had one or more underlying serious medical conditions. A triage category based on vitals and presentation was not assigned by the EMS in 286 (68.9%) cases, of which 38 (13.3%) would meet red and 126 (44.1%) orange criteria. For 409 (94.0%) patients, it was estimated that death within 48 h could not have been avoided prehospitally, and for 26 (6.0%) patients it was uncertain. We found 27 patients with acute aortic syndrome as admission diagnosis, of these nine (33.3%) had not been admitted urgently to a hospital with vascular surgery specialty.

Conclusions

It was estimated that death within 48 h could generally not be avoided prehospitally. The patients’ median age was 83 years, and they often had serious comorbidity. Patients whose vital parameters met red or orange triage criteria were to a lesser degree triaged prehospitally, compared to patients in the yellow or green categories. Patients with acute aortic syndrome were not recognized by EMS 33.3% of the time.
Identification of a novel ER-NFĸB-driven stem-like cell population associated with relapse of ER+ breast tumors
Authors: Semina Svetlana E. , Alejo Luis H. , Chopra Shivani , Kansara Nidhi S. , Kastrati Irida , Sartorius Carol A. , Frasor Jonna
Published: December 2022

Background

Up to 40% of patients with estrogen receptor-positive (ER+) breast cancer experience relapse. This can be attributed to breast cancer stem cells (BCSCs), which are known to be involved in therapy resistance, relapse, and metastasis. Therefore, there is an urgent need to identify genes/pathways that drive stem-like cell properties in ER+ breast tumors.

Methods

Using single-cell RNA sequencing and various bioinformatics approaches, we identified a unique stem-like population and established its clinical relevance. With follow-up studies, we validated our bioinformatics findings and confirmed the role of ER and NFĸB in the promotion of stem-like properties in breast cancer cell lines and patient-derived models.

Results

We identified a novel quiescent stem-like cell population that is driven by ER and NFĸB in multiple ER+ breast cancer models. Moreover, we found that a gene signature derived from this stem-like population is expressed in primary ER+ breast tumors, endocrine therapy-resistant and metastatic cell populations and predictive of poor patient outcome.

Conclusions

These findings indicate a novel role for ER and NFĸB crosstalk in BCSCs biology and understanding the mechanism by which these pathways promote stem properties can be exploited to improve outcomes for ER+ breast cancer patients at risk of relapse.
Impact of antigen avoidance test for fibrotic hypersensitivity pneumonitis in stable phase
Authors: Okuda Ryo , Takemura Tamiko , Iwasawa Tae , Kaburaki Shota , Baba Tomohisa , Hagiwara Eri , Ogura Takashi
Published: December 2022

Background

The antigen avoidance has been used in the diagnosis and treatment of hypersensitivity pneumonitis (HP); however, its usefulness in stable fibrotic HP is controversial.

Objective

To investigate the usefulness of the antigen avoidance test in patients with fibrotic HP in stable phase.

Methods

The antigen avoidance test was conducted during a 2-week hospitalization comparing clinical parameters at admission and before discharge. A retrospective review of patients who underwent surgical lung biopsy or transbronchial lung cryobiopsy, who were diagnosed with fibrotic HP by multi-disciplinary discussion, and whose disease progression was stable for more than two months before the antigen avoidance test was done.

Results

Between 2016 and 2021, 40 patients met the criteria, and 17 (43%) patients had a positive antigen avoidance test. The patients with positive in the antigen avoidance test had significantly greater annual forced vital capacity (FVC) decline than those with negative before the test (− 6.5% vs. − 0.3%, p = 0.045). The patients with positive antigen avoidance test had less annual FVC decline than those with negative in the year following the test (0.8% vs. − 5.0%, p = 0.048). The differences in annual improvement were found for serum Krebs von den Lungen-6 between the positive and negative patients in the year following the test (− 27% vs. − 5%, p = 0.049). In multivariate Cox hazard regression analysis, a negative result of the antigen avoidance test was a risk factor for death or acute exacerbation of fibrotic HP (HR = 0.26 [95% CI: 0.07–0.90], p = 0.034).

Conclusions

In fibrotic HP patients in stable phase, the antigen avoidance test under a 2-week hospitalization was valuable in predicting prognosis.
Plasma TIMP-1 as a sex-specific biomarker for acute lung injury
Authors: Almuntashiri Sultan , Jones Timothy W. , Wang Xiaoyun , Sikora Andrea , Zhang Duo
Published: December 2022

Background

Acute respiratory distress syndrome (ARDS) confers high morbidity and mortality, with a death rate reaching 40%. Pre-clinical and clinical studies have cited sex-specific sex hormones as a critical contributor to divergent immunologic responses. Therefore, exploration of sex and sex hormone roles following lung injury and ARDS development is needed. Tissue inhibitor of metalloproteinase-1 (TIMP-1) was the first-discovered natural collagenase inhibitor and is located exclusively on the X chromosome. This study aimed to evaluate the prognostic role of circulating TIMP-1, and if concentration differences between males and females correlate with the mortality of ARDS patients.

Methods

Human plasma samples from 100 ARDS patients enrolled in Albuterol to Treat Acute Lung Injury (ALTA) trial on the day of randomization were evaluated. The amount of TIMP-1 was measured using an enzyme-linked immunoassay (ELISA). Area under the receiver operating characteristic (AUROC) was computed to assess the predictive power of TIMP-1 for 30 and 90-day mortality. Chi-squared tests and Kaplan–Meier curves were computed to assess different variables and survival.

Results

AUROC analysis of TIMP-1 and 30-day mortality among females showed that TIMP-1 exhibited an AUC of 0.87 (95% confidence interval [CI] 0.78 to 0.97; P = 0.0014) with an optimal cut-off value of 159.7 ng/mL producing a 100% sensitivity and 74% specificity. For 90-day mortality, AUROC analysis showed an AUC of 0.82 (95% confidence interval [CI] 0.67 to 0.97; P = 0.0016) with a similar cut-off value producing a 90% sensitivity and 76.47% specificity. Stratifying subjects by TIMP-1 concentration as high (≥ 159.7 ng/mL) or low (< 159.7 ng/mL) indicated that high TIMP-1 was associated with increased 30 and 90-day mortality rates (all P < 0.0001). Lastly, high TIMP-1 group was associated with worse other outcomes including ventilator-free days (VFDs) and ICU-free days (all P < 0.05).

Conclusion

Circulating TIMP-1 appeared to be a promising biomarker for mortality among females with ARDS. The high TIMP-1 group showed worse VFDs and ICU-free days. Circulating TIMP-1 may be a sex-specific biomarker in the setting of ARDS and could improve ARDS phenotyping as well as provide a novel therapeutic target in females.
How strong is demand for public transport service in Nepal? A case study of Kathmandu using a choice-based conjoint experiment
Authors: Aryal Tulsi Ram , Ichihashi Masaru , Kaneko Shinji
Published: December 2022

A public transport system is the most efficient and equitable solution to the challenges of urban mobility and climate change. To improve public transport, technological innovations, policy interventions, and behavioral changes should all be applied appropriately; however, there is a lack of information about the demand for public transport services in developing countries. This paper aims to measure the degree of demand for public transport services by comparing various factors used as a case study in Kathmandu, one of the most congested urban areas in a developing country. We designed a choice-based conjoint experiment with five attributes: mode of transport, waiting time, one-way fare per km, commute time per km, and payment method. Our results indicate that 73% of the respondents are in favor of changing the current transport policy and wish for a shift to public transport, which means that most commuters are in favor of the proposed mode of transport, that is, MRT. On the other hand, the study reveals that respondents have a negative evaluation of motorbikes, one of the most popular modes of transport in Kathmandu. Our results, showing users’ unsatisfactory situation with motorbikes as a transport measure, provide transport planners guidance for addressing current public transport policies, indicating a massive rapid transit system with a low fare would be highly welcome in a typical congestion area like Kathmandu.
Asymmetric deformation of the Earth’s magnetosphere under low Alfvén Mach number solar wind: Observations and MHD simulation
Authors: Nishino Masaki N. , Hasegawa Hiroshi , Saito Yoshifumi , Lavraud Benoit , Miyashita Yukinaga , Nowada Motoharu , Kasahara Satoshi , Nagai Tsugunobu
Published: December 2022

The density of the solar wind plasma near the Earth’s magnetosphere sometimes decreases to only several per cent of the usual value, and such density extrema result in a significant reduction of the dynamic pressure and Alfvén Mach number ($$M_A$$

M
A

) of the solar wind flow. While a symmetric expansion of the Earth’s magnetosphere by the low dynamic pressure was assumed in previous studies, a global magnetohydrodynamic (MHD) simulation study predicted a remarkable dawn-dusk asymmetry of the magnetospheric shape under low-density solar wind and Parker-spiral interplanetary magnetic field (IMF) configuration. Here, we present observations consistent with the asymmetric deformation of the magnetosphere under low-$$M_A$$

M
A

solar wind and Parker-spiral IMF conditions, focusing on the significant expansion of the dawn-flank magnetosphere detected by the Geotail spacecraft. A global MHD simulation reproduced the dawnward expansion of the near-Earth magnetosphere, which was consistent with the observation by Geotail. The solar wind flow had a non-negligible dusk-to-dawn component and partly affected the dawnward expansion of the magnetosphere. Local, roughly Alfvénic sunward acceleration of magnetosheath ions at the dawn flank magnetopause suggests magnetosheath plasma entry into the magnetosphere through open field lines generated by magnetic reconnection at the dayside magnetopause. At the same time, Cluster 1 and 3, located near the southern polar cusp, also detected continuous antisunward ion jets and occasional sunward jets, which are consistent with the occurrence of magnetic reconnection near the southern cusp. These observations suggest that enhanced plasma acceleration at the dayside magnetopause operates under the low-$$M_A$$

M
A

solar wind and Parker spiral IMF conditions and that plasma influx across the dawnside magnetopause is at work under such a low-$$M_A$$

M
A

condition. These results can be helpful in understanding interactions between low-$$M_A$$

M
A

solar/stellar winds and celestial objects, such as inner planets and exoplanets.

Graphic Abstract
A proposal for adaptive cruise control balancing followability and comfortability through reinforcement learning
Authors: Maruyama Nagayasu , Mouri Hiroshi
Published: December 2022

Adaptive cruise control (ACC), which is an extension of conventional cruise control, has been applied in many commercial vehicles. Traditional ACC is controlled by proportional-integral-derivative control or linear quadratic regulation (LQR), which can provide sufficient performance to follow a preceding vehicle. However, they can also cause excessive acceleration and jerk. To avoid these excessive behaviors, we propose reinforcement learning (RL), which can consider various objectives to determine control inputs, as an ACC controller. To balance the performance of following a preceding vehicle and reducing jerk, RL rewards are designed using unique thresholds. Additionally, to balance performance and robustness to the zero-order delay (dead time) of the controlled system, dead time is also considered by scattering it randomly in the learning phase. As a result of this study, an RL agent trained using the proposed RL method and two LQR units specialized for followability and comfortability were simulated using Simulink® (MATLAB®).
Protocol paper: kainic acid excitotoxicity-induced spinal cord injury paraplegia in Sprague–Dawley rats
Authors: Anjum Anam , Cheah Yt Jun , Yazid Muhammad Da’in , Daud Muhammad Fauzi , Idris Jalilah , Ng Min Hwei , Naicker Amaramalar Selvi , Ismail Ohnmar Htwe , Athi Kumar Ramesh Kumar , Tan Geok Chin , Wong Yin Ping , Mahadi Mohd Kaisan , Lokanathan Yogeswaran
Published: December 2022

Background

Excitotoxicity-induced in vivo injury models are vital to reflect the pathophysiological features of acute spinal cord injury (SCI) in humans. The duration and concentration of chemical treatment controls the extent of neuronal cell damage. The extent of injury is explained in relation to locomotor and behavioural activity. Several SCI in vivo methods have been reported and studied extensively, particularly contusion, compression, and transection models. These models depict similar pathophysiology to that in humans but are extremely expensive (contusion) and require expertise (compression). Chemical excitotoxicity-induced SCI models are simple and easy while producing similar clinical manifestations. The kainic acid (KA) excitotoxicity model is a convenient, low-cost, and highly reproducible animal model of SCI in the laboratory. The basic impactor approximately cost between 10,000 and 20,000 USD, while the kainic acid only cost between 300 and 500 USD, which is quite cheap as compared to traditional SCI method.

Methods

In this study, 0.05 mM KA was administered at dose of 10 µL/100 g body weight, at a rate of 10 µL/min, to induce spinal injury by intra-spinal injection between the T12 and T13 thoracic vertebrae. In this protocol, detailed description of a dorsal laminectomy was explained to expose the spinal cord, following intra-spinal kainic acid administration at desired location. The dose, rate and technique to administer kainic acid were explained extensively to reflect a successful paraplegia and spinal cord injury in rats. The postoperative care and complication post injury of paraplegic laboratory animals were also explained, and necessary requirements to overcome these complications were also described to help researcher.

Results

This injury model produced impaired hind limb locomotor function with mild seizure. Hence this protocol will help researchers to induce spinal cord injury in laboratories at extremely low cost and also will help to determine the necessary supplies, methods for producing SCI in rats and treatments designed to mitigate post-injury impairment.

Conclusions

Kainic acid intra-spinal injection at the concentration of 0.05 mM, and rate 10 µL/min, is an effective method create spinal injury in rats, however more potent concentrations of kainic acid need to be studied in order to create severe spinal injuries.
Bone envelope for implant placement after alveolar ridge preservation: a systematic review and meta-analysis
Authors: Fischer Kai R. , Solderer Alex , Arlt Kristina , Heumann Christian , Liu Chun Ching , Schmidlin Patrick R.
Published: December 2022

Purpose

To assess the dimensional establishment of a bony envelope after alveolar ridge preservation (ARP) with deproteinized bovine bone mineral (DBBM) in order to estimate the surgical feasibility of standard diameter implants placement without any additional augmentation methods.

Methods

PubMed, Embase and CENTRAL databases were searched for suitable titles and abstracts using PICO elements. Inclusion criteria were as follows: randomized controlled trials (RCTs) comprising at least ten systemically healthy patients; test groups comprised placement of (collagenated) DBBM w/o membrane and control groups of no grafting, respectively. Selected abstracts were checked regarding their suitability, followed by full-text screening and subsequent statistical data analysis. Probabilities and number needed to treat (NNT) for implant placement without any further need of bone graft were calculated.

Results

The initial database search identified 2583 studies. Finally, nine studies with a total of 177 implants placed after ARP with DBBM and 130 implants after SH were included for the quantitative and qualitative evaluation. A mean difference of 1.13 mm in ridge width in favour of ARP with DBBM could be calculated throughout all included studies (95% CI 0.28–1.98, t2 = 1–1063, I2 = 68.0%, p < 0.01). Probabilities for implant placement with 2 mm surrounding bone requiring theoretically no further bone augmentation ranged from 6 to 19% depending on implant diameter (3.25: 19%, RD = 0.19, C = 0.06–0.32, p < 0.01/4.0: 14%, RD = 0.14, C = 0.05–0.23, p < 0.01/5.0: 6%, RD = 0.06, C = 0.00–0.12, p = 0.06).

Conclusion

ARP employing DBBM reduces ridge shrinkage on average by 1.13 mm and improves the possibility to place standard diameter implants with up to 2 mm circumferential bone housing; however, no ARP would have been necessary or additional augmentative bone interventions are still required in 4 out of 5 cases.

Graphical Abstract
Effects of Acute Resistance Exercise on Executive Function: A Systematic Review of the Moderating Role of Intensity and Executive Function Domain
Authors: Huang Tzu-Yu , Chen Feng-Tzu , Li Ruei-Hong , Hillman Charles H. , Cline Trevor L. , Chu Chien-Heng , Hung Tsung-Min , Chang Yu-Kai
Published: December 2022

Background

Research has demonstrated that there is a beneficial effect of acute exercise on cognitive function; however, the moderators of the acute resistance exercise (RE) effect on executive function (EF) are underestimated. This systematic review aims to clarify the effects of acute RE on EF by examining the moderating effect of exercise intensity (light, moderate, and vigorous) and EF domains (inhibitory control, working memory, and cognitive flexibility), as well as their interactions.

Methods

The search strategy was conducted in four databases (PubMed, Scopus, PsycARTICLES, and Cochrane Library) prior to January 29, 2022. Included studies had to: (1) investigate acute RE in adults with normal cognition and without diagnosed disease; (2) include a control group or control session for comparison; (3) include outcomes related to the core EF domains; and (4) be published in English. The methodological quality of the included studies was judged according to the PEDro scale guidelines.

Results

Nineteen studies were included which included a total of 692 participants. More than half of the outcomes (24/42, 57.14%) indicate that acute RE had a statistically significant positive effect on overall EF. In terms of RE intensity and EF domain, moderate intensity acute RE benefited EF more consistently than light and vigorous intensity acute RE. Acute RE-induced EF benefits were more often found for inhibitory control than for working memory and cognitive flexibility. When considering moderators simultaneously, measuring inhibitory control after light or moderate intensity RE and measuring working memory or cognitive flexibility after moderate intensity RE most often resulted in statistically significant positive outcomes.

Conclusion

Acute RE has a beneficial effect on EF, observed most consistently for inhibitory control following moderate intensity RE. Future studies should include all exercise intensities and EF domains as well as investigate other potential moderators to enable a better understanding of the benefits of acute RE on EF.
A Proposed Conceptual Sport Nutrition Approach for Athlete Development and Assessment: The Athlete Nutrition Development Approach
Authors: Iwasa-Madge Kevin , Sesbreno Erik
Published: December 2022

Appropriate dietary intake can improve athletes’ health and sport performance and is a direct result of eating behaviours. Therefore, assessing and shaping athletes’ eating behaviours and dietary intake is critical to the provision of sport nutrition services. As such, nutrition practitioners must also consider the determinants of eating behaviours. However, dietary intake, eating behaviours, and its determinants are inconsistently defined in the literature, requiring nutrition practitioners to navigate a complicated landscape of concepts and terminology. This is further complicated by limitations in practically measuring and influencing eating behaviours and dietary intake. The proposed Athlete Nutrition Development Approach was developed to aid practitioners in servicing decisions through the athlete development process, through a three-tiered approach to sport nutrition service delivery. Tier 1 addresses the determinants of eating behaviours, Tier 2 directly addresses eating behaviours and dietary intake, and Tier 3 addresses the consequences of dietary intake in relation to health and sport performance. Each tier includes tools for assessment and development.