bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Non-Cancer Medications in New Zealand Women at the Diagnosis of Primary Invasive Breast Cancer: Prevalence, Associated Factors and Effects on Survival
Authors: Aye Phyu Sin , Scott Oliver W. , Elwood J. Mark , Sarfati Diana , Lawrenson Ross , Campbell Ian D. , Kuper-Hommel Marion , Tin Tin Sandar
Published: October 2020

Background: Assessing the use of multiple medications in cancer patients is crucial as such use may affect cancer outcomes. This study reports the prevalence of non-cancer medication use at breast cancer diagnosis, its associated factors, and its effect on survival. Methods: We identified all women diagnosed with primary invasive breast cancer between 1 January 2007 and 31 December 2016, from four population-based breast cancer registries, in Auckland, Waikato, Wellington, and Christchurch, New Zealand. Through linkage to the pharmaceutical records, we obtained information on non-cancer medications that were dispensed for a minimum of 90 days’ supply between one year before cancer diagnosis and first cancer treatment. We performed ordered logistic regressions to identify associated factors and Cox regressions to investigate its effect on patient survival. Results: Of 14,485 patients, 52% were dispensed at least one drug (mean—1.3 drugs; maximum—13 drugs), with a higher prevalence observed in patients who were older, treated at a public facility, more economically deprived, and screen-detected. The use of 2–3 drugs showed a reduced non-breast cancer mortality (HR = 0.75, 95%CI = 0.60–0.92) in previously hospitalised patients, with other groups showing non-significant associations when adjusted for confounding factors. Drug use was not associated with changes in breast cancer-specific mortality. Conclusions: Non-cancer medication use at breast cancer diagnosis was common in New Zealand, more prevalent in older and disadvantaged women, and showed no effect on breast cancer-specific mortality, but a reduction in other cause mortality with the use of 2–3 drugs.
Physical Activity and Sociodemographic Profile of Brazilian People during COVID-19 Outbreak: An Online and Cross-Sectional Survey
Authors: Vancini Rodrigo L. , Camargo-Neto Luiz , de Lira Claudio A. B. , Andrade Marília S. , Viana Ricardo B. , Nikolaidis Pantelis T. , Knechtle Beat , Gentil Paulo , Piacezzi Luiz H. V. , Lopes Maria C. B. Teixeira , Batista Ruth E. Assayag , Vancini-Campanharo Cássia R.
Published: October 2020

The Coronavirus Disease 2019 (COVID-19) outbreak has created an unprecedented impact on global health and further aggravated the physical inactivity pandemic. For this reason, the understanding of sociodemographic variables in the context of physical activity levels are important for the field of public health in order to assist in relevant public health decisions. Our main aim was to characterize sociodemographic variables and physical activity levels and their association with COVID-19 aspects. We applied an online Google survey with closed questions in Brazilian people of different age and regions, both sexes and physical activity levels (n = 1.726). Our main results were that participants who had symptoms of COVID-19 had the highest percentage of level 1 of physical activity (the lowest level according to the classification used) and those who showed no symptoms had the highest percentage of levels 2 and 3 of physical activity; that is, close to the light/moderate levels of physical activity. This cross-sectional study in the Brazilian population provided important sociodemographic data and COVID-19 aspects regarding the level of physical activity. It is possible to assume that the regular practice of physical activity could positively impact health status and quality of life and be a tool in the field of public health to cope (from a physical and mental point of view) with disease scenarios that require quarantine.
Alignment of Medical and Psychosocial Sectors for Promotion of Tobacco Cessation among Residents of Public Housing: A Feasibility Study
Authors: Jassal Mandeep S. , Oliver-Keyser Tracey , Galiatsatos Panagis , Burdalski Catherine , Addison Bonnie , Lewis-Land Cassia , Butz Arlene
Published: October 2020

The inequity in cessation resources is at the forefront of the recently enacted US smoking ban in public housing facilities. This pre-post, non-randomized pilot study assessed the feasibility of a smoking cessation program targeting smokers in Baltimore City public housing. The study implemented a four-phased, 10-week, community-based cessation program using a joint academic–housing partnership that provided on-site cessation pharmacotherapy, behavioral counseling, and psychosocial/legal services. The community-led strategy involved: (1) two-week smoking cessation training for lay health workers; (2) screening and recruitment of smokers by housing authority residential leadership; (3) four-week resident-led cessation using evidenced-based strategies along with wraparound support services; (4) formative evaluation of the intervention’s acceptability and implementation. Thirty participants were recruited of which greater than one-half attended the majority of weekly cessation events. Thirty percent were able to achieve biomarker-proven cessation, as measured by a reduction in exhaled CO levels—a percentage comparable to the reported state quitline 30-day cessation rate. Despite weekly joint community–academic led-education of nicotine replacement therapy (NRT) therapies, only two participants regularly and properly used NRT transdermal patches; <20% of participants used NRT gum correctly at their first follow-up visit. Less than one-half utilized psychosocial and legal services by our community-based organization partners. Post-intervention interviews with participants noted broad approval of the ease in accessibility of the cessation intervention, but more diversification in the timing and personalization of offerings of services would have assisted in greater adoptability and participant retention. Though a reduction in smoking behaviors was not broadly observed, we elucidated modifiable social, educational, and physical features that could enhance the likelihood of smoking cessation among public housing residents.
Attitudes towards Immigration among Students in the First Year of a Nursing Degree at Universities in Coimbra, Toledo and Melilla
Authors: Ugarte Gurrutxaga M Idoia , Sánchez-Ojeda María Angustias , Segura-Fragoso Antonio , Cardoso María Lucilia , Molina Gallego Brígida
Published: October 2020

Increased migration has led to increased prejudice towards immigrant populations. This study aims to analyse attitudes towards immigration among student nurses in three universities, two in Spain and one in Portugal. Methodology: A descriptive, transversal, prospective study was carried out among student nurses (n = 624), using the Attitude towards Immigration in Nursing scale. Results: Nursing students showed some positive attitudes towards immigration, such as that immigrants should have the right to maintain their customs or that immigrants should have free access to healthcare and education, in contrast to some negative attitudes, such as that crime rates have increased due to immigration or that immigrants receive more social welfare assistance than natives. Significant differences in attitudes were revealed between students from the three universities. Discussion: Training in transcultural nursing is necessary for all nursing students in order to reduce negative attitudes towards the immigrant population and increase the awareness and sensitivity of future healthcare staff in caring for patients of all backgrounds.
Getting Active with Active Video Games: A Quasi-Experimental Study
Authors: Liang Yan , Lau Patrick W. C. , Jiang Yannan , Maddison Ralph
Published: October 2020

Given the cultural emphasis on academic achievement and environmental constraints to physical activity (PA), active video games (AVGs) may be used to decrease sedentary behavior and increase PA of Hong Kong children. This study explored the potential of a school-based AVG intervention on sedentary time, PA, body composition, and psychosocial factors among children. Eighty-seven children (intervention n = 30) were recruited from one primary school. Classes in Grades 4–6 were allocated to either the intervention group or the control group in a 2:1 ratio. The eight-week intervention involved children playing AVGs in an after-school class twice a week. Participants in the control group continued with their usual activities. Outcome included the change of participants in sedentary time, PA, percentage body fat, body mass index (BMI), and psychosocial variables (enjoyment, self-efficacy and social support), from baseline to eight weeks. No significant group differences were observed in sedentary time (−33.9 min/day, 95% CI −70.8 to 4.8; p = 0.07). The intervention group significantly increased total PA (53.7 counts/min, 95% CI 8.6 to 104.2; p = 0.04) compared with those in the control condition. No differences were found in body composition and psychosocial variables. However, significant treatment effects were found on BMI z score among boys (−0.1, 95% CI −0.2 to 0; p = 0.04). An eight-week school-based AVG intervention delivered during after-school hours was effective in increasing activity levels among Hong Kong children. The treatment effects of AVGs on sedentary behavior and body composition need to be further demonstrated in a more robust study, especially in boys.
Cultivated Land Change, Driving Forces and Its Impact on Landscape Pattern Changes in the Dongting Lake Basin
Authors: Li Junhan , Zhou Kaichun , Dong Huimin , Xie Binggeng
Published: October 2020

Comprehending the dynamic change characteristics of land use/cover and the driving factors causing the change are prerequisites for protecting land resources. This paper analyzes changes in cultivated land, the driving factors that cause them, and their tremendous impact on landscape pattern changes in the Dongting Lake Basin. For this purpose, we used mathematical statistics, buffer analysis, trend analysis, landscape pattern index, and logistic regression model to analyze the land use data of the study area from 1980 to 2018. The results show that the cultivated land showed a decreasing trend, with the total area decreased by 4.76% (or 716.13 km2) from 1980 to 2018, and the activity of mutual transformation with other land use types decreased. The spatial distribution pattern of cultivated land and landscape shows the change characteristics gradually from Dongting Lake to the surroundings. Among the driving factors of cultivated land changes, the influence of human activities was gradually increasing, while the natural factors were decreasing. The cultivated land landscape pattern index and the overall landscape pattern index have a significant positive correlation, showing relatively consistent change trend and spatial distribution characteristics. We believe that the decrease of cultivated land area has a certain relationship with the increase of landscape fragmentation in the Dongting Lake Basin. Our research is expected to provide a reference for strengthening regional cultivated land management and rational development and utilization of regional land resources.
Exploring How Media Influence Preventive Behavior and Excessive Preventive Intention during the COVID-19 Pandemic in China
Authors: Liu Liqun , Xie Jingzhong , Li Ke , Ji Suhe
Published: October 2020

In the context of global fighting against the unexpected COVID-19 pandemic, how to promote the public implementation of preventive behavior is the top priority of pandemic prevention and control. This study aimed at probing how the media would affect the public’s preventive behavior and excessive preventive intention accordingly. Data were collected from 653 respondents in the Chinese mainland through online questionnaires and further analyzed by using partial least squares structural equation modeling (PLS-SEM). Taking risk perception, negative emotions, and subjective norms as mediators, this study explored the impact of mass media exposure and social networking services involvement on preventive behavior and excessive preventive intention. Based on differences in the severity of the pandemic, the samples were divided into the Wuhan group and other regions group for multi-group comparison. The results showed that mass media exposure had a significant positive impact on subjective norms; moreover, mass media exposure could significantly enhance preventive behavior through subjective norms, and social networking services involvement had a significant positive impact on negative emotions; meanwhile, social networking services involvement promoted excessive preventive intention through negative emotions.
The Effects of Different Smoking Patterns in Pregnancy on Perinatal Outcomes in the Southampton Women’s Survey
Authors: O’Donnell Martin M. , Baird Janis , Cooper Cyrus , Crozier Sarah R. , Godfrey Keith M. , Geary Michael , Inskip Hazel M. , Hayes Catherine B.
Published: October 2020

Maternal smoking during pregnancy has established associations with poor perinatal outcomes. Among continuing pregnant smokers, harm-reduction strategies have been suggested, including temporary cessation of smoking during pregnancy, also known as partial quitting. Support for this strategy, however, remains limited. Six hundred and ninety-seven women in the Southampton Women’s Survey who smoked at their last menstrual period were categorised into sustained quitters, partial quitters (quit in either the first or third trimester but not both) or sustained smokers (continued to smoke throughout pregnancy). In regression models, compared with infants born to sustained smokers, infants born to sustained quitters and partial quitters were heavier at birth by β = 0.64 standard deviations (SD) (WHO z-score) (95% CI: 0.47–0.80) and 0.48 SD (WHO z-score) (95% CI: 0.24–0.72) respectively, adjusted for confounders, with similar patterns seen for other anthropometric measures (head circumference and crown–heel length). Sustained quitters had longer gestations by β = 3.5 days (95% CI: 1.8–5.2) compared with sustained smokers, but no difference was seen for partial quitters. While sustained quitting remains the most desired outcome for pregnant smokers, partial quitting should be explored as a strategy to reduce some of the harmful effects of smoking on offspring in those who cannot achieve sustained quitting.
Validation of the Multidimensional Fatigue Inventory with Coronary Artery Disease Patients
Authors: Gecaite-Stonciene Julija , Bunevicius Adomas , Burkauskas Julius , Brozaitiene Julija , Neverauskas Julius , Mickuviene Narseta , Kazukauskiene Nijole
Published: October 2020

Background: Fatigue is a common distressing symptom in patients with coronary artery disease (CAD). The Multidimensional Fatigue Inventory (MFI) is used for measuring fatigue in various clinical settings. Nevertheless, its multidimensional structure has not been consistent across studies. Thus, we aimed to psychometrically evaluate the MFI in patients with CAD. Methods: In sum, 1162 CAD patients completed questionnaires assessing their subjective fatigue level (MFI-20), mental distress symptoms (HADS, STAI), and health-related quality of life (SF-36). Participants also completed exercise capacity (EC) testing. Results: Confirmatory factor analysis of the four-factor model, showed acceptable fit (CFI = 0.905; GFI = 0.895; NFI = 0.893, RMSEA = 0.077). After eliminating four items, confirmatory factor analysis testing showed improvement in the four-factor model of the MFI-16 (CFI = 0.910; GFI = 0.909; NFI = 0.898, RMSEA = 0.077). Internal consistency values were adequate for the total score and four MFI-16 subscales: General fatigue, physical fatigue, reduced activity, and mental fatigue with Cronbach’s α range: 0.60–0.82. The inadequate value (Cronbach’s α = 0.43) was received for the subscale of reduced motivation in both MFI-20 and MFI-16. Correlations between the MFI-16 and HADS, STAI, SF-36, and EC measures were statistically significant (all p’s < 0.001). Conclusions: The Lithuanian version of the modified MFI of 16 items showed good factorial structure and satisfactory psychometric characteristics, except for reduced motivation subscale.
Association of Allelic Variants of the Reelin Gene with Autistic Spectrum Disorder: A Systematic Review and Meta-Analysis of Candidate Gene Association Studies
Authors: Hernández-García Ignacio , Chamorro Antonio-Javier , Ternavasio-de la Vega Hugo Guillermo , Carbonell Cristina , Marcos Miguel , Mirón-Canelo José-Antonio
Published: October 2020

Autistic spectrum disorder (ASD) is a complex neurodevelopmental disability with a genetic basis, and several studies have suggested a potential role of the reelin gene (RELN) in ASD susceptibility. Accordingly, genetic association studies have explored this potential association, but the results have been controversial thus far. For this reason, we assessed the association of four genetic variants of RELN (the 5′UTR CGG triplet repeat and polymorphisms rs736707, rs362691, and rs2229864) with ASD by means of a systematic review and meta-analysis. We retrieved studies comparing the distribution of the above-mentioned genetic variants between ASD patients and healthy controls. A meta-analysis was conducted using a random effects model, and calculations of the odds ratios (ORs) and confidence intervals (CIs) were performed. A sensitivity analysis and tests to determine the heterogeneity of the results were also performed. Eleven previous studies fulfilled the inclusion criteria and analyzed the association of the above-mentioned genetic variants and ASD. We did not find any significant association between the allele or genotype frequencies of the analyzed polymorphisms and ASD, and large heterogeneity was found for the rs736707 polymorphism. Moreover, no significant differences were found between the 5′UTR triplet repeat and this disorder. In light of current evidence, no single genetic variant within this gene is clearly associated with the development of ASD, and ethnic differences may explain part of the observed heterogeneity. Larger studies among different ethnic groups are needed to establish the role of specific genetic variants within RELN in the etiology of this disorder.
Retbindin: A riboflavin Binding Protein, Is Critical for Photoreceptor Homeostasis and Survival in Models of Retinal Degeneration
Authors: Genc Ayse M. , Makia Mustafa S. , Sinha Tirthankar , Conley Shannon M. , Al-Ubaidi Muayyad R. , Naash Muna I.
Published: October 2020

The large number of inherited retinal disease genes (IRD), including the photopigment rhodopsin and the photoreceptor outer segment (OS) structural component peripherin 2 (PRPH2), has prompted interest in identifying common cellular mechanisms involved in degeneration. Although metabolic dysregulation has been shown to play an important role in the progression of the disease etiology, identifying a common regulator that can preserve the metabolic ecosystem is needed for future development of neuroprotective treatments. Here, we investigated whether retbindin (RTBDN), a rod-specific protein with riboflavin binding capability, and a regulator of riboflavin-derived cofactors flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), is protective to the retina in different IRD models; one carrying the P23H mutation in rhodopsin (which causes retinitis pigmentosa) and one carrying the Y141C mutation in Prph2 (which causes a blended cone-rod dystrophy). RTBDN levels are significantly upregulated in both the rhodopsin (Rho)P23H/+ and Prph2Y141C/+ retinas. Rod and cone structural and functional degeneration worsened in models lacking RTBDN. In addition, removing Rtbdn worsened other phenotypes, such as fundus flecking. Retinal flavin levels were reduced in RhoP23H/+/Rtbdn−/− and Prph2Y141C/+/Rtbdn−/− retinas. Overall, these findings suggest that RTBDN may play a protective role during retinal degenerations that occur at varying rates and due to varying disease mechanisms.
The Interplay between Oxidative Phosphorylation and Glycolysis as a Potential Marker of Bladder Cancer Progression
Authors: Petrella Greta , Ciufolini Giorgia , Vago Riccardo , Cicero Daniel Oscar
Published: October 2020

Urothelial bladder cancer (UBC) is the most common tumor of the urinary system. One of the biggest problems related to this disease is the lack of markers that can anticipate the progression of the cancer. Genomics and transcriptomics have greatly improved the prediction of risk of recurrence and progression. Further progress can be expected including information from other omics sciences such as metabolomics. In this study, we used 1H-NMR to characterize the intake of nutrients and the excretion of products in the extracellular medium of three UBC cell lines, which are representatives of low-grade tumors, RT4, high-grade, 5637, and a cell line that shares genotypic features with both, RT112. We have observed that RT4 cells show an activated oxidative phosphorylation, 5637 cells depend mostly on glycolysis to grow, while RT112 cells show a mixed metabolic state. Our results reveal the relative importance of glycolysis and oxidative phosphorylation in the growth and maintenance of different UBC cell lines, and the relationship with their genomic signatures. They suggest that cell lines associated with a low risk of progression present an activated oxidative metabolic state, while those associated with a high risk present a non-oxidative state and high glycolytic activity.
The Anti-Senescence Activity of Cytokinin Arabinosides in Wheat and Arabidopsis Is Negatively Correlated with Ethylene Production
Authors: Kučerová Zuzana , Rác Marek , Mikulík Jaromír , Plíhal Ondřej , Pospíšil Pavel , Bryksová Magdaléna , Sedlářová Michaela , Doležal Karel , Špundová Martina
Published: October 2020

Leaf senescence, accompanied by chlorophyll breakdown, chloroplast degradation and inhibition of photosynthesis, can be suppressed by an exogenous application of cytokinins. Two aromatic cytokinin arabinosides (6-benzylamino-9-β-d-arabinofuranosylpurines; BAPAs), 3-hydroxy- (3OHBAPA) and 3-methoxy- (3MeOBAPA) derivatives, have recently been found to possess high anti-senescence activity. Interestingly, their effect on the maintenance of chlorophyll content and maximal quantum yield of photosystem II (PSII) in detached dark-adapted leaves differed quantitatively in wheat (Triticum aestivum L. cv. Aranka) and Arabidopsis (Arabidopsisthaliana L. (Col-0)). In this work, we have found that the anti-senescence effects of 3OHBAPA and 3MeOBAPA in wheat and Arabidopsis also differ in other parameters, including the maintenance of carotenoid content and chloroplasts, rate of reduction of primary electron acceptor of PSII (QA) as well as electron transport behind QA, and partitioning of absorbed light energy in light-adapted leaves. In wheat, 3OHBAPA had a higher protective effect than 3MeOBAPA, whereas in Arabidopsis, 3MeOBAPA was the more efficient derivative. We have found that the different anti-senescent activity of 3OHBAPA and 3MeOBAPA was coupled to different ethylene production in the treated leaves: the lower the ethylene production, the higher the anti-senescence activity. 3OHBAPA and 3MeOBAPA also efficiently protected the senescing leaves of wheat and Arabidopsis against oxidative damage induced by both H2O2 and high-light treatment, which could also be connected with the low level of ethylene production.
Biological Control: A Major Component of the Pest Management Program for the Invasive Coconut Scale Insect, Aspidiotus rigidus Reyne, in the Philippines
Authors: Almarinez Billy Joel M. , Barrion Alberto T. , Navasero Mario V. , Navasero Marcela M. , Cayabyab Bonifacio F. , Carandang Jose Santos R. , Legaspi Jesusa C. , Watanabe Kozo , Amalin Divina M.
Published: October 2020

The coconut scale insect, Aspidiotus rigidus Reyne, caused a major pest outbreak in coconut plantations and stands in the Southern Tagalog region of Luzon Island in the Philippines between 2010 and 2015. To determine if parasitism by Comperiella calauanica Barrion, Almarinez and Amalin, a native encyrtid, could have been a factor in the eventual management of the outbreak by 2015, we estimated and assessed its parasitization levels on A. rigidus colonies on field-collected samples from selected points in three provinces in the Southern Tagalog Region across three sampling periods. We observed that C. calauanica consistently occurred only in areas where A. rigidus populations occurred, with high parasitization levels in the Southern Tagalog sites from 2014 to 2015. Results of correlation and regression of total scale count against parasitized scale count suggest putative host density-dependent parasitism by C. calauanica in the field. A marked decrease in the abundance of A. rigidus was recorded concurrently with visually observable recovery of coconut trees from the third quarter of 2014 up to the second quarter of 2016. Similar results of significant reduction in A. rigidus populations concurrent with high percent parasitization by mass-reared and released C. calauanica were found in the Zamboanga Peninsula from 2018 to 2020. Our findings and observations altogether suggest that host-specific parasitization by C. calauanica effected biological control, which may have contributed to the eventual management of the A. rigidus outbreak in the Southern Tagalog Region, and also in the Zamboanga Peninsula where similar recovery of coconut trees were observed within a year after inoculative releases of C. calauanica.
Effect of Trap Color on Captures of Bark- and Wood-Boring Beetles (Coleoptera; Buprestidae and Scolytinae) and Associated Predators
Authors: Cavaletto Giacomo , Faccoli Massimo , Marini Lorenzo , Spaethe Johannes , Magnani Gianluca , Rassati Davide
Published: October 2020

Traps baited with attractive lures are increasingly used at entry-points and surrounding natural areas to intercept exotic wood-boring beetles accidentally introduced via international trade. Several trapping variables can affect the efficacy of this activity, including trap color. In this study, we tested whether species richness and abundance of jewel beetles (Buprestidae), bark and ambrosia beetles (Scolytinae), and their common predators (i.e., checkered beetles, Cleridae) can be modified using trap colors different to those currently used for surveillance of jewel beetles and bark and ambrosia beetles (i.e., green or black). We show that green and black traps are generally efficient, but also that many flower-visiting or dark-metallic colored jewel beetles and certain bark beetles are more attracted by other colors. In addition, we show that checkered beetles have color preferences similar to those of their Scolytinae preys, which limits using trap color to minimize their inadvertent removal. Overall, this study confirmed that understanding the color perception mechanisms in wood-boring beetles can lead to important improvements in trapping techniques and thereby increase the efficacy of surveillance programs.
COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases
Authors: Abou Ghayda Ramy , Li Han , Lee Keum Hwa , Lee Hee Won , Hong Sung Hwi , Kwak Moonsu , Lee Minwoo , Kwon Minjae , Koyanagi Ai , Kronbichler Andreas , Jacob Louis , Smith Lee , Shin Jae Il
Published: October 2020

(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.
Dissimilar Conservation Pattern in Hepatitis C Virus Mutant Spectra, Consensus Sequences, and Data Banks
Authors: García-Crespo Carlos , Soria María Eugenia , Gallego Isabel , Ávila Ana Isabel de , Martínez-González Brenda , Vázquez-Sirvent Lucía , Gómez Jordi , Briones Carlos , Gregori Josep , Quer Josep , Perales Celia , Domingo Esteban
Published: October 2020

The influence of quasispecies dynamics on long-term virus diversification in nature is a largely unexplored question. Specifically, whether intra-host nucleotide and amino acid variation in quasispecies fit the variation observed in consensus sequences or data bank alignments is unknown. Genome conservation and dynamics simulations are used for the computational design of universal vaccines, therapeutic antibodies and pan-genomic antiviral agents. The expectation is that selection of escape mutants will be limited when mutations at conserved residues are required. This strategy assumes long-term (epidemiologically relevant) conservation but, critically, does not consider short-term (quasispecies-dictated) residue conservation. We calculated mutant frequencies of individual loci from mutant spectra of hepatitis C virus (HCV) populations passaged in cell culture and from infected patients. Nucleotide or amino acid conservation in consensus sequences of the same populations, or in the Los Alamos HCV data bank did not match residue conservation in mutant spectra. The results relativize the concept of sequence conservation in viral genetics and suggest that residue invariance in data banks is an insufficient basis for the design of universal viral ligands for clinical purposes. Our calculations suggest relaxed mutational restrictions during quasispecies dynamics, which may contribute to higher calculated short-term than long-term viral evolutionary rates.
The Impact of Epstein-Barr Virus Infection on Juvenile Idiopathic Arthritis Activity and Patient’s Response to Treatment
Authors: Opoka-Winiarska Violetta , Grywalska Ewelina , Sobiesiak Aleksandra , Roliński Jacek
Published: October 2020

This study aimed to investigate the relationship between Epstein-Barr virus (EBV) infection and the onset of juvenile idiopathic arthritis (JIA), disease activity, and response to treatment. The study included 44 children with JIA, 23 children with different types of arthritis, and 44 controls. We measured EBV infection markers, including the EBV DNA load and the concentration of antibodies to viral antigens, at disease onset, before treatment. Six months after JIA diagnosis and the initiation of treatment patients with anti-viral capsid antigen IgG had a higher disease activity and worse response to treatment than patients without previous infection. After six months of treatment, the probability of disease inactivity in children without a history of EBV infection was almost 6.5 times greater than in a child with a history of infection. Furthermore, the probability of a better response after six months of treatment in a child with a history of EBV infection was more than five times smaller than in a child without infection. A past EBV infection can have a negative effect on achieving disease remission and may be associated with a worse response to treatment. Our results do not indicate the need for routine assessment of EBV infection markers in patients with JIA.
Efficacy and Safety of High-Dose Immunoglobulin-Based Regimen in Statin-Associated Autoimmune Myopathy: A Multi-Center and Multi-Disciplinary Retrospective Study
Authors: Treppo Elena , Infantino Maria , Benucci Maurizio , Ravagnani Viviana , Palterer Boaz , Fabris Martina , Tomietto Paola , Manfredi Mariangela , Giudizi Maria Grazia , Ligobbi Francesca , Cammelli Daniele , Grandis Marina , Parronchi Paola , De Vita Salvatore , Quartuccio Luca
Published: October 2020

Statin-associated autoimmune myopathy is a rare muscle disorder, characterized by autoantibodies against HMGCR. The anti-HMGCR myopathy persists after statin, and often requires immunosuppressive therapy. However, there is not a standardized therapeutic approach. The purpose of this study is to report the effectiveness of the immunosuppressive treatment employed in a multi-center and multi-disciplinary cohort of patients affected by anti-HMGCR myopathy, in which an immunoglobulin (IVIG)-based treatment strategy was applied. We collected 16 consecutive patients with a diagnosis of anti-HMGCR myopathy, between 2012 and 2019, and recorded data on clinical and laboratory presentation (i.e., muscle strength, serum CK levels, and anti-HMGCR antibody titer) and treatment strategies. Our results highlight the safety and efficacy of an induction therapy combining IVIG with GCs and/or methotrexate to achieve persistent remission of the disease and steroid-free maintenance. Under IVIG-based regimens, clinical improvement and CK normalization occurred in more than two thirds of patients by six months. Relapse rate was low (3/16) and 2/3 relapses occurred after treatment suspension. Nearly 90% of the patients who successfully discontinued GCs were treated with a triple immunosuppressive regimen. In conclusion, an IVIG-based regimen, which particularly includes high-dose immunoglobulin, GCs and methotrexate, can provide a fast remission achievement with GC saving.
A Prediction Equation to Assess Resting Energy Expenditure in Japanese Patients with COPD
Authors: Morikawa Keisuke , Tabira Kazuyuki , Takemura Hiroyuki , Inaba Shogo , Kusuki Haruka , Hashitsume Yu , Suzuki Yuta , Tenpaku Yosuke , Yasuma Taro , D’Alessandro-Gabazza Corina N. , Gabazza Esteban , Hataji Osamu
Published: October 2020

Background: Medical nutrition therapy is important in the management of chronic obstructive pulmonary disease (COPD) patients. Determination of resting energy expenditure is essential to define therapeutic goals for medical nutrition. Previous studies proposed the use of equations to predict resting energy expenditure. No prediction equation is currently available for the Japanese population. The objective of this study was to develop an equation to predict resting energy expenditure in Japanese chronic obstructive pulmonary disease patients. To this end, we investigated clinical variables that correlate with the resting energy expenditure. Methods: This study included 102 COPD patients admitted at the Matsusaka Municipal Hospital Respiratory Center. We measured resting energy expenditure by indirect calorimetry and explored the relationship of resting energy expenditure with clinical variables by univariate and stepwise linear regression analysis. Results: The resting energy expenditure by indirect calorimetry was significantly correlated with fat-free mass, body weight, body mass index, height, gender, and pulmonary function test by univariate analysis. In the stepwise linear regression analysis, the fat-free mass, body weight, and age remained significantly correlated with indirect calorimetry’s resting energy expenditure. The fat-free mass, body weight, and age explained 50.5% of the resting energy expenditure variation. Conclusion: Fat-free mass, body weight, and age were significantly correlated with resting energy expenditure by stepwise linear regression analysis, and they were used to define a predictive equation for Japanese COPD patients.
Systematic Review of Primary Outcome Measurements for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in Randomized Controlled Trials
Authors: Kim Do-Young , Lee Jin-Seok , Son Chang-Gue
Published: October 2020

Background: Due to its unknown etiology, the objective diagnosis and therapeutics of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) are still challenging. Generally, the patient-reported outcome (PRO) is the major strategy driving treatment response because the patient is the most important judge of whether changes are meaningful. Methods: In order to determine the overall characteristics of the main outcome measurement applied in clinical trials for CFS/ME, we systematically surveyed the literature using two electronic databases, PubMed and the Cochrane Library, throughout June 2020. We analyzed randomized controlled trials (RCTs) for CFS/ME focusing especially on main measurements. Results: Fifty-two RCTs out of a total 540 searched were selected according to eligibility criteria. Thirty-one RCTs (59.6%) used single primary outcome and others adapted ≥2 kinds of measurements. In total, 15 PRO-derived tools were adapted (50 RCTs; 96.2%) along with two behavioral measurements for adolescents (4 RCTs; 7.7%). The 36-item Short Form Health Survey (SF-36; 16 RCTs), Checklist Individual Strength (CIS; 14 RCTs), and Chalder Fatigue Questionnaire (CFQ; 11 RCTs) were most frequently used as the main outcomes. Since the first RCT in 1996, Clinical Global Impression (CGI) and SF-36 have been dominantly used each in the first and following decade (26.1% and 28.6%, respectively), while both CIS and Multidimensional Fatigue Inventory (MFI) have been the preferred instruments (21.4% each) in recent years (2016 to 2020). Conclusions: This review comprehensively provides the choice pattern of the assessment tools for interventions in RCTs for CFS/ME. Our data would be helpful practically in the design of clinical studies for CFS/ME-related therapeutic development.
Dectin-1 and TIM3 Expression in Deep Vein Thrombosis of Lower Limbs (DVTLL)
Authors: Barresi Vincenza , Napoli Salvatore , Spampinato Giorgia , Condorelli Daniele Filippo , Signorelli Salvatore Santo
Published: October 2020

The pathophysiological mechanisms of venous thromboembolism are venous stasis, endothelial damage, and hypercoagulability, while less attention has been given to the role of both innate and native immunity. In this paper, we investigate the involvement of the activated immune system detected through some indicators such as TIM3 and Dectin-1 expressed by T lymphocytes. TIM3 and Dectin-1, two surface molecules that regulate the fine-tuning of innate and adaptive immune responses, were evaluated in patients affected by deep vein thrombosis of lower limbs (DVTLL). CD3+, CD4+ and CD8+ T lymphocytes obtained from patients affected by DVTLL were analysed using fluorescence-conjugated antibodies for TIM3 and Dectin-1 by an imaging flow cytometer. DVTLL patients showed a higher number of CD4+ and CD8+ T lymphocytes. TIM3 expression in T lymphocytes was very low in both DVTLL patients and controls. On the contrary, an increase in Dectin-1+ cells among CD4+ and CD8+ T lymphocytes from DVTLL patients was observed. Dectin-1 is known to play a role in inflammation and immunity and our result suggests its potential involvement in thrombotic venous disease.
Prognostic Significance of Tumor Regression Rate during Concurrent Chemoradiotherapy in Locally Advanced Cervix Cancer: Analysis by Radiation Phase and Histologic Type
Authors: Kang Jun-Hyeok , Cho Won Kyung , Yeo Hie Jun , Jeong Soo Young , Noh Joseph J. , Shim Jung In , Lee Yoo-Young , Kim Tae-Joong , Lee Jeong-Won , Kim Byoung-Gie , Bae Duk-Soo , Park Won , Choi Chel Hun
Published: October 2020

This study aimed to evaluate the prognostic significance of tumor regression rate according to radiation phase and histologic subtype in patients with locally advanced cervical cancer (LACC) treated with chemoradiation. We retrospectively reviewed the medical records of 398 patients with FIGO stage IIB-IVA cervical cancer treated with concurrent chemoradiotherapy (CCRT) between 2001 and 2019. Tumor response was assessed using serial magnetic resonance imaging (MRI) at three time points: pre-treatment, post-external beam radiotherapy (EBRT), and post-intracavitary radiotherapy (ICR). Tumor regression pattern according to histologic subtype and radiation phase (EBRT and ICR) was evaluated. Overall survival (OS) and progression-free survival (PFS) were the primary outcomes. Of 398 patients, 44 patients had adenocarcinoma/adenosquamous carcinoma (AC/ASC) and 354 patients had squamous cell carcinoma (SCC). AC/ASC was associated with significantly worse PFS and OS than SCC (p < 0.001). AC/ASC had a relatively poorer regression rate in response to EBRT than SCC (p < 0.001), whereas there was no significant difference in overall tumor regression rate after completion of RT (EBRT and ICR) between the two histologic subtypes. Multivariable analysis demonstrated AC/ASC histology to be an independent prognostic factor of decreased PFS and OS. Moreover, tumor regression rate after completion of EBRT (post-EBRT tumor regression rate (EBRTregression ≤ 26%) and proportion of tumor regression during EBRT to overall tumor regression (EBRTproportion ≤ 40%) were independent predictors of poor survival in patients with LACC. Tumor regression pattern of LACC in response to CCRT differs according to histologic subtype. AC/ASC histology and poor tumor response to EBRT are independent prognostic factors for worse survival in patients with LACC. Further studies are needed to develop a CCRT protocol that is specialized for patients with AC/ASC.
Evaluating the Association between Contrast Medium Dosage and Acute Kidney Injury in Transcatheter Aortic Valve Replacement Using Different Predictive Models
Authors: Mach Markus , Hasan Waseem , Andreas Martin , Winkler Bernhard , Weiss Gabriel , Adlbrecht Christopher , Delle-Karth Georg , Grabenwöger Martin
Published: October 2020

Recent studies have suggested that contrast medium (CM) volume is associated with acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR). However, in a high-risk elderly TAVR population, the prognostic value and ideal threshold of CM dosage for AKI is unclear. Data of 532 successive TAVR patients (age 81.1 ± 6.8 years, EuroSCORE II 4.8% ± 6.0%) were therefore retrospectively analyzed. Based on a recently published formula, the renal function (preprocedural serum creatinine: SCr) corrected ratio of CM and body weight (CM*SCr/BW) was calculated to determine the risk of postprocedural contrast-associated AKI. AKI occurred in 94 patients (18.3%) and significantly increased 1-year all-cause mortality (23.4% vs. 13.1%; p = 0.001). A significant correlation between AKI and 30-day as well as 1-year all-cause mortality was observed (p = 0.001; p = 0.007). However, no association between CM dosage or the CM*SCr/BW ratio with the occurrence of AKI was seen (p = 0.968; p = 0.442). In our all-comers, all-access cohort, we found no relationship between CM dosage, or the established risk ratio model and the occurrence of postprocedural AKI. Further research needs to be directed towards different pathophysiological causes and preventive measures as AKI impairs short- and long-term survival.
In-Hospital Mortality Risk of Transcatheter Arterial Embolization for Patients with Severe Blunt Trauma: A Nationwide Observational Study
Authors: Gakumazawa Masayasu , Toida Chiaki , Muguruma Takashi , Shinohara Mafumi , Abe Takeru , Takeuchi Ichiro
Published: October 2020

This study investigated the risk factors for in-hospital mortality of severe blunt trauma patients who underwent transcatheter arterial embolization (TAE). We analysed data from the Japan Trauma Data Bank from 2009 to 2018. Patients with severe blunt trauma and an Injury Severity Score (ISS) ≥ 16 who underwent TAE were enrolled. The primary analysis evaluated patient characteristics and outcomes, and variables with significant differences were included in the secondary multivariate logistic regression analysis. In total, 5800 patients (6.4%) with ISS ≥ 16 underwent TAE. There were significant differences in the proportion of male patients, transportation method, injury mechanism, injury region, Revised Trauma Score, survival probability values, and those who underwent urgent blood transfusion and additional urgent surgery. In multivariable regression analyses, higher age, urgent blood transfusion, and initial urgent surgery were significantly associated with higher in-hospital mortality risk [p < 0.001, odds ratio (OR), 95% confidence interval (CI): 1.01 (1.00–1.01); p < 0.001, 3.50 (2.55–4.79); and p = 0.001, 1.36 (1.13–1.63), respectively]. Inter-hospital transfer was significantly associated with lower in-hospital mortality risk (p < 0.001, OR = 0.56, 95% CI = 0.44–0.71). Treatment protocols for urgent intervention before and after TAE and a safe, rapid inter-hospital transport system are needed to improve mortality risks for severe blunt trauma patients.