bluuebunny/crossref_metadata_2025 huggingface dataset:
Lifestyle Medicine in the Midst of a Pandemic
Authors: Friedman Susan M. , Barnett Carol Hee , Barnett Ted D.
Published: September 2020

Patients with chronic conditions are at higher risk of complications and mortality if they get COVID-19. Approximately half of American adults have at least 1 condition that increases their risk of complications if they become infected. The medical and public health communities need to send a clear message about the impact of lifestyle on health, particularly in the time of this pandemic. We need to communicate with patients and the public, to let them know how rapidly major lifestyle changes can improve health. This communication is urgent; the timeline for self-care and lifestyle medicine interventions has been telescoped, so that chronic diseases are now acute risk factors.
Collecting Sensorial Litter: Ethnographic Reflexive Grappling With Corporeal Complexity
Authors: Hare Kathleen A.
Published: September 2020

In this three-part narrative paper, I put forward “collecting sensorial litter” as an innovative method for helping ethnographers reflexively grapple with complicated corporeality during fieldwork. First, I highlight the continued need for experimentation with body-based reflexive methods that can help capture the messiness of ethnographers’ experiences, especially for sensuous, embodied forms of ethnography. Second, I use theories of intensity and embodiment to conceptualize the “too intense experiences” that are refuse/d by ethnographers’ bodies (e.g., fleeting, whirling emotions; spatial disorientations). Third, I draw upon my fieldwork to illustrate that such experiences are not lost when refuse/d, but manifest symbolically and materially as “sensorial litter.” I detail my methodological process for: A) identifying B) re-claiming and C) reflexively considering three pieces of sensorial litter. I argue the value of collecting sensorial litter includes enhancing self-communication, attending to uncomfortable power relations, and rendering visible critical data (perhaps) inadvertently thrown away in research.
Probabilistic analysis of crack growth in railway axles using a Gaussian process
Authors: He Jiajie , Cui Yong , Liu Yusun , Wang Hui
Published: September 2020

To reduce maintenance costs, it is important to carry out probabilistic analyses on railway vehicle components. In this work, a data-driven approach based on a Gaussian process for regression is developed to determine the probability of axle failure caused by crack growth in railway axles. For complicated failure modes, it is difficult or even impossible to build a reliable analytical or simulation model before using an analytical approach. The main purpose of this work is to develop an algorithm to infer the distribution of crack growth from limited measured data without having to build an underlying model. The results of the case study show that the determined timing for the first inspection and the probability of failure coincide with the known results derived by analytically based approaches. The problems associated with modelling and calibration can be overcome by a data-driven approach. The developed Gaussian process model can serve as a complementary instrument to validate other analytically based approaches or numerical analyses. The model can also be applied to the probabilistic analyses of other railway components.
Mathematical modeling of (Cu−Al2O3) water based Maxwell hybrid nanofluids with Caputo-Fabrizio fractional derivative
Authors: Ahmad M , Imran MA , Nazar M
Published: September 2020

In this article, a free convection flow of [Formula: see text] hybrid Maxwell nanofluids through a channel formed by two infinite vertical plates have been studied. Together with the the energy balance and heat source, a fractional model of Maxwell fluid is considered. To develop an analytical exact solution for velocity field, only the Caputo-Fabrizio definition of non-integral derivative together with application of Laplace transform method has been used. Some graphical presentation and discussion are made to see the effects of hybrid nanofluids and non-dimensional parameters on velocity boundary layer. As a result, a dual behavior of velocity was exposed due to fractional parameter for large and small times. A comparison between two kind of non-Newtonian fluids has been made and found that Brinkman fluid is more viscous than Maxwell fluid. Also, by letting Brinkman and Maxwell parameters zero, they coincides and the results obtained for Newtonian fluid showed graphically. The obtained results are realistic from the fractional model as by adjusting the values of fractional parameter can be compared with some experimental data.
Rainforest villages, eighteenth-century history
Authors: Price Richard
Published: September 2020

Based on long term ethnographic work with the Saamaka, and with the benefit of hindsight, this paper unpacks the specific ways in which the descendants of these Suriname Maroons have constructed and transmitted the historical knowledge of their 18th-century ancestors, who escaped slave plantations and confronted the colonial powers from their new settlements in the depth of the forest. In the process, they created an original memory of these historical events— First-Time or Fesiten knowledge—and managed to keep it alive. The article explores the specific ontology, frames and idioms of this historical knowledge, as well as its ideological role, the (dis)connections to hegemonic colonial memory devices, its evolution in time, the ways of transmission, and the memory specialists that have kept and circulated it.
Memory worlds: Reframing time and the past – An introduction
Authors: Hristova Marije , Ferrándiz Francisco , Vollmeyer Johanna
Published: September 2020

This article, a prologue to the special issue ‘Memory Worlds: Reframing Time and the Past’, is a follow-up to the plenary session ‘Connecting Memory Traditions around the World’, organised by the authors in the Third Annual Conference of the Memory Studies Association held in Madrid (2019). Elaborating on the work of critical physicists such as Rovelli and Barad, it calls into question hegemonic conceptions of linear time and the past in two ways. First, by bringing in crucial concepts elaborated in the field of memory studies that anticipate, support or may accommodate this claim. Secondly, by summoning social anthropology to the debate, as a field where subaltern epistemologies of time and the past have become a crucial area of research in the last decades. The article calls for the broadening of the Memory Studies agenda in order to move beyond implicit well-established conceptions of linear time that may obscure or obliterate alternate epistemologies, usually dwelling in the margins.
Effects of Acanthopanax senticosus supplementation on innate immunity and changes of related immune factors in healthy mice
Authors: Zhang YunQiang , Zhang YunLu , Liu ZiKui
Published: September 2020

Modern scientific research has shown that Acanthopanax senticosus (AS) can regulate the innate immunity of healthy animals, thus affecting the health of animals. However, there are few systematic reports on the changes of innate immune indices of healthy animals after consuming AS. The purpose of this project was to study the effect on healthy mice’s innate immunity and changes of related immune factors induced by feeding AS root powder supplementation. The results showed that the killing rate of natural cells increased in a dose-dependent manner in a certain time period. Compared to the control group, the treatment groups (T1, T2 and T3) improved significantly in the innate immune index (lysozyme, β-defensin-2 and duodenal secretory IgA (SIgA) to varying degrees) and induced corresponding changes of immune factors at certain time periods. The correlation between SIgA and IFN-γ in mouse serum was enhanced, and the higher the concentration of AS in the diet, the stronger the correlation was. However, there was no significant difference in growth performance among groups. It is proved that AS supplementation can enhance innate immunity and change several relevant immune factors and cells of healthy mice without affecting growth performance.
Role of androgen receptor expression in early stage ER+/PgR−/HER2– breast cancer
Authors: Tagliaferri Barbara , Quaquarini Erica , Palumbo Raffaella , Balletti Emanuela , Presti Daniele , Malovini Alberto , Agozzino Manuela , Teragni Cristina Maria , Terzoni Andrea , Bernardo Antonio , Villani Laura , Sottotetti Federico
Published: September 2020

Background:

Progesterone receptor (PgR) negative breast cancer (BC) is an aggressive subtype with poor prognosis and reduced response to endocrine treatments. Several studies have suggested that androgen receptor (AR) expression is associated with a favorable tumor biology, longer recurrence free survival (RFS), and overall survival. In the literature no data exist regarding the role of AR expression in early stage estrogen receptor (ER)+/PgR– BCs. The aim of this study was to evaluate the prognostic role of AR expression in this setting.

Patients and methods:

This is a monocentric retrospective study in which 208 patients who underwent surgical intervention for ER+/PgR−/Human Epidermal growth factor Receptor 2 (HER2)– BC were included. The primary objective was to analyze the relationship between AR expression and RFS.

Results:

At a median follow-up of 77 months, 75 patients (36%) had a disease relapse (all sites included). AR expression was significantly higher in patients who did not relapse compared with those who relapsed with an impact on RFS (hazard ratio [HR] = 0.99, p = 0.025). Patients with AR expression ⩾80% had a lower risk of relapse compared with those with AR <80% (HR = 0.53, p = 0.008). In addition, breast tumors with higher AR expression had good biological features (low ki67 and nuclear grade) compared with BCs with lower AR expression, at least partly explaining the different outcome.

Conclusions:

The results of this study support the potential prognostic role of AR in patients with ER+/PgR− BCs and may contribute to the identification of subgroups of high-risk patients.
Mathematical Models of Meal Amount and Timing Variability With Implementation in the Type-1 Diabetes Patient Decision Simulator
Authors: Camerlingo Nunzio , Vettoretti Martina , Del Favero Simone , Facchinetti Andrea , Sparacino Giovanni
Published: September 2020

Background:

In type 1 diabetes (T1D) research, in-silico clinical trials (ISCTs) have proven effective in accelerating the development of new therapies. However, published simulators lack a realistic description of some aspects of patient lifestyle which can remarkably affect glucose control. In this paper, we develop a mathematical description of meal carbohydrates (CHO) amount and timing, with the aim to improve the meal generation module in the T1D Patient Decision Simulator (T1D-PDS) published in Vettoretti et al.

Methods:

Data of 32 T1D subjects under free-living conditions for 4874 days were used. Univariate probability density function (PDF) parametric models with different candidate shapes were fitted, individually, against sample distributions of: CHO amounts of breakfast (CHOB), lunch (CHOL), dinner (CHOD), and snack (CHOS); breakfast timing (TB); and time between breakfast-lunch (TBL) and between lunch-dinner (TLD). Furthermore, a support vector machine (SVM) classifier was developed to predict the occurrence of a snack in future fixed-length time windows. Once embedded inside the T1D-PDS, an ISCT was performed.

Results:

Resulting PDF models were: gamma (CHOB, CHOS), lognormal (CHOL, TB), loglogistic (CHOD), and generalized-extreme-values (TBL, TLD). The SVM showed a classification accuracy of 0.8 over the test set. The distributions of simulated meal data were not statistically different from the distributions of the real data used to develop the models (α = 0.05).

Conclusions:

The models of meal amount and timing variability developed are suitable for describing real data. Their inclusion in modules that describe patient behavior in the T1D-PDS can permit investigators to perform more realistic, reliable, and insightful ISCTs.
Synthesis of Glycosides of α-Tocopherol, Daidzein, Resveratrol, Hesperetin, Naringenin, and Chrysin as Antiallergic Functional Foods and Cosmetics
Authors: Fujitaka Yuya , Hamada Hiroki , Hamada Hatsuyuki , Iwaki Takafumi , Shimoda Kei , Kiriake Yuya , Saikawa Tomohiro
Published: September 2020

Glucosyltransferase from Phytolacca americana (Phytolaccaceae), glucosylated α-tocopherol, daidzein, resveratrol, hesperetin, naringenin, and chrysin to α-tocopherol 6-β-d-glucoside, daidzein 7-β-d-glucoside, resveratrol 3-β-d-glucoside, hesperetin 7-β-d-glucoside, naringenin 7-β-d-glucoside, and chrysin 7-β-d-glucoside, respectively. The antiallergic activity of the glycosides and their aglycons was examined by an in vivo immunoglobulin E (IgE) antibody formation-suppression bioassay using rat. It was found that α-tocopherol 6-β-d-glucoside showed much higher antiallergic activity against glutenin than the positive control, hydrocortisone. On the other hand, daidzein 7-β-d-glucoside had much higher antiallergic activity toward 7S-globulin than hydrocortisone. These glycosides inhibited O2 − generation from rat neutrophils, which leads to the suppression of histamine release from rat peritoneal mast cells, resulting in the decrease of IgE antibody formation in rat. Chrysin 7-β-d-glucoside had stronger antityrosinase activity than chrysin. Cultured P. americana cells regioselectively introduced methoxyl and glucosyl residues on exogenously administrated chrysin to give 8-methoxychrysin and chrysin 7-β-d-glucoside. This is the first report on methoxylation of flavone compound at its eighth position by cultured plant cells.
Transdermal Delivery of Small-Sized Resveratrol Nanoparticles to Epidermis Using Anionic Phospholipids
Authors: Uchida Noriyuki , Yanagi Masayoshi , shimoda Kei , Hamada Hiroki
Published: September 2020

Composite nanoparticles composed of anionic phospholipid of 1,2-dipalmitoyl- sn-glycero-3-phosphorylglycerol (DPPG) and resveratrol (Res) were successfully prepared by mixing them in water and a subsequent heating/cooling process. Small-sized DPPG-Res nanoparticles (<60 nm) could be prepared by ultrasonic fragmentation. Upon addition of size-controlled fluorescently labeled Res (FLRes) nanoparticles stabilized with DPPG (DPPG-FLRes) to rat skin tissue, FLRes molecules infiltrated into the epidermis layer permeating stratum corneum.
Evaluating Patient Satisfaction in Township Hospitals in the Cold Regions of China
Authors: Wu Yue , Mu Jingyi , Zhang Shanshan
Published: September 2020

Objective:

This study focused on township hospitals in the cold regions of China and aimed to evaluate patient satisfaction during the medical care process. This study also discusses the correlation between patient needs and satisfaction.

Background:

Hospitals seek to improve patient satisfaction to provide better service. However, there is a lack of existing literature on grassroots medical institutions in towns and townships, especially in cold regions. Therefore, this study aimed to examine the correlation between patient needs and the satisfaction of township hospitals in the cold regions of China.

Methods:

First, a hierarchical task analysis method was used to build the hierarchy for patient satisfaction demands. Patients from 15 township hospitals in cold areas were subjected to semistructured interviews, and a theoretical model was proposed using the grounded theory method. Finally, each open code index was evaluated, and 270 questionnaires were issued to evaluate patient satisfaction.

Results:

The framework for patient satisfaction demands included five dimensions: tangibles, reliability, responsiveness, assurance, and empathy. A theoretical model for patient satisfaction demands was built, and four selective codes, including “Characteristic”, “Perceived Quality”, “Loyalty Intention”, and “Environment Expectation”, were extracted. The weights of these satisfaction-influencing factors were subsequently evaluated.

Conclusions:

This study summarizes the existing problems in a basic health service provision capacity, climate adaptability, lack of environmental design, and so on; proposes four influencing factors; establishes a patient satisfaction evaluation model; and obtains the weight of influence of each factor. These results will help provide accurate and effective suggestions for hospital management.
Infection After Endoscopic Dacryocystorhinostomy: Incidence and Implications
Authors: Jafari Aria , Lehmann Ashton E. , Shen Sarek A. , Banks Catherine G. , Scangas George A. , Metson Ralph
Published: September 2020

Background

Endoscopic dacryocystorhinostomy (EN-DCR) is an increasingly common procedure performed by otolaryngologists. While EN-DCR has a high rate of success at relieving blockage of the lacrimal system, little is known regarding associated postoperative infection (POI) rates and risk factors.

Objective

The purpose of this study was to identify factors associated with the occurrence of postoperative orbital and rhinologic infection in a large cohort of patients undergoing EN-DCR.

Methods

A retrospective review of 582 patients who underwent EN-DCR was performed. All patients received antibiotic prophylaxis as a single intraoperative intravenous administration and a ten-day postoperative oral course. Clinical and demographic information was reviewed, including the occurrence of acute orbital or rhinologic infection within 30 days of surgery. Multivariable analysis was performed to identify risk factors associated with POI.

Results

Fifteen of 582 patients (2.6%) developed POI following EN-DCR. The most common POI was acute rhinosinusitis (10/15, 66.7%), followed by acute dacryocystitis (2/15, 13.3%), preseptal cellulitis (2/15,13.3%), and acute bacterial conjunctivitis (1/15, 6.7%). The majority of patients (464/582, 79.7%) underwent concurrent endoscopic sinus surgery (ESS). In most cases (302/464, 65.1%), ESS was performed to address comorbid rhinosinusitis, whereas 7.8% (36/464) of patients underwent surgery to enhance surgical access to the lacrimal sac. Patients who underwent concurrent ESS were less likely to develop POI (OR: 0.17, CI: 0.04-0.80, p < 0.05). Evidence of mucopurulence at surgery increased the likelihood of POI (OR: 6.24, CI: 1.51-25.84, p < 0.05).

Conclusion

Mucopurulence at the time of surgery significantly increased the risk of POI, whereas concurrent ESS, performed most commonly to address comorbid rhinosinusitis, significantly decreased the risk of POI. Awareness of risk factors for POI and appropriate surgical management of concurrent rhinosinusitis can lead to reduced infectious complications after EN-DCR.
Treatment of Frontal Sinus Osteomyelitis in the Age of Endoscopy
Authors: Thompson Harrison M. , Tilak Ashwini M. , Miller Peter L. , Grayson Jessica W. , Cho Do-Yeon , Woodworth Bradford A.
Published: September 2020

Objective

Frontal sinus osteomyelitis is a severe complication which can result from chronic rhinosinusitis, trauma, or as a complication of reconstruction or obliteration of the frontal sinus. The objective of the current study is to evaluate the contemporary management of frontal sinus osteomyelitis in light of recent advancements in endoscopic surgical techniques.

Methods

Review of a prospectively collected database of patients with frontal sinus pathology was performed from 2008–2020. Data from individuals with frontal sinus osteomyelitis was collected including demographics, etiology, surgical technique, adjunctive medical treatments, complications, and clinical follow up.

Results

Sixteen patients (average age 48.3, range 8–84) were included in the study. An open approach was utilized in 6 patients (2 osteoplastic flaps, 3 Reidel procedures, 1 cranialization). Seven patients underwent completely endoscopic approaches (3 Draf IIB, 4 Draf III), while 3 individuals had combined procedures (Lynch with Draf III, osteoplastic flap + Draf III, fistula excision + Draf IIb). All patients received 6 weeks of antibiotics. Average clinical follow up was 24.4 months with no patients requiring revision procedures.

Conclusion

Endoscopic, endoscopic-assisted, and open approaches were utilized successfully in the current series of patients with osteomyelitis of the anterior table of the frontal sinus. While the progression of endoscopic techniques allows an additional surgical treatment option, it is important to select patients appropriately as open procedures continue to have an important role in the treatment algorithm.
SF-36 Physical Component Score Is Predictive of Achieving a Clinically Meaningful Improvement after Osteochondral Allograft Transplantation of the Femur
Authors: Owusu-Akyaw Kwadwo A. , Bido Jennifer , Warner Tyler , Rodeo Scott A. , Williams Riley J.
Published: September 2020

Background

Osteochondral allograft (OCA) transplantation is an increasingly common treatment for patients with symptomatic focal chondral lesions of the knee. There has been increasing interest in determining predictive factors to maximize patient benefit after this operation. The aim of the present study is to evaluate the predictive association of the physical component (PCS) and mental component (MCS) scores of the Short Form 36 (SF-36) questionnaire for achievement of the minimal clinically important difference (MCID) after OCA transplantation.

Methods

This retrospective study of a longitudinally maintained institutional registry included 91 patients who had undergone OCA transplantation for symptomatic focal osteochondral lesions of the femoral condyle. Included patients were those with complete preoperative questionnaires for the SF-36 and IKDC and completed postoperative IKDC at 2-year follow-up. Multivariate analysis was performed evaluating predictive association of the preoperative MCS and PCS with achievement of the MCID for the IKDC questionnaire.

Results

Logistic multivariate modeling demonstrated a statistically significant association between lower preoperative PCS and achievement of the MCID ( P = 0.022). A defect diameter >2 cm was also associated with achievement of MCID ( P = 0.049). Preoperative MCS did not demonstrate a significant association ( P = 0.09) with achievement of the MCID.

Conclusions

For this cohort of 91 patients, the preoperative SF-36 PCS and lesion size were predictive of achievement of the MCID at 2-year follow-up after femoral OCA transplantation. These findings support an important role of baseline physical health scores for predicting which patients will obtain a meaningful clinical benefit from this surgery.
Smoking Is Associated with Anterior Ankle Impingement After Isolated Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus
Authors: Viehöfer Arnd F. , Casari Fabio , Waibel Felix W.A. , Beeler Silvan , Imhoff Florian B. , Wirth Stephan H. , Ackermann Jakob
Published: September 2020

Objective

To determine potential predictive associations between patient-/lesion-specific factors, clinical outcome and anterior ankle impingement in patients that underwent isolated autologous matrix-induced chondrogenesis (AMIC) for an osteochondral lesion of the talus (OLT).

Design

Thirty-five patients with a mean age of 34.7 ± 15 years who underwent isolated cartilage repair with AMIC for OLTs were evaluated at a mean follow-up of 4.5 ± 1.9 years. Patients completed AOFAS (American Orthopaedic Foot and Ankle Society) scores at final follow-up, as well as Tegner scores at final follow-up and retrospectively for preinjury and presurgery time points. Pearson correlation and multivariate regression models were used to distinguish associations between patient-/lesion-specific factors, the need for subsequent surgery due to anterior ankle impingement and patient-reported outcomes.

Results

At final follow-up, AOFAS and Tegner scores averaged 92.6 ± 8.3 and 5.1 ± 1.8, respectively. Both body mass index (BMI) and duration of symptoms were independent predictors for postoperative AOFAS and Δ preinjury to postsurgery Tegner with positive smoking status showing a trend toward worse AOFAS scores, but this did not reach statistical significance ( P = 0.054). Nine patients (25.7%) required subsequent surgery due to anterior ankle impingement. Smoking was the only factor that showed significant correlation with postoperative anterior ankle impingement with an odds ratio of 10.61 when adjusted for BMI and duration of symptoms (95% CI, 1.04-108.57; P = 0.047).

Conclusion

In particular, patients with normal BMI and chronic symptoms benefit from AMIC for the treatment of OLTs. Conversely, smoking cessation should be considered before AMIC due to the increased risk of subsequent surgery and possibly worse clinical outcome seen in active smokers.
Comparison of diagnostic accuracy of computed tomography virtual endoscopy and flexible fibre-optic laryngoscopy in the evaluation of neck anatomic structures and neoplasms
Authors: Guarnizo Angela , Glikstein Rafael , Tsehmaister-Abitbul Vered , Busca Ionut , El-Sayed Samy , Odell Michael
Published: September 2020

Background and purpose

Computed tomography virtual endoscopy (CT-VE) is a non-invasive technique which allows visualisation of intraluminal surfaces by tridimensional reconstruction of air/soft tissues. The aim of this study was to compare the diagnostic accuracy of CT-VE and flexible fibre-optic laryngoscopy (FFL) in identifying normal neck anatomic structures and pharyngeal and laryngeal lesions.

Methods

Forty-two patients with a history of neck cancer were assessed by two ENT surgeons using FFL and by one neuroradiologist using CT-VE in order to evaluate the visualisation of the epiglottis, vallecula, glossoepiglottic folds, pyriform sinuses, vocal cords and mass pathology. The visualisation of the structures in both modalities was assessed according to the following score: 0 = not visualised, 1 = partial visualisation, 2 = complete and clear visualisation. A weighted kappa coefficient was used to evaluate the inter-observer agreement. McNemar’s test was performed to compare the two diagnostic tests.

Results

The inter-observer agreement between FFL and CT-VE was fair in the assessment of the vocal cords ( k = 0.341); moderate in the assessment of the glossoepiglottic folds ( k = 0.418), epiglottis ( k = 0.513) and pyriform sinuses ( k = 0.477); and substantial in the assessment of the vallecula ( k = 0.618) and the tumour (0.740). McNemar’s test showed no significant difference between the two tests ( p<0.05).

Conclusion

CT-VE is a non-invasive technique with a diagnostic accuracy comparable to FFL in terms of visualisation of anatomical structures and pharyngeal and laryngeal lesions.
Primary lymphoma of bone: a population-based study of 2558 patients
Authors: Liu Chen-Xin , Xu Tian-Qi , Xu Li , Wang Pan-Pan , Cao Chun , Gao Guang-Xun , Zheng Yan-Hua
Published: September 2020

Background:

Primary lymphoma of bone (PLB) is an extremely rare malignancy arising in the skeletal system. There is no consensus over the best definition of PLB. Most of the published articles are single-institutional retrospective studies with a limited sample size. The rarity of PLB and discrepancies on diagnostic criteria has resulted in a vague understanding of PLB.

Methods

We retrospectively analyzed the clinical characteristics and prognostic factors of 2558 PLB patients who were registered in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2016. Survival rates were calculated using the Kaplan–Meier method. The effects of various factors on survival outcomes were analyzed by using the log-rank test. Univariate and multivariate analyses were conducted by using the Cox proportional hazards model to determine independent prognostic factors.

Results:

The median follow-up time of all eligible patients was 58 months. There seemed no sex preponderance in PLB incidence. The most involved sites are axial skeletons. The most common histological subtype was diffuse large B-cell lymphoma. The 3-, 5-, 10-, and 20-year overall survival (OS) rates were 70.70%, 65.70%, 54.40% and 39.50%, respectively. PLB patients whose primary tumor sites were appendicular and craniofacial skeletons had a significant survival advantage [hazard ratio (HR) = 0.694, 95% confidence interval (CI) 0.552–0.872; HR = 0.729, 95% CI 0.597–0.889, respectively] over those with axial skeletons as primary tumor sites. Patients with Hodgkin lymphoma, non-Hodgkin lymphoma (NHL)–mature B-cell lymphoma, and NHL-precursor-cell lymphoblastic lymphoma also had a significant OS advantage (HR = 0.392, 95% CI 0.200–0.771; HR = 0.826, 95% CI 0.700–0.973; and HR = 0.453, 95% CI 0.223–0.923, respectively). Patients with Ann Arbor stage III–IV at diagnosis were at higher risk of death than those with stage I–II (HR = 1.348, 95% CI 1.107–1.641). Chemotherapy was an independent favorable prognostic factor (HR = 0.734, 95% CI 0.605–0.890).

Conclusions:

Primary anatomic site, histology type, higher Ann Arbor stage and chemotherapy were independent prognostic factors. Chemotherapy played a pivotal role in PLB treatment.
Molecular genotypes of gag sequences in HIV-1 infected children treated with antiretroviral therapy in Vietnam
Authors: Dang Linh Vu Phuong , Pham Hung Viet , Dinh Thanh Thi , Vu Phuong Thi , Nguyen Lam Van , Le Hai Thanh , Larsson Mattias , Olson Linus
Published: September 2020

Background:

Gag protein of human immunodeficiency virus (HIV) has been reported to play a crucial role in establishing infection, viral replication, and disease progression; thus, gag might be related to treatment response. The objective of this study was to investigate molecular genotypes of the gag gene, particularly the important functional binding domains in relation to treatment outcomes.

Methods:

HIV-infected children enrolled and treated at Vietnam National Children’s Hospital were recruited in the study. A total of 25 gag sequences were generated and used to construct phylogenetic trees and aligned with a reference sequence comparing 17 functional domains.

Results:

We found that all patients in a treatment failure (TF) group belonged to one cluster of the phylogenetic tree. In addition, the rate of mutations was significantly higher in TF compared with a treatment success (TS) group, specifically the PIP2 recognition motif, and the nucleocapsid basic and zinc motif 2 domains [median and (interquartile range (IQR): 12.5 (6.25–12.5) versus 50 (25–50), p < 0.01; 0 (0–0) versus 0 (0–21.43), p = 0.03 and 0 (0–7.14) versus 7.14 (7.14–7.14), p = 0.04, respectively]. When analyzing gag sequences at different time points in seven patients, we did not observe a consistent mutation pattern related to treatment response.

Conclusion:

Gag mutations in certain domains might be associated with increased viral load; therefore, studying the molecular genotype of the gag gene might be beneficial in monitoring treatment response in HIV-infected children.
The role of criminogenic needs and emotions in restorative justice: Offenders’ experiences in victim–offender mediation
Authors: Meléndez Anna
Published: September 2020

Restorative interventions can deal with some criminogenic needs. They can address the offenders’ antisocial attitudes, lack of problem-solving strategies, empathy and self-control or, substance use problems (Moraleda et al., 2004; Raynor et al., 2012; Vanstone and Raynor, 2012). At the same time, restorative justice practices offer the possibility to express emotions and feelings, which are essential elements in a transformative process. The purpose of this article is to identify both, criminogenic needs and emotions expression through offenders’ experiences in Victim–Offender mediation (VOM). The research is developed in three phases and include qualitative and quantitative research methods. This article focuses in the second and third phases. The second involves non participant observation of VOM (40); and the third requires a post-analysis of the process (questionnaires 40), which includes an interview (12) occurring six months after VOM. General data give us a variety of results, and qualitative analysis exemplifies the different cases.
Representing the True and False Text Information About Human Papillomavirus Vaccines
Authors: Chin Chieh-Li , Su Wen-Yuh , Chin Jessie
Published: September 2020

While the virality of misinformation has been recognized as one of the significant global issues in the modern societies, few studies had examined the computational approaches to represent and identify false information in health domains. The current study aimed at using both psycholinguistic and natural language processing models to represent verified true and false texts about human papillomavirus (HPV) vaccines. Compared to the conventional word-embedding models representing texts in the levels of words, sentences or documents, results showed that introducing the embedding in the levels of propositions best differentiated the semantic representations in true and false texts. The study would advance our understandings in representing health texts and have implications on detecting false health information.
Endogenous Endophthalmitis in an Urban University Setting: Characteristics, Treatment, and Outcomes
Authors: Budoff Greg , Zarbin Marco A. , Bhagat Neelakshi
Published: September 2020

Purpose:

This work describes the characteristics, treatment, and outcomes of endogenous endophthalmitis (EE) cases over 13 years at a tertiary care hospital.

Methods:

This retrospective case series included EE cases from 2006 to 2018. Eyes were categorized by cultured organism and initial treatment status.

Results:

Forty-five eyes of 38 patients were identified with EE. Mean age was 48 ± 12 years and approximately three-fourths were male. Mean visual acuity (VA) at presentation was logMAR 1.86 ± 0.83. More than 50% of patients had a history of intravenous drug use. In a quarter of patients, no systemic source of infection was identified; 90% of these patients had a history of intravenous drug use. Bilateral infections occurred in 18% of participants. Of positive cultures, 29%, 56%, and 13% were fungal, gram-positive, and gram-negative in etiology, respectively. Eyes with fungal infections had a better presenting VA and were more likely to have better than 20/100 final VA vs those with bacterial infections. All patients received IV antibiotics; additionally 29% of eyes underwent initial combined pars plana vitrectomy with intravitreal antibiotic injection while 51% of eyes initially received bedside intravitreal antibiotic injection. There was no significant difference in final VA with respect to initial mode of treatment.

Conclusions:

Initial treatment of intravitreal antibiotics with or without pars plana vitrectomy did not show any difference in the average final VA in eyes with EE. Eyes with fungal infections had more favorable visual outcomes than those with bacterial infections. Almost 1 in 5 EE eyes were enucleated.
Role of 532 nm transfoveal subthreshold micropulse laser in non-resolving central serous chorioretinopathy with subfoveal leaks
Authors: Ambiya Vikas , Kumar Ashok
Published: September 2020

Purpose:

The purpose of this study was to evaluate the role of 532 nm transfoveal subthreshold micropulse laser in non-resolving central serous chorioretinopathy with subfoveal leak.

Methods:

A retrospective chart analysis of 23 eyes of 21 patients with central serous chorioretinopathy was performed. Inclusion criteria include vision loss ⩾3 months and focal subfoveal leak on fluorescein angiography. Exclusion criteria include prior treatment for central serous chorioretinopathy and chronic central serous chorioretinopathy. All eyes were treated with 532 nm subthreshold micropulse laser (5% duty cycle). Visual acuity score, contrast sensitivity, autofluorescence, spectral domain optical coherence tomography, and fundus fluorescein angiography were assessed at baseline, 1, 3, 6 months.

Results:

Average visual acuity score (letters) improved from 66.0 ± 8.51 (baseline) to 71.35 ± 8.48 (1 month, p < 0.01), 77.30 ± 11.34 (3 months, p < 0.01), 80.17 ± 9.30 (6 months, p < 0.01). Contrast sensitivity improved from 0.75 ± 0.30 to 1.30 ± 0.37 ( p < 0.01) at 6 months. Two eyes needed rescue laser at 3 months followed by photodynamic therapy at 6 months; two eyes needed rescue laser at 6 months.

Conclusion:

The 532 nm subthreshold micropulse laser is safe in non-resolving central serous chorioretinopathy with subfoveal leaks.
Treatment of Chronic Refractory Cough in Adults: Focus on Neuromodulators and Other Therapeutic Modalities
Authors: O’Hare Caroline , Rahman Tashrique , Williams Nancy Toedter
Published: September 2020

Objective: To evaluate the literature and educate health care professionals about the different management options for chronic refractory cough (CRC). Data Sources: Searches were performed through MEDLINE (1966 to July 2020) using OVID and EBSCOhost and EMBASE (1947 to July 2020) using OVID. Search terms included chronic cough, neurogenic cough, neuromodulators, chronic cough management, and chronic cough treatment. References of all relevant articles were further used to obtain additional articles. Study Selection and Data Extraction: This review includes articles in the English language and human trial literature. Twenty-three trials explored the use of oral neuromodulators in the management of CRC. Data Synthesis: CRC is a poorly understood disease that may have a complex neuropathic etiology. Oral neuromodulators, such as amitriptyline, baclofen, gabapentin, and pregabalin, continue to be the most commonly used agents for the management of CRC. Alternative pharmacological therapies such as botulinum toxin, anesthetic agents (benzonatate, lidocaine), and narcotic agents have efficacy data, and further research into effective doses and routes of administration is warranted. Alternative nonpharmacologic therapies more commonly used included speech pathology treatment. Conclusion: Several medication and alternative treatment interventions may be effective in managing CRC. Current studies used wide dosing and titration strategies, making it challenging to standardize therapy. No consistent method of assessing cough reflex was used between studies, as well as a lack of consistent randomization and small sample sizes. Additional research is needed to standardize treatment durations, optimum doses, and place in therapy of the available interventions in the management of CRC.
The S enantiomer of 2-hydroxyglutarate increases central memory CD8 populations and improves CAR-T therapy outcome
Authors: Foskolou Iosifina P. , Barbieri Laura , Vernet Aude , Bargiela David , Cunha Pedro P. , Velica Pedro , Suh Eunyeong , Pietsch Sandra , Matuleviciute Rugile , Rundqvist Helene , McIntyre Dominick , Smith Ken G. C. , Johnson Randall S.
Published: September 2020

Cancer immunotherapy is advancing rapidly and gene-modified T cells expressing chimeric antigen receptors (CARs) show particular promise. A challenge of CAR-T cell therapy is that the ex vivo–generated CAR-T cells become exhausted during expansion in culture, and do not persist when transferred back to patients. It has become clear that naive and memory CD8 T cells perform better than the total CD8 T-cell populations in CAR-T immunotherapy because of better expansion, antitumor activity, and persistence, which are necessary features for therapeutic success and prevention of disease relapse. However, memory CAR-T cells are rarely used in the clinic due to generation challenges. We previously reported that mouse CD8 T cells cultured with the S enantiomer of the immunometabolite 2-hydroxyglutarate (S-2HG) exhibit enhanced antitumor activity. Here, we show that clinical-grade human donor CAR-T cells can be generated from naive precursors after culture with S-2HG. S-2HG–treated CAR-T cells establish long-term memory cells in vivo and show superior antitumor responses when compared with CAR-T cells generated with standard clinical protocols. This study provides the basis for a phase 1 clinical trial evaluating the activity of S-2HG–treated CD19-CAR-T cells in patients with B-cell malignancies.
The self-fulfilling prophecy of pulmonary fibrosis: a selective inspection of pathological signalling loops
Authors: Rackow Ashley R. , Nagel David J. , McCarthy Claire , Judge Jennifer , Lacy Shannon , Freeberg Margaret A.T. , Thatcher Thomas H. , Kottmann R. Matthew , Sime Patricia J.
Published: September 2020

Pulmonary fibrosis is a devastating, progressive disease and carries a prognosis worse than most cancers. Despite ongoing research, the mechanisms that underlie disease pathogenesis remain only partially understood. However, the self-perpetuating nature of pulmonary fibrosis has led several researchers to propose the existence of pathological signalling loops. According to this hypothesis, the normal wound-healing process becomes corrupted and results in the progressive accumulation of scar tissue in the lung. In addition, several negative regulators of pulmonary fibrosis are downregulated and, therefore, are no longer capable of inhibiting these feed-forward loops. The combination of pathological signalling loops and loss of a checks and balances system ultimately culminates in a process of unregulated scar formation. This review details specific signalling pathways demonstrated to play a role in the pathogenesis of pulmonary fibrosis. The evidence of detrimental signalling loops is elucidated with regard to epithelial cell injury, cellular senescence and the activation of developmental and ageing pathways. We demonstrate where these loops intersect each other, as well as common mediators that may drive these responses and how the loss of pro-resolving mediators may contribute to the propagation of disease. By focusing on the overlapping signalling mediators among the many pro-fibrotic pathways, it is our hope that the pulmonary fibrosis community will be better equipped to design future trials that incorporate the redundant nature of these pathways as we move towards finding a cure for this unrelenting disease.
Intravenous methylprednisolone pulse as a treatment for hospitalised severe COVID-19 patients: results from a randomised controlled clinical trial
Authors: Edalatifard Maryam , Akhtari Maryam , Salehi Mohammadreza , Naderi Zohre , Jamshidi Ahmadreza , Mostafaei Shayan , Najafizadeh Seyed Reza , Farhadi Elham , Jalili Nooshin , Esfahani Masoud , Rahimi Besharat , Kazemzadeh Hossein , Mahmoodi Aliabadi Maedeh , Ghazanfari Tooba , Sattarian Mohammadreza , Ebrahimi Louyeh Hourvash , Raeeskarami Seyed Reza , Jamalimoghadamsiahkali Saeidreza , Khajavirad Nasim , Mahmoudi Mahdi , Rostamian Abdolrahman
Published: September 2020

Introduction

There are no determined treatment agents for severe COVID-19. It is suggested that methylprednisolone, as an immunosuppressive treatment, can reduce the inflammation of the respiratory system in COVID-19 patients.

Methods

We conducted a single-blind, randomised controlled clinical trial involving severe hospitalised patients with confirmed COVID-19 at the early pulmonary phase of the illness in Iran. The patients were randomly allocated in a 1:1 ratio by the block randomisation method to receive standard care with methylprednisolone pulse (intravenous injection, 250 mg·day−1for 3 days) or standard care alone. The study end-point was the time of clinical improvement or death, whichever came first. Primary and safety analysis was done in the intention-to-treat (ITT) population.

Results

68 eligible patients underwent randomisation (34 patients in each group) from April 20, 2020 to June 20, 2020. In the standard care group, six patients received corticosteroids by the attending physician before the treatment and were excluded from the overall analysis. The percentage of improved patients was higher in the methylprednisolone group than in the standard care group (94.1%versus57.1%) and the mortality rate was significantly lower in the methylprednisolone group (5.9%versus42.9%; p<0.001). We demonstrated that patients in the methylprednisolone group had a significantly increased survival time compared with patients in the standard care group (log-rank test: p<0.001; hazard ratio 0.293, 95% CI 0.154–0.556). Two patients (5.8%) in the methylprednisolone group and two patients (7.1%) in the standard care group showed severe adverse events between initiation of treatment and the end of the study.

Conclusions

Our results suggest that methylprednisolone pulse could be an efficient therapeutic agent for hospitalised severe COVID-19 patients at the pulmonary phase.
Respiratory muscle senescence in ageing and chronic lung diseases
Authors: Gea Joaquim , Ausín Pilar , Martínez-Llorens Juana Ma , Barreiro Esther
Published: September 2020

Ageing is a progressive condition that usually leads to the loss of physiological properties. This process is also present in respiratory muscles, which are affected by both senescent changes occurring in the whole organism and those that are more specific for muscles. The mechanisms of the latter changes include oxidative stress, decrease in neurotrophic factors and DNA abnormalities. Ageing normally coexists with comorbidities, including respiratory diseases, which further deteriorate the structure and function of respiratory muscles. In this context, changes intrinsic to ageing become enhanced by more specific factors such as the impairment in lung mechanics and gas exchange, exacerbations and hypoxia. Hypoxia in particular has a direct effect on muscles, mainly through the expression of inducible factors (hypoxic-inducible factor), and can result in oxidative stress and changes in DNA, decrease in mitochondrial biogenesis and defects in the tissue repair mechanisms. Intense exercise can also cause damage in respiratory muscles of elderly respiratory patients, but this can be followed by tissue repair and remodelling. However, ageing interferes with muscle repair by tampering with the function of satellite cells, mainly due to oxidative stress, DNA damage and epigenetic mechanisms. In addition to the normal process of ageing, stress-induced premature senescence can also occur, involving changes in the expression of multiple genes but without modifications in telomere length.
Dexmedetomidine sedation for endobronchial ultrasound-guided transbronchial needle aspiration, a randomised controlled trial
Authors: Lin Ting-Yu , Huang Yu-Chen , Kuo Chih-Hsi , Chung Fu-Tsai , Lin Yu-Ting , Wang Tsai-Yu , Lin Shu-Min , Lo Yu-Lun
Published: September 2020

Background and aim

Appropriate sedation is important to the success of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Dexmedetomidine is a sedative agent that operatesviathe α2 adrenergic agonist, which provides sleep-like sedation with little respiratory suppression. This study compared the efficacy and safety of dexmedetomidine sedation with propofol in cases of EBUS-TBNA.

Methods

Patients requiring EBUS-TBNA were randomly assigned dexmedetomidine sedation (D, n=25) or propofol sedation (P, n=25). Vital signs, diagnostic yield and the bispectral index (BIS) were recorded throughout the bronchoscopic procedure and recovery period. The tolerance and cooperation of the patients were evaluated using questionnaires.

Measurements and results

The lowest mean arterial blood pressure in group D (79.2±9.9versus72.5±12.9 mmHg, p=0.049) exceeded that in group P, the lowest heart rate was lower (60.9±10.2versus71.4±11.8 beats·min−1, p=0.006) and the mean BIS during sedation was significantly higher (84.1±8.3versus73.6±5.7, p<0.001). Patients in group D were more likely to report perceiving procedure-related symptoms and express an unwillingness to undergo the bronchoscopy again, if indicated (41.1versus83.3%, p=0.007). One subject in group D aborted EBUS-TBNA due to intolerance. Many of the variables in the two groups were similar, including the proportion of hypoxaemic events, recovery times, patient cooperation and diagnostic yield.

Conclusions

The effects of dexmedetomidine on haemodynamics were in line with its pharmacodynamic features. Patients who received dexmedetomidine were more likely than those who received propofol to perceive the procedures. Overall, dexmedetomidine did not prove inferior to propofol sedation in terms of patient cooperation or diagnostic yield.