bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimodal Neuroimaging Using Concurrent EEG/fNIRS for Poststroke Recovery Assessment: An Exploratory Study
Authors: Li Rihui , Li Sheng , Roh Jinsook , Wang Chushan , Zhang Yingchun
Published: November 2020

Background

Persistent motor deficits are very common in poststroke survivors and often lead to disability. Current clinical measures for profiling motor impairment and assessing poststroke recovery are largely subjective and lack precision.

Objective

A multimodal neuroimaging approach was developed based on concurrent functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) to identify biomarkers associated with motor function recovery and document the poststroke cortical reorganization.

Methods

EEG and fNIRS data were simultaneously recorded from 9 healthy controls and 18 stroke patients during a hand-clenching task. A novel fNIRS-informed EEG source imaging approach was developed to estimate cortical activity and functional connectivity. Subsequently, graph theory analysis was performed to identify network features for monitoring and predicting motor function recovery during a 4-week intervention.

Results

The task-evoked strength at ipsilesional primary somatosensory cortex was significantly lower in stroke patients compared with healthy controls ( P < .001). In addition, across the 4-week rehabilitation intervention, the strength at ipsilesional premotor cortex (PMC) ( R = 0.895, P = .006) and the connectivity between bilateral primary motor cortices (M1) ( R = 0.9, P = .007) increased in parallel with the improvement of motor function. Furthermore, a higher baseline strength at ipsilesional PMC was associated with a better motor function recovery ( R = 0.768, P = .007), while a higher baseline connectivity between ipsilesional supplementary motor cortex (SMA)–M1 implied a worse motor function recovery ( R = −0.745, P = .009).

Conclusion

The proposed multimodal EEG/fNIRS technique demonstrates a preliminary potential for monitoring and predicting poststroke motor recovery. We expect such findings can be further validated in future study.
Telerehabilitation After Stroke Using Readily Available Technology: A Randomized Controlled Trial
Authors: Saywell Nicola L. , Vandal Alain C. , Mudge Suzie , Hale Leigh , Brown Paul , Feigin Valery , Hanger Carl , Taylor Denise
Published: November 2020

Background

The number of people living with stroke has increased demand for rehabilitation. A potential solution is telerehabilitation for health care delivery to promote self-management. One such approach is the Augmented Community Telerehabilitation Intervention (ACTIV). This structured 6-month program uses limited face-to-face sessions, telephone contact, and text messages to augment stroke rehabilitation.

Objective

To investigate whether ACTIV improved physical function compared with usual care.

Methods

This 2-arm, parallel randomized controlled trial was conducted in 4 New Zealand centers. Inclusion criteria were patients with first-ever stroke, age >20 years, and discharged home. A blinded assessor completed outcome measurement in participants’ homes at baseline, postintervention, and 6 months postintervention. Stratified block randomization occurred after baseline assessment, with participants allocated to ACTIV or usual care control.

Results

A total of 95 people were recruited (ACTIV: n = 47; control: n = 48). Postintervention intention-to-treat analysis found a nonsignificant difference between the groups in scores (4·51; P = .07) for physical function (measured by the physical subcomponent of the Stroke Impact Scale). The planned per-protocol analysis (ACTIV: n = 43; control: n = 48) found a significant difference in physical function between the groups (5·28; P = .04). Improvements in physical function were not maintained at the 12-month follow-up.

Conclusions

ACTIV was not effective in improving physical function in the ACTIV group compared with the usual care group. The per-protocol analysis raises the possibility that for those who receive more than 50% of the intervention, ACTIV may be effective in preventing deterioration or even improving physical function in people with stroke, in the period immediately following discharge from hospital.
The Proximal Fasciocutaneous Hypothenar Flap Based on the Cutaneous Branch of the Deep Palmar Artery: A Case Report
Authors: Postan Daniel
Published: November 2020

The abductor digiti quinti flap for thumb hypoplasia has been used in its muscular variant as musculocutaneous flap. Several authors have reported myocutaneous branches in the proximal hypothenar region which would vascularize the skin segment covering the hypothenar muscles. Nevertheless, the presence of a cutaneous branch deep palmar artery (CBDPA) vascularizing the proximal hypothenar territory and possibly responsible for the proximal hypothenar cutaneous vascularization was reported. In this paper, a fasciocutaneous hypothenar flap was designed, based on the CBDPA, transposed to the wrist anterior region for the treatment of a post burn contracture which was limiting the wrist extension. Its viability was assessed. The flap had a lozenge-shaped design from the cutaneous fold of the wrist to the fifth metacarpophalangeal joint over the abductor digiti quinti muscle. It was dissected in the fasciocutaneous plane to a width of 20 mm. The adipose tissue zone 10 mm distal to the pisiform was preserved, as well as the ulnar nerve sensory branch crossing the flap longitudinally. The flap was transposed to the anterior fold of the wrist. Neither the flap nor the donor site underwent complications. The patient improved wrist extension without referring any discomfort. Sensitivity was 8 mm 2 months after surgery compared to 6 mm within the preoperative period. In conclusion, it is possible to develop a proximal fasciocutaneous hypothenar flap based on CBDPA involving the proximal and distal hypothenar territory.
Frequency and predictors of occult cancer in ischemic stroke: A systematic review and meta-analysis
Authors: Rioux Bastien , Touma Lahoud , Nehme Ahmad , Gore Genevieve , Keezer Mark R , Gioia Laura C
Published: November 2020

Background

The optimal approach for cancer screening after an ischemic stroke remains unclear.

Aims

We sought to summarize the existing evidence regarding the frequency and predictors of cancer after an ischemic stroke.

Summary of review

We searched seven databases from January 1980 to September 2019 for articles reporting malignant tumors and myeloproliferative neoplasms diagnosed after an ischemic stroke (PROSPERO protocol: CRD42019132455). We screened 15,400 records and included 51 articles. The pooled cumulative incidence of cancer within one year after an ischemic stroke was 13.6 per thousand (95% confidence interval [CI], 5.6–24.8), higher in studies focusing on cryptogenic stroke (62.0 per thousand; 95% CI, 13.6–139.3 vs 9.6 per thousand; 95% CI, 4.0–17.3; p = 0.02) and those reporting cancer screening (39.2 per thousand; 95% CI, 16.4–70.6 vs 7.2 per thousand; 95% CI, 2.5–14.1; p = 0.003). Incidence of cancer after stroke was generally higher compared to people without stroke. Most cases were diagnosed within the first few months after stroke. Several predictors of cancer were identified, namely older age, smoking, and involvement of multiple vascular territories as well as elevated C-reactive protein and d-dimers.

Conclusions

The frequency of incident cancer after an ischemic stroke is low, but higher in cryptogenic stroke and after cancer screening. Several predictors may increase the yield of cancer screening after an ischemic stroke. The pooled incidence of post-stroke cancer is likely underestimated, and larger studies with systematic assessment of cancer after stroke are needed to produce more precise and valid estimates.
Precise Prediction of Total Body Lean and Fat Mass From Anthropometric and Demographic Data: Development and Validation of Neural Network Models
Authors: Cichosz Simon Lebech , Rasmussen Nicklas Højgaard , Vestergaard Peter , Hejlesen Ole
Published: November 2020

Background:

Estimating body composition is relevant in diabetes disease management, such as drug administration and risk assessment of morbidity/mortality. It is unclear how machine learning algorithms could improve easily obtainable body muscle and fat estimates. The objective was to develop and validate machine learning algorithms (neural networks) for precise prediction of body composition based on anthropometric and demographic data.

Methods:

Cross-sectional cohort study of 18 430 adults and children from the US population. Participants were examined with whole-body dual X-ray absorptiometry (DXA) scans, anthropometric assessment, and answered a demographic questionnaire. The primary outcomes were predicted total lean body mass (predLBM), total body fat mass (predFM), and trunk fat mass (predTFM) compared with reference values from DXA scans.

Results:

Participants were randomly partitioned into 70% training (12 901) data and 30% validation (5529) data. The prediction model for predLBM compared with lean body mass measured by DXA (DXALBM) had a Pearson’s correlation coefficient of R = 0.99 with a standard error of estimate (SEE) = 1.88 kg ( P < .001). The prediction model for predFM compared with fat mass measured by DXA (DXAFM) had a Pearson’s coefficient of R = 0.98 with a SEE = 1.91 kg ( P < .001). The prediction model for predTFM compared with DXA measured trunk fat mass (DXAFM) had a Pearson’s coefficient of R = 0.98 with a SEE = 1.13 kg ( P < .001).

Conclusions:

In this study, neural network models based on anthropometric and demographic data could precisely predict body muscle and fat composition. Precise body estimations are relevant in a broad range of clinical diabetes applications, prevention, and epidemiological research.
Corporate Entrepreneurship and Business Performance: The Mediating Role of Employee Engagement
Authors: Ahmed Umair , Umrani Waheed Ali , Zaman Umer , Rajput Sheraz Mustafa , Aziz Tariq
Published: November 2020

The present study examined corporate entrepreneurship (CE) influence upon business performance following the mediation of employee engagement. In all, 201 middle managers from big 5 banks in Pakistan were sampled for the present study. Through applying structural equation modeling to test statistical relationship, the results revealed significant positive relationship between CE and business performance. Accordingly, the results also indicated mediation of employee engagement in this relationship thus, supporting both the hypothesized relationships. The study is first of its kind, addressing critical gap concerning employee engagement in the domain of CE and business performance. The study presents critical explanations and potential implications through which CE prospects could help employees to feel obliged to respond back with higher engagement and business performance. Toward the end, the chapter also discusses future research directions and scope for further study.
Behavioral Finance Experiments: A Recent Systematic Literature Review
Authors: Valcanover Vanessa Martins , Sonza Igor Bernardi , da Silva Wesley Vieira
Published: November 2020

This article aims to elaborate a systematic literature review (SLR) on the subject of experiments in behavioral finance, including papers published between 2014 and 2018. Methodology involved the careful selection of articles published in Web of Science and Scopus databases, and bibliometric analysis was applied. Final sample included 60 articles, the Journal of Behavioral Finance was the most productive journal and the majority of the 152 authors worked in the Americas. For cocitation, important authors, such as Kahneman and Tversky and Barber and Odean were among the most cited and with greater relational ties. For bibliographic coupling, Bursztyn et al. and Bigelow et al. were the most cited, whereas Kadous et al. presented more relational ties. The research contribution lies in the application of the SLR to a growing research area, allowing to know the most relevant subjects, articles, journals, authors, and countries in the area nowadays.
Microsurgical Anastomosis Rating Scale (MARS10): A Final Product Scoring System for Initial Microsurgical Training
Authors: Stogowski Piotr , Fliciński Filip , Białek Jan , Dąbrowski Filip , Piotrowski Maciej , Mazurek Tomasz
Published: November 2020

Background:

High cost and ethical controversy of using living models in microsurgical training made non-living models more popular. However, non-living models don’t provide appropriate feedback of microsurgical performance. Currently existing Global Rating Scales used for advanced microsurgical skills validation are difficult to apply on non-living model. This study presents a simple instrument for basic assessment of microsurgical anastomosis on non-living model.

Methods:

Seventy medical students were divided into 2 groups depending on their prior microsurgical experience. Each participant performed 3 end-to-end anastomoses on chicken femoral artery model. Anastomoses were reviewed by 3 blinded experts and then photographed. Evaluation included a patency tests, longitudinal cut of anastomosis, and the newly proposed tool 10 Point Microsurgical Anastomosis Rating Scale (MARS10). Presented scale consists of 5 factors important for anastomosis closure (anastomosis closure, suture spacing, bites size, knot tying, and cut ends length), graded on 3 point scale (0-2 points). Results were analyzed with analysis of variance, Spearman correlation, and t Student test.

Results:

Anastomoses evaluated by experts as patent significantly correlated with a high summary score in MARS10 scale (r = 0.73 P < .0001). There was a significant difference in MARS10 score between groups (P < .0001). There were no significant inter-rater differences in scoring among all 3 evaluators (p > .05).

Conclusions:

10 Point Microsurgical Anastomosis Rating Scale is a quick, valid, and reliable tool to assess microsurgical end-to-end arterial anastomoses on non-living model.
Individual pain sensitivity is associated with resting-state cortical activities in healthy individuals but not in patients with migraine: a magnetoencephalography study
Authors: Hsiao Fu-Jung , Chen Wei-Ta , Liu Hung-Yu , Wang Yen-Feng , Chen Shih-Pin , Lai Kuan-Lin , Pan Li-Ling Hope , Wang Shuu-Jiun
Published: November 2020

Background

Pain sensitivity may determine the risk, severity, prognosis, and efficacy of treatment of clinical pain. Magnetic resonance imaging studies have linked thermal pain sensitivity to changes in brain structure. However, the neural correlates of mechanical pain sensitivity remain to be clarified through investigation of direct neural activities on the resting-state cortical oscillation and synchrony.

Methods

We recorded the resting-state magnetoencephalographic (MEG) activities of 27 healthy individuals and 30 patients with episodic migraine (EM) and analyzed the source-based oscillatory powers and functional connectivity at 2 to 59 Hz in pain-related cortical regions, which are the bilateral anterior cingulate cortex (ACC), medial orbitofrontal (MOF) cortex, lateral orbitofrontal (LOF) cortex, insula cortex, primary somatosensory cortex (SI), primary motor cortex (MI), and posterior cingulate cortex (PCC). The mechanical punctate pain threshold (MPPT) was obtained at the supraorbital area (the first branch of the trigeminal nerve dermatome, V1) and the forearm (the first thoracic nerve dermatome, T1) and further correlated with MEG measures.

Results

The MPPT is inversely correlated with the resting-state relative powers of gamma oscillation in healthy individuals (all corrected P < 0.05). Specifically, inverse correlation was noted between the MPPT at V1 and gamma powers in the bilateral insula (r = − 0.592 [left] and − 0.529 [right]), PCC (r = − 0.619 and − 0.541) and MI (r = − 0.497 and − 0.549) and between the MPPT at T1 and powers in the left PCC (r = − 0.561) and bilateral MI (r = − 0.509 and − 0.520). Furthermore, resting-state functional connectivity at the delta to beta bands, especially between frontal (MOF, ACC, LOF, and MI), parietal (PCC), and sensorimotor (bilateral SI and MI) regions, showed a positive correlation with the MPPT at V1 and T1 (all corrected P < 0.05). By contrast, in patients with EM, the MPPT was not associated with resting-state cortical activities.

Conclusions

Pain sensitivity in healthy individuals is associated with the resting-state gamma oscillation and functional connectivity in pain-related cortical regions. Further studies must be conducted in a large population to confirm whether resting-state cortical activities can be an objective measurement of pain sensitivity in individuals without clinical pain.
Comparison of the efficacy and safety of circumcision by freehand technique and Plastibell device in children
Authors: Hamza Babatunde K. , Ahmed Muhammed , Bello Ahmad , Sholadoye Tunde Talib , Tolani Musliu Adetola , Lawal Ahmad Tijjani , Muhammad Muhammad Salihu , Abdulsalam Khalifah Ibrahim , Oyelowo Nasir , Maitama Hussein Yusuf
Published: November 2020

Background

Circumcision has been practiced since antiquity and is one of the most commonly performed surgical procedures. The aim of the study was to compare the efficacy and safety of the two most common techniques: Freehand and Plastibell techniques of circumcision.

Methods

The study was a prospective randomized study that was conducted on uncircumcised males at or below the age of 5 years that presented for circumcision. All boys who satisfied the inclusion criteria and whose parents consented, were randomized into two groups. Group A had freehand circumcision, while Group B had Plastibell circumcision. Patients were followed up at day 7 and day 28 postoperatively. The variables compared were operating time, cost, complications and parents’ satisfaction. All the data obtained were entered into a proforma. The data obtained were analyzed using SPSS version 20.

Results

A total of 110 boys were circumcised, 55 boys in each group. The median ages in the Plastibell and freehand groups were one and three months respectively. The mean operating time was significantly shorter in the Plastibell group compared to freehand (3.53 min versus 16.7 min). Total cost implication per procedure was also cheaper in Plastibell compared to freehand (₦3700 versus ₦6600). However, complications were more in the Plastibell group compared to freehand (29.1% versus 9.1%; P = 0.008). These complications in Plastibell group were age related. Parents in both groups were equally satisfied with the outlook on day 28.

Conclusion

Plastibell circumcision has the advantage of being faster and cheaper than freehand circumcision. Complications were more in the Plastibell group, and they were found to be age related.
A comprehensive analysis of cotton VQ gene superfamily reveals their potential and extensive roles in regulating cotton abiotic stress
Authors: Chen Pengyun , wei Fei , Cheng Shuaishuai , Ma Liang , Wang Hantao , Zhang Meng , Mao Guangzhi , Lu Jianhua , Hao Pengbo , Ahmad Adeel , Gu Lijiao , Ma Qiang , Wu Aimin , Wei Hengling , Yu Shuxun
Published: November 2020

Background

Valine-glutamine (VQ) motif-containing proteins play important roles in plant growth, development and abiotic stress response. For many plant species, theVQgenes have been identified and their functions have been described. However, little is known about the origin, evolution, and functions (and underlying mechanisms) of theVQfamily genes in cotton.

Results

In this study, we comprehensively analyzed the characteristics of 268VQgenes from fourGossypiumgenomes and found that theVQproteins evolved into 10 clades, and each clade had a similar structural and conservative motif. The expansion of theVQgene was mainly through segmental duplication, followed by dispersal. Expression analysis revealed that manyGhVQsmight play important roles in response to salt and drought stress, andGhVQ18andGhVQ84were highly expressed under PEG and salt stress. Further analysis showed thatGhVQswere co-expressed withGhWRKYtranscription factors (TFs), and microRNAs (miRNAs) could hybridize to their cis-regulatory elements.

Conclusions

The results in this study broaden our understanding of theVQgene family in plants, and the analysis of the structure, conserved elements, and expression patterns of theVQsprovide a solid foundation for exploring their specific functions in cotton responding to abiotic stresses. Our study provides significant insight into the potential functions ofVQgenes in cotton.
iCLIP analysis of RNA substrates of the archaeal exosome
Authors: Bathke Jochen , Gauernack A. Susann , Rupp Oliver , Weber Lennart , Preusser Christian , Lechner Marcus , Rossbach Oliver , Goesmann Alexander , Evguenieva-Hackenberg Elena , Klug Gabriele
Published: November 2020

Background

The archaeal exosome is an exoribonucleolytic multiprotein complex, which degrades single-stranded RNA in 3′ to 5′ direction phosphorolytically. In a reverse reaction, it can add A-rich tails to the 3′-end of RNA. The catalytic center of the exosome is in the aRrp41 subunit of its hexameric core. Its RNA-binding subunits aRrp4 and aDnaG confer poly(A) preference to the complex. The archaeal exosome was intensely characterized in vitro, but still little is known about its interaction with natural substrates in the cell, particularly because analysis of the transcriptome-wide interaction of an exoribonuclease with RNA is challenging.

Results

To determine binding sites of the exosome to RNA on a global scale, we performed individual-nucleotide resolution UV crosslinking and immunoprecipitation (iCLIP) analysis with antibodies directed against aRrp4 and aRrp41 of the chrenarchaeon Sulfolobus solfataricus. A relatively high proportion (17–19%) of the obtained cDNA reads could not be mapped to the genome. Instead, they corresponded to adenine-rich RNA tails, which are post-transcriptionally synthesized by the exosome, and to circular RNAs (circRNAs). We identified novel circRNAs corresponding to 5′ parts of two homologous, transposase-related mRNAs. To detect preferred substrates of the exosome, the iCLIP reads were compared to the transcript abundance using RNA-Seq data. Among the strongly enriched exosome substrates were RNAs antisense to tRNAs, overlapping 3′-UTRs and RNAs containing poly(A) stretches. The majority of the read counts and crosslink sites mapped in mRNAs. Furthermore, unexpected crosslink sites clustering at 5′-ends of RNAs was detected.

Conclusions

In this study, RNA targets of an exoribonuclease were analyzed by iCLIP. The data documents the role of the archaeal exosome as an exoribonuclease and RNA-tailing enzyme interacting with all RNA classes, and underlines its role in mRNA turnover, which is important for adaptation of prokaryotic cells to changing environmental conditions. The clustering of crosslink sites near 5′-ends of genes suggests simultaneous binding of both RNA ends by the S. solfataricus exosome. This may serve to prevent translation of mRNAs dedicated to degradation in 3′-5′ direction.
Natural variation of physiological traits, molecular markers, and chlorophyll catabolic genes associated with heat tolerance in perennial ryegrass accessions
Authors: Zhang Jing , Li Hui , Jiang Yiwei , Li Huibin , Zhang Zhipeng , Xu Zhipeng , Xu Bin , Huang Bingru
Published: November 2020

Background

Identification of genetic diversity in heat tolerance and associated traits is of great importance for improving heat tolerance in cool-season grass species. The objectives of this study were to determine genetic variations in heat tolerance associated with phenotypic and physiological traits and to identify molecular markers associated with heat tolerance in a diverse collection of perennial ryegrass (Lolium perenneL.).

Results

Plants of 98 accessions were subjected to heat stress (35/30 °C, day/night) or optimal growth temperature (25/20 °C) for 24 d in growth chambers. Overall heat tolerance of those accessions was ranked by principal component analysis (PCA) based on eight phenotypic and physiological traits. Among these traits, electrolyte leakage (EL), chlorophyll content (Chl), relative water content (RWC) had high correlation coefficients (− 0.858, 0.769, and 0.764, respectively) with the PCA ranking of heat tolerance. We also found expression levels of four Chl catabolic genes (CCGs), includingLpNYC1,LpNOL,LpSGR, andLpPPH, were significant higher in heat sensitive ryegrass accessions then heat tolerant ones under heat stress. Furthermore, 66 pairs of simple sequence repeat (SSR) markers were used to perform association analysis based on the PCA result. The population structure of ryegrass can be grouped into three clusters, and accessions in cluster C were relatively more heat tolerant than those in cluster A and B. SSR markers significantly associated with above-mentioned traits were identified (R2 > 0.05,p < 0.01)., including two pairs of markers located on chromosome 4 in association with Chl content and another four pairs of markers in association with EL.

Conclusion

The result not only identified useful physiological parameters, including EL, Chl content, and RWC, and their associated SSR markers for heat-tolerance breeding of perennial ryegrass, but also highlighted the involvement of Chl catabolism in ryegrass heat tolerance. Such knowledge is of significance for heat-tolerance breeding and heat tolerance mechanisms in perennial ryegrass as well as in other cool-season grass species.
Congenital coronary artery fistula in pediatric patients: transcatheter versus surgical closure
Authors: Wang Xiaoyong , Pang Chengcheng , Liu Xiaobing , Wang Shushui , Zhang Zhiwei , Chen Jimei , Zhuang Jian , Zhou Chengbin
Published: November 2020

Objectives

Transcatheter closure (TCC) and surgical closure (SC) are the two main approaches for congenital coronary artery fistula (CCAF), but data on the comparisons of the efficacy and safety of these two approaches are limited.

Methods

We retrospectively reviewed pediatric patients with CCAF in Guangdong Cardiovascular Institute between January 2002 and December 2017. Patients who were qualified into our criteria were included into final analysis. The rate of successful closure and complications during hospitalization and at follow-up were compared between SC and TCC groups.

Results

In total, 121 pediatric patients (male, n = 69; female, n = 52) with CCAF were divided to TCC (n = 63) and SC groups (n = 58) according to the indications. The mean age was 5.3 ± 1.4 years. The baseline characteristics of these two groups were similar except for the fistula anatomic feature. After adjusted for the fistula anatomy, compared to SC, TCC was associated with higher risk of major complications (p = 0.013). Proportions of patients requiring blood transfusion and intra-operative blood loss were higher in SC versus TCC groups, as were longer duration of hospital and ICU stay during hospitalization. In contrast, myocardial ischemia (10.2% vs 0.0%, p = 0.028), residual shunts (16.9% vs 3.6%, p = 0.045) and new-onset moderate-to-severe valve regurgitation (11.9% vs 0.0%, p = 0.013) were higher in TCC group versus SC groups during follow-up.

Conclusions

TCC has less invasive and faster recovery. However, SC had a higher successful rate and lower risk of major complications in pediatric patients.
HER2 gene assessment in liquid biopsy of gastric and esophagogastric junction cancer patients qualified for surgery
Authors: Grenda Anna , Wojas-Krawczyk Kamila , Skoczylas Tomasz , Krawczyk Paweł , Sierocińska-Sawa Jadwiga , Wallner Grzegorz , Milanowski Janusz
Published: November 2020

Background

Amplification of HER2 gene (ERBB2) and overexpression of HER2 protein on cancer cells are found in 10–26% of gastric cancer (GC) and esophagogastric junction cancer (EGJC). Gene copy number variation (CNV) could be detected in these patients in liquid biopsy and in cancer cells.

Methods

We analysed HER2 gene CNV used qPCR method in 87 sera collected from GC and EGJC patients before surgical treatment and in 40 sera obtained from healthy donors. HER2 gene CNV was also assessed in formalin-fixed paraffin-embedded (FFPE) tumor tissue. Furthermore, we assessed the number of HER2 gene copies and HER2 expression in cancer cells using the fluorescent in situ hybridization method (FISH) and immunohistochemistry (IHC).

Results

We found that the HER2 gene copy number in liquid biopsy was higher in GC and EGJC patients compared to healthy people (p = 0.01). Moreover, EGJC patients had higher number of HER2 gene copies than healthy donors (p = 0.0016). HER2 CNV examination could distinguish healthy individuals and patients with gastric or esophagogastric junction cancers with sensitivity and specificity of 58% and 98% (AUC = 0.707, 95% CI 0.593–0.821, p = 0.004). We found that patients with a high copy number of the HER2 gene in the tumor tissue assessed by qPCR (but not by FISH) have significantly more often a high number of HER2 gene copies in liquid biopsy (p = 0.04).

Conclusions

We suggested that HER2 testing in liquid biopsy could be used as an auxiliary method to analysis of HER2 status in tumor tissue in gastric or esophagogastric junction cancers.
The migrating mediators and the interaction associated with the use of essential public health services: a cross-sectional study in Chinese older migrants
Authors: Long Chengxu , Tang Shangfeng , Wang Ruoxi , Ji Lu , Wang Yang , Wu Tailai , Li Zhifei , Feng Zhanchun
Published: November 2020

Background

Despite the incremental implementation of the essential public health services (EPHS) during the last decade, the goal of EPHS’s equalization is impossible to cannot be achieved without appropriate policies targeting older migrants. Therefore, this study aims to examine whether the supply side meets the needs of older migrants and to explore the relationships among health status, the use of health services, and diverse factors.

Methods

The data were derived from a national cross-sectional dataset (N = 11,161) of the 2015 Chinese Migrant Dynamic Monitoring Survey. Mediating effects analysis and moderating effects analysis were conducted to explore the interactions between physical status and the use of EPHS in older migrants such as physical examination, health record, and follow-up services.

Results

The use of physical examination, health record, and follow-up services were correlated with each other. Household income, migrating for employment, and migrating for offspring were negatively associated with the use of EPHS. A positive association was observed between the use of EPHS and willingness for long-stay. The mediating effects of household income, migrating for employment, migrating for offspring, and willingness for long-stay were observed on the relationship between physical status and the use of EPHS. The moderating effects of household income and migrating for employment were discovered.

Conclusion

Public health policies that may be worthy of consideration include further enhancing the delivery capacity of primary health institutions, integrating professional clinical resources into the primary health system, and launching the target policies to improve the accessibility of EPHS in older migrants.
The influence of co-residential and non-co-residential living arrangements on sufficient fruit and vegetable consumption in the aging population in Thailand
Authors: Phulkerd Sirinya , Gray Rossarin Soottipong , Chamratrithirong Aphichat
Published: November 2020

Background

Living arrangements have an impact on a family’s health-related behaviors, especially its eating behaviors. However, studies that have examined the association between living arrangements and food intake, especially fruit and vegetable (FV) consumption of older adults, are rare. This study aimed to investigate the association between living arrangements and FV consumption in a population of older adults in Thailand from a national sample of households.

Methods

This study extracted data on 2048 persons age 60 years or older from a study of a nationally-representative sample of Thai households. The survey asked respondents about FV intake, living arrangements, household size, and socio-demographic characteristics. Binary logistic regression analysis was used to investigate the association between the variables and FV intake.

Results

The mean age of the respondents was 68.2 ± 6.5 years. Of the total sample, only 31.9% had sufficient FV intake. The group with the lowest possibility of sufficient FV intake was persons who lived alone. Those who lived with at least one child or lived in a skipped-generation household were 2.7 and 2.2 times as likely to have sufficient FV intake as those who lived alone (p < 0.001 and p < 0.01, respectively). Older adults living only with their spouse were 2.1 times as likely to have sufficient FV intake as those who lived alone. FV intake also differed significantly by socio-demographic characteristics (sex, place of residence, educational attainment, occupation and income), self-rated health, FV knowledge, and exposure to a FV promotion campaign in the community.

Conclusions

The findings from this study suggest that a different approach is required to improve FV consumption in the older population by taking into account their living arrangements, community context, level of FV knowledge, and socio-demographic characteristics. The older adults who live alone, as well as those living in a large household, are at particular risk of inadequate FV intake, and require special attention.
Triple therapy combined with ventriculoperitoneal shunts can improve neurological function and shorten hospitalization time in non-HIV cryptococcal meningitis patients with increased intracranial pressure
Authors: Li Min , Liu Jia , Deng Xuhui , Gan Qingzhou , Wang Yijie , Xu Xiaofeng , Jiang Ying , Peng Fuhua
Published: November 2020

Background

Raised intracranial pressure (ICP) and insufficient antifungal regimens are the two main factors result to unsatisfactory outcomes in non-HIV cryptococcal meningitis (CM) patients. In this study, we try to discuss that whether triple therapy of amphotericin B (AmB), fluconazole, 5-flucytosine (5-FC) plus ventriculoperitoneal shunts (VPS) is superior to AmB, 5-FC, fluconazole plus intermittent lumbar puncture in induction therapy in non-HIV CM patients with increased ICP.

Methods

We reviewed 66 clinical records from non-HIV CM patients with increased ICP. The demographic and clinical characteristics, BMRC staging, cerebrospinal fluid profiles (CSF), brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. All non-HIV CM patients with increased ICP (≥ 25 cmH2O) were divided into two groups, including 27 patients treated with triple antifungal agents and 39 patients treated with the same triple therapy plus VPS.

Results

Triple therapy plus VPS group had more satisfactory outcomes, more CSF sterilization at 10 weeks follow-up, lower CSF opening pressure, lower BMRC staging scores one week after VPS, less CSF C. neoformans counts and CSF culture positive. Besides, these patients had shorter hospital stay than triple therapy group.

Conclusions

Triple antifungal agents combined with VPS could effectively reduce ICP, had faster rate of clearance of C. neoformans counts, more improved neurological function, shorten hospitalization time and better outcomes in non-HIV CM patients with increased ICP. Our study indicated that triple therapy plus early VPS may be an optimal treatment for non-HIV CM patients with increased ICP.
Acceptability of on-site rapid HIV/HBV/HCV testing and HBV vaccination among three at-risk populations in distinct community-healthcare outreach centres: the ANRS-SHS 154 CUBE study
Authors: Calin Ruxandra , Massari Véronique , Pialoux Gilles , Reydellet Nelly , Plenel Eve , Chauvin Carole , Jauffret-Roustide Marie , Day Nesrine , Kreplak Georges , Maresca Anaenza Freire , Derche Nicolas , Louis Sandra , Pol Stanislas , Doré Véronique , Rouzioux Christine , Chauvin Pierre
Published: November 2020

Background

HIV, HBV and HCV infections continue to represent major health concerns, especially among key at-risk populations such as men who have sex with men (MSM), people who inject drugs (PWIDs), transgender women (TGW) and sex workers (SW). The objective of the ANRS-CUBE study was to evaluate the acceptability of a healthcare, community-based strategy offering a triple rapid HIV-HBV-HCV testing, and HBV vaccination, targeted at three priority groups (MSM, PWIDs and TGW/SWs), in three community centers, in the Paris area.

Methods

This longitudinal multicentric non-randomized study included all adult volunteers attending one of the three specialized community centers in Paris, between July 2014 and December 2015. HIV, HBV and HCV status and acceptability of HBV vaccination were evaluated.

Results

A total of 3662, MSM, 80 PWIDs and 72 TGW/SW were recruited in the three centers respectively. Acceptability of rapid tests was 98.5% in MSM and 14.9% in TGW/SWs, but could not be estimated in PWIDs since the number of users attending and the number of proposals were not recorded. User acceptability of HBV vaccination was weak, only 17.9% of the eligible MSM (neither vaccinated, nor infected) agreed to receive the first dose, 12.2% two doses, 5.9% had a complete vaccination. User acceptability of HBV vaccination was greater in PWIDs and TGW/SWs, but decreased for the last doses (66.7 and 53.3% respectively received a first dose, 24.4 and 26.7% a second dose and 6.7 and 0% a third dose). Fifty-three participants (49 MSM and 4 PWIDs) were discovered HIV positive, more than half with a recent infection. All but two HIV positive participants were linked to appropriate care in less than one month.

Conclusions

Rapid HIV-HCV-HBV screening showed a very high level of acceptability among MSM. Efforts need to be made to improve immediate acceptability for HBV vaccination, especially among MSM, and follow-up doses compliance. Our results show the important role of community centers in reaching targets, often fragile, populations, while also suggesting the need to reinforce on-site human support in terms of testing and vaccination, especially when addressing PWIDs.
Association of vitamin D and FGF23 with serum ferritin in hypoparathyroid thalassemia: a case control study
Authors: Saki Forough , Salehifar Azita , Kassaee Seyed Reza , Omrani Gholamhossein Ranjbar
Published: November 2020

Background

FGF23 controls serum l,25(OH)2D3 levels and phosphate homeostasis. This study evaluates the effects of ferritin on intact PTH, FGF23, and l,25(OH)2D3 in patients with major thalassemia. It also evaluates FGF23 changes in patients with hypoparathyroidism to clarify the interaction between FGF23 and PTH in the absence of proper PTH functioning in human.

Methods

In this case-control study, 25 major-beta thalassemia patients with hypoparathyroidism were age- and gender-matched with major-beta thalassemia patients having normal parathyroid function. Biochemical studies assessed the serum calcium, albumin, phosphorus, alkaline phosphatase, PTH, FGF23, 25(OH) D, 1,25(OH)2D3, ferritin, and the fractional excretion of phosphorous.

Results

FGF23 was higher in the patients with hypoparathyroidism than the controls (P = 0.002). The fractional excretion of phosphorous was lower in patients with hypoparathyroidism, despite the high level of FGF23 (P = 0.001). There was a correlation between serum 1,25(OH)2D3 and FGF23 with ferritin in the controls (P = < 0.001and P = < 0.001, respectively).

Conclusions

The present study showed a strong positive correlation between serum ferritin and levels of FGF23 and 1,25(OH)2D3. We hypothesized that ferritin could have a stimulatory effect on the production of 1,25(OH)2D3. Moreover, a rise in FGF23 in patients with thalassemia, might be either associated with the stimulating effect of PTH and 1,25(OH)2D3, or directly related to the stimulating effect of ferritin.
Safety and efficacy of manual vacuum suction compared with conventional dilatation and sharp curettage and electric vacuum aspiration in surgical treatment of miscarriage: a randomized controlled trial
Authors: Kakinuma Toshiyuki , Kakinuma Kaoru , Sakamoto Yuuka , Kawarai Yoshimasa , Saito Koyomi , Ihara Motomasa , Matsuda Yoshio , Sato Ikuo , Ohwada Michitaka , Yanagida Kaoru , Tanaka Hirokazu
Published: November 2020

Background

The World Health Organization does not recommend dilatation and sharp curettage (D&C) for the surgical treatment of miscarriage during the first trimester because this may cause Asherman’s syndrome due to endometrial damage; therefore, suction remains the primary treatment option. While manual vacuum aspiration (MVA) has been widely used since the 1990s outside Japan, the use of an MVA device (Women’s MVA system) was approved in Japan in October 2015. Here, we examined the efficacy of the MVA kit in women surgically treated for miscarriage.

Methods

This retrospective cohort study was conducted between 2014 and 2018 at the International University of Health and Welfare Hospital in Japan. Women who underwent surgical treatment for miscarriage within 12 weeks of pregnancy were identified and enrolled in the study. A total of 404 women were included who underwent the following procedures: 121 D&C, 123 electric vacuum aspiration (EVA), and 160 MVA. For each participant, the duration of surgery, amount of bleeding, amount of anesthetic used, incomplete abortion requiring repeat procedures, and intraoperative/postoperative complications were evaluated.

Results

The duration of surgery was 13.7 ± 7.2, 11.2 ± 4.2, and 6.9 ± 4.3 min in the D&C, EVA, and MVA groups, respectively (p = 1.00). The amount of anesthetic used was not significantly different among all groups. Bleeding of ≥ 100 mL was confirmed in three (2.4%), one (0.8%), and one (0.6%) patient(s) in the D&C, EVA, and MVA groups, respectively (p = 0.50). Incomplete abortion was identified in three (2.4%), two (1.6%), and one (0.6%) patient(s) in the D&C, EVA, and MVA groups, respectively (p = 0.61). However, severe intraoperative/postoperative complications were not observed in any group.

Conclusions

Surgical treatment for miscarriage performed using the MVA kit has safety and efficacy similar to those of conventional methods, such as D&C and EVA.
Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales: a linked data study
Authors: Griffiths L. J. , Johnson R. D. , Broadhurst K. , Bedston S. , Cusworth L. , Alrouh B. , Ford D. V. , John A.
Published: November 2020

Background

Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers.

Methods

Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used.

Results

Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% < 21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%).

Conclusion

This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women’s needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.
CRAFT (Cerclage after full dilatation caesarean section): protocol of a mixed methods study investigating the role of previous in-labour caesarean section in preterm birth risk
Authors: Carlisle Naomi , Glazewska-Hallin Agnieszka , Story Lisa , Carter Jenny , Seed Paul T. , Suff Natalie , Giblin Lucie , Hutter Jana , Napolitano Raffaele , Rutherford Mary , Alexander Daniel C. , Simpson Nigel , Banerjee Amrita , David Anna L. , Shennan Andrew H.
Published: November 2020

Background

Full dilatation caesarean sections are associated with recurrent early spontaneous preterm birth and late miscarriage. The risk following first stage caesarean sections, are less well defined, but appears to be increased in late-first stage of labour. The mechanism for this increased risk of late miscarriage and early spontaneous preterm birth in these women is unknown and there are uncertainties with regards to clinical management. Current predictive models of preterm birth (based on transvaginal ultrasound and quantitative fetal fibronectin) have not been validated in these women and it is unknown whether the threshold to define a short cervix (≤25 mm) is reliable in predicting the risk of preterm birth. In addition the efficacy of standard treatments or whether benefit may be derived from prophylactic interventions such as a cervical cerclage is unknown.

Methods

There are three distinct components to the CRAFT project (CRAFT-OBS, CRAFT-RCT and CRAFT-IMG).

CRAFT-OBS: Observational Study; To evaluate subsequent pregnancy risk of preterm birth in women with a prior caesarean section in established labour. This prospective study of cervical length and quantitative fetal fibronectin data will establish a predictive model of preterm birth.

CRAFT-RCT: Randomised controlled trial arm; To assess treatment for short cervix in women at high risk of preterm birth following a fully dilated caesarean section.

CRAFT-IMG: Imaging sub-study; To evaluate the use of MRI and transvaginal ultrasound imaging of micro and macrostructural cervical features which may predispose to preterm birth in women with a previous fully dilated caesarean section, such as scar position and niche.

Discussion

The CRAFT project will quantify the risk of preterm birth or late miscarriage in women with previous in-labour caesarean section, define the best management and shed light on pathological mechanisms so as to improve the care we offer to women and their babies.

Trial registration

CRAFT was prospectively registered on 25th November 2019 with the ISRCTN registry (10.1186/ISRCTN15068651).