bluuebunny/crossref_metadata_2025 huggingface dataset:
Neovagina creation in congenital vaginal agenesis: New mini-laparoscopic approach applying intraoperative indocyanine green fluorescence
Authors: Fontoura Oliveira Andreia , Ferreira Hélder
Published: October 2020

Background. There is still no standardized treatment for vaginal agenesis; surgical repair using a minimally invasive technique is a good option, as it offers rapid results along with a fast postoperative recovery. Objective. To describe a new modified Vecchietti procedure by a mini-laparoscopic approach with intraoperative use of indocyanine green fluorescence technology for the creation of a neovagina in the setting of congenital vaginal agenesis. Methods. Retrospective review of all cases of congenital vaginal agenesis submitted to a mini-laparoscopic modified Vecchietti procedure with intraoperative use of indocyanine green (ICG) fluorescence (between June and September 2019). Patient relevant medical history, surgical technique, postoperative care, outcomes, and complications are described. Results. Four patients with Mayer–Rokitansky–Küster–Hauser syndrome (mean age: 19 years; mean preoperative vaginal length: 1.5 cm) were included in the study. The procedure was completed successfully and uneventfully in all patients. External traction device was removed 5–7 days after surgery and replaced by external vaginal silicone dilators. This technique was able to create 10–11 cm neovaginas in 1 week; six weeks after surgery all patients had an epithelized 10.5–12 cm length and 2.5–3 cm diameter neovagina. Complications consisted of one case of isolated fever at the ninth postoperative day, solved with empiric antibiotic treatment. Conclusion. The mini-laparoscopic modified Vecchietti approach, associated with ICG fluorescence imaging, is feasible and effective in the treatment of congenital vaginal agenesis, as it is a simple and safe procedure with promising outcomes.
Induced Pluripotent Stem Cells Attenuate Acute Lung Injury Induced by Ischemia Reperfusion via Suppressing the High Mobility Group Box-1
Authors: Li Yijun , Wang Shun , Liu Jinbo , Li Xingyu , Lu Meng , Wang Xiaokai , Ren Yansong , Li Xiaoming , Xiang Meng
Published: October 2020

Pulmonary endothelial cell injury is a hallmark of acute lung injury. High-mobility group box 1 (HMGB1) can modulate the inflammatory response via endothelial cell activation and release of inflammatory molecules. Thus, we tested whether induced pluripotent stem cells (iPSCs) can alleviate ischemia/reperfusion (I/R) induced lung injury, and, if so, whether HMGB1 mediates the effect in a male C57BL/6 mouse model. Intravenously injected iPSCs into mice 2 h after I/R showed a significant attenuation of lung injury (assessed by lung mechanics, edema, and histology) 24 h after reperfusion (compared with controls), along with decreases in HMGB1, phosphorylated nuclear factor-κB, inflammatory cytokines [interleukin (IL)1β, IL6 and tumor necrosis factor-α], and the activation of endothelial cells. Furthermore, these effects of iPSCs can be mimicked by blocking HMGB1 with an inhibitor in vivo and in vitro. We conclude that iPSCs can be a potential therapy for I/R-induced lung injury. These cells may exert therapeutic effects through blocking HMGB1 and inflammatory cytokines.
Icariin Promote Stem Cells Regeneration and Repair Acinar Cells in L-arginine / Radiation -Inducing Chronic Pancreatitis in Rats
Authors: Moustafa Enas M. , Moawed Fatma S. M. , Abdel-Hamid Gehan R.
Published: October 2020

Objective:

Chronic Pancreatitis (CP) is a multifactorial disease. It was characterized by severe inflammation and acinar cell destruction. Thus, the present study was initiated to evaluating the ability of bone marrow-based mesenchymal stem cell (MSCs) combined with Icariin to restore and regenerate acinar cells in the pancreas of rats suffering chronic pancreatitis.

Methods:

Chronic pancreatitis was induced in rats via both L-arginine plus radiation, repeated L-arginine injection (2.5g/Kg body-weight, 1, 4,7,10,13,16,19 days), then, on day 21, rats were exposed to a single dose of gamma-radiation (6 Gy), which exacerbate injury of pancreatic acinar cells. One day after irradiation, rats were treated with either MSCs (1 × 107 /rat, once, tail vein injection) labeled PKH26 fluorescent linker dye and/or Icariin (100 mg/Kg, daily, orally) for 8 weeks.

Results:

Icariin promotes MSCs proliferation boosting its productivity in vitro. MSCs, and/or icariin treatments has regulated molecular factors TGF-β/PDGF and promoted the regeneration of pancreatic tissues by releasing PDX-1 and MafA involved in the recruitment of stem/progenitor cell in the tissue, and confirmed by histopathological examination. Moreover, a significant decrease in IL-8 and TNF-α cytokines with significant amelioration of myeloperoxidase activity were noted. As well as, reduction in MCP-1 and collagen type-1 levels along with Hedgehog signaling down-regulating expression in such cells, Patched-1, Smoothened, and GLi-1.

Conclusion:

The potent bioactive therapeutic Icariin combined with MSCs induces a significantly greater improvement, compared to each therapy alone.
A new modal analysis method applied to changing machine tool using clustering
Authors: Jiang Xuchu , Mao Xinyong , Chen Yingjie , Hao Caihua
Published: October 2020

The states of the machine tool, such as the components’ position and the spindle speed, play leading roles in the change of dynamic parameters. However, the traditional modal analysis method that modal parameters manually identified from vibration signal is greatly interfered by harmonics, and the process of eliminating interference is very inefficient and subjective. At present, there is a lack of a standard and efficient method to characterize modal parameter changes in different states of machine tools. This paper proposes a new machine tool modal classification analysis method based on clustering. The characteristics related to the modal parameters are extracted from the response signal in different states, and the clustering results are used to reflect the changes of machine tool modal parameters. After the amplitude of the frequency response function is normalized, the characteristics related to the natural frequency are acquired, and the clustering results further reflect the difference of the natural frequency of the signal. The new method based on clustering can be a standard and efficient method to characterize modal parameter changes in different states of machine tools.
Fault diagnosis method of rolling bearings Based on SPA-FE-IFSVM
Authors: Han Hui , Hao Lina
Published: October 2020

Rolling bearings are the most frequently failed components in rotating machinery. Once a failure occurs, the entire system will be shut down or even cause catastrophic consequences. Therefore, a fault detection of rolling bearings is of great significance. Due to the complexity of the mechanical system, the randomness of the vibration signal appears on different scales. Based on the multi-scale fuzzy entropy (FE) analysis of the vibration signal, a rolling bearing fault diagnosis method based on smoothness priors approach (SPA) -FE-IFSVM is proposed. The SPA method was used to adaptively decompose the vibration signal and obtain the trend item and de-trend item of the vibration signal. Then the fuzzy entropy of the trend item and de-trend item was calculated respectively. Meanwhile, aiming at the problem that the support vector machine (SVM) cannot process the data set containing fuzzy messages and was sensitive to noise, the fuzzy support vector machine (FSVM) was introduced and improved, and then the FE as the feature vector was input into the improved fuzzy support vector machine (IFSVM) to identify the failure. The method was applied to the rolling bearing experimental data. The analysis results show that: this method can achieve 100% fault diagnosis accuracy when only two component features are extracted, which can effectively realize the fault diagnosis of rolling bearings.
Perception of social support provided by coaches, optimism/pessimism, and psychological well-being: Gender differences and mediating effect models
Authors: Cnen Tung-Wei , Chiu Yi-Chuan , Hsu Yawen
Published: October 2020

This study explored whether gender differences exist in social support, optimism/pessimism, and psychological well-being among university student athletes and examined the relationship among these three variables and the mediating effect of optimism/pessimism. A total of 322 university student athletes (159 men and 163 women) who were Division 1 athletes participated in this study. The research instruments used in this study comprised the revised Athletes’ Received Support Questionnaire, the Life Orientation Test, and the Psychological Well-Being Scale. The results demonstrated the influence of gender differences for some variables. Regarding pessimistic tendency and autonomy (a dimension of the Psychological Well-Being Scale), the average scores of men were significantly higher than those of women. Regarding the other three dimensions of the Psychological Well-Being Scale (purpose in life, positive relationships with others, and personal growth), the average scores were higher for women than for men. Moreover, significant positive correlations were observed among social support provided by coaches, optimism, and psychological well-being. Optimism mediated the relationship between social support and psychological well-being, and pessimism was negatively correlated with psychological well-being; however, the mediating path was not significant. Finally, suggestions for future research and practical implications are proposed for researchers, educators, and supervisors in the field of sports.
Comparison of different measures to monitor week-to-week changes in training load in high school runners
Authors: Ryan Megan R , Napier Christopher , Greenwood Daniel , Paquette Max R
Published: October 2020

Training load is commonly used to monitor training stress and is the product of external and internal physiological loads experienced by an athlete. With emerging wearable technology, it is possible to evolve existing external load measurement from duration or distance to runner-specific biomechanical data, which when combined with existing measures of internal load such as session rating of perceived exertion (sRPE), may improve the quantification of training stress. This study compared week-to-week changes in training duration with different training loads obtained from common and more individualized measures of external load. The training of nine male high school cross-country runners from the same team undertaking the same training program was monitored for two consecutive weeks. This two-week cycle included a “coach-prescribed” low and high training load week. Training loads were calculated with sRPE and external load measures including: duration (minutes), Step Count, “Bone Stimulus” (IMeasureU), and cumulative vertical force. Weekly distances (in miles) were also measured. Between-week percent change (%Δ) was compared among training loads and minutes using paired t-tests and Cohen’s d effect size. Different %Δ were found between sRPExMinutes (%Δ=65 ± 25%; p = 0.002, d = 1.83), sRPExStep Count (%Δ=66 ± 31%; p = 0.006, d = 2.06), sRPExForce (%Δ=66 ± 29%; p = 0.002, d = 1.91), and miles (%Δ=28 ± 13%; p = 0.019, d = 0.71) compared to minutes (%Δ=20 ± 8%). These findings highlight that only using weekly volume can greatly misrepresent changes in training stress in runners. We therefore encourage coaches and practitioners to consider training monitoring approaches beyond just weekly distance or duration. Simple measures of training load that include duration and sRPE might be sufficient.
The PaCO2-ETCO2 gradient in pre-hospital intubations of all aetiologies from a single UK helicopter emergency medicine service 2015–2018
Authors: Hibberd Owen , Hazlerigg Antonia , Cocker Paul John , Wilson Alastair W , Berry Neil , Harris Tim
Published: October 2020

Background

Control of the arterial partial pressure of carbon dioxide (PaCO2) is important in the ventilated patient. End-tidal carbon dioxide (ETCO2) levels are often used as a proxy, but are clinically limited. The difference between the PaCO2 and ETCO2 has been suggested to be 0.5–1.0 kPa. However, this has not been consistently reflected in the physiologically unstable pre-hospital patient. This study aims to elucidate the PaCO2-ETCO2 gradient for pre-hospital intubated patients.

Methods

This was a retrospective, cohort study using data identified from the HEMSbase 2 database (Feb 2015–Nov 2018). Patients were included if they had documented ETCO2 and arterial PaCO2 measurements. Arterial PaCO2 data that could not be linked to within 5 minutes of ETCO2 were excluded. Bland-Altman plots were calculated to describe agreement.

Results

A total of 73 patients were identified. Aetiology was arranged into three categories: 13 (17.8%) medical, 22 (30.1%) traumatic and 38 (52.1%) out-of-hospital cardiac arrest (OHCA). The median PaCO2-ETCO2 gradient was 2.0 [1.3–3.1] kPa. A PaCO2-ETCO2 gradient of 0–1 kPa was seen for only 11 (15.1%) of total patients. The Bland-Altman agreement for all aetiologies was more than the accepted gradient of 0-1 kPa with the largest bias and widest limits of agreement seen for OHCA (–3.2 [0.3 – –6.8]).

Conclusion

The magnitude of the differences between the ETCO2 and PaCO2, levels of variation and inability to predict this suggest that ETCO2 is not a suitable surrogate upon which to base ventilatory settings in conditions where pH or PaCO2 require precise control.
Effect of post-extubation high-flow nasal cannula on reintubation in elderly patients: a retrospective propensity score-matched cohort study
Authors: Ko Ryoung-Eun , Park Chul , Nam Jimyoung , Ko Myeong Gyun , Na Soo Jin , Ahn Joong Hyun , Carriere Keumhee C. , Jeon Kyeongman
Published: October 2020

Background:

Studies of mechanically ventilated patients with a low risk of reintubation have suggested that the use of high-flow nasal cannula (HFNC) oxygen therapy reduces the risk of reintubation compared with conventional oxygen therapy (COT). However, the effect of HFNC following extubation in elderly patients with a high risk of reintubation remains unclear.

Methods:

All consecutive medical intensive care unit (ICU) patients aged >65 years who were mechanically ventilated for >24 h were prospectively registered between July 2017 and June 2018. Control was obtained from a historical database of patients attending the same ICU from January 2012 to December 2013. A total of 152 patients who underwent HFNC after planned extubation according to institutional protocols (HFNC group) were compared with a propensity-matched historical control group who underwent COT ( n = 175, COT group). The primary outcome was the proportion of reintubated patients within 48 h after planned extubation.

Results:

One hundred patients from the HFNC group and 129 patients from the COT group were matched by a propensity score that reflected the probability of receiving HFNC, and all variables were well matched. Post-extubation respiratory failure (41.0% versus 33.3%, p = 0.291) and reintubation rate within 48 h (16.0% versus 11.6%, p = 0.436) did not differ between the HFNC and COT groups. However, decreased levels of consciousness as a sign of post-extubation respiratory failure (27.0% versus 11.7%, p = 0.007) were significantly increased in the HFNC group compared with the COT group.

Conclusion:

Among elderly patients who underwent planned extubation, HFNC was not associated with a decrease in the risk of reintubation. Further prospective study evaluating the clinical benefits of post-extubation HFNC in elderly patients is needed. The reviews of this paper are available via the supplemental material section.
The Effect of Overexpression of Lrp5 on the Temporomandibular Joint
Authors: Utreja Achint , Motevasel Hengameh , Bain Carol , Holland Robert , Robling Alexander
Published: October 2020

Objective

The temporomandibular joint (TMJ) is a unique fibrocartilaginous joint that adapts to mechanical loading through cell signaling pathways such as the Wnt pathway. Increased expression of low-density lipoprotein receptor-related protein 5 (Lrp5), a co-receptor of the Wnt pathway, is associated with a high bone mass (HBM) phenotype. The objective of this study was to analyze the effect of overexpression of Lrp5 on the subchondral bone and cartilage of the TMJ in mice exhibiting the HBM phenotype.

Design

Sixteen-week-old Lrp5 knock-in transgenic mice carrying either the A214V (EXP-A) or G171V (EXP-G) missense mutations, and wildtype controls (CTRL) were included in this study. Fluorescent bone labels, calcein, alizarin complexone, and demeclocycline were injected at 3.5, 7.5, and 11.5 weeks of age, respectively. The left mandibular condyle was used to compare the subchondral bone micro-computed tomography parameters and the right TMJ was used for histological analyses. Cartilage thickness, matrix proteoglycan accumulation, and immunohistochemical localization of Lrp5 and sclerostin were compared between the groups.

Results

Subchondral bone volume (BV) and percent bone volume (BV/TV) were significantly increased in both EXP-A and EXP-G compared with CTRL ( P < 0.05) whereas trabecular spacing (Tb.Sp) was decreased. Cartilage thickness, extracellular matrix production, and expression of Lrp5 and Sost were all increased in the experimental groups. The separation between the fluorescent bone labels indicated increased endochondral maturation between 3.5 and 7.5 weeks.

Conclusions

These data demonstrate that Lrp5 overexpression leads to adaptation changes in the mandibular condylar cartilage of the TMJ to prevent cartilage degradation.
An Introduction to Research for Primary Dental Care Clinicians
Authors: Santini Ario , Eaton Kenneth A
Published: October 2020

This paper, the fifth in the series, will address the sixth of the ten stages of a research project suggested in the first paper. The ten suggested stages are:

1. The initial idea (asking a research question).

2. Searching the literature.

3. Refining the research question.

4. Planning the study.

5. Writing a protocol.

6. Obtaining ethical approval and funding.

7. Piloting the methodology and project management.

8. Collecting data.

9. Analysing the data.

10. Writing up and disseminating the results.

A previous paper1 has outlined the how to plan a research project. The next stage has two elements, which are to obtain ethical approval and to obtain funding. Each is the topic of a separate paper. This paper outlines the key areas within the topic of funding and updates two previous publications.2,3
Autologous rectus fascia sling for post-vesicovaginal fistula repair stress incontinence: case series from a Nigerian experience
Authors: Lawal Olatunji Okikiola , Nasir Sadiya , Bello Oluwasomidoyin Olukemi , Abdus-salam Rukiyat Adeola , Morhason-Bello Imran Oludare , El-ladan A. M. , Ojengbede Oladosu Akanbi
Published: October 2020

Background

Successful outcome of a urinary fistula repair involves a successful closure of the fistula without residual incontinence. However, a few women have post-repair stress urinary incontinence despite closure of the fistula, which requires special surgical technique to achieve total continence.

Case presentation

Four women with post-vesicovaginal fistula repair residual incontinence were selected for sling operation using autologous rectus fascia in a low resource setting. Their ages ranged between 20 and 30 years. None had a fistulous opening on vaginal examination and dye test. Two patients had one previous attempt at repair of post-repair stress incontinence, while the others had two and three attempts, respectively, without success. The patients had none to mild vaginal adhesion. Following the procedure, they were followed up for 6 months and they remained continent of urine.

Conclusion

All patients achieved total urinary continence following autologous rectus fascia slings with minimal complications. This demonstrates the possibility of achieving a successful outcome despite lack of modern equipment for diagnosis and follow-up, a typical problem of low-income country like Nigeria.
Ocular syphilis with optic disc neovascularization treated with bevacizumab evaluated by OCT angiography and electroretinography
Authors: Miura Gen , Baba Takayuki , Takeishi Marie , Tatsumi Tomoaki , Yokouchi Hirotaka , Yamamoto Shuichi
Published: October 2020

We present our findings in an atypical case of ocular syphilis with optic disc neovascularization that was treated with intravitreal bevacizumab and followed by multimodal imaging and electroretinography. A 29-year-old man presented with a chief complaint of night blindness of one-year duration. Our initial examination showed that an optic disc neovascularization was present, and the optical coherence tomographic (OCT) images showed a reduction in the length of the ellipsoid zone of both eyes. Fluorescein angiography showed leakage from the optic disc neovascular tissue, and the presence of nonperfused areas in the peripheral retina. Blood test was strongly positive for syphilis. He was administered oral amoxicillin and prednisolone. He was also treated with an intravitreal injection of bevacizumab which led to a rapid suppression of the neovascularization. However, panretinal photocoagulation had to be performed because OCT angiography and fluorescein angiography detected residual neovascularization. Although these treatments suppressed the activity of the ocular syphilis, electrophysiological improvements were not seen even 1 year after the initial treatment. OCT angiography and electroretinogram are useful techniques for monitoring the effectiveness of the treatments.
BurnCare tablet trainer to enhance burn injury care and treatment
Authors: Baird Austin , Serio-Melvin Maria , Hackett Matthew , Clover Marcia , McDaniel Matthew , Rowland Michael , Williams Alicia , Wilson Bradly
Published: October 2020

Background

Applied Research Associates (ARA) and the United States Army Institute of Surgical Research (USAISR) have been developing a tablet-based simulation environment for burn wound assessment and burn shock resuscitation. This application aims to supplement the current gold standard in burn care education, the Advanced Burn Life Support (ABLS) curriculum.

Results

Subject matter experts validate total body surface area (TBSA) identification and analysis and show that the visual fidelity of the tablet virtual patients is consistent with real life thermal injuries. We show this by noting that the error between their burn mapping and the actual patient burns was sufficiently less than that of a random sample population. Statistical analysis is used to confirm this hypothesis. In addition a full body physiology model developed for this project is detailed. Physiological results, and responses to standard care treatment, are detailed and validated. Future updates will include training modules that leverage this model.

Conclusion

We have created an accurate, whole-body model of burn TBSA training experience in Unreal 4 on a mobile platform, provided for free to the medical community. We hope to provide learners with more a realistic experience and with rapid feedback as they practice patient assessment, intervention, and reassessment.
Comparison of spatiotemporal characteristics of the COVID-19 and SARS outbreaks in mainland China
Authors: Zhang Xi , Rao Huaxiang , Wu Yuwan , Huang Yubei , Dai Hongji
Published: October 2020

Background

Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are caused by coronaviruses and have infected people in China and worldwide. We aimed to investigate whether COVID-19 and SARS exhibited similar spatial and temporal features at provincial level in mainland China.

Methods

The number of people infected by COVID-19 and SARS were extracted from daily briefings on newly confirmed cases during the epidemics, as of Mar. 4, 2020 and Aug. 3, 2003, respectively. We depicted spatiotemporal patterns of the COVID-19 and SARS epidemics using spatial statistics such as Moran’s I and the local indicators of spatial association (LISA).

Results

Compared to SARS, COVID-19 had a higher overall incidence. We identified 3 clusters (predominantly located in south-central China; the highest RR = 135.08, 95% CI: 128.36–142.08) for COVID-19 and 4 clusters (mainly in Northern China; the highest RR = 423.51, 95% CI: 240.96–722.32) for SARS. Fewer secondary clusters were identified after the “Wuhan lockdown”. The LISA cluster map detected a significantly high-low (Hubei) and low-high spatial clustering (Anhui, Hunan, and Jiangxi, in Central China) for COVID-19. Two significant high-high (Beijing and Tianjin) and low-high (Hebei) clusters were detected for SARS.

Conclusions

COVID-19 and SARS outbreaks exhibited distinct spatiotemporal clustering patterns at the provincial levels in mainland China, which may be attributable to changes in social and demographic factors, local government containment strategies or differences in transmission mechanisms.
Development and external validation of a nomogram for predicting the effect of tumor size on survival of patients with perihilar cholangiocarcinoma
Authors: Zhang Yaodong , Wu Zhengshan , Wang Xing , Li Changxian , Chang Jiang , Jiang Wangjie , Wang Hongwei , Wang Yirui , Li Xiangcheng
Published: October 2020

Background

The effect of tumor size on account of long-term survival results in perihilar cholangiocarcinoma (PCCA) patients has remained a controversial debate. It is urgent necessary to identify the optimal cutoff value of tumor size in PCCA and integrate tumor size with other prognostic factors into a nomogram to improve the predictive accuracy of prognosis of patients with PCCA.

Methods

Three hundred sixty-three PCCA patients underwent surgical resection were extracted from the Surveillance, Epidemiology and End Results (SEER) database. X-tile program was used to identify the optimal cutoff value of tumor size. A nomogram including tumor size was established to predict 1-, 3- and 5-year cancer-specific survival (CSS) based on the independent risk factors chosen by Kaplan-Meier methods and multivariable cox regression models. The precision of the nomogram for predicting survival was validated internally and externally.

Results

PCCA patients underwent surgical resection were classified into 1–19 mm, 20–33 mm and ≥ 34 mm subgroups based on the optimal cutoff for tumor size in terms of CSS. And we noticed that more larger tumor size group had worse tumor grade, advanced T stage, more positive regional lymph nodes and more frequent vascular invasion. The nomogram according to the independent factors was well calibrated and displayed better discrimination power than 7th Tumor-Node-Metastasis (TNM) stage systems.

Conclusions

The results demonstrated that the larger tumor size of PCCA was, the worse survival would be. The proposed nomogram, which outperforms the conventional TNM staging system, showed relatively good performance and could be considered as convenient individualized predictive tool for prognosis of PCCA patients.
Effect of plasma polyunsaturated fatty acid levels on leukocyte telomere lengths in the Singaporean Chinese population
Authors: Chang Xuling , Dorajoo Rajkumar , Sun Ye , Wang Ling , Ong Choon Nam , Liu Jianjun , Khor Chiea Chuen , Yuan Jian-Min , Koh Woon Puay , Friedlander Yechiel , Heng Chew-Kiat
Published: October 2020

Background

Shorter telomere length (TL) has been associated with poor health behaviors, increased risks of chronic diseases and early mortality. Excessive shortening of telomere is a marker of accelerated aging and can be influenced by oxidative stress and nutritional deficiency. Plasma n6:n3 polyunsaturated fatty acid (PUFA) ratio may impact cell aging. Increased dietary intake of marine n-3 PUFA is associated with reduced telomere attrition. However, the effect of plasma PUFA on leukocyte telomere length (LTL) and its interaction with genetic variants are not well established.

Methods

A nested coronary artery disease (CAD) case-control study comprising 711 cases and 638 controls was conducted within the Singapore Chinese Health Study (SCHS). Samples genotyped with the Illumina ZhongHua-8 array. Plasma n-3 and n-6 PUFA were quantified using mass spectrometry (MS). LTL was measured with quantitative PCR method. Linear regression was used to test the association between PUFA and LTL. The interaction between plasma PUFAs and genetic variants was assessed by introducing an additional term (PUFA×genetic variant) in the regression model. Analysis was carried out in cases and controls separately and subsequently meta-analyzed using the inverse-variance weighted method. We further assessed the association of PUFA and LTL with CAD risk by Cox Proportional-Hazards model and whether the effect of PUFA on CAD was mediated through LTL by using structural equation modeling.

Results

Higher n6:n3 ratio was significantly associated with shorter LTL (p = 0.018) and increased CAD risk (p = 0.005). These associations were mainly driven by elevated plasma total n-3 PUFAs, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (p < 0.05). There was a statistically significant interaction for an intergenic single nucleotide polymorphism (SNP) rs529143 with plasma total n-3 PUFA and DHA on LTL beyond the genome-wide threshold (p < 5 ×  10− 8). Mediation analysis showed that PUFA and LTL affected CAD risk independently.

Conclusions

Higher plasma n6:n3 PUFA ratio, and lower EPA and DHA n-3 PUFAs were associated with shorter LTL and increased CAD risk in this Chinese population. Furthermore, genetic variants may modify the effect of PUFAs on LTL. PUFA and LTL had independent effect on CAD risk in our study population.
Src kinase inhibition with dasatinib impairs neutrophil function and clearance of Escherichia coli infection in a murine model of acute lung injury
Authors: Macfarlane James G. , Dorward David A. , Ruchaud-Sparagano Marie-Hélène , Scott Jonathan , Lucas Christopher D. , Rossi Adriano G. , Simpson A. John
Published: October 2020

Background

Neutrophils rapidly respond to and clear infection from tissues, but can also induce tissue damage through excessive degranulation, when acute inflammation proceeds unchecked. A number of key neutrophil functions, including adhesion-dependent degranulation, are controlled by src family kinases. Dasatinib is a potent src inhibitor used in treating patients with chronic myeloid leukaemia and treatment-resistant acute lymphoblastic leukaemia. We hypothesized that dasatinib would attenuate acute inflammation by inhibiting neutrophil recruitment, degranulation and endothelial cell injury, without impairing bacterial clearance, in a murine model of bacteria-induced acute lung injury. C57BL/6 mice received intratrachealEscherichia coli, and were treated with intraperitoneal dasatinib or control. Bacterial clearance, lung injury, and markers of neutrophil recruitment and degranulation were measured. Separately, human blood neutrophils were exposed to dasatinib or control, and the effects on a range of neutrophil functions assessed.

Results

Dasatinib was associated with a dose-dependent significant increase inE. coliin the mouse lung, accompanied by impairment of organ function, reflected in significantly increased protein leak across the alveolar-capillary membrane. However, the number of neutrophils entering the lung was unaffected, suggesting that dasatinib impairs neutrophil function independent of migration. Dasatinib did not cause direct toxicity to human neutrophils, but led to significant reductions in phagocytosis ofE. coli, adhesion, chemotaxis, generation of superoxide anion and degranulation of primary and secondary granules. However, no biologically important effect of dasatinib on neutrophil degranulation was observed in mice.

Conclusions

Contrary to our starting hypothesis, src kinase inhibition with dasatinib had a detrimental effect on bacterial clearance in the mouse lung and therefore does not represent an attractive therapeutic strategy to treat primary infective lung inflammation. Data from human neutrophils suggest that dasatanib has inhibitory effects on a range of neutrophil functions.
Mortality calculator as a possible prognostic predictor of overall survival after gastrectomy in elderly patients with gastric cancer
Authors: Akaike Hidenori , Kawaguchi Yoshihiko , Maruyama Suguru , Shoda Katsutoshi , Saito Ryo , Furuya Shinji , Hosomura Naohiro , Amemiya Hidetake , Kawaida Hiromichi , Sudoh Makoto , Inoue Shingo , Kohno Hiroshi , Ichikawa Daisuke
Published: October 2020

Abstracts

Background

The number of elderly patients with gastric cancer has been increasing. Most elderly patients have associated reduced physiologic functions that can sometimes become an obstacle to safe surgical treatment. The National Clinical Database Risk Calculator, which based on a large Japanese surgical database, provides predicted mortality and morbidity in each case as the surgical-related risks. The purpose of this study was to investigate the clinical significance of the risk for operative mortality (NRC-mortality), as calculated by the National Clinical Database Risk Calculator, during long-term follow-up after gastrectomy for elderly patients with gastric cancer.

Methods

We enrolled 73 patients aged ≥ 80 years and underwent gastrectomy at our institution. Their surgical risk was evaluated based on the NRC-mortality. Several clinicopathologic factors, including NRC-mortality, were selected and analyzed as the possible prognostic factors for elderly patients who have undergone gastrectomy for gastric cancer. Statistical analysis was performed using the log-rank test and Cox proportional hazard model.

Results

NRC-mortality ranged from 0.5 to 10.6%, and the median value was 1.7%. Dividing the patients according to mortality, the overall survival was significantly worse in the high mortality group (≥ 1.7%,n= 38) than in the low mortality group (< 1.7%,n= 35), whereas disease-specific survival was not different between the two groups. In the Cox proportional hazard model, multivariate analysis revealed NRC-mortality, performance status, and surgical procedure as the independent prognostic factors for overall survival. For disease-specific survival, the independent prognostic factors were performance status and pathological stage but not NRC-mortality.

Conclusion

The NRC-mortality might be clinically useful for predicting both surgical mortality and overall survival after gastrectomy in elderly patients with gastric cancer.
Impact of initial treatment and prognostic factors on postprogression survival in BRAF-mutated metastatic melanoma treated with dacarbazine or vemurafenib ± cobimetinib: a pooled analysis of four clinical trials
Authors: Ascierto Paolo A. , Ribas Antoni , Larkin James , McArthur Grant A. , Lewis Karl D. , Hauschild Axel , Flaherty Keith T. , McKenna Edward , Zhu Qian , Mun Yong , Dréno Brigitte
Published: October 2020

Background

We sought to identify patient subgroups with distinct postprogression overall survival (ppOS) outcomes and investigate the impact of original treatment assignment and initial postprogression treatment (ppRx) on ppOS.

Methods

Recursive partitioning analysis (RPA) was performed to model relationships between prespecified covariates and ppOS in patients with BRAFV600-mutated metastatic melanoma who had experienced progressive disease (PD) following treatment with cobimetinib plus vemurafenib, vemurafenib monotherapy, or dacarbazine in the BRIM-2, BRIM-3, BRIM-7, and coBRIM studies. Prognostic subgroups identified by RPA were then applied to pooled treatment cohorts. The primary endpoint was ppOS, defined as time from first PD to death from any cause.

Results

RPA identified baseline lactate dehydrogenase (LDH), baseline disease stage, Eastern Cooperative Oncology Group performance status at PD, and ppRx as significant prognostic factors for ppOS. Median ppOS was longest in patients with normal baseline LDH, stage M1c disease at baseline, and ppRx with immunotherapy or targeted therapy (12.2 months; 95% CI 10.3–16.1) and shortest in those with elevated baseline LDH > 2 × upper limit of normal (2.3 months; 95% CI 1.8–2.7). Original treatment assignment did not impact ppOS. Across treatment cohorts, patients treated with immunotherapy or targeted therapy after PD had better ppOS than those given other treatments.

Conclusion

A combination of factors at baseline (LDH, disease stage) and PD (performance status, ppRx) impact ppOS outcomes. ppRx with immunotherapy or targeted therapy is an independent prognostic factor for improved overall survival following progression regardless of original treatment.

Trial registration The trials included in this analysis are registered with ClinicalTrials.gov: NCT00949702 (BRIM-2), NCT01006980 (BRIM-3), NCT01271803 (BRIM-7), and NCT01689519 (coBRIM).
Ethnoichthyology of freshwater fish in Europe: a review of vanishing traditional fisheries and their cultural significance in changing landscapes from the later medieval period with a focus on northern Europe
Authors: Svanberg Ingvar , Locker Alison
Published: October 2020

Background

Fishing is probably one of the oldest economic activities in the history of humankind. Lakes, rivers and streams in Europe are important elements in the European landscape with a rich diversity of fish and other aquatic organisms. Artisanal fisheries have therefore been of great importance for the provision of food, but also animal feed, medicine, fertilizer and other needs. These fishermen had a deep knowledge about the waterscape and its biota. However, ethnoichthyology remains a small topic within contemporary ethnobiology in Europe. Our focus lies within northern Europe in the late medieval to modern period, but encompasses the wider area with some reference to earlier periods where informative.

Method

We have reviewed a large amount of literature mainly on the relationship between man and fish in freshwaters from late medieval times (defined here as the fifteenth century) until the early twenty-first century. The main focus is on freshwater (including anadromous and catadromous) fish in northern Europe, the main area of study for both authors, though examples have been included from elsewhere to indicate the widespread importance of these fisheries. The review includes studies from various fields such as archaeology, ethnography, fish biology, geography, linguistics and osteology to map what has been studied of interest in ethnoichthyology. These data have been analysed and critically reviewed.

Results

There are archaeozoological studies, studies of specialised fishers as well as artisanal fishing among the peasantry, research of folk taxonomies, fishing methods (including the use of poison) and gear, which are all of great interest for ethnoichthyology. There is also research on traditional preserving methods for fish as food and for other purposes. Of interest is the keeping of fish in wells, ponds and aquaria. However, there is still room for more research within many domains of ethnoichthyology.

Conclusion

Humans have always utilized fish and other aquatic resources. Nonetheless, few ethnobiologists working within Europe are so far researching human-fish relationships. This paper demonstrates the range of research available, but also points to future studies. It is important to widen ethnobiological research in Europe to include fish.
Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC
Authors: Tol Wietse A. , Ager Alastair , Bizouerne Cecile , Bryant Richard , El Chammay Rabih , Colebunders Robert , García-Moreno Claudia , Hamdani Syed Usman , James Leah E. , Jansen Stefan C.J. , Leku Marx R. , Likindikoki Samuel , Panter-Brick Catherine , Pluess Michael , Robinson Courtland , Ruttenberg Leontien , Savage Kevin , Welton-Mitchell Courtney , Hall Brian J. , Harper Shehadeh Melissa , Harmer Anne , van Ommeren Mark
Published: October 2020

Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC’s research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).
Lycorine hydrochloride inhibits cell proliferation and induces apoptosis through promoting FBXW7-MCL1 axis in gastric cancer
Authors: Li Chongyang , Deng Chaowei , Pan Guangzhao , Wang Xue , Zhang Kui , Dong Zhen , Zhao Gaichao , Tan Mengqin , Hu Xiaosong , Shi Shaomin , Du Juan , Ji Haoyan , Wang Xiaowen , Yang Liqun , Cui Hongjuan
Published: October 2020

Background

Lycorine hydrochloride (LH), an alkaloid extracted from the bulb of the Lycoris radiata, is considered to have anti-viral, anti-malarial, and anti-tumorous effects. At present, the underlying mechanisms of LH in gastric cancer remain unclear. MCL1, an anti-apoptotic protein of BCL2 family, is closely related to drug resistance of tumor. Therefore, MCL1 is considered as a potential target for cancer treatment.

Methods

The effect of LH on gastric cancer was assessed in vitro (by MTT, BrdU, western blotting…) and in vivo (by immunohistochemistry).

Results

In this study, we showed that LH has an anti-tumorous effect by down-regulating MCL1 in gastric cancer. Besides, we unveiled that LH reduced the protein stability of MCL1 by up-regulating ubiquitin E3 ligase FBXW7, arrested cell cycle at S phase and triggered apoptosis of gastric cancer cells. Meanwhile, we also demonstrated that LH could induce apoptosis of the BCL2-drug-resistant-cell-lines. Moreover, PDX (Patient-Derived tumor xenograft) model experiment proved that LH combined with HA14–1 (inhibitor of BCL2), had a more significant therapeutic effect on gastric cancer.

Conclusions

The efficacy showed in our data suggests that lycorine hydrochloride is a promising anti-tumor compound for gastric cancer.
Relationship between pre- and post-operative isokinetic strength after ACL reconstruction using hamstring autograft
Authors: Riesterer J. , Mauch M. , Paul J. , Gehring D. , Ritzmann R. , Wenning M.
Published: October 2020

Background

Anterior cruciate ligament (ACL) ruptures are of major concern in sports. As mostly young and active individuals are affected there is an emphasis on the rapid and safe return to sports (RTS). Strengthening the ventral and dorsal thigh muscles is a prerequisite for a successful RTS after ACL reconstruction (ACLR), as persistent muscle weakness may increase the incidence for secondary injuries and impair performance. Aiming to increase evidence on the importance of preoperative muscle strength and the coaching of patients, the purpose of this study is to compare thigh muscle strength pre- and post-operatively after ACLR.

Methods

We performed a retrospective analysis of 80 patients with primary, isolated ACLR using a four-stranded hamstring autograft. We performed bilateral isokinetic concentric strength measurement (60°/s) before and six months after ACLR. Primary outcomes were the maximal knee extension and flexion torque, hamstrings-to-quadriceps ratio (H/Q ratio) and the corresponding limb symmetry indices (LSI). Pearson correlations were calculated for pre- and post-surgical values.

Results

The operated as well as the unaffected leg increased maximal knee extension (+ 18% ± 7% p < 0.05; + 11% ± 5% p < 0.05) and flexion torque (+ 9% ± 5% p < 0.05, + 10% ± 6% p < 0.05) throughout the 6 months of rehabilitation. The H/Q ratio remained unaffected (− 2% ± 3% p = 0.93; − 4% ± 4% p = 0.27). LSI of knee extension strength increased significantly (6% ± 3% p < 0.05), while flexion strength remained unaffected (+ 2% ± 4% p = 0.27). Positive correlations underline the interrelationship between the strength pre- and post-surgery for the knee extension (r = 0.788 p < 0.05) and knee flexion strength (r = 0.637 p < 0.05) after ACLR.

Conclusions

Preoperative leg extension and flexion strength normalized to body mass are strongly correlated to postoperative strength performance after ACLR. Therefore, pre-operative quadriceps and hamstring muscle strength deficits may have a significant negative impact on functional performance following ACLR. This emphasizes the need for intensive preoperative screening and subsequent treatment to achieve the best possible preoperative leg strength before ACLR.

Trial registration

DRKS00020210.
Can management buffer pasture loss and fragmentation for Sami reindeer herding in Sweden?
Authors: Uboni Alessia , Åhman Birgitta , Moen Jon
Published: October 2020

Today, climate change and competing land use practices are threatening rangelands around the world and the pastoral societies that rely on them. Reindeer husbandry practised by the indigenous Sami people is an example. In Sweden, approximately 70% of the most productive lichen pastures (important in winter) has been lost, either completely or because of a reduction in forage quality, as a result of competing land use (primarily commercial forestry). The remaining pastures are small and fragmented. Yet, the number of reindeer in Sweden shows no general decline. We investigated the strategies that have allowed reindeer herders to sustain their traditional livelihood despite a substantial loss of pastures and thus natural winter forage for their reindeer. Changes in harvest strategy and herd structure may partially explain the observed dynamics, and have increased herd productivity and income, but were not primarily adopted to counteract forage loss. The introduction of supplementary feeding, modern machinery, and equipment has assisted the herders to a certain extent. However, supplementary feeding and technology are expensive. In spite of governmental support and optimized herd productivity and income, increasing costs provide low economic return. We suggest that the increased economical and psychosocial costs caused by forage and pasture losses may have strong effects on the long-term sustainability of reindeer husbandry in Sweden.