bluuebunny/crossref_metadata_2025 huggingface dataset:
Statin Exposure and Risk of Heart Failure After Anthracycline‐ or Trastuzumab‐Based Chemotherapy for Early Breast Cancer: A Propensity Score‒Matched Cohort Study
Authors: Abdel‐Qadir Husam , Bobrowski David , Zhou Limei , Austin Peter C. , Calvillo‐Argüelles Oscar , Amir Eitan , Lee Douglas S. , Thavendiranathan Paaladinesh
Published: January 2021

Background

Statins are hypothesized to reduce the risk of cardiotoxicity associated with anthracyclines and trastuzumab. Our aim was to study the association of statin exposure with hospitalization or emergency department visits (hospital presentations) for heart failure (HF) after anthracycline‐ and/or trastuzumab‐containing chemotherapy for early breast cancer.

Methods and Results

Using linked administrative databases, we conducted a retrospective cohort study of women aged ≥66 years without prior HF who received anthracyclines or trastuzumab for newly diagnosed early breast cancer in Ontario between 2007 to 2017. Statin‐exposed and unexposed women were matched 1:1 using propensity scores. Trastuzumab‐treated women were also matched on anthracycline exposure. We matched 666 statin‐discordant pairs of anthracycline‐treated women and 390 pairs of trastuzumab‐treated women (median age, 69 and 71 years, respectively). The 5‐year cumulative incidence of HF hospital presentations after anthracyclines was 1.2% (95% CI, 0.5%–2.6%) in statin‐exposed women and 2.9% (95% CI, 1.7%–4.6%) in unexposed women (
P
value, 0.01). The cause‐specific hazard ratio associated with statins in the anthracycline cohort was 0.45 (95% CI, 0.24–0.85;
P
value, 0.01). After trastuzumab, the 5‐year cumulative incidence of HF hospital presentations was 2.7% (95% CI, 1.2%–5.2%) in statin‐exposed women and 3.7% (95% CI, 2.0%–6.2%) in unexposed women (
P
value 0.09). The cause‐specific hazard ratio associated with statins in the trastuzumab cohort was 0.46 (95% CI, 0.20–1.07;
P
value, 0.07).

Conclusions

Statin‐exposed women had a lower risk of HF hospital presentations after early breast cancer chemotherapy involving anthracyclines, with non‐significant trends towards lower risk following trastuzumab. These findings support the development of randomized controlled trials of statins for prevention of cardiotoxicity.
Inscribing Scriptural Catalogs: Apropos of Two Southern Song Pagodas and Related Buddhist Monuments in the Sichuan Basin
Authors: Xiaodong Yang
Published: January 2021

Commonly referred to in Chinese by the term jinglu, scriptural catalogs constitute a specific sort of Sinitic bibliographical literature that deals primarily with texts accepted in East Asian Buddhist circles as authoritative in matters of religion. The role that these catalogs played in the history of the Chinese Buddhist canon has become the subject of various important studies, but still oft-neglected are the functional places that such texts filled in the sphere of Buddhist devotional practice. To try to redress the balance, this essay brings into focus a small but significant group of Southern Song (1127-1279) Buddhist monuments in the Sichuan basin. Not only do these monuments allow us a rare glimpse into the devotional uses and symbolic functions of scriptural catalogs, but they offer a vantage point from which to view at least a part of what premodern Buddhists in the Sichuan basin actually believed and practiced.
Federation Day at the World of Tomorrow
Authors: Kopacz Marek S. , Bajka-Kopacz Aleksandra D.
Published: January 2021

Ninety years ago, the Federation of Polish Jews in America hosted their national convention and world congress in the New York City area. In this article, we will discuss some of what transpired at these events. Set at a tumultuous crossroads in world history, the Federation rallied Jewish groups throughout the United States and the world in humanitarian support for a war-torn Polish nation. The national convention and world congress were also set to have their own respective satellite sessions at the New York World’s Fair of 1939 and 1940. These satellite sessions are noteworthy in that they mark a Jewish presence at the Fair which extended beyond the Jewish Palestine Pavilion. They also mark a uniquely Polish presence, extending beyond Poland’s own Pavilion at the Fair.
Technology-Driven Revolutions in Military Affairs
Authors: Lorber Azriel
Published: January 2021

The term Revolutions in Military Affair (rma) was originally coined by the Soviets realizing that the US planned to utilize electronics and computers to improve both its weapons and battle management. Other such revolutions were caused by the emergence of aircraft, submarines, mechanized warfare, precision-guided munitions (pgms), unmanned vehicles and Net-Centric-Warfare. Beside its effect on fighting, military technology also affects the public and its leadership. Several technological developments, such as rockets and drones, cyberwarfare, and homemade explosives and chemical and biological weapons, are already changing current concepts and conduct of warfare through their direct effect on warfighting and by their potential effect on the public and its leadership. Consequently, rmas should be analyzed in terms of the linkages between the rear, where chaos can be created, and the front, where the armed forces typically operate.
Gyrocheilos taishanense: A new species of Gesneriaceae from Guangdong, China

Authors: WANG GANG-TAO , LIU FANG-PU , JIANG GUO-BIN , ZHANG YING , CHEN YU-QIANG , WANG RUI-JIANG
Published: January 2021

Gyrocheilos taishanense G.T. Wang, Yu Q. Chen & R.J. Wang (Gesneriaceae) from south China is described and illustrated with photographs. It is morphologically similar to G. microtrichum W.T.Wang, but it is distinguished by its glabrous or sparsely hairy pedicels, zygomorphic calyx with hairs in unequal length, and slightly bilobed adaxial corolla lips. Molecular phylogenetic analysis based on nuclear ITS and plastid trnL-F sequences strongly supported this new species as sister to a clade comprising the previously described Gyrocheilos species (100% posterior probability and bootstrap support). The new species is evaluated here as Least Concern (LC) according to the IUCN Red List Categories and Criteria.
Ionopsis × atalibae (Orchidaceae, Oncidiinae), a new natural hybrid from the Brazilian Amazon
Authors: KRAHL AMAURI HERBERT , KRAHL DAYSE RAIANE PASSOS , PANSARIN EMERSON RICARDO
Published: January 2021

Hybridization plays a relevant role in the evolution and diversification of flowering plants. Natural hybridization has been commonly recorded in some orchid groups. During fieldwork in a Citrus plantation in the Brazilian Amazon, plants of Ionopsis utricularioides, I. satyrioides and an unidentified taxon with intermediate morphology between both sympatric species were found. The plants with intermediate features are most likely a natural hybrid between I. utricularioides and I. satyrioides described here as I. × atalibae.
Morphology of the early larval stages of Lysmata lipkei Okuno & Fiedler, 2010 (Caridea: Lysmatidae): an invasive shrimp in the Western Atlantic
Authors: ALMEIDA ANDRÉA SANTOS E , ALVES DOUGLAS FERNANDES RODRIGUES , DE PAIVA BARROS-ALVES SAMARA , PESCINELLI RÉGIS AUGUSTO , SANTOS RAFAEL DE CARVALHO , DA COSTA ROGÉRIO CAETANO
Published: January 2021

Considering the importance of establishing different approaches to the early detection of invasive species, the present study aimed to describe and illustrate the morphology of the early larval stages of the shrimp Lysmata lipkei, an invasive species in the Western Atlantic. Additionally, we did a morphological comparison and a review of the other Lysmata species from the Western Atlantic Ocean with a known larvae description. The larvae used in this study were obtained by the maintenance, under laboratory conditions, of ovigerous hermaphrodites of L. lipkei, collected in the wild. Then, larvae were dissected under a stereo microscope and illustrated using a microscope equipped with a camera lucida. The first three larval stages (zoeae) of L. lipkei were illustrated, described, and compared to other species of Lysmata previously described of the Western Atlantic. Some features of the larval morphology of L. lipkei are very similar when compared to other Lysmata species with previous larval descriptions, such as a rostrum long and simple, the eyes stalked with a long peduncle from the second zoeae, one pterygostomian spine and several denticles along the anterior ventral margin of the carapace, similarities in the segmentation of the maxillipeds, and the presence of dorsolateral spines on the posterior margin of the 5th pleomere, among other features. Also, unique features were observed for L. lipkei, such as differences in the setation of some structures, including the antennule, antenna, maxillule, and maxillipeds. Using the morphological descriptions, we expect to identify species from the plankton, especially invaders, that might be present in the Western Atlantic, as well as assist in several areas in which the larval morphology is relevant.
Solar-Blind Photodetector with Lower Dark Current and Higher Ilight/Idark Ratio Based on Mg0.38Zn0.62O Film Deposited by Pulsed Laser Deposition Method
Authors: Cao Pei-Jiang , Wang Qing , Rao Ch. N. , Han Shun , Xu Wang-Ying , Fang Ming , Liu Xin-Ke , Zeng Yu-Xiang , Liu Wen-Jun , Zhu De-Liang , Lu You-Ming
Published: January 2021

In this study, pulsed laser deposition method (PLD) was employed to grow MgxZn1-xO films on quartz substrates. The optimal deposition temperature of 300 °C for MgxZn1-xO film was decided and Mg0.38Zn0.62O, Mg0.56Zn0.44O
and Mg0.69Zn0.31O films were grown respectively using MgxZn1-xO targets with different Mg contents (x = 0.3, 0.5 and 0.7). As-deposited Mg0.38Zn0.62O film possessed the mixed-phase (hexagonal and cubic phase) structure,
appropriate band gap of 4.68 eV and smaller surface roughness of 1.72 nm, and the solar-blind photodetector (PD) based on it was fabricated. The key features of our PD are the cutoff wavelength of 265 nm lying in solar-blind band, lower dark current (Idark) of 88 pA, higher
peak responsivity of 0.10 A/W and bigger Ilight/Idark ratio of 1688, which provide the new idea for the application of solar-blind PDs based on MgxZn1-xO films.
Investigation on the Electrical Stability of 5,11-Bis(triethylsilylethynyl)anthradithiophene Thin-Film Transistors
Authors: Ndikumana Joel , Chintalapalli Jyothi , Kwon Jin-Hyuk , Bae Jin-Hyuk , Park Jaehoon
Published: January 2021

We investigate the effects of environmental conditions on the electrical stability of spin-coated 5,11-bis(triethylsilylethynyl)anthradithiophene (TES-ADT) thin-film transistors (TFTs) in which crosslinked poly(4-vinylphenol-co-methyl methacrylate) (PVP-co-PMMA) was utilized as a gate
insulator layer. Atomic force microscopy observations show molecular terraces with domain boundaries in the spin-coated TEST-ADT semiconductor film. The TFT performance was observed to be superior in the ambient air condition. Under negative gate-bias stress, the TES-ADT TFTs showed a positive
threshold voltage shift in ambient air and a negative threshold voltage shift under vacuum. These results are explained through a chemical reaction between water molecules in air and unsubstituted hydroxyl groups in the cross-linked PVP-co-PMMA as well as a charge-trapping phenomenon at the
domain boundaries in the spin-coated TES-ADT semiconductor.
Enhanced Electrical Properties of AZO/IZO Multilayered Thin Film with Post Laser Annealing Process
Authors: Kang Jihye , Park Dongsu , Lee Donghun , Kamiko Masao , Kim Sung-Jin , Lee Sang-Kwon , Koh Jung-Hyuk
Published: January 2021

In this research, alternative deposition process of ZnO-based thin films have been studied for transparent conducting oxide (TCO) application. To improve the electrical and optical properties of transparent oxide thin films, alternatively stacked Al-doped ZnO and In-doped ZnO thin films
were investigated. Multilayer structure of alternative 6 layers of thin films were prepared in this research. Especially, Aluminum and Indium were chosen as dopant materials. Thin films of Al-doped ZnO (AZO) and In-doped ZnO (IZO) were alternatively deposited by spin coating with sol-gel method.
After deposition of multilayered thin films, multi steps of furnace (F), rapid thermal annealing (R) and CO2 laser annealing (L) processes were carried out and investigated thin film properties by dependence of post-annealing sequence and thin film structures. The electrical and
optical properties of thin films were investigated by 4-point probe and UV-vis spectroscopy and its shows the greatest sheet resistance value of 0.59 kΩ/sq. from AZO/IZO multilayered structure and upper 85% of transmittance. The structural property and surface morphology were measured
by X-Ray Diffraction (XRD) and field emission scanning electron microscopy (FE-SEM). The Al- and In-doped ZnO thin film shows the highest intensity value at (002) peak of AZO/IZO multilayer structure which was performed FRL process.
Effect of Cerium Oxide Nanostructures on CO Oxidation
Authors: Lakshmi R. V. , Bera Parthasarathi , Pal Kamalesh , Alwera Vijay , Gayen Arup , Mandal Tapas Kumar , Aruna S. T.
Published: January 2021

Cerium oxide particles with different morphologies, namely nanoparticles, nanofibers, nanocubes, and rice grains have been prepared by simple chemical routes. The shape and size of the synthesized morphologies have been studied using field emission scanning electron microscopy (FESEM)
and transmission electron microscopy (TEM). X-ray diffraction (XRD) and selected area electron diffraction (SAED) techniques have been used to determine their crystal phases. Both nanoparticles and nanocubes of cerium oxide exclusively crystallize in fluorite structure of CeO2 as
observed in XRD patterns, whereas nanofibers and rice grains are characterized by the presence of CeO2, Ce2O3, and Ce(OH)3 phases. X-ray photoelectron spectroscopy (XPS) has been employed to evaluate Ce species present in the different cerium oxide
morphologies and to estimate their relative surface concentrations. As evident from Ce 3d core level spectra cerium oxide nanoparticles and nanocubes are basically CeO2 having Ce in the +4 oxidation state along with some amount of Ce3+ species. In contrast, Ce is in +3
oxidation state on its surface in cerium oxide nanofibers and rice grains that contain intermediate phases like Ce2O3 and Ce(OH)3 as endorsed by XRD patterns. CO oxidation has been carried out over these cerium oxide morphologies and among all morphologies
lowest temperature CO oxidation has been demonstrated by the nanocube morphology.
Synthesis of Ethylenediaminetetraacetic Acid Disodium Salt Functionalized Magnetite/Chitosan Nanospheres for the Highly Efficient Removal of Methylene Blue
Authors: Zheng Mengke , Wu Zhenguo , Wang Yang , Chen Nannan , Teng Zhaogang , Su Xiaodan , Xu Peng
Published: January 2021

In this paper, novel Ethylenediaminetetraacetic acid disodium salt (EDTA) functionalized magnetite/ chitosan nanospheres (Fe3O4/CS-EDTA) are synthesized by combining solvothermal method and chemical modification, and they are further applied as a kind of adsorbent
to eliminate dye of methylene blue (MB) from wastewater. The properties as well as structure exhibited by the fabricated adsorbent are characterized through FTIR, XRD, TG and TEM, together with VSM. The impact exerted by sorption parameters (time of contact, initial dye concentration, temperature,
etc.) on the adsorptions were evaluated in batch system. These results demonstrated that our magnetic materials held the adsorption capacity for MB of 256 mg g−1 (pH = 11), and the kinetic model of pseudo-second-order and the Langmuir model could make an effective simulation
regarding the adsorption kinetics and isotherm, respectively. Besides, the external magnetic field can assist in easily separating dye adsorbed Fe3O4/CS-EDTA from solution for regeneration. The removal efficiency of recycled adsorbents remained above 92% in the 5th adsorption/desorption
cycle. These superioritiesmake Fe3O4/CS-EDTA a high-efficientmultifunctional adsorbent for removing dyes from wastewater.
Identification of differentially expressed proteins and clinicopathological significance of HMGB2 in cervical cancer
Authors: Han Xiao , Zhong Siyi , Zhang Pengnan , Liu Yanmei , Shi Sangsang , Wu Congquan , Gao Shujun
Published: January 2021

To investigate the complexity of proteomics in cervical cancer tissues, we used isobaric tags for relative and absolute quantitation (iTRAQ)-based mass spectrometry analysis on a panel of normal cervical tissues (N), high-grade squamous intraepithelial lesion tissues (HSIL) and cervical cancer tissues (CC). Total 72 differentially expressed proteins were identified both in CC vs N and CC vs HSIL. The expression of HMGB2 was markedly higher in CC than that in HSIL and N. High HMGB2 expression was significantly correlated with primary tumor size, invasion and tumor stage. The up-regulated HMGB2 was discovered to be associated with human cervical cancer. These findings suggest that HMGB2 may be a potentially prognostic biomarker and a target for the therapy of cervical cancer.
Image and clinical analysis of common carotid web: a case report
Authors: Gao Man , Lei Jing
Published: January 2021

Background

A carotid web is a very rare vascular disease of the carotid artery, leading to thrombosis and ischemic stroke.

Case presentation

A 65-year-old male patient was admitted due to left limb weakness. On arrival, he had moderate left hemiplegia, neglect, and sensory loss; the National Institutes of Health Stroke Scale score was 8. Computed tomography angiography (CTA) and magnetic resonance (MR) examination were performed to determine the cause of basal ganglia infarction. Thin-section axial CTA showed a membrane-like structure in the posterior wall of the right common carotid artery. The sagittal reconstruction image showed a membrane-like protrusion in the posterior wall of the right common carotid artery under the right carotid sinus. The MR axial T2 image showed a membrane-like high-signal protrusion into the carotid artery lumen, which was diagnosed as a right carotid web. The patient was treated with dual antihypertensive therapy by adjusting blood pressure, controlling brain edema, improving cerebral circulation, and nourishing the nerves.

Conclusion

Careful comparison of axial thin-layer CTA and MR axial T2 images combined with sagittal reconstruction of CTA images can greatly improve the diagnostic rate of carotid web.
Oxytocin use in trial of labor after cesarean and its relationship with risk of uterine rupture in women with one previous cesarean section: a meta-analysis of observational studies
Authors: ZHANG Huan , LIU Haiyan , LUO Shouling , GU Weirong
Published: January 2021

Background

Trial of labor after a previous cesarean delivery (TOLAC) has reduced the rate of cesarean sections (CS). Nevertheless, the widespread use of TOLAC has been limited by an increase in adverse outcomes, the most serious one being the risk of symptomatic uterine rupture, which is possibly associated with oxytocin. In this meta-analysis, we explored the risk association between oxytocin use and uterine rupture in TOLAC.

Methods

Multiple electronic databases (PubMed, Embase, Web of Science, and Google Scholar) were searched for cross-sectional studies reporting on TOLAC, oxytocin and uterine rupture, which were published between January 1986 and October 2019. The bias-corrected Hedge’s g was calculated as the effect size using the random-effects model. A two-sample Z test was used to compare the differences in synthetic rates between groups. The Newcastle-Ottawa Scale (NOS) was used to evaluate the risk of bias. Quality of the evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) certainty ratings system.

Results

A total of 14 studies, which included 48,457 women who underwent TOLAC, met the inclusion criteria. The pooled rate of vaginal birth after a cesarean section (VBAC) and the rate of uterine rupture in spontaneous labor were 74.3 and 0.7%, respectively. In addition, the pooled rate of VBAC and the rate of uterine rupture in the induction labor group was 60.7 and 2.2%, respectively. The women who had spontaneous labor had a significantly higher rate of VBAC (p = 0.001) and a lower rate of uterine rupture (p = 0.0003) compared to induced labor. The pooled rates of uterine rupture in women using oxytocin and women not using oxytocin in TOLAC were 1.4% and 0.5%, respectively, and the difference was significant (p = 0.0002). Also, the synthetic rate of uterine rupture in oxytocin augmentation among women with spontaneous labor and women who had a successful induction of labor were 1.7% and 2.2%, respectively, without significant difference (p = 0.443).

Conclusions

Women with induced labor had a higher risk of uterine rupture compared to women with spontaneous labor following TOLAC. Oxytocin use may increase this risk, which could be influenced by the process of induction or individual cervix condition. Consequently, simplified and standardized intrapartum management, precise protocol, and cautious monitoring of oxytocin use in TOLAC are necessary.
Micronutrient status and associated factors of adiposity in primary school children with normal and high body fat in Colombo municipal area, Sri Lanka
Authors: Thillan Kalaichelvi , Lanerolle Pulani , Thoradeniya Tharanga , Samaranayake Dulani , Chandrajith Rohana , Wickramasinghe Pujitha
Published: January 2021

Background

The prevalence of obesity and associated risk of chronic diseases are increasing among the paediatric population. The effectiveness of preventive measures and interventions are likely to improve when all factors which associate with obesity in a specific target group are considered. Currently such comprehensive data is unavailable for Sri Lankan children aged 8–9 years.

Methods

This paper pertains to the data collected from August-2015 to November-2016 for a case-control study which included cases (high body fat) (N = 160; males-81) and controls (normal body fat) (N = 164; males-80) recruited from primary schools in the Colombo Municipal area. Anthropometry and body composition (Bioelectrical impedance analysis-BIA) were measured. Diet, physical activity and socio-demographic data were collected using validated interviewer administered questionnaires. Serum concentrations of vitamins A, D [25(OH)D], E, folate (serum and red blood cell-RBC), zinc (Zn), selenium (Se), copper (Cu), iron (Fe), magnesium (Mg), calcium (Ca), chromium (Cr), manganese (Mn), cobalt (Co), ferritin, leptin and high sensitivity C-reactive protein (hs-CRP) were assessed using fasting blood samples.

Results

Cases were from higher socio-economic strata and spent significantly less time on physical activities, more time on sedentary behaviours and consumed higher energy compared to the controls. Cases from both genders had significantly lower levels of vitamin D [25 (OH)D], Fe and Mg (all p < 0.05) and higher levels of Cu and Ca (all p < 0.01) compared to controls. Higher levels of ferritin and Cr were seen among male (p < 0.001) and female (p > 0.05) cases compared to the controls. However, total serum folate levels were lower in male (p < 0.01) and female (p > 0.05) cases while the RBC folate levels were higher among male (p < 0.01) and female (p > 0.05) cases compared with controls. Vitamins A, E, Se, Mn and Co (p > 0.05) were not significantly different between groups. The inflammatory markers, both hs-CRP and leptin levels were higher among cases (p < 0.001) compared to the controls.

Conclusions

This study highlights higher socio-economic status, lower physical activity, more sedentary behaviours, higher energy intake and inconsistent distribution of micronutrients among the children with high body fat when compared with the control group. Increased levels of inflammatory markers indicate the presence of the risk of chronic inflammation in children with high body fat.
Programmed cell death-1 blockade in kidney carcinoma may induce eosinophilic granulomatosis with polyangiitis: a case report
Authors: Harada Masanori , Naoi Hyogo , Yasuda Kazuyo , Ito Yutaro , Kagoo Namio , Kubota Tsutomu , Ichijo Koshiro , Mochizuki Eisuke , Uehara Masahiro , Matsuura Shun , Tsukui Masaru , Koshimizu Naoki
Published: January 2021

Background

Immune checkpoint inhibitors have potential applications in treating various cancers but are associated with immune-related adverse events, such as inflammation, in a wide range of organs; however, allergic inflammation caused by these agents has not been extensively studied.

Case presentation

A 65-year-old man was diagnosed with a kidney neuroendocrine carcinoma. Three months after kidney resection surgery, the tumor cells had metastasized to his liver and lymph nodes. Subsequently, the patient started chemotherapy; however, regardless of treatment, the tumor grew, and the patient experienced a series of adverse effects, such as taste disorder, anorexia, and general fatigue. Finally, he was administered a programmed cell death (PD)-1 inhibitor, nivolumab (biweekly, toal 200 mg/body), which was effective against kidney carcinoma. However, the patient had a bronchial asthma attack at 22 cycles of nivolumab treatment and chest computed tomography (CT) revealed an abnormal bilateral shadow after 37 cycles of nivolumab treatment. Bronchoscopy findings revealed eosinophil infiltration in the lungs along with severe alveolar hemorrhage. Paranasal sinus CT scanning indicated sinusitis and nerve conduction analysis indicated a decrease in his right ulnar nerve conduction velocity. Based on these findings, the patient was diagnosed with eosinophilic granulomatosis with polyangiitis; he was treated with prednisolone, which alleviated his bronchial asthma. To restart nivolumab treatment, the dose of prednisolone was gradually tapered, and the patient was administered a monthly dose of mepolizumab and biweekly dose of nivolumab. To date, there have been no bronchial attacks or CT scan abnormalities upon follow up.

Conclusions

We present a rare case in which a patient with cancer was diagnosed with eosinophilic granulomatosis with polyangiitis following treatment with a PD-1 inhibitor. Blockade of PD-1 and the programmed cell death ligand (PD-L) 1/PD-1 and PD-L2/PD-1 signaling cascade may cause allergic inflammation. Further studies are needed to identify the specific mechanisms underlying allergic inflammation after PD-1 blockade.
The “floating ulna” injury in adults: a case report, literature review and proposed injury classification
Authors: He Tian , Wang Xin , Sun Shui , Zhou Lugang
Published: January 2021

Background

Ipsilateral Galeazzi fracture with elbow dislocation, namely the “floating ulna” injury, is a rare injury pattern. A few reports have described this type of injury and its treatment.

Case presentation

A 33-year-old female at 38+ weeks gestational age presented with Galeazzi fracture and posterolateral elbow dislocation of the left upper extremity. The patient was treated with closed reduction of the elbow, open reduction, and internal fixation of the radial shaft fracture with a dynamic compression plate and K-wire stabilization of the unstable distal radioulnar joint. At the 12-month follow-up, the patient had no pain or signs of instability. Range of motion was 0–135° at the elbow, 70° extension and 80° flexion at the wrist, and 80° supination and 80° pronation at the forearm.

Conclusion

The “floating ulna” injury is a rare and special injury pattern with ipsilateral Galeazzi fracture and elbow dislocation. This type of injury was likely caused by significant amount of deforming force and the unique position of upper limb when the patient fell from a height of 1–2 m in high-energy trauma.
Bladder squamous cell carcinoma in a pregnant woman: case report and review of the literature
Authors: Rojas Pablo A. , González Cristián , Mendez Gonzalo P. , Majerson Alejandro , San Francisco Ignacio F.
Published: January 2021

Background

Bladder tumors in pregnancy are extremely rare. No more than 50 cases have been published to date, including all histologic variants, and only three cases of bladder squamous cell carcinoma have been described.

Case presentation

We present a clinical case of a 31-year-old woman with bladder squamous cell carcinoma in the second trimester of pregnancy. After a C-section at 30 weeks, we performed radical cystectomy with extended bilateral lymphadenectomy, hysterectomy and right oophorectomy. The Studer neobladder technique was performed for urinary tract reconstruction. Definitive pathology showed invasive bladder squamous cell carcinoma, Grade 2, with microscopic infiltration of the perivesical fat, negative margins, and 3/28 lymph nodes with carcinoma (pT3aN2M0). The patient underwent 18 months of surveillance after radical cystectomy, without recurrence by PET-CT.

Conclusions

Bladder cancer in pregnant women is extremely rare but must be considered in those with recurrent gross hematuria and/or recurrent urinary tract infection. To our knowledge, this case involves the longest recurrence-free survival of a pregnant woman with squamous cell bladder cancer published thus far.
Frequency and clinical characteristics of HER2 over-expressed breast cancer in Saudi Arabia: a retrospective study
Authors: Zekri Jamal , Saadeddin Ahmed , Alharbi Hulayel
Published: January 2021

Introduction

This study aimed to determine the frequency of human epidermal growth factor receptor 2 (HER2) over-expression in newly diagnosed breast cancer (BC) patients in Saudi Arabia and to assess the clinical characteristics and outcomes in patients with HER2-positive disease.

Methods

In the first part of the study, we retrospectively reviewed the pathology records of all patients diagnosed with BC between 2007 and 2013 at 3 hospitals in the largest 3 cities in Saudi Arabia to determine the frequency of HER2 over-expression. In the second part, a representative sample from the patients identified with HER2 over-expressed BC was selected for further investigation. Data collected included demographic and clinical characteristics such as hormone-receptor status, treatment regimens, survival data, response to treatment, and selected adverse events.

Results

1867 BC records were included in the study. HER2 was overexpressed in 559 patients (29.9%); of those, 348 HER2-positive BC patients were included in subsequent analyses. In the sample of HER2-positive BC patients, median age at diagnosis was 46 years, 0.9% were male, 92.5% were Saudi, 42.4% were Hormone Receptor-negative, and 13.1% had stage IV tumors. Most patients (84.2%) underwent curative intent surgery and 71.8% received radiotherapy. Average tumor size was 3.5 ± 2.5 cm and infiltrating ductal carcinoma was the most common pathology (92.9%). As for pharmacological therapy, the most commonly used regimens were Chemotherapy + Trastuzumab combination (79.1%) in neoadjuvant setting, Hormonotherapy alone (56.2%) in adjuvant setting, and Chemotherapy + Targeted therapy combination (64.8%) as palliative treatment. At the last patient evaluation, 36.9% had complete response, while 33.2% had progressive disease. Median overall survival (OS) and progression-free survival (PFS) were not reached in patients on neoadjuvant/adjuvant pharmacotherapy. As for patients on palliative intent pharmacotherapy, median OS and PFS were 64.7 and 29.3 months respectively.

Conclusion

This study provided updated figures regarding HER2 overexpression in BC in Saudi Arabia: HER2 overexpression rate (29.9%) was within the range reported in previous studies. Patients’ demographic and clinical characteristics were also similar to those reported earlier, with a median age at diagnosis of 46 years and one third of patients having locally advanced/metastatic disease at diagnosis.
Systematic elucidation of the pharmacological mechanisms of Rhynchophylline for treating epilepsy via network pharmacology
Authors: Geng Hua , Chen Xuqin , Wang Chengzhong
Published: January 2021

Abstact

Background

Epilepsy, one of the most common neurological disorders, affects over 70 million people worldwide. Rhynchophylline displays a wide variety of pharmacologic actives. However, the pharmacologic effects of rhynchophylline and its mechanisms against epilepsy have not been systematically elucidated.

Methods

The oral bioavailability and druglikeness of rhynchophylline were evaluated using the Traditional Chinese Medicine Systems Pharmacology Database. Rhynchophylline target genes to treat epilepsy were identified using PharmMapper, SwissTargetPrediction and DrugBank databases integration. Protein-protein interaction analysis was carried out by utilizing the GeneMANIA database. WebGestalt was employed to perform Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. The drug-disease-target-Gene Ontology-pathway network was constructed using Cytoscape.

Results

The oral bioavailability and druglikeness of rhynchophylline were calculated to be 41.82% and 0.57, respectively. A total of 20 rhynchophylline target genes related to epilepsy were chosen. Among the 20 genes and their interacting genes, 54.00% shared protein domains and 16.61% displayed co-expression characteristics. Gene ontology, Kyoto Encyclopedia of Genes and Genomes and network analyses illustrate that these targets were significantly enriched in regulation of sensory perception, morphine addiction, neuroactive ligand-receptor interaction and other pathways or biological processes.

Conclusion

In short, rhynchophylline targets multiple genes or proteins, biological processes and pathways. It shapes a multiple-layer network that exerts systematic pharmacologic activities on epilepsy.
Medical teachers’ opinions about students with neurodevelopmental disorders and their management
Authors: Magnin Eloi , Ryff Ilham , Moulin Thierry
Published: January 2021

Background

Some students have neurodevelopmental disorders that might affect their academic and professional careers if they are not identified and addressed by specific pedagogic adaptations. The objective of this work was to describe medical teachers’ opinions of students with neurodevelopmental disorders and their management of these students.

Methods

An anonymous cross-sectional electronic survey was performed to describe medical teachers’ opinions about the impact of neurodevelopmental disorders on the student’s life and on the medical teachers’ management. aThe survey was created, including visual analogic scales and free text, to assess teachers’ opinions from identification and assessment of neurodevelopemental burden on students and teachers, to their own knowledge about neurodevelopemental disorders and the specific pedagogic management available. The survey was sent to 175 medical teachers in 2019, of whom 67 responded. Quantitative descriptive statistics and qualitative analysis of free text were reported.

Results

Many medical teachers report having encountered students who might have had neurodevelopmental disorders (dyspraxia 33%; dyslexia 46%; autism spectrum disorders 68%; attention deficit hyperactivity disorders 75%). Impact on students and on teachers was considered as important (mean VAS score for impact over 60/100 for all syndromes except for dyspraxia). Medical teachers’ self-reported knowledge about neurodevelopmental disorders (mean VAS score 43.9/100) and available pedagogical adaptations (mean VAS score 19.0/100) was limited. The teachers were concerned about ethical issues (mean VAS score 72.2/100) but were interested in receiving specialized training (mean VAS score 64.4/100).

Conclusion

Medical teachers feel unprepared to manage students with neurodevelopmental disorders. They would be interested in specific training and procedures about the pedagogic management of these students.
Effectiveness of hospital emergency department regionalization and categorization policy on appropriate patient emergency care use: a nationwide observational study in Taiwan
Authors: Lin Chih-Yuan , Lee Yue-Chune
Published: January 2021

Background

Emergency department (ED) overcrowding is a health services issue worldwide. Modern health policy emphasizes appropriate health services utilization. However, the relationship between accessibility, capability, and appropriateness of ED use is unknown. Thus, this study aimed to examine the effect of hospital ED regionalization policy and categorization of hospital emergency capability policy (categorization policy) on patient-appropriate ED use.

Methods

Taiwan implemented a nationwide three-tiered hospital ED regionalization and categorization of hospital emergency capability policies in 2007 and 2009, respectively. We conducted a retrospective observational study on the effect of emergency care policy intervention on patient visit. Between 2005 and 2011, the Taiwan National Health Insurance Research Database recorded 1,835,860 ED visits from 1 million random samples. ED visits were categorized using the Yang-Ming modified New York University-ED algorithm. A time series analysis was performed to examine the change in appropriate ED use rate after policy implementation.

Results

From 2005 to 2011, total ED visits increased by 10.7%. After policy implementation, the average appropriate ED visit rate was 66.9%. The intervention had no significant effect on the trend of appropriate ED visit rate.

Conclusions

Although regionalization and categorization policies did increase emergency care accessibility, it had no significant effect on patient-appropriate ED use. Further research is required to improve data-driven policymaking.
Identification of a novel mutation in the KITLG gene in a Chinese family with familial progressive hyper- and hypopigmentation
Authors: Wang Jianbo , Li Weisheng , Zhou Naihui , Liu Jingliu , Zhang Shoumin , Li Xueli , Li Zhenlu , Yang Ziliang , Sun Miao , Li Min
Published: January 2021

Background

Familial progressive hyper- and hypopigmentation (FPHH, MIM 145250) is a rare hereditary skin disorder that is predominantly characterized by progressive, diffuse, partly blotchy hyperpigmented lesions intermingled with scattered hypopigmented spots, lentigines and sometimes Cafe-au-lait spots (CALs). Heterozygous mutations of the KIT ligand (KITLG, MIM 184745) gene are responsible for FPHH. To date, only eightKITLGmutations have been reported to be associated with FPHH, and no clear genotype–phenotype correlations have been established. This study aimed to identify the causative mutations in theKITLGgene in two Chinese FPHH patients.

Methods

Direct sequencing of the coding regions ofKITLGwas performed. Pathogenicity prediction was performed using bioinformatics tools, including SIFT, Polyphen2, and SWISS-MODEL, and the results were further evaluated according to the 2015 American College of Medical Genetics and Genomics (ACMG) guidelines.

Results

The novel mutation c.104A > T (p.Asn35Ile) and the recurrent mutation c.101C > T (p.Thr34Ile) inKITLGwere identified. As shown using SIFT and Polyphen-2 software, both mutations identified in this study were predicted to be detrimental variations. Three-dimensional protein structure modeling indicated that the mutant KITLG proteins might affect the affinity of KITLG for its receptor, c-KIT. According to the 2015 ACMG guidelines, the novel mutation c.104A > T was ‘likely pathogenic’.

Conclusions

To date, most of the identifiedKITLGmutations have been clustered within the conserved VTNNV motif (amino acids 33–37) in exon 2. The known mutations are only involved in 33 V, 34 T, 36 N, and 37 V but not 35 N. We have now identified a novel mutation inKITLG, c.104A > T, that was first reported in FPHH within the conserved 35 N motif. These results strengthen our understanding of FPHH and expand the mutational spectrum of theKITLGgene.
RETRACTED ARTICLE: Targeting MALAT1 and miRNA-181a-5p for the intervention of acute lung injury/acute respiratory distress syndrome
Authors: Liu Yaling , Wang Xiaodong , Li Peiying , Zhao Yanhua , Yang Liqun , Yu Weifeng , Xie Hong
Published: January 2021

Background

ALI/ARDS is a severe lung injury leading to refractory respiratory failure, accounting for high morbidity and mortality. However, therapeutic approaches are rather limited. Targeting long non-coding RNA MALAT1 and microRNA miR-181a-5p might be potential option for ALI/ARDS intervention.

Objective

We aimed to investigate the role of MALAT and miR-181a-5p in the pathogenesis of ALI/ARDS, and test the therapeutic effects of targeting MALAT and miR-181a-5p for ALI/ARDS intervention in vitro.

Methods

MALAT1 and miR-181a-5p levels were measured in plasma from ALI/ARDS patients. In vitro human pulmonary microvascular endothelial cell (HPMEC) injury was induced by LPS treatment, and molecular targets of MALAT1 and miR-181a-5p were explored by molecular biology approaches, mainly focusing on cell apoptosis and vascular inflammation. Interaction between MALAT1 and miR-181a-5p was also detected. Finally, the effects of targeting MALAT1 and miR-181a-5p for ALI/ARDS intervention were validated in a rat ALI/ARDS model.

Results

MALAT1 upregulation and miR-181a-5p downregulation were observed in ALI/ARDS patients. Transfection of mimic miR-181a-5p into HPMECs revealed decreased Fas and apoptosis, along with reduced inflammatory factors. Fas was proved to be a direct target of miR-181a-5p. Similar effects were also present upon MALAT1 knockdown. As for the interaction between MALAT1 and miR-181a-5p, MALAT1 knockdown increased miR-181a-5p expression. Knocking down of MALAT1 and miR-181a-5p could both improve the outcome in ALI/ARDS rats.

Conclusion

MALAT1 antagonism or miR-181a-5p could both be potential therapeutic strategies for ALI/ARDS. Mechanistically, miR-181a-5p directly inhibits Fas and apoptosis, along with reduced inflammation. MALAT1 negatively regulates miR-181a-5p.
Mutation profile of non-small cell lung cancer revealed by next generation sequencing
Authors: Chang Ya-Sian , Tu Siang-Jyun , Chen Yu-Chia , Liu Ting-Yuan , Lee Ya-Ting , Yen Ju-Chen , Fang Hsin-Yuan , Chang Jan-Gowth
Published: January 2021

Background

Precision therapy for lung cancer requires comprehensive genomic analyses. Specific effects of targeted therapies have been reported in Asia populations, including Taiwanese, but genomic studies have rarely been performed in these populations.

Method

We enrolled 72 patients with non-small cell lung cancer, of whom 61 had adenocarcinoma, 10 had squamous cell carcinoma, and 1 had combined adenocarcinoma and squamous cell carcinoma. Whole-exome or targeted gene sequencing was performed. To identify trunk mutations, we performed whole-exome sequencing in two tumor regions in four patients.

Results

Nineteen known driver mutations in EGFR, PIK3CA, KRAS, CTNNB1, and MET were identified in 34 of the 72 tumors evaluated (47.22%). A comparison with the Cancer Genome Atlas dataset showed that EGFR was mutated at a much higher frequency in our cohort than in Caucasians, whereas KRAS and TP53 mutations were found in only 5.56% and 25% of our Taiwanese patients, respectively. We also identified new mutations in ARID1A, ARID2, CDK12, CHEK2, GNAS, H3F3A, KDM6A, KMT2C, NOTCH1, RB1, RBM10, RUNX1, SETD2, SF3B1, SMARCA4, THRAP3, TP53, and ZMYM2. Moreover, all ClinVar pathogenic variants were trunk mutations present in two regions of a tumor. RNA sequencing revealed that the trunk or branch genes were expressed at similar levels among different tumor regions.

Conclusions

We identified novel variants potentially associated with lung cancer tumorigenesis. The specific mutation pattern in Taiwanese patients with non-small cell lung cancer may influence targeted therapies.
Perinatal psychological interventions to promote breastfeeding: a narrative review
Authors: Gómez Lidia , Verd Sergio , de-la-Banda Gloria , Cardo Esther , Servera Mateu , Filgueira Ana , Ponce-Taylor Jaume , Mulet Margarita
Published: January 2021

Background

Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However, literature on initiatives to improve breastfeeding rates has focused mainly on providing community-based peer support, or social policies. The aim of this review is to assess evidence on the effectiveness of a broad range of psychological interventions to facilitate breastfeeding for mothers facing difficulties around the time of delivery.

Methods

The review of the literature is derived from a search on Cochrane Library, PubMed, EBSCOhost, and PsycINFO for papers published since 1980. The approach was to explore quantitative and qualitative parameters. Quantitative parameters included breastfeeding initiation, duration, and composition. Qualitative parameters recorded the evaluation of maternal perceptions on breastfeeding success. The high heterogeneity of the studies led to a narrative review; 20 selected papers that report on breastfeeding outcomes and psychological programs met the inclusion criteria.

Results

The evidence on breastfeeding support through psychotherapy is heterogeneous and scant. Out of the included studies, 11 were randomized controlled trials, two were non-randomised trials, and two used a quasi-experimental design. None of the studies reported an increase in adverse breastfeeding outcomes. Three studies failed to report an association between psychological procedures and improved breastfeeding outcomes. A literature review showed that 17 (85%) analyses support stress-releasing techniques to facilitate breastfeeding.

Conclusions

This review suggests that relaxation interventions carefully tailored to address perinatal emotional distress may lead to important health benefits, including improvement in breastfeeding outcomes. There is also some indication that psychotherapy support while breastfeeding may have more impact than routine counselling. Conversely, this review did not find an association between self-hypnosis and breastfeeding outcomes. Data from this study can be used in designing prevention programs and future research with appropriate theoretical underpinning.
Supporting sexuality for people living with epidermolysis bullosa: clinical practice guidelines
Authors: King Alex , Hanley Humphrey , Popenhagen Mark , Perez Florencia , Thompson Kerry , Purvis Diana , Garcia Nora , Steinlein Ida , Werkentoft Mia , Lightfoot Matthew , Lahat Michelle , Begum Kalsoom , Tanabe Julio
Published: January 2021

This article presents evidence-based Clinical Practice Guidelines (CPG) for the provision of healthcare services to address sexuality for people living with epidermolysis bullosa (EB). Currently, a lack of EB-specific research limits these services to sexual health assessment and intervention strategies designed for the general population. Due to the unique challenges of EB, a rare skin-fragility condition causing blistering responses to minor skin trauma and other systemic and secondary complications, condition-specific strategies are needed to support people with EB in achieving valued sexual lifestyles. This CPG represents the work of an international panel comprised of thirteen members including a medical doctor, nurses, psychologists, a social worker, an occupational therapist, and patient population involvement members living with EB. It describes the development of EB-specific recommendations for two primary domains of assessment and intervention related to sexuality: psychosocial and mechanical. Following a rigorous evidence-based guideline development process, this CPG establishes the first internationally actionable clinical practice recommendations for sexuality-related assessment and intervention for this population. Future research priorities are identified. Supplemental materials included provide additional support to clinicians in developing the necessary understanding and skills to promote equity and efficacy in this care domain.