bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the efficacy and patient satisfaction of the intracavernosal alprostadil in the treatment of erectile dysfunction following robot-assisted radical prostatectomy
Authors: Kocatürk Hüseyin , Altay Mehmet Sefa , Bedir Fevzi , Bedir Banu
Published: September 2021

Objective: Erectile dysfunction (ED) following robot-assisted radical prostatectomy (RARP) is an important problem. The purpose of this study was to evaluate the effectiveness of and patient satisfaction with intracavernosal alprostadil used in the treatment of ED. Material and Methods: Patients using intracavernosal alprostadil in the treatment of ED following RARP were assessed retrospectively. Patients’ demographic characteristics, pre- and postoperative International Index of Erectile Function (IIEF) scores, and general satisfaction evaluated using questions 13 and 14 of the IIEF form were all recorded. Complications developing during treatment, dosages used, and reasons for discontinuation were investigated. Results: Thirty-four patients with a mean age of 61.73±5.80 years were included in the study. Preoperative ED was determined in 52.9% (n=18) of patients. The mean IEFF of the patients who used preoperative, postoperative 1st month, postoperative 3 months after tadalafil use and intracavernosal alprostadil was 20.64 ± 3.46, 15.08 ± 2.09, 15.32 ± 2.18, 26.67 ± 2.30, respectively. The mean length of use of intracavernosal alprostadil was 8.20±2.48 months, and full erection was achieved in 70.58% of patients. Hematoma associated with intracavernosal alprostadil use developed in 2.9% of patients, ecchymosis in 8.8%, and pain in 8.8%. In addition, 73.5% of patients continued to take their medication during the follow-up process. Patients’ general satisfaction following alprostadil therapy was statistically significantly high. Conclusion: Intracavernosal alprostadil therapy following RARP represents a good therapeutic option due to its high success in achieving full erection, low complication rates, and high patient satisfaction. Keywords: Erectile dysfunction, Alprostadil, robot-assisted radical prostatectomy
Young Maternal Death Caused by COVID-19
Authors: Kucuk Izzet Goker , Aladag Ebru
Published: September 2021

Maternal death refers to the death of a woman during pregnancy, during delivery, or within 42 days after the termination of pregnancy, and for any reason exaggerated by the pregnancy condition or pregnancy process regardless of the duration and location of the pregnancy. Starting on 11 March 2020 in Turkey, the COVID-19 pandemic resulted in a total of 5,638,178 confirmed cases and 51,048 deaths. Our case aged 24 years was a young mother having severe weight loss since the beginning of pregnancy because of malnutrition due to depression, smoking, and nausea. The weight loss of the patient, who was infected by COVID-19 in a short while after the last visit in family healthcare, became more severe, the general appearance became worse, and she gave preterm birth in the 30th gestational week. The cardiopulmonary arrest occurred during the delivery. Although necessary interventions were made, the patient was lost on the same day. Since it is a rare case, this case is presented together with a literature review.

Keywords: COVID-19, pandemics, maternal mortality
Mucosal Administration of Recombinant Baculovirus Displaying Toxoplasma gondii ROP4 Confers Protection Against T. gondii Challenge Infection in Mice
Authors: Yoon Keon-Woong , Chu Ki-Back , Kang Hae-Ji , Kim Min-Ju , Eom Gi-Deok , Lee Su-Hwa , Moon Eun-Kyung , Quan Fu-Shi
Published: September 2021

Pathogens require physical contact with the mucosal surface of the host organism to initiate infection and as such, vaccines eliciting both mucosal and systemic immune responses would be promising. Studies involving the use of recombinant baculoviruses (rBVs) as mucosal vaccines are severely lacking despite their inherently safe nature, especially against pathogens of global importance such as Toxoplasma gondii. Here, we generated rBVs displaying T. gondii rhoptry protein 4 (ROP4) and evaluated their protective efficacy in BALB/c mice following immunization via intranasal (IN) and oral routes. IN immunization with the ROP4-expressing rBVs elicited higher levels of parasite-specific IgA antibody responses compared to oral immunization. Upon challenge infection with a lethal dose of T. gondii ME49, IN immunization elicited significantly higher parasite-specific antibody responses in the mucosal tissues such as intestines, feces, vaginal samples, and brain than oral immunization. Marked increases in IgG and IgA antibody-secreting cell (ASC) responses were observed from intranasally immunized mice. IN immunization elicited significantly enhanced induction of CD4+, CD8+ T cells, and germinal center B (GC B) cell responses from secondary lymphoid organs while limiting the production of the inflammatory cytokines IFN-γ and IL-6 in the brain, all of which contributed to protecting mice against T. gondii lethal challenge infection. Our findings suggest that IN delivery of ROP4 rBVs induced better mucosal and systemic immunity against the lethal T. gondii challenge infection compared to oral immunization.
The Presence of Blastocystis in Tibetan Antelope (Pantholops hodgsonii)
Authors: Geng Hong-Li , Sun Yu-Zhe , Jiang Jing , Sun He-Ting , Li Yuan-Guo , Qin Si-Yuan , Wang Zhen-Jun , Ma Tao , Zhu Jun-Hui , Xue Nian-Yu , Ni Hong-Bo
Published: September 2021

Blastocystis is a protozoan that parasitizes the intestines. A number of hosts of Blastocystis have been found, including human and animals. However, there has been no research on the prevalence of Blastocystis in Tibetan antelope. Here, a molecular test was performed using 627 Tibetan antelope fecal samples collected on Tibet in China from 2019 to 2020. The result showed that 30 (4.8%) samples were Blastocystis positive. The highest prevalence of Blastocystis was in Shuanghu County (25/209, 12.0%), followed by Shenza County (2/103, 1.9%), Nyima County (3/182, 1.6%), and Baigoin County (0/133, 0.0%). In addition, logistic regression analysis showed that the gender, sampling year, and area of Tibetan antelope were risk factors for Blastocystis prevalence. Three subtypes (ST10, ST13, and ST14) of Blastocystis were found in Tibetan antelope through a subtype sequence analysis, and ST13 was identified to be the dominant subtype. This is the first investigation for the infection of Blastocystis in Tibetan antelope. Collectively, the data in this study have expanded the host range of Blastocystis and provided basic information for the distribution of Blastocystis subtypes, which could support the prevention of Blastocystis infection in wild animals.
Deficiency of Myeloid Pfkfb3 Protects Mice From Lung Edema and Cardiac Dysfunction in LPS-Induced Endotoxemia
Authors: Xu Jiean , Wang Lina , Yang Qiuhua , Ma Qian , Zhou Yaqi , Cai Yongfeng , Mao Xiaoxiao , Da Qingen , Lu Tammy , Su Yunchao , Bagi Zsolt , Lucas Rudolf , Liu Zhiping , Hong Mei , Ouyang Kunfu , Huo Yuqing
Published: September 2021

Sepsis, a pathology resulting from excessive inflammatory response that leads to multiple organ failure, is a major cause of mortality in intensive care units. Macrophages play an important role in the pathophysiology of sepsis. Accumulating evidence has suggested an upregulated rate of aerobic glycolysis as a key common feature of activated proinflammatory macrophages. Here, we identified a crucial role of myeloid 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (Pfkfb3), a glycolytic activator in lipopolysaccharide (LPS)-induced endotoxemia in mice. Pfkfb3 expression is substantially increased in bone marrow derived macrophages (BMDMs) treated with LPS in vitro and in lung macrophages of mice challenged with LPS in vivo. Myeloid-specific knockout of Pfkfb3 in mice protects against LPS-induced lung edema, cardiac dysfunction and hypotension, which were associated with decreased expression of interleukin 1 beta (Il1b), interleukin 6 (Il6) and nitric oxide synthase 2 (Nos2), as well as reduced infiltration of neutrophils and macrophages in lung tissue. Pfkfb3 ablation in cultured macrophages attenuated LPS-induced glycolytic flux, resulting in a decrease in proinflammatory gene expression. Mechanistically, Pfkfb3 ablation or inhibition with a Pfkfb3 inhibitor AZ26 suppresses LPS-induced proinflammatory gene expression via the NF-κB signaling pathway. In summary, our study reveals the critical role of Pfkfb3 in LPS-induced sepsis via reprogramming macrophage metabolism and regulating proinflammatory gene expression. Therefore, PFKFB3 is a potential target for the prevention and treatment of inflammatory diseases such as sepsis.
Unraveling the Holocene Eruptive History of Flores Island (Azores) Through the Analysis of Lacustrine Sedimentary Records
Authors: Andrade Mariana , Ramalho Ricardo S. , Pimentel Adriano , Hernández Armand , Kutterolf Steffen , Sáez Alberto , Benavente Mario , Raposeiro Pedro M. , Giralt Santiago
Published: September 2021

Lacustrine sequences from active volcanic settings usually hold a rich and continuous record of tephra layers, providing a critical source of information to reconstruct a most complete eruptive history of a region. Lake sedimentary records on volcanic islands are particularly useful as the typical small size of these islands and their steep subaerial and submarine slopes lead to a lower preservation of potential erodible pyroclastic deposits. Here we explore the lacustrine sedimentary record of Lagoa da Lomba, a crater lake in the central upland area of Flores Island (Azores), to gain insight into the recent eruptive history of this island. The strategic location of Lagoa da Lomba, half distance between the two clusters of recent volcanic activity of the island, together with its long-lasting record, back to 23.52 cal kyr BP, makes this lake a privileged site to investigate the Holocene volcanic history of Flores. Based on a detailed stratigraphic characterization of sediments from a lake transect of three cores, supported by glass shard geochemistry and radiocarbon dating, we recognized four Holocene eruptive events taking place between 6.28 and 2.36 cal kyr BP, demonstrating that the Holocene volcanic activity at Flores Island may have lasted longer than previously reported. Glass shard geochemistry from the different tephra layers suggests three populations, basaltic to trachybasaltic in composition, where the last eruption is the least evolved endmember. Two of the four eruptive events correlate with subaerially-exposed pyroclastic sequences, in terms of stratigraphy and geochemistry. The most recent event recorded at Lagoa da Lomba was constrained to 3.66 – 2.36 cal kyr BP and linked to an eruption sourced from Lagoa Comprida Volcanic System. The second most recent eruptive event was sourced from Lagoa Funda Volcanic System and dated at 3.66 cal kyr BP. Our observations show that Flores experienced vigorous volcanic activity during the Late Holocene. Therefore, contrary to what is assumed, the possibility of future eruptions should be properly considered, and the volcanic hazard here should not be underestimated. Moreover, we highlight the importance of tephrostratigraphy in recent lake sediments to reconstruct past volcanic activity, especially at small volcanic islands, such as Flores, where exposure is poor due to erosion within the limited subaerial area and the dense vegetation.
Simulation of Rapid Intensification of Super Typhoon Lekima (2019). Part I: Evolution Characteristics of Asymmetric Convection Under Upper-Level Vertical Wind Shear
Authors: Huang Qijun , Ge Xuyang , Peng Melinda
Published: September 2021

The role of the upper-level vertical wind shear (VWS) on the rapid intensification (RI) of super typhoon Lekima (2019) is investigated with a high-resolution numerical simulation. Our simulation shows that under moderate upper-level easterly VWS, the tilting-induced convective asymmetry is transported from the initially downshear quadrant to the upshear quadrant and wrapped around the storm center by the cyclonic flow of the storm while moving inward. This process enhances upward motions at the upshear flank and creates upper-level divergent flow. As such, the establishment of outflow acts against the environmental flow to reduce the VWS, allowing vertical alignment of the storm. The organized outflow plays an important role in sustaining the inner-core deep convection by modulating the environmental upper-level thermal structure. Accompanying deep convective bursts (CBs), cold anomalies are generated in the tropopause layer due to the adiabatic cooling by the upward motion and radiative process associated with the cloud anvil. Physically, cold anomalies at the tropopause locally destabilize the atmosphere and enhance the convections and the secondary circulation. The CBs continue to develop episodically through this process as they wrap around the storm center to form a symmetric eyewall. The results suggest that deep convections are capable of reducing the upper-level VWS, promoting the development of upper-level outflow. Lekima overcame the less favorable environment and eventually intensified to become a super typhoon.
Case Report: Successful Use of Minoxidil to Promote Facial Hair Growth in an Adolescent Transgender Male
Authors: Pang Kenneth C. , Nguyen Thomas P. , Upreti Rita
Published: September 2021

Increasing numbers of trans and gender diverse young people are presenting to health services seeking gender-affirming medical care. While testosterone therapy in transgender males is generally effective in inducing masculinization, some adolescents encounter barriers to accessing such treatment or may not wish to experience all the changes that usually accompany testosterone. Here, we describe the case of a 17 year old trans male who presented with gender dysphoria but was initially unable to start testosterone therapy. Due to a desire for facial hair, he was therefore treated with topical minoxidil, an easily accessible, over-the-counter medication that has been used to treat androgenic alopecia for several decades. In this case, minoxidil was applied regularly to the lower face and, after three months of treatment, he developed obvious pigmented facial hair that was sufficient to help him avoid being misgendered. The only reported side effect was excessive skin dryness. Unexpectedly, despite no direct application to other areas, there was also an increase in pigmented body hair, suggestive of systemic absorption and effect. Given its long-standing use and safety record in the management of alopecia, minoxidil might thus represent a useful treatment option for trans males who desire an increase in facial hair.
Assessment of Alveolar Macrophage Dysfunction Using an in vitro Model of Acute Respiratory Distress Syndrome
Authors: Mahida Rahul Y. , Scott Aaron , Parekh Dhruv , Lugg Sebastian T. , Belchamber Kylie B. R. , Hardy Rowan S. , Matthay Michael A. , Naidu Babu , Thickett David R.
Published: September 2021

Background: Impaired alveolar macrophage (AM) efferocytosis may contribute to acute respiratory distress syndrome (ARDS) pathogenesis; however, studies are limited by the difficulty in obtaining primary AMs from patients with ARDS. Our objective was to determine whether an in vitro model of ARDS can recapitulate the same AM functional defect observed in vivo and be used to further investigate pathophysiological mechanisms.

Methods: AMs were isolated from the lung tissue of patients undergoing lobectomy and then treated with pooled bronchoalveolar lavage (BAL) fluid previously collected from patients with ARDS. AM phenotype and effector functions (efferocytosis and phagocytosis) were assessed by flow cytometry. Rac1 gene expression was assessed using quantitative real-time PCR.

Results: ARDS BAL treatment of AMs decreased efferocytosis (p = 0.0006) and Rac1 gene expression (p = 0.016); however, bacterial phagocytosis was preserved. Expression of AM efferocytosis receptors MerTK (p = 0.015) and CD206 (p = 0.006) increased, whereas expression of the antiefferocytosis receptor SIRPα decreased following ARDS BAL treatment (p = 0.036). Rho-associated kinase (ROCK) inhibition partially restored AM efferocytosis in an in vitro model of ARDS (p = 0.009).

Conclusions: Treatment of lung resection tissue AMs with ARDS BAL fluid induces impairment in efferocytosis similar to that observed in patients with ARDS. However, AM phagocytosis is preserved following ARDS BAL treatment. This specific impairment in AM efferocytosis can be partially restored by inhibition of ROCK. This in vitro model of ARDS is a useful tool to investigate the mechanisms by which the inflammatory alveolar microenvironment of ARDS induces AM dysfunction.
Soluble Triggering Receptor Expressed on Myeloid Cells 2 From Cerebrospinal Fluid in Sleep Disorders Related to Parkinson’s Disease
Authors: Mo Mingshu , Tang Yuting , Wei Lijian , Qiu Jiewen , Peng Guoyou , Lin Yuwan , Zhou Miaomiao , Dai Wei , Zhang Zhiling , Chen Xiang , Liu Hanqun , Ding Liuyan , Ye Panghai , Wu Yijuan , Zhu Xiaoqin , Wu Zhuohua , Guo Wenyuan , Xu Pingyi
Published: September 2021

Background: Triggering receptor expressed on myeloid cells 2 (TREM2) is a microglial receptor exclusively expressed in the central nervous system (CNS). It contributes to abnormal protein aggregation in neurodegenerative disorders, but its role in Parkinson’s disease (PD) is still unclear.

Methods: In this case-control study, we measured the concentration of the soluble fragment of TREM2 (sTREM2) in PD patients, evaluated their sleep conditions by the PD sleep scale (PDSS), and analyzed the relationship between sTREM2 and PD symptoms.

Results: We recruited 80 sporadic PD patients and 65 healthy controls without disease-related variants in TREM2. The concentration of sTREM2 in the CSF was significantly higher in PD patients than in healthy controls (p < 0.01). In the PD group, the concentration of sTREM2 had a positive correlation with α-syn in the CSF (Pearson r = 0.248, p = 0.027). Receiver operating characteristic curve (ROC) analyses showed that sTREM2 in the CSF had a significant diagnostic value for PD (AUC, 0.791; 95% CI, 0.711–0.871, p < 0.05). The subgroup analysis showed that PD patients with sleep disorders had a significantly higher concentration of sTREM2 in their CSF (p < 0.01). The concentration of sTREM2 in the CSF had a negative correlation with the PDSS score in PD patients (Pearson r = −0.555, p < 0.01). The ROC analyses showed that sTREM2 in the CSF had a significant diagnostic value for sleep disorders in PD (AUC, 0.733; 95% CI, 0.619–0.846, p < 0.05).

Conclusion: Our findings suggest that CSF sTREM2 may be a potential biomarker for PD and it could help predict sleep disorders in PD patients, but multicenter prospective studies with more participants are still needed to confirm its diagnostic value in future.
The Untouchable Ventral Nucleus of the Trapezoid Body: Preservation of a Nucleus in an Animal Model of Autism Spectrum Disorder
Authors: Mansour Yusra , Kulesza Randy J.
Published: September 2021

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by repetitive behaviors, poor social skills, and difficulties with communication and hearing. The hearing deficits in ASD range from deafness to extreme sensitivity to routine environmental sounds. Previous research from our lab has shown drastic hypoplasia in the superior olivary complex (SOC) in both human cases of ASD and in an animal model of autism. However, in our study of the human SOC, we failed to find any changes in the total number of neurons in the ventral nucleus of the trapezoid body (VNTB) or any changes in cell body size or shape. Similarly, in animals prenatally exposed to the antiepileptic valproic acid (VPA), we failed to find any changes in the total number, size or shape of VNTB neurons. Based on these findings, we hypothesized that the neurotransmitter profiles, ascending and descending axonal projections of the VNTB are also preserved in these neurodevelopmental conditions. We investigated this hypothesis using a combination of immunohistochemistry and retrograde tract tracing. We found no difference between control and VPA-exposed animals in the number of VNTB neurons immunoreactive for choline acetyltransferase (ChAT). Additionally, we investigated the ascending projections from the VNTB to both the central nucleus of the inferior colliculus (CNIC) and medial geniculate (MG) and descending projections to the cochlea. Our results indicate no significant differences in the ascending and descending projections from the VNTB between control and VPA-exposed animals despite drastic changes in these projections from surrounding nuclei. These findings provide evidence that certain neuronal populations and circuits may be protected against the effects of neurodevelopmental disorders.
Integrative ATAC-seq and RNA-seq Analysis of the Longissimus Muscle of Luchuan and Duroc Pigs
Authors: Miao Weiwei , Ma Zeqiang , Tang Zhanyang , Yu Lin , Liu Siqi , Huang Tengda , Wang Peng , Wu Tian , Song Ziyi , Zhang Haojie , Li Yixing , Zhou Lei
Published: September 2021

Luchuan pig is a typical obese pig breed in China, and the diameter and area of its longissimus dorsi muscle fibers are significantly smaller than those of Duroc (lean) pig. Skeletal muscle fiber characteristics are related to meat quality of livestock. There is a significant correlation between the quality of different breeds of pork and the characteristics of muscle fiber, which is an important factor affecting the quality of pork. The diameter and area of muscle fibers are related to muscle growth and development. Therefore, we used the assay for transposase-accessible chromatin using sequencing (ATAC-seq) and RNA sequencing (RNA-seq) analysis to investigate the potential mechanism underlying the difference in skeletal muscle growth and development between the two types of pigs. First, transposase-accessible chromatin was analyzed to map the landscape of open chromatin regions and transcription factor binding sites. We identified several transcription factors that potentially affected muscle growth and development, including TFAP4, MAX, NHLH1, FRX5, and TGIF1. We also found that transcription factors with basic helix-loop-helix structures had a preference for binding to genes involved in muscle development. Then, by integrating ATAC-seq and RNA-seq, we found that the Wnt signaling pathway, the mTOR signaling pathway, and other classical pathways regulate skeletal muscle development. In addition, some pathways that might regulate skeletal muscle growth, such as parathyroid hormone synthesis, secretion, and action, synthesis and degradation of ketone bodies, and the thyroid hormone signaling pathway, which were significantly enriched. After further study, we identified a number of candidate genes (ASNS, CARNS1, G0S2, PPP1R14C, and SH3BP5) that might be associated with muscle development. We also found that the differential regulation of chromatin openness at the level of some genes was contrary to the differential regulation at the level of transcription, suggesting that transcription factors and transcriptional repressors may be involved in the regulation of gene expression. Our study provided an in-depth understanding of the mechanism behind the differences in muscle fibers from two species of pig and provided an important foundation for further research on improving the quality of pork.
Prediction of Malignant Transformation of WHO II Astrocytoma Using Mathematical Models Incorporating Apparent Diffusion Coefficient and Contrast Enhancement
Authors: Wong Alex Mun-Ching , Siow Tiing Yee , Wei Kuo-Chen , Chen Pin-Yuan , Toh Cheng Hong , Castillo Mauricio
Published: September 2021

Using only increasing contrast enhancement as a marker of malignant transformation (MT) in gliomas has low specificity and may affect interpretation of clinical outcomes. Therefore we developed a mathematical model to predict MT of low-grade gliomas (LGGs) by considering areas of reduced apparent diffusion coefficient (ADC) with increased contrast enhancement. Patients with contrast-enhancing LGGs who had contemporaneous ADC and histopathology were retrospectively analyzed. Multiple clinical factors and imaging factors (contrast-enhancement size, whole-tumor size, and ADC) were assessed for association with MT. Patients were split into training and validation groups for the development of a predictive model using logistic regression which was assessed with receiver operating characteristic analysis. Among 132 patients, (median age 46.5 years), 106 patients (64 MT) were assigned to the training group and 26 (20 MT) to the validation group. The predictive model comprised age (P = 0.110), radiotherapy (P = 0.168), contrast-enhancement size (P = 0.015), and ADC (P < 0.001). The predictive model (area-under-the-curve [AUC] 0.87) outperformed ADC (AUC 0.85) and contrast-enhancement size (AUC 0.67). The model had an accuracy of 84% for the training group and 85% respectively for the validation group. Our model incorporating ADC and contrast-enhancement size predicted MT in contrast-enhancing LGGs.
Direct Comparison Between the Addition of Pembrolizumab or Bevacizumab for Chemotherapy-Based First-Line Treatment of Advanced Non-Squamous Non-Small Cell Lung Cancer Lacking Driver Mutations
Authors: Liao Jiatao , Liu Chang , Long Qianqian , Wu Xianghua , Wang Huijie , Yu Hui , Sun Si , Zhang Yao , Lin Ying , Zhao Xinmin , Wang Jialei
Published: September 2021

Background

The addition of bevacizumab or pembrolizumab to pemetrexed-platinum chemotherapy has produced significant clinical benefits to patients with untreated, advanced non-squamous non-small cell lung cancer (NSCLC) lacking targetable genetic aberrations. However, the direct comparison between these two first-line treatments needs to be investigated.

Methods

We retrospectively investigated the medical records of 102 patients with stage IIIB~IV non-squamous NSCLC, and without sensitizing EGFR/ALK/ROS1 alterations. All patients received pembrolizumab or bevacizumab plus pemetrexed-platinum chemotherapy as the first-line treatment between December 2018 to April 2021 at Fudan University Shanghai Cancer Center. Assessments included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). We also evaluated the prognostic biomarkers in the overall population and explored potential predictive biomarkers to aid the selection of optimal treatment regimens.

Results

The median PFS was 10.0 months in the pembrolizumab group and 9.2 months in bevacizumab group (HR = 1.006; P = 0.982), while the median OS was not reached in either group (HR= 1.193; P =0.714). ORR was 36.7% versus 43.4% (P = 0.548) and DCR was 89.8% versus 92.5% (P = 0.735) in the pembrolizumab and bevacizumab groups, respectively. In the overall study population, baseline lymphocyte to monocyte ratio (LMR) >1.95 (HR = 0.312, P < 0.001) was an indicator of longer PFS. The presence of baseline bone metastasis (HR = 4.107, P = 0.009), baseline lactate dehydrogenase (LDH) >300 U/L (HR = 4.300, P = 0.025) and LMR ≤1.95 (HR = 5.291, P = 0.039) were associated with inferior OS. Baseline neutrophil-to-lymphocyte ratio (NLR) ≤3.10 was predictive of significantly favorable OS in the bevacizumab combination treatment (HR = 5.073, P = 0.039). The safety profiles were generally comparable between the two groups.

Conclusions

In patients with chemotherapy-naive, advanced, non-squamous NSCLC who lack driver mutations, the efficacy and safety of pembrolizumab and bevacizumab when combined with pemetrexed-platinum were comparable. For patients with baseline NLR ≤3.10, the bevacizumab combination therapy elicited significantly better OS benefits.
Dual-Specificity Phosphatase 11 Is a Prognostic Biomarker of Intrahepatic Cholangiocarcinoma
Authors: Xu Lin , Wang Peng , Zhang Wei , Li Weiran , Liu Tao , Che Xu
Published: September 2021

Background

Cholangiocarcinoma (CCA), including intrahepatic (iCCA), perihilar (pCCA), and distal (dCCA) CCA, is a highly aggressive malignancy originating from bile duct. The prognosis of CCA is very poor, and the biomarker study is unsatisfactory compared with other common cancers.

Materials and methods

In our study, we investigated the expression of dual-specificity phosphatase 11(DUSP11) in eight pairs of iCCAs, pCCAs, and dCCAs, and their corresponding tumor-adjacent tissues, as well as their tumor-adjacent tissues with qPCR. Moreover, we investigated the expression of DUSP11 in 174 cases of CCAs with immunohistochemistry, including 74 iCCAs, 64 pCCAs, and 36 dCCAs. We classified these patients into subsets with low and high expressions of DUSP11, and evaluated the correlations between the DUSP11 subsets and clinicopathological factors. With univariate and multivariate analyses, we assessed the correlation between DUSP11 and the overall survival (OS) rates in these CCA patients.

Results

In all the CCA subtypes, DUSP11 was elevated in CCAs compared with their paired adjacent tissues. In iCCA, pCCA, and dCCA, the percentages of DUSP11 high expression were 44.59%, 53.85%, and 55.56%, respectively. In iCCA, high DUSP11 expression was significantly associated with an advanced T stage and a poor prognosis. However, the prognostic value of DUSP11 in pCCA and dCCA was not significant. To decrease the statistical error caused by the small sample size of the dCCA cohort, we merged pCCA and dCCA into extracellular CCA (eCCA). In the 101 cases of eCCA, DUSP11 expression was also not significantly associated with the prognosis.

Conclusions

DUSP11 expression was associated with tumor infiltration and the OS rate in iCCA, but not in pCCA and dCCA. DUSP11 was an independent biomarker of iCCA indicating a poor prognosis. Our results suggested that a high expression of DUSP11 was a post-operational risk factor, and detecting DUSP11 could guide the individual treatment for patients with CCA.
Safety of Cyproheptadine, an Orexigenic Drug. Analysis of the French National Pharmacovigilance Data-Base and Systematic Review
Authors: Bertrand Valérie , Massy Nathalie , Vegas Nancy , Gras Valérie , Chalouhi Christel , Tavolacci Marie-Pierre , Abadie Véronique
Published: September 2021

Objectives: Cyproheptadine is a first-generation H1-antihistamine drug first that was distributed in the 1960s. While its orexigenic effect was observed early, cyproheptadine is not yet authorized for this indication in all countries today. There is an increasing medical interest and demand for the orexigenic effect of cyproheptadine, especially in children with poor appetite. As cyproheptadine might be evaluated in future clinical trials, we wanted to assess its safety profile.

Methods: Using the French national pharmacovigilance database, we retrospectively analyzed all pediatric and adult reports of adverse effects of cyproheptadine recorded since its first distribution in France. Next, we performed a systematic review of the literature of cyproheptadine adverse effects.

Results: Since 1985, 93 adverse effects were reported in the French pharmacovigilance database (adults 81.7%, children 18.3%); these were mainly neurological symptoms (n = 38, adults 71%, children 28.9%), and hepatic complications (n = 15, adults 86.7%, children 13.3%). In the literature, the most frequent adverse effect reported was drowsiness in adults or children, and five case reports noted liver complications in adults. We estimated the frequency of hepatic adverse effects at 0.27 to 1.4/1000, regardless of age.

Conclusion: Cyproheptadine can be considered a safe drug. Mild neurological effects appear to be frequent, and hepatotoxicity is uncommon to rare. Randomized controlled trials are needed to evaluate the safety and efficacy of cyproheptadine before authorization for appetite stimulation, especially in young children as studies at this age are lacking. Possible hepatic complications should be monitored, as very rare cases of liver failure have been reported.
Online Communication of Local Governments During COVID-19 Pandemic in Hungary
Authors: Baranyai Nóra , Barsi Boglárka , Nárai Márta
Published: September 2021

Local governments had key and prominent roles in tackling the COVID-19 pandemic. Their task was to take short-term measures quickly and to organize protection and care for those in need. The main objective of our paper is to present how local governments communicated with their inhabitants on various online interfaces in this crisis situation. Our analysis covers 54 settlements representing all the different levels of the settlement network from large cities to small villages. We examined the webpages and Facebook pages of local governments and mayors, first during the first wave and then during the second and third waves of the pandemic. Recognizing their responsibility, local governments clearly tried to provide information to the inhabitants as quickly as possible. They considered the online interfaces the most effective, but the online communication had typically been complemented by information published on more traditional channels as well. There were no significant differences in terms of the way and characteristics of communication among the different types of settlements, although local governments of different sizes obviously had to face different challenges in terms of the amount of tasks they had to tackle. The communication process was a very difficult task because of the lack of information and the not-transparent data provision. Even on the Facebook pages especially suitable for this purpose, interactivity rumbled, and in many cases the questions and suggestions of the inhabitants remained unanswered. It is instructive that, with few exceptions, settlements do not place emphasis on surveying local needs and opinions.
What Do They Do? Construction of a Team Leader Intervention Model
Authors: Ledin Kjell , Bengtsson Peter , Ärlemalm Tore
Published: September 2021

This research report aimed to present a team leader intervention model regarding when unexpected events arise in meetings. Onward, the model will form a starting point for the creation and validation of a team leader interventions inventory. Sixteen managers provided the empirical material for the construction of the model. The subjects proposed as many interventions as possible based on 10 different group meeting scenarios. In total, 327 interventions were proposed, which constituted the basis for a conceptual framework comprising six categories—Control, Inform, Initiate, Investigate, Support, and Avoid. Three of the categories correspond to classical leadership behaviours: the Control category to Authoritative Leadership and Task Behaviour and structure; the Support category to Democratic Leadership and Relationship Behaviour and consideration; and the Avoid category to Laissez-Faire Leadership, letting events pass without taking leadership. In addition, the conceptual framework includes three new categories in addition to the classical leadership theory. The Inform category is related to the controlling function. When the leader clarifies goals and how to achieve the goals, it is indirectly a controlling function. The Initiate category is related to launching procedural or distracting activities. Finally, the Investigate category is an almost necessary step ahead of the other categories. Before controlling, informing, initiating, supporting, or avoiding, the leader ought to investigate the causes of the disorder and then decide which intervention is most appropriate.
Seed Systems of Traditional African Vegetables in Eastern Africa: A Systematic Review
Authors: Ayenan Mathieu A. T. , Aglinglo Lys Amavi , Zohoungbogbo Herbaud P. F. , N'Danikou Sognigbe , Honfoga Judith , Dinssa Fekadu F. , Hanson Peter , Afari-Sefa Victor
Published: September 2021

Traditional African Vegetables (TAV) play an important role in the livelihoods, food and nutritional security of local populations. Access to high-quality seeds of improved varieties is a foundation for increasing crop productivity. TAV seed systems have received little attention. We systematically reviewed the literature to assess the sustainability (seed quality, availability, accessibility, affordability, and profitability of seed businesses) of TAV seed systems in Eastern Africa. The review revealed that the private sector mediated seed system (i.e., formal) offered higher potential for seed quality, and profitability for seed growers. The community-based seed system showed higher potential in ensuring a better access to seeds. The quality of TAV seeds was partially addressed in the studies with a focus on germination percentage and purity, which varied across systems, crops, and geography. While there was a trend of poorer seed quality in the informal system, seed quality in the formal and community-based systems was not necessarily better. The affordability of seed from the various systems (private sector mediated, community based and informal) needs further investigation. Because TAV seed systems are localized and differ significantly among and within countries, tailored interventions are required when promoting a given TAV seed system. We identified inter-regional gaps in TAV seed systems studies, with all the studies concentrated in Eastern Africa, mainly in Tanzania and Kenya. Filling these gaps will require more investment in other regions in sub-Saharan Africa to document existing initiatives or initiate interventions seeking to promote access to high-quality TAV seeds. This review sheds light on existing gaps in research on TAV seed systems to guide future interventions.
Recommendations on Postoperative Activities After Abdominal Operations and Incisional Hernia Repair—A National and International Survey
Authors: Schaaf Sebastian , Schwab Robert , Güsgen Christoph , Vilz Tim O. , Willms Arnulf
Published: September 2021

Background: There is no conclusive data on postoperative recommendations after abdominal and hernia surgery, and there is significant variation in the literature on that question. Thus, this study evaluates the status quo of recommendations of postoperative activity restriction after abdominal surgery.

Materials and Methods: A national (German) and international survey of general surgeons on postoperative recommendations after abdominal and hernia surgery was pooled and analyzed.

Results: A total of 74.6% recommended postoperative reduced activity for 2 weeks or less after laparoscopy. For midline laparotomy, 48.8% considered a reduced activity of 4 weeks or less to be sufficient. A majority from the national survey recommended more than 4 weeks instead (60.2%), whereas only 31.5% from the international survey did so (p = 0.000). In the pooled analysis, 258 of 450 (57.3%) rated 4 weeks or less suitable. However, the recommendations differed significantly between the surveys (4 weeks or less: a national survey, 47.1% vs. international survey, 64.6%; p = 0.000).

Conclusion: There was substantial variation in the given recommendations. However, we found no evidence against immediate mobilization, reduced physical activity, and lifting for up to 2 weeks after laparoscopic surgery and for up to 4 weeks after open abdominal surgery and open incisional/ventral hernia repair in uncomplicated and standard cases. There might be individual and socioeconomic benefits to allow patients to return to their whole personal level of activity and work without putting them at risk of complications. Due to lack of evidence, both retrospective and prospective, controlled studies are in need to develop reliable recommendations.
Motivations and Barriers for Veterinarians When Facilitating Fertility Management on UK Dairy Farms
Authors: Brocket James John , Fishbourne Emma , Smith Robert Frank , Higgins Helen Mary
Published: September 2021

It is economically essential, but challenging, for dairy farmers to manage bovine fertility. Vets can help farmers to improve fertility, and this is cost-effective bringing benefits for production, animal health and welfare, and the environment. However, the extent to which vets are involved in fertility varies considerably between farms, for reasons that are unclear. This study investigated the motivators and barriers that vets perceive when trying to increase their involvement with fertility management on UK dairy farms. Interviews were conducted with 20 vets and four themes identified. The first, “clinical baggage,” highlighted vets' disillusionment due to past experiences of low uptake of their advice by farmers. Consequently, some vets made assumptions about farmer needs and behaviours, and exhibited ageist stereotyping. These issues, along with concerns and fatigue associated with repeatedly offering the same advice which was not acted upon, negatively influenced vets' engagement with farmers. The second theme “stuck in the comfort zone” revealed a loss of enthusiasm by some senior vets, whilst others lacked confidence to engage due to perceived gaps in their knowledge. Vets also reported farmers not perceiving their problems and lack of farm data or facilities, as barriers. The “vet-farmer relationship” theme highlighted building trust and developing strong relationships which were key drivers for vets to proactively engage and to “go the extra mile” for their clients. The final theme “money matters” explored vets' motivations to improve their clients' profitability and included the future sustainability of their own businesses. Our themes provide useful insight into the challenges vets face and provide key areas that can be targeted in future interventions to improve veterinary involvement in fertility management. For example, post-graduate training and support for vets needs to consider factors such as reflection, mentorship, stereotyping, relationships, communication, and leadership skills. This type of postgraduate support is currently limited for vets and requires investment from stakeholders if improvements in production, animal health and welfare, and the environment are to be achieved. Our findings are informative for facilitating veterinary involvement in any disease context, and are relevant for stakeholders including governments, educators, charities, farmer representatives, environmentalists, and veterinary leaders.
Double-Blind, Placebo-Controlled Trial of Cyproterone Acetate to Prevent Flare-Up Effect on Dogs Implanted With Deslorelin
Authors: Masson Sylvia , Medam Tiphaine , Raibon Elsa , Fontaine Christelle , Levy Xavier
Published: September 2021

Deslorelin slow-released implants are registered in Europe for the reversible suppression of fertility in male dogs. After administration, a time-limited increase in sex hormones concentration and related behavioral problems may be observed. The aim of this work was to assess whether cyproterone acetate, a synthetic progestogen, can prevent this flare-up effect. Eighteen privately-owned entire male dogs were enrolled in this double-blind, placebo-controlled, randomized clinical trial. All subjects received a 4.7 mg deslorelin implant by SC route and 1–3 capsules containing either cyproterone acetate 2 mg/kg (N = 9) or a placebo (N = 9), by oral route BID for 14 days, depending on the dog's weight. The dogs were followed for 28 days. An increase in the blood testosterone concentration was observed in respectively 9/9 and 7/9 dogs of the control and cyproterone groups (p = 0.47). However, a worsening of the sex hormone related problems (i.e., urinary marking, mounting, aggressiveness toward other dogs and/or escape) was only observed in the placebo group, in 56 or 66% of the dogs as measured by respectively the veterinarian and the owners. Our study suggests that cyproterone acetate is effective and safe to supress the deslorelin induced behavioral flare-up effect, but not the rise in testosterone.
The Use of Municipal Solid Waste Compost in Combination with Proper Irrigation Scheduling Influences the Productivity, Microbial Activity and Water Use Efficiency of Direct Seeded Rice
Authors: Dharminder  , Singh Ram Kumar , Kumar Vishal , Pramanick Biswajit , Alsanie Walaa F. , Gaber Ahmed , Hossain Akbar
Published: September 2021

Appropriate irrigation scheduling, along with proper nutrient management practice for direct seeded rice (DSR), are very much essential to attain higher water use efficiency. Huge amounts of municipal waste are been produced every year and these wastes are left untreated and have caused many environmental hazards. However, these wastes can be converted into potential manures for crop production when enhanced with microbial consortia. Concerning these, the current research was carried out to know the effect of compost of enriched municipal soil waste (E-MSWC) with suitable irrigation scheduling on growth, yield, microbial activity, and water use efficiency of the DSR grown under Indo-Gangetic plains during two consecutive rice seasons of 2017–2018 and 2018–2019 at Varanasi, India. From the experiment, it was found that E-MSWC applied at 10 Mg·ha−1 along with 75% recommended dose of fertilizer (RDF) was capable to improve growth, yield, soil microbes, and water use efficiency (WUE) of rice. Amongst different enriched MSWC, the consortia (blend of N-fixing, P and Zn-solubilizing bacteria and Trichoderma) enriched MSWC was found to be the most effective. Concerning, different irrigation scheduling, it was observed that 50 mm cumulative pan evaporation (CPE) based irrigation was the most suitable as compared to providing irrigation at 75 mm CPE. Comparing rice varieties used in the research, the rice variety Swarna has appeared as a better choice in terms of yield and WUE than the variety, Sahbhagi. Thus, it can be recommended that irrigation at 50 mm of CPE in conjunction with 75% RDF + E-MSWC (consortia) at 10 Mg·ha−1 could improve the water use efficiency of rice grown in Indo-Gangetic plains.
Implementation of Food Retail Functions in Poland in the SARS-CoV-2 Pandemic
Authors: Skawińska Eulalia , Zalewski Romuald I. , Wyrwa Joanna , Ślusarz Bogdan
Published: September 2021

Retail trade is one of many links of the food supply chain to the consumer. Therefore, the efficiency of its operation is influenced by the earlier located links in the chain, first of all by agriculture, processing, logistics, and wholesale trade, as well as by consumers. The research problem in this paper, specified in the form of questions, is as follows: Has the 2020 pandemic reduced the performance of food retailing functions in less-developed regions of Poland? What is the assessment of the degree of their implementation? What directions should be taken at the micro and macro level to increase resilience to the negative effects of future crisis phenomena, in the implementation of the functions of this trade? The cognitive aim of the study was to examine the degree of performance of economic and social functions by the food retail trade in Poland, after one year of the SARS-CoV-2 pandemic (with the example of the Lubuskie region). For its implementation, four research hypotheses were formulated. The work was carried out in three stages, theoretical-interpretative, methodological, empirical, and consisted of three parts. In the experimental part, the method of CATI interviews with store owners/managers and the method of advanced statistics, classification, and visualization were used. The article brings new cognitive and normative value concerning food retailing in Poland. The results of the study enabled the realization of the aim of the paper and the verification of the hypotheses. The conclusions are presented in the summary of the individual parts of the empirical data analysis and in the conclusion of the paper. The paper contributes to the literature a new recognition of the degree of performance of the seven examined functions by food retail units, during the pandemic.