bluuebunny/crossref_metadata_2025 huggingface dataset:
Inter-rater reliability and concurrent validity of ROBINS-I: protocol for a cross-sectional study
Authors: Jeyaraman Maya M. , Rabbani Rasheda , Al-Yousif Nameer , Robson Reid C. , Copstein Leslie , Xia Jun , Pollock Michelle , Mansour Samer , Ansari Mohammed T. , Tricco Andrea C. , Abou-Setta Ahmed M.
Published: January 2020

Background

The Cochrane Bias Methods Group recently developed the “Risk of Bias (ROB) in Non-randomized Studies of Interventions” (ROBINS-I) tool to assess ROB for non-randomized studies of interventions (NRSI). It is important to establish consistency in its application and interpretation across review teams. In addition, it is important to understand if specialized training and guidance will improve the reliability of the results of the assessments. Therefore, the objective of this cross-sectional study is to establish the inter-rater reliability (IRR), inter-consensus reliability (ICR), and concurrent validity of ROBINS-I. Furthermore, as this is a relatively new tool, it is important to understand the barriers to using this tool (e.g., time to conduct assessments and reach consensus—evaluator burden).

Methods

Reviewers from four participating centers will appraise the ROB of a sample of NRSI publications using the ROBINS-I tool in two stages. For IRR and ICR, two pairs of reviewers will assess the ROB for each NRSI publication. In the first stage, reviewers will assess the ROB without any formal guidance. In the second stage, reviewers will be provided customized training and guidance. At each stage, each pair of reviewers will resolve conflicts and arrive at a consensus. To calculate the IRR and ICR, we will use Gwet’s AC1 statistic.

For concurrent validity, reviewers will appraise a sample of NRSI publications using both the New-castle Ottawa Scale (NOS) and ROBINS-I. We will analyze the concordance between the two tools for similar domains and for the overall judgments using Kendall’s tau coefficient.

To measure the evaluator burden, we will assess the time taken to apply the ROBINS-I (without and with guidance), and the NOS. To assess the impact of customized training and guidance on the evaluator burden, we will use the generalized linear models. We will use Microsoft Excel and SAS 9.4 to manage and analyze study data, respectively.

Discussion

The quality of evidence from systematic reviews that include NRS depends partly on the study-level ROB assessments. The findings of this study will contribute to an improved understanding of the ROBINS-I tool and how best to use it.
Proportion of bacterial isolates, their antimicrobial susceptibility profile and factors associated with puerperal sepsis among post-partum/aborted women at a referral Hospital in Bahir Dar, Northwest Ethiopia
Authors: Admas Alemale , Gelaw Baye , BelayTessema  , Worku Amsalu , Melese Addisu
Published: January 2020

Background

Puerperal sepsis is any bacterial infection of the genital tract that occurs after childbirth. It is among the leading causes of maternal morbidity and mortality especially in low-income countries including Ethiopia. The aim of this study was to determine the proportion of bacterial isolates, their antimicrobial susceptibility profile and factors associated with puerperal sepsis among post-partum/aborted women at a Referral Hospital in Bahir Dar, Northwest Ethiopia.

Methods

A cross sectional study was conducted from January to May 2017 among 166 post-partum/aborted women admitted to Felege Hiwot Referral Hospital for medical services and suspected for puerperal sepsis.. Socio-demographic data and associated factors were collected using structured questionnaire. Bacteria were isolated and identified from blood samples on Trypton soya broth, blood, Chocolate and MacConkey agars following standard bacteriological procedures. The VITEK 2 identification and susceptibility testing system was used to determine the antimicrobial susceptibility profiles of bacterial isolates. Data were entered and analyzed using SPSS version 20. Factors associated with puerperal sepsis were considered statistically significant atP-value < 0.05.

Results

The overall proportion of bacterial isolates among post-partum/aborted women was 33.7% (56/166); of which 55.4% was caused by Gram-negative and 44.6% was by Gram-positive bacteria. The most frequently isolated bacteria wereEscherichia coli(32.1%) from Gram-negatives andStaphylococcus aureus (33.9%) from Gram-positives. The proportion of other isolates was(7.2%) for Coagulase NegativeStaphylococci(CoNS), (12.5%) forKlebsiella pneumoniae,(10.7%) forAcinetobacter baumanniand(3.6%) forRaoultella ornithinolytica. All isolates of Gram-positive and Gram-negative bacteria were resistant to tetracycline (100%). The gram negatives show resistance to Cefazolin (72.7%), Tetracycline (93.9%) and Ampicillin (100%). The overall prevalence of multidrug resistance (MDR) was 84%. Women having multiparous parity were more likely to develop puerperal sepsis than primiparous parity (AOR 4.045; 95% CI: 1.479–11.061;P < 0.05). Other socio-demographic and clinical factors had no significant association with puerperal sepsis.

Conclusion

About one third of post-partum/aborted women suspected for puerperal sepsis were infected with one or more bacterial isolates. Significant proportion of bacterial isolates showed mono and multi-drug resistance for the commonly prescribed antibiotics. Women with multiparous parity were more likely to develop puerperal sepsis than primiparous parity.
Deep brain stimulation for Tourette’s syndrome
Authors: Xu Wenying , Zhang Chencheng , Deeb Wissam , Patel Bhavana , Wu Yiwen , Voon Valerie , Okun Michael S. , Sun Bomin
Published: January 2020

Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder characterized by the presence of multiple motor and vocal tics. TS usually co-occurs with one or multiple psychiatric disorders. Although behavioral and pharmacological treatments for TS are available, some patients do not respond to the available treatments. For these patients, TS is a severe, chronic, and disabling disorder. In recent years, deep brain stimulation (DBS) of basal ganglia-thalamocortical networks has emerged as a promising intervention for refractory TS with or without psychiatric comorbidities. Three major challenges need to be addressed to move the field of DBS treatment for TS forward: (1) patient and DBS target selection, (2) ethical concerns with treating pediatric patients, and (3) DBS treatment optimization and improvement of individual patient outcomes (motor and phonic tics, as well as functioning and quality of life). The Tourette Association of America and the American Academy of Neurology have recently released their recommendations regarding surgical treatment for refractory TS. Here, we describe the challenges, advancements, and promises of the use of DBS in the treatment of TS. We summarize the results of clinical studies and discuss the ethical issues involved in treating pediatric patients. Our aim is to provide a better understanding of the feasibility, safety, selection process, and clinical effectiveness of DBS treatment for select cases of severe and medically intractable TS.
Expert consensus on the diagnosis and treatment of heat stroke in China
Authors:   Expert Group of Heat Stroke Prevention and Treatment of the People’s Liberation Army, and People’s Liberation Army Professional Committee of Critical Care Medicine, Liu Shu-Yuan , Song Jing-Chun , Mao Han-Ding , Zhao Jin-Bao , Song Qing
Published: January 2020

Heat stroke (HS) is a fatal disease caused by thermal damage in the body, and it has a very high mortality rate. In 2015, the People’s Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China, Expert consensus on standardized diagnosis and treatment for heat stroke. With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years, the 2015 consensus no longer meet the requirements for HS prevention and treatment. It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with China’s national conditions. This new expert consensus includes new concept of HS, recommendations for laboratory tests and auxiliary examinations, new understanding of diagnosis and differential diagnosis, On-site emergency treatment and In-hospital treatment, translocation of HS patients and prevention of HS.
Surgery to avoid fatal complications and secure radicality after definitive chemoradiotherapy for clinical T4N2M0 stage IIIB non-small cell lung cancer: a case report
Authors: Yagi Yuriko , Kodama Ken , Momozane Toru , Kimura Yukio , Takeda Masashi , Kishima Hiroki
Published: January 2020

Background

Chemoradiotherapy (CRT) is the standard treatment for c-stage IIIB non-small cell lung cancer (NSCLC); however, patients who respond to CRT are at risk of developing fatal complications such as massive hemoptysis or infection. In such cases, surgery is an alternative option. Currently, there are limited reports on surgery for complications arising during definitive CRT for locally advanced NSCLC. We report a case of hemoptysis after definitive CRT for c-T4N2M0 stage IIIB NSCLC that was successfully treated with lower bilobectomy combined with left atrial resection.

Case presentation

A 72-year-old man with c-T4N2M0 stage IIIB NSCLC with left atrial invasion developed hemoptysis during CRT, which was discontinued to control hemoptysis. Chest computed tomography revealed a regressed and cavitated tumor. Three weeks after discontinuation of CRT, surgery was performed to avoid fatal complications and secure radicality. We performed lower bilobectomy combined with partial left atrial resection, which was performed using an automatic tri-stapler. The bronchial stump was covered with an omental flap. The resected specimen pathologically showed complete response with fistula between the intermediate bronchus and necrotic cavity in the tumor. His postoperative course was uneventful, and the patient was disease free at 10 months after surgery.

Conclusions

We successfully performed surgery after definitive CRT in a patient with c-T4N2M0 stage IIIB NSCLC. Partial left atrial resection was safely performed with an automatic tri-stapler. A complete pathological response to CRT was achieved. In a case with a chance of complete (R0) resection, when the risk of developing fatal complications might outweigh the risk of post-CRT surgery perioperative complications, surgery should be considered as a treatment option.
Successful removal of a giant esophageal lipoma by thoracoscopic enucleation: a case report
Authors: Goto Wataru , Sakurai Katsunobu , Kubo Naoshi , Tamamori Yutaka , Maeda Kiyoshi , Ohira Masaichi
Published: January 2020

Background

We report a rare case of giant esophageal lipoma treated with thoracoscopic enucleation successfully.

Case presentation

A 69-year-old woman was referred to our department with dysphagia. Computed tomography examination revealed a large hypoattenuating submucosal mass with dense fat in the middle and lower esophagus. Upper gastrointestinal endoscopy revealed a submucosal mass with normal mucosa on the middle and lower esophageal wall. On a diagnosis of esophageal lipoma, we performed a video-assisted thoracoscopic operation and the 14.0 × 6.5 × 3.0 cm in size submucosal tumor was completely enucleated. We could successfully avoid a subtotal esophagectomy with high invasiveness. The patient was discharged on the 36th day after operation, and no symptoms had been noted.

Conclusions

Video-assisted thoracoscopic enucleation with minimal invasiveness may be an appropriate treatment option even for such a huge benign esophageal submucosal tumor.
Cholecystohepatic duct detected during laparoscopic cholecystectomy: a case report
Authors: Maeda Koki , Tabata Masami , Sakamoto Tatsuya , Fujimura Yu , Takeuchi Taijiro , Desaki Ryosuke , Kobayashi Motoyuki , Ohsawa Ichiro , Kato Kenji , Iwata Makoto , Sanda Takayuki
Published: January 2020

Background

The cholecystohepatic duct is a rare form of an aberrant hepatic duct that connects to the gallbladder. Although cholecystohepatic duct is reported to be a very rare anomaly, injury of cholecystohepatic duct during cholecystectomy may result in serious complications. Herein, we present a case of cholecystohepatic duct in the ventral branch of the right posterior inferior segmental bile duct detected during laparoscopic cholecystectomy.

Case presentation

A 77-year-old woman with cholecystolithiasis had been referred to our hospital for surgery. Drip infusion cholecystocholangiography-computed tomography revealed a bile duct branch without communication between the intra- and extrabiliary systems, although the existence of this aberrant hepatic duct was not suspected preoperatively. A 4-port laparoscopic cholecystectomy was performed. After critical view of safety was confirmed, the cystic artery and duct were divided after double clipping. During antegrade mobilization of the gallbladder from the gallbladder bed, a thin, white cord-like material connecting the gallbladder neck and bed was detected. After clipping and dividing it, a cholecystohepatic duct injury was recognized through rechecking the results of the preoperative examinations. Biliary reconstruction was considered unnecessary because of the lesion’s small drainage area. The postoperative course was uneventful, and an enhanced computed tomography performed 6 months after the surgery revealed a dilation in the ventral branch of the right posterior inferior segmental bile duct. The patient’s liver function remained normal, and she had no symptoms of cholangitis 42 months after the surgery.

Conclusions

Although cholecystohepatic duct is a rare anomaly compared to other aberrant hepatic ducts, surgeons performing cholecystectomy should always keep its existence in mind to avoid serious postoperative complications. Ideally, preoperative detection of cholecystohepatic duct is preferable, but even if it is detected during surgery, the appropriate management according to the drainage area is also important.
Surgery for Killian-Jamieson diverticulum: a report of two cases
Authors: Saisho Kohei , Matono Satoru , Tanaka Toshiaki , Mori Naoki , Hino Haruhiro , Fujisaki Masahiro , Nakagawa Masashi , Fujita Fumihiko , Akagi Yoshito
Published: January 2020

Background

Killian-Jamieson diverticulum (KJD) is a rare diverticulum arising from a muscular gap in the anterolateral wall of the proximal cervical esophagus. The first choice of treatment for KJD remains controversial due to its rare incidence. Here, we report two cases of KJD for which we performed different surgery: diverticulectomy in one case and diverticulopexy in the other.

Case presentation

Case 1 involved a 58-year-old woman presenting progressive pharyngeal discomfort for the past year. She was diagnosed as KJD using endoscopic and radiographic findings. She underwent diverticulectomy with cricopharyngeal and proximal esophageal myotomy. Staple line leakage developed at 1 month after surgery and was successfully treated conservatively. At 5 months after surgery, she was asymptomatic. Case 2 involved a 77-year-old woman presenting dysphagia for the past 2 years. She had a history of bilateral breast cancer and had hypertension, asthma, and osteoporosis. Taking her age and medical history into account, we selected diverticulopexy with cricopharyngeal and proximal esophageal myotomy. The postoperative course was uneventful. At 2 years after surgery, she remained free of dysphagia.

Conclusion

The first choice of surgery for KJD is diverticulectomy. In a high-risk patient, diverticulopexy is a reasonable treatment. We recommend the addition of myotomy as a part of any surgical treatment.
Tail dependence in emerging ASEAN-6 equity markets: empirical evidence from quantitative approaches
Authors: Duong Duy , Huynh Toan Luu Duc
Published: January 2020

This study contributes a rich set of quantitative methodologies including a non-parametric approach (Chi-plots and K-plots) as well as copulas (traditional and time-varying with Student’s t-copulas) to the existing literature in terms of determining the dependence structure in ASEAN stock markets. Drawing on the emerging ASEAN equity returns of six countries from January 2001 to December 2017, we found that Student’s t-copulas under time-varying approach is the most appropriate approach to explain these co-movements. Among all research return pairs, the dependence between Vietnam and other ASEAN equity indices has the lowest value. Meanwhile, all couples show left- and right- tail dependence by each pair for pre- and post- financial shocks. Hence, diversification across these pairs of equity markets from ASEAN is still adequate for international investors, though it might trigger contagion risks.
MicroRNAs in bovine milk exosomes are bioavailable in humans but do not elicit a robust pro-inflammatory cytokine response
Authors: Mutai Ezra , Ramer-Tait Amanda E. , Zempleni Janos
Published: January 2020

Background

Bovine milk exosomes are studied for their roles as bioactive food compounds and as vehicles for drug delivery. Both lines of investigation converge on immune function, e.g., immune regulation by absorption of microRNAs encapsulated in milk exosomes across species boundaries, and the possibility of exosomes and their cargos triggering an immune response if used in drug delivery. This study assessed the bioavailability of immune-related microRNAs from bovine milk and changes in plasma cytokine concentrations after milk consumption in humans, and the secretion of cytokines by human peripheral blood mononuclear cells (PBMCs) cultured with milk exosomes transfected with immune-relevant microRNAs.

Results

Human plasma samples were collected before and at timed intervals after a milk meal and analyzed for concentrations of six immune-relevant microRNAs and nine cytokines. The peak plasma concentrations of miR-15b-5p, miR-21-5p, miR-106b-5p, and miR-223-3p were 60 ± 9.80% to 162 ± 31.80% higher after milk consumption (Ct values 23 ± 1.2 to 26 ± 1.1 cycles) compared to baseline values (P < 0.05). Plasma concentrations of TNF-alpha were not significantly different before versus after milk consumption; eight other cytokines were below detection limit. PBMCs were collected before and six hours after milk consumption and cultured with or without concanavalin A (ConA). TNF-alpha, IL-1β, IL-6 and IL-10 were detectable in culture media, but concentrations did not depend on milk consumption prior to PBMC isolation (P > 0.05). When PBMC cultures from fasted subjects were supplemented with milk exosomes that had been transfected with immune-relevant microRNAs, the concentrations of IL-1β, IL-6, IL-10 and TNF-alpha were 29 ± 12% to 220 ± 33% higher than controls cultured with non-transfected exosomes (P < 0.05), but cytokine concentrations were not different compared with control exosomes transfected with scrambled microRNA (P > 0.05).

Conclusions

MicroRNAs in bovine milk exosomes are bioavailable. Milk exosomes do not elicit an increase of plasma cytokines following oral administration.

Trial registration

ISRCTN registry ID: 16329971. Retrospectively registered on February 7th, 2019.
An emerging framework for fully incorporating public involvement (PI) into patient-reported outcome measures (PROMs)
Authors: Carlton J. , Peasgood T. , Khan S. , Barber R. , Bostock J. , Keetharuth A. D.
Published: January 2020

Patient-reported outcome measures (PROMs) are widely used in the United Kingdom (UK) and internationally to report and monitor patients’ subjective assessments of their symptoms and functional status and also their quality of life. Whilst the importance of involving the public in PROM development to increase the quality of the developed PROM has been highlighted this practice is not widespread. There is a lack of guidance on how public involvement (PI) could be embedded in the development of PROMs, where the roles can be more complex than in other types of research. This paper provides a timely review and sets out an emerging framework for fully incorporating PI into PROM development.
Patients’ perspectives of outcomes after total knee and total hip arthroplasty: a nominal group study
Authors: Goodman Susan M. , Mehta Bella , Mirza Serene Z. , Figgie Mark P. , Alexiades Michael , Rodriguez Jose , Sculco Peter , Parks Michael , Singh Jasvinder A.
Published: January 2020

Background

While total joint replacements (TJR) are frequently performed, there is little qualitative research to define the outcomes most important to patients.

Methods

Patients who had received total hip (THR) or total knee replacements (TKR) participated in 8 nominal groups to answer the question “What result/results matter the most to a patient undergoing/having a knee or hip replacement?” Total 270 votes were allocated.

Results

Eight nominal groups were performed with 45 patients, 6 groups with mean age (71.1 ± 9.3), and 2 with 9 younger patients (mean age 36.8 ± 7.4). All had TJR between 2016 and 2018; overall, 40% were male, 15.6% were Black, and 75% were performed for osteoarthritis. While all groups ranked the same top 3 outcomes, responses varied with age: 1) relief of pain (46% vs. 35% in the young groups); 2) improved function including mobility (29% vs. 18% in the young groups); 3) restored quality of life (13% vs 33% of votes in the younger group).

Conclusion

Relief of pain and restoration of function, and improved quality of life are the 3 outcomes ranked highest by patients, confirming their inclusion in TJR clinical trials.
The sedimentary dynamics of Sabellaria alveolata bioconstructions (Ostia, Tyrrhenian Sea, central Italy)
Authors: Lisco Stefania Nunzia , Acquafredda Pasquale , Gallicchio Salvatore , Sabato Luisa , Bonifazi Andrea , Cardone Frine , Corriero Giuseppe , Gravina Maria Flavia , Pierri Cataldo , Moretti Massimo
Published: January 2020

Sabellaria alveolata (Linnaeus 1767) is a polychaete able to build bioconstructions of different thickness, size and patchiness, in intertidal and subtidal environments. Its biological features have been the object of numerous studies worldwide. The worm reefs are formed by millions of tubes built by sand and shells (whole or in fragments) bonded together with a strong glue produced by the worm itself. Hence, Sabellaria alveolata represents a sedimentological asset for the coastal protection, since it contributes to create natural barriers against storm waves and erosion, and supplies the beach with new sandy deposits. This work shows a multidisciplinary approach to studying a bioconstruction of Sabellaria alveolata along the Latium coast (Ostia, Tyrrhenian Sea, central Italy), proposing image analysis as a novel technique to investigate worm reefs, along with classical sedimentological/ecological tools. The Sabellaria bioconstructions have been analysed at different scales of observation, suggesting the more appropriate strategies to develop a reliable model illustrating the different growth steps of these bioconstructions.
Corrected calculation of the overestimated ejection fraction in valvular heart disease by phase-contrast cardiac magnetic resonance imaging for better prediction of patient morbidity
Authors: Yousef Hosam A. , Hamdan Abdulrahman E. S. , Elminshawy Ahmed , Mohammed Nisreen A. A. , Ibrahim Ahmed S.
Published: January 2020

Background

To establish a more accurate technique for the assessment of the left ventricular function correlated with patients’ clinical condition avoiding the miscalculation of the ejection fraction in valvular regurgitation. A prospective study carried out between July 2018 and June 2019. The studied group included 35 subjects, 25 patients with valvular regurgitation, and 10 healthy control subjects. All subjects underwent cardiovascular magnetic resonance examination to evaluate the ejection fraction by two methods: the volumetric method which assesses stroke volume via subtraction of the end-systolic volume from the end-diastolic volume, and phase-contrast method which assesses the aortic stroke volume via a through-plane phase contrast across the aortic valve. The sensitivity, specificity, P value and the area under the curve of both methods were calculated.

Results

In the healthy group, using the volumetric method, the calculated mean ejection fraction was 62.44 ± 6.61, while that calculated by the phase-contrast method was 64.34 ± 5.33, with a non-significant difference (P = 0.62) showing the validity of the phase-contrast method. In the patients’ group, by using the volumetric method, the calculated mean ejection fraction was 47.17 ± 14.31%, which was significantly higher than that calculated by the phase-contrast method (29.39 ± 7.98%) (P = 0.02). According to the results of the calculation of the ejection fraction by the volumetric method, there were 18 patients (72%) having impaired cardiac function and 7 (28%) patients of normal function; while according to the phase-contrast method, all the 25 patients had impaired cardiac function. The current study shows that the phase-contrast cardiac magnetic resonance had 89.29% sensitivity and 85.7% specificity in diagnosing impaired cardiac function with the area under the curve of 0.87 (P = 0.00).

Conclusion

The phase-contrast cardiac magnetic resonance can provide a better assessment of the ejection fraction in valvular regurgitation.
Linking Porter’s generic strategies to firm performance
Authors: Islami Xhavit , Mustafa Naim , Topuzovska Latkovikj Marija
Published: January 2020

In this study, the significance of using Porter’s generic strategies in firms that operate in competitive environments is investigated. The aim is to indicate the effects of Porter’s generic strategies (low-cost strategy, differentiation strategy, and focus strategy) on firm performance. The questionnaires of the study have been prepared, the responses have been obtained, and the econometric model is constructed to measure these relationships. Findings stemmed by data that were taken from 113 firms that operate in the Republic of Kosovo.ttest, Pearson’s correlation analysis, and multivariate regression analysis were used to provide testing of hypotheses. Econometric results suggest that pursuing differentiation strategy provides higher firm performance compared to two other Porter’s generic strategies (low-cost strategy or focus strategy) that have a positive impact as well.
Effects of parenting interventions for mothers with depressive symptoms and an infant: systematic review and meta-analysis
Authors: Rayce Signe B. , Rasmussen Ida S. , Væver Mette Skovgaard , Pontoppidan Maiken
Published: January 2020

Background

Postpartum depression is common in the perinatal period and poses a risk for the development of the infant and the mother–infant relationship. Infancy is a critical developmental period of life and supportive parenting is crucial for healthy development, however, the effects of interventions aimed at improving parenting among mothers with depression are uncertain.

Aims

To assess the effects of parenting interventions on parent–child relationship and child development among mothers with depressive symptoms with 0–12-month-old infants.

Method

We conducted a systematic review with the inclusion criteria: (a) randomised controlled trials of structured psychosocial parenting interventions for women with depressive symptoms and a child aged 0–12 months in Western Organisation for Economic Co-operation and Development countries, (b) minimum three sessions with at least half of these delivered postnatally and (c) outcomes relating to the parent–child-relationship and/or child development. Publications were extracted from 10 databases in September 2018 and supplemented with grey search and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analysis.

Results

Eight papers representing seven trials were included. We conducted meta-analysis on the post-intervention parent–child relationship. The analysis included six studies and showed no significant effect. For individual study outcomes, no significant effects on the majority of both the parent–child relationship and child development outcomes were reported.

Conclusions

No evidence of the effect of parenting interventions for mothers with depressive symptoms was found on the parent–child relationship and child development. Larger studies with follow-up assessments are needed, and future reviews should examine the effects in non-Western countries.
Estrogen and Progesterone Receptor Testing in Breast Cancer: ASCO/CAP Guideline Update
Authors: Allison Kimberly H. , Hammond M. Elizabeth H. , Dowsett Mitchell , McKernin Shannon E. , Carey Lisa A. , Fitzgibbons Patrick L. , Hayes Daniel F. , Lakhani Sunil R. , Chavez-MacGregor Mariana , Perlmutter Jane , Perou Charles M. , Regan Meredith M. , Rimm David L. , Symmans W. Fraser , Torlakovic Emina E. , Varella Leticia , Viale Giuseppe , Weisberg Tracey F. , McShane Lisa M. , Wolff Antonio C.
Published: January 2020

PURPOSE

To update key recommendations of the American Society of Clinical Oncology/College of American Pathologists estrogen (ER) and progesterone receptor (PgR) testing in breast cancer guideline.

METHODS

A multidisciplinary international Expert Panel was convened to update the clinical practice guideline recommendations informed by a systematic review of the medical literature.

RECOMMENDATIONS

The Expert Panel continues to recommend ER testing of invasive breast cancers by validated immunohistochemistry as the standard for predicting which patients may benefit from endocrine therapy, and no other assays are recommended for this purpose. Breast cancer samples with 1% to 100% of tumor nuclei positive should be interpreted as ER positive. However, the Expert Panel acknowledges that there are limited data on endocrine therapy benefit for cancers with 1% to 10% of cells staining ER positive. Samples with these results should be reported using a new reporting category, ER Low Positive, with a recommended comment. A sample is considered ER negative if < 1% or 0% of tumor cell nuclei are immunoreactive. Additional strategies recommended to promote optimal performance, interpretation, and reporting of cases with an initial low to no ER staining result include establishing a laboratory-specific standard operating procedure describing additional steps used by the laboratory to confirm/adjudicate results. The status of controls should be reported for cases with 0% to 10% staining. Similar principles apply to PgR testing, which is used primarily for prognostic purposes in the setting of an ER-positive cancer. Testing of ductal carcinoma in situ (DCIS) for ER is recommended to determine potential benefit of endocrine therapies to reduce risk of future breast cancer, while testing DCIS for PgR is considered optional. Additional information can be found at www.asco.org/breast-cancer-guidelines .
Understanding Aboriginal Peoples’ Cultural and Family Connections Can Help Inform the Development of Culturally Appropriate Cancer Survivorship Models of Care
Authors: Ristevski Eli , Thompson Sharyn , Kingaby Sharon , Nightingale Claire , Iddawela Mahesh
Published: January 2020

PURPOSE

To explore the cancer diagnosis, treatment, and survivorship experiences of Aboriginal people in the Gippsland region, Victoria, Australia, and identify factors critical to the development of a culturally appropriate cancer survivorship model of care.

PATIENTS AND METHODS

Yarning circles were used to capture the stories of 15 people diagnosed with cancer and/or those of family members. Yarning circles were conducted in two locations in the Gippsland region. Sessions were facilitated by an Aboriginal Elder, audio recorded, and transcribed verbatim. Thematic analysis of the data were triangulated among three researchers and incorporated researcher reflexivity.

RESULTS

Cultural connections and family were critical supports on the cancer journey. Putting the needs of the family first and caring for sick family members were more important than an individual’s own health. There was “no time to grieve” for one’s own cancer diagnosis and look after oneself. Cancer was a private experience; however, the constancy of deaths highlighted the importance of raising family awareness. Health professionals did not always understand the importance of people’s cultural and family supports in their treatment and recovery. There were negatives attitudes in hospitals when family come to visit, seeing family as too large and overstaying visiting times. Health professionals did not seek family assistance with communication of information to family members whose literacy level was low, nor did they include family in treatment decision-making. Access to services depended on family support with transport, finances, and family responsibilities, often resulting in lapses in treatment and follow-up services.

CONCLUSION

Understanding the importance of Aboriginal peoples’ cultural and family connections can help to inform the development of culturally safe cancer survivorship models of care.
Current Treatment Strategies for Multiple Myeloma
Authors: Branagan Andrew , Lei Matthew , Lou Uvette , Raje Noopur
Published: January 2020

The treatment of multiple myeloma (MM) continues to evolve with the approval of numerous agents over the past decade. Advances in treatment have led to the incorporation of these newer therapies into the treatment paradigm, with improvements in overall survival and the possibility of deep responses including a minimal residual disease–negative state. The strategy of triplet therapies for patients with newly diagnosed MM, followed by high-dose chemotherapy and autologous stem-cell transplantation for eligible patients, and subsequently consolidation and maintenance therapy, is the current treatment roadmap for patients. However, patients with MM will ultimately develop refractoriness to antimyeloma therapies. In this article, we summarize our current practice of managing patients with MM. We highlight our approach to patients with newly diagnosed MM who are transplantation eligible and ineligible and highlight risk-adapted strategies for these patients. In addition, we discuss our approach to the management of patients with relapsed or refractory MM. Last, we review standard therapies and emerging strategies such as targeted approaches, immune-based therapies, and drugs with novel mechanisms of action. Trials evaluating chimeric antigen receptor T cells targeting B-cell maturation antigen are ongoing and are only one of several novel approaches targeting cell maturation antigen, which include the use of bispecific T-cell engager antibodies and antibody drug conjugates. Emerging therapies offer the promise of more individualized approaches in the management of patients with MM and ultimately may result in the possibility of being one step closer to curing patients with MM.
Schizosaccharomyces pombe DNA translocases Rrp1 and Rrp2 have distinct roles at centromeres and telomeres that ensure genome stability
Authors: Barg-Wojas Anna , Muraszko Jakub , Kramarz Karol , Schirmeisen Kamila , Baranowska Gabriela , Carr Antony M. , Dziadkowiec Dorota
Published: January 2020

The regulation of telomere and centromere structure and function is essential for maintaining genome integrity. Schizosaccharomyces pombe Rrp1 and Rrp2 are orthologues of Saccharomyces cerevisiae Uls1, a SWI2/SNF2 DNA translocase and SUMO-targeted ubiquitin ligase. Here, we show that Rrp1 or Rrp2 overproduction leads to chromosome instability and growth defects, a reduction in global histone levels and mislocalisation of centromere-specific histone Cnp1. These phenotypes depend on putative DNA translocase activities of Rrp1 and Rrp2, suggesting that Rrp1 and Rrp2 may be involved in modulating nucleosome dynamics. Furthermore, we confirm that Rrp2, but not Rrp1, acts at telomeres, reflecting a previously described interaction between Rrp2 and Top2. In conclusion, we identify roles for Rrp1 and Rrp2 in maintaining centromere function by modulating histone dynamics, contributing to the preservation of genome stability during vegetative cell growth.
A GTPase-induced switch in phospholipid affinity of collybistin contributes to synaptic gephyrin clustering
Authors: Kilisch Markus , Mayer Simone , Mitkovski Miso , Roehse Heiko , Hentrich Jennifer , Schwappach Blanche , Papadopoulos Theofilos
Published: January 2020

Synaptic transmission between neurons relies on the exact spatial organization of postsynaptic transmitter receptors, which are recruited and positioned by dedicated scaffolding and regulatory proteins. At GABAergic synapses, the regulatory protein collybistin (Cb, also known as ARHGEF9) interacts with small GTPases, cell adhesion proteins and phosphoinositides to recruit the scaffolding protein gephyrin and GABAA receptors to nascent synapses. We dissected the interaction of Cb with the small Rho-like GTPase TC10 (also known as RhoQ) and phospholipids. Our data define a protein–lipid interaction network that controls the clustering of gephyrin at synapses. Within this network, TC10 and monophosphorylated phosphoinositides, particulary phosphatidylinositol 3-phosphate (PI3P), provide a coincidence detection platform that allows the accumulation and activation of Cb in endomembranes. Upon activation, TC10 induces a phospholipid affinity switch in Cb, which allows Cb to specifically interact with phosphoinositide species present at the plasma membrane. We propose that this GTPase-based regulatory switch mechanism represents an important step in the process of tethering of Cb-dependent scaffolds and receptors at nascent postsynapses.
Detection of compound heterozygous variants in LPIN1 does not necessarily imply pathogenicity in a patient with rhabdomyolysis
Authors: Finsterer Josef , Aliyev Rahim
Published: January 2020

In a recent article by Yim et al., a 15-month-old male is described who experienced severe rhabdomyolysis with a creatine-kinase value (CKV) of 127494 U/l one day after intramuscular injection of an unidentified drug by the general practitioner. Rhabdomyolysis was not attributed to this injected drug but to compound heterozygous variants in LPIN1. The study has a number of shortcomings. Triggers of rhabdomyolysis should be unequivocally identified, a more extensive family history should be taken, and previous CKVs should be provided. Functional and biochemical tests should be carried out to confirm or exclude pathogenicity of the LPIN1 variants.
Body composition and physical ability of trained and non-trained elderly women
Authors: Hernits Kertu , Vaher Ivi
Published: January 2020

Body composition and physical ability affect the life quality and health condition of elderly people. The aim of this study was to evaluate and compare body composition and physical ability of regularly trained and non-trained elderly women. 22 elderly women in the average age 74 years were divided into two groups based on their physical activity: twice a week training and non-training groups. Body weight, body height, blood pressure and waist-hip ratio were measured, and the body composition was evaluated with a SECA 525 analyser. A handgrip strength test, a “Timed Up and Go” test, “Five Times Sit to Stand” test were also performed by the participants. Based on the results of the study, the following conclusions were made: regularly training women had lower body mass index and systolic blood pressure than non-trained women in the same age; regularly training women had lower body fat mass and higher total body water, fat-free mass and muscle mass than non-training women in the same age; regularly training women had greater hand grip strength than nontraining women in the same age; regularly training women performed “Five Times Sit to Stand” test and “Timed Up and Go” test faster than non-training women in the same age.
Habitual physical activity pattern and its association with gender and body composition in healthy adults
Authors: Lagzdiņa Rudīte , Rumaka Maija
Published: January 2020

An appropriate level of physical activity (PA) is beneficial for health and weight management. This study examines the relationship of habitual PA and activity energy expenditure (AEE) in a typical week with gender and body composition parameters. Data of habitual PA of 72 healthy adults were collected with the heart rate and motion sensor (Actiheart). Total and segmental body fat was measured with bioelectrical impedance analyser. Men were more active in total and on working days and had shorter light and longer moderate and vigorous PA on working days than females (p<0.05). Females had less inactive and sitting time on days off. Inactive and sitting time in working days for both genders correlated positively with visceral fat rating, body and leg fat % (p<0.05). In male’s duration of working days’ moderate PA correlated inversely, but light PA positively with these parameters (p<0.05). Males with more vigorous PA in working day and AEE in days off had lower body fat % (p<0.05). A distinctive PA pattern on working days and days off indicates a gender-related differences. Decrease of time of inactivity and light PA and increase of duration of moderate and vigorous PA was associated with lower body and segmental fat amount.
Physical fitness of physiotherapy students
Authors: Juhkam Edward , Vaher Ivi
Published: January 2020

One of the inevitable and crucial elements of a physiotherapist’s work, in addition to professional competence, is physical fitness. The aim of the study was to evaluate and compare the level of health and physical fitness of the first year physiotherapy program students in Tartu Health Care College (THCC) and Kaunas College of Applied Sciences (KCAS). The subjects were 20 and 29 physiotherapy students, respectively. The students’ physical fitness has been assessed by the following tests: Hand grip test, Stork test, ACSM’s push up test, Biering–Sorensen test, ACSM’s curl up test, YMCA sit– and– reach test, and Harvard step–test. The physical fitness level of THCC students were average and below average in different categories. Only the endurance of the abdominal muscle of THCC male students was “excellent”. However, the health indicators (BMI and waist-hip ratio) of both gender of THCC remained within normal range. In most tests, both male and female students from KCAS received a good grade and their avarage fitness level was better than students from THCC. Despite the fact that BMI results of KCAS students remained within normal range and did not differ from THCC students result, their waist–hip ratio was higher. This may indicate an increased abdominal obesity and thereby health risk. In conclusion, the fintess level of the first-year physiotherapy students of THCC is not satisfactory that can negatively affect their future health and coping with future work.
ПОИСК РАЦИОНАЛЬНЫХ ХАРАКТЕРИСТИК ШИН ВЕДУЩИХ КОЛЕС ТЕХНОЛОГИЧЕСКОГО МОДУЛЯ
Authors: Sidorov Maxim Vladimirovich , Sidorova Anastasia Vladimirovna
Published: January 2020

Рассмотрена динамическая модель технологического модуля с двумя вращающимися массами: обода и шины ведущего колеса и поступательной массы технологического модуля. Шина ведущего колеса технологического модуля характеризуется коэффициентами жесткости и демпфирования. Приведена методика оптимизации характеристики пневматической шины ведущего колеса технологического модуля с учетом спектральной плотности выходной нагрузки технологического модуля. За показатель эффективности демпфирования шины ведущих колес технологического модуля принята дисперсия спектральной плотности. Резонансный эффект определяется по наличию у кривой спектральной плотности колебаний выходного процесса технологического модуля явно выраженных экстремумов (пиков).За рациональные значения коэффициентов жесткости и демпфирования шины ведущих колес технологического модуля при выполнении технологической операции МТА с ТМ приняты их значения, соответствующие минимальному значению целевой функции.Цель – определение рациональных параметров пневматических шин колес технологического модуля по минимальному значению целевой функции.Метод или методология проведения работы: в статье использованы методы статистической динамики и теории случайных процессов.Результаты: повышена плавность хода трактора демпфированием колебаний тягового усилия за счет подбора рациональных значений эластичности пневматических шин колес и инерционности поступательной массы технологического модуля.Область применения результатов: полученные результаты целесообразно применять для повышения плавности хода трактора и виброзащищенности тракториста.
Content Selection of Teaching Students Reflexive Activity Methods at English Lessons under Basic Secondary Education
Authors: Kazanceva Elena , Sokolova Ol'ga
Published: January 2020

The article is devoted to the problem of reflexive skills forming of students at English lessons and the absence of component list in the content selection of teaching English. In conditions of educational standard implementation school English lesson is to develop students’ reflexive skills, thus this article contains the description of content selection peculiarities in teaching students reflexive activity methods within the school subject “Foreign language”.
The Student’s Brain As Decoder with Increasing Bandwidth: the Simulation Modeling Results
Authors: Mayer Robert
Published: January 2020

Modern theory of learning uses v arious metaphors and analogies that explain the educational process features. The article is devoted to the analysis and further development of metaphors «man – communication channel» and «brain – message decoder» widely used in didactics and cognitive psychology. It discusses the possibility of semantic complexity assessing of the educational text or oral message and building its complexity profile. For this, the analyzed text is divided into elementary phrases expressing simple thoughts. The semantic complexity of phrase relative to certain thesaurus is considered to be equal to the number of words that need to be spoken to explain it to the student with the given thesaurus. Assessing the complexity of each phrase, you can create complex text profile – graph of dependence of the phrase presence probability in the text from its complexity. The concepts «transmission coefficient of the brain decoder», «volume and information understanding coefficients» are introduced. The mathematical modeling methods show how the learning result depends on the co mplexity profile of the educational material and the capacity of the student’s «decoder brain». With the growth of student’s knowledge an increase of the volume and information understanding coefficients occurs. The computer model simulating the learning process is built. It is taken into account that: 1) the teacher and the student form an information semantic system, and the training is reduced to the perception (listening or reading) of the increasing complexity texts sequence; 2) as the student learns more complex ideas (phrases), the message decoder capacity in creases because of the «near development zone»; 3) the greater the complexity of the acquired ideas (phrases), the higher the rate of forgetting. The simulation results show that the considered metaphor and the proposed models really allow to explain how the training takes place.