bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of NPY1 Receptor Antagonism on Intervertebral Disc and Bone Changes in Ovariectomized Rats
Authors: Tucci Michelle , Wilson Gerri A. , McGuire Robert , Benghuzzi Hamed A.
Published: August 2020

Study Design:

Basic science.

Objective:

To compare the effects of a neuropeptide Y1 receptor antagonist (NPY-1RA) to estrogen on maintaining vertebral bone microarchitecture and disc height in a rat model of menopause.

Methods:

This study was an institutional animal care approved randomized control study with 104 ovariectomized rats and 32 intact control animals. Comparison of disc height, trabecular bone, body weights, circulating levels of NPY and estrogen, and distribution of Y1 receptors in the intervertebral disc in an established rodent osteoporotic model were made at baseline and after 2, 4, and 8 weeks after receiving either an implant containing estrogen or an antagonist to the neuropeptide Y1 receptor. Data was compared statistically using One-way analysis of variance.

Results:

Circulating levels of estrogen increased and NPY decreased following estrogen replacement, with values comparable to ovary-intact animals. NPY-1RA-treated animals had low estrogen and high NPY circulating levels and were similar to ovariectomized control rats. Both NPY-1RA and estrogen administration were able reduce, menopause associated weight gain. NPY-1RA appeared to restore bone formation and maintain disc height, while estrogen replacement prevented further bone loss.

Conclusion:

NPY-1RA in osteoporotic rats activates osteoblast production of bone and decreased marrow and body fat more effectively than estrogen replacement when delivered in similar concentrations. Annulus cells had NPY receptors, which may play a role in disc nutrition, extracellular matrix production, and pain signaling cascades.
Efficacy, Cost, and Complications of Demineralized Bone Matrix in Instrumented Lumbar Fusion: Comparison With rhBMP-2
Authors: Eleswarapu Ananth , Rowan F. Andrew , Le Hai , Wick Joseph B. , Roberto Rolando F. , Javidan Yashar , Klineberg Eric O.
Published: August 2020

Study Design:

Retrospective cohort study.

Objectives:

To evaluate demineralized bone matrix as an adjunct for instrumented lumbar spine fusion compared with recombinant human bone morphogenetic protein–2 (rhBMP-2).

Methods:

Clinical and radiographic review was performed of 43 patients with degenerative spine disease treated with posterolateral spinal fusion with or without posterior or transforaminal lumbar interbody fusion. Final analysis included sixteen patients treated with demineralized bone matrix (DBM; Accell Evo3, SeaSpine) compared with a retrospective matched group of 21 patients treated with rhBMP-2 (rhBMP-2, Infuse, Medtronic). All patients were followed for 24 months. Fusion was evaluated by computed tomography and/or x-ray. Clinical outcomes included visual analogue scale (VAS), Oswestry Disability Index (ODI), and Short Form 12 (SF-12).

Results:

Overall fusion rate, including posterolateral and/or interbody fusion, was 100% for both groups, though the fusion rates in the posterolateral space alone were 93.5% and 100% for the DBM and rhBMP-2 groups, respectively. Clinical outcomes were similar between groups, with the DBM group showing greater improvement in ODI. The rhBMP-2 group showed higher rates of radiographic complications with 7 of 21 patients (33.3%) demonstrating either adjacent level fusion or ectopic bone formation, compared with zero in the DBM group. Average biologic cost per level was $1522 for DBM and $3505 for rhBMP-2.

Conclusions:

DBM and rhBMP-2 demonstrated similar radiographic and clinical outcomes in instrumented lumbar fusions. rhBMP-2 was associated with higher rates of radiographic complications and significantly higher costs.
Exemplary and Unacceptable Workplace Communication Skills
Authors: Coffelt Tina A. , Smith Frances L. M.
Published: August 2020

Thematic analysis of interviews with 22 managers highlight their perspectives on exemplary and unacceptable workplace communication skills. Exemplary skills were perceived to be relatability, documentation, and audience awareness/adaptation, while unacceptable skills were verbal aggression, deception, and defensive communication behaviors. The findings contribute to closing-the-gap research by identifying highly notable skills—both positive and negative—on typical lists of business and professional communication skills. This study also enriches anticipatory socialization scholarship by its application to vocational preparation. Business and professional communication instructors can use the findings here when deciding what topics to emphasize in a course.
Roads to China and infrastructural relations in Nepal
Authors: Murton Galen
Published: August 2020

Across the Himalaya region, infrastructure development constitutes an array of material practices that produce space for both Nepali and Chinese state making efforts in historically roadless places. In northern Nepal, the production of large-scale transportation infrastructure has reached unprecedented levels, and Chinese interventions under the Belt and Road Initiative continue to fuel Kathmandu’s development imaginary. Examining the anticipation, articulation and implementation of road networks between northern Nepal and Chinese Tibet, I analyse the incorporation of a small development project into larger international transportation systems to argue that infrastructure is a symbolic project of national development imaginaries, a process and practice of state making, and a vector for the spatial operations of geopolitical power. Putting infrastructure studies into closer conversation with political geography, I propose infrastructural relationality as a heuristic that illuminates how trans-national road construction advances regional development objectives, visible specifically through inter-related projects, practices and processes between China and Nepal.
Probiotic characteristics of Lactobacillus plantarum E680 and its effect on Hypercholesterolemic mice
Authors: Zheng Zhi-yao , Cao Fei-Wei , Wang Wei-jun , Yu Jing , Chen Chen , Chen Bo , Liu Jian-xin , Firrman Jenni , Renye John , Ren Da-xi
Published: August 2020

Background

Probiotics have been reported to reduce total cholesterol levels in vitro, but more evidence is needed to determine the clinical relevance of this activity. Chinese traditional fermented pickles are a good source of lactic acid bacteria. Therefore, pickle samples were collected for screening lactic acid bacteria based on their ability to survive stresses encountered during gastrointestinal passage and cholesterol reducing potency.

Results

Seventy five lactic acid bacteria strains were isolated from 22 fermented pickles. From these bacteria, Lactobacillus plantarum E680, showed the highest acid (85.25%) and bile tolerance (80.79%). It was sensitive to five of the eight antibiotics tested, inhibited the growth of four pathogenic bacteria, and reduced the total cholesterol level by 66.84% in broth culture. In vivo testing using hypercholesterolemic mice fed high-fat emulsion, independent of food intake, found that L. plantarum E680 suppressed body weight gain and reduced total cholesterol and low-density lipoprotein cholesterol levels, with no effect on high-density lipoprotein cholesterol.

Conclusions

Chinese traditional fermented pickles are a good source for probiotics. L. plantarum E680, isolated from pickles, was acid and bile tolerant, sensitive to antibiotics, and reduced cholesterol levels both in vitro and in vivo. Based on these results, L. plantarum E680 may have potential as a novel probiotic for the development of cholesterol-lowering functional food.
The contribution of vascular risk factors in neurodegenerative disorders: from mild cognitive impairment to Alzheimer’s disease
Authors: Cheng Yu-Wen , Chiu Ming-Jang , Chen Ya-Fang , Cheng Ting-Wen , Lai Ya-Mei , Chen Ta-Fu
Published: August 2020

Background

Optimization of vascular risk factor control is emerging as an alternative approach to improve cognitive outcomes in Alzheimer’s disease, although its efficacy is still under debate. We aimed to investigate the contribution of vascular risk factors on Alzheimer’s biomarkers and conversion rate to dementia in subjects with mild cognitive impairment (MCI) with low cerebral small vessel disease burden.

Methods

Two hundred ninety-five newly diagnosed MCI subjects were enrolled from March 2005 to May 2017 for a cross-sectional assessment of vascular risk factors and Alzheimer’s plasma and imaging biomarkers, followed by a cognitive outcome assessment 24 months after enrollment. The association between vascular risk factors and Alzheimer’s biomarkers were tested using multivariable linear regression models adjusted with age, gender, education, and APOE ε4 allele. The association between vascular risk factors and conversion to dementia was tested using multivariable logistic regression models adjusted with age, gender, education, and baseline Mini-Mental State Examination (MMSE) score.

Results

At baseline, higher low-density lipoprotein (LDL) cholesterol level was associated with more advanced plasma biomarkers, including Aβ42/Aβ40 ratio (P = 0.012) and tau level (P = 0.001). A history of hypertension was associated with more advanced white matter hyperintensity (P = 0.011), while statin therapy for dyslipidemia was associated with less advanced white matter hyperintensity (P = 0.002). At 24 months, individual vascular risk factor was not significantly associated with cognitive outcome. By contrast, statin therapy for dyslipidemia was associated with reduced conversion to dementia (adjusted OR = 0.191, 95% CI = 0.062~0.586, P = 0.004).

Conclusions

For MCI subjects, dyslipidemia may contribute to AD-related neurodegeneration while hypertension may contribute to vascular pathology. The association between statin therapy for dyslipidemia and reduced conversion to dementia supports further interventional study to evaluate the potential beneficial effect of statin in MCI subjects.
The human gut archaeome: identification of diverse haloarchaea in Korean subjects
Authors: Kim Joon Yong , Whon Tae Woong , Lim Mi Young , Kim Yeon Bee , Kim Namhee , Kwon Min-Sung , Kim Juseok , Lee Se Hee , Choi Hak-Jong , Nam In-Hyun , Chung Won-Hyong , Kim Jung-Ha , Bae Jin-Woo , Roh Seong Woon , Nam Young-Do
Published: August 2020

Background

Archaea are one of the least-studied members of the gut-dwelling autochthonous microbiota. Few studies have reported the dominance of methanogens in the archaeal microbiome (archaeome) of the human gut, although limited information regarding the diversity and abundance of other archaeal phylotypes is available.

Results

We surveyed the archaeome of faecal samples collected from 897 East Asian subjects living in South Korea. In total, 42.47% faecal samples were positive for archaeal colonisation; these were subsequently subjected to archaeal 16S rRNA gene deep sequencing and real-time quantitative polymerase chain reaction-based abundance estimation. The mean archaeal relative abundance was 10.24 ± 4.58% of the total bacterial and archaeal abundance. We observed extensive colonisation of haloarchaea (95.54%) in the archaea-positive faecal samples, with 9.63% mean relative abundance in archaeal communities. Haloarchaea were relatively more abundant than methanogens in some samples. The presence of haloarchaea was also verified by fluorescence in situ hybridisation analysis. Owing to large inter-individual variations, we categorised the human gut archaeome into four archaeal enterotypes.

Conclusions

The study demonstrated that the human gut archaeome is indigenous, responsive, and functional, expanding our understanding of the archaeal signature in the gut of human individuals.
Indian Ocean trade connections: characterization and commercial routes of torpedo jars
Authors: Lischi Silvia , Odelli Eleonora , Perumal Jhashree L. , Lucejko Jeannette J. , Ribechini Erika , Mariotti Lippi Marta , Selvaraj Thirumalini , Colombini Maria Perla , Raneri Simona
Published: August 2020

During the Classical Period (300 BC–400 AD), the Indian Ocean emerged as one of the largest hubs of ancient international trade. For a long period, these contacts were described from a Rome-centric point of view, looking at the connections between Rome and India. However, recent studies have demonstrated that the Roman-Indo connection was only one of the vast medium and short distance trade routes involving numerous regions and populations, exchanging goods and culture. Current archaeological investigations have demonstrated that several minor trade dynamics formed the primary connective tissue of the Indian Ocean. This study attempts to trace these mid-range connections by focusing on the transport of torpedo jars, recently found in several settlements throughout the Indian Ocean. Two archaeological sites were considered: Al Hamr al-Sharqiya 1 (Inqitat, southern Oman), and the port of Alagankulam (southern India). An analytical protocol based on thin sections analysis, SEM–EDS, XRD and GC/MS was applied to a selection of fragments from the two archaeological sites. The analytical investigation carried out on these vessels identified three different ceramic compositions, which distributed differently in the two sites, characterized by a black coating due to a similar bitumen source. The location of the production sites and comparative studies between these vessels and reference materials available in the literature enabled us to cast new light on the routes followed by the torpedo jars, from Mesopotamia to India and Oman.
RECOMIA—a cloud-based platform for artificial intelligence research in nuclear medicine and radiology
Authors: Trägårdh Elin , Borrelli Pablo , Kaboteh Reza , Gillberg Tony , Ulén Johannes , Enqvist Olof , Edenbrandt Lars
Published: August 2020

Background

Artificial intelligence (AI) is about to transform medical imaging. The Research Consortium for Medical Image Analysis (RECOMIA), a not-for-profit organisation, has developed an online platform to facilitate collaboration between medical researchers and AI researchers. The aim is to minimise the time and effort researchers need to spend on technical aspects, such as transfer, display, and annotation of images, as well as legal aspects, such as de-identification. The purpose of this article is to present the RECOMIA platform and its AI-based tools for organ segmentation in computed tomography (CT), which can be used for extraction of standardised uptake values from the corresponding positron emission tomography (PET) image.

Results

The RECOMIA platform includes modules for (1) local de-identification of medical images, (2) secure transfer of images to the cloud-based platform, (3) display functions available using a standard web browser, (4) tools for manual annotation of organs or pathology in the images, (5) deep learning-based tools for organ segmentation or other customised analyses, (6) tools for quantification of segmented volumes, and (7) an export function for the quantitative results. The AI-based tool for organ segmentation in CT currently handles 100 organs (77 bones and 23 soft tissue organs). The segmentation is based on two convolutional neural networks (CNNs): one network to handle organs with multiple similar instances, such as vertebrae and ribs, and one network for all other organs. The CNNs have been trained using CT studies from 339 patients. Experienced radiologists annotated organs in the CT studies. The performance of the segmentation tool, measured as mean Dice index on a manually annotated test set, with 10 representative organs, was 0.93 for all foreground voxels, and the mean Dice index over the organs were 0.86 (0.82 for the soft tissue organs and 0.90 for the bones).

Conclusion

The paper presents a platform that provides deep learning-based tools that can perform basic organ segmentations in CT, which can then be used to automatically obtain the different measurement in the corresponding PET image. The RECOMIA platform is available on request at www.recomia.org for research purposes.
Innovating editorial practices: academic publishers at work
Authors: Horbach Serge P. J. M. , Halffman Willem
Published: August 2020

Background

Triggered by a series of controversies and diversifying expectations of editorial practices, several innovative peer review procedures and supporting technologies have been proposed. However, adoption of these new initiatives seems slow. This raises questions about the wider conditions for peer review change and about the considerations that inform decisions to innovate. We set out to study the structure of commercial publishers’ editorial process, to reveal how the benefits of peer review innovations are understood, and to describe the considerations that inform the implementation of innovations.

Methods

We carried out field visits to the editorial office of two large academic publishers housing the editorial staff of several hundreds of journals, to study their editorial process, and interviewed editors not affiliated with large publishers. Field notes were transcribed and analysed using coding software.

Results

At the publishers we analysed, the decision-making structure seems to show both clear patterns of hierarchy and layering of the different editorial practices. While information about new initiatives circulates widely, their implementation depends on assessment of stakeholder’s wishes, impact on reputation, efficiency and implementation costs, with final decisions left to managers at the top of the internal hierarchy. Main tensions arise between commercial and substantial arguments. The editorial process is closely connected to commercial practices of creating business value, and the very specific terms in which business value is understood, such as reputation considerations and the urge to increase efficiency. Journals independent of large commercial publishers tend to have less hierarchically structured processes, report more flexibility to implement innovations, and to a greater extent decouple commercial and editorial perspectives.

Conclusion

Our study demonstrates that peer review innovations are partly to be understood in light of commercial considerations related to reputation, efficiency and implementations costs. These arguments extend beyond previously studied topics in publishing economics, including publishers’ choice for business or publication models and reach into the very heart of the editorial and peer review process.
DBT-galactography: a promising tool for improving the diagnostic workup of nipple discharge
Authors: Moschetta Marco , De Ruvo Vincenzo , Drago Angelica , Troiano Nicoletta , Paolicelli Simona , Rubini Giuseppe , Stabile Ianora Amato Antonio , Telegrafo Michele
Published: August 2020

Background

Our aim was to compare the diagnostic performance of digital breast tomosynthesis (DBT)-galactography with that of full-field digital (FFD)-galactography for detecting intraductal breast lesions using an intra-individual design.

Methods

Forty-nine consecutive patients with spontaneous, unilateral, single-pore nipple discharge and inconclusive FFD mammography and ultrasonography underwent galactography with a “COMBO” technique combining FFD- and DBT-galactography acquisitions. Examinations were independently analysed by two breast radiologists with 10-year experience. Sensitivity, specificity, and accuracy for both FFD- and DBT-galactography were calculated having histological examinations of surgical specimens as a reference standard. Data were presented as percentages with their 95% confidence intervals (CI). McNemar test was used. Interobserver agreement was assessed by using Cohen κ test for both techniques.

Results

Sensitivity was 41/43 (95%, 95% CI 84.2–99.4) for DBT-galactography and 33/43 (77%, 95% CI 61.4–88.2) for FFD-galactography (p = 0.008), specificity 6/6 (100%, 95% CI 54.1–100.0) for both imaging tools, accuracy 47/49 (96%, 95% CI 86.0–99.5) and 39/49 (80%, 95% CI 65.7–89.8) (p = 0.038), respectively. The inter-observer agreement was 0.86 for DBT-galactography and 0.78 for FFD-galactography. The AGD resulted to 1.94 ± 0.64 for the combined technique.

Conclusion

DBT-galactography showed a significantly higher sensitivity and accuracy than FFD-galactography for the identification of the intraductal findings, improving the possibility of a reliable diagnosis in patients with pathologic nipple-discharge.
Incorporating socioscientific issues into a STEM education course: exploring teacher use of argumentation in SSI and plans for classroom implementation
Authors: Johnson Joseph , Macalalag Augusto Z. , Dunphy Julie
Published: August 2020

The Socioscientific Issue (SSI) framework was applied to explore how a team of two teachers navigated SSI cases as students in a STEM education graduate program. Using a case study approach, we found a connection between the specific SSI case and levels of scientific argumentation, as well as teachers’ plans for teaching. Our findings suggest successes and challenges for our teachers in incorporating scientific argumentation through SSI cases into his/her intended classroom practices. Specifically, our participating teachers displayed notably higher levels of claims, reasoning, and ability to question the sources of information, but lower levels of evidence and rebuttals. They had difficulty in connecting claims to evidence and reasoning in discussing the SSI cases. Moreover, their intended classroom implementation considered how to connect the lessons to their students’ lives, build scientific knowledge, and provide meaningful context to engage their students in the study of SSI.
Use of BioMime Morph stent in treating left main triple vessel disease: a case report
Authors: Sharma Yash Paul , Santosh Krishna , Panda Prashant , Prasad Krishna , Uppal Lipi , Y S Shrimanth , Pruthvi C. R. , Dinakar B.
Published: August 2020

Background

Diffuse long coronary lesions require long overlapping stents which produce less than optimal long-term results. Sizing of long stents becomes difficult owing to tapering of coronaries and overlapping with excessive metal which makes restenosis a nagging problem on long-term follow-up. The optimal stent sizing becomes even more important when left main (LM) needs to be treated along with left ascending artery (LAD) or left circumflex artery (Lcx). The chronic total occlusions (CTO) represent other complex diffuse coronary lesions which not only require higher expertise and better hardware but also usually long lengths of overlapping stents. The long-tapered sirolimus-eluting stent system (BioMime Morph) has been successfully used in long diffuse lesions in individual coronaries including CTO but the use of the same in LM-LAD/LM-Lcx diffuse lesions has not been explored well where its tapered design can really be favourable.

Case presentation

We here present a case of a 51-year-old hypertensive male presented with NSTEMI and angiography showing left main triple vessel disease with CTO of right coronary artery (RCA). We successfully stented the LM-LAD and RCA (staged) using a long-tapered BioMime Morph system. IVUS was used for optimising the LM-LAD stent. At 6 months follow-up, the patient was doing well on double anti-platelets.

Conclusion

Complex coronary disease, involving the left main and LAD diffusely and CTO of RCA, can be well managed by using a single long-tapered stents thereby avoiding multiple stenting strategy. The stents with decremental diameter will provide better adaptation to the vessel size and their natural tapering. The usage of intravascular imaging helps in better optimisation of stents
Chest CT findings of COVID-19-infected patients, are there differences between pediatric and adult patients? A systematic review
Authors: Azadbakht Javid , Haghi-Aminjan Hamed , Farhood Bagher
Published: August 2020

Background

Purpose of this study was to deliver a report of chest CT findings of COVID-19-infected pediatric and adult patients and to make an age-based comparison. A systematic search was conducted in accordance with PRISMA guidelines to identify relevant studies in the electronic databases of PubMed, Scopus, ProQuest, ScienceDirect, and Web of Sciences from January 1, 2020 to March 27, 2020 using search terms in the titles and abstracts. Based on our inclusion and exclusion criteria, 762 articles were screened. Finally, 15 eligible articles which had adequate data on chest CT findings of COVID-19-infected patients were enrolled in this systematic review.

Results

In pediatric patients (15 years old or younger), peripheral distribution was found in 100% of cases, ground glass opacities (GGO) in 55.2%, bilateral involvement in 50%, halo sign in 50%, unilateral involvement in 30%, consolidation in 22.2%, crazy paving pattern in 20%, nodular opacities in 15%, pleural effusion in 4.2%, lymphadenopathy in none, and normal imaging in 20.8% of cases. On the other hand, in adult patients, bilateral involvement was reported in 76.8%, GGO in 68.4%, peripheral distribution in 62.2%, mixed GGO and consolidation in 48.7%, consolidation in 33.7%, crazy paving pattern in 27.7%, mixed central and peripheral distribution in 25.0%, unilateral involvement in 15.2%, nodular opacities in 9.2%, pleural effusion in 5.5%, central distribution of lesions in 5.4%, lymphadenopathy in 2.4%, and normal imaging in 9.8% of cases.

Conclusion

According to the findings of this systematic review, children infected with COVID-19 can present with normal or atypical findings (nodular opacities/unilateral involvement) in chest imaging more frequently than adult patients. Therefore, more caution should be taken to avoid misdiagnosis or missed diagnosis in infected children. Besides, clinical and laboratory findings need to be considered more decision-making for pediatric patients with normal or atypical chest CT scan but high suspicion of COVID-19.
Vertebral artery compression of medulla oblongata causing isolated symptom of dizziness: two case reports
Authors: Mahrous Mahmoud M. , Busaad Ibrahim A.
Published: August 2020

Background

Symptomatic medulla oblongata compressing lesions due to dilated vertebral artery are rare in the literature. The symptoms are extremely heterogeneous and not correlated to the severity of compression in many cases.

Case presentation

This paper describes two cases with vertebral artery compression of medulla oblongata complaining only from dizziness without any other neurological symptoms or signs. In both cases, videonystagmography revealed positional nystagmus. Head magnetic resonance imaging showed abnormal dilatation, elongation, and tortuosity of the vertebral artery compressing the medulla oblongata. Vestibular rehabilitation was described in both cases and had a significant effect on symptom improvement.

Conclusion

In the study cases, the sense of vertigo and/or unsteadiness is due to vertebral artery compression of medulla oblongata and can be an isolated symptom. Positional nystagmus is the only sign in vestibular evaluation.
Diagnostic Performance of Indocyanine Green Plus Methylene Blue Versus Radioisotope Plus Methylene Blue Dye Method for Sentinel Lymph Node Biopsy in Node-Negative Early Breast Cancer
Authors: Agrawal Sanjit Kumar , Hashlamoun Izideen , Karki Banira , Sharma Abhishek , Arun Indu , Ahmed Rosina
Published: August 2020

PURPOSE

Sentinel lymph node biopsy (SLNB) by dual-dye method (radioisotope plus blue) is the gold standard for axillary staging in patients with breast cancer, but in developing countries, logistic issues and financial constraint play a vital role. Recently, indocyanine green (ICG) has emerged as an alternative to radioisotope (technetium-99 [Tc-99]) for SLNB in breast cancer. This study compared the diagnostic performance of Tc-99 plus methylene blue (MB) dye versus ICG + MB dye SLNB.

METHODS

Two hundred seven patients with early breast cancer (T1-3N0) were included in the study from 2017 to 2019. SLNB was done either with Tc-99 + MB or with ICG + MB as per availability of radioisotope. SLN identification rate (IR), SLN positivity rate, and metastatic SLN counts were compared between the 2 groups.

RESULTS

IR was 199 (96%) of 207. IR was 95% in Tc-99 + MB compared with 97% with ICG + MB. The mean number of SLNs identified were 3.17 (standard deviation [SD], 1.84), with > 1 SLN identified in 87% patients by Tc-99 + MB. SLN was positive in 31.3% of patients with a metastatic SLN count of 0.37 (SD, 0.76). With ICG + MB, the number of SLNs was 2.73 (SD, 1.55), with > 1 SLN identified in 79% of patients. Twenty-eight percent of patients had positive SLNs, with a metastatic SLN count of 0.41 (SD, 0.77). A sharp decline in the availability of Tc-99 was observed, with 58% of patients in 2014 and only 12% of patients in 2018.

CONCLUSION

ICG is equivalent to Tc-99 for SLNB in early breast cancer and has a good potential to be adopted by surgeons in resource-constrained setups.
Bevacizumab Plus mFOLFOX6 Versus mFOLFOX6 Alone as First-Line Treatment for RAS Mutant Unresectable Colorectal Liver-Limited Metastases: The BECOME Randomized Controlled Trial
Authors: Tang Wentao , Ren Li , Liu Tianshu , Ye Qinghai , Wei Ye , He Guodong , Lin Qi , Wang Xiaoying , Wang Mingliang , Liang Fei , Cui Yuehong , Xu Jianmin
Published: August 2020

PURPOSE

To assess the effects of bevacizumab plus modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) as first-line treatment of RAS mutant unresectable colorectal liver metastases.

METHODS

From October 2013 to December 2017, patients with RAS mutant unresectable liver-limited metastases from colorectal cancer were randomly assigned to receive mFOLFOX6 plus bevacizumab (arm A) or mFOLFOX6 alone (arm B). The resectability of liver metastases was determined by a local multidisciplinary team. The primary end point was the actual rate of patients converted to R0 resection for liver metastases. Secondary end points included tumor response, survival, and toxicity. The block randomization method was used.

RESULTS

The intention-to-treat population comprised 241 patients. A total of 121 patients were randomly assigned to arm A and 120 to arm B. The median follow-up time was 37.0 months for all patients. The R0 resection rates for liver metastases were 22.3% (27 of 121 patients) in arm A and 5.8% (7 of 120 patients) in arm B, with a significant difference ( P < .01). Patients in arm A had significantly better objective response rates (54.5% v 36.7%; P < .01), median progression-free survival (9.5 v 5.6 months; P < .01) and median overall survival (25.7 v 20.5 months; P = .03) compared with those in arm B. The addition of bevacizumab was associated with more frequent proteinuria (9.9% v 3.3%; P = .04) and hypertension (8.3% v 2.5%; P < .05).

CONCLUSION

For patients with initially unresectable RAS mutant colorectal liver metastases, bevacizumab combined with mFOLFOX6 increased the resectability of liver metastases and improved response rates and survival compared with mFOLFOX6 alone.
Glucocorticoid Resistance in Premature Adrenarche and PCOS: From Childhood to Adulthood
Authors: Panayiotopoulos Aristotle , Bhangoo Amrit , Khurana Divya , Ten Svetlana , Michl Josef , Ghanny Steven
Published: August 2020

Context

We hypothesize that impaired glucocorticoid sensitivity (GC sensitivity) plays a role in the development of premature adrenarche (PA) and polycystic ovarian syndrome (PCOS) by increasing androgen synthesis.

Objective

To study glucocorticoid sensitivity in vitro in subjects with PA and PCOS.

Patients and Methods

Fourteen subjects (10 girls, 4 boys, 6.9 ± 0.6 years) with PA; 27 subjects with PCOS (17 ± 2.5 years) and 31 healthy controls were enrolled in the study. All subjects and controls underwent GC sensitivity analysis in vitro using a fluorescein labeled-dexamethasone (F-DEX) assay. A GC sensitivity index (GCSI) was calculated as area under the curve of the F-DEX assay results. Subjects were classified as GC resistant if the GCSI ≤ 264 and GC sensitive if the GCSI ≥ 386.

Results

In the PA group, 8 of 14 subjects were resistant with GCSI of 179.7 ± 39.9, 4 were within the normal range with GCSI of 299.6 ± 27.9, and 2 had increased GC sensitivity with GCSI of 423.5 ± 47.9. In the PCOS group, 18 of 27 subjects were GC-resistant with GCSI of 180.9 ± 58.2, 8 were within the normal range with GCSI of 310.7 ± 26.4, and 1 had increased GCSI of 395.4. In the PCOS GC-resistant subgroup, cortisol was higher compared with PCOS with normal GCSI (P < 0.05). In the combined PCOS plus female control group, GCSI correlated negatively with cortisol and testosterone (P < 0.05).

Conclusion

GC resistance was found in more than 50% of patients with PCOS and PA. The findings strongly suggest that GC resistance is associated with states of PA and PCOS.
Place-Based Policies and Spatial Disparities across European Cities
Authors: Ehrlich Maximilian v. , Overman Henry G.
Published: August 2020

Spatial disparities in income levels and worklessness in the European Union are profound, persistent and may be widening. We describe disparities across metropolitan regions and discuss theories and empirical evidence that help us understand what causes these disparities. Increases in the productivity benefits of cities, the clustering of highly educated workers and increases in their wage premium all play a role. Europe has a long-standing tradition of using capital subsidies, enterprise zones, transport investments and other place-based policies to address these disparities. The evidence suggests these policies may have partially offset increasing disparities but are not sufficient to fully offset the economic forces at work.
Venture Capital’s Role in Financing Innovation: What We Know and How Much We Still Need to Learn
Authors: Lerner Josh , Nanda Ramana
Published: August 2020

Venture capital is associated with some of the most high-growth and influential firms in the world. Academics and practitioners have effectively articulated the strengths of the venture model. At the same time, venture capital financing also has real limitations in its ability to advance substantial technological change. Three issues are particularly concerning to us: 1) the very narrow band of technological innovations that fit the requirements of institutional venture capital investors; 2) the relatively small number of venture capital investors who hold and shape the direction of a substantial fraction of capital that is deployed into financing radical technological change; and 3) the relaxation in recent years of the intense emphasis on corporate governance by venture capital firms. While our ability to assess the social welfare impact of venture capital remains nascent, we hope that this article will stimulate discussion of and research into these questions.
The psychological impact of the COVID-19 pandemic on medical students in Turkey
Authors: Torun Fuat , Torun Sebahat Dilek
Published: August 2020

Objective: We aimed to investigate the knowledge of medical students about COVID-19, the effects of the traumatic situation they experienced, the stress they perceived and the factors affecting them. In addition, we aimed to learn the thoughts of the students about the virus due to the uncertainties.

Methods: The study was carried out online between April 30, May 5, 2020 with a questionnaire prepared with googleforms. For the study, all students studying at the Faculty of Medicine of Istanbul Yeni Yüzyıl University were called through class representatives and WhatsApp class groups. The questionnaire included sociodemographic information, knowledge and sources of information about the disease, to agreement degree the proposition whether covid 19 is produced as a biological weapon. The Perceived Stress Scale (PSS) and Impact of Events Scale-Revised (IES-R) were applied.

Results: The total number of participants was 275 students. No student was infected with COVID-19 at the time of the survey. The presence of chronic disease in the participants was found to be a factor that increased anxiety (p = 0.01). Majority of participants (60.40%) stated that they agree with COVID-19 is a biological weapon. The mean scores of women ‘s total PSS and IES-R were higher than men. It was found that the families of the students had a lower monthly income than the minimum monthly wage is increasing the anxiety about getting COVID-19 infection and perceived stress. One-third of the students reported that sleep and appetite were impaired than the before pandemic. The announcements and website of Ministry of Health and the social media was the main source of information of the participants.

Conclusions: It was found that medical students were highly worried about being infected with COVID-19. The scores obtained from the pre-clinic students’ anxiety to become infected with COVID-19, PSS and IES-R total scores were found to be significantly higher than their clinical students.

doi: https://doi.org/10.12669/pjms.36.6.2985

How to cite this:Torun F, Torun SD. The psychological impact of the COVID-19 pandemic on medical students in Turkey. Pak J Med Sci. 2020;36(6):1355-1359. doi: https://doi.org/10.12669/pjms.36.6.2985

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Lipidomics reveal the protective effects of a vegetable-derived isothiocyanate against retinal degeneration
Authors: Kwa Faith A. , Dulull Nabeela K. , Roessner Ute , Dias Daniel A. , Rupasinghe Thusitha W.
Published: August 2020

Background:Age-related macular degeneration (AMD) is a leading cause of blindness in the ageing population. Without effective treatment strategies that can prevent disease progression, there is an urgent need for novel therapeutic interventions to reduce the burden of vision loss and improve patients’ quality of life. Dysfunctional innate immune responses to oxidative stress observed in AMD can be caused by the formation of oxidised lipids, whilst polyunsaturated fatty acids have shown to increase the risk of AMD and disease progression in affected individuals. Previously, our laboratory has shown that the vegetable-derived isothiocyanate, L-sulforaphane (LSF), can protect human adult pigment epithelial cells from oxidative damage by upregulating gene expression of the oxidative stress enzyme Glutathione-S-Transferase µ1. This study aims to validate the protective effects of LSF on human retinal cells under oxidative stress conditions and to reveal the key players in fatty acid and lipid metabolism that may facilitate this protection.

Methods:Thein vitrooxidative stress model of AMD was based on the exposure of an adult retinal pigment epithelium-19 cell line to 200µM hydrogen peroxide. Percentage cell proliferation following LSF treatment was measured using tetrazolium salt-based assays. Untargeted fatty acid profiling was performed by gas chromatography-mass spectrometry. Untargeted lipid profiling was performed by liquid chromatography-mass spectrometry.

Results:Under hydrogen peroxide-induced oxidative stress conditions, LSF treatment induced dose-dependent cell proliferation. The key fatty acids that were increased by LSF treatment of the retinal cells include oleic acid and eicosatrienoic acid. LSF treatment also increased levels of the lipid classes phosphatidylcholine, cholesteryl ester and oxo-phytodienoic acid but decreased levels of phosphatidylethanolamine lipids.

Conclusions:We propose that retinal cells at risk of oxidative damage and apoptosis can be pre-conditioned with LSF to regulate levels of selected fatty acids and lipids known to be implicated in the pathogenesis and progression of AMD.
A review of advances in the understanding of lupus nephritis pathogenesis as a basis for emerging therapies
Authors: Yung Susan , Yap Desmond YH , Chan Tak Mao
Published: August 2020

Lupus nephritis is an important cause of both acute kidney injury and chronic kidney disease that can result in end-stage renal disease. Its pathogenic mechanisms are characterized by aberrant activation of both innate and adaptive immune responses, dysregulation of inflammatory signaling pathways, and increased cytokine production. Treatment of lupus nephritis remains a challenging issue in the management of systemic lupus erythematosus since the clinical presentation, response to treatment, and prognosis all vary considerably between patients and are influenced by ethnicity, gender, the degree of chronic kidney damage, pharmacogenomics, and non-immunological modulating factors. Elucidation of the various immunopathogenic pathways in lupus nephritis has resulted in the development of novel therapies, including biologics that target specific antigens on B lymphocytes to achieve B cell depletion, agents that modulate B cell proliferation and development, drugs that block co-stimulatory pathways, drugs that target T lymphocytes primarily, and therapies that target complement activation, signaling pathways, pro-inflammatory cytokines, and neutrophil extracellular traps. This review will discuss recent advances in the understanding of disease pathogenesis in lupus nephritis in the context of potential emerging therapies.
Jupyter notebook-based tools for building structured datasets from the Sequence Read Archive
Authors: Bernstein Matthew N. , Gladstein Ariella , Latt Khun Zaw , Clough Emily , Busby Ben , Dillman Allissa
Published: August 2020

The Sequence Read Archive (SRA) is a large public repository that stores raw next-generation sequencing data from thousands of diverse scientific investigations.  Despite its promise, reuse and re-analysis of SRA data has been challenged by the heterogeneity and poor quality of the metadata that describe its biological samples. Recently, the MetaSRA project standardized these metadata by annotating each sample with terms from biomedical ontologies. In this work, we present a pair of Jupyter notebook-based tools that utilize the MetaSRA for building structured datasets from the SRA in order to facilitate secondary analyses of the SRA’s human RNA-seq data. The first tool, called the Case-Control Finder, finds suitable case and control samples for a given disease or condition where the cases and controls are matched by tissue or cell type.  The second tool, called the Series Finder, finds ordered sets of samples for the purpose of addressing biological questions pertaining to changes over a numerical property such as time. These tools were the result of a three-day-long NCBI Codeathon in March 2019 held at the University of North Carolina at Chapel Hill.
Preserving the endothelial glycocalyx in patients undergoing cardiopulmonary bypass: a prospective randomised interventional pilot study of lidocaine and doxycycline (LiDEG trial)
Authors: Pannekoek Adrian , Johnson Mark , Buggy Donal , Pavey Warren
Published: August 2020

Background: During major surgery, particularly heart surgery, an element of the lining of blood vessels, known as the endothelial glycocalyx (EG), can be damaged. This can lead to swelling, low oxygen levels, kidney failure and other problems, which delay recovery. There are laboratory studies that show lidocaine (a local anaesthetic) and doxycycline (an antibiotic) may help protect this lining. The study agents are widely available, cheap and safe drugs.

Trial design and objective: This is a phase IV, single centre, prospective, unblinded, randomised, parallel-group trial. The objectives of the trial are to investigate the role of doxycycline and lidocaine as potential agents to reduce EG shedding and correlate with early postoperative outcomes.

Methods: 60 adult patients undergoing heart surgery requiring cardiopulmonary bypass (CPB) will be randomly assigned to one of three groups: doxycycline group (oral doxycycline, 200mg preoperatively); lidocaine group (perioperative intravenous lidocaine, 1.5mg/kg bolus at induction followed by 2mg/kg/hr infusion for the duration of surgery); and control group (standard care). The randomisation will be undertaken using a sealed opaque envelope method. The primary outcome will be the relative difference in the biochemical marker of EG injury, syndecan-1, at different timepoints in the intraoperative and early post-operative period. Secondary endpoints include vasopressor requirements, markers of organ dysfunction (lung, kidney, brain, arrhythmia), coagulation and inflammation.

Discussion: EG injury is ubiquitous in patients undergoing CPB. Maintaining homeostasis of this delicate layer would appear to be a valuable therapeutic target.  To date no agents have been shown to be effective in protecting the EG. Our study agents have shown some promise in the preclinical setting and would represent a novel therapeutic approach should they show a protective effect.

Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12619000621112 (26th April 2019).
Lifestyle and reproductive health: the aetiology of ovarian cancer in Pakistan
Authors: Alvi Qurratulann , Baloch Gul Muhammad , Chinna Karuthan , Dabbagh Ali
Published: August 2020

Ovarian cancer is a fatal gynaecological cancer and eighth most common cancer in women globally. Lifestyle, reproductive and sociodemographic factors are among the influential parameters that may significantly affect the risk of ovarian cancer and its mortality rate. However, the epidemiological investigations have shown that the risk of ovarian cancers associated with these factors is different in varied geographical distributions. Lifestyle and reproductive factors have not been investigated thoroughly across a wide cultural diversity. The objective of this study is to investigate the association of these factors with ovarian cancer in Pakistan. This investigation will focus on the lifestyle effects of fat intake, intake of tea, habitual exercise, use of talc, personal hygiene, habit of holding urine for long time, obesity on ovarian cancer among Pakistani women.  Reproductive variables will include age at menarche, natural menopausal age, parity, nulliparity (miscarriages, abortion, stillbirths), infertility, fertility treatment, tubal ligation, oral contraceptive use, and family history of breast or ovarian cancer. Sociodemographic variables will include effect of age, income, education, and geographical location. A case-control study will be conducted in the major cancer hospitals of Pakistan and the patients will also be interviewed. The controls will be recruited outside the hospital. For controls the same age limit and residency requirements will be applied. The information gained from this research will be an important contribution to develop programs for health promotion, with a focus on ovarian cancer prevention and women’s health. The findings could be used for health policies and planning to prevent ovarian cancer. The research will pave the way for a public policy and interventions to reduce the burden of ovarian cancer in Pakistan.