bluuebunny/crossref_metadata_2025 huggingface dataset:
Corporate environmental responsibility in Ethiopia: a case study of the Akaki River Basin
Authors: Amare Abebe
Published: January 2019

This research is aimed at investigating Corporate Environmental Responsibility in Manufacturing Enterprises in the Akaki River basin on protecting the urban environment with particular emphasis on twenty selected industries. To attain its objective, the study employed a mixed methods research approach. Data were collected by employing tools such as questionnaire, key informant interview, group discussions and observation. The findings of the research show that corporate environmental responsibility is very low. The majority of Large Scale Industries encompassed in the survey did not show considerable effort on protecting the environment responsibly. The reasons identified by this research are among others the absence of corporate environmental responsibility, low pressure from the enforcing institutions, and lack of financial and human resources. As a result, the Akaki River is highly polluted mainly through toxic industrial effluents released with little or no prior treatment. The consequences are countless. The populations living across the river are facing health deteriorations and economic damages. Based on the findings of this study, setting up strong institutions which are capable of developing new laws and implementing the existing environmental legal framework is commended.
Mathematical Finance: A Very Short Introduction
Authors: Davis Mark H. A.
Published: January 2019

In recent years, the finance industry has mushroomed to become an important part of modern economies with many science and engineering graduates joining the industry as quantitative analysts, using mathematical and computational skills to solve complex problems of asset valuation and risk management. Mathematical Finance: A Very Short Introduction provides an overview of mathematical finance today. It introduces arbitrage theory, explaining why it works the way it does, and how it is key to pricing financial contracts, to credit trading, fund management, and the setting of interest rates. It also discusses developments to mathematical finance in the wake of the 2008 financial crash, and surveys the most pressing issues in mathematical finance today.
Reptiles: A Very Short Introduction
Authors: Kemp T. S.
Published: January 2019

Reptiles: A Very Short Introduction introduces the extraordinary diversity of reptiles that have walked the Earth, from the dinosaurs and other reptiles of the past to modern-day living species. It discusses the adaptations reptiles made to first leave the water and colonize dry land, which fitted them for their unique ways of life. Considering the variety of different living groups of reptiles today, from lizards and snakes to crocodiles and turtles, it explores their biology and behaviour. Finally, this VSI assesses the threat of extinction to modern-day reptile species due to over-exploitation, habitat destruction, and climate change, and considers what can be done.
Incidence of Adverse Reactions to Parenteral Thiamine in the Treatment of Wernicke’s Encephalopathy, and Recommendations
Authors: Thomson Allan , Guerrini Irene , Marshall Elizabeth Jane
Published: January 2019

Aim

To offer an estimate of the incidence of anaphylactic reactions to parenteral products containing thiamine used in the treatment of Wernicke’s encephalopathy (WE) and make recommendations.

Method

Review of previously released data on some older products and parenteral thiamine use in some other countries; analysis of sales and adverse incident data on anaphylaxis for a contemporary parenteral product used in the UK, Pabrinex.

Results

It was difficult to estimate the incidence of related anaphylactic reactions to Pabrinex in the UK because the number of doses given is unknown. Sales data are only an approximation to doses given because for products with a limited shelf life not all product sold is administered. However, available data indicate that there have been 10 anaphylactic reactions to Pabrinex from between 5,431,235–6,651,947 patient-days (14,880–16,080 years) of treatment.

Conclusion

It is reasonable to assume that the risk of anaphylaxis is low, and lower than for many other drugs. The risk-benefit ratio for administration is favourable given the potential severity of brain damage in Wernicke–Korsakoff (WK) syndrome. There is a need for international agreement on the reporting of anaphylaxis and on the optimum thiamine therapy for the treatment of WK syndrome. We make recommendations on how this might be achieved.
Estimating the importance of maize root hairs in low phosphorus conditions and under drought
Authors: Klamer Florian , Vogel Florian , Li Xuelian , Bremer Hinrich , Neumann Günter , Neuhäuser Benjamin , Hochholdinger Frank , Ludewig Uwe
Published: January 2019

Background and Aims

Root hairs are single-cell extensions of the epidermis that face into the soil and increase the root–soil contact surface. Root hairs enlarge the rhizosphere radially and are very important for taking up water and sparingly soluble nutrients, such as the poorly soil-mobile phosphate. In order to quantify the importance of root hairs for maize, a mutant and the corresponding wild type were compared.

Methods

The rth2 maize mutant with very short root hairs was assayed for growth and phosphorus (P) acquisition in a slightly alkaline soil with low P and limited water supply in the absence of mycorrhization and with ample P supply.

Key Results

Root and shoot growth was additively impaired under P deficiency and drought. Internal P concentrations declined with reduced water and P supply, whereas micronutrients (iron, zinc) were little affected. The very short root hairs in rth2 did not affect internal P concentrations, but the P content of juvenile plants was halved under combined stress. The rth2 plants had more fine roots and increased specific root length, but P mobilization traits (root organic carbon and phosphatase exudation) differed little.

Conclusions

The results confirm the importance of root hairs for maize P uptake and content, but not for internal P concentrations. Furthermore, the performance of root hair mutants may be biased by secondary effects, such as altered root growth.
Neurofeedback Training of Gamma Oscillations in Monkey Primary Visual Cortex
Authors: Chauvière L , Singer W
Published: January 2019

In humans, neurofeedback (NFB) training has been used extensively and successfully to manipulate brain activity. Feedback signals were derived from EEG, fMRI, MEG, and intracranial recordings and modifications were obtained of the BOLD signal, of the power of oscillatory activity in distinct frequency bands and of single unit activity. The purpose of the present study was to examine whether neuronal activity could also be controlled by NFB in early sensory cortices whose activity is thought to be influenced mainly by sensory input rather than volitional control. We trained 2 macaque monkeys to enhance narrow band gamma oscillations in the primary visual cortex by providing them with an acoustic signal that reflected the power of gamma oscillations in a preselected band and rewarding increases of the feedback signal. Oscillations were assessed from local field potentials recorded with chronically implanted microelectrodes. Both monkeys succeeded to raise gamma activity in the absence of visual stimulation in the selected frequency band and at the site from which the NFB signal was derived. This suggests that top–down signals are not confined to just modulate stimulus induced responses but can actually drive or facilitate the gamma generating microcircuits even in a primary sensory area.
Kidney transplantation: an attractive and cost-effective alternative for older patients? A cost–utility study
Authors: Heldal Kristian , Midtvedt Karsten , Lønning Kjersti , Iversen Tor , Hernæs Kjersti Helene , Tsarpali Vasiliki , Reisæter Anna Varberg , Bernklev Tomm
Published: January 2019

Background

In the elderly, kidney transplantation is associated with increased survival and improved health-related quality of life compared with dialysis treatment. We aimed to study the short-term health economic effects of transplantation in a population of elderly kidney transplant candidates.

Methods

Self-perceived health, quality-adjusted life years (QALYs) and costs were evaluated and compared 1 year before and 1 year after kidney transplantation in patients included in a single-centre prospective study of 289 transplant candidates ≥65 years of age.

Results

Self-perceived health and QALYs both significantly improved after transplantation. At 1 year, the costs per QALY were substantially higher for transplantation (€88 100 versus €76 495), but preliminary analyses suggest a favourable long-term health economic effect.

Conclusions

Kidney transplantation in older kidney transplant recipients is associated with improved health but also with increased costs the first year after engraftment when compared with remaining on the waiting list. Any long-term cost-effectiveness needs to be confirmed in studies with longer observation times.
High-risk human papilloma virus infection and cervical neoplasm in female inflammatory bowel disease patients: a cross-sectional study
Authors: Li Miao , Yang Qing-Fan , Cao Qian , Tang Jian , Gao Yu , Zhi Min , Chao Kang , Su Ming-Li , Huang Wei-Min , Yi Yan , Xia Sui-Yan , Huang Ling-Jie , Zhao Yuan , Wang Xiao-Hong , Liu Xiao-Ying , Lin Lin , Hu Pin-Jin , Gao Xiang
Published: January 2019

Background and aim

This cross-sectional study investigated the prevalence and risk factors of high-risk human papilloma virus (HPV) infection, especially types 16 and 18, and cervical neoplasia in female Inflammatory bowel disease (IBD) patients.

Methods

From July 2014 to January 2017, sexually active, female, Chinese IBD patients (21–60 years) and age-matched controls underwent cervical ThinPrep cytology testing (TCT) and high-risk HPV-DNA detection, and completed questionnaires about awareness of cervical cancer and HPV. Cervical dysplasia was categorized as cervical intraepithelial neoplasia (CIN) 1, 2 and 3.

Results

Of 124 IBD patients (30 ulcerative colitis and 94 Crohn’s disease), 17 (13.7%) had high-risk HPV among whom 9 (7.3%) had HPV 16/18 infection and 4 (3.2%) had cervical CIN (3 CIN 3, 1 CIN 1) by pathology. Among 372 controls, 33 (8.9%) had high-risk HPV and only 1 (0.3%) had HPV 16 infection. Cervical TCT detected atypical squamous cells of unknown significance in one control; no control had CIN. The HPV 16/18 infection rate and CIN prevalence were significantly higher in IBD patients than controls (both P < 0.001). The HPV-infection rate was higher in patients administered methotrexate [P = 0.005, odds ratio (95% confidence interval) 4.76 (1.471–15.402)] or more than two immunosuppressants [P = 0.013, odds ratio (95% confidence interval) 3.64 (1.255–10.562)]. Thiopurine, steroid, infliximab and disease behavior/location were not associated with HPV infection. Only 29.3% of patients had undergone cervical-cancer screening. Awareness of HPV infection and HPV-related cervical cancer was poor (28.2%).

Conclusions

Female IBD patients are at increased risk of high-risk HPV infection and cervical neoplasia, which may be associated with immunosuppressants. Education and routine follow-up with HPV-DNA testing and TCT are recommended, especially in female Chinese IBD patients.
A Multisite Case Study of Caregiver Advise, Record, Enable Act Implementation
Authors: Leighton Cassandra , Fields Beth , Rodakowski Juleen L , Feiler Connie , Hawk Mary , Bellon Johanna E , James A Everette
Published: January 2019

Background and Objectives

The Commonwealth of Pennsylvania passed the Caregiver Advise, Record, Enable (CARE) Act on April 20, 2016. We designed a study to explore early implementation at a large, integrated delivery financing system. Our goal was to assess the effects of system-level decisions on unit implementation and the incorporation of the CARE Act’s three components into routine care delivery.

Research Design and Methods

We conducted a multisite, ethnographic case study at three different hospitals’ medical–surgical units. We conducted observations and semi-structured interview to understand the implementation process and the approach to caregiver identification, notification, and education. We used thematic analysis to code interviews and observations and linked findings to the Promoting Action on Research Implementation in Health Services framework.

Results

Organizational context and electronic health record capability were instrumental to the CARE Act implementation and integration into workflow. The implementation team used a decentralized strategy and a variety of communication modes, relying on local hospital units to train staff and make the changes. We found that the system facilitated the CARE Act implementation by placing emphasis on the documentation and charting to demonstrate compliance with the legal requirements.

Discussion and Implications

General acute hospitals will be making or have made similar decisions on how to operationalize the regulatory components and demonstrate compliance with the CARE Act. This study can help to inform others as they design and improve their compliance and implementation strategies.
Integrable Systems of Double Ramification Type
Authors: Buryak Alexandr , Dubrovin Boris , Guéré Jérémy , Rossi Paolo
Published: January 2019

In this paper we study various aspects of the double ramification (DR) hierarchy, introduced by the 1st author, and its quantization. We extend the notion of tau-symmetry to quantum integrable hierarchies and prove that the quantum DR hierarchy enjoys this property. We determine explicitly the genus $1$ quantum correction and, as an application, compute completely the quantization of the $3$- and $4$-KdV hierarchies (the DR hierarchies for Witten’s $3$- and $4$-spin theories). We then focus on the recursion relation satisfied by the DR Hamiltonian densities and, abstracting from its geometric origin, we use it to characterize and construct a new family of quantum and classical integrable systems that we call of DR type, as they satisfy all of the main properties of the DR hierarchy. In the 2nd part, we obtain new insight towards the Miura equivalence conjecture between the DR and Dubrovin-Zhang (DZ) hierarchies, via a geometric interpretation of the correlators forming the DR tau-function. We then show that the candidate Miura transformation between the DR and DZ hierarchies (which we uniquely identified in our previous paper) indeed turns the DZ Poisson structure into the standard form. Eventually, we focus on integrable hierarchies associated with rank-$1$ cohomological field theories and their deformations, and we prove the DR/DZ equivalence conjecture up to genus $5$ in this context.
“Verses of My Owne Making”: Literacy, Work, and Social Identity in Early Modern England
Authors: Waddell Brodie
Published: January 2019

Reading and writing became widespread in England over the course of the early modern period, with literacy expanding alongside rapid commercial development and growing economic inequality. This article shows how tradesmen and others of similar rank used reading and writing to create a powerful identity that cut across some of the sharpening divisions in wealth from the late sixteenth to the early eighteenth centuries. Growing numbers of economically precarious “middling” men and women took advantage of the spread of literacy to construct social roles for themselves based on godly work, vocational knowledge, and occupational fraternity. This analysis begins with the uniquely voluminous collection of notebooks filled by an Essex tradesman named Joseph Bufton (1651–1718). Drawing on his notebooks together with other examples of non-elite writing and cheap print, it reveals a broad literary culture that was emerging in provincial towns at this time. Through this, it connects the historiography of social structure and economic change to the growing research on non-elite literacy and life-writing. Taken together, these findings suggest that the existing narrative of early modern “social polarization” should be revisited. Rather than consistently reinforcing the deep economic divisions between workers and masters, literacy could often serve as a tool for crafting a shared identity that could encompass a whole trade.
Genome Resource for Neocamarosporium betae (syn. Pleospora betae), the Cause of Phoma Leaf Spot and Root Rot on Beta vulgaris
Authors: Vaghefi Niloofar , Silva Alex , Koenick Lori B. , Pethybridge Sarah J.
Published: January 2019

Neocamarosporium betae (syn. Phoma betae, Pleospora betae) is the cause of Phoma leaf spot and root decay on Beta vulgaris worldwide. Despite the economic importance of the pathogen, many aspects of its life cycle and population biology remain unknown. The first genome assembly of N. betae was constructed to facilitate identification of mating-type loci and development of microsatellite markers for population genetics studies. The de novo assembled genome is provided as a resource for future genetic studies to understand the genetic mechanisms underlying disease development and host-pathogen interactions.
Unmet Menstrual Hygiene Needs Among Low-Income Women
Authors: Sebert Kuhlmann Anne , Peters Bergquist Eleanor , Danjoint Djenie , Wall L. Lewis
Published: January 2019

OBJECTIVE:

To assess the menstrual hygiene needs of low-income women in St. Louis, Missouri.

METHODS:

Using an exploratory, cross-sectional design, women 18 years of age and older were recruited from a purposive sample of 10 not-for-profit community organizations that serve low-income women in St. Louis. From July 2017 to March 2018, 183 interviewer-administered surveys and three focus group discussions were conducted. Surveys and focus groups identified where and how women access menstrual hygiene products and what they do when they cannot afford to buy them. Using a snowball sampling strategy, 18 community organizations were also surveyed electronically to assess what services and supplies they provide for menstrual hygiene.

RESULTS:

All women invited to participate in the interviews and the focus groups agreed to do so. Nearly two thirds (64%) of women were unable to afford needed menstrual hygiene supplies during the previous year. Approximately one fifth of women (21%) experienced this monthly. Many women make do with cloth, rags, tissues, or toilet paper; some even use children’s diapers or paper towels taken from public bathrooms. Nearly half of women (46%) could not afford to buy both food and menstrual hygiene products during the past year. There was no difference in menstrual hygiene needs by age. Two thirds of organizations indicated that menstrual hygiene was a need of their clients. Thirteen provide menstrual hygiene supplies to their clients; two provide menstrual hygiene education.

CONCLUSION:

Menstrual hygiene supplies are a basic necessity that many low-income women lack. We document the extent to which low-income women in a major metropolitan area in the United States are unable to afford these basic necessities and what they do to cope. Women’s health care providers should advocate for improved access to menstrual hygiene supplies for low-income females across the United States.
Short-Term Effects and Long-Term Cost-Effectiveness of Universal Hepatitis C Testing in Prenatal Care
Authors: Tasillo Abriana , Eftekhari Yazdi Golnaz , Nolen Shayla , Schillie Sarah , Vellozzi Claudia , Epstein Rachel , Randall Liisa , Salomon Joshua A. , Linas Benjamin P.
Published: January 2019

OBJECTIVE:

To estimate the clinical effects and cost-effectiveness of universal prenatal hepatitis C screening, and to calculate potential life expectancy, quality of life, and health care costs associated with universal prenatal hepatitis C screening and linkage to treatment.

METHODS:

Using a stochastic individual-level microsimulation model, we simulated the lifetimes of 250 million pregnant women matched at baseline with the U.S. childbearing population on age, injection drug use behaviors, and hepatitis C virus (HCV) infection status. Modeled outcomes included hepatitis C diagnosis, treatment and cure, lifetime health care costs, quality-adjusted life years (QALY) and incremental cost-effectiveness ratios comparing universal prenatal hepatitis C screening to current practice. We modeled whether neonates exposed to maternal HCV at birth were identified as such.

RESULTS:

Pregnant women with hepatitis C infection lived 1.21 years longer and had 16% lower HCV-attributable mortality with universal prenatal hepatitis C screening, which had an incremental cost-effectiveness ratio of $41,000 per QALY gained compared with current practice. Incremental cost-effectiveness ratios remained below $100,000 per QALY gained in most sensitivity analyses; notable exceptions included incremental cost-effectiveness ratios above $100,000 when assuming mean time to cirrhosis of 70 years, a cost greater than $500,000 per false positive diagnosis, or population HCV infection prevalence below 0.16%. Universal prenatal hepatitis C screening increased identification of neonates exposed to HCV at birth from 44% to 92%.

CONCLUSIONS:

In our model, universal prenatal hepatitis C screening improves health outcomes in women with HCV infection, improves identification of HCV exposure in neonates born at risk, and is cost-effective.
p53, stem cell biology and childhood blastomas
Authors: Oh Lixian , Hafsi Hind , Hainaut Pierre , Ariffin Hany
Published: January 2019

Purpose of review

Childhood blastomas, unlike adult cancers, originate from developing organs in which molecular and cellular features exhibit differentiation arrest and embryonic characteristics. Conventional cancer therapies, which rely on the generalized cytotoxic effect on rapidly dividing cells, may damage delicate organs in young children, leading to multiple late effects. Deep understanding of the biology of embryonal cancers is crucial in reshaping the cancer treatment paradigm for children.

Recent findings

p53 plays a major physiological role in embryonic development, by controlling cell proliferation, differentiation and responses to cellular stress. Tumor suppressor function of p53 is commonly lost in adult cancers through genetic alterations. However, both somatic and germline p53 mutations are rare in childhood blastomas, suggesting that in these cancers, p53 may be inactivated through other mechanisms than mutation. In this review, we summarize current knowledge about p53 pathway inactivation in childhood blastomas (specifically neuroblastoma, retinoblastoma and Wilms’ tumor) through various upstream mechanisms. Laboratory evidence and clinical trials of targeted therapies specific to exploiting p53 upstream regulators are discussed.

Despite the low rate of inherentTP53mutations, p53 pathway inactivation is a common denominator in childhood blastomas. Exploiting p53 and its regulators is likely to translate into more effective targeted therapies with minimal late effects for children. (see Video Abstract, Supplemental Digital Content 1, http://links.lww.com/COON/A23).
Prevalence of Pigment Dispersion Syndrome in Patients Seeking Refractive Surgery
Authors: Doane John F. , Rickstrew Jace J. , Tuckfield James Q. , Cauble Jae E.
Published: January 2019

Purpose:

To determine the prevalence of pigment dispersion syndrome (PDS) in patients presenting for vision correcting refractive surgery.

Setting:

Discover Vision Centers, Kansas City, MO.

Design:

This is a prospective case series.

Materials and Methods:

A total of 637 eyes of 319 serial patients who presented seeking refractive surgery were included in this prospective, observational study. Patients underwent routine ophthalmologic examination before refractive surgery. PDS was diagnosed by the presence of a deep anterior chamber, posterior bowing of the irides, Krukenberg spindles, and/or presence of mid-peripheral iris transillumination defects by the same experienced ophthalmologist. The prevalence of PDS and its associated ophthalmic and demographic characteristics were evaluated in those diagnosed.

Results:

Of the 637 eyes, 165 (25.9%) eyes were diagnosed with PDS. Krukenberg spindles were present in 53 (8.3%) of the total eyes and in 47 (28.5%) eyes that were diagnosed with PDS. Transillumination defects were present in 153 (95%) eyes diagnosed with PDS and 161 (25.2%) total eyes. There was equal distribution between sex in those diagnosed with PDS (male vs. female: 26 vs. 25.8%; P=0.942). Blue colored eyes were most likely to have PDS (35.8% of patients).

Conclusions:

The prevalence of PDS within the population of patients seeking refractive surgery is likely greater than the general population as a whole. This is most likely the result of self-selection and high association between myopia and PDS. Given that not infrequent sequela can occur from untreated PDS, it is prudent that refractive surgeons be aware of this increased prevalence and perform thorough examinations to properly identify the condition.
Neoadjuvant chemotherapy reduces the expression rates of ER, PR, HER2, Ki67, and P53 of invasive ductal carcinoma
Authors: Peng Jian-Heng , Zhang Xiang , Song Jun-Long , Ran Liang , Luo Rong , Li Hong-Yuan , Wang Yong-Hong
Published: January 2019

To analyze whether neoadjuvant chemotherapy (NAC) changes the expression rates of invasive ductal carcinoma (IDC) markers: estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki67, and P53.

This was a retrospective study of 112 IDC patients who underwent NAC (docetaxel+epirubicin/pirarubicin+cyclophosphamide) but without pathological complete response (pCR) in 2012 to 2013 at the First Affiliated Hospital of Chongqing Medical University. The IDC subtypes and tumor protein markers were analyzed by immunohistochemistry (IHC). Specific changes in tumor protein markers before/after NAC were compared.

The decrease in the positive rate of Ki-67 was the most significant, from 75.9% before NAC to 41.1% after NAC (P < .001). The positive rate of HER2 decreased from 42.0% before NAC to 32.1% after NAC (P = .04). The positive rate of ER decreased from 66.1% before NAC to 56.2% after NAC (P = .04). Increased number of metastatic lymph nodes (P = .006) and body mass index (BMI) (P = .028) seemed to be related to conversion of PR (positive to negative). There was statistical association between the Ki-67 (positive to negative) with the age greater or equal to 50 (P = .015). The BMI greater or equal to 24 (P = .021), age greater or equal to 50 (P = .047), and blood type A (P = .038) were independently associated with conversion of P53 (positive to negative). The BMI greater or equal to 24 (P = .004), number of metastatic lymph nodes greater or equal to 1 (P = .029) and TNM stages I–II (P = .008) were statistically associated with change of HER2 (positive to negative).

In patients without pCR, NAC leads to changes in Ki-67, HER2, and hormone receptor (HR) expression. Age, BMI, number of metastatic lymph nodes, and TNM stage are associated with some changes of markers.
CALD1, CNN1, and TAGLN identified as potential prognostic molecular markers of bladder cancer by bioinformatics analysis
Authors: Liu Yun , Wu Xia , Wang Guokun , Hu Shisong , Zhang Yuandong , Zhao Shenglong
Published: January 2019

Background:

Bladder cancer (BC) is one of the most common malignant neoplasms in the genitourinary tract. We employed the GSE13507 data set from the Gene Expression Omnibus (GEO) database in order to identify key genes related to tumorigenesis, progression, and prognosis in BC patients.

Methods:

The data set used in this study included 10 normal bladder mucosae tissue samples and 165 primary BC tissue samples. Differentially expressed genes (DEGs) in the 2 types of samples were identified by GEO2R. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed using the online website DAVID. The online website STRING was used to construct a protein–protein interaction network. Moreover, the plugins in MCODE and cytoHubba in Cytoscape were employed to find the hub genes and modules in these DEGs.

Results:

We identified 154 DEGs comprising 135 downregulated genes and 19 upregulated genes. The GO enrichment results were mainly related to the contractile fiber part, extracellular region part, actin cytoskeleton, and extracellular region. The KEGG pathway enrichment results mainly comprised type I diabetes mellitus, asthma, systemic lupus erythematosus, and allograft rejection. A module was identified from the protein–protein interaction network. In total, 15 hub genes were selected and 3 of them comprising CALD1, CNN1, and TAGLN were associated with both overall survival and disease-free survival.

Conclusion:

CALD1, CNN1, and TAGLN may be potential biomarkers for diagnosis as well as therapeutic targets in BC patients.
Efficacy and safety of Yinchen Sini decoction in treating biliary atresia patients after Kasai portoenterostomy
Authors: Chen Guoming , Huang Chuyao , Lu Jiaxin , Huang Ruilan , Zhang Jie , Chen Ziyin , Xu Hua
Published: January 2019

Background:

Biliary atresia (BA) is a neonatal obstructive biliary tract disease in which the intrahepatic and extrahepatic bile ducts are obstructed and can lead to congenital biliary atresia of cholestatic cirrhosis and eventually liver failure. It has been confirmed that the Kasai portoenterostomy is an effective treatment for BA. But most patients still face complications, such as cholangitis and liver fibrosis. Yinchen Sini decoction (YCSND), a traditional herbal formula, is used as a treatment for BA after Kasai portoenterostomy. And it is supported that YCSND can improve jaundice and liver fibrosis through multiple targets and pathways. Based on the published literature, this study aims to evaluate the current situation in the treatment of BA in children with YCSND.

Methods:

The following databases will be searched until October 2018: PubMed, The Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese biomedical literature database (CBM), Wan Fang Database, Chinese Scientific Journals Database (VIP) and other sources such as Hand searching, Conference proceeding, International Clinical Trials Registry Platform and Chinese Clinical Trials Registry. All randomized controlled trials (RCTs) of YCSND or related formula as a treatment for postoperative patients of Kasai portoenterostomy for BA will be collected. Data extraction and risk of bias assessments will be carried out by 2 verifiers independently. The risk of bias will be evaluated through the Cochrane risk of bias tool. Review Manager software (RevMan V.5.3.0) and STATA 15 will be used for statistical analyses.

Results:

This study will provide a high-quality synthesis of current evidence of YCSND in treating children undergoing Kasai portoenterostomy for BA from several aspects.

Conclusion:

The conclusion of the meta-analysis will offer evidence for deciding whether YCSND is an effective measure for children undergoing Kasai portoenterostomy for BA.

Ethics and dissemination:

Not only will this systematic review be published in a peer-reviewed journal, but it will also be propagated electronically and in print. The review will bring patients benefit and provide practitioners reference in the fields of conventional medicine.

PROSPERO registration number:

PROSPERO CRD 42018111321.
Event-free survival following early endometrial events in breast cancer patients treated with anti-hormonal therapy
Authors: Lee Yura , Park Yu Rang , Kim Hae Reong , Lee Jong Won
Published: January 2019

Tamoxifen, an anti-estrogen agent that can suppress breast cancer, has been reported to increase endometrium-related adverse events. There are no guidelines for screening tamoxifen-treated patients for endometrial disease. We analyzed nationwide claims data related to endometrial diseases to investigate patterns of endometrial disease in breast cancer patients who underwent hormonal treatment.

We sourced claims data from the Health Insurance Review and Assessment Service in South Korea. Patients who made their first claim for an anti-hormonal agent between January 1, 2010 and December 31, 2012 were enrolled retrospectively. We analyzed patient characteristics and all claims related to endometrial disease, stratified by prescribed hormonal agents.

Among a total of 32,496 enrolled patients, 19,603 used tamoxifen only and 10,101 were treated with an aromatase inhibitor (AI) alone. Endometrial events occurred in 15.4% (3028/19603) of the tamoxifen-only patients and 2.0% (201/10101) of the AI-only group. In patients diagnosed with breast cancer at the age of 50 or older, the hazard ratio (HR) of endometrial malignancy in the tamoxifen-only group compared to the AI-only group was 4.13 (95% CI 1.404–12.159, P = .010). The HR of curettage in the tamoxifen-only group was 31.0 (95% CI 19.668–48.831, P <.001).

The occurrence of endometrial events among tamoxifen-treated breast cancer patients was higher than in patients treated with only AI, similar to previous studies. However, the HR of curettage was uniquely high, despite its invasiveness. Guidelines for screening endometrial disease and improvements of healthcare policy are required to appropriately manage high-risk patients.
Successful entecavir plus prednisolone treatment for hepatitis B virus-associated membranoproliferative glomerulonephritis
Authors: Kataoka Hiroshi , Mochizuki Toshio , Akihisa Taro , Kawasoe Kentaro , Kawachi Keiko , Makabe Shiho , Sawada Anri , Manabe Shun , Sato Masayo , Amemiya Nobuyuki , Mitobe Michihiro , Akanuma Takafumi , Ito Yasuko , Inoue Takahiro , Suzuki Tomo , Matsui Katsuomi , Moriyama Takahito , Horita Shigeru , Ohara Mamiko , Honda Kazuho , Nitta Kosaku
Published: January 2019

Rationale:

Adult-onset hepatitis B virus-associated membranoproliferative glomerulonephritis (HBV-MPGN) is generally refractory, and an effective treatment for this condition has not been established. The indications for steroids in HBV-MPGN are an important clinical concern.

Patient concerns:

A 28-year-old woman with a chronic hepatitis B virus infection developed nephrotic syndrome in her second month of pregnancy, with urinary protein levels of 3 to 10 g/d that continued into her postpartum period. She was a carrier of HBV with HBeAg seroconversion. As her renal impairment could have been a result of pregnancy, we observed her for 10 months postpartum without any intervention. However, spontaneous remission after childbirth was not achieved and urine protein levels were sustained at 1 to 3 g/d. About 10 months after delivery, elevated serum liver enzyme levels were observed.

Diagnosis:

Biopsies showed MPGN, with deposition of hepatitis B antigen in the glomeruli, and chronic B-type hepatitis with a severity grade of A1F0. She was diagnosed with HBV-MPGN.

Interventions:

The patient was started on entecavir 0.5 mg/d in March 2008. Within 1 month, serum HBV DNA became undetectable; within 3 months, her alanine aminotransferase levels normalized. However, urinary protein excretion did not decrease to <2 g/d. On a second renal biopsy, performed 7 months after entecavir treatment, proliferative lesions of the glomeruli were observed; therefore, prednisolone was started at an initial dose of 30 mg/d.

Outcomes:

Her proteinuria improved immediately and prednisolone was tapered over 10 months. A third renal biopsy showed a remarkable resolution of HBV-MPGN, with a significant decrease in mesangial proliferation and immune complex deposition. HBV reactivation was not observed during the prednisolone treatment.

Lessons:

Additional prednisolone therapy in combination with antiviral therapy should be considered for refractory HBV-MPGN, with sufficient care taken regarding HBV reactivation.
The cost-effectiveness of medication, laser trabeculoplasty, and trabeculectomy for treatment of open-angle glaucoma in South Korea
Authors: Choi Jin A. , Song Lina D. , Choi Seulggie , Park Sang Min , Kwon Jin Woo , Jee Donghyun
Published: January 2019

Objectives:

Open-angle glaucoma (OAG) imposes high disease burden in South Korea. Although various effective interventions are available to manage the progression of OAG, there is limited data on the cost-effectiveness of these treatment strategies in South Korea.

Methods:

Using a Markov cohort model, we evaluated the cost-effectiveness of 3 major treatment strategies (medication, laser trabeculoplasty, and trabeculectomy) for South Korean patients with OAG. We projected a 25-year time horizon to study a hypothetical cohort of 10,000 patients of age 40 with mild OAG. The outcome measures were quality-adjusted life-years (QALYs) gained, cost from the societal perspective, and the incremental cost-effectiveness ratio (ICER) of medication, laser trabeculoplasty, and trabeculectomy. Interventions were evaluated at a willingness-to-pay (WTP) threshold of 30,000,000 KRW ($29,152) per QALY gained. Deterministic and probabilistic sensitivity analyses were conducted to address the model uncertainty.

Results:

The mean costs for medication, laser trabeculoplasty, and trabeculectomy were 29,661,740 KRW, 17,34,1342 KRW, and 22,275,438 KRW, respectively. The mean QALYs gained were 15.7, 15.3, and 14.8 for medication, laser trabeculoplasty, and trabeculectomy, respectively. Surgery was strongly dominated because it generated fewer expected QALYs but incurred greater expected cost than laser. The ICER was 30,885,179 KRW per QALY for medication versus laser trabeculoplasty. Laser was cost-effective, however, at a lower WTP threshold of 21,000,000 KRW per QALY gained or below. The results were most sensitive to the progression rates from mild to moderate glaucoma under laser treatment.

Conclusion:

Under the WTP threshold of 30,000,000 KRW per QALY, medication was cost-effective compared with laser trabeculoplasty and trabeculectomy for treating mild OAG in South Korean population. Laser, however, can be a cost-effective alternative in more resource-limited settings.
Chronic active EBV infection associated with NK cell lymphoma and hemophagocytic lymphohistiocytosis in a 27-year-old woman
Authors: Wang Ya-Dong , Wu Ling-Ling , Ma Lu-Yuan , Shang Xiao-Bo , Li Zi-Yue , Wang Wei , Shen Chuan , Yang Jing-Jing , Sun Li-Xia , Zhao Cai-Yan
Published: January 2019

Rationale:

Chronic active Epstein-Barr virus infection (CAEBV) is a common infectious disease that often affects multiple organs or systems. However, it is liable to be neglected and misdiagnosed owing to its insidious onset, lack of specific findings in the early phase, and a general lack of awareness among clinicians.

Patient concerns:

a 27-year-old woman case has been described who was initially misdiagnosed as drug-induced liver injury due to onset presentation of mild splenomegaly, recurrent liver dysfunction, and disputable pathological evidence of liver biopsy.

Diagnoses:

CAEBV complicated with natural killer (NK) cell lymphoma and hemophagocytic lymphohistiocytosis (HLH) was diagnosed by in situ hybridization of liver tissue section with EBV-encoded RNA -1 probe and flow cytometry of bone marrow.

Interventions:

After admission, the patient received symptomatic treatment and antiviral therapy (combination of acyclovir and foscarnet sodium) as well as adjuvant treatment (thymosin alpha 1 and methylprednisolone); later, the patient received etoposide and dexamethasone for diagnosis of EBV associated HLH. Subsequently, the disease progressed to NK cell lymphoma and the patient received the revised EPOCH chemotherapy regimen [etoposide (100 mg/d, d1–5), dexamethasone (7.5 mg/d, d1–5; 5 mg/d, d6–14), cyclophosphamide (0.8 g/d, d1–2), and pegaspargase (3750 u/d, tid, d1–2)].

Outcomes:

Although the patient received a series of therapies and other comprehensive measures, finally she died of gastrointestinal hemorrhage and multiple organ failure.

Lessons:

Liver is one of the main target organs of EBV infection. In the clinical setting of unexplained fever and liver injury, it is necessary to be aware of CAEBV, as well as its fatal complication such as EBV associated NK cell lymphoma and HLH.
Identification of key regulators of pancreatic ductal adenocarcinoma using bioinformatics analysis of microarray data
Authors: Li Nan , Zhao Xin , You Shengyi
Published: January 2019

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal forms of cancer, and its etiology remains largely unknown. This study aimed to screen a panel of key genes and to identify their potential impact on the molecular pathways associated with the development of PDAC. Four gene expression profiles, GSE28735, GSE15471, GSE102238, and GSE43795, were downloaded from the Gene Expression Omnibus (GEO) database. The intersection of the differentially expressed genes (DEGs) in each dataset was obtained using Venn analysis. Gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) analysis were subsequently carried out. To screen for hub genes, a protein–protein interaction (PPI) network was constructed.

The intersection of the DEGs revealed 7 upregulated and 9 downregulated genes. Upon relaxation of the selection criteria, 58 upregulated and 32 downregulated DEGs were identified. The top 5 biological processes identified by GO analysis involved peptide cross-linking, extracellular matrix (ECM) disassembly, regulation of the fibroblast growth factor receptor signaling pathway, mesoderm morphogenesis, and lipid digestion. The results of KEGG analysis revealed that the DEGs were significantly enriched in pathways involved in protein digestion and absorption, ECM-receptor interaction, pancreatic secretion, and fat digestion and absorption. The top ten hub genes were identified based on the PPI network.

In conclusion, the identified hub genes may contribute to the elucidation of the underlying molecular mechanisms of PDAC and serve as promising candidates that can be utilized for the early diagnosis and prognostic prediction of PDAC. However, further experimental validation is required to confirm these results.
Papillary glioblastoma exhibiting a neuroradiological cyst with a mural nodule
Authors: Homma Taku , Hanashima Yuya , Maebayashi Toshiya , Nakanishi Yoko , Ishige Toshiyuki , Ohta Takashi , Yoshino Atsuo , Hao Hiroyuki
Published: January 2019

Rationale:

Glioblastomas are malignant, infiltrating gliomas classified as grade IV by the World Health Organization. Genetically, most glioblastomas do not exhibit the isocitrate dehydrogenase (IDH) 1/2 gene mutation and rarely harbor the 1p/19q co-deletion. Neuroradiologically, glioblastomas rarely form a cyst with a mural nodule lesion.

Patient concerns:

In this study, a 78-year-old woman, with speech difficulty and forgetfulness, had a cystic tumor with a mural nodule in the right frontoparietal lobe. Therefore, partial tumor resection was performed.

Diagnosis:

Histopathology of the tumor, a glioblastoma, exhibited pseudopapillary features with non-hyalinized capillary cores and rich mini-gemistocytic cells. Genetic analysis of the tumor revealed co-deletion of 1p36/19q13, with wild-type IDH.

Interventions:

The patient underwent a combination of postoperative radiotherapy and temozolomide chemotherapy before leaving the hospital. After discharge, she was treated by 20 courses of temozolomide chemotherapy.

Outcomes:

The patient is free from tumor recurrence 23 months after the operation.

Lessons:

We present a unique case of glioblastoma that exhibited novel neuroradiological, histopathological, and genetic features with a favorable prognosis for the patient. Therefore, a compilation of similar cases with clinicopathological and genetic analyses to characterize this unique glioblastoma is critical. Clinical evidence will help develop effective therapeutic approaches to improve prognosis in patients with glioblastoma.
Dietary patterns and Helicobacter pylori infection in a group of Chinese adults ages between 45 and 59 years old
Authors: Shu Long , Zheng Pei-Fen , Zhang Xiao-Yan , Feng Yu-Liang
Published: January 2019

Limited studies have reported the association between dietary patterns and the risk of Helicobacter pylori (H pylori) infection. The purpose of this study was to evaluate the relationship between dietary patterns and H pylori infection in a Chinese population ages from 45 to 59 years. We performed a cross-sectional examination of the associations between dietary patterns and H pylori infection in 3014 Chinese adults ages between 45 and 59 years from Hangzhou city, Zhejiang province, China. Dietary intake was assessed through a semi-quantitative food frequency questionnaire (FFQ). H pylori infection was diagnosed using the 13C-urea breath test. Multivariable logistic regression analyses were used to determine the associations between dietary patterns and the risk of H pylori infection. The prevalence of H pylori infection was 27.5%. Four major dietary patterns were identified by means of factor analysis: health-conscious, Western, grains-vegetables and high-salt patterns. After adjustment for the potential confounders, participants in the highest quartile of the “grains-vegetables” pattern scores had a lower odds ratio (OR) for H pylori infection (OR = 0.82; 95% confidence interval [CI]: 0.732–0.973; P = .04) than did those in the lowest quartile. Compared with those in the lowest quartile, participants in the highest quartile of the “high-salt” pattern scores had a greater OR for H pylori infection (OR = 1.13; 95%CI: 1.004–1.139; P = .048). Besides, no significant associations were found between the “health-conscious” and “Western” dietary patterns and the risk of H pylori infection.

Our findings demonstrate that the “grains-vegetables” pattern is associated with a decreased risk, while “high-salt” pattern is associated with an increased risk of H pylori infection.
Docosahexaenoic Acid in Mature Breast Milk of Low‐income Mothers
Authors: Visentin Silvana , Malpeli Agustina , Fasano Victoria , Falivene Mariana , Malizia Betiana E. , González Horacio F.
Published: January 2019

Docosahexaenoic acid (DHA) is among the main components of synaptosomal membranes and myelin sheaths. Because DHA is essential for child neurodevelopment, breast milk DHA levels should be improved by optimizing maternal nutrition. We determined DHA percentage levels in breast milk of low‐income mothers receiving care at the public healthcare sector. We performed a descriptive, cross‐sectional study in breast milk samples from 39 exclusively breast‐feeding adult mothers with normal fetal and neonatal history. Samples were collected 90 ± 7 days after delivery. Breast milk fatty acid composition was determined by gas chromatography. The cut‐off value of DHA was 0.3% of total fatty acids in milk according to recommendations. Median DHA in milk was 0.14% (0.12–0.21). Breast milk DHA levels were lower than the minimum recommended in 92% of samples. The analysis of breast milk samples from low‐income exclusively breast‐feeding mothers showed that they did not reach the minimum recommended DHA percentage.