bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol Use, Intimate Partner Violence, and HIV Sexual Risk Behavior Among Young People in Fishing Communities of Lake Victoria, Uganda
Authors: Wandera Stephen Ojiambo , Mbona Nazarius Tumwesigye , Walakira Eddy , Wagman Jennifer , Kisaakye Peter
Published: December 2020

BackgroundThere is limited evidence about the effect of alcohol use and intimate partner violence (IPV) on HIV risk among young people in fishing communities from eastern and central Uganda. Therefore, we aimed to determine whether alcohol use and intimate partner violence were HIV behavior among young people in fishing communities on the shores of Lake Victoria, in Uganda. MethodsWe conducted multivariable logistic regression analyses of HIV risk behavior using cross-sectional data from 501 young people from Mukono (Katosi landing site) and Namayingo districts (Lugala landing site). Results Almost all (97%) respondents reported at least one HIV risk behavior; more than half (54%) reported engagement in three or more HIV risk behaviors. Results from the adjusted model indicate that alcohol use, working for cash or kind, being married and having multiple sexual partners increased the odds of HIV risk behavior. IPV was not associated with HIV risk behavior. Conclusion Interventions to promote consistent condom use and fewer sexual partnerships are critical for young people in the fishing communities in Uganda.
SNP Markers Reveal Relationships between Fruit Paternity, Fruit Quality and Distance from a Cross-pollen Source in Persea Americana Orchards
Authors: Kämper Wiebke , Ogbourne Steven , Hawkes David , Trueman Stephen
Published: December 2020

Plant reproductive output is increasingly pollen limited, and cross-pollination can improve fruit yield, fruit size and nutritional quality of many food crops. However, we rarely understand what proportions of the crop result from self- or cross-pollination, how cross-pollination affects crop quality, and how far pollen is transported by pollinators. Management strategies to improve pollination services are consequently not optimal for many crops.We utilised a series of SNP markers, unique for each cultivar of avocado, to quantify proportions of self- and cross-paternity in fruit of Hass avocado at increasing distances from cross-pollen sources. We assessed whether distance from a cross-pollen source determined the proportions of self-pollinated and cross-pollinated fruit, and evaluated how self- and cross-paternity affected fruit size and nutritional quality.Avocado fruit production resulted from both self- and cross-pollination. Cross-pollination levels decreased with increasing distance from a cross-pollen source, from 63% in the row adjacent to another cultivar to 25% in the middle of a single-cultivar block, suggesting that pollen transport was limited across orchard rows. Limited pollen transport did not affect fruit size or quality in Hass avocados as xenia effects of a Shepard polliniser on size and nutritional quality were minor.
Graph-Based Open-Ended Survey on Concerns Related to COVID-19
Authors: Kawamoto Tatsuro , Aoki Takaaki , Ueda Michiko
Published: December 2020

The COVID-19 pandemic is an unprecedented public health crisis with broad social and economic consequences. We conducted four surveys between April and August 2020 using the graph-based open-ended survey (GOS) framework, and investigated the most pressing concerns and issues for the general public in Japan. The GOS framework is a hybrid of the two traditional survey frameworks that allows respondents to post their opinions in a free-format style, which can subsequently serve as one of the choice items for other respondents, just as in a multiple-choice survey. As a result, this framework generates an opinion graph that relates opinions and respondents. We can also construct annotated opinion graphs to achieve a higher resolution. By clustering the annotated opinion graphs, we revealed the characteristic evolution of the response patterns as well as the interconnectedness and multi-faceted nature of opinions.
Genomic Scans for Selective Sweeps With Four Complementary Statistical Tests on 14 Indigenous Sheep Breeds From Middle East and South Asia
Authors: Eydivandi Sirous , Karimi Mohammad Osman , Roudbar Mahmood Amiri , Sahana Goutam
Published: December 2020

The performance and productivity of livestock have consistently improved by natural and artificial selection over the centuries. Both these selections are expected to leave patterns on the genome and lead to changes in allele frequencies, but natural selection has played the major role among indigenous populations. Detecting selective sweeps in livestock may assist in understanding the processes involved in domestication, genome evolution and discovery of genomic regions associated with economically important traits. We investigated selection signals in this study using SNP genotype data of 14 indigenous sheep breeds from Middle East and South Asia, including six breeds from Iran, namely Iranian Balochi, Afshari, Moghani, Qezel, Zel, and Lori-Bakhtiari, three breeds from Afghanistan, namely Afghan Balochi, Arabi, and Gadik, three breeds from India, namely Indian Garole, Changthangi, and Deccani, and two breeds from Bangladesh, namely Bangladeshi Garole and Bangladesh East. The SNP genotype data were generated by the Illumina OvineSNP50 Genotyping BeadChip array. We applied four complementary statistical tests, FST (fixation index), xp-EHH (cross-population extended haplotype homozygosity), Rsb (extended haplotype homozygosity between-populations), and FLK (the extension of the Lewontin and Krakauer) to detect selective sweeps. Our results not only confirm the previous studies but also provide a suite of novel candidate genes involved in different traits in sheep. On average, FST, xp-EHH, Rsb, and FLK detected 128, 207, 222, and 252 genomic regions as candidates for selective sweeps, respectively. Furthermore, overlapping candidate genes were detected by these four tests, including; TNIK, DOCK1, SFMBT1, SPO11, USH2A, TYW1B, NELL2, EML5, and IQCE. The first six of these genes, especially TNIK, DOCK1, and SPO11 were enriched by Gene Ontology (GO) and are involved in embryonic development, immune response, and fertility respectively. Knowledge of candidate genomic regions in sheep populations may facilitate the identification and potential exploitation of the underlying genes in sheep breeding.
Perception of the Community Toward Transition of Pharmaceutical Care Services from Ministry of Health Primary Healthcare Centers to Community Pharmacies
Authors: Aloola Noha Al , Aljudaib Sumaiah , Behery Fathy , Alwhaibi Monira , Alhawassi Tariq
Published: December 2020

Background: Pharmaceutical care services in Saudi Arabia recently transferred from Ministry of Health (MOH) primary healthcare centers (PHCs) to community pharmacies (Wasfaty service). However, there is a lack of research on the need and impact of this transition. This study explored the Saudi community’s perception toward the transition of pharmaceutical care service from MOH PHCs to the Wasfaty service. Community needs and expectations from the Wasfaty service were assessed, and its experience, concerns, and limitations were evaluated. Methods: Qualitative, in-depth, semistructured interviews of Saudi community members who visited community pharmacies with electronic prescriptions from MOH primary healthcare clinics were conducted. The data obtained from 18 participants were thematically organized and analyzed using NVivo software. Results: Seven themes related to the new Wasfaty service were identified and divided into three categories: perception toward the transition in pharmaceutical care, experience of the Wasfaty service, and concerns about and limitations of the Wasfaty service. The Saudi community was generally satisfied with the new Wasfaty service and highlighted its benefits: easier access, time flexibility, and less crowded community pharmacies. In addition, the Wasfaty service provided them with better communication with pharmacists, better education about their medications, better availability of medications, better control over medication dispensing, and easier refills compared to primary healthcare pharmacies. However, the community complained about the lack of privacy in community pharmacies, the number and location of community pharmacies having the Wasfaty service, a few technical issues, a lack of female pharmacists, few Saudi pharmacists, a lack of labels on medications, and limited or no instructions about medication storage. Conclusion: The Saudi community needs the transition from MOH PHCs to the Wasfaty service in pharmaceutical care. The community also has concerns about this transition and the limitations of the Wasfaty service.
Effectiveness of movement-based animal signals is a function of display structure and habitat characteristics: simulations of Australian dragons
Authors: Bian Xue , Pinilla Angela , Chandler Tom , Peters Richard
Published: December 2020

Habitat-specific characteristics can affect signal transmission such that different habitats dictate the optimal signal. One way to examine how the environment influences signals is by comparing changes in signal efficacy in different habitats. Examinations of signal efficacy between different habitats has helped to explain signal divergence/convergence between populations and species utilising acoustic and colour signals. Although previous research has provided evidence for local adaptations and signal divergence in many species of lizards, comparative studies in movement-based signals are rare due to technical difficulties in quantifying movements in nature and ethical restrictions in translocating animals between habitats. We demonstrate herein that these issues can be addressed using 3D animations, and compared the relative performance of the displays of four Australian lizard species in the habitats of each species under varying environmental conditions. Our simulations show that habitats differentially affect signal performance, and an interaction between display and habitat structure. Interestingly, the signal adapted to the noisier environment did not show an advantage in signal efficacy, but the noisy habitat was detrimental to the performance of all displays. Our study is one of the first studies for movement-based signals that directly compares signal performance in multiple habitats, and our approach has laid the foundation for future investigations in motion ecology that have been intractable to conventional research methods.
Use of the Clock Drawing Test and the Rey–Osterrieth Complex Figure Test-copy With Convolutional Neural Networks to Predict Cognitive Impairment
Authors: Youn Young Chul , Pyun Jung-Min , Ryu Nayoung , Baek Min Jae , Jang Jae-Won , Park Young Ho , Ahn Suk-Won , Shin Hae-Won , Park Kwang-Yeol , Kim SangYun
Published: December 2020

Background: The Clock Drawing Test (CDT) and Rey–Osterrieth Complex Figure Test (RCFT) are widely used as a part of neuropsychological test batteries to assess cognitive function. Our objective was to confirm the prediction accuracies of the RCFT-copy and CDT for cognitive impairment (CI) using the convolutional neural network (CNN) algorithm as a screening tool. Methods: The CDT and RCFT-copy data were obtained from patients aged 60 to 80 years who had more than 6 years of education. In total, 747 CDT and 980 RCFT-copy figures were utilized. CNN algorithms using TensorFlow (ver. 2.3.0) on the Colab cloud platform (www.colab.research.google.com) were used for preprocessing and modeling. We measured the prediction accuracy of each drawing test 10 times using this dataset: normal cognition (NC) vs. mild impairment of cognition (MI), NC vs. severely impaired cognition (SI), and NC vs. CI (MI +SI). Results: The accuracy of the CDT was better for differentiating MI (CDT: 78.04±2.75, RCFT-copy: not being trained) and SI from NC (CDT: 91.45±0.83, RCFT-copy: 90.27±1.52); however, the RCFT-copy was better at predicting CI (CDT: 77.37±1.77, RCFT: 83.52±1.41). The accuracy for 3-way classification (NC vs. MI vs. SI) was approximately 71% for both tests; no significant difference was found.Conclusions: The two drawing tests showed good performance for predicting severe impairment of cognition; however, a drawing test alone is not enough to predict overall CI. There are some limitations to our study: the sample size was small, all participants did not perform both the CDT and RCFT-copy, and only the copy condition of the RCFT was used. Algorithms involving memory performance and longitudinal changes are worth future exploration. These results may contribute to improved home-based healthcare delivery.
Impaired Anaplerosis Is a Major Contributor to Glycolysis Inhibitor Toxicity in Glioma
Authors: Khadka Sunada , Arthur Kenisha , Washington Mykia , Barekatain Yasaman , Ackroyd Jeff , Behr Eliot , Suriyamongkol Pornpa , Lin Yu-Hsi , Crowley Kaitlyn , Pham Cong-Dat , Georgiou Dimitra K. , Asara John , Muller Florian
Published: December 2020

Reprogramming of metabolic pathways is crucial to satisfy the bioenergetic and biosynthetic demands and maintain the redox status of rapidly proliferating cancer cells. In tumors, the tricarboxylic acid (TCA) cycle generates biosynthetic intermediates by oxidation of anaplerotic substrates, such as glucose-derived pyruvate and glutamine20 derived glutamate. We have previously documented that a subset of tumors with 1p36 homozygous deletion exhibit co-deletion of ENO1, in turn becoming extremely dependent on its redundant isoform ENO2 and sensitive to an overall enzymatic deficiency of enolase. Metabolomic profiling of ENO1-deleted glioma cells treated with an enolase inhibitor revealed a profound decrease in TCA cycle metabolites, which correlated with cell-line specific sensitivity to enolase inhibition, highlighting the importance of glycolysis derived pyruvate for anaplerosis. Correspondingly, the toxicity of the enolase inhibitor was significantly attenuated by exogenous supplementation of supraphysiological levels of anaplerotic substrates including pyruvate. These findings led us to hypothesize that cancer cells with ENO1 homozygous deletions treated with an enolase inhibitor might show exceptional sensitivity to inhibition of glutaminolysis because of reduced anaplerotic flow from glycolysis. We found that ENO1-deleted cells indeed exhibited selective sensitivity to the glutaminase inhibitor CB-839, and this sensitivity was also attenuated by exogenous supplementation of anaplerotic substrates including pyruvate. Despite these promising in vitro results, the antineoplastic effects of CB-839 as a single agent in ENO1-deleted xenograft tumors in vivo were modest in both intracranial orthotopic tumors, where the limited efficacy could be attributed to the blood brain barrier (BBB), and subcutaneous xenografts, where BBB penetration is not an issue. This contrasts with the enolase inhibitor HEX, which, despite its negative charge, achieved antineoplastic effects in both intracranial and subcutaneous tumors. Together, these data suggest that at least for 1p36-deleted gliomas, tumors in vivo—unlike cells in culture—show limited dependence on glutaminolysis and instead primarily depend on glycolysis for anaplerosis. Our findings reinforce the previously reported metabolic idiosyncrasies of the in vitro and in vivo environments as the potential reasons for the differential efficacy of metabolism targeted therapies in in vitro and in vivo systems.
Ref-1 Redox Activity Alters Cancer Cell Metabolism in Pancreatic Cancer: Exploiting This Novel Finding as a Potential Target  
Authors: Gampala Silpa , Shah Fenil , Lu Xiaoyu , Moon Hye-ran , Sandusky George , Hulsey Emily , Mosley Amber , Han Bumsoo , Ivan Mircea , Kelley Mark R , Zhang Chi , Fishel Melissa L
Published: December 2020

Background: Pancreatic cancer is a complex disease with a desmoplastic stroma, extreme hypoxia, and inherent resistance to therapy. Understanding the signaling and adaptive response of such an aggressive cancer is key to making advances in therapeutic efficacy. Redox factor-1 (Ref-1), a redox signaling protein, regulates the DNA binding activity of several transcription factors (TFs), including HIF-1α, STAT3 and NFκB . The conversion of these TFs from an oxidized to reduced state lead to enhancement of their DNA binding. In our previously published work, knockdown of Ref-1 under normoxia resulted in altered gene expression patterns on pathways including EIF2, protein kinase A, and mTOR. In this study, single cell RNA sequencing (scRNA-seq) and proteomics were used to explore the effects of Ref-1 on metabolic pathways under hypoxia.Methods: scRNA-seq comparing pancreatic cancer cells expressing less than 20% of the Ref-1 protein was analyzed using left truncated mixture Gaussian model and validated using proteomics and qRT-PCR. The impact of knocking down Ref-1 under hypoxia was dramatic on the mitochondria and metabolic pathways. Ref-1’s role in mitochondrial function was confirmed using mitochondrial function assays and qRT-PCR. Further, the effect of Ref-1 redox function inhibition against pancreatic cancer metabolism was assayed using 3D co-culture in vitro and xenograft studies in vivo and compared to Devimistat, a drug that disrupts mitochondrial metabolism.Results: Distinct transcriptional variation in central metabolism, cell cycle, apoptosis, immune response, and genes downstream of a series of signaling pathways and transcriptional regulatory factors were identified in Ref-1 knockdown vs Scrambled control from the scRNA-seq data. Mitochondrial DEG subsets downregulated with Ref-1 knockdown were significantly reduced following Ref-1 redox inhibition and more dramatically in combination with Devimistat in vitro. Mitochondrial function assays demonstrated that Ref-1 knockdown and Ref-1 redox signaling inhibition decreased utilization of TCA cycle substrates and slowed the growth of pancreatic cancer co-culture spheroids. In vivo xenograft studies demonstrated that tumor reduction was potent with Ref-1 redox inhibitor similar to Devimistat.Conclusion: Ref-1 redox signaling inhibition conclusively alters cancer cell metabolism by causing TCA cycle dysfunction while also reducing the pancreatic tumor growth in vitro as well as in vivo.
YYFZBJS Inhibits Colorectal Tumorigenesis by Remodeling Enterotoxigenic Bacteroides Fragilis Mediated M2 Macrophage Polarization in Vivo and in Vitro
Authors: Chai Ni , Cheng Yuelei , Xiong Yibai , Shi Wenfei , Yao Yiqing , Yang Limei , Sui Hua , Zhu Huirong
Published: December 2020

BackgroundThe occurrence of CRC is believed to be related to a variety of factors. Accumulating evidence shows that microbiota can influence the outcome of cancer immunotherapy. Our previous studies indicated that the extract of Yi-Yi-Fu-Zi-Bai-Jiang-San (YYFZBJS), had potent anticancer activities by significantly inhibiting intestinal tumor development in ApcMin/+ mice. However, knowledge regarding the mechanism and effect of YYFZBJS in the prevention of colorectal cancer is limited.MethodsIn this study, we investigated the preventive effects of oral administration of YYFZBJS in enterotoxigenic Bacteroides fragilis (ETBF)-colonized mice with azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced tumorigenesis. Here, the tumor load, tumor number, histology, and the severity of disease activity index (DAI) scores were reduced as expected.Resultsthe intragastric administration of YYFZBJS in AOM/DSS model significantly decreased ETBF abundance, immunity and some M2 macrophage markers, including CD206, Arg-1, IL-10, and TGF-β. Additionally, reversing polarized macrophages, which has been modified by YYFZBJS, could suppressed CRC cell proliferation and infiltration, as demonstrated by decreasing some tumor proliferation-related proteins in a dose-dependent manner, including c-Met, cyclinD1 and MMPs. Importantly, ETBF dysbiosis can contribute to the development of colon tumor by stimulating p-STAT3 medicated M2 macrophages polarization to promote chronic inflammation and adenoma malignant transformation, which effectively constrained by YYFZBJS.Conclusion﻿Altogether, we demonstrate that ETBF dysbiosis may contribute to M2 macrophages-promoted colon carcinogenesis and progression of CRC cells, and indicating that YYFZBJS could be employed as a promising protective agent against ETBF-mediated colorectal cancer.
Stromal Score-based Gene Signature: A Prognostic Prediction Model for Colon Cancer
Authors: Jia Jing , Dai Yuhan , Zhang Qing , Tang Peiyu , Fu Qiang , Xiong Guanying
Published: December 2020

BackgroundGrowing evidence has revealed the crucial roles of stromal cells in the microenvironment of various malignant tumors. However, efficient prognostic signatures based on stromal characteristics in colon cancer have not been well-established yet. The present study aimed to construct a stromal score-based multigene prognostic prediction model for colon cancer.MethodStromal scores were calculated based on the expression profiles of a colon cancer cohort from TCGA database applying the ESTIMATE algorithm. Linear models were used to identify differentially expressed genes between low-score and high-score groups by limma R package. Univariate and multivariate CoxPH regression analyses were used successively to select prognostic gene signature. An independent dataset from GEO was used as a validation cohort.ResultsLow stromal score was demonstrated to be a favorable factor to overall survival of colon cancer patients in TCGA cohort (log-rank test p = 0.0046). Three hundred and seven stromal score-related differentially expressed genes were identified. Through univariate and multivariate CoxPH regression analyses, a gene signature consisting of LEP, SYT3, NOG and IGSF11 was recognized to build a prognostic prediction model. Based on the predictive values estimated by the established integrated model, patients were divided into two groups with significantly different overall survival outcomes (log-rank test p < 0.0001). Time-dependent Receiver operating characteristic curve analyses suggested the satisfactory predictive efficacy for 5-year overall survival of the model (AUC value = 0.736). A nomogram with great predictive performance combining the multigene prediction model and clinicopathological factors was developed. The established model was verified to be of significant prognostic value for different subgroups in an independent colon cancer cohort from GEO database, which was demonstrated to be especially accurate for young patients (AUC value = 0.752). ConclusionThe well-established model based on stromal score-related gene signature might serve as a promising tool for the prognostic prediction of colon cancer.
Impact of Donation Physicians on Deceased Organ Donation: A Systematic Review
Authors: Squires Janet , Aloisio Laura D , Santos Wilmer John , Cho-Young Danielle , Taljaard Monica , Gritters Nills , Dhanani Sonny , Knoll Gregory
Published: December 2020

Background: An emerging strategy to increase deceased organ donation is to use dedicated donation physicians to champion organ donation. We sought to conduct a systematic review of the effectiveness of donation physicians in improving organ donation outcomes.Data Sources: A systematic review was conducted following Cochrane principles. MEDLINE, Embase, and CINHAL databases were searched from inception to March 26, 2020. Study Selection: Quantitative studies examining the effects of donation physicians on all deceased organ donation outcomes were considered for inclusion. Review articles, editorials and opinion articles, and case studies were excluded. Study selection was completed independently by two team members; all discrepancies were resolved by consensus.Data Extraction: Two team members independently extracted data from studies. Data Synthesis: A total of 1,017 studies were screened, and 12 met inclusion criteria. Included studies were published between 1994 and 2019. Half used an interrupted time series design (n = 6; 50%), three (25%) were cohort studies, and three (25%) used a before-and-after study design. Outcomes (reported in greater than 50% of included articles) included consent/refusal rate (n = 8; 67%), number of potential donors (n = 7; 58%), and number of actual donors (n = 7; 58%). Across studies and design types, there was an increase in potential organ donors ranging from 8 to 143% (Mdn = 33%), an increase in actual organ donors from 15 to 113% (Mdn = 27%), an increase in donor consent rate from -3 to 258% (Mdn = 12%) and an increase in deceased donor transplants from 13 to 24% (Mdn = 19%) following the introduction of donation physicians.Conclusions: Donation physicians have the potential to significantly improve deceased organ donation. Further implementation and evaluation of donation physician programs is warranted. However, implementation should be undertaken with a clear plan for a methodologically rigorous evaluation of outcomes.
Prognostic Value and Immune Infiltration of Novel Biomarkers in Glioma: Evidence From a Comprehensive Analysis of Tumor Microenvironment
Authors: Zhang Bolun , Guan Feng , Dai Bin , Zhu Guangtong , Mao Beibei , Liang Xin , Hu Zhiqiang
Published: December 2020

BackgroundIn the glioma microenvironment, infiltrating immune cells has been shown to possess beneficial effects for tumor progression. Immune cells and stromal cells dominate the tumor microenvironment in glioma. The complex interplay between the tumor progression with immune cells or stromal cells was still unknown. MethodsIn this study, we used Estimation of stromal and immune cells in malignant tumor tissues using expression data (ESTIMATE) calculations to calculate the proportion of tumour-infiltrating immune cells (TIC) and the number of immune and stromal components in glioma cases from the cancer Genome Atlas (TCGA) and the Chinese Glioma Genome Atlas (CGGA) databases. Differentially expressed genes (DEG) were analyzed by COX regression analysis and protein-protein interaction (PPI) network construction. Then, JAK3, IL2RB and CD3E were identified as predictors by the intersection analysis of univariate COX and PPI, and further analysis showed that the expression of them were positively correlated with survival and clinicopathological characteristics of glioma patients. Finally, the Cell type Identification By Estimating Relative Subsets Of known RNA Transcripts (CIBERSORT) deconvolution algorithm was applied to quantify the fraction and infiltration of 22 types of immune cells in glioma. ResultsOur results showed that ESTIMATEScores Were Correlated with the Survival of glioma Patients, DEGs Shared by ImmuneScore and StromalScore were predominantly presented as the enrichment of immune-related genes gene set enrichment analysis (GSEA). The intersection analysis of PPI network and univariate COX regression enabled us to identify three genes (JAK3, IL2RB and CD3E) that had never been reported before, whose expression was correlated with clinical characteristics such as survival and WHO grading of these patients. CITICSORT analysis of TIC ratio showed that B cell memory and CD8 + T cells were positively correlated with JAK3, IL2RB and CD3E expression, suggesting that these genes may be responsible for maintaining the immunodominant state of TME. CIBERSORT analysis for the proportion of TICs revealed that the levels of JAK3, IL2RB and CD3E affected the immune activity of TME.ConclusionOur results confirmed that the JAK3, IL2RB and CD3E can be used as diagnostic and prognostic biomarkers for glioma and may be used as therapeutic targets in the future.
Needle Biopsy Compared With Surgical Biopsy: Pitfalls of Small Biopsy in Histologial Diagnosis of IgG4-related Disease
Authors: Liu Yanying , Yang Fei , Chi Xiying , Zhang Yuxin , Fu Jiangnan , Bian Wenjie , Shen Danhua , Li Zhanguo
Published: December 2020

ObjectiveThe growing utilization of needle biopsy has challenged the current pathology consensus of IgG4-related disease (IgG4-RD). The aims of this study were to identify the histological characteristics of needle biopsy and surgical specimens, and evaluate the ability of needle biopsy in histological diagnosis of IgG4-RD.MethodsBiopsies from patients who were referred to as IgG4-RD by the 2019 ACR/EULAR IgG4-RD classification criteria in Peking University People’s Hospital from 2012 to 2019 were re-evaluated. Typical histological features and diagnostic categories were compared between needle biopsy and surgical biopsy.ResultsIn total, 69 patients met the 2019 ACR/EULAR classification criteria and 72 biopsies of them were re-evaluated. All cases showed lymphoplasmacytic infiltrate, while storiform fibrosis and obliterative phlebitis were only present in 35 (48.6%) and 23 (31.9%) specimens, respectively. Storiform fibrosis was more likely to be seen in retroperitoneum lesion (P=0.033). Surgical biopsy showed significantly higher IgG4+ plasma cells/high power field (IgG4/HPF) count (P<0.01) and higher proportion of IgG4/HPF>10 (P<0.01). No significant difference was observed with regard to the ratio of IgG4+/IgG+ cells (IgG4/IgG) (P=0.399), storiform fibrosis (P=0.739), and obliterative phletibis (P=0.153). According to the 2011 comprehensive diagnostic criteria, patients who performed a needle biopsy were less likely to be probable IgG4-RD (P=0.045). Based on the 2011 pathology consensus, needle biopsy was tougher to be diagnosed as IgG4-RD (P<0.01), especially to be highly suggestive IgG4-RD (P<0.01). Only 1/18 (5.6%) needle salivary specimens fulfilled the cutoff of IgG4/HPF>100, which was significantly less than 15/23 (65.2%) of surgical ones (P<0.01).ConclusionsNeedle biopsy shows an inferiority in detecting IgG4/HPF count but not in IgG4/IgG ratio, storiform fibrosis and obliterative phlebitis. Compared with surgical samples, it is tougher for needle biopsy to obtain a histological diagnosis of IgG4-RD. A different IgG4/HPF threshold for needle biopsy of salivary glands may be considered.
Perceived Stress Among University Students in South-East Serbia During the COVID-19 Outbreak
Authors: Kostic Jelena , Zikić Olivera , Đorđevic Vladimir , Krivokapic Zilijeta
Published: December 2020

Background The COVID-19 pandemic has brought into focus the mental health the student population. The study aimed to analyze the psychological response to the COVID-19 outbreak in terms of perceived stress and its related factors among university students in the southeastern Serbia. The study was conducted during the increasing rate of the coronavirus disease in Serbia. Method A total of 434 students from the public university in South-East Serbia enrolled in the study and completed the measures of socio-demographical data, the Perceived stress scale (PSS-10), the Coping Strategy Indicator (CSI) and the General Health Questionnaire (GHQ-28). The data were analyzed through quantitative and qualitative methods. Results Study findings suggest that the mean perceived stress score was placed to 20.43 (±7.67), suggesting that the students showed high stress level during the COVID-19 outbreak. Our model showed that female gander, higher scores on anxiety/insomnia and depression subscales as well as the coping strategy avoidance predicted higher level of perceived stress, while higher scores on social dysfunction were related to the reduced perceived stress scores. Conclusion Besides limitation of the study, findings provided authentic data of stress reactions of students in South-East Serbia during the COVID-19 outbreak. The findings confirm the need to examine the experience of students in states of emergencies and crisis as well as introduce a plan for support programs aimed at preventing a decline in education efficacy in the long run, together with preventing the occurrence of mental disorders.
Assessing Frequency and Clinical Outcomes of BRCA Mutated Ovarian Cancer in Saudi Women
Authors: Agha Naela , Alshamsan Bader , Al-Farsi Sharifa , Ateya Heba Aly , Almugbel Fahed A , Alotaibi Hazem Abdullah , Omar Ayman , Mohamed Amgad Shahin , Alharthy Hanan , Elhassan Tusneem , Salem Hany , Alhussainia Hamed
Published: December 2020

Background: BRCA gene mutations (BRCAm) had an impact on patients' characteristics and clinical outcomes of ovarian cancer (OC). The frequency and patterns of BRCAm vary among countries and ethnicities. There are limited data from Saudi Arabia (SA); thus, this study aims to determine the frequency, pattern, and impact on patient characteristics and outcomes of BRCAm OC compared to wild-type BRCA (BRCAw) in Saudi women.This retrospective study evaluated women diagnosed with non-mucinous OC, fallopian tube, or peritoneal carcinoma who had BRCA status tested in an accredited lab between January 2016 and December 2017. The associations between various parameters and BRCAm were estimated using logistic regression. The objective response rate (ORR) of the first line and subsequent lines for BRCAm and BRCAw were evaluated using Response Evaluation Criteria in Solid Tumors Version 1. The disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan–Meier methods and compared by log-rank tests.Result: Sixty-one women with a median age of 52 at diagnosis were analyzed. Germline BRCA mutations were found in 41% of cases (25/61). The majority were BRCA 1 (92%), and the most common deleterious germline BRCA1 mutation was c.1140dupG (39%), followed by c.5530del (13%) and c.5095C>T (8%). Most women (72%) had no family history of cancers, all had high-grade serous carcinoma, and 82% had advanced stage at presentation. Regardless of BRCA mutations, an optimal ORR to first-line treatment has been achieved although most cases relapsed after the first line of management (84%) and the majority were platinum-sensitive relapse (85%). The ORR was higher in BRCAm in subsequent lines compared to BRCAw type. BRCAm women experienced longer median DFS (25 vs 17 months, p = 0.02) and a higher five-year OS rate (90.9% vs 66.7%, p = 0.19) than BRCAw.Conclusion: The prevalence of BRCAm of OC was higher in Saudi women when compared with the regional and most of the international figures. The better clinical outcomes of BRCAm women is in concordance with the reported evidence. Further studies on BRCA mutations of OC, education, genetic counseling, and free access to genetic testing are highly recommended.
A Multiplex PCR Assay for Six Aedini Species, Including Aedes albopictus
Authors: Bang Woo Jun , Won Min Hyeok , Cho Seong Tae , Ryu Jihun , Choi Kwang Shik
Published: December 2020

BackgroundMosquitoes, as vectors of various human pathogens, are significant drivers of serious human illness. In particular, those species in the Aedini tribe, which typically transmit dengue virus, Chikungunya fever virus, and Zika virus, are increasing their range because of climate change and international commerce. In order to prevent mosquito-borne disease, accurate mosquito species identification and monitoring are needed. The goal of this work was to develop a rapid and simple molecular diagnostic method for six morphologically similar Aedini species (Aedes flavopictus, Aedes albopictus, Ochlerotatus koreicus, Ochlerotatus japonicus, Ochlerotatus togoi, and Ochlerotatus hatorii) in Korea.MethodsIn total, 109 samples were used in this study. The internal transcribed spacer 2 (ITS2) regions from all six species were amplified, sequenced and analyzed using Mega 6. Once regions that were consistently different in sequence between all six species were identified, multiplex primers were designed to amplify them to generate species-specific fragments distinguishable by their size. ResultsUniquely sized fragments were generated in Aedes flavopictus (495bp), Aedes albopictus (438bp), Ochlerotatus koreicus (361bp), Ochlerotatus togoi (283bp), Ochlerotatus hatorii (220bp), and Ochlerotatus japonicus (160bp). Pairwise distance analysis showed that the difference was 35.0±1.5% between Aedes spp. and Ochlerotatus spp., 17.4±0.2% between Aedes albopictus and Aedes flavopictus, and 11.1±0.3% between Ochlerotatus koreicus and Ochlerotatus japonicus.ConclusionsIn this study, a multiplex PCR assay for six species of the Aedini tribe was developed. This assay is more accurate than morphological identification and will be useful for monitoring and controlling these vector mosquitoes.
Effectiveness of multicomponent treatment in patients with fibromyalgia: Protocol for a systematic review and meta-analysis
Authors: Araya-Quintanilla Felipe , Gutierrez-Espinoza Hector , Fuentes Jorge , Prieto-Lafrentz Fernanda , Pavez Leonardo , Cristi-Montero Carlos , Cavero-Redondo Ivan , Alvarez-Bueno Celia
Published: December 2020

Background
The purpose of this protocol is to provide new and clear data on the systematic review with meta-analysis with the current Cochrane methodology to compare the effectiveness of multicomponent treatment versus other interventions for patients with fibromyalgia.
Methods
This protocol conforms to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the recommendations of the Cochrane Collaboration Handbook. An electronic search will be conducted in MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL, LILACS, CINAHL, and PEDro, from the inception until January 2021. There will be no language restrictions. The Cochrane Collaboration tool for assessing the risk of bias (RoB2) will be used. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale will be used to evaluate the strength of the evidence. The DerSimonian and Laird random effects of Mantel-Haenszel fixed effects methods will be used, depending on the heterogeneity. To compute a pooled estimate of mean difference (MD) or standardized mean difference (SMD), and respective 95% confidence intervals (CI) for pain intensity, physical function, pain catastrophizing, kinesiophobia, quality of life, sleep quality, and level of depression.
Discussion
This systematic review will synthesize evidence on the effectiveness of multicomponent treatment in patients with fibromyalgia. This systematic review could add important evidence in the treatment of FM that could improve the clinical practice and the making of decisions and actions in this field. The novel statistical analysis will try to show the effects of multicomponent treatment by type and dose of exercise in patients with FM. The results will be disseminated by publication in a peer-reviewed journal. Ethics approval will not be needed because the data used for this systematic review will be obtained from individual trials and there will be no concerns about privacy.
PROSPERO systematic review registration number:
CRD42020142082
The longitudinal association between the use of antihypertensive drugs and 24-hour sleep in nursing homes. Results from the randomized controlled COSMOS trial
Authors: Flo-Groeneboom Elisabeth , Elvegaard Tony , Gulla Christine , Husebo Bettina Sandgate
Published: December 2020

BackgroundAntihypertensive drug use and sleep problems are highly prevalent in nursing home patients. While it is hypothesized that blood pressure and antihypertensive drug use can affect sleep, this has not been investigated in depth in this population. We aimed to investigate the longitudinal association between antihypertensive drug use, blood pressure and day- and night-time sleep over 4 months.MethodsThis study was based on secondary analyses from the multicomponent randomized controlled COSMOS trial, in which the acronym denotes the intervention: COmmuncation, Systematic pain assessment and treatment, Medication review, Organization of activities and Safety. We included baseline and 4-month follow-up data from a subgroup of nursing home patients who wore actigraphs (n = 107). The subgroup had different levels of blood pressure, from low (< 120) to high (≥ 141). Assessments included blood pressure, antihypertensive drug use, and sleep parameters as assessed by actigraphy.ResultsWe found a significant reduction in total sleep time at month four in the intervention group compared to the control group. When analyzing the control group alone, we found a significant association between antihypertensive use and increased daytime sleep. We also found negative associations between blood pressure, antihypertensive drug use and sleep onset latency in the control group.ConclusionOur results suggest a correlation between excessive daytime sleep and hypertensive drug use. These findings have clinical urgency, as antihypertensive drugs are frequently used in nursing homes, and sleep problems may be especially detrimental for this population.The trial is registered at clinicaltrials.gov (NCT02238652).
Early oral Feeding is Safe and Useful after Rectosigmoid Resection with Anastomosis During Cytoreductive Surgery for Primary Ovarian Cancer
Authors: Kato Kazuyoshi , Omatsu Kohei , Okamoto Sanshiro , Matoda Maki , Nomura Hidetaka , Tanigawa Terumi , Aoki Yoichi , Yunokawa Mayu , Kanao Hiroyuki
Published: December 2020

BackgroundThe aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer.MethodsWe performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer during a 7-year period. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol during the middle of the study period. Before the introduction of EOF, conventional oral feeding (COF) had been used.ResultsTwo hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range: 2–8) in the COF group and 2 (range: 2–8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range: 9–67) days for the COF group versus 11 (8–49) days for the EOF group (P < 0.001).ConclusionEOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.
Clinical Evaluation of Fluoroscopically Guided Removal of Tracheal Tube Metallic Stents
Authors: Li Zong-Ming , Jiao De-Chao , Han Xinwei , Lu Hui-Bin , Ren Ke-Wei , Yang Hong
Published: December 2020

Background: The risk of complications associated with stent placement is high in patients with long-term airway stent placement. Our aim is to evaluate the removal of tracheal tube metallic stents under fluoroscopic guidance.Methods: We retrospectively reviewed 45 cases (31 males and 14 females; age, 12–71 years) of tracheal metallic stent removal performed at our center between January 2014 and December 2018. Covered stents were applied in 36 cases, and uncovered stents were applied in 9 cases. In the covered stent group, 15 patients presented with granulation tissue at both ends; 3 cases, with stent fracture; and 2, with stent intolerance. In the uncovered stents group, all patients presented with granulation tissue formation; 2 patients, with stent fracture; and 1 patient, with stent intolerance. Results: A total of 41 (91.1%) stents were successfully removed (34 [94.4%] in the covered stent group and 7 [77.8%] in the uncovered stent group). The average duration of stent placement was 3.2 ± 0.7 and 2.5 ± 1.2 months in the covered stent group and uncovered stent group, respectively. With regard to the complications, hemoptysis occurred in 4 cases (average blood volume lost, 100 ml), tracheal mucosa tear occurred in 5 cases, tracheal collapse requiring emergency airway stent placement occurred in 1 case, and tracheal rupture requiring emergency surgical suture occurred in 1 case. No procedure-related deaths occurred in either group. Conclusions: Fluoroscopically guided removal of tracheal tube metallic stents is safe, and may reduce the complications associated with long-term stent placement.
Integrated implementation of evidence-based interventions to increase colorectal cancer screening through public health-primary care partnerships
Authors: Soloe Cindy , Arena Laura , Schlueter Dara , Melillo Stephanie , DeGroff Amy , Tangka Florence , Hoover Sonja , Subramanian Sujha
Published: December 2020

Background

In 2015, the Centers for Disease Control and Prevention funded the Colorectal Cancer Control Program (CRCCP), which partners with health systems and primary care clinics to increase CRC screening uptake. We interviewed CRCCP stakeholders to explore factors that support an integrated implementation of evidence-based interventions and supporting activities to promote CRC screening with other screening and chronic disease management activities in primary care clinics.
Methods

Using the Consolidated Framework for Implementation Research, we conducted a literature review and identified constructs to guide data collection and analysis. We purposively selected four CRCCP awardees that demonstrated ongoing engagement with clinic partner sites, willingness to collaborate with CDC and other stakeholders, and availability of high-quality data. We gathered background information on the selected program sites and conducted primary data collection interviews with program staff and partners. We used NVivo QSR 11.0 to systematically pilot-code interview data, achieving a Kappa coefficient of 0.8 or higher, and then implemented a stepwise process to identify site-specific and cross-cutting emergent themes.
Results

Programs reported that they support clinic partners’ integrated implementation by providing coordinated application processes and braided funding streams, and by funding partner organizations to provide technical assistance to support efficient implementation of evidence-based interventions and supporting activities into existing clinic workflows. These actions, in turn, support clinics in implementing evidence-based interventions and supporting activities that promote both CRC screening and other chronic disease screening and management.
Discussion

The selected CRCCP programs and their partners implement activities to support the integration of evidence-based interventions and supporting activities with other clinic efforts. These integrated efforts support increased efficiency of clinic workflow, improved coordination of patient care, increased uptake of screening and improved patient outcomes.
Conclusions

The findings provide insights into how public health programs can support primary care clinics in integrating interventions and activities into existing workflows to support efficient, coordinated delivery of quality patient-centered care.