bluuebunny/crossref_metadata_2025 huggingface dataset:
A rare case of Flood syndrome in emergency department: A case report and review of recent reported cases
Authors: Tan Daniel Weei Jang , Chan Jing Jing
Published: November 2020

Introduction:

Flood syndrome is a rare and potentially fatal complication of liver cirrhosis with gross ascites.

Case presentation:

We present a case of Flood syndrome in a gentleman with alcoholic cirrhosis and ascites who had sudden spontaneous rupture of umbilical hernia, resulting in sudden gush of ascitic fluid from the hernia. The wound was cleaned and covered in sterile dressing and was admitted for further management. His umbilical hernia wound was closed at bedside by General Surgery team and he underwent ultrasound‐guided ascitic drain insertion by Interventional Radiology. His stay was complicated by bacterial peritonitis which was treated with intravenous antibiotic. Patient eventually recovered and was discharged well.

Discussion:

Flood syndrome has high complication and mortality rate. Recent reported cases were reviewed, focusing on the causes of cirrhosis, complications of Flood syndrome, treatments provided and the outcomes.

Conclusion:

There is currently no standard guideline for the management of Flood syndrome which falls in the grey area between medical and surgical management. Proper medical management with early surgical consultation is important to reduce the morbidity and mortality for these patients.
Role of collectin-11 in innate defence against uropathogenic Escherichia coli infection
Authors: Yuan Hai , Gao Zhao , Lu Xiaohan , Hu Fengqi
Published: November 2020

Classical collectins (surfactant protein A and D) play a significant role in innate immunity and host defence in uropathogenic Escherichia coli (UPEC)-induced urinary tract infection (UTI). However, the functions of collectin-11 (CL-11) with respect to UPEC and UTI remain largely unexplored. This study aimed to investigate the effect of CL-11 on UPEC and its role in UTI. We further examined its modulatory effect on inflammatory reactions in proximal tubular epithelial cells (PTECs). The present study provides evidence for the effect of CL-11 on the growth, agglutination, binding, epithelial adhesion and invasion of UPEC. We found increased basal levels of phosphorylated p38 MAPK and human cytokine homologue (keratinocyte-derived chemokine) expression in CL-11 knockdown PTECs. Furthermore, signal regulatory protein α blockade reversed the increased basal levels of inflammation associated with CL-11 knockdown in PTECs. Additionally, CL-11 knockdown effectively inhibited UPEC-induced p38 MAPK phosphorylation and cytokine production in PTECs. These were further inhibited by CD91 blockade. We conclude that CL-11 functions as a mediator of innate immunity via direct antibacterial roles as well as dual modulatory roles in UPEC-induced inflammatory responses during UTI. Thus, the study findings suggest a possible function for CL-11 in defence against UTI.
Shortened telomeres and serum protein biomarker abnormalities in collision sport athletes regardless of concussion history and sex
Authors: Symons Georgia F , Clough Meaghan , O’Brien William T , Ernest Joel , Salberg Sabrina , Costello Daniel , Sun Mujun , Brady Rhys D , McDonald Stuart J , Wright David K , White Owen , Abel Larry , O’Brien Terence J , Mccullough Jesse , Aniceto Roxanne , Lin I-Hsuan , Agoston Denes V , Fielding Joanne , Mychasiuk Richelle , Shultz Sandy R
Published: November 2020

Mild brain injuries are frequent in athletes engaging in collision sports and have been linked to a range of long-term neurological abnormalities. There is a need to identify how these potential abnormalities manifest using objective measures; determine whether changes are due to concussive and/or sub-concussive injuries; and examine how biological sex affects outcomes. This study investigated cognitive, cellular, and molecular biomarkers in male and female amateur Australian footballers (i.e. Australia’s most participated collision sport). 95 Australian footballers (69 males, 26 females), both with and without a history of concussion, as well as 49 control athletes (28 males, 21 females) with no history of brain trauma or participation in collision sports were recruited to the study. Ocular motor assessment was used to examine cognitive function. Telomere length, a biomarker of cellular senescence and neurological health, was examined in saliva. Serum levels of tau, phosphorylated tau, neurofilament light chain, and 4-hydroxynonenal were used as markers to assess axonal injury and oxidative stress. Australian footballers had reduced telomere length (p = 0.031) and increased serum protein levels of 4-hydroxynonenal (p = 0.001), tau (p = 0.007), and phosphorylated tau (p = 0.036). These findings were independent of concussion history and sex. No significant ocular motor differences were found. Taken together, these findings suggest that engagement in collision sports, regardless of sex or a history of concussion, is associated with shortened telomeres, axonal injury, and oxidative stress. These saliva- and serum-based biomarkers may be useful to monitor neurological injury in collision sport athletes.
EmPHasis-10 as a measure of health-related quality of life in pulmonary arterial hypertension: data from PHAR
Authors: Borgese Marissa , Badesch David , Bull Todd , Chakinala Murali , DeMarco Teresa , Feldman Jeremy , Ford H. James , Grinnan Dan , Klinger James R. , Bolivar Lena , Shlobin Oksana A. , Frantz Robert P. , Sager Jeffery S. , Mathai Stephen C. , Kawut Steven , Leary Peter J. , Gray Michael P. , Popat Rita A. , Zamanian Roham T.
Published: November 2020

Introduction

While the performance of the emPHasis-10 (e10) score has been evaluated against limited patient characteristics within the United Kingdom, there is an unmet need for exploring the performance of the e10 score among pulmonary arterial hypertension (PAH) patients in the United States.

Methods

Using the Pulmonary Hypertension Association Registry, we evaluated relationships between the e10 score and demographic, functional, haemodynamic and additional clinical characteristics at baseline and over time. Furthermore, we derived a minimally important difference (MID) estimate for the e10 score.

Results

We analysed data from 565 PAH (75% female) adults aged mean±sd55.6±16.0 years. At baseline, the e10 score had notable correlation with factors expected to impact quality of life in the general population, including age, education level, income, smoking status and body mass index. Clinically important parameters including 6-min walk distance and B-type natriuretic peptide (BNP)/N-terminal proBNP were also significantly associated with e10 score at baseline and over time. We generated a MID estimate for the e10 score of −6.0 points (range −5.0–−7.6 points).

Conclusions

The e10 score was associated with demographic and clinical patient characteristics, suggesting that health-related quality of life in PAH is influenced by both social factors and indicators of disease severity. Future studies are needed to demonstrate the impact of the e10 score on clinical decision-making and its potential utility for assessing clinically important interventions.
World Health Organization recommendations on the treatment of drug-resistant tuberculosis, 2020 update
Authors: Mirzayev Fuad , Viney Kerri , Linh Nguyen Nhat , Gonzalez-Angulo Licé , Gegia Medea , Jaramillo Ernesto , Zignol Matteo , Kasaeva Tereza
Published: November 2020

Antimicrobial resistance is a major public health problem globally. Likewise, forms of tuberculosis (TB) resistant to first- and second-line TB medicines present a major challenge for patients, healthcare workers and healthcare services. In November 2019, the World Health Organization (WHO) convened an independent international expert panel to review new evidence on the treatment of multidrug- (MDR) and rifampicin-resistant (RR) TB, using the Grading of Recommendations Assessment, Development and Evaluation approach.

Updated WHO guidelines emerging from this review, published in June 2020, recommend a shorter treatment regimen for patients with MDR/RR-TB not resistant to fluoroquinolones (of 9–11 months), with the inclusion of bedaquiline instead of an injectable agent, making the regimen all oral. For patients with MDR-TB and additional fluoroquinolone resistance, a regimen composed of bedaquiline, pretomanid and linezolid may be used under operational research conditions (6–9 months). Depending on the drug-resistance profile, extent of TB disease or disease severity, a longer (18–20 months) all-oral, individualised treatment regimen may be used. In addition, the review of new data in 2019 allowed the WHO to conclude that there are no major safety concerns on the use of bedaquiline for >6 months’ duration, the use of delamanid and bedaquiline together and the use of bedaquiline during pregnancy, although formal recommendations were not made on these topics.

The 2020 revision has highlighted the ongoing need for high-quality evidence and has reiterated the need for clinical trials and other research studies to contribute to the development of evidence-based policy.
Identification of recent exacerbations in COPD patients by electronic nose
Authors: van Bragt Job J.M.H. , Brinkman Paul , de Vries Rianne , Vijverberg Susanne J.H. , Weersink Els J.M. , Haarman Eric G. , de Jongh Frans H.C. , Kester Sigrid , Lucas Annelies , in 't Veen Johannes C.C.M. , Sterk Peter J. , Bel Elisabeth H.D. , Maitland-van der Zee Anke H.
Published: November 2020

Molecular profiling of exhaled breath by electronic nose (eNose) might be suitable as a noninvasive tool that can help in monitoring of clinically unstable COPD patients. However, supporting data are still lacking. Therefore, as a first step, this study aimed to determine the accuracy of exhaled breath analysis by eNose to identify COPD patients who recently exacerbated, defined as an exacerbation in the previous 3 months.

Data for this exploratory, cross-sectional study were extracted from the multicentre BreathCloud cohort. Patients with a physician-reported diagnosis of COPD (n=364) on maintenance treatment were included in the analysis. Exacerbations were defined as a worsening of respiratory symptoms requiring treatment with oral corticosteroids, antibiotics or both. Data analysis involved eNose signal processing, ambient air correction and statistics based on principal component (PC) analysis followed by linear discriminant analysis (LDA).

Before analysis, patients were randomly divided into a training (n=254) and validation (n=110) set. In the training set, LDA based on PCs 1–4 discriminated between patients with a recent exacerbation or no exacerbation with high accuracy (receiver operating characteristic (ROC)–area under the curve (AUC)=0.98, 95% CI 0.97–1.00). This high accuracy was confirmed in the validation set (AUC=0.98, 95% CI 0.94–1.00). Smoking, health status score, use of inhaled corticosteroids or vital capacity did not influence these results.

Exhaled breath analysis by eNose can discriminate with high accuracy between COPD patients who experienced an exacerbation within 3 months prior to measurement and those who did not. This suggests that COPD patients who recently exacerbated have their own exhaled molecular fingerprint that could be valuable for monitoring purposes.
Patients' experiences of asthma exacerbation and management: a qualitative study of severe asthma
Authors: Song Woo-Jung , Won Ha-Kyeong , Lee Suh Young , Park Han-Ki , Cho You Sook , Chung Kian Fan , Heaney Liam G. , Joung Woo Joung
Published: November 2020

Exacerbation is a defining feature of severe asthma, and oral corticosteroids (OCSs) are frequently prescribed to manage exacerbations. This qualitative study was conducted to examine the experience of patients with severe asthma, with a focus on asthma exacerbation and OCS treatment.

Adults with severe asthma were recruited from three tertiary hospitals in South Korea. Data were collected through in-depth qualitative interviews. Verbatim transcripts were analysed using Colaizzi's phenomenological method to uncover the meaning of the participants’ experience. Recruitment of participants continued until thematic saturation.

14 patients with severe asthma were recruited. Four theme clusters emerged: 1) experience of asthma exacerbation; 2) impact on life; 3) OCS treatments; and 4) disease perception. The patients experienced severe physical and psychosocial distress from asthma exacerbations, felt helpless due to failed efforts to prevent exacerbation and were living a restricted life due to fear of exacerbation. They feared OCS side-effects but had no other choice than to rely on OCSs because other interventions were ineffective. Most had poor knowledge and understanding of severe asthma and the long-term health consequences.

Asthma exacerbation affects wide aspects of life in patients with severe asthma. Several components may underlie reliance on OCSs, including experience of distress during exacerbation, fear of future exacerbation and lack of proper knowledge about the long-term health consequences of severe asthma and OCS treatments. A multi-disciplinary approach is warranted to support the patients and to provide systematic education about the long-term health implications of severe asthma.
Improving spirometry testing by understanding patient preferences
Authors: Johnson Barbara , Steenbruggen Irene , Graham Brian L. , Coleman Courtney
Published: November 2020

The American Thoracic Society and European Respiratory Society commissioned a task force to update the technical standards for spirometry testing with the aim of increasing the accuracy, precision and quality of spirometry measurements and improving the patient experience.

To inform the task force with patient experiences, the European Lung Foundation, in collaboration with the task force, conducted an online survey in 10 languages between August and September 2018.

There were 1760 respondents from 52 countries. The majority were adults (97.1%); the most common reasons for spirometry referral were diagnosis (35.0%) and management of an ongoing condition (60.1%). 53.2% reported regularly using inhalers. Respondents were very experienced with spirometry: 89.9% completed more than one test; 48% completed 10 or more tests. However, most reported not knowing what forced expiratory volume in 1 s (FEV1) means (59.4%) and only 39.6% knew their most recent FEV1; the exception was respondents with cystic fibrosis who reported much greater knowledge. Respondents rated as moderately or seriously problematic: being told to keep blowing when they felt nothing is coming out (31.4%), coughing (30.4%), tiredness (26.3%) and concern about shortness of breath (20.1%).

Overall, respondents found spirometry to be acceptable; however, an important minority (17%) found it difficult. Patients want clear information before, during and after the test, including information on stopping medications. Operators have an important role in increasing the ease of patients and changes to the testing environment can increase patient comfort. Patients want access to their results and want to understand how they relate to their individual health.
Identifying the key purchase factors for organic food among Chinese consumers
Authors: Li Shimiao , Jaharuddin Nor Siah
Published: November 2020

The current study primarily aims to identify the critical purchase factors that affect Chinese consumer purchase intention and purchase decision with regard to organic food consumption, in accordance with a modified theory of planned behavior and the alphabet theory. Specifically, this study builds a conceptual research framework by which to delve into the relationships between purchase factors and purchase intention, and elucidate the mediating roles of purchase factors in the relationships between purchase intention and purchase decision. Moreover, by leveraging a modified theory of planned behavior and the alphabet theory, the current study also determines the critical roles of subjective norms and reveals the information and knowledge that impact consumer attitude toward the purchase of organic food. The current study leverages the purposive sampling method and captures 310 records within Beijing, China. The results indicate that purchase attitude correlates positively with subjective norms and knowledge, while purchase intention correlates positively with purchase attitude, perceived behavior control, and food therapy culture. Furthermore, purchase intention can significantly mediate relationships between each of purchase attitude, perceived behavior control, food therapy culture, and purchase decision. Finally, we discuss the theoretical and practical significance of the framework, and propose subsequent research directions regarding organic food purchase behavior.
Combining the theory of change and realist evaluation approaches to elicit an initial program theory of the MomConnect program in South Africa
Authors: M Kabongo Eveline , Mukumbang Ferdinand C. , Delobelle Peter , Nicol Edward
Published: November 2020

Background

One of the Sustainable Development Goals is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. In South Africa, the flagship National Department of Health MomConnect program was launched in 2014 to strengthen the quality of maternal and child health (MCH) services and improve mortality outcomes. MomConnect was rapidly rolled out with a limited understanding of how and why the program was expected to work even though studies had shown the effectiveness of the MomConnect program in improving the uptake of MCH services. This study aimed to unearth the initial program theory of the MomConnect program based on explicit and implicit assumptions of how the program was organized and expected to work.

Methods

We conducted a document analysis using design- and implementation-related documents of the MomConnect program guided by the principles of Theory of Change (ToC) and Realist Evaluation (RE). Content and thematic analysis approaches were deductively applied to analyze the documents toward constructing ToC and RE-informed models. Abductive thinking and retroduction were further applied to the realist-informed approach to link program context, mechanisms, and outcomes to construct the initial program theory.

Results

ToC and RE-informed models illustrated how the MomConnect program was organized and expected to work. The process of constructing the ToC provided the platform for the development of the initial program theory, which identified three critical elements: (1) the central modalities of the MomConnect program; (2) the intended outcomes; and (3) the tentative causal links indicating, in a stepwise manner of, how the outcomes were intended to be achieved. The RE approach ‘enhanced’ the causal links by identifying relevant programmatic contexts and linking the postulated mechanisms of action (empowerment, encouragement, motivation, and knowledge acquisition) to program outcomes.

Conclusion

The application of ToC and RE provided an explicitly cumulative approach to knowledge generation in unveiling the initial program theory of MomConnect rather than delivering answers to questions of program effectiveness.
Gestational weight gain and offspring’s cognitive skills: a systematic review and meta-analysis
Authors: Martínez-Hortelano Jose Alberto , Álvarez-Bueno Celia , Cavero-Redondo Iván , Herráiz-Adillo Ángel , Berlanga-Macías Carlos , Martínez-Vizcaíno Vicente
Published: November 2020

Background

Gestational weight gain has been associated with some adverse perinatal outcomes, but few studies have examined the association between gestational weight gain and offspring’s cognition and their conclusions are inconsistent. Our systematic review and meta-analysis aimed to synthesize the evidence regarding the association between gestational weight gain and offspring’s cognitive skills.

Methods

In this systematic review and meta-analysis (PROSPERO number, CRD42017073266), we systematically searched MEDLINE, EMBASE, Web of Science and the Cochrane Library for studies examining association between gestational weight gain and offspring’s cognitive skills, without restriction in study design or language. Two reviewers extracted in an independent way the data. The Quality of Reporting of Observational Longitudinal Research scale was used to assess the quality of included studies. Effect size (ES) for adjusted models and their corresponding 95% confidence intervals were calculated for (i) intelligence quotient, (ii) language related skills and (iii) mathematic related skills comparing offspring’s cognitive skills when gestational weight gain was within recommendations (as reference) with those from mothers whose gestational weight gain was above or below the recommendations.

Results

Thirteen studies were included. There was a positive trend that associated gestational weight gain above recommendations with better offspring’s intelligence quotient, although not statistically significant (ES 0.02, 95% CI -0.00, 0.05; I2 = 0.00%).

Conclusions

There is a not significant positive association between gestational weight gain above recommendations and intelligence quotient and some studies reported associations between gestational weight gain and offspring’s cognitive skills. Our analyses confirm a wide variability in the results of studies published so far and highlights the need for conducting studies including specific samples of pregnant women by pre-pregnancy body mass index and trimester of pregnancy.
Clinical trials and drug cost savings for Italian health service
Authors: D’Ambrosio Francesca , De Feo Gianfranco , Botti Gerardo , Capasso Arturo , Pignata Sandro , Maiolino Piera , Triassi Maria , Nardone Antonio , Perrone Franco , Piezzo Michela , Grimaldi Antonio Maria , Palazzo Ida , De Stasio Immacolata , D’Aniello Roberta , Morabito Alessandro , Pascarella Giacomo
Published: November 2020

Background

The cost of anticancer drugs is constantly growing. The aim of this study was determine the impact in terms of cost reduction for anticancer drug in the Italian Health Service due to patient participation in clinical trials.

Methods

We evaluated the cost of drugs administered to patients treated in clinical trials at the National Cancer Institute of Naples in a four-week time period. Patients with a diagnosis of different cancers were considered, including adjuvant therapy and treatment for advanced disease, pharma sponsored and investigator initiated phase I, II and III clinical studies. We defined the expected standard treatment for each patient and we calculated the cost of the standard antineoplastic drugs that should be administered in clinical practice outside clinical trials. We used the market price of drugs to determine the cost savings value. Costs other than drugs were not included in the cost saving calculation.

Results

From 23.10.2017 to 17.11.2017, 126 patients were treated in 34 pharma sponsored and investigator initiated clinical trials, using experimental drugs provided free of charge by the sponsors, for an overall number of 152 cycles of therapy. If these patients were treated with conventional therapies in clinical practice the cost of antineoplastic drugs would account for 517,658 Euros, with an average of 5487 Euros saved per patients for a period of 4 weeks.

Conclusions

Clinical trials with investigational antineoplastic drugs provided free of charge by Sponsors render considerable cost savings, with a tangible benefit in clinical and administrative strategies to reduce drug expenditures.
The differences of clinical characteristics and outcomes between imported and local patients of COVID-19 in Hunan: a two-center retrospective study
Authors: Wang Chang , Zhou Lizhi , Chen Juan , Yang Yong , Huang Tianlong , Fu Min , Li Ya , George Daniel M. , Chen Xiangyu
Published: November 2020

Background

The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission.

Methods

We investigated 169 cases of COVID-19 pneumonia in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted.

Results

The incidence of fever on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia, hyponatremia, prolonged PT, elevated D-dimer and elevated blood glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients.

Conclusions

In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments.

Trial registration Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017).
Cross-cultural adaptation and validity of the Chinese version of the Oxford elbow score
Authors: Ngwayi James Reeves Mbori , Tan Jie , Liang Ning , Sita Emmanuel Gildas Eric , Porter Daniel Edward
Published: November 2020

Background

The Oxford Elbow score (OES) is a patient-reported outcome measure designed to evaluate patients before and after elbow surgery. Although various translated versions of the score are available, there is no Chinese mandarin version. The aim of this study was to develop a Chinese language version of the OES and evaluate its psychometric properties for clinical use.

Methods

The English version of the OES was forward translated into Chinese, followed by a backward translation into English. Then a final Chinese version was produced following expert committee discussions and pilot study of 11 patients. A smart device compatible electronic version of the OES was designed and completed by 70 patients with elbow pathology alongside the Quick-Dash and the SF-36. Reliability was assessed by measuring intraclass correlation coefficient (ICC) for test-retest reliability and Cronbach’s alpha for internal consistency. Spearman’s correlation coefficient was used to test the construct validity. Confirmatory factor analysis (CFA) was performed to evaluate the 3-factor structure of the OES.

Results

The overall Cronbach’s α coefficient was 0.906 and for the 3 different domains Function, Pain, and Social-psychological was 0.806, 0.796, and 0.776 respectively. The overall intraclass correlation coefficient was 0.764 and for the three different domains Function, Pain, and Social-psychological was 0.764, 0.624, and 0.590 respectively. The Spearman’s coefficient for correlation, between the QuickDASH and OES domains Function, Pain, and Social-psychological, was − 0.824, − 0.734, and − 0.622 respectively, showing strong correlation (r > 0.5; p < 0.01). There were moderate correlations between OES domains and the physical functioning, role physical, and strong correlations with bodily pain subscales of the PCS domain of the SF-36; results were insignificant for all other subscales.

Conclusion

Our translated Chinese mandarin OES version (mainland) was reliable and valid, suitable for evaluating elbow disorders in the Chinese population. Reliability was measured using both the Cronbach’s α for internal consistency and the intraclass correlation. Results were classified as “excellent” and were similar to results from the original OES. Electronic PROMs were used instead of the traditional paper-based PROMs for collection of data which was well tolerated by patients.
Therapeutic evaluation of palbociclib and its compatibility with other chemotherapies for primary and recurrent nasopharyngeal carcinoma
Authors: Xue Zhichao , Lui Vivian Wai Yan , Li Yongshu , Jia Lin , You Chanping , Li Xin , Piao Wenying , Yuan Hui , Khong Pek Lan , Lo Kwok Wai , Cheung Lydia Wai Ting , Lee Victor Ho Fan , Lee Anne Wing Mui , Tsao Sai Wah , Tsang Chi Man
Published: November 2020

Background

Recent genomic analyses revealed that druggable molecule targets were only detectable in approximately 6% of patients with nasopharyngeal carcinoma (NPC). However, a dependency on dysregulated CDK4/6–cyclinD1 pathway signaling is an essential event in the pathogenesis of NPC. In this study, we aimed to evaluate the therapeutic efficacy of a specific CDK4/6 inhibitor, palbociclib, and its compatibility with other chemotherapeutic drugs for the treatment of NPC by using newly established xenograft models and cell lines derived from primary, recurrent, and metastatic NPC.

Methods

We evaluated the efficacies of palbociclib monotherapy and concurrent treatment with palbociclib and cisplatin or suberanilohydroxamic acid (SAHA) in NPC cell lines and xenograft models. RNA sequencing was then used to profile the drug response–related pathways. Palbociclib-resistant NPC cell lines were established to determine the potential use of cisplatin as a second-line treatment after the development of palbociclib resistance. We further examined the efficacy of palbociclib treatment against cisplatin-resistant NPC cells.

Results

In NPC cells, palbociclib monotherapy was confirmed to induce cell cycle arrest in the G1 phase in vitro. Palbociclib monotherapy also had significant inhibitory effects in all six tested NPC tumor models in vivo, as indicated by substantial reductions in the total tumor volumes and in Ki-67 proliferation marker expression. In NPC cells, concurrent palbociclib treatment mitigated the cytotoxic effect of cisplatin in vitro. Notably, concurrent treatment with palbociclib and SAHA synergistically promoted NPC cell death both in vitro and in vivo. This combination also further inhibited tumor growth by inducing autophagy-associated cell death. NPC cell lines with induced palbociclib or cisplatin resistance remained sensitive to treatment with cisplatin or palbociclib, respectively.

Conclusions

Our study findings provide essential support for the use of palbociclib as an alternative therapy for NPC and increase awareness of the effective timing of palbociclib administration with other chemotherapeutic drugs. Our results provide a foundation for the design of first-in-human clinical trials of palbociclib regimens in patients with NPC.
Correction to: Inhaled nitric oxide in patients admitted to intensive care unit with COVID-19 pneumonia
Authors: Tavazzi Guido , Pozzi Marco , Mongodi Silvia , Dammassa Valentino , Romito Giovanni , Mojoli Francesco
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Iron accumulation in macrophages promotes the formation of foam cells and development of atherosclerosis
Authors: Cai Jing , Zhang Meng , Liu Yutong , Li Huihui , Shang Longcheng , Xu Tianze , Chen Zhipeng , Wang Fudi , Qiao Tong , Li Kuanyu
Published: November 2020

Background

Macrophages that accumulate in atherosclerotic plaques contribute to progression of the lesions to more advanced and complex plaques. Although iron deposition was found in human atherosclerotic plaques, clinical and pre-clinical studies showed controversial results. Several epidemiological studies did not show the positive correlation between a systemic iron status and an incidence of cardiovascular diseases, suggesting that the iron involvement occurs locally, rather than systemically.

Results

To determine the direct in vivo effect of iron accumulation in macrophages on the progression of atherosclerosis, we generated Apoe−/− mice with a macrophage-specific ferroportin (Fpn1) deficiency (Apoe−/−Fpn1LysM/LysM). Fpn1 deficiency in macrophages dramatically accelerated the progression of atherosclerosis in mice. Pathophysiological evidence showed elevated levels of reactive oxygen species, aggravated systemic inflammation, and altered plaque-lipid composition. Moreover, Fpn1 deficiency in macrophages significantly inhibited the expression of ABC transporters (ABCA1 and ABCG1) by decreasing the expression of the transcription factor LXRα, which reduced cholesterol efflux and therefore promoted foam cell formation and enhanced plaque formation. Iron chelation relieved the symptoms moderately in vivo, but drastically ex vivo.

Conclusions

Macrophage iron content in plaques is a critical factor in progression of atherosclerosis. The interaction of iron and lipid metabolism takes place in macrophage-rich atherosclerotic plaques. And we also suggest that altering intracellular iron levels in macrophages by systemic iron chelation or dietary iron restriction may be a potential supplementary strategy to limit or even regress the progression of atherosclerosis.
The vexing relationship between socioeconomic status and health
Authors: Donahoe J. Travis , McGuire Thomas G.
Published: November 2020

In a recent issue of this Journal, Politzer, Shmueli, and Avni estimate the economic costs of health disparities due to socioeconomic status (SES) in Israel (Politzer et al., Isr J Health Policy Res 8: 46, 2019). Using three measures of SES, the socioeconomic ranking of localities, individual income, and individual education, Politzer and colleagues estimate welfare loss due to higher mortality, productivity loss due to poorer health, excess health care treatment costs, and excess disability payments for individuals with below median SES relative to those with above median SES. They find the economic costs of health disparities are substantial, adding up to between 1.1 and 3.1 billion USD annually—between 0.7 and 1.6% of Israel’s GDP.

This paper is useful and informative. It is, to our knowledge, the first comprehensive quantification of the economic costs stemming from health disparities in Israel. In spite of many social policies designed to level economic opportunity and social welfare generally, by most measures, Israel is among the most unequal in the distribution of income among all OECD countries (Cornfeld and Danieli, Isr Econ Rev 12:51–95, 2015). Politzer and colleagues expose the magnitude and sources of health-related loss that Israel faces because of such inequality and shows how the costs of inequality are borne to some degree by all members of society. This short commentary discusses the complicated relationship between SES and health and puts the findings from Politzer and colleagues in the context of the international literature on the subject.
Stakeholder perceptions of non-regulatory bovine health issues in Ireland: past and future perspectives
Authors: Meunier Natascha V. , McKenzie Kenneth , Graham David A. , More Simon J.
Published: November 2020

Background

In recent years, there have been multiple (political, environmental, cultural) drivers of change in Irish agriculture, including the establishment of Animal Health Ireland (AHI) in 2009, to provide leadership of non-regulatory livestock health issues (diseases and conditions of livestock that are endemic in Ireland but which are not currently subject to international legislation). In this study, we describe the opinion of stakeholders (farmers, veterinary practitioners and agricultural industry professional service providers), elicited by means of a survey, on their perceptions of changes in selected non-regulatory bovine health issues over the last 10 years and priority issues relevant to non-regulatory bovine health to be tackled over the next 10 years.

Results

A total of 673 individuals participated in the online questionnaire. For the majority of the non-regulatory bovine health issues, most participants felt there had been improvements over the last 10 years. However, professional service providers were generally more conservative in their response to improvements on-farm compared to farmers. Several issues, particularly BVD and udder health/milk quality, were viewed more positively by all relevant respondents. There was reasonable agreement between responses from different respondent types and sectors regarding the top three priorities relevant to non-regulatory bovine animal health for the next 10 years in Ireland, which included antimicrobial resistance (highlighting measures to reduce both on-farm usage and resistance), anthelmintic resistance, greenhouse emissions and calf welfare.

Conclusions

The results are encouraging, demonstrating a perception of improvement in a number of non-regulatory bovine health issues in Ireland over the last ten years. With respect to the next 10 years, stakeholders prioritised antimicrobial and anthelmintic resistance, greenhouse gas emissions and calf welfare, which aligns closely with broader societal concerns. This information is useful to AHI, particularly with respect to future priorities. However, these concerns are broad in scope and will require further considerations, including collaborations, between AHI and partnering organisations. Given that there were differences between farmers and professional service providers in responses, it is useful to consider how the aims and the benefits of future AHI programmes are framed and communicated to all stakeholders.
Surface deformation evolution in the Pearl River Delta between 2006 and 2011 derived from the ALOS1/PALSAR images
Authors: Li Genger , Feng Guangcai , Xiong Zhiqiang , Liu Qi , Xie Rongan , Zhu Xiaoling , Luo Shuran , Du Yanan
Published: November 2020

This study monitors the land subsidence of the whole Pearl River Delta (PRD) (area: ~ 40,000 km2) in China using the ALOS1/PALSAR data (2006–2011) through the SBAS-InSAR method. We also analyze the relationship between the subsidence and the coastline change, river distribution, geological structure as well as the local terrain. The results show that (1) the land subsidence with the average velocity of 50 mm/year occurred in the low elevation area in the front part of the delta and the coastal area, and the area of the regions subsiding faster than 30 mm/year between 2006 and 2011 is larger than 122 km2; (2) the subsidence order and area estimated in this study are both much larger than that measured in previous studies; (3) the areas along rivers suffered from surface subsidence, due to the thick soft soil layer and frequent human interference; (4) the geological evolution is the intrinsic factor of the surface subsidence in the PRD, but human interference (reclamation, ground water extraction and urban construction) extends the subsiding area and increases the subsiding rate.
Effect of dietary supplementation of seaweed (Ulva lactuca) and Azolla on growth performance, haematological and serum biochemical parameters of Aseel chicken
Authors: Thavasi Alagan Vijayalingam , Nakulan Vatsala Rajesh , Sagadevan Ilavarasan , Subbiah Vairamuthu , Ragothaman Venkataramanan
Published: November 2020

Background

An effort was made to assess the effectiveness of dietary supplementation of Ulva lactuca (U. lactuca), a seaweed and Azolla individually and in combination on different physiological parameters of Aseel chicken. A total of 40 Aseel chicks of 8 weeks old were allocated into four groups, C1 (control), T1 (Azolla alone), T2 (seaweed alone) and T3 (seaweed plus Azolla). Aseel chicks in C1 were fed with formulated grower feed alone, birds in T1 had control diet with 5% Azolla, birds in T2 had control diet with 3% U. lactuca and birds in T3 had control diet admixtured with 5% of Azolla and 3% of U. lactuca. Parameters were recorded for a continuous period of 2 months in 15 days interval.

Results

The growth performance was found to be significant (P ≤ 0.05) during 30 days of feed trials and highly significant (P ≤ 0.01) during 45 and 60 days of treatment. Birds in T3 had a higher body weight gain, shank length and feed conversion efficiency followed with T1 and T2 compared to C1. PCV, RBC, WBC and heterophil counts were not influenced (P ≥ 0.05) by dietary treatments. Uric acid, creatinine, AST, glucose, triglycerides and magnesium levels revealed a high significant (P ≤ 0.01) variation, and cholesterol level showed significant (P ≤ 0.05) changes during 30th and 60th day of feed trials between the control and treatment groups. Total protein, globulin, phosphorus and electrolytes like Na, K and Cl levels were not significant (P ≥ 0.05) during 30th day and were highly significant (P ≤ 0.01) during the 60th day of the trial.

Conclusions

It could be noted that inclusion of U. lactuca and Azolla as feed supplement in grower chicken had a better body weight gain when given in combination (U. lactuca and Azolla) rather than supplemented with the sole entity. Based on the haematological and serum biochemical analysis, the supplementation of U. lactuca and Azolla at the levels included in this trial did not pose any threat to the physiological well-being of Aseel chicken.
Testing the pecking order theory of capital structure: the case of Islamic financing modes
Authors: Guizani Moncef
Published: November 2020

The purpose of this paper is to examine whether or not the basic premises according to the pecking order theory provide an explanation for the capital structure mix of firms operating under Islamic principles. Pooled OLS and random effect regressions were performed to test the pecking order theory applying data from a sample of 66 Islamic firms listed on Kingdom of Saudi Arabia stock market over the period 2006–2016. The results show that sale-based instruments (Murabahah, Ijara) track the financial deficit quite closely followed by equity financing and as the last alternative to finance deficit, Islamic firms issue Sukuk. In the crisis period, these firms seem more reliant on equity, then on sale-based instrument and on Sukuk as last option. The study findings also indicate that the cumulative financing deficit does not wipe out the effects of conventional variables, although it is empirically significant. This provides no support for the pecking order theory attempted by Saudi Islamic firms. This research highlights the capital structure choice of firms operating under Islamic principles. It explores the implication of the relevant Islamic principles on corporate financing preferences. It can serve firm executive managers in their financing decisions to add value to the companies.
Case Report: Aortitis associated with rheumatoid arthritis: A challenging rheumatoid vasculitis presentation
Authors: Teyeb Zeineb , Ben Salah Mohamed , Kharrat Lobna , Abdellali Imen , Jomni Taieb , Douggui Mohamed Hedi
Published: November 2020

Rheumatoid vasculitis (RV) is a rare but serious extra-articular manifestation of rheumatoid arthritis (RA). Its varied clinical presentation makes it hard to diagnose and treat. Hereby we describe a case of an aortitis revealing RV, which is a rare presentation of a rare complication of RA. A 56-year-old man with rheumatoid arthritis treated with methotrexate presented with fever, chest pain and arthritis. Blood tests revealed inflammatory syndrome associated with cholestasis. The diagnosis of pericarditis associated with aortitis was retained. Cholestasis was mostly due to methotrexate. The patient was treated with cyclophosphamide pulses and high doses of prednisolone. The patient was in complete remission of articular and extra-articular manifestations after two months of treatment.
Determinants of Work Motivation and Work Ability among Older Workers and Implications for the Desire for Continued Employment
Authors: Büsch Victoria , Dittrich Dennis , Lieberum Uta
Published: November 2020

In times of demographic change, with the associated challenges for social security systems and the looming lack of skilled workers, extending working life becomes increasingly significant. According to the continuity theory (Atchley 1989) we can assume that individuals who are satisfied with their structures and performance will stay at work longer. We will therefore examine whether motivation and perceived work ability have an influence on the desire for continued employment. In addition, we will answer the question of whether factors that have a positive influence on motivation and work ability also have a direct influence on continued employment. Besides objective factors such as enterprise size and occupational status, we will examine subjective factors, such as assessment of recognition, the demands, and the meaningfulness of the work for their contributions to the explanation. The following analysis is based on a survey taken in May 2008 together with the Bundesinstitut für Bevölkerungsforschung (BiB). It enables us to identify the desire for continued employment in old age, the existing work motivation, and the state of health. The core results of the statistical analysis show that in men high motivation is linked to the desire for continued employment in retirement age. This does not apply to women; for them, work ability is the decisive criterion. In general, we observe that a positive assessment of the subjective influencing factors strengthen work motivation. In addition, with regard to objective factors it was ascertained that for men the working hour regime (full-time work) and occupation status (salaried “white-collar” employees) correlate positively with the desire for continued employment. In particular, meaningful work increases motivation among men and work ability increases motivation among women. It appears important that enterprises convince their employees of the meaningfulness of the work.
Marital status differences in mortality in later life
The significance of health-related behaviour
[Article withdrawn]
Authors: Rapp Ingmar
Published: November 2020

This article has been withdrawn by the author due to a copyright infringement claim concerning the data on which the article is based. Therefore, we kindly ask you not to quote the article any longer.We apologise for any inconvenience caused.The Editors of CPoS
Fertility Data for German-speaking Countries:
What is the Potential? Where are the Pitfalls?

Authors: Kreyenfeld Michaela , Zeman Kryštof , Burkimsher Marion , Jaschinski Ina
Published: November 2020

This paper provides an overview of fertility data for Germany, Austria and Switzerland. Particular attention is given to the availability of order-specific fertility data. We discuss the quality of data provided by the Statistical Offices, both birth registration data and censuses or microcensuses. In addition, we explore how social science surveys can be used to generate order-specific fertility indicators, and compare survey fertility estimates with estimates from vital statistics. Prior studies have shown that there is a “family bias” in most surveys, with the fertility of younger cohorts being overstated, because respondents with young children are easier to reach by interviewers. Our assessment of various types of surveys from the three countries mostly supports this notion. The “family bias” is most pronounced in family surveys in contrast to all-purpose surveys. Weighting data does not fully cure the “family bias”, which we attribute to the fact that the number of children is usually not considered a factor in calculating sample weights, as provided by the survey agencies and Statistical Offices. The confounding role of migration in the production of reliable and comparable fertility statistics is also discussed.