bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental investigation of porous materials for trailing-edge noise reduction
Authors: Rossignol K-S , Suryadi A , Herr M , Schmidt J , Tychsen J
Published: September 2020

The introduction of quiet short take-off and landing for civil aircraft operations in close proximity to the population poses important technological challenges. One critical aspect is the realization of extreme lift augmentation at low acoustic emissions. The aircraft concept selected to achieve this goal is a high-lift system equipped with an active flow-control non-slotted flap and a droop nose. For this specific configuration, trailing edge noise becomes a dominant noise source. Porous materials as a passive means for trailing-edge noise reduction are selected and characterized. Results of extensive experimental investigations in the acoustic wind tunnel Braunschweig are presented and discussed to point out the potential and limitations of the selected porous devices. Practical issues related to material manufacturing and integration into the wind tunnel model are addressed. The noise reduction potential of passive porous trailing-edge devices is found to strongly depend on both these aspects. Issues related to the characterization of the porous materials properties are described. Although porous materials are found to be successful at reducing trailing-edge noise emissions, the results indicate that there is still a need for more generic investigations to further clarify the parametric dependencies between noise reduction and material properties.
Endovascular Treatment for Vertebrobasilar Artery Tandem Occlusion Beyond 24 Hours From Onset of Stroke—Case Report
Authors: Mizowaki Takashi , Fujita Atsushi , Inoue Satoshi , Kurihara Eiji
Published: September 2020

We report a case in which endovascular treatment (EVT) was performed for vertebral and basilar artery (VA and BA) tandem occlusion beyond 24 hours from onset of stroke. A 78-year-old man was admitted to our institution with dysarthria and disturbance of gait. MRI revealed occlusion of the BA with acute ischemic change in bilateral cerebellum and brain stem. At 36 hours after onset and 30 hours after administration, EVT was performed because of deteriorating neurological symptom. Successful revascularization was achieved with percutaneous transluminal angioplasty for VA and thrombectomy for BA occlusion. The neurological symptoms were improved in postoperative course.
Cognitive impairment in a classical rat model of chronic migraine may be due to alterations in hippocampal synaptic plasticity and N-methyl-D-aspartate receptor subunits
Authors: Zhang Mingjie , Liu Yufei , Hu Guanqun , Kang Li , Ran Ye , Su Min , Yu Shengyuan
Published: September 2020

Although migraine is a major global public health problem, its impact on cognitive abilities remains controversial. Thus, the present study investigated the effects of repeated administration of inflammatory soup to the dura of rats, over three weeks, on spatial cognition, hippocampal synaptic plasticity, and the expression of N-methyl-D-aspartate receptor subunits. Additionally, low doses of amitriptyline (5 mg/kg) were applied to assess its therapeutic effects. The inflammatory soup group exhibited significant reductions in the cutaneous stimulation threshold, presence of mild cognitive impairment, and decreased long-term potentiation in right hippocampus. However, amitriptyline improved pain behaviors, enhanced cognitive function, and increased synaptic plasticity in the inflammatory soup rats. On the other hand, the administration of amitriptyline to normal rats negatively influenced synaptic plasticity and reduced the expression of N-methyl-D-aspartate receptor subunits. The present results indicate that inflammatory soup-induced dural nociception led to impairments in spatial cognition that could be attributed to reductions in hippocampal long-term potentiation and the decreased expression of N-methyl-D-aspartate receptor subunits.
Anaemia in chronic kidney disease pregnancy
Authors: Morton Adam , Burke Michael , Morton Anthony , Kumar Sailesh
Published: September 2020

Aim

To review the incidence and management of anaemia and outcomes in pregnancies in a cohort of Australian women with chronic kidney disease.

Methods

A retrospective audit of 63 pregnancies in 52 women with chronic kidney disease.

Results

Sixty-eight percent of chronic kidney disease pregnancies were complicated by haemoglobin less than 100 g/L. Iron stores were measured in only 62% of all pregnancies. Serum ferritin was less than 100 ng/ml in 95% of those tested. Erythropoietin-stimulating agents were used in 24 pregnancies (38%). Intravenous iron was used in only nine non-dialysis pregnancies.

Conclusion

Greater awareness of the importance of regular measurement of iron stores and appropriate levels for repletion in chronic kidney disease pregnancies amongst health professionals involved in obstetric care may result in earlier detection and treatment of iron deficiency, and potentially improve maternal and fetal outcomes.
Comparison of Insulin Pump Bolus Calculators Reveals Wide Variation in Dose Recommendations
Authors: Buchanan Jeanne , Zabinsky Jennifer A. , Ferrara-Cook Christine , Adi Saleh , Wong Jenise C.
Published: September 2020

Background:

The introduction of insulin pumps with bolus calculators (BCs) has improved glycemic outcomes and quality of life for those with type 1 diabetes. Despite the increased reliance on BCs, the formulas used to derive recommended boluses are not standardized. Our objective was to examine whether recommendations from different pump BCs vary significantly for identical clinical scenarios.

Methods:

Three commercially available insulin pump BCs were programmed with identical settings and then presented with combinations of blood glucose (BG) and carbohydrates (CHOs) to generate a 4-unit bolus. At one- and two-hour time points, while there was insulin-on-board (IOB) present, we simulated various BG and CHO scenarios in order to compare BC-recommended doses.

Results:

Differences in suggested doses were noted between BCs, as well as within the same brand. The greatest variation was apparent when BG was below target. Doses suggested by one BC varied depending on whether the IOB resulted from a previous dose given for BG or CHO, while the other two BCs adjusted for total IOB regardless of the source.

Conclusions:

In this simulation study, there were large differences in recommended doses between BCs due to the unique way each manufacturer incorporates IOB into their formulas as well as the pharmacokinetics used to derive the IOB amount. Providers should be aware that identical pump settings will result in a different dose recommendation for each pump brand and advise patients accordingly.
Adoption of online multimedia resources in a general chemistry laboratory course context: A case study
Authors: Tisoglu Secil , Cagiltay Kursat , Kursun Engin
Published: September 2020

Pre-laboratory practices and online pre-laboratory resources have been implemented in laboratory courses through various instructional approaches. This study seeks to elicit information about how online multimedia resources are embraced and used in the course system and which factors might affect the adoption of the resources in this context. This research was designed as a case study in order to explore the enablers and barriers of online multimedia resource adoption and associated problems in the system through two resources developed in video and simulation formats. Interviews, observations, and documents were applied so as to provide a detailed perspective of the course and the phenomenon. The findings of the study revealed that the multimedia components of the resources attracted the students’ interest and engagement, and affected the users’ preparation routines; however, attitude toward the course and resources, lack of policy practices and support, quality of the resources, problems in classroom practices, and administration were found to be prominent issues that challenged the adoption of online resources. The study offers suggestions concerning how to adopt the online resources into laboratory courses, and insights about the implications of online resources and their different multimedia features are also presented.
Slice of life in a live and wired masquerade: Playful prosumption as identity work and performance in an identity college Bilibili
Authors: Chen Zhen Troy
Published: September 2020

This article investigates Chinese urban youth’s mediated ‘slice of life’ and playful encounters as part of their identity construction and performance work on Bilibili, one of China’s most influential video-sharing social media sites mediating anime, comics, games and novels. Using a mix-method approach of digital ethnography, participant observation, interviews and data visualisation, this article examines fans’ hermeneutic practices through anime, comic, game and novel prosumption, exemplified by danmaku: ‘bullet screen’, barrage-like comments overlaid on videos. This article argues that Bilibili works as an ‘identity college’ for fans to perform various roles and explore their hybrid identities in a social-hermeneutic engagement process. In particular, the function of anonymous danmaku comments will be closely analysed as it offers a quasi-real-time engagement experience for fans and helps shape fans’ social self. Following a symbolic interactionist tradition, Mead’s ‘generalised other’ and Goffman’s dramaturgical theory are contextualised in the Chinese socio-cultural milieu where fans’ identity performance is regarded as masquerade. Departing from the moral panic rhetoric that Generation Z is ‘amused to death’, becoming ‘infantile and animalised’, or even enslaved by their desires and capable only of ‘cold intimacies’, the findings of this explorative study present a more complex understanding of Chinese youth’s identity work through participatory social media use and networked fandom.
A Bibliometric Analysis and Visualization of Current Research Trends in the Treatment of Cervical Spondylotic Myelopathy
Authors: Yin Mengchen , Xu Chongqing , Ma Junming , Ye Jie , Mo Wen
Published: September 2020

Study Design:

Bibliometric analysis.

Objective:

Cervical spondylotic myelopathy (CSM) has become the most common cause of spinal cord dysfunction. Many topics of CSM still remain controversial. This study aimed to illustrate the overall knowledge structure and development trends of CSM.

Methods:

Research data sets were acquired from the Web of Science database and the time span was defined as “2000 to 2019.” VOS viewer and Citespace software was used to analyze the data and generate visualization knowledge maps. Annual trends of publications, distribution, H-index status, co-authorship status, and research hotspots were analyzed.

Results:

A total of 2367 publications met the requirement. The largest number of articles was from the United States, followed by Japan, China, Canada, and India. The highest H-index was found for articles from the United States. The highest number of articles was published in Spine. The cooperation between the countries, institutes, and authors were relatively weak. Cervical sagittal alignment, predictive factor, diffusion tensor imaging, and the natural history of CSM may become a frontier in this research field.

Conclusion:

The number of publications showed an upward trend with a stable rise. Most of the publications are limited to a few countries and institutions with relatively weak interaction. The United States, Canada, Japan, China, and India have made significant contributions to the field of CSM. The United States is the country with the highest productivity, not only in quality but also in quantity. Cervical sagittal alignment, predictive factor, diffusion tensor imaging, and the natural history of CSM are the research hotspots in the recent years.
Complications of Spine Surgery in “Super Obese” Patients
Authors: Katsevman Gennadiy A. , Daffner Scott D. , Brandmeir Nicholas J. , Emery Sanford E. , France John C. , Sedney Cara L.
Published: September 2020

Study Design:

Retrospective chart review with matched control.

Objective:

To evaluate the indications and complications of spine surgery on super obese patients.

Methods:

A retrospective review assessed super obese patients undergoing spine surgery at a level-1 trauma and spine referral center from 2012 to 2016. Outcomes were compared to age-matched controls with body mass index (BMI) <50 kg/m2. The control group was further subdivided into patients with BMI <30 kg/m2 (normal) and BMI between 30 and 50 kg/m2 (obese).

Results:

Sixty-three super obese patients undergoing 86 surgeries were identified. Sixty patients (78 surgeries) were in the control group. Age and number of elective versus nonelective cases were not significantly different. Mean BMI of the super obese group was 55 kg/m2 (range 50-77 kg/m2) versus 29 kg/m2 in the controls (range 20-49 kg/m2). Fifty-two percent of surgeries were elective, and the most common indication was degenerative disease (39%). Compared with controls, super obese patients had a higher complication rate (30% [n = 19] vs 10% [N = 6], P = .0055) but similar 30-day mortality rate (5% vs 5%), a finding that was upheld when comparing super obese with each of the control group stratifications (BMI 30-50 and BMI <30 kg/m2). The most common complication among super obese patients was wound dehiscence/infection (n = 8, 13%); 2 patients’ surgeries were aborted. Complication rates for elective surgery were 21% (n = 7) for super obese patients and 4% (n = 1) for controls ( P = .121); complication rates for nonelective procedures were 40% (n = 12) and 14% (n = 5), respectively ( P = .023).

Conclusion:

The complication rate of spine surgery in super obese patients (BMI ≥ 50 kg/m2) is significantly higher than other patients, particularly for nonelective cases.
Initiation and response of joint attention bids in autism spectrum disorder children depend on the visibility of the target
Authors: Cilia Federica , Touchet Claire , Vandromme Luc , Driant Barbara Le
Published: September 2020

Background and aims

Response to joint attention (RJA) and initiation of joint attention (IJA) are impaired in pre-schoolers with autism spectrum disorder (ASD). Children’s response to joint attention may depend on the presence of the target in the child's field of vision or on the type of deictic index (head and eye orientation, pointing and verbalisations) used by the adult to initiate joint attention.

Methods

This study deals with 50 ASD children aged from 2 years 8 months to 11 years 7 months, with a communicative level comparable to children under 31 months of age, according to the French version of the Early Social Communication Scales (ECSP, by its French acronym). We compared the aforementioned ASD children with 50 typically developing (TD) children, aged 9 to 30 months who had no communication disorders according to the ECSP. During the ECSP test, we analysed joint attention behaviours on three posters present or absent from the children's visual field.

Results

We did not observe any difference in the number of IJAs between groups, but ASD children were less responsive than TD children were. Our results showed a developmental progression in the responses of children with ASD if several deictic cues were used by an adult simultaneously (looking and pointing, or looking and verbalising to indicate a target), whether the referent was present or absent from the child’s visual field. In addition, we observed developmental progression when the referent was behind the child and the adult only used their gaze to refer to it.

Conclusion

Thus, we argue that the type of cues used affects ASD children’s response behaviours during joint attention towards a referent that may be present or absent from their visual field. Implications: Regarding the social and the sensory difficulties of children with ASD, many therapeutic approaches focus their intervention methods on non-verbal communication skills and joint attention. This fundamental research makes it possible to identify the most appropriate type of deictic index for children with ASD with developmental delay, depending on the presence or absence of the referent in the child's visual field.
An Examination of the Effect of New Venture Ideation Exercises on Entrepreneurial Intentions
Authors: Mathews Robert D. , Wessel Roger , Goldsby Michael
Published: September 2020

Entrepreneurship programming has become a popular choice among higher education students. Entrepreneurial intent is regarded as a strong predictor of entrepreneurial behavior and success of entrepreneurial education programs, while ideation is viewed as a key skill needed for successful entrepreneurial behavior. Despite the widespread discussion of entrepreneurial intent in the literature, few studies have reported the actual impact of entrepreneurship education and more specifically, ideation exercises, on intent. The authors contend that ideation is a key skill and thus, barrier to entrepreneurial intentions when students have a lack of efficacy surrounding the ideation process. This study examined the impact of a 150-minute divergent activity training session and new venture ideation exercise on entrepreneurial intent in students enrolled in undergraduate entrepreneurship courses. These measures come together in this study to help further explain how entrepreneurship educators can drive more impactful entrepreneurial behavior in students. In this study, entrepreneurial intent significantly increased in students after the brief 150-minute intervention. This study infers that entrepreneurial self-efficacy of ideation skills are critical to increased entrepreneurial intent in college students, and exercises such as the ones conducted in this study can positively impact entrepreneurial intentions among students. Recommendations for future research and practice are provided.
Efficacy and safety results from CheckMate 140, a phase 2 study of nivolumab for relapsed/refractory follicular lymphoma
Authors: Armand Philippe , Janssens Ann , Gritti Giuseppe , Radford John , Timmerman John , Pinto Antonio , Mercadal Vilchez Santiago , Johnson Peter , Cunningham David , Leonard John P. , Rodig Scott J. , Martín-Regueira Patricia , Sumbul Anne , Samakoglu Selda , Tang Hao , Ansell Stephen M.
Published: September 2020

Nivolumab, an anti–programmed death-1 (PD-1) monoclonal antibody, showed promising activity in relapsed or refractory (R/R) follicular lymphoma (FL) in a phase 1 study. We conducted a phase 2 trial to further evaluate its efficacy and safety in patients with R/R FL and to explore biomarkers of response. Patients with R/R FL and at least 2 prior lines of therapy, each containing a CD20 antibody or an alkylating agent, were treated with nivolumab 3 mg/kg every 2 weeks. The primary end point was objective response rate (ORR) assessed by an independent radiologic review committee. Biomarker analyses included gene expression profiling and multiplex immunofluorescence studies of pretreatment tumor samples. A total of 92 patients were treated. After a minimum follow-up of 12 months, ORR was 4% (4 of 92 patients). Median progression-free survival (PFS) was 2.2 months (95% confidence interval [CI], 1.9-3.6 months). Median duration of response was 11 months (95% CI, 8-14 months). Exploratory analyses suggested that responders had significantly higher proportion of CD3+ T cells in the tumor microenvironment than nonresponders, but no significant differences in PD-1 or programmed death-ligand 1 expression were observed. High expression of a set of tumor-associated macrophage genes was associated with reduced PFS (hazard ratio, 3.28; 95% CI, 1.76-6.11; P = .001). The safety profile was consistent with previous reports of nivolumab. In conclusion, nivolumab monotherapy was associated with very limited activity in patients with R/R FL. Better understanding of the immune biology of this disease may facilitate the development of effective checkpoint-based strategies. This trial was registered at www.clinicaltrials.gov as #NCT02038946.
Plasmacytoid dendritic cell expansion defines a distinct subset of RUNX1-mutated acute myeloid leukemia
Authors: Xiao Wenbin , Chan Alexander , Waarts Michael R. , Mishra Tanmay , Liu Ying , Cai Sheng F. , Yao Jinjuan , Gao Qi , Bowman Robert L. , Koche Richard P. , Csete Isabelle S. , DelGaudio Nicole L. , Derkach Andriy , Baik Jeeyeon , Yanis Sophia , Famulare Christopher A. , Patel Minal , Arcila Maria E. , Stahl Maximilian , Rampal Raajit K. , Tallman Martin S. , Zhang Yanming , Dogan Ahmet , Goldberg Aaron D. , Roshal Mikhail , Levine Ross L.
Published: September 2020

Plasmacytoid dendritic cells (pDCs) are the principal natural type I interferon–producing dendritic cells. Neoplastic expansion of pDCs and pDC precursors leads to blastic plasmacytoid dendritic cell neoplasm (BPDCN), and clonal expansion of mature pDCs has been described in chronic myelomonocytic leukemia. The role of pDC expansion in acute myeloid leukemia (AML) is poorly studied. Here, we characterize patients with AML with pDC expansion (pDC-AML), which we observe in ∼5% of AML cases. pDC-AMLs often possess cross-lineage antigen expression and have adverse risk stratification with poor outcome. RUNX1 mutations are the most common somatic alterations in pDC-AML (>70%) and are much more common than in AML without pDC expansion and BPDCN. We demonstrate that pDCs are clonally related to, as well as originate from, leukemic blasts in pDC-AML. We further demonstrate that leukemic blasts from RUNX1-mutated AML upregulate a pDC transcriptional program, poising the cells toward pDC differentiation and expansion. Finally, tagraxofusp, a targeted therapy directed to CD123, reduces leukemic burden and eliminates pDCs in a patient-derived xenograft model. In conclusion, pDC-AML is characterized by a high frequency of RUNX1 mutations and increased expression of a pDC transcriptional program. CD123 targeting represents a potential treatment approach for pDC-AML.
No evidence of SARS-CoV-2 transfusion transmission despite RNA detection in blood donors showing symptoms after donation
Authors: Cappy Pierre , Candotti Daniel , Sauvage Virginie , Lucas Quentin , Boizeau Laure , Gomez Johanna , Enouf Vincent , Chabli Lila , Pillonel Josiane , Tiberghien Pierre , Morel Pascal , Laperche Syria
Published: September 2020

The risk of transfusion-associated transmission of SARS-CoV-2 is unknown. Cappy and colleagues report on hemovigilance studies of 268 blood donations from individuals reporting symptoms shortly after donation. Of 268 samples, 3 tested positive for viral RNA, of which 1 had components that were transfused before testing; no cases of transfusion-documented transmission were seen.
The critical role of CD4+ T cells in PD-1 blockade against MHC-II–expressing tumors such as classic Hodgkin lymphoma
Authors: Nagasaki Joji , Togashi Yosuke , Sugawara Takeaki , Itami Makiko , Yamauchi Nobuhiko , Yuda Junichiro , Sugano Masato , Ohara Yuuki , Minami Yosuke , Nakamae Hirohisa , Hino Masayuki , Takeuchi Masahiro , Nishikawa Hiroyoshi
Published: September 2020

Classic Hodgkin lymphoma (cHL) responds markedly to PD-1 blockade therapy, and the clinical responses are reportedly dependent on expression of major histocompatibility complex class II (MHC-II). This dependence is different from other solid tumors, in which the MHC class I (MHC-I)/CD8+ T-cell axis plays a critical role. In this study, we investigated the role of the MHC-II/CD4+ T-cell axis in the antitumor effect of PD-1 blockade on cHL. In cHL, MHC-I expression was frequently lost, but MHC-II expression was maintained. CD4+ T cells highly infiltrated the tumor microenvironment of MHC-II–expressing cHL, regardless of MHC-I expression status. Consequently, CD4+ T-cell, but not CD8+ T-cell, infiltration was a good prognostic factor in cHL, and PD-1 blockade showed antitumor efficacy against MHC-II–expressing cHL associated with CD4+ T-cell infiltration. Murine lymphoma and solid tumor models revealed the critical role of antitumor effects mediated by CD4+ T cells: an anti-PD-1 monoclonal antibody exerted antitumor effects on MHC-I−MHC-II+ tumors but not on MHC-I−MHC-II− tumors, in a cytotoxic CD4+ T-cell–dependent manner. Furthermore, LAG-3, which reportedly binds to MHC-II, was highly expressed by tumor-infiltrating CD4+ T cells in MHC-II–expressing tumors. Therefore, the combination of LAG-3 blockade with PD-1 blockade showed a far stronger antitumor immunity compared with either treatment alone. We propose that PD-1 blockade therapies have antitumor effects on MHC-II–expressing tumors such as cHL that are mediated by cytotoxic CD4+ T cells and that LAG-3 could be a candidate for combination therapy with PD-1 blockade.
Association between physical function and long-term care in community-dwelling older and oldest people: the SONIC study
Authors: Srithumsuk Werayuth , Kabayama Mai , Godai Kayo , Klinpudtan Nonglak , Sugimoto Ken , Akasaka Hiroshi , Takami Yoichi , Takeya Yasushi , Yamamoto Koichi , Yasumoto Saori , Gondo Yasuyuki , Arai Yasumichi , Masui Yukie , Ishizaki Tatsuro , Shimokata Hiroshi , Rakugi Hiromi , Kamide Kei
Published: September 2020

Background

Preventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden. The objective of this study was to investigate whether grip strength and/or walking speed, which are components of the frailty definition, are associated with LTC in community-dwelling older and oldest people.

Methods

The participants were 1098 community-dwelling older and oldest people who had not received LTC at the baseline. The endpoint was receiving LTC after the baseline survey. The independent variables were grip strength and walking speed, and participants were divided into two groups based on these variables. The confounding factors were age, sex, the Japanese version of the Montreal Cognitive Assessment (MoCA-J), hypertension, diabetes mellitus, stroke, joint diseases, living alone, body mass index, and serum albumin. We calculated the hazard ratio of receiving LTC using the Cox proportional hazard model.

Results

Among the 1098 participants, 107 (9.7%) newly received LTC during the follow-up. Regarding the physical function, only slow walking speed was significantly correlated with LTC after adjusting for all confounding factors except the MoCA-J score (HR = 1.74, 95% CI = 1.10–2.75, P = .018). However, slow walking speed was still a risk factor for LTC after adjusting for the MoCA-J score and other confounding factors (HR = 1.64, 95% CI = 1.03–2.60, P = .037).

Conclusions

The findings from this study may contribute to a better understanding of slow walking speed as a factor related to LTC, which might be a criterion for disability prevention and could serve as an outcome measure for physical function in older people.
Identification of quantitative trait nucleotides and candidate genes for soybean seed weight by multiple models of genome-wide association study
Authors: Karikari Benjamin , Wang Zili , Zhou Yilan , Yan Wenliang , Feng Jianying , Zhao Tuanjie
Published: September 2020

Background

Seed weight is a complex yield-related trait with a lot of quantitative trait loci (QTL) reported through linkage mapping studies. Integration of QTL from linkage mapping into breeding program is challenging due to numerous limitations, therefore, Genome-wide association study (GWAS) provides more precise location of QTL due to higher resolution and diverse genetic diversity in un-related individuals.

Results

The present study utilized 573 breeding lines population with 61,166 single nucleotide polymorphisms (SNPs) to identify quantitative trait nucleotides (QTNs) and candidate genes for seed weight in Chinese summer-sowing soybean. GWAS was conducted with two single-locus models (SLMs) and six multi-locus models (MLMs). Thirty-nine SNPs were detected by the two SLMs while 209 SNPs were detected by the six MLMs. In all, two hundred and thirty-one QTNs were found to be associated with seed weight in YHSBLP with various effects. Out of these, seventy SNPs were concurrently detected by both SLMs and MLMs on 8 chromosomes. Ninety-four QTNs co-localized with previously reported QTL/QTN by linkage/association mapping studies. A total of 36 candidate genes were predicted. Out of these candidate genes, four hub genes (Glyma06g44510, Glyma08g06420, Glyma12g33280andGlyma19g28070) were identified by the integration of co-expression network. Among them, three were relatively expressed higher in the high HSW genotypes at R5 stage compared with low HSW genotypes exceptGlyma12g33280. Our results show that using more models especially MLMs are effective to find important QTNs, and the identified HSW QTNs/genes could be utilized in molecular breeding work for soybean seed weight and yield.

Conclusion

Application of two single-locus plus six multi-locus models of GWAS identified 231 QTNs. Four hub genes (Glyma06g44510,Glyma08g06420,Glyma12g33280&Glyma19g28070) detected via integration of co-expression network among the predicted candidate genes.
Co-infection with trichomonas vaginalis increases the risk of cervical intraepithelial neoplasia grade 2–3 among HPV16 positive female: a large population-based study
Authors: Yang Mei , Li Lin , Jiang Chunfan , Qin Xiaomin , Zhou Min , Mao Xiaogang , Xing Hui
Published: September 2020

Background

Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of high risk HPV (hr-HPV).

Methods

From January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions.

Results

Among 310,545 female, 6067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p < 0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42–2.31). Co-infection with TV increased the risk of CIN 2–3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16–2.53).

Conclusions

Co-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.
Cervical spine osteoradionecrosis or bone metastasis after radiotherapy for nasopharyngeal carcinoma? The MRI-based radiomics for characterization
Authors: Zhong Xi , Li Li , Jiang Huali , Yin Jinxue , Lu Bingui , Han Wen , Li Jiansheng , Zhang Jian
Published: September 2020

Background

To develop and validate an MRI-based radiomics nomogram for differentiation of cervical spine ORN from metastasis after radiotherapy (RT) in nasopharyngeal carcinoma (NPC).

Methods

A radiomics nomogram was developed in a training set that comprised 46 NPC patients after RT with 95 cervical spine lesions (ORN, n = 51; metastasis, n = 44), and data were gathered from January 2008 to December 2012. 279 radiomics features were extracted from the axial contrast-enhanced T1-weighted image (CE-T1WI). A radiomics signature was created by using the least absolute shrinkage and selection operator (LASSO) algorithm. A nomogram model was developed based on the radiomics scores. The performance of the nomogram was determined in terms of its discrimination, calibration, and clinical utility. An independent validation set contained 25 consecutive patients with 47 lesions (ORN, n = 25; metastasis, n = 22) from January 2013 to December 2015.

Results

The radiomics signature that comprised eight selected features was significantly associated with the differentiation of cervical spine ORN and metastasis. The nomogram model demonstrated good calibration and discrimination in the training set [AUC, 0.725; 95% confidence interval (CI), 0.622–0.828] and the validation set (AUC, 0.720; 95% CI, 0.573–0.867). The decision curve analysis indicated that the radiomics nomogram was clinically useful.

Conclusions

MRI-based radiomics nomogram shows potential value to differentiate cervical spine ORN from metastasis after RT in NPC.
Polymyoclonus aggravated by neck flexion as the isolated presenting symptom of Hirayama disease: case report
Authors: Kim Jun-Young , Hwang Su-Keong , Kwon Soonhak , Park Jin-Sung
Published: September 2020

Background

We report a rare case of an 18-year-old male with unilateral hand tremor who was finally diagnosed with Hirayama disease (HD).

Case presentation

An 18-year-old male presented with unilateral polymyoclonus that aggravated with neck flexion. The patient did not complain of muscle weakness or muscle atrophy. The needle electromyography showed giant motor unit potentials in right cervical 7 and 8 innervated muscles. The cervical magnetic resonance imaging on supine and flexion state showed prominent forward effacement of posterior dural sac that was compatible with HD.

Conclusions

HD usually presents with unilateral distal hand weakness, muscle atrophy and tremor. Although it is a benign and self-limiting disease, early diagnosis may lead to less clinical deterioration. Moreover, electromyography should be completed in the differentiation of young male patients who present with polymyoclonus without hand weakness or atrophy.
Mechanical thrombectomy: can it be safely delivered out of hours in the UK?
Authors: Weddell Jake , Parr Emma , Knight Stacey , Muddegowda Girish , Natarajan Indira , Chembala Jayan , Ferdinand Phillip , Ahmad Nasar , Pencz Zoltan , Rana Saad , Warusevitane Anushka , Jadun Changez , Nayak Sanjeev , Hashim Zafar , Augustine Albin , Sim Julius , Roffe Christine
Published: September 2020

Background

Mechanical thrombectomy was approved by NICE as a treatment for stroke in 2016. However, most of the evidence is from studies conducted during working hours. Only few centres in the UK perform thrombectomies out-of-hours. The Royal Stoke University Hospital (RSUH) has offered thrombectomies over 24 h (24/7) since 2010. The aim of this service review is to compare the outcomes for patients treated in regular working hours to those treated outside normal working hours within this unit.

Methods

This retrospective service analysis includes all patients treated with mechanical thrombectomy at RSUH since the start of the service in January 2010 to June 2019. Data on key demographics, timings, procedural complications, and long-term outcomes including death and disability at 90 days were collected. In-hours was defined as the time between 8:00–17:00 h, Monday to Friday; out-of-hours was defined as any time outside this period.

Results

In total, 516 mechanical thrombectomies were performed in this time period; data were available on 501 of these. Successful recanalization (TICI 2b/3) was achieved in 86% of patients. By 90 days 96 (19%) had died and 234 (47%) were functionally independent (modified Rankin Scale score ≤ 2). 211 (42%) of the procedures were performed in-hours and 290 (58%) out-of-hours. Door-to-CT and door-to-groin times were significantly longer out-of-hours than in-hours, but thrombectomy duration was significantly shorter. There were no significant differences in complications and short- and long-term outcomes.

Conclusion

Mechanical thrombectomy was delivered safely and effectively 24/7 in this UK hospital, with no difference in clinical outcomes.
Cost-effectiveness analysis of first and second-generation EGFR tyrosine kinase inhibitors as first line of treatment for patients with NSCLC harboring EGFR mutations
Authors: Arrieta Oscar , Catalán Rodrigo , Guzmán-Vazquez Silvia , Barrón Feliciano , Lara-Mejía Luis , Soto-Molina Herman , Ramos-Ramírez Maritza , Flores-Estrada Diana , de la Garza Jaime
Published: September 2020

Background

Tyrosine-kinase inhibitors (TKIs) have become the cornerstone treatment of patients with non-small cell lung cancer that harbor oncogenic EGFR mutations. The counterpart of these drugs is the financial burden that they impose, which often creates a barrier for accessing treatment in developing countries. The aim if the present study was to compare the cost-effectiveness of three different first and second generation TKIs.

Methods

We designed a retrospective cost-effectiveness analysis of three different TKIs (afatinib, erlotinib, and gefitinib) administered as first-line therapy for patients with NSCLC that harbor EGFR mutations.

Results

We included 99 patients with the following TKI treatment; 40 treated with afatinib, 33 with gefitinib, and 26 with erlotinib. Median PFS was not significantly different between treatment groups; 15.4 months (95% CI 9.3–19.5) for afatinib; 9.0 months (95% CI 6.3- NA) for erlotinib; and 10.0 months (95% CI 7.46–14.6) for gefitinib. Overall survival was also similar between groups: 29.1 months (95% CI 25.4-NA) for afatinib; 27.1 months (95% CI 17.1- NA) for erlotinib; and 23.7 months (95% CI 18.6-NA) for gefitinib. There was a statistically significant difference between the mean TKIs costs; being afatinib the most expensive treatment. This difference was observed in the daily cost of treatment (p < 0.01), as well as the total cost of treatment (p = 0.00095). Cost-effectiveness analysis determined that afatinib was a better cost-effective option when compared with first-generation TKIs (erlotinib and gefitinib).

Conclusion

In our population, erlotinib, afatinib, and gefitinib were statistically equally effective in terms of OS and PFS for the treatment of patients with advanced EGFR-mutated NSCLC population. Owing to its marginally increased PFS and OS, the cost-effectiveness analysis determined that afatinib was a slightly better cost-effective option when compared with first-generation TKIs (erlotinib and gefitinib).
Short-course radiation followed by mFOLFOX-6 plus avelumab for locally-advanced rectal adenocarcinoma
Authors: Shamseddine Ali , Zeidan Youssef H. , Kreidieh Malek , Khalifeh Ibrahim , Turfa Rim , Kattan Joseph , Mukherji Deborah , Temraz Sally , Alqasem Kholoud , Amarin Rula , Al Awabdeh Tala , Deeba Samer , Jamali Faek , Mohamad Issa , Elkhaldi Mousa , Daoud Faiez , Al Masri Mahmoud , Dabous Ali , Hushki Ahmad , Jaber Omar , Khoury Clement , El Husseini Ziad , Charafeddine Maya , Al Darazi Monita , Geara Fady
Published: September 2020

Background

Current standard practice for locally advanced rectal cancer (LARC) entails a multidisciplinary approach that includes preoperative chemoradiotherapy, followed by total mesorectal excision, and then adjuvant chemotherapy. The latter has been accompanied by low compliance rates and no survival benefit in phase III randomized trials, so the strategy of administering neoadjuvant, rather than adjuvant, chemotherapy has been adapted by many trials, with improvement in pathologic complete response. Induction chemotherapy with oxaliplatin has been shown to have increased efficacy in rectal cancer, while short-course radiation therapy with consolidation chemotherapy increased short-term overall survival rate and decreased toxicity levels, making it cheaper and more convenient than long-course radiation therapy.

This led to recognition of total neoadjuvant therapy as a valid treatment approach in many guidelines despite limited available survival data. With the upregulation (PDL-1) expression in rectal tumors after radiotherapy and the increased use of in malignant melanoma, the novel approach of combining immunotherapy with chemotherapy after radiation may have a role in further increasing pCR and improving overall outcomes in rectal cancer.

Methods

The study is an open label single arm multi- center phase II trial. Forty-four recruited LARC patients will receive 5Gy x 5fractions of SCRT, followed by 6 cycles of mFOLFOX-6 plus avelumab, before TME is performed. The hypothesis is that the addition of avelumab to mFOLFOX-6, administered following SCRT, will improve pCR and overall outcomes. The primary outcome measure is the proportion of patients who achieve a pCR, defined as no viable tumor cells on the excised specimen. Secondary objectives are to evaluate 3-year progression-free survival, tumor response to treatment (tumor regression grades 0 & 1), density of tumor-infiltrating lymphocytes, correlation of baseline Immunoscore with pCR rates and changes in PD-L1 expression.

Discussion

Recent studies show an increase in PD-L1 expression and density of CD8+ TILs after CRT in rectal cancer patients, implying a potential role for combinatory strategies using PD-L1- and programmed-death- 1 inhibiting drugs. We aim through this study to evaluate pCR following SCRT, followed by mFOLFOX-6 with avelumab, and then TME procedure in patients with LARC.

Trial registration

Trial Registration Number and Date of Registration: ClinicalTrials.gov NCT03503630, April 20, 2018.
Effectiveness of instrumented gait analysis in interdisciplinary interventions on parents’ perception of family-centered service and on gross motor function in children with cerebral palsy: a randomized controlled trial
Authors: Fonvig Christina Esmann , Rasmussen Helle Mätzke , Overgaard Søren , Holsgaard-Larsen Anders
Published: September 2020

Background

Children with cerebral palsy often exhibit an altered gait pattern; however, it is uncertain whether the use of an instrumented gait analysis in interdisciplinary interventions affects the perceived experience of family-centered service (FCS) and/or gross motor function. The aim of this study is to investigate whether individually tailored interdisciplinary interventions, based on an instrumented gait analysis report, has a superior effectiveness on perceived FCS and gross motor function in children with cerebral palsy, compared to ‘care as usual’ without the use of instrumented gait analysis. Furthermore, to investigate potential associations between perceived FCS and gross motor function improvement with the goal of improving future therapy on gross motor function.

Method

This is a sequel analysis on tertiary outcome measures from a prospective, single blind, randomized, parallel group study including two groups of 30 children aged 5–8 years with spastic cerebral palsy at Gross Motor Function Classification System levels I-II (n = 60). The intervention group underwent a three-dimensional gait analysis, from which a clinical report was written with recommendations on interdisciplinary interventions, such as physical therapy, orthopedic surgery, orthotics or spasticity management.

To assess effectiveness on perceived FCS and gross motor function, at baseline, 26 weeks and 52 weeks, the five domains in the Measure of Processes of Care (MPOC-20) (Enabling and partnership, Providing general information, Providing specific information about the child, Respectful and supportive service, and Coordinated and comprehensive care) and the Gross Motor Function Measurement (GMFM-66) were used as outcome measures.

Results

No significant differences in between-group change scores in any of the five MPOC-20 domains were observed (p = 0.40–0.97). In favor of the intervention group a significantly higher between-group change score in GMFM-66 (mean difference: 3.05 [95%CI: 1.12–4.98], p = 0.003) after 52 weeks was observed.

Conclusion

The addition of an instrumented gait analysis report to ‘care as usual’ did not improve the parents’ perceptions of FCS in treatment of children with cerebral palsy. However, superior improvement in the GMFM-66 was observed in the intervention group, suggesting meaningful gross motor function improvement.

Trial registration

Clinical Trials, NCT02160457. Registered June 10th 2014.
Associations between (sub) clinical stress- and anxiety symptoms in mentally healthy individuals and in major depression: a cross-sectional clinical study
Authors: Konstantopoulou Georgia , Iliou Theodoros , Karaivazoglou Katerina , Iconomou Gregoris , Assimakopoulos Konstantinos , Alexopoulos Panagiotis
Published: September 2020

Background

Responses to stressful circumstances have psychological and physiological dimensions, and are related to anxiety symptoms and mental disorders such as depression. Nonetheless, the relationship between subclinical stress and anxiety symptoms is still elusive.

Methods

To explore possible associations between stress and anxiety symptoms, patients with major depression (N = 77) and mentally healthy individuals of different age clusters and occupations (N = 412) were enrolled into the study. Stress was assessed with the new subclinical stress symptom questionnaire (SSQ-25). Anxiety was studied with the Beck Anxiety Inventory (BAI), mainly focusing on clinical anxiety, whilst anxiety as a personality trait was assessed with the trait aspect of the State Τrait Αnxiety Ιnventory Y (STAI Y). Statistical analyses included ANOVA, Scheffe test, linear regression models and a two-step cluster analysis using Log-Likelihood Distance measure and fixed number of two clusters.

Results

Age, stress symptoms and BAI scores differed significantly between among groups (P < 0.001), whilst STAI Y scores did not. Stress levels were found to be related to clinical anxiety (P < 0.001), while neither group identity nor age exerted any influence on anxiety levels (P > 0.05). The two Step Cluster analysis classified 76 out of 77 participants with milder stress (subclinical) symptoms into the cluster with moderate anxiety, as indicated by BAI scores, and all individuals with more severe stress into the severe anxiety cluster.

Conclusions

The observed associations between stress and anxiety shed light on the interrelations between even very mild (subclinical) stress and anxiety symptoms and may point to the potential of mild stress to serve as a target for early interventions aiming to prevent anxiety morbidity.