bluuebunny/crossref_metadata_2025 huggingface dataset:
Autologous bone-marrow mononuclear stem cell therapy in patients with stroke: a meta-analysis of comparative studies
Authors: Chumnanvej Sorayouth , Chumnanvej Siriluk
Published: September 2020

Background

There is a need to promote recovery after stroke with novel therapeutic interventions. Of them, bone-marrow mononuclear cell (BM-MNC) therapy offers promising outcomes in preclinical and clinical models.

Aims

To investigate the efficacy and safety of BM-MNCs versus traditional medical care of stroke patients.

Summary of review

A meta-analysis was conducted involving controlled prospective studies and randomized clinical trials (RCTs) which investigated the changes in the scores of neurological functions (the National Institutes of Health Stroke Scale [NIHSS]), the indices of functional recovery (the Barthel Index [BI] and the modified Rankin scale [mRS]) at 3 and 6 month post-transplantation. A total of nine studies (five RCTs) recruited 469 stroke patients (65.5% males, 49.25% received the intervention). There were no significant differences in NIHSS, BI, or mRS scores after 3 months of follow-up. However, the BI indices of BM-MNCs-receiving patients improved significantly after 6 months (standardized mean difference = 1.17, 95% confidence interval, 0.23 to 2.10, P = 0.01) as compared to traditional treatment. The risk of mortality and adverse events and the proportion of patients with favorable outcomes (mRS ≤ 3) were similar in both groups.

Conclusion

Both the BM-MNCs and medical stroke treatment have similar outcomes in terms of safety and short-term efficacy, while the effect of therapy is significant only after 6 months. More well-designed, large sized RCTs are needed to confirm the efficacy of stem cell therapy over long periods of follow-up.
Neutrophils mediated multistage nanoparticle delivery for prompting tumor photothermal therapy
Authors: Ye Bo , Zhao Bao , Wang Kun , Guo Yilong , Lu Qinguo , Zheng Longpo , Li Ang , Qiao Jianou
Published: September 2020

Background

Neutrophil-based drug delivery system possesses excellent advantages in targeting at tumour because neutrophils are easily recruited by chemotactic factor in tumor microenvironment. Herein, we developed a novel tactic of multistage neutrophils-based nanoparticle delivery system for promoting photothermal therapy (PTT) of lung cancer.

Results

Au nanorod (AuNR) was successfully modified with bovine serum albumin (AuNRB) and further conjugated with RGD (AuNRBR), followed by neutrophil internalisation to obtain neutrophils-based delivery system (AuNRBR/N). The engineered neutrophils efficiently migrated across the epithelial cells due to inflammatory signal. They exhibited better toxicity against Lewis cells with laser irradiation in vitro. Moreover, AuNRBR/N showed significantly more targetability to tumour tissue compared with cell carrier-free AuNRBR, as demonstrated in Lewis tumour-bearing mice. The enhanced tumour homing efficiency of AuNRBR/N together with subsequently released AuNRBR from the neutrophils was favourable for further deep tissue diffusion and contributed to the inhibition of the tumour growth in PTT and improved survival rate (over 120 days).

Conclusions

Overall results illustrated that the design of cell-based nanoparticle delivery system for PTT of cancer is promising.
Impact of maternal and child dental anxiety on oral health-related quality of life of 5–6-year-old preschool children
Authors: Esa Rashidah , Jamaludin Marhazlinda , Yusof Zamros Yuzadi Mohd
Published: September 2020

Background

There is a lack of evidence with regards to the association between both maternal and child dental anxiety and the mother’s perception of her child’s oral health-related quality of life (COHRQoL). The aim of this study was to investigate the association of maternal and child dental anxiety with COHRQoL and the effect of demographic factors as moderators in this relationship. In addition, the association between child’s dental caries experience and the COHRQoL was also assessed.

Methods

A cross-sectional study was conducted involving 1150, 5–6 year-old preschool children in Selangor, Malaysia. Mothers answered a questionnaire on socio-economic status, the Malay-Modified Dental Anxiety Scale to assess maternal dental anxiety, and the Malay-Early Childhood Oral Health Impact Scale to assess COHRQoL. Child's dental anxiety was assessed using the Malay-Modified Child Dental Anxiety Scale via a face-to-face interview prior to oral examination to assess dental caries. Data were analysed using structural equation modelling to assess the relationship between maternal and child dental anxiety and COHRQoL.

Results

Overall, complete data on 842 mother–child dyads were analysed. The mean scores of total ECOHIS, the child impacts section (CIS), and the family impacts section (FIS) were 17.7 (SD = 4.9), 12.6 (SD = 3.7), and 5.1 (SD = 1.9), respectively. The mean dental anxiety scores for mothers and children were 11.8 (SD = 4.5) and 16.9 (SD = 4.3), respectively. Maternal dental anxiety was associated with the CIS (b = 0.08,p < 0.001), the FIS (b = 0.01,p = 0.001), and the total ECOHIS (b = 0.14,p < 0.001). Maternal education level, income, urban/rural location, and kindergarten type were moderators to the relationship. In addition, there was also a significant relationship between child’s dental caries experience and COHRQoL (p < 0.001).

Conclusions

Maternal dental anxiety and child’s dental caries experience have significantly impacted the COHRQoL, the CIS, and the FIS domains. Demographic factors such as maternal education, income, urban/rural location, and kindergarten type acted as moderators that can strengthen or weaken the relationship between maternal dental anxiety and COHRQoL of 5–6-year-old preschool children.
Impact of oral health conditions on the quality of life of quilombola and non-quilombola rural adolescents in the countryside of Bahia, Brazil: a cross-sectional study
Authors: da Silva Etna Kaliane Pereira , de Medeiros Danielle Souto
Published: September 2020

Background

This study aimed to estimate the prevalence of negative impacts of oral health conditions on the quality of life ofquilombolaand non-quilombolarural adolescents and identify associated factors.

Methods

This cross-sectional study was carried out in a rural area in the countryside of Bahia, Brazil, in 2015. Participants were asked to complete the Oral Impacts on Daily Performance Questionnaire. Prevalence and prevalence ratios (PR) were estimated together with their respective 95% confidence intervals. Multiple analysis was conducted using Poisson regression with robust error variance and hierarchical entry of variables.

Results

Of the 390 rural adolescents who took part in the study, 42.8% werequilombolas, and 45.6% of all participants reported a negative impact of their oral health conditions on their quality of life. The most prevalent impact was difficulty eating (32.6%). After adjusted analysis, the following factors were found to be associated with the negative impact of oral health conditions on quality of life: age (PR = 1.04), feeling lonely (PR = 1.42), worst evaluation of oral health (PR = 1.52), need of dental care (PR = 1.33), and occurrence of toothache in the last 6 months (PR = 1.83).Quilombolasand non-quilombolaspresented with a different prevalence of discomfort when brushing their teeth and had different factors associated with the negative impact of oral health conditions on their quality of life. Bothquilombolaand non-quilombolarural adolescents showed a high prevalence of negative impact of oral health conditions on their quality of life.

Conclusions

These results support the need for improved oral healthcare for specific populations like thequilombolas. Furthermore, the results illustrate the importance of incorporating oral healthcare strategies that take into consideration the sociocultural context of adolescents.
Curcumin derivative C212 inhibits Hsp90 and
eliminates both growing and quiescent leukemia cells in deep dormancy
Authors: Liu Bi , Shen Yunzhu , Huang Huafang , Croce Kimiko Della , Wu Min , Fan Yingjuan , Liu Yang , Xu Jianhua , Yao Guang
Published: September 2020

Background

Relapsed leukemia following initial therapeutic response and
remission is difficult to treat and causes high patient mortality. Leukemia
relapse is due to residual quiescent leukemia cells that escape conventional
therapies and later reemerge. Eliminating not only growing but quiescent
leukemia cells is critical to effectively treating leukemia and preventing its
recurrence. Such dual targeting therapeutic agents, however, are lacking in the
clinic. To start tackling this problem, encouraged by the promising anticancer
effects of a set of curcumin derivatives in our earlier studies, we examined in
this work the effects of a 4-arylmethyl curcumin derivative (C212) in
eliminating both growing and quiescent leukemia cells.

Methods

We analyzed the effects of C212 on the growth and viability of
growing and quiescent leukemia cells using MTS, apoptosis, cell cycle and cell
tracking assays. The effects of C212 on the quiescence depth of leukemia cells
were measured using EdU incorporation assay upon growth stimulation. The
mechanisms of C212-induced apoptosis and deep dormancy, particularly associated
with its inhibition of Hsp90 activity, were studied using molecular docking,
protein aggregation assay, and Western blot of client proteins.

Results

C212, on the one hand, inhibits growing leukemia cells at a higher
efficacy than curcumin by inducing apoptosis and G2/M accumulation; it, on the
other hand, eliminates quiescent leukemia cells that are resistant to
conventional treatments. Furthermore, C212 drives leukemia cells into and kills
them at deep quiescence. Lastly, we show that C212 induces apoptosis and drives
cells into deep dormancy at least partially by binding to and inhibiting Hsp90,
leading to client protein degradation and protein aggregation.

Conclusion

C212 effectively eliminates both growing and quiescent leukemia
cells by inhibiting Hsp90. The property of C212 to kill quiescent leukemia cells
in deep dormancy avoids the risk associated with awaking therapy-resistant
subpopulation of quiescent leukemia cells during treatments, which may lead to
the development of novel therapies against leukemia relapse.
Different neighborhood walkability indexes for active commuting to school are necessary for urban and rural children and adolescents
Authors: Molina-García Javier , Campos Sergio , García-Massó Xavier , Herrador-Colmenero Manuel , Gálvez-Fernández Patricia , Molina-Soberanes Daniel , Queralt Ana , Chillón Palma
Published: September 2020

Background

Literature focusing on youth has reported limited evidence and non-conclusive associations between neighborhood walkability measures and active commuting to and from school (ACS). Moreover, there is a lack of studies evaluating both macro- and micro-scale environmental factors of the neighborhood when ACS is analyzed. Likewise, most studies on built environment attributes and ACS focus on urban areas, whereas there is a lack of studies analyzing rural residential locations. Moreover, the relationship between built environment attributes and ACS may differ in children and adolescents. Hence, this study aimed to develop walkability indexes in relation to ACS for urban and rural children and adolescents, including both macro- and micro-scale school-neighborhood factors.

Methods

A cross-sectional study of 4593 participants from Spain with a mean age of 12.2 (SD 3.6) years was carried out. Macro-scale environmental factors were evaluated using geographic information system data, and micro-scale factors were measured using observational procedures. Socio-demographic characteristics and ACS were assessed with a questionnaire. Several linear regression models were conducted, including all the possible combinations of six or less built environment factors in order to find the best walkability index.

Results

Analyses showed that intersection density, number of four-way intersections, and residential density were positively related to ACS in urban participants, but negatively in rural participants. In rural children, positive streetscape characteristics, number of regulated crossings, traffic calming features, traffic lanes, and parking street buffers were also negatively related to ACS. In urban participants, other different factors were positively related to ACS: number of regulated crossings, positive streetscape characteristics, or crossing quality. Land use mix acted as a positive predictor only in urban adolescents. Distance to the school was a negative predictor on all the walkability indexes. However, aesthetic and social characteristics were not included in any of the indexes.

Conclusions

Interventions focusing on improving built environments to increase ACS behavior need to have a better understanding of the walkability components that are specifically relevant to urban or rural samples.
The study of the association between immune monitoring and pneumonia in kidney transplant recipients through machine learning models
Authors: Peng Bo , Gong Hang , Tian Han , Zhuang Quan , Li Junhui , Cheng Ke , Ming Yingzi
Published: September 2020

Background

Kidney transplantation is the optimal treatment to cure the patients with end-stage renal disease (ESRD). However, the infectious complication, especially pneumonia, is the main cause of mortality in the early stage. Immune monitoring by relevant biomarkers provides direct evidence of immune status. We aimed to study the association between immune monitoring and pneumonia in kidney transplant patients through machine learning models.

Methods

A total of 146 patients receiving the immune monitoring panel in our center, including 46 pneumonia recipients and 100 stable recipients, were retrospectively reviewed to develop the models. All the models were validated by external data containing 10 pneumonia recipients and 32 stable recipients. The immune monitoring panel consisted of the percentages and absolute cell counts of CD3+CD4+ T cells, CD3+CD8+ T cells, CD19+ B cells and natural killer (NK) cells, and median fluorescence intensity (MFI) of human leukocyte antigen (HLA)-DR on monocytes and CD64 on neutrophils. The machine learning models including support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP) and random forest (RF) were applied for analysis.

Results

The pneumonia and stable groups showed significant difference in cell counts of each subpopulation and MFI of monocyte HLA-DR and neutrophil CD64. The SVM model by monocyte HLA-DR (MFI), neutrophil CD64 (MFI), CD8+ T cells (cells/μl), NK cells (cell/μl) and TBNK (T cells, B cells and NK cells, cells/μl) had the best performance with the average area under the curve (AUC) of 0.940. The RF model best predicted the patients who would progress into severe pneumonia, with the average AUC of 0.760. All the models had good performance validated by external data.

Conclusions

The immune monitoring panel was tightly associated with pneumonia in kidney transplant recipients. The models developed by machine learning techniques identified patients at risk and predicted the prognosis. Based on the results of immune monitoring, better individualized therapy might be achieved.
Role of sex and high-fat diet in metabolic and hypothalamic disturbances in the 3xTg-AD mouse model of Alzheimer’s disease
Authors: Robison Lisa S. , Gannon Olivia J. , Thomas Melissa A. , Salinero Abigail E. , Abi-Ghanem Charly , Poitelon Yannick , Belin Sophie , Zuloaga Kristen L.
Published: September 2020

Background

Hypothalamic dysfunction occurs early in the clinical course of Alzheimer’s disease (AD), likely contributing to disturbances in feeding behavior and metabolic function that are often observed years prior to the onset of cognitive symptoms. Late-life weight loss and low BMI are associated with increased risk of dementia and faster progression of disease. However, high-fat diet and metabolic disease (e.g., obesity, type 2 diabetes), particularly in mid-life, are associated with increased risk of AD, as well as exacerbated AD pathology and behavioral deficits in animal models. In the current study, we explored possible relationships between hypothalamic function, diet/metabolic status, and AD. Considering the sex bias in AD, with women representing two-thirds of AD patients, we sought to determine whether these relationships vary by sex.

Methods

WT and 3xTg-AD male and female mice were fed a control (10% fat) or high-fat (HF 60% fat) diet from ~ 3–7 months of age, then tested for metabolic and hypothalamic disturbances.

Results

On control diet, male 3xTg-AD mice displayed decreased body weight, reduced fat mass, hypoleptinemia, and mild systemic inflammation, as well as increased expression of gliosis- and inflammation-related genes in the hypothalamus (Iba1, GFAP, TNF-α, IL-1β). In contrast, female 3xTg-AD mice on control diet displayed metabolic disturbances opposite that of 3xTg-AD males (increased body and fat mass, impaired glucose tolerance). HF diet resulted in expected metabolic alterations across groups (increased body and fat mass; glucose intolerance; increased plasma insulin and leptin, decreased ghrelin; nonalcoholic fatty liver disease-related pathology). HF diet resulted in the greatest weight gain, adiposity, and glucose intolerance in 3xTg-AD females, which were associated with markedly increased hypothalamic expression of GFAP and IL-1β, as well as GFAP labeling in several hypothalamic nuclei that regulate energy balance. In contrast, HF diet increased diabetes markers and systemic inflammation preferentially in AD males but did not exacerbate hypothalamic inflammation in this group.

Conclusions

These findings provide further evidence for the roles of hypothalamic and metabolic dysfunction in AD, which in the 3xTg-AD mouse model appears to be dependent on both sex and diet.
Kinematic parameters obtained with the ArmeoSpring for upper-limb assessment after stroke: a reliability and learning effect study for guiding parameter use
Authors: Brihmat Nabila , Loubinoux Isabelle , Castel-Lacanal Evelyne , Marque Philippe , Gasq David
Published: September 2020

Background

After stroke, kinematic measures obtained with non-robotic and robotic devices are highly recommended to precisely quantify the sensorimotor impairments of the upper-extremity and select the most relevant therapeutic strategies. Although the ArmeoSpring exoskeleton has demonstrated its effectiveness in stroke motor rehabilitation, its interest as an assessment tool has not been sufficiently documented. The aim of this study was to investigate the psychometric properties of selected kinematic parameters obtained with the ArmeoSpring in post-stroke patients.

Methods

This study involved 30 post-stroke patients (mean age = 54.5 ± 16.4 years; time post-stroke = 14.7 ± 26.7 weeks; Upper-Extremity Fugl-Meyer Score (UE-FMS) = 40.7 ± 14.5/66) who participated in 3 assessment sessions, each consisting of 10 repetitions of the ‘horizontal catch’ exercise. Five kinematic parameters (taskandmovement time, hand path ratio, peak velocity, number of peak velocity) anda globalScorewere computed from raw ArmeoSpring’ data. Learning effect and retention were analyzed using a 2-way repeated-measures ANOVA, and reliability was investigated using the intra-class correlation coefficient (ICC) and minimal detectable change (MDC).

Results

We observed significant inter- and intra-session learning effects for most parameters except peak velocity. The measures performed in sessions 2 and 3 were significantly different from those of session 1. No additional significant difference was observed after the first 6 trials of each session and successful retention was also highlighted for all the parameters. Relative reliability was moderate to excellent for all the parameters, and MDC values expressed in percentage ranged from 42.6 to 102.8%.

Conclusions

After a familiarization session, the ArmeoSpring can be used to reliably and sensitively assess motor impairment and intervention effects on motor learning processes after a stroke.

Trial registrationThe study was approved by the local hospital ethics committee in September 2016 and was registered under number 05-0916.
Rugged landscapes: complexity and implementation science
Authors: Ornstein Joseph T. , Hammond Ross A. , Padek Margaret , Mazzucca Stephanie , Brownson Ross C.
Published: September 2020

Background

Mis-implementation—defined as failure to successfully implement and continue evidence-based programs—is widespread in public health practice. Yet the causes of this phenomenon are poorly understood.

Methods

We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches—Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM).

Results

The model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM.

Conclusions

The model’s results emphasize the importance of adapting one’s approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.
COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy
Authors: Caravatta Luciana , Rosa Consuelo , Di Sciascio Maria Bernadette , Tavella Scaringi Andrea , Di Pilla Angelo , Ursini Lucia Anna , Taraborrelli Maria , Vinciguerra Annamaria , Augurio Antonietta , Di Tommaso Monica , Trignani Marianna , Nuzzo Marianna , Falco Maria Daniela , De Nicola Andrea , Adorante Nico , Patani Fabiola , Centofanti Giuseppe , Gasparini Lucrezia , Fasciolo David , Di Guglielmo Fiorella Cristina , Bonfiglio Cecilia , Borgia Marzia , Caravaggio Gabriella , Marcucci Stefano , Turchi Consalvo , Mancinelli Domenico , Sartori Stephanie , Schael Thomas , Muraglia Angelo , Caputi Sergio , D’Amario Claudio , Verì Nicoletta , Genovesi Domenico
Published: September 2020

Background

COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II.

Methods

The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily.

Results

By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed.

Conclusion

During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.
Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion
Authors: Zhou Yuanxing , Fu Xin , Yang Ming , Ke Song , Wang Bo , Li Zhonghai
Published: September 2020

Background

With respect to spinal surgeries, elucidating absolute and relative amount of hidden blood loss (HBL) is of great importance in order to avoid aforementioned potential complications. To evaluate HBL and its possible risk factors among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative diseases.

Methods

Between June 2018 and March 2019, 137 consecutive patients with lumbar degenerative disease, who underwent operation with MIS-TLIF technique, were enrolled in this study. The patient’s demographic characteristics and blood loss-related parameters were collected, respectively. The Pearson or Spearman correlation analysis was used to investigate an association between patient’s characteristics and HBL. Multivariate linear regression analysis was used to confirm independent risk factors of HBL.

Results

A total of 137 patients (86 males and 51 females, age range 19–78 years) were reviewed in our hospital. A substantial amount of HBL (488.4 ± 294.0 ml, 52.5% of TBL) occurred after MIS-TLIF. Multivariate linear regression showed that the age, muscle thickness, the Patients’ Society of Anesthesiologists (ASA) classification, patient’s blood volume (PBV), total blood loss (TBL), postoperative (i.e., day 2 or 3) hematocrit (Hct), Hct loss, and fibrinogen level were independent risk factors for HBL (P1 = 0.000,P2 = 0.002,P3 = 0.006,P4 = 0.002,P5 = 0.003,P6 = 0.048,P7 = 0.004,P8 = 0.000).

Conclusion

A large amount of HBL was incurred in patients undergoing MIS-TLIF. More importantly, the age, muscle thickness, ASA classification, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen level were independent risk factors for HBL in MIS-TLIF. HBL and its risk factors should be paid more attention to during the perioperative period.
Anatomical analysis of the left upper lobe of lung on three-dimensional images with focusing the branching pattern of the subsegmental veins
Authors: Isaka Tamami , Mitsuboshi Shota , Maeda Hideyuki , Kikkawa Takuma , Oyama Kunihiro , Murasugi Masahide , Kanzaki Masato , Onuki Takamasa
Published: September 2020

Background

A clear understanding of the anatomical characteristics of the pulmonary veins (PVs) is essential for the successful performance of segmentectomy and important to avoid intraoperative pulmonary vessels injury. However, there is no report showing the relations between the branching patterns of PVs and pulmonary arteries (PAs). Moreover, internationally accepted symbols for describing PVs remain unavailable. For anatomically assessing the branches and courses of the subsegmental veins in the left upper lobe (LUL), the diverse branching patterns of blood vessels and bronchi should be investigated.

Methods

The branching patterns and intersegmental courses of PVs were assessed by performing three-dimensional image analysis of the bronchi, and PAs and PVs in the LUL in 103 patients who were scheduled to receive segmentectomy in LUL from January 2008 through August 2012.

Results

Branching types of the bronchi and pulmonary vessels failed to be independent each other. Although the combinations of anterior extension type of bronchus with the inter-lobar type (IL-type) of arterial branching pattern were often observed, but those with the mediastinal type (M-type) were rarely observed. The combinations of apical vein dominant type with the IL-type of arteries, and intermediate and central vein types with the M-type were often observed. Since LUL was adjoined by various subsegments, and the intersegmental pulmonary veins showed diverse patterns.

Conclusions

This study found the relationship among PA, PV, and bronchus patterns, in the subsegment where the branching patterns were fixed in 103 cases. This study discovered PVs that was difficult to be named by the conventional naming systems because of the diversity of the locations in the subsegment.
Left apicoposterior segmentectomy for lung cancer with displaced segmental bronchus: a case report
Authors: Yanagiya Masahiro , Yamaguchi Hirokazu , Hiyama Noriko , Matsumoto Jun
Published: September 2020

Background

Pulmonary segmentectomy can be challenging when thoracic surgeons encounter anatomical anomalies. A displaced left apicoposterior bronchus is a rare bronchial anomaly that makes lung anatomical resection challenging. We herein present a case of successful left apicoposterior segmentectomy for lung cancer in a patient with an anomalous segmental bronchus.

Case presentation

A 70-year-old man was clinically diagnosed with early-stage lung cancer for which segmentectomy was indicated. A preoperative image revealed a displaced left apicoposterior bronchus that branched behind the left main pulmonary artery. With the aid of three-dimensional reconstruction imaging and systemic indocyanine green injection, we successfully performed left apicoposterior segmentectomy under complete video-assisted thoracic surgery. The pathological diagnosis was adenocarcinoma. The patient was alive without recurrence 8 months after segmentectomy.

Conclusion

Preoperative three-dimensional imaging and systemic indocyanine green injection enabled us to successfully conduct challenging segmentectomy in a patient with an anomalous bronchus.
Antiphospholipid syndrome and valvular heart disease, a complex scenario of thrombotic events, a case report
Authors: Endara Santiago A. , Dávalos Gerardo A. , Fierro Christian H. , Ullauri Vladimir E. , Molina Gabriel A.
Published: September 2020

Background

Antiphospholipid syndrome (APS) is a rare coagulation disorder associated with thrombotic events, myocardial infarction, and valvular heart disease. During valvular replacement surgery, the high risk of thrombosis combined with the operative risks in these specific groups of patients poses a challenge to the medical team.

Case presentation

We present a case of a female patient with APS and mixed aortic valve disease. During surgery, she suddenly developed complete cardiac arrest. Three months later, after she recovered, and while she was still on close follow up, a thrombotic event caused myocardial infarction. After prompt and precise treatment, the patient successfully recovered; one year after surgery patient is doing well.

Conclusion

Adequate surgical technique along with optimal anticoagulation strategies and long term follow up are of paramount importance to ensure an uneventful recovery. A multidisciplinary team is required to manage these complex scenarios and high-risk patients.
RNA N6-methyladenosine reader IGF2BP3 regulates cell cycle and angiogenesis in colon cancer
Authors: Yang Zhou , Wang Tingfeng , Wu Dejun , Min Zhijun , Tan Jingyun , Yu Bo
Published: September 2020

Background

N6-Methyladenosine (m6A) modification has been implicated in multiple processes for colon cancer development. IGF2BP3 was a newly reported m6A reader, whereas its role in colon cancer remains unclear.

Methods

The expression of m6A associated enzymes and total m6A level were measured by Western Blotting analysis and m6A RNA Methylation Quantification Kit respectively. Cell cycle was analyzed by flowcytometry. The interaction of IGF2BP3 and related targets was analyzed by RNA immunoprecipitation (RIP) and m6A RNA immunoprecipitation (MeRIP) assays.

Results

We investigated all m6A regulated enzymes in colon cancer and found only the overexpression of IGF2BP3 was associated with cancer progression and survival based on The Cancer Genome Atlas (TCGA) databases. Additionally, we also demonstrated IGF2BP3 was associated with DNA replication in the cell cycle. Knockdown of IGF2BP3 significantly repressed percentage of S phase of cell cycle as well as cell proliferation. Further research demonstrated IGF2BP3 bound to the mRNA of Cyclin D1 (CCND1, checkpoint of G1/S phase of cell cycle) and reduced its mRNA stability via reading m6A modification in the CDS region. Overexpression of Cyclin D1 in IGF2BP3 down-regulated cells completely rescued the inhibited percentage of S phase in cell cycle as well as cell proliferation. Additionally, we also demonstrated a similar role of IGF2BP3 at VEGF. IGF2BP3 bound to the mRNA of VEGF and reads m6A modification, thus regulated both expression and stability of VEGF mRNA. Knockdown of IGF2BP3 repressed angiogenesis in colon cancer via regulating VEGF.

Conclusion

Knockdown of IGF2BP3 repressed DNA replication in the S phase of cell cycle and angiogenesis via reading m6A modification of CCND1 and VEGF respectively. IGF2BP3 was a possible prognosis marker and potential therapeutic target of colon cancer.
Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years
Authors: Brentnall Adam R. , Warren Ruth , Harkness Elaine F. , Astley Susan M. , Wiseman Julia , Fox Jill , Fox Lynne , Eriksson Mikael , Hall Per , Cuzick Jack , Evans D. Gareth , Howell Anthony
Published: September 2020

Background

A decrease in breast density due to tamoxifen preventive therapy might indicate greater benefit from the drug. It is not known whether mammographic density continues to decline after 1 year of therapy, or whether measures of breast density change are sufficiently stable for personalised recommendations.

Methods

Mammographic density was measured annually over up to 5 years in premenopausal women with no previous diagnosis of breast cancer but at increased risk of breast cancer attending a family-history clinic in Manchester, UK (baseline 2010-2013). Tamoxifen (20 mg/day) for prevention was prescribed for up to 5 years in one group; the other group did not receive tamoxifen and were matched by age. Fully automatic methods were used on mammograms over the 5-year follow-up: three area-based measures (NN-VAS, Stratus, Densitas) and one volumetric (Volpara). Additionally, percentage breast density at baseline and first follow-up mammograms was measured visually. The size of density declines at the first follow-up mammogram and thereafter was estimated using a linear mixed model adjusted for age and body mass index. The stability of density change at 1 year was assessed by evaluating mean squared error loss from predictions based on individual or mean density change at 1 year.

Results

Analysis used mammograms from 126 healthy premenopausal women before and as they received tamoxifen for prevention (median age 42 years) and 172 matched controls (median age 41 years), with median 3 years follow-up. There was a strong correlation between percentage density measures used on the same mammogram in both the tamoxifen and no tamoxifen groups (all correlation coeficients > 0.8). Tamoxifen reduced mean breast density in year 1 by approximately 17–25% of the inter-quartile range of four automated percentage density measures at baseline, and from year 2, it decreased further by approximately 2–7% per year. Predicting change at 2 years using individual change at 1 year was approximately 60–300% worse than using mean change at 1year.

Conclusions

All measures showed a consistent and large average tamoxifen-induced change in density over the first year, and a continued decline thereafter. However, these measures of density change at 1 year were not stable on an individual basis.
Predictive validity of the 5-item Compliance Questionnaire for Rheumatology (CQR5) in detecting poor adherence of patients with rheumatoid arthritis to biological medication
Authors: Salaffi Fausto , Di Carlo Marco , Carotti Marina , Ceccarelli Luca , Farah Sonia , Marotto Daniela , Giorgi Valeria , Sarzi-Puttini Piercarlo
Published: September 2020

Background

Adherence is a key factor for therapeutic success in patients with rheumatoid arthritis (RA). The aim of this study was to determine whether results from the 5-item Compliance Questionnaire for Rheumatology (CQR5) can predict future poor adherence to biological disease-modifying anti-rheumatic drugs (bDMARDs) in patients with RA, using medication possession ratio (MPR) as the gold standard comparator.

Methods

RA patients starting a bDMARD were prospectively followed for 12 months. At baseline, CQR5 was collected in relation to the prescribed bDMARD. Patients were dichotomised into good adherers and poor adherers, categories that were then used as the variable in a predictive function analysis of the CQR5 in order to determine the accuracy of the classification at the end of the study period in comparison with the MPR. The sensitivity, specificity, and likelihood ratio of detecting poor adherers were also determined because this is the clinically important purpose of the questionnaire. Satisfactory adherence was defined as > 80% compliance with the prescribed dose regimen.

Results

Of the 210 RA patients enrolled (147 women and 63 men; mean age 58.6 ± 12.8 years; mean disease duration 7.4 ± 2.5 years), at the end of the 12-month follow-up, 152 patients (72.4%) were good adherers and 58 (27.6%) were poor adherers according to MPR. Predictive analyses showed that the sensitivity and specificity of the CQR5 in detecting poor adherence were respectively 89.9% (95% CI 84.07–94.10%) and 80.8% (95% CI 67.46–90.37%). The accuracy of the CQR5 was 83.04% (95% CI 77.27–87.85%), the positive likelihood ratio (i.e. detecting ≤ 80% adherence) 4.67 (95% CI 2.58–8.18), and the area under curve 0.85 (95% CI 0.79–0.89).

Conclusion

Higher baseline CQR5 scores significantly predict the treatment adherence of RA patients. This suggests that this instrument could be used for screening purposes in order to identify patients who are poorly adherent to bDMARDs.
Klinefelter syndrome and germ cell tumors: review of the literature
Authors: Bonouvrie Kimberley , van der Werff ten Bosch Jutte , van den Akker Machiel
Published: September 2020

Objective

The most common presentation of Klinefelter syndrome (KS) is infertility and features of hypogonadism. Currently no consensus exists on the risk of malignancy in this syndrome. Several case reports show an incidence of extragonadal germ cells tumors (eGCT) of 1.5 per 1000 KS patients (OR 50 against healthy population). Malignant germ cell tumors are rare in children. They account for 3% of all children cancers. Young patients with a germ cell tumor are not routinely tested for Klinefelter syndrome. This can therefore result in underdiagnosing. Literature data suggest a correlation between eGCT and KS. To the best of our knowledge there is no precise description of the primary locations of germ cell tumors in KS patients. The purpose of this study is to evaluate age groups and primary locations of extragonadal germ cell tumors in Klinefelter patients. With this data we investigate whether it is necessary to perform a cytogenetic analysis for KS in every eGCT patient.

Study design

This study is based on case report publications in PubMed/Medline published until march 2020 that described “Klinefelter Syndrome (MeSH) AND/OR extragonadal germ cell tumors”. Publications were included when patients age, location and histology of the germ cell tumor was known. Two double blinded reviewers selected the studies.Results: 141 KS patients with eGCTs were identified. Mean age at presentation was 17.3 years (StDev + − 10.2). In contrast to the extragonadal germ cell tumors in adults, most eGCT in children were mediastinal or in the central nervous system (respectively 90/141; 64% and 23/141; 16% of all tumors). Distribution of histologic subtypes showed that the largest fraction represented a teratoma, mixed-type-non-seminomateus GCT and germinoma, respectively 34/141; 24%, 26/141; 18% and 20/141; 14% of all tumors.

Conclusion

These data suggest a correlation between primary extragonadal germ cell tumors and Klinefelter syndrome. There appears to be an indication for screening on KS in young patients with an eGCT in the mediastinum. A low threshold for radiologic examinations should be considered to discover eGCT. We emphasize the need for genetic analysis in all cases of a male with a mediastinal germ cell tumor for the underdiagnosed Klinefelter syndrome.
Radio environment maps for military cognitive networks: density of small-scale sensor network vs. map quality
Authors: Suchański Marek , Kaniewski Paweł , Romanik Janusz , Golan Edward , Zubel Krzysztof
Published: September 2020

In this paper, we present the dependency between density of a sensor network and map quality in the radio environment map (REM) concept. The architecture of REM supporting military communications systems is described. The map construction techniques based on spatial statistics and transmitter location determination are presented. The problem of REM quality and relevant metrics are discussed. The results of field tests for UHF range with a different number of sensors are shown. Exemplary REM maps with different interpolation algorithms are presented. Finally, the problem of density of a sensor network versus REM map quality is analyzed.
Modified Krasnoselski–Mann iterative method for hierarchical fixed point problem and split mixed equilibrium problem
Authors: Kim Jong Kyu , Majee Prashanta
Published: September 2020

In this paper, we introduce a modified Krasnoselski–Mann type iterative method for capturing a common solution of a split mixed equilibrium problem and a hierarchical fixed point problem of a finite collection of k-strictly pseudocontractive nonself-mappings. Many of the algorithms for solving the split mixed equilibrium problem involve a step size which depends on the norm of a bounded linear operator. Since the computation of the operator norm is very difficult, we formulate our iterative algorithm in such a way that the implementation of the proposed algorithm does not require any prior knowledge of operator norm. Weak convergence results are established under mild conditions. We also establish strong convergence results for a certain class of hierarchical fixed point and split equilibrium problem. Our results generalize some important results in the recent literature.
Stability analysis of fractional-order linear neutral delay differential–algebraic system described by the Caputo–Fabrizio derivative
Authors: Al Sawoor Ann
Published: September 2020

This paper is concerned with the asymptotic stability of linear fractional-order neutral delay differential–algebraic systems described by the Caputo–Fabrizio (CF) fractional derivative. A novel characteristic equation is derived using the Laplace transform. Based on an algebraic approach, stability criteria are established. The effect of the index on such criteria is analyzed to ensure the asymptotic stability of the system. It is shown that asymptotic stability is ensured for the index-1 problems provided that a stability criterion holds for any delay parameter. Also, asymptotic stability is still valid for higher-index problems under the conditions that the system matrices have common eigenvectors and each pair of such matrices is simultaneously triangularizable so that a stability criterion holds for any delay parameter. An example is provided to demonstrate the effectiveness and applicability of the theoretical results.
Human neutrophil elastase inhibitory dihydrobenzoxanthones and alkylated flavones from the Artocarpus elasticus root barks
Authors: Ban Yeong Jun , Baiseitova Aizhamal , Nafiah Mohd Azlan , Kim Jeong Yoon , Park Ki Hun
Published: September 2020

Neutrophil elastases are deposited in azurophilic granules interspace of neutrophils and tightly associated with inflammatory ailments. The root barks of Artocarpus elasticus had a strong inhibitory potential against human neutrophil elastase (HNE). The responsible components for HNE inhibition were confirmed as alkylated flavones (2–4, IC50 = 14.8 ~ 18.1 μM) and dihydrobenzoxanthones (5–8, IC50 = 9.8 ~ 28.7 μM). Alkyl groups on flavone were found to be crucial functionalities for HNE inhibition. For instance, alkylated flavone 2 (IC50 = 14.8 μM) was 20-fold potent than mother compound norartocarpetin (1, IC50 > 300 μM). The kinetic analysis showed that alkylated flavones (2–4) were noncompetitive inhibition, while dihydrobenzoxanthones (5–8) were a mixed type I (KI < KIS) inhibitors, which usually binds with free enzyme better than to complex of enzyme–substrate. Inhibitors and HNE enzyme binding affinities were examined by fluorescence quenching effect. In the result, the binding affinity constants (KSV) had a significant correlation with inhibitory potencies (IC50).
Cost-effectiveness analysis of malaria rapid diagnostic test in the elimination setting
Authors: Du Yan-Qiu , Ling Xiao-Xiao , Jin Jia-Jie , Zhou Hua-Yun , Zhu Si , Zhu Guo-Ding , Wang Wei , Cao Jun , Huang Jia-Yan
Published: September 2020

Background

As more and more countries approaching the goal of malaria elimination, malaria rapid diagnostic tests (RDT) was recomendated to be a diagnostic strategy to achieve and maintain the statute of malaria free, as it’s less requirments on equipment and experitise than microscopic examination. But there are very few economic evaluations to confirm whether RDT was cost-effective in the setting of malaria elimination. This research aimed to offer evidence for helping decision making on malaria diagnosis strategy.

Methods

A cost-effectiveness analysis was conducted to compare RDT with microscopy examination for malaria diagnosis, by using a decision tree model. There were three strategies of malaria diagnostic testing evaluated in the model, 1) microscopy, 2) RDT, 3) RDT followed by microscopy. The effect indicator was defined as the number of malaria cases treated appropriately. Based on the joint perspective of health sector and patient, costs data were collected from hospital information systems, key informant interviews, and patient surveys. Data collection was conducted in Jiangsu from September 2018 to January 2019. Epidemiological data were obtained from local malaria surveillance reports. A hypothetical cohort of 300 000 febrile patients were simulated to calculate the total cost and effect of each strategy. One-way, two-way, and probabilistic sensitivity analysis were performed to test the robustness of the result.

Results

The results showed that RDT strategy was the most effective (245 cases) but also the most costly (United States Dollar [USD] 4.47 million) compared to using microscopy alone (238 cases, USD 3.63 million), and RDT followed by microscopy (221 cases, USD 2.75 million). There was no strategy dominated. One-way sensitivity analysis reflected that the result was sensitive to the change in labor cost and two-way sensitivity analysis indicated that the result was not sensitive to the proportion of falciparum malaria. The result of Monte Carlo simulation showed that RDT strategy had higher effects and higher cost than other strategies with a high probability.

Conclusions

Compared to microscopy and RDT followed by microscopy, RDT strategy had higher effects and higher cost in the setting of malaria elimination.