bluuebunny/crossref_metadata_2025 huggingface dataset:
Vertical Guided Bone Regeneration with Mineralized Cancellous Bone Allograft in a Severe Anterior Maxillary Defect: A Clinical Report with 14-Year Follow-Up
Authors: La Monaca Gerardo , Pranno Nicola , Pompa Giorgio , Annibali Susanna , Vozza Iole , Cristalli Maria Paola
Published: November 2019

Purpose. To report the supracrestal bone regeneration of approximately 10 mm using solvent-dehydrated mineralized cancellous bone allograft and nonresorbable membrane in rehabilitation of unsuccessful implants in the anterior maxilla and stability of the regenerated bone at the 14th-year follow-up.Case Presentation. A 24-year-old female patient with a history of anterior dentoalveolar trauma resulting in the loss of upper left incisors and canine underwent rehabilitation several years ago with three implant-supported fixed prostheses. The prosthesis was both functionally and aesthetically inadequate, and the patient complained of gingival swelling, bleeding, and food impaction at the site of the implants. A staged approach for retreatment was planned, wherein the first surgical stage aimed at removing the existing implants and preparing the bone ridge and soft tissues for the augmentation procedure. The second stage was vertical ridge augmentation and simultaneous prosthetic-driven placement of two new implants at the sites of the left central incisor and canine. After nine months of uneventful healing, complete regeneration of the bony defect was achieved, and the new prosthetic rehabilitation satisfied both functional and aesthetic requirements.Conclusion. The therapeutic approach followed in the present case proved effective in achieving satisfactory functional and aesthetic results and in maintaining the stability of the regenerated bone at 14 years of follow-up.
Musculoskeletal Factors and Geriatric Syndromes Related to the Absence of Musculoskeletal Degenerative Disease in Elderly People Aged over 70 Years
Authors: Imagama Shiro , Ando Kei , Kobayashi Kazuyoshi , Seki Taisuke , Ishizuka Shinya , Machino Masaaki , Tanaka Satoshi , Morozumi Masayoshi , Kanbara Shunsuke , Ito Sadayuki , Inoue Taro , Nakashima Hiroaki , Ishiguro Naoki , Hasegawa Yukiharu
Published: November 2019

Purpose. To investigate factors with a significant relationship with the absence of musculoskeletal disease (MSD: osteoporosis, knee osteoarthritis (K-OA), and lumbar spondylosis (L-OA)) in elderly people ≥70 years old. Methods. The subjects were 279 people (134 males, 145 females, mean age: 75.2 years) who attended an annual health checkup and were prospectively included in the study. Osteoporosis was defined as %YAM ≤70%, K-OA as Kellgren–Lawrence grade ≥2, and L-OA as osteophytes of Nathan class ≥3. Subjects were divided into those with (group D) and without (group N) any MSD. Clinical variables including locomotive syndrome (LS), frailty, sarcopenia, and QOL (SF-36) were compared between the groups. Results. There was no significant difference in age or gender between group N (n=54) and group D (n=225). Lower BMI and pain, including neuropathic pain; greater back muscle strength, physical ability, and balance with eyes closed; larger lumbar lordosis, sacral inclination, and lumbar ROM; and smaller spinal inclination were found in group N. The rates of LS and sarcopenia were significantly lower and QOL was significantly higher in group N. Conclusions. This study firstly revealed the significant musculoskeletal factors and geriatric syndromes related to an absence of MSD, which may form the basis of interventions to improve QOL in elderly people ≥70 years old.
Sensitive Biomarker Analysis of Xue-Fu-Zhu-Yu Capsule for Patients with Qi Stagnation and Blood Stasis Pattern: A Nested Case-Control Study
Authors: Chen Guang , He Haoqiang , Hu Kun , Gao Jialiang , Li Jun , Han Mei , Wang Jie
Published: November 2019

Objectives. To identify the sensitive biomarker to predict the effectiveness of Xue-Fu-Zhu-Yu capsules (XFZYC). Methods. This nested case-control study included 5 patients with response to XFZYC in the treatment group, 5 patients with no response to XFZYC also in the treatment group, and 5 patients in the control group treated with placebo who participated in the previous RCT. The mRNAs, miRNAs, lncRNAs, and circRNAs were sequenced by next-generation sequencing and differential-expressed (DE) RNAs were identified if p value ≤ 0.05 and fold change ≥2, bioinformatics analysis was conducted in terms of function annotations and signaling pathways, and then sensitive biomarker was analyzed based on real-time PCR. Results. The distributions of clinical characteristics between the selected participants from treatment group and placebo group were well balanced. A total of 1156 DE RNAs, 388 miRNAs, 1954 lncRNAs, and 560 circRNAs were identified, which was associated the mechanism of XFZYC and composed the targeted potential biomarkers for further real-time PCR. The DE RNAs were enriched in KEGG pathways pertaining to pathogenesis of Qi Stagnation and Blood Stasis- (QS & BS-) & associated diseases such as coronary heart disease and digestive diseases. The expression level of FZD8 was significantly higher in response patients than that in nonresponse patients (p=0.041) and circRNA_13799 significantly lower in response patients than that in nonresponse patients (p=0.040) based on real-time PCR. Patients with higher expression level of FZD8 with 75% stratification have significantly higher reduction in the questionnaire score (p=0.010), and the area under the curve (AUC) was 0.765 (95%CI = 0.593–0.936; p=0.014). Conclusions. FZD8 might perform the sensitive biomarker for predicting the effectiveness of XFZYC. However, further prospective cohort study was warranted to confirm the exact specificity and sensitivity of this biomarker.
Automatic Pipelining and Vectorization of Scientific Code for FPGAs
Authors: Nabi Syed Waqar , Vanderbauwhede Wim
Published: November 2019

There is a large body of legacy scientific code in use today that could benefit from execution on accelerator devices like GPUs and FPGAs. Manual translation of such legacy code into device-specific parallel code requires significant manual effort and is a major obstacle to wider FPGA adoption. We are developing an automated optimizing compiler TyTra to overcome this obstacle. The TyTra flow aims to compile legacy Fortran code automatically for FPGA-based acceleration, while applying suitable optimizations. We present the flow with a focus on two key optimizations, automatic pipelining and vectorization. Our compiler frontend extracts patterns from legacy Fortran code that can be pipelined and vectorized. The backend first creates fine and coarse-grained pipelines and then automatically vectorizes both the memory access and the datapath based on a cost model, generating an OpenCL-HDL hybrid working solution for FPGA targets on the Amazon cloud. Our results show up to 4.2× performance improvement over baseline OpenCL code.
Mathematical Modelling of Acetaminophen Release in HPC/PAAm Hydrogel: Synthesis and Application
Authors: Díaz-Guerrero Abigail M. , Castillo-Miranda Claudia A. , Castro-Guerrero Carlos F. , Peraza-Vázquez Hernán , Morales-Cepeda Ana B. , Peña-Delgado Adrián F.
Published: November 2019

Hydrogels are commonly used as Drug Delivery Systems (DDS) as patches due to its ability to store drug molecules within their structures. The release can be activated under certain stimuli, such as temperature and pH. In this paper, the mathematical modelling of acetaminophen release in hydroxypropyl cellulose with polyacrylamide (HPC/PAAm) is reported. The HPC/PAAm gel was synthesized in proportions of 25/75 wt% and was characterized by FTIR, DSC, optical microscopy, SEM, and TGA, with and without acetaminophen. The release tests were performed for hypothermic, normal, and febrile human body conditions, at 35, 37, and 39°C, respectively, on two release media: water and phosphate buffer solution. In order to describe the release of acetaminophen in HPC/PAAm gel, a genetic programming algorithm was used to accomplish Multigene Symbolic Regression (MSR). Characterization results showed that the drug was crystallized on the surface of the HPC/PAAm gel. Release test results showed that several simultaneous processes occurred in the acetaminophen diffusion phenomenon. A unique mathematical model was obtained by MSR. This model was able to describe the release of acetaminophen in HPC/PAAm gel with high values of R2 and adjusted R2 and to simulate the drug release at times beyond the end of the experiment. High values of R2 and low values of Coefficient of Variation (CV), Root-Mean-Square Error (RMSE), and Mean Absolute Error (MAE) were obtained from the comparison between the simulated and the experimental data. This allows to conclude that the mathematical model is reliable to represent and simulate the acetaminophen release in HPC/PAAm gel at 35, 37, and 39°C.
USP22 Functions as an Oncogenic Driver in Prostate Cancer by Regulating Cell Proliferation and DNA Repair
Authors: McCann Jennifer J. , Vasilevskaya Irina A. , Poudel Neupane Neermala , Shafi Ayesha A. , McNair Christopher , Dylgjeri Emanuela , Mandigo Amy C. , Schiewer Matthew J. , Schrecengost Randy S. , Gallagher Peter , Stanek Timothy J. , McMahon Steven B. , Berman-Booty Lisa D. , Ostrander William F. , Knudsen Karen E.
Published: November 2019

Emerging evidence indicates the deubiquitinase USP22 regulates transcriptional activation and modification of target substrates to promote pro-oncogenic phenotypes. Here, in vivo characterization of tumor-associated USP22 upregulation and unbiased interrogation of USP22-regulated functions in vitro demonstrated critical roles for USP22 in prostate cancer. Specifically, clinical datasets validated that USP22 expression is elevated in prostate cancer, and a novel murine model demonstrated a hyperproliferative phenotype with prostate-specific USP22 overexpression. Accordingly, upon overexpression or depletion of USP22, enrichment of cell-cycle and DNA repair pathways was observed in the USP22-sensitive transcriptome and ubiquitylome using prostate cancer models of clinical relevance. Depletion of USP22 sensitized cells to genotoxic insult, and the role of USP22 in response to genotoxic insult was further confirmed using mouse adult fibroblasts from the novel murine model of USP22 expression. As it was hypothesized that USP22 deubiquitylates target substrates to promote protumorigenic phenotypes, analysis of the USP22-sensitive ubiquitylome identified the nucleotide excision repair protein, XPC, as a critical mediator of the USP22-mediated response to genotoxic insult. Thus, XPC undergoes deubiquitylation as a result of USP22 function and promotes USP22-mediated survival to DNA damage. Combined, these findings reveal unexpected functions of USP22 as a driver of protumorigenic phenotypes and have significant implications for the role of USP22 in therapeutic outcomes.

Significance:

The studies herein present a novel mouse model of tumor-associated USP22 overexpression and implicate USP22 in modulation of cellular survival and DNA repair, in part through regulation of XPC.
A Systematic Review of Repeat Fecal Occult Blood Tests for Colorectal Cancer Screening
Authors: Murphy Caitlin C. , Sen Ahana , Watson Bianca , Gupta Samir , Mayo Helen , Singal Amit G.
Published: November 2019

Screening with fecal occult blood tests (FOBT) reduces colorectal cancer mortality. Failure to complete repeat tests may compromise screening effectiveness. We conducted a systematic review of repeat FOBT across diverse health care settings. We searched MEDLINE, Embase, and the Cochrane Library for studies published from 1997 to 2017 and reported repeat FOBT over ≥2 screening rounds. Studies (n = 27 reported in 35 articles) measured repeat FOBT as (i) proportion of Round 1 participants completing repeat FOBT in Round 2; (ii) proportion completing two, consecutive FOBT; or (iii) proportion completing ≥3 rounds. Among those who completed FOBT in Round 1, 24.6% to 89.6% completed repeat FOBT in Round 2 [median: 82.0%; interquartile range (IQR): 73.7%–84.6%]. The proportion completing FOBT in two rounds ranged from 16.4% to 80.0% (median: 46.6%; IQR: 40.5%–50.0%), and in studies examining ≥3 rounds, repeat FOBT ranged from 0.8% to 64.1% (median: 39.2%; IQR: 19.7%–49.4%). Repeat FOBT appeared higher in mailed outreach (69.1%–89.6%) compared with opportunistic screening (24.6%–48.6%). Few studies examined correlates of repeat FOBT. In summary, we observed a wide prevalence of repeat FOBT, and prevalence generally declined in successive screening rounds. Interventions that increase and maintain participation in FOBT are needed to optimize effectiveness of this screening strategy.
Quantitative Assessment of Breast Density: Transmission Ultrasound is Comparable to Mammography with Tomosynthesis
Authors: Natesan Rajni , Wiskin James , Lee Sanghyeb , Malik Bilal H.
Published: November 2019

Elevated breast density is among the strongest independent predictors of breast cancer. Breast density scores are critical inputs in models used to calculate a patient's lifetime risk of developing breast cancer. Today, the only FDA-cleared technology for assessing breast density uses mammography. An alternative modality for breast density quantification is 3D transmission ultrasound (TU). In this retrospective study, we compared automated breast density calculations derived from TU using quantitative breast density (QBD) and mammography with tomosynthesis using VolparaDensity 3.1 for 225 breasts. Pearson correlation coefficients (r) and intraclass correlation coefficients were compared. Subset analyses of extremely dense breasts, premenopausal, and postmenopausal breasts were also performed. Comparative analysis between radiologist-derived density assessment and objective automated scores was performed. Calculations from TU and mammography with tomosynthesis for breast density, total breast volume (TBV), and fibroglandular volume (FGV) were strongly correlated (r = 0.91, 0.92, and 0.67, respectively). We observed moderate absolute agreement for FGV and breast density, and strong absolute agreement for TBV. A subset of 56 extremely dense breasts showed similar trends, however with lower breast density agreement in the subset than in the full study. No significant difference existed in density correlation between premenopausal and postmenopausal breasts across modalities. QBD calculations from TU were strongly correlated with breast density scores from VolparaDensity. TU systematically measured higher FGV and breast density compared with mammography, and the difference increased with breast density.

Impact:

TU of the breast can accurately quantify breast density comparable with mammography with tomosynthesis.
Radiofrequency Coblation-Assisted Resection of Skull Base Neoplasms Using an Endoscopic Endonasal Approach
Authors: Zhang Ling , Shi Haibo , Li Dawei , Ye Haibo , Zhang Weitian , Yin Shankai
Published: November 2019

Objectives: We describe our early experiences with resecting skull base tumors using a radiofrequency ablation-assisted endoscopic endonasal approach. Ninety-seven patients with skull base tumors who were admitted to the Otorhinolaryngology department at Shanghai Jiaotong University Affiliated Shanghai Sixth People’s Hospital between January 2014 and December 2016 were operated on using a radiofrequency ablation-assisted endoscopic endonasal approach. Complete resection was achieved in all patients. This paper describes the operative technique and presents the degree of resection, complications, and early clinical outcomes. Methods: We investigated the safety and feasibility of the technique and assessed preliminary treatment outcomes. Results: No patients experienced a new neurological deficit, cerebrospinal fluid leak, or meningitis after surgery. No deaths related to skull base tumors were observed during the follow-up period (14–50 months). The volume of intraoperative blood loss was 100–1,200 mL (median 350 mL), the duration of operation was 40–510 min (median 180 min), and the hospital stay was 6–65 days (median 18). Conclusions: Our limited experience indicates that this technique is feasible and safe for complete resection of some skull base tumors in selected cases and in the future will have an increasing role to play in endoscopic sinonasal and skull base tumor dissection.
Validation Prognostic of the Baylor Profound Mental Status Examination
Authors: Salmerón Sergio , Lozoya Silvia , Plaza Laura , Soler-Moratalla Isabel , Solís Julián , Abizanda Pedro
Published: November 2019

Background: There are no validated prognostic instruments to evaluate severe Alzheimer’s disease (AD) patients. Objective: To validate the prognostic value of the Baylor Profound Mental Status Examination (BPMSE). Methods: We selected 200 patients with severe AD. The following prognostic variables were collected: hospitalization, use of the emergency room, death, and prescription of drugs. ROC curve analysis was performed to see the overall behavior of the test when predicting the adverse event. We analyzed the AUC ROC and the best cut point was determined, and by using contingency tables, the risk was calculated. Results: For a BPMSE ≥16 points, there was a risk of 1.8 (95% CI 0.9–3.4) of prescription of psychotropic drugs in 12 months. For memantine in 12 months, for a BPMSE ≥16 points, there was a risk of 2.9 (95% CI 1.1–7.2). Emergency room visits, for a BMPSE ≤15 points, showed a risk of 1.7 (95% CI 1–3.2). The risk of hospitalization at 12 months, for a BPMSE ≤15, was 1.4 (95% CI 0.8–2.6). When comparing medians, patients with a higher BPMSE were prescribed more drugs at 12 months. Conclusions: BPMSE has a limited predictive value for the variables studied.
Previously Unreported COL7A1 Mutation in a Somali Patient with Dystrophic Epidermolysis Bullosa
Authors: Venti Valeria , Scalia Bruna , Sauna Alessandra , Nasca Maria Rita , Smilari Pierluigi , Praticò Andrea D. , Fiumara Agata , Pappalardo Xena G. , Pavone Piero
Published: November 2019

Epidermolysis bullosa (EB) encompasses a group of inheritable skin disorders characterized by various degrees of epithelial fragility that lead to cutaneous and mucosal blistering following negligible mechanical traumas. These disorders are clinically and genetically heterogeneous, ranging from mild skin involvement to severe disabling conditions with associated manifestations affecting the gastrointestinal and vesico-urinary tracts. EB may be classified into 4 main categories: simplex, junctional, dystrophic, and Kindler syndrome. Clinically, EB may present as syndromic or nonsyndromic forms. EB subtypes have mainly reported a number of mutations in the candidate COL7A1 gene encoding type VII collagen, a major stabilizing molecule of the dermoepidermal junction. Herein, we report a Somali girl with dystrophic EB who showed a previously unreported missense variant c.6797G>T in exon 86 in COL7A1.
Presence of JC Polyomavirus in Nonneoplastic Inflamed Colon Mucosa and Primary and Metastatic Colorectal Cancer
Authors: Esmailzadeh Nadia , Ranaee Mohammad , Alizadeh Ahad , Khademian Aynaz , Saber Amoli Saghar , Sadeghi Farzin
Published: November 2019

Background: Despite decades of epidemiologic and histopathologic investigations, the association between JC polyomavirus (JCPyV) infection and colorectal cancer (CRC) remains controversial. Objective: This study tested the presence of JCPyV sequences and determined the viral load in a series of colorectal samples from Iranian patients. In total, 223 formalin-fixed paraffin-embedded samples from patients diagnosed with primary and metastatic CRC as well as with nonneoplastic inflamed colon mucosa were analyzed by quantitative real-time PCR for the presence of JCPyV large tumor antigen (LT-Ag) sequences. Results: JCPyV LT-Ag sequences were detected in 18.6% of the CRC tissues and in 15.5% of the nonneoplastic control group. Viral LT-Ag was quantified in 18/100 primary colon adenocarcinomas, 2/10 metastatic adenocarcinomas, and 1/3 primary adenocarcinomas of the rectum. Two JCPyV-positive metastatic tumors presented a negative test result for JCPyV in the corresponding primary tumor. The median JCPyV LT-Ag copy number was 64 × 10–2 per cell and 14 × 10–2 per cell in the CRC cases and the nonneoplastic samples, respectively. There was no statistically significant difference between the two study groups regarding median LT-Ag DNA load (p = 0.059). Among the JCPyV-positive samples, the LT-Ag DNA load was higher in 2 metastatic tumors (from a patient with lung metastasis: 232 × 10–2 copies per cell; from a patient with liver metastasis: 121 × 10–2 copies per cell). Conclusions: The detection of JCPyV DNA at low copy numbers (lower than 1 viral copy per cell equivalent) and the absence of viral sequences in the corresponding primary tumors of the JCPyV-positive metastatic samples weaken the hypothesis of an etiological role of JCPyV in primary CRC induction.
Association of Metabolic Syndrome and Its Components with Decreased Estimated Glomerular Filtration Rate in Adults
Authors: Qiu Yun , Zhao Qi , Gu Yian , Wang Na , Yu Yuting , Wang Ruiping , Zhang Yue , Zhu Meiying , Liu Xing , Jiang Yonggen , Zhao Genming
Published: November 2019

Background/Aims: Metabolic syndrome (MetS) and its metabolic components, the common risk factors, may be involved in the development and progression of decreased estimated glomerular filtration rate (eGFR). The aim of this study was to examine the association of MetS and its metabolic components with eGFR status and severity among Chinese adults. Methods: The population-based, cross-sectional study recruited a total of 33,300 Chinese adults (aged ≥18 years) from 4 study community sites in Songjiang District, Shanghai, between June 2016 and December 2017. Decreased eGFR was defined as a value of eGFR below 60 mL/min/1.73 m2. Weighted multiple logistic regression models were used to examine the association of MetS and its components with eGFR status and severity. Results: After adjusting for potential confounders, subjects with MetS had an increased risk of decreased eGFR with an adjusted OR of 1.76 (95% CI 1.53–2.01), and subjects with increasing numbers of MetS components had a gradually increased risk for decreased eGFR (p trend <0.001). The multivariable-adjusted ORs (95% CI) of decreased eGFR were 1.66 (1.44–1.93) for abdominal obesity, 1.37 (1.18–1.60) for elevated triglycerides, 1.13 (0.96–1.33) for reduced high-density lipoprotein cholesterol, 0.84 (0.72–0.98) for elevated fasting glucose, and 1.92 (1.57–2.35) for elevated blood pressure (BP). Furthermore, these associations remained in most of the subgroups analyses. Significant associations between elevated BP and the risks of mildly, moderately, and severely decreased eGFR were also found. Conclusions: MetS was independently associated with an increased risk of decreased eGFR, and individual components of MetS each play a different role in decreased eGFR. Elevated BP may be an important risk factor for the progression of renal dysfunction or even chronic kidney disease.
Chascolytrum neobulbosum (Poaceae: Pooideae), a new species from southern Brazil

Authors: FUNEZ LUÍS ADRIANO , DRECHSLER-SANTOS ELISANDRO RICARDO
Published: November 2019

During field works in Santa Catarina state, we found a new species of Chascolytrum that presents a bulb-like rhizome. This species is similar to Chascolytrum bulbosum, from Pampa biome, differing by glabrous leaf blades, inflorescences larger and laxer, longer spikelets and paleas glabrous between the keels. We additionally provide field and studio photographs and assess its conservation status according to IUCN criteria.
Isoetes shangrilaensis, a new species of Isoetes from Hengduan mountain region of Shangri-la, Yunnan. Phytotaxa 397 (1): 65–73 (ERRATUM)

Authors: LI X. , HUANG Y.Q. , DAI X.K. , LIU X.
Published: November 2019

ERRATUM
Establishing Photovoltaic (PV) Education in RIO DE JANEIRO
Authors: Krauter Stefan , Hanitsch Rolf , Stephan Richard
Published: November 2019

A course consisting of 4 hours of theoretical teaching a week and 4 hours of practical laboratory work every two weeks was established at COPPE/UFRJ in Rio de Janeiro, Brazil, to initiate education on solar electric systems (also photovoltaic (PV) systems). The course is presented during a quarter. Further details are also accessible by the Internet.
Combined dynamic DCE-MRI and diffusion-weighted imaging to evaluate the effect of neoadjuvant chemotherapy in cervical cancer
Authors: Feng Yusen , Liu Hui , Ding Yingying , Zhang Ya , Liao Chengde , Jin Yan , Ai Conghui
Published: November 2019

Purpose:

To prospectively investigate changes in quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in patients with cervical cancer before and after neoadjuvant chemotherapy (NACT).

Methods:

Thirty-eight patients with cervical cancer underwent DCE-MRI and DWI 1 week before and 4 weeks after NACT. The patients were classified into 2 groups: significant reaction (sCR) group and the non-sCR group. DCE-MRI parameters and ADC values were measured and compared between the 2 groups.

Results:

Before NACT, the mean Ktrans value was higher, but the mean Ve was lower, in the sCR group compared with the non-sCR group; these differences were statistically significant ( p<0.05). After NACT, the mean Ktrans value and the delta (i.e., changed) value of Ktrans were significantly lower in the sCR group compared with the non-sCR group ( p<0.05). However, the mean ADC and the delta value of the mean ADC between the 2 groups were slightly higher in the sCR group compared with the non-sCR group ( p<0.05). The area under the curve of pre-mean Ktrans, DKtrans, and pre-mean Ktrans combined with post-mean ADC values were 0.801, 0.955, and 0.878, respectively ( p<0.05). The optimal cutoff values for distinguishing sCR from non-sCR were pretreatment Ktrans (0.7020 min−1) and DKtrans (0.0437 min−1).

Conclusions:

Quantitative parameters (pre-mean Ktrans, DKtrans, and pre-mean Ktrans) combined with post-mean ADC could predict treatment efficacy more precisely. However, quantitative DCE-MRI combined with DWI could not significantly improve prognostic efficacy.
Revisiting tourism’s additional impact on income
Authors: He Tina T , Li Wilson XB
Published: November 2019

This study revisits the question of whether tourism development is an additional determinant of income or works through other standard income determinants. Both a panel data analysis from 2006 to 2015 and a cross-sectional country average analysis reveal that the incremental effect of tourism is significantly positive, suggesting that tourism is an additional determinant of income. Further analyses show that the income effect of tourism is contingent on some country characteristics: the positive income effect of tourism mainly appears in countries with weak policies or institutions for environmental sustainability or with better quality of overall infrastructure. These findings help enhance the understanding of the significant contribution of international tourism to the economic growth worldwide. The implication is that the governments of destination countries should fully support tourism development.
Network analysis of medical care services
Authors: Niyirora Jerome , Aragones Ossayne
Published: November 2019

Medical care services can be organized into a network. Understanding the structure of this network cannot only help analyze common clinical protocols but can also help reveal previously unknown patterns of care. The objective of this research is to introduce the concept and methods for constructing and analyzing the network of medical care services. We start by demonstrating how to build the network itself and then develop algorithms, based on principal component analysis and social network analysis, to detect communities of services. Finally, we propose novel graphical techniques for representing and assessing patterns of care. We demonstrate the application of our algorithms using data from an Emergency Department in New York State. One of the implications of our research is that clinical experts could use our algorithms to detect deviations from either existing protocols of care or administrative norms.
The effect of an mHealth intervention for titration of insulin for type 2 diabetes: A pilot study
Authors: Bramwell Siân E , Meyerowitz-Katz Gideon , Ferguson Caleb , Jayaballa Rajini , McLean Mark , Maberly Glen
Published: November 2019

Background:

Stabilising blood glucose levels (BGL) after starting or changing insulin and related therapies can be challenging for diabetes services and the patient with type 2 diabetes. Traditionally, a credentialled diabetes educator (CDE) would talk with the patient over the phone to obtain a history of their BGLs over the previous week and provide advice on the insulin dose adjustments as required. This study trialled a smartphone application for sharing BGLs, with the ability to digitally transmit advice back to patients compared with their usual care.

Aims:

The aim of this study was to compare desirability, efficiency and ease of use.

Methods:

Participants were enrolled in either the traditional ( n=50) or Health2Sync (H2S) ( n=42) treatment group by patient preference. All insulin stabilisations were conducted by the CDE. Descriptive statistics were used for analysis.

Results:

The average total time taken to titrate patients was similar in both groups ( p>0.05), however there were fewer failure of contacts reported with H2S ( p<0.01) and time per interaction was also lower ( p<0.01). Sensitivity analysis revealed that, excluding the influence of no contacts, H2S patients had a lower average time for titration ( p<0.01). There was no difference in clinical outcomes as measured by HbA1c between the two groups ( p=0.75).

Conclusion:

We demonstrated a high acceptance and clinical utility of the H2S application. Clinicians were happy to use H2S and found it easy and convenient for most patients. Importantly, this reduced frequency of contacts with patients, time per interaction and average time for titration ( p<0.01). Patient selection for this communication intervention is important.
Driver assessment service for people with mental illness
Authors: Chiu Calvin WC , Law Colin KM , Cheng Andy SK
Published: November 2019

Mental illness often leads to functional deficits that likely affect one’s driving performance and may even pose threat to other road users. However, having a mental illness does not automatically preclude one from driving which is essential to mobility and productivity. Indeed, evaluating their fitness-to-drive would be of necessary. Despite that, there is still a lack of a local driving evaluation service that specifically addresses the impact of mental illness on driving capacity. This paper discusses the needs to evaluate the fitness-to-drive of people with mental illness. It advocates the development of such specific driver assessment service with a local example as illustration. Lastly, some of the challenges related to the drivers’ responsibility to declare personal health status and large variety of assessment approaches are also discussed.
RNA‐sequencing analysis of gene expression in a rat model of acute right heart failure
Authors: Cao Yunshan , Li Yahong , Wu Mianmian , Song Jiyang , Zhang Min , Duan Yichao , Jiang Kaiyu , Zhou Xing , Zhang Yan
Published: November 2019

Background

Acute right heart failure (RHF) is the main cause of death in patients with acute pulmonary embolism and emergent pulmonary hypertension. However, the molecular mechanisms underpinning the acute RHF and the interactions between the right (RV) and left ventricles (LVs) under the diseased condition remain unknown.

Methods and results

The Sprague Dawley male rats were randomly divided into the normal control, sham, and pulmonary artery banding (PAB) groups. One hour after the PAB operation, after measuring the haemodynamic and anatomical parameters, the free walls of RV and LV were harvested to detect the differential gene expression profiling by high‐throughput RNA sequencing. The results showed that the PAB lead to 50–60% obstruction of the main pulmonary artery, which was accompanied by the significant elevation in the positive rate of rise in RV pressure and the maximum RV pressure as compared to the sham group. Moreover, compared with the counterparts in the sham group, the RV and LV in the PAB group exhibited 2057 differentially expressed genes (DEGs, 1159 upregulated and 898 downregulated) and 1196 DEGs (709 upregulated and 487 downregulated), respectively (DEG criteria: |log2 fold change| ≥1, q value ≤0.05). In comparison to the sham group, the enriched pathways in the PAB group include nuclear factor‐κB signalling pathway, extracellular matrix–receptor interaction, and nucleotide oligomerization domain‐like receptor signalling pathway.

Conclusions

The PAB rat model exhibited the haemodynamic and gene expression changes in the RV that lead to acute RHF. Further, the acute RHF induced by pressure overload also caused gene expression changes in the LV, suggesting the molecular interactions between the RV and LV under the diseased condition.
Results of Arthroscopic Bankart Repair in Recreational Athletes and Laborers: A Retrospective Study With 5 to 14 Years of Follow-up
Authors: Komnos George A. , Banios Konstantinos , Liantsis Athanasios , Alexiou Konstantinos , Varitimidis Sokratis , Bareka Metaxia , Hantes Michael E.
Published: November 2019

Background:

Arthroscopic Bankart repair is the most common procedure for anterior shoulder instability management. However, the long-term efficacy of the procedure is questionable, and the results are different among different populations. Few studies have focused on specific populations, such as recreational athletes and laborers.

Hypothesis:

Good to excellent long-term results, with a low recurrence rate, can be achieved using arthroscopic Bankart repair in recreational athletes and laborers suffering from anterior shoulder instability.

Study Design:

Case series; Level of evidence, 4.

Methods:

A specific group of laborers and recreational athletes were included in this study. A total of 52 patients (52 shoulders) with anterior-inferior traumatic shoulder instability underwent arthroscopic Bankart repair and met our strict criteria for study inclusion. The recurrence rate was recorded. Patients were evaluated at a minimum follow-up of 5 years using the American Shoulder and Elbow Surgeons (ASES) score, the Rowe score, the Constant score, and a visual analog scale (VAS) for pain. A radiological evaluation for arthritis was also performed according to the Samilson-Prieto classification.

Results:

The mean follow-up was 105.4 months (range, 65-164 months). Our overall recurrence rate was 11.5% (6/52 patients). All patients were able to return to their previous job status with minimum limitations, and 76.7% of our study population reported returning to their preinjury sporting activities. Postoperatively, all scores were improved, with statistically significant increases from preoperative values ( P < .001). At the last radiographic follow-up, 9 patients (18.8%) had mild arthritis, while 2 patients (4.2%) had moderate arthritis.

Conclusion:

Arthroscopic soft tissue Bankart repair may provide good to excellent long-term clinical results with an acceptable recurrence rate in medium-demand patients (recreational athletes and laborers).
A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery
Authors: Kothari Nikisha , Read Sarah P. , Baumal Caroline R. , Capone Antonio , Chang Emmanuel , Drenser Kimberly A. , Ferrone Philip J. , Nudleman Eric , Rao Prethy , Sisk Robert A. , Smiddy William E. , Yonekawa Yoshihiro , Berrocal Audina
Published: November 2019

Purpose:

Pediatric macular holes occur often related to trauma and rarely require surgical intervention. The purpose of the present study was to evaluate outcomes of microincisional vitrectomy surgery.

Methods:

A multicenter retrospective consecutive case series was conducted of pediatric patients undergoing surgery for macular hole repair.

Results:

A total of 31 eyes from 8 centers were included in this study. The mechanism of macular hole development was blunt trauma in 30 eyes (97%) and industrial laser in 1 eye (3%). The rate of anatomic closure after primary vitrectomy was 81% (25 eyes); the final anatomic closure rate after a secondary vitrectomy was 94% (29 eyes). There was a statistically significant improvement in visual acuity from initial presentation (20/164) to final follow-up (20/100) ( P = .009).

Conclusions:

Microincisional vitrectomy surgery for pediatric macular holes results in substantial anatomic success and modest improvement in visual acuity.
Out-of-home placement decisions: How individual characteristics of professionals are reflected in deciding about child protection cases
Authors: de Haan Whitney D. , van Berkel Sheila R. , van der Asdonk Sabine , Finkenauer Catrin , Forder Caroline J. , van IJzendoorn Marinus H. , Schuengel Carlo , Alink Lenneke R. A.
Published: November 2019

Decisions regarding out-of-home placement of children are complicated and of high impact for children and parents. Previous studies show low agreement between professionals on these decisions, and research regarding the influence of characteristics of decision-makers on the content of the decisions taken remains inconclusive. This study explored the relation between general and psychological characteristics of 144 professionals (child welfare professionals, children’s court judges, and master students) using vignettes and questionnaires. Professionals’ mind-set regarding the ability of parents to achieve change (parent-specific mind-set) and their attitude toward the harmfulness of out-of-home placements were related to their decision-making. General decision-maker factors (the professional’s background and work experience), the mind-set toward the ability of people in general to change (dispositional mind-set), and professionals’ attitude toward the effectiveness of out-of-home placements were not related to their decisions. This field of practice needs to reflect on the role of implicit beliefs in making placement decisions about children.
High Sensitivity Detection of Malignant-Specific M-Proteins Using Mass Spectrometry
Authors: Murray David L , Mills John R , Katzmann Jerry A. , Kyle Robert , Rajkumar Vincent , Dispenzieri Angela , Barnidge David R
Published: November 2019

Detection of an M-protein (monoclonal immunoglobulin) has been used to diagnose and monitor multiple myeloma (MM). As therapies for MM have improved, more sensitive methods have been used to define response: immunofixation electrophoresis (IFX) of serum and urine, normalization of the serum immunoglobulin free light chain (FLC) ratio, and high sensitivity flow cytometry to detect clonal plasma bone marrow cells. It is hoped that these more sensitive approaches will differentiate those patients with minimal residual disease (MRD) versus no residual disease (NRD), that later which could mean a cure. Flow cytometry of plasma cells requires bone marrow aspiration, which is inconvenient and expensive and is potentially limited by sampling bias. More sensitive methods to differentiate MRD from NRD using serum would be advantageous.

We have developed a sensitive test for the presence of the monoclonal antibody produced by the plasma cells which may serve as a substitute for invasive bone marrow biopsy. Briefly, patient serum is enriched for immunoglobulins (Ig) and the Ig light chains are decoupled from the heavy chain by reduction with DTT. The mass distribution of the light chains is resolved using a micro LC-ESI-Q-TOF mass spectrometry and the presence of the M-protein is detected as a spike in the mass distribution. In addition to the detection, the accurate mass measurement of the light chain serves as a unique individualized marker which can aid in detection in subsequent patient monitoring. We have termed this method: monoclonal-immunoglobulin-Rapid-Accurate-Mass-Measurement (miRAMM). By spiking monoclonal immunoglobulins into human serum, we have demonstrated that miRAMM is approximately 1000x more sensitive than SPEP at detecting M-proteins. Initial results on 21 patients in stringent complete response (sCR) demonstrated that 67% (n=14) had detectable malignant specific clones by miRAMM. Given these promising results we have extended the method to a larger series of myeloma patients for whom we had long term follow-up and serum samples prior to treatment and at 6-12 months status post stem cell treatment. The results of this data will be correlated to the clinical outcomes for these patients. Early results demonstrate the potential of miRAMM to be a more sensitive, cost effective approach to detect MRD compared with current methods.

Disclosures

Murray: Mayo Clinic: Patent Application filed Patents & Royalties. Barnidge:Mayo Clinic: Patent filed Patents & Royalties.
A deletion in the proximal untranslated pX region of human T-cell leukemia virus type II decreases viral replication but not infectivity in vivo
Authors: Cockerell GL , Rovnak J , Green PL , Chen IS
Published: November 2019

The function of untranslated (UT) nucleotide sequences in the proximal portion of the pX region of the human T-cell leukemia virus (HTLV) family of retroviruses remains enigmatic. Previous studies have shown that these sequences are not necessary for the expression of viral proteins or for the induction, transmission, or maintenance of the transformed cell type in vitro. To determine the effect of the UT region in vivo, separate groups of rabbits were inoculated with lethally irradiated, stable clones of the human B-lymphoblastoid cell line, 729, transfected with either a full-length wild-type HTLV-II clone (pH6neo) or a mutant clone containing a 324-bp deletion in the proximal UT portion of pX (pH6neo delta UT[6661–6984]), or nontransfected 729 cells. All rabbits inoculated with either wild-type or pX-deleted HTLV-II developed a similar profile and titer of serum antibodies against HTLV-II antigens, as determined by Western immunoblots, by 4 weeks postinoculation (PI). Antibody titers, as determined by enzyme immunoassay, were similar between the two groups of rabbits and increased over the 18-week period of study. All rabbits were killed at 18 weeks PI, and spleen, peripheral blood lymphocytes (PBMC), bone marrow, and mesenteric lymph node were assayed for HTLV-II tax/rex sequences by quantitative polymerase chain reaction. Virus was detected in all tissues tested from all rabbits inoculated with 729pH6neo cells containing wild-type HTLV-II, which contained between 1.4 and 0.3 mean copies of provirus per cell. In contrast, the distribution and number of provirus copies were more limited in rabbits inoculated with 729pH6neo delta UT(6661–6984) cells containing UT- deleted HTLV-II; in most tissues, there was a fivefold to sevenfold reduction in mean provirus copies per cell as compared with rabbits inoculated with wild-type HTLV-II. All rabbits inoculated with control 729 cells remained negative for HTLV-II infection, as determined by the same techniques. It was concluded that UT sequences in the proximal portion of HTLV-II are not necessary for infection but confer increased replicative capacity in vivo.
Male circumcision and global HIV/AIDS epidemic challenges
Authors: Olapade-Olaopa Emiola Oluwabunmi , Salami Mudasiru Adebayo , Lawal Taiwo Akeem
Published: November 2019

Background

Given the devastating mortality and morbidity associated with HIV/AIDS, many potential prevention measures against HIV infection continue to be explored. Most prevention methods are in the realm of sexual behavior change. However, of all aspects of human behavior, it is sexual behavior that is least amenable to change. Newer and simpler interventions are therefore required. Male circumcision, the surgical removal of some or all of the foreskin (or prepuce) from the penis, is one of the ways being promoted as a preventive measure. This paper reviews the scientific basis and evidence for the efficacy of male circumcision within the context of the global challenges involved.

Main body

We reviewed articles with emphasis on male circumcision and HIV/AIDS transmission. Published abstracts of presentations at international scientific meetings were also reviewed.

Conclusions

Current epidemiological evidence supports the promotion of male circumcision for HIV prevention, especially in populations with high HIV prevalence and low circumcision rates. Three notable randomized control trials strengthen the case for applied research studies to demonstrate that safe male circumcision is protective at the population level, particularly as ideal and well-resourced conditions of a randomized trial are often not replicated in other service delivery settings. Ethically and culturally responsive strategies in promoting circumcision in a culturally heterogenous world need to be developed, too. Male circumcision should also be viewed as a complementary measure along with other proven approaches to turn the HIV/AIDS epidemic around.
Study protocol: a single-blind, multi-center, randomized controlled trial comparing dynamic intraligamentary stabilization, internal brace ligament augmentation and reconstruction in individuals with an acute anterior cruciate ligament rupture: LIBRƎ study
Authors: Heusdens Christiaan H. W. , Zazulia Katja , Roelant Ella , Dossche Lieven , van Tiggelen Damien , Roeykens Johan , Smits Elke , Vanlauwe Johan , Van Dyck Pieter
Published: November 2019

Background

The current gold standard for the treatment of an anterior cruciate ligament (ACL) rupture is reconstruction with tendon graft. Recently, two surgical ACL repair techniques have been developed for treating an acute ACL rupture: Dynamic Intraligamentary Stabilization (DIS, Ligamys®) and Internal Brace Ligament Augmentation (IBLA,InternalBrace™). We will conduct a single-blind, multi-center, randomized controlled trial which compares DIS, IBLA and reconstruction for relative clinical efficacy and economic benefit.

Methods

Subjects, aged 18–50 years, with a proximal, primary and repairable ACL rupture will be included. DIS is preferably performed within 4 weeks post-rupture, IBLA within 12 weeks and reconstruction after 4 weeks post-rupture. Patients are included in study 1 if they present within 0–4 weeks post-rupture and surgery is feasible within 4 weeks post-rupture. Patients of study 1 will be randomized to either DIS or IBLA. Patients are included in study 2 if they present after 4 weeks post-rupture and surgery is feasible between 5 and 12 weeks post-rupture. Patients of study 2 will be randomized to either IBLA or reconstruction. A total of 96 patients will be included, with 48 patients per study and 24 patients per study arm. Patients will be followed-up for 2 years. The primary outcome is change from baseline (pre-rupture) in International Knee Documentation Committee score to 6 months post-operatively. The main secondary outcomes are the EQ-5D-5 L, Tegner score, Lysholm score, Lachman test, isokinetic and proprioceptive measurements, magnetic resonance imaging outcome, return to work and sports, and re-rupture/failure rates. The statistical analysis will be based on the intention-to-treat principle. The economic impact of the surgery techniques will be evaluated by the cost-utility analysis. The LIBRƎ study is to be conducted between 2018 and 2022.

Discussion

This LIBRƎ study protocol is the first study to compare DIS, IBLA and ACL reconstruction for relative clinical efficacy and economic benefit. The outcomes of this study will provide data which could aid orthopaedic surgeons to choose between the different treatment options for the surgical treatment of an acute ACL rupture.

Trial registration

This study is registered at ClinicalTrials.gov;NCT03441295. Date registered 13.02.2018.
Correction to: RNA sequencing identifies novel non-coding RNA and exon-specific effects associated with cigarette smoking
Authors: Parker Margaret M. , Chase Robert P. , Lamb Andrew , Reyes Alejandro , Saferali Aabida , Yun Jeong H. , Himes Blanca E. , Silverman Edwin K. , Hersh Craig P. , Castaldi Peter J.
Published: November 2019

Following publication of the original article [1], the authors provided an updated accession number in the “Availability of data and materials” section of the declarations.