bluuebunny/crossref_metadata_2025 huggingface dataset:
Dana Farber Protocol (DFCP) for Treatment of Adolescents and Young Adults with ALL, Single Institution Experience in Saudi Arabia
Authors: Alabdulwahab Amal S. , ELSayed Hussein G. , Sherisher Mohamed Atia , Elbjeirami Wafa M.
Published: April 2020

Background :

Recent reports indicate that adolescents and young adults (AYA) have a better outcome when treated with pediatric protocols rather than adult ones. Many explanations were raised to explain that including the more intense pediatric protocols and different disease biology.

Patients & Methods : This is a retrospective study that included AYA patients diagnosed as ALL and treated at King Abdulla Medical City (KAMC),Saudi Arabia, in the period from mid 2011- March 2015.

Results: 37 patients were included in this study including 25 males and 12 females with a ratio of 2:1. The median age at diagnosis was 19.4 y. At presentation the mean number of WbCs was 63.7 x 109/L + 103.4 (range 1.9 to 500,000 x109/L), HB 8.87 + 2.3 gm/L (range 6.5-15.2 gm/L), platelets 59 x 109/L + 43.9 (range 8-100,000 x109/L. Bone marrow blasts ranged from 35 -99% with a mean and median of 80.3 + 18.5, 84 % respectively. B-cell phenotype constituted the majority of cases 29/37(78.3%). Cytogenetics using karyotyping and FISH Panel for ALL (done in Mayo clinic,USA) revealed Very high risk cytogenetics (Philadelphia, MLL, complex cytogenetics, hypodiploidy in 14/37 (37.8%) patients, Intermediate / high 16 patients (43.2%) and 7 (18.9%) with favorable cytogenetics (hyperdiploidy, tetraploidy, del p16).

Complete remission was confirmed in 35 of 37 patients (94.5%). (one did not achieve remission while response was not evaluable in another patient who died during induction due to hepatic failure). Repeat cytogenetics at the time of D28 BM evaluation was done in 29/37 patients while in 8/37 it was not done for technical reasons. Cytogenetic remission was confirmed in 18 out of 21 with cytogenetic abnormality (85.7%).

After a median follow up period of 12 m (range 3-52.5 m).. Leukemia free survival ranged from 3 to 52.5 m with a median of 10.5 m, mean 17.5 {CI (95%) 12.61-22.53}: while median survival was 12m with a mean of 18.5m {CI (95%) 13.6-23.5}.

As a whole 6 cases relapsed (5 in the first 18 m and 1 after 4 Y) and 1 was primary resistant constituting (7/35 18.9% of cases) while response could not be documented in one patient who died during induction. Of the 6 relapsed cases, 4 of them due to disease progression and non-responsive to salvage treatment or transplant procedure

Toxicity included febrile neutropenia in virtually all patients with negative cultures in 20/37 patients (54%) while Gram negative sepsis was confirmed in 12/37 patients (32%). Major complications occurred in 9/37 patients (24.3%) and include: septic shock that required ICU (1 patient), typhilitis (1 patient), pancreatitis (2 patients), avascular necrosis of head of femur (2 patients).neuropathy ≥ GIII (2 patients)

In conclusion : Although DFCP is an effective treatment for AYA with ALL, Yet toxicity can not be overlooked.

Disclosures

No relevant conflicts of interest to declare.
Retrovirally Transduced Human Dendritic Cells Express a Normal Phenotype and Potent T-Cell Stimulatory Capacity
Authors: Szabolcs Paul , Gallardo H.F. , Ciocon David H. , Sadelain Michel , Young James W.
Published: April 2020

Dendritic cells are attractive candidates for vaccine-based immunotherapy because of their potential to function as natural adjuvants for poorly immunogenic proteins derived from tumors or microbes. In this study, we evaluated the feasibility and consequences of introducing foreign genetic material by retroviral vectors into dendritic cell progenitors. Proliferating human bone marrow and cord blood CD34+ cells were infected by retroviral vectors encoding the murine CD2 surface antigen. Mean transduction efficiency in dendritic cells was 11.5% from bone marrow and 21.2% from cord blood progenitors. Transduced or untransduced dendritic cell progeny expressed comparable levels of HLA-DR, CD83, CD1a, CD80, CD86, S100, and p55 antigens. Granulocytes, macrophages, and dendritic cells were equally represented among the transduced and mock-transduced cells, thus showing no apparent alteration in the differentiation of transduced CD34+ precursors. The T-cell stimulatory capacity of retrovirally modified and purified mCD2-positive allogeneic or nominal antigen-pulsed autologous dendritic cells was comparable with that of untransduced dendritic cells. Human CD34+ dendritic cell progenitors can therefore be efficiently transduced using retroviral vectors and can differentiate into potent immunostimulatory dendritic cells without compromising their T-cell stimulatory capacity or the expression of critical costimulatory molecules and phenotypic markers. These results support ongoing efforts to develop genetically modified dendritic cells for immunotherapy.
Prothrombotic Genetic Risk Factors in Young Survivors of Myocardial Infarction
Authors: Ardissino D. , Mannucci P.M. , Merlini P.A. , Duca F. , Fetiveau R. , Tagliabue L. , Tubaro M. , Galvani M. , Ottani F. , Ferrario M. , Corral J. , Margaglione M.
Published: April 2020

It has long been thought that an individual thrombotic tendency increases the risk of myocardial infarction, especially in young adults. Several “prothrombotic” genetic factors that may influence the individual thrombotic risk have been identified. To investigate the association between the risk of myocardial infarction at a young age and genetic factors thought to be associated with an increased tendency to thrombosis (the polymorphisms 4G/5G of the PAI-1 gene, PIA1/PIA2 of the platelet glycoprotein IIIa, C3550T of the platelet glycoprotein Ib gene, G10976A of the factor VII gene, C677T of the methylenetetrahydrofolate reductase gene, G1691A of the factor V gene, and G20210A of the prothrombin gene), we performed a case-control study evaluating 200 survivors (185 men, 15 women) of myocardial infarction who had experienced the event before the age of 45 years and 200 healthy subjects with a negative exercise test, individually matched for sex, age, and geographic origin with the cases. The presence of the PIA2 polymorphic allele was the only prothrombotic genetic factor associated with the risk of myocardial infarction at a young age. The odds ratio for carriers of the PIA2 allele compared with those of the PIA1 allele was 1.84 (95% confidence intervals (CI) 1.12 to 3.03). There was a significant interaction between the presence of the PIA2 allele and smoking: with their simultaneous presence, 46% (95% confidence intervals 11% to 81%) of premature myocardial infarctions were attributable to the interaction between the two factors. In conclusion, carrying the PIA2 polymorphic allele of platelet glycoprotein IIIa was the only genetic prothrombotic factor associated with the risk of developing myocardial infarction at a young age. The clinical expression of this genetic predisposition seems to be enhanced by smoking.
On the utility of RNA sample pooling to optimize cost and statistical power in RNA sequencing experiments
Authors: Takele Assefa Alemu , Vandesompele Jo , Thas Olivier
Published: April 2020

Background

In gene expression studies, RNA sample pooling is sometimes considered because of budget constraints or lack of sufficient input material. Using microarray technology, RNA sample pooling strategies have been reported to optimize both the cost of data generation as well as the statistical power for differential gene expression (DGE) analysis. For RNA sequencing, with its different quantitative output in terms of counts and tunable dynamic range, the adequacy and empirical validation of RNA sample pooling strategies have not yet been evaluated. In this study, we comprehensively assessed the utility of pooling strategies in RNA-seq experiments using empirical and simulated RNA-seq datasets.

Result

The data generating model in pooled experiments is defined mathematically to evaluate the mean and variability of gene expression estimates. The model is further used to examine the trade-off between the statistical power of testing for DGE and the data generating costs. Empirical assessment of pooling strategies is done through analysis of RNA-seq datasets under various pooling and non-pooling experimental settings. Simulation study is also used to rank experimental scenarios with respect to the rate of false and true discoveries in DGE analysis. The results demonstrate that pooling strategies in RNA-seq studies can be both cost-effective and powerful when the number of pools, pool size and sequencing depth are optimally defined.

Conclusion

For high within-group gene expression variability, small RNA sample pools are effective to reduce the variability and compensate for the loss of the number of replicates. Unlike the typical cost-saving strategies, such as reducing sequencing depth or number of RNA samples (replicates), an adequate pooling strategy is effective in maintaining the power of testing DGE for genes with low to medium abundance levels, along with a substantial reduction of the total cost of the experiment. In general, pooling RNA samples or pooling RNA samples in conjunction with moderate reduction of the sequencing depth can be good options to optimize the cost and maintain the power.
Construction of a high-density genetic map and mapping of growth related QTLs in the grass carp (Ctenopharyngodon idellus)
Authors: Huang Xiaoli , Jiang Yanxin , Zhang Wanting , Cheng Yingyin , Wang Yaping , Ma Xiaocui , Duan You , Xia Lei , Chen Yaxin , Wu Nan , Shi Mijuan , Xia Xiao-Qin
Published: April 2020

Background

Grass carp (Ctenopharyngodon idellus) are important species in Asian aquaculture. A draft genome for grass carp has already been published in 2015. However, there is still a requirement for a suitable genetic linkage map to arrange scaffolds on chromosomal frameworks. QTL analysis is a powerful tool to detect key locations for quantitative traits, especially in aquaculture. There no growth related QTLs of grass carp have been published yet. Even the growth trait is one of the focuses in grass carp culture.

Results

In this study, a pair of distantly related parent grass carps and their 100 six-month-old full-sib offspring were used to construct a high-density genetic map with 6429 single nucleotide polymorphisms (SNPs) by 2b-RAD technology. The total length of the consensus map is 5553.43 cM with the average marker interval of 1.92 cM. The map has a good collinearity with both the grass carp draft genome and the zebrafish genome, and it assembled 89.91% of the draft genome to a chromosomal level. Additionally, according to the growth-related traits of progenies, 30 quantitative trait loci (QTLs), including 7 for body weight, 9 for body length, 5 for body height and 9 for total length, were identified in 16 locations on 5 linkage groups. The phenotypic variance explained for these QTLs varies from 13.4 to 21.6%. Finally, 17 genes located in these regions were considered to be growth-related because they either had functional mutations predicted from the resequencing data of the parents.

Conclusion

A high density genetic linkage map of grass carp was built and it assembled the draft genome to a chromosomal level. Thirty growth related QTLs were detected. After the cross analysis of Parents resequencing data, 17 candidate genes were obtained for further researches.
Clinical utility of serum cystatin C for prediction of multi-vessel disease by coronary angiography in type 2 diabetes mellitus patients with normal renal function
Authors: Wang Shaoyi , Liu Qiaohui , Guo Fangfang , Zhou Xiaocong , Shi Jie , Xie Qing
Published: April 2020

Background

The aim of this study was to evaluate whether serum cystatin C could serve as a predictor of multivessel coronary artery disease identified by coronary angiography in type 2 diabetes patients with normal renal function and to suggest the cutoff point of serum cystatin C for predicting multivessel disease.

Methods

Serum cystatin C concentrations were measured by using particle-enhanced immunonephelometric assays before coronary angiography in 135 consecutive type 2 diabetes patients and 179 nondiabetic patients with normal renal function. Routine anthropometric and serologic data were collected. The severity of multivessel disease was assessed with the Gensini score after coronary angiography. The associations of serum cystatin C with the Gensini score were investigated, and the independent risk factors associated with multivessel disease were assessed.

Results

Serum cystatin C and the Gensini score were significantly elevated in diabetes patients. Cystatin C had a positive correlation with Gensini score. A multiple logistic regression analysis demonstrated that cystatin C was independently associated with the presence of multivessel disease (the OR score is 2.21, P = 0.003). Based on the ROC curve, a cystatin C level of 0.865 mg/L showed 67.7% sensitivity and 76.3% specificity with an AUC of 0.748 in diabetes patients for detecting multivessel disease.

Conclusion

Serum cystatin C is significantly correlated with the presence of multivessel disease, suggesting that cystatin C might be utilized as a screening tool for predicting multivessel disease in type 2 diabetes mellitus patients with normal renal function.
Value of appendicular skeletal muscle mass to total body fat ratio in predicting obesity in elderly people: a 2.2-year longitudinal study
Authors: Zhang Yu-Jie , Fu Shi-Hui , Wang Jing-Xin , Zhao Xin , Yao Yao , Li Xiao-Ying
Published: April 2020

Background

Obesity is a disease characterized by much fat accumulation and abnormal distribution, which was related to cardiovascular diseases, diabetes mellitus (DM) and muscular skeletal diseases. The aim of this study was to evaluate the usefulness of appendicular skeletal muscle mass to total body fat ratio (ASM/TBF) in screening for the risk of obesity in elderly people.

Methods

A prospective study was carried out with 446 participants (non-obese elderly people with body mass index (BMI) < 28 kg/m2) who underwent baseline and an average around 2.2-year follow-up health check-up examinations.

Results

The mean age at baseline was 63.6 years. The incidence of new obesity was 5.4% during follow-up. Linear regression demonstrated that baseline ASM/TBFs were negatively correlated with follow-up BMIs in both men and women (β = − 1.147 (− 1.463—-0.831) for men and − 4.727 (− 5.761—-3.692) for women). The cut-off points of baseline ASM/TBF in elderly people for obesity were 1.24 in men and 0.90 in women which were identified by Classification and Regression Tree (CART). Logistic regression showed that both men and women with decreased ASM/TBF had higher risks of obesity over the follow-up period (Relative Risk (RRs) = 5.664 (1.879–17.074) for men and 34.856 (3.930–309.153) for women).

Conclusions

Elderly people with a low ASM/TBF had a higher risk of new obesity, which suggested that ASM/TBF should be considered in obesity management in the elderly.
Molecular diagnosis of autochthonous human anaplasmosis in Austria – an infectious diseases case report
Authors: Hoepler Wolfgang , Markowicz Mateusz , Schoetta Anna-Margarita , Zoufaly Alexander , Stanek Gerold , Wenisch Christoph
Published: April 2020

Background

The diagnosis of human anaplasmosis remains elusive and is probably often missed. This case report highlights the efficacy of molecular diagnostic techniques.

Case presentation

We would like to report the case of a 74-year-old man who was admitted to hospital because of a high fever, marked chills, transient diplopic images and vertigo, 6 weeks after multiple tick bites. The laboratory results showed mild anemia, marked thrombocytopenia and leukopenia and a moderately elevated C-reactive protein. The initial serology seemed to indicate an active infection with Borrelia spp., and Anaplasma phagocytophilum was detected in peripheral blood by polymerase chain reaction (PCR) and subsequent sequencing. The patient received intravenous ceftriaxone for 14 days and oral doxycycline for 4 weeks and made a fast and complete recovery.

Conclusions

While human anaplasmosis has been reported very rarely in Austria, it should be considered as a differential diagnosis in febrile patients with low leukocyte and platelet counts with elevated levels of C-reactive protein after exposure to tick bites. Molecular detection of A. phagocytophilum is the technique of choice allowing rapid and reliable diagnosis.
A case report of NPHP1 deletion in Chinese twins with nephronophthisis
Authors: Chen Feng , Dai Limeng , Zhang Jun , Li Furong , Cheng Jinbo , Zhao Jinghong , Zhang Bo
Published: April 2020

Background

Nephronophthisis (NPHP) is a rare autosomal recessive inherited disorder with high heterogeneity. The majority of NPHP patients progress to end-stage renal disease (ESRD) within the first three decades of life. As an inherited disorder with highly genetic heterogeneity and clinical presentations, NPHP still poses a challenging task for nephrologists without special training to make a well-judged decision on its precise diagnosis, let alone its mechanism and optimal therapy.

Case presentation

A Chinese family with NPHP was recruited in current study. The clinical characteristics (including findings from renal biopsy) of NPHP patients were collected from medical records and the potential responsible genes were explored by the whole exome sequencing (WES). A homozygous deletion of NPHP1 (1–20 exons) was found in both affected patients, which was further confirmed by quantitative PCR.

Conclusions

Homozygous full gene deletion of the NPHP1 gene was identified in a Chinese family with NPHP, which was the molecular pathogenic basis of this disorder. Furthermore, identification of the pathogenic genes for those affected patients can help to have a full knowledge on NPHP’s molecular mechanism and precise treatment.
Maternal ABVD chemotherapy for Hodgkin lymphoma in a dichorionic diamniotic pregnancy: a case report
Authors: Cotteret Camille , Pham Yen-Vi , Marcais Ambroise , Driessen Marine , Cisternino Salvatore , Schlatter Joël
Published: April 2020

Background

Hodgkin lymphoma (HL) is the most common hematological malignancy during pregnancy. The first-line treatment for HL in pregnancy is the standard ABVD regimen without any drug and/or dose adjustment. However, data on chemotherapy during twin pregnancies are sparse, and a better understanding of the mechanisms involved in exposure to and the toxic effects of anticancer drugs in the fetuses is needed.

Case presentation

A 41-year-old dichorionic diamniotic pregnant patient was given ABVD treatment for HL at a gestational age of 28 weeks and 3 days. The patient received 2 cycles of chemotherapy with a 15-day therapeutic window including an actual 25 mg/m2 dose of doxorubicin per cycle. Unlike the female twin, the male twin presented four days after birth a left cardiac dysfunction. Doxorubicin cardiotoxicity in the male newborn was also supported by high blood levels of troponin. At one month of age, echocardiography findings were normal. We investigated literature data on physiological aspects of pregnancy that may influence doxorubicin pharmacokinetics, and pharmacodynamic and pharmacokinetic data on the use of doxorubicin in pregnancy. We detailed the role of the transporters in doxorubicin placenta distribution, and tried to understand why only one fetus was affected.

Conclusions

Fetal safety depends at least on maternal doxorubicin pharmacokinetics.Because of drug interactions (i.e. drug metabolism and drug transport), care should always be taken to avoid maternal pharmacokinetic variability. The toxic effects were discrepant between the dizygotic twins, suggesting additional fetus-specific pharmacokinetic/pharmacodynamic factors in doxorubicin toxicity.
Hospitalization and definitive radiotherapy in lung cancer: incidence, risk factors and survival impact
Authors: Hazell Sarah Z. , Mai Nicholas , Fu Wei , Hu Chen , Friedes Cole , Negron Alex , Voong Khinh Ranh , Feliciano Josephine L. , Han Peijin , Myers Samantha , McNutt Todd R. , Hales Russell K.
Published: April 2020

Background

Unplanned hospitalization during cancer treatment is costly, can disrupt treatment, and affect patient quality of life. However, incidence and risks factors for hospitalization during lung cancer radiotherapy are not well characterized.

Methods

Patients treated with definitive intent radiation (≥45 Gy) for lung cancer between 2008 and 2018 at a tertiary academic institution were identified. In addition to patient, tumor, and treatment related characteristics, specific baseline frailty markers (Charlson comorbidity index, ECOG, patient reported weight loss, BMI, hemoglobin, creatinine, albumin) were recorded. All cancer-related hospitalizations during or within 30 days of completing radiation were identified. Associations between baseline variables and any hospitalization, number of hospitalizations, and overall survival were identified using multivariable linear regression and multivariable Cox proportional-hazards models, respectively.

Results

Of 270 patients included: median age was 66.6 years (31–88), 50.4% of patients were male (n = 136), 62% were Caucasian (n = 168). Cancer-related hospitalization incidence was 17% (n = 47), of which 21% of patients hospitalized (n = 10/47) had > 1 hospitalization. On multivariable analysis, each 1 g/dL baseline drop in albumin was associated with a 2.4 times higher risk of any hospitalization (95% confidence interval (CI) 1.2–5.0, P = 0.01), and baseline hemoglobin ≤10 was associated with, on average, 2.7 more hospitalizations than having pre-treatment hemoglobin > 10 (95% CI 1.3–5.4, P = 0.01). After controlling for baseline variables, cancer-related hospitalization was associated with 1.8 times increased risk of all-cause death (95% CI: 1.02–3.1, P = 0.04).

Conclusions

Our data show baseline factors can predict those who may be at increased risk for hospitalization, which was independently associated with increased mortality. Taken together, these data support the need for developing further studies aimed at early and aggressive interventions to decrease hospitalizations during treatment.
Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy
Authors: Ismail Mohammad , Khan Sehrash , Khan Fahadullah , Noor Sidra , Sajid Hira , Yar Shazia , Rasheed Irum
Published: April 2020

Background

Cancer patients often receive multiple drugs to maximize their therapeutic benefit, treat co-morbidities and counter the adverse effects of chemotherapy. Concomitant administration of multiple drugs increases the risk of drug interactions leading to compromised therapeutic efficacy or safety of therapy. The purpose of this study was to identify the prevalence, levels and predictors of potential drug-drug interactions (pDDIs) among cancer patients.

Methods

Six hundred and 78 patients receiving chemotherapy from two tertiary care hospitals were included in this cross-sectional study. Patient medication profiles were screened for pDDIs using the Micromedex® database. Logistic regression analysis was performed to identify the predictors of pDDIs.

Results

The overall prevalence of pDDIs was 78%, majority of patients had 1–2 pDDIs (39.2%). A total of 1843 pDDIs were detected. Major-pDDIs were most frequent (67.3%) whereas, a significant association of pDDIs was found between > 7 all prescribed drugs (p < 0.001) and ≥ 3 anti-cancer drugs (p < 0.001). Potential adverse outcomes of these interactions include reduced therapeutic effectiveness, QT interval prolongation, tendon rupture, bone marrow suppression and neurotoxicity.

Conclusions

Major finding of this study is the high prevalence of pDDIs signifying the need of strict patient monitoring for pDDIs among cancer patients. Patients at higher risk to pDDIs include those prescribed with > 7 any types of drugs or ≥ 3 anticancer drugs. Moreover, list of most frequently identified major and moderate interactions will aid health care professional in timely identification and prevention of pDDIs.
Astigmatism in school students of eastern China: prevalence, type, severity and associated risk factors
Authors: Wang Jianyong , Cheng Qianqian Ellie , Fu Xiaojin , Zhang Ronghua , Meng Jia , Gu Fang , Li Juanjuan , Ying Gui-shuang
Published: April 2020

Background

China has been undergoing dramatic economic development, accompanied by increased education load on the young children. This study is to investigate the prevalence, type, severity, and associated risk factors of astigmatism in school students in eastern China.

Method

In this cross-sectional school-based study, students underwent refraction using NIDEK non-cycloplegic autorefractor. Astigmatism was defined as cylinder 1.5 diopter (D) or greater, and high astigmatism was defined as cylinder 3.0 D or greaterMultivariate regression models were used to determine factors associated with astigmatism.

Results

Among 4801 children (55% male) with mean age (±standard deviation) 12.3 (±3.8) years, 680 (14.2, 95% confidence interval (95% CI): 13.2–15.2%) had astigmatism (85% were with-the-rule) and 103 (2.2, 95% CI: 1.8–2.6%) had high astigmatism. The prevalence rate of astigmatism was 7–8% in grades 4 or below, 15–16% in grades 6–8, 20% in grade 9, and 20–25% in grade 10 or above. In multivariate analyses, higher grade and male gender were associated with higher prevalence of astigmatism (all p < 0.0001) and high astigmatism (p = 0.04 for grade, p = 0.001 for gender). When multivariate models were further adjusted by spherical equivalent, only gender remained statistically associated with astigmatism (odds ratio (OR) = 1.65, p < 0.0001) and high astigmatism (OR = 2.21, p = 0.0004), myopic and hyperopic refractive error were significantly associated with higher risk of astigmatism and high astigmatism (all p < 0.0001).

Conclusion

Astigmatism is common in Chinese school-age children and increases with grade. Majority of astigmatism is with-the-rule. Male gender and myopic or hyperopic refractive error are significantly associated with higher prevalence and severity of astigmatism.
A pilot study: lenticule quality of hyperopic small incision lenticule extraction (SMILE) in rabbits
Authors: Zhao Yu , Zhao Feng , Han Tian , Zhao Jing , Zhou Xingtao
Published: April 2020

Background

To evaluate lenticule surface characteristics of small incision lenticule extraction (SMILE) for hyperopia correction in rabbits.

Methods

The left and right eyes of 8 rabbits were divided into two groups. The right eyes were assigned to a myopia group, and the left eyes to a hyperopia group. The rabbits received SMILE procedures with + 3.00 D and − 3.00 D correction for the hyperopia and myopia groups, respectively. Extracted lenticules were examined via scanning electron microscopy. Lenticules from odd-numbered rabbits were accessed with the anterior surface, and lenticules from even-numbered rabbits were observed with the posterior surface. A previously established scoring system was used to evaluate lenticule surface characteristics. Statistical analysis was conducted to compare the scores between the two groups.

Results

All procedures were performed successfully, and the lenticules were extracted smoothly. One myopia lenticule that was facing downward was handled failed in preparation for imaging, thus 15 lenticules were ultimately graded. Twelve lenticules exhibited smooth surfaces, and regularly arranged tissue bridges were observed in almost all regions. Three lenticules exhibited a partially rough surface and irregularities affecting more than 10% of the lenticules (2 in the hyperopia group and 1 in the myopia group). Rough lenticules occurred in twice as many lenticules in the hyperopia group compared to the myopia group.

Conclusions

Scan quality of lenticules after SMILE for hyperopia correction is comparable to that of myopia lenticules. The shape of hyperopic lenticule may increase the difficulty of surgical manipulation and result in surface roughness.
Long term outcomes of cataract surgery in severe and end stage primary angle closure glaucoma with controlled IOP: a retrospective study
Authors: Fu Lin , Chan Yau Kei , Li Junhua , Nie Li , Li Na , Pan Weihua
Published: April 2020

Background

To investigate the long term surgical outcomes of cataract surgery in severe and end stage glaucoma patients with preoperative intraocular pressure less than 21 mmHg, and to detect the associated factors.

Methods

A retrospective study of primary angle closure glaucoma patients was conducted on who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications.

Results

Sixteen patients (19 eyes) were included. The mean age was 64.89 ± 11.68 years and the mean followed up duration was 21.89 ± 7.85 months. The final visual acuity was significantly improved from 0.69 ± 0.55 to 0.46 ± 0.52 logMAR, within 12 (63.2%) eyes improved, 4 (21.1%) eyes kept unchanged, and 3 (15.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with better final visual acuity (r = − 0.511, r = − 0.493, r = 0.537 respectively). Moreover, the final number of medications were reduced from 1.26 ± 0.99 to 0.26 ± 0.56 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 14.48 ± 3.74 mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was decreased to 6 (31.6%) eyes compared to 10 (52.6%) eyes at baseline. Moreover, the number of eyes free of medications was increased from 4 (21.1%) preoperatively to 15 (78.9%) eyes postoperatively.

Conclusions

Final visual acuity was significantly improved in the severe and end stage primary angle closure glaucoma patients and the number of eyes came off medications increased by 57.8% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the final visual acuity after cataract surgery.
Sex-on-premise venues, associated risk behaviors, and attitudes toward venue-based HIV testing among men who have sex with men in Lima, Perú
Authors: Lankowski Alexander , Sánchez Hugo , Hidalgo José , Cabello Robinson , Duerr Ann
Published: April 2020

Background

In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the high rate of new HIV infections has remained unchanged over the last decade. Low knowledge of HIV status associated with late diagnosis is a key factor underlying the high HIV incidence observed in this setting, creating conditions for efficient onward transmission. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) – saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted – may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts.

Methods

We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners.

Results

Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last 3 months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, substance use around the time of sex, and higher number of partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs.

Conclusions

SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.
Dietary diversity and associated factors among adolescents in eastern Uganda: a cross-sectional study
Authors: Isabirye Nathan , Bukenya Justine Nnakate , Nakafeero Mary , Ssekamatte Tonny , Guwatudde David , Fawzi Wafaie
Published: April 2020

Background

Globally adolescents constitute over 16% but in SSA, they make up 23% of the population. While little is known about diets of these adolescents, rapid changes in physiological and social processes undergone require adequate diets. This study aimed to determine dietary diversity and associated factors among adolescents residing in the Iganga -Mayuge HDSS.

Methods

As part of the African Research, Implementation Science, and Education (ARISE) Network, we analysed collected data among 598 adolescents to assess the health status and adolescents’ behaviour. Dietary diversity was scored using the 9 food group categories as per the Food and Agriculture Organization -WDDS. Crude and adjusted prevalence rate ratios were estimated using the modified Poisson regression model to identify associated factors.

Results

Among the participants, 45.3% had a low dietary diversity score. Proportions of adolescents who consumed from the different food categories over a 24-h period were; cereals/roots/tubers (99.7%), fats & oils (87.0%), spices & beverages (84.1%), sweets (77.1%), legumes (66.2%), other non-vitamin A-rich vegetables (53.8%), dark green leafy vegetables (42.3%), meat/poultry/fish (33.1%), dairy products (32.9%), eggs (11.2%), vitamin A-rich fruits and vegetables (33.4%) and other fruits (8.2%). Staying with a single parent or guardian, low socio-economic class, and dependency on home meals was associated with low dietary diversity.

Conclusions

Adolescents diets were low in diversity and characterised with low micronutrients source foods, but plenty of fats and oils. Interventions to address contributing factors to the burden ought to target the parenting contexts of the adolescents residing in rural eastern Uganda.
Perforation of anastomotic peptic ulcer following pancreaticoduodenectomy: a report of three cases
Authors: Shioi Ikuma , Yokoyama Naoyuki , Hirai Motoharu , Komatsu Masaru , Kubota Akira , Aoki Makoto , Sato Daisuke , Otani Tetsuya
Published: April 2020

Background

Perforation of a marginal peptic ulcer after pancreaticoduodenectomy (PD) can lead to severe conditions, although its clinical features have not been well reported. In this article, we present three cases of marginal peptic ulcer perforation after PD that we experienced in our institute and attempt to clarify its appropriate treatment and prevention.

Case presentation

Marginal ulcer perforation confirmed with computed tomography and/or surgical exploration occurred in 3 (1.8%) of 163 consecutive patients who underwent PD (including 160 patients who underwent a total or subtotal stomach-preserving procedure) at our institution. The three patients (one man and two women) had a median age of 77 (65–79) years. Two of these patients had a medical history of duodenal peptic ulcer. All three patients had biliary neoplasms. Two of the patients underwent subtotal stomach-preserving PD with antro-jejunal anastomosis, and the other patient underwent pylorus-preserving PD with duodenal jejunostomy. The perforation occurred with a sudden and severe onset of abdominal pain 34, 94, and 1204 days, respectively, after the PDs. At the time of the perforation, all of the patients had been withdrawn from postoperative prophylactic antipeptic ulcer agents, with the cessation periods ranging from 12 to 1008 days. In addition, all the patients were in fasting conditions for 1 to 13 days just before the perforation. Surgical treatment with direct suturing of the perforated ulcer was performed for two patients, while conservative therapy was performed for one patient. Their primary treatment courses were satisfactory. Chronic antisecretory agent therapy was prescribed for 562, 271, and 2370 days, respectively, from marginal ulcer perforation, and no ulcer recurrence was noted in any of the patients.

Conclusions

Lack of antisecretory therapy and fasting were considered an essential cause of marginal peptic ulcer perforation after PD. In addition, unlike the native duodenum, the jejunal limb used for reconstruction to a preserved stomach may be at increased risk of ulceration. Chronic permanent administration of antisecretory agents and fasting avoidance are desirable for patients who have undergone stomach-preserving PD to prevent marginal ulcer perforation.
Comparison of two caries prevention programs among Thai kindergarten: a randomized controlled trial
Authors: Pisarnturakit Pagaporn , Detsomboonrat Palinee
Published: April 2020

Background

Intensified preventive regimen based on a ‘high-risk’ approach has been proposed instead the routine prevention that is generally given to the whole population. The effectiveness of these regimens may still be an issue. Therefore, the aim of this study was to compare two preventive programs carried out in a Public School for kindergarten children.

Methods

The data from clinical examinations were used to assess the caries risk for 121 children. Children with at least 2 carious lesions were considered as high risk for dental caries development. These children were randomized into two groups. Half (High risk basic-HRB group) were provided the basic prevention regimen (oral-hygiene instruction and hands-on brushing practice for teachers and caregivers, daytime tooth brushing supervised by teachers at least once a week, newly erupted first permanent molar sealant, provision of toothbrush, fluoride-containing dentifrice, and a guidebook), which was also given to low-risk children (Low risk basic-LRB group). The other half (High risk intensive-HRI group) were additionally given an intensified preventive regimen (F-varnish application, primary molar sealant, and silver diamine fluoride (SDF) application on carious lesions). Clinical examinations were performed semiannually to determine the dmfs caries increment of the three groups.

Results

The 89 children completed the 24-month examination were 3- to 5-year-old with 19, 35, and 35 children in the LRB, HRB, and HRI group, respectively. The new caries development at 24 months of the HRB group (75%) was higher than that of the HRI group (65.7%) and the LRB group (21.1%). One-way analysis of variance (ANOVA) indicated no significant differences of caries increment between the HRB and HRI groups at the end of our study (p = 0.709).

Conclusions

The negligible difference in caries increment between the HRI and HRB groups implies that intensified prevention produced minimal additional benefit. Offering all children only basic prevention could have obtained virtually the same preventive effect with substantially less effort and lower cost.

Trial registration

Thai Clinical Trials Registry (TCTR), TCTR20180124001. Registered 24 January 2018 - Retrospectively registered.
Effect of ginger on the blood glucose level of women with gestational diabetes mellitus (GDM) with impaired glucose tolerance test (GTT): a randomized double-blind placebo-controlled trial
Authors: Hajimoosayi Fariba , Jahanian Sadatmahalleh Shahideh , Kazemnejad Anoshirvan , Pirjani Reihane
Published: April 2020

Background

Gestational diabetes mellitus (GDM) is one the most common complications of pregnancy. The present work aimed at investigating the effect of ginger on the blood glucose level of GDM women with impaired glucose tolerance test (GTT).

Methods

This randomized double-blind placebo-controlled clinical trial was performed on the total of 70 women with GDM, who were in 24–28 weeks of pregnancy with impaired GTT from 2015 to 2016. For this purpose, the women were assigned to two groups of ginger or placebo. The ginger group received 126 tablets of ginger, and the placebo group received 126 tablets of placebo for six weeks. The serum Blood Sugar 2 h post-prandial (BS2hpp), Fast Blood Sugar (FBS) and insulin, as well as Homeostasis Model Assessment (HOMA) index were analyzed before and six weeks after intervention.

Results

The mean of FBS (P = 0.04), fasting insulin (P = 0.01), and HOMA index (P = 0.05) was reduced significantly in the ginger group six weeks after intervention in comparison to the placebo group. But the mean of BS2hpp did not show any significant reduction in the two groups (P > 0.05(.

Conclusions

Oral administration of ginger tablet improved FBS, serum insulin and HOMA index in the women with GDM; however, it could not reduce their BS2hpp level.

The trial has been registered in the Iranian Registry of Clinical Trials (IRCT2015090523897N1).
Negative chronotropic and inotropic effects of lubiprostone on iPS cell-derived cardiomyocytes via activation of CFTR
Authors: Akita Hiraku , Yoshie Susumu , Ishida Takafumi , Takeishi Yasuchika , Hazama Akihiro
Published: April 2020

Background

Lubiprostone (LBP) is a novel chloride channel opener that has been reported to activate chloride channel protein 2 (ClC-2) and cystic fibrosis transmembrane conductance regulator (CFTR). LBP facilitates fluid secretion by activating CFTR in the intestine and is used as a drug for treating chronic constipation. While ClC-2 and CFTR expression has been confirmed in cardiomyocytes (CMs), the effect of LBP on CMs has not yet been investigated. Thus, the present study aimed to investigate the effect of LBP on CMs using mouse-induced pluripotent stem (iPS) cell-derived CMs (iPS-CMs).

Methods

We induced mouse iPS cells into CMs through embryoid body (EB) formation. We compared the differentiated cells to CMs isolated from adult and fetal mice using gene expression, spontaneous beating rate, and contraction ratio analyses.

Results

Gene expression analysis revealed that, in the iPS-CMs, the mRNA expression of the undifferentiated cell markers Rex1 and Nanog decreased, whereas the expression of the unique cardiomyocyte markers cardiac troponin I (cTnI) and cardiac troponin T (cTNT), increased. Immunostaining showed that the localization of cTnI and connexin-43 in the iPS-CMs was similar to that in the primary fetal CMs (FCMs) and adult CMs (ACMs). LBP decreased the spontaneous beating rate of the iPS-CMs and FCMs, and decreased the contraction ratio of the iPS-CMs and ACMs. The reduction in the beating rate and contraction ratio caused by LBP was inhibited by glycine hydrazide (GlyH), which is a CFTR inhibitor.

Conclusion

These results suggest that LBP stimulates CFTR in CMs and that LBP has negative chronotropic and inotropic effects on CMs. LBP may be useful for treating cardiac diseases such as heart failure, ischemia, and arrhythmia.
A palliative care approach in psychiatry: clinical implications
Authors: Strand Mattias , Sjöstrand Manne , Lindblad Anna
Published: April 2020

Background

Traditionally, palliative care has focused on patients suffering from life-threatening somatic diseases such as cancer or progressive neurological disorders. In contrast, despite the often chronic, severely disabling, and potentially life-threatening nature of psychiatric disorders, there are neither palliative care units nor clinical guidelines on palliative measures for patients in psychiatry.

Main text

This paper contributes to the growing literature on a palliative approach in psychiatry and is based on the assumption that a change of perspective from a curative to a palliative approach could help promote patient-centeredness and increase quality of life for severely ill patients in psychiatry as well as in somatic medicine. To exemplify this, we offer three different clinical scenarios: severe and enduring anorexia nervosa, treatment-refractory schizophrenia, and chronic suicidality and persistent self-injury in borderline personality disorder.

Conclusion

We emphasize that many typical interventions for treatment-refractory psychiatric disorders may indeed be of a palliative nature. Furthermore, introducing traditional features of palliative care, e.g. so-called goals of care conversations, could aid even further in ensuring that caregivers, patients, and families agree on which treatment goals are to be prioritized in order to optimize quality of life in spite of severe, persistent mental disorder.
Efficient identification of patients eligible for clinical studies using case-based reasoning on Scottish Health Research register (SHARE)
Authors: Shi Wen , Kelsey Tom , Sullivan Frank
Published: April 2020

Background

Trials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients’ consent for their EHRs to be used as a searching base from which researchers can find potential participants. However, due to the fact that EHR data is not complete, sufficient or accurate, a database search strategy may not generate the best case-finding result. The current study aims to evaluate the performance of a case-based reasoning method in identifying participants for population-based clinical studies recruiting through SHARE, and assess the difference between its resultant cohort and the original one deriving from searching EHRs.

Methods

A case-based reasoning framework was applied to 119 participants in nine projects using two-fold cross-validation, with records from a further 86,292 individuals used for testing. A prediction score for study participation was derived from the diagnosis, procedure, pharmaceutical prescription, and laboratory test results attributes of each participant. Evaluation was conducted by calculating Area Under the ROC Curve and information retrieval metrics for the ranking list of the test set by prediction score. We compared the most likely participants as identified by searching a database to those ranked highest by our model.

Results

The average ROCAUC for nine projects was 81% indicating strong predictive ability for these data. However, the derived ranking lists showed lower predictive performance, with only 21% of the persons ranked within top 50 positions being the same as identified by searching databases.

Conclusions

Case-based reasoning is may be more effective than a database search strategy for participant identification for clinical studies using population EHRs. The lower performance of ranking lists derived from case-based reasoning means that patients identified as highly suitable for study participation may still not be recruited. This suggests that further study is needed into improvements in the collection and curation of population EHRs, such as use of free text data to aid reliable identification of people more likely to be recruited to clinical trials.