bluuebunny/crossref_metadata_2025 huggingface dataset:
Can the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting
Authors: Reddy Kessendri , Whitelaw Andrew Christopher
Published: July 2020

Background: Positive blood cultures showing Gram positive cocci in clusters can signify the presence of Staphylococcus aureus or the less-virulent coagulase-negative staphylococci. Rapid identification and methicillin susceptibility determination with the Xpert MRSA/SA BC assay has the potential to improve management of S. aureus bloodstream infection and reduce inappropriate antibiotic use, and to support antibiotic cessation in patients with coagulase-negative staphylococci who have received further workup while awaiting blood culture positivity. Methods: We prospectively evaluated the Xpert MRSA/SA BC assay in comparison with culture-based methods on samples referred to our laboratory in the Western Cape, South Africa. We interviewed attending clinicians upon culture result availability, to assess antibiotic choices and to estimate potential impact of the assay.Results: We included 231 samples, for which the error rate was 1.7%. There was 100% concordance between the Xpert MRSA/SA BC assay and culture-based methods (methicillin-resistant S. aureus 15/15, methicillin-susceptible S. aureus 42/42, coagulase-negative staphylococci 170/170). We estimated a time saving of approximately 30 hours in time to final result with the assay. Of the 177 patients with adequate antibiotic history, changes to optimise antistaphylococcal therapy could have occurred more than one day sooner in 68.9% with S. aureus bloodstream infection (31/45, 95% CI 53.2-81.4%). Six of the 11 patients with methicillin-resistant S. aureus bloodstream infection (54.5%) could have received anti-MRSA cover sooner. Fifty-three days of antibiotic therapy could have been spared in these 177 based on use of this assay, equating to 0.3 days (95% CI, 0.2-0.4) saved per patient. The most substantial reductions were for broad-spectrum beta-lactam agents (31 days, in 17.5% of the cohort), aminoglycosides (7 days) and vancomycin (5 days).Conclusion: This assay has potential for use as an antibiotic stewardship tool; further studies should assess costing and impact on clinical outcome in patients with S. aureus bloodstream infection.
Comparison of the Effectiveness and Safety of Intravenous and Topical Regimens of Tranexamic Acid in Complex Tibial Plateau Fracture: A Retrospective Study
Authors: Wang Zhimeng , Lu Yao , Wang Qian , Song Leilei , Ma Teng , Ren Cheng , Li Zhong , Yang Jiarui , Zhang Kun , Zhang Bing
Published: July 2020

Background Previous studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in orthopedics surgery. However, no study has investigated TXA in complex tibial plate surgery. Therefore, the purpose of this study was to confirm the safety and effectiveness of IV (intravenous) TXA and topical TXA.Material and methods This was a retrospective analysis of prospectively collected data. The control group received an equal amount of placebo (physiological saline solution); the IV group received 1.0 g TXA by intravenous injection before the tourniquet was inflated and before the surgical incision was closed, and the topical group received 3.0 g TXA in 75 mL of physiological saline solution before 5 min prior to the final tourniquet release. Perioperative blood loss, vascular events, wound complications, and adverse reactions were compared for the three groups.The pain functional and quality of life (QoL) assessment based on their corresponding scoring system.Results Baseline data were comparable for all groups. The IV group showed the best results for total blood loss (TBL) and hidden blood loss (HBL) (424.5 ± 49.4 ml, 219.3 ± 33.4 ml, respectively, all p values < 0.001). The topical group performed excellently with regard to postoperative vascular events, wound complications, and adverse reactions, but there was no statistical significant in the incidence of these between the groups. In addition, the topical group benefited in reducing postoperative pain.Conclusion This study presents the first information to show that both IV TXA and topical TXA are safe and effective for complex tibial plateau fractures. The IV regimen effectively reduced blood loss during the perioperative period, whereas the topical regimen had a better safety profile and control early postoperative pain.
Endoscopic ultrasound-guided fine-needle aspiration of pelvic lesions via the upper and lower gastrointestinal tract approaches
Authors: Mita Naoki , Iwashita Takuji , Senju Akihiko , Ichikawa Hironao , Iwasa Yuhei , Yasuda Ichiro , Shimizu Masahito
Published: July 2020

Background
Combining upper and lower gastrointestinal tract (GI) approaches allows expansion of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) indications for pelvic lesions. The upper GI approach has been used for pelvic lesions around the level of the aortoiliac bifurcation in our institution. The aim of this study is to evaluate the feasibility and safety of EUS-FNA for pelvic lesions via the upper and lower GI approaches.
Methods
All consecutive patients who underwent EUS-FNA for the pelvic lesion between January 2008 and December 2018 were retrospectively analyzed. Pelvic lesions were defined as lesions located around and below the aortoiliac bifurcation level. The primary outcome was technical success rate, and the secondary outcomes were the diagnostic capability of EUS-FNA for malignancy and the safety.
Results
EUS-FNA for pelvic lesions was performed in 49 patients—upper and lower GI approaches were used in 28 and 21 patients, respectively. The technical success rates were 91.8% (45/49) in all patients—89.3% (25/28) and 95.2% (20/21) with the upper and lower GI approaches, respectively. Among patients who achieved technical success, the diagnostic accuracy for malignancy was 97.8% (44/45) in all patients—100% (25/25) and 95.0% (19/20) with the upper and lower GI approaches, respectively. One (2.0%) patient developed an adverse event of sigmoid colon perforation.
Conclusions
EUS-FNA for pelvic lesions via the upper and lower GI approaches was a safe, feasible, and effective method, although careful endoscopic manipulation is reuqired to avoid perforation, especially with the lower GI approach. Further large-scale, well-designed studies are needed to validate our findings.
Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.
Authors: D'Ascanio Michela , Innammorato Marta , Pasquariello Lara , Pizzirusso Dario , Guerrieri Giulio , Castelli Silvia , Pezzuto Aldo , De Vitis Claudia , Mancini Rita , Ricci Alberto , Sciacchitano Salvatore
Published: July 2020

Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the evolution of the disease in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to may 2020, divided in two groups according to their age (G1 65-80 years old; G2 >80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariable Cox proportional hazard regression and ordinal logistic regression were performed to estimate associations between age, comorbidities and provenance from residential care homes and clinical outcomes.Results: We found that G2 patients had an increased mortaliy rate, also due to (the frequent prevalence of) multiple comorbidities. Moreover we found that patients coming from long-stay residential care homes appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease.Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes; moreover, to establish a correct risk stratification, comorbidities and information about provenience from residential care homes should be considered.
An Infrared 3D Scanning Device as a Novel Limb Volume Measurement Tool in Breast Cancer Patients
Authors: White Bernadette N , Lu Iris M , Kao LeslieAnn S , Dixon Brandon J , Weiler Michael J , Frank Nathan D , Binkley Jill , Subhedar Preeti , Okoli Joel , Buhariwalla Karen , Suarez-Ligon Adriana , Gabram Sheryl G
Published: July 2020

Background Lymphedema is a common complication of breast cancer treatment that affects one in five breast cancer survivors yet there is no reliable method to detect lymphedema in the subclinical range. The objective of this study was to determine the feasibility and reliability of using an infrared 3D scanning device (ISD) as a peri-operative limb volume measurement tool.Methods Fifteen patients were analyzed based on inclusion criteria. Peri-operative measurements were obtained using tape measure and an ISD. Volumes were calculated using a standard algorithm for tape measure and a custom algorithm for ISD measurements. Linear regression models were used to assess ISD and tape measurement volume and circumference correlation. One-way ANOVA was used to compare change in percent difference at set time points post-operatively (2–3 weeks, 4–6 weeks, and 7–12 weeks) for both ISD and tape measure. T-Tests for unequal variances with the Bonferroni correction were performed among these groups.Results There is a positive linear correlation (R-squared = 0.8518) between absolute volume measurements by the ISD and tape measure. Analyses over 2–10 weeks post-operatively showed that the ISD was able to detect volume changes in both the unaffected and the affected arm. Furthermore, the affected arm tended to have a greater increase in volume in the majority of patients, indicating these patients could be at risk for lymphedema.Conclusions Technology utilizing infrared 3D scanners can reliably measure limb volume pre and post treatment similarly to tape measure in a small sample of patients. Further large-scale studies are needed to validate this method in a diverse population.
Sparse Signal Recovery from Modulo Observations
Authors: Shah Viraj , Hegde Chinmay
Published: July 2020

We consider the problem of reconstructing a signal from under-determined modulo observations (or measurements). This observation model is inspired by a (relatively) less well-known imaging mechanism called modulo imaging, which can be used to extend the dynamic range of imaging systems; variations of this model have also been studied under the category of phase unwrapping. Signal reconstruction in the under-determined regime with modulo observations is a challenging ill-posed problem, and existing reconstruction methods cannot be used directly. In this paper, we propose a novel approach to solving the inverse problem limited to two modulo periods, inspired by recent advances in algorithms for phase retrieval under sparsity constraints. We show that given a sufficient number of measurements, our algorithm perfectly recovers the underlying signal and provides improved performance over other existing algorithms. We also provide experiments validating our approach on both synthetic and real data to depict its superior performance.
Polyethylenimine-Based Theranostic Nanoplatform for Glioma-Targeting SPECT Imaging and Anticancer Drug Delivery
Authors: Zhao Lingzhou , Zhu Jingyi , Gong Jiali , Song Ningning , Wu Shan , Qiao Wenli , Yang Jiqin , Zhu Meilin , Zhao Jinhua
Published: July 2020

Background Glioma is the deadliest brain cancer in adults because the blood-brain-barrier (BBB) prevents the vast majority of therapeutic drugs from entering into the central nervous system. The development of BBB-penetrating drug delivery systems for glioma therapy still remains a great challenge. In this study, we aimed to design and develop a theranostic nanocomplex with enhanced BBB penetrability and tumor-targeting efficiency for glioma (SPECT) imaging and anticancer drug delivery. Results This multifunctional nanocomplex was manufactured using branched polyethylenimine (PEI) as a template to sequentially conjugate with methoxypolyethylene glycol ( m PEG), glioma-targeting peptide chlorotoxin (CTX), and diethylenetriaminepentaacetic acid (DTPA) for 99m Tc radiolabeling on the surface of PEI. After the acetylation of the remaining PEI surface amines using acetic anhydride (Ac 2 O), the CTX-modified PEI ( m PEI-CTX) was utilized as a carrier to load chemotherapeutic drug doxorubicin (DOX) in its interior cavity. The m PEI-CTX/DOX complex had excellent water dispersibility and released DOX in a sustainable and pH-dependent manner; furthermore, it showed targeting specificity and therapeutic effect of DOX toward glioma cells in vitro and in vivo (a subcutaneous tumor mouse model). Owing to the unique biological properties of CTX, the m PEI-CTX/DOX complex was able to cross the BBB and accumulate at the tumor site in an orthotopic rat glioma model. In addition, after efficient radiolabeling of PEI with 99m Tc via DTPA, the 99m Tc-labeled complex could help to visualize the drug accumulation in tumors of glioma-bearing mice and the drug delivery into the brains of rats through SPECT imaging. Conclusions These results indicate the potential of the developed PEI-based nanocomplex in facilitating glioma-targeting SPECT imaging and chemotherapy.
Use of the Combination of Ankle-brachial Index and Percentage of Mean Arterial Pressure at Ankle for Improving Prediction of All-cause Mortality in type 2 Diabetes Mellitus
Authors: Li Yu-Hsuan , Sheu Wayne Huey-Herng , Lee I-Te
Published: July 2020

Background: Peripheral artery disease (PAD) in lower extremities is a common complication in type 2 diabetes and has shown to be associated with mortality. The ankle-brachial index (ABI) is a simple noninvasive method to screen PAD, but has limited sensitivity. We hypothesized that using the percentage of mean arterial pressure (%MAP) and the ABI in combination would improve prediction of mortality.Methods: We retrospectively collected the data of patients with type 2 diabetes who had undergone measurement of ABI and %MAP at our hospital. We separated the cohort into four groups according to the ABI and %MAP values, and examined these indices were associated with mortality.Results: A total of 5101 patients (mean age, 65 ± 11 years) were enrolled. During the follow-up period (median, 22.9 months), 266 (4.8%) of enrolled patients died. The combination of ABI and %MAP was significantly better at predicting mortality than ABI alone. (C index: 0.62 [95% CI: 0.57, 0.65] vs. 0.57 [95% CI: 0.53, 0.62], P = 0.038). In multivariate analysis (with ABI >0.90 and %MAP ≤45% as the reference group), the highest risk of mortality was seen in patients with ABI ≤0.90 and %MAP >45% (hazard ratio = 1.983 [95% CI: 1.380, 2.848], P < 0.001).Conclusions: Adding %MAP to ABI appears to significantly improve the predictive ability for all-cause mortality in patients with type 2 diabetes.
The effectiveness of listening to the Holy Quran to improve mental disorders and psychological well-being: Systematic review and meta-analysis
Authors: Abd-alrazaq Alaa , Malkawi Ashraf A , Maabreh Ahmed H , Alam Tanvir , Bewick Bridgette M , Akhu-Zaheya Laila , Househ Mowafa
Published: July 2020

Background: Listening to the Quran is one of spiritual therapies that have been used for treating mental disorders. Many studies have been conducted to assess the effect of listening to the Quran on mental health and psychological wellbeing. Several reviews were conducted to summarise results of such evidence. However, they either focused on studies published in a certain country (Iran), focused on certain setting (intensive care unit), or were written by Persian language. Moreover, none of them synthesised results of studies statistically.Objective: The study aimed to assess the effectiveness of listening to the Quran to improve mental disorders and psychological well-being by summarizing and pooling the findings of previous literature.Methods: A systematic review was conducted to accomplish this objective. The search sources included 6 bibliographic databases (e.g., MEDLINE, PsycINFO, CINHAL), the search engine “Google Scholar”, and backward and forward reference list checking of the included studies and relevant reviews. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence evaluation. Results of the included studies were synthesized narratively and statistically, as appropriate.Results: Of 1724 citations retrieved, 11 studies met the eligibility criteria. Of these studies, 7 were included in meta-analysis. The evidence showed that listening to the Quran is significantly effective in improving state anxiety, trait anxiety, general anxiety, depression, stress and mental health. However, the evidence quality ranged from very low to low due to the high risk of bias, heterogeneity, and impression.Conclusion: Listening to the Quran has the potential to improve mental disorders and psychological well-being. Until high-quality studies approve its effect, health professionals and individuals should consider listening to the Quran as a complementary therapy to already available interventions. Researchers should conduct further studies to compare the effectiveness of reciting and listening to the Quran and Al-Ruqya Al-Shariya with active interventions on mental disorders and psychological well-being among Muslims and non-Muslims from different countries.
A general onepot-method for nucleic acid detection with CRISPR-Cas12a
Authors: Guanghui Tang , Gong Jiaojiao , Kan Lijuan , Zhang Xiuming , He Ying , Pan Jiaqiang , Zhao Liping , Tian Jie , Lin Sili , Lu Zhouyu , Xue Liang , Wang Chaojun , Li Qianyun
Published: July 2020

CRISPR/Cas12a system has been shown promising for nucleic acid diagnostics due to its rapid, portable and accurate features. In combination with isothermal amplification technology, single-copy sensitivity can be achieved. However, cleavage of the amplicons and primers by the cis- and trans-activity of Cas12a hinders the attempts to integrate the amplification and detection steps into a single reaction.
Through phosphorothioate modification of primer and design of crRNA that allow for the cutting site locating at the modified site of the primer, we realized onepot detection of SARS-CoV-2 with single-copy sensitivity. We also identified the activated Cas12a has a much higher affinity to C nucleotide-rich reporter than others. By applying such reporters, we significantly reduced the reaction time required for the lateral-flow readout. Furthermore, to improve the specificity of the strip-based assay, we created a novel reporter and, when combined with a customized strip, the unspecific signal could be completely eliminated. This established system termed Targeting DNA by Cas12a-based Eye Sight Testing in Onepot Reaction (TESTOR) was validated using clinical cervical samples for human papillomaviruses (HPVs) detection.
Our system represents a general approach to integrating the nucleic acid amplification and detection into a onepot reaction in CRISPR-Cas systems, highlighting its potential as a rapid, portable and accurate detection platform of nucleic acids.
Role of Physiotherapy in Long Term Physical and Mental Health of People Recovered From COVID 19: A Systematic Review Protocol
Authors: Gyanpuri Vyom , Dhiman Neetu , Pathak Abhishek , Singh Om Prakash
Published: July 2020

Background: the objective of the study to design a protocol on the effectiveness of physiotherapy on long term physical and mental health of recovered patients from coronavirus disease 2019. Methods: The following electronic databases will be searched from inception to June 2020: PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Databases, and other databases. We will include all published documents regarding this topic. Two separate individuals will analyse studies and select accordingly after removal of duplicate studies. Then, final screening, assessment of quality of the articles and data analysis will be done. Meta-analyses, subgroup analysis, and descriptive analysis will be performed based on the included data conditions. Results: Methodological heterogeneity analysis of current evidence will be provided from Physical health outcomes like Barthel Index or Functional Independence measure scale and questionnaires describing health status like Physical Health Questionnaire and Mental health outcomes like SRQ-20, Hamilton Depression scale or Hamilton Anxiety scale.Conclusion: This study will provide the evidence regarding the importance of physiotherapy in future physical and mental health of recovered COVID-19 patients, when performed during treatment of disease in acute hospital management.PROSPERO registration number: CRD42020190863
Coal petrology analysis and implications in depositional environments from Upper Cretaceous to Miocene: a study case in the Eastern Cordillera of Colombia
Authors: Guatame Clara , Rincón Marco
Published: July 2020

Coal petrological characteristics along the Piedemonte Llanero and the reconstruction of the deposit environment were obtained from macerals and micro-lithotypes analysis since these data provide information about the processes and prevalent conditions during the peat formation. We analyzed seams from Cenomanian to Miocene geological units (Chipaque Formation, Palmichal Group, Arcillas del Limbo Formation, and San Fernando Formation). Coal range decreases gradually from high-volatile C bituminous (HVCB) in the Chipaque Formation to sub-bituminous C in the San Fernando Formation. The coals are enriched in macerals of vitrinite, whereas the liptinite and inertinite concentrations vary according to the stratigraphic position. The micro-lithotypes are bi-maceral and tri-macerals, being the highest concentrations of clarite and vitrinertoliptite. The results of the facies analysis show that the peat in which the coals developed is mainly of arboreal and herbaceous affinity (rich in lignin and cellulose). Peats are ombrotrophic (rainfed) to mesotrophic (transitional or mixed mires) with variations in the flooding surface and influxes of brackish water. Good tissue preservation is inferred from the wet conditions in forest swamps with few humification and gelation. According to the micro-lithotypes composition, the peat environment was deduced as estuarine system, evolving to lacustrine environment of the deltaic system, both restricted by changes in sea level, which are evidenced by oxic and anoxic periods in the analyzed sequence.
The Value of High-flow Nasal Cannula Oxygen Therapy in Treating Patients With Severe Novel Coronavirus Pneumonia
Authors: Teng Xiao-bao , Shen Ya , Han Ming-feng , Yang Gang , Zha Lei , Shi Jing-feng
Published: July 2020

Objective

This study aimed to investigate the value of high-flow nasal cannula (HNFC) oxygen therapy in treating patients with severe novel coronavirus pneumonia (COVID-19).
Methods

The clinical data of 22 patients with severe COVID-19 were collected. The heart rate (HR), respiratory rate (RR) and oxygenation index (PO2/FiO2) at 0, 6, 24 and 72 hours after treatment were compared between the HFNC oxygen therapy group and the conventional oxygen therapy (COT) group. In addition, the white blood cell (WBC) count, lymphocyte (L) count, C-reactive protein (CRP) and procalcitonin (PCT) were compared before and at 72 hours after oxygen therapy treatment.
Results

Of the included patients, 12 were assigned to the HFNC oxygen therapy group and 10 were assigned to the COT group. The differences in HR, RR, PaO2/FiO2, WBC, L, CRP and PCT at 0 hours between the two groups were not statistically significant. At 6 hours after treatment with the two oxygen therapies, HR, RR and PaO2/FiO2 were better in the HFNC oxygen therapy group than in the COT group (p < 0.05), while at 24 and 72 hours after treatment with the two oxygen therapies, PaO2/FiO2 was better in the HFNC oxygen therapy group than in the COT group (p < 0.05), but the differences in HR and RR were not statistically significant. At 72 hours after treatment, L and CRP had significantly improved in the HFNC oxygen therapy group compared with the COT group, but the differences in WBC and PCT were not statistically significant. The length of stay in the intensive care unit (ICU) and the total length of hospitalization were shorter in the HFNC oxygen therapy group than in the COT group, and the differences between the two groups were statistically significant.
Conclusion

Compared with COT, early application of HFNC oxygen therapy in patients with severe COVID-19 can significantly improve oxygenation and RR, and HFNC oxygen therapy can improve the infection indexes of patients and reduce the length of stay in the ICU of patients. Therefore, it has high clinical application value.
Splenic Infarction and Infectious Diseases in Korea
Authors: Im Jae Hyoung , Chung Moon-Hyun , Lee Hye-Jin , Kwon Hea Yoon , Baek JiHyeon , Jang Ji-Hun , Lee Jin-Soo
Published: July 2020

Background
Although the etiology of splenic infarction (SI) is multi-factorial, the nature of its relationship with infectious diseases is not well understood. We thus aimed to investigate the relationship between SI and infection using a retrospective approach.
Methods
We reviewed the hospital records of patients with SI who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018. We collected and analyzed data on the patients’ clinical presentation, causative pathogens, risk factors, and radiologic findings.
Results
Of the 353 patients with SI, 101 patients with infectious conditions were enrolled in the study and their data were analyzed to identify an association between SI and infection. Ten patients were diagnosed as having infective endocarditis (IE), and 26 patients had bacteremia without IE. Twenty-seven patients had systemic infection due to miscellaneous causes (negative result on conventional automatic blood culture), such as the following intracellular organisms: parasites (12 cases of malaria and 1 case of babesiosis), bacteria (five cases of scrub typhus), viruses (one case each of Epstein–Barr virus infection and cytomegalovirus infection) or not identified pathogen (seven cases). Splenomegaly was more common among patients with miscellaneous systemic infection, and infarction involving other organs was rare. Twenty-one patients had localized infections (e.g. respiratory, intra-abdominal, or skin and soft tissue infection), and most of them (18 of 21) had other risk factors of SI.
Conclusions
In this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common pathogens observed. Further studies are needed to examine other possible etiologies and the underlying pathophysiologic mechanisms.
Renal Failure and Hepatitis Following Ingestion of Raw Grass Carp Gallbladder: A Case Report
Authors: Zhou Lina , Dong Shaoshao , Zhang Shengze , Huang Wen
Published: July 2020

Background: Fish gallbladder has long been used as folk remedy in Asian countries.Multiple organ damage after fish gallbladder ingestion resulting in near mortality has been known to occur.Here,we describe a case of grass carp gallbladder poisoning and review the literature.Case Presentation: A previously healthy, 50-year-old woman was admitted to our hospital with a 2-day history of generalized abdominal pain and repeated vomiting following ingestion of 2 raw, grass carp gallbladders in an attempt to alleviate her cough. She developed anuria on day 4 with markedly elevated serum creatinine, urea, bilirubin, alanineaminotransferase, and aspartate aminotransferase.Based on thorough evaluation of her history and prompt biochemical investigations, we diagnosed her with acute renal failure and hepatitis secondary to fish gallbladder poisoning.Her renal biopsy revealed acute tubular necrosis.And she underwent six sessions of conventional hemodialysis due to renal failure. Supportive treatment, like gastric mucosal protectant and liver protectant were administered for targeted organ protection.The patient’s liver function gradually recovered and serum creatinine was 164 ummol/l at discharge on day 24. Over a period of 2-week follow-up, her renal function completely recovered. Conclusion: The purpose of this paper is to highlight the need for physicians to be mindful of the toxic complications of raw grass carp gallbladder ingestion and to promote its awareness among the people to help reduce this incidence of food poisoning.
A Different Point of View: The Evaluation of Motor Imagery Perspectives in Patients With Sensorimotor Impairments in A Longitudinal Study
Authors: Gäumann Szabina , Gerber Rahel Sarah , Suica Zorica , Schuster-Amft Corina
Published: July 2020

BackgroundMotor imagery (MI) has been successfully applied in neurological rehabilitation. Little is known about the spontaneous selection of the MI perspectives in patients with sensorimotor impairments. What MI perspective is selected: internal (first- person view), or external (third-person view)? The aim was to evaluate the MI perspective preference in patients after stroke (STR), with Multiple Sclerosis (MS) or Parkinson’s disease (PD).MethodsIn a longitudinal study including four measurement sessions over two weeks, MI ability and MI perspective preference in both visual and kinaesthetic imagery modalities were assessed using the Kinaesthetic and Visual Imagery Questionnaire including 20 items (KVIQ-20), mental rotation, and mental chronometry. Additionally, patients' activity level was assessed. Descriptive statistical analyses were performed regarding different age- (≤44, 45-63, 64≤) and activity levels (inactive, partially active, active), and KVIQ-20 movement classifications (axial, proximal, distal, upper and lower limb).ResultsIn total, 55 in- and outpatients (25 SRT, 25 MS, 5 PD; 25 females; mean age 58±14 years) were included. At the first measurement session, the mean mental rotation score was 27±4.1 out of 32. For mental chronometry, a congruency ratio of 1.0±0.3 was determined. The KVIQ-20 scores for the visual and kinaesthetic subscales were 62.4±16.2 and 58.2±17.2. The internal MI perspective was favoured in 66.5% on the visual subscale and in 72.7% on the kinaesthetic subscale. The external perspective was preferred in 30.3% on the visual subscale and in 26.5% on the kinaesthetic subscale. Over the four measurement sessions, patients became more consistent in their MI perspective selection. MI perspective changes occurred mainly during imagination of shoulder, arm and neck movements. During imagination of foot and finger movements their MI perspective was more constant. Results showed a tendency to use an external perspective in patients older than 64 years and in patients with a descreasing physical activity level. Axial and proximal movements were commonly imagined using the external perspective. ConclusionIt is recommended to evaluate the spontaneous MI perspective selection to design patient-specific MI training interventions. Distal movements (foot, finger) may be an indicator when evaluating the consistency of the MI perspective in patients with sensorimotor impairments. Trial registrationThis is a research project involving persons other than a clinical trial according to the Human Research Act other than clinical (non-clinical trial). Registered: EKNZ 2015-172, 19. Mai 2015
Non‑invasive prostate cancer detection by measuring expression level of miR-21 and miR-214 in urine
Authors: Emamvirdizadeh Alireza , Jamshidian Faranak , Hashemi Mehrdad , Nooraei Saghi , Entezari Maliheh
Published: July 2020

Background: Prostate cancer is the most prevalent cancer among men worldwide. Diagnosis in this cancer is primarily done using aggressive methods, such as biopsy. Laboratory methods, such as measurement of prostate specific antigen (PSA) in the blood, do not have high sensitivity and specificity. MicroRNAs, a group of diagnostic biomarkers, can be used to diagnose diseases such as cancer. MicroRNA is small, non-coding, single-stranded RNA with a length of 21-23 nucleotides. The present study was undertaken to investigate changes in the expression level of miR-21 and miR-214 in the urine to detect prostate cancer. Methods: Testing was done on 70 urine samples from prostate cancer patients (32 metastatic and 38 non-metastatic) and 30 from healthy individuals with negative biopsy reports as the control group. Changes in the expression level of miR-21 and miR-214 in the urine were investigated by using qRT-PCR. Results: miR-21 showed a significant increase in expression (p = 0.003) and miR-214 showed a significant decrease in expression (p = 0.000) over the results of the control group. The specificity, sensitivity and AUC for combined panels of both microRNAs were 100%, 72.14% and 0.721 and for PSA were 63.33%, 61.43% and 0.620, respectively. Conclusions: The results show that miR-21 and miR-214 show significant changes in expression in patients with prostate cancer compared to the control group. A combined panel of miR-21 and miR-214 can be used as a non-invasive method for detecting prostate cancer with higher sensitivity and specificity than the PSA test.
Patterns of breast, prostate and cervical cancer incidence and mortality in Colombia: An administrative registry data analysis
Authors: Vargas Juliana Alexandra Hernández , Barbosa Paula Ximena Ramírez , Quijano Ana Milena Gil , García Ana María Valbuena , Merchán Lizbeth Acuña , González Jaime
Published: July 2020

Background
Cancer is widely recognized as a global public health problem. Breast, prostate and cervical cancer are among the most frequent types in developing countries. Assessing their incidence and mortality by regions and municipalities is important to guide evidence-based health policy. Our aim was to describe the incidence and mortality trends for breast, cervical and prostate cancer across regions and municipalities in Colombia during 2018.
Methods
We performed a cross-sectional analysis with data from people with breast, prostate or cervical cancer, reported to the National Administrative Cancer Registry during 2018. A descriptive analysis was performed. Age-standardized incidence and mortality rates were estimated at national, regional and municipal levels. Finally, we identify the regions and municipalities with significantly higher or lower incidence and mortality rates compared to national estimations.
Results
Breast cancer was the most frequent type among all new cases and deaths in Colombia. Breast, prostate and cervical cancer incidence and mortality rates were: 18,69 (CI 95%: 18,15–19,25) and 10,48 (CI 95%: 10,07–10,91); 11,34 (CI 95%: 10,90 − 11,78) and 7,58 (CI 95%: 7,22 − 7,96); 5,93 (CI 95%: 5,62 − 6,25) and 4,31 (CI 95%: 4,05 − 4,58), respectively. Eastern region had both, incidence and mortality rates, significantly lower than national for all types of cancer. By municipalities, there were a heterogeneous pattern. Nonetheless, Agua de Dios (Cundinamarca), had one of the highest incidence rates for all types.
Conclusions
We observed clear differences in cancer incidence and mortality across regions and municipalities, depending on each type of cancer. Our findings are important to improve screening coverage, early detection and treatment in the country.
Estrous cycle stage critically affects 21-gene recurrence scores in Mmtv-Pymt mouse mammary tumours
Authors: Bernhardt Sarah M , Dasari Pallave , Glynn Danielle J , Woolford Lucy , Moldenhauer Lachlan M , Walsh David , Townsend Amanda R , Price Timothy J , Ingman Wendy V
Published: July 2020

Background: The Oncotype DX 21-gene Recurrence Score is predictive of adjuvant chemotherapy benefit for women with early-stage, estrogen receptor (ER)-positive, HER2-negative breast cancer. In premenopausal women, fluctuations in estrogen and progesterone during the menstrual cycle impact gene expression in hormone-responsive cancers. However, the extent to which menstrual cycling affects the Oncotype DX 21-gene signature remains unclear. Here, we investigate the impact of ovarian cycle stage on the 21-gene signature using a naturally cycling mouse model of breast cancer. Methods: ER-positive mammary tumours were dissected from naturally cycling Mmtv-Pymt mice at either the estrus or diestrus phase of the ovarian cycle. The Oncotype DX 21-gene signature was assessed through quantitative real time-PCR, and a 21-gene experimental recurrence score analogous to the Oncotype DX Recurrence Score was calculated. Results: Tumours collected at diestrus exhibited significant differences in expression of 6 Oncotype DX signature genes (Ki67, Ccnb1, Esr1, Erbb2, Grb7, Bag1; p≤0.05) and a significant increase in 21-gene recurrence score (21.8±2.4; mean±SEM) compared to tumours dissected at estrus (15.5±1.9; p=0.03). Clustering analysis revealed a subgroup of tumours collected at diestrus characterised by increased expression of proliferation- (p<0.001) and invasion-group (p=0.01) genes, and increased 21-gene recurrence score (p=0.01). These tumours also exhibited higher expression of estrogen-group genes (p=0.005) suggesting increased sensitivity to hormonal fluctuations during the ovarian cycle. Conclusions: Ovarian cycle stage at the time of tissue collection critically affects the 21-gene signature and recurrence scores in Mmtv-Pymt murine mammary tumours. Whether Oncotype DX Recurrence Scores in women are similarly affected by menstrual cycle stage is not yet known. To address this question and ensure young breast cancer patients receive optimal treatment advice, future prospective studies using breast cancer samples from premenopausal women with known cycle stage are required.
Long Non-Coding RNA GRIK1-AS1 Inhibits the Proliferation and Invasion of Gastric Cancer Cells by Regulating the miR-375/IFIT2 axis
Authors: Zhou Qi , Li Yuan , Chen Lujun , Zheng Xiao , Jiang Tianwei , Liu Juan , Fu Yuanyuan , Guan Liping , Ju Jingfang , Wu Changping
Published: July 2020

Backgroud Long non-coding RNAs (lncRNAs) played important roles in various biological processes and human diseases, including cancer. Methods In this study, RNAi technology, RNA-FISH, RNA-pull down assay and cellular function studies were used to demonstrate a regulatory relationship between lncRNA GRIK1-AS1 and miR-375/IFIT2 axis in gastric cancer. Results Our results show a decreased expression of GRIK1-AS1 in gastric cancer tissues compared to adjacent normal gastric tissues. Gastric cell lines also have reduced levels of GRIK1-AS1 compared to gastric epithelial cell line GES-1. Ectopic expression of GRIK1-AS1 in gastric cancer cell lines significantly inhibits cellular viability, migration and invasion. RNA-pull down and the luciferase activity assays show that GRIK1-AS1 mainly interacts specifically with miR-375. We further demonstrate a negatively regulatory relationship between lncRNA GRIK1-AS1 and miR-375. We discovered that IFIT2 was one of the direct key downstream target gene of miR-375, and established the important role of GRIK1-AS1/miR-375/IFIT2 axis in the progression of gastric cancer. Conclusions Our results revealed a novel mechanism of GRIK1-AS1 as sponge to miR-375that impact gastric cancer progression via modulating target mRNA IFIT2 translation, and as a result, open a new strategy to future GRIK1-AS1 based therapeutic development.
Clinical diagnosis of patients subjected to surgical lung biopsy with a probable usual interstitial pneumonia pattern on high-resolution computed tomography
Authors: Tibana Regina , Soares Maria Raquel , Storrer Karin Mueller , Meirelles Gustavo de Souza Portes , Nishiyama Katia , Missrie Israel , Coletta Ester Nei Aparecida Martins , Ferreira Rimarcs Gomes , Pereira Carlos Alberto de Castro
Published: July 2020

Background: Usual interstitial pneumonia (UIP) can present with a probable pattern on high-resolution computed tomography (HRCT), but the probability of UIP by surgical lung biopsy in such cases remains controversial. We aimed to determine the final clinical diagnosis in patients with a probable UIP pattern on HRCT subjected to surgical lung biopsy.Methods: HRCT images were assessed and categorized by three radiologists, and tissue slides were evaluated by two pathologists, all of whom were blinded to the clinical findings. The final clinical diagnosis was accomplished via a multidisciplinary discussion. Patients with a single layer of honeycombing located outside of the lower lobes on HRCT were not excluded.Results: A total of 50 patients were evaluated. The most common final clinical diagnosis was fibrotic hypersensitivity pneumonitis (38.0%; 95% CI: 24.7% to 52.8%), followed by idiopathic pulmonary fibrosis (24.0%; 95% CI: 13.1% to 38.2%) and interstitial lung disease ascribed to gastroesophageal reflux disease (12.0%; 95% CI: 4.5% to 24.3%) and familial interstitial lung disease (10.0%; 95% CI: 3.3% to 21.8%). In the group without environmental exposure (n = 22), 10 patients had a final clinical diagnosis of idiopathic pulmonary fibrosis (45.5%; 95% CI: 24.4% to 67.8%). Irrespective of the final clinical diagnosis, by multivariate Cox analysis, patients with honeycombing, dyspnoea and the presence of fibroblastic foci on surgical lung biopsy had a high risk of death.Conclusions: The most common disease associated with a probable UIP pattern on HRCT is fibrotic hypersensitivity pneumonitis, followed by idiopathic pulmonary fibrosis and interstitial lung disease ascribed to gastroesophageal reflux disease. In patients without environmental exposure, the frequency of UIP and a final clinical diagnosis of idiopathic pulmonary fibrosis are not sufficiently high to obviate the indication for surgical lung biopsy.
Long-Term Survival With Sebelipase Alfa Enzyme Replacement Therapy in Infants With Rapidly Progressive Lysosomal Acid Lipase Deficiency Final Results From 2 Open-Label Studies
Authors: Vijay Suresh , Brassier Anais , Ghosh Arunabha , Fecarotta Simona , Abel Florian , Marulkar Sachin , Jones Simon A.
Published: July 2020

Background
If symptomatic in infants, the autosomal recessive disease lysosomal acid lipase deficiency (LAL-D; sometimes called Wolman disease or LAL-D/Wolman phenotype) is characterized by complete loss of LAL enzyme activity. This very rare, rapidly progressive form of LAL-D results in severe manifestations leading to failure to thrive and death, usually by 6 months of age. We report results from 2 open-label studies of enzyme replacement therapy with sebelipase alfa, a recombinant human LAL, in infants with LAL-D: the phase 2/3 Survival of LAL-D Infants Treated With Sebelipase Alfa (VITAL) study (NCT01371825) and a phase 2 dose-escalation study (LAL-CL08 [CL08]; NCT02193867). In both, infants received once-weekly intravenous infusions of sebelipase alfa.
Results
The analysis population contained 19 patients (9 in VITAL; 10 in CL08). Kaplan-Meier estimates of survival to 12 months and 5 years of age were 79% and 68%, respectively, in the combined population, and the median age of surviving patients was 5.2 years in VITAL and 3.2 years in CL08. In both studies, median weight-for-age, length-for-age, and mid-upper arm circumference-for-age z scores increased from baseline to end of study. Decreases in median liver and spleen volume over time were noted in both studies. Short-term transfusion-free hemoglobin normalization was achieved by 100% of patients eligible for assessment in VITAL, in an estimated median (95% confidence interval [CI]) time of 4.6 (0.3–16.6) months. In CL08, short-term transfusion-free hemoglobin normalization was achieved by 70% of patients eligible for assessment, in an estimated median (95% CI) time of 5.5 (3.7–19.6) months. No patient discontinued treatment because of treatment-emergent adverse events. Most infusion-associated reactions (94% in VITAL and 88% in CL08) were mild or moderate in severity.
Conclusions
The findings of these 2 studies of infants with rapidly progressive LAL-D demonstrated that enzyme replacement therapy with sebelipase alfa prolonged survival with normal psychomotor development, improved growth, hematologic, and liver parameters, and was generally well tolerated, with an acceptable safety profile.
A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases
Authors: de Gruijter Nina M , Naja Meena , Peckham Hannah , Radziszewska Anna , Kinsella Matthew , Glenister James , Rosser Elizabeth , Butler Gary E , Jury Elizabeth C , Ciurtin Coziana
Published: July 2020

Background: Autoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARDs related outcomes.Methods: Studies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS).Results: 14 non-randomised studies reporting on the impact of puberty on ARD outcomes (n = 7), ARD impact on puberty-related outcomes (n = 6), or both (n = 1) have been identified. The impact of puberty on ARD outcomes have been investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n = 1), juvenile systemic lupus erythematosus (JSLE) (n = 5) or in healthy controls who developed adult-onset SLE (n = 1) or had non-specific symptoms (n = 1). The impact of ARD on puberty outcomes was explored in JIA (n = 4) and JSLE (n = 3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4–9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment.Conclusion: A bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.