bluuebunny/crossref_metadata_2025 huggingface dataset:
CD247 expression is associated with differentiation and classification in ovarian cancer
Authors: Ye Wenfeng , Zhou Yi , Xu Bin , Zhu Dawei , Rui Xiaohui , Xu Ming , Shi Lijuan , Zhang Dachuan , Jiang Jingting
Published: December 2019

Ovarian cancer (OC) is one of the most common malignant tumors in female reproductive system and most OC cases are diagnosed at an advanced stage with the overall 5-year survival rate below 40%. The function of CD247 enhances T-cell antigen receptor (TCR) signaling cascade and it is necessary for assembling of the TCR/CD3 complex on the surface of T lymphocytes. It is well established that defective CD247 function leads to impaired activation of T cells upon engagement of the TCR.

Flow cytometry was used to examine the difference of CD247+ T lymphocyte between the OC and ovarian cyst, immunohistochemistry analysis was used to investigate the correlation between CD247 expression and clinicopathologic features of epithelial OC patients.

Our study showed that the expression of CD247 in peripheral blood lymphocytes from patients with OC is decreased compared with ovarian cyst patients and the expression of CD247 in tumor infiltrating lymphocytes with cancer tissue is decreased compared with adjacent tissues. We showed that abnormal expression of CD247 was related with differentiation and classification in OC.

Our findings suggested that CD247-targeted treatment could be used as a potential therapeutic strategy for OC.
Concomitance of pulmonary spindle cell carcinoma and sclerosing pneumocytoma in a woman
Authors: LuLu Xu , Jian Shu
Published: December 2019

Rationale:

Pulmonary spindle cell carcinoma (PSCC) is a rare subset of pulmonary sarcomatoid carcinoma. PSCC is aggressive and has a poor prognosis. Pulmonary sclerosing pneumocytoma (PSP) is an asymptomatic slow-growing benign tumor, which usually occurs in middle-aged women.

Patient concerns:

Herein, we report a case of solitary PSCC, occurring concomitantly with PSP in a 74-year-old woman. The patient visited our institution with productive purulent cough, dyspnea after activity, and hemoptysis. Enhanced computed tomography revealed an inhomogeneous enhanced mass with central low-attenuation in the right upper lobe (RUL). The mass located in the right lower lobe (RLL) exhibited homogeneous enhancement.

Diagnosis:

These lesions were subsequently diagnosed as PSCC in the RUL and PSP in the RLL, following postoperative pathological examination.

Interventions:

We performed lobectomy for the RUL and wedge resection for the RLL in one procedure.

Outcomes:

The patient did not experience complications after surgery. No radiological evidence of recurrence was observed on follow-up computed tomography performed within 7 months after the procedure.

Lessons:

This case fully reflects the importance of the differential preoperative diagnosis of benign and malignant solitary pulmonary nodules. However, a rare and aggressive malignant tumor may have imaging features typical of a lung abscess, which should be treated carefully.
Peroneal tendon irritation after arthroscopic modified Broström procedure
Authors: Lee Young Koo , Lee Hong Seop , Cho Whi Je , Won Sung Hun , Kim Chang Hyun , Kim Hyun Kwon , Ryu Aeli , Kim Woo Jong
Published: December 2019

Rationale:

With the development of ankle arthroscope techniques and procedures, the number of arthroscopic modified Broström procedures (MBPs) is increasing. All-inside arthroscopic MBP was developed recently, with good to excellent results. However, several complications have been reported in patients after arthroscopic MBP. This case report describes a rare complication of arthroscopic MBP.

Patient concerns:

A 34-year-old woman presented with severe pain in her right ankle and underwent arthroscopic MBP for lateral ankle instability. About 6 months postoperatively, she presented with severe pain on the lateral aspect of the right ankle, especially while walking.

Diagnosis:

In physical examinations, there was marked swelling around the ankle and focal tenderness in the posterolateral malleolar area. Ankle ultrasonography showed a diffuse low-echoic mass-like lesion at the distal fibula between the fibular tip and peroneus tendon. T1-weighted sagittal magnetic resonance imaging images showed an irregularly shaped mass-like lesion with a heterogeneous signal near the distal fibula posteriorly where the anchor protruded.

Interventions:

The suture anchor in the posterior distal fibula area, which had irritated the peroneus tendon, was removed with debridement of the granulomatous lesion.

Outcomes:

At the 3-month follow-up, the patient was almost asymptomatic and had a nearly full range of motion. No complications or recurrent symptoms were noted at the 1-year follow-up.

Lessons:

Three-dimensional computed tomography studies of the appropriate fibular depth and position of suture anchors are needed to standardize the procedure and reduce complications.
Association of periodic limb movements during sleep and Parkinson disease
Authors: Hwang Shang-Rung , Hwang Sheng-Wei , Chen Jin-Cherng , Hwang Juen-Haur
Published: December 2019

Both of periodic limb movements during sleep (PLMS) and Parkinson disease (PD) were related with dopaminergic system dysfunction. We aimed to investigate the detailed association of PLMS severity and PD.

Clinical and overnight polysomnographic data of 2230 adults older than 40 from a community hospital between November 2011 and June 2017 in Taiwan were collected retrospectively. The association of PLMS severity and PD was analyzed by Fisher exact test, univariate, and multivariate logistic regression.

The mean age was 55.6 years old (standard deviation = 9.8, range = 40–91) for all subjects. There were 2205 subjects without PD and 25 subjects with PD in this study. The distribution of PLMS severity was not significantly different between subjects without PD and with PD (Fischer exact test, P = .215). Also, PLMS was not significantly associated with PD using univariate and multivariate logistic regression.

The PLMS severity was not associated with PD.
Priority of lymph node dissection for advanced esophagogastric junction adenocarcinoma with the tumor center located below the esophagogastric junction
Authors: Cai Ming-Zhi , Lv Chen-Bin , Cai Li-Sheng , Chen Qiu-Xian
Published: December 2019

To clarify the priority of lymph node dissection (LND) in advanced Siewert type II and III AEG, in which the center of the tumor is located below the esophagogastric junction (EGJ).

Data in 395 patients with advanced Siewert type II or III AEG was analyzed retrospectively. The index of estimated benefit from LND (IEBLD) was used to evaluate the efficacy of LND for each nodal station.

The mean number of dissected LNs did not differ significantly between patients with type II and III AEG, nor did the mean number of retrieved LNs at each station significantly differ between the 2 groups. According to the IEBLD, the dissection of parahiatal LNs (No.19 and 20) and LNs along the distal portion of the stomach (No.5, 6, and 12a) seemed unlikely to be beneficial, whereas the dissection of Nos.1–3, 7, 9 and 11p yielded high therapeutic benefit (IEBLD>3.0) in both groups. The IEBLDs of No.4d, 8a, and 10 were much higher in type III than in type II AEG cases. No.10 LND may improve survival for type III AEG cases (IEBLD = 2.9), especially for subgroups with primary tumors invading the serosa layer, undifferentiated cancers, macroscopic type 3–4 tumors and tumors ≥50 mm in size (all IEBLDs > 4.0).

For advanced AEG located below the EGJ, the dissection of paracardial LNs, lesser curvature LNs, and LNs around the celiac axis would promote higher survival benefits regardless of the Siewert subtype. Patients with type III AEG, especially those with serosa-invasive tumors, undifferentiated tumors, macroscopic type 3–4 tumors and tumors ≥50 mm in size may obtain relatively higher survival benefits from No. 10 lymphadenectomy.
Effect of oral alpha-lipoic acid (ALA) on the treatment of male infertility
Authors: Dong Liang , Zhang Xiaojin , Yang Fang , Li Junjun , Yu Xujun , Li Yulin
Published: December 2019

Background:

Male fertility has gradually become a worldwide problem. Because of the limitation of treatment, many drugs have been used for improving sperm quality. Among them, alpha-lipoic acid (ALA), as a treatment of diabetic neuropathy, has been applied to improve the quality of sperm in clinical practice, with satisfactory effect. However, there is still no systematic review on the field of male infertility treating with oral ALA.

Methods:

The databases of MEDLINE, EMBASE, Web of Science, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), China Biology Medicine Database (CBM), Wan fang Database, VIP Science Technology Periodical Database, and Cochrane Library were retrieved. Grey literature will be searched in OpenGrey. Related Randomized controlled trials (RCTs) will be collected and selected before December 30, 2019. We will search English literature and Chinese literature using search terms including “male infertility”, “semen”, “sperm”, “alpha-lipoid acid”, “ alpha lipoid acid”, “lipoid acid”. We will start to search database in November 20, 2019. Sperm concentration, motility and morphology, sperm DNA fragmentation index, sperm number of per ejaculate, sperm viability and adverse events will be evaluated. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement.

Results:

Through systematic review, and meta-analysis when necessary, we can obtain the effect of ALA on sperm quality, including sperm motility, concentration, morphology and other indicators.

Conclusion and dissemination:

Efficacy and safety of oral ALA on male sperm quality in infertile men will be assessed. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make better clinical decisions.
Effects of preemptive intravenous paracetamol and ibuprofen on headache and myalgia in patients after electroconvulsive therapy
Authors: Karaaslan Erol , Akbas Sedat , Ozkan Ahmet Selim , Zayman Esra Porgali
Published: December 2019

Background:

The aim of this study is to determine the efficacy of preemptive analgesia with paracetamol and ibuprofen to reduce the intensity and incidence of headache and myalgia after electroconvulsive therapy (ECT).

Methods:

Sixty patients with major depression who were treated with ECT were randomized to receive ECT 3 times a week. The first 3 sessions were included in the study. The patients were divided into 3 groups; Group C (Control, Saline, n = 20), Group P (Paracetamol, n = 20), and Group I (Ibuprofen, n = 20). Demographics, duration of seizure, visual analog scale (VAS) for headache and myalgia and nausea, vomiting and pruritus were evaluated at postoperative 24 hours period.

Results:

Duration of seizure after ECT was similar in all groups (P = .148). In the study, heart rate and mean arterial pressure were found to be some changes in some of the sessions. There were no significant differences in any comparison for all groups in all sessions regarding VAS scores for headache and myalgia. Incidence of headache and myalgia in Group I was lower than the other groups (P = .233, P = .011, respectively). But, there was no significant difference between the other groups. There was no significant difference in vomiting, intergroups, and intragroup.

Conclusions:

The findings of our study indicate that pain intensity of headache and myalgia did not show a significant change between groups and within groups. While pain intensity of myalgia between the groups reached no statistical significance, ibuprofen was significantly lowered the incidence of myalgia at postoperative 24 hours period.
Restrictive allogeneic blood transfusion strategy in patients with extremity bone sarcomas
Authors: Park Jong Hoon , Hong Seok Ha , Jang Woo Young
Published: December 2019

Allogeneic blood transfusions (ABTs) are common in patients with cancer. The present study investigated the safety of a restrictive ABT strategy in patients with extremity sarcomas.

Patients who underwent operations for extremity bone sarcomas between May 2008 and November 2018 were retrospectively reviewed. Clinical outcomes based on hemoglobin concentrations, postoperative infections, and hospital stay were compared between 20 patients who received liberal ABT (control group) and 19 patients who received restrictive ABT (restrictive group). The rates of distant metastasis and death were compared between the groups.

The mean number of ABTs was 3.6 ± 3.8 units in the control group and 0.33 ± 0.74 units in the restrictive group (P < .001). Only 3 of 19 patients received transfusions (2 red cell packs each). The hemoglobin levels tended to fall during the first 3 postoperative days but seemed to stabilize within the first postoperative week in both groups. Postoperative surgical site infections only occurred in the patients who received ABTs regardless of the group. The rates of distant metastasis and death were higher in the control group than in the restrictive group (25.0% vs 15.7% and 10.0% vs 0%, respectively), but the differences were not significant.

A restrictive ABT strategy may be safely performed in patients with extremity bone sarcomas depending on the intraoperative status and specific characteristics of each patient.
TYMS presents a novel biomarker for diagnosis and prognosis in patients with pancreatic cancer
Authors: Fu Zhuo , Jiao Yan , Li Yanqing , Ji Bai , Jia Baoxing , Liu Bin
Published: December 2019

Pancreatic cancer is one of the most malignant tumors worldwide. DNA replication plays a critical role in the occurrence and development of pancreatic cancer. TYMS encodes thymidylate synthase, which is important for DNA synthesis. The TYMS gene has been assessed in some tumors. However, the specific role of TYMS in pancreatic cancer has not been identified. This study was designed to clarify the diagnostic and prognostic significance of TYMS in pancreatic cancer.

The Cancer Genome Atlas (TCGA) database was used to compare TYMS expression in pancreatic cancer, and ROC curve analysis was used to investigate its diagnostic value. The correlation between clinical characteristics and TYMS expression was analyzed, and the prognostic value of TYMS expression in the patients with pancreatic cancer was assessed by Kaplan–Meier curves and Cox analysis.

TYMS was upregulated in pancreatic cancer and associated with poor overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate survival analysis demonstrated that TYMS is an independent risk factor for OS and RFS in patients with pancreatic cancer.

The upregulation of TYMS in pancreatic cancer leads to unfavorable OS and RFS in patients, and represents a diagnostic and prognostic biomarker for patients with pancreatic cancer.
Comparison between ultrasound-guided aspiration performed using an intravenous cannula or a conventional needle in patients with peri-prosthetic seroma
Authors: Lee Jeeyeon , Park Ho Yong , Kim Wan Wook , Park Chan Sub , Lee Ryu Kyung , Yang Jung Dug , Lee Joon Seok , Jung Jin Hyang
Published: December 2019

Background:

Peri-prosthetic seroma after implant insertion for breast reconstruction is a common but difficult-to-manage complication. This study aimed to compare peri-prosthetic seroma duration and the number of aspirations associated with intravenous cannula with those associated with conventional needle.

Methods:

Seventy-one patients who underwent skin- or nipple-sparing mastectomy and implant insertion were treated for peri-prosthetic seroma. When peri-prosthetic seroma was detected, ultrasound-guided aspiration was performed either by using an intravenous cannula (n = 35) or a conventional needle (n = 36); however, the method adopted was randomly selected. We analyzed the participants’ clinicopathologic factors after medical record review.

Results:

There were no significant intergroup differences in mean age (P = .052), mean body mass index (P = .601), total clinical tumor size (P = .107), pathologic tumor size (P = .269), specimen weight (P = .147), implant size (P = .313), or operation time (P = .595). However, the mean total peri-prosthetic seroma volume was significantly higher (105.80 vs 88.58, P = .015) but the number of aspirations was lower (4.48 vs 5.80, P = .043) in the intravenous cannula group than in the conventional needle group. Mean peri-prosthetic seroma volume per aspiration was nonsignificantly higher in the intravenous cannula group (26.92 vs 19.14, P = .291).

Conclusion:

Ultrasound-guided aspiration performed using an intravenous cannula was comparable to the procedure performed using a conventional needle. Furthermore, the former method can be safer and effective alternative to manage peri-prosthetic seroma.
Efficacy and safety of intra-arterial chemotherapy combined with intravesical chemotherapy for high-risk non-muscle invasive bladder cancer
Authors: Li Xing , Ma Haohao , Shu Kunpeng , Wang Lingdian , Ding Degang
Published: December 2019

Background:

Non-muscle invasive bladder cancer (NMIBC) is the most common bladder cancer. Many studies have reported that intra-arterial chemotherapy (IAC) combined with intravesical chemotherapy (IVC) could effectively reduce the recurrence rate of NMIBC. The purpose of this study is to assess the efficacy and safety of IAC combined with IVC for patients with high-risk NMIBC.

Methods:

PubMed, Cochrane Library, Medline, Embase, Web of Science, and 4 Chinese databases will be searched for eligible studies published without language restrictions from their inception up August 31, 2019. Subgroup analysis will be mainly explored in study design, types of chemotherapy drugs, and sample size. Cochrane Collaboration Risk of bias Tool will be applied in evaluating the quality of enrolled articles. Statistical analysis will be carried out by the Stata version 14.0 software.

Results:

The primary outcome is recurrence-free survival (RFS). The secondary outcomes include overall survival (OS), progression-free survival (PFS), adverse reactions and toxicity grade coded by common toxicity criteria for adverse events.

Conclusion:

The findings of this study will provide latest evidence to verify whether IAC combined with IVC is more effective and safer than IVC alone for patients with high-risk NMIBC.

PROSPERO registration number:

CRD42019146847
Epidemiology of acute pediatric poisonings in Spain: a prospective multicenter study from the Spanish Society of Pediatric Emergency Medicine
Authors: Santiago Paula , Bilbao Nerea , Martinez-Indart Lorea , Mintegi Santiago , Azkunaga Beatriz
Published: December 2019

Objective:

To identify types of childhood poisoning exposures leading to consultation to emergency departments (ED) in Spain.

Methods:

We carried out a multicenter prospective registry-based cohort study including children with acute poisonings presenting to 55 pediatric EDs of the Spanish Society of Pediatric Emergency Medicine between 2008 and 2017, during previously designated certain days.

Results:

During the study period, we registered 749 803 pediatric ED presentations, of which 1749 were for poisonings (0.23%). Most commonly involved toxicants were therapeutic drugs (845, 48.3%), household products (387, 22.1%), ethanol (168, 9.6%), cosmetics (88, 5%) and CO (73, 4.2%). We identified five types of poisoning presentations. Two types occurring at home involving young children accounted for 1368 episodes (78.2%): non-intentional ingestions and dosage error of therapeutic drugs (791, 45.2%), and non-intentional ingestions of household products and cosmetics (577, 33%). Most commonly involved toxicants were benzodiazepines and detergents in each group. The remaining three groups required more interventions in the ED and had a lower rate of outpatient management: intentional ingestion of therapeutic drugs (105, 6%, frequently suicide attempts, mainly with benzodiazepines or combinations of therapeutic drugs), non-intentional inhalation of CO (76, 4.3%) and recreational ingestion of ethanol or use of illicit drugs (200, 11.4%). The distribution of these groups showed differences related to sex, domestic habits of storage of toxicants, symptoms, management in the ED and patient disposition.

Conclusion:

We identified five different types of childhood poisoning presentations to Spanish EDs. Best practices need to be identified for prevention of these episodes. European Journal of Emergency Medicine XXX: 000–000 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Extrapancreatic Inflammation on Magnetic Resonance Imaging for the Early Prediction of Acute Pancreatitis Severity
Authors: Zhou Ting , Chen Yong , Wu Jia-Long , Deng Yan , Zhang Ju , Sun Huan , Lan Chuan , Zhang Xiao-ming
Published: December 2019

Objectives

This work aimed to study the early predictive value of extrapancreatic inflammation on magnetic resonance imaging (EPIM) for acute pancreatitis (AP) severity.

Methods

The EPIM score, magnetic resonance severity index, Acute Physiology and Chronic Health Evaluation (APACHE II) score, bedside index of severity in AP, and high-sensitivity C-reactive protein levels were evaluated for 337 AP patients. The extrapancreatic inflammation on computed tomography (EPIC) was also assessed for 86 patients undergoing computed tomography. The predictive values of these scores for severe AP and organ failure were evaluated using receiver operating characteristic curve analyses.

Results

Of the 337 AP patients, 55 (16.3%) had organ failure and 17 (5.0%) had severe AP. The EPIM showed a strong correlation with the EPIC (r = 0.794, P < 0.001) and had a higher correlation with the APACHE II and hospital stay compared with the EPIC. The accuracy of the EPIM in predicting severe AP and organ failure (areas under the curve, 0.844 and 0.817) was consistent with that of the APACHE II and bedside index of severity in AP, and higher than that of the magnetic resonance severity index.

Conclusion

The EPIM is more helpful in assessing AP severity than the EPIC and can indicate the occurrence of severe AP and organ failure early.
Endometrioid Tubal Intraepithelial Neoplasia (E-TIN) of the Fallopian Tube: A Case Series
Authors: Hecht Jonathan L. , Lin Douglas I. , Garrett Leslie
Published: December 2019

Although serous tubal intraepithelial carcinoma has been well described in the distal fallopian tube as precancers of pelvic high-grade serous carcinoma, endometrioid precancers have drawn less attention. Recently, endometrioid precursor lesions have been identified and reported to have a specific immunophenotype (PAX2−, ALDH1+, diffuse nuclear beta-catenin), as well as an association with both uterine and ovarian endometrioid carcinomas. These have been referred to as endometrioid (or type II) secretory cell outgrowths. A subset of endometrioid secretory cell outgrowths show architectural complexity resembling hyperplasia of the endometrium and have been referred to as endometrioid tubal intraepithelial neoplasia. We report 4 cases of endometrioid tubal intraepithelial neoplasia with clinical correlation and morphologic differential diagnosis.
PAX8-positive, Cytokeratin-positive Intra-abdominal Ewing Sarcoma Masquerading as a Mullerian Carcinoma in a Postmenopausal Female
Authors: Shiyanbola Oyewale , Buehler Darya , Fritchie Karen , Weisman Paul
Published: December 2019

Extraskeletal Ewing sarcoma presenting as intra-abdominal or pelvic disease in adult female patients is very rare and may lead to diagnostic difficulty due to clinical and histologic overlap with Mullerian adenocarcinomas, which are far more common. We report a case of an intra-abdominal Ewing sarcoma in a postmenopausal female patient whose clinical and radiological presentation closely resembled that of peritoneal carcinomatosis. Biopsy of an omental nodule revealed numerous histologic features suggestive of a Mullerian carcinoma, including gland-like rosettes, strong, diffuse PAX8 immunoreactivity and cytokeratin expression. After excluding other differential diagnostic considerations, the possibility that this might represent an intra-abdominal Ewing sarcoma was entertained. Reverse transcriptase polymerase chain reaction testing demonstrated the presence of an EWSR1-ERG fusion transcript, confirming the diagnosis. The differential diagnostic considerations when dealing with this unusual clinical scenario and the uncommon yet important pitfall of PAX8 immunoreactivity in Ewing sarcoma are discussed.
The Quebec Low Back Pain Study: a protocol for an innovative 2-tier provincial cohort
Authors: Pagé Gabrielle M. , Lacasse Anaïs ,   the Quebec Back Pain Consortium (in alphabetical order), Beaudet Nicolas , Choinière Manon , Deslauriers Simon , Diatchenko Luda , Dupuis Laurent , Grégoire Stéphanie , Hovey Richard , Leclair Erwan , Leonard Guillaume , Meloto Carolina B. , Montagna Francesca , Parent Alexandre , Rainville Pierre , Roy Jean-Sébastien , Roy Mathieu , Ware Mark A. , Wideman Timothy H. , Stone Laura S.
Published: December 2019

Introduction:

The neurobiological mechanisms underlying recovery from or persistence of low back pain (LBP) remain misunderstood, limiting progress toward effective management. We have developed an innovative two-tier design to study the transition from acute to chronic LBP. The objective of the first tier is to create a provincial web-based infrastructure to recruit and monitor the trajectory of individuals with acute LBP. The objective of the second tier is to fuel hypothesis-driven satellite data collection centers with specialized expertise to study the role of biomechanical, epigenetic, genetic, neuroanatomical, ontological, physiological, psychological, and socioeconomic factors in LBP chronicity.

Methods:

This article describes the first tier of the protocol: establishment of the Core Dataset and Cohort. Adults with acute LBP will be recruited through networks, media, and health care settings. A web-based interface will be used to collect self-reported variables at baseline and at 3, 6, 12, and 24 months. Acute LBP will be defined according to the Dionne 2008 consensus. Measurements will include the Canadian minimum data set for chronic LBP research, DN4 for neuropathic pain, comorbidities, EQ-5D-5L for quality of life, and linkage with provincial medico-administrative databases. The primary outcome will be the transition to chronic LBP, as defined by Deyo 2014. Secondary outcomes include health care resource utilization, disability, sick leave, mood, and quality of life.

Perspective:

This study brings together diverse research expertise to investigate the transition from acute to chronic LBP, characterize the progression to recovery or chronicity, and identify patterns associated with that progression.
Improvements in clinical pain and experimental pain sensitivity after cognitive functional therapy in patients with severe persistent low back pain
Authors: Vaegter Henrik Bjarke , Ussing Kaper , Johansen Jannick Vaaben , Stegemejer Irene , Palsson Thorvaldur Skuli , O'Sullivan Peter , Kent Peter
Published: December 2019

Introduction:

Multidisciplinary care is recommended for disabling persistent low back pain (pLBP) nonresponsive to primary care. Cognitive functional therapy (CFT) is a physiotherapy-led individualised intervention targeting psychological, physical, and lifestyle barriers to recovery, to self-manage pLBP.

Objectives:

This pilot study investigated clinical outcomes and pain thresholds after a 12-week CFT pathway in patients with severe pLBP referred to a University Pain Center. Exploratory analyses compared changes in clinical outcomes, opioid consumption, and costs after CFT with changes after a multidisciplinary pain management (MPM) pathway.

Methods:

In total, 47 consecutively referred pLBP patients consented to the CFT pathway. At baseline, 3 and 6 months, clinical outcomes and PPTs were assessed. Control patients (n = 99) who had completed an MPM pathway in the last 3 years were matched from the clinical pain registry used in the Pain Center in a 3:1 ratio based on propensity scores derived from relevant baseline variables of the CFT cases.

Results:

Most clinical outcomes and low back pressure pain threshold were improved at 3 and 6 months after the CFT pathway. Compared with MPM, CFT patients had significantly larger reductions in disability and improved quality of life after the interventions at a lower cost (−3688€ [confidence interval: −3063 to −4314€]). Reduction in pain intensity and proportion of patients withdrawing from opioids (18.2% vs 27.8%) were similar between CFT and MPM groups.

Conclusion:

Improvements in clinical and experimental pain were found after the CFT pathway. Fully powered randomized controlled trials comparing CFT with an MPM program in patients with disabling pLBP are warranted to control for the current limitations.
Imaging of Novel Oncologic Treatments in Lung Cancer Part 1
Authors: Halpenny Darragh , O’Dwyer Elisabeth , Girshman Jeffrey , Ginsberg Michelle S.
Published: December 2019

Thoracic tumors are a leading cause of cancer-related morbidity and mortality. In recent years, developments in oncologic treatments for these tumors have ushered in an era of targeted therapy, and, in many cases, these novel treatments have replaced conventional strategies to become standard therapeutic options, particularly in those with lung cancer. Targeted medical therapies for lung cancer now include angiogenesis inhibitors, tyrosine kinase inhibitors, and immunotherapeutic agents. Several novel ablative therapies have also gained widespread acceptance as alternatives to conventional surgical options in appropriately selected patients. Tumors treated with targeted medical therapies can respond to treatment differently when compared with conventional therapies. For example, pseudoprogression is a well-described phenomenon in patients receiving checkpoint inhibitor immunotherapy in which an initial increase in tumor burden is followed by a decrease in tumor burden and sometimes partial or complete response, while the frequent cavitating responses seen when antiangiogenic agents are used can be difficult to quantify using existing response assessment criteria. In some cases, novel response assessment criteria are needed to adequately capture response. In addition, numerous treatment-related side effects have been described, which are important to recognize, both to ensure appropriate treatment and to avoid misclassification as worsening tumor. Imaging plays a vital role in the assessment of patients receiving targeted medical therapy, and it is essential that thoracic radiologists are familiar with the rationale underpinning these treatments and the expected posttherapy findings.
Cardiac Magnetic Resonance in Patients With Cardiac Implantable Electronic Devices
Authors: Rajiah Prabhakar , Kay Fernando , Bolen Michael , Patel Amit R. , Landeras Luis
Published: December 2019

Until recently, cardiac implantable electronic devices (CIEDs) were an absolute contraindication to magnetic resonance imaging (MRI), due to concerns about their adverse interaction in the MRI environment. The increasing clinical need to perform MRI examinations in these patients was an impetus to the development of MR-Conditional CIEDs. Secure performance of MRI in these patients requires scanning under specified MR conditions as well as operating the device in MR-scanning mode. This requires robust institutional protocols and a well-trained multidisciplinary team of radiologists, cardiologists, device applications specialists, physicists, nurses, and MRI technologists. MRI can also be performed in patients with non-MRI Conditional or “legacy” CIEDs by following safety precautions and continuous monitoring. Cardiac magnetic resonance (CMR) is additionally challenging due to expected susceptibility artifacts generated by the CIEDs, which are either near or in the heart. As the most common indication for CMR in these patients is the evaluation of myocardial scar/fibrosis, acquiring a high-quality late gadolinium enhancement image is of the utmost importance. This sequence is hampered by artifactual high signal due to inadequate myocardial nulling. Several solutions are available to reduce these artifacts, including reducing inhomogeneity, technical adjustments, and use of sequences that are more resilient to artifacts. In this article, we review the precautions for CMR in patients with CIEDs, provide guidelines for secure performance of CMR in these patients, and discuss techniques for obtaining high quality CMR images with minimized artifacts.
How Should the Surgical Approach In Thyroidectomy Be Selected? A Prospective Study Comparing the Trauma of 3 Different Thyroidectomy Surgical Approaches
Authors: Jian Chen-xing , Wu Li-min , Zheng Zi-fang , Liu Wei , Fang Jian-ying , Tu Hai-jian
Published: December 2019

Objective:

To compare the trauma of 3 different surgical approaches and provide a reference for clinicians in choosing the operative procedure.

Patients and Methods:

A total of 150 patients were divided into the total endoscopic thyroidectomy (TET), endoscopic-assisted thyroidectomy (EAT), and conventional open thyroidectomy (COT) groups, with 50 patients in each group. The peripheral blood C-reactive protein (CRP) levels at different postoperative time points, operative time, intraoperative blood loss, postoperative drainage volume, postoperative pain, degree of satisfaction with the incision appearance, postoperative extubation time, and swallowing discomfort 3 months after surgery were compared among the groups that received different surgical approaches.

Results:

The operative time of TET was longer than that of COT and EAT. The intraoperative blood loss was significantly lower in the TET and EAT groups than in the COT group. The postoperative drainage volume was lowest after EAT and highest after TET. The extubation time was significantly shorter after EAT than after TET and COT. The 6-hour CRP level was significantly higher after TET than after EAT and COT, and the 24-hour CRP level was better in the EAT group than in the other 2 groups. The CRP levels at 72 hours postoperatively were lowest in the EAT group and highest in the TET group. Postoperative pain was significantly lower after EAT than after TET and COT. Cosmetic satisfaction was highest in the TET group and lowest in the COT group. Swallowing discomfort was lowest in the EAT group and highest in the TET group. There was a positive correlation between the drainage volume on the first postoperative day, the drainage tube removal time, dysphagia, and the CRP level in each period. There was a positive correlation between pain, cosmetic satisfaction and CRP in 2 of the time periods.

Conclusions:

All 3 types of thyroidectomy are safe and reliable in benign tumor resection. Therefore, in clinical practice, the age, sex, and cosmetic needs of the patients, and the oncological safety should all be considered to provide patients with the most appropriate recommendations. In view of oncological safety, TET should be carefully selected for malignant tumor resection.
Levonorgestrel modulates innate immune activation in human endocervical epithelium and monocytes duringChlamydia trachomatisinfection
Authors: Eastman Alison J. , Liu Sophia , Bell Jason D.
Published: December 2019

Problem

Our group has previously shown that baboons with a levonorgestrel-releasing intrauterine system (LNG-IUS) have delayed clearance ofChlamydia trachomatis(Ct). Based on this result, we hypothesized that LNG results in changes to development of the immune response by epithelial and resident innate immune cells.

Method of Study

Using the end1 endocervical cell line or the THP.1 monocyte-like cell line, cells were exposed to increasing levels of progesterone (P4) or a dose of LNG representative of LNG in reproductive tract tissues of women with an LNG-IUS. Ct was used at an MOI of 1 and supernatants were collected for ELISA at 48 hours post-infection. Select nuclear receptors were inhibited to determine which receptor contributed to LNG-mediated immunosuppression.

Results

Cervical epithelial cells infected with Ct expressed IL-1β when treated with vehicle control. P4 further increased IL-1β expression during Ct infection, while LNG decreased IL-1β expression. Treatment with the androgen receptor blocker ailanthone prevented LNG-mediated immunosuppression.

Conclusions

LNG in the presence of increasing P4 suppresses IL-1β production in response to Ct infectionin vitro. This appears to be mediated at least in part by the androgen receptor. This has implications for women with LNG-IUS at high risk for sexually transmitted infections.
LGI1 downregulation increases neuronal circuit excitability
Authors: Lugarà Eleonora , Kaushik Rahul , Leite Marco , Chabrol Elodie , Dityatev Alexander , Lignani Gabriele , Walker Matthew C.
Published: December 2019

LGI1 (Leucine-Rich Glioma-Inactivated 1) is a secreted trans-synaptic protein that interacts presynaptically with Kv1.1 potassium channels and ADAM23, and postsynaptically, influencing AMPA receptors through a direct link with the ADAM22 cell adhesion protein. Haploinsufficiency of LGI1 or autoantibodies directed against LGI1 are associated with human epilepsy, generating the hypothesis that a subacute reduction of LGI1 is sufficient to increase network excitability. We tested this hypothesis inex vivohippocampal slices and in neuronal cultures, by subacutely reducing LGI1 expression with shRNA. Injection of shRNA-LGI1 in the hippocampus increased dentate granule cell excitability and low frequency facilitation of mossy fibers to CA3 pyramidal cell neurotransmission. Application of the Kv1 family blocker, alpha-dendrotoxin, occluded this effect, implicating the involvement of Kv1.1. This subacute reduction of LGI1 was also sufficient to increase neuronal network activity in neuronal primary culture. These results indicate that a subacute reduction in LGI1 potentiates neuronal excitability and short-term synaptic plasticity, and increases neuronal network excitability, opening new avenues for the treatment of limbic encephalitis and temporal lobe epilepsies.

Significant Statement

Down-regulation of LGI1 protein increases excitability at mossy fiber to CA3 pyramidal cell synapses and in hippocampal primary cultures. These alterations alter network function and so could contribute to symptoms observed in patients affected by limbic encephalitis.
sisterless Ais required for activation ofSex lethalin theDrosophilagermline
Authors: Goyal Raghav , Baxter Ellen , Van Doren Mark
Published: December 2019

Both somatic cells and germ cells must establish their correct sexual identity for proper gametogenesis. InDrosophila,sex determination in somatic cells is controlled by the switch geneSex lethal(Sxl), which is activated in females by the presence of two X chromosomes. Though germline sex determination is much less well understood,Sxlis also essential for the female identity in germ cells. Loss ofSxlfunction in the germline results in ovarian germline tumors, a characteristic of male germ cells developing in a female soma. Further,Sxlexpression is sufficient for XY (male) germ cells to produce eggs when transplanted into XX (female) somatic gonads. As in the soma, the presence of two X chromosomes activatesSxlin the germline, but the mechanism for “counting” X chromosomes in the germline is thought to be different from the soma. Here we have explored this mechanism at bothcis- andtrans-levels. Our data support the model that theSxl“establishment” promoter (SxlPE) is activated in a female-specific manner in the germline, as in the soma, but that the timing ofSxlPEactivation, and the DNA elements that regulateSxlPE,are different in the germline. Nevertheless, we find that the X chromosome genesisterless A (sisA),which helps activateSxlin the soma, is also essential forSxlactivation in the germline. Loss ofsisAleads causes of Sxl expression in the germline, and to ovarian tumors and germline loss. These defects can be rescued by Sxl expression, demonstrating thatsisAlies upstream ofSxlin germline sex determination. We conclude thatsisAacts as an X chromosome counting element in both the soma and the germline, but that additional factors regulating female-specific expression ofSxlin the germline remain to be discovered.

AUTHOR SUMMARY

The production of sperm and eggs requires proper sexual identity to be established in both somatic cells and the germ cells, which ultimately produce the gametes. While somatic sex determination has been well studied in a number of organisms, how germ cells establish their sexual identity is much less well understood. In Drosophila, the RNA binding protein Sex lethal (Sxl) is essential for female sexual identity in both the soma and the germline, but its regulation in the germline is thought to be different than in the soma. Here we explore howSxlis activated in the germline. We find that the germline uses a different set of DNA elements to control activation of the key sex-specificSxlpromoter. Nonetheless, one of the activators ofSxlin the soma, the transcription factor Sisterless A (SisA), also acts to activateSxlin the germline. Our data indicate that, while SisA acts as a common activator in both the soma and germline, additional, germline-specificSxlactivators remain to be discovered.
Disease associated protein-protein interaction network reconstruction based on comprehensive influence analysis
Authors: Zhu Fei , Li Feifei , Ling Xinghong , Liu Quan , Shen Bairong
Published: December 2019

Proteins and their interactions are fundamental to biological system. With the scientific paradigm shifting to systems biology, functional study of proteins from a network viewpoint to get a deep understanding of their roles in human life and diseases being increasingly essential. Although several methods already existed for protein-protein interaction (PPI) network building, the precise reconstruction of disease associated PPI network remains a challenge. In this paper we introduce a novel concept of comprehensive influence of proteins in network, in which direct and indirect connections are adopted for the calculation of influential effects of a protein with different weights. With the optimized weights, we calculate and select the important proteins and their interactions to reconstruct the PPI network for further validation and confirmation. To evaluate the performance of the method, we compared our model with the six existed ones by using five standard data sets. The results indicated that our method outperforms the existed ones. We then applied our model to prostate cancer and Parkinson’s disease to predict novel disease associated proteins for the future experimental validation.

Author Summary

The diverse protein-protein interaction networks have dramatic effects on biological system. The disease associated PPI networks are generally reconstructed from experimental data with computational models but with limited accuracy. We developed a novel concept of comprehensive influence of proteins in network for reconstructing the PPI network. Our model outperforms the state-of-the-art ones and we then applied our model to identify novel interactions for further validation.
Phase-contrast 3D tomography of HeLa cells grown in PLLA polymer electrospun scaffolds using synchrotron X-rays
Authors: Bhartiya A. , Madi K. , Disney C. M. , Courtois L. , Jupe A. , Zhang F. , Bodey A. J. , Lee P. , Rau C. , Robinson I. K. , Yusuf M.
Published: December 2019

Advanced imaging is useful for understanding the three-dimensional (3D) growth of cells. X-ray tomography serves as a powerful noninvasive, nondestructive technique that can fulfill these purposes by providing information about cell growth within 3D platforms. There are a limited number of studies taking advantage of synchrotron X-rays, which provides a large field of view and suitable resolution to image cells within specific biomaterials. In this study, X-ray synchrotron radiation microtomography at Diamond Light Source and advanced image processing were used to investigate cellular infiltration of HeLa cells within poly L-lactide (PLLA) scaffolds. This study demonstrates that synchrotron X-rays using phase contrast is a useful method to understand the 3D growth of cells in PLLA electrospun scaffolds. Two different fiber diameter (2 and 4 µm) scaffolds with different pore sizes, grown over 2, 5 and 8 daysin vitro, were examined for infiltration and cell connectivity. After performing visualization by segmentation of the cells from the fibers, the results clearly show deeper cell growth and higher cellular interconnectivity in the 4 µm fiber diameter scaffold. This indicates the potential for using such 3D technology to study cell–scaffold interactions for future medical use.
Gratitude in franchisor-franchisee relationships: does personality matter?
Authors: Quach Sara , Weaven Scott K. , Thaichon Park , Baker Brent , Edwards Chase Jeremiah
Published: December 2019

Purpose

This paper aims to investigate the emerging relevance of gratitude within a contracted, long-term business-to-business context. Specifically, the authors examine the relationships between personality, gratitude and performance in franchisor–franchisee relationships.

Design/methodology/approach

A self-report survey was used to collect data from a sample of 225 franchisees drawn from across 28 franchise systems.

Findings

The results reveal that extraversion had a negative relationship with gratitude, while agreeableness and emotional stability were positively related to gratitude. Gratitude was also positively related to performance and mediated the relationship between extraversion, agreeableness and emotional stability and performance. Moreover, the results confirm that relationship length moderated the relationship between conscientiousness and gratitude.

Research limitations/implications

The study shows that an individual’s personality is a factor in determining the onset of perceived gratitude, which acts as a mediating mechanism between personality and performance. This extends current research into the relational sentiment of gratitude, which has, to date, only examined the traits of the benefactor within the context of perceived benefits.

Practical implications

It is proposed that the knowledge of franchisees’ personal characteristics can be used to develop and maintain on-going interpersonal relationships between franchisees and franchisors. Moreover, the authors suggest that franchisors’ relationship strategy should be revised over time to maintain its effectiveness.

Originality/value

This paper represents the first empirical examination of the influence of personality on an individual’s proclivity to experience felt gratitude in a franchisor–franchisee relationship. This addresses one of the major issues in franchising research, which often overlooks the role of individual dispositional personality traits.
Study on mechanical properties of non-dispersible concrete in seawater environment
Authors: Wu Huijun
Published: December 2019

Purpose

The purpose of this paper is to research the hardened properties of non-dispersible concrete in seawater environment, especially in seawater environment.

Design/methodology/approach

The main approach is according to the experiment.

Findings

The findings of this paper are: first, because of the washing effect of water, the strength of underwater non-dispersible concrete is lower than that of terrestrial concrete. Second, the strength of non-dispersible underwater concrete with silica fume increases remarkably at different ages. Third, underwater non-dispersible concrete does not produce new products when it is formed and cured in seawater.

Originality/value

In this paper, underwater non-dispersible concrete is formed and maintained on land, freshwater and seawater by underwater pouring method. The working performance, mechanical properties and durability of underwater non-dispersible concrete mixtures after hardening are tested.