bluuebunny/crossref_metadata_2025 huggingface dataset:
Local and Systemic Inflammation and Oxidative Stress After a Single Bout of Maximal Walking in Patients With Symptomatic Peripheral Artery Disease
Authors: Andrade-Lima Aluisio , da Silva Junior Natan , Chehuen Marcel , Miyasato Roberto , Souza Rodrigo W.A. , Leicht Anthony S. , Brum Patricia C. , de Oliveira Edilamar M. , Wolosker Nelson , Forjaz Claudia L.M.
Published: May 2020

Objective

The aim of this study was to assess the effects of a single bout of maximal walking on blood and muscle nitric oxide (NO) bioavailability, oxidative stress, and inflammation in symptomatic peripheral artery disease (PAD) patients.

Methods

A total of 35 men with symptomatic PAD performed a graded maximal exercise test on a treadmill (3.2 km/h, 2% increase in grade every 2 minutes). Plasma samples and gastrocnemius muscle biopsies were collected preexercise and postexercise for assessment of NO bioavailability (plasma NO and muscle, endothelial NO synthase), oxidative stress and antioxidant function (lipid peroxidation [LPO], catalase [CAT], and superoxide dismutase), and inflammation (interleukin-6, C-reactive protein, tumor necrosis factor-α, intercellular adhesion molecules, and vascular adhesion molecules). The effects of the walking exercise were assessed using paired t tests or Wilcoxon tests.

Results

After maximal walking, plasma NO and LPO were unchanged (P > .05), plasma CAT decreased, and all blood inflammatory markers increased (all P ≤ .05). In the disease-affected skeletal muscle, endothelial NO synthase, CAT, LPO, and all inflammatory markers increased, whereas superoxide dismutase decreased (all P ≤ .05).

Conclusion

In patients with symptomatic PAD, maximal exercise induces local and systemic impairments, which may play a key role in atherogenesis. Exercise strategies that avoid maximal effort may be important to reduce local and systemic damage and enhance clinical benefits.
Estimating the Impact of Verification Bias on Celiac Disease Testing
Authors: Hujoel Isabel A. , Jansson-Knodell Claire L. , Hujoel Philippe P. , Hujoel Margaux L.A. , Choung Rok Seon , Murray Joseph A. , Rubio-Tapia Alberto
Published: May 2020

Goal:

The goal of this study was to estimate the impact of verification bias on the diagnostic accuracy of immunoglobulin A tissue transglutaminase (IgA tTG) in detecting celiac disease as reported by an authoritative meta-analysis, the 2016 Comparative Effectiveness Review (CER).

Background:

Verification bias is introduced to diagnostic accuracy studies when screening test results impact the decision to verify disease status.

Materials and Methods:

We adjusted the sensitivity and specificity of IgA tTG reported by the 2016 CER with the proportion of IgA tTG positive and negative individuals who are referred for confirmatory small bowel biopsy. We performed a systematic review from January 1, 2007, to July 19, 2017, to determine these referral rates.

Results:

The systematic review identified 793 articles of which 9 met inclusion criteria (n=36,477). Overall, 3.6% [95% confidence interval (CI): 1.1%-10.9%] of IgA tTG negative and 79.2.2% (95% CI: 65.0%-88.7%) of IgA tTG positive individuals were referred for biopsy. Adjusting for these referral rates the 2016 CER reported sensitivity of IgA tTG dropped from 92.6% (95% CI: 90.2%-94.5%) to 57.1% (95% CI: 35.4%-76.4%) and the specificity increased from 97.6% (95% CI: 96.3%-98.5%) to 99.6% (95% CI: 98.4%-99.9%).

Conclusions:

The CER may have largely overestimated the sensitivity of IgA tTG due to a failure to account for verification bias. These findings suggest caution in the interpretation of a negative IgA tTG to rule out celiac disease in clinical practice. More broadly, they highlight the impact of verification bias on diagnostic accuracy estimates and suggest that studies at risk for this bias be excluded from systematic reviews.
Association between interleukin-10-819T/C polymorphism and risk of ischemic stroke
Authors: Zuo Shuang , Zheng Tingting , Li Haishan
Published: May 2020

Background:

The interleukin-10 (IL-10)-819T/C polymorphism has been indicated to be correlated with ischemic stroke susceptibility, but this relationship remains controversial. A meta-analysis was conducted to investigate the potential association between IL-10-819T/C polymorphism and ischemic stroke risk.

Methods:

Databases including Pubmed, Embase, and CNKI were searched. Data were extracted and odds ratios (OR) with 95% confidence intervals (CI) were calculated.

Results:

Eight case-control studies with 1832 cases and 1520 controls were included in this meta-analysis. IL-10-819T/C polymorphism may decrease the risk of ischemic stroke (C vs T: OR = 1.01, 95% CI: 0.91–1.12; CC vs TT: OR = 0.91, 95% CI: 0.73–1.14; CT vs TT: OR = 1.10, 95% CI: 0.95–1.28; CC + CT vs TT: OR = 1.06, 95% CI: 0.92–1.22; CC vs CT + TT: OR = 0.91, 95% CI: 0.75–1.11). In the stratified analysis by sample size, and case-control matched status, significant associations were still not observed in all genetic models. In the subgroup meta-analysis based on source of controls, IL-10-819T/C polymorphism had decreased ischemic stroke risk for recessive model in population-based controls’ subgroup (CC vs CT + TT: OR = 0.69, 95% CI: 0.50–0.95), but not in the hospital-based controls’ subgroup. In the stratified analysis based on ethnicity, IL-10-819T/C polymorphism had decreased ischemic stroke risk for recessive model in Asian populations (CC vs CT + TT: OR = 0.78, 95% CI: 0.62–0.99), but not in Caucasian populations.

Conclusions:

In conclusion, the results suggest that the IL-10-819T/C polymorphism is not associated with ischemic stroke risk. Larger scale studies are needed for confirmation.
The cost-effectiveness of empirical antibiotic treatments for high-risk febrile neutropenic patients
Authors: Tori Katerina , Tansarli Giannoula S. , Parente Diane M. , Kalligeros Markos , Ziakas Panayiotis D. , Mylonakis Eleftherios
Published: May 2020

Purpose:

Febrile neutropenia has a significant clinical and economic impact on cancer patients. This study evaluates the cost-effectiveness of different current empiric antibiotic treatments.

Methods:

A decision analytic model was constructed to compare the use of cefepime, meropenem, imipenem/cilastatin, and piperacillin/tazobactam for treatment of high-risk patients. The analysis was performed from the perspective of U.S.-based hospitals. The time horizon was defined to be a single febrile neutropenia episode. Cost-effectiveness was determined by calculating costs and deaths averted. Cost-effectiveness acceptability curves for various willingness-to-pay thresholds (WTP), were used to address the uncertainty in cost-effectiveness.

Results:

The base-case analysis results showed that treatments were equally effective but differed mainly in their cost. In increasing order: treatment with imipenem/cilastatin cost $52,647, cefepime $57,270, piperacillin/tazobactam $57,277, and meropenem $63,778. In the probabilistic analysis, mean costs were $52,554 (CI: $52,242-$52,866) for imipenem/cilastatin, $57,272 (CI: $56,951-$57,593) for cefepime, $57,294 (CI: $56,978-$57,611) for piperacillin/tazobactam, and $63,690 (CI: $63,370-$64,009) for meropenem. Furthermore, with a WTP set at $0 to $50,000, imipenem/cilastatin was cost-effective in 66.2% to 66.3% of simulations compared to all other high-risk options.

Discussion:

Imipenem/cilastatin is a cost-effective strategy and results in considerable health care cost-savings at various WTP thresholds. Cost-effectiveness analyses can be used to differentiate the treatments of febrile neutropenia in high-risk patients.
Anlotinib combined with etoposide for platinum-resistant recurrent ovarian cancer
Authors: Sun Li , Yang Meng , Zhang Xuan , Li Hua , Wu Lingying , Zhang Yuzi , Cai Shangli
Published: May 2020

Introduction:

Platinum-resistant ovarian cancer is characterized by its poor prognosis and limited treatment options. Angiogenesis plays a fundamental role in the development of drug-resistance in ovarian cancer. Anlotinib, a novel oral multi-targeted tyrosine kinase inhibitor which targets a board spectrum of angiogenesis-associated growth factor receptors, has shown promising anti-tumor efficacy in clinical trials. Herein, we report a case of ovarian cancer treated with anlotinib plus etoposide after secondary cytoreductive surgery.

Patient concerns:

A 45-year-old female with primary platinum-resistant ovarian cancer who progressed rapidly after the first cytoreductive surgery, the second cytoreductive surgery, and several lines of treatment. The patient refused to receive intravenous chemotherapy any more.

Diagnosis:

Primary platinum-resistant ovarian cancer.

Interventions:

The oral combination treatment of anlotinib (12 mg, qd) and etoposide (100 mg, qd) were delivered.

Outcomes:

Finally, the patient was responsive to the orally treatment of anlotinib combined with etoposide. The patient has been alive with no evidence of disease progression for 18 weeks.

Conclusion:

Our case suggests that oral treatment of anlotinib combined with etoposide which is acceptable and convenient, may be an additional option for the management of platinum-resistant ovarian cancer.
Exercise or sport activities for patients with cancer
Authors: Wang Fang-fang , Yuan Yang , Song Yu-jun , Wu Yan-qiong , He Yun , Deng Xiu-xiu , Wu Shui-lin , Dai Ding-mei , Wang Min
Published: May 2020

Objective:

We plan to review all published systematic reviews (SRs) and meta-analyses (MAs) of exercise or sport activities for patients with cancer. The aim of this study is to combine and reanalyze related data and to provide more comprehensive and higher-level evidence.

Methods:

We plan to search four English databases and four Chinese databases from inception to June 2019. Patients who were treated by all of exercise or sport activities such as running, gymnastics, taichi, and qigong, will be included. The following information will be extracted from each included SR: first author, year of publication, country of origin, number of primary study; the number of patients enrolled, participant characteristics, duration of cancer diagnosis, cancer types. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and A Measurements Tool to Assess Systematic Reviews 2 (AMSTAR-2) will be used to assess the reporting and methodological quality of SRs/MAs. The characteristics of included SRs/MAs and their quality will be descriptively summarized using systematically structured tables. The network MA approach and narrative synthesis will be used to examine data when applicable. Odds ratio and (standardized) mean difference with their 95% confidence intervals will be used as summary statistics. Stata 13.0 software will be used to analyze and pool data.

Results:

The results of the overview will be submitted to a peer-reviewed journal for publication.

Ethics and dissemination:

The study is not a clinical study, and we will search and evaluate existing sources of literature. So, ethical approval is not required.
The effects of physical activity on physiological markers in breast cancer survivors
Authors: Kang Xin-Yao , Xu Qun-Ying , Yu Ze , Han Shu-Fang , Zhu Yu-Fang , Lv Xin
Published: May 2020

Background:

To systematically evaluate the effects of physical activity on physiological markers in breast cancer survivors.

Methods:

A systematic search of the PubMed, Wed of Science, Medline, CNKI and Wanfang Database was performed to identify eligible randomized controlled trials to explore physical activity on physiological markers in breast cancer survivors. STATA version 13.0 (Stata Corp LP, College Station, TX) was used for all statistical analyses.

Results:

A total of 11 articles with 941 cases were eligible in this meta-analysis. The results of the meta-analysis showed that physical activity could decrease the levels of insulin (SMD = −1.90, 95%CI: −3.2 to −0.60; I2 = 92.3%, P < .001), insulin-like growth factor 1 (IGF-I) (WMD = −4.67, 95%CI: −23.14 to 13.79; I2 = 96.2%, P < .001), insulin-like growth factor binding protein-3 (IGFBP-3) (WMD = −20.09, 95%CI: −47.15 to 6.97; I2 = 93.3%, P < .001). However, compared with the control group, there was not the significant change of insulin-like growth factor 2 (IGF-II), insulin-like growth factor binding protein-1 (IGFBP-1), leptin, adiponectin, glucose, C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-ɑ) levels after the intervention.

Conclusions:

Physical activity could improve the insulin function that might be associated with decreasing the levels of IGF-I, IGFBP-3 and insulin in breast cancer survivors.
Sex-based differences in pediatric supracondylar humerus fractures
Authors: LiBrizzi Christa L. , Klyce Walter , Ibaseta Alvaro , Shannon Claire , Lee R. Jay
Published: May 2020

Supracondylar humerus (SCH) fractures are reported to be approximately twice as common among boys as among girls. Little is known about sex-associated differences in fracture patterns and complications. We compared the incidence of pediatric SCH fractures, injury mechanism (high-energy or low-energy), fracture subtypes, associated neurologic injuries, and treatment types by patient sex.

We reviewed 1231 pediatric SCH fractures treated at 1 center from 2008 to 2017, analyzing sex distributions overall and by year and fracture subtype. We noted patient demographic characteristics, injury mechanisms, neurologic injuries, and treatments (nonoperative or operative). Binomial 2-tailed, chi-squared, and Student's t tests were used for analysis. Multiple logistic regression was performed to assess associations between sex, age, and injury mechanism. Alpha = 0.05.

We found no significant difference in the distribution of girls (52%) vs boys (48%) in our sample compared with a binomial distribution (
P = .11). Annual percentages of fractures occurring in girls ranged from 46% to 63%, and sex distribution did not change significantly over time. The mean (± standard deviation) age at injury was significantly younger for girls (5.5 ± 2.5 years) than for boys (6.1 ± 2.5 years) (P < .001). High-energy injury mechanism was associated with older age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.03–1.06) but not male sex (OR, 1.04; 95% CI, 0.98–1.1). The overall incidence of neurologic injury was 9.5% but boys did not have greater odds of sustaining neurologic injury (OR, 1.03; 95% CI, 1.0–1.1). We found no sex-associated differences in the distribution of Gartland fracture subtypes (P = .13) or treatment type (P = .39).

Compared with boys, girls sustain SCH fractures at a younger age. SCH fractures were distributed equally among girls and boys in our sample. Patient sex was not associated with fracture subtype, injury mechanism, neurologic injury, or operative treatment. These findings challenge the perception that SCH fracture is more common in boys than girls.

Level III, retrospective study.
Dietary supplements for prediabetes
Authors: Liu Dongying , Wen Qing , Liu Min , Gao Yang , Luo Lihong , Zhang Zhuo , Chen Qiu
Published: May 2020

Background:

The number of prediabetic individuals is at a high level worldwide and they have an increased risk of developing diabetes, causing severe physical impairment and heavy financial burden. Recently, using various dietary supplements is increasingly common, and relevant trials of different diseases are increasing correspondingly. The effects of dietary supplements have been confirmed in some studies among prediabetic individuals. However, there remains no comprehensive systematic review to assess the efficacy and safety of dietary supplements intake in prediabetic individuals.

Methods:

We plan to search and retrieve applicable randomized controlled trials of dietary supplements for prediabetic individuals in the following databases before June 2020: PubMed, Web of Science, EMBASE, the Cochrane Library, the Cochrane Central Register of Controlled Trials(CENTRAL), Allied and Complementary Medicine Database(AMED), Chinese Biomedical Literature database, Wan Fang database, Chinese Scientific Journal database (VIP), Chinese National Knowledge Infrastructure database(CNKI), and the ClinicalTrials.gov website. Two reviewers will separately perform study selection, data extraction, methodological quality assessment and quality of evidence assessment. Data analysis and publication bias will be conducted by Review Manager 5.3.

Results and conclusions:

This evidence-based medicine systematic review will prove the efficacy and safety of multifarious dietary supplements for prediabetes.

Ethics and dissemination:

As this systematic review is based merely on already published literature, no approval of the ethics committee is required. We will disseminate this systematic review to a peer-reviewed journal.

Protocol registration number:

INPLASY202040057.
Recent advances in neuroimaging of bladder, bowel and sexual function
Authors: Coolen Rosa L. , Groenendijk Ilse M. , Blok Bertil F.M.
Published: May 2020

Purpose of review

In this review, we summarize recent advances in the understanding of the neural control of the bladder, bowel and sexual function, in both men and women.

Recent findings

Evidence of supraspinal areas controlling the storage of urine and micturition in animals, such as the pontine micturition centre, emerged in the early 20th century. Neurological stimulation and lesion studies in humans provided additional indirect evidence for additional bladder-related brain areas. Thereafter, functional neuroimaging in humans with PET and fMRI provided more direct evidence of the involvement of these brain areas. The areas involved in the storage and expulsion of urine also seem to be involved in the central control of storage and expulsion of feces. Furthermore, most knowledge on the brain control of sexual function is obtained from dynamic imaging in human volunteers. Relatively little is known about the dysfunctional central circuits in patients with pelvic organ dysfunction.

fMRI has been the most widely used functional neuroimaging technique in the last decade to study the central control of bladder function, anorectal function and sexual function. The studies described in this review show which sensory and motor areas are involved, including cortical and subcortical areas. We propose the existence of a switch-like phenomenon located in the pons controlling micturition, defecation and orgasm.
Creating Healthful Work Environments to Deliver on the Quadruple Aim
Authors: Grant Susan , Davidson Judy , Manges Kirstin , Dermenchyan Anna , Wilson Elise , Dowdell Elizabeth
Published: May 2020

Nurses face workplace stressors that contribute to job dissatisfaction, burnout, and turnover, impacting not only patient safety but the nurses' physical and emotional well-being. At the 2018 American Academy of Nursing conference, a policy dialogue “Creating Healthy Work Environments to Address the Quadruple Aim” was convened focusing on creating healthy work environments by addressing stressors such as violence and bullying. That discussion is encapsulated in this article, providing proven and practical strategies for reducing risk.
Military Sexual Trauma and Chronic Pain in Veterans
Authors: Turner Aaron P. , Harding Kaitlin A. , Brier Moriah J. , Anderson Derek R. , Williams Rhonda M.
Published: May 2020

Objective

Chronic pain rehabilitation warrants sensitivity to unique psychosocial factors, such as trauma history. In Veterans of the United States Armed Forces, military sexual trauma (MST) is a pervasive type of trauma associated with a host of physical and psychological sequelae. A growing literature suggests a relationship between history of MST and chronic pain. This study sought to clarify the relationship between MST and chronic pain among male and female Veterans and explore whether individual factors moderate this relationship.

Design

A baseline survey of 328 Veterans seeking care for chronic pain via behavioral pain treatments was conducted.

Results

MST was reported by 31.4% of the sample and uniquely predicted pain interference. A significant interaction was found between MST and age, such that younger Veterans with a history of MST reported greater pain interference than younger Veterans with no MST.

Conclusion

Findings provide further evidence that the experience of MST may intensify the overall burden of chronic pain and suggest that younger Veterans with MST seem to be most vulnerable to impaired pain rehabilitation. Unique study contributions include a robust sample of women and men with elevated rates of MST and examination of MST-age relationships concurrent with chronic pain.
Brief Report: Willingness to Accept HIV-Infected and Increased Infectious Risk Donor Organs Among Transplant Candidates Living With HIV
Authors: Seaman Shanti M. , Van Pilsum Rasmussen Sarah E. , Nguyen Anh Q. , Halpern Samantha E. , You Susan , Waldram Madeleine M. , Anjum Saad K. , Bowring Mary Grace , Muzaale Abimereki D. , Ostrander Darin B. , Brown Diane , Massie Allan B. , Tobian Aaron A.R. , Henderson Macey L. , Fletcher Faith E. , Smith Burke , Chao Ada , Gorupati Nishita , Prakash Katya , Aslam Saima , Lee Dong H. , Kirchner Varvara , Pruett Timothy L. , Haidar Ghady , Hughes Kailey , Malinis Maricar , Trinh Sonya , Segev Dorry L. , Sugarman Jeremy , Durand Christine M.
Published: May 2020

Background:

HIV-infected (HIV+) donor to HIV+ recipient (HIV D+/R+) transplantation might improve access to transplantation for people living with HIV. However, it remains unknown whether transplant candidates living with HIV will accept the currently unknown risks of HIV D+/R+ transplantation.

Methods:

We surveyed transplant candidates living with HIV from 9 US transplant centers regarding willingness to accept HIV+ donor organs.

Results:

Among 116 participants, the median age was 55 years, 68% were men, and 78% were African American. Most were willing to accept HIV+ living donor organs (87%), HIV+ deceased donor organs (84%), and increased infectious risk donor organs (70%). Some (30%) were concerned about HIV superinfection; even among these respondents, 71% were willing to accept an HIV D+ organ. Respondents from centers that had already performed a transplant under an HIV D+/R+ transplantation research protocol were more willing to accept HIV+ deceased donor organs (89% vs. 71%, P = 0.04). Respondents who chose not to enroll in an HIV D+/R+ transplantation research protocol were less likely to believe that HIV D+/R+ transplantation was safe (45% vs. 77%, P = 0.02), and that HIV D+ organs would work similar to HIV D− organs (55% vs. 77%, P = 0.04), but more likely to believe they would receive an infection other than HIV from an HIV D+ organ (64% vs. 13%, P < 0.01).

Conclusions:

Willingness to accept HIV D+ organs among transplant candidates living with HIV does not seem to be a major barrier to HIV D+/R+ transplantation and may increase with growing HIV D+/R+ transplantation experience.
Sex Work Is Associated With Increased Vaginal Microbiome Diversity in Young Women From Mombasa, Kenya
Authors: Sivro Aida , Mwatelah Ruth , Kambaran Cheli , Gebrebrhan Henok , Becker Michael G. , Ma Huiting , Klatt Nichole R. , Zevin Alexander S. , King'ola Nzioki , Wambua Sammy , Gichangi Peter , Cheuk Eve , McLaren Paul J. , Mishra Sharmistha , Becker Marissa , McKinnon Lyle R.
Published: May 2020

Background:

Although nonoptimal vaginal bacteria and inflammation have been associated with increased HIV risk, the upstream drivers of these phenotypes are poorly defined in young African women.

Setting:

Mombasa, Kenya.

Methods:

We characterized vaginal microbiome and cytokine profiles of sexually active young women aged 14–24 years (n = 168) in 3 study groups: those engaging in formal sex work, in transactional sex, and nonsex workers. Vaginal secretions were collected using self-inserted SoftCup, and assayed for cytokines and vaginal microbiome through multiplex ELISA and 16S rRNA sequencing, respectively. Epidemiological data were captured using a validated questionnaire.

Results:

The median age of participants was 20 years (interquartile range: 18–22 years). Approximately two-thirds of young women (105/168) had vaginal microbial communities characterized by Gardnerella and/or Prevotella spp. dominance; a further 29% (49/168) were predominantly Lactobacillus iners. Microbiome clustering explained a large proportion of cytokine variation (>50% by the first 2 principal components). Age was not associated with vaginal microbial profiles in bivariable or multivariable analyses. Women self-identifying as sex workers had increased alpha (intraindividual) diversity, independent of age, recent sexual activity, HIV, and other sexually transmitted infections (beta = 0.47, 95% confidence interval: 0.05 to 0.90, P = 0.03). Recent sex (number of partners or sex acts last week, time since last vaginal sex) correlated with increased alpha diversity, particularly in participants who were not involved in sex work.

Conclusion:

Nonoptimal vaginal microbiomes were common in young Kenyan women and associated with sex work and recent sexual activity, but independent of age. Restoring optimal vaginal microflora may represent a useful HIV prevention strategy.
Computed Tomography Appearance of Unusual Nonaortic Thoracic Aneurysms and Pseudoaneurysms
Authors: Maldjian Pierre D. , Bertot John H. , Jon Ali F.
Published: May 2020

Although aneurysms of the thoracic aorta are easily recognized on computed tomography (CT), nonaortic intrathoracic aneurysms and pseudoaneurysms are unusual and not often encountered by radiologists. These lesions can result in complications such as hemorrhage or symptoms from mass effect. In some cases, patients may be asymptomatic and the aneurysms may represent incidental findings. Radiologists should be familiar with the CT appearances of these rare vascular abnormalities to enable prompt diagnosis. The goals of this pictorial essay are to: (1) illustrate and describe the CT appearances of various unusual intrathoracic nonaortic aneurysms and pseudoaneurysms; (2) discuss the etiology and clinical significance of these lesions; and (3) discuss management options where appropriate.
Adrenalectomy for Secondary Malignancy: Patients, Outcomes, and Indications
Authors: Wachtel Heather , Roses Robert E. , Kuo Lindsay E. , Lindeman Brenessa M. , Nehs Matthew A. , Tavakkoli Ali , Parangi Sareh , Hodin Richard A. , Fraker Douglas L. , James Benjamin C. , Carr Azadeh A. , Wang Tracy S. , Solórzano Carmen C. , Lubitz Carrie C.
Published: May 2020

Objective:

The goal of this study was to examine a multi-institutional experience with adrenal metastases to describe survival outcomes and identify subpopulations who benefit from adrenal metastasectomy.

Background:

Adrenalectomy for metastatic disease is well-described, although indications and outcomes are incompletely defined.

Methods:

A retrospective cohort study was performed of patients undergoing adrenalectomy for secondary malignancy (2002–2015) at 6 institutions. The primary outcomes were disease free survival (DFS) and overall survival (OS). Analysis methods included Kaplan-Meier and Cox proportional hazards.

Results:

Of 269 patients, mean age was 60.1 years; 50% were male. The most common primary malignancies were lung (n = 125, 47%), renal cell (n = 38, 14%), melanoma (n = 33, 12%), sarcoma (n = 18, 7%), and colorectal (n = 12, 5%). The median time to detection of adrenal metastasis after initial diagnosis of the primary tumor was 17 months (interquartile range: 6–41). Post-adrenalectomy, the median DFS was 18 months (1-year DFS: 54%, 5-year DFS: 31%). On multivariable analysis, lung primary was associated with longer DFS [hazard ratio (HR): 0.49, P = 0.008). Extra-adrenal oligometastatic disease at initial presentation (HR: 1.84, P = 0.016), larger tumor size (HR: 1.07, P = 0.013), chemotherapy as treatment of the primary tumor (HR: 2.07 P = 0.027) and adjuvant chemotherapy (HR: 1.95, P = 0.009) were associated with shorter DFS. Median OS was 53 months (1-year OS: 83%, 5-year OS: 43%). On multivariable analysis, extra-adrenal oligometastatic disease at adrenalectomy (HR: 1.74, P = 0.031), and incomplete resection of adrenal metastasis (R1 margins; HR: 1.62, P = 0.034; R2 margins; HR: 5.45, P = 0.002) were associated with shorter OS.

Conclusions:

Durable survival is observed in patients undergoing adrenal metastasectomy and should be considered for subjects with isolated adrenal metastases.
Evidence-based Reviews in Surgery Long-term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis
Authors: Patel Sunil V. , Hendren Samantha , Zaborowski Alexandra , Winter Des
Published: May 2020

Question:

Does surgery or conservative management of recurring diverticulitis/ongoing symptoms results in a higher quality of life (QoL) at 5-year follow-up.

Design:

Randomized controlled trial.

Setting:

Multicenter trial in the Netherlands.

Patients:

Patients aged 18 to 75 years, who presented with either ongoing abdominal complaints (for >3 months) and/or frequently recurring left-sided diverticulitis (>2 episodes in 2 years) after an objectified (via Computed Tomography, Ultrasound or Endoscopy) episode of diverticulitis were included in this study.

Intervention:

Elective Sigmoid Resection within 6 weeks vs. Conservative Management

Main Outcome:

QoL at 5-year follow-up, as measured by the Gastrointestinal Quality of Life Index (GIQLI). Secondary outcomes included additional QoL assessments (including the EuroQoL-5D-3L, Visual Analogue Score for pain, and the short form 36 health survey)

Results:

The intention to treat analysis showed the surgical group had a higher quality of life (GIQLI) score than the conservative group (mean difference 9.7, 95% confidence interval 1.7–17.7, P = 0.018), which approached but did not meet the minimum important difference of 10. This difference was achieved in 67% of those in the operative group versus 57% in the conservative group (many of who eventually underwent surgery).

Conclusions:

The study results demonstrate that HRQOL at 5-year follow-up may be improved in patients undergoing surgical resection, although this difference did not meet the MID for the GIQLI.
Urinary Tract Infection After Midurethral Sling
Authors: Varasteh Kia Mujan , Long Jaime Bashore , Chen Chi Chiung Grace
Published: May 2020

Objective

The aim of the study was to clarify which baseline, operative, and postoperative factors are associated with the development and recurrence of urinary tract infection (UTI) after midurethral sling (MUS).

Methods

This is a retrospective analysis of patients who underwent a MUS from February 2010 to April 2014 within a single practice with 2 surgeons. Distribution of perioperative factors with relation to 6-week UTI occurrence (primary outcome) and recurrent UTI (secondary outcome) within a year after surgery were analyzed using Student's t test and χ2 test. Then, independent risk factors were determined using multiple logistic regression. A P value of less than 0.05 defined statistical significance.

Results

From the 500 patients who underwent MUS, 79 (15.8%) developed a UTI within 6 weeks of surgery and 5.8% had recurrent UTI within a year. Looking at the independent effects, patients with a history of recurrent UTI and voiding dysfunction requiring catheterization more than 24 hours were at a higher risk of developing UTI within 6 weeks after surgery. In addition, having a history of recurrent UTI, asymptomatic bacteriuria, and postoperative UTI within 6 weeks after surgery were significantly associated with postoperative recurrent UTI.

Conclusions

In this study, we identified baseline and postoperative characteristics that are associated with greater risk of UTI within 6 weeks and recurrent UTI after MUS. These factors can be potentially modified or useful in counseling patients on personalized risks and benefits of the surgical procedure.
Psychosocial therapies in severe mental illness: update on evidence and recommendations
Authors: Gühne Uta , Weinmann Stefan , Riedel-Heller Steffi G. , Becker Thomas
Published: May 2020

Purpose of review

To provide an overview of the update of the evidence-based and consensus-based German S3 guideline on psychosocial therapies for severe mental illnesses (SMI), with particular attention to current developments and future research tasks.

Recent findings

There has been a significant increase in studies on the effectiveness of psychosocial interventions in treatment of people with SMI. In the guideline a distinction is made between system-level interventions (e.g. multidisciplinary team-based psychiatric community care) and single-handed (nonteam-based) interventions (e.g. psychoeducation). Furthermore, principles of treatment (e.g. recovery-orientation) and self-help interventions (e.g. peer support) are addressed. The update of the guideline includes 33 recommendations and 12 statements. Compared with the first edition, there were upgrades in the recommendation of Supported Employment (A) and Supported Housing (A). Interventions such as peer support (B) and lifestyle interventions (A) were included for the first time. Developments are discussed in the context of most recent literature. Areas for further research are highlighted and fields for next updates such as antistigma interventions and supported parenting were identified.

The present guideline offers an important opportunity to further improve health services for people with SMI. However, guideline implementation is challenging.
Satellite cells in ageing: use it or lose it
Authors: Chen William , Datzkiw David , Rudnicki Michael A.
Published: May 2020

Individuals that maintain healthy skeletal tissue tend to live healthier, happier lives as proper muscle function enables maintenance of independence and actuation of autonomy. The onset of skeletal muscle decline begins around the age of 30, and muscle atrophy is associated with a number of serious morbidities and mortalities. Satellite cells are responsible for regeneration of skeletal muscle and enter a reversible non-dividing state of quiescence under homeostatic conditions. In response to injury, satellite cells are able to activate and re-enter the cell cycle, creating new cells to repair and create nascent muscle fibres while preserving a small population that can return to quiescence for future regenerative demands. However, in aged muscle, satellite cells that experience prolonged quiescence will undergo programmed cellular senescence, an irreversible non-dividing state that handicaps the regenerative capabilities of muscle. This review examines how periodic activation and cycling of satellite cells through exercise can mitigate senescence acquisition and myogenic decline.
A hybrid gravity and route choice model to assess vector traffic in large-scale road networks
Authors: Fischer S. M. , Beck M. , Herborg L.-M. , Lewis M. A.
Published: May 2020

Human traffic along roads can be a major vector for infectious diseases and invasive species. Though most road traffic is local, a small number of long-distance trips can suffice to move an invasion or disease front forward. Therefore, understanding how many agents travel over long distances and which routes they choose is key to successful management of diseases and invasions. Stochastic gravity models have been used to estimate the distribution of trips between origins and destinations of agents. However, in large-scale systems, it is hard to collect the data required to fit these models, as the number of long-distance travellers is small, and origins and destinations can have multiple access points. Therefore, gravity models often provide only relative measures of the agent flow. Furthermore, gravity models yield no insights into which roads agents use. We resolve these issues by combining a stochastic gravity model with a stochastic route choice model. Our hybrid model can be fitted to survey data collected at roads that are used by many long-distance travellers. This decreases the sampling effort, allows us to obtain absolute predictions of both vector pressure and pathways, and permits rigorous model validation. After introducing our approach in general terms, we demonstrate its benefits by applying it to the potential invasion of zebra and quagga mussels (
Dreissena
spp.) to the Canadian province British Columbia. The model yields an
R
2
-value of 0.73 for variance-corrected agent counts at survey locations.
Divalent cations bind to phosphoinositides to induce ion and isomer specific propensities for nano-cluster initiation in bilayer membranes
Authors: Bradley Ryan P. , Slochower David R. , Janmey Paul A. , Radhakrishnan Ravi
Published: May 2020

We report all-atom molecular dynamics simulations of asymmetric bilayers containing phosphoinositides in the presence of monovalent and divalent cations. We have characterized the molecular mechanism by which these divalent cations interact with phosphoinositides. Ca2+desolvates more readily, consistent with single-molecule calculations, and forms a network of ionic-like bonds that serve as a ‘molecular glue’ that allows a single ion to coordinate with up to three phosphatidylinositol-(4,5)-bisphosphate (PI(4, 5)P2) lipids. The phosphatidylinositol-(3,5)-bisphosphate isomer shows no such effect and neither does PI(4, 5)P2in the presence of Mg2+. The resulting network of Ca2+-mediated lipid-lipid bonds grows to span the entire simulation space and therefore has implications for the lateral distribution of phosophoinositides in the bilayer. We observe context-specific differences in lipid diffusion rates, lipid surface densities and bilayer structure. The molecular-scale delineation of ion-lipid arrangements reported here provides insight into similar nanocluster formation induced by peripheral proteins to regulate the formation of functional signalling complexes on the membrane.
Effect of contact characteristics on the self-rotation performance of conical picks based on impact dynamics modelling
Authors: Liu Xiaohui , Geng Qi
Published: May 2020

Conical picks have a harsh working environment and 70% of their failures are caused by wear. It has been found that conical picks can rotate while interacting with the working material. This self-rotation ability is an important factor affecting pick wear, but the self-rotation mechanism remains unclear. Researching the mechanism involves the impact and friction dynamics of the interaction between a pick and its holder. Thus, a dynamic finite-element numerical model for the pick–holder interaction is established. How the handle–holder gap width, pick body and handle lengths and pick handle diameter affect the settling time and the percentage of time with no contact is studied to compare the numerical results with the equivalent effects on the rotation angle in experiments. Doing so indicates that the main factor in the self-rotation ability of a conical pick is not the magnitude of the contact load but its duration. The present research provides a new method for revealing the mechanism for the self-rotation of conical picks.
Gordonia crocea sp. nov. and Gordonia spumicola sp. nov. isolated from sludge of a wastewater treatment plant
Authors: Tamura Tomohiko , Saito Satomi , Hamada Moriyuki , Kang Yingqian , Hoshino Yasutaka , Gonoi Tohru , Mikami Yuzuru , Yaguchi Takashi
Published: May 2020

Two novel actinobacteria, designated NBRC 107696T and NBRC 107697T, were isolated from sludge samples from a wastewater treatment plant and their taxonomic positions were investigated by a polyphasic approach. The cells of the strains were aerobic, rod-shaped, non-motile and non-endospore-forming. The strains contained glutamic acid, alanine and meso-diaminopimelic acid in the peptidoglycan. Galactose and arabinose were detected as cell-wall sugars. The predominant menaquinone was identified as MK-9(H2) and the major fatty acids were C16  :  0, C18 : 1ω9c and C16 : 1ω7c. The DNA G+C contents of NBRC 107696T and NBRC 107697T were 68.07 and 68.99 mol%, respectively. Phylogenetic analyses based on 16S rRNA gene sequence comparisons revealed that NBRC 107696T and NBRC 107697T were a clade with members of the genus

Gordonia

. The highest 16S rRNA gene sequence similarity values were obtained with

Gordonia araii

IFM 10211T (98.9 %) for NBRC 107697T, and

Gordonia malaquae

IMMIB WWCC-22T,

Gordonia neofelifaecis

AD-6T and

Gordonia humi

CC-12301T (98.1 %) for NBRC 107696T, respectively. The digital DNA–DNA relatedness data coupled with the combination of genotypic and phenotypic data indicated that the two strains are representatives of two novel separate species. The names proposed to accommodate these two strains are Gordonia spumicola sp. nov. and Gordonia crocea sp. nov., and the type strains are NBRC 107696T (=IFM 10067T=TBRC 11239T) and NBRC 107697T (=IFM 10881T=TBRC 11240T), respectively.
Evaluation of Contact-Tracing Policies Against the Spread of SARS-CoV-2 in Austria – An Agent-Based Simulation
Authors: Bicher Martin , Rippinger Claire , Urach Christoph , Brunmeir Dominik , Siebert Uwe , Popper Niki
Published: May 2020

Background

Many countries have successfully managed to stop the exponential spread of SARS-CoV-2. Still, the danger of a second wave of infections is omnipresent and it is clear that every containment policy must be carefully evaluated and possibly replaced by a different, less restrictive policy, before it can be lifted. Contact tracing and consequential breaking of infection-chains is a promising strategy to help contain the disease, although its precise impact on the epidemic is unknown.

Objective

In this work we aim to quantify the impact of tracing on the containment of the disease.

Design

We developed an agent-based simulation model that simulates the spread of the disease and allows for exploratory analysis of containment policies. We apply this model to quantify the impact of contact tracing in different characteristics in Austria and to derive general conclusions on contract tracing.

Results

This modelling study displays the dynamics of the interplay between strictness of the tracing policies, isolated persons, and active COVID-19 infections. It shows that a strict tracing policy does not necessarily imply that the total number of quarantined persons is high as well, because the disease is better contained.

Limitations

The results are limited by the validity of the modeling assumptions, model parameter estimates, and the quality of the parametrization data.

Conclusions

The study shows that tracing is indeed an efficient measure to keep COVID-19 case numbers low but comes at the price of too many precautious quarantined people if the disease is not well contained. Therefore, contact tracing must be executed strictly and compliance within the population must be held up to prevent new disease outbreaks.
Comparison of SARS-CoV-2 detection in nasopharyngeal swab and saliva
Authors: Iwasaki Sumio , Fujisawa Shinichi , Nakakubo Sho , Kamada Keisuke , Yamashita Yu , Fukumoto Tatsuya , Sato Kaori , Oguri Satoshi , Taki Keisuke , Senjo Hajime , Hayasaka Kasumi , Sugita Junichi , Konno Satoshi , Nishida Mutsumi , Teshima Takanori
Published: May 2020

We prospectively compared the efficacy of PCR detection of SARS-CoV-2 between paired nasopharyngeal and saliva samples in 76 patients including ten COVID-19 patients. The overall concordance rate of the virus detection between the two samples was 97.4% (95%CI, 90.8-99.7). Viral load was equivalent in COVID-19 patients, but the virus tended to disappear earlier in saliva at convalescent phase compared to nasopharyngeal samples. These results suggest that saliva is a reliable noninvasive alternative to nasopharyngeal swabs and facilitate widespread PCR testing in the face of shortages of swabs and protective equipment without posing a risk to healthcare workers.
When strong mitigation against a pandemic backfires
Authors: Chaigneau Pierre
Published: May 2020

I introduce social feasibility constraints in a SIR epidemiological model: at any point in time, the ability of a social planner to impose mitigation measures is limited, but it is increasing in the proportion of infected individuals. When considering threshold policies with constant levels of mitigation for a time period, the overall fatality rate in the population is non-monotonic in the levels of mitigation: higher levels of mitigation can increase the overall fatality rate. Intuitively, strong mitigation at a point in time can undermine the social feasibility of future mitigation.
A sound strategy for homology modeling-based affinity maturation of a HIF-1α single-domain intrabody
Authors: Hu Min , Kang Guangbo , Cheng Xin , Wang Jiewen , Li Ruowei , Bai Zixuan , Yang Dong , Huang He
Published: May 2020

A sound strategy for computer-aided binding affinity prediction was developed forin siliconanobody affinity maturation. Venn-intersection of multi-algorithm screening (VIMAS), an iterative computer-assisted nanobody affinity maturation virtual screening procedure, was designed. Homology modeling and protein docking methods were used to substitute the need for solution of a complex crystal structure, which is expanding the application of this platform. As a test case, an anti-HIF-1α nanobody, VHH212, was screenedviaa native ribosome display library with a 26.6 nM of KDvalue was used as the parent. A mutant with a 17.5-fold enhancement in binding affinity (1.52 nM) was obtained by using the VIMAS strategy. Furthermore, the protein-protein interaction of interface residues, which is important for binding affinity, was analyzed in-depth. Targeting HIF-1α can sensitize PDAC tumors to gemcitabine, which is a potential co-treatment method for pancreatic cancer patients. Under combined treatment, the cytotoxicity of gemcitabine on pancreatic cancer cell lines increased with the enhanced-affinity of an intrabody. Thus, this study provides a platform for universal, efficient and convenientin silicoaffinity maturation of nanobodies.