bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the effect of immersive virtual reality technology on gait rehabilitation in stroke patients: a study protocol for a randomized controlled trial
Authors: Cai Huihui , Lin Tao , Chen Lina , Weng Huidan , Zhu Ruihan , Chen Ying , Cai Guoen
Published: January 2021

Background

The high incidence of cerebral apoplexy makes it one of the most important causes of adult disability. Gait disorder is one of the hallmark symptoms in the sequelae of cerebral apoplexy. The recovery of walking ability is critical for improving patients’ quality of life. Innovative virtual reality technology has been widely used in post-stroke rehabilitation, whose effectiveness and safety have been widely verified. To date, however, there are few studies evaluating the effect of immersive virtual reality on stroke-related gait rehabilitation. This study outlines the application of immersive VR-assisted rehabilitation for gait rehabilitation of stroke patients for comparative evaluation with traditional rehabilitation.

Methods

The study describes a prospective, randomized controlled clinical trial. Thirty-six stroke patients will be screened and enrolled as subjects within 1 month of initial stroke and randomized into two groups. The VRT group (n = 18) will receive VR-assisted training (30 min) 5 days/week for 3 weeks. The non-VRT group (n = 18) will receive functional gait rehabilitation training (30 min) 5 days/week for 3 weeks. The primary outcomes and secondary outcomes will be conducted before intervention, 3 weeks after intervention, and 6 months after intervention. The primary outcomes will include time “up & go” test (TUGT). The secondary outcomes will include MMT muscle strength grading standard (MMT), Fugal-Meyer scale (FMA), motor function assessment scale (MAS), improved Barthel index scale (ADL), step with maximum knee angle, total support time, step frequency, step length, pace, and stride length.

Discussion

Virtual reality is an innovative technology with broad applications, current and prospective. Immersive VR-assisted rehabilitation in patients with vivid treatment scenarios in the form of virtual games will stimulate patients’ interest through active participation. The feedback of VR games can also provide patients with performance awareness and effect feedback, which could be incentivizing. This study may reveal an improved method of stroke rehabilitation which can be helpful for clinical decision-making and future practice.

Trial registration

Chinese Clinical Trial Registry ChiCTR1900025375. Registered on 25 August 2019
Global distribution, host range and prevalence of Trypanosoma vivax: a systematic review and meta-analysis
Authors: Fetene Eyerusalem , Leta Samson , Regassa Fikru , Büscher Philippe
Published: January 2021

Background

Trypanosomosis caused byTrypanosoma vivaxis one of the diseases threatening the health and productivity of livestock in Africa and Latin America.Trypanosoma vivaxis mainly transmitted by tsetse flies; however, the parasite has also acquired the ability to be transmitted mechanically by hematophagous dipterans. Understanding its distribution, host range and prevalence is a key step in local and global efforts to control the disease.

Methods

The study was conducted according to the methodological recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A systematic literature search was conducted on three search engines, namely PubMed, Scopus and CAB Direct, to identify all publications reporting natural infection ofT. vivaxacross the world. All the three search engines were screened using the search termTrypanosoma vivaxwithout time and language restrictions. Publications onT. vivaxthat met our inclusion criteria were considered for systematic review and meta-analysis.

Result

The study provides a global database ofT. vivax, consisting of 899 records from 245 peer-reviewed articles in 41 countries. A total of 232, 6277 tests were performed on 97 different mammalian hosts, including a wide range of wild animals. Natural infections ofT. vivaxwere recorded in 39 different African and Latin American countries and 47 mammalian host species. All the 245 articles were included into the qualitative analysis, while information from 186 cross-sectional studies was used in the quantitative analysis mainly to estimate the pooled prevalence. Pooled prevalence estimates ofT. vivaxin domestic buffalo, cattle, dog, dromedary camel, equine, pig, small ruminant and wild animals were 30.6%, 6.4%, 2.6%, 8.4%, 3.7%, 5.5%, 3.8% and 12.9%, respectively. Stratified according to the diagnostic method, the highest pooled prevalences were found with serological techniques in domesticated buffalo (57.6%) followed by equine (50.0%) and wild animals (49.3%).

Conclusion

The study provides a comprehensive dataset on the geographical distribution and host range ofT. vivaxand demonstrates the potential of this parasite to invade other countries out of Africa and Latin America.

Graphical Abstract
Comprehensive molecular characterization of gastric cancer patients from phase II second-line ramucirumab plus paclitaxel therapy trial
Authors: Kim Seung Tae , Sa Jason K. , Oh Sung Yong , Kim Kyung , Hong Jung Yong , Kang Won Ki , Kim Kyoung-Mee , Lee Jeeyun
Published: January 2021

Background

Gastric cancer (GC) is a heterogenous disease consisted of several subtypes with distinct molecular traits. The clinical implication of molecular classification has been limited especially in association with treatment efficacy of ramucirumab or various targeted agents.

Methods

We conducted a prospective non-randomized phase II single-arm trial of ramucirumab plus paclitaxel as second-line chemotherapy in 62 patients with metastatic GC who failed to respond to first-line fluoropyrimidine plus platinum treatment. For integrative molecular characterization, all patients underwent pre-ramucirumab treatment tissue biopsy for whole-exome/whole-transcriptome sequencing to categorize patients based on molecular subtypes. We also systematically performed integrative analysis, combining genomic, transcriptomic, and clinical features, to identify potential molecular predictors of sensitivity and resistance to ramucirumab treatment.

Results

Sixty-two patients were enrolled in this study between May 2016 and October 2017. Survival follow-up in all patients was completed as of the date of cut-off on January 2, 2019. No patient attained complete response (CR), while 22 patients achieved confirmed partial response (PR), resulting in a response rate (RR) of 35.5% (95% CI, 23.6–47.4). According to TCGA molecular classification, there were 30 GS, 18 CIN, 3 EBV, and 0 MSI tumors. The RR was 33% in GS (10/30), 33% in CIN (6/18), and 100% in EBV-positive GC patients with significant statistical difference for EBV(+) against EBV(−) tumors (P = 0.016; chi-squared test). Moreover, responsive patients were marked by activation of angiogenesis, VEGF, and TCR-associated pathways, while non-responder patients demonstrated enrichments of sonic hedgehog signaling pathway and metabolism activity. Integrative multi-layer data analysis further identified molecular determinants, including EBV status, and somatic mutation in GNAQ to ramucirumab activity.

Conclusions

Prospective molecular characterization identified a subset of GC patients with distinct clinical response to ramucirumab therapy, and our results demonstrate the feasibility of personalized therapeutic opportunities in gastric cancer.

Trial registration

The study was registered on ClinicalTrial.gov (NCT02628951) on June 12, 2015.
A bioavailable form of curcumin, in combination with vitamin-D- and omega-3-enriched diet, modifies disease onset and outcomes in a murine model of collagen-induced arthritis
Authors: Hemshekhar Mahadevappa , Anaparti Vidyanand , El-Gabalawy Hani , Mookherjee Neeloffer
Published: January 2021

Objective

Curcumin (CUR), vitamin D3(D3), and omega-3-fatty acids (O3FA) individually modulate inflammation and pain in arthritis. Although these supplements are widely used, their combinatorial effects have not been defined. In this study, we examined the effects of a D3 and O3FA (VO)-enriched diet in conjunction with a highly bioavailable form of CUR (Cureit/Acumin™) in a collagen-induced arthritis (CIA) murine model.

Methods

Male DBA/1J mice were acclimatized to VO-enriched diet and challenged with bovine collagen II (CII). Bioavailable CUR was administered daily by oral gavage from the onset of CII challenge. Disease severity was determined by monitoring joint thickness and standardized clinical score. Cellular infiltration and cartilage degradation in the joints were assessed by histology, serum cytokines profiled by Meso Scale Discovery multiplex assay, and joint matrix metalloproteinases examined by western blots.

Results

CUR by itself significantly decreased disease severity by ~ 60%. Administration of CUR in CIA mice taking a VO-enriched diet decreased disease severity by > 80% and maximally delayed disease onset and progression. Some of the disease-modifying effects was mediated by CUR alone, e.g., suppression of serum anti-collagen antibodies and decrease of cellular infiltration and MMP abundance in the joints of CIA mice. Although CUR alone suppressed inflammatory cytokines in serum of CIA mice, the combination of CUR and VO diet significantly enhanced the suppression (> 2-fold compared to CUR) of TNF, IFN-γ, and MCP-1, all known to be associated with RA pathogenesis.

Conclusion

This study provides proof-of-concept that the combination of bioavailable CUR, vitamin D3, and O3FA substantially delays the development and severity of CIA. These findings provide a rationale for systematically evaluating these widely available supplements in individuals at risk for developing future RA.
Supplementing wastewater with NPK fertilizer as a cheap source of nutrients in cultivating live food (Chlorella vulgaris)
Authors: Mtaki Kulwa , Kyewalyanga Margareth S. , Mtolera Matern S. P.
Published: January 2021

Introduction

The decline in fishery resources from the wild has led to an ever increasing focus on aquaculture in recent years. With increasing aquaculture of animal species, there is an increasing need for suitable microalgae in the production of these animals. However, cultivation of microalgae in expensive pure chemical media is one of the major challenges facing large-scale cultivation of microalgae.

Purpose

The present study investigated the suitability of aquaculture wastewater (AWW) supplemented with NPK (nitrogen:phosphorus:potassium) fertilizer as a cheap source of nutrient to cultivate a microalgaChlorella vulgaris(C. vulgaris).

Methods

C. vulgariswith an initial cell density of 0.8 × 106cells/mL was batch cultured in AWW supplemented with NPK at 0.1, 0.5, 1.0 g/L and BBM for 20 days under laboratory conditions using 2000 mL Erlenmeyer flasks. The proximate composition, chlorophyll, minerals, and vitamins analysis ofC. vulgarisbiomass were done using standard analytical methods.

Results

The highest values in optical density (4.872 ± 0.025), dry cell weight (2.858 ± 0.015 g/L), specific growth rate (0.2097 ± 0.0038 day–1), and biomass productivity (0.1701 ± 0.0007 g/L/day) were obtained inC. vulgarisgrown in AWW + 1.0 NPK medium. The total chlorophyll, protein, lipid, and carbohydrate content of the microalgae biomass were in the range of 0.05–0.862%, 44.062–57.089%, 17.064–23.260%, and 15.217–21.896%, respectively. Furthermore, microalgae grown in AWW + 1.0 NPK showed good vitamin and mineral content compared to BBM grown alga.

Conclusion

These findings indicated that the AWW + 0.1 NPK, AWW + 0.5 NPK, and AWW + 1.0 NPK are potential growth media forC. vulgariscultivation and can replace the BBM medium, which is very expensive and less accessible to users.
Systemic lupus erythematosus manifestation following COVID-19: a case report
Authors: Zamani Batool , Moeini Taba Seyed-Masoud , Shayestehpour Mohammad
Published: January 2021

Background

Systemic lupus erythematosus (SLE) is a complex and challenging autoimmune disease. Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a novel viral agent that can cause a life-threatening respiratory disorder named coronavirus disease 2019 (COVID‑19). Association between SARS‑CoV‑2 and SLE is not clear. We reported the first case of SLE manifestation following COVID-19.

Case presentation

A 39-year-old Iranian/Persian man with complaints of fever, scaling on the palms of the hands and feet, lower extremity edema, and ankle swelling was referred to Kashan Rheumatology Clinic in 2020. He was infected with SARS-CoV-2 2 months ago. The patient had proteinuria and was positive for SLE laboratory tests. After one week of treatment with prednisolone (30 mg daily) and hydroxychloroquine, paresthesia, proteinuria, and edema continued. The patient was treated with pulse methylprednisolone (1000 mg for three consecutive days), gabapentin, and vitamin B (300 mg daily), which reduced paresthesia.

Conclusions

This is the first case of SLE manifestation following COVID-19. SARS-CoV-2 may produce autoantibodies or develop the clinical features of subclinical SLE.
Advancements in stem cell-derived hepatocyte-like cell models for hepatotoxicity testing
Authors: Jin Meixian , Yi Xiao , Liao Wei , Chen Qi , Yang Wanren , Li Yang , Li Shao , Gao Yi , Peng Qing , Zhou Shuqin
Published: January 2021

Drug-induced liver injury (DILI) is one of the leading causes of clinical trial failures and high drug attrition rates. Currently, the commonly used hepatocyte models include primary human hepatocytes (PHHs), animal models, and hepatic cell lines. However, these models have disadvantages that include species-specific differences or inconvenient cell extraction methods. Therefore, a novel, inexpensive, efficient, and accurate model that can be applied to drug screening is urgently needed. Owing to their self-renewable ability, source abundance, and multipotent competence, stem cells are stable sources of drug hepatotoxicity screening models. Because 3D culture can mimic the in vivo microenvironment more accurately than can 2D culture, the former is commonly used for hepatocyte culture and drug screening. In this review, we introduce the different sources of stem cells used to generate hepatocyte-like cells and the models for hepatotoxicity testing that use stem cell-derived hepatocyte-like cells.
Increased [18F]FMISO accumulation under hypoxia by multidrug-resistant protein 1 inhibitors
Authors: Shimizu Yoichi , Nakai Yukihiro , Watanabe Hiroyuki , Iikuni Shimpei , Ono Masahiro , Saji Hideo , Kuge Yuji , Saga Tsuneo , Nakamoto Yuji
Published: January 2021

Background

[18F]Fluoromisonidazole ([18F]FMISO) is a PET imaging probe widely used for the detection of hypoxia. We previously reported that [18F]FMISO is metabolized to the glutathione conjugate of the reduced form in hypoxic cells. In addition, we found that the [18F]FMISO uptake level varied depending on the cellular glutathione conjugation and excretion ability such as enzyme activity of glutathione-S-transferase and expression levels of multidrug resistance-associated protein 1 (MRP1, an efflux transporter), in addition to the cellular hypoxic state. In this study, we evaluated whether MRP1 activity affected [18F]FMISO PET imaging.

Methods

FaDu human pharyngeal squamous cell carcinoma cells were pretreated with MRP1 inhibitors (cyclosporine A, lapatinib, or MK-571) for 1 h, incubated with [18F]FMISO for 4 h under hypoxia, and their radioactivity was then measured. FaDu tumor-bearing mice were intravenously injected with [18F]FMISO, and PET/CT images were acquired at 4 h post-injection (1st PET scan). Two days later, the same mice were pretreated with MRP1 inhibitors (cyclosporine A, lapatinib, or MK-571) for 1 h, and PET/CT images were acquired (2nd PET scan).

Results

FaDu cells pretreated with MRP1 inhibitors exhibited significantly higher radioactivity than those without inhibitor treatment (cyclosporine A: 6.91 ± 0.27, lapatinib: 10.03 ± 0.47, MK-571: 10.15 ± 0.44%dose/mg protein, p < 0.01). In the in vivo PET study, the SUVmean ratio in tumors [calculated as after treatment (2nd PET scan)/before treatment of MRP1 inhibitors (1st PET scan)] of the mice treated with MRP1 inhibitors was significantly higher than those of control mice (cyclosporine A: 2.6 ± 0.7, lapatinib: 2.2 ± 0.7, MK-571: 2.2 ± 0.7, control: 1.2 ± 0.2, p < 0.05).

Conclusion

In this study, we revealed that MRP1 inhibitors increase [18F]FMISO accumulation in hypoxic cells. This suggests that [18F]FMISO-PET imaging is affected by MRP1 inhibitors independent of the hypoxic state.
Cost containment by peer prior authorization program for second line treatment in patients with retinal disease
Authors: Rosenblatt Amir , Hekselman Igal , Rosenblatt Irit , Hekselman Idan , Gaton Dan
Published: January 2021

Background

High and increasing drug prices have prompted the establishment of a broad range of cost-containment treatment policies in health systems globally. In 2012, the supplemental insurance program of a large Israeli health maintenance organization (Clalit Health Services) introduced a prior authorization process for second-line use of ranibizumab in patients with retinal disease for whom treatment with bevacizumab proved to be ineffective. A Clalit steering committee established authorization criteria based on cost and periodically updated clinical considerations, while a team of ophthalmic specialists evaluated their colleagues’ individual patient subsidization requests, based on the funding criteria. The objectives of this study were to detail this unique authorization process and study its effectiveness in limiting unwarranted spending, while allowing for a smooth transition to a second-line more expensive drug when needed.

Methods

A retrospective cohort study including all applications for a first or ongoing treatment with ranibizumab, for one or both eyes, received during March 1, 2012 - December 31, 2015. The key parameters examined were percentages of requests from patients treated by first line treatment bevacizumab, requests approved, reapplications, and results. Requests studied include reapplications and requests for treatment continuation.

Results

During the study period, Clalit affiliated ophthalmologists’ submitted 16,778 funding applications for intravitreal ranibizumab treatment on behalf of 5642 patients who applied for approximately three applications. An efficient sentinel effect was achieved, resulting in only 31% of patients treated with bevacizumab applying for treatment, while maintaining extremely high accessibility to second line treatment with almost 95% of requests being approved.

Conclusions

The data presented shows a low request rate for funding with a high approval rate, proving this peer reviewed report-based authorization process successfully achieved a sentinel effect while controlling cost. We suggest this innovative model be considered in similar decisions processes.
Clinical signs of brachycephalic ocular syndrome in 93 dogs
Authors: Costa Joana , Steinmetz Andrea , Delgado Esmeralda
Published: January 2021

Background

Brachycephalic breeds have anatomical skull changes that are responsible for ocular clinical signs, known as the brachycephalic ocular syndrome (BOS). Their popularity has increased in recent years but the excessive pressure of selection lead to extreme conformation of skull shapes, resulting in facial alterations that can put these dogs’ vision at risk.

Objectives

This study aimed to analyse the ocular disorders in a sample of 93 brachycephalic dogs to better characterize the disease complex BOS.

Material and methods

Brachycephalic dogs were submitted to a complete ophthalmological examination. The studied parameters included animal’s sex, age and breed, age, ophthalmological tests performed, results of complementary exams, clinical signs, ocular disorders, treatment protocols and their outcomes. Data were organized using Microsoft Office Excel 2007® and statistical analysis was performed with IBM SPSS Statistics 20®.

Results

The studied population included 93 brachycephalic dogs 45 males (48%) and 48 females (52%) from different breeds: French Bulldog (n = 38), Shih-Tzu (n = 22), Pug (n = 17), English Bulldog (n = 5), Pekingese (n = 4), Boxer (n = 4) and Boston Terrier (n = 3), aged between 0.2–16 years, median 4.65 years. The most frequent ocular abnormalities were corneal ulcers in 44%, corneal pigmentation in 36%, corneal fibrosis in 25% and entropion in 22% of the animals. There was a higher incidence of corneal pigmentary keratitis in Pugs (53%) and corneal fibrosis in Shih Tzus (36%). The most common surgical techniques were medial canthoplasty in 22%, conjunctival flap in 10% and electroepilation in 7% of the cases, without post-operative complications. Conclusions: This study contributed to a better characterization of the disease complex brachycephalic ocular syndrome. The percentage of ocular disorders like entropion, corneal pigmentation, fibrosis and ulcers was high, highlighting the importance of a regular ophthalmological check-up, and early diagnosis of the primary disorders. A higher incidence of corneal pigmentation was noticed in Pugs and corneal fibrosis in Shih Tzus, which suggests that some brachycephalic breeds may be predisposed to certain ocular abnormalities. A responsible reproductive strategy should be implemented to avoid undesired transmission of the abnormal traits to the offspring.
Development of smart insole for cycle time measurement in sewing process
Authors: Kim Eung Tae , Kim Sungmin
Published: January 2021

A smart insole system consisting of pressure sensors, wireless communication modules, and pressure monitoring software has been developed to measure plantar pressure distribution that appears in sewing process. This system calculates the cycle time of each operation by analyzing the real-time plantar pressure data. The operation cycle time was divided into the time done by machine and by manual and calculated by adding the two types of time. By analyzing the cycle time, it is possible to estimate the type of operation a worker is performing. The ability to calculate accurate cycle time and to manage a large volume of data is the advantage of this system. Establishing an accurate cycle time of all operations would be of great help in improving the production process, capacity planning, line efficiency, and labor cost calculation. The system is expected to be a good alternative to the conventional manual measurement process. It will also be able to meet the high demand from garment manufacturers for automated monitoring systems.
Autologous micrografts from the palatal mucosa for bone regeneration in calvarial defects in rats: a radiological and histological analysis
Authors: Kawakami Sawako , Shiota Makoto , Kon Kazuhiro , Shimogishi Masahiro , Iijima Hajime , Kasugai Shohei
Published: January 2021

Background

The application of dental implants is often restricted by bone volume. In such cases, bone grafts are required, although bone graft materials have some disadvantages. Therefore, other effective approaches are needed. Our previous study showed that the autologous micrograft, a dissociated cell suspension made out of palatal connective tissue grafts, promoted bone-marrow cell proliferation and differentiation under osteogenic conditions. In this study, we aimed to evaluate the effects of dissociated soft-tissue suspensions relevant to bone regeneration in animal model.

Material and methods

Twelve-week-old male Wistar rats were used in the study. Defects were created in rat calvaria, and were filled with hydrogel containing either dissociated soft-tissue suspension (test) or sucrose (control). The new bone formation was evaluated at 1 and 2 weeks after surgery (n = 16) by radiological and histological analysis.

Results

The conducted radiological analysis showed that the new bone volume was significantly greater in the dissociated soft-tissue suspension group. This finding was further confirmed by the conducted histological analysis.

Conclusions

The dissociated mucosa tissue suspension enhanced bone regeneration in vivo; thus, it is a promising potential method to aid the successful application for bone augmentation in the implant practice.
Laparoscopic resection of a metachronous secondary lymph node metastasis in the mesentery of the ileum after surgery for sigmoid colon cancer with ileum invasion: a case report
Authors: Eto Seiichiro , Omura Nobuo , Shimada Tetsuya , Takishima Teruyuki , Takeuchi Hideyuki , Kai Wataru , Kodera Keita , Matsumoto Tomo , Hirabayashi Tsuyoshi , Kawahara Hidejiro
Published: January 2021

Background

Extended excision of the permeation organ neighborhood is often performed in locally invasive colon cancer, and it is reported to have a survival benefit. In addition, some cases of secondary lymph node metastases in a permeation organ were reported. However, they are reports of synchronous secondary lymph node metastases, not metachronous secondary lymph node metastases. To the best of our knowledge, there are no cases of metachronous secondary lymph node metastases after the resection of a primary colorectal cancer in PubMed.

Case presentation

The case was a 67-year-old man who underwent colonoscopy because of weight loss. Sigmoid colon cancer with all circumference-related stenosis was found by examination, and the patient was transferred to our hospital for the purpose of scrutiny and treatment. The small intestine ileus caused by the invasion of sigmoid colon cancer developed after the transfer. Laparoscopic high anterior resection and extended excision of small intestine segmental resection was performed after the intestinal tract decompression with a nasal ileus tube. Histopathological analysis revealed a pathological diagnosis of pT4b (ileal submucosal invasion) N0 (0/11) M0 f Stage II, tub2, ly1, v2, PN0. Although adjuvant chemotherapy with capecitabine after the operation was planned for half a year, treatment was suspended in the first course by the patient’s self-judgment. No recurrence was observed for a year after the operation, but metastasis recurrence in the para-aortic lymph node was found by a computed tomography (CT) one and a half years after the operation. 18 F-fluorodeoxyglucose (FDG) positron emission tomography revealed that FDG was accumulated only in the para-aortic lymph node. Laparoscopic metastasis lymphadenectomy was performed due to the diagnosis of metachronous metastasis to the para-aortic lymph node alone. Intraoperative findings revealed that lymph node metastasis occurred in the mesentery of the ileum. No adjuvant treatment was done after the secondary operation, and he is still alive with no recurrence 1 year and 9 months after the operation.

Conclusions

We report a rare case of a laparoscopic resection of a metachronous secondary lymph node metastasis in the mesentery of the ileum after surgery for sigmoid colon cancer with ileum invasion.
Adherence to self-managed exercises for patients with persistent subacromial pain: the Ad-Shoulder feasibility study
Authors: Major Daniel H. , Grotle Margreth , Littlewood Chris , Brox Jens Ivar , Matre Dagfinn , Gallet Heidi V. , Røe Yngve
Published: January 2021

Background

Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programmes for patients with subacromial pain.

Methods

A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past 6 months, were recruited. The Ad-Shoulder intervention consisted of 1–5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: (1) the recruitment rate (10 patients enrolled within 12 weeks), (2) follow-up rate (≥ 80% on all self-reported measures), (3) objective physical activity measures (≥ 80% of participants would contribute valid data at each time point), (4) adherence with the self-managed exercises (≥ 80% of the participants would adhere to ≥ 80% of the assigned home exercise programme), (5) fidelity of the delivery of the intervention (the therapists delivered the intervention according to the protocol) and (6) adverse events (< 30% would report adverse events (including mild)). The results were reported using descriptive statistics.

Results

Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and week 12. Objective physical activity measures were successfully obtained for 100% (11/11) at baseline, 64% (7/11) at week six and 82% at week 12. Fifty-five percent (6/11) of the participants satisfactorily completed at least 80% of their home exercise programme. All sessions were delivered according to the protocol. None of the patients reported any adverse events.

Conclusions

Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise programme were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial.

Trial registration

ClinicalTrials.gov, NCT04190836, Registered December 9, 2019—retrospectively registered
Healthcare disparities in cardio oncology: patients receive same level of surveillance regardless of race at a safety net hospital
Authors: Chen Crystal B. , Dalsania Raj K. , Hamad Eman A.
Published: January 2021

Background

Cardiotoxicity remains a dreaded complication for patients undergoing chemotherapy with human epidermal growth factor (HER)-2 receptor antagonists and anthracyclines. Though many studies have looked at racial disparities in heart failure patients, minimal data is present for the cardio-oncology population.

Methods

We queried the echocardiogram database at a safety net hospital, defined by a high proportion of patients with Medicaid or no insurance, for patients who received HER2 receptor antagonists and/or anthracyclines from January 2016 to December 2018. Patient demographics, clinical characteristics, and treatment outcomes were collected. Based on US census data in 2019, home ZIP codes were used to group patients into quartiles based on median annual household income. The primary end point studied was referral rate to cardiology for patients undergoing chemotherapy.

Results

We identified 149 patients who had echocardiograms and also underwent treatment with HER2 receptor antagonists and/or anthracyclines, of which 70 (47.0%) were referred to the cardio-oncology program at our institution. Basic demographics were similar, but white patients were more likely to live in ZIP codes with higher income quartiles (p < 0.00001). Comparing between racial groups, there was no statistical difference in the percentage of patients that had a reduction in ejection fraction (EF) (p = 0.75). There was no statistical difference between racial groups in the number of cardiology or oncology appointments attended, number of appointments cancelled, average number of echocardiograms received, additional cardiac imaging received. Black patients were more likely to receive ACEI/ARB post chemotherapy (p = 0.047). A logistic regression model was created using race, age, gender, insurance, income quartile by home ZIP code, comorbidities (hypertension, hyperlipidemia, coronary artery disease, arrhythmia, diabetes mellitus, smoking, family history, age > 65), procedures (coronary stents, cardiac surgery), medications pre-chemotherapy, cancer type, cancer stage, and chemotherapy. This model found that there was an increased referral rate among patients from higher income quartiles (p = 0.017 for quartile 3, p = 0.049 for quartile 4), patients with a history of hypertension (p < 0.0001), and patients with breast cancer (p = 0.02).

Conclusions

The results of this study suggest that patients of our cardio-oncology population at a safety net hospital receive the same level of surveillance and treatment, and develop drop in ejection fraction at similar rates regardless of their race. However, patients that reside in ZIP codes associated with higher income quartiles, with hypertension, and with breast cancer, are associated with increased rate of referral.
The additive role of dynamic contrast-enhanced and diffusion-weighted MR imaging in preoperative staging of breast cancer
Authors: Hashem Lamiaa Mohamed Bassam , Sawy Yasmine Ahmed Elsayed , Kamal Rasha Mohamed , Ahmed Soha Mohamed , elmesidy Dalia Salaheldin
Published: January 2021

Background

In women with diagnosed breast cancer, accurate loco-regional staging and preoperative examination are of utmost importance for optimal patient management decisions. MRI may be warranted for correct preoperative staging as recommended from international guidelines. DWI-MRI can be combined with CE-MRI to assess more functional data. So we aimed to evaluate the performance of CE-MRI and qualitative DWI-MRI in preoperative loco-regional staging of malignant breast lesions as regards the local extension of the disease and axillary lymph node status, beyond standard assessment with mammography and ultrasound. This prospective study included 50 female patients with pathologically proven malignant breast lesions (BIRADS VI) coming for preoperative staging. Full-field digital mammography (FFDM) and ultrasound, CE-MRI, and DWI-MRI findings were compared for all patients, and the findings were evaluated independently. Results were then correlated to postoperative histopathology.

Results

Fifty women with pathologically proven malignant breast lesions (BIRADS VI) were enrolled in this study; the mean age of this study population was 43.25 years. The 50 patients were divided into 2 groups: 37/50 (74%) underwent upfront surgery and 13/50 (26%) received neoadjuvant therapy before surgery. All patients performed DCE and DWI-MRI breast. Among patients who underwent upfront surgery, DCE-MRI showed the highest correlation with the postoperative pathology size and the overall sensitivity regarding multiplicity. Regarding patients who received neoadjuvant therapy, DCE-MRI was found to have the highest correlation with the postoperative pathology concerning lesion size and multiplicity after completion of the neoadjuvant chemotherapy cycles.

Conclusion

CE-MRI can accurately map lesion extension and detect multifocality/multicentricity, thus tailor surgical management options (either conservative surgery or mastectomy). Qualitative DWI can be combined with ultrasonography for better evaluation of the axillary nodal status.
Offset-extended sparse Radon transform: Application to multiple suppression in the presence of amplitude variations with offset
Authors: Kazemi Nasser , Sacchi Mauricio D.
Published: January 2021

The conventional Radon transform suffers from a lack of resolution when data kinematics and amplitudes differ from those of the Radon basis functions. Also, a limited aperture of data, missing traces, aliasing, a finite number of scanned ray parameters, noise, residual statics, and amplitude variations with offset (AVO) reduce the decorrelation power of the Radon basis functions. Posing Radon transform estimation as an inverse problem by searching for a sparse model that fits the data improves the performance of the algorithm. However, due to averaging along the offset axis, the conventional Radon transform cannot preserve AVO. Accordingly, we modify the Radon basis functions by extending the model domain along the offset direction. Extending the model space helps in fitting data; however, computing the offset-extended Radon transform is an underdetermined and ill-posed problem. To alleviate this shortcoming, we add model domain sparsity and smoothing constraints to yield a stable solution. We have developed an algorithm using offset-extended Radon basis functions with sparsity promoting in offset-stacked Radon images in conjunction with a smoothing restriction along the offset axis. Because the inverted model is sparse and fits the data, muting common-offset Radon panels based on ray-parameter/curvature is sufficient for separating primaries from multiples. We successfully apply the algorithm to suppress multiples in the presence of strong AVO on synthetic data and a real data example from the Gulf of Mexico, Mississippi Canyon. The results indicate that extending the Radon model space is necessary for improving the separation and suppression of the multiples in the presence of strong AVO.
Mutations in the splicing regulator Prp31 lead to retinal degeneration in Drosophila
Authors: Hebbar Sarita , Lehmann Malte , Behrens Sarah , Hälsig Catrin , Leng Weihua , Yuan Michaela , Winkler Sylke , Knust Elisabeth
Published: January 2021

Retinitis pigmentosa (RP) is a clinically heterogeneous disease affecting 1.6 million people worldwide. The second-largest group of genes causing autosomal dominant RP in human encodes regulators of the splicing machinery. Yet, how defects in splicing factor genes are linked to the aetiology of the disease remains largely elusive. To explore possible mechanisms underlying retinal degeneration caused by mutations in regulators of the splicing machinery, we induced mutations in Drosophila Prp31, the orthologue of human PRPF31, mutations in which are associated with RP11. Flies heterozygous mutant for Prp31 are viable and develop normal eyes and retina. However, photoreceptors degenerate under light stress, thus resembling the human disease phenotype. Degeneration is associated with increased accumulation of the visual pigment rhodopsin 1 and increased mRNA levels of twinfilin, a gene associated with rhodopsin trafficking. Reducing rhodopsin levels by raising animals in a carotenoid-free medium not only attenuates rhodopsin accumulation, but also retinal degeneration. Given a similar importance of proper rhodopsin trafficking for photoreceptor homeostasis in human, results obtained in flies presented here will also contribute to further unravel molecular mechanisms underlying the human disease.

This paper has an associated First Person interview with the co-first authors of the article.
Ca2+ elevations disrupt interactions between intraflagellar transport and the flagella membrane in Chlamydomonas
Authors: Fort Cecile , Collingridge Peter , Brownlee Colin , Wheeler Glen
Published: January 2021

The movement of ciliary membrane proteins is directed by transient interactions with intraflagellar transport (IFT) trains. The green alga Chlamydomonas has adapted this process for gliding motility, using retrograde IFT motors to move adhesive glycoproteins in the flagella membrane. Ca2+ signalling contributes directly to the gliding process, although uncertainty remains over the mechanism through which it acts. Here, we show that flagella Ca2+ elevations initiate the movement of paused retrograde IFT trains, which accumulate at the distal end of adherent flagella, but do not influence other IFT processes. On highly adherent surfaces, flagella exhibit high-frequency Ca2+ elevations that prevent the accumulation of paused retrograde IFT trains. Flagella Ca2+ elevations disrupt the IFT-dependent movement of microspheres along the flagella membrane, suggesting that Ca2+ acts by directly disrupting an interaction between retrograde IFT trains and flagella membrane glycoproteins. By regulating the extent to which glycoproteins on the flagella surface interact with IFT motor proteins on the axoneme, this signalling mechanism allows precise control of traction force and gliding motility in adherent flagella.
Endovascular treatment of iatrogenic superior mesenteric arteriovenous fistula resulting in recurrent abdominal ascites
Authors: Wong Amy Ho Ching , Leung Warren K W , Kan Wai Kuen
Published: January 2021

Superior mesenteric arteriovenous fistulas (AVFs) are rare and are usually caused by previous bowel surgery or blunt abdominal trauma. Patients may be asymptomatic, have non-specific symptoms of abdominal pain, nausea and vomiting or present with symptoms of portal hypertension; some patients may present years after initial surgery or trauma. Traditionally, superior mesenteric AVFs are treated by surgical ligation. However, percutaneous endovascular treatment has become increasingly popular in recent years. Different options of endovascular treatment include coil embolisation, covered stent and vascular plugs. There is a risk of coil migration with coil embolisation and covered stents may cause abnormal vessel straightening. Vascular plugs allow the fistula to be treated with fewer devices and have minimal risk of migration. Newer devices such as microvascular plugs have the added advantage of being able to be delivered through microcatheters or diagnostic catheters. The smaller profile of the microvascular plug also allows it to navigate through tortuous vessels. We report a case of a 77-year-old patient presenting with recurrent abdominal ascites three years after small bowel resection. CT and angiogram demonstrated a superior mesenteric AVF, which was successfully treated with a combination of microvascular plug and coil. He remained relatively asymptomatic four months after treatment.
EFEITOS DA REFORMA TRABALHISTA NA JUSTIÇA DO TRABALHO: ANÁLISE DA DINÂMICA PROCESSUAL NA SEGUNDA VARA DO TRABALHO DE SANTA MARIA/RS
Authors: Libardoni Paulo José , Galia Rodrigo Wasen
Published: January 2021

Objetivos: A Reforma Trabalhista, operada pela Lei nº 13.467/2017, trouxe modificações substanciais ao Direito Processual do Trabalho. Nesse sentido, o presente artigo destina-se a analisar tais impactos reformistas na seara processual trabalhista, mormente na dinâmica processual trabalhista, operadas na segunda Vara do Trabalho de Santa Maria/RS, que reclamam uma nova e diferenciada atuação dos profissionais que atuam na área trabalhista (advogados e contadores).Metodologia: O presente estudo constitui-se como uma sistematização de dados quantitativos da segunda Vara do Trabalho de Santa Maria apresentados pelo sistema do Tribunal Regional do Trabalho da 4º Região a partir do ano de 2012 até 2019, seguida por revisões bibliográfica e legislativa que seguem o método dedutivo. Utiliza-se de pesquisa de campo complementada por um aporte bibliográfico, legislativo e doutrinário multidisciplinar e interdisciplinar.Resultados: Várias alterações processuais trabalhistas foram operadas pela Reforma Trabalhista. Dessa forma, conclui-se que houve modificações na distribuição quantitativa das ações por rito, entretanto manteve-se constante o número total de ações ajuizadas. Contribuições: A principal contribuição desta pesquisa reside na possibilidade de se refletir e de se indagar sobre os impactos da Reforma Trabalhista nas ações judiciais que tramitam na segunda Vara do Trabalho de Santa Maria-RS (Justiça do Trabalho).
The Literary Work as a Debt to Beauty
Authors: Bekri Tahar
Published: January 2021

Reflections
The Library versus The Lyre: The Paths of Survival and the Poetry of Textual History
Authors: Balmer Josephine
Published: January 2021

What is the relationship between poetry and scholarship? What can poetry add to the sum of knowledge that scholarship might not? Conceived as a coda to my 2013 study, Piecing Together the Fragments: Translating Classical Verse, Creating Contemporary Poetry, “The Library versus The Lyre” applies the same methods of critical discussion of, and commentary on, my practice as a poet and classical translator to my latest collection, The Paths of Survival (2017). This collection comprises a poetic sequence which moves backwards in time from the present-day to antiquity as it explores the fragility of the written word; how it is destroyed and how it can endure, often in surprising ways, against all odds. In particular, it focuses on the ten tiny scraps of Aeschylus’s play Myrmidons all that now remains of his tragic masterpiece written in the fifth century BCE— commencing with a tiny scrap preserved in the Sackler Library, Oxford and concluding with the Athenian tragedian himself revising his manuscript on his deathbed in Sicily in 456 BCE. Of all my collections, The Paths of Survival offers the most scholarly concerns, raising most questions about the correlations and disruptions between the poetic and the academic. “The Library versus The Lyre” examines this sometimes distrustful, often productive, relationship between the two fields as it looks forward to a new, mutually sympathetic synthesis. As it concludes: “...without scholarship Myrmidons would be lost. And without poetry it would never have been written.”
Studying accelerated cardiovascular ageing in Russian adults through a novel deep-learning ECG biomarker
Authors: Diez Benavente Ernest , Jimenez-Lopez Francisco , Attia Zachi I. , Malyutina Sofia , Kudryavtsev Alexander , Ryabikov Andrew , Friedman Paul A. , Kapa Suraj , Voevoda Michael , Perel Pablo , Schirmer Henrik , Hughes Alun D. , Clark Taane G. , Leon David A.
Published: January 2021

Background: A non-invasive, easy-to-access marker of accelerated cardiac ageing would provide novel insights into the mechanisms and aetiology of cardiovascular disease (CVD) as well as contribute to risk stratification of those who have not had a heart or circulatory event. Our hypothesis is that differences between an ECG-predicted and chronologic age of participants (δage) would reflect accelerated or decelerated cardiovascular ageing

Methods: A convolutional neural network model trained on over 700,000 ECGs from the Mayo Clinic in the U.S.A was used to predict the age of 4,542 participants in the Know Your Heart study conducted in two cities in Russia (2015-2018). Thereafter, δage was used in linear regression models to assess associations with known CVD risk factors and markers of cardiac abnormalities.

Results: The biomarker δage (mean: +5.32 years) was strongly and positively associated with established risk factors for CVD: blood pressure, body mass index (BMI), total cholesterol and smoking. Additionally, δage had strong independent positive associations with markers of structural cardiac abnormalities: N-terminal pro b-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin T (hs-cTnT) and pulse wave velocity, a valid marker of vascular ageing.

Conclusion: The difference between the ECG-age obtained from a convolutional neural network and chronologic age (δage) contains information about the level of exposure of an individual to established CVD risk factors and to markers of cardiac damage in a way that is consistent with it being a biomarker of accelerated cardiovascular (vascular) ageing. Further research is needed to explore whether these associations are seen in populations with different risks of CVD events, and to better understand the underlying mechanisms involved.