bluuebunny/crossref_metadata_2025 huggingface dataset:
How do third sector organisations or charities providing health and well-being services in England implement patient-reported outcome measures (PROMs)? A qualitative interview study
Authors: Foster Alexis , O'Cathain Alicia , Harris Janet
Published: October 2020

Objectives

To identify the facilitators and barriers to implementing patient-reported outcome measures (PROMs) in third sector organisations (TSOs) delivering health and well-being services.

Design

A qualitative interview study. Participants were recruited using purposive, opportunistic and snowballing methods. Framework analysis was used.

Setting

TSOs including charities, community groups and not-for-profit organisations in England, UK.

Participants

Thirty interviewees including service users, TSO front-line workers and managers, commissioners of TSOs and other stakeholders such as academic researchers.

Results

TSOs primarily used PROMs because of pressures arising from the external funding context. However, organisations often struggled to implement PROMs, rarely getting the process right first time. Facilitators for implementation included having an implementation lead committed to making it work, investing resources in data management systems and support staff and taking a collaborative approach to designing the PROMs process. The latter helped to ensure an appropriate PROMs process for the specific TSO including choosing a suitable measure and planning how data would be collected, processed and used. There was a dilemma about whether TSOs should use standardised well-being measures (eg, the Warwick-Edinburgh Mental Well-being Scale) or design their own PROM. Not all TSOs sustained the collection and reporting of PROMs over time because this required a change in organisational culture to view PROMs as beneficial for the TSO and PROMs becoming part of front-line workers’ job specifications.

Conclusions

TSOs are trying to use PROMs because they feel they have no choice but often struggle with implementation. Having an implementation lead, designing an appropriate process, investing resources, training staff and taking mitigating action to address potential barriers can facilitate implementation. Some of the findings are consistent with the experiences of more clinical services so appear relevant to the implementation of PROMs irrespective of the specific context.
Bridging the gap between respiratory research and health literacy: an
interactive web-based platform
Authors: Burrowes Kelly , Kumar Haribalan , Clark Alys , de Wolff Taco , Tawhai Merryn
Published: October 2020

Many patients with respiratory disease lack an understanding of basic
respiratory physiology and the changes occurring in their lungs due to disease.
Describing how the lungs work using realistic 3D visualisation of lung structure
and function will improve communication of complicated concepts, resulting in
improved health literacy. We developed a web-based platform, using anatomically
realistic 3D lung models, to create an interactive visualisation tool to improve
health literacy for patients with respiratory disease. A small amount of
non-identifying personal information including gender, age, weight, height and
smoking history can be used to customise the visualisation to an individual user.
3D computer modelling was used to create a web-based application that helps people
understand how their lungs work in health and disease. The web-based application
includes pages describing and visualising how the lungs work and the changes that
occur during asthma and damage that smoking may be doing to their lungs. The
application is freely available and located at https://sites.bioeng.auckland.ac.nz/silo6/lung_new/. This
application bridges the gap between computational modelling and patient education,
giving a visually compelling view into the patient’s body that cannot be provided
with any existing tools, hence providing a novel platform for enhancing
patient–clinician interaction.
Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy
Authors: Pinato David J , Kaseb Ahmed , Wang Yinghong , Saeed Anwaar , Szafron David , Jun Tomi , Dharmapuri Sirish , Naqash Abdul Rafeh , Muzaffar Mahvish , Navaid Musharraf , Khan Uqba , Lee ChiehJu , Bulumulle Anushi , Yu Bo , Paul Sonal , Fessas Petros , Nimkar Neil , Bettinger Dominik , Hildebrand Hannah , Pressiani Tiziana , Abugabal Yehia I , Personeni Nicola , Huang Yi-Hsiang , Lozano-Kuehne Jingky , Rimassa Lorenza , Ang Celina , Marron Thomas U
Published: October 2020

The impact of corticosteroid therapy (CT) on efficacy of immune checkpoint inhibitors (ICI) is undefined in hepatocellular carcinoma (HCC). We evaluated whether CT administered at baseline (bCT) or concurrently with ICI (cCT) influences overall (OS), progression-free survival (PFS) and overall response rates (ORR) in 341 patients collected across 3 continents. Of 304 eligible patients, 78 (26%) received >10 mg prednisone equivalent daily either as bCT (n=14, 5%) or cCT (n=64, 21%). Indications for CT included procedure/prophylaxis (n=37, 47%), management of immune-related adverse event (n=27, 35%), cancer-related symptoms (n=8, 10%) or comorbidities (n=6, 8%). Neither overall CT, bCT nor cCT predicted for worse OS, PFS nor ORR in univariable and multivariable analyses (p>0.05). CT for cancer-related indications predicted for shorter PFS (p<0.001) and was associated with refractoriness to ICI (75% vs 33%, p=0.05) compared with cancer-unrelated indications. This is the first study to demonstrate that neither bCT nor cCT influence response and OS following ICI in HCC. Worse outcomes in CT recipients for cancer-related indications appear driven by the poor prognosis associated with symptomatic HCC.
Combining IL-2-based immunotherapy with commensal probiotics produces enhanced antitumor immune response and tumor clearance
Authors: Shi Linlin , Sheng Jianyong , Chen Guozhong , Zhu Peng , Shi Changping , Li Bei , Park Chaiwoo , Wang Jingyi , Zhang Bixiang , Liu Zhi , Yang Xiangliang
Published: October 2020

Background

Interleukin-2 (IL-2) serves as a pioneer of immunotherapeutic agent in cancer treatment. However, there is a considerable proportion of patients who cannot benefit from this therapy due to the limited clinical responses and dose-limiting toxicities. Mounting evidence indicates that commensal microbiota shapes the outcome of cancer immunotherapies. In this study, we aim to investigate the enhancing effect of Akkermansia muciniphila (AKK), a beneficial commensal microbe receiving considerable attentions, on the antitumor efficacy of IL-2 and explore the underlying molecular mechanism.

Methods

Colorectal carcinoma patient-derived tumor tissues were used to evaluate the therapeutic efficacy of combination treatment. AKK was orally delivered to B16F10 and CT26 tumor-bearing mice along with systemic IL-2 treatment. Flow cytometry was carried out to analyze the tumor immune microenvironment. The molecular mechanism of the enhanced therapeutic efficacy was explored by RNA-seq and then verified in tumor-bearing mice.

Results

Combined treatment with IL-2 and AKK showed a stronger antitumor efficacy in colorectal cancer patient-derived tumor tissues. Meanwhile, the therapeutic outcome of IL-2 was significantly potentiated by oral administration of AKK in subcutaneous melanoma and colorectal tumor-bearing mice, resulting from the strengthened antitumor immune surveillance. Mechanistically, the antitumor immune response elicited by AKK was partially mediated by Amuc, derived from the outer membrane protein of AKK, through activating toll-like receptor 2 (TLR2) signaling pathway. Besides, oral supplementation with AKK protected gut barrier function and maintained mucosal homeostasis under systemic IL-2 treatment.

Conclusion

These findings propose that IL-2 combined with AKK is a novel therapeutic strategy with prospecting application for cancer treatment in clinical practice.
Gene signature of antigen processing and presentation machinery predicts response to checkpoint blockade in non-small cell lung cancer (NSCLC) and melanoma
Authors: Thompson Jeffrey C , Davis Christiana , Deshpande Charuhas , Hwang Wei-Ting , Jeffries Seth , Huang Alexander , Mitchell Tara C , Langer Corey J , Albelda Steven M
Published: October 2020

Background

Limited data exist on the role of alterations in HLA Class I antigen processing and presentation machinery in mediating response to immune checkpoint blockade (ICB).

Methods

This retrospective cohort study analyzed transcriptional profiles from pre-treatment tumor samples of 51 chemotherapy-refractory advanced non-small cell lung cancer (NSCLC) patients and two independent melanoma cohorts treated with ICB. An antigen processing machinery (APM) score was generated utilizing eight genes associated with APM (B2M, CALR, NLRC5, PSMB9, PSME1, PSME3, RFX5,andHSP90AB1). Associations were made for therapeutic response, progression-free survival (PFS) and overall survival (OS).

Results

In NSCLC, the APM score was significantly higher in responders compared with non-responders (p=0.0001). An APM score above the median value for the cohort was associated with improved PFS (HR 0.34 (0.18 to 0.64), p=0.001) and OS (HR 0.44 (0.23 to 0.83), p=0.006). The APM score was correlated with an inflammation score based on the established T-cell-inflamed resistance gene expression profile (Pearson’s r=0.58, p<0.0001). However, the APM score better predicted response to ICB relative to the inflammation score with area under a receiving operating characteristics curve of 0.84 and 0.70 for PFS and OS, respectively. In a cohort of 14 high-risk resectable stage III/IV melanoma patients treated with neoadjuvant anti-PD1 ICB, a higher APM score was associated with improved disease-free survival (HR: 0.08 (0.01 to 0.50), p=0.0065). In an additional independent melanoma cohort of 27 metastatic patients treated with ICB, a higher APM score was associated with improved OS (HR 0.29 (0.09 to 0.89), p=0.044).

Conclusion

Our data demonstrate that defects in antigen presentation may be an important feature in predicting outcomes to ICB in both lung cancer and melanoma.
Diagnostic utility of CT for suspected immune checkpoint inhibitor enterocolitis
Authors: Durbin Sienna M , Mooradian Meghan J , Fintelmann Florian Johannes , Zubiri Leyre , Chute Donald F , Kambadakone Avinash , Pisuchpen Nisanard , Reynolds Kerry L , Dougan Michael
Published: October 2020

Background and aims

Immune checkpoint inhibitor (ICI) enterocolitis is a common immune-related adverse event and can be fatal, especially when not diagnosed and treated promptly. The current gold standard for diagnosis is endoscopy with biopsy, but CT scan is a possible alternative. The primary objective of this study is to identify the diagnostic performance of CT in the evaluation of ICI enterocolitis.

Methods

With institutional review board approval, we conducted a retrospective cohort study of patients who received ICI therapy between 2015 and 2019 across a healthcare system. Patients were included if they underwent both abdominal CT and endoscopy with biopsy within 3 days. The radiological and pathological diagnoses, as well as clinical characteristics, were extracted from the electronic medical record. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CT for diagnosing ICI enterocolitis when compared with tissue diagnosis.

Results

Of the 4474 patients screened, 138 met inclusion criteria. Most common tumor types were melanoma (37%) and lung cancer (19%). Seventy-four per cent were treated with antiprogrammed cell death (PD-1)/PD-L1 therapy. Thirty-nine per cent had signs of enterocolitis on CT scan and 58% had biopsy-proven ICI enterocolitis. Sensitivity and specificity of CT were 50% and 74%, respectively. PPV was 73% and NPV was 52%. Of those with confirmed ICI enterocolitis, 70% had grade 3 or higher symptoms, 91% received steroids and 40% received infliximab.

Conclusion

The performance of CT scan for diagnosis of ICI enterocolitis is moderate to poor and does not replace endoscopy with biopsy.
Radiographic findings and anatomical variations of the caudal cervical area in horses with neck pain and ataxia: case–control study on 116 horses
Authors: Beccati Francesca , Pepe Marco , Santinelli Isabella , Gialletti Rodolfo , Di Meo Antonio , Romero Jose Manuel
Published: October 2020

Background

Abnormalities of the ventral lamina of the sixth cervical vertebra (AVL‐C6) are thought to exert abnormal stress on the articular process joints (APJs) of the cervicothoracic junction. The aim of the study was to investigate the association between AVL‐C6 and radiographic findings in the caudal cervical area and between clinical signs of neck pain and ataxia and radiographic findings.

Methods

Medical records of horses subjected to cervical radiography were reviewed. Horses were classified into those with neck pain (group C), those with ataxia (group A) and healthy horses (group H). Presence of AVL‐C6 and increased size, dysplasia, remodelling, fragmentation and osteochondral fragment at the APJs (C5–T1) were recorded. Univariable logistic regression analysis was performed to identify the associations between explanatory and dependent variables. Variables with P<0.2 were included in the multivariable analysis.

Results

One hundred and sixteen horses were included (44 in group C, 29 in group A, 66 in group H); 24 of 116 horses had radiographic AVL‐C6. Age, AVL‐C6 and overall/C6–C7 increase in size remained in the final models.

Conclusions

The presence of AVL‐C6 and moderate/severe increase in size of the caudal cervical APJs increase the odds of showing neck pain and, if severe, ataxia.
Grease trap waste (griddle grease) as a feed ingredient for finishing lambs: growth performance, dietary energetics, and carcass characteristics
Authors: Ramos-Méndez Jorge L. , Estrada-Angulo Alfredo , Rodríguez-Gaxiola Miguel A. , Gaxiola-Camacho Soila M. , Chaidez-Álvarez Christian , Manriquez-Núñez Olga M. , Barreras Alberto , Zinn Richard A. , Soto-Alcalá Jorge , Plascencia Alejandro
Published: October 2020

Forty-eight (37.7 ± 3.4 kg, initial shrunk live weight) lambs were used in a 61 d experiment to evaluate the energy value of grease trap waste (GT) at four levels of supplementation (0%, 2%, 4%, and 6%). Supplemental GT replaced cracked corn in the basal diet. The GT contained 6.4% moisture, 3.1% impurities, and 79.8% total fatty acids (FA). Increasing GT level in diets did not affect dry matter intake and daily weight gain but linearly increased gain efficiency and estimated dietary net energy (NE). However, the ratio of observed-to-expected diet NE decreased with increased levels of GT. The estimated NE values for GT based on FA intake were in close agreement (98% and 102% of predicted, respectively) with those NE values determined by replacement technique for 2% and 4% supplementation level. However, the observed NE value for GT supplemented at the 6% level was 9% lower than predicted. Kidney–pelvic–heart fat increased as level of GT supplementation increased; otherwise, carcass characteristics and shoulder composition were not affected. We conclude that GT is a suitable alternative to conventional feed fats in diets for finishing lambs. The estimated NE of GT is 93% the energy value assigned by current standards for tallow and yellow grease.
Effect of seed size on germination in three species from arid Arabian deserts
Authors: Gairola Sanjay , Mahmoud Tamer , Shabana Hatem A. , AlKetbi Asma , Phartyal Shyam S.
Published: October 2020

In many species, seeds with different sizes show diverse responses in their requirements for temperature and light for optimal germination. In this study, the effect of seed size (i.e., small and large) on germination was tested in seeds of Brassica tournefortii Gouan, Lotus garcinii DC., and Salvadora persica L. from arid Arabian Desert habitats. The mean seed size of all three study species differs significantly between small and large-sized seeds. Differences were observed in seed germination between large and small seeds of B. tournefortii and L. garcinii. We found that the large seeds of B. tournefortii and L. garcinii showed a higher germination percentage at all tested temperatures than that displayed by the small seeds. However, both small and large seeds of S. persica germinated equally (100%) well under all tested incubation conditions. Our results show significant differences in germination percentage between the small and large seeds of B. tournefortii at 25/35 °C under a 12 h light regime. However, seeds of L. garcinii showed a significant difference in germination percentage at low temperatures (15/25 °C) under a 12 h light regime.
Exact solution of the non-Hermitian eigenvalue problem for electron orbital excitations in a hydrogen atom
Authors: Popov Andrey V.
Published: October 2020

A new way of solving the spectral problem to describe electronic excitations is demonstrated for a hydrogen atom. The applied methodology is based formally on the idea of electronic excitation description without introducing boundary conditions to the eigenvalue problem for the square of the angular momentum operator. The eigenvalues of such an operator are considered as complex in general. As a result, the spectral problem for the Schrödinger equation becomes non-Hermitian with complex energy values. The imaginary part of the total energy helps to estimate the excitation lifetime within a unified scheme. The existence of the Stark shift of atomic energy levels and the collapse of the atomic spectra are confirmed.
Quantum search with an ensemble of single-query search processes
Authors: Toyama F.M. , van Dijk W.
Published: October 2020

Recently we introduced an additive composition formulation of an iterative quantum-search algorithm of Grover type. In this paper, an ensemble-processing scheme suggested by the additive composition is presented. The ensemble-processing consists of single-query search processes and yields the quantum search with certainty. Furthermore, we propose a possible quantum circuit for the ensemble processing.
Semileptonic transition of $$\varLambda _{b}$$ baryon
Authors: Thakkar Kaushal
Published: October 2020

The semileptonic transition of $$\varLambda _b$$

Λ
b

baryon is studied using the Hypercentral constituent quark model. The six-dimensional hyperradial $$Schr\ddot{o}dinger$$

S
c
h
r

o
¨

d
i
n
g
e
r

equation is solved in the variational approach to get masses and wavefunctions of heavy baryons. The matrix elements of weak decay are written in terms of the overlap integrals of the baryon wave function. The Isgur-Wise function is determined to calculate exclusive semileptonic decay $$\varLambda _b$$

Λ
b

$$\rightarrow $$
→
$$\varLambda _c$$

Λ
c

$$\ell $$
ℓ
$${\bar{\nu }}$$

ν

¯

. The calculated decay rate and the branching ratio of $$\varLambda _b$$

Λ
b

baryon are consistent with other theoretical predictions and with the available experimental observations.
Exploiting knowledge graph and text for ranking entity types
Authors: Rahman Md Mostafizur , Takasu Atsuhiro
Published: October 2020

Most of the online queries target entities and the type of an entity is a key piece of information. Entity type helps us to understand what an entity is and how it relates to other entities mentioned in a document. Search engine result pages (SERPs) often surface facts and entity type information from a background Knowledge Graph (KG) in response to queries that carry a semantic information need. In a KG, an entity usually holds multiple type properties. For example, popular types attached to the entity `Donald Trump' via
rdfs:type
statements might be Person, Businessman, and Leader. However, other types of this entity, e.g., Solicitor, Restaurateur, and Writer might also be interesting to some users. Unpopular entity types can be useful for tail queries like, for example, `Is Donald Trump an American Television Producer' or `Is Donald Trump an American Television Actor'. It is then important to, given an entity in a KG, rank entity types attached to the entity by relevance to a certain user and information need as not always the most popular type is the most informative within a textual context. In this paper we address the entity type ranking problem by means of KG embedding models. In our work, we show that entity type ranking can be seen as a special case of the KG completion problem. Embeddings can be learned from the structural, probabilistic and contextual description information of the entities. We propose and evaluate our methods to find the most relevant entity type based on collection statistics and on the graph structure interconnecting entities and types. Experimental results show that our proposed approaches outperform the state-of-the-art type ranking models while, at the same time, being more efficient and scalable. Our approach focuses on the task of ranking a set of types associated to an entity in a background knowledge graph to select the most relevant types.
Reliability of diaphragmatic motor-evoked potentials induced by transcranial magnetic stimulation
Authors: Welch Joseph F. , Argento Patrick J. , Mitchell Gordon S. , Fox Emily J.
Published: October 2020

Transcranial magnetic stimulation (TMS) is a noninvasive technique to assess neural impulse conduction along the cortico-diaphragmatic pathway. The reliability of diaphragm motor-evoked potentials (MEP) induced by TMS is unknown. Notwithstanding large variability in MEP amplitude, we found good-to-excellent reproducibility of all MEP characteristics (latency, duration, amplitude, and area) both within- and between-day in healthy adult men and women. Our findings support the use of TMS and surface EMG to assess diaphragm activation in humans.
Blood flow, capillary transit times, and tissue oxygenation: the centennial of capillary recruitment
Authors: Østergaard Leif
Published: October 2020

The transport of oxygen between blood and tissue is limited by blood’s capillary transit time, understood as the time available for diffusion exchange before blood returns to the heart. If all capillaries contribute equally to tissue oxygenation at all times, this physical limitation would render vasodilation and increased blood flow insufficient means to meet increased metabolic demands in the heart, muscle, and other organs. In 1920, Danish physiologist August Krogh was awarded the Nobel Prize in Physiology or Medicine for his mathematical and quantitative, experimental demonstration of a solution to this conceptual problem: capillary recruitment, the active opening of previously closed capillaries to meet metabolic demands. Today, capillary recruitment is still mentioned in textbooks. When we suspect symptoms might represent hypoxia of a vascular origin, however, we search for relevant, flow-limiting conditions in our patients and rarely ascribe hypoxia or hypoxemia to short capillary transit times. This review describes how natural changes in capillary transit-time heterogeneity (CTH) and capillary hematocrit (HCT) across open capillaries during blood flow increases can account for a match of oxygen availability to metabolic demands in normal tissue. CTH and HCT depend on a number of factors: on blood properties, including plasma viscosity, the number, size, and deformability of blood cells, and blood cell interactions with capillary endothelium; on anatomical factors including glycocalyx, endothelial cells, basement membrane, and pericytes that affect the capillary diameter; and on any external compression. The review describes how risk factor- and disease-related changes in CTH and HCT interfere with flow-metabolism coupling and tissue oxygenation and discusses whether such capillary dysfunction contributes to vascular disease pathology.
In vivo supraspinatus muscle contractility and architecture in rabbit
Authors: Hyman Sydnee A. , Norman Mackenzie B. , Dorn Shanelle N. , Bremner Shannon N. , Esparza Mary C. , Lieber Richard L. , Ward Samuel R.
Published: October 2020

We introduce an improved method to assess rabbit supraspinatus muscle physiology. Maximum isometric force measured for the rabbit supraspinatus was dramatically greater than previous reports in the literature. Consequently, the isometric contractile stress reported is almost 10 times greater than previous reports of rabbit supraspinatus, but similar to available literature of other mammalian skeletal muscle. We show that previous reports of peak supraspinatus isometric force were subphysiological by ∼90%
The Separation of Antler Polypeptide and Its Effects on the Proliferation and Osteogenetic Differentiation of Bone Marrow Mesenchymal Stem Cells
Authors: Wang Ping , Sun Tie-Feng , Li Gang , Zhang Hui-Min , Liu Fan-jie , Gao Zhi-hui , Cao Sheng-nan , Sun Guo-dong , Du Hai-tao , Wang Cong-an , Wang Dan-dan , Shi Bin , Lin Ling
Published: October 2020

Background. Colla Cornus Cervi (CCC) has been used as a traditional Chinese medicine in the treatment of osteoporosis and osteonecrosis of the femoral head. However, the bioavailability of CCC is seriously limited owing to its large molecular weight and complex ingredients. In the present study, antler polypeptide was separated from CCC, and the effects of antler polypeptide on rat bone marrow mesenchymal stem cells (BMSCs) were investigated. Methods. Antler polypeptide was separated from Colla Cornus Cervi by ultrafiltration into different samples according to the molecular weight. The total peptide content of these samples was determined by the biuret method. The content of antler polypeptide in different samples was quantified by high‐performance liquid chromatography (HPLC). The effects of antler polypeptide at different concentrations on the proliferation, cell cycle, alkaline phosphatase activity, and BMP7 expression of BMSCs were investigated. Results. Antler polypeptide was separated by ultrafiltration into different samples: A (molecular weight <800 Da), B (molecular weight 800–1500 Da), and C (molecular weight >1500 Da). The total peptide contents of A, B, and C were 0.602 mg/mL, 8.976 mg/mL, and 38.88 mg/mL. Antler polypeptide B eluted at 14.279∼15.351 min showed that the content of antler polypeptide was significantly higher than that of A and C with a peak area of 933.80927. The BMSCs proliferation rate (84.66%) of polypeptide B was the highest at the concentration of 1.578 × 10−2 g/mL. Antler polypeptide B significantly promoted the proliferation of BMSCs with a proliferation index of 38.68%, which was significantly higher than that of the other groups. Antler polypeptide B significantly enhanced the activity of alkaline phosphatase in BMSCs compared to that of the blank group (P < 0.001). Antler polypeptide B increased the BMP7 protein expression in BMSCs. Conclusions. Results suggested that antler polypeptide may promote the proliferation and osteogenic differentiation of BMSCs. Our study lays an experimental foundation for the further development and application of antler polypeptide in medicine.
Position Tracking of a Pneumatic-Muscle-Driven Rehabilitation Robot by a Single Neuron Tuned PID Controller
Authors: Zhong Jun , Zhu Yue , Zhao Chun , Han Zhenfeng , Zhang Xin
Published: October 2020

Pneumatic muscle actuators (PMAs) own compliant characteristics and are suitable for use in rehabilitation equipment. This paper introduces a rehabilitation robot driven by PMAs devised in the Rehabilitation and Medical Robot Laboratory. Considering high nonlinearities inside PMAs, a single neuron tuned PID controller is carefully designed. Experimental setup is built up and trials are performed. Results demonstrate the proposed advanced PID algorithm can achieve better capacity in position tracking than the conventional PID controller.
Low Advanced Lung Cancer Inflammation Index Predicts Poor Prognosis in Locally Advanced Nasopharyngeal Carcinoma Patients Treated with Definitive Concurrent Chemoradiotherapy
Authors: Topkan Erkan , Ozdemir Yurday , Kucuk Ahmet , Guler Ozan Cem , Sezer Ahmet , Besen Ali Ayberk , Mertsoylu Huseyin , Senyurek Sukran , Kilic Durankus Nulifer , Bolukbasi Yasemin , Selek Ugur , Pehlivan Berrin
Published: October 2020

Purpose. We aimed to retrospectively investigate the prognostic worth of pretreatment advanced lung cancer inflammation index (ALI) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients treated with concurrent chemoradiotherapy (C-CRT). Patients and Methods. A total of 164 LA-NPC patients treated with cisplatinum-based definitive C-CRT were included in this retrospective cohort analysis. The convenience of ideal pre-C-CRT ALI cut-offs affecting survival results was searched by employing the receiver operating characteristic (ROC) curve analyses. The primary endpoint was the link between the ALI groups and overall survival (OS), while cancer-specific survival (CSS), locoregional progression-free survival [LR(PFS)], distant metastasis-free survival (DMFS), and PFS comprised the secondary endpoints. Results. The ROC curve analyses distinguished a rounded ALI cut-off score of 24.2 that arranged the patients into two cohorts [ALI ≥ 24.2 (N = 94) versus < 24.2 (N = 70)] with significantly distinct CSS, OS, DMFS, and PFS outcomes, except for the LRPFS. At a median follow-up time of 79.2 months (range: 6–141), the comparative analyses showed that ALI < 24.2 cohort had significantly shorter median CSS, OS, DMFS, and PFS time than the ALI ≥ 24.2 cohort (

P
<
0.001

for each), which retained significance at 5- (

P
<
0.001

) and 10-year (

P
<
0.001

) time points. In multivariate analyses, ALI < 24.2 was asserted to be an independent predictor of the worse prognosis for each endpoint (

P
<
0.001

for each) in addition to the tumor stage (T-stage) (

P
<
0.05

for all endpoints) and nodal stage (N-stage) (

P
<
0.05

for all endpoints). Conclusion. As a novel prognostic index, the pretreatment ALI < 24.2 appeared to be strongly associated with significantly diminished survival outcomes in LA-NPC patients treated with C-CRT independent of the universally recognized T- and N-stages.
Serum Cystatin C and Coronavirus Disease 2019: A Potential Inflammatory Biomarker in Predicting Critical Illness and Mortality for Adult Patients
Authors: Chen Dan , Sun Wenwu , Li Jia , Wei Bohua , Liu Wei , Wang Xiaopin , Song Fan , Chen Liangkai , Yang Junhui , Yu Li
Published: October 2020

This study aimed at determining the relationship between baseline cystatin C levels and coronavirus disease 2019 (COVID-19) and investigating the potential prognostic value of serum cystatin C in adult patients with COVID-19. 481 patients with COVID-19 were consecutively included in this study from January 2, 2020, and followed up to April 15, 2020. All clinical and laboratory data of COVID-19 patients with definite outcomes were reviewed. For every measure, COVID-19 patients were grouped into quartiles according to the baseline levels of serum cystatin C. The highest cystatin C level was significantly related to more severe inflammatory conditions, worse organ dysfunction, and worse outcomes among patients with COVID-19 (P values < 0.05). In the adjusted logistic regression analyses, the highest cystatin C level and ln-transformed cystatin C levels were independently associated with the risks of developing critically ill COVID-19 and all-cause death either in overall patients or in patients without chronic kidney disease (P values < 0.05). As a potential inflammatory marker, increasing baseline levels of serum cystatin C might independently predict adverse outcomes for COVID-19 patients. Serum cystatin C could be routinely monitored during hospitalization, which showed clinical importance in prognosticating for adult patients with COVID-19.
Pregnancy and Neonatal Outcomes in SARS-CoV-2 Infection: A Systematic Review
Authors: Chamseddine Reem S. , Wahbeh Farah , Chervenak Frank , Salomon Laurent J. , Ahmed Baderledeen , Rafii Arash
Published: October 2020

With the emergence of SARS-CoV-2 and its rapid spread, concerns regarding its effects on pregnancy outcomes have been growing. We reviewed 245 pregnancies complicated by maternal SARS-CoV-2 infection across 48 studies listed on PubMed and MedRxiv. The most common clinical presentations were fever (55.9%), cough (36.3%), fatigue (11.4%), and dyspnea (12.7%). Only 4.1% of patients developed respiratory distress. Of all patients, 89.0% delivered via cesarean section (

n
=
201

), with a 33.3% rate of gestational complications, a 35.3% rate of preterm delivery, and a concerning 2.5% rate of stillbirth delivery or neonatal death. Among those tested, 6.45% of newborns were reported positive for SARS-CoV-2 infection. Relative to known viral infections, the prognosis for pregnant women with SARS-CoV-2 is good, even in the absence of specific antiviral treatment. However, neonates and acute patients, especially those with gestational or preexisting comorbidities, must be actively managed to prevent the severe outcomes being increasingly reported in the literature.
Application of BERT to Enable Gene Classification Based on Clinical Evidence
Authors: Su Yuhan , Xiang Hongxin , Xie Haotian , Yu Yong , Dong Shiyan , Yang Zhaogang , Zhao Na
Published: October 2020

The identification of profiled cancer‐related genes plays an essential role in cancer diagnosis and treatment. Based on literature research, the classification of genetic mutations continues to be done manually nowadays. Manual classification of genetic mutations is pathologist‐dependent, subjective, and time‐consuming. To improve the accuracy of clinical interpretation, scientists have proposed computational‐based approaches for automatic analysis of mutations with the advent of next‐generation sequencing technologies. Nevertheless, some challenges, such as multiple classifications, the complexity of texts, redundant descriptions, and inconsistent interpretation, have limited the development of algorithms. To overcome these difficulties, we have adapted a deep learning method named Bidirectional Encoder Representations from Transformers (BERT) to classify genetic mutations based on text evidence from an annotated database. During the training, three challenging features such as the extreme length of texts, biased data presentation, and high repeatability were addressed. Finally, the BERT+abstract demonstrates satisfactory results with 0.80 logarithmic loss, 0.6837 recall, and 0.705 F‐measure. It is feasible for BERT to classify the genomic mutation text within literature‐based datasets. Consequently, BERT is a practical tool for facilitating and significantly speeding up cancer research towards tumor progression, diagnosis, and the design of more precise and effective treatments.
INHBB Is a Novel Prognostic Biomarker Associated with Cancer‐Promoting Pathways in Colorectal Cancer
Authors: Yuan Jinpeng , Xie Aosi , Cao Qiangjian , Li Xinxin , Chen Juntian
Published: October 2020

Background. Inhibin subunit beta B (INHBB) is a protein‐coding gene that participated in the synthesis of the transforming growth factor‐β (TGF‐β) family members. The study is aimed at exploring the clinical significance of INHBB in patients with colorectal cancer (CRC) by bioinformatics analysis. Methods. Real‐time PCR and analyses of Oncomine, Gene Expression Omnibus (GEO), and The Cancer Genome Atlas (TCGA) databases were utilized to evaluate the INHBB gene transcription level of colorectal cancer (CRC) tissue. We evaluated the INHBB methylation level and the relationship between expression and methylation levels of CpG islands in CRC tissue. The corresponding clinical data were obtained to further explore the association of INHBB with clinical and survival features. In addition, Gene Set Enrichment Analysis (GSEA) was performed to explore the gene ontology and signaling pathways of INHBB involved. Results. INHBB expression was elevated in CRC tissue. Although the promoter of INHBB was hypermethylated in CRC, methylation did not ultimately correlate with the expression of INHBB. Overexpression of INHBB was significantly and positively associated with invasion depth, distant metastasis, and TNM stage. Cox regression analyses and Kaplan‐Meier survival analysis indicated that high expression of INHBB was correlated with worse overall survival (OS) and disease‐free survival (DFS). GSEA showed that INHBB was closely correlated with 5 cancer‐promoting signaling pathways including the Hedgehog signaling pathway, ECM receptor interaction, TGF‐β signaling pathway, focal adhesion, and pathway in cancer. INHBB expression significantly promoted macrophage infiltration and inhibited memory T cell, mast cell, and dendritic cell infiltration. INHBB expression was positively correlated with stromal and immune scores of CRC samples. Conclusion. INHBB might be a potential prognostic biomarker and a novel therapeutic target for CRC.
Protecting Healthcare Professionals during the COVID‐19 Pandemic
Authors: Qi Baiwen , Peng Haiheng , Shou Kangquan , Pan Zhengyu , Zhou Min , Li Rui , Deng Liping , Shen Jun , Rao Xin , Yu Aixi
Published: October 2020

Objective. To understand how to implement proactive prevention measures among healthcare professionals for preventing potential nosocomial infection. Methods. 91 healthcare professionals confirmed with the COVID‐19 infection were collected, and clinical characteristics and epidemiological data were evaluated. Results. Among the cases, 77 cases (84.6%) were confirmed by the viral nucleic acid test, and the other 14 cases were diagnosed by the clinical investigation. Ground glass opacity and bilateral shadows distribution were observed in 78 cases (85.6%). 56 cases (61.5%) were admitted into Zhongnan Hospital and subjected to antiviral treatment. 73 of a total of 91 cases (80.2%) with a median incubation period of 3 days (IQR, 2 to 6) reported close contact history with patients with the COVID‐19 infection. The most common symptoms at the onset of illness were fever (66 cases, 72.5%) and cough (54 cases, 59.3%). The initial positive rate of the CT scan and RT‐PCR assay were 84.6% and 48.4%, respectively (P < 0.01). There were 50 cases occurred during the early stage (before Jan 20, 2020), whereas 41 cases occurred at a late stage (after Jan 20, 2020). In the early stage, the most common route of exposure to COVID‐19 was via direct care in the absence of any invasive procedure. By contrast, 37 healthcare professionals infected with COVID‐19 in the late stage were confirmed to have been exposed via aerosol‐generating procedures. Conclusion. Identification of the asymptomatic individuals in healthcare settings and prompt response when a suspicious case is considered may render effective control of the nosocomial infection during this pandemic.
Translation and Validation of the Spiritual Care Intervention-Provision Scale in the Greek Language
Authors: Fradelos Evangelos C. , Papathanasiou Ioanna V. , Tzavella Foteini
Published: October 2020

Introduction. Spiritual care is defined as activities and interventions that promote spiritual health and the spiritual dimension of quality of life. Empirical data indicate the importance that spiritual care provision has on nursing practice. The spiritual care intervention-provision (SCIP) scale was developed to assess the frequency of spiritual care intervention implemented by nurses. Currently, there are no validated scales for assessing spiritual care in the Greek language. Objective. To adapt and validate the spiritual care intervention-provision scale in the Greek language. Methods. A descriptive cross-sectional study was employed, in which 275 nurses working in two public hospitals participated. The SCIP scale underwent the process of cross-cultural adaptation and was evaluated by assessing its reliability and validity. Results. The process resulted in a valid Greek version of the SCIPS, the internal consistency (Cronbach’s α 0.887), reliability testing-retesting (r = 0.997,

p
<
0.001

, and t = 0.387,

p
>
0.05

), construct, and convergent validities were evaluated. Conclusion. The Greek version of the spiritual care intervention-provision scale is a validated scale that can be used to examine spiritual care provision in Greek health services.
A Comprehensive Review of Atmosphere-Breathing Electric Propulsion Systems
Authors: Zheng Peng , Wu Jianjun , Zhang Yu , Wu Biqi
Published: October 2020

To develop the satellites for a low-Earth-orbit environment, atmosphere-breathing electric propulsion (ABEP) systems have become more attractive to researchers in the past decade. The system can use atmospheric molecules as the propellant to provide thrust compensation, which can extend the lifetime of spacecraft (S/C). This comprehensive review reviews the efforts of previous researchers to develop concepts for ABEP systems. Different kinds of space propulsion system are analysed to determine the suitable propulsion for atmosphere-breathing S/C. Further discussion about ABEP systems shows the characteristic of different thrusters. The main performance of the ABEP system of previous studies is summarized, which provides further research avenues in the future. Results show great potential for thrust compensation from atmospheric molecules. However, the current studies show various limitations and are difficult to apply to space. The development of ABEP needs to solve some problems, such as the intake efficiency, ionization power, and electrode corrosion.
Cervical, Thoracic, and Lumbar Spine Epidural Abscess: Case Report and Literature Review
Authors: Baralo Bohdan , Kulkarni Mrunal , Ellangovan Rithikaa , Selko Robert , Kulkarni Ajinkya , Guha Roy Shambo , Gilbert Mark
Published: October 2020

We report a case of a spinal epidural abscess (SEA) in a patient without significant risk factors. The patient was treated in an outpatient setting for one week for worsening back pain and subsequently admitted to the hospital for the treatment of sepsis and suspected SEA. An MRI obtained on admission showed an epidural abscess extending from the lower cervical to the upper lumbar region and accompanying paraspinal cervical and psoas abscesses. The patient was successfully treated with antibiotics based on the sensitivity of the surgical cultures received from a needle aspiration of the abscess. SEA has a low incidence; however, the number of cases is consistently rising over the last two decades. The outcome of SEA treatment is related to the duration of the process prior to intuition of the treatment. Patients with no neurological symptoms, or with symptoms lasting less than 36 h, have the best recovery rate. As the typical symptoms of SEA are seen in only 13% of cases, physicians should have a low threshold to order MRI in patients with back pain that is new or changed from the baseline. With the help of CT-guided aspiration for culture analysis, patients can be successfully treated conservatively using antibiotics in cases where neurological signs are absent.
Refined Rigid Block Model for In‐Plane Loaded Masonry
Authors: Baraldi Daniele , De Carvalho Bello Claudia Brito , Cecchi Antonella
Published: October 2020

In this work, a refined rigid block model is proposed for studying the in‐plane behavior of regular masonry. The rigid block model is based on an existing discrete/rigid model with rigid blocks and elastoplastic interfaces that already proven its effectiveness in representing masonry behavior in linear and nonlinear fields. In this case, the proposed model is improved by assuming rigid quadrilateral elements connected by one‐dimensional nonlinear interfaces, which are adopted both to represent mortar (or dry) joints between the blocks and also to represent inner potential cracks into the blocks. Furthermore, the softening behavior of interfaces in tension and shear is taken into account. Several numerical tests are performed by considering masonry panels with regular texture subjected to compression and shear. Particular attention is given to the collapse mechanisms and the pushover curves obtained numerically and compared with existing numerical and laboratory results. Furthermore, the numerical tests aim to evaluate the applicability limits of the proposed model with respect to existing results.
Interleukin-1 Receptor-Associated Kinase 4 Deficiency in a Greek Teenager
Authors: Karananou Panagiota , Alataki Anastasia , Papadopoulou-Alataki Efimia
Published: October 2020

Background. Human interleukin- (IL-) 1 receptor-associated kinase 4 (IRAK-4) deficiency is a recently described primary immunodeficiency. It is a rare, autosomal recessive immunodeficiency that impairs toll/IL-1R immunity, except for the toll-like receptor (TLR) 3- and TLR4-interferon alpha (IFNA)/beta (IFNB) pathways. Case Report. We report the first patient in Greece with IRAK-4 deficiency. From the age of 8 months, she presented with recurrent infections of the upper and lower respiratory tract and skin abscesses. For this, she had been repeatedly hospitalized and treated empirically with intravenous antibiotics. No severe viral, mycobacterial, or fungal infections were noted. Her immunological laboratory evaluation revealed low serum IgA and restored in subsequent measurements; normal IgG, IgM, and IgE; and normal serum IgG subclasses. Peripheral blood immunophenotyping by flow cytometry and dihydrorhodamine (DHR) test revealed normal counts. She was able to make functional antibodies against vaccine antigens, including tetanus and diphtheria. She was administered with empirical IgG substitution for 5 years until the age of 12 years, and she has never experienced invasive bacterial infections so far. DNA analysis revealed a heterozygous variant in the patient: c.823delT (p.S275fs∗13 at protein level) in the IRAK4 gene. Conclusions. The importance of clinical suspicion is emphasized in order to confirm the diagnosis by IRAK4 gene sequencing and provide the appropriate treatment for this rare primary immunodeficiency, as soon as possible.
Value of Urinary Neutrophil Gelatinase-Associated Lipocalin versus Conventional Biomarkers in Predicting Response to Treatment of Active Lupus Nephritis
Authors: El-Mohsen Mohamed Abd , Tawfik Ahmed , Bichari Walid , Shawky Sahar , Mady Gamal , Hassan Mohamed
Published: October 2020

Introduction. Lupus nephritis (LN) affects almost two-thirds of systemic lupus erythematosus (SLE) patients. Despite initial aggressive therapy, up to 25% of patients with LN will progress to permanent renal damage. Conventional serum markers for LN lack the sensitivity of an ideal biomarker. Urinary neutrophil gelatinase-associated lipocalin (UNGAL) is an excellent biomarker for early diagnosis of acute kidney injury and predicting renal outcomes. Objective. To measure UNGAL among LN patients to correlate its levels with renal disease activity and to investigate its predictive performance in response to induction therapy. Patients and Methods. 40 SLE patients with biopsy-proven LN class III, IV, or V were randomly selected. The study was conducted in the internal medicine department and outpatient clinic in Ain Shams University Hospitals and completed after six months. UNGAL was measured at baseline, three-month follow-up, and after complete induction therapy. Results. In LN patients at baseline, the mean serum creatinine was 2.57 ± 0.96 mg/dL and the mean UNGAL was 33.50 ± 18.34 ng/dL. Mean UNGAL levels of complete response, partial response, and nonresponse groups were 14.48 ± 2.99 ng/mL, 34.49 ± 4.09 ng/mL, and 62.07 ± 14.44 ng/mL, respectively. Based on the ROC curve, we found a better performance of baseline UNGAL to discriminate the complete response group from partial and nonresponse groups to predict response to induction, outperforming conventional biomarkers. The area under the curve was 0.943, and the best cutoff level was 26.5 ng/mL (92.31% sensitivity and 88.89% specificity). Conclusion. UNGAL performed better than conventional biomarkers in predicting response to treatment of active LN.