bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Learning-Based Assessment of Sports-Assisted Teaching and Learning
Authors: Su Wei , Feng Jian
Published: April 2022

The current Internet development situation regarding the analysis of sports teaching information is very necessary and can be a way to improve the effectiveness of sports teaching in the information environment. Aiming at the defects of strong subjectivity and low discrimination accuracy of the current sports video classification results, this paper proposes an effective sports video classification method based on deep learning, which can effectively evaluate the sports assisted teaching. Specifically, the key frame features are obtained by using the similarity coefficient key frame extraction algorithm, and the sports video image classification is established through the deep learning coding model. Thus, the ability of the school to rely on the scheme proposed in this paper to improve the teaching facilities, physical education curriculum teaching materials, assessment teaching materials, management, and so on. The results show that for different types of sports videos, the overall effect of the classification of the method in the paper is significantly better than that of other current sports-assisted teaching evaluation methods, which has significantly improved the effect of sports-assisted teaching evaluation.
Efficacy of Apatinib plus S-1 Therapy in the Treatment of Advanced Gastric Cancer Patients and the Effect on the Levels of Tumor Markers and Th1 and Th2-Like Cytokines
Authors: Gu Jishu , Ni Xuejiao , Ji Jinfeng , Wei Guohua , Shi Lei , Xu Chunming
Published: April 2022

Objective. To assess the efficacy of apatinib plus S-1 therapy in the treatment of advanced gastric cancer patients and the effect on the levels of tumor markers and Th1 and Th2-like cytokines. Methods. From October 2019 to December 2020, 100 patients with advanced gastric cancer assessed for eligibility were recruited and assigned at a ratio of 1 : 1 to receive either S-1 regimen (tegafur, gimeracil, and oteracil potassium capsules) (observation group) or apatinib plus S-1 therapy (experimental group). Outcome measures included clinical efficacy serum tumor marker levels, Th1 and Th2-like cytokine levels, time to progression (TTP), overall survival (OS), and adverse events. Results. The S-1 therapy plus apatinib was associated with a significantly higher efficacy versus S-1 therapy alone (

P

 < 0.05). The eligible patients given S-1 therapy plus apatinib showed significantly lower levels of serum carcinoembryonic antigen (CEA), glycoantigen 199 (CA199), and glycoantigen 125 (CA125) versus those receiving S-1 therapy (

P

 < 0.05). S-1 therapy plus apatinib outperformed the single therapy of S-1 therapy in mitigating the levels of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and interleukin-10 (IL-10) (

P

 < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (

P

 > 0.05). S-1 therapy plus apatinib was associated with a significantly shorter TTP (5.2 ± 0.7 months) and a longer OS (9.3 ± 2.5 months) versus S-1 therapy alone (7.1 ± 1.3, 5.1 ± 1.3 months) (

P

 < 0.05). Conclusion. The efficacy of apatinib plus S-1 therapy showed better improvement in lowering the serum tumor marker levels and ameliorating the Th1 and Th2-like cytokine levels versus S-1 therapy alone, so it is worthy of clinical application.
N-((1-(4-Fluorophenyl)-1H-1,2,3-triazol-4-yl)methyl)-2-methylene-3-oxo-olean-12-en-28-amide Induces Apoptosis in Human Breast Cancer Cells by Stimulating Oxidative Stress and Inhibiting the Notch-Akt Signaling Pathway
Authors: Li Xiaorui , Wang Shisheng , Deng Ning , Guo Xiangyu , Fu Meiyi , Ma Yiwen , Sun Tao
Published: April 2022

Breast cancer is of the leading causes of cancer-related deaths and the most frequently diagnosed cancer among females worldwide. Despite advancements in breast cancer therapy, the disease eventually progresses in most patients because of de novo or secondary resistance. Thus, discovering novel drugs with high effectiveness and low toxicity for systemic therapy is essential. In this study, we investigated whether a new oleanolic derivative N-((1-(4-fluorophenyl)-1H-1,2,3-triazol-4-yl)methyl)-2-methylene-3-oxo-olean-12-en-28-amide (ZQL-4c) exhibits potential anticancer effects against breast cancer. We determined that ZQL-4c strongly inhibited cell proliferation and invasion and induced G2/M phase arrest and apoptosis in breast cancer cells. We then found that ZQL-4c induced the production of reactive oxygen species (ROS). We then found that ZQL-4c significantly inhibited Notch-AKT signaling pathways that are related to oxidative stress. Taken together, this study is the first to show that ZQL-4c can significantly suppress the growth and invasion of breast cancer by blocking Notch-Akt signaling pathways, which are mainly regulated by ROS-mediated oxidative stress. Thus, ZQL-4c might be considered a novel and potential anticancer drug for breast cancer treatment.
Evaluation Frequency of Human Papillomavirus and Its Related Genotypes in Women of the General Population Living in 11 Provinces of Iran
Authors: Hassani Somayeh , Nadji Proshat Sadat , Mohseni Anita , Rahnamaye Farzami Marjan , Mirab Samiee Siamak , Sadr Makan , Nadji Seyed Alireza
Published: April 2022

Introduction. Persistent infection with one of the most high-risk genotypes of human papillomavirus causes all cases of cervical cancer and a significant proportion of other genital cancers. The HPV virus, unlike any other infection that leads to cancer, is transmitted only through sexual intercourse and is less affected by the general changes and development in lifestyle and medical standards, so only vaccination and screening can prevent the HPV virus and cancers caused by it. Therefore, determining the prevalence and distribution of HPV genotypes are of utmost importance in screening strategies regarding cervical cancer and vaccination decisions against HPV that vary based on the geographical and cultural characteristics of the study area. As a result, this study aimed to determine the frequency of human papillomavirus and the distribution of this virus’s genotypes in the general population of women living in 11 provinces of Iran. Materials and Methods. This study is a community-based survey study. Sampling was done by the cluster sampling method. Women aged 15–59 years old from the general population living in 11 provinces of Iran were included in the study after considering the inclusion and exclusion criteria. Data were collected using a questionnaire and vaginal examination. The study was performed on 2562 vaginal specimens that were referred to the laboratory of the present study. HPV genome was detected by the nested MY-GP method and papillomavirus genotyping was performed using the PCR multiplex method to identify 19 papillomavirus genotypes. Results. The general prevalence of HPV in the 11 provinces was obtained at 2.4% (108 out of 2562 people). The highest prevalence of the virus was in the age group of 25–34 years. The prevalence of HPV was statistically significant among different provinces. Hormozgan province with 22 cases (5.9%) had the highest and Isfahan province with 6 cases (2.2%) had the lowest incidence of HPV. The prevalence of high-risk HPV and medium-risk HPV is 3%, and the prevalence of low-risk HPV was estimated to be 2.1% of the total female population. Also, the highest prevalence was related to genotype 16. Conclusion. According to the high prevalence of the HPV virus in young age groups in Iran, it is necessary to pay attention to screening programs to reduce the incidence of cervical cancer.
Effect of PCSK9 Inhibitor on Blood Lipid Levels in Patients with High and Very-High CVD Risk: A Systematic Review and Meta-Analysis
Authors: Zhang Yue , Suo Yanrong , Yang Lin , Zhang Xiaolu , Yu Qun , Zeng Miao , Zhang Wenlan , Jiang Xijuan , Wang Yijing
Published: April 2022

Objectives. We aimed to investigate the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor on blood lipid levels in patients with high and very-high cardiovascular risk. Design. 14 trials (n = 52,586 patients) comparing treatment with or without PCSK9 inhibitors were retrieved from PubMed and Embase updated to 1st Jun 2021. The data quality of included studies was assessed by two independent researchers using the Cochrane systematic review method. All-cause mortality, cardiovascular mortality, and changes in serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), lipoprotein (a) (LP (a)), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein A1 (ApoA1) from baseline were analyzed using Rev Man 5.1.0 software. Results. Compared with treatments without PCSK9 inhibitor, addition of PCSK9 inhibitors (evolocumab and alirocumab) had obvious decreasing effects on the levels of LDL-C [MD = −46.86, 95% CI (−54.99 to −38.72),

P
<
0.00001

], TC [MD = −31.92, 95% CI (−39.47 to −24.38),

P
<
0.00001

], TG [MD = −8.13, 95% CI (−10.48 to −5.79),

P
<
0.00001

], LP(a) [MD = −26.69, 95% CI (-27.93 to −25.44),

P
<
0.00001

], non-HDL-C [MD = −42.86, 95% CI (−45.81 to −39.92),

P
<
0.00001

], and ApoB [MD = −38.44, 95% CI (−42.23 to -34.65),

P
<
0.00001

] in high CVD risk patients. Conversely, changes of HDL-C [MD = 6.27, CI (5.17 to 7.36),

P
<
0.00001

] and ApoA1 [MD = 4.33, 95% CI (3.53 to 5.13),

P
<
0.00001

] from baseline were significantly more in high cardiovascular disease risk patients who received PCSK9 inhibitors treatment. Conclusion. Addition of PCSK9 inhibitors to standard therapy resulted in definite improvement in blood lipid levels compared with therapies that did not include them.
A Framework for Identification and Classification of IoT Devices for Security Analysis in Heterogeneous Network
Authors: Zahid Hafiz Muhammad , Saleem Yasir , Hayat Faisal , Khan Farrukh Zeeshan , Alroobaea Roobaea , Almansour Fahad , Ahmad Muneer , Ali Ihsan
Published: April 2022

Internet of Things (IoT) is a promising technology enabling physical devices like cameras, home appliances, and other devices to communicate and interoperate with each other. The next wave transforms our homes, society, enterprises, and cities with the massive presence of IoT devices. The devices in the Internet of Things (IoT) may exchange sensitive data, and an important issue for any organization is to get the data secured and protected. The preliminary requirement for this is a mechanism detecting and reporting anomalies automatically to some central controller. Therefore, this mechanism should be able to classify legit IoT devices from unauthorized ones. Malicious IoT devices, non-IoT devices, and other types of man-in-the-middle traffic sources must be quarantined for noncompliance. This helps formulate administrative policies and regulate/police traffic in the network for better QoS management. This work proposed a framework-based hierarchical deep neural network (HDNNs) to distinguish IoT devices from non-IoT devices using a feature set of IoT-specific traffic. A system has been designed based on HDNN that classifies IoT devices to their specific categories and identifies new entrants with reasonable accuracy. The results show that HDNN can distinguish IoT and non-IoT devices with higher accuracy and as well as classify IoT devices into the respective classes with the required accuracy.
Effect of High-Quality Nursing Based on Comprehensive Nursing on the Postoperative Quality of Life and Satisfaction of Patients with Malignant Glioma
Authors: Gong Xue , Wu Wei , Xing Dengyu , Guo Xu , Yang Meng
Published: April 2022

Objective. To explore the effect of high-quality nursing based on comprehensive nursing on postoperative quality of life and satisfaction of patients with malignant glioma. Methods. From September 2017 to May 2020, 86 patients with malignant glioma treated in our hospital were recruited and assigned (1 : 1) to receive either comprehensive nursing (comprehensive group) or high-quality nursing plus comprehensive nursing (high-quality group). Outcome measures included preoperative and postoperative self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, quality of life, and nursing satisfaction. Results. High-quality nursing plus comprehensive nursing was associated with significantly lower SAS and SDS scores versus comprehensive nursing alone (

P
<
0.05

). Patients receiving high-quality nursing plus comprehensive nursing showed higher quality of life scores versus those only given comprehensive nursing (

P
<
0.05

). High-quality nursing plus comprehensive nursing resulted in higher nursing satisfaction of the patients versus comprehensive nursing alone (

P
<
0.05

). Conclusion. High-quality nursing can relieve the negative emotions of patients with malignant glioma and significantly enhance their quality of life, thereby improving the nursing satisfaction of patients with nursing, so it is worthy of clinical application.
Improving the Accuracy of Rainfall Prediction Using Bias-Corrected NMME Outputs: A Case Study of Surabaya City, Indonesia
Authors: Faidah Defi Y. , Kuswanto Heri , Sutikno Sutikno
Published: April 2022

Generating an accurate rainfall prediction is a challenging work due to the complexity of the climate system. Numerous efforts have been conducted to generate reliable prediction such as through ensemble forecasts, the North Multi-Model Ensemble (NMME). The performance of NMME globally has been investigated in many studies. However, its performance in a specific location has not been much validated. This paper investigates the performance of NMME to forecast rainfall in Surabaya, Indonesia. Our study showed that the rainfall prediction from NMME tends to be underdispersive, which thus requires a bias correction. We proposed a new bias correction method based on gamma regression to model the asymmetric pattern of rainfall distribution and further compared the results with the average ratio method and linear regression. This study showed that the NMME performance can be improved significantly after bias correction using the gamma regression method. This can be seen from the smaller RMSE and MAE values, as well as higher R2 values compared with the results from linear regression and average ratio methods. Gamma regression improved the R2 value by about 30% higher than raw data, and it is about 20% higher than the linear regression approach. This research showed that NMME can be used to improve the accuracy of rainfall forecast in Surabaya.
Discriminatory Value of Adiponectin to Leptin Ratio for COVID-19 Pneumonia
Authors: Tonon Federica , Di Bella Stefano , Giudici Fabiola , Zerbato Verena , Segat Ludovica , Koncan Raffaella , Misin Andrea , Toffoli Barbara , D’Agaro Pierlanfranco , Luzzati Roberto , Fabris Bruno , Bernardi Stella
Published: April 2022

Purpose. Obesity is a risk factor for severe coronavirus disease 2019 (COVID-19). Circulating adipokines have been associated with inflammatory burden and amplified or dysregulated immune responses. This study aimed to evaluate the discriminatory ability of adipokines to identify COVID-19 pneumonia and to assess disease severity. Methods. We conducted an observational case-control study, with a prospective design, and recruited patients with diagnosis of COVID-19 pneumonia (n = 48) and healthy controls (n = 36), who were matched by age, sex, and BMI. Leptin, adiponectin, IL-6, and TNF-α were measured by ELISA. Results. Patients with COVID-19 pneumonia had higher levels of leptin, lower adiponectin/leptin (Adpn/Lep) ratio, and higher expression of IL-6. Leptin had an acceptable discriminatory accuracy for COVID-19 pneumonia in patients with BMI >30 (AUC 0.74 [0.58, 0.90]) with a cutoff of 7852 pg/mL and it was associated with maximum respiratory support. By contrast, Adpn/Lep had an excellent discriminatory accuracy for COVID-19 pneumonia in patients with BMI <25 (AUC 0.9 [0.74, 1.06]) with a cutoff of 2.23. Conclusion. Our data indicate that high Adpn/Lep (>2.23) in lean patients is consistent with a state of good health, which decreases in case of inflammatory states, ranging from adipose tissue dysfunction with low-grade inflammation to COVID-19 pneumonia.
Stage Shift as an Endpoint in Cancer Screening Trials: Implications for Evaluating Multicancer Early Detection Tests
Authors: Owens Lukas , Gulati Roman , Etzioni Ruth
Published: April 2022

Background:

Disease-specific mortality is a consensus endpoint in cancer screening trials. New liquid biopsy-based screening tests, including multi-cancer early detection (MCED) tests, are creating a need to reduce the typically lengthy screening trial process. Endpoints based on the reduction in late-stage disease (stage shift) have been proposed but it is unclear how well they predict the impact of screening on disease-specific mortality across a variety of cancers potentially detectable by MCED tests.

Methods:

We develop a mathematical formulation relating the reduction in late-stage cancer to the expected reduction in disease-specific mortality if cases diagnosed early via screening receive a corresponding shift in mortality. We investigate the similarity between the expected mortality reduction and the observed mortality reduction in published trials of screening for breast, lung, ovarian, and prostate cancer.

Results:

The expected mortality reduction for a given stage shift varies significantly depending on cancer- and stage-specific survival distributions, with some cancer types showing little possibility for mortality improvement even under substantial stage shift. The expected mortality reduction fails to consistently match the mortality outcomes of published trials.

Conclusions:

In MCED, any mortality benefit is likely to vary substantially across target cancers. Stage shift does not appear to be a reliable basis for inference about mortality reduction across cancers potentially detectable by MCED tests.

Impact:

Stage shift may be an appealing endpoint for evaluation of cancer screening tests but it appears to be an unreliable predictor of mortality benefit; furthermore, the same stage shift can mean different things for different cancers.
Poor Oral Health and Esophageal Cancer Risk: A Nationwide Cohort Study
Authors: Zhang Ji , Bellocco Rino , Sandborgh-Englund Gunilla , Yu Jingru , Sällberg Chen Margaret , Ye Weimin
Published: April 2022

Background:

Previous research indicates that poor dental health increases risks for certain types of cancers, including esophageal cancer. This study aimed to investigate the association with esophageal cancer using Swedish Dental Health Register.

Methods:

This is a prospective cohort study. The exposures were dental diagnoses classified into healthy, caries, root canal infection, mild inflammation, and periodontitis, as well as number of remaining teeth, at baseline and during multiple visits. The outcome was the incidence of esophageal cancer, which was further divided into esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Cox proportional hazards models were used to estimate hazard ratios (HR) and its corresponding confidence intervals (CI).

Results:

A total of 5,042,303 individuals were included in the study and 1,259 EAC and 758 ESCC cases were identified. Root canal infection at baseline was associated with 41% higher risk for EAC (HR, 1.41; 95% CI, 1.10–1.82), whereas periodontitis at baseline was linked to 32% and 45% higher risks for respective histopathological subtypes (HR for EAC, 1.32; 95% CI, 1.13–1.53; HR for ESCC, 1.45; 95% CI, 1.20–1.75). Fewer remaining teeth at baseline also increased the risks for both histopathological types of esophageal cancer, with a dose–response effect (Ptrend < 0.01). Cox regression analyses with time-varying exposures corroborated the above-mentioned results.

Conclusions:

Impaired dental health before cancer diagnosis is associated with excess risks for both histopathological subtypes of esophageal cancer.

Impact:

Our study provided corroborating evidence for the association between poor oral health and esophageal cancer risk.
Combination Neoantigen-Based Dendritic Cell Vaccination and Adoptive T-Cell Transfer Induces Antitumor Responses Against Recurrence of Hepatocellular Carcinoma
Authors: Peng Sui , Chen Shuling , Hu Wei , Mei Jie , Zeng Xuezhen , Su Tianhong , Wang Wei , Chen Zebin , Xiao Han , Zhou Qian , Li Bin , Xie Yubin , Hu Huanjing , He Minghui , Han Yanyan , Tang Longqing , Ma Yifan , Li Xiaoshuang , Zhou Xiangjun , Dai Zihao , Liu Zelong , Tan Jiehui , Xu Lixia , Li Shaoqiang , Shen Shunli , Li Dongming , Lai Jiaming , Peng Baogang , Peng Zhenwei , Kuang Ming
Published: April 2022

A high rate of recurrence after curative therapy is a major challenge for the management of hepatocellular carcinoma (HCC). Currently, no effective adjuvant therapy is available to prevent HCC recurrence. We designed a personalized neoantigen-loaded dendritic cell vaccine and neoantigen-activated T-cell therapy, and used it as adjuvant therapy to treat 10 patients with HCC who had undergone curative resection or radiofrequency ablation in the first stage of a phase II trial (NCT03067493). The primary outcomes were safety and neoantigen-specific immune response. Disease-free survival (DFS) was also evaluated. The immunotherapy was successfully administered to all the patients without unexpected delay and demonstrated a reasonable safety profile with no grade ≥3 treatment-related side effects reported. Seventy percent of patients generated de novo circulating multiclonal neoantigen-specific T-cell responses. Induced neoantigen-specific immunity was maintained over time, and epitope spreading was observed. Patients who generated immune responses to treatment exhibited prolonged DFS compared with nonresponders (P = 0.012), with 71.4% experiencing no relapse for 2 years after curative treatment. High expression of an immune stimulatory signature, enhanced immune-cell infiltration (i.e., CD8+ T cells), and upregulated expression of T-cell inflammatory gene profiles were found in the primary tumors of the responders. In addition, neoantigen depletion (immunoediting) was present in the recurrent tumors compared with the primary tumors (7/9 vs. 1/17, P = 0.014), suggesting that immune evasion occurred under the pressure of immunotherapy. Our study indicates that neoantigen-based combination immunotherapy is feasible, safe, and has the potential to reduce HCC recurrence after curative treatment.
Trophoblast Cell Surface Antigen 2 Expression in Human Tumors: A Tissue Microarray Study on 18,563 Tumors
Authors: Dum David , Taherpour Noushin , Menz Anne , Höflmayer Doris , Völkel Cosima , Hinsch Andrea , Gorbokon Natalia , Lennartz Maximilian , Hube-Magg Claudia , Fraune Christoph , Bernreuther Christian , Lebok Patrick , Clauditz Till S. , Jacobsen Frank , Sauter Guido , Uhlig Ria , Wilczak Waldemar , Steurer Stefan , Minner Sarah , Marx Andreas H. , Simon Ronald , Burandt Eike , Krech Till , Luebke Andreas M.
Published: April 2022

Introduction: Trophoblast cell surface antigen 2 (TROP2) is the target of sacituzumab govitecan, an antibody-drug conjugate approved for treatment of triple negative breast cancer and urothelial carcinoma. Methods: A tissue microarray containing 18,563 samples from 150 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by TROP2 immunohistochemistry. Results: TROP2 positivity was found in 109 tumor categories, including squamous cell carcinomas of various origins, urothelial, breast, prostate, pancreatic, and ovarian cancers (>95% positive). High TROP2 expression was linked to advanced stage (p = 0.0069) and nodal metastasis (p < 0.0001) in colorectal cancer as well as to nodal metastasis in gastric adenocarcinoma (p = 0.0246) and papillary thyroid cancer (p = 0.0013). Low TROP2 expression was linked to advanced stage in urothelial carcinoma (p < 0.0001), high pT (p = 0.0024), and high grade (p < 0.0001) in breast cancer, as well as with high Fuhrmann grade (p < 0.0001) and pT stage (p = 0.0009) in papillary renal cell carcinomas. Conclusion: TROP2 is expressed in many epithelial neoplasms. TROP2 deregulation can be associated with cancer progression in a tumor-type dependent manner. Since anti-TROP2 cancer drugs have demonstrated efficiency, they may be applicable to a broad range of tumor entities in the future.
Evaluation of the Effects of Vitrectomy with Primary Epiretinal Membrane Peel on Optical Quality Using Double-Pass Aberrometry
Authors: Varenne Fanny , Malecaze François , Mahieu Laurence , Meyer Pauline , Gomane Clément , Fournié Pierre , Soler Vincent
Published: April 2022

Introduction: We performed a prospective, single-center, cohort study in order to evaluate the effects of vitrectomy with epiretinal membrane (ERM) peel on optical quality in patients with primary ERM. Methods: Thirty patients treated for primary ERM by vitrectomy with ERM peel were included from our tertiary university hospital ophthalmology department. The main study outcome was a variation in optical quality parameters measured using the HD Analyzer™ between preoperative and 2-month postoperative evaluations in operated eyes. Optical quality parameters comprised point spread function (PSF) width at 10% and 50%, objective scatter index (OSI), and modulation transfer function (MTF) cutoff. Contralateral non-operated eyes were used as an internal control for measurement reproducibility. Results: Mean PSF width at 10% (42.22 vs. 27.37 arc/min; p = 0.0002) and mean OSI (3.32 vs. 2.32; p = 0.0003) were significantly improved between pre- versus postoperative evaluations. Mean PSF width at 50% and mean MTF cutoff showed no changes. Subgroup analysis according to crystalline lens status gave similar results, demonstrating that improvements in mean PSF width at 10% and OSI were not lens-related. Non-operated eyes showed no changes in any of the parameters analyzed. Conclusion: Reduced light scattering measured by OSI indicates improved optical quality following vitrectomy with ERM peel among patients with primary ERM. OSI measurement could thus be a new parameter of interest in the preoperative assessment of primary ERM and other pre-vitrectomy assessments.
Gene Mutations in Cushing’s Syndrome
Authors: Ojha Utkarsh , Ogunmwonyi Innocent , Xiang Jinpo , Ojha Harsh
Published: April 2022

Background: Prolonged exposure to glucocorticoids can result in the development of Cushing’s syndrome. Excess serum cortisol can occur due to several factors including exogenous steroids, pituitary and adrenal adenoma, and ectopic ACTH secretion. Summary: The last 2 decades have seen significant progress in identifying new genetic and molecular mechanisms underlying hypercortisolemia. This has implicated mutations seen in a multitude of aberrant pathways that underpin the pathophysiology of Cushing’s syndrome. Key Messages: There is much overlap between the different, with mutations affecting well-understood molecular pathways such as the cAMP/PKA/MAPK and Wnt signalling systems. Further work should delineate the exact involvement of specific mutations in Cushing’s syndrome and the effect of epigenetic/microenvironmental interactions. This could have implications for screening, as the identification of specific mutations may lead to earlier identification and subsequently improved prognosis.
Effectiveness of Intraoperative Endoscopy for Localization of Early Gastric Cancer during Laparoscopic Distal Gastrectomy
Authors: Oh Yoon Jung , Yang Seung Geun , Han Won Ho , Eom Bang Wool , Yoon Hong Man , Kim Young-Woo , Ryu Keun Won
Published: April 2022

Introduction: Intraoperative localization of tumors has been considered crucial in determining adequate resection margins during laparoscopic gastrectomy for early gastric cancer (EGC). This study has evaluated the effectiveness of intraoperative endoscopy for localization of EGC during the totally laparoscopic distal gastrectomy. Methods: Patients with EGC who received totally laparoscopic distal gastrectomy from January 2018 to March 2020 were included in this study. Except the tumors located in the antrum, the patients were categorized into two groups: no localization procedure (n = 144) and intraoperative endoscopy (n = 65). To evaluate the effectiveness of the localization procedure, proximal resection margin (PRM) involvement by the tumor and approximation of optimal PRM were compared, including their postoperative outcomes. Results: There were 3 patients (2.1%) with tumor involvement of the PRM at the initial gastric resection in the no localization group. Distance from the tumor to the PRM was determined to be not significantly different between the no localization group and intraoperative endoscopy group. The PRM distribution pattern and reconstruction method were also not significantly different between the two groups. Discussion/Conclusion: Intraoperative endoscopy for localization of EGC is an effective method to avoid tumor involvement at the resection margin during the laparoscopic gastrectomy with intracorporeal gastric resection and reconstruction.
The Effect of a Dispersible Curcumin (HydroCurc®) Compared to a Placebo for Reducing Joint Pain in an Adult Population – A Randomised, Double-Blind Study
Authors: Briskey David , Roche Georgia , Rao Amanda
Published: April 2022

Introduction: This study aimed to assess the efficacy of a novel curcumin formulation, HydroCurc®, for alleviating joint pain and improving quality of life in adults. Method: A randomised, double blind, placebo-controlled study was conducted on adults aged 25–70 years reporting joint pain. Eighty participants received either curcumin or a placebo daily for 2 weeks. The primary outcome was a self-assessed reduction in pain as assessed by a visual analogue scale (VAS) for pain, completed daily in the morning and evening. Quality of life was assessed by the RAND 36-Item Health Survey (SF-36) and the Profile of Mood States (POMS). Results: VAS pain scores reduced over the 2 weeks of treatment in both groups. Morning VAS scores were significantly reduced from baseline in the curcumin and placebo groups from day 6 and 12, respectively. Morning VAS scores were significantly lower in the curcumin group compared to the placebo group for days 11, 13, and 14 (p < 0.05). Evening VAS scores were significantly reduced from baseline in the curcumin and placebo groups from day 5 and 6, respectively. There were no differences in the evening VAS scores, SF-36 nor POMS between groups. Conclusion: This study demonstrates that HydroCurc® is an effective option for reducing morning joint pain. Future studies would benefit from investigating whether long-term supplementation and/or a split dose can show further improvements in pain scores.
Therapy Patterns and Surveillance Measures of Inflammatory Bowel Disease Patients beyond Disease-Related Hospitalization: A Claims-Based Cohort Study
Authors: Bähler Caroline , Brüngger Beat , Blozik Eva , Vavricka Stephan R. , Schoepfer Alain M.
Published: April 2022

Introduction: Medical care and surveillance of inflammatory bowel disease (IBD) patients have been shown to be far from satisfactory. Data on therapy patterns and surveillance measures in IBD patients are scarce. We, therefore, aimed to compare the therapy patterns and surveillance management of IBD patients in the year before and after IBD-related hospitalization. Methods: We examined medical therapy, surveillance management (influenza vaccination, dermatologist visits, Pap smear screening, creatinine measurements, iron measurements, and ophthalmologist visits) and healthcare utilization in 214 ulcerative colitis (UC) and 259 Crohn’s disease (CD) patients who underwent IBD-related hospitalization from 2012 to 2014. Results: IBD-related drug classes changed in 64.5% of IBD patients following hospitalization. During the 1-year follow-up period, biological treatment increased in UC and CD patients, while steroid use decreased. Following hospitalization, 63.1% of UC and 27.0% of CD patients received 5-ASA. Only 21.6% of all IBD patients had a flu shot, and 19.6% of immunosuppressed IBD patients were seen by a dermatologist in the follow-up; other surveillance measures were more frequent. Surveillance before hospital admission and consultations by gastroenterologists were strongly correlated with surveillance during the postoperative follow-up, while gender and diagnosis (UC vs. CD) were not. During the 1-year follow-up, 20.5% of all IBD patients had no diagnostic or disease-monitoring procedure. Discussion/Conclusion: Surveillance measures for IBD patients are underused in Switzerland. Further research is needed to examine the impact of annual screenings and surveillance on patient outcomes.
How Do Lipoprotein(a) Concentrations Affect Clinical Outcomes for Patients With Stable Coronary Artery Disease Who Underwent Different Dual Antiplatelet Therapy After Percutaneous Coronary Intervention?
Authors: Cui Kongyong , Yin Dong , Zhu Chenggang , Song Weihua , Wang Hongjian , Jia Lei , Zhang Rui , Wang Haoyu , Cai Zhongxing , Feng Lei , Dou Kefei
Published: April 2022

Background

Lp(a) (lipoprotein[a]) plays an important role in predicting cardiovascular events in patients with coronary artery disease through its proatherogenic and prothrombotic effects. We hypothesized that prolonged dual antiplatelet therapy (DAPT) might be beneficial for patients undergoing percutaneous coronary intervention who had elevated Lp(a) levels. This study aimed to evaluate the effect of Lp(a) on the efficacy and safety of prolonged DAPT versus shortened DAPT in stable patients with coronary artery disease who were treated with a drug‐eluting stent.

Methods and Results

We selected 3201 stable patients with CAD from the prospective Fuwai Percutaneous Coronary Intervention Registry, of which 2124 patients had Lp(a) ≤30 mg/dL, and 1077 patients had Lp(a) >30 mg/dL. Patients were divided into 4 groups according to Lp(a) levels and the duration of DAPT therapy (≤1 year versus >1 year). The primary end point was major adverse cardiovascular and cerebrovascular event, defined as a composite of all‐cause death, myocardial infarction, or stroke. The median follow‐up time was 2.5 years. Among patients with elevated Lp(a) levels, DAPT >1 year presented lower risk of major adverse cardiovascular and cerebrovascular event and definite/probable stent thrombosis compared with DAPT ≤1 year. In contrast, in patients with normal Lp(a) levels, the risks of major adverse cardiovascular and cerebrovascular event and definite/probable stent thrombosis were not significantly different between the DAPT >1 year and DAPT ≤1 year groups. Prolonged DAPT had 2.4‐times higher risk of clinically relevant bleeding than shortened DAPT in patients with normal Lp(a) levels, although without statistical difference.

Conclusions

In stable patients with coronary artery disease, who underwent percutaneous coronary intervention with a drug‐eluting stent, prolonged DAPT was associated with reduced risk of cardiovascular events among those with elevated Lp(a) levels, whereas it did not show statistically significant evidence of benefit for reducing ischemic events and tended to increase clinically relevant bleeding among those with normal Lp(a) levels.
Serial Assessment of Right Ventricular Deformation in Patients With Hypoplastic Left Heart Syndrome: A Cardiovascular Magnetic Resonance Feature Tracking Study
Authors: Kanngiesser Luca Mitch , Freitag‐Wolf Sandra , Boroni Grazioli Simona , Gabbert Dominik Daniel , Hansen Jan Hinnerk , Uebing Anselm Sebastian , Voges Inga
Published: April 2022

Background

As right ventricular dysfunction is a major cause of adverse outcome in patients with hypoplastic left heart syndrome, the aim was to assess right ventricular function and deformation after Fontan completion by performing 2‐dimensional cardiovascular magnetic resonance feature tracking in serial cardiovascular magnetic resonance studies.

Methods and Results

Cardiovascular magnetic resonance examinations of 108 patients with hypoplastic left heart syndrome (female: 31) were analyzed. Short‐axis cine images were used for right ventricular volumetry. Two‐dimensional cardiovascular magnetic resonance feature tracking was performed using long‐axis and short‐axis cine images to measure myocardial global longitudinal, circumferential, and radial strain. All patients had at least 2 cardiovascular magnetic resonance examinations after Fontan completion and 41 patients had 3 examinations. Global strain values and right ventricular ejection fraction decreased from the first to the third examination with a significant decline in global longitudinal strain from the first examination to the second examination (median, first, and third quartile: −18.8%, [−20.5;−16.5] versus −16.9%, [−19.3;−14.7]) and from the first to the third examination in 41 patients (−18.6%, [−20.9;−15.7] versus −15.8%, [−18.7;−12.6];
P
‐values <0.004). Right ventricular ejection fraction decreased significantly from the first to the third examination (55.4%, [49.8;59.3] versus 50.2%, [45.0;55.9];
P
<0.002) and from the second to the third examination (53.8%, [47.2;58.7] versus 50.2%, [45.0;55.9];
P
<0.0002).

Conclusions

Serial assessment of cardiovascular magnetic resonance studies in patients with hypoplastic left heart syndrome after Fontan completion demonstrates a significant reduction in global strain values and right ventricular ejection fraction at follow‐up. The significant reduction in global longitudinal strain between the first 2 examinations with non‐significant changes in right ventricular ejection fraction suggest that global longitudinal strain measured by 2‐dimensional cardiovascular magnetic resonance feature tracking might be a superior technique for the detection of changes in myocardial function.
Canonical Workflow for Experimental Research
Authors: Betz Dirk , Biniossek Claudia , Blanchi Christophe , Henninger Felix , Lauer Thomas , Wieder Philipp , Wittenburg Peter , Zünkeler Martin
Published: April 2022

The overall expectation of introducing Canonical Workflow for Experimental Research and FAIR digital objects (FDOs) can be summarised as reducing the gap between workflow technology and research practices to make experimental work more efficient and improve FAIRness without adding administrative load on the researchers. In this document, we will describe, with the help of an example, how CWFR could work in detail and improve research procedures. We have chosen the example of “experiments with human subjects” which stretches from planning an experiment to storing the collected data in a repository. While we focus on experiments with human subjects, we are convinced that CWFR can be applied to many other data generation processes based on experiments. The main challenge is to identify repeating patterns in existing research practices that can be abstracted to create CWFR. In this document, we will include detailed examples from different disciplines to demonstrate that CWFR can be implemented without violating specific disciplinary or methodological requirements. We do not claim to be comprehensive in all aspects, since these examples are meant to prove the concept of CWFR.
Diaporthe orixae sp. nov., an endophytic species isolated from Orixa japonica in southern China
Authors: LU QING-TAO , ZHANG JING-YI , SUN YA-RU , TANG XIA , LU YONG-ZHONG , ZHANG ZHEN
Published: April 2022

In this study, a novel endophytic fungus, Diaporthe orixae, and a new host record of Diaporthe caryae were obtained from a medicinal plant, Orixa japonica in southern China. Phylogenetic analyses based on a combination of ITS, tef1-α, β-tub, cal, and his3 datasets confirmed that D. orixae is a distinct species, which is sister to D. sackstonii (BRIP 54669b). Diaporthe orixae sp. nov. differs from D. sackstonii in having larger conidiomata and smaller conidiogenous cells and alpha conidia on morphological examination. The new species and new host record are reported with taxonomic descriptions and illustrations.
Contributions of External Forcing and Internal Climate Variability to Changes in the Summer Surface Air Temperature over East Asia
Authors: Zha Jinlin , Shen Cheng , Zhao Deming , Feng Jinming , Xu Zhongfeng , Wu Jian , Fan Wenxuan , Luo Meng , Zhang Liya
Published: April 2022

Summer mean (June, July, and August) surface air temperature (SSAT) in East Asia during the period from 1958 to 2001 has shown a warming. However, the relative contributions of external forcing (EF) and internal climate variability (ICV) to the SSAT changes over East Asia remain unclear. In this study, a new approach is applied to estimate the changes in the SSAT determined by the effects of EF and ICV over East Asia during the period from 1958 to 2001. Reanalysis data as well as simulated results from both global atmosphere–ocean coupled model outputs and a regional climate model (RCM) are used for this approach. The observed SSATs over East Asia have undergone a decreasing trend from 1958 to 1972 (−0.14°C decade−1, p < 0.01) and an increasing trend after 1972 (0.24°C decade−1, p < 0.01). While these features are not captured by the reanalysis studied here, they are reproduced when the reanalysis output is downscaled using an RCM. The effects of the EF and the ICV on the SSAT can be separated based on the RCM downscaling simulation. The results show that the SSAT with EF displayed significant warming over most regions of East Asia, whereas the SSAT with ICV mainly exhibited cooling over East Asia. Furthermore, EF mainly influenced the decadal changes of the SSAT, whereas the ICV mainly influenced the interannual changes in the SSAT over East Asia. The interannual changes of the SSAT over East Asia that were influenced by the ICV are mainly manifested as the combined effects of the large-scale ocean–atmosphere circulations, which expressed 79% explanatory power on the SSAT changes.
Biases of the Barotropic Atmospheric Circulation Variability in CMIP6 Models
Authors: Castanheira José M. , Marques Carlos A. F.
Published: April 2022

Two ensembles of Atmospheric Model Intercomparison Project (AMIP) simulations, in the scope of the current Coupled Model Intercomparison Project (CMIP6), are compared with their fully coupled counterparts. The atmospheric models simulate less barotropic atmospheric circulation variability over the North Atlantic and more barotropic atmospheric circulation variability over the North Pacific when compared with reanalysis variability, at intraseasonal and interannual scales. The coupled climate simulations have smaller global barotropic variability than the corresponding AMIP simulations. The smaller variability of the coupled simulations results in no mean overestimation of the subtropical jet variability in the North Pacific, but further underestimation of the jet stream variability in the North Atlantic. The results suggest that the reduction of the biases, in the North Pacific barotropic atmospheric variability, of coupled climate simulations is achieved through compensating biases in the mean sea surface temperatures (SSTs). Moreover, the reduction of the positive biases in the North Pacific seems to be associated with a reduction of the excitation of the most unstable barotropic mode of the atmospheric circulation, which contributes also to a reduction of the barotropic atmospheric variability in the North Atlantic.
Robotic Repair of a Symptomatic Perineal Hernia With Self-Fixating Synthetic Mesh
Authors: Mack Joseph D. , Hyde G. Alan , Giles W. Health , Stanley J. Daniel
Published: April 2022

Primary acquired perineal hernias are rare defects through the pelvic floor diaphragm. The optimal surgical technique for repair remains unknown, and recurrence rates approach 50%. We present a 65-year-old female without previous obstetric or pelvic surgical history who was found to have herniated sigmoid colon through a 2×2 cm levator ani defect. The patient underwent robotic transabdominal hernia repair with a synthetic self-fixating underlay mesh. The peritoneum was primarily closed and the patient was discharged the same day. There is no sign of recurrence to date. Our minimally invasive approach with extraperitoneal mesh placement provided us with several advantages: ambulatory surgery; excellent visualization of the defect; easier suturing in the deep pelvis compared to traditional laparoscopy; and mesh reinforcement while minimizing the risks of erosion, migration, adhesion, and fistula formation.
Effect of Implementation of an Early Treatment of Sepsis Protocol on Surgical Outcomes
Authors: Wasfie Tarik , Buzadzhi Anna , Naisan Mursal , Cataline Chase , Ahmady Ada , Wong Victor , Hicken Jared , Depuydt Mikayla , Hella Jennifer , Senger Barbara , Barber Kimberly
Published: April 2022

Sepsis outcomes remain high regarding mortality and morbidity, despite efforts to reduce them. We retrospectively evaluated a protocol in the first 6 months of implementation to measure outcomes. Retrospective data collection and analysis was performed of 200 consecutive patients seen in the ED during the first 4 months of 2020 after implementation of the sepsis protocol (group 1) and compared to another 200 consecutive patients during the same time frame in 2019 before the sepsis protocol (group 2). The collected parameters included age, gender, race, length of stay comorbid conditions, mortality, and therapy received. Statistical significance was determined at a p-value ≤.05. Mean age and gender of the groups were similar, 64 vs 66 years for group 1 and 2, respectively. Each group was 45% male. Mean length of stay were 8.9 and 8.6 days in group 1 and 2, respectively. Group 1 had a mortality rate of 13% vs 18% in group 2 (p = .21). Comorbid conditions including cardiovascular disease, diabetes, renal failure, and COPD were analyzed regarding mortality that influenced outcomes using Cox regression analysis. COPD and diabetic patient mortality were significantly lower in the protocol group. Surgical patients had a survival rate of 92.4%. Therefore, the current protocol for sepsis management did improve mortality. Further studies with a larger number of patients are in progress.
Green Plasma Has a Superior Hemostatic Profile Compared With Standard Color Plasma
Authors: Kalkwarf Kyle J. , Cardenas Jessica C. , Wade Charles E. , Cotton Bryan A.
Published: April 2022

Background

Limitations in available donors have dramatically reduced plasma availability over the past several decades, concurrent with increasing demand for some types of plasma. Plasma from female donors who are pregnant or taking oral contraceptives often has a green appearance, which frequently results in these units being discarded. This pilot study aimed to evaluate the hemostatic potential of green compared to standard-color plasma.

Materials and Methods

Plasma from twelve blood group-matched female and twelve male donors was obtained from the local blood center. Six of the female and all of the male units of plasma had a normal appearance (STANDARD), while six of the female units were grossly green (GREEN). The hemostatic potential was evaluated by thrombelastography (TEG), calibrated automated thrombogram (CAT), and coagulation factor level measurements. Univariate analysis was performed using Wilcoxon Rank-Sum.

Results

GREEN plasma was more procoagulant for all TEG values ( r-value, k-time, angle, mA) when compared to STANDARD plasma. Differences were also observed in coagulation factor levels, with GREEN plasma having higher than STANDARD (factors II; VII, IX; X, XI, Protein S, and plasminogen); conversely, GREEN plasma had a longer lag time in CAT.

Discussion

This pilot study demonstrates that female donors with green plasma have a superior hemostatic profile than standard plasma. GREEN plasma should be further investigated for its safety profile and hemostatic potential, so if it is found to be a safe and functionally non-inferior product, it should be actively re-introduced for transfusion in bleeding patients.