bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful emergency evacuation from a hospital within a 5-km radius of Fukushima Daiichi Nuclear Power Plant: the importance of cooperation with an external body
Authors: Sawano Toyoaki , Shigetomi Shuichi , Ozaki Akihiko , Nishikawa Yoshitaka , Hori Arinobu , Oikawa Tomoyoshi , Maeda Masaharu , Tsubokura Masaharu
Published: November 2020

Emergency evacuation during a disaster may have serious health implications in vulnerable populations. After the accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) in March 2011, the Japanese central government immediately issued an evacuation order for residents living near the plant. There is limited information on the process of evacuation from medical institutions within the evacuation zone and the challenges faced. This study collected and analyzed publicly available resources related to the Futaba Kosei Hospital, located 3.9 km northwest of the FDNPP, and reviewed the hospital’s evacuation procedures. On the day of the accident at the FDNPP, 136 patients were admitted in the aforementioned hospital. The hospital’s director received information about the situation at the FDNPP from the local disaster task force and requested the immediate evacuation of all patients. Consequently, four patients, including those with an end-stage condition, died during the evacuation. Early intervention by external organizations, such as the Japan Self-Defense Forces, helped the hospital to complete the evacuation without facing major issues. However, despite such an efficient evacuation, the death of four patients suggests that a significant burden is placed on vulnerable people during emergency hospital evacuations. Those with compromised health experience a heavy burden during a nuclear disaster. It is necessary for hospitals located close to a nuclear power plant to develop a more detailed evacuation plan by determining the methods of communication with external organizations that could provide support during evacuation to minimize the burden on vulnerable patients.
EUV irradiation of exoplanet atmospheres occurs on Gyr time-scales
Authors: King George W , Wheatley Peter J
Published: November 2020

Exoplanet atmospheres are known to be vulnerable to mass-loss through irradiation by stellar X-ray and extreme-ultraviolet (EUV) emission. We investigate how this high-energy irradiation varies with time by combining an empirical relation describing stellar X-ray emission with a second relation describing the ratio of solar X-ray to EUV emission. In contrast to assumptions commonly made when modelling atmospheric escape, we find that the decline in stellar EUV emission is much slower than in X-rays, and that the total EUV irradiation of planetary atmospheres is dominated by emission after the saturated phase of high-energy emission (which lasts around 100 Myr after the formation of the star). The EUV spectrum also becomes much softer during this slow decline. Furthermore, we find that the total combined X-ray and EUV emission of stars occurs mostly after the saturated phase. Our results suggest that models of atmospheric escape that focus on the saturated phase of high-energy emission are oversimplified, and when considering the evolution of planetary atmospheres it is necessary to follow EUV-driven escape on Gyr time-scales. This may make it more difficult to use stellar age to separate the effects of photoevaporation and core-powered mass-loss when considering the origin of the planet radius valley.
Odorant Receptors for Detecting Flowering Plant Cues Are Functionally Conserved across Moths and Butterflies
Authors: Guo Mengbo , Du Lixiao , Chen Qiuyan , Feng Yilu , Zhang Jin , Zhang Xiaxuan , Tian Ke , Cao Song , Huang Tianyu , Jacquin-Joly Emmanuelle , Wang Guirong , Liu Yang
Published: November 2020

Odorant receptors (ORs) are essential for plant–insect interactions. However, despite the global impacts of Lepidoptera (moths and butterflies) as major herbivores and pollinators, little functional data are available about Lepidoptera ORs involved in plant-volatile detection. Here, we initially characterized the plant-volatile-sensing function(s) of 44 ORs from the cotton bollworm Helicoverpa armigera, and subsequently conducted a large-scale comparative analysis that establishes how most orthologous ORs have functionally diverged among closely related species whereas some rare ORs are functionally conserved. Specifically, our systematic analysis of H. armigera ORs cataloged the wide functional scope of the H. armigera OR repertoire, and also showed that HarmOR42 and its Spodoptera littoralis ortholog are functionally conserved. Pursuing this, we characterized the HarmOR42-orthologous ORs from 11 species across the Glossata suborder and confirmed the HarmOR42 orthologs form a unique OR lineage that has undergone strong purifying selection in Glossata species and whose members are tuned with strong specificity to phenylacetaldehyde, a floral scent component common to most angiosperms. In vivo studies via HarmOR42 knockout support that HarmOR42-related ORs are essential for host-detection by sensing phenylacetaldehyde. Our work also supports that these ORs coevolved with the tube-like proboscis, and has maintained functional stability throughout the long-term coexistence of Lepidoptera with angiosperms. Thus, beyond providing a rich empirical resource for delineating the precise functions of H. armigera ORs, our results enable a comparative analysis of insect ORs that have apparently facilitated and currently sustain the intimate adaptations and ecological interactions among nectar feeding insects and flowering plants.
Alpha 1-antichymotrypsin contributes to stem cell characteristics and enhances tumorigenicity of glioblastoma
Authors: Lara-Velazquez Montserrat , Zarco Natanael , Carrano Anna , Phillipps Jordan , Norton Emily S , Schiapparelli Paula , Al-kharboosh Rawan , Rincon-Torroella Jordina , Jeanneret Stephanie , Corona Teresa , Segovia Jose , Jentoft Mark E , Chaichana Kaisorn L , Asmann Yan W , Quiñones-Hinojosa Alfredo , Guerrero-Cazares Hugo
Published: November 2020

Background

Glioblastomas (GBMs) are the main primary brain tumors in adults with almost 100% recurrence rate. Patients with lateral ventricle proximal GBMs (LV-GBMs) exhibit worse survival compared to distal locations for unknown reasons. One hypothesis is the proximity of these tumors to the cerebrospinal fluid (CSF) and its chemical cues that can regulate cellular phenotype. We therefore investigated the role of CSF on GBM gene expression and the role of a CSF-induced gene, SERPINA3, in GBM malignancy in vitro and in vivo.

Methods

We utilized human CSF and GBM brain tumor-initiating cells (BTICs). We determined the impact of SERPINA3 expression in glioma patients using The Cancer Genome Atlas (TCGA) database. SERPINA3 expression changes were evaluated at mRNA and protein levels. The effects of knockdown (KD) and overexpression (OE) of SERPINA3 on cell migration, viability and cell proliferation were evaluated. Stem cell characteristics on KD cells were evaluated by differentiation and colony formation experiments. Tumor growth was studied by intracranial and flank injections.

Results

GBM-CSF increased BTIC migration accompanied by upregulation of the SERPINA3 gene. In patient samples and TCGA data, we observed SERPINA3 to correlate directly with brain tumor grade and indirectly with GBM patient survival. SERPINA3 KD induced a decrease in cell proliferation, migration, invasion, and stem cell characteristics, while SERPINA3 OE increased cell migration. In vivo, SERPINA3 KD BTICs showed increased survival in a murine model.

Conclusions

SERPINA3 plays a key role in GBM malignancy and its inhibition results in a better outcome using GBM preclinical models.
Neuropathology of Pituitary Adenomas and Sellar Lesions
Authors: Kobalka Peter J , Huntoon Kristin , Becker Aline P
Published: November 2020

The pituitary gland is the site of numerous neoplastic and inflammatory processes. The overwhelmingly most frequent tumors arise from cells of the anterior lobe, the pituitary neuroendocrine tumors (PitNETs). Immunohistochemistry assay staining for pituitary hormones is the core tool for classifying PitNETs, resulting in the diagnosis of somatotroph PitNETs, lactotroph PitNETs, and so on. For cases showing no hormonal expression, the updated WHO classification system now considers the assessment of several transcription factors: PIT-1 (pituitary-specific POU-class homeodomain transcription factor); T-PIT (T-box family member TBX19); and SF-1 (steroidogenic factor regulating gonadotroph cell differentiation) before rendering a diagnosis of null cell adenoma. Other tumors and disease processes of this site often mimic PitNETs radiographically and sometimes even clinically (ie, compression of the optic chiasm). These potpourri of processes include germ cell neoplasms (especially germinomas), tumors that originate from Rathke's pouch (craniopharyngiomas, Rathke's cleft cyst), tumors that originate from the posterior lobe of the pituitary (pituicytoma, spindle cell oncocytoma, granular cell tumor), and tumors that originate from the meninges (especially meningiomas). In addition to neoplasms, several described inflammatory and related conditions exist that need to be distinguished from PitNETs. These include lymphocytic hypophysitis and Langerhans cell histiocytosis, a neoplastic disorder of histiocytes. In this review, we aim to briefly describe the main pituitary and sellar lesions, with emphasis on the most common tumors, the PitNETs.
Understanding collaborative interactions in relation to research impact in social sciences and humanities: A meta-ethnography
Authors: Dewaele Alexis , Vandael Kristof , Meysman Stefan , Buysse Ann
Published: November 2020

The number and type of collaborations between researchers and stakeholders has increased significantly. This responds to the demand from policymakers, funders, and citizens that researchers should help to tackle important social issues (e.g. climate change, healthy aging). However, there is little knowledge about how collaboration processes are experienced, how we can theoretically conceptualize them, and how in this way we can develop efficient collaboration methods that contribute to solving urgent societal problems. In this meta-ethnography, we gathered relevant knowledge from carefully selected qualitative studies. A title/abstract analysis of 3422 articles from Web of Science and ProQuest led to the interpretative analysis of qualitative data from eight publications. The results of this study show that despite the need for a better understanding of complex collaborative interactions, the differences (or asymmetry) between organizations to which various partners belong hinder efficient collaboration. Bridging figures (brokers) can play an essential role if they succeed in drawing diverse stakeholders out of their organizational context into a new dimension that allows creativity and mutual understanding, but that also allows conflict and distortion. In ideal circumstances, this leads to a quasi-automatic transfer of knowledge between partners that takes place naturally and in both directions (knowledge diffusion).
DEVELOPMENTS IN THE USE OF THERMOLUMINESCENCE AND OPTICALLY STIMULATED LUMINESCENCE FROM MOBILE PHONES IN EMERGENCY DOSIMETRY
Authors: McKeever S W S , Sholom S , Chandler J R
Published: November 2020

Proposed physical dosimetry methods for emergency dosimetry in radiological, mass-casualty incidents include both thermoluminescence (TL) and optically stimulated luminescence (OSL). Potential materials that could feasibly be used for TL and OSL dosimetry include clothing, shoes and personal accessories. However, the most popular target of study has been personal electronics, especially different components from smartphones. Smartphones have been a focus because they are widely available and, in principle, may be viewed as surrogates for commercial TL or OSL dosimeters. The components of smartphones that have been studied include surface mount devices (such as resistors, capacitors and inductors) and glass materials, including front protective glass, display glass and (with more modern devices) back protective glass. This paper reviews the most recent developments in the use of TL and OSL with these materials and guides the way to future, and urgently needed, research.
The Under-Utilization of Women’s Talent: Academic Achievement and Future Leadership Positions
Authors: Qian Yue , Yavorsky Jill E
Published: November 2020

Despite high labor force participation, women remain underrepresented in leadership at every level. In this study, we examine whether women and men who show early academic achievement during their adolescence—and arguably signs of future leadership potential—have similar or different pathways to later leadership positions in the workplace. We also examine how leadership patterns by gender and early academic achievement differ according to parenthood status. Using data from the National Longitudinal Survey of Youth 1979, we find that overall, men supervise more people than women at work during their early-to-mid careers, regardless of their grade point averages (GPAs) in high school. In addition, among men and women who are parents, early academic achievement is much more strongly associated with future leadership roles for fathers than it is for mothers. Such patterns exacerbate gender gaps in leadership among parents who were top achievers in high school. Indeed, among those who had earned a 4.0 GPA in high school, fathers manage over four times the number of supervisees as mothers do (nineteen vs. four supervisees). Additional analyses focusing on parents suggest that gender leadership gaps by GPA are not attributable to different propensities for taking on leadership roles between the genders but are in part explained by unequal returns to educational attainment and differences in employment-related characteristics by gender. Overall, our results reveal that suppressed leadership prospects apply to even women who show the most promise early-on and highlight the vast under-utilization of women’s (in particular mothers’) talent for organizational leadership.
Rheumatology in the era of precision medicine: synovial tissue molecular patterns and treatment response in rheumatoid arthritis
Authors: Lakhanpal Amit , Smith Melanie H. , Donlin Laura T.
Published: November 2020

Purpose of review

A critical unmet need in rheumatoid arthritis (RA) is the identification of biomarkers that predict which of the available medications will be most effective for an individual in order to lower disease activity sooner than is afforded by the current treat-to-target approach. Here we will discuss recent reports examining the potential for synovial tissue molecular, cellular, and spatial profiling in defining objective measures of treatment response and therein developing personalized medicine for RA.

Recent findings

Recent high-dimensional molecular profiling of RA synovium has provided unprecedented resolution of the cell types and pathways in tissues affected by rheumatic diseases. Heightened attention to tissue architecture is also emerging as a means to classify individual disease variation that may allow patients to be further stratified by therapeutic response. Although this wealth of data may have already pinpointed promising biomarkers, additional studies, likely including tissue-based functional drug response assays, will be required to demonstrate how the complex tissue environment responds.

Molecular, cellular, and more recently spatial profiling of the RA synovium are uncovering fundamental features of the disease. Current investigations are examining whether this information will provide meaningful biomarkers for individualized medicine in RA.
Chronic Obstructive Pulmonary Disease
Authors: Virani Ahmed , Baltaji Stephanie , Young Meilin , Dumont Tiffany , Cheema Tariq
Published: November 2020

This article describes the various steps required to confirm the diagnosis of chronic obstructive pulmonary disease (COPD). The GOLD Criteria developed by the Global Initiative for COPD will be outlined as they relate to the diagnosis and management of COPD. Pulmonary function testing, imaging, and symptom assessment will be explored.
COPD and Cardiovascular Disease
Authors: Shnoda Mina , Gajjar Kushani , Ivanova Valentyna
Published: November 2020

The presence of comorbid cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD) can result in unfavorable outcomes, ranging from deterioration in quality of life to increases in all-cause and cardiovascular mortality. Moreover, cardiovascular events are major cause of hospitalization in patients with COPD and contributing significantly to the economic burden of the disease. Despite the acknowledgment of the prognostic significance of CVD comorbidity in COPD patients, CVD remains underrecognized and undertreated in this patient population. In this article, we address the current knowledge about the estimated prevalence, pathophysiologic association, as well as important considerations in the diagnosis and management of CVD in COPD patients.
POTENTIAL NEW-ONSET CLINICALLY DETECTABLE PENTOSAN POLYSULFATE MACULOPATHY YEARS AFTER DRUG CESSATION
Authors: Barnett Joshua M. , Jain Nieraj
Published: November 2020

Purpose:

To describe a potential case of pentosan polysulfate maculopathy that seemed to manifest nearly 3 years after drug cessation.

Methods:

Complete ophthalmic examination, including multimodal fundus imaging, electroretinography, automated perimetry, and molecular testing, was performed.

Results:

A 44-year-old woman with a 435 g cumulative exposure to pentosan polysulfate sodium presented 38 months after drug cessation with 6 months of worsening metamorphopsia and prolonged dark adaptation. Fundus examination and multimodal fundus imaging demonstrated characteristic features of pentosan polysulfate maculopathy, and molecular testing was unremarkable. By contrast, color fundus photographs of the same patient acquired at an outside facility 25 months before did not display features consistent with pentosan polysulfate sodium maculopathy.

Conclusion:

This case suggests that new-onset clinically detectable pentosan polysulfate maculopathy may develop years after drug cessation. If corroborated, this finding has important ramifications for pentosan polysulfate sodium dosing and surveillance guidelines.
CAVITARY CHOROIDAL NEVUS: A CASE REPORT
Authors: Preziosa Chiara , Kashyap Bibhuti P. , Staurenghi Giovanni , Pellegrini Marco
Published: November 2020

Purpose:

To describe a case of choroidal nevus with intralesional cavitations detected with enhanced depth imaging optical coherence tomography and to show its changes during an 8-year follow-up.

Methods:

A case report.

Results:

A 55-year-old male patient was found to have a pigmented lesion at the posterior pole of his right eye, just temporal to the fovea. A complete multiimaging examination was obtained and showed a lesion of about 4 mm of diameter with a small amount of subretinal fluid and chronic changes in the retina overlying the lesion. Based on clinical examination, a diagnosis of choroidal nevus was made, but interestingly the enhanced depth imaging optical coherence tomography revealed the presence of intralesional cavitations. Close follow-up with no intervention was planned, and over 8 years of observation, the lesion remained stable in size, with a gradual increase of the central necrosis.

Conclusion:

Benign pigmented choroidal lesions can show internal cavitations likely secondary to internal necrosis. This feature does not represent a sign of malignancy of the lesion. Enhanced depth imaging optical coherence tomography is a feasible imaging tool for the visualization of the internal cavitations and to follow their evolution over time.
The prevalence and incidence of community-acquired pressure injury
Authors: Chen Geng , Lin Lv , Yan-Lin Yang , Loretta Chung Yuet-Foon , Han Lin
Published: November 2020

Background:

Pressure injury (PI) is a serious problem in health care settings globally. It leads to tremendous burden both individuals and healthcare systems. Since 2008, hospital-acquired pressure injuries have been a major focus of nursing quality improvement programs within hospitals and are considered never events. However, insufficiency attention has been paid to community-acquired pressure injuries (CAPI) or pressure ulcers that occur at home or in nursing homes. The prevalence or incidence of community-acquired pressure injury has been reported but never been synthesized in a meta-analysis manner. To fill the gaps in the evidence matrix, the aims of this study are to estimate the prevalence of CAPI in the general population and to pool the overall incidence of CAPI in the general population.

Methods:

PubMed, Web of Science, EMBASE, CINHAL, the Cochrane Library, Chongqing VIP, and China National Knowledge Infrastructure were electronically searched to identify eligible studies updated to May 2020 to collect studies on the prevalence or incidence of community-acquired pressure injuries. Two reviewers independently will screen the literature, extracted data, and assess the risk of bias of included studies using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline. Meta-analyses of pooled weighted estimates will be calculated using random effect models with 95% CIs reported due to high heterogeneity.

Results:

Of the 5242 studies initially identified, of the 22 studies (total 479,761 participants) 17 reporting prevalence of community-acquired pressure injury and 5 reporting incidence were included. Other results of this study will be published in a peer-reviewed journal.

Conclusion:

This study will summarize the pooled estimate prevalence and incidence of community-acquired pressure injuries and the pooled estimate of frequencies of different anatomic sites.

Ethics and dissemination:

Ethics approval and patient consent are not required, because this study is a meta-analysis based on published studies.

INPLASY registration number:

INPLASY202080044
Fungal endocarditis with heart valve replacement and atrial fibrillation posing a treatment challenge
Authors: Zhu Xiaoxia , Cao Shugang , Xia Mingwu , Ding Chandong , Wang Rongfeng
Published: November 2020

Rationale:

Fungal endocarditis (FE) is a rare disease, in which antifungal treatment is necessary. When FE is complicated with prosthetic heart valve and/or atrial fibrillation, the coadministration of antifungal agents and warfarin is inevitable. We report a case of rheumatic heart disease with atrial fibrillation who developed FE following prosthetic heart valve replacement. The international normalized ratio (INR) increased significantly during the antifungal treatment with fluconazole. A discussion of the antifungal strategy in FE patients with prosthetic heart valves and/or atrial fibrillation and the interaction between antifungal agents and warfarin was performed.

Patient concerns:

A 54-year-old Chinese woman experienced intermittent fevers, aphemia, and weakness in her right extremities. Her temperature was 38.7°C, and there was atrial fibrillation with heart rate 110 times/min. Neurological examination revealed that she had drowsiness, Broca aphasia, right central facial paralysis, and hemiplegia (Medical Research Council scale, upper limb grade 0, lower limb grade II).

Diagnoses:

Multiple infarction on magnetic resonance imaging and the occlusion of left middle cerebral artery suggested the occurrence of cerebral embolism. The presence of Candida parapsilosis in the results of 4 blood cultures and the existence of valve vegetation in the reexamination of echocardiogram supported the diagnosis of FE.

Interventions:

The patient was given antifungal therapy with fluconazol. The INR increased dramatically on the 9th day of antifungal treatment, and subcutaneous bruising occurred at the intravenous infusion site. The antagonist of vitamin K1 was used and warfarin was reduced to a smaller dosage. The antifungal agent was replaced with caspofungin.

Outcomes:

Her speech improved significantly, and the muscle strength of her paralyzed side reached the Medical Research Council scale of grade IV+. She continued to receive caspofungin for antifungal treatment with relatively stable INR and waited for heart valve surgery.

Lessons:

The choice of antifungal agents is often a big challenge for FE patients, especially when they need warfarin for anticoagulation. It is better to administer a low dose of warfarin while carefully monitoring the INR or choose the antifungal drugs with little or no effect on warfarin.
Occult olfactory neuroblastoma presenting with multiple bone metastases: a case report
Authors: Zhou Qi , Li Zijian , Liu Bei , Zhao Long , Tian Baohong , Wang Lina , Xi Yaming
Published: November 2020

Rationable:

Olfactory neuroblastoma (ONB) is a rare malignant tumor of the nasal cavity, the primary local symptoms are usually inconspicuous. Patients are often admitted to various specialties based on different primary symptoms, which may result in delayed diagnosis and even a misdiagnosis.

Patient concerns:

Here we report a case of ONB that presented initially as multiple ostealgia without any local symptoms of the tumor and primarily misdiagnosed as multiple myeloma. The patient was a 47-year-old female with bone pain at multiple sites. The initial diagnosis was considered as multiple myeloma. However, the morphologic examination of bone marrow suggested that the tumor cells originated from the nervous tissues. After the positron emission computed tomography scan, the primary lesion in the nasal cavity was located, and a biopsy was performed.

Diagnosis:

The final diagnosis of ONB was confirmed by histopathological tests.

Interventions:

The patient was treated with metronomic chemotherapy.

Outcomes:

The symptoms of bone pain were significantly relieved 3 months later. The emission computed tomography scan of the whole body bones and the magnetic resonance imaging of the head showed that the tumor size did not change significantly and proved a progression-free of the disease.

Lessons:

It is a reasonable strategy to identify the original latent tumor by a prompt positron emission computed tomography scan when the primary diagnosis indicates a metastatic disease, especially for the occult malignancies like ONB.
A nomogram for estimating the probability of nonalcoholic fatty liver disease in a Chinese population
Authors: Xie Weining , Chen Shengxin
Published: November 2020

Studies have showed that dyslipidemia is closely related to nonalcoholic fatty liver disease (NAFLD). However, less attention has been paid to the relationship between early dyslipidemia and long-term risk of NAFLD. Therefore, we aimed to develop a simple-to-use nomogram to predict early dyslipidemia and long-term risk of NAFLD onset.

A retrospective cohort study including 3621 employees (including retirees) from 7 companies was conducted between 2012 and 2019. Anthropometric, potential laboratory parameters and abdominal ultrasound were performed at baseline and after a 5-year follow-up. Cox proportional hazards model was used to determine predictors for NAFLD onset. The effects of lipids, age, body mass index (BMI), and serum uric acid (UA) on NAFLD were evaluated with the use of Kaplan–Meier curves (log-rank test). A nomogram was developed based on the Cox proportional hazard model and a 2-piecewise linear regression model. The accuracy of model was evaluated according to the area under the receiver operating characteristic curves.

A total of 1545 subjects were included in the final analysis. The mean follow-up time was 52 ± 6.6 months. Of the total subjects, 77.61% were male and 22.39% were female. The mean age at the time of initial visit was 45.21 ± 11.20 years. Five hundred fifty-five subjects (35.92% of all subjects) were finally diagnosed with NAFLD. Variables in the nomogram included age, BMI, triglycerides, high-density lipoprotein, low-density lipoprotein, and UA. The accuracy of the nomogram for predicting 5-year cumulative occurrence of NAFLD was 0.8135 (95% confidence interval: 0.7921–0.8349), and the sensitivity and specificity were 0.8108 and 0.6960, respectively.

The combination of age, BMI, triglycerides, high-density lipoprotein, low-density lipoprotein, and UA translated into a nomogram can reliably estimate the incidence of NAFLD within 5 years. It may serve as a decision support tool to determine whether to intervene at an early stage.
Nebulized versus invasively delivered surfactant therapy for neonatal respiratory distress syndrome
Authors: Rong Hui , Bao Ying , Wen Zunjia , Chen Xiuli , Chen Cen , Li Fang
Published: November 2020

Background:

Pulmonary surfactant (PS) is commonly used for the treatment of neonatal respiratory distress syndrome (NRDS), several randomized controlled trials (RCTs) have evaluated the role of nebulized versus invasively delivered PS, yet the results remained inconsistent. Therefore, we aimed to conduct this meta-analysis to evaluate the effects and safety of nebulized versus invasively delivered PS in the treatment of NRDS.

Methods:

We searched PubMed et al databases from inception date to May 15, 2020 for RCTs that compared nebulized vs invasively delivered PS. Two authors independently screened the studies and extracted data from the published articles. Summary odd ratios (OR) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated for each outcome by means of fixed- or random-effects model.

Results:

Two RCTs with a total of 95 preterm neonates were identified, with 48 neonates received PS nebulization and 47 neonates undergone invasive PS administration. There was no significant difference in the SpO2 level (MD = −0.44, 95% CI −6.01 to 5.12) and the A/APaO2 level (MD = 0.01, 95% CI −0.02 to 0.05) 1 hour after treatment among 2 groups. But the duration of mechanical ventilation in the nebulization groups was significantly less than that of invasive group (MD = −30.70, 95% CI −41.45 to 19.95).

Conclusions:

Given the limited evidences, the effects and safety of nebulized versus invasively delivered PS still need further verification.
A valuable MRI examination method for prostate cancer screening
Authors: Yang Xuezhen , Shan Lianqiang , Cao Haiming , Jiang Xu , Ma Xueping
Published: November 2020

To investigate the value of the 1.5T magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) and the prostate imaging reporting and data system (PI-RADS) score in prostate cancer (PCa) screening.

Forty PCa patients diagnosed by pathology from December 2014 to September 2018 were recruited as the PCa group; 60 patients with benign prostatic hyperplasia (BPH) were recruited as the benign group. Patients from both groups underwent 1.5T MRI scanning. The prostate ADC values, exponential apparent diffusion coefficient (eADC) values, and PI-RADS scores of patients from the 2 groups were compared. The different methods for PCa diagnosis were compared.

The ADC values of patients in the PCa group were significantly lower than those in the benign group, whereas the eADC values of patients were significantly higher than those in the benign group, with statistically significant differences (P < .05). The differences in the PI-RADS scores of patients from the 2 groups were statistically significant (P < .05). Receiver Operating Characteristic (ROC) curve results showed that the ADC value combined with the PI-RADS score was superior to the ADC value or the PI-RADS score alone in sensitivity, specificity, and Youden index for PCa diagnosis. By comparing the area under the curve (AUC) of each ROC curve from the different diagnostic methods, the combination of ADC value and PI-RADS score showed the largest area.

The ADC value from 1.5T MRI combined with the PI-RADS score could be used as the standard for PCa screening, which would effectively improve screening for PCa and be valuable for clinical applications.
FDG PET/CT for evaluating systemic arterial inflammation induced by anthracycline-based chemotherapy of Hodgkin lymphoma
Authors: Lawal Ismaheel O. , Orunmuyi Akintunde T. , Popoola Gbenga O. , Lengana Thabo , Mokoala Kgomotso M.G. , Ankrah Alfred O. , Sathekge Mike M.
Published: November 2020

To evaluate arterial fluorodeoxyglucose (FDG) uptake as a marker of arterial inflammation in multiple vascular beds in patients treated with anthracycline-based chemotherapy for Hodgkin lymphoma (HL).

We used maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR) to quantify arterial FDG uptake in the carotid artery, ascending aorta, abdominal aorta, and femoral artery obtained on positron emission tomography/computed tomography (PET/CT) imaging performed at baseline before chemotherapy and after completion of chemotherapy in patients with HL treated with an anthracycline-containing regimen. We compared the SUVmax and TBR obtained at baseline with that obtained post-chemotherapy for each arterial bed to evaluate the effect of anthracycline-based chemotherapy. We evaluated the effect of cardiovascular risk factors such as human immunodeficiency virus (HIV) infection, smoking, hypertension, and diabetes on the changes in SUVmax and TBR seen in the different arterial beds after anthracycline-based chemotherapy.

Fifty-two patients were included with a mean age of 34.56 ± 10.19 years. There were 33 males, and 18 patients were HIV-infected. The mean interval between completion of chemotherapy and follow-up flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan was 65 weeks. We found no significant difference in arterial FDG uptake measured by SUVmax and TBR in all arterial beds between the pre- and post-chemotherapy FDG PET/CT. There was no significant impact of HIV infection, smoking, and hypertension on the changes in arterial FDG uptake following treatment with anthracycline-based chemotherapy.

In patients with HL who were treated with anthracycline-based chemotherapy, we found no significant increase in arterial inflammation measured by FDG PET/CT after an average follow-up period of about 65 weeks since completion of chemotherapy.
Traditional Chinese medicine formula Xiaoqinglong decoction for cough caused by COVID-19
Authors: Ren Xiaodan , Shi Yu , Li Guizhong
Published: November 2020

Background:

Assessing the effectiveness and safety of Traditional Chinese medicine formula Xiaoqinglong decoction for cough caused by COVID-19 is the main purpose of this systematic review protocol.

Methods:

The following electronic databases will be searched from their respective inception dates to October 1, 2020: PubMed, MEDLINE, the Cochrane Library, Embase, WorldSciNet, Ovid, the Allied and Complementary Medicine Database, the Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database (VIP), the Wanfang Database, and the China Biology Medicine Disc. All published randomized controlled trials in English or Chinese related to Traditional Chinese medicine formula Xiaoqinglong decoction for cough caused by COVID-19 will be included. The primary outcome is the time and rate of appearance of coughing. The secondary outcomes are the length of hospital stay. Two reviewers will conduct the study selection, data extraction, and assessment independently. The assessment of risk of bias and data synthesis will be conducted with RevMan V.5.2.

Results:

The results will provide a high-quality synthesis of current evidence for researchers in this subject area.

Conclusion:

The conclusion of our study will provide an evidence to judge whether traditional Chinese medicine formula Xiaoqinglong decoction is an effective intervention for patients with cough caused by COVID-19.

Ethics and dissemination:

Formal ethical approval is not necessary as the data cannot be individualized. The results of this protocol will be disseminated in a peer-reviewed journal or presented at relevant conferences.

PROSPERO registration number:

CRD42020202079.
Quantifying alcohol use among Ecuadorian human immunodeficiency virus positive individuals and assessing alcohol as an independent risk factor for human immunodeficiency virus
Authors: Downen Jeffrey M. , Swendener Briana , Bodlak Adriana A. , Añazco Diego F. , Nicolalde Bryan I. , Mhaskar Rahul , Cevallos Nelson , Castillo Alberto , Larreategui David , Torres Edmundo , Izurieta Ricardo , Teran Enrique
Published: November 2020

Alcohol abuse has been identified as a risk factor for contracting human immunodeficiency virus (HIV) and accelerating disease progression. Our study aims to determine alcohol consumption rates among Ecuadorian HIV positive (HIV+) patients prior to diagnosis to evaluate its impact as an independent risk factor for contracting HIV. Additionally, we will examine post-diagnosis consumption rates among the HIV+ population.

We provided anonymous questionnaires to 300 HIV+ patients and 600 internal medicine patients at 3 hospitals in Quito, Ecuador. Questionnaires quantified alcohol usage prior to HIV diagnosis, at time of diagnosis, and post-diagnosis while accounting for other potential HIV risk factors. We then determined frequencies of alcohol consumption and confounding variables. Finally, we performed a multivariable logistic regression controlling for confounders to determine the statistical significance of alcohol consumption as an independent risk factor for HIV.

Our results showed increased odds for contracting HIV among those who drank daily (OR 5.3, CI 2.0–14.0) and those who consumed 6 or more alcoholic beverages on days they drank (OR 5.0, CI 3.1–8.2). Through multivariable analysis, we found that abstaining from binge drinking was a protective factor with an OR 0.5 (0.3–0.96). The percentage of HIV+ patients abstaining from alcohol increased from 30% twelve months prior to diagnosis to 57% after diagnosis.

Our results show that alcohol abuse significantly increases the risk of contracting HIV. We found that prior to diagnosis, HIV patients consistently drank more frequently and a greater amount than the control group. Alcohol use significantly decreased among HIV+ patients after diagnosis.
Resting-state functional brain alterations in functional dyspepsia
Authors: Sun Ruirui , Zhou Jie , Qu Yuzhu , Zhou Jun , Xu Guixing , Cheng Shirui
Published: November 2020

Background:

Functional dyspepsia (FD) is one of the most common functional gastrointestinal disorders (FGIDs) and significantly influences patients’ quality of life. Many studies have found that patients with FD show significant functional abnormalities in multiple brain regions. However, these functional cerebral abnormalities are not fully consistent. This protocol aims to qualitatively and quantitatively assess and synthesize the functional cerebral abnormalities found in FD.

Methods:

A systematic search will be conducted in 4 electronic databases (Medline, Web of Science, EMBASE, and the Cochrane Library) from inception to June 30, 2019, with the language restricted to English. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality assessment will be performed with a custom 11-point checklist. The functional changes in brain regions and the correlations between these altered brain regions and clinical variables in patients with FD will be evaluated through qualitative review. If data are available, an Anisotropic Effect Size version of Signed Differential Mapping (AES-SDM) will be used to synthesize the brain functional alterations and clinical variables in patients with FD.

Results:

This review and meta-analysis will qualitatively and quantitatively assess and synthesize functional cerebral abnormalities consistently found in FD.

Conclusion:

This may assist in mapping functional brain abnormalities to characterize imaging-based neural markers of FD and improve our knowledge of the pathogenesis of FD.

PROSPERO registration number:

CRD42019134983 (https://www.crd.york.ac.uk/prospero/)
Effect of hyperglycemia on all-cause mortality from pediatric brain injury
Authors: Chen Shuyun , Liu Zhaohe
Published: November 2020

Background:

This study aimed to assess the effect of hyperglycemia on all-cause mortality in pediatric patients with brain injury, based on currently available evidence.

Methods:

We systematically searched the PubMed, Embase, and Cochrane Library databases with the keywords “hyperglycemia”, “brain injury”, and “pediatrics”. The retrieved records were screened by title, abstract, and full-text to include original articles assessing the effects of hyperglycemia on pediatric brain injury. The extracted data were assessed by a fixed-effects model. The risk of bias in the eligible studies was evaluated with the Newcastle-Ottawa Scale. Publication bias was visually examined with a funnel plot. Begg and Egger tests, respectively, were used to identify small-study effects. Sensitivity analysis was performed to evaluate the robustness of the original effect size.

Results:

Nine observational studies were identified from 1439 primary hits. A total of 970 pediatric patients, including 304 with hyperglycemia and brain injury, were included for meta-analysis. Hyperglycemia was strongly associated with a higher risk of all-cause mortality in pediatric patients (odds ratio = 11.60, 95% confidence interval [CI] 7.88–17.08; I
2 = 0%). The overall quality of eligible studies was low, but the funnel plot indicated no publication bias.

Conclusions:

Hyperglycemia is significantly associated with high all-cause mortality in pediatric patients with brain injury. However, the relationship should be confirmed by larger-scale observational studies and randomized controlled trials.
Coagulation parameters predictive of repeated implantation failure in Chinese women
Authors: Yang Wen , Sun Qian , Zhou Zihao , Gao Yuan , Shi Fan , Wu Xiaoyan , Yang Yan , Feng Wen , Wu Ze , Kang Xiaomin
Published: November 2020

Repeated implantation failure (RIF) greatly influences pregnancy rate after assisted reproductive technologies (ART) with elusive causes. Our study aimed to explore coagulation parameters in association with RIF and establish a model to predict the risk of RIF in Chinese women.

Coagulation parameters, including prothrombin time (PT), thrombin time (TT), activated partial prothrombin time (APTT), D-dimer (DD), fibrin degradation products (FDP), fibrinogen (FG), and platelet aggregation induced by arachidonic acid (AA) and adenosine diphosphate (ADP) were measured in RIF patients and controls. A logistic regression model was built by using the purposeful selection to select important factors for the prediction of RIF.

Between 92 RIF patients and 47 controls, we found a statistically significant difference in all of the coagulation parameters except APTT, FDP and platelet aggregation induced by ADP. The purposeful selection method selected PT (odds ratio [OR] = 0.28, 95% CI: 0.12-0.66, P = .003), APPT (odds ratio [OR] = 0.76, 95% CI: 0.63-0.91, P = .004), TT (odds ratio [OR] = 0.75, 95% CI: 0.53-1.08, P = .124), and platelet aggregation induced by AA (odds ratio [OR] = 1.27, 95% CI: 1.11-1.44, P = .0003) as important predictors of RIF risk. ROC curve analysis indicated that the area under ROC curve (AUC) of the model was 0.85 with an optimal cut-off point of the predicted probability being P = .65, leading to a sensitivity of 0.83 and a specificity 0.75.

We found that coagulation parameters including PT, APTT, TT and platelet aggregation induced by AA are predictive of RIF in Chinese women. Our results highlight the potential of anti-coagulation therapies to lower the risk of RIF.
Noninvasive flow evaluations of coronary artery bypass grafting using dynamic cardiac CT
Authors: Sakabe Daisuke , Fukui Toshihiro , Oda Seitaro , Tominaga Osamu , Okamoto Ken , Kato Shingo , Yamashiro Tsuneo , Funama Yoshinori , Kidoh Masafumi , Ikeda Osamu , Utsunomiya Daisuke
Published: November 2020

We aimed to investigate the correlation of graft flow measurements between transit-time flow measurement (TTFM) during coronary artery bypass grafting (CABG) surgery and dynamic cardiac CT after the surgery.

Fourteen patients underwent CABG with TTFM and postoperative dynamic cardiac CT; 11 internal thoracic artery (ITA) grafts and 15 saphenous venous grafts (SVGs) were included for analysis. Pearsons correlation analysis was performed for the comparisons of the TTFM and cardiac dynamic CT flow parameters.

TTFM was not significantly correlated with the CT flow of the ITA grafts (r = −0.23, P = .49), but it had a very strong correlation with the CT flow of the SVGs (r = 0.83, P < .01).

In patients who underwent CABG surgery, dynamic cardiac CT enabled quantitative evaluation of SVG flow, with good correlation with TTFM.
Prognostic value of γ-glutamyl transpeptidase to albumin ratio combined with aspartate aminotransferase to lymphocyte ratio in patients with hepatocellular carcinoma after hepatectomy
Authors: Liu Ke-jun , Lv Yong-xue , Niu Yi-ming , Bu Yang
Published: November 2020

Hepatocellular carcinoma (HCC) is a malignant tumor associated with a high recurrence rate after hepatectomy. Recently, preoperative inflammatory and liver function reserve indices were found to predict increased risk of recurrence and decreased survival in HCC patients. This study aims to evaluate the ability of the γ-glutamyl transpeptidase-to-albumin ratio (GAR) and aspartate aminotransferase-to-lymphocyte ratio (ALRI), individually and in combination, to predict the prognosis of HCC patients after hepatectomy.

We retrospectively reviewed 206 HCC patients who underwent radical resection at the General Hospital of Ningxia Medical University from January 2011 to November 2016. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off value for GAR and ALRI. The Pearson Chi-Squared test was used to analyze the correlations between GAR, ALRI and clinicopathological characteristics. Univariate and multivariate analyses were used to determine the predictive value of these factors for disease-free survival (DFS) and overall survival (OS). Survival rates were drawn according to the Kaplan-Meier method and differences between subgroups were compared by the log-rank statistics.

GAR and ALRI were significantly correlated with gender, history of smoking, prothrombin time, tumor diameter, T stage and early intrahepatic recurrence by the Pearson Chi-Squared test (all P < .05). Univariate analysis indicated that T stage, GAR and ALRI were significantly correlated with DFS and OS in HCC patients after hepatectomy. Multivariate analysis illustrated that GAR and ALRI were independently related to DFS and OS in HCC patients. Preoperative GAR > 0.946 or ALRI > 18.734 predicted poor prognosis in HCC patients after hepatectomy. Additionally, the predictive scope of GAR combined with ALRI was more sensitive than that of either individual measurement alone.

Our data indicate that there is a close association between the clinicopathological characteristics in HCC patients and increased GAR or ALRI. Higher levels of GAR and ALRI could sensitively and specifically predict a poor prognosis in HCC patients after hepatectomy. Furthermore, combined usage of GAR and ALRI could improve the accuracy of this prediction.