bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients’ Expectations of Physiotherapeutic Treatment for Long-Term Side Effects After Cancer: A Qualitative Study
Authors: Jensen Rikke Klitlund , Jakobsen Sarah , Gundersen Sigrid Velling , Andersen Martin Faerch , Kongsgaard Marianne , Thomsen Janus Laust , Riis Allan
Published: September 2021

Objective

This study aims to explore the expectations of physiotherapeutic treatment of long-term side effects (LTSEs) after cancer among patients treated in physiotherapy clinics.

Methods

This a qualitative interview study based on a phenomenological approach. Adult patients with LTSEs after cancer were recruited through The Danish Cancer Society and a private physiotherapy clinic in Denmark. Individual semi-structured interviews were carried out using Microsoft Teams based on an interview guide piloted before the interviews. Interviews were audiotaped and transcribed verbatim. Sampling was conducted with a focus on variation in LTSE. The data were analyzed using Malterud’s principles of systematic text condensation and coded in NVivo 12.

Results

2 males and 8 females with an average age of 55.8 years were interviewed for between 40 and 60 minutes from October to November 2020. Four main themes emerged from the interviews 1 : The importance of the physiotherapist’s approach, 2 the benefits of meeting patients with similar symptoms, 3 the importance of receiving knowledge, and 4 patients seeking to maintain their current state more often than aiming to improve their condition.

Conclusions

Patients consulting a physiotherapy clinic with LTSE after cancer prefer the physiotherapist to have knowledge about cancer and to be emphatic. Furthermore, patients prefer to meet like-minded people and expect support to maintain their current condition rather than improve their condition.
Cost-effectiveness of encorafenib plus cetuximab in BRAF V600E-mutated colorectal cancer
Authors: Giuliani Jacopo , Mantoan Beatrice , Bonetti Andrea
Published: September 2021

Recently, the introduction of encorafenib in combination with cetuximab was considered as a practice changing in BRAFV600-mutated metastatic colorectal cancer. The aim of this paper was to assess the cost-effectiveness of encorafenib plus cetuximab in the second-line treatment of BRAFV600-mutated metastatic colorectal cancer. BEACON CRC Trail was considered. Incremental cost-effectiveness ratio was calculated as the ratio between the difference of the costs in the intervention and in the control groups (pharmacy costs) and the difference between the effect in the intervention and in the control groups (overall survival). Four hundred forty-one patients were included. Differences in costs between the two arms (encorafenib plus cetuximab vs FOLFIRI plus cetuximab) was 59 501 €, with a cost of 17 500 € per month of overall survival-gain. Combining pharmacological costs of drugs with the measure of efficacy represented by overall survival, at the actual prize encorafenib cannot be considered cost-effectiveness for second-line treatment of BRAFV600-mutated metastatic colorectal cancer.
Implementation of Postpartum Depression Screening for Women Participating in the WIC Program
Authors: Giron Kelli , Noe Shelly , Saiki Lori , Kuchler Elizabeth , Rao Satyapriya
Published: September 2021

Introduction:

The national average for the occurrence of postpartum depression (PPD) is 11.5%. Women enrolled in the Women, Infants, and Children (WIC) program are at an elevated risk for PPD symptoms due to risk factors such as a low income, unemployment, low education level, and younger maternal age.

Aim:

To implement screening for PPD symptoms using the Edinburgh Postnatal Depression Scale (EPDS) (1987) for women participating in the local WIC program with an infant <12 months old and compare results of positive screenings to the national average. The second goal was to provide community resources to those women with a positive score.

Methods:

Of 72 women screened, 69 scores were used in the comparison of the positive scores to the national Centers for Disease Control and Prevention average of 11.5%. Women were offered community resources after completion of the EPDS.

Results:

There were 13 positive scores out of the sample size of 69. The percentage of positive scores obtained from these data were 18.84% for the WIC population, which is higher than the national average of 11.5%. This was significant with p = .0494. One limitation of this project was a small sample size.

Conclusion:

It would be beneficial for the WIC program to screen women for PPD symptoms in this high-risk population, so that recommendations for follow-up care could be made and quality of life could be increased.
Advances and Controversies With Checkpoint Inhibitors in Bladder Cancer
Authors: Rhea Logan P , Aragon-Ching Jeanny B
Published: September 2021

Immune checkpoint inhibitors have revolutionized the treatment of bladder urothelial cancers and have wide application in almost all disease states. Although several drugs have initially been shown to be beneficial in the second-line metastatic setting, there are still ongoing controversies and debate, including voluntary withdrawals of durvalumab and atezolizumab, along with the approval of agents in the first-line setting in the cisplatin-ineligible state based on inconsistent confirmatory phase III trials. As novel immunotherapy drugs are discovered and studied in various phases of clinical trials, these agents will continue to change the treatment landscape for bladder cancer patients. This review will discuss current available evidence and information and key pivotal trials using checkpoint inhibitors in bladder cancer.
Everyday Intimacies and Inter-Ethnic Relationships: Tracing Entanglements of Gender and Race in Multicultural Singapore
Authors: Raghunathan Ranjana
Published: September 2021

Through the proposed frame of ‘everyday intimacies’, this article explores the entanglements of race and gender in inter-ethnic relationships. ‘Everyday intimacies’ brings together the minority experiences of everyday racism, the state practices and policies of multiculturalism, and their inflections in intimate relationships of marriage, friendship, and dating. This approach demonstrates not just how the state regulates people’s intimate life through policies of marriage and family, but also how other indirect processes of multicultural governance mediate intimate life. Drawing on biographical narratives of mainly Indian women from in-depth life story interviews and ethnographic fieldwork, the article brings the literature on intimacies in conversation with the scholarship on race and ethnic relations in Singapore. Through a focus on intimacy, the article illustrates how tacit knowledge and embodied effects of everyday racism relate to larger trends of intermarriages, rising singlehood among Indian women and possibilities of co-ethnic friendships and solidarities. In doing so, the article presents novel insight into race and gender relations in Singapore.
L2 knowledge of English prefixes: The effect of vocabulary breadth and exposure
Authors: Sonbul Suhad , El-Dakhs Dina Abdel Salam
Published: September 2021

Very few studies have investigated second language (L2) knowledge of word parts. The present study was set to measure L2 recognition of 35 English prefixes and the factors that might predict scores. The form and meaning sections of Sasao and Webb’s Word Part Levels Test were administered to 152 Arabic learners of English as a foreign language (EFL), followed by a test of vocabulary breadth, and a short language background questionnaire. The factors we explored in the mixed-effects model analysis were the following: vocabulary breadth, duration of L2 exposure, and type/amount of contact with English in the four modalities. We additionally, explored whether Sasao and Webb’s difficulty estimates reflect Arabic EFL learners’ knowledge of prefixes. Results showed that vocabulary breadth significantly predicted both form and meaning knowledge of English prefixes. Moreover, weekly hours of reading and communication in English contributed significantly to prefix knowledge. Finally, Webb and Sasao’s difficulty estimates predicted scores on both the form and meaning tests and interacted with vocabulary breadth, showing that the most difficult prefixes were challenging regardless of vocabulary breadth. These results are discussed in light of previous research on L2 morphological awareness, highlighting implications for teaching practices.
Quasi-zero stiffness isolator based on bistable structures with variable cross-section
Authors: Zhang Zhongwen , Shi Fenglan , Yang Chuang , Xu Zhao-Dong
Published: September 2021

Simple and light-weighted quasi-zero stiffness (QZS) isolators can be designed based on nonlinear and negative stiffness generated by the snap-through effect of bistable structures. Traditionally, the snap-through force of the bistable structure is limited which makes the weight which can be isolated based on this mechanism very low. This paper investigates increasing loading capacity of this kind of isolator by using an optimized and varying sectional profile. Numerical models were derived for the bistable structures with variable sectional distributions. Optimized sections’ alignment of the bistable beam was derived based on the numerical model which was consequently validated by experimental results. Influences of the bistable beams with a variable section on nonlinear stiffness characteristics and performance of the isolator were at last investigated with the harmonic balance method.
Customer Experience: Extracting Topics From Tweets
Authors: Mishra Manit
Published: September 2021

The ubiquity of social media platforms facilitates free flow of online chatter related to customer experience. Twitter is a prominent social media platform for sharing experiences, and e-retail firms are rapidly emerging as the preferred shopping destination. This study explores customers’ online shopping experience tweets. Customers tweet about their online shopping experience based on moments of truth shaped by encounters across different touchpoints. We aggregate 25,173 such tweets related to six e-retailers tweeted over a 5-year period. Grounded on agency theory, we extract the topics underlying these customer experience tweets using unsupervised latent Dirichlet allocation. The output reveals five topics which manifest into customer experience tweets related to online shopping—ordering, customer service interaction, entertainment, service outcome failure, and service process failure. Topics extracted are validated through inter-rater agreement with human experts. The study, thus, derives topics from tweets about e-retail customer experience and thereby facilitates prioritization of decision-making pertaining to critical service encounter touchpoints.
COVID-19 and the Democracy–Autocracy Freedom Divide: Reflections on Post-Pandemic Regime Change Scenarios
Authors: Cassani Andrea
Published: September 2021

This research note contributes to the emerging debate on the consequences of the COVID-19 pandemic for democracy, autocracy and regime change. Following a review of the literature on the short-term impact of the pandemic on citizen freedoms, I conduct a preliminary test showing that COVID-19 has widened the freedom divide between democracy and autocracy. I propose a prudential interpretation of this new finding and of its implications for medium- to long-term regime change dynamics. In an age of advancing autocratization, regaining awareness that democracies and autocracies treat citizens differently could help marginalize antisystem political forces in democratic countries. However, increased levels of repression in regimes that are already authoritarian are no good news in terms of prospective democratization. Moreover, the management of the social and economic consequences of the pandemic is likely to represent a key driver of future regime change, duo to its impact on the legitimacy and stability of both democracies and autocracies.
Inflammation Unleashed in Viral-Induced Epileptogenesis
Authors: DePaula-Silva Ana Beatriz , Bell Laura A. , Wallis Glenna J. , Wilcox Karen S.
Published: September 2021

Viral infection of the central nervous system increasingly places people at risk of developing life-threatening and treatment-resistant acute and chronic seizures (epilepsy). The emergence of new human viruses due to ongoing social, political, and ecological changes places people at risk more than ever before. The development of new preventative or curative strategies is critical to address this burden. However, our understanding of the complex relationship between viruses and the brain has been hindered by the lack of animal models that survive the initial infection and are amenable for long-term mechanistic, behavioral, and pharmacological studies in the process of viral-induced epileptogenesis. In this review, we focus on the Theiler’s murine encephalomyelitis virus (TMEV) mouse model of viral infection–induced epilepsy. The TMEV model has a number of important advantages to address the quintessential processes underlying the development of epilepsy following a viral infection, as well as fuel new therapeutic development. In this review, we highlight the contributions of the TMEV model to our current understanding of the relationship between viral infection, inflammation, and seizures.
Body Mass Index Changes in Relation to Male Reproductive Hormones: Longitudinal Results From a Community-Based Cohort Study
Authors: Ye Yun , Liang Qun-Feng , Li Jian-Hui , Zheng Jun-Biao , Yu Xiao-Hua , Zhang Shu-Cheng , Zhou Wei-Jin , Shi Hui-Juan , Liang Guo-Qing , Zhu Qian-Xi
Published: September 2021

The objective of the current study was to explore the relationship between longitudinal change in body mass index (BMI) and reproductive hormones in middle-aged and elderly Chinese men. A cohort study was conducted in a rural area of China. Local male residents aged 40–80 years were recruited at baseline in 2012 and were followed up in 2016. Information about weight, height, waist circumference, sex hormones, smoking status, and medical history were obtained. The change in BMI reported no significant relationship with the change in total testosterone (TT), calculated free testosterone (cFT), and bioavailable testosterone (BioT) in Pearson correlation analyses. When the change in BMI was divided into three groups—“great loss,” “normal fluctuation,” and “great gain”—TT, cFT and BioT had the highest increase (or the lowest decrease) in men with “normal fluctuation” in BMI compared with the other two groups. The advantage of maintaining a stable BMI was more evident for those who were overweight, non-smoking, and disease-free. There was a tendency of a continuous increase in cFT and BioT with BMI increase in smoking and diseased populations. Maintaining a stable BMI is associated with maintaining normal levels of reproductive hormones, especially in overweight, non-smoking, and healthy men aged over 40 years.
Making Qualitative Interviews in Music Therapy Research More Accessible for Participants Living With Dementia – Reflections on Development and Implementation of Interview Guidelines
Authors: Thompson Zara , Baker Felicity Anne , Clark Imogen Nicola , Tamplin Jeanette
Published: September 2021

Purpose. This paper reports findings from a project that sought to develop accessible guidelines for including people with dementia in qualitative interviews in a music therapy study, based on experience from people previously involved in qualitative music therapy research. Method. People with previous experience of qualitative music therapy research were invited to participate in semi-structured interviews about how the interview process could be made more accessible. Participants included four family-caregivers and three music therapy-researchers. Interview data were analysed using thematic analysis. Findings were used to develop guidelines for a subsequent study; reflections on the implementation of these guidelines are provided. Results. Five themes were identified: (a) motivators and barriers to participating in interviews; (b) pragmatic elements that impact interview participation; (c) relationship dynamics may impact the interview; (d) familiarity fosters comfort, enables preparation and support and (e) broader considerations for accessible research design. Conclusions. Themes identified align with reports from the extant literature. Reflections on implementation of the guidelines reveal the need for more clarity around the ethics of building rapport in qualitative research. Implications about future uses of the guidelines, including the use of music as a research tool are discussed.
CircRNA-MSR Regulates LPS-Induced C28/I2 Chondrocyte Injury through miR-643/MAP2K6 Signaling Pathway
Authors: Jia Zhen , Wei Qing-Jun
Published: September 2021

Objective

Osteoarthritis (OA) is a degenerative joint disease characterized by deterioration of articular cartilage functions. Previous studies have confirmed the role of circular RNAs (circRNAs) in OA, but the role of mechanical stress–related circRNA (circRNA-MSR) in OA is unknown.

Design

The human chondrocytes C28/I2 were cultured and treated with lipopolysaccharide (LPS) to establish the OA model. The mRNA and protein levels were measured by qRT-PCR or Western blot. Cell viability was analyzed by MTT assay. Flow cytometry was carried out to detect cell apoptosis. The levels of TNF-α, IL-1β, and IL-6 were determined by enzyme-linked immunosorbent assay (ELISA). Pull-down assay was conducted to measure circRNA-MSR-related miRNA. Dual-luciferase reporter gene detection was performed to detect the target relationships between miR-643 and circRNA-MSR or Mitogen-activated protein kinase kinase 6 (MAP2K6). The RNA–fluorescence in situ hybridization (RNA-FISH) assay was conducted to verify the localization of circRNA-MSR and miR-643.

Results

The expressions of circRNA-MSR were upregulated in LPS stimulated C28/I2 cells. Knockdown of circRNA-MSR can inhibit LPS-induced apoptosis, inflammatory response, and extracellular matrix (ECM) degradation, and promote cell C28/I2 cells proliferation. Moreover, circRNA-MSR directly targeted miR-643. RNA-FISH exhibited that circRNA-MSR may act as a competing endogenous RNA (ceRNA) of miR-643. Over-expression of miR-643 could alleviate LPS-induced C28/I2 chondrocyte injury and promote cell proliferation. Besides, miR-643 directly bound to MAP2K6 mRNA. MiR-643 inhibition or MAP2K6 overexpression can reverse the role of circRNA-MSR knockdown on LPS-treated chondrocytes.

Conclusion

circRNA-MSR can upregulate MAP2K6 by targeting miR-643, thereby inhibiting cell proliferation and promoting apoptosis of C28/I2 cells.
Alcohol use disorder and its determinant factors among patients with schizophrenia attending treatment at mental specialized hospital, Addis Ababa, Ethiopia: A cross-sectional study
Authors: Tadesse Habtamu , Mirkena Lemu Yohannes , Misgana Tadesse
Published: September 2021

Background:

Alcohol use disorder is one of the primary causes of avoidable death, illness, and injury in many societies throughout the world. Although alcohol use disorder can influence the natural history of a disease, disease recurrence, quality of life, and treatment adherence in psychiatric patients, the data on its magnitude is scarce.

Objectives:

This study was aimed to determine the magnitude of alcohol use disorder and its determinants among patients with schizophrenia attending a mental specialized hospital in Addis Ababa, Ethiopia.

Methods:

An institutional-based cross-sectional study was conducted from May 15 to June 15, 2018. An alcohol use disorder identification test was employed among a sample of 414 randomly selected patients with schizophrenia. Alcohol use disorder was categorized as hazardous drinking (Alcohol Use Disorders Identification Test (AUDIT) score of 8–15), harmful drinking (AUDIT score of 16–19), and alcohol dependence (AUDIT score of 20 or above). The data were entered into Epi-Data 3.1 and exported to SPSS 20 for analysis. Logistic regression was fitted to identify factors associated with alcohol use disorder.

Results:

The prevalence of alcohol use disorder was 38.4% (95% confidence interval (CI) 33.7, 42.9). Of this, 22.4% of the patients had hazardous drinking, 8.4% harmful drinking, and 7.6% alcohol dependence. Factors associated with alcohol use disorder were male sex (adjusted odds ratio (AOR) = 5.8, 95% CI 2.55, 13.19), being single (AOR = 3.0, 95% CI 1.63, 5.51), divorced (AOR = 4.3, 95% CI 1.95, 9.47) and widowed (AOR = 3.5, 95% CI 1.39, 8.81), having family history of alcoholism (AOR = 3.8, 95% CI 1.98, 7.19), longer duration of illness (AOR = 3.9, 95% CI 1.83, 8.36), previous history of psychiatric diagnosis (AOR = 2.2, 95% CI 1.1, 4.34), and concomitant use of non-alcoholic substances (AOR = 3.7, 95% CI 2.06, 6.74).

Conclusions:

Almost four in ten patients with schizophrenia had alcohol use disorder. Male sex, single, divorced, and widowed, family history of alcohol use, long duration of illness, previous history of psychiatric diagnosis, and concomitant use of non-alcoholic substances were significantly associated with alcohol use disorder. Continuous counseling of at risk populations about alcohol consumption should be strengthened.
A case report of palmar xanthoma with xanthomatous neuropathy
Authors: Lee Hyun Yi , Koo Dae Won , Lee Joong Sun
Published: September 2021

Xanthomas are plaques or nodules consisting of an accumulation of excess lipids, resulting in the formation of foam cells in the skin or tendons. Typically, xanthomas are not accompanied by other symptoms. Here, we report a patient with a presentation of painful palmar xanthomas and subsequent diagnosis of metabolic and cardiovascular morbidities. A 44-year-old man presented with multiple yellowish, firm, and painful nodules on his right palm and fingers. Lipid panel and medical examination revealed a diagnosis of type III hyperlipoproteinemia and diabetes mellitus type II. Histopathological examination of the lesions revealed numerous lipid-laden foamy cells surrounding the nerve bundles through the dermis. This unique presentation of painful xanthomas prior to the manifestation of more significant underlying conditions suggested that xanthomas might be used as early diagnostic indicators. Based on this case, we propose more thorough examinations of palmar xanthomas in patients for earlier detection of potentially lethal diseases.
Aortic compression of the esophagus: A case report and literature review
Authors: Tomforde Manuela , Kupsch Heidi , Christe Andreas , Sturzenegger Mathias , Essig Manfred
Published: September 2021

Distal aortic compression of the lower esophagus with consecutive dilatation of the proximal esophagus was first described in the literature in 1932. Here, the authors describe the case of a 66 year-old male complaining of gastroesophageal reflux. Due to a positive family history of carcinoma of the esophagus and compression of the dorsal esophagus during an esophageal barium swallow test, further tests were performed. Endoscopy and CT exam revealed a dilated esophagus due to compression of a crossing aorta. Because of mild symptoms and the absence of dysphagia, no further treatment was necessary except for the use of a proton pump inhibitor and recommended follow-ups every one to two years.
Dynamic Energy Efficiency, Energy Decoupling Rate, and Decarbonization: Evidence from ASEAN+6
Authors: Chen Chiang-Ping , Chang Ming-Chung , Tsai Wei-Che
Published: September 2021

Improving energy efficiency is widely identified as shifting energy usage to an optimal status in order to ultimately strengthen a country’s competitiveness and development, and indeed this is of particular relevance to the Association of Southeast Asian Nations plus Six’ (ASEAN+6). The traditional data envelopment analysis (DEA) approach has extensively been employed for estimating energy efficiency, but it does not properly utilize the weight in the DEA model to probe the behavior change of a decision making unit (DMU). This research therefore applies a progressive time-weighted dynamic efficiency model (PTDEM) to estimate the energy efficiency of ASEAN+6 and discusses the issues concerning their energy decoupling rates and decarbonization. The proposed model herein fully considers a DMU’s behavior change by estimating its energy efficiency. Empirical results reveal that: (i) improvements in energy efficiency within ASEAN are greater than in the other six countries; (ii) members of ASEAN still have more room for improvement than the other six countries with regard to achieving the standard ratio of the energy decoupling rate; and (iii) there is no evidence of convergence to decarbonization within ASEAN+6.
The Social Isolation of Neurotic Bloom in James Joyce’s Ulysses
Authors: Farahmandian Hamid , Shao Lu
Published: September 2021

This paper studies Leopold Bloom’s social isolation and detached personality through the lens of neurosis in James Joyce’s Ulysses. To achieve this, this paper draws on Karen Horney’s theory of neurotics, in which people with detached personality feel as though they do not belong among other people. Such neurotics not only separate themselves from others but become alienated even from themselves. According to Horney, three neurotic elements lead to the formation of a detached personality: the need for “self-sufficiency,” “perfection,” and “narrow limits in life.” In Ulysses, Bloom distances himself from other people because of his anxiety and his desire for freedom, which results in his social alienation. To deal with his isolation, Bloom needs to flaunt his superiority, prove his independence, and set limitations on his life to relieve the pressures imposed on him by people and society.
Outcomes of Pediatric Posterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Scarcella Michael J. , Yalcin Sercan , Scarcella Nicholas R. , Saluan Paul , Farrow Lutul D.
Published: September 2021

Background:

Little has been reported in the literature regarding surgical treatment of posterior cruciate ligament (PCL) injuries in pediatric patients.

Purpose/Hypothesis:

The purpose was to evaluate presentation, injury pattern, outcomes, and complications of surgically managed PCL injuries in pediatric patients. It was hypothesized that pediatric patients would have good patient-reported outcomes and no significant radiographic changes or complications.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search was performed using PubMed, Medline, EMBASE, Scopus, and Cochrane databases between 1975 and December 16, 2019. Search terms included “posterior cruciate ligament,” “peel-off injury,” “avulsion,” “PCL,” “pediatric,” “skeletally immature,” and “adolescent.” Included were studies on pediatric patients with PCL injuries managed operatively. Exclusion criteria included case reports, studies not reporting clinical results, reviews, abstract or conference papers, or papers not in the English language. Quality assessment was performed on all included studies using the MINORS (Methodological Index for Non-Randomized Studies) criteria.

Results:

Four articles comprising 43 knees in 42 patients met the criteria and were included. Motor vehicle accidents were the most common mechanism of injury (39.5%; n = 17/43), followed by sports-related injuries (35%; n = 15/43). All studies commented on tear pattern, with the following distribution: 42% (n = 18/43) midsubstance tears, 37% (n = 16/43) tibial avulsions, and 21% (n = 9/43) femoral avulsions. Overall, good patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score and Pediatric International Knee Documentation Committee, Tegner, and Lysholm scores) and return to activity, as well as satisfactory posterior stability (KT-1000 arthrometer, posterior drawer test, and kneeling radiographs) and range of motion, were reported. There was no significant leg-length discrepancy or angular deformity reported. Arthrofibrosis was reported in 7% of postoperative knees and was the most commonly reported complication. Osteoarthritis was reported in 21% (n = 9/43) of knees. The average MINORS score was 7 (range, 6-8) for noncomparative studies and 10 for comparative studies.

Conclusion:

Good patient-reported outcomes and return to activity can be obtained using repair or reconstruction. This evidence was limited by the quality of the included studies and overall small sample size; however, this review serves as a baseline for futures studies on PCL repair/reconstruction in pediatric patients.
Latissimus Dorsi Tendon Reconstruction at the Myotendinous Junction With Acellular Dermal Allograft
Authors: Recker Andrew J. , Torres LeeAnne , Dennis Eric , Scholten Donald J. , Waterman Brian R.
Published: September 2021

Background:

Limited available data have shown latissimus dorsi tendon reconstruction to be an effective treatment for tendon tears in specific subpopulations of elite overhead throwing athletes.

Indications:

Primary indication for latissimus dorsi tendon reconstruction is a symptomatic, full-thickness humeral avulsion with or without a concomitant teres major tendon tear. Surgical candidates are typically young, high-demand, elite or professional overhead throwing athletes. In this case, the patient is a 29-year-old male former minor league pitcher and current pitching coach with a full-thickness avulsion of the latissimus dorsi tendon.

Technique Description:

The patient was positioned left lateral decubitus with a dynamic limb positioner maintaining the arm in 90° abduction and maximal internal rotation. This technique used a single posterior axillary incision, which was performed and dissected down to the ruptured latissimus dorsi tendon. We circumferentially applied an acellular dermal allograft to augment the reconstruction at the myotendinous junction. Subsequently, the construct was prepared for transfer with a Krackow suture technique. Suture buttons were used to secure the reconstructed latissimus dorsi tendon to the anatomic footprint on the proximal humerus with a tension slide technique.

Results:

One case series showed return to the previous level of competition for all baseball pitchers who underwent a latissimus dorsi reconstruction with excellent improvement in visual analog scale pain, American Shoulder and Elbow Surgeons, and Kerlan-Jobe Orthopaedic Clinic scores. Another larger study demonstrated equal return to play rates for professional baseball pitchers with a latissimus dorsi tear treated either nonoperatively or operatively. However, those treated operatively had no decline in performance, whereas the nonoperative cohort saw decline in some statistics.

Conclusion:

Latissimus dorsi tendon reconstruction using an acellular dermal allograft at the myotendinous junction is a viable treatment option for elite overhead throwing athletes with full-thickness tendon avulsions. It allows for full return to play, particularly if the patient has failed nonoperative management.
Seeing Red: Effects of Practice Interventions on Woodwind Students’ Accuracy in Performing Articulation
Authors: Stambaugh Laura A. , Bryan Carolyn J.
Published: September 2021

Music reading is a central part of most band programs, yet research about music reading has rarely included articulation markings. The purpose of this study was to explore the effect of four experimental practice conditions to a control condition on woodwind players’ performance of slur, accent, and staccato markings. A secondary purpose was to examine the role of working memory in performing articulation. The practice conditions used visual and kinesthetic approaches: colored notation, tracing over articulation marks, and speaking syllables. University woodwind players ( N = 26) practiced short etudes on 1 day, and they returned approximately 24 hours later for retention testing. Participants’ working memory was strongly related to playing articulation on the first day of practice. Woodwind players prioritized playing slurs over accents and staccatos, and there was some support for tracing with color to support accurate performance of articulation.
Macrophages and cancer stem cells: a malevolent alliance
Authors: Allavena Paola , Digifico Elisabeth , Belgiovine Cristina
Published: September 2021

Myeloid cells infiltrating tumors are gaining ever growing attention in the last years because their pro-tumor and immunosuppressive functions are relevant for disease progression and therapeutic responses. The functional ambiguity of tumor-associated macrophages (TAMs), mostly promoting tumor evolution, is a challenging hurdle. This is even more evident in the case of cancer stem cells (CSCs); as active participants in the specialized environment of the cancer stem cell niche, TAMs initiate a reciprocal conversation with CSCs. TAMs contribute to protect CSCs from the hostile environment (exogenous insults, toxic compounds, attacks from the immune cells), and produce several biologically active mediators that modulate crucial developmental pathways that sustain cancer cell stemness. In this review, we have focused our attention on the interaction between TAMs and CSCs; we describe how TAMs impact on CSC biology and, in turn, how CSCs exploit the tissue trophic activity of macrophages to survive and progress. Since CSCs are responsible for therapy resistance and tumor recurrence, they are important therapeutic targets. In view of the recent success in oncology obtained by stimulating the immune system, we discuss some macrophage-targeted therapeutic strategies that may also affect the CSCs and interrupt their malevolent alliance.
Genome-wide association study and transcriptome of olecranon-type traits in peach (Prunus persica L.) germplasm
Authors: Liu Jianliang , Bao Yao , Zhong Yuming , Wang Qin , Liu Huifan
Published: September 2021

Background

The top of the olecranon honey peach (Prunus persica L.) fruit appears similar to an eagle’s beak. In this study, a single olecranon honey peach with a round-type fruit was observed in our fruit orchard. To explore the genetic mechanism of olecranon formation, we performed full-length transcriptome sequencing analysis of olecranon and round peaches as well as a genome-wide association study of the association of olecranon-type trait loci.

Results

The gene locus was 26,924,482 base pairs in NC_034014.1. Transcriptome sequencing showed that the clean sequencing data of each sample reached 7.10GB, with 14,360 genes and 23,167 transcripts expressed in both the olecranon honey peach and round peach. Among the 11 differentially expressed genes selected as candidate genes, six were highly expressed in olecranon peach and named as LOC18775282, LOC18772209, LOC18773929, LOC18772013, LOC18773401, and ONT.13798.5. Five genes were highly expressed in round peach and named as LOC18773079, LOC18773525, LOC18773067, LOC18775244, and LOC18772236. Notably, ONT.13798.5 was not previously identified. The genes were within 1 Mb up- or down-stream of the main genome-wide association study locus for olecranon-type traits.

Conclusions

This study revealed loci associated with olecranon and provides useful information for analysis and breeding of olecranon honey peach.
An efficient method to identify virus-specific TCRs for TCR-T cell immunotherapy against virus-associated malignancies
Authors: Chen Lei , Dong Lianhua , Ma Yipeng , Wang Juntao , Qiao Dongjuan , Tian Geng , Wang Mingjun
Published: September 2021

Adoptive transfer of T cells genetically engineered with a T cell receptor (TCR) is a promising cancer treatment modality that requires the identification of TCRs with good characteristics. Most T cell cloning methods involve a stringent singularization process, which necessitates either tedious hands-on operations or high cost. We present an efficient and nonstringent cloning approach based on existing techniques. We hypothesize that after elimination of most nonspecific T cells, a clonotype with high quality could outcompete other clonotypes and finally form a predominant population. This TCR identification method can be used to clone virus-specific TCRs efficiently from cancer patients and is easily adoptable by any laboratory.
Oral iron supplementation after antibiotic exposure induces a deleterious recovery of the gut microbiota
Authors: Cuisiniere Thibault , Calvé Annie , Fragoso Gabriela , Oliero Manon , Hajjar Roy , Gonzalez Emmanuel , Santos Manuela M.
Published: September 2021

Background

Oral iron supplementation is commonly prescribed for anemia and may play an important role in the gut microbiota recovery of anemic individuals who received antibiotic treatment. This study aims to investigate the effects of iron supplementation on gut microbiota recovery after antibiotics exposure.

Results

Mice were subjected to oral antibiotic treatment with neomycin and metronidazole and were fed diets with different concentrations of iron. The composition of the gut microbiota was followed throughout treatment by 16S rRNA sequencing of DNA extracted from fecal samples. Gut microbiota functions were inferred using PICRUSt2, and short-chain fatty acid concentration in fecal samples was assessed by liquid-chromatography mass spectrometry. Iron supplementation after antibiotic exposure shifted the gut microbiota composition towards a Bacteroidetes phylum-dominant composition. At the genus level, the iron-supplemented diet induced an increase in the abundance ofParasutterellaandBacteroides, and a decrease ofBilophilaandAkkermansia.Parasutterella excrementihominis,Bacteroides vulgatus, andAlistipes finegoldii, were more abundant with the iron excess diet. Iron-induced shifts in microbiota composition were accompanied by functional modifications, including an enhancement of the biosynthesis of primary bile acids, nitrogen metabolism, cyanoamino acid metabolism and pentose phosphate pathways. Recovery after antibiotic treatment increased propionate levels independent of luminal iron levels, whereas butyrate levels were diminished by excess iron.

Conclusions

Oral iron supplementation after antibiotic therapy in mice may lead to deleterious changes in the recovery of the gut microbiota. Our results have implications on the use of oral iron supplementation after antibiotic exposure and justify further studies on alternative treatments for anemia in these settings.
Current progress of fluoroquinolones-increased risk of aortic aneurysm and dissection
Authors: Jun Cui , Fang Bian
Published: September 2021

Aortic aneurysm (AA) and aortic dissection (AD) are major life-threatening diseases around the world. AA is a localized or diffuse dilation of the aorta, while AD is the separation of the layers creating a false lumen within the aortic wall. Fluoroquinolones (FQ) remain one of the most important kind of antibiotics and have a wider clinical use and broad antibacterial spectrum. FQ were also reported to treat infected AA. The most common adverse events (AEs) of FQ are mild and reversible, like headaches, diarrhea and nausea. Due to FQ-related serious AEs, such as tendonitis and tendon rupture, chondrotoxicity, or retinal detachment, QT-prolongation and dysglycemia, the United States Food and Drug Administration (FDA) issued a black box warning for FQ for systemic use in 2016 and updated warnings for FQ several times since then. Of note, in December 2018, FDA issued several “black box warnings” against FQ with the latest safety announcement warning about an increased risk of ruptures in the aorta blood vessel in certain patients. Recently, many studies have indicated an association between FQ and an increase risk of AA and AD. However, the exact mechanism of FQ-induced AA/AD remains unclear. This review aims to highlight the latest research progress of the alarming association between FQ and AA/AD. Moreover, molecular mechanisms of FQ in increasing risk of AA and AD are explored. Hopefully, this review can provide novel insights into FQ-increased the risk of AA/AD and a starting place for stewardship interventions.
Transition from metabolically healthy to unhealth status associated with risk of carotid artery plaque in Chinese adults
Authors: Tan Tao , Zhou Yiquan , Wan Yanping , Fan Zhuping , Xu Renying , Gao Xiang
Published: September 2021

Objective

We aimed to evaluate the association between the shift of metabolic status and future risk of carotid artery plaque (CAP) in community-based Chinese adults.

Methods

The current study included 9836 Chinese adults (4085 males and 5751 females, mean age 35.8 years) with metabolically healthy status at baseline (2013). Metabolically healthy status was defined as no self-reported history of metabolic diseases and cancer, and normal blood pressure, fasting blood glucose, glycated hemoglobin A1c level, and lipid profiles. Metabolically unhealthy status was defined if any of the following metabolic abnormalities were confirmed twice during follow up: high blood pressure, impaired glucose regulation, high triglycerides, high total cholesterol, high low-density lipoprotein cholesterols, or low high-density lipoprotein cholesterols. The transition was confirmed if participants’ metabolic status shifted from baseline healthy to unhealthy status during follow up (2014–2018).

Results

We have identified 133 incident cases of CAP during follow up. Compared to those who remained metabolically healthy, the transition to high blood pressure, high total cholesterol, and high low-density lipoprotein cholesterols, were associated with high risk of developing carotid artery plaque (Hazards ratios (HRs) ranged from 1.69 to 2.34; p < 0.05 for all). The transition to impaired glucose regulation, high total triglycerides, and low high-density lipoprotein cholesterols, were associated with high risk of carotid artery plaque only in participants with metabolically healthy overweight at baseline (HR ranged from 1.95 to 4.62; p < 0.05 for all).

Conclusion

The transition from baseline metabolically healthy status to unhealth status was associated with high risk of incident CAP.
Follow-up colonoscopy after an abnormal stool-based colorectal cancer screening result: analysis of steps in the colonoscopy completion process
Authors: Coronado Gloria D. , Kihn-Stang Alexandra , Slaughter Matthew T. , Petrik Amanda F. , Thompson Jamie H. , Rivelli Jennifer S. , Jimenez Ricardo , Gibbs Jeffrey , Yadav Neha , Mummadi Rajasekhara R.
Published: September 2021

Background

Delays in receiving follow-up colonoscopy after an abnormal fecal immunochemical test (FIT) result are associated with increased colorectal cancer incidence and mortality. Little is known about patterns of follow-up colonoscopy completion in federally qualified health centers.

Methods

We abstracted the medical records of health center patients, aged 50–75 years, who had an abnormal FIT result between August 5, 2017 and August 4, 2018 (N = 711). We assessed one-year rates of colonoscopy referral, pre-procedure visit completion, colonoscopy completion, and time to colonoscopy; associations between these outcomes and patient characteristics; and reasons for non-completion found in the medical record.

Results

Of the 711 patients with an abnormal FIT result, 90% were referred to colonoscopy, but only 52% completed a pre-procedure visit, and 43% completed a colonoscopy within 1 year. Median time to colonoscopy was 83 days (interquartile range: 52–131 days). Pre-procedure visit and colonoscopy completion rates were relatively low in patients aged 65–75 (vs. 50–64), who were uninsured (vs. insured) or had no clinic visit in the prior year (vs. ≥ 1 clinic visit). Common reasons listed for non-completion were that the patient declined, or the provider could not reach the patient.

Discussion

Efforts to improve follow-up colonoscopy rates in health centers might focus on supporting the care transition from primary to specialty gastroenterology care and emphasize care for older uninsured patients and those having no recent clinic visits. Our findings can inform efforts to improve follow-up colonoscopy uptake, reduce time to colonoscopy receipt, and save lives from colorectal cancer.

Trial registration: National Clinical Trial (NCT) Identifier: NCT03925883.
Association of neutrophil-to-lymphocyte ratio with severe radiation-induced mucositis in pharyngeal or laryngeal cancer patients: a retrospective study
Authors: Kawashita Yumiko , Kitamura Masayasu , Soutome Sakiko , Ukai Takashi , Umeda Masahiro , Saito Thoshiyuki
Published: September 2021

Background

The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that informs clinical decisions regarding recurrence and overall survival in most epithelial cancers. Radiotherapy for head and neck cancer leads to mucositis in almost all patients and severe radiation-mucositis affects their quality of life (QOL). However, little is known about the NLR for severe mucositis. Therefore, this study aimed to show the association between the NLR and severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.

Methods

In this retrospective study, we determined the incidence of grade 3 mucositis in 99 patients who were receiving definitive radiotherapy or chemoradiotherapy (CRT) for hypopharyngeal or laryngeal cancer. We performed univariate and multivariate logistic regression analyses to investigate the characteristics of grade 3 mucositis. Kaplan–Meier curves and log-rank tests were used to evaluate the occurrence of grade 3 mucositis between two groups with high (NLR > 5) or low (NLR < 5) systemic inflammation.

Results

The incidence of grade 3 mucositis was 39%. Univariate logistic regression analysis showed that the NLR (Odd ratio [OR] = 1.09; 95% confidence interval [CI] = 1.02–1.16;p = 0.016) and smoking (OR = 1.02; 95% CI = 1.00–1.03;p = 0.048) were significantly associated with grade 3 mucositis. Multivariate logistic regression analysis showed that the NLR was independently associated with grade 3 mucositis (OR = 1.09; 95% CI = 1.01–1.17;p = 0.021). Kaplan–Meier curves also showed that patients with higher NLR (NLR > 5) prior to radiotherapy developed grade 3 mucositis more frequently than those with lower NLR during radiotherapy (p = 0.045).

Conclusion

This study suggests that a higher NLR is a risk factor and predictor of severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.
Minimally invasive management versus open surgery in the treatment of penetrating bladder injuries: a retrospective cohort study
Authors: Culhane John , Syed Johar Raza , Siddiqui Sameer
Published: September 2021

Background

While blunt extra-peritoneal bladder injury is typically treated non-operatively or with minimally invasive management, the treatment for penetrating bladder injury is generally open surgery. We identify a group of patients with penetrating bladder injury who were treated with minimally invasive management and compare the results with those who underwent traditional open surgical treatment.

Methods

This retrospective cohort study analyzes penetrating bladder injuries from a single trauma center from 2012 through 2019, and from the National Trauma Data Bank for 2016 and 2017. Mortality, complications, and length of stay were compared for minimally invasive management versus open surgery. We used Chi square to test significance for categorical variables, Mann–Whitney U test for ordinal variables, and T-test for continuous variables. Multivariate analysis was performed with multiple logistic, ordinal, and linear regression.

Results

Local: 117 (0.63%) had a bladder injury; 30 (25.6%) were penetrating. 6 (20.0%) were successfully treated with minimally invasive management with no complication versus 24 complications in 11 patients (45.8%) for open surgery (p = 0.047). Open surgical management was not a significant independent predictor of mortality or hospital length of stay. National Trauma Data Bank: 5330 (0.27%) had a bladder injury; 963 (19.5%) were penetrating. 97 (10.1%) were treated with minimally invasive management. The minimally invasive management group had 12 complications in 5 patients (4.9%) versus 280 complications in 169 patients (19.7%) for open surgery (p =  < 0.001). Open surgery was a significant independent predictor of complications (OR 1.57, p = 0.003) and longer hospital length of stay (B = 5.31, p < 0.001).

Conclusions

Most penetrating bladder injury requires open surgery, however a small proportion can safely be managed with minimally invasive management. Minimally invasive management is associated with lower total complications and shorter hospital length of stay in select patients.