bluuebunny/crossref_metadata_2025 huggingface dataset:
Biosecurity
Authors: Revill James , Roessing Anna
Published: March 2021

This chapter discusses the term ‘biosecurity’, which is a relatively new addition to the global security lexicon. It looks at the origins and evolution of the concept of biosecurity, drawing attention to drivers of interest in biosecurity and the linguistic, cultural, and political challenges to cohesively defining this concept. Notwithstanding such conceptual difficulties, biosecurity has become an important topic in twenty-first-century security discourse as multilateral and national security-policymaking organs have recognized the potential security-related risks associated with contemporary biotechnology and have sought to mitigate such risks. The chapter then elaborates on what has been achieved in terms of building a biosecurity architecture. It also considers the current status of the biosecurity debate, drawing on examples from the patchwork of biosecurity measures undertaken across the globe to illustrate how this is an area that has made considerable progress over the course of the last two decades. Ultimately, biosecurity is a work in progress that will become increasingly salient in the global security discourse as life sciences and biotechnology continue to advance in a changing geostrategic context.
Cybersecurity and International Law
Authors: Schmitt Michael N.
Published: March 2021

This chapter discusses the international law of cybersecurity, which, at just over two decades old, remains in a relative state of infancy. States continue to struggle with such basic issues as sovereignty in cyberspace. In great part, the challenge is that many States are conflicted over the application and interpretation of key aspects of international law in the cyber context. After all, although international law can serve as a normative firewall against hostile cyber operations, the principle of sovereign equality means that protective norms also can act as barriers to a State's own cyber operations, some of which may be deemed essential to the State, especially with respect to national security. These differences in normative perspective often play out domestically in disagreements between ministries with different roles vis-à-vis cyberspace, and internationally between States wielding offensive cyber capability and those that see themselves primarily as victims thereof. To examine the relationship between cybersecurity and international law, the chapter begins by cataloguing the development of the international law of cyberspace. It then turns to the substantive legal issues, paying particular attention to those matters that presently are the source of contention amongst States.
Criminal Prosecution
Authors: Pocar Fausto
Published: March 2021

This chapter focuses on criminal prosecution. Traditionally, in domestic law, criminal prosecution has been regarded as a tool capable of contributing to peaceful and secure governance. Under international law, however, recourse to criminal prosecution as a safeguard for maintaining international peace and security is very recent and still limited, and in many respects disputed. This is the case both when international rules are applied by international jurisdictions and when they are directed at soliciting the exercise of criminal prosecution by domestic courts. The chapter looks at the Rome Statute of the International Criminal Court (ICC Statute), which expressly provides that the jurisdiction of the Court ‘shall be limited to the most serious crimes of concern to the international community as a whole’, and identifies these crimes as the crime of genocide, crimes against humanity, war crimes, and the crime of aggression. Given that the ICC Statute does not merely codify customary international law, but also partially develops or restricts it, its adoption has produced some degree of fragmentation of international criminal law, which further impacts on the existing international case law.
Queer kinship and the rights of refugee families
Authors: Ritholtz Samuel , Buxton Rebecca
Published: March 2021

Over the past decade, the refugee protection regime has supposedly become more inclusive of queer and trans* people. Much literature has focused on the expansion of refugee status determination and the inclusion of LGBTQ asylum seekers. However, there are many areas of refugee policy that remain dependent on cisheteronormative assumptions and therefore exclude the queer and trans* forcibly displaced. This paper considers the concept of ‘the family’ and how it is used and understood in refugee protection. We make the normative argument that queer and trans* family units ought to qualify for refugee family reunion and group status determination. We do so by considering the concept of queer and trans* ‘chosen families’, arguing that these queer articulations of kinship are functionally and morally comparable to cisheteronormative conceptions of the family. We contend that considering the cisheteronormative underpinnings of the family in this way opens up the potential to queer other areas of refugee policy, and therefore paves the way to a more inclusive refugee protection regime.
New NEO Detection Techniques using the FPGA
Authors: Yanagisawa Toshifumi , Kamiya Kohki , Kurosaki Hirohisa
Published: March 2021

We have developed a new method for detecting near-Earth objects (NEOs) based on a Field Programmable Gate-Array (FPGA). Unlike conventional methods, our technique uses 30–40 frames to detect faint NEOs that are almost invisible on a single frame. To reduce analysis time, image binarization and an FPGA-implemented algorithm were used. This method has aided in the discovery of 11 NEOs by analyzing frames captured with 20 cm class telescopes. This new method will contribute to discovering new NEOs that approach the Earth closely.
Veterans’ Experiences of an Opioid Specialty Clinic
Authors: Sowicz Timothy Joseph , Hausmann Leslie R M
Published: March 2021

Objective

Opioid specialty clinics have emerged as an approach for mitigating the risks associated with opioid therapies. Many opioid specialty clinics within the Department of Veterans Affairs (VA) have been described in the extant literature, yet veterans’ experiences of these remain absent. This research study was undertaken to describe veterans’ responses (e.g., knowledge, attitudes, and beliefs) toward being evaluated in an opioid specialty clinic.

Design

Qualitative descriptive research study.

Setting

A VA medical center in the northeast United States.

Subjects

Twenty veterans were interviewed between December 2017 and May 2018.

Methods

Veterans’ characteristics were extracted from the VA’s electronic health record and analyzed with descriptive statistics. Qualitative data about veterans’ experiences with the opioid specialty clinic were collected via semistructured interviews (in person or via telephone) and were analyzed with qualitative content analysis.

Results

Most participants were older, non-Hispanic or non-Latino white men. Generally, veterans had positive experiences in the opioid specialty clinic. However, there was wide variation in their understanding of the purpose of the clinic, who staffed the clinic, and why they had been referred to the clinic.

Conclusions

For veterans prescribed opioid therapies, this clinic served as an adjunct service for ensuring appropriate and safe prescribing. Data from this study can be used to inform interventions to promote veterans’ understanding across the total opioid safety clinic experience—referral, actual visit, and follow-up.
Assessment of Professional Quality of Life in the Alabama Physical Therapy Workforce
Authors: Bowens Andrea N , Amamoo M Ahinee , Blake Dana Daniel , Clark Bethany
Published: March 2021

Objective

The purposes of this study were to 1) determine the level of professional quality of life among physical therapists and physical therapist assistants in Alabama and 2) to identify personal or professional factors that may contribute to compassion satisfaction (CS), burnout, and secondary traumatic stress (STS).

Methods

This study used a cross-sectional design and mixed-methods survey methodology to calculate odds ratios for factors affecting professional quality of life. Respondents completed a survey that included the Professional Quality of Life (ProQOL) scale, an open-ended question regarding their experience with professional burnout, and personal and professional demographics.

Results

Of the 742 physical therapists and physical therapist assistants in Alabama who completed the survey, the majority experienced moderate-high levels of CS and moderate-low levels of burnout and STS. Regression analyses indicated clinicians working 40 or more hours per week in patient care had greater odds for low-moderate CS and moderate-high burnout and STS subscale scores. Clinicians in our sample licensed between 6 to 15 or more than 30 years and those working in private outpatient settings had reduced odds of having moderate-high burnout, whereas those working 16 or more years had significantly increased odds for high CS scores. Responses to the open-ended question indicated workload demands and documentation as the top factors contributing to clinician burnout, while the connections with patients and coworkers help minimize such feelings.

Conclusion

Individuals later in their career may develop protective factors to mitigate feelings of burnout compared to those early in their career. Also, clinicians working 40 or more hours per week may be more vulnerable to experiencing low-moderate CS and moderate-high burnout. Thus, individual clinicians and employers must evaluate personal, occupational, and systemic factors that contribute to reduced professional quality of life to inform preventive strategies for mitigating burnout.
The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2339 patients
Authors: Atzeni Fabiola , Alciati Alessandra , Salaffi Fausto , Di Carlo Marco , Bazzichi Laura , Govoni Marcello , Biasi Giovanni , Di Franco Manuela , Mozzani Flavio , Gremese Elisa , Dagna Lorenzo , Batticciotto Alberto , Fischetti Fabio , Giacomelli Roberto , Guiducci Serena , Guggino Giuliana , Bentivegna Mario , Gerli Roberto , Salvarani Carlo , Bajocchi Gianluigi , Ghini Marco , Iannone Florenzo , Giorgi Valeria , Farah Sonia , Bonazza Sara , Barbagli Stefano , Gioia Chiara , Marino Noemi Giuliana , Capacci Annunziata , Cavalli Giulio , Cappelli Antonella , Carubbi Francesco , Nacci Francesca , Riccucci Ilenia , Cutolo Maurizio , Sinigaglia Luigi , Sarzi-Puttini Piercarlo
Published: March 2021

Objective

Various studies have shown that overweight and obesity are central features of FM, but the real impact of a high BMI on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a Web-based registry of patients with FM.

Methods

Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, in addition to the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status questionnaire (ModFAS) and the Polysymptomatic Distress Scale (PDS).

Results

A total of 2339 patients were recruited and divided into two weight categories, underweight/normal (U/N, n = 1127, 48.2%) and overweight/obese (O/O, n = 1212, 51.8%). The total and subscales of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all the mean scores of the individual FIQR items (P < 0.001 for all).

Conclusion

Our findings demonstrate that O/O patients with FM are significantly more impaired than U/N patients in all the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS, thus suggesting that being O/O has an additional effect on symptoms and function.
RADIATION EXPOSURE TO THE BACK WITH DIFFERENT TYPES OF APRONS
Authors: Hong Seung Wan , Kim Tae Won , Kim Jae Hun
Published: March 2021

Physicians and nurses stand with their back towards the C-arm fluoroscope when using the computer, taking things out of closets and preparing drugs for injection or instruments for intervention. This study was conducted to investigate the relationship between the type of lead apron and radiation exposure to the backs of physicians and nurses while using C-arm fluoroscopy. We compared radiation exposure to the back in the three groups: no lead apron (group C), front coverage type (group F) and wrap-around type (group W). The other wrap-around type apron was put on the bed instead of on a patient. We ran C-arm fluoroscopy 40 times for each measurement. We collected the air kerma (AK), exposure time (ET) and effective dose (ED) of the bedside table, upper part and lower part of apron. We measured these variables 30 times for each location. In group F, ED of the upper part was the highest (p < 0.001). ED of the lower part in group C and F was higher than that in group W (p = 0.012). The radiation exposure with a front coverage type apron is higher than that of the wrap-around type and even no apron at the neck or thyroid. For reducing radiation exposure to the back of physician or nurse, the wrap-around type apron is recommended. This type of apron can reduce radiation to the back when the physician turns away from the patient or C-arm fluoroscopy.
Late sequelae of osteoarticular infections in pediatric patients
Authors: Saad Lydia , Hupin Mathilde , Buteau Chantal , Nault Marie-Lyne
Published: March 2021

To review the orthopedic sequelae of pediatric patients diagnosed with osteoarticular infections (OAIs) and identify significant differences between those with and without sequelae.

Medical charts between 2010 and 2016 from a tertiary-care pediatric hospital were reviewed to collect demographic and clinical data for this retrospective case series. The main inclusion criteria were:

The following late sequelae were observed and aggregated: osteal deformations that led to limb-length discrepancies (LLD) superior to 5 mm, abnormal articular angulations of more than 5°, and symptomatic chondropathies visible on imaging studies after 1 year. The patients were divided into 2 subgroups: with and without sequelae. Chi-Squared tests were used for categorical variables and Mann–Whitney U tests for continuous data to identify statistically significant differences between the 2 subgroups.

Among 401 patients with osteomyelitis and/or septic arthritis, 50 (12.5%) were included (24 girls and 26 boys). There were 36 (72%) cases of osteomyelitis, 8 (16%) cases of septic arthritis, and 6 (12%) cases of combined infection (3 acute/subacute and 3 chronic cases). Five (10%) patients had orthopedic sequelae at the latest follow-up. The total duration of antibiotic treatment (P = .002), infectious disease follow-up (P = .002), and the presence of sequestra (P = .005) were significantly different between subgroups. There were no statistically significant differences between the 2 subgroups for the other variables, but some trends could be discerned. Only 4/50 patients developed a sequestrum, 2 of which were in the orthopedic sequelae subgroup. Furthermore, initial C-reactive protein (CRP) values were higher in the sequelae subgroup, as were the CRP values at hospital discharge. The orthopedic follow-up was also longer in the sequelae subgroup. Finally, the delay between the onset of symptoms and the beginning of antibiotic treatment was longer in the sequelae group.

Patients with orthopedic sequelae had a longer antibiotic treatment and infectious disease follow-up, and were more likely to have presented with a sequestrum.

Level of evidence: IV – case series.
Rapid degradation of psychomotor memory causes poor quality chest compressions in frequent cardiopulmonary resuscitation providers and feedback devices can only help to a limited degree
Authors: Lim Wan Yen , Ong John , Ong Sharon , Teo L.M. , Fook-Chong S. , Ho V.K.
Published: March 2021

Studies report a decline in the psychomotor memory of cardiopulmonary resuscitation (CPR) providers within months of training, but they are prone to subject bias. We hypothesized that this degradation is faster and more prevalent in real world practice. The aims of our study were to

Forty anaesthetists and intensivists participated in a voluntary, half-day, randomized crossover study using case-based simulation. Participants were paired and randomly assigned into 2 groups; each receiving automated feedback either in the first or second cycle of CPR. Two cycles of CC and defibrillation (ACLS protocol) were administered on a manikin. CC parameters including overall quality were measured by a feedback device.

The median proportion of good quality CC was poor at baseline but improved with feedback; 38.2% (IQR 27.7, 58.7) to 57.7% (IQR 38.0, 68.7), P < .05. The median proportion of good quality CC fell after feedback withdrawal; 50.5% (IQR 24.5, 67.7) to 25.6% (9, 37.6), P < .05. No carryover effect was observed. Treatment effect and period effect were detected.

Baseline quality of CC amongst frequent CPR providers is poor, and can be improved partly by feedback devices. As psychomotor memory of good quality CCs degrades rapidly after removal of feedback, a multimodal approach is required for CPR skill retention. Future research on the optimal frequency of CPR training, including the use of feedback devices in clinical practice should be explored.
The clinical course and prognostic factors of severe COVID-19 in Wuhan, China
Authors: Liu Jiacheng , Tu Chao , Zhu Muxin , Wang Jianwen , Yang Chongtu , Liu Wei , Xiong Bin
Published: March 2021

With the surge of newly diagnosed and severe cases of coronavirus disease 2019 (COVID-19), the death toll is mounting, this study is aimed to explore the prognostic factors of severe COVID-19. This retrospective study included 122 inpatients diagnosed with COVID-19 from January 13 to February 25, 2020. Univariate and multivariate analysis were used to identity the risk factors, receiver operating characteristics curve (ROC) analysis was used for risk stratification. The baseline neutrophil-to-lymphocyte ratio (NLR) (OR = 1.171, 95%CI = 1.049–1.306, P = .005) and Lactate dehydrogenase (LDH) (OR = 1.007, 95%CI = 1.002–1.011, P = .004) were identified as the independent risk factors for severe COVID-19 conditions, and the NLR-LDH grading system was developed to perform risk stratification. The baseline C-reactive protein (CRP) (OR = 1.019, 95%CI = 1.004–1.306, P = .016) and B-type natriuretic peptide (BNP) (OR = 1.018, 95%CI = 1.004–1.035, P = .007) were identified as the independent predictors for disease progression of severe patients. Accordingly, The NLR-LDH grading system was a useful prognostic tool for the early detection of severe COVID-19. And in the severe patients, CRP and BNP seemed to be helpful for predicting the disease progression or death.
Prognostic significance of the expression of metastasis-associated in colon cancer-1 in gynecologic cancers and breast cancer
Authors: Wang Lijun , Fan Liying , Xu Hongyan , Jiang Haiyuan
Published: March 2021

Background:

The prognostic role of the expression of metastasis-associated in colon cancer-1 (MACC1) in gynecologic cancers and breast cancer remains unclear. The aim of this systematic review and meta-analysis was to determine the prognostic significance of MACC1 expression in gynecologic cancers and breast cancer.

Materials and methods:

PubMed, Web of Science and Embase were comprehensively searched up to February 9, 2020. Studies focusing on the relationship between the expression of MACC1 and prognosis in gynecologic cancers and breast cancer were included into the analysis. Pooled hazard ratio (HR) or odd ratio with 95% confidence interval (CI) was used to estimate the prognostic value of the expression of MACC1.

Results:

A total of 1,811patients with gynecologic cancers or breast cancer were included into the analysis. Patients with high expression of MACC1 tended to suffer a shorter overall survival (HR = 2.76, 95%CI = 2.12–3.59, P < .01) and recurrence-free survival (HR = 2.37, 95%CI = 1.44–3.90, P < .01) compared to those with low expression of MACC1. High expression of MACC1 was significantly associated with worse tumor differentiation (P = .04), more advanced FIGO stage (P < .01) and earlier lymph node metastasis (P < .01) compared to low expression of MACC1.

Conclusion:

Compared to low expression of MACC1, high expression of MACC1 predicts a worse prognosis of gynecologic cancers and breast cancer. The expression of MACC1 can serve as a prognostic indicator of gynecologic cancers and breast cancer.
Long-term response with low-dose of apatinib combined with S-1 in pretreated patient with advanced squamous cell lung cancer
Authors: Chen Jianxin , Wang Junhui , Zou Yan
Published: March 2021

Rationale:

Squamous cell lung cancer is one of the major pathological types in patients with non-small cell lung cancer. Since treatment with angiogenic agents and target drugs in patients with advanced squamous cell lung cancer is not promising, there are limited strategies to improve the outcome in such patients. Herein, we report a pretreated patient with advanced squamous cell lung cancer, who received low-dose of apatinib combined with S-1 as salvage treatment, with good long-term response.

Patient concerns:

The patient complained of dry cough for one month without any relief by medication. Otherwise, she denied any other medical or family history.

Diagnosis:

According to the chest computed tomography, and pathologic findings from biopsy for lesion in lung, the patient was diagnosed with lung squamous cell lung cancer with enlargement of bilateral supraclavicular lymph nodes suggesting metastasis, staged as IIIb.

Interventions:

The patient received gemcitabine plus cisplatin as first line treatment, and gemcitabine as maintenance therapy. After progression, she received vinorelbine as second line treatment. After progression again, she received low-dose apatinib combined with S-1 as third line treatment.

Outcomes:

With the follow-up period from October 21, 2014, to April 6, 2019, there were 15 months, 9 months, and 24 months of progression-free survival time for first line (including maintenance therapy), second line, and third line treatment, respectively. The only adverse event was neutropenia at grade 2 (CTC AE) occurring during the maintenance treatment.

Lessons:

This case indicated that low-dose apatinib combined with S-1 might be effective and safe in selected pretreated patients with advanced squamous cell lung cancer. It might be worthy to conduct further researches to investigate the efficacy and safety of the combination therapy in such patients.
Hospital anxiety and depression scale exhibits good consistency but shorter assessment time than Zung self-rating anxiety/depression scale for evaluating anxiety/depression in non-small cell lung cancer
Authors: Guo Congying , Huang Xuan
Published: March 2021

This study aimed to compare Zung self-rating anxiety/depression scale (SAS/SDS) and hospital anxiety and depression scale (HADS) regarding the detection rate, detection consistency, and time of assessment in non-small cell lung cancer (NSCLC) patients.

Totally 290 NSCLC patients who underwent surgical resection were consecutively recruited and clinical data of patients were collected. Patients’ anxiety and depression were assessed using HADS and SAS/SDS when they were discharged from hospital and consumption of the time for completing HADS and SAS/SDS was recorded.

The anxiety detection rates by SAS (57.9%) and HADS-A (51.0%) were of no difference (P = .095). Also, there was no difference in anxiety severity detected by the 2 scales (P = .467). Additional correlation analysis revealed that both anxiety scores (r = 0.702, P < .001) and detected anxiety (Kappa = 0.626, P < .001) were consistent by SAS and HADS-A. Regarding depression, depression detection rate by SDS (47.6%) was higher than that of HADS-D (39.3%) (P = .044); the depression severity by SDS was more advanced than that by HADS-D (P = .002). The subsequent correlation analysis showed that both depression scores (r = 0.639, P < .001) and detected depression (Kappa = 0.624, P < .001) were consistent by SDS and HADS-D. In addition, the time for HADS assessment (7.6 ± 1.2 minutes) was shorter than SAS/SDS assessment (16.2 ± 2.1 minutes) (P < .001).

HADS could be a better choice for assessing anxiety and depression in NSCLC patients, benefiting from its shorter assessment time but consistent detection rate compared with SAS/SDS.
Warm acupuncture therapy for Primary sciatica
Authors: Cao Fang , He XingWei , Guo Cui , Wang JingWei , Zeng RuiLin , Lu LunBin , Meng FanLei , Zhao Fenfen , Wang ChangKang
Published: March 2021

Introduction:

This meta-analysis aims to assess the effectiveness and safety of warm acupuncture therapy for treating Primary sciatica.

Methods:

The following 9 databases will be search from their inception to December 6, 2020: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Biomedical Literature Database (CBM), the Chinese Medical Current Content (CMCC), the Wan-Fang Database and the China National Knowledge Infrastructure (CNKI). Randomized controlled trials (RCTs) of warm acupuncture for treating Primary sciatica, Chinese or Japanese without restriction of publication status will be included. Two researchers will independently undertake study selection, extraction of data and assessment of study quality. Meta-analysis will be conducted after screening of studies. Data will be analyzed using risk ratio for dichotomous data, and standardized mean difference or weighted mean difference for continuous data.

Dissemination:

This meta-analysis will be disseminated electronically through a peer-reviewed publication or conference presentations.

Conclusion:

This study will provide evidence to judge whether warm acupuncture

Trial registration number:

INPLASY2020120109.
Epidermal growth factor receptor-mutant pulmonary adenocarcinoma coexisting with tuberculosis
Authors: Liu Ning , Zheng Lingnan , Yu Min , Zhang Shuang
Published: March 2021

Rationale:

Lung cancer and pulmonary infections can have similar clinical and radiographic manifestations. Treatment for the coexistence of epidermal growth factor receptor (EGFR)-mutant pulmonary adenocarcinoma and tuberculosis remains unclear.

Patient concerns:

We reported a case of EGFR-mutant lung adenocarcinoma (mimicking pulmonary infections) that coexisted with pulmonary tuberculosis during the course of the disease.

Diagnoses:

The patient was initially diagnosed with pneumonia-like pulmonary adenocarcinoma with EGFR exon 19 deletions based on computed tomography scan, fiberoptic bronchoscopy, pathology, and genetic analysis, and then coexistence with active tuberculosis (TB) was confirmed via laboratory examinations and TB-DNA polymerase chain reaction.

Interventions:

Antibiotics and gefitinib were administered initially. A combination of gefitinib and anti-TB treatment was then administered when active TB was confirmed, and osimertinib was then prescribed because the disease was progressive and EGFR T790 M mutation was detected.

Outcomes:

The patient has survived with a stable disease status to date.

Lessons:

Exploring and ruling out differential diagnoses between pulmonary malignancies and infectious diseases is vital for treatment decisions and outcomes. The combined gefitinib-anti-TB regimen was safe, though it needed modification.
The prognostic value of the peripheral blood cell counts changes during induction chemotherapy in Chinese patients with adult acute myeloid leukemia
Authors: Huang Yuan-Mao , Wang Yan-Ni , Zheng Yi , Pan Li-Li , Li Yang , Li Jing-Gang , Wang Shao-Yuan
Published: March 2021

To investigate the prognostic value of the circulating peripheral blood cell counts changes in acute myeloid leukemia (AML) at different time points during induction chemotherapy.

We retrospectively analyzed the clinical and laboratory data of 237 newly diagnosed AML patients admitted to Fujian Medical University Union Hospital from January 2011 to December 2014.

1. When primitive cells were first removed from the circulating peripheral blood, it was called peripheral blood blast clearance (PBBC). These patients were divided into two groups, according to PBBC. Statistical analysis showed that the day 5 of induction chemotherapy was a better cut-off for PBBC. PBBC≤5 days is defined as early-blast-clearance, while PBBC >6 days is delayed-blast-clearance. There was significant difference between the two groups on complete remission (CR) rate (P = .002), recurrence-free survival (RFS) (P = .026) and overall survival (OS) (P = .001). 2. Multivariate analysis suggested PBBC is an independent prognostic factor for CR, RFS, and OS in AML. Receiver operating characteristic(ROC) curve analysis showed the CR rate of patients with white blood cell count less than 1.25 × 109/L was significantly higher than that of patients with white blood cell count more than 1.25 × 10 9/L (P < .001) at day 5 of induction chemotherapy, but the RFS and OS was no significantly different (P > .05).

The dynamics of peripheral blood blast in AML after initiation of induction chemotherapy, especially the time length to achieve PBBC, has important prognostic value for CR rate, RFS, and OS in AML patients. It is a simple and feasible method to evaluate the efficacy of AML.
Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients
Authors: Liu Shengsheng , Wu Meiying , A Ertai , Wu Shucai , Geng Shujun , Li Zhihui , Li Mingwu , Li Liang , Pang Yu , Kang Wanli , Tang Shenjie
Published: March 2021

The T-SPOT.TB assay detects cellular immune responses to 2 core Mycobacterium tuberculosis antigens, early secreted antigenic target of 6-kDa protein (ESAT-6) and culture filtrate protein-10 (CFP-10). T-SPOT.TB has been recently used for auxiliary diagnosis of active pulmonary tuberculosis (PTB). However, testing can produce inconsistent results due to differential PTB patient immune responses to these antigens, prompting us to identify factors underlying inconsistent results.

Data were retrospectively analyzed from 1225 confirmed PTB patients who underwent T-SPOT.TB testing at 5 specialized tuberculosis hospitals in China between December 2012 and November 2015. Numbers of spot-forming cells (SFCs) reflecting T cell responses to ESAT-6 and CFP-10 antigens were recorded then analyzed via multivariable logistic regression to reveal factors underlying discordant T cell responses to these antigens.

The agreement rate of 84.98% (82.85%–86.94%) between PTB patient ESAT-6 and CFP-10 responses demonstrated high concordance. Additionally, positivity rates were higher for ESAT-6 than for CFP-10 (84.8% vs 80.7%, P < .001), with ESAT-6 and CFP-10 microwell SFC numbers for each single positive group not differing significantly (P > .99), while spot numbers of the single positive group were lower than numbers for the double positive group (P < .001). Elderly patients (aged ≥66 years) and patients receiving retreatment were most likely to have discordance results.

ESAT-6 promoted significantly more positive T-SPOT.TB results than did CFP-10 in PTB patients. Advanced age and retreatment status were correlated with discordant ESAT-6 and CFP-10 results. Assessment of factors underlying discordance may lead to improved PTB diagnosis using T-SPOT.TB.
The effect of pretreatment BMI on the prognosis and serum immune cells in advanced LSCC patients who received ICI therapy
Authors: Wang Fei , Zhou Lei , Chen Na , Li Xiaoming
Published: March 2021

This study aims to evaluate the prognosis and serum immune cells of patients with different pretreatment body mass index (BMI) values. The data of 61 newly diagnosed patients with advanced lung squamous cell carcinoma (LSCC) who received immune checkpoint inhibitors (ICIs) combined with chemotherapy were obtained from the database of Rizhao People's Hospital (Rizhao, Shandong). According to the cutoff value of BMI (23.2 kg/m2), 32 patients had a high BMI and the remaining 29 patients had a low BMI. The effects of different BMIs on the prognosis and serum immune cells of patients were analyzed. The median progression-free survival (PFS) times were 7.72 months in the high BMI group and 4.83 months in the low BMI group [adjusted hazard ratio (HR), 0.23; 95% confidence interval (CI), 0.11–0.48; P < .001]. In terms of the overall survival (OS), the median times of the high BMI group and low BMI group were 18.10 and 13.90 months, respectively (adjusted HR, 0.15; 95% CI, 0.07–0.32; P < .001). After 4 cycles of ICI therapy combined with chemotherapy, the objective response rate was 59.4% for the high BMI group and 20.7% for the low BMI group (P = .002). In addition, the number of serum immune cells in patients with high BMI was significantly higher than that in patients with low BMI (all P < .001). There was a linear relationship between BMI value and the number of serum immune cells (all R
2 > 0.7). The current results showed that high BMI is associated with better prognosis in LSCC patients who received ICIs, which may be related to higher levels of serum immune cells.
The relationship between healthy lifestyles and bone health
Authors: Sheng Bin , Li Xin , Nussler Andreas K. , Zhu Sheng
Published: March 2021

Background

Bone health, especially osteoporosis among ageing populations, has become an important topic for both clinical and basic researchers. The relationship between bone health and healthy lifestyles has been frequently discussed. The present study focuses on the relationship between bone health and healthy lifestyles among older adults, based on a global comparison.

Methods

This narrative review was performed by collecting clinical trials, basic research and reviews on lifestyle and bone health in PubMed database.

Results

Positive effects of physical activity and negative effects of malnutrition, alcohol abuse, and cigarette smoking on bone health were revealed. The relationship between bone health and drinking coffee and tea is still inconclusive. Moreover, the diversity of each region should be aware when considering healthy lifestyles to improve bone health.

Conclusion

Healthy lifestyles are highly related to bone health, and different lifestyles may have different influences on regions with a high risk of bone diseases. It is practical to acknowledge the diversity of economic, religious, environmental and geological conditions in each region when providing suitable and effective recommendations for healthy lifestyles that can improve overall bone health.
Posterior interosseous nerve syndrome caused by a ganglion cyst and its surgical release with intraoperative neurophysiological monitoring
Authors: Park Dougho , Kim Dong Young , Eom Yoon Sik , Lee Sang-Eok , Chae Seung Bum
Published: March 2021

Rationale:

Intraoperative neurophysiological monitoring (IONM) has been utilized not only for the rapid detection of neural insults during surgeries, but also to verify the neurophysiological integrity of nerve lesions in the surgical field.

Patient concerns:

A 32-year-old woman presented with a wrist and finger drop that had lasted about 3 months.

Diagnoses:

The result of the initial electrodiagnostic test was consistent with posterior interosseous nerve (PIN) syndrome. Ultrasonography and magnetic resonance imaging of the proximal forearm showed a cystic mass at the anterolateral aspect of the radial head, which was diagnosed as a ganglion cyst.

Interventions:

Surgical release of the ganglion cyst with IONM was performed. During the surgery, we induced nerve action potentials and compound motor action potentials across the ganglion cyst, which demonstrated neural continuity.

Outcomes:

Three months after the surgery, the patient showed partial recovery of wrist and finger extensor muscle power. An electrodiagnostic test conducted 3 months after the surgery showed reinnervation potentials in PIN-innervated muscles.

Lessons:

IONM during peripheral nerve surgeries can support surgical decisions and confirm the location and degree of nerve damage.
Effect of breastfeeding on metabolic-related outcomes in women with previous gestational diabetes mellitus
Authors: Zhou Bingfeng , Zhou Jun
Published: March 2021

Background:

This meta-analysis was to systematically investigate the effect of breastfeeding on metabolic-related outcomes in women with previous gestational diabetes mellitus (GDM).

Methods:

We will search the online databases of Relevant studies were searched in Pubmed, Embase, Cochrane Library, Web of Science. Relative risk and weighted mean difference with 95% confidence interval will pooled using Stata14.0 software.

Conclusion:

Our meta-analysis will explore the effect of breastfeeding on metabolic-related outcomes in women with previous GDM and may provide effective treatment options of GDM.

OSF registration number:

10.17605/OSF.IO/HA5U8
Role of antithymocyte globulin in matched sibling donor peripheral blood stem cell transplantation for hematologic malignancies
Authors: Dou Liping , Wang Lu , Li Xin , Liu Yvchen , Li Fei , Wang Lijun , Gao Xiaoning , Huang Wenrong , Wang Shuhong , Gao Chunji , Yu Li , Liu Daihong
Published: March 2021

Background:

High incidence of chronic graft-versus-host disease (GVHD) has been a major drawback of matched sibling donor peripheral blood stem cell transplantation (MSD -PBSCT). This study aimed to investigate the safety and efficacy of antithymocyte globulin (ATG) as a standardized part of GVHD prophylaxis in patients receiving MSD -PBSCT.

Methods:

A total of 72 patients with hematological malignancies receiving MSD -PBSCT who displayed similar baseline characteristics were either given rabbit ATG ( n = 42) or no ATG (n = 30), in addition to cyclosporine, methotrexate, and mycophenolate mofetil as a standard GVHD prophylaxis regimen. Either patients or donors aged ≥40 years were included in the study. Thymoglobulin was administered at a daily dose of 1.5 mg/kg on day −5 and 3.5 mg/kg on day −4 prior to transplant (the total dose was 5 mg/kg)

Results:

After a median follow-up of 874 days, the 3-year cumulative incidence of chronic GVHD (cGVHD) was 37.3% in the ATG group and 52.1% in the non -ATG group. The 3-year overall and disease-free survival probability were 71.0% and 62.0% (ATG versus non -ATG, P = .262) and 66.7% and 58.4% (ATG versus non -ATG, P = .334). No difference was found in the 2-year cumulative incidence of nonrelapse mortality and relapse between the ATG and non -ATG groups. This significant reduction in the incidence of cGVHD without increased relapse risk and nonrelapse mortality led to a 3-year GVHD-free, relapse-free survival probability of 66.7% and 40.0% in the ATG and non-ATG groups, respectively.

Conclusions:

These data suggested that rabbit antithymocyte globulin in the current protocol for GVHD prophylaxis was well tolerable and efficacious.

The clinical trial was registered on January 1, 2016 (ClinicalTrials.gov Identifier NCT02677181). https://clinicaltrials.gov/ct2/show/NCT02677181.
The effects of LncRNA PVT1 on clinical characteristics and survival in breast cancer patients
Authors: Xie Li , Feng Gang , Zhu Ping , Xie Jiang
Published: March 2021

Background:

Currently, an increasing number of long noncoding RNAs (LncRNAs) have been reported to be abnormally expressed in human carcinomas and play a vital role in tumourigenesis. Some studies were carried out to investigate the influence of the expression of plasmacytoma variant translocation 1 (PVT1) on prognosis and its clinical significance in patients with breast cancer, while the results were contradictory and uncertain. A meta-analysis was conducted with controversial data to accurately assess the issue.

Methods:

A detailed search of relevant researches was performed in Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science. Two reviewers independently conducted data extraction and literature quality evaluation. Odd ratio and its 95% confidence intervals were applied to evaluate the relationship between PVT1 and clinicopathological characteristics of breast cancer patients. Hazard ratios and its 95% confidence intervals were adopted to assess the prognostic effects of PVT1 on overall survival and disease-free survival. Meta-analysis was conducted with Stata 14.0 software

Results:

This study will provide high-quality evidence-based medical evidence for the correlation between PVT1 expression and overall survival, and disease-free survival and clinicopathological features.

Conclusion:

The study will provide updated evidence to evaluate whether the expression of PVT1 is in association with poor prognosis in patients with breast cancer.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/C2TYE.
The value of melanoma inhibitory activity and LDH with melanoma patients in a Chinese population
Authors: Li Chujun , Liu Jinfang , Jiang Lu , Xu Jun , Ren Anjing , Lin Yu , Yao Gang
Published: March 2021

Malignant melanoma is a highly malignant tumor originating from the melanocytes of the neural crest, which is prone to metastasis and has a poor prognosis. Previous research demonstrated that melanoma inhibitory activity (MIA) and lactate dehydrogenase (LDH) could serve as serum markers in malignant melanoma and indicate prognosis in the Caucasian race. Researchers suspected that both MIA and LDH could prompt the prognosis of malignant melanoma in the Chinese population. This study aimed to investigate the value of MIA and LDH in the prognosis of acral malignant melanoma.

From January 1, 2014, to December 31, 2017, in Jiangsu Province, 44 acral malignant melanoma patients with complete data were chosen from the clinic. The LDH levels were extracted from their clinical data, and MIA levels were measured by enzyme-linked immunosorbent assay method. 8 paired advancing samples before and after metastasis were examined. 22 health donors were matched to the patient group. Receiver operating characteristic (ROC) curves of MIA and LDH were drawn to determine acral malignant melanoma tumorigenesis and metastasis and finally got the cut-off value. Cumulative survival was illustrated with the Kaplan-Meier plot, and factors were compared using the Log-rank test.

Compared with age-matched healthy donors, MIA was significantly high in patients (P < .001). Moreover, serum MIA was significantly higher in III-IV stage patients than I-II stage patients (P < .001). However, there was no such association between LDH and melanoma stage and risk. Further study indicated that the MIA cut-off > 914.7pg/mL predicted disease progression with 86.4% specificity and 95.5% sensitivity. In the Kaplan-Meier analysis, MIA levels were independent risk factors for long-term mortality of acral malignant melanoma patients.

It concluded that the quantification of MIA in the serum should be performed as a general standard of care in patients at risk of developing metastatic melanoma.
Efficacy and safety of Shugan Jieyu capsule in the treatment of essential hypertension with insomnia, anxiety or depression
Authors: Fan Maoxia , Guo Dong , Tian Ying , Liu Yongcheng , Zhao Jisen
Published: March 2021

Background:

Shugan Jieyu capsule can reduce blood pressure and improve its concomitant symptoms. However, it is not widely used in clinic because of its incomplete understanding of its nature. There are many reports on the clinical trials of Shugan Jieyu capsule in the treatment of essential hypertension with insomnia, anxiety or depression in recent years. However, the lack of systematic review and meta-analysis has not provided effective evidence. As a consequence, we provide a protocol to evaluate the efficacy and safety of Shugan Jieyu capsule (SJC) in the treatment of essential hypertension (EH) with insomnia, anxiety or depression.

Methods:

The search time range of Cochrane Library, PubMed, excerpt Database (EMBASE), Chinese Biomedical Literature Database (CBM), China National knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), and Wanfang Database (WanFang), was searched by computer from the establishment of the database to December 31, 2020. In the meanwhile, the list of references and related reviews were checked. The data were extracted by 2 evaluators independently, and the literature quality was evaluated according to Cochrane manual 4.2.2. In addition, CochraneRevman5.3 software was used for heterogeneity test, meta-analysis, publication bias analysis and GRADE3.6 evidence quality classification system evaluation related statistical data.

Results:

This study intends to evaluate the efficacy and safety of SJC in the treatment of EH from many aspects, including changes in blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], effective rate of blood pressure reduction, improvement rate of concomitant symptoms and adverse reactions.

Conclusion:

The conclusion of systematic review intends to provide evidence for judging that SJC is an effective intervention for EH patients with insomnia, anxiety and depression.

PROSPERO registration number:

PROSPERO CRD 42021219704.
Effectiveness and safety of Liuhedan for treating acute pancreatitis
Authors: Cheng Tao , Liu Bo-Fu , Han Tian-Yong , Gu Zhi-Han , Pan Pan , Haifang Yu
Published: March 2021

Background:

Liuhedan is a famous traditional Chinese medicine (TCM) formula used to treat acute pancreatitis (AP) in China. However, there is no systematic reviews for the evidence and the therapeutic effectiveness and safety of Liuhedan for treating AP. The aim of this study is to summarize previous evidence, assessing the efficacy and safety of Liuhedan in the treatment of AP.

Methods:

We will search the EMBASE, WANFANG DATA, Web of Knowledge, CNKI, PubMed, ClinicalTrials.gov and Cochrane Library from inception to June 30, 2021 to retrieve relevant studies using the search strategy: (“Liuhedan” OR “Liuhe Pill” OR “Liu-He-Dan”) AND (“pancreatitis” OR “pancreatitides”). Two authors independently judged study eligibility and extracted data. Heterogeneity will be examined by computing the Q statistic and I
2 statistic.

Results:

This study assessed the efficiency and safety of Liuhedan for treating acute pancreatitis.

Conclusions:

This study will provide reliable evidence-based evidence for the clinical application of Liuhedan for treating AP.

Ethics and dissemination:

Ethical approval is unnecessary as this protocol is only for systematic review and does not involve privacy data. The findings of this study will be disseminated electronically through a peer-review publication or presented at a relevant conference.
Novel oxidative stress-related prognostic biomarkers for melanoma associated with tumor metastasis
Authors: Wu Xianpei , Zhao Jinmin
Published: March 2021

Skin cutaneous melanoma (SKCM) is a prevalent skin cancer whose metastatic form is dangerous due to its high morbidity and mortality. Previous studies have systematically established the vital role of oxidative stress (OS) in melanoma progression. This study aimed to identify prognostic OS genes closely associated with SKCM and illustrate their potential mechanisms. Transcriptome data and corresponding clinical traits of patients with SKCM were retrieved from The Cancer Genome Atlas and Gene Expression Omnibus databases. A weighted gene co-expression network analysis was conducted to identify relationships between clinical features and OS genes in specific modules. Subsequently, Cox regression analysis was performed on candidate OS genes; four hub prognosis-associated OS genes (AKAP9, VPS13C, ACSL4, and HMOX2) were identified to construct a prognostic model. After a series of bioinformatics analysis, our prognostic model was identified significantly associated with the overall survival of patients with SKCM and metastatic ability of the cancer. Furthermore, our risk model demonstrated improved diagnostic accuracy in the Cancer Genome Atlas and Gene Expression Omnibus cohorts. In addition, we established 2 nomograms based on either risk score or hub genes, which displayed favorable discriminating ability for SKCM. Our results provide novel insight into the potential applications of OS-associated genes in SKCM.