bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Recurrent Peroneal Tendon Dislocation by Peroneal Retinaculum Reattachment without Fibular Groove Deepening
Authors: Park Seung-Hwan , Lee Jaehyung , Choi Young Rak , Seo Jaehyeon , Lee Ho-seong
Published: November 2020

Category:

Ankle; Sports; Trauma

Introduction/Purpose:

There are numerous studies recommending fibular groove deepening in the surgical treatment of peroneal tendon dislocation; however, there are some disadvantages to fibular groove deepening procedures. In this study, we evaluated the results of anatomic reattachment of the peroneal retinaculum without fibular groove deepening as a treatment for traumatic peroneal tendon dislocation.

Methods:

Thirty six patients with recurrent peroneal tendon dislocation, who underwent retinaculum repair without a fibular groove deepening procedure performed by two surgeons between March 2004 and March 2017, were enrolled in this study. Resubluxation of tendon, pain on inversion and eversion power of the ankle were monitored. The range of motion of inversion and eversion were measured and then compared to that of the contralateral side. AOFAS, VAS, FFI scores were obtained for all patients preoperatively and at the final follow-up. Postoperative complications such as infection, sural nerve injury, and recurrence were monitored.

Results:

Thirty four patients fully recovered without resubluxation of tendon. Two patients were injured again while playing soccer 6 months after the surgery and fast running 20 months after the surgery respectively. One patient had sural nerve injury. But the symptom was relieved at 6 months after the surgery. None of the patients had weakness of evertor. None of the patients had limited ankle motion. Mean AOFAS, VAS, FFI score improved significantly.

Conclusion:

In conclusion, for the treatment of recurrent dislocation of the peroneal tendon reattachment of the superior retinaculum only without groove deepening followed by proper rehabilitation is sufficient.
Total Ankle Arthroplasty in Valgus Deformity
Authors: Piga Camilo , Usuelli Federico Giuseppe , Maccario Camilla , Silvestri Claudia A. Di
Published: November 2020

Category:

Ankle Arthritis

Introduction/Purpose:

Total ankle replacement use has increased among patients with end-stage ankle arthritis. Substantial coronal plane deformity is usual in that context. In addition, recent literature shows a trend towards the extension of the indication of total ankle arthroplasty in increasingly severe coronal deformities, showing good results when correct alignment is achieved. Nevertheless, the results of lateral transfibular total ankle replacement (LTTAR) in valgus has not been extensively studied. We aimed to evaluate if the outcomes of LTTAR in ankles with valgus deformity are similar with those with no major deformity.

Methods:

This retrospective cohort study included 228 LTTAR. Patients were classified into 2 groups according to the preoperative coronal plane tibiotalar angle (TTS): neutral (less than 10° of coronal deformity, 209 patients) and valgus (above 10° of valgus, 19 patients). Clinical evaluation was performed using American Orthopaedic Foot & Ankle Society Score (AOFAS), Visual analogue scale (VAS), short Form 12 Quality of Life (SF-12) regarding its physical (PCS) and mental (MCS) items. Radiographic evaluation considered anteroposterior and lateral ankle radiographs. Surgical times were recorded in all the cases. There were no differences between groups regarding mean age, mean body mass index and follow up. The minimum follow up was 24 months.

Results:

The average AOFAS, VAS and SF-12 scores improved significantly postoperatively (p-value<0.01), without differences between groups. At final radiographic follow up, the valgus alignment group did not show significant differences with the neutral alignment group regarding TTS, lateral distal tibial angle or anterior distal tibial angle (p-value>0.05). Surgical time was longer in the valgus group (152.84 +- 40.86 mins vs 129.51 +- 52.13), but the difference was not statistically significant.

Conclusion:

Lateral transfibular total ankle replacement in ankles with valgus deformity achieved and maintained correction of coronal alignment in a short term follow up, as obtained in neutral alignment ankles. Clinical outcomes improved significantly regardless preoperative valgus deformity. Additional surgical time may be needed in order to obtain a good deformity correction in a valgus ankle. This short term analysis shows that LTTAR in a valgus ankle seems to be a safe option in experienced surgeons hands.
Do Geographic Region, Pathologic Chronicity, and Hospital Affiliation Affect Access to Care Among Medicaid- and Privately-Insured Foot and Ankle Surgery Patients?
Authors: Pitts Charles C. , McKissack Haley M. , He Jun Kit , Alexander Bradley , Sutherland Charles R. , Cage Benjamin B. , Shah Ashish
Published: November 2020

Category:

Other

Introduction/Purpose:

Studies have shown that patients enrolled in Medicaid have difficulty obtaining access to care compared to patients with private insurance. Whether variables such as geographic location, state expansion vs. non-expansion, and private versus academic affiliation affect access to care among foot and ankle surgery patients enrolled in Medicaid has not been previously established.

Methods:

Twenty providers from each of five Medicaid-expanded and five non-expanded states in different U.S. geographic regions were randomly chosen via the American Orthopaedic Foot & Ankle Society (AOFAS) directory. One investigator contacted each office requesting the earliest available appointment for their fictitious relative’s acute Achilles tendon rupture or hallux valgus. Investigator insurance was stated to be Medicaid for half of phone calls, and Blue-Cross Blue-Shield (BCBS) for the other half. Appointment success rate and average time to appointment were compared between private insurance and Medicaid. Results were further compared across geographic regions, between private and academic practices, and between urgent acute injury (Achilles rupture) and chronic non-urgent injury (hallux valgus).

Results:

Appointments were successful for all 100 (100%) calls made with BCBS, in comparison to 73 of 100 calls (73%) with Medicaid (p<0.001). Both acute and chronic injury had significantly higher success rates with BCBS than Medicaid (p<0.001). Appointment success rate was significantly lower with Medicaid than with BCBS (p<=0.01) in all geographic regions. Success rate with Medicaid (66.7%) was significantly lower than with BCBS (100.0%, p<0.001) for private practice offices, but not for academic practices.

Conclusion:

Patients with Medicaid experience difficulty in obtaining appointments for common non-emergent foot and ankle problems and may experience increased difficulty scheduling appointments at private rather than academic institutions. The medical community should continue to seek and identify potential interventions which can improve access to orthopaedic care for all patients, regardless of insurance status. [Table: see text]
New extractive frontiers in Ireland and the moebius strip of wind/data
Authors: Bresnihan Patrick , Brodie Patrick
Published: November 2020

This article maps the interconnections between two emergent resource frontiers in Ireland: wind and data. Adding to literature about extraction and extractivism, we account for how these expanded extractive frontiers are mobilised within self-sustaining and automated formations. In Ireland, digital infrastructures such as data centres are developed by multinational tech companies to avail of a naturally cool climate and business environment friendly to their investment, part of a wider extractive system by which data are made valuable for their expansive operations. Wind farms similarly make use of Ireland’s climate to generate energy, often used to power digital infrastructures, and are increasingly embedded within ‘smart’ energy and data systems. Wind and data are seen discretely as ‘abundant’ resources, their infrastructures built on terra or (offshore) mare nullius, and their operations ‘green’. However, their infrastructures are entangled with non-renewable energy systems and tax evasive capital, and built across existing communities and environments through policy, planning logics and increasingly automated methods of maintenance and optimisation. Through what we call ‘the moebius strip of wind/data’, wind and data infrastructures are increasingly formidable in dictating our energy futures. In this article, we articulate how they are connected and how we can disentangle them, especially in their operation across urban and rural geographies.
Resveratrol inhibits Ca2+ signals and aggregation of platelets
Authors: Marumo Mikio , Ekawa Kazumi , Wakabayashi Ichiro
Published: November 2020

Background

Resveratrol has been shown to inhibit platelet aggregation. However, the mechanism for this action of resveratrol remains to be clarified. The purpose of this study was to elucidate the Ca2+-related mechanism for the inhibitory action of resveratrol on platelet aggregation.

Methods

Ca2+entry and subsequent aggregation of human platelets induced by different stimulants including thrombin, thapsigargin, and 1-oleoyl-2-acetylglycerol (OAG) were measured by the fluorescence method and light transmittance method, respectively. Each stimulant was added to a nominally Ca2+-free medium containing platelets, and then CaCl2was added to the medium to induce Ca2+influx into platelets.

Results

Thapsigargin-induced Ca2+entry into platelets and subsequent platelet aggregation were significantly inhibited in the presence of resveratrol at 6.25 μM or higher concentrations, while OAG-induced Ca2+entry and subsequent platelet aggregation were not affected by resveratrol at concentrations up to 50 μM. In the nominally Ca2+-free medium, thrombin induced a small transient increase in intracellular Ca2+concentrations, which was attenuated in the presence of resveratrol at 12.5 μM or higher concentrations. Thrombin-induced Ca2+entry into platelets and subsequent platelet aggregation were significantly inhibited in the presence of resveratrol at 12.5 μM or higher concentrations.

Conclusions

The results suggest that resveratrol inhibits thrombin-induced platelet aggregation through decreasing Ca2+release from its stores and inhibiting store-operated Ca2+influx into platelets.
Prediction and prioritization of autism-associated long non-coding RNAs using gene expression and sequence features
Authors: Wang Jun , Wang Liangjiang
Published: November 2020

Background

Autism spectrum disorders (ASD) refer to a range of neurodevelopmental conditions, which are genetically complex and heterogeneous with most of the genetic risk factors also found in the unaffected general population. Although all the currently known ASD risk genes code for proteins, long non-coding RNAs (lncRNAs) as essential regulators of gene expression have been implicated in ASD. Some lncRNAs show altered expression levels in autistic brains, but their roles in ASD pathogenesis are still unclear.

Results

In this study, we have developed a new machine learning approach to predict candidate lncRNAs associated with ASD. Particularly, the knowledge learnt from protein-coding ASD risk genes was transferred to the prediction and prioritization of ASD-associated lncRNAs. Both developmental brain gene expression data and transcript sequence were found to contain relevant information for ASD risk gene prediction. During the pre-training phase of model construction, an autoencoder network was implemented for a representation learning of the gene expression data, and a random-forest-based feature selection was applied to the transcript-sequence-derivedk-mers. Our models, including logistic regression, support vector machine and random forest, showed robust performance based on tenfold cross-validations as well as candidate prioritization with hypothetical loci. We then utilized the models to predict and prioritize a list of candidate lncRNAs, including some reported to becis-regulators of known ASD risk genes, for further investigation.

Conclusions

Our results suggest that ASD risk genes can be accurately predicted using developmental brain gene expression data and transcript sequence features, and the models may provide useful information for functional characterization of the candidate lncRNAs associated with ASD.
Delayed diagnosis of Angioimmunoblast T-cell lymphoma presenting with type II Cryoglobulinemia and acute kidney injury: a case report and narrative review of the literature
Authors: Li Xiang-Yang , He Hai-Yan , Yue Shu-Ling , Pai Pearl
Published: November 2020

Background

Angioimmunoblastic T cell lymphoma (AITL) is an infrequent hematological malignancy with variable and often atypical presentations. The presence of dysproteinemia, autoantibodies and systemic involvement in AITL has often led to a delay in diagnosis or even misdiagnosis in practice. We herewith present a case of AITL that primarily presented with acute kidney injury associated with type II Cryoglobulinemia, the underlying cause was only identified 8 months after the emergence of initial symptoms.

Case presentation

A 67-year old woman presented with 2-month history of intermittent joint pain and a 3-day history of bilateral lower limb edema and acute kidney injury. Initial laboratory investigations showed marked hypocomplementemia with positive autoantibodies of ANA, anti-cardiolipin-IgM and direct antiglobulin. The serum and urinary Immunofixation and serum cryoglobulin tests were negative, while the serum free κ to λ light chain ratio was 0.231. A renal biopsy showed a diffuse proliferative glomerulonephritis with intracapillary pseudothrombi formation. There were orderly arranged microtubular structures of 20–35 nm in diameter in the subendothelial and mesangial area on electron microscopy. Shortly afterwards, the patient developed tingling affecting her finger tips and weak hands and legs. A diagnosis of cryoglobulinemia complicated with cryoglobulinemic glomerulonephritis and polyneuropathy was made. She responded well to methylprednisolone, plasma exchange and rituximab. However, 3 months later, she presented with generalized pruritic rash, weight loss, and inguinal lymphadenopathy. A subsequent inguinal excisional lymph node biopsy at month 8 revealed AITL as the underlying disease.

Conclusions

AITL and its associated B cell dysregulation can give rise to autoimmunity and cryoglobulinemia which may conceal itself as the underlying disorder. In various clinical scenarios of auto-immune diseases, it is advisable that the clinicians should take into consideration the multi-faceted lymphoma.
Oral neuromuscular training in patients with dysphagia after stroke: a prospective, randomized, open-label study with blinded evaluators
Authors: Hägglund Patricia , Hägg Mary , Levring Jäghagen Eva , Larsson Bengt , Wester Per
Published: November 2020

Background

Oral and pharyngeal swallowing dysfunction are common complications in acute stroke patients. This primary aim of this study was to determine whether oral neuromuscular training improves swallowing function in participants with swallowing dysfunction after stroke. A secondary aim was to assess how well results of the timed water-swallow test (TWST) correspond with swallowing dysfunction diagnosed by videofluoroscopy (VFS).

Methods

This was an intention-to-treat two-centre prospective randomized open-label study with blinded-evaluators (PROBE) design. At 4 weeks after stroke onset, participants with swallowing dysfunction were randomized to 5 weeks of continued orofacial sensory-vibration stimulation with an electric toothbrush or additional oral neuromuscular training with an oral device (Muppy®). Participants were examined with TWST, a lip-force test, and VFS before (baseline), after 5 weeks’ treatment (the end-of-treatment), and 12 months after treatment (follow-up). The baseline VFS results were compared with the TWST results. The primary endpoint was changes in swallowing rate assessed using TWST, from baseline to the end of training and from baseline to follow-up based on intention-to-treat analyses. The secondary endpoint was the corresponding changes in lip-force between baseline, the end of treatment, and follow-up.

Results

The participants were randomly assigned as controls (n = 20) or for intervention with oral neuromuscular training (n = 20). After treatment, both groups had improved significantly (intervention, P < 0.001; controls, P = 0.001) in TWST but there was no significant between-group difference in swallowing rate. At the 12-month follow-up, the intervention group had improved further whereas the controls had deteriorated, and there were significant between-group differences in swallowing rate (P = 0.032) and lip force (P = 0.001). A TWST < 10 mL/sec at baseline corresponded to VFS-verified swallowing dysfunction in all assessed participants.

Conclusion

The 5-week oral neuromuscular training improved swallowing function in participants with post-stroke dysphagia compared with the controls 12 months after intervention, but there was no between-group difference in improvement immediately after treatment. TWST results corresponded with VFS results, making TWST a feasible method for identifying persons with swallowing dysfunction after stroke. Larger randomized controlled trials are required to confirm our preliminary positive long-term results.

Trial registration

Retrospectively registered at ClinicalTrials.gov: NCT04164420. Registered on 15 November 2019.
Targeted nanopore sequencing for the identification of ABCB1 promoter translocations in cancer
Authors: Williams Mark S. , Basma Naseer J. , Amaral Fabio M. R. , Williams Gillian , Weightman John P. , Breitwieser Wolfgang , Nelson Louisa , Taylor Stephen S. , Wiseman Daniel H. , Somervaille Tim C. P.
Published: November 2020

Background

Resistance to chemotherapy is the most common cause of treatment failure in acute myeloid leukemia (AML) and the drug efflux pump ABCB1 is a critical mediator. Recent studies have identified promoter translocations as common drivers of high ABCB1 expression in recurrent, chemotherapy-treated high-grade serous ovarian cancer (HGSC) and breast cancer. These fusions place ABCB1 under the control of a strong promoter while leaving its open reading frame intact. The mechanisms controlling high ABCB1 expression in AML are largely unknown. We therefore established an experimental system and analysis pipeline to determine whether promoter translocations account for high ABCB1 expression in cases of relapsed human AML.

Methods

The human AML cell line THP-1 was used to create a model of chemotherapy resistance in which ABCB1 expression was driven by a promoter fusion. The THP-1 model was used to establish a targeted nanopore long-read sequencing approach that was then applied to cases of ABCB1high HGSC and AML. H3K27Ac ChIP sequencing was used to assess the activity of native promoters in cases of ABCB1high AML.

Results

Prolonged in vitro daunorubicin exposure induced activating ABCB1 promoter translocations in human THP-1 AML cells, similar to those recently described in recurrent high-grade serous ovarian and breast cancers. Targeted nanopore sequencing proved an efficient method for identifying ABCB1 structural variants in THP-1 AML cells and HGSC; the promoter translocations identified in HGSC were both previously described and novel. In contrast, activating ABCB1 promoter translocations were not identified in ABCB1high AML; instead H3K27Ac ChIP sequencing demonstrated active native promoters in all cases studied.

Conclusions

Despite frequent high level expression of ABCB1 in relapsed primary AML we found no evidence of ABCB1 translocations and instead confirmed high-level activity of native ABCB1 promoters, consistent with endogenous regulation.
Factors associated with breast cancer awareness and breast self-examination in Fiji and Kashmir India – a cross-sectional study
Authors: Malik Rukaiya , Vera Numa , Dayal Chandra , Choudhari Abhay , Mudaliar Jyotishna , Noovao Hill Amanda , Kubuabola Ilisapeci , Gunnarsson Ronny
Published: November 2020

Background

In low-income countries breast cancer awareness (BCA) is essential to reduce the proportion of advanced stage presentations of breast cancer. There is a lack of studies using multivariable techniques to explore factors related to BCA in low-income countries. The objective of this study was to identify to what extent women in Fiji and Kashmir, India have BCA and practice breast self-examination (BSE) as well as factors associated with BCA and BSE.

Methods

A survey of women aged ≥18 years was conducted in Fiji and Kashmir, India to assess BCA and rates of BSE. Comparison between Fiji and Kashmir was done using student’s t-test for continuous data and chi-square for binary data. Factors associated with BCA and BSE were analysed using a multivariable logistic regression for Fiji and Kashmir separately.

Results

Data were collected from 399 and 1982 women in Kashmir and Fiji, respectively. Of 1968 women in Fiji 57% were deemed to have an acceptable BCA compared to only 7.3% of 395 women in Kashmir. Having some education was associated with having BCA with an odds ratio of 4.7 (1.7–13) in Fiji and 10 (1.7–59) in Kashmir. Of 1976 women in Fiji 40% had tertiary education while 40% of 392 women in Kashmir had no education at all. The marital status was similar in both samples (n = 1973 and 395) with 68–69% being married and 21–26% being single. The lack of female doctors or nurses with whom to discuss issues, was perceived as a problem in both countries.

Conclusions

The key finding is an association between having any level of education and BCA. This correlation was much stronger than for a family history of breast cancer and BCA. Hence, general education to illiterate women may reduce the proportion of women in low-income countries presenting with advanced-stage breast cancer.
Clinicopathological features, risk and survival in lung cancer survivors with therapy-related acute myeloid leukaemia
Authors: Wang Huabin , Yin Yin , Wang Ru , Huang Junbin , Xue Hongman , Cheng Yucai , Zhang Lidan , Chen Chun
Published: November 2020

Background

A secondary malignancy is the most serious complication in lung cancer (LC) survivors. This study aimed to evaluate the clinicopathological features, predictable risk factors and survival of patients with LC who developed therapy-related acute myeloid leukaemia (t-AML).

Methods

Patients from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with t-AML after LC between 1975 and 2015 were included. Standardized incidence ratios (SIRs) were used to perform multiple primary analyses. The risk of t-AML development among LC patients was assessed using a logistic regression model. Kaplan–Meier analysis was used to construct overall survival (OS) curves. Cox regression was used to assess the influence of various prognostic factors.

Results

A total of 104 patients with t-AML after LC-targeting chemotherapy were included. The median latency period to the development of t-AML was 35.5 months. The calculated SIR of t-AML was 4.00. Chemoradiotherapy, small cell lung cancer (SCLC), or localized/regional-stage LC was a risk factor for the development of t-AML. The median OS was only 1 month, and those younger than 65 years were predicted to have a better OS time.

Conclusions

t-AML is a rare but serious late complication in LC patients and is associated with a poor prognosis. It is necessary to carry out long-term follow-up and screen for t-AML in LC patients, especially among those undergoing both radiotherapy and chemotherapy, with SCLC or with localized/regional-stage LC.
Western influenced lifestyle and Kv2.1 association as predicted biomarkers for Tunisian colorectal cancer
Authors: Barbirou Mouadh , Woldu Henok G. , Sghaier Ikram , Bedoui Sinda A. , Mokrani Amina , Aami Radhia , Mezlini Amel , Yacoubi-Loueslati Besma , Tonellato Peter J. , Bouhaouala-Zahar Balkiss
Published: November 2020

Background

Colorectal cancer (CRC) is the third most diagnosed malignancy worldwide. The global burden is expected to increase along with ongoing westernized behaviors and lifestyle. The etiology of CRC remains elusive and most likely combines environmental and genetic factors. The Kv2.1 potassium channel encoded by KCNB1 plays a collection of roles in malignancy of cancer and may be a key factor of CRC susceptibility. Our study provides baseline association between Tunisian CRC and interactions between KCNB1 variants and lifestyle factors.

Methods

A case-control study involving 300 CRC patients, and 300 controls was conducted Patients were carefully phenotyped and followed till the end of study. KCNB1 genotyping was confirmed by Sanger sequencing. Bivariate and multivariable logistic regression analyses were used to assess the clinical status, lifestyle and study polymorphisms association with CRC.

Results

We noted significant gender association with CRC occurrence. Moreover, CRC risk increases with high meat and fat consumption, alcohol use and physical activity (PA). Carriage of rs1051296 A/G and both rs11468831 ins/del and del/del genotypes (p < 0.001) were significantly associated with CRC risk. Analysis according to gender reveals correlation of rs1051295 A/G, rs11468831 non ins/ins (p = 0.01) with CRC susceptibility regardless of patients’ gender while rs3331 T/C (p = 0.012) was associated with females. Stratification study according to malignancy site; Rectal Cancer (RC) and Colon Cancer (CC), reveals increasing RC risk by gender and high meat and fat consumption, alcohol use and PA. However, additional association with high brine consumption was noted for CC. The rs1051295 A/G (p = 0.01) was associated with RC risk. Increased CC risk was associated with carriage of rs1051295 A/G, rs11168831 (del/del) and (ins/del) genotypes.

Conclusion

The risk of CRC increases with modifiable factors by Western influences on Tunisian lifestyle such as alcohol use, high fat consumption and possibly inadequate intake of vegetables. In addition, KCNB1 polymorphisms also markedly influence CRC susceptibility. Our study establishes key elements of a baseline characterization of clinical state, Western influenced lifestyle and KCNB1 variants associated with Tunisian CRC.
B7-H6, an immunoligand for the natural killer cell activating receptor NKp30, reveals inhibitory effects on cell proliferation and migration, but not apoptosis, in cervical cancer derived-cell lines
Authors: Banu Nehla , Riera-Leal Annie , Haramati Jesse , Ortiz-Lazareno Pablo Cesar , Panikar Sandeep Surendra , Bastidas-Ramirez Blanca Estela , Gutierrez-Silerio Gloria Yareli , Solorzano-Ibarra Fabiola , Tellez-Bañuelos Martha Cecilia , Gutierrez-Franco Jorge , Bueno-Topete Miriam Ruth , Pereira-Suarez Ana Laura , del Toro-Arreola Susana
Published: November 2020

Background

Although great progress has been made in treatment regimens, cervical cancer remains as one of the most common cancer in women worldwide. Studies focusing on molecules that regulate carcinogenesis may provide potential therapeutic strategies for cervical cancer. B7-H6, an activating immunoligand expressed by several tumor cells, is known to activate NK cell-mediated cytotoxicity once engaged with its natural receptor NKp30. However, the opposite, that is, the effects in the tumor cell triggered by B7-H6 after interacting with NKp30 has not yet been well explored.

Methods

In this study, we evaluated the surface expression of B7-H6 by flow cytometry. Later, we stimulated B7-H6 positive cervical cancer derived-cell lines (HeLa and SiHa) with recombinant soluble NKp30 (sNKp30) protein and evaluated biological effects using the impedance RTCA system for cell proliferation, the scratch method for cell migration, and flow cytometry for apoptosis. Cellular localization of B7-H6 was determined using confocal microscopy.

Results

Notably, we observed that the addition of sNKp30 to the cervical cancer cell lines decreased tumor cell proliferation and migration rate, but had no effect on apoptosis. We also found that B7-H6 is selectively maintained in tumor cell lines, and that efforts to sort and purify B7-H6 negative or positive cells were futile, as negative cells, when cultured, regained the expression of B7-H6 and B7-H6 positive cells, when sorted and cultivated, lost a percentage of B7-H6 expression.

Conclusions

Our results suggest that B7-H6 has an important, as of yet undescribed, role in the biology of the cervical tumor cells themselves, suggesting that this protein might be a promising target for anti-tumor therapy in the future.
Links between the amount of antipsychotic medication prescribed per population at general practice level, local demographic factors and medication selection
Authors: Heald A. H. , Stedman M. , Farman S. , Khine C. , Davies M. , De Hert M. , Taylor D.
Published: November 2020

Background

Antipsychotic medications are the first-line pharmacological intervention for severe mental illnesses (SMI) such as schizophrenia and other psychoses, while also being used to relieve distress and treat neuropsychiatric symptoms in dementia.

Our aim was to examine the factors relating to antipsychotic prescribing in general practices across England and how cost changes in recent years have impacted on antipsychotic prescribing.

Methods

The study examined over time the prescribing volume and prices paid for antipsychotic medication by agent in primary care.

Monthly prescribing in primary care was consolidated over 5 years (2013–2018) and DDD amount from WHO/ATC for each agent was used to convert the amount to total DDD/practice.

The defined Daily Dose (DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults.

Results

We included 5750 general practices with practice population > 3000 and with > 30 people on their SMI register. In 2018/19 there were 10,360,865 prescriptions containing 136 million DDD with costs of £110 million at an average cost of £0.81/DDD issued in primary care.

In 2017/18 there was a sharp increase in overall prices and they had not reduced to expected levels by the end of the 2018/19 evaluation year. There was a gradual increase in antipsychotic prescribing over 2013–2019 which was not perturbed by the increase in drug price in 2017/18.

The strongest positive relation to increased prescribing of antipsychotics came from higher social disadvantage, higher population density (urban), and comorbidities e.g. chronic obstructive pulmonary disease (COPD). Higher % younger and % older populations, northerliness and non-white (Black and Minority Ethnic(BAME)) ethnicity were all independently associated with less antipsychotic prescribing.

Higher DDD/general practice population was linked with higher proportion(%) injectable, higher %liquid, higher doses/prescription and higher %zuclopenthixol depot. Less DDD/population was linked with general practices using higher % risperidone and higher spending/dose of antipsychotic.

Conclusions

The levels of antipsychotic prescribing at general practice level are driven by social factors/comorbidities. We found a link between depot prescriptions with higher antipsychotic DDD and risperidone prescriptions with lower antipsychotic DDD. It is important that all prescribers are aware of these drivers / links.
High prevalence of cardiovascular risk factors in adults living in Greece: the EMENO National Health Examination Survey
Authors:   on behalf of the EMENO study group, Touloumi Giota , Karakosta Argiro , Kalpourtzi Natasa , Gavana Magda , Vantarakis Apostolos , Kantzanou Maria , Hajichristodoulou Christos , Chlouverakis Grigoris , Trypsianis Grigoris , Voulgari Paraskevi V. , Alamanos Yannis , Makrilakis Konstantinos , Liatis Stavros , Chatzipanagiotou Stylianos , Stergiou George
Published: November 2020

Background

Nationwide data on cardiovascular risk factors prevalence is lacking in Greece. This work presents the findings of the national health examination survey EMENO (2013–2016) regarding the prevalence of hypertension, hypercholesterolemia, diabetes, obesity and smoking.

Methods

A random sample of adults (≥18 years) was drawn by multistage stratified random sampling based on 2011 Census. All EMENO participants with ≥1 measurement of interest [blood pressure (BP), fasting glucose, HbA1c, total cholesterol (TC), Body Mass Index (BMI)] were included. Hypertension was defined as BP ≥ 140/90 mmHg and/or antihypertensive treatment; diabetes as fasting glucose≥126 mg/dL and/or HbA1c ≥ 6.5% or self-reported diabetes; hypercholesterolemia as TC ≥ 190 mg/dL. Sampling weights were applied to adjust for study design and post-stratification weights to match sample age and sex distribution to population one. Non-response was adjusted by inverse probability weighting.

Results

Of 6006 EMENO participants, 4822 were included (51.5% females, median age:47.9 years). The prevalence of hypertension was 39.2%, higher in men (42.4%) than in women (36.1%); of hypercholesterolemia 60.2%, similar in men (59.5%) and women (60.9%); of diabetes 11.6%, similar men (12.4%) and women (10.9%); of obesity 32.1%, higher in women (33.5% vs 30.2%), although in subjects aged 18–40 year it was higher in men; of current smoking 38.2%, higher in men (44.0%) than in women (32.7%). The prevalence of all risk factors increased substantially with age, except smoking, which followed an inverse U shape.

Conclusions

The burden of cardiovascular risk factors among Greek adults is alarming. There is considerable preventive potential and actions at health care and societal level are urgently needed.
Comparison of self-reports and biomedical measurements on hypertension and diabetes among older adults in China
Authors: Xie Donghong , Wang Jiwen
Published: November 2020

Background

Researchers interested in the effects of health on various life outcomes often use self-reported health and disease as an indicator of true, underlying health status. However, the validity of reporting is questionable as it relies on the awareness, recall bias and social desirability. Accordingly, biomedical test is generally regarded as a more precise indication of the disease.

Methods

Using data from the third wave of China Health and Retirement Longitudinal Study (CHARLS), we selected individuals aged 40–85 years old who participated in both health interview survey and biomedical test. Sensitivity, specificity, false negative reporting and false positive reporting were used as measurements of (dis) agreement or (in) validity, and binary and multinomial logistic regression were used to estimate under-report or over-report of hypertension and diabetes.

Results

Self-reported hypertension and diabetes showed low sensitivity (73.24 and 49.21%, respectively) but high specificity (93.61 and 98.05%, respectively). False positive reporting of hypertension and diabetes were 3.97 and 1.67%, while false negative reports were extremely high at 10.14 and 7.38%. Educational attainment, hukou, age and gender affected both group-specific error and overall error with some differences in their magnitude and directions.

Conclusion

Self-reported conditions underestimate the disease burden of hypertension and diabetes in China. Adding objective measurements into social survey could improve data accuracy and allow better understanding of socioeconomic inequalities in health. Furthermore, there is an urgent need to provide basic health education and physical examination to citizens, and promote the use of healthcare to lower the incidence and unawareness of disease in China.
Joint motion of bipolar hemiarthroplasty in routine hip functional movements: a dynamic motion study
Authors: Jiang Weizhou , Xiao Jun , Chen Bin , Jia Ming , Zhang Yang , Wang Jian , Shi Zhanjun
Published: November 2020

Background

Many motion studies have shown that the inner bearing of bipolar prostheses moves less than expected under non-weight-bearing and static weight-bearing positions, which are not routine functional movements performed postoperatively. The aim of this study was to investigate the behaviours of bipolar prostheses during normal gait and simulative squatting.

Methods

Thirty-one femoral neck fracture patients were enrolled, and fluoroscopy examinations of walking on a treadmill, simulative squatting, and non-weight-bearing abduction-adduction and flexion-extension motions were performed at an average of 40 months postoperatively. The rate of acetabular cartilage degeneration was calculated. The ranges of motion of the outer bearing and inner bearing were determined, and the O/I ratios were calculated. Clinical efficacy was assessed by HHS and EQ-5D score.

Results

The inner bearing moved more than the outer bearing did, with an O/I ratio of 0.81, during the normal gait examination, while the motion of the outer bearing was obviously dominant during the simulative squatting and non-weight-bearing abduction-adduction and flexion-extension examinations. The mean acetabular cartilage degeneration rate was 0.82 ± 0.54 mm/year at the follow-up. In subgroup analyses, the motion of the outer bearing decreased to some extent with the increase in acetabular wear, and the corresponding O/I ratios among the groups showed a trend of decreasing first and then increasing. The HHS and EQ-5D scores of the patients with osteolysis and femoral stem loosening were much worse than those with fixed implants.

Conclusion

Bipolar prostheses do function as originally intended during gait, but movement primarily occurs at the outer bearing during other examinations. The motion patterns of bipolar prostheses change with the increase in acetabular wear.
Efficacy and factors affecting the choice of enucleation and liver resection for giant hemangioma: a retrospective propensity score-matched study
Authors: Ju Mingguang , Xu Feng , Zhao Wenyan , Dai Chaoliu
Published: November 2020

Background

Liver resection (LR) and enucleation (EN) are the main surgical treatment for giant hepatic hemangioma (HH), but how to choose the type of surgery is still controversial. This study aimed to explore the efficacy and the factors affecting the choice of open procedure for HH.

Methods

The data for patients with pathologically confirmed HH who underwent open surgery from April 2014 to August 2020 were analyzed retrospectively. Univariate and multivariate analyses with logistic regression were performed to disclose the factors associated with the choice of EN or LR. Propensity score matching (PSM) analysis was used to compare the efficacy of the two procedures.

Results

A total of 163 and 110 patients were enrolled in the EN and LR groups. Following 1:1 matching by PSM analysis, 66 patients were selected from each group. Centrally located lesions (OR: 0.131, 95% CI 0.070–0.244), tumors size > 12.1 cm (OR: 0.226, 95% CI 0.116–0.439) and multiple tumors (OR: 1.860, 95% CI 1.003–3.449) were independent factors affecting the choice of EN. There was no significant difference in the median operation time (156 vs. 195 min, P = 0.156), median blood loss (200 vs. 220 ml, P = 0.423), blood transfusion rate (33.3% vs. 33.3%, P = 1.000), mean postoperative feeding (3.1 vs. 3.3 d, P = 0.460), mean postoperative hospital stay (9.5 vs. 9.0 d, P = 0.206), or the major complication rates between the two groups.

Conclusions

Peripherally located lesions, tumors size ≤ 12.1 cm and multiple tumors were more inclined to receive EN. There was no significant difference in the efficacy of EN or LR.
Can thyroidectomy be considered safe in obese patients? A retrospective cohort study
Authors: Canu Gian Luigi , Medas Fabio , Cappellacci Federico , Podda Michele Guido , Romano Giorgio , Erdas Enrico , Calò Pietro Giorgio
Published: November 2020

Background

Obesity is a growing public health concern in most western countries. More and more patients with high body mass index (BMI) are undergoing surgical procedures of all kinds and, in this context, obese patients are undergoing thyroid surgery more than ever before.

The aim of the present study was to evaluate whether thyroidectomy can be considered safe in obese patients.

Methods

Patients undergoing thyroidectomy in our Unit between January 2014 and December 2018 were retrospectively analysed.

Patients were divided into two groups: those with BMI < 30 kg/m2 were included in Group A, while those with BMI ≥ 30 kg/m2 in Group B. Univariate analysis was performed to compare these two groups.

Moreover, multivariate analyses were performed to evaluate whether the BMI value (considered in this case as a continuous variable) had a significant role in the development of each individual postoperative complication.

Results

A total of 813 patients were included in this study: 31 (3.81%) were underweight, 361 (44.40%) normal-weight, 286 (35.18%) overweight, 94 (11.57%) obese and 41 (5.04%) morbidly obese. Six hundred and seventy-eight patients were included in Group A and 135 in Group B.

At univariate analysis, the comparison between the two groups, in terms of operative time and thyroid weight resulted in statistically significant results (P = 0.001, P = 0.008; respectively). These features were significantly higher in Group B than in Group A. About postoperative stay and complications, no statistically significant difference was found between the two groups.

At multivariate analyses, only the development of cervical haematoma was statistically significantly correlated to the BMI value. Patients with high BMI had a lower risk of cervical haematoma (P = 0.045, OR 0.797, 95% CI 0.638–0.995).

Conclusions

This study showed that obesity, in the field of thyroid surgery, is not associated with any increase of postoperative complications. Thus, it is possible to conclude that thyroidectomy can be performed safely in obese patients. Our result about operative times had no clinical significance.
Health-related quality of life in the randomized phase 3 study of ramucirumab plus docetaxel versus placebo plus docetaxel in platinum-refractory advanced urothelial carcinoma (RANGE)
Authors: Necchi Andrea , Nishiyama Hiroyuki , Matsubara Nobuaki , Lee Jae-Lyun , Petrylak Daniel P. , de Wit Ronald , Drakaki Alexandra , Liepa Astra M. , Mao Huzhang , Bell-McGuinn Katherine , Powles Thomas
Published: November 2020

Background

To evaluate patient-reported outcomes with ramucirumab plus docetaxel, a regimen which improved progression-free survival in platinum-refractory advanced urothelial carcinoma (aUC).

Methods

RANGE—a randomized, double-blinded, phase 3 trial in patients with platinum-refractory aUC. Ramucirumab (10 mg/kg) plus docetaxel (75 mg/m2) or placebo plus docetaxel were administered every 21 days until disease progression or unacceptable toxicity. Patients received maximum 10 cycles of docetaxel. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and EuroQoL five-dimensions (EQ-5D-5L) were administered at baseline, start of each cycle, and 30-day follow-up visit. A ≥ 10-point change in QLQ-C30 scores was considered meaningful. Rates of improved/stable scores were compared between treatment arms using Fisher’s exact test. Time to deterioration (TtD) was estimated and compared using Kaplan–Meier estimation and log-rank test.

Results

Of the 530 patients, ~ 97% patients in each arm provided baseline QLQ-C30 data. On-treatment compliance was ≥ 88% for first 8 cycles. Mean baseline QLQ-C30 scores were similar between arms, with global quality of life (QoL), fatigue, pain, and insomnia having greatest impairment. Postbaseline rates of improved/stable QLQ-C30 scores were similar between treatment arms except for greater improvement in pain score with ramucirumab. TtD of QLQ-C30 scales favored ramucirumab arm. Baseline EQ-5D-5L index and visual analogue scale scores were similar between arms, followed by relatively stable on-treatment scores. EQ-5D-5L scores worsened at post-discontinuation follow-up visit.

Conclusions

Ramucirumab plus docetaxel did not negatively impact QoL compared with docetaxel alone in platinum-refractory aUC. Improved TtD and tumor associated rates of pain favored ramucirumab treatment.

Clinical trail registration

NCT02426125.https://clinicaltrials.gov/ct2/show/NCT02426125.Date of registration: April 24th 2015
Pharmacists’ background, interests, barriers, self-perceived competence and confidence to design and undertake pharmacy practice-based research in the GCC geographic area
Authors: Alhomoud Farah Kais
Published: November 2020

Background

The absence of ability and certainty to design and undertake pharmacy practice-based research (PPBR) was a major issue among pharmacists worldwide as reported in previous literature, despite them having an interest in conducting PPBR. Therefore, this study aimed at highlighting the research background of the Gulf Cooperation Council (GCC) pharmacists which are the six Arab states of the Arabian Gulf, and examining barriers to conducting PPBR. In addition, to determine the self-perceived level of competence and confidence when planning and conducting PPBR.

Methods

This is a descriptive, cross-sectional questionnaire-based study, performed among pharmacists working in the GCC countries (i.e. Saudi Arabia, United Arab Emirates, Kuwait, Bahrain, Oman and Qatar). A pre-validated questionnaire was distributed to a convenience sample, via distribution of 500 research participation cards to conference attendees. These cards a quick response (QR) code, which should be scanned via mobile phone, to direct all readers to the online survey. All pharmacist delegates attending the conference (i.e. the Saudi International Pharmaceutical Sciences Annual National Conference (SIPHA) and Dubai International Pharmaceuticals and Technologies Conference and Exhibition (DUPHAT) in 2020 and who are working in one of the GCC co.

untries as pharmacists were considered. The data were analysed using the Statistical Package for the Social Sciences (SPSS) and Excel software.

Results

Two hundred and fourteen pharmacists were included. Seventy percent of the pharmacists had past PPBR background. Confidence and competence of pharmacists for research skills in regard to employing appropriate inferential statistical test, choosing software for statistical analysis, drafting a comprehensive plan for data analyses and determining appropriate sample size were weak. Highest competence and confidence were seen in preparing a presentation and searching the literature. Pharmacists with previous research experience (K-W: p = 0.001) and training (K-W: p = 0.003) had an overall ability to conduct PPBR. In addition, they had more interest in conducting PPBR (MWU = 3061.500, z = − 4.126, p = 0.000) and in learning about how to do so (MWU = 8698, z = − 1.898, p = 0.050).

Conclusions

Pharmacists practicing in the GCC geographic area realized the importance of planning and conducting PPBR and were more confident and competent to undertake and contribute to PPBR, except for skills related to statistical analysis. Therefore, training programmes especially for biostatistics and data analysis are mandatory to enhance pharmacists’ research capabilities.