bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Impact of APOBEC3B Expression for Tumor-infiltrating Cytotoxic T cells in Metastatic Urothelial Carcinoma
Authors: Kim Hyunho , Kim Okran , Lee Myung Ah , Lee Ji Youl , Hong Sung-Hoo , Ha U-Syn , Yim Kwangil , Kim In-Ho
Published: August 2020

Background: The APOBEC3B enzymes are endogenous carcinogenic mutagens. Metastatic urothelial carcinomas often harbor APOBEC3B-mediated mutations in which tCw to T or G substitution occurs. A high mutation burden in urothelial carcinoma can increase T-cell immunity against cancer cells, affecting prognosis. In this study, we aimed to evaluate patient survival and CD8+ T-cell density according to APOBEC3B expression in patients with metastatic urothelial carcinoma who underwent cytotoxic chemotherapy.Methods: We performed a retrospective study in 94 patients with urothelial carcinoma who were treated with the first line palliative chemotherapy. Immunohistochemistry staining was performed to evaluate APOBEC3B expression and CD8+/CD3 ratio of tumor-infiltrating lymphocytes. Survival curves according to APOBEC3B expression were generated using the Kaplan–Meier method and compared using the log-rank test. The correlation between APOBEC3B expression and tumor-infiltrating lymphocytes was analyzed using Pearson’s chi-squared test. Results: A high APOBEC3B expression was detected in 71 of the 94 patients (75.5%). The median overall survival of patients with high APOBEC3B expression (15 months) was longer than that of patients with low APOBEC3B expression (p = 0.045 by log-rank test). The hazard ratio based on the Cox regression analysis was 0.252 (95% confidence interval 0.082–0.781, p = 0.017). APOBEC3B expression was associated with the CD8+/CD3+ ratio of tumor-infiltrating lymphocytes (odds ratio 2.914, 95% confidence interval 1.030–8.249, p = 0.039).Conclusions: APOBEC3B expression was an independent prognostic factor in patients with metastatic urothelial carcinoma treated with platinum-based chemotherapy. Tumor-infiltrating cytotoxic T cells correlated with APOBEC3B expression.
Prognostic Nomogram for Penile Cancer, an Analysis Based on SEER Database
Authors: Chen Yong-Bo , Gao Liang , Tang Liang-You , Guo Jiang , Tian Yu-Chang , You Ping-Hong
Published: August 2020

Background: We aimed to establish a prognostic nomogram for Penile Cancer (PC) patients based on the Surveillance, Epidemiology, and End Results Program (SEER) database.Methods: Data of 1694 patients between 2010 and 2015 were downloaded and extracted from the SEER database. Then, they were randomly divided into the development group (70%) and the verification group (30%). Following, the univariate and multivariate Cox proportional hazards regression was respectively used to explore the possible risk factors of PC. Factors which significantly related to the overall survival (OS) were used to establish the nomogram. Further, the concordance index (C-index), receiver operating characteristic curve (ROC) and calibration curve were used to assess the nomogram, respectively. An internal validation was carried out to test the accuracy and effectiveness of nomogram. Finally, the Kaplan-Meier calculation was used to predict the further survival status of these patients.Results: Multivariate Cox proportional hazards regression demonstrated that the independent prognostic risk factors associated with PC were age, stage T, N and M, and grade, with a moderate c-index of 0.732 [95% confidence interval (CI), 0.706-0.757] in development group and 0.743 (95% CI, 0.703-0.782) in verification group. Meanwhile, the areas under the ROC (AUC) of 3-year and 5-year survival were 0.739 and 0.727, respectively. The survival calibration curves of 3-year and 5-year brought out a high consistency. Conclusion: Our study obtained a satisfactory nomogram to reveal the survival of PC patients, which could be helpful for clinicians to assess the situation of PC patients and to implement the further treatment.
Adenosquamous Carcinoma of the Breast: A Population-Based Study Using the SEER Database
Authors: Gu Zhangyuan , Liu Juan , Lin Xiaoyan , Wang Cheng , Li Jiejing , Fu Yun , Cheng Xiaolin , Xu Cheng , Zhuang Zhigang
Published: August 2020

Background: The present study is aimed at summarizing the clinicopathological characteristics, prognosis, and management of breast adenosquamous carcinoma (ASC). Methods: A population-based study was performed using retrospectively extracted data from the Surveillance, Epidemiology and End Results database for breast cancer patients with histological diagnoses of ASC, infiltrating duct carcinoma (IDC) and squamous cell carcinoma (SCC) from 2004 to 2016. End-points were overall survival (OS) and breast cancer-specific mortality (BCSM). Propensity Score Matching (PSM) was employed to minimize selection bias of baseline characteristics. Univariable and multivariable analyses were used for identifying valuable prognostic factors. Results: ASC presented similar tumor size but low histological grade and less lymph node metastasis compared to IDC. ASC expressed less positive rate of hormone receptors and barely HER2, which was similar with SCC (estrogen receptor (ER): ASC 27.74% and SCC 21.53%, progesterone receptor (PR): ASC 18.06% and SCC 12.85%, HER2: ASC 4.44% and SCC 7.53%). ASC patients underwent the same treatment as IDC (chemotherapy 36.99% vs. 41.86%, BCS 50.58% vs 52.83%, P >0.05), only with less radiotherapy (39.88% vs. 48.34%, P<0.05). Median follow-up data of 78 months showed that the prognosis of IDC patients was better than that of ASC patients (all P <0.05 for BCSM and OS). After adjustment for clinicopathological and therapeutic factors in Cox proportional hazards models, ASC was no longer an independent poor prognosis factor. In matched groups, no significant difference in BCSM nor OS was observed between ASC and IDC groups. In HR-negative patients, the prognosis of ASC was similar with that of IDC, and both were superior to SCC. In HR-positive patients, the five-year survival rate of ASC was only about 60%, which was far less than that in ASC of HR-negative, the poor prognosis of ASC was closer to that of SCC. Multivariate analysis showed that older age (age≥60) and advanced AJCC stage (III and IV) were independent factors of poor prognosis in ASC, breast-conserving surgery was also ideally suited for ASC. Conclusions: ASC has unique clinicopathological characteristics and prognosis. To improve the clinical and biological understanding of ASC can make breast cancer patients get more individualized treatment.
Maximum chest CT score predicts progression to severe illness in patients with COVID-19: a retrospective study from Wuhan, China
Authors: Xiao Jianwei , Li Xiang , Xie Yuanliang , Huang Zengfa , Ding Yi , Zhao Shengchao , Yang Pei , Du Dan , Liu Bin , Wang Xiang
Published: August 2020

Background: We investigated the clinical course and imaging findings of hospitalized patients who were initially diagnosed with moderate COVID-19 symptoms to identify risk factors associated with progression to severe/critical symptoms.Methods: This study was a retrospective single-center study at The Central Hospital of Wuhan. 243 patients with confirmed COVID­19 pneumonia were enrolled in the analysis, of which 40 patients progressed from moderate to severe/critical symptoms during follow up. Demographic, clinical, laboratory and radiological data were extracted from electronic medical records and compared between moderate and severe/critical symptom types. Univariable and multivariable logistic regressions were used to identify the risk factors associated with symptom progression.Results: Patients with severe/critical symptoms were older (p＜0.001) and more often male (p=0.046). We found that the combination of chronic obstructive pulmonary disease and high maximum CT scores was associated with disease progression. Maximum CT scores (≥11) had the greatest predictive value for disease progression. The area under the receiver operating characteristic curve (ROC) was 0.861 (95% CI: 0.811-0.902).Conclusions: Maximum CT scores and COPD are associated with patient deterioration. Maximum CT scores (≥11) are associated with severe illness.
Clinical Characteristics and Outcomes of Critically Ill COVID-19 Patients in Tokyo: A Single-Center Observational Study
Authors: Banno Aya , Hifumi Toru , Okamoto Hiroshi , Masaki Minori , Seki Koichiro , Isokawa Shutaro , Otani Norio , Hayashi Kuniyoshi , Ishimatsu Shinichi
Published: August 2020

Background: Japan has been successful in maintaining low mortality rates during the coronavirus disease 2019 (COVID-19) pandemic. We sought to investigate the characteristics, inflammatory laboratory finding trends, and outcomes among critically ill Japanese patients who were admitted to the intensive care unit (ICU) with COVID-19. Methods: A retrospective observational study was performed in a single institution in the center of Tokyo. Laboratory-confirmed COVID-19 patients admitted to the ICU from March 19 to April 30, 2020 were included. Trends for significant inflammatory laboratory findings were analyzed. In-hospital death, days of mechanical ventilation or oxygen supplementation, days of ICU or hospital stay were followed until May 26, 2020. Results: Twenty-four patients were included. Median age was 57.5 years, and 79% were male. The neutrophil-to-lymphocyte ratio was elevated to a median of 10.1 on admission and peaked on Day 10 of illness. Seventeen patients were intubated on Day 11 of illness and received mechanical ventilation. One patient underwent extracorporeal membrane oxygenation. The majority (88%) received systemic steroids, including 16 patients who received high dose methylprednisolone (500-1000 mg). Favipiravir was used in 38% of patients. Two patients, including 1 who refused intensive care, died. Eighteen patients were discharged. Median length of ICU and hospital stay for all patients was 6 and 22 days, respectively. Median length of ventilator dependency was 7 days. Four patients underwent a tracheostomy and received prolonged ventilation for more than 21 days. One patient receiving mechanical ventilation died. All survivors discontinued ventilator use. Mortality was remarkably low and prolonged ventilation was inevitable yet discontinued.Conclusions: Mortality was remarkably low in our single institutional study. Prolonged ventilation was inevitable yet discontinued. Trends of systemic inflammatory laboratory markers reflected the clinical course of COVID-19.
Analysis of Factors Influencing Coal Prices Under the New Normal of China's Economy
Authors: LI Yang , CHENG Haozhou , REN Yuqi , YANG Kunpeng
Published: August 2020

Background: After China's economy entered a new normal, the economic growth slowed down, energy market demand shrank, and the coal industry suffered from serious overcapacity. In this context, the Chinese government carried out supply-side structural reform and implemented a series of policies to cut overcapacity and destocking.Methods: By using time series data, this paper establishes vector error correction model, combined with Granger causality test and variance decomposition, to study the factors influencing coal prices under the new normal of economy. Results: The empirical results show that under the new normal of the economy, coal social inventory, oil production and natural gas production have a greater impact on the coal price, while coal consumption and raw coal production have a smaller impact on the coal price. According to the analysis, at the present stage, fossil energy, especially coal, occupies too high proportion in China's energy structure, which can no longer meet the requirements of energy use under the new normal of economy. Conclusion: According to the empirical results and analysis, the Chinese energy structure must be adjusted. In the short term, supply-side structural reform policies must be deepened to change the status quo of China's coal industry as soon as possible. In the long run, non-fossil energy technologies should be vigorously developed to provide stable and cheap non-fossil energy, thus reducing the use of fossil energy and increasing the use of non-fossil energy.
The Prognostic Roles and Clinical Features of CD44v9 in Human Solid Cancers—A Meta-Analysis
Authors: Deng Yuanxiu , Wang Jie , Ji Shenhui , Huang Lu , Feng Meijiang
Published: August 2020

Background: CD44 is the primary receptor for hyaluronic acid and serves as a marker for cancer stem cells. CD44v9 is one of CD44’s variants and takes part in cancer’s growth and metastasis. However, the prognostic roles and clinical features of CD44v9 in cancers remain unclear. Therefore, we conducted this meta-analysis to summarize the prognostic significance and clinical features of CD44v9 in human solid cancers.Methods: we systematically searched all of related studies in PubMed, the Web of Science, Embase and Cochrane library up to June 2020. We analyzed the pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) to assess the prognostic functions and clinical features of CD44v9 in various human solid cancers.Results: In this meta-analysis, we included 1705 cancer patients among 12 studies. Results indicated that high expression of CD44v9 was significantly related to poorer overall survival (OS) (HR=1.60, 95%CI 1.28-1.99, P<0.0001), recurrence-free survival/progression-free survival/disease-free survival (RFS/PFS/DFS).( HR=1.81, 95%CI 1.16-2.84, P=0.009) and disease-specific survival/cancer-specific survival (DSS/CSS) (HR=2.93, 95%CI 1.69-5.10, P<0.001). At the same time, we also found that high expression of CD44v9 increased the possibility of lymphoid infiltrates (OR=1.59, 95%CI 1.16-2.20, P=0.005), vascular invasion (OR=1.57, 95%CI 1.11-2.22, P=0.010) and higher TNM stage (OR=1.63, 95%CI 1.19-2.23, P=0.002).Conclusion: Our results demonstrate that CD44v9 overexpression is associated with worse OS, RFS/PFS/CFS and DSS/CSS in patients with solid cancers, which might be a biomarker in the diagnosis and prognosis of cancers in the future.
Dimensions of Sexual Violence in Perimenopausal Women: A Systematic Review Protocol
Authors: Hajifoghaha Mahboubeh , Mokhlesi Seyede-Samira , Alizadeh Shiva , Dabiri Fatemeh
Published: August 2020

Objective: Violence against women is a crisis in public health and breaking human rights. Sexual violence has more adverse outcomes for middle-aged women, their families and society. The present study will be conducted to review the dimensions of sexual violence in perimenopausal women. In this study, published articles from 2010 to 2020 will be reviewed. Methods: This protocol is written based on the PRISMA-P checklist. For this purpose, the articles that have the inclusion criteria will be selected by searching in databases PubMed, Scopus, Web of Science, ProQuest, SID and, Magiran using appropriate keywords. Articles of systematic review, letters to the editor, abstracts, and clinical trials will be excluded. A STROBE checklist will be used to assess the quality of articles. Discussion: This systematic review will be addressed sexual violence in perimenopausal women as well as demographic factors affecting the existence of sexual violence. The results can be a guide for health planners to reduce this social problem and solve the worries of this group of society by providing the counseling programs. Registration: This protocol is registered in PROSPERO with number CRD42020191679.
Correlations of Scapular Dimensions: A Tool to Identify Scapulae with Completely Ossified Superior Transverse Scapular Ligaments and Suprascapular Neuropathy
Authors: Adewale Adesanya Olamide , Segun Okeniran Olatayo , Usman Ibe Michael , Monima Ann Lemuel , Kegoye Eric Simidi , Kasozi Keneth Iceland , Nalugo Halima , Ssempijja Fred
Published: August 2020

Background. A better understanding of the anatomy of the suprascapular notch and relationship with scapular dimensions are vital in the diagnosis, prevention, and assessment of the suprascapular nerve (SN) entrapment syndrome. Our purposes were to classify the suprascapular notches, determine the prevalence of completely ossified superior transverse scapular ligament, scapular dimensions, and their relationship among the different types of the suprascapular notch (SSN). Methods: An experimental study in which the SSN types and scapular dimensions were determined using previous methods. Statistical analyses were done using GraphPad Prism v.6 and MS Excel Version 2019, one-way ANOVA was used to compare and Spearman’s correlation coefficient was used to evaluate the correlation of scapular dimensions. Results: The superior transverse scapular ligament (STSL) was completely ossified in 8% of cases. There were no significant differences between the scapular dimensions for the different SSN types. For type VI SSN there is a strong negative correlation between A, B against D. There are strong (positive or negative) correlations between types I and III from type VI for A-axis; types I, III from VI for B; type IV and VI for C axis; and type III and VI for D axis.Conclusions: The prevalence of the completely ossified STSL in our study was moderately high; the correlation studies suggest that the scapular dimensions could be a valuable tool in the prediction, diagnosis, prevention, and assessment of the SN neuropathy due to the scapulae with the completely ossified superior transverse scapular ligaments (type VI SSN). Further studies on correlation analyses of scapular dimensions and characteristics of suprascapular notches are vital.
Changes in resting-state Functional Connectivity of Cerebellum in amnestic Mild Cognitive Impairment and Alzheimer’s disease: a case-control study
Authors: Zhou Zhi , Zhu Rui , Shao Wen , Zhang Shujuan , Wang Lei , Ding Xuejiao , Peng Dantao
Published: August 2020

Background This case-control study is aimed to investigate the correlation of altered functional connectivity (FC) in cerebellum with cognitive impairment in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD).Methods The morphometric and resting-state FC MRI analysis including 47 participants with AD, 32 with aMCI and 43 age-matched normal controls (NCs) were conducted. We compared the cerebellar gray matter volume and cerebellar FC with cerebral cortical regions among three groups. To investigate the relationship of cerebellar FC with cognition, we measure the correlation of significant altered FC and individual cognitive domain.Results No significant morphometric differences of cerebellum was observed across three groups. The patients with AD had weaker cerebral cortical FCs in bilateral Crus I, left VIIb and IX compared to NCs, and in bilateral Crus I compared to patients with aMCI. For patients with aMCI, the weaker FC were found between right Crus I, left VIIb and IX and cerebral cortical regions compared to NCs. The strength of left cerebellar FC positively correlated with specific cognitive subdomains, including executive function, attention, visuospatial function, and global cognition in AD and aMCI.Conclusions These findings demonstrated the alteration of cerebellar FC with cerebral cortical regions, and the correlation of cerebellar FC and cognitive impairment in AD and aMCI.
Bile acid, glucose, lipid profile, and liver enzyme changes in pre-diabetics after sleeve gastrectomy
Authors: Mak Tsz Kin , Huang Shifang , Guan Bingsheng , Au Hoyin , Chong Tsz Hong , Peng Juzheng , Chen Fazhi , Liang Chuqiao , Lai Wanjing , Ho LongLam , Wang Cunchuan , yang jingge
Published: August 2020

BackgroundFew articles have studied pre-diabetes after sleeve gastrectomy. Bile acid, and lipid metabolism remains inconsistent in post-bariatric patients. ObjectiveTo explore bile acid and glucose, lipid, and liver enzyme changes in different diabetic status underwent sleeve gastrectomy. To discuss the impact of bariatric surgery and its potential benefits to pre-diabeticsMethods202 overweight and obese patients underwent bariatric surgery between January 2016 and October 2018 in our hospital were retrospectively reviewed. They were divided into Pre-diabetes (n=32), Non-diabetes (n=144), and Diabetes (n=26) and analyzed respectively. Data of glucose and lipid metabolism were collected from medical records from baseline and each follow-up visit.ResultSignificant improvement in body weight, glucose and lipid metabolism, and liver enzyme at P≤0.05 in prediabetics were found throughout first year post-op. Improvement of glycemic control was first seen in a month post op, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, associated with ALT improvement, in pre-diabetes 1-year post-surgery. There was no significant differences in HbA1c, glucose, and triglycerides (TG) between Pre-diabetics and T2DM nor between prediabetics and non-diabetics at 12 months post-surgery.ConclusionLSG is highly effective in interfering glucose and lipid metabolism as well as total bile acid of prediabetics in the first year post op. Thus, LSG is indeed an alternative for overweight and obese prediabetics
Reducing community infection by institutional interventions: a minimal SEIRJ model applied to COVID-19
Authors: Plan Emmanuel Lance Christopher VI , Man Minh Tan , Dinh Binh , Bui Thuy , Le Manh
Published: August 2020

The 2019 Coronavirus Disease continues to spread, and in the interim absence of a proven cure and vaccine, preventive community interventions continue to be implemented across countries. Here we propose and analyze a minimal compartmental model that simultaneously incorporates three such interventions: lockdowns, rapid isolation, and institutional propaganda. Using a modified SEIRJ model, we vary three different factors in the quantity that determines the effective rate of infection. Estimates of the model parameters are obtained from publicly-available data and were used to simulate various combinations of interventions. Our results show that a combination of interventions could decrease the total number of infected individuals by one or two orders of magnitude and keep the number of active cases low. In particular we show that lockdowns need not be very stringent if proper social distancing via media awareness and rapid identification and isolation is practiced. We also highlight that an effective isolation system strongly improves the effect of these interventions.
Entanglement generation in a quantum network at distance-independent rate
Authors: Patil Ashlesha , Pant Mihir , Englund Dirk , Towsley Don , Guha Saikat
Published: August 2020

We develop a protocol for entanglement generation in the quantum internet that allows a repeater node to use n-qubit Greenberger-Horne-Zeilinger (GHZ) projective measurements that can fuse n successfully-entangled links, i.e., two-qubit entangled Bell pairs shared across n network edges, incident at that node. Implementing n-fusion, for n≥3, is in principle not much harder than 2-fusions (Bell-basis measurements) in solid-state qubit memories. If we allow even 3-fusions at the nodes, we find---by developing a connection to a modified version of the site-bond percolation problem---that despite lossy (hence probabilistic) link-level entanglement generation, and probabilistic success of the fusion measurements at nodes, one can generate entanglement between end parties Alice and Bob at a rate that stays constant as the distance between them increases. We prove that this powerful network property is not possible to attain with any quantum networking protocol built with Bell measurements and multiplexing alone. We also design a two-party quantum key distribution protocol that converts the entangled states shared between two nodes into a shared secret, at a key generation rate that is independent of the distance between the two parties.
Additive-Manufactured Ti-6Al-4V/Polyetheretherketone Composite Porous Cage for Interbody Fusion: Bone Growth and Biocompatibility Evaluation in a Porcine Model
Authors: Tsai Pei-I , Wu Meng-Huang , Li Yen-Yao , Lin Tzu-Hung , Tsai Jane SC , Tai Ting-Han , Lee Ming-Hsueh , Chen Chih-Yu
Published: August 2020

Background: We developed a porous Ti alloy/PEEK composite interbody cage by utilizing the advantages of polyetheretherketone (PEEK) and titanium alloy (Ti alloy) in combination with additive manufacturing technology. Methods: Porous Ti alloy/PEEK composite cages were manufactured using various controlled porosities. Anterior intervertebral lumbar fusion and posterior augmentation were performed at three vertebral levels on 20 female pigs. Each level was randomly implanted with one of the five cages that were tested: a commercialized pure PEEK cage, a Ti alloy/PEEK composite cage with nonporous Ti alloy endplates, and three composite cages with porosities of 40%, 60%, and 80%, respectively. Micro-computed tomography (CT), backscattered-electron SEM (BSE-SEM), and histological analyses were performed.Results: Micro-CT and histological analyses revealed improved bone growth in high-porosity groups. Micro-CT and BSE-SEM demonstrated that structures with high porosities, especially 60% and 80%, facilitated more bone formation inside the implant but not outside the implant. Histological analysis also showed that bone formation was higher in Ti alloy groups than in the PEEK group. Conclusion: The composite cage presents the biological advantages of Ti alloy porous endplates and the mechanical and radiographic advantages of the PEEK central core, which makes it suitable for use as a single implant for intervertebral fusion.
Equal critical care consideration for both immunocompromised and immunocompetent patients during the COVID-19 surge
Authors: DENIS Cynthia , BALDACINI Mathieu , SCHENCK Maleka , ARTZNER Thierry , GRIMAUD Yoann , LAVIGNE Thierry , MEZIANI Ferhat , CASTELAIN Vincent , CLERE-JEHL Raphael , SCHNEIDER Francis , MOREL Guillaume
Published: August 2020

Background: SARS-CoV-2 disease (COVID) affects all sections of the community, but some people contract the disease in a form requiring ICU admission. Immunocompromised patients (ICP) figure among the fragile patients whose access to critical care may be denied in the event of ICU bed-shortage. Our aims were: 1) to describe our management experience in seeking to assure equal critical-care consideration for both ICP and immuno-competent patients during the COVID surge, 2) to assess how successful this would be in terms of outcome for all patients, 3) to compare ICU stays of ICP, whether they survived or not, so as to detect possible prognostic factors.Methods: We conducted a cohort study in medical ICUs of a university-affiliated hospital hit by an uncontrolled cluster of COVID. We compared the levels of activity before and during COVID: number of patients (whether COVID+ or COVID-, whether ICP or not); bed-occupancy and bed-availability; mortality rates and the need for sanitary evacuations analyzed to avoid triage decisions.Results: During the pre-COVID period, 396 patients, including 9.3% ICP, were admitted. During the COVID period, 547 patients, including 243 COVID+ (of whom 24 ICP), were admitted: this required an 8 ICU bed-extension (+14.5% beds), a transfer of 69 immuno-competent COVID- patients to surgical ICU step-down beds, and the transfer of 22 immuno-competent COVID patients to distant hospitals. Despite sanitary evacuations, there was a daily average of 2 ICU-access refusals, the patients being taken in charge by step-down units. Health evacuations were decided on when the weekly number of COVID admissions doubled. No ICP was denied access to the ICU; no COVID- ICP was hospitalized during the first 9 weeks of the surge. 28-day mortality was 41.6% in ICP versus 27.3% in immuno-competent patients (p=0.021, log-rank test). With the exception of SAPSII and SOFA, no factor was different between clinical and ICU-stay characteristics among ICP, whether surviving or not.Conclusion and Relevance: Equal critical-care consideration for both immuno-compromised and immunocompetent patients during the COVID-19 surge was possible with acceptable outcome. Sanitary doctrine and fine-tuned hospital logistics were mandatory both at local and national level to reach this goal.
Clinical characteristics and post-intensive care outcomes of COVID-19 pneumonia.
Authors: C Neil MD , Lakey Samuel M , McMahon Sean M , Downey Megan K , Duncan Megan S , Hewitt Julie-Anne , Simpson Calum B , Duffy Martin J , O’Reilly Rosalind F , Johnston Paul , Silversides Jonathan A , Group Belfast COVID ICU
Published: August 2020

Background: COVID-19 can result in a severe viral pneumonia, with high reported mortality rates in patients requiring mechanical ventilation. There is controversy as to whether established therapeutic approaches to acute respiratory distress syndrome are optimal in this condition, and numerous novel therapies have been used, often outside the context of randomised trials. In addition, longer term quality of life outcomes associated with COVID-19 are as yet unknown. The aim of this case series is to describe demographic, physiological and outcome data of patients with COVID-19 admitted to our intensive care units who were treated according to evidence-based guidelines for acute respiratory distress syndrome.Methods: We retrospectively reviewed the records of all patients admitted to intensive care units in our institution with COVID-19 between March and June, 2020. Physiological and laboratory data were recorded at baseline and daily until intensive care discharge or death. Quality of life was assessed at a virtual post-intensive care follow-up clinic around 10 weeks after ICU discharge.Results: 45 patients with COVID-19 were included, 37 (82.2%) of whom were male, with a mean age of 55 years. 42 (93.3%) of this cohort met criteria for acute respiratory distress syndrome at time of admission. Clinical management was consistent with evidence based institutional guidelines introduced for acute respiratory distress syndrome. Median length of intensive care stay was 14 days. The intensive care mortality rate was 8.9%. Functional and psychological morbidity post intensive care was significant: 45.2% of respondents had at least moderate impairment of mobility and 35.5% described at least moderate symptoms of anxiety or depression at the time of follow up.Conclusions : This case series demonstrates low mortality in a cohort of patients treated according to an established evidence-based approach for acute respiratory distress syndrome. However, COVID-19 survivors have a marked functional and psychological morbidity impacting quality of life following ICU admission. The therapeutic goal in the future will be to achieve similar survival outcomes while minimizing the significant morbidity associated with COVID-19 related critical care admission.
A pilot study on showcasing the forensic relevance of skin microflora
Authors: Jain Toshi , Nema Vijay , Gupta Mahendra K , Kumawat R. K , Singhal Pradeep K , Chaubey Gyaneshwer , Kango Naveen , SHRIVASTAVA PANKAJ
Published: August 2020

Background

Utility of skin microflora is coming up now with the advancement of molecular techniques and the use of results in predicting infection transmission, genetic relatedness of the source of the origin, forensic use etc. Hence, preparing a catalogue of such endogenous and exogenous microbes would serve as a reference for future studies.
Results

Isolates identified showed typical pattern of having core microbial communities as found in all the samples and the typical ones which were found only in one individual and not in others. This study showed a potential to identify and classify microbes associated with skin of healthy individuals.
Conclusion

This can serve as a reference model for future studies and to employ the knowledge into forensic as well as other studies related to health. However, it would be worthwhile to consider similar study with large number of individuals with variable food habits and ethnicity for making an exclusive catalogue for skin microflora.
Risk of pre-term births and major birth defects resulting from paternal intake of COVID-19 medications prior to conception
Authors: Rizzi Silvia , Wensink Maarten Jan , Lindahl-Jacobsen Rune , Tian Lu , Lu Ying , Eisenberg Michael
Published: August 2020

Objective. With the ongoing COVID-19 pandemic, large numbers of people will receive one of the several medications proposed to treat COVID-19, including patients of reproductive age. Given that some medications have shown adverse effects on sperm quality, there might be a transgenerational concern. We aim at examining the association between drugs proposed to treat COVID-19 when taken by the father around conception and any pre-term birth or major birth defects in offspring in a nation-wide cohort study using Danish registry data. Offspring whose father filled at least one prescription of the following medications in the three months preceding conception were considered exposed: chloroquine, hydroxychloroquine, losartan, azithromycin, naproxen, dexamethasone and prednisone. Results. For azithromycin and naproxen, large numbers of offspring were exposed (> 1800 offspring), and we found no association with adverse birth outcomes. For chloroquine, losartan and dexamethasone, exposure was intermediate (~ 900 offspring), and there was no statistically significant association with birth defects. For hydroxychloroquine and prednisone, exposure was limited (< 300 offspring). There is strong evidence that azithromycin and naproxen are safe with respect to pre-term birth and birth defects. With some caution, the other drugs investigated can be considered safe.
Efficacy and Safety of CD22 Chimeric Antigen Receptor (CAR) T-cell Therapy in Patients With B-cell Malignancies: A Protocol for a Systematic Review and Meta-analysis
Authors: Adeel Komal , Fergusson Nathan , Shorr Risa , Atkins Harry , Hay Kevin Anthony
Published: August 2020

Background: Chimeric antigen receptor (CAR) T-cell therapy has had great success in treating patients with relapsed or refractory B-cell malignancies, with CD19-targeting therapies now approved in many countries. However, a subset of patients fail to respond or relapse after CD19 CAR T-cell therapy, in part due to antigen loss, which has prompted the search for alternative antigen targets. CD22 is another antigen found on the surface of B-cells. CARs targeting CD22 alone or in combination with other antigens have been investigated in several pre-clinical and clinical trials.Given the heterogeneity and small size of CAR T-cell therapy clinical trials, systematic reviews are needed to evaluate their efficacy and safety. Here, we propose a systematic review of CAR T-cell therapies targeting CD22, alone or in combination with other antigen targets, in B-cell malignancies.Methods:We will perform a systematic search of EMBASE, MEDLINE, Web of Science, Cochrane Register of Controlled Trials, clinicaltrials.gov, and the International Clinical Trials Registry Platform. Ongoing and completed clinical trials will be identified and catalogued. Interventional studies investigating CD22 CAR T-cells, including various multi-antigen targeting approaches, in patients with relapsed or refractory B-cell malignancies will be eligible for inclusion. Only full-text articles, conferences abstracts, letters and case reports will be considered. Our primary outcome will be a complete response, defined as absence of detectable cancer. Secondary outcomes will include adverse events, overall response, minimal residual disease, and relapse, among others. Quality assessment will be performed using a modified Institute of Health Economics tool designed for interventional single-arm studies. We will report a narrative synthesis of clinical studies, presented in tabular format. If appropriate a meta-analysis will be performed using a random effects model to synthesize results.Discussion:The results of the proposed review will help inform clinicians, patients and other stakeholders of the risks and benefits of CD22 CAR T-cell therapies. It will identify gaps or inconsistencies in outcome reporting and help to guide future clinical trials investigating CAR T-cells.PROSPERO Registration Number: CRD42020193027.
Anesthesia Management of Children With Head and Neck Hemangiomas Associated With the Kasabach–merritt Phenomenon
Authors: sun mingyang , Li Ningtao , Chang Enqiang , Ruan Xiaoguo , Zhi Hui , Dong Changxian , Zhang Jiaqiang
Published: August 2020

Background: We reported the anesthesia management of the patients with head and neck hemangiomas associated with the Kasabach–Merritt phenomenon (KMP).Methods: All 12 young patients with KMP involving the head and neck region who admitted in Henan Provincial Hospital for surgery between June 2012 and December 2016 were included in the study. The data during preoperative preparation including platelet infusion and glucocorticoid treatment, anesthetic management and postoperative recovery were were harvested and analysed.Results: Of the 12 patients, the platelet counts were less than 40× 109/L on admission but no gender difference and three of them responded to glucocorticoid treatment extremely well. The patients who did not respond glucocorticoid treatment well and whose platelets <40× 109/L were transfused platelets 12 hours prior to surgery to correct the platelet count to be equal or more than 100 × 109/L. The patients who had pneumonia before surgery had a prolonged hospital stay. All 12 patients had surgical excision successfully. After surgery, the platelet counts were increased rapidly in all patients.Conclusion Careful pre-anesthesia assessment and preparation, and thoughtful anesthesia management are needed for KMP patients to receive surgical excision.
Subsurface Located Geothermal Well – Case Study
Authors: Langbauer Clemens , Schwarzenegger Christoph , Fruhwirth Rudolf Konrad
Published: August 2020

The recovery of geothermal energy has become very attractive in the last decades. Advantages like the small footprint, the waste-free and CO2 neutral energy production and the continuous geothermal resource, will highly promote geothermal energy usage soon. This paper presents a case study of a subsurface located geothermal well. The overall approach is to use existing subsurface facilities and construct the geothermal energy recovery system within them.Currently, the generated power, produced by geothermal energy systems, is more expensive than energy produced from competitive sources, because of the costs associated with the construction of the wellbore. To extend the use of geothermal energy, its recovery costs have to be reduced. The primary wellbore cost driver is the depth. The drilling costs rise exponentially with depth. When situating a geothermal power plant in an underground structure, the temperature at the start point of such a geothermal well is already at an elevated temperature level, and the total amount of meters to be drilled is substantially reduced, thus saving drilling costs. A primary focus of this paper is, on the one hand, the amount of energy to be recovered and, on the other hand, the technical realization of such a project. The results have shown that the efficiency of subsurface located geothermal wells is higher than for surface located ones. Technical equipment and technology for drilling subsurface are already available today. A case study for investigating the influence of parameters like depth and number of wells is performed. Depending on geology, simulations have indicated that it is from the technical point of view more efficient to drill a deeper well in comparison to drill several shallow subsurface wells. Nevertheless, from the economic point of view, currently, surface drilled wells are more economical.So far, a drilling rig has never been positioned below ground, and the legal framework is just partially defined so far. This paper presents a case study of a subsurface located geothermal well positioned in existing underground infrastructure. This case study shows the vast potential but indicates the risks and limitations as well.
Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: A systematic review and meta-analysis
Authors: O'Brien Doireann , Long Jean , Quigley Joan , Lee Caitriona , McCarthy Anne , Kavanagh Paul
Published: August 2020

Aim: This systematic review of longitudinal cohort studies aimed to explore whether electronic cigarette (e-cigarette) use by adolescents, in Europe and North America, who had never smoked conventional tobacco cigarettes (tobacco cigarettes) at baseline was associated with subsequent initiation of tobacco cigarette smoking. Methods: A key word search identified peer-reviewed literature published between 1 January 2005 and 2 October 2019 from seven bibliographic databases and one search engine. Using a predefined inclusion/exclusion criteria two authors independently screened abstracts, and subsequently, full text papers. Eligible papers were quality assessed and scored by two authors. Included papers had data on population characteristics, exposure and outcome measures extracted into an adapted Cochrane Data Extraction Form. Statistical analysis was preceded by a feasibility assessment, and included a pairwise random effects meta-analysis, and sensitivity and subgroup analyses. Findings: From an initial 6,619 studies (6,510 papers from the initial searches, plus 109 papers from supplemental searches), 14 unique studies in 21 papers were identified. Nine of the 14 unique longitudinal studies with follow-up periods between 4 and 24 months were eligible for inclusion in a meta-analysis of the association between ever use of e-cigarettes and subsequent initiation of tobacco cigarette use. Based on primary study adjusted odds ratios, our meta-analysis calculated a 4.06 (95%confidence interval (CI): 3.00-5.48) times higher odds of initiating tobacco cigarette smoking for those who had ever used e-cigarettes at baseline, although the odds ratio was reduced slightly (to 3.71 times odds, 95%CI: 2.83-4. 86) when only the four high-quality studies were included. The initial meta-analysis model had a moderate to high statistical heterogeneity, sensitivity analysis restricted to high-quality studies had a low to moderate statistical heterogeneity. Conclusion: The systematic review found that e-cigarette use was associated with initiation of tobacco cigarette smoking among adolescents in Europe and North America, identifying a potentially serious public health harm. Given the widespread availability and use of e-cigarettes, this study further supports urgent action by policymakers to prevent their use by adolescents to reduce direct harms in this vulnerable population group as well as to protect gains in reducing tobacco cigarette initiation.
Molecular and Cellular Characterization of Two Patient-Derived Ductal Carcinoma in Situ (DCIS) Cell Lines, ETCC-006 and ETCC-010
Authors: Samson Julia , Dean Kellie
Published: August 2020

Background: Currently it is unclear how in situ breast cancer progresses to invasive disease; therefore, a better understanding of the events that occur during the transition to invasive carcinoma is warranted. Here we have conducted a detailed molecular and cellular characterization of two, patient-derived, ductal carcinoma in situ (DCIS) cell lines, ETCC-006 and ETCC-010. Methods: Human DCIS cell lines, ETCC-006 and ETCC-010, were compared against a panel of cell lines including the immortalized, breast epithelial cell line, MCF10A, breast cancer cell lines, MCF7 and MDA-MB-231, and another DCIS line, MCF10DCIS.com. Cell morphology, hormone and HER2/ERBB2 receptor status, cell proliferation, survival, migration, anchorage-independent growth, indicators of EMT, cell signalling pathways and cell cycle proteins were examined using immunostaining, immunoblots, and quantitative, reverse transcriptase PCR (qRT-PCR), along with clonogenic, wound-closure and soft agar assays. RNA sequencing (RNAseq) was used to provide a transcriptomic profile. Results: ETCC-006 and ETCC-010 cells displayed notable differences to another DCIS cell line, MCF10DCIS.com, in terms of morphology, steroid-receptor/HER status and markers of EMT. The ETCC cell lines lack ER/PR and HER, form colonies in clonogenic assays, have migratory capacity and are capable of anchorage-independent growth. Despite being isogenic, less than 30% of differentially expressed transcripts overlapped between the two lines, with enrichment in receptor tyrosine kinase pathways and DNA replication/cell cycle programs. Conclusions: For the first time, we provide a molecular and cellular characterization of two, patient-derived DCIS cell lines, ETCC-006 and ETCC-010, facilitating future investigations into the molecular basis of DCIS to invasive ductal carcinoma transition.
Efficient Monitoring of Fall Risk in the Elderly via Functional Data Analysis
Authors: Wang Haiyan , Zhou Conggen , Kang Xiaoning , Deng Xinwei
Published: August 2020

Background: A disease screening service is a preventive healthcare service. Accurate and efficient disease examination based on continuous monitoring data obtained from diseased subjects is the basis of developing this service. The traditional disease screening method for a specific disease is designed according to the physical meaning of the collected data.Methods: In this paper, a general disease detection statistical model based on monitoring data is proposed. By analyzing the distribution of data obtained from subjects who may have certain diseases, we used functional data analysis to establish a statistical model and obtain an efficient algorithm for parameter estimation. Results: The proposed model is applied to a real example of an elderly fall risk screening service based on plantar pressure data collected from elderly individuals walking over obstacles. Reasonable intervals of the model parameters used to screen the elderly for fall risk are obtained from the training samples, which are used to estimate the fall risk of the elderly with the test samples.Conclusions: The study shows that the foot plantar pressure measured in screening tests can be characterized by functional data analysis, and a linear mixed effect model can be used when time points are fixed. The restricted maximum likelihood technique is used for parameter estimation, and a nonlinear optimization algorithm is employed to iteratively determine the model parameters. This paper is to provide a method of detecting falls in the elderly based on statistical data rather than the physical meaning of collected data.