bluuebunny/crossref_metadata_2025 huggingface dataset:
On axial compressive behavior of steel fiber reinforced concrete confined by FRP
Authors: Saberi Hossein , Hatami Farzad , Rahai Alireza
Published: January 2021

In this study, the co-effects of steel fibers and FRP confinement on the concrete behavior under the axial compression load are investigated. Thus, the experimental tests were conducted on 18 steel fiber-reinforced concrete (SFRC) specimens confined by FRP. Moreover, 24 existing experimental test results of FRP-conﬁned specimens tested under axial compression are gathered to compile a reliable database for developing a mathematical model. In the conducted experimental tests, the concrete strength was varied as 26 MPa and 32.5 MPa and the steel fiber content was varied as 0.0%, 1.5%, and 3%. The specimens were confined with one and two layers of glass fiber reinforced polymer (GFRP) sheet. The experimental test results show that simultaneously using the steel fibers and FRP confinement in concrete not only significantly increases the peak strength and ultimate strain of concrete but also solves the issue of sudden failure in the FRP-confined concrete. The simulations confirm that the results of the proposed model are in good agreement with those of experimental tests.
Rewilding policy futures: Maori whakapapa and the ecology of the subject
Authors: Irwin Ruth
Published: January 2021

The world is changing, but political and educational institutions appears to be stuck in the 19th century. Modern policy and education are both premised on an Enlightenment assumption of the human, rational, individual subject. Increasingly, elements of these philosophical premises are being interrogated. The critique emerges from the environmental interest in collapsing the dualism between subject and object, and reintegrating the human with/in our ecological context. Indigenous philosophy is important for rethinking the integration of the dualism between humanity and ecology. Maori philosophy is a vital counterpoint to the anthropomorphic position of modern policy and education. Taking Maori concepts to inform contemporary philosophy generates a substantive shift in world view that does not lose sight of the solipsist, phenomenological parameters of human sense making, but enables us to make deeper ethical decisions, and transform the basis of education and policy.
Psychological and Cognitive Barriers to Diabetes-Related Foot Complication Treatment: Clinicians’ Perspectives
Authors: Nguyen Mai , Wong Dana , Barson Elizabeth , Staunton Eva Therese , Fisher Caroline Anne
Published: January 2021

This study investigated clinicians’ perspectives about cognitive functioning and mental health in individuals with diabetes-related foot complications (DRFCs), and how these impact the clinicians’ treatment of the patients’ conditions. Psychological and cognitive impairments may be more pronounced in individuals with DRFCs compared with the general diabetes mellitus population. Understanding these factors will identify potential barriers to DRFC treatment adherence and effective disease self-management. Fourteen multidisciplinary clinicians (Meanage = 37.86 years; standard deviation = 9.26; range = 27-51) were recruited from a metropolitan hospital diabetic foot unit. Semistructured interviews were conducted with each clinician, followed by the completion of a brief quantitative questionnaire. Interview data were analyzed thematically. Six themes that encompassed factors affecting DRFC treatment were identified: (1) psychological and cognitive characteristics; (2) the person in the environment; (3) illness and self-identity; (4) burden of chronic disease; (5) engaging with treatment; and (6) the clinician and health system response. Quantitative questionnaire results coincided with qualitative findings, with endorsement of global psychological and cognitive impairment in individuals with DRFC, which considerably affected their ability to engage in treatment. From the perspectives of clinicians working with patients with DRFCs, psychological, cognitive, and social factors have a considerable influence on DRFC treatment and self-management. Further investigation of these factors and their interrelationships is necessary to enhance treatment adherence in individuals with DRFCs.
Pilot Study of French-Canadian Lifestyle Redesign® for Chronic Pain Management
Authors: Lagueux É. , Masse J. , Levasseur M. , Pagé R. , Dépelteau A. , Lévesque M.-H. , Tousignant-Laflamme Y. , Pinard A.-M.
Published: January 2021

As chronic pain (CP) interferes with an individual’s lifestyle by limiting meaningful activities and health-related quality of life (HRQoL), occupational therapy (OT) plays an important role in CP management interventions. This pilot study aimed to explore the influence of a 13-week French-Canadian Lifestyle Redesign® for CP. A mixed-methods research design including a preexperimental quantitative component pre-/posttest was used with 15 participants with fibromyalgia. Although pain remained unchanged after the intervention, improvements were observed in participants’ engagement in meaningful activities ( p < .01), life balance ( p < .01), mental components of HRQoL ( p < .01), depressive symptoms ( p = .047), and pain self-efficacy ( p < .01). After the intervention, phone interviews ( n = 6) highlighted the participants’ appreciation of the focus being placed on their daily routines and the development of a sense of belonging throughout the intervention. This study suggests the potential feasibility and benefits of an occupation-based approach in CP management.
Food Assistance Deserts in Central Florida: Identifying Service Gaps Using Spatial Analysis
Authors: Curran Emily , Armenia Amy
Published: January 2021

Food assistance works to relieve food insecurity, a persistent problem in the United States disproportionately affecting marginalized communities. In this study, we take a closer look at geographical service gaps in food assistance using Geographic Information System (GIS) analysis to measure food assistance deserts, a term for areas where the nearest food assistance location is more than a mile away from the population centroid of a block group. By combining geographic data with data from the American Community Survey, we identified characteristics and predictors of food assistance deserts. Our results indicate that locations of food assistance in Central Florida are generally responsive to the needs of the community but are lacking in more affluent areas. This research was made possible through a partnership between our institution and Second Harvest Food Bank of Central Florida. The affordability and accessibility of this project should serve as a model for assessing spatial inequality in social service agencies through collaborative community-based research.
Resuming Dental and Craniomaxillofacial Surgical Missions During the COVID-19 Pandemic: Guidelines and Recommendations
Authors: Mañón Victoria A. , Tran Ashley , Sifri Ziad C. , Aziz Shahid R.
Published: January 2021

Study Design:

Descriptive review article.

Objective:

The purpose of this article is to provide guidelines and recommendations for how to safely resume dental and craniomaxillofacial STSMs. The following considerations will be discussed: the need for extensive collaboration between organizations and local leadership, the importance of COVID-19 testing, use and management of personal protective equipment, team selection and training, social distancing protocols, and criteria for patient and case selection.

Methods:

A literature review was completed, identifying resources and current data regarding the safe resumption clinical activities during the COVID-19 pandemic.

Results:

At this time, there are no protocols developed regarding the safe resumption of STSMs. Primary resources, including the CDC, WHO, and FDA should be closely monitored so that developed protocols from these recommendations reflect the latest information.

Conclusion:

This paper outlines general considerations and recommendations for dentists, oral health specialists, and craniomaxillofacial surgeons seeking to safely resume STSMs. These recommendations are designed to minimize the risk of exposure to COVID-19 by reinforcing social distancing protocols, reviewing criteria for patient and case selections, encouraging collaboration between organizations and local leadership, and team training. These guidelines should be tailored to fit the needs of each individual mission while keeping the safety as the main objective.
Exploring the opinion of stakeholders about self-care, home care and hospital management of heart failure patients: A qualitative study
Authors: Kumari Bandna , Kaur Sukhpal , Dutta Monika , Barwad Parag , Bahl Ajay
Published: January 2021

Introduction

Heart failure is a widespread chronic cardiac illness with varying etiologies. If the HF patients manage themselves at home by following the appropriate advice by healthcare professionals, they tend to have better quality of life and less readmissions. This study was aimed to identify and explore practices of self-management by heart failure patients, home management of heart failure by their family caregivers and hospital management by healthcare providers.

Methods

A qualitative study was conducted in a tertiary care center in Northern India on participants (patients, their family caregivers, doctors and nurses) who were recruited purposively and interviewed individually by principle investigator using semi-structured questionnaires. Interviews were audio recorded and transcribed after taking informed consent. Iterative process including coding, reviewing and analyzing was done by four researchers and themes were finalized.

Results

Total 41 participants (15 patients, 12 family caregivers, 4 doctors and 10 nurses) completed the interviews. It was observed that patients and family caregivers were not able to manage heart failure efficiently. Nurses and doctors reported many barriers to provide specialized care to these patients.

Discussion

There were definite barriers and challenges in the management of heart failure symptoms by the stakeholders. For the patients and family members who suffer this debilitating illness, managing heroically is a challenge. It is important to develop self-care management protocol for the heart failure patients. Healthcare professionals must overcome the barriers to train patients and family caregivers. Multidisciplinary integration can fulfill the gap in providing care to such patients.
Patient Perspective on the Management of Cancer Pain in Spain
Authors: García-Foncillas Jesús , Antón-Torres Antonio , Caballero-Martínez Fernando , Campos Francisco J , Feyjoo Margarita , de Liaño Alfonso Gómez , Monge Diana , Camps Carlos
Published: January 2021

Pain in cancer is often underdiagnosed and undertreated. Breakthrough pain, in particular, severely impacts the quality of life of patients. In this study, we evaluated management and care of pain in Spain from the patient perspective by assessing the experience of 275 patients who had suffered breakthrough pain. Although most patients had suffered moderate-to-severe pain in the last 24 hours, pain relief was achieved in the majority of cases. The body areas with a higher pain intensity was felt varied based on primary cancer. Adherence to treatment was subpar, and patients were moderately concerned about addiction to treatment and adverse events. Doctors did not assess pain in every visit and there is room for improvement in its classification. Education strategies directed toward patients and health care personnel are needed to improve pain assessment, follow-up, and compliance. These could guide shared decision-making and improve communication about cancer pain to improve its care.
Aerodynamic-Parameter Identification and Attitude Control of Quad-Rotor Model with CIFER and Adaptive LADRC
Authors: Yang Sen , Xi Leiping , Hao Jiaxing , Wang Wenjie
Published: January 2021

Current research on quadrotor modeling mainly focuses on theoretical analysis methods and experimental methods, which have problems such as weak adaptability to the environment, high test costs, and long durations. Additionally, the PID controller, which is currently widely used in quadrotors, requires improvement in anti-interference. Therefore, the aforementioned research has considerable practical significance for the modeling and controller design of quadrotors with strong coupling and nonlinear characteristics. In the present research, an aerodynamic-parameter estimation method and an adaptive attitude control method based on the linear active disturbance rejection controller (LADRC) are designed separately. First, the motion model, dynamics model, and control allocation model of the quad-rotor are established according to the aerodynamic theory and Newton–Euler equations. Next, a more accurate attitude model of the quad-rotor is obtained by using a tool called CIFER to identify the aerodynamic parameters with large uncertainties in the frequency domain. Then, an adaptive attitude decoupling controller based on the LADRC is designed to solve the problem of the poor anti-interference ability of the quad-rotor and adjust the key control parameter b0automatically according to the change in the moment of inertia in real time. Finally, the proposed approach is verified on a semi-physical simulation platform, and it increases the tracking speed and accuracy of the controller, as well as the anti-disturbance performance and robustness of the control system. This paper proposes an effective aerodynamic-parameter identification method using CIFER and an adaptive attitude decoupling controller with a sufficient anti-interference ability.
The CEBPE rs2239633 genetic polymorphism on susceptibility to childhood acute lymphoblastic leukemia: an updated meta-analysis
Authors: Liu Jin , Weiling Gu , Xueqin Li , Liang Xie , Linhong Wang , Zhongwen Chen
Published: January 2021

Objectives

We performed an updated meta-analysis to clarify the relationship between the CEBPE rs2239633 polymorphism and the childhood acute lymphoblastic leukemia (CALL) susceptibility.

Methods

All the case-control studies were updated on October 5, 2020, through Web of Science, PubMed, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI) electronic database. The heterogeneity in the study was tested by the Q test and I2, and then the random ratio or fixed effect was utilized to merge the odds ratios (OR) and 95% confidence interval (CI). We also performed sensitivity analysis to estimate the impact of individual studies on aggregate estimates. Publication bias was investigated by using funnel plot and Egger’s regression test. All statistical analyses were performed using Stata 12.0.

Results

A total of 20 case-control studies were selected, including 7014 patients and 16,428 controls. There was no association of CEBPE rs2239633 polymorphism with CALL (CC vs CT + TT: OR = 1.08, 95% CI = 0.94–1.26; CC + CT vs TT: OR = 1.10, 95% CI = 0.94–1.30; C vs T: OR = 1.02, 95% CI = 0.92–1.13). In the subgroup analysis by ethnicity, there is no significant association of this polymorphism and CALL risks among Asian and Caucasian populations in the three genetic models (CC vs CT + TT, CC + CT vs TT, and C vs T).

Conclusion

This meta-analysis found no significant association between the CEBPE rs2239633 polymorphism and susceptibility to CALL.
Cooperative messages to enhance the performance of L3 vehicles approaching roadworks
Authors: Agriesti Serio Angelo Maria , Ponti Marco , Marchionni Giovanna , Gandini Paolo
Published: January 2021

Introduction

In the near future, automated vehicles will drive on public roads together with traditional vehicles. Even though almost the whole academia agrees on that statement, the possible interferences between the two different kinds of driver are still to be analyzed and the real impacts on the traffic flow to be under-stood.

Objectives

Aim of this paper is to study one of the most likely L3 automated system to be deployed on public roads in the short term: Highway Chauffeur. The analysis of this system is carried out on a roadwork scenario to assess the positive impacts arising from a joint implementation of the automated system and the C-ITS Use Case signaling the closure of a lane. In fact, the main contribution of this paper is the assessment of the possible benefits in travel times and driving regime arising from the joint implementation of the Highway Chauffeur system and of C-ITS messages, both for the vehicles equipped with both technologies and for the surrounding traffic.

Methods

The assessment is achieved through traffic simulations carried out with the VISSIM software and a Python script developed by the authors. The overall process is described and the obtained results are provided, commented and compared to define the implementation of the C-ITS Use Case that could maximize the benefits of L3 driving.

Results

These results showed how triggering the take-over maneuver in ad-vance fosters the bottleneck efficiency (the same speed values reached between 80 and 100% Market Penetration for around 700 m range of the C-ITS message are reached at 50% Market Penetration with a 1500 m range). Besides, an in-creased speed up to 30 km/h at the bottleneck is recorded, depending on the mar-ket penetration and the message range. Finally, the delay upstream the roadworks entrance is reduced by 6% and arises at around 700 m, without the need to deploy the message up to 1500 m.

Conclusions

The paper investigates the impacts of take-over maneuvers and of automated driving while considering different operational parameters such as the message range. The results suggest all the potentialities of the Use Case while providing interesting figures that frame the trends related to the different imple-mentations. Finally, the tool developed to carry out the presented analysis is re-ported and made available so that hopefully the Use Case may be explored further and a precise impact assessment may be carried out with different prototypes of AVs and on different infrastructures.
Prevalence and correlates of maternal early stimulation behaviors during pregnancy in northern Ghana: a cross-sectional survey
Authors: Mackness Jessica , Gallis John A. , Owusu Raymond Kofi , Ali Mohammed , Abubakr-Bibilazu Safiyatu , Adam Haliq , Aborigo Raymond , Awoonor-Williams John Koku , Lillie Margaret , McEwan Elena , Hembling John , Vasudevan Lavanya , Baumgartner Joy Noel
Published: January 2021

Background

Per UNICEF’s Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana.

Methods

This cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis.

Results

About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors.

Conclusion

Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development.

Trial registration

Clinical Trials # NCT03665246, August 29, 2018.
Childcare practices among teenage mothers in Ghana: a qualitative study using the ecological systems theory
Authors: Twintoh Reuben Foster , Anku Prince Justin , Amu Hubert , Darteh Eugene Kofour Maafo , Korsah Kwaku Kissah
Published: January 2021

Background

While appropriate care for children is essential for optimal growth and protection against child morbidity and mortality, teenage mothers have been shown to deviate from the recommended childcare practices. This study explored the childcare practices among teenage mothers in Ghana using Ecological Systems Theory by Bronfenbrenner as a theoretical framework.

Methods

Employing qualitative approach to inquiry, evidence was drawn from 30 teenage mothers using in-depth interviews. The data were analysed and presented following systematic qualitative-oriented text analysis strategy with verbatim quotes from study participants to support the emergent themes.

Results

It was evident that teenage mothers have limited skills in childcare practices and often resorted to practices with potentially adverse health outcomes for their children. They, for instance, applied hot towels they had heated with hot stones to the children’s umbilical stump. We found that teenage mothers were not in sync with their macro- and exo-systems, thereby depriving themselves and their babies of the much-needed guidance and support in caring for their babies. Teenage mothers were often confused and sometimes clueless about best childcare practices at a given point in time.

Conclusions

Childcare practices by teenage mothers are far from the ideal. To improve on child health (especially children born to teenage mothers), efforts at both the macro- and exo-systems should be directed at exposing teenage mothers to best child care practices that inure to the benefits of their children. Ante- and postnatal visits should be used to provide specific education for mothers, especially first-time teenage mothers on the care needs of babies and how to provide these needs.
Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study
Authors: Chen Xu , Du Liang , Wu Ruiheng , Xu Jia , Ji Haoqiang , Zhang Yu , Zhu Xuexue , Zhou Ling
Published: January 2021

Background

The stigma of tuberculosis (TB) poses a significant challenge to TB control because it leads to delayed diagnosis and non-adherence. However, few studies on TB-related stigma have been completed in China. The aim of the current study was to explore the status of TB-related stigma and its associated predictive factors among TB patients in Dalian, Northeast China.

Methods

An institution-based, cross-sectional survey was conducted among outpatients at Dalian Tuberculosis Hospital in Liaoning Province, Northeast China. Data were collected by using a questionnaire that measured TB-related stigma, treatment status, anxiety, social support, doctor-patient communication and so on. A multiple linear regression model was used to determine the predictors of TB-related stigma.

Results

A total of 601 eligible participants were recruited. The mean score for TB-related stigma was 9.07, and the median score was 10. The average scores for anxiety, social support and doctor-patient communication were 4.03, 25.41 and 17.17, respectively. Multiple linear regression analysis revealed that patients who were female (β = 1.19, 95% CI: 0.38–2.01, P < 0.05), had self-assessed moderate or severe disease (β = 1.08, 95% CI: 0.12–2.03 and β = 1.36, 95% CI: 0.03–2.70, respectively, P < 0.05), and had anxiety (β = 0.38, 95% CI: 0.30–0.46, P < 0.001) were more likely to have a greater level of TB-related stigma than their counterparts. However, a significantly lower level of TB-related stigma was observed in patients with good social support (β = − 0.25, 95% CI: − 0.33--0.17, P < 0.001) and doctor-patient communication (β = − 0.14, 95% CI: − 0.29--0.00, P < 0.05).

Conclusions

This study showed that stigma among TB patients was high. Targeted attention should be paid to female patients and patients with moderate or severe disease in TB stigma-related interventions. Moreover, the important role of social support and doctor-patient communication in reducing TB-related stigma should also be emphasized.
Clinical teaching of university-degree nursing students: are the nurses in practice in Uganda ready?
Authors: Drasiku Amos , Gross Janet L. , Jones Casey , Nyoni Champion N.
Published: January 2021

Background

Nurses with degree qualifications offer better nursing care compared to nurses prepared at lower levels. University based nursing degrees have been sanctioned as entry into professional nursing and several low-resource states have introduced university based nursing degrees. The clinical teaching of students enrolled in such degrees is challenged, as most nurses in practice do not have university degrees and may not have the necessary skills to facilitate clinical learning as expected at degree level. A university in Uganda established a bachelor’s degree in Nursing program and was expecting to use nurses in practice at a teaching hospital for the clinical teaching of university-degree nursing students. This study reports on the perceptions of the nurses in practice regarding their readiness for the clinical teaching of undergraduate nursing students.

Methods

A qualitative descriptive research study was conducted among 33 conveniently sampled nurses from Arua Regional Referral Hospital (ARRH) who had been supervising Diploma and/or Certificate in Nursing students. Five focus group discussions and three informant interviews were used to generate the data. Data were transcribed verbatim and analysed using an inductive approach through thematic analysis.

Results

The nurses in practice perceived themselves as ready for clinical teaching of undergraduate nursing students. Three themes emerged namely; “Willingness to teach undergraduate students” “Perceived attributes of undergraduate students”, and “The clinical practice environment”.

Conclusion

The nurses in practice need support in the execution of the clinical teaching role of university-degree nursing students. The nature of supports would include, continuing professional development specific to clinical teaching, engaging the educators in the clinical environment, positively engaging power gradients and address insecurities among the nurses and the students. Students in these programmes should be exposed to the clinical environment earlier within the programme, and be exposed to interprofessional and trans-professional education.
A splice-site variant (c.3289-1G>T) in OTOF underlies profound hearing loss in a Pakistani kindred
Authors: Ahmed Ashfaque , Wang Meng , Khan Rizwan , Shah Abid Ali , Guo Hui , Malik Sajid , Xia Kun , Hu Zhengmao
Published: January 2021

Background

Hearing loss/deafness is a common otological disorder found in the Pakistani population due to the high prevalence of consanguineous unions, but the full range of genetic causes is still unknown.

Methods

A large consanguineous Pakistani kindred with hearing loss was studied. Whole-exome sequencing and Sanger sequencing were performed to search for the candidate gene underlying the disease phenotype. A minigene assay and reverse transcription polymerase chain reaction was used to assess the effect of splicing variants.

Results

The splicing variants of OTOF (NM_194248, c.3289-1G>T) cosegregated with the disease phenotype in this Pakistani family. The substitution of a single base pair causes the deletion of 10 bp (splicing variant 1) or 13 bp (splicing variant 2) from exon 27, which results in truncated proteins of 1141 and 1140 amino acids, respectively.

Conclusion

Our findings reveal an OTOF splice-site variant as pathogenic for profound hearing loss in this family.
Leptin Receptor (LEPR) promotes proliferation, migration, and invasion and inhibits apoptosis in hepatocellular carcinoma by regulating ANXA7
Authors: Huang He , Zhang Jun , Ling Fei , Huang Yuhong , Yang Min , Zhang Yao , Wei Yuanyi , Zhang Qingqing , Wang Honghai , Song Lin , Wu Ying , Yang Jiayu , Tang Jianwu
Published: January 2021

Background

Leptin Receptor (LEPR) has been suggested to have several roles in cancer metastasis. However, the role of LEPR and its underlying mechanisms in lymphatic metastasis of hepatocarcinoma have not yet been studied.

Methods

We performed bioinformatics analysis, qRT-PCR, western blotting, immunohistochemistry, immunofluorescence, enzyme-linked immunosorbent, coimmunoprecipitation assays and a series of functional assays to investigate the roles of LEPR in hepatocellular carcinoma.

Results

We discovered that LEPR was highly expressed in liver cancer tissues, and the expression of LEPR in Hca-F cells was higher than that in Hca-P cells. Furthermore, LEPR promotes the proliferation, migration and invasion and inhibits the apoptosis of hepatocarcinoma lymphatic metastatic cells. Further studies indicated that LEPR interacts with ANXA7. Mechanistically, LEPR regulated ERK1/2 and JAK2/STAT3 expression via ANXA7 regulation.

Conclusions

These findings unveiled a previously unappreciated role of LEPR in the regulation of lymphatic metastatic hepatocellular carcinoma, assigning ANXA7-LEPR as a promising therapeutic target for liver cancer treatments.
Cytokine-chemokine network driven metastasis in esophageal cancer; promising avenue for targeted therapy
Authors: Bhat Ajaz A. , Nisar Sabah , Maacha Selma , Carneiro-Lobo Tatiana Correa , Akhtar Sabah , Siveen Kodappully Sivaraman , Wani Nissar A. , Rizwan Arshi , Bagga Puneet , Singh Mayank , Reddy Ravinder , Uddin Shahab , Grivel Jean-Charles , Chand Gyan , Frenneaux Michael P. , Siddiqi Mushtaq A. , Bedognetti Davide , El-Rifai Wael , Macha Muzafar A. , Haris Mohammad
Published: January 2021

Esophageal cancer (EC) is a disease often marked by aggressive growth and poor prognosis. Lack of targeted therapies, resistance to chemoradiation therapy, and distant metastases among patients with advanced disease account for the high mortality rate. The tumor microenvironment (TME) contains several cell types, including fibroblasts, immune cells, adipocytes, stromal proteins, and growth factors, which play a significant role in supporting the growth and aggressive behavior of cancer cells. The complex and dynamic interactions of the secreted cytokines, chemokines, growth factors, and their receptors mediate chronic inflammation and immunosuppressive TME favoring tumor progression, metastasis, and decreased response to therapy. The molecular changes in the TME are used as biological markers for diagnosis, prognosis, and response to treatment in patients. This review highlighted the novel insights into the understanding and functional impact of deregulated cytokines and chemokines in imparting aggressive EC, stressing the nature and therapeutic consequences of the cytokine-chemokine network. We also discuss cytokine-chemokine oncogenic potential by contributing to the Epithelial-Mesenchymal Transition (EMT), angiogenesis, immunosuppression, metastatic niche, and therapeutic resistance development. In addition, it discusses the wide range of changes and intracellular signaling pathways that occur in the TME. Overall, this is a relatively unexplored field that could provide crucial insights into tumor immunology and encourage the effective application of modulatory cytokine-chemokine therapy to EC.
TNFα priming through its interaction with TNFR2 enhances endothelial progenitor cell immunosuppressive effect: new hope for their widespread clinical application
Authors: Nouri Barkestani Mahsa , Shamdani Sara , Afshar Bakshloo Mazdak , Arouche Nassim , Bambai Bijan , Uzan Georges , Naserian Sina
Published: January 2021

Background

Bone marrow derived endothelial progenitor cells (EPCs) are immature endothelial cells (ECs) involved in neo-angiogenesis and endothelial homeostasis and are considered as a circulating reservoir for endothelial repair. Many studies showed that EPCs from patients with cardiovascular pathologies are impaired and insufficient; hence, allogenic sources of EPCs from adult or cord blood are considered as good choices for cell therapy applications. However, allogenic condition increases the chance of immune rejection, especially by T cells, before exerting the desired regenerative functions. TNFα is one of the main mediators of EPC activation that recognizes two distinct receptors, TNFR1 and TNFR2. We have recently reported that human EPCs are immunosuppressive and this effect was TNFα-TNFR2 dependent. Here, we aimed to investigate if an adequate TNFα pre-conditioning could increase TNFR2 expression and prime EPCs towards more immunoregulatory functions.

Methods

EPCs were pre-treated with several doses of TNFα to find the proper dose to up-regulate TNFR2 while keeping the TNFR1 expression stable. Then, co-cultures of human EPCs and human T cells were performed to assess whether TNFα priming would increase EPC immunosuppressive and immunomodulatory effect.

Results

Treating EPCs with 1 ng/ml TNFα significantly up-regulated TNFR2 expression without unrestrained increase of TNFR1 and other endothelial injury markers. Moreover, TNFα priming through its interaction with TNFR2 remarkably enhanced EPC immunosuppressive and anti-inflammatory effects. Conversely, blocking TNFR2 using anti-TNFR2 mAb followed by 1 ng/ml of TNFα treatment led to the TNFα-TNFR1 interaction and polarized EPCs towards pro-inflammatory and immunogenic functions.

Conclusions

We report for the first time the crucial impact of inflammation notably the TNFα-TNFR signaling pathway on EPC immunological function. Our work unveils the pro-inflammatory role of the TNFα-TNFR1 axis and, inversely the anti-inflammatory implication of the TNFα-TNFR2 axis in EPC immunoregulatory functions. Priming EPCs with 1 ng/ml of TNFα prior to their administration could boost them toward a more immunosuppressive phenotype. This could potentially lead to EPCs’ longer presence in vivo after their allogenic administration resulting in their better contribution to angiogenesis and vascular regeneration.
The evidence base for physiotherapy in myalgic encephalomyelitis/chronic fatigue syndrome when considering post-exertional malaise: a systematic review and narrative synthesis
Authors: Wormgoor Marjon E. A. , Rodenburg Sanne C.
Published: January 2021

Background

Due to the inconsistent use of diagnostic criteria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), it is unsure whether physiotherapeutic management regarded effective in ME/CFS is appropriate for patients diagnosed with criteria that consider post-exertional malaise (PEM) as a hallmark feature.

Purpose

To appraise current evidence of the effects of physiotherapy on symptoms and functioning in ME/CFS patients in view of the significance of PEM in the applied diagnostic criteria for inclusion.

Methods

A systematic review of randomized controlled trials published over the last two decades was conducted. Studies evaluating physiotherapeutic interventions for adult ME/CFS patients were included. The diagnostic criteria sets were classified into three groups according to the extent to which the importance of PEM was emphasized: chronic fatigue (CF; PEM not mentioned as a criterion), CFS (PEM included as an optional or minor criterion) or ME (PEM is a required symptom). The main results of included studies were synthesized in relation to the classification of the applied diagnostic criteria. In addition, special attention was given to the tolerability of the interventions.

Results

Eighteen RCTs were included in the systematic review: three RCTs with CF patients, 14 RCTs with CFS patients and one RCT covering ME patients with PEM. Intervention effects, if any, seemed to disappear with more narrow case definitions, increasing objectivity of the outcome measures and longer follow-up.

Conclusion

Currently, there is no scientific evidence when it comes to effective physiotherapy for ME patients. Applying treatment that seems effective for CF or CFS patients may have adverse consequences for ME patients and should be avoided.
Obesity and COVID-19: what makes obese host so vulnerable?
Authors: Mohammad Sameer , Aziz Rafia , Al Mahri Saeed , Malik Shuja Shafi , Haji Esraa , Khan Altaf Husain , Khatlani Tanvir Saleem , Bouchama Abderrezak
Published: January 2021

The disease (COVID-19) novel coronavirus pandemic has so far infected millions resulting in the death of over a million people as of Oct 2020. More than 90% of those infected with COVID-19 show mild or no symptoms but the rest of the infected cases show severe symptoms resulting in significant mortality. Age has emerged as a major factor to predict the severity of the disease and mortality rates are significantly higher in elderly patients. Besides, patients with underlying conditions like Type 2 diabetes, cardiovascular diseases, hypertension, and cancer have an increased risk of severe disease and death due to COVID-19 infection. Obesity has emerged as a novel risk factor for hospitalization and death due to COVID-19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to COVID-19. Here we review the published data related to obesity and overweight to assess the possible risk and outcome in Covid-19 patients based on their body weight. Besides, we explore how the obese host provides a unique microenvironment for disease pathogenesis, resulting in increased severity of the disease and poor outcome.
Predicting risk of early discontinuation of exclusive breastfeeding at a Brazilian referral hospital for high-risk neonates and infants: a decision-tree analysis
Authors: Silva Maíra Domingues Bernardes , de Oliveira Raquel de Vasconcellos Carvalhaes , da Silveira Barroso Alves Davi , Melo Enirtes Caetano Prates
Published: January 2021

Background

Determinants at several levels may affect breastfeeding practices. Besides the known historical, socio-economic, cultural, and individual factors, other components also pose major challenges to breastfeeding. Predicting existing patterns and identifying modifiable components are important for achieving optimal results as early as possible, especially in the most vulnerable population. The goal of this study was building a tree-based analysis to determine the variables that can predict the pattern of breastfeeding at hospital discharge and at 3 and 6 months of age in a referral center for high-risk infants.

Methods

This prospective, longitudinal study included 1003 infants and was conducted at a high-risk public hospital in the following three phases: hospital admission, first visit after discharge, and monthly telephone interview until the sixth month of the infant’s life. Independent variables were sorted into four groups: factors related to the newborn infant, mother, health service, and breastfeeding. The outcome was breastfeeding as per the categories established by the World Health Organization (WHO). For this study, we performed an exploratory analysis at hospital discharge and at 3 and at 6 months of age in two stages, as follows: (i) determining the frequencies of baseline characteristics stratified by breastfeeding indicators in the three mentioned periods and (ii) decision-tree analysis.

Results

The prevalence of exclusive breastfeeding (EBF) was 65.2% at hospital discharge, 51% at 3 months, and 20.6% at 6 months. At hospital discharge and the sixth month, the length of hospital stay was the most important predictor of feeding practices, also relevant at the third month. Besides the mother’s and child’s characteristics (multiple births, maternal age, and parity), the social context, work, feeding practice during hospitalization, and hospital practices and policies on breastfeeding influenced the breastfeeding rates.

Conclusions

The combination algorithm of decision trees (a machine learning technique) provides a better understanding of the risk predictors of breastfeeding cessation in a setting with a large variability in expositions. Decision trees may provide a basis for recommendations aimed at this high-risk population, within the Brazilian context, in light of the hospital stay at a neonatal unit and period of continuous feeding practice.
Nutritional supplements and mother’s milk composition: a systematic review of interventional studies
Authors: Keikha Mojtaba , Shayan-Moghadam Ramin , Bahreynian Maryam , Kelishadi Roya
Published: January 2021

Background

This study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk.

Methods

We systematically searched electronic databases including Medline via PubMed, Scopus and ISI Web of Science till May 24, 2018. The following terms were used systematically in all mentioned databases: (“human milk” OR “breast milk” OR “breast milk composition” OR “human breast milk composition” OR “composition breast milk” OR “mother milk” OR “human breast milk” OR “maternal milk”) AND (“vitamin a” OR “retinol” OR “retinal” OR “retinoic acid” OR “beta-carotene” OR “beta carotene” OR “ascorbic acid” OR “l-ascorbic acid” OR “l ascorbic acid” OR “vitamin c” OR “vitamin d” OR “cholecalciferol” OR “ergocalciferol” OR “calciferol” OR “vitamin e” OR “tocopherol” OR “tocotrienol” OR “alpha-tocopherol” OR “alpha tocopherol” OR “α-tocopherol” OR “α tocopherol” OR “vitamin k” OR “vitamin b” OR “vitamin b complex” OR “zinc” OR “iron” OR “copper” Or “selenium” OR “manganese” OR “magnesium”) and we searched Medline via Medical subject Headings (MeSH) terms. We searched Google Scholar for to increase the sensitivity of our search. The search was conducted on human studies, but it was not limited to the title and abstract. Methodological quality and risk of bias of included studies were evaluated by Jadad scale and Cochrane risk of bias tools, respectively.

Results

This review included papers on three minerals (zinc, iron, selenium) and 6 vitamins (vitamin A, B, D, C, E and K) in addition to multi-vitamin supplements. Although studies had different designs, e.g. not using random allocation and/or blinding, our findings suggest that maternal use of some dietary supplements, including vitamin A, D, vitamin B1, B2 and vitamin C might be reflected in human milk. Vitamin supplements had agreater effect on breast milk composition compared to minerals. Higher doses of supplements showed higher effects and they were reflected more in colostrum than in the mature milk.

Conclusion

Maternal dietary vitamin and/or mineral supplementation, particularly fat- soluble vitamins, vitamin B1, B2 and C might be reflected in the breast milk composition. No difference was found between mega dose and single dose administration of minerals.
ASC-J9® suppresses prostate cancer cell proliferation and invasion via altering the ATF3-PTK2 signaling
Authors: Tian Hao , Chou Fu-ju , Tian Jing , Zhang Yong , You Bosen , Huang Chi-Ping , Yeh Shuyuan , Niu Yuanjie , Chang Chawnshang
Published: January 2021

Background

Early studies indicated that ASC-J9®, an androgen receptor (AR) degradation enhancer, could suppress the prostate cancer (PCa) progression. Here we found ASC-J9® could also suppress the PCa progression via an AR-independent mechanism, which might involve modulating the tumor suppressor ATF3 expression.

Methods

The lentiviral system was used to modify gene expression in C4–2, CWR22Rv1 and PC-3 cells. Western blot and Immunohistochemistry were used to detect protein expression. MTT and Transwell assays were used to test the proliferation and invasion ability.

Results

ASC-J9® can suppress PCa cell proliferation and invasion in both PCa C4–2 and CWR22Rv1 cells via altering the ATF3 expression. Further mechanistic studies reveal that ASC-J9® can increase the ATF3 expression via decreasing Glutamate-cysteine ligase catalytic (GCLC) subunit expression, which can then lead to decrease the PTK2 expression. Human clinical studies further linked the ATF3 expression to the PCa progression. Preclinical studies using in vivo mouse model also proved ASC-J9® could suppress AR-independent PCa cell invasion, which could be reversed after suppressing ATF3.

Conclusions

ASC-J9® can function via altering ATF3/PTK2 signaling to suppress the PCa progression in an AR-independent manner.
Hepatitis B virus P protein initiates glycolytic bypass in HBV-related hepatocellular carcinoma via a FOXO3/miRNA-30b-5p/MINPP1 axis
Authors: Chen Wenbiao , Jiang Jingjing , Gong Lan , Shu Zheyue , Xiang Dairong , Zhang Xujun , Bi Kefan , Diao Hongyan
Published: January 2021

Background

Hepatitis B virus (HBV) infection is a crucial risk factor for hepatocellular carcinoma (HCC). However, its underlying mechanism remains understudied.

Methods

Microarray analysis was conducted to compare the genes and miRNAs in liver tissue from HBV-positive and HBV-negative HCC patients. Biological functions of these biomarkers in HBV-related HCC were validated via in vitro and in vivo experiments. Furthermore, we investigated the effect of HBV on the proliferation and migration of tumor cells in HBV-positive HCC tissue. Bioinformatics analysis was then performed to validate the clinical value of the biomarkers in a large HCC cohort.

Results

We found that a gene, MINPP1 from the glycolytic bypass metabolic pathway, has an important biological function in the development of HBV-positive HCC. MINPP1 is down-regulated in HBV-positive HCC and could inhibit the proliferation and migration of the tumor cells. Meanwhile, miRNA-30b-5p was found to be a stimulator for the proliferation of tumor cell through glycolytic bypass in HBV-positive HCC. More importantly, miRNA-30b-5p could significantly downregulate MINPP1 expression. Metabolic experiments showed that the miRNA-30b-5p/MINPP1 axis is able to accelerate the conversion of glucose to lactate and 2,3-bisphosphoglycerate (2,3-BPG). In the HBV-negative HCC cells, miRNA-30b-5p/MINPP1 could not regulate the glycolytic bypass to promote the tumorigenesis. However, once HBV was introduced into these cells, miRNA-30b-5p/MINPP1 significantly enhanced the proliferation, migration of tumor cells, and promoted the glycolytic bypass. We further revealed that HBV infection promoted the expression of miRNA-30b-5p through the interaction of HBV protein P (HBp) with FOXO3. Bioinformatics analysis on a large cohort dataset showed that high expression of MINPP1 was associated with favorable survival of HBV-positive HCC patients, which could lead to a slower progress of this disease.

Conclusion

Our study found that the HBp/FOXO3/miRNA-30b-5p/MINPP1 axis contributes to the development of HBV-positive HCC cells through the glycolytic bypass. We also presented miRNA-30b-5p/MINPP1 as a novel biomarker for HBV-positive HCC early diagnosis and a potential pharmaceutical target for antitumor therapy.