bluuebunny/crossref_metadata_2025 huggingface dataset:
A phase II study of daily carboplatin plus irradiation followed by durvalumab for stage III non-small cell lung cancer patients with PS 2 up to 74 years old and patients with PS 0 or 1 from 75 years: NEJ039A (trial in progress)
Authors: Kaira Kyoichi , Mouri Atsuto , Kato Shingo , Yoshimura Kenichi , Kagamu Hiroshi , Kobayashi Kunihiko
Published: October 2020

Background

Durvalumab is a standard drug used during maintenance therapy after chemoradiotherapy in patients with locally advanced non-small cell lung cancer (LA-NSCLC). However, little is known about the clinical benefits of durvalumab after chemoradiotherapy in patients with LA-NSCLC with a performance status (PS) of 2 and/or aged > 75 years. As daily carboplatin plus concurrent thoracic radiotherapy is recommended for elderly patients according to guideline, the current phase II study aims to investigate the effect of daily carboplatin plus radiotherapy followed by durvalumab for patients with stage III NSCLC who have a PS of 2 and/or are older.

Methods

Daily carboplatin plus radiotherapy followed by durvalumab is performed for the patients with stage III NSCLC who have a PS of 2 and/or are older. This is a trial in progress manuscript.

Study treatment

Daily, intravenous, low-dose carboplatin (30 mg/m2 in a 30-min infusion) is administered to patients 1 h before radiotherapy for the first 20 fractions. Radiotherapy for all patients consisted of 60 Gy administered as 30 fractions over 6 weeks. Durvalumab at a dose of 10 mg/kg/body is intravenously administered every 2 weeks for up to 12 months after chemoradiotherapy.

Exploratory assessment

In the future, an exploratory investigation will be performed to determine whether the combined assessment of T-cell markers, PD-L1 expression, and tumor mutation burden could predict the outcomes of the regimen.

Discussion

The results of our study will exhibit the efficacy and tolerability of durvalumab as maintenance therapy after daily carboplatin plus radiotherapy.

Trial registration

During the first registration (before induction chemoradiotherapy), 70 patients will be included; then, we include 58 patients during the second registration (before durvalumab treatment after chemoradiotherapy). https://jcrb.niph.go.jp/.

Primary endpoint

The primary endpoint of the current study is the 12-month progression-free survival (PFS) rate after the initiation of durvalumab.

Secondary endpoints

The secondary endpoints are the feasibility, objective response, PFS, overall survival, and adverse events.
Ultrasound findings in a case of Eales’ disease and ocular trauma with anterior chamber cholesterolosis
Authors: Lu Peng , Huang Jingjing
Published: October 2020

Background

Anterior chamber cholesterolosis is a rare phenomenon which occurs mostly in chronically blind eyes. We present the anterior and posterior ultrasound findings in a case of anterior chamber cholesterolosis secondary to Eales’ disease and ocular trauma, which may contribute to the understanding of the potential mechanism of this phenomenon.

Case presentation

A 48-year-old man presented with “sparking” right eye, which appeared soon after the ocular trauma. Both eyes were confirmed Eales’ disease in our center 8 years ago, and right eye remained no light perception since then. Intraocular pressure of right eye measured by Goldmann applanation tonometry was 1 mmHg. Slitlamp photograph revealed multiple polychromatic large crystals in anterior chamber. Ultrasound biomicroscopy showed that anterior chamber was filled with extensive large granular substances. Dense dotted hyperechoic foci and retinal detachment was found in B-scan ultrasound examination. The right eye was diagnosed as anterior chamber cholesterolosis secondary to Eales’ disease and ocular trauma. The patient was asymptomatic, and therefore was advised to have regular follow-up.

Conclusion

The findings of above imaging examinations, as well as complaint of “sparkling” eye appeared soon after ocular trauma elucidate that anterior chamber cholesterol crystals were from vitreous cavity. Any factors facilitating the communication of anterior chamber and vitreous body may lead to the occurrence of this rare phenomenon in predisposing eyes. The anterior and posterior ultrasound findings may give a clue on the potential mechanism.
Assessment of tear film lipid layer thickness in patients with Meibomian gland dysfunction at different ages
Authors: Li Junhua , Ma Jiling , Hu Man , Yu Jianqin , Zhao Yune
Published: October 2020

Background

To evaluate the correlations between lipid layer thickness (LLT) and morphology and function of the meibomian glands in patients who were diagnosed as meibomian gland dysfunction (MGD) in different age groups.

Methods

Patients who have diagnosed as obstructive MGD were included in this prospective, cross-sectional study. Patients were divided into three groups: young (ages 20–39 years), middle-aged (ages 40–59 years), and older (aged ≥60 years). All patients completed an Ocular Surface Disease Index (OSDI) questionnaire and were evaluated for LLT, tear meniscus height (TMH), noninvasive tear film break-up time (NI-BUT) measurement, invasive TBUT (ITBUT), corneal fluoresceinstaining (CFS) score, eyelid margin abnormalities, Schirmer I test, and MG function and morphology, by using the Keratograph 5 and LipiView interferometer.

Results

Two hundred and nine patients (209 eyes) were included. The median LLT of all patient was 57 nm (IQR, 36.5 nm), and the LLT values were significantly different among the young group (median, 51 nm; IQR, 23.5 nm), middle-aged group (median, 59.5 nm; IQR 46.5 nm) and older group (median, 62 nm; IQR, 42.5 nm) (P = 0.033, Kruskal-Wallis test). In regression analyses controlling for confounder factors sex and MG loss, the LLT was positively correlated with age (β = 5.539, P = 0.001). There was a negative correlation between LLT and MG dropout in the all (r = − 0.527, P < 0.001), young (r = − 0.536, P < 0.001), middle-aged (r = − 0.576, P < 0.001), and older (r = − 0.501, P < 0.001) groups. LLT was positively correlated with the MG expressibility in the all (r = 0.202, P = 0.003), middle-aged (r = 0.280, P = 0.044) and older (r = 0.452, p < 0.001) groups, but it was no statistical significance in the young group (r = 0.007, P = 0.949).

Conclusions

The thickness of LLT was increased with age and significantly correlated with both MG secretion and morphology in middle-aged and older patients with obstructive MGD. LLT measurement is a useful screening tool for detecting obstructive MGD and age as an influential factor should be accounted for when interpreting the meaning of the LLT value.

Trial registration

NCT02481167; Registered 25 June, 2015.
Risk areas for tuberculosis among children and their inequalities in a city from Southeast Brazil
Authors: Alves Yan Mathias , Berra Thaís Zamboni , Alves Luana Seles , de Assis Ivaneliza Simionato , Arcoverde Marcos Augusto Moraes , Ramos Antonio Carlos Vieira , Arroyo Luiz Henrique , Campoy Laura Terenciani , Bruce Alexandre Tadashi Inomata , dos Santos Felipe Lima , Souza Ludmilla Leidianne Limirio , de Almeida Crispim Juliane , Arcêncio Ricardo Alexandre
Published: October 2020

Background

The objective of the study was to identify areas of risk for the appearance of tuberculosis in children and their association with social inequalities in a municipality in southeastern Brazil.

Methods

Ecological study conducted in Ribeirão Preto, Brazil. To identify areas of spatial risk for tuberculosis in children, we used spatial scanning statistics. To analyze the association of cases of childhood tuberculosis with social vulnerability, we used the Social Vulnerability Index of São Paulo, and four explanatory statistical models were listed.

Results

There were 96 cases of childhood tuberculosis, of which 90 were geocoded through a process of converting addresses to geographic coordinates. A risk area was identified in the municipality, where children under 15 years old have 3.14 times greater risk of contracting tuberculosis than those living outside this area. The variables identified as risk factors were: number of private and collective households, proportion of children aged 0 to 5 years in the population, proportion of households without per capita income, and the proportion of private households with monthly nominal incomes of up to one quarter of wage minimums. The variables identified as protection factors were the proportion of women under the age of 30 years responsible for the household under and women responsible for the household with an average income over BRL 2344.

Conclusion

The study showed areas of risk for the occurrence of tuberculosis in children. The study is in line with the End TB Strategy and the 2030 Agenda, which aim to support strategic actions and, therefore, save the lives of children through the systematic, intensified, and comprehensive identification of children with tuberculosis respiratory symptoms in the community.
Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: a case report
Authors: Kitaoka Hiroki , Inatomi Jun , Chikai Hayato , Watanabe Keiko , Kumagai Tadayuki , Masui Ayako , Shimizu Nobutaka
Published: October 2020

Background

Renal abscess in children is a rare and severe form of infectious kidney disease that is responsible for several serious complications. In this report, we describe a previously healthy 5-year-old girl with a renal abscess caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli), which led to bacteremia and renal scarring.

Case presentation

The patient presented to our department with high fever, headache, vomiting for 2 days and high inflammatory response. We diagnosed her with a urinary tract infection and initiated treatment with ampicillin and cefotaxime. Gram-negative bacilli bacteremia was noted on day 3. On day 4, her fever persisted, and a computed tomography (CT) scan revealed a renal abscess in the left kidney. After identifying the bacteria as ESBL-producing E. coli from the blood culture, we switched to the antibiotic meropenem and continued treatment for 3 weeks. The renal abscess was not drained. Although the renal abscess was successfully treated and it disappeared, a low-density area remained in same lesion on subsequent CT scans and a dimercaptosuccinic acid renal scan performed 4 months after onset revealed renal scarring.

Conclusion

Given the increasing prevalence of ESBL-producing microorganisms, clinicians should be aware of the possibility of renal abscesses caused by community-acquired ESBL-producing organisms even in previously healthy children. Once a renal abscess is suspected, early diagnosis and management are important for reducing the risk of life-threating complications and renal scarring.
Health behaviours and psychosocial working conditions as predictors of disability pension due to different diagnoses: a population-based study
Authors: Ropponen Annina , Narusyte Jurgita , Silventoinen Karri , Svedberg Pia
Published: October 2020

Background

To investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses.

Methods

A population-based sample of 24,987 Swedish twins born before 1958 were followed from national registers for disability pension until 2013. Baseline survey data in 1998–2003 were used to assess health behaviours and psychosocial Job Exposure Matrix for job control, job demands and social support. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI).

Results

During follow-up, 1252 disability pensions due to musculoskeletal disorders (5%), 601 due to mental diagnoses (2%) and 1162 due to other diagnoses (5%) occurred. In the models controlling for covariates, each one-unit increase in job demands was associated with higher (HR 1.16, 95%CI 1.01–1.33) and in job control with lower (HR 0.87, 95%CI 0.80–0.94) risk of disability pension due to musculoskeletal disorders among those with unhealthy behaviours. Among those with healthy behaviours, one-unit increase of social support was associated with a higher risk of disability pension due to mental and due to other diagnoses (HRs 1.29–1.30, 95%CI 1.04–1.63).

Conclusions

Job control and job demands were associated with the risk of disability pension due to musculoskeletal disorders only among those with unhealthy behaviours. Social support was a risk factor for disability pension due to mental or other diagnoses among those with healthy behaviours. Workplaces and occupational health care should acknowledge these simultaneous circumstances in order to prevent disability pension.
Preventing clinically relevant pancreatic fistula with combination of linear stapling plus continuous suture of the stump in laparoscopic distal pancreatectomy
Authors: Aoki Takeshi , Mansour Doaa A. , Koizumi Tomotake , Matsuda Kazuhiro , Kusano Tomokazu , Wada Yusuke , Hakozaki Tomoki , Tomioka Kodai , Hirai Takahito , Yamazaki Tatsuya , Watanabe Makoto , Otsuka Koji , Gahin Ahmed Elewa Abbas , Murakami Masahiko
Published: October 2020

Background

Pancreatic fistula is one of the serious complications for patients undergoing distal pancreatectomy, which leads to significant morbidity. The aim of our study is to compare linear stapling closure plus continuous suture with linear stapling closure alone during laparoscopic distal pancreatectomy (LDP) in terms of clinically relevant postoperative pancreatic fistula (POPF) rate.

Methods

Twenty-two patients underwent LDP at our institution between 2011 and 2013. Twelve patients had linear stapling closure with peri-firing compression (LSC) alone compared with ten patients who had linear stapling closure, peri-firing compression plus continuous suture (LSC/CS) for stump closure of remnant pancreas in LDP. Biochemical leak and clinically relevant POPF were compared between both groups.

Results

POPF occurred in 4 of 12 (33.3%) patients with linear stapling closure while no patient developed a clinically relevant POPF in the triple combination of linear stapling, peri-firing compression plus continuous suture group (p = 0.043).1 patient (8.3%) in the LSC group and 5 patients (50%) in the LSC/CS group had evidence of a biochemical leak. There were no significant differences in operative time (188.3 vs 187.0 min) and blood loss (135 vs. 240 g) between both groups but there was a significantly of shorter length of hospital stay (11.9 vs. 19.9 days) in LSC/CS group (p = 0.037). There was no mortality in either group.

Conclusions

The triple combination of linear stapling, peri-firing compression plus continuous suture in LDP has effectively prevented occurrence of clinically relevant ISGPF POPF.

Trial registration

The study was retrospectively registered September 30, 2019 at Showa University Ethics Committee as IRB protocol numbers 2943.
Pediatric liver transplantation and COVID-19: a case report
Authors: Nikoupour Hamed , Kazemi Kourosh , Arasteh Peyman , Ghazimoghadam Saba , Eghlimi Hesameddin , Dara Naghi , Gholami Siavash , Nikeghbalian Saman
Published: October 2020

Background

Immunosuppressed patients, including individuals with organ transplantation, have been among susceptible groups with regard to COVID-19, on the other hand pediatric patients more commonly undergo a mild clinical course after acquiring COVID-19. To the best of the authors knowledge, to this date very little data exists on COVID-19 in a pediatric patient with liver transplantation.

Case presentation

We report a three year-old boy who had liver transplantation at 18 months old. He was admitted due to dyspnea with impression of acute respiratory distress syndrome and was then transferred to the intensive care unit. Chest X-ray at admission showed bilateral infiltration. Vancomycin, meropenem, azithromycin, voriconazole and co-trimoxazole were started from the first day of admission. On day 4 of admission, with suspicion of COVID-19, hydroxychloroquine, lopinavir/ritonavir and oseltamivir were added to the antibiotic regimen. PCR was positive for COVID-19. The patient developed multi-organ failure and died on day 6 of admission.

Conclusions

For pediatric patients with organ transplantations, extreme caution should be taken, to limit and prevent their contact with COVID-19 during the outbreak, as these patients are highly susceptible to severe forms of the disease.
Levels, trends and determinants of technical efficiency of general hospitals in Uganda: data envelopment analysis and Tobit regression analysis
Authors: Ayiko Rogers , Mujasi Paschal N. , Abaliwano Joyce , Turyareeba Dickson , Enyaku Rogers , Anguyo Robert , Odoch Walter , Bakibinga Pauline , Aliti Tom
Published: October 2020

Background

General hospitals provide a wide range of primary and secondary healthcare services. They accounted for 38% of government funding to health facilities, 8.8% of outpatient department visits and 28% of admissions in Uganda in the financial year 2016/17. We assessed the levels, trends and determinants of technical efficiency of general hospitals in Uganda from 2012/13 to 2016/17.

Methods

We undertook input-oriented data envelopment analysis to estimate technical efficiency of 78 general hospitals using data abstracted from the Annual Health Sector Performance Reports for 2012/13, 2014/15 and 2016/17. Trends in technical efficiency was analysed using Excel while determinants of technical efficiency were analysed using Tobit Regression Model in STATA 15.1.

Results

The average constant returns to scale, variable returns to scale and scale efficiency of general hospitals for 2016/17 were 49% (95% CI, 44–54%), 69% (95% CI, 65–74%) and 70% (95% CI, 65–75%) respectively. There was no statistically significant difference in the efficiency scores of public and private hospitals. Technical efficiency generally increased from 2012/13 to 2014/15, and dropped by 2016/17. Some hospitals were persistently efficient while others were inefficient over this period. Hospital size, geographical location, training status and average length of stay were statistically significant determinants of efficiency at 5% level of significance.

Conclusion

The 69% average variable returns to scale technical efficiency indicates that the hospitals could generate the same volume of outputs using 31% (3439) less staff and 31% (3539) less beds. Benchmarking performance of the efficient hospitals would help to guide performance improvement in the inefficient ones. There is need to incorporate hospital size, geographical location, training status and average length of stay in the resource allocation formula and adopt annual hospital efficiency assessments.
Stigmasterol sensitizes endometrial cancer cells to chemotherapy by repressing Nrf2 signal pathway
Authors: Liao Hong , Zhu Dan , Bai Mingzhu , Chen Huifen , Yan Shihuan , Yu Jing , Zhu Huiting , Zheng Wenxin , Fan Guorong
Published: October 2020

Background

Chemoresistance reduces the 5-year survival rate of endometrial cancer patient, which is the current major obstacle for cancer therapy. Increasing evidence state that Nrf2 contributes to chemoresistance in several kinds of cancer. However, its role in endometrial cancer cells remains unclarified.

Methods

Immunohistochemistry staining was used to detect the expression of Nrf2 in normal patient and endometrial cancer patient. Stable transfection Ishikawa cell line with high level of Nrf2 was established to evaluate its role in chemoresistance. Dot blot assays were used to assess global hydroxymethylation level after stigmasterol treatment. Cellular growth profile was detected by CCK8 assay. Western blot was used to evaluate the changes of the target molecules after various treatments.

Results

Nrf2 is overexpressed in endometrial cancer tissues compared with the normal endometrium. Overexpression of Nrf2 resulted in decrease sensitivity to cisplatin. In addition, stigmasterol has been identified as a novel Nrf2 inhibitor. It enhanced the sensitivity of endometrial cancer cells to cisplatin, and the underlying mechanism is that stigmasterol declines the Nrf2 protein level.

Conclusions

Our findings identified stigmasterol as a new potential inhibitor of Nrf2 and highlight a critical role of stigmasterol in overcoming chemoresistance in endometrial cancer therapy.
Association between copy-number alteration of +20q, −14q and −18p and cross-sensitivity to tyrosine kinase inhibitors in clear-cell renal cell carcinoma
Authors: Wang Liang , Li Yuqing , Lyu Yinfeng , Wen Hui , Feng Chenchen
Published: October 2020

Background

We aim to explore association between copy number alteration (CNA) and sensitivity to common tyrosine kinase inhibitors (TKIs) used in clear-cell renal cell carcinoma (ccRCC) treatment.

Methods

CNA with related sensitivity profiles were extracted from the Genomics of Drug Sensitivity in Cancer (GDSC) dataset and was cross-referenced with common CNA in ccRCC in the Cancer Genome Atlas (TCGA) dataset. Functional annotation was profiled using GSEA and NET-GE. Target genes within cytobands of interest were screened in silico and validated in vitro using proliferation assays in A498 and 786-O ccRCC cells.

Results

Four TKIs (Sunitinib, Cabozantinib, Axitinib and Sorafenib) that were clinically used in ccRCC were selected. In silico analysis showed gain of 20q (+20q) occurred in ~ 23% of cases and was associated with resistance to all four TKIs; loss of 14q (−14q) occurred in ~ 39% of cases and was associated with resistance to Sunitinib and Sorafenib; loss of 18p (−18p) occurred in ~ 39% of cases and was associated with sensitivity to Sunitinib and Sorafenib. All 3 CNAs were associated with worsened prognosis, respectively. Candidate target genes included of RBL1 on 20q, KLHL33 on 14q and ARHGAP28 on18q. In vitro validation showed RBL1 overexpression induced resistance to Sunitinib and Cabozantinib; KLHL33 silencing induced resistance to Sunitinib; ARHGAP28 silencing induced sensitivity to Cabozantinib. Functional annotation indicated FoxO signaling, hypoxic response and Wnt pathway, and Rho-related cellular adhesion were mechanistically associated with +20q, −14q and −18p, respectively.

Conclusion

Common CNAs in ccRCC are associated with cancer-intrinsic cross-sensitivity to common TKIs. Further validation and functional analyses are therefore needed.
A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania
Authors: Rwegoshora France John , Muganyizi Projestine Selestine , Kimario Grasiana Festus , Paul Ponsian Patrick , Makins Anita
Published: October 2020

Background

Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been in progress since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania.

Methodology

A prospective cohort study of women who had TCu380A insertion within 48 h of delivery in 6 hospitals in Tanzania between 1st December 2017 and 18th April 2018 was conducted. Face to face post insertion interviews were made with 1114 clients before discharge and later through phone calls up to the beginning of 13th month postpartum. Postpartum Intrauterine Device (PPIUD) continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA).

Results

In total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, being a youth (16–24 years), and delivery by Cesarean section.

Conclusions

The continuation rate when CuT380A is used for immediate postpartum contraception is high, with low complication and failure rates. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.
‘They are my future’: childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare
Authors: Ganle John Kuumuori , Apolot Rebecca Racheal , Rugoho Tafadzwa , Sumankuuro Joshua
Published: October 2020

Background

Previous research has highlighted widespread public mis/perceptions that portray women with disabilities (WWDs) as asexual, less likely to marry, and often not interested in childbearing. However, evidence from high-income settings shows that many WWDs are sexually active and do have or want to have children. Notwithstanding this, very few studies have focused on understanding childbearing desires and motivations among WWDs in low-income settings. This qualitative research explored childbearing desires and motivations among WWDs in Ghana.

Methods

A cross-sectional qualitative study was conducted with WWDs aged 18–49 years in Northern Ghana. The distribution of participants by disability types were as follows: physical disability/impairment (n = 37); visual impairment (n = 11); speech and hearing impairment (n = 14); epilepsy (n = ten); and albinism (n = five). A pre-tested open-ended thematic topic guide was designed and used to conduct in-depth interviews. Interviews were tape-recorded and later transcribed for analysis. Transcripts were coded using QSR NVivo 11 software. Thematic content analysis techniques were used to analyse and present the data.

Results

Nearly all the WWDs interviewed were sexually active, desiring to have children, and intended to have as many children as they could support. Strong desire to experience the joy of motherhood; fear of social insecurity; fear of old age economic insecurity; desire to challenge stigma and negative stereotypes about disability, sexuality and motherhood; and desire for self-actualisation, were key motivations for childbearing.

Conclusion

Our findings challenge existing negative public perceptions about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services.
ECMO-assisted resection of left main bronchial malignant tumor and left pneumonectomy with comprehensive nursing support: a case report
Authors: Yang Hui , Chen Ruiyun , Chen Jingru , Yan Fan , Zhang Hongmei , Wei Li , Jia Xiangbo , Wang Yuming
Published: October 2020

Background

Patients with Extracorporeal Membrane Oxygenation (ECMO) undergoing primary bronchial malignancy resection and left pneumonectomy via bilateral thoracic approach are rare for there exist few reports available to date. And the nursing experience about this disease is rare reported.

Case presentation

This study reported a 50-year-old man with adenoid cystic carcinoma in left main bronchus by computed tomography (CT), fiberoptic bronchoscopy, and puncture biopsy. The case is the first report about operation method and the comprehensive nursing care, including conventional nursing, airway management, fluid management, nutritional support, and psychosocial support for patients undergoing primary bronchial malignancy resection and left pneumonectomy. After multidisciplinary treatment and comprehensive care, the patient was cured and discharged on the 17th day after surgery.

Conclusion

This study reported a rare case with bronchial malignancy resection and left pneumonectomy and discussed its nursing care. A skilled management of ECMO, intraoperative position transformation, and prevention, as well as control of pulmonary complications are fundamental in caring patients with bronchial tumors. Monitoring of pulmonary function and blood pressure, adequate nutrition, and psychological support could be contributing factors for successful treatment during the postoperative stage.
Genomic analyses reveal evolutionary and geologic context for the plateau fungus Ophiocordyceps sinensis
Authors: Liu Jie , Guo Linong , Li Zongwei , Zhou Zhe , Li Zhen , Li Qian , Bo Xiaochen , Wang Shengqi , Wang Junli , Ma Shuangcheng , Zheng Jian , Yang Ying
Published: October 2020

Background

Ophiocordyceps sinensis, which is only naturally found in the high-elevation extreme environment of the Tibetan Plateau, has been used in traditional Chinese medicine. Information concerning the evolutionary and geologic context of O. sinensis remains limited, however.

Methods

We constructed the high-quality genome of O. sinensis and provided insight into the evolution and ecology of O. sinensis using comparative genomics.

Results

We mapped the whole genome of the anamorph/asexual form Hirsutella of O. sinensis using Illumina and PacBio sequencing technologies and obtained a well assembled genome of 119.2 Mbp size. Long-read Single Molecule Real Time (SMRT) sequencing technology generated an assembly with more accurate representation of repeat sequence abundances and placement. Evolutionary analyses indicated that O. sinensis diverged from other fungi 65.9 Mya in the Upper Cretaceous, during the uplift of the Tibetan Plateau. Gene family expansions and contractions in addition to genome inflation via long terminal repeat (LTR) retrotransposon insertions were implicated as an important driver of O. sinensis divergence. The insertion rate of LTR sequences into the O. sinensis genome peaked ~ 30–40 Mya, when the Tibetan Plateau rose rapidly. Gene Ontology (GO) enrichment analysis suggested that O. sinensis contained more genes related to ice binding compared to other closely related fungi, which may aid in their adaptability to the cold Tibetan Plateau. Further, heavy metal resistance genes were in low abundance in the O. sinensis genome, which may help to explain previous observations that O. sinensis tissues contain high levels of heavy metals.

Conclusions

Our results reveal the evolutionary, geological, and ecological context for the evolution of the O. sinensis genome and the factors that have contributed to the environmental adaptability of this valuable fungus. These findings suggest that genome inflation via LTR retrotransposon insertions in O. sinensis coincided with the uplift of the Tibetan Plateau. LTRs and the specific genetic mechanisms of O. sinensis contributed to its adaptation to the environment on the plateau.
Association of schistosomiasis and risk of prostate cancer development in residents of Murehwa rural community, Zimbabwe
Authors: Choto Emilia T. , Mduluza Takafira , Mutapi Francisca , Chimbari Moses J.
Published: October 2020

Background

Prostatic male genital schistosomiasis and prostate cancer co-existence cases are uncommon however, some studies have indicated that schistosomiasis may trigger development of prostate cancer regardless of age. Schistosomiasis is a public health problem in sub-Saharan Africa and may account for some undocumented cases of schistosomiasis prostatic cancer in schistosome endemic rural communities. It is against this background that we investigated the association between schistosomiasis and risk of prostate cancer development in residents of Murehwa Community, a schistosomiasis endemic area.

Methodology

We conducted a cross sectional study involving 366 men residing in Murehwa District, Zimbabwe.Schistosoma haematobiumandS. mansoniinfection was diagnosed using urine filtration and Kato Katz techniques, respectively. Haematuria was detected using urinalysis reagent strip test. A structured questionnaire was used to obtain history of schistosomiasis infection among study participants. Risk of prostate cancer development was assessed by measuring prostate-specific antigen levels in serum using the ELISA.

Results

Prevalence ofS. haematobiumandS. mansoniinfection was 12.3% and 1.4%, respectively. Individuals with schistosomiasis had higher prostate-specific antigen levels (mean 1.208 ± SD 1.557 ng/mL) compared to those without schistosomiasis (mean 0.7721 ± SD 1.173 ng/mL;p < 0.05). Older individuals > 50 years had higher prostate specific antigen levels (mean 0.7212 ± SD 1.313 ng/mL) compared to individuals < 50 years old (mean 0.4159 ± SD 0.8622 ng/mL;p < 0.05). Prostate-specific antigen levels log10(mean 0.2584 ± SD 0.2128 ng/mL) and were associated toS. haematobiuminfection intensity log10(mean 1.121 ± SD 0.5371 eggs/10 mL), r(s) = − 0.3225,p < 0.05. There was a correlation between prostate-specific antigen levels log10(mean 0.2246 ± SD 0.1858 ng/mL) andS. haematobiuminfection intensity log10(mean 1.169 ± SD 0.5568 eggs/10 mL) among participants with a history of schistosomiasis infection (r(s) = − 0.3520;p < 0.05). There was no correlation between prostate-specific antigen levels of > 4 ng/mL (mean 5.324 ± SD1.568 ng/mL) and schistosome eggs log10(mean 1.057 ± SD 0.6730 eggs/10 mL;p > 0.05).

Conclusion

Urogenital schistosome infections and history of schistosome infections were associated with prostate specific antigen levels, an indicator for risk of prostate cancer. Therefore,S. haematobiumschistosome egg burden was associated with the risk of prostate cancer development in adult males residing in Murehwa District, Zimbabwe.
An integrated peach genome structural variation map uncovers genes associated with fruit traits
Authors: Guo Jian , Cao Ke , Deng Cecilia , Li Yong , Zhu Gengrui , Fang Weichao , Chen Changwen , Wang Xinwei , Wu Jinlong , Guan Liping , Wu Shan , Guo Wenwu , Yao Jia-Long , Fei Zhangjun , Wang Lirong
Published: October 2020

Background

Genome structural variations (SVs) have been associated with key traits in a wide range of agronomically important species; however, SV profiles of peach and their functional impacts remain largely unexplored.

Results

Here, we present an integrated map of 202,273 SVs from 336 peach genomes. A substantial number of SVs have been selected during peach domestication and improvement, which together affect 2268 genes. Genome-wide association studies of 26 agronomic traits using these SVs identify a number of candidate causal variants. A 9-bp insertion inPrupe.4G186800, which encodes a NAC transcription factor, is shown to be associated with early fruit maturity, and a 487-bp deletion in the promoter ofPpMYB10.1is associated with flesh color around the stone. In addition, a 1.67 Mb inversion is highly associated with fruit shape, and a gene adjacent to the inversion breakpoint,PpOFP1, regulates flat shape formation.

Conclusions

The integrated peach SV map and the identified candidate genes and variants represent valuable resources for future genomic research and breeding in peach.
Prime editing efficiently generates W542L and S621I double mutations in two ALS genes in maize
Authors: Jiang Yuan-Yuan , Chai Yi-Ping , Lu Min-Hui , Han Xiu-Li , Lin Qiupeng , Zhang Yu , Zhang Qiang , Zhou Yun , Wang Xue-Chen , Gao Caixia , Chen Qi-Jun
Published: October 2020

Prime editing is a novel and universal CRISPR/Cas-derived precision genome-editing technology that has been recently developed. However, low efficiency of prime editing has been shown in transgenic rice lines. We hypothesize that enhancing pegRNA expression could improve prime-editing efficiency. In this report, we describe two strategies for enhancing pegRNA expression. We construct a prime editing vector harboring two pegRNA variants for W542L and S621I double mutations in ZmALS1 and ZmALS2. Compared with previous reports in rice, we achieve much higher prime-editing efficiency in maize. Our results are inspiring and provide a direction for the optimization of plant prime editors.
Successful treatment of pyopneumothorax secondary to Streptococcus constellatus infection with linezolid: a case report and review of the literature
Authors: Zhang Zhaorui , Xiao Binbin , Liang Zhixin
Published: October 2020

Background

Pyopneumothorax secondary to Streptococcus constellatus infection is a clinically rare event, and few cases have been reported.

Case presentation

We report the case of a 55-year-old Han Chinese man with underlying diabetes who presented with fever of 17 days duration. A pulmonary computed tomography scan revealed right-sided massive pyopneumothorax. A culture of the pleural effusion and blood grew S. constellatus. A drug sensitivity test showed that the isolate was sensitive to linezolid, penicillin G, cefotaxime, vancomycin, and cefuroxime. Our patient was treated with linezolid for a total of 6 weeks. Subsequently, his chest computed tomography scan showed improved lung condition.

Conclusion

To the best of our knowledge, this is the first case of pyopneumothorax secondary to S. constellatus to be treated with linezolid. Pyopneumothorax may be caused by streptococcal infection, and linezolid is another good choice for treatment.
Dynamic service migration in ultra-dense multi-access edge computing network for high-mobility scenarios
Authors: Lin Haowei , Xu Xiaolong , Zhao Juan , Wang Xinheng
Published: October 2020

The multi-access edge computing (MEC) has higher computing power and lower latency than user equipment and remote cloud computing, enabling the continuing emergence of new types of services and mobile application. However, the movement of users could induce service migration or interruption in the MEC network. Especially for highly mobile users, they accelerate the frequency of services’ migration and handover, impacting on the stability of the total MEC network. In this paper, we propose a hierarchical multi-access edge computing architecture, setting up the infrastructure for dynamic service migration in the ultra-dense MEC networks. Moreover, we propose a new mechanism for users with high mobility in the ultra-dense MEC network, efficiently arranging service migrations for users with high-mobility and ordinary users together. Then, we propose an algorithm for evaluating migrated services to contribute to choose the suitable MEC servers for migrated services. The results show that the proposed mechanism can efficiently arrange service migrations and more quickly restore the services even in the blockage. On the other hand, the proposed algorithm is able to make a supplement to the existing algorithms for selecting MEC servers because it can better reflect the capability of migrated services.
Geometric modeling and applications of generalized blended trigonometric Bézier curves with shape parameters
Authors: Maqsood Sidra , Abbas Muhammad , Miura Kenjiro T. , Majeed Abdul , Iqbal Azhar
Published: October 2020

A Bézier model with shape parameters is one of the momentous research topics in geometric modeling and computer-aided geometric design. In this study, a new recursive formula in explicit expression is constructed that produces the generalized blended trigonometric Bernstein (or GBT-Bernstein, for short) polynomial functions of degreem. Using these basis functions, generalized blended trigonometric Bézier (or GBT-Bézier, for short) curves with two shape parameters are also constructed, and their geometric features and applications to curve modeling are discussed. The newly created curves share all geometric properties of Bézier curves except the shape modification property, which is superior to the classical Bézier. The$C^{3}$C3and$G^{2}$G2continuity conditions of two pieces of GBT-Bézier curves are also part of this study. Moreover, in contrast with Bézier curves, our generalization gives more shape adjustability in curve designing. Several examples are presented to show that the proposed method has high applied values in geometric modeling.
Oblique explicit wave solutions of the fractional biological population (BP) and equal width (EW) models
Authors: Abdel-Aty Abdel-Haleem , Khater Mostafa M. A. , Baleanu Dumitru , Abo-Dahab S. M. , Bouslimi Jamel , Omri M.
Published: October 2020

This research uses the extended exp-$( -\varphi(\vartheta ) ) $(−φ(ϑ))-expansion and the Jacobi elliptical function methods to obtain a fashionable explicit format for solutions to the fragmented biological population and the same width models that depict popular logistics because of deaths or births. In mathematical terminology, the linear, hyperbolic, and trigonometric equation solutions that have been found describe several innovative aspects from the two models. Sketching these solutions in different types is used to give them more details. The accuracy and performance of the method adopted show their ability to be applied to various nonlinear developmental equations.
Existence and uniqueness results for Φ-Caputo implicit fractional pantograph differential equation with generalized anti-periodic boundary condition
Authors: Ahmed Idris , Kumam Poom , Abdeljawad Thabet , Jarad Fahd , Borisut Piyachat , Demba Musa Ahmed , Kumam Wiyada
Published: October 2020

The present paper describes the implicit fractional pantograph differential equation in the context of generalized fractional derivative and anti-periodic conditions. We formulated the Green’s function of the proposed problems. With the aid of a Green’s function, we obtain an analogous integral equation of the proposed problems and demonstrate the existence and uniqueness of solutions using the techniques of the Schaefer and Banach fixed point theorems. Besides, some special cases that show the proposed problems extend the current ones in the literature are presented. Finally, two examples were given as an application to illustrate the results obtained.
On multivalued L-contractions and an application
Authors: Barakat M. A. , Aydi Hassen , Mukheimer Aiman , Soliman Ahmed A. , Hyder Abdallah
Published: October 2020

The aim of this paper is to present several fixed-point results for L-contractive multivalued mappings involving θ-functions in the class of metric spaces. We also give some examples in support of the related concepts and presented results. A homotopy result is also provided.
Offering mental health first aid to a person after a potentially traumatic event: a Delphi study to redevelop the 2008 guidelines
Authors: Chalmers Kathryn J. , Jorm Anthony F. , Kelly Claire M. , Reavley Nicola J. , Bond Kathy S. , Cottrill Fairlie A. , Wright Judith
Published: October 2020

Background

Trauma has a major impact on the mental health and wellbeing of people globally. Friends, family and members of the public are often well positioned to provide initial assistance if someone is experiencing extreme distress following a potentially traumatic event. Expert consensus guidelines for high income, Western countries on how to do this were published in 2008. The aim of the current study was to re-develop these guidelines to ensure they are current and reflect best practice.

Methods

The Delphi consensus method was used to determine which helping statements should be included in the guidelines. Helping statements were derived from a systematic search of literature that considered how a member of the public could help someone experiencing extreme distress following a potentially traumatic event. Two expert panels, comprising 28 mental health professionals with expertise in managing trauma and 26 consumer advocates, rated each statement. Statements were accepted for inclusion in the guidelines if they were endorsed by at least 80% of each panel.

Results

Out of 183 statements, 103 were endorsed as appropriate helping actions in providing assistance to someone experiencing extreme distress following a potentially traumatic event. These statements were used to form the re-developed guidelines.

Conclusion

This study has resulted in a more comprehensive set of guidelines than the original version, with the endorsement of 103 helping actions, compared to 65 previously. The updated guidelines better represent the complexities of experiencing trauma and the considered approach required when providing first aid after a potentially traumatic event. The additional guidance on providing initial assistance, talking about the trauma, offering short-term assistance and seeking appropriate professional help reflects current knowledge. A notable addition is the inclusion of content on how a first aider can assist after a disclosure of abuse. The guidelines are available to the public and will inform future updates of Mental Health First Aid training courses.
5-Hydroxytryptamine-3 receptor antagonist and dexamethasone as prophylaxis for chemotherapy-induced nausea and vomiting during moderately emetic chemotherapy for solid tumors: a multicenter, prospective, observational study
Authors: Matsui Reiko , Suzuki Kenichi , Takiguchi Tomomi , Nishio Makoto , Koike Takeshi , Hayashi Toshinobu , Seto Takashi , Kogure Yuki , Nogami Naoyuki , Fujiwara Kimiko , Kaneda Hiroyasu , Harada Tomohiko , Shimizu Satoru , Kimura Masashi , Kenmotsu Hirotsugu , Shimokawa Mototsugu , Goto Koichi
Published: October 2020

Background

Of patients receiving moderate emetic risk chemotherapy (MEC), 30–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial.

Methods

In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone.

Results

Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51 and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC.

Conclusions

Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5) + ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.