bluuebunny/crossref_metadata_2025 huggingface dataset:
An in-depth exploration of the post-test informational needs of BRCA1 and BRCA2 pathogenic variant carriers in Asia
Authors: Yuen Jeanette , Fung Si Ming , Sia Chin Leong , Venkatramani Mallika , Shaw Tarryn , Courtney Eliza , Li Shao-Tzu , Chiang Jianbang , Tan Veronique Kiak-Mien , Tan Benita Kiat-Tee , Ngeow Joanne
Published: October 2020

Introduction

Identification of one’s status as a BRCA1/2 pathogenic variant carrier often marks the start of navigating challenging decisions related to cancer risk management and result disclosure. Carriers report unmet informational needs, but studies have yet to explore the specific aspects of and how best to fulfill these needs. This study aims to explore the informational needs of BRCA1/2 pathogenic variant carriers in Asia to inform for the design of educational materials to support risk management decision-making.

Methods

Semi-structured in-depth interviews were conducted with two male and 22 female English-speaking BRCA1/2 pathogenic variant carriers, aged 29–66 years, identified through the Cancer Genetics Service at the National Cancer Centre Singapore. A grounded theory approach with thematic analysis was undertaken to extract dominant themes.

Results

Four themes were identified: (i) proactive online information seeking behaviors (ii) personalized informational needs; (iii) challenges in sharing the results; and (iv) lack of genetic awareness.

Discussion

Participants highlight challenges with sharing their result arising from significant post-result informational needs, which have manifested into proactive online information-seeking behaviors. They desire for an online source of information, where content is personalized, reliable and local. Participants foresee the potential of an online resource to raise genetic awareness. This suggests the use of a culturally tailored online-based genetics resource, to promote result disclosure, empower risk-management decisions and raise genetic literacy rates.
Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)
Authors: Singh Yogen , Villaescusa Javier Urbano , da Cruz Eduardo M. , Tibby Shane M. , Bottari Gabriella , Saxena Rohit , Guillén Marga , Herce Jesus Lopez , Di Nardo Matteo , Cecchetti Corrado , Brierley Joe , de Boode Willem , Lemson Joris
Published: October 2020

Background

Cardiovascular instability is common in critically ill children. There is a scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children.

Methods

Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature—a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document.

Results

Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement,” 20 “weak agreement,” and 2 had “no agreement.” Six statements were considered as redundant after rephrasing of statements following the first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to a lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus.

Conclusions

These expert consensus-based recommendations may be used to guide clinical practice for hemodynamic monitoring in critically ill children, and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.
Correction to: Trastuzumab-induced upregulation of a protein set in extracellular vesicles emitted by ErbB2-positive breast cancer cells correlates with their trastuzumab sensitivity
Authors: Drucker Arik , Yoo Byong Hoon , Khan Iman Aftab , Choi Dongsic , Montermini Laura , Liu Xiaoyang , Jovanovic Sanja , Younis Tallal , Rosen Kirill V.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Smoking-related changes in DNA methylation and gene expression are associated with cardio-metabolic traits
Authors: Maas Silvana C. E. , Mens Michelle M. J. , Kühnel Brigitte , van Meurs Joyce B. J. , Uitterlinden André G. , Peters Annette , Prokisch Holger , Herder Christian , Grallert Harald , Kunze Sonja , Waldenberger Melanie , Kavousi Maryam , Kayser Manfred , Ghanbari Mohsen
Published: October 2020

Background

Tobacco smoking is a well-known modifiable risk factor for many chronic diseases, including cardiovascular disease (CVD). One of the proposed underlying mechanism linking smoking to disease is via epigenetic modifications, which could affect the expression of disease-associated genes. Here, we conducted a three-way association study to identify the relationship between smoking-related changes in DNA methylation and gene expression and their associations with cardio-metabolic traits.

Results

We selected 2549 CpG sites and 443 gene expression probes associated with current versus never smokers, from the largest epigenome-wide association study and transcriptome-wide association study to date. We examined three-way associations, including CpG versus gene expression, cardio-metabolic trait versus CpG, and cardio-metabolic trait versus gene expression, in the Rotterdam study. Subsequently, we replicated our findings in The Cooperative Health Research in the Region of Augsburg (KORA) study. After correction for multiple testing, we identified both cis- and trans-expression quantitative trait methylation (eQTM) associations in blood. Specifically, we found 1224 smoking-related CpGs associated with at least one of the 443 gene expression probes, and 200 smoking-related gene expression probes to be associated with at least one of the 2549 CpGs. Out of these, 109 CpGs and 27 genes were associated with at least one cardio-metabolic trait in the Rotterdam Study. We were able to replicate the associations with cardio-metabolic traits of 26 CpGs and 19 genes in the KORA study. Furthermore, we identified a three-way association of triglycerides with two CpGs and two genes (GZMA; CLDND1), and BMI with six CpGs and two genes (PID1; LRRN3). Finally, our results revealed the mediation effect of cg03636183 (F2RL3), cg06096336 (PSMD1), cg13708645 (KDM2B), and cg17287155 (AHRR) within the association between smoking and LRRN3 expression.

Conclusions

Our study indicates that smoking-related changes in DNA methylation and gene expression are associated with cardio-metabolic risk factors. These findings may provide additional insights into the molecular mechanisms linking smoking to the development of CVD.
Co-encapsulation of HNF4α overexpressing UMSCs and human primary hepatocytes ameliorates mouse acute liver failure
Authors: Kong Defu , Xu Huiming , Chen Mo , Yu Yeping , Qian Yongbing , Qin Tian , Tong Ying , Xia Qiang , Hang Hualian
Published: October 2020

Background

Acute liver failure (ALF) is a complicated condition that is characterized by global hepatocyte death and often requires immediate liver transplantation. However, this therapy is limited by shortage of donor organs. Mesenchymal stem cells (MSCs) and hepatocytes are two attractive sources of cell-based therapies to treat ALF. The combined transplantation of hepatocytes and MSCs is considered to be more effective for the treatment of ALF than single-cell transplantation. We have previously demonstrated that HNF4α-overexpressing human umbilical cord MSCs (HNF4α-UMSCs) promoted the expression of hepatic-specific genes. In addition, microencapsulation allows exchange of nutrients, forming a protective barrier to the transplanted cells. Moreover, encapsulation of hepatocytes improves the viability and synthetic ability of hepatocytes and circumvents immune rejection. This study aimed to investigate the therapeutic effect of microencapsulation of hepatocytes and HNF4α-UMSCs in ALF mice.

Methods

Human hepatocytes and UMSCs were obtained separately from liver and umbilical cord, followed by co-encapsulation and transplantation into mice by intraperitoneal injection. LPS/D-gal was used to induce ALF by intraperitoneal injection 24 h after transplantation. In addition, Raw 264.7 cells (a macrophage cell line) were used to elucidate the effect of HNF4α-UMSCs-hepatocyte microcapsules on polarization of macrophages. The protein chip was used to define the important paracrine factors in the conditioned mediums (CMs) of UMSCs and HNF4α-UMSCs and investigate the possible mechanism of HNF4α-UMSCs for the treatment of ALF in mice.

Results

HNF4α-UMSCs can enhance the function of primary hepatocytes in alginate–poly-L-lysine–alginate (APA) microcapsules. The co-encapsulation of both HNF4α-UMSCs and hepatocytes achieved better therapeutic effects in ALF mice by promoting M2 macrophage polarization and reducing inflammatory response mainly mediated by the paracrine factor HB-EGF secreted by HNF4α-UMSCs.

Conclusions

The present study confirms that the co-encapsulation of HNF4α-UMSC and hepatocytes could exert therapeutic effect on ALF mainly by HB-EGF secreted by HNF4α-UMSCs and provides a novel strategy for the treatment of ALF.
HSPB7 regulates osteogenic differentiation of human adipose derived stem cells via ERK signaling pathway
Authors: Jin Chanyuan , Shuai Ting , Tang Zhihui
Published: October 2020

Background

Heat shock protein B7 (HSPB7), which belongs to small heat shock protein family, has been reported to be involved in diverse biological processes and diseases. However, whether HSPB7 regulates osteogenic differentiation of human adipose derived stem cells (hASCs) remains unexplored.

Methods

The expression level of HSPB7 during the osteogenesis of hASCs was examined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot analysis. Lentivirus transfection was used to knock down or overexpress HSPB7, which enabled us to investigate the effect of HSPB7 on osteogenic differentiation of hASCs. U0126 and extracellular signal-regulated protein kinase 1/2 (ERK1/2) siRNA were used to identify the mechanism of the HSPB7/ERK1/2 axis in regulating osteogenic differentiation of hASCs. Moreover, ectopic bone formation in nude mice and osteoporosis mice model was used to investigate the effect of HSPB7 on osteogenesis in vivo.

Results

In this study, we found the expression of HSPB7 was significantly downregulated during the osteogenic differentiation of hASCs. HSPB7 knockdown remarkably promoted osteogenic differentiation of hASCs, while HSPB7 overexpression suppressed osteogenic differentiation of hASCs both in vitro and in vivo. Moreover, we discovered that the enhancing effect of HSPB7 knockdown on osteogenic differentiation was related to the activation of extracellular signal-regulated protein kinase (ERK) signaling pathway. Inhibition of ERK signaling pathway with U0126 or silencing ERK1/2 effectively blocked the stimulation of osteogenic differentiation induced by HSPB7 knockdown. Additionally, we found that HSPB7 expression was markedly increased in mouse bone marrow mesenchymal stem cells (mBMSCs) from the osteoporotic mice which suggested that HSPB7 might be utilized as a potential target in the development of effective therapeutic strategies to treat osteoporosis and other bone diseases.

Conclusion

Taken together, these findings uncover a previously unrecognized function of HSPB7 in regulating osteogenic differentiation of hASCs, partly via the ERK signaling pathway.
Acute respiratory failure in immunocompromised patients: outcome and clinical features according to neutropenia status
Authors: Mokart Djamel , Darmon Michael , Schellongowski Peter , Pickkers Peter , Soares Marcio , Rello Jordi , Bauer Philippe R. , van de Louw Andry , Lemiale Virginie , Taccone Fabio Silvio , Martin-Loeches Ignacio , Salluh Jorge , Rusinova Katerina , Mehta Sangeeta , Antonelli Massimo , Kouatchet Achille , Barratt-Due Andreas , Valkonen Miia , Landburg Precious Pearl , Bukan Ramin Brandt , Pène Frédéric , Metaxa Victoria , Burghi Gaston , Saillard Colombe , Nielsen Lene B. , Canet Emmanuel , Bisbal Magali , Azoulay Elie ,   for the Efraim investigators and the Nine-I study group
Published: October 2020

Background

The impact of neutropenia in critically ill immunocompromised patients admitted in a context of acute respiratory failure (ARF) remains uncertain. The primary objective was to assess the prognostic impact of neutropenia on outcomes of these patients. Secondary objective was to assess etiology of ARF according to neutropenia.

Methods

We performed a post hoc analysis of a prospective multicenter multinational study from 23 ICUs belonging to the Nine-I network. Between November 2015 and July 2016, all adult immunocompromised patients with ARF admitted to the ICU were included in the study. Adjusted analyses included: (1) a hierarchical model with center as random effect; (2) propensity score (PS) matched cohort; and (3) adjusted analysis in the matched cohort.

Results

Overall, 1481 patients were included in this study of which 165 had neutropenia at ICU admission (11%). ARF etiologies distribution was significantly different between neutropenic and non-neutropenic patients, main etiologies being bacterial pneumonia (48% vs 27% in neutropenic and non-neutropenic patients, respectively). Initial oxygenation strategy was standard supplemental oxygen in 755 patients (51%), high-flow nasal oxygen in 165 (11%), non-invasive ventilation in 202 (14%) and invasive mechanical ventilation in 359 (24%). Before adjustment, hospital mortality was significantly higher in neutropenic patients (54% vs 42%; p = 0.006). After adjustment for confounder and center effect, neutropenia was no longer associated with outcome (OR 1.40, 95% CI 0.93–2.11). Similar results were observed after matching (52% vs 46%, respectively; p = 0.35) and after adjustment in the matched cohort (OR 1.04; 95% CI 0.63–1.72).

Conclusion

Neutropenia at ICU admission is not associated with hospital mortality in this cohort of critically ill immunocompromised patients admitted for ARF. In neutropenic patients, main ARF etiologies are bacterial and fungal infections.
Sparse code multiple access on the generalized frequency division multiplexing
Authors: Aquino Guilherme P. , Mendes Luciano L.
Published: October 2020

Recent advances in the communication systems culminated in a new class of multiple access schemes, named non-orthogonal multiple access (NOMA), where the main goal is to increase the spectrum efficiency by overlapping data from different users in a single time-frequency resource used by the physical layer. NOMA receivers can resolve the interference among data symbols from different users, increasing the overall system spectrum efficiency without introducing symbol error rate (SER) performance loss, which makes this class of multiple access techniques interesting for future mobile communication systems. This paper analyzes one promising NOMA technique, called sparse code multiple access (SCMA), where C users can share U<C time-frequency resources from the physical layer. Initially, the SCMA and orthogonal frequency division multiplexing (OFDM) integration is considered, defining a benchmark for the overall SER performance for the multiple access technique. Furthermore, this paper proposes the SCMA and generalized frequency division multiplexing (GFDM) integration. Since GFDM is a highly flexible non-orthogonal waveform that can mimic several other waveforms as corner cases, it is an interesting candidate for future wireless communication systems. This paper proposes two approaches for combining SCMA and GFDM. The first one combines a soft equalizer, called block expectation propagation (BEP), and a multi-user detection (MUD) scheme based on the sum-product algorithm (SPA). This approach achieves the best SER performance, but with the significant increment of the complexity at the receiver. In the second approach, BEP is integrated with a simplified MUD, which is an original contribution of this paper, aiming for reducing the receiver’s complexity at the cost of SER performance loss. The solutions proposed in this paper show that SCMA-GFDM can be an interesting solution for future mobile networks.
Correction to: A novel FPGA-based test-bench framework for SDI stream verification
Authors: Conti Giuseppe , Kyrkou Christos , Theocharides Theocharis , Hernández-Peñaloza Gustavo , Jiménez David
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Recommendations from the Italian intersociety consensus on Perioperative Anesthesa Care in Thoracic surgery (PACTS) part 2: intraoperative and postoperative care
Authors: Piccioni Federico , Droghetti Andrea , Bertani Alessandro , Coccia Cecilia , Corcione Antonio , Corsico Angelo Guido , Crisci Roberto , Curcio Carlo , Del Naja Carlo , Feltracco Paolo , Fontana Diego , Gonfiotti Alessandro , Lopez Camillo , Massullo Domenico , Nosotti Mario , Ragazzi Riccardo , Rispoli Marco , Romagnoli Stefano , Scala Raffaele , Scudeller Luigia , Taurchini Marco , Tognella Silvia , Umari Marzia , Valenza Franco , Petrini Flavia ,   on behalf of AIPO, Associazione Italiana Pneumologi Ospedalieri; SIAARTI, Società Italiana di Anestesia Analgesia Rianimazione Terapia Intensiva; SIC, Società Italiana di Chirurgia; SICT, Società Italiana di Chirurgia Toracica; SIET, Società Italiana di Endoscopia Toracica; SIP, Società Italiana di Pneumologia
Published: October 2020

Introduction

Anesthetic care in patients undergoing thoracic surgery presents specific challenges that require a multidisciplinary approach to management. There remains a need for standardized, evidence-based, continuously updated guidelines for perioperative care in these patients.

Methods

A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, was established to develop recommendations for anesthesia practice in patients undergoing elective lung resection for lung cancer. The project addressed three key areas: preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventive Services Task Force criteria.

Results

Recommendations for intraoperative care focus on airway management, and monitoring of vital signs, hemodynamics, blood gases, neuromuscular blockade, and depth of anesthesia. Recommendations for postoperative care focus on the provision of multimodal analgesia, intensive care unit (ICU) care, and specific measures such as chest drainage, mobilization, noninvasive ventilation, and atrial fibrillation prophylaxis.

Conclusions

These recommendations should help clinicians to improve intraoperative and postoperative management, and thereby achieve better postoperative outcomes in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve.
RETRACTED ARTICLE: Inhibition of human liver cancer cell growth by evodiamine involves apoptosis and deactivation of PI3K/AKT pathway
Authors: Jia Jia , Kang Xigang , Liu Yanfang , Zhang Jianwei
Published: October 2020

Evodiamine is an active alkaloid member found in Traditional Chinese Herb (TCH) Evodia rutaecarpa. It has been reported to exhibit remarkable biological and medicinal activities including anticancer and anti-inflammatory. This study was designed to investigate the anticancer effects of evodiamine against human liver cancer and evaluate its effects on cell migration, cell invasion, cellular apoptosis and PI3K/AKT pathway. The results showed that evodiamine exhibits potent antiproliferative effects against two human liver cancer cell lines (HepG2 and PLHC-1) with an IC50 of 20 µM. Nonetheless, the cytotoxic effects of evodiamine were comparatively low against the normal cells as evident from the IC50 of 100 μM. The growth inhibitory effects of evodiamine were found to be due to the induction of apoptosis as revealed by the DAPI, AO/EB and annexin V/PI staining assays. The induction of apoptosis was also associated with upregulation of Bax and downregulation of Bcl-2 expression in a concentration dependent manner. The wound healing and transwell assay revealed that evodiamine caused a significant decline in the migration and invasion of the HepG2 and PLHC-1 cells. Investigation of the effects of evodiamine on the PI3K/AKT signalling revealed that evodiamine inhibited the phosphorylation of PI3K and AKT proteins. Taken together, the results showed that evodiamine inhibits the growth of human liver cancer via induction of apoptosis and deactivation of PI3K/AKT pathway. The results point towards the therapeutic potential of evodiamine in the treatment of liver cancer.
Treatment of the mandibular shift in an adult woman and the diagnostic value of joint space index: a case report
Authors: Xia Kai , Sun Wentian , Yu Liyuan , Huang Xinqi , Zhao Zhihe , Liu Jun
Published: October 2020

Background

Mandibular deviations are common clinical complaints. The orthodontic or orthognathic treatment of mandibular deviations is tricky because a comprehensive diagnosis, especially a functional one, is difficult to make. A inaccurate diagnosis may lead to a compromised and unstable treatment outcome.

Case presentation

This article describes the diagnosis and treatment of a woman with a mandibular deviation and facial skeletal asymmetry. By eliminating the disharmony of the arch form with elastics and bite turbos, her esthetic and functional outcomes improved. Cone-beam CT (CBCT) and Joint Space Index (JSI) analyses served as the diagnostic approaches and outcome evaluation methods before and after treatment.

Conclusions

A condyle position displacement could be an indication of functional deviation. JSI analysis is a quantitative and convenient choice to compare condyle relative positions.
“Finding my own identity”: a qualitative metasynthesis of adult anorexia nervosa treatment experiences
Authors: Conti Janet E. , Joyce Caroline , Hay Phillipa , Meade Tanya
Published: October 2020

Background

The aim of this metasynthesis was to explore adult anorexia nervosa (AN) treatment experiences, including facilitators and barriers to treatment engagement and ways that questions of identity and personal agency were negotiated in treatment contexts.

Methods

From 14 qualitative studies that met the search criteria, this thematic synthesis analyzed the sensitized concept of identity in the participants’ experiences of AN treatments, including their sense of personal agency, and implications for their recovery. The study was registered with Prospero (ID: CRD42018089259) and is reported according to PRISMA guidelines.

Results

Three meta-themes were generated with the following key findings: grappling with identity, where collaborative and tailored interventions were positively experienced; the quality of the therapeutic relationship, which existed in a recursive relationship; and, rebuilding identity that included therapists standing with the person in recovering a sense of identity outside the anorexic identity. Importantly, interventions that failed to be negotiated with the person were experienced as disempowering however, where a two-way trust existed in the therapeutic relationship, it critically empowered and shaped participants’ sense of identity, and broadened the perception that they were valuable as a person.

Conclusions

There was consensus across the range of treatment contexts that individuals with a lived AN experience preferred treatments where they experienced (1) a sense of personal agency through tailored interventions; and (2) therapists who treated them as a person who, in the face of their struggles, had skills and capacities in the processes of recovering and rebuilding sustainable and preferred identities outside the AN identity.
COV-OBS.x2: 180 years of geomagnetic field evolution from ground-based and satellite observations
Authors: Huder Loïc , Gillet Nicolas , Finlay Christopher C. , Hammer Magnus D. , Tchoungui Hervé
Published: October 2020

We present the geomagnetic field model COV-OBS.x2 that covers the period 1840–2020. It is primarily constrained by observatory series, satellite data, plus older surveys. Over the past two decades, we consider annual differences of 4-monthly means at ground-based stations (since 1996), and virtual observatory series derived from magnetic data of the satellite missions CHAMP (over 2001–2010) and Swarm (since 2013). A priori information is needed to complement the constraints carried by geomagnetic records and solve the ill-posed geomagnetic inverse problem. We use for this purpose temporal cross-covariances associated with auto-regressive stochastic processes of order 2, whose parameters are chosen so as to mimic the temporal power spectral density observed in paleomagnetic and observatory series. We aim this way to obtain as far as possible realistic posterior model uncertainties. These can be used to infer for instance the core dynamics through data assimilation algorithms, or an envelope for short-term magnetic field forecasts. We show that because of the projection onto splines, one needs to inflate the formal model error variances at the most recent epochs, in order to account for unmodeled high frequency core field changes. As a by-product of the core field model, we co-estimate the external magnetospheric dipole evolution on periods longer than 2 years. It is efficiently summarized as the sum of a damped oscillator (of period 10.5 years and decay rate 55 years), plus a short-memory (6 years) damped random walk.
Introduction of a digital near-vision reading test for normal and low vision adults: development and validation
Authors: Labiris Georgios , Panagiotopoulou Eirini-Kanella , Chatzimichael Eleftherios , Tzinava Maria , Mataftsi Asimina , Delibasis Konstantinos
Published: October 2020

Background

MNREAD is an advanced near-vision acuity chart that has already been translated and validated in Greek language. Considering that no validated Greek digital near-vision test exists, our primary objective was to develop and validate a digital near-vision reading test based on the fundamental properties of the Greek printed MNREAD (MNREAD-GR).

Methods

This is a prospective, comparative study. A digital near-vision chart was developed (Democritus Digital Acuity Reading Test – DDART) with text size calibration, audio recording for automatic reading timing, as well as automatic calculation of reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC). Normal and low vision subjects participated in the validation process, responding to MNREAD-GR and DDART at the same day, at a 40 cm viewing distance. Differences in all parameters between the charts were compared with t-test and intraclass correlation coefficients (ICCs). Within 15 days, all participants responded again to DDART in a different set of sentences to assess its test-retest reliability.

Results

One hundred patients (normal vision group - NVG: 70 patients; low vision group - LVG: 30 patients) responded to both reading tests. Non-significant differences were detected for all parameters between DDART and MNREAD-GR except for MRS and ACC that were significantly higher in MNREAD-GR in NVG (p <  0.01). NVG participants demonstrated sufficient ICCs that ranged from 0.854 to 0.963, while LVG demonstrated ICCs for RA, ACC, MRS and CPS equal to 0.986, 0.894, 0.794 and 0.723, respectively. All parameters calculated with DDART demonstrated excellent test-retest reliability (ICCs: 0.903 – 0.956).

Conclusions

The proposed reading test presented comparable validity and repeatability to MNREAD-GR suggesting that it can be used both in normal and low vision Greek patients.

Trial registration

ClinicalTrials.gov, NCT04242836. Registered 24 January 2020 – Retrospectively registered.
Refractory pneumothorax and hemothorax associated with metastatic scalp angiosarcoma
Authors: Isowa Masahide , Tanaka Satona , Nakanobo Ryo , Yamada Yoshito , Date Hiroshi
Published: October 2020

Background

Pulmonary metastasis of scalp angiosarcoma (SA) is a rare, but life-threatening disease, challenging to diagnose and manage. We report two cases of pneumothorax and hemothorax with pathologically proven metastasis of SA in the parietal pleura, which was not predictable from images and difficult to manage.

Patient A

A 73-year-old man with SA underwent chemoradiotherapy and surgical resection for primary skin lesion, was sent to our department to treat right empyema, which was developed during chest tube drainage for pneumothorax. Computed tomography (CT) showed multiple bullous lesions. We performed repetitive video-assisted thoracoscopic surgery (VATS) for the debridement and hemostasis; however, hemothorax was uncontrollable. The repeated cytology of pleural effusion showed no malignancy. We eventually performed fenestration and metastatic SA was pathologically diagnosed by the biopsy of parietal pleura. The patient developed respiratory failure and uncontrolled anemia, which were fatal.

Patient B

A 71-year-old man with SA previously treated with chemoradiotherapy was referred to our department for left pneumothorax. CT showed multiple bullous lesions at apex without any changes at parietal pleura. VATS was performed and the apex bullous lesion with air leakage was resected. The parietal pleura showed several dark-red spots and the biopsy was undertaken. The pathological diagnosis was a metastasis of SA along with visceral pleura and parietal pleura. The patient then developed right pneumothorax and left hemopneumothorax. Bilateral pleurodesis was ineffective and the patient died due to deteriorating general condition.

Conclusions

In patients with a history of SA who develop pneumothorax and hemothorax, metastatic SA to visceral and parietal pleura should be always considered. Surgical biopsy, not cytology, is needed for pathological diagnosis. Lesions in the parietal pleura prior to hemothorax were thoracoscopically observed in one case. Surgeons must recognize that conventional surgical intervention or pleurodesis will have unsatisfactory results.
How the provision of childcare affects attitudes towards maternal employment
Authors: Roth Anja
Published: October 2020

Do childcare institutions affect gender norms of individuals? I examine the introduction of childcare services and their impact on voters’ support of policies promoting maternal employment. I address the inherent endogeneity between institutions and attitudes by exploiting regional variation in the regulations and provision of childcare for school children outside of regular school hours. My results show that the expansion of childcare for school children increases voters’ support of policies promoting maternal employment. This indicates a direct effect of local institutions on voters’ attitudes. I additionally show that as public costs of the new facilities increase, support of additional policies promoting maternal employment decreases.
Evidence of Long-range nerve pathways connecting and coordinating activity in secondary lymph organs
Authors: Cotero Victoria , Kao Tzu-Jen , Graf John , Ashe Jeffrey , Morton Christine , Chavan Sangeeta S. , Zanos Stavros , Tracey Kevin J. , Puleo Christopher M.
Published: October 2020

Background

Peripheral nerve reflexes enable organ systems to maintain long-term physiological homeostasis while responding to rapidly changing environmental conditions. Electrical nerve stimulation is commonly used to activate these reflexes and modulate organ function, giving rise to an emerging class of therapeutics called bioelectronic medicines. Dogma maintains that immune cell migration to and from organs is mediated by inflammatory signals (i.e. cytokines or pathogen associated signaling molecules). However, nerve reflexes that regulate immune function have only recently been elucidated, and stimulation of these reflexes for therapeutic effect has not been fully investigated.

Methods

We utilized both electrical and ultrasound-based nerve stimulation to activate nerve pathways projecting to specific lymph nodes. Tissue and cell analysis of the stimulated lymph node, distal lymph nodes and immune organs is then utilized to measure the stimulation-induced changes in neurotransmitter/neuropeptide concentrations and immune cellularity in each of these sites.

Results and conclusions

In this report, we demonstrate that activation of nerves and stimulated release of neurotransmitters within a local lymph node results in transient retention of immune cells (e.g. lymphocytes and neutrophils) at that location. Furthermore, such stimulation results in transient changes in neurotransmitter concentrations at distal organs of the immune system, spleen and liver, and mobilization of immune cells into the circulation. This report will enable future studies in which stimulation of these long-range nerve connections between lymphatic and immune organs can be applied for clinical purpose, including therapeutic modulation of cellularity during vaccination, active allergic response, or active auto-immune disease.
L-fuzzy pre-proximities, L-fuzzy filters and L-fuzzy grills
Authors: Ramadan A. A. , Usama M. A. , Abd El-Latif A. A.
Published: October 2020

This article gives results on fixed complete lattice L-fuzzy pre-proximities, L-fuzzy grills and L-fuzzy filters. Moreover, we investigate the relations among the L-fuzzy pre-proximities , L-fuzzy grills and L-fuzzy filters. We show that there is a Galois correspondence between the category of separated L-fuzzy grill spaces and that of separated L-fuzzy pre-proximity spaces. We introduced the local function associated with L-fuzzy grill and L-fuzzy topology and studied some of its properties. Finally, we build an L-fuzzy topology for the corresponding L-fuzzy grill by using local function.
Understanding the experience of initiating community-based group physical activity by people with serious mental illness: A systematic review using a meta-ethnographic approach
Authors: Quirk Helen , Hock Emma , Harrop Deborah , Crank Helen , Peckham Emily , Traviss-Turner Gemma , Machaczek Katarzyna , Stubbs Brendon , Horspool Michelle , Weich Scott , Copeland Robert
Published: October 2020

Background

People living with serious mental illness (SMI) experience debilitating symptoms that worsen their physical health and quality of life. Regular physical activity (PA) may bring symptomatic improvements and enhance wellbeing. When undertaken in community-based group settings, PA may yield additional benefits such as reduced isolation. Initiating PA can be difficult for people with SMI, so PA engagement is commonly low. Designing acceptable and effective PA programs requires a better understanding of the lived experiences of PA initiation among people with SMI.

Methods

This systematic review of qualitative studies used the meta-ethnography approach by Noblit and Hare (1988). Electronic databases were searched from inception to November 2017. Eligible studies used qualitative methodology; involved adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder, or psychosis; reported community-based group PA; and captured the experience of PA initiation, including key features of social support. Study selection and quality assessment were performed by four reviewers.

Results

Sixteen studies were included in the review. We identified a “journey” that depicted a long sequence of phases involved in initiating PA. The journey demonstrated the thought processes, expectations, barriers, and support needs of people with SMI. In particular, social support from a trusted source played an important role in getting people to the activity, both physically and emotionally.

Discussion

The journey illustrated that initiation of PA for people with SMI is a long complex transition. This complex process needs to be understood before ongoing participation in PA can be addressed. Registration—The review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 22/03/2017 (registration number CRD42017059948).
Iodine Deficiency Increases Fat Contribution to Energy Expenditure in Male Mice
Authors: Bocco Barbara M L C , Fernandes Gustavo W , Fonseca Tatiana L , Bianco Antonio C
Published: October 2020

More than a billion people worldwide are at risk of iodine deficiency (ID), with well-known consequences for development of the central nervous system. Furthermore, ID has also been associated with dyslipidemia and obesity in humans. To further understand the metabolic consequences of ID, here we kept 8-week-old C57/Bl6 mice at thermoneutrality (~28°C) while feeding them on a low iodine diet (LID). When compared with mice kept on control diet (LID + 0.71 μg/g iodine), the LID mice exhibited marked reduction in T4 and elevated plasma TSH, without changes in plasma T3 levels. LID mice grew normally, and had normal oxygen consumption, ambulatory activity, and heart expression of T3-responsive gene, confirming systemic euthyroidism. However, LID mice exhibited ~5% lower respiratory quotient (RQ), which reflected a ~2.3-fold higher contribution of fat to energy expenditure. LID mice also presented increased circulating levels of nonesterified fatty acids, ~60% smaller fat depots, and increased hepatic glycogen content, all indicative of accelerated lipolysis. LID mice responded much less to forced mobilization of energy substrates (50% food restriction for 3 days or starvation during 36 hours) because of limited size of the adipose depots. A 4-day treatment with T4 restored plasma T4 and TSH levels in LID mice and normalized RQ. We conclude that ID accelerates lipolysis and fatty acid oxidation, without affecting systemic thyroid hormone signaling. It is conceivable that the elevated plasma TSH levels trigger these changes by directly activating lipolysis in the adipose tissues.
Ssc-miR-21-5p regulates endometrial epithelial cell proliferation, apoptosis and migration via the PDCD4/AKT pathway
Authors: Hua Renwu , Zhang Xiuling , Li Wenchao , Lian Weisi , Liu Qiaorui , Gao Dengying , Wang Yueying , Lei Minggang
Published: October 2020

Endometrial receptivity plays a vital role in successful embryo implantation in pigs. MicroRNAs (miRNAs), known as regulators of gene expression, have been implicated in the regulation of embryo implantation. However, the role of miRNAs in endometrial receptivity during the pre-implantation period remains elusive. In this study, we report that the expression level of Sus scrofa (ssc)-miR-21-5p in porcine endometrium tissues was significantly increased from day 9 to day 12 of pregnancy. Knockdown of ssc-miR-21-5p inhibited proliferation and migration of endometrial epithelial cells (EECs), and induced their apoptosis. We verified that programmed cell death 4 (PDCD4) was a target gene of ssc-miR-21-5p. Inhibition of PDCD4 rescued the effect of ssc-miR-21-5p repression on EECs. Our results also revealed that knockdown of ssc-miR-21-5p impeded the phosphorylation of AKT (herein referring to AKT1) by targeting PDCD4, which further upregulated the expression of Bax, and downregulated the levels of Bcl2 and Mmp9. Furthermore, loss of function of Mus musculus (mmu)-miR-21-5p in vivo resulted in a decreased number of implanted mouse embryos. Taken together, knockdown of ssc-miR-21-5p hampers endometrial receptivity by modulating the PDCD4/AKT pathway.
Endophilin-A2 dependent tubular endocytosis promotes plasma membrane repair and parasite invasion
Authors: Corrotte Matthias , Cerasoli Mark , Maeda Fernando Y. , Andrews Norma W.
Published: October 2020

Endocytosis of caveolae was previously implicated in the repair of plasma membrane wounds. Here we show that caveolin-1-deficient fibroblasts lacking caveolae upregulate a tubular endocytic pathway, and have a reduced capacity to reseal after permeabilization with pore-forming toxins when compared to wild type cells. Silencing endophilin-A2 expression inhibited fission of endocytic tubules and further reduced plasma membrane repair in cells lacking caveolin-1, supporting a role for tubular endocytosis as an alternative pathway for the removal of membrane lesions. Endophilin-A2 was visualized in association with cholera toxin B-containing endosomes and was recruited to recently formed intracellular vacuoles containing Trypanosoma cruzi, a parasite that utilizes the plasma membrane wounding/repair pathway to invade host cells. Endophilin-A2 deficiency inhibited T. cruzi invasion, and fibroblasts deficient in both caveolin-1 and endophilin-A2 did not survive prolonged exposure to the parasites. These findings reveal a novel cross-talk between caveolin-1 and endophilin-A2 in the regulation of clathrin-independent endocytosis and plasma membrane repair, a process that is subverted by T. cruzi parasites for cell invasion.
Can We Reliably Identify the Pathological Outcomes of Neoadjuvant Chemotherapy in Patients with Breast Cancer? Development and Validation of a Logistic Regression Nomogram Based on Preoperative Factors
Authors: Zhang Jian , Xiao Linhai , Pu Shengyu , Liu Yang , He Jianjun , Wang Ke
Published: October 2020

Background

Pathological responses of neoadjuvant chemotherapy (NCT) are associated with survival outcomes in patients with breast cancer. Previous studies constructed models using out-of-date variables to predict pathological outcomes, and lacked external validation, making them unsuitable to guide current clinical practice.

Objective

The aim of this study was to develop and validate a nomogram to predict the objective remission rate (ORR) of NCT based on pretreatment clinicopathological variables.

Methods

Data from 110 patients with breast cancer who received NCT were used to establish and calibrate a nomogram for pathological outcomes based on multivariate logistic regression. The predictive performance of this model was further validated using a second cohort of 55 patients with breast cancer. Discrimination of the prediction model was assessed using an area under the receiver operating characteristic curve (AUC), and calibration was assessed using calibration plots. The diagnostic odds ratio (DOR) was calculated to further evaluate the performance of the nomogram and determine the optimal cut-off value.

Results

The final multivariate regression model included age, NCT cycles, estrogen receptor, human epidermal growth factor receptor 2 (HER2), and lymphovascular invasion. A nomogram was developed as a graphical representation of the model and showed good calibration and discrimination in both sets (an AUC of 0.864 and 0.750 for the training and validation cohorts, respectively). Finally, according to the Youden index and DORs, we assigned an optimal ORR cut-off value of 0.646.

Conclusion

We developed a nomogram to predict the ORR of NCT in patients with breast cancer. Using the nomogram, for patients who are operable and whose ORR is < 0.646, we believe that the benefits of NCT are limited and these patients can be treated directly using surgery.
Establishing local diagnostic reference levels for common orthopaedic procedures using the mini C-arm fluoroscope
Authors: Kropelnicki Anna , Eaton Rosemary , Adamczyk Alexandra , Waterman Jacqueline , Mohaghegh Pegah
Published: October 2020

Objective:

Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years.

Methods:

This retrospective audit evaluates the end dose–area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital.

We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope.

Results:

For our data set (n = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm2), hand (7.62 cGycm2), and foot/ankle (8.56 cGycm2), and highest for wrist (10.64 cGycm2) and elbow (14.61 cGycm2) procedures.

Advances in knowledge:

To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.
Assessing the role of the universal addition of CT thorax to CT abdomen and pelvis in the COVID era. A retrospective multicentre cohort study
Authors: Brennan Christopher Anthony , Morrissey Brian , Dubois-Marshall Sylvie , McAteer Dympna , Qadir Abdul , Ramsay George
Published: October 2020

Objective:

The SARS-CoV2 infection is associated with high mortality for individuals who undergo emergency surgery. The United Kingdom surgical associations and Colleges of Surgeons collectively recommended the addition of CT Thorax to all emergency CT abdomen/pelvis imaging in order to help identify possible COVID-19 patients. Early identification of these patients would lead to optimal treatment strategies for the patient and protection for staff members. However, an extension of CT would be associated with increased irradiation doses for the patient, and its diagnostic relevance was unclear.

Methods:

This was a retrospective observational review looking at all surgical admissions that required a CT Thorax/Abdomen/Pelvis across 7 weeks during the COVID-19 pandemic, across four Scottish Hospitals. CT thorax investigations (of non-surgical patients) were also re-assessed by a single radiologist to assess the extent of pathology identified at the lung bases (and therefore would be included in a standard CT abdomen and pelvis).

Results:

Of 216 patients identified who had a CT thorax/Abdomen/Pelvis during the timeframe, 5 were diagnosed with COVID-19. During this timeframe, 77 patients underwent solely CT thorax. Across the entire cohort, 98% of COVID pathology was identified at the lung bases. The estimated sensitivity and specificity of CT thorax was 60 and 86.4% respectively.

Conclusions:

In a region with relatively low prevalence of SARS-COV2 infection, inclusion of CT Thorax in surgical admission imaging does not significantly contribute to identification and management of SARS-COV2 patients. We therefore suggest that imaging the lung bases can be sufficient to raise clinical suspicion of COVID-19.

Advances in knowledge:

This paper adds further evidence to that from other single UK centres that the addition of CT chest for all patients does not yield any further diagnostic information regarding coronavirus. Additionally, rapid SARS-CoV-2 testing in the UK (which is currently widely available) further demonstrates that inclusion of the entire chest during CT examination of the acute abdomen is not required.