bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytology in the time of coronavirus disease (COVID-19): an Italian perspective
Authors: Vigliar Elena , Iaccarino Antonino , Bruzzese Dario , Malapelle Umberto , Bellevicine Claudio , Troncone Giancarlo 
Published: April 2020

IntroductionThe coronavirus disease 2019 (COVID-19) is changing the way we practice pathology, including fine needle aspiration (FNA) diagnostics. Although recommendations have been issued to prioritise patients at high oncological risk, postponing those with unsuspicious presentations, real world data have not been reported yet.MethodsThe percentages of the cytological sample types processed at the University of Naples Federico II, during the first 3 weeks of Italian national lockdown were compared with those of the same period in 2019.ResultsDuring the emergency, the percentage of cytology samples reported as malignant increased (p<0.001), reflecting higher percentages of breast (p=0.002) and lymph nodes FNAs (p=0.008), effusions (p<0.001) and urine (p=0.005). Conversely, thyroid FNAs (p<0.001) and Pap smears (p=0.003) were reduced.ConclusionsEven in times of COVID-19 outbreak, cytological examination may be safely carried out in patients at high oncological risk, without the need to be postponed.
Leukocyte Telomere Length and Its Interaction with Germline Variation in Telomere-Related Genes in Relation to Pancreatic Adenocarcinoma Risk
Authors: Antwi Samuel O. , Bamlet William R. , Rabe Kari G. , Cawthon Richard M. , Umudi Isoken , Druliner Brooke R. , Sicotte Hugues , Oberg Ann L. , Jatoi Aminah , Boardman Lisa A. , Petersen Gloria M. 
Published: April 2020

Abstract

Background:
Leukocyte telomere length (LTL) has been associated with risk of multiple cancers, but its association with pancreatic ductal adenocarcinoma (PDAC) is unclear. We therefore investigated the association between peripheral blood LTL and PDAC risk, and examined effect modification by candidate SNPs previously reported to be associated with variation in LTL.

Methods:
A case–control study of 1,460 PDAC cases and 1,459 frequency-matched controls was performed using biospecimens and data from the Mayo Clinic Biospecimen Resource for Pancreas Research. Quantitative PCR was used to measure LTL and categorized into tertiles based on sex-specific control distribution. Eleven telomere-related SNPs also were genotyped. Logistic regression was used to calculate ORs and 95% confidence intervals (CI).

Results:
Shorter peripheral blood LTL was associated with a higher risk of PDAC (ORT1vsT3 = 1.26, 95% CI = 1.03–1.54, Ptrend = 0.02; ORcontinuous = 1.14, 95% CI = 1.02–1.28), but the association was restricted to cases with treatment-naïve blood samples (ORT1vsT3 = 1.51, 95% CI = 1.16–1.96, Ptrend = 0.002; ORcontinuous = 1.25, 95% CI = 1.08–1.45) and not cases whose blood samples were collected after initiation of cancer therapy (ORT1vsT3 = 1.10, 95% CI = 0.87–1.39, Ptrend = 0.42; ORcontinuous = 1.08, 95% CI = 0.94–1.23). Three SNPs (TERC-rs10936599, ACYP2-rs11125529, and TERC-rs1317082) were each associated with interindividual variation in LTL among controls, but there was no evidence of effect modification by these SNPs.

Conclusions:
Treatment-naïve short LTL is associated with a higher risk of PDAC, and the association does not differ by germline variation in the candidate telomere-related SNPs examined.

Impact:
Peripheral blood LTL might serve as a molecular marker for risk modeling to identify persons at high risk of PDAC.
Cytotoxic Therapy–Induced Effects on Both Hematopoietic and Marrow Stromal Cells Promotes Therapy-Related Myeloid Neoplasms
Authors: Stoddart Angela , Wang Jianghong , Fernald Anthony A. , Davis Elizabeth M. , Johnson Camille R. , Hu Chunmei , Cheng Jason X. , McNerney Megan E. , Le Beau Michelle M. 
Published: April 2020

Abstract

Therapy-related myeloid neoplasms (t-MN) following treatment with alkylating agents are characterized by a del(5q), complex karyotypes, alterations of TP53, and a dismal prognosis. To decipher the molecular pathway(s) leading to the pathogenesis of del(5q) t-MN and the effect(s) of cytotoxic therapy on the marrow microenvironment, we developed a mouse model with loss of two key del(5q) genes, EGR1 and APC, in hematopoietic cells. We used the well-characterized drug, N-ethyl-N-nitrosurea (ENU), to demonstrate that alkylating agent exposure of stromal cells in the microenvironment increases the incidence of myeloid disease. In addition, loss of Trp53 with Egr1 and Apc was required to drive the development of a transplantable leukemia, and accompanied by the acquisition of somatic mutations in DNA damage response genes. ENU treatment of mesenchymal stromal cells induced cellular senescence and led to the acquisition of a senescence-associated secretory phenotype, which may be a critical microenvironmental alteration in the pathogenesis of myeloid neoplasms.

Significance:
This study challenges the historic view that prior cytotoxic therapy targets only hematopoietic cells and shows that chemotherapy-induced alterations to the microenvironment contribute to myeloid neoplasms in a model of del(5q) t-MN. The DNA damage response in hematopoietic cells and senescence of stromal cells are identified as potential therapeutic targets.
See related commentary by Shannon and Link, p. 10.
This article is highlighted in the In This Issue feature, p. 5
Left Atrial End-Diastolic Volume Index as a Predictor of Cardiovascular Outcomes
Authors: Thadani Samir R. , Shaw Richard E. , Fang Qizhi , Whooley Mary A. , Schiller Nelson B. 
Published: April 2020

Background:
The left atrial end-systolic volume index (LAESVI) is a predictor of cardiovascular outcomes and is the recommended measurement of left atrial size. The left atrial end-diastolic volume index (LAEDVI), representing the minimum or residual left atrial volume, has not been fully evaluated as a predictor of cardiovascular events. This study evaluated the predictive power of LAEDVI compared with LAESVI for heart failure (HF) hospitalizations, a composite of HF hospitalizations, myocardial infarction, stroke, and heart disease death, and all-cause mortality.

Methods:
We measured LAESVI and LAEDVI in subjects without atrial fibrillation or flutter or significant mitral valve disease. Using Cox proportional-hazard models, the association of LAESVI and LAEDVI with the stated outcomes was examined.

Results:

After a mean of 7.3±2.6 years of follow-up, there were 147 HF hospitalizations, 118 myocardial infarctions, 45 strokes, 96 heart disease deaths, and 351 deaths from all causes in 938 subjects. When comparing the highest and the lowest quartiles of LAEDVI, there was a near 6-fold increase in the hazard ratio (HR) for HF hospitalization (HR, 5.96;
P
<0.001). This was higher than what was seen with LAESVI (HR, 4.85;
P
<0.001). Similar associations were noted for the composite cardiovascular outcome (HR for LAEDVI, 2.97;
P
<0.001) and for all-cause mortality (HR for LAEDVI, 2.08;
P
<0.001). In adjusted models, LAEDVI demonstrated equal or better predictive power than LAESVI for HF hospitalization and the composite cardiovascular outcome.

Conclusions:
LAEDVI is a strong predictor of cardiovascular events in ambulatory patients with stable coronary heart disease and may merit routine use.
Coronary Artery Calcium as a Synergistic Tool for the Age‐ and Sex‐Specific Risk of Cardiovascular and Cancer Mortality: The Coronary Artery Calcium Consortium
Authors: Dzaye Omar , Al Rifai Mahmoud , Dardari Zeina , Shaw Leslee J. , Al‐Mallah Mouaz H. , Handy Marshall Catherine , Rozanski Alan , Mortensen Martin B. , Duebgen Matthias , Matsushita Kunihiro , Rumberger John A. , Berman Daniel S. , Budoff Matthew J. , Miedema Michael D. , Nasir Khurram , Blaha Michael J. , Whelton Seamus P. 
Published: April 2020

Background

Coronary artery calcium (
CAC
) is a predictor for the development of cardiovascular disease (
CVD
) and to a lesser extent cancer. The age‐ and sex‐specific relationship of
CAC
with
CVD
and cancer mortality is unknown.

Methods and Results

Asymptomatic patients aged 40 to 75 years old without known
CVD
were included from the
CAC
Consortium. We calculated sex‐specific mortality rates per 1000 person‐years’ follow‐up. Using parametric survival regression modeling, we determined the age‐ and sex‐specific
CAC
score at which the risk of death from
CVD
and cancer were equal. Among the 59 502 patients included in this analysis, the mean age was 54.9 (±8.5) years, 34% were women, and 89% were white. There were 671 deaths attributable to
CVD
and 954 deaths attributable to cancer over a mean follow‐up of 12±3 years. Among patients with
CAC
=0, cancer was the leading cause of death, the total mortality rate was low (women, 1.8; men, 1.5), and the
CVD
mortality rate was exceedingly low for women (0.3) and men (0.3). The age‐specific
CAC
score at which the risk of
CVD
and cancer mortality were equal had a U‐shaped relationship for women, while the relationship was exponential for men.

Conclusions

The age‐ and sex‐specific relationship of
CAC
with
CVD
and cancer mortality differed significantly for women and men. Our age‐ and sex‐specific
CAC
score provides a more precise estimate and further facilitates the use of
CAC
as a synergistic tool in strategies for the prediction and prevention of
CVD
and cancer mortality.
Shovels Out
Authors: Pandey Nandini 
Published: April 2020

Abstract
Review of: T.P. Wiseman, The House of Augustus: A Historical Detective Story. This engaging and accessible book conclusively puts to rest the longstanding misidentification of grand ruins on Rome’s Palatine Hill as the ‘House of Augustus’. Wiseman defends the view that Augustus’ buildings on the Palatine carefully differentiated between private modesty and public munificence while aligning the princeps with Romulus through their various imprints on this storied landscape. Sound archaeological arguments are couched within a less convincing attempt to reframe Augustus as a populist hero.
An exploration using system dynamics modelling of population-level mindfulness, mindful eating and healthy weight following intervention
Authors: Roesler Anna , Nishi Nobuo 
Published: April 2020

Background: Mindful eating has been introduced as a strategy to help prevent overweight and obesity. Aim: The purpose of this research was to develop a simple system dynamics model to investigate the impact of different interventions on population level mindfulness, mindful eating and healthy weight over a 10-year period. Methods: A model was constructed and outcomes analysed following the addition of four mindful eating interventions, including decreasing busyness (formal and informal work), promotion of mindful eating (e.g. classes and media), promotion of mindfulness, reduction of external eating cues (decreased portion sizes and variety) or a combination of all interventions. Results: The model projected that if the current situation was to continue over the next 10-year period, there would be a small decrease of 0.6% in the healthy-weight population despite a 42% increase in people practising mindfulness and 40% increase in people eating mindfully. Of the four interventions introduced, decreasing busyness had the greatest impact on the number of people practising mindfulness, eating mindfully and of a healthy weight. However, when all four interventions were introduced together this resulted in the greatest (19%) increase in the proportion of healthy-weight people. Conclusions: The study suggests that mindful eating can be improved through intervention, however, the interventions will not greatly contribute to improving the healthy-weight population unless implemented in combination.
Increased ROCK1 not ROCK2 in circulating leukocytes in rats with myocardial ischemia/reperfusion
Authors: Cheng Chao , Liu Xiao-Bo , Xu Dong-Ling , Zhang Juan 
Published: April 2020

Background: Rho-associated protein kinase (ROCK) plays a vital role in the pathogenesis of many cardiovascular diseases. Previous studies have demonstrated that ROCK is overactivated and involved in myocardial ischemia/reperfusion in vivo. But the role of ROCK in circulating leukocytes during myocardial ischemia/reperfusion is not well studied. Material and methods: This study was performed to evaluate ROCK activity in circulating leukocytes in rats with myocardial ischemia/reperfusion injury. Myocardial ischemia/reperfusion Wistar rats were subjected to 30-min ischemia followed by 180-min reperfusion. ROCK activity in circulating leukocytes was examined by the phosphorylation state of myosin phosphatase targeting subunit 1, a substrate of ROCK. Results: ROCK activity significantly increased in leukocytes in rat ischemia/reperfusion models compared to the sham group. ROCK1 not ROCK2 level in circulating leukocytes was significantly elevated in ischemia/reperfusion. Administration of the selective inhibitor of ROCK, fasudil, significantly reduced myocardial infarct size, myocyte apoptosis, and inflammatory cytokine, including interleukin 6 and tumor necrosis factor α. Furthermore, fasudil upregulated ischemia/reperfusion-induced reduction of nitric oxide production. Conclusion: Increased ROCK1 not ROCK2 in circulating leukocytes plays a role in the pathogenesis of myocardial ischemia/reperfusion injury. Inhibition of ROCK1 in circulating leukocytes has an important role in fasudil-induced cardioprotective effects. ROCK1 in circulating leukocytes might be a new biomarker in myocardial ischemia/reperfusion injury.
An expert consensus to standardize acupuncture treatment for knee osteoarthritis
Authors: Sun Ning , Wang Li-Qiong , Shao Jia-Kai , Zhang Na , Zhou Ping , Fang Sai-Nan , Chen Wei , Yang Jing-Wen , Liu Cun-Zhi 
Published: April 2020

Background: Acupuncture has been advocated for as a potentially effective therapy for patients with knee osteoarthritis (KOA) in systematic reviews and guidelines. However, there is still a lack of agreement on the optimal therapeutic protocol for acupuncture. This aim of this study was to develop an expert consensus regarding the therapeutic protocol of acupuncture to guide doctors in clinical practice. Methods: An initial list of items was based on an overview of research evidence from four databases and clinical problem investigation with a multidisciplinary panel. A two-step process was used to optimize the list, including semi-structured interviews with three acupuncture clinical experts and a three-round Delphi consensus survey with the voting panel. A nine-point Likert-type scale (1 = strongly disagree, 9 = strongly agree) was used to measure agreement. Results: In total, 52 professionals (response rate: 52%) confirmed their participation in the voting panel. The initial list including 28 items was evaluated. Following a three-round Delphi survey, a consensus was achieved including 37 items that can be broadly categorized into six domains: (1) main treatment principles, (2) acupuncture treatment, (3) dose of acupuncture intervention, (4) primary outcomes, (5) adverse events and (6) others. Conclusion: This expert consensus could be used to guide doctors in clinical practice and help patients with KOA gain access to appropriate and coordinated acupuncture treatment.
Advance Care Planning for African American Caregivers of Relatives With Dementias: Cluster Randomized Controlled Trial
Authors: Bonner Gloria J. , Freels Sally , Ferrans Carol , Steffen Alana , Suarez Marie L. , Dancy Barbara L. , Watkins Yashika J. , Collinge William , Hart Alysha S. , Aggarwal Neelum T. , Wilkie Diana J. 
Published: April 2020

Background and Objectives: African-American family caregivers may have insufficient knowledge to make informed end-of-life (EOL) decisions for relatives with dementias. Advance Care Treatment Plan (ACT-Plan) is a community-based education intervention to enhance knowledge of dementia and associated EOL medical treatments, self-efficacy, intentions, and behavior (written EOL care plan). This study evaluated efficacy of the intervention compared to attention control. Research Design and Methods: In a theoretically based, 2-group, cluster randomized controlled trial, 4 similar Midwestern urban megachurches were randomized to experimental or control conditions. Each church recruited African-American caregivers, enrolling concurrent waves of 5 to 9 participants in 4 weekly 1-hour sessions (358 total: ACT-Plan n = 173, control n = 185). Dementia, cardiopulmonary resuscitation (CPR), mechanical ventilation (MV), and tube feeding (TF) treatments were discussed in ACT-Plan classes. Participants completed assessments before the initial class, after the final class (week 4), and at week 20. Repeated measures models were used to test the intervention effect on changes in outcomes across time, adjusting for covariates as needed. Results: Knowledge of CPR, MV, TF, and self-efficacy to make EOL treatment decisions increased significantly more in the ACT-Plan group at weeks 4 and 20. Knowledge of dementia also increased more in the ACT-Plan group at both points, reaching statistical significance only at week 20. Intentions to make EOL treatment decisions and actually an advance care plan were similar between treatment arms. Discussion and Implications: Findings demonstrate promise for ACT-Plan to increase informed EOL treatment decisions for African American caregivers of individuals with dementias.
Palladium-103 plaque therapy for multifocal iris melanoma: Radiation of the entire anterior segment of the eye
Authors: Finger Paul T , Tomar Ankit Singh , Chin Kimberly J 
Published: April 2020

Purpose: To investigate the safety and tolerability of total anterior segment palladium-103 (103Pd) eye plaque brachytherapy for multifocal iris melanoma. Methods: Interventional case series of 11 patients with multifocal iris melanomas. Anterior segment ultrasound revealed tumor size, location, and intraocular margins. Epicorneal amniotic membrane grafts protected the cornea and decreased pain during total anterior segment 103-Pd ophthalmic plaque brachytherapy. Results: Eleven diffuse iris melanomas were American Joint Committee on Cancer 8th edition–classified as T1 (n = 5, 45.5%) and T2 (n = 6, 54.5%). Plaque radiation was completed to a minimum mean tumor dose of 85 Gy (mean dose rate, 58.1 cGy/h). Ultrasonographic tumor thickness regression was 41% (follow up mean 58.7, median 50, range: 8–139 months). Despite 100% local control and 100% eye retention, one patient (9.1%) developed metastatic disease. Four eyes required cataract surgery. There was no corneal stem-cell deficiency, corneal opacity, radiation maculopathy, or optic neuropathy. While visual acuity prior to treatment was 20/40 or better in 10 (91%), 9 were 20/40 or better (81.9%) at last follow-up. Four (36%) had glaucoma prior to treatment and three eyes developed glaucoma after treatment for a total of 63%. Conclusion: Total anterior segment (103Pd) plaque brachytherapy resulted in local control, good visual acuity, eye and life preservation in the treatment of multifocal iris melanoma.
Unusual presentation of early-onset X-linked retinoschisis: Report after 1 year of multimodal follow-up
Authors: Lembo Andrea , Bacci Giacomo Maria , Serafino Massimiliano , Lucentini Stefano , Caputo Roberto , Bargiacchi Sara , Passerini Ilaria , Barca Francesco , Nucci Paolo 
Published: April 2020

Purpose: To describe the unusual presentation, diagnosis, and clinical course of an early-onset X-linked infantile retinoschisis Case report: A 6-month-old infant presented with strabismus and poor fixation. After the detection of bilateral intraretinal hemorrhage and diffuse dystrophic retinal pattern at indirect ophthalmoscopy, the patient received a complete evaluation under anesthesia. Retinal wide-field imaging, spectral domain optical coherence tomography, and electroretinogram were performed and revealed a retinoschisis involving the posterior pole and the inferior periphery in the right eye. In the left eye, an inferior retinal detachment extending to the macula was detected. Blood sample and genetic counseling were required in the strong suspicion of an inherited retinal dystrophy. Genetic tests confirmed the diagnosis of X-linked retinoschisis (RS1 gene mutation). After consultation with a pediatric vitreoretinal surgeon, a wait and see strategy was chosen. The follow up visits showed a surprisingly good natural course of the disease. Conclusion: X-linked retinoschisis is a well-known inherited retinal disease potentially affecting young children as early as 3 months old. In this case, the stunning presentation (diffuse retinal pigment epithelium dystrophic changes resembling a macular dystrophy) and the positive course of the disease (resolution of macular retinal detachment in the left eye and stability of schisis in the right eye) arise some interesting considerations about the necessity of an early surgical treatment.
Predicting Healthy Lifestyle Behaviours Among Patients With Type 2 Diabetes in Rural Bali, Indonesia
Authors: Asril Nice Maylani , Tabuchi Keiji , Tsunematsu Miwako , Kobayashi Toshio , Kakehashi Masayuki 
Published: April 2020

Background: Type 2 diabetes is a lifelong metabolic disease closely related to unhealthy lifestyle behaviours. This study aimed to identify factors explaining the healthy lifestyle behaviours of patients with type 2 diabetes in rural Indonesia. The extended health belief model, demographic characteristics, clinical lifestyle factors and diabetes knowledge were investigated to provide a complete description of these behaviours. Method: A sample of 203 patients with type 2 diabetes representing a cross-section of the population were recruited from community health centres in the rural areas of Bali province. The data were collected through questionnaires. Descriptive statistics and a hierarchical regression test were employed. Results: This study showed demographic characteristics, clinical and lifestyle factors, diabetes knowledge and the extended health belief model accounted for 71.8% of the variance in healthy lifestyle behaviours of patients with type 2 diabetes in rural Indonesia. The significant demographic factors were age, education level, employment status and traditional beliefs. The significant clinical and lifestyle factors were alcohol use, diabetic medicine and duration of symptoms. Finally, the significant extended health belief model factors were perceived severity, susceptibility, barriers, family support, bonding social capital and chance locus of control. Conclusions: The extended health belief model forms an adequate model for predicting healthy lifestyle behaviours among patients with diabetes in rural Indonesia. The contribution of this model should be strengthened in developing the diabetes management.