bluuebunny/crossref_metadata_2025_split huggingface dataset:
EBV-EBNA1 constructs an immunosuppressive microenvironment for nasopharyngeal carcinoma by promoting the chemoattraction of Treg cells
Authors: Huo Shaofen , Luo Yunfan , Deng Rui , Liu Xiong , Wang Jie , Wang Lu , Zhang Bao , Wang Fan , Lu Juan , Li Xiangping 
Published: October 2020

BackgroundNasopharyngeal carcinoma (NPC) is primarily caused by the Epstein-Barr virus (EBV) infection in NPC endemic areas. EBNA1 is an EBV-encoded nuclear antigen, which plays a critical role in the maintenance and replication of EBV genome. However, the mechanisms of EBNA1-promoted NPC immune escape are unknown. Regulatory T (Treg) cells are among the key regulators in restraining antitumor responses. However, the mechanisms of accumulation of Treg cells in NPC have not been defined. This study attempted to identify the detailed mechanisms of EBNA1 functions as a tumor accelerator to promote NPC immune escape by enhancing chemoattraction of Treg cells.MethodsmRNA profiles were determined by next-generation sequencing in NPC cells. In vitro and in vivo assays were performed to analyze the role of EBNA1 in regulation of recruitment of Treg cells. Colocation and coimmunoprecipitation analyzes were used to identify the SMAD3/c-JUN complex. Chromatin immunoprecipitation assay and dual luciferase reporter assays were designed to demonstrate c-JUN binding to miR-200a promoter and miR-200a targeting to CXCL12 3’Untranslated Regions. The hepatocellular carcinoma models were designed to demonstrate universality of the CXCL12-CXCR4-Treg axis in promoting immune evasion of various tumors.ResultA novel molecular mechanism was identified that involves EBV-EBNA1-stimulated chemotactic migration of Treg cells toward NPC microenvironment by upregulation of the transforming growth factor-β1 (TGFβ1)-SMAD3-PI3K-AKT-c-JUN-CXCL12-CXCR4 axis and downregulation of miR-200a. EBV-EBNA1 promotes the chemoattraction of Treg cells by governing the protein–protein interactions of the SMAD3/c-JUN complex in a TGFβ1-dependent manner in vitro and in vivo. TGFβ1 suppresses miR-200a by enhancing the SMAD3/c-JUN complex. miR-200a negatively regulates the CXCL12 chemokine by direct targeting of the CXCL12 3’UTR region. However, CXCL12 acts as the target gene of miR-200a and as an inhibitor of miR-200a transcription, and inhibition of miR-200a by CXCL12 is mediated by c-JUN, which directly binds to the miR-200a promoter and forms a c-JUN-miR-200a-CXCL12-c-JUN feedback loop. In addition, enhanced CXCL12 efficiently attracts CXCR4-positive Treg cells to remodel an immunosuppressive microenvironment.ConclusionsEBV-EBNA1 promotes chemotactic migration of Treg cells via the TGFβ1-SMAD3-PI3K-AKT-c-JUN-miR-200a-CXCL12-CXCR4 axis in the NPC microenvironment. These results suggest that EBV-EBNA1 may serve as a potential therapeutic target to reshape the NPC microenvironment.
Incidence and predictors of ophthalmic artery occlusion in intra-arterial chemotherapy for retinoblastoma
Authors: Sweid Ahmad , El Naamani Kareem , Sajja Kalyan Chekravarthy , Hammoud Batoul , Knapp Michael D , Moylan Daniel D , Joffe Daniel , Morse Charles E , Habbal Daniel , Weinberg Joshua H , Tjoumakaris Stavropoula I , Shields Carol L , Lezama David A , Lim Li-Anne S , Dalvin Lauren A , Rosenwasser Robert , Jabbour Pascal 
Published: October 2020

BackgroundRetinoblastoma is the most common primary intraocular malignancy in children.ObjectiveTo determine the incidence of ophthalmic artery (OA) occlusion in patients treated with selective ophthalmic artery catheterization (OAC) for chemotherapy infusion for retinoblastoma. Also, to evaluate technical, anatomical, tumorous, and patient-related factors that are predictors of OA occlusion.MethodsA retrospective chart review was performed for patients diagnosed with intraocular retinoblastoma and managed with intra-arterial chemotherapy (IAC).ResultsThe total study cohort included 208 retinoblastoma tumors of 208 eyes in 197 consecutive patients who underwent 688 attempted IAC infusions overall with a total of 624 successful OAC infusions. The total incidence of ophthalmic artery thrombosis was 11.1% (23/208). The numbers of successful OAC procedures before diagnosing OA occlusion were one OAC in six cases (27.3%), two in seven cases (31.8%), three in four cases (18.2%), four in one case (4.5%), five in two cases (9.1%), and six in one case (4.5%).ConclusionsLocal factors relating to the chemotherapy and selective microcatheterization of the OA are essential factors in the development of OA thrombosis, as seen by the association of OA thrombosis with the frequency of IAC.
Do EXCEL and NOBLE translate into real world? A 5-year observational study of left main stem outcomes
Authors: Joy George , Eissa Hany 
Published: October 2020

AimsWe aimed to uncover the 5-year real world outcomes of patients with significant left mainstem (LMS) disease managed with percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) or medical management.MethodsWe identified patients with LMS disease in 2012 and analysed baseline characteristics and outcomes in the following 5 years.Results119 patients were identified, 62% (74) received CABG and 12% (14) received PCI and 26% (31) were medically managed. In PCI versus CABG, there was no significant difference in age and Synergy between PCI with Taxus and Cardiac Surgery score but there were significantly higher rates of pretreatment heart failure (ejection fraction 42%±10 vs 52%±13p=0.01). Overall major adverse cardiovascular event (MACE) being a composite of stroke, myocardial infarction (MI), target vessel revascularisation and all-cause mortality were not statistically different but numerically higher in the PCI group (36% (5) vs 23% (17) p=0.12). Medically managed patients were significantly older than those that were revascularised (PCI or CABG n=88; 75±11 vs 69±9 years p=0.01). They also had higher MACE (74% (23) vs 25% (22) p=0.000002) driven by MI (19% (6) vs 2% (1) p=0.01) and all-cause mortality (52% (16) vs 19% (17) p=0.01) compared with those with revascularisation.ConclusionsThe bleak outcomes of medical management in LMS disease are reflective findings from studies performed from several decades ago. Our findings show that there is still a role for PCI in the management of LMS disease in selected patients.
Managing drug-induced QT prolongation in clinical practice
Authors: Khatib Rani , Sabir Fatima R N , Omari Caroline , Pepper Chris , Tayebjee Muzahir Hassan 
Published: October 2020

ABSTRACTMany drug therapies are associated with prolongation of the QT interval. This may increase the risk of Torsades de Pointes (TdP), a potentially life-threatening cardiac arrhythmia. As the QT interval varies with a change in heart rate, various formulae can adjust for this, producing a ‘corrected QT’ (QTc) value. Normal QTc intervals are typically &lt;450 ms for men and &lt;460 ms for women. For every 10 ms increase, there is a ~5% increase in the risk of arrhythmic events. When prescribing drugs associated with QT prolongation, three key factors should be considered: patient-related risk factors (eg, female sex, age &gt;65 years, uncorrected electrolyte disturbances); the potential risk and degree of QT prolongation associated with the proposed drug; and co-prescribed medicines that could increase the risk of QT prolongation. To support clinicians, who are likely to prescribe such medicines in their daily practice, we developed a simple algorithm to help guide clinical management in patients who are at risk of QT prolongation/TdP, those exposed to QT-prolonging medication or have QT prolongation.
In-hospital complications affect short-term and long-term mortality in ICH: a prospective cohort study
Authors: Zhang Yaqing , Wang Yongjun , Ji Ruijun , Wang Anxin , Wang Yilong , Yang Zhonghua , Liu Liping , Wang Penglian , Zhao Xingquan 
Published: October 2020

BackgroundMedical complications strongly affected the mortality of patients with stroke. However, only limited research has studied the effect of in-hospital medical complications on the mortality of patients with spontaneous intracerebral haemorrhage (ICH) globally. Using the China National Stroke Registry, the effect was prospectively and systematically investigated in patients with spontaneous ICH during their hospitalisation, at 3, 6 and 12 months after disease onset.MethodsThis study collected data on patients over 18 years old with spontaneous ICH from 132 Chinese clinical centres across 32 provinces and four municipalities (Hong Kong included), from September 2007 to August 2008. Data on patient complications, death and other information were acquired through paper-based registry forms. Using multivariable logistic regression, the association of medical complications with stroke outcomes was evaluated.ResultsOf 3255 patients with spontaneous ICH, 878 (26.97%) had in-hospital medical complications. In-hospital medical complications were independent risk factors for death during the hospitalisation (adjusted OR 4.41, 95% CI 3.18 to 6.12), at 3 months (adjusted OR 2.18, 95% CI 1.70 to 2.80), 6 months (adjusted OR 1.84, 95% CI 1.45 to 2.34) and 12 months (adjusted OR 1.59, 95% CI 1.26 to 2.01) after spontaneous ICH.ConclusionThe results revealed that the short-term and long-term mortality of patients with spontaneous ICH in China was significantly associated with their in-hospital medical complications.
Acute upper limb compartment syndrome in children: special focus on nerve recovery
Authors: Jerome Terrence Jose 
Published: October 2020

BackgroundMany studies have discussed acute compartment syndrome in children associated with or without fractures and have given their visible perspectives. Little is known about the nerve involvement and the factors associated with recovery patterns in these patients. We intend to propose that ischemic nerve and muscles tend to regenerate after surgical decompression but in a different pattern and the given circumstances.MethodsTwenty-four children with acute compartment syndrome in the upper limb were analyzed between 2009 and 2015. Data included demographic features of these patients, the time interval between the injury and surgery, and the attempt to correlate with motor and sensory recovery.ResultsThe average follow-up was 67.3 months (range 59–80). Of the 24, 14 patients (58%) had immediate recovery of motor and sensory functions. The remaining 10 patients had variable recovery patterns with a mean time for the radial nerve, median nerve and ulnar nerve motor recovery of 6.0, 7.5 and 8.5 months, respectively, and sensory recovery at 12, 12 and 13 months, respectively. The overall study had a mean sensory recovery as per the Medical Research Council (MRC) of S3 in 3 (12%) and S4 in 21 (88%). The mean 2-point discrimination (2PD) was 6.9 mm (range 5–10). Twenty-one patients (88%) had a full range of movements at their final follow-up with a mean Visual Analog Scale score of 0.6; a quick Disabilities of the Arm, Shoulder and Hand score of 5.9 (range 2.3–25.0) and a Mayo wrist score of 79.ConclusionsThere was a definite motor and sensory recovery in patients who underwent surgical decompression in acute compartment syndrome of the upper limb irrespective of age, gender, delay in presentation and various etiologies. The motor and nerve fibers can regenerate after ischemic sequela of compartment syndrome.
Distribution of integrons and phylogenetic groups among Escherichia coli causing community-acquired urinary tract infection in Upper Egypt
Authors: Farahat Eman M. , Hassuna Noha A. , Hammad Adel M. , Fattah Medhat Abdel , Khairalla Ahmed S. 
Published: October 2020

Escherichia coli is a major cause of community‐acquired urinary tract infections (CA‐UTIs). In this study, we investigated the antimicrobial resistance patterns, the distribution of phylogenetic groups, and the prevalence and characteristics of integron-bearing E. coli isolates from outpatients with CA‐UTIs in El-Minia governorate, in Upper Egypt. Out of the 583 urine samples collected, 134 were positive for E. coli, from which the most resistant isolates (n = 80) were selected for further analysis. The majority of these isolates (62.5%, 50/80) showed multidrug resistance profiles. Group B2 was the most predominant phylogenetic group (52.5%), followed by group F (21.25%), Clades I or II (12.5%), and finally isolates of unknown phylogroup (13.75%). Of the 80 isolates, 7 (8.75%) carried class 1 integrons, which contained 3 different types of integrated gene cassettes, including those conferring resistance to streptomycin/spectinomycin, trimethoprim, and some open reading frames of unknown function (gcuF). In conclusion, the types and combinations of the gene cassettes in our study may reflect the specific selective pressures to which the isolates were subjected within the study region, therefore, providing valuable data for future intervention strategies that are precisely tailored to prevent the dissemination of the uropathogenic E. coli strains circulating within Upper Egypt.
The Avocado Hand – the UK Experience of the Management of Avocado Hand Injuries
Authors: Sajid Soha , Gill James , Chojnowski Adrian , Singh Rohit 
Published: October 2020

Background: Avocados are increasingly being consumed due to the nutritional benefits they provide. Avocado related hand injuries reflect their increasing popularity. Most injuries occur in attempting to de-stone the fruit. This is a prospective cohort study reviewing hand injuries sustained from preparing the fruit. Methods: Data was prospectively collected from three centres across United Kingdom (UK) over a 4-year period. The data was analysed for patient demographics, nature and zone of injury and management required. Results: A total of 35 patients and 42 injuries were included in the study. The median age of patients presenting with these injuries was 33 years, with majority of injuries occurring in the 21–30 age group. Most (88%, n = 31) of patients were male. Majority (85%, n = 36) of injuries happened during the de-stoning of the fruit. All injuries occurred in the non-dominant hand, with 70%, (n = 30) of wounds being sustained in zone 3. All injuries required surgical management and needed between 1 to 6 follow up outpatient visits. Vital structures such as tendons, digital nerves, pulleys and joint capsule were frequently implicated and required exploration or repair. Conclusions: Avocado related hand wounds are serious injuries with an associated morbidity. They frequently sustained by young patients. They usually require surgical management and may need numerous outpatient attendances. Caution and public education should be advocated on the preparation of avocados. This is the largest study to date that has reviewed the surgical management of avocado hand injuries.
Clinical Outcomes in Distal Radius Fractures Accompanied by Volar Lunate Facet Fragments: A Comparison between Dorsal and Volar Displaced Fractures
Authors: Obata Hiroyuki , Naito Kiyohito , Kaneko Ayaka , Goto Keniji , Sugiyama Yoichi , Nagura Nana , Kawakita So , Iwase Yoshiyuki , Kaneko Kazuo 
Published: October 2020

Background: The treatment strategy for distal radius fractures accompanied by volar lunate facet fragment is controversial. In most cases, only the bone fragment size was discussed and a plate for distal placement is selected due to the accompanying volar lunate facet fragment regardless of the direction of bone fragment displacement. In this study, we divided distal radius fractures accompanied by volar lunate facet fragment into dorsal and volar displaced fractures, and treated these surgically based on different treatment strategies. Methods: The subjects were 25 patients with distal radius fractures accompanied by volar lunate facet fragment treated by reduction and fixation using a volar locking plate (VLP) (male: 14, female: 11, mean age: 57.8 years old). A proximal VLP (PVLP) was selected for 13 dorsal displaced fractures and a distal VLP (DVLP) was selected for 12 volar displaced fractures. The range of motion, VAS, Q-DASH, and Mayo score were evaluated at 12 months after surgery, and compared. Results: No significant difference due to the difference in the direction of displacement was noted in the range of motion, VAS, Q-DASH, or Mayo score at 12 months after surgery and there were no perioperative complications. In addition, no re-displacement of volar lunate facet fragment was noted after surgery in any patient and bone fusion was observed. Conclusions: Reduction and fixation with a PVLP are possible even for dorsal displaced distal radius fractures accompanied by volar lunate facet fragment. For the volar displaced distal radius fractures, a favorable postoperative outcome is possible by applying a DVLP to the distal ulnar.
Treatment of Chronic Severe Flexion Contractures of Fingers with Bilateral Side-Finger Flaps (Wing Flaps) and Full-Thickness Skin Graft
Authors: Pataradool Kawee 
Published: October 2020

Background: Severe flexion contractures of proximal interphalangeal joint of fingers can significantly impair hand function, typically after burn injury recovery. Extensive surgical release exposes deep vital structures, which subsequently requires significant skin coverage. The author presents the results of using bilateral side-finger flaps (wing flaps) and full-thickness skin graft for coverage of the defects. Methods: Seven patients (8 fingers) with chronic severe flexion contractures of fingers resulting from burn injury were included. Results: Mean flexion contracture and full flexion angles of the joints were improved from 84.4°/93.7° to 4.7°/92.5° at the last follow-up visit. No major complications were observed during the postoperative follow-up period (range, 6–16 months). Conclusions: This alternative surgical technique can be successfully applied for the treatment of chronic severe flexion contractures of fingers. The advantages of this approach are the use of local flaps from injured digit, and that it can be performed as a one-session procedure.
Predicting Cognitive Decline in Parkinson’s Disease with Mild Cognitive Impairment: A One-Year Observational Study
Authors: Chen Pei-Hao , Cheng Fang-Yu , Cheng Shih-Jung , Shaw Jin-Siang 
Published: October 2020

We conducted an observational study to investigate clinical predictors of cognitive decline in patients with mild cognitive impairment (MCI), with a focus on patients with Parkinson’s disease (PD) and Alzheimer’s disease (AD). The study was performed with detailed neuropsychological testing, a portable device for gait analysis, and a comprehensive geriatric assessment for patients with MCI. Cognitive decline was defined as subjective cognitive impairment with an objective decline in the Mini-Mental State Examination (MMSE) ≥2 points at the one-year follow-up. Participants (n = 74) had a median age of 70 (interquartile range 60–79) years, and 45.9% of them were women. At the end of the study, 17.6% of the patients with MCI had a cognitive decline. Although no differences were observed between groups at the baseline cognitive study, patients with PD-MCI demonstrated more cognitive decline than patients with AD-MCI (28.6% vs. 7.7%

p

= 0.03). Patients with PD-MCI had more physical disabilities, including scores of instrumental activities of daily living (IADL), Tinetti balance, and gait scores, and some Timed Up and Go components. Initial Clinical Dementia Rating—Sum of Boxes score was a better predictor of future cognitive decline than MMSE in PD-MCI. For predicting the occurrence of cognitive decline in PD-MCI, the prediction accuracy increased from the reduced model (AUC = 0.822,

p
<
0.001

) to the full model (a total of five independent variables, AUC = 0.974,

p
<
0.001

). Given the potentially modifiable predictor, our findings also highlight the importance of identifying sleep quality and the ability to perform IADL.
Reimaginando futuros
Authors: Mandiola Marcela 
Published: October 2020

Se habla de ‘recesión rosa’ (Edwards, 2019), el nuevo nombre que la discusión pública le ha puesto al problema de siempre: el mayor impacto que ha tenido la crisis sanitaria y social sobre una parte de la población. La histórica doble carga de las mujeres ha redundado en una mayor dificultad para conservar trabajos y, al mismo tiempo, cumplir con las demandas del hogar durante la actual crisis. Esta vez la recesión está siendo leída en clave de género. En nuestro país esta realidad se viene a instalar sobre una desigualdad de género que en los últimos años ha sido ampliamente denunciada y documentada. Continuar leyendo...
Lp(a) (Lipoprotein[a]) Concentrations and Incident Atherosclerotic Cardiovascular Disease
Authors: Patel Aniruddh P. , Wang Minxian , Pirruccello James P. , Ellinor Patrick T. , Ng Kenney , Kathiresan Sekar , Khera Amit V. 
Published: October 2020

Objective:
Lp(a) (lipoprotein[a]) concentrations are associated with atherosclerotic cardiovascular disease (ASCVD), and new therapies that enable potent and specific reduction are in development. In the largest study conducted to date, we address 3 areas of uncertainty: (1) the magnitude and shape of ASCVD risk conferred across the distribution of lipoprotein(a) concentrations; (2) variation of risk across racial and clinical subgroups; (3) clinical importance of a high lipoprotein(a) threshold to guide therapy.

Approach and Results:
Relationship of lipoprotein(a) to incident ASCVD was studied in 460 506 middle-aged UK Biobank participants. Over a median follow-up of 11.2 years, incident ASCVD occurred in 22 401 (4.9%) participants. Median lipoprotein(a) concentration was 19.6 nmol/L (25th–75th percentile 7.6–74.8). The relationship between lipoprotein(a) and ASCVD appeared linear across the distribution, with a hazard ratio of 1.11 (95% CI, 1.10–1.12) per 50 nmol/L increment. Substantial differences in concentrations were noted according to race—median values for white, South Asian, black, and Chinese individuals were 19, 31, 75, and 16 nmol/L, respectively. However, risk per 50 nmol/L appeared similar—hazard ratios of 1.11, 1.10, and 1.07 for white, South Asian, and black individuals, respectively. A high lipoprotein(a) concentration defined as ≥150 nmol/L was present in 12.2% of those without and 20.3% of those with preexisting ASCVD and associated with hazard ratios of 1.50 (95% CI, 1.44–1.56) and 1.16 (95% CI, 1.05–1.27), respectively.

Conclusions:
Lipoprotein(a) concentrations predict incident ASCVD among middle-aged adults within primary and secondary prevention contexts, with a linear risk gradient across the distribution. Concentrations are variable across racial subgroups, but the associated risk appears similar.
Painted Eroticism: Sex and Death in Cain and Abel’s Story
Authors: González Holguín Julián Andrés 
Published: October 2020

Abstract
Using George Bataille’s concepts of continuity/discontinuity, eroticism, and death, I read the stories of Genesis 3–4 to demonstrate how these notions provide a hermeneutical framework to understand the myths of creation. I present a unique perspective around the idea of continuity/discontinuity, the role of work, and the possibility of killing latent in all humanity. I demonstrate how eroticism is part of the semantical potential of the stories and how the artistic renderings of Cain and Abel’s tale by Albrecht Dürer, Jan Harmensz, Daniele Crespi, and Alexandre Falguière actualize it. I analyze how in the paintings the experience of pleasure in eroticism is tightly bound together with states of fear and pain. I demonstrate how the visual representations can contribute to decentering closed models of subjectivity and spirituality that emerge within the history of interpretation. Finally, I offer an alternative reading of Cain’s mark using Bataille’s notions.
Jesus-Disciple Relationship and Guru-Devotee Union: An Intercultural Reading of the Gospel of John and Tiruvācakam
Authors: Basker Gregory Thomas 
Published: October 2020

Abstract
This paper attempts an intercultural reading of the Jesus-Disciple relationship present in the Gospel of John taking the Tamil Śaiva perspective as a distinct hermeneutical approach. The paper presents select principles of ‘union’ represented in the master-disciple relationships of both John and Tiruvācakam and juxtaposes their implications to their respective contexts.