bluuebunny/crossref_metadata_2025_split huggingface dataset:
H3K27me3 loss indicates an increased risk of recurrence in the Tübingen meningioma cohort
Authors: Behling Felix , Fodi Christina , Gepfner-Tuma Irina , Kaltenbach Kristina , Renovanz Mirjam , Paulsen Frank , Skardelly Marco , Honegger Jürgen , Tatagiba Marcos ,   International Consortium on Meningiomas, Schittenhelm Jens , Tabatabai Ghazaleh 
Published: December 2020

Abstract

Background
A loss of the trimethylation of lysine 27 of histone H3 (H3K27me3) in meningioma has been recently suggested as an adjunct to identify subsets of higher risk of recurrence. The aim of the present study was to assess the prognostic value of H3K27 histone trimethylation and its potential clinical utility in the “Tübingen meningioma cohort.”

Methods
Patients who underwent meningioma resection between October 2003 and December 2015 at the University Hospital Tübingen were included. Immunohistochemical stainings for H3K27me3 and the proliferation marker MIB1 were assessed and correlated with clinical parameters using univariate and multivariate Cox regressions as well as Pearson's chi-squared and log-rank test.

Results
Overall, 1268 meningiomas were analyzed with a female to male ratio of 2.6 and a mean age of 58.7 years (range 8.3–91.0). With 163 cases lost to follow up, 1103 cases were available for further analysis with a mean follow-up of 40.3 months (range 1.1–186.3). Male gender, younger age, intracranial tumor localization, progressive tumor, subtotal resection, higher WHO grade, increased MIB1 rate, and loss of H3K27me3 were significant negative prognostic factors in the univariate analysis. H3K27me3 status and all other prognostic factors, except age and tumor location, remained significant in the multivariate model. Furthermore, adjuvant radiotherapy was an independent positive prognostic factor.

Conclusions
Loss of H3K27me3 combined with MIB1 labeling index are independent prognostic factors in meningioma. These data from the Tübingen meningioma cohort support the clinical utility of H3K27me3 immunohistochemical staining in meningioma and its integration into the routine histopathological workup.
Chimeric Antigen Receptor T-Cell Therapy: Updates in Glioblastoma Treatment
Authors: Feldman Lisa , Brown Christine , Badie Behnam 
Published: December 2020

Abstract
Glioblastoma multiforme (GBM) are the most common and among the deadliest brain tumors in adults. Current mainstay treatments are insufficient to treat this tumor, and therefore, more effective therapies are desperately needed. Immunotherapy, which takes advantage of the body's natural defense mechanism, is an exciting emerging field in neuro-oncology. Adoptive cell therapy with chimeric antigen receptor (CAR) T cells provides a treatment strategy based on using patients’ own selected and genetically engineered cells that target tumor-associated antigens. These cells are harvested from patients, modified to target specific proteins expressed by the tumor, and re-introduced into the patient with the goal of destroying tumor cells. Here, we review the history of CAR T-cell therapy, and describe the characteristics of various generations of CAR T therapies, and the challenges inherent to treatment of GBM. Finally, we describe recent and current CAR T clinical trials designed to combat GBM.
E-cigarette Use in Prisons With Recently Established Smokefree Policies: A Qualitative Interview Study With People in Custody in Scotland
Authors: Brown Ashley , O’Donnell Rachel , Eadie Douglas , Ford Allison , Mitchell Danielle , Hackett Alison , Sweeting Helen , Bauld Linda , Hunt Kate 
Published: December 2020

Abstract

Introduction
E-cigarettes were one measure introduced to help people in custody (PiC) to prepare for and cope with implementation of comprehensive smokefree policies in Scottish prisons. Our earlier study explored experiences of vaping when e-cigarettes were first introduced and most participants were dual tobacco and e-cigarette users. Here we present findings of a subsequent study of vaping among a different sample of PiC when use of tobacco was prohibited in prison, and smokefree policy had become the norm.

Methods
Twenty-eight qualitative interviews were conducted with PiC who were current or former users of e-cigarettes in prison, 6–10 months after implementation of a smokefree policy. Data were managed and analyzed using the framework approach.

Results
PiC reported that vaping helped with mandated smoking abstinence. However, findings suggest that some PiC may be susceptible to heavy e-cigarette use potentially as a consequence of high nicotine dependence and situational factors such as e-cigarette product choice and availability in prisons; issues with nicotine delivery; prison regimes; and use of e-cigarettes for managing negative emotions. These factors may act as barriers to cutting down or stopping use of e-cigarettes by PiC who want to make changes due to dissatisfaction with vaping or lack of interest in continued use of nicotine, cost, and/or health concerns.

Conclusions
E-cigarettes helped PiC to cope with smokefree rules, although concerns about e-cigarette efficacy, cost, and safety were raised. PiC may desire or benefit both from conventional smoking cessation programs and from interventions to support reduction, or cessation, of vaping.

Implications
Findings highlight successes, challenges, and potential solutions in respect of use of e-cigarettes to cope with mandated smoking abstinence in populations with high smoking prevalence and heavy nicotine dependence. Experiences from prisons in Scotland may be of particular interest to health and/or justice services in other jurisdictions, with similar legislation on e-cigarettes to the United Kingdom, who are planning for institutional smokefree policies in their prisons or inpatient mental health settings in the future.
Affordability of nutritious foods for complementary feeding in Eastern and Southern Africa
Authors: Ryckman Theresa , Beal Ty , Nordhagen Stella , Chimanya Kudakwashe , Matji Joan 
Published: December 2020

AbstractLow intake of diverse complementary foods causes critical nutrient gaps in the diets of young children. Inadequate nutrient intake in the first 2 years of life can lead to poor health, educational, and economic outcomes. In this study, the extent to which food affordability is a barrier to consumption of several nutrients critical for child growth and development was examined in Ethiopia, Mozambique, South Africa, Tanzania, Uganda, and Zambia. Drawing upon data from nutrient gap assessments, household surveys, and food composition tables, current consumption levels were assessed, the cost of purchasing key nutritious foods that could fill likely nutrient gaps was calculated, and these costs were compared with current household food expenditure. Vitamin A is affordable for most households (via dark leafy greens, orange-fleshed vegetables, and liver) but only a few foods (fish, legumes, dairy, dark leafy greens, liver) are affordable sources of iron, animal-source protein, or calcium, and only in some countries. Zinc is ubiquitously unaffordable. For unaffordable nutrients, approaches to reduce prices, enhance household production, or increase household resources for nutritious foods are needed.
Mental health of staff working in intensive care during Covid-19
Authors: Greenberg N , Weston D , Hall C , Caulfield T , Williamson V , Fong K 
Published: December 2020

AbstractBackgroundStaff working in intensive care units (ICUs) have faced significant challenges during the COVID-19 pandemic which have the potential to adversely affect their mental health.AimsTo identify the rates of probable mental health disorder in staff working in ICUs in nine English hospitals during June and July 2020.MethodsAn anonymized brief web-based survey comprising standardized questionnaires examining depression, anxiety symptoms, symptoms of post-traumatic stress disorder (PTSD), well-being and alcohol use was administered to staff.ResultsSeven hundred and nine participants completed the surveys comprising 291 (41%) doctors, 344 (49%) nurses and 74 (10%) other healthcare staff. Over half (59%) reported good well-being; however, 45% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6%), PTSD (40%), severe anxiety (11%) or problem drinking (7%). Thirteen per cent of respondents reported frequent thoughts of being better off dead, or of hurting themselves in the past 2 weeks. Within the sample used in this study, we found that doctors reported better mental health than nurses across a range of measures.ConclusionsWe found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. Whilst further work is needed to better understand the real level of clinical need amongst ICU staff, these results indicate the need for a national strategy to protect the mental health, and decrease the risk of functional impairment, of ICU staff whilst they carry out their essential work during COVID-19.
Effects of Diacutaneous Fibrolysis on Mechanosensitivity, Disability, and Nerve Conduction Studies in Mild to Moderate Carpal Tunnel Syndrome: Secondary Analysis of a Randomized Controlled Trial
Authors: Jiménez del Barrio Sandra , Ceballos-Laita Luis , Bueno-Gracia Elena , Rodríguez-Marco Sonia , Haddad-Garay María , Estébanez-de-Miguel Elena 
Published: December 2020

Abstract

Objective
People diagnosed with carpal tunnel syndrome (CTS) have fibrosis between the soft, connective, and neural tissues that could worsen the compression of the median nerve. The diacutaneous fibrolysis (DF) technique may release tissue adhesions and increase the mobility of connective tissues. The purpose of this study was to compare the outcomes of DF in people with mild to moderate CTS on mechanosensitivity, disability, and nerve conduction studies.

Methods
This was a secondary analysis of a double-blinded, randomized, placebo-controlled trial. Patients were recruited between April and September 2016 from the Department of Neurophysiology at the Hospital Miguel Servet, Zaragoza, Spain. Thirty-nine people (52 wrists) diagnosed with mild to moderate CTS were included. Participants were randomly assigned to either the DF group (n = 26) or the sham group (n = 26). Both groups received 5 therapy sessions, 2 sessions per week. Mechanosensitivity with the Upper Limb Neurodynamic Test 1, symptom severity and functional status with the Boston Carpal Tunnel Questionnaire, and median nerve sensory conduction velocity with nerve conduction studies were the outcomes measured. Assessments were recorded at baseline and after the intervention.

Results
The DF group showed significant improvements in the following: mechanosensitivity, with 28.46 degrees of elbow extension range of motion (95% CI = 19.2–37.7); an increase of 1.0 point (95% CI = 0.7–1.4) for the Boston Carpal Tunnel Questionnaire symptom severity and functional status score; and sensory conduction velocity of median nerve, which improved to 5.8 m/s (95% CI = 2.5–9.2).

Conclusion
Participants with mild to moderate CTS experienced improvements in symptom severity, functional status, mechanosensitivity, and nerve conduction studies after 5 sessions of DF.

Impact
This study provides evidence of an approach based on soft and connective tissues around the median nerve in patients with CTS.
Prevalence of gastrointestinal, cardiovascular, autonomic and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study
Authors: Brooks Rachel S , Grady James , Lowder Thomas W , Blitshteyn Svetlana 
Published: December 2020

Abstract

Objective
Previous observations suggest an association between Ehlers-Danlos syndrome (EDS) and gastrointestinal (GI), cardiovascular, immune, and autonomic nervous system dysfunction. We sought to determine whether a hospital diagnosis of EDS is associated with a higher prevalence of these manifestations vs hospitalized patients without EDS. We also evaluated hospital outcomes.

Methods
A total of 6,021 cases and matched controls were acquired from the 2016 National Inpatient Sample. In total, 2,007 EDS patients were identified via ICD-10 code. After bivariate analyses, multivariate logistic regression models were used to adjust for potential confounders.

Results
GI conditions were found in 44% of EDS patients vs 18% of controls [odds ratio (OR) = 3.57, 95% CI: 3.17, 4.02, P &lt; 0.0001], with irritable bowel syndrome, gastroparesis and coeliac disease strongly associated with EDS. Autonomic dysfunction, including postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope and orthostatic hypotension was found in 20% of EDS patients vs 6% of controls (OR = 4.45, 95% CI: 3.71, 5.32, P &lt; 0.0001). EDS patients were more likely to have food allergy (OR = 3.88, 95% CI: 2.65, 5.66, P &lt; 0.0001) and cardiovascular complications such as mitral valve disorders, aortic aneurysm and dysrhythmias (OR = 6.16, 95% CI: 4.60, 8.23, P &lt; 0.0001). These conditions remained highly associated with EDS after considering confounders. EDS patients were 76% more likely to have longer than average hospitalizations (OR = 1.76, 95% CI: 1.54, 2.02, P &lt; 0.0001).

Conclusion
GI, cardiovascular, autonomic and allergic manifestations are significantly more prevalent in EDS patients compared with hospitalized patients without EDS. Physicians should consider EDS in patients with unexplained GI, cardiovascular, autonomic and allergic conditions and exercise precautions when treating EDS patients in a hospital setting.
Timing of spring xylogenesis in temperate deciduous tree species relates to tree growth characteristics and previous autumn phenology
Authors: Marchand Lorène Julia , Dox Inge , Gričar Jožica , Prislan Peter , Van den Bulcke Jan , Fonti Patrick , Campioli Matteo 
Published: December 2020

Abstract
We explored the timing of spring xylogenesis and its potential drivers in homogeneous mature forest stands in a temperate European region. Three species with contrasting leaf development dynamics and wood anatomy were studied: European beech, silver birch and pedunculate oak. Detailed phenological observations of xylogenesis and leaf phenology were performed from summer 2017 until spring 2018. Cambium reactivation (CR) occurred before the buds of oak and birch were swollen, whereas these two phenological phases were concurrent for beech. On the other hand, initial earlywood vessels were fully differentiated (FDIEV) after leaf unfolding for all three species. Timing of CR was correlated to average ring-width of the last 10 years (2008–17), tree diameter and, partially, with tree age. In addition, the timing of FDIEV was correlated to tree age and previous year’s autumn phenology, i.e., timing of wood growth cessation and onset of leaf senescence. Multivariate models could explain up to 68% of the variability of CR and 55% of the variability of FDIEV. In addition to the ‘species’ factor, the variability could be explained by ca 30% by tree characteristics and previous year’s autumn phenology for both CR and FDIEV. These findings are important to better identify which factors (other than environment) can be driving the onset of the growing season, and highlight the influence of tree growth characteristics and previous year’s phenology on spring wood phenology, wood formation and, potentially, forest production.
“Life Isn't as Carefree as It Used to Be”: A Mixed-Methods Evaluation of the Experiences of Women With Fear of Falling During Cancer Survivorship
Authors: Covington Kelley R. , Atler Karen E. , Bailey Jessica James A. , Lucas Katie , Pergolotti Mackenzi 
Published: December 2020

Purpose/Objective:
To understand activities and experiences of women with fear of falling during cancer survivorship.

Design:
Parallel, mixed-methods design.

Setting:
Academic research.

Participants and Measurement:
Women who had completed active treatment and reported fear of falling completed structured surveys, the Timed Up and Go (TUG) test, a time-use assessment(s) guided by individual interview, and a focus group. Descriptive statistics, independent-samples t test, and exploratory Pearson correlations were used to analyze quantitative variables. Qualitative themes were identified through inductive, descriptive analysis.

Results:
Three (38%) participants had fallen in the past 6 months and 4 (50%) were considered at risk for falling (ie, TUG >10.7 seconds). Most of participants' time was spent at home versus away from home (t = −1.2, P = .04) and in committed occupations (M = 5.5 ± 2.1 hours; 34.8% of time per day). TUG fall risk (>10.7 seconds) and global mental health (r = −0.83, P = .01), TUG time and Activities Balance Confidence (r = −0.71, P < .05), and fear of falling and global mental health (r = −0.76, P = .03) were significantly correlated. Fear of falling led to (1) identity challenges and (2) ongoing lifestyle adaptations during survivorship. Adaptations included increased awareness, avoidance, or making modifications to support (or diminish) participation in daily activities and roles while avoiding falls.

Limitations:
Small sample and lack of precancer data.

Conclusions:
Fear of falling is an important influence on women's activities and experiences during cancer survivorship. Fear of falling may negatively influence mental health and physical function. Women may experience identity challenges and the need to make ongoing adaptations to participate in important roles and activities during survivorship.
The Role of Cannabis Use in Suicidal Ideation Among Patients With Opioid Use Disorder
Authors: Naji Leen , Rosic Tea , Sanger Nitika , Dennis Brittany , Worster Andrew , Paul James , Thabane Lehana , Samaan Zainab 
Published: December 2020

Objectives:
Cannabis use is associated with suicide risk in the general population; however, it is unknown if this association is also present in patients with opioid use disorder (OUD). The purpose of this study is to investigate the association between cannabis use and suicidal ideation in patients with OUD.

Methods:
We conducted a multivariable logistic regression analysis to assess the association between cannabis use and suicidal ideation, amongst a large cohort of patients with OUD. Current cannabis use and suicidal ideation over the past 30 days were obtained by self-report.

Results:
Cross-sectional data from 2335 participants with OUD were included in the analysis, of whom 51% report current cannabis use. We found a positive association between cannabis use and suicidal ideation (OR = 1.41, 95% CI 1.11, 1.80, P = 0.005). We found that men (OR = 1.84, 95% CI 1.44, 2.35, P < 0.001), younger individuals (OR = 1.02, 95% CI 1.01, 1.03), P = 0.004), and that those with more symptoms of anxiety or depression (OR = 1.16, 95% CI 1.15, 1.18, P < 0.001) were more likely to report suicidal ideation.

Conclusions:
Cannabis use is associated with a heightened propensity for suicidal ideation amongst patients with OUD, who are already a high-risk population. Further research into the potential harms of cannabis use in this population is required given the prevalence of its use and potential benefits in mitigating opioid withdrawal.
Clinical Efficacy of Pulsed Radiofrequency Treatment Targeting the Mid-cervical Medial Branches for Intractable Cervicogenic Headache
Authors: Park Mu Seung , Choi Hyuk Jai , Yang Jin Seo , Jeon Jin Pyeong , Kang Suk Hyung , Cho Yong Jun 
Published: December 2020

Objective:
Cervicogenic headache has been known to originate from the convergence of the upper 3 cervical and trigeminal afferents. The administration of conservative treatments, interventional procedures, and more recently, pulsed radiofrequency, has been used to relieve cervicogenic headache. In this study, the authors evaluated the clinical efficacy and safety of pulsed radiofrequency targeting the mid-cervical medial branches.

Materials and Methods:
From September 2012 until December 2017, 395 patients were diagnosed with cervicogenic headache based on the third edition of the International Classification of Headache Disorders. The authors treated them conservatively at first, and those patients with nonresolution of pain were treated with mid-cervical medial branches block applied from C3 to C5 twice. Subsequently, if any patient continued to experience persistent pain, the authors classified them as having intractable cervicogenic headache and performed pulsed radiofrequency treatment targeting the mid-cervical medial branches from C3 to C5 bilaterally. The authors analyzed their demographics and used a Visual Analogue Scale to assess their pain for 12 months.

Results:
Fifty-seven patients were enrolled in this study. The mean age was 49.8 years, and the mean duration of symptoms was 47.7 months. The mean Visual Analogue Scale score was 6.21 before pulsed radiofrequency treatment, and it improved to 1.54 immediately after the procedure without the symptoms recurring for a minimum of 12 months. There were no severe complications, such as vascular or nerve injuries.

Conclusions:
In patients with intractable cervicogenic headache, pulsed radiofrequency treatment targeting the mid-cervical medial branches resulted in a satisfactory, long-lasting outcome without serious complications.
Biomechanical Contributions of Spinal Structures with Different Degrees of Disc Degeneration
Authors: Cornaz Frédéric , Widmer Jonas , Farshad-Amacker Nadja A. , Spirig José Miguel , Snedeker Jess G. , Farshad Mazda 
Published: December 2020

Study Design.
Biomechanical cadaveric study.

Objective.
The aim of this study was to evaluate the effect of degeneration on biomechanical properties of the passive structures of the lumbar spine.

Summary of Background Data.
Although the load apportionment among the passive structures in healthy spines follows well-defined contribution patterns, it remains unknown how this load distribution and sagittal preload changes by degenerative processes of the intervertebral disc (IVD).

Methods.
Fifty lumbar spinal segments were tested in a displacement-controlled stepwise reduction study in flexion, extension, axial rotation, lateral bending, anterior, posterior and lateral shear. The intertransverse ligaments (ITLs), supraspinous and interspinous ligaments (ISL&SSL), facet joint capsules (FJC), facet joints (FJ), ligamentum flavum (LF), posterior longitudinal ligament (PLL), anterior longitudinal ligament (ALL), and spondylophytes were subsequently reduced. The results were set in relation to IVD-degeneration, quantified with Pfirrmann classification.

Results.
In flexion, a load redistribution from LF (−28% n.s.) and PLL (−13% n.s.) towards the IVD (+9%, n.s.) is observed comparing grade 2 to 5 IVD degeneration, whereas in all other loading directions, a reduction of IVD-contribution from −12% to −53% is recorded. In axial rotation, anterior and lateral shear, more load is shared by the FJ (+4% n.s., +23% ∗, +13% n.s.). The preload of the ALL, LF, PLL, and IVD is reduced ranging from −0.06 Nm to −0.37 Nm.

Conclusion.
IVD degeneration is related to notable load-redistributions between the passive spinal structures. With further degeneration, reduced contribution of the LF and PLL and higher loads on the IVD are observed in flexion. In the other tested loading directions, the relative load on the IVD is reduced, whereas higher FJ-exposure in axial rotation, anterior and lateral shear is observed. Furthermore, the preload of the spinal structures is reduced. These observations can further the understanding of the degenerative cascade in the spine.

Level of Evidence: N/A