bluuebunny/crossref_metadata_2025_split huggingface dataset:
THER-06. THERAPEUTIC EFFICACY OF RRV-MEDIATED PRODRUG ACTIVATOR GENE THERAPY IN CLINICAL TRIALS OF RECURRENT HIGH-GRADE GLIOMA AND IN MURINE ORTHOTOPIC MODELS OF INTRACEREBRAL GLIOMA AND INTRACEREBELLAR MEDULLOBLASTOMA
Authors: Richardson Angela , Collins Sara , Inagaki Akihito , Armstrong Valerie , Robbins David , Ayad Nagi , Gruber Harry , Jolly Douglas , Cloughesy Timothy , Kasahara Noriyuki 
Published: December 2020

Abstract
Toca 511, a clinical-stage tumor-selective retroviral replicating vector (RRV), encodes optimized yeast cytosine deaminase (CD), which converts the prodrug 5-fluorocytosine (5-FC) to the active drug 5-fluorouracil (5-FU) within infected cancer cells. In preclinical models of intracerebral glioblastoma, 5-FU generated locally by Toca 511 (RRV-CD) prodrug activator gene therapy has also been shown to kill immunosuppressive myeloid cells in the tumor microenvironment, leading to anti-cancer immune activation and long-term survival. Early-phase clinical trials of Toca 511 in recurrent high-grade glioma showed highly promising evidence of therapeutic benefit, leading to a Phase III trial completed in late 2019 (n=400 patients, randomized 1:1 vs. standard chemotherapy), which appeared to show negative results overall. However, additional analysis showed possible efficacy in prespecified subgroups, and further clinical investigation is being pursued. In preclinical studies, we have also evaluated RRV for use in medulloblastoma, the most common malignant tumor of the pediatric nervous system. Both established and primary human medulloblastoma cell lines supported efficient RRV replication in vitro, with spread to &gt;90% of cells by day 10 post-inoculation, and RRV-CD-transduced medulloblastoma cells showed significant dose-dependent reduction of viability upon exposure to 5-FC, compared to controls. In an intracerebellar HDMB03 medulloblastoma model, RRV-CD-treated mice exhibited long-term survival while on sequential cycles of 5-FC prodrug, until prodrug treatment was stopped, after which 25% long-term survival was observed (median survival 110 days) as compared to controls (median survival 28 days, 100% lethality) (p=0.00007). These results support further evaluation of RRV-mediated prodrug activator gene therapy for pediatric brain tumors.
THER-07. INHIBITION OF THE RAS SIGNALING ENHANCES VIRAL ONCOLYSIS IN MALIGNANT GLIOMAS
Authors: Arakawa Yoshiki , Yamaguchi Makoto , Tanji Masahiro , Mineharu Yohei , Miyamoto Susumu 
Published: December 2020

Abstract
Pediatric malignant glioma indicates rapid proliferation, widely infiltrative properties and resistance to various therapies, and carries a very poor prognosis. There are methods of using virus within novel therapies under development against malignant neoplasms, which have been studied for many years already. We examined the treatment with sunitinib or GW5074 to our experimental model of vaccinia virus therapy for malignant glioma, and then evaluated changes in the tumoricidal activity, the viral infectivity, and the impact on the Ras signaling pathway. Glioma cells (U251MG, LN229, LN18, rat C6) infected with vaccinia virus was fatal, in its course of death, apoptosis and autophagy were induced. The activity of Ras signaling in vaccinia-infected cells heightened in the early stage and declined in the late stage Inhibition of the Ras signaling pathway at the early stage of viral infection prevented vaccinia virus replication, while viral oncolysis was not inhibited when the pathway was blocked after sufficient viral spread. Glioma cells infected with vaccinia virus are led to cell death. Vaccinia virus regulates Ras or other survival signaling pathways in the infected cells. It enhances the signaling in the early stage (viral replicative period), however suppresses in the later stage (virus-releasing stage). Inhibition of the Ras signaling pathway at the early stage of viral infection prevents vaccinia virus from replicating, while viral oncolysis appears to be accelerated when the pathway was blocked after sufficient viral reproduction.
More about illusory trusts: is “tantamount” to ownership the same as “ownership”? The Privy Council takes a step too far
Authors: Nitikman Joel 
Published: December 2020

Abstract
In Webb v. Webb,1 a decision of the Privy Council on appeal from the Cook Islands, the Board2 had to consider a number of issues arising from matrimonial proceedings. One of the issues was whether Mr Webb had created a valid trust or whether he had retained such extensive powers in relation to the trust that the trust was an “illusion”. The Board held that the trust was invalid. In doing so, the Board purported to follow the reasoning of the New Zealand Supreme Court in another matrimonial decision, Clayton v. Clayton,3 about which I have written before.4 But, for the reasons discussed below, in my opinion, the Board in Webb went beyond what the Supreme Court decided in Clayton. I believe that the Board has taken a step too far in its reasoning.
Which Characteristics of Fecal Incontinence Predispose Incontinence-Associated Dermatitis? A Classification and Regression Tree Analysis
Authors: Hoedl Manuela , Eglseer Doris 
Published: December 2020

ABSTRACT

OBJECTIVE
To investigate which characteristics of fecal incontinence (FI) are predictors for incontinence-associated dermatitis (IAD) using the Classification and Regression Tree method.

DESIGN AND SETTING
Data collected from 2014 to 2016 during the Austrian Nursing Quality Measurement 2.0, an annually conducted, cross-sectional, multicenter prevalence study, were merged and analyzed.

MAIN OUTCOME MEASURE
The duration, frequency, and amount of FI were used as predictors for IAD. Nurses were asked if the participants suffered from IAD based on their clinical judgment (yes/no).

MAIN RESULTS
In total, 1,513 participants with FI were included in this analysis. More than 75% of the participants with FI were to a great extent or completely care dependent. Of all FI participants, nearly 6% suffered from IAD, and more than 70% received special skin care for IAD prevention. Participants with FI had the highest risk of developing IAD if they experienced FI every day, had FI for less than 3 months, and had developed the FI in their current institution.

CONCLUSIONS
Nurses face many challenges while helping patients with FI maintain healthy skin. Knowledge of the results of this study and accumulated knowledge about the specific characteristics of FI that are associated with the development of IAD can help healthcare personnel prevent IAD. Based on these results, improving patient education for persons with newly diagnosed FI to prevent IAD is recommended. Research studies should use the definition of FI established by the International Continence Society.
Efficacy and safety of Shexiang Baoxin pill (MUSKARDIA) in patients with stable coronary artery disease: a multicenter, double-blind, placebo-controlled phase IV randomized clinical trial
Authors: Ge Jun-Bo , Fan Wei-Hu , Zhou Jing-Min , Shi Hai-Ming , Ji Fu-Sui , Wu Yang , Zhao Yu-Lan , Qian Jun , Jin Yuan-Zhe , Liu Ying-Wu , Wang Sheng-Huang , He Sheng-Hu , Yang Ping , Wu Jie , Lu Feng , Hou Zi-Shan 
Published: December 2020

Abstract

Background:
The Shexiang Baoxin Pill (MUSKARDIA) has been used for treating coronary artery disease (CAD) and angina for more than 30 years in China. Nevertheless, methodologically sound trials on the use of MUSKARDIA in CAD patients are scarce. The aim of the study is to determine the effects of MUSKARDIA as an add-on to optimal medical therapy (OMT) in patients with stable CAD.

Methods:
A total of 2674 participants with stable CAD from 97 hospitals in China were randomized 1:1 to a MUSKARDIA or placebo group for 24 months. Both groups received OMT according to local tertiary hospital protocols. The primary outcome was the occurrence of a major adverse cardiovascular event (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction (MI), or non-fatal stroke. Secondary outcomes included all-cause mortality, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or heart failure, peripheral revascularization, angina stability and angina frequency.

Results:
In all, 99.7% of the patients were treated with aspirin and 93.0% with statin. After 2 years of treatment, the occurrence of MACEs was reduced by 26.9% in the MUSKARDIA group (MUSKARDIA: 1.9% vs. placebo: 2.6%; odds ratio = 0.80; 95% confidence interval: 0.45–1.07; P
= 0.2869). Angina frequency was significantly reduced in the MUSKARDIA group at 18 months (P = 0.0362). Other secondary endpoints were similar between the two groups. The rates of adverse events were also similar between the two groups (MUSKARDIA: 17.7% vs. placebo: 17.4%, P = 0.8785).

Conclusions:
As an add-on to OMT, MUSKARDIA is safe and significantly reduces angina frequency in patients with stable CAD. Moreover, the use of MUSKARDIA is associated with a trend toward reduced MACEs in patients with stable CAD. The results suggest that MUSKARDIA can be used to manage patients with CAD.

Trial registration
chictr.org.cn, No. ChiCTR-TRC-12003513
Association between use of amiodarone for non-valvular atrial fibrillation and patient survival: from the prospective China Atrial Fibrillation Registry
Authors: Hou Xiao-Xia , He Liu , Du Xin , Wang Guo-Hong , Dong Jian-Zeng , Ma Chang-Sheng 
Published: December 2020

Abstract

Background

Post hoc analysis of the landmark atrial fibrillation follow-up investigation of rhythm management trial revealed that amiodarone was associated with higher risks of mortality, intensive care unit admission, and non-cardiovascular death. We aim to evaluate the association between amiodarone use and patient survival under updated medical mode and level using data from the China Atrial Fibrillation (China-AF) Registry study.

Methods
Clinical data of 8161 non-valvular atrial fibrillation (NVAF) patients who were antiarrhythmic drug (AAD)-naive before enrollment into the China-AF Registry, recruited between August 2011 and February 2017, were collected. The primary outcome was all-cause mortality. A Cox proportional hazard regression model was used to evaluate the association between amiodarone use and the outcome. We also calculated the rate of sinus rhythm maintenance at the penultimate follow-up.

Results
Compared with 6167 patients of non-AAD group, 689 patients of the amiodarone group were younger (mean age 65.6 vs. 68.6 years), more frequently completed high school education, had fewer comorbidities such as chronic heart failure, prior bleeding, and stroke, and were more likely to be treated in tertiary hospitals while less hospitalization. The proportion of persistent AF was much lower among users of amiodarone, who were also less likely to be taking oral anticoagulants. The patients in the amiodarone group had a statistically insignificant lower incidence of all-cause mortality (2.44 vs. 3.91 per 100 person-years) over a mean follow-up duration of 300.6 ± 77.5 days. After adjusting for potential confounders, amiodarone use was not significantly associated with a lower risk of all-cause mortality (adjusted hazard ratio, 0.79; 95% confidence interval, 0.42–1.49). Sub-group analysis revealed the consistent results. The rate of sinus rhythm maintenance at the penultimate follow-up in the amiodarone group was significantly higher than in the non-AAD group.

Conclusions
Our study indicated that amiodarone use was not significantly associated with a lower risk of 1-year all-cause mortality compared with a non-AAD strategy in “real-world” patients with NVAF.
A Primer on the Good Samaritan Act
Authors: McDevitt Diane , McDevitt Meaghan 
Published: December 2020

ABSTRACT:
This article explores the various legal and ethical facets for healthcare professionals to consider in order to avoid legal liability when rendering aid in an emergency. A general overview of Good Samaritan legislation enacted throughout the United States is discussed along with varying levels of assistance required or protected by law in selected states. Moral considerations for Christian nurses are addressed.
Faith Community Nursing
Authors: May Indea , George Nancy 
Published: December 2020

ABSTRACT:
The high prevalence of hypertension among African Americans makes faith-based education programs culturally appropriate. Faith-enhanced health education is a way to reach these often healthcare-disenfranchised populations. With Every Heartbeat is Life (WEHL), a community-based heart health program, was enhanced with Scripture and prayer for this project. The program took place in an African American nondenominational church. The Scripture-enhanced WEHL program emphasized biblical teachings of self-care with standard lessons on nutrition, exercise, smoking cessation, and disease management interventions that increased knowledge of hypertension and associated cardiovascular risks.
Enhancing Personhood in the Care of Older Adults with Dementia
Authors: Rajamohan Santhiny 
Published: December 2020

ABSTRACT:
Using a biblical worldview, this article develops a philosophical discussion about what comprises an individual's personhood. The author contends for the perspective of a person as a human being created in the image of God based on who he or she is, not on the basis of how well he or she functions. Understanding the biblical concept of personhood allows the establishment of meaningful relationships with people with dementia, resulting in compassionate, quality care.
Measurement of SBP at home by parents using hand-held Doppler device and aneroid sphygmomanometer: a single-centre experience
Authors: Newton Joanna , Singh Cheentan , Sinha Manish D. 
Published: December 2020

Objective:
We taught parents to use at
h
ome a hand-held
D
oppler device and aneroid sphygmomanometer for S
BP

m
easurement (HDBPM).

Methods:
Retrospective study including all children referred to evaluate hypertension over a 6-year period. Each child underwent HDBPM measurements performed by parents while awake over 2 weeks with three measurements performed twice daily.

Results:
Of n = 155 children, 145 (93.5%) were successful and aged median (interquartile range) 2.48 (1.01, 5.12) years, including 85 boys. Overall, there were 25, 19, 30 and 26% aged less than 1, 1 to less than 2, 2 to less than 5 and at least 5 years old, respectively. Seventy-eight (54%) had been referred for confirming diagnosis and 67 (46%) for ongoing monitoring of treated hypertension. Following HDBPM, 70 of 78 (90%) patients in the ‘Diagnosis subgroup’ were observed to have normal blood pressure (BP). In the monitoring subgroup, treated hypertension that required no medication changes was recorded in 35 of 67 (52%) and medication changed in 32 of 67 (48%), [increased, decreased or changed] in 22, 6 and 5%, respectively. In 10 of 67 (15%) medication was weaned and stopped completely following HDBPM. None of the children required admission to hospital to evaluate their BP level or manage hypertension.

Conclusion:
Out-of-office BP monitoring using HDBPM is acceptable to children and families of young children when parents are taught to measure BP and supported by health professionals. We report evidence of the feasibility and clinical utility of HDBPM in a challenging population of children who are either too young or unable to tolerate 24-h ambulatory BP monitoring for both the diagnosis and ongoing management of clinically relevant hypertension.
Temperature-adjusted hypertension prevalence and control rate: a series of cross-sectional studies in Guangdong Province, China
Authors: Hu Jie , He Guanhao , Luo Jiali , Xu Yanjun , Xu Xiaojun , Song Xiuling , Chen Shaowei , Ji Guiyuan , Chen Zihui , Jiang Qi , Liu Tao , Hu Jianxiong , Xiao Jianpeng , Zeng Weilin , Guo Lingchuan , Lin Lifeng , Lin Peng , Ma Wenjun 
Published: December 2020

Background:
Previous studies have shown negative relationships between ambient temperature and blood pressure (BP). However, few studies estimated temperature-adjusted hypertension prevalence and control rate in different population.

Objective:
To estimate the effects of temperature on BP, and further calculate temperature-adjusted hypertension prevalence and control rate.

Methods:
Meteorological and BP data in Guangdong Province from 2004 to 2015 were collected. There were 31 351 participants aged 18 years and over. Based on 2018 European society Arterial Hypertension Guidelines, participants were divided into normotensive patients (n = 23 046), known hypertensive patients (n = 2807), and newly detected hypertensive patients (n = 5498). We first used generalized additive model to establish the nonlinear relationship between daily mean temperature and BP, and then calculated the linear effects of temperature on BP among populations with different hypertension status. Finally, we calculated the temperature-adjusted hypertension prevalence and control rate.

Results:
Generally, there is an inverse relationship between temperature and BP. For a 1 °C increase in temperature, the decreased SBPs for normotensive patients, newly detected hypertensive patients, and known hypertensive patients were 0.37 [95% confidence interval (CI): −0.40, −0.33] mmHg, 0.21 (95% CI: −0.32, −0.10) mmHg and 0.81 (95% CI: −1.02, −0.59) mmHg, while reduced DBPs were 0.19 (95% CI: −0.21, −0.16) mmHg, 0.01 (95% CI: −0.06,0.08) mmHg, and 0.44 (95% CI: −0.56, −0.32) mmHg, respectively. At 5, 10, 15, 20, and 25 °C, the hypertension prevalence rates were 32.5, 29.7, 27.7, 26.0, and 25.0%, respectively, and the control rates were 12.0, 17.5, 23.5, 30.1, and 37.1%, respectively.

Conclusion:
Low temperature increased BP for all populations, especially for known hypertensive patients, which makes hypertension prevalence increase and control rate decrease if temperature reduce. Our findings suggest that temperature should be considered in hypertension clinic management and epidemiological survey.
Primary pure large cell neuroendocrine carcinoma of the ovary
Authors: Peng Xue , Wang Hongjing 
Published: December 2020

Abstract

Introduction:
Ovarian large cell neuroendocrine carcinoma (LCNEC), or ovarian non-small cell neuroendocrine carcinoma, which is a newly described tumour in the classification of primary ovarian neoplasms by the World Health Organization, is a rare entity that is frequently associated with a surface epithelial and germ cell neoplasm component. Few cases have been reported in the literature, and only 18 primary pure ovarian LCNEC cases have been reported so far, including our 1 case. Ovarian LCNEC is a highly aggressive tumor with a poor prognosis even at an early stage.

Patient concerns:
We report a case of a 55-year-old postmenopausal woman who complained of abdominal pain. CT examination revealed a mass in the right adnexial region and CA125 level was elevated.

Diagnosis:
She underwent a exploratory laparotomy, and diagnosed as LCNEC histopathologically.

Interventions:
Cytoreductive surgery was administered to the patient, and had accepted 5 cycles of chemotherapy consisting of paclitaxel and cisplatin.

Outcomes:
Follow-up for 12 months showed no clinical or radiological evidence of disease recurrence.

Conclusion:
This case is 1 of the ovarian LCNEC which is a rare and extremely malignant tumor. Diagnosis requires histopathology and immunohistochemistry. The treatment includes primary cytoreductive surgery followed by chemotherapy.
Rapid screening for safety of donation from donors with central nervous system malignancies
Authors: Zhu Mingxin , Bian Yi , Jiang Jipin , Lei Ting , Shu Kai 
Published: December 2020

Abstract
With the increasing demand on organ transplants, it has become a common practice to include patients with primary central nervous system (CNS) malignancies as donors given the suggested low probability metastatic spread outside of the CNS. However, an extra-CNS spread of the disease cannot be excluded raising potential risks of cancer transmission from those donors. In order to balance between the risk of donor-derived disease transmission and the curative benefit for the recipient, a careful donor and organ selection is important. We performed a literature research and summarized all reported studies of organ transplants from donors suffered from primary CNS malignancies and determined the risk of tumor transmission to recipients. There were 22 cases of transplant-transmitted CNS tumors onto recipients since 1976. The association risks of cancer transmission were attributed to donor tumor histology, disruption of the blood-brain barrier, cerebrospinal fluid extra-CNS, and false diagnosis of primary intracranial tumor as well as the molecular properties of the primary tumor such as the existence of EGFR-amplification. The association risks and features of CNS tumors transmission recipients indicated that we need to reassess our thresholds for the potential fatal consequences of these donors.
Clinical assessment of synbiotics for treating chronic kidney disease
Authors: Li Xiao-Jun , Lu Yan-Yan , Wang Yuan 
Published: December 2020

Abstract

Background:
This research aims to evaluate the efficacy and safety of synbiotics for treating chronic kidney disease.

Methods:
Related articles written in English were sourced from EMBASE, PubMed, Cochrane Library, and China National Knowledge Infrastructure. These articles were used in the evaluation of the effect of synbiotics for treating chronic kidney disease. The extent of the relationship was assessed by calculating the pooled risk ratio, mean differences or standardized mean difference along with the equivalent 95% confidence intervals. The risk of bias introduced through each study was considered by adopting the Cochrane Risk of Bias Tool. Suitable statistical research methods were utilized for the synthesis of the data. The RevMan 5.3 software was used to conduct all statistical analysis.

Results:
The final results of the current study is due to be included in a peer-reviewed journal.

Conclusion:
The final remarks of the current study will be useful evidence for determining whether synbiotics is an effective and safe therapeutic method for treating chronic kidney disease.

OSF registration number:
DOI 10.17605/OSF.IO/UASF4 (https://osf.io/uasf4/).
Successful treatment of a critically ill patient with acute respiratory distress syndrome from COVID-19 using mechanical ventilation strategy with low levels of positive end-expiratory pressure
Authors: Guo Wei-guang , Fang Bin , Xian Yan-shan , Yu Zhi-hui , Zhou Li-xin 
Published: December 2020

Abstract

Introduction:
Acute respiratory distress syndrome (ARDS) secondary to COVID-19 is different from the ARDS caused by other infections. Conventional mechanical ventilation strategies using high levels of PEEP may not be beneficial and can even be harmful to patient with ARDS from COVID-19. So the ventilation strategies should be adjusted in order to improve the pulmonary ventilation function and oxygenation status, and outcomes of the patient.

Patient concerns:
Herein, we present a 76-year-old male patient with ARDS secondary to COVID-19. We describe our experience with mechanical ventilation strategy and the changes in respiratory mechanics in the patient during treatment.

Diagnosis:
The patient had tested positive for coronavirus (COVID-19) in nucleic acid test. Chest CT showed multiple ground glass shadows in both lungs.

Interventions:
The patient received mechanical ventilation with low tidal volume and low PEEP.

Outcomes:
After treatment, the patients condition, as well as oxygenation status was improved, and he tested negative for the coronavirus several times.

Conclusion:
This case demonstrated that the low tidal volume with low levels of PEEP ventilation strategy may be more suitable for ARDS from COVID-19.