bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term outcomes and safety of radiotherapy for immediate breast reconstruction with autologous flap transfer following breast-conserving surgery
Authors: Zhang Shu-Ling , Song Jun , Wang Yan-Ru , Guo Yi-Jia , Zhao Jian-Zhu , Sun Li , Huang Le-Tian , Ma Jie-Tao , Han Cheng-Bo 
Published: March 2021

Abstract
Background
The outcomes of immediate autologous breast reconstruction (IABR) after partial mastectomy followed by postoperative radiotherapy (RT) in terms of aesthetics, treatment-related complications, and local control are unclear. In this study, we evaluated the efficacy of IABR after partial mastectomy with or without breast RT, and thus the impact of radiation on autologous flap transfer.

Method
A retrospective cohort study involving consecutive breast cancer patients who underwent IABR after partial mastectomy between July 2011 and December 2017 at Shengjing Hospital was performed. Patients were divided into two groups based on whether or not they received RT after IABR. We compared aesthetic outcomes and changes in the flap size over the three-dimensional coordinates at various timepoints (pre-RT, 1, 6, and 12 months post-RT), as well as postoperative complications, survival, and recurrence rates between the two groups.

Results
In total, 84 breast cancer patients were enrolled, with 32 patients in the RT group and 52 in the non-RT group. At a median follow-up time of 33.3 months, no significant difference was found in the rate of regional recurrence between the two groups (3.13% vs. 3.85%, P = 1.00), and no local recurrences occurred in either group. At the timepoints pre-RT, 1, and 6 months post-RT (approximately 4, 7, and 12 months after IABR, respectively), 77 (91.7%), 70 (83.3%), and 83 (98.8%) patients, respectively, had achieved very good or good cosmetic outcomes, and only changes in breast skin color at 1 month after RT significantly differed between the RT and non-RT groups, with very good or good cosmetic result rates of 62.5% vs. 96.2%, respectively (P < 0.001). No significant difference in the reduction of flap size was observed at any timepoint between the two groups. There were no significant differences between the two groups in the rates of postoperative complications including necrosis of the flap, infection, hematoma, or seroma (all P > 0.05). Additionally, no grade 3 or greater RT-associated adverse events occurred during or after RT.

Conclusion
RT following IABR provides aesthetically satisfactory results without intolerable adverse complications and may safely be performed in patients who underwent IABR after partial mastectomy.
IL-4Rα blockade reduces influenza-associated morbidity in a murine model of allergic asthma
Authors: Shahangian Kimia , Ngan David A. , Chen H. H. Rachel , Oh Yeni , Tam Anthony , Wen Jing , Cheung Chung , Knight Darryl A. , Dorscheid Delbert R. , Hackett Tillie L. , Hughes Michael R. , McNagny Kelly M. , Hirota Jeremy A. , Niikura Masahiro , Man S. F. Paul , Sin Don D. 
Published: March 2021

Abstract
Background
Asthma was identified as the most common comorbidity in hospitalized patients during the 2009 H1N1 influenza pandemic. We determined using a murine model of allergic asthma whether these mice experienced increased morbidity from pandemic H1N1 (pH1N1) viral infection and whether blockade of interleukin-4 receptor α (IL-4Rα), a critical mediator of Th2 signalling, improved their outcomes.

Methods
Male BALB/c mice were intranasally sensitized with house dust mite antigen (Der p 1) for 2 weeks; the mice were then inoculated intranasally with a single dose of pandemic H1N1 (pH1N1). The mice were administered intraperitoneally anti-IL-4Rα through either a prophylactic or a therapeutic treatment strategy.

Results
Infection with pH1N1 of mice sensitized to house dust mite (HDM) led to a 24% loss in weight by day 7 of infection (versus 14% in non-sensitized mice; p < .05). This was accompanied by increased viral load in the airways and a dampened anti-viral host responses to the infection. Treatment of HDM sensitized mice with a monoclonal antibody against IL-4Rα prior to or following pH1N1 infection prevented the excess weight loss, reduced the viral load in the lungs and ameliorated airway eosinophilia and systemic inflammation related to the pH1N1 infection.

Conclusion
Together, these data implicate allergic asthma as a significant risk factor for H1N1-related morbidity and reveal a potential therapeutic role for IL-4Rα signalling blockade in reducing the severity of influenza infection in those with allergic airway disease.
Time-dependent efficacy of combination of silver-containing hydroxyapatite coating and vancomycin on methicillin-resistant Staphylococcus aureus biofilm formation in vitro
Authors: Hashimoto Akira , Miyamoto Hiroshi , Kii Sakumo , Kobatake Tomoki , Shobuike Takeo , Noda Iwao , Sonohata Motoki , Mawatari Masaaki 
Published: March 2021

AbstractObjectiveWe developed a silver-containing hydroxyapatite (Ag-HA) coating to prevent periprosthetic joint infection (PJI). Methicillin-resistantStaphylococcus aureus(MRSA) is the main PJI-causing bacteria. Previously, we had reported the combined effect of Ag-HA coating and vancomycin (VCM) on MRSA biofilm formation 24 h after MRSA inoculation. In this study, we investigated the time-dependent efficacy of Ag-HA coating and VCM on MRSA biofilm formation on Ti discs in vitro by three-dimensional confocal laser scanning microscopic analysis.ResultsFor the Ti VCM and HA VCM groups, the total biofilm volumes per area at 96 h after MRSA inoculation were significantly larger than those at 48 h after MRSA inoculation, respectively (p < 0.001). In contrast, for the Ag-HA VCM group, the total biofilm volume per area at 96 h was significantly smaller than that at 48 h (p < 0.0001). Moreover, 96 h after MRSA inoculation, the total biofilm volume per area of the Ag-HA VCM groups was significantly smaller than those of the Ti VCM and HA VCM groups (p < 0.0001). Thus, the combination of Ag-HA and VCM might be useful for the prevention of MRSA-associated PJI.
Weight management intervention identifies association of decreased DNA methylation age with improved functional age measures in older adults with obesity
Authors: Petersen Curtis L. , Christensen Brock C. , Batsis John A. 
Published: March 2021

Abstract
Background
Assessing functional ability is an important component of understanding healthy aging. Objective measures of functional ability include grip strength, gait speed, sit-to-stand time, and 6-min walk distance. Using samples from a weight loss clinical trial in older adults with obesity, we examined the association between changes in physical function and DNA-methylation-based biological age at baseline and 12 weeks in 16 individuals. Peripheral blood DNA methylation was measured (pre/post) with the Illumina HumanMethylationEPIC array and the Hannum, Horvath, and PhenoAge DNA methylation age clocks were used. Linear regression models adjusted for chronological age and sex tested the relationship between DNA methylation age and grip strength, gait speed, sit-to-stand, and 6-min walk.

Results
Participant mean weight loss was 4.6 kg, and DNA methylation age decreased 0.8, 1.1, and 0.5 years using the Hannum, Horvath, and PhenoAge DNA methylation clocks respectively. Mean grip strength increased 3.2 kg. Decreased Hannum methylation age was significantly associated with increased grip strength (β = −0.30, p = 0.04), and increased gait speed (β = 0.02, p = 0.05), in adjusted models. Similarly, decreased methylation age using the PhenoAge clock was associated with significantly increased gait speed (β = 0.02, p = 0.04). A decrease in Horvath DNA methylation age and increase in physical functional ability did not demonstrate a significant association.

Conclusions
The observed relationship between increased physical functional ability and decreased biological age using DNA methylation clocks demonstrate the potential utility of DNA methylation clocks to assess interventional approaches to improve health in older obese adults.
Trial registration: National Institute on Aging (NIA), NCT03104192. Posted April 7, 2017, https://clinicaltrials.gov/ct2/show/NCT03104192
The angiogenic potential of CD271+ human adipose tissue-derived mesenchymal stem cells
Authors: Smith Richard J. P. , Faroni Alessandro , Barrow James R. , Soul Jamie , Reid Adam J. 
Published: March 2021

Abstract
Background
Autologous fat grafting is often a crucial aspect of reconstructive and aesthetic surgeries, yet poor graft retention is a major issue with this technique. Enriching fat grafts with adipose tissue-derived mesenchymal stem cells (AD-MSCs) improves graft survival—however, AD-MSCs represent a heterogeneous population. Selection of subpopulations of AD-MSCs would allow the targeting of specific AD-MSCs that may benefit fat graft survival more than the general AD-MSC population.

Methods
Human AD-MSCs were selected for the surface marker CD271 using magnetic-activated cell sorting and compared to the CD271 negative phenotype. These subpopulations were analysed for gene expression using Real-Time qPCR and RNA sequencing; surface marker characteristics using immunostaining; ability to form tubules when cultured with endothelial cells; and gene and protein expression of key angiogenic mediators when cultured with ex-vivo adipose tissue.

Results
Human AD-MSCs with the surface marker CD271 express angiogenic genes at higher levels, and inflammatory genes at lower levels, than the CD271− AD-MSC population. A greater proportion of CD271+ AD-MSCs also possess the typical complement of stem cell surface markers and are more likely to promote effective neoangiogenesis, compared to CD271− AD-MSCs.

Conclusion
Enriching grafts with the CD271+ AD-MSC subpopulation holds potential for the improvement of reconstructive and aesthetic surgeries involving adipose tissue.
Identification of a potent antagonist of smoothened in hedgehog signaling
Authors: Fan Junwan , Li Haowen , Kuang Lun , Zhao Zichen , He Wenyan , Liu Chen , Wang Yongjun , Cheng Steven Y. , Chen Wei 
Published: March 2021

AbstractBackgroundHedgehog signaling is essential to the regulation of embryonic development, tissue homeostasis, and stem cell self-renewal, making it a prime target for developing cancer therapeutics. Given the close link between aberrant Hedgehog signaling and cancers, many small molecular compounds have been developed to inhibit Smoothened, a key signal transducer of this pathway, for treating cancer and several such compounds have been approved by the United States Food and Drug Administration (GDC-0449 and LDE-225). However, acquired drug resistance has emerged as an important obstacle to the effective use of these first generation Hedgehog pathway blockers. Thus, new Smoothened inhibitors that can overcome such resistance is an urgent need going forward.ResultsWe established the Smoothened/βarrestin2-GFP high-throughput screening platform based on the mechanistic discovery of Hedgehog signaling pathway, and discovered several active small molecules targeting Smoothened including 0025A. Here we show that 0025A can block the translocation of βarrestin2-GFP to Smoothened, displace Bodipy-cyclopamine binding to wild-type Smoothened or mutant Smoothened-D473H, reduce the accumulation of Smo on primary cilia and the expression of Gli upon Hedgehog stimulation. In addition, we show that 0025A can effectively suppress hair follicle morphogenesis and hair growth in mice.ConclusionsOur results demonstrate that 0025A is a potent antagonist targeting Smoothened wild-type and mutant receptors in the Hedgehog signaling pathway and may provide a new therapy for refractory cancers.
In respond to commensal bacteria: γδT cells play a pleiotropic role in tumor immunity
Authors: Liu Yongting , Han Ying , Zeng Shan , Shen Hong 
Published: March 2021

AbstractγδT cells are a mixture of innate programming and acquired adaptability that bridge the adaptive and innate immune systems. γδT cells are mainly classified as tissue-resident Vδ1 or circulating Vδ2 γδT cells. In the tumor microenvironment, tumor immunity is influenced by the increased quantity and phenotype plasticity of γδT cells. Commensal bacteria are ubiquitous in the human body, and they have been confirmed to exist in various tumor tissues. With the participation of commensal bacteria, γδT cells maintain homeostasis and are activated to affect the development and progression of tumors. Here, we summarize the relationship between γδT cells and commensal bacteria, the potential protumor and antitumor effects underlying γδT cells, and the new developments in γδT cell-based tumor therapy which is expected to open new opportunities for tumor immunotherapy.
Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside
Authors: Carteaux Guillaume , Pons Manuella , Morin François , Tuffet Samuel , Lesimple Arnaud , Badat Bilal , Haudebourg Anne-Fleur , Perier François , Deplante Yvon , Guillaud Constance , Schlemmer Frédéric , Fois Elena , Mongardon Nicolas , Khellaf Mehdi , Jaffal Karim , Deguillard Camille , Grimbert Philippe , Huguet Raphaëlle , Razazi Keyvan , de Prost Nicolas , Templier François , Beloncle François , Mercat Alain , Brochard Laurent , Audard Vincent , Lim Pascal , Richard Jean-Christophe , Savary Dominique , Mekontso Dessap Armand 
Published: March 2021

Abstract
Background
We describe a frugal approach (focusing on needs, performance, and costs) to manage a massive influx of COVID-19 patients with acute hypoxemic respiratory failure (AHRF) using the Boussignac valve protected by a filter (“Filter Frugal CPAP”, FF-CPAP) in and out the ICU.

Methods
(1) A bench study measured the impact of two filters with different mechanical properties on CPAP performances, and pressures were also measured in patients. (2) Non-ICU healthcare staff working in COVID-19 intermediate care units were trained with a video tutorial posted on a massive open online course. (3) A clinical study assessed the feasibility and safety of using FF-CPAP to maintain oxygenation and manage patients out of the ICU during a massive outbreak.

Results
Bench assessments showed that adding a filter did not affect the effective pressure delivered to the patient. The resistive load induced by the filter variably increased the simulated patient’s work of breathing (6–34%) needed to sustain the tidal volume, depending on the filter’s resistance, respiratory mechanics and basal inspiratory effort. In patients, FF-CPAP achieved pressures similar to those obtained on the bench. The massive training tool provided precious information on the use of Boussignac FF-CPAP on COVID-19 patients. Then 85 COVID-19 patients with ICU admission criteria over a 1-month period were studied upon FF-CPAP initiation for AHRF. FF-CPAP significantly decreased respiratory rate and increased SpO2. Thirty-six (43%) patients presented with respiratory indications for intubation prior to FF-CPAP initiation, and 13 (36%) of them improved without intubation. Overall, 31 patients (36%) improved with FF-CPAP alone and 17 patients (20%) did not require ICU admission. Patients with a respiratory rate > 32 breaths/min upon FF-CPAP initiation had a higher cumulative probability of intubation (p < 0.001 by log-rank test).

Conclusion
Adding a filter to the Boussignac valve does not affect the delivered pressure but may variably increase the resistive load depending on the filter used. Clinical assessment suggests that FF-CPAP is a frugal solution to provide a ventilatory support and improve oxygenation to numerous patients suffering from AHRF in the context of a massive outbreak.
Policing and public health calls for service in Philadelphia
Authors: Ratcliffe Jerry H. 
Published: March 2021

AbstractThis contribution outlines various spatial and temporal aspects of medical or public-health related calls for service from the public to police in Philadelphia in 2019. These incidents comprise about 8% of the police department’s workload that originates from the public. Calls appear to be highly concentrated in a few areas, and specifically the Center City and Kensington neighborhoods. They are also more likely to occur late afternoon and evening. The article shows that some medical or public health activity initially masquerades as crime or other policing work and some events eventually determined to be police/crime activity can initially appear to be public health related. About 20% of activity in this area does not appear predictable from the initial call type as handled by police dispatch.
An online survey to explore the awareness and acceptance of geothermal energy among an educated segment of the population in five European and American countries
Authors: Balzan-Alzate D. , López-Sánchez J. , Blessent D. , Raymond J. , Dezayes C. , Portela J. P. , Restrepo E. Ramírez , Rendón D. Moreno , Malo M. , Goderniaux P. , Daniele L. , Le Borgne T. 
Published: March 2021

AbstractAdvances in new technologies and the desire to achieve a sustainable and safe energy supply, enable communities to transition from conventional to renewable resources, such as geothermal energy. Perception and acceptance amongst different audiences have a high impact on the feasibility of energy projects, which is an important aspect to analyze. For this reason, this study focuses on describing the level of awareness and acceptance of deep geothermal energy within an educated segment of the population in five European and American countries (Canada, Colombia, Chile, Belgium, and France) at different stages of geothermal development. This study was conducted through an online survey, which was targeted to post-secondary students and professionals. Some of the most significant conclusions are: (1) there is a high degree of awareness of geothermal energy among the respondents in Chile and Canada, a medium level in Belgium and France, and a low one in Colombia; (2) there is a favorable acceptance of a geothermal project in each country, even when hydraulic stimulation is considered; (3) environmental aspects and community safety are the most important issues that must be addressed to support a pilot geothermal project.
Healing the next generation: an adaptive agent model for the effects of parental narcissism
Authors: Jabeen Fakhra , Gerritsen Charlotte , Treur Jan 
Published: March 2021

AbstractParents play an important role in the mental development of a child. In our previous work, we addressed how a narcissistic parent influences a child (online/offline) when (s)he is happy and admires the child. Now, we address the influence of a parent who is not so much pleased, and may curse the child for being the reason for his or her unhappiness. An abusive relationship with a parent can also cause trauma and poor mental health of the child. We also address how certain coping behaviors can help the child cope with such a situation. Therefore, the aim of the study is threefold. We present an adaptive agent model of a child, while incorporating the concept of mirroring through social contagion, the avoidance behaviors from a child, and the effects of regulation strategies to cope with stressful situations.
Negative-pressure wound therapy in combination with bronchial occlusion to treat bronchopleural fistula: a case report
Authors: Iwasaki Masashi , Shimomura Masanori , Ii Tsunehiro 
Published: March 2021

Abstract
Background
Bronchopleural fistula, which usually accompanies bronchial fistula and empyema, is a severe complication of lung cancer surgery. Negative-pressure wound therapy can enhance drainage and reduce the empyema cavity, potentially leading to early recovery. This therapy is not currently indicated for bronchopleural fistulas because of the risk of insufficient respiration due to air loss from the fistula.

Case presentation
A 73-year-old man, who was malnourished because of peritoneal dialysis, was referred to our hospital for the treatment of lung cancer. Right lower lobectomy with mediastinal lymph node dissection was performed via posterolateral thoracotomy, and the bronchial stump was covered with the intercostal muscle flap. His postoperative course was uneventful and he was discharged. However, he was readmitted to our hospital because of respiratory failure and diagnosed as having bronchopleural fistula on the basis of the bronchoscopic finding of a 10-mm hole at the membranous portion of the inlet of the remnant lower lobe bronchus. Thus, thoracotomy debridement and open window thoracostomy were immediately performed. After achieving infection control, bronchial occlusion was performed using fibrin glue and a polyglycolic acid sheet was inserted through a fenestrated wound. Bronchial fistula closure was observed on bronchoscopy; therefore, a negative-pressure wound therapy system was applied to close the fenestrated wound. The collapsed lung was re-expanded and the granulation tissue around the wound increased; therefore, thoracic cavity size decreased and thoracoplasty using the latissimus dorsi was performed.

Conclusions
This bronchopleural fistula was treated successfully after a right lower lobectomy using an extra-pleural bronchial occlusion and negative-pressure wound therapy.
Investigation of bioactivities of endophytes of Ficus carica L. Fam Moraceae
Authors: Abdou Randa , Mojally Mariam , Attia Gouda H. 
Published: March 2021

Abstract
Background
The medicinal plant Ficus carica L., inhabiting southwest regions of Asia, is known for its wide ethnopharmacological applications. In traditional medicine, it has been applied as a treatment of respiratory, gastrointestinal and cardiovascular disorders, among others. Recent studies confirmed antimicrobial and anticancer activities for the plant extract. To find out whether endophytes of F. carica contribute to its biological activities, endophytes of the aerial parts of the plant were isolated and examined for anticancer and antimicrobial effects.

Results
The isolated species were identified as Chaetomium globosum, Penicillium oxalicum, Alternaria alternata, Fusarium proliferatum and Aspergillus neoniger. An anticancer assay was carried out on the extracts of fungal strains against human umbilical vein endothelial cells (HUVEC), human immortalized myelogenous leukemia cell line (K-562) and human immortal cervical cancer cell line (HeLa). Results revealed antiproliferative effects for all endophytic strains against HUVEC and K-562 with GI50 values ranging from 4.75 to 13.75 µg mL−1 as well as cytotoxicity against HeLa with CC50 ranging from 8.25 to 18.75 µg mL−1. The antimicrobial activity of the extracts was tested against several test strains in agar diffusion assay, and MIC values were determined by the broth microdilution method. All strain extracts exerted antibacterial and antifungal activities with highest antifungal effect observed for A. neoniger extract (MIC = 3.75 µg mL−1).

Conclusions
These results support the assumption that endophytes of F. carica contribute to the plant’s reported antimicrobial and anticancer activities and its corresponding applications in traditional medicine.