A Call for Gene Expression Analysis in Whole Blood of Patients With Rheumatoid Arthritis (RA) as a Biomarker for RA-Associated Interstitial Lung Disease

OBJECTIVE

Rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) is one of the most common and prognostic organ manifestations of RA. Therefore, to allow effective treatment, it is of crucial importance to diagnose RA-ILD at the earliest possible stage. So far, the gold standard of early detection has been high-resolution computed tomography (HRCT) of the lungs. This procedure involves considerable radiation exposure for the patient and is therefore unsuitable as a routine screening measure for ethical reasons. Here, we propose the analysis of characteristic gene expression patterns as a biomarker to aid in the early detection and initiation of appropriate, possibly antifibrotic, therapy.

METHODS

To investigate unique molecular patterns of RA-ILD, whole blood samples were taken from 12 female patients with RA-ILD (n = 7) or RA (n = 5). The RNA was extracted, sequenced by RNA-Seq, and analyzed for characteristic differences in the gene expression patterns between patients with RA-ILD and those with RA without ILD.

RESULTS

The differential gene expression analysis revealed 9 significantly upregulated genes in RA-ILD compared to RA without ILD: arginase 1 (ARG1), thymidylate synthetase (TYMS), sortilin 1 (SORT1), marker of proliferation Ki-67 (MKI67), olfactomedin 4 (OLFM4), baculoviral inhibitor of apoptosis repeat containing 5 (BIRC5), membrane spanning 4-domains A4A (MS4A4A), C-type lectin domain family 12 member A (CLEC12A), and the long intergenic nonprotein coding RNA (LINC02967).

CONCLUSION

All gene products of these genes (except for LINC02967) are known from the literature to be involved in the pathogenesis of fibrosis. Further, for some, a contribution to the development of pulmonary fibrosis has even been demonstrated in experimental studies. Therefore, the results presented here provide an encouraging perspective for using specific gene expression patterns as biomarkers for the early detection and differential diagnosis of RA-ILD as a routine screening test.

Evidence-based research impact praxis: Integrating scholarship and practice to ensure research benefits society

Effective research impact development is essential to address global challenges. This commentary highlights key issues facing research impact development as a nascent professional field of practice. We argue that those working on research impact should take a strategic, 'evidence-based' approach to maximize potential research benefits and minimize potential harms. We identify key features of evidence-based good practice in the context of research impact work. This includes integrating relevant research and theory into professional decision-making, drawing on a diversity of academic disciplines offering pertinent insights. Such an integration of scholarship and practice will improve the capacity of research impact work to make a positive difference for society. Moving the focus of research impact work to earlier stages in the research and innovation process through stakeholder engagement and anticipatory research can also boost its effectiveness. The research impact evidence base should be combined with the right kind of professional capacities and practical experience to enhance positive impact. Such capacities need to be developed through relevant education and training, for example, in participatory methods and social inclusion. Such training for research impact work needs to forge strong links between research impact scholarship and practice. Finally, there is a need for improvements in the evidence base for research impact to make it more practically useful.

[Consensus guideline on the interdisciplinary diagnosis of interstitial lung diseases]

The evaluation of a patient with interstitial lung disease (ILD) includes assessment of clinical, radiological, and often histopathological data. As there were no specific recommendations to guide the evaluation of patients under the suspicion of an ILD within the German practice landscape, this position statement from an interdisciplinary panel of ILD experts provides guidance related to the diagnostic modalities which should be used in the evaluation of ILD. This includes clinical assessment rheumatological evaluation, radiological examinations, histopathologic sampling and the need for a final discussion in a multidisciplinary team.

Effect of Fractal Topology on the Resistivity Response of Thin Film Sensors

We discuss the effect of topological inhomogeneity of very thin metallic conductometric sensors on their response to external stimuli, such as pressure, intercalation, or gas absorption, that modify the material's bulk conductivity. The classical percolation model was extended to the case in which several independent scattering mechanisms contribute to resistivity. The magnitude of each scattering term was predicted to grow with the total resistivity and diverge at the percolation threshold. We tested the model experimentally using thin films of hydrogenated palladium and CoPd alloys where absorbed hydrogen atoms occupying the interstitial lattice sites enhance the electron scattering. The hydrogen scattering resistivity was found to grow linearly with the total resistivity in the fractal topology range in agreement with the model. Enhancement of the absolute magnitude of the resistivity response in the fractal range thin film sensors can be particularly useful when the respective bulk material response is too small for reliable detection.

A Longitudinal Study of Thrombosis and Bleeding Outcomes With Thromboprophylaxis in Pregnant Women at Intermediate and High Risk of VTE

BACKGROUND

The efficacy and safety of thromboprophylaxis in pregnancy at intermediate to high risk of venous thrombo-embolism (VTE) is an area of ongoing research.

AIM

This study aimed to assess thrombosis and bleeding outcomes associated with thromboprophylaxis in women at risk of VTE.

METHODS

A cohort of 129 pregnancies, who received thromboprophylaxis for the prevention of VTE, were identified from a specialist obstetric clinic in Johannesburg, South Africa. Intermediate-risk pregnancies, with medical comorbidities or multiple low risks, were managed with fixed low-dose enoxaparin antepartum and for a median (interquartile range) of 4 (4) weeks postpartum. High-risk pregnancies, with a history of previous VTE, were managed with anti-Xa adjusted enoxaparin antepartum and for a median of 6 (0) weeks postpartum. Pregnancy-related VTE was objectively confirmed. Major bleeding, clinically relevant nonmajor bleeding (CRNMB) and minor bleeding were defined according to the International Society on Thrombosis and Hemostasis Scientific Subcommittee.

RESULTS

Venous thrombo-embolism occurred antepartum in 1.4% (95% CI: 0.04-7.7) of intermediate and 3.4% (95% CI: 0.4-11.7) of high-risk pregnancies. Bleeding events occurred in 7.1% (95% CI: 2.4-15.9) of intermediate and 8.5% (95% CI: 2.8-18.7) of high-risk pregnancies. Of these bleeding events, 3.1% (95% CI: 1.0-8.0) were classified as major bleeding. On univariate analysis, no independent predictors of bleeding were identified.

CONCLUSION

The rates of thrombosis and bleeding in this predominantly African population were consistent with similar studies and can be used to inform pregnant women of the benefits of anticoagulation and the risks of potential bleeding.

Effective inter-organisational networks for Responsible Research and Innovation and global sustainability: a scoping review

Background: Achieving the United Nations Sustainable Development Goals (SDGs) is beyond the capacity of any single organisation. The model for Responsible Research and Innovation (RRI) includes principles of engaging stakeholders and suggests that an engaged, multi-sectoral approach hold promise to mobilise humanity to solve complex and urgent global issues. Methods: This scoping review explores the characteristics of effective and sustainable inter-organisational networks for fostering RRI in service of the SDGs. An inductive-deductive search of prior studies (1990-2020), with the exception of Benson's (1975) seminal work was conducted, which focused on strategies to initiate and maintain inter-organisational networks relevant to the implementation of RRI and/or SDGs. The search began with themes derived from prior network theory, focusing on: (a) the type and function of networks; (b) the aims and vision; and (c) the relationships between networks and network members. In total, 55 articles on inter-organisational network theory were included for the final analysis. Results: Results are reported under themes of: (1) Effectiveness, Sustainability, and Success; (2) Governance and Management; and (3) Network Relationship. Network structures, forms of management and funding are linked to sustainable networks. Potential threats include power imbalances within networks, and internal and external factors that may affect relationships at network and community levels. Few studies examine diversity or cultural viewpoints. Studies highlight the benefits of networks such as enhancing knowledge sharing among researchers, practitioners, and other stakeholders. Conclusions: The effectiveness of the managerial structure may be observed as outputs of the intention and values of an inter-organisational network. Our review demonstrates that a global inter-organisational network approach is achievable. Such a network would have many benefits, including allowing organisations to be responsive and flexible towards change and innovation. Keywords RRI, SDGs, network theory, inter-organisational networks, governance, trust.

Low-Cost Probabilistic 3D Denoising with Applications for Ultra-Low-Radiation Computed Tomography

We propose a pipeline for synthetic generation of personalized Computer Tomography (CT) images, with a radiation exposure evaluation and a lifetime attributable risk (LAR) assessment. We perform a patient-specific performance evaluation for a broad range of denoising algorithms (including the most popular deep learning denoising approaches, wavelets-based methods, methods based on Mumford−Shah denoising, etc.), focusing both on accessing the capability to reduce the patient-specific CT-induced LAR and on computational cost scalability. We introduce a parallel Probabilistic Mumford−Shah denoising model (PMS) and show that it markedly-outperforms the compared common denoising methods in denoising quality and cost scaling. In particular, we show that it allows an approximately 22-fold robust patient-specific LAR reduction for infants and a 10-fold LAR reduction for adults. Using a normal laptop, the proposed algorithm for PMS allows cheap and robust (with a multiscale structural similarity index >90%) denoising of very large 2D videos and 3D images (with over 107 voxels) that are subject to ultra-strong noise (Gaussian and non-Gaussian) for signal-to-noise ratios far below 1.0. The code is provided for open access.

Aerosol exposure of staff during dental treatments: a model study

Background

Due to exposure to potentially infectious aerosols during treatments, the dental personnel is considered being at high risk for aerosol transmitted diseases like COVID-19. The aim of this study was to evaluate aerosol exposure during different dental treatments as well as the efficacy of dental suction to reduce aerosol spreading.

Methods

Dental powder-jet (PJ; Air-Flow^®), a water-cooled dental handpiece with a diamond bur (HP) and water-cooled ultrasonic scaling (US) were used in a simulation head, mounted on a dental unit in various treatment settings. The influence of the use of a small saliva ejector (SE) and high-volume suction (HVS) was evaluated. As a proxy of aerosols, air-born particles (PM10) were detected using a Laser Spectrometer in 30 cm distance from the mouth. As control, background particle counts (BC) were measured before and after experiments.

Results

With only SE, integrated aerosol levels [median (Q25/Q75) µg/m³ s] for PJ [91,246 (58,213/118,386) µg/m³ s, p < 0.001, ANOVA] were significantly increased compared to BC [7243 (6501/8407) µg/m³ s], whilst HP [11,119 (7190/17,234) µg/m³ s, p > 0.05] and US [6558 (6002/7066) µg/m³ s; p > 0.05] did not increase aerosol levels significantly. The use of HVS significantly decreased aerosol exposure for PJ [37,170 (29,634/51,719) µg/m³ s; p < 0.01] and HP [5476 (5066/5638) µg/m³ s; p < 0.001] compared to SE only, even reaching lower particle counts than BC levels for HP usage (p < 0.001).

Conclusions

To reduce the exposure to potentially infectious aerosols, HVS should be used during aerosol-forming dental treatments.

HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data)

BACKGROUND

Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use.

METHODS

We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not.

RESULTS

Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction).

CONCLUSIONS

Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.

Resistivity Testing of Palladium Dilution Limits in CoPd Alloys for Hydrogen Storage

Palladium satisfies most of the requirements for an effective hydrogen storage material with two major drawbacks: it has a relatively low gravimetric hydrogen density and is prohibitively expensive for large scale applications. Pd-based alloys should be considered as possible alternatives to a pure Pd. The question is how much one can dilute the Pd concentration in a variety of candidate materials while preserving the hydrogen absorption capability. We demonstrate that the resistivity measurements of thin film alloy samples can be used for a qualitative high-throughput screening and study of the hydrogen absorbing properties over the entire range of palladium concentrations. Contrary to palladium-rich alloys where additional hydrogen scattering indicates a degree of hydrogen content, the diluted alloy films respond by a decrease in resistance due to their thickness expansion. Evidence of significant hydrogen absorption was found in thin CoPd films diluted to just 20% of Pd.

Role of anti-phase boundaries in the formation of magnetic domains in magnetite thin films

Anti-phase boundaries (APBs) are structural defects which have been shown to be responsible for the anomalous magnetic behavior observed in different nanostructures. Understanding their properties is crucial in order to use them to tune the properties of magnetic materials by growing APBs in a controlled way since their density strongly depends on the synthesis method. In this work we investigate their influence on magnetite (Fe₃O₄) thin films by considering an atomistic spin model, focussing our study on the role that the exchange interactions play across the APB interface. We conclude that the main atypical features reported experimentally in this material are well described by the model we propose here, confirming the new exchange interactions created in the APB as the responsible for this deviation from bulk properties.

Particulate matter emissions of four types of one cigarette brand with and without additives: a laser spectrometric particulate matter analysis of secondhand smoke

OBJECTIVE

Inhaled particulate matter (PM) in secondhand smoke (SHS) is deleterious for smokers and non-smokers. Different additives in cigarettes might effect the amount of PM. This study aimed to assess the influence of additives on the PM emissions from different cigarette types in SHS.

DESIGN

An experimental study of PM measuring in SHS of cigarettes without exposition of any person.

METHOD

The concentrations of PM (PM10, PM2.5 and PM1) in SHS of four different types of cigarettes of the brand Lucky Strike, two types with additives (Original Red, Original Blue) and two types without additives (Straight Red, Straight Blue), in comparison to the reference cigarette 3R4F were analysed. An automatic environmental tobacco smoke emitter generated SHS in an enclosed space with a volume of 2.88 m3. PM was measured with a laser aerosol spectrometer (Grimm model 1.109). Afterwards, the measuring values of the four Lucky Strike brands and the reference cigarette were statistically evaluated and visualised.

RESULTS

Lucky Strike Straight Blue, a cigarette type without additives and lower tar amount, showed 10% to 25% lower PM mean values compared with the other tested Lucky Strike products, but 21% (PM1) respectively 27% (PM2.5,PM10) higher mean values than the reference cigarette. The PM mean of all measured smoke-free baseline values (clean air) was 1.6 µg/m³. It increased up to about 1800 µg/m³ for the reference cigarette and up to about 3070 µg/m³ for the Lucky Strike Original Blue.

CONCLUSIONS

The findings of this study show the massive increase of PM amount by smoking cigarettes in enclosed spaces and suggest that additives in tobacco products increase the PM amount in SHS. For validation, further comparative studies are necessary focusing on the comparison of the PM concentration of cigarettes with and without additives.

IMPLICATIONS

Due to the exposure to SHS, 890 000 people die each year worldwide. PM in SHS endangers the health of both non-smokers and smokers. This study considers the effect of additives like aromatics and humectant agents in cigarettes on PM in SHS. Do additives in tobacco products increase the amount of PM?

[Epidemiology of systemic lupus erythematosus in Reunion Island, Indian Ocean: A case-series in adult patients from a University Hospital]

OBJECTIVES

The study aimed at assessing the epidemiology and clinical features of systemic lupus erythematosus (SLE) in Reunion Island, South West of Indian Ocean.

PATIENTS AND METHODS

A retrospective study was conducted at the University Hospital of La Reunion (Saint-Denis) by charts review from 2004 to 2015. Patients with a SLE diagnosed over 15 years according to SLICC 2012 criteria were included. Incidence and prevalence were inferred from national health insurance database and population census results.

RESULTS

In total, 123 patients met inclusion criteria: 116 were women (94%) and mean age at diagnosis was 34.7±13.4 years. Ten percent of all patients had a least one parent with autoimmune disease, and 4% with lupus. The main manifestations were musculoskeletal (89%) and mucocutaneous with acute or subacute lesions (76%), alopecia (25%), ulcers (15%) and discoid lupus (11%). Lupus nephropathy occurred in 39%, serositis in 31% and neurological features in 15%. Antinuclear antibodies were positive in 99% (threshold >1/80), and associated to anti-DNA (70%), anti-SSA (47%), anti-RNP (42%), and anti-Sm (37%). APL syndrome was diagnosed in 15%. The average annual standardized incidence between 2010 and 2016 was 6.3 cases per 100,000 inhabitants (95% confidence interval [CI]: 5.6-6.9). The prevalence was 76 cases per 100,000 inhabitants in 2016 (95% CI: 70-82).

CONCLUSION

Lupus in the multi-ethnic population of Reunion Island is characterized by high incidence and high rates of articular and renal manifestations, as well as anti-ENA antibodies.

[The gender gap in highest quality medical research - A scientometric analysis of the representation of female authors in highest impact medical journals]

OBJECTIVE

 The study aims to elucidate the state of gender equality in high-impact medical research, analyzing the representation of female authorships from January, 2008 to September, 2017.

METHODS

 133 893 male and female authorships from seven high-impact medical journals were analyzed. The key methodology was the combined analysis of the relative frequency, odds ratio and citations of female authorships. The Prestige Index measures the distribution of prestigious authorships between the two genders.

RESULTS

 35.0 % of all authorships and 34.3 % of the first, 36.1 % of the co- and 24.2 % of the last authorships were held by women. Female authors have an odds ratio of 0.97 (KI: 0.93 - 1.01) for first, 1.36 (KI: 1.32 - 1.40) for co- und 0.57 (KI: 0.54 - 0.60) for last authorships compared to male authors. The proportion of female authorships exhibits an annual growth of 1.3 % overall, with 0.5 % for first, 1.2 % for co-, and 0.8 % for last authorships. Women are underrepresented at prestigious authorship compared to men (Prestige Index = -0.38). The underrepresentation accentuates in highly competitive articles attracting the highest citation rates, namely, articles with many authors and articles that were published in highest-impact journals. Multi-author articles with male key authors are more frequently cited than articles with female key authors. The gender-specific differences in citation rates increase the more authors contribute to an article. Women publish fewer articles compared to men (39.6 % female authors are responsible for 35.0 % of the authorships) and are underrepresented at productivity levels of more than 1 article per author. Distinct differences at the country level were revealed.

CONCLUSION

 High impact medical research is characterized by few female group leaders as last authors and many female researchers being first or co-authors early in their career. It is very likely that this gender-specific career dichotomy will persistent in the next decade.

Cell Specific Matrix Metalloproteinase-1 Regulates Lung Metastasis Synergistically with Smoke Exposure

MMP1, a matrix metalloproteinase that degrades the extracellular matrix, is produced not only by cancer cells but also synthesized in stromal and inflammatory cells during tumorigenesis, invasion and lung metastasis. However, the function of MMP1 expression from host cells, especially tumor-associated macrophages (TAMs), and cells in the lung parenchyma remains to be elucidated. Here we demonstrate that in vitro macrophages co-cultured with tumor cells drastically enhance MMP1 expression, which is further exacerbated upon cigarette smoke exposure. In addition, in vivo, macrophage specific MMP1 was found to have a causative role in primary tumor development and lung metastasis, which was enhanced under smoke exposure as demonstrated in a transgenic mouse model that expressed human MMP1 specifically in macrophages (Mac-MMP1). In contrast, MMP1 from lung cells (Lung-MMP1) reduced colonization to the lung despite the fact that collagen deposition decreased in the Lung-MMP1 mouse tumors. These results demonstrate that the varying cellular source of MMP1 in tumors leads to the complexity observed in the tumor microenvironment. Furthermore, macrophage-specific inhibition of MMP1 secretion may be a potential therapy to aid in the reduction of lung metastasis.

Fit to play: posture and seating position analysis with professional musicians - a study protocol

Background

Musical performance-associated musculoskeletal disorders (MSD) are a common health problem among professional musicians. Considering the manifold consequences arising for the musicians, they can be seen as a threat for their professional activity. String players are the most affected group of musicians in this matter. Faults in upper body posture while playing the instrument, causing un-ergonomic static strain on the back and unergonomic limp-movements, are a main reason for musculoskeletal disorders and pain syndromes.

Methods

A total of 66 professional musicians, divided into three groups, are measured.

The division is performed by average duration of performance, intensity of daily exercise and professional experience. Video raster stereography, a three-dimensional analysis of the body posture, is used to analyse the instrument-specific posture. Furthermore the pressure distribution during seating is analysed. Measurements are performed because the musician is sitting on varying music chairs differing in structure and/or construction of the seating surface. The measurements take place in habitual seating position as well as during playing the instrument.

Results

To analyse the influence of different chairs, ANOVA for repeated measurements or Friedman-test is used, depending on normality assumptions. Comparison of posture between amateur musicians, students, and professional orchestral musicians is carried out the non-parametric Jonckheere-Terpstra-test.

Conclusions

Our method attempts to give the musicians indications for the right music chair choice by analyzing the chair concepts, so that thereby preemptively MSD can be reduced or prevented.

Abstract P5-03-10: Development of a novel HER2 testing strategy, using image-based cell-sorting to isolate pure cell populations from FFPE upstream of FISH

Fluorescent in Situ Hybridization (FISH) guidelines defined by American Society of Clinical Oncology (ASCO) and the College of American Pathologists for determining HER2 status are set to improve accuracy and usefulness as a diagnostic marker in breast cancer. Despite these guidelines, many factors can influence HER2 testing results such as sample preparation, assay-conditions and interpretation of test results due to heterogeneous breast cancer samples. In this multi-site study, sample preparation was carried out using the DEPArray™ to recover pure tumor cell populations from formalin-fixed, paraffin-embedded (FFPE) breast tumor samples. We then compared HER2/CEP17 ratios obtained from the DEPArray™ processed samples from each laboratory to routine FISH on tissue sections.

Methods: Eight breast FFPE tumor tissue biopsies were obtained from commercial tissue banks. From the paraffin tissue blocks, four consecutive tissue curls (each 50 microns thick) were prepared. One curl from each of the 8 patient samples was distributed to four different laboratories for analysis following DEPArray™ based sample preparation. After an initial disassociation of each curl into a single-cell suspension, intact cells were sorted and then recovered based on cytokeratin/ vimentin/DAPI staining using the DEPArray™. Cytokeratin+/Vimentin-/DAPI+ tumor (~250) and Cytokeratin-/Vimentin+/DAPI+ stromal (~250) recovered cells were then deposited onto glass slides prior to standard dual-color HER2/CEP17 FISH analysis for comparison to conventional HER2 FISH result.

Results: Serially sectioned breast tumors from 8 negative/positive cases: 7 infiltrating ductal carcinoma (IDC) and 1 metastatic carcinoma were studied. All four sites demonstrated 100% concordance between FISH results compared to the conventional HER2 FISH result. Overall, &gt;60% of DEPArray™ isolated cells were recovered from FFPE samples that ranged from 1- 15 years of age and reported to contain 60% to 80% tumor content. The use of pure sorted cells permitted the accurate determination of HER2 amplification status in only the tumor cells while the stromal cells consistently yielded a more normalized ratio of HER2 to centromere 17.

Conclusion: The preliminary results of this multi-site study demonstrate that use of DEPArray™ for sorted pure populations is reproducible as well as reliable method for subsequent analysis of HER2 by FISH on FFPE derived tumor cells. Given that traditional FFPE-based HER2 FISH results may be influenced by the tissue sectioning procedure, tissue heterogeneity and/or the scattering of few HER2 amplified tumor cells among normal stromal cells. The DEPArray™ allows analysis of immunofluorescence images and DNA content to isolate and recover pure and intact cell populations. This isolation of pure cell populations prior to FISH analysis is attractive for achieving precise determination of HER2 status on equivocal cases. A more formal analytical validation of this approach through CLIA is currently underway.

Citation Format: Gerber A, Konig L, Millner L, Strotoman L, Khurana A, Kasimir-Bauer S, Moore MW, Cotter PD, Bischoff F. Development of a novel HER2 testing strategy, using image-based cell-sorting to isolate pure cell populations from FFPE upstream of FISH [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-03-10.

Importance to question sinonasal symptoms and to perform rhinoscopy and rhinomanometry in cystic fibrosis patients

OBJECTIVES

Cystic fibrosis (CF) patients almost regularly reveal sinonasal pathology. The purpose of this study was to assess association between objective and subjective measurements of sinonasal involvement comparing nasal airflow obtained by active anterior rhinomanometry (AAR), nasal endoscopic findings, and symptoms assessed with the Sino-Nasal Outcome Test-20 (SNOT-20).

METHODS

Nasal cavities were explored by anterior rigid rhinoscopy and findings were compared to inspiratory nasal airflow measured by AAR to quantify nasal patency and subjective health-related quality of life in sinonasal disease obtained with the SNOT-20 questionnaire. Relations to upper and lower airway colonization with Pseudomonas aeruginosa, medical treatment, and sinonasal surgery were analysed.

RESULTS

A total of 124 CF patients were enrolled (mean age 19.9 ± 10.4 years, range 4-65 years). A significant association of detection of nasal polyposis (NP) in rhinoscopy was found with increased primary nasal symptoms (PNS) which include "nasal obstruction," "sneezing," "runny nose," "thick nasal discharge," and "reduced sense of smell." At the same time patients with pathologically decreased airflow neither showed elevated SNOT-20 scores nor abnormal rhinoscopic findings. Altogether, rhinomanometric and rhinoscopic findings are not significantly related.

CONCLUSIONS

Among SNOT-20 scores the PNS subscore is related to rhinoscopically detected polyposis and sinonasal secretion. Therefore, we recommend including short questions regarding PNS into CF-routine care. At the same time our results show that a high inspiratory airflow is not associated with a good sensation of nasal patency. Altogether, rhinomanometry is not required within routine CF-care, but it can be interesting as an outcome parameter within clinical trials. Pediatr Pulmonol. 2017;52:167-174. © 2016 Wiley Periodicals, Inc.

High particulate matter emission from additive-free Natural American Spirit cigarettes

BACKGROUND

Involuntary exposure to health-threatening environmental tobacco smoke (Combined Mainstream and Side-stream Smoke, CMSS) is a worldwide problem, causing premature death of thousands of people. CMSS consists of particulate matter (PM), one of the main sources of indoor air pollution. PM constitutes a considerable health risk for passive smokers. It is important to inform the public about brand-specific differences in CMSS-associated PM, especially in the case of brands without additives, which are therefore promoted as natural and less health-threatening.

METHODS

Mean concentrations and the area under the curve of PM10, PM2.5 and PM1 generated by Natural American Spirit cigarettes without additives and the 3R4F standard research cigarette (University of Kentucky, USA) were measured, analyzed and compared with each other. An automatic environmental tobacco smoke emitter was used to smoke 100 cigarettes, 20 of each brand, according to a standardized smoking protocol.

RESULTS

This study could show that CMSS-associated PM released from tobacco brands without additives, which are therefore promoted as natural and less harmful, are higher than expected.

CONCLUSIONS

It is highly improbable that Natural American Spirit tobacco products are a less harmful choice-at least not for passive smokers as this study could show. We conclude, the CMSS-associated PM level of every single customized brand should be measured because the origin of the tobacco and not the amount of CO, tar and nicotine (given as product information) seem to be responsible for the brand-specific PM release. This data is urgently needed to adequately inform the public about CMSS-associated PM exposure and the related health risk especially for passive smokers.

Snakebite Envenoming - A Combined Density Equalizing Mapping and Scientometric Analysis of the Publication History

Estimates suggest that more than 25,000 to 125,000 people die annually from snakebite envenomation worldwide. In contrast to this major disease burden, thorough bibliometric studies do not exist so far that illustrate the overall research activity over a long time span. Therefore, the NewQIS-platform conducted an analysis on snakebite envenoming using the Thomson Reuters database Web of Science. To determine and assess changes regarding the scientific activities and to specifically address the more recent situation we analyzed two time intervals (t). During the first time interval from 1900 to 2007 (t1) 13,015 publications (p) were identified. In the following period (2008-2016 = t2) 4,982 publications were identified by the same search strategy. They originate from 114 (t1) respectively 121 countries (t2), with the USA (p = 3518), Brazil (p = 1100) and Japan (p = 961) being most productive in the first period, and the USA (p = 1087), Brazil (p = 991) and China (p = 378) in the second period, respectively. Setting the publication numbers in relation to GDP/capita, Brazil leads with 92 publications per 10,000 Int$GDP/capita, followed by India with 79 publications per 10000 Int$GDP/capita (t1). Comparing the country's publication activity with the Human Development Index level indicates that the majority of the publications is published by highly developed countries. When calculating the average citation rates (citations per published item = CR) mainly European countries show the highest ranks: From 1900-2007 Sweden ranks first with a CR = 27, followed by the Netherlands (CR = 24.8), Switzerland (CR = 23), Spain, Austria and the USA (CR = 22). From 2008 to 2016 the highest rate achieves Switzerland with a value of 24.6, followed by Belgium (CR = 18.1), Spain (CR = 16.7), Costa Rica (CR = 14.9) and Netherlands (CR = 14). Compared with this, the USA was placed at rank 13 (CR = 9,5). In summary, the present study represents the first density-equalizing map projection and in-depth scientometric analysis of the global research output on snakebites and its venoms. So it draws a sketch of the worldwide publication architecture and indicates that countries with a high incidence of snakebites and a low economical level still need to be empowered in carrying out research in this area.

[Rhinosinusitis in cystic fibrosis]

In cystic fibrosis (CF) mucociliary clearance of the entire respiratory system is impaired. This allows pathogens, such as Pseudomonas aeruginosa to persist and proliferate, which by progressive pulmonary destruction causes 90 % of premature deaths due to this inherited disease. The dramatic improvement in life expectation of patients due to intensive therapy has resulted in the inevitable but variably expressed sinonasal involvement coming into the clinical and scientific focus. Thereby, almost all CF patients reveal sinonasal pathology and many suffer from chronic rhinosinusitis. Recently, the sinonasal niche has been recognized as a site of initial and persistent colonization by pathogens. This article presents the pathophysiological background of this multiorgan disease as well as general diagnostic and therapeutic standards. The focus of this article is on sinonasal involvement and conservative and surgical options for treatment. Prevention of pathogen acquisition is an essential issue in the otorhinolaryngological treatment of CF patients.

Particulate Matter in Second-Hand Smoke Emitted from Different Cigarette Sizes and Types of the Brand Vogue Mainly Smoked by Women

Indoor air pollution with harmful particulate matter (PM) is mainly caused by cigarette smoke. Super-Slim-Size-Cigarettes (SSL) are considered a less harmful alternative to King-Size-Cigarettes (KSC) due to longer filters and relatively low contents. We ask if “Combined Mainstream and Sidestream Smoke” (CMSS)-associated PM levels of SSL are lower than of KSC and thus are potentially less harmful. PM concentrations in CMSS (PM₁₀, PM_2.5, and PM₁) are measured from four cigarette types of the brand Vogue, using an “automatic-environmental-tobacco-smoke-emitter” (AETSE) and laser aerosol spectrometry: SSL-BLEUE, -MENTHE, -LILAS and KSC-La Cigarette and -3R4F reference. This analysis shows that SSL MENTHE emitted the highest amount of PM, and KSC-La Cigarette the lowest. 3R4F reference emitted PM in the middle range, exceeding SSL BLEUE and falling slightly below SSL LILAS. It emerged that PM₁ constituted the biggest proportion of PM emission. The outcome shows significant type-specific differences for emitted PM concentrations. Our results indicate that SSL are potentially more harmful for passive smokers than the respective KSC. However, this study cannot give precise statements about the general influence of the size of a cigarette on PM. Alarming is that PM₁ is responsible for the biggest proportion of PM pollution, since smaller particles cause more harmful effects.

World-wide architecture of osteoporosis research: density-equalizing mapping studies and gender analysis

OBJECTIVE

While research activities on osteoporosis grow constantly, no concise description of the global research architecture exists. Hence, we aim to analyze and depict the world-wide scientific output on osteoporosis combining bibliometric tools, density-equalizing mapping projections and gender analysis.

METHOD

Using the NewQIS platform, we analyzed all osteoporosis-related publications authored from 1900 to 2012 and indexed by the Web of Science. Bibliometric details were analyzed related to quantitative and semi-qualitative aspects.

RESULTS

The majority of 57 453 identified publications were original research articles. The USA and Western Europe dominated the field regarding cooperation activity, publication and citation performance. Asia, Africa and South America played a minimal role. Gender analysis revealed a dominance of male scientists in almost all countries except Brazil.

CONCLUSION

Although the scientific performance on osteoporosis is increasing world-wide, a significant disparity in terms of research output was visible between developed and low-income countries. This finding is particularly concerning since epidemiologic evaluations of future osteoporosis prevalences predict enormous challenges for the health-care systems in low-resource countries. Hence, our study underscores the need to address these disparities by fostering future research endeavors in these nations with the aim to successfully prevent a growing global burden related to osteoporosis.

Are Filter-Tipped Cigarettes Still Less Harmful than Non-Filter Cigarettes?--A Laser Spectrometric Particulate Matter Analysis from the Non-Smokers Point of View

BACKGROUND

Environmental tobacco smoke (ETS) is associated with human morbidity and mortality, particularly chronic obstructive pulmonary disease (COPD and lung cancer. Although direct DNA-damage is a leading pathomechanism in active smokers, passive smoking is enough to induce bronchial asthma, especially in children. Particulate matter (PM) demonstrably plays an important role in this ETS-associated human morbidity, constituting a surrogate parameter for ETS exposure.

METHODS

Using an Automatic Environmental Tobacco Smoke Emitter (AETSE) and an in-house developed, non-standard smoking regime, we tried to imitate the smoking process of human smokers to demonstrate the significance of passive smoking. Mean concentration (C(mean)) and area under the curve (AUC) of particulate matter (PM2.5) emitted by 3R4F reference cigarettes and the popular filter-tipped and non-filter brand cigarettes "Roth-Händle" were measured and compared. The cigarettes were not conditioned prior to smoking. The measurements were tested for Gaussian distribution and significant differences.

RESULTS

C(mean) PM2.5 of the 3R4F reference cigarette: 3911 µg/m³; of the filter-tipped Roth-Händle: 3831 µg/m³; and of the non-filter Roth-Händle: 2053 µg/m³. AUC PM2.5 of the 3R4F reference cigarette: 1,647,006 µg/m³·s; of the filter-tipped Roth-Händle: 1,608,000 µg/m³·s; and of the non-filter Roth-Händle: 858,891 µg/m³·s.

CONCLUSION

The filter-tipped cigarettes (the 3R4F reference cigarette and filter-tipped Roth-Händle) emitted significantly more PM2.5 than the non-filter Roth-Händle. Considering the harmful potential of PM, our findings note that the filter-tipped cigarettes are not a less harmful alternative for passive smokers. Tobacco taxation should be reconsidered and non-smoking legislation enforced.

Pancreatitis: Global Research Activities and Gender Imbalances: A Scientometric Approach Using Density-Equalizing Mapping

OBJECTIVE

Despite the high impact of acute and chronic pancreatitis on the global burden of disease, no scientometric evaluation in this research field has yet been conducted. Therefore, we have issued an analysis in the field of pancreatitis research covering the past 112 years.

METHODS

Data were retrieved from the Web of Science database. Density-equalizing mapping and large-scale data analysis were used to visualize bilateral and multilateral research cooperation.

RESULTS

Finland is the only 1 of the 15 most productive countries showing a ratio in favor of female scientists. The United States is the most productive supplier with 24.1% of all publications. The most successful international cooperation proved to be the one between the United States and Germany. Although the United States holds the highest h-index, Switzerland obtains by far the highest citation rate. China, Russia, and India show only little international cooperation, given their scientific productivity.

CONCLUSIONS

For the benefit of scientific progress, more countries with considerable numbers of patients should contribute to international collaborations and female researchers should be encouraged and supported.

Telemedicine - a scientometric and density equalizing analysis

BACKGROUND

As a result of the various telemedicine projects in the past years a large number of studies were recently published in this field. However, a precise bibliometric analysis of telemedicine publications does not exist so far.

METHODS

The present study was conducted to establish a data base of the existing approaches. Density-equalizing algorithms were used and data was retrieved from the Thomson Reuters database Web of Science.

RESULTS

During the period from 1900 to 2006 a number of 3290 filed items were connected to telemedicine, with the first being published in 1964. The studies originate from 101 countries, with the USA, Great Britain and Canada being the most productive suppliers participating in 56.08 % of all published items. Analyzing the average citation per item for countries with more than 10 publications, Ireland ranked first (10.19/item), New Zealand ranked second (9.5/item) followed by Finland (9.04/item). The citation rate can be assumed as an indicator for research quality. The ten most productive journals include three journals with the main focus telemedicine and another five with the main focus "Information/Informatics". In all subject categories examined for published items related to telemedicine, "Health Care Sciences & Services" ranked first by far. More than 36 % of all publications are assigned to this category, followed by "Medical Informatics" with 9.72 % and "Medicine, General & Internal" with 8.84 % of all publications.

CONCLUSION

In summary it can be concluded that the data shows clearly a strong increase in research productivity. Using science citation analysis it can be assumed that there is a large rise in the interest in telemedicine studies.

The systemic control of circadian gene expression

The mammalian circadian timing system consists of a central pacemaker in the brain's suprachiasmatic nucleus (SCN) and subsidiary oscillators in nearly all body cells. The SCN clock, which is adjusted to geophysical time by the photoperiod, synchronizes peripheral clocks through a wide variety of systemic cues. The latter include signals depending on feeding cycles, glucocorticoid hormones, rhythmic blood-borne signals eliciting daily changes in actin dynamics and serum response factor (SRF) activity, and sensors of body temperature rhythms, such as heat shock transcription factors and the cold-inducible RNA-binding protein CIRP. To study these systemic signalling pathways, we designed and engineered a novel, highly photosensitive apparatus, dubbed RT-Biolumicorder. This device enables us to record circadian luciferase reporter gene expression in the liver and other organs of freely moving mice over months in real time. Owing to the multitude of systemic signalling pathway involved in the phase resetting of peripheral clocks the disruption of any particular one has only minor effects on the steady state phase of circadian gene expression in organs such as the liver. Nonetheless, the implication of specific pathways in the synchronization of clock gene expression can readily be assessed by monitoring the phase-shifting kinetics using the RT-Biolumicorder.

2β- and 16β-hydroxylase activity of CYP11A1 and direct stimulatory effect of estrogens on pregnenolone formation

The biosynthesis of steroid hormones in vertebrates is initiated by the cytochrome P450 CYP11A1, which performs the side-chain cleavage of cholesterol thereby producing pregnenolone. In this study, we report a direct stimulatory effect of the estrogens estradiol and estrone onto the pregnenolone formation in a reconstituted in vitro system consisting of purified CYP11A1 and its natural redox partners. We demonstrated the formation of new products from 11-deoxycorticosterone (DOC), androstenedione, testosterone and dehydroepiandrosterone (DHEA) during the in vitro reaction catalyzed by CYP11A1. In addition, we also established an Escherichia coli-based whole-cell biocatalytic system consisting of CYP11A1 and its redox partners to obtain sufficient yields of products for NMR-characterization. Our results indicate that CYP11A1, in addition to the previously described 6β-hydroxylase activity, possesses a 2β-hydroxylase activity towards DOC and androstenedione as well as a 16β-hydroxylase activity towards DHEA. We also showed that CYP11A1 is able to perform the 6β-hydroxylation of testosterone, a reaction that has been predominantly attributed to CYP3A4. Our results are the first evidence that sex hormones positively regulate the overall production of steroid hormones suggesting the need to reassess the role of CYP11A1 in steroid hormone biosynthesis and its substrate-dependent mechanistic properties.

Density equalizing mapping of the global tuberculosis research architecture

BACKGROUND

Tuberculosis belongs to the lung infectious diseases with the highest impact on global burden of disease. Yet there is no concise scientometric study about tuberculosis research. Therefore, the NewQiS project elected this subject as focus of an in depth analysis to perform density equalizing mapping in combination with scientometrics.

METHOD

In this retrospective study all publications related to tuberculosis research listed in the Web of Science database between 1900 and 2012 were identified, analyzed and submitted to density equalizing mapping procedures.

RESULTS

In total 58,319 entries on TBC were identified with the USA being the most productive country with 11,788 publications, followed by the United Kingdom (4202), India (3456), France (2541), South Africa (1840), Germany (1747) and China (1427). Concerning the citations rate Denmark leads with 43.7 citations per article, followed by Latvia (39.1), Gambia (38.3), Senegal (34.9), and the Netherlands (31.4). Chart techniques demonstrates a widely ramified international network with a focus the joint work of USA, the UK and South Africa.

CONCLUSIONS

This is the first density equalizing and scientometric study that addresses tuberculosis research over a period of 112 years. It illustrates global tuberculosis research architecture and stresses the need for strengthening global research efforts and funding program.

Tobacco smoke particles and indoor air quality (ToPIQ-II) - a modified study protocol and first results

Background

Environmental tobacco smoke (ETS)-associated particulate matter (PM) has to be seen as an independent health hazard and needs to be discussed separately from the already well-known toxic and carcinogenic compounds contained in cigarette smoke. We believe that brand-specific amounts of PM are of public interest and should be investigated.

Methods

An automatic environmental tobacco smoke emitter was developed and placed into a glass-chamber to generate cigarette smoke as reliably as possible. Cigarettes were smoked automatically according to a standardized protocol. Mean concentrations (C_mean) and area under the curve (AUC) of PM2.5 released by the brands P&S, Virginia (without filter) and the 3R4F standard research cigarette of the University of Kentucky, USA, were measured and compared with each other.

Results

C_mean PM2.5 of 3R4F reference was 1,725 μg/m³, for P&S: 1,982 μg/m³ and for Virginia without filter: 1,525 μg/m³. AUC PM2.5 for 3R4F reference was: 527,644 μg/m³×sec, for P&S: 606,171 μg/m³×sec, and for Virginia without filter: 464,788 μg/m³×sec.

Conclusions

Our modified ToPIQ-II study protocol shows significant brand-specific differences in the amounts of PM2.5 released by cigarettes into the environment, when compared to 3R4F reference cigarettes. We believe that information about PM-release of all relevant brands in relation to reference cigarettes should be published. In the light of PM as an independent risk factor for morbidity and mortality, this may serve as a basis for further epidemiologic investigations.

Hepatitis B: global scientific development from a critical point of view

Hepatitis B is the tenth leading cause of death worldwide. Countries with high endemicity, such as China and Taiwan show high scientific productivity in this field and dominate the top ten list of the most productive authors worldwide, providing four of them. This is remarkable, as the USA and Europe usually maintain leading positions, not only regarding country-specific scientific productivity, but also top ten ranking of most productive and most cited authors in other important medical sectors. So far, a scientometric analysis of the topic 'hepatitis B' has not been generated despite an increased need for it in times of modified evaluation criteria for academic personnel and a subsequent tendency to co-authorship and author self-citation. In this study, scientometric methods and large-scale data analysis were used to evaluate quality and quantity of scientific research dealing with the topic 'hepatitis B' and to contribute to distinguish relevant research output. Data were gained from Pubmed and ISI-Web. In the time span of 1971-2011, 49 166 items were published by 250 countries, of which the USA have been the most productive supplier with 28% of all publications, followed in considerable distance by Germany, China, the United Kingdom, Japan, France, Italy and Taiwan, respectively. The USA have established their position as centre of international cooperation. Their cooperation with China proves to be the most productive one. The most prolific journals in the field of hepatitis b were 'Hepatology', the 'Journal of Hepatology' and the 'Journal of Medical Virology'. h-index, citation rate and impact factor, commonly used for assessment of scientific quality, were determined and discussed critically with regard to distortion by bias of self-citation and co-authorship.

Global research on smoking and pregnancy-a scientometric and gender analysis

The exposure to tobacco smoke during pregnancy is considered to be amongst the most harmful avoidable risk factors. In this scientometric and gender study scientific data on smoking and pregnancy was analyzed using a variety of objective scientometric methods like the number of scientific contributions, the number of citations and the modified h-index in combination with gender-specific investigations. Covering a time period from 1900 to 2012, publishing activities of 27,955 authors, institutions and countries, reception within the international scientific community and its reactions were analyzed and interpreted. Out of 10,043 publications the highest number of scientific works were published in the USA (35.5%), followed by the UK (9.9%) and Canada (5.3%). These nations also achieve the highest modified h-indices of 128, 79 and 62 and the highest citation rates of 41.4%, 8.6% and 5.3%, respectively. Out of 12,596 scientists 6,935 are female (55.1%), however they account for no more than 49.7% of publications (12,470) and 42.8% of citations (172,733). The highest percentage of female experts about smoking and pregnancy is found in Australasia (60.7%), while the lowest is found in Asia (41.9%). The findings of the study indicate an increase in gender equality as well as in quantity and quality of international scientific research about smoking and pregnancy in the future.

Airborne particulate matter in public transport: a field study at major intersection points in Frankfurt am Main (Germany)

Background

Chronic particulate matter (PM) exposure is correlated to various health effects, even at low amounts. WHO has defined PM concentration limits as daily and annual mean values which were made legally binding in the European Union. While many studies have focused on PM concentrations in special environments, little is known about the average PM- exposure for both employees and passengers in the German public transportation system.

Methods

Particulate matter (PM10, PM2.5, PM1) – concentrations were monitored for 30 minutes at 15 different areas in Frankfurt am Main with major public traffic. Maximum and mean concentrations and, as a surrogate for the inhaled dosage, the Area Under the Curve (AUC) for 15 minutes of exposure were calculated.

Results

The WHO limits for PM10 and PM2.5 were exceeded at nearly all times and areas. Highest maximum concentrations were found at underground stations, subterranean railway stations and subterranean shopping arcades with much lower values obtained at surface points. In one measurement at a surface test point smokers who neglected the non-smoking policy could be identified as a major cause for a at least temporary strong increase of PM-load as seen in high maximum values and normal averages.

Conclusions

Subterranean areas have high particulate matter contamination exceeding WHO limits. Improvement may be achieved by increased ventilation. Subterranean shops and kiosks, being workplaces with long term exposure, should be equipped with external air supply. The non- smoking policy of the “Deutsche Bahn” for public spaces should be enforced.