bluuebunny/crossref_metadata_2025 huggingface dataset:
Secretome of Adipose-Derived Stem Cells Protect Ischemia-Reperfusion and Partial Hepatectomy by Attenuating Autophagy
Authors: Ma Yajun , Jiao Zhihui , Liu Xiaoning , Zhang Qianzhen , Piao Chenxi , Xu Jiayuan , Wang Hongbin
Published: June 2020

Background: The therapeutic effects of adipose-derived mesenchymal stem cells (ADSCs) may mainly come from their paracrine effects. ADSCs can ameliorate hepatic ischemia-reperfusion injury (IRI). We explored the therapeutic effect of ADSCs secretome from the perspective of excessive autophagy of hepatocytes induced by hepatic IRI.Methods: In this study, we established a miniature pig model of hepatic ischemia-reperfusion (I/R) combined with hepatectomy using laparoscopic technique, and transplanted ADSCs and adipose-derived mesenchymal stem cell-conditioned medium (ADSC-CM) into the liver parenchyma immediately after surgery. Histopathological and TEM examinations were performed on liver tissue samples collected. We analyzed the roles of ADSC-CM and ADSCs in autophagy by RT-qPCR, western-blot and immunohistochemistry. Results: The results showed that ADSCs and ADSC-CM all alleviated the pathological changes of liver tissue and the microstructural damage of hepatocytes after IRI. Moreover, the expression of the critical markers of autophagy including Beclin-1, ATG5, ATG12 and LC3II all decreased, whereas expression of p62 increased. And the data of autophagy regulation between ADSC-CM and ADSCs showed no significant difference. Finally, we found that ADSC-CM possibly inhibited autophagy by regulating the PI3K/Akt/mTOR pathway.Conclusion: ADSC-CM can ameliorate excessive autophagy injury in hepatic I/R combined with partial hepatectomy, which is possibly involved with the modulation of the PI3K/Akt/mTOR signaling pathway. There was no significant difference between ADSCs and ADSC-CM in the regulation of hepatocyte autophagy. Therefore, ADSCs may improve the excessive autophagy injury of hepatocytes in hepatic I/R combined with hepatectomy through paracrine effect, thus protecting the liver and promoting the liver tissue repair.
MYC and TP53 aberrant of CSF tumor cells in children with metastatic medulloblastoma
Authors: Li Miao , Du Shuxu , Li Yujie , Xiao Jiang , Wang Yuan , Zhang Jin , Gong Xiaojun , Sun Yanling , Wu Wanshui , Sun Liming
Published: June 2020

Background: Medulloblastoma (MB) is the most common primary malignant brain tumor in childhood. MYC and TP53 aberrant is the high risk factor for its prognosis, but its values in tumor cells of CSF has not been reported.Methods: During October 1, 2012 to April 10, 2020, a total of 185 metastatic MB were enrolled in this study, CSF cytology and MYC and TP53 aberrant statuses were analyzed.Results: We found that forty-two patients were positive presence of tumor cells in CSF, and 39 cases were positive with MYC or TP53 aberrant, which was present in about 66% of Group 3 MB. The PFS and OS rates of patients with positive gene aberrant were much lower than that of negative aberrant group (P<0.01), and MYC and TP53 aberrant of tumor cells in CSF was high independent risk factor for OS of metastatic patients (95% CI was 0.266-0.998, P<0.05).Conclusion: Thus detection of MYC and TP53 aberrant of tumor cells in CSF could be an important method to complement detection of surgical specimen, and can improve the molecular diagnosis.
The prevalence of uterine rupture and associated factors in Ethiopia: A systematic review and Meta – analysis
Authors: Ayenew Asteray Assmie , Nigussie Azezu Asres , Zewdu Biruk Ferede
Published: June 2020

Background Globally, maternal morbidity and mortality a major public health challenge. Uterine rupture is a life-threatening obstetrical emergency with serious undesired complications for both the mother and her infant. Uterine rupture is the leading cause of maternal and fetal death in developing countries. Therefore, the aim of this systematic review and meta-analysis was to assess the prevalence of uterine rupture and its associated factors in Ethiopia. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases used were; PubMed, Google scholar, Cochrane Library, African Journals Online, Ethiopian's university research repository online library, and manual searching. The search was further limited to studies conducted in Ethiopia and reported in English. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity of studies. The pooled estimate prevalence and the odds ratios with 95% confidence intervals were computed by a random effect model. Result: A total of 16 studies were included in this meta-analysis with a sample size of 10,550. The national pooled prevalence of uterine rupture was 14.74%. The pooled adjusted odds ratio (AOR) of uterine rupture for prolonged labour(>24hours) was 4.3 (95% CI=2.57,7.19), not having antenatal care during pregnancy was 3.71(95%CI=2.26,6.08),grand multiparity was 1.99(95%CI=1.04,3.81),rural residency was 4.17 (95%CI=1.72,10.12),having cesarean section scar was 8.52 (95%CI: 4.98,14.59),not using partograph during labour was 3.43(1.62,7.29), and obstructed labour was 8.78(95%CI:3.38,22.8). Conclusion: This systematic review and meta-analysis showed that uterine rupture was high in Ethiopia. Being from the rural residence, prolonged labour(>24hours) , not having ante natal care , grand multiparity, having cesarean section scar , not using partograph during labour, and obstructed labour increased the risk of uterine rupture.
Ion channel profiling of the Lymnaea stagnalis ganglia via transcriptome analysis
Authors: Dong Nan , Bandura Julia , Zhang Zhaolei , Wang Yan , Labadie Karine , Noel Benjamin , Davison Angus , Koene Joris M , Sun Hong-Shuo , Coutellec Marie-Agnes , Feng Zhong-Ping
Published: June 2020

Background. The pond snail Lymnaea stagnalis (L. stagnalis) has been widely used as a model organism in neurobiology, ecotoxicology, and parasitology due to the relative simplicity of its CNS. However, its usefulness is restricted by a limited availability of transcriptome data. While sequence information for the L. stagnalis CNS transcripts has been obtained from EST library and a de novo RNA-seq assembly, the quality of these assemblies is limited by a combination of low coverage of EST libraries, the fragmented nature of de novo assemblies, and lack of reference genome. Results. In this study, taking advantage of the recent availability of the L. stagnalis reference genome, we generated an RNA-seq library from the adult L. stagnalis CNS, using a combination of genome-guided and de novo assembly programs to identify 17,832 protein-coding L. stagnalis transcripts. We combined our library with existing resources to produce a transcript set with greater sequence length, completeness, and diversity than previously available ones. Using our assembly and functional domain analysis, we profiled L. stagnalis CNS transcripts encoding ion channels and ionotropic receptors, which are key proteins for CNS function, and compared their sequences to other vertebrate and invertebrate model organisms. Interestingly, L. stagnalis transcripts encoding numerous putative Ca2+ channels showed the most sequence similarity to those of mouse, zebrafish, Xenopus tropicalis, fruit fly, and C. elegans, suggesting that many calcium channel-related signaling pathways may be evolutionarily conserved. Conclusions. Our study provides the most thorough characterization to date of the L. stagnalis transcriptome and provides insights into differences between vertebrates and invertebrates in CNS transcript diversity, according to function and protein class. Furthermore, this study is, to the best of our knowledge, the first to provide a complete characterization of the ion channels of a single species, opening new avenues for future research on fundamental neurobiological processes.
FOXO3a shRNA and simultaneous induction of P27Kip1gene Inhibit the Breast Cancer Growth in Nude Mice
Authors: Mayahi Sabah , Golalipour Masood , Ashari Mohammad , Shahbazi Majid
Published: June 2020

Background: FOXO proteins, which are overexpressed in multiple human tumors, belong to the Forkhead family of transcription factors that are involved in cell-cycle regulation, cell apoptosis, differentiation, stress response, and metabolism. The p27Kip1 gene leads to cell cycle arrest, cell apoptosis, tumor suppressor genes, and cell adhesion. The low expression level of the p27Kip1 gene is attributed to poor prognosis in patients with colorectal, gastric, pulmonary, and breast cancers. Accordingly, the present study aimed to investigate the possibility of tumor growth inhibition in a mouse model by targeting FOXO3a shRNA and the simultaneous induction of P27Kip1gene.Methods: The tumor model was generated by intratumoral inoculating with plasmids. When tumor size reached an average volume of 8 mm in diameter, the mice received injections of construct and control plasmids three times a week for two weeks, followed by tumor growth assessment.Results: Based on the obtained results, the delivery of construct plasmid significantly inhibited tumor growth in nude mice, as compared to the control plasmid. Moreover, the immunohistochemical analysis indicated that the delivery of construct plasmid significantly suppressed expression of FOXo3a and induced P27Kip1 in tumor samples.Conclusion: The findings of the present study revealed that FOXO3a shRNA, along with simultaneous induction of P27Kip1gene using a useful in vivo gene delivery strategy, seems a practical therapeutic approach for breast cancer treatment and may provide profound insight into gene therapy of solid cancers.
Relationships Between Nursing Management, Nurses’ Job Satisfaction, Patient Satisfaction, and Medication Errors at the unit Level: A Correlational Study
Authors: Nurmeksela Anu , Mikkonen Santtu , Kinnunen Juha , Kvist Tarja
Published: June 2020

Background Nurse managers play a critical role in enhancing nursing and patient outcomes. Nurse managers’ behaviour and the clinical environment have been shown to affect nurses’ job satisfaction. In addition, leadership, managers’ support, and nurse-manager trust all improve the patient safety culture climate and reduce medication errors. However, hospital management and organisational support influence both manager and staff attitudes, which can affect care quality outcomes. This study aims to describe the relationships between nurse managers’ work content, nurses’ job satisfaction, patient satisfaction, and medication errors at the hospital unit level. Methods The questionnaire data were collected from nurse managers (n= 29), nursing staff (n=306), and patients (n=651) from 28 units across three Finnish acute care hospitals in year 2017. Analysis of covariance (ANCOVA) was used to estimate relationships between data from Nurse Managers’ Work Content Questionnaire, Kuopio University Hospital Job Satisfaction Scale, and Revised Humane Caring Scale subscales, along with medication errors reports. Results Multiple relationships were identified for components of nurse managers’ work content, nurses’ job satisfaction, patient satisfaction, and medication errors. How nurse managers divide their time between various responsibilities was shown to influence the patient satisfaction Outcomes subarea (p< .001), the Requiring factors of work subarea of nurses’ job satisfaction (p< .001), as well as medication errors (p< .001).Conclusions It would be recommendable for nurse managers to prioritise focusing on employee well-being, development, and communication. However, to be effective and beneficial, the work in each of these subareas must be well organised. The results demonstrate that nurse managers need to consciously balance their workloads to achieve better outcomes.
Comparison of levonorgestrel level and creamatocrit in milk following immediate vs. delayed postpartum insertion of levonorgestrel IUD: a pilot randomized controlled trial
Authors: Hopelian Niaree , Simmons Rebecca G. , Sanders Jessica N. , Ward Katherine , Jenkins Sabrina Malone , Espey Eve , Turok David K.
Published: June 2020

Background: Both breastfeeding and the use of postpartum contraception critically influence infant and maternal health outcomes. In this pilot study, we explore the effects of timing and duration of postpartum levonorgestrel exposure on breastfeeding through objective assessments of milk lipid and levonorgestrel content to establish baseline data for future research.Methods: This substudy includes thirty-two participants from multiple clinical sites in Salt Lake City, Utah. All participants planned to breastfeed, and self-selected for this sub-study from among 259 women enrolled in a parent randomized controlled trial comparing immediate to delayed (4-8 weeks) postpartum levonorgestrel IUD insertion. Participants provided two milk samples: first at 4-8 weeks postpartum (before IUD placement for the delayed group) and second four weeks later. Participants were paired by group assignment, and we used the Wilcoxon rank sum (inter-group) and signed rank (intra-group) tests to compare milk lipid content (creamatocrit) and levonorgestrel levels between groups and time points.Results: Fifteen participants were allocated to the immediate group and 17 to the delayed group. Initially, median levonorgestrel concentration of the immediate group (n=10) (32.5 pg/mL, IQR: 24.8, 59.4) exceeded that of the delayed group (n=12) (17.5 pg/mL, IQR: 0.0, 25.8) (p=0.01). Four weeks later, the values aligned: 26.2 pg/mL (IQR: 20.3, 37.3) vs. 28.0 pg/mL (IQR: 25.2, 40.8). Creamatocrits were similar between both groups and timepoints.Conclusions: Immediate postpartum levonorgestrel IUD placement results in steady, low levels of levonorgestrel in milk without significant effects on lipid content. These findings support the safety of immediate postpartum levonorgestrel IUD initiation, and future research should assess time-based meaningful outcome changes to capture clinically significant differences.Trial Registration: This randomized controlled trial was registered with ClinicalTrials.gov (registry number NCT01990703) on November 21, 2013.
Metatranscriptomic analyses reveal ruminal pH regulates fiber degradation and fermentation by shifting the microbial community and gene expression of carbohydrate-active enzymes
Authors: Li MengMeng , White Robin R. , Guan Le Luo , Harthan Laura , Hanigan Mark D.
Published: June 2020

Background
Volatile fatty acids (VFA) generated from ruminal fermentation by microorganisms provide up to 75% of total metabolizable energy in ruminants. Ruminal pH is an important factor affecting the profile and production of VFA by shifting the microbial community. However, how ruminal pH affects the microbial community and its relationship with expression of genes encoding carbohydrate-active enzyme (CAZyme) for fiber degradation and fermentation are not well investigated. To fill in this knowledge gap, six cannulated Holstein heifers were subjected to a continuous 10-day intraruminal infusion of distilled water or a dilute blend of hydrochloric and phosphoric acids to achieve a pH reduction of 0.5 units in a cross-over design. RNA-seq based transcriptome profiling was performed using total RNA extracted from ruminal liquid and solid fractions collected on day 9 of each period, respectively.
Results
Metatranscriptomic analyses identified 19 bacterial phyla with 121 genera, 3 archaeal genera, 11 protozoal genera, and 97 CAZyme transcripts in sampled ruminal contents. Within these, 4 bacteria phyla (Proteobacteria, Firmicutes, Bacteroidetes, and Spirochaetes), 2 archaeal genera (Candidatus Methanomethylophilus and Methanobrevibacter), and 5 protozoal genera (Entodinium, Polyplastron, Isotricha, Eudiplodinium, and Eremoplastron) were considered as the core active microbes, and genes encoding for cellulase, endo-1,4-beta- xylanase, amylase, and alpha-N-arabinofuranosidase were the most abundant CAZyme transcripts distributed in the rumen. Rumen microbiota is not equally distributed throughout the liquid and solid phases of rumen contents, and ruminal pH significantly affect microbial ecosystem, especially for the liquid fraction. In general, 76 bacterial genera, 4 protozoal genera, and 48 genes encoding CAZyme were significantly correlated with metabolic pathways for fiber degradation and VFA production. Within them, 29 bacterial genera, 4 protozoal genera, and 6 genes encoding CAZyme could be regulated by ruminal pH.
Conclusions
The ruminal microbiome changed the expression of transcripts for biochemical pathways of fiber degradation and VFA production in response to reduced pH, and at least a portion of the shifts in enzyme transcripts was associated with altered microbial community structure.
Early Axonal Dysfunction of the Peripheral Nervous System Influences Disease Progression of ALS: Evidences From Clinical Neuroelectrophysiology
Authors: Yu Huiyan , Chen Lu , Zhang Shuo , He Jing , Fan Dongsheng
Published: June 2020

Background:Studies have indicated that more axonal dysfunction in early ALS predictive of more aggressive phenotypes. However, as an important electrophysiological index to detect motor axonal damage, the prognostic value of compound muscle action potential (CMAP) in ALS remains unclear. We aimed to determine if CMAP could be a prognostic indicator of disease progression in early ALS.Methods: Patients were stratified into 4 groups according to the decrement of the CMAP amplitude within 12 months of symptom onset (CMAP-12 amplitudes): normal (≥the lower limit of normal, LLN), mild (<LLN but ≥50% of LLN), moderate (<50% but ≥30% of LLN) and severe (<30% of LLN). All patients were followed up every 3 months. Survival was analyzed using the Kaplan-Meier method and Cox proportional hazards regression.Results: A total of 149 patients included in the analysis [90 male (60.4%); mean age at onset, 50.7 years]. The decrement of CMAP-12 amplitudes was normal in 24.2%, mildly in 22.1%, moderately in 15.4% and severely in 38.3%. Kaplan-Meier analysis showed there was a significant difference in the overall survival across the 4 groups (p<0.05). Further pairwise comparison found there were significant differences in survival between the normal vs. the moderately groups (p<0.05), and the normal vs. the severely groups (p<0.01). There was a significant inverse correlation between the CMAP-12 amplitude and overall survival. Compared to the normal group, survival in the moderately and severely decreased groups were significantly shorter (HR 3.394, 95%CI 1.292-8.917, p=0.013; and HR 4.732, 95%CI 2.032-11.017; p=0.000, respectively).Conclusions: Our results suggested that CMAP-12 amplitude could be a prognostic indicator of disease progression in ALS. More importantly, it provided clinical evidences to the viewpoint that early axonal dysfunction of peripheral nervous system accelerates disease progression of ALS.
Validation of an Immune-related Gene Pair Index as a Prognostic Marker of Early-Stage Lung Squamous Cell Carcinoma
Authors: Wang Zihao , Xiang Xuan , Wei Xiaoshan , Ye Linlin , Niu Yiran , Peng Wenbei , Li Yu , Wang Xu , Zhang Siyu , Zhou Qiong
Published: June 2020

Background. Lung squamous cell carcinoma (LUSC) is one of the subtypes of non-small-cell lung cancer (NSCLC) and accounts for approximately 20 to 30% of all lung cancers.Methods. In this study, we developed an immune-related gene pair index (IRGPI) for early-stage LUSC from 3 public LUSC data sets, including The Cancer Genome Atlas LUSC cohort and Gene Expression Omnibus data sets, and explored whether IRGPI could act as a prognostic marker to identify patients with early-stage LUSC at high risk.Results. IRGPI was constructed by 68 gene pairs consisting of 123 unique immune-related genes from TCGA LUSC cohort. In the derivation cohort, the hazard of death among high-risk group was 10.51 times that of the low-risk group (HR, 10.51; 95%CI, 6.96-15.86; p<0.001). The hazard of death among the high-risk group was 2.26 times that of the low-risk group (HR, 2.26; 95%CI, 1.2-4.25; p=0.009) in the GSE37745 validation cohort and was 3.2 times that of low-risk group (HR, 3.2; 95%CI, 0.98-10.4; p=0.042) in the GSE41271 validation cohort. The infiltrations of CD8+ T cells and T follicular helper cells were lower in the high-risk group, as compared with the low-risk group in the TCGA cohort (6.94% vs 9.63%, p=0.004; 2.15% vs 3%, p=0.002, respectively). The infiltrations of neutrophils, activated mast cells and monocytes were higher in the high-risk group, as compared with the low-risk group in the TCGA cohort (1.63% vs 0.72%, p=0.001; 1.64% vs 1.02%, p=0.007; 0.57% vs 0.35%, p=0.041, respectively).Conclusions. IRGPI is a significant prognostic biomarker for predicting overall survival in early-stage LUSC patients.
Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?
Authors: Mattevi Catherine , Garnier Jonathan , Marchese Ugo , Ewald Jacques , Gilabert Marine , Poizat Flora , Piana Gilles , Delpero Jean-Robert , Turrini Olivier
Published: June 2020

Purpose: To determine if improvement in imaging reduces the non-resection rate (NRR) among patients with pancreatic ductal adenocarcinoma (PDAC).Methods: From 2000 to 2019, 751 consecutive patients with PDAC were considered eligible for a intention-to-treat pancreatectomy and entered the operating room. In April 2011, our institution acquired a dual energy spectral computed tomography (CT) scanner and liver diffusion weighted magnetic resonance imaging (DW-MRI) was included in the imaging workup. We consequently considered 2 periods of inclusion: period #1 (February 2000–March 2011) and period #2 (April 2011–August 2019). Results: All patients underwent a preoperative CT scan with a median delay to surgery of 18 days. Liver DW-MRI was performed among 407 patients (54%). Median delay between CT and surgery decreased (21 days to 16 days, P<.01), and liver DW-MRI was significantly most prescribed during period #2 (14% vs 75%, P<.01). According to the intraoperative findings, the overall NRR was 24.5%, and remained stable over the two periods (24% vs 25%, respectively). While vascular invasion, liver metastasis, and carcinomatosis rates remained stable, PALNs invasion rate (0.4% vs 4.6%; P<0.001) significantly increased over the 2 periods. The mean size of the bigger extra pancreatic tumor significantly decrease (7.9mm vs 6.4mm (P<.01), respectively) when the resection was not done. In multivariate analysis, CA 19-9<500U/mL (P<.01), and liver DW-MRI prescription (P<.01) favoured the resection. Conclusions: Due to changes in our therapeutic strategies, the NRR did not decrease during two decades despite imaging improvement.
Psycho-social wellbeing among in-school adolescents of Sri Lanka; prevalence of selected attributes and associated factors
Authors: Wellappuli Nalinda , Gunawardena Nalika Sepali , Mahesh PK Buddhika , Gunawardena Shanthi , Wickramasinghe Champika , Lokubalasooriya Ayesha , Peiris Renuka , Liyanage Chinthika , Hathurusinghe Lalindi , Mahagamage Kanchana , Senanayake Sameera
Published: June 2020

Background

Adolescence period is associated with psycho-social issues which affect their day to day activities and go beyond their adolescent age group. It has been recorded that prevalence of psycho-social issues are rising globally. The aim of this study was to estimate the prevalence and factors associated with the selected attributes of psycho-social well-being among 13 to 17-year in-school adolescents of Sri Lanka using the Global School Health Survey (GSHS), conducted in Sri Lanka.
Methods

GSHS, was a cross-sectional study conducted among 3,650 adolescents of aged 13–17, attending government schools. Data was collected using a self-administered questionnaire. Psychosocial well-being included questions of four selected outcomes (i.e. bullying, felling alone, sleep disturbances due to a worry, suicidal ideation and practices) and 10 potential associated factors of these. The sample was selected through a two-staged cluster sampling technique. In determining the independent associated factors, multivariable analysis was done with multiple logistic regression.
Results

Most of the students who responded belonged to the 13–15 age group (66.5%) and with 51.1% were females. More than one third of the participants (37.7%, 95%CI 36.1–39.5) had experienced bullying 30 days prior to the study. ‘Feeling loneliness’ and ‘experiencing anxiety’ had been experienced by 9.0% (95%CI 8.0–10.0) and 4.7% (95%CI 3.9–5.4), respectively. The prevalence of planning an attempt of suicide was 6.3%, while 6.6% had at least once attempted suicide. Multivariable analysis revealed that lacked parental support and being engaged in a fight were independently associated with being bullied, feeling lonely and considering attempting suicide. Mutual association of the four outcomes with each other indicate that being bullied was significantly associated with experiencing loneliness and feeling anxiety. In addition, experiencing loneliness was independently associated “considering an attempt of suicide” (OR = 2.9, 95%CI = 2.0 to 4.3). Feeling anxiety was also associated with considering attempting suicide (OR = 3.4, 95%CI = 2.1 to 5.4).
Conclusion

This study demonstrated that the prevalence of psycho-social wellbeing is among school going adolescents is a major public health problem in Sri Lanka. School-based interventions to address these issues should be designed with the goal of increasing adolescents’ awareness of possible preventive measures of unintentional injuries.
Small Bowel Volvulus (SBV) in Northcentral Ethiopia
Authors: Awedew Atalel Fentahun , Belay Woldemariam Beka , Amsalu Bedemariam Tadesse , Yalewu Dawit Zerihun
Published: June 2020

Background: Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia Method: The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV.Result: There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within four years. The annual occurrence rate of SBV was 35cases per year. Small bowel volvulus represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority of SBV were males (N=125, 84.5%) and females were (N=23, 15.5%). The age ranged from 15-78years.The mean age was 41.14±(SD=15.4) .The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR=2).The mean duration of illness before hospital admission was 2days (± SD=1.4) and median was 1 day (± IQR=2). The morbidity rate was 5.4% (N=8) and the mortality rate was 3.4 %( N=5) Conclusion: Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.
Bridge to Surgery Using a Self-Expandable Metallic Stent for Stages II–III Obstructive Colorectal Cancer
Authors: Ohta Katsuya , Ikenaga Masakazu , Ueda Masami , Iede Kiyotsugu , Tsuda Yujiro , Nakashima Shinsuke , Nojiri Takashi , Matsuyama Jin , Murata Jun , Kobayashi Ichizo , Tsujii Masahiko , Yamada Terumasa
Published: June 2020

Background: Bridge to surgery (BTS) using a self-expandable metallic stent (SEMS) for the treatment of obstructive colorectal cancer improves the patient’s quality of life. This study aimed to examine prognostic factors of obstructive colorectal cancer. Methods: We analyzed stage II-III resectable colon cancer cases (Cur A) retrospectively registered between January 2005 and 2017. We encountered Cur A cases after BTS with SEMS placement (BTS group). We compared surgical results and prognoses between the two groups. Results: A total of 50 patients underwent endoscopic SEMS placement, which technical success of 96% and morbidity rate of 18%. Overall, 117 patients were evaluated: 67 of them underwent emergency surgery (ES) and 50 underwent BTS. Primary anastomosis rates were 77.6% in ES and 95.7% in BTS (p < 0.001); postoperative complication, 46.3% in ES and 10.5% in BTS (p < 0.001); pathological findings of lymphatic invasion, 66.7% in ES and 100% in BTS (p < 0.001); venous invasion were 66.8% in ES and 92% in BTS (p = 0.04); and recurrence of 25.4% in ES and 39.1% in BTS. The 3-year overall survival was significantly different between two groups (ES, 86.8%:BTS, 58.8%), BTS is worse than ES (log-rank test; p < 0.001). Venous invasion independently predicted worsened recurrence-free and overall survival. Conclusions: The vascular invasiveness was correlated with tumor progression after SEMS placement, and the survival rate was lower in BTS. SEMS potentially worsens prognostic outcomes in stage II–III obstructive colorectal cancer.
3,4-diaminopyridine Treatment for Lambert-Eaton Myasthenic Syndrome in Adults: A Meta-analysis of Randomized Controlled Trials
Authors: Zhang Na , Hong Daojun , Ouyang Taohui , Meng Wei , Huang Jingwei , Li Meihua , Hong Tao
Published: June 2020

Background: Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of neuromuscular transmission. The objective was to examine the efficacy and safetyof 3,4-diaminopyridine (3,4-DAP) in LEMS. Methods: We searched several databases to identify relevant studies, including PubMed, EMBASE, Cochrane Neuromuscular Disease Group Specialized Register and the Cochrane Controlled Trials Register.The primary outcome Quantitative Myasthenia Gravis (QMG) muscle score and secondary outcome compound muscle action potentials (CMAP) amplitude were pooled by meta-analysis. Results: Six randomised controlled trials (RCT) involving 115 patients with LEMS were included. A meta-analysis of the primary outcome showed a significant improvement of 2.33 (95% CI, -2.81 to -1.85, p<0.001) in QMG muscle score after treatment with 3,4-DAP. Moreover, a meta-analysis of the secondary outcome showed that the overall mean CMAP amplitude improved significantly in LEMS patients with 3, 4-DAP treatment, compared with placebo treatment(mean difference 1.63 mV, 95% CI, 0.85 to 2.41, p<0.001). The overall assessment of all included trials showed low risk of bias and low heterogeneity. Conclusioins: The pooled results demonsrated that 3,4-DAP had a significant effect on LEMS treatment, with improvements in muscle strength score and CMAP amplitude, which are moderate to high evidence from randomized controlled trials.
Multiple Sclerosis incidence rate in southern Iran: A Bayesian epidemiological study
Authors: Asmarian Naeimehossadat , Sharafi Zahra , Mousavi Amin , Jacques Reis , Tamayo Ibon , Bind Marie-Abèle , abutorabi-zarchi Marzie , Moradian Mohammad Javad
Published: June 2020

Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanism and clinical impact on young people. The prevalence of this disease in Iran is reported to be 5.3 to 74.28 per 100000 cases. Due to high prevalence of this disease in Fars province, this study aimed to assess the distribution of MS in this region in southern Iran by evaluating its covariates.Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria, which was reported by the MS Society of Fars from 1991 until 2016. Bayesian spatio-temporal models was also used to describe MS incidence in Fars province. We also investigated the association between overall MS incidence rate and the overall percentage of vitamin D intake, smokers in the population as well as the overall percentage of people with normal BMI as well as alcohol consumption in a population from 1991 until 2016 by Besag, York and Mollie's (BYM) model.Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000 population. The highest relative risk was estimated at 1.8 in the city of Shiraz, the capital of Fars province while the lowest relative risk was estimated at 0.11 in Zarindasht County in southern Fars. The percentages of vitamin D3 intake was significantly associated with the incidence of MS. Although 1% increase in Vitamin D3 intake is associated with 2% decrease in the risk of MS, 1% increase in smoking is associated with 16% increase in the risk of MS, respectively.Conclusion: Spatial analysis of MS showed low incidence rate of this disease in the south and south east of Fars province, which is due to the effect of different covariates. As suggested by previous studies, vitamin D and smoking among all covaiates might be associated with high incidence of MS.
Network pharmacology based investigation into the bioactive ingredients and molecular mechanisms of QingFeiPaiDu Decoction treating COVID-19
Authors: Liu Yan , Xiong Lewen , Wang YanYu , Luo Mengxiong , Zhang Longfei , Zhang Yongqing
Published: June 2020

Objective: To study the QingFeiPaiDu Decoction (QFPDD) in the treatment of Corona Virus Disease 2019 (COVID-19) bioactive ingredient and its potential mechanism. Methods: Combined with the clinical symptoms of COVID-19 patients, a "component-target-disease" network model was constructed based on the network pharmacology method, and potential active components, targets and molecular mechanisms of QFPDD for COVID-19 were screened out through topology parameter analysis.Results: We collected 376 active ingredients of QFPDD from the database, and 18833 potential anti-novel coronaviruses (SARS-CoV-2) targets were analyzed and screened. The principal targets involved PIK3CA, PIK3R1, APP, SRC, MAPK1, MAPK3, AKT1, HSP90AA1, EP300, CDK1, etc. We obtained 574 GO entries by Gene Ontology enrichment analysis and obtained 214 signal pathways with P<0.05 by KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis. Among them, the antiviral biological processes of QFPDD included a cellular response to nitrogen compound, protein kinase activity, membrane raft, etc. Pathways involved in the regulation include Pathways in cancer, Endocrine resistance, PI3K-Akt signaling pathway, Proteoglycans in cancer, etc. Molecular docking results showed that the core ingredients of QFPDD have a better affinity to the 2019-nCoV 3CL hydrolytic enzyme (Mpro) and angiotensin-converting enzyme 2 (ACE2). Conclusion: Through network pharmacology research and molecular docking verification, this paper preliminarily explored the potential molecular mechanism and relevant active ingredients of QFPDD playing an anti-SARS-CoV-2 role, providing a reference for the further development and utilization of QFPDD and the development of new specific antiviral drugs.
Modern contraceptive use among sexually active female adolescent: Trends and determinants insight from National Demographic and health survey
Authors: Kebede Alemi , Belina Sena , Biratu Yonas , Kebede Ayantu
Published: June 2020

Background

The sexual and reproductive health of young people is a global priority. Access to sexual and reproductive health information and services will determine, the burden of adolescent pregnancies and unwanted pregnancies. Teenage pregnancy that has profound effects on the health and wellbeing of young women across their life course is a burning public health and a demographic challenge in Ethiopia. Contraceptive use allows girls to postpone motherhood and space births. However, little is known about the trends in contraceptive use and its determinant among girls aged 15 to 19 in Ethiopia. Therefore, this study was designed to identify factors associated with modern contraceptive methods use among sexually active adolescent girls in Ethiopia.
Methods

Four Ethiopian demographic and health survey data were used to examine trends of contraceptive methods use among sexually active adolescent girls. To identify factors associated with contraceptive use, the 2016 Ethiopian demographic and health survey data was used. The data was accessed from the demographic and health survey program data base and data for sexually active adolescent girls were extracted. Data analysis was done using SPSS version 21. Data were weighted for analysis. Descriptive analysis was used to describe independent variables of the study participants. And design effect was considered during analysis. Multivariable logistic regression model was used to identify factors associated with contraceptive use.
Results

Modern contraceptive use increased significantly from 5.9% in 2000 to 39.3% in 2016. The odds of contraceptive use were lower among female adolescent who had no education (AOR: .038; 95%CI: (.007 to 0.216), primary education (AOR: 0.112; 95%CI: 0.026 to 0.483). But the odds of contraceptive methods use were higher among adolescent living in rich wealth status AOR: 5.131; 95%CI: (1.795 to 14.669) and those told about family planning during their health facility visit (A0R: 3.700; 95%CI: 1.517 to 9.020)
Conclusion

Modern contraceptive use increased significantly among sexually active adolescent girls in Ethiopia. Wealth index, education, told about family planning during their health facility visit and partner occupation were factors associated with contraceptive use. Improving economic and educational status of young women may help improve contraceptive use in Ethiopia.
Systematic Development and Refinement of a Contextually Relevant Strategy for Undergraduate Medical Ethics Education: a qualitative study
Authors: Shamim Muhammad Shahid , Torda Adrienne , Baig Lubna , Zubairi Nadeem , Balasooriya Chinthaka
Published: June 2020

Background
Delivery of medical ethics education is complex due to various reasons, compounded by the context-dependent nature of the content. The scarcity of relevant resources in the contexts of some developing countries adds a further layer of difficulty to ethics education in these contexts. We used a consultative approach with students, teachers and external experts to develop a contextually relevant and practical approach to medical ethics education. The aim of this study was to develop and refine a contextually relevant approach to ethics education in the region of Saudi Arabia.
Methods
The study utilized explorative qualitative methodology to seek views of students and faculty of Rabigh Faculty of Medicine, Kaing Abdulaziz University, Jeddah, Saudi Arabia, and international experts in the field of ethics and education to review and enhance a preliminary version of workbook-based ethics learning strategy. Three focus groups with 12 students and in-depth interviews with four faculty members enabled the study participants to objectively critique the WBEL and provide feedback to enhance its quality. In addition, eleven external experts critically analyzed the workbook. Thematic content analysis of the data was done to draw inferences which were used to refine the educational strategy.
Results
The analysis generated twenty-one sub-themes within four main themes: design features, content, teaching methods and assessment. These findings helped to modify the educational strategy for improve its effectiveness in the given context.
Conclusion
The study drew on the views of students, faculty and external experts to systematically develop a novel approach to ethics education for countries like Saudi Arabia. It also demonstrated the use of consultative approach for informing a culturally relevant educational strategy in Middle East context.
Effectiveness of Blended Learning versus Lectures alone on ECG Analysis and Interpretation by Medical Students
Authors: Viljoen Charle Andre , Millar Rob Scott , Manning Kathryn , Burch Vanessa Celeste
Published: June 2020

Background Most medical students lack confidence and are unable to accurately interpret ECGs. Better methods of ECG instruction are therefore being sought. Current literature indicates that the use of e-learning for ECG analysis and interpretation skills (ECG competence) is not superior to lecture-based teaching. We aimed to assess whether blended learning (lectures supplemented with the use of a web application) resulted in better acquisition and retention of ECG competence in medical students, than with conventional teaching (lectures alone). Methods Two cohorts of fourth-year medical students were studied prospectively. The conventional teaching cohort (n=67) attended four hours of interactive lectures, covering the basic principles of Electrocardiography, waveform abnormalities and arrhythmias. In addition to attending the same lectures, the blended learning cohort (n=64) used a web application that facilitated deliberate practice of ECG analysis and interpretation, with structured feedback. All participants completed three tests: pre-intervention (assessing baseline ECG competence at start of clinical clerkship), immediately post-intervention (assessing acquisition of ECG competence at end of six-week clinical clerkship) and delayed post-intervention (assessing retention of ECG competence six months after clinical clerkship, without any further ECG training). Diagnostic accuracy and uncertainty were assessed in each test. Results The pre-intervention test scores were similar for blended learning and conventional teaching cohorts (mean 31.02±13.19% versus 31.23±11.52% respectively, p=0.917). While all students demonstrated meaningful improvement in ECG competence after teaching, blended learning was associated with significantly better scores, compared to conventional teaching, in immediate (75.27±16.22% vs 50.27±17.1%, p<0.001; Cohen’s d =1.58), and delayed post-intervention tests (57.70±18.54% vs 37.63±16.35%, p<0.001; Cohen’s d =1.25). Although diagnostic uncertainty decreased after ECG training in both cohorts, blended learning was associated with better confidence in ECG analysis and interpretation. Conclusion Blended learning was superior in teaching ECG analysis and interpretation skills to medical students and achieved better levels of ECG competence and confidence than conventional lectures. Although medical students undergo a significant attrition of ECG competence without ongoing training, blended learning also resulted in better retention of ECG competence than conventional teaching. Web applications enabling deliberate practice with structured feedback may therefore be a useful adjunct to lectures for teaching Electrocardiography.
Differences and Similarities of High-resolution Computed Tomography Features Between Pneumocystis Pneumonia and Cytomegalovirus Pneumonia in Aids Patients
Authors: Du Chunjing , Liu Jingyuan , Chen Hui , Yan Shuo , Pu Lin , Xiong Haofeng , Xiang Pan , Li Chuansheng , Zhang Ming , Chen Budong , Li Ang
Published: June 2020

Background: Accurate differentiating diagnosis of pneumocystis pneumonia and cytomegalovirus pneumonia is crucial for choosing therapies in AIDS patients. Hence, the purposes of this study was to compare the CT features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and to spot the valuable findings which might contribute to an accurate diagnosis between two cohorts.MethodsA total of 112 AIDS patients, 78 withpneumocystis pneumoniaand 34 werecytomegalovirus pneumonia,were included in this study.Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square(χ2)test.ResultsThe presence of consolidation (61.77% in cytomegalovirus pneumonia,35.9% in pneumocystis pneumonia, p=0.011), halo signs (32.35% in cytomegalovirus pneumonia, 11.54% in pneumocystis pneumonia, p＜0.001), and nodules (47.06% in cytomegalovirus pneumonia,8.97% in pneumocystis pneumonia, p＜0.001), especially small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, p＜0.001) without perilymphatic distribution,was significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity (100% in pneumocystis pneumonia and cytomegalovirus pneumonia), reticulation(57.69% in pneumocystis pneumonia, 52.94% in cytomegalovirus pneumonia, p=0.782) andbronchial wall thickening (34.62% in pneumocystis pneumonia, 47.06% in cytomegalovirus pneumonia, p=0.213) were common in both groups.ConclusionsAnalysis of consolidation, nodules, and halo signs may contribute to prioritize differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typicalin oneor other diseases appear with similar frequency in both cohorts of AIDS patients.
Spatial Variations in Seismicity Characteristics in and Around the Source Region of the 2019 Yamagata-Oki Earthquake, Japan
Authors: Ueda Taku , Kato Aitaro , Ogata Yoshihiko , Yamaya Lina
Published: June 2020

The 2019 {\text{M}}_{\text{j}} 6.7 Yamagata-Oki Earthquake occurred adjacent to the northeastern edge of the source region of the 1964 {\text{M}}_{\text{j}} 7.5 Niigata Earthquake, offshore of Yamagata Prefecture, Japan. Few aftershocks occurred in the source region of the Yamagata-Oki earthquake immediately following the Niigata earthquake, and the recent seismicity rate in this region is extremely low compared with that of the surrounding region. This spatial variation in seismicity may allow us to elucidate plausible physical processes that shape the spatiotemporal evolution of these shallow-crustal environments. Here, we investigate the spatial variations in seismicity characteristics by applying the HIerarchical Space–Time Epidemic Type Aftershock Sequence (HIST-ETAS) model to an earthquake catalog compiled by the Japan Meteorological Agency for events in and around the Yamagata-Oki earthquake rupture region. We compare spatial variations in the background seismicity rate and aftershock productivity estimated from the HIST-ETAS model with the geophysical features in the study region. The background seismicity rate is high along the eastern margin of the Sea of Japan and correlates well with a previously identified zone that possesses a high geodetic shear strain rate. The two major earthquakes occurred in and around an active shear zone, suggesting that the background seismicity rate may serve as a key parameter for evaluating seismic hazard across the Japanese Archipelago. Furthermore, the source region of the Yamagata-Oki earthquake has a higher aftershock productivity, lower b-value, and lower seismic-wave velocity than that of the Niigata earthquake. We interpret this low-velocity zone to be a well-developed damaged rock that resulted in both a reduction in the b-value and an increase in aftershock productivity based on previous laboratory experiments and numerical results; this damage makes the rock more ductile at the macroscopic scale. The higher ductility in the source region of the Yamagata-Oki earthquake may have worked as a soft barrier against the propagation of dynamic rupture that occurred during the Niigata earthquake.