bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel nomogram to predict the overall survival in esthesinoeroblastoma
Authors: Jiang Lijie , Lin Tengjiao , Zhang Yu , Gao Wenxiang , Deng Jie , Xu Zhaofeng , Luo Xin , Huang Zhaoqi , Chen Fenghong , Shi Jianbo , Lai Yinyan
Published: April 2020

BackgroundIncreasing evidence indicates that the pathology and the modified Kadish system have some influence on the prognosis of esthesioneuroblastoma (ENB). However, an accurate system to combine pathology with a modified Kadish system has not been established.MethodsThis study aimed to set up and evaluate a model to predict overall survival (OS) accurately in ENB, including clinical characteristics, treatment and pathological variables. We screened the information of patients with ENB between January 1, 1976, and December 30, 2012 from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program as a training cohort. The validation cohort consisted of patients with ENB at Sun Yat-sen University Cancer Center and The First Affiliated Hospital of Sun Yat-sen University in the same period, and 87 patients were identified. The Pearson’s chi-squared test was used to assess significance of clinicopathological and demographic characteristics. We used the Cox proportional hazards model to examine univariate and multivariate analyses. The model coefficients were used to calculate the Hazard ratios (HR) with 95% confidence intervals (CI). Prognostic factors with a p-value < 0.05 in multivariate analysis were included in the nomogram. The concordance index (c-index) and calibration curve were used to evaluate the predictive power of the nomogram.ResultsThe c-index of training cohort and validation cohort are 0.737 (95% CI, 0.709 to 0.765) and 0.791 (95% CI, 0.767 to 0.815) respectively. The calibration curves revealed a good agreement between the nomogram prediction and actual observation regarding the probability of 3-year and 5-year survival. We used a nomogram to calculate the 3-year and 5-year growth probability and stratified patients into three risk groups.ConclusionsThe nomogram provided the risk group information and identified mortality risk and can serve as a reference for designing a reasonable follow-up plan.# Co-first authors: Lijie Jiang and Tengjiao Lin contributed equally to this article.
Association of human cytomegalovirus (HCMV) neutralizing antibodies with antibodies to the HCMV glycoprotein complexes
Authors: Shibamura Miho , Yoshikawa Tomoki , Yamada Souichi , Inagaki Takuya , Nguyen Phu Hoang Anh , Fujii Hikaru , Harada Shizuko , Fukushi Shuetsu , Oka Akira , Mizuguchi Masashi , Saijo Masayuki
Published: April 2020

Background
Human cytomegalovirus (HCMV) causes asymptomatic infections, but also causes congenital infections when women were infected with HCMV during pregnancy, and life-threatening diseases in immunocompromised patients. To better understand the mechanism of the neutralization activity against HCMV, the association of HCMV NT antibody titers was assessed with the antibody titers against each glycoprotein complex (gc) of HCMV.
Methods
Sera collected from 78 healthy adult volunteers were used. HCMV Merlin strain and HCMV clinical isolate strain 1612 were used in the NT assay with the plaque reduction assay, in which both the MRC-5 fibroblasts cells and the RPE-1 epithelial cells were used. Glycoprotein complex of gB, gH/gL complexes (gH/gL/gO and gH/gL/UL128-131A [PC]) and gM/gN were selected as target glycoproteins. 293FT cells expressed with gB, gM/gN, gH/gL/gO, or PC, were prepared and used for the measurement of the antibody titers against each gc in an indirect immunofluorescence assay (IIFA). The correlation between the IIFA titers to each gc and the HCMV-NT titers was evaluated.
Results
There were no significant correlations between gB-specific IIFA titers and the HCMV-NT titers in epithelial cells or between gM/gN complex-specific IIFA titers and the HCMV-NT titers. On the other hand, there was a statistically significant positive correlation between the IIFA titers to gH/gL complexes and HCMV-NT titers.
Conclusions
The data suggest that the gH/gL complexes might be the major target to induce NT activity against HCMV.
Using the drug repositioning approach to develop a novel therapy, tipepidine hibenzate sustained-release tablet (TS-141), for children and adolescents with Attention-Deficit/Hyperactivity Disorder
Authors: Saito Takuya , Yamashita Yushiro , Tomoda Akemi , Okada Takashi , Umeuchi Hideo , Iwamori Saki , Shinoda Satoru , Mizuno-Yasuhira Akiko , Urano Hidetoshi , Nishino Izumi , Saito Kazuhiko
Published: April 2020

Background
Asverin® (tipepidine hibenzate) has been used as an antitussive for > 50 years in Japan. Studies revealed that tipepidine modulates monoamine levels, by inhibiting G-protein-activated inwardly rectifying potassium (GIRK) channels, expecting the potential therapeutic effects of tipepidine for attention-deficit/hyperactivity disorder (ADHD) in recent years. In this study, TS-141, a sustained-release tablet of tipepidine, was developed for the treatment of ADHD through a drug repositioning approach.
Methods
The sustained-release profile of TS-141 in healthy adults was investigated, and tipepidine exposure in the plasma after the TS-141 administration was compared to that of Asverin in the phase I study. Phase II study was conducted to examine the effects of TS-141 30 (once a day), 60 (once a day), 120 mg (60 mg twice a day), or placebo, that is within the exposure in the maximum dosage of Asverin, in children and adolescents with ADHD, and was designed as an 8-week treatment, randomized, parallel group, double-blind, placebo-controlled trial recruiting 6–17-year-old children and adolescents diagnosed with ADHD. A total of 216 patients were randomized according to the CYP2D6 phenotype. The primary end-point was ADHD Rating Scale IV-J changes. Furthermore, effects of CYP2D6 phenotype on the efficacy in the subgroup analysis were investigated.
Results
TS-141 had the sustained-release profile, and the CYP2D6 phenotype had effects on the plasma exposure of tipepidine. ADHD RS-IV-J scores in all TS-141 dosages decreased from their baseline scores; however, no significant difference was observed in ADHD RS-IV-J score changes between the placebo and TS-141-administered groups. In patients with intermediate metabolizer CYP2D6, ADHD RS-IV-J score changes in the 120 mg group tended to be larger than that in the placebo group.
Conclusions
ADHD RS-IV-J changes on TS-141 may depend on the interaction between the TS-141 dose and CYP2D6 phenotype, suggesting that further clinical trials should be conducted with careful consideration of polymorphism. Drug repositioning approach of TS-141 was attempted at the same dose as that of antitussive; however, dose setting according to the indication was necessary.
Trial Registration
Phase I study: JapicCTI-205235 (Registered 25 March 2020), Phase II study: JapicCTI-163244 (Registered 9 May 2016), https://www.clinicaltrials.jp/cti-user/trial/Show.jsp
Surgical management of sarcoma in adolescent and young adult patients
Authors: Hashimoto Kazuhiko , Nishimura Shunji , Oka Naohiro , Akagi Masao
Published: April 2020

Objective To examine the clinical features and outcomes of adolescent and young adult sarcoma patients who underwent surgical management and clarify important factors associated with prognosis. We reviewed 18 young adult sarcoma patients sarcoma patients treated surgically in our hospital. The tumor site, histology, grade, stage, and American Society of Anesthesiologists-Physical Status before surgery, operation time, intraoperative blood loss, surgical margin, local recurrence, metastasis, and final outcome were investigated. The 3-year survival rate was also calculated. We compared survival based on age, grade, operation time, and intraoperative blood loss and surveyed features of cases of poor outcomes.Results The 3-year survival rate was 61.3%. There was no significant difference in survival based on age, grade, operation time, or intraoperative blood loss. Three of five patients who died of the disease had stage ≥ IV at diagnosis. All patients with inadequate surgical margins developed recurrence and all those with an American Society of Anesthesiologists-Physical Status ≥ 2 died. Patients with a late-stage sarcomas, inadequate tumor margin, or high American Society of Anesthesiologists-Physical Status score had poor prognosis. To achieve a favorable outcome in adolescent and young adult sarcoma patients, early detection and obtaining an adequate surgical margin are important.
Gut microbiota dysbiosis in stable coronary artery disease combined type 2 diabetes mellitus influence cardiovascular prognosis
Authors: Tian Ran , Liu Honghong , Feng Siqin , Xu Haopeng , Xing Haiping , Zhang Shuyang
Published: April 2020

Background : Host-microbiota interactions involving metabolic pathways have been linked to the pathogenesis of cardiovascular diseases like atherosclerotic disease and diabetes. Since stable coronary artery disease patients combined with diabetes mellitus have significantly increased risk for cardiac event, we focused on elucidating the role of microbiota affecting cardiometabolic disease development.Method : We used multi-omics analyses (metagenomics and metabolomics) of fecal and serum samples from a prospective cohort including stable coronary artery disease combined diabetes mellitus (SCAD+DM, n = 38), stable coronary artery disease (SCAD, n = 71), and healthy control (HC, n = 55). We connected microbiome features to disease severity in a three-pronged association analysis and identified prognostic bacterial biomarkers.Results: We investigated bacterial and metabolic signatures of diabetic and atherosclerotic phenotypes. SCAD+DM individuals were characterized by increased levels of aromatic amino acids and carbohydrates, which correlate with a gut microbiome with enriched biosynthetic potential. Meanwhile, our study addressed how metformin may confound gut dysbiosis and increase the potential for nitrogen metabolism. What’s more, we found that speciﬁc bacterial taxa Ruminococcus torques was predictive of cardiac survival outcomes.Conclusions: Overall, our study identified relationships between features of the gut microbiota and circulating metabolites, providing a new direction for future studies aiming to understand the host–gut microbiota interplay in atherosclerotic cardiovascular pathogenesis.
Effect modification by ferritin on the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance
Authors: Sciacqua Angela , Ventura Ettore , Tripepi Giovanni , Cassano Velia , D'Arrigo Graziella , Roumeliotis Stefanos , Maio Raffaele , Miceli Sofia , Perticone Maria , Andreozzi Francesco , Sesti Giorgio , Perticone Francesco
Published: April 2020

Backgroud: Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance.Methods: We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was definied by carotid-femoral pulse wave velocity (PWV).Results: Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin.Conclusion: Ferritin represents an independent predictor of AS in our study population and a strong effect modifier on the relationship between inflammation and PWV.
Involving Research Participants in a Pan-European Research Initiative: The EPAD Participant Panel Experience
Authors: Gregory Sarah , Bunnick Eline M , Callado Ana Belén , Carrie Isabelle , De Boer Casper , Duffus Julie , Fauria Karine , Forster Shona , Gove Dianne , Knezevic Iva , Pennetier Delphine , Saunders Stina , Sparks Sarah , Rice J. , Ritchie Craig W , Milne Richard
Published: April 2020

Background
Patient, public and participant involvement (PPPI) is increasingly acknowledged as a key pillar of successful research activity. PPPI can influence recruitment and retention, as well as researcher experience and contribute to decision making in research studies. However, there are few established methodologies of how to set up and manage PPPI activities.
Methods
In this paper we describe the set-up, running and experiences of the EPAD participant panel. The EPAD study was established as a pan-European cohort study aiming at understanding risks for developing Alzheimer’s disease and building a readiness cohort for Phase 2 clinical trials. Due to the longitudinal nature of this study, combined with the enrolment of healthy volunteers and those with mild cognitive impairments, the EPAD team highlighted PPPI involvement as crucial to the success of this project. The EPAD project employed a nested model, with local panels meeting at least twice a year established in England, France, Scotland, Spain and The Netherlands, feeding into a central panel who met once a year at the project’s General Assembly. The local panels were governed by terms of reference which were adaptable to meet local needs. We discuss the recruitment opportunities employed by the centres and the set-up of the panels.
Results
Impact of the panels has been widespread, and varies from feedback on documentation, to supporting with design of media materials and representation of the project at national and international meetings.
Conclusions
The EPAD panels have contributed to the success of the project and the model established is easily transferable to other disease areas investigating healthy or at-risk populations.
Comparison of the Efficacy of Posterior-Anterior Screws, Anterior-Posterior Screws and a Posterior-Anterior Plate in the Fixation of Posterior Malleolar Fractures with a Fragment Size of ≥15% and <15%
Authors: Wang Zheng , Sun Jianbin , Yan Jun , Gao Pengcheng , Zhang Hao , Yang Yong , Jin Qunhua
Published: April 2020

Background To investigate the efficacy of posterior-anterior (PA), anterior-posterior (AP) screws and a PA plate in the fixation of posterior malleolar fractures (PMFs) with a fragment size of ≥ 15% and < 15%.MethodsThis is a retrospective study of the clinical data of 243 patients with unilateral ankle fractures involving the posterior malleolus. All patients were divided into two groups based on their fragment size, ≥ 15% (n = 136) and < 15% (n = 107). PA screws, AP screws and a posterior plate were used for fixation of PMF in the two groups. All patients were followed up at 1, 3, 6, and 12 months after surgery and thereafter at 6-month intervals. The primary outcomes were AOFAS and ROM, which were recorded at the final follow-up.Results The average follow-up time for all patients was 18.9 months and all fractures healed. There was no significant difference between the PA plate fixation, PA screw, and AP screw fixations in terms of AOFAS scores or ankle ROM in the fragment size of ≥ 15% group (P > 0.05). In the fragment size of < 15% group, there were statistically significant differences in the AOFAS scores and ankle ROM between the PA plate fixation and PA, AP screw fixation (P < 0.05); while no significant difference was observed between PA and AP screw fixation.Conclusion For PMFs with fragment size ≥ 15%, there was no significant difference in the outcomes between the three fixation methods. For PMF with fragmentation < 15%, the PA and AP screws both provided good fixation.
Expression Patterns of SREBF1 and SREBF2 in Liver and Adipose Tissues of Two Fat-Tailed Sheep Breeds
Authors: Liang Chen , Qiao Liying , Han Yongli , Liu Jianhua , Zhang Jianhai , Liu Wenzhong
Published: April 2020

Background

The fat-tailed sheep is raised largely in China and other countries due to its high adaptability to nutritionally challenging environments and disease resistance as well as fat deposition in tails. So the purpose of the study is to explore the expression pattern and regulation mechanism of sterol regulatory element binding proteins (SREBPs) in liver and adipose tissues of fat-tailed sheep bases on its role in fat metabolism and deposition with sheep grown and development.
Methods

Two representative Chinese fat-tailed sheep breeds i.e. Guangling Large Tailed (GLT) and Small Tailed Han (STH) were employed to evaluate the ontogenetic expressions of SREBF1 and SREBF2 from seven different adipose tissues and liver at 4, 6, 8, 10 and 12 month by real-time PCR. Five serum indicators were detected, and the function speculation of SREBP1 and SREBP2 were evaluated by bioinformatics approaches.
Results

Serum indicators, especially total cholesterol TC and non-esterified fatty acid (NEFA) showed obvious differences and dynamical changes with the different development ages, gender factors only had a significant effect on serum NEFA concentrations. Both SREBF1 and SREBF2 mRNA expression in sheep were significantly affected by breed, tissue, age factors, and show a significant positive correlation (r = 0.286). Merely the expression of SREBF1 gene in STH is significantly higher than that in GLT, but SREBF2 gene expression is opposite. The expressions of SREBF1/2 in liver are extremely higher than that in seven adipose tissues, the interaction of two factors between breed and month age, breed and tissue, and tissue and gender also significantly affects its expression. Subcellular locations and function prediction imply that SREBP1/2 expressions are closely related with metabolism processes in cells.
Conclusions

The mRNA expression profiling of SREBF1 and SREBF2 showing a breed-specific, gender-specific, and temporal and spatial expressions differences, which imply that SREBF1/2 play a crucial role in lipid metabolism regulation during growth and development of two fat-tailed sheep. This study provides a phenotypic basis for further revealing the genetic mechanism in lipid metabolism and fat deposition that causes differences in ovine tail types, which also provides a novel insight for improving quality of meat.
Neurological manifestations associated with COVID19: a review and a call for action
Authors: Leonardi Matilde , Padovani Alessandro , McArthur Justin Charles
Published: April 2020

While the epidemics of Coronavirus disease 2019 (COVID-19) continues to spread globally, more and more evidence is collected about the presence of neurological manifestations and symptoms associated with it. A systematic review has been performed of papers published until 5 April 2020. 29 papers related to neurological manifestations associated with COVID-19 were examined. The results show presence of central and peripheral nervous system manifestations related to coronavirus. Neurological manifestations or NeuroCOVID are part of the COVID-19 clinical picture, but questions remain regarding the frequency and severity of CNS symptoms, the mechanism of action underlying neurological symptoms, and the relationship of symptoms with the course and severity of COVID-19. Further clinical, epidemiological, and basic science research is urgently needed in order to understand and address neurological sequalae of COVID-19. Concomitant risk factors or determinants (e.g. demographic factors, comorbidities, or available biomarkers) that may predispose a person with COVID-19 to neurological manifestations also need to be identified. The review shows that although more and more papers are reporting neurological manifestations associated with COVID19, however many items remain unclear and this uncertainty calls for a global action that requires close coordination and open-data sharing between hospitals, academic institutions and the fast establishment of harmonised research priorities and research consortia to face the NeuroCOVID19 complications.
The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study
Authors: Zhao Lei , Wang Gang Jian , Kong Jingxia , Zhen Xing , Yu Xin
Published: April 2020

Background: To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.Methods: Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI< 18.5kg/ m2, Group1), normal (18.5≤BMI< 23kg/m2, Group2), overweight (BMI≥ 23kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.Results: Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44 %. Conversion rate in the three groups was 14.29%, 21.54% and 20.69 % (P=0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85±4.04, 11.57±5.56, and 10.88±5.70, P=0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P=0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P=0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P=0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P=0.043).Conclusions: Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.
Developing a Sociocultural Framework of Compliance: An Exploration of Factors Related to the Use of Early Warning Systems Among Acute Care Clinicians
Authors: Flenady Tracy , Dwyer Trudy , Sobolewska Agnieszka , Lagadec Danielle Le , Connor Justine , Signal Tania , Browne Matthew , Kahl Julie
Published: April 2020

Background: Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised. Objectives: To explore sociocultural factors influencing acute care clinicians’ compliance with an early warning system commonly used in Queensland public hospitals in Australia. Methods: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia.Results: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication. Conclusions: The overarching organisational context including the hospital’s embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians’ and teams’ compliance or non-compliance with early warning system’s monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.
‘An exploration of stakeholder involvement in decision-making: a qualitative study of commissioning for alcohol services’
Authors: Alderson hayley , Kaner Eileen , Hunter David , O'Donnell Amy , Bate Angela
Published: April 2020

Background: The concept of providing individuals with a ‘voice’ via stakeholder involvement has been advocated within English health care policy for several decades. Stakeholder involvement encourages people affected by an issue to contribute to planning and decision making regarding treatment and care, inclusive of providers and recipients of care. This paper explores stakeholder involvement within the commissioning of public health alcohol services and illustrates whether stakeholders perceived that meaningful involvement had taken place. Methods: We conducted a qualitative case study, inclusive of in-depth interviews with 10 Alcohol commissioners, 11 alcohol service providers and 6 general practitioners plus three facilitated focus groups with 31 alcohol service users. All interviews and focus groups were audio-recorded and data were transcribed verbatim. Thematic analysis drawing on Arnstein’s theory was used to discuss key issues related to participants involvement which are illuminated using direct quotes. Results: Overall findings suggest that most participants were aware of and could name various methods of stakeholder involvement, methods varied from formal strategically imposed mechanisms to innovative opportunities. We found that strategic mechanisms of involvement focused on collating data to help construct a national picture regarding service delivery. Using Arnstein’s ladder to illustrate the extent of stakeholder involvement, the majority of the participants perceived involvement to occur at the level of informing or consultation implying a level of tokenism. In addition, the impact of stakeholder involvement is not systematically monitored making it hard to identify the impact that involvement methods have had. Conclusion: This paper has shown a lack of consistency regarding the opportunities within the commissioning process for stakeholder involvement to influence service design and delivery. It is essential within public health that a deeper understanding is generated of who stakeholders are within this complex and fluid environment and to develop a clearer understanding of the different roles that stakeholders can play within the entire commissioning process in order to maximise its utility. Future commissioning guidance also needs to reflect more dimensionality than ladders of involvement currently afford.
Effect of Story-Based Audio Visual Mnemonics in Comparison with Text Reading Method on Memory Consolidation among Medical Students: A randomized Controlled Trial
Authors: Abdalla Mona Mohamed Ibrahim , Azzani Meram , Rajendren Reanugah , Hong Tan Kim , Balachandran Yamunah A/P , Hassan Toffahah Ruwa Fayyad Mohd , Wei Tan Yi , Yahaya Ummu Kulthum Binti , En Lau Jing , Ajaykumar Sridhar , Moore Rebecca Anak Roger , Haja Mohammed Hanifa Salman
Published: April 2020

Background: Traditional teaching methods via faculty lectures lacked interactivity, as seen with text-based materials. Hence, this research aimed to compare the effectiveness of story-based audio-visual mnemonics and conventional text reading methods on medical students’ memory consolidation. Methods: A single-center, systematic random sampling, single-blinded, controlled study was conducted among 80 medical students in year one. The students were randomly assigned to the text-based (control) or story-based audio-visual mnemonics (intervention). Then, a test was held immediately, consisting of ten multiple-choice questions and ten oral recall keywords based on the topic given. The test was repeated in one week, two weeks, and four weeks later. Both descriptive and inferential statistics were utilized. The mean score difference between the audiovisual mnemonic and control groups was determined using a two-tailed unpaired t-test. Results: This study found that participants who underwent a story-based audiovisual mnemonics method had statistically significant higher marks in the single-response answer questions compared to participants who undergone a text reading method. The audiovisual group also spent a statistically significant shorter time to recall in the oral recall test in comparison to the control group. In conclusion, story-based audio-visual mnemonics are more effective in medical student’s memory retention compared to the conventional text reading method.
Effects of reflection and immediate feedback to improve clinical reasoning of medical students in the assessment of dermatologic conditions: A randomised controlled trial
Authors: Choi Sungjun , Oh Sohee , Lee Dong-Hun , Yoon Hyun-Sun
Published: April 2020

BACKGROUND: There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. OBJECTIVE: To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electives in improving medical students' ability in evaluating skin lesions.METHODS: The participants were fourth-year medical students of Seoul National University College of Medicine, Korea, who were enrolled to take a 2-week dermatology elective course (n=87). Students were assigned to one of the three educational interventions: 2-hour training involving 10 written clinical cases (experimental); 1-hour lecture and 1-hour outpatient clinic (lecture); and 2-hour outpatient clinic (no intervention). Before and at the end of rotation, diagnostic accuracy was estimated using 20 written clinical cases with photographs (10 novel cases presented in diagnostic training [training set], 10 cases with diagnoses not included in training [control set]).RESULTS: There was a significant interaction effect of intervention×set×time. A post hoc analysis indicated that the students in the experimental group outperformed students in the other two groups only in the training set of the final tests; after completing the 2-week rotation, for the training set, the mean score was higher in the experimental group (7.5±1.3) than in the lecture (5.7±1.6) and no intervention (5.6±1.3) groups, producing an effect size of 1.2 standard deviation (SD) and 1.5 SD, respectively. CONCLUSION: Practicing written clinical cases with reflection and feedback is superior to a lecture-based approach and yields additional benefits to a dermatology elective, thereby enhancing medical students’ ability to accurately diagnose skin lesions.
Serum levels of D-dimer and fibrinogen/fibrin degradation products correlate with BP severity
Authors: Lu Mei , Wang Xiuying , Xiao Tong , Wang Sijia , Fang Min , Cheng Chuantao , Xia Yumin , Liu Yale
Published: April 2020

Background Bullous pemphigoid (BP) is the most common blistering dermatosis with increasing mortality. Currently, the severity of BP can be assessed by the detection of anti-BP180 immunoglobulin G (IgG) titer, but it is absent in many grassroots clinics. BP patients are usually in a hypercoagulable state, and the levels of D-dimer and fibrin degradation products (FDPs) are elevated. Therefore, we aim to evaluate the use of D-dimer and FDPs in the assessment of BP severity. Methods This study included 33 BP and 33 Herpes zoster (HZ) patients, with the HZ patients serving as a control. The levels of plasma D-dimer and FDPs as along with eosinophil counts were recorded during a routine screening examination. Anti-BP180 IgG titer was tested by ELISA. BP lesion area was evaluated on admission. Correlational analyses were carried out between these indexes. Results The plasma D-dimer and FDP levels were higher in BP patients than in HZ patients. A significant positive correlation was found between the lesion area and both D-dimer and FDP levels in BP patients. There was also a positive association between anti-BP180 IgG and D-dimer, and between anti-BP180 IgG and FDP. Conclusions Plasma D-dimer and FDP may be convenient markers to evaluate the severity of BP.
Pulmonary function of patients with 2019 novel coronavirus induced pneumonia: A Retrospective Cohort Study
Authors: Lv Dongqing , Chen Xi , Mao Linghong , Sun Jiao , Wu Guixian , Lin Zhi , Lin Ronghai , Yu Jiansong , Wu Xiaomai , Jiang Yongpo
Published: April 2020

Background: Pulmonary fibrosis is a common complication in patients with viral pneumonia, which causes restricted ventilation disorders and affects the prognosis of patients. However, the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia has not yet been reported.Methods: A retrospective analysis of 137 patients with COVID-19-induced pneumonia who were discharged from the Enze Hospital, Taizhou Enze Medical Center (Group), from January 31, 2020, to March 11, 2020. Follow-up occurred two weeks after hospital discharge, whereupon patients received a pulmonary function test. Results: Of the 137 patients who received a pulmonary function test two weeks after discharge, 51.8% were male, and the mean age was 47 years. Only 19.7% of the patients were identified as having severe novel coronavirus pneumonia. The pulmonary function test showed that for a small number of patients ((FEV1/FVC)/% <70%,) the mean ICV and FVC was 2.4±0.7 L, 3.2±0.8 L, respectively. In severe cases, 88.9% of patients had an IVC <80% of the predicted value and 55.6% of patients had an FVC <80% of the predicted value. The MEF25, MEF50, and MEF75 <70% values were 55.6%, 40.7%, and 25.9%, respectively. In the non-severe group, 79.1% of patients has an IVC <80% of the predicted value, and 16.4% of patients had an FVC <80% of the predicted value. The mean MEF25, MEF50, and MEF75 <70% values were 57.3%, 30%, and 13.6%, respectively.Conclusions: In this study, the results suggest that the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia manifested as restrictive ventilation disorder and small airway obstruction. The incidence was increased among critically ill patients.Trial registration number: ChiCTR2000029866.
Acceptance of illness, quality of life and nutritional status of patients after lower limb amputation due to diabetes mellitus
Authors: Szymanska-Chabowska Anna , Łabuń Adrianna , Tański Wojciech , Zielińska Dorota , Juzwiszyn Jan , Chabowski Mariusz
Published: April 2020

Introduction. Diabetes mellitus is one of the most common chronic diseases with a high number of sufferers worldwide. Diabetic neuropathy and diabetic angiopathy lead to serious infectious complications which are very difficult to combat and may finally lead to the amputation of a lower limb. The aim of the study was to evaluate the quality of life, the level of acceptance of the illness and the nutritional status of patients after lower limb amputation due to diabetes. Methods. Ninety nine patients (23 men and 76 women) were enrolled into the study. They had all undergone lower limb amputation due to diabetic foot in the Department of General and Oncological Surgery. The following questionnaires were used: the WHO Quality of Life-BREF, the Mini Nutritional Assessment, the Acceptance of Illness Scale and the socio-demographic questionnaire. Results. The diabetes-related amputees had a higher QoL within the social domain (64.48), an intermediate QoL – within the environmental domain (63.04) and the mental domain (59.61), and a lower QoL – within physical (somatic) domain (54.69). There was no statistical correlation between genders or between all the domains of QoL (p>0.05). The patients were at risk of malnutrition (MNA was 22.66). There were statistical differences between women and men as regards nutritional status (p=0.034). The mean AIS score was 27.65, which means that the respondents accept their disease. There was no statistical correlation between gender and the acceptance of the disease (p=0.288). There was not statistical correlation between age and QoL (p>0.05). There were statistical differences between age and nutritional status (p<0.05), and between age and acceptance of the illness (p=0.044). Conclusions. The better the quality of life was in all the domains, the better the level of acceptance of illness was. The less malnourished the patient was, the better their quality of life was in all the domains.
Automated Systems for Detection of COVID-19 Using Chest X-ray Images and Lightweight Convolutional Neural Networks
Authors: Alqudah Ali Mohammad , Qazan Shoroq , Alqudah Amin
Published: April 2020

Since December 2019, the appearance of an outbreak of a novel coronavirus disease namely COVID-19 and which is previously known as 2019-nCoV. COVID-19 is a type of coronavirus that leads to the general destruction of respiratory systems and a severe respiratory symptom which are associated with highly Intensive Care Unit (ICU) admissions and death. Like any disease, the early diagnosis of coronavirus leads to limit its wide-spreading and increases the recovery rates of patients. The gold standard of COVID-19 detection is the real-time reverse transcription-polymerase chain reaction (RT-PCR) which has been used by the clinician to discover the presence or absence of this type of virus. The clinicians report that this technique has a low positive rate in the early stage of this disease. Based on this, the clinicians were forced to use another way to help in the early diagnosis of COVID-2019. So, the clinician's attention moved towards the medical imaging modalities especially the computed Tomography (CT) and X-ray chest images. Both modalities show that there is a change in the lungs in the case of COVID-19 that is different from any other type of pneumonic disease. Therefore, this research targeted toward employing different Artificial Intelligence (AI) techniques to propose a system for early detection of COVID-19 using chest X-ray images. These images are classified using different AI algorithms and a combination of them, then their performance was evaluated to recognize the best of them. These algorithms include a convolutional neural network (CNN), Softmax, support vector machine (SVM), Random Forest, and K nearest neighbor (KNN). Here CNN is into two scenarios, the first one to classify the X-ray images using a softmax classifier, and the second one to extract automated features from the images and pass these features to other classifiers (SVM, RFF, and KNN). According to the results, the performance of all classifiers is good and most of them record accuracy, sensitivity, specificity, and precision of more than 98%.
Characterization of the complete mitochondrial genomes of two sibling species of parasitic roundworms, Haemonchus contortus and Teladorsagia circumcincta.
Authors: Palevich Nikola , Maclean Paul Haydon , Choi Young-Jun , Mitreva Makedonka
Published: April 2020

Background Haemonchus contortus and Teladorsagia circumcincta are among the two most pathogenic internal parasitic nematodes infecting small ruminants, such as sheep and goats, and are a global animal health issue. Accurate identification and delineation of Haemonchidae species is essential for development of diagnostic and control strategies with high resolution for Trichostrongyloidea infection in ruminants. Here, we describe in detail and compare the complete mitochondrial (mt) genomes of the New Zealand H. contortus and T. circumcincta field strains to improve our understanding of species- and strain-level evolution in these closely related roundworms. Methods In the present study, we performed extensive comparative bioinformatics analyses on the recently sequenced complete mt genomes of the New Zealand H. contortus NZ_Hco_NP and T. circumcincta NZ_Teci_NP field strains. Amino acid sequences inferred from individual genes of each of the two mt genomes were compared, concatenated and subjected to phylogenetic analysis using Bayesian inference (BI), Maximum Likelihood (ML) and Maximum Parsimony (MP).Results The AT-rich mt genomes of H. contortus NZ_Hco_NP and T. circumcincta NZ_Teci_NP are 14,001 bp (A+T content of 77.4 %) and 14,081 bp (A+T content of 77.3 %) in size, respectively. All 36 of the typical nematode mt genes are transcribed in the forward direction in both species and comprise of 12 protein-encoding genes (PCGs), 2 ribosomal RNA (rrn) genes, and 22 transfer RNA (trn) genes. The secondary structures for the 22 trn genes and two rrn genes differ between H. contortus NZ_Hco_NP and T. circumcincta NZ_Teci_NP, however the gene arrangements of both are consistent with other Trichostrongylidea sequenced to date. Conclusions Comparative analyses of the complete mitochondrial nucleotide sequences, PCGs, A+T rich and non-coding repeat regions of H. contortus NZ_Hco_NP and T. circumcincta NZ_Teci_NP further reinforces the high levels of diversity and gene flow observed among Trichostrongylidea, and supports their potential as ideal markers for strain-level identification from different hosts and geographical regions with high resolution for future studies. The complete mt genomes of H. contortus NZ_Hco_NP and T. circumcincta NZ_Teci_NP presented here provide useful novel markers for further studies of the meta-population connectivity and the genetic mechanisms driving evolution in nematode species.
Assessing Preventive Health Behaviors from COVID-19 Based on the Health Belief Model (HBM) among People in Golestan Province: A Cross-Sectional Study in Northern Iran
Authors: Shahnazi Hossein , Ahmadi-Livani Maryam , Pahlavanzadeh Bagher , Rajabi Abdolhalim , Hamrah Mohammad Shoaib , Charkazi Abdurrahman
Published: April 2020

Background: COVID-19 is a new viral disease that has caused a pandemic in the world. Due to the lack of vaccines and definitive treatment, preventive behaviors are the only way to overcome the disease. Therefore, the present study aimed to determine the preventive behaviors from the disease based on constructs of the health belief model.Methods: In the present cross-sectional study during March 11 to 16, 2019, 750 individuals in Golestan province of Iran were included in the study using the convenience sampling and they completed the questionnaires through cyberspace. Factor scores were calculated using the confirmatory factor analysis. The effects of different factors were separately investigated using the univariate analyses, including students sample t-test, ANOVA, and simple linear regression. Finally, the effective factors were examined by the multiple regression analysis at a significant level of 0.05 and through Mplus 7 and SPSS 16.Results: The participants' mean age was 33.9±9.45 years; and 57.1% of them had associate and bachelor's degrees. Multiple regression indicated that the mean score of preventive behavior from COVID-19 was higher in women than men, and greater in urban dwellers than rural dwellers. Furthermore, one unit increase in the standard deviation of factor scores of self-efficacy and perceived benefits increased the scores of preventive behavior from COVID-19 by 0.22 and 0.17 units respectively. On the contrary, one unit increase in the standard deviation of factor score of perceived barriers and fatalistic beliefs decreased the scores of the preventive behavior from COVID-19 by 0.36 and 0.19 units respectively.Conclusion: Results of the present study indicated that female gender, perceived barriers, perceived self-efficacy, fatalistic beliefs, perceived interests, and living in city had the greatest preventive behaviors from COVID-19 respectively. Preventive interventions were necessary among men and villagers.
Changes in RT-PCR test results and symptoms during the menstrual cycle of a female individual infected with SARS-CoV-2: a case report
Authors: Zheng Hua , Tan Juan , Ma Ke , Meng Weihua
Published: April 2020

Background: The implications of the menstrual cycle for disease susceptibility, development, and severity of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are largely unknown.Case presentation: We report a 37-year-old woman infected with SARS-CoV-2 who showed a 16-day incubation period. She developed a fever on the first day of her menstrual period, and again on the first day of her next menstrual period after hospital discharge. RT-PCR test results were positive during the first menstrual period before admission, turned negative during hospitalization, and then positive again during the second menstrual period after hospital discharge.Conclusions: This case indicates sex hormones may play an important role in SARS-CoV-2 infection. For women with history of exposure to SARS-CoV-2, the management protocol should include assessment of the menstrual status.
Evaluating the Suitability of Hyper- and Multispectral Imaging to Detect Foliar Symptoms of the Grapevine Trunk Disease Esca in Vineyards
Authors: Bendel Nele , Kicherer Anna , Backhaus Andreas , Klück Hans-Christian , Seiffert Udo , Fischer Michael , Voegele Ralf T. , Töpfer Reinhard
Published: April 2020

Background: Grapevine trunk diseases (GTDs) such as Esca are among the most devastating threats to viticulture. Due to the lack of efficient preventive and curative treatments, Esca causes severe economic losses worldwide. Since symptoms do not develop consecutively, the true incidence of the disease in a vineyard is difficult to assess. Therefore, an annual monitoring is required. In this context, automatic detection of symptoms could be a great relief for winegrowers. Spectral sensors have proven to be successful in disease detection, allowing a non-destructive, objective, and fast data acquisition. The aim of this study is to evaluate the feasibility of the in-field detection of foliar Esca symptoms over three consecutive years using ground-based hyperspectral and airborne multispectral imaging.Results: Hyperspectral disease detection models have been successfully developed using either original field data or manually annotated data. In a next step, these models were applied on plant scale. While the model using annotated data performed better during development, the model using original data showed higher classification accuracies when applied in practical work. Moreover, the transferability of disease detection models to unknown data was tested. Although the visible and near-infrared (VNIR) range showed promising results, the transfer of such models is challenging. Initial results indicate that external symptoms could be detected pre-symptomatically, but this needs further evaluation. Furthermore, an application specific multispectral approach was simulated by identifying the most important wavelengths for the differentiation tasks, which was then compared to real multispectral data. Even though the ground-based multispectral disease detection was successful, airborne detection remains difficult.Conclusions: In this study, different approaches for the detection of foliar Esca symptoms are presented. Both sensor systems seem to be suitable for the in-field detection of the disease, even though airborne data acquisition has to be further optimized. Our disease detection approaches could facilitate monitoring plant phenotypes in a vineyard.