bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of TB treatment initiation delay with clinical severity and risk of transmission among pulmonary tuberculosis patients in Tigray, Northern Ethiopia: Cross-sectional study
Authors: Tedla kiros , Medhin Girmay , Berhe Gebretsadik , Mulgeta Afework , Berhe Nega
Published: March 2020

Background Delayed treatment initiation of tuberculosis (TB) increases disease progression and development of complications which may lead to a higher risk of transmission, clinical severity and increased mortality. But, published evidences that investigated the effect of delayed initiation of treatment on clinical severity and risk of transmission of pulmonary tuberculosis patients is scarce in Tigray, Northern Ethiopia. Objective To investigate the association of delayed treatment initiation of Pulmonary Tuberculosis with clinical severity and risk of transmission. Methods In this cross-sectional study design, a total of 875 newly diagnosed adult pulmonary tuberculosis patients were recruited from 21 health facilities from October 2018 to October 2019. Health facilities were selected by simple random sampling method and the study participants were enrolled consecutively. Data were collected using questionnaires through face-to-face interviews of patients within the first 2 weeks of treatment initiation. Clinical severity was assessed by Bandim tuberculosis score and risk of transmission was assessed by smear positivity or lung cavitations. Data were analyzed using SPSS version 21 software program. Logistic regression analysis was used to ascertain the association of delay with clinical severity and risk of transmission. P-value of less than 0.05 was reported as being statistically significant. Results Those who had initiating treatment without delay and those who were initiated treatment after a medium delay of 31 to 60 days were significantly associated with decreased clinical score compared to those who initiated treatment after a delay of more than two months. Compared with patients who were initiated treatment within one month, the risk of transmission was greater for delay of 30-60 days and above 60 days. Patients having more than 3 family members have higher risk to transmit TB as compared to those who have maximum of 3 family members. Whereas, patients having at least two rooms and being HIV negative have lower risk to transmit TB compared to their counter patients. Conclusion Narrowing the gap between initial occurrence of TB symptoms and treatment initiation is the way forward to improve clinical courses of TB patients and to reduce the risk of transmission of TB to other people from these patients.
Performance of Xpert® MTB/RIF in diagnosing tuberculous pleuritis using thoracoscopic pleural biopsies
Authors: Li Chengjun , Liu Chang , Sun Bingqi , Zhang Wei , Wang Yang , Sun Jiao , Ma Fang , Chen Yu
Published: March 2020

Background: Etiological diagnosis of tuberculous pleuritis is challenging owing to the low number of Mycobacterium tuberculosis (MTB) cells in the affected region. Moreover, currently available methods, such as detection of acid-fast bacilli and microbiological cultures, are not always conducive to timely diagnosis and treatment. Objectives: We evaluated the performance of GeneXpert MTB/RIF assay (referred to as “Xpert” hereafter) in detecting MTB in difficult-to-diagnose patients using suspensions of pleural biopsy tissue specimens under direct thoracoscopic guidance. Methods: All suspected patients with pleural effusion who visited Shenyang Tenth People’s Hospital and Shenyang Chest Hospital between 2017 and 2018 were screened. Excluding the confirmed patients, the remaining 160 patients with unexplained pleural effusion underwent local anesthesia, and an intercostal incision of approximately 1.0 cm was made for biopsy. The specimen was used for pathological and etiological examination. The performance of Xpert MTB/RIF test was evaluated for its sensitivity, specificity, and the positive and negative predictive values (PPV and NPV, respectively) against the gold standards, MGIT 960 culture, and a composite reference standard (CRS). Results: The sensitivity and specificity of Xpert were 69.84% and 66.67%, respectively against those of MGIT 960. The PPV and NPV of Xpert were 59.46% and 75.95%, respectively. The sensitivity of Xpert was 70.27% against CRS, which was significantly higher than that of MGIT at 59.26%. The PPV and NPV of Xpert against CRS were 100.0% and 58.75%, respectively. Conclusions: Xpert showed better sensitivity than MGIT in the pleural biopsy and is a potential tool for diagnosing tuberculous pleuritis.
Analysis of Retractions from Hospitals in Mainland China from 2017-2019
Authors: Zhao Tianye , Dai Tiancong , Lun Zhijun , Gao Yanli
Published: March 2020

Objective: The aim of this study is to analyze the features of retractions from hospitals in mainland China, and to discuss the causes of research misconduct by Chinese doctors.Research Methods: PubMed, Web of Science, and Retraction Watch Database were searched to collect eligible records and to extract characteristics of the included entries, including publishers and Open Access status of the journals involved, ORCID, PubPeer comments before the retraction, whether there are authors from Grade A, Third-class hospitals, and whether there are response or requirements from authors.Results: 521 retractions were included. Retractions were found primarily from authors of grade A, third-class hospitals, a limited regions, and published in journals with medium and high impact factor. The main reasons for retractions were Data Manipulation/Fabrication/Fraud(27.1%), Error by Author(19.9%), Plagiarism(16.7%), Self-Plagiarism(9.1%), Fake Peer Review(7.6%) and Forged Authorship(6.3%). Most of the retracted publications have neither ORCID nor PubPeer comments before their retraction.Conclusion: This is the first report focus on the retractions from hospitals in mainland China. The large number of retractions from Chinese hospitals in recent years is worrying. The results suggests that some retractions are related to third-parties. Some features of retractions are centralized, and it is difficult to evaluate the role of ORCID and PubPeer in the retractions during this period.
Five-year longitudinal study of frailty prevalence and course assessed using the Kihon Checklist among community-dwelling older adults in Japan
Authors: Ohashi Masayuki , Yoda Takuya , Imai Norio , Fujii Toshihide , Watanabe Kei , Tashi Hideki , Shibuya Yohei , Watanabe Jin , Endo Naoto
Published: March 2020

Background: The natural course of scores of the Kihon Checklist, one of the promising tools used for frailty screening, is unknown. We aimed to analyze the 5-year natural course of frailty as assessed using the Kihon Checklist in community-dwelling older adults. Methods: We used the data from the postal Kihon Checklist survey conducted by the municipal government between 2011 and 2016. The sample of the current study consisted of 551 older adults (265 men and 286 women) aged 65-70 years in 2011, who responded to the postal Kihon Checklist both in 2011 and in 2016. A Kihon Checklist score of 0 to 3 was considered an indicator of robustness, 4 to 7 of prefrailty, and 8 or higher of frailty. Group comparisons were performed with significance set at p<0.05. To identify independent risk factors for a transition towards frailty, a logistic regression analysis was performed using factors of p <0.20 in the group comparisons. Results: The median Kihon Checklist score significantly increased from 2 (interquartile range, 1-3) in 2011 to 3 (1-5) in 2016 (p<0.001). Hence, the prevalence of frailty significantly increased from 8.0% to 12.3% (p<0.001) during the same period. Regarding the 5-year transitions in frailty status, the majority (68.3%) of older adults remained unchanged, while 21.4% transitioned towards a worse frailty status, and 10.3% towards an improved status. Of the 507 respondents who were robust or prefrail at the baseline, 44 experienced a transition towards frailty, indicating that the 5-year incidence of frailty was 8.7%. These 44 individuals had higher body mass indexes and lower physical activity scores on the Kihon Checklist than the others (p<0.05). Multivariate analyses demonstrated that the physical activity score of the Kihon Checklist independently predicted a transition towards frailty in 5 years (odds ratio, 1.55; 95% confidence interval, 1.12–2.15; p=0.009). Conclusions: This study was the first to evaluate the course of frailty status, assessed using the Kihon Checklist in community-dwelling elderly adults, and should provide reference data to evaluate the effects of frailty interventions. Additionally, our results suggest that maintaining optimal physical activity should be recommended to prevent transition towards frailty.
miR-432 is a novel biomarker for PCNSL and is associated with cell adhesion: An integrated bioinformatics analysis
Authors: Ma Qiang
Published: March 2020

Background: Primary central nervous system lymphoma (PCNSL), a rare form of the non-Hodgkin's lymphoma (NHL), usually has a poor prognosis, and molecular pathogenesis of PCNSL has not been fully elucidated. Here, potential miRNA biomarkers were investigated in patients with PCNSL using an integrated bioinformatics analysis. Methods: Expression profile arrays (GSE122011, GSE139031, and GSE25297) were obtained from the Gene Expression Omnibus (GEO). Free-scale miRNA co-expression networks were constructed with 27 PCNSL patients from GSE122011 by the weighted gene co-expression network analysis (WGCNA) in order to identify candidate biomarkers. Subsequently, miRNA-miRNA networks were visualized with the Cytoscape. Expression of candidate miRNAs was assessed in serum samples from GSE139031, including 42 PCNSL patients and 77 non-cancer individuals, and the sensitivity and the specificity were assessed by the receiver operating characteristic (ROC) curve. From GSE25297, differentially expressed genes (DEGs) from the PCNSL tissues (n = 7) and the normal lymph nodes (n = 7) were compared, target genes of candidate miRNAs were downloaded from TargetScan database, and target genes that were also down-regulated in GSE25297 were used to construct the protein-protein interaction (PPI) networks and for the gene ontology (GO) analysis. Results: miRNAs were clustered into two groups with 8 modules in 27 patients with PCNSL. One group consisted of the yellow and the turquoise modules, and the second group consisted of the other six modules. In the miRNA-miRNA network, the highest nodes were observed between miR-432 and miR-330-3p, which were from the yellow and the turquoise modules, and only miR-432 was closely associated with both the yellow (0.977, P = 2.88E -18 ) and the turquoise modules (0.525, P = 0.005). Additionally, patients with PCNSL had higher serum miR-432 expression compared with that in the non-cancer controls in GSE139031, and miR-432 has a higher accuracy for discriminating between PCNSL and non-cancer samples (AUC: 0.77; 95% CI: 0.6923 to 0.8550). For target genes of miR-432, RASGRF , DGKG , SMIM22 , SPOCD1 , NRCAM , CNTN2 , PTPRD , POTED , IGSF3 , SLC24A2 , CTNND2 , AIF1L , TMEM229A , GLDN , and MOBP were down-regulated in the PCNSL tissues. Among them, CTNND2 , GLDN , NRCAM , and PTPRD were associated with cell adhesion. Conclusion: Up-regulated miR-432 expression is a novel biomarker for patients with PCNSL and may be associated with cell adhesion.
Molecular allergen sensitization of Aspergillus fumigatus in allergic bronchopulmonary aspergillosis in Guangzhou, Southern China
Authors: Luo Wenting , Hu Haisheng , Wu Zehong , Wei Nili , Huang Huimin , Zheng Peiyan , Sun Baoqing , Liu Yong
Published: March 2020

Background Few studies have assessed the sensitization of mycotic allergens and Aspergillus fumigatus molecular allergen. This study aimed to investigate the connection between A.fumigatus components and mycotic allergens between allergic bronchopulmonary aspergillosis (ABPA) patients and A. fumigatus (Af)-sensitized asthma. Methods Serum Penicillium chrysogenum , Cladosporium herbarum , Mucor racemosus , Candida albicans , Alternaria alternata , Helminthosporium halodes and A.fumigatus allergen components (Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6) sIgE level were measured via ImmunoCAP assay in 18 ABPA patients and 54 Af-sensitized asthma patients in Guangzhou city. Results 94.44% of ABPA patients and 87.04% of Af-sensitized asthma patients were co-sensitization to at least one another fungal allergen. The positivity rates of C. albicans ( P < 0.05) and A.alternata ( P < 0.05) were higher in ABPA than that in Af-sensitized asthma patients. The positive rates of Asp f 1 (88.89% vs 59.26%, P < 0.05), Asp f 2 (66.67% vs 33.33%, P < 0.05), Asp f 4 (61.11% vs 33.33%, P < 0.05), and Asp f 6 (66.67% vs 14.81%, P < 0.001) in ABPA were higher than those in Af-sensitized asthma patients. Patients with ABPA had higher IgE levels of Asp f 1 ( P < 0.05), Asp f 4 ( P < 0.05) and Asp f 6 ( P < 0.001) than those of Af-sensitized asthma patients. A.fumigatus was strongly correlated with C.herbarum ( r s = 0.688) in ABPA and A.alternata ( r s = 0.692) in Af-sensitized asthma patients. Optimal scale analysis was show that ABPA was more relevant to Af-components. (Cronbach`s alpha = 90.7%) Conclusion The A.fumigatus components and it`s connection with various mycotic allergens were different in ABPA and Af-sensitized asthma patients. This findings can expected to help local doctors in the diagnosis and immunotherapy of fungal allergies.
Microbial succession during the transition from active to inactive stages of deep-sea hydrothermal vent sulfide chimneys
Authors: Hou Jialin , Sievert Stefan M. , Wang Yinzhao , Seewald Jeff S. , Natarajan Vengadesh Perumal , Wang Fengping , Xiao Xiang
Published: March 2020

Background Deep-sea hydrothermal vents are highly productive, yet ephemeral biodiversity hotspots in the deep ocean supported by chemosynthetic microorganisms that play critical roles in the maintenance and development of these extreme ecosystems. While several studies have investigated the microbial diversity in both active and inactive sulfide chimneys that have been extinct for a long time, little is known about chimneys that ceased activity more recently as well as the microbial succession occurring during the transition from active to inactive chimneys. Results Genome-resolved metagenomics was applied to an active and a recently ceased (~7 years) sulfide chimney from the 9°50'N hydrothermal vent field on the East Pacific Rise. Full-length 16S rRNA gene and a total of 173 high quality metagenome assembled genomes (MAGs) were retrieved for comparative analysis. In the active chimney (EPR-L), sulfide- and/or hydrogen-oxidizing Campylobacteria and Aquificae with the potential for denitrification were identified as the dominant community members and primary producers, fixing carbon through the reductive tricarboxylic acid (rTCA) cycle. In contrast, the microbiome of the recently extinct chimney (EPR-M) was largely composed of heterotrophs from various bacterial phyla, including Delta -/ Beta -/ Alphaproteobacteria and Bacteroidetes . Gammaproteobacteria were identified as the main primary producers, using the oxidation of metal sulfides and/or iron oxidation coupled to nitrate reduction to fix carbon through the Calvin-Benson-Bassham (CBB) cycle. Further analysis revealed a phylogenetically distinct Nitrospirae cluster that has the potential to oxidize sulfide minerals coupled to oxygen and/or nitrite reduction, as well as for sulfate reduction, and that might serve as an indicator for the early stages of chimneys after venting has ceased. Conclusions This study shed light on the composition, metabolic functions, and succession of microbial communities in deep-sea hydrothermal vent chimneys. Collectively, microbial succession during the life span of a chimney could be described to go from a "fluid-shaped" microbial community in newly formed and actively venting chimneys to a "mineral-shaped" community after hydrothermal activity has ceased. Remarkably, the transition appears to happen early on, after which the communities stay stable for thousands of years.
Increased serum calpain activity is associated with HMGB1 levels in systemic sclerosis
Authors: Zheng Ji-Na , Li Yang , Yan Yue-Mei , Yu Yong , Shao Wen-Qi , Wang Qiang
Published: March 2020

Background Systemic sclerosis (SSc) or scleroderma is an intractable autoimmune disorder that affects multiple organs. The objectives were to investigate clinical correlations of serum calpain activity and high mobility group box 1 (HMGB1) levels with immunological and clinical traits. Methods A total of 31 patients with SSc, 20 age- and gender-matched healthy control subjects (HC) and 10 patients with other connective tissue diseases (CTD) were recruited in the study. We measured serum calpain activity and HMGB1 levels and analyzed the datasets (GSE40839, GSE48149, GSE76808, GSE81292 and GSE33463) from gene expression omnibus (GEO) database to explore potential mechanism by which calpain exerts its function through bioinformatics methods. Results Serum calpain activity was significantly increased in patients with SSc compared with those in HC and in patients with CTD and was correlated with serum HMGB1 levels, modified Rodnan skin score, erythrocyte sedimentation rate, mean platelet volume and plateletcrit. Notably, serum calpain activity and HMGB1 levels in SSc patients with interstitial lung disease (ILD) were significantly higher than that in SSc patients without ILD. Serum calpain activity and HMGB1 levels could be the independent risk factors for SSc-ILD and novel biomarkers in patients with SSc. Conclusion This is the first study that reports increased serum calpain activity and the correlation between calpain and HMGB1 in patients with SSc or SSc-ILD. The serum calpain activity and HMGB1 levels may serve as measures of ILD in patients with SSc. Also, calpain and HMGB1 could be potentially therapeutic targets for patients with SSc or SSc-ILD in the future.
Calcium supplementation prolongs the time of hospitalization and has a double effect on mortality in septic patients: A retrospective study from MIMIC-III
Authors: He Wencheng , An Youzhong , Huang Lei , Luo Hua , Chen Jingying , Li Weijia , Zhang Yiming , Zhang Weixing
Published: March 2020

Background Hypocalcemia is a common electrolyte disturbance in sepsis, calcium administration in those patients remains a controversial issue. The aim of this study was to assess the association of calcium supplementation with the time of hospitalization and mortality in septic patients. Method 5761 eligible septic patients, including 2689 with calcium supplementation and 3072 without calcium supplementation, were extracted from the MIMIC-III database. A total of 1463 pair patients were included in the analysis after propensity score matching according to the age, sex, SOFA score and lactate on first ICU admission. We compared the length of stay (LOS) in the intensive care unit (ICU) and hospital, as well as the 28-day and hospital mortality, which stratified the analysis according to the Sequential Organ Failure Assessment (SOFA) score, and the iCa on the first ICU admission between the matched groups. Results The results showed that either a too-low or a too-high iCa increased the risk for septic patients, but the minimum of the mortality curve in the non-calcium supplement group was locally in the mild hypocalcemia range. Regardless of the SOFA score and iCa, the LOS in both the ICU and hospital were higher in the calcium supplement group than in the non-calcium supplement group. Overall, the 28-day and hospital mortality were greater but not statistically significant in the calcium supplement group than in the non-calcium supplement group (14.83% vs 13.39%, p=0.416; 16.20% vs 13.88%, p=0.079, respectively). However, the survival analysis stratified by SOFA score showed that calcium supplementation reduced mortality when the patient’s SOFA score was >8 (p=0.028), while it worsen the outcome when the SOFA score was ≤4 (p<0.001) and had no significant effect with SOFA scores from 5~8 (p=0.556). Conclusion Our findings suggest that mild hypocalcemia may be protective in septic patients and that calcium supplementation may prolong hospitalization and have a double effect on mortality. The SOFA score may be a valuable clinical index for calcium administration decision making.
Procalcitonin, a Biomarker for Diagnosing and Differentiating Infection among Liver Transplant Recipients: a systematic review and meta-analysis
Authors: Dong Wei , Wan Ding-yuan , Zhong Xi , Luo Xin-yao , Wu Yu-meng , Guo Jun , Fu Min , Zhang Zhong-wei
Published: March 2020

Background Infection has long been the major cause for death after liver transplantation. Diagnosing this deadly disease in time can be of great help to support the patients in intensive care units. However, tests like blood culture would take too much time to generate an outcome. Procalcitonin seems to be a promising biomarker in such clinical settings these days. To evaluate its diagnostic value as a biomarker in identifying and differentiating infectious complications in liver transplant recipients. Methods PUBMED, Scopus, Web of Science, Cochrane Library were searched for articles published from January 1990 to September 2019 without language limitation. Cohort or case-control study investigating the value of PCT in distinguishing postoperative infectious complications among liver transplant recipients were included, followed by measurement using QUADAS-2 tool to estimate the risk of bias of each study. Bivariate approach and random-effects model were performed to generate the pooled outcomes. Results 8 studies (studying 560 liver transplant recipients) from 6 populations were reviewed and included, one of which is later excluded due to huge heterogeneity it caused. No significant threshold effect was found, suggesting that heterogeneity returned by the I 2 was not due the various cutoff values. The pooled DOR was 18.65 (95%CI 9.85-35.31) and the area under HSROC was 0.857 ( θ =-0.024; β =-0.203). The positive likelihood ratio and negative likelihood ratio are 3.472 (95% 2.352-5.127) and 0.289 (95% 0.192-0.434). Conclusion Current articles suggest a reasonable diagnostic value for the procalcitonin test in identifying infectious complications among patients undergoing liver transplantation. However, the reason why no threshold effect was found remained explored.
Modified pedicle screw-rod versus anterior subcutaneous internal pelvic fixation for unstable pelvic anterior ring fracture: A retrospective study and finite element analysis
Authors: Ding Sheng-Long , Chen Fan-Cheng , Huang Jun-Ming , Zhang Guang-Ming , Wang Fu-Yong , Lei Jing-Hui , Wu Xiao-Tian , Ruan Zhi-yong
Published: March 2020

Objectives: This study compared the stability and clinical outcomes of modified pedicle screw-rod fixation (MPSRF) and anterior subcutaneous internal pelvic fixation (INFIX) for the treatment of anterior pelvic ring fractures. Methods: In a retrospective review of a consecutive patient series conducted in a level 1 trauma university hospital, 63 patients with Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B or C pelvic ring fractures were treated by MPRSF (n=30) or INFIX (n=33). The mean follow-up was 20 months. The main outcome measure was the incidence of complications and adverse outcomes, and fixation stability was evaluated by finite element analysis (FEA). Results: The 2 groups did not differ in terms of injury severity score, OTA classification, cause of injury, and time to pelvic surgery (P>0.05). However, the MPSRF group had a higher satisfactory rate according to the Tornetta and Matta grading system than the INFIX group (73.33% vs 63.63%) as well as a higher Majeed score (81.5±10.4 vs 76.3±11.2), which was statistically significant at 6 months’ post-surgery (P<0.001). FEA showed that MPRSF was stiffer and more stable than INFIX and had a lower risk of implant failure. Conclusions: Both MPSRF and INFIX have acceptable biomechanical stability for the treatment of unstable pelvic anterior ring fractures. However, MPRSF has better fixation stability and lower risk of implant failure, which can lead to better clinical outcomes.
Protocol for the development and validation of a risk prediction model for stillbirths from 35 weeks gestation in Australia
Authors: Sexton Jessica , Coory Michael , Kumar Sailesh , Smith Gordon , Gordon Adrienne , Chambers Georgina , Pereira Gavin , Raynes-Greenow Camille , Hilder Lisa , Middleton Philippa , Bowman Anneka , Lieske Scott , Warrilow Kara , Ellwood David , Flenady Vicki
Published: March 2020

Background Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform decision-making around timing of birth to reduce the risk of stillbirth from 35 weeks gestation. Methods This is a protocol for a retrospective cohort study of all late-pregnancy births in Australia (1998-2015) from 35 weeks gestation including 7,200 stillbirths among 4.9 million births at an estimated rate of 1.47 stillbirths per 1000 live births. A multivariable logistic regression model will be developed in line with current T ransparent R eporting of a multivariable prediction model for I ndividual P rognosis or D iagnosis (TRIPOD) guidelines to estimate the gestation-specific probability of stillbirth with prediction intervals. Candidate predictors were identified from systematic reviews and clinical consultation and will be assessed through univariate regression analysis. To generate a final model, elimination by backward stepwise logistic regression will be performed. The model will be internally validated using K-fold cross-validation and externally validated using a geographically unique dataset. Overall model performance will be assessed with R 2 in addition calibration and discrimination. Calibration will be visualized using a calibration plot. Discrimination will be measured by the C- statistic and visualized using area underneath the receiver-operator curves (AUROC). Clinical usefulness will be reported as positive and negative predictive values and a decision curve analysis will be considered. Discussion A robust method to predict a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform timely, appropriate care to reduce stillbirth. Among existing prediction models designed for obstetric use, few have been subject to internal and external validation and many fail to meet recommended reporting standards. In developing a risk prediction model for late-gestation stillbirth with both providers and pregnant women in mind, we endeavor to develop a validated model for clinical use in Australia that meets current reporting standards.
Occupational injuries, daily workload, and fitness levels among fitness and swimming instructors.
Authors: Bonato Matteo , Merati Giampiero , Agnello Luca , Grevers Dorothée , Maggioni Martina Anna
Published: March 2020

Introduction: Few data has been published on injury risk among fitness instructors, especially regarding those who are expected to continuously practice while teaching. As the number of fitness instructors is increasing, new specific information about their possible injuries, daily workload, and fitness levels is needed. Objectives: The aim of this study was to assess occupational injuries, cardiorespiratory fitness, and daily workload of fitness (FI) and swimming instructors (SI). Methods. An online survey addressing occupational injuries was conduct among 435 FI (n=256) and SI (n=179). In a subgroup, cardiorespiratory fitness level was evaluated using maximal oxygen consumption ( O 2max ) as in indicator. Daily workload was monitored by heart rate (HR) and perception of fatigue. Results. Of the two groups, FI exhibited a higher incidence of musculoskeletal injuries and SI experienced more upper respiratory tract infections. O 2max ranged from 47.0±4.0 to 51.9±3.7 ml·kg -1 ·min -1 , and was similar between FI and SI. Regarding the daily workload, female SI had significantly higher HR mean and HR mean /HR max compared to female FI, but no significant differences between male FI and SI were found. No significant differences were observed between the perceived fatigue of FI and SI. Conclusions. Preventive strategies for the reduction of occupational injuries in FI and SI are needed.
Spinal Cerebrospinal Fluid Leak in the context of Pars Interarticularis Fracture: A Case Series
Authors: Chan Tommy Lik Hang , Cowan Robert , Hindiyeh Nada , Hashmi Syed , Lanzman Bryan , Carroll Ian
Published: March 2020

Introduction: Spinal Cerebrospinal fluid (CSF) leak can lead to intracranial hypotension and is an important differential diagnosis to consider in patients with sudden-onset chronic daily headaches. Pars interarticularis (PI) fracture is a potential rare cause of suspected spinal CSF leak.

Methods: This is a retrospective case series of 6 patients with suspected spinal CSF leak evaluated between January 2016 and September 2019. All patients received a magnetic resonance imaging (MRI) of the brain with and without gadolinium, MRI whole spine and full spine computed tomography (CT) myelogram. Targeted epidural patches with fibrin sealant were performed. Treatment response at return visit (3 months post patch) was documented.

Results: Six patients (4 females, 2 males) were diagnosed with a suspected spinal CSF leak and PI fracture. Mean age at the time of headache onset was 39 years old, and a range from 32 to 50 years old. Mean time to targeted epidural patches with fibrin sealant was 4.5 years. All 6 patients had PI fractures identified on CT myelogram and received targeted epidural patches with fibrin sealant at the site of the PI fracture. All patients had significant improvement in their headache intensity.

Conclusion: Our study highlights: 1) the importance of PI fracture as a possible culprit of suspected spinal CSF leak in patients with intracranial hypotension; 2) the added benefit of CT imaging for detecting bony abnormalities such as fractures in patients with intracranial hypotension; and 3) the successful treatment of suspected spinal CSF leak when targeting the fracture site.
Efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke: A multicenter, randomized, double-blind, placebo-controlled trial
Authors: Ni Jun , Chen Huisheng , Chen Guofang , Ji Yong , Yi Fei , Zhang Zhuobo , Yang Yi , Wu Jin , Cai Xueli , Shao Bei , Wang Jianfeng , Liu Yafang , Geng Deqin , Qu Xinhui , Li Xiaohong , Wei Yan , Ding Jianping , Lu Hua , Huang Yining , Huang Yonghua , Xiao Bo , Gong Tao , Cui Liying
Published: March 2020

Background: Ischemic stroke is a leading cause of morbidity and mortality. Thrombolytic therapy improves disability and survival rates; however, to be effective, it must be given within 4.5 hours of onset. Moreover, thrombolytic therapy is frequently contraindicated. Therefore, alternative therapeutic options are required. In China, cinepazide maleate injection has been shown to improve the cerebral collateral circulation and further reduce disability in stroke patients; however, very few studies investigating this therapy have been conducted to date. Therefore, this study aimed to further confirm the efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke were administered an intravenous infusion of 320 mg cinepazide maleate or placebo once daily for 14 days. All patients were also administered basic therapy (citicoline sodium). The primary efficacy endpoint was the proportion of patients with a modified Rankin scale (mRS) ≤2 on day 90. Secondary efficacy endpoints included Barthel Index ≥95. Safety was evaluated by recording all adverse events (AEs), monitoring laboratory parameters and vital signs, and electrocardiogram. Results: In total, 937 patients with an acute ischemic stroke were included, with a mean (standard deviation, SD) National Institutes of Health Stroke Scale score of 8.8 (2.4) and a mean (SD) stroke onset of 30.9 (11.4) hours prior. Following treatment for 90 days, the proportion of patients with an mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group (60.9% vs. 50.1%; p=0.0004). Moreover, the proportion of patients with a Barthel Index of ≥95 on day 90 was also significantly higher in the cinepazide maleate group than in the control group (53.4% vs. 46.7%; p=0.0230). There were no statistically significant differences in safety parameters between the cinepazide maleate and control groups. Conclusions: The results of this study show that cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery in patients with acute ischemic stroke. Cinepazide maleate injection was safe and well tolerated with no unexpected AEs reported.
Cigarette smoking is associated with abnormal ferroptosis in human sperm
Authors: Ou Zhanhui , Wen Qirong , Deng Yu , Yu Yang , Chen Zhiheng , Sun Ling
Published: March 2020

Purpose The effects of cigarette smoking on male semen quality are controversial, and the molecular mechanisms underlying how cigarette smoking affects semen quality are not clear yet. Methods In this study, semen samples from 70 heavy smokers and 75 non-smokers receiving infertility treatment were included. Basic semen parameters in non-smokers and heavy smokers were evaluated. Levels of ferroptosis glutathione (GSH), lipid reactive oxygen species (ROS), iron and GSH-dependent peroxidase 4 (GPX4) protein level) were observed in human semen and in GC-2 Spd cells exposed to cigarette smoke condensate (CSC). Results Heavy smokers had significantly higher abnormalities (sperm viability and sperm progressive motility) than non-smoking counterparts. Comparing non-smokers group, GSH level was reduced in the group of heavy smokers (P<0.05). However, the level of lipid ROS and iron were significantly increased (P<0.05). Besides, GSH level was reduced following treatment with CSC for 24 h, while lipid ROS and iron levels were increased (P<0.05). However, the levels were reduced after being co-cultured with Ferrostatin-1 (Fer-1) (P<0.05). The level of GPX4 protein was reduced after being treated with CSC in 24 h, and increased after being co-cultured with Fer-1(P<0.05). Conclusion Cigarette smoking is associated with abnormalities of ferroptosis in human sperm.
Determinants of dehydration status and associated risk factors of cholera outbreak in Oromia, Ethiopia
Authors: Ali Endale Alemayehu , Tilahun Tsigereda , Mebrate Eshetu
Published: March 2020

Introductions: Cholera is a diarrheal disease caused by infection of the intestine with the gram-negative bacteria Vibrio cholera. According to updated global burden of cholera estimate 2018 in Ethiopia 68,805,272 populations are at risk of cholera with incidence rate of 4 per 1000 population and case fatality of 3.8% estimated annual number of cases 275,221.Methods: The main objective of this study is to identify the significant risk factors of dehydration status of cholera outbreak in Oromia regional state of Ethiopia. Ordinal logistic regression was used to model the data by incorporating the assumption behind this novel model. Results: The results of the study indicated that of the total 965 cholera patients, most of them 560(58%) were severely dehydrated by cholera. The overall goodness of model (p-valu=0.07) shows that the model fits the data well. Besides, the proportional odds assumption also revealed that the slop coefficients in the model are the same across dehydration status (p-value=0.094). For those have history of travel, the odds of severely dehydrated versus the combined some dehydrated and no dehydrated was exp(1.133804)=3.11 times higher than those have no history of travel (p-value<0.01). All the other factors like history of contact with other patients, other sick patients in the family, Intravenous and Antibiotics drugs are statistically significant with 5% level of significance to determine the status of dehydration. Conclusions: The ordinal logistic regression was fitted the data well and most of the included factors were significant for the dehydration status of cholera outbreak.
Effects Of Virtual Reality Associated With Serious Games For Upper Limb Rehabilitation In Patients With Multiple Sclerosis: A Randomized Controlled Trial
Authors: Cuesta-Gómez Alicia , Baeza Patricia Sanchez-Herrera , Oña-Simbaña Edwin Daniel , Martínez-Medina Alicia , Ortiz-Comino Carmen , de Quirós Carlos Balaguer-Bernaldo , Jardón-Huete Alberto , Cuerda Roberto Cano-de la
Published: March 2020

Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance.Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of one month without receiving any treatment.Results: In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.
Relationship of para- and perirenal fat and high-density lipoprotein and its function in patients with type 2 diabetes mellitus
Authors: Ke Jing , Wang Yan , Liu Simo , Li Kun , Xu YueChao , Yang Longyan , Zhao Dong
Published: March 2020

Background Para- and perirenal fat is a fat pad surrounding the kidneys. Recent researches have showed the association between para- and perirenal fat and cardiovascular diseases including atherosclerosis, hypertension and so on. Limited studies have explored the relation between para- and perirenal fat and serum high density lipoprotein (HDL) level, but the results were inconsistent. We aimed to assess the relationship between para-perirenal ultrasonographic fat thickness and serum HDL level and cholesterol efflux capacity of HDL in patients with type 2 diabetes mellitus (T2DM). Methods We recruited 58 subjects with T2DM and collected anthropometric indices including height, weight, waist circumference and so on. Para-perirenal ultrasonographic fat thickness (PUFT) was measured via ultrasound. Serum lipid profile and other metabolic indices were determined as well. Then we analyzed the relationship between PUFT and HDL level and cholesterol efflux capacity in all patients and subgroups divided by gender and body mass index (BMI). Results Patients with higher PUFT have lower serum HDL level but increased cholesterol efflux capacity of HDL. Further analysis showed that PUFT negatively correlated with serum HDL level in all patients, with no difference in group divided by BMI. While subgroup analysis divided by gender indicated that the relationship only existed in males. In addition, PUFT was positively correlated with cholesterol efflux capacity in all patients. However, subgroup analysis showed that PUFT did not significantly correlated with cholesterol efflux capacity in males and BMI ≥28kg/m 2 . Multiple stepwise regression analysis showed an independent association of PUFT and serum HDL level and cholesterol efflux capacity. Conclusions PUFT is closely correlated with serum HDL level and cholesterol efflux capacity in patients with T2DM.
Age-specific associations of blood pressure variability with cardiovascular disease and mortality: 10-year Diabetes cohort study
Authors: WAN Eric Yuk Fai , Yu Esther Yee Tak , Chin Weng Yee , Barrett Jessica K. , Wong Ian Chi Kei , Chan Esther Wai Yin , Chui Celine Sze Ling , Chen Shiqi , Lam Cindy Lo Kuen
Published: March 2020

Background: This study evaluated the age-specific association of systolic blood pressure variability with cardiovascular disease and mortality in Type-2 diabetic patients. The detrimental effects of increased systolic blood pressure variability on cardiovascular disease and mortality risk in diabetic patients remains unclear. Methods: A retrospective cohort study investigated 155,982 diabetic patients aged from 45 to 84 years old without prior history of cardiovascular disease at baseline from 2008 to 2010). systolic blood pressure variability was estimated using systolic blood pressure standard deviation from mixed effects model to reduce regression dilution bias. Age-specific associations (45-54; 55-64; 65-74; 75-84 years) between systolic blood pressure variability, cardiovascular disease and mortality risk were assessed by Cox regression adjusted for patient characteristics with subgroups stratified by subject baseline characteristics. Results: After a median follow-up of 9.7 years (16.4 million person-years), 49,816 events (including 34,039 events with and 29,211 mortalities) were identified. Elevated and independent systolic blood pressure variability was positively and log-linearly associated with higher risk on cardiovascular disease and mortality among all age groups, without evidence of a specific threshold. The cardiovascular disease and mortality risk per 5mmHg increase in systolic blood pressure variability within 45-54 years age group is over three times higher than the 70-79 years age group [Hazard Ratio: 1.66 (1.49, 1.85) vs. Hazard Ratio: 1.19 (1.15, 1.23)]. The significant associations remained consistent among all subgroups. Patients with younger age, lower systolic blood pressure and comorbidity with more types of anti-hypertensive prescription drug users had higher hazard ratios. Conclusions: The findings suggest that systolic blood pressure variability was strongly associated with cardiovascular disease and mortality risk without evidence of a specific threshold in diabetic population. In addition to optimize blood pressure control, the systolic blood pressure variability particularly for younger patients should be monitored and evaluated in routine practice.
Impact of plasma omentin levels on glucose metabolic disorders and early stage of endothelial dysfunction in elderly patients
Authors: YE DONG DONG , Liang Wei , Su Zhengjia , Pan Wenqi
Published: March 2020

Background: Diabetes-induced endothelial dysfunction is a critical and initiating factor in the genesis of diabetic vascular complications. Omentin exerts direct influence on glucose metabolic disorders and vascular dysfunction. But the association between omentin and cardiovascular events reported by recent studies are paradoxical. Thus, we intend to investigate the relationship between omentin and vascular function in patients with different glucose metabolism states.Methods: A total of 162 elderly patients were stratified into three groups by the status of glucose tolerance test [normal glucose tolerance (NGT), impaired glucose regulation (IGR), type 2 diabetes mellitus (T2DM)]. All participants underwent complete clinical work-up. Fasting blood samples were collected for biochemical measurement. Circulating omentin, adiponectin, interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) levels were detected by enzyme-linked immunosorbent assays. Endothelial and vascular smooth muscle function were evaluated by flow-mediated dilatation (FMD) and nitrate-mediated dilation test (NMD) respectively.Results: Circulating omentin levels were lower in IGR group compared with NGT and were lowest in individuals with T2DM group (P=0.004). FMD has a significant and negative association with systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), fasting insulin and interleukin-6 (IL-6), while have a positive relationship with log (omentin) by bivariate correlation analysis in all subjects. After adjusting for traditional cardiovascular factors, log (omentin) was independent related factor that influenced FMD (β=-0.346，P=0.01) in IGR subjects, but not in the subgroups NGT and T2DM.Conclusions: A decreased omentin levels had been suggested to be a biomarker of glucose metabolic disorders and potentially cardiovascular risk. Higher circulating omentin level are independent determining factors for endothelial dysfunction in impaired glucose regulation (IGR) subjects suggesting and may be a compensatory mechanism for early diabetic vascular injury. which suggest omentin may act as potential markers for assessing endothelial dysfunction and identifying high risk of cardiovascular complications among asymptomatic prediabetic individuals.
Minocycline-Modified Pure Titanium Has Good Antibacterial Properties and Improves the Osteogenesis of Bone Marrow Stem Cells
Authors: Zhang Yancong , Dou Linbo , Zhang Fenghe
Published: March 2020

Background : The development of an ideal implant material with appropriate antibacterial properties and that improves osteogenesis is essential for the guidance of new bone formation in orthopedic and tooth implant surgeries. In this study, we developed minocycline-modified pure titanium. Methods: We exploited the chemistry of polydopamine (PD) for the coating of minocycline. PD was coated on pure titanium, on which minocycline was subsequently immobilized under certain conditions. Minocycline coating was verified by characterizing the surface chemical composition of the coated Ti sheet and was quantitatively measured by fluorescamine assay. Results: The minocycline-coated pure titanium showed a lower bacterial adhesion rate and supported the spread of the osteogenesis differentiation of human mesenchymal stem cells (hMSCs). A remarkable increase in alkaline phosphatase activity and calcium deposition was found when hMSCs were cultured on minocycline-coated pure titanium for 28 days. Conclusions: The minocycline-coated pure titanium may be optimized as clinically applicable bioactive materials for implant and bone materials.
Microbial symbiosis and coevolution of an entire clade of ancient vertebrates: the gut microbiota of sea turtles and its relationship to their phylogenetic history
Authors: Scheelings Titus , Moore Robert J. , Van Thi Thu Hao , Klaassen Marcel , Reina Richard D.
Published: March 2020

Background: The microbiota plays a critical role in host homeostasis and has been shown to be a major driving force in host evolution. However, our understanding of these important relationships is hampered by a lack of data for many species, and by significant gaps in sampling of the evolutionary tree. In this investigation we improve our understanding of the host-microbiome relationship by obtaining samples from all seven extant species of sea turtle, and correlate microbial compositions with host evolutionary history.Results: Our analysis shows that the predominate phyla in the microbiota of nesting sea turtles was Proteobacteria. We also demonstrate a strong relationship between the bacterial phyla SR1 and sea turtle phylogeny, and that sea turtle microbiotas have changed very slowly over time in accordance with their similarly slow phenotypic changes.Conclusions: This is one of the most comprehensive microbiota studies to have been performed in a single clade of animals and further improves our knowledge of how microbial populations have influenced vertebrate evolution.