bluuebunny/crossref_metadata_2025 huggingface dataset:
High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis
Authors: Abrar Daniel B. , Schleich Christoph , Nebelung Sven , Frenken Miriam , Radke Karl Ludger , Vordenbäumen Stefan , Brinks Ralph , Schneider Matthias , Ostendorf Benedikt , McGonagle Dennis , Sewerin Philipp
Published: February 2020

Background: To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel high resolution hand coil. Methods: Seventeen patients with active PsA, 20 patients with active RA and 16 healthy controls (HC) underwent high-resolution 3T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses Spearman rho correlation was calculated. Results: Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p<0.001) and HC (mean difference 0.2 mm, p<0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA: 4.7, p= 0.048; mean difference from HC: 14.65, p<0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis and periarticular inflammation (for second digit: synovitis ρ= 0.72, flexor tenosynovitis ρ= 0.7, overall PsAMRIS ρ= 0.72, p< 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ= 0.49, flexor tenosynovitis ρ= 0.49, periarticular inflammation ρ= 0.4). Conclusion: The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC. Trial registration: 2014123117, December 2014.
Understanding implementation barriers in the national scale-up of Differentiated ART delivery in Uganda
Authors: ZAKUMUMPA HENRY , Rujumba Joseph , Kwiringira Japheth , Katureebe Cordelia , Spicer Neil
Published: February 2020

Background: Although Differentiated Service Delivery (DSD) for anti-retroviral therapy (ART) has been rolled-out nationally in several countries since World Health Organization (WHO)’s landmark 2016 guidelines, there is little research evaluating post-implementation outcomes. The objective of this study was to explore patients’ and HIV service managers’ perspectives on barriers to implementation of Differentiated ART service delivery in Uganda.Methods: We employed a qualitative descriptive design involving 124 participants. Between April and June 2019 we conducted 76 qualitative interviews with national-level HIV program managers (n=18), District Health Team leaders (n=24), representatives of PEPFAR implementing organizations (11), ART clinic in-charges (23) in six purposively selected Uganda districts with a high HIV burden (Kampala, Luwero, Wakiso, Mbale, Budadiri, Bulambuli). Six focus group discussions (48 participants) were held with patients enrolled in DSD models in case-study districts. Data were analyzed by thematic approach as guided by a multi-level analytical framework: Individual-level factors; Health-system factors; Community factors; and Context.Results: Our data shows that multiple barriers have been encountered in DSD implementation. Individual-level: Individualized stigma and a fear of detachment from health facilities by stable patients enrolled in community-based models were reported as bottlenecks. Socio-economic status was reported to have an influence on patient selection of DSD models. Health-system: Insufficient training of health workers in DSD delivery and supply chain barriers to multi-month ART dispensing were identified as constraints. Patients perceived current selection of DSD models to be provider-intensive and not sufficiently patient-centred. Community: Community-level stigma and insufficient funding to providers to fully operationalize community drug pick-up points were identified as limitations. Context: Frequent changes in physical addresses among urban clients were reported to impede the running of patient groups of rotating ART refill pick-ups. Conclusion: This is one of the first multi-stakeholder evaluations of national DSD implementation in Uganda since initial roll-out in 2017. Multi-level interventions are needed to accelerate further DSD implementation in Uganda from demand-side (addressing HIV-related stigma, community engagement) and supply-side dimensions (strengthening ART supply chain capacities, increasing funding for community models and further DSD program design to improve patient-centeredness).
PTH Derivative Promotes Chronic Wound Healing via Synergistic Multicellular Stimulating and Exosomal Activities
Authors: Shen Yi-Fan , Huang Jing-Huan , Wang Kai-Yang , Zheng Jin , Cai Lin , Gao Hong , Li Xiao-Lin , Li Jing-Feng
Published: February 2020

Background: Chronic diabetic wounds are a disturbing and rapidly growing clinical problem. Parathyroid hormone related peptide (PTHrP-2) was assumed as multifunctional factor in angiogenesis, fibrogenesis and re-epithelization. This study aims to test PTHrP-2 efficiency and mechanism in chronic wound healing. Methods: Through repair phenomenon in vivo some problems were detected, and further research on their mechanisms was made. In vivo therapeutic effects of PTHrP-2 was determined by HE, Masson, microfil and immunohistochemical staining. In vitro direct effects of PTHrP-2 was determined by proliferation, migration, Vascular Endothelial Grown Factor and collagen I secretion of cells and Akt/ Erk1/2 pathway change. In vitro indirect effects of PTHrP-2 was study via exosomes. Exosomes from PTHrP-2 untreated and treated HUVECs and HFF-1 cells were insolated and identified. Exosomes were co-cultured with original cells, HUVECs or HFF-1 cells, and epithelial cells. Proliferation and migration and pathway change were observed. PTHrP-2-HUVEC-Exos was added into in vivo wound to testify its hub role in PTHrP-2 indirect effects in wound healing. Results: In vivo, PTHrP-2 exerted multifunctional pro-angiogenesis, pro-firbogenesis and re-epithelization effects. In vitro, PTHrP-2 promoted proliferation and migration of endothelial and fibroblast cells, but had no effect on epithelial cells. Therefore, we tested PTHrP-2 indirect effects via exosomes. PTHrP-2 intensified intercellular communication between endothelial cells and fibroblasts and initiated endothelial-epithelial intercellular communication. PTHrP-2-HUVEC-Exos played hub role in PTHrP-2 indirect effects in wound healing. Conclusion: The findings of this study indicate that PTHrP-2, a multifunctional factor, can promote chronic wound healing via synergistic multicellular stimulating and exosomal activities.
Age- and gender-specific trends in respiratory outpatient visits and diagnoses at a tertiary pediatric hospital in China: a 10-year retrospective study
Authors: Shi Peng , Zhang Xiaobo , Liu Lijuan , Tang Liangfeng , Li Jing , Wang Libo , Li Albert M. , Cao Yang , Xu Hong , Huang Guoying
Published: February 2020

Background: Respiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported. However, data on trends of respiratory diseases over long period of time is limited. This study aimed to determine the trends of respiratory disease outpatient visits (ROVs) and diagnoses (RODs) in one of the largest children’s teaching hospitals in China between 2009 and 2018.

Methods: A retrospective study based on routine administrative data was designed and implemented according to the RECORD statement. Demographic details and diagnoses of the outpatients <18 years visiting the respiratory department of the hospital were extracted from the Hospital Information System. Age- and gender-specific trends were illustrated by calculating average annual growth rate (AAGR) for ROVs and comparing change of proportion for different RODs over time.

Results: There were 698054 ROVs from 285574 children (40.4% female). AAGR of ROVs was 15.2%. Children aged 4 to < 7 years had a faster increase than other age groups. Bronchitis (27.6%), pneumonia (18.5%), pneumonia affecting other systems (18.4%), asthma and status asthmaticus (10.7%), and vasomotor and allergic rhinitis (9.2%) accounted for 84.4% of all RODs. The proportion of bronchitis decreased across years, with the concomitant increasing trend in the proportion of pneumonia. Age-specific trend in diagnoses showed greater proportion of asthma in all visits for the children aged 7 to < 18 years than younger children. Gender-specific trend in diagnoses showed the proportion of asthma was greater for males but the AAGR was greater for females.

Conclusion: The persistent upward trend in ROVs was observed among children at different ages and a gender difference was also seen. In contrast to what has been reported, burden of asthma and allergies diseases continues to increase locally.
Information-Motivation-Behavioral Skills Model of Consistent Condom Use among Transgender Women in Shenyang, China
Authors: Wang Huwen , Chang Ruijie , Shen Qiuming , Tsamlag Lhakpa , Zhang Shuxian , Shi Yue , Ma Tiecheng , Wang Zixin , She Rui , Lau Joseph TF , Wang Ying , Cai Yong
Published: February 2020

Background: The Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, but not yet among transgender women (TGW). None effective interventions has been carried out among TGW so far to control their high prevalence of unprotected anal intercourse. The intent of the current study is to examine the application of the IMB model to clarifying the association between condom use correlates and condom use frequency among TGW in China.
Methods: Using snowball sampling, we recruited 198 self-identified TGW in Shenyang, China from April 2017 to July 2017. Participants were required to complete a questionnaire assessing their background characteristics and IMB model constructs. Structural equation modeling (SEM) was conducted to demonstrate the utility of the IMB model.
Results: The consistent condom use (CCU) rate was 47.0%. Results of SEM indicated that HIV-preventive motivation (comprising condom use attitude and subjective norms; β = 0.823, P < 0.001) and behavioral skills (including condom use skills and self-efficacy; β = 0.979, P = 0.004) were related to more frequent condom use, whereas HIV knowledge was unrelated to condom use (β = 0.052, P = 0.540).
Conclusions: The low CCU rate suggested that TGW in China were at high risk of HIV infection and transmission and a key intervention population. HIV-preventive interventions for this population should focus on enhancing motivation and strengthening behavioral skills to increase condom use frequency and reduce HIV infection.
Ankle Joint Pressure Change in Varus Malalignment of the Tibia
Authors: Zhu Yuan , Li Xingchen , Xu Xiangyang
Published: February 2020

Background: Varus malalignment of the tibia could alter ankle biomechanics, and might lead to degenerative changes of the ankle joint. However, previous studies failed to report the detailed changes of ankle biomechanics in varus malalignment of the tibia. The aim of this biomechanical study was to evaluate how the ankle joint pressure would change in response to the incremental increases in varus malalignment of the tibia. Methods 8 fresh-frozen human cadaver legs were tested in this study. Varus malalignment of the tibia and a total of 600N compressive force was simulated using a custom made fixture. Intra-articular sensors (TeckScan) were inserted in the ankle joint to collect the ankle joint pressure data. The testing sequence was 0°, 2°,4°,6°,8°,10°,12°,14°,16°,18°,20° of tibial varus. Results As the tibial varus progressed, the center of force (COF) shifted laterally both for the medial and lateral aspect of the ankle joint. For the medial aspect of the ankle joint, the lateral shift reached its maximum at 8º [2.76 (1.62) mm, p=0.002] of tibial varus, while for the lateral aspect of the ankle joint, the lateral shift reached its maximum at 12º [2.11 (1.19) mm, p=0.002] of tibial varus. Thereafter, the COF shifted medially as the tibial varus progressed. For the lateral aspect of the ankle joint, The Pmean increased from 2103.8 (625.1) kPa at 0º to 2295.3 (589.7) kPa at 8º of tibial varus (p=0.047) , significant difference was found between the Pmean at 0º and 8º (p=0.047) of tibial varus. Then as the tibial varus progressed, the Pmean decreased to 1748.9 (467.2) kPa at 20º of tibial varus (p=0.002) . The lateral joint pressure ratio also increased from 0.481 (0.125) at 0º to 0.548 (0.108) at 10º of tibial varus (p=0.002) , then decreased to 0.517 (0.101) at 20º of tibial varus (p=0.002) . Conclusions For mild tibial varus deformities, there was a lateral shift of COF and lateral stress concentration within the ankle joint. However, as the tibial varus progressed, the COF shifted medially and the lateral stress concentration decreased.
Explanatory histological findings for urinary protein and serum creatinine levels at renal biopsy in lupus nephritis: A cross-sectional study
Authors: Katsuyama Eri , Miyawaki Yoshia , Sada Ken-ei , Asano Yosuke , Hayashi Keigo , Yamamura Yuriko , Hiramatsu-Asano Sumie , Morishita Michiko , Ohashi Keiji , Watanabe Haruki , Katsuyama Takayuki , Narazaki Mariko , Matsumoto Yoshinori , Wada Jun
Published: February 2020

Background To evaluate histological active and chronic lesions associated with proteinuria and serum creatinine (SCr) level as common clinical endpoints in many clinical trials for lupus nephritis (LN). Methods One hundred and nineteen patients from 1990 to 2015 with LN class III, IV, and V, as defined by the International Society of Nephrology/Renal Pathology Society classification, were enrolled. Multiple regression analysis was performed to explore semiquantitative histological variables related to urinary protein and SCr levels. Results The mean age of enrolled patients was 45 years and 79% were female. The mean SCr level was 0.87 mg/dl and mean urinary protein was 3.00 g/gCr at the time of the renal biopsy. Class IV (71%) was the most common type, followed by class III (17%) and class V (13%). Multicollinearity was confirmed between monocellular infiltration (variance inflation factor [VIF] = 10.22) and interstitial fibrosis (VIF = 10.29) and between karyorrhexis (VIF = 4.14) and fibrinoid necrosis (VIF = 4.29). After excluding fibrinoid necrosis and monocellular infiltration because of multicollinearity, only urinary protein level was correlated with wire loop (β−coefficient [β]: 1.09 and confidence interval [CI]: 0.35 to 1.83), and SCr level was correlated with glomerular sclerosis (β: 1.08 and CI: 0.43 to 1.74) by multiple regression analysis. Conclusion As urinary protein and SCr levels could not reflect active lesions quantitatively, they might be difficult to be evaluated for response to induction remission treatments in patients with LN.
Comparative study between Fenton and Intergrowth 21 charts in a sample of Lebanese premature babies
Authors: Samarani Marie , Restom Gianna , Mardini Joelle , Fares Georges Abi , Hallit Souheil , Khalife Marie-Claude Fadous
Published: February 2020

Background Different charts are used to assess premature growth. The Fenton chart, based on prenatal growth, has been used in the neonates’ intensive care unit (NICU) of the Notre Dame des Secours University Hospital to assess premature newborns’ development. Intergrowth21 is a new multidisciplinary, multiethnic growth chart better adapted to premature growth. Our objective was to compare both charts Fenton and Intergrowth21 in order to implement Intergrowth in our unit. Methods We analyzed 318 files of premature babies born who were admitted to the NICU from 2010 till 2017. Anthropometric data (weight, height and head circumference) converted to percentiles was filled on both charts from birth till 1 month of age. Results The results of the linear regression, taking the weight at birth as the dependent variable, showed that the Fenton scale (R2=0.391) would predict the weight at birth better than the Intergrowth 21 scale (R2=0.257). The same applies for height and cranial perimeter at birth when taken as dependent variables. When considering the weight and height at 2 weeks, the results showed that the Intergrowth 21 scale would predict those variables better than the Fenton scale, with higher R2 values higher in favor of the Intergrowth 21 scale for both weight (0.384 vs 0.311) and height (0.650 vs 0.585). At 4 weeks, the results showed that the Fenton scale would predict weight (R2=0.655 vs 0.631) and height (R2=0.710 vs 0.643) better than the Intergrowth 21 scale. The results obtained were adjusted over the newborns’ sociodemographic and clinical factors.
Exploring contraception myths and misconceptions among young men and women in Kwale County, Kenya
Authors: Mwaisaka Jefferson , Gonsalves Lianne , Thiongo Mary , Waithaka Michael , Sidha Hellen , Agwanda Alfred , Mukiira Carol , Gichangi Peter
Published: February 2020

Background: Myths and misconceptions around modern contraceptives have been associated with low contraceptive uptake. Nearly all the research on the link between contraceptives’ misconceptions and low contraceptive prevalence comes mostly from women with little focus on men. This qualitative study therefore sought to explore and understand both young men’s and young women’s knowledge of modern contraception and to identify key concerns regarding modern pregnancy prevention methods.Methods: We used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18-24 per FGD, one FGD had 8 participants.Results: Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions around contraception were discussed, they included jeopardizing future fertility, prolonged menstrual bleeding, problems conceiving, birth defects, promiscuity, against religion and perceived to be un-African including denying couples their sexual freedom. Compared to female respondents in the study, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. Results are presented under three key themes namely (i) Awareness of contraception (ii) Myths and misconceptions around contraception and (iii) Males’ contraceptive narratives. Conclusions : This study revealed a low level of contraceptive knowledge among young men and women in Kwale County, Kenya. Most respondents reported contraceptive fears and misconceptions resulting from critical gaps in Sexual and Reproductive Health knowledge. Improved sexual and reproductive health (SRH) literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may contribute to increased uptake of SRH services including modern contraceptive methods.
The incremental prognostic value of sIL-2R and HGF in acute ischemic stroke
Authors: Zhao Haiping , Li Fangfang , Huang Yuyou , Zhang Sijia , Li Lingzhi , Yang Zhenhong , Wang Rongliang , Tao Zhen , Han Ziping , Fan Junfen , Zheng Yangmin , Ma Qingfeng , Luo Yumin
Published: February 2020

Background: Inflammation affect long-term neurological outcome after acute ischemic stroke (AIS). Comprehensive and insightful understanding of correlation of inflammatory mediators and stroke outcome may offer new biomarkers or therapeutic approaches for AIS.
Methods: We collected plasma from 204 AIS patients and 76 healthy controls, and ten cytokines (HGF, IL-1β, IL-2, sIL-2R, IL-5, IL-10, IL-16, MIP-3α, CD40L and MMP1) screened out by Immune Monitoring 65-Plex Human ProcartaPlex Panel were measured. Functional outcome 3 months after stroke was assessed using the modified Rankin Scale. To assess the prognostic ability of inflammatory mediators, we applied multivariate logistic regression and construction of multimarker score.
Results: HGF, IL-10, IL-1β, MIP-3α, IL-2, sIL-2R, and IL-5 were significantly upregulated in AIS patients compared to controls. After multivariable adjustment, sIL-2R (OR, 1.138; 95% CI, 1.028-1.259; P=0.012) and HGF (OR, 1.121; 95% CI, 1.030-1.218; P=0.008) remained individually associated with unfavorable outcomes at 3 months after AIS (p < 0.05). Furthermore, adding sIL-2R and HGF to the conventional model significantly improved risk reclassification for unfavorable outcomes (continuous net reclassification improvement 32.18%, p < 0.001; integrated discrimination improvement 10.21%, p < 0.001).
Conclusions: Higher plasma sIL-2R was a new independent predictor of unfavorable outcomes in AIS, and incorporation of sIL-2R and HGF into the conventional model significantly improved risk stratification for unfavorable outcomes.
Subclavian steal syndrome without Stenosis: A Case Report and Review of the Literature
Authors: Lou Zhe , Jin Youhe , Yang Jun , Ma Chunyan , Li Qiaobei , Wang Xu
Published: February 2020

Background："Stealing" of the subclavian artery is a phenomenon where proximal subclavian artery stenosis or occlusion causes retrograde blood flow in the ipsilateral vertebral artery. This, combined with ischemic symptoms of vertebrobasilar arteries or ipsilateral upper limb artery, is called subclavian steal syndrome. Sometimes, subclavian steal syndrome can occur in patients without subclavian artery stenosis, such as in patients with high-flow arteriovenous dialysis fistulas or subclavian artery aneurysms. Interestingly, compared with classic atherosclerotic subclavian steal syndrome, the former patient is more prone to symptoms like paroxysmal vertigo, drop attacks, diplopia, and arm claudication. Case Presentation ： In our case, we present a 35-year-old male who suffered from paroxysmal vertigo. Clinical physical examination did not reveal any substantial evidence of proximal subclavian artery stenosis. Transcranial Doppler and ultrasonography revealed an abnormal blood flow pattern in the right vertebral artery, consistent with partial subclavian steal syndrome. Ultrasonography and computed tomography angiography showed no stenosis in the right subclavian artery and three aneurysms in the proximal segment. The hypoplastic vertebral artery originated from the third aneurysm. Conclusions ： There are few reports of subclavian steal syndrome caused by subclavian aneurysms in the literature; our case is the first to report partial subclavian steal syndrome caused by multiple aneurysms. Following a literature review, combined with our analysis of this case, we suggest that subclavian artery aneurysm which induced subclavian steal syndrome is an often unnoticed cause of vertigo.
Behavioral Profile, Lifestyle and Social Skills in Portuguese Adolescents
Authors: Magalhães Clarisse , Ribeiro Maria de Fátima , Esteves Maria Raquel , Aires Luísa , Lima Sara , Silva Gustavo , Nogueira Assunção , Herdeiro Maria Teresa , Pedras Susana
Published: February 2020

Background: Seventy percent of premature deaths in adults are due to behaviors initiated during adolescence. Therefore, it is essential to promote individual and social behaviors that educate adolescents in the ability to make healthy choices. Thus, the goals of this study were to characterize the lifestyle and social skills as well as to identify homogeneous subgroups in a sample of Portuguese adolescents. Methods : We conduct a cross-sectional study including 1008 adolescents attending 7 th to 9 th grade of five middle schools from Tâmega and Sousa region, of Portugal. My Lifestyle Questionnaire and the Social Skills Inventory were used. To establish a profile of the participants, a Cluster Analysis (K-means) was performed and the Jaccard coefficient was used to assess the stability of the solution found. Results: From the total sample, 556 adolescents with a mean age of 13.43 years (SD=1.1) were included in the analysis. The majority of the sample presented a good lifestyle (72.26% indicating good LS) and 50.7% of the adolescents had a highly elaborated repertoire of social skills. Moreover, three clusters were found. Cluster 1 (n=92) showed a less elaborate SS repertoire and was named the “Adjusted”. Cluster 2 (n=115) comprised adolescents with a good SS repertoire and was named the “Sociable”. Cluster 3 (n=258) was composed by adolescents with a highly elaborate SS repertoire and the best LS indicators, and was named the “Healthy”. Conclusions : The group of adolescents in cluster called “Sociable” needs to be included in health education and social skills programs. NUT and MS behaviors have low values and, therefore, present a greater need for awareness, sensitization and intervention in the school context. Promoting a healthy lifestyle should be part of the academic curriculum and be transversal to all academic disciplines.
Adjunct use of mouth rinses with a sonic toothbrush accelerates the detachment of a Streptococcus mutans biofilm: an in vitro study
Authors: Ohsumi Tatsuya , Takenaka Shoji , Sakaue Yuuki , Suzuki Yuki , Nagata Ryoko , Hasegawa Taisuke , Ohshima Hayato , Terao Yutaka , Noiri Yuichiro
Published: February 2020

Background : The aim of this in vitro study was to examine the possible enhancement of the biofilm peeling effect of a sonic toothbrush following the use of an antimicrobial mouth rinse.
Methods: The biofilm at a noncontact site in the interdental area was treated by sound wave convection with the test solution or by immersion in the solution. The biofilm peeling effect was evaluated by determining the bacterial counts and performing morphological observations. A Streptococcus mutans biofilm was allowed to develop on composite resin discs by cultivation with stirring at 50 rpm for 72 hours. The specimens were then placed in recesses located between plastic teeth and divided into an immersion group and a combination group. The immersion group was treated with phosphate buffer or Listerine ® mouth rinse. The combination group was treated with Listerine ® and a sonic toothbrush.
Results: The biofilm thickness was reduced by approximately one-half compared with the control group. The combination treatment produced a 1 log reduction in the number of bacteria compared to the Listerine ® immersion treatment. No significant difference was observed in the biofilm peeling effect of the immersion group compared to the control group.
Conclusions: The combined use of a sonic toothbrush and a mouth rinse enhanced the peeling of the biofilm that proliferates in places that are difficult to reach using mechanical stress.
Acceptability, motivation and the prospect of cure for people living with HIV and their healthcare providers in HIV cure-focused treatment interruption studies
Authors: Lau Jillian SY , Smith Miranda Z , Allan Brent , Martinez Cipriano , Power Jennifer , Lewin Sharon R , McMahon James H
Published: February 2020

Background Analytical treatment interruptions (ATI) are commonly used clinical endpoints to assess interventions aimed at curing HIV or achieving antiretroviral therapy (ART)-free HIV remission. Understanding the acceptability of ATI amongst people living with HIV (PLHIV) and their HIV healthcare providers (HHP) is limited. Methods Two online surveys for PLHIV and HHP assessed awareness and acceptability of ATI, and understanding of the prospect for HIV cure in the future. Responses were collected from July 2017-January 2018. A descriptive analysis was performed and similar questions across the two surveys were compared using χ squared test. Results 442 PLHIV and 144 HHP completed the survey. 105/400 (26%) PLHIV had ever interrupted ART, 8% of which were in a clinical trial. Altruistic motivations were drivers of participation of PLHIV in cure related research. 81/135 (60%) HHP would support their patients wishing to enrol in an HIV cure-focused trial, but fewer would promote and allow such participation (25% and 31% respectively). Compared to HHP, PLHIV were more likely to believe that an HIV cure would be achievable within 10 years (55% vs 19%, p<0.001), had less awareness of ATI (46% vs 62%,p<0.001) and were less likely to have had experience of either participation or enrolment in an ATI study (5% vs 18%,p<0.001) Conclusion PLHIV were more optimistic about the potential for HIV cure. HHP had more direct experience with HIV cure-focused studies. Educational strategies are required for both groups to increase understanding around ATIs in HIV cure research but should be tailored specifically to each group.
The Effect of Early Rehabilitation Intervention on Functional Outcome in Patients with Traumatic Brain Injury: A Systematic Review Protocol
Authors: khankeh Hamidreza , Eghbali Mohammad , Hosseini Sayed Ali , Rahimi-Movaghar Vafa
Published: February 2020

Introduction: Traumatic Brain Injury (TBI) is a serious health problem which is considered as a silent epidemic. Early rehabilitation interventions are among significant factors affecting the functional improvement, reduction of disability and impairment in patients. Initial observations indicate evidence for the effectiveness of such interventions; however, there is no related systematic review study conducted so far. The main objective of the present study is to investigate the prevalence of the interventions and to determine the effectiveness of such interventions on functional outcomes for patients with TBI. Methodology: In order to find related studies, several data bases such as Embase, Medline, Scopus, PubMed and Web of Science and also Gray Literature are observed. Inclusion and exclusion criteria are designed and modified by a team of experts. Observation of the content of the titles and abstracts will be done by two reviewers and then the data will be extracted and evaluated. All the studies published in English between 1990 and 2019 were included. Primary outcomes include the frequency of early rehabilitation interventions and the effects of such interventions on functional outcomes. If possible, meta-analysis will be conducted as well. Discussion: The results of this systematic review study will contribute to identification and clarification of different types of rehabilitation interventions and the effects of such interventions on TBI patients’ functional outcomes.
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis
Authors: Hoeve Jolanda C. van , Vernooij Robin W.M. , Fiander Michelle , Nieboer Peter , Siesling Sabine , Rotter Thomas
Published: February 2020

Background Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify, and synthesise existing literature on the effects of pathways in oncological care. Methods All patients diagnosed with cancer in primary and secondary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding “patient outcomes” and “costs” were extracted from each study. Results Out of 12,689 search results, we selected 158 articles eligible for full text assessment. The remaining 10 studies represented 4,786 patients. Most studies were conducted in secondary care. LOS was the most common used indicator for patients outcomes, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (WMD: -2.75, CI: -4.67–-0.83) and gynaecological cancer (WMD: -1.58, CI: -2.10–-1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary care regarding the positive effects of LOS in favour of cancer care pathways.
Computational Modelling of Nephron Progenitor Cell Movement and Aggregation During Kidney Organogenesis
Authors: Tikka Pauli , Mercker Moritz , Skovorodkin Ilya , Saarela Ulla , Vainio Seppo , Ronkainen Veli-Pekka , Sluka James P. , Glazier James A. , Marciniak-Czochra Anna , Schaefer Franz
Published: February 2020

During early kidney organogenesis, nephron progenitor (NP) cells move from the tip to the corner region of the ureteric bud (UB) branches in order to form the pretubular aggregate, the early structure giving rise to nephron formation. Chemotaxis and cell-cell adhesion differences are believed to drive cell patterning during this critical period of organogenesis, but the spatiotemporal organization of this process is incompletely understood.
We applied a Cellular Potts model to explore to how these processes contribute to directed cell movement and aggregation. Model parameters were estimated based on fitting to experimental data obtained in ex vivo kidney explant and dissociation-reaggregation organoid culture studies.
Our simulations indicated that optimal enrichment and aggregation of NP cells in the UB corner niche requires chemoattractant secretion from both the UB epithelial cells and the NP cells themselves, as well as differences in cell-cell adhesion energies. Furthermore, NP cells were observed, both experimentally and by modelling, to move at higher speed in the UB corner as compared to the tip region where they originated. The existence of different cell speed domains along the UB was confirmed using self-organizing map analysis.
In summary, we demonstrated the suitability of a Cellular Potts Model approach to simulate cell movement and patterning during early nephrogenesis. Further refinement of the model should allow us to recapitulate the effects of developmental changes of cell phenotypes and molecular crosstalk during organ development.
The Role of Parental Mediation, Mental Health, High-Risk Behaviors, and Cyberspace Activities in Internet Addiction: A Cross-Sectional Study
Authors: Dasteaee Shekoofeh Mottaghi , Koohestani Fahimeh , Sorbi Mohammad Hossein
Published: February 2020

Background: Today, the Internet provides an important tool to access information and opportunities for learning and entertainment, but its use is not without potential risks. This study investigates the relationship between parental mediation, mental health, high-risk behaviors, and cyberspace activities in Iranian adolescent Internet addiction. Methods: This was a cross-sectional study that lasted from January 10 to June 14, 2019. The sample consisted of 300 high school students aged 14-17 years in Kerman, Iran. Cluster sampling method was used to collect data. Data were analyzed using SPSS-21 software. Results: The prevalence of internet addiction disorder in adolescents was 51.7% (girls=26.7% and boys=25%). Chi-square results showed a significant negative relationship between mother's job and internet addiction (p<0.016). The t-test result showed that the role of mediate active parental immunity was more in people with Internet addiction and they experienced more online activities, cyberbullying victimization, substance use, and depression, whereas the role of restrictive mediation, parental attachment and self-esteem were higher in people without internet addiction. Logistic regression showed that variables of online activities OR=1.21 (95% CI: 1.12-1.3), cyberbullying victimization OR=1.18 (95% CI: 1.04-1.34) and depression OR=1.05 (95% CI: 0.99-1.09) had positive effect on Internet addiction, and self-esteem OR=0.92 (95% CI: 0.86-0.97) and restrictive parental mediation OR=0.89 (95% CI: 0.83-0.97) had negative effect (p<0.05). Conclusions : The prevalence rate of internet addiction in Iranian adolescents is high which important factors such as inappropriate parental mediation, psychological weakness (such as low self-esteem and depression), high levels of cyber activities, and cyberbullying victimization are considered as important factors to predict this disorder. Keywords: internet addiction, parental mediation, attachment, depression, self-esteem
The predictive value of lncRNA MIR31HG expression on clinical outcomes in patients with solid malignant tumors
Authors: Tu Chao , Ren Xiaolei , He Jieyu , Li Shuangqing , Qi Lin , Duan Zhixi , Wang Wanchun , Li Zhihong
Published: February 2020

Background

Emerging studies have explored the prognostic value of MIR31HG in cancers, but its role remains elusive. Herein, we aimed to summarize the prognostic potential of MIR31HG in this study.

Methods

Several databases were searched for literature retrieval on Dec 5, 2019. Overall and subgroup analyses were conducted to measure the relationship between MIR31HG expression and clinical outcomes. Moreover, GEPIA was applied for validation of prognostic value of MIR31HG in tumor patients in TCGA dataset.

Results

Overall, seventeen studies with 2,573 patients were enrolled. Compared to counterparts, those patients with high MIR31HG expression tended to have shorter RFS. Notably, MIR31HG overexpression predicted unfavorable OS in lung cancer. By contrast, gastrointestinal cancer patients with elevated MIR31HG expression predicted better OS and disease-free survival. Additionally, MIR31HG overexpression was significantly associated with worse clinicopathological features including advanced tumor stage and LNM in lung cancer, but favorable clinical characteristics in gastrointestinal cancer. Moreover, the positive association between MIR31HG and OS in lung cancer was further confirmed in TCGA dataset.

Conclusion

Overexpression of MIR31HG suggested remarkable association with poor prognosis in terms of OS, tumor stage, and LNM in lung cancer, but favorable prognosis in gastrointestinal cancer. Therefore, MIR31HG may serve as a promising prognostic biomarker in multiple cancers.
Preparation and sintering characteristics of nano-silver wrapped tin paste
Authors: Yang Hui , Wu Jihui
Published: February 2020

Nanosilver paste, an interconnect solder is a common choice in the electronics packaging industry, however higher sintering temperatures and lower sintering strength limit its application. At present, core-shell nano-slurry has been studied and applied to chip interconnection. Based on the mechanism of heterogeneous flocculation, we have developed a new nano-silver wrapped tin paste (Sn@Ag paste), and according to the decomposition temperature of the organic dispersant in the slurry, A corresponding sintering process with a maximum temperature of 300 ° C was developed. The Sn@Ag core-shell structure makes Sn have good dispersibility and oxidation resistance, and the sintered product of the slurry is a mixture of a solid solution of Ag and an Ag 3 Sn phase. Among them, the hard and brittle phase Ag 3 Sn acts as a dispersion strengthening effect in the Ag matrix phase, and the solid solution of Ag acts as a replacement solid solution strengthening. With the increase of doping Sn content, the sintering strength is significantly improved. When the Sn content is 5%, the joint shear strength reaches the highest value of 50Mpa, which is higher than the pure nano silver paste by 10 Mpa. This new nano-silver wrapped tin paste technology has the characteristics of low temperature sintering and high temperature service, so it is expected to be widely used in semiconductor power devices.
Phantom and clinical evaluation of bone SPECT/CT image reconstruction using novel conjugate gradient method
Authors: Miyaji Noriaki , Miwa Kenta , Tokiwa Ayaka , Ichikawa Hajime , Terauchi Takashi , Koizumi Misturu , Onoguchi Masahisa
Published: February 2020

Background Two novel methods of image reconstruction, xSPECT Quant (xQ) and xSPECT Bone (xB) that use an ordered subset conjugate gradient minimizer (OSCGM) for bone SPECT/CT have been proposed. The present study compares the performance characteristics of xQ, xB and conventional Flash3D (F3D) reconstruction using images derived from phantoms and patients. Methods A custom-designed body phantom for bone SPECT was scanned using a Symbia Intevo (Siemens Healthineers) and reconstructed xSPECT images were evaluated. A phantom with 28-mm spheres containing a 99m Tc background, and having tumor-to-bone ratios (TBR) of 1, 2, 4 and 10, was evaluated as the convergence of 1 - 96 iterations. The full width at half maximum (FWHM) of a simulated spinous process (10 mm), coefficients of variance (CV) and recovery coefficients (RC) of a simulated spine on SPECT images determined using F3D, xQ, xB were compared in a phantom containing four spheres with diameters of 13, 17, 22, 28 mm at TBR4 containing a 99m Tc-background. Images from 20 patients with suspected bone metastases (male, n = 13) were acquired using 99m Tc-(H)MDP SPECT/CT, then the CV and standardized uptake value (SUV) at the 4 th vertebral body (L4) were compared with xQ and xB in a clinical setup. Results Mean radioactive concentrations with various TBR converged in accordance with increasing numbers of iterations. Spatial resolution was improved in the order of xB, xQ and F3D regardless of the number of iterations during reconstruction. The CV and RC were better for xQ and xB than F3D. The RC significantly differed between xQ and xB at lower numbers of iterations, whereas those of xQ and xB became almost saturated at higher iteration numbers. The CV and SUV for clinical patients did not significantly differ between xQ and xB. Conclusions The reconstructed xQ and xB images were better than those conventionally reconstructed using F3D. Bone SPECT xB imaging offered essentially unchanged spatial resolution even when the numbers of iterations did not converge. The xB further enhanced SPECT image quality using CT data. Our findings provide important evidence for understanding the performance characteristics of the novel xQ and xBalgorithms.
Development and validation of an immune-related gene-based prognostic signature in gastric cancer
Authors: Ge Penglei , Chen Xiaofang , Wu Yang , Fu Yubin , Li Chunbo , Feng Zhengkai , Xue Jiahao , Li Lin , Zhang Gong , Gao Zhiqiang , Dang Xiaowei
Published: February 2020

Background: Gastric cancer is a common lethal cancer worldwide. We aimed to develop a reliable, individualized, immune-related prognostic signature that can be used to stratify and estimate prognosis in patients with gastric cancer.
Methods: This retrospective study analyzed the gene expression profiles of gastric cancer with tumor tissue samples from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) cohorts, which included 676 cases in total. Immune genes from the InnateDB database were selected to develop and validate an immune-related prognostic model for gastric cancer patients.
Results: An immune-related gene pair (IRGP) model was constructed that enabled us to stratify patients into high- and low-risk immune risk groups in the training set. Patients with a low risk score had a significantly longer median survival time than those with a high risk score. Further, we compared the predictive accuracy of the IRGP model with clinical characteristics, including TNM, grade, age, and stage. The results showed that the model had the highest mean C-index (0.69) compared with grade (0.55) or stage (0.60) in survival prediction. Then, we constructed a nomogram that integrated the IRGP model with independent clinical characteristics, which showed the best prognostic accuracy compared with other signatures.
Conclusion: A clinical-immune signature based on IRGP is a promising prognostic biomarker in gastric cancer. Prospective studies are needed to further validate its accuracy and to test its clinical utility in individualized treatment.
The construction and validation of the model for predicting the incidence and prognosis of brain metastasis in lung cancer patients
Authors: Zuo Chunjian , Sun Peng , Liu Guanchu , Che Pengyu , Li Gang , Li Xiang , Bai Ye , Tian Jie , Chen Huanwen
Published: February 2020

Background: Brain metastasis (BM) causes high morbidity and mortality rate in lung cancer (LC). The present study aims to develop models for predicting the development and prognosis of brain metastasis using a large sample size lung cancer cohort.
Methods: A total of 266,522 lung cancer cases that were diagnosed between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results Program (SEER) cohort. The risk factors for developing BM and prognosis were calculated by uni and multivariable logistic and Cox regression analysis, respectively and nomograms were constructed basing on the risk factors. The performance of the nomogram was evaluated by receiver operating characteristics curve (ROC) or C-index and calibration curve, respectively.
Results: The prevalence of BM was 16.25%, the associated factors for developing BM including advanced age, Asian or Pacific Islander race, uninsured status, primary tumor site, higher T stage, N stage, poorly differentiated grade, the presence of lung, liver and bone metastases and adenocarcinoma histology. The median overall survival (OS) was 4 months; the associated prognosis factors were familiar with risk factors plus female gender, unmarried status, and surgery. The calibration curve showed good agreement between predicted and actual probability and the AUC/C-index were 73.1% (95% CI: 72.6-73.6%) and 0.88 (95 % CI 0.87-0.89) for risk and prognosis predictive models, respectively.
Quantitative proteomics reveals stage-specific protein regulation of triple negative breast cancer
Authors: Lin Yuxiang , Lin Ling , Fu Fangmeng , Wang Chuan , Hu Anqi , Xie Juanjuan , Jiang Meichen , Wang Zhenxin , Yang Lujie , Zhang Jie , Chen Minyan , Li Yan , Guo Rongrong , Yang Pengyuan , Shen Huali
Published: February 2020

BackgroundTriple negative breast cancer (TNBC) is a heterogeneous disease with more aggressive clinical courses than other subtypes of breast cancer. In this study, we performed high-resolution mass spectrometry-based quantitative proteomics with TNBC clinical tissue specimens to explore the early and sensitive diagnostic signatures and potential therapeutic targets for TNBC patients. Methods We performed an iTRAQ-labeling coupled LC-MS/MS approach to explore the global proteome in tumor tissues and corresponding para-tumor tissues from 24 patients with grade I-II and grade III primary TNBC. Relative peptide quantification and protein identification were performed by Proteome Discoverer TM software with Mascot search engine. Differentially expressed proteins were analyzed by bioinformatic analyses, including GO function classification annotation and KEGG enrichment analysis. Pathway analyses for protein-protein interactions and upstream regulations of differentially expressed candidates were performed by Ingenuity Pathway Analysis (IPA) software. Results Totally, 5,401 unique proteins were identified and quantified in different stage of TNBCs. 865 proteins were changed in patients with grade I or II TNBC, among which 309 were up-regulated and 556 were down-regulated. Meanwhile, for patients with grade III TNBC, 359 proteins were increased and 672 proteins were decreased. Comparing to para-cancerous tissues, various signaling pathways and metabolic processes, including PPAR pathways, PI3K-Akt pathway, one-carbon metabolism, amino acid synthesis, and lipid metabolism were activated in TNBC cancer tissues. Death receptor signaling was significantly activated in grade I-II TNBCs, however, remarkably inhibited in grade III TNBCs. Conclusions Overall, our proteomic data presented precise quantification of potential signatures, signaling pathways, regulatory networks, and characteristic differences in each clinicopathological subgroup. The proteome provides complementary information for TNBC accurate subtype classification and therapeutic targets research.