bluuebunny/crossref_metadata_2025 huggingface dataset:
Metodologias sobre Bom Governo e Boa Governança
Authors: Migliari Wellington
Published: June 2020

O presente artigo tem como objetivo a produção de mapas aplicados a estudos de governança com o auxílio da linguagem de programação em R. Escrevemos um código que pode ser usado perfeitamente para outras representações gráficas relacionadas à criação de cartografias, geoprocessamento e modelos estatísticos. O debate proposto indica quão importante são os modelos visuais, uma vez que é relevante em diferentes campos do conhecimento como ciência política, políticas públicas, direito, história, biologia, saúde pública, medicina e planejamento urbano entre outros. É também um convite à análise quantitativa para estudos de governança, já que muitas formas de pesquisa sobre o tema ocorrem sem muito suporte de imagens ou interfaces geográficas. Quanto à pesquisa inter/transdisciplinar, ressaltamos o fato de que a produção da pesquisa aplicada está intimamente relacionada a distintos atores, perspectivas e saberes.
Model Construction of Medical Endoscope Service Evaluation System-Based on the Analysis of Delphi Method
Authors: Zheng Jun , Lou Ligang , Xie Ying , Chen Siyao , Li Jun , Wei Jingming , Feng Jingyi
Published: June 2020

Background: Medical endoscope is widely used in clinical practice for the purpose of diagnosis and treatment，occupying around 5% of the medical device market. Evaluating the true service level of medical endoscope is essential and necessary to improve overall performance of medical diagnosis and treatment, and to maintain competitiveness of endoscope manufacturers, however, such a tool is not available in the market. This study develops an Evaluation Index System (EIS) to assess service level of medical endoscope, and to provide suggestions for improving the service level through the Delphi method.Methods: Firstly, the possible factors influencing the service level were identified from literature review. In parallel, the Delphi expert method questionnaire was designed and 25 experts were invited to conduct three rounds of questionnaire, to evaluate and rate the possible factors. Finally, we determined the weights associated with the factors, using the analytic hierarchy process (AHP) and percentage method, and developed the service level EIS.Results: The EIS consists of 3 first-level indicators, 24 second-level indicators and 68 third-level indicators. According to the weights computed using AHP, first-level indicators are ranked as post-sale (0.62), in-sale (0.25) and pre-sale (0.13). Through case verification, the medical endoscope brand Olympus had a total score of 4.17, Shanghai Aohua had a total score of 3.71, and Shanghai Chengyun had a total score of 3.28, which matches its market popularity and ranking in terms of market share. The results obtained from the EIS are consistent with the reality.Conclusions: The EIS established in this study is comprehensive, reliable and reasonable with strong practicality. The EIS can act as a tool for the endoscope users to evaluate potential products and make informed choices. It also provides a measurable basis for endoscope manufacturers and service providers to improve service quality.
Comparative transcriptome analysis of root, stem, and leaf tissues of Entada phaseoloides reveals potential genes involved in triterpenoid saponin biosynthesis
Authors: Liao Weifang , Mei Zhinan , Miao Lihong , Liu Pulin , Gao Ruijie
Published: June 2020

Background: Entada phaseoloides (L.) Merr. is an important traditional medicinal plant. The stem of Entada phaseoloides is popularly used as traditional medicine because of its significance in dispelling wind and dampness and remarkable anti-inflammatory activities. Triterpenoid saponins are the major bioactive compounds of Entada phaseoloides. However, genomic or transcriptomic technologies have not been used to study the triterpenoid saponin biosynthetic pathway in this plant.Results: We performed comparative transcriptome analysis of the root, stem, and leaf tissues of Entada phaseoloides with three independent biological replicates and obtained a total of 53.26 Gb clean data and 116,910 unigenes, with an average N50 length of 1218 bp. Putative functions could be annotated to 42,191 unigenes (36.1%) based on BLASTx searches against the Non-redundant, Uniprot, KEGG, Pfam, GO, KEGG and COG databases. Most of the unigenes related to triterpenoid saponin backbone biosynthesis were specifically upregulated in the stem. A total of 26 cytochrome P450 and 17 uridine diphosphate glycosyltransferase candidate genes related to triterpenoid saponin biosynthesis were identified. The differential expressions of selected genes were further verified by qPT-PCR. Conclusions: The dataset reported here will facilitate the research about the functional genomics of triterpenoid saponin biosynthesis and genetic engineering of Entada phaseoloides.
Oncolytic vaccinia virus GLV-1h68 exhibits profound antitumoral activities in cell lines originating from neuroendocrine neoplasms
Authors: Kloker Linus D , Berchtold Susanne , Smirnow Irina , Beil Julia , Krieg Andreas , Sipos Bence , Lauer Ulrich M
Published: June 2020

Background: Oncolytic virotherapy is an upcoming treatment option for many tumor entities. But so far, a first oncolytic virus only was approved for advanced stages of malignant melanomas. Neuroendocrine tumors (NETs) constitute a heterogenous group of tumors arising from the neuroendocrine system at diverse anatomic sites. Due to often slow growth rates and (in most cases) endocrine non-functionality, NETs are often detected only in a progressed metastatic situation, where therapy options are still severely limited. So far, immunotherapies and especially immunovirotherapies are not established as novel treatment modalities for NETs.Methods: In this immunovirotherapy study, pancreatic NET (BON-1, QGP-1), lung NET (H727, UMC-11), as well as neuroendocrine carcinoma (NEC) cell lines (HROC-57, NEC-DUE1) were employed. The well characterized genetically engineered vaccinia virus GLV-1h68, which has already been investigated in various clinical trials, was chosen as virotherapeutical treatment modality. Results: Profound oncolytic efficiencies were found for NET/NEC tumor cells. Besides, NET/NEC tumor cell bound expression of GLV-1h68-encoded marker genes was observed also. Furthermore, a highly efficient production of viral progenies was detected by sequential virus quantifications. Moreover, the mTOR inhibitor everolimus, licensed for treatment of metastatic NETs, was not found to interfere with GLV-1h68 replication, making a combinatorial treatment of both feasible. Conclusions: In summary, the oncolytic vaccinia virus GLV-1h68 was found to exhibit promising antitumoral activities, replication capacities and a potential for future combinatorial approaches in cell lines originating from neuroendocrine neoplasms. Based on these preliminary findings, virotherapeutic effects now have to be further evaluated in animal models for treatment of Neuroendocrine neoplasms (NENs).
Incidence, risk factors and outcomes of early postoperative hyperglycemia in surgical patients: a protocol for a systematic review and meta-analysis
Authors: Ssentongo Paddy , Lewcun Joseph A. , Ssentongo Anna E. , Soybel David I.
Published: June 2020

Background: Early postoperative hyperglycemia (POHG) is common and associated with poor postoperative outcomes. Currently, there is no systematic review and meta-analysis that addresses the knowledge gap of the incidence of POHG in surgical patients and that explores the associated risk factors and complications. The objective of this study will be to estimate the pooled incidence, risk factors and clinical outcomes of early postoperative hyperglycemia in men and women globally. Methods: We designed and registered a study protocol for a systematic review and meta-analysis of studies reporting the incidence of postoperative hyperglycemia (POHG). We will search PubMed (MEDLINE), Scopus, Web of Science, EMBASE, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE), Joana Briggs Institute EBF Database (from inception onwards). Randomized controlled trials and observational cohort studies reporting the incidence of POHG and conducted in surgical patients will be included. No age, geographical location, study-design or language limits will be applied. The primary outcome will be the incidence of POHG. Secondary outcomes will be risk factors and clinical outcomes of POHG. Two reviewers will independently screen citations, full text articles, and abstract data, extract data, and evaluate the quality and bias of included studies. Discrepancies will be resolved through discussion or consultation with a third researcher. The risk of bias and study methodological quality of included studies will be evaluated by the appropriate Cochrane risk of bias tool for randomized trials and Newcastle-Ottawa Scale for cohort studies. If feasible, we will conduct random effects meta-analysis with a logit transformation of proportions. We will report the probability of postoperative hyperglycemia as a measure of incidence rate, relative risk ratios (RR) and 95% confidence intervals to report the effects of the risk factors and postoperative outcomes. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, gender, geographical location, publication year, comorbidities, type of surgical procedure). The Egger’s test and funnel plots will be used to assess small study effects (publication bias).Discussion This systematic review and meta-analysis will identify, evaluate and integrate the evidence on the incidence, risk factors and outcomes of early POHG in surgical patients. The results of this study can be used to identify populations which may be at particular risk for POHG. Future studies which use this information to better guide post-operative glycemic control in surgical patients could be considered.Systematic review registration: PROSPERO registration number CRD42020167138
Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2.
Authors: Bes Taniela , Nagano Debora , Martins Roberta , Marchi Ana Paula , Neto Lauro Perdigão , Higashino Hermes , Prado Gladys , Guimaraes Thais , Levin Anna S , Costa Silvia
Published: June 2020

Carbapenem-resistant Enterobacteriaceae is a worldwide health problem, however isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe microbiological and clinical characteristics of five cases of bloodstream infection (BSI) caused by carbapenem-resistant Klebsiella pneumoniae and Serratia marcescens co-harboring blaKPC-2 and blaNDM-1.Of the five blood culture isolates, three from are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a soft tissue surgical patient. All patients lived in low-income neighborhoods and had no travel history. Despite antibiotic treatment, four of five patients died. The phenotypic assays showed that Meropenem added with either EDTA, PA or both showed increased zone of inhibition in comparison to Meropenem alone. Molecular tests confirmed blaKPC-2 and blaNDM-1 genes, the K. pneumoniae were assigned as ST258 and ST340 by Whole Genome Sequencing.This case-series showed high mortality of BSI caused by Enterobacteria coproducing KPC-2 and NDM-1. The detection of samples co-harboring blaKPC-2 and blaNDM-1 remains unsatisfactory with phenotypic assay. Routine microbiology laboratories must be on alert for samples co-harboring these mechanisms.
Functional analysis of SlERF01 gene in the disease resistance to S.lycopersici
Authors: Yang Huanhuan , Shen Fengyi , Wang Hexuan , Zhao Tingting , Zhang He , Jiang Jingbin , Xu Xiangyang , LI JINGFU
Published: June 2020

Background: Tomato gray leaf spot disease caused by Stemphylium lycopersici ( S. lycopersici ) is a serious disease that can severely affect tomato production. So far, only resistance gene Sm has been reported and the molecular mechanism of tomato resistance to the disease remains unclear. To better understand this mechanism of tomato resistance to S. lycopersici , qRT-PCR analysis, physiological index determination, microscopic observation and transgenic technology were used in this study.
Results: Our results showed that SlERF01 could be strongly induced by S. lycopersici and the exogenous hormones salicylic acid (SA) and jasmonic acid (JA). Furthermore, overexpression of SlERF01 enhanced the hypersensitive response to S. lycopersici and elevated the expression of defense genes in tomato. Furthermore, the accumulation of lignin, callose and H 2 O 2 was increased in transgenic lines after inoculation with S. lycopersici. Here, our results showed that SlERF01 played an indispensable role in among multiple SA, JA and ROS signaling pathways to confer resistance to S. lycopersici invasion. Our findings also indicated that SlERF01 could activate PR1 gene expression and enhance resistance to S. lycopersici .
Conclusions: We identified SlERF01 , a novel tomato AP2/ERF transcription factor. The Functional verification demonstrated SlERF01 positively regulated tomato resistance to S. lycopersici . Our findings indicate that SlERF01 plays a key role in the multiple SA, JA and ROS signaling pathways to confer resistance to invasion by S. lycopersici. The findings of this study not only can help to better understanding of mechanisms of response to pathogens, but also will enable targeted breeding strategies for tomato resistance to S. lycopersici .
Comparative transcriptome analysis between inbred and hybrids reveals molecular insights into yield heterosis of upland cotton
Authors: Shahzad Kashif , Zhang Xuexian , Guo Liping , Qi Tingxiang , Bao Lisheng , Zhang Meng , Zhang Bingbing , Wang Hailin , Tang Huini , Qiao Xiuqin , Feng Juanjuan , Wu Jianyong , Xing Chaozhu
Published: June 2020

Background: Utilization of heterosis has greatly improved the productivity of many crops worldwide. Understanding the potential molecular mechanism about how hybridization produces superior yield in upland cotton is critical for efficient breeding programs. Results: In this study, high, medium, and low hybrids varying in the level of yield heterosis were screened based on field experimentation of different years and locations. Phenotypically, high hybrid produced a mean of 14% more seed cotton yield than its better parent. Whole-genome RNA sequencing of these hybrids and their four inbred parents was performed using different tissues of the squaring stage. Comparative transcriptomic differences in each hybrid parent triad revealed a higher percentage of differentially expressed genes (DEGs) in each tissue. Expression level dominance analysis identified majority of hybrids DEGs were biased towards parent like expressions. An array of DEGs involved in ATP and protein binding, membrane, cell wall, mitochondrion, and protein phosphorylation had more functional annotations in hybrids. Sugar metabolic and plant hormone signal transduction pathways were most enriched in each hybrid. Further, these two pathways had most mapped DEGs on known seed cotton yield QTLs. Integration of transcriptome, QTLs, and gene co-expression network analysis discovered genes Gh_A03G1024, Gh_D08G1440, Gh_A08G2210, Gh_A12G2183, Gh_D07G1312, Gh_D08G1467, Gh_A03G0889, Gh_A08G2199, and Gh_D05G0202 displayed a complex regulatory network of many interconnected genes. qRT-PCR of these DEGs was performed to ensure the accuracy of RNA-Seq data. Conclusions: Through genome-wide comparative transcriptome analysis, the current study identified nine key genes and pathways associated with biological process of yield heterosis in upland cotton. Our results and data resources provide novel insights and will be useful for dissecting the molecular mechanism of yield heterosis in cotton.
Effect of a free healthy school meal on fruit, vegetables and unhealthy snacks intake in Norwegian 10- to 12-year-old children
Authors: Vik Frøydis Nordgård , Heslien Kaia Elisabeth Paulsen , Lippevelde Wendy Van , Øverby Nina Cecilie
Published: June 2020

Background: Norwegian children have a lower intake of fruit, vegetables, and a higher intake of unhealthy snacks compared to dietary guidelines. Such dietary inadequacies may be detrimental for their current and future health. Schools are favorable settings to establish healthy eating practices. Still, no school meal arrangement is provided in Norway, and most children typically bring packed lunches from home. The aim of this study was to investigate whether serving a free healthy school meal for one year resulted in a higher intake of fruit and vegetables and a lower intake of unhealthy snacks in total among 10-12-year-olds in Norway.Methods: The School Meal Project in Southern Norway was a non-randomized trial in two elementary schools in rural areas in the school year 2014/2015. The study sample consisted of 10- to 12-year-old children; an intervention group (N=55) and a control group (N=109) resulting in a total of 164 school children at baseline. A food frequency questionnaire was completed by the children at baseline, at five months follow-up and after one year to assess fruit, vegetable and snacks intake. Multiple linear regression analyses were performed to assess intervention effects on overall intake of fruit and vegetables and unhealthy snacks.Results: Serving of a free healthy school meal for one year was associated with a higher weekly intake of vegetables on sandwiches in the intervention group compared to the control group, adjusted for baseline intake (B: 1.11 (95% CI: .38, 1.85)) at the end of the intervention. No other significant intervention effects were found for the remaining fruit and vegetables measures. Serving of a free healthy school meal was not associated with a lower weekly intake of unhealthy snacks (i.e. potato chips, candy and sugar sweetened beverages) in the intervention group compared to the control group. Conclusions: A free healthy school meal was associated with a higher weekly intake of vegetables on sandwiches but did not significantly change any other investigated dietary behaviors. However, given the inadequate intake of vegetables among children and that even moderate improvements have public health relevance, a free healthy school meal for all school children could be beneficial.
The effects of aerobic exercise training with octopamine supplementation on cardiomyocyte apoptosis induced by deep frying oil: the role of caspase and pro-Caspase 3
Authors: kianmehr Pantea , Azarbayjani Mohammad Ali , Peeri Maghsoud , Farzanegi Parvin
Published: June 2020

Background: Deep frying is a common cooking method, in which cooking is accompanied by carcinogenic by-products such as acrolein. Acrolein is a toxic byproduct of lipid peroxidation, which has been implicated in pulmonary, cardiac, and neurodegenerative diseases. The aim of this study was to explore the effect of aerobic exercise and octopamine on caspase 3 and pro-caspase 3 expression level in heart tissue of rat exposed deep frying oil.Methods: 30 male wistar rats were divided into 5 groups (n=6 in each) including 1) control (CO), 2) deep frying oil (DFO), 3) deep frying oil + exercise (DFO+EXE), 4) deep frying oil + octopamine (DFO+OCT), and 5) deep frying oil + exercise + octopamine (DFO+EXE+OCT). The apoptotic effects of DFO in heart tissue were examined by TUNEL assay. Masson's trichrome stain used to study cardiomyocytic fibers. Moreover, caspase 3 and pro-caspase 3 genes and proteins expression in all groups was evaluated using quantitative real-time PCR and western blotting method, respectively. Results: Data showed a significant increase in apoptotic cells in the DFO-treated group (P <0.05). In Masson's Trichrome stain analysis demonstrated more cardiomyocytic fibers degradation and aggregation lymphocytic cells in DFO that exercise and OCT signisicantly improve this degradation. Also, the expression level of caspase 3 and pro-caspase 3 was significantly decrease in deep frying oil + exercise + octopamine group (P <0.05). Conclusions: According to the result of the current study, it can be assumed that DFO can lead to programmed cell death via the activation of caspase in heart tissue. However, it seems that aerobic exercise with octopamine supplementation improve heart tissue by significantly decrease expression of caspase 3 and pro-caspase 3 that inhibit apoptosis.
Association between musculoskeletal function deterioration and locomotive syndrome in the general elderly population: A Japanese cohort survey randomly sampled from a basic resident registry
Authors: Tokida Ryosuke , Ikegami Shota , Takahashi Jun , Ido Yoshikazu , Sato Ayaka , Sakai Noriko , Horiuchi Hiroshi , Kato Hiroyuki
Published: June 2020

Background: Locomotive syndrome (LoS) is defined as the loss of mobility due to age-related impairment of motor organs. The purpose of this study was to evaluate the prevalence and severity of LoS, muscular strength and balancing ability, and prevalence of sarcopenia in relation to the presence of LoS according to sex and age groups ranging between 50-89 years.Methods: Male and female participants between the ages of 50-89 were randomly selected in the resident registry of a cooperating town. Calls for participation continued until approximately 50 consenting participants were successfully recruited for each age group and sex. A total of 413 participants (203 male and 210 female) were enrolled for undergoing a LoS risk test and measuring their physical function. Physical function was compared to participants with or without LoS.Results: A total of 312 patients (75.5%) were diagnosed as LoS, of which 144 (46.2%) were male and 168 (53.8%) were female. The severity of LoS for the 312 patients were 210 (67.3%) for stage 1 and 102 (32.7%) for stage 2. The prevalence of LoS in males were 37%, 59%, 91%, and 100% in the 50s, 60s, 70s, and 80s age strata, respectively. The prevalence of LoS in females were 71%, 62%, 89%, and 98% in the 50s, 60s, 70s, and 80s age strata, respectively. The prevalence of sarcopenia was significantly higher as the age strata in males grew higher. Knee extension strength was significantly lower for participants in their 50s and females in addition to females in their 60s with LoS. The 31 patients diagnosed as sarcopenia included 29 (93.5%) with LoS, 11 (35.4%) classified as LoS stage 1, and 18 (58.1%) classified as stage 2.Conclusions: The prevalence of LoS was high in participants over 70 years of age. In males, the prevalence of sarcopenia was higher as the age strata grew higher. Patients with LoS exhibited lower knee extension strength. We believe that some measures to prevent or improve LoS may require exercise to increase the muscle strength of the lower limbs.
Regional education on endoscopic surgery using a teleconference system with high-quality video via the internet: Saga surgical videoconferences
Authors: Manabe Tatsuya , Takasaki Mitsuhiro , Ide Takao , Kitahara Kenji , Sato Seiji , Yunotani Seiji , Hirohashi Yoshimi , Iyama Akihiro , Taniguchi Masahiko , Ogata Toshiro , Shimizu Shuji , Noshiro Hirokazu
Published: June 2020

Background: Effective education about endoscopic surgery (ES) is greatly needed for unskilled surgeons, especially at low-volume institutions, to maintain the safety of patients. We have tried to establish the remote educational system using videoconference system through the internet for education about ES to surgeons belonging to affiliate institutions. The aim of this manuscript was to report the potential to establish a comfortable remote educational system and to debate its advantages. Methods: We established a local remote educational conference system by combining the use of a general web conferencing system and a synchronized remote video playback system with annotation function through a high-speed internet. Results: During 2014 – 2019, we conducted 14 videoconferences to review and improve surgeons’ skills in performing ES at affiliated institutions. At these conferences, while an uncut video of ES that had been performed at one of the affiliated institutions was shown, the surgical procedure was discussed frankly, and expert surgeons advised improvements. The annotation system is useful for easy, prompt recognition among the audience regarding anatomical structures and procedures that are difficult to explain verbally. Conclusions: This system is of low initial cost and offers easy participation and high-quality videos. It would therefore be a useful tool for regional ES education.
Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review
Authors: Bangura Joseph Benjamin , Xiao Shui-yuan , Qiu Dan , Ouyang Feiyun , Chen Lei
Published: June 2020

Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.
An in vivo multimodal feasibility study in a rat brain tumour model using flexible multinuclear MR and PET systems
Authors: Choi Chang-Hoon , Stegmayr Carina , Shymanskaya Aliaksandra , Worthoff Wieland A. , Silva Nuno A da , Felder Jörg , Langen Karl-Josef , Shah Nadim Jon
Published: June 2020

Background: In addition to the structural information afforded by 1H MRI, the use of X-nuclei, such as sodium-23 (23Na) or phosphorus-31 (31P), offers important complementary information concerning physiological and biochemical parameters. By then combining this technique with PET, which provides valuable insight into a wide range of metabolic and molecular processes by using of a variety of radioactive tracers, the scope of medical imaging and diagnostics can be significantly increased. While the use of multimodal imaging is undoubtedly advantageous, identifying the optimal combination of these parameters to diagnose a specific dysfunction is very important and is advanced by the use of sophisticated imaging techniques in specific animal models. Methods: In this pilot study, rats with intracerebral 9L gliosarcomas were used to explore a combination of sequential multinuclear MRI using a sophisticated switchable coil set in a small animal 9.4 T MRI scanner and, subsequently, a small animal PET with the tumour tracer O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET). This made it possible for in vivo multinuclear MR-PET experiments to be conducted without compromising the performance of either multinuclear MR or PET. Results: High-quality in vivo images and spectra including high-resolution 1H imaging, 23Na-weighted imaging, detection of 31P metabolites and [18F]FET uptake were obtained, allowing the characterisation of tumour tissues in comparison to a healthy brain. It has been reported in the literature that these parameters are useful in the identification of the genetic profile of gliomas, particularly concerning the mutation of the isocitrate hydrogenase gene, which is highly relevant for treatment strategy.Conclusions: The combination of multinuclear MR and PET in, for example, brain tumour models with specific genetic mutations will enable the physiological background of signal alterations to be explored and the identification of the optimal combination of imaging parameters for the non-invasive characterisation of the molecular profile of tumours.
Artificial Immune Network Clustering Based on a Cultural Algorithm
Authors: Deng Liyuan , Yang Ping , Liu Weidong
Published: June 2020

Data mining technology has been applied in many fields. Prototype-based cluster analysis is an important data mining method, but its ability to discover knowledge is limited because of the need to know the number of target data categories and cluster prototypes in advance. Artificial immune evolutionary network clustering is a clustering method based on network structure. Compared with prototype-based cluster analysis, it has the advantage of realizing unsupervised learning and clustering without any prior knowledge of data. However, artificial immune evolutionary network clustering also has problems such as a lack of guidance in the clustering process, fuzzy boundary sensitivity, and difficulty in determining parameters. To solve these problems, an artificial immune network clustering algorithm based on a cultural algorithm is proposed. First, three kinds of knowledge are constructed: normative knowledge is used to regulate the spatial range of population initialization to avoid blindness; state knowledge is used to distinguish the type of antigen, and immune defense measures are taken to prevent the network structure caused by noise and boundaries from being unclear; topology knowledge is used to guide the antigen for optimal antibody search. Second, topology knowledge in the cultural algorithm is used to characterize the distribution of antigens and antibodies in space, and elite learning is used to improve the traditional clone mutation operator. Based on the shadow set theory, a method for adaptively determining the compression threshold is proposed. Finally, the results of simulation experiments show that the proposed algorithm can effectively overcome the above problems, and the clustering performances on a synthetic dataset and an actual dataset are satisfactory.
Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study
Authors: Yi Ping , Yang Xiang , Ding Cheng , Chen Yanfei , Xu Kaijin , Ni Qing , Zhao Hong , Li Yongtao , Zhang Xuan , Liu Jun , Sheng Jifang , Li Lanjuan
Published: June 2020

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.
The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents
Authors: Rees Christiaan , PINEROS Dwan , AMOUR Maryam , MUNSERI Patricia , SAID Jamila , MAGOHE Albert , MATEE Mecky , PALLANGYO Kisali , VON REYN C Fordham
Published: June 2020

Background: Ratios of different immune cell populations (i.e., monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios) have been studied as a means of predicting future tuberculosis (TB) disease risk or to assist in the diagnosis of incident TB disease. No studies to-date, however, have evaluated the potential of these ratios to predict or assist in the diagnosis of incident TB infection - the first step in the natural history of TB disease. Methods: In this prospective study, we evaluated the complete blood count (CBC)-derived metrics of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of future TB infection risk or aids in the diagnosis of TB infection among 145 Tanzanian adolescents enrolled in the DAR-901 vaccine trial, using paired CBCs and interferon-gamma release assays (IGRAs) obtained at 0, 60 and 720 days after study enrollment.Results: At baseline, there were no significant differences between study participants who remained persistently IGRA negative throughout the study period and those who subsequently converted to IGRA positive with respect to MLR (0.18 vs 0.17, p=0.10), NLR (0.88 vs 1.02, p=0.08), or PLR (115 vs 120, p=0.28). Similarly, no significant differences were noted with respect to MLR, NLR, and PLR between IGRA converters and time-matched negative controls at the time of IGRA conversion. With respect to other blood cell measures, however, there were modest but significant differences between IGRA negatives and IGRA converters with respect to red blood cell count (4.8 vs 4.6 × 106 cells/mcL, p=0.008), hemoglobin (12.6 vs 12.3 g/dL, p=0.01), and hematocrit (38.8 vs 37.8 %, p=0.005).Conclusions: In contrast to prior studies that have suggested that the ratios of different immune cell populations are associated with development of TB disease, our present findings do not demonstrate an association between these ratios and the development of TB infection. However, decreased red blood cell measures were associated with the subsequent development of TB infection, suggesting either that dysregulation of iron metabolism may play a role in TB pathogenesis or that following TB infection, iron dysregulation may precede IGRA positivity. Trial Registration: Data presented are from clinical trial NCT02712424.
Similar outcomes with first-line observation versus metastasectomy for bone giant cell tumor lung metastases
Authors: Tsukamoto Shinji , Ciani Giovanni , Mavrogenis Andreas F. , Ferrari Cristina , Akahane Manabu , Tanaka Yasuhito , Rocca Michele , Longhi Alessandra , Donati Davide Maria , Errani Costantino
Published: June 2020

Background: The outcome of lung metastases in patients with giant cell tumor of bone (GCTB) varies from spontaneous regression to uncontrolled growth. To investigate whether observation is an appropriate first-line management for patients with lung metastases from GCTB, we compared the outcomes of patients initially treated with observation with those treated with metastasectomy.Methods: We retrospectively reviewed the data of 29 patients with lung metastases from histologically confirmed GCTB. The median follow-up period was 114 months. We evaluated progression-free survival, which was defined as the time from the date of occurrence of lung metastases to the date of disease progression in the observation or incomplete metastasectomy group, disease recurrence in the complete metastasectomy group, or the last follow-up.Results: Disease progression or recurrence occurred in 14 patients (48.3%). Progression-free survival did not vary significantly between the observation and metastasectomy groups (p=0.373). The total number of metastasectomies was significantly higher in the initial metastasectomy group than in the observation group (p=0.017).Conclusions: The number of patients included in this study is small, however the data suggests that observation can be used safely as first-line management for patients with lung metastases from GCTB with an outcome similar to that of metastasectomy. It is necessary to confirm our result in multi-institutional study with sufficient number of patients.
Developing a Sensor-Based Mobile Application for In-Home Frailty Assessment: A Qualitative Study
Authors: Blinka Marcela D. , Buta Brian , Bader Kevin D , Hanley Casey , Schoenborn Nancy , McNabney Matthew , Xue Qian-Li
Published: June 2020

Background Frailty syndrome disproportionately affects older people, including 15% of non-nursing home population, and is known to be a strong predictor of poor health outcomes. There is a growing interest in incorporating frailty assessment into research and clinical practice, which may provide an opportunity to improve in home frailty assessment and improve doctor patient communication.Methods We conducted focus groups discussions to solicit input from older adult care recipients (non-frail, pre-frail, and frail), their informal caregivers, and medical providers about their preferences to tailor a mobile app to measure frailty in the home using sensor based technologies. Focus groups were recorded, transcribed, and analyzed thematically.Results We identified three major themes: 1) perspectives of frailty; 2) perceptions of home based sensors; and 3) data management concerns. These relate to the participants’ insight, attitudes and concerns about having sensor-based technology to measure frailty in the home. Our qualitative findings indicate that knowing frailty status is important and useful and would allow older adults to remain independent longer. Participants also noted concerns with data management and the hope that this technology would not replace in-person visits with their healthcare provider.Conclusions This study found that study participants of each frailty status expressed high interest and acceptance of sensor-based technologies. Based on the qualitative findings of this study, sensor-based technologies show promise for frailty assessment of older adults with care needs. The main concerns identified related to the volume of data collected and strategies for responsible and secure transfer, reporting, and distillation of data into useful and timely care information. Sensor-based technologies should be piloted for feasibility and utility. This will inform the larger goal of helping older adults to maintain independence while tracking potential health declines, especially among the most vulnerable, for early detection and intervention. Keywords: Frailty, wearable, health services
Clinical Risk Factors for Long-term Hospital Stay in Common Patients with coronavirus disease 2019(COVID-19)
Authors: Lu Wei , Fang Junjie , Chen Bin , Wu Dan , Yu Chunyao , Piao Sirong , Zhang Shun , Jin Yinhua
Published: June 2020

Background

This study aimed to investigate the potential risk factors associated with hospital stay in mild patients with COVID-19.
Methods

A total of 109 laboratory-confirmed COVID patients with initial common subtype diseased by real-time RT-PCR that meet discharge standards were retrospectively included from January 16 to March 15 of 2020. Baseline demographic, clinical, laboratory examination was extracted from electronic medical records at the first day of admission and compared between short-term hospital stay and long-term hospital stay. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with hospital stay.
Results

Of 109 COVID-19 patients, 61 patients were short-term stay (≤ 10 days) and 48 patients were long-term stay (> 10 days). The average age of patients in short-term stay were younger than those long-term stay(P = 0.01). Hypertension was the most common comorbidity (34%, 21/61), followed by diabetes (15%,9/61) and Cardiopathy (8%, 5/61). Fever and cough were the typical clinical manifestation in two group. Decreased WBC, Hemoglobin and increased Monocyte, MLR (Monocyte Lymphocyte ratio) and Hypersensitive CRP showed a long-term stay (all P < 0.05). The treatment of Resochin and Human immunoglobulin had a shorter hospital stay. Multivariable regression showed that MLR and CRP on admission were risk factors for predicting the hospital stay, with the HR (hazard ratio 2.03, 1.02–5.39; P = 0.022) and (1.32,1.05–3.24, P = 0.045) respectively.
Conclusions

The potential risk factors of MLR and CRP may help clinicians to predict the hospital stay of COVID-19 patients.
Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio for predicting clinical outcomes in COVID-19
Authors: Zhang Ting , Huang Shaoping , Liu Min , Li Xiaolu , Shang Zhiyin , Lu Hongzhou
Published: June 2020

Background

The epidemic of 2019 novel coronavirus (COVID-19) struck China in late December,2019, resulting in about 200000 deaths all over the world. Numerous observational studies have suggested that the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte proportion and the platelet-to-lymphocyte ratio (PLR) are inflammatory markers. Our study aimed to detect the role of NLR, PLR in predicting the prognosis of COVID-19.
Results

Four hundred and fifteen consecutive patients were enrolled in Shanghai Public Health Clinical Center affiliated to Fudan University, between 20 January and 11 April 2020 with confirmed COVID-19,among which 386 (93%) patients were not severe, and 27 (7%) were severe. The proportion of males in severe cases is higher than in non-severe cases (75.86% vs. 50.52%, P = 0.008). The age between the two groups is different (p = 0.022). Compared with non-severe patients, severe patients exhibited more comorbidities, including hypertension (48.28% vs. 19.43%, p < 0.001), diabetes (20.69% vs. 6.99%, p = 0.009), chronic obstructive pulmonary disease (51.72% vs. 6.22%, p < 0.001), and fatty liver (37.93% vs. 15.8%, p = 0.002), respectively. NLR and PLR showed significant difference (p < 0.001). Diabetes (OR 0.28; 95% CI 15.824-187.186), fatty liver (OR 21.469; 95% CI 2.306-199.872), coronary heart disease (OR 18.157; 95% CI 2.085-158.083), NLR (OR 1.729; 95% CI 1.050–2.847) were significantly associated with severe cases with COVID-19. The NLR of patients in severe group had a 1.729-fold higher than that of no-severe group (OR 1.729; 95% CI 1.050–2.847, P = 0.031).
Conclusions

NLR is an independent risk factor of severe COVID-19 patients. PLR, NLR were significantly different between severe and non-severe patients, so assessment of NLR, PLR may help identify high risk cases with COVID-19.
Microskeletal stiffness promotes aortic aneurysm by sustaining pathological vascular smooth muscle cell mechanosensation via Piezo1    
Authors: Qian Weiyi , Hadi Tarik , Ma Xiao , Silvestro Michele , Rivera Cristobal , Bajpai Apratim , Zhang Zijing , Qu Hengdong , Corsica Annanina , Miscovich Bradley , Aykut Berk , Miller George , Ramkhelawon Bhama , Chen Weiqiang
Published: June 2020

Mechanical overload of the vascular wall is a pathological hallmark of life-threatening abdominal aortic aneurysms (AAA). However, how this mechanical stress resonates at the unicellular level of vascular smooth muscle cells (VSMC) in AAA is undefined. Here, we combined novel ultrasound tweezers-based micromechancal system and single-cell RNA sequencing to map defective mechano-phenotype signature of VSMC niched in AAA. VSMC gradually adopted a mechanically solid-like state by upregulating cytoskeleton (CSK) crosslinker, α-actinin2, which stiffened VSMC cell membrane thereby directly powering the activity of mechano-sensory ion channel Piezo1 during AAA development. Theoretical modelling predicted that in AAA, such CSK alterations fueled cell membrane tension thereby blocking physiological mechanoallostatic responses of VSMC. Single-cell mechanical measurements and frequency spectrum analysis validated the mechanosensation deficiency in VSMC during AAA development. Our findings demonstrate that deviations of mechanosensation behaviors of VSMC is detrimental for AAA and identifies Piezo1 as a novel target to curb AAA onset.
Bioinformatics Analysis Reveals Biomarkers With Prognostic Benefits in Diffuse Type Gastric Cancer
Authors: Li Sheng , Yu Chao , Cheng Yuanguang , Du Fangchao , Wen Gang
Published: June 2020

BackgroundGastric cancer (GC) is one of the most common malignancies in digestive system, among which the differentiation of diffuse type GC is relatively poor, the probability of distant metastasis and lymph node metastasis is relatively high, and the clinical prognosis is relatively poor. The purpose of this study is to explore potential signaling pathways and key biomarkers that drive the development of diffuse type GC. Methods Using the “limma” package in R to screen Differentially expressed genes. Screening hub genes by PPI analysis. Immunohistochemistry analysis and qRT-PCR analysis was carried out to detect genes expression. Using Kaplan-Meier Plotter database analyzed the prognostic roles of hub genes.ResultsA total of 355 DEGs consisting of 293 diffuse type DEGs and 62 intestinal type DEGs were selected according to screening criteria, 3 hub genes were chosen from diffuse type DEGs according to the degree of connectivity by using protein-protein interaction (PPI) networks and Cytoscape software including AGT, CXCL12 and ADRB2. Immunohistochemistry analysis and qRT-PCR results showed that the expression of three genes was related to the different GC lauren types. The Kaplan Meier analysis showed that the expression values of these three genes were related to prognosis of diffuse type GC. ConclusionsAGT, CXCL12 and ADRB2 might contribute to the progression of diffuse type GC, which could have potential as biomarkers or therapeutic targets for diffuse type GC.