bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between life style factors and sub-fertility among women, attend two specials hospital for women in Colombo: A case control study
Authors: Piyasenage Munasinghe P.M , - Balachandran Kumarendran , - Chandani Denawaka , - Kosala Lakmal , - Kumari Illukpitiya
Published: December 2020

Background: Sub-fertility has become a dominant health issue among married couples, expecting a baby with impacting social, psychological, and financial consequences especially in developing countries. As well as life style factors, which cause to immense effect on reproductive health has been changing dramatically at present. This study accordingly determines the association between life style factors and sub-fertility of women. Method: 125 of case and 320 of control were enrolled. A pre tested structured questionnaire was used to collect the data through face to face interview. Chi-square, Man Whitney and independent sample T tests were performed (SPSS-22 version). Furthermore Odds Ratio (OR) was done for passive smoking and entertains with music. Result: The mean age at marriage was 25.1±3.1 and 26.5±3 for fertile sub-fertile women respectively. Vigorous and moderate physical activities were significantly high among sub-fertile than fertile (P<0.05 C.I 95%), but total sitting time was not significantly different between two groups (P=0.16 CI 95%). Time of sedentary hobbies were high among fertile than sub-fertile (P=0.00 CI 95%). OR for passive smoking was 1.32 CI 95% and it was 0.6 CI 95% for entertainment with music. Invoking blessing of god is the most common religious practices among both groups. Conclusion: This study demonstrated that the moderate physical activities and sedentary hobbies are not associated with fertility and second hand smoking has a negative effect while entertainment with music has a positive effect to the fertility.
The Association of Baseline N-terminal Pro-B-type Natriuretic Peptide With Short and Long-term Prognosis Following Percutaneous Coronary Intervention in Non-ST Segment Elevation Acute Coronary Syndrome With Multivessel Coronary Artery Disease: a Retrospective Cohort Study
Authors: He Wen-fei , Jiang Lei , Chen Yi-yue , Liu Yuan-hui , Chen Peng-yuan , Duan Chong-yang , Zeng Li-huan , Fan Hua-lin , Wei Xue-biao , Guo Wei , Chen Wei , Li Jun , Li Wen-sheng , Guo Zhi-qiang , Liu Zhi-kai , Tan Ning , Chen Ji-yan , He Pengcheng
Published: December 2020

Background: Although several studies have shown that N-terminal pro-B-type natriuretic peptide (NT-proBNP) is strongly correlated with coronary artery lesion complexity as well as prognosis in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients, the prognostic value of NT-proBNP in patients with NSTE-ACS and multivessel coronary artery disease undergoing PCI remains unclear. This study aimed to reveal the relationship between NT-proBNP levels and prognosis among NSTE-ACS patients with multivessel coronary artery disease undergoing successfully percutaneous coronary intervention.Methods: We consecutively enrolled 1022 patients from January 2010 to December 2014. Patients with a diagnosis of NSTE-ACS with multivessel coronary artery disease and NT-proBNP levels were included. The primary outcome was in-hospital all-cause death. The 3-year follow-up all-cause death was also ascertained.Results: A total of 12 (1.2%) deaths occurred during hospitalization. The 4th quartile group of NT-proBNP (>1287 pg/ml) had the highest rate of in-hospital all-cause death (4.3%) (P<0.001). Logistic analyses revealed that increasing NT-proBNP was robustly associated with a higher risk of in-hospital all-cause death (adjusted OR: 2.86, 95% CI=1.16-7.03, P=0.022). NT-proBNP had a good ability to predict in-hospital all-cause death (AUC=0.888, 95% CI=0.834-0.941, P<0.001; cutoff: 1568pg/ml). The cumulative event analyses exhibited a statistically significant relationship between a higher level of NT-proBNP and a higher rate of the long-term all-cause death compared with a lower level of NT-proBNP (P< 0.0001).Conclusions: Increasing NT-proBNP is significant associated with a high risk of in-hospital and long-term all-cause death in NSTE-ACS patients with multivessel coronary artery disease who received percutaneous coronary intervention. NT-proBNP > 1568pg/ml was associated with all-cause, in-hospital death.
Proteomic And Metabolomic Analyses Reveal The Full Spectrum of Inflammatory and Lipid Metabolic Abnormalities In Dyslipidemia
Authors: DU Hui , RAO Yifei , LIU Ronghua , DENG Kesui , GUAN Yongmei , LUO Dewei , MAO Qiping , YU Jianwei , BO Tao , FAN Ziquan , ouyang hui , FENG Yulin , ZHU Weifeng
Published: December 2020

Background: Dyslipidemia is a common, chronic metabolic disease associated with cardiovascular complications. Due to the multiplicity of etiological factors, the pathogenesis of dyslipidemia is still unclear.Methods: In this study, we combined proteomics and metabolomics methods to analyze the plasma of patients with dyslipidemia and healthy subjects. ITRAQ markers, combined with LC-MS/MS proteomics technology and the UHPLC/ Orbitfast-X Tribrid system, were used to establish the metabolite profile in clinical dyslipidemia.Results: A total of 137 differentially expressed proteins were identified, mainly related to biological processes such as protein activation cascades, adaptive immune responses, complement activation, acute inflammatory responses and regulation of acute inflammatory responses. These proteins are involved in the regulation of important metabolic pathways, such as immunity and inflammation, coagulation and hemostasis, lipid metabolism, and oxidation and antioxidant defenses. Analysis of clinical metabolites showed there were 69 different metabolites in plasma, mainly related to glycerolipid, sphingolipid, porphyrin, alpha-linolenic acid, linoleic acid and arachidonic acid metabolism, suggesting that regulation of inflammation and lipid metabolism may be disturbed in patients with dyslipidemia. Among these, significant changes were observed in indole-3-propionic acid (IPA), which is considered a potential biomarker of dyslipidemia. Conclusions: Combined analysis of proteins and metabolites showed that arachidonic acid, linoleic acid and lipid metabolic pathways were closely related to dyslipidemia. IPA may be a potential biomarker.The information provided in this study may provide new insights into the pathogenesis of dyslipidemia and related diseases, as well as potential intervention targets.
Serum Anti-AP3D1 Antibodies Are Broad-Spectrum Biomarkers for Atherosclerosis, Acute Ischemic Stroke, Cardiovascular Disease, Diabetes Mellitus, Chronic Kidney Disease, and Digestive Organ Cancer
Authors: Li Shu-Yang , Yoshida Yoichi , Kobayashi Eiichi , Kubota Masaaki , Matsutani Tomoo , Mine Seiichiro , Machida Toshio , Wada Takeshi , Aotsuka Akiyo , Maezawa Yoshiro , Takemoto Minoru , Yokote Koutaro , Kobayashi Yoshio , Kitamura Kenichiro , Takizawa Hirotaka , Kashiwado Koichi , Sata Mizuki , Yamagishi Kazumasa , Iso Hiroyasu , Sawada Norie , Tsugane Shoichiro , Kobayashi Sohei , Matsushita Kazuyuki , Nomura Fumio , Matsubara Hisahiro , Sumazaki Makoto , Ito Masaaki , Yajima Satoshi , Shimada Hideaki , Iwase Katsuro , Ashino Hiromi , Zhang Xiao-Meng , Wang Hao , Goto Kenichiro , Tomiyoshi Go , Shinmen Natsuko , Nakamura Rika , Kuroda Hideyuki , Iwadate Yasuo , Hiwasa Takaki
Published: December 2020

Background: Atherosclerosis has been considered as the main cause of morbidity, mortality, premature incapacity, and disability worldwide. For early and sensitive diagnosis, development of novel biomarkers is expected and of significant practical importance.Methods: The first screening for antigen markers was conducted using the serological identification of antigens by recombinant cDNA expression cloning (SEREX). Serum antibody levels were examined using the amplified luminescent proximity homogeneous assay-linked immunosorbent assay (AlphaLISA) using a recombinant protein as an antigen.Results: SEREX screening has identified adaptor-related protein complex 3 subunit delta 1 (AP3D1) as an antigen recognized by serum IgG antibodies of patients with atherosclerosis. As per the results of AlphaLISA, it was determined that the serum antibody levels against AP3D1 were higher in patients with acute ischemic stroke (AIS), transient ischemic attack (TIA), diabetes mellitus (DM), cardiovascular disease (CVD), chronic kidney disease (CKD), esophageal squamous cell carcinoma (ESCC), and colorectal carcinoma than those in the healthy donors. The area under the curve values of DM, nephrosclerosis type of CKD, and ESCC calculated using receiver operating characteristic curve analysis were noted to be higher than that of other diseases. Correlation analysis showed that the anti-AP3D1 antibody levels were highly associated with maximum intima-media thickness, which indicates that this marker reflected the development of atherosclerosis. The Japan Public Health Center-based Prospective Study results have verified that the serum antibody levels against AP3D1 showed significantly higher odds ratios with the risk of AIS for persons with the third quartiles and the highest quartiles versus the lowest quartile, indicating that this antibody marker is deemed useful as risk factors for AIS.Conclusions: Serum anti-AP3D1 antibodies, which are broad-spectrum biomarkers of atherosclerotic diseases and digestive organ cancers, could be useful in predicting the onset of AIS.
Cancer-Associated Fibroblasts Release Exosomal CBFB That Dictate an Aggressive Bone Metastasis Phenotype in Breast Cancer
Authors: Su Chih-Ming , Lai Yu-Hsin , Bamodu Oluwaseun Adebayo , Kuo Kuang-Tai , Fong Iat-Hang , Yeh Chi-Tai , Lee Wei-Hwa , Huang Wen-Chien
Published: December 2020

The authors have requested that this preprint be removed from Research Square.
Burnout and Peritraumatic Distress of Healthcare Workers in the COVID-19 Pandemic
Authors: Jang Yeonhhon , You Myoungsoon , Lee Heeyoung , lee Minjung , Lee Yeji , Han Jin-ok , Oh Jeonghyun
Published: December 2020

Background
To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status.
Methods
An online survey involving 1,068 HCWs that included nurses, physicians, and public health officers was conducted. Descriptive statistics and multivariate regression analyses were performed on the collected data.
Results
Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers’ experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress.
Conclusions
Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.
WITHDRAWN: Proxalutamide (GT0918) Reduces the Rate of Hospitalization and Death in COVID-19 Male Patients: A Randomized Double-Blinded Placebo-Controlled Trial.
Authors: Cadegiani Flavio Adsuara , McCoy John , Wambier Carlos Gustavo , Kovacevic Maja , Shapiro Jerry , Sinclair Rodney , Goren Andy
Published: December 2020

Importance: Previously, we have reported a retrospective cohort analysis demonstrating the protective effect of anti-androgens (5-alpha-reductase inhibitors) in COVID-19. Objective: To determine if the anti-androgen proxalutimide is an effective treatment for men with ambulatory mild COVID-19 disease.Design: A double-blinded, randomized, prospective, investigational study of proxalutamide for the treatment men with ambulatory mild COVID-19 disease.Setting: Outpatient centers (Brasilia, Brazil) from July 15 to December 1, 2020. Participants: Men with ambulatory mild COVID-19 disease (WHO ordinal scale ≤3).Interventions: Proxalutimide 200mg/day, or standard of care for 30 days or until full COVID-19 remission. Main Outcome and Measures: Percentage of subjects hospitalized due to COVID-19 [Time Frame: 30 days].Results: A total of 214 men were included and completed the trial; 114 men were randomized to the proxalutamide group, and 100 men were randomized to the control group. A statistically significant reduction in the percentage of subjects hospitalized due to COVID-19 was observed in men taking proxalutamide (0%) compared to the standard of care (27%), (p<0.001). The percentage of men requiring mechanical ventilation was reduced in the proxalutamide group (0%) compared to control (9%), (p<0.001). Zero fatalities occurred in the proxalutamide group, versus 2 in the control group.Conclusions and Relevance: Men with ambulatory mild COVID-19 disease (WHO ordinal scale ≤3) receiving anti-androgen treatment with proxalutamide, had significantly reduced rate of hospitalization compared to men not receiving anti-androgen treatment. Trial Registration: NCT04446429
Antimicrobial-Resistance Pathogen Load and Public Health Risk of Drinking Water in South Gondar, Ethiopia
Authors: Yenew Chalachew , Kebede Melese , Mulat Melkamu
Published: December 2020

Objectives: This study aims to determine the contamination Antimicrobial-Resistance Pathogen load and Public Health Risk of Drinking Water in the case of Debre Tabor Town, Northwest Ethiopia.Study design and period: A laboratory-based cross-sectional study design was employed from March to May 2020.Methods: A total of 60 water samples were collected from the household tap and household drinking water storage container by following the standard microbial analysis method. Besides Sanitary survey was conducted for the municipal water supply system. Water samples were analyzed for differences in bacteriological parameters and drug-susceptibility patterns. Descriptive statistics, independent sample t-test, and multiple linear regression models were used to analyze the data.Results: The drinking water was mostly contaminated with multiple antibiotics-resistance waterborne Escherichia coli 35% (95% CI: 31.2%, 46.9%), Salmonella 22.7% (95% CI: 23.2%, 28.7%), and Shigella 15% (95% CI: 11.2%, 20.9%). Approximately 52.78% and 36.11% of the tap and an equal 23.33% of the household storage container water samples were categorized under low and intermediate risks respectively, and the overall health risk index of the water samples showed that 45.83%, 41.67%, and 12.5%, of them, are categorized under low, intermediate and high-risk classes respectively.Conclusion: The contamination of drinking water with antimicrobial-resistant waterborne bacteria in the community could indicate the likelihood of the occurrence of treatment failure and increased mortality. Hence, proper drinking water treatment and strict supervision are needed to prevent the contamination of the water and related consequences.
ITPR3 Facilitates Tumor Growth, Metastasis and Stemness by Inducing the NF-ĸB/CD44 Pathway in Urinary Bladder Carcinoma
Authors: Zhang Mengzhao , Wang Lu , Yue Yangyang , Zhang Lu , Liu Tianjie , Jing Minxuan , Liang Xiao , Ma Minghai , Xu Shan , Wang Ke , Wang Xinyang , Fan Jinhai
Published: December 2020

Background: Bladder carcinoma is one of the most common urological cancers. ITPR3, as a ubiquitous endoplasmic reticulum calcium channel protein, was reported to be involved in the development and progression of various types of cancer. However, the potential roles and molecular mechanism of ITPR3 in bladder cancer are still unclear. Herein, we elucidated a novel role of ITPR3 in regulating the proliferation, metastasis, and stemness of bladder cancer cells.Methods: The expression of ITPR3 in bladder cancer was analyzed using public databases and bladder cancer tissue microarrays. To demonstrate the role of ITPR3 in regulating the NF-ĸB/CD44 pathway and the progression of bladder cancer, a series of molecular biology and biochemistry methods was performed on clinical tissues, along with in vivo and in vitro experiments. The methods used included western blot assay, quantitative RT-PCR assay, immunofluorescence assay, immunohistochemistry (IHC) assays, wound healing assay, Transwell assay, colony formation assay, tumorsphere formation assay, cell flow cytometry analysis, EdU assay, MTT assay, cell transfection, bisulfite sequencing PCR (BSP), a xenograft tumor model and a tail vein cancer metastasis model.Results: Higher ITPR3 expression was found in bladder cancer tissues and bladder cancer cells compared with the corresponding normal peritumor tissues and SV-HUC-1 cells, which was attributed to demethylation in the ITPR3 promoter region. ITPR3 promoted the proliferation of bladder cancer by accelerating cell cycle transformation and promoted local invasion and distant metastasis by inducing epithelial-to-mesenchymal transition (EMT). Meanwhile, ITPR3 maintained the cancer stemness phenotype by regulating CD44 expression. NF-κB, which is upstream of CD44, also played a critical role in this process.Conclusions: Our study clarifies that ITPR3 serves as an oncogene in bladder cancer cells and represents a novel candidate for bladder cancer diagnosis and treatment.
Extrapericardial Pleural Lipoma: A Surgical Case Report and Current Literature Review
Authors: Lu Peng , Zhu Dawei , Deng Fanxin , Zhang Xiaojing
Published: December 2020

BackgroundLipomas arising from the intrathoracic pleura are exceedingly rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as intrathoracic lipoma that arose from the mediastinal pleura of the left pericardium. Here the tumor was completely resected by uniportal video assisted thoracic surgery. Case presentationA 64-year-old female presented with a symptomatic left chest pain, which was confirmed to be an lipomatous tumor using computed tomography. An oval extrapericardial lipoma originating from the mediastinal pleura was resected through uniportal video assisted thoracic surgery. Pathological examination indicated a diagnosis of pleura lipoma. Conclusion﻿The tumor was infectious and relatively hyperemia when detected during a medical checkup. We enabled the successful tumor excision via uniportal video assisted thoracic surgery approach. Extratumoral haemorrhage was confirmed during the operation. Although intrathoracic pleural lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.
Mucosal and Systemic Immune Responses Modulated by in Ovo-Delivered Bioactive Compounds in Distinct Chicken Genotypes
Authors: Slawinska Anna , Dunislawska Aleksandra , Kowalczyk Artur , Łukaszewicz Ewa , Siwek Maria
Published: December 2020

BackgroundMucosal and systemic immune responses are different strategies to cope with environmental stimuli. In ovo delivery of prebiotic, probiotic, or synbiotic into the avian embryo allows for indigenous microbiota stimulation. Intestinal microbiota in animals is responsible for immune system maturation. The genetic component is critical in host-microbiota crosstalk and immune system development. The goal of this study was to compare mucosal and systemic immune responses in two distinct chicken genotypes stimulated in ovo. ResultsThe experiment was constructed in full-factorial design and was aimed to study the effects of two chicken genotypes (chicken broilers or native chickens), four in ovo-delivered compounds (GOS/galactooligosaccharides/prebiotic, Lactococcus lactis subsp. cremoris/probiotic, or GOS+L.lactis/synbiotic, vs. physiological saline) and three different stimuli (LPS or LTA vs. physiological saline) on a panel of cytokine genes (IL-1B, IL-2, IL-4, IL-6, IL-10, IL-12p40, and IL-17) expressed in caecal tonsils and spleen. We tested significance of the main effects and their interactions. Genotype had the most significant influence on all gene expression signatures in both tissues (P < 0.001 for all genes, except P < 0.05 for IL-10 in spleen). Immune challenge was the second most significant main effect, and influenced IL-1β, IL-6 IL-10 (P < 0.001), and IL-17 genes (P < 0.05) in caecal tonsils, and all genes in spleen (P < 0.001), except IL-4 (P > 0.05). In ovo stimulation influenced IL-2, IL-4, and IL-10 in caecal tonsils (P < 0.05), as well as IL-2 and IL-12p40 in spleen (P < 0.05). ConclusionsThe mucosal and systemic immune responses of chicken broilers and native chickens showed distinct patterns. Genotype influenced gene expression signatures of all immune-related genes, but chicken broilers developed stronger immune responses than native chickens. LPS triggered both mucosal (caecal tonsils) and systemic (spleen) immune responses in chicken broilers, but only systemic (spleen) in native chickens. In ovo stimulation with bioactive compounds (especially prebiotic) modulated innate immune responses to LPS. GOS delivered in ovo induced the most pronounced responses to LPS, which validated its further application as a potent immunomodulator for in ovo applications.
Comparative Analysis of Spatial-temporal Patterns of Human Metapneumovirus and Respiratory Syncytial Virus in Africa Using Genetic Data, 2011-2014
Authors: Oketch John W , Kamau Everlyn , Otieno James R , Mwema Anthony , Lewa Clement , Isoe Everlyne , Nokes James D , Agoti Charles N
Published: December 2020

Background: Human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) are leading causes of viral severe acute respiratory illnesses in childhood. Both the two viruses belong to the Pneumoviridae family and show overlapping clinical, epidemiological and transmission features. However, it is unknown whether these two viruses have similar geographic spread patterns which may provide insight into designing and evaluating their epidemic control measures.Methods: We conducted comparative phylogenetic and phylogeographic analyses to explore the spatial-temporal patterns of HMPV and RSV across Africa using 232 HMPV and 842 RSV attachment (G) glycoprotein gene sequences obtained from 5 countries (The Gambia, Zambia, Mali, South Africa, and Kenya) between August 2011 and January 2014. Results: Phylogeographic analyses found frequently similar patterns of spread of RSV and HMPV. Viral sequences commonly clustered by region, i.e., West Africa (Mali, Gambia), East Africa (Kenya) and Southern Africa (Zambia, South Africa), and similar genotype dominance patterns were observed between neighbouring countries. Both HMPV and RSV country epidemics were characterized by co-circulation of multiple genotypes. Sequences from different African sub-regions (East, West and Southern Africa) fell into separate clusters interspersed with sequences from other countries globally. Conclusion: The spatial clustering patterns of viral sequences and genotype dominance patterns observed in our analysis suggests strong regional links and predominant local transmission. The geographical clustering further suggests independent introduction of HMPV and RSV variants in Africa from the global pool, and local regional diversification.
Abrupt Change of Bandgap Energy in Quantum System of Nanolayer on Silicon Surface
Authors: Huang Wei-Qi , Liu Shi-Rong , Wang Zi-Lin , Chen Cui-Fen , Wang Ke , Peng Hong-Yan , Huang Zhong-Mei , Wang An-Chen , Li Xin
Published: December 2020

In the quantum system of nanolayer (NL) on silicon, the bandgap energy obviously increases with decreasing thickness of NL, in which the quantum confinement (QC) effect plays a main role. In simulating calculation, the QC effect has been exhibited as the thickness of Si NL changes along with (100), (110) and (111) direction respectively. And the simulation result demonstrated that the direct bandgap can be obtained as the NL with (001) direction is thinner than 10nm on Si surface. However, it is discovered in the simulated calculation that the QC effect disappears as the NL thickness arrives at size of monoatomic layer, in which its bandgap sharply deceases, where the abrupt change effect in bandgap energy occurs near idea 2D-layer. In experiment, we fabricated the Si NL structure by using electron beam irradiation and pulsed laser deposition methods, in which a novel way was used to control the NL thickness by modulating irradiation time of electron beam. The new effect should have a good application on optic-electronic chip of silicon.
Relationship Between Patellofemoral Finite Helical Axis and Femoral Trans-Epicondyle Axis Using a Static Magnetic Resonance-Based Methodology
Authors: Yu Zhenguo , Cai Hong , Yang Bin , Yao Jie , Zhang Ke , Tian Hua , Liu Zhongjun
Published: December 2020

Background: To manage patellofemoral joint disorders, a complete understanding of the in vivo patellofemoral kinematics is critical. However, as one of the parameters of joint kinematics, the location and orientation of patellofemoral finite helical axis (FHA) remains unclear. The purpose of this study is to quantify the location and orientation of the patellar FHA both in vivo and non-invasively at various flexion angles and to relate the FHA to the trans-epicondyle axis (TEA).Methods: The Magnetic resonance (MR) images of 18 unilateral knees were collected at full extension and at 30°, 60°, 90°, and maximum angle of knee flexion. Three-dimensional models of knee joint at different flexion angles were developed with the MR images, and were used to calculate the patellar tracking and FHA with a spline interpolation algorithm. By using a coordinate system based on the TEA, the FHA tracking was quantified. Six parameters concerning the location and orientation of the patellar FHA were analyzed.Results: The average patellar FHA of 18 knees drew an L-shaped tracking on the midsagittal plane moving from the posteroinferior side of the TEA to the anterosuperior with knee flexion. Before 90° flexion, the patellar rotational radius decreased slightly, with an average value of 5.65 ± 1.09 cm. During 20° to 90° knee flexion, the average angle between the patellar FHA and TEA was approximately 10° and that between the FHA and coronal plane was maintained at about 0°, while that between the FHA and level plane fluctuated between -10° and 10°.Conclusions: Patellar FHA was not fixed during flexion, which showed a close relationship with femoral TEA in both location and orientation. The results could help us better understand the patellofemoral joint kinematics and further deal with troublesome patellofemoral disorders.
IgG4-Related Nephritis Misdiagnosed as a Malignant Tumor Based on 18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Case Report
Authors: Bo Pan , Wang Shi-cun , Chen Xi , Chen Zong-Ke
Published: December 2020

Introduction: IgG4-related diseases is an autoimmune disease newly recognized in recent years, it is rarely seen in clinical practice, the main clinical features of IgG4-RKD include acute or chronic renal insufficiency, proteinuria, elevated serum Ig G4, histopathological manifestations were tubulointerstitial nephritis, mainly characterized by a large amount of IgG4 positive plasma cell infiltration in the tubulointerstitial, it responded well to glucocorticoid therapy. Renal parenchymal damage could be seen on imaging. However, PET/CT imaging has been less reported, here we reported a case of IgG4-related kidney disease with PET/CT imaging.Case presentation: A 50-year-old female presented with chills and fever for more than 2 months, she came to the urology department of our hospital for further diagnosis and treatment due to the right kidney occupation revealed by CT examination in local hospital. MRI plain scan plus diffusion imaging suggested multiple lesions in the right kidney, multiple nodular abnormally hypermetabolism foci in the right kidney were seen on PET/CT imaging, and the negative findings in the other parts of the body, therefore, a primary malignant tumor of the kidney was considered. Laboratory tests revealed elevated Levels of C-reactive protein, erythrocyte sedimentation rate, and IgG4 of immunoglobulin, histological pathology of right kidney puncture indicated inflammation and infection with surgical indications, she underwent radical right nephrectomy with laparoscopic under general anesthesia and was discharged 1 week after the right kidney operation, her clinical symptom disappeared and kept in good health during follow-up.Conclusions: IgG4-related nephritis could manifest multiple or solitary hypermetabolism foci in unilateral kidney on PET/CT imaging, while the rest of the systemic PET/CT imaging manifestation was negative, which may be related to the infiltration of lymphocytes, plasma cells and inflammatory cells at the lesion site. The cause of abnormal accumulation of FDG in lesion site was unclear, and the true mechanism needs to be further clarified.
Higher SARS-CoV-2 Seroprevalence in Workers with Lower Socioeconomic Status in Cape Town, South Africa.
Authors: Shaw Jane Alexandra , Meiring Maynard , Cummins Tracy , Chegou Novel , Claassen Conita , Plessis Nelita du , Flinn Marika , Hiemstra Andriette , Kleynhans Leanie , Leukes Vinzeigh , Loxton Andre G , MacDonald Candice , Mtala Nosipho , Reuter Helmuth , Simon Donald , Stanley Kim , Tromp Gerard C , Preiser Wolfgang , Malherbe Stephanus T , Walzl Gerhard
Published: December 2020

Background: South Africa has a high degree of inequality between population groups. The first wave of COVID-19 may have affected people in lower socioeconomic groups worse than the affluent. The SARS-CoV-2 seroprevalence and the specificity of anti-SARS-CoV-2 antibody tests in South Africa is not known. Methods: We tested 405 volunteers representing all socioeconomic strata from the workforce of a popular shopping and tourist complex in central Cape Town with the Abbott SARS-CoV-2 IgG assay. We assessed the association between antibody positivity and COVID-19 symptom status, medical history, and sociodemographic variables. We tested 137 serum samples from healthy controls collected in Cape Town prior to the COVID-19 pandemic, to confirm the specificity of the assay in the local population.Results: Of the 405 volunteers tested one month after the first peak of the epidemic in Cape Town, 96(23.7%) were SARS-CoV-2 IgG positive. Of those who tested positive, 46(47.9%) reported no symptoms of COVID-19 in the previous 6 months. Seropositivity was significantly associated with living in informal housing, residing in a subdistrict with low income-per household, and having a low-earning occupation. The specificity of the assay was 98.54%(95%CI 94.82%-99.82%) in the pre-COVID controls.Conclusions: There is a high background seroprevalence in Cape Town, particularly in people of lower socioeconomic status. Half of cases are asymptomatic, and therefore undiagnosed by local testing strategies. These results cannot be explained by low assay specificity.
Epidemiology of Sepsis-Associated Acute Kidney Injury in Beijing, China: A Descriptive Analysis
Authors: Wang Haiman , Ji Xiaojun , Wang Amanda Y , Wu Patrick , Liu Zhuang , Dong Lei , Liu Jingfeng , Liu Pei , Qi Zhili , Duan Meili
Published: December 2020

Background Sepsis is the most common contributing factor towards development of acute kidney injury (AKI), which is strongly associated to poor prognostic outcomes. There are numerous epidemiological studies about sepsis-associated acute kidney injury (S-AKI), however current literature is limited with the majority of studies being conducted only in the intensive care unit (ICU) setting. The aim of this study was to assess the epidemiology of S-AKI in all hospitalized in-patients. Methods This was a retrospective population-based study using a large regional population database in Beijing city from January, 2005 to December, 2017. It included patients with S-AKI. Patients with pre-existing end-stage kidney disease (ESKD), previous history of kidney transplantation, or being pregnant were excluded. Patients’ demographic characteristics, incidence, risk factors and outcomes of S-AKI were analyzed. The differences between different time periods, different levels of hospitals, and types of the hospitals (i.e. traditional Chinese medicine hospitals (TCMHs) and Western medicine hospitals (WMHs)) were also compared using Mann-Whitney U test. Results A total of 19,579 patients were included. The overall incidence of S-AKI in all in-patients was 48.1%. The risk factors for AKI included: age (P<0.001), male (P<0.001), treatment in a level-II hospital (P<0.001), hypertension (P<0.001), ICU admission (P<0.001) and so on. The overall mortality rate in this cohort was 55%. The risk factors for mortality included: age (P<0.001), female (P<0.001), pre-existing chronic kidney disease (CKD) (P=0.023), ICU admission (P=0.005),pulmonary infection (P<0.001) and so on. The incidence of S-AKI increased over time, but the mortality rate did not. Compared with level-II hospitals, the incidence of S-AKI was similar in tertiary hospitals, but the mortality rate was significantly higher. Although patients treated in TCMHs had a shorter hospital stay and a lower cost of care, this cohort had a higher mortality rate when compared with patients treated in WMHs. Conclusions AKI is a common complication in all hospitalized patients with sepsis, and its incidence increases over time, especially when ICU admission is required. Exploring interventional strategies to address modifiable risk factors will be important to reduce incidence and mortality of S-AKI.
Quality of Care for Adult Inpatients with Malaria in a Tertiary Hospital in Uganda
Authors: Kiguba Ronald , Karamagi Charles , Bird Sheila M.
Published: December 2020

Background: Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria inpatients is not well documented in sub-Saharan Africa, particularly in Uganda. We sought to describe the patterns of malaria diagnosis and treatment among adult inpatients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014.Methods: A prospective cohort of 762 consented inpatients aged >18 years was assembled. Proportions of inpatients who received preadmission and in-hospital antimalarials, missed Day 1 dosing of hospital-initiated antimalarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of antimalarials.Results: One in five (19%, 146/762) inpatients had an admitting or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22 to 42 years). Microscopy was requested in 77% (108/141) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for malaria parasitaemia. Only 13% (11/83) of inpatients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); only 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated antimalarial followed by injectable Q only (23%, 23/100). A quarter (25%, 25/100; 95% CI: 17% to 35%) of inpatients missed Day 1 dosing of hospital-initiated antimalarials. Each additional admitting diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital antimalarials (aOR = 2.6, 95% CI: 1.52-4.56; P-value = 0.001).Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. The majority of inpatients initiated on injectable AS or Q did not receive the recommended follow-up treatment of oral AL. One in four inpatients delayed to initiate hospital antimalarials by at least one calendar day. The hospital should encourage prompt availability of malaria test-results to promote the timely initiation and completion of antimalarial treatment, thereby improving the quality of care for hospitalized malaria patients in Uganda.
Progesterone levels predict pregnancy outcome in individuals with fallopian tube associated infertility
Authors: BO Wenjia , Zhang Ning , Wang Ling , Guo Ying , Wu Haicui
Published: December 2020

BACKGROUND: This study aimed at determining the predictive value of human chorionic gonadotropin and progesterone levels on pregnancy outcomes in patients receiving in vitro fertilization due to fallopian tube associated infertility.METHODS: We retrospectively analyzed the clinical data of 854 cycles due to fallopian tube associated infertility in vitro fertilization fresh embryo transfer. The clinical data had been collected from January 2010 to December 2018 and was divided into 7 groups depending on the progesterone level on human chorionic gonadotropin administration day. Live birth rates and observation trends were calculated. The receiver operating characteristic curve was established to determine the optimal cutoff value for progesterone, which was used to further divide the data into 3 groups; Group 1 (progesterone ≦ 1.0 ng/ml), Group 2 (1.0 ng/ml ≤ progesterone ≤ 1.25 ng/ml), and Group 3 (progesterone≥1.25 ng/ml). We then compared the ovulation results and clinical outcomes among the 3 groups.RESULTS: There were no significant differences in age, infertility years, gonadotropin dosage, gonadotropin days, Luteinizing hormone level on human chorionic gonadotropin day, 2 pronuclear fertilization rates, clinical pregnancy rates, live birth rates, full-term birth rate, and preterm birth rates among the three groups. However body mass index (p = 0.001), basal luteinizing hormone (p = 0.034), estrogen peak (p ＜0.001), number of oocytes obtained (P＜0.001) were significantly different.CONCLUSION: Progesterone level on human chorionic gonadotropin day does not affect the clinical pregnancy rate and live birth rates after in vitro fertilization. However, progesterone levels between 1.0-1.25 ng/ml may lead to good clinical pregnancy outcomes.
A Generalised Approach for High-throughput Instance Segmentation of Stomata in Microscope Images
Authors: Jayakody Hiranya Samanga , Petrie Paul , de Boer Hugo , Whitty Mark
Published: December 2020

Background: Stomata analysis using microscope imagery provides important insight into plant physiology, health and the surrounding environmental conditions. Plant scientists are now able to conduct automated high-throughput analysis of stomata in microscope data, however, existing detection methods are sensitive to the appearance of stomata in the training images, thereby limiting general applicability. In addition, existing methods only generate bounding-boxes around detected stomata, which require users to implement additional image processing steps to study stomata morphology. In this paper, we develop a fully automated, robust stomata detection algorithm which can also identify individual stomata boundaries regardless of the plant species, sample collection method, imaging technique and magnification level. Results: The proposed solution consists of three stages. First, the input image is pre-processed to remove any colour space biases occurring from different sample collection and imaging techniques. Then, a Mask R-CNN is applied to estimate individual stomata boundaries. The feature pyramid network embedded in the Mask R-CNN is utilised to identify stomata at different scales. Finally, a statistical filter is implemented at the Mask R-CNN output to reduce the number of false positive generated by the network. The algorithm was tested using 16 datasets from 12 sources, containing over 60,000 stomata. For the first time in this domain, the proposed solution was tested against 7 microscope datasets never seen by the algorithm to show the generalisability of the solution. Results indicated that the proposed approach can detect stomata with a precision, recall, and F-score of 95.10\%, 83.34\%, and 88.61\%, respectively. A separate test conducted by comparing estimated stomata boundary values with manually measured data showed that the proposed method has an IoU score of 0.70; a 7\% improvement over the bounding-box approach. Conclusions: The proposed method shows robust performance across multiple microscope image datasets of different quality and scale. This generalised stomata detection algorithm allows plant scientists to conduct stomata analysis whilst eliminating the need to re-label and re-train for each new dataset. The open-source code shared with this project can be directly deployed in Google Colab or any other Tensorflow environment.
High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo
Authors: Francis Wat’senga Tezzo , Sylvie Fasine , Zola Manzambi Emile , Carmen Marquetti Maria del , Guillaume Binene Mbuka , Gillon Ilombe , Richard Mundeke Takasongo , Nathalie Smitz , Andre Bisset Juan , Wim Van Bortel , Vanlerberghe Veerle
Published: December 2020

BACKGROUND: Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts.METHODS: In 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA-barcoding of the specimens to validate identifications.RESULTS: The most rural commune (Mont Ngafula) had the highest pupal index of 246 (20) pupae/100 houses and a Breteau Index of 82.2 (19.5)/100 houses, while this latter was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N’Djili in the rainy (and dry) season, respectively. The House Index was on average across all communes 27.5% (7.6%); and the Container Index 15.0% (10.0%) in rainy (and dry) season, respectively. The vast majority of Aedes positive containers were found outside the houses (adjusted OR 27.4 (95%CI 14.9-50.1)). During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season trash and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season. CONCLUSIONS: . In both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target outdoor spaces for larval habitats destruction or reduction.
A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases
Authors: de Gruijter Nina M , Naja Meena , Peckham Hannah , Radziszewska Anna , Kinsella Matthew , Glenister James , Rosser Elizabeth , Butler Gary E , Jury Elizabeth C , Ciurtin Coziana
Published: December 2020

BackgroundAutoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias, which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARD-related outcomes.MethodsStudies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, disease outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS).Results16 non-randomised studies reporting on the impact of puberty on ARD outcomes (n=7), ARD impact on puberty-related outcomes (n=8), or both (n=1) have been identified. The impact of puberty on ARD outcomes were investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n=1), juvenile systemic lupus erythematosus (JSLE) (n=5) or in healthy controls who developed adult-onset SLE (n=1) or had non-specific symptoms (n=1). The impact of ARD on puberty outcomes was explored in JIA (n=4) and JSLE (n=3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4-9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment.ConclusionA bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.
Characteristics and diversity of mutations in regulatory genes of resistance-nodulation-cell division efflux pumps in association with drug-resistant clinical isolates of Acinetobacter baumannii
Authors: Salehi Bahare , Ghalavand Zohreh , Yadegar Abbas , Eslami Gita
Published: December 2020

Background: This study aimed to characterize the regulation and expression of three putative resistance-nodulation-cell division (RND)-type efflux systems and their contribution to multidrug efflux in clinical isolates of Acinetobacter baumannii. Methods: Antimicrobial susceptibility testing (AST) of 95 A. baumannii isolates was determined by Kirby-Bauer disk diffusion for 18 antibiotics and minimum inhibitory concentration (MIC) of colistin was determined by broth microdilution method. Moreover, MIC of five classes of antibiotics was assessed using E-test strips in the presence and absence of phenylalanine-arginine beta-naphthylamide (PAβN). Regulatory genes of RND efflux pumps (AdeRS, AdeL, AdeN and BaeSR) were subjected to sequencing. The relative expression of adeB. adeG and adeJ genes was determined by quantitative real-time PCR (RT-PCR).Results: Overall, majority of isolates (93%) were extensively drug-resistant (XDR). In the phenotypic assay, efflux pump activity was observed in 40% of isolates against multiple antibiotics mainly tigecycline, but not to imipenem. Several amino acid substitutions were detected in the regulatory genes; except in AdeN. Of note, G186V in AdeS were found to be associated with overexpression of their relative efflux pumps. No insertion sequences (ISs) were detected. Conclusions: Our findings outline the role of RND efflux pumps in resistance of A. baumannii against multiple antibiotics particularly tigecycline, and point out importance of a variety of single mutations in the corresponding regulatory systems. Even though it has been concluded that multidrug resistance occurs as a result of a complex sets of different resistant mechanisms.