bluuebunny/crossref_metadata_2025 huggingface dataset:
Constructe a novel 5 hypoxia genes signature for cervical cancer
Authors: Yang Yang , Li Yaling , Qi Ruiqun , Zhang Lan
Published: July 2021

Background

Hypoxia, which affects the development, metastasis and prognosis of cancer, represents a key feature of cancer. This study describe a hypoxia risk factor model, with predicting the prognosis of cervical cancer.

Methods

Based on hypoxia pathway related genes, we divided cervical cancer samples into high and low expression groups. A cox analysis was then performed. Genes from these cervical cancer samples showing a significant impact on OS were selected for cluster analysis to obtain two subtypes. The TPM dataset of TCGA was divided into training and validation sets. For the training set, a lasso analysis was conducted as based on cox analysis of meaningful genes and a risk factor model was constructed. The constructed model was verified in internal and external data sets. Finally, RT-PCR, immunohistochemistry were used to detect the expression of relative genes or proteins and functional assays were used to evaluate the biological function of signature genes.

Results

Two molecular subtypes were obtained, Cluster2 vs Cluster1.These subtypes were obtained by clustering with a total of 149 DEGs (Differential expressed genes) being in line with this standard, of which 27 were up-regulated and 122 were down-regulated. The five genes with lambda = 0.0571 were selected to construct the model, the RiskScore = AK4*0.042 + HK2*0.021 + P4HA1*0.22 + TGFBI*0.1 + VEGFA*0.077. Further, in order to verify the signature, we used TCGA-test and GSE44001 chip datasets to test, and finally got a good risk prediction effect in those datasets. Moreover, the result of RT-PCR and immunohistochemistry demonstrated that AK4, HK2, P4HA1, TGFBI and VEGFA were all highly expressed in these cervical cancer tissue samples. The functional study shown that expression of AK4, HK2, P4HA1, TGFBI and VEGFA can regulate the proliferation, migration, and invasion ability of cervical cancer cells in vitro.

Conclusions

In summary, we developed a 5-gene signature prognostic hierarchical system based on the hypoxic pathway of cervical cancer, which is independent of clinical characteristics. And also conducted experimental verifications on these signature gene. Therefore, we propose that use of this classifier as a molecular diagnostic test can provide an effective means for evaluating the prognostic risk of cervical cancer patients, and provide potential targets for the treatment of cervical cancer patients.
Aberrantly methylated-differentially genes and pathways among Iranian patients with colorectal cancer
Authors: Ghorbani Mahla , Azghandi Marjan , Kerachian Mohammad Amin
Published: July 2021

Background

Methylation plays an important role in colorectal cancer (CRC) pathogenesis. The goal of this study was to identify aberrantly differentially methylated genes (DMGs) and pathways through bioinformatics analysis among Iranian CRC patients using Methylation Next Generation Sequencing.

Methods

This study has integrated results of SureSelectXT Methyl-Seq Target with the potential key candidate genes and pathways in CRC. Six CRC and six samples of normal colon were integrated and deeply analyzed. In addition to this gene methylation profiling, several other gene methylation profiling datasets were obtained from Gene Expression Omnibus (GEO) and TCGA datasets. DMGs were sorted and candidate genes and enrichment pathways were analyzed. DMGs-associated protein–protein interaction network (PPI) was constructed based on the STRING online database.

Results

Totally, 320 genes were detected as common genes between our patients and selected GEO and TCGA datasets from the Agilent SureSelect analysis with selecting criteria of p-value < 0.05 and FC ≥ 1.5. DMGs were identified from hyper-DMGs PPI network complex and 10 KEGG pathways were identified. The most important modules were extracted from MCODE, as most of the corresponding genes were involved in cellular process and protein binding.

Conclusions

Hub genes including WNT2, SFRP2, ZNF726 and BMP2 were suggested as potentially diagnostic and therapeutic targets for CRC.
Decomposition of socioeconomic inequalities in the uptake of intermittent preventive treatment of malaria in pregnancy in Nigeria: evidence from Demographic Health Survey
Authors: Okoli Chijioke Ifeanyi , Hajizadeh Mohammad , Rahman Mohammad Mafizur , Khanam Rasheda
Published: July 2021

Background

Although malaria in pregnancy is preventable with the use of intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP), it still causes maternal morbidity and mortality, in sub-Saharan Africa and Nigeria in particular. Socioeconomic inequality leads to limited uptake of IPTp-SP by pregnant women and is, therefore, a public health challenge in Nigeria. This study aimed to measure and identify factors explaining socioeconomic inequality in the uptake of IPTp-SP in Nigeria.

Methods

The study re-analysed dataset of 12,294 women aged 15–49 years from 2018 Nigeria Demographic Health Survey (DHS). The normalized concentration index (Cn) and concentration curve were used to quantify and graphically present socioeconomic inequalities in the uptake of IPTp-SP among pregnant women in Nigeria. The Cn was decomposed to identify key factors contributing to the observed socioeconomic inequality in the uptake of adequate (≥ 3) IPTp-SP.

Results

The study showed a higher concentration of the adequate uptake of IPTp-SP among socioeconomically advantaged women (Cn = 0.062; 95% confidence interval [CI] 0.048 to 0.076) in Nigeria. There is a pro-rich inequality in the uptake of IPTp-SP in urban areas (Cn = 0.283; 95%CI 0.279 to 0.288). In contrast, a pro-poor inequality in the uptake of IPTp-SP was observed in rural areas (Cn = − 0.238; 95%CI − 0.242 to − 0.235). The result of the decomposition analysis indicated that geographic zone of residence and antenatal visits were the two main drivers for the concentration of the uptake of IPTp-SP among wealthier pregnant women in Nigeria.

Conclusion

The pro-rich inequalities in the uptake of IPTp-SP among pregnant women in Nigeria, particularly in urban areas, warrant further attention. Strategies to improve the uptake of IPTp-SP among women residing in socioeconomically disadvantaged geographic zones (North-East and North-West) and improving antenatal visits among the poor women may reduce pro-rich inequality in the uptake of IPTp-SP among pregnant women in Nigeria.
Toll-like receptor 9 and 4 gene polymorphisms in susceptibility and severity of malaria: a meta-analysis of genetic association studies
Authors: Naing Cho , Wong Siew Tung , Aung Htar Htar
Published: July 2021

Background

Malaria is still a major public health problem in sub-Saharan Africa and South-east Asia. The clinical presentations of malaria infection vary from a mild febrile illness to life-threatening severe malaria. Toll like receptors (TLRs) are postulated to be involved in the innate immune responses to malaria. Individual studies showed inconclusive findings. This study aimed to assess the role of TLR4 (D299G, T399I) and TLR9 (T1237C, T1486C) in severity or susceptibility of malaria by meta-analysis of data from eligible studies.

Methods

Relevant case–control studies that assessed the association between TLR 4/9 and malaria either in susceptibility or progression were searched in health-related electronic databases. Quality of included studies was evaluated with Newcastle–Ottawa scale. Pooled analyses for specific genetic polymorphisms were done under five genetic models. Stratified analysis was done by age and geographical region (Asian countries vs non-Asian countries).

Results

Eleven studies (2716 cases and 2376 controls) from nine endemic countries were identified. Five studies (45.4%) obtained high score in quality assessment. Overall, a significant association between TLR9 (T1486C) and severity of malaria is observed in allele model (OR: 1.26, 95% CI: 1.08–1.48, I2 = 0%) or homozygous model (OR: 1.55, 95% CI: 1.08–2.28, I2 = 0%). For TLR9 (T1237C), a significant association with severity of malaria is observed in in heterozygous model (OR:1.89, 95% CI: 1.11–3.22, I2 = 75%). On stratifications, TLR9 (T1486C) is only significantly associated with a subgroup of children of non-Asian countries under allele model (OR: 1.25, 95% CI: 1.02–1.38), while 1237 is with a subgroup of adults from Asian countries under heterozygous model (OR: 2.0, 95% CI: 1.09–3.64, I2 = 39%). Regarding the susceptibility to malaria, TLR9 (T1237C) is significantly associated only with the children group under recessive model (OR: 2.21, 95% CI: 1.06–4.57, I2=85%) and homozygous model (OR: 1.49, 95% CI: 1.09–2.0, I2 = 0%). For TLR4 (D299G, T399I), none is significantly associated with either severity of malaria or susceptibility to malaria under any genetic models.

Conclusions

The findings suggest that TLR 9 (T1486C and T1237C) seems to influence the progression of malaria, under certain genetic models and in specific age group of people from specific geographical region. TLR 9 (T1237C) also plays a role in susceptibility to malaria under certain genetic models and only with children of non-Asian countries. To substantiate these, future well designed studies with larger samples across endemic countries are needed.
Ribonucleic acid-binding protein CPSF6 promotes glycolysis and suppresses apoptosis in hepatocellular carcinoma cells by inhibiting the BTG2 expression
Authors: Liu Yang , Zou Hongbo , Xie Qichao , Zou Lan , Kong Rui , Mao Bijing
Published: July 2021

Hepatocellular carcinoma (HCC) is currently the sixth most common malignancy and the second major cause of tumor-related deaths in the world. This study aimed to investigate the role of cleavage and polyadenylation factor-6 (CPSF6) and B-cell translocation gene 2 (BTG2) in regulating the glycolysis and apoptosis in HCC cells. The RNA and protein expression of CPSF6 and BTG2 in normal hepatocyte and HCC were, respectively, detected by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) analysis and Western blot analysis. The viability and apoptosis of transfected Huh-7 cells were, respectively, analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay. The expression of apoptosis-related proteins and HK-2 in transfected Huh-7 cells was also detected by Western blot analysis. The levels of glucose and lactate in the culture supernatant of transfected Huh-7 cells were, respectively, detected with the glucose assay kit and lactate assay kit. The interaction of CPSF6 and BTG2 was confirmed by RNA binding protein immunoprecipitation (RIP) assay. As a result, CPSF6 expression was increased while BTG2 expression was decreased in Huh-7 cells. Interference with CPSF6 suppressed the viability and glycolysis, and promoted the apoptosis of Huh-7 cells. Furthermore, CPSF6 interacted with BTG2 and interference with CPSF6 upregulated the BTG2 expression and inhibited the protein kinase B (AKT)/extracellular signal-regulated kinase (ERK)/nuclear factor (NF)-κB pathway. Interference with BTG2 could partially reverse the above cell changes caused by interference with CPSF6. In conclusion, CPSF6 inhibited the BTG2 expression to promote glycolysis and suppress apoptosis in HCC cells by activating AKT/ERK/NF-κB pathway.
An intersectional analysis of the composite index of anthropometric failures in India
Authors: Kochupurackal Sabu Ulahannan , Channa Basappa Yogish , Vazhamplackal Sangeetha Joice , Srinivas Prashanth N
Published: July 2021

Background

Nutritional inequality in India has been estimated typically using stunting, wasting and underweight separately which hide the overall magnitude and severity of undernutrition. We used the Composite Index of Anthropometric Failure (CIAF) that combines all three forms of anthropometric failures to assess the severity of undernutrition and identify the most vulnerable social groups and geographical hotspots.

Method

CIAF was constructed using child anthropometric data from the fourth round of the National Family Health Survey (NFHS-4, 2015–16). We considered 24 intersecting sub-groups based on intersections across four main axes of inequality i.e., caste [Scheduled Tribe (ST), Scheduled Caste (SC) and Other], economic position (poor and non-poor), place of residence (rural and urban) and gender (male and female) (eg. ST-Poor-Rural-Female). Cross-tabulation and logistic regression were done to assess the odds of CIAF among intersecting groups and to identify the most vulnerable sub-groups. Concentration curve was plotted to visualise economic position inequality in child undernutrition across caste categories. Choropleth maps were constructed and descriptive analysis of the district-level prevalence of CIAF was performed to identify the geographic clustering of undernutrition.

Results

Overall 55.32% of children were undernourished by CIAF and 6.62% of children have simultaneous three anthropometric failure. In sub-group analysis, children from ST and SC caste have a higher risk of undernutrition irrespective of other axis of inequality. Compared with CIAF, economic position inequality was amplified for simultaneous-three-failures among all caste categories. Economic position inequalities within caste are more for other caste and SC categories than with ST. Economic position, caste and gender based inequality in all three failures is more consistent in rural areas than with urban areas. Based on the analysis of the high prevalence in the co-occurrence of two or three failures, 111 districts from 12 of 29 states in India were identified across four geographic clusters.

Conclusions

The study shows social and eco-geographical clustering of multi-dimensional anthropometric failures and indicates the need for focused nutritional interventions among SC and ST community in general and ST children from the poor households. Furthermore, governance interventions that target entire regions across districts and states combined with decentralised planning are needed.
An easy-to-operate web-based calculator for predicting the progression of chronic kidney disease
Authors: Xu Qian , Wang Yunyun , Fang Yiqun , Feng Shanshan , Chen Cuiyun , Jiang Yanxia
Published: July 2021

Background

This study aimed to establish and validate an easy-to-operate novel scoring system based on simple and readily available clinical indices for predicting the progression of chronic kidney disease (CKD).

Methods

We retrospectively evaluated 1045 eligible CKD patients from a publicly available database. Factors included in the model were determined by univariate and multiple Cox proportional hazard analyses based on the training set.

Results

Independent prognostic factors including etiology, hemoglobin level, creatinine level, proteinuria, and urinary protein/creatinine ratio were determined and contained in the model. The model showed good calibration and discrimination. The area under the curve (AUC) values generated to predict 1-, 2-, and 3-year progression-free survival in the training set were 0.947, 0.931, and 0.939, respectively. In the validation set, the model still revealed excellent calibration and discrimination, and the AUC values generated to predict 1-, 2-, and 3-year progression-free survival were 0.948, 0.933, and 0.915, respectively. In addition, decision curve analysis demonstrated that the model was clinically beneficial. Moreover, to visualize the prediction results, we established a web-based calculator (https://ncutool.shinyapps.io/CKDprogression/).

Conclusion

An easy-to-operate model based on five relevant factors was developed and validated as a conventional tool to assist doctors with clinical decision-making and personalized treatment.
Utilization and its factors of post abortion modern contraceptive in Ethiopia: a systematic review and meta-analysis
Authors: Beyene Fentahun Yenealem , Tesfu Azimeraw Arega , Wudineh Kihinetu Gelaye , Sendeku Fikadu Waltenigus , Ayenew Asteray Assemie
Published: July 2021

Background

Providing post-abortion care service is a widely accepted to reduce maternal morbidity and mortality by promoting, preventing and treating maternal and neonatal health, identifying the utilization and its factor of post abortion contraceptive is crucial. Therefore we tried to review post abortion contraceptive utilization and its factors in Ethiopia.

Methods

A review was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic and a comprehensive literature searching mechanism were used without any restriction, through Google scholar, PubMed, EMBASE, Scopus, Web of Sciences, and Grey literature databases for reporting utilization of post abortion family planning. Pilo-tested were performed in random sample studies and a standardized data extraction form was used. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was used with a random-effects method. The results are presented using texts, tables and forest plots with measures of effect and 95% confidence interval.

Results

Among 1221 records, 11 studies were taken in the meta-analysis with 4336 Participants that full fill the inclusion criteria. The pooled prevalence of post abortion contraceptive in Ethiopia was 74.56% (95% CI (73.31%, 75.81%)). Married women (OR 2.01 (95% CI (1.52, 2.66), I2: 0.0%)), women who were counseled (OR 5.36 (95% CI (3.10, 9.29), I2: 79.5%)), women whose educational level tertiary and above (OR 2.28 (95% CI (1.66, 3.17), I2: 0.0%)), women who had ever used contraceptive (OR 3.76 (95% CI (2.19, 6.47), I2: 67.8%)) and those women’s age 15–24 years old (OR 8.35 (95% CI (2.74, 14.74), I2: 87.4)) were statistically significant.

Conclusion

According to World Health Organization (WHO) guideline, "after a miscarriage or induced abortion, the recommended minimum interval to next pregnancy is at least 6 months in order to reduce risks of adverse maternal and perinatal outcomes".. According to this post abortion contraceptive utilization in Ethiopia is not optimal. Marital status, education, Counsel, previously exposed and age were significantly associated. Therefore, the Ministry of Health should work target fully to address those problems to maintain maternal and child health in Ethiopia.
A study based on four immunoassays: Hepatitis C virus antibody against different antigens may have unequal contributions to detection
Authors: Jiang Xinyi , Chang Le , Yan Ying , Ji Huimin , Sun Huizhen , Guo Fei , Wang Lunan
Published: July 2021

Background

All commercial Hepatitis C virus antibody (anti-HCV) assays use a combination of recombinant antigens to detect antibody response. Antibody responses to individual antigenic regions (core, NS3/4 and NS5) used in assays have not been investigated.

Methods

In this study, we quantified HCV viral load, tested anti-HCV with four commercial assays (Ortho-ELISA, Murex-ELISA, Architect-CMIA and Elecsys-ECLIA) in 682 plasma specimens. In antigenic region ELISA platform, microwells were coated with three antigens: core (c22-3), NS3/4 (c200) and NS5 individually. The signal-to-cutoff (S/Co) values of different assays, and antibody responses to individual antigens were compared. The specimens were divided into HCV RNA positive group, anti-HCV consistent group, and anti-HCV discrepant group.

Results

Anti-core and anti-NS3/4 were simultaneously detected in 99.2% of HCV RNA positive specimens and showed great consistency with total anti-HCV signals. Responses to the core region were more robust than those to the NS3/4 region in anti-HCV consistent group (p < 0.001). Anti-NS5 only occurred in companying with responses to the core and NS3/4 antigens, and failed to affect the final anti-HCV positive signals. In anti-HCV discrepant group, 39.0% of positive signals could not be traced back to any single antigenic region.

Conclusion

Antibody responses to the core and NS3/4 antigens were stronger, whereas responses to the NS5 antigen were the weakest, indicating that individual antigenic regions played different roles in total anti-HCV signals. This study provides an impetus for optimizing commercial anti-HCV assays.
Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases
Authors: Mahmood Majid , Ilyas Noor-ul-ain , Khan Muhammad Faraz , Hasrat Muhammad Naseem , Richwagen Nicholas
Published: July 2021

Background

The COVID-19 pandemic is a catastrophic global phenomenon, affecting human life in a way unseen since the 1918 influenza pandemic. Effective management of this threat requires halting transmission, a strategy requiring accurate knowledge of SARS-CoV-2 transmission patterns.

Methods

This was a retrospective contact study aiming to estimate the transmission rate of COVID-19 by tracing contacts in symptomatic, pre-symptomatic, and asymptomatic patients. History of patients’ contacts during 24 h before appearance of symptoms or infection confirmation was traced for disease transmission.

Results

Overall, a total of 201 COVID-19 patients had contact with 7168 people in 24 h with an average of 35.66 contacts per patient, ranging from a minimum of 4 to maximum of 87 contacts (meetings). Out of 7168 persons met, infection was detected in 64 (0.89%). For the 155 symptomatic patients, a total of 5611 contacted persons were traced before appearance of symptoms (pre-symptomatic) in last 24 h with an average of 36.20 meetings per patient. The infection was transmitted in 63 (1.12%) people with 5548 (98.88%) remaining uninfected. Out of the 63 transmissions, 62 (98.4%) were traced within 6 h before symptom onset, while only 1 was identified in the 6–12 h timeframe before symptoms. A total of 1557 persons were traced having meeting/contacts with asymptomatic cases in last 24 h before infection confirmation. Out of these 1557 persons, only 1 was found to be infected and the infection rate was calculated to be 0.06%. Statistically, the transmission rate by pre-symptomatic patients was found to be significantly higher than the transmission rate by asymptomatic individuals (P < 0.05).

Conclusion

In the studied population, the risk of pre-symptomatic and asymptomatic transmission of COVID-19 was low, with transmission risks of 1.12% and 0.06% respectively. Pre-symptomatic infection becomes very rare in contacts made longer than 6 h before onset of symptoms. The infection transmission is traced as long as about 9 h before the appearance of clear symptoms in the patients, but the incidence rate was as low as about 0.02% of the total contacts in that period.
The key amino acids of E protein involved in early flavivirus infection: viral entry
Authors: Hu Tao , Wu Zhen , Wu Shaoxiong , Chen Shun , Cheng Anchun
Published: July 2021

Flaviviruses are enveloped viruses that infect multiple hosts. Envelope proteins are the outermost proteins in the structure of flaviviruses and mediate viral infection. Studies indicate that flaviviruses mainly use envelope proteins to bind to cell attachment receptors and endocytic receptors for the entry step. Here, we present current findings regarding key envelope protein amino acids that participate in the flavivirus early infection process. Among these sites, most are located in special positions of the protein structure, such as the α-helix in the stem region and the hinge region between domains I and II, motifs that potentially affect the interaction between different domains. Some of these sites are located in positions involved in conformational changes in envelope proteins. In summary, we summarize and discuss the key envelope protein residues that affect the entry process of flaviviruses, including the process of their discovery and the mechanisms that affect early infection.
Exploring factors that contribute to human trafficking in Ethiopia: a socio-ecological perspective
Authors: Gezie Lemma Derseh , Yalew Alemayehu Worku , Gete Yigzaw Kebede , Samkange-Zeeb Florence
Published: July 2021

Background

A number of individuals in Ethiopia are involved in illegal types of transnational migration, namely human trafficking and smuggling. The magnitude is not declining despite efforts to curb it. An in-depth understanding of the reasons for trafficking is needed to control human trafficking and its consequences.

Methods

The study included four focus group discussions and 44 in-depth interviews conducted in three border towns, five trafficking-stricken areas, and the IOM transit center for returnees in Addis Ababa. Participants were victims of trafficking, emigrants, community members, police, immigration personnel, and staff of labor and social affairs offices and non-government organizations. Based on the social-ecological model framework, content analysis was implemented using opencode-4.03 software.

Results

Factors identified as possibly encouraging acts of illegal migration included community attitudes such as having a child abroad being considered a measure of status, and the reluctance to do certain types of works associated with low social status when at home. There was, however, willingness to do similar work abroad, which was coupled with the belief that wages for such jobs were better abroad than at home and a lack of knowledge regarding differences in working conditions in the two settings. Further reasons given were poor government service provisions, ineffective immigration policies, political instability, government focus on reactive and poorly coordinated control rather than on sustainable prevention of human trafficking and corruption. Corruption was said to be the underlying factor for the poor coordination among government agencies, communities, and individuals. These factors, among others, led to the loss of trust and belief in local governance, resources, and opportunities to build one’s future at home, thereby creating fertile ground for illegal migration, including smuggling and possibly trafficking.

Conclusions

Individual lack of trust and belief in local governance, resources, and opportunities to build one’s future was the main reason why people resorted to migrate in a manner subjecting them to human trafficking. Thus, comprehensive and coordinated efforts involving government agencies, communities, and other stakeholders are needed to help curb human trafficking and its consequences.
Implementation of tobacco control measures in the Gulf Cooperation Council countries, 2008–2020
Authors: Monshi Sarah S. , Ibrahim Jennifer
Published: July 2021

Background

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) was developed to assist nations in reducing the demand and supply of tobacco. As of 2020, 182 nations joined the FCTC, agreeing to implement the recommended tobacco control measures. The Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE) ratified the WHO FCTC by August 2006. Given the unique political, cultural, and religious context – and known tobacco industry efforts to influence tobacco use- in these nations, a careful examination of the translation of FCTC measures into policy is needed. This study aimed to assess the implementation of FCTC tobacco control measures at the national level within the six GCC countries.

Method

We collected and coded the FCTC measures that were implemented in the GCC countries. We examined trends and variations of the implementation between 2008 and 2020.

Results

GCC countries implemented most FCTC measures targeting the demand for and supply of tobacco, with some variation among countries. Bahrain and Qatar were more comprehensively implementing FCTC measures while Kuwait and Oman implemented the least number of the FCTC measures. Implementing measures related to tobacco prices and eliminating the illicit tobacco trade has slowly progressed in GCC countries. All GCC countries entirely banned smoking in workplaces while three countries implemented a partial ban in restaurants. Only Oman has restrictions on tobacco ads shown in media. There is progress in implementing FCTC measures related to tobacco packaging, cessation, and sale to minors in most GCC countries.

Conclusions

Given the influence of the tobacco industry in the Gulf region, the findings suggest a need for ongoing surveillance to monitor the proliferation of tobacco control measures and evaluate their effectiveness. Efforts required to address tobacco use should correspond to the unique political and cultural background of the GCC countries.
Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper
Authors: Amara Yousef , Leppaniemi Ari , Catena Fausto , Ansaloni Luca , Sugrue Michael , Fraga Gustavo P. , Coccolini Federico , Biffl Walter L. , Peitzman Andrew B. , Kluger Yoram , Sartelli Massimo , Moore Ernest E. , Di Saverio Salomone , Darwish Esfo , Endo Chikako , van Goor Harry , ten Broek Richard P.
Published: July 2021

Background

Small bowel obstruction (SBO) is a common surgical emergency, causing high morbidity and healthcare costs. The majority of SBOs are caused by adhesions that result from previous surgeries. Bowel obstruction, however, also occurs in patients without previous operation or known pathology, a so called virgin abdomen. It is unknown if small bowel obstruction in the virgin abdomen (SBO-VA) can be managed according to the same principles as other cases of small bowel obstruction. The aim of this position paper is to evaluate the available evidence on etiology and management of small bowel obstruction in the virgin abdomen.

Methods

This is a narrative review with scoping aspects. Clinical topics covered in this review include epidemiology and etiology of SBO-VA, diagnosis and imaging, initial assessment, the role of surgical management in SBO-VA, and the role of non-operative management in SBO-VA.

Results

Our scoping search revealed seven original studies reporting original patient data related to SBO-VA. All the included studies are retrospective cohorts, with populations ranging between 44 and 103 patients with SBO-VA. Adhesions were found to be the cause of the obstruction in approximately half of the reported cases of SBO-VA. A relatively high number of cases of SBO-VA were managed surgically with studies reporting 39–83%. However, in cases where a trial of non-operative management was started, this was generally successful.

Conclusion

The data available suggest that etiology and treatment results for patients with SBO-VA are largely comparable to the results in patients with SBO after previous abdominal surgery. We therefore propose that patients with a virgin abdomen could be treated according to existing guidelines for SBO and adhesive small bowel obstruction.
An updated national survey of triage and triage related work in Sweden: a cross-sectional descriptive and comparative study
Authors: Wireklint Sara C. , Elmqvist Carina , Göransson Katarina E.
Published: July 2021

Background

Triage and triage related work has been performed in Swedish Emergency Departments (EDs) since the mid-1990s. According to two national surveys from 2005 to 2011, triage was carried out with different triage scales and without guidelines or formal education. Furthermore, a review from 2010 questioned the scientific evidence for both triage as a method as well as the Swedish five level triage scale Medical Emergency Triage and Treatment System (METTS); nevertheless, METTS was applied in 65% of the EDs in 2011. Subsequently, METTS was renamed to Rapid Emergency Triage and Treatment System (RETTS©). The hypothesis for this study is that the method of triage is still applied nationally and that the use of METTS/RETTS© has increased. Hence, the aim is to describe the occurrence and application of triage and triage related work at Swedish Emergency Departments, in comparison with previous national surveys.

Methods

In this cross-sectional study with a descriptive and comparative design, an electronic questionnaire was developed, based on questionnaire from previous studies. The survey was distributed to all hospital affiliated EDs from late March to the middle of July in 2019. The data was analysed with descriptive statistics, by IBM SPSS Statistics, version 26.

Results

Of the 51 (75%) EDs partaking in the study, all (100%) applied triage, and 92% used the Swedish triage scale RETTS©. Even so, there was low concordance in how RETTS© was applied regarding time frames i.e., how long a patient in respective triage level could wait for assessment by a physician. Additionally, the results show a major diversion in how the EDs performed education in triage.

Conclusion

This study confirms that triage method is nationally implemented across Swedish EDs. RETTS© is the dominating triage scale but cannot be considered as one triage scale due to the variation with regard to time frames per triage level. Further, a diversion in introduction and education in the pivotal role of triage has been shown. This can be counteracted by national guidelines in what triage scale to use and how to perform triage education.
The predicting roles of carcinoembryonic antigen and its underlying mechanism in the progression of coronavirus disease 2019
Authors: Huang Runzhi , Meng Tong , Zha Qiongfang , Cheng Kebin , Zhou Xin , Zheng Junhua , Zhang Dingyu , Liu Ruilin
Published: July 2021

Background

The coronavirus disease 2019 (COVID-19) has induced a worldwide epidemiological event with a high infectivity and mortality. However, the predicting biomarkers and their potential mechanism in the progression of COVID-19 are not well known.

Objective

The aim of this study is to identify the candidate predictors of COVID-19 and investigate their underlying mechanism.

Methods

The retrospective study was conducted to identify the potential laboratory indicators with prognostic values of COVID-19 disease. Then, the prognostic nomogram was constructed to predict the overall survival of COVID-19 patients. Additionally, the scRNA-seq data of BALF and PBMCs from COVID-19 patients were downloaded to investigate the underlying mechanism of the most important prognostic indicators in lungs and peripherals, respectively.

Results

In total, 304 hospitalized adult COVID-19 patients in Wuhan Jinyintan Hospital were included in the retrospective study. CEA was the only laboratory indicator with significant difference in the univariate (P < 0.001) and multivariate analysis (P = 0.020). The scRNA-seq data of BALF and PBMCs from COVID-19 patients were downloaded to investigate the underlying mechanism of CEA in lungs and peripherals, respectively. The results revealed the potential roles of CEA were significantly distributed in type II pneumocytes of BALF and developing neutrophils of PBMCs, participating in the progression of COVID-19 by regulating the cell–cell communication.

Conclusion

This study identifies the prognostic roles of CEA in COVID-19 patients and implies the potential roles of CEACAM8-CEACAM6 in the progression of COVID-19 by regulating the cell–cell communication of developing neutrophils and type II pneumocyte.
Adrenocortical adenoma with myelolipomatous metaplasia: a potential diagnostic pitfall: a case report and review of the literature
Authors: Anbardar Mohammad Hossein , Soleimani Neda , Nikeghbalian Saman , Mohebbi Maryam
Published: July 2021

Background

Adrenal incidentalomas are often found during investigation for another tumor or unrelated problems. Except for adrenal myelolipoma (second most common primary adrenal incidentaloma following adrenocortical adenomas), adrenal lipomatous tumors are uncommon generally and are often described as case reports in the literature. Since the amount of fat is variable, without the help of advanced imaging techniques, some adrenal lipomatous tumors may be misdiagnosed before pathologic examination. Herein, we report a case of adrenal adenoma with myelolipomatous metaplasia that was excised as a periceliac mass in the setting of recurrent pancreatic cyst.

Case report

A 45-year-old Iranian woman with hypertension and end-stage renal disease presented with recurrence of a pancreatic cyst (previous pathologic report was mucinous cyst adenoma). During exploratory laparotomy, the mentioned pancreatic cyst was tightly attached to the stomach and jejunum. There was also a periceliac round rubbery lesion (firstly diagnosed by endoscopic ultrasound) that was excised for ruling out malignancy. Histologic examination of the periceliac mass was found to be adrenocortical adenoma with foci of myelolipomatous metaplasia. The pancreatic cyst histology was just a pseudocyst.

Conclusion

Our case highlights the significance of complete evaluation of incidental findings before surgical intervention, even in the setting of another primary tumor. Myelolipoma and myelolipomatous change (metaplasia) are two different entities. Although very similar as to pathogenesis, there are still some differences.
Whole-body [18F]-FDG-PET/MRI for staging of pediatric non-Hodgkin lymphoma: first results from a single-center evaluation
Authors: Kurch L. , Kluge R. , Sabri O. , Fischer L. , Wendt S. , Graf Einsiedel H. , Starke S. , Kühl J.-S. , Christiansen H. , Hirsch F. W. , Sorge I. , Roth C.
Published: July 2021

Aim

In 2015, the revised International Pediatric Non-Hodgkin Lymphoma Staging System was published. It mentions [18F]-FDG-PET/MRI as the latest method to perform whole-body imaging. However, supporting data are pending. Our aim was to investigate the performance of whole-body [18F]-FDG-PET/MRI in pediatric non-Hodgkin lymphoma patients by using a limited number of MRI sequences.

Materials and methods

Ten pediatric patients with histologically proven non-Hodgkin lymphoma underwent whole-body [18F]-FDG-PET/MRI at staging. The retrospective analysis included three steps: First, [18F]-FDG-PET and MR scans were evaluated separately by a nuclear medicine physician and a pediatric radiologist. Nineteen nodal and two extranodal regions as well as six organs were checked for involvement. Second, discrepant findings were reviewed together in order to reach consensus. Third, [18F]-FDG-PET/MRI findings were correlated with the results of other clinical investigations.

Results

Of the 190 lymph node regions evaluated, four were rated controversial. Consensus was reached by considering metabolic, functional and morphologic information combined. Concordantly, [18F]-FDG-PET and MRI detected Waldeyer’s ring involvement in two patients whose Waldeyer’s ring was negative on clinical assessment. In four patients MRI showed pleural effusion. However, in only two of them an increased glucose metabolism as a reliable sign of pleural involvement was detectable. In six patients [18F]-FDG-PET and MRI detected skeletal lesions although bone marrow biopsy was positive in only one of them.

Conclusion

Despite the small number of cases evaluated, whole-body [18F]-FDG-PET turned out to be a valuable tool for staging of pediatric non-Hodgkin lymphoma.
Applications and analytical tools of cell communication based on ligand-receptor interactions at single cell level
Authors: Ma Fen , Zhang Siwei , Song Lianhao , Wang Bozhi , Wei Lanlan , Zhang Fengmin
Published: July 2021

Background

Cellular communication is an essential feature of multicellular organisms. Binding of ligands to their homologous receptors, which activate specific cell signaling pathways, is a basic type of cellular communication and intimately linked to many degeneration processes leading to diseases.

Main body

This study reviewed the history of ligand-receptor and presents the databases which store ligand-receptor pairs. The recently applications and research tools of ligand-receptor interactions for cell communication at single cell level by using single cell RNA sequencing have been sorted out.

Conclusion

The summary of the advantages and disadvantages of analysis tools will greatly help researchers analyze cell communication at the single cell level. Learning cell communication based on ligand-receptor interactions by single cell RNA sequencing gives way to developing new target drugs and personalizing treatment.
Complex mathematical SIR model for spreading of COVID-19 virus with Mittag-Leffler kernel
Authors: Akyildiz F. Talay , Alshammari Fehaid Salem
Published: July 2021

This paper investigates a new model on coronavirus-19 disease (COVID-19), that is complex fractional SIR epidemic model with a nonstandard nonlinear incidence rate and a recovery, where derivative operator with Mittag-Leffler kernel in the Caputo sense (ABC). The model has two equilibrium points when the basic reproduction number $R_{0} > 1$

R
0

>
1
; a disease-free equilibrium $E_{0}$

E
0

and a disease endemic equilibrium $E_{1}$

E
1

. The disease-free equilibrium stage is locally and globally asymptotically stable when the basic reproduction number $R_{0} <1$

R
0

<
1
, we show that the endemic equilibrium state is locally asymptotically stable if $R_{0} > 1$

R
0

>
1
. We also prove the existence and uniqueness of the solution for the Atangana–Baleanu SIR model by using a fixed-point method. Since the Atangana–Baleanu fractional derivative gives better precise results to the derivative with exponential kernel because of having fractional order, hence, it is a generalized form of the derivative with exponential kernel. The numerical simulations are explored for various values of the fractional order. Finally, the effect of the ABC fractional-order derivative on suspected and infected individuals carefully is examined and compared with the real data.
Effects of COVID-19 prevention procedures on other common infections: a systematic review
Authors: Dadras Omid , Alinaghi Seyed Ahmad Seyed , Karimi Amirali , MohsseniPour Mehrzad , Barzegary Alireza , Vahedi Farzin , Pashaei Zahra , Mirzapour Pegah , Fakhfouri Amirata , Zargari Ghazal , Saeidi Solmaz , Mojdeganlou Hengameh , Badri Hajar , Qaderi Kowsar , Behnezhad Farzane , Mehraeen Esmaeil
Published: July 2021

Introduction

Since the outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) began, necessary measures to prevent virus transmission and reduce mortality have been implemented, including mandatory public use of masks, regular hand-sanitizing and hand-washing, social distancing, avoidance of crowds, remote work, and cancellation of public events. During and after the introduction of COVID-19 lockout, we performed a systematic review of available published literature to investigate the incidence of seasonal influenza and other respiratory viral infections.

Methods

PubMed, Embase, Web of Science, Scopus, Science Direct, Google Scholar, Research Gate, and the World Health Organization databases and websites were systematically searched for original studies concerning the impact of COVID-19 prevention means and measures on other common respiratory infectious diseases during the pandemic published by March 2021.

Results

The findings showed that the adherence to health protocols to prevent COVID-19 could help to reduce the incidence of other infectious diseases such as influenza, pneumonia, and Mycobacterium tuberculosis.

Conclusion

The implemented prevention measures and protocols might have reduced the incidence of influenza and some other common respiratory infections. However, controversies exist on this matter and future large population-based studies might provide further information to address these controversies.
Developing horizontal subsurface flow constructed wetland using pumice and Chrysopogon zizanioides for tannery wastewater treatment
Authors: Aregu Mekonnen Birhanie , Asfaw Seyoum Leta , Khan Mohammed Mazharuddin
Published: July 2021

Background

High-strength wastewater defined by elevated levels of hazardous pollutants measured in BOD, heavy metals, nutrients and other toxic substances. This kind of wastewater discharged to water body without treatment from different industrial sectors that adversely affects aquatic environment and downstream water consumers. The general objective of this study is to investigate efficient substrate with selected plant type for constructed wetland to remove hazardous pollutants from tannery wastewater. This study was conducted at Modjo town, Modjo tannery PLC. Plug flow experimental study design was carried out. The substrate (Pumice) was collected around the study area and chemical characteristics were determined. Chrysopogon zizanioides was planted and grown for 5 months before running tannery wastewater for the treatment. The composite wastewater was introduced to the constructed wetland from Modjo leather industry, Ethiopia. The physicochemical analysis of the sample wastewater was done before and after treatment at four different hydraulic retention time.

Results

Characterization of the untreated tannery wastewater revealed that the mean concentration of BOD5, COD, TSS, PO4-P, TP, NO3-N, TN and total chromium were 1641 ± 373.6, 6953.33 ± 339.4, 1868 ± 863.1, 88.06 ± 40.8, 144.53 ± 20.8, 116.66 ± 26.6, 650.33 ± 93.6 and 18.33 ± 6.7 mg/l respectively beyond the permissible limits. The maximum removal efficiency of the constructed wetland in pumice bed revealed that BOD5 at HRT 7and 9 days (96.42%, 96.30%), COD at HRT 5 and 7 days (96.76%, 96.91%), NO3-N at HRT 5 and 7 days (99.99%, 99.68%), TN (98.67%, 99.00%), PO4-P HRT 7and 9 days (96.97%,100%), TP at HRT 5 and 7 days (94.79%, 96.17%) and total Chromium at HRT 5 and 7 days (98.36%, 98.91%) respectively. Whereas, the removal efficiency of constructed wetland bed with gravel substrate used as a control subject with similar condition to pumice showed lower performance. The result between pumice and gravel bed was tested for their significance difference using two sample t-test statistics. Based on the test statistics, the pumice substrate perform better than the gravel significantly at 95% confidence interval, p-value = 0.01.

Conclusion

Pumice substrate and Chrysopogon zizanioides have a potential ability to remove hazardous pollutants from tannery wastewater in horizontal subsurface constructed wetlands.
‘A roller coaster of emotions’: a phenomenological study on medical students lived experiences of emotions in complex simulation
Authors: Behrens Claudia C. , Driessen Erik W. , Dolmans Diana H. , Gormley Gerard J.
Published: July 2021

Background

Simulation-based education can induce intense learner emotions. The interplay between emotions and learning is less well understood. Gaining greater insights into learner emotions has potential to guide how best we manage emotions and optimise learning. This study aimed to understand learners’ lived emotional experiences in complex simulation and the perceived impact on learning.

Methods

Eight final-year medical students participated in the study. Wearing video-glasses, participants took part in a ward-based simulation. Video-footage was used to elicitate exploratory interviews and analysed using Template Analysis reflexively.

Results

Analysis yielded four main themes: ‘nervous anticipation’: encapsulating the fear, anxiety and uncertainty experienced by learners prior to simulation; ‘shock and awe’: feelings of anxiousness and being overwhelmed at the start of a simulation; ‘in the moment: flowing or buffeting with the emotions’: experiencing fear of being judged as incompetent, but also experiencing positive emotions such as satisfaction; ‘safe-landing?’: whilst debriefing aimed to encourage more positive emotions, negative emotions about the simulation could persist even with debriefing.

Conclusions

Complex simulation can evoke intense emotions in students. If students experienced a positive progression, they reported positive emotions and felt competent which was perceived to have a positive impact on learning. If students experienced failure, they reported strong negative emotions which made them question about their future performance and was perceived as negative for learning. Bringing to the surface these complex emotional dynamics, could permit educators to be aware of and adapt the emotional climate within simulation in order to optimise learning.