bluuebunny/crossref_metadata_2025 huggingface dataset:
Early low-dose ghrelin intervention via mini-osmotic pumps could protect against the progressive dopaminergic neuron loss in Parkinson’s disease mice
Authors: Jiao Lingling , Du Xixun , Jia Fengju , Zhang Pei , Li Yong , Zhu Dexiao , Tang Tinging , Jiao Qian , Jiang Hong
Published: June 2020

BackgroundGhrelin has been identified as a multifunctional peptide that has a potential applications for the treatment Parkinson’s disease (PD). Method: ELISA was used for detecting plasma total and active ghrelin levels, dopamine (DA) content was measured by HPLC-ECD, immunofluorescence staining and Western blot were used to detect protein expressions, and cytokine was tested by Bio-PlexPro™ assay.ResultsHere, we reported a subcutaneous administration of low-dose ghrelin via mini-osmotic pumps to PD mice. The decreased levels of total and active ghrelin in plasma were rescued by ghrelin administration. Interestingly, ghrelin had no effect on weight gain in wild-type mice but improved weight loss in PD mice. We observed the attenuation of dopaminergic (DAergic) neuron loss in substantia nigra (SN) and low level of dopamine content in the striatum in PD mice with ghrelin treatment. Ghrelin administration could improve the environment of DAergic neuron by inhibiting microglia proliferation and pro-inflammatory cytokine expression, and could enhance cell survival by upregulating Bcl-2/Bax ratio and superoxide dismutase1 (SOD1) protein level in SN in PD mice.ConclusionsOur results suggested that subcutaneous administration of low-dose ghrelin could prevent the onset or the progression of PD, and also provided a possible method for ghrelin application to cure PD.
Clinical characteristics and health care cost among patients successfully treated for COVID-19 in Henan, China: A Descriptive Study
Authors: Miao Yudong , Bhuyan Soumitra S , Liu Mengzhu , Gu Jianqin , Hussain Sabiha , Wu Jian , Wang Liuyi , Liu Min , Cheng Ruirui , Basu Urmi , Liu Feng , Zhang Huayu , Chang Zhanjun
Published: June 2020

Objective: To clarify the clinical and medical expense characteristics of COVID-19. Methods: In this retrospective, single-center study, 55 cured cases with confirmed COVID-19 were analyzed for demographic, epidemiological, clinical, and radiological features and medical expense data.Results: The average age of the 54 successfully treated patients with COVID-19 was 53.2 years old (SD 19.0), including 27 men and 27 women. Off this, 31 (57.4%) patients had chronic diseases. Patients commonly had clinical manifestations of fever (45 [83.3%] patients), cough (29[54.7%] patients), expectoration (28 [51.9%] patients), fatigue (24[44.4%] patients) and diarrhea (8[14.8%] patients) on admission. There was a 10-day interval from the onset of signs and symptoms to hospital admission. About 80% of them got recovery after a two-week treatment. The mean interval from the onset of signs and symptoms to hospital discharge was 20.5 (IQR 16-29) days. The median total medical expense of the treated patient, in general, was 2579.6 (IQR 1366.1-4837.6) U.S. dollars. Still, the median medical expense was 8904.1 (IQR 6660.1- 27143.8) U.S. dollars in patients with more than five comorbid illnesses during the treatment.Conclusion: There is a 3-week interval from the onset of signs and symptoms to cure, and most hospitalized patients get recovery within two weeks. The total medical expense of cases with more than five comorbid conditions during the treatment is higher. Quite a few COVID-19 cases with other serious diseases are likely to account for most of the total medical expenses.
Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases
Authors: Peng Linbo , Zeng Junfeng , Zeng Yi , Wu Yuangang , Yang Jing , Shen Bin
Published: June 2020

Background: Verify if the elevated preoperative International Normalized Ratio (INR) can increase transfusion and complication rate in primary total hip arthroplasty.Methods: We retrospectively reviewed the database of adults who underwent primary total hip arthroplasty between 2014 to 2018 by the same surgeon. 552 cases were assigned into 3 groups by preoperative INR class: INR≤0.9, 0.9＜INR＜1.0, and INR≥1.0 eventually. We regarded the transfusion rate as the primary outcome. We also included perioperative blood loss, maximum Hb-drop, postoperative anemia needs medicine, length of stay (LOS), re-operation, the complication rate in 90 days and mortality as the secondary outcomes. Univariable analyses were utilized to compare baselines and outcomes between groups. Binary Logistic Regression was used to adjust differences of baselines among groups.Results: All the cases had an INR＜1.5. Among all the cases, 93(16.8%) had INR≤0.9, 268 (48.6%) had 0.9＜INR＜1.0, and 191 (34.6%) had INR≥1.0, respectively. In the univariable analyses, with the INR elevated, The transfusion rates increased from 1.08% for INR≤0.9, 1.12% for 0.9＜INR＜1.0 to 5.76% for INR≥1.0 (p＜0.05). The overall complication rate increased from 10.8% for INR≤0.9, 16.4% for 0.9＜INR＜1.0 to 22.5% for INR≥1.0 (p＜0.05). When controlling for the demographics and comorbidities characteristics, there was no statistically significant difference when evaluating the odds of transfusion nor overall complication rate between the groups (p＞0.05).Conclusions: The transfusion and complication rate cannot increase along with the INR elevated in primary THA. With the improvement of arthroplasty protocol and use of tranexamic acid, the INR＜1.5 was still a conventional safe threshold.
The effect and long-term outcome of Partial Anterior Myometrial Resection and Reconstruction under tourniquet and/or prophylactic abdominal aorta balloon occlusion on the patients with placenta percreta
Authors: Zhao Huidan , Chen Chen , Tao Ya , Liu Zhuan , Liu Cai , Zhao Xianlan
Published: June 2020

Background

Patients with placenta accreta spectrum (PAS) disorders often experience overwhelming hemorrhage during cesarean. Placenta percreta is the most serious subtype. In this paper, we propose a new procedure in order to control intraoperative bleeding. We aimed to evaluate the effect and long-term outcome of Partial Anterior Myometrial Resection and Reconstruction under tourniquet and/or prophylactic abdominal aorta balloon occlusion on patients with placenta percreta.
Methods

In a retrospective study, data from patients with placenta percreta who delivered by cesarean section between January 1, 2017 and December 31, 2019 were analyzed. Short-term and long-term outcomes were followed up by outpatient clinic and by phone. The quantity of estimated blood loss (EBL), operation time, urine tube time, hospital stay and short-term and long-term complications including fever, thrombosis, hematoma, breast feeding and menstruation problems, lower limb complaints, intrauterine adhesion and so on, were analyzed.
Results

For all cases, the mean EBL in the surgery was 1399 ± 948 mL, the mean operation time was 107 ± 35minutes, and the mean perioperative hospital stay was 9.6 ± 5.0 days. All the patients had a preserved uterus. Menstrual quantity decreased in 12 patients. Menstrual period prolonged in 11 cases. Uncomfortable abdomen symptoms happened in 9 cases after the surgery. Four cases got thrombosis and 3 got hematoma. Lower extremity discomfort was found in 6 patients.
Conclusion

Combined with prophylactic abdominal aorta balloon occlusion and/or tourniquet, Partial Anterior Myometrial Resection and Reconstruction is highly effective in reducing the intraoperative blood loss and hysterectomy in placenta percreta. But we should pay great attention to short-term and long-term complications, especially to the complications associated with aorta balloon occlusion.
Screening COVID-19 with Chest CT in Preference to RT-PCR: Based on Mortality Analysis
Authors: Xie Yuanlong , Wu Minhao , Zhang Chong , Zhu Yufan , Li Kun , Wu Meng , Deng Zhouming , Zhu Xiaobin , Cai Lin
Published: June 2020

Corona Virus Disease 2019 (COVID-19) became the outbreak of infectious diseases emergency worldwide. It remains unknown whether the RT-PCR test results was associated with the prognosis of COVID-19 patients or not. In this study, a total number of 495 patients with typical chest CT feature and symptom consistent with COVID-19 were retrospectively included from Jan 23, 2020 to Feb 26, 2020. 186 (37.58%), 32 (6.46%) and 277 (55.96%) COVID-19 patients had initial positive, suspected and negative RT-PCR results, respectively. The mean age was 58.55 years and 254(51.3%) were older than 60 years. 60.00% (297/495), 22.02% (109/495) and 17.98% (89/495) of COVID-19 patients were common, severe and critically type, respectively. There were no significant differences of age, gender, time from onset to hospitalization and severity classification in the patients with initial positive and negative RT-PCR result. The mortality rate of patients with positive and negative were 7.14% and 7.94%. Patients with initial negative or initial positive RT-PCR results had no significant difference of mortality rate (c2=4.079, p=0.130). The number of patients with lymphocyte ratios under the normal level was significantly larger in patients with initial negative RT-PCR results (59/92) compared with the patients with initial positive result (86/167), p=0.033. COVID-19 patients with positive or negative RT-PCR results had no significant difference in severity and mortality. Chest CT may be a more effective tool to screen COVID-19 in preference to RT-PCR.
Comparative transcription analysis of hard and tender fruit spines of cucumber to identify genes involved in morphological development of fruit spines
Authors: Lv Duo , Yu Yao , Xiong Liang-Rong , Wang Gang , Pang Jin-An , Sun Jing-Xian , Zhang Ke-Yan , He Huan-Le , Cai Run , Pan Junsong
Published: June 2020

Background
The trichomes of cucumber on the fruit are also called spines, it not only has important commercial value but also is a classical tissue to study cell division and differentiation mode of multicellular trichomes. Although there have been many researches about the development of unicellular trichomes in model plants, the molecular mechanism of multicellular trichomes formation remains elusive. In this study, we took a pair of cucumber materials defined as hard (Ts, wild-type) and tender spines (ts, mutant) in previous study, the whole developmental process of fruit spines was continuously observed by microscope and SEM, in an attempt to define the development stage of fruit spines, transcriptome profiles at different stages was made to explore the molecular mechanism in the process of spines development.
Results
With significant phenotypic differences, the developmental process of fruit spines was clearly defined as four stages. Comparion of transcriptome profilings showed a total of 2,788 differential expression genes (DEGs) between the wild-type and mutant at different developmental stages of fruit spines, these genes exhibited different expression patterns at different spines developmental stage. Some DEGs related to cell cycle and meristem had also been identified in transcriptome data. By correlating the expression patterns of several transcription factors that have been reported to be involved in the development of spines, we identified some genes that may be involved in the formation of cucumber fruit spines. The cluster analysis of transcription factors revealed that there were 26 transcription factor families that may be involved in the development of fruit spines, among them, the ERF-ERF, bHLH and WAKY family transcription factor gene families were the top three gene families.
Conclusions
We defined the four stages of fruit spines development and identified a number of genes that may be involved in the development of multicellular trichomes based on comparative transcription. The results provided a step stone for further analysis of the molecular mechanism in the developmental process of multicellular trichomes.
Preoperative Risk Grade Predicts the Long-Term Prognosis of Intrahepatic Cholangiocarcinoma: A Retrospective Cohort Analysis
Authors: Zhao Jianping , Chen Yao , Wang Jingjing , Wang Jian , Wang Ying , Chai Songshan , Zhang Yuxin , Chen Xiaoping , zhang wanguang
Published: June 2020

Background: Cumulating evidence indicates that the systemic inflammatory response (SIR) plays a crucial role in the prognosis of various cancers. We aimed to generate a preoperative risk grade (PRG) by integrating SIR markers to preoperatively predict the long-term prognosis of intrahepatic cholangiocarcinoma (ICC).Methods: 468 consecutive ICC patients who underwent hepatectomy between 2010 to 2017 were enrolled. The PRG and a nomogram were generated and their predictive accuracy was evaluated. Results: The PRG consisted of two non-tumor-specific SIR markers platelet-to-lymphocyte ratio (PLR) and albumin (ALB), which were both the independent predictors of overall survival (OS). Multivariate analysis showed that the PRG was significantly associated with OS (PRG =1: Hazard ratio (HR) = 3.800, p < 0.001; PRG = 2: HR = 7.585, p < 0.001). The PRG (concordance index (C-index) 0.685; 95% CI: 0.655 to 0.716) had a better predictive ability than the American Joint Committee on Cancer (AJCC) 8th edition (C-index 0.645; 95% CI: 0.612 to 0.679), the Liver Cancer Study Group of Japan (LCSGJ) (C-index 0.644; 95% CI: 0.611 to 0.678) and the Okabayashi (C-index 0.633; 95% CI: 0.600 to 0.666) (p < 0.05). Besides, the C-index of the nomogram only consisting of the tumor-specific factors (serum carcinoembryonic antigen, carbohydrate antigen 19-9, tumor number) could be improved to 0.737 (95% CI: 0.062-0.768) from 0.625 (95% CI: 0.585-0.665) when the PRG was incorporated (p < 0.001).Conclusions: The PRG integrating two non-tumor-specific SIR markers PLR and ALB was a novel method to preoperative predicting the prognosis of ICC.
Efficacy of percutaneous short segment fixation on the treatment of Magerl A3 thoracolumbar fractures: a retrospective study
Authors: lin hongheng , Ou Xiaoting , Li Wenchao , Chen Minyuan , Liu Caijun , Mo Ling , Yuan Chao , Zhu Hui , Liang De
Published: June 2020

BackgroundThis is a retrospective study to evaluate the efficacy of percutaneous short segment fixation (PSSF) with or without intermediate screws in Magerl A3 thoracolumbar (TL) fractures accompanied with low bone mineral density (BMD).Methods From January 2017 to December 2018, 30 patients diagnosed with Magerl A3 TL fractures having a BMD between 0.5/cm2 and 1g/cm2 in the lumbar vertebrae with intact neurological functions and a history of major trauma who underwent PSSF with or without intermediate screws were enrolled in this study. The patients were divided into two groups of those with intermediate screws (group F) or without (group S). The operation time and intra-operation blood loss were recorded. Oswestry disability index (ODI) questionnaire and visual analogue scale (VAS) were employed as clinical assessments and quantified. Radiographic follow-up assessed according to the Cobb angle (CA), Vertebral wedge angle (VWA), and anterior vertebral body height (AVBH).ResultsLoose screws were observed in 4 of the 30 enrolled patients. Significant differences were observed in operation time and intra-operative blood loss between the two groups. The enrolled patients’ clinical results (VAS and ODI scores) were good, however, no significant differences during all follow-up periods were present between the two groups. Radiographic evaluation (CA, VWA and AVBH) improved immediately after surgery, but significant correction loss was observed in the follow-up periods, especially in the first month. Radiographic evaluation demonstrated no significant differences between the two groups.Conclusion Although the patients’ clinical results were satisfactory, PSSF could not resist the correction loss in Magerl A3 TL fractures accompanied with BMD below 1g/cm2. Accordingly, the use of intermediate pedicle screws may be unnecessary due to their limited ability in resisting correction loss and increasing operation time as well as intra-operation blood loss.
Characterization of isolated thermophilic campylobacters and associated risk factors in poultry farms of Uttarakhand, India
Authors: Garhia Geetika , Mani Maansi , Kumar Deepak , Upadhyay Ajay Kumar
Published: June 2020

Background

Campylobacters are the common commensals of poultry responsible for several cases of gastroenteritis in humans. The illness, if severe can result into complications causing a nervous disorder named Guillian Barre syndrome. Owing to its serious health implications, the study aimed to screen eight organized poultry farms and their environment (water, litter, manure, and feed) of Uttarakhand state, India for the presence of thermophilic Campylobacter species and their virulence and antibiotic resistance profile. It also undertook identification of risk factors associated with the occurrence of campylobacters in each farm using a questionnaire survey comprising eleven potential risk factors (other animals on farm, reuse of litters, use of foot bath, in house or branded feed, chlorination of water, distance of manure heap, housing system, flock size, floor type, shoe use by farm personnels, moist or dry litter and number of broiler floor).
Results

Of eight, six farms showed varying occurrence of C.jejuni and C.coli with an overall prevalence of 12.29%. Not a single isolate of C.lari and C.upsaliensis was recorded. Poultry faecal, water and litter samples observed 18.2%, 6% and 1.9% presence, respectively. Feed and manure samples did not appear positive. In 48 revived Campylobacter isolates, 100% presence of cadF and flaA virulence genes were detected followed by cdtB (97.9%), cgtB (22.9%) and ciaB (12.5%), respectively. Ten isolates 23.80%) were multidrug resistant (MDR) exhibiting resistance to at least 3 or more antimicrobial classes. The most common MDR patterns were AMP CX CIP TE (n = 2) and AMP CX CIP (n = 2). Feeding of branded feed was found to have significant association with Campylobacter presence in the examined broiler flocks (p-value 0.0047).
Conclusions

The study highlights the occurrence of food pathogens, Campylobacter jejuni and C.coli in the poultry farms and their environment of the state. The organisms possessed significant virulence genes capable of developing critical human illness. Overall, the presence of MDR thermophilic campylobacters appears to be a severe public threat.
Effect of discharge conference on rehospitalization among older patients: An analysis of administrative claims data in Japan
Authors: Jeon Boyoung , Tamiya Nanako , Jin Xueying , Yoshie Satoru , Iijima Katsuya , Ishizaki Tatsuro
Published: June 2020

Background

The policy of discharge conference has function of guiding patients to stay at community. This study aims to investigate the effect of a discharge conference on a probability of hospital readmission and readmission costs among older patients in Japan.
Methods

We included 8,096 individuals admitted to acute care hospitals, using health and long-term care insurance claims data on older patients (age ≥ 75 years) in a suburban city in Japan, from April 2012 to September 2013. To balance the two groups according to whether a patient received a service of discharge conference or not, we used propensity score matching method. We identified readmission within 360 days from discharges and estimated the impact of a discharge conference on the probability of readmission and readmission costs using multiple logistic and linear regression model.
Results

Among patients who discharged from an acute care hospital, 367 (4.5%) received a discharge conference. Using the matching method, 304 participants in a control group was matched to 304 participants in a discharge conference group. Readmission rate was 21.1% in patients with a discharge conference and 23.0% in those without a discharge conference. Although there was no significant effect of discharge conference on probability of readmission, but it showed significant effect on lower cost per day.
Conclusions

These results imply a discharge conference has effect on mitigating cost per day of readmission after adjusting for confounding. This study suggests that there are potential possibilities in the policy of discharge conference on reducing the readmission costs per day amongst older patients.
Outcome of Free-Flap Transfer for Head and Neck Reconstruction in Hypercoagulable Patients
Authors: Zhou Wei , Zhang Wen-Bo , Yu Yao , Wang Yang , Mao Chi , Guo Chuan-Bin , Yu Guang-Yan , Peng Xin
Published: June 2020

Background: The purpose of this study was to examine the outcome and complications of hypercoagulable patients undergoing free-flap transfer in the head and neck region. Methods：We retrospectively reviewed the data of 685 consecutive free-flap transfers in the head and neck region performed by a single surgical team at the Peking University School and Hospital of Stomatology between January 2013 and December 2018. Based on preoperative coagulation indices the patients were separated into two groups: those with hypercoagulablity (group A, n = 45) and those with normal coagulation indices (group B, n = 640). Demographic characteristics, thrombosis and flap failure were compared between the two groups. Chi-square test and repeated-measures ANOVA were used for data comparisons.Results：Microvascular thrombosis rate (P = 0.42) and free-flap success rate (P = 0.38) were not significantly different between the groups. The platelet count and activated partial thromboplastin time changed significantly during the perioperative period in the hypercoagulable group (repeated-measures ANOVA, P < 0.001 for both).Conclusions：Hypercoagulability does not seem to increase risk of free-flap failure in head and neck microsurgery provided standard anticoagulation protocols are followed.
Peritoneal Serous Borderline Tumour with Ultra-Mutated NGS Profile Including POLE E, BRAF, RB1, HER2 and P53 Mutations : A Case Report.
Authors: Noel Jean-Christophe , Buonomo Antonio , Bouri Sarah , D’Haene Nicky , Catteau Xavier
Published: June 2020

Background: Serous borderline tumors of the peritoneum are rare low-grade epithelial proliferation with a tubal-type differentiation occurring in the pelvis or abdomen without underlying tissue invasion that resemble to ovarian serous borderline tumors but by definition without ovrian or tubal involvement. To date, the mutation status in molecular biology of these tumours remains largely unknown.Case presentation: Here we describe the case of a borderline peritoneal serous tumour which occurred in a 48 year old patient in whom an analysis of the mutation status by NGS technique identified a ultra-mutated profile including POLE E, BRAF, RB1, HER2 and p53 mutations.Conclusions: To the best of our knowledge, this particular mutation status has never been described in this type of tumour. It could represent an early event with transient mutations, most of them will not fixate on the genome.
Osteogenic effect in rat osteoporosis model and femur defect model by intraosseous administration of simvastatin microcrystals
Authors: Zhu Junxiong , Zhang Chenggui , Jia Jialin , Wang Hong , Leng Huijie , Xu Yingsheng , Wu Cuishuan , Zhang Qiang , Song Chunli
Published: June 2020

Background: Currently, drugs for local bone formation are very limited in clinic. Simvastatin is one of most potential translational drugs by repositioning for its significant osteogenic effect and its history as a safe lipid-lowering medicine. In this study, we prepared the pre-clinical simvastatin microcrystals which could be potentially translated and industrialized. Methods: Simvastatin microcrystals were made by wet media milling method. Characterization of microcrystal particles were evaluated by laser particle size analyzer and high-performance liquid chromatography (HPLC). Furthermore, we verified the osteogenic effect in rat ovariectomy(OVX)-induced osteoporosis model and femur defect model. For osteoporosis model, we delivered simvastatin microcrystals to tibia with poloxamer hydrogel by intraosseous injection. Bone mineral density (BMD) and ultimate force were assessed after treatment. For femur defect model, simvastatin microcrystal was incorporated in clinically used calcium phosphate cements (CPCs) as an implant. Histology and μCT were used for evaluation of the healing. Results: The D 10 , D 50, and D 90 showed size of the most particles ranged from 0.226-3.425 μm. The mean particle size of the microcrystals is determined as 1.365 μm which demonstrated a successful preparation. For osteoporosis model, BMD and the ultimate force of the treated tibia were significantly improved in osteoporosis rat after injection of 0.5 mg and 1 mg simvastatin microcrystals compared with OVX or 0 mg groups. There were no differences observed in BMD and ultimate force between 0.5 mg, 1 mg simvastatin microcrystals group and bone morphogenetic protein (BMP) 5 ug group. For femur defect model, quantitative analysis of bone regeneration by μCT showed bone volume/tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N) were significantly increased in simvastatin microcrystals 50ug (SIM-C 50 ug), SIM-C 100 ug and BMP 5 ug group compared with CPC vehicle group. Trabecular separation (Tb.Sp), and cement volume/tissue volume (CV/TV) were decreased in SIM-C 50 ug, SIM-C 100 ug and BMP 5 ug groups compared with CPC vehicle group. Semiquantitative scale for histology assessment further demonstrated a higher bone regeneration score in drug loaded groups compared with CPC group.﻿Conclusions: Our study shows that simvastatin microcrystals were successfully prepared by wet media milling method and the microcrystals can promote bone formation by local delivery by poloxamer hydrogel or CPC, which is of great translational potential.
Prognostic Value of Quantitative 18F-FDG PET/CT Parameters Measured in Primary Tumors and Suspicious Lymph Nodes in Patients With Esophageal Carcinoma
Authors: Tustumi Francisco , Takeda Flávio Roberto , Duarte Paulo Schiavom , Albenda David Gutiérrez , Sallum Rubens Antonio Aissar , Junior Ulysses Ribeiro , Buchpiguel Carlos Alberto , Cecconello Ivan
Published: June 2020

Objective:Quantitative 18F-FDG PET/CT parameters have been described as prognostic indicators in esophageal cancer. The objective of this study isto evaluate the prognostic value of the maximum standardized uptake value (SUVmax), metabolic tumor value (MTV) and total lesion glycolysis (TLG) measured in the primary tumor and suspicious lymph nodes.Methods: A cohort study was performed to assess the association of SUVmax, MTV and TLG measured prior to and post neoadjuvant therapywithoverall survival (OS) of patients with esophageal cancer who received trimodal therapy. The quantitative techniques were applied in the primary tumor and suspicious lymph nodes. The OS rates were analyzed. Results: Before neoadjuvant therapy, 106 patients underwent PET/CT, and 39 patients underwent post-neoadjuvant therapy PET/CT exams. Before neoadjuvanttherapy, PET/CT showed that all the variables of the evaluated lymph nodes were statistically significant in predicting OS. Postneoadjuvanttherapy, none of the PET/CT variables of lymph nodes were related to prognosis. On the other hand, all primary tumor volumetric variables were related to overall survival. The MTV (HR: 4.66; 95% CI: 1.54-14.08) and TLG (HR: 4.86; 95% CI: 1.66-14.26) of the primary tumor post neoadjuvanttherapy and the variations in MTV (HR: 2.95; 95% CI: 1.01-3.52) and TLG (HR: 3.49; 95% CI: 1.01-3.52) of the primary tumor pre-to-post-neoadjuvanttherapy were prognostic variables. Conclusion: ﻿In patients with esophageal cancer, the burden of disease in suspicious lymph nodes and the primary tumor prior to therapy and the residual burden of disease in the primary tumor post therapy assessed by PET/CT were associated with prognosis.
Comparison of Beta Diversity Measures in Clustering the High-dimensional Microbial Data
Authors: Chen Biyuan , He Xueyi , Pan Bangquan , Zou Xiaobing , You Na
Published: June 2020

Background: Heterogeneity of disease is a major concern in medical research, which is commonly recognized as subtypes with different pathogenesis, exhibiting distinct prognosis and treatment effects. The classification of population into homogenous subgroups is challenging, especially for the complex diseases. Recent studies show that gut microbiome compositions play a vital role in disease development, and it is of great interest to cluster the patients according to their microbial profiles. There are a variety of beta diversity measures to quantify the dissimilarity between the compositions of different samples for clustering. However, using different beta diversity measures results in different clusters, and it is difficult to make a choice.

Results: Considering the microbial compositions from 16S rRNA sequencing, which are presented as a high-dimensional vector with large proportion of extremely small or even zero-valued elements, we set up three simulation experiments to mimic the microbial compositional data and evaluate the performance of different beta diversity measures in clustering. Their performance in two real datasets demonstrates the validity of the simulation experiments.

Conclusion: It is shown that J-divergence/Jensen-Shannon divergence/square root of Jensen-Shannon divergence and Bhattacharyya/Hellinger can capture the compositional changes at low abundance elements more efficiently, and Bhattacharyya/Hellinger is suggested.
Barriers and Facilitators for Implementation of a Patient Prioritization Tool in Rehabilitation Settings
Authors: Déry Julien , Ruiz Angel , Routhier François , Bélanger Valérie , Côté André , Ait-Kadi Daoud , Gagnon Marie-Pierre , Lamontagne Marie-Eve
Published: June 2020

Introduction. Prioritization tools aim to manage access to care by ranking patients equitably in waiting list based on determined criteria. Patient prioritization has been studied in a wide variety of clinical health services, including rehabilitation contexts. We created a web-based patient prioritization tool with the participation of stakeholders in two rehabilitation programs, which we aim to implement into clinical practice. Successful implementation of such innovation can be influenced by a variety of determinants. The goal of this study was to explore facilitators and barriers to the implementation of a patient prioritization tool in rehabilitation programs.Methods. We used two questionnaires and conducted two focus groups among service providers from two rehabilitation programs. We used descriptive statistics to report results of the questionnaires and qualitative content analysis based on Consolidated Framework for Implementation Research.Results. Key facilitators are the flexibility and relative advantage of the tool to improve clinical practices and produce beneficial outcomes on patients. Main barriers are the lack of training, financial support and human resources to sustain the implementation process.Conclusion. This is the first study that highlights organizational, individual and innovation levels facilitators and barriers for the implementation of a prioritization tool from service providers’ perspective.Contributions to the literatureMethods used in this study could be operationalized in future studies to investigate barriers and facilitators of the implementation of an innovative intervention in rehabilitation settings.We used a well-known implementation framework (CFIR) to classified the determinants of the implementation, which could help to compare the results with other similar studies in implementation science.The barriers and facilitators identified in this study are an important first step in the implementation process of a patient prioritization tool in rehabilitation programs.
Effectiveness of Scoliosis-Specific Exercises for Alleviating Adolescent Idiopathic Scoliosis: A Systematic Review
Authors: Fan Yunli , Ren Qing , TO Michael KT , Cheung Jason Pui Yin
Published: June 2020

Background
Adolescent idiopathic scoliosis (AIS) is the most common pediatric spinal deformity with reported complications including pain, mental health concern and respiratory dysfunction. The Scoliosis-specific exercise (SSE) is prescribed throughout pubertal growth to slow progression although effects are unclear. This review aims to establish the effectiveness of SSE in alleviating AIS in terms of reducing Cobb angle, improving trunk asymmetry and quality of life (QoL). Additionally, it aims to define the effects of age, skeletal maturity, curve magnitude and exercise compliance on the outcomes of SSE.
Methods
A systematic reviewed was conducted to net SSE articles. Searched databases included PubMed, MEDLINE, Cochrane Library, Scopus, CINAHL and Google scholar. The quality of study was critically appraised according to the PEDro scale.
Results
A total of ten trials with an average PEDro score of 6.9/10 were examined in this study. Two randomized controlled trials (RCTs) and two clinical controlled trials suggested that SSE alone and with bracing or traditional exercise had clinical significance in reducing Cobb angle more than 5°. One RCT specifically implicated no comparable effects between bracing and SSE in prevention of curve progression for moderate scoliosis. Insufficient evidence demonstrated the positive effects of SSE in improving truck asymmetry (n = 4) and QoL (n = 3). Five studies evaluated the interaction effects of age (n = 2), skeletal maturity (n = 1) and curve magnitude (n = 2) with SSE in reducing Cobb angle yet without drawing any firm conclusions.
Conclusions
Insufficient evidence is available to prove that SSE with or without other conservative treatments can reduce Cobb angle, improve trunk balance and QoL. The interaction effects of age, skeletal maturity, curve magnitude, and exercise compliance with SSE in reducing Cobb angle are not proven. Future studies should investigate the relationship of influencing factors and SSE in treating AIS but not only testing its effectiveness.
Effect of eight weeks of cervical stability exercise on flexion relaxation phenomenon, pain, and disability in patients with non-specific chronic neck pain
Authors: Shamsi Hasan , Khademi-Kalantari Khosro , Akbarzade-Baghban Alireza , Izadi Neda , Okhovatian Farshad
Published: June 2020

Background: The effect of therapeutic exercise on cervical flexion relaxation phenomenon (FRP) is questionable. This study aimed at investigating the effect of eight weeks of cervical stability exercise on FRP, pain, and disability in NSCNP patients.Methods: This quasi-experimental study was conducted on 25 subjects with NSCNP. Surface electromyographic signals of the cervical erector spinae (CES) muscles in a sitting position were recorded before and after the intervention. The occurrence of FRP and flexion relaxation ratio (FRR) were analyzed before and after the eight weeks of cervical stability exercise. The low-load craniocervical flexion exercise was performed by the subjects in crook lying position. In addition, the intensity of pain and disability were assessed via visual analogue index (VAS) and neck disability index (NDI).Results: The FRR of CES muscles increased after the intervention. Similarly, the occurrence of FRP increased among NSCNP patients after the intervention. The average changes of VAS, NDI, and FRR were not associated with gender and duration of pain. Moreover, VAS and NDI scores significantly decreased after the intervention. Conclusions: Flexion relaxation phenomenon can be improved via specific stability exercises. The improvement of flexion relaxation phenomenon apparently can pain and disability.
Capillary blood reference intervals for platelet parameters in healthy full-term neonates in China
Authors: Cui Dongyan , Hou Yan , Feng Ling , Li Guo , Zhang Chi , Huang Yanli , Fan Jiubo , Hu Qun
Published: June 2020

Background
No consensus has been reached on reference intervals for platelet parameters in full-term neonates. We aimed to establish neonatal capillary blood reference intervals for platelet parameters and evaluate influences of gender, gestational age and postnatal age on platelet parameters.
Methods
This study was implemented in 594 healthy full-term neonates from 12 to 84 hours of age, using SYSMEX XN-9000 haematology automatic analyser by means of capillary blood. Reference intervals for platelet parameters were defined by an interval of 2.5th − 97.5th percentiles.
Results
Capillary reference interval for platelet count was (152–464) × 109/L. No significance was found between gender-divided reference intervals for platelet parameters. The values of platelet count changed significantly across gestational age and postnatal age. Reference intervals for other platelet parameters were affected by these factors to a different extent.
Conclusions
We established capillary blood reference intervals for platelet parameters in the early phases after birth of full-term neonates in China for the first time.
Factors associated with minimum dietary diversity and meal frequency among children aged 6-59 months in northwest Ethiopia: finding from the baseline survey of nutrition project
Authors: Bikes Gashaw Andargie , Tariku Amare , Wassie Molla Mesele , Mekonnen Solomon , Muhammad Esmael Ali , Belew Aysheshim Kassahun , Abebe Zegeye , Gete Azeb Atnafu , Yesuf Melkie Edris , Awoke Tadesse , Fekadu Abel , Gebeye Ejigu , Kebede Yigzaw , Alemu Kassahun , Addis Abebaw , Fentahun Kindie , Sisay Mekonnen , Gonete Kedir Abdela , Hunegnaw Melkamu Tamir
Published: June 2020

Background: Studies on the feeding practice of children, including meal frequency and dietary diversity are scarce among children. Therefore, this study aimed to assess dietary diversity and meal frequency and associated factors among children aged 6-59 months at Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia.Methods: A community based cross-sectional study was conducted at Dabat HDSS site from February to June 2016 on 1,174 mother-child pairs. A multistage stratified sampling followed by a systematic random sampling technique was employed to select the study participants. A binary logistic regression model was fitted to identify factors associated with dietary diversity and meal frequency. Variables having a p-value < 0.2 in the bivariate logistic regression were entered into multivariate logistic regression and a p-value < 0.05 were considered statistically significant with feeding practices.Result: The overall prevalence of a minimum dietary diversity practice and a minimum meal frequency was 27 % (95%CI: 24.4, 29.7) and 83.7 % (95%CI: 86.0, 91.7), respectively. Having antenatal care (ANC) service (AOR = 1.6; 95% CI: 1.18, 2.27) and institutional delivery (AOR = 2.6; 95% CI: 1.85, 3.55) increased odds of adequate dietary diversity. On the contrary, the odds of practicing an adequate dietary diversity was lower among a household obtained food from home gardens (AOR = 0.4; 95% CI: 0.29, 0.52) and currently breast fed children (AOR = 0.6; 95% CI: 0.42, 0.78). The probability of having a minimum meal frequency was decreased among children in the first two years of age (AOR = 0.1; 95% CI: 0.06, 0.15), however increased in children who fed alone (AOR = 1.9; 95% CI: 1.29, 2.69). Conclusion: The proportion of children who received the minimum dietary diversity was low while the proportion of children who obtained minimum meal frequency was good. Providing a health and nutrition counseling on Infant and Young Child Feeding (IYCF) during maternal ANC services and delivery period are recommended for achieving the recommended dietary practices.
The present shock and time re-appropriation: rethinking science education in the pandemic era
Authors: Levrini Olivia , Fantini Paola , Barelli Eleonora , Branchetti Laura , Satanassi Sara , Tasquier Giulia
Published: June 2020

The crisis due to the COVID-19 pandemic is so huge that raises enormous questions about its implications for our societies and personal lives. In this article, we focus on science education and the role it can play to prepare future generations to grapple with this complex, fast-changing and fragile society. The approach we chose is centered on the concept of time, whose perception and organisation has been deeply affected by pandemic-induced changes. An exploratory qualitative study has been carried out with secondary school students to investigate how they were experiencing time during lockdown and which (if any) scientific knowledge they were activating to grapple with the current uncertainty and change in time structures.The main result concerns the discovery of the potential of the dichotomy between alienation from time and time re-appropriation to highlight the difference between future shock, (characteristic of the pre-crisis society of acceleration) and present shock (characteristic of the pandemic era). The analysis of students’ interviews allowed us to start unpacking time re-appropriation and its links with science learning and identity development.On the basis of the analysis, we identified three directions that science education research could explore to support schools and science teaching in playing a leading role in this fast-changing society. The directions concern new thematic and epistemological priorities for science curricula, new emphasis on learning and teaching rituals fostering appropriation, and arguments for revising the institutional role of schools.
Circular RNA SIPA1L1 Promotes Osteogenesis via Regulating the MIR-617/SMAD3 Axis in Dental Pulp Stem Cells
Authors: Ge Xingyun , Li Zehan , Zhou Zhou , Xia Yibo , Bian Minxia , Yu Jinhua
Published: June 2020

Background: Bone regeneration is preferred for bone loss caused by tumors, bone defects, fractures, etc. Recently, mesenchymal stem cells are considered as optimistic tools for bone defect therapy. Dental pulp stem cells (DPSCs) are a promising candidate for regenerative medicine and bone regeneration. Our previous study showed that up-regulated circSIPA1L1 during osteogenesis of DPSCs is of significance. In this paper, the potential role of circSIPA1L1 in osteogenesis of DPSCs and its underlying mechanisms are explored.Methods: The circular structure of circSIPA1L1 was identified by Sanger sequencing and PCR. Regulatory effects of circSIPA1L1 and miR-617 on mineral deposition in DPSCs were assessed by alkaline phosphatase (ALP) and alizarin red S (ARS) staining and in vivo bone formation assay were conducted to verify the biological inﬂuences of circSIPA1L1 on DPSCs. Western blot was performed to detect the protein expression of Smad3. Localization of circSIPA1L1 and miR-617 was confirmed by FISH. Dual-luciferase reporter assay and rescue experiments were conducted to investigate the role of the circSIPA1L1/miR-617/Smad3 regulatory axis in osteogenesis of DPSCs.Results: Sanger sequencing and back-to-back primer experiments confirmed the closed loop structure of circSIPA1L1. CircSIPA1L1 could promote the committed differentiation of DPSCs. MiR-617 was predicted to be the target binding circSIPA1L1 through MiRDB, miRTarBase, and TargetScan database analyses, which was further confirmed by dual-luciferase reporter assay. FISH results showed that circSIPA1L1 and miR-617 colocalize in the cytoplasm of DPSCs. MiR-617 exerted an inhibitory effect on osteogenesis of DPSCs. Knockdown of circSIPA1L1 or upregulation of miR-617 down-regulated phosphorylated Smad3. In addition, rescue experiments showed that knockdown of miR-617 reversed the inhibitory effect of circSIPA1L1 on osteogenesis of DPSCs.Conclusion: CircRNASIPA1L1 promotes osteogenesis of DPSCs by adsorbing miR-617 and further targeting Smad3.
Tracheal Solid Variant of Adenoid Cystic Carcinoma with Basaloid Features: A Case Report and Review of Literature
Authors: Gao Feng , Zang Lijuan , He Jin , Xu Weiqing
Published: June 2020

Background: Primary tracheal adenoid cystic carcinoma (ACC) is a rare and heterogeneous group of neoplasms arising from the respiratory tract. The solid variant of ACC is a histologically distinct subtype with unfavorable clinical course. We report a case of tracheal ACC with immunohistochemical and molecular analysis together with a review of the literature. Case presentation: A 31-year-old man presented with a neoplasm growing on the lower part of the total tracheal membrane, left side wall and anterior wall. The tumor was obtained via fiberoptic bronchoscopy. Histologically, the tumor is characterized by a predominant compact sheet-like and nested pattern of rounded basaloid cells. Immunohistochemically, the tumor was diffusely positive for CK and CD117. CK7 and CK5/6 was focally positive in the genuine glandular structures. P63 was completely negative in majority of neoplastic cells. Fluorescence in situ hybridization analysis revealed MYB gene rearrangement. The current case showed an almost entirely solid pattern of growth with basaloid features, and was morphologically difficult to distinguish from a variety of other round cell neoplasms. Conclusions: This case report highlights the significance of various histological patterns and diagnostic modalities in making an accurate diagnosis of primary tracheal ACC at an early stage.
Epidemic and molecular characterization of fluoroquinolone-resistant Shigella dysenteriae 1 isolates from calves with diarrhea
Authors: Zhu Zhen , Cao Mingze , Wang Weiwei , Zhang Liwei , Liu Guanhui , Zhou Xuzheng , Li Bing , Shi Yuxiang , Zhang Jiyu
Published: June 2020

Background: The widespread distribution of antimicrobial-resistant Shigella has become a recurrent challenge in many parts of the developing world. Previous studies indicate that the host of Shigella has expanded from humans to animals. This study aimed to investigate the prevalence of fluoroquinolone resistance and associated molecular characterization of S. dysenteriae 1 isolated from calves. Methods and Results: All 38 unduplicated S. dysenteriae 1 isolates were collected from calves in Gansu Province from October 2014 to December 2016. According to MLST and PFGE analysis, these isolates were separated into 4 and 28 genotypes, respectively. The most common STs identified were ST228 (34.21%, 13/38) and ST229 (39.47%, 15/38), which were first found in the present study. All isolates harbored virulence genes, and the incidence of the five virulence genes were ipaH (100%), ipaBCD (92.11%), stx (73.68%), ial (57.89%), and sen (28.95%). According to the results of antimicrobial susceptibilities, 76.32% (29/38) of S. dysenteriae isolates were resistant to fluoroquinolone and showed multidrug resistance. In a study on the polymorphism of QRDR of gyrA/B and parC/E genes, we identified two mutations in gyrA (Ser83→Leu and Asp87→Asn) and parC (Ser80→Ile and Ser83→Leu), respectively. Among them, 55.17% (16/29) of resistant strains had the gyrA point mutations (Ser83→Leu) and parC point mutation (Ser83→Leu). Moreover, 41.38% (12/29) of isolates had all five point mutations of gyrA and parC. In addition, the prevalence of the PMQR determinant genes was also investigated. All 29 fluoroquinolone-resistant isolates were positive for the aac(6’)-Ib-cr gene but negative for qepA, except SD001. In addition, only 6 (20.69%, 6/29) isolates harbored the qnr gene, including two with qnrB (6.90%, 2/29) and four with qnrS (13.79%, 4/29). Conclusion: Given the increased common emergence of multidrug resistant isolates, uninterrupted surveillance will be necessary to understand the actual epidemic burden and control this infection.