bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient in vitro plant regeneration from leaf derived callus and genetic fidelity assessment of an endemic medicinal plant of Ranunculus wallichianus Wight & Arnn using RAPD and ISSR markers
Authors: P Srinivasan , H David Raja , R Tamilvanan
Published: May 2021

Ranunculus wallichianus is a medicinally important plant and an endemic species to Western Ghats of South India. An efficient and reliable indirect regeneration protocol system for R. wallichianus was developed from leaf explants in the present investigation. Leaf explants were cultured on both full-strength and half-strength MS (Murashige & Skoog) medium supplemented with different concentrations (1.0 mg L− 1 to 3.0 mg L− 1) of 2,4-D and NAA. Among the different concentrations tested, the highest percentage of yellowish green compact nodular callus formation was observed on half-strength MS medium with 2.0 mg L− 1 of 2, 4-D. Then, the in vitro raised organogenic callus was cultured on half strength MS medium containing various concentrations (1.0 mg L− 1 to 3.0 mg L− 1) of BA, KIN and TDZ with 0.5 mg L− 1 NAA and 10% CW for in vitro shoot regeneration. The highest percentage of regeneration response (97%) and maximum number of shoots formation (11.1 ± 0.13 shoots/culture with 9.2 ± 0.35 cm mean shoot length) were obtained from MS medium containing 2.5 mg L− 1 BA with 0.5 mg L− 1 NAA and 10% CW. The well elongated in vitro raised shoots were rooted in half strength MS medium with 2.5 mg L− 1 IBA + 250 mg L− 1 activated charcoal shows high frequency of root formation. The well rooted plantlets were successfully hardened and acclimatized with the survival rate of 94%. Clonal fidelity of in vitro raised plantlets was assessed by using DNA based RAPD and ISSR molecular markers. The total of 56 and 47 monomorphic bands were obtained from RAPD and ISSR markers respectively. This present in vitro propagation protocol system could be an effective for the conservation of R. wallichianus with their genetic purity and its further investigations.
The First Line Treatment of Advanced or Metastatic BRAF Mutant Melanoma: A Network Meta-analysis
Authors: Yang Zhenyi , Zhong Wen , Wen Ping , Luo Yixuan , Wu Chunli
Published: May 2021

Purpose: The treatments for advanced or metastatic BRAF mutant melanoma are flourish, but the most effective treatment is unclear. Here, we conducted a network meta-analysis (NMA) in unresectable stage III or advanced (or metastatic) stage IV BRAF mutant melanoma patients to estimate the efficacy of various first line treatments.Methods: A comprehensive search for RCTs in PubMed and EMBASE was conducted to January 2021. Randomized control trials of unresectable stage III or advanced stage IV BRAF mutant melanoma were eligible if not receive previously treatment. By a Bayesian network meta-analysis, the effectiveness of each treatment was estimated and ranked based on the odds ratio (OR) for Object response rate (ORR) and hazard ratio (HR) for Overall survival (OS).Results: Eight trials enrolling 3272 patients were included. Combination dabrafenib and trametinib with pembrolizumab (HR: 0.37; 95% confidence interval [CI]: 0.21-0.66; compared with dacarbazine) ranked as the best effective treatment for OS.Conclusion: Combination pembrolizumab with trametinib and dabrafenib and combination atezolizumab with trametinib and dabrafenib appear more effective as first line treatments for unresectable stage III or advanced (or metastatic) stage IV BRAF mutant melanoma patients. Whereas, further RCTs are needed to complete the network.
Development and Validation of a Lncrnas-Based Nomogram for Survival Prediction in Neuroblastoma Patients
Authors: Lv Yong , Jin ShuGuang , Xiang Bo
Published: May 2021

BackgroundTreatment of neuroblastoma is evolving toward precision medicine. LncRNAs can be used as prognostic biomarkers in many types of cancer.MethodsBased on the RNA-seq data from GSE49710, we built a lncRNAs-based risk score using the least absolute shrinkage and selection operation (LASSO) regression. Cox regression, receiver operating characteristic curves were used to evaluate the association of the LASSO risk score with overall survival. Nomograms were created and then validated in an external cohort from TARGET database. Gene set enrichment analysis was performed to identify the significantly changed biological pathways. ResultsThe 16-lncRNAs-based LASSO risk score was used to separate patients into high-risk and low-risk groups. In GSE49710 cohort, the high-risk group exhibited a poorer OS than those in the low-risk group (P<0.001). Moreover, multivariate Cox regression analysis demonstrated that LASSO risk score was an independent risk factor (HR=6.201;95%CI:2.536-15.16). The similar prognostic powers of the 16-lncRNAs were also achieved in the external cohort and in stratified analysis. In addition, a nomogram was established and worked well both in the internal validation cohort (C-index=0.831) and external validation cohort (C-index=0.773). The calibration plot indicated the good clinical utility of the nomogram. Gene set enrichment analysis (GSEA) indicated that high-risk group was related with cancer recurrence, metastasis and inflammatory associated pathways.ConclusionThe lncRNA-based LASSO risk score is a promising and potential prognostic tool in predicting the survival of patients with neuroblastoma. The nomogram combined the lncRNAs and clinical parameters allows for accurate risk assessment in guiding clinical management.
HIV virological non-suppression and its associated factors amongst children on antiretroviral therapy at a major paediatric treatment centre in Southern Ghana: a cross-sectional study
Authors: Afrane Adwoa K. A. , Goka Bamenla Q. , Renner Lorna , Yawson Alfred Edwin , Alhassan Yakubu , Owiafe Seth N. , Agyeman Seth , Sagoe Kwamena W.C , Kwara Awewura
Published: May 2021

Background
Children with human immunodeficiency virus (HIV) infection require lifelong effective Antiretroviral Therapy (ART). The aim of ART in HIV-infected persons is sustained viral suppression. There is limited information on virological non-suppression or failure and its associated factors in children in resource limited countries, particularly Ghana.
Methods
A cross-sectional study of 250 children aged 8 months to 15 years who had been on ART for at least 6 months attending the Paediatric HIV clinic at Korle Bu Teaching hospital in Ghana was performed. Socio-demographic, clinical, laboratory and ART Adherence related data were collected using questionnaires as well as medical records. Blood samples were obtained for viral load and CD4+ count determination. Viral load levels > 1000 copies/ml on ART was considered virological non-suppression. Logistic regression was used to identify factors associated with virological non-suppression.
Results
The mean (± SD) age of the study participants was 11.4 ± 2.4 years and the proportion of males was 53.2%. Of the 250 study participants, 96 (38.4%) had virological non-suppression. After adjustment for significant variables, the factors associated with non-suppressed viral load were female gender (AOR 2.51 [95% CI 1.04–6.07], p = 0.041), having a previous history of treatment of tuberculosis (AOR 4.95 [95% CI 1.58–15.5], p = 0.006), severe CD4 immune suppression status (CD4% < 15% / CD4+ count < 200 cells/mm 3) at study recruitment (AOR 24.93 [95% CI 4.92-126.31], p < 0.001) and being on a Nevirapine based regimen (AOR 7.93 [95% CI 1.58–1.15], p = 0.005).
Conclusion
The prevelance of virological non-suppression was high. Virological non-suppression was associated with a previous history of TB treatment, female gender, severe CD4 immune suppression status (CD4% <15% / CD4+ count < 200 cells/mm3), at study recruitment and being on a Nevirapine based regimen. Early initiation of ART and phasing out Nevirapine based regimen might improve viral load suppression in children. In addition, children with a history of TB may need focused measures to maximize virological suppression.
Robot-Assisted, Laparoscopic, and Open Radical Cystectomy (RC): Pre-Operative Data of 1400 Patients From The Italian Radical Cystectomy Registry (RIC)
Authors: Porreca Angelo , Busetto Gian Maria , Colicchia Michele , Palmer Katie , Artibani Walter , Antonelli Alessandro , Bianchi Lorenzo , Bocciardi Aldo , Brunocilla Eugenio , Carini Marco , Carrieri Giuseppe , Cormio Luigi , Falagario Ugo Giovanni , De Berardinis Ettore , Sciarra Alessandro , Leonardo Costantino , Giudice Francesco Del , Maggi Martina , de Cobelli Ottavio , Ferro Matteo , Musi Gennaro , Ercolino Amelio , Maida Fabrizio Di , Gallina Andrea , Introini Carlo , Mearini Ettore , Cochetti Giovanni , Minervini Andrea , Montorsi Francesco , Schiavina Riccardo , Serni Sergio , Simeone Claudio , Parma Paolo , Serao Armando , Mangano Mario Salvatore , Pomara Giorgio , Ditonno Pasquale , Simonato Alchiede , Romagnoli Daniele , Crestani Alessandro , D'Agostino Daniele
Published: May 2021

Introduction: the Italian Radical Cystectomy Registry (RIC) is an observational prospective study aiming to understand clinical variables and patient characteristics associated with short- and long-term outcomes among bladder cancer (BC) patients undergoing radical cystectomy (RC). Moreover, it compares the effectiveness of three RC techniques - open, robotic, and laparoscopic.Methods: from 2017 to 2020, 1400 patients were enrolled at one of the 28 centers across Italy. Patient characteristics, as well as preoperative, postoperative, and follow-up (3, 6, 12, and 24 months) clinical variables and outcomes were collected. Results: preoperatively, it was found that patients undergoing robotic procedures were younger (p<.001) and more likely to have undergone preoperative neoadjuvant chemotherapy (p<.001) and BCG instillation (p<.001). Hypertension was the most common comorbidity among all patients (55%), and overall, patients undergoing open and laparoscopic RC had a higher Charlson Comorbidities Index (CCI) compared to robotic RC (p<.001). Finally, laparoscopic patients had a lower G-stage classification (p=.003) and open patients had a higher ASA score (p<.001). Conclusion: the present study summarizes the characteristic of patients included in the RIC. Future results will provide invaluable information about outcomes among BC patients undergoing RC. This will inform physicians about the best techniques and course of care based on patient clinical factors and characteristics.
The Transcriptional Regulation and Ubiquitination Dependent Regulation of Hnrnpk Oncogenic Function in Prostate Tumorigenesis
Authors: Wu Huan-Lei , Li Sen-Mao , Huang Yao-chen , Xia Qi-Dong , Zhou Peng , Li Xian-Miao , Yu Xiao , Wang Shao-Gang , Ye Zhang-Qun , Hu Jia
Published: May 2021

Background
Heterogeneous nuclear ribonucleoprotein K (hnRNPK) is a nucleic acid-binding protein that regulates diverse biological events. Pathologically, hnRNPK proteins are frequently overexpressed and clinically correlated with poor prognosis to various types of human cancers, therefore pursued as attractive therapeutic targets for selective patients. However, both the transcriptional regulation and degradation of hnRNPK in prostate cancer are remain poorly understood.
Methods
qRT-PCR was used to detect the expression of hnRNPK and miRNA; Immunoblots and immunohistochemical assays were used to determine the levels of hnRNPK and other proteins. Flow cytometry was used to investigate cell cycle stage. MTS and clonogenic assays were used to investigate cell proliferation. Immunoprecipitation was used to analyze the interaction between SPOP and hnRNPK. A prostate carcinoma xenograft mouse model was used to detect the in vivo effects of hnRNPK and miRNA.
Results
In the present study, we observed that hnRNPK emerged as an important player in carcinogenesis process of PrCa. miR-206 and miR-613 suppressed hnRNPK expression by targeting the 3’-UTR of hnRNPK in PrCa cell lines, where hnRNP K is overexpressed. In biological effects studies, proliferation and colony formation of PrCa cells in vitro, and tumor growth in vivo, were also dramatically suppressed upon reintroduction of miR-206/ miR-613. We have further provided clear evidence that Cullin 3 SPOP as a novel upstream E3 ubiquitin ligase complex that governs hnRNPK proteins stability and oncogenic functions through promoting the degradation of HnRNP K in a poly-ubiquitinaion dependent proteolysis in the prostate cancer setting. Moreover, prostate cancer-associated SPOP mutants fail to interact with and promote the destruction of hnRNPK proteins.
Conclusion
Our finding reveal new post-transcriptional and post-translational modifications mechanism of hnRNPK regulation via miR-206/ miR-613 and SPOP, respectively. More important, given the critical oncogenic role of hnRNPK and high frequency of SPOP mutation in prostate cancer, our results provide a molecular rationale for the clinical investigation of novel strategies to combat prostate cancer based on SPOP genetic status.
Lipid droplets modulate proteostasis, SQST-1/SQSTM1 dynamics, and lifespan in C. elegans
Authors: Kumar Anita , Mills Joslyn , Parker Wesley , Leitão Joshua , Ng Celeste , Patel Rishi , Aguilera Joseph , Johnson Joseph , Wong Shi Quan , Lapierre Louis
Published: May 2021

The ability of organisms to live long depends largely on the maintenance of proteome stability via proteostatic mechanisms including translational regulation, protein chaperoning and degradation machineries. In several long-lived Caenorhabditis elegans strains, such as insulin/IGF-1 receptor daf-2 mutants, enhanced proteostatic mechanisms are accompanied by elevated intestinal lipid stores, but the role of lipid droplets in longevity has remained obscure. Here, while determining
the regulatory network of the selective autophagy receptor SQST-1/SQSTM1, we unexpectedly uncovered a novel role for lipid droplets in proteostasis and longevity. Using an unbiased genomewide RNAi screening approach, we identified several SQST-1 modulators, including proteins found on lipid droplets and those prone to aggregate with age. SQST-1 accumulated on lipid droplets when autophagy was inhibited, suggesting that lipid droplets may serve a role in facilitating selective autophagy. Expansion of intestinal lipid droplets by silencing the conserved cytosolic triacylglycerol lipase gene atgl-1/ATGL enhanced autophagy, and extended lifespan in an HSF-1/HSF1-dependent and CDC-48/VCP-dependent manner. Silencing atgl-1 mitigated the age-related accumulation of SQST-1 and reduced overall ubiquitination of proteins. Reducing atgl-1 also improved proteostasis in a nematode model of Alzheimer’s disease. Subcellular analyses revealed that lipid droplets unexpectedly harbor more ubiquitinated proteins than the cytosol. Accordingly, low lipid droplet levels exacerbated the proteostatic collapse when autophagy or proteasome function was compromised. Altogether, our study uncovers a key role for lipid droplets in C. elegans as a proteostatic mediator that reduces protein ubiquitination, facilitates autophagy, and promotes longevity.
Effect of Zinc Oxide on the Efficiency Enhancement of Al/Li2O/PSi/Si/Al solar cell
Authors: Al-Hussan Shahlaa M. Abd , Bakr Nabeel A. , Abd Ahmed N.
Published: May 2021

In this paper, electrochemical etching of the p-type silicon wafer is used to prepare p-type porous silicon with current density of 10 mA.cm− 2 for 10 minutes. Field Emission Scanning Electron Microscopy (FESEM) has been used to study porous silicon layer surface morphology. Zinc oxide and lithium oxide nanoparticles are prepared separately by chemical precipitation method and simple precipitation method, respectively and deposited on glass substrates by drop casting method. Moreover,, the structural properties of the films were analyzed by using XRD and SEM. The XRD results showed that the ZnO and Li2O films are polycrystalline with hexagonal wurtzite structure and cubic structure, and preferred orientation along (101) and (003) planes, respectively. Using Scherrer's formula, the crystallite size was measured and it was found that ZnO and Li2O thin films have a crystallite size of 22.04 and 45.6 nm respectively. Surface topography of the prepared thin films is studied by using Scanning Electron Microscopy (SEM). Later, certain proportions of both materials were mixed and deposited on porous silicon using drop casting method at thickness of 1.4 µm. After that, the characteristics of the solar cell were investigated. Mixing zinc oxide nanoparticles in particular proportions with lithium oxide played a major role in increasing the solar cell's performance. The highest prepared film efficiency was obtained at mixing ratio (0.5: 0.5) for (ZnO: Li2O) and its value was (11.09 %).
Global dynamics for a non-smooth Filippov system with the threshold strategy
Authors: Zhu Yuxun , Liu Lu , Zhang Zhengdi
Published: May 2021

In this study, the Leslie-Gower model with functional response is extended into a non-smooth Filippov system by applying IPM strategies. Once the number of pests reaches or surpasses the given economic threshold(ET), spraying pesticides and releasing the natural enemy are implemented simultaneously. In order to maintain the pest population at or below ET, global dynamics of the proposed model are investigated completely, including the existence of sliding mode and various equilibria, sliding dynamics and global stability of equilibria. The result shows that real equilibrium cannot coexist with the unique pseudo-equilibrium. In particular, after excluding the existence of any possible limit cycle, the global stability of equilibria is obtained by employing qualitative and numerical techniques. In the end, the effect of our work on pest control are discussed.
Replumbing the Bengal Basin: A Shift in Recharge Driven by Groundwater Irrigation Revealed by Stable Water Isotopes
Authors: Jameel Yusuf , Stahl Mason , Michael Holly , Bostick Benjamin , Steckler Mike , Schlosser Peter , Geen Alexander van , Harvey Charles
Published: May 2021

Groundwater supports agriculture and provides domestic water for over 250 million people in the Bengal Basin. Our analysis of stable water isotope ratios in rain, surface, and groundwater shows that the proportion of groundwater recharge originating from stagnant surface water bodies has increased by about 50% over the last seventy years while the relative contribution from direct infiltration of rain has decreased. This regional shift in the source of groundwater shows how the simultaneous expansion of irrigated rice, excavated ponds and groundwater pumping has changed the hydrologic system by cycling evaporated standing water through the subsurface. Analysis of water isotope data also reveals that most recharge from standing water enters during the latter part of the dry season (February-April), while most rainwater recharge occurs in the early months of the monsoon (June-August) before aquifers fill to capacity and reject additional recharge of rainwater.
Reliability allocation of rotary ultrasonic vibration-assisted EDM machine tool based on maximum entropy ordered weighted average and constraint under the index of overall cost
Authors: Xu Minggang , Fu Hao , Tian Wang , Lyu Binbin , Jiang Zihao , Guan Baosheng
Published: May 2021

Rotary ultrasonic vibration-assisted EDM is a composite machining method which uses EDM technology to process metal surface and adds rotation and ultrasonic vibration. In this paper, the failure rate of each module of the rotary ultrasonic vibration-assisted EDM machine tool can be accurately predicted by the maximum entropy ordered weighted average algorithm so that the corrected maintenance cost can be predicted. And effective control of preventive maintenance costs can be achieved by selecting the best maintenance times under the premise of reliability. The results showed that the reliability of rotary ultrasonic vibration-assisted EDM machine tool is smoother at non-fixed maintenance intervals by varying the maintenance interval according to the comparison between non-fixed and fixed maintenance cycle. The cost of corrective maintenance can be reduced by varying the measurement to achieve cost optimization in the context of reliability with an optimum number of maintenance cycles and reliability.
Prognosis of Very Elderly Patients After Intensive Care
Authors: Michel Philippe , FADEL Fouad , Plantefève Gaëtan , Ehrmann Stephan , Gelée bruno
Published: May 2021

Background: Very elderly patients (aged over 85 years) are increasingly treated in intensive care units (ICU) despite the reluctance of doctors to admit these patients considered fragile. Only a few studies in this age group have described the relevance of treatment of these patients in the intensive care unit. Methods: he inclusion criterion for this study was patients aged 85 years or over on admission. The exclusion criteria were high dependence before admission or an inability to answer the telephone. Epidemiological data, antecedents, lifestyle, autonomy (ADL score of six items) were recorded on admission to the ICU and by telephone interview at six months. Results: Eight French ICU included 239 patients aged over 85 years. The most common diagnoses were non-cradiogenic lung disease (36%), severe sepsis / septic shock (29%) and acute pulmonary oedema (28%). 23% of patients were dependent on admission. 71% of patients were still living when discharged from the ICU and 52% were still living at 6 months. Among the non-dependent patients before hospitalisation, 17% became dependent. The only prognostic criteria found were the SAPS II score on admission and the place of residence before admission (nursing home or ”with family” had a poor prognosis). Conclusions: Although the prognosis of these very elderly patients was good after hospitalisation in the ICU, it should be noted that the population was highly selected with few comorbidities or dependence. No triage criteria could be proposed. ClinicalTrials.gov Identiﬁer: NCT02849756
Liver Failure in Pregnancy: A Retrospective Study of 62 Cases
Authors: Han Zhenyan , Zhou Jin , Zhang Peizhen , Tan Zhangmin , He Tiantian , Hou Hongying , Yin Yuzhu , Zhang Yuan
Published: May 2021

Background: Liver failure in pregnancy is a rare but potentially severe disease with a high rate of short-term morbidity and mortality, while there is still a lack of accurate diagnosis, effective treatments and prognostic indicators for liver failure in pregnancy. This study aims to retrospectively investigate the clinical characteristics of liver failure in pregnancy caused by AFLP and hepatitis B, and to explore the potential prognostic indicators. Methods: Sixty-two pregnant women with symptoms and signs of hepatic dysfunction, admitting to the Third Affiliated Hospital of Sun Yat-sen University between January 1, 2010 and December 31, 2019 were retrospectively recruited. The baseline clinical characteristics, in-hospital mortality and changes of important laboratory examination parameters during hospitalization were determined.Results: The in-hospital mortality rate of liver failure in pregnancy was 27.4% and most of the deaths were recorded in the first 7 days after admission. Patients suffered in-hospital death had a significant lower gestational age, a higher incidence rate of hepatorenal syndrome and were more likely to receive hysterectomy but less likely to receive intrauterine balloon tamponade. The baseline aspartate aminotransferase, total bilirubin, indirect bilirubin and platelet levels were significantly higher, while cholinesterase, prothrombin activity and creatinine levels were significantly lower in patients with in-hospital death than that in patients discharged alive. The change tendencies of total bilirubin level and prothrombin activity were greatly different between patients with in-hospital deaths and patients discharged alive. Some differences in baseline clinical characteristics between different underlying etiologies of pregnant patients with liver failure were also detected.Conclusions: The mortality rate of liver failure in pregnancy is high especially within 7 days after admission. The change tendencies of total bilirubin and prothrombin activity were greatly different between dead and survived patients with liver failure during hospitalization, which suggested that these parameters might be important prognostic factors of liver failure in pregnancy and their alterations should be carefully tracked.
Signals of Cardiovascular Issues with COVID19 Vaccines in VAERS
Authors: Clark Matthew
Published: May 2021

While COVID19 vaccines have been administered to over 100 million patients, a small minority (40,000) have reported adverse events, and an even smaller fraction have reported cardiovascular issues (~500). There have been reporting of a few unusual cardiovascular events associated with some varieties of COVID19 vaccines resulting in pauses of use. Here we analyze the reports of adverse events associated with the COVID19 vaccines in the FDA Vaccine Adverse Event Reporting System (VAERS) database to apply standard methods of detecting safety signals.
In this work we apply this methodology to reports in the FDA VAERS database and have identified concerning signals for pulmonary embolism and myocardial infarction associated with COVID19 vaccines. These signals are compared with cardiovascular events reported in connection with influenza (FLU3) vaccines that are administered to a similar population. While signals of these events are higher for COVID19 than other vaccines, the incidence rates are comparable to the normally expected rate for non-vaccinated individuals.
Impact of Tenofovir Alafenamide Vs. Entecavir on Hepatocellular Carcinoma Risk in Patients With Chronic Hepatitis B
Authors: Lee Hye Won , Cho Young Youn , Kim Beom Kyung , Lee Hyein , Lee Jae Seung , Kim Seung Up , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Park Soo Young
Published: May 2021

Background & aims: Whether entecavir (ETV) or tenofovir alafenamide (TAF) is better at preventing hepatocellular carcinoma (HCC) development among patients with chronic hepatitis B (CHB) remains unclear. The present study was conducted to explore the ability of these two antivirals to prevent HCC.Methods: From 2012 to 2019, treatment-naïve CHB patients undergoing ETV or TAF therapy were recruited at three academic teaching hospitals. The TAF group comprised patients starting TAF as first-line antiviral and those switching antivirals from tenofovir disoproxil fumarate to TAF. Patients with decompensated cirrhosis or HCC at enrollment were excluded from the analysis. Cumulative probabilities of HCC were assessed using the Kaplan-Meier method.Results: In total, 1,810 patients (1,525 and 286 in ETV and TAF groups, respectively) were recruited. The annual HCC incidence was statistically not different between the ETV and TAF groups (1.67 vs. 1.19 per 100 person-years, respectively) with an adjusted hazard ratio (HR) of 0.681 (p=0.255), as determined by multivariate analysis. Male, hypertension, liver cirrhosis, FIB-4 index, and albumin were independent prognostic factors for HCC development. Propensity score-matched and inverse probability of treatment weighting analyses yielded similar results, with non-statistically different HCC incidence between the ETV and TAF groups (1.07 vs. 1.19 per 100 person-years (HR=0.973; p=0.953) and 1.67 vs. 1.89 per 100 person-years, respectively (HR=0.949; p=0.743).Conclusions: These findings suggest that ETV- and TAF-treated CHB patients have similar risk of developing HCC. Further studies with the larger sample size and longer follow-up are needed to validate these results.
Posterior-stabilized Arthroplasty Versus Cruciate-retaining Arthroplasty in Treatment of Osteoarthritis: a 5-year Follow-up Study
Authors: Niu Yingzhen , Bai Weixia , Ji Gang , Kang Huijun , Piao Kang , Dong Zhenyue , Dong Conglei , Wang Fei
Published: May 2021

Backgroud: A prospective cohort study was performed to compare clinical outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) arthroplasty.Methods: In total, 210 patients (210 knees) underwent CR arthroplasty (n=102) and PS arthroplasty (n=108) from January 2014 to January 2015. The Knee Society Score (KSS), range of motion, patellar stability, and complications were compared between the CR and PS groups 5 years postoperatively. Results: The CR group comprised 99 knees and the PS group comprised 105 knees at the 5-year follow-up. In the CR and PS groups, the mean postoperative KSS improved to 90±5 and 91±4, and the function score improved to 87±4 and 84±6, respectively (p>0.05). The mean postoperative range of motion was −2°±3° extension to 114°±8° flexion in the CR group and −2°±4° extension to 126°±7° flexion in the PS group, with no significant difference (p>0.05). In terms of patellofemoral complications, eight patients had patellar clunk syndrome, one had patellar subluxation, and one had patellar lateral facet fracture in the PS group. Three patients had patellar clunk syndrome, and one had symptomatic subluxation in the CR group. These patellofemoral complications were significantly different between the groups (p<0.05).Conclusions: CR and PS TKA can achieve good clinical outcomes with respect to the KSS. Better knee flexion but more patella complications in the PS arthroplasty than CR group 5 years postoperatively.Trail registration: This study was approved by our hospital institutional ethics committee.
Psoriasis Is Associated With Worse Quality of Life Compared With the Other 12 Skin Diseases: A Cross-sectional Study
Authors: Zhou Li , Ouyang Wenwei , Wen Zehuai , Lu Chuanjian , He Zehui
Published: May 2021

Background: Skin diseases impair patients’ quality of life (QoL). Psoriasis is of particular concern because it affects multiple facets of patients’ lives.Objective: The aim of this study was to investigate whether having psoriasis was associated with the more severe QoL impairment compared with the other 12 skin diseases, based on the Dermatology Life Quality Index (DLQI).Methods: This multicenter observational cross-sectional study was conducted in 9centers in China. Socio-demographic variables and health history were collected with a standardized form questionnaire. QoL was measured by the DLQI. DLQI scores were compared between patients with psoriasis and without psoriasis using univariate analysis. Then multivariate linear regression was used to related QoL to groups (psoriasis vs. non psoriasis), clinical and socio-demographic characteristics.Results: Of 8,339 included dermatological participants, 1,310 (15.7%) had psoriasis, and 7,029 (84.3%) did not. The QoL of patients with psoriasis was lower than that of patients without psoriasis based on the DLQI score (11.20 ± 7.37 vs 8.12 ± 6.26, P < 0.05). The results of multivariate linear regression indicated the same results when adjusting clinical and socio-demographic characteristics.Conclusion: Patients with psoriasis experience more quality of life impairment than patients without psoriasis. More attention should be paid to patients with psoriasis in dermatological health policy decision.
Stigmatization and Psychological Impact of COVID-19 Pandemic on Frontline Healthcare Workers in Nigeria: A Qualitative Study
Authors: Kwaghe Ayi Vandi , Kwaghe Vivian Gga , Habib Zaiyad Garba , Kwaghe Gga Vandi , Ilesanmi Olayinka Stephen , Ekele Bissalah , Umeokonkwo Chukwuma David , Balogun Muhammad Shakir
Published: May 2021

Introduction: The COVID-19 pandemic has had a great toll on global health. Frontline healthcare workers (FHCW) directly involved in the treatment of COVID-19 patients have faced some physical and psychological challenges. This study explored the stigma and traumatic experiences of the FHCW during the COVID-19 pandemic in Nigeria. Methods: We recruited twenty FHCW directly involved in the treatment of COVID-19 patients through purposive and snowball sampling techniques. Face-to-face in-depth interviews were conducted for all participants, and qualitative analysis of data was done using Colaizzi's phenomenological method.Results: Five themes identified were: Early stage of the pandemic (fear, anxiety, public fright and countries repatriating their citizens, the socio-economic impact of the pandemic and a call to duty for the FHCW); working with COVID-19 patients (excitement on patients recovery and duty stress); psychological, mental and emotional trauma; stigmatization (stigmatized by colleagues, family, friends or their residential communities, reasons for stigmatization which were fear of infection, limited knowledge of the virus and working at the isolation centre and the effect of stigma); and recommendations (education and awareness creation, government showing more care towards the FHCW and provision of health insurance for FHCW to take care of those that get infected in the line of duty).Conclusion: Stigmatization has proven to be a major challenge for FHCW in conducting their duties. The psychological impact experienced by FHCW may affect the quality of the services rendered by these workers. The study reveals the need of education and awareness creation in the ongoing pandemic. There is a need for the government and society to acknowledge and appreciate the efforts of FHCW.
Weighted Gene Co-Expression Network Analysis Reveals a New Survival Model for Prognostic Prediction in Ewing Sarcoma
Authors: Li Debao , Wang Lei , Wang Guanghui , Yang Yaowen , Yang Weiyu , Wang Hurong , Ma Yingui , Zhang Jin , Tian Jianing , Jia She , Cong Yujie , Li Jing , Xia Liang
Published: May 2021

Background: Ewing sarcoma (ES) is a malignant bone or soft-tissue cancer that mainly arises in children and young adults. However, the prognosis of Ewing sarcoma remains very poor, and there is no effective prediction method. The aim of our study was to identify a prognostic model for ES patients based on prognosis-associated mRNA expression profiles. Methods: The GSE17679 dataset was downloaded from the Gene Expression Omnibus (GEO) database. Differently expressed genes (DEGs) between ES and normal control were identified using R package “limma”. A weighted gene co-expression network analysis (WGCNA) was used to screen gene modules associated with recurrence/metastasis and survival status based on DEGs. Results: The prognostic model was constructed based on genes in MEbrown module, which was most associated with recurrence/metastasis and survival status, using Kaplan-Meier survival and lasso regression analysis. Sixteen genes were screened to construct the prognostic model. ES patients were grouped into high- and low-risk groups based on the median of risk score calculated for each of them. ES patients in high-risk group have worse survival than patients in low-risk group. The AUCs (Area under the ROC curve) for 1-year, 3-year, and 6-year overall survival were 0.903, 0.995, 0.953. Conclusions: Taken together, our research constructed a prognostic model which has excellent prediction performance for overall survival of ES patients.
Severe Neuroinflammatory Relapse After Extrauterine Pregnancy and Abortion: A Case Report on a Patient With Heterogenic Ms Phenotype Carrying Myelin Oligodendrocyte Glycoprotein Autoantibodies
Authors: Kulmala Katja , Vaitiniemi Roosa , Blad Helene , Karrenbauer Virginija Danylaite
Published: May 2021

Background. Pregnancy has disease-modifying effects in MS. First trimester abortion might be followed by increased MS activity. MS with myelin oligodendrocyte glycoprotein (MOG) autoantibodies is a rare and agressive disease variant. Objectives. This case illustrates severe inflammatory reactivation after surgical abortion in MS patient who carries MOG antibodies. Methods. Case-report. Patient provided written informed consent for information and images to be published. Results. MRI and CSF biomarkers indicated high inflammatory activity post-abortion. Conclusions. Pregnancy termination in combination with MOG antibody carriership and termination of dimethyl fumarate treatment just prior abortion have had contributed to extensive reactivation of MS.
Design and Psychometric Properties of a Questionnaire for Assessing Sexual and Reproductive Health Needs of Married Adolescent Women: An Exploratory Sequential Mixed Methods Study
Authors: Ghiasi Ashraf , Keramat Afsaneh , Zayeri Farid , Farjamfar Maryam , Vakilian Katayon , Bagheri Leila
Published: May 2021

BackgroundTo date, there is no valid and reliable instrument to specifically evaluate the married adolescent women's SRH needs. Hence, the aim of this study was to develop and evaluate the psychometric properties of a questionnaire for assessing Iranian married adolescent women's SRH needs. MethodsThe current exploratory sequential mixed method study was performed in two phases. In the first phase, a preliminary questionnaire was developed based on in-depth interviews with 34 married adolescent women and 4 key informants as well as a comprehensive literature review. In the second phase, validity of the questionnaire was assessed using face, content, and construct validity and reliability of the questionnaire was assessed using internal consistency and test-retest reliability.ResultsBased on qualitative content analysis and literature review, 137 items were extracted. After several modifications of the generated items, a 108-item questionnaire was prepared for the psychometric process. After checking face and content validity, 85 items remained in the study. In the exploratory factor analysis, eleven items were removed and the remaining 74 items were categorized into nine factors. The Cronbach's alpha coefficient and the Intraclass correlation coefficient were found to be 0.878 and 0.99 for whole scale, respectively.Conclusions The 74-item questionnaire has acceptable validity and reliability. Therefore, it can be used as an appropriate instrument for assessing married adolescent women's SRH needs.
Final Height in Pubertal Short Stature Boys Treated with GH Combination with Letrozole: A retrospective study
Authors: Ma Yaping , Jia Ruofan , Xia Bingyang , Tang Bin , Xu Zhuangjian
Published: May 2021

BackgroundThe growth potential of pubertal short stature boys is limited by the effect of estrogen on epiphyseal fusion. This study aims to identify the efficacy and safety of growth hormone (GH) combination with letrozole on final adult height (FAH) in pubertal short stature boys. MethodsThis is a retrospective study. Among pubertal short stature boys who treated with GH and letrozole were be followed up in our hospital, 20 cases reached FAH. ResultsBaseline chronological age were 12.12±1.14yr, bone age were 13.00±0.93yr. The treatment duration was 1.94±0.67yr. The height standard deviation score for bone age was increased from -1.46±0.51 to -0.12±0.57 (p<0.000). The predicted FAH before treatment, predicted FAH after treatment, FAH, and genetic target height were 161.02 ±4.12 cm, 172.11±4.20 cm, 172.67±2.72cm and 167.67±3.56 cm, respectively. There was significant differences between predicted FAH before treatment and after treatment (p<0.000), as well as predicted FAH before treatment and genetic target height (p<0.000).The predicted FAH after treatment was higher than that of genetic target height (p<0.001), as well as FAH and genetic target height (p<0.000). Conclusions﻿The GH combination with letrozole can enhance the FAH in pubertal short stature boys. No significant side effects were observed.
Liver Transplantation Is Highly Effective in Children With Irresectable Hepatoblastoma
Authors: Moosburner Simon , Schmelzle Moritz , Globke Brigitta , Schöning Wenzel , Eggert Angelika , Seika Philippa , Kästner Anika , Pratschke Johann , Öllinger Robert , Gül-Klein Safak
Published: May 2021

IntroductionIn children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. Aim of our study was to compare short- and long-term results after LR and LT for the curative treatment of hepatoblastoma. Materials and methodsRetrospective analysis of all patients treated surgically for hepatoblastoma from January 2000 till December 2019. Demographic and clinical data were collected before and after surgery. Primary endpoints were disease free survival and patient survival.ResultsIn total, 38 patients were included into our analysis (n=28 for LR, n=10 for LT) with a median follow up of 5 years. 36 patients received chemotherapy prior to surgery. Total hospital stay and intensive care unit (ICU) stay were significantly longer within the LT vs. the LR group (ICU 23 vs. 4 days, hospital stay 34 vs. 16 days, respectively; p < 0.001). Surgical complications (≤ Clavien-Dindo 3a) were equally distributed in both groups (60% vs. 57%; p =1.00). Severe complications (≥ Clavien-Dindo 3a) were more frequent after LT (50% vs. 21.4%; p = 0.11). Recurrence rates were 7% for LR and 0% for LT at 5 years after resection or transplantation (p=. Overall, 5-year survival was 90% for LT and 96% for LR (p = 0.44). ConclusionIn unresectable cases, liver transplantation reveals excellent outcomes in children with hepatoblastoma with an acceptable number of perioperative complications.
Breastfeeding-Friendly Policies And Programs In Selected Public Universities In Ghana
Authors: Gbagbo Fred Yao , Nkrumah Jacqueline
Published: May 2021

Background The United Nations through its Sustainable Development Goals 3 and 5 has championed Women empowerment for exclusive breastfeeding through various action plans and expected the concept to be decentralized through locally mandatory implementation of various institutional policies and programs in member Countries. Using Kabeer’s empowerment concept, the authors in this paper assessed the availability and implementation of breastfeeding policies and programs in selected public universities in Ghana. MethodsThe study design was an integration of descriptive, exploratory, and case study using an unstructured interview guide developed by the authors for qualitative data collection. Thematic analysis of data on breastfeeding experiences was done yielding three main categories (breastfeeding policy and programs, support, and views on breastfeeding) emerged during data analysis. The in-depth interviews of respondents lasted 60 minutes. The University of Cape-Coast Ethics Review Board gave ethical approval for the study. ResultsAlthough Ghana has ascribed to various international conventions on childcare and developed policies enshrined in its labour law to support breastfeeding, none of the universities in this study has a formal breastfeeding/childcare policy/program and there are no future policy plans for on-campus facilities to enhance breastfeeding. Financial cost emerged as a major challenge hindering the universities from implementing a policy/program in this regard, hence nursing mothers continue to make personal but challenging arrangements for breastfeeding on university campuses.Conclusions The finding that formal breastfeeding-friendly policy/program was unavailable in the various universities in Ghana reflects negative implications for childcare, hence achieving the Sustainable Development Goals 3 and 5 in Ghana. The authors recommend formal breastfeeding-friendly policies/programs as a criterion for accreditation of universities in Ghana to enhance childcare.
WITHDRAWN: Toxicity Investigation of Nano-SiO2 on Male Reproductive System in Pubertal Mice
Authors: Sun Fanli , Wang Xuying , Zhang Pinzheng , Chen Ziyun , Guo Zhiyi , Shang Xuan
Published: May 2021

BackgroundPuberty is a crucial stage to gain reproductive capacity, but it is also a period vulnerable to exogenous materials. While exposure to nanoparticles (NPs) has been linked to toxic responses in reproductive system in previous findings, little is known about the age-dependent effect of NPs, let alone the underlying mechanism. In the present study, we assessed male fertility parameters and explored its mechanism following intraperitoneal exposure to Nano-Silicon dioxide (Nano-SiO2) in mice during puberty.Methods40 mice aged 5 weeks were divided into 2 groups after 1 week acclimation and then exposed to 40mg/kg Nano-SiO2 dissolved in saline or vehicle controls by intraperitoneal injection every day over a period of 7-day, respectively. Changes in the structure and function of male reproductive organs were detected after exposure.ResultsNano-SiO2 exposed through intraperitoneal injection could cause damage to the testicular and epididymal histological architecture and reduce the level of sex hormone (testosterone), leading to a decrease in sperm quality and quantity. Furthermore, Nano-SiO2 could induce oxidative stress and inflammation in male reproductive tissues, indicated by reduced activity of antioxidants (superoxide dismutase, SOD) and increased level of the lipid peroxidation marker (malondialdehyde, MDA), which leads to the activation of cell apoptosis.Conclusion﻿Exposure to Nano-SiO2 in pubertal mice could cause toxicity on male reproductive system via inducing oxidative stress and activating TNF-α mediated apoptotic pathway.
Sex hormone dysregulations are associated with disease severity in critically ill male COVID-19 patients - a retrospective analysis
Authors: Schroeder Maria , Schaumburg Berfin , Mueller Zacharias , Parplys Ann , Jarczak Dominik , Roedl Kevin , Nierhaus Axel , de Heer Geraldine , Grensemann Joern , Schneider Bettina , Stoll Fabian , Bai Tian , Jacobsen Henning , Zickler Martin , Stanelle-Bertram Stephanie , Klaetschke Kristin , Renne Thomas , Meinhardt Andreas , Aberle Jens , Hiller Jens , Peine Sven , Kreienbrock Lothar , Klingel Karin , Kluge Stefan , Gabriel Guelsah
Published: May 2021

BACKGROUNDMale sex was repeatedly identified as a risk factor for death and intensive care admission. However, it is yet unclear whether sex hormones are associated with disease severity in COVID-19 patients. We sought to characterize sex differences in hormone levels and cytokine responses in critically ill COVID-19 patients.METHODSWe performed a retrospective cohort study of critically ill COVID-19 patients. Males and females were compared. Multivariate regression was performed to assess the association between sex hormones, cytokine responses and the requirement for extracorporeal membrane oxygenation (ECMO) treatment.RESULTSWe analyzed sex hormone levels (estradiol and testosterone) of n=181 male and female individuals. These consisted of n=50 critically ill COVID-19 patients (n=39 males, n=11 females), n=42 critically ill non-COVID-19 patients (n=27 males, n=15 females), n=39 non-COVID-19 patients with coronary heart diseases (CHD) (n=25 males, n=14 females) and n=50 healthy individuals (n=30 males, n=20 females). We detected highest estradiol levels in critically ill male COVID-19 patients compared to non-COVID-19 patients (p=0.0123), patients with CHD (p=0.0002) or healthy individuals (p=0.0007). Lowest testosterone levels were detected in critically ill male COVID-19 patients compared to non-COVID-19 patients (p=0.0094), patients with CHD (p=0.0068) or healthy individuals (p<0.0001). No statistically significant differences in sex hormone levels were detected in critically ill female COVID-19 patients, albeit similar trends in estradiol levels were observed. In critically ill male COVID-19 patients, cytokine and chemokine responses (IFN-γ, p=0.0301; IL-1RA, p=0.0160; IL-6, p=0.0145; MCP-1, p=0.0052; MIP-1α, p=0.0134) were significantly elevated in those with higher Sequential Organ Failure Assessment (SOFA) scores (8-11). Linear regression analysis revealed that herein IFN-γ levels correlate with estradiol levels in male and female COVID-19 patients (R2=0.216, =0.0009). Male COVID-19 patients with elevated estradiol levels were more likely to receive ECMO treatment in the course of their ICU stay (p=0.0009). CONCLUSIONS We identified high estradiol and low testosterone levels as a hallmark of critically ill male COVID-19 patients. Elevated estradiol levels in critically ill male COVID-19 patients were positively associated with IFN-γ levels and increased risk for ECMO requirement.