bluuebunny/crossref_metadata_2025 huggingface dataset:
Case management after acquired brain injury compared to care as usual: study protocol for a two-year pragmatic randomized controlled trial
Authors: Stiekema Annemarie , Resch Christine , Donkervoort Mireille , Jansen Natska , Jurrius Kitty HM , Zadoks Judith M , Heugten Caroline M van
Published: July 2020

Background: People with acquired brain injury may suffer from cognitive, emotional and behavioural changes in the long term. Continuity of care is often lacking, leading to a variety of unmet needs and hindering psychosocial functioning from the occurrence of brain injury up to years thereafter. Case management aims to prevent (escalation of) problems and to facilitate timely access to appropriate services. In other populations, case management has shown to improve psychosocial well-being. In this study, we aim to evaluate the feasibility of case management after acquired brain injury and its effectiveness and cost-effectiveness, compared to care as usual.Methods: This is a pragmatic randomized controlled study with repeated measures in adults with ABI and their family, taking place between November 2019 and December 2021 in three provinces in the Netherlands. Participants will be randomly allocated to either the case management group, receiving case management from hospital discharge up to two years thereafter, or the control group, receiving care as usual. Effectiveness will be evaluated every six months for 18-24 months by patient-reported psychosocial well-being (Hospital Anxiety and Depression Scale (HADS), Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) restriction subscale and the Life Satisfaction Questionnaire (LiSat)), self-management (Patient Activation Measure (PAM)) and care needs (Longer-term Unmet Needs after Stroke (LUNS)). Family outcomes include self-efficacy (Carer Self-Efficacy Scale (CSES)), caregiver burden (Caregiver Strain Index (CSI)), psychosocial well-being (LiSat, HADS), family needs (Family Needs Questionnaire (FNQ)). Feasibility will be evaluated using qualitative methods, assessing fidelity, dose delivered, dose received, reach, recruitment and context. Cost-effectiveness will be determined by the EQ-5D-3L and service use.Discussion: At the moment there is no integrated health care service for people with acquired brain injury and their family members in the long-term. If case management is shown to be feasible and (cost)-effective, it could bridge the gap between patients’ and families’ needs and the available services.Trial registration: Netherlands Trial Register, NL8104. Registered 22 October 2019, https://www.trialregister.nl/trial/8104.
Cervical Spine Osteoradionecrosis or Bone Metastasis after Radiotherapy for Nasopharyngeal Carcinoma? The MRI-Based Radiomics for Characterization
Authors: Zhong Xi , Li Li , Jiang Huali , Yin Jinxue , Lu Bingui , Han Wen , Li Jiansheng , Zhang Jian
Published: July 2020

Background: To develop and validate an MRI-based radiomics nomogram for differentiation of cervical spine ORN from metastasis after radiotherapy (RT) in nasopharyngeal carcinoma (NPC).Methods: A radiomics nomogram was developed in a training set that comprised 46 NPC patients after RT with 95 cervical spine lesions (ORN, n = 51; metastasis, n = 44), and data were gathered from January 2008 to December 2012. 279 radiomics features were extracted from the axial contrast-enhanced T1-weighted image (CE-T1WI). A radiomics signature was created by using the least absolute shrinkage and selection operator (LASSO) algorithm. A nomogram model was developed based on the radiomics scores. The performance of the nomogram was determined in terms of its discrimination, calibration, and clinical utility. An independent validation set contained 25 consecutive patients with 47 lesions (ORN, n = 25; metastasis, n = 22) from January 2013 to December 2015. Results: The radiomics signature that comprised eight selected features was significantly associated with the differentiation of cervical spine ORN and metastasis. The nomogram model demonstrated good calibration and discrimination in the training set [AUC, 0.725; 95% confidence interval (CI), 0.622–0.828] and the validation set (AUC, 0.720; 95% CI, 0.573–0.867). The decision curve analysis indicated that the radiomics nomogram was clinically useful.Conclusions: MRI-based radiomics nomogram shows potential value to differentiate cervical spine ORN from metastasis after RT in NPC.
Validation of the Italian version of the Revised Prenatal Coping Inventory (NuPCI) and its correlations with Pregnancy-Specific Stress.
Authors: Penengo Chiara , Colli Chiara , Garzitto Marco , Driul Lorenza , Cesco Maddalena , Balestrieri Matteo
Published: July 2020

Background: Pregnancy is a period of happiness but also of physical and psychological changes that can lead to distress. Functional coping strategies can reduce the pregnancy specific-stress. This study aimed to assess the psychometric properties of the Revised Prenatal Coping Inventory (NuPCI) in an Italian sample and to investigate how coping strategies were associated with pregnancy-specific stress.Methods: In this cross-sectional study, low-risk pregnant women (N=211) were assessed with NuPCI, NuPDQ (Revised-Prenatal Distress Questionnaire), Brief-COPE (Coping Orientation to the Problems Experienced), and STAI (State-Trait Anxiety Inventory). The reliability of NuPCI was evaluated by assessing its internal consistency and factor structure. The concurrent validity between NuPCI and Brief-COPE and NuPDQ and STAI was investigated. Lastly, the relationship between NuPCI and NuPDQ was analyzed, as well as the ability of these scales to predict Apgar score at birth.Results: Internal consistency of NuPCI scales was good for Planning-Preparation (ɑC=0.84) and Spiritual-Positive Coping (ɑC=0.81), acceptable for Avoidance (ɑC=0.76). The original three-factor structure was confirmed, using a promax solution. NuPCI and NuPDQ showed good concurrent validity. The NuPCI scales predicted NuPDQ score (Avoidance and Planning-Preparation positively, Spiritual-Positive Coping negatively). Also, Avoidance and Spiritual-Positive Coping scales were associated respectively to decreasing and to increasing Apgar score, with the moderation of NuPDQ.Conclusions: Italian NuPCI has sound psychometric properties and it is a useful coping measure. NuPDQ showed also a good validity. Our results may suggest a significant role for coping strategies, particularly in modulating the condition of the newborn at birth.
VALD-3, a Schiff base ligand synthesized from o-vanillin derivatives, induces cell cycle arrest and apoptosis in breast cancer cells by inhibiting the Wnt/β-catenin pathway
Authors: Li Hongling , Dang Chunyan , Tai Xiaohui , Xue Li , Meng Yuna , Ma Shuping , Zhang Jing
Published: July 2020

Background: Schiff base compounds and their metal complexes have become important synthetic organic drugs due to their extensive biological activities, which include anticancer, antibacterial and antiviral effects. In this study, we investigated the cytotoxic and apoptotic effects of VALD-3, a Schiff base ligand synthesized from o-vanillin derivatives, on human breast cancer cells and the possible underlying mechanisms.Methods: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)-test was used to observe the proliferation of human breast cancer MCF-7 and MDA-MB-231 cells induced on VALD-3. The effects of VALD-3 on the cell cycle were analyzed in MCF-7 and MDA-MB-231 cells by PI single staining. Hoechst 33258 staining was performed to determine if VALD-3 induced apoptosis of MCF-7 and MDA-MB-231 cells and Annexin V/PI staining was performed to quantify the percentages of apoptosis. The expression of pro-apoptotic proteins and anti-apoptotic proteins in MCF-7 and MDA-MB-231 cells was investigated by Western blotting. Wnt/β-catenin signaling pathways were also examined. The antitumor activity and survival analysis of VALD-3 in vivo was determined by the nude mice xenograft assay.Results: Flow cytometry analysis showed that VALD-3 triggered cell cycle arrest and induced apoptosis of breast cancer cells. Western blot analysis revealed that VALD-3 upregulated pro-apoptotic proteins (Bad and Bax), downregulated anti-apoptotic proteins (Bcl-2, Bcl-xl, survivin and XIAP) and increased the expression of cleaved caspase-3, cleaved caspase-8, Cyto-c and cleaved PARP. VALD-3 also regulated the Wnt/β-catenin signaling pathway in breast cancer cells, inhibiting the activation of downstream molecules. By xenografting human breast cancer cells into nude mice, we found that VALD-3 significantly suppressed tumor cell growth while showing low toxicity against major organs. In addition, survival analysis results showed that VALD-3 can significantly prolong the survival time of mice (P=0.036).Conclusion: This study is the first to show that VALD-3 induces apoptosis and cell cycle arrest in human breast cancer cells by suppressing Wnt/β-catenin signaling, indicating that it could be a potential drug for the treatment of breast cancer.
Prognostic value of a five-lncRNA signature in esophageal squamous cell carcinoma
Authors: Zhang Lan , Li Pan , Liu Enjie , Xing Chenju , Zhu Di , Zhang Jianying , Wang Weiwei , Jiang Guozhong
Published: July 2020

Background: The aim of this study was to identify prognostic long non-coding RNAs (lncRNAs) and develop a multi-lncRNA signature for suvival prediction in esophageal squamous cell carcinoma (ESCC). Methods: The clinical and gene expression data from Gene Expression Omnibus database (GSE53624, n=119) were obtianed as training set. A total of 98 paired ESCC tumor and normal tissues were detected by RNA sequencing and used as test set. Another 84 ESCC tissues were used for real-time quantitative PCR(qRT-PCR) and as an independent validation cohort. Survival analysis, Cox regression and Kaplan–Meier analysis were performed. Results: We screened a prognostic marker of ESCC from the GSE53624 dataset and named it as the five-lncRNA signature including AC007179.1, MORF4L2-AS1, RP11-488I20.9, RP13-30A9.2, RP4-735C1.6, which could classify patients into high- and low-risk groups with significantly different survival(median survival: 1.75 years vs. 4.01 years, log rank P<0.05). Then test dataset and validation dataset confirmed that the five-lncRNA signature can determine the prognosis of ESCC patients. Predictive independence of the prognostic marker was proved by multivariable Cox regression analyses in the three datasets (P<0.05). In addition, the signature was found to be better than TNM stage in terms of prognosis. Conclusion: The five-lncRNA signature could be a good prognostic biomarker for ESCC patients and has important clinical value.
A Surgeon's Handedness in Direct Anterior Approach-Hip Replacement
Authors: Kong Xiangpeng , Yang Minzhi , Ong Alvin , Guo Renwen , Chen Jiying , Wang Yan , Chai Wei
Published: July 2020

Background: The impact of handedness on clinical outcomes was easily overlooked in hip replacement. This study aimed to find whether the component positioning and hip function were affected by the handedness in total hip arthroplasty (THA) through direct anterior approach (DAA). Methods: Total 102 patients who underwent bilateral DAA-THAs simultaneously between May 2016 and November 2018 in our institute were reviewed. All surgeries were operated by one right-handed surgeon. Their demographic, cup positioning, stem alignment, femoral stem fit, Harris hip score (HHS), intraoperative and postoperative complications were used to evaluate the role of handedness in DAA.Results: The inclination of left cups was significantly larger than that of right cups (42.61±7.32 vs 39.42±7.19, p=0.000). The stem fit of left femur was significantly larger than that of right femur (84.34±4.83 vs 82.81±6.07, p=0.043). No significant differences in safe zone ratio, HHS and complications between bilateral hips were found. Conclusions: A surgeon’s handedness had significant impact on cup’s inclination and femoral stem fit in DAA-THA. However, there were no significant differences of cup malpositioning, stem alignment, hip function scores and complications between bilateral DAA-THAs.
Effects of canola or olive oil on plasma lipids, lipoprotein-associated phospholipase A2 and inflammatory cytokines in patients referred to coronary angiography
Authors: Khandouzi Nafiseh , Zahedmehr Ali , Nasrollahzadeh Javad
Published: July 2020

Background: The potential cardioprotective benefits of olive oil (OO) and canola oil (CO) consumption have been shown in some studies. The present study was conducted to compare the effects of CO and OO on plasma lipids, some inflammatory cytokines, and lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity in patients undergoing coronary angiography. Methods: A randomized, controlled, parallel-arm, clinical trial involving 48 patients (44 men and 4 women, aged 57.63 ± 6.34 years) with at least one classic cardiovascular risk factor (hypertension, dyslipidemia, or diabetes) who referred to coronary angiography was performed. Patients were randomly divided into two groups and received 25 mL/day refined olive oil (n=24) or canola oil (n=24) for 6 weeks. Plasma lipids, some selected inflammatory markers, and Lp-PLA2 levels were measured at the baseline and after the intervention. Results: CO consumption produced a significant reduction in plasma Lp-PLA2 mass (-0.97 ± 1.84 vs. 0.34 ± 1.57 ng/mL, P = 0.008 for CO and OO, respectively), whereas the mean changes of Interleukine-6 concentration were significantly lower after OO consumption compared with CO (-9.46 ± 9.46 vs. -0.90 ± 6.80 pg/mL, P = 0.008 for OO and CO, respectively). After 6 weeks of intervention, no significant changes were observed in plasma Lp-PLA2 activity, complement C3, C4, and lipid profile in two intervention groups. Conclusions: Comparing the two vegetable oils in subjects with cardiovascular risk factors shows that consumption of olive oil is more effective in reducing the level of inflammatory cytokine Interleukine-6 whereas canola oil is more effective in lowering the level of Lp-PLA2, but, this finding should be interpreted with caution since the Lp-PLA2 activity did not change significantly.
Study on the derived based catalysts from Theobroma cacao pod husks for the conversion of beef tallow blend with waste used vegetable oil for fatty acid ethyl ester synthesis: burnt, submerged fermented, calcination, hybrid design, catalyst refining and reusability
Authors: FOLORUNSHO Adepoju TUNDE , Mayen Ibeh A , O Babatunde E , Jackson Asuquo A , C Eloboka
Published: July 2020

Billions of dollars paid by industries on catalysts used as feedstocks to obtain their end products are increasing at a geometrical rate, the report revealed that the global marketplace price of catalysts stood at USD 26.1 billion in 2019, and is anticipated to increase by 4% in 2020, and 4.5% progress rate in 2025. To salvage the world from extravagance spending, there is an urgent need for biomass wastes consideration and utilization. In this paper, three novel CaO-based catalysts derived from Theobroma cacao pod husks were tested based on efficacy for the production of biodiesel (fatty acid ethyl ester: FAEE) from the blend of beef tallow-waste use oil in the ratio of 5:95 (BTO5),10:90 (BTO10),15:85 (BTO15), 20:80 (BTO20),….., 95:5 (BTO95), respectively. Process optimization of the transesterification reaction was carried out using a hybrid design to determine the effects of catalyst on the FAEE yield. The efficiencies of the catalyst were tested via the refining and reusability test. Results revealed the oil blend ratio of BTO60: WUO40 sufficiently produced low viscous oil that was easily converted to biodiesel. Catalysts' characterization revealed the three catalysts produced high CaO-based of 68.20, 81.46, and 87.65 (wt.%), which accounted for the high yield of FAEEs. Mathematical optimization showed that the catalyst amount (F-value between 14159.69-3063.24 with P-value between 0.0053-0.0115), played the most significant role in oil conversion to biodiesel among the constraint factors considered (reaction time, catalyst amount, reaction temperature, and EtOH/OMR). Based on Box-Cox transformation, the values of the lambda obtained indicated a normal data results with an inverse function of Y2 and Y3 and normal function of Y3 for polynomial model accuracy. Optimum validated FAEEs yields of 92.81, 93.02, and 99.64 (%wt.), respectively, with high R2. The qualities of the FAEEs were within the standard specification and the produced catalysts can serve as feedstocks for industrial application.
Influence of Indications on Perinatal Outcomes After Radio Frequency Ablation in Complicated Monochorionic Pregnancies: A Retrospective Cohort Study
Authors: Wang Hongmei , Zhou Qian , Wang Xietong , Song Jia , Chen Pengzheng , Wang Yanyun , Li Lei , Li Hongyan
Published: July 2020

Background:Radiofrequency ablation (RFA) is recommended to prevent potential neurological injury or intrauterine foetal death (IUFD) of the co-twin(s) in complicated monochorionic (MC) pregnancies. However, the impacts of various indications on the pregnancy outcome following RFA remain undefined clearly. This study aimed to determine how the indications influence the perinatal outcomes in complicated MC pregnancies undergoing radiofrequency ablation.Methods:This was a retrospective cohort study performed in a single centre. All consecutive women treated with RFA between July 2011 and July 2019 were included. The adverse perinatal outcomes and the survival rate were analysed based on various indications. The continuous variables with and without normal distribution were compared between the groups using Student’s t-test and Mann–Whitney U test, respectively, and for categorical variables, Chi-square and Fisher’s exact tests were used. P < 0.05 indicated a significant difference.Results:We performed 272 RFA procedures in 268 complicated MC pregnancies, including 60 selective intrauterine growth restriction (sIUGR), 64 twin–twin transfusion syndrome (TTTS), 12 twin reversed arterial perfusion sequence (TRAPs), 66 foetal anomaly and 66 elective foetal reduction (EFR) cases. The overall survival rate of the co-twin was 201/272 (73.9%). The overall technical successful rate was determined at 201/263 (76.7%). The intrauterine foetal death (IUFD) rate in the co-twin was 20/272 (7.4%). The TTTS group had recorded the lowest survival rate (37/64, 57. 8%), and the survival rate significantly correlated with Quintero stages (P = 0.029). Moreover, the sIUGR III subgroup had a lower survival rate compared with sIUGR II (55.6%, versus 84.3%). The subgroup of foetal anomaly of gastroschisis or exomphalos had the highest IUFD rate (4/10, 40%), followed by sIUGR III (2/9, 22.2%) and dichorionic triamniotic (DCTA) subgroup (8/46, 17.9%). In EFR group, eight IUFD cases were all coming from the DCTA subgroup and received RFA before 17 weeks.Conclusions:The perinatal outcome of RFA was correlated with the indications, with the lowest survival rate in TTTS IV and the highest IUFD incidence in abdominal wall defect followed by sIUGR III. Elective RFA after 17 weeks may prevent IUFD in DCTA pregnancies.
Intracranial compliance concepts and assessment: A scoping review protocol
Authors: Russo Thiago , Ocamoto Gabriela , Zambetta Rafaella , Vilela Gustavo , Hayashi Cintya , Brasil Sérgio , Rabelo Nícollas , Spavieri Deusdedit
Published: July 2020

Background: Monitoring patients with acute brain injury is crucial in neurocritical care. Intracranial compliance (ICC) has been studied to complement the interpretation of intracranial pressure (ICP) and help the neurocritical care team to anticipate brain function deterioration. ICC has been found to be related to compensatory mechanisms that maintain the stability of ICP (e.g., the higher the compensation, the higher the compliance of intracranial content to adapt to changes in volume and pressure). However, ICC has not been properly translated to clinical practice and has remained a critical technology gap in clinical neuroscience. The objective of this study is to establish a protocol for a scoping review to map the key concepts of ICC in the literature. In addition, this study is designed to characterize the relationship between ICC and ICP, as well as systematically describe the outcomes that are used to assess ICC, considering both the invasive and noninvasive methods.Methods: The scoping review protocol will be conducted according to the Joanna Briggs Institute’s recommendation. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews will be followed. Animals and humans are considered as the population to be investigated. No age criteria or health condition will be considered. ICC, as well as the relationship between ICC and ICP, will be considered as a core concept in this review. Information will be screened based on the context of neurocritical care. Several databases (PubMed, CINAHL, Web of Science, EMBASE, Epistemonikos, Grey Literature Report, clinical trial registries, and Cochrane Clinical Trials) will be searched to identify literature using a combination of keywords and descriptors, and there will be no restriction on the time frame. Data will be extracted systematically by the research team and the results will be summarized.Discussion: No systematic review has mapped the concepts of ICC and its relationship with ICP. Providing the key concepts of ICC and the methods of assessment might show its possible applications in clinical practice and the gaps in research.Systematic review registration: Currently, scoping review protocols are not eligible for registration in the International Prospective Register of Systematic Review database.
High Place Phenomenon: Prevalence and Clinical Correlates in Two German Samples
Authors: Teismann Tobias , Brailovskaia Julia , Schaumburg Svenja , Wannemüller André
Published: July 2020

Background: The high place phenomenon, that is, a sudden urge to jump when in a high place, is an experience known to many people, that has rarely been studied. The present study aimed to assess the prevalence of the high place phenomenon in a non-clinical and a clinical German sample. Furthermore, clinical correlates of the experience were assessed. Methods: The study sample comprised 276 participants (67% female; Mage=32.08, SDage=10.73) who took part in an online assessment and 94 patients (73.4% female; Mage=49.26, SDage=13.32) suffering from clinically relevant fear of flying. Participants filled out questionnaires on experiences with the high place phenomenon, depression, anxiety, suicide ideation and anxiety sensitivity.Results: The high place phenomenon was known to nearly 60% of the online sample and to 45% of the patient sample. Suicide ideation as well as anxiety sensitivity were positively associated with experiences with the high place phenomenon in the online sample. Depression, anxiety and suicide ideation were unrelated to experiences with the phenomenon in the patient sample. Conclusion: The high place phenomenon is commonly reported by (lifetime/current) suicide ideators. However, it is also a common experience in individuals who have never suffered from suicide ideation. It is therefore cautioned not to interpret such experiences as an expression of a hidden death wish.
Dexmedetomidine Versus Midazolam on Cough and Recovery Quality After Partial and Total Laryngectomy – a Randomized Controlled Trial
Authors: Xu Rui , Zhu Yun , Lu Yi , Li Wen Xian , Jia Jie
Published: July 2020

Backgroundː During emergence from anesthesia after partial and total laryngectomy, excessive airway reflex and systemic hypertension may lead to pneumoderm, hemorrhage or pneumothorax. Methodsː ASA Ⅲ-Ⅳ male adults undergoing elective laryngectomy were recruited and randomly allocated to receive either dexmedetomidine or midazolam. The primary outcome was incidence and severity of cough. Pulse oximetry (SpO2 ), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Visual Analogue Scale (VAS) and Ramsay sedation scale (RSS) were recorded at the point of awareness and departure from PACU. Rescue analgesia required consumption, time of spontaneous breath recovery, duration of the PACU stay, incidence of adverse effects were also recorded.Resultsː The prevalence of no coughing was significantly higher in group D than group M while the patients were at the point of awake and departure. Compared with group M, there was significant decrease in HR, SBP and DBP in group D than group M, and SpO2 was statistically significantly higher in group D than group M at the moment of laryngectomy. Pain scores were lower in group D than group M. The Ramsay score at awake in PACU was higher in group D than group M. There was no difference in time to spontaneous breathing recovery, duration of the PACU stayand incidence of adverse effects.Conclusionsː Compared with midazolam, dexmedetomidine is an effective alternative to attenuate coughing and hemodynamic changes with low incidence of adverse events during emergence for partial and total laryngectomy.Trial registration: NCT03918889, registered at clinicaltrials.gov, date of registration: March 28, 2019. Https://register.clinicaltrials.gov/prs/app/action/DownloadReceipt?uid=U0003V5T&ts=3&sid=S0008S19&cx=haixch
Triboelectric Touch Sensor for Position Mapping During Total Hip Arthroplasty
Authors: Jeong Jae Bum , Kim Hyeok , Yoo Jun-Il
Published: July 2020

Objective: In this research, a triboelectric nanogenerator (TENG) was utilized to determine if a pressure-based sensor could detect bearing friction in a total hip arthroplasty (THA) and detect the contact of specific areas during ROM checks. Results: The pressure-based sensor shows capability to sense bearing friction. In more detail, the TENG embedded in four different sides of the trial exhibits up to 1 V from peak-to-peak. Moreover, these flexible touch sensors with TENG describes a peak signal in output voltage which should lead to extremely sensitive detection of bearing friction induced by the THA.
Association of Gestational Diabetes Mellitus with Offspring Weight Status Across Infancy: A Prospective Birth Cohort Study in China
Authors: Hu Jiajin , Liu Yilin , Wei Xiaotong , Li Lin , Gao Ming , Liu Yang , Ma Yanan , Wen Deliang
Published: July 2020

Background: The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations.Methods: This prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length (WFLZ), weight-for-age (WFAZ), and length-for-age (LFAZ) z-scores at birth, 1, 3, 6, 8, and 12 months of age.Results: Offspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13–0.40)] across infancy than those of mothers without GDM. The association was more pronounced in normal-weight and overweight/obese women (P for interaction< 0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.32 SD units (95% CI: 0.07– 0.57)], remained significant at 1 [β: 0.24 SD units (95% CI: 0.05–0.43)] and 3 [β:0.20 SD units (95% CI: 0.01–0.39)] months of age and decreased across infancy. Maternal GDM status were not associated with infant WFAZ or LFAZ.Conclusions: Maternal GDM status were associated with infant weight status, the association was more pronounced in normal-weight and overweight/obese women. The study results may contribute to the development interventions to prevent childhood obesity and to better define the target population.
Association Between Haematological Parameters and Sickle Cell Genotypes in Children With Plasmodium Falciparum Malaria Residents in Kisumu County in Western Kenya
Authors: Kosiyo Paul , Otieno Walter , Gitaka Jesse , Munde Elly O. , Ouma Collins
Published: July 2020

Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters. Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012]. Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.
High-grade Endometrial Stromal Sarcoma With BCOR Gene Alterations is Recommended as an Independent Subtype of Endometrial Carcinoma: A Case Report
Authors: LING Feng , Ruan Sibei , Li Na , Xiong XiaoMing , Zhao DongMei , Zhang Cuiwei
Published: July 2020

Background:The uterine leiomyosarcoma combined high-grade endometrial stromal sarcoma (HGESS) with BCOR gene alterations is exceedingly rare. The subtype of YWHAE-FAM22 HGESS is shown in the current World Health Organization classification, but not HGESS with BCOR alterations. Case presentation: We reported such a case in which HGESS with BCOR gene alterations and leiomyosarcoma coexist in a patient. And, most impressively, HGESS with BCOR gene alterations caused ovarian and pelvic metastases, although its volume was less than 1% of leiomyosarcoma.Conclusions: Given the more aggressive of HGESS with BCOR gene alterations, we suggest that it is classified as an independent subtype of HGESS, and when it coexists with other types of tumors, the HGESS with BCOR gene alterations needs to be noted in the pathological report even if it accounts for less than 1% of the tumour mass.
Genome sequence analysis of Bacillus subtilis PTA-271 isolated from a Vitis vinifera (cv. Chardonnay) rhizospheric soil: an highlight on some of its biocontrol traits
Authors: LEAL Catarina , Fontaine Florence , Aziz Aziz , Egas Conceiçao , Clement Christophe , Trotel-Aziz Patricia
Published: July 2020

Background: Bacillus subtilis strains have been widely studied for their innumerous benefits in agriculture, including viticulture. Providing numerous assets, B. subtilis spp. are widely described as promising grapevine-protectors against a broad spectrum of pathogens, ranging from biotroph to necrotroph. B. subtilis spp. may both elicit host defenses and promote host vigor, but may also directly antagonize pathogens and detoxify their aggressive molecules. This study reports the draft genome sequence of the Bacillus subtilis PTA-271, isolated from the rhizospheric soil of healthy Vitis vinifera cv. Chardonnay at Champagne Region in France, attempting to draw outlines of its full biocontrol capacity. Results: The PTA-271 genome has a size of 4,001,755 bp, with 43.78% of G + C content and 3,945 protein coding genes. The draft genome of PTA-271 highlights (1) a functional swarming motility system hypothesizing a colonizing capacity and a strong interacting capacity, (2) strong survival capacities and (3) a set of genes encoding for bioactive substances. Bioactive compounds are known both (i) to stimulate plant growth or defenses such as hormones and elicitors, and (ii) to counteract pathogen aggressiveness such as effectors and many kinds of detoxifying enzymes.Conclusions: The plurality of the encoded biomolecules by Bacillus subtilis PTA-271 genome appears as strengths for PTA-271 biocontrol potential towards plants, offering a big potential against a broad spectrum of pathogens, especially those responsible for the complex grapevine trunk diseases.
Risk Factors and Comorbidities Associated With Magnesium Deficiency in Pregnant Women and Women With Hormone-related Conditions: Analysis of a Large Real-world Dataset
Authors: Orlova Svetlana , Dikke Galina , Pickering Gisele , Yaltseva Natalya , Konchits Sofya , Starostin Kirill , Bevz Alina
Published: July 2020

Purpose
An accumulating body of literature indicates that magnesium deficiency is associated with a number of hormone-related conditions (HRC) in women, and epidemiological studies are needed to assess its prevalence and risk factors. Here, we present a secondary analysis of data pooled from four large observational studies that assessed magnesium deficiency among pregnant women and women with HRC across the Russian Federation.
Methods
The main objective of this analysis was to estimate the prevalence of magnesium deficiency in this population and to describe risk factors and comorbidities associated with low serum magnesium. Univariate logistic regression analysis was performed to identify the risk factors and comorbid conditions associated with an increased risk of low serum magnesium level.
Results
A total of 983 pregnant women and 9444 women with HRC were eligible for analysis. Prevalence of hypomagnesemia (magnesium serum level cut-off < 0.66 mmol/L/<0.8 mmol/L) was 34.0%/78.9% in pregnant women and 21.4%/54.8% in women with HRC. The highest prevalence of magnesium deficiency was observed for osteoporosis and climacteric syndrome. Risk factors included diastolic blood pressure, previous pregnancy complications, infections and edema for pregnant women, and age, body mass index, and various comorbidities for women with HRC.
Conclusions
These results confirm the importance of magnesium in various aspects of women’s health and support the use of magnesium supplementation in populations at risk.
QiShenYiQi Pill Improves Myocardial Hypertrophy Caused by Pressure Overload in Rats
Authors: Lv Shichao , Wang Qiang , Wu Meifang , Li Meng , Wang Xiaojing , Xu Ling , Zhang Junping
Published: July 2020

Background: QiShenYiQi pill (QSYQ), a traditional Chinese medicine, is widely used in the treatment of cardiovascular diseases, but its specific mechanism of action is still unclear. In the current study, we investigated the effect of QSYQ on myocardial hypertrophy in rats by partial abdominal aortic coarctation, and explored its mechanism of action.Methods: Wistar rats underwent the partial abdominal aortic coarctation were randomized into three groups: model, valsartan and QSYQ groups. And we treated rats which were sham operation as control group. Rats were euthanized at 4 and 8 weeks, and we weighed rat body mass, heart mass, and left ventricular mass. Myocardium sections were stained with hematoxylin and eosin (H&E) and Masson trichrome. Myocardial TGF- beta 1 and CTGF protein expression was detected by immunohistochemistry, and myocardial TGF-b1 and CTGF mRNA expression was detected by real-time qPCR. Results: QSYQ reduced HMI, LVMI and CVF, improved the changes of myocardial pathology, and reduced the degree of myocardial hypertrophy. After 4 weeks, QSYQ inhibited the mRNA and protein expression of TGF- beta 1 and CTGF. In addition, after 8 weeks, QSYQ reduced the positive area of TGF- beta 1 protein, and its effect is better than that of valsartan. Conclusions: QSYQ can effectively improve the degree of myocardial hypertrophy in the pressure overload rats, which is related to the mechanism of regulation of TGF- beta 1 and CTGF.
Characteristics and Mortality of Older Adults Presenting to the Emergency Department With Generalized Weakness
Authors: Borodin Oksana , Cialic Ron , Halperin Pinchas , Lerman Yaffa
Published: July 2020

Background

Worldwide aging of the population leads to an increased number of older, more complicated patients attending emergency departments (ED). Presenting symptoms of various conditions can be vague in this population, leading to delayed and potentially missed diagnoses. In the current study, we sought to characterize the demographics, final diagnoses, and outcomes of older patients who are referred to the ED for generalized weakness.
METHODS

We conducted a retrospective observational study in an urban tertiary hospital ED. Participants were patients aged 65 years or older who were referred to a geriatric evaluation in the ED. A total of 2,226 patients met study eligibility criteria and were enrolled between April 1, 2010 and March 31, 2013. Data on physical characteristics, discharge diagnoses, and vital status were obtained from an electronic medical database and the Ministry of the Interior.
RESULTS

There was no significant difference between the “weakness” and “non-weakness” groups for patients who were discharged from the ED. For admitted patients, statistically significant differences (although of no clinical significance) were noted for white blood cells (WBC) and sodium levels. Both statistically and clinically significant differences were observed for functional level. The main discharge diagnosis for admitted patients was an infection (24%), followed by "nonspecific diagnoses" (22%). Social issues as the main diagnosis were attributed to < 1% of the patients. Patients who were hospitalized for weakness were less likely to survive during the following year compared with patients hospitalized for non-weakness, but that was not the case for patients who were not admitted.
CONCLUSIONS

Patients admitted due to weakness were significantly more dependent on others for carrying out their daily activities. They were also more likely to die during and following hospitalization. Most of them were diagnosed during the hospitalization as having a specific medical condition.
PHISDetector: a tool to detect diverse in silico phage-host interaction signals for virome studies
Authors: Zhou Fengxia , Gan Rui , Zhang Fan , Ren Chunyan , Yu Ling , Si Yu , Huang Zhiwei
Published: July 2020

Background: Phage-host interaction is one of the essential questions in microbial environments. These interactions not only are appealing systems to study coevolution but also have been increasingly emphasized due to their roles in human health, diseases, and novel therapeutic development. Meanwhile, molecular and ecological co-evolutionary processes of phages and microbe leave signals in their genomic sequences, defined as phage-host interaction signals (PHISs) in this study, which allow us to predict microbe-phage interactions in silico . Results: We developed PHISDetector, which utilizes sophisticated bioinformatics methods to detect comprehensive in silico PHISs, including sequence composition, CRISPR targeting, prophage, and protein-protein interaction signals, further systematically integrates various categories of PHISs, and carries out machine-learning modeling to predict phage-host interactions. PHISDetector captures phage-host associations in a data-driven manner and reflects various phage-microbe interaction patterns or mechanisms so that users can easily compare the results from different approaches to better understand phage-microbe coevolution. We present it as a software pipeline for phage-host interaction identification, annotation and analysis in a comprehensive and user-friendly manner. PHISDetector can be run either as a web-server (http://www.microbiome-bigdata.com/PHISDetector/) or as a stand-alone version especially designed for virome studies.Conclusions: PHISDetector is a unique tool capable of incorporating all five categories of PHISs for comprehensive prediction of global phage-host interactions. PHISDetector outperforms currently available tools which are limited by accuracy, effective detection range, types of interacting signals, and the capability to apply for high-throughput virome studies.
Radiomics analysis of magnetic resonance imaging helps to identify preclinical Alzheimer’s disease: an exploratory study
Authors: Li Tao-Ran , Wu Yue , Jiang Juan-Juan , Jiang Jie-Hui , Han Ying
Published: July 2020

Background: Diagnosing Alzheimer’s disease (AD) in the preclinical stage offers opportunities to early intervention, however, there is a lack of convenient biomarkers currently. By using the methods of radiomics analysis, we aimed to determine whether the features extracted from multi-parameter magnetic resonance imaging (MRI) can be used as potential biomarkers. Methods: This study is part of the SILCODE project (NCT03370744). All participants were cognitively healthy at baseline. The cohort 1 (n=183) was divided into individuals with preclinical AD (n=78) and controls (n=105) by amyloid-positron emission tomography, used as the training dataset (80%) and validation dataset (the rest 20%); cohort 2 (n=51) was divided into “converters” and “non-converters” by individuals’ future cognitive status, used as a separate test dataset; cohort 3 included 37 “converters” (13 from ADNI), was used as another test set for independent longitudinal researches. We extracted radiomics features from multi-parameter MRI of each participant, used t-tests, autocorrelation tests, and three independent selection algorithms, respectively, to select features. Then we established two classification models (support vector machine (SVM) and random forest (RF)) to verify the efficiency of retained features. Five-fold cross-validation and 100 repetitions were carried out for the above process. Furthermore, the acquired stable high-frequency features were tested in cohort 3 by paired two-sample t-tests and survival analyses, in order to identify whether their levels change with cognitive decline and impact conversion time. Results: The SVM and RF models both showed excellent classification efficiency, with the average accuracy of 89.65%-95.90% and 87.07%-90.81% respectively in the validation set, 81.86%-89.10% and 83.19%-83.68% respectively in the test set. Three stable high-frequency features were identified, namely Large zone high-gray-level emphasis feature of right posterior cingulate gyrus, Variance feature of left superior parietal gyrus and Coarseness feature of left posterior cingulate gyrus, all based on structural MRI modality; their levels were correlated with amyloid-β deposition, played good roles in predicting future cognitive decline (AUCs 64.9%-76.1%). In addition, levels of the Variance feature at baseline timepoint decreased with cognitive decline, and can affect the conversion time (p<0.05). Conclusion: In this exploratory study, we show radiomics features of multi-parameter MRI can be potential biomarkers of preclinical AD.
Modelling the SARS-CoVid-2 outbreak in Italy: development of a robust statistical index to track disease dynamics.
Authors: Bizzarri Mariano , Traglia Mario Di , Giuliani Alessandro , Vestri Annarita , Fedeli Valeria , Prestininzi Alberto
Published: July 2020

COVID-19 pandemic in Italy had a spatial distribution that made the tracking of its time course quite difficult. The most relevant anomaly was the marked spatial heterogeneity of pandemics. Lombardia region accounted for around 60% of fatal cases (while hosting 15% of Italian population); moreover, 86% of fatalities concentrated in four Northern Italy regions. The ‘explosive’ outbreak of COVID-19 in Lombardia at the very beginning of pandemic fatally biased the R-like statistics routinely used to control the disease dynamics. To (at least partially) overcome this bias, we propose a new index RI= dH/dI (daily derivative ratio of H and I, given H=Healed and I=Infected), corresponding to the ratio between healed and infected patients relative daily changes. The proposed index is less affected than R by the uncertainty related to the estimated number of infected persons and allows to follow (and possibly forecast) epidemic dynamics in a largely model-independent way. To analyze the dynamics of the epidemic, starting from the beginning of the virus spreading - when data are insufficient to make an estimate by adopting a SIR model - a "sigmoidal family" model was introduced. That approach allowed in estimating the epidemic peak using the few data gathered even before mid-March. Based on this analysis, the peak had been expected to occur by end of April. Later on, real data of the epidemic evolution have demonstrated to fit with the predicted values.The methodology of analysis of the dynamics of the epidemic we are proposing herein aims to forecast the time and intensity of the epidemic peak (forward prediction), while allowing identifying the (more likely) beginning of the epidemic (backward prediction). Finally, we established a relationship between hospitalization in intensive care units (ICU) versus deaths daily rates by avoiding the necessity to rely on precise estimates of the infected fraction of the population (the most difficult, uncertain and expensive data that can confidently be acquired, especially in presence of an elevated number of asymptomatic patients). The joint evolution of the above parameters over time allows for a trustworthy and unbiased estimation of the dynamics of the epidemics.
Multiple Arterial Conduits for Multi-Vessel Coronary Artery Bypass Graft in Patients with Mild to Moderate Left Ventricular Systolic Dysfunction: A Multicenter Retrospective Study
Authors: Zhang Hang , Chen Wen , Zhao Yang , Guan Lichun , Yu Min , Wang Rui , Chen Xin
Published: July 2020

Background: Advantages of multiple arterial conduits for coronary artery bypass graft (CABG) have been reported previously. We aimed to evaluate the mid-term outcomes of multiple arterial CABG (MABG) among patients with mild to moderate left ventricular systolic dysfunction (LVSD).Methods: This multicenter study using propensity score matching (PSM) took place from January 2013 to June 2019 in Jiangsu Province and Shanghai, China, with a mean and maximum follow-up of 3.3 and 6.8 years, respectively. We included patients with LVSD, underwent primary, isolated multi-vessel CABG with left internal thoracic artery (LITA). The in-hospital and mid-term outcomes of MABG versus traditional LITA supplemented by saphenous vein grafts [single arterial CABG (SABG)] were compared. The primary endpoints were death from all causes and death from cardiovascular causes. The secondary endpoints were stroke, myocardial infarction (MI) and repeat revascularization, and a composite of all mentioned outcomes, including death from all causes [major adverse events (MAEs)]. Sternal wound infection was included with 6 months of follow-up after surgery.Results: 243 and 676 patients were formed in the MABG and SABG after PSM in a 1:3 ratio. Compared with SABG, MABG was associated with lower rate of MAEs (HR, 0.64; 95% CI, 0.44-0.94; P=0.02), MI (HR, 0.39; 95% CI, 0.16-0.99; P=0.05) and repeat revascularization (HR, 0.42; 95% CI, 0.18-0.97; P=0.03). There was no difference in the rate of death, stroke, and sternal wound infection.Conclusions: In patients with mild to moderate LVSD, MABG was associated with reduced mid-term rate of MAEs and cardiovascular events, but without reduced rate of death and stroke. MABG did not increase sternal wound infection rate.